Question 1

Why is a laryngoscope blade used when placing an endotracheal tube?

Accepted Answer

A)  To guide the endotracheal tube into the esophagus 
B)  To provide visualization of the vocal cords 
C)  To keep the airway open during the intubation attempt 
D)  To determine if the patient has a gag reflex 
A)  To guide the endotracheal tube into the esophagus 
B)  To provide visualization of the vocal cords 
C)  To keep the airway open during the intubation attempt 
D)  To determine if the patient has a gag reflex B

Question 2

A 6-year-old requires immediate intubation. To rapidly determine the proper-sized tube, use the tube that is the same:

Accepted Answer

A)  size as the patient's age. 
B)  length as the distance from the patient's mouth to his earlobe. 
C)  size as 2 + (age in years divided by 4). 
D)  diameter as the patient's little finger. 
A)  size as the patient's age. 
B)  length as the distance from the patient's mouth to his earlobe. 
C)  size as 2 + (age in years divided by 4). 
D)  diameter as the patient's little finger. D

Question 3

When attempting to place an endotracheal tube in an apneic adult patient, what is the maximum amount of time that ventilations can be interrupted?

Accepted Answer

A)  5 seconds 
B)  15 seconds 
C)  30 seconds 
D)  60 seconds 
A)  5 seconds 
B)  15 seconds 
C)  30 seconds 
D)  60 seconds C

Question 4

During an intubation attempt, you can see the patient's vocal cords, but you are having a difficult time directing the endotracheal tube upward and through them. Which of the following pieces of equipment would be beneficial?

Accepted Answer

A)  Stylet 
B)  Curved laryngoscope blade 
C)  Flashlight 
D)  Murphy eye 
A)  Stylet 
B)  Curved laryngoscope blade 
C)  Flashlight 
D)  Murphy eye

Question 5

Which of the following is the best way to continually monitor endotracheal tube placement and ongoing ventilation of the lungs?

Accepted Answer

A)  Capnometer 
B)  Esophageal detection device 
C)  Pulse oximeter 
D)  Breath sounds 
A)  Capnometer 
B)  Esophageal detection device 
C)  Pulse oximeter 
D)  Breath sounds

Question 6

After confirming endotracheal tube placement with auscultation, you attach a bulb-type esophageal detector for added confirmation. Given how this device works, what should happen to the bulb after it is depressed and attached to the end of the endotracheal tube?

Accepted Answer

A)  It should not reinflate. 
B)  It should slowly reinflate. 
C)  It should rapidly reinflate. 
D)  It should not reinflate until you begin ventilations. 
A)  It should not reinflate. 
B)  It should slowly reinflate. 
C)  It should rapidly reinflate. 
D)  It should not reinflate until you begin ventilations.

Question 7

A 4-year-old requires endotracheal intubation with an uncuffed tube. What tube size is most appropriate?

Accepted Answer

A)  5.0 mm 
B)  3.0 mm 
C)  1.0 mm 
D)  7.0 mm 
A)  5.0 mm 
B)  3.0 mm 
C)  1.0 mm 
D)  7.0 mm

Question 8

Which one of the following conditions causes the greatest immediate threat to life when you are attempting an intubation of a patient?

Accepted Answer

A)  Trauma to the airway while you are inserting the tube 
B)  Increase in the patient's heart rate 
C)  Placement of the tube into the trachea 
D)  Placement of the tube in the esophagus 
A)  Trauma to the airway while you are inserting the tube 
B)  Increase in the patient's heart rate 
C)  Placement of the tube into the trachea 
D)  Placement of the tube in the esophagus

Question 9

Which one of the following endotracheal tubes can be used safely in either the adult male or female patient?

Accepted Answer

A)  5.0 mm 
B)  7.5 mm 
C)  Any size, uncuffed 
D)  Medium size 
A)  5.0 mm 
B)  7.5 mm 
C)  Any size, uncuffed 
D)  Medium size

Question 10

You are attempting orotracheal intubation with a laryngoscope handle and a #3 curved blade on a 210-pound, obese male. You cannot achieve adequate glottic visualization for passing the tube despite application of cricoid pressure. Which one of the following changes could be helpful on your next attempt?

Accepted Answer

A)  Use a #2 curved blade. 
B)  Use a #1 straight blade. 
C)  Use a gum elastic bougie. 
D)  Cease application of cricoid pressure. 
A)  Use a #2 curved blade. 
B)  Use a #1 straight blade. 
C)  Use a gum elastic bougie. 
D)  Cease application of cricoid pressure.

Question 11

The EMT has just placed an endotracheal tube in an unresponsive patient who is vomiting. Placement has been confirmed. With the placement of this airway, the EMT recognizes that:

Accepted Answer

A)  the head-tilt, chin-lift still must be maintained. 
B)  the tongue still can block the airway. 
C)  the risk of aspiration is eliminated. 
D)  maintaining a seal with the bag-valve mask is easier. 
A)  the head-tilt, chin-lift still must be maintained. 
B)  the tongue still can block the airway. 
C)  the risk of aspiration is eliminated. 
D)  maintaining a seal with the bag-valve mask is easier.

Question 12

The EMT understands that capnometry informs the care provider of:

Accepted Answer

A)  Level of oxygen in the lungs. 
B)  Amount of CO₂ being exhaled. 
C)  Measure of O₂ being delivered to the cells. 
D)  The adequacy of oxygen diffusion into the bloodstream. 
A)  Level of oxygen in the lungs. 
B)  Amount of CO₂ being exhaled. 
C)  Measure of O₂ being delivered to the cells. 
D)  The adequacy of oxygen diffusion into the bloodstream.

Question 13

Of the following intubation techniques, which one is most likely to be successful on first attempt?

Accepted Answer

A)  Digital intubation 
B)  Intubation with an ETC in place 
C)  Lighted stylet intubation 
D)  Visual orotracheal intubation 
A)  Digital intubation 
B)  Intubation with an ETC in place 
C)  Lighted stylet intubation 
D)  Visual orotracheal intubation

Question 14

You are assisting a paramedic with the placement of an endotracheal tube. The paramedic states that he needs to indirectly lift the epiglottis by pressing on the ligament located in the vallecula to visualize the vocal cords. Which laryngoscope blade should you hand him?

Accepted Answer

A)  Wide 
B)  Straight 
C)  Short 
D)  Curved 
A)  Wide 
B)  Straight 
C)  Short 
D)  Curved

Question 15

While transporting a patient with an Esophageal Tracheal Combitube (ETC) airway in place, the patient regains consciousness and begins gagging on the device. You would immediately:

Accepted Answer

A)  encourage the patient to relax and accept the airway. 
B)  contact medical direction for advisement. 
C)  deflate the cuffs and remove the airway. 
D)  suction the airway through the ETC. 
A)  encourage the patient to relax and accept the airway. 
B)  contact medical direction for advisement. 
C)  deflate the cuffs and remove the airway. 
D)  suction the airway through the ETC.

Question 16

You are transporting an intubated patient, with a heartbeat and on the ventilator, to another hospital for specialized care. The patient is sedated with the following vital signs: pulse 68, respiration via ventilator at 12/minute, blood pressure 112/68, SpO₂ 97%, and PETCO₂ 40 mHg. When reassessing the patient, which of the following is the greatest concern and demands that the EMT notify the ALS provider?

Accepted Answer

A)  Blood pressure 102/58 
B)  SpO₂ drop to 96% 
C)  Pupils both are 4 mm 
D)  PETCO₂ level 15 mmHg 
A)  Blood pressure 102/58 
B)  SpO₂ drop to 96% 
C)  Pupils both are 4 mm 
D)  PETCO₂ level 15 mmHg

Question 17

You have been called to help transport a sedated patient who has been endotracheally intubated and is on a capnometer. The vital signs are: pulse 88, respiration 12 (delivered through a ventilator), and blood pressure 106/64 mmHg. If the tube is in place, what should you see on the capnometer?

Accepted Answer

A)  CO₂ reading of near 0 
B)  Decreasing SpO₂ reading 
C)  CO₂ level of 40 mmHg 
D)  Unchanging blood pressure 
A)  CO₂ reading of near 0 
B)  Decreasing SpO₂ reading 
C)  CO₂ level of 40 mmHg 
D)  Unchanging blood pressure

Question 18

An endotracheal tube has just been placed in an unresponsive asthmatic patient. To confirm proper placement, which one of the following interventions should be performed first?

Accepted Answer

A)  Attach an end-tidal CO₂ detector and watch for color changes. 
B)  Listen for sounds of ventilation over the epigastrium. 
C)  Listen for breath sounds over each lung field. 
D)  Determine the ease by which positive pressure ventilation can be delivered. 
A)  Attach an end-tidal CO₂ detector and watch for color changes. 
B)  Listen for sounds of ventilation over the epigastrium. 
C)  Listen for breath sounds over each lung field. 
D)  Determine the ease by which positive pressure ventilation can be delivered.

Question 19

Why would providing Sellick's maneuver be beneficial when performing endotracheal intubation?

Accepted Answer

A)  Assist the paramedic in visualizing the glottis opening. 
B)  Movement of air from the pharynx into the esophagus is increased. 
C)  Chance of vomitus entering the esophagus is decreased. 
D)  Sellick's stabilizes the cervical spine while intubation is attempted. 
A)  Assist the paramedic in visualizing the glottis opening. 
B)  Movement of air from the pharynx into the esophagus is increased. 
C)  Chance of vomitus entering the esophagus is decreased. 
D)  Sellick's stabilizes the cervical spine while intubation is attempted.

Question 20

You have elected to place an endotracheal tube in an unresponsive, apneic patient. Prior to inserting the laryngoscope blade into the patient's mouth, what instruction would you give your partner?

Accepted Answer

A)  "Lubricate the endotracheal tube with a petroleum-based lubricant." 
B)  "Test the cuff by inflating it with 20 mL of air." 
C)  "Insert the stylet into the endotracheal tube so that it extends ½ inch beyond the end of the tube." 
D)  "Hyperoxygenate the patient for 2 minutes with the bag-valve mask." 
A)  "Lubricate the endotracheal tube with a petroleum-based lubricant." 
B)  "Test the cuff by inflating it with 20 mL of air." 
C)  "Insert the stylet into the endotracheal tube so that it extends ½ inch beyond the end of the tube." 
D)  "Hyperoxygenate the patient for 2 minutes with the bag-valve mask."

Exam 48: Advanced Airway Management

Why is a laryngoscope blade used when placing an endotracheal tube?

A 6-year-old requires immediate intubation. To rapidly determine the proper-sized tube, use the tube that is the same:

When attempting to place an endotracheal tube in an apneic adult patient, what is the maximum amount of time that ventilations can be interrupted?

During an intubation attempt, you can see the patient's vocal cords, but you are having a difficult time directing the endotracheal tube upward and through them. Which of the following pieces of equipment would be beneficial?

Which of the following is the best way to continually monitor endotracheal tube placement and ongoing ventilation of the lungs?

After confirming endotracheal tube placement with auscultation, you attach a bulb-type esophageal detector for added confirmation. Given how this device works, what should happen to the bulb after it is depressed and attached to the end of the endotracheal tube?

A 4-year-old requires endotracheal intubation with an uncuffed tube. What tube size is most appropriate?

Which one of the following conditions causes the greatest immediate threat to life when you are attempting an intubation of a patient?

Which one of the following endotracheal tubes can be used safely in either the adult male or female patient?

The EMT has just placed an endotracheal tube in an unresponsive patient who is vomiting. Placement has been confirmed. With the placement of this airway, the EMT recognizes that:

The EMT understands that capnometry informs the care provider of:

Of the following intubation techniques, which one is most likely to be successful on first attempt?

You are assisting a paramedic with the placement of an endotracheal tube. The paramedic states that he needs to indirectly lift the epiglottis by pressing on the ligament located in the vallecula to visualize the vocal cords. Which laryngoscope blade should you hand him?

While transporting a patient with an Esophageal Tracheal Combitube (ETC) airway in place, the patient regains consciousness and begins gagging on the device. You would immediately:

You have been called to help transport a sedated patient who has been endotracheally intubated and is on a capnometer. The vital signs are: pulse 88, respiration 12 (delivered through a ventilator), and blood pressure 106/64 mmHg. If the tube is in place, what should you see on the capnometer?

An endotracheal tube has just been placed in an unresponsive asthmatic patient. To confirm proper placement, which one of the following interventions should be performed first?

Why would providing Sellick's maneuver be beneficial when performing endotracheal intubation?

You have elected to place an endotracheal tube in an unresponsive, apneic patient. Prior to inserting the laryngoscope blade into the patient's mouth, what instruction would you give your partner?

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