NRSG 2640 EXAM 1 | 169 QUESTIONS AND ANSWERS |
2026 UPDATE | WITH COMPLETE SOLUTION
What are possible indications for placement of an artificial airway? Answer - -
upper airway obstruction (EX: burns, tumor, TBI, etc.)
- apnea
- risk of aspiration
- ineffective clearance of secretions
- respiratory distress
- mechanical ventilation
- protect airway
- neuromuscular disorders
- acid/base imbalance
Is consent required for intubation? Answer - Yes, unless it is an emergent
intubation.
Even if the patient is unresponsive, always try to communicate to the patient
about the procedure.
How do we protect patients and the ET tube during intubation? Answer -
Sedation along with a bite block may be used to prevent obstruction of the
tube or biting down on it.
,Why is proper inflation of the cuff so important when intubating a patient?
Answer - Too much inflation can cause damage to the tissue of the trachea and
eventually cause necrosis.
Too little inflation or no inflation can allow secretions to fall into the lungs,
development of aspiration pneumonia, and/or the tube can become dislodged.
True or false: Nurses are responsible for initiating and maintaining proper
inflation of the ET tube cuff. Answer - False
Only a physician and/or RT are trained to properly handle inflation of the cuff.
True or false: Any time a patient is intubated, the cuff must be inflated. Answer
- False
If the patient is sedated/unconcious or on a ventilator, the cuff must be
inflated. However, if the patient is alert and *able to clear secretions* the cuff
can be deflated.
What specific piece of rescue equipment must be in a ventilated patient's room
*at all times*? Answer - Self-inflating bag-valve-mask (BVM, or Ambu bag)
If something goes wrong during or after intubation or at any point the
ventilator becomes detached, what is your first action? Answer - Attach the
Ambu bag (that should always be located in the patient room) to the ET tube
and begin manual ventilation
What drugs are administered during rapid sequence intubation (RSI)? Answer -
Rapid, concurrent administration of sedative and paralytic agents
,A sedative-hypnotic-amnesic is used to induce unconsiousness along with a
rapid-onset opioid to blunt the pain of the procedure.
A paralytic drug is then given to produce skeletal muscle paralysis.
True or false: Paralytics are usually given before sedatives. Answer - False
The sedative should always be given before the paralytic.
Sedation eliminates what reflex that makes intubation particularly difficult?
Answer - The gag reflex
Intubation that fights against the gag reflex will likely lead to vomiting and
aspiration pneumonia.
What is the recommended head/neck position for ease of intubation? Answer
- Supine, sniffing position
Head tilted back, chin up, neck flexed
What are nursing implications regarding oxygenation during intubation?
Answer - - preoxygenate using BVM/Ambu with 100% O2 for 3-5 minutes
- limit each intubation attempt to <30 seconds
- ventilate patient for 2 minutes between successive attempts using
BVM/Ambu with 100% O2
How do we assess for proper ET tube placement? What is necessary to confirm
exact placement? Answer - Is the chest moving bilaterally? Do you hear breath
sounds in both lungs? Do you hear air in the belly?
, A chest x-ray is needed to confirm exact placement of the ET tube.
What is left to be done by the nurse (or possibly RT) immediately following
intubation? Answer - - mark and record exact position of the tube
- cut off excess tubing
- obtain ABGs within 15-30 minutes
- continously monitor pulse ox and end-tidal CO2
True or false: ET tube placement must be *continuously* monitored. Answer -
True
Confirm exit mark on ET tube remains constant at the lip. Also observe chest
wall movement and auscultate bilateral breath sounds.
True or false: Incorrect tube placement is an *emergency*. Answer - True
Stay with your patient and support ventilation. If necessary, ventilate manually
with BVM and 100% O2. Call for help.
If the tube is not in the lungs, the patient is not being oxygenated. If the tube is
only in one lung, the patient is not being oxygenated adequately.
How do we continuously monitor and assess oxygenation and ventilation for a
patient with an artificial airway? Answer - Oxygenation
- ABGs
- SpO2
- clinical s/s of hypoxemia
2026 UPDATE | WITH COMPLETE SOLUTION
What are possible indications for placement of an artificial airway? Answer - -
upper airway obstruction (EX: burns, tumor, TBI, etc.)
- apnea
- risk of aspiration
- ineffective clearance of secretions
- respiratory distress
- mechanical ventilation
- protect airway
- neuromuscular disorders
- acid/base imbalance
Is consent required for intubation? Answer - Yes, unless it is an emergent
intubation.
Even if the patient is unresponsive, always try to communicate to the patient
about the procedure.
How do we protect patients and the ET tube during intubation? Answer -
Sedation along with a bite block may be used to prevent obstruction of the
tube or biting down on it.
,Why is proper inflation of the cuff so important when intubating a patient?
Answer - Too much inflation can cause damage to the tissue of the trachea and
eventually cause necrosis.
Too little inflation or no inflation can allow secretions to fall into the lungs,
development of aspiration pneumonia, and/or the tube can become dislodged.
True or false: Nurses are responsible for initiating and maintaining proper
inflation of the ET tube cuff. Answer - False
Only a physician and/or RT are trained to properly handle inflation of the cuff.
True or false: Any time a patient is intubated, the cuff must be inflated. Answer
- False
If the patient is sedated/unconcious or on a ventilator, the cuff must be
inflated. However, if the patient is alert and *able to clear secretions* the cuff
can be deflated.
What specific piece of rescue equipment must be in a ventilated patient's room
*at all times*? Answer - Self-inflating bag-valve-mask (BVM, or Ambu bag)
If something goes wrong during or after intubation or at any point the
ventilator becomes detached, what is your first action? Answer - Attach the
Ambu bag (that should always be located in the patient room) to the ET tube
and begin manual ventilation
What drugs are administered during rapid sequence intubation (RSI)? Answer -
Rapid, concurrent administration of sedative and paralytic agents
,A sedative-hypnotic-amnesic is used to induce unconsiousness along with a
rapid-onset opioid to blunt the pain of the procedure.
A paralytic drug is then given to produce skeletal muscle paralysis.
True or false: Paralytics are usually given before sedatives. Answer - False
The sedative should always be given before the paralytic.
Sedation eliminates what reflex that makes intubation particularly difficult?
Answer - The gag reflex
Intubation that fights against the gag reflex will likely lead to vomiting and
aspiration pneumonia.
What is the recommended head/neck position for ease of intubation? Answer
- Supine, sniffing position
Head tilted back, chin up, neck flexed
What are nursing implications regarding oxygenation during intubation?
Answer - - preoxygenate using BVM/Ambu with 100% O2 for 3-5 minutes
- limit each intubation attempt to <30 seconds
- ventilate patient for 2 minutes between successive attempts using
BVM/Ambu with 100% O2
How do we assess for proper ET tube placement? What is necessary to confirm
exact placement? Answer - Is the chest moving bilaterally? Do you hear breath
sounds in both lungs? Do you hear air in the belly?
, A chest x-ray is needed to confirm exact placement of the ET tube.
What is left to be done by the nurse (or possibly RT) immediately following
intubation? Answer - - mark and record exact position of the tube
- cut off excess tubing
- obtain ABGs within 15-30 minutes
- continously monitor pulse ox and end-tidal CO2
True or false: ET tube placement must be *continuously* monitored. Answer -
True
Confirm exit mark on ET tube remains constant at the lip. Also observe chest
wall movement and auscultate bilateral breath sounds.
True or false: Incorrect tube placement is an *emergency*. Answer - True
Stay with your patient and support ventilation. If necessary, ventilate manually
with BVM and 100% O2. Call for help.
If the tube is not in the lungs, the patient is not being oxygenated. If the tube is
only in one lung, the patient is not being oxygenated adequately.
How do we continuously monitor and assess oxygenation and ventilation for a
patient with an artificial airway? Answer - Oxygenation
- ABGs
- SpO2
- clinical s/s of hypoxemia
