airway Flashcards by A P

1) Which of the following is the correct order of events after an endotracheal tube has been properly inserted?

A) Inflate the cuff with 5 to 10 mL of air, secure the tube, listen for equal breath sounds bilaterally, and listen for breath sounds over the epigastrium.

B) Inflate the cuff with 5 to 10 mL of air, auscultate the epigastrium and then the lungs, and secure the tube.

C) Secure the tube, listen for breath sounds over the epigastrium, listen for equal breath sounds bilaterally, and inflate the cuff with 5 to 10 mL of air.

D) Inflate the cuff with 5 to 10 mL of air, listen for breath sounds over the epigastrium, listen for equal breath sounds bilaterally, and secure the tube.

inflate the cuff with 5- 10 ml of air, auscultate the epigastrium and then the lungs, and secure the tube

How well did you know this?

Not at all

Perfectly

2) The patient with COPD may benefit from oxygen delivery through a Venturi mask because:

A) oxygen concentration is controlled more carefully.

B) it delivers intermittent positive pressure to the airway.

C) it both protects the airway and delivers oxygen.

D) it delivers the highest oxygen concentration possible.

oxygen concentration is controlled more carefully

How well did you know this?

Not at all

Perfectly

3) A peak flow meter measures:

A) inspiratory reserve volume.

B) tidal volume.

C) the force of expiratory volume.

D) respiratory efficacy during forced expiration.

respiratory efficacy during forced expiration

How well did you know this?

Not at all

Perfectly

4) Applying posteriorly directed pressure on the cricoid cartilage to facilitate endotracheal intubation is also referred to as:

A) digital intubation.

B) cricoid pressure.

C) retrograde intubation.

D) cricothyrotomy.

cricoid pressure

How well did you know this?

Not at all

Perfectly

5) When swallowing occurs, the structure that occludes the tracheal opening to prevent aspiration of food and liquid is the:

A) cricoid cartilage.

B) epiglottis.

C) pyriform fossa.

D) uvula.

epiglottis

How well did you know this?

Not at all

Perfectly

6) Moderate hypoxemia is indicated with a pulse oximeter reading of ________ percent.

A) 86 to 90

B) 95 to 100

C) 81 to 85

D) 90 to 94

86-90

How well did you know this?

Not at all

Perfectly

7) During spontaneous breathing, which of the following reflexes prevents overexpansion of the lungs?

A) Cheyne-Stokes

B) Hering-Breuer

C) Apneustic

D) Cushing’s

Hering- Breuer

How well did you know this?

Not at all

Perfectly

8) Which of the following is an objective technique to verify proper endotracheal tube placement?

A) Direct visualization

B) Esophageal detector device

C) Tube misting

D) Auscultation

Esophageal detector device

How well did you know this?

Not at all

Perfectly

9) Which of the following interferes with ventilation in the presence of a flail segment?

A) The ability to generate positive intrathoracic pressure is impaired.

B) Intrathoracic pressure increases on the affected side.

C) Intrathoracic pressure decreases on the affected side.

D) The ability to generate negative intrathoracic pressure is impaired.

the ability to generate negative intrathoratic pressure

How well did you know this?

Not at all

Perfectly

10) Progressively deeper, faster breathing alternating gradually with shallow, slower breathing is called:

A) Cheyne-Stokes respirations.

B) Kussmaul’s respirations.

C) Biot’s respirations.

D) agonal respirations.

cheyne stokes respirations

How well did you know this?

Not at all

Perfectly

11) Which of the following is an advantage of the two-person method of bag-valve-mask ventilation?

A) Reduces the risk of gastric distension

B) Provides tidal volumes of 1,500 to 1,700 mL

C) Delivers a higher concentration of oxygen

D) Easier to maintain a seal between the patient’s face and the mask

easier to maintain a seal between the patients face and the mask

How well did you know this?

Not at all

Perfectly

12) What is the normal partial pressure of oxygen (in torr) in the arterial blood?

A) 35 to 45

B) 50 to 75

C) 80 to 100

D) 100 to 150

80 -100

How well did you know this?

Not at all

Perfectly

13) Which of the following is the most common cause of airway obstruction?

A) Foreign bodies

B) Food

C) Upper airway edema

D) Tongue

tongue

How well did you know this?

Not at all

Perfectly

14) In an adult, the narrowest part of the airway is the:

A) trachea.

B) cricoid cartilage.

C) hypopharynx.

D) glottis.

glottis

How well did you know this?

Not at all

Perfectly

15) A musical, squeaking, or whistling sound that may be heard on inspiration or expiration while auscultating lung fields is known as:

A) crackles.

B) stridor.

C) rhonchi.

D) wheezing.

wheezing

How well did you know this?

Not at all

Perfectly

16) The automatic transport ventilator is contraindicated for all of the following intubated patients, EXCEPT:

A) a 17-year-old gunshot victim.

B) a 4-year-old near-drowning victim.

C) a 56-year-old patient in pulmonary edema.

D) a 34-year-old patient with adult respiratory distress syndrome.

a 17 year old gun shot victim

How well did you know this?

Not at all

Perfectly

17) Of the normal tidal volume for the average 70-kg adult, what amount of air (in mL) is NOT available for gas exchange?

A) 50

B) 100

C) 150

D) 250

150

How well did you know this?

Not at all

Perfectly

18) The preferred depolarizing neuromuscular agent for rapid sequence intubation is:

A) pancuronium.

B) midazolam.

C) succinylcholine.

D) vecuronium.

succinycholine

How well did you know this?

Not at all

Perfectly

19) All of the following are indications for endotracheal intubation, EXCEPT:

A) a heart rate over 100.

B) respiratory arrest.

C) cardiac arrest.

D) airway swelling.

a heart rate over 100

How well did you know this?

Not at all

Perfectly

20) A properly placed ________ effectively isolates the trachea for ventilation and protection from aspiration.

A) dual lumen airway

B) endotracheal tube

C) laryngeal mask airway

D) King LTD airway

endotrachial tube

How well did you know this?

Not at all

Perfectly

21) When using a colorimetric end-tidal carbon dioxide detector, the absence of carbon dioxide in exhaled air after six breaths indicates that the endotracheal tube has been placed:

A) in the right mainstem bronchus.

B) in the esophagus.

C) in the left mainstem bronchus.

D) in the trachea.

in the esophagus

How well did you know this?

Not at all

Perfectly

22) Which of the following devices is known as a dual-lumen airway?

A) Combitube

B) Endotracheal tube

C) Laryngeal mask airway

D) King LTD airway

combitube

How well did you know this?

Not at all

Perfectly

23) What percentage of oxygen is delivered by a simple face mask?

A) 60 to 80

B) 95 to 100

C) 40 to 60

D) 80 to 90

95-100

How well did you know this?

Not at all

Perfectly

24) A high-pitched inspiratory noise caused by a partial upper airway obstruction is called:

A) stridor.

B) dysphonia.

C) rhonchi.

D) wheezing.

stridor

How well did you know this?

Not at all

Perfectly

25) An attempt at endotracheal intubation must not interrupt ventilations for more than ________ seconds. A) 10 B) 15 C) 20 D) 30

26) A(n) ________ may be used to facilitate nasotracheal intubation. A) uncuffed endotracheal tube B) malleable stylette C) lighted stylette D) Endotrol tube

endotrol tube

27) Which of the following serves as an important visual landmark when performing endotracheal intubation under direct visualization? A) Cricothyroid membrane B) Cricoid cartilage C) Thyroid cartilage D) Posterior cartilages

posterior cartilages

28) What is the highest flow rate on a demand valve device (in liters per minute)? A) 30 B) 20 C) 15 D) 40

29) The hypoxic drive is stimulated by: A) high PaCO2. B) low PaO2. C) high PaO2. D) low PaCO2.

low pa02

30) The reading obtained by the use of a pulse oximeter reflects the: A) amount of saturated hemoglobin per deciliter of blood. B) amount of oxygen dissolved in the blood. C) ratio of unsaturated hemoglobin to saturated hemoglobin. D) partial pressure of oxygen in capillary blood.

ratio of unsaturated hemoglobin to saturated hemoglobin

31) Which of the following is NOT a structure of the upper airway? A) Larynx B) Trachea C) Hypopharynx D) Nasopharynx

trachea

32) Shallow, slow, or infrequent breathing, indicating severe ICP buildup and brain anoxia, is known as: A) Kussmaul's respirations. B) grunting. C) Biot's respirations. D) agonal respirations.

agonal respirations

33) At the end of exhalation, the intrathoracic pressure is: A) significantly less than atmospheric pressure. B) slightly less than atmospheric pressure. C) greater than atmospheric pressure. D) equal to atmospheric pressure.

equal to atmospheric pressure

34) Which of the following manual airway maneuvers should be used when you are caring for a patient with a suspected cervical spine injury? A) Sellick's B) Modified jaw-thrust C) Jaw/tongue lift D) Head-tilt/chin-lift

modified jaw- thrust

35) When you are intubating a stoma site, how far beyond the distal cuff (in cm) should you insert the endotracheal tube? A) 1 to 2 B) 3 to 4 C) 2 to 3 D) 4 to 5

1 to 2

36) In which of the following conditions should you suspect pulmonary shunting? A) A foreign body in the right mainstem bronchus B) Pneumonia C) Pulmonary embolism D) All of the above

all of the above

37) Which of the following mechanisms is responsible for hypoxemia in the patient with a pulmonary embolism? A) Pulmonary shunting B) Pulsus paradoxus C) Lower airway obstruction D) Atelectasis

pulmonary shunting

38) End-tidal colorimetric capnography measures: A) carbon dioxide in exhaled air. B) the partial pressure of carbon dioxide in arterial blood. C) the amount of carbon dioxide dissolved in plasma. D) the percentage of hemoglobin saturated with carbon dioxide.

carbon dioxide in exhaled air

39) A drop in blood pressure of greater than 10 torr during inspiration is called: A) pulsus paradoxus. B) pulsus obliterans. C) pulsus tardus. D) pulsus alternans.

pulsus paradoxus

40) What is visualized with a class 3 Mallampati score? A) Entire tonsil B) Upper half of the tonsil fossa C) Soft and hard palate D) Only the hard palate

soft and hard palate

41) The major drawback of mouth-to-mouth ventilations is: A) an oxygen level in the rescuer's exhaled air of only 10 to 12 percent. B) potential exposure of the rescuer to body fluids. C) inability to achieve adequate tidal volumes for ventilation. D) a high level of carbon dioxide in the rescuer's exhaled air.

potential exposure of the rescuer to body fluids

42) The maximum flow rate to be used with a nasal cannula is ________ liters per minute. A) 10 B) 6 C) 8 D) 4

43) Which of the following increases the risk of foreign body airway obstruction? A) Age B) Alcohol consumption C) Dentures D) All of the above

all of the above

44) The simplest airway management technique in a patient without suspected cervical spine injury is the: A) head-tilt/chin-lift maneuver. B) modified jaw-thrust maneuver. C) use of an oropharyngeal airway. D) Sellick's maneuver.

head tilt chin lift maneuver

45) The aspiration of vomitus into the lungs may result in: A) tissue damage. B) pulmonary edema. C) pneumonia. D) all of the above.

all of the above

46) The MOST common indication for a surgical cricothyrotomy is: A) massive facial or neck trauma. B) failed rapid sequence intubation. C) status seizures with trismus. D) foreign body airway obstruction.

massive facial or neck trauma

47) When you are suctioning an adult patient, the onset of bradycardia is most likely due to: A) hypercarbia. B) hypoxia. C) stimulation of the vagus nerve. D) increased intracranial pressure.

stimulation of the vagus nerve

48) Which of the following basic airway adjuncts prevents the tongue from falling back to occlude the airway? A) Yankauer catheter B) Laryngeal mask airway C) Nasal cannula D) Oropharyngeal airway

oropharyngeal airway

49) A fine, bubbling sound heard on inspiration and associated with fluid in the alveoli and terminal bronchioles is called: A) bronchovesicular sounds. B) rales (crackles). C) rhonchi. D) pleural friction.

rales (crackles)

50) The tip of a curved laryngoscope blade is placed correctly: A) at the junction of the hard and soft palates. B) at the glottic opening. C) under the epiglottis. D) in the vallecular.

in the vallecular

51) Which of the following is a disadvantage of pulse oximetry? A) Tissue hypoxia may be present even with a normal SaO2 reading. B) Pulse oximetry cannot differentiate between hemoglobin bound to oxygen and hemoglobin bound to carbon monoxide. C) Pulse oximetry gives no information about the amount of carbon dioxide in the blood. D) All of the above are disadvantages.

all of the above

52) The movement of oxygen from the alveoli to the blood in the pulmonary capillaries depends on: A) facilitated transport by way of the hemoglobin molecule. B) active transport of oxygen from an area of lower concentration to an area of higher concentration. C) diffusion of oxygen from an area of higher concentration to an area of lower concentration. D) osmosis of the H2O molecule across the respiratory membrane, where oxygen dissociates from hydrogen.

diffusion of oxygen from an area of higher concentration to an area of lower concentration

53) A portable suction device should generate a flow rate of ________ liters per minute when the tube is open. A) 20 B) 30 C) 40 D) 50

54) As the thoracic cavity begins to expand, the intrathoracic pressure: A) does not change. B) is greater than atmospheric pressure. C) is the same as atmospheric pressure. D) is less than atmospheric pressure.

is less than atmospheric pressure

55) When a bag-valve ventilation device is used with supplemental oxygen, it delivers an oxygen concentration of ________ percent. A) 40 B) 90 C) 60 D) 21

56) In which of the following patients would a Combitube dual-lumen airway be used with caution? A) A 28-year-old man who is in cardiac arrest after his kayak capsized, trapping him under water for several minutes B) A 40-year-old woman who has taken an overdose of tricyclic antidepressants and is unresponsive to all stimuli C) A 59-year-old man with a history of chronic alcoholism who was found in cardiac arrest at a homeless shelter D) A 16-year-old woman who is unresponsive following a motor vehicle collision in which she was ejected, sustaining traumatic brain injury

a 59 year old man with a history of chronic alcoholism who was found in cardiac arrest at a homeless shelter

57) When a portion of the lung is unavailable for gas exchange, yet pulmonary circulation continues in that area of the lung, a condition known as ________ results. A) pulsus paradoxus B) ventilation/perfusion mismatch C) atelectasis D) eupnea

ventilation/ perfusion mismatch

58) Physiologically, the term respiration refers to the: A) exchange of gases at the alveolar-capillary interface. B) mechanical process that moves air into and out of the lungs. C) exchange of all gases, nutrients, and wastes at the cellular level. D) exchange of gases at the cellular level.

exchange of gas at the cellular level

59) Without adequate airway maintenance and ventilation, the patient can succumb to brain injury or death in how many minutes? A) 4 B) 10 C) 6 D) 12

60) The bifurcation of the trachea is called the: A) glottic opening. B) hilum. C) cricoid cartilage. D) carina.

carina

61) Which of the following statements about manual airway maneuvers is TRUE? A) They require specialized equipment. B) They are often neglected by EMTs and paramedics. C) They are contraindicated in trauma patients. D) They are difficult to learn.

they are often neglected by EMT's and paramedics

62) Which of the following about the use of a dual-lumen airway device is TRUE? A) It is not recommended for trauma patients. B) It may be used for adult and pediatric patients. C) It may be inserted in patients with a gag reflex. D) Insertion requires no direct visualization.

insertion requires direct visualization

64) Insertion of an endotracheal tube too far is likely to result in ventilation of: A) the right lung only. B) the left lung only. C) only the lower lobes of both lungs. D) neither lung.

the right lung only

65) During a respiratory assessment, the absence of breath sounds may indicate: A) a pneumothorax. B) a pulmonary embolism. C) flail chest. D) bronchitis.

a pneumothorax

66) In which of the following conditions is insertion of a nasogastric tube contraindicated? A) Patient having a gag reflex B) Patient with facial fractures C) Patient awake and alert D) All of the above

patient with facial fractures

67) Which of the following may complicate airway management procedures in the pediatric patient? A) The trachea narrows at the cricoid cartilage. B) The tongue occupies a greater proportion of space. C) The epiglottis is larger and floppier than in an adult. D) All of the above are possible complications.

all of the above

68) When performing tracheobronchial suctioning, what should be the maximum amount of suction time? A) 15 seconds B) 20 seconds C) 10 seconds D) 5 seconds

10 seconds

69) Which of the following best suggests an esophageal intubation? A) Color change from purple to yellow with a colorimetric ETCO2 detector B) Free return of air when aspirating with an esophageal detector device C) Gurgling sounds over the epigastrium with each ventilation delivered D) Maintaining a pulse oximetry reading of 80 to 85 percent

gurgling sounds over the epigastrium with each ventilation delivered

70) The tip of the endotracheal tube for the pediatric patient should be inserted no more than ________ cm below the vocal cords. A) 1 to 2 B) 3 to 4 C) 2 to 3 D) 4 to 5

2-3

71) The respiratory rate may be greater than normal because of: A) alcoholic beverage ingestion. B) the use of medications such as diazepam or morphine. C) being asleep or nearly asleep. D) acidosis.

acidosis

72) In which of the following situations would you expect end-tidal carbon dioxide levels to be very low, despite a patent airway? A) Room air PPV B) Hyperthermia C) Hypoventilation D) Cardiac arrest

cardiac arrest

73) You are managing a 29-year-old male patient who was shot in the head. There is a gurgling noise in the airway. The patient is breathing spontaneously at 42 breaths per minute and has a heart rate of 110 and a systolic and diastolic pressure of 102/82. What airway intervention should be performed first on this patient? A) Head-tilt/chin-lift maneuver B) Suctioning the airway C) Insertion of an oropharyngeal airway D) Endotracheal intubation

suctioning the airway

74) You are managing a 29-year-old male patient who was shot in the head. There is a gurgling noise in the airway. The patient is breathing spontaneously at 42 breaths per minute and has a heart rate of 110 and a systolic and diastolic pressure of 102/82. The correct rate of assisted ventilation for this patient is ________ breaths per minute. A) 6 B) 12 C) 14 D) 18

75) When intubating using a lighted stylet, you see a dim, indistinct light in the throat. You have MOST likely intubated the: A) esophagus. B) left mainstem bronchus. C) trachea. D) right mainstem bronchus.

esophagus

76) In which of the following instances might digital intubation NOT be indicated? A) The airway is blocked by a foreign body. B) The patient has copious secretions. C) Your equipment fails. D) Patient position does not allow for visualization.

the airway is blocked by a foreign body

77) When providing rescue breathing to an apneic patient using a pocket face mask, each breath should be delivered with ________ of air. A) 6-8 mL/kg B) 10 mL/kg C) 15 mL/kg D) 2-4 mL/kg

6-8 ml/kg

78) What is the MOST commonly aspirated material? A) Vomit B) Blood C) Pus D) Saliva

vomit

79) Which of the following statements regarding needle cricothyrotomy is FALSE? A) Upon removal of the needle, the secured catheter allows for direct tracheal suctioning. B) High pressure during jet ventilation may cause a pneumothorax. C) Perforation of the esophagus may occur if the needle is advanced too far. D) It is the least invasive of the surgical procedures and can be initiated quickly.

upon removal of the needle, the secured catheter allows for direct tracheal suctioning

80) Chemoreceptors could be stimulated when which one of the following chemical imbalances occurs? A) Decreased pH B) Increased bicarbonate C) Decreased renin D) Increased nitrogen

decreased pH

81) Advantages of a nasopharyngeal airway include all of the following, EXCEPT: A) it isolates the trachea. B) it can be suctioned through. C) it can be inserted with an intact gag reflex. D) it can be placed blindly and safely.

it isolates the trachea

82) One disadvantage of the oropharyngeal airway is: A) it doesn't prevent aspiration. B) air can pass around it. C) it can be used as a bite block. D) it can be sized to the patient.

it doesn't prevent aspiration

83) All of the following are disadvantages of the LMA-Fastrach, EXCEPT: A) it can facilitate blind endotracheal intubation. B) its inability to decompress the stomach. C) its absence of sizes for patients less than 30 kg. D) its temperamental positioning.

it can facilitate blind tracheal intubation

84) The amount of gas moved in and out of the respiratory tract in one minute is termed: A) minute volume. B) alveolar volume. C) tidal volume. D) residual volume.

minute volume

85) A slow, deep, involuntary inspiration followed by a prolonged expiration that hyperinflates the lungs and re-expands atelectatic alveoli is a: A) sigh. B) hiccough. C) grunt. D) sneeze.

sigh

86) One way to improve airway management and ventilation is to make sure that: A) the ear-to-sternal notch axis is aligned. B) the BVM is squeezed as fully as possible. C) oxygen is not administered to COPD patients. D) a patient is never put in the "ramped" position.

the ear to sternal notch axis is aligned

87) Which of the following devices can be used as a simple mechanical airway adjunct in situations in which laryngoscopy is difficult and is similar to an oropharyngeal airway and also as a blind endotracheal tube introducer in situations in which laryngoscopy is difficult? A) S.A.L.T. B) LMA C) ETC D) NPA

S.A.L.T

88) Which of the following is NOT an absolute contraindication to rapid sequence airway (RSA)? A) Only one paramedic on scene B) Blunt or penetrating anterior neck trauma C) Upper airway tumor D) Caustic ingestion

only one paramedic on scene

89) The CORRECT sequence for intubating an apneic patient is: A) ventilation, positioning, visualization, tube placement, and verification of tracheal insertion. B) visualization, tube placement, positioning, verification of tracheal insertion, and ventilation. C) tube placement, visualization, positioning, verification of tracheal insertion, and ventilation. D) verification of tracheal insertion, tube placement, visualization, positioning, and ventilation.

ventilation, positioning, visualization, tube placement, and verification of tracheal insertion

90) When ventilating a patient via a nasal ET, what is one advantage this has over an orally placed ET? A) The tube cannot be bitten down on. B) There is a need for a laryngoscope. C) Gag stimulation occurs every time. D) Head and neck are extended into position.

the tube cannot be bitten down on

91) A technique for intubation by passing a wire through the cricothyroid membrane cephalad through a catheter is called ________ intubation. A) retrograde B) reverse C) recumbent D) rear tracheal

retrograde

92) What does the "L" in the LEMONS mnemonic stand for? A) Look externally B) Leave alone C) Laryngoscopy D) Loose dentures

look externally

93) Which of the following patients tends to have a decreased oxygen storage capacity? A) Pregnant woman B) Patient in shock C) Child D) Patient in pain

pregnant women

94) All of the following are indications for RSI, EXCEPT: A) predicted difficult airway. B) hypoxemia despite maximal therapy. C) combativeness secondary to presumed head trauma. D) impending or actual respiratory failure from any cause.

predicted difficult airway

95) What would be the approximate size ET tube to use for a toddler you intend to intubate? A) 4 B) 5 C) 3 D) 6

96) What does the "B" in BURP stand for? A) Backward B) Below C) Bloody D) Behind

backward

97) Which of the followng is not one of the Rule of Threes? A) three providers B) three bags C) three fingers D) three PEEP

three bags

98) Studies with video laryngoscopy demonstrate that it is superior to traditional direct laryngoscopy unless: A) the patient is not properly positioned. B) optical laryngoscopy has already been used. C) retrograde intubation is in effect. D) the pharynx is full of blood, emesis, or secretions.

the pharynx is full of blood, emesis or secretions

99) Which of these is NOT a step in performing field extubation? A) Advance the straight blade gently into the esophagus. B) Suction the patient’s oropharynx. C) Remove the ETT upon cough or expiration. D) Position patient on side if possible.

advance the straight blade directly into the esophagus

100) Gastric tubes may be gently placed in patients who have gastric or esophageal varices unless they have undergone a banding or cautery procedure within the past: A) month. B) week. C) six weeks. D) two weeks.

two weeks