Question 1

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 2

After determining a patient has a complete obstruction of an oral endotracheal tube, your efforts to relieve the obstruction by moving the patient's head and neck and deflating the cuff both fail. What should be your next step?

Accepted Answer

A)  Immediately extubate the patient. 
B)  Try to pass a suction catheter. 
C)  Call for an emergency tracheotomy. 
D)  Apply manual positive pressure. 
A)  Immediately extubate the patient. 
B)  Try to pass a suction catheter. 
C)  Call for an emergency tracheotomy. 
D)  Apply manual positive pressure.

Question 3

Which of the following injuries are seen with tracheostomy tubes?
1) Tracheomalacia
2) Tracheal stenosis
3) Glottic edema
4) Vocal cord granulomas

Accepted Answer

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

Question 4

Which of the following is false about cuff inflation techniques (MOV = minimal occluding volume; MLT = minimal leak technique)?

Accepted Answer

A)  The MLT approach negates the need for pressure monitoring. 
B)  The MLT allows a small leak at peak or end of inspiration. 
C)  At MOV, air leakage around the tube cuff should cease. 
D)  With MLT, secretions tend to be blown upward during inflation. 
A)  The MLT approach negates the need for pressure monitoring. 
B)  The MLT allows a small leak at peak or end of inspiration. 
C)  At MOV, air leakage around the tube cuff should cease. 
D)  With MLT, secretions tend to be blown upward during inflation.

Question 5

Which of the following autonomic or protective neural responses represent potential hazards of emergency airway management?
1) Hypotension
2) Bradycardia
3) Cardiac arrhythmias
4) Laryngospasm

Accepted Answer

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

Question 6

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 7

For which of the following purposes is a tracheal button appropriate?
1) Facilitate secretion removal.
2) Protect the airways from aspiration.
3) Relieve airway obstruction.
4) Aid in positive-pressure ventilation.

Accepted Answer

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

Question 8

What size endotracheal tube would you select to intubate a 3-year-old child?

Accepted Answer

A)  3.0 to 4.0 mm 
B)  4.5 to 5.0 mm 
C)  5.5 to 6.0 mm 
D)  6.0 to 7.0 mm 
A)  3.0 to 4.0 mm 
B)  4.5 to 5.0 mm 
C)  5.5 to 6.0 mm 
D)  6.0 to 7.0 mm

Question 9

Which of the following are goals of airway preparation before conducting fiberoptic bronchoscopy?
1) To decrease cough and gagging
2) To decrease pain
3) To prevent bleeding

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 10

Complications of fiberoptic bronchoscopy include which of the following?
1) Hypocapnia
2) Infection
3) Hypotension
4) Hypoxemia

Accepted Answer

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

Question 11

Which of the following are appropriate orders before an elective fiberoptic bronchoscopy procedure scheduled for the next morning?
1) Have patient take nothing by mouth (NPO) after midnight.
2) Establish vascular access.
3) Premedicate with a benzodiazepine.

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

Which of the following methods can help to reduce the likelihood of atelectasis due to tracheal suctioning?
1) Limit the amount of negative pressure used.
2) Hyperinflate the patient before and after the procedure.
3) Suction for as short a period of time as possible.

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 13

A patient with a tracheostomy tube is receiving positive-pressure ventilation through a volume ventilator. Over the past 5 min, the peak inspiratory pressure has risen, and the pressure limit alarm is now sounding. On quick examination, you notice a generalized decreased in breath sounds. Which of the following problems is most likely?

Accepted Answer

A)  Partial obstruction of the tracheostomy tube 
B)  Complete obstruction of the tracheostomy tube 
C)  Development of a left-sided pneumothorax 
D)  Obstruction of the left bronchus by a mucus plug 
A)  Partial obstruction of the tracheostomy tube 
B)  Complete obstruction of the tracheostomy tube 
C)  Development of a left-sided pneumothorax 
D)  Obstruction of the left bronchus by a mucus plug

Question 14

Serious complications of oral intubation include which of the following?
1) Cardiac arrest
2) Acute hypoxemia
3) Bradycardia
4) Tongue lacerations

Accepted Answer

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

Question 15

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 16

What is the average distance from the tip of a properly positioned oral endotracheal tube to the incisors of an adult man?

Accepted Answer

A)  16 to 18 cm 
B)  19 to 21 cm 
C)  21 to 23 cm 
D)  24 to 26 cm 
A)  16 to 18 cm 
B)  19 to 21 cm 
C)  21 to 23 cm 
D)  24 to 26 cm

Question 17

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

Exam 36: Airway Management

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

After determining a patient has a complete obstruction of an oral endotracheal tube, your efforts to relieve the obstruction by moving the patient's head and neck and deflating the cuff both fail. What should be your next step?

Which of the following injuries are seen with tracheostomy tubes? 1) Tracheomalacia 2) Tracheal stenosis 3) Glottic edema 4) Vocal cord granulomas

Which of the following is false about cuff inflation techniques (MOV = minimal occluding volume; MLT = minimal leak technique)?

Which of the following autonomic or protective neural responses represent potential hazards of emergency airway management? 1) Hypotension 2) Bradycardia 3) Cardiac arrhythmias 4) Laryngospasm

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

For which of the following purposes is a tracheal button appropriate? 1) Facilitate secretion removal. 2) Protect the airways from aspiration. 3) Relieve airway obstruction. 4) Aid in positive-pressure ventilation.

What size endotracheal tube would you select to intubate a 3-year-old child?

Which of the following are goals of airway preparation before conducting fiberoptic bronchoscopy? 1) To decrease cough and gagging 2) To decrease pain 3) To prevent bleeding

Complications of fiberoptic bronchoscopy include which of the following? 1) Hypocapnia 2) Infection 3) Hypotension 4) Hypoxemia

Which of the following are appropriate orders before an elective fiberoptic bronchoscopy procedure scheduled for the next morning? 1) Have patient take nothing by mouth (NPO) after midnight. 2) Establish vascular access. 3) Premedicate with a benzodiazepine.

Which of the following methods can help to reduce the likelihood of atelectasis due to tracheal suctioning? 1) Limit the amount of negative pressure used. 2) Hyperinflate the patient before and after the procedure. 3) Suction for as short a period of time as possible.

Serious complications of oral intubation include which of the following? 1) Cardiac arrest 2) Acute hypoxemia 3) Bradycardia 4) Tongue lacerations

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

What is the average distance from the tip of a properly positioned oral endotracheal tube to the incisors of an adult man?

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?

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