Chapter 23 Bleeding

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

The correct answer is: arterioles.

A fractured femur can result in the loss of ______ or more of blood into the soft tissues of the thigh. A. 250 mL B. 2 L C. 1 L D. 500 mL

The correct answer is: 1 L

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. 200 mL C. 100 mL D. 150 mL

The correct answer is: 100 mL

What is the approximate blood volume of a 75-kg adult? A. 6.50 L B. 5.25 L C. 5.50 L D. 6.25 L

The correct answer is: 5.25 L

Which of the following statements regarding the clotting of blood is correct? A. Venous and capillary blood typically does not clot spontaneously. B. Bleeding begins to clot when the end of a damaged vessel dilates. C. A person taking aspirin will experience slower blood clotting. D. Direct contact with the environment prevents blood from clotting.

The correct answer is: A person taking aspirin will experience slower blood clotting.

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

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

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. air splint B. cardboard splint C. vacuum splint D. sling and swathe

The correct answer is: air splint

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

The correct answer is: applying local direct pressure.

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: A. assist the patient's ventilations. B. obtain baseline vital signs. C. apply a nonrebreathing mask. D. perform a secondary assessment.

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

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

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

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

The correct answer is: circulation of blood within an organ in adequate amounts to meet the body'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: A. apply a tourniquet proximal to the wound. B. control the bleeding with direct pressure. C. ensure the patient has a patent airway. D. apply oxygen with a nonrebreathing mask.

The correct answer is: control the bleeding with direct pressure.

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

The correct answer is: dizziness upon standing.

As red blood cells begin to clump together to form a clot, __________ reinforces the clumped red blood cells. A. plasma B. fibrin C. fibrinogen D. plasminogen

The correct answer is: fibrinogen

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: A. apply direct pressure to the wound. B. place the patient on 100% oxygen. C. follow appropriate standard precautions. D. perform a rapid head-to-toe assessment.

The correct answer is: follow appropriate standard precautions.

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

The correct answer is: hematemesis.

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

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

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

The correct answer is: 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. splint the arm and keep it below heart level. B. apply a tourniquet proximal to the wound. C. replace the dressing with another dressing. D. place additional dressings over the wound.

The correct answer is: place additional dressings over the wound.

A 22-year-old male was kicked in the abdomen multiple times during an attack by a gang. 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: A. a detailed assessment of his abdomen. B. performing a focused physical exam. C. applying oxygen via nasal cannula. D. preparing for immediate transport.

The correct answer is: 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: A. assess the quality of her pulse. B. begin assisting her ventilations. C. perform a secondary assessment. D. repeat the primary assessment.

The correct answer is: repeat the primary assessment.

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

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

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

The correct answer is: shock.

Following blunt trauma to the abdomen, a 21-year-old female complains of left upper quadrant abdominal pain with referred 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. liver. B. pancreas. C. spleen. D. gallbladder.

The correct answer is: spleen.

When using a stick and square knot as a tourniquet to control severe bleeding from an amputated arm, the EMT should: A. stop twisting the stick when the bleeding stops. B. cover the tourniquet with a sterile dressing. C. twist the stick until the radial pulse disappears. D. remove the tourniquet if the bleeding has stopped.

The correct answer is: stop twisting the stick when the bleeding stops.

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

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

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

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

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

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

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

The correct answer is: veins are under a lower pressure.

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

The correct answer is: weakness or dizziness.