Monitoring: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Anaesthesia · Monitoring

Sample item

Immediately after intubation, chest movement is poor and breath sounds are doubtful. Which finding most reliably confirms tracheal placement of the tube?

AA sustained end-tidal carbon dioxide waveform on capnographyBPalpable firmness of the pilot balloonCAbsence of gurgling sounds over the epigastriumDMisting of the tube during expiration

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. A sustained end-tidal carbon dioxide waveform on capnography

Continuous capnography showing carbon dioxide over several consecutive breaths is the most reliable confirmation of tracheal intubation. In oesophageal intubation the trace is absent or fades after a few breaths. Clinical signs alone can mislead.

Option by option

A. A sustained end-tidal carbon dioxide waveform on capnography (correct)
Correct. Sustained exhaled carbon dioxide indicates that gas is passing through the lungs.
B. Palpable firmness of the pilot balloon
The pilot balloon only shows that the cuff is inflated and says nothing about tube position.
C. Absence of gurgling sounds over the epigastrium
Absence of epigastric sounds is reassuring, but it is not a reliable confirmation.
D. Misting of the tube during expiration
Misting can occur in the oesophagus as well and is unreliable.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is A, A sustained end-tidal carbon dioxide waveform on capnography. Continuous capnography showing carbon dioxide over several consecutive breaths is the most reliable confirmation of tracheal intubation.

Why is "Palpable firmness of the pilot balloon" not the answer?

The pilot balloon only shows that the cuff is inflated and says nothing about tube position.

Why is "Absence of gurgling sounds over the epigastrium" not the answer?

Absence of epigastric sounds is reassuring, but it is not a reliable confirmation.

Why is "Misting of the tube during expiration" not the answer?

Misting can occur in the oesophagus as well and is unreliable.

What concept does this question test?

It tests Monitoring in Anaesthesia. In oesophageal intubation the trace is absent or fades after a few breaths. Clinical signs alone can mislead.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Monitoring?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.