NBRC TMC/CRT/RRT EXAM TESTBANK
5 QUESTIONS AND ANSWERS
1. A 68-year-old male with a history of COPD is receiving mechanical ventilation. The
ventilator settings are: VC/AC mode, Rate 12, VT 500 mL, PEEP 5 cmH2O, FiO2 0.40. The
patient’s current ABG shows: pH 7.36, PaCO2 58 mmHg, PaO2 62 mmHg, HCO3 32 mEq/L.
Which of the following is the most appropriate action?
A. Increase the respiratory rate to 16
B. Increase the tidal volume to 600 mL
C. Maintain current settings
D. Increase FiO2 to 0.50
Answer: C
Conceptual Explanation: The patient has compensated respiratory acidosis, which is
common in chronic CO2 retainers (COPD). The pH is within the normal range (7.35-7.45),
indicating that the current ventilation is appropriate for this patient’s baseline.
,2. During a bedside assessment of a patient with a chest tube, the respiratory therapist
notices continuous bubbling in the water-seal chamber. This most likely indicates:
A. Normal function of the drainage system
B. A leak in the system or the pleural space
C. Excessive suction is being applied
D. The chest tube is occluded
Answer: B
Conceptual Explanation: Continuous bubbling in the water-seal chamber indicates a
persistent air leak either from the patient’s pleural space (e.g., bronchopleural fistula) or
within the tubing system itself.
3. A patient is being treated for status asthmaticus. Despite receiving aggressive
bronchodilator therapy and corticosteroids, the patient’s condition is deteriorating. The
therapist should recommend:
A. Inhaled nitric oxide
B. Intravenous aminophylline
C. Heliox therapy
D. High-frequency oscillatory ventilation
Answer: C
, Conceptual Explanation: Heliox (a mixture of helium and oxygen) reduces gas density,
promoting laminar flow and decreasing the work of breathing in patients with severe
airway obstruction, such as status asthmaticus.
4. Which of the following hemodynamic parameters is the best indicator of left-sided heart
function?
A. Pulmonary Capillary Wedge Pressure (PCWP)
B. Mean Pulmonary Artery Pressure (mPAP)
C. Central Venous Pressure (CVP)
D. Cardiac Output (CO)
Answer: A
Conceptual Explanation: PCWP (or PAOP) reflects the pressure in the left atrium and is
the primary indicator of left ventricular end-diastolic pressure (preload of the left heart).
5. A 32-year-old female is admitted to the ED following a motor vehicle accident. She is
tachypneic and complaining of chest pain. A physical exam reveals paradoxical chest wall
movement on the right side. This finding is consistent with:
A. Tension pneumothorax
B. Cardiac tamponade
C. Pulmonary contusion
D. Flail chest
5 QUESTIONS AND ANSWERS
1. A 68-year-old male with a history of COPD is receiving mechanical ventilation. The
ventilator settings are: VC/AC mode, Rate 12, VT 500 mL, PEEP 5 cmH2O, FiO2 0.40. The
patient’s current ABG shows: pH 7.36, PaCO2 58 mmHg, PaO2 62 mmHg, HCO3 32 mEq/L.
Which of the following is the most appropriate action?
A. Increase the respiratory rate to 16
B. Increase the tidal volume to 600 mL
C. Maintain current settings
D. Increase FiO2 to 0.50
Answer: C
Conceptual Explanation: The patient has compensated respiratory acidosis, which is
common in chronic CO2 retainers (COPD). The pH is within the normal range (7.35-7.45),
indicating that the current ventilation is appropriate for this patient’s baseline.
,2. During a bedside assessment of a patient with a chest tube, the respiratory therapist
notices continuous bubbling in the water-seal chamber. This most likely indicates:
A. Normal function of the drainage system
B. A leak in the system or the pleural space
C. Excessive suction is being applied
D. The chest tube is occluded
Answer: B
Conceptual Explanation: Continuous bubbling in the water-seal chamber indicates a
persistent air leak either from the patient’s pleural space (e.g., bronchopleural fistula) or
within the tubing system itself.
3. A patient is being treated for status asthmaticus. Despite receiving aggressive
bronchodilator therapy and corticosteroids, the patient’s condition is deteriorating. The
therapist should recommend:
A. Inhaled nitric oxide
B. Intravenous aminophylline
C. Heliox therapy
D. High-frequency oscillatory ventilation
Answer: C
, Conceptual Explanation: Heliox (a mixture of helium and oxygen) reduces gas density,
promoting laminar flow and decreasing the work of breathing in patients with severe
airway obstruction, such as status asthmaticus.
4. Which of the following hemodynamic parameters is the best indicator of left-sided heart
function?
A. Pulmonary Capillary Wedge Pressure (PCWP)
B. Mean Pulmonary Artery Pressure (mPAP)
C. Central Venous Pressure (CVP)
D. Cardiac Output (CO)
Answer: A
Conceptual Explanation: PCWP (or PAOP) reflects the pressure in the left atrium and is
the primary indicator of left ventricular end-diastolic pressure (preload of the left heart).
5. A 32-year-old female is admitted to the ED following a motor vehicle accident. She is
tachypneic and complaining of chest pain. A physical exam reveals paradoxical chest wall
movement on the right side. This finding is consistent with:
A. Tension pneumothorax
B. Cardiac tamponade
C. Pulmonary contusion
D. Flail chest
