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Flashcards in Chapter 30 Bleeding Deck (44)
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1. Which of the following components is LEAST crucial to the continuous circulation of oxygenated blood throughout the body? A) Heart B) Spleen C) Vasculature D) Fluid volume

Ans: B Page: 1519


2. The cardiac cycle begins with the onset of myocardial contraction and ends: A) as blood returns to the right atrium. B) as both ventricles are filling with blood. C) when the ventricles are emptied of blood. D) with the beginning of the next contraction.

Ans: D Page: 1520


3. Afterload is defined as the: A) pressure in the aorta against which the left ventricle must pump. B) amount of resistance to blood flow offered by the heart valves. C) amount of blood ejected from the ventricle with each contraction. D) volume of blood remaining in the ventricles following contraction.

Ans: A Page: 1520


4. Which of the following two factors DIRECTLY affect cardiac output? A) Preload and afterload B) Vessel size and stroke volume C) Stroke volume and pulse rate D) Blood pressure and pulse rate

Ans: C Page: 1520


5. Which of the following statements regarding blood flow is correct? A) Ejection fraction is the percentage of blood that the heart pumps per contraction. B) If more blood returns to the heart, stroke volume decreases and cardiac output falls. C) As more blood is pumped with each contraction, the ejection fraction increases. D) The amount of blood that returns to the atrium remains fixed from minute to minute.

Ans: A Page: 1520-1521


6. Hemoglobin functions by: A) dissolving in blood plasma to create the partial pressure of carbon dioxide. B) binding to oxygen that is absorbed in the lungs and transporting it to the tissues. C) absorbing hydrogen ions in the blood in order to maintain acid-base balance. D) transporting red blood cells throughout the body to ensure adequate oxygenation.

Ans: B Page: 1522


7. What aggregates in a clump and forms much of the foundation of a blood clot during the process of coagulation? A) Fibrin B) Calcium C) Plasmin D) Platelets

Ans: D Page: 1522


8. Perfusion is defined as: A) the effective exchange of oxygen and carbon dioxide within the lungs and at the cellular level. B) the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands. C) an ejection fraction that is adequate to maintain radial pulses or a systolic blood pressure of at least 90 mm Hg. D) the circulation of an adequate volume of blood to ensure uninterrupted cerebral and myocardial oxygenation.

Ans: B Page: 1522


9. Which of the following organs or body systems requires a constant blood supply, regardless of external factors? A) Skin B) Muscles C) Kidneys D) Gastrointestinal tract

Ans: C Page: 1522


10. Which of the following organs can sustain the longest period of inadequate perfusion? A) Gastrointestinal tract B) Kidneys C) Spinal cord D) Skeletal muscle

Ans: A Page: 1522-1523


11. An organ or tissue that is considerably colder than 98.6°F is better able to resist damage from hypoperfusion because: A) the body's metabolic rate is slower. B) cells shrink as body temperature falls. C) hypothermia promotes oxygen metabolism. D) hypothermia protects hemoglobin molecules.

Ans: A Page: 1523


12. The amount of blood returned to the heart is called: A) preload. B) cardiac output. C) afterload. D) stroke volume.

Ans: A Page: 1520


13. External bleeding would be the MOST difficult to control in a patient with a large laceration to the _____________ and a blood pressure of ______ mm Hg. A) jugular vein, 96/62 B) brachial artery, 68/46 C) femoral vein, 114/60 D) carotid artery, 100/70

Ans: D Page: 1524-1525


14. Patients with internal hemorrhage will benefit MOST from: A) IV therapy. B) high-flow oxygen. C) rapid transport. D) PASG placement.

Ans: C Page: 1524


15. What is the approximate total blood volume of a 150-pound male? A) 4.8 L B) 5.1 L C) 6.2 L D) 6.5 L

Ans: A Page: 1524


16. The MOST significant factor that determines how well the body compensates for blood loss is: A) the patient's pulse rate at the time of the injury. B) the period of time over which the blood is lost. C) whether the bleeding is internal or external. D) whether the bleeding is venous or arterial.

Ans: B Page: 1524


17. Venous bleeding: A) is dark red in color and usually oozes from the wound. B) is bright red in color and typically spurts from a wound. C) is more likely to clot spontaneously than arterial bleeding. D) is generally more difficult to control than arterial bleeding.

Ans: C Page: 1525


18. Which of the following factors would have the MOST negative effect on the body's process of hemostasis? A) Bradycardia B) Hyperthermia C) Chronic heroin use D) Anticoagulant use

Ans: D Page: 1525


19. If you suspect internal bleeding during the primary assessment, you should: A) stop the assessment and transport at once. B) start two large-bore IV lines of normal saline. C) determine the source of the internal bleeding. D) keep the patient warm and administer oxygen.

Ans: D Page: 1529


20. Hematochezia: A) indicates digested blood from the upper gastrointestinal tract. B) is the passage of stools that contain bright red blood. C) suggests kidney injury and is characterized by bloody urine. D) is the passage of dark stools and indicates lower gastrointestinal bleeding.

Ans: B Page: 1529


21. All of the following are common early signs or symptoms of nontraumatic internal hemorrhage in older patients, EXCEPT: A) vomiting. B) syncope. C) weakness. D) dizziness.

Ans: A Page: 1528


22. Most external hemorrhage can be controlled with a combination of: A) pressure dressings and ice. B) elevation and immobilization. C) direct pressure and pressure dressings. D) pressure point control and elevation.

Ans: C Page: 1528


23. What is "warm ischemic time"? A) The period of time that organs and tissues can survive without perfusion, assuming a normal body temperature B) The preservation of ischemic organs and tissues when the patient's body temperature is reduced by 1°F per hour C) The period of time in which perfusion can be restored to ischemic organs and tissues before permanent damage occurs D) The preservation of ischemic organs and tissues when the patient's body temperature is increased to at least 101°F

Ans: A Page: 1523


24. Much of the bleeding associated with unsplinted fractures continues because: A) most fractures are unstable and usually lacerate major blood vessels. B) swelling associated with such fractures prevents platelet aggregation. C) bone ends will continue to move and destroy partially formed clots. D) patient anxiety increases the blood pressure, which exacerbates bleeding.

Ans: C Page: 1534


25. When applying a tourniquet to control major external hemorrhage from an extremity injury, you should: A) apply the tourniquet over a joint, as this will further help compress blood vessels. B) maintain direct pressure to the wound until the tourniquet has been fully applied. C) secure the tourniquet in place until the pulses distal to the injury have weakened. D) apply a pressure dressing over the tourniquet to further help control the bleeding.

Ans: B Page: 1532-1534


26. Agents such as Celox, HemCon, and QuikClot are used to: A) repair damaged vessels. B) replace lost blood. C) raise blood pressure. D) promote hemostasis.

Ans: D Page: 1535


27. A patient with hemorrhagic shock would be expected to have: A) warm, flushed skin. B) flattened jugular veins. C) a widened pulse pressure. D) an increased hematocrit.

Ans: B Page: 1527


28. Which of the following injuries or mechanisms would MOST likely lead to nonhemorrhagic shock? A) Fractures B) Blunt trauma C) Hemothorax D) Severe burns

Ans: D Page: 1525


29. A trauma patient with suspected internal hemorrhage and inadequate breathing requires: A) ventilation assistance and rapid transport. B) intubation that is facilitated by medications. C) on-scene IV therapy and rapid fluid boluses. D) oxygen via nonrebreathing mask and transport.

Ans: A Page: 1535-1536


30. A trauma patient with hypotension secondary to internal hemorrhage should receive IV fluid boluses in order to: A) increase the systolic blood pressure to at least 110 mm Hg. B) restore the patient's blood pressure to its pretrauma reading. C) increase the pulse rate by no more than 10 beats/min. D) maintain the systolic blood pressure in a low normal range.

Ans: D Page: 1537