Question 1

How often should patients be suctioned?

Accepted Answer

A)  At least once every 2 to 3 hr 
B)  Whenever they are moved or ambulated 
C)  When physical findings support the need 
D)  Whenever the charge nurse requests it 
A)  At least once every 2 to 3 hr 
B)  Whenever they are moved or ambulated 
C)  When physical findings support the need 
D)  Whenever the charge nurse requests it

Question 2

Before the suctioning of a patient, auscultation reveals coarse breath sounds during both inspiration and expiration. After suctioning, the coarseness disappears, but expiratory wheezing is heard over both lung fields. What is most likely the problem?

Accepted Answer

A)  Secretions are still present and the patient should be suctioned again. 
B)  The patient has hyperactive airways and has developed bronchospasm. 
C)  A pneumothorax has developed and the patient needs a chest tube. 
D)  The patient has developed a mucous plug and should undergo bronchoscopy. 
A)  Secretions are still present and the patient should be suctioned again. 
B)  The patient has hyperactive airways and has developed bronchospasm. 
C)  A pneumothorax has developed and the patient needs a chest tube. 
D)  The patient has developed a mucous plug and should undergo bronchoscopy.

Question 3

Which of the following indicate that a patient being considered for extubation can provide adequate clearance of pulmonary secretions?
1) The patient has a maximum inspiratory pressure of 73 cm H2O.
2) The patient is alert and cooperative.
3) The patient has a dead space-to-tidal volume ratio of 0.7.
4) The patient coughs rigorously on suctioning.

Accepted Answer

A) 1 and 3 only 
B) 1, 2, and 4 only 
C) 3 and 4 only 
D) 2, 3, and 4 only 
A) 1 and 3 only 
B) 1, 2, and 4 only 
C) 3 and 4 only 
D) 2, 3, and 4 only

Question 4

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 5

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

Accepted Answer

A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3 
A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3

Question 6

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)  3 to 6 cm 
D)  6 to 8 cm 
A)  1 to 2 cm 
B)  2 to 4 cm 
C)  3 to 6 cm 
D)  6 to 8 cm

Question 7

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 min. 
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 min.

Question 8

Which of the following techniques or procedures should be used to help minimize infection of a tracheotomy stoma?
1) Regular aseptic stoma cleaning
2) Adherence to sterile techniques
3) Regular change of tracheostomy dressings

Accepted Answer

A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3 
A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3

Question 9

What is the most common complication of suctioning?

Accepted Answer

A)  Hypoxemia 
B)  Hypotension 
C)  Arrhythmias 
D)  Infection 
A)  Hypoxemia 
B)  Hypotension 
C)  Arrhythmias 
D)  Infection

Question 10

Total application time for endotracheal suction in adults should not exceed which of the following?

Accepted Answer

A)  20 to 25 sec 
B)  15 to 20 sec 
C)  10 to 15 sec 
D)  3 to 5 sec 
A)  20 to 25 sec 
B)  15 to 20 sec 
C)  10 to 15 sec 
D)  3 to 5 sec

Question 11

What general condition requires airway management?
1) Airway compromise
2) Respiratory failure
3) Need to protect the airway

Accepted Answer

A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3 
A) 1 and 2 only 
B) 1 and 3 only 
C) 2 and 3 only 
D) 1, 2, and 3

Question 12

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)  Re-intubate 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)  Re-intubate the patient immediately. 
C)  Administer a racemic epinephrine treatment. 
D)  Draw and analyze an arterial blood gas.

Question 13

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

Accepted Answer

A)  30 sec 
B)  60 sec 
C)  90 sec 
D)  2 min 
A)  30 sec 
B)  60 sec 
C)  90 sec 
D)  2 min

Question 14

What size endotracheal tube would you select to intubate an adult female?

Accepted Answer

A)  6 mm 
B)  7 mm 
C)  8 mm 
D)  9 mm 
A)  6 mm 
B)  7 mm 
C)  8 mm 
D)  9 mm

Question 15

Which of the following factors should be considered when deciding to change from an endotracheal tube to a tracheostomy tube?
1) Patient's tolerance of the endotracheal tube
2) Relative risks of continued intubation versus tracheostomy
3) Patient's severity of illness and overall condition
4) Length of time that the patient will need an artificial airway
5) Patient's ability to tolerate a surgical procedure

Accepted Answer

A) 1, 3, and 4 only 
B) 3, 4, and 5 only 
C) 2, 3, 4, and 5 only 
D) 1, 2, 3, 4, and 5 
A) 1, 3, and 4 only 
B) 3, 4, and 5 only 
C) 2, 3, 4, and 5 only 
D) 1, 2, 3, 4, and 5

Question 16

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 17

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

Accepted Answer

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

Question 18

Which of the following types of artificial airways are inserted through the larynx?
1) Pharyngeal airways
2) Tracheostomy tubes
3) Nasotracheal tubes
4) Orotracheal tubes

Accepted Answer

A) 1 and 4 only 
B) 1, 2, and 3 only 
C) 3 and 4 only 
D) 1, 2, 3, and 4 
A) 1 and 4 only 
B) 1, 2, and 3 only 
C) 3 and 4 only 
D) 1, 2, 3, and 4

Question 19

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 20

Key points to consider in planning fiberoptic bronchoscopy include which of the following?
1) Equipment preparation
2) Premedication
3) Airway preparation
4) Monitoring

Accepted Answer

A) 2 and 4 only 
B) 3 and 4 only 
C) 1, 2, and 3 only 
D) 1, 2, 3, and 4 
A) 2 and 4 only 
B) 3 and 4 only 
C) 1, 2, and 3 only 
D) 1, 2, 3, and 4

Exam 36: Airway Management

How often should patients be suctioned?

Before the suctioning of a patient, auscultation reveals coarse breath sounds during both inspiration and expiration. After suctioning, the coarseness disappears, but expiratory wheezing is heard over both lung fields. What is most likely the problem?

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

Immediately after insertion of an oral endotracheal tube on an adult, what should you do? 1) Stabilize it with your right hand. 2) Inflate the tube cuff. 3) Provide ventilation or oxygenation.

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?

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

Which of the following techniques or procedures should be used to help minimize infection of a tracheotomy stoma? 1) Regular aseptic stoma cleaning 2) Adherence to sterile techniques 3) Regular change of tracheostomy dressings

What is the most common complication of suctioning?

Total application time for endotracheal suction in adults should not exceed which of the following?

What general condition requires airway management? 1) Airway compromise 2) Respiratory failure 3) Need to protect the airway

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

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

What size endotracheal tube would you select to intubate an adult female?

What is the most common problem with fenestrated tracheostomy tubes?

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

Which of the following types of artificial airways are inserted through the larynx? 1) Pharyngeal airways 2) Tracheostomy tubes 3) Nasotracheal tubes 4) Orotracheal tubes

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

Key points to consider in planning fiberoptic bronchoscopy include which of the following? 1) Equipment preparation 2) Premedication 3) Airway preparation 4) Monitoring

History of Respiratory Care

Delivering Evidence-Based Respiratory Care

Quality, Patient Safety, and Communication, and Recordkeeping

Principles of Infection Prevention and Control

Ethical and Legal Implications of Practice

Physical Principles of Respiratory Care

E-Medicine in Respiratory Care

Fundamentals of Respiratory Care Research

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

Interpreting Clinical and Laboratory Data

Interpreting the Electrocardiogram

Analysis and Monitoring of Gas Exchange

Pulmonary Function Testing

Review of Thoracic Imaging

Flexible Bronchoscopy and the Respiratory Therapist

Nutrition Assessment

Pulmonary Infections

Obstructive Lung Disease: Chronic Obstructive Pulmonary Disease Copd, Asthma, and Related Diseases

Interstitial Lung Disease

Pleural Diseases

Pulmonary Vascular Disease

Acute Respiratory Distress Syndrome

Trauma, Burns and Near Drowning

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

Airway Clearance Therapy Act

Respiratory Failure and the Need for Ventilatory Support

Mechanical Ventilators

Physiology of Ventilatory Support

Patient Ventilator Interaction

Initiating and Adjusting Invasive Ventilatory Support

Noninvasive Ventilation

Extracorporeal Life Support Ecls

Monitoring 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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