Airway Management Exam Questions and Answers 2024, Exams of Nursing

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Air methods 1 Exam Questions 2024

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What is the First adjustment you should make to a vent - Correct Answer Tidal Volume first then rate Three killers of vent patients during flight - Correct Answer pericardial tamponade tension pneumothorax hypovolemia ET tube depth - Correct Answer Adult 3 X ET tube Peds 10 + age in years Neonate 6 + age in weight To change CO2 on vent - Correct Answer adjust rate or tidal volume To change oxygenation on vent - Correct Answer adjust PEEP or PAP induction drug of choice with bronchospastic patients - Correct Answer ketamine Ativan indication dose max - Correct Answer Lorazepam seizures 1 - 2 mg max 4 mg

mannitol dose - Correct Answer 1 - 2 g/kg drug choice for cyclic antidepressant OD - Correct Answer sodium bicarbonate drug choice for beta blocker OD - Correct Answer glucagon Fentanyl dose - Correct Answer sublimate 3 micro/kg treatment for malignant hyperthermia - Correct Answer Dantrium (dantrolene) Drug for GI bleeds - Correct Answer Sandostatin (octreotide) Potassium normal range - Correct Answer 3.5-5. Sodium normal range - Correct Answer 135 - 146 Chloride normal range - Correct Answer 95 - 105 Calcium normal range - Correct Answer 8.5-10. Metabolic acidosis elevates? - Correct Answer Potassium Calculate MAP - Correct Answer (Diastolic x 2) + Systolic / 3 calculate cerebral pressure perfusion CPP - Correct Answer CPP=MAP-ICP GCS Scale - Correct Answer Mild 14 - 15 Moderate 9 - 13 Severe 3 - 8 Ischemia Injury

Infarct - Correct Answer ST depression >1mm in 2 leads ST elevation >1mm in 2 leads Q wave >25% height of R wave Pediatric 10 11 12 rules - Correct Answer uncuffed tube under 10 needle cricothyrotomy only under 11 no nasal intubation under 12 Controlled Mandatory Ventilation-CMV vent mode - Correct Answer preset volume or PIP at set rate; patient cannot initiate breath; All breaths are triggered, limited and cycled by vent; used in sedated, axenic or paralyzed patients Assist Control- AC vent mode - Correct Answer preset volume or PIP with every breath; pt can trigger breath but can't control tidal volume; preferred method respiratory distress; used in ARDS Synchronized Intermittent Mandatory Ventilaiton-SIMV vent mode - Correct Answer assisted mechanical ventilation synchronized with patients breathing; delivers a breath sync with patient; spontaneous breathing occurs; if patient fails to take breath vent provides; preferred with intact respiratory drive; Similar to CPAP Bipap must be administered within - Correct Answer three hours of onset of chest pain

acute respiratory failure - Correct Answer pO2 below 60; pCO2 above 55; pH below 7.2; only one needs to be off to indicate the need to intubate calculate cardiac output - Correct Answer heart rate x stroke volume Mac blade lifts the - Correct Answer vallecula miller blade lifts the - Correct Answer epiglottis Gold standard for ET tube placement confirmation - Correct Answer Xray 2 - 3cm/above the carina; level of T2 or T3 vertebrae; Murphys eye (vent hole) located on side of clavicle bones Intubation indications - Correct Answer unable to swallow; unable to ventilate/oxygenate; GCS <8; Inhalation burns; circumferential neck or chest burns; anaphylaxis; apnea; airway obstruction-foreign body/maxillofacial trauma; respiratory failure LEMON - Correct Answer Look Evaluate Mallampati

Obstructions Neck Mobility ETCO 2 - Correct Answer measured on expiration 7 P's of RSI - Correct Answer Preparation Pre-oxygenate Pretreatment Paralysis with induction Protect and position Placement with proof Post intubation management LOAD (RSI pre treatment) - Correct Answer Lidocaine (head/lung injury)-blunts cough reflex preventing ICP increase Opiates-blunts pain response Atropine for Infants-prevents reflexive bradycardia in infants <1 yr old Defasiculating Dose-use succinylcholine rocuronium or vecuronium Succinylcholine - Correct Answer Dose 1 - 2 mg/kg Onset 1 - 2 minute Duration 4 - 6 min Malignant Hyperthermia S & S - Correct Answer Masseter spasm/lockjaw muscle contractions rapid increase in temp (as high as 110) increased ETCO 2 tachycardia

mixed acidosis Malignant hyperthermia treatment - Correct Answer Dantrolene Sodium (Dantrium) Dose 3 mg/kg Do NOT give CCB Vecuronuim (norcuron) - Correct Answer Dose 0.04-0.06 mg/kg IVP if following Suc + maintenance 0.01-0.015 mg/kg IVP 20 - 45 min Onset 4 - 6 min Duration 30 - 45 min Refrigeration not required Vecuronuim is used - Correct Answer after succinylcholine to keep patient paralyzed Rocuronium (Zemeron) - Correct Answer Dose 0.1-0.2 mg/kg IV q 20 - 30 mim Onset 4 - 6 min Duration 30 - 45 min Refrigeration required Rocuronium is used - Correct Answer after succinylcholine to keep patient paralyzed Succinylcholine contraindications - Correct Answer crush injuries eye injuries narrow angle glaucoma history of malignant hyperthermia burns > 24 hrs Hyperkalemia any nervous system disorder

Etomidate - Correct Answer induction agent preferred for awake sedation fast onset short half life no BP change Etomidate Contraindications - Correct Answer some adrenal suppression Do NOT use in septic shock or Addisons disease Etomidate (Amidate) - Correct Answer Dose 0.3 mg/kg Onset 30 - 60 seconds Duration 3 - 12 minutes Midazolam (Versed) - Correct Answer Dose 2.5- 5 mg IV Onset 60 - 90 seconds Duration 15 - 30 minutes Midazolam - Correct Answer Versed is used for sedation or seizures use lowest dose possible reversal agent Romazicon/Flumazenil Propofol (Diprivan) - Correct Answer Dose varies based on intended use Dose 1.5 mg/kg IV Onset 15 - 45 seconds Duration 5 - 10 minutes Propofol - Correct Answer Milk of Amnesia decreases CPP and MAP use lowest dose possible Do not use in head injury not good for hemodynamically unstable/shock-ketamine safer in shock pt

contraindicated for egg and egg product allergy Ketamine (Ketalar) - Correct Answer Dose 1mg/kg IV or 2mg/kg IM Onset 45 - 60 seconds Duration 11 - 17 minutes Ketamine uses - Correct Answer stop pain impulses potent brochiodilator RSI asthmatic can be given IO Ketamine does not - Correct Answer dry secretions and may actually increase them- evidenced by laryngospam-give 0.01 mg/kg IV atropine or 0./3 mg IV scopolamine slowly Morphine - Correct Answer Dose based on intended use Dose 2mg IV/IM/IO for mild pain control 5mg IV/IM/IO for moderate pain control Onset minutes Duration 2 - 3 hours Preferred Route IV Morphine Contraindications - Correct Answer avoid in head injuries avoid in respiratory depression may cause hypotension nausea and flushing often requires antiemetic reversal agent narcan Fentanyl - Correct Answer Dose 50 - 100 mcg IV Q2H PRN Onset 1 - 2 minutes

Duration 45 - 60 minutes Fentanyl Contraindications - Correct Answer avoid in patients with increased ICP, hypoventilation, hypotension often requires antiemetic reversal agent narcan Tidal volume Vt - Correct Answer How much air the patient breathes in a normal breath; 6 - 8cc/kg (excessive TV can cause ventilator induced lung injury) inspiratory reserve volume IRV - Correct Answer Amount of air that can be forcefully inhaled after a normal tidal volume inhalation expiratory reserve volume ERV - Correct Answer Amount of air that can be forcefully exhaled after a normal tidal volume exhalation Vital Capacity (VC) - Correct Answer TV + IRV + ERV Residual Volume (RV) - Correct Answer Amount of air remaining in the respiratory tract after a forced exhalation Total Lung Capacity (TLC) - Correct Answer inspiratory reserve volume + tidal volume + expiratory reserve volume + residual volume Dead space - Correct Answer the surfaces of the airway that are not involved in gases exchange; Gas exchange ONLY occurs in aveoli; formula 2ml/kg

• Correct Answer

Hypercarbic Respiratory Failure - Correct Answer inability to remove CO2; evidenced by respiratory acidosis; Treatment increase TV then rate Hypoxic Respiratory Failure - Correct Answer Inability to diffuse 02; Evidenced by low PaO2; Treatment increase tidal volume and O2 concentration then rate The first word in the vent mode describes the interaction the patient has with the ventilator - Correct Answer Controlled-patient breathing controlled completely Intermittent-patient can take intermittent breaths Synchronized-vent synchronizes delivery of breath Assist-ventilator assists Gold standard for oxygenation=pulse oximetry SP02 - Correct Answer Gold standard for ventilation=capnography ETCO Minute Volume Ve - Correct Answer how much air is breathed by patient in one minute; Rate x tidal volume; 4 - 8 liters/min PEEP (positive end expiratory pressure) - Correct Answer PEEP is what keeps aveoli open so that oxygen can diffuse; adequate peep helps prevent atelectasis/ alveolar collapse I:E (inspiratory:expiratory ratio) - Correct Answer 1: ratio of inspiration vs expiration

(takes longer to breathe out) Rate F - Correct Answer number of breaths per minute 8 - 20/min Pressure Support Ventilation (PSV) - Correct Answer positive pressure is delivered with spontaneous breaths to decrease work of breathing; requires constant effort from patient ABG-pH - Correct Answer 7.35-7. ABG PaCO2 - Correct Answer 35 - 45 ABG-PA02 - Correct Answer 80 - 100 Hemoglobin normal range - Correct Answer 14 - 17. What do high and low levels of Hgb indicate? - Correct Answer High-smoking low-anemia/blood loss Hematocrit normal range - Correct Answer 41 - 50% What do high and low levels of hematocrit indicate? - Correct Answer High- dehydrated low-anemia/blood loss WBC normal range - Correct Answer 4500 - 11000 What do high and low levels of WBC indicate? - Correct Answer High-infection, anemia, steroid use low-viral infection immunodeficiency

RBC normal range - Correct Answer 3.9-5. What do high and low levels of RBC indicate? - Correct Answer High-polycythemia or high altitude low-cancer or bone marrow suppression PT - Correct Answer measures anticoagulation Coumadin normal 10 - 13 seconds what do high values of PT indicate? - Correct Answer liver cirrhosis vitamin K deficiency DIC INR - Correct Answer international normalized ratio normal-1. aPTT - Correct Answer measures heparin 25 - 40 seconds Pre-eclampsia - severe Signs & symptoms - Correct Answer BP >160/100Pulmonary edema; Platelets under 100k; Headache/ vision changes; RUQ pain; Proteins in urine Magnesium - Correct Answer OB SMOOTH MUSCLE RELAXANT Near protection for baby seizure prophylaxis

Magnesium Dose - Correct Answer Dose - 4G in 100ml D5W over 15 minutes, followed by 2G/hr infusion. Name some physiological changes that occur during pregnancy - Correct Answer blood volume increases by 40%; Cardiac Output increases up to 50%; Heart Rate decreases by 10 - 15; Body becomes more insulin resistant; uterus enlarges 20x Physical assessment of pregnant woman - Correct Answer palpate check vitals check FHT GPAL GPAL - Correct Answer gradvida para preterms abortion living children treatment for distressed fetus - Correct Answer 100% 02 NRB; Place in LLR; Fluids for Hypotension; external vaginal exam vaginal bleeding is caused by - Correct Answer ovarian cysts; spotting; fetal loss; ectopic pregnancy;

uterine rupture vaginal bleeding treatment - Correct Answer 02/IV; manage blood loss; blood products; treatment for shock; monitor Fetal Heart Tones gestational hypertension treatment - Correct Answer beta blockers-labetalol; arterial vasodilators-hydrolozine; seizure prophylaxis-4g mag > 20 min Pre-eclampsia treatment - Correct Answer Beta blockers-labetalol; arterial vasodilator-hydrolozine; seizure prophylaxis-4G>20 min Eclampsia Signs & Symptoms and treatment - Correct Answer HTN with seizures; treatment mag 4g bolus over 2 minutes; midazalom 2 - 5 mg IM if seizure continues Placenta previa Signs & Symptoms - Correct Answer painless bright red bleeding; no significant findings on abdomen exam abruptio placentae Signs & Symptoms and treatment - Correct Answer caused by trauma, HTN and drugs; signs & symptoms: tearing abdominal pain; vaginal bleeding;

hemorrhagic shock; rigid abdomen treatment-100% 02 NRB; PIV-volume replacement; Mag 4G/steroid Uterine rupture Signs & Symptoms treatment - Correct Answer sharp pain; hypovolemic shock; distention and possible bleeding treatment- LLR; 100% O2; PIV; Mag 4G bolus Prolasped cord treatment - Correct Answer knees to chest; don't push; 100% 02; keep cord moist; manual displacement; mag 4G; nitro infusion 2ug/min Name delivery positions - Correct Answer Cephalic/vertex-normal presentation; cephalic/face-head down, posterior, head not flexed; complete breech-feet first, Indian style; incomplete breech-one foot presenting;

transverse-non deliverable butt first or sideways Vitals at birth - Correct Answer (neonate) RR 30 - 60 HR 100 - 160 SBP 50 - 70 BGL > post-delivery hemorrhage may be caused by - Correct Answer Tissue Trauma Tone Thrombin amniotic fluid embolism Signs & Symptoms and treatment - Correct Answer trauma, coughing, AMS, chest pain, hypoxia aggressive airway management with PEEP Epi/Solumedrol Fluid replacement Nifedipine (Procardia) - Correct Answer uterine smooth muscle relaxant Dose 10mg PO watch for hypotension terbutaline - Correct Answer smooth muscle relaxant stops contractions vasodilator Dose 0.25mg IM Indomethacin (Indocin) - Correct Answer NSAID Dose 25 - 50 mg PO

contraindicated in 3rd trimester Labetalol OB - Correct Answer Beta Blocker smooth muscle relaxant antihypertensive Dose 20 - 40 mg (300mg max) Betamethasone steroid - Correct Answer dose 12 mg IM x 12 24 hours apart Dexamethasone (Decadron) - Correct Answer steroid dose 6mg IM x 4 12 hours apart contraindicated for preterm infants Oxytocin - Correct Answer 10 - 20U added to 1000ml NS/LR Levophed (norepinephrine) - Correct Answer Vasopressor vasoconstrictor Gold standard for septic shock Dose 1 - 5 mcg/min mixed with D5W Inotropes are used to treat? - Correct Answer CHF Digoxin - Correct Answer inotrope Dose 1 - 2 ng/ml indication: left sided heart failure SV arrhythmias Afib Dopamine - Correct Answer inotrope Dose 3 - 5 mcg/kg/ml

indication: bradycardia, cariogenic shock contraindication hypovolemic shock SVR increase through vasoconstriction Atropine - Correct Answer Chronotrope Dose-0.5mg IV q 5 Indication brady Adenosine - Correct Answer Chronotrope Dose 6mg- 12 mg indication SVT Amiodarone - Correct Answer chronotrope dose 150 mg IV > 10 min in 50cc D5W Beat blockers are used to treat? - Correct Answer Puts the breaks on the heart slows all aspects of heart function Metoprolol - Correct Answer Beta Blocker Dose 5mg q 5 indications hypertension CHF aging MI tachycardia

Labetalol - Correct Answer Beta Blocker Dose 0.25mg/kg initial dose Indications hypertension Dobutamine - Correct Answer inotrope dose 2 - 20mcg/kg/min indications decompensated CHF cardiogenic shock Warfarin Eliquis - Correct Answer Indicated for DIC trauma DVT sepsis fibrolynics Dose 2 - 10 mg Lovenox - Correct Answer Indicated for MI gain thrombolynic therapy dose 30mg IV bolus then 1mg/kg SQ BiPap - Correct Answer 2 different pressures;; ventilates patient with COPD to get rid of increased CO2 and oxygentate; treats Emphysema, chronic bronchitis COPD MOANS - Correct Answer bag compliance M-mask good seal O-obstruction/obesity A-age over 50 N-no teeth S-stiff lungs

RODS - Correct Answer Difficult Igel airway R-restricted mouth opening O-obstruction/obesity D-distorted airway S-stiff lungs SMART - Correct Answer difficult cricket airway S-stiff neck M-mass A-access/anatomu R-radiation T-tumor Surgical airway contraindications - Correct Answer < 10 years old; cannot id landmarks; tumor; severe damaged trachea; coag; lack of experience Size tube for Cric - Correct Answer Shiley # ETT 6. ICP S&S - Correct Answer cushings triad; bradycardia, widening pulse pressure, Cheyenne stokes respirations seizures AMS posturing Hypovolemic Shock - Correct Answer causes: loss of blood volume caused by blood loss, 3rd degree burns, excessive NVD, acute pancreatitis, DKA signs & symptoms

decreased Cardiac output; increased SVR; cyanosis and hypoxia Treatment: fluid replacement LR or blood keep warm; albumin cardiogenc shock - Correct Answer pump problem causes myocarditis, MI, congenital heart defects, arrhythmias, valve issues signs & symptoms hypotension; low co2; high SVR; Tachycardia treatment: treat underlying cause; 02; small amouts of fluid; vasopressors obstructive shock - Correct Answer Pump problem: hemothorax, caused by tension pnuemothorax, pericardial tamponade, PE Signs & symptoms: hypotension; hypoxia; decreased cardiac output altered mental status shunting; increased respirations

treatment: 02; vasopressors; fluids; distributive shock/septic shock - Correct Answer permeability problem signs & symptoms: decreased BP; fever; hypoxia; treatment: IV antibiotics: LR fluids: vasopressors distributive shock/neuro shock - Correct Answer acute spinal cord injury signs & symptoms: bradycardia; decreased SVR; hypotension; bradycardia; hypoxia treatment: fluids; vasopressors Second Degree Heart Block (Mobitz II) - Correct Answer PR-interval is normal; QRS complexes are dropped erratically ALL must have a pacemaker in the next 72 hrs.

How do you mix epi? - Correct Answer Mix 1 mg in 1 L NS or D5W or LR for a concentration of 1 mcg/ ml PALS management of respiratory distress due to poisoning - Correct Answer Support airway give antidote call poison control Magnesium - Correct Answer 1.7-2.2 Hemoglobin - Correct Answer Male 14 - 18 g/dl Female 12 - 16 g/dl Stroke Volume (SV) - Correct Answer The volume of blood pumped forward with each ventricular contraction 50 - 100 cc per beat Adult Vassopressin Gtt dose - Correct Answer 0.01 to 0.05 units/min most common cause of PEA - Correct Answer hypovolemia hypoxia Definition of sepsis, severe sepsis and septic shock - Correct Answer Sepsis-SIRS + infection Septic Shock-severe sepsis + SBP <90 MAP <65 Lactate >4 after fluid 30cc/kg What three things cause cerebral vasoconstriction? - Correct Answer hypertension hypocarbia alkalosis Which of the following may be useful in systolic dysfunction but may be detrimental in diastolic dysfunction? - Correct Answer Vasodilators are used for preload and

afterload reduction in systolic dysfunction but may detrimentally decrease diastolic filling in diastolic dysfunction. Which of the following is a cause of diastolic dysfunction? - Correct Answer Diastolic dysfunction is an inability of the heart to fill adequately. Tamponade compresses the chambers so that filling is impaired. If filling is impaired, cardiac output is diminished. Tracheal deviation AWAY from the affected side, decreased breath sounds, and hyperresonance... What's happening? - Correct Answer tension pneumothorax fetal distress is an early sign of maternal distress... Why? - Correct Answer Catecholamine mediated vasoconstriction resulting from blood loss shunts blood away from the fetus to the mom. Junctional Escape Rhythm - Correct Answer a rhythm that occurs when the SA node fails to initiate the electrical activity and one of the backup pacemaker sites takes over Rate 40 - 60 (61- 100 accelerated) No p wave ventricular fibrillation - Correct Answer disorganized, ineffective twitching of the ventricles, resulting in no blood flow and a state of cardiac arrest No pulse SHOCK Biphasic 200J Mono 360J monomorphic ventricular tachycardia - Correct Answer QRS complexes that are the same shape, size, and direction. Unshockable rhythms - Correct Answer PEA and asystole Give Epi 1mg q 3 - 5 minutes fix underlying cause ACLS VF or PULSELESS VT Amiodarone dose - Correct Answer Shock, CPREpi 1 mg q 3 - 5 minutesAmio 300 mg bolus first dose Amio 150 mg Second dose

What happens to cerebral blood flow when the patient is hypoxic? ( pao2 less than 50)? - Correct Answer cerebral vasodilation occurs. Pneumothorax that re-accumulates after needle decompression or chest tube - Correct Answer tracheobronchial injury correction for pneumothorax that re-accumulates after needle decompression or chest tube - Correct Answer move ETT into right main stem advance below level of injury correct insertion site recommended for chest tube - Correct Answer 5 intercostal anterior mid axillary Consensus Burn Formula - Correct Answer 2 - 4cc/kg/BSA; LR; first 1/2 over 8 hours; 2nd half over remaining 16 hours.