10 free EMT practice questions: Airway Assessment

Perform a jaw-thrust to open the airway: Jaw-thrust is exactly right for this patient and is your very next action. It is the airway maneuver of choice in trauma because it lifts the tongue off the posterior pharynx without moving the cervical spine, and snoring respirations are the finding that calls for it. The only problem is order. Open the airway first and you have a patent airway on a patient whose arterial volume is still emptying onto the pavement; both are indicated, and hemorrhage goes first because it kills first.

Insert an oropharyngeal airway: An oropharyngeal airway holds the tongue forward and is appropriate for a patient with no gag reflex. This patient is moaning, which means responsive enough that a gag is likely still present, so inserting an oropharyngeal airway risks provoking vomiting and aspiration before the simple manual maneuver has even been tried. It sits behind the jaw-thrust within the airway step, and the airway step itself sits behind the bleeding.

Apply high-concentration oxygen by NRB: High-concentration oxygen belongs on this call and will be part of the treatment once the immediate threats are controlled. Oxygen is carried by hemoglobin, and the hemoglobin is what is currently spurting onto the ground, enriching the blood that remains does nothing about the volume being lost, and a mask does not open an obstructed airway either. It is a supportive measure layered on afterward, not the action that changes what happens in the next sixty seconds.

Position the patient supine with the legs elevated to treat shock: Elevating the legs is aimed at shock this patient genuinely has, since a distended abdomen with pale, cool, diaphoretic skin says internal bleeding. Position does not replace lost blood, and the maneuver is of limited value at best, but the deeper problem is sequence: an obstructed airway starves the brain in minutes, while this bleeding needs an operating room that no positioning substitutes for. The key opens the airway, while this rearranges a patient who still is not moving air.

Apply a pelvic binder to control suspected internal bleeding: A pelvic binder is right for a suspected unstable pelvic fracture, meaning instability or crepitus on gentle palpation, or a suggestive mechanism with unexplained shock, because closing the ring tamponades bleeding. This question describes a distended abdomen, not an unstable pelvis, so the indication is not established. Even if the pelvis were the source, circulation is addressed after the airway is open in a patient who is not maintaining it on his own.

Obtain a full set of vital signs before intervening: A full set of vital signs is part of the assessment, but it belongs after the primary survey, not in front of it. The primary survey is a treat-as-you-find sequence, so finding snoring in a patient who responds only to pain means opening the airway at that moment. Numbers gathered while the tongue is obstructing the airway change nothing and cost time this patient does not have.

Obtain a full set of baseline vital signs: A full set of baseline vital signs belongs to the secondary assessment, not the primary assessment that immediately follows the general impression.

Open the airway with a head-tilt/chin-lift: The airway is assessed only after level of consciousness is determined. In the primary assessment sequence, LOC (AVPU) precedes the airway step.

Palpate a radial pulse to assess circulation: Circulation is evaluated after airway and breathing (the 'C' in A-B-C), which themselves follow the LOC check; it is not the next step after forming a general impression.

Resume the abdominal thrusts the caregiver started: Resuming the abdominal thrusts the caregiver started continues a technique that's never used in infants because it risks injuring the liver and other abdominal organs at this age.

Begin chest compressions on a firm surface: Beginning chest compressions on a firm surface is for an unresponsive infant. This infant is still awake, so the relief sequence of back blows and chest thrusts comes first, not compressions.

Begin positive pressure ventilations with a BVM: Beginning positive pressure ventilations with a BVM doesn't help while the airway is still obstructed: ventilations can't get past a complete obstruction, and this infant is still awake and needs the relief maneuvers, not ventilation support.

On the soft tissue under the chin: Compressing the soft tissue under the chin may block the airway rather than open it.

Behind the angles of the lower jaw: Placing fingers behind the angles of the lower jaw describes the jaw-thrust maneuver, used when spinal trauma is suspected.

On the patient's forehead: The forehead is where the heel of the other hand is placed to apply backward pressure, not where the chin-lifting fingertips go.

Head tilt-chin lift maneuver: The head tilt-chin lift maneuver extends the neck, which is avoided when trauma is suspected. This patient's fall down a flight of stairs is exactly that situation, calling for the jaw-thrust instead.

Recovery position with no airway maneuver: Positioning alone does not open an airway that is obstructed by the tongue or other soft tissue; an actual airway-opening maneuver is needed.

Blind finger sweep of the mouth: A blind finger sweep is not a recommended routine airway step and risks pushing any foreign material further into the airway rather than clearing it.

Cross-finger technique: The cross-finger technique opens the mouth to look inside it or suction it. It doesn't move the jaw forward to open a blocked airway, so it doesn't answer what the EMT needs to do here.

Head-tilt chin-lift maneuver: You'd reach for head-tilt chin-lift on a medical patient with no trauma concern, but tilting the head back here risks moving a spine that a fall from a roof could have injured.

Tongue-jaw lift: used to visualize the airway during a foreign-body removal, not as the general airway-opening step in a primary assessment.

Nasopharynx: You'd pick this if you were thinking of where the nose opens into the throat. The nasopharynx is the first section of the pharynx, sitting well above the division, so it's entirely upper airway.

Oropharynx: You'd pick this if you were thinking of where an oropharyngeal airway sits. The oropharynx is the middle section of the pharynx, still above the division and still upper airway.

Pharynx: names the whole three-part structure, not the specific section where the divide happens. Only the laryngopharynx, its lowest section, marks that boundary.

An intact gag reflex in a patient with a decreased level of consciousness: An intact gag reflex is actually a reason to choose a nasopharyngeal airway over an oropharyngeal airway; it is not a contraindication to the nasopharyngeal airway.

Snoring respirations that are relieved by repositioning of the head: Snoring from the tongue that improves with repositioning is an indication for an airway adjunct such as a nasopharyngeal airway, not a reason to withhold one.

A blood pressure of 148/92 mmHg with a strong and regular pulse: This blood pressure with a strong, regular pulse is unrelated to nasal airway placement and does not contraindicate a nasopharyngeal airway.

Apply continuous suction until the airway is completely clear: Continuous suction until the airway is 'completely clear' could take far longer than 15 seconds, evacuating the patient's oxygen supply the entire time and driving profound hypoxia.

Suction for up to 30 seconds per attempt to save time: Thirty seconds is double the accepted adult limit; the time 'saved' comes at the cost of dangerous oxygen depletion.

Suction for a full 20 seconds, then immediately insert an oropharyngeal airway: Twenty seconds also exceeds the 15-second limit, and the patient must be reoxygenated after suctioning, moving straight to airway adjunct insertion skips that critical step.