Name: __________________________ Date: _____________



1.
If direct pressure with a sterile dressing fails to immediately stop severe bleeding from an extremity, you should apply:
A.
additional sterile dressings.
B.
a splint and elevate the extremity.
C.
a tourniquet proximal to the injury.
D.
digital pressure to a proximal artery.


2.
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.
preparing for immediate transport.
B.
applying oxygen via nasal cannula.
C.
performing a focused physical exam.
D.
a detailed assessment of his abdomen.


3.
What is the approximate blood volume of a 75-kg adult?
A.
5.25 L
B.
5.50 L
C.
6.25 L
D.
6.50 L


4.
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.
body's temperature is considerably less than 98.6°F (37.0°C).
C.
systolic arterial blood pressure is at least 60 mm Hg.
D.
heart rate is maintained at more than 100 beats/min.


5.
The severity of bleeding should be based on all of the following findings, EXCEPT:
A.
systolic blood pressure.
B.
poor general appearance.
C.
the mechanism of injury.
D.
clinical signs and symptoms.


6.
Which of the following organs can tolerate inadequate perfusion for up to 2 hours?
A.
brain
B.
heart
C.
kidneys
D.
skeletal muscle


7.
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.
Direct contact with the environment prevents blood from clotting.
D.
A person taking aspirin will experience slower blood clotting.


8.
A fractured femur can result in the loss of ______ or more of blood into the soft tissues of the thigh.
A.
250 mL
B.
500 mL
C.
1 L
D.
2 L


9.
Perfusion is MOST accurately defined as the:
A.
effective transfer of oxygen from the venules across the systemic capillary membrane walls.
B.
ability of the systemic arteries to constrict as needed to maintain an adequate blood pressure.
C.
effective removal of carbon dioxide and other metabolic waste products from the body's cells.
D.
circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.


10.
In which of the following situations would external bleeding be the MOST difficult to control?
A.
femoral artery laceration and a blood pressure of 140/90 mm Hg
B.
jugular vein laceration and a systolic blood pressure of 90 mm Hg
C.
carotid artery laceration and a systolic blood pressure of 60 mm Hg
D.
antecubital vein laceration and a blood pressure of 138/92 mm Hg


11.
You arrive at the home of a 50-year-old female with severe epistaxis. As you are treating her, it is MOST important to recall that:
A.
the patient may be significantly hypertensive.
B.
the patient is at risk for vomiting and aspiration.
C.
a detailed exam is needed to determine the cause.
D.
many medications interfere with blood clotting.


12.
A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Appropriate treatment for this patient includes:
A.
having the patient pinch his own nostrils and then lie supine.
B.
pinching the patient's nostrils and having him lean forward.
C.
placing a rolled 4″ × 4″ dressing between his lower lip and gum.
D.
packing both nostrils with gauze pads until the bleeding stops.


13.
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.
vacuum splint
C.
sling and swathe
D.
cardboard splint


14.
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.
an intact system of blood vessels
C.
adequate blood in the vasculature
D.
the filtering of blood cells in the spleen


15.
Gastrointestinal bleeding should be suspected if a patient presents with:
A.
dyspnea.
B.
hematuria.
C.
hemoptysis.
D.
hematemesis.


16.
When using a stick and square knot as a tourniquet to control severe bleeding from an amputated arm, the EMT should:
A.
cover the tourniquet with a sterile dressing.
B.
stop twisting the stick when the bleeding stops.
C.
twist the stick until the radial pulse disappears.
D.
remove the tourniquet if the bleeding has stopped.


17.
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.


18.
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.
obtain baseline vital signs.
B.
apply a nonrebreathing mask.
C.
perform a secondary assessment.
D.
assist the patient's ventilations.


19.
Hypovolemic shock occurs when:
A.
the clotting ability of the blood is enhanced.
B.
the body cannot compensate for rapid blood loss.
C.
the patient's systolic blood pressure is less than 100 mm Hg.
D.
at least 10% of the patient's blood volume is lost.


20.
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.


21.
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.
spleen.
C.
pancreas.
D.
gallbladder.


22.
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.
ensure the patient has a patent airway.
B.
control the bleeding with direct pressure.
C.
apply oxygen with a nonrebreathing mask.
D.
apply a tourniquet proximal to the wound.


23.
As red blood cells begin to clump together to form a clot, __________ reinforces the clumped red blood cells.
A.
fibrin
B.
plasma
C.
fibrinogen
D.
plasminogen


24.
Early signs and symptoms of intra-abdominal bleeding include:
A.
bruising only.
B.
pain and distention.
C.
widespread ecchymosis.
D.
significant hypotension.


25.
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.
100 mL
C.
150 mL
D.
200 mL


26.
Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume.
A.
5%
B.
10%
C.
15%
D.
20%


27.
Bleeding from the nose following head trauma:
A.
is a sign of a skull fracture and should not be stopped.
B.
should be controlled by packing the nostril with gauze.
C.
should be assumed to be caused by a fractured septum.
D.
is usually due to hypertension caused by the head injury.


28.
Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that:
A.
you should try to control the bleeding by applying pressure to a proximal arterial pressure point first.
B.
the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released.
C.
bulky dressings should be securely applied over the tourniquet to further assist in controlling the bleeding.
D.
the tourniquet should be applied directly over a joint if possible because this provides better bleeding control.


29.
Which of the following statements regarding hemophilia is correct?
A.
Hemophilia is defined as a total lack of platelets.
B.
Patients with hemophilia may bleed spontaneously.
C.
Hemophiliacs take aspirin to enhance blood clotting.
D.
Approximately 25% of the population has hemophilia.


30.
The systemic veins function by:
A.
returning deoxygenated blood back to the heart.
B.
delivering oxygen-poor blood to the capillaries.
C.
returning oxygen-rich blood back to the left atrium.
D.
delivering deoxygenated blood to the capillaries.


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