Chapter 16: Blood Vessels

Question 1

1. Induration, edema, and hyperpigmentation are common associated findings with which of the following?
   a. Peripheral arterial disease
   b. Venous ulcer
   c. Arterial embolic disease
   d. Venous thrombus

Answer 1

b. Venous ulcer

Question 2

2. The most prominent component of the jugular venous pulse is the
   a. a wave.
   b. c wave.
   c. v wave.
   d. x slope

Answer 2

a. a wave.

Question 3

3. During a routine prenatal visit, Ms. T was noted as having dependent edema, varicosities of the legs, and hemorrhoids. She expressed concern about these symptoms. You explain to Ms. T that her enlarged uterus is compressing her pelvic veins and her inferior vena cava. You would further explain that these findings
   a. are usual conditions during pregnancy.
   b. indicate a need for hospitalization.
   c. indicate the need for amniocentesis.
   d. suggest that she is having twins.

Answer 3

a. are usual conditions during pregnancy.

Question 4

4. Vascular changes expected in the older adult include
   a. loss of vessel elasticity.
   b. decreased peripheral resistance.
   c. decreased pulse pressure.
   d. constriction of the aorta and major bronchi.

Answer 4

a. loss of vessel elasticity

Question 5

5. You are examining Mr. S, a 79-year-old diabetic man complaining of claudication. Which of
   the following physical findings is consistent with the diagnosis of peripheral arterial disease?
   a. Thick, calloused skin
   b. Ruddy, thin skin
   c. Warmer temperature of extremity in contrast to other body parts
   d. Loss of hair over the extremities

Answer 5

d. Loss of hair over the extremities

Question 6

6. You are performing a physical examination on a 46-year-old male patient. His examination findings include the following: positive peripheral edema, holosystolic murmur in the tricuspid region, and a pulsatile liver. His diagnosis is
   a. an aortic aneurysm.
   b. an arteriovenous fistula.
   c. tricuspid stenosis.
   d. tricuspid regurgitation.

Answer 6

d. tricuspid regurgitation.

Question 7

7. A characteristic distinguishing primary Raynaud phenomenon from secondary Raynaud phenomenon includes which of the following?
   a. Vasospasm
   b. Digital ischemia with pain
   c. Triphasic demarcated skin
   d. Cold and achy improving with warming

Answer 7

b. Digital ischemia with pain

Question 8

8. In children, coarctation of the aorta should be suspected if you detect
   a. a delay between the radial and femoral pulses.
   b. a simultaneous radial and femoral pulse.
   c. an absent femoral pulse on the left.
   d. bilateral absence of femoral pulses.

Answer 8

a. a delay between the radial and femoral pulses.

Question 9

9. Which of the following statements is true regarding the development of venous ulcers in older adults?
   a. The major symptom is severe leg pain, especially when walking.
   b. The affected leg is commonly pale and hairless, and pulses are difficult to palpate.
   c. Diabetes, peripheral neuropathy, and nutritional deficiencies are causative factors.
   d. The ulcers are generally located on the tips of toes.

Answer 9

c. Diabetes, peripheral neuropathy, and nutritional deficiencies are causative factors.

Question 10

10. When examining arterial pulses, the thumb may be used
    a. especially if vessels have a tendency to move.
    b. never for palpating pulses.
    c. checking the jugular venous pressure.
    d. during the Allen test.

Answer 10

a. especially if vessels have a tendency to move.

Question 11

11. To assess a patient’s jugular veins, the patient should first be placed in which position?
    a. Supine
    b. Semi-Fowler
    c. Upright
    d. Left lateral recumbent

Answer 11

a. Supine

Question 12

12. Observation of hand veins can facilitate the assessment of
    a. mitral valve competency.
    b. a heart murmur.
    c. right heart pressure.
    d. left heart pressure.

Answer 12

c. right heart pressure.

Question 13

13. You are assessing Mr. Z’s fluid volume status as a result of heart failure. If your finger depresses a patient’s edematous ankle to a depth of 6 mm, you should record this pitting as
    a. 1+.
    b. 2+.
    c. 3+.
    d. 4+.

Answer 13

c. 3+.

Question 14

14. A bounding pulse in an infant may be associated with
    a. patent ductus arteriosus.
    b. coarctation of the aorta.
    c. decreased cardiac output.
    d. peripheral vaso-occlusion.

Answer 14

a. patent ductus arteriosus.

Question 15

15. In infants or small children, a capillary refill time of 4 seconds
    a. is normal.
    b. indicates hypervolemia.
    c. indicates dehydration or hypovolemic shock.
    d. indicates renal artery stenosis.

Answer 15

c. indicates dehydration or hypovolemic shock.

Question 16

16. A venous hum heard over the internal jugular vein of a child
    a. usually signifies untreatable illness.
    b. usually has no pathologic significance.
    c. usually requires surgical intervention.
    d. must be monitored until the child is grown.

Answer 16

b. usually has no pathologic significance.

Question 17

17. You are palpating bilateral pedal pulses and cannot feel one of the pulses. The feet are equally warm. You find that both great toes are pink, with a capillary refill within 2 seconds. Which of the following statements is correct?
    a. Immediate emergency surgery is indicated.
    b. Pedal pulses are not always palpable.
    c. Unilateral pulses are never normal.
    d. Venogram studies will be needed.

Answer 17

b. Pedal pulses are not always palpable.

Question 18

1. When palpating the carotid artery, which of the following is most important? (Select all that apply.)
   a. Rotate the patient’s head to the side being examined to relax the sternocleidomastoid.
   b. Excessive carotid sinus massage can compromise blood flow to the brain.
   c. Excessive carotid sinus massage can cause slowing of the pulse.
   d. Palpate both sides simultaneously.

Answer 18

a. Rotate the patient’s head to the side being examined to relax the sternocleidomastoid.
b. Excessive carotid sinus massage can compromise blood flow to the brain.
c. Excessive carotid sinus massage can cause slowing of the pulse.

Question 19

2. Which are risk factors for varicose veins? (Select all that apply.)
   a. Gender
   b. Alcohol use
   c. Lower extremity trauma
   d. Increased body mass
   e. Hypertension
   f. Diabetes

Answer 19

a. Gender
c. Lower extremity trauma
d. Increased body mass