EMT Chapter 26 bleeding PreWork

A fractured femur can result in the loss of ______ or more of blood into the soft tissues of the thigh.

1 L

What is the approximate blood volume of an 80-kg adult male?

5.60 L

Which of the following statements regarding the clotting of blood is correct?

A person taking blood thinners will experience slower blood clotting

Which of the following conditions might an EMT suspect as a possible cause for bleeding from the nose and mouth?

A skull fracture High blood pressure A sinus infection

A patient is bleeding severely from a severed femoral artery high in the groin region. Which of the following would most likely control the bleeding? A. Apply a topical hemostatic agent with direct pressure. B. Apply a pelvic binder device to stabilize the pelvis. C. Position the patient with his injured side down. D. Apply chemical ice packs to the wound and transport.

A. apply a topical hemostatic agent with direct pressure

A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should first: A. apply direct pressure to the wound. B. cover the patient with a blanket. C. provide high-flow oxygen. D. obtain baseline vital signs.

A. apply direct pressure to the wound

All of the following should be addressed during the primary assessment except: A. capillary bleeding. B. slow, shallow breathing. C. severe hemorrhage. D. airway obstruction.

A. capillary bleeding

Perfusion is most accurately defined as the: A. circulation of blood within an organ in adequate amounts to meet the body's metabolic needs. B. effective transfer of oxygen from the venules across the systemic capillary membrane walls. C. effective removal of carbon dioxide and other metabolic waste products from the body's cells. D. ability of the systemic arteries to constrict as needed to maintain an adequate blood pressure.

A. circulation of blood within an organ in adequate amounts to meet the boyd's metabolib needs

A 39-year-old male accidentally cut his wrist while sharpening his hunting knife. He is conscious and alert with adequate breathing but is bleeding significantly from the wound. You should: A. control the bleeding with direct pressure. B. apply a tourniquet proximal to the wound. C. apply oxygen with a nonrebreathing mask. D. ensure the patient has a patent airway.

A. control the bleeding with direct pressure

Bleeding from the nose following head trauma: A. is a sign of a skull fracture and should not be stopped. B. should be controlled by packing the nostril with gauze. C. should be assumed to be caused by a fractured septum. D. is usually due to hypertension caused by the head injury.

A. is a sign of a skull fracture and should not be stopped

A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes: A. pinching the patient's nostrils and having him lean forward. B. having the patient pinch his own nostrils and then lie supine. C. placing a rolled 4 × 4-inch dressing between his lower lip and gum. D. packing both nostrils with gauze pads until the bleeding stops.

A. pinching the patient's nostrils and having him lean forward

Which of the following organs can tolerate inadequate perfusion for two to three hours? A. Skeletal muscle B. Heart C. Kidneys D. Brain

A. skeletal muscle

Which of the following findings would be the most significant when assessing a patient with possible internal bleeding? A. The patient takes rivaroxaban (Xarelto). B. The patient has a history of hypertension. C. The patient had a stroke five years prior. D. The patient has not eaten in 24 hours.

A. the patient takes rivaroxaban (Xarelto)

In older patients, the first indicator of nontraumatic internal bleeding might be: A. weakness or dizziness. B. a heart rate over 120 beats/min. C. a low blood pressure. D. diaphoresis and pale skin.

A. weakness or dizziness

If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply: A. additional sterile dressings. B. a tourniquet proximal to the injury. C. a splint and elevate the extremity. D. digital pressure to a proximal artery.

B. a tourniquet proximal to the injury

Which of the following splinting devices would be most appropriate to use for a patient who has an open fracture of the forearm with external bleeding? A. Vacuum splint B. Air splint C. Sling and swathe D. Cardboard splint

B. air splint

Most cases of external bleeding from an extremity can be controlled by: A. packing the wound with gauze. B. applying local direct pressure. C. compressing a pressure point. D. elevating the injured extremity.

B. applying local direct pressure

In nontrauma patients, an early indicator of internal bleeding is: A. a decreasing blood pressure. B. dizziness upon standing. C. rapid, shallow breathing. D. a rapid, thready pulse.

B. dizziness upon standing

Early signs and symptoms of intra-abdominal bleeding include: A. significant hypotension. B. pain and distention. C. widespread ecchymosis. D. bruising only.

B. pain and distention

After applying a pressure dressing to a laceration on a patient's arm, you notice that blood is slowly beginning to saturate it. You should: A. apply a tourniquet proximal to the wound. B. place additional dressings over the wound. C. splint the arm and keep it below heart level. D. replace the dressing with another dressing.

B. place additional dressings over the wound

Which of the following occurs after tissues are injured? A. Red blood cells separate from plasma. B. Platelets collect at the injury site. C. Local blood vessels begin to dilate. D. Red blood cells become less sticky.

B. platelets collect at the injury site

After blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be most suspicious of injury to the: A. pancreas. B. spleen. C. kidneys. D. gallbladder

B. spleen

Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume. A. 5% B. 10% C. 20% D. 15%

C. 20%

What is the approximate blood volume of an 80-kg adult male? A. 5.25 L B. 6.25 L C. 6.0 L D. 6.50 L

C. 6.0 L

The smaller vessels that carry blood away from the heart and connect the arteries to the capillaries are called the: A. venules. B. capillary arteries. C. arterioles. D. vena cavae.

C. arterioles

An organ or tissue might better resist damage from hypoperfusion if the: A. heart rate is maintained at more than 100 beats/min. B. systolic arterial blood pressure is at least 60 mm Hg. C. body's temperature is considerably less than 98.6°F (37.0°C). D. body's demand for oxygen is markedly increased.

C. body's temperature is considerably less than 98.6ºF (37.0ºC)

The ability of a person's cardiovascular system to compensate for blood loss is mostrelated to: A. how fast his or her heart beats. B. his or her baseline blood pressure. C. how rapidly he or she bleeds. D. the part of the body injured.

C. how rapidly he or she bleeds

Hypovolemic shock occurs when: A. at least 10% of the patient's blood volume is lost. B. the clotting ability of the blood is enhanced. C. low fluid volume leads to inadequate perfusion. D. the patient's systolic BP is less than 100 mm Hg.

C. low fluid volume leads to inadequate perfusion

Which of the following statements regarding hemophilia is correct? A. Hemophiliacs take aspirin to enhance blood clotting. B. Hemophilia is defined as a total lack of platelets. C. Patients with hemophilia might bleed spontaneously. D. Approximately 25% of the population has hemophilia.

C. patients with hemophilia might bleed spontaneously

Hypoperfusion is another name for: A. hypoxemia. B. cellular death. C. shock. D. cyanosis.

C. shock

Internal bleeding into a fractured extremity is most often controlled by: A. keeping the patient warm. B. applying chemical ice pack. C. splinting the extremity. D. applying a tourniquet.

C. splinting the extremity

The severity of bleeding should be based on all of the following findings, except: A. clinical signs and symptoms. B. poor general appearance. C. systolic blood pressure. D. the mechanism of injury.

C. systolic blood pressure

Which of the following body systems or components is the least critical for supplying and maintaining adequate blood flow to the body? A. An intact system of blood vessels B. An effectively pumping heart C. The filtering of blood cells in the spleen D. Adequate blood in the vasculature

C. the filtering of blood cells in the spleen

You arrive at the home of a 50-year-old female with severe epistaxis. As you are treating her, it is most important to recall that: A. the patient might be significantly hypertensive. B. many medications interfere with blood clotting. C. the patient is at risk for vomiting and aspiration. D. a detailed exam is needed to determine the cause.

C. the patient is at risk for vomiting and aspiration

Regardless of the type of tourniquet used, it is important to remember that: A. you should try to control the bleeding by applying pressure to a proximal arterial pressure point first. B. the tourniquet should be applied directly over a joint if possible because this provides better bleeding control. C. the tourniquet should only be removed at the hospital because bleeding might return if the tourniquet is released. D. bulky dressings should be securely applied over the tourniquet to further assist in controlling the bleeding.

C. the tourniquet should only be removed at the hospital because bleeding might return if the tourniquet is released

An infant with a total blood volume of 800 mL would start showing signs of shock when as little as ______ of blood is lost. A. 50 mL B. 150 mL C. 200 mL D. 100 mL

D. 100 mL

Blood stasis, changes in the vessel wall, and certain medications affect the: A. systolic blood pressure exclusively. B. white blood cells' ability to fight infection. C. ability of red blood cells to carry oxygen. D. ability of the blood to effectively clot.

D. ability of the blood to effectively clot

Which of the following is not considered a basic technique when controlling bleeding? A. Pack the wound with a hemostatic impregnated gauze. B. Apply a tourniquet to an extremity above the level of the bleeding. C. Apply direct pressure over the wound with a dry, sterile dressing. D. Apply a cervical collar and place the patient on a long backboard.

D. apply a cervical collar and place the patient on a long backboard

A 48-year-old male has a suspected open-book pelvic fracture. He is conscious but restless, and his skin is pale and diaphoretic. His respirations are 22 breaths/min and his pulse rate is 120 beats/min. There is no external bleeding noted. The EMT should: A. stabilize his pelvis by placing him onto his side. B. elevate his legs, keep him warm, and transport. C. assess his blood pressure to detect hypotension. D. apply a compression device around his pelvis.

D. apply a compression device around his pelvis

In which of the following situations would external bleeding be the most difficult to control? A. Jugular vein laceration and a systolic blood pressure of 90 mm Hg B. Antecubital vein laceration and a blood pressure of 138/92 mm Hg C. Carotid artery laceration and a systolic blood pressure of 60 mm Hg D. Femoral artery laceration and a blood pressure of 140/90 mm Hg

D. femoral artery laceration and a blood pressure of 140/90mmHg

Gastrointestinal bleeding should be suspected if a patient presents with: A. dyspnea. B. hemoptysis. C. hematuria. D. hematemesis.

D. hematemesis

A 22-year-old male was kicked in the abdomen multiple times during an assault. He is conscious but restless and his pulse is rapid. His skin is cold and moist. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The mostappropriate treatment for this patient includes: A. applying oxygen via nasal cannula. B. performing a focused physical exam. C. a detailed assessment of his abdomen. D. preparing for immediate transport.

D. preparing for immediate transport

External bleeding from a vein is relatively easy to control because: A. veins carry deoxygenated blood. B. blood typically oozes from a vein. C. veins hold smaller blood volume. D. veins are under a lower pressure.

D. veins are under a lower pressure

Capillaries link the arterioles and the: A. cells. B. veins. C. aorta. D. venules.

D. venules

Which of the following is a term for vomited blood?

Hematemesis

In which of the following situations would external bleeding be the MOST difficult to control?

femoral artery laceration and a blood pressure of 140/90 mm Hg

Bleeding from the nose following head trauma:

is a sign of a skull fracture and should not be stopped.

After applying a pressure dressing to a laceration on a patient's arm, you notice that blood is slowly beginning to saturate it. You should:

place additional dressings over the wound

A 22-year-old male was kicked in the abdomen multiple times during an assault. He is conscious but restless and his pulse is rapid. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The MOST appropriate treatment for this patient includes:

preparing for immediate transport.

During transport of a 40-year-old female with acute abdominal pain, you note that she has stopped talking to you and has become extremely diaphoretic. You should:

repeat the primary assessment.

When using a stick and square knot as a tourniquet to control severe bleeding from an amputated arm, the EMT should:

stop twisting the stick when the bleeding stops.

Hypovolemic shock occurs when:

the body cannot compensate for rapid blood loss.

You arrive at the home of a 50-year-old female with severe epistaxis. As you are treating her, it is MOST important to recall that:

the patient is at risk for vomiting and aspiration.

When encountering a suspected bleeding emergency, the most pertinent finding during the SAMPLE history phase of assessment would be that ________.

the patient states that she takes blood-thinner medications

Hypoperfusion is another name for:

Shock.

Which part of the cardiovascular system is considered "a container"?

The blood vessels

An infant with a total blood volume of 800 mL would start showing signs of shock when as little as ______ of blood is lost. Select one: A. 50 mL B. 100 mL C. 150 mL D. 200 mL

The correct answer is: 100 mL

Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume. Select one: A. 10% B. 20% C. 15% D. 5%

The correct answer is: 20%

Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding? Select one: A. Sling and swathe B. Vacuum splint C. Air splint D. Cardboard splint

The correct answer is: Air splint

If applying a dressing to control the bleeding of a patient's arm, the EMT should ________. Select one: A. apply direct pressure first B. use large or small gauze pads or dressings depending upon the size of the wound C. cover the entire wound, above and below, with the dressing D. All of these answers are correct.

The correct answer is: All of these answers are correct.

What mechanism(s) does the body use to control bleeding? Select one: A. Clotting B. Coagulation C. Vasoconstriction D. All of these answers are correct.

The correct answer is: All of these answers are correct.

A patient is bleeding severely from a severed femoral artery high in the groin region. Which of the following would MOST likely control the bleeding? Select one: A. Position the patient with his injured side down B. Apply a pelvic binder device to stabilize the pelvis C. Apply a topical hemostatic agent with direct pressure D. Apply chemical ice packs to the wound and transport

The correct answer is: Apply a topical hemostatic agent with direct pressure

Which organ or organ system has the greatest tolerance for lack of perfusion (shock)? Select one: A. Gastrointestinal system B. Kidneys C. Brain D. Skeletal muscle

The correct answer is: Gastrointestinal system

A 70-year-old man presents with a severe nosebleed. His medical history includes COPD, depression, and a hemorrhagic stroke 3 years ago. His BP is 190/110 mm Hg, his pulse is 100 beats/min, and his respirations are 24 breaths/min. His medications include albuterol, sertraline (Zoloft), and multivitamins. Which of the following is MOST likely causing his nosebleed today? Select one: A. His prescribed albuterol B. Diabetic complications C. High blood pressure D. Hemorrhagic stroke

The correct answer is: High blood pressure

Which of the following statements regarding hemophilia is correct? Select one: A. Patients with hemophilia may bleed spontaneously. B. Approximately 25% of the population has hemophilia. C. Hemophilia is defined as a total lack of platelets. D. Hemophiliacs take aspirin to enhance blood clotting.

The correct answer is: Patients with hemophilia may bleed spontaneously.

Which of the following occurs after tissues are injured? Select one: A. Local blood vessels begin to dilate B. Red blood cells separate from plasma C. Platelets collect at the injury site D. Red blood cells become less sticky

The correct answer is: Platelets collect at the injury site

Which portion of the blood carries oxygen to and wastes away from body tissues? Select one: A. Plasma B. Red blood cells C. White blood cells D. Platelets

The correct answer is: Red blood cells

Which section of the heart receives deoxygenated blood? Select one: A. Atria B. Ventricles C. Left D. Right

The correct answer is: Right

Which of the following organs can tolerate inadequate perfusion for 2 to 3 hours? Select one: A. Brain B. Heart C. Skeletal muscle D. Kidneys

The correct answer is: Skeletal muscle

Which of the following body systems or components is the LEAST critical for supplying and maintaining adequate blood flow to the body? Select one: A. Adequate blood in the vasculature B. An intact system of blood vessels C. The filtering of blood cells in the spleen D. An effectively pumping heart

The correct answer is: The filtering of blood cells in the spleen

Which of the following findings would be the MOST significant when assessing a patient with possible internal bleeding? Select one: A. The patient has not eaten in 24 hours. B. The patient has a history of hypertension. C. The patient had a stroke 5 years prior. D. The patient takes rivaroxaban (Xeralto).

The correct answer is: The patient takes rivaroxaban (Xeralto).

If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply: Select one: A. a splint and elevate the extremity. B. additional sterile dressings. C. a tourniquet proximal to the injury. D. digital pressure to a proximal artery.

The correct answer is: a tourniquet proximal to the injury.

Blood stasis, changes in the vessel wall, and certain medications affect the: Select one: A. ability of red blood cells to carry oxygen. B. ability of the blood to effectively clot. C. systolic blood pressure exclusively. D. white blood cells' ability to fight infection.

The correct answer is: ability of the blood to effectively clot.

Most cases of external bleeding from an extremity can be controlled by: Select one: A. elevating the injured extremity. B. compressing a pressure point. C. applying local direct pressure. D. packing the wound with gauze.

The correct answer is: applying local direct pressure.

The smaller vessels that carry blood away from the heart and connect the arteries to the capillaries are called the: Select one: A. vena cavae. B. capillary arteries. C. arterioles. D. venules.

The correct answer is: arterioles.

A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should: Select one: A. assist the patient's ventilations. B. obtain baseline vital signs. C. perform a secondary assessment. D. apply a nonrebreathing mask.

The correct answer is: assist the patient's ventilations.

An organ or tissue may be better able to resist damage from hypoperfusion if the: Select one: A. body's demand for oxygen is markedly increased. B. body's temperature is considerably less than 98.6°F (37.0°C). C. heart rate is maintained at more than 100 beats/min. D. systolic arterial blood pressure is at least 60 mm Hg.

The correct answer is: body's temperature is considerably less than 98.6°F (37.0°C).

In nontrauma patients, an early indicator of internal bleeding is: Select one: A. a rapid, thready pulse. B. a decreasing blood pressure. C. dizziness upon standing. D. rapid, shallow breathing.

The correct answer is: dizziness upon standing.

A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should first: Select one: A. follow appropriate standard precautions. B. place the patient on high-flow oxygen. C. perform a rapid head-to-toe assessment. D. apply direct pressure to the wound.

The correct answer is: follow appropriate standard precautions.

A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing: Select one: A. an aortic aneurysm. B. acute appendicitis. C. gastrointestinal bleeding. D. intrathoracic hemorrhaging.

The correct answer is: gastrointestinal bleeding.

Gastrointestinal bleeding should be suspected if a patient presents with: Select one: A. hematuria. B. hemoptysis. C. dyspnea. D. hematemesis.

The correct answer is: hematemesis.

The ability of a person's cardiovascular system to compensate for blood loss is MOST related to: Select one: A. his or her baseline blood pressure. B. the part of the body injured. C. how fast his or her heart beats. D. how rapidly he or she bleeds.

The correct answer is: how rapidly he or she bleeds.

Early signs and symptoms of intra-abdominal bleeding include: Select one: A. significant hypotension. B. bruising only. C. widespread ecchymosis. D. pain and distention.

The correct answer is: pain and distention.

Circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste-removal needs is termed _______. Select one: A. coagulation B. hypoperfusion C. perfusion D. hemorrhage

The correct answer is: perfusion

A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes: Select one: A. placing a rolled 4² × 4² dressing between his lower lip and gum. B. pinching the patient's nostrils and having him lean forward. C. having the patient pinch his own nostrils and then lie supine. D. packing both nostrils with gauze pads until the bleeding stops.

The correct answer is: pinching the patient's nostrils and having him lean forward.

The systemic veins function by: Select one: A. delivering oxygen-poor blood to the capillaries. B. delivering deoxygenated blood to the capillaries. C. returning deoxygenated blood back to the heart. D. returning oxygen-rich blood back to the left atrium.

The correct answer is: returning deoxygenated blood back to the heart.

Following blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the: Select one: A. gallbladder. B. pancreas. C. spleen. D. liver.

The correct answer is: spleen.

Internal bleeding into a fractured extremity is MOST often controlled by: Select one: A. splinting the extremity. B. applying chemical ice pack. C. applying a tourniquet. D. keeping the patient warm.

The correct answer is: splinting the extremity.

The severity of bleeding should be based on all of the following findings, EXCEPT: Select one: A. the mechanism of injury. B. systolic blood pressure. C. clinical signs and symptoms. D. poor general appearance.

The correct answer is: systolic blood pressure.

Hypovolemic shock occurs when: Select one: A. the patient's systolic blood pressure is less than 100 mm Hg. B. the body cannot compensate for rapid blood loss. C. at least 10% of the patient's blood volume is lost. D. the clotting ability of the blood is enhanced.

The correct answer is: the body cannot compensate for rapid blood loss.

Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that: Select one: A. bulky dressings should be securely applied over the tourniquet to further assist in controlling the bleeding. B. you should try to control the bleeding by applying pressure to a proximal arterial pressure point first. C. the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released. D. the tourniquet should be applied directly over a joint if possible because this provides better bleeding control.

The correct answer is: the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released.

In older patients, the first indicator of nontraumatic internal bleeding may be: Select one: A. weakness or dizziness. B. a heart rate over 120 beats/min. C. a low blood pressure. D. diaphoresis and pale skin.

The correct answer is: weakness or dizziness.

Which of the following organs/body systems cannot tolerate lack of blood flow for more than a few minutes?

The heart and brain

A 48-year-old male has a suspected open-book pelvic fracture. He is conscious but restless, and his skin is pale and diaphoretic. His respirations are 22 breaths/min and his pulse rate is 120 beats/min. There is no external bleeding noted. The EMT should:

apply a compression device around his pelvis.

Perfusion is MOST accurately defined as the:

circulation of blood within an organ in adequate amounts to meet the organ's metabolic needs.

A 39-year-old male accidentally cut his wrist while sharpening his hunting knife. He is conscious and alert with adequate breathing, but is bleeding significantly from the wound. You should:

control the bleeding with direct pressure.