Chapter 16: Blood Vessels
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Induration, edema, and hyperpigmentation are common associated findings with which of the
following?
a. Peripheral arterial disease
b. Venous ulcer
c. Arterial embolic disease
d. Venous thrombus
ANS: B
A venous ulcer also results from chronic venous insufficiency and demonstrates induration
edema and hyperpigmentation.
Peripheral arterial edema results in ischemia, in which the foot or leg is painful and cold;
nonulceration is common as the muscles atrophy. Arterial embolic disease includes occlusion of
the small arteries, resulting in blue toe syndrome and splinter hemorrhages in the nail bed. A
venous thrombus presents with minimal ankle edema, low-grade fever, tachycardia, and possibly
a positive Homan sign.
DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—diagnosis
MSC: Physiologic Integrity: Reduction of Risk Potential
2. The most prominent component of the jugular venous pulse is the:
a. a wave.
b. c wave.
c. v wave.
d. x slope.
ANS: A
The a wave is the first and most prominent component of the jugular venous pulse. The a wave
represents a brief backflow of blood into the vena cava during right atrial contraction.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
3. During a routine prenatal visit, Ms. T was noted as having dependent edema, varicosities of
the legs, and hemorrhoids. She expressed concern about these symptoms. You explain to Ms. T
that her enlarged uterus is compressing her pelvic veins and her inferior vena cava. You would
further explain that these findings:
a. are usual conditions during pregnancy.
b. indicate a need for hospitalization.
c. indicate the need for amniocentesis.
d. suggest that she is having twins.
ANS: A
, Explain to the patient that these are usual conditions during pregnancy. Blood in the lower
extremities tends to pool in later pregnancy because of the occlusion of the pelvic veins and
inferior vena cava from pressure created by the enlarged uterus. This occlusion results in an
increase in dependent edema, varicosities of the legs and vulva, and hemorrhoids.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
4. Vascular changes expected in the older adult include:
a. loss of vessel elasticity.
b. decreased peripheral resistance.
c. decreased pulse pressure.
d. constriction of the aorta and major bronchi.
ANS: A
With age, the walls of the arteries become calcified and they lose their elasticity and vasomotor
tone; therefore, they lose their ability to respond appropriately to changing body needs. Increased
peripheral vascular resistance occurs, causing an increase in blood pressure.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
5. You are examining Mr. S, a 79-year-old diabetic man complaining of claudication. Which of
the following physical findings is consistent with the diagnosis of peripheral arterial disease?
a. Thick, calloused skin
b. Ruddy, thin skin
c. Warmer temperature of extremity in contrast to other body parts
d. Loss of hair over the extremities
ANS: D
An individual with peripheral artery disease or claudication will have thin skin with localized
pallor and cyanosis, a loss of body warmth in the affected area, and loss of hair over the
extremities.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
6. You are performing a physical examination on a 46-year-old male patient. His examination
findings include the following: positive peripheral edema, holosystolic murmur in the tricuspid
region, and a pulsatile liver. His diagnosis is:
a. an aortic aneurysm.
b. an arteriovenous fistula.
c. tricuspid stenosis.
d. tricuspid regurgitation.
ANS: D
An aneurysm is a localized isolation that results in a pulsatile swelling and a thrill or bruit. An
arteriovenous fistula is a pathologic communication between an artery and vein resulting in a
thrill or bruit and edema or ischemia in the involved extremity. Tricuspid regurgitation results in
a holosystolic murmur in the tricuspid region, a pulsatile liver, and peripheral edema.
DIF: Cognitive Level: Analyzing (Analysis) OBJ: Nursing process—diagnosis
MSC: Physiologic Integrity: Reduction of Risk Potential
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Induration, edema, and hyperpigmentation are common associated findings with which of the
following?
a. Peripheral arterial disease
b. Venous ulcer
c. Arterial embolic disease
d. Venous thrombus
ANS: B
A venous ulcer also results from chronic venous insufficiency and demonstrates induration
edema and hyperpigmentation.
Peripheral arterial edema results in ischemia, in which the foot or leg is painful and cold;
nonulceration is common as the muscles atrophy. Arterial embolic disease includes occlusion of
the small arteries, resulting in blue toe syndrome and splinter hemorrhages in the nail bed. A
venous thrombus presents with minimal ankle edema, low-grade fever, tachycardia, and possibly
a positive Homan sign.
DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—diagnosis
MSC: Physiologic Integrity: Reduction of Risk Potential
2. The most prominent component of the jugular venous pulse is the:
a. a wave.
b. c wave.
c. v wave.
d. x slope.
ANS: A
The a wave is the first and most prominent component of the jugular venous pulse. The a wave
represents a brief backflow of blood into the vena cava during right atrial contraction.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
3. During a routine prenatal visit, Ms. T was noted as having dependent edema, varicosities of
the legs, and hemorrhoids. She expressed concern about these symptoms. You explain to Ms. T
that her enlarged uterus is compressing her pelvic veins and her inferior vena cava. You would
further explain that these findings:
a. are usual conditions during pregnancy.
b. indicate a need for hospitalization.
c. indicate the need for amniocentesis.
d. suggest that she is having twins.
ANS: A
, Explain to the patient that these are usual conditions during pregnancy. Blood in the lower
extremities tends to pool in later pregnancy because of the occlusion of the pelvic veins and
inferior vena cava from pressure created by the enlarged uterus. This occlusion results in an
increase in dependent edema, varicosities of the legs and vulva, and hemorrhoids.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
4. Vascular changes expected in the older adult include:
a. loss of vessel elasticity.
b. decreased peripheral resistance.
c. decreased pulse pressure.
d. constriction of the aorta and major bronchi.
ANS: A
With age, the walls of the arteries become calcified and they lose their elasticity and vasomotor
tone; therefore, they lose their ability to respond appropriately to changing body needs. Increased
peripheral vascular resistance occurs, causing an increase in blood pressure.
DIF: Cognitive Level: Remembering (Knowledge)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
5. You are examining Mr. S, a 79-year-old diabetic man complaining of claudication. Which of
the following physical findings is consistent with the diagnosis of peripheral arterial disease?
a. Thick, calloused skin
b. Ruddy, thin skin
c. Warmer temperature of extremity in contrast to other body parts
d. Loss of hair over the extremities
ANS: D
An individual with peripheral artery disease or claudication will have thin skin with localized
pallor and cyanosis, a loss of body warmth in the affected area, and loss of hair over the
extremities.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
6. You are performing a physical examination on a 46-year-old male patient. His examination
findings include the following: positive peripheral edema, holosystolic murmur in the tricuspid
region, and a pulsatile liver. His diagnosis is:
a. an aortic aneurysm.
b. an arteriovenous fistula.
c. tricuspid stenosis.
d. tricuspid regurgitation.
ANS: D
An aneurysm is a localized isolation that results in a pulsatile swelling and a thrill or bruit. An
arteriovenous fistula is a pathologic communication between an artery and vein resulting in a
thrill or bruit and edema or ischemia in the involved extremity. Tricuspid regurgitation results in
a holosystolic murmur in the tricuspid region, a pulsatile liver, and peripheral edema.
DIF: Cognitive Level: Analyzing (Analysis) OBJ: Nursing process—diagnosis
MSC: Physiologic Integrity: Reduction of Risk Potential
