Question 1

What is the primary indication for tracheostomy?

Accepted Answer

A) when a patient loses pharyngeal or laryngeal reflexes 
B) when a patient has a long-term need for an artificial airway 
C) when a patient has been orally intubated for more than 24 hours 
D) when a patient has upper airway obstruction due to secretions 
A) when a patient loses pharyngeal or laryngeal reflexes 
B) when a patient has a long-term need for an artificial airway 
C) when a patient has been orally intubated for more than 24 hours 
D) when a patient has upper airway obstruction due to secretions

Question 2

All of the following indicate that a patient being considered for extubation can provide adequate clearance of pulmonary secretions except:

Accepted Answer

A) The patient has a maximum inspiratory pressure of 73 cm H2O. 
B) The patient is alert and cooperative. 
C) The patient has a dead space-to-tidal volume ratio of 0.7. 
D) The patient coughs rigorously on suctioning. 
A) The patient has a maximum inspiratory pressure of 73 cm H2O. 
B) The patient is alert and cooperative. 
C) The patient has a dead space-to-tidal volume ratio of 0.7. 
D) The patient coughs rigorously on suctioning.

Question 3

Which of the following equipment would you gather before assisting in extubation of a patient?
I.suctioning apparatus
II.oxygen or aerosol therapy equipment
III.manual resuscitator and mask
IV.nebulizer with racemic epinephrine
V.intubation tray

Accepted Answer

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

Question 4

Which of the following equipment is NOT needed to perform nasotracheal suctioning?

Accepted Answer

A) suction kit (catheter, gloves, basin, etc.) 
B) laryngoscope with MacIntosh and Miller blades 
C) oxygen delivery system (mask and manual resuscitator) 
D) bottle of sterile water or saline solution 
A) suction kit (catheter, gloves, basin, etc.) 
B) laryngoscope with MacIntosh and Miller blades 
C) oxygen delivery system (mask and manual resuscitator) 
D) bottle of sterile water or saline solution

Question 5

In a properly performed traditional surgical tracheotomy, entrance to the trachea is made through an incision in what area?

Accepted Answer

A) through or between the first and second tracheal rings 
B) through the ligament between the thyroid and cricoid cartilages 
C) through or between the second and third tracheal rings 
D) between the cricoid cartilage and the first tracheal ring 
A) through or between the first and second tracheal rings 
B) through the ligament between the thyroid and cricoid cartilages 
C) through or between the second and third tracheal rings 
D) between the cricoid cartilage and the first tracheal ring

Question 6

Which of the following bedside methods can absolutely confirm proper endotracheal tube position in the trachea?

Accepted Answer

A) auscultation 
B) observation of chest movement 
C) tube length (cm to teeth) 
D) fiberoptic laryngoscopy 
A) auscultation 
B) observation of chest movement 
C) tube length (cm to teeth) 
D) fiberoptic laryngoscopy

Question 7

You are assisting a physician in the emergency care of a patient with a maxillofacial injury who will require short-term ventilatory support. Which of the following airway approaches would you recommend?

Accepted Answer

A) Intubate via the oral route. 
B) Insert an oropharyngeal airway. 
C) Perform an emergency tracheotomy. 
D) Intubate via the nasal route. 
A) Intubate via the oral route. 
B) Insert an oropharyngeal airway. 
C) Perform an emergency tracheotomy. 
D) Intubate via the nasal route.

Question 8

Soon after endotracheal tube extubation, an adult patient exhibits a high-pitched inspiratory noise, heard without a stethoscope. Which of the following actions would you recommend?

Accepted Answer

A) STAT heated aerosol treatment with saline 
B) STAT racemic epinephrine aerosol treatment 
C) careful observation of the patient for 6 hours 
D) immediate reintubation via the nasal route 
A) STAT heated aerosol treatment with saline 
B) STAT racemic epinephrine aerosol treatment 
C) careful observation of the patient for 6 hours 
D) immediate reintubation via the nasal route

Question 9

To prevent hypoxemia when suctioning a patient, the respiratory care practitioner should initially do which of the following?

Accepted Answer

A) Manually ventilate the patient with a resuscitator. 
B) Preoxygenate the patient with 100% oxygen. 
C) Give the patient a bronchodilator treatment. 
D) Have the patient hyperventilate for 2 minutes. 
A) Manually ventilate the patient with a resuscitator. 
B) Preoxygenate the patient with 100% oxygen. 
C) Give the patient a bronchodilator treatment. 
D) Have the patient hyperventilate for 2 minutes.

Question 10

For which of the following purposes is a tracheal button appropriate?
I.facilitate secretion removal
II.protect the airways from aspiration
III.relieve airway obstruction
IV.aid in positive-pressure ventilation

Accepted Answer

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

Question 11

Tracheal stenosis occurs in as many as 1 in 10 patients after prolonged tracheostomy. At what sites does this stenosis usually occur?
I.cuff site
II.tip of the tube
III.stoma site

Accepted Answer

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

Question 12

What is the maximum recommended range for tracheal tube cuff pressures?

Accepted Answer

A) 15 to 20 mm Hg 
B) 20 to 25 mm Hg 
C) 25 to 30 mm Hg 
D) 30 to 35 mm Hg 
A) 15 to 20 mm Hg 
B) 20 to 25 mm Hg 
C) 25 to 30 mm Hg 
D) 30 to 35 mm Hg

Question 13

A physician is concerned about the potential for tracheal damage due to tube movement in a patient who recently underwent tracheotomy and is now receiving 40% oxygen through a T-tube (Briggs adapter). Which of the following would be the best way to limit tube movement in this patient?

Accepted Answer

A) Give a neuromuscular blocker to prevent patient movement. 
B) Secure the T-tube delivery tubing to the bed rail. 
C) Tape the T-tube to the tracheostomy tube connector. 
D) Switch from the T-tube to a tracheostomy collar. 
A) Give a neuromuscular blocker to prevent patient movement. 
B) Secure the T-tube delivery tubing to the bed rail. 
C) Tape the T-tube to the tracheostomy tube connector. 
D) Switch from the T-tube to a tracheostomy collar.

Question 14

Which of the following can help to minimize the likelihood of mucosal trauma during suctioning?
I.	Use as large a catheter as possible.
II.	Rotate the catheter while withdrawing.
III.	Use as rigid a catheter as possible.
IV.	Limit the amount of negative pressure.

Accepted Answer

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

Question 15

Which of the following statements is false about the potential for aspiration in patient with cuffed tracheal tubes?

Accepted Answer

A) Periodic oropharyngeal suctioning can help to minimize aspiration. 
B) Aspiration is least likely in spontaneously breathing patients. 
C) The methylene blue test can help detect leakage-type aspiration. 
D) Aspiration is more likely with tracheostomy tubes than with endotracheal tubes. 
A) Periodic oropharyngeal suctioning can help to minimize aspiration. 
B) Aspiration is least likely in spontaneously breathing patients. 
C) The methylene blue test can help detect leakage-type aspiration. 
D) Aspiration is more likely with tracheostomy tubes than with endotracheal tubes.

Question 16

During fiberoptic bronchoscopy, a patient receiving intravenous fentanyl exhibits signs of respiratory depression. Which of the following would you recommend?

Accepted Answer

A) Increase the oxygen flow rate and continue monitoring. 
B) Immediately administer naloxone (Narcan). 
C) Decrease the oxygen flow rate and continue monitoring. 
D) Immediately administer neostigmine or prostigmine. 
A) Increase the oxygen flow rate and continue monitoring. 
B) Immediately administer naloxone (Narcan). 
C) Decrease the oxygen flow rate and continue monitoring. 
D) Immediately administer neostigmine or prostigmine.

Question 17

What does a positive cuff leak test indicate?

Accepted Answer

A) The patient has significant upper airway edema. 
B) The patient's neuromuscular function is adequate to protect the lower airway. 
C) The patient is at minimal risk for upper airway obstruction. 
D) The patient's muscle strength will provide an effective cough. 
A) The patient has significant upper airway edema. 
B) The patient's neuromuscular function is adequate to protect the lower airway. 
C) The patient is at minimal risk for upper airway obstruction. 
D) The patient's muscle strength will provide an effective cough.

Question 18

A patient with a tracheal airway exhibits severe respiratory distress. On quick examination, you notice the complete absence of breath sounds and no gas flowing through the airway. What is most likely the problem?

Accepted Answer

A) partial tube obstruction 
B) right-sided pneumothorax 
C) complete tube obstruction 
D) vocal cord paralysis 
A) partial tube obstruction 
B) right-sided pneumothorax 
C) complete tube obstruction 
D) vocal cord paralysis

Question 19

What is the most common sign associated with the transient glottic edema or vocal cord inflammation that follows extubation?

Accepted Answer

A) difficulty in swallowing 
B) wheezing 
C) orthopnea 
D) hoarseness 
A) difficulty in swallowing 
B) wheezing 
C) orthopnea 
D) hoarseness

Question 20

To make oral intubation easier, how should the patient's head and neck be positioned?

Accepted Answer

A) neck extended over the edge of the bed, with head dangling down 
B) neck extended, with head supported by towel and flexed forward 
C) both the neck and head fully extended, with neck supported by towel 
D) neck flexed, with head supported by towel and tilted back 
A) neck extended over the edge of the bed, with head dangling down 
B) neck extended, with head supported by towel and flexed forward 
C) both the neck and head fully extended, with neck supported by towel 
D) neck flexed, with head supported by towel and tilted back

Exam 33: Airway Management

What is the primary indication for tracheostomy?

All of the following indicate that a patient being considered for extubation can provide adequate clearance of pulmonary secretions except:

Which of the following equipment would you gather before assisting in extubation of a patient? I.suctioning apparatus II.oxygen or aerosol therapy equipment III.manual resuscitator and mask IV.nebulizer with racemic epinephrine V.intubation tray

Which of the following equipment is NOT needed to perform nasotracheal suctioning?

In a properly performed traditional surgical tracheotomy, entrance to the trachea is made through an incision in what area?

Which of the following bedside methods can absolutely confirm proper endotracheal tube position in the trachea?

You are assisting a physician in the emergency care of a patient with a maxillofacial injury who will require short-term ventilatory support. Which of the following airway approaches would you recommend?

Soon after endotracheal tube extubation, an adult patient exhibits a high-pitched inspiratory noise, heard without a stethoscope. Which of the following actions would you recommend?

To prevent hypoxemia when suctioning a patient, the respiratory care practitioner should initially do which of the following?

For which of the following purposes is a tracheal button appropriate? I.facilitate secretion removal II.protect the airways from aspiration III.relieve airway obstruction IV.aid in positive-pressure ventilation

Tracheal stenosis occurs in as many as 1 in 10 patients after prolonged tracheostomy. At what sites does this stenosis usually occur? I.cuff site II.tip of the tube III.stoma site

What is the maximum recommended range for tracheal tube cuff pressures?

A physician is concerned about the potential for tracheal damage due to tube movement in a patient who recently underwent tracheotomy and is now receiving 40% oxygen through a T-tube (Briggs adapter). Which of the following would be the best way to limit tube movement in this patient?

Which of the following can help to minimize the likelihood of mucosal trauma during suctioning? I. Use as large a catheter as possible. II. Rotate the catheter while withdrawing. III. Use as rigid a catheter as possible. IV. Limit the amount of negative pressure.

Which of the following statements is false about the potential for aspiration in patient with cuffed tracheal tubes?

During fiberoptic bronchoscopy, a patient receiving intravenous fentanyl exhibits signs of respiratory depression. Which of the following would you recommend?

What does a positive cuff leak test indicate?

A patient with a tracheal airway exhibits severe respiratory distress. On quick examination, you notice the complete absence of breath sounds and no gas flowing through the airway. What is most likely the problem?

What is the most common sign associated with the transient glottic edema or vocal cord inflammation that follows extubation?

To make oral intubation easier, how should the patient's head and neck be positioned?

History of Respiratory Care

Quality and Evidence-Based Respiratory Care

Patient Safety, Communication, and Record Keeping

Principles of Infection Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

Computer Applications in Respiratory Care

The Respiratory System

The Cardiovascular System

Ventilation

Gas Exchange and Transport

Solutions, Body Fluids, and Electrolytes

Acid-Base Balance

Regulation of Breathing

Bedside Assessment of the Patient

Interpretation of Clinical Laboratory Data

Interpreting the Electrocardiogram

Analysis and Monitoring of Gas Exchange

Pulmonary Function Testing

A Review of Thoracic Imaging

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Pulmonary Vascular Disease

Acute Lung Injury, Pulmonary Edema, and Multiple System Organ

Lung Cancer

Neuromuscular and Other Diseases of the Chest Wall

Disorders of Sleep

Neonatal and Pediatric Respiratory Disorders

Airway Pharmacology

Emergency Cardiovascular Life Support

Humidity and Bland Aerosol Therapy

Aerosol Drug Therapy

Storage and Delivery of Medical Gases

Medical Gas Therapy

Lung Expansion Therapy

Bronchial Hygiene Therapy

Respiratory Failure and the Need for Ventilatory Support

Mechanical Ventilators

Physiology of Ventilatory Support

Initiating and Adjusting Ventilatory Support

Noninvasive Positive Pressure Ventilation

Monitoring and Management of the Patient in the Intensive Care Unit

Discontinuing Ventilatory Support

Neonatal and Pediatric Respiratory Care

Patient Education and Health Promotion

Cardiopulmonary Rehabilitation

Respiratory Care in Alternative Settings

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