Airway Management MCQs Quiz With Answers

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Airway Management MCQs Quiz With Answers - Quiz

How much do you know about airway management? We have this "Airway management MCQs quiz" to test your knowledge. 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 of airway management.


Questions and Answers
  • 1. 

    What is most helpful to determine the need for intubation?

    • A.

      ABG

    • B.

      Clinical assessment

    • C.

      Lung auscultation

    • D.

      Pulse oximetry alone

    • E.

      Testing the gag reflex

    Correct Answer
    B. Clinical assessment
    Explanation
    Clinical assessment is the most helpful in determining the need for intubation. This is because clinical assessment involves evaluating the patient's overall condition, including their respiratory effort, mental status, oxygenation, and airway patency. It allows healthcare providers to assess the severity of respiratory distress and determine if intubation is necessary to maintain adequate oxygenation and ventilation. Other options such as ABG, lung auscultation, pulse oximetry, and testing the gag reflex may provide additional information, but clinical assessment encompasses a comprehensive evaluation of the patient's condition.

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  • 2. 

    A decision to intubate should be based on which essential criteria?

    • A.

      Failure to maintain or protect the airway.

    • B.

      Failure of ventilation or oxygenation.

    • C.

      Patient’s anticipated clinical course and likelihood of deterioration.

    • D.

      All of the above.

    Correct Answer
    D. All of the above.
    Explanation
    The decision to intubate should be based on several essential criteria, including failure to maintain or protect the airway, failure of ventilation or oxygenation, and the patient's anticipated clinical course and likelihood of deterioration. These criteria are crucial in determining whether intubation is necessary to ensure the patient's airway is secure and adequate oxygenation and ventilation are maintained. Therefore, the correct answer is "All of the above."

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  • 3. 

    What is the “gold standard” for confirmation of endotracheal tube placement?

    • A.

      Aspiration technique

    • B.

      Chest and gastric auscultation

    • C.

      Chest x-ray

    • D.

      Fiberoptic scope can be passed through the endotracheal tube to identify tracheal rings

    • E.

      End-tidal carbon dioxide (CO2) color change

    Correct Answer
    D. Fiberoptic scope can be passed through the endotracheal tube to identify tracheal rings
    Explanation
    The gold standard for confirmation of endotracheal tube placement is using a fiberoptic scope to pass through the tube and identify tracheal rings. This method allows for direct visualization of the trachea and provides a reliable confirmation of correct placement. Chest and gastric auscultation, chest x-ray, and end-tidal carbon dioxide (CO2) color change are other methods commonly used, but they may not always provide definitive confirmation.

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  • 4. 

    You can predict relatively easy intubation in a patient who:

    • A.

      Has a receding mandible

    • B.

      Has a short neck

    • C.

      Has no teeth

    • D.

      Has prominent upper incisors

    • E.

      Is immobilized due to potential neck trauma

    Correct Answer
    C. Has no teeth
    Explanation
    Patients who have no teeth have a higher likelihood of easy intubation because the absence of teeth allows for better visualization and access to the airway. Teeth can obstruct the view and make it difficult to insert the endotracheal tube. Therefore, in patients without teeth, intubation can be performed more easily and with less risk of complications.

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  • 5. 

    You can safely manage the airway in a patient with suspected cervical spine injury by using:

    • A.

      Chin lift

    • B.

      Direct tongue depression

    • C.

      Head tilt

    • D.

      Jaw thrust

    • E.

      None of the above

    Correct Answer
    D. Jaw thrust
    Explanation
    The jaw thrust maneuver is the safest way to manage the airway in a patient with suspected cervical spine injury. This technique involves placing the fingers behind the angle of the jaw and lifting the jaw forward, which helps to open the airway without flexing or extending the neck. By using the jaw thrust maneuver, the healthcare provider can maintain proper alignment of the cervical spine and minimize the risk of further injury. The other options mentioned, such as chin lift, direct tongue depression, and head tilt, may potentially cause movement or manipulation of the cervical spine, which could worsen the injury.

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  • 6. 

    Difficulty with cricothyrotomy can be anticipated with all of the following EXCEPT:

    • A.

      Prior neck surgery

    • B.

      Hematoma, tumor, or abscess on the neck

    • C.

      Scarring from radiation on the neck

    • D.

      Obesity

    • E.

      Class III or Class IV Mallampati

    Correct Answer
    E. Class III or Class IV Mallampati
    Explanation
    Difficulty with cricothyrotomy can be anticipated with all of the following except Class III or Class IV Mallampati. Mallampati classification is a method used to assess the ease of intubation based on the visibility of the patient's tonsils and uvula. Class III or Class IV Mallampati indicates a difficult airway, which can make cricothyrotomy more challenging. Prior neck surgery, hematoma, tumor, or abscess on the neck, scarring from radiation on the neck, and obesity can all contribute to anatomical difficulties during cricothyrotomy.

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  • 7. 

    All of the following indicate difficult extra-glottic device (EGD) placement EXCEPT:

    • A.

      Suspected cervical spine injury

    • B.

      Restricted mouth opening

    • C.

      Stiffness (resistance to ventilation)

    • D.

      Obstruction or obesity

    • E.

      Distorted anatomy

    Correct Answer
    A. Suspected cervical spine injury
    Explanation
    Suspected cervical spine injury is not a factor that indicates difficult extra-glottic device (EGD) placement. Difficult EGD placement can be influenced by factors such as restricted mouth opening, stiffness (resistance to ventilation), obstruction or obesity, and distorted anatomy. However, a suspected cervical spine injury does not directly affect the placement of an EGD.

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  • 8. 

    Identify the correct sequence:

    • A.

      Preparation, preoxygenation, pretreatment, paralysis with induction, placement of tube, positioning, postintubation management.

    • B.

      Preparation, preoxygenation, pretreatment, positioning, paralysis with induction, placement of tube, postintubation management.

    • C.

      Preparation, pretreatment, preoxygenation, paralysis with induction, placement of tube, postintubation management.

    • D.

      Preparation, preoxygenation, pretreatment, paralysis with induction, positioning, placement of tube, postintubation management

    • E.

      Preparation, pretreatment, preoxygenation, positioning, placement of tube, postintubation management.

    Correct Answer
    C. Preparation, pretreatment, preoxygenation, paralysis with induction, placement of tube, postintubation management.
    Explanation
    In the context of airway management, the correct sequence involves preparation, preoxygenation to maximize oxygen reserves, pretreatment to mitigate potential complications, inducing paralysis for safe intubation, placing the endotracheal tube, and managing the patient post-intubation to ensure optimal recovery and stabilization of airway and breathing functions.

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  • 9. 

    Etomidate

    • A.

      Phencyclidine derivative

    • B.

      Increases intracranial pressure

    • C.

      Causes hypotension

    • D.

      Never causes myoclonus

    • E.

      Induction dose is 0.3mg/kg IV.

    Correct Answer
    E. Induction dose is 0.3mg/kg IV.
    Explanation
    Etomidate is a medication used for induction of anesthesia. The correct answer states that the induction dose of etomidate is 0.3mg/kg IV. This means that when administering etomidate for anesthesia induction, the recommended dose is 0.3 milligrams per kilogram of the patient's body weight, given intravenously. This information is important for healthcare professionals who are responsible for administering anesthesia and need to ensure that the correct dose of etomidate is given to achieve the desired effect.

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  • 10. 

    10.  All are true of Ketamine EXCEPT:

    • A.

      Can increase intracranial pressure

    • B.

      Bronchoconstrictor

    • C.

      Can increase blood pressure

    • D.

      Can cause an emergence phenomenon (frightening dreams)

    • E.

      1-2mg/kg produces loss of awareness within 30 seconds, peaks in 1 minute, and lasts 10-15 minutes.

    Correct Answer
    B. Bronchoconstrictor
    Explanation
    Ketamine is a dissociative anesthetic that is commonly used for induction and maintenance of anesthesia. It is known to have bronchodilator properties, meaning it relaxes the smooth muscles of the airways and helps to open up the bronchial tubes. This makes it a useful option for patients with asthma or other respiratory conditions. Therefore, the statement that ketamine is a bronchoconstrictor is incorrect.

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  • 11. 

    Which should be avoided when intubating a status asthmaticus?

    • A.

      Thiopental

    • B.

      Ketamine

    • C.

      Midazolam

    • D.

      Etomidate

    Correct Answer
    A. Thiopental
    Explanation
    Thiopental should be avoided when intubating a status asthmaticus because it is a barbiturate that can cause respiratory depression. In status asthmaticus, the patient already has compromised lung function and any further respiratory depression can worsen their condition. Therefore, it is important to avoid medications that can further suppress the respiratory drive, such as thiopental.

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  • 12. 

    Which of the following is correctly paired?

    • A.

      MOANS = mnemonic for difficult extra-glottic device placement

    • B.

      RODS = mnemonic for difficult cricothyrotomy

    • C.

      LEMON = mnemonic for evaluation of difficult direct laryngoscopy

    • D.

      SHORT = mnemonic for difficult extra-glottic device placement

    • E.

      HELP = mnemonic for difficult cricothyrotomy

    Correct Answer
    C. LEMON = mnemonic for evaluation of difficult direct laryngoscopy
    Explanation
    LEMON is correctly paired with the mnemonic for evaluation of difficult direct laryngoscopy. The LEMON acronym stands for Look externally, Evaluate 3-3-2 rule, Mallampati score, Obstruction, and Neck mobility. It is a systematic approach used to assess the factors that may contribute to difficult direct laryngoscopy. This mnemonic helps healthcare professionals evaluate the patient's airway before attempting laryngoscopy, allowing them to anticipate and manage potential difficulties during the procedure.

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  • 13. 

    Which of the following are true of succinycholine?

    • A.

      Succinylcholine is rapidly acting and can produce intubation conditions within 10 seconds of administration by rapid IV bolus.

    • B.

      The clinical duration of action of succinylcholine before spontaneous respirations occurs is 20 minutes.

    • C.

      Use of 0.5 mg/kg of succinylcholine results in both less fasiculations and less myalgias than occur with 1mg/kg.

    • D.

      Succinylcholine has been associated with masseter spasm and malignant hyperthermia.

    • E.

      Succinylcholine is contraindicated in renal failure, acute burns, strokes and spinal cord injuries because of its propensity to cause hyperkalemia.

    Correct Answer
    D. Succinylcholine has been associated with masseter spasm and malignant hyperthermia.
    Explanation
    Succinylcholine has been associated with masseter spasm and malignant hyperthermia. This means that the use of succinylcholine can lead to involuntary contraction of the masseter muscle, causing difficulty in opening the mouth. It is also associated with a rare but potentially life-threatening condition called malignant hyperthermia, which is characterized by a rapid rise in body temperature and severe muscle contractions. These adverse effects of succinylcholine are important considerations when using this medication in clinical practice.

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  • 14. 

    Contraindications to nasotracheal intubation in a trauma patient include

    • A.

      Cervical spine fracture

    • B.

      Apnea

    • C.

      Depressed mental status

    • D.

      Hypotension

    • E.

      Pneumothorax

    Correct Answer
    B. Apnea
    Explanation
    Apnea is a contraindication to nasotracheal intubation in a trauma patient because during the procedure, the patient's airway is temporarily blocked, and if the patient is already experiencing apnea (the absence of breathing), this can lead to a further decrease in oxygen levels and potentially worsen their condition. It is important to ensure that the patient has a stable respiratory status before attempting nasotracheal intubation to prevent any complications.

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  • 15. 

    Which statement concerning the adult failed airway is correct?

    • A.

      Airways such as the laryngeal mask airway and esophageal obturator airway are available in the event of a failed airway.

    • B.

      Awake intubation may be done by the nasotracheal route.

    • C.

      Care should be taken before intubation to assess the airway for ease of ventilation as well as intubation.

    • D.

      Cricothyrotomy is the crucial rescue procedure when intubation and ventilation fail.

    • E.

      All of the above are true.

    Correct Answer
    E. All of the above are true.
    Explanation
    The correct answer is "All of the above are true." This means that all of the statements mentioned in the question are correct. Airways such as the laryngeal mask airway and esophageal obturator airway are indeed available in the event of a failed airway. Awake intubation can be done by the nasotracheal route. Before intubation, it is important to assess the airway for ease of ventilation as well as intubation. In cases where intubation and ventilation fail, cricothyrotomy is considered the crucial rescue procedure.

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  • 16. 

    Predicted difficulties during intubation with a fiberoptic bronchoscope include:

    • A.

      Bleeding in the airway

    • B.

      Cervical spine injury

    • C.

      Epiglottitis

    • D.

      Limited mouth opening

    • E.

      Protuberant teeth

    Correct Answer
    A. Bleeding in the airway
    Explanation
    During intubation with a fiberoptic bronchoscope, bleeding in the airway can be a predicted difficulty. This is because the insertion of the bronchoscope into the airway can cause trauma to the delicate tissues, leading to bleeding. This can obstruct the view and make it challenging to navigate the bronchoscope properly. Additionally, excessive bleeding can also compromise the patient's oxygenation and ventilation, further complicating the intubation process. Therefore, it is important for the healthcare provider to be prepared for this potential difficulty and have appropriate measures in place to manage bleeding if it occurs.

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  • 17. 

    Contraindication to cricothyrotomy include:

    • A.

      Acute airway obstruction

    • B.

      Age younger than 10 years

    • C.

      Apnea

    • D.

      Inability to orotracheally or digitally intubate

    • E.

      Severe facial trauma

    Correct Answer
    B. Age younger than 10 years
    Explanation
    Cricothyrotomy is a procedure used to establish a temporary airway in cases of severe airway obstruction. It involves making an incision in the cricothyroid membrane to access the airway. However, performing cricothyrotomy in children younger than 10 years old is not recommended due to anatomical differences in the airway. The cricothyroid membrane in younger children is smaller and more difficult to access, making the procedure riskier and potentially ineffective. Therefore, age younger than 10 years is a contraindication to cricothyrotomy.

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  • 18. 

    When using rapid sequence intubation to place an endotracheal tube, which of the following medication should be used for paralysis:

    • A.

      Etomidate

    • B.

      Ketamine

    • C.

      Propofol

    • D.

      Rocuronium

    • E.

      Thiopental

    Correct Answer
    D. Rocuronium
    Explanation
    Rocuronium should be used for paralysis during rapid sequence intubation. Rocuronium is a non-depolarizing neuromuscular blocking agent that causes skeletal muscle relaxation and paralysis. It is commonly used in emergency intubation because it has a rapid onset of action and a relatively short duration of effect. This allows for quick and effective intubation while minimizing the risk of complications. Etomidate, ketamine, propofol, and thiopental are all sedative agents used for induction of anesthesia, but they do not provide paralysis.

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  • 19. 

    In an asthmatic patient who requires intubation:

    • A.

      Inspiratory to expiratory ration should be kept at 1:2, and 14 breaths/minute

    • B.

      Ketamine is the preferred paralytic agent

    • C.

      Nasotracheal intubation is preferred over orotracheal

    • D.

      Propofol can be used as a sedating agent

    • E.

      Tidal volume should be kept at 10mL/kg ideal body weight.

    Correct Answer
    D. Propofol can be used as a sedating agent
    Explanation
    Propofol can be used as a sedating agent in an asthmatic patient who requires intubation. This is because propofol is a short-acting sedative-hypnotic agent that provides rapid onset and offset of sedation, allowing for better control of the patient's airway. It has bronchodilatory properties and does not cause histamine release, making it a suitable choice for asthmatic patients. Additionally, propofol has antiemetic effects, which can be beneficial in preventing aspiration during intubation.

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  • 20. 

    The advantages of noninvasive positive-pressure ventilation (NPPV) over endotracheal mechanical ventilation  include:

    • A.

      Preservation of speech, swallowing, and physiologic airway defense mechanisms

    • B.

      Reduced risk of airway injury

    • C.

      Reduced risk of nosocomial infection

    • D.

      Decreased length of stay in, and reduced need for ICU admission.

    • E.

      All of the above

    Correct Answer
    E. All of the above
    Explanation
    Noninvasive positive-pressure ventilation (NPPV) offers several advantages over endotracheal mechanical ventilation. Firstly, it allows for the preservation of speech, swallowing, and physiologic airway defense mechanisms, which are important for patient comfort and recovery. Secondly, NPPV reduces the risk of airway injury compared to invasive methods. Thirdly, it also decreases the risk of nosocomial infections, which are common in ICU settings. Lastly, NPPV has been shown to decrease the length of stay in the hospital and reduce the need for ICU admission, potentially improving patient outcomes and reducing healthcare costs. Therefore, all of the above advantages are associated with NPPV.

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  • 21. 

    Contraindications to noninvasive-pressure ventilation (NPPV) include all of the following EXCEPT:

    • A.

      Severely impaired level of consciousness

    • B.

      Uncontrolled vomiting

    • C.

      Acute MI

    • D.

      Copious secretions

    • E.

      Pneumonia

    Correct Answer
    E. Pneumonia
    Explanation
    Contraindications to noninvasive-pressure ventilation (NPPV) include severely impaired level of consciousness, uncontrolled vomiting, acute MI, and copious secretions. Pneumonia, on the other hand, is not a contraindication to NPPV. This means that NPPV can still be used in patients with pneumonia as a treatment option.

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  • 22. 

    Which of the following is correct about initial settings and ongoing monitoring:

    • A.

      Tachycardia and hypertension can indicate ventilatory intolerance and a need for increased sedation or adjustment of ventilatory settings.

    • B.

      Recommended initial settings for BiPAP ventilators are IPAP 100 % and EPAP of 50%.

    • C.

      Reasonable initial ventilatory settings are a TV of 12ml/kg body mass and a rate of 16 breaths/minute.

    • D.

      PEEP should be initiated at 15cm H2O

    • E.

      Bradycardia and ventricular irritability represents oxygen toxicity.

    Correct Answer
    A. Tachycardia and hypertension can indicate ventilatory intolerance and a need for increased sedation or adjustment of ventilatory settings.
    Explanation
    Tachycardia and hypertension can indicate that the patient is not tolerating the ventilator settings and may need more sedation or adjustment of the ventilatory settings. This means that the patient's heart rate and blood pressure are elevated, which could be a sign of distress or discomfort caused by the ventilator. Increasing sedation or adjusting the ventilatory settings can help alleviate these symptoms and improve the patient's comfort and tolerance to the ventilator.

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  • 23. 

    Invasive blood pressure monitoring via an arterial catheter should be considered in the following EXCEPT:

    • A.

      Patients requiring continuous BP monitoring (sodium nitroprusside)

    • B.

      Patients with impending shock states

    • C.

      Patients with anatomic abnormalities

    • D.

      Normotensive patients

    • E.

      Patients who require frequent arterial samplings

    Correct Answer
    D. Normotensive patients
    Explanation
    Invasive blood pressure monitoring via an arterial catheter should be considered in patients requiring continuous BP monitoring (sodium nitroprusside), patients with impending shock states, patients with anatomic abnormalities, and patients who require frequent arterial samplings. However, normotensive patients do not typically require invasive blood pressure monitoring as their blood pressure is within the normal range.

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  • 24. 

    Which of the following statements are about colorimetric readings are true:

    • A.

      A purple color is associated with CO2 less than 4mm Hg.

    • B.

      A yellow color is associated with CO2 greater than 20mm Hg.

    • C.

      Purple color generally indicates esophageal intubation.

    • D.

      Ambient CO2 levels in the esophagus are less than 4mm Hg

    • E.

      All of the above are true.

    Correct Answer
    E. All of the above are true.
    Explanation
    The given correct answer states that all of the statements about colorimetric readings are true. This means that a purple color is indeed associated with CO2 levels less than 4mm Hg, a yellow color is associated with CO2 levels greater than 20mm Hg, and a purple color generally indicates esophageal intubation. Additionally, it is true that ambient CO2 levels in the esophagus are less than 4mm Hg. Therefore, all of the given statements are accurate.

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  • 25. 

    In ED studies, overall intubation failure rates are:

    • A.

      15%

    • B.

      10%

    • C.

      5%

    • D.

      Less than 3%

    • E.

      0 %

    Correct Answer
    D. Less than 3%
    Explanation
    The correct answer is "Less than 3%". In ED studies, the overall intubation failure rates are reported to be less than 3%. This means that out of all the intubation procedures performed in the emergency department, less than 3% of them result in failure. This low failure rate indicates that the majority of intubations in the ED are successful and highlights the proficiency of the medical staff in performing this procedure.

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  • Current Version
  • Mar 26, 2024
    Quiz Edited by
    ProProfs Editorial Team
  • May 08, 2011
    Quiz Created by
    Educomtg

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