Question 1

The nurse is providing care to a patient with a tracheostomy tube that has an inner cannula.Which intervention by the nurse follows proper procedure for tracheostomy tube care?

Accepted Answer

A)  Carefully removes the inner cannula and places it in a basin of 1:10 bleach solution
B)  Scrubs the inner cannula on the inside and outside with a 1:10 bleach solution
C)  After scrubbing the inner cannula, rinses it with normal saline
D)  Uses a wet 4 ´ 4 gauze and cleans the inside of the outer cannula C

Question 2

The nurse is evaluating a patient to determine whether the endotracheal tube cuff is properly inflated.Which findings indicate proper inflation? (Select all that apply.)

Accepted Answer

A)  Exhaled tidal volume is 50 mL less than the tidal volume set on the ventilator.
B)  Air leak is heard with a stethoscope only at the end of inspiration.
C)  The patient is able to vocalize.
D)  Gastric contents are noted in airway secretions. A, B

Question 3

When assessing a patient's tracheostomy site, the nurse notes redness and inflammation around the stoma.Which intervention can the nurse provide to address this problem?

Accepted Answer

A)  Decrease the frequency of tracheostomy care.
B)  Apply a dry gauze dressing just under the stoma.
C)  Remove the ties at frequent intervals.
D)  Apply a topical antibacterial solution and allow it to dry. D

Question 4

Too much oxygen reduces the drive to breathe in patients with chronic _____________.

Accepted Answer

The answer of Too much oxygen reduces the drive to...

Question 5

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 6

The nurse is performing nasotracheal suctioning for a patient.Which action by the nurse is appropriate?

Accepted Answer

A)  Applying intermittent suctioning while slowly withdrawing the suction catheter
B)  Carefully pushing the suction catheter in and out while applying suction
C)  Applying suction for 15 seconds or less
D)  Asking the patient to deep-breathe for 15 seconds before passing the catheter a second time

Question 7

A patient on mechanical ventilation with an endotracheal tube requires suctioning.A closed in-line catheter is in place.Which action by the nurse is appropriate?

Accepted Answer

A)  Use manual ventilation to hyperoxygenate the patient with 100% oxygen via Ambu bag.
B)  Push the catheter and slide the plastic sleeve back when the patient exhales.
C)  Push the catheter in until resistance is felt or the patient coughs.
D)  Apply suction for no longer than 30 seconds as you remove the catheter.

Question 8

A patient with head trauma following 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 2 times with each suctioning procedure.

Question 9

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

Accepted Answer

The answer of A _______________ is inserted directly into the...

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 1 time followed by NSI with suctioning 2 more times
C)  Dry suctioning as long as the heart rate is above 60 beats/min
D)  Dry suctioning

Question 11

The nurse is performing nasotracheal suctioning on a patient.The nurse should discontinue the suctioning if which of the following occurs?

Accepted Answer

A)  The patient coughs as the catheter is inserted.
B)  The heart rate decreases from 84 beats per minute to 60 beats per minute.
C)  An increase in pulse occurs from 74 beats per minute to 94 beats per minute.
D)  Oxygen saturation levels decrease from 97% to 94%.

Question 12

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 13

The nurse is assessing a patient with an endotracheal tube and notes an audible air leak when standing by the patient.Which intervention should the nurse perform first to address this problem?

Accepted Answer

A)  Deflating the cuff of the endotracheal tube
B)  Repositioning the patient or tube
C)  Inserting a new endotracheal tube
D)  Notifying the health care provider

Question 14

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 15

A patient with increased secretions may develop airway obstruction.The nurse can promote a patent airway by using which of the following techniques? (Select all that apply.)

Accepted Answer

A)  Limiting fluid intake
B)  Positioning
C)  Deep breathing
D)  Humidity

Question 16

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 center of the mouth at least every 24 to 48 hours

Question 17

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 18

The nurse is assessing a patient who is intubated and on a ventilator.When listening above the sternal notch with a stethoscope, the nurse notes a minimal amount of air leak at the end of inspiration.Which action by the nurse is appropriate?

Accepted Answer

A)  Remove all air from the cuff and reinflate the cuff until no air leak is present.
B)  Note that the cuff is properly inflated.
C)  Notify the health care provider.
D)  Suction the patient.

Question 19

A patient has been on mechanical ventilation with an endotracheal tube for 1 week.Which intervention by the nurse will help prevent ventilator-associated pneumonia (VAP)?

Accepted Answer

A)  Providing oral care with a toothbrush at least twice daily
B)  Changing the ventilator circuits at least every 72 hours
C)  Removing subglottal secretions before every position change
D)  Maintaining endotracheal cuff pressures at 10 cm H2O

Question 20

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 6 to 8 inches during inspiration
D)  Suctioning the pharynx first and then the trachea

Exam 25: Airway Management