FISDAP AIRWAY AND BREATHING EXAM
QUESTIONS AND ANSWERS
A 42-year old female is having trouble breathing. She has dysphagia and stridor. You
should suspect: - Answer-Epiglottitis
Overinflating the distal cuff of an endotracheal tube can cause: - Answer-ischemia of the
tracheal wall
A hospice patient has developed dyspnea. Raspy sounds are coming from his
tracheostomy tube. You should: - Answer-Assess and suction if needed
When using the Macintosh blade for orotracheal intubation, the blade: - Answer--Fits
into the vallecula
A 58-yo male has a newly placed stoma and is experiencing difficulty breathing. Vital
signs are P 104, R 22 and labored, SpO2 83%. How can you rapidly confirm that his
stoma is clear? - Answer--Insert a soft catheter completely through the stoma
A 48 yo patient is choking on a hot dog. He is unresponsive, apneic, and has a strong
pulse. Chest compressions are ineffective at relieving the obstruction. You should: -
Answer-Use laryngoscopy and Magill forceps to remove the object
A 19 yo female is unresponsive. Her pupils are nonreactive, she has dried vomit on her
oropharynx, and bilateral rhonchi in her lungs. Vital signs are P 60, R 6. What should
you suspect? - Answer--Recent aspiration
A 28 yo male was driving his motorcycle at 45 mph when it hit a parked car. He was not
wearing a helmet. He is supine with an open fracture to his maxilla. Vital signs are P
120, R 4. What should you do? - Answer--Perform a surgical cricothyrotomy
EM Responders are performing BVM ventilations on a pt in respiratory arrest. The pt's
abdomen is distended. After you intubate the pt. you notice resistance when you
squeeze the BVM. Lung sounds are diminished bilaterally, neck veins are normal, and
the trachea is midline. You should: - Answer--Insert a nasogastric tube
When moving a pt that is endotrachially intubated, which is the most common life-
threatening hazard? - Answer--Dislodging the tube
Which of the following is a complication caused by orotracheal intubation? - Answer--
The right mainstem bronchi is intubated
A 21 yo male was eating dinner and drinking beer when he suddenly grasped his throat.
He is unable to speak or cough. What should you do? - Answer--Abdominal thrusts
, An unresponsive cancer pt is suffering from respiratory acidosis after wearing too many
fentanyl patches. You are managing her airway and have established an IV. Your next
treatment priority should be ventilation at: - Answer--18x per min with 2mg naloxone
What is the maximum allowable time for each individual intubation attempt? - Answer--
30 secs
A 71 yo female complains of dyspnea and pedal edema. Her husband tells you that she
had trouble breathing one hour ago. She is no unresponsive and breathing 34 times per
minute with minimal chest wall movement. What should you do? - Answer--Begin PPV
with a BVM at 15 lpm
What is the main determinant of respirations in a late stage COPD patient? - Answer--
Arterial PCO2
A 5 yo pt swallowed bleach. He is unresponsive , apneic, and drooling. You should: -
Answer--Insert an endotracheal tube
A 44 yo male has a blood pH of 7.32 and a CO2 of 51. What should you suspect? -
Answer--Respiratory acidosis
A 16 yo male went to the school nurse with severe dyspnea, diminished breath sounds
and minimal wheezing. Prior to your arrival, the nurse administered nebulized albuterol.
He speaks to you in 2-3 word sentences and your assessment reveals inspiratory and
expiratory wheezes in all lung fields. What should you do? - Answer--Administer mag
sulfate 2 mg IV
A trauma patient's chest appears to be bloated. When you press on it, you hear a
crackling sound. This is caused by: - Answer--Subcutaneous emphysema
Your medical director is questioning you about a recent intubation. Which of the
following would be your best evidence of endotracheal confirmation? - Answer--End
tidal carbon dioxide waveform printout
Upon placing the endotracheal tube, you can auscultate breath sounds only on the right.
You should: - Answer--Withdraw the tube a couple of centimeters
When inserting the laryngoscope blade into a 31 year old male, his toungue begins to
bleed profusely. What should you do? - Answer--Suction with a large bore catheter
What is the best treatment for hyperventilation syndrome? - Answer--Try to calm and
reassure the patient
A patient with CHF complains of shortness of breath. What breath sounds should you
expect to hear? - Answer--Rhonchi in the upper lobes, especially posterior
QUESTIONS AND ANSWERS
A 42-year old female is having trouble breathing. She has dysphagia and stridor. You
should suspect: - Answer-Epiglottitis
Overinflating the distal cuff of an endotracheal tube can cause: - Answer-ischemia of the
tracheal wall
A hospice patient has developed dyspnea. Raspy sounds are coming from his
tracheostomy tube. You should: - Answer-Assess and suction if needed
When using the Macintosh blade for orotracheal intubation, the blade: - Answer--Fits
into the vallecula
A 58-yo male has a newly placed stoma and is experiencing difficulty breathing. Vital
signs are P 104, R 22 and labored, SpO2 83%. How can you rapidly confirm that his
stoma is clear? - Answer--Insert a soft catheter completely through the stoma
A 48 yo patient is choking on a hot dog. He is unresponsive, apneic, and has a strong
pulse. Chest compressions are ineffective at relieving the obstruction. You should: -
Answer-Use laryngoscopy and Magill forceps to remove the object
A 19 yo female is unresponsive. Her pupils are nonreactive, she has dried vomit on her
oropharynx, and bilateral rhonchi in her lungs. Vital signs are P 60, R 6. What should
you suspect? - Answer--Recent aspiration
A 28 yo male was driving his motorcycle at 45 mph when it hit a parked car. He was not
wearing a helmet. He is supine with an open fracture to his maxilla. Vital signs are P
120, R 4. What should you do? - Answer--Perform a surgical cricothyrotomy
EM Responders are performing BVM ventilations on a pt in respiratory arrest. The pt's
abdomen is distended. After you intubate the pt. you notice resistance when you
squeeze the BVM. Lung sounds are diminished bilaterally, neck veins are normal, and
the trachea is midline. You should: - Answer--Insert a nasogastric tube
When moving a pt that is endotrachially intubated, which is the most common life-
threatening hazard? - Answer--Dislodging the tube
Which of the following is a complication caused by orotracheal intubation? - Answer--
The right mainstem bronchi is intubated
A 21 yo male was eating dinner and drinking beer when he suddenly grasped his throat.
He is unable to speak or cough. What should you do? - Answer--Abdominal thrusts
, An unresponsive cancer pt is suffering from respiratory acidosis after wearing too many
fentanyl patches. You are managing her airway and have established an IV. Your next
treatment priority should be ventilation at: - Answer--18x per min with 2mg naloxone
What is the maximum allowable time for each individual intubation attempt? - Answer--
30 secs
A 71 yo female complains of dyspnea and pedal edema. Her husband tells you that she
had trouble breathing one hour ago. She is no unresponsive and breathing 34 times per
minute with minimal chest wall movement. What should you do? - Answer--Begin PPV
with a BVM at 15 lpm
What is the main determinant of respirations in a late stage COPD patient? - Answer--
Arterial PCO2
A 5 yo pt swallowed bleach. He is unresponsive , apneic, and drooling. You should: -
Answer--Insert an endotracheal tube
A 44 yo male has a blood pH of 7.32 and a CO2 of 51. What should you suspect? -
Answer--Respiratory acidosis
A 16 yo male went to the school nurse with severe dyspnea, diminished breath sounds
and minimal wheezing. Prior to your arrival, the nurse administered nebulized albuterol.
He speaks to you in 2-3 word sentences and your assessment reveals inspiratory and
expiratory wheezes in all lung fields. What should you do? - Answer--Administer mag
sulfate 2 mg IV
A trauma patient's chest appears to be bloated. When you press on it, you hear a
crackling sound. This is caused by: - Answer--Subcutaneous emphysema
Your medical director is questioning you about a recent intubation. Which of the
following would be your best evidence of endotracheal confirmation? - Answer--End
tidal carbon dioxide waveform printout
Upon placing the endotracheal tube, you can auscultate breath sounds only on the right.
You should: - Answer--Withdraw the tube a couple of centimeters
When inserting the laryngoscope blade into a 31 year old male, his toungue begins to
bleed profusely. What should you do? - Answer--Suction with a large bore catheter
What is the best treatment for hyperventilation syndrome? - Answer--Try to calm and
reassure the patient
A patient with CHF complains of shortness of breath. What breath sounds should you
expect to hear? - Answer--Rhonchi in the upper lobes, especially posterior
