Chapter 20: Peripheral Vascular System and Lymphatic System
Jarvis: Physical Examination & Health Assessment, 7th Edition
MULTIPLE CHOICE
1. Which statement is true regarding the arterial system?
a. Arteries are large-diameter vessels.
b. The arterial system is a high-pressure
system.
c. The walls of arteries are thinner than those
of the veins.
d. Arteries can greatly expand to
accommodate a large blood volume
increase.
ANS: B
The pumping heart makes the arterial system a high-pressure system.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 509
MSC: Client Needs: General
2. The nurse is reviewing the blood supply to the arm. The major artery
supplying the arm is the artery.
a. Ulnar
b. Radial
c. Brachial
d. Deep palmar
ANS: C
The major artery supplying the arm is the brachial artery. The brachial artery bifurcates
into the ulnar and radial arteries immediately below the elbow. In the hand, the ulnar and
radial arteries form two arches known as the superficial and deep palmar arches.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 509
MSC: Client Needs: General
3. The nurse is preparing to assess the dorsalis pedis artery. Where is the
correct location for palpation?
a. Behind the knee
b. Over the lateral malleolus
c. In the groove behind the medial malleolus
d. Lateral to the extensor tendon of the great
toe
ANS: D
The dorsalis pedis artery is located on the dorsum of the foot. The nurse should palpate
,Chapter 20: Peripheral Vascular System and Lymphatic System
Jarvis: Physical Examination & Health Assessment, 7th Edition
just lateral to and parallel with the extensor tendon of the big toe. The popliteal artery is
palpated behind the knee. The posterior tibial pulse is palpated in the groove between the
malleolus and the Achilles tendon. No pulse is palpated at the lateral malleolus.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 509
MSC: Client Needs: General
4. A 65-year-old patient is experiencing pain in his left calf when he
exercises that disappears after resting for a few minutes. The nurse recognizes that this
description is most consistent with the left leg.
a. Venous obstruction of
b. Claudication due to venous abnormalities
in
c. Ischemia caused by a partial blockage of
an artery supplying
d. Ischemia caused by the complete blockage
of an artery supplying
ANS: C
Ischemia is a deficient supply of oxygenated arterial blood to a tissue. A partial blockage
creates an insufficient supply, and the ischemia may be apparent only during exercise
when oxygen needs increase.
DIF: Cognitive Level: Analyzing (Analysis) REF: pp. 509-510
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
5. The nurse is reviewing venous blood flow patterns. Which of these
statements best describes the mechanism(s) by which venous blood returns to the heart?
a. Intraluminal valves ensure unidirectional
flow toward the heart.
b. Contracting skeletal muscles milk blood
distally toward the veins.
c. High-pressure system of the heart helps
facilitate venous return.
d. Increased thoracic pressure and decreased
abdominal pressure facilitate venous
return to the heart.
ANS: A
Blood moves through the veins by (1) contracting skeletal muscles that proximally milk
the blood; (2) pressure gradients caused by breathing, during which inspiration makes the
thoracic pressure decrease and the abdominal pressure increase; and (3) the intraluminal
valves, which ensure unidirectional flow toward the heart.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 511
MSC: Client Needs: General
, Chapter 20: Peripheral Vascular System and Lymphatic System
Jarvis: Physical Examination & Health Assessment, 7th Edition
6. Which vein(s) is(are) responsible for most of the venous return in the arm?
a. Deep
b. Ulnar
c. Subclavian
d. Superficial
ANS: D
The superficial veins of the arms are in the subcutaneous tissue and are responsible for
most of the venous return.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 510
MSC: Client Needs: General
7. A 70-year-old patient is scheduled for open-heart surgery. The surgeon
plans to use the great saphenous vein for the coronary bypass grafts. The patient asks,
“What happens to my circulation when this vein is removed?” The nurse should reply:
a. “Venous insufficiency is a common
problem after this type of surgery.”
b. “Oh, you have lots of veins—you won’t
even notice that it has been removed.”
c. “You will probably experience decreased
circulation after the vein is removed.”
d. “This vein can be removed without
harming your circulation because the
deeper veins in your leg are in good
condition.”
ANS: D
As long as the femoral and popliteal veins remain intact, the superficial veins can be
excised without harming circulation. The other responses are not correct.
DIF: Cognitive Level: Analyzing (Analysis) REF: p. 510
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
8. The nurse is reviewing the risk factors for venous disease. Which of these
situations best describes a person at highest risk for the development of venous disease?
a. Woman in her second month of pregnancy
b. Person who has been on bed rest for 4
days
c. Person with a 30-year, 1 pack per day
smoking habit
d. Older adult taking anticoagulant
medication
ANS: B
People who undergo prolonged standing, sitting, or bed rest are at risk for venous disease.
Hypercoagulable (not anticoagulated) states and vein-wall trauma also place the person at
Jarvis: Physical Examination & Health Assessment, 7th Edition
MULTIPLE CHOICE
1. Which statement is true regarding the arterial system?
a. Arteries are large-diameter vessels.
b. The arterial system is a high-pressure
system.
c. The walls of arteries are thinner than those
of the veins.
d. Arteries can greatly expand to
accommodate a large blood volume
increase.
ANS: B
The pumping heart makes the arterial system a high-pressure system.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 509
MSC: Client Needs: General
2. The nurse is reviewing the blood supply to the arm. The major artery
supplying the arm is the artery.
a. Ulnar
b. Radial
c. Brachial
d. Deep palmar
ANS: C
The major artery supplying the arm is the brachial artery. The brachial artery bifurcates
into the ulnar and radial arteries immediately below the elbow. In the hand, the ulnar and
radial arteries form two arches known as the superficial and deep palmar arches.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 509
MSC: Client Needs: General
3. The nurse is preparing to assess the dorsalis pedis artery. Where is the
correct location for palpation?
a. Behind the knee
b. Over the lateral malleolus
c. In the groove behind the medial malleolus
d. Lateral to the extensor tendon of the great
toe
ANS: D
The dorsalis pedis artery is located on the dorsum of the foot. The nurse should palpate
,Chapter 20: Peripheral Vascular System and Lymphatic System
Jarvis: Physical Examination & Health Assessment, 7th Edition
just lateral to and parallel with the extensor tendon of the big toe. The popliteal artery is
palpated behind the knee. The posterior tibial pulse is palpated in the groove between the
malleolus and the Achilles tendon. No pulse is palpated at the lateral malleolus.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 509
MSC: Client Needs: General
4. A 65-year-old patient is experiencing pain in his left calf when he
exercises that disappears after resting for a few minutes. The nurse recognizes that this
description is most consistent with the left leg.
a. Venous obstruction of
b. Claudication due to venous abnormalities
in
c. Ischemia caused by a partial blockage of
an artery supplying
d. Ischemia caused by the complete blockage
of an artery supplying
ANS: C
Ischemia is a deficient supply of oxygenated arterial blood to a tissue. A partial blockage
creates an insufficient supply, and the ischemia may be apparent only during exercise
when oxygen needs increase.
DIF: Cognitive Level: Analyzing (Analysis) REF: pp. 509-510
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
5. The nurse is reviewing venous blood flow patterns. Which of these
statements best describes the mechanism(s) by which venous blood returns to the heart?
a. Intraluminal valves ensure unidirectional
flow toward the heart.
b. Contracting skeletal muscles milk blood
distally toward the veins.
c. High-pressure system of the heart helps
facilitate venous return.
d. Increased thoracic pressure and decreased
abdominal pressure facilitate venous
return to the heart.
ANS: A
Blood moves through the veins by (1) contracting skeletal muscles that proximally milk
the blood; (2) pressure gradients caused by breathing, during which inspiration makes the
thoracic pressure decrease and the abdominal pressure increase; and (3) the intraluminal
valves, which ensure unidirectional flow toward the heart.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 511
MSC: Client Needs: General
, Chapter 20: Peripheral Vascular System and Lymphatic System
Jarvis: Physical Examination & Health Assessment, 7th Edition
6. Which vein(s) is(are) responsible for most of the venous return in the arm?
a. Deep
b. Ulnar
c. Subclavian
d. Superficial
ANS: D
The superficial veins of the arms are in the subcutaneous tissue and are responsible for
most of the venous return.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 510
MSC: Client Needs: General
7. A 70-year-old patient is scheduled for open-heart surgery. The surgeon
plans to use the great saphenous vein for the coronary bypass grafts. The patient asks,
“What happens to my circulation when this vein is removed?” The nurse should reply:
a. “Venous insufficiency is a common
problem after this type of surgery.”
b. “Oh, you have lots of veins—you won’t
even notice that it has been removed.”
c. “You will probably experience decreased
circulation after the vein is removed.”
d. “This vein can be removed without
harming your circulation because the
deeper veins in your leg are in good
condition.”
ANS: D
As long as the femoral and popliteal veins remain intact, the superficial veins can be
excised without harming circulation. The other responses are not correct.
DIF: Cognitive Level: Analyzing (Analysis) REF: p. 510
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
8. The nurse is reviewing the risk factors for venous disease. Which of these
situations best describes a person at highest risk for the development of venous disease?
a. Woman in her second month of pregnancy
b. Person who has been on bed rest for 4
days
c. Person with a 30-year, 1 pack per day
smoking habit
d. Older adult taking anticoagulant
medication
ANS: B
People who undergo prolonged standing, sitting, or bed rest are at risk for venous disease.
Hypercoagulable (not anticoagulated) states and vein-wall trauma also place the person at
