NBRC TMC/CRT/RRT COMPREHENSIVE
EXAM TESTBANK QUESTIONS AND
ANSWERS
1. A 58-year-old patient with COPD is receiving mechanical ventilation. The peak inspiratory
pressure (PIP) has increased from 25 cm H2O to 45 cm H2O over the last hour, while the
plateau pressure remains stable at 20 cm H2O. What is the most likely cause?
A. Pneumothorax
B. Increased Airway Resistance
C. Pulmonary Edema
D. Decreased Lung COMPLIANCE
Answer: B
Conceptual Explanation: An increase in PIP without a corresponding increase in plateau
pressure indicates an increase in transairway pressure, which is caused by increased
airway resistance (e.g., secretions, bronchospasm, or biting the tube).
2. Which of the following hemodynamic parameters is most indicative of left heart failure?
A. Increased CVP
,B. Increased SVR
C. Decreased PAP
D. Increased PCWP
Answer: D
Conceptual Explanation: Pulmonary Capillary Wedge Pressure (PCWP) measures the
pressures in the left atrium and left ventricle at the end of diastole. An elevated PCWP is a
primary indicator of left-sided heart failure or mitral valve stenosis.
3. A patient’s ABG results are: pH 7.26, PaCO2 58 mmHg, PaO2 65 mmHg, HCO3 26 mEq/L.
How should this be interpreted?
A. Compensated Respiratory Acidosis
B. Uncompensated Respiratory Acidosis
C. Uncompensated Metabolic Acidosis
D. Partially Compensated Metabolic Alkalosis
Answer: B
Conceptual Explanation: The pH is acidic (<7.35) and the PaCO2 is high (>45). Since the
HCO3 is within the normal range (22-26), the body has not yet compensated, making it
uncompensated respiratory acidosis.
, 4. To evaluate the effectiveness of a bronchodilator treatment, which PFT parameter is most
useful?
A. FEV1
B. TLC
C. FRC
D. DLCO
Answer: A
Conceptual Explanation: Forced Expiratory Volume in 1 second (FEV1) is the primary
measure used to determine the reversibility of airway obstruction after administering a
bronchodilator.
5. A neonatal patient has a L/S ratio of 1.2:1. What does this suggest?
A. Mature lungs
B. Excessive surfactant production
C. Normal lung development
D. High risk of IRDS
Answer: D
Conceptual Explanation: A Lecithin/Sphingomyelin (L/S) ratio of less than 2:1 indicates
immature lungs and a high risk of Infant Respiratory Distress Syndrome (IRDS).
EXAM TESTBANK QUESTIONS AND
ANSWERS
1. A 58-year-old patient with COPD is receiving mechanical ventilation. The peak inspiratory
pressure (PIP) has increased from 25 cm H2O to 45 cm H2O over the last hour, while the
plateau pressure remains stable at 20 cm H2O. What is the most likely cause?
A. Pneumothorax
B. Increased Airway Resistance
C. Pulmonary Edema
D. Decreased Lung COMPLIANCE
Answer: B
Conceptual Explanation: An increase in PIP without a corresponding increase in plateau
pressure indicates an increase in transairway pressure, which is caused by increased
airway resistance (e.g., secretions, bronchospasm, or biting the tube).
2. Which of the following hemodynamic parameters is most indicative of left heart failure?
A. Increased CVP
,B. Increased SVR
C. Decreased PAP
D. Increased PCWP
Answer: D
Conceptual Explanation: Pulmonary Capillary Wedge Pressure (PCWP) measures the
pressures in the left atrium and left ventricle at the end of diastole. An elevated PCWP is a
primary indicator of left-sided heart failure or mitral valve stenosis.
3. A patient’s ABG results are: pH 7.26, PaCO2 58 mmHg, PaO2 65 mmHg, HCO3 26 mEq/L.
How should this be interpreted?
A. Compensated Respiratory Acidosis
B. Uncompensated Respiratory Acidosis
C. Uncompensated Metabolic Acidosis
D. Partially Compensated Metabolic Alkalosis
Answer: B
Conceptual Explanation: The pH is acidic (<7.35) and the PaCO2 is high (>45). Since the
HCO3 is within the normal range (22-26), the body has not yet compensated, making it
uncompensated respiratory acidosis.
, 4. To evaluate the effectiveness of a bronchodilator treatment, which PFT parameter is most
useful?
A. FEV1
B. TLC
C. FRC
D. DLCO
Answer: A
Conceptual Explanation: Forced Expiratory Volume in 1 second (FEV1) is the primary
measure used to determine the reversibility of airway obstruction after administering a
bronchodilator.
5. A neonatal patient has a L/S ratio of 1.2:1. What does this suggest?
A. Mature lungs
B. Excessive surfactant production
C. Normal lung development
D. High risk of IRDS
Answer: D
Conceptual Explanation: A Lecithin/Sphingomyelin (L/S) ratio of less than 2:1 indicates
immature lungs and a high risk of Infant Respiratory Distress Syndrome (IRDS).
