NREMT AEMT Level Quiz: Airway Adjuncts And Supraglottic Airway Devices

What this quiz covers

This quiz focuses on Airway Adjuncts And Supraglottic Airway Devices, giving you a quick way to practice the rules, question types, and explanations that matter most for NREMT AEMT Level.

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

Question 1

1. No need to monitor breath sounds after placement
2. Patient coughs strongly when you ventilate
3. Gurgling over the epigastrium with each breath
4. Bilateral chest rise with improved SpO2 and compliance (correct answer)

Explanation: This question tests AEMT-level knowledge of airway adjuncts and supraglottic airway devices, focusing on their indications and complications. Airway adjuncts like oropharyngeal and nasopharyngeal airways are used to maintain patency in patients with compromised airway reflexes. Supraglottic devices are used when endotracheal intubation is not feasible. In this scenario, the patient's unresponsive state with difficult BVM requires the use of a supraglottic airway to maintain airway patency and ensure adequate ventilation. Choice D is correct because it identifies the assessment finding of bilateral chest rise with improved SpO2 and compliance in this specific context. Choice C is incorrect due to a misunderstanding of placement indicators, such as interpreting gurgling over the epigastrium as success. To improve understanding, practice scenarios involving a variety of airway management situations and review the indications and contraindications for each device. Encourage students to focus on patient assessment findings to guide device selection.

Question 2

1. Hypothermia from positive pressure ventilation
2. Immediate bronchospasm from oxygen concentration
3. Dislodgement causing loss of chest rise and ventilation (correct answer)
4. Hypertension from nasal passage stimulation

Explanation: This question tests AEMT-level knowledge of airway adjuncts and supraglottic airway devices, focusing on their indications and complications. Airway adjuncts like oropharyngeal and nasopharyngeal airways are used to maintain patency in patients with compromised airway reflexes. Supraglottic devices are used when endotracheal intubation is not feasible. In this scenario, the patient's drowsy state with intermittent obstruction requires the use of a supraglottic airway to maintain airway patency and ensure adequate ventilation. Choice C is correct because it identifies the complication of dislodgement causing loss of chest rise and ventilation in this specific context. Choice D is incorrect due to a misunderstanding of physiological effects, such as associating hypertension with nasal passage stimulation. To improve understanding, practice scenarios involving a variety of airway management situations and review the indications and contraindications for each device. Encourage students to focus on patient assessment findings to guide device selection.

Question 3

1. Epistaxis or nasal mucosa trauma during insertion (correct answer)
2. Tracheal perforation from overinflating a cuff
3. Loss of gag reflex from excessive oxygen delivery
4. Pulmonary embolism from increased airway resistance

Explanation: This question tests AEMT-level knowledge of airway adjuncts and supraglottic airway devices, focusing on their indications and complications. Airway adjuncts like oropharyngeal and nasopharyngeal airways are used to maintain patency in patients with compromised airway reflexes. Supraglottic devices are used when endotracheal intubation is not feasible. In this scenario, the patient's severe asthma with exhaustion requires the use of a nasopharyngeal airway to maintain airway patency and ensure adequate ventilation. Choice A is correct because it identifies the complication of epistaxis or nasal mucosa trauma during insertion in this specific context. Choice B is incorrect due to a misunderstanding of device features, such as associating tracheal perforation with cuff overinflation in an NPA. To improve understanding, practice scenarios involving a variety of airway management situations and review the indications and contraindications for each device. Encourage students to focus on patient assessment findings to guide device selection.

Question 4

1. To prevent vomiting by sealing the esophagus
2. To maintain patency when OPA is not tolerated (correct answer)
3. To replace the need for suctioning oral secretions
4. To provide definitive airway control in the trachea

Explanation: This question tests AEMT-level knowledge of airway adjuncts and supraglottic airway devices, focusing on their indications and complications. Airway adjuncts like oropharyngeal and nasopharyngeal airways are used to maintain patency in patients with compromised airway reflexes. Supraglottic devices are used when endotracheal intubation is not feasible. In this scenario, the patient's semi-conscious state with clenched jaw requires the use of a nasopharyngeal airway to maintain airway patency and ensure adequate ventilation. Choice B is correct because it identifies the primary indication to maintain patency when OPA is not tolerated in this specific context. Choice D is incorrect due to a misunderstanding of airway control, such as assuming NPA provides definitive tracheal control. To improve understanding, practice scenarios involving a variety of airway management situations and review the indications and contraindications for each device. Encourage students to focus on patient assessment findings to guide device selection.

Question 5

1. To maintain airway patency in an unresponsive patient (correct answer)
2. To reduce bronchospasm during an asthma attack
3. To splint the trachea open during laryngospasm
4. To confirm adequate ventilation without reassessment

Explanation: This question tests AEMT-level knowledge of airway adjuncts and supraglottic airway devices, focusing on their indications and complications. Airway adjuncts like oropharyngeal and nasopharyngeal airways are used to maintain patency in patients with compromised airway reflexes. Supraglottic devices are used when endotracheal intubation is not feasible. In this scenario, the patient's postictal snoring requires the use of an oropharyngeal airway to maintain airway patency and ensure adequate ventilation. Choice A is correct because it identifies the primary indication to maintain airway patency in an unresponsive patient in this specific context. Choice B is incorrect due to a misunderstanding of device purpose, such as using it to reduce bronchospasm in asthma. To improve understanding, practice scenarios involving a variety of airway management situations and review the indications and contraindications for each device. Encourage students to focus on patient assessment findings to guide device selection.

Question 6

1. Absent breath sounds with rising heart rate
2. Increasing somnolence with slowing respirations
3. New gurgling sounds over the epigastrium
4. Improved SpO2 with decreased work of breathing (correct answer)

Explanation: This question tests AEMT-level knowledge of airway adjuncts and supraglottic airway devices, focusing on their indications and complications. Airway adjuncts like oropharyngeal and nasopharyngeal airways are used to maintain patency in patients with compromised airway reflexes. Supraglottic devices are used when endotracheal intubation is not feasible. In this scenario, the patient's severe asthma with fatigue requires the use of CPAP to maintain airway patency and ensure adequate ventilation. Choice D is correct because it identifies the assessment finding of improved SpO2 with decreased work of breathing in this specific context. Choice C is incorrect due to a misunderstanding of response indicators, such as interpreting new gurgling sounds as success. To improve understanding, practice scenarios involving a variety of airway management situations and review the indications and contraindications for each device. Encourage students to focus on patient assessment findings to guide device selection.

Question 7

1. Oropharyngeal airway because gag reflex is present
2. Nasopharyngeal airway because mouth access is limited (correct answer)
3. Supraglottic airway as the first-line adjunct for snoring
4. Endotracheal tube to bypass facial swelling

Explanation: This question tests AEMT-level knowledge of airway adjuncts and supraglottic airway devices, focusing on their indications and complications. Airway adjuncts like oropharyngeal and nasopharyngeal airways are used to maintain patency in patients with compromised airway reflexes. Supraglottic devices are used when endotracheal intubation is not feasible. In this scenario, the patient's facial swelling and clenched teeth with gag reflex requires the use of a nasopharyngeal airway to maintain airway patency and ensure adequate ventilation. Choice B is correct because it identifies the appropriate initial adjunct when mouth access is limited in this specific context. Choice A is incorrect due to a misunderstanding of gag reflex implications, such as using an OPA despite the presence of a gag reflex. To improve understanding, practice scenarios involving a variety of airway management situations and review the indications and contraindications for each device. Encourage students to focus on patient assessment findings to guide device selection.

Question 8

1. To deliver nebulized medication more effectively
2. To bypass the need for cervical spine precautions
3. To improve ventilation when BVM seal is inadequate (correct answer)
4. To definitively secure the trachea like an endotracheal tube

Explanation: This question tests AEMT-level knowledge of airway adjuncts and supraglottic airway devices, focusing on their indications and complications. Airway adjuncts like oropharyngeal and nasopharyngeal airways are used to maintain patency in patients with compromised airway reflexes. Supraglottic devices are used when endotracheal intubation is not feasible. In this scenario, the patient's unresponsive state with poor BVM seal requires the use of a supraglottic airway to maintain airway patency and ensure adequate ventilation. Choice C is correct because it identifies the primary indication for improving ventilation when BVM seal is inadequate in this specific context. Choice D is incorrect due to a misunderstanding of device function, such as assuming supraglottic airways provide definitive tracheal security like an endotracheal tube. To improve understanding, practice scenarios involving a variety of airway management situations and review the indications and contraindications for each device. Encourage students to focus on patient assessment findings to guide device selection.

Question 9

1. Vomiting or aspiration if gag reflex returns (correct answer)
2. Epistaxis from nasal mucosa irritation
3. Tension pneumothorax from improper sizing
4. Hypoglycemia from increased airway resistance

Explanation: This question tests AEMT-level knowledge of airway adjuncts and supraglottic airway devices, focusing on their indications and complications. Airway adjuncts like oropharyngeal and nasopharyngeal airways are used to maintain patency in patients with compromised airway reflexes. Supraglottic devices are used when endotracheal intubation is not feasible. In this scenario, the patient's postictal unresponsive state requires the use of an oropharyngeal airway to maintain airway patency and ensure adequate ventilation. Choice A is correct because it identifies the complication of vomiting or aspiration if gag reflex returns in this specific context. Choice B is incorrect due to a misunderstanding of insertion route, such as associating epistaxis with an oral device. To improve understanding, practice scenarios involving a variety of airway management situations and review the indications and contraindications for each device. Encourage students to focus on patient assessment findings to guide device selection.

Question 10

1. Tracheal injury from rigid airway insertion
2. Tongue obstruction from loss of airway reflexes
3. Decreased venous return causing hypotension (correct answer)
4. Bradycardia from carotid sinus stimulation

Explanation: This question tests AEMT-level knowledge of airway adjuncts and supraglottic airway devices, focusing on their indications and complications. Airway adjuncts like oropharyngeal and nasopharyngeal airways are used to maintain patency in patients with compromised airway reflexes. Supraglottic devices are used when endotracheal intubation is not feasible. In this scenario, the patient's severe asthma with hypotension after CPAP requires monitoring for complications to maintain airway patency and ensure adequate ventilation. Choice C is correct because it identifies the complication of decreased venous return causing hypotension in this specific context. Choice B is incorrect due to a misunderstanding of reflex effects, such as associating tongue obstruction with loss of airway reflexes in CPAP. To improve understanding, practice scenarios involving a variety of airway management situations and review the indications and contraindications for each device. Encourage students to focus on patient assessment findings to guide device selection.

Question 11

1. Wheezing resolves without any other intervention
2. Immediate loss of gag reflex after insertion
3. Gurgling over the epigastrium during ventilation
4. Decreased snoring with easier air movement at the nose (correct answer)

Explanation: This question tests AEMT-level knowledge of airway adjuncts and supraglottic airway devices, focusing on their indications and complications. Airway adjuncts like oropharyngeal and nasopharyngeal airways are used to maintain patency in patients with compromised airway reflexes. Supraglottic devices are used when endotracheal intubation is not feasible. In this scenario, the patient's semi-conscious state with clenched jaw requires the use of a nasopharyngeal airway to maintain airway patency and ensure adequate ventilation. Choice D is correct because it identifies the assessment finding of decreased snoring with easier air movement at the nose in this specific context. Choice C is incorrect due to a misunderstanding of ventilation effects, such as interpreting gurgling over the epigastrium as success. To improve understanding, practice scenarios involving a variety of airway management situations and review the indications and contraindications for each device. Encourage students to focus on patient assessment findings to guide device selection.

Question 12

1. The King LT has become dislodged into the esophagus.
2. Return of spontaneous circulation (ROSC) has occurred. (correct answer)
3. The patient is being hyperventilated, causing CO2 retention.
4. The distal cuff of the King LT has ruptured, causing a leak.

Explanation: A sudden and significant rise in end-tidal CO2 to a normal or near-normal range (35-45 mmHg) during CPR is the most reliable indicator of Return of Spontaneous Circulation (ROSC). This occurs because restored circulation delivers a large amount of accumulated CO2 from the tissues to the lungs for exhalation. Dislodgement, hyperventilation, or cuff rupture would typically cause a decrease, not a sharp increase, in the EtCO2 reading.

Question 13

1. The SGA is properly placed, but the patient has developed a tension pneumothorax.
2. The distal tip of the SGA is correctly positioned in the esophagus, but the proximal cuff is leaking.
3. The SGA is too deep, with the ventilation ports positioned within the esophagus. (correct answer)
4. The SGA is too shallow, and the proximal cuff has failed to properly seal the oropharynx.

Explanation: Gastric distention, gurgling over the epigastrium, and poor bilateral lung sounds strongly indicate that the ventilation ports of the SGA are misplaced within the esophagus, directing air into the stomach instead of the trachea. This usually happens when the device is inserted too deeply. A shallow placement would likely result in a significant air leak from the mouth, not gastric distention. A tension pneumothorax would present with unilateral breath sound changes and tracheal deviation, not epigastric gurgling. A leaking proximal cuff would also result in an oral air leak.

Question 14

1. Continue inserting the OPA quickly to bypass the gag reflex.
2. Remove the OPA, prepare to suction, and attempt to insert a nasopharyngeal airway. (correct answer)
3. Log-roll the patient onto her side and apply cricoid pressure to prevent aspiration.
4. Remove the OPA and immediately begin ventilations with a bag-valve mask.

Explanation: The presence of a gag reflex is an absolute contraindication for an OPA, as it can induce vomiting and aspiration. The correct action is to immediately remove the device. Since the patient still requires an airway adjunct due to her unresponsiveness and sonorous respirations, a nasopharyngeal airway (NPA) is the next best choice, as it is tolerated by patients with an intact gag reflex. Suction should always be ready when manipulating an airway. Continuing insertion is dangerous. BVM without an adjunct may not be effective, and cricoid pressure is not the priority.

Question 15

1. Auscultation of clear and equal breath sounds over both lung apices.
2. Improvement in the patient's skin color from cyanotic to pink.
3. A quantitative waveform capnography reading of 38 mmHg. (correct answer)
4. The absence of gurgling sounds when auscultating over the epigastrium.

Explanation: While chest rise, breath sounds, and absence of epigastric sounds are all essential parts of the confirmation process, quantitative waveform capnography is the most definitive, objective measure of correct placement in the AEMT scope. A normal reading (35-45 mmHg) with a proper waveform confirms that the device is ventilating the lungs and that metabolic activity is present. Skin color can be a late and unreliable sign. Auscultation can be misleading, especially in noisy environments.

Question 16

1. The patient's actual body weight in kilograms.
2. The patient's gender and underlying body habitus.
3. The patient's estimated ideal body weight based on height.
4. The patient's height in centimeters or inches. (correct answer)

Explanation: Sizing for extraglottic airway devices like the King LT is based primarily on the patient's height, not their weight. Airway anatomy correlates more closely with height than with weight. A tall, slender patient and a short, obese patient may have the same weight but will have different airway lengths and require different sized devices. Therefore, height is the most critical determinant for proper size selection.

Question 17

1. The OPA has become dislodged, allowing the tongue to obstruct the airway. (correct answer)
2. The patient has developed a tension pneumothorax from positive pressure ventilation.
3. The pop-off valve on the bag-valve mask has malfunctioned and is stuck open.
4. The OPA is too small for the patient and is being drawn into the hypopharynx.

Explanation: The most common reason for a sudden increase in difficulty when ventilating a patient with an OPA is that the device has become dislodged. Patient movement or improper securing can cause the OPA to slip out of position, allowing the tongue to fall back and obstruct the pharynx. The first step should always be to reassess and reposition the airway and the adjunct. While a tension pneumothorax is possible, it is less common and would likely present with other signs like unilateral breath sounds or tracheal deviation.

Question 18

1. The i-gel's non-inflatable cuff made of a thermoplastic elastomer may form a better seal around swollen tissues. (correct answer)
2. The i-gel provides definitive protection against aspiration, which is a high risk in anaphylaxis.
3. The cuffed LMA requires precise sizing based on weight, which is difficult to estimate in an emergency.
4. The i-gel has a larger internal diameter, making it easier to suction through the device.

Explanation: The i-gel features a soft, gel-like, non-inflatable cuff that is designed to conform to the patient's perilaryngeal anatomy. In a patient with anaphylaxis and laryngeal edema, this flexible material may create a more effective seal compared to an inflatable cuff, which might not sit properly around swollen structures. Neither device offers definitive protection from aspiration, though they reduce the risk. Both devices require proper sizing.

Question 19

1. Inflate both cuffs simultaneously with 10 mL of air using a single inflation port.
2. Attach a syringe to the port and inflate with air until the pilot balloon is firm to the touch.
3. Inflate the cuffs with the specific volume of air recommended by the manufacturer for a size 4. (correct answer)
4. Fill the cuffs with sterile saline instead of air to ensure a more uniform seal against the tissues.

Explanation: Each size of the King LT airway has a specific, manufacturer-recommended inflation volume. It is critical to use this exact volume to ensure a proper seal without causing excessive pressure and potential tissue damage. For a size 4 (yellow) King LT, this is typically 60-70 mL. Inflating until the pilot balloon is firm is subjective and can lead to over-inflation. The King LT has a single inflation port for both cuffs. Saline is not used for cuff inflation in this device.

Question 20

1. The device is obstructed with a mucus plug; attempt to suction through the device.
2. The patient is experiencing severe bronchospasm; administer an in-line nebulized bronchodilator. (correct answer)
3. The cuffs are overinflated, compressing the trachea; deflate and reinflate the cuffs to the proper volume.
4. The tip of the device is lodged in the vallecula; withdraw the device 1-2 cm and reassess.

Explanation: The combination of high ventilation resistance and a "shark fin" capnography waveform in an asthmatic patient is the classic presentation of severe bronchospasm. The airway is correctly placed, but air has difficulty exiting the constricted lower airways. The most appropriate AEMT-level action is to treat the underlying cause by administering a nebulized bronchodilator (like albuterol) in-line with the ventilation circuit, per protocol. The other options do not fit the complete clinical picture.