Adult Critical Care Specialty (ACCS) Practice Exam

What is the appropriate action when a patient exhibits sonorous upper airway sounds and a respiratory rate of 6?

1. Administer oxygen

2. Prepare for immediate intubation

3. Perform bag-mask ventilation

4. Monitor vital signs closely

The correct answer is: Prepare for immediate intubation

In the scenario where a patient exhibits sonorous upper airway sounds, which often indicate a partial obstruction, and has a significantly low respiratory rate of 6 breaths per minute, immediate action is critical. The presence of sonorous sounds suggests that the airway may not be adequately cleared, potentially due to an obstruction at the level of the pharynx, while the low respiratory rate indicates hypoventilation, leading to inadequate oxygenation and ventilation. Preparing for immediate intubation is the appropriate action because this intervention directly addresses the compromised airway and enables secure ventilation. Intubation will not only help bypass the obstruction but also provide a controlled route for mechanical ventilation if the patient is unable to maintain adequate respiratory effort. Given the combination of altered airway sounds and the low respiratory rate, which indicates significant respiratory distress or failure, securing the airway is paramount to prevent further deterioration. Other actions, such as administering oxygen, might temporarily alleviate hypoxemia, but do not address the underlying airway obstruction issue. Performing bag-mask ventilation might seem like a quick fix; however, if there is a significant obstruction, this method may not be effective and can even exacerbate the problem. Monitoring vital signs closely is essential for overall patient management but does not provide a definitive solution for the