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 w ith
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 o f the
occlusion of the pelvic veins and inferior vena cava from pressure created by