SOLVED

41) Septic shock results from massive infection releasing what substances into the vascular system? A) Toxins B) Lactic acid C) Catecholamines D) Aldosterone 42) Which of the following statements about the patient in neurogenic shock is NOT true? A) Signs of hypovolemic shock may be masked. B) Unopposed sympathetic nervous stimulation results in generalized pallor and diaphoresis. C) The heart rate may be normal. D) Neurogenic shock may be temporary, even if spinal cord damage is permanent. 43) 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? A) Relative to body size, this patient can tolerate a larger amount of hemorrhage before showing signs of shock. B) This patient will tolerate blood loss well, as only nonvital tissues will become ischemic. C) Relative to body weight, a smaller amount of hemorrhage may result in shock. D) Blood volume increases proportionally with body weight, and the patient will experience signs of shock consistent with the classic stages of hemorrhage. 44) Which of the following fluids is appropriate for the prehospital management of hypovolemic shock? A) Five percent dextrose in water B) Lactated Ringer’s C) A 0.2% sodium chloride solution D) A 0.45% sodium chloride solution 45) Which of the following would be the most likely cause of neurogenic shock? A) Pericardial tamponade B) Spinal cord injury C) Systemic infection D) Massive histamine release 46) Rapid volume replacement is best achieved under which of the following conditions? A) Use of a long catheter with a large internal diameter B) Use of a long catheter with a small internal diameter C) Use of a short catheter with a small internal diameter D) Use of a short catheter with a large internal diameter 47) Which of the following vessels has the greatest ability to change diameter? A) Arterioles B) Capillaries C) Systemic arteries D) Aorta 48) Your patient is a 29-year-old male 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. This patient is exhibiting signs and symptoms consistent with a Class ________ hemorrhage. A) III B) II C) IV D) I 49) Which of the following early signs of shock is easily missed? A) Tachycardia B) Decrease in respiratory rate and volume C) Decrease in blood pressure D) Narrowing pulse pressure 50) Which of the following is TRUE of the elderly trauma patient? A) The elderly trauma patient is more likely to experience myocardial ischemia as a result of hemorrhage. B) Medications like beta-blockers may interfere with normal compensatory mechanisms. C) Hemorrhage may not result in tachycardia as expected. D) All of the above are true. 51) Your patient is a 24-year-old male who was struck just below the left scapula with a 3-inch diameter metal pipe. He is awake but having difficulty breathing. His pulse is 112 at the radial artery, and his respiratory rate is 28 per minute and shallow. His breath sounds are present bilaterally but diminished on the left. He has a blood pressure of 108/68. The patient is coughing up some bloody sputum. He has no other complaints, and a rapid trauma survey reveals no additional life-threatening injuries. Which of the following represents the best sequence of intervention for this patient? A) Begin transport immediately, oxygen 15 lpm by nonrebreathing mask, a large-bore IV of isotonic solution to maintain a systolic blood pressure of 120 mmHg or greater B) Oxygen 10–12 lpm by nonrebreathing mask, a large-bore IV of normal saline solution at a keep-open rate, transport C) Oxygen, 15 lpm by nonrebreathing mask, begin transport, a 14-gauge IV of lactated Ringer’s solution, wide open D) Oxygen 10–12 lpm by nonrebreathing mask, begin transport, 16-gauge IV at a keep-open rate 52) Which of the following is NOT a characteristic of arterial bleeding? A) Rapid blood loss B) Spurting or pumping as it leaves the body C) Clots quickly on its own D) Bright red 53) 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? A) Rapid heart rate and anxiety B) Rapidly dropping blood pressure C) Rapid breathing and air hunger D) Rapidly dropping level of responsiveness 54) Which of the following represents the correct sequence for controlling hemorrhage from an extremity? A) Direct pressure on the dressing and wound, finger pressure through the dressing to the leaking vessel, and, if pressure fails, application of a tourniquet B) Direct pressure on the dressing and wound, elevation, ice C) Finger pressure through the dressing to the leaking vessel, splinting, ice, elevation D) Direct pressure on the dressing and wound , elevation, ice, tourniquet as a last resort 55) Which of the following terms is best described as the loss of blood from the vascular space? A) Hypovolemia B) Hemorrhage C) Hemostasis