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Quizzes > Health & Medicine

Fundamentals of Nursing Oxygenation Quiz

Quick, free nursing oxygenation quiz with instant results and study tips.

Editorial: Review CompletedCreated By: Suzy KindUpdated Aug 26, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art lungs interlaced with fruits vegetables and heart shapes on sky blue background

This quiz helps you check your grasp of oxygenation in nursing fundamentals, including how breathing and nutrition support oxygen delivery. For more practice, explore the fundamentals of nursing quiz, build respiratory skills with a med surg respiratory quiz, and challenge yourself with an rn respiratory practice quiz.

What is the primary function of hemoglobin in the blood?
Regulating blood glucose levels
Clotting blood at injury sites
Transporting oxygen to tissues
Mounting an immune response
Hemoglobin binds oxygen in the lungs and releases it in peripheral tissues, facilitating cellular respiration. Impaired hemoglobin function reduces oxygen delivery and leads to hypoxia. This function is critical for maintaining adequate tissue oxygenation.
Which nutrient is essential for collagen production to maintain alveolar integrity?
Vitamin D
Vitamin C
Folic acid
Vitamin B12
Vitamin C acts as a cofactor for proline and lysine hydroxylase enzymes needed in collagen synthesis. Collagen maintains structural strength of alveolar walls. Deficiency can weaken alveolar tissue and impair gas exchange.
Which arterial blood gas value best reflects oxygenation status?
PaO2
PaCO2
pH
HCO3-
PaO2 measures the partial pressure of dissolved oxygen in arterial blood and directly indicates oxygenation efficiency. It is the most accurate parameter for detecting hypoxemia. Other ABG values reflect ventilation and acid-base status.
Which organ serves as the primary storage site for iron?
Kidney
Liver
Bone marrow
Spleen
The liver stores iron in ferritin and hemosiderin complexes and releases it for erythropoiesis as needed. Hepatic iron reserves maintain hemoglobin synthesis when dietary iron is low. Excess liver iron is seen in hemochromatosis.
A deficiency in which vitamin can lead to impaired hemoglobin synthesis and anemia?
Vitamin C
Vitamin K
Vitamin B12
Vitamin A
Vitamin B12 is required for DNA synthesis in red blood cell precursors; deficiency results in megaloblastic anemia. Impaired erythropoiesis reduces oxygen-carrying capacity. Early detection prevents neurologic and hematologic complications.
What is the normal range for arterial oxygen saturation (SaO2) in healthy adults?
95% - 100%
65% - 70%
75% - 80%
85% - 90%
Healthy adults typically maintain SaO2 between 95% and 100%, indicating effective oxygen loading in the lungs. Values below 90% suggest hypoxemia requiring intervention. Continuous pulse oximetry monitors these levels at bedside.
Which mineral is essential for oxygen transport in hemoglobin?
Calcium
Zinc
Magnesium
Iron
Iron is the central atom in the heme group that binds oxygen molecules. Without sufficient iron, hemoglobin synthesis is impaired, leading to iron-deficiency anemia. Adequate dietary iron is essential for oxygen transport.
Which macronutrient provides the primary fuel for respiratory muscle work?
Carbohydrates
Proteins
Fats
Alcohol
Carbohydrates are the preferred fuel for the diaphragm and accessory respiratory muscles due to rapid ATP generation. Excessive fat intake can increase CO2 production per oxygen consumed. Balanced macronutrient intake supports optimal breathing effort.
Loss of which nutrient store leads to respiratory muscle weakness in malnourished patients?
Vitamin D
Protein
Vitamin K
Calcium
Muscle mass and strength depend on adequate protein intake; depletion impairs diaphragmatic and accessory muscle function. Respiratory muscle weakness increases risk for hypoventilation and atelectasis. Nutritional support includes high-protein diets.
Which physical finding indicates chronic hypoxia and poor oxygenation?
Petechiae
Jaundice
Edema
Digital clubbing
Clubbing of the fingernails develops over time with chronic low arterial oxygen levels. It reflects long-standing pulmonary or cardiovascular disease affecting oxygenation. Early detection prompts further respiratory evaluation.
Which anthropometric measure best reflects a patient's protein stores?
Height
Waist circumference
Mid-arm muscle circumference
Body mass index
Mid-arm muscle circumference estimates lean body mass and protein reserves. It is more sensitive than BMI in detecting malnutrition in hospital settings. Declines signal risk for muscle weakness including respiratory muscles.
Which trace element plays a role in antioxidant protection of alveolar cells?
Copper
Selenium
Manganese
Chromium
Selenium is a cofactor for glutathione peroxidase, an enzyme that neutralizes reactive oxygen species in lung tissue. Deficiency increases susceptibility to oxidative lung injury. Proper trace element balance supports respiratory defense mechanisms.
Low serum albumin levels can contribute to which respiratory complication?
Pleural effusion
Atelectasis
Pulmonary edema
Pneumothorax
Hypoalbuminemia reduces oncotic pressure, allowing fluid to leak into pulmonary interstitium and alveoli. This fluid buildup impairs gas exchange and oxygenation. Addressing protein deficits helps prevent edema.
Increasing intake of which foods most directly improves hemoglobin synthesis?
Starchy vegetables and grains
Dairy and citrus fruits
Red meat and leafy greens
Fruits and nuts
Red meat provides heme iron, and leafy greens supply non-heme iron and cofactors like folate. Both forms of iron are required for hemoglobin production in bone marrow. Vitamin C from other sources enhances non-heme iron absorption.
Which vitamin enhances non-heme iron absorption when consumed together?
Vitamin C
Vitamin B6
Vitamin D
Vitamin K
Vitamin C reduces ferric iron (Fe3+) to the more absorbable ferrous form (Fe2+) in the gut. This enhances uptake of plant-based (non-heme) iron. Co-ingestion of citrus fruits with iron-rich vegetables is recommended.
Which vitamin is important for mucus production in the respiratory tract?
Vitamin K
Vitamin B12
Vitamin A
Vitamin E
Vitamin A maintains epithelial integrity and goblet cell function, which produce protective mucus in airways. Deficiency can lead to dry, compromised mucosal barriers. Adequate intake supports respiratory defense.
How does anemia affect tissue oxygenation?
Lowers PaCO2
Increases PaO2
Decreases oxygen-carrying capacity
Elevates SaO2
Anemia reduces the number of functional hemoglobin molecules available to transport oxygen. This leads to decreased oxygen delivery despite normal lung function. Compensatory mechanisms include increased cardiac output.
Why are high-fat, low-carbohydrate diets sometimes recommended for patients with chronic respiratory disease?
They boost hemoglobin levels
They increase lung surfactant
They enhance mucociliary clearance
They produce less CO2 per O2 consumed
Fat oxidation generates less carbon dioxide relative to the amount of oxygen consumed compared to carbohydrates. This lowers ventilatory demand in patients with limited respiratory reserve. Nutritional strategies can optimize gas exchange.
Which laboratory test best evaluates iron stores in the body?
Serum iron
TIBC
Serum ferritin
Transferrin saturation
Serum ferritin reflects total body iron stores and correlates closely with hepatic ferritin levels. Low ferritin is an early indicator of iron depletion. Other tests like transferrin saturation vary with inflammation.
What does an elevated alveolar - arterial (A - a) gradient indicate?
High cardiac output
Hyperventilation
Impaired gas diffusion
Metabolic acidosis
An increased A - a gradient signifies a difference between alveolar oxygen and arterial oxygen levels, indicating issues with diffusion, shunting, or V/Q mismatch. It helps differentiate hypoxemia causes. Calculation requires PaO2 and estimated PAO2.
How does vitamin A deficiency impair respiratory epithelial function?
Elevates PaO2
Enhances collagen synthesis
Increases surfactant production
Reduces mucociliary clearance
Vitamin A maintains epithelial cell differentiation and mucin-producing goblet cells. Deficiency leads to loss of cilia and impaired clearance of pathogens and debris. This increases infection risk and compromises oxygenation.
Which nutritional support method bypasses the gastrointestinal tract entirely?
Total parenteral nutrition
Oral supplementation
Oral rehydration
Enteral tube feeding
Total parenteral nutrition (TPN) delivers nutrients directly into the bloodstream via a central venous catheter, avoiding the gut. It is indicated when the GI tract cannot be used safely. Monitoring for infection and metabolic complications is essential.
Which electrolyte imbalance impairs respiratory muscle contraction and can lead to hypoventilation?
Hypophosphatemia
Hyperkalemia
Hypocalcemia
Hypernatremia
Phosphate is required for ATP production in muscle cells; low phosphate reduces energy availability and weakens respiratory muscles. Severe hypophosphatemia can cause diaphragmatic fatigue and hypoventilation. Correction improves ventilation.
What role does zinc play in respiratory health?
Acts as a surfactant component
Directly binds oxygen
Supports immune function in airway epithelium
Buffers arterial pH
Zinc is essential for normal development and function of immune cells in respiratory mucosa. It supports barrier integrity and antioxidant enzyme activity. Deficiency increases susceptibility to infections.
How does obesity negatively affect respiratory mechanics?
Increases lung compliance
Reduces functional residual capacity
Improves diaphragmatic excursion
Lowers airway resistance
Excess adipose tissue around the thorax and abdomen restricts chest wall expansion and diaphragm movement, reducing functional residual capacity and tidal volume. This can impair gas exchange and increase work of breathing. Weight management improves respiratory function.
Which fatty acid has anti-inflammatory effects beneficial in airway disease?
Omega-6
Trans fats
Saturated fats
Omega-3
Omega-3 fatty acids (e.g., EPA, DHA) modulate cytokine production and reduce inflammation in airway tissues. They can improve respiratory symptoms and reduce exacerbation frequency. Sources include fatty fish and flaxseed.
What term describes the oxygen dissolved in plasma measured on ABG?
CaO2
SvO2
PaO2
SaO2
PaO2 is the partial pressure of oxygen dissolved in arterial blood plasma. It is obtained from arterial blood gas analysis. SaO2 measures hemoglobin-bound oxygen percentage.
Which protein is a negative acute-phase reactant that decreases during inflammation and can indicate malnutrition?
Ferritin
Prealbumin
Transferrin
CRP
Prealbumin (transthyretin) levels drop quickly in response to inflammation and protein-energy malnutrition. It has a short half-life, making it a sensitive marker for nutritional status changes. Interpretation requires consideration of inflammatory states.
What ratio of fat to carbohydrate calories is recommended to reduce CO2 production in ventilated patients?
30% fat, 70% carbohydrate
10% fat, 90% carbohydrate
60% fat, 40% carbohydrate
100% carbohydrate
A higher fat-to-carbohydrate calorie ratio decreases CO2 produced per unit of oxygen consumed, easing ventilatory demand. Typically, fat provides 60% of non-protein calories in respiratory-compromised patients. Monitoring acid-base balance is essential.
Which gas exchange measure indicates ventilation efficacy rather than oxygenation?
PaCO2
PaO2
SaO2
CaO2
PaCO2 reflects how effectively CO2 is eliminated via alveolar ventilation. Elevated levels indicate hypoventilation, while low levels suggest hyperventilation. It is distinct from oxygenation parameters like PaO2.
Which deficiency is responsible for refeeding syndrome that can precipitate respiratory failure?
Hyponatremia
Hypokalemia
Hypophosphatemia
Hypernatremia
In refeeding syndrome, sudden glucose infusion drives phosphate into cells, causing serum hypophosphatemia. Low phosphate impairs ATP production and respiratory muscle contractility. Vigilant monitoring in malnourished patients prevents complications.
Why is enteral feeding preferred over parenteral nutrition in ventilated patients?
Preserves gut barrier function
Requires no monitoring
Eliminates aspiration risk
Is less expensive
Enteral nutrition supports gut integrity, reduces bacterial translocation, and maintains mucosal immunity. It is associated with fewer infections than TPN. Adequate feeding improves respiratory outcomes.
How does 2,3-diphosphoglycerate (2,3-DPG) concentration affect the oxygen - hemoglobin dissociation curve?
Causes hemoglobin polymerization
A leftward shift increasing O? affinity
No effect on the curve
A rightward shift increasing O? release to tissues
Increased 2,3-DPG binds to hemoglobin and reduces its affinity for oxygen, shifting the curve right and enhancing O? unloading in tissues. Low levels shift the curve left, inhibiting release. Factors like anemia and high altitude raise 2,3-DPG.
What is the impact of chronic hypercapnia on renal acid-base compensation?
Immediate pH normalization
Decreased acid excretion
Increased bicarbonate reabsorption
Reduced ammonium production
In chronic hypercapnia, the kidneys retain bicarbonate and excrete hydrogen ions to buffer elevated PaCO2, partially normalizing pH. This compensation takes days to develop. Monitoring electrolytes is essential during adjustment.
Which IV lipid emulsion component may exacerbate lung inflammation in critically ill patients?
High omega-6 fatty acids
Olive oil
Fish oil
Medium-chain triglycerides
Omega-6 fatty acids are precursors to pro-inflammatory eicosanoids, which can worsen pulmonary inflammation. Alternative lipid emulsions with omega-3 or MCTs reduce this risk. Choice of lipid support influences respiratory outcomes.
How does refeeding syndrome impair oxygen delivery at the cellular level?
Magnesium overload enhances hemoglobin
Phosphate depletion reduces ATP synthesis
Excess glucose increases PAO2
Elevated insulin levels raise SaO2
Phosphate is essential for ATP generation, and its depletion during refeeding impairs energy-dependent processes including oxygen utilization. Weakened respiratory muscles and cellular metabolism follow. Prevention involves gradual refeeding and electrolyte monitoring.
Which measurement best reflects systemic oxygen delivery?
Cardiac output × CaO2
PaO2 × SaO2
A - a gradient × hemoglobin
SvO2 × PaCO2
Systemic oxygen delivery (DO2) equals cardiac output multiplied by arterial oxygen content (CaO2). CaO2 incorporates hemoglobin and SaO2 values. This calculation guides critical care interventions.
What is the role of glutathione in protecting alveolar membranes?
Neutralizes free radicals
Transports oxygen
Stimulates surfactant
Activates macrophages
Glutathione is a major intracellular antioxidant that scavenges reactive oxygen species in lung cells. Adequate levels prevent oxidative damage to alveolar membranes. Deficiency increases risk of acute lung injury.
Why is prealbumin a more sensitive marker than albumin for acute changes in nutritional status?
Higher plasma concentration
It is an acute-phase reactant
Binds more nutrients
Shorter half-life
Prealbumin has a half-life of about 2 days compared to albumin's 20 days, making it responsive to recent nutrition changes. It decreases quickly with inadequate protein intake. Interpretation must consider inflammation effects.
Which condition increases 2,3-DPG levels, thereby facilitating tissue oxygen delivery?
Alkalosis
Hypothermia
Chronic anemia
Carbon monoxide poisoning
Chronic anemia reduces hemoglobin concentration, stimulating increased 2,3-DPG production in red blood cells to enhance O? unloading. This physiological adaptation improves tissue oxygenation capacity. Other conditions like alkalosis decrease 2,3-DPG.
Which byproduct of carbohydrate metabolism increases CO2 production and respiratory demand?
Urea
Lactic acid
Ketones
Carbon dioxide
Metabolism of carbohydrates consumes oxygen and produces CO? in a 1:1 ratio, elevating ventilatory demand to remove excess CO?. High carbohydrate loads can stress compromised respiratory systems. Adjusting macronutrient ratios can minimize this effect.
How does vitamin D deficiency influence susceptibility to respiratory infections?
Decreases surfactant synthesis
Elevates PaCO2
Increases mucosal thickness
Reduces antimicrobial peptide production
Vitamin D induces expression of antimicrobial peptides such as cathelicidin in respiratory epithelium. Deficiency impairs innate immune defenses, increasing infection risk. Supplementation can reduce incidence of acute respiratory infections.
Which nutritional parameter is most predictive of weaning failure in ventilated patients?
Elevated CRP
Low serum prealbumin
High BMI
High serum sodium
Low prealbumin reflects inadequate protein reserves necessary for respiratory muscle strength, predicting difficulty in weaning from mechanical ventilation. Monitoring and nutritional intervention can improve outcomes. BMI is less specific.
What is the effect of metabolic acidosis on the oxygen - hemoglobin dissociation curve?
Right shift, enhancing O? release
No change
Curve becomes steeper
Left shift, reducing O? release
In metabolic acidosis, increased H+ concentration binds hemoglobin, stabilizing the T-state and shifting the curve right. This Bohr effect facilitates oxygen unloading to acidotic tissues. It is an important physiological adaptation.
Which method most accurately measures mixed venous oxygen saturation (SvO2)?
Pulmonary artery catheter
Pulse oximetry
Arterial blood gas
Capnography
SvO2 is measured directly from blood sampled in the pulmonary artery via a pulmonary artery (Swan-Ganz) catheter. It reflects balance between oxygen delivery and consumption. Noninvasive methods cannot accurately measure SvO2.
How does hypoalbuminemia affect drug binding and oxygen delivery?
Improves CO2 transport
Raises plasma oncotic pressure
Enhances hemoglobin oxygen affinity
Increases free drug levels, may worsen edema
Low albumin leads to higher free (active) drug concentrations and decreased oncotic pressure, promoting fluid shifts into interstitial spaces like the lung. Pulmonary edema impairs oxygen diffusion. Drug dosing must be adjusted in hypoalbuminemia.
How does the P50 value provide insight into hemoglobin - oxygen affinity under different physiological conditions?
P50 is independent of 2,3-DPG
Higher P50 indicates lower affinity with a rightward shift
Lower P50 indicates lower affinity
P50 remains constant in acidosis
P50 is the PO2 at which hemoglobin is 50% saturated; increased P50 means hemoglobin releases oxygen more readily (right shift), while decreased P50 means greater affinity (left shift). Factors like pH, CO2, temperature, and 2,3-DPG alter P50. Clinically, P50 shifts indicate tissue oxygen delivery status.
Describe the enzymatic mechanism by which NADH-cytochrome b5 reductase restores methemoglobin to functional hemoglobin.
Transports electrons to oxygen
Oxidizes Fe2+ to Fe3+
Binds carbon monoxide
Reduces Fe3+ to Fe2+ using NADH
NADH-cytochrome b5 reductase transfers electrons from NADH to cytochrome b5, which then reduces the iron in methemoglobin (Fe3+) back to the ferrous form (Fe2+). This enzymatic pathway prevents methemoglobinemia and maintains oxygen-binding capacity. Deficiencies lead to methemoglobin accumulation.
Explain how glutathione depletion exacerbates alveolar oxidative stress in ARDS.
Reduces detoxification of reactive oxygen species
Enhances surfactant production
Stimulates cytokine release
Increases oxygen binding to hemoglobin
Glutathione is a critical thiol antioxidant in alveolar cells. Depletion impairs neutralization of reactive oxygen species generated during inflammation, worsening cell injury in ARDS. Replenishing glutathione precursors may improve outcomes.
How does the Bohr effect facilitate oxygen unloading in metabolically active tissues?
Elevated O2 raises hemoglobin affinity
Low temperature shifts curve right
High pH enhances CO2 binding
Increased CO2 and H+ shift curve right
Increased CO2 and hydrogen ion concentrations in active tissues lower blood pH, causing hemoglobin to release oxygen more readily (right shift). This Bohr effect optimizes oxygen delivery where metabolic activity and demand are highest. It is reversed in the lungs.
Which vitamin K-dependent proteins influence pulmonary microvascular coagulation and may mitigate alveolar hemorrhage?
Albumin and globulin
Protein C and S
Fibrinogen and prothrombin
Factor VIII and XIII
Proteins C and S are anticoagulant factors that require vitamin K for activation, regulating microvascular thrombosis. Their function helps maintain alveolar capillary integrity and prevents hemorrhage. Deficiency can predispose to pulmonary microthrombi and bleeding.
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Study Outcomes

  1. Understand oxygenation nursing fundamentals -

    Grasp the core principles of oxygen transport and exchange in tissues to reinforce your foundational knowledge of oxygenation nursing fundamentals.

  2. Analyze nutrition and oxygenation quiz scenarios -

    Examine how nutrient intake influences oxygen distribution through our interactive nutrition and oxygenation quiz, reinforcing the connection between diet and respiratory function.

  3. Apply strategies to NCLEX questions for oxygenation -

    Practice targeted techniques for tackling NCLEX-style questions focused on oxygenation to boost your exam readiness and confidence.

  4. Evaluate nursing fundamentals oxygenation in clinical scenarios -

    Assess patient-specific factors to determine appropriate interventions that align with established nursing fundamentals for optimizing oxygenation.

  5. Identify essential nutrients supporting oxygen delivery -

    Recall key vitamins and minerals that enhance hemoglobin function and improve the body's oxygen-carrying capacity.

  6. Differentiate normal versus impaired oxygenation states -

    Recognize clinical signs and symptoms of effective and compromised oxygenation to guide timely and effective patient care decisions.

Cheat Sheet

  1. Alveolar Gas Equation Mastery -

    Understand the formula PAO₂ = FiO₂×(Patm - PH₂O) - (PaCO₂/RQ) to calculate alveolar oxygen pressure; using the mnemonic "PAF" (Pressure in Alveoli Formula) can help you recall each term. This equation is foundational in oxygenation nursing fundamentals for predicting gas exchange efficiency (source: American Thoracic Society). Remember that adjusting FiO₂ directly impacts PAO₂ and patient oxygenation.

  2. Oxygen-Hemoglobin Dissociation Curve Insights -

    Recognize how shifts in the curve affect oxygen unloading: a right shift (↑Temp, ↑CO₂, ↓pH) facilitates tissue release, while a left shift (↓Temp, ↓CO₂, ↑pH) holds onto O₂. Use the mnemonic "CADET, face Right!" (CO₂, Acid, 2,3-DPG, Exercise, Temperature) to recall right”shift factors (source: Journal of Clinical Monitoring). Integrating this into nursing fundamentals oxygenation helps you interpret SpO₂ trends clinically.

  3. Calculating Oxygen Delivery (DO₂) -

    DO₂ = Cardiac Output × [(Hb × 1.34 × SaO₂) + (PaO₂ × 0.003)] × 10, so knowing your patient's hemoglobin and saturation is key. This formula from Critical Care Medicine guides how adjustments in CO or Hb concentration affect total oxygen delivery. Practice with sample values (e.g., CO 5 L/min, Hb 12 g/dL, SaO₂ 97%) to reinforce your math skills for nclex questions for oxygenation.

  4. Nutrition's Role in Hemoglobin Synthesis -

    Essential nutrients like iron, vitamin B₝₂, and folate are vital for erythropoiesis and oxygen transport; remember "IRON'S BEST Fit" for Iron, Riboflavin, B₝₂, Folate, and Selenium. The CDC and NIH highlight iron's role in heme formation and B vitamins in DNA synthesis - core content for any nutrition and oxygenation quiz. Monitoring dietary intake or supplements can prevent anemia-related hypoxia.

  5. NCLEX-Ready Airway Assessment Mnemonic -

    Apply the "A - B - C - D - E" approach (Airway, Breathing, Circulation, Disability, Exposure) to rapidly evaluate oxygenation status in emergencies. This structured framework from the National League for Nursing ensures nothing is skipped in your initial assessment. Practicing scenario-based questions with this mnemonic sharpens your confidence in nclex questions for oxygenation and improves real”world readiness.

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