LYMPHATIC SYSTEM: ALL PRACTICE QUESTIONS &
ANSWERS
A patient reports an insidious onset of swelling of 1 month's duration on the dorsum of
the left foot. Which of the following conditions is the MOST likely cause?
1. Heart failure
2. Chronic venous insufficiency
3. Lymphedema
4. Lipedema
3. Lymphedema
Rationale: Lymphedema is usually unilateral with typical presentation distally on the
extremity (dorsum of the foot or hand) (Goodman, Differential Diagnosis; Goodman,
Pathology, pp. 680-682).
Manual lymphatic drainage is CONTRAINDICATED for a patient who has which of the
following conditions?
1. Chronic edema
2. Congestive heart failure
3. Chronic venous insufficiency
4. Complex regional pain syndrome
2. CHF
Rationale: Manual lymph drainage facilitates the removal of fluid from the extremities
back into the circulatory system. If the patient has heart failure, the heart will not be able
to handle the additional fluid and the heart failure will worsen. (p. 253)
Which of the following findings is MOST associated with Stage 2 lymphedema?
1. Swelling that feels hard with palpation
, 2. Edema that forms a dimple when fingertip pressure is removed
3. Signs and symptoms that are improved with elevation of the limb
4. Skin on the dorsum of the foot that can be pinched in a fold
1. Swelling, hard with palpation
Rationale: Swelling that feels hard with palpation describes brawny edema. Brawny
edema is associated with Stage 2 (spontaneously irreversible) lymphedema.
Which of the following tests is MOST accurate for assessing volume reduction in a
patient who has lymphedema?
1. Water displacement
2. Limb circumference
3. Bioelectrical impedance
4. Optoelectronic volumetry
1. Water displacement
Rationale: Water displacement has been regarded as the most sensitive and accurate
standard for volume measurement.
A patient who has Stage 0 lymphedema should be educated to AVOID which of the
following activities?
1. Prolonged air travel
2. Running barefoot
3. Aquatic activities
4. Stationary cycling
2. Running barefoot
Rationale: Individuals who have lymphedema in any stage (Stage 0 or risk for other
stages) should protect the skin and avoid any activities that could pierce the skin tissue.
When educating a patient regarding the prognosis of lymphedema, which of the
following concepts is MOST appropriate to communicate?
ANSWERS
A patient reports an insidious onset of swelling of 1 month's duration on the dorsum of
the left foot. Which of the following conditions is the MOST likely cause?
1. Heart failure
2. Chronic venous insufficiency
3. Lymphedema
4. Lipedema
3. Lymphedema
Rationale: Lymphedema is usually unilateral with typical presentation distally on the
extremity (dorsum of the foot or hand) (Goodman, Differential Diagnosis; Goodman,
Pathology, pp. 680-682).
Manual lymphatic drainage is CONTRAINDICATED for a patient who has which of the
following conditions?
1. Chronic edema
2. Congestive heart failure
3. Chronic venous insufficiency
4. Complex regional pain syndrome
2. CHF
Rationale: Manual lymph drainage facilitates the removal of fluid from the extremities
back into the circulatory system. If the patient has heart failure, the heart will not be able
to handle the additional fluid and the heart failure will worsen. (p. 253)
Which of the following findings is MOST associated with Stage 2 lymphedema?
1. Swelling that feels hard with palpation
, 2. Edema that forms a dimple when fingertip pressure is removed
3. Signs and symptoms that are improved with elevation of the limb
4. Skin on the dorsum of the foot that can be pinched in a fold
1. Swelling, hard with palpation
Rationale: Swelling that feels hard with palpation describes brawny edema. Brawny
edema is associated with Stage 2 (spontaneously irreversible) lymphedema.
Which of the following tests is MOST accurate for assessing volume reduction in a
patient who has lymphedema?
1. Water displacement
2. Limb circumference
3. Bioelectrical impedance
4. Optoelectronic volumetry
1. Water displacement
Rationale: Water displacement has been regarded as the most sensitive and accurate
standard for volume measurement.
A patient who has Stage 0 lymphedema should be educated to AVOID which of the
following activities?
1. Prolonged air travel
2. Running barefoot
3. Aquatic activities
4. Stationary cycling
2. Running barefoot
Rationale: Individuals who have lymphedema in any stage (Stage 0 or risk for other
stages) should protect the skin and avoid any activities that could pierce the skin tissue.
When educating a patient regarding the prognosis of lymphedema, which of the
following concepts is MOST appropriate to communicate?
