NRSG 2640 EXAM 1 QUESTIONS AND
ANSWERS GRADED A+ 2026
What are possible indications for placement of an artificial airway? - ANS - 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? - ANS 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? - ANS Sedation along with a
bite block may be used to prevent obstruction of the tube or biting down on it.
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 1
,Why is proper inflation of the cuff so important when intubating a patient? - ANS 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. - ANS 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. - ANS 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*? -
ANS 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? - ANS 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)? - ANS 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.
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 2
,True or false: Paralytics are usually given before sedatives. - ANS False
The sedative should always be given before the paralytic.
Sedation eliminates what reflex that makes intubation particularly difficult? - ANS 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? - ANS Supine, sniffing
position
Head tilted back, chin up, neck flexed
What are nursing implications regarding oxygenation during intubation? - ANS - 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? - ANS 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? -
ANS - mark and record exact position of the tube
- cut off excess tubing
- obtain ABGs within 15-30 minutes
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 3
, - continously monitor pulse ox and end-tidal CO2
True or false: ET tube placement must be *continuously* monitored. - ANS 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*. - ANS 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? - ANS Oxygenation
- ABGs
- SpO2
- clinical s/s of hypoxemia
Ventilation
- PaCO2
- end tidal CO2
- respiratory rate and rhythm
- use of accessory muscles
True or false: Patients with an artificial airway should be routinely suctioned to maintain tube
patency. - ANS False
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 4
ANSWERS GRADED A+ 2026
What are possible indications for placement of an artificial airway? - ANS - 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? - ANS 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? - ANS Sedation along with a
bite block may be used to prevent obstruction of the tube or biting down on it.
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 1
,Why is proper inflation of the cuff so important when intubating a patient? - ANS 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. - ANS 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. - ANS 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*? -
ANS 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? - ANS 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)? - ANS 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.
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 2
,True or false: Paralytics are usually given before sedatives. - ANS False
The sedative should always be given before the paralytic.
Sedation eliminates what reflex that makes intubation particularly difficult? - ANS 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? - ANS Supine, sniffing
position
Head tilted back, chin up, neck flexed
What are nursing implications regarding oxygenation during intubation? - ANS - 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? - ANS 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? -
ANS - mark and record exact position of the tube
- cut off excess tubing
- obtain ABGs within 15-30 minutes
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 3
, - continously monitor pulse ox and end-tidal CO2
True or false: ET tube placement must be *continuously* monitored. - ANS 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*. - ANS 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? - ANS Oxygenation
- ABGs
- SpO2
- clinical s/s of hypoxemia
Ventilation
- PaCO2
- end tidal CO2
- respiratory rate and rhythm
- use of accessory muscles
True or false: Patients with an artificial airway should be routinely suctioned to maintain tube
patency. - ANS False
@COPYRIGHT 2026/2027 ALLRIGHTS RESERVED 4
