NBRC Exam Practice
Questions And 100% Correct
Answers
PATIENT ASSESSMENT:
All the following could cause capnography to go from 3 6 to 30 EXCEPT:
A. Endotracheal tube positioned in the right mainstream bronchus
B. Hyperventilation
C. pulmonary emboli
D. Hypovolemia
Endotracheal tube positioned in right mainstem bronchus is a problem but the co2
reading would not change, so
ANSWER is A.
What is the target Vt for individual on mechanical ventilation
6-8 ml/kg (of ideal body weight) This is new strategy as of January 2015
Is the following Static OR Dynamic Compliance:
Means flow throughout the respiratory system has stopped and all ventilatory
muscle activity is absent. _______ conditions can be imposed with an
inspiratory pause when a patient is sedated and mechanically ventilated.
Static Compliance
Is the following Static OR Dynamic Compliance:
Flow at airway opening is zero. Mechanics are evaluated under ______
conditions, when non-intubated patient breathes spontaneously.
Dynamic Compliance
A balloon tipped flow directed catheter is positioned in the pulmonary artery
with the balloon deflated. Which of the following pressures will be measured
by the proximal lumen:
a. Cvp
b. Pap
c. Pwp
d. Map
,ANSWER is A. Cvp = deflated/proximal lumen
Pap = deflated/distal
Pwp = inflated/wedged
All of the following will affect the accuracy of a capnography EXCEPT
a. Long sampling line
b. Low sampling flow
c. Condensation in the tubing
d. Use of desiccant
Gas will pass through and out of a long sampling line before reaching analyzer so,
low sampling flow will not give you enough information for a good reading, and
condensation as a rule is always a problem especially in analyzers. Dessicant
removes moisture from the gas, which is a good thing, so
ANSWER is D
A 1000 g neonate (normal baby is 3000 g) is stable in nicu. Which of the
following should the respiratory therapist use to monitor the neonates overall
cardiopulmonary status.
a. TcPCO2 and TcPO2 monitor
b. Arterial blood gas analysis Q4
c. SpO2 monitor
d. Capillary gas analysis Q8
Since the baby is stable, go less invasive, also go continuous monitoring (not 4 hour
or 8 hour), Transcutaneous (Tc) continuous monitoring of CO2 and O2 is the best.
Answer is A
A unilateral wheeze would most likely indicate which of the following.
a. Asthma
b. Atelectasis
c. Foreign body aspiration
d. Epiglottitis
You wouldn't have asthma on just one side (unilateral), atelectasis would cause
diminished breath sounds, with epiglottitis you would get stridor, since you are only
hearing wheezing on one side, you are hearing it on the side where you aspirated
something,
so ANSWER is C
,All of the following would be associated with the presence of a pneumothorax
EXCEPT
a. Tracheal deviation
b. Dull percussion
c. Absent breath sounds
d. Respiratory distress
With pneumothorax you would hear a high pitch hyperresonnance, breath sounds
would be absent, and respiratory distress could be present. Dull percussion would
NOT be present,
so ANSWER is B.
What should you recommend FIRST for a patient with multifocal pvc's
a. Administration of lidocaine
b. Administration of 100% oxygen
c. Administration of atropine
d. Administration of epinephrine
Multiple pvc's coming from multiple locations (multifocal) is a real problem and you
should administer oxygen FIRST, so ANSWER is B. lidocaine will help reduce
irritability of heart and help with pvc's but would not be first option, atropine is used
for bradycardia and cardiac irregularities but not pvc's, epinephrine is emergency
drug not for pvc's but more for pulseless ventricular tachycardia or ventricular
fibrilation where heart is not responding .
What is the normal range for the mean pulmonary artery pressure in an adult
a. 2-6 mm Hg
b. 4-12 mmHg
c. 9-18 mmHg
d. 21-28 mmHg
Mean pulmonary artery pressure in an adult should be in the teens
so best ANSWER is C
A patient in the emergency dept has frothy secretions, moist crackles, and
tachypnea. The patient has marked dyspnea and a history of heart disease.
Which of the following should the respiratory therapist recommend.
1.suction immediately
, 2.administer 100% oxygen
3.place in Fowlers position
4.administer furosemide
This is an emergency, they are having heart problems, dyspnea, frothy secretions
indicating severe pulmonary edema, etc. so 100% oxygen immediately, having the
patient in the Fowlers position (an upright position) will help pull fluid down away
from the lungs, furosemide is a lasix (loop diuretic) which gets rid of excess fluid.
You do NOT suction someone with frothy secretions and heart problems, this just
delays appropriate therapy. So ANSWER is 2,3,4
Fine crepitant crackles are most commonly associated with which of the
following conditions.
a. Bronchiectasis
b. Congestive heart failure
c. Pneumonia
d. Croup
Crackles are associated with fluid so a, b, and c would be good answers, but "fine
crepitant" crackles indicates fluid entering alveoli (pulmonary edema) which is most
often caused by heart failure so the best ANSWER is B. (with croup you would hear
more of a stridor sound).
A patient is found in full cardiopulmonary arrest. CPR is started and the
patient is orally intubated with an EtCO2 monitor attached. Which of the
following EtCO2 patterns would the respiratory therapist expect to observe on
the monitor?
a. Initially high, then falling
b. Initially low, then rising
c. Initially high, stays high
d. Initially low, stays low
Full cardiac arrest will cause the CO2 in the lungs to slowly dissipate out because no
blood is flowing, then during CPR when you get blood flowing, the CO2 should
slowly rise back up;
so ANSWER is B
If the blood pressure obtained from the arterial line is higher than the blood
pressure obtained from a sphygmomanometer (cuff pressure). Based upon
this information, the respiratory therapist should conclude that.
Questions And 100% Correct
Answers
PATIENT ASSESSMENT:
All the following could cause capnography to go from 3 6 to 30 EXCEPT:
A. Endotracheal tube positioned in the right mainstream bronchus
B. Hyperventilation
C. pulmonary emboli
D. Hypovolemia
Endotracheal tube positioned in right mainstem bronchus is a problem but the co2
reading would not change, so
ANSWER is A.
What is the target Vt for individual on mechanical ventilation
6-8 ml/kg (of ideal body weight) This is new strategy as of January 2015
Is the following Static OR Dynamic Compliance:
Means flow throughout the respiratory system has stopped and all ventilatory
muscle activity is absent. _______ conditions can be imposed with an
inspiratory pause when a patient is sedated and mechanically ventilated.
Static Compliance
Is the following Static OR Dynamic Compliance:
Flow at airway opening is zero. Mechanics are evaluated under ______
conditions, when non-intubated patient breathes spontaneously.
Dynamic Compliance
A balloon tipped flow directed catheter is positioned in the pulmonary artery
with the balloon deflated. Which of the following pressures will be measured
by the proximal lumen:
a. Cvp
b. Pap
c. Pwp
d. Map
,ANSWER is A. Cvp = deflated/proximal lumen
Pap = deflated/distal
Pwp = inflated/wedged
All of the following will affect the accuracy of a capnography EXCEPT
a. Long sampling line
b. Low sampling flow
c. Condensation in the tubing
d. Use of desiccant
Gas will pass through and out of a long sampling line before reaching analyzer so,
low sampling flow will not give you enough information for a good reading, and
condensation as a rule is always a problem especially in analyzers. Dessicant
removes moisture from the gas, which is a good thing, so
ANSWER is D
A 1000 g neonate (normal baby is 3000 g) is stable in nicu. Which of the
following should the respiratory therapist use to monitor the neonates overall
cardiopulmonary status.
a. TcPCO2 and TcPO2 monitor
b. Arterial blood gas analysis Q4
c. SpO2 monitor
d. Capillary gas analysis Q8
Since the baby is stable, go less invasive, also go continuous monitoring (not 4 hour
or 8 hour), Transcutaneous (Tc) continuous monitoring of CO2 and O2 is the best.
Answer is A
A unilateral wheeze would most likely indicate which of the following.
a. Asthma
b. Atelectasis
c. Foreign body aspiration
d. Epiglottitis
You wouldn't have asthma on just one side (unilateral), atelectasis would cause
diminished breath sounds, with epiglottitis you would get stridor, since you are only
hearing wheezing on one side, you are hearing it on the side where you aspirated
something,
so ANSWER is C
,All of the following would be associated with the presence of a pneumothorax
EXCEPT
a. Tracheal deviation
b. Dull percussion
c. Absent breath sounds
d. Respiratory distress
With pneumothorax you would hear a high pitch hyperresonnance, breath sounds
would be absent, and respiratory distress could be present. Dull percussion would
NOT be present,
so ANSWER is B.
What should you recommend FIRST for a patient with multifocal pvc's
a. Administration of lidocaine
b. Administration of 100% oxygen
c. Administration of atropine
d. Administration of epinephrine
Multiple pvc's coming from multiple locations (multifocal) is a real problem and you
should administer oxygen FIRST, so ANSWER is B. lidocaine will help reduce
irritability of heart and help with pvc's but would not be first option, atropine is used
for bradycardia and cardiac irregularities but not pvc's, epinephrine is emergency
drug not for pvc's but more for pulseless ventricular tachycardia or ventricular
fibrilation where heart is not responding .
What is the normal range for the mean pulmonary artery pressure in an adult
a. 2-6 mm Hg
b. 4-12 mmHg
c. 9-18 mmHg
d. 21-28 mmHg
Mean pulmonary artery pressure in an adult should be in the teens
so best ANSWER is C
A patient in the emergency dept has frothy secretions, moist crackles, and
tachypnea. The patient has marked dyspnea and a history of heart disease.
Which of the following should the respiratory therapist recommend.
1.suction immediately
, 2.administer 100% oxygen
3.place in Fowlers position
4.administer furosemide
This is an emergency, they are having heart problems, dyspnea, frothy secretions
indicating severe pulmonary edema, etc. so 100% oxygen immediately, having the
patient in the Fowlers position (an upright position) will help pull fluid down away
from the lungs, furosemide is a lasix (loop diuretic) which gets rid of excess fluid.
You do NOT suction someone with frothy secretions and heart problems, this just
delays appropriate therapy. So ANSWER is 2,3,4
Fine crepitant crackles are most commonly associated with which of the
following conditions.
a. Bronchiectasis
b. Congestive heart failure
c. Pneumonia
d. Croup
Crackles are associated with fluid so a, b, and c would be good answers, but "fine
crepitant" crackles indicates fluid entering alveoli (pulmonary edema) which is most
often caused by heart failure so the best ANSWER is B. (with croup you would hear
more of a stridor sound).
A patient is found in full cardiopulmonary arrest. CPR is started and the
patient is orally intubated with an EtCO2 monitor attached. Which of the
following EtCO2 patterns would the respiratory therapist expect to observe on
the monitor?
a. Initially high, then falling
b. Initially low, then rising
c. Initially high, stays high
d. Initially low, stays low
Full cardiac arrest will cause the CO2 in the lungs to slowly dissipate out because no
blood is flowing, then during CPR when you get blood flowing, the CO2 should
slowly rise back up;
so ANSWER is B
If the blood pressure obtained from the arterial line is higher than the blood
pressure obtained from a sphygmomanometer (cuff pressure). Based upon
this information, the respiratory therapist should conclude that.
