Question 1

A sound similar to a murmur that is heard over arteries is a:
A) thrill.
B) heave.
C) friction rub.
D) bruit.

Accepted Answer

A bruit is the sound of turbulent blood flow that is auscultated over the arteries and heard best with the bell of the stethoscope. Thrills, as well as heaves, are palpated findings. A friction rub is a distinct sound heard when two surfaces are rubbed together, as occurs with pericardial or pleural inflammation.

Question 2

In which location would carotid bruits be heard best?
A) Posterior cervical triangle
B) Anterior margin of the sternocleidomastoid muscle
C) Over the aortic valve
D) At the angle of the mandible

Accepted Answer

Carotid artery bruits are best heard at the anterior margin of the sternocleidomastoid muscle.

Question 3

A major risk factor for arterial embolic disease is:
A) venous thrombosis.
B) atrial fibrillation.
C) hypotension.
D) diuretic therapy.

Accepted Answer

Atrial fibrillation results in a disturbance of blood flow through the atrium. Blood is not pumped out completely, so it may pool and clot. An embolus can travel throughout the arterial system, causing an occlusion of small arteries and leading to necrosis of the tissue.

Question 4

The characteristics of arterial pulses are directly affected by all the following except:
A) the volume of blood ejected.
B) peripheral arterial resistance.
C) venous valvular competence.
D) blood viscosity.

Accepted Answer

Arterial pulses are not affected by venous valvular competence. Venous valvular competence contributes to the venous blood flow back to the heart.

Question 5

In newborn infants, closure of the ductus arteriosus usually occurs:
A) 12 to 14 hours after birth.
B) after 7 days of life.
C) between the second and third months.
D) during the toddler period.

Accepted Answer

The ductus arteriosus usually closes within the first 12 to 14 hours of life.

Question 6

Conduction system impairment should be suspected if an irregular heartbeat is:
A) galloping.
B) paradoxical.
C) loud.
D) weak.

Accepted Answer

A patternless, unpredictable, irregular rate may indicate heart disease or conduction system impairment. A gallop is an abnormal regular heart rhythm with three sounds in each cycle resembling the gallop of a horse. Amplitude of the paradoxical pulse decreases on inspiration. Conduction system impairment would not be suspected if an irregular heartbeat is loud or weak.

Question 7

The structure that carries oxygenated blood to the body from the left ventricle is the:
A) aorta.
B) pulmonary artery.
C) pulmonary vein.
D) superior vena cava.

Accepted Answer

The aorta carries oxygenated blood from the left ventricle to the body. The pulmonary artery carries deoxygenated blood from the right side of the heart to the lungs. The pulmonary vein carries oxygenated blood from the lungs to the left side of the heart. The superior vena cava carries blood from the upper body to the right atrium.

Question 8

The most prominent component of the jugular venous pulse is the:
A) a wave.
B) c wave.
C) v wave.
D) x slope.

Accepted Answer

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.

Question 9

Which of the following statements is true regarding the examination of peripheral arteries?
A) The thumb should not be used to assess pulses.
B) Palpate at least one pulse in each extremity, usually the most proximal one.
C) The pulses are most readily felt over bony prominences.
D) Extremity pulses do not normally generate waveforms.

Accepted Answer

A pulse is most readily felt over a bony prominence. The thumb may also be used if vessels have a tendency to move or roll when palpated by the fingers. Palpate at least one pulse, the most distal pulse, in each extremity to determine the sufficiency of the arterial circulation. The most distal pulse, not the most proximal one, in each extremity is palpated to determine the sufficiency of the arterial circulation. Extremity pulses generate waveforms.

Question 10

Vascular changes expected in the older adult include:
A) loss of vessel elasticity.
B) decreased peripheral resistance.
C) decreased pulse pressure.
D) constriction of the aorta and major bronchi.

Accepted Answer

With age, the walls of the arteries become calcified and they lose their elasticity and vasomotor tone; therefore, they lose their ability to respond appropriately to changing body needs. Increased peripheral vascular resistance occurs, causing an increase in blood pressure.

Question 11

You are examining Mr. S, a 79-year-old diabetic man complaining of claudication. Which of the following physical findings is consistent with the diagnosis of peripheral arterial disease?
A) Thick, calloused skin
B) Ruddy, thin skin
C) Warmer temperature of extremity in contrast to other body parts
D) Loss of hair over the extremities

Accepted Answer

An individual with peripheral artery disease or claudication will have thin skin with localized pallor and cyanosis, a loss of body warmth in the affected area, and loss of hair over the extremities.

Question 12

An idiopathic spasm of arterioles in the digits is termed:
A) arteriosclerosis obliterans.
B) giant cell arteritis.
C) Raynaud disease.
D) a peripheral arterial aneurysm.

Accepted Answer

Raynaud disease is idiopathic, intermittent spasm of the arterioles in the digits, which causes skin pallor. Arteriosclerosis obliterans is occlusion of the blood supply to the extremities by atherosclerotic plaques. Giant cell arteritis is a generalized inflammatory disease that affects the carotid, temporal, and occipital arteries. An aneurysm is dilation of an artery caused by a weakness in the arterial wall. Aneurysms occur in the aorta, renal, femoral, and popliteal arteries.

Question 13

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.

Accepted Answer

Explain to the patient that these are usual conditions during pregnancy. Blood in the lower extremities tends to pool in later pregnancy because of the occlusion of the pelvic veins and inferior vena cava from pressure created by the enlarged uterus. This occlusion results in an increase in dependent edema, varicosities of the legs and vulva, and hemorrhoids.

Question 14

Which arterial pulse is most useful for evaluating heart activity?
A) Femoral
B) Radial
C) Temporal
D) Carotid

Accepted Answer

Carotid arteries are the most easily accessible arterial pulse and closest to the heart; therefore, the carotid pulse is the most useful for evaluating heart activity.

Question 15

Mrs. Carrol is a 33-year-old patient who is pregnant and presents for a routine checkup. On examination, you note that her blood pressure has decreased. Blood pressure normally decreases during which period?
A) First trimester of pregnancy
B) Second trimester of pregnancy
C) Third trimester of pregnancy
D) Labor and delivery

Accepted Answer

Blood pressure reaches its lowest during the second trimester. During the third trimester, hypotension usually occurs when the patient is lying in the supine position.

Question 16

The amplitude of pulses is recorded on a(n):
A) Likert scale of absent to bounding.
B) numeric scale of 0 to 4.
C) alphabetic scale of A to E.
D) descriptive scale of mild, moderate, and severe.

Accepted Answer

The amplitude of pulses is recorded on a numeric scale of 0 to 4-0 is absent, not palpable; 1 is diminished, barely palpable; 2 is expected finding; 3 is full, increased; and 4 is bounding.

Question 17

Persons of Irish or German descent and genetically predisposed women who take birth control pills are at risk for developing:
A) kidney dysfunction.
B) liver disease.
C) renal calculi.
D) varicose veins.

Accepted Answer

Genetically predisposed women who take birth control pills are at risk for developing varicose veins. Other risk factors include female gender, being a daughter of a woman with varicosities, leading a sedentary lifestyle, old age, and being white.

Question 18

You are performing a physical examination on a 46-year-old male patient. His examination findings include the following: positive peripheral edema, holosystolic murmur in the tricuspid region, and a pulsatile liver. His diagnosis is:
A) an aortic aneurysm.
B) an arteriovenous fistula.
C) tricuspid stenosis.
D) tricuspid regurgitation.

Accepted Answer

An aneurysm is a localized isolation that results in a pulsatile swelling and a thrill or bruit. An arteriovenous fistula is a pathologic communication between an artery and vein resulting in a thrill or bruit and edema or ischemia in the involved extremity. Tricuspid regurgitation results in a holosystolic murmur in the tricuspid region, a pulsatile liver, and peripheral edema.

Question 19

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

Accepted Answer

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 with minimal ankle edema, low-grade fever, tachycardia, and possibly a positive Homan sign.

Question 20

The term claudication refers to:
A) pain from muscle ischemia.
B) lack of palpable pulsations.
C) visible extremity changes of arterial occlusion.
D) numbness and tingling in toes and fingers.

Accepted Answer

Claudication is known as pain that results from muscle ischemia. This pain is described as a dull ache with muscle fatigue and can often be accompanied by cramping. It is brought on by sustained exercise and relieved by rest. Individuals with peripheral artery disease (PAD) experience claudication because of the decrease in the amount of blood passing through the artery as a result of atherosclerosis, which causes arteries to become narrow. Risk factors for claudication are hypertension, smoking, hyperlipidemia, diabetes, and old age.

Quiz 15: Blood Vessels

A sound similar to a murmur that is heard over arteries is a:

In which location would carotid bruits be heard best?

A major risk factor for arterial embolic disease is:

The characteristics of arterial pulses are directly affected by all the following except:

In newborn infants, closure of the ductus arteriosus usually occurs:

Conduction system impairment should be suspected if an irregular heartbeat is:

The structure that carries oxygenated blood to the body from the left ventricle is the:

The most prominent component of the jugular venous pulse is the:

Which of the following statements is true regarding the examination of peripheral arteries?

Vascular changes expected in the older adult include:

You are examining Mr. S, a 79-year-old diabetic man complaining of claudication. Which of the following physical findings is consistent with the diagnosis of peripheral arterial disease?

An idiopathic spasm of arterioles in the digits is termed:

Which arterial pulse is most useful for evaluating heart activity?

Mrs. Carrol is a 33-year-old patient who is pregnant and presents for a routine checkup. On examination, you note that her blood pressure has decreased. Blood pressure normally decreases during which period?

The amplitude of pulses is recorded on a(n) :

Persons of Irish or German descent and genetically predisposed women who take birth control pills are at risk for developing:

You are performing a physical examination on a 46-year-old male patient. His examination findings include the following: positive peripheral edema, holosystolic murmur in the tricuspid region, and a pulsatile liver. His diagnosis is:

Induration, edema and hyperpigmentation are common associated findings with which of the following?

The term claudication refers to: