NR 304 Peripheral Vascular System Questions With
Complete Solutions
A client has a 1+/0-4+ dorsalis pedis pulse on the right. The
lower leg is cool, pale, and painful. This description is most
consistent with:
1. Venous insufficiency
2. Arterial insufficiency
3. Thrombophlebitis
4. Lymphatic insufficiency Correct Answers 2. Arterial
insufficiency
-Arterial insufficiency is inadequate circulation in the arterial
system, which results in diminished pulses; cool, shiny skin;
deep muscle pain; absence of hair on the toes; pallor on
elevation; and a red color when dependent. Venous insufficiency
is inadequate circulation in the venous system due to
incompetent valves in the deep veins or a blood clot in the veins.
Edema is usually present. The temperature of the skin is normal.
Thrombophlebitis is inflammation of a vein with a clot.
Alterations in the lymphatic system may result in lymphedema,
not alterations in the arterial circulation such as in arterial
insufficiency as described above.
A client is being evaluated for suspected thrombosis of a deep
leg vein. Which of the following is the nurse most likely to note
during the assessment?
1. Pain in the calf when dorsiflexing the foot
2. A cool foot with diminished pulses
3. Increased pain with elevation of the extremity
4. Decreased hair distribution on the legs Correct Answers 1.
Pain in the calf when dorsiflexing the foot
,-Pain in the calf when dorsiflexing the foot (Homans' sign) may
indicate thrombosis (blood clot) of a deep leg vein. A cool foot
with diminished pulses indicates problems with arterial
circulation, not venous circulation. Increased pain with elevation
of the extremity would be present with arterial circulation
abnormalities. Decreased hair distribution on the lower legs is
related to arterial abnormalities, not venous.
A client tells the nurse, "My legs really hurt when I walk, but if I
stop walking the pain gets better in a few minutes." This
symptom most likely describes:
1. The presence of varicosities
2. Lymphatic abnormalities
3. Decreased arterial circulation
4. Deep vein thrombosis Correct Answers 3. Decreased arterial
circulation
-Pain associated with arterial insufficiency increases with
exercise and is relieved with the cessation of movement.
Varicosities occur in the venous system and are not affected by
exercise. Alterations in the lymphatic system are not
exacerbated by exercise. Deep vein thrombosis is occlusion of a
deep vein (e.g., blockage of the femoral vein by a blood clot).
The client may have pain and edema that are present both at rest
and with exercise.
A patient is complaining of new-onset calf & foot pain.
The nurse notes that the leg below the knee is cool & pale. The
dorsalis pedis & post-tibial pulses are assessed as "0" w/
palpation and "0" following validation with a doppler. The
priority nursing intervention is:
1. place a cradle over the bed to prevent pressure from bedding
, 2. Elevate the leg
3. massage the leg
4. notify the physician immediately Correct Answers 4. notify
the physician immediately
Allen's test Correct Answers Determines patency of the radial
and ulnar arteries
-If nomral color does not return after compressing radial arteries,
the ULNAR arteries may be occluded (and vice versa)
An eight-month-pregnant client states that she has developed a
few varicose veins during her pregnancy. What can the nurse tell
the client about these veins?
1. "These are common and will go away after delivery."
2. "We need to talk to your health care provider about this."
3. "This is a normal finding and is caused by pressure from your
uterus delaying blood return from your legs."
4. "This is related to decreased circulation." Correct Answers 3.
"This is a normal finding and is caused by pressure from your
uterus delaying blood return from your legs."
-Pressure from the uterus on the lower extremities is common
during pregnancy and can obstruct venous return leading to
edema, varicosities of the leg, or hemorrhoids. The varicosities
may not resolve after pregnancy. This is a common finding and
not cause for alarm at this point. Notification of the health care
provider is not warranted at this time. Decreased circulation
doesn't cause varicosities. Symptoms of decreased circulation
would include cool feet and diminished pulses.
Complete Solutions
A client has a 1+/0-4+ dorsalis pedis pulse on the right. The
lower leg is cool, pale, and painful. This description is most
consistent with:
1. Venous insufficiency
2. Arterial insufficiency
3. Thrombophlebitis
4. Lymphatic insufficiency Correct Answers 2. Arterial
insufficiency
-Arterial insufficiency is inadequate circulation in the arterial
system, which results in diminished pulses; cool, shiny skin;
deep muscle pain; absence of hair on the toes; pallor on
elevation; and a red color when dependent. Venous insufficiency
is inadequate circulation in the venous system due to
incompetent valves in the deep veins or a blood clot in the veins.
Edema is usually present. The temperature of the skin is normal.
Thrombophlebitis is inflammation of a vein with a clot.
Alterations in the lymphatic system may result in lymphedema,
not alterations in the arterial circulation such as in arterial
insufficiency as described above.
A client is being evaluated for suspected thrombosis of a deep
leg vein. Which of the following is the nurse most likely to note
during the assessment?
1. Pain in the calf when dorsiflexing the foot
2. A cool foot with diminished pulses
3. Increased pain with elevation of the extremity
4. Decreased hair distribution on the legs Correct Answers 1.
Pain in the calf when dorsiflexing the foot
,-Pain in the calf when dorsiflexing the foot (Homans' sign) may
indicate thrombosis (blood clot) of a deep leg vein. A cool foot
with diminished pulses indicates problems with arterial
circulation, not venous circulation. Increased pain with elevation
of the extremity would be present with arterial circulation
abnormalities. Decreased hair distribution on the lower legs is
related to arterial abnormalities, not venous.
A client tells the nurse, "My legs really hurt when I walk, but if I
stop walking the pain gets better in a few minutes." This
symptom most likely describes:
1. The presence of varicosities
2. Lymphatic abnormalities
3. Decreased arterial circulation
4. Deep vein thrombosis Correct Answers 3. Decreased arterial
circulation
-Pain associated with arterial insufficiency increases with
exercise and is relieved with the cessation of movement.
Varicosities occur in the venous system and are not affected by
exercise. Alterations in the lymphatic system are not
exacerbated by exercise. Deep vein thrombosis is occlusion of a
deep vein (e.g., blockage of the femoral vein by a blood clot).
The client may have pain and edema that are present both at rest
and with exercise.
A patient is complaining of new-onset calf & foot pain.
The nurse notes that the leg below the knee is cool & pale. The
dorsalis pedis & post-tibial pulses are assessed as "0" w/
palpation and "0" following validation with a doppler. The
priority nursing intervention is:
1. place a cradle over the bed to prevent pressure from bedding
, 2. Elevate the leg
3. massage the leg
4. notify the physician immediately Correct Answers 4. notify
the physician immediately
Allen's test Correct Answers Determines patency of the radial
and ulnar arteries
-If nomral color does not return after compressing radial arteries,
the ULNAR arteries may be occluded (and vice versa)
An eight-month-pregnant client states that she has developed a
few varicose veins during her pregnancy. What can the nurse tell
the client about these veins?
1. "These are common and will go away after delivery."
2. "We need to talk to your health care provider about this."
3. "This is a normal finding and is caused by pressure from your
uterus delaying blood return from your legs."
4. "This is related to decreased circulation." Correct Answers 3.
"This is a normal finding and is caused by pressure from your
uterus delaying blood return from your legs."
-Pressure from the uterus on the lower extremities is common
during pregnancy and can obstruct venous return leading to
edema, varicosities of the leg, or hemorrhoids. The varicosities
may not resolve after pregnancy. This is a common finding and
not cause for alarm at this point. Notification of the health care
provider is not warranted at this time. Decreased circulation
doesn't cause varicosities. Symptoms of decreased circulation
would include cool feet and diminished pulses.
