NBRC TMC EXAM MOCK QUESTIONS
AND ANSWERS
1. A patient in the ICU has a CVP of 12 mmHg, a PAP of 35/15 mmHg, and a PCWP of 8 mmHg.
Which of the following is the most likely diagnosis?
A. Pulmonary hypertension
B. Left heart failure
C. Hypervolemia
D. Right heart failure
Answer: A
Conceptual Explanation: The CVP is elevated (normal 2-6 mmHg) and the PAP is elevated
(normal 25/8 mmHg), but the PCWP is normal (normal 4-12 mmHg). This indicates a
problem in the lungs or pulmonary vasculature, such as pulmonary hypertension or
embolism, rather than left heart failure.
2. What is the most appropriate action for a patient with a tension pneumothorax?
A. Immediate needle decompression
B. Obtain a chest X-ray
C. Increase PEEP settings
,D. Perform an arterial blood gas
Answer: A
Conceptual Explanation: A tension pneumothorax is a life-threatening emergency
requiring immediate needle decompression in the 2nd intercostal space, followed by chest
tube insertion.
3. A 6-foot tall male patient requires mechanical ventilation. What is his approximate Ideal
Body Weight (IBW) for tidal volume calculation?
A. 77 kg
B. 85 kg
C. 70 kg
D. 65 kg
Answer: A
Conceptual Explanation: IBW for males is calculated as 50 + 2.3 * (height in inches - 60).
For 72 inches: 50 + 2.3 * 12 = 77.6 kg.
4. Which of the following PFT results is most characteristic of a restrictive lung disease?
A. Decreased FEV1/FVC ratio
B. Increased Functional Residual Capacity
C. Increased Residual Volume
D. Decreased Total Lung Capacity (TLC)
, Answer: D
Conceptual Explanation: Restrictive diseases are characterized by a reduction in lung
volumes, specifically a TLC below the 80th percentile of predicted.
5. While monitoring a patient on a ventilator, the respiratory therapist notices the Peak
Inspiratory Pressure (PIP) has increased while the Plateau Pressure remains unchanged. This
indicates:
A. Decreased lung compliance
B. A pulmonary embolism
C. Increased airway resistance
D. Development of a pneumothorax
Answer: C
Conceptual Explanation: An increase in the PIP-Plateau gradient indicates an increase in
airway resistance (e.g., secretions, bronchospasm, or ETT obstruction).
6. A patient has an ABG showing pH 7.28, PaCO2 55 mmHg, PaO2 62 mmHg, and HCO3 26
mEq/L. How would you interpret this?
A. Compensated metabolic acidosis
B. Uncompensated metabolic alkalosis
C. Partially compensated respiratory alkalosis
D. Uncompensated respiratory acidosis
AND ANSWERS
1. A patient in the ICU has a CVP of 12 mmHg, a PAP of 35/15 mmHg, and a PCWP of 8 mmHg.
Which of the following is the most likely diagnosis?
A. Pulmonary hypertension
B. Left heart failure
C. Hypervolemia
D. Right heart failure
Answer: A
Conceptual Explanation: The CVP is elevated (normal 2-6 mmHg) and the PAP is elevated
(normal 25/8 mmHg), but the PCWP is normal (normal 4-12 mmHg). This indicates a
problem in the lungs or pulmonary vasculature, such as pulmonary hypertension or
embolism, rather than left heart failure.
2. What is the most appropriate action for a patient with a tension pneumothorax?
A. Immediate needle decompression
B. Obtain a chest X-ray
C. Increase PEEP settings
,D. Perform an arterial blood gas
Answer: A
Conceptual Explanation: A tension pneumothorax is a life-threatening emergency
requiring immediate needle decompression in the 2nd intercostal space, followed by chest
tube insertion.
3. A 6-foot tall male patient requires mechanical ventilation. What is his approximate Ideal
Body Weight (IBW) for tidal volume calculation?
A. 77 kg
B. 85 kg
C. 70 kg
D. 65 kg
Answer: A
Conceptual Explanation: IBW for males is calculated as 50 + 2.3 * (height in inches - 60).
For 72 inches: 50 + 2.3 * 12 = 77.6 kg.
4. Which of the following PFT results is most characteristic of a restrictive lung disease?
A. Decreased FEV1/FVC ratio
B. Increased Functional Residual Capacity
C. Increased Residual Volume
D. Decreased Total Lung Capacity (TLC)
, Answer: D
Conceptual Explanation: Restrictive diseases are characterized by a reduction in lung
volumes, specifically a TLC below the 80th percentile of predicted.
5. While monitoring a patient on a ventilator, the respiratory therapist notices the Peak
Inspiratory Pressure (PIP) has increased while the Plateau Pressure remains unchanged. This
indicates:
A. Decreased lung compliance
B. A pulmonary embolism
C. Increased airway resistance
D. Development of a pneumothorax
Answer: C
Conceptual Explanation: An increase in the PIP-Plateau gradient indicates an increase in
airway resistance (e.g., secretions, bronchospasm, or ETT obstruction).
6. A patient has an ABG showing pH 7.28, PaCO2 55 mmHg, PaO2 62 mmHg, and HCO3 26
mEq/L. How would you interpret this?
A. Compensated metabolic acidosis
B. Uncompensated metabolic alkalosis
C. Partially compensated respiratory alkalosis
D. Uncompensated respiratory acidosis
