TCRN Practice Exam 2026 – Complete Prep for Your Test

The insertion of nasal airways is contraindicated in patients with ecchymosis behind the ear, as this finding can indicate a potential basilar skull fracture. In cases of basilar skull fractures, there is a risk of introducing an airway device through the nasal passage that could traverse the cribriform plate of the ethmoid bone and enter the cranial cavity, potentially leading to serious complications such as intracranial hemorrhage or infection.

The presence of this ecchymosis suggests trauma that may compromise the structural integrity of the skull and surrounding areas. Therefore, avoiding nasal airway insertion in such cases is essential for patient safety.

In contrast, while pneumothorax, pleural effusion, and a perforated stomach are critical conditions that require careful management, they do not have the same immediate anatomical risk associated with the insertion of a nasal airway as does a potential basilar skull fracture. In those situations, other forms of airway management would be prioritized, but nasal airway insertion specifically is not contraindicated by those conditions.