Ch18 Peripheral Vascular System

60 Questions  I  By Shinichiro
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  • 1. 
    When performing an assessment on a client the nurse notes the presence of an enlarged epitrochlear lymph node. The nurse would anticipate finding which of the following on the assessment?
    • A. 

      The forearm and hand for infection or inflammation

    • B. 

      The lower legs for injury

    • C. 

      The equality of radial pulse

    • D. 

      Capillary refill and temperature of the extremities


  • 2. 
    When performing an assessment on a client the nurse notes the presence of an enlarged superficial inguinal nodes. The nurse would anticipate finding which of the following on the assessment?
    • A. 

      The forearm and hand for infection or inflammation

    • B. 

      The lower legs for injury

    • C. 

      The equality of radial pulse

    • D. 

      Capillary refill and temperature of the extremities


  • 3. 
    When performing an assessment on a client the nurse notes the determine circulation. The nurse would anticipate finding which of the following on the assessment?
    • A. 

      The forearm and hand for infection or inflammation

    • B. 

      The lower legs for injury

    • C. 

      The equality of radial pulse

    • D. 

      Capillary refill and temperature of the extremities


  • 4. 
    When performing an assessment on a client the nurse notes the determine circulation to the extremities. The nurse would anticipate finding which of the following on the assessment?
    • A. 

      The forearm and hand for infection or inflammation

    • B. 

      The lower legs for injury

    • C. 

      The equality of radial pulse

    • D. 

      Capillary refill and temperature of the extremities


  • 5. 
    When performing an assessment, the nurse notes the presence of ankle edema bilaterally. The nurse knows that:
    • A. 

      It is caused by an infection.

    • B. 

      It is caused by blood pooling in the legs.

    • C. 

      It is caused by a blood clot in the lower leg.

    • D. 

      It is caused by decreased arterial circulation.


  • 6. 
    When performing an assessment, the nurse notes the presence of inflammation and edema over the affected area. The nurse knows that:
    • A. 

      It is caused by an infection.

    • B. 

      It is caused by blood pooling in the legs.

    • C. 

      It is caused by a blood clot in the lower leg.

    • D. 

      It is caused by decreased arterial circulation.


  • 7. 
    When performing an assessment, the nurse notes the presence of edema in the affected extremity. The nurse knows that:
    • A. 

      It is caused by an infection.

    • B. 

      It is caused by blood pooling in the legs.

    • C. 

      It is caused by a blood clot in the lower leg.

    • D. 

      It is caused by decreased arterial circulation.


  • 8. 
    When performing an assessment, the nurse notes the presence of decreased pulses. The nurse knows that:
    • A. 

      It is caused by an infection.

    • B. 

      It is caused by blood pooling in the legs.

    • C. 

      It is caused by a blood clot in the lower leg.

    • D. 

      It is caused by decreased arterial circulation.


  • 9. 
    The neonatal(rookie) nurse obtains a newborn's blood pressure of 76/40 mm Hg. Which of the following should the nurse do?
    • A. 

      Continue with the assessment as this is a normal neonatal blood pressure reading.

    • B. 

      Perform a focused assessment and call the health care provider.

    • C. 

      Assess the thigh blood pressure expecting that it will be lower than that of the arm.

    • D. 

      Ask another nurse to validate the blood pressure because it is low.


  • 10. 
    An eight-month-pregnant client states that she has developed a few varicose veins during her pregnancy. What can the nurse tell the client about these veins?
    • A. 

      "These are common and will go away after delivery."

    • B. 

      "We need to talk to your health care provider about this."

    • C. 

      "This is a normal finding and is caused by pressure from your uterus delaying blood return from your legs."

    • D. 

      "This is related to decreased circulation."


  • 11. 
    When assessing the carotid arteries, the nurse should:
    • A. 

      Palpate both carotid arteries simultaneously to assess for the symmetry of the pulse.

    • B. 

      Palpate firmly to occlude the artery.

    • C. 

      Utilize the bell of the stethoscope to assess for bruits.

    • D. 

      Massage the area noting any masses or hardness.


  • 12. 
    The neonatal(rookie) nurse obtains a newborn's blood pressure of 76/40 mm Hg. Perform a focused assessment and call the health care provider.
    • A. 

      True

    • B. 

      False


  • 13. 
    The neonatal(rookie) nurse obtains a newborn's blood pressure of 76/40 mm Hg. Assess the thigh blood pressure expecting that it will be lower than that of the arm.
    • A. 

      True

    • B. 

      False


  • 14. 
    The neonatal(rookie) nurse obtains a newborn's blood pressure of 76/40 mm Hg. Ask another nurse to validate the blood pressure because it is low.
    • A. 

      True

    • B. 

      False


  • 15. 
    An eight-month-pregnant client states that she has developed a few varicose veins during her pregnancy. the nurse tell the client about these veins, "These are common and will go away after delivery."
    • A. 

      True

    • B. 

      False


  • 16. 
    An eight-month-pregnant client states that she has developed a few varicose veins during her pregnancy. the nurse tell the client about these veins, "We need to talk to your health care provider about this."
    • A. 

      True

    • B. 

      False


  • 17. 
    An eight-month-pregnant client states that she has developed a few varicose veins during her pregnancy. the nurse tell the client about these veins, "This is related to decreased circulation."
    • A. 

      True

    • B. 

      False


  • 18. 
    An eight-month-pregnant client states that she has developed a few varicose veins during her pregnancy. the nurse tell the client about these veins, "This is related to decreased circulation."
    • A. 

      True

    • B. 

      False


  • 19. 
    When assessing the carotid arteries, the nurse should utilize the bell of the stethoscope to assess for bruits.
    • A. 

      True

    • B. 

      False


  • 20. 
    When assessing the carotid arteries, the nurse should palpate both carotid arteries simultaneously to assess for the symmetry of the pulse.
    • A. 

      True

    • B. 

      False


  • 21. 
    When assessing the carotid arteries, the nurse should palpate firmly to occlude the artery.
    • A. 

      True

    • B. 

      False


  • 22. 
    When assessing the carotid arteries, the nurse should massage the area noting any masses or hardness.
    • A. 

      True

    • B. 

      False


  • 23. 
    When assessing the characteristics of the pulse, the nurse notes which of the following? Select all that apply.
    • A. 

      Rate

    • B. 

      Rhythm

    • C. 

      Symmetry

    • D. 

      Amplitude

    • E. 

      Capillary refill


  • 24. 
    A client has a 1+/0-4+ dorsalis pedis pulse on the right. The lower leg is cool, pale, and painful. This description is most consistent with:
    • A. 

      Venous insufficiency

    • B. 

      Arterial insufficiency

    • C. 

      Thrombophlebitis

    • D. 

      Lymphatic insufficiency


  • 25. 
    A client has a 1+/0-4+ dorsalis pedis pulse on the right. The lower leg is cool, pale, and painful. This description is most consistent with arterial insufficiency.
    • A. 

      True

    • B. 

      False


  • 26. 
    A client has a 1+/0-4+ dorsalis pedis pulse on the right. The lower leg is cool, pale, and painful. This description is most consistent with venous insufficiency
    • A. 

      True

    • B. 

      False


  • 27. 
    A client has a 1+/0-4+ dorsalis pedis pulse on the right. The lower leg is cool, pale, and painful. This description is most consistent with thrombophlebitis。
    • A. 

      True

    • B. 

      False


  • 28. 
    A client has a 1+/0-4+ dorsalis pedis pulse on the right. The lower leg is cool, pale, and painful. This description is most consistent with lymphatic insufficiency
    • A. 

      True

    • B. 

      False


  • 29. 
    A client tells the nurse, "My legs really hurt when I walk, but if I stop walking the pain gets better in a few minutes." This symptom most likely describes:
    • A. 

      The presence of varicosities

    • B. 

      Lymphatic abnormalities

    • C. 

      Decreased arterial circulation

    • D. 

      Deep vein thrombosis


  • 30. 
    A client tells the nurse, "My legs really hurt when I walk, but if I stop walking the pain gets better in a few minutes." This symptom most likely describes decreased arterial circulation.
    • A. 

      True

    • B. 

      False


  • 31. 
    A client tells the nurse, "My legs really hurt when I walk, but if I stop walking the pain gets better in a few minutes." This symptom most likely describes the presence of varicosities.
    • A. 

      True

    • B. 

      False


  • 32. 
    A client tells the nurse, "My legs really hurt when I walk, but if I stop walking the pain gets better in a few minutes." This symptom most likely describes lymphatic abnormalities
    • A. 

      True

    • B. 

      False


  • 33. 
    A client tells the nurse, "My legs really hurt when I walk, but if I stop walking the pain gets better in a few minutes." This symptom most likely describes deep vein thrombosis
    • A. 

      True

    • B. 

      False


  • 34. 
    Evaluation of the texture, moisture, and temperature of the skin; hair distribution; capillary refill; and auscultating for bruits are primarily related to which of the following assessments?
    • A. 

      Lymphatic

    • B. 

      Respiratory

    • C. 

      Venous

    • D. 

      Arterial


  • 35. 
    Evaluation of the texture, moisture, and temperature of the skin; hair distribution; capillary refill; and auscultating for bruits are primarily related to arterial.
    • A. 

      True

    • B. 

      False


  • 36. 
    Evaluation of the texture, moisture, and temperature of the skin; hair distribution; capillary refill; and auscultating for bruits are primarily related to lymphatic.
    • A. 

      True

    • B. 

      False


  • 37. 
    Evaluation of the texture, moisture, and temperature of the skin; hair distribution; capillary refill; and auscultating for bruits are primarily related to respiratory.
    • A. 

      True

    • B. 

      False


  • 38. 
    Evaluation of the texture, moisture, and temperature of the skin; hair distribution; capillary refill; and auscultating for bruits are primarily related to venous.
    • A. 

      True

    • B. 

      False


  • 39. 
    The nurse performs Allen's test to assess which of the following?
    • A. 

      Patency of the radial and ulnar arteries

    • B. 

      Arterial circulation to the lower extremities

    • C. 

      Varicose veins

    • D. 

      Edema


  • 40. 
    The nurse performs Allen's test to assess patency of the radial and ulnar arteries.
    • A. 

      True

    • B. 

      False


  • 41. 
    The nurse performs Allen's test to assess arterial circulation to the lower extremities.
    • A. 

      True

    • B. 

      False


  • 42. 
    The nurse performs Allen's test to assess varicose veins.
    • A. 

      True

    • B. 

      False


  • 43. 
    The nurse performs Allen's test to assess edema.
    • A. 

      True

    • B. 

      False


  • 44. 
    A client's blood pressure is 158/90 mm Hg. What does this reading suggest to the nurse?
    • A. 

      This blood pressure is normal.

    • B. 

      This client has prehypertension.

    • C. 

      This client has stage 1 hypertension.

    • D. 

      This client has stage 2 hypertension.


  • 45. 
    When performing an assessment on a client with COPD the nurse notes the presence of clubbing. Which of the following is noted in this condition? Select all that apply.
    • A. 

      Fingertips large and round

    • B. 

      Delayed capillary refill

    • C. 

      Flattening of the angle of the nail

    • D. 

      Delayed Allen's test

    • E. 

      Base of the nail feels spongy


  • 46. 
    A client is being evaluated for suspected thrombosis of a deep leg vein. Which of the following is the nurse most likely to note during the assessment?
    • A. 

      Pain in the calf when dorsiflexing the foot

    • B. 

      A cool foot with diminished pulses

    • C. 

      Increased pain with elevation of the extremity

    • D. 

      Decreased hair distribution on the legs


  • 47. 
    A client is being evaluated for suspected thrombosis of a deep leg vein. Client has pain in the calf when dorsiflexing the foot.
    • A. 

      True

    • B. 

      False


  • 48. 
    A client is being evaluated for suspected thrombosis of a deep leg vein. Client has a cool foot with diminished pulses.
    • A. 

      True

    • B. 

      False


  • 49. 
    A client is being evaluated for suspected thrombosis of a deep leg vein. Client has increased pain with elevation of the extremity.
    • A. 

      True

    • B. 

      False


  • 50. 
    A client is being evaluated for suspected thrombosis of a deep leg vein. Client has decreased hair distribution on the legs
    • A. 

      True

    • B. 

      False


  • 51. 
    An elderly client has lower-extremity edema and thick skin discolored to a dark brown. The client complains of his legs feeling "full." Which of the following does this information suggest to the nurse?
    • A. 

      The client may have varicose veins.

    • B. 

      The client might have venous insufficiency.

    • C. 

      The client might have arterial insufficiency.

    • D. 

      The client may have an arterial aneurysm.


  • 52. 
    An elderly client has lower-extremity edema and thick skin discolored to a dark brown. The client complains of his legs feeling "full." The client might have venous insufficiency.
    • A. 

      True

    • B. 

      False


  • 53. 
    An elderly client has lower-extremity edema and thick skin discolored to a dark brown. The client complains of his legs feeling "full." The client may have varicose veins.
    • A. 

      True

    • B. 

      False


  • 54. 
    An elderly client has lower-extremity edema and thick skin discolored to a dark brown. The client complains of his legs feeling "full." The client might have arterial insufficiency.
    • A. 

      True

    • B. 

      False


  • 55. 
    An elderly client has lower-extremity edema and thick skin discolored to a dark brown. The client complains of his legs feeling "full." The client may have an arterial aneurysm.
    • A. 

      True

    • B. 

      False


  • 56. 
    When palpating a client's pulse, the nurse notes that strength of the pulse alternates between strong and weak pulsations. The nurse would document the presence of which of the following?
    • A. 

      Weak/thready pulsations

    • B. 

      Unequal pulses

    • C. 

      Pulsus alternans

    • D. 

      Pulsus paradoxus


  • 57. 
    When palpating a client's pulse, the nurse notes that strength of the pulse alternates between strong and weak pulsations. The nurse would document the presence of pulsus alternans.
    • A. 

      True

    • B. 

      False


  • 58. 
    When palpating a client's pulse, the nurse notes that strength of the pulse alternates between strong and weak pulsations. The nurse would document the presence of weak/thready pulsations.
    • A. 

      True

    • B. 

      False


  • 59. 
    When palpating a client's pulse, the nurse notes that strength of the pulse alternates between strong and weak pulsations. The nurse would document the presence of unequal pulses.
    • A. 

      True

    • B. 

      False


  • 60. 
    When palpating a client's pulse, the nurse notes that strength of the pulse alternates between strong and weak pulsations. The nurse would document the presence of pulsus paradoxus.
    • A. 

      True

    • B. 

      False


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