Neonatal Nurse Practitioner Practice Exam

What is the most indicative sign of a plugged endotracheal tube?

1. Condensation in the endotracheal tube

2. Sudden decrease in chest wall movement

3. Tachycardia

4. Bradycardia

The correct answer is: Sudden decrease in chest wall movement

The most indicative sign of a plugged endotracheal tube is a sudden decrease in chest wall movement. This occurs because a plugged tube prevents adequate airflow into the lungs, leading to diminished ventilation. As a result, there may not be sufficient air exchange during respiration, which can significantly reduce chest wall expansion. In a neonatal patient, effective ventilation is crucial, and any obstruction in the airway, such as a plugged endotracheal tube, will manifest as a noticeable change in the movement of the chest cavity. While condensation in the endotracheal tube may occur with various airway conditions, it is not as specific to obstruction as the decrease in chest wall movement. Tachycardia can be a response to decreased oxygenation or other stressors but is not uniquely indicative of a plugged tube. Similarly, bradycardia may occur due to insufficient oxygen but does not directly point to the condition of the endotracheal tube itself. Therefore, the sudden decrease in chest wall movement is the most direct and indicative sign of a plugged endotracheal tube in this scenario.