NBRC TMC/CRT/RRT Version 1-3 Exam:
Questions & Answers 2026/2027 | Complete
A+ Guide | 100% Guaranteed Success
Version 1
Version 2
Version 3
Version 1 Exam
Question 1
A 68-year-old patient with COPD is receiving oxygen via nasal cannula at 2 L/min. ABG
results show pH 7.32, PaCO₂ 68 mmHg, PaO₂ 55 mmHg, HCO₃⁻ 34 mEq/L. What is the
most appropriate intervention?
A) Increase oxygen to 4 L/min via nasal cannula
B) Initiate noninvasive positive pressure ventilation (NIPPV)
C) Administer sodium bicarbonate
D) Decrease oxygen to 1 L/min
Correct Answer: B) Initiate noninvasive positive pressure ventilation (NIPPV)
Rationale: This ABG shows acute respiratory acidosis (pH 7.32, PaCO₂ 68) with chronic
compensation (HCO₃⁻ 34). The patient is in respiratory failure and would benefit from
NIPPV to improve ventilation. Increasing oxygen alone would not address the CO₂
retention .
Question 2
A patient's ABG shows pH 7.48, PaCO₂ 30 mmHg, HCO₃⁻ 22 mEq/L. This is consistent
with:
A) Respiratory acidosis
B) Respiratory alkalosis
,C) Metabolic acidosis
D) Metabolic alkalosis
Correct Answer: B) Respiratory alkalosis
Rationale: Respiratory alkalosis is characterized by elevated pH (>7.45) and decreased
PaCO₂ (<35 mmHg) with normal HCO₃⁻. This ABG shows pH 7.48, PaCO₂ 30, and normal
HCO₃⁻ 22, indicating hyperventilation .
Question 3
A patient's ABG shows pH 7.28, PaCO₂ 55 mmHg, HCO₃⁻ 25 mEq/L. This is consistent
with:
A) Acute respiratory acidosis
B) Chronic respiratory acidosis
C) Metabolic acidosis with respiratory compensation
D) Mixed acidosis
Correct Answer: A) Acute respiratory acidosis
Rationale: Acute respiratory acidosis is characterized by decreased pH (<7.35), elevated
PaCO₂ (>45 mmHg), and normal or minimally elevated HCO₃⁻. Here, pH 7.28, PaCO₂ 55,
and normal HCO₃⁻ 25 indicate acute respiratory acidosis .
Question 4
A patient's ABG shows pH 7.50, PaCO₂ 48 mmHg, HCO₃⁻ 36 mEq/L. This is consistent
with:
A) Acute respiratory acidosis
B) Metabolic alkalosis with respiratory compensation
C) Respiratory alkalosis with metabolic compensation
D) Mixed alkalosis
Correct Answer: B) Metabolic alkalosis with respiratory compensation
,Rationale: Metabolic alkalosis is characterized by elevated pH (>7.45) and elevated HCO₃⁻
(>26 mEq/L) with compensatory respiratory acidosis (elevated PaCO₂). Here, pH 7.50,
HCO₃⁻ 36, and PaCO₂ 48 indicate metabolic alkalosis with respiratory compensation .
Question 5
A patient's ABG shows pH 7.25, PaCO₂ 30 mmHg, HCO₃⁻ 12 mEq/L. This is consistent
with:
A) Respiratory acidosis with metabolic compensation
B) Metabolic acidosis with respiratory compensation
C) Mixed acidosis
D) Respiratory alkalosis with metabolic compensation
Correct Answer: B) Metabolic acidosis with respiratory compensation
Rationale: Metabolic acidosis is characterized by decreased pH (<7.35) and decreased
HCO₃⁻ (<22 mEq/L) with compensatory respiratory alkalosis (decreased PaCO₂). Here, pH
7.25, HCO₃⁻ 12, and PaCO₂ 30 indicate metabolic acidosis with respiratory compensation .
Question 6
A patient's ABG shows pH 7.35, PaCO₂ 50 mmHg, HCO₃⁻ 28 mEq/L. This is consistent
with:
A) Acute respiratory acidosis
B) Chronic respiratory acidosis with compensation
C) Metabolic acidosis with respiratory compensation
D) Normal
Correct Answer: B) Chronic respiratory acidosis with compensation
Rationale: Chronic respiratory acidosis is characterized by decreased pH (near normal),
elevated PaCO₂ (>45 mmHg), and elevated HCO₃⁻ (>26 mEq/L) indicating renal
compensation. Here, pH 7.35, PaCO₂ 50, and HCO₃⁻ 28 indicate chronic respiratory
acidosis with compensation .
, Question 7
A patient's ABG shows pH 7.40, PaCO₂ 40 mmHg, HCO₃⁻ 24 mEq/L. This is:
A) Normal
B) Respiratory acidosis
C) Metabolic acidosis
D) Respiratory alkalosis
Correct Answer: A) Normal
Rationale: Normal ABG values are pH 7.35–7.45, PaCO₂ 35–45 mmHg, and HCO₃⁻ 22–26
mEq/L. This ABG is within normal limits .
Question 8
Which of the following is the most reliable indicator of adequate oxygenation in a
patient receiving mechanical ventilation?
A) SpO₂ of 92%
B) PaO₂/FiO₂ ratio
C) PaO₂ of 80 mmHg
D) SaO₂ of 95%
Correct Answer: B) PaO₂/FiO₂ ratio
Rationale: The PaO₂/FiO₂ (P/F) ratio is the most reliable indicator of oxygenation status
because it accounts for both the partial pressure of oxygen and the fraction of inspired
oxygen. A P/F ratio <300 indicates acute lung injury, and <200 indicates ARDS .
Question 9
A patient has a PaO₂ of 50 mmHg on FiO₂ 0.40. The P/F ratio is:
A) 100
B) 125
C) 150
D) 200
Correct Answer: B) 125
Questions & Answers 2026/2027 | Complete
A+ Guide | 100% Guaranteed Success
Version 1
Version 2
Version 3
Version 1 Exam
Question 1
A 68-year-old patient with COPD is receiving oxygen via nasal cannula at 2 L/min. ABG
results show pH 7.32, PaCO₂ 68 mmHg, PaO₂ 55 mmHg, HCO₃⁻ 34 mEq/L. What is the
most appropriate intervention?
A) Increase oxygen to 4 L/min via nasal cannula
B) Initiate noninvasive positive pressure ventilation (NIPPV)
C) Administer sodium bicarbonate
D) Decrease oxygen to 1 L/min
Correct Answer: B) Initiate noninvasive positive pressure ventilation (NIPPV)
Rationale: This ABG shows acute respiratory acidosis (pH 7.32, PaCO₂ 68) with chronic
compensation (HCO₃⁻ 34). The patient is in respiratory failure and would benefit from
NIPPV to improve ventilation. Increasing oxygen alone would not address the CO₂
retention .
Question 2
A patient's ABG shows pH 7.48, PaCO₂ 30 mmHg, HCO₃⁻ 22 mEq/L. This is consistent
with:
A) Respiratory acidosis
B) Respiratory alkalosis
,C) Metabolic acidosis
D) Metabolic alkalosis
Correct Answer: B) Respiratory alkalosis
Rationale: Respiratory alkalosis is characterized by elevated pH (>7.45) and decreased
PaCO₂ (<35 mmHg) with normal HCO₃⁻. This ABG shows pH 7.48, PaCO₂ 30, and normal
HCO₃⁻ 22, indicating hyperventilation .
Question 3
A patient's ABG shows pH 7.28, PaCO₂ 55 mmHg, HCO₃⁻ 25 mEq/L. This is consistent
with:
A) Acute respiratory acidosis
B) Chronic respiratory acidosis
C) Metabolic acidosis with respiratory compensation
D) Mixed acidosis
Correct Answer: A) Acute respiratory acidosis
Rationale: Acute respiratory acidosis is characterized by decreased pH (<7.35), elevated
PaCO₂ (>45 mmHg), and normal or minimally elevated HCO₃⁻. Here, pH 7.28, PaCO₂ 55,
and normal HCO₃⁻ 25 indicate acute respiratory acidosis .
Question 4
A patient's ABG shows pH 7.50, PaCO₂ 48 mmHg, HCO₃⁻ 36 mEq/L. This is consistent
with:
A) Acute respiratory acidosis
B) Metabolic alkalosis with respiratory compensation
C) Respiratory alkalosis with metabolic compensation
D) Mixed alkalosis
Correct Answer: B) Metabolic alkalosis with respiratory compensation
,Rationale: Metabolic alkalosis is characterized by elevated pH (>7.45) and elevated HCO₃⁻
(>26 mEq/L) with compensatory respiratory acidosis (elevated PaCO₂). Here, pH 7.50,
HCO₃⁻ 36, and PaCO₂ 48 indicate metabolic alkalosis with respiratory compensation .
Question 5
A patient's ABG shows pH 7.25, PaCO₂ 30 mmHg, HCO₃⁻ 12 mEq/L. This is consistent
with:
A) Respiratory acidosis with metabolic compensation
B) Metabolic acidosis with respiratory compensation
C) Mixed acidosis
D) Respiratory alkalosis with metabolic compensation
Correct Answer: B) Metabolic acidosis with respiratory compensation
Rationale: Metabolic acidosis is characterized by decreased pH (<7.35) and decreased
HCO₃⁻ (<22 mEq/L) with compensatory respiratory alkalosis (decreased PaCO₂). Here, pH
7.25, HCO₃⁻ 12, and PaCO₂ 30 indicate metabolic acidosis with respiratory compensation .
Question 6
A patient's ABG shows pH 7.35, PaCO₂ 50 mmHg, HCO₃⁻ 28 mEq/L. This is consistent
with:
A) Acute respiratory acidosis
B) Chronic respiratory acidosis with compensation
C) Metabolic acidosis with respiratory compensation
D) Normal
Correct Answer: B) Chronic respiratory acidosis with compensation
Rationale: Chronic respiratory acidosis is characterized by decreased pH (near normal),
elevated PaCO₂ (>45 mmHg), and elevated HCO₃⁻ (>26 mEq/L) indicating renal
compensation. Here, pH 7.35, PaCO₂ 50, and HCO₃⁻ 28 indicate chronic respiratory
acidosis with compensation .
, Question 7
A patient's ABG shows pH 7.40, PaCO₂ 40 mmHg, HCO₃⁻ 24 mEq/L. This is:
A) Normal
B) Respiratory acidosis
C) Metabolic acidosis
D) Respiratory alkalosis
Correct Answer: A) Normal
Rationale: Normal ABG values are pH 7.35–7.45, PaCO₂ 35–45 mmHg, and HCO₃⁻ 22–26
mEq/L. This ABG is within normal limits .
Question 8
Which of the following is the most reliable indicator of adequate oxygenation in a
patient receiving mechanical ventilation?
A) SpO₂ of 92%
B) PaO₂/FiO₂ ratio
C) PaO₂ of 80 mmHg
D) SaO₂ of 95%
Correct Answer: B) PaO₂/FiO₂ ratio
Rationale: The PaO₂/FiO₂ (P/F) ratio is the most reliable indicator of oxygenation status
because it accounts for both the partial pressure of oxygen and the fraction of inspired
oxygen. A P/F ratio <300 indicates acute lung injury, and <200 indicates ARDS .
Question 9
A patient has a PaO₂ of 50 mmHg on FiO₂ 0.40. The P/F ratio is:
A) 100
B) 125
C) 150
D) 200
Correct Answer: B) 125
