FISDAP Airway 2023 EXAM ACTUAL EXAM QUESTIONS AND WELL ELABORATED ANSWERS WITH (100% VE, Exams of Nursing

Download FISDAP Airway 2023 EXAM ACTUAL EXAM QUESTIONS AND WELL ELABORATED ANSWERS WITH (100% VE and more Exams Nursing in PDF only on Docsity! FISDAP Airway 2023 EXAM ACTUAL EXAM QUESTIONS AND WELL ELABORATED ANSWERS WITH (100% VERIFIED SOLUTIONS) LATEST UPDATES | ALREADY GRADED A+ From the atmosphere, what structures does air pass through during ventilation? - ANSWER>>Starts in atmosphere, then nose, nasopharyngeal space/orophargyneal space (if mouth breather), then pharynx, larynx, trachea, bronchi, bronchioles, alveoli What is the purpose of the nasal passages and nasopharynx? - ANSWER>>To warm/humidify air as it passes through What is the difference between respiration and ventilation? - ANSWER>>Respiration refers to the exchange of gases in the alveoli, ventilation refers to the movement of air into the lungs. Respiration is needed to provide O2 to cells and remove waste products. Also regulates pH of blood. What are the structures of the upper airway? - ANSWER>>nose, mouth, tongue, jaw, pharynx and larynx What structure is considered a landmark that divides the upper airway from lower? - ANSWER>>The larynx, anything above is upper. The larynx and below are lower. What are the structures of the lower airways? - ANSWER>>larynx (includes adam's apple/thyroid cartilage, cricothyroid membrane, cricoid cartilage), trachea, bronchi, bronchioles, alveoli Describe the anatomy of the larynx. - ANSWER>>From superior to inferior. Thyroid cartilage, cricothyroid membrane, and cricoid membrane. The thyroid cartilage and cricoid cartilage are anterior to the larynx, and the cricothyroid membrane is posterior to both structures. True or false: the lungs are completely equal in the midsaggital plane. - ANSWER>>False, right lungs has 3 lobes, left lung only has 2 lobes. Together they have 5 total. Also, the right bronchi is inferior to the left bronchi. What are the structures of the lungs in order of ventilation? - ANSWER>>bronchioles, and alveoli True or false: the lungs use muscles found in the lateral lobes to expand and contract? - ANSWER>>False: the lungs are hollow organs and contain no muscles. When the diaphragm contracts it expands the thoracic cavity. The pleural space has a negative pressure and the lungs expand. This results in a slightly negative pressure (compared to the atmosphere) and air rushes in. What is expiratory reserve volume/Vital Capacity? - ANSWER>>maximum amount you can breathe out after normal breath. What is residual volume? - ANSWER>>Remaining gas in lungs after exhalation. This is to keep lungs inflated What is dead space? What structures are considered part of dead space? - ANSWER>>Part of respiratory system not involved in active respiration. Air moves through here but little to no respiration occurs. Mouth, trachea, bronchi and bronchioles considered dead space What is minute volume? What does it measure? - ANSWER>>Minute volume = RR x tidal volume. Volume of air moving through lungs in 1 minute. Can be estimated quickly. Count RR rate. If normal check to see chest rise and fall (tidal volume). If chest rise and fall is weak and/or little air coming out of nose, then the person has small minute volume. Alveolar Minute Volume - ANSWER>>Volume of air moved through lungs in 1 minute minus the dead space. Alveolar Minute Volume = (tidal volume - dead space) x RR Alveolar Ventilation - ANSWER>>Volume of air that reaches alveoli. Alveolar ventilation = tidal volume - dead space Name the characteristics of normal breathing - ANSWER>>1. Normal rate (12-20) 2. regular pattern of inhalation/exhalation 3. clear bilateral lung sounds 4. regular and equal chest rise/fall 5. adequate depth (tidal volume) What are the characteristics of inadequate breathing (adults)? - ANSWER>>Chapter 6 1. labored breathing (activating accessory muscles of respiration) 2. 12< or >20 breaths/minute 3. muscle retractions above clavicles or between ribs and below rib cage 4. pale/cyanotic skin 5. cool, damp, clammy skin 6. tripod position Chapter 10 1. 12< or 20> 2. irregular rhythm 3. diminished, absent or noisy auscultated breath sounds 4. reduced flow of expired air at nose/mouth 5. unequal or inadequate chest expansion 6. labored breathing 7. shallow depth 8. pale, cyanotic, cool or moist skin 9. retractions around ribs or above clavicles What are agonal gasps? What should you do if a pt has agonal gasps? - ANSWER>>Pt in cardiac arrest has occasional gasping breaths because respiratory center in brain continues to send signals to breathing muscles. Artificial ventilations and chest compressions. Where are the alpha-1 receptors located? What is their effect? - ANSWER>>location-blood vessels constricted blood vessels, skin is pale, cool, clammy They essentially increase BP Where are the Beta-1 receptors located? What is their effect? - ANSWER>>location-heart effect- increased HR, increased force of contraction They essentially increase CO since CO = HR x SV Where are the Beta-2 receptors located? What is their effect? - ANSWER>>location - lungs (beta-2 is beta-tube) effect - bronchodilation (more air enters lungs) Where are the muscarinic receptors located? What is their effect? - ANSWER>>location - heart Glottis - ANSWER>>Space between vocal cords and narrowest portion of adult's airway. Lateral borders of glottis are the vocal cords. They contain defense reflexes that protect lower airway, and spasm to prevent foreign substances from entering trachea Carina - ANSWER>>The branching area of the left and right bronchi Mediastinum - ANSWER>>Area between the lungs which is surrounded by tough connective tissue. Contains heart, great vessels, esophagus, trachea, major bronchi and nerves. What is the term used to describe the amount of gas in air or dissolved in fluid? How is this relevant to ventilation? How is this relevant to respiration? - ANSWER>>Partial pressure of gas, measured in mmHg. When lungs expand, partial pressure of air is less than that in atmosphere. Air rushes in during ventilation. Inhalation In oxygen rich lungs, PO2 > PO2 oxygen poor blood. O2 diffuses across alveoli into blood. In CO2 rich blood, PCO2 > PCO2 of lungs so CO2 diffuses from blood to lungs, and then is exhaled out What does it mean if someone says they are "keeping the airways patent"? - ANSWER>>Keeping airway patent = maintaining open airway so air can enter/leave lungs freely How is regulation of breathing different in those with COPD? What does research indicate about assisting in respiration with COPD sufferers? - ANSWER>>COPD sufferers have difficulty removing CO2 from body. Overtime, respiratory control centers in brain adjust to this new baseline of CO2. In late stage COPD hypoxic drive is activated. Some research suggests that providing high flow O2 could negatively affect body's drive to breathe. What is Dyspnea? - ANSWER>>Shortness of breath Signs and symptoms of Hypoxia? - ANSWER>>Early 1. Restlessness 2. Irritability 3. apprehension 4. tachycardia 5. anxiety Late 1. mental status changes 2. weak (thready) pulse 3. cyanosis 4. Dyspnea Cellular respiration (Metabolism)? - ANSWER>>Cells take energy from nutrients through series of chemical processes. What is the difference between external and internal respiration? - ANSWER>>External - process of breathing fresh air into respiratory system and exchanging O2 and CO2 between alveoli and blood in pulmonary capillaries internal - exchange of oxygen and CO2 between systemic circulatory systems and cells of body What are the critical periods in which a cell needs O2? - ANSWER>>0-1 minute: cardiac irritability 0-4 minute: brain damage not likely 4-6 minute: brain damage possible 6-10 minute: brain damage likely more than 10: irreversible brain damage What is intrapulmonary shunting? What is the cause of it? - ANSWER>>It's when blood enters lungs from right side of heart bypasses alveoli and return to left side of heart in unoxygenated state. Can be caused by nonfunctional alveoli due to diseases What factors can lead to hypoxia due to circulatory compromise? - ANSWER>>1. obstruction of blood flow due to a. pulmonary embolism b. pneumothorax trauma is suspected, use a jaw thrust. If head trauma is not suspected, use a head-tilt-chin-lift maneuver You encounter an unconscious pt. They have a pulse but inadequate respirations. You open the airway and find vomit. What should you do? - ANSWER>>You should suction the pt using How do you use suction equipment? - ANSWER>>Can use rigid (Yankauer/tonsil tips) or nonrigid (french/whistle-tip). Use rigid unless you are suctioning a stoma or suctioning nose/liquid at back of mouth. Make sure to measure for proper size. Don't touch back of throat, don't want to activate gag reflex. Turn on to at least 300 mmHg. Attach appropriate tubing. Suction for no more than 15 seconds for adults, 10 seconds for children, and 5 seconds for infants. Rinse with water. Asthma Signs and Symptoms? - ANSWER>>1. wheezing on inspiration/expiration 2. Bronchospasm Anaphylaxis Signs and Symptoms? - ANSWER>>1. Flushed skin/hives (urticaria) 2. Generalized edema 3. hypotension 4. laryngeal edema w/ dyspnea 5. wheezing/stridor Most rxns occur w/in 30 mins, administer epi using epipen. O2 also helps Bronchiolitis signs and symptoms? - ANSWER>>1. Dyspnea 2. wheezing 3. Coughing 4. fever 5. dehydration 6. Tachypnea 7. Tachycardia Often due to RSV infection, severe bronchiole inflammation. Occurs most frequently in infants, especially boys. Provide O2 therapy, allow pt to remain in comfortable position. Reassess frequently and be prepared to manage airway/positive pressure ventilation Bronchitis Signs and Symptoms - ANSWER>>1. Chronic cough w/ sputum production 2. Wheezing 3. cyanosis 4. Tachypnea Type of COPD, can be due to tobacco. When excess mucus created. Carbon Monoxide Poisoning - ANSWER>>1. flu like symptoms 2. headache 3. dizziness 4. fatigue 5. nausea 6 . vomiting 7. chest pain remove them from scene, administer high flow o2 by nonrebreathing mask. May need full airway control w/ airway adjunct and bvm ventilation CHF - ANSWER>>1. Dependent edema 2. Crackles (pulmonary edema) 3. Orthopnea 4. Paroxysmal nocturnal dyspnea Common Cold - ANSWER>>1. cough 2. runny/stuffy nose 3. sore throat COPD - ANSWER>>slow process of dilation/disruption of airways/alveoli caused by chronic bronchial obstruction Croup - ANSWER>>1. fever 2. barking cough 3. stridor 4. mostly seen in pediatric patients inflammation/swelling of pharynx, larynx and trachea. Typically seen in young children Treat w/ humidified O2 Pleural Effusion - ANSWER>>collection of fluid outside lung on one or both sides that compresses lung/lungs and causes dyspnea. Lung sounds = decreased breath sounds from lungs where fluid is. Pt's feel better sitting upright, but only treatment is fluid removal in hospital Pneumonia - ANSWER>>1. dyspnea 2. chills/fever 3. cough 4. green, red or rust colored sputum 5. localized wheezing or crackles Infection of lungs, often secondary infection. Affects people who are chronically/terminally ill. May hear wheezing, crackles, friction rubs or rhonchi. Provide airway support, supplemental O2 pneumothorax - ANSWER>>1. sudden chest pain w/ dyspnea 2. decreased breath sounds on affected side 3. subcutaneous emphysema 4. JVD Effects tall and thin people more. Caused when air leaks into pleural space from opening in chest/lung surface. Lung collapses and pleural spaces no longer contact Pulmonary edema - ANSWER>>caused by CHF, where heart can't pump blood away as fast as it collects in pulmonary arteries. So you have edema in lungs. 1. difficulty breathing w/ exertion 2. sudden attack of respiratory distress 3. suffocation feeling 4. cold sweats 5. tachycardia 6. cool, diaphoretic, cyanotic kin 7. adventitious breath sounds like crackles/wheezing 8. tachycardia 9. hypertension initially then hypotension pulmonary embolus - ANSWER>>1. sharp chest pain 2. sudden onset 3. dyspnea 4. tachycardia 5. clear breath sounds initially 6. hemoptysis (coughing up blood) 7. tachypnea tension pneumothorax - ANSWER>>1. severe shortness of breath 2. decreased/altered level of consciousness 3. neck vein distension 4. tracheal deviation (late sign) 5. hypotension, signs of shock (late sign) Respiratory syncytial Virus (RSV) - ANSWER>>1. cough 2. wheezing 3. fever 4. dehydration Look for signs of dehydration, infants w/ RSV often refuse liquids. Humidified O2 can be helpful TB - ANSWER>>1. cough 2. fever 3. fatigue 4. productive/bloody sputum bacterial infection, can be dormant for years. High prevalence for people living in close contact. Need to wear gloves, eye protection, N-95 respirator How would you differentiate COPD and CHF? - ANSWER>>COPD emphysema - thin w/ barrel chest, pink puffer, tripod position, flat neck veins, dry lungs, shortness of breath on exertion, rhonchi, wheezing, no mucus bronchitis - obese, difficulty w/ expiration, flat neck veins, blue bloat, lungs wet, shortness of breath on exertion, rhonchi, wheezing, frequent/chronic cough, excessive thick mucous cause - Air passing through narrowed air passages as a result of secretions, swelling, tumors location - Loud sounds can be heard over most lung areas, but predominate over the trachea and bronchi associated w/- Secretions, Obstructions, Pneumonia, Bronchitis, COPD Friction rub - ANSWER>>description - Superficial grating or creaking sounds heard during inspiration and expiration. Not relieved by coughing. cause - Rubbing together of inflamed pleural surfaces location - Heard most often in areas of greatest thoracic expansion (e.g., lower anterior and lateral chest) associated w/ - Pleuritis, Pulmonary embolism, COPD, Pneumonia Wheeze - ANSWER>>description - Continuous, high-pitched, squeaky musical sounds. Best heard on expiration. Not usually altered by coughing. cause - Air passing through a constricted bronchus as a result of secretions, swelling, tumors location - Heard over all lung fields associated w/ - Asthma, Allergic reaction, Airway obstruction, COPD Stridor - ANSWER>>description - A harsh vibrating noise when breathing, caused by obstruction of the windpipe or larynx. cause - Obstruction or narrowing of the upper airway. location - Less than severe stridor can be auscultated over the larynx. Severe stridor can be heard without a stethoscope. associated w/ - Obstruction in Larynx, Obstruction in Trachea, Croup, Epiglottitis Laryngeal edema What are the two purposes of inserting an OPA? - ANSWER>>1. lift the tongue 2. Make it easier to suction oropharynx Indications/contraindications for OPA? - ANSWER>>Indications a. unresponsive pt's w/o gag reflex b. any apneic pt ventilated w/ a BVM Contraindications a. conscious pt's b. any pt (conscious or unconscious) w/ BVM Indications/contraindications for NPA? - ANSWER>>indications a. semiconscious/unconscious pt w/ intact gag reflex b. pat's who otherwise will not tolerate OPA contraindications a. severe head injury w/ blood draining from nose b. history of fractured nasal bone What is the recovery position? - ANSWER>>used to help maintain clear airway in unconscious pt who is not injured and is breathing on his or her own w/ normal respiratory rate and adequate tidal volume Bag Valve Mask - ANSWER>>use w/ or w/o oxygen. Use for pt's in respiratory arrest, cardiopulmonary arrest, and respiratory failure. CPAP - ANSWER>>Continous Positive Airway Pressure increases pressure in lungs, opens collapsed alveoli, pushes more oxygen across alveolar membrane, and forces interstitial fluid back into pulmonary circulation. indications - alert pt able to follow commands, obvious signs of moderate to severe respiratory distress, pt is breathing rapidly (over 26 breaths/min), pulse oximetry is less than 90 contraindications - pt who is in respiratory arrest, Si/sx of pneumothorax or chest trauma, pt who has a tracheostomy, active Gi bleeding/vomiting, pt unable to follow verbal commands An unresponsive trauma patient is gurgling. When you suction the oropharynx with a rigid catheter, the patient gags. You should? - ANSWER>>Assess insertion depth of the catheter Thin 54 year old male with a nonproductive cough complains of difficulty breathing. Sitting upright with hands on his knees and you see retractions. Notice oxygen tubing around the house. You should suspect medical history of? - ANSWER>>Chronic Bronchitis Semiconscious patient's dentures completely loosened. You should? - ANSWER>>Remove dentures Carbon dioxide and oxygen exchange at the alveolar level by which process? - ANSWER>>Diffusion 20 year old female unable to cath breath after minor car crash, numbness and tingling to hands and face. Vitals are P 118, R 24. What should you do? - ANSWER>>High flow oxygen with a nonrebreather mask Which term best describes respiratory difficulty? - ANSWER>>Dyspnea What is the amount of air that normally reaches the alveoli in an adult? - ANSWER>>350 mL The average adult ventilation is 500 mL, but there is an area of dead space that traps 150 mL of air. 350 mL effectively reaches the alveoli for oxygen and carbon dioxide exchange. A 77 year old female has dyspnea, speaks in short word burst, and breathes with pursed lips. Lung sounds are diminished, distant, and clear. Vital signs are BP 152/90, P 86 and irregular, R 23. What should you suspect? - ANSWER>>Empysema Emphysema is a chronic destructive process of the alveoli. The alveoli regenerate but they are misshaped and consist of scar tissue. The scar tissue inhibits gas exchange. She has pursed lips because she is attempting to keep the alveoli open. Without the extra effort her alveoli will collapse due to increased surface tension. 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. What is the most likely cause? - ANSWER>>Spontaneous pneumothorax Performing strenuous activites can, on occasion, cause a collapsed (spontaneous pnemothorax) He has stable vital signs so you should suspect a S.P. If he had been hypotensive (88/40), you should suspect that the S.P had developed into a tension pneumothorax. An unresponsive 43 year old male is cool, pale, diaphoretic, and breathing 6 times a minute. Which device should you use to administer oxygen? - ANSWER>>Bag-valve mask He is unresponsive and breathing too slow. This is a "Sick" patient and assisting his ventilations should be the first intervention. You can increase his respiratory rate with a bag valve mask, which is why it is the most correct choice. 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. What should you do? - ANSWER>>Assist his ventilations He is in respiratory failure. His breathing is ineffective because his respirations are fast and shallow. Shallow respirations do not allow for adequate oxygen exchange because the air is not drawn down far enough into the lungs. Assisting his breathing with positive pressure ventilations will help reduce any pulmonary edemy from the lower airway burns. What are the structures that brach off the trachea into the lower airway? - ANSWER>>Bronchi The trachea splits at the carina into the left and right bronchus. The bronchi get smaller and smaller until it reaches the terminal bronchioles where the alveoli are located. What is the term for high-pitched whistling sounds heard during expiration? - ANSWER>>Wheezing 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. What is the most likely cause? - ANSWER>>Pneumonia Pneumonia is an infection of the lung tissue and the "rusty" sputum (spit) is a sign of lower airway infection. He is febrile (fever) from an immune response to the infection, and the "dull" chest pain is a common symptom at the location of the infection. 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. What should you expect? - ANSWER>>Pulmonary embolism A pulmonary embolism is typically the result of a clot that has formed in the lower extremity with poor circulation. Hip surgery requires a patient to be immobilized for an extended period of time which can permit a clot to form in the distal portion of an extremity. The sudden unilateral chest pain is the lung with the clot. Any lung tissue distal of the clot will not allow for adequate oxygen exchange. How should you insert a nasopharyngeal airway? - ANSWER>>First step is to face the bevel towards the septum. Apply a water soluble lubricant, do not use an oil based lubricant. What is the Name of the hollow, semi flexible tube that carries in held air from the larynx to the lungs? - ANSWER>>Trachea The trachea is a tube like structure that allows air passage from the upper airway into the lungs What is the most common location for an airway obstruction - ANSWER>>Pharynx This passage way is shared by air and food so it is a common site for a partial or complete obstruction, which could be food or a flaccid tongue What part of the respiratory system contains the vocal chords? - ANSWER>>larynx This structure is directly above the trachea the vocal cords are located here it is also known as the voice box What is directly posterior to the nose? - ANSWER>>nasopharynx The nasopharynx connects the opening of the nostrils to the soft palate? Which is located at the back of the mouth. This passage is designed to warm up and held air in filter out fine particulate matter. What ring shaped structure forms the lower portion of the larynx? - ANSWER>>Cricoid Cartilage The inferior portion of the larynx is a cartilaginous ring. It is located directed inferior of the Thyroid cartilage. Where is Sellick's Maneuver applied? - ANSWER>>cricoid cartilage Sellicks maneuver is also called cricoid pressure. It inhibits gas entering the stomach during assisted ventilations. What happens to your diaphragm during inhalation? - ANSWER>>Contracts The diaphragm contracts in a downward motion drawing air into the lungs. What is the name of the cartilaginous Ridge in the trachea at which the right and left lungs split? - ANSWER>>Carina Located beneath the sternum. What is directly posterior to the mouth? - ANSWER>>Oropharynx How many lobes are in the lungs? - ANSWER>>5 3 on the right and two on the left. What is the name of the passageway shared by the digestive tract and the respiratory systems for air and food? - ANSWER>>Pharynx A 34-year-old male says he's choking. You note Stridor and hoarseness in his voice what should you do? - ANSWER>>encourage him to cough Which condition could be considered an upper airway obstruction? - ANSWER>>Epiglottitis An 18-year-old male complains of shortness of breath. He has a history of asthma and self administered two doses of his prescribed metered dose inhaler with no relief. Vital signs are P104 R 22 SP02 91% what should you do? - ANSWER>>Administer oxygen by non-rebreather mask Which of the following conditions is most likely to cause decreased compliance while ventilating via bag valve mask? - ANSWER>>tension pneumothorax A febrile 2 year old male in respiratory distress with crackles in the lower left lung field. You should suspect? - ANSWER>>Pneumonia Which of the following shows a sign of lower respiratory tract problem? - ANSWER>>Expiratory wheezes and long expiration A 64 year old male complains of dyspnea and is coughing up blood tinged sputum. Upon auscultation you note cracks bilaterally. What should you suspect? - ANSWER>>Tuberculosis Which statement indicates that the patient is suffering from a CHF rather than Pneumonia? - ANSWER>>feels like I'm drowning when I sleep When suctioning blood, fluid, and mucous from the oropharynx, the most appropriate device is? - ANSWER>>A rigid tip suction catheter The reason for assessing the radial and the carotid pulse simultaneously is to? - ANSWER>>Confirm Cardiac Rhythm Problem A patient presents with a sudden onset of shortness of breath crackles, hypertension, and jugular distension. You Should suspect? - ANSWER>>Acute Pulmonary Edema A 73 year old male is dyspneic. You note jugular vein distension and dependent edema. Vital signs are BP 158/93, P 130 R 36. What should you suspect? - ANSWER>>Congestive Heart Failure A 19-year-old female began choking after eating a hot dog. When you first arrived on scene, she was coughing and drooling.Now, she is drowsy, slow to respond, and unable to cough. You should? - ANSWER>>Perform abdominal thrusts A 65 year old male is having trouble breathing. He is moderately overweight and has been coughing up yellowish phlegm. He smokes two packs of cigarettes a day and reports having episodes like this for many years - ANSWER>>Chronic bronchitis Which of the following can be present with a sudden onset of difficult breathing and diminished breath sounds - ANSWER>>pneumothorax A semi-conscious 34 year old male begins to gag after insertion of an OPA - ANSWER>>Insert an NPA An 18 year old febrile patient complains of malaise for several days. He is taking an oral antibiotic for an upper respiratory infection. Vital signs are bp 128/72, P118 and weak, R22 with rhonchi - ANSWER>>Bronchitis Which of the following assessment findings should cause you to suspect a history of COPD? - ANSWER>>Barrel shaped chest A thin 75 year old male complains of difficulty breathing. He states he has smoked "3 packs of cigarettes a day for 30 years." He has bilateral wheezes - ANSWER>>Emphysema 16 asthmatic female is in tripod position complains of increased shortness of breath. SPO2 is 79% you should administer oxygen at - ANSWER>>10 lpm via nonrebreather