Chapter 41 Oxygenation Practice Questions

Question 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

Answer 1

b. 4, 3, 5, 1, 2

Question 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

Answer 2

c. 3, 4, 1, 2

Question 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.

Answer 3

a. Carries out gas exchange.

Question 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

Answer 4

c. Aortic and pulmonic

Question 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

Answer 5

d. Diffusion

Question 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

Answer 6

b. Respirations

Question 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

Answer 7

a. Stimulation of chemical receptors in the aorta

Question 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.

Answer 8

b. Carbon monoxide tightly binds to hemoglobin, causing hypoxia.

Question 9

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

Answer 9

c. Left-sided heart failure

Question 10

A patient has experienced 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

Answer 10

c. Coronary artery

Question 11

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

Answer 11

c. Right ventricle, left atrium, left ventricle

Question 12

The nurse suspects the patient has increased cardiac afterload. Which piece of equipment should the nurse obtain to determine the presence of this condition?

a. Pulse oximeter
b. Oxygen cannula
c. Blood pressure cuff
d. Yankauer suction tip catheter

Answer 12

c. Blood pressure cuff

Question 13

A patient has been diagnosed with heart failure and cardiac output is decreased. Which formula can the nurse use to calculate cardiac output?

a. Myocardial contractility × myocardial blood flow
b. Ventricular filling time/diastolic filling time
c. Stroke volume × heart rate
d. Preload/afterload

Answer 13

c. Stroke volume × heart rate

Question 14

A patient’s heart rate increased from 94 to 164 beats/min. What will the nurse expect as a result?

a. Increase in diastolic filling time
b. Decrease in hemoglobin level
c. Decrease in cardiac output
d. Increase in stroke volume

Answer 14

c. Decrease in cardiac output

Question 15

Which determination is the nurse trying to achieve by monitoring a patient’s cardiac output?

a. Peripheral extremity circulation
b. Oxygenation requirements
c. Presence of cardiac dysrhythmias
d. Ventilation status

Answer 15

a. Peripheral extremity circulation

Question 16

A nurse is caring for a group of patients. Which patient should the nurse see first?

a. A patient with hypercapnia wearing an oxygen mask
b. A patient with a chest tube ambulating with the chest tube unclamped
c. A patient with thick secretions being tracheal suctioned first and then orally
d. A patient with a new tracheostomy and tracheostomy obturator at bedside

Answer 16

a. A patient with hypercapnia wearing an oxygen mask

Question 17

A patient has inadequate stroke volume related to decreased preload. Which treatment does the nurse prepare to administer?

a. Diuretics
b. Vasodilators
c. Chest physiotherapy
d. Intravenous (IV) fluids

Answer 17

d. Intravenous (IV) fluids

Question 18

A nurse is preparing to suction a patient. The pulse is 65 and pulse oximetry is 94%. Which finding will cause the nurse to stop suctioning?

a. Pulse 75
b. Pulse 80
c. Oxygen saturation 91%
d. Oxygen saturation 88%

Answer 18

d. Oxygen saturation 88%

Question 19

The patient is experiencing right-sided heart failure. Which finding will the nurse expect when performing an assessment?

a. Peripheral edema
b. Basilar crackles
c. Chest pain
d. Cyanosis

Answer 19

a. Peripheral edema

Question 20

A nurse is reviewing the electrocardiogram (ECG) results. Which portion of the conduction system does the nurse consider when evaluating the P wave?

a. SA node
b. AV node
c. Bundle of His
d. Purkinje fibers

Answer 20

a. SA node

Question 21

A nurse teaches a patient about atelectasis. Which statement by the patient indicates an understanding of atelectasis?

a. “Atelectasis affects only those with chronic conditions such as emphysema.”
b. “It is important to do breathing exercises every hour to prevent atelectasis.”
c. “If I develop atelectasis, I will need a chest tube to drain excess fluid.”
d. “Hyperventilation will open up my alveoli, preventing atelectasis.”

Answer 21

b. “It is important to do breathing exercises every hour to prevent atelectasis.”

Question 22

The nurse is caring for a patient with respiratory problems. Which assessment finding indicates a late sign of hypoxia?

a. Elevated blood pressure
b. Increased pulse rate
c. Restlessness
d. Cyanosis

Answer 22

d. Cyanosis

Question 23

A nurse is caring for a 5-year-old patient whose temperature is 101.2° F. The nurse expects this patient to hyperventilate. Which factor does the nurse remember when planning care for this type of hyperventilation?

a. Anxiety over illness
b. Decreased drive to breathe
c. Increased metabolic demands
d. Infection destroying lung tissues

Answer 23

c. Increased metabolic demands

Question 24

A nurse is preparing a patient for nasotracheal suctioning. In which order will the nurse perform the steps, beginning with the first step?

1. Insert catheter.
2. Apply suction and remove.
3. Have patient deep breathe.
4. Encourage patient to cough.
5. Attach catheter to suction system.
6. Rinse catheter and connecting tubing.

a. 1, 2, 3, 4, 5, 6
b. 4, 5, 1, 2, 3, 6
c. 5, 3, 1, 2, 4, 6
d. 3, 1, 2, 5, 4, 6

Answer 24

c. 5, 3, 1, 2, 4, 6

Question 25

A patient is experiencing carbon dioxide retention from lung problems. Which type of diet will the nurse most likely suggest for this patient?

a. Moderate-carbohydrate
b. Low-caffeine
c. High-caffeine
d. High-carbohydrate

Answer 25

a. Moderate-carbohydrate

Question 26

A nurse caring for a patient prescribed warfarin discovers that the patient is taking garlic to help with hypertension. Which condition will the nurse assess for in this patient?

a. Increased cholesterol level
b. Distended jugular vein
c. Bleeding
d. Angina

Answer 26

c. Bleeding

Question 27

A nurse is caring for a patient whose tissue perfusion is poor as the result of hypertension. When the patient asks what to eat for breakfast, which meal should the nurse suggest?

a. A cup of nonfat yogurt with granola and a handful of dried apricots
b. Whole wheat toast with butter and a side of bacon
c. A bowl of cereal with whole milk and a banana
d. Omelet with sausage, cheese, and onions

Answer 27

a. A cup of nonfat yogurt with granola and a handful of dried apricots

Question 28

Upon auscultation of the patient’s chest, the nurse hears a whooshing sound at the fifth intercostal space. What does this finding indicate to the nurse?

a. The beginning of the systolic phase
b. Regurgitation of the mitral valve
c. The opening of the aortic valve
d. Presence of orthopnea

Answer 28

b. Regurgitation of the mitral valve

Question 29

A nurse is caring for a patient diagnosed with chronic obstructive pulmonary disease (COPD) who is receiving 2 L/min of oxygen. Which oxygen delivery device is most appropriate for the nurse to administer the oxygen?

a. Nasal cannula
b. Simple face mask
c. Non-rebreather mask
d. Partial non-rebreather mask

Answer 29

a. Nasal cannula

Question 30

The nurse plans to closely monitor the oxygen status of an older-adult patient undergoing anesthesia because of which age-related change?

a. Thinner heart valves cause lipid accumulation and fibrosis.
b. Diminished respiratory muscle strength may cause poor chest expansion.
c. Alterations in mental status prevent patients’ awareness of ineffective breathing.
d. An increased number of pacemaker cells make proper anesthesia induction more difficult.

Answer 30

b. Diminished respiratory muscle strength may cause poor chest expansion.

Question 31

The nurse determines that an older-adult patient is at risk for infection due to decreased immunity. Which plan of care best addresses the prevention of infection for the patient?

a. Inform the patient of the importance of finishing the entire dose of antibiotics.
b. Encourage the patient to stay up-to-date on all vaccinations.
c. Schedule patient to get annual tuberculosis skin testing.
d. Create an exercise routine to run 45 minutes every day.

Answer 31

b. Encourage the patient to stay up-to-date on all vaccinations.

Question 32

The nurse is caring for a patient experiencing fluid volume overload. Which physiological effect does the nurse most likely expect?

a. Increased preload
b. Increased heart rate
c. Decreased afterload
d. Decreased tissue perfusion

Answer 32

a. Increased preload

Question 33

A nurse is caring for a patient prescribed continuous cardiac monitoring for heart dysrhythmias. Which rhythm will cause the nurse to intervene immediately?

a. Ventricular tachycardia
b. Atrial fibrillation
c. Sinus rhythm
d. Paroxysmal supraventricular tachycardia

Answer 33

a. Ventricular tachycardia

Question 34

The patient is experiencing angina pectoris. Which assessment finding does the nurse expect when conducting a history and physical examination?

a. Experiences chest pain after eating a heavy meal.
b. Experiences adequate oxygen saturation during exercise.
c. Experiences crushing chest pain for more than 20 minutes.
d. Experiences tingling in the left arm that lasts throughout the morning.

Answer 34

a. Experiences chest pain after eating a heavy meal.

Question 35

Which risk factor for cardiopulmonary disease should the nurse describe as modifiable?

a. Stress
b. Allergies
c. Family history
d. Gender

Answer 35

a. Stress

Question 36

The nurse is creating a plan of care for an obese patient who is experiencing fatigue related to ineffective breathing. Which intervention best addresses a short-term goal the patient could achieve?

a. Sleeping on two to three pillows at night
b. Sensibly reducing daily calorie intake
c. Running 30 minutes every morning
d. Stopping smoking immediately

Answer 36

a. Sleeping on two to three pillows at night

Question 37

A patient experiencing left-sided hemiparesis has developed bronchitis and has a heart rate of 105 beats/min, blood pressure of 156/90 mm Hg, and respiration rate of 30 breaths/min. Which nursing diagnosis is a priority?

a. Risk for skin breakdown
b. Impaired gas exchange
c. Activity intolerance
d. Risk for infection

Answer 37

b. Impaired gas exchange

Question 38

Which nursing intervention is most effective in preventing hospital-acquired pneumonia in an older-adult patient?

a. Discontinue the humidification delivery device to keep excess fluid from lungs.
b. Monitor oxygen saturation, and frequently auscultate lung bases.
c. Assist the patient to cough, turn, and deep breathe every 2 hours.
d. Decrease fluid intake to 300 mL a shift.

Answer 38

c. Assist the patient to cough, turn, and deep breathe every 2 hours.

Question 39

The nurse is assessing a patient diagnosed with emphysema. Which assessment finding requires further follow-up with the health care provider?

a. Increased anterior-posterior diameter of the chest
b. Accessory muscle used for breathing
c. Clubbing of the fingers
d. Hemoptysis

Answer 39

d. Hemoptysis

Question 40

A patient diagnosed with chronic obstructive pulmonary disease (COPD) asks the nurse why clubbing occurs. Which response by the nurse is most therapeutic?

a. “Your disease doesn’t send enough oxygen to your fingers.”
b. “Your disease affects both your lungs and your heart, and not enough blood is being pumped.”
c. “Your disease will be helped if you pursed-lip breathe.”
d. “Your disease often makes patients lose mental status.”

Answer 40

a. “Your disease doesn’t send enough oxygen to your fingers.”

Question 41

A patient experiencing a pneumothorax has a chest tube inserted and is placed on low constant suction. Which finding requires immediate action by the nurse?

a. The patient reports pain at the chest tube insertion site that increases with movement.
b. Fifty milliliters of blood gushes into the drainage device after the patient coughs.
c. No bubbling is present in the suction control chamber of the drainage device.
d. Yellow purulent discharge is seen leaking out from around the dressing site

Answer 41

c. No bubbling is present in the suction control chamber of the drainage device.

Question 42

The nurse is caring for a patient who has had a tracheostomy tube inserted. Which nursing intervention is most effective in promoting effective airway clearance?

a. Suctioning respiratory secretions several times every hour
b. Administering humidified oxygen through a tracheostomy collar
c. Instilling normal saline into the tracheostomy to thin secretions before suctioning
d. Deflating the tracheostomy cuff before allowing the patient to cough up secretions

Answer 42

b. Administering humidified oxygen through a tracheostomy collar

Question 43

The nurse is educating a student nurse on caring for a patient with a chest tube. Which statement from the student nurse indicates successful learning?

a. “I should clamp the chest tube when giving the patient a bed bath.”
b. “I should report if I see continuous bubbling in the water-seal chamber.”
c. “I should strip the drains on the chest tube every hour to promote drainage.”
d. “I should notify the health care provider first, if the chest tube becomes dislodged.”

Answer 43

b. “I should report if I see continuous bubbling in the water-seal chamber.”

Question 44

Which coughing technique will the nurse use to help a patient clear central airways?

a. Huff
b. Quad
c. Cascade
d. Incentive spirometry

Answer 44

a. Huff

Question 45

The nurse is suctioning a patient with a tracheostomy tube. Which action will the nurse take?

a. Set suction regulator at 150 to 200 mm Hg.
b. Limit the length of suctioning to 10 seconds.
c. Apply suction while gently rotating and inserting the catheter.
d. Liberally lubricate the end of the suction catheter with a water-soluble solution

Answer 45

b. Limit the length of suctioning to 10 seconds.

Question 46

The nurse is caring for a patient who is prescribed oxygen via a nasal cannula. Which task can the nurse delegate to the nursing assistive personnel?

a. Applying the nasal cannula
b. Adjusting the oxygen flow
c. Assessing lung sounds
d. Setting up the oxygen

Answer 46

a. Applying the nasal cannula

Question 47

The nurse is using a closed suction device. Which patient will be most appropriate for this suctioning method?

a. A 5 year old with excessive drooling from epiglottitis
b. A 5 year old with an asthma attack following severe allergies
c. A 24 year old with a right pneumothorax following a motor vehicle accident
d. A 24 year old with acute respiratory distress syndrome requiring mechanical ventilation

Answer 47

d. A 24 year old with acute respiratory distress syndrome requiring mechanical ventilation

Question 48

While the nurse is changing the ties on a tracheostomy collar, the patient coughs, dislodging the tracheostomy tube. Which action will the nurse take first?

a. Press the emergency response button.
b. Insert a spare tracheostomy with the obturator.
c. Manually occlude the tracheostomy with sterile gauze.
d. Place a face mask delivering 100% oxygen over the nose and mouth.

Answer 48

b. Insert a spare tracheostomy with the obturator.

Question 49

A nurse is following the How-to Guide to prevent ventilator-associated pneumonia. Which strategies is the nurse using? (Select all that apply.)

a. Head of bed elevation to 90 degrees at all times
b. Daily oral care with chlorhexidine
c. Delirium monitoring
d. Clean technique when suctioning
e. Daily “sedation vacations”
f. Heart failure prophylaxis

Answer 49

b. Daily oral care with chlorhexidine

c. Delirium monitoring

e. Daily “sedation vacations”

Question 50

A nurse is teaching a community health promotion class and discusses the flu vaccine. Which information will the nurse include in the teaching session? (Select all that apply.)

a. It is given yearly.
b. It is given in a series of four doses.
c. It is safe for children allergic to eggs.
d. It is safe for adults with acute febrile illnesses.
e. The live, attenuated nasal spray is given to people over 50.
f. The vaccines are recommended for all people 6 months and older

Answer 50

a. It is given yearly.

f. The vaccines are recommended for all people 6 months and older

Question 51

A nurse is caring for a patient being treated for sleep apnea. Which types of ventilator support should the nurse be prepared to administer for this patient? (Select all that apply.)

a. Assist-control (AC)
b. Pressure support ventilation (PSV)
c. Bilevel positive airway pressure (BiPAP)
d. Continuous positive airway pressure (CPAP)
e. Synchronized intermittent mandatory ventilation (SIMV)

Answer 51

c. Bilevel positive airway pressure (BiPAP)

d. Continuous positive airway pressure (CPAP)