NBRC Exam Practice Questions & Verified
Answers
Normal Urine Output 40ml/hr (approximatley 1 Liter a day)
Intake exceeds output -weight gain
-electrolyte imbalance
-increased hemodynamic pressures
-decreased lung compliance
Central Venous Pressure (CVP) can indicate changes in fluid balance
Normal CVP 2-6mmhg or 4-12cmh20
-decreased CVP can indicate hypovalemia (fluid therapy)
-increased CVP can indicate hypervalemia (diuretics)
Stuporous, confused , sleepy consider sleep apnea or excessive O2 therapy (COPD patient)
Semicomatose responds only to painful stimuli
Obtunded drowsy state, may have decreased cough or gag reflux (protect airway)
Coma does not respond to painful stimuli
Electrolyte Imbalance Traits anger, combative, irritable
Drug Overdose Traits Euphoria-intense feelings of emotions ( joy)
Panic Traits severe hypoxemia, tension pnemothorax, status asthmaticus, or possibly AAA
(abdominal aortic anerysm)
Activites of Daily Living (ADL) Scoring Katz Scoring System
0-dependent
6-independent
Orthopnea difficulty breathing except in the upright position (CHF)
Genreal malaise run down feeling, nausea, weakness, fatique, headache (consider electrolyte
imbalance)
COPD diet high fats, low carbs (carbs causes higher CO2)
Edema caused by CHF and renal failure
Occurs primarily in arms and ankles
Ascites accumulation of fluid in the abdomen generally caused by liver failure
, Clubbing of fingers caused by chronic hypoxemia
Presence of clubbing suggests pulmonary disease
Venous distension or Jugular venous distension (JVD) occurs with CHF
Seen during exhalation in patients with obstructive lung disease
Capillary refill indication of peripheral circulation
color should return within 3 seconds
Diaphoresis heart failure (recommend diuretics, positive inotropic agents)
fever, infection (recommend antibiotics)
Anxiety, nervousness (recommend sedatives)
tuberculosis/night sweats (recommend antitubercular drugs)
Cheyne-Stokes Breathing gradually increasing then decreasing rate and depth in a cycle lasting from 30-
180 seconds, with periods of apnea lasting up to 60 seconds
Cause: Increased intracranial pressure, brainstem inury, drug overdose
Biot's Breathing increased respiratory rate and depth with irregular periods of apnea. Each
breath has the same depth
Cause: CNS problem
Kussmaul's breathing increased respiratory rate (usually over 20 breaths/min), increased depth,
irregular rhythm, breathing sounds labored
Cause: metabolic acidosis, renal failure, diabetic ketoacidosis
Dry or nonproductive cough may indicate a tumor in the lungs
Productive cough may indicate an infection or chronic lung disease
Tachycardia indications hypoxemia, anxiety, stress (recommend oxygen therapy)
Bradycardia indications heart failure, shock, code/emergency (recommend atropine)
Paradoxical pulse/pulsus paradoxus pulse/blood pressure varies with respiration. May indicate severe air trapping
(status asthmaticus, tension pneumothorax, cardica tampanade)-felt on
exhalation
Tracheal deviation pulled toward the abnormal side -pulmonary atelectasis
(same side of pathology) -pulmonary fibrosis
-pneumonectomy
-diaphragmatic paralysis
Tracheal deviation pushed to the normal side (opposite -massive pleural effusion
side of pathology) -tension pneumothorax
-neck or thyroid tumors
-large mediastinal mass
Crepitus or Extrapulmonary air subcutaneous emphysema
Resonant normal air-filled lung
Flat normally heard over the sternus, muscle, or areas of atelctasis
Answers
Normal Urine Output 40ml/hr (approximatley 1 Liter a day)
Intake exceeds output -weight gain
-electrolyte imbalance
-increased hemodynamic pressures
-decreased lung compliance
Central Venous Pressure (CVP) can indicate changes in fluid balance
Normal CVP 2-6mmhg or 4-12cmh20
-decreased CVP can indicate hypovalemia (fluid therapy)
-increased CVP can indicate hypervalemia (diuretics)
Stuporous, confused , sleepy consider sleep apnea or excessive O2 therapy (COPD patient)
Semicomatose responds only to painful stimuli
Obtunded drowsy state, may have decreased cough or gag reflux (protect airway)
Coma does not respond to painful stimuli
Electrolyte Imbalance Traits anger, combative, irritable
Drug Overdose Traits Euphoria-intense feelings of emotions ( joy)
Panic Traits severe hypoxemia, tension pnemothorax, status asthmaticus, or possibly AAA
(abdominal aortic anerysm)
Activites of Daily Living (ADL) Scoring Katz Scoring System
0-dependent
6-independent
Orthopnea difficulty breathing except in the upright position (CHF)
Genreal malaise run down feeling, nausea, weakness, fatique, headache (consider electrolyte
imbalance)
COPD diet high fats, low carbs (carbs causes higher CO2)
Edema caused by CHF and renal failure
Occurs primarily in arms and ankles
Ascites accumulation of fluid in the abdomen generally caused by liver failure
, Clubbing of fingers caused by chronic hypoxemia
Presence of clubbing suggests pulmonary disease
Venous distension or Jugular venous distension (JVD) occurs with CHF
Seen during exhalation in patients with obstructive lung disease
Capillary refill indication of peripheral circulation
color should return within 3 seconds
Diaphoresis heart failure (recommend diuretics, positive inotropic agents)
fever, infection (recommend antibiotics)
Anxiety, nervousness (recommend sedatives)
tuberculosis/night sweats (recommend antitubercular drugs)
Cheyne-Stokes Breathing gradually increasing then decreasing rate and depth in a cycle lasting from 30-
180 seconds, with periods of apnea lasting up to 60 seconds
Cause: Increased intracranial pressure, brainstem inury, drug overdose
Biot's Breathing increased respiratory rate and depth with irregular periods of apnea. Each
breath has the same depth
Cause: CNS problem
Kussmaul's breathing increased respiratory rate (usually over 20 breaths/min), increased depth,
irregular rhythm, breathing sounds labored
Cause: metabolic acidosis, renal failure, diabetic ketoacidosis
Dry or nonproductive cough may indicate a tumor in the lungs
Productive cough may indicate an infection or chronic lung disease
Tachycardia indications hypoxemia, anxiety, stress (recommend oxygen therapy)
Bradycardia indications heart failure, shock, code/emergency (recommend atropine)
Paradoxical pulse/pulsus paradoxus pulse/blood pressure varies with respiration. May indicate severe air trapping
(status asthmaticus, tension pneumothorax, cardica tampanade)-felt on
exhalation
Tracheal deviation pulled toward the abnormal side -pulmonary atelectasis
(same side of pathology) -pulmonary fibrosis
-pneumonectomy
-diaphragmatic paralysis
Tracheal deviation pushed to the normal side (opposite -massive pleural effusion
side of pathology) -tension pneumothorax
-neck or thyroid tumors
-large mediastinal mass
Crepitus or Extrapulmonary air subcutaneous emphysema
Resonant normal air-filled lung
Flat normally heard over the sternus, muscle, or areas of atelctasis
