Airway FISDAP Questions & Answers, Exams of Nursing

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Airway Management: FISDAP

Questions and Answers

Airway FISDAP Questions & Answers

1. Which patient would be classified as 'immediate' during

an MCI?

An 8-year-old female with no respirations after 5 positive pressure ventilations would be classified as 'immediate' during a Mass Casualty Incident (MCI). This patient requires immediate intervention to restore breathing and oxygenation.

2. A 13-year-old female watching a horror movie states she

can't catch her breath and her fingers are numb.

Respirations are 30 and deep with SpO2 of 100%. She is

speaking in clear sentences, has clear and equal breath

sounds.

You should calmly reassure her, encouraging her to slow her rate of breathing. This patient is experiencing a panic attack, and the appropriate intervention is to help her calm down and regulate her breathing.

3. You have inserted an OPA for a 21-year-old apneic male.

How many times per minute should you ventilate him with

a BVM?

You should ventilate the patient 10 to 12 times per minute with a bag-valve mask (BVM).

4. Proper technique to suction a patient's airway includes:

Oxygenating and ventilating the patient before and after suctioning.

5. When ventilating a patient with a BVM, what is the

appropriate oxygen flow rate?

The appropriate oxygen flow rate when ventilating a patient with a BVM is 15 liters per minute.

6. An obese man complains of severe difficulty breathing.

His skin is cool and moist, and he is breathing 22 times per

minute. He indicates he never goes to the doctor and often

feels dizzy after walking.

You should apply a non-rebreather mask at 10 liters per minute. This patient is likely experiencing respiratory distress, and the high-flow oxygen will help improve his oxygenation.

7. A 42-year-old asthmatic patient complains of chest pain,

shortness of breath, and a violent cough that produces

brownish sputum.

The most likely cause is pneumonia. Asthmatic patients are more susceptible to developing pneumonia, and the symptoms described are consistent with a lower respiratory infection.

8. An 89-year-old patient complains of difficulty breathing

and a productive cough that has gotten worse over the past

12 hours.

You should suspect pneumonia. Older adults are at a higher risk of developing pneumonia, and the worsening symptoms over time are indicative of a lower respiratory infection.

9. As the diaphragm and intercostal muscles relax, the

chest cavity:

Decreases in size, causing exhalation. Relaxation of the respiratory muscles leads to a decrease in the size of the chest cavity, resulting in the passive process of exhalation.

10. During the initial assessment of an adult's respiratory

status, you should:

Evaluate both the respiratory rate and the rise and fall of the chest. Assessing both the rate and the depth of breathing provides a comprehensive evaluation of the patient's respiratory status.

11. In which group of patients are you likely to encounter

'see-saw' breathing?

Pediatrics. 'See-saw' breathing, characterized by paradoxical movement of the abdomen and chest, is more commonly observed in pediatric patients.

12. Which sequence correctly traces the path oxygen takes

from the atmosphere to the lungs?

Mouth, Pharynx, Trachea, Bronchi, Alveoli.

13. A 16-year-old asthmatic female in a tripod position

complains of increased shortness of breath. SpO2 is 79%.

You should administer oxygen at 10 liters per minute via a non-rebreather mask. The low oxygen saturation and the patient's distress indicate the need for high-flow supplemental oxygen.

14. A 34-year-old man is saying he is choking, and you note

stridor and hoarseness in his voice.

You should encourage him to cough. Coughing can help dislodge a foreign object or clear the airway in a partial obstruction.

15. An unresponsive trauma patient is gurgling. When you

suction the oropharynx with a rigid catheter, the patient

gags.

You should assess the insertion depth of the catheter. Gagging indicates the catheter may be too deep and stimulating the gag reflex, which could further compromise the airway.

16. A thin 54-year-old male with a nonproductive cough

complains of difficulty breathing. Sitting upright with

hands on his knees, you see retractions. You notice oxygen

tubing around the house.

You should suspect a medical history of chronic bronchitis. The patient's symptoms, posture, and the presence of supplemental oxygen at home suggest a chronic respiratory condition like chronic bronchitis.

17. A semiconscious patient's dentures are completely

loosened.

You should remove the dentures.

18. Carbon dioxide and oxygen exchange at the alveolar

level by which process?

Diffusion. The exchange of gases, including oxygen and carbon dioxide, occurs through the process of diffusion at the alveolar-capillary interface.

19. A 20-year-old female is unable to catch her breath after

a minor car crash, with numbness and tingling to her

hands and face. Vitals are P 118, R 24.

You should provide high-flow oxygen with a non-rebreather mask. The patient's symptoms and vital signs suggest respiratory distress, and high- flow oxygen is the appropriate intervention.

20. Which term best describes respiratory difficulty?

Dyspnea. Dyspnea is the medical term used to describe difficulty or discomfort in breathing.

21. What is the amount of air that normally reaches the

alveoli in an adult?

The average adult ventilation is 500 mL, but there is an area of dead space that traps 150 mL of air. Therefore, 350 mL of air effectively reaches the alveoli for oxygen and carbon dioxide exchange.

22. A 77-year-old female has dyspnea, speaks in short word

bursts, and breathes with pursed lips. Lung sounds are

diminished, distant, and clear. Vital signs are BP 152/90, P

86 and irregular, R 23.

The patient likely has emphysema. Emphysema is a chronic destructive process of the alveoli, leading to scar tissue that inhibits gas exchange. The patient's pursed-lip breathing is an attempt to keep the alveoli open and improve ventilation.

23. An 18-year-old male is cyanotic and complains of sharp

chest pain and difficulty breathing after lifting weights.

Vital signs are BP 110/66, P 88, R 22.

The most likely cause is a spontaneous pneumothorax. Strenuous activities can, on occasion, cause a collapsed lung (spontaneous pneumothorax). The patient's stable vital signs suggest a spontaneous pneumothorax rather than a tension pneumothorax.

24. An unresponsive 43-year-old male is cool, pale,

diaphoretic, and breathing 6 times a minute.

You should use a bag-valve mask to administer oxygen. The patient is unresponsive and breathing too slowly, indicating the need for assisted ventilations, which can be provided effectively with a bag-valve mask.

25. A 42-year-old male complains of shortness of breath

after being sprayed with super-heated steam. He has burns

to his face, neck, and upper chest. Vital signs are BP

112/66, P 124, R 28, shallow and labored.

You should assist his ventilations. The patient is in respiratory failure due to the burns, and positive pressure ventilations will help reduce any pulmonary edema from the lower airway burns.

26. What are the structures that branch off the trachea

into the lower airway?

The bronchi. The trachea splits at the carina into the left and right bronchi, which then continue to branch into smaller bronchioles and ultimately reach the alveoli.

27. What is the term for high-pitched whistling sounds

heard during expiration?

Wheezing. Wheezing is a high-pitched whistling sound heard on exhalation, suggesting a lower airway obstruction or constriction.

28. The use of accessory muscles and nasal flaring are

signs of what type of breathing?

Labored. The use of accessory muscles and nasal flaring are signs of respiratory distress or failure, as the body attempts to increase the size of the airway and draw in more air with each breath.

29. What is the term for abnormal breath sounds that

result from an obstructed airway?

Stridor. Stridor is an upper airway obstruction caused by tissue swelling around the trachea, larynx, or epiglottis, resulting in a high-pitched sound during inspiration.

30. A 53-year-old male is sleepy, diaphoretic, difficult to

arouse, and breathing 8 times per minute.

You should suspect respiratory failure. A respiratory rate of 8 breaths per minute is too slow for adequate gas exchange, and the patient's altered mental status indicates respiratory failure.

31. An alert 32-year-old female complains of difficulty

breathing. She speaks in 2-3 word sentences and has an

oxygen saturation of 92%.

You should apply high-flow oxygen. The patient is alert and her respirations are still effective, so the priority is to improve her oxygenation with high- flow oxygen.

32. A 56-year-old female has a complete airway obstruction

from a piece of food. She becomes unconscious while you

assess her.

When a patient has a completely obstructed airway and becomes unconscious, the first thing you should do is start chest compressions.

33. A male complains of mild respiratory distress. He

smokes 4 packs of cigarettes a day and reports a consistent

cough and frequent respiratory infections. Chest sounds

reveal bilateral rhonchi.

You should suspect chronic bronchitis. The patient's history of heavy smoking, persistent cough, and the presence of rhonchi (sounds like snoring) suggest chronic bronchitis.

34. A febrile 44-year-old male complains of shortness of

breath and has dull chest pain. He has been coughing up

'rusty' sputum for the last three days.

The most likely cause is pneumonia. The patient's fever, chest pain, and the production of 'rusty' sputum are indicative of a lower respiratory infection, specifically pneumonia.

35. A 75-year-old female complains of a sudden onset of

right-sided chest pain and dyspnea. She is recovering from

a recent hip surgery.

You should expect a pulmonary embolism. The patient's recent immobilization due to hip surgery increases the risk of a deep vein thrombosis, which can lead to a pulmonary embolism and the sudden onset of unilateral chest pain and shortness of breath.

36. How should you insert a nasopharyngeal airway?

The first step is to face the bevel towards the septum. Apply a water-soluble lubricant, but do not use an oil-based lubricant.

37. What is the name of the hollow, semi-flexible tube that

carries inhaled air from the larynx to the lungs?

The trachea. The trachea is the tube-like structure that allows air passage from the upper airway into the lungs.

38. What is the most common location for an airway

obstruction?

The pharynx. The pharynx is a shared passage for both air and food, making it a common site for partial or complete airway obstruction.

39. What part of the respiratory system contains the vocal

cords?

The larynx. The larynx, also known as the voice box, is the structure that contains the vocal cords.

40. What is directly posterior to the nose?

The nasopharynx. The nasopharynx connects the opening of the nostrils to the soft palate at the back of the mouth, and it is designed to warm and filter the incoming air.

41. What ring-shaped structure forms the lower portion of

the larynx?

The cricoid cartilage. The cricoid cartilage is the inferior, cartilaginous ring that forms the lower portion of the larynx.

42. Where is Sellick's Maneuver applied?

Sellick's Maneuver, also called cricoid pressure, is applied to the cricoid cartilage. This maneuver helps prevent gas from entering the stomach during assisted ventilations.

43. What happens to your diaphragm during inhalation?

The diaphragm contracts in a downward motion, drawing air into the lungs.

44. What is the name of the passageway shared by the

digestive tract and the respiratory systems for air and

food?

The pharynx, also known as the throat, is the passageway shared by the digestive and respiratory systems for air and food.

45. What is the name of the upper portion of the pharynx?

The oropharynx.

46. How many lobes are in the lungs?

The lungs have a total of 5 lobes, with 3 lobes on the right and 2 lobes on the left.

47. What is the name of the passageway shared by the

digestive tract and the respiratory systems for air and

food?

The pharynx is the passageway shared by the digestive tract and the respiratory system for air and food.

Airway Management and Respiratory

Conditions

Airway Obstruction and Respiratory Distress

Foreign Body Obstruction : If a 48.56-year-old female is struggling to breathe with wheezing, the first step is to check the airway for any foreign body obstructions.

Phrenic Nerve : The phrenic nerve primarily controls respiration.

Snoring Respirations : If an unresponsive 16-year-old male has snoring respirations after diving in a pond and nearly drowning, you should perform chest compressions.

Upper Airway Obstruction : Stridor is an indication of an upper airway obstruction.

Lower Airway Obstruction : Wheezing is the sound of a lower airway obstruction.

Apneic Patient with Pulse : If an adult is breathing at a rate of 6 breaths per minute, you should ventilate the patient using a bag-valve mask.

Obstructive Pulmonary Disease : Prescribed inhalers are helpful for patients with an obstructive pulmonary disease because they activate beta-2 receptors.

Apneic Patient without Pulse : If a 50-year-old is not breathing and has a faint pulse, you should use a bag-valve mask to ventilate the patient.

COPD Patient and Inhaler : Before assisting a patient with COPD in self-administering their inhaler, you should shake the inhaler vigorously.

Ventilation Rate for Apneic Patient : You should ventilate an apneic patient with a pulse at a rate of 5-6 breaths per minute.

Respiratory Conditions and Interventions

Mucus Secretions : If a 14-year-old female is short of breath and lung sounds reveal coarse rhonchi, the most likely cause is mucus secretions.

Laryngectomy Patient : If a 64-year-old woman with a complete laryngectomy is in respiratory arrest, you should suction the stoma completely.

Bag-Valve Mask Ventilation : When ventilating a patient with a bag- valve mask device, you should use two rescuers whenever possible.

Wheezing and Dyspnea : If a 28-year-old patient is experiencing dyspnea and wheezing, you should request an albuterol inhaler from medical control.

Sudden Shortness of Breath : If a 20-year-old male complains of sudden onset shortness of breath, with a respiratory rate of 24 and pulse oximetry of 85%, you should administer oxygen via a non- rebreather mask at 15 liters per minute.

Choking : If a 34-year-old male is choking, with stridor and hoarseness in his voice, you should encourage him to cough.

Upper Airway Obstruction : Epiglottitis is a condition that could be considered an upper airway obstruction.

Shortness of Breath : If an 18-year-old male complains of shortness of breath, with a heart rate of 104, respiratory rate of 22, and oxygen saturation of 91%, you should administer oxygen via a non-rebreather mask.

Ventilation Difficulty : A tension pneumothorax is the condition most likely to cause decreased compliance while ventilating a patient via a bag-valve mask.

Pneumonia : If a febrile 2-year-old male is in respiratory distress with crackles in the lower left lung field, you should suspect pneumonia.

Lower Respiratory Tract Problem : Expiratory wheezes and a long expiration are signs of a lower respiratory tract problem.

Tuberculosis : If a 64-year-old male complains of dyspnea and is coughing up blood-tinged sputum, you should suspect tuberculosis.

Congestive Heart Failure vs. Pneumonia : A patient stating they feel like they're "drowning when I sleep" is an indication that the patient is suffering from congestive heart failure rather than pneumonia.

Suctioning : When suctioning blood, fluid, and mucus from the oropharynx, the most appropriate device is a rigid-tip suction catheter.

Pulse Assessment : The reason for assessing the radial and carotid pulses simultaneously is to confirm a cardiac rhythm problem.

Acute Pulmonary Edema : If a patient presents with a sudden onset of shortness of breath, crackles, hypertension, and jugular distension, you should suspect acute pulmonary edema.

Congestive Heart Failure : If a 73-year-old male is dyspneic, with jugular vein distension, dependent edema, and vital signs of BP 158/ and HR 130 with RR 36, you should suspect congestive heart failure.

Choking : If a 19-year-old female began choking after eating a hot dog and was coughing and drooling when you arrived, you should perform abdominal thrusts.

Chronic Bronchitis : If a 65-year-old male is having trouble breathing, is moderately overweight, has been coughing up yellowish phlegm, smokes two packs of cigarettes a day, and has had episodes like this for many years, you should suspect chronic bronchitis.

Pneumothorax : A sudden onset of difficult breathing and diminished breath sounds can be present with a pneumothorax.

Airway Obstruction : If a semi-conscious 34-year-old male begins to gag after the insertion of an oropharyngeal airway, you should insert a nasopharyngeal airway.

Bronchitis : If an 18-year-old febrile patient complains of malaise for several days, is taking an oral antibiotic for an upper respiratory infection, and has vital signs of BP 128/72, HR 118 (weak), and RR 22 with rhonchi, you should suspect bronchitis.

COPD Assessment : A barrel-shaped chest is an assessment finding that should cause you to suspect a history of COPD.

Emphysema : If a thin 75-year-old male complains of difficulty breathing, has smoked 3 packs of cigarettes a day for 30 years, and has bilateral wheezes, you should suspect emphysema.

Asthma Exacerbation : If a 16-year-old asthmatic female is in the tripod position, complaining of increased shortness of breath, and has an oxygen saturation of 79%, you should administer oxygen at 10 liters per minute via a non-rebreather mask.

Oxygen Administration : During a long transport, you should consider using humidified oxygen.

Cyanosis : If a 45-year-old female is complaining of breathing difficulty, has clear lung sounds, but is becoming cyanotic on the lips, you should deliver oxygen via a non-rebreather mask at 15 liters per minute.