Exam 36: Airway Management

The major limitations of using a laryngeal mask airway are: 1) It should not be used in conscious or semicomatose patients. 2) Gastric distention may occur if ventilating pressures greater than 20 cm H₂O are needed. 3) It does not provide absolute protection against aspiration of gastric contents.

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

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

Which of the following approaches may be used in "weaning" a patient from a tracheostomy tube? 1) Using progressively smaller tubes 2) Using a fenestrated tube 3) Using a tracheostomy button

Absolute contraindication for nasotracheal suctioning includes which of the following? 1) Epiglottitis 2) Croup 3) Irritable airway

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?

The removable inner cannula commonly incorporated into modern tracheostomy tubes serves which of the following purposes? 1) Aid in routine tube cleaning and tracheostomy care 2) Prevent the tube from slipping into the trachea 3) Provide a patent airway should it become obstructed

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

A patient receiving mechanical ventilatory support accidentally displaces the endotracheal tube out of the trachea. What would be the most appropriate action at this time?

Which of the following is likely to increase the likelihood of damage to the tracheal mucosa?

Compared with traditional surgical tracheostomy, which of the following are true about percutaneous dilatational tracheostomy? 1) Percutaneous dilatational tracheostomy has a lower incidence of complications. 2) Percutaneous dilatational tracheostomy is faster than traditional tracheostomy. 3) Percutaneous dilatational tracheostomy can be performed at the bedside. 4) Percutaneous dilatational tracheostomy does not require anterior neck dissection.

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?

Equipment required for patient support and monitoring during a fiberoptic bronchoscopy procedure includes which of the following? 1) Pulse oximeter 2) Oxygen cannula 3) Electrocardiographic monitor 4) Capnometer

A patient has been receiving positive-pressure ventilation through a tracheostomy tube for 4 days. In the past 2 days, there is evidence of both recurrent aspiration and abdominal distention but minimal air leakage around the tube cuff. What is most likely cause of the problem?

During oral intubation of an adult, the endotracheal tube should be advanced into the trachea about how far?

Which of the following features incorporated into most modern endotracheal tubes assist in verifying proper tube placement? 1) Length markings on the curved body of the tube 2) Imbedded radiopaque indicator near the tube tip 3) Additional side port (Murphy eye) near the tube tip

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

Successful tube passage through the larynx during blind nasotracheal intubation is indicated by which of the following? 1) Louder breath sounds 2) Harsh cough 3) Vocal silence

Which of the following can help to minimize the likelihood of mucosal trauma during suctioning? 1) Use as large a catheter as possible. 2) Rotate the catheter while withdrawing. 3) Use as rigid a catheter as possible. 4) Limit the amount of negative pressure.

You are about to suction a 10-year-old patient who has a 6-mm (internal diameter) endotracheal tube in place. What is the maximum size of catheter that you would use in this case?