242 ch40
18. The blood pressure of an infant or child can be maintained with blood loss of up to:
35% to 40%.
27. If the left ventricle fills with 85 mL of blood and ejects 60 mL during a contraction, the ejection fraction is approximately______%.
70
35. If you can feel a pulse over the femoral artery of an adult, but are unable to feel a pulse over the radial artery, his or her systolic blood pressure is MOST likely between__ and_mm
70, 80
46. Which of the following substances or elements reinforces red blood cells, creating the final step in the formation of a blood clot?
Fibrinogen
31. By which of the following mechanisms do patients with septic shock become hypovolemic?
Fluid leakage out of the vascular space
67. By which of the following mechanisms do patients with septic shock become hypovolemic?
Fluid leakage out of the vascular space
75. You and your team are treating an unresponsive trauma patient. Which of the following questions would be the MOST relevant to ask your team when evaluating for the presence of a tension pneumothorax?
Is the patient becoming difficult to ventilate?
59. Which of the following solutions is preferred for fluid resuscitation of a patient in shock in the prehospital setting?
Isotonic crystalloid
38. The force or resistance against which the heart pumps is called:
afterload
69. A characteristic sign of neurogenic shock caused by a spinal injury is:
an absence of sweating below the level of the injury.
52. Disseminated intravascular coagulation is defined as a(n):
pathological condition in which the proteins that normally control blood clotting become active.
66. Premorbid conditions are those that:
precede the onset of a disease.
72. A young woman experiences a sudden nervous system reaction that produces temporary, generalized vasodilation and causes her to faint. This is MOST descriptive of ______shock
psychogenic
71. Hypotension during anaphylactic shock is caused primarily by:
relative hypovolemia
34. Hypotension during anaphylactic shock is caused primarily by:
relative hypovolemia.
50. During anaerobic metabolism, the precapillary sphincters_____ in response to _______
relax, lactic acid buildup
16. Signs and symptoms of multiple-organ dysfunction syndrome may include:
uncontrollable bleeding
45. Carbonic acid is formed by the combination of:
water and carbon dioxide
4. When attempting to resuscitate a patient in cardiac arrest, which of the following questions would you pose if you suspect that the patient is hyperkalemic?
"Does this patient undergo dialysis?"
39. What is the mean arterial pressure of a person who has a blood pressure of 140/90 mm Hg?
107 mm Hg
3. Which of the following scenarios would MOST likely cause a bias to decision making?
23-year-old male with crushing substernal chest pain and nausea
60. You have given an 800-mL normal saline bolus to a patient in shock. How much of this fluid will remain in the intravascular space after minutes?
320 mL
40. The mean arterial pressure must be greater than or equal to ____mm Hg to ensure that the brain, coronary arteries, and kidneys remained perfused.
60
29. Which of the following blood pressures is MOST consistent with a pericardial tamponade?
90/70 mm Hg
65. Which of the following blood pressures is MOST consistent with a pericardial tamponade?
90/70 mm Hg
49. Which of the following is a normal response of the body to hypoperfusion?
Antidiuretic hormone is released by the pituitary gland.
7. Which of the following is a normal response of the body to hypoperfusion?
Antidiuretic hormone is released by the pituitary gland.
43. Which of the following is an element of the Fick principle?
An adequate number of red blood cells
77. Your primary assessment of a multisystems trauma patient reveals that he is unresponsive and is not breathing. What should you do next?
Assess for a pulse.
25. Which of the following vital signs values are MOST consistent with neurogenic shock?
Blood pressure, 80/60; pulse, 50: respirations. 24
15. During multiple-organ dysfunction syndrome, the release of ______a potent vasodilator, leads to tissue hypoperfusion and may contribute to hypotension.
Bradykinin
74. What is formed when carbon monoxide binds to the hemoglobin molecule?
Carboxyhemoglobin
62. Which of the following injuries or conditions would cause obstructive shock?
Cardiac tamponade
5. Which of the following lists, in the correct order, the smallest to largest units of life?
Cells, tissues, organs. organ systems, organism
14. Which of the following is the MOST accurate definition of multiple-organ dysfunction syndrome?
Combined failure of two or more organs or organ systems that were initially unharmed by the acute disorder or injury that caused the patient's initial illness
2. A tendency to gather and rely on information that confirms your existing views and avoids or downplays information that does not confirm your preexisting hypothesis or field differential is called a(n)
Confirmation
76. Which of the following will be of MOST help to the paramedic when formulating a field diagnosis?
Considering or ruling out various conditions
1. Which of the following premorbid conditions would MOST likely occur in an otherwise healthy adult?
Drug toxicity
6. Which of the following components represent the perfusion triangle?
Heart, blood, blood vessels
36. Shock in the trauma patient should be considered ______until proved otherwise.
Hemorrhagic
53. Which of the following occurs during compensated shock?
Increased rate of breathing causes respiratory alkalosis
47. Which of the following would MOST likely allow you to reach the status of entry-level competence?
Interning with an experienced preceptor
63. Which of the following assessment findings should increase your index of suspicion for obstructive shock?
Jugular venous distention
54. Which of the following is the BEST indicator of tissue perfusion during compensated shock?
Level of responsiveness
22. Which of the following hemodynamic parameters decreases, regardless of the etiology of the shock?
Mean arterial pressure
57. Which of the following hemodynamic parameters decreases, regardless of the etiology of the shock?
Mean arterial pressure
44. Which of the following statements regarding gas exchange in the lungs is correct?
Oxygen molecules move from the alveoli into the blood by diffusion by the
17. Which of the following depicts a positive orthostatic tilt test?
The patient becomes dizzy upon standing
61. Which of the following is a disadvantage of using a crystalloid solution when treating a patient with hemorrhagic shock?
They do not have oxygen-carrying capacity.
32. Which of the following clinical signs would differentiate septic shock from hypovolemic shock?
Warm or hot skin
30. Which of the following is the MOST accurate definition of distributive shock?
Widespread dilation of the resistance and capacitance vessels
73. A 40-year-old man had a syncopal episode after receiving news of the death of a loved one. He complains of a headache and is unable to walk without becoming dizzy. You should be the MOST suspicious for:
a head injury.
42. Parasympathetic nervous system stimulation results in:
a negative dromotropic effect.
10. Afterload is increased following alpha-1 stimulation because of:
arteriolar constriction.
20. In addition to IV fluids, treatment for a patient in neurogenic shock may include:
atropine
21. An adult patient presents with a blood pressure of 78/60 mm Hg, a pulse rate of 120 beats/min and irregular, and labored breathing. Further assessment reveals pale, cool, moist skin and diffuse crackles in all lung fields. You should suspect:
cardiogenic shock.
26. Intrinsic causes of cardiogenic shock include:
cardiomyopathy.
19. When an adult patient with hemorrhagic shock loses more than 40% of his or her blood volume:
cardiovascular deterioration cannot be reversed by compensatory mechanisms.
56. When an adult patient with hemorrhagic shock loses more than 40% of his or her blood volume:
cardiovascular deterioration cannot be reversed by compensatory mechanisms.
79. Tissue perfusion is primarily a function of the:
cardiovascular system
70. The negative target-organ effects of anaphylactic shock are reversed with:
epinephrine
33. The negative target-organ effects of anaphylactic shock are reversed with:
epinephrine.
28. The MOST immediate treatment for the patient with a tension pneumothorax is to:
evacuate air from the pleural space.
9. Systemic effects of epinephrine include:
increased afterload.
8. Anaerobic metabolism is the process in which:
inefficient cellular metabolism produces lactic acid.
51. Accumulating acids and other waste products in the blood:
inhibit hemoglobin from binding with and carrying oxygen.
24. When administering IV fluid boluses to an elderly patient in shock, it is especially important to monitor his or her:
lung sounds.
64. The MOST common cause of cardiogenic shock is:
myocardial infarction. following
78. When communicating an intuitive decision and obtaining feedback to your team, you should FIRST advise your team:
of what you think the patient's problem is.
41. Clinical indicators of sympathetic nervous system discharge include:
pupillary dilation.
12. Incomplete glucose breakdown leads to an accumulation of:
pyruvic acid.
48. Baroreceptors function by:
sensing decreased blood flow and activating vasomotor center.
37. Cardiac output is dependent upon:
stroke volume and heart rate.
11. According to the Frank-Starling mechanism:
the length of myocardial fibers determines force of cardiac contraction.
13. The capillary "washout" phase occurs when:
the postcapillary sphincters relax, releasing accumulated hydrogen, potassium, carbon dioxide, and thrombosed red blood cells.
68. Relative bradycardia during neurogenic shock occurs because:
the sympathetic nervous system is not stimulated to release catecholamines
23. A 6-year-old male was struck in the abdomen. He is restless; his skin is cool, pale, and clammy; and his blood pressure is 94/60 mm Hg. After applying high-flow oxygen and keeping him warm, you should:
transport promptly and establish vascular access en route.
58. A 6-year-old male was struck in the abdomen. He is restless; his skin is cool, pale, and clammy; and his blood pressure is 94/60 mm Hg. After applying high-flow oxygen and keeping him warm, you should:
transport promptly and establish vascular access en route.
55. A patient with severe dehydration is found to be hypotensive during your assessment. The MOST important intervention in this case is:
transport with fluid resuscitation en route.