Which sign suggests later stages of blood loss?

• A. Rapid, regular and thready pulse
• B. Severe hypertension
• C. Bradypnea
• D. Warm extremities

Answer: (A)

As blood loss progresses, the body can still push the heart to beat faster to maintain perfusion, so the pulse may become rapid. But with substantial volume loss, the force of each heartbeat weakens, making the pulse feel very faint and thin—described as a thready pulse—while the rhythm can remain regular. This combination signals the late stage of hypovolemia when compensatory mechanisms are failing and perfusion to vital organs is deteriorating.

Other signs don’t fit: severe hypertension would be unlikely after significant blood loss, due to reduced circulating volume. Bradypnea would not occur; the body typically rate-tunes breathing up (tachypnea) to compensate for metabolic acidosis and hypoxia. Warm extremities are more consistent with adequate perfusion or other shock types; in late blood loss, extremities are usually cold and clammy from peripheral vasoconstriction.