Question 1

Compared with the oral route, the advantages of nasal intubation include all of the following except:

Accepted Answer

A) reduced risk of kinking 
B) less retching and gagging 
C) less accidental extubation 
D) greater long-term comfort 
A) reduced risk of kinking 
B) less retching and gagging 
C) less accidental extubation 
D) greater long-term comfort

Question 2

After removal of an oral endotracheal tube, a patient exhibits hoarseness and stridor that do not resolve with racemic epinephrine treatments. What is most likely the problem?

Accepted Answer

A) vocal cord paralysis 
B) tracheoesophageal fistula 
C) glottic edema or cord inflammation 
D) tracheomalacia 
A) vocal cord paralysis 
B) tracheoesophageal fistula 
C) glottic edema or cord inflammation 
D) tracheomalacia

Question 3

A patient exhibits persistent mild hypoxemia after a fiberoptic bronchoscopy procedure. Which of the following would you recommend?

Accepted Answer

A) Continue oxygen therapy and reassess in 4 hours. 
B) Administer a benzodiazepine (e.g., Valium or Versed). 
C) Administer a racemic epinephrine aerosol treatment. 
D) Have the patient refrain from eating or drinking. 
A) Continue oxygen therapy and reassess in 4 hours. 
B) Administer a benzodiazepine (e.g., Valium or Versed). 
C) Administer a racemic epinephrine aerosol treatment. 
D) Have the patient refrain from eating or drinking.

Question 4

Which of the following autonomic or protective neural responses represent potential hazards of emergency airway management?
I.hypotension
II.bradycardia
III.cardiac arrhythmias
IV.laryngospasm

Accepted Answer

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

Question 5

What is the primary indication for tracheal suctioning?

Accepted Answer

A) presence of pneumonia 
B) presence of atelectasis 
C) ineffective coughing 
D) retention of secretions 
A) presence of pneumonia 
B) presence of atelectasis 
C) ineffective coughing 
D) retention of secretions

Question 6

Complications of tracheal suctioning include all of the following except:

Accepted Answer

A) bronchospasm 
B) hyperinflation 
C) mucosal trauma 
D) elevated intracranial pressure 
A) bronchospasm 
B) hyperinflation 
C) mucosal trauma 
D) elevated intracranial pressure

Question 7

What is the standard size for endotracheal or tracheostomy tube adapters?

Accepted Answer

A) 22 mm external diameter 
B) 15 mm external diameter 
C) 15 mm internal diameter 
D) 22 mm internal diameter 
A) 22 mm external diameter 
B) 15 mm external diameter 
C) 15 mm internal diameter 
D) 22 mm internal diameter

Question 8

Which of the following tracheal tube cuff designs are used as alternatives to cuff pressure measurement?
I.Kamen-Wilkinson foam cuff
II.low-residual-volume cuff
III.Lanz pressure-regulated cuff

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 9

While suctioning a patient, you observe an abrupt change in the electrocardiogram wave form being displayed on the cardiac monitor. Which of the following actions would be most appropriate?

Accepted Answer

A) Change to a smaller catheter and repeat the procedure. 
B) Stop suctioning and immediately administer oxygen. 
C) Stop suctioning and report your findings to the nurse. 
D) Decrease the amount of negative pressure being used. 
A) Change to a smaller catheter and repeat the procedure. 
B) Stop suctioning and immediately administer oxygen. 
C) Stop suctioning and report your findings to the nurse. 
D) Decrease the amount of negative pressure being used.

Question 10

What is the purpose of the pilot balloon on an endotracheal or a tracheostomy tube?

Accepted Answer

A) help ascertain proper tube position 
B) minimize mucosal trauma during insertion 
C) monitor cuff status and pressure 
D) protect the airway against aspiration 
A) help ascertain proper tube position 
B) minimize mucosal trauma during insertion 
C) monitor cuff status and pressure 
D) protect the airway against aspiration

Question 11

Repeated connecting and disconnecting of a cuff pressure manometer to the pilot tube of a cuffed tracheal airway will do which of the following?

Accepted Answer

A) increase cuff pressure 
B) not affect cuff pressure 
C) decrease cuff pressure 
D) rupture the cuff 
A) increase cuff pressure 
B) not affect cuff pressure 
C) decrease cuff pressure 
D) rupture the cuff

Question 12

Immediately after insertion of an oral endotracheal tube on an adult, what should you do?
I.	Stabilize it with your right hand.
II.	Inflate the tube cuff.
III.	Provide ventilation or oxygenation.

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 13

A patient is being evaluated for tracheal damage sustained while having undergone prolonged tracheostomy intubation approximately 3 months earlier. The flow-volume loop demonstrates a fixed obstructive pattern. What is the most likely cause of the problem?

Accepted Answer

A) tracheomalacia 
B) laryngeal web 
C) cord paralysis 
D) tracheal stenosis 
A) tracheomalacia 
B) laryngeal web 
C) cord paralysis 
D) tracheal stenosis

Question 14

What is the most common problem with fenestrated tracheostomy tubes?

Accepted Answer

A) relative frequency of accidental extubation 
B) increased likelihood of tracheomalacia 
C) poor positioning of the tube fenestration 
D) inability to provide mechanical ventilation 
A) relative frequency of accidental extubation 
B) increased likelihood of tracheomalacia 
C) poor positioning of the tube fenestration 
D) inability to provide mechanical ventilation

Question 15

Which of the following types of artificial airways are inserted through the larynx?
I.pharyngeal airways
II.tracheostomy tubes
III.nasotracheal tubes
IV.orotracheal tubes

Accepted Answer

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

Question 16

To minimize laryngeal swelling, a physician orders "continuous aerosol therapy" after the extubation of a patient. Which of the following specific approaches would you recommend?

Accepted Answer

A) heated mist therapy through a jet nebulizer and aerosol mask 
B) cool mist therapy through a jet nebulizer and aerosol mask 
C) oxygen therapy through a "venti-mask" and bubble humidifier 
D) racemic epinephrine or saline through a small jet nebulizer 
A) heated mist therapy through a jet nebulizer and aerosol mask 
B) cool mist therapy through a jet nebulizer and aerosol mask 
C) oxygen therapy through a "venti-mask" and bubble humidifier 
D) racemic epinephrine or saline through a small jet nebulizer

Question 17

What is the normal range of negative pressure to use when suctioning children?

Accepted Answer

A) -60 to -80 mm Hg 
B) -80 to -100 mm Hg 
C) -100 to -120 mm Hg 
D) -150 to -200 mm Hg 
A) -60 to -80 mm Hg 
B) -80 to -100 mm Hg 
C) -100 to -120 mm Hg 
D) -150 to -200 mm Hg

Question 18

After intubation of a cardiac arrest victim, you observe a slow but steady rise in the expired CO2 levels as measured by a bedside capnometer. Which of the following best explains this observation?

Accepted Answer

A) return of spontaneous circulation 
B) abnormally high $\dot { V } / \dot { Q }$ 
C) placement of the endotracheal tube in the esophagus 
D) failure of the cuff to properly seal the airway 
A) return of spontaneous circulation 
B) abnormally high $\dot { V } / \dot { Q }$ 
C) placement of the endotracheal tube in the esophagus 
D) failure of the cuff to properly seal the airway

Question 19

In the absence of neck or facial injuries, what is the procedure of choice to establish a patent tracheal airway in an emergency?

Accepted Answer

A) surgical tracheotomy 
B) orotracheal intubation 
C) nasotracheal intubation 
D) cricothyrotomy 
A) surgical tracheotomy 
B) orotracheal intubation 
C) nasotracheal intubation 
D) cricothyrotomy

Question 20

When checking for proper placement of an endotracheal tube in an adult patient on chest radiograph, it is noted that the distal tip of the tube is 2 cm above the carina. Which of the following actions would you recommend?

Accepted Answer

A) Withdraw the tube by 2 to 3 cm (using tube markings as a guide). 
B) Withdraw the tube by 7 to 8 cm (using tube markings as a guide). 
C) Advance the tube by 2 to 3 cm (using tube markings as a guide). 
D) Advance the tube by 7 to 8 cm (using tube markings as a guide). 
A) Withdraw the tube by 2 to 3 cm (using tube markings as a guide). 
B) Withdraw the tube by 7 to 8 cm (using tube markings as a guide). 
C) Advance the tube by 2 to 3 cm (using tube markings as a guide). 
D) Advance the tube by 7 to 8 cm (using tube markings as a guide).

Exam 33: Airway Management

Compared with the oral route, the advantages of nasal intubation include all of the following except:

After removal of an oral endotracheal tube, a patient exhibits hoarseness and stridor that do not resolve with racemic epinephrine treatments. What is most likely the problem?

A patient exhibits persistent mild hypoxemia after a fiberoptic bronchoscopy procedure. Which of the following would you recommend?

Which of the following autonomic or protective neural responses represent potential hazards of emergency airway management? I.hypotension II.bradycardia III.cardiac arrhythmias IV.laryngospasm

What is the primary indication for tracheal suctioning?

Complications of tracheal suctioning include all of the following except:

What is the standard size for endotracheal or tracheostomy tube adapters?

Which of the following tracheal tube cuff designs are used as alternatives to cuff pressure measurement? I.Kamen-Wilkinson foam cuff II.low-residual-volume cuff III.Lanz pressure-regulated cuff

While suctioning a patient, you observe an abrupt change in the electrocardiogram wave form being displayed on the cardiac monitor. Which of the following actions would be most appropriate?

What is the purpose of the pilot balloon on an endotracheal or a tracheostomy tube?

Repeated connecting and disconnecting of a cuff pressure manometer to the pilot tube of a cuffed tracheal airway will do which of the following?

Immediately after insertion of an oral endotracheal tube on an adult, what should you do? I. Stabilize it with your right hand. II. Inflate the tube cuff. III. Provide ventilation or oxygenation.

A patient is being evaluated for tracheal damage sustained while having undergone prolonged tracheostomy intubation approximately 3 months earlier. The flow-volume loop demonstrates a fixed obstructive pattern. What is the most likely cause of the problem?

What is the most common problem with fenestrated tracheostomy tubes?

Which of the following types of artificial airways are inserted through the larynx? I.pharyngeal airways II.tracheostomy tubes III.nasotracheal tubes IV.orotracheal tubes

To minimize laryngeal swelling, a physician orders "continuous aerosol therapy" after the extubation of a patient. Which of the following specific approaches would you recommend?

What is the normal range of negative pressure to use when suctioning children?

After intubation of a cardiac arrest victim, you observe a slow but steady rise in the expired CO2 levels as measured by a bedside capnometer. Which of the following best explains this observation?

In the absence of neck or facial injuries, what is the procedure of choice to establish a patent tracheal airway in an emergency?

When checking for proper placement of an endotracheal tube in an adult patient on chest radiograph, it is noted that the distal tip of the tube is 2 cm above the carina. Which of the following actions would you recommend?

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

Filters

After intubation of a cardiac arrest victim, you observe a slow but steady rise in the expired CO₂ levels as measured by a bedside capnometer. Which of the following best explains this observation?