Paramedic Vol 4 chapter 3

Which of the following terms is best described as the loss of blood from the vascular​ space?

Hemorrhage

Which of the following fluids is appropriate for the prehospital management of hypovolemic​ shock?

Lactated​ Ringer's

Peripheral vascular resistance is measured as which of the​ following?

Mean arterial pressure

Which type of wound facilitates the effectiveness of normal blood clotting​ mechanisms?

Transverse laceration of the vessel

Which of the following statements about the patient in neurogenic shock is​ FALSE?

Unopposed sympathetic nervous stimulation results in systemic pallor and diaphoresis.

Even with​ intervention, survival is unlikely with blood loss over​ ________ percent of the total blood volume.

35

Red blood cells make up approximately​ ________ percent of whole blood volume.

45

Which of the following guidelines applies to the prehospital administration of IV fluids in the patient with hemorrhagic​ shock?

Administer isotonic crystalloid fluids only as necessary to maintain perfusion.

Which of the following impairs blood​ clotting?

All of the above

Which of the following is TRUE of the elderly trauma​ patient?

All of the above are true.

Which of the following does NOT indicate compensated​ shock?

Altered mental status

Which of the following findings indicates a progression from compensated shock to decompensated​ shock?

Altered mental status

Which of the following mechanisms is responsible for accumulating lactic acid in​ shock?

Anaerobic metabolism

What is the mechanism of​ TXA?

Antifibrinolytic

Which of the following vessels has the greatest ability to change​ diameter?

Arteriole

Which of the following may move more slowly through the early stages of hemorrhage with greater loss percentages needed to transition from one stage class to​ another?

Athletes

Which of the following patients with hemorrhagic shock is likely to be internally​ bleeding, solely?

A​ 45-year-old woman with a suspected ruptured ectopic pregnancy

Brighter​ red, slow, oozing blood flow is characteristic of which type of​ hemorrhage?

Capillary

Which of the following is NOT a characteristic of arterial​ bleeding?

Clots quickly on its own

As a patient with hemorrhagic blood loss becomes more​ acidotic, what homeostatic process is usually​ impaired?

Coagulation

What is the best course of action in the case of hemorrhage from either the nose or ear​ canal?

Cover the area with a​ soft, porous dressing

Your patient is a​ 23-year-old man with a gunshot wound to the abdomen and an exit wound in the right flank. He responds to verbal​ stimuli; has​ pale, cool, diaphoretic​ skin; and has a heart rate of​ 128, respirations at​ 24, and a blood pressure of​ 82/60. These findings indicate which of the following kind of​ shock?

Decompensated

Which of the following represents the correct sequence for controlling hemorrhage from an​ extremity?

Direct pressure on the dressing and​ wound, finger pressure through the dressing to the leaking​ vessel, and, if pressure​ fails, application of a tourniquet

Which of the following findings is NOT likely with a patient in cardiogenic​ shock?

Excessive urination

Your patient is a​ 45-year-old man who has received several stab wounds to the chest and abdomen. Although bleeding was significant at​ first, the rate of bleeding had slowed considerably before your arrival. The patient is agitated and​ confused, pale,​ diaphoretic, and cool to the touch. He lacks a radial​ pulse, and his carotid pulse is weak and rapid. Respirations are 28 and shallow. Which of the following is certain with this​ patient?

He is in decompensated shock.

When assessing the chest during a rapid trauma​ assessment, what is most likely to indicate major internal​ hemorrhage?

Hyporesonance to percussion

Which of the following indicates that a patient has transitioned from compensated to decompensated​ shock?

Hypotension

A hematoma resulting from a fracture of the humerus may contain enough blood to make it a class​ ________ hemorrhage.

I

Your patient is a​ 29-year-old man who works in a​ meat-processing plant. He received a knife wound in the proximal anteromedial​ thigh, which is continuing to bleed on your arrival. He is restless and thirsty and has​ pale, cool skin. He has a weak radial pulse of 130 and a blood pressure of​ 118/88 mmHg. This patient is exhibiting signs and symptoms consistent with a class​ ________ hemorrhage.

II

A fracture of the femur may result in a hematoma that contains enough blood to make it a class​ ________ hemorrhage.

III

When a patient has lost 2 liters or more of blood from​ hemorrhage, which classification is​ that?

IV

Which of the following best describes definitive care for the trauma patient with​ ongoing, significant​ hemorrhage?

Immediate surgery

In which stage of shock are the​ body's cells are so badly injured and die in such quantities that organs no longer are able to function​ normally?

Irreversible

In responding to a trauma patient at the scene of a motor vehicle​ crash, which of the following is an early sign or signs of shock you might encounter during the primary​ assessment?

Rapid heart rate and anxiety

Your patient is an obese​ 39-year-old woman involved in a​ lateral-impact motor vehicle collision. Which of the following should you remember when assessing and treating this​ patient?

Relative to body​ weight, a smaller amount of hemorrhage may result in shock.

Which of the following would be the most likely cause of neurogenic​ shock?

Spinal cord injury

Which of the following is defined as the volume of blood ejected from the heart with each​ beat?

Stroke volume

Which of the following early signs of shock is easily​ missed?

Tachycardia

What method of controlling hemorrhage should be done as a last​ resort?

Tourniquet

Rapid volume replacement is best achieved under which of the following​ conditions?

Use of a short catheter with a large internal diameter

Which of the following vessels does NOT make up the microcirculation in the circulatory​ system?

Veins

Which of the following is the preferred​ in-hospital fluid for resuscitation in hemorrhagic​ shock?

Whole blood

Which of the following is a manifestation of orthostatic​ hypotension?

Your​ patient's blood pressure is​ 142/90 when she is supine but​ 116/88 when she sits up.

Managing a laceration with arterial bleeding most often​ requires:

direct pressure.

Blood present in the stool of a patient is known​ as:

hematochezia.

The blood flowing to the heart best​ describes:

preload.

The phase of blood clotting in which the smooth muscle of an injured blood vessel contracts is known as the​ ________ phase.

vascular

Under normal​ circumstances, at any given moment most of the blood is in the​ ________ system.

venous

The rapid trauma exam focuses on finding injuries that may cause shock by quickly assessing which of the following body​ areas? 1. Head 2. Neck 3. Chest 4. Abdomen 5. Pelvis 6. Proximal extremities 7. Distal extremities

​1, 2,​ 3, 4, and 5

Your patient is a​ 42-year-old man with multiple lacerations on his​ arms, head, and torso after falling through a​ plate-glass window. On your​ arrival, he appears to be​ unresponsive, lying prone on the sidewalk. Which of the following is the correct sequence of actions in caring for this​ patient? 1. Control major hemorrhage. 2. Take Standard Precautions. 3. Check the area for broken glass before kneeling next to the patient. 4. Turn him to a supine position. 5. Open his airway.

​2, 3,​ 4, 1, 5