Deck 15: Blood Vessels

Question 1

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

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

Answer 1

bruit.

Question 2

In which location would carotid bruits be heard best?

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

Answer 2

Anterior margin of the sternocleidomastoid muscle

Question 3

A major risk factor for arterial embolic disease is:

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

Answer 3

atrial fibrillation.

Question 4

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

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

Question 5

In newborn infants, closure of the ductus arteriosus usually occurs:

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

Question 6

Conduction system impairment should be suspected if an irregular heartbeat is:

A) galloping.
B) paradoxical.
C) loud.
D) weak.

Question 7

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.

Question 8

The most prominent component of the jugular venous pulse is the:

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

Question 9

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

A) The thumb should not 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 bony prominences.
D) Extremity pulses do not normally generate waveforms.

Question 10

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.

Question 11

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

Question 12

An idiopathic spasm of arterioles in the digits is termed:

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

Question 13

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.

Question 14

Which arterial pulse is most useful for evaluating heart activity?

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

Question 15

Mrs. Carrol is a 33-year-old patient who is pregnant and presents for a routine checkup. On examination, you note that her blood pressure has decreased. Blood pressure normally decreases during which period?

A) First trimester of pregnancy
B) Second trimester of pregnancy
C) Third trimester of pregnancy
D) Labor and delivery

Question 16

The amplitude of pulses is recorded on a(n):

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

Question 17

Persons of Irish or German descent and genetically predisposed women who take birth control pills are at risk for developing:

A) kidney dysfunction.
B) liver disease.
C) renal calculi.
D) varicose veins.

Question 18

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.

Question 19

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

Question 20

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.

Question 21

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

Question 22

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+.

Question 23

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.

Question 24

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.

Question 25

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

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

Question 26

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.

Question 27

In pregnancy, blood pressure is at its lowest at:

A) conception.
B) 4 to 12 weeks.
C) 16 to 20 weeks.
D) time of delivery.

Question 28

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.

Question 29

Which of the following statements is most accurate in describing hepatojugular 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.

Question 30

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

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

Question 31

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.

Question 32

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

A) after running a marathon.
B) on dorsiflexion of the foot.
C) on extending a flexed thigh.
D) while wearing high-heeled shoes.

Question 33

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.

Question 34

Observation of hand veins can facilitate assessment of:

A) mitral valve competency.
B) a heart murmur.
C) right heart pressure.
D) left heart pressure.

Question 35

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.

Question 36

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.

Question 37

The arterial pulse is produced by ____________________.

Question 38

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.

Question 39

Kawasaki disease is suspected when assessment of a child reveals:

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.

Question 40

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

Question 41

When palpating the carotid artery, which of the following is most important?

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.