PVS & lymphatic system ch. 20 ?s

Question 1

Which of these statements is true regarding the arterial system?
A) Arteries are large-diameter vessels.
B) The arterial system is a high-pressure system.
C) The walls of arteries are thinner than those of veins.
D) Arteries can expand greatly to accommodate a large blood volume increase

Answer 1

B) The arterial system is a high-pressure system.

Question 2

The nurse is reviewing the blood supply to the arm. The major artery supplying the arm is the \_\_\_\_\_ artery.
A) ulnar 
B) radial 
C) brachial 
D) deep palmar

Answer 2

C) brachial

Question 3

The nurse is preparing to assess the dorsalis pedis artery. Where is the correct location for palpation?
A) Behind the knee
B) Over the lateral malleolus
C) In the groove behind the medial malleolus
D) Lateral to the extensor tendon of the great toe

Answer 3

D) Lateral to the extensor tendon of the great toe

Question 4

A 65-year-old patient is experiencing pain in his left calf when he exercises that disappears after resting for a few minutes. The nurse recognizes that this description is most consistent with ___ the left leg.
A) venous obstruction of
B) claudication due to venous abnormalities in
C) ischemia caused by partial blockage of an artery supplying
D) ischemia caused by complete blockage of an artery supplying

Answer 4

C) ischemia caused by partial blockage of an artery supplying

Question 5

The nurse is reviewing venous blood flow patterns. Which of these statements best describes the mechanism(s) by which venous blood returns to the heart?
A) Intraluminal valves ensure unidirectional flow toward the heart.
B) Contracting skeletal muscles milk blood distally toward the veins.
C) The high-pressure system of the heart helps to facilitate venous return.
D) Increased thoracic pressure and decreased abdominal pressure facilitate venous return to the heart.

Answer 5

A) Intraluminal valves ensure unidirectional flow toward the heart.

Question 6

Which of these veins are responsible for most of the venous return in the arm?
A) Deep 
B) Ulnar 
C) Subclavian 
D) Superficial

Answer 6

D) Superficial

Question 7

A 70-year-old patient is scheduled for open-heart surgery. The surgeon plans to use the great saphenous vein for the coronary bypass grafts. The patient asks, “What happens to my circulation when the veins are removed?” The nurse should reply:
A) “Venous insufficiency is a common problem after this type of surgery.”
B) “Oh, we have lots of veins—you won’t even notice that it has been removed.”
C) “You will probably experience decreased circulation after the veins are removed.”
D) “Because the deeper veins in your leg are in good condition, this vein can be removed without harming your circulation.”

Answer 7

D) “Because the deeper veins in your leg are in good condition, this vein can be removed without harming your circulation.”

Question 8

The nurse is reviewing risk factors for venous disease. Which of these situations best describes a person at highest risk for development of venous disease?
A) Woman in her second month of pregnancy
B) Person who has been on bed rest for 4 days
C) Person with a 30-year, 1 pack per day smoking history
D) Elderly person taking anticoagulant medication

Answer 8

B) Person who has been on bed rest for 4 days

Question 9

The nurse is teaching a review class on the lymphatic system. A participant shows correct understanding of the material with which statement?
A) “Lymph flow is propelled by the contraction of the heart.”
B) “The flow of lymph is slow compared with that of the blood.”
C) “One of the functions of the lymph is to absorb lipids from the biliary tract.”
D) “Lymph vessels have no valves, so there is a free flow of lymph fluid from the tissue spaces into the bloodstream.”

Answer 9

B) “The flow of lymph is slow compared with that of the blood.”

Question 10

When performing an assessment of a patient, the nurse notices the presence of an enlarged right epitrochlear lymph node. What should the nurse do next?
A) Assess the patient’s abdomen, and notice any tenderness.
B) Carefully assess the cervical lymph nodes, and check for any enlargement.
C) Ask additional history questions regarding any recent ear infections or sore throats.
D) Examine the patient’s lower arm and hand, and check for the presence of infection or lesions.

Answer 10

D) Examine the patient’s lower arm and hand, and check for the presence of infection or lesions.

Question 11

A 35-year-old man is seen in the clinic for an infection in his left foot. Which of these findings should the nurse expect to see during an assessment of this patient?
A) Hard and fixed cervical nodes
B) Enlarged and tender inguinal nodes
C) Bilateral enlargement of the popliteal nodes
D) “Pellet-like” nodes in the supraclavicular region

Answer 11

B) Enlarged and tender inguinal nodes

Question 12

During an assessment of an older adult, the nurse should expect to notice which finding as a normal physiologic change associated with the aging process?
A) Hormonal changes causing vasodilation and a resulting drop in blood pressure
B) Progressive atrophy of the intramuscular calf veins, causing venous insufficiency
C) Peripheral blood vessels growing more rigid with age, producing a rise in systolic blood pressure
D) Narrowing of the inferior vena cava, causing low blood flow and increases in venous pressure resulting in varicosities

Answer 12

C) Peripheral blood vessels growing more rigid with age, producing a rise in systolic blood pressure

Question 13

A 67-year-old patient states that he recently began to have pain in his left calf when climbing the 10 stairs to his apartment. This pain is relieved by sitting for about 2 minutes; then he is able to resume his activities. The nurse interprets that this patient is most likely experiencing:
A) claudication.
B) sore muscles.
C) muscle cramps.
D) venous insufficiency

Answer 13

A) claudication

Question 14

A patient complains of leg pain that wakes him at night. He states that he “has been having problems” with his legs. He has pain in his legs when they are elevated that disappears when he dangles them. He recently noticed “a sore” on the inner aspect of the right ankle. On the basis of this history information, the nurse interprets that the patient is most likely experiencing:
A) pain related to lymphatic abnormalities.
B) problems related to arterial insufficiency.
C) problems related to venous insufficiency.
D) pain related to musculoskeletal abnormalities.

Answer 14

B) problems related to arterial insufficiency.

Question 15

During an assessment, the nurse uses the “profile sign” to detect:
A) pitting edema.
B) early clubbing.
C) symmetry of the fingers.
D) insufficient capillary refill.

Answer 15

B) early clubbing.

Question 16

The nurse is performing an assessment on an adult. The adult’s vital signs are normal and capillary refill time is 5 seconds. What should the nurse do next?
A) Ask the patient about a past history of frostbite.
B) Suspect that the patient has a venous insufficiency problem.
C) Consider this a delayed capillary refill time and investigate further.
D) Consider this a normal capillary refill time that requires no further assessment.

Answer 16

C) Consider this a delayed capillary refill time and investigate further.

Question 17

When assessing a patient the nurse notes that the left femoral pulse as diminished, 1+/4+. What should the nurse do next?
A) Document the finding.
B) Auscultate the site for a bruit.
C) Check for calf pain.
D) Check capillary refill in the toes.

Answer 17

B) Auscultate the site for a bruit.

Question 18

When performing a peripheral vascular assessment on a patient, the nurse is unable to palpate the ulnar pulses. The patient’s skin is warm and capillary refill time is normal. The nurse should next:
A) check for the presence of claudication.
B) refer the individual for further evaluation.
C) consider this a normal finding and proceed with the peripheral vascular evaluation.
D) ask the patient if he or she has experienced any unusual cramping or tingling in the arm.

Answer 18

C) consider this a normal finding and proceed with the peripheral vascular evaluation.

Question 19

The nurse is assessing the pulses of a patient who has been admitted for untreated hyperthyroidism. The nurse should expect to find a(n) \_\_\_\_\_ pulse.
A) normal 
B) absent 
C) bounding 
D) weak, thready

Answer 19

C) bounding

Question 20

The nurse is preparing to perform a modified Allen test. Which is an appropriate reason for this test?
A) To measure the rate of lymphatic drainage
B) To evaluate the adequacy of capillary patency before venous blood draws
C) To evaluate the adequacy of collateral circulation before cannulating the radial artery
D) To evaluate the venous refill rate that occurs after the ulnar and radial arteries are temporarily occluded

Answer 20

C) To evaluate the adequacy of collateral circulation before cannulating the radial artery

Question 21

A patient has a positive Homans’ sign. The nurse knows that a positive Homans’ sign may indicate:
A) venous insufficiency.
B) deep vein thrombosis.
C) severe edema.
D) problems with arterial circulation

Answer 21

B) deep vein thrombosis.

Question 22

A patient has been diagnosed with venous stasis. Which of these findings would the nurse most likely observe?
A) A unilateral cool foot
B) Thin, shiny, atrophic skin
C) Pallor of the toes and cyanosis of the nail beds
D) A brownish discoloration to the skin of the lower leg

Answer 22

D) A brownish discoloration to the skin of the lower leg

Question 23

The nurse is attempting to assess the femoral pulse in an obese patient. Which of these actions would be most appropriate?
A) Have the patient assume a prone position.
B) Ask the patient to bend his or her knees to the side in a froglike position.
C) Press firmly against the bone with the patient in a semi-Fowler position.
D) Listen with a stethoscope for pulsations because it is very difficult to palpate the pulse in an obese person

Answer 23

B) Ask the patient to bend his or her knees to the side in a froglike position.

Question 24

When auscultating over a patient’s femoral arteries the nurse notices the presence of a bruit on the left side. The nurse knows that:
A) bruits are often associated with venous disease.
B) bruits occur in the presence of lymphadenopathy.
C) hypermetabolic states will cause bruits in the femoral arteries.
D) bruits occur with turbulent blood flow, indicating partial occlusion

Answer 24

D) bruits occur with turbulent blood flow, indicating partial occlusion

Question 25

How should the nurse document mild, slight pitting edema present at the ankles of a pregnant patient?
A) 1+/0-4+
B) 3+/0-4+
C) 4+/0-4+
D) Brawny edema

Answer 25

A) 1+/0-4+

Question 26

A patient has hard, nonpitting edema of the left lower leg and ankle. The right leg has no edema. Based on these findings, the nurse recalls that:
A) nonpitting, hard edema occurs with lymphatic obstruction.
B) alterations in arterial function will cause this edema.
C) phlebitis of a superficial vein will cause bilateral edema.
D) long-standing arterial obstruction will cause pitting edema.

Answer 26

A) nonpitting, hard edema occurs with lymphatic obstruction.

Question 27

When assessing a patient’s pulse, the nurse notes that the amplitude is weaker during inspiration and stronger during expiration. When the nurse measures the blood pressure, the reading decreases 20 mm Hg during inspiration and increases with expiration. This patient is experiencing pulsus:
A) alternans.
B) bisferiens.
C) bigeminus.
D) paradoxus

Answer 27

D) paradoxus

Question 28

The nurse is performing a peripheral vascular assessment on a bedridden patient and notices the following findings in the right leg: increased warmth, swelling, redness, tenderness to palpation, and a positive Homan’s sign. The nurse should:
A) reevaluate the patient in a few hours.
B) consider this a normal finding for a bedridden patient.
C) seek emergency referral because of the risk of pulmonary embolism.
D) ask the patient to raise his leg off of the bed and check for pain on elevation

Answer 28

C) seek emergency referral because of the risk of pulmonary embolism.

Question 29

During an assessment the nurse has elevated a patient’s legs 12 inches off the table and has had him wag his feet to drain off venous blood. After helping him to sit up and dangle his legs over the side of the table, the nurse should expect a normal finding at this point would be:
A) marked elevational pallor.
B) venous filling within 15 seconds.
C) no change in coloration of the skin.
D) color returning to the feet within 20 seconds of assuming a sitting position

Answer 29

B) venous filling within 15 seconds.

Question 30

The nurse is preparing to perform a manual compression test on a patient. Which of these statements is true about this procedure?
A) Rapid filling of the veins indicates incompetent veins.
B) Competent valves in the veins will transmit a wave to the distal fingers.
C) A palpable wave transmission occurs when the valves are incompetent.
D) The test assesses whether the valves of varicosity are competent when the person is in the supine position.

Answer 30

C) A palpable wave transmission occurs when the valves are incompetent.

Question 31

During an assessment, the nurse notices that a patient’s left arm is swollen from the shoulder down to the fingers, with nonpitting brawny edema. The right arm is normal. The patient had a left-sided mastectomy 1 year ago. The nurse suspects which problem?
A) Venous stasis
B) Lymphedema
C) Arteriosclerosis
D) Deep vein thrombosis

Answer 31

B) Lymphedema

Question 32

The nurse is preparing to assess the ankle-brachial index (ABI) of a patient. Which statement about the ABI is true?
A) Normal ABI indices are from 0.50 to 1.0.
B) The normal ankle pressure is slightly lower than the brachial pressure.
C) The ABI is a reliable measurement of peripheral vascular disease in diabetic individuals.
D) An ABI of 0.90 to 0.70 indicates the presence of peripheral vascular disease and mild claudication.

Answer 32

D) An ABI of 0.90 to 0.70 indicates the presence of peripheral vascular disease and mild claudication.

Question 33

When using a Doppler ultrasonic stethoscope, the nurse recognizes venous flow when which sound is heard?
A) Low humming sound
B) Regular “lub, dub” pattern
C) Swishing, whooshing sound
D) Steady, even, flowing sound

Answer 33

C) Swishing, whooshing sound

Question 34

The nurse is describing a weak, thready pulse on the documentation flow sheet. Which statement is correct?
A) “Easily palpable, pounds under the fingertips.”
B) “Greater than normal force, then collapses suddenly.”
C) “Hard to palpate, may fade in and out, easily obliterated by pressure.”
D) “Rhythm is regular, but force varies with alternating beats of large and small amplitude.”

Answer 34

C) “Hard to palpate, may fade in and out, easily obliterated by pressure.”

Question 35

During an assessment, a patient tells the nurse that her fingers often change color when she goes out in cold weather. She describes these episodes as her fingers first turning white, then blue, then red with a burning, throbbing pain. The nurse suspects that she is experiencing:
A) lymphedema.
B) Raynaud’s disease.
C) deep vein thrombosis.
D) chronic arterial insufficiency

Answer 35

B) Raynaud’s disease.

Question 36

During a routine office visit, a patient takes off his shoes and shows the nurse “this awful sore that won’t heal.” On inspection, the nurse notes a 3-cm round ulcer on the left great toe, with a pale ischemic base, well-defined edges, and no drainage. The nurse should assess for other signs and symptoms of:
A) varicosities.
B) a venous stasis ulcer.
C) an arterial ischemic ulcer.
D) deep vein thrombophlebitis

Answer 36

C) an arterial ischemic ulcer.

Question 37

The nurse is reviewing an assessment of a patient’s peripheral pulses and notices that the documentation states that the radial pulses are “2+.” The nurse recognizes that this reading indicates what type of pulse?
A) Bounding
B) Normal
C) Weak
D) Absent

Answer 37

B) Normal