Sherpath: Chapter 21, Peripheral Vascular System and Lymphatic System: Findings for the Peripheral Vascular System

Question 1 of 18

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Which findings regarding the contour of the arterial pulse would the nurse note as normal?

• • EvenThe rhythm, not the contour, of a pulse would be described as regular.
• • SharpThe normal contour or waveform of a pulse is not sharp.
• Correct
  • SmoothThe normal contour or waveform of a pulse is smooth.
• Correct
  • RoundedThe normal contour or waveform of a pulse is rounded.
• Correct
  • Dome-shapedThe normal contour or waveform of a pulse is dome-shaped.

Question 2 of 18

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The expected amplitude of the arterial pulse is __ on a scale of 0-4.

• • Your answer: 2Correct answer: 2The expected amplitude of the arterial pulse is 2.

Question 3 of 18

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When the health of the vascular system of an adult is evaluated, a capillary refill time less than __ seconds is normal and indicates an intact vascular system.

• • Your answer: 2Correct answer: 2A capillary refill time of 2 seconds or less is normal and indicates an intact vascular system.

Question 4 of 18

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When assessing the jugular pulse wave (JVP), which finding is expected after the application of gentle pressure at the base of the neck above the clavicle?

• • TachycardiaTachycardia, or an abnormally rapid heartbeat, will not occur when pressure is applied at the base of the neck above the clavicle.
• Correct
  • Elimination of the pulse waveThe pulse wave will be eliminated when pressure is applied at the base of the neck above the clavicle.
• • Increase in pulse wave frequencyThere will not be an increase in pulse wave frequency when pressure is applied at the base of the neck above the clavicle.
• • Decrease in pulse wave frequencyA decrease in pulse wave frequency when pressure is applied at the base of the neck above the clavicle is not the expected finding.

Question 5 of 18

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What is the expected effect of respiration on venous pulse waves?

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  • A decrease on inspirationThe venous pulse wave decreases on inspiration.
• • An increase on inspirationThe venous pulse wave does not increase on inspiration.
• • A decrease on expirationThe venous pulse wave does not decrease on expiration.
• • A decrease on both inspiration and expirationThe venous pulse wave does not decrease on both inspiration and expiration.

Question 6 of 18

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When the nurse assesses edema in a healthy adult, which finding is normal after an index finger is pressed over the bony prominence of the tibia?

• • Soft, squishy skinSoft, squishy skin is not found over the tibia.
• Correct
  • Rapid refill of the depressionRapid refill of the depression occurs after an index finger is pressed over the bony prominence of the tibia.
• • Slow refill of the depressionA slow refill of the depression would not be considered a normal finding.
• • Lack of a depressionA lack of depression would not be considered a normal finding.

Question 7 of 18

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A venous hum, common in children, can be classified in which ways?

• • RapidThe venous hum does not sound rapid.
• Correct
  • ContinuousThe venous hum is a continuous sound.
• Correct
  • Low-pitchedThe venous hum has a low-pitched sound.
• • AcceleratingThe venous hum does not sound like it is accelerating.
• Correct
  • Louder during diastoleThe venous hum is louder during diastole.

Question 8 of 18

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Which finding, common in children, is caused by the turbulence of blood flow in the internal jugular veins?

• • Carotid bruitA carotid bruit is not caused by turbulent blood flow in the internal jugular veins and requires further investigation. It is not a common finding.
• Correct
  • Venous humThe venous hum is caused by the turbulence of blood flow in the internal jugular veins.
• • HypertensionHypertension is unrelated to the turbulent blood flow from the internal jugular veins.
• • Increased jugular venous pressureIncreased JVP is not caused by turbulent blood flow in the internal jugular veins and is not a common finding.

Question 9 of 18

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When the nurse examines the peripheral vascular system of an infant, a diminished femoral pulse may indicate which condition?

• • HypertensionHypertension is evidenced by high blood pressure, not by the absence of femoral pulses in the infant.
• • Kawasaki diseaseKawasaki disease is evidenced by a “strawberry tongue,” not absent femoral pulses.
• Correct
  • Coarctation of the aortaCoarctation of the aorta is evidenced in the infant by absent or diminished femoral pulses.
• • Venous insufficiencyVenous insufficiency is not evidenced by absent femoral pulses in the infant and is more common in adults.

Question 10 of 18

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Which pulses may be more difficult to find in older adults?

• • RadialThe radial pulse is easily located in the wrist of older adults.
• • CarotidThe carotid pulse is easily located on the older adult’s neck.
• • BrachialThe brachial pulse is easy to find in the bend of the arm in older adults.
• Correct
  • Posterior tibialThe posterior tibial pulse is often absent in the older adult due to peripheral arterial disease.
• Correct
  • Dorsalis pedisThe dorsalis pedis is often absent in the older adult due to peripheral arterial disease.

Question 11 of 18

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Plaque buildup in the walls of the arteries can lead to dilation of which vessels in older adults?

• Correct
  • AortaThe aortic arch can be dilated due to plaque buildup in the arteries.
• • Hand veinsHand veins are not dilated due to plaque buildup in the arteries.
• Correct
  • Temporal arteryThe temporal artery can be dilated due to plaque buildup in the arteries.
• • Inferior vena cavaThe inferior vena cava is not dilated due to plaque buildup in the arteries.

Question 12 of 18

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Which age-related condition is associated with artery stiffness in older adults?

• • Peripheral vein diseasePeripheral vein disease does not cause artery stiffness in older adults.
• • HypotensionHypotension does not cause artery stiffness in older adults.
• • Atrial fibrillationAtrial fibrillation is a cardiac rhythm disorder that can lead to blood clots but does not cause artery stiffness in older adults.
• Correct
  • Peripheral arterial diseasePeripheral arterial disease is the buildup of plaque along the walls of the arteries causing stiffness throughout.

Question 13 of 18

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Describe abnormal findings from assessment of the peripheral arteries.

5

6

1

2

Correct Answers:

5

6

1

2

Submitted Answers:

Correct

1 Bigeminal pulse

Correct

2 Large, bounding pulse

3 Paradoxical pulse

4 Corrigan pulse

Correct

5 Alternating pulse

Correct

6 Pulsus bisferiens

Question 14 of 18

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When auscultating the carotid vessels, which findings would the nurse note as abnormal?

• Correct
  • BruitA carotid bruit over the carotid and/or femoral arteries would be an abnormal finding and require further investigation.
• • Strong pulseA strong pulse would be considered a normal finding.
• • Steady rhythmA steady rhythm would be considered a normal finding.
• • Consistent heart rateA consistent, even heart rate would be considered a normal finding.
• Correct
  • Transmitted murmurA murmur heard on auscultation would be an abnormal finding and require further investigation.

Question 15 of 18

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When measuring an adult patient’s blood pressure, which finding does the nurse note as abnormal?

• • A pulse pressure of 39Pulse pressure, as defined by the systolic pressure minus the diastolic pressure, should be between 30 and 40 mm Hg; 39 mm Hg is within the normal limits.
• Correct
  • A blood pressure of 130/95A blood pressure of 130/95 is considered elevated and an abnormal finding.
• • A blood pressure of 119/75A blood pressure of 119/75 is considered a normal finding, not abnormal.
• • A blood pressure difference of 5 mm Hg between the left and right armsA difference of 5 mm Hg between the left and right arms would be within normal limits.

Question 16 of 18

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When assessing for varicose veins, the nurse has the patient stand on his or her toes 10 times in succession. Which findings would the nurse note as abnormal?

• Correct
  • PainPain after this test would be considered abnormal.
• Correct
  • Dilated veinsDilated veins after performing this test would indicate abnormalities.
• Correct
  • Swollen veinsSwollen veins after performing this test would indicate abnormalities.
• Correct
  • Venous distention that does not quickly disappearPressure that does not go away quickly would be considered abnormal.
• • Disappearance of vein distention in 2 secondsA decrease in vein distention a couple of seconds after this test would be considered normal.

Question 17 of 18

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When evaluating the presence of compensating circulation, the nurse assesses blood flow after putting the affected limb in a dependent position, stripping the vein, then releasing pressure. Which findings would the nurse note as abnormal?

• • The procedure is easily repeatable on the other side.The procedure should be easily repeatable and the same on both sides.
• • There is no pain associated with the procedure.There should not be pain associated with this procedure.
• • Normal heart rate is observed during the procedure.The patient would be expected to have a normal heart rate during the procedure.
• Correct
  • The stripped vessel fills before pressure is released.This is abnormal, as the stripped vessel should remain unfilled until pressure is released.

Question 18 of 18

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Which finding would the nurse note as abnormal when evaluating the Perthes’ peripheral veins?

• • The emptying of superficial veinsThe emptying of superficial veins would be considered normal Perthes’, not abnormal, when evaluating the peripheral veins.
• • The filling of superficial veinsThe filling of superficial veins would be considered normal not abnormal, when evaluating the peripheral veins.
• Correct
  • The failure of superficial veins to emptyThe failure of superficial veins to empty would be considered abnormal when the Perthes’ when evaluating the peripheral veins.
• • Slow-filling of the veinsRapidly-filling veins, not slow-filling veins, is an abnormal finding when assessing the peripheral veins.