NBRC TMC Exam | Therapist Multiple-Choice Practice
Questions, Correct Answers & Detailed Rationales
(2026/2027)
QUESTION 1 An ABG is analyzed and shows the following: pH 7.28,
PaCO2 55 mmHg, HCO3 24 mEq/L, PaO2 88 mmHg. What is the
interpretation?
• A. Uncompensated respiratory acidosis
• B. Partially compensated respiratory acidosis
• C. Fully compensated metabolic acidosis
• D. Respiratory alkalosis with hypoxemia
Correct Answer: A. Uncompensated respiratory acidosis.
Detailed Rationale: The pH is acidotic (< 7.35). The PaCO2 is elevated (>
45 mmHg), indicating a respiratory cause for the acidosis. The HCO3 is
normal (22–26), indicating no metabolic compensation has occurred
yet.
QUESTION 2 A patient is receiving mechanical ventilation with a set
tidal volume of 600 mL. The delivered tidal volume is 500 mL. What is
the most likely cause?
• A. The patient’s compliance has increased.
• B. The circuit tubing is disconnected.
• C. Gas is being lost to system compression/tubing compliance.
• D. The peak inspiratory pressure is too low.
,Correct Answer: C. Gas is being lost to system compression/tubing
compliance.
Detailed Rationale: In mechanical ventilation, a portion of the set tidal
volume is lost to the expansion of the circuit tubing (tubing compliance)
and compression of gas within the circuit. This is common in adult
circuits.
QUESTION 3 Which of the following PFT results is most characteristic of
a patient with severe emphysema?
• A. Decreased FEV1/FVC ratio and increased TLC
• B. Increased FEV1/FVC ratio and decreased TLC
• C. Decreased FEV1/FVC ratio and decreased TLC
• D. Normal FEV1/FVC ratio and normal TLC
Correct Answer: A. Decreased FEV1/FVC ratio and increased TLC.
Detailed Rationale: Emphysema is an obstructive lung disease. It results
in air trapping (increased TLC/RV) and decreased airflow (decreased
FEV1/FVC ratio).
QUESTION 4 A 60-kg ideal body weight patient is being set up on
mechanical ventilation. What is the appropriate initial tidal volume
range?
• A. 200–300 mL
• B. 360–480 mL
• C. 600–700 mL
• D. 800–900 mL
,Correct Answer: B. 360–480 mL.
Detailed Rationale: The standard protective lung strategy tidal volume
is 6–8 mL/kg of ideal body weight (IBW). 60 kg x 6 = 360 mL; 60 kg x 8 =
480 mL.
QUESTION 5 When performing tracheal suctioning, what is the
maximum recommended vacuum pressure for an adult?
• A. –60 to –80 mmHg
• B. –80 to –100 mmHg
• C. –100 to –120 mmHg
• D. –150 to –180 mmHg
Correct Answer: C. –100 to –120 mmHg.
Detailed Rationale: Excessive vacuum pressure can damage the
tracheal mucosa. For adults, the recommended range is –100 to –120
mmHg; for children, it is lower.
QUESTION 6 A patient with an acute asthma exacerbation is receiving
albuterol via SVN. The patient develops tachycardia. What is the most
appropriate action?
• A. Discontinue the drug immediately.
• B. Increase the dose to achieve faster bronchodilation.
• C. Switch to an anticholinergic agent (Ipratropium).
• D. Continue the treatment but monitor the patient closely.
Correct Answer: D. Continue the treatment but monitor the patient
closely.
, Detailed Rationale: Tachycardia is a common side effect of beta-
agonists like albuterol. Unless the heart rate increases excessively or the
patient develops arrhythmias, the treatment is generally continued.
QUESTION 7 A patient in the ICU has a Pulmonary Artery Catheter. The
Pulmonary Capillary Wedge Pressure (PCWP) is 22 mmHg. This is
suggestive of:
• A. Hypovolemia
• B. Pulmonary embolus
• C. Left heart failure
• D. Dehydration
Correct Answer: C. Left heart failure.
Detailed Rationale: Normal PCWP is 4–12 mmHg. An elevated PCWP
(>18 mmHg) indicates left ventricular dysfunction or fluid overload.
QUESTION 8 Which of the following is an indication for Incentive
Spirometry?
• A. Upper airway obstruction
• B. Prevention of postoperative atelectasis
• C. Management of severe COPD
• D. Delivery of aerosolized medication
Correct Answer: B. Prevention of postoperative atelectasis.
Detailed Rationale: Incentive spirometry is primarily used to encourage
deep breathing and alveolar recruitment to prevent or treat atelectasis
in high-risk postoperative patients.
Questions, Correct Answers & Detailed Rationales
(2026/2027)
QUESTION 1 An ABG is analyzed and shows the following: pH 7.28,
PaCO2 55 mmHg, HCO3 24 mEq/L, PaO2 88 mmHg. What is the
interpretation?
• A. Uncompensated respiratory acidosis
• B. Partially compensated respiratory acidosis
• C. Fully compensated metabolic acidosis
• D. Respiratory alkalosis with hypoxemia
Correct Answer: A. Uncompensated respiratory acidosis.
Detailed Rationale: The pH is acidotic (< 7.35). The PaCO2 is elevated (>
45 mmHg), indicating a respiratory cause for the acidosis. The HCO3 is
normal (22–26), indicating no metabolic compensation has occurred
yet.
QUESTION 2 A patient is receiving mechanical ventilation with a set
tidal volume of 600 mL. The delivered tidal volume is 500 mL. What is
the most likely cause?
• A. The patient’s compliance has increased.
• B. The circuit tubing is disconnected.
• C. Gas is being lost to system compression/tubing compliance.
• D. The peak inspiratory pressure is too low.
,Correct Answer: C. Gas is being lost to system compression/tubing
compliance.
Detailed Rationale: In mechanical ventilation, a portion of the set tidal
volume is lost to the expansion of the circuit tubing (tubing compliance)
and compression of gas within the circuit. This is common in adult
circuits.
QUESTION 3 Which of the following PFT results is most characteristic of
a patient with severe emphysema?
• A. Decreased FEV1/FVC ratio and increased TLC
• B. Increased FEV1/FVC ratio and decreased TLC
• C. Decreased FEV1/FVC ratio and decreased TLC
• D. Normal FEV1/FVC ratio and normal TLC
Correct Answer: A. Decreased FEV1/FVC ratio and increased TLC.
Detailed Rationale: Emphysema is an obstructive lung disease. It results
in air trapping (increased TLC/RV) and decreased airflow (decreased
FEV1/FVC ratio).
QUESTION 4 A 60-kg ideal body weight patient is being set up on
mechanical ventilation. What is the appropriate initial tidal volume
range?
• A. 200–300 mL
• B. 360–480 mL
• C. 600–700 mL
• D. 800–900 mL
,Correct Answer: B. 360–480 mL.
Detailed Rationale: The standard protective lung strategy tidal volume
is 6–8 mL/kg of ideal body weight (IBW). 60 kg x 6 = 360 mL; 60 kg x 8 =
480 mL.
QUESTION 5 When performing tracheal suctioning, what is the
maximum recommended vacuum pressure for an adult?
• A. –60 to –80 mmHg
• B. –80 to –100 mmHg
• C. –100 to –120 mmHg
• D. –150 to –180 mmHg
Correct Answer: C. –100 to –120 mmHg.
Detailed Rationale: Excessive vacuum pressure can damage the
tracheal mucosa. For adults, the recommended range is –100 to –120
mmHg; for children, it is lower.
QUESTION 6 A patient with an acute asthma exacerbation is receiving
albuterol via SVN. The patient develops tachycardia. What is the most
appropriate action?
• A. Discontinue the drug immediately.
• B. Increase the dose to achieve faster bronchodilation.
• C. Switch to an anticholinergic agent (Ipratropium).
• D. Continue the treatment but monitor the patient closely.
Correct Answer: D. Continue the treatment but monitor the patient
closely.
, Detailed Rationale: Tachycardia is a common side effect of beta-
agonists like albuterol. Unless the heart rate increases excessively or the
patient develops arrhythmias, the treatment is generally continued.
QUESTION 7 A patient in the ICU has a Pulmonary Artery Catheter. The
Pulmonary Capillary Wedge Pressure (PCWP) is 22 mmHg. This is
suggestive of:
• A. Hypovolemia
• B. Pulmonary embolus
• C. Left heart failure
• D. Dehydration
Correct Answer: C. Left heart failure.
Detailed Rationale: Normal PCWP is 4–12 mmHg. An elevated PCWP
(>18 mmHg) indicates left ventricular dysfunction or fluid overload.
QUESTION 8 Which of the following is an indication for Incentive
Spirometry?
• A. Upper airway obstruction
• B. Prevention of postoperative atelectasis
• C. Management of severe COPD
• D. Delivery of aerosolized medication
Correct Answer: B. Prevention of postoperative atelectasis.
Detailed Rationale: Incentive spirometry is primarily used to encourage
deep breathing and alveolar recruitment to prevent or treat atelectasis
in high-risk postoperative patients.
