INSTRUCTIONS Managing the airway in acute care patients
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Lippincott Professional Development will award 1.5 contact hours for this continuing nursing education activity.
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Managing the airway in acute care patients
General Purpose: To describe the basics of airway management, including how to assess, secure, and manage an airway in an emergent situation. Learning Objectives/Outcomes: After completing this continuing-education activity, you should be able to: 1. Recall methods of airway assessment in patients experiencing respiratory failure. 2. Identify methods of oxygen administration and ventilation when treating patients in respiratory distress. 3. Summarize standard guidelines and techniques for securing an airway in a patient in respiratory distress.
1. When a patient has acute respiratory failure, the key objective is to facilitate adequate gas exchange by
a. monitoring respiratory status.
b. administering supplemental oxygen.
c. maintaining a patent airway.
2. Which of the following assessment findings indicates a more rapid respiratory decline?
a. copious secretions
b. chest retractions
c. snoring
3. For patients who have a history of opioid use, which of the following actions could help NPs avoid intubation?
a. inserting an oral airway
b. applying a rebreather mask
c. administering a reversal agent
4. Patients should be intubated for airway protection when, with an unclear history of the cause, they have a GCS below
a. 8.
b. 10.
c. 12.
5. Visibility of only the base of the uvula and the soft palate is the criterion for a score of Mallampati
a. II.
b. III.
c. IV.
6. The examiner who sees only the soft palate scores this as a Cormack-Lehane grade of
a. 2.
b. 3.
c. 4.
7. Which technique should NPs use to open the airway when suspecting a cervical spine injury?
a. jaw thrust
b. chin lift
c. head tilt
8. To select the correct size of nasopharyngeal airway, NPs should measure the distance from the
a. corner of the mouth to the angle of the mandible.
b. tip of the nose to the earlobe.
c. corner of the mouth to the earlobe.
9. Delivering oxygen via a low-flow nasal cannula system delivers 100% oxygen, but the maximum Fio2 the patient will receive is
a. 30%.
b. 50%.
c. 70%.
10. While evaluating patients who have severe respiratory failure, NPs should apply which oxygen-delivery device?
a. high-flow nasal cannula
b. air entrainment mask
c. reservoir face mask
11. With the E-O technique, NPs use which two fingers of both hands to hold the mask in place?
a. index and middle fingers
b. index finger and thumb
c. middle and ring fingers
12. If, during bag mask ventilation, the chest does not rise, the appropriate action is to
a. reposition the head and mask.
b. insert a laryngeal mask airway.
c. insert an endotracheal tube.
13. When using a Macintosh blade for DL, NPs place the tip
a. directly under the epiglottis.
b. beyond the glottis.
c. in the vallecula
14. The gold standard for checking for carbon dioxide release is
a. use of a color-changing device.
b. quantitative waveform capnography.
c. arterial blood gas analysis.
15. Which of the following conditions is a criterion for endotracheal tube placement for airway protection and invasive mechanical ventilation initiation?
a. evolving hepatic encephalopathy
b. an oxygen saturation of 94%
c. GCS less than 10
16. A quick way to identify a difficult airway is one in which
a. secretions are copious enough to require suctioning prior to intubation.
b. the patient has hypercarbia refractory to more basic modes of oxygen delivery.
c. at least one attempt at endotracheal intubation via DL has already failed.
17. NPs should consider using which of the following as a first-line method when confronted with potential life-threatening complications, such as failed endotracheal intubation via DL?
a. video laryngoscopy
b. laryngeal mask airway
c. cricothyroidotomy
18. When inserting a laryngeal mask airway, NPs should direct it into the mouth so that it ultimately rests
a. beyond the vocal cords.
b. in the pharynx.
c. above the glottis.