NR 304 Health assessment II Exam 1 | Actual
Exam Study Questions and Answers + Expert
Rationales | 2026 Updated | 100% correct
1. How does a nurse perform a capillary refill assessment?
A. Depress and blanch the nail beds, hold for 5 seconds, then release and note the time for
color to return
B. Depress the nail bed, hold for 30 seconds, release, and note the time for color to return
C. Pinch the nail bed, hold for 10 seconds, release, and assess for blanching
D. Apply pressure to the fingertip, hold for 15 seconds, release, and note the color change
Correct Answer: A
Expert Rationale: Capillary refill assessment involves depressing and blanching the nail beds,
holding for 5 seconds, releasing the depression, and noting the time the capillaries take to refill.
This is a standard technique used to assess peripheral perfusion status. A normal refill rate is
less than 1-2 seconds. The 2026 American College of Radiology vascular ultrasound exam
requirements emphasize that peripheral perfusion assessment remains a cornerstone of
vascular evaluation.
2. The capillary refill assessment is an indicator of:
A. Central venous pressure
B. Peripheral perfusion status
C. Cardiac output
D. Respiratory function
Correct Answer: B
Expert Rationale: Capillary refill is a quick, non-invasive test that evaluates peripheral perfusion
status. It reflects the adequacy of blood flow to the peripheral tissues. While it can provide
some insight into circulatory status, it is specifically an indicator of peripheral perfusion, not
central venous pressure (A), cardiac output (C), or respiratory function (D). Prolonged capillary
refill (>2 seconds) may indicate decreased peripheral perfusion.
,3. A patient reports aching pain in the lower leg/calf with itching and stasis dermatitis. This
subjective data is most consistent with:
A. Peripheral arterial disease (PAD)
B. Venous insufficiency (stasis ulcers)
C. Neuropathy
D. Musculoskeletal strain
Correct Answer: B
Expert Rationale: The subjective data of aching pain in the lower leg/calf with itching and stasis
dermatitis is classic for venous insufficiency and venous (stasis) ulcers. Patients with venous
disease often report a dull ache or heaviness in the legs, which worsens with prolonged
standing or sitting. The aching pain is associated with increased venous pressure. The 2026
literature on peripheral arterial disease distinguishes venous symptoms from arterial
claudication.
4. What makes the aching pain associated with venous ulcers worse?
A. Elevation of the legs
B. Prolonged standing and prolonged sitting
C. Walking and exercise
D. Resting with legs elevated
Correct Answer: B
Expert Rationale: The aching pain associated with venous insufficiency and venous ulcers is
worsened by prolonged standing and prolonged sitting. This is due to increased venous pressure
and pooling of blood in the lower extremities. Elevation (A) typically relieves venous pain, while
walking (C) can help improve venous return through calf muscle pump action.
5. A nurse is assessing a patient with venous insufficiency. Which objective finding would the
nurse expect?
A. Diminished pulses and cool extremities
B. Lower extremity edema, brawny edema, and brown pigment discoloration
C. Pallor on elevation and dependent rubor
D. Thick-ridged nails and hair loss on the lower extremities
Correct Answer: B
,Expert Rationale: Venous insufficiency is characterized by lower extremity edema, brawny
edema (firm, non-pitting edema), coarse/thickened skin, normal pulses, brown pigment
discoloration (hemosiderin deposition), petechiae, dermatitis, and shallow granulation tissue. In
contrast, arterial disease (A) presents with diminished pulses and cool extremities. The 2026
NICE guidelines on peripheral arterial disease confirm these distinguishing features for
differential diagnosis.
6. Venous ulcers cause an increase in:
A. Arterial pressure
B. Venous pressure
C. Capillary pressure
D. Lymphatic pressure
Correct Answer: B
Expert Rationale: Venous ulcers are caused by chronic venous insufficiency, which leads to
increased venous pressure in the lower extremities. This increased pressure results in fluid
leakage, edema, and eventual skin changes and ulceration. The management focuses on
reducing venous pressure through compression, elevation, and exercise.
7. Which of the following are clinical manifestations of peripheral arterial disease (PAD)?
A. Leg pain, cramps, and claudication
B. Edema, brown pigmentation, and dermatitis
C. Night pain, coolness to touch, and paralysis
D. A and C only
E. All of the above
Correct Answer: D
Expert Rationale: Peripheral arterial disease (PAD) clinical manifestations include leg pain,
cramps, skin color changes in arms/legs, swelling, lymph node enlargement, fatigue,
claudication, night pain, coolness to touch (poikilothermia), and paralysis in severe cases. The
2026 ACC/AHA PAD performance measures highlight that prompt recognition of these
symptoms is critical for diagnosis and management. Venous symptoms (B) include edema,
brown pigmentation, and dermatitis, which are more consistent with venous insufficiency.
, 8. The term "poikilothermic" in the context of peripheral arterial disease refers to:
A. Pain while walking
B. Coolness to the touch
C. Paralysis of the lower extremity
D. Pallor of the skin
Correct Answer: B
Expert Rationale: Poikilothermia refers to the condition of having cool skin, which is a key
finding in peripheral arterial disease. This coolness is due to decreased blood flow to the
extremities. The 2026 NICE PAD guidelines confirm that temperature gradient assessment is an
important part of the physical examination, with coolness in one foot or leg being a significant
finding.
9. What does "claudication" mean in the context of peripheral arterial disease?
A. Numbness and tingling in the feet
B. Pain while walking
C. Paralysis of the lower extremity
D. Coolness to the touch
Correct Answer: B
Expert Rationale: Claudication is defined as pain, cramping, or fatigue in the legs that occurs
with walking or exercise and is relieved by rest. It is a hallmark symptom of peripheral arterial
disease caused by inadequate blood flow to the muscles during activity. The 2026 NICE
guidelines confirm that intermittent claudication is a classic presentation of PAD.
10. Which clinical manifestation would be noted if peripheral arterial disease is severe?
A. Edema
B. Paralysis
C. Brown pigmentation
D. Dermatitis
Correct Answer: B
Expert Rationale: Paralysis is a severe manifestation of peripheral arterial disease, indicating
significant ischemia and potential tissue death. This is one of the "6 P's" of acute arterial
occlusion. Severe PAD can lead to critical limb ischemia, with symptoms progressing from
Exam Study Questions and Answers + Expert
Rationales | 2026 Updated | 100% correct
1. How does a nurse perform a capillary refill assessment?
A. Depress and blanch the nail beds, hold for 5 seconds, then release and note the time for
color to return
B. Depress the nail bed, hold for 30 seconds, release, and note the time for color to return
C. Pinch the nail bed, hold for 10 seconds, release, and assess for blanching
D. Apply pressure to the fingertip, hold for 15 seconds, release, and note the color change
Correct Answer: A
Expert Rationale: Capillary refill assessment involves depressing and blanching the nail beds,
holding for 5 seconds, releasing the depression, and noting the time the capillaries take to refill.
This is a standard technique used to assess peripheral perfusion status. A normal refill rate is
less than 1-2 seconds. The 2026 American College of Radiology vascular ultrasound exam
requirements emphasize that peripheral perfusion assessment remains a cornerstone of
vascular evaluation.
2. The capillary refill assessment is an indicator of:
A. Central venous pressure
B. Peripheral perfusion status
C. Cardiac output
D. Respiratory function
Correct Answer: B
Expert Rationale: Capillary refill is a quick, non-invasive test that evaluates peripheral perfusion
status. It reflects the adequacy of blood flow to the peripheral tissues. While it can provide
some insight into circulatory status, it is specifically an indicator of peripheral perfusion, not
central venous pressure (A), cardiac output (C), or respiratory function (D). Prolonged capillary
refill (>2 seconds) may indicate decreased peripheral perfusion.
,3. A patient reports aching pain in the lower leg/calf with itching and stasis dermatitis. This
subjective data is most consistent with:
A. Peripheral arterial disease (PAD)
B. Venous insufficiency (stasis ulcers)
C. Neuropathy
D. Musculoskeletal strain
Correct Answer: B
Expert Rationale: The subjective data of aching pain in the lower leg/calf with itching and stasis
dermatitis is classic for venous insufficiency and venous (stasis) ulcers. Patients with venous
disease often report a dull ache or heaviness in the legs, which worsens with prolonged
standing or sitting. The aching pain is associated with increased venous pressure. The 2026
literature on peripheral arterial disease distinguishes venous symptoms from arterial
claudication.
4. What makes the aching pain associated with venous ulcers worse?
A. Elevation of the legs
B. Prolonged standing and prolonged sitting
C. Walking and exercise
D. Resting with legs elevated
Correct Answer: B
Expert Rationale: The aching pain associated with venous insufficiency and venous ulcers is
worsened by prolonged standing and prolonged sitting. This is due to increased venous pressure
and pooling of blood in the lower extremities. Elevation (A) typically relieves venous pain, while
walking (C) can help improve venous return through calf muscle pump action.
5. A nurse is assessing a patient with venous insufficiency. Which objective finding would the
nurse expect?
A. Diminished pulses and cool extremities
B. Lower extremity edema, brawny edema, and brown pigment discoloration
C. Pallor on elevation and dependent rubor
D. Thick-ridged nails and hair loss on the lower extremities
Correct Answer: B
,Expert Rationale: Venous insufficiency is characterized by lower extremity edema, brawny
edema (firm, non-pitting edema), coarse/thickened skin, normal pulses, brown pigment
discoloration (hemosiderin deposition), petechiae, dermatitis, and shallow granulation tissue. In
contrast, arterial disease (A) presents with diminished pulses and cool extremities. The 2026
NICE guidelines on peripheral arterial disease confirm these distinguishing features for
differential diagnosis.
6. Venous ulcers cause an increase in:
A. Arterial pressure
B. Venous pressure
C. Capillary pressure
D. Lymphatic pressure
Correct Answer: B
Expert Rationale: Venous ulcers are caused by chronic venous insufficiency, which leads to
increased venous pressure in the lower extremities. This increased pressure results in fluid
leakage, edema, and eventual skin changes and ulceration. The management focuses on
reducing venous pressure through compression, elevation, and exercise.
7. Which of the following are clinical manifestations of peripheral arterial disease (PAD)?
A. Leg pain, cramps, and claudication
B. Edema, brown pigmentation, and dermatitis
C. Night pain, coolness to touch, and paralysis
D. A and C only
E. All of the above
Correct Answer: D
Expert Rationale: Peripheral arterial disease (PAD) clinical manifestations include leg pain,
cramps, skin color changes in arms/legs, swelling, lymph node enlargement, fatigue,
claudication, night pain, coolness to touch (poikilothermia), and paralysis in severe cases. The
2026 ACC/AHA PAD performance measures highlight that prompt recognition of these
symptoms is critical for diagnosis and management. Venous symptoms (B) include edema,
brown pigmentation, and dermatitis, which are more consistent with venous insufficiency.
, 8. The term "poikilothermic" in the context of peripheral arterial disease refers to:
A. Pain while walking
B. Coolness to the touch
C. Paralysis of the lower extremity
D. Pallor of the skin
Correct Answer: B
Expert Rationale: Poikilothermia refers to the condition of having cool skin, which is a key
finding in peripheral arterial disease. This coolness is due to decreased blood flow to the
extremities. The 2026 NICE PAD guidelines confirm that temperature gradient assessment is an
important part of the physical examination, with coolness in one foot or leg being a significant
finding.
9. What does "claudication" mean in the context of peripheral arterial disease?
A. Numbness and tingling in the feet
B. Pain while walking
C. Paralysis of the lower extremity
D. Coolness to the touch
Correct Answer: B
Expert Rationale: Claudication is defined as pain, cramping, or fatigue in the legs that occurs
with walking or exercise and is relieved by rest. It is a hallmark symptom of peripheral arterial
disease caused by inadequate blood flow to the muscles during activity. The 2026 NICE
guidelines confirm that intermittent claudication is a classic presentation of PAD.
10. Which clinical manifestation would be noted if peripheral arterial disease is severe?
A. Edema
B. Paralysis
C. Brown pigmentation
D. Dermatitis
Correct Answer: B
Expert Rationale: Paralysis is a severe manifestation of peripheral arterial disease, indicating
significant ischemia and potential tissue death. This is one of the "6 P's" of acute arterial
occlusion. Severe PAD can lead to critical limb ischemia, with symptoms progressing from
