Suctioning and Foreign Body Obstruction Practice Questions

30 multiple-choice questions on Suctioning and foreign body obstruction for paramedic and EMT students, from Chapter 16 (Airway Management). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

30 practice questions

1. What is the maximum time you should apply suction during a single attempt in an adult?

   1. A. 10 seconds
   2. B. 5 seconds
   3. C. 30 seconds
   4. D. 15 seconds
   Show answer

   Answer: D. 15 seconds

   Limit adult suctioning to 15 seconds per attempt to avoid hypoxia. Children are generally limited to 10 seconds and infants to 5.

2. A nonvigorous newborn is delivered through thick meconium-stained fluid and is not breathing. What should you do first?

   1. A. Intubate and suction the trachea first
   2. B. Deep-suction the stomach before anything
   3. C. Initial steps, then PPV if still apneic
   4. D. Give blow-by oxygen and wait 2 minutes
   Show answer

   Answer: C. Initial steps, then PPV if still apneic

   Current NRP guidance does not recommend routine intubation for tracheal suction in nonvigorous meconium-stained newborns. Warm, dry, position, clear the mouth if needed, and start positive-pressure ventilation within the first minute if she is apneic. Tracheal suction delays ventilation. Gastric suction is not a first step. Blow-by oxygen does not treat apnea.

3. When should suction be applied with a rigid catheter?

   1. A. While withdrawing it
   2. B. Continuously throughout
   3. C. While inserting it
   4. D. Only at the deepest point
   Show answer

   Answer: A. While withdrawing it

   Insert the catheter without suction, then apply suction as you withdraw to clear material while limiting hypoxia and mucosal injury.

4. Which suction catheter is best for clearing large volumes of vomitus from the oropharynx?

   1. A. Bulb syringe device
   2. B. Rigid tonsil-tip catheter
   3. C. Soft French catheter
   4. D. Small whistle-tip catheter
   Show answer

   Answer: B. Rigid tonsil-tip catheter

   A rigid, large-bore catheter removes thick material from the mouth and oropharynx quickly. Soft catheters are used in the nose, ET tubes, and stomas.

5. For suctioning through an endotracheal tube, which catheter should you use?

   1. A. Large-bore Yankauer
   2. B. Soft sterile catheter
   3. C. Rigid tonsil-tip tube
   4. D. Bulb syringe device
   Show answer

   Answer: B. Soft sterile catheter

   A soft (French) catheter passes through the ET tube. Use sterile technique and preoxygenate before suctioning.

6. How far should you insert a rigid catheter when suctioning the mouth of an adult?

   1. A. Past the vocal cords
   2. B. Only as far as visible
   3. C. To the depth of an OPA
   4. D. Until the patient gags
   Show answer

   Answer: B. Only as far as visible

   Insert a rigid tip only as far as you can see to avoid triggering the gag reflex, laryngospasm, or tissue injury.

7. While suctioning the airway of a 60-year-old, the heart rate drops from 88 to 44. What is the most likely cause?

   1. A. A pain response
   2. B. Hyperkalemia
   3. C. Hypercapnia
   4. D. Vagal stimulation
   Show answer

   Answer: D. Vagal stimulation

   Stimulating the posterior pharynx can trigger a vagal response. Stop suctioning and oxygenate or ventilate the patient.

8. What should you do before suctioning a patient whenever time allows?

   1. A. Preoxygenate
   2. B. Give atropine
   3. C. Hyperventilate
   4. D. Deflate the cuff
   Show answer

   Answer: A. Preoxygenate

   Preoxygenation builds an oxygen reserve to offset the hypoxia that suctioning causes. Avoid hyperventilating.

9. You are managing the airway of a patient who is actively vomiting large amounts. There is no suspected trauma. What should you do first?

   1. A. Turn the patient onto the side
   2. B. Place a supraglottic airway
   3. C. Insert an oropharyngeal airway
   4. D. Begin BVM ventilation
   Show answer

   Answer: A. Turn the patient onto the side

   Rolling the patient lets gravity drain vomitus while you prepare suction. With suspected spinal injury, log-roll with stabilization.

10. In the suction-assisted laryngoscopy and airway decontamination (SALAD) technique, where is the rigid catheter left after the initial clearing?

    1. A. In the trachea
    2. B. In the right cheek pocket
    3. C. In the nasopharynx
    4. D. In the upper esophagus
    Show answer

    Answer: D. In the upper esophagus

    The catheter is parked in the upper esophagus, to the left of the blade, to continuously remove regurgitated material while the tube is placed.

11. A 52-year-old at a restaurant suddenly clutches his throat. He cannot speak or cough, and his face is turning dusky. What should you do?

    1. A. Give 5 back blows, then 5 chest thrusts
    2. B. Alternate 5 back blows and 5 abdominal thrusts
    3. C. Sweep his mouth with a finger, then give thrusts
    4. D. Encourage him to keep trying to cough
    Show answer

    Answer: B. Alternate 5 back blows and 5 abdominal thrusts

    He cannot speak or cough, so this is a severe obstruction. The 2025 AHA adult BLS guideline recommends repeated cycles of 5 back blows followed by 5 abdominal thrusts until the object comes out or he becomes unresponsive, plus early EMS activation. Older guidance used abdominal thrusts alone, but observational data showed back blows cleared more obstructions with fewer injuries. Back blows with chest thrusts are for a rescuer who cannot reach around the abdomen or for late pregnancy, and he is neither. Blind finger sweeps can push the object deeper and are classed as harmful. Coughing is encouraged in a mild obstruction with good air exchange, not when he cannot cough. (2025 AHA Guidelines, Part 7: Adult BLS, section 10.)

12. A 30-year-old is choking but coughing forcefully and able to speak. What is the best action?

    1. A. Give back blows
    2. B. Give abdominal thrusts
    3. C. Encourage coughing
    4. D. Try Magill forceps
    Show answer

    Answer: C. Encourage coughing

    With good air exchange, a forceful cough is the most effective way to clear the airway. Monitor closely for deterioration.

13. A woman in her third trimester of pregnancy is conscious with a severe airway obstruction. What sequence should you use?

    1. A. 5 back blows, then 5 abdominal thrusts
    2. B. Abdominal thrusts until it clears
    3. C. Blind finger sweep, then chest thrusts
    4. D. 5 back blows, then 5 chest thrusts
    Show answer

    Answer: D. 5 back blows, then 5 chest thrusts

    In late pregnancy abdominal thrusts are impossible to do effectively or inappropriate, so the 2025 AHA adult BLS guideline recommends repeated cycles of 5 back blows followed by 5 chest thrusts until the object comes out or she becomes unresponsive. Back blows followed by abdominal thrusts is the sequence for other conscious adults, not for a gravid abdomen. Abdominal thrusts alone is the older adult approach and is still wrong here. Blind finger sweeps are classed as harmful because they can push the object deeper. (2025 AHA Guidelines, Part 7: Adult BLS, section 10.3.)

14. A 7-month-old is choking, cannot cry, and is conscious. What is the correct technique?

    1. A. Blind finger sweeps, then thrusts
    2. B. 5 back slaps, then 5 chest thrusts
    3. C. 5 abdominal thrusts, then reassess
    4. D. Hang the infant upside down
    Show answer

    Answer: B. 5 back slaps, then 5 chest thrusts

    For a responsive infant with severe obstruction, alternate 5 back slaps and 5 chest thrusts. Abdominal thrusts are not used in infants.

15. A 5-year-old is choking and cannot speak or cough. Compared with a choking 7-month-old, how does your technique change?

    1. A. Abdominal thrusts replace the chest thrusts
    2. B. Back blows are skipped and thrusts start at once
    3. C. Each cycle uses 10 thrusts instead of 5
    4. D. A blind finger sweep is added before thrusts
    Show answer

    Answer: A. Abdominal thrusts replace the chest thrusts

    For a child (about 1 year to puberty) with severe obstruction, the 2025 AHA/AAP pediatric BLS guideline recommends repeated cycles of 5 back blows alternating with 5 abdominal thrusts. An infant gets 5 back blows alternating with 5 chest thrusts, because abdominal thrusts can injure an infant's abdominal organs. Both ages start with back blows; what changes is the type of thrust. Skipping back blows and starting with abdominal thrusts was the 2020 child sequence, replaced in 2025. Each set is 5, not 10. Blind finger sweeps are classed as harmful in infants and children because they can push the object deeper. (2025 AHA/AAP Guidelines, Part 6: Pediatric BLS.)

16. An adult choking victim becomes unresponsive while you are giving abdominal thrusts. What should you do?

    1. A. Do a blind finger sweep
    2. B. Check a pulse for 30 seconds
    3. C. Lower him and start CPR
    4. D. Keep giving abdominal thrusts
    Show answer

    Answer: C. Lower him and start CPR

    Once unresponsive, lower the patient to the ground and begin CPR. Look in the mouth before each set of breaths and remove any visible object.

17. Why are blind finger sweeps not recommended?

    1. A. They require two rescuers
    2. B. They are too slow to perform
    3. C. They cause a vagal response
    4. D. They may push it deeper
    Show answer

    Answer: D. They may push it deeper

    Blind sweeps can wedge the object deeper or injure the pharynx. Remove an object only if you can see it.

18. An unresponsive adult has a complete airway obstruction that has not cleared with CPR. As a paramedic, what is your next step?

    1. A. Continue compressions only
    2. B. Laryngoscopy and forceps
    3. C. Insert a nasopharyngeal airway
    4. D. Give more abdominal thrusts
    Show answer

    Answer: B. Laryngoscopy and forceps

    Direct visualization with a laryngoscope lets you find and remove an object above the cords using Magill forceps.

19. A man is choking and holding his throat with both hands. This gesture is known as:

    1. A. A sign of mild obstruction
    2. B. A sign of laryngospasm
    3. C. The universal choking sign
    4. D. Tripod positioning
    Show answer

    Answer: C. The universal choking sign

    Clutching the throat is the universal sign of choking. Confirm severity by asking if he can speak or cough.

20. A choking patient has a weak, ineffective cough, high-pitched noises on inhalation, and increasing cyanosis. How should you manage this?

    1. A. As a mild obstruction
    2. B. As a severe obstruction
    3. C. As an asthma attack
    4. D. As an anaphylactic reaction
    Show answer

    Answer: B. As a severe obstruction

    Poor air exchange with a weak cough and stridor should be treated as a severe obstruction, even though some air is moving.

21. Where should your hands be placed for abdominal thrusts on an adult?

    1. A. On the xiphoid process
    2. B. On the lower sternum
    3. C. Just above the navel
    4. D. Below the navel
    Show answer

    Answer: C. Just above the navel

    Place the fist slightly above the navel and well below the xiphoid to reduce the risk of internal injury.

22. A choking adult was successfully treated with abdominal thrusts and now feels fine. What should you advise?

    1. A. Get a medical evaluation
    2. B. Drink water to clear it
    3. C. Return only if pain begins
    4. D. No further care is needed
    Show answer

    Answer: A. Get a medical evaluation

    Abdominal thrusts can cause internal injuries, and fragments may remain. The patient should be evaluated by a physician.

23. You need to suction through a patient's tracheostomy tube. Before suctioning, should you instill normal saline?

    1. A. Yes, 5 mL first to loosen the secretions
    2. B. No; routine saline is not recommended
    3. C. Yes, if the secretions are clear and thin
    4. D. Yes, then suction for at least 20 seconds
    Show answer

    Answer: B. No; routine saline is not recommended

    The 2022 AARC guideline on artificial airway suctioning recommends against routine saline instillation: it does not reliably thin mucus and can push bacteria deeper and lower oxygenation. Humidification and adequate hydration help thick secretions. Clear and thin secretions are no reason for saline either. Each pass should be brief, not 20 seconds or more.

24. When you suction through an adult's endotracheal tube, how far should the soft catheter be passed?

    1. A. Just to the level of the teeth
    2. B. As far as the catheter will go
    3. C. To about the tip of the tube
    4. D. Halfway down the tube's length
    Show answer

    Answer: C. To about the tip of the tube

    Current AARC guidance favors shallow suctioning: pass the catheter to about the end of the tube (measure it against a spare tube or use the depth markings). Deep passes down to the carina cause mucosal injury, coughing, and vagal bradycardia, and advancing it as far as it goes does the same. Stopping at the teeth or halfway down the tube leaves secretions in the lower part of the tube.

25. When clearing a newborn's airway with a bulb syringe, which order is correct?

    1. A. Mouth first, then the nose
    2. B. Nose first, then the mouth
    3. C. Nose and mouth at the same time
    4. D. The nose, skipping the mouth
    Show answer

    Answer: A. Mouth first, then the nose

    Suction the mouth before the nose ('M before N') so that a gasp triggered by nasal suction does not pull mouth secretions into the lungs. Suctioning the nose first, or both at the same time, risks that aspiration. Skipping the mouth leaves secretions that can be aspirated.

26. A paramedic sees a foreign body lodged above the vocal cords that cannot be removed with Magill forceps, and the patient cannot be ventilated. Which procedure is indicated?

    1. A. Nasotracheal intubation
    2. B. More abdominal thrusts
    3. C. Supraglottic airway
    4. D. Cricothyrotomy
    Show answer

    Answer: D. Cricothyrotomy

    An obstruction above the cords that cannot be removed and prevents ventilation is an indication for a surgical airway below the level of obstruction.

27. When should you look in the mouth of an unresponsive choking adult during CPR?

    1. A. Only at each pulse check
    2. B. Only after 5 minutes
    3. C. Before each set of breaths
    4. D. After every 5 compressions
    Show answer

    Answer: C. Before each set of breaths

    Open the airway and look for the object each time you go to give breaths. Remove it only if you can see it.

28. During a daily check, you clamp the tubing of the portable suction unit and the gauge reads 120 mmHg. What does this mean?

    1. A. It is ready for oral suctioning
    2. B. It is set correctly for infants
    3. C. It is too weak and needs service
    4. D. It is ready after 5 more minutes
    Show answer

    Answer: C. It is too weak and needs service

    A portable suction unit should reach a vacuum of at least about 300 mmHg when the tubing is clamped. 120 mmHg is too weak to clear thick vomitus or blood, so it is not ready for oral suctioning: take it out of service and repair or replace it. Lower settings for infants are chosen at the regulator during use; a weak unit is a failure, not an infant setting. Waiting 5 more minutes does not fix a weak pump.

29. An obese adult choking victim is conscious, and you cannot get your arms around his abdomen. What should you do?

    1. A. Alternate 5 back blows and 5 abdominal thrusts
    2. B. Lower him to the floor and begin CPR
    3. C. Sweep his mouth, then give chest thrusts
    4. D. Alternate 5 back blows and 5 chest thrusts
    Show answer

    Answer: D. Alternate 5 back blows and 5 chest thrusts

    When you cannot reach around the abdomen, the 2025 AHA adult BLS guideline recommends repeated cycles of 5 back blows followed by 5 chest thrusts until the object comes out or he becomes unresponsive. Older guidance used chest thrusts alone; back blows are now part of the sequence. Abdominal thrusts cannot be given effectively if your arms do not fit around him. CPR starts once he becomes unresponsive, not while he is conscious. Blind finger sweeps are classed as harmful because they can push the object deeper. (2025 AHA Guidelines, Part 7: Adult BLS, section 10.3.)

30. Thick vomitus keeps clogging a rigid suction tip. Which change clears the airway fastest?

    1. A. Suction with the large-bore tubing itself
    2. B. Switch to a small soft French catheter
    3. C. Rinse the tip with saline after each pass
    4. D. Lower the vacuum to reduce clogging
    Show answer

    Answer: A. Suction with the large-bore tubing itself

    Removing the rigid tip and using the wide tubing directly clears large particles quickly; some devices are designed for this. A small soft catheter clogs even faster. Rinsing between passes wastes time while the airway fills. Lower vacuum removes less material.