American Association of Critical-Care Nurses (AACN) Certification Practice Test

What is the typical presentation of tracheoinnominate artery fistula?

1. A sudden drop in blood pressure

2. Severe chest pain

3. Massive hemoptysis

4. Uncontrolled coughing

The correct answer is: Massive hemoptysis

The typical presentation of a tracheoinnominate artery fistula is indeed characterized by massive hemoptysis. This condition often occurs as a complication of prolonged intubation or tracheostomy, during which the inner wall of the trachea can become necrotic and erode into the adjacent innominate artery. When this erosion occurs, it can result in an abnormal connection between the trachea and the innominate artery, leading to significant arterial bleeding. Massive hemoptysis can manifest as sudden episodes of coughing up large quantities of blood, which is a critical and life-threatening situation. This presentation is indicative of the underlying vascular compromise and necessitates immediate medical intervention to manage the hemorrhage and address the fistula. In contrast, while sudden drops in blood pressure, severe chest pain, and uncontrolled coughing can arise from other pulmonary or cardiovascular complications, they are not the defining characteristics of a tracheoinnominate artery fistula. The hallmark symptom of massive hemoptysis serves as a crucial indicator of this specific condition, guiding healthcare providers to the likely diagnosis and urgent treatment needed.