Airway Management TMC Exam Practice Questions

Airway Management Sample TMC Practice Questions (2024)

by | Updated: Apr 9, 2024

Airway management is the process of maintaining ventilation so the patient can take in oxygen while removing carbon dixiode. This includes suctioning, intubation, airway maintenance, and extubation.

Respiratory therapists are responsible for this process, which is why this is an important topic for students.

In this guide, we’ve listed sample TMC practice questions on the topic of airway management. This can help you practice and prepare with questions similar to what you’ll see on the licensure exam offered by the NBRC.

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Note: We didn’t include the correct answers on this page so that you can test your knowledge. If you want to see the correct answers (with detailed rationales), just simply download the digital study guide.

Airway Management Sample TMC Practice Questions:

1. A 50-year-old male patient is intubated with a size 8 endotracheal tube and is receiving volume-controlled A/C ventilation. Upon assessment, you note that the patient’s cuff pressure is measured at 38 cmH2O. Which of the following would you recommend?
A. Withdraw the tube 1-2 cm and reassess the patient’s breath sounds
B. Recommend reintubation with a smaller endotracheal tube
C. Lower the cuff pressure to < 30 cmH2O
D. Recommend ventilation via a tracheostomy instead

2. A 58-year-old female patient is intubated and appears to be breathing asynchronously with the ventilator. Her breath sounds are absent on the left side, and the trachea is shifted to the left. The patient has a dull percussion note on the left side as well. Which of the following is the most likely explanation of these findings?
A. A tracheoesophageal fistula has developed
B. A tension pneumothorax has developed on the left side
C. The endotracheal tube is in the right mainstem bronchus
D. The patient is experiencing diffuse bronchospasm

3. The physician has requested the insertion of a nasopharyngeal airway in an adult patient. This type of airway is helpful in supporting which of the following?
A. Mechanical ventilation
B. Frequent suctioning
C. Incentive spirometry
D. Aerosol drug therapy

4. You would expect it to be difficult establishing a patent airway in a patient with which of the following conditions?
A. ARDS
B. Morbid obesity
C. Pleural effusion
D. Ventilator-associated pneumonia

5. A 43-year-old female patient in the emergency department was just orally intubated with an endotracheal tube. Which of the following would you INITIALLY recommend in order to confirm that the tube is in the proper position?
A. Auscultate the patient’s chest and abdomen
B. Perform a STAT chest x-ray
C. Use capnography to verify exhaled CO2
D. Observe chest wall movement

6. A 61-year-old female was orally intubated and is now receiving positive pressure ventilatory support. A chest radiograph was ordered to confirm the proper placement of the endotracheal tube. Where should the tip of the tube be positioned?
A. No more than 2 cm above the carina
B. At the same level as the carina
C. Level with the fifth cervical vertebra
D. Between the 2nd and 4th thoracic vertebra

7. A 64-year-old male patient is intubated and receiving ventilatory support in the volume-controlled SIMV mode. The physician anticipates that the patient will be on the ventilator for another 3–5 days. Which of the following would you recommend?
A. Switch the patient to NPPV
B. Switch from an ET tube to a tracheostomy
C. Maintain the endotracheal tube in place
D. Switch to a pressure-controlled mode

8. Which of the following is true regarding the insertion of a laryngeal mask airway compared to endotracheal intubation?
A. It must be removed in order to insert an endotracheal tube
B. It poses a greater risk of trauma than endotracheal intubation
C. It can be inserted blindly without any special equipment
D. It can completely prevent the aspiration of gastric contents

9. A 49-year-old male is intubated and receiving mechanical ventilation with a size 7.5 endotracheal tube. Over the past hour, the patient has been compressing the tube between his teeth. Which of the following would you recommend?
A. The application of a Brigg’s adapter
B. The use of a bite block
C. The administration of a neuromuscular blocking agent
D. The administration of a strong narcotic analgesic

10. A chest x-ray was ordered to confirm that the endotracheal tube is positioned in the correct place. Where should the tip of the tube be located?
A. Even with the carina
B. Level with the 5th cervical vertebra
C. At the sixth intercostal space
D. 1–2 inches above the carina

11. A 63-year-old female patient is orally intubated with a size 7 endotracheal tube and is receiving ventilatory support. While attempting to suction the patient with a size 12 Fr catheter, the catheter cannot pass beyond the tip of the tube. Which of the following is the most likely cause of this problem?
A. There is a kink in the tube
B. The tube is in the right mainstem bronchus
C. The suction catheter is too short
D. The suction catheter size is too large

12. After the extubation of a 54-year-old male patient, he begins to complain of a sore throat. Which of the following drugs would you recommend for this patient?
A. Levalbuterol
B. Isoetharine
C. Racemic epinephrine
D. Acetylcysteine

13. You are called to the NICU to assist with the intubation of a newborn infant. While gathering supplies, which of the following laryngoscope blades would you select?
A. Miller
B. Macintosh
C. Guedel
D. Berman

14. Immediately after an intubation procedure in the ER, the doctor requests for you to auscultate the patient to confirm proper tube placement. While listening, you hear gurgling over the epigastrium and no breath sounds. Which of the following is the most likely cause of this finding?
A. Right-sided tension pneumothorax
B. Intubation of the right mainstem bronchus
C. Intubation of the left mainstem bronchus
D. Intubation of the patient’s esophagus

15. In which of the following cases would you recommend against the insertion of a supraglottic airway?
A. A patient that needs emergency ventilation
B. A patient with a suspected cervical spine injury
C. A patient whom ET intubation is difficult
D. A patient with a known esophageal disease

16. An unconscious patient with apnea was admitted to the ER, and the physician warns that the patient is at risk of aspirating. Which of the following would you recommend for securing this patient’s airway?
A. Performing a percutaneous tracheotomy
B. Inserting a laryngeal mask airway
C. Intubating via the nasal route instead
D. Inserting an esophageal-tracheal combitube

17. Which of the following is the normal average depth of oral endotracheal tube insertion in an adult patient?
A. 26 cm from the patient’s teeth
B. 22 inches from the patient’s lip
C. 22 cm from the patient’s lip
D. 32 cm from the patient’s teeth

18. A physician requested the insertion of a nasopharyngeal airway in a conscious patient who requires frequent nasotracheal suctioning. On your first attempt, you are only able to pass the airway about 3 cm into the patient’s nostril. Which of the following actions should you take at this time?
A. Recommend nasotracheal intubation
B. Use a laryngeal mask airway instead
C. Switch to an oropharyngeal airway
D. Insert the airway in the other nostril

19. After a patient was recently intubated, you fear that too much air was inserted into the endotracheal tube cuff. Which of the following would result from significant overinflation?
A. Air leakage
B. Laryngospasm
C. Silent aspiration
D. Mucosal ischemia

20. Which of the following devices can be used to measure a patient’s endotracheal tube cuff pressure?
A. Volumeter
B. Manometer
C. Respirometer
D. Pneumotachometer

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21. A 57-year-old male patient is being ventilated with a bag-valve resuscitator through an LMA. While providing manual breaths, you notice a significant air leak. Which of the following should be your first approach to eliminate the leak?
A. Add more air to the LMA cuff
B. Decrease the cuff pressure
C. Pull the tube out 2–3 cm
D. Bag more slowly to reduce the peak pressure

22. You are called to the emergency room to assist with rapid sequence intubation. Before the attempt, the injection of air into the pilot line fails to inflate the cuff. Which of the following would you recommend?
A. Inspect the pilot line for patency
B. Replace the endotracheal tube
C. Check the cuff for leaks
D. Check the valve on the pilot line

23. Which of the following actions can you take to allow a patient with a tracheostomy button to talk or cough effectively?
A. Attach a one-way inspiratory valve
B. Completely deflate the button cuff
C. Use spacers to position the button
D. Attach a standard 15-mm connector

24. Which of the following is a contraindication for the insertion of a laryngeal mask airway (LMA)?
A. Conscious or semi-conscious patients
B. Patients with a risk of aspiration
C. Patients who are breathing spontaneously
D. Both A and B

25. A 21-year-old male patient arrives in the ER with a cervical collar after a motor vehicle accident. Which of the following would you recommend to quickly secure the airway and provide ventilation?
A. Perform blind nasotracheal intubation
B. Orally intubate with manual in-line stabilization
C. Insert a nasopharyngeal airway
D. Apply the head-tilt, chin-lift maneuver

26. An adult patient in the emergency room requires STAT intubation. Before starting the procedure, it’s required to check all of the following devices EXCEPT:
A. Suction equipment
B. Laryngoscope light source
C. Rigidity of the stylet
D. Endotracheal tube cuff

27. A chest x-ray was performed on an intubated 44-year-old male patient. Which of the following indicates that the endotracheal tube is in the proper position?
A. The tip of the tube is even with the carina
B. The tip of the tube is 2–6 cm above the carina
C. The tip of the tube is at the sixth intercostal space
D. The tip of the tube is level with the 5th cervical vertebra

28. An 59-year-old female patient is receiving mechanical ventilation with a size 7.0 endotracheal tube. Over the last hour, the patient has been clamping the tube with her teeth. Which of the following would you recommend?
A. Insert an oropharyngeal airway
B. Use a Brigg’s adapter
C. Administer a strong narcotic analgesic
D. Administer a neuromuscular blocking agent

29. All of the following are indications for changing a tracheostomy tube EXCEPT?
A. The need for a different size
B. A damaged tube cuff
C. A soiled stoma dressing
D. The need for a fenestrated tube

30. You were called to help extubate an adult patient who is orally intubated. All of the following equipment must be available for extubation EXCEPT:
A. Laryngoscope
B. Suction equipment
C. Bag-valve mask
D. Noninvasive ventilator

31. What size suction catheter is most appropriate for an adult patient who is intubated with a size 8.0 mm endotracheal tube?
A. 10 Fr
B. 12 Fr
C. 14 Fr
D. 16 Fr

32. An adult patient is receiving volume-controlled ventilation in the ICU. Upon assessment, you note a sudden drop in the peak inspiratory pressure. Which of the following is most likely the cause of this problem?
A. Mucus plug
B. Tension pneumothorax
C. Ruptured ET tube cuff
D. Copious airway secretions

33. A 61-year-old male patient is intubated with a size 8 endotracheal tube and is receiving positive pressure ventilation in the volume-controlled A/C mode. Upon assessment, you notice a large air leak throughout inspiration with a cuff pressure measurement of 14 cmH2O. Which of the following would you recommend?
A. Reassess the cuff pressure during expiration
B. Inflate the ET tube cuff to 20–30 cmH2O
C. Add an additional 10 mL of air to the ET tube cuff
D. Replace the endotracheal tube with a larger size

34. The nurse calls for you to help extubate a female patient who is orally intubated. All of the following equipment is required for this procedure EXCEPT:
A. New endotracheal tube
B. Suction equipment
C. Bag-valve mask
D. Arterial blood gas kit

35. An adult patient in the ER is intubated with a King LT airway. After being admitted, you were called to exchange the current airway with an endotracheal tube. Which of the following would you recommend?
A. Insert the ET tube under the King LT
B. Insert the ET tube above the King LT
C. Remove the King LT and temporarily apply NIPPV
D. Use an airway exchange catheter

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Final Thoughts

As previously mentioned, airway management is an important subject that is featured on the TMC Exam. Therefore, it’s essential that respiratory therapists (and students) develop a strong understanding of the topic.

Hopefully, this guide with sample TMC practice questions can help make the learning process easier.

If you want to increase your chances of passing the TMC exam on your first (or next) attempt, be sure to check out some of our other helpful resources:

You can join thousands of our other previous students who passed both board exams to earn their RRT credentials. Best of luck, and thanks for reading!

John Landry, BS, RRT

Written by:

John Landry, BS, RRT

John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. He enjoys using evidence-based research to help others breathe easier and live a healthier life.

References

  • Faarc, Kacmarek Robert PhD Rrt, et al. Egan’s Fundamentals of Respiratory Care. 12th ed., Mosby, 2020.
  • Chang, David. Clinical Application of Mechanical Ventilation. 4th ed., Cengage Learning, 2013.
  • Rrt, Cairo J. PhD. Pilbeam’s Mechanical Ventilation: Physiological and Clinical Applications. 7th ed., Mosby, 2019.
  • Faarc, Heuer Al PhD Mba Rrt Rpft. Wilkins’ Clinical Assessment in Respiratory Care. 8th ed., Mosby, 2017.

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