Which of the following is a contraindication for using a nasopharyngeal airway?

A nasopharyngeal airway is a medical device used to maintain an open airway in unconscious patients who do not have a gag reflex. The presence of a gag reflex indicates that the patient can potentially protect their airway and may not require an artificial airway, making it a contraindication for using this device.

Severe facial injury can also contraindicate the use of a nasopharyngeal airway, particularly if there are fractures or trauma that could lead to further complications or incorrect placement of the airway. In such cases, using the airway might worsen the patient's condition.

Both of these considerations highlight the need to assess a patient's overall condition and anatomy before proceeding with airway management techniques. Therefore, it is crucial to recognize that both the presence of a gag reflex and severe facial injury are valid reasons to avoid the use of a nasopharyngeal airway.