Certified Pediatric Emergency Nurse (CPEN) Practice Exam

What key action should be taken first when assessing airway patency in an emergency?

1. Provide supplemental oxygen

2. Determine responsiveness

3. Insert airway adjunct

4. Initiate bag-valve-mask ventilation

The correct answer is: Insert airway adjunct

When assessing airway patency in an emergency, the first key action is to insert an airway adjunct. This step is crucial because an airway adjunct is designed to help maintain openness of the airway, particularly in situations where there is a risk of obstruction due to the tongue, foreign bodies, or other factors. Inserting an airway adjunct can facilitate ventilation and improve oxygenation by preventing the collapse of the airway. Although the other actions may be important in a comprehensive assessment and management of the airway, they are secondary to establishing patency. For instance, providing supplemental oxygen is beneficial for improving oxygen levels but does not address an obstructed airway directly. Determining responsiveness is an essential initial assessment step but does not directly resolve airway issues. Initiating bag-valve-mask ventilation would be appropriate if the airway is secure, but it cannot be done effectively without first ensuring that the airway is clear. Therefore, inserting an airway adjunct is the foundational step to ensure effective ventilation.