Question 1

You are about to suction a female patient who has an 8-mm (internal diameter) endotracheal tube in place. What is the maximum size of catheter you would use in this case?

Accepted Answer

A) 8 Fr 
B) 10 Fr 
C) 12 Fr 
D) 14 Fr 
A) 8 Fr 
B) 10 Fr 
C) 12 Fr 
D) 14 Fr

Question 2

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

Accepted Answer

A) aerosol therapy with albuterol (Proventil) 
B) administration of a benzodiazepine (e.g., Valium) 
C) aerosol therapy with racemic epinephrine 
D) administration a narcotic antagonist (e.g., Narcan) 
A) aerosol therapy with albuterol (Proventil) 
B) administration of a benzodiazepine (e.g., Valium) 
C) aerosol therapy with racemic epinephrine 
D) administration a narcotic antagonist (e.g., Narcan)

Question 3

What should be the maximum time devoted to any intubation attempt?

Accepted Answer

A) 30 seconds 
B) 60 seconds 
C) 90 seconds 
D) 2 minutes 
A) 30 seconds 
B) 60 seconds 
C) 90 seconds 
D) 2 minutes

Question 4

All of the following indicate an inability to adequately protect the airway except:

Accepted Answer

A) wheezing 
B) coma 
C) lack of gag reflex 
D) inability to cough 
A) wheezing 
B) coma 
C) lack of gag reflex 
D) inability to cough

Question 5

What is the purpose of a cuff on an artificial tracheal airway?

Accepted Answer

A) seal off and protect the lower airway 
B) stabilize the tube and prevent its movement 
C) provide a means to determine tube position via radiograph 
D) help clinicians determine the depth of tube insertion 
A) seal off and protect the lower airway 
B) stabilize the tube and prevent its movement 
C) provide a means to determine tube position via radiograph 
D) help clinicians determine the depth of tube insertion

Question 6

An adult man on ventilatory support has just been intubated with a 7-mm oral endotracheal tube equipped with a high-residual-volume, low-pressure cuff. When sealing the cuff to achieve a minimal occluding volume, you note a cuff pressure of 45 cm H2O. What is most likely the problem?

Accepted Answer

A) The tube chosen is too small for the patient. 
B) The cuff pilot balloon and line are obstructed. 
C) The tube is in the right mainstem bronchus. 
D) The cuff has herniated over the tube tip. 
A) The tube chosen is too small for the patient. 
B) The cuff pilot balloon and line are obstructed. 
C) The tube is in the right mainstem bronchus. 
D) The cuff has herniated over the tube tip.

Question 7

To provide local anesthesia and vasoconstriction during nasal intubation, what would you recommend?

Accepted Answer

A) nasal spray of 0.25% racemic epinephrine 
B) SVN aerosol delivery of 2% lidocaine for 10 minutes 
C) nasal spray of 0.25% racemic epinephrine/2% lidocaine 
D) SVN aerosol delivery of 0.25% racemic epinephrine for 10 minutes 
A) nasal spray of 0.25% racemic epinephrine 
B) SVN aerosol delivery of 2% lidocaine for 10 minutes 
C) nasal spray of 0.25% racemic epinephrine/2% lidocaine 
D) SVN aerosol delivery of 0.25% racemic epinephrine for 10 minutes

Question 8

You have been asked to monitor a patient who has just been extubated. Which of the following parameters would you monitor?
I.color
II.breath sounds
III.vital signs
IV.inspiratory force

Accepted Answer

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

Question 9

An adult patient receiving cool mist therapy after extubation begins to develop stridor. Which of the following actions would you recommend?

Accepted Answer

A) Change from cool mist to heated aerosol. 
B) Reintubate the patient immediately. 
C) Administer a racemic epinephrine treatment. 
D) Draw and analyze an arterial blood gas. 
A) Change from cool mist to heated aerosol. 
B) Reintubate the patient immediately. 
C) Administer a racemic epinephrine treatment. 
D) Draw and analyze an arterial blood gas.

Question 10

The removable inner cannula commonly incorporated into modern tracheostomy tubes serves which of the following purposes?
I.aid in routine tube cleaning and tracheostomy care
II.prevent the tube from slipping into the trachea
III.provide a patent airway should it become obstructed

Accepted Answer

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

Question 11

What is the purpose of a tracheostomy tube obturator?

Accepted Answer

A) minimize trauma to the tracheal mucosal during insertion 
B) provide a patent airway should the tube become obstructed 
C) help ascertain the proper tube position by radiograph 
D) provide a means to inflate and deflate the tube cuff 
A) minimize trauma to the tracheal mucosal during insertion 
B) provide a patent airway should the tube become obstructed 
C) help ascertain the proper tube position by radiograph 
D) provide a means to inflate and deflate the tube cuff

Question 12

Which of the following techniques may be used to diagnose injury associated with artificial airways?
I.laryngoscopy or bronchoscopy
II.physical examination
III.air tomography
IV.pulmonary function studies

Accepted Answer

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

Question 13

A physician has requested your assistance in extubating an orally intubated patient. Which of the following should be done before the tube itself is removed?
I.	Suction the orolaryngopharynx.
II.	Preoxygenate the patient.
III.	Suction the endotracheal tube.
IV.	Confirm cuff inflation.

Accepted Answer

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

Question 14

When checking for proper placement of an endotracheal tube or a tracheostomy tube on a chest radiograph, how far above the carina should the distal tip of the tube be positioned?

Accepted Answer

A) 1 to 2 cm 
B) 2 to 4 cm 
C) 4 to 6 cm 
D) 6 to 8 cm 
A) 1 to 2 cm 
B) 2 to 4 cm 
C) 4 to 6 cm 
D) 6 to 8 cm

Question 15

Which of the following approaches may be used in "weaning" a patient from a tracheostomy tube?
I.using progressively smaller tubes
II.using a fenestrated tube
III.using a tracheostomy button

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 16

Complications of fiberoptic bronchoscopy include all of the following except:

Accepted Answer

A) hypocapnia 
B) infection 
C) hypotension 
D) hypoxemia 
A) hypocapnia 
B) infection 
C) hypotension 
D) hypoxemia

Question 17

After repeated nasotracheal suctioning over 2 days, a patient with retained secretions develops minor bleeding through the nose. Which of the following actions would you recommend?

Accepted Answer

A) Perform a tracheotomy for better access to the lower airway. 
B) Discontinue nasotracheal suctioning for 48 hours and reassess. 
C) Stop the bleeding and use a nasopharyngeal airway for access. 
D) Orally intubate the patient for better access to the lower airway. 
A) Perform a tracheotomy for better access to the lower airway. 
B) Discontinue nasotracheal suctioning for 48 hours and reassess. 
C) Stop the bleeding and use a nasopharyngeal airway for access. 
D) Orally intubate the patient for better access to the lower airway.

Question 18

Which of the following statements are FALSE about methods used to displace the epiglottis during oral intubation?

Accepted Answer

A) Regardless of the blade used, the laryngoscope is lifted up and forward. 
B) The curved (MacIntosh) blade lifts the epiglottis indirectly. 
C) The straight (Miller) blade lifts the epiglottis directly. 
D) Levering the laryngoscope against the teeth can aid displacement. 
A) Regardless of the blade used, the laryngoscope is lifted up and forward. 
B) The curved (MacIntosh) blade lifts the epiglottis indirectly. 
C) The straight (Miller) blade lifts the epiglottis directly. 
D) Levering the laryngoscope against the teeth can aid displacement.

Question 19

Serious complications of oral intubation include which of the following?
I.cardiac arrest
II.acute hypoxemia
III.bradycardia
IV.tongue lacerations

Accepted Answer

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

Exam 33: Airway Management

You are about to suction a female patient who has an 8-mm (internal diameter) endotracheal tube in place. What is the maximum size of catheter you would use in this case?

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

What should be the maximum time devoted to any intubation attempt?

All of the following indicate an inability to adequately protect the airway except:

What is the purpose of a cuff on an artificial tracheal airway?

An adult man on ventilatory support has just been intubated with a 7-mm oral endotracheal tube equipped with a high-residual-volume, low-pressure cuff. When sealing the cuff to achieve a minimal occluding volume, you note a cuff pressure of 45 cm H2O. What is most likely the problem?

To provide local anesthesia and vasoconstriction during nasal intubation, what would you recommend?

You have been asked to monitor a patient who has just been extubated. Which of the following parameters would you monitor? I.color II.breath sounds III.vital signs IV.inspiratory force

An adult patient receiving cool mist therapy after extubation begins to develop stridor. Which of the following actions would you recommend?

The removable inner cannula commonly incorporated into modern tracheostomy tubes serves which of the following purposes? I.aid in routine tube cleaning and tracheostomy care II.prevent the tube from slipping into the trachea III.provide a patent airway should it become obstructed

What is the purpose of a tracheostomy tube obturator?

Which of the following techniques may be used to diagnose injury associated with artificial airways? I.laryngoscopy or bronchoscopy II.physical examination III.air tomography IV.pulmonary function studies

A physician has requested your assistance in extubating an orally intubated patient. Which of the following should be done before the tube itself is removed? I. Suction the orolaryngopharynx. II. Preoxygenate the patient. III. Suction the endotracheal tube. IV. Confirm cuff inflation.

When checking for proper placement of an endotracheal tube or a tracheostomy tube on a chest radiograph, how far above the carina should the distal tip of the tube be positioned?

Which of the following approaches may be used in "weaning" a patient from a tracheostomy tube? I.using progressively smaller tubes II.using a fenestrated tube III.using a tracheostomy button

Complications of fiberoptic bronchoscopy include all of the following except:

After repeated nasotracheal suctioning over 2 days, a patient with retained secretions develops minor bleeding through the nose. Which of the following actions would you recommend?

Which of the following statements are FALSE about methods used to displace the epiglottis during oral intubation?

Serious complications of oral intubation include which of the following? I.cardiac arrest II.acute hypoxemia III.bradycardia IV.tongue lacerations

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

An adult man on ventilatory support has just been intubated with a 7-mm oral endotracheal tube equipped with a high-residual-volume, low-pressure cuff. When sealing the cuff to achieve a minimal occluding volume, you note a cuff pressure of 45 cm H₂O. What is most likely the problem?