FINAL EXAM QUESTIONS WITH
COMPLETE ANSWERS
When viewing a CXR film of an intubated patient, what feature of the endotracheal tube
actually allows you to visualize it on the CXR image? - ANSWER-The radiopaque line
On the CXR in the previous question, the ideal position of the endotracheal tube would
be with the tip sitting - ANSWER-3 to 7 centimeters above the carina
You are caring for an intubated adult female patient, and note that her oral endotracheal
tube is secured in place showing the 24 cm mark lining up with her mid-lip line. 2 hours
later you assess the patient again, and note that now the 20 cm mark lines up with her
mid-lip line. This means - ANSWER-The tube has been withdawn or pulled out of the
patient by 4 cm.
One of the standard parts of a tracheostomy tube kit, this device is only used when the
entire tube is being placed into the neck stoma of a patient. It has a rounded smooth
edge to make the insertion less traumatic. It is called the - ANSWER-Obturator
What is the main purpose of the fenestration holes found on the outer cannula of a
fenestrated tracheostomy tube? - ANSWER-They allow air to reach the upper airway
and vocal cords to facilitate speech.
In comparing the traditional OR surgical approach for tracheostomy tube placement to
the newer percutaneous method seen in the ICU setting, which of the following
statements is true? - ANSWER-The traditional OR approach is associated with a larger
incision and longer healing time than the percutaneous method.
You are out shopping at the local mall, when you witness an elderly person collapse in
the Hot Topic store. You rush to help and find them pulseless, apneic, and
unresponsive. Another shopper has started doing chest compressions, and you decide
to perform mouth-to-mouth ventilations. What should your goal be, regarding effective
ventilation technique? - ANSWER-Provide rescue breathing with enough force to cause
visible chest rise at a ratio of 30 chest compressions to 2 ventilations.
Which of the following is a potential advantage that self-inflating bag valve mask
devices have over mouth-to-mask ventilation devices - ANSWER-Higher FIO2 can be
delivered with the bag valve mask device when compared to mouth-to-mask devices.
PEEP valves can be readily applied to a bag valve mask device, but may be impossible
to use on a mouth-to-mask device.
Rescuer fatigue happens less frequently with bag valve mask devices when compared
to mouth-to-mask devices.
, Which one of the following devices DOES NOT require a compressed oxygen gas
source and flow to operate? - ANSWER-Self Inflating Bag Valve Mask Device
The red arrow is pointing to what feature, and what does it do? - ANSWER-The oxygen
reservoir bag; it ensures delivery of high FIO2 to the patient when used properly
Which scenario below would deliver the highest FIO2 possible to a patient when using a
self inflating bag valve resuscitator device? - ANSWER-A device that has a functioning
reservoir bag, attached to an oxygen flowmeter set at 15 LPM..
You are performing bag valve mask resuscitation with a self inflating style device on an
adult patient during a code blue. Suddenly, you notice that you are failing to achieve
chest rise on the patient during inhalation. The FIRST thing you should do is -
ANSWER-Check the fit and seal of the mask on the patient
What is the purpose of a pressure relief valve (AKA pressure pop off) as a feature on an
infant self inflating bag valve mask resuscitator device? - ANSWER-It prevents excess
pressure from being delivered to the infant, protecting the lungs from trauma.
You are performing a pre-use check on an adult sized self inflating bag valve mask
resuscitator device. When you completely occlude the patient port with a clean, gloved
hand and attempt to squeeze the bag, it allows you to completely squeeze the bag until
it appears emptied. This means: - ANSWER-The device has failed the pre-use check
and should be immediately discarded.
Regarding the portable, emergency ventilators that some facilities use for patient
transport or in the event of a mass casualty situation, which one choice is a general
truth? - ANSWER-These devices are very primitive in design compared to the larger
ventilators seen in critical care units.
An adult patient has been intubated in the ER, and now the RRT is assisting with patient
transport up to the ICU. The RRT manually ventilates the patient at a consistent rate of
36 breaths/minute, with full 2-handed squeezes of the bag on each inhalation. When the
patient arrives to the ICU, what might you expect to see on the ICU monitor when the
first arterial blood pressure is taken? - ANSWER-80/60
Ideal resuscitation bags have an exhalation port that will allow for the attachment of
what device to further improve lung expansion and improve oxygenation if needed? -
ANSWER-PEEP valve
You are in clinicals, and a patient arrives to the ER being manually ventilated by EMS
staff via an endotracheal tube. The patient was involved in a severe MVA, and has
multiple broken ribs throughout the thorax. A STAT CXR confirms proper ETT
placement, but also reveals the presence of a large tension pneumothorax on the left
chest. You take over bagging from the EMS staff. What effect would the large