Certified Registered Nurse Anesthetist (CRNA) Practice Exam

What is the most common complication associated with nasotracheal intubation?

1. Pneumothorax

2. Epistaxis

3. Bronchospasm

4. Hypotension

The correct answer is: Epistaxis

The most common complication associated with nasotracheal intubation is epistaxis, or nosebleed. This occurs because the procedure involves inserting a tube through the nasal passage, which can damage the delicate blood vessels in the nasal mucosa. The risk of epistaxis increases particularly in patients who have pre-existing nasal pathology, are on anticoagulation therapy, or have had recent nasal surgery. In contrast, while pneumothorax, bronchospasm, and hypotension can occur due to other airway management techniques or underlying conditions, they are not specifically linked to the nasotracheal intubation process itself. Pneumothorax is more associated with trauma or improper ventilation techniques, bronchospasm can be a reaction to intubation or allergic response, and hypotension could arise from various factors including pharmacological influences or volume status. Therefore, epistaxis is the most direct and prevalent complication specifically related to nasotracheal intubation.