Overview of Oxygenation and Perfusion
Which response would the nurse give to a patient with weak right ventricular systole who asks "What is wrong with my heart?" A) "The blood is not moving with enough force to propel an adequate supply of blood to your arms and legs." B) "The right side of your heart has a leaky valve and is filling with blood too rapidly." C) "The right side of your heart is not pumping with enough force to propel an adequate amount of blood to the lungs." D) "The lower part of your heart is not beating with enough force to propel blood into the upper part of your heart."
A) "The blood is not moving with enough force to propel an adequate supply of blood to your arms and legs." The left ventricle, not the right ventricle, pumps blood into the systemic circulation. A weak right ventricular systole decreases the heart's ability to pump an adequate amount of blood into the lungs. B) "The right side of your heart has a leaky valve and is filling with blood too rapidly." A weak right ventricular systole does not involve a leaky tricuspid valve. C) "The right side of your heart is not pumping with enough force to propel an adequate amount of blood to the lungs." The right ventricle empties during systole, and the blood is pushed to the lungs via the pulmonary artery. D) "The lower part of your heart is not beating with enough force to propel blood into the upper part of your heart." Normal movement of blood within the heart is always from atrium to ventricle and never vice versa. Blood flows through the tricuspid valve from the right atrium to the right ventricle during right ventricular diastole.
Which acute respiratory disorder may decrease oxygenation? A) COPD B) Pneumonia C) Sarcoidosis D) Peripheral vascular disease
A) COPD Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disorder that can decrease oxygenation. B) Pneumonia Pneumonia is an acute respiratory disorder that can decrease oxygenation. C) Sarcoidosis Sarcoidosis is a chronic respiratory disorder that can decrease oxygenation. D) Peripheral vascular disease Peripheral vascular disease not a condition of the respiratory system. This disorder affects blood vessels and can decrease perfusion.
Which trigger of inspiration would the nurse include when teaching a patient with a chronic respiratory disease about the breathing process? A) Impulses in the respiratory center of the brain B) Phrenic nerve stimulation of the diaphragm C) Outward expansion of the intercostal muscles D) Metabolism of oxygen at the cellular level
A) Impulses in the respiratory center of the brain The movement of air into and out of the lungs is known as ventilation, which starts with inspiration (inhalation) triggered by impulses generated in the respiratory center of the brain. B) Phrenic nerve stimulation of the diaphragm The phrenic nerve stimulates the diaphragm to move downward, which aids inspiration but does not trigger the ventilation process. C) Outward expansion of the intercostal muscles Intercostal muscles along the ribs contract and cause the chest cavity to expand during inspiration but do not trigger the ventilation process. D) Metabolism of oxygen at the cellular level When cells use oxygen for metabolism, they release carbon dioxide in the process; however, this is not related to triggering inspiration.
Which statement describes the role of the phrenic nerve during the inspiratory phase of respiration? A) Initiates the release of carbon dioxide B) Signals the intercostal muscles to contract C) Causes the chest and lung tissues to recoil D) Stimulates the diaphragm to move downward
A) Initiates the release of carbon dioxide The phrenic nerve is not involved in the release of carbon dioxide. This occurs during gas exchange. B) Signals the intercostal muscles to contract The intercostal nerve stimulates the intercostal muscles. C) Causes the chest and lung tissues to recoil Expiration, not inspiration, results in relaxation of the diaphragm and recoil of the chest and lungs. D) Stimulates the diaphragm to move downward The phrenic nerve stimulates the diaphragm to move downward, which aids inspiration.
Which factors that control blood vessel diameter would the nurse include when teaching about factors affecting oxygenation and perfusion? Select all that apply. A) Oxygen B) Hormones C) Nitrous oxide D) Prostaglandins E) Glucose
A) Oxygen Blood vessel diameter is controlled by chemical mediators (prostaglandins, neurotransmitters, hormones, nitrous oxide) and the levels of oxygen and carbon dioxide in the circulation. B) Hormones Blood vessel diameter is controlled by chemical mediators (prostaglandins, neurotransmitters, hormones, nitrous oxide) and the levels of oxygen and carbon dioxide in the circulation. C) Nitrous oxide Blood vessel diameter is controlled by chemical mediators (prostaglandins, neurotransmitters, hormones, nitrous oxide) and the levels of oxygen and carbon dioxide in the circulation. Nitrous oxide causes vasodilation. D) Prostaglandins Blood vessel diameter is controlled by chemical mediators (prostaglandins, neurotransmitters, hormones, nitrous oxide) and the levels of oxygen and carbon dioxide in the circulation. E) Glucose Blood vessel diameter is not controlled by blood glucose levels.
Which order does blood flow through the heart? A) Blood enters the lungs via the pulmonary arteries, and gas exchange occurs through the pulmonary capillary system. B) Blood moves through the aortic valve into the aorta. C) Deoxygenated blood enters the right atrium via the superior vena cava, inferior vena cava, and coronary sinus. F) Blood passes through the tricuspid valve to the right ventricle. D) Blood flows through pulmonary veins to the left atrium. E) Blood moves through the mitral valve to the left ventricle.
C) Deoxygenated blood enters the right atrium via the superior vena cava, inferior vena cava, and coronary sinus. D) Blood passes through the tricuspid valve to the right ventricle. A) Blood enters the lungs via the pulmonary arteries, and gas exchange occurs through the pulmonary capillary system. F) Blood flows through pulmonary veins to the left atrium. E) Blood moves through the mitral valve to the left ventricle. B) Blood moves through the aortic valve into the aorta.
Which heart wall changes would the nurse expect in a patient with damage to the epicardium? Select all that apply. A) Decreased contractility B) Impaired secretion of serous fluid C) Interrupted blood flow to the myocardium D) Increased friction during heart contractions E) Increased contractility
Decreased contractility Contractility is a function of the myocardium, not the epicardium. Impaired secretion of serous fluid Secretion of serous fluid is a function of the epicardium. Interrupted blood flow to the myocardium The coronary arteries are responsible for blood flow to the myocardium. Increased friction during heart contractions The epicardium secretes serous fluid, which decreases friction during heart contractions. Increased contractility Contractility is a function of the myocardium, not the epicardium.
Which factors influence the binding of oxygen to hemoglobin? A) pH B) 2,3 BPG C) Temperature D) Blood pressure E) Carbon dioxide
The binding of oxygen to hemoglobin is influenced by pH, carbon dioxide, 2,3 BPG, and temperature. A) pH B) 2,3 BPG C) Temperature D) Blood pressure E) Carbon dioxide
Which information would the nurse include when teaching about the heart? Select all that apply. A) The heart has two atrial chambers and two ventricular chambers. B) The heart is made up of two layers. C) The heart pumps oxygenated blood to all parts of the body. D) The heart receives deoxygenated blood from the lungs. E) The heart plays a role in tissue oxygenation.
The heart has two atrial chambers and two ventricular chambers. The heart consists of four chambers. The upper two smaller chambers are the right and left atria. The lower two larger chambers are the right and left ventricles. The heart is made up of two layers. The heart has three layers: the epicardium, myocardium, and endocardium. The heart pumps oxygenated blood to all parts of the body. The heart pumps oxygenated blood to all parts of the body. The heart receives deoxygenated blood from the lungs. The heart delivers deoxygenated blood to the lungs and receives oxygenated blood from the lungs. The heart plays a role in tissue oxygenation. The heart pumps oxygenated blood to all parts of the body.
In which order does the process of inspiration and expiration occur? The respiratory center in the brain sends an impulse to nerves. Air is forced out from the lungs. The chest cavity expands, causing decreased intraalveolar pressure. The phrenic nerve stimulates the diaphragm to move downward, and the intercostal nerve causes the intercostal muscles to contract. Atmospheric pressure exceeds intraalveolar pressure, causing air to move into the respiratory tract and the lungs to fill with air. The diaphragm relaxes, and intraalveolar pressure increases.
The respiratory center in the brain sends an impulse to nerves. The phrenic nerve stimulates the diaphragm to move downward, and the intercostal nerve causes the intercostal muscles to contract. The chest cavity expands, causing decreased intraalveolar pressure. Atmospheric pressure exceeds intraalveolar pressure, causing air to move into the respiratory tract and the lungs to fill with air. The diaphragm relaxes, and intraalveolar pressure increases. Air is forced out from the lungs.
