Chapter 23: Congenital and Surgical Disorders that Affect Respiratory Care Test Bank
MULTIPLE CHOICE 1. What intervention should the therapist perform when an infant is born with choanal atresia? a. Perform nasotracheal intubation b. Recommend a tracheotomy procedure c. Insert an oropharyngeal airway d. Perform a cricothyroidotomy ANS: C
A newborn infant is an obligate nasal breather, so the presence of complete nasal obstruction caused by choanal atresia results in immediate respiratory distress and possible death by asphyxia. During the newborn’s first breaths, the tongue becomes directly associated with the hard and soft palates, creating a vacuum. An oral airway should be inserted and maintained to relieve the airway obstruction. REF: p. 455 2. What should a respiratory therapist do to confirm a diagnosis of choanal atresia? a. Recommend lateral mandibular radiographs b. Inspect the nasal cavities with a rhinoscope c. Attempt to insert an 8 French suction catheter through each nasal cavity d. Gently pinch the infant’s nose closed until oral breathing occurs ANS: C
An 8 French catheter is the best diagnostic tool for atresia in the newborn intensive care unit. If the catheter fails to pass through the nose into the oropharynx, choanal atresia should be suspected. The neonate is stabilized by immediately inserting an oral airway. REF: p. 455 3. Which of the following interventions is used to treat macroglossia? a. Positioning the patient appropriately corrects most cases. b. Most cases are corrected surgically. c. Polysomnography to determine any effect on sleep is all that is required. d. Treatment is based on the severity of airway obstruction and etiology. ANS: D
Treatment for macroglossia should be individualized, depending on the severity of respiratory obstruction and etiology. For isolated macroglossia, prone positioning usually relieves mild cases. More severe cases may require one of the many surgical techniques to reduce tongue size. Lymphangiomas and small hemangiomas of the tongue may require excision, and large congenital hemangiomas frequently respond to systemic corticosteroid or interferon therapy. Chronic hypoxia and carbon dioxide retention are frequent sequelae of macroglossia and
