Deck 17: Peripheral Vasculature And Lymphatic System

Question 1

When the head of the patient's bed is at a 90° angle,the JVP reading would be

A) absent.
B) bounding.
C) excelerated.
D) greater than 4 cm.

Answer 1

absent.

Question 2

When palpating for the epitrochlear node,you should place your finger pads

A) in the suprasternal notch in the space between the sternocleidomastoid muscle and the trachea.
B) in the axillary area between the pectoral muscles and the latissimus dorsi.
C) along the path of the trochlear nerve.
D) in the groove between the biceps and the triceps muscles, superior to the medial condyle of the humerus.

Answer 2

in the groove between the biceps and the triceps muscles, superior to the medial condyle of the humerus.

Question 3

Normally,the jugular veins are most distended when the

A) patient is lying flat.
B) head of the bed (HOB) is elevated at a 45° angle.
C) head of the bed is at a 90° angle.
D) patient is upright.

Answer 3

patient is lying flat.

Question 4

The U.S.Preventive Service Task Force recommends screening for high blood pressure in which of the following groups?

A) infants and toddlers
B) children 8 years old
C) adolescents
D) adults aged 18 and older

Question 5

A positive Homans' sign is present when the patient complains of pain in the

A) ankle upon dorsiflexion of the foot.
B) calf upon dorsiflexion of the foot.
C) calf upon flexion of the knee.
D) thigh upon elevation of the leg.

Question 6

In the Allen test to examine the patency of the radial artery,which of the following indicates normal blood flow?

A) return of normal color of the hand within 60 seconds
B) presence of a radial pulse
C) return of normal color of the hand within 6 seconds
D) return of normal color of the hand within 16 seconds

Question 7

General guidelines for palpating peripheral pulses include

A) positioning the patient in a supine position with the head of the bed elevated 90°.
B) counting the pulse for 30 seconds and multiplying by 2.
C) palpating the pulses on both sides of the patient's body simultaneously, with the exception of the carotid pulse.
D) palpating with the finger pads of all five fingers.

Question 8

Upon releasing the tourniquet from the patient's upper thigh while performing the retrograde filling test,you would observe which of the following in a patient whose valves are functioning normally?

A) blood filling the veins from below the compression
B) blood continuing to pool in the leg veins for more than 35 seconds
C) blood filling the veins from the thigh downward
D) blood pooling around the incompetent valves

Question 9

When examining a patient's popliteal lymph nodes,the nurse determines that the nodes are enlarged.The nurse should then ask the patient to assume which of the following positions?

A) side-lying
B) lithotomy
C) Trendelenburg
D) reverse Trendelenburg

Question 10

Pulsus paradoxus is examined by taking the patient's blood pressure and determining the difference between the point at which the first systolic sound is heard and the point at which

A) the sounds become muted.
B) the diastolic sounds are heard.
C) all sounds disappear.
D) all systolic sounds are heard regardless of respirations.

Question 11

You examine the patient for the hepatojugular reflux by examining for a rise in the jugular venous pressure after

A) applying firm pressure to the left upper quadrant of the abdomen for 30 to 60 seconds.
B) lowering the head of the bed from a 45° angle until the patient is lying flat.
C) palpating the liver for 20 seconds.
D) applying firm pressure to the right upper quadrant of the abdomen for 30 to 60 seconds.

Question 12

To indirectly estimate the jugular venous pressure (JVP)of a patient positioned supine at a 45° angle,you would measure in centimeters the distance from the

A) sternal notch to the point of maximum venous engorgement.
B) sternal angle (angle of Louis) to the top of the distended neck vein.
C) tip of the manubrium to the point of maximum venous engorgement.
D) xiphoid process to the top of the distended neck vein.

Question 13

To test the competency of the saphenous vein's valves with manual compression,you would note if an impulse is felt when palpating the dilated vein with one hand while

A) raising the patient's leg 90°.
B) compressing the femoral vein with the other hand.
C) compressing the same vein 20 cm higher in the leg with the other hand.
D) the patient is supine and then while the patient is standing.

Question 14

A patient with a patent ductus arteriosis or aortic regurgitation would most likely have which of the following?

A) pulsus aternans
B) pulsus bisferiens
C) pulsus paradoxus
D) water-hammer pulse

Question 15

Which jugular vein pulsation results from the slow buildup of blood in the right atrium during ventricular contractions?

A) a wave
B) c wave
C) g wave
D) v wave

Question 16

According to the U.S.Preventive Services Task Force recommendations,one time screening for abdominal aortic aneurysm by ultrasonography is needed for which of the following patients?

A) 21-year-old female
B) 39-year-old male
C) 50-year-old female
D) 70-year-old male

Question 17

Water-hammer pulse is characterized by which of the following?

A) A normal rhythm is normal; however, it alternates between increased amplitude and decreased amplitude.
B) A high stroke volume that results in an increased rate of ejection of blood flow from the left ventricle followed by a rapid fall in ejection
C) Rhythm that is irregular (pulse with increased amplitude is followed by a pulse with decreased amplitude).
D) Marked decrease (10 mm Hg or more) in pulse amplitude during inspiration and increased amplitude during expiration.

Question 18

Which of the following is characteristic of an arterial ulceration occurring on the feet?

A) There is black and necrotic tissue, but no bleeding.
B) It commonly occurs at the sides of the ankles.
C) Pain is relieved by elevating the leg.
D) Pain is relieved by walking.

Question 19

The central venous pressure (CVP)of a patient positioned supine at a 45° angle with a jugular venous pressure (JVP)of 3 is

A) 2 cm.
B) 5 cm.
C) 8 cm.
D) 15 cm.

Question 20

Pallor occurring in an extremity within 20 seconds after that extremity is lifted most likely indicates

A) normal arterial circulation.
B) venous insufficiency.
C) arterial insufficiency.
D) thrombophlebitis.

Question 21

Which of the following best describes lymphadenopathy?

A) occurs when lymph nodes become infected
B) group of cancers that originate in the lymphatic system
C) inherited condition whereby lymphatic vessels are impaired or missing
D) inflammation of the lymph node(s) related to a bacterial infection of the node tissue

Question 22

You are examining a patient with lymphedema.You would most likely discover which of the following findings?

A) fatigue
B) swelling in the extremities
C) weight loss
D) night sweats

Question 23

Raynaud's disease is best defined as which of the following?

A) localized abnormal dilation of a blood vessel
B) brain damage that results from decreased blood flow
C) condition caused by abnormal blood vessel spasms in the extremities, especially
In response to cold temperatures
D) formation of a blood clot in a deep vein (most commonly in the leg or pelvis);
Inflammation of a vein due to a blood clot

Question 24

You plan to inspect and palpate your patient's epitrochlear lymph nodes.You would ask the patient to assume which of the following positions?

A) supine
B) prone
C) sitting
D) standing

Question 25

When examining a patient for pulsus paradoxus,the nurse would do which of the following? Select all that apply.

A) Place the patient in a supine position.Instruct the patient to breathe normally.
B) Apply the blood pressure cuff.
C) Inflate the cuff to 40 mm Hg above the patient's last systolic blood pressure reading.
D) Slowly deflate the cuff until the first systolic sound is heard.
E) Observe the patient's respirations because the systolic sound may disappear during normal inspiration.
F) Quickly deflate the cuff again and note the point at which the dyastolic sound is heard.

Question 26

When examining a patient,you realize that the patient's lymph nodes are swollen.You hypothesize that the patient has which of the following conditions?

A) lymphoma
B) lymphadenitis
C) lymphadenopathy
D) lymphedema

Question 27

You are examining a patient for venous insufficiency.You are most likely to find which of the following? Select all that apply.

A) Severe pain
B) Warm skin
C) Normal nails
D) Edema
E) Hair loss on extremity
F) Diminished or absent pulses

Question 28

Which of the following disorders can occur with arterial insufficiency?

A) DVT
B) aneurisms
C) varicose veins
D) venus stasis ulcers

Question 29

Possible causes of pulse paradox include which of the following? Select all that apply.

A) Cardiac tamponade
B) Pericardial effusion
C) Constrictive pericarditis
D) Restrictive cardiomyopathy
E) Superior vena cava obstruction
F) Severe chronic obstructive lung disease

Question 30

Possible causes for a hyperkinetic/bounding pulse would include which of the following? Select all that apply.

A) Fever
B) Exercise
C) Hypovolemia
D) Hyperthyroidism
E) Cardiogenic shock
F) Congestive heart failure

Question 31

Jugular venous pulsations consist of two or three waves called the "a," "c",and "v" waves.The "a" wave is produced by which of the following?

A) contraction of the right atrium
B) contraction of the left atrium
C) contraction of the right ventricle
D) contraction of the left ventricle

Question 32

Lymphatics supplement which of the following systems?

A) respiratory
B) digestive
C) endocrine
D) cardiovascular

Question 33

The visceral layer,a serous layer that lies against the heart,is also called the ____________________.

Question 34

A nursing instructor asks a group of students which disorders are related to arterial insufficiency.Which responses by the students would indicate that further teaching is needed? Select all that apply.

A) DVT
B) Varicose veins
C) Buerger's disease
D) Aortic dissection
E) Raynaud's disease
F) Thrombophlebitis

Question 35

In addition to bone marrow,the other primary organ of the lymphatic system is which of the following?

A) spleen
B) appendix
C) lymph nodes
D) thymus gland

Question 36

How much lymph is transported through the lymphatic vessels each day?

A) 2 liters/day
B) 3 litersl/day
C) 4 liters/minute
D) 5 liters/minute