GUARANTEED
CHAMBERLAIN UNIVERSITY · COLLEGE OF NURSING
PASS.
NR 304 Exam 1
Practice Question Bank
Health Assessment II — Peripheral Vascular & Lymphatic Systems
EXAM 1 REVIEW:
Arterial · Venous · Lymphatic · DVT · PAD · Ulcers · Pulse Assessment
ARTERIAL DISORDERS VENOUS DISORDERS LYMPHATIC SYSTEM CLINICAL JUDGMENT
PAD, ulcers, ABI CVI, DVT, varicose veins Lymphedema, nodes Assessment & intervention
P r e pa r e · P r a c t i c e · Pa s s
Excellence in Nursing Education
,NR 304 EXAM 1 — CHAMBERLAIN UNIVERSITY QUESTIONS 1–22: ARTERIAL & VENOUS FUNDAMENTALS
Section 1: Arterial & Venous Fundamentals — Questions 1–22
1 Which structure is most likely compromised if a 68-year-old client reports calf pain that begins after walking two blocks and
disappears with rest?
A Arteries supplying the lower extremities
B Superficial veins of the lower leg
C Lymphatic vessels in the calf
D Deep veins of the thigh
Why A is correct: Intermittent claudication — calf pain with exertion that resolves with rest — is the hallmark symptom of peripheral arterial disease
(PAD). It results from arterial insufficiency unable to meet increased oxygen demand during exercise.
2 What is the most appropriate next step if the dorsalis pedis pulse is faint and thready?
A Assess other peripheral pulses and compare bilaterally
B Document the finding and take no further action
C Apply a warm compress to the foot
D Immediately call a code blue
Why A is correct: A faint/thready pulse warrants further assessment — compare bilaterally and assess all peripheral pulses to determine if the finding is
isolated or systemic. Use a Doppler if needed.
3 What is the priority action if a postoperative client has a cool and pale right calf with diminished pulses?
A Notify the provider immediately and keep the limb dependent
B Elevate the leg above the heart
C Apply a heating pad to improve circulation
D Massage the calf to stimulate blood flow
Why A is correct: Cool, pale limb with diminished pulses suggests acute arterial occlusion — a vascular emergency. Keep limb dependent (gravity aids
arterial flow), notify provider immediately. Never massage (could dislodge clot).
4 Why does leg elevation help a patient with chronic venous insufficiency?
A It promotes venous return by reducing pressure in the leg veins
B It increases arterial blood flow to the feet
C It stimulates lymphatic drainage through gravity
D It strengthens the calf muscle pump
Why A is correct: Elevation above heart level reduces hydrostatic pressure in leg veins, promoting venous return. This decreases edema and discomfort.
This is the opposite of PAD management (dangling helps arterial flow).
5 Which physiological structure is primarily responsible for draining excess fluid from the interstitial spaces?
A Lymphatic vessels
B Arterioles
C Venules
D Capillary beds
Why A is correct: The lymphatic system drains excess interstitial fluid and plasma proteins back into the circulatory system. Without this, edema
develops. It also absorbs lipids and defends against disease.
6 What explains the finding of a weak femoral pulse, cool extremities, and delayed capillary refill?
A Decreased arterial perfusion to the lower extremity
B Venous stasis from prolonged sitting
C Lymphatic obstruction from surgery
D Neuropathic changes from diabetes
Why A is correct: Weak proximal pulse + coolness + delayed capillary refill = arterial insufficiency. The femoral pulse is proximal; weakness there
suggests significant upstream obstruction.
7 Why do varicose veins appear twisted and enlarged?
A They result from incompetent venous valves causing blood to pool
B They are caused by arterial blood leaking into veins
C They develop from lymphatic fluid accumulation
D They result from excessive collagen in vessel walls
Why A is correct: Incompetent venous valves allow blood to reflux and pool, distending the vein walls. Prolonged standing increases venous pressure,
stretching veins and weakening valves over time.
, 8 What does a capillary refill time of 4 seconds indicate?
A Possible arterial insufficiency or hypoperfusion
B Normal peripheral perfusion
C Venous congestion
D Lymphatic obstruction
Why A is correct: Normal capillary refill is <3 seconds. >3 seconds suggests decreased arterial perfusion, vasoconstriction, or hypovolemia. Technique:
depress nail bed until blanched, release, time color return.
9 What physiological mechanism supports the idea that walking helps improve circulation in a patient with PAD?
A Exercise promotes development of collateral circulation
B Walking dissolves arterial plaque
C Exercise increases venous valve competency
D Walking reduces blood viscosity
Why A is correct: Regular walking stimulates angiogenesis — development of collateral blood vessels that bypass blocked arteries. This is a key PAD
treatment. Patients should walk to the point of pain, rest, then resume.
10 What physiological process is responsible for a warm, red, and swollen right leg compared to the left?
A Venous stasis and inflammation
B Increased arterial perfusion
C Lymphatic drainage insufficiency
D Neurogenic vasodilation
Why A is correct: Warmth, redness, and unilateral swelling suggest venous stasis with inflammation — characteristic of DVT or thrombophlebitis.
Arterial insufficiency presents with cool, pale skin.
11 Which finding during palpation of the epitrochlear lymph node would be most concerning?
A A firm, enlarged, and tender node
B A small, soft, non-tender node
C A node that is barely palpable
D A mobile, pea-sized node
Why A is correct: Firm, enlarged, tender nodes suggest infection/inflammation. Hard, fixed, non-tender nodes are more concerning for malignancy.
Normal nodes are small, soft, mobile, and non-tender.
12 What assessment finding would confirm lymphatic obstruction rather than venous insufficiency?
A Nonpitting, firm edema that does not resolve with elevation
B Pitting edema that improves with leg elevation
C Brown discoloration around the ankles
D Varicose veins with tortuous appearance
Why A is correct: Lymphedema = nonpitting, firm, persistent (doesn't resolve with elevation). Venous insufficiency = pitting edema, improves with
elevation, brown discoloration (hemosiderin). Varicose veins = venous.
13 What are the main functions of the lymphatic system?
A Conserving fluid and plasma proteins, absorbing lipids from the intestinal tract, and defending the body against disease
B Transporting oxygen to tissues and removing carbon dioxide
C Regulating blood pressure through vasoconstriction
D Producing red blood cells and platelets
Why A is correct: The lymphatic system: 1) conserves fluid/proteins by returning them to circulation, 2) absorbs lipids from GI tract (lacteals), 3) defends
against disease (lymph nodes filter pathogens).
14 What does a 2+ amplitude of the radial pulse indicate?
A Normal
B Weak and diminished
C Bounding and forceful
D Absent
Why A is correct: Pulse amplitude scale: 0=absent, 1+=weak/diminished, 2+=normal, 3+=increased/bounding, 4+=bounding/aneurysmal. 2+ is the
expected normal finding.
CHAMBERLAIN UNIVERSITY · COLLEGE OF NURSING
PASS.
NR 304 Exam 1
Practice Question Bank
Health Assessment II — Peripheral Vascular & Lymphatic Systems
EXAM 1 REVIEW:
Arterial · Venous · Lymphatic · DVT · PAD · Ulcers · Pulse Assessment
ARTERIAL DISORDERS VENOUS DISORDERS LYMPHATIC SYSTEM CLINICAL JUDGMENT
PAD, ulcers, ABI CVI, DVT, varicose veins Lymphedema, nodes Assessment & intervention
P r e pa r e · P r a c t i c e · Pa s s
Excellence in Nursing Education
,NR 304 EXAM 1 — CHAMBERLAIN UNIVERSITY QUESTIONS 1–22: ARTERIAL & VENOUS FUNDAMENTALS
Section 1: Arterial & Venous Fundamentals — Questions 1–22
1 Which structure is most likely compromised if a 68-year-old client reports calf pain that begins after walking two blocks and
disappears with rest?
A Arteries supplying the lower extremities
B Superficial veins of the lower leg
C Lymphatic vessels in the calf
D Deep veins of the thigh
Why A is correct: Intermittent claudication — calf pain with exertion that resolves with rest — is the hallmark symptom of peripheral arterial disease
(PAD). It results from arterial insufficiency unable to meet increased oxygen demand during exercise.
2 What is the most appropriate next step if the dorsalis pedis pulse is faint and thready?
A Assess other peripheral pulses and compare bilaterally
B Document the finding and take no further action
C Apply a warm compress to the foot
D Immediately call a code blue
Why A is correct: A faint/thready pulse warrants further assessment — compare bilaterally and assess all peripheral pulses to determine if the finding is
isolated or systemic. Use a Doppler if needed.
3 What is the priority action if a postoperative client has a cool and pale right calf with diminished pulses?
A Notify the provider immediately and keep the limb dependent
B Elevate the leg above the heart
C Apply a heating pad to improve circulation
D Massage the calf to stimulate blood flow
Why A is correct: Cool, pale limb with diminished pulses suggests acute arterial occlusion — a vascular emergency. Keep limb dependent (gravity aids
arterial flow), notify provider immediately. Never massage (could dislodge clot).
4 Why does leg elevation help a patient with chronic venous insufficiency?
A It promotes venous return by reducing pressure in the leg veins
B It increases arterial blood flow to the feet
C It stimulates lymphatic drainage through gravity
D It strengthens the calf muscle pump
Why A is correct: Elevation above heart level reduces hydrostatic pressure in leg veins, promoting venous return. This decreases edema and discomfort.
This is the opposite of PAD management (dangling helps arterial flow).
5 Which physiological structure is primarily responsible for draining excess fluid from the interstitial spaces?
A Lymphatic vessels
B Arterioles
C Venules
D Capillary beds
Why A is correct: The lymphatic system drains excess interstitial fluid and plasma proteins back into the circulatory system. Without this, edema
develops. It also absorbs lipids and defends against disease.
6 What explains the finding of a weak femoral pulse, cool extremities, and delayed capillary refill?
A Decreased arterial perfusion to the lower extremity
B Venous stasis from prolonged sitting
C Lymphatic obstruction from surgery
D Neuropathic changes from diabetes
Why A is correct: Weak proximal pulse + coolness + delayed capillary refill = arterial insufficiency. The femoral pulse is proximal; weakness there
suggests significant upstream obstruction.
7 Why do varicose veins appear twisted and enlarged?
A They result from incompetent venous valves causing blood to pool
B They are caused by arterial blood leaking into veins
C They develop from lymphatic fluid accumulation
D They result from excessive collagen in vessel walls
Why A is correct: Incompetent venous valves allow blood to reflux and pool, distending the vein walls. Prolonged standing increases venous pressure,
stretching veins and weakening valves over time.
, 8 What does a capillary refill time of 4 seconds indicate?
A Possible arterial insufficiency or hypoperfusion
B Normal peripheral perfusion
C Venous congestion
D Lymphatic obstruction
Why A is correct: Normal capillary refill is <3 seconds. >3 seconds suggests decreased arterial perfusion, vasoconstriction, or hypovolemia. Technique:
depress nail bed until blanched, release, time color return.
9 What physiological mechanism supports the idea that walking helps improve circulation in a patient with PAD?
A Exercise promotes development of collateral circulation
B Walking dissolves arterial plaque
C Exercise increases venous valve competency
D Walking reduces blood viscosity
Why A is correct: Regular walking stimulates angiogenesis — development of collateral blood vessels that bypass blocked arteries. This is a key PAD
treatment. Patients should walk to the point of pain, rest, then resume.
10 What physiological process is responsible for a warm, red, and swollen right leg compared to the left?
A Venous stasis and inflammation
B Increased arterial perfusion
C Lymphatic drainage insufficiency
D Neurogenic vasodilation
Why A is correct: Warmth, redness, and unilateral swelling suggest venous stasis with inflammation — characteristic of DVT or thrombophlebitis.
Arterial insufficiency presents with cool, pale skin.
11 Which finding during palpation of the epitrochlear lymph node would be most concerning?
A A firm, enlarged, and tender node
B A small, soft, non-tender node
C A node that is barely palpable
D A mobile, pea-sized node
Why A is correct: Firm, enlarged, tender nodes suggest infection/inflammation. Hard, fixed, non-tender nodes are more concerning for malignancy.
Normal nodes are small, soft, mobile, and non-tender.
12 What assessment finding would confirm lymphatic obstruction rather than venous insufficiency?
A Nonpitting, firm edema that does not resolve with elevation
B Pitting edema that improves with leg elevation
C Brown discoloration around the ankles
D Varicose veins with tortuous appearance
Why A is correct: Lymphedema = nonpitting, firm, persistent (doesn't resolve with elevation). Venous insufficiency = pitting edema, improves with
elevation, brown discoloration (hemosiderin). Varicose veins = venous.
13 What are the main functions of the lymphatic system?
A Conserving fluid and plasma proteins, absorbing lipids from the intestinal tract, and defending the body against disease
B Transporting oxygen to tissues and removing carbon dioxide
C Regulating blood pressure through vasoconstriction
D Producing red blood cells and platelets
Why A is correct: The lymphatic system: 1) conserves fluid/proteins by returning them to circulation, 2) absorbs lipids from GI tract (lacteals), 3) defends
against disease (lymph nodes filter pathogens).
14 What does a 2+ amplitude of the radial pulse indicate?
A Normal
B Weak and diminished
C Bounding and forceful
D Absent
Why A is correct: Pulse amplitude scale: 0=absent, 1+=weak/diminished, 2+=normal, 3+=increased/bounding, 4+=bounding/aneurysmal. 2+ is the
expected normal finding.
