Certified Ambulatory Perianesthesia Nurse (CAPA) Practice Exam

Upon arrival to the PACU, how does the perianesthesia nurse assess the correct placement of the endotracheal tube?

1. Evaluating the respiratory effort

2. Checking the cuff inflations

3. Measuring residual tidal volume

4. Auscultating the chest bilaterally

The correct answer is: Auscultating the chest bilaterally

Auscultating the chest bilaterally is crucial for verifying the correct placement of the endotracheal tube. This practice allows the nurse to listen for breath sounds in both lungs, ensuring that air is adequately being delivered to each side. If the tube is correctly positioned, the nurse should hear symmetrical breath sounds. In contrast, if the tube is improperly placed, such as being in the esophagus or in the main bronchus, breath sounds may be diminished or absent on one side. Therefore, auscultation is a direct method to assess whether the endotracheal tube is positioned appropriately to provide adequate ventilation. The other assessment techniques, while having their importance in patient evaluation, do not specifically confirm the tube's placement. Evaluating respiratory effort may indicate how hard a patient is trying to breathe but does not directly assess the tube's location. Checking cuff inflations provides information on whether the cuff is adequately inflated to prevent aspiration but does not confirm proper placement in the trachea. Measuring residual tidal volume is related to assessing lung function but does not provide insight into the position of the endotracheal tube itself.