TEST BANK FOR FUNDAMENTALS OF NURSING 9TH EDITION LATEST VERSION [SAMPLE]

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?
2. Bundle of His
3. Purkinje network
4. Intraatrial pathways
5. Sinoatrial (SA) node
6. 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.
7. 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.
8. Mitral
9. Aortic
10. Tricuspid
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11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. 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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18. While performing an assessment, the nurse hears crackles in the patient’s lung fields. The
    nurse also learns that the patient is sleeping on three pillows to help with the difficulty breathing
    during the night. Which condition will the nurse most likely observe written in the patient’s
    medical record?
    a. Atrial fibrillation
    b. Myocardial ischemia
    c. Left-sided heart failure
    d. Right-sided heart failure
    ANS: C
    Left-sided heart failure results in pulmonary congestion, the signs and symptoms of which
    include shortness of breath, cough, crackles, and paroxysmal nocturnal dyspnea (difficulty
    breathing when lying flat). Right-sided heart failure is systemic and results in peripheral edema,
    weight gain, and distended neck veins. Atrial fibrillation is often described as an irregularly
    irregular rhythm; rhythm is irregular because of the multiple pacemaker sites. Myocardial
    ischemia results when the supply of blood to the myocardium from the coronary arteries is
    insufficient to meet myocardial oxygen demands, producing angina or myocardial infarction.
19. A patient has a myocardial infarction. On which primary blood vessel will the nurse focus
    care to reduce ischemia?
    a. Superior vena cava
    b. Pulmonary artery
    c. Coronary artery
    d. Carotid artery
    ANS: C
    A myocardial infarction is the lack of blood flow due to obstruction to the coronary artery, which
    supplies the heart with blood. The superior vena cava returns blood back to the heart. The
    pulmonary artery supplies deoxygenated blood to the lungs. The carotid artery supplies blood to
    the brain.
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20. A nurse is teaching a health class about the heart. Which information from the class members
    indicates teaching by the nurse is successful for the flow of blood through the heart, starting in
    the right atrium?
    a. Right ventricle, left ventricle, left atrium
    b. Left atrium, right ventricle, left ventricle
    c. Right ventricle, left atrium, left ventricle
    d. Left atrium, left ventricle, right ventricle