DAANCE Airway Management and Oxygen Therapy 5 — Questions and Answers
Question 1: The sniffing position optimizes airway alignment by achieving which combination?
- Flexion of the neck and extension of the cervical spine
- Extension of the lower cervical and flexion of the upper cervical spine (Correct answer)
- Flexion of both the lower and upper cervical spine
- Neutral alignment of the entire cervical spine
Correct answer: Extension of the lower cervical and flexion of the upper cervical spine
The sniffing position involves lower cervical extension and upper cervical flexion, aligning the oral, pharyngeal, and laryngeal axes for optimal airway visualization.
Question 2: Which of the following is a contraindication to nasopharyngeal airway (NPA) insertion?
- Patient with intact gag reflex
- Suspected basilar skull fracture (Correct answer)
- Mild nasal congestion
- Patient under minimal sedation
Correct answer: Suspected basilar skull fracture
A suspected basilar skull fracture is an absolute contraindication to NPA insertion due to risk of intracranial placement through a cribriform plate fracture.
Question 3: During oxygen flush of an N2O delivery system at end of procedure, the recommended duration of 100% oxygen administration is:
- 1-2 minutes
- 3-5 minutes (Correct answer)
- 8-10 minutes
- 15-20 minutes
Correct answer: 3-5 minutes
A 3-5 minute flush with 100% oxygen at the end of N2O sedation prevents diffusion hypoxia as N2O rapidly exits the bloodstream.
Question 4: Which Mallampati class is associated with the MOST difficult laryngoscopy and intubation?
- Class I
- Class II
- Class III
- Class IV (Correct answer)
Correct answer: Class IV
Mallampati Class IV, in which only the hard palate is visible, correlates with the highest likelihood of difficult laryngoscopy and intubation.
Question 5: A patient breathing 100% oxygen via non-rebreather mask has an SpO2 of 99%. This SpO2 reading confirms:
- Adequate ventilation and CO2 elimination
- Absence of respiratory depression
- Adequate hemoglobin oxygen saturation only (Correct answer)
- Normal cardiac output
Correct answer: Adequate hemoglobin oxygen saturation only
SpO2 measures hemoglobin oxygen saturation only; a high SpO2 on supplemental oxygen does not rule out hypoventilation or CO2 retention.
Question 6: An oropharyngeal airway (OPA) of correct size should extend from the:
- Tip of the nose to the earlobe
- Corner of the mouth to the earlobe (Correct answer)
- Center of the lips to the angle of the mandible
- Incisors to the hyoid bone
Correct answer: Corner of the mouth to the earlobe
The correct OPA size is estimated by measuring from the corner of the mouth to the earlobe (or center of mouth to angle of mandible).
Question 7: Which capnography waveform pattern is characteristic of bronchospasm?
- Absent waveform (flatline)
- Normal rectangular waveform with elevated plateau
- Shark-fin shaped waveform with sloped plateau (Correct answer)
- Waveform with cleft during plateau phase
Correct answer: Shark-fin shaped waveform with sloped plateau
Bronchospasm causes uneven alveolar emptying, producing a characteristic shark-fin or sloped capnography waveform due to obstructed expiratory flow.
DAANCE Airway Management and Oxygen Therapy 5
The sniffing position optimizes airway alignment by achieving which combination?