Egan's Final Exam 2023 with complete solution;Actual
Questions and Answers
What is the primary indication for tracheal suctioning?
Retention of secretions
What is the most common complication of suctioning?
hypoxemia.
Complications of tracheal suctioning include all of the following except:
hyperinflation
How often should patients be suctioned?
When physical findings support the need
What is the normal range of negative pressure to use when suctioning an adult
patient?
-100 to -120 mm Hg
but in egan's -120 to -150 mmHg
What is the normal range of negative pressure to use when suctioning children?
-100 to -120 mm Hg
or -80 to -120 mmHg
You are about to suction a 10-year-old patient who has a 6-mm (internal diameter)
endotracheal tube in place. What is the maximum size of catheter that you would
use in this case?
10Fr
You are about to suction a female patient who has an 8-mm (internal diameter)
endotracheal tube in place. What is the maximum size of catheter you would use
in this case?
14 Fr
To prevent hypoxemia when suctioning a patient, the respiratory care practitioner
should initially do which of the following?
preoxygenate
To maintain positive end expiratory pressure (PEEP) and high FiO2 when
suctioning a mechanically ventilated patient, what would you recommend?
Use a closed-system multiuse suction catheter.
Total application time for endotracheal suction in adults should not exceed which
of the following?
10-15 sec
While suctioning a patient, you observe an abrupt change in the
electrocardiogram waveform being displayed on the cardiac monitor. Which of
the following actions would be most appropriate?
Stop suctioning and immediately administer oxygen
what methods can help to reduce the likelihood of atelectasis due to tracheal
suctioning?
1. Limit the amount of negative pressure used.
2. Hyperoxygenate the patient before and after the procedure.
3. Suction for as short a period of time as possible.
,Which of the following can help to minimize the likelihood of mucosal trauma
during suctioning?
1. Use as large a catheter as possible.
2. Rotate the catheter while withdrawing.
3. Use as rigid a catheter as possible.
4. Limit the amount of negative pressure.
2 and 4
Absolute contraindication for nasotracheal suctioning includes which of the
following?
1. Epiglottitis
2. Croup
3. Irritable airway
1 and 2
Which of the following equipment is NOT needed to perform nasotracheal
suctioning?
a.suction kit (catheter, gloves, basin, etc.)
b.laryngoscope with MacIntosh and Miller blades
c.oxygen delivery system (mask and manual resuscitator)
d.bottle of sterile water or saline solution
b.laryngoscope with MacIntosh and Miller blades
After repeated nasotracheal suctioning over 2 days, a patient with retained
secretions develops minor bleeding through the nose. Which of the following
actions would you recommend?
Stop the bleeding and use a nasopharyngeal airway for access.
Before the suctioning of a patient, auscultation reveals coarse breath sounds
during both inspiration and expiration. After suctioning, the coarseness
disappears, but expiratory wheezing is heard over both lung fields. What is most
likely the problem?
The patient has hyperactive airways and has developed bronchospasm.
What general condition requires airway management?
1. Airway compromise
2. Respiratory failure
3. Need to protect the airway
1, 2, and 3
Which of the following conditions require emergency tracheal intubation?
1. Upper airway or laryngeal edema
2. Loss of protective reflexes
3. Cardiopulmonary arrest
4. Traumatic upper airway obstruction
1,2,3,4
All of the following indicate an inability to adequately protect the airway except:
a.wheezing
b.coma
c.lack of gag reflex
d.inability to cough
a.wheezing
, Compared with the nasal route, the advantages of oral intubation include all of
the following except:
a.reduced risk of kinking
b.less retching and gagging
c.easier suctioning
d.less traumatic insertion
b.less retching and gagging
Compared with the oral route, the advantages of nasal intubation include all of
the following except:
a.reduced risk of kinking
b.less retching and gagging
c.less accidental extubation
d.greater long-term comfort
a.reduced risk of kinking
Compared with translaryngeal intubation, the advantages of tracheostomy
include all of the following except:
a.greater patient comfort
b.reduced risk of bronchial intubation
c.no upper airway complications
d.decreased frequency of aspiration
d.decreased frequency of aspiration
What is the standard size for endotracheal or tracheostomy tube adapters?
15 mm external diameter
What is the purpose of the additional side port (Murphy eye) on most modern
endotracheal tubes?
ensure gas flow if the main port is blocked
What is the purpose of a cuff on an artificial tracheal airway?
to seal off and protect the lower airway
What is the purpose of the pilot balloon on an endotracheal or a tracheostomy
tube?
to monitor cuff status and pressure
Which of the following features incorporated into most modern endotracheal
tubes assist in verifying proper tube placement?
1. Length markings on the curved body of the tube
2. Imbedded radiopaque indicator near the tube tip
3. Additional side port (Murphy eye) near the tube tip
1 and 2
The removable inner cannula commonly incorporated into modern tracheostomy
tubes serves which of the following purposes?
1. aid in routine tube cleaning and tracheostomy care
2. prevent the tube from slipping into the trachea
3. provide a patent airway should it become obstructed
1 and 3
What is the purpose of a tracheostomy tube obturator?
assist in the insertion of a tracheostomy tube
Questions and Answers
What is the primary indication for tracheal suctioning?
Retention of secretions
What is the most common complication of suctioning?
hypoxemia.
Complications of tracheal suctioning include all of the following except:
hyperinflation
How often should patients be suctioned?
When physical findings support the need
What is the normal range of negative pressure to use when suctioning an adult
patient?
-100 to -120 mm Hg
but in egan's -120 to -150 mmHg
What is the normal range of negative pressure to use when suctioning children?
-100 to -120 mm Hg
or -80 to -120 mmHg
You are about to suction a 10-year-old patient who has a 6-mm (internal diameter)
endotracheal tube in place. What is the maximum size of catheter that you would
use in this case?
10Fr
You are about to suction a female patient who has an 8-mm (internal diameter)
endotracheal tube in place. What is the maximum size of catheter you would use
in this case?
14 Fr
To prevent hypoxemia when suctioning a patient, the respiratory care practitioner
should initially do which of the following?
preoxygenate
To maintain positive end expiratory pressure (PEEP) and high FiO2 when
suctioning a mechanically ventilated patient, what would you recommend?
Use a closed-system multiuse suction catheter.
Total application time for endotracheal suction in adults should not exceed which
of the following?
10-15 sec
While suctioning a patient, you observe an abrupt change in the
electrocardiogram waveform being displayed on the cardiac monitor. Which of
the following actions would be most appropriate?
Stop suctioning and immediately administer oxygen
what methods can help to reduce the likelihood of atelectasis due to tracheal
suctioning?
1. Limit the amount of negative pressure used.
2. Hyperoxygenate the patient before and after the procedure.
3. Suction for as short a period of time as possible.
,Which of the following can help to minimize the likelihood of mucosal trauma
during suctioning?
1. Use as large a catheter as possible.
2. Rotate the catheter while withdrawing.
3. Use as rigid a catheter as possible.
4. Limit the amount of negative pressure.
2 and 4
Absolute contraindication for nasotracheal suctioning includes which of the
following?
1. Epiglottitis
2. Croup
3. Irritable airway
1 and 2
Which of the following equipment is NOT needed to perform nasotracheal
suctioning?
a.suction kit (catheter, gloves, basin, etc.)
b.laryngoscope with MacIntosh and Miller blades
c.oxygen delivery system (mask and manual resuscitator)
d.bottle of sterile water or saline solution
b.laryngoscope with MacIntosh and Miller blades
After repeated nasotracheal suctioning over 2 days, a patient with retained
secretions develops minor bleeding through the nose. Which of the following
actions would you recommend?
Stop the bleeding and use a nasopharyngeal airway for access.
Before the suctioning of a patient, auscultation reveals coarse breath sounds
during both inspiration and expiration. After suctioning, the coarseness
disappears, but expiratory wheezing is heard over both lung fields. What is most
likely the problem?
The patient has hyperactive airways and has developed bronchospasm.
What general condition requires airway management?
1. Airway compromise
2. Respiratory failure
3. Need to protect the airway
1, 2, and 3
Which of the following conditions require emergency tracheal intubation?
1. Upper airway or laryngeal edema
2. Loss of protective reflexes
3. Cardiopulmonary arrest
4. Traumatic upper airway obstruction
1,2,3,4
All of the following indicate an inability to adequately protect the airway except:
a.wheezing
b.coma
c.lack of gag reflex
d.inability to cough
a.wheezing
, Compared with the nasal route, the advantages of oral intubation include all of
the following except:
a.reduced risk of kinking
b.less retching and gagging
c.easier suctioning
d.less traumatic insertion
b.less retching and gagging
Compared with the oral route, the advantages of nasal intubation include all of
the following except:
a.reduced risk of kinking
b.less retching and gagging
c.less accidental extubation
d.greater long-term comfort
a.reduced risk of kinking
Compared with translaryngeal intubation, the advantages of tracheostomy
include all of the following except:
a.greater patient comfort
b.reduced risk of bronchial intubation
c.no upper airway complications
d.decreased frequency of aspiration
d.decreased frequency of aspiration
What is the standard size for endotracheal or tracheostomy tube adapters?
15 mm external diameter
What is the purpose of the additional side port (Murphy eye) on most modern
endotracheal tubes?
ensure gas flow if the main port is blocked
What is the purpose of a cuff on an artificial tracheal airway?
to seal off and protect the lower airway
What is the purpose of the pilot balloon on an endotracheal or a tracheostomy
tube?
to monitor cuff status and pressure
Which of the following features incorporated into most modern endotracheal
tubes assist in verifying proper tube placement?
1. Length markings on the curved body of the tube
2. Imbedded radiopaque indicator near the tube tip
3. Additional side port (Murphy eye) near the tube tip
1 and 2
The removable inner cannula commonly incorporated into modern tracheostomy
tubes serves which of the following purposes?
1. aid in routine tube cleaning and tracheostomy care
2. prevent the tube from slipping into the trachea
3. provide a patent airway should it become obstructed
1 and 3
What is the purpose of a tracheostomy tube obturator?
assist in the insertion of a tracheostomy tube
