Question 1

The nurse is assessing the risk for aspiration of gastric contents into the lungs resulting in airway obstruction.The nurse identifies patients with which conditions as creating increased risk? (Select all that apply.)

Accepted Answer

A)  Presence of a gastrostomy feeding tube 
B)  History of smoking two packs per day for 30 years 
C)  Head injury with a decreased level of consciousness 
D)  Stroke with dysphagia

Question 2

The nurse is caring for a patient on mechanical ventilation with an endotracheal tube.Which nursing interventions will help prevent ventilator-associated pneumonia (VAP)? (Select all that apply.)

Accepted Answer

A)  Changing the patient's position every 2 hours 
B)  Keeping the head of the bed elevated 30 to 45 degrees 
C)  Providing oral care with a toothette every 8 hours 
D)  Keeping the head flat during and for 30 minutes after enteral feedings

Question 3

The student nurse is preparing to perform nasotracheal suctioning on an adult patient wearing a face mask.Which action by the student should the nursing instructor question?

Accepted Answer

A)  Increasing the oxygen flow rate for the face mask and asking the patient to deep breathe slowly before suctioning 
B)  Inserting the catheter into the nares slanting slightly downward 
C)  Asking the patient to swallow while the catheter is being inserted 
D)  Inserting the catheter about 8 inches without applying suction

Question 4

The nurse is providing care to a patient on mechanical ventilation with an endotracheal tube.The nurse carefully inflates the cuff of the endotracheal tube using the minimal leak method,knowing that a properly inflated cuff provides which benefits to the patient? (Select all that apply.)

Accepted Answer

A)  Prevents aspiration of gastric contents 
B)  Promotes accumulation of secretions below the epiglottis 
C)  Prevents air from escaping between the tube and the tracheal wall 
D)  Promotes lung inflation for mechanical ventilation

Question 5

The nurse is preparing to suction an infant with a tracheostomy tube.Which action by the nurse follows appropriate procedure?

Accepted Answer

A)  Using a suction catheter that is half the diameter of the tracheostomy tube 
B)  Suctioning 0.5 cm to 1.25 cm (0.2-0.5 inches)beyond the tip of the tracheostomy tube 
C)  Hyperoxygenating with 90% oxygen to avoid oxygen toxicity 
D)  Using less than 150 mm Hg negative pressure

Question 6

A _______________ is inserted directly into the trachea through a small incision made in the patient's neck.

Accepted Answer

A)  nasogastric tube 
B)  nasoduodenal tube 
C)  endotracheal tube 
D)  tracheostomy tube

Question 7

The nurse performing nasotracheal suctioning should be assessing the patient for which possible unexpected outcomes? (Select all that apply.)

Accepted Answer

A)  Severe reduction in heart rate 
B)  Wheezing and inability to breathe 
C)  Reduction in oxygen saturation 
D)  Nasal bleeding 
E)  None of the above

Question 8

A patient using a nasal cannula has gurgling on inspiration.The nurse notes a productive cough but the inability to clear the secretions from the mouth.Which action should the nurse take first to prepare for oropharyngeal suctioning?

Accepted Answer

A)  Apply clean gloves and a mask. 
B)  Insert the suction device to the back of the throat. 
C)  Remove the patient's nasal cannula. 
D)  Connect the tubing to a standard suction catheter.

Question 9

The nurse is caring for a patient with an oral endotracheal tube in place.Which intervention by the nurse demonstrates proper procedure when providing endotracheal tube care?

Accepted Answer

A)  Determining proper endotracheal tube depth by noting the length of tube beyond the gum line 
B)  Instructing the assistant to hold the tube away from the lips while changing the tape 
C)  Removing the oral airway if the patient is actively biting down after the tape is removed from the endotracheal tube 
D)  Repositioning the tube on the opposite side or at the centre of the mouth at least every 24 to 48 hours

Question 10

A patient with a tracheostomy tube has thick,tenacious mucus that is difficult to remove.The nurse should choose which technique to suction the airway?

Accepted Answer

A)  Normal saline instillation (NSI)before suctioning 
B)  Dry suctioning one time followed by NSI with suctioning two more times 
C)  Dry suctioning as long as the heart rate is greater than 60 beats per minute 
D)  Dry suctioning

Question 11

The nurse is providing nasotracheal suctioning for a 13-year-old patient with secretions in the throat and trachea.Which action by the nurse demonstrates proper technique?

Accepted Answer

A)  Applying sterile petroleum jelly to the distal tip of the suction catheter 
B)  Applying clean gloves to both hands 
C)  Inserting the suction catheter 16 to 20 cm (6-8 inches)during inspiration 
D)  Suctioning the pharynx first and then the trachea

Question 12

The nurse is suctioning a patient with an endotracheal tube.Which action should the nurse take when the patient develops respiratory distress?

Accepted Answer

A)  Quickly remove the catheter and carefully reinsert it. 
B)  Continue to apply intermittent suction to remove thick secretions. 
C)  Administer oxygen directly through the suction catheter. 
D)  Withdraw the catheter and encourage the patient to cough and deep breathe.

Question 13

The nurse is caring for an infant who has been vomiting and is having difficulty breathing.What actions by the nurse are appropriate for suctioning the infant?

Accepted Answer

A)  Place the infant in a side-lying position. 
B)  Suction only when a large amount of mucus is present. 
C)  Suction for only 30 seconds. 
D)  Compress the bulb syringe after it is placed in the nostril.

Question 14

A patient with head trauma after a motor vehicle accident is on mechanical ventilation with an endotracheal tube.Which action by the nurse will reduce the risk for elevations in intracranial pressure during suctioning?

Accepted Answer

A)  Avoid hyperoxygenating the patient before suctioning. 
B)  Insert the suction catheter just to the end of the endotracheal tube. 
C)  Apply suction while inserting the catheter. 
D)  Limit suctioning to two times with each suctioning procedure.

Question 15

The nurse is caring for a patient who has a tracheostomy.To prevent the patient from developing an airway obstruction,the nurse assesses which of the following? (Select all that apply.)

Accepted Answer

A)  Patient's nutritional status 
B)  Environmental humidity 
C)  Existing respiratory infection 
D)  Patient's ability to cough 
E)  None of the above

Exam 25: Airway Management