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NR 226 CHAPTER 41 QUIZ
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NR 226 CHAPTER 41 QUIZChapter 41: Oxygenation
Potter et al.: Fundamentals of Nursing, 9th Edition
MULTIPLE CHOICE
1. A nurse is teaching staff about the conduction of the heart. In which order will the nurse
present the conduction cycle, starting with the first structure?
1. Bundle of His
2. Purkinje network
3. Intraatrial pathways
4. Sinoatrial (SA) node
5. Atrioventricular (AV) node
a. 5, 4, 3, 2, 1
b. 4, 3, 5, 1, 2
c. 4, 5, 3, 1, 2
d. 5, 3, 4, 2, 1
ANS: B
The conduction system originates with the SA node, the “pacemaker” of the heart. The
electrical impulses are transmitted through the atria along intraatrial pathways to the AV node.
It assists atrial emptying by delaying the impulse before transmitting it through the Bundle of
His and the ventricular Purkinje network.
DIF: Understand (comprehension) REF: 875
OBJ: Describe the structure and function of the cardiopulmonary system.
TOP: Teaching/Learning MSC: Physiological Adaptation
2. A nurse is teaching the patient with mitral valve problems about the valves in the heart.
Starting on the right side of the heart, describe the sequence of the blood flow through these
valves.
1. Mitral
2. Aortic
3. Tricuspid
4. Pulmonic
a. 1, 3, 2, 4
b. 4, 3, 2, 1
c. 3, 4, 1, 2
d. 2, 4, 1, 3
ANS: C
The blood flows through the valves in the following direction: tricuspid, pulmonic, mitral, and
aortic.
DIF: Understand (comprehension) REF: 874
OBJ: Describe the structure and function of the cardiopulmonary system.
TOP: Teaching/Learning MSC: Physiological Adaptation
,3. A nurse explains the function of the alveoli to a patient with respiratory problems. Which
information about the alveoli’s function will the nurse share with the patient?
a. Carries out gas exchange
b. Regulates tidal volume
c. Produces hemoglobin
d. Stores oxygen
ANS: A
The alveolus is a capillary membrane that allows gas exchange of oxygen and carbon dioxide
during respiration. The alveoli do not store oxygen, regulate tidal volume, or produce
hemoglobin.
DIF: Understand (comprehension) REF: 872-873
OBJ: Describe the physiological processes of ventilation, perfusion, and exchange of respiratory
gases. TOP: Teaching/Learning MSC: Physiological Adaptation
4. A nurse auscultates heart sounds. When the nurse hears S2, which valves is the nurse hearing
close?
a. Aortic and mitral
b. Mitral and tricuspid
c. Aortic and pulmonic
d. Mitral and pulmonic
ANS: C
As the ventricles empty, the ventricular pressures decrease, allowing closure of the aortic and
pulmonic valves, producing the second heart sound, S2. The mitral and tricuspid produce the
first heart sound, S1. The aortic and mitral do not close at the same time. The mitral and
pulmonic do not close at the same time.
DIF: Apply (application) REF: 874
OBJ: Describe the structure and function of the cardiopulmonary system.
TOP: Assessment MSC: Health Promotion and Maintenance
5. The nurse is teaching about the process of exchanging gases through the alveolar capillary
membrane. Which term will the nurse use to describe this process?
a. Ventilation
b. Surfactant
c. Perfusion
d. Diffusion
ANS: D
Diffusion is the process of gases exchanging across the alveoli and capillaries of body tissues.
Ventilation is the process of moving gases into and out of the lungs. Surfactant is a chemical
produced in the lungs to maintain the surface tension of the alveoli and keep them from
collapsing. Perfusion is the ability of the cardiovascular system to carry oxygenated blood to
tissues and return deoxygenated blood to the heart.
DIF: Understand (comprehension) REF: 873
OBJ: Describe the physiological processes of ventilation, perfusion, and exchange of respiratory
gases. TOP: Teaching/Learning MSC: Physiological Adaptation
, 6. A nurse is caring for a patient who was in a motor vehicle accident that resulted in cervical
trauma to C4. Which assessment is the priority?
a. Pulse
b. Respirations
c. Temperature
d. Blood pressure
ANS: B
Respirations and oxygen saturation are the priorities. Cervical trauma at C3 to C5 usually
results in paralysis of the phrenic nerve. When the phrenic nerve is damaged, the diaphragm
does not descend properly, thus reducing inspiratory lung volumes and causing hypoxemia.
While pulse and blood pressure are important, respirations are the priority. Temperature is not
a high priority in this situation.
DIF: Analyze (analysis) REF: 877
OBJ: Assess for the risk factors affecting a patient’s oxygenation.
TOP: Assessment MSC: Management of Care
7. The patient is breathing normally. Which process does the nurse consider is working properly
when the patient inspires?
a. Stimulation of chemical receptors in the aorta
b. Reduction of arterial oxygen saturation levels
c. Requirement of elastic recoil lung properties
d. Enhancement of accessory muscle usage
ANS: A
Inspiration is an active process, stimulated by chemical receptors in the aorta. Reduced arterial
oxygen saturation levels indicate hypoxemia, an abnormal finding. Expiration is a passive
process that depends on the elastic recoil properties of the lungs, requiring little or no muscle
work. Prolonged use of the accessory muscles does not promote effective ventilation and
causes fatigue.
DIF: Understand (comprehension) REF: 872
OBJ: State the process of the neural and chemical regulation of respiration.
TOP: Assessment MSC: Physiological Adaptation
8. The home health nurse recommends that a patient with respiratory problems install a carbon
monoxide detector in the home. What is the rationale for the nurse’s action?
a. Carbon monoxide detectors are required by law in the home.
b. Carbon monoxide tightly binds to hemoglobin, causing hypoxia.
c. Carbon monoxide signals the cerebral cortex to cease ventilations.
d. Carbon monoxide combines with oxygen in the body and produces a deadly toxin.
ANS: B
Carbon monoxide binds tightly to hemoglobin; therefore, oxygen is not able to bind to
hemoglobin and be transported to tissues, causing hypoxia. A carbon monoxide detector is not
required by law, does not signal the cerebral cortex to cease ventilations, and does not
combine with oxygen but with hemoglobin to produce a toxin.
DIF: Apply (application) REF: 876
OBJ: Describe nursing care interventions used to promote oxygenation in the primary care, acute
care, and restorative and continuing care settings. TOP: Planning
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