NBRC TMC/CRT/RRT COMPREHENSIVE
EXAM 2026/2027 QUESTIONS AND
ANSWERS
1. A 58-year-old male with a history of COPD presents to the ER with increased shortness of
breath. ABG results on 2L/min nasal cannula are: pH 7.28, PaCO2 68 mmHg, PaO2 54 mmHg,
HCO3 31 mEq/L. Which of the following describes this acid-base status?
A. Compensated metabolic alkalosis
B. Partially compensated respiratory acidosis
C. Uncompensated respiratory acidosis
D. Partially compensated metabolic acidosis
Answer: B
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated above normal (compensation). Because the pH is not yet in the
normal range, it is partially compensated.
2. While monitoring a patient on mechanical ventilation, the respiratory therapist notes that
the Peak Inspiratory Pressure (PIP) has increased from 25 to 35 cmH2O, while the Plateau
Pressure remains constant at 15 cmH2O. This indicates:
A. Decreased lung compliance
,B. Pulmonary edema
C. Development of a pneumothorax
D. Increased airway resistance
Answer: D
Conceptual Explanation: An increase in the PIP-Plateau gradient (transairway pressure)
indicates an increase in airway resistance, such as secretions, bronchospasm, or a kinked
tube.
3. Which of the following values is the most reliable indicator of a patient’s readiness to wean
from mechanical ventilation?
A. VC of 8 mL/kg
B. MIP of -15 cmH2O
C. RSBI of 85
D. Minute ventilation of 12 L/min
Answer: C
Conceptual Explanation: A Rapid Shallow Breathing Index (RSBI) of less than 105 is a
strong predictor of weaning success. Other values provided are borderline or inadequate.
4. A patient is receiving 80/20 Heliox therapy via a non-rebreathing mask. If the oxygen
flowmeter reads 10 L/min, what is the actual flow of the gas mixture to the patient?
A. 10 L/min
, B. 18 L/min
C. 16 L/min
D. 24 L/min
Answer: B
Conceptual Explanation: The factor for an 80/20 Heliox mixture is 1.8. 10 L/min x 1.8 =
18 L/min.
5. Which bedside pulmonary function test is the best indicator of a patient’s ability to cough
and clear secretions?
A. Peak Expiratory Flow Rate (PEFR)
B. Forced Vital Capacity (FVC)
C. Maximum Inspiratory Pressure (MIP)
D. Tidal Volume (Vt)
Answer: A
Conceptual Explanation: PEFR measures the maximum flow generated during expiration,
which correlates directly with the effectiveness of a cough.
6. In the management of a patient with ARDS, which of the following ventilator strategies is
recommended to prevent Volutrauma?
A. Low Tidal Volumes (4-6 mL/kg)
B. High Tidal Volumes (>10 mL/kg)
EXAM 2026/2027 QUESTIONS AND
ANSWERS
1. A 58-year-old male with a history of COPD presents to the ER with increased shortness of
breath. ABG results on 2L/min nasal cannula are: pH 7.28, PaCO2 68 mmHg, PaO2 54 mmHg,
HCO3 31 mEq/L. Which of the following describes this acid-base status?
A. Compensated metabolic alkalosis
B. Partially compensated respiratory acidosis
C. Uncompensated respiratory acidosis
D. Partially compensated metabolic acidosis
Answer: B
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated above normal (compensation). Because the pH is not yet in the
normal range, it is partially compensated.
2. While monitoring a patient on mechanical ventilation, the respiratory therapist notes that
the Peak Inspiratory Pressure (PIP) has increased from 25 to 35 cmH2O, while the Plateau
Pressure remains constant at 15 cmH2O. This indicates:
A. Decreased lung compliance
,B. Pulmonary edema
C. Development of a pneumothorax
D. Increased airway resistance
Answer: D
Conceptual Explanation: An increase in the PIP-Plateau gradient (transairway pressure)
indicates an increase in airway resistance, such as secretions, bronchospasm, or a kinked
tube.
3. Which of the following values is the most reliable indicator of a patient’s readiness to wean
from mechanical ventilation?
A. VC of 8 mL/kg
B. MIP of -15 cmH2O
C. RSBI of 85
D. Minute ventilation of 12 L/min
Answer: C
Conceptual Explanation: A Rapid Shallow Breathing Index (RSBI) of less than 105 is a
strong predictor of weaning success. Other values provided are borderline or inadequate.
4. A patient is receiving 80/20 Heliox therapy via a non-rebreathing mask. If the oxygen
flowmeter reads 10 L/min, what is the actual flow of the gas mixture to the patient?
A. 10 L/min
, B. 18 L/min
C. 16 L/min
D. 24 L/min
Answer: B
Conceptual Explanation: The factor for an 80/20 Heliox mixture is 1.8. 10 L/min x 1.8 =
18 L/min.
5. Which bedside pulmonary function test is the best indicator of a patient’s ability to cough
and clear secretions?
A. Peak Expiratory Flow Rate (PEFR)
B. Forced Vital Capacity (FVC)
C. Maximum Inspiratory Pressure (MIP)
D. Tidal Volume (Vt)
Answer: A
Conceptual Explanation: PEFR measures the maximum flow generated during expiration,
which correlates directly with the effectiveness of a cough.
6. In the management of a patient with ARDS, which of the following ventilator strategies is
recommended to prevent Volutrauma?
A. Low Tidal Volumes (4-6 mL/kg)
B. High Tidal Volumes (>10 mL/kg)
