lecture 1 exam week 2

What is ventilation?

A. Movement of blood through tissues

B. Exchange of O₂ and CO₂ across a membrane

C. Movement of gas into and out of the lungs

D. Oxygen binding to hemoglobin

C

What are the two major purposes of ventilation?

A. Increase BP and HR

B. Supply O₂ and eliminate metabolically produced CO₂

C. Produce RBCs and remove WBCs

D. Increase cardiac output

B

Why is inspiration considered active?

A. The lungs recoil

B. Respiratory muscles contract and use energy

C. Respiratory muscles completely relax

D. CO₂ leaves without muscular activity

B

What happens to pressure during inspiration?

A. Negative pressure in the pleural space increases

B. Negative pressure disappears

C. Blood pressure decreases

D. Intracranial pressure increases

A

What is the major muscle of inspiration?

A. Abdominal muscle

B. Trapezius

C. Diaphragm

D. Pectoralis major

C

Which nerve innervates the diaphragm?

A. Vagus

B. Phrenic

C. Radial

D. Sciatic

B

The phrenic nerve originates primarily from which cervical spinal levels?
A. C1–C2
B. C3–C5
C. C6–C8
D. T1–T3

B

A patient has a high cervical spinal cord injury affecting C3–C5. Which function is the greatest concern?

A. Digestion

B. Hearing

C. Breathing

D. Urination

C

Normal expiration at rest is:

A. Active

B. Passive

C. Controlled by skeletal muscle contraction

D. Dependent on accessory muscles

B

A patient is continuously using accessory muscles to breathe. What should the nurse recognize?
A. This indicates very effective ventilation
B. Prolonged use may cause fatigue and ineffective ventilation
C. This is normal during quiet breathing
D. It indicates increased hemoglobin

B

What are alveoli?

A. Blood vessels supplying the heart

B. Air-filled sacs where gas exchange occurs

C. Muscles controlling breathing

D. Upper-airway structures

B

What happens to alveoli during inspiration?
A. They collapse
B. They expand, increasing surface area for gas exchange
C. They fill with blood
D. They stop exchanging CO₂

B

Gas crosses which structure between the alveoli and blood?
A. Myocardium
B. Alveolar-capillary membrane
C. Pericardium
D. Aortic valve

B

What is atelectasis?
A. Fluid buildup in the heart
B. Excess RBC production
C. Increased cardiac output

D.Alveolar collapse

D

What is the primary function of surfactant?

A. Reduce surface tension and help prevent alveolar collapse

B.Increase surface tension

C. Produce mucus

D. Increase blood pressure

A

A patient does not have adequate surfactant. Which problem is most likely?

A. Alveoli are more likely to collapse

B. Cardiac output increases

C. Hemoglobin rises

D. Blood becomes alkaline

A

Ventilation is easiest to remember as:
A. Blood
B. Exchange
C. Air
D. Heart

C

Perfusion is easiest to remember as:

A. Air

B. Lung expansion

C. Breathing rate

D. Blood flow

D

Diffusion is easiest to remember as:

A. Gas exchange

B. Muscle contraction

C. Blood pumping

D. Lung expansion

A

Perfusion refers to the cardiovascular system's ability to:

A. Move air into the lungs

B. Pump oxygenated blood to tissues and return deoxygenated blood to the lungs

C. Produce surfactant

D. Contract the diaphragm

B

The primary function of pulmonary circulation is to:

A. Supply the kidneys

B. Move blood to and from the alveolar-capillary membrane for gas exchange

C. Produce RBCs

D. Control respiratory rate

B

Pulmonary circulation depends heavily on the function of the:
A. Left atrium
B. Aorta

C. Right ventricle
D. Left ventricle

C

A patient develops severe right ventricular failure. Which process may be impaired?

A. Pulmonary perfusion

B. Surfactant production

C. Inspiration only

D. Hemoglobin production

A

During diffusion, oxygen normally travels:

A. Blood → alveoli

B. Heart → alveoli

C. Alveoli → blood

D. Tissues → blood

C

During diffusion, CO₂ normally travels:

A. Alveoli → blood

B. Lungs → tissues

C. Atmosphere → blood

D. Blood → alveoli

D

Diffusion is particularly affected by:

A. Alveolar-capillary membrane thickness and surface area

B. Hair color

C. Body height only

D. Pulse location

A

Which condition can interfere with diffusion by increasing membrane thickness or interfering with surface area?

A. Pulmonary edema

B. Normal sleep

C. Increased appetite

D. Normal inspiration

A

Which conditions are listed as potentially interfering with diffusion?

A. Pulmonary edema, infiltrates, effusion, and pulmonary disease

B. Only hypertension

C. Only anemia

D. Only tachycardia

A

Adequate oxygen transport depends on which combination?

A. Ventilation only

B. Perfusion only

C. Ventilation, perfusion, diffusion, hemoglobin oxygen-carrying capacity, and CO₂ levels

D. Heart rate only

C

Why is hemoglobin important to oxygenation?

A. It carries oxygen

B. It produces surfactant

C. It controls respiratory rate

D. It produces CO₂

A

A patient has normal lung ventilation but extremely low hemoglobin. Why can tissue oxygenation still be impaired?
A. There is inadequate oxygen-carrying capacity
B. The diaphragm cannot contract
C. The alveoli automatically collapse
D. The patient cannot produce CO₂

A

CO₂ is produced by:
A. Cellular metabolism
B. Surfactant
C. Inspiration
D. The pleural space

A

CO₂ is transported back to the lungs primarily through:

A. The lymphatic system only

B. The trachea

C. Venous circulation

D. The pleural cavity

C

CO₂ is transported back to the lungs primarily through:

A. Venous circulation

B. The trachea

C. The lymphatic system only

D. The pleural cavity

A

CO₂ is considered:
A. Basic
B. Neutral
C. Acidic
D. An electrolyte

C

Deoxygenated blood returns to which chamber first?

A. Left atrium

B. Right atrium

C. Left ventricle

D. Aorta

B

Deoxygenated blood enters the right atrium through the:

A. Pulmonary veins

B. Pulmonary arteries

C. Superior and inferior vena cavae

D. Aorta

C

Which chamber pumps blood into pulmonary circulation?

A. Right ventricle

B. Left ventricle

C. Left atrium

D. Right atrium

A

Which vessels carry deoxygenated blood from the heart toward the lungs?

A. Pulmonary veins

B. Pulmonary arteries

C. Coronary veins

D. Aorta

B

Which vessels return oxygenated blood from the lungs to the heart?

A. Pulmonary arteries

B. Carotid arteries

C. Vena cavae

D. Pulmonary veins

D

Oxygenated blood from the lungs first enters the:

A. Right atrium

B. Left atrium

C. Right ventricle

D. Aorta

B

Which chamber pumps blood into systemic circulation?

A. Right ventricle

B. Right atrium

C. Left ventricle

D. Left atrium

C

Put the blood-flow pathway in the correct order.

A. RA → RV → lungs → LA → LV → body

B. LA → LV → lungs → RA → RV → body

C. RV → RA → lungs → LV → LA

D. RA → LA → RV → LV

A

What is systemic circulation?

A. Blood flow between heart and lungs

B. Oxygenated blood delivered to body tissues and deoxygenated blood returned to the heart

C. Blood supply only to the heart muscle

D. Air movement into the lungs

B

Coronary circulation supplies oxygenated blood to the:

A. Lung tissue only

B. Brain only

C. Heart muscle itself

D. Diaphragm only

C

What is cardiac output?

A. Blood pumped per heartbeat

B. Blood pumped by the heart in one minute

C. Resistance against ventricular ejection

D. Ventricular filling only

B

Cardiac output equals:
A. HR ÷ SV
B. HR × SV
C. BP × RR
D. RR × SpO₂

B

What is preload?

A. Resistance against ejection

B.Heart rate

C. Strength of contraction

D. Ventricular filling/stretch before contraction

D

What is afterload?

A. Ventricular filling

B. Resistance the ventricle must overcome to eject blood

C. Oxygen level in blood

D. Respiratory rate

B

What is contractility?

A. Strength of myocardial contraction

B. Resistance to ventricular emptying

C. Amount of blood returning to the heart

D. Amount of CO₂ exhaled

A

An ECG primarily provides information about:
A. Cardiac electrical conduction and arrhythmias
B. Lung diffusion
C. Hemoglobin concentration
D. Surfactant

A

Which can affect oxygenation and circulation?

A. Hyperventilation and hypoventilation

B. Hypoxia

C. Heart failure and anemia

D. All of the above

D

Which condition decreases the blood's oxygen-carrying capacity?
A. Anemia
B. Normal ventilation
C. Normal surfactant
D. Normal cardiac output

A

Which are physiological factors affecting oxygenation/circulation from the lecture?
A. Hypovolemia, pregnancy, obesity, trauma, CNS disease
B. Eye color and handedness
C. Hair texture
D. None

A

Carbon monoxide toxicity primarily threatens:

A. Effective oxygen transport

B. Surfactant production only

C. Body temperature only

D. Digestion

A

Infants receive early protection against infection from:
A. Maternal antibodies
B. Increased surfactant
C. High BP
D. Increased cardiac output

A

According to the lecture, infection risk increases in infants around:

A. Birth only

B. 3–6 months

C. 5 years

D. Adolescence

B

Which is an important oxygenation risk for infants/toddlers?
A. Airway obstruction
B. Coronary atherosclerosis
C. Occupational asbestos exposure
D. Chronic hypertension

A

Important factors for school-age children/adolescents include:
A.Only heart rate
B. Only age
C. Only genetics
D. Infection exposure, smoke/inhalants, inactivity, obesity, diet

D

For young and middle-aged adults, the lecture emphasizes:
A. Lifestyle risks are often modifiable
B. Lifestyle does not affect oxygenation
C. All risks are genetic
D. Exercise should be avoided

A

Which age-related change occurs in older adults?
A. Increased ciliary effectiveness
B. Decreased effectiveness of cough due partly to decreased cilia
C. More flexible vessels
D. Complete prevention of atherosclerosis

B

Which changes are associated with older adulthood?

A. Valve/airway calcification and atherosclerosis

B. Vascular and costal cartilage stiffening

C. Thoracic changes and immune changes

D. All of the above

D

Lifestyle factors affecting oxygenation/circulation include:
A. Nutrition, exercise, smoking, substance abuse, and stress
B. Eye color
C. Shoe size
D. Hand dominance

A

Environmental risks include:

A. Smog and pollution

B. Workplace toxins and pesticides

C. Fungal and asbestos exposure

D. All of the above

D

Which should the nurse inspect when assessing oxygenation/circulation?

A. Skin and mucous membranes

B. Nail beds and edema

C. Chest wall and work of breathing

D. All of the above

D

Dyspnea means:
A. Normal breathing
B. Difficulty breathing/shortness of breath
C. No pulse
D. High temperature

B

Which finding indicates increased work of breathing?

A. Accessory-muscle use

B. Retractions

C. Nasal flaring

D. All of the above

D

Orthopnea refers to breathing difficulty associated with:
A. Lying flat
B. Eating
C. Walking only
D. Fever

A

What is the purpose of a cough?
A. Protective clearance of irritants, secretions, and foreign material
B. Increase afterload
C. Decrease hemoglobin
D. Produce surfactant

A

What should the nurse assess about sputum/cough?
A. Productive vs nonproductive
B. Color and consistency
C. Frequency, taste, odor, and hemoptysis
D. All of the above

D

Hemoptysis means:

A. Blood associated with coughing/sputum

B. Low hemoglobin

C. Low BP

D. Slow respirations

A

Percussion of the chest can help identify:

A. Abnormal air or fluid

B. Hemoglobin level

C. Cardiac output directly

D. Blood glucose

A

Which are normal lung-sound categories taught in the lecture?

A. Vesicular, bronchovesicular, bronchial

B. Crackles, wheezes, rhonchi

C. Murmurs and bruits

D. S1 and S2

A

Which are adventitious lung sounds?

A.Vesicular only

B. S1 and S2

C. Crackles, rhonchi, wheezes, pleural friction rub

D. Bronchovesicular only

C

Which are findings associated with cardiac auscultation?

A. S1 and S2

B. S3/S4

C. Murmurs, gallops, rubs, and bruits

D. All of the above

D

Which visible findings can indicate oxygenation/circulation problems?

A. Cyanosis

B. Clubbing

C. All of the above

D. Edema

C

Eupnea means:

A. Normal unlabored breathing
B. Rapid breathing
C. Slow breathing
D. No breathing

A

Tachypnea means:
A. Slow breathing
B. Rapid breathing
C. Deep breathing only
D. Absent breathing

B

Bradypnea means:
A. Rapid respirations
B. Slow respirations
C. No respirations
D. Irregular pulse

B

Apnea means:
A. Cessation of breathing
B. Rapid breathing
C. Deep breathing
D. Normal breathing

A

Hyperpnea means:

A. Increased depth and rate of respirations

B. Complete absence of breathing

C. Slow shallow breathing

D. Normal breathing

A

Hyperventilation involves:
A. Increased rate and depth
B. Decreased rate and depth
C. No breathing
D. Only decreased depth

A

Hypoventilation involves:

A. Increased ventilation

B. Depressed rate/depth of ventilation

C. Increased diffusion

D. Increased cardiac output

B

Hypoventilation can cause retention of:

A. O₂

B. CO₂

C. Hemoglobin

D. Platelets

B

Cheyne-Stokes respirations are characterized by:
A. Normal breathing
B. Alternating apnea with increasing/decreasing ventilation
C. Constant shallow respirations
D. Deep regular breathing only

B

Kussmaul respirations are:
A. Abnormally deep, regular, and increased in rate
B. Shallow with irregular apnea
C. Normal and quiet
D. Slow and shallow

A

Biot respirations are:
A. Deep regular respirations
B. Shallow respirations with irregular periods of apnea
C. Normal breathing
D. Rapid breathing without apnea

B

What does PATCHES assess?
A. Peripheral perfusion/circulation
B. Memory
C. Digestion
D. Vision

A

P in PATCHES =
A. Pain
B. Pulse
C. Pressure
D. Pallor

B

A in PATCHES =
A. Airway
B. Artery
C. Appearance
D. Apnea

C

T in PATCHES =
A. Temperature
B. Tachycardia
C. Tissue
D. Tension

A

C in PATCHES =
A. Cardiac output
B. Capillary refill
C. Cough
D. Cyanosis

B

H in PATCHES =
A. Heart rate
B. Hardness
C. Hemoglobin
D. Hypoxia

B

E in PATCHES =
A. Edema
B. Exercise
C. Expiration
D. Eupnea

A

S in PATCHES =
A. Surfactant
B. Systolic
C. Sensation
D. Sputum

C

Body temperature represents the balance between:
A. Heat production and heat loss
B. HR and SV
C. O₂ and CO₂
D. Systolic and diastolic BP

A

When assessing a pulse, the nurse evaluates:
A. Rate, rhythm, and quality
B. Rate only
C. Rhythm only
D. Temperature only

A

A pulse may be described as:
A. Bounding or thready
B. Vesicular or bronchial
C. Kussmaul or Biot
D. Systolic or diastolic

A

Respirations should ideally be assessed:
A. Discreetly
B. Only after telling the patient to breathe normally
C. Only during exercise
D. Once per admission

A

Which can alter respiratory rate/pattern?
A. Exercise
B. Pain and anxiety
C. Medications, smoking, and position
D. All of the above

D