1.

The best way to control bleeding from an extremity is with:

A: bandaging.

B: a tourniquet and elevation.

C: direct pressure and elevation.

D: pressure on arterial pulse points.

2. Which of the following sets of vital signs would be MOST indicative of

internal bleeding?
A: BP, 140/90 mm Hg; pulse rate, 104 beats/min; dry skin

B: BP, 90/50 mm Hg; pulse rate, 66 beats/min; cool skin

C: BP, 100/62 mm Hg; pulse rate,112 beats/min; moist skin

D: BP, 160/78 mm Hg; pulse rate,124 beats/min; warm skin

3. A 69-year-old woman calls EMS because of a severe nosebleed.

Upon arrival, you note that the patient is leaning over a basin that
contains an impressive amount of blood. She states that she has a
history of diabetes, coronary artery disease, andmigraine headaches.
Her blood pressure is 170/100 mm Hg and her heart rate is 112
beats/min. Which of the following is the MOST contributive factor to
her nosebleed?
A: Her blood pressure

B: Her history of diabetes

C: The fact that she is elderly

D: Her heart rate of 112 beats/min

4. In providing treatment to a patient with internal bleeding, the EMT-B

must first:
A: ensure a patent airway.

B: control the bleeding.

C: assess the blood pressure.

D: put on a pair of gloves.

5. If a patient is bleeding from the lower extremities, you can control

bleeding using a:
 A: tourniquet.

B: pressure dressing.

C: PASG.

D: splint.

6. To appropriately record the time a tourniquet is applied, you must:

A: call medical control immediately after application.

B: write "applied at" and the time on the tourniquet once it has been
applied.
C: write the time of application in the patient's medical record at the
hospital.
D: write TK and the time of application on tape and place it on the
patient's forehead.

7. Which of the following is best used as a tourniquet?

A: Belt

B: Rope

C: Blood pressure cuff

D: Narrow strip of bandage

8. Venous bleeding is characterized by:

A: bright red blood flowing steadily from the wound.

B: bright red blood spurting from the wound.

C: dark maroon blood flowing steadily from the wound.

D: dark maroon blood spurting from the wound.

9. Which of the following components is NOT a part of the cardiovascular

system?
A: The alveoli

B: The pulmonary arteries

C: The coronary arteries

D: The capillary beds

10. Which of the following statements is true regarding the control of
external venous bleeding from an extremity?
A: Direct pressure is usually not effective in controlling bleeding.

B: Elevation and direct pressure should be accomplished together.

C: Pressure on a distal arterial point is very effective in controlling

bleeding.
D: Once bleeding has been controlled by direct pressure, a
tourniquet should be applied.

11. When managing a patient with a nosebleed (epistaxis), the BEST way
to prevent possible aspiration of blood is to:
A: place the patient supine with his or her head in the flexed
position.
B: tilt the patient's head forward while he or she is leaning forward.

C: tilt the patient's head forward while he or she is leaning

backward.
D: insert a nasopharyngeal airway and lean the patient back.

12. When applying a tourniquet to an amputated arm, the EMT-B should:

A: avoid applying the tourniquet over a joint.

B: use the narrowest bandage possible.

C: cover the tourniquet with a sterile bandage.

D: use rope to ensure that the tourniquet is tight.

13. A 50-year-old man was involved in a motor vehicle accident and has
sustained a fractured pelvis as well as bilateral femur fractures. His
blood pressure is 70/40 mm Hg; pulse rate is 130 beats/min, and
respirations are 28 breaths/min and shallow. The patient has a past
medical history of congestive heart failure and gout. Which of the
following is the BEST method of stabilizing this patient's fractures?
A: Apply and inflate the entire PASG.

B: Apply and inflate only the legs of the PASG.

C: Secure the patient to a long spineboard.

D: Apply two traction splints to the patient's legs.

 14. A 70-kg trauma patient without evidence of external bleeding is
displaying signs and symptoms of shock. At a minimum, you can
estimate that this patient has lost how much blood internally?
A: 650 mL

B: 725 mL

C: 980 mL

D: 1,200 mL

15. A patient was involved in a motorcycle accident and has sustained

multiple lacerations and abrasions. When assessing for bleeding,
which of the following injuries would have priority?
A: A 3" laceration to the forearm with dark red, freely flowing blood

B: Widespread abrasions to the patient's back with pinkish ooze

C: A 1" laceration to the patient's thigh with spurting, bright red

blood
D: A 4" laceration to the patient's forehead with dark red flowing
blood
ANSWERS:

NO ANS REASON

Reason: The best way to control bleeding from an extremity, and the least
1. C
damaging, is to use direct pressure and elevation. (ECTSI 8, p. 535)

Reason: Vital signs indicative of internal bleeding and shock include a

2. C decreasing blood pressure, tachycardia, and cold, moist (clammy) skin.
(ECTSI 8, p. 543)

Reason: Several conditions can result in bleeding from the nose and/or
mouth. These include skull fracture, facial injuries, sinusitis (inflamed
3. A
sinuses), high blood pressure, coagulation disorders, and digital trauma (ie
nose picking). (ECTSI 8, p. 540)

Reason: Body substance isolation (BSI) precautions are the first actions the
EMT-B should take in managing a patient with internal bleeding (or any
4. D
patient for that matter). Once this has been accomplished, assessment of
the ABCs should proceed. (ECTSI 8, p. 543)

Reason: If a patient has injuries and bleeding to the lower extremities, you
5. C may be able to use a pneumatic antishock garment to control bleeding and
minimize chances of shock. (ECTSI 8, p. 537)

Reason: After you apply a tourniquet, write TK and the time of application
6. D on a piece of adhesive tape. Then, securely fasten the tape to the patient's
forehead. (ECTSI 8, p. 540)
 Reason: Of the choices provided, the blood pressure cuff is the best item to
7. C use as a tourniquet because it is the widest. Narrow tourniquets cause more
injury to the tissues they are constricting. (ECTSI 8, p. 539)

Reason: Venous bleeding is characteristically dark red and flows steadily

8. C
from a wound. (ECTSI 8, p. 534)

Reason: The cardiovascular system includes the heart, arteries, veins, and
9. A
interconnecting capillaries. (ECTSI 8, p. 531)

Reason: Elevating a bleeding extremity by as little as 6" often stops venous

bleeding. Whenever possible, use both elevation and direct pressure. In
10. B
most cases, this will stop the bleeding. However, if it does not, you still have
more options. (ECTSI 8, p. 535)

Reason: Leaning forward, with the head tilted forward, will stop blood from
11. B
trickling down the throat or being aspirated into the lungs. (ECTSI 8, p. 541)

Reason: Whenever you apply a tourniquet, you should never apply it

directly over a joint. You should use the widest bandage possible and make
12. A sure it is secured tightly. Never use wire, rope, a belt, or any other narrow
material, as it could cut the skin. The tourniquet should never be covered
with a bandage. Leave it open and in full view. (ECTSI 8, p. 540)

Reason: The PASG can be used to stabilize pelvic and proximal femur
fractures; however, their use is contraindicated in patients with pulmonary
edema of cardiac origin or acute heart failure. The pressure from the
garment would result in more blood backing up into the lungs than what is
13. C
already there. The application of two traction splints would not be practical
due to the patient's unstable condition as well as his fractured pelvis. The
most effective and fastest way to immobilize these fractures would be to
secure the patient to a long spineboard.

Reason: The body will not tolerate an acute blood loss of greater than 20%
of blood volume. The typical adult has approximately 70 mL of blood per
kilogram of body weight. A 70-kg patient, who is displaying signs and
14. C
symptoms of shock, has lost approximately 980 mL of blood volume (70 kg
70 mL = 4,900 mL of total blood volume 20% = 980 mL of blood). (ECTSI 8,
p. 534)

Reason: Typically, bleeding from an open artery is bright red (high in

oxygen) and spurts in time with the pulse. The pressure that causes the
15. C blood to spurt also makes this type of bleeding difficult to control. Blood loss
from an artery is much faster than that of a vein or capillary. (ECTSI 8, p.
534)