Deck 25: Airway Management

Question 1

To perform oral pharyngeal suctioning,what should the nurse do first?

A) Apply gloves and mask
B) Insert the suction device to the back of the throat
C) Remove the patient's nasal cannula
D) Connect the tubing to a standard suction catheter

Answer 1

Apply gloves and mask

Question 2

A patient develops respiratory distress during suctioning of the endotracheal tube.What should the nurse do?

A) Remove and reinsert the catheter
B) Continue to remove thick secretions
C) Administer oxygen directly through the catheter
D) Encourage the patient to cough and deep-breathe

Answer 2

Administer oxygen directly through the catheter

Question 3

The nurse is caring for a patient who is sedated and is on a ventilator.When assessing the patient,the nurse notes that there is a sound that may indicate that air is escaping around the tube.What should the nurse do?

A) Prepare for reintubation
B) Repeat taping or securing procedure
C) Suction the patient
D) Verify correct position of the tube and assess cuff pressure

Answer 3

Verify correct position of the tube and assess cuff pressure

Question 4

The nurse notes that her ventilated patient needs suctioning via his tracheostomy tube.From experience,she knows that the patient has thick,tenacious mucus that is often difficult to remove.One option to help remove those secretions is the practice of normal saline instillation (NSI)into the tracheostomy tube.What risks does the nurse realize accompany the use of NSI?

A) Increases the amounts of secretions
B) Increases oxygen saturation
C) Decreases heart rate
D) May increase the potential of ventilated-associated pneumonia

Question 5

Preparation for tracheostomy care in the acute care environment includes:

A) Using clean technique, gloves, and supplies
B) Placing the patient in high-Fowler's position
C) Removing and cleaning the outer cannula
D) Preparing cotton applicators with normal saline and hydrogen peroxide

Question 6

An appropriate step for the nurse to take when providing tracheostomy care when the tracheostomy tube has an inner cannula is:

A) Suctioning the patient after the procedure
B) Removing the old ties before applying the new ones
C) Rinsing the inner cannula with saline
D) Cleaning the inside of the outer cannula toward the stoma site

Question 7

How do the guidelines for suctioning an infant differ from the guidelines for suctioning an adult?

A) Secretions are easier to remove
B) Suctioning occurs in 5-second intervals
C) Suctioning is done 2 to 3 cm beyond an artificial airway
D) The suction catheter measures two thirds of the diameter of a tracheostomy tube

Question 8

After suctioning a patient,a nurse notes the return of bloody secretions.What should the nurse do next?

A) Increase the suction pressure
B) Provide additional oxygen
C) Reduce the frequency of oral hygiene
D) Check the suction catheter for nicks

Question 9

A critical point in performing endotracheal tube (ET)care is:

A) Leaving sufficient slack in the tape
B) Holding the tube firmly in place at all times
C) Suctioning the patient after care is provided
D) Removing the oral airway if patient is biting on the ET tube

Question 10

Suctioning is discontinued if the patient experiences:

A) Coughing
B) A decrease in pulse from 84 beats per minute to 60 beats per minute
C) An increase in pulse from 84 beats per minute to 94 beats per minute
D) A reduction in oxygen saturation from 97% to 94%

Question 11

The nurse is providing nasotracheal suction for a patient.Which of the following is proper technique?

A) Insert the catheter during exhalation
B) Insert the catheter while the patient is swallowing
C) Apply suction only when pulling the catheter out
D) Remove the catheter immediately and quickly if patient coughs

Question 12

Ventilator-associated pneumonia (VAP)is a major concern for ventilated patients because it:

A) Occurs in 5% of ventilated patients
B) Causes 75% of nosocomial infections in vented patients
C) Develops within 24 hours of intubation
D) Increases hospital stay length and mortality

Question 13

When performing nasotracheal suctioning,the nurse:

A) Inserts the catheter about 20 cm
B) Uses clean gloves and equipment to suction
C) Applies pressure to insert the catheter through the nares
D) Slants the catheter upward through the mouth

Question 14

In the acute care environment,what is the wall suction pressure setting for adults?

A) 20 to 40 mm Hg
B) 80 to 100 mm Hg
C) 100 to 150 mm Hg
D) 100 to 120 mm Hg

Question 15

When suctioning a ventilated patient with a closed (in-line)system for suctioning of an ET or tracheostomy tube,the nurse knows that:

A) No complications are associated with its use
B) This system has a greater risk for infection than do open systems
C) The artificial airway does not have to be disconnected
D) Suctioning with an in-line system interrupts oxygenation

Question 16

What should the nurse do to improve the effectiveness of tracheal suctioning?

A) Suction for 20-second intervals
B) Pass the catheter through to the carina
C) Suction during insertion of the catheter
D) Hyperinflate and/or hyperoxygenate before suctioning

Question 17

Upon completion of suctioning,what should the nurse do first?

A) Reduce the suction level
B) Save the face shield for future suctioning episodes
C) Reposition the patient, and complete personal care using sterile gloves
D) Pull the gloves off over the rolled catheter, and discard

Question 18

A patient's tracheostomy tube is extubated accidentally.What should the nurse do immediately?

A) Call the physician
B) Mechanically ventilate the patient
C) Insert a new tube
D) Hold the stoma open with the fingertips

Question 19

The nurse is caring for an infant who has been vomiting and who is having breathing problems.What should the nurse do to suction the infant?

A) Place the infant in a supine position
B) Suction only when a large amount of mucus is present
C) Place the infant in a prone position
D) Use bulb syringe and compress the bulb after it is in place

Question 20

In the acute care environment,what is the wall suction pressure setting for infants?

A) 10 to 30 mm Hg
B) 40 to 60 mm Hg
C) 80 to 100 mm Hg
D) 100 to 150 mm Hg

Question 21

Airway management involves maintaining the patency of which of the following? (Select all that apply.)

A) Nose
B) Upper airway
C) Trachea
D) Lower airway
E) None of above

Question 22

A _______________ is inserted directly into the trachea through a small incision made in the patient's neck.

Question 23

A nurse notes an excessive air leak of the endotracheal (ET)cuff when auscultating.What should the nurse do to address this problem?

A) Deflate the cuff
B) Reposition the patient
C) Insert a new ET tube
D) Apply clamps to the tubing

Question 24

What are the goals of correctly inflating the cuff on an artificial airway? (Select all that apply.)

A) Promote lung inflation
B) Prevent aspiration of gastric contents
C) Allow drainage of secretions that accumulate
D) Apply maximum pressures to prevent leakage

Question 25

Interventions that are advantageous in preventing ventilator-associated pneumonia (VAP)include which of the following? (Select all that apply.)

A) Changing the patient's position every 30 minutes
B) Providing oral care with a toothbrush every 8 hours
C) Maintaining the endotracheal cuff pressures at 40 mm Hg
D) Keeping the head flat especially after feedings

Question 26

A plastic or rubber tube that is inserted through the nares or mouth past the epiglottis and vocal cords to maintain an airway is known as an _________________.

Question 27

A device made of rigid plastic that is used for oropharyngeal suctioning is known as a _________________.

Question 28

Too much oxygen reduces the drive to breathe in patients with chronic _____________.

Question 29

What is the purpose of the cuff that is molded onto the endotracheal (ET)tube? (Select all that apply.)

A) Prevents aspiration
B) Obstructs the escape of air from the ventilator
C) Allows gastric contents access to airways
D) Obstructs the escape of air from the lower airway

Question 30

An underinflated ET cuff is suspected with the presence of:

A) Tracheomalacia
B) Decreased phonation
C) Tracheoesophageal fistula
D) Aspiration of gastric contents

Question 31

Noninvasive techniques that are helpful in maintaining a patent airway include which of the following? (Select all that apply.)

A) Hydration
B) Emergency tracheostomy
C) Deep breathing
D) Coughing

Question 32

The nurse is caring for a patient who has a tracheostomy.To prevent the patient from developing an airway obstruction,the nurse assesses which of the following? (Select all that apply.)

A) The patient's fluid status
B) Environmental humidity
C) The presence of infection
D) The patient's anatomy
E) None of above

Question 33

Risks associated with airway suctioning include which of the following? (Select all that apply.)

A) Cardiac dysrhythmias
B) Laryngeal spasm
C) Bradycardia
D) Nasal trauma
E) None of above

Question 34

When assessing a patient's tracheostomy site,a nurse notes the presence of irritation around the stoma.What should the nurse do to address this problem?

A) Decrease the frequency of care
B) Apply a dry gauze dressing
C) Remove the ties at intervals
D) Apply a topical antibacterial solution

Question 35

Contraindications to nasotracheal suctioning include which of the following? (Select all that apply.)

A) Facial trauma
B) Bleeding disorders
C) Epiglottis or croup
D) Laryngospasm
E) None of above