NBRC TMC/CRT/RRT COMPREHENSIVE
EXAM PREP 2026/2027 QUESTIONS AND
ANSWERS
1. A 65-year-old patient with congestive heart failure (CHF) presents with a CVP of 12 mmHg,
a PAP of 45/25 mmHg, and a PCWP of 22 mmHg. The cardiac output is 3.5 L/min. Which of
the following is the most likely diagnosis?
A. Right heart failure
B. Left heart failure
C. Pulmonary embolism
D. Hypovolemia
Answer: B
Conceptual Explanation: The PCWP is elevated (normal 4-12 mmHg) along with a low
cardiac output and elevated PAP, which indicates left-sided heart dysfunction or CHF.
,2. While monitoring a patient on volume-control ventilation, the respiratory therapist notes
that the peak inspiratory pressure (PIP) has increased from 25 cmH2O to 40 cmH2O, while the
plateau pressure remains stable at 18 cmH2O. What is the most likely cause?
A. Decreased lung compliance
B. Development of a pneumothorax
C. Pulmonary edema
D. Increased airway resistance
Answer: D
Conceptual Explanation: An increase in PIP with a stable plateau pressure indicates an
increase in transairway pressure, which is characteristic of increased airway resistance
(e.g., secretions, bronchospasm, or a kinked tube).
3. A patient with COPD is receiving oxygen via a nasal cannula at 2 L/min. The arterial blood
gas (ABG) results are: pH 7.36, PaCO2 62 mmHg, PaO2 58 mmHg, HCO3 34 mEq/L. How
should these results be interpreted?
A. Acute respiratory acidosis
B. Compensated metabolic alkalosis
C. Fully compensated respiratory acidosis
D. Partially compensated respiratory acidosis
Answer: C
, Conceptual Explanation: The pH is within the normal range (7.35-7.45), the PaCO2 is
high, and the HCO3 is high. This indicates a chronic condition where the kidneys have
compensated for the respiratory acidosis.
4. An adult patient is being ventilated in VC-A/C mode. The set VT is 500 mL, rate 12, FiO2
0.50, and PEEP 5 cmH2O. The patient’s ABG shows: pH 7.52, PaCO2 28 mmHg, PaO2 95
mmHg. Which of the following adjustments is most appropriate?
A. Decrease the tidal volume
B. Increase the PEEP
C. Increase the FiO2
D. Decrease the respiratory rate
Answer: D
Conceptual Explanation: The patient is experiencing respiratory alkalosis (pH 7.52,
PaCO2 28). Decreasing the respiratory rate or tidal volume will help normalize the PaCO2.
5. During a bedside PFT, a patient has a forced expiratory volume in 1 second (FEV1) that is
55% of the predicted value and an FEV1/FVC ratio of 60%. This indicates which of the
following?
A. Obstructive lung disease
B. Restrictive lung disease
C. Normal lung function
EXAM PREP 2026/2027 QUESTIONS AND
ANSWERS
1. A 65-year-old patient with congestive heart failure (CHF) presents with a CVP of 12 mmHg,
a PAP of 45/25 mmHg, and a PCWP of 22 mmHg. The cardiac output is 3.5 L/min. Which of
the following is the most likely diagnosis?
A. Right heart failure
B. Left heart failure
C. Pulmonary embolism
D. Hypovolemia
Answer: B
Conceptual Explanation: The PCWP is elevated (normal 4-12 mmHg) along with a low
cardiac output and elevated PAP, which indicates left-sided heart dysfunction or CHF.
,2. While monitoring a patient on volume-control ventilation, the respiratory therapist notes
that the peak inspiratory pressure (PIP) has increased from 25 cmH2O to 40 cmH2O, while the
plateau pressure remains stable at 18 cmH2O. What is the most likely cause?
A. Decreased lung compliance
B. Development of a pneumothorax
C. Pulmonary edema
D. Increased airway resistance
Answer: D
Conceptual Explanation: An increase in PIP with a stable plateau pressure indicates an
increase in transairway pressure, which is characteristic of increased airway resistance
(e.g., secretions, bronchospasm, or a kinked tube).
3. A patient with COPD is receiving oxygen via a nasal cannula at 2 L/min. The arterial blood
gas (ABG) results are: pH 7.36, PaCO2 62 mmHg, PaO2 58 mmHg, HCO3 34 mEq/L. How
should these results be interpreted?
A. Acute respiratory acidosis
B. Compensated metabolic alkalosis
C. Fully compensated respiratory acidosis
D. Partially compensated respiratory acidosis
Answer: C
, Conceptual Explanation: The pH is within the normal range (7.35-7.45), the PaCO2 is
high, and the HCO3 is high. This indicates a chronic condition where the kidneys have
compensated for the respiratory acidosis.
4. An adult patient is being ventilated in VC-A/C mode. The set VT is 500 mL, rate 12, FiO2
0.50, and PEEP 5 cmH2O. The patient’s ABG shows: pH 7.52, PaCO2 28 mmHg, PaO2 95
mmHg. Which of the following adjustments is most appropriate?
A. Decrease the tidal volume
B. Increase the PEEP
C. Increase the FiO2
D. Decrease the respiratory rate
Answer: D
Conceptual Explanation: The patient is experiencing respiratory alkalosis (pH 7.52,
PaCO2 28). Decreasing the respiratory rate or tidal volume will help normalize the PaCO2.
5. During a bedside PFT, a patient has a forced expiratory volume in 1 second (FEV1) that is
55% of the predicted value and an FEV1/FVC ratio of 60%. This indicates which of the
following?
A. Obstructive lung disease
B. Restrictive lung disease
C. Normal lung function
