Question 1

How should the nurse document mild, slight pitting edema the ankles of a pregnant patient?

Accepted Answer

A)  1+/0-4+ 
B)  3+/0-4+ 
C)  4+/0-4+ 
D)  Brawny edema

Question 2

The nurse is preparing to perform a modified Allen test. Which is an appropriate reason for this test?

Accepted Answer

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

Question 3

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

Accepted Answer

A)  Deep 
B)  Ulnar 
C)  Subclavian 
D)  Superficial

Question 4

A patient has been admitted with chronic arterial symptoms. During the assessment, the nurse should expect which findings? (Select all that apply.)

Accepted Answer

A)  Skin of the patient is pale and cool. 
B)  His ankles have two small, weeping ulcers. 
C)  He states that the pain gets worse when walking. 
D)  Patient works long hours sitting at a computer desk. 
E)  Patient has a history of diabetes and cigarette smoking.
F) Patient states that the pain is worse at the end of the day.

Question 5

Which statement is true regarding the arterial system?

Accepted Answer

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 the veins. 
D)  Arteries can greatly expand to accommodate a large blood volume increase.

Question 6

The nurse is performing a well-child checkup on a 5-year-old boy. The child has no current condition that would lead the nurse to suspect an illness. His health history is unremarkable, and he received immunizations 1 week ago. Which of these findings should be considered normal in this patient?

Accepted Answer

A)  Enlarged, warm, and tender nodes 
B)  Lymphadenopathy of the cervical nodes 
C)  Palpable firm, small, shotty, mobile, and nontender lymph nodes 
D)  Firm, rubbery, and large nodes, somewhat fixed to the underlying tissue

Question 7

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 "a couple of minutes"; then he is able to resume his activities. What do these symptoms suggest?

Accepted Answer

A)  Claudication 
B)  Sore muscles 
C)  Muscle cramps 
D)  Venous insufficiency

Question 8

The nurse is reviewing the blood supply to the arm. What major artery supplies blood to the arm?

Accepted Answer

A)  Ulnar 
B)  Radial 
C)  Brachial 
D)  Deep palmar

Question 9

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. What does the nurse suspect?

Accepted Answer

A)  Lymphedema 
B)  Raynaud phenomenon 
C)  Deep-vein thrombosis 
D)  Chronic arterial insufficiency

Question 10

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?" How should the nurse reply?

Accepted Answer

A)  "Venous insufficiency is a common problem after this type of surgery." 
B)  "Oh, you have lots of veins-you won't even notice that it has been removed." 
C)  "You will probably experience decreased circulation after the vein is removed." 
D)  "This vein can be removed without harming your circulation because the deeper veins in your leg are in good condition."

Question 11

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. Based on these findings, what does the nurse suspect?

Accepted Answer

A)  Varicosities 
B)  Venous stasis ulcer 
C)  Arterial ischemic ulcer 
D)  Deep vein thrombophlebitis

Question 12

The nurse is assessing the pulses of a patient who has been admitted for untreated hyperthyroidism. When assessing this patient's pulse, what should the nurse expect?

Accepted Answer

A)  Normal 
B)  Bounding 
C)  Weak, thready 
D)  Unpalpable pedal pulse

Question 13

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

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 health 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.

Question 14

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. What should the nurse do next?

Accepted Answer

A)  Check for the presence of claudication. 
B)  Refer the individual for further evaluation. 
C)  Consider this finding normal, 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.

Question 15

The nurse is teaching a review class on the lymphatic system. Which statement by a class participant indicates correct understanding of the material?

Accepted Answer

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; therefore, lymph fluid flows freely from the tissue spaces into the bloodstream."

Question 16

The nurse is describing a weak, thready pulse on the documentation flow sheet. Which statement is correct?

Accepted Answer

A)  "Easily palpable; pounds under the fingertips." 
B)  "Greater than normal force that suddenly collapses." 
C)  "Hard to palpate, may fade in and out, and is easily obliterated by pressure." 
D)  "Rhythm is regular, but force varies with alternating beats of large and small amplitude."

Question 17

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

A)  Hard and fixed cervical nodes 
B)  Enlarged and tender inguinal nodes 
C)  Bilateral enlargement of the popliteal nodes 
D)  Pelletlike nodes in the supraclavicular region

Question 18

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

A)  Ask the patient about a history of frostbite. 
B)  Suspect that the patient has venous insufficiency. 
C)  Consider this a delayed capillary refill time, and investigate further. 
D)  Consider this a normal capillary refill time that requires no further assessment.

Exam 21: Peripheral Vascular System and Lymphatic System