NBRC TMC/CRT/RRT COMPREHENSIVE
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A patient in the ICU has a Central Venous Pressure (CVP) of 18 mmHg. Their breath sounds
reveal fine crackles and they have +2 pitting edema. What is the most likely cause?
A. Hypovolemia
B. Left heart failure/Fluid overload
C. Right heart failure
D. Pulmonary embolism
Answer: B
Conceptual Explanation: A CVP of 18 mmHg is significantly elevated (normal 2-6 mmHg).
Combined with fine crackles and edema, this suggests fluid overload or left heart failure
leading to pulmonary congestion.
2. A 28-year-old male with a history of asthma presents to the ER with acute shortness of
breath. ABG results on room air are: pH 7.52, PaCO2 28 mmHg, PaO2 60 mmHg, HCO3 22
mEq/L. This interpretation is:
A. Compensated Respiratory Alkalosis
,B. Uncompensated Respiratory Alkalosis with mild hypoxemia
C. Uncompensated Metabolic Alkalosis
D. Partially compensated Respiratory Acidosis
Answer: B
Conceptual Explanation: The pH is high (alkalosis) and the PaCO2 is low (respiratory).
The HCO3 is normal, meaning no compensation has occurred yet. PaO2 of 60 indicates mild
hypoxemia.
3. A patient on mechanical ventilation in Volume Control mode has a Peak Inspiratory
Pressure (PIP) of 45 cmH2O and a Plateau Pressure of 25 cmH2O. Which of the following
should the therapist investigate?
A. Decreasing lung compliance
B. Development of a pneumothorax
C. Increased airway resistance
D. Pulmonary edema
Answer: C
Conceptual Explanation: The transairway pressure (PIP - Plateau) is 20 cmH2O, which is
high. A large gap between PIP and Plateau indicates an airway resistance problem, such as
secretions or bronchospasm.
, 4. Which of the following Apgar scores would indicate that a newborn requires immediate
resuscitation?
A. Apgar of 8 at 1 minute
B. Apgar of 5 at 5 minutes
C. Apgar of 2 at 1 minute
D. Apgar of 9 at 5 minutes
Answer: C
Conceptual Explanation: An Apgar score of 0-3 is considered severely depressed and
requires immediate resuscitative efforts, including possible intubation and chest
compressions.
5. A Pulmonary Function Test reveals the following: FVC 60% of predicted, FEV1 55% of
predicted, FEV1/FVC 82%. What is the most likely interpretation?
A. Obstructive Lung Disease
B. Normal Lung Function
C. Restrictive Lung Disease
D. Mixed Obstructive/Restrictive Disease
Answer: C
Conceptual Explanation: A normal or increased FEV1/FVC ratio (typically >70-75%) with
decreased FVC and FEV1 indicates a restrictive pattern.
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A patient in the ICU has a Central Venous Pressure (CVP) of 18 mmHg. Their breath sounds
reveal fine crackles and they have +2 pitting edema. What is the most likely cause?
A. Hypovolemia
B. Left heart failure/Fluid overload
C. Right heart failure
D. Pulmonary embolism
Answer: B
Conceptual Explanation: A CVP of 18 mmHg is significantly elevated (normal 2-6 mmHg).
Combined with fine crackles and edema, this suggests fluid overload or left heart failure
leading to pulmonary congestion.
2. A 28-year-old male with a history of asthma presents to the ER with acute shortness of
breath. ABG results on room air are: pH 7.52, PaCO2 28 mmHg, PaO2 60 mmHg, HCO3 22
mEq/L. This interpretation is:
A. Compensated Respiratory Alkalosis
,B. Uncompensated Respiratory Alkalosis with mild hypoxemia
C. Uncompensated Metabolic Alkalosis
D. Partially compensated Respiratory Acidosis
Answer: B
Conceptual Explanation: The pH is high (alkalosis) and the PaCO2 is low (respiratory).
The HCO3 is normal, meaning no compensation has occurred yet. PaO2 of 60 indicates mild
hypoxemia.
3. A patient on mechanical ventilation in Volume Control mode has a Peak Inspiratory
Pressure (PIP) of 45 cmH2O and a Plateau Pressure of 25 cmH2O. Which of the following
should the therapist investigate?
A. Decreasing lung compliance
B. Development of a pneumothorax
C. Increased airway resistance
D. Pulmonary edema
Answer: C
Conceptual Explanation: The transairway pressure (PIP - Plateau) is 20 cmH2O, which is
high. A large gap between PIP and Plateau indicates an airway resistance problem, such as
secretions or bronchospasm.
, 4. Which of the following Apgar scores would indicate that a newborn requires immediate
resuscitation?
A. Apgar of 8 at 1 minute
B. Apgar of 5 at 5 minutes
C. Apgar of 2 at 1 minute
D. Apgar of 9 at 5 minutes
Answer: C
Conceptual Explanation: An Apgar score of 0-3 is considered severely depressed and
requires immediate resuscitative efforts, including possible intubation and chest
compressions.
5. A Pulmonary Function Test reveals the following: FVC 60% of predicted, FEV1 55% of
predicted, FEV1/FVC 82%. What is the most likely interpretation?
A. Obstructive Lung Disease
B. Normal Lung Function
C. Restrictive Lung Disease
D. Mixed Obstructive/Restrictive Disease
Answer: C
Conceptual Explanation: A normal or increased FEV1/FVC ratio (typically >70-75%) with
decreased FVC and FEV1 indicates a restrictive pattern.
