Question 1

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 D

Question 2

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 B

Question 3

After oropharyngeal suctioning of a patient,the nurse notes bloody secretions in the suction catheter and tubing.What should the nurse do next?

Accepted Answer

A)  Increase the suction pressure.
B)  Provide additional oxygen.
C)  Reduce the frequency of oral hygiene.
D)  Check the suction catheter for nicks. D

Question 4

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 0.2 to 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 5

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 having increased risk?

Accepted Answer

A)  Presence of a gastrostomy feeding tube
B)  History of smoking 2 packs per day for 30 years
C)  Head injury with a decreased level of consciousness
D)  Stroke with dysphagia

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

The nurse has completed suctioning a patient's airway.Which action should the nurse take first?

Accepted Answer

A)  Reduce the suction level to medium.
B)  Remove the face shield and save for future suctioning.
C)  Reposition the patient and assist with oral hygiene using sterile gloves.
D)  Pull the gloves off over the rolled catheter and discard.

Question 8

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 9

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

Question 10

The nurse is assessing several patients who have returned from surgery.Which finding most likely indicates a need for suctioning?

Accepted Answer

A)  Complaint of pain when breathing
B)  Cough producing thick yellow mucus
C)  Oxygen saturation level of 88%
D)  Drowsiness and respiratory rate of 8

Question 11

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 12

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 supine 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 13

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 14

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?

Accepted Answer

A)  Patient's nutritional status
B)  Environmental humidity
C)  Existing respiratory infection
D)  Patient's ability to cough

Question 15

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 16

The nurse performing nasotracheal suctioning should be assessing the patient for which possible unexpected outcomes?

Accepted Answer

A)  Severe reduction in heart rate
B)  Wheezing and inability to breathe
C)  Reduction in oxygen saturation
D)  Nasal bleeding

Question 17

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?

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 18

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 19

The student nurse is providing tracheostomy care to a patient who has intratracheal secretions and a damp tracheostomy dressing and ties.Which action by the student should the nursing instructor question?

Accepted Answer

A)  Suctioning the tracheostomy tube before removing the soiled tracheostomy dressing
B)  Assisting the patient to semi-Fowler's position
C)  Placing new tracheostomy ties before cutting the old ties
D)  Cutting gauze pads to place around the tracheostomy tube

Question 20

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

Accepted Answer

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

Exam 25: Airway Management