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Chapter 41: Oxygenation

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.

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

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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.

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.

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

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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.

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.

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

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and blood pressure are important, respirations are the priority. Temperature is not a high priority

in this situation.

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.

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.

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