Chapter 21: Peripheral Vascular System and Lymphatic System

Chapter 21: Peripheral Vascular System and Lymphatic System

MULTIPLE CHOICE

• Which statement is true regarding the arterial system?
• Arteries are large-diameter vessels.
• The arterial system is a high-pressure system.
• The walls of arteries are thinner than those of the veins.
• Arteries can greatly expand to accommodate a large blood volume increase.

ANS: B

The pumping heart makes the arterial system a high-pressure system.DIF: Cognitive Level: Remembering (Knowledge) MSC: Client Needs: General

• The nurse is reviewing the blood supply to the arm. The major artery supplying the arm is the _____ artery.
• Ulnar
• Radial
• Brachial
• Deep palmar

ANS: C

The major artery supplying the arm is the brachial artery. The brachial artery bifurcates into the ulnar and radial arteries immediately below the elbow. In the hand, the ulnar and radial arteries form two arches known as the superficial and deep palmar arches.DIF: Cognitive Level: Remembering (Knowledge) MSC: Client Needs: General

• The nurse is preparing to assess the dorsalis pedis artery. Where is the correct location for palpation?
• Behind the knee
• Over the lateral malleolus
• In the groove behind the medial malleolus

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• Lateral to the extensor tendon of the great toe

ANS: D

The dorsalis pedis artery is located on the dorsum of the foot. The nurse should palpate just lateral to and parallel with the extensor tendon of the big toe. The popliteal artery is palpated behind the knee. The posterior tibial pulse is palpated in the groove between the malleolus and the Achilles tendon. No pulse is palpated at the lateral malleolus.DIF: Cognitive Level: Understanding (Comprehension) MSC: Client Needs: General

• A 65-year-old patient is experiencing pain in his left calf when he exercises that disappears after resting for

a few minutes. The nurse recognizes that this description is most consistent with _______ the left leg.

• Venous obstruction of
• Claudication due to venous abnormalities in
• Ischemia caused by a partial blockage of an artery supplying
• Ischemia caused by the complete blockage of an artery supplying

ANS: C

Ischemia is a deficient supply of oxygenated arterial blood to a tissue. A partial blockage creates an insufficient supply, and the ischemia may be apparent only during exercise when oxygen needs increase.DIF: Cognitive Level: Analyzing (Analysis) MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation

• The nurse is reviewing venous blood flow patterns. Which of these statements best describes the

mechanism(s) by which venous blood returns to the heart?

• Intraluminal valves ensure unidirectional flow toward the heart.
• Contracting skeletal muscles milk blood distally toward the veins.
• High-pressure system of the heart helps facilitate venous return.
• Increased thoracic pressure and decreased abdominal pressure facilitate venous return to the heart.

ANS: A

Blood moves through the veins by (1) contracting skeletal muscles that proximally milk the blood; (2) pressure gradients caused by breathing, during which inspiration makes the thoracic pressure decrease and the abdominal pressure increase; and (3) the intraluminal valves, which ensure unidirectional flow toward the heart.Test Bank - Physical Examination and Health Assessment 8e (by Jarvis)304

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DIF: Cognitive Level: Understanding (Comprehension) MSC: Client Needs: General

• Which vein(s) is(are) responsible for most of the venous return in the arm?
• Deep
• Ulnar
• Subclavian
• Superficial

ANS: D

The superficial veins of the arms are in the subcutaneous tissue and are responsible for most of the venous return.DIF: Cognitive Level: Remembering (Knowledge) MSC: Client Needs: General

• 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?

The nurse should reply:

• Venous insufficiency is a common problem after this type of surgery.
• Oh, you have lots of veinsyou wont even notice that it has been removed.
• You will probably experience decreased circulation after the vein is removed.
• This vein can be removed without harming your circulation because the deeper veins in your leg

are in good condition.

ANS: D

As long as the femoral and popliteal veins remain intact, the superficial veins can be excised without harming circulation. The other responses are not correct.DIF: Cognitive Level: Analyzing (Analysis) MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation

• The nurse is reviewing the risk factors for venous disease. Which of these situations best describes a person

at highest risk for the development of venous disease?

• Woman in her second month of pregnancy
• Person who has been on bed rest for 4 days

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• Person with a 30-year, 1 pack per day smoking habit
• Older adult taking anticoagulant medication

ANS: B

People who undergo prolonged standing, sitting, or bed rest are at risk for venous disease. Hypercoagulable (not anticoagulated) states and vein-wall trauma also place the person at risk for venous disease. Obesity and the late months of pregnancy are also risk factors.DIF: Cognitive Level: Applying (Application) MSC: Client Needs: Physiologic Integrity: Reduction of Risk Potential

• The nurse is teaching a review class on the lymphatic system. A participant shows correct understanding of

the material with which statement?

• Lymph flow is propelled by the contraction of the heart.
• The flow of lymph is slow, compared with that of the blood.
• One of the functions of the lymph is to absorb lipids from the biliary tract.
• Lymph vessels have no valves; therefore, lymph fluid flows freely from the tissue spaces into the

bloodstream.

ANS: B

The flow of lymph is slow, compared with flow of the blood. Lymph flow is not propelled by the heart but rather by contracting skeletal muscles, pressure changes secondary to breathing, and contraction of the vessel walls. Lymph does not absorb lipids from the biliary tract. The vessels do have valves; therefore, flow is one way from the tissue spaces to the bloodstream.DIF: Cognitive Level: Understanding (Comprehension) MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation

• 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?

• Assess the patients abdomen, and notice any tenderness.
• Carefully assess the cervical lymph nodes, and check for any enlargement.
• Ask additional health history questions regarding any recent ear infections or sore throats.
• Examine the patients lower arm and hand, and check for the presence of infection or lesions.

ANS: D

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PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK