Quiz 7 - Trauma & Bleeding Flashcards Preview

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Flashcards in Quiz 7 - Trauma & Bleeding Deck (35):
1

You are treating a 20-year-old man with a large laceration involving the brachial artery. The patient is confused, is pale, and has weak peripheral pulses. Your initial attempts to control the bleeding have failed. You should:

A. administer high-flow oxygen, establish vascular access at the scene, transport, and apply a proximal tourniquet en route.

B. control the bleeding by applying pressure to a proximal pressure point, administer high-flow oxygen, and transport.

C. administer high-flow oxygen, transport, and apply a proximal tourniquet and establish vascular access en route.

D. apply a proximal tourniquet, administer high-flow oxygen, transport, and establish vascular access en route.

D. apply a proximal tourniquet, administer high-flow oxygen, transport, and establish vascular access en route.

2

The paramedic's MAIN goal in treating a patient with shock is to:

A. administer oxygen in a concentration sufficient to maintain an oxygen saturation greater than 95%.

B. recognize the signs and symptoms of shock in its earliest phase and begin immediate treatment before permanent damage occurs.

C. start two large-bore IV lines and infuse enough isotonic crystalloid solution to maintain adequate tissue perfusion.

D. maintain body temperature and elevate the patient's legs 6 to 12 inches in order to improve blood flow to the core of the body.

B. recognize the signs and symptoms of shock in its earliest phase and begin immediate treatment before permanent damage occurs.

3

If you suspect internal bleeding during the primary assessment, you should:

A. keep the patient warm and administer oxygen.

B. stop the assessment and transport at once.

C. start two large-bore IV lines of normal saline.

D. determine the source of the internal bleeding.

A. keep the patient warm and administer oxygen.

4

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. carotid artery, 100/70

C. brachial artery, 68/46

D. femoral vein, 114/60

B. carotid artery, 100/70

5

Unlike blunt trauma, penetrating trauma:

A. is usually more fatal because of the severe external bleeding that accompanies it.

B. involves a disruption of the skin and underlying tissues in a small, focused area.

C. is especially common during the primary blast injury following an explosion.

D. often causes damage to a large body surface area, even from a single projectile.

B. involves a disruption of the skin and underlying tissues in a small, focused area.

6

Much of the bleeding associated with unsplinted fractures continues because:

A. swelling associated with such fractures prevents platelet aggregation.

B. bone ends will continue to move and destroy partially formed clots.

C. patient anxiety increases the blood pressure, which exacerbates bleeding.

D. most fractures are unstable and usually lacerate major blood vessels.

B. bone ends will continue to move and destroy partially formed clots.

7

Unlike adults, children who are struck by a motor vehicle are MORE likely to:

A. experience injuries to the lower extremities from the initial impact.

B. be run over by the vehicle as they are propelled to the ground.

C. turn away from the oncoming vehicle, resulting in posterior trauma.

D. be propelled onto the hood of the vehicle during the second impact.

B. be run over by the vehicle as they are propelled to the ground.

8

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.

D. maintain the systolic blood pressure in a low normal range.

9

Following a head-on collision of a motorcycle and a truck, the motorcyclist would MOST likely experience initial injury to the:

A. wrists and forearms.

B. cervical spine.

C. femurs and tibias.

D. chest and abdomen.

C. femurs and tibias.

10

What aggregates in a clump and forms much of the foundation of a blood clot during the process of coagulation?

A. Calcium

B. Plasmin

C. Fibrin

D. Platelets

D. Platelets

11

Patients with internal hemorrhage will benefit MOST from:

A. high-flow oxygen.

B. rapid transport.

C. IV therapy.

D. PASG placement

B. rapid transport.

12

Knowledge of kinetics can help the paramedic:

A. determine which organs have been injured.

B. quantify how much blood a patient has lost.

C. differentiate between medical and trauma patients.

D. predict injury patterns found in a patient.

D. predict injury patterns found in a patient.

13

If a Level I trauma center is 30 miles away, and a Level II trauma center is 10 miles away, it would be MOST appropriate to transport a patient with a severe traumatic brain injury:

A. to the closest hospital for stabilization.

B. via air transport to the Level I trauma center.

C. by ground to the Level I trauma center.

D. by ground to the Level II trauma center.

B. via air transport to the Level I trauma center.

14

You have successfully controlled a large arterial hemorrhage from a 42-year-old man's leg with direct pressure and a pressure dressing. He is conscious, but restless. His blood pressure is 84/58 mm Hg, pulse is 120 beats/min, and respirations are 24 breaths/min. You should:

A. keep him warm, administer high-flow oxygen, establish one large-bore IV line at the scene, and transport.

B. administer high-flow oxygen, keep him warm, transport, and establish two large-bore IV lines en route.

C. administer high-flow oxygen, start two large-bore IV lines at the scene and give a 2- to 3-L fluid bolus, and transport.

D. Keep him warm, assist his ventilations, place a hemostatic agent in the wound, transport, and start a large-bore IV en route.

B. administer high-flow oxygen, keep him warm, transport, and establish two large-bore IV lines en route.

15

Which of the following organs is LEAST susceptible to pressure changes caused by an explosion?

A. Liver

B. Gastrointestinal tract

C. Tympanic membrane

D. Lungs

A. Liver

16

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 period of time in which perfusion can be restored to ischemic organs and tissues before permanent damage occurs

C. The preservation of ischemic organs and tissues when the patient's body temperature is increased to at least 101°F

D. The preservation of ischemic organs and tissues when the patient's body temperature is reduced by 1°F per hour

A. The period of time that organs and tissues can survive without perfusion, assuming a normal body temperature

17

The energy stored in an object, such as a bridge pillar, is called __________ energy, and the energy from motion is called __________ energy.

A. potential, kinetic

B. kinetic, potential

C. barometric, kinetic

D. chemical, potential

A. potential, kinetic

18

The third phase of a motor vehicle accident involves:

A. injuries caused by flying debris.

B. crush injuries to the body.

C. deceleration of internal organs.

D. impact by another vehicle.

C. deceleration of internal organs.

19

During abrupt deceleration:

A. the neck commonly sustains hyperextension injuries.

B. shearing or rupturing of internal organs can occur.

C. the skull provides excellent protection for the brain.

D. supporting structures of the aorta keep it attached.

B. shearing or rupturing of internal organs can occur.

20

All of the following statements regarding front air bags are correct, EXCEPT:

A. Front air bags will not activate in side impacts or impacts to the front quarter panel.

B. Small children riding in the front seat can be killed when the air bag deploys.

C. Air bags will provide protection from both initial and secondary impacts.

D. Without the use of a seat belt, front air bags are insufficient in preventing ejection.

C. Air bags will provide protection from both initial and secondary impacts.

21

The MOST significant factor that determines how well the body compensates for blood loss is:

A. whether the bleeding is venous or arterial.

B. the period of time over which the blood is lost.

C. whether the bleeding is internal or external.

D. the patient's pulse rate at the time of the injury.

B. the period of time over which the blood is lost.

22

When a person falls from a significant height and lands on his or her feet, axial loading results in:

A. compression or burst fractures to the lumbar spine.

B. crushing injuries to the heels and hip dislocations.

C. shearing injuries to the liver, spleen, and aorta.

D. disc injuries to the lower cervical and upper thoracic spine.

A. compression or burst fractures to the lumbar spine.

23

Which of the following organs can sustain the longest period of inadequate perfusion?

A. Skeletal muscle

B. Spinal cord

C. Gastrointestinal tract

D. Kidneys

C. Gastrointestinal tract

24

Most external hemorrhage can be controlled with a combination of:

A. elevation and immobilization.

B. pressure point control and elevation.

C. pressure dressings and ice.

D. direct pressure and pressure dressings.

D. direct pressure and pressure dressings.

25

Which of the following general statements regarding trauma is correct?

A. The position of the patient at the time of the event is considered to be an internal factor.

B. Rapidly applied amounts of energy are better tolerated than a similar amount of energy applied over a longer period.

C. Blunt trauma is difficult to diagnose by paramedics in the field and is often more lethal than penetrating trauma.

D. Bullet impact is less if the energy in the bullet is applied to a small area.

C. Blunt trauma is difficult to diagnose by paramedics in the field and is often more lethal than penetrating trauma.

26

An object increases its kinetic energy more by:

A. increasing its mass than by increasing its velocity.

B. increasing its velocity than by increasing its mass.

C. decreasing its speed than by increasing its mass.

D. decreasing its velocity than by decreasing its mass.

B. increasing its velocity than by increasing its mass.

27

When a patient takes the “up and over” pathway during a head-on collision:

A. the head takes a higher trajectory, striking the windshield and causing stretching injuries to the neck.

B. injuries to the parietal aspect of the skull are common as the head strikes the side window.

C. the anterior part of the neck may strike the steering wheel, resulting in a fractured larynx.

D. secondary injuries as the patient is ejected are often less severe than the primary injuries.

C. the anterior part of the neck may strike the steering wheel, resulting in a fractured larynx.

28

In contrast to a patient with compensated shock, a patient with decompensated shock would be expected to present with:

A. restlessness and pale cool skin.

B. bounding radial pulses.

C. mottled skin and dilated pupils.

D. polyuria and weak pulses.

C. mottled skin and dilated pupils.

29

Agents such as Celox, HemCon, and QuikClot are used to:

A. replace lost blood.

B. raise blood pressure.

C. promote hemostasis.

D. repair damaged vessels.

C. promote hemostasis.

30

Which of the following factors would have the MOST negative effect on the body's process of hemostasis?

A. Bradycardia

B. Chronic heroin use

C. Anticoagulant use

D. Hyperthermia

C. Anticoagulant use

31

Perfusion is defined as:

A. the circulation of an adequate volume of blood to ensure uninterrupted cerebral and myocardial oxygenation.

B. the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands.

C. the effective exchange of oxygen and carbon dioxide within the lungs and at the cellular level.

D. an ejection fraction that is adequate to maintain radial pulses or a systolic blood pressure of at least 90 mm Hg.

B. the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands.

32

A fall in blood pressure and the resultant changes in plasma osmolality cause the release of:

A. acetylcholine and angiotensin I.

B. aldosterone and antidiuretic hormone.

C. T3 and T4 from the thyroid gland.

D. glycogen and luteinizing hormone.

B. aldosterone and antidiuretic hormone.

33

Which of the following mechanisms of injury poses the LEAST threat for significant injury?

A. Death of an occupant in the same vehicle

B. Motorcycle crash at greater than 20 mph

C. Rear-end collision with restrained driver

D. Vehicular intrusion of greater than 12 inches

C. Rear-end collision with restrained driver

34

Which of the following types of medication would MOST likely reduce a patient's ability to compensate when in shock?

A. Beta-2 adrenergic agonists

B. Tricyclic antidepressants

C. Nasal decongestants

D. Calcium channel blockers

D. Calcium channel blockers

35

A motorcycle rider struck a parked car and was catapulted over the handlebars of his bike. Your assessment reveals that he is tachypneic, diaphoretic, and tachycardic. There is no gross external bleeding present. What is the MOST likely cause of this patient's clinical presentation?

A. Closed head injury

B. Sympathetic nervous system failure

C. Bilateral femur fractures

D. Proximal upper extremity fractures

C. Bilateral femur fractures