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Quizzes > Health & Medicine > Human Anatomy & Medicine

Test Your Peripheral Vascular System Assessment Knowledge

Ready to tackle assessing the peripheral vascular system? Take the quiz now!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art with stethoscope diagram blood vessel icons for peripheral vascular assessment quiz on golden yellow background

Use this peripheral vascular assessment nursing quiz to practice key bedside checks - palpating pulses, judging capillary refill, spotting edema, and linking findings to next steps. Work through brief case questions to sharpen judgment and reinforce safe care. Want a quick tune-up first? Try these nursing assessment warm-ups , then see where you still have gaps before a skills check or exam.

Which artery is typically palpated on the lateral aspect of the wrist to assess circulation to the hand?
Brachial artery
Ulnar artery
Femoral artery
Radial artery
The radial artery is easily palpated on the lateral aspect of the wrist and is commonly used to assess pulse strength and circulation in the hand.
What is the normal capillary refill time when assessing the hands?
4 to 6 seconds
Greater than 6 seconds
Less than 2 seconds
2 to 4 seconds
Normal capillary refill time is less than 2 seconds, reflecting adequate peripheral perfusion.
How is 1+ pitting edema described in a clinical assessment?
A slight pit (2 mm) that disappears rapidly
A deeper pit (4 mm) that takes a few seconds to rebound
A pit (6 mm) that lasts up to 30 seconds
Severe indentation (8 mm) lasting over 30 seconds
Grade 1+ pitting edema is characterized by a minimal indentation (around 2 mm) that rebounds quickly, indicating mild fluid accumulation.
Which skin change is characteristic of arterial insufficiency in the lower extremity?
Hyperpigmentation
Thin, shiny skin
Varicose veins
Brownish discoloration around ankles
Chronic arterial insufficiency leads to trophic changes including thin, shiny skin due to reduced perfusion and atrophy.
Which site is best for palpating the dorsalis pedis pulse?
Medial to the tibialis anterior tendon
In the popliteal fossa
Posterior to the medial malleolus
Lateral to the extensor hallucis longus tendon
The dorsalis pedis pulse is located lateral to the extensor hallucis longus tendon on the dorsum of the foot.
A patient presents with swelling around the ankles after prolonged standing. Which condition does this most likely indicate?
Kidney failure
Congestive heart failure
Venous insufficiency
Peripheral arterial occlusion
Venous insufficiency often causes ankle edema that worsens with prolonged standing due to poor venous return.
What term describes muscle pain in the calves during exercise that is relieved by rest?
Rest pain
Lymphangitis
Intermittent claudication
Thrombophlebitis
Intermittent claudication is calf pain during exercise due to inadequate arterial blood flow, which resolves with rest.
Which of the following is a nonmodifiable risk factor for peripheral vascular disease?
Smoking
Diabetes mellitus
Age
Hypertension
Age is a nonmodifiable risk factor for peripheral vascular disease, while smoking, hypertension, and diabetes are modifiable.
What is the normal range for ankle-brachial index (ABI)?
0.5 to 0.7
1.0 to 1.3
Less than 0.5
0.8 to 0.9
A normal ABI is between 1.0 and 1.3, indicating no significant arterial obstruction.
Which instrument is commonly used to measure segmental limb blood pressures during vascular assessment?
Ankle tourniquet
Stethoscope
Handheld Doppler ultrasound
Sphygmomanometer only
A handheld Doppler ultrasound is used with a blood pressure cuff to detect arterial signals when measuring segmental pressures.
A positive Homan's sign is indicative of which condition?
Deep vein thrombosis
Peripheral arterial disease
Lymphedema
Varicose veins
Homan's sign - a calf pain on forced dorsiflexion - can indicate deep vein thrombosis, although it's not highly specific.
Arterial ulcers are most commonly found on which location?
Tips of the toes
Lateral calf
Medial malleolus
Shin
Arterial ulcers typically occur on the tips of toes or pressure points due to poor distal perfusion.
What clinical finding suggests superficial thrombophlebitis?
Presence of varicose veins
Non-pitting edema
Palpable, tender cord along a superficial vein
Brownish skin discoloration
Superficial thrombophlebitis is marked by a tender, cord-like structure along the course of a superficial vein.
Elevating the legs above heart level most effectively reduces which of the following?
Arterial blood pressure
Venous pooling
Lymphatic flow
Capillary refill time
Leg elevation facilitates venous return and reduces venous pooling in the lower extremities.
The Rubor Dependency Test evaluates which aspect of vascular function?
Capillary refill
Lymphatic drainage
Arterial circulation
Venous valve competence
The Rubor Dependency Test assesses arterial circulation by observing color changes with limb elevation and dependency.
Which artery is palpated behind the knee during vascular examination?
Posterior tibial artery
Femoral artery
Popliteal artery
Dorsalis pedis artery
The popliteal artery is palpated in the popliteal fossa, behind the knee, to assess distal perfusion.
What is the primary purpose of using Doppler ultrasound in peripheral vascular assessment?
To visualize lymph nodes
To detect blood flow when pulses are not palpable
To measure systemic blood pressure
To assess nerve conduction
Doppler ultrasound amplifies the sound of blood flow, allowing detection of arterial signals when pulses cannot be palpated.
Which characteristic is most typical of venous ulcers?
Necrotic black eschar at the wound bed
Granular red base with minimal drainage
Irregular shape with shallow depth and heavy exudate
Punched-out appearance with minimal exudate
Venous ulcers often have irregular borders, are shallow, and produce moderate to heavy exudate.
The Trendelenburg test assesses incompetence in which vascular structures?
Deep arteries
Superficial veins and perforator valves
Arteriovenous malformations
Lymphatic vessels
The Trendelenburg test evaluates the competency of superficial venous valves and perforator veins by observing venous refill patterns.
An ABI value of 0.7 suggests which degree of peripheral arterial disease?
Normal arterial flow
Severe PAD
Critical limb ischemia
Mild to moderate PAD
An ABI between 0.5 and 0.9 indicates mild to moderate peripheral arterial disease.
When performing a tourniquet test on a patient's leg, what is being evaluated?
Capillary refill time
Arterial patency
Competency of venous valves
Lymphatic flow
A tourniquet test assesses the competency of venous valves by occluding superficial veins and observing refill after release.
What is brawny edema characterized by?
Pitting more than 6 mm depth
Non-pitting, firm skin with brownish discoloration
Transient pit less than 2 mm depth
Generalized swelling with clear skin
Brawny edema is non-pitting and often associated with firm, discolored (brownish) skin due to chronic venous stasis.
Hemosiderin deposition in the lower extremities typically results in which skin discoloration?
Whitening of the skin
Red macules
Blue-black streaks
Brownish pigmentation
Chronic venous hypertension leads to RBC breakdown and hemosiderin deposition, causing brownish hyperpigmentation.
Which of the following is a common trigger for Raynaud's phenomenon?
Venous stasis
Prolonged standing
High altitude
Cold exposure
Cold exposure induces vasospasm in Raynaud's phenomenon, leading to color changes in the digits.
Where are superficial inguinal lymph nodes palpated?
In the groin crease below the inguinal ligament
Above the clavicle
Behind the knee
In the axilla
Superficial inguinal lymph nodes lie in the groin crease, just below the inguinal ligament.
A bruit heard over the femoral artery indicates what?
Nerve conduction
Normal laminar flow
Lymphatic obstruction
Turbulent blood flow through a narrowed vessel
A bruit is an audible murmur of turbulent flow, often indicating arterial stenosis at that site.
Which finding suggests lymphangitis rather than superficial thrombophlebitis?
Red streaks along lymphatic channels
Non-pitting edema
Varicose veins
Palpable cord along a vein
Lymphangitis presents with red streaks following lymphatic channels toward regional lymph nodes, differentiating it from phlebitis.
What does a positive diascopy test (blanching with pressure) indicate?
Calcified plaque
Vascular dilation
Hemorrhage into the skin
Infected lesion
Diascopy distinguishes vascular lesions (which blanch) from nonvascular (which do not), indicating vascular dilation.
Temperature comparison between two legs reveals coolness in one limb. This finding most likely indicates?
Cellulitis
Arterial insufficiency
Lymphedema
Venous stasis
Coolness in one limb compared to the other often points to impaired arterial blood flow.
An absent dorsalis pedis pulse may indicate which condition?
Varicose veins
Deep vein thrombosis
Peripheral arterial disease
Lymphedema
An absent dorsalis pedis pulse is a key sign of peripheral arterial disease or severe arterial obstruction.
During the modified Trendelenburg test, rapid venous filling upon tourniquet release suggests incompetence of which valves?
Arteriovenous valves
Perforator valves
Superficial vein valves
Lymphatic valves
Rapid filling upon tourniquet release indicates that perforator vein valves are incompetent, allowing deep-to-superficial flow.
How is the ankle-brachial index calculated?
Average ankle pressure over average brachial pressure
Ankle diastolic pressure over brachial diastolic pressure
Highest brachial pressure divided by highest ankle pressure
Highest ankle systolic pressure divided by highest brachial systolic pressure
ABI is computed by dividing the highest ankle systolic pressure by the highest brachial systolic pressure to assess arterial patency.
Segmental limb pressure measurements show a drop of 25 mmHg between thigh and calf segments. This finding suggests what?
Arterial obstruction between those segments
Normal physiologic variation
Venous insufficiency
Lymphatic blockage
A segmental pressure drop ?20 mmHg indicates arterial obstruction between the measurement sites.
What does photoplethysmography (PPG) primarily measure?
Blood glucose fluctuations
Nerve conduction velocity
Changes in blood volume in the microvascular bed
Arterial blood gas levels
PPG detects volumetric changes in blood flow within the microvascular network using infrared light.
According to the Rutherford classification, rest pain in peripheral arterial disease corresponds to which category?
Category 4
Category 2
Category 5
Category 6
Rutherford category 4 denotes ischemic rest pain in peripheral arterial disease staging.
Which management plan is most appropriate for a patient with an ABI of 0.5 and intermittent claudication?
High-dose diuretic therapy
Immediate vascular surgery
No intervention needed
Supervised exercise therapy
Supervised exercise therapy is first-line for intermittent claudication with moderate arterial disease (ABI ~0.5).
Lymphoscintigraphy is primarily used to evaluate which condition?
Venous thrombosis
Lymphedema
Skin malignancies
Arterial stenosis
Lymphoscintigraphy assesses lymphatic flow and function, aiding in the diagnosis of lymphedema.
Plethysmography can assess which of the following?
Venous reflux and capacitance
Lymphatic drainage capacity
Nerve sensory function
Arterial oxygen content
Venous plethysmography evaluates venous function, including reflux and capacitance, by measuring volume changes.
Which clinical feature helps distinguish lymphedema from venous edema?
Excess limb hair growth
Pitting edema
Prominent varicosities
Positive Stemmer's sign (inability to pinch skin)
A positive Stemmer's sign - skin that cannot be pinched - is characteristic of lymphedema rather than venous edema.
The Buerger's test (leg elevation) assessing pallor indicates what?
Lymphatic drainage
Cardiac preload
Venous valve competence
Severity of arterial insufficiency
The Buerger's test evaluates arterial insufficiency by noting pallor on leg elevation and rubor on dependency.
Hair loss on the lower legs is a sign of which vascular pathology?
Chronic arterial insufficiency
Venous stasis
Lymphatic obstruction
Peripheral neuropathy
Poor arterial perfusion leads to trophic changes such as hair loss on the legs.
In diabetic patients with calcified arteries, which modification is used for ABI measurement?
Calf compression index
Diastolic ABI
Systolic differential index
Toe-brachial index (TBI)
Toe-brachial index is preferred in diabetics with arterial calcification because toe vessels remain compressible.
Toe pressures are particularly useful in assessing which patient population?
Patients with lymphangitis
Patients with acute DVT
Patients with varicose veins
Patients with medial arterial calcification (e.g., diabetes)
Toe pressures bypass calcified pedal arteries and are reliable in diabetic individuals with arterial calcification.
Venous refill time greater than 20 seconds after percussion suggests what?
Incompetent venous valves
Competent venous valves
Arterial insufficiency
Lymphatic obstruction
A refill time >20 seconds indicates intact venous valves and absence of significant reflux.
Venous claudication is primarily caused by what?
Deep venous outflow obstruction
Arterial stenosis
Nerve compression
Muscle fatigue
Venous claudication results from impaired venous outflow leading to pain with exercise.
A positive Camp test (passive plantar flexion) reproducing calf pain suggests which condition?
Lymphangitis
Arterial claudication
Superficial varicosities
Deep vein thrombosis
Pain with passive plantar flexion (Camp test) is a sign of deep vein thrombosis.
Delayed venous filling time upon leg elevation indicates which insufficiency?
Lymphatic edema
Arterial insufficiency
Peripheral neuropathy
Venous insufficiency
Delay in venous filling when the leg is elevated suggests decreased arterial inflow and arterial insufficiency.
Transcutaneous oximetry measures what parameter?
Skin oxygen tension (TcPO2)
Nerve conduction velocity
Tissue glucose level
Blood pressure
Transcutaneous oximetry noninvasively measures the oxygen partial pressure at the skin surface to assess perfusion.
In plethysmography waveforms, loss of the dicrotic notch with a monophasic pattern indicates which condition?
Venous thrombosis
Lymphatic obstruction
Normal circulation
Peripheral arterial occlusive disease
A monophasic plethysmography waveform with loss of the dicrotic notch signifies diminished arterial compliance and occlusive disease.
Continuous wave Doppler produces a monophasic waveform. What does this indicate?
Normal arterial flow
Venous reflux
Significant proximal arterial stenosis
High cardiac output
A monophasic signal on continuous wave Doppler suggests marked proximal stenosis reducing flow phasicity.
Which condition is most commonly associated with high-output lymphedema?
Congestive heart failure
Primary lymphatic hypoplasia
Traumatic injury
Cancer-related lymph node removal
High-output lymphedema occurs when lymph production exceeds transport capacity, commonly seen in CHF due to increased capillary filtration.
In segmental waveform analysis, loss of waveform amplification distally suggests which pathology?
Nerve damage
Lymphatic blockage
Arterial obstruction
Venous insufficiency
Normally waveforms amplify distally; loss of this indicates arterial blockage along the limb.
After iliofemoral stenting, which imaging artifact is most likely to impair accurate Doppler assessment?
Bone artifact
Metallic stent reverberation causing signal dropout
Skin thickening attenuation
Acoustic shadowing by gas
Metallic stents often cause reverberation artifacts, leading to signal dropout on Doppler studies.
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Study Outcomes

  1. Identify Peripheral Pulses -

    Locate and palpate major peripheral pulses accurately to establish baseline data for peripheral vascular assessment nursing.

  2. Interpret Perfusion Indicators -

    Analyze skin color, temperature, and capillary refill to detect early signs of compromised perfusion in the peripheral vascular system.

  3. Perform Peripheral Vascular System Nursing Assessment -

    Conduct a systematic peripheral vascular system nursing assessment, integrating inspection, palpation, and auscultation techniques.

  4. Differentiate Vascular Abnormalities -

    Distinguish between arterial and venous disorders based on assessment findings, such as pulse strength and edema characteristics.

  5. Integrate Findings into Care Plans -

    Use assessment results to formulate targeted interventions and document care priorities for patients with vascular impairments.

  6. Evaluate and Refine Assessment Techniques -

    Critique your peripheral vascular assessment approach and adopt best practices for ongoing skills improvement.

Cheat Sheet

  1. Pulse Palpation & Grading -

    When performing a peripheral vascular assessment nursing exam, palpate major arteries like the radial, dorsalis pedis, and posterior tibial, and record their amplitude on a 0 (absent) to 4+ (bounding) scale. Remember the scale: 0=Absent, 1=Diminished, 2=Normal, 3=Increased, 4=Bounding. This systematic approach is endorsed by the American Heart Association for consistent peripheral vascular system nursing assessment.

  2. Capillary Refill Time -

    Measure capillary refill by pressing on the nail bed of a toe or finger for five seconds, then timing how long it takes for color to return; under 2 seconds is normal, per the American Academy of Pediatrics. Use this quick test to assess peripheral perfusion and microvascular function in peripheral vascular assessment nursing. Note that prolonged refill (>3 seconds) may signal poor perfusion, especially in pediatric and geriatric populations.

  3. Skin, Temperature & Edema Assessment -

    Inspect skin color for pallor or cyanosis and use the dorsum of your hand to compare temperature symmetry between limbs, an essential step in assessing the peripheral vascular system. Check for pitting edema by pressing over the shin or tibia for five seconds and grade it from 1+ (mild) to 4+ (severe), following guidelines from the Journal of Vascular Nursing. Document trophic changes like hair loss or nail thickening, which may indicate chronic arterial insufficiency.

  4. Ankle-Brachial Index (ABI) Calculation -

    The ABI is a simple ratio: highest ankle systolic blood pressure divided by highest brachial systolic pressure; values of 1.0 - 1.2 are normal, while <0.9 suggests peripheral arterial disease (PAD), according to ACC/AHA guidelines. Accurate ABI measurement is a key skill in peripheral vascular system assessment, providing quantitative data on limb perfusion. For practice, remember "Ankle over Arm" and verify using a Doppler probe and calibrated sphygmomanometer.

  5. Acute Arterial Occlusion & the "6 Ps" -

    Recognize the 6 Ps - Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Poikilothermia - to swiftly identify acute arterial occlusion, a critical emergency in peripheral vascular assessment nursing. Use this mnemonic from vascular surgery literature to perform immediate neurovascular checks and escalate care without delay. Early detection based on these signs can significantly improve limb salvage outcomes.

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