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NURS 629 – Nurse Anesthesia Breathing tract
Handling Study Guide 2027
1. What structures are included in the breathing tract?
A. Nasal cavity, oral cavity, pharynx, larynx, trachea, and principal bronchi
B. Esophagus, stomach, small intestine, and colon
C. Heart, lungs, diaphragm, and pleura
D. Nasal cavity, esophagus, stomach, and bronchioles
Correct Answer: A. Nasal cavity, oral cavity, pharynx, larynx, trachea, and principal bronchi
Expert Rationale: The breathing tract includes the anatomical passages responsible for conducting air from the nose or
mouth through the pharynx and larynx, into the trachea and principal bronchi.
2. Which two principal bronchi are part of the breathing tract?
A. Superior and inferior bronchi
B. Left and right mainstem bronchi
C. Anterior and posterior bronchi
D. Upper and lower bronchi
Correct Answer: B. Left and right mainstem bronchi
Expert Rationale: The trachea divides into the right and left mainstem, or principal, bronchi, which conduct air into the
respective lungs.
3. Why is the breathing tract considered anatomically complex?
A. It contains only one type of tissue
B. Its size and shape are influenced by multiple developmental factors
C. It remains the same throughout life
D. It is completely independent of hormonal changes
Correct Answer: B. Its size and shape are influenced by multiple developmental factors
Expert Rationale: Airway anatomy varies because growth, genetics, nutrition, hormones, and congenital abnormalities can
influence the size, shape, and structural characteristics of the airway.
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4. Which factors can influence the size and shape of the breathing tract?
A. Genetic, nutritional, and hormonal factors
B. Cardiovascular and renal factors only
C. Environmental temperature only
D. Blood type and skin color
Correct Answer: A. Genetic, nutritional, and hormonal factors
Expert Rationale: Genetic development, nutritional status, and hormonal influences can all alter airway anatomy and affect
airway management.
5. Which is an example of a congenital malformation that can affect the breathing tract?
A. Hypertension
B. Cleft lip and palate
C. Diabetes mellitus
D. Anemia
Correct Answer: B. Cleft lip and palate
Expert Rationale: Cleft lip and cleft palate are congenital structural abnormalities that can alter the anatomy of the upper
airway and complicate airway management.
6. How can malnutrition affect the breathing tract?
A. It makes airway tissues stronger
B. It causes the airway to become more rigid
C. It can result in fragile and friable airway tissue
D. It permanently enlarges the airway
Correct Answer: C. It can result in fragile and friable airway tissue
Expert Rationale: Malnutrition can impair tissue integrity, making airway tissues fragile and more susceptible to trauma
during airway manipulation.
7. Why does malnutrition increase concern during airway handling?
A. The airway becomes completely immobile
B. Fragile tissues can be easily injured or compressed
C. The trachea becomes filled with fluid
D. The bronchi become permanently closed
Correct Answer: B. Fragile tissues can be easily injured or compressed
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Expert Rationale: Friable airway tissue is more vulnerable to trauma, bleeding, and compression during airway
instrumentation.
8. How can obesity affect airway management?
A. It always decreases airway resistance
B. It can produce a thick neck and increased soft-tissue compression
C. It eliminates the need for airway assessment
D. It makes intubation universally easier
Correct Answer: B. It can produce a thick neck and increased soft-tissue compression
Expert Rationale: Excess soft tissue around the neck and upper airway can contribute to airway narrowing, obstruction, and
difficulty with airway visualization or instrumentation.
9. Which physical characteristic associated with obesity can complicate airway management?
A. Thin neck
B. Thick neck
C. Short fingers
D. Increased foot size
Correct Answer: B. Thick neck
Expert Rationale: A thick neck and increased soft tissue can make airway positioning, visualization, ventilation, and
instrumentation more difficult.
10. How can pregnancy affect the upper airway?
A. It eliminates airway edema
B. It can cause nasal and oral cavity edema
C. It permanently narrows the trachea
D. It causes the bronchioles to close
Correct Answer: B. It can cause nasal and oral cavity edema
Expert Rationale: Hormonal and physiologic changes during pregnancy, particularly in the third trimester, can increase
vascularity and edema of upper-airway tissues.
11. During which period of pregnancy may nasal and oral airway edema become particularly significant?
A. First trimester only
B. Second trimester only
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C. Third trimester
D. After delivery only
Correct Answer: C. Third trimester
Expert Rationale: The study guide specifically identifies the third trimester as a period when edema of the nasal and oral
cavities can become clinically important for airway management.
12. Why is proper airway handling important in perioperative care?
A. It is unrelated to patient safety
B. It is paramount to safe perioperative care
C. It is needed only after surgery
D. It applies only to pediatric patients
Correct Answer: B. It is paramount to safe perioperative care
Expert Rationale: Maintaining a patent and adequately managed airway is a fundamental component of perioperative patient
safety.
13. How many airway-management plans should be prepared?
A. One
B. Two
C. Three
D. Four
Correct Answer: B. Two
Expert Rationale: The guide emphasizes having a primary airway-management plan and a backup plan in case the initial
approach is unsuccessful.
14. What is the purpose of having a backup airway plan?
A. To avoid assessing the airway
B. To provide an alternative approach if the primary plan fails
C. To delay airway management
D. To eliminate airway equipment
Correct Answer: B. To provide an alternative approach if the primary plan fails
Expert Rationale: A backup plan improves preparedness for unexpected airway difficulty and allows the clinician to
transition promptly to an alternative strategy.
NURS 629 – Nurse Anesthesia Breathing tract
Handling Study Guide 2027
1. What structures are included in the breathing tract?
A. Nasal cavity, oral cavity, pharynx, larynx, trachea, and principal bronchi
B. Esophagus, stomach, small intestine, and colon
C. Heart, lungs, diaphragm, and pleura
D. Nasal cavity, esophagus, stomach, and bronchioles
Correct Answer: A. Nasal cavity, oral cavity, pharynx, larynx, trachea, and principal bronchi
Expert Rationale: The breathing tract includes the anatomical passages responsible for conducting air from the nose or
mouth through the pharynx and larynx, into the trachea and principal bronchi.
2. Which two principal bronchi are part of the breathing tract?
A. Superior and inferior bronchi
B. Left and right mainstem bronchi
C. Anterior and posterior bronchi
D. Upper and lower bronchi
Correct Answer: B. Left and right mainstem bronchi
Expert Rationale: The trachea divides into the right and left mainstem, or principal, bronchi, which conduct air into the
respective lungs.
3. Why is the breathing tract considered anatomically complex?
A. It contains only one type of tissue
B. Its size and shape are influenced by multiple developmental factors
C. It remains the same throughout life
D. It is completely independent of hormonal changes
Correct Answer: B. Its size and shape are influenced by multiple developmental factors
Expert Rationale: Airway anatomy varies because growth, genetics, nutrition, hormones, and congenital abnormalities can
influence the size, shape, and structural characteristics of the airway.
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4. Which factors can influence the size and shape of the breathing tract?
A. Genetic, nutritional, and hormonal factors
B. Cardiovascular and renal factors only
C. Environmental temperature only
D. Blood type and skin color
Correct Answer: A. Genetic, nutritional, and hormonal factors
Expert Rationale: Genetic development, nutritional status, and hormonal influences can all alter airway anatomy and affect
airway management.
5. Which is an example of a congenital malformation that can affect the breathing tract?
A. Hypertension
B. Cleft lip and palate
C. Diabetes mellitus
D. Anemia
Correct Answer: B. Cleft lip and palate
Expert Rationale: Cleft lip and cleft palate are congenital structural abnormalities that can alter the anatomy of the upper
airway and complicate airway management.
6. How can malnutrition affect the breathing tract?
A. It makes airway tissues stronger
B. It causes the airway to become more rigid
C. It can result in fragile and friable airway tissue
D. It permanently enlarges the airway
Correct Answer: C. It can result in fragile and friable airway tissue
Expert Rationale: Malnutrition can impair tissue integrity, making airway tissues fragile and more susceptible to trauma
during airway manipulation.
7. Why does malnutrition increase concern during airway handling?
A. The airway becomes completely immobile
B. Fragile tissues can be easily injured or compressed
C. The trachea becomes filled with fluid
D. The bronchi become permanently closed
Correct Answer: B. Fragile tissues can be easily injured or compressed
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Expert Rationale: Friable airway tissue is more vulnerable to trauma, bleeding, and compression during airway
instrumentation.
8. How can obesity affect airway management?
A. It always decreases airway resistance
B. It can produce a thick neck and increased soft-tissue compression
C. It eliminates the need for airway assessment
D. It makes intubation universally easier
Correct Answer: B. It can produce a thick neck and increased soft-tissue compression
Expert Rationale: Excess soft tissue around the neck and upper airway can contribute to airway narrowing, obstruction, and
difficulty with airway visualization or instrumentation.
9. Which physical characteristic associated with obesity can complicate airway management?
A. Thin neck
B. Thick neck
C. Short fingers
D. Increased foot size
Correct Answer: B. Thick neck
Expert Rationale: A thick neck and increased soft tissue can make airway positioning, visualization, ventilation, and
instrumentation more difficult.
10. How can pregnancy affect the upper airway?
A. It eliminates airway edema
B. It can cause nasal and oral cavity edema
C. It permanently narrows the trachea
D. It causes the bronchioles to close
Correct Answer: B. It can cause nasal and oral cavity edema
Expert Rationale: Hormonal and physiologic changes during pregnancy, particularly in the third trimester, can increase
vascularity and edema of upper-airway tissues.
11. During which period of pregnancy may nasal and oral airway edema become particularly significant?
A. First trimester only
B. Second trimester only
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C. Third trimester
D. After delivery only
Correct Answer: C. Third trimester
Expert Rationale: The study guide specifically identifies the third trimester as a period when edema of the nasal and oral
cavities can become clinically important for airway management.
12. Why is proper airway handling important in perioperative care?
A. It is unrelated to patient safety
B. It is paramount to safe perioperative care
C. It is needed only after surgery
D. It applies only to pediatric patients
Correct Answer: B. It is paramount to safe perioperative care
Expert Rationale: Maintaining a patent and adequately managed airway is a fundamental component of perioperative patient
safety.
13. How many airway-management plans should be prepared?
A. One
B. Two
C. Three
D. Four
Correct Answer: B. Two
Expert Rationale: The guide emphasizes having a primary airway-management plan and a backup plan in case the initial
approach is unsuccessful.
14. What is the purpose of having a backup airway plan?
A. To avoid assessing the airway
B. To provide an alternative approach if the primary plan fails
C. To delay airway management
D. To eliminate airway equipment
Correct Answer: B. To provide an alternative approach if the primary plan fails
Expert Rationale: A backup plan improves preparedness for unexpected airway difficulty and allows the clinician to
transition promptly to an alternative strategy.
