Take This Airway Management Quiz
(249).jpg "Take This Airway Management Quiz")
Anesthetists need to ensure your breathing is adequate and safe once you are asleep. Oxygen needs to be provided and other gases eliminated from your lungs. Your breathing passages need to be protected from soiling from stomach contents during an anesthetic. Take up the quiz and test your knowledge on airway management.
- 1.What is most helpful to determine the need for intubation?
- A.
A. ABG
- B.
B. Clinical assessment
- C.
C. Lung auscultation
- D.
D. Pulse oximetry alone
- E.
E. Testing the gag reflex
- 2.A decision to intubate should be based on which essential criteria?
- A.
A. Failure to maintain or protect the airway.
- B.
B. Failure of ventilation or oxygenation.
- C.
C. Patient’s anticipated clinical course and likelihood of deterioration.
- D.
D. All of the above.
- 3.What is the “gold standard” for confirmation of endotracheal tube placement?
- A.
A. Aspiration technique
- B.
B. Chest and gastric auscultation
- C.
C. Chest x-ray
- D.
D. Fiberoptic scope can be passed through the endotracheal tube to identify tracheal rings
- E.
E. End-tidal carbon dioxide (CO2) color change
- 4.You can predict relatively easy intubation in a patient who:
- A.
A. has a receding mandible
- B.
B. has a short neck
- C.
C. has no teeth
- D.
D. has prominent upper incisors
- E.
E. is immobilized due to potential neck trauma
- 5.You can safely manage the airway in a patient with suspected cervical spine injury by using:
- A.
A. chin lift
- B.
B. direct tongue depression
- C.
C. head tilt
- D.
D. jaw thrust
- E.
E. none of the above
- 6.6. Difficulty with cricothyrotomy can be anticipated with all of the following EXCEPT:
- A.
A. prior neck surgery
- B.
B. hematoma, tumor, or abscess on the neck
- C.
C. scarring from radiation on the neck
- D.
D. obesity
- E.
E. Class III or Class IV Mallampati
- 7.7. All of the following indicate difficult extraglottic device (EGD) placement EXCEPT:
- A.
A. suspected cervical spine injury
- B.
B. restricted mouth opening
- C.
C. stiffness (resistance to ventilation)
- D.
D. obstruction or obesity
- E.
E. distorted anatomy
- 8.8. Identify the correct sequence:
- A.
A. Preparation, preoxygenation, pretreatment, paralysis with induction, placement of tube, positioning, postintubation management.
- B.
B. Preparation, preoxygenation, pretreatment, positioning, paralysis with induction, placement of tube, postintubation management.
- C.
C. Preparation, pretreatment, preoxygenation, paralysis with induction, placement of tube, postintubation management.
- D.
D. Preparation, preoxygenation, pretreatment, paralysis with induction, positioning, placement of tube, postintubation management
- E.
E. Preparation, pretreatment, preoxygenation, positioning, placement of tube, postintubation management.
- 9.9. Etomidate
- A.
A. phencyclidine derivative
- B.
B. increases intracranial pressure
- C.
C. causes hypotension
- D.
D. never causes myoclonus
- E.
E. induction dose is 0.3mg/kg IV.
- 10.10. All are true of Ketamine EXCEPT:
- A.
A. can increase intracranial pressure
- B.
B. bronchoconstrictor
- C.
C. can increase blood pressure
- D.
D. can cause an emergence phenomenon (frightening dreams)
- E.
E. 1-2mg/kg produces loss of awareness within 30 seconds, peaks in 1 minute, and lasts 10-15 minutes.
- 11.11. Which should be avoided when intubating a status asthmaticus?
- A.
A. Thiopental
- B.
B. Ketamine
- C.
C. Midazolam
- D.
D. Etomidate
- 12.12. Which of the following is correctly paired?
- A.
A. MOANS = mnemonic for difficult extraglottic device placement
- B.
B. RODS = mnemonic for difficult cricothyrotomy
- C.
C. LEMON = mnemonic for evaluation of difficult direct laryngoscopy
- D.
D. SHORT = mnemonic for difficult extraglottic device placement
- E.
E. HELP = mnemonic for difficult cricothyrotomy
- 13.13. Which of the following are true of succinycholine?
- A.
A. Succinylcholine is rapidly acting and can produce intubation conditions within 10 seconds of administration by rapid IV bolus.
- B.
B. The clinical duration of action of succinylcholine before spontaneous respirations occurs is 20 minutes.
- C.
C. Use of 0.5 mg/kg of succinylcholine results in both less fasiculations and less myalgias than occur with 1mg/kg.
- D.
D. Succinylcholine has been associated with masseter spasm and malignant hyperthermia.
- E.
E. Succinylcholine is contraindicated in renal failure, acute burns, strokes and spinal cord injuries because of its propensity to cause hyperkalemia.
- 14.14. Contraindications to nasotracheal intubation in a trauma patient include
- A.
A. cervical spine fracture
- B.
B. apnea
- C.
C. depressed mental status
- D.
D. hypotension
- E.
E. pneumothorax
- 15.15. Which statement concerning the adult failed airway is correct?
- A.
A. Airways such as the laryngeal mask airway and esophageal obturator airway are available in the event of a failed airway.
- B.
B. Awake intubation may be done by the nasotracheal route.
- C.
C. Care should be taken before intubation to assess the airway for ease of ventilation as well as intubation.
- D.
D. Cricothyrotomy is the crucial rescue procedure when intubation and ventilation fail.
- E.
E. All of the above are true.
- 16.16. Predicted difficulties during intubation with a fiberoptic bronchoscope include:
- A.
A. bleeding in the airway
- B.
B. cervical spine injury
- C.
C. epiglottitis
- D.
D. limited mouth opening
- E.
E. protuberant teeth
- 17.17. Contraindication to cricothyrotomy include:
- A.
A. acute airway obstruction
- B.
B. age younger than 10 years
- C.
C. apnea
- D.
D. inability to orotracheally or digitaly intubate
- E.
E. severe facial trauma
- 18.18. When using rapid sequence intubation to place an endotracheal tube, which of the following medication should be used for paralysis:
- A.
A. Etomidate
- B.
B. Ketamine
- C.
C. Propofol
- D.
D. Rocuronium
- E.
E. Thiopental
- 19.19. In an asthmatic patient who requires intubation:
- A.
A. Inspiratory to expiratory ration should be kept at 1:2, and 14 breaths/minute
- B.
B. Ketamine is the preferred paralytic agent
- C.
C. Nasotracheal intubation is preferred over orotracheal
- D.
D. Propofol can be used as a sedating agent
- E.
E. Tidal volume should be kept at 10mL/kg ideal body weight.
- 20.20. The advantages of noninvasive positive-pressure ventilation (NPPV) over endotracheal mechanical ventilation include:
- A.
A. Preservation of speech, swallowing, and physiologic airway defense mechanisms
- B.
B. Reduced risk of airway injury
- C.
C. Reduced risk of nosocomial infection
- D.
D. Decreased length of stay in, and reduced need for ICU admission.
- E.
E. All of the above
- 21.21. Contraindications to noninvasive-pressure ventilation (NPPV) include all of the following EXCEPT:
- A.
A. severely impaired level of consciousness
- B.
B. uncontrolled vomiting
- C.
C. acute MI
- D.
D. copious secretions
- E.
E. pneumonia
- 22.22. Which of the following is correct about initial settings and ongoing monitoring:
- A.
A. Tachycardia and hypertension can indicate ventilatory intolerance and a need for increased sedation or adjustment of ventilatory settings.
- B.
B. Recommended initial settings for BiPAP ventilators are IPAP 100 % and EPAP of 50%.
- C.
C. Reasonable initial ventilatory settings are a TV of 12ml/kg body mass and a rate of 16 breaths/minute.
- D.
D. PEEP should be initiated at 15cm H2O
- E.
E. Bradycardia and ventricular irritability represents oxygen toxicity.
- 23.23. Invasive blood pressure monitoring via an arterial catheter should be considered in the following EXCEPT:
- A.
A. Patients requiring continuous BP monitoring (sodium nitroprusside)
- B.
B. Patients with impending shock states
- C.
C. Patients with anatomic abnormalities
- D.
D. Normotensive patients
- E.
E. Patients who require frequent arterial samplings
- 24.24. Which of the following statements are about colorimetric readings are true:
- A.
A. A purple color is associated with CO2 less than 4mm Hg.
- B.
B. A yellow color is associated with CO2 greater than 20mm Hg.
- C.
C. Purple color generally indicates esophageal intubation.
- D.
D. Ambient CO2 levels in the esophagus are less than 4mm Hg
- E.
E. All of the above are true.
- 25.25. In ED studies, overall intubation failure rates are:
- A.
A. 15%
- B.
B. 10%
- C.
C. 5%
- D.
D. less than 3%
- E.
E. 0 %
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