Deck 20: Emergency Airway Management

Question 1

A patient needs to placed on mechanical ventilation.For intubation,the practitioner selects a Macintosh laryngoscope blade.Where in the airway should the tip of the blade be placed?

A) The tip directly lifts the epiglottis.
B) The distal tip is placed in the vallecula.
C) The tip is placed on the left side of the tongue and positioned until the trachea is visualized.
D) The tip is inserted posteriorly to the trachea to ensure tracheal intubation.

Answer 1

The distal tip is placed in the vallecula.

Question 2

Why is a large endotracheal tube preferred to a small endotracheal tube as an airway for an intubated patient?

A) Decreased risk of vomiting
B) Decreased airway resistance
C) Decreased lung compliance
D) Increased oxygenation

Answer 2

Decreased airway resistance

Question 3

All of the following are conditions requiring management of the airway EXCEPT ____________

A) secretions in the airway.
B) respiratory failure.
C) airway compromise.
D) the need to protect the airway.

Answer 3

secretions in the airway.

Question 4

What is the most common cause of upper airway obstruction?

A) Spasm of the larynx
B) Dried secretions occluding the airway
C) The tongue falling back against the posterior pharynx
D) Food or other foreign material obstructing the airway

Question 5

What is the name of the cartilage that protects the trachea from foreign material entering the trachea during swallowing?

A) Vallecula
B) Vocal cords
C) Epiglottis
D) Arytenoid Cartilage

Question 6

Which resuscitation bag would be the best to assess a patient's compliance of the lungs and thorax?

A) Self-inflating resuscitator
B) Flow-inflating resuscitator
C) Gas-powered resuscitator
D) Manual resuscitator

Question 7

What is the most important consideration in determining endotracheal tube position?

A) Depth of the endotracheal tube
B) Bilateral breath sounds
C) Symmetrical chest movement
D) Detection of esophageal intubation

Question 8

A patient is admitted to the emergency department following a motor vehicle accident.The patient has obvious head trauma and needs to have his airway maintained.What should be done to open and maintain the patient's airway?

A) Emergency tracheostomy
B) Cricothyrotomy
C) Head tilt
D) Anterior mandibular displacement

Question 9

As a person loses consciousness,what happens to the reflexes that protect the airway?

A) They remain intact
B) They are lost in ascending order
C) They are lost in descending order
D) The cough reflexes are lost but the others remain intact

Question 10

A patient is intubated and the physician would like the respiratory care practitioner to use a manual resuscitator to deliver 100% oxygen.Which of the following devices could be used to satisfy the order?

A) Self-inflating resuscitator
B) Flow-inflating resuscitator
C) Gas-powered resuscitator
D) All of these devices

Question 11

If vomiting and aspiration is a concern with a patient who needs an airway in place,which of the following airways would best protect the patient's airway?

A) Nosopharyngeal airway
B) Oropharyngeal airway
C) Laryngeal mask airway
D) a and b

Question 12

How is ventilation confirmed through a Combitube airway?

A) Ventilation is attempted through one tube and chest rise and exhaled C02 is observed; if ventilation is not confirmed, the same sequence is performed with the other tube of the airway.
B) Ventilation is attempted through one tube and chest rise and exhaled C02 is observed, if ventilation is not confirmed the Combitube airway is removed and reinserted.
C) Ventilation is attempted through one tube and chest rise and exhaled C02 is observed, if ventilation is not confirmed an oropharyngeal airway is inserted to release pressure from the airway.
D) Ventilation is attempted through one tube and chest rise and exhaled C02 is observed, if ventilation is not confirmed the same sequence is attempted again after withdrawing the airway 2 cm.

Question 13

Which of the following is NOT a contraindication for resuscitation of a patient?

A) Resuscitation has been determined to be futile because of the patient's underlying condition or disease
B) A patient that has had a diagnosis of lung cancer with metastasis to another part of the body
C) The patient's desire not to be resuscitated has been clearly expressed and documented in the patient's medical record
D) a and c

Question 14

What is the proper position of a properly placed endotracheal tube in the patient's trachea?

A) 1.5" or 5 cm above the vallecula
B) 1.5" or 5 cm above the vocal cords
C) 1.5" or 5 cm above the epiglottitis
D) 1.5" or 5 cm above the carina

Question 15

A patient requires an airway to prevent the tongue from occluding the airway.The patient lapses in and out of conscious periodically.Which airway would be best to use for the patient?

A) Oropharyngeal airway
B) Combitube airway
C) Nasopharyngeal airway
D) Laryngeal mask airway

Question 16

Partial upper airway obstruction is characterized by ________________

A) bronchospasm.
B) asymmetrical chest movement.
C) noisy inspiratory efforts.
D) no sound of air movement.

Question 17

Defibrillation is contraindicated when immediate danger to the rescuers is present due to: I.the environment.
II.the patient's condition.
III.the patient's location.

A) II and III
B) I, II, III
C) III only
D) I and II

Question 18

What is the purpose of all valves used in manual resuscitators?

A) To determine the compliance of a patient's lung and thorax
B) To deliver gas to the patient during inspiration
C) To allow the patient to exhale to the ambient atmosphere on exhalation
D) b and c

Question 19

What should be evaluated once an airway is established on a patient?

A) Ventilation
B) Central nervous system function
C) Retractions
D) Stridor

Question 20

Which of the following reflexes of the upper airway are cough reflexes?
I.Carinal reflex
II.Tracheal reflex
III.Laryngeal reflex
IV.Gag reflex
V.Swallow reflex

A) I and II
B) III and V
C) II only
D) I, III, IV, V

Question 21

To lessen the damage caused to the tracheal wall by the endotracheal tube cuff,it is best to use what type of cuff?

A) Pilot balloon
B) Low-volume, high-pressure cuff
C) High-volume, low-pressure cuff
D) PVC cuff

Question 22

To help determine proper positioning of the endotracheal tube on a chest radiograph,which of the following is placed on the endotracheal tube?

A) Murphy eye
B) Radiopaque stripe
C) Polyvinyl chloride plastic
D) Pilot balloon

Question 23

An endotracheal tube is placed in a patient followed by the attachment of a capnograph.The reading reads zero.What could cause this problem and how could it be corrected?

Question 24

What is described by the following: "A technique performed to inflate the endotracheal tube cuff under positive pressure.Cuff inflation is stopped when a small leak is heard at the mouth during inspiration."?

A) Minimal occluding volume
B) Bivona cuff technique
C) Minimal leak technique
D) Mainstem intubation

Question 25

Which of the following is NOT an advantage of the nasal route of intubation?

A) Oral care is much easier, allowing sufficient access to the mouth.
B) It is easier to stabilize the endotracheal tube.
C) It is the fastest and most direct route of intubation.
D) Conscious patients tolerate nasal intubation better.

Question 26

The physician is attempting a difficult intubation.Which medication should be recommended to paralyze the patient to facilitate the intubation and minimize trauma?

A) Succinylcholine
B) Midazolam
C) Lorazepam
D) Etomidate

Question 27

Where is the Miller laryngoscope blade placed during endotracheal intubation?

A) Under the epiglottis
B) In the vallecula
C) In the trachea
D) In the esophagus

Question 28

A respiratory care practitioner is attempting to place an oral endotracheal tube in a patient.The attempt is unsuccessful.What should be done before attempted reintubation?

A) Reventilation
B) Reoxygenation
C) Suctioning the airway
D) a and b

Question 29

Which of the following objective criteria indicates that a patient is ready for ventilator discontinuance and extubation?
I.PaO₂/FIO₂ of 350
II.Minute volume of 18 LPM
III.NIF of -35 cmH₂O
IV.f/Vt of 60

A) II and III
B) I, III, IV
C) I and IV
D) I, II, III, IV

Question 30

A patient is unconscious and has blood is his mouth upon being admitted to the emergency department.Breath sounds are diminished bilaterally.What would you recommend to maintain the patient's airway and why?

Question 31

A 6'5",300-lb male patient is admitted to ICU for mechanical ventilation via an endotracheal tube.A 7.5 mm-ID tube is in place.What problems could be present with this patient and how could they be treated?

Question 32

What endotracheal tube cuff pressure should be maintained to minimize tracheal damage?

A) 25 cmH2O or greater
B) 20 cmH2O or less
C) 1.5 inHg
D) 25 mmHg or greater

Question 33

A physician asks the practitioner for Magill forceps.What type of airway is the physician going to place in the patient's airway?

A) Nasotracheal tube
B) Orotracheal tube
C) Laryngeal mask airway (LMA)
D) Combitube airway

Question 34

After an emergency intubation,the respiratory care practitioner auscultates the chest and the abdomen.Breath sounds are absent over the chest but heard over the abdomen.What is the cause?

A) Endotracheal tube in the esophagus
B) Endotracheal tube in the trachea
C) Trauma has occurred to the upper airway
D) Left mainstem intubation