NBRC TMC COMPREHENSIVE BOARD
PREP QUESTIONS AND ANSWERS
1. A patient on volume control ventilation exhibits a sudden increase in Peak Inspiratory
Pressure (PIP) while the Plateau Pressure (Pplat) remains constant. What is the most likely
cause?
A. Increased airway resistance
B. Decreased lung compliance
C. Development of a tension pneumothorax
D. Pulmonary edema
Answer: A
Conceptual Explanation: An increase in PIP without a corresponding increase in Pplat
indicates an increase in transairway pressure, which is caused by increased airway
resistance (e.g., secretions, bronchospasm, or a kinked ETT).
2. Calculate the Static Compliance (Cs) for a patient with the following data: Vt 600 mL, PIP 45
cmH2O, Pplat 30 cmH2O, PEEP 10 cmH2O.
A. 20 mL/cmH2O
,B. 40 mL/cmH2O
C. 30 mL/cmH2O
D. 15 mL/cmH2O
Answer: C
Conceptual Explanation: Cs = Vt / (Pplat - PEEP). So, 600 / (30 - 10) = = 30
mL/cmH2O.
3. Which hemodynamic parameter is the most sensitive indicator for Left Ventricular failure?
A. Central Venous Pressure (CVP)
B. Mean Arterial Pressure (MAP)
C. Pulmonary Artery Pressure (PAP)
D. Pulmonary Capillary Wedge Pressure (PCWP)
Answer: D
Conceptual Explanation: PCWP measures the pressures in the left atrium and reflects left
ventricular end-diastolic pressure, making it the best indicator for left heart function.
4. Interpret the following ABG: pH 7.26, PaCO2 58 mmHg, PaO2 65 mmHg, HCO3 25 mEq/L.
A. Compensated Metabolic Acidosis
B. Uncompensated Metabolic Acidosis
C. Partially Compensated Respiratory Acidosis
, D. Uncompensated Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is within the normal range (uncompensated).
5. A 65-year-old patient with suspected CO poisoning is brought to the ED. The SpO2 is 98%,
but the patient is cyanotic. What should the therapist recommend first?
A. Obtain an ABG and measure SaO2 via a standard co-oximeter
B. Continue current oxygen therapy via nasal cannula
C. Start Albuterol treatment
D. Perform an EKG
Answer: A
Conceptual Explanation: Pulse oximetry (SpO2) is unreliable in CO poisoning because it
cannot distinguish between HbO2 and HbCO. Co-oximetry is necessary to measure actual
carboxyhemoglobin levels.
6. What is the Alveolar Oxygen Tension (PAO2) for a patient on 40% oxygen at sea level with
a PaCO2 of 40 mmHg?
A. 315 mmHg
B. 150 mmHg
C. 235 mmHg
PREP QUESTIONS AND ANSWERS
1. A patient on volume control ventilation exhibits a sudden increase in Peak Inspiratory
Pressure (PIP) while the Plateau Pressure (Pplat) remains constant. What is the most likely
cause?
A. Increased airway resistance
B. Decreased lung compliance
C. Development of a tension pneumothorax
D. Pulmonary edema
Answer: A
Conceptual Explanation: An increase in PIP without a corresponding increase in Pplat
indicates an increase in transairway pressure, which is caused by increased airway
resistance (e.g., secretions, bronchospasm, or a kinked ETT).
2. Calculate the Static Compliance (Cs) for a patient with the following data: Vt 600 mL, PIP 45
cmH2O, Pplat 30 cmH2O, PEEP 10 cmH2O.
A. 20 mL/cmH2O
,B. 40 mL/cmH2O
C. 30 mL/cmH2O
D. 15 mL/cmH2O
Answer: C
Conceptual Explanation: Cs = Vt / (Pplat - PEEP). So, 600 / (30 - 10) = = 30
mL/cmH2O.
3. Which hemodynamic parameter is the most sensitive indicator for Left Ventricular failure?
A. Central Venous Pressure (CVP)
B. Mean Arterial Pressure (MAP)
C. Pulmonary Artery Pressure (PAP)
D. Pulmonary Capillary Wedge Pressure (PCWP)
Answer: D
Conceptual Explanation: PCWP measures the pressures in the left atrium and reflects left
ventricular end-diastolic pressure, making it the best indicator for left heart function.
4. Interpret the following ABG: pH 7.26, PaCO2 58 mmHg, PaO2 65 mmHg, HCO3 25 mEq/L.
A. Compensated Metabolic Acidosis
B. Uncompensated Metabolic Acidosis
C. Partially Compensated Respiratory Acidosis
, D. Uncompensated Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is within the normal range (uncompensated).
5. A 65-year-old patient with suspected CO poisoning is brought to the ED. The SpO2 is 98%,
but the patient is cyanotic. What should the therapist recommend first?
A. Obtain an ABG and measure SaO2 via a standard co-oximeter
B. Continue current oxygen therapy via nasal cannula
C. Start Albuterol treatment
D. Perform an EKG
Answer: A
Conceptual Explanation: Pulse oximetry (SpO2) is unreliable in CO poisoning because it
cannot distinguish between HbO2 and HbCO. Co-oximetry is necessary to measure actual
carboxyhemoglobin levels.
6. What is the Alveolar Oxygen Tension (PAO2) for a patient on 40% oxygen at sea level with
a PaCO2 of 40 mmHg?
A. 315 mmHg
B. 150 mmHg
C. 235 mmHg
