Question 1

The nurse is reviewing the risk factors for venous disease.Which of these situations best describes a person at highest risk for the development of venous disease?

Accepted Answer

People who undergo prolonged standing,sitting,or bed rest are at risk for venous disease.Hypercoagulable (not anticoagulated)states and vein-wall trauma also place the person at risk for venous disease.Obesity and the late months of pregnancy are also risk factors.

Question 2

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 this vein is removed?" The nurse should reply:

Accepted Answer

As long as the femoral and popliteal veins remain intact,the superficial veins can be excised without harming circulation.The other responses are not correct.

Question 3

The nurse is teaching a review class on the lymphatic system.A participant shows correct understanding of the material with which statement?

Accepted Answer

The flow of lymph is slow,compared with flow of the blood.Lymph flow is not propelled by the heart but rather by contracting skeletal muscles,pressure changes secondary to breathing,and contraction of the vessel walls.Lymph does not absorb lipids from the biliary tract.The vessels do have valves; therefore,flow is one way from the tissue spaces to the bloodstream.

Question 4

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.

Accepted Answer

A full,bounding pulse occurs with hyperkinetic states (e.g.,exercise,anxiety,fever),anemia,and hyperthyroidism.An absent pulse occurs with occlusion.Weak,thready pulses occur with shock and peripheral artery disease.

Question 5

The nurse is examining the lymphatic system of a healthy 3-year-old child.Which finding should the nurse expect?

Accepted Answer

Lymph nodes are relatively large in children,and the superficial ones are often palpable even when the child is healthy.

Question 6

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 health history information,the nurse interprets that the patient is most likely experiencing:

Accepted Answer

Night leg pain is common in aging adults and may indicate the ischemic rest pain of peripheral vascular disease.Alterations in arterial circulation cause pain that becomes worse with leg elevation and is eased when the extremity is dangled.

Question 7

During an assessment,the nurse uses the profile sign to detect:

Accepted Answer

The nurse should use the profile sign (viewing the finger from the side)to detect early clubbing.

Question 8

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?

Accepted Answer

Normal capillary refill time is less than 1 to 2 seconds.The following conditions can skew the findings: a cool room,decreased body temperature,cigarette smoking,peripheral edema,and anemia.

Question 9

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?

Accepted Answer

The inguinal nodes in the groin drain most of the lymph of the lower extremities.With local inflammation,the nodes in that area become swollen and tender.

Question 10

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?

Accepted Answer

Blood moves through the veins by (1)contracting skeletal muscles that proximally milk the blood; (2)pressure gradients caused by breathing,during which inspiration makes the thoracic pressure decrease and the abdominal pressure increase; and (3)the intraluminal valves,which ensure unidirectional flow toward the heart.

Question 11

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.

Accepted Answer

Ischemia is a deficient supply of oxygenated arterial blood to a tissue.A partial blockage creates an insufficient supply,and the ischemia may be apparent only during exercise when oxygen needs increase.

Question 12

When assessing a patient,the nurse notes that the left femoral pulse as diminished,1+/4+.What should the nurse do next?

Accepted Answer

If a pulse is weak or diminished at the femoral site,then the nurse should auscultate for a bruit.The presence of a bruit,or turbulent blood flow,indicates partial occlusion.The other responses are not correct.

Question 13

Which statement is true regarding the arterial system?

Accepted Answer

The pumping heart makes the arterial system a high-pressure system.

Question 14

Which vein(s)is(are)responsible for most of the venous return in the arm?

Accepted Answer

The superficial veins of the arms are in the subcutaneous tissue and are responsible for most of the venous return.

Question 15

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?

Accepted Answer

The epitrochlear nodes are located in the antecubital fossa and drain the hand and lower arm.The other actions are not correct for this assessment finding.

Question 16

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?

Accepted Answer

Peripheral blood vessels grow more rigid with age,resulting in a rise in systolic blood pressure.Aging produces progressive enlargement of the intramuscular calf veins,not atrophy.The other options are not correct.

Question 17

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 approximately 2 minutes; then he is able to resume his activities.The nurse interprets that this patient is most likely experiencing:

Accepted Answer

Intermittent claudication feels like a cramp and is usually relieved by rest within 2 minutes.The other responses are not correct.

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.Next,the nurse should:

Accepted Answer

Palpating the ulnar pulses is not usually necessary.The ulnar pulses are not often palpable in the normal person.The other responses are not correct.

Question 19

The nurse is preparing to assess the dorsalis pedis artery.Where is the correct location for palpation?

Accepted Answer

The dorsalis pedis artery is located on the dorsum of the foot.The nurse should palpate just lateral to and parallel with the extensor tendon of the big toe.The popliteal artery is palpated behind the knee.The posterior tibial pulse is palpated in the groove between the malleolus and the Achilles tendon.No pulse is palpated at the lateral malleolus.

Question 20

The nurse is reviewing the blood supply to the arm.The major artery supplying the arm is the _____ artery.

Accepted Answer

The major artery supplying the arm is the brachial artery.The brachial artery bifurcates into the ulnar and radial arteries immediately below the elbow.In the hand,the ulnar and radial arteries form two arches known as the superficial and deep palmar arches.

Quiz 20: Peripheral Vascular System and Lymphatic System