NBRC EXAM, Part I Questions and Answers Graded A+
PATIENT ASSESSMENT:
All the following could cause capnography to go from 3 6
to 30 EXCEPT: Endotracheal tube positioned in right mainstem bronchus
A. Endotracheal tube positioned in the right mainstream is a problem but the co2 reading would not change, so
bronchus
B. Hyperventilation ANSWER is A.
C. pulmonary emboli
D. Hypovolemia
What is the target Vt for individual on mechanical ventila- 6-8 ml/kg (of ideal body weight) This is new strategy as of
tion January 2015
Is the following Static OR Dynamic Compliance:
Means flow throughout the respiratory system has
stopped and all ventilatory muscle activity is absent.
Static Compliance
conditions can be imposed with an inspiratory
pause when a patient is sedated and mechanically venti-
lated.
Is the following Static OR Dynamic Compliance:
Flow at airway opening is zero. Mechanics are evaluated
Dynamic Compliance
under conditions, when non-intubated patient
breathes spontaneously.
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 ANSWER is A. Cvp = deflated/proximal lumen
lumen:
a. Cvp Pap = deflated/distal
b. Pap Pwp = inflated/wedged
c. Pwp
d. Map
Gas will pass through and out of a long sampling line
before reaching analyzer so, low sampling flow will not
, NBRC EXAM, Part I Questions and Answers Graded A+
All of the following will attect the accuracy of a capnogra-
give you enough information for a good reading, and
phy EXCEPT
condensation as a rule is always a problem especially
a. Long sampling line
in analyzers. Dessicant removes moisture from the gas,
b. Low sampling flow
which is a good thing, so
c. Condensation in the tubing
ANSWER is D
d. Use of desiccant
A 1000 g neonate (normal baby is 3000 g) is stable in
nicu. Which of the following should the respiratory thera-
pist use to monitor the neonates overall cardiopulmonary Since the baby is stable, go less invasive, also go contin-
status. uous monitoring (not 4 hour or 8 hour), Transcutaneous
a. TcPCO2 and TcPO2 monitor (Tc) continuous monitoring of CO2 and O2 is the best.
b. Arterial blood gas analysis Q4 Answer is A
c. SpO2 monitor
d. Capillary gas analysis Q8
A unilateral wheeze would most likely indicate which of the You wouldn't have asthma on just one side (unilateral),
following. atelectasis would cause diminished breath sounds, with
a. Asthma epiglottitis you would get stridor, since you are only hear-
b. Atelectasis ing wheezing on one side, you are hearing it on the side
c. Foreign body aspiration where you aspirated something,
d. Epiglottitis so ANSWER is C
All of the following would be associated with the presence With pneumothorax you would hear a high pitch hyper-
of a pneumothorax EXCEPT resonnance, breath sounds would be absent, and respira-
a. Tracheal deviation tory distress could be present. Dull percussion would NOT
b. Dull percussion be present,
c. Absent breath sounds
d. Respiratory distress so ANSWER is B.
Multiple pvc's coming from multiple locations (multifocal)
What should you recommend FIRST for a patient with
is a real problem and you should administer oxygen FIRST,
multifocal pvc's
so ANSWER is B. lidocaine will help reduce irritability of
a. Administration of lidocaine
heart and help with pvc's but would not be first option,
, NBRC EXAM, Part I Questions and Answers Graded A+
atropine is used for bradycardia and cardiac irregularities
b. Administration of 100% oxygen
but not pvc's, epinephrine is emergency drug not for pvc's
c. Administration of atropine
but more for pulseless ventricular tachycardia or ventric-
d. Administration of epinephrine
ular fibrilation where heart is not responding .
What is the normal range for the mean pulmonary artery
pressure in an adult Mean pulmonary artery pressure in an adult should be in
a. 2-6 mm Hg the teens
b. 4-12 mmHg
c. 9-18 mmHg so best ANSWER is C
d. 21-28 mmHg
A patient in the emergency dept has frothy secretions, This is an emergency, they are having heart problems, dys-
moist crackles, and tachypnea. The patient has marked pnea, frothy secretions indicating severe pulmonary ede-
dyspnea and a history of heart disease. Which of the ma, etc. so 100% oxygen immediately, having the patient
following should the respiratory therapist recommend. in the Fowlers position (an upright position) will help pull
1. suction immediately fluid down away from the lungs, furosemide is a lasix (loop
2. administer 100% oxygen diuretic) which gets rid of excess fluid. You do NOT suction
3. place in Fowlers position someone with frothy secretions and heart problems, this
4. administer furosemide just delays appropriate therapy. So ANSWER is 2,3,4
Fine crepitant crackles are most commonly associated with
Crackles are associated with fluid so a, b, and c would be
which of the following conditions.
good answers, but "fine crepitant" crackles indicates fluid
a. Bronchiectasis
entering alveoli (pulmonary edema) which is most often
b. Congestive heart failure
caused by heart failure so the best ANSWER is B. (with
c. Pneumonia
croup you would hear more of a stridor sound).
d. Croup
A patient is found in full cardiopulmonary arrest. CPR is
started and the patient is orally intubated with an EtCO2
Full cardiac arrest will cause the CO2 in the lungs to slowly
monitor attached. Which of the following EtCO2 patterns
dissipate out because no blood is flowing, then during
would the respiratory therapist expect to observe on the
CPR when you get blood flowing, the CO2 should slowly
monitor?
a. Initially high, then falling
, NBRC EXAM, Part I Questions and Answers Graded A+
b. Initially low, then rising
rise back up;
c. Initially high, stays high
so ANSWER is B
d. Initially low, stays low
If the blood pressure obtained from the arterial line is Arterial line BP and cutt pressure should be the same, so
higher than the blood pressure obtained from a sphyg- there is a problem. Non-compliant tubing is a good thing
momanometer (cutt pressure). Based upon this informa- because it's a stitt tubing, if transducer is placed too high
tion, the respiratory therapist should conclude that. (above the heart), the flood will have to go uphill and you
a. Non-compliant tubing is being used will get a lower pressure; transducer dome contained air
b. Transducer is placed too low bubbles would give you erratic readings but not a higher
c. Patient was lying flat during the measurement of the reading, but if the transducer is placed too low (below
arterial line pressure heart), the blood is flowing downhill & will give a higher
d. Transducer dome contained air bubbles pressure reading, so ANSWER is B
A 2-year old child enters the emergency room. The mother
states that the child was playing with friends and devel- Unilateral wheezing indicates aspirated object and fact
oped violent coughing and unilateral wheezing. Physical that the child was playing with friends causes you to
examination reveals a hyperresonant percussion note on believe the child inhaled a small toy or something, hy-
the left and resonant percussion on the right. Inspiratory perresonant percussion indicates air trapping, so you are
and expiratory chest films indicate air trapping with no thinking foreign object but x-ray says no foreign bod-
foreign bodies "noted." The respiratory therapist should ies "noted." Just because it says "noted" does not mean
suspect the child has. something is not there, it just means it could not be seen
a.pneumothorax on the xray, also if the child had swallowed a small plastic
b.orthopnea toy, "plastic" does not show up on xrays (radiolucent). The
c.aspirated a foreign object ANSWER is C
d.tachyphylaxis
A patient is admitted to the ICU complaining of nausea
and chest pain. A nasogastric tube has been inserted Since the patient received Lasix and nasogastric tube, they
to help relieve the nausea. The patient was started on are losing fluids, and a side ettect of fluid loss is a decrease
Lasix and nitroglycerin. Which of the following should be in electrolytes, so ANSWER is B (there isn't enough evi-
monitored to closely identify side ettects at this time. dence of heart attack to justify cardiac enzymes, also they
a. Cardiac enzymes are used to confirm a heart attack).
b. Serum electrolytes
PATIENT ASSESSMENT:
All the following could cause capnography to go from 3 6
to 30 EXCEPT: Endotracheal tube positioned in right mainstem bronchus
A. Endotracheal tube positioned in the right mainstream is a problem but the co2 reading would not change, so
bronchus
B. Hyperventilation ANSWER is A.
C. pulmonary emboli
D. Hypovolemia
What is the target Vt for individual on mechanical ventila- 6-8 ml/kg (of ideal body weight) This is new strategy as of
tion January 2015
Is the following Static OR Dynamic Compliance:
Means flow throughout the respiratory system has
stopped and all ventilatory muscle activity is absent.
Static Compliance
conditions can be imposed with an inspiratory
pause when a patient is sedated and mechanically venti-
lated.
Is the following Static OR Dynamic Compliance:
Flow at airway opening is zero. Mechanics are evaluated
Dynamic Compliance
under conditions, when non-intubated patient
breathes spontaneously.
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 ANSWER is A. Cvp = deflated/proximal lumen
lumen:
a. Cvp Pap = deflated/distal
b. Pap Pwp = inflated/wedged
c. Pwp
d. Map
Gas will pass through and out of a long sampling line
before reaching analyzer so, low sampling flow will not
, NBRC EXAM, Part I Questions and Answers Graded A+
All of the following will attect the accuracy of a capnogra-
give you enough information for a good reading, and
phy EXCEPT
condensation as a rule is always a problem especially
a. Long sampling line
in analyzers. Dessicant removes moisture from the gas,
b. Low sampling flow
which is a good thing, so
c. Condensation in the tubing
ANSWER is D
d. Use of desiccant
A 1000 g neonate (normal baby is 3000 g) is stable in
nicu. Which of the following should the respiratory thera-
pist use to monitor the neonates overall cardiopulmonary Since the baby is stable, go less invasive, also go contin-
status. uous monitoring (not 4 hour or 8 hour), Transcutaneous
a. TcPCO2 and TcPO2 monitor (Tc) continuous monitoring of CO2 and O2 is the best.
b. Arterial blood gas analysis Q4 Answer is A
c. SpO2 monitor
d. Capillary gas analysis Q8
A unilateral wheeze would most likely indicate which of the You wouldn't have asthma on just one side (unilateral),
following. atelectasis would cause diminished breath sounds, with
a. Asthma epiglottitis you would get stridor, since you are only hear-
b. Atelectasis ing wheezing on one side, you are hearing it on the side
c. Foreign body aspiration where you aspirated something,
d. Epiglottitis so ANSWER is C
All of the following would be associated with the presence With pneumothorax you would hear a high pitch hyper-
of a pneumothorax EXCEPT resonnance, breath sounds would be absent, and respira-
a. Tracheal deviation tory distress could be present. Dull percussion would NOT
b. Dull percussion be present,
c. Absent breath sounds
d. Respiratory distress so ANSWER is B.
Multiple pvc's coming from multiple locations (multifocal)
What should you recommend FIRST for a patient with
is a real problem and you should administer oxygen FIRST,
multifocal pvc's
so ANSWER is B. lidocaine will help reduce irritability of
a. Administration of lidocaine
heart and help with pvc's but would not be first option,
, NBRC EXAM, Part I Questions and Answers Graded A+
atropine is used for bradycardia and cardiac irregularities
b. Administration of 100% oxygen
but not pvc's, epinephrine is emergency drug not for pvc's
c. Administration of atropine
but more for pulseless ventricular tachycardia or ventric-
d. Administration of epinephrine
ular fibrilation where heart is not responding .
What is the normal range for the mean pulmonary artery
pressure in an adult Mean pulmonary artery pressure in an adult should be in
a. 2-6 mm Hg the teens
b. 4-12 mmHg
c. 9-18 mmHg so best ANSWER is C
d. 21-28 mmHg
A patient in the emergency dept has frothy secretions, This is an emergency, they are having heart problems, dys-
moist crackles, and tachypnea. The patient has marked pnea, frothy secretions indicating severe pulmonary ede-
dyspnea and a history of heart disease. Which of the ma, etc. so 100% oxygen immediately, having the patient
following should the respiratory therapist recommend. in the Fowlers position (an upright position) will help pull
1. suction immediately fluid down away from the lungs, furosemide is a lasix (loop
2. administer 100% oxygen diuretic) which gets rid of excess fluid. You do NOT suction
3. place in Fowlers position someone with frothy secretions and heart problems, this
4. administer furosemide just delays appropriate therapy. So ANSWER is 2,3,4
Fine crepitant crackles are most commonly associated with
Crackles are associated with fluid so a, b, and c would be
which of the following conditions.
good answers, but "fine crepitant" crackles indicates fluid
a. Bronchiectasis
entering alveoli (pulmonary edema) which is most often
b. Congestive heart failure
caused by heart failure so the best ANSWER is B. (with
c. Pneumonia
croup you would hear more of a stridor sound).
d. Croup
A patient is found in full cardiopulmonary arrest. CPR is
started and the patient is orally intubated with an EtCO2
Full cardiac arrest will cause the CO2 in the lungs to slowly
monitor attached. Which of the following EtCO2 patterns
dissipate out because no blood is flowing, then during
would the respiratory therapist expect to observe on the
CPR when you get blood flowing, the CO2 should slowly
monitor?
a. Initially high, then falling
, NBRC EXAM, Part I Questions and Answers Graded A+
b. Initially low, then rising
rise back up;
c. Initially high, stays high
so ANSWER is B
d. Initially low, stays low
If the blood pressure obtained from the arterial line is Arterial line BP and cutt pressure should be the same, so
higher than the blood pressure obtained from a sphyg- there is a problem. Non-compliant tubing is a good thing
momanometer (cutt pressure). Based upon this informa- because it's a stitt tubing, if transducer is placed too high
tion, the respiratory therapist should conclude that. (above the heart), the flood will have to go uphill and you
a. Non-compliant tubing is being used will get a lower pressure; transducer dome contained air
b. Transducer is placed too low bubbles would give you erratic readings but not a higher
c. Patient was lying flat during the measurement of the reading, but if the transducer is placed too low (below
arterial line pressure heart), the blood is flowing downhill & will give a higher
d. Transducer dome contained air bubbles pressure reading, so ANSWER is B
A 2-year old child enters the emergency room. The mother
states that the child was playing with friends and devel- Unilateral wheezing indicates aspirated object and fact
oped violent coughing and unilateral wheezing. Physical that the child was playing with friends causes you to
examination reveals a hyperresonant percussion note on believe the child inhaled a small toy or something, hy-
the left and resonant percussion on the right. Inspiratory perresonant percussion indicates air trapping, so you are
and expiratory chest films indicate air trapping with no thinking foreign object but x-ray says no foreign bod-
foreign bodies "noted." The respiratory therapist should ies "noted." Just because it says "noted" does not mean
suspect the child has. something is not there, it just means it could not be seen
a.pneumothorax on the xray, also if the child had swallowed a small plastic
b.orthopnea toy, "plastic" does not show up on xrays (radiolucent). The
c.aspirated a foreign object ANSWER is C
d.tachyphylaxis
A patient is admitted to the ICU complaining of nausea
and chest pain. A nasogastric tube has been inserted Since the patient received Lasix and nasogastric tube, they
to help relieve the nausea. The patient was started on are losing fluids, and a side ettect of fluid loss is a decrease
Lasix and nitroglycerin. Which of the following should be in electrolytes, so ANSWER is B (there isn't enough evi-
monitored to closely identify side ettects at this time. dence of heart attack to justify cardiac enzymes, also they
a. Cardiac enzymes are used to confirm a heart attack).
b. Serum electrolytes
