NBRC TMC Practice Questions and Answers
Which of the following is needed to calculate alveolar B.
oxygen tension? Barometric pressure, FiO2, and PaO2 are all included in the formula (BP stands
A. VD/VT, PAO2 for barometric pressure)
B. BP and FiO2
C. PetCO2 and PaO2
D. QS/QT, deadspace
L/min/m2 is the unit of measure for: C.
A. Systemic vascular resistance
B. Cardiac output
C. Cardiac index
D. Stroke volume
A spontaneously breathing patient has the following B.
arterial blood gas results: A patient who is showing signs of hypoxemia should receive supplemental
pH 7.38 PaCO2 42 mmHgPaO2 76 mmHgHCO3- 24 oxygen. If the patient is not a COPD patient and the situation is not an
mEq/LBE 0 mEq/L emergency, then the proper supplemental oxygen is an adult therapeutic dose,
Which of the following supplemental oxygen levels is which is 40% to 55%. Of the options available only 5 L/min nasal cannula will
most appropriate? approach this. Other options are either insufficient or too much.
A. 2 L/min nasal cannula
B. 5 L/min nasal cannula
C. non-rebreathing mask
D. Venturi mask at 30%
Left heart failure would be manifested in which of the D.
following values? The function of the left heart, specifically the left ventricle, is best assessed
A. CVP and mPAP hemodynamically by looking at those values that precede and come after the left
B. mPAP and wedge pressure heart. In this case pulmonary capillary wedge pressure and cardiac output (or
C. MAP and SVR cardiac index) are the values found before and after the left heart.
D. cardiac output and wedge pressure
Which of the following findings is most closely associated B.
with increased airway resistance? Of the options given, use of accessory muscles is most closely associated with
A. reduced SpO2 an increase in airway resistance. This is especially true with patients who have
B. accessory muscle use asthma or other types of upper airway inflammation or bronchoconstriction.
C. altered P50
D. increased PetCO2
For a patient receiving volume-controlled mechanical A.
ventilation, the lower inflection point on a pressure- The lowest inflection point on a pressure-volume ventilator graphic is an
volume loop can best be described as: indication of the minimum pressure needed to keep alveoli open.
A. amount of pressure required to keep the alveoli and
small airways open
B. optimal PEEP
C. minimal PEEP
D. upper limit of residual volume
The results of a V/Q scan shows poor perfusion with C.
adequate ventilation. A chest radiograph shows a wedge- A VQ scan that shows poor perfusion but adequate ventilation is most closely
shaped infiltrate over the right lung field. The patient associated with a pulmonary embolism. Supportive data is found in the
most likely has radiological report of wedge-shaped infiltrates.
A. fluid overload
B. ARDS
C. a pulmonary embolism
D. pneumonia
The respiratory therapist notes in the medical record of a D.
65-year-old male that the patient is ordered to receive Because albuterol is a beta-agonist medication, patients who are taking beta-
bronchodilator therapy with Albuterol. The therapist also blockers should utilize other bronchodilation medication.
notes the patient is receiving beta-blocker medication.
The therapist should recommend
A. Administer Dexamethasone (Decadron) in place of
Albuterol
B. Add Xopenex to the bronchodilator regimen
C. Replace Albuterol with Beclamethasone (Beclovent)
D. Switch from Albuterol to ipratropium bromide
(Atrovent)
, NBRC TMC Practice Questions and Answers
A hospital has an extremely low incidence of ventilator- A.
associated pneumonia. To which of the following reasons The incidence of ventilator-associated pneumonia, or VAP, is lowered by using a
may this be attributed? closed system suction catheter, periodically discontinuing sedation, keeping the
A. periodic discontinuation of sedation patient and semi-Fowler's position, and proper handwashing among caregivers.
B. use of respiratory precautions with the population All are correct.
C. diversion of infectious patients to other facilities
D. broad use of prophylactic antibiotics
A pressure-volume loop ventilator graphic shows no rise B.
in pressure for the first 200 mL of delivered volume. The In this question the description of the pressure volume loop would indicate a flat
therapist should bottom as manifested by no rise in pressure with the first 200 mL of delivered
A. increase inspiratory flow rate volume. We call this a "flat football". The solution is to increase PEEP to a level
B. increase PEEP that the pressure begins to rise immediately as volume is introduced.
C. decrease tidal volume
D. decrease inspiratory flow rate
Which of the following would be the most effective, A.
appropriate method for resolving atelectasis in a A postoperative patient under sedation, and possibly in pain, may be tempted to
spontaneously breathing, post operative patient who is breathe less, causing respiratory acidosis and atelectasis. To correct this
under the influence of sedation and will not respond to problem, IPPB therapy is most appropriate. Incentive spirometry would also help
verbal stimuli? but the patient is unable to respond to verbal stimuli. This alone is an indication
A. IPPB for IPPB therapy.
B. sustained maximal inhalation (incentive spirometer)
C. deep breathing coaching
D. intubation and mechanical ventilation
After performing minimum occluding volume technique A.
with a 65-kg (143-lb) patient who is orally intubated with The ET tube cuff pressure may be adjusted correctly by several techniques
a 7.0-mm ET tube, the respiratory therapist should NEXT including minimum leak technique (also called minimum occluding volume,
A. check ET tube cuff pressure minimal seal technique, and the use of a pressure manometer called a cuffalator.
B. perform tracheal palpation If minimum seal or minimal leak technique is used, the respiratory therapist is still
C. order a chest radiograph required to monitor the pressure after the technique is performed. Although this is
D. document ET tube markings at the lips often not done in real life, it is technically part of the procedure.
The respiratory therapist observes an ECG wave form on D.
a patient that is consistent with atrial tachycardia. The Non-deadly arrhythmias, such as this one, may be addressed through
patient is complaining of chest pain, dizziness, and cardioversion. Cardioversion is a form of defibrillation with low wattage and with
nausea. The respiratory therapist should recommend the synchronization set to "active". This allows the shock to be synchronized to
A. unsynchronized defibrillation the R wave.
B. Atropine sulfate
C. epinephrine
D. cardioversion
A 38-year-old male presents in the emergency C.
department (ED) complaining of frequent vomiting. The This patient has a CO2 of 42 mmHg, which suggests adequate ventilation.
following laboratory data is available: Arterial blood However, the high pH is associated with alkalosis. Because the CO2 is normal,
gases the cause of the alkalosis must be metabolic in nature. One treatment for
pH 7.55 PaCO2 42 torrPaO2 85 torrHCO3- 31 mEq/LBE metabolic alkalosis is to administer potassium chloride or KCl.
+7 mEq/LFIO2 0.21K+ 3.0 mEq/LCl- 95 mEq/LNa+ 135
mEq/L
Which of the following should the respiratory therapist
recommend?
A. administer NaCL
B. administer NaHCO3-
C. administer KCL
D. administer volume-expanding fluids
A patient is receiving volume-controlled ventilation B.
following bariatric surgery for obesity. Which of the Morphine sulfate is one of the best medications to administer to patients
following medications should the respiratory therapist receiving mechanical ventilatory support to help the patient rest pain-free and to
recommend to ensure the patient's comfort and assist in generally sedate and relax the patient.
ventilator management?
A. Pronestyl
B. morphine sulfate
C. vecuronium bromide (Norcuron)
D. Mestinon
A patient has idiopathic pneumonia with consolidation in A.
the right lower lobe. The physician suspects a bacterial A bacterial infection is diagnosed primarily by examining the white blood cell
infection. Which of the following will provide conclusive count, also called the leukocyte count. An elevated temperature and yellow
data to rule out the physician's suspicions? sputum indicate the possibility of an infection but are not confirming in nature.
A. WBC
B. color of sputum
C. sputum acid-fast stain
D. oral temperature
, NBRC TMC Practice Questions and Answers
After making the universal sign of choking, a person C.
collapses. The observer should FIRST When a person indicates the universal sign of choking, they are unable to
A. check for a pulse verbalize because there is likely something caught in their airway. The person
B. call for help responding must first focus on removing the obstruction, which is done by
C. perform abdominal thrusts performing abdominal thrusts. Administering rescue breaths would not be
D. administer 2 rescue breaths appropriate because the airway is obstructed. Calling for help is tempting but is
only related to two-man CPR. The patient is not yet at that point. Performing
abdominal thrusts is a one-man maneuver and therefore obtaining additional
help is not the first concern.
A home care patient calls into the clinic and complains C.
that his oxygen concentrator is not working even though When a homecare patient reports a problem with their oxygen concentrator, the
the machine is plugged in and the switch is in the 'on'. first action should be to ensure the patient is receiving oxygen from an alternate
Position. After ensuring the patient is receiving oxygen source (an E cylinder). After that is accomplished, the respiratory therapist may
from a reliable alternate source, the therapist should instruct the patient in some basic troubleshooting. This includes ensuring the
advise the patient to device is plugged in, changing the filter, and checking the circuit breaker. All
A. check and replace the internal in-line fuse other troubleshooting should be done by a professional.
B. find the reset switch in the machine and press it
C. ensure the circuit breaker is in the on position
D. change the filters and cycle the machine off then on
again
An adult patient with asthma is receiving Albuterol by C.
small volume nebulizer Q.I.D. at a dosage of 0.5 mL. The When a patient experiences an adverse reaction, the first step is to stop the
patient complains of dizziness, tingling in his fingers, and therapy and then modify the therapy to accomplish the same objective. In this
anxiety with each treatment. The therapist should case, decreasing the dose of Xopenex is suitable because 0.63 mg is still in the
A. increase dosage to 1.0 mL adult therapeutic range.
B. decrease dosage to 0.15 mL
C. switch to Xopenex 0.63 mg
D. switch to Mucomyst 20%
Which of the following conditions would benefit most C.
from a thoracentesis? A thoracentesis is a procedure that removes air or fluid from the pleural space.
A. atelectasis This would be appropriate with a small pneumothorax. A large pneumothorax,
B. complete opacification of the right lung however, would require chest tubes.
C. small pneumothorax
D. pericardial contusion
ASK***** A patient with ARDS and asthma could benefit B.
from which of the following medications? A patient with adult respiratory distress syndrome could benefit from surfactant
A. Spiriva and decadron therapy to decrease the surface tension of the alveoli.
B. exogenous surfactant
C. Tobramycin and albuterol
D. cromolyn sodium
The respiratory therapist should look to which of the B.
following clinical data to determine the effectiveness of The effectiveness of incentive spirometry can best be determined by auscultating
incentive spirometry? breath sounds before and after the treatment and noting changes in air
A. Arterial blood gas analysis pre and post treatment movement. While achieving inspiratory capacity is the goal, the real goal is to
B. Breath sounds before and after every treatment increase lung volume, improve alveolar recruitment, and prevent consolidation of
C. Inspiratory capacity predicted volume sputum in the lungs.
D. Maximum voluntary ventilation done periodically
increased labor of breathing. The mandatory rate is A.
14/min. Which of the following would most likely help the During ventilator weaning, a patient must maintain a moderately low respiratory
patient? rate, an adequate sized tidal volume, and low work of breathing. In this case, the
A. Use of pressure support patient is experiencing increased labor of breathing and an increase in
B. Switch to pressure control ventilation respiratory rate. This is likely due to a reduced spontaneous tidal volume.
C. Increase the machine flow rate Although this data is not shown, this condition can be assumed. The solution for
D. Increase PEEP a low spontaneous tidal volume and increased work of breathing during weaning
is to provide pressure support.
When analyzing the FIO2 for an infant in an oxygen hood D.
receiving oxygen therapy with a blender set at 50%, the When administering oxygen by oxygen hood with a blender and a nebulizer, the
respiratory therapist notes an oxygen concentration of oxygen control on the nebulizer should be set to 100%. This will prevent
35% near the patient's mouth. The jet nebulizer additional entrainment of room air which will cause a decrease in FIO2.
entrainment setting is set to 50%. To correct the problem,
the therapist should
A. adjust blender setting to 60%
B. increase total flow to the oxyhood
C. obtain a smaller oxyhood
D. change the nebulizer entrainment port to 100%
, NBRC TMC Practice Questions and Answers
Following the insertion of a tracheostomy tube, the A.
patient is found to have diffuse crackles upon Hyperlucency, seen on a chest x-ray is darker in color. Air is radiolucent.
auscultation secondary to subcutaneous emphysema. Therefore, air located in the soft tissue, as seen with subcutaneous emphysema
Which of the following radiographic findings would be would result in a hyperlucent X-ray over soft tissue areas. Subcutaneous
expected with this condition? emphysema by itself will not shift the trachea from midline. Scattered patchy
A. Hyperlucency in the soft tissues infiltrates are associated with ARDS, not subcutaneous emphysema.
B. Diffuse pulmonary hyperlucency
C. Tracheal shift from midline
D. Scattered patchy infiltrates
Placement of a pulmonary artery catheter is associated C.
with which of the following most common complications? Several complications may arise from the placement of a pulmonary artery
A. hypotension catheter, otherwise called a Swan-Ganz catheter. The development of cardiac
B. pulmonic valve damage arrhythmias is the most common complication of the options offered. Another
C. cardiac arrhythmias serious complication is perforation of a vessel or cardiac muscle during the
D. internal bleeding insertion.
A galvanic fuel cell oxygen analyzer may read C.
erroneously high under which of the following A galvanic fuel-cell oxygen analyzer may read erroneously when ambient
conditions? pressures change significantly, such as when a patient is receiving high
A. when the analyzer batteries are depleted inspiratory pressure or when a patient changes altitude quickly.
B. during a sudden increase in the partial pressure of
oxygen
C. when a volume-controlled ventilator at high inspiratory
pressures
D. when liquid gets on the membrane
Results of a quality control maneuver for a spirometer A.
using a 3.0 L calibration syringe as follows: These calibration results are all very close together, indicating the machine is
Volume 1 2.65 L Volume 2 2.68 LVolume 3 2.66 L very precise. However, the results are too far from the 3.0 L of gas introduced by
According to ATS Standards, the spirometer is the calibration syringe. The maximum variance is 2.85 L - 3.15 L. Therefore,
A. inaccurate although the machine is precise, it is considered inaccurate and should not be
B. proof that the syringe requires calibration used for patient testing and reporting.
C. lacking in precision
D. operating correctly
Which of the following will be most helpful at preventing A.
complications for a 48-year-old male patient who has just One of the best methods to prevent postoperative complications is the use of
undergone bariatric surgery for obesity? incentive spirometry, also called maximal sustained inspiration or SMI.
A. Incentive spirometry every hour
B. Small volume nebulizer therapy with Albuterol every 4
hours
C. Ambulation twice a day
D. IPPB with 3.0 mL normal saline every 4 hours
Which of the following results should the respiratory C.
therapist evaluate to determine the adequacy of oxygen Oxygen transport refers to the ability for blood to carry oxygen from the alveoli to
transport on a patient who is diagnosed with carbon the tissues. In a case involving carbon monoxide poisoning, it is transport that is
monoxide poisoning and is being treated with FIO2 of most affected. This is true because hemoglobin becomes occupied with carbon
1.0? monoxide rather than oxygen. Hemoglobin is 19 times more attracted to carbon
A. arterial-venous oxygen content difference monoxide compared to oxygen. Of the options listed, the best method to monitor
B. cardiac output the adequacy of oxygen transport would be to evaluate the arterial oxygen
C. arterial oxygen content content. This value takes into account the amount of oxygen tied to the
D. oxygen consumption at the tissues hemoglobin as well as the oxygen dissolved in the plasma of the blood
A patient complains of shortness of breath during a A.
nebulizer treatment is hypertonic saline. The respiratory Adverse reactions during any therapy should be responded to initially by
therapist should do which of the following? discontinuing therapy and notifying the physician.
A. Discontinue therapy and notify the physician
B. Add Albuterol to the nebulizer treatment
C. Switch to normal saline
D. Switch to hypotonic saline
In preparation for a helium dilution study, a respiratory B.
therapist is calibrating the helium analyzer. While To calibrate a helium analyzer, sometimes called a Wheatstone Bridge, the
exposing the analyzer to ambient room air, what will the device must be calibrated to room air for the low calibration and to a known level
analyzer read for helium concentration? of helium for the high calibration. Because room air has no significant level of
A. 21% helium, helium analyzers should read 0% when exposed to ambient room air
B. 0% conditions.
C. 2%
D. 79%
Which of the following is needed to calculate alveolar B.
oxygen tension? Barometric pressure, FiO2, and PaO2 are all included in the formula (BP stands
A. VD/VT, PAO2 for barometric pressure)
B. BP and FiO2
C. PetCO2 and PaO2
D. QS/QT, deadspace
L/min/m2 is the unit of measure for: C.
A. Systemic vascular resistance
B. Cardiac output
C. Cardiac index
D. Stroke volume
A spontaneously breathing patient has the following B.
arterial blood gas results: A patient who is showing signs of hypoxemia should receive supplemental
pH 7.38 PaCO2 42 mmHgPaO2 76 mmHgHCO3- 24 oxygen. If the patient is not a COPD patient and the situation is not an
mEq/LBE 0 mEq/L emergency, then the proper supplemental oxygen is an adult therapeutic dose,
Which of the following supplemental oxygen levels is which is 40% to 55%. Of the options available only 5 L/min nasal cannula will
most appropriate? approach this. Other options are either insufficient or too much.
A. 2 L/min nasal cannula
B. 5 L/min nasal cannula
C. non-rebreathing mask
D. Venturi mask at 30%
Left heart failure would be manifested in which of the D.
following values? The function of the left heart, specifically the left ventricle, is best assessed
A. CVP and mPAP hemodynamically by looking at those values that precede and come after the left
B. mPAP and wedge pressure heart. In this case pulmonary capillary wedge pressure and cardiac output (or
C. MAP and SVR cardiac index) are the values found before and after the left heart.
D. cardiac output and wedge pressure
Which of the following findings is most closely associated B.
with increased airway resistance? Of the options given, use of accessory muscles is most closely associated with
A. reduced SpO2 an increase in airway resistance. This is especially true with patients who have
B. accessory muscle use asthma or other types of upper airway inflammation or bronchoconstriction.
C. altered P50
D. increased PetCO2
For a patient receiving volume-controlled mechanical A.
ventilation, the lower inflection point on a pressure- The lowest inflection point on a pressure-volume ventilator graphic is an
volume loop can best be described as: indication of the minimum pressure needed to keep alveoli open.
A. amount of pressure required to keep the alveoli and
small airways open
B. optimal PEEP
C. minimal PEEP
D. upper limit of residual volume
The results of a V/Q scan shows poor perfusion with C.
adequate ventilation. A chest radiograph shows a wedge- A VQ scan that shows poor perfusion but adequate ventilation is most closely
shaped infiltrate over the right lung field. The patient associated with a pulmonary embolism. Supportive data is found in the
most likely has radiological report of wedge-shaped infiltrates.
A. fluid overload
B. ARDS
C. a pulmonary embolism
D. pneumonia
The respiratory therapist notes in the medical record of a D.
65-year-old male that the patient is ordered to receive Because albuterol is a beta-agonist medication, patients who are taking beta-
bronchodilator therapy with Albuterol. The therapist also blockers should utilize other bronchodilation medication.
notes the patient is receiving beta-blocker medication.
The therapist should recommend
A. Administer Dexamethasone (Decadron) in place of
Albuterol
B. Add Xopenex to the bronchodilator regimen
C. Replace Albuterol with Beclamethasone (Beclovent)
D. Switch from Albuterol to ipratropium bromide
(Atrovent)
, NBRC TMC Practice Questions and Answers
A hospital has an extremely low incidence of ventilator- A.
associated pneumonia. To which of the following reasons The incidence of ventilator-associated pneumonia, or VAP, is lowered by using a
may this be attributed? closed system suction catheter, periodically discontinuing sedation, keeping the
A. periodic discontinuation of sedation patient and semi-Fowler's position, and proper handwashing among caregivers.
B. use of respiratory precautions with the population All are correct.
C. diversion of infectious patients to other facilities
D. broad use of prophylactic antibiotics
A pressure-volume loop ventilator graphic shows no rise B.
in pressure for the first 200 mL of delivered volume. The In this question the description of the pressure volume loop would indicate a flat
therapist should bottom as manifested by no rise in pressure with the first 200 mL of delivered
A. increase inspiratory flow rate volume. We call this a "flat football". The solution is to increase PEEP to a level
B. increase PEEP that the pressure begins to rise immediately as volume is introduced.
C. decrease tidal volume
D. decrease inspiratory flow rate
Which of the following would be the most effective, A.
appropriate method for resolving atelectasis in a A postoperative patient under sedation, and possibly in pain, may be tempted to
spontaneously breathing, post operative patient who is breathe less, causing respiratory acidosis and atelectasis. To correct this
under the influence of sedation and will not respond to problem, IPPB therapy is most appropriate. Incentive spirometry would also help
verbal stimuli? but the patient is unable to respond to verbal stimuli. This alone is an indication
A. IPPB for IPPB therapy.
B. sustained maximal inhalation (incentive spirometer)
C. deep breathing coaching
D. intubation and mechanical ventilation
After performing minimum occluding volume technique A.
with a 65-kg (143-lb) patient who is orally intubated with The ET tube cuff pressure may be adjusted correctly by several techniques
a 7.0-mm ET tube, the respiratory therapist should NEXT including minimum leak technique (also called minimum occluding volume,
A. check ET tube cuff pressure minimal seal technique, and the use of a pressure manometer called a cuffalator.
B. perform tracheal palpation If minimum seal or minimal leak technique is used, the respiratory therapist is still
C. order a chest radiograph required to monitor the pressure after the technique is performed. Although this is
D. document ET tube markings at the lips often not done in real life, it is technically part of the procedure.
The respiratory therapist observes an ECG wave form on D.
a patient that is consistent with atrial tachycardia. The Non-deadly arrhythmias, such as this one, may be addressed through
patient is complaining of chest pain, dizziness, and cardioversion. Cardioversion is a form of defibrillation with low wattage and with
nausea. The respiratory therapist should recommend the synchronization set to "active". This allows the shock to be synchronized to
A. unsynchronized defibrillation the R wave.
B. Atropine sulfate
C. epinephrine
D. cardioversion
A 38-year-old male presents in the emergency C.
department (ED) complaining of frequent vomiting. The This patient has a CO2 of 42 mmHg, which suggests adequate ventilation.
following laboratory data is available: Arterial blood However, the high pH is associated with alkalosis. Because the CO2 is normal,
gases the cause of the alkalosis must be metabolic in nature. One treatment for
pH 7.55 PaCO2 42 torrPaO2 85 torrHCO3- 31 mEq/LBE metabolic alkalosis is to administer potassium chloride or KCl.
+7 mEq/LFIO2 0.21K+ 3.0 mEq/LCl- 95 mEq/LNa+ 135
mEq/L
Which of the following should the respiratory therapist
recommend?
A. administer NaCL
B. administer NaHCO3-
C. administer KCL
D. administer volume-expanding fluids
A patient is receiving volume-controlled ventilation B.
following bariatric surgery for obesity. Which of the Morphine sulfate is one of the best medications to administer to patients
following medications should the respiratory therapist receiving mechanical ventilatory support to help the patient rest pain-free and to
recommend to ensure the patient's comfort and assist in generally sedate and relax the patient.
ventilator management?
A. Pronestyl
B. morphine sulfate
C. vecuronium bromide (Norcuron)
D. Mestinon
A patient has idiopathic pneumonia with consolidation in A.
the right lower lobe. The physician suspects a bacterial A bacterial infection is diagnosed primarily by examining the white blood cell
infection. Which of the following will provide conclusive count, also called the leukocyte count. An elevated temperature and yellow
data to rule out the physician's suspicions? sputum indicate the possibility of an infection but are not confirming in nature.
A. WBC
B. color of sputum
C. sputum acid-fast stain
D. oral temperature
, NBRC TMC Practice Questions and Answers
After making the universal sign of choking, a person C.
collapses. The observer should FIRST When a person indicates the universal sign of choking, they are unable to
A. check for a pulse verbalize because there is likely something caught in their airway. The person
B. call for help responding must first focus on removing the obstruction, which is done by
C. perform abdominal thrusts performing abdominal thrusts. Administering rescue breaths would not be
D. administer 2 rescue breaths appropriate because the airway is obstructed. Calling for help is tempting but is
only related to two-man CPR. The patient is not yet at that point. Performing
abdominal thrusts is a one-man maneuver and therefore obtaining additional
help is not the first concern.
A home care patient calls into the clinic and complains C.
that his oxygen concentrator is not working even though When a homecare patient reports a problem with their oxygen concentrator, the
the machine is plugged in and the switch is in the 'on'. first action should be to ensure the patient is receiving oxygen from an alternate
Position. After ensuring the patient is receiving oxygen source (an E cylinder). After that is accomplished, the respiratory therapist may
from a reliable alternate source, the therapist should instruct the patient in some basic troubleshooting. This includes ensuring the
advise the patient to device is plugged in, changing the filter, and checking the circuit breaker. All
A. check and replace the internal in-line fuse other troubleshooting should be done by a professional.
B. find the reset switch in the machine and press it
C. ensure the circuit breaker is in the on position
D. change the filters and cycle the machine off then on
again
An adult patient with asthma is receiving Albuterol by C.
small volume nebulizer Q.I.D. at a dosage of 0.5 mL. The When a patient experiences an adverse reaction, the first step is to stop the
patient complains of dizziness, tingling in his fingers, and therapy and then modify the therapy to accomplish the same objective. In this
anxiety with each treatment. The therapist should case, decreasing the dose of Xopenex is suitable because 0.63 mg is still in the
A. increase dosage to 1.0 mL adult therapeutic range.
B. decrease dosage to 0.15 mL
C. switch to Xopenex 0.63 mg
D. switch to Mucomyst 20%
Which of the following conditions would benefit most C.
from a thoracentesis? A thoracentesis is a procedure that removes air or fluid from the pleural space.
A. atelectasis This would be appropriate with a small pneumothorax. A large pneumothorax,
B. complete opacification of the right lung however, would require chest tubes.
C. small pneumothorax
D. pericardial contusion
ASK***** A patient with ARDS and asthma could benefit B.
from which of the following medications? A patient with adult respiratory distress syndrome could benefit from surfactant
A. Spiriva and decadron therapy to decrease the surface tension of the alveoli.
B. exogenous surfactant
C. Tobramycin and albuterol
D. cromolyn sodium
The respiratory therapist should look to which of the B.
following clinical data to determine the effectiveness of The effectiveness of incentive spirometry can best be determined by auscultating
incentive spirometry? breath sounds before and after the treatment and noting changes in air
A. Arterial blood gas analysis pre and post treatment movement. While achieving inspiratory capacity is the goal, the real goal is to
B. Breath sounds before and after every treatment increase lung volume, improve alveolar recruitment, and prevent consolidation of
C. Inspiratory capacity predicted volume sputum in the lungs.
D. Maximum voluntary ventilation done periodically
increased labor of breathing. The mandatory rate is A.
14/min. Which of the following would most likely help the During ventilator weaning, a patient must maintain a moderately low respiratory
patient? rate, an adequate sized tidal volume, and low work of breathing. In this case, the
A. Use of pressure support patient is experiencing increased labor of breathing and an increase in
B. Switch to pressure control ventilation respiratory rate. This is likely due to a reduced spontaneous tidal volume.
C. Increase the machine flow rate Although this data is not shown, this condition can be assumed. The solution for
D. Increase PEEP a low spontaneous tidal volume and increased work of breathing during weaning
is to provide pressure support.
When analyzing the FIO2 for an infant in an oxygen hood D.
receiving oxygen therapy with a blender set at 50%, the When administering oxygen by oxygen hood with a blender and a nebulizer, the
respiratory therapist notes an oxygen concentration of oxygen control on the nebulizer should be set to 100%. This will prevent
35% near the patient's mouth. The jet nebulizer additional entrainment of room air which will cause a decrease in FIO2.
entrainment setting is set to 50%. To correct the problem,
the therapist should
A. adjust blender setting to 60%
B. increase total flow to the oxyhood
C. obtain a smaller oxyhood
D. change the nebulizer entrainment port to 100%
, NBRC TMC Practice Questions and Answers
Following the insertion of a tracheostomy tube, the A.
patient is found to have diffuse crackles upon Hyperlucency, seen on a chest x-ray is darker in color. Air is radiolucent.
auscultation secondary to subcutaneous emphysema. Therefore, air located in the soft tissue, as seen with subcutaneous emphysema
Which of the following radiographic findings would be would result in a hyperlucent X-ray over soft tissue areas. Subcutaneous
expected with this condition? emphysema by itself will not shift the trachea from midline. Scattered patchy
A. Hyperlucency in the soft tissues infiltrates are associated with ARDS, not subcutaneous emphysema.
B. Diffuse pulmonary hyperlucency
C. Tracheal shift from midline
D. Scattered patchy infiltrates
Placement of a pulmonary artery catheter is associated C.
with which of the following most common complications? Several complications may arise from the placement of a pulmonary artery
A. hypotension catheter, otherwise called a Swan-Ganz catheter. The development of cardiac
B. pulmonic valve damage arrhythmias is the most common complication of the options offered. Another
C. cardiac arrhythmias serious complication is perforation of a vessel or cardiac muscle during the
D. internal bleeding insertion.
A galvanic fuel cell oxygen analyzer may read C.
erroneously high under which of the following A galvanic fuel-cell oxygen analyzer may read erroneously when ambient
conditions? pressures change significantly, such as when a patient is receiving high
A. when the analyzer batteries are depleted inspiratory pressure or when a patient changes altitude quickly.
B. during a sudden increase in the partial pressure of
oxygen
C. when a volume-controlled ventilator at high inspiratory
pressures
D. when liquid gets on the membrane
Results of a quality control maneuver for a spirometer A.
using a 3.0 L calibration syringe as follows: These calibration results are all very close together, indicating the machine is
Volume 1 2.65 L Volume 2 2.68 LVolume 3 2.66 L very precise. However, the results are too far from the 3.0 L of gas introduced by
According to ATS Standards, the spirometer is the calibration syringe. The maximum variance is 2.85 L - 3.15 L. Therefore,
A. inaccurate although the machine is precise, it is considered inaccurate and should not be
B. proof that the syringe requires calibration used for patient testing and reporting.
C. lacking in precision
D. operating correctly
Which of the following will be most helpful at preventing A.
complications for a 48-year-old male patient who has just One of the best methods to prevent postoperative complications is the use of
undergone bariatric surgery for obesity? incentive spirometry, also called maximal sustained inspiration or SMI.
A. Incentive spirometry every hour
B. Small volume nebulizer therapy with Albuterol every 4
hours
C. Ambulation twice a day
D. IPPB with 3.0 mL normal saline every 4 hours
Which of the following results should the respiratory C.
therapist evaluate to determine the adequacy of oxygen Oxygen transport refers to the ability for blood to carry oxygen from the alveoli to
transport on a patient who is diagnosed with carbon the tissues. In a case involving carbon monoxide poisoning, it is transport that is
monoxide poisoning and is being treated with FIO2 of most affected. This is true because hemoglobin becomes occupied with carbon
1.0? monoxide rather than oxygen. Hemoglobin is 19 times more attracted to carbon
A. arterial-venous oxygen content difference monoxide compared to oxygen. Of the options listed, the best method to monitor
B. cardiac output the adequacy of oxygen transport would be to evaluate the arterial oxygen
C. arterial oxygen content content. This value takes into account the amount of oxygen tied to the
D. oxygen consumption at the tissues hemoglobin as well as the oxygen dissolved in the plasma of the blood
A patient complains of shortness of breath during a A.
nebulizer treatment is hypertonic saline. The respiratory Adverse reactions during any therapy should be responded to initially by
therapist should do which of the following? discontinuing therapy and notifying the physician.
A. Discontinue therapy and notify the physician
B. Add Albuterol to the nebulizer treatment
C. Switch to normal saline
D. Switch to hypotonic saline
In preparation for a helium dilution study, a respiratory B.
therapist is calibrating the helium analyzer. While To calibrate a helium analyzer, sometimes called a Wheatstone Bridge, the
exposing the analyzer to ambient room air, what will the device must be calibrated to room air for the low calibration and to a known level
analyzer read for helium concentration? of helium for the high calibration. Because room air has no significant level of
A. 21% helium, helium analyzers should read 0% when exposed to ambient room air
B. 0% conditions.
C. 2%
D. 79%
