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Airway Trauma associated with Tracheal Tubes

Total questions: 103

Worksheet time: 52mins

Name
Class
Date
1.

Which of the following is a type of trauma that can occur due to artificial airways?

a)

Ischemia or ulceration

b)

Friction injuries

c)

Negative reactions

d)

Laryngeal dysfunction

e)

All of the above

2.

Ischemia or ulceration due to artificial airways is caused by ________ on the soft tissue of the airway.

a)

pressure

b)

infection

c)

humidity

d)

temperature

3.

Friction injuries from tracheal tubes are due to:

a)

Pressure on the soft tissue

b)

Patient moving their head and position of tube

c)

Reaction to the material of the tube

d)

Lack of stimulation from airflow

4.

Negative reactions to tracheal tubes may occur because the patient may have a reaction to the ________ of the tube.

a)

material

b)

length

c)

color

d)

shape

5.

Laryngeal dysfunction occurs secondary to a lack of stimulation from ________.

a)

airflow

b)

blood flow

c)

nerve impulses

d)

muscle contraction

6.

Which of the following is a technique used to diagnose airway trauma?

a)

Physical examination

b)

Blood transfusion

c)

Chemotherapy

d)

Dialysis

7.

Which of the following is a technique used to diagnose airway trauma?

a)

Fluoroscopy

b)

Appendectomy

c)

Insulin therapy

d)

Cataract surgery

8.

Which of the following is a technique used to diagnose airway trauma?

a)

Laryngoscopy

b)

Colonoscopy

c)

Angioplasty

d)

Gastrectomy

9.

Which of the following is a technique used to diagnose airway trauma?

a)

Bronchoscopy

b)

Endoscopy

c)

Lithotripsy

d)

Phlebotomy

10.

Which of the following imaging techniques is used to diagnose airway trauma?

a)

MRI

b)

X-ray

c)

Ultrasound

d)

CT scan

11.

Fill in the blank: ________ is a technique used to diagnose airway trauma and is abbreviated as PFT.

a)

Pulmonary Function Test

b)

Peak Flow Test

c)

Pulmonary Fiberoptic Test

d)

Pulmonary Flow Technique

12.

What is the most common complication of artificial airways?

a)

Glottic edema

b)

Sore throat/hoarseness

c)

Infection

d)

Bleeding

13.

Sore throat/hoarseness as a complication of artificial airways is usually the result of _________?

a)

tube irritation

b)

infection of the lungs

c)

allergic reaction to medication

d)

improper humidification

14.

How long does sore throat/hoarseness usually last after artificial airway insertion?

a)

1-2 hours

b)

2-3 days

c)

1 week

d)

1 month

15.

Which of the following is a recommended treatment for sore throat/hoarseness after artificial airway insertion?

a)

Antibiotics

b)

Cool mist aerosol

c)

Surgery

d)

Oxygen therapy

16.

Inspiratory stridor is the #1 clinical sign of which complication of artificial airways?

a)

Sore throat/hoarseness

b)

Glottic edema

c)

Infection

d)

Bleeding

17.

Glottic edema can be caused by all of the following EXCEPT:

a)

Traumatic intubation

b)

Insertion with oversized tube or trach

c)

Poor artificial airway maintenance

d)

Regular exercise

18.

Which of the following is NOT a treatment for glottic edema?

a)

Cool aerosol

b)

Vasoconstrictor

c)

Corticosteroids

d)

Antibiotics

19.

What is subglottic edema?

a)

Edema that occurs above the glottis

b)

Edema that occurs below the glottis at the level of the cricoid cartilage

c)

Edema that occurs in the lungs

d)

Edema that occurs in the vocal cords

20.

Subglottic edema is a serious complication after extubation that commonly requires _________

a)

reintubation

b)

antibiotics only

c)

humidified oxygen only

d)

chest physiotherapy

21.

What action should be taken if subglottic edema occurs after extubation?

a)

Wait and observe

b)

Aggressive actions should be taken

c)

No action is needed

d)

Give antibiotics only

22.

Marked inspiratory stridor with or without sternal retractions is a sign of which condition?

a)

Subglottic edema

b)

Asthma

c)

Pneumonia

d)

Bronchitis

23.

Vocal cord ulceration should be suspected if hoarseness continues for more than _________.

a)

1 week

b)

2 days

c)

3 months

d)

5 hours

24.

Which of the following is NOT a cause of vocal cord ulceration?

a)

Traumatic intubation

b)

Tight-fitting ETT

c)

Allergic reaction

d)

Viral infection

e)

Excessive movement of the tube

25.

Vocal cord ulceration can be caused by traumatic intubation.

a)

True

b)

False

26.

What is vocal cord paralysis caused by?

a)

Damage to the recurrent laryngeal nerve

b)

Damage to the trachea

c)

Infection in the lungs

d)

Allergic reaction

27.

Vocal cord paralysis occurs secondary to which type of injury?

a)

Upper chest or neck injury

b)

Leg injury

c)

Abdominal injury

d)

Arm injury

28.

Laryngotracheal web is caused by necrotic tissue at the ______ or subglottic level.

a)

glottic

b)

tracheal

c)

epiglottic

d)

cricoid

29.

What does necrotic tissue at the glottic or subglottic level lead to?

a)

Fibrin formation

b)

Infection

c)

Bleeding

d)

Swelling

30.

Fibrin formation in laryngotracheal web combines with ______ and cellular debris.

a)

secretions

b)

cartilage

c)

mucosa

d)

blood vessels

31.

What does the combination of fibrin, secretions, and cellular debris create in laryngotracheal web?

a)

Web

b)

Tumor

c)

Scar

d)

Cyst

32.

Stridor and acute airway obstruction can occur in laryngotracheal web.

a)

True

b)

False

33.

Severe cases of laryngotracheal web require ______ removal.

a)

surgical

b)

medical

c)

laser

d)

chemical

34.

Look at the images provided. Which image shows a Normal Glottis?

a)

Left image

b)

Right image

35.

What is the main difference between a Normal Glottis and a Glottic Web? Fill in the blank: A Glottic Web is characterized by the presence of a _______ across the glottis.

a)

web or membrane

b)

nodule

c)

polyp

d)

ulcer

36.

What are the most common types of tracheal lesions?

a)

Granulomas, tracheomalacia, and tracheal stenosis

b)

Bronchiectasis, asthma, and pneumonia

c)

Laryngeal nodules, vocal cord paralysis, and epiglottitis

d)

Pulmonary embolism, pleural effusion, and pneumothorax

37.

Which of the following is less common among tracheal lesions?

a)

Granulomas

b)

Tracheomalacia

c)

Tracheoesophageal fistulas

d)

Tracheal stenosis

38.

Tracheomalacia is defined as the softening of the cartilaginous rings which cause collapse of the trachea during inspiration.

a)

True

b)

False

39.

Tracheal stenosis is the narrowing of the lumen of the trachea due to what cause?

a)

Fibrous scarring

b)

Bacterial infection

c)

Congenital malformation

d)

Allergic reaction

40.

In intubated patients, tracheal stenosis most commonly occurs at which site?

a)

At the site of the cuff

b)

At the carina

c)

At the vocal cords

d)

At the tip of the endotracheal tube

41.

Stenosis at the stoma is caused by which of the following?

a)

The stoma being too large

b)

Infection

c)

Movement of the trach

d)

Frequent trach changes

e)

All of the above

42.

What is a tracheoesophageal fistula?

a)

A hole between the esophagus and the trachea

b)

A blockage in the trachea

c)

An infection of the esophagus

d)

A narrowing of the trachea

43.

Tracheoesophageal fistula rarely occurs.

a)

True

b)

False

44.

Tracheoesophageal fistula is most commonly due to ________ surgical technique.

a)

incorrect

b)

sterile

c)

minimally invasive

d)

robotic

45.

Late occurrence of tracheoesophageal fistula can be due to all of the following EXCEPT:

a)

Malnutrition

b)

Tracheal erosion

c)

Sepsis

d)

Viral infection

e)

Esophageal erosion from NG tube

46.

Tracheoesophageal fistula is diagnosed by recurrent aspiration and ________ distension.

a)

abdominal

b)

thoracic

c)

cervical

d)

cranial

47.

The treatment for tracheoesophageal fistula is by ________ repair.

a)

surgical

b)

medical

c)

radiological

d)

conservative

48.

What is a tracheoinnominate fistula?

a)

A hole between the trachea and esophagus

b)

A hole between the trachea and innominate artery

c)

A blockage in the trachea

d)

An infection of the trachea

49.

A tracheoinnominate fistula results in massive blood loss and usually death.

a)

True

b)

False

50.

Only ___% of patients with tracheoinnominate fistula will survive.

a)

25

b)

50

c)

75

d)

10

51.

What is a very rare complication caused by low positioning of the stoma in tracheostomy patients?

a)

Tracheoinnominate fistula

b)

Tracheal stenosis

c)

Tracheomalacia

d)

Tracheoesophageal fistula

52.

Pulsing of the trach tube may be an indication of tracheoinnominate fistula.

a)

True

b)

False

53.

Which of the following is NOT a treatment for tracheoinnominate fistula?

a)

Inflate cuff to apply pressure

b)

Slows bleeding

c)

Surgical repair

d)

Antibiotic therapy

54.

This picture shows how close the trachea is to the brachiocephalic artery and aorta. What complication can occur if a stoma is placed too low during a tracheostomy?

a)

Pneumothorax

b)

Tracheoinnominate fistula (TIF)

c)

Vocal cord paralysis

d)

Subcutaneous emphysema

55.

This picture shows how close the trachea is to the brachiocephalic artery and aorta. Fill in the blank: If a stoma is placed too low, it is easy to cause a _________

a)

trachoinnominate fistula (TIF)

b)

pneumothorax

c)

esophageal perforation

d)

subcutaneous emphysema

56.

Which of the following is a method to limit tube movement for the prevention of complications?

a)

Sedation

b)

Use of sterile technique

c)

High cuff pressures

d)

Changing tube frequently

57.

Which device can be used to limit tube movement?

a)

Swivel adapters

b)

Oxygen mask

c)

Nasal cannula

d)

Face shield

58.

Using a trach collar over a Briggs adapter helps in _________

a)

limiting tube movement

b)

increasing airway resistance

c)

reducing oxygen concentration

d)

causing tube blockage

59.

Why is the selection of proper size tube important in the prevention of complications?

a)

It helps prevent complications related to improper tube fit.

b)

It increases the risk of infection.

c)

It makes the procedure more difficult.

d)

It reduces the effectiveness of the treatment.

60.

Tubes should be changed frequently to prevent complications.

a)

True

b)

False

61.

Which group of patients should be encouraged not to try to speak?

a)

Intubated patients

b)

Ambulatory patients

c)

Pediatric patients

d)

Elderly patients

62.

Using low cuff pressures is recommended for the prevention of complications.

a)

True

b)

False

63.

Which of the following is a part of infection control in the prevention of complications?

a)

Use of sterile technique

b)

High cuff pressures

c)

Frequent tube changes

d)

Encouraging speech

64.

Proper trach care and maintenance is important for _________

a)

infection control

b)

color enhancement

c)

weight gain

d)

improved vision

65.

What is one effect of artificial airways on patients?

a)

They improve the ability to speak

b)

They inhibit the ability to speak

c)

They have no effect on communication

d)

They cure respiratory diseases

66.

Always communicate to your patient regardless if they can talk back.

a)

True

b)

False

67.

Name one way to promote communication for patients with artificial airways.

a)

Speaking trach

b)

Sign language

c)

Lip reading

d)

Hand gestures

68.

Which of the following is NOT a way to promote communication for patients with artificial airways?

a)

A) Speaking trach

b)

B) Writing utensils

c)

C) Use of letter, phrase, or picture board

d)

D) Ignoring the patient

69.

Fill in the blank: The ________ is a device that can help promote communication in patients with artificial airways.

a)

Passy-muir valve

b)

Tracheostomy tube

c)

Endotracheal tube

d)

Nasogastric tube

70.

Artificial airways bypass the upper airways. What is one consequence for patients? Fill in the blank: Patients will have a ________ deficit.

a)

humidity

b)

oxygen

c)

nutrient

d)

calcium

71.

Which of the following is a consequence of a humidity deficit in patients with artificial airways?

a)

Increased ciliary function

b)

Causes thickened secretions and decreases ciliary function

c)

Improved airway clearance

d)

Reduced infection risk

72.

What can occlude the trach tube resulting in airway obstruction, infection, and difficulty breathing? Fill in the blank: ________ secretions can occlude the trach tube.

a)

Thickened

b)

Watery

c)

Clear

d)

Diluted

73.

Selection of humidification based on patient needs includes which of the following options?

a)

HME

b)

Heated humidifier

c)

Both A and B

d)

None of the above

74.

What does HME stand for in the context of humidification? Fill in the blank: HME stands for ________ ________ ________.

a)

Heat Moisture Exchanger

b)

High Moisture Evaporator

c)

Humidification Management Equipment

d)

Heated Medical Element

75.

Tracheostomy tubes require daily cleaning and care to prevent which of the following?

a)

Infection and mucus plugging

b)

Bleeding

c)

Fractures

d)

High blood pressure

76.

If a patient is having trouble breathing or if a suction catheter cannot be passed, what should be done?

a)

Leave the tube in place

b)

Remove the tube

c)

Increase oxygen

d)

Call for help only

77.

A patient with a tracheostomy tube could decompensate quickly if there is an obstruction.

a)

True

b)

False

78.

Fill in the blank: Tracheostomy tubes require daily cleaning and care to prevent ______ and mucus plugging.

a)

infection

b)

bleeding

c)

fracture

d)

swelling

79.

Which of the following is required for proper trach care procedure?

a)

Gloves and goggles/face shield

b)

Stethoscope

c)

Blood pressure cuff

d)

Thermometer

80.

Fill in the blank: For proper trach care procedure, ________ equipment is required to clear the airway.

a)

Suction

b)

Oxygen

c)

Nebulizer

d)

Stethoscope

81.

Which of the following should be checked before starting the trach care procedure?

a)

Resuscitation bag and mask

b)

Oxygen tank

c)

Tracheostomy tube

d)

Syringe

82.

Fill in the blank: ________ is required to provide breathing support during trach care.

a)

Oxygen

b)

Glucose

c)

Saline

d)

Antibiotics

83.

Which kit is specifically mentioned as required for trach care?

a)

First aid kit

b)

Tracheostomy care kit

c)

Suture kit

d)

IV kit

84.

Fill in the blank: A spare ________ cannula is required for proper trach care procedure.

a)

inner

b)

outer

c)

nasal

d)

arterial

85.

Which of the following is used for cleaning during trach care?

a)

Peroxide and sterile water

b)

Alcohol wipes

c)

Soap and water

d)

Hand sanitizer

86.

Fill in the blank: ________ tipped applicators are required for proper trach care procedure.

a)

Cotton

b)

Plastic

c)

Metal

d)

Foam

87.

Which of the following is used to secure the trach tube?

a)

New trach ties

b)

Bandage

c)

Tape

d)

Gauze

88.

Fill in the blank: A new ________ tube is required for proper trach care procedure.

a)

trach

b)

feeding

c)

endotracheal

d)

nasogastric

89.

Which type of lubricant is required for proper trach care procedure?

a)

Water soluble lubricant

b)

Petroleum jelly

c)

Oil-based lubricant

d)

Silicone gel

90.

Fill in the blank: A ________ is required for proper trach care procedure to help with inflation or suction.

a)

Syringe

b)

Stethoscope

c)

Bandage

d)

Thermometer

91.

What should you do before performing any procedure on a patient?

a)

Suction the patient

b)

Clean the inner cannula

c)

Explain the procedure to the patient

d)

Skip to the next step

92.

Step 3: What must always be done prior to care?

a)

Clean the inner cannula

b)

Clear secretions

c)

Add sterile water

d)

Allow cannula to soak

93.

What is the first action when cleaning the inner cannula?

a)

Add sterile water and peroxide to basin

b)

Remove the inner cannula and place it in the basin

c)

Use brushes to remove dried secretions

d)

Rinse with sterile water

94.

Step 4: After adding sterile water and peroxide to the basin, what should you do next?

a)

Rinse with sterile water

b)

Allow cannula to soak

c)

Remove the inner cannula

d)

Explain the procedure to the patient

95.

What should you do first when cleaning the stoma site?

a)

Apply new gauze dressing

b)

Remove the gauze dressing

c)

Change the ties

d)

Use peroxide solution

96.

After removing the gauze dressing, what should you do with it?

a)

Reuse it

b)

Dispose

c)

Wash and keep

d)

Leave it aside

97.

When using applicators dipped in the peroxide/water solution, where should you start cleaning?

a)

Far from the stoma

b)

Close to the stoma and work away

c)

Only on the ties

d)

On the neck

98.

Step 5: Clean the stoma site

a)

True

b)

False

99.

What should you do to the old ties or velcro holder?

a)

Tighten them

b)

Cut or loosen them

c)

Wash them

d)

Ignore them

100.

When changing the ties, what should you keep one hand on?

a)

The neck

b)

The gauze dressing

c)

The flange of the trach tube

d)

The peroxide solution

101.

Which of the following is a potential long-term complication of tracheal intubation?

a)

Tracheal stenosis

b)

Pneumothorax

c)

Asthma

d)

Pulmonary embolism

102.

What is the primary cause of subglottic edema following extubation?

a)

Allergic reaction

b)

Viral infection

c)

Trauma from the endotracheal tube

d)

Congenital abnormality

103.

Which of the following best describes tracheomalacia?

a)

Stiffening of the tracheal wall

b)

Softening and collapse of the tracheal cartilage

c)

Formation of a tracheal web

d)

Obstruction by a foreign body

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