NBRC Airway Management 2 — Questions and Answers
Question 1: Right mainstem bronchus intubation is most commonly detected by:
- Decreased ETCO2 readings
- Absent left-sided breath sounds (Correct answer)
- Lower peak airway pressures
- Decreased heart rate
Correct answer: Absent left-sided breath sounds
Intubation of the right mainstem bronchus results in absent or decreased breath sounds over the left lung because only the right lung is being ventilated.
Question 2: Which medication is a depolarizing neuromuscular blocking agent used in RSI?
- Rocuronium
- Vecuronium
- Succinylcholine (Correct answer)
- Atracurium
Correct answer: Succinylcholine
Succinylcholine is the only depolarizing neuromuscular blocker in clinical use; it causes rapid-onset fasciculations followed by paralysis.
Question 3: A tracheostomy tube is indicated for all of the following EXCEPT:
- Prolonged mechanical ventilation (>2 weeks)
- Upper airway obstruction
- Facilitation of secretion removal
- Short-term airway management during a brief surgery (Correct answer)
Correct answer: Short-term airway management during a brief surgery
Tracheostomy is reserved for situations requiring a prolonged or secure airway; an endotracheal tube is preferred for short-term surgical airway needs.
Question 4: Nasopharyngeal airways are contraindicated in patients with:
- Intact gag reflex
- Basilar skull fracture (Correct answer)
- Trismus (lockjaw)
- Nasal congestion
Correct answer: Basilar skull fracture
Basilar skull fractures are a contraindication for nasopharyngeal airways because the tube may inadvertently enter the cranial vault through the fracture.
Question 5: The Mallampati classification is used to predict:
- Degree of COPD severity
- Difficulty of endotracheal intubation (Correct answer)
- Severity of upper airway obstruction
- Likelihood of aspiration pneumonia
Correct answer: Difficulty of endotracheal intubation
The Mallampati scale assesses oropharyngeal anatomy by viewing visible structures with the mouth open, helping predict difficult intubation.
Question 6: Video laryngoscopy compared to direct laryngoscopy typically provides:
- Worse glottic visualization in most patients
- Improved glottic view, especially in difficult airways (Correct answer)
- Faster time to intubation in all situations
- No advantage in obese patients
Correct answer: Improved glottic view, especially in difficult airways
Video laryngoscopy offers an improved view of the glottis by providing an indirect, magnified image, particularly benefiting patients with difficult airway anatomy.
NBRC Airway Management 2
Right mainstem bronchus intubation is most commonly detected by: