Deck 15: Blood Vessels

Question 1

A sound similar to a murmur that is heard over arteries is a

A)thrill.
B)hum.
C)friction rub.
D)bruit.
E)heave.

Answer 1

bruit.

Question 2

You are examining Mr. S., a 79-year-old man with diabetes who is complaining of claudication. Which of the following physical findings is consistent with the diagnosis of arterial insufficiency?

A)Thick, calloused skin
B)Ruddy, thin skin
C)Warmer temperature of extremity in contrast to other body parts
D)Thin atrophied skin
E)Full superficial veins with rapid filling

Answer 2

Thin atrophied skin

Question 3

In differentiating between an occluded artery or vein, a differentiating sign (present in venous but not arterial occlusion) is

A)color change.
B)edema.
C)pain with walking.
D)pain with palpation.
E)paralysis.

Answer 3

edema.

Question 4

The most prominent component of the jugular venous pulse is the

A)a wave.
B)c wave.
C)v wave.
D)x slope.
E)y slope.

Question 5

In newborn infants, closure of the ductus arteriosus usually occurs

A)before the initiation of labor.
B)12 to 14 hours after birth.
C)after 7 days of life.
D)between the second and third month.
E)during the toddler period.

Question 6

Vascular changes expected in older adults include

A)loss of vessel elasticity.
B)decreased peripheral resistance.
C)decreased pulse pressure.
D)constriction of the aorta and major bronchi.
E)increased vasomotor tone.

Question 7

To assess a patient's jugular veins, he or she should first be placed in which position?

A)Supine
B)Semi-Fowler
C)Upright
D)Left lateral recumbent
E)Leaning forward

Question 8

The arterial pulse is produced by

A)atrial contraction.
B)ventricular systole.
C)peripheral vascular resistance.
D)diastolic pressure.
E)atrial relaxation.

Question 9

The structure that carries oxygenated blood to the body from the left ventricle is the

A)aorta.
B)pulmonary artery.
C)pulmonary vein.
D)superior vena cava.
E)inferior vena cava.

Question 10

Conduction system impairment should be suspected if an irregular heartbeat is

A)galloping.
B)paradoxical.
C)patternless.
D)weak.
E)bounding.

Question 11

Observation of hand veins can facilitate assessment of

A)mitral valve competency.
B)stoke volume.
C)right heart pressure.
D)pulse pressure.
E)left heart pressure.

Question 12

The term claudication refers to

A)pain from muscle ischemia.
B)lack of palpable pulsations.
C)visible extremity changes of arterial occlusion.
D)numbness and tingling in toes and fingers.
E)constriction or narrowing of a vessel.

Question 13

In which location would carotid bruits best be heard?

A)Posterior cervical triangle
B)Anterior margin of the sternocleidomastoid muscle
C)Over the aortic valve
D)At the angle of the mandible
E)Just anterior to the ear

Question 14

Blood pressure normally decreases during what period?

A)Fertilization
B)First trimester of pregnancy
C)Second trimester of pregnancy
D)Third trimester of pregnancy
E)During labor and delivery

Question 15

Which arterial pulse is most useful in evaluating heart activity?

A)Femoral
B)Radial
C)Temporal
D)Brachial
E)Carotid

Question 16

The level at which the jugular venous pulse is visible gives an indication of

A)mitral valve efficiency.
B)aortic valve efficiency.
C)stroke volume.
D)left ventricular pressure.
E)right atrial pressure.

Question 17

The amplitude of pulses is recorded on a(n)

A)Likert scale of absent to bounding.
B)numerical scale of 0 to 4.
C)alphabetic scale of A to E.
D)descriptive scale of mild, moderate, and severe.
E)graded scale of I to VI.

Question 18

The characteristics of arterial pulses are directly affected by all of the following except

A)the volume of blood ejected.
B)peripheral arterial resistance.
C)venous valvular competence.
D)blood viscosity.
E)distensibility of aorta.

Question 19

Which of the following statements is true regarding the examination of peripheral arteries?

A)The thumb should never be used to assess pulses.
B)Palpate at least one pulse in each extremity, usually the most proximal one.
C)The pulses are most readily felt over arteries that lie over bones.
D)Extremity pulses do not normally generate waveforms.
E)The pads of the fourth and fifth digits of the examiner's hands are the most sensitive.

Question 20

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.
E)suggest that she never lie on her side.

Question 21

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+.
E)5+.

Question 22

An idiopathic spasm of arterioles in the digits is called

A)arteriosclerosis obliterans.
B)giant cell arteritis.
C)arteriovenous fistula.
D)peripheral arterial aneurysm.
E)Raynaud disease.

Question 23

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.
E)usually indicates dehydration.

Question 24

If pitting edema is unilateral, you would suspect occlusion of a

A)lymphatic duct.
B)major vein.
C)surface capillary.
D)superficial artery.
E)deep artery.

Question 25

In pregnancy, blood pressure is lowest

A)at conception.
B)during the first trimester.
C)during the second trimester.
D)during the third trimester.
E)at the time of delivery.

Question 26

Kawasaki disease is suspected when assessments of a child reveal

A)conjunctival injection, strawberry tongue, and edema of the hands and feet.
B)conjunctival infection, lymphadenopathy, and a vesicular rash.
C)low-grade fever, strawberry tongue, and edema of the hands and feet.
D)dermatomal bullae rash, high fever, and cyanotic hands and feet.
E)recent streptococcal pharyngitis, vesicular rash, and geographic tongue.

Question 27

A major risk factor for arterial embolic disease is

A)venous thrombosis.
B)atrial fibrillation.
C)hypotension.
D)diuretic therapy.
E)constrictive pericarditis.

Question 28

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.
E)equal blood pressures in the arms and legs.

Question 29

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.
E)indicates venous occlusion.

Question 30

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.
E)painful, swollen extremities.

Question 31

You are performing jugular venous pressure measurement for your patient in heart failure. You see a pulse wave with the patient's head elevated at a 45-degree angle. Your action as a result of this assessment is to

A)record this measurement as less than 9 cm H₂O pressure.
B)record this measurement as more than 9 cm H₂O pressure.
C)confirm that the pulsations decrease with inspirations.
D)confirm that the pulsations increase with inspirations.
E)place the patient in the supine position and recheck.

Question 32

Thrombosis of a leg vein should be suspected if the patient feels calf pain

A)after running a short distance.
B)on dorsiflexion of the foot.
C)on extending a flexed thigh.
D)while wearing high-heeled shoes.
E)flexing the knee.

Question 33

Which of the following statements is most accurate in describing hepatic jugular reflux?

A)It is an accurate indicator of heart failure.
B)It is exaggerated in patients with right heart failure.
C)It is normal when patients are sitting up straight.
D)It should be absent in older patients with heart failure.
E)It never elevates the jugular venous pressure (JVP) in patients without heart failure.