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67 Cards in this Set
- Front
- Back
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Problems associated with endotracheal and tracheal tubes include:
I. loss of a patient's ability to communicate effectively II. decreases the effectiveness of the cough mechanism III. decreased chance of nosocomial infection IV. tracheal injury V. contamination of the lower airway A. I, IV, V B. II, III, IV, V C. II, IV, V D. I, II, IV, V E. I, II, III, IV, V |
D
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When using a Miller laryngoscope blade for intubation you should:
A. insert the tip of the blade into the vallecula B. insert the tip of the blade through the vocal cords C. insert the tip of the blade into the larynx D. lift the uvula with the tip of the blade E. lift the epiglottis with the tip of the blade |
E
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An adult patient has become apneic and mechanical ventilatory support is required. At this point, what tube or airway would you recommend?
A. an uncuffed endotracheal tube B. a cuffed endotracheal tube C. an uncuffed tracheostomy tube D. a cuffed tracheostomy tube |
B
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When it is necessary to completely deflate the cuff before an endotracheal tube extubation which of the following is the proper sequence of steps to be taken?
A. deflate cuff, suction trachea, suction pharynx B. deflate cuff, suction pharynx, suction trachea C. suction trachea, deflate cuff, suction pharynx D. suction trachea, suction pharynx, deflate cuff |
D
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The cuff pressure on the ETT of a mechanically ventilated patient:
A. Must be adjusted to maintain at least 20 cmH20 pressure on the tracheal wall at all times to prevent aspiration B. Must never be allowed to fall below 30cmH20 in order to prevent air leak C. must be kept below 20 cmH20 unless there is airleak with positive pressure ventilation D. Is no longer a problem with high volume low pressure cuffs in use today, except for the Bivona foam cuff, which still could develop high pressures |
A
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Which is true of resuscitator bags?
I. the spring and ball valve still functions best when contaminated with blood or vomit II. a reservoir can increase FIO2 to 100% oxygen III. a resuscitator bag without a reservoir provides approximately 40% 02 IV. a self inflation bag provides the best "feel" for the patient's lung compliance A. I, II B. II, III C. I, IV D. II, III, V E. all of the above |
B
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Inserting an endotracheal tube too far in the airway will most likely result in its entering the:
A. Esophagus B. Right mainstem bronchus C. Right middle lobe bronchus D. Left mainstem bronchus |
B
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A patient with a foam cuff tracheostomy tube:
A. should have a syringe to inflate the cuff B. will need a stopcock on the pilot balloon to form a tracheal seal C. will have the pilot balloon open to correctly inflate the cuff D. should have the pilot balloon inflated and capped to guarantee a tracheal seal |
C
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When selecting a suction catheter to be placed through an endotracheal tube, it is important that:
A. The catheter is no more than one-fourth the internal diameter of the endotracheal tube. B. The catheter is no more than one half the internal diameter of the endotracheal tube. C. The catheter is greater than two-thirds of the internal diameter of the endotracheal tube. D. It should be as close to the internal diameter of the endotracheal tube as possible. |
B
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To open an obstructed airway of a patient who has a possible cervical fracture, the respiratory therapist should:
A. perform a cricothyroid puncture with a 13-gauge needle B. flex the patient's head forward after a cervical collar is in place C. hyperextend the patient's head back after a cervical collar is in place D. perform the jaw thrust maneuver |
D
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A patient has a -15 cm water pressure negative inspiratory pressure (NIF) . What can you conclude from this result?
I. The patient has weak inspiratory muscles. II. The patient meets extubation criteria III. The patient has obstructive airways disease. A. I B. II C. I, II D. I, III |
A
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Indications for extubating a patient include:
I. Patient is unable to clear their own secretions II. patient no longer needs mechanical ventilation III. Patient appears to be developing tracheal stenosis from the tube IV. Patient wants to be extubated V. Correction of the condition that caused the patient to be intubated A. I, III, IV B. II, V C. I, III, V D. II, III, IV E. All of the above |
B
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Which of the following are complications of intubation?
I. main stem intubation II. aspiration III. vocal cord damage IV. esophageal intubation V. mechanical ventilation A. I, II, III B. II, III, IV C. II, III, IV, V D. I, II, III, IV E. all of the above |
D
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Regarding the newly-extubated patient, which of the following is
false? A. the breath sounds should be assessed B. their voice may be hoarse C. a heated aerosol mist should be administered D. if stridor is present, a racemic epinephrine neb should be given |
C
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The first thing you should do after intubation to assess the
placement of an endotracheal tube is: A. order a chest X-ray B. check for cyanosis C. auscultate the chest D. order an arterial blood gas E. observe the stomach expanding on inspiration |
C
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Regarding intubation, which of the following is false?
A. the oral route is the route of choice in an emergency B. it should be performed in no more than 30 seconds C. it is indicated in the patient whose airway cannot be maintained with the use of other artificial airways D. the nasal route is more commonly used in most ICUs today |
D
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Indications for tracheal intubation include:
I. Severe obstruction in the laryngopharynx accompanied by sternal retractions, tachypnea and deteriorating ABGs II. An obtunded patient who can't cough and shows signs of retained secretions III. A PaO2 below 60 mmHg due to V/Q mismatch IV. Respiratory arrest V. Provide the means for mechanical ventilation A. I, IV, V B. II, III, IV, V C. I, II, IV, V D. V E. All of the above |
C
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Following extubation a patient develops mild inspiratory stridor; actions to be taken would include:
I. Immediate reintubation II. Administering nebulized racemic epinephrine III. Administration of cool mist IV. No action necessary, it is normal to have inspiratory stridor post extubation V. close monitoring of patient A. I B. II, III C. II, III, V D. IV E. I, II, III, IV, V |
C
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Which of the following are criteria for extubation?
I. minute volume of less than 10 Liters II. FiO2 less than or equal to .50 III. negative inspiratory force greater than -20 cmH2O press. IV. acceptable arterial blood gas values V. vital capacity greater than 15 ml. per Kg. of ideal body weight. A. I, II, IV B. II, III, IV C. II, III, IV, V D. I, II, III, IV E. all of the above |
E
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You are caring for a patient who is maintaining his airway well
but is requiring frequent suctioning. The best first choice would be to try: A. a nasopharyngeal airway B. a nasal endotracheal airway C. a tracheostomy tube D. an oropharyngeal airway |
A
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A 31 year old unconscious man is admitted to the emergency room. His breathing is very shallow at a rate of 10 BPM. A drug overdose is suspected. Five minutes later you notice him go into a respiratory arrest. What position must the patient be in to open an airway?
A. neck flexed only B. neck flexed and jaw forward C. neck extended only D. neck extended and jaw lift E. head to the side |
D
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Regarding "flow inflating" (flow-dependent) manual resuscitators,
which of the following is false? A. they must be connected to a gas source in order for them to operate B. they can be used on intubated or non-intubated patients C. their use can cause a decrease in cardiac output D. they have a diaphragm, spring and disk (or ball), or duck bill valve E. none of the above |
D
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The most likely problem associated with the insertion of a correctly sized oropharyngeal airway with appropriate technique is:
A. damage to the epiglottis B. gagging and vomiting C. airway obstruction D. nasal obstruction E. tracheoesophageal fistula |
B
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Which of the following devices will best facilitate mask and bag ventilation when a patient is deeply sedated from a drug overdose?
A. an oropharyngeal airway B. an esophageal obturator airway C. a transtracheal catheter D. a nasal trumpet E. a nonrebreather |
A
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A 500 pound ER Patient goes into respiratory arrest. You can not adequately ventilate with mask and bag and no one can intubate the trachea. Assuming all the equipment is available which (is) are the best airway choice(s)?
i. nasopharyneal airway ii. esophageal obturator iii. combitube iv. fenestrated trach tube A. i, iv B. i, ii, iii, iv C. iii D. ii, iii, iv E. none of the above |
C
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Which of the following are good reasons to suction a patient?
I. As a routine part of every therapy II. An endotracheal tube with secretions present III. The nurse asks you to IV. An inadequate cough with evidence of retained secretion V. Basilar infiltrates on the x-ray A. II, IV, V B. II, IV C. I, II, III D. I, III, IV E. all of the above |
B
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Which of the following are hazards of suctioning?
I. Contamination of the lower airway II. Bradycardia III. Tachycardia IV. Metabolic alkalosis A. I B. II, IV C. I, III D. III, IV E. I, II, III |
E
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Which of the following are components of proper endotracheal
suctioning technique when not using the closed system (Ballard) catheter? I. suction should be applied during insertion and withdrawal of the suction catheter II. use of sterile technique with the catheter III. the patient should be hyperoxygenated before and after each pass of the catheter IV. the mouth should always be suctioned first with the same catheter used for the ETT before suctioning the ETT V. the heart rate should be closely monitored A. I, II, III B. I, IV, V C. II, III, IV D. II, III, V E. I, II, III, V |
D
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When suctioning a patient via an endotracheal tube you should
limit the suctioning time to no more than: A. 5 seconds B. 15 seconds C. 20 seconds D. 25 seconds E. 2 minutes |
B
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During endotracheal suctioning, a respiratory therapy practitioner notices that the patient has developed tachycardia and tachypnea. This problem probably has been caused by:
A. vagal stimulation B. atelectasis C. hypoxemia D. tracheal trauma |
C
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You are about to suction the adult patient through the nasopharyneal airway; where should the suction pressure gauge be set?
A. 100 - 120 mmHg B. To the maximum setting C. 120 - 160 mmHg D. The pressure set is dependant on the particular patient and the quality and quantity of sputum encountered; anywhere between 40 - 300 PSI |
A
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What structure marks the upper border of the oropharynx?
A. vallecula B. epiglottis C. uvula D. eustachian tube |
C
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The _______________is located from the base of the skull to the tip of the uvula, and houses the ________________
A. laryngopharynx...... cuneiform cartilage B. oral cavity..... choana C. nasopharynx..... eustachian opening D. oropharynx..... adenoids |
C
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The epiglottis closes down to:
A. facilitate speech B. protect the esophagus during breathing C. protect the glottis during swallowing D. protect the asparagus from digestion E. produce a maximal cough |
C
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Indications for a tracheostomy include which of the following?
I. allow transfer out of the ICU II. sudden cardiac arrest III. need for alternate airway (due to upper airway trauma etc.) IV. long term mechanical ventilation V. decrease anatomical deadspace A. I, II, IV B. I, II, V C. I, III, IV, V D. II, III, IV, V E. I, II, III, IV, V |
C
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What structure marks the upper border of the oropharynx? (sorry, duplicate question)
A. vallecula B. epiglottis C. uvula D. eustachian tube |
C
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Reflexes in the airway will be lost in what order?
A. gag, swallow, tracheal, laryngeal, carinal B. carinal, tracheal, laryngeal, gag, swallow C. laryngeal, tracheal, gag, swallow, carinal D. swallow, gag, laryngeal, tracheal, carinal |
D
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Damage to which nerve will result in vocal cord paralysis?
A. Superior laryngeal B. Recurrent laryngeal C. Hypoglossal D. Lingual |
B
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The function(s) of the pharynx are(is)
A. to provide a conducting airway B. to provide musculature for swallowing C. swallow and gag protective reflexes D. lymphoid tissue to protect against infection E. all of the above |
E
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Which of the following is not considered part of the upper airway
anatomy? A. the tongue B. the carina C. the vallecula D. the vocal cords E. the arytenoid cartilages |
B
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Which of the following is true regarding endotracheal tubes
commonly used today? I. they are made out of poly-vinyl-chloride (PVC) II. they have a radiopaque mark (X-ray stripe) III. they have high-volume low-pressure cuffs IV. they are coated with an anti-bacterial agent A. I, III B. II, III C. I, II D. I, II, III E. I, III, IV |
D
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Which of the following is not an advantage of the oral route of intubation?
A. fastest, most direct route B. most secure C. a relatively larger tube can be used D. least likelihood of trauma E. none of the above |
B
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During manual resuscitation cardiac output can be decreased. This is due to:
A. higher airway resistance B. lower lung compliance C. higher intrathoracic pressures in the chest D. lack of passive exhalation |
C
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. Which of the following is true regarding the MacIntosh
laryngoscope blade? A. it is straight B. it is placed in the vallecula C. it is used to insert an oropharyngeal airway D. it uses fiberoptics |
B
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While auscultating to verify endotracheal tube placement, a respiratory therapy practitioner finds breath sounds on the right louder than on the left side of the chest. The most likely cause of this would be:
A. Inadvertent intubation of the esophagus B. Inadvertent intubation of the left main stem bronchus C. Inadvertent intubation of the right main stem bronchus D. Inadvertent intubation of the glottis E. Aspiration to the left upper lobe |
C
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During a post intubation assessment you realize the tube is in the esophagus. What would be the most appropriate action to take?
A. Withdraw the tube 1 to 2 centimeters and recheck breath sounds B. Remove the tube immediately and ventilate with a bag and mask before reattempting to intubate C. Suction the patient thoroughly D. Order a larger endotracheal tube and continue to ventilate until it arrives E. None. This is a normal occurrence during a respiratory arrest |
B
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A patient is intubated during a prolonged respiratory arrest, you notice immediately after intubation that the patient's chest is not rising with positive pressure breaths and air movement is heard over the stomach. What is the most likely cause of this?
A. Inadvertent intubation of the esophagus B. Inadvertent intubation of the left main stem bronchus C. The patient has chronic fibrotic lung disease D. Bilateral aspiration of stomach contents E. The endotracheal tube is too small for the patient |
A
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The most commonly used airway when ventilating a patient with a
manual resuscitator and mask is: A. an oropharyngeal airway B. an endotracheal tube C. a tracheostomy tube D. a nasopharyngeal airway E. a Kistner button |
A
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The most likely complication of manual resuscitation (bagging) of the
non-intubated patient is: A. vagal stimulation B. bradycardia C. pneumothorax D. gastric distension E. bronchospasm |
D
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Which of the following are complications of suctioning?
I. tissue trauma II. hypoxemia III. cardiac arrythmias IV. infection (pneumonia) V. removal of retained secretions A. I, II, IV B. I, II, III, IV C. II, III, V D. II, III, IV, V E. all of the above |
B
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Which type of suction catheter is used to selectively suction a
main stem bronchus? A. Coude tip B. Ballard ( lf-contained) C. Whistle tip D. Airflow "ring tip" |
A
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Regarding the use of foam-cuffed airways, which of the following
is false? A. they are found only on tracheostomy tubes B. normally air should not be added to the cuff C. they serve the same function as a regular air-filled cuff D. when extubating, one can simply cut the pilot line instead of deflating the cuff |
D
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Which nerve would be responsible for a patient's decrease in blood pressure, heart rate, and laryngospasm during intubation or extubation.
A. hypoglossal B. lingual C. vagus D. radial E. femoral |
C
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The last reflex a person regains when coming out of unconsciousness is:
A. carinal B. tracheal C. swallow and gag D. laryngeal |
C
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The following are characteristics of the trachea.
i. leads anteriorly to the larynx and posteriorly to the esophagus ii. extends from the base of the tongue to the carina iii. is supported by 16-20 complete rings of cartilage iv. can be 2.5 cm in diameter in the adult v. a tracheostomy will be performed between the 2nd and 3rd tracheal ring A. i, iii, v B. iv, v C. iii, iv, v D. ii, iv, v E. all of the above |
B
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A patient is ventilating adequately following intubation. The respiratory therapist encounters difficulty when attempting to pass a suction catheter through the nasotracheal tube. The most likely cause of the problem suggests the nasotracheal tube:
A. has just been inserted B. was placed endobronchially during a traumatic intubation C. is totally occluded by thick secretions D. is kinked in the nasopharynx E. is narrowed by the lingual tonsils |
D
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The most significant factor leading to the development of tracheal stenosis in the adult patient is:
A. trauma during intubation B. cuff tracheal wall pressure C. tube thickness D. tube length |
B
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Which is not an indication for a nasopharyngeal airway
A. provide long term mechanical ventilation B. relieve obstruction caused by the soft palate C. use in conjunction with a resuscitator bag D. access the airway for frequent suctioning |
A
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During a cardiac arrest you notice that the patient has not had a ventilation in 7 seconds while the physician is trying to intubate. In this situation you should:
A. attempt to ventilate the patient B. continue to monitor the time C. call for a stat ABG D. inform the physician she is taking too long to intubate E. begin compressions over the lower third of the sternum |
B
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Oropharyngeal and nasopharyngeal airways serve what purpose when used?
I. They allow attachment to positive pressure breathing devices for long term ventilation II. They help prevent soft tissue airway obstruction III. They prevent gagging and aspiration IV. They aid manual ventilation with a mask and bag V. They serve as a guide for pharyngeal suction A. I, II, III B. II, IV, V C. II, III, V D. I, III, IV E. I, II, III, IV, V |
B
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A patient with severe acute respiratory distress syndrome (ARDS) is intubated with a 8.0 millimeter ID endotracheal tube. What size suction catheter is the best choice to ensure optimal secretion removal without increasing the probability of complications?
A. 8 French B. 10 French C. 24 mm D. 14 French E. 18 French |
D
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Damage to which nerve will result in numbness of the tongue?
A. Superior laryngeal B. Recurrent laryngeal C. Hypoglossal D. Lingual |
D
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The best tube to use in a cardiac arrest situation is:
A. a double cuffed tracheostomy tube B. nasal endotracheal tube C. oral endotracheal tube D. combitube E. a fenestrated tracheostomy tube |
C
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The tip of a correctly positioned endotracheal tube is located:
A. At the vallecula B. 1 - 2cm above the true vocal chords C. At the carina D. 2 - 5cm above the carina E. Just above the esophagus |
D
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Which of the following procedures is never required when using the ballard closed system suction catheter?
A. it should be changed every 24 hours B. the vacuum gauge should be set between 120 - 160 mmHg C. sterile gloves must be worn D. the catheter should be cleared with saline after use E. the patient must be oxygenated with 100% oxygen |
C
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Mechanical ventilation has been initiated, and the patient requires deep tracheal suctioning. The correct suctioning procedure would include which of the following?
I. Preoxygenation II. A maximum suction time of 25 seconds III. The application of continuous suction as the catheter is inserted A. I B. II C. III D. I & II E. All of the above |
A
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Which of the following tracheostomy tubes are non-disposable,
metal tubes? A. Jackson or Hollanger B. regular single cuffed C. fenestrated D. foam cuff E. regular single cuffed with inner cannula |
A
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