Certified Registered Nurse Anesthetist (CRNA) Practice Exam

What condition may lead to aspirational risk during intubation with succinylcholine?

1. Incompetent lower esophageal sphincter

2. Severe bronchospasm

3. Sepsis?

4. Uncontrolled hypertension

The correct answer is: Incompetent lower esophageal sphincter

The correct answer highlights that an incompetent lower esophageal sphincter can lead to an increased risk of aspiration during intubation when succinylcholine is administered. The use of succinylcholine, a depolarizing neuromuscular blocker, can rapidly induce paralysis, which, in combination with a relaxed lower esophageal sphincter, may allow gastric contents to regurgitate into the throat. If aspiration occurs, it can result in serious pulmonary complications, making this condition particularly relevant in the context of intubation. While severe bronchospasm, sepsis, and uncontrolled hypertension are significant conditions that may complicate a patient's overall status and management during intubation, they do not specifically create an aspirational risk like an incompetent lower esophageal sphincter does. In the case of bronchospasm, the airway may become narrowed, complicating ventilation but not directly influencing aspiration risk. Sepsis may cause hemodynamic instability, and uncontrolled hypertension presents its own risks; however, neither condition directly affects the mechanics of aspiration in the same way as a poorly functioning lower esophageal sphincter.