QUALITYT TEST BANK
TMC NBRC ACTUAL EXAM, PRACTICE EXAM
AND STUDYGUIDE (ALL IN ONE DOCUMENT)
NEWEST 2025 ACTUAL EXAM COMPLETE
550 QUESTIONS AND CORRECT ANSWERS
with DETAILED RATIONALES GRADED A+
GUARANTEED PASS- ACE YOUR EXAM
Chapter 1 : Introduction
A respiratory therapist is called to stand by at the delivery of a newborn that has experienced cardiac
decelerations during labor. After the baby is delivered and presented to the warmer, the respiratory
therapist should assess
A. radiograph
B. gestational age
C. age of the mother
D. APGAR –
ANS :The correct answer is : D
One minute after delivery by c-section, the respiratory therapist does NOT do which of the following on a
neonate?
A. check heart rate
B. assess general appearance
C. auscultate the lungs
D. view color
- ANS :The correct answer is : C
Which of the following medications should the respiratory therapist suggest to promote bronchodilation
for a patient who is not responding to beta-agonist bronchodilator medication?
A. Pirbuterol (Maxair)
B. Salmeterol (Serevent)
C. Aminophylline
D. Xopenx
- ANS :C.
, QUALITYT TEST BANK
A patient that is not responding to a beta agonist medication, such as Albuterol, may benefit from other
bronchodilator medications that have different modes of action. Xanthine medications may be helpful to
reduce bronchoconstriction. One such medication in this classification is Aminophylline.
While monitoring a patient receiving mechanical ventilation, the respiratory therapist notices the low-
pressure and low exhaled volume alarms are sounding. Which of the following could be the cause?
A. herniated endotracheal tube cuff
B. kinked endotracheal tube
C. excess water in the inspiratory limb of the circuit
D. disconnected thermistor line
- ANS :D.
If you have a low pressure or low exhaled volume ventilator alarm, you must look for the problem that
could cause that specific type of alarm. If you look at the answers, a kink in the endotracheal tube would
cause a high-pressure alarm so that cannot be the cause. Excess water in the limbs of the circuit would do
the same. A high-pressure alarm would also develope if there is a herniated endotracheal tube cuff. This
leaves the only possible answer which is a disconnected thermistor line.
What is the relative humidity of the inspired gas of a patient who is intubated if the humidity deficit is 33
mg/L?
A. 50%
B. 75%
C. 25%
D. 100%
- ANS :C.
There are 44 mg of water per liter of gas if the gas is at 100% relative humidity. If you have only 11 mg/L
of gas (deficit of 33 mg) then you have only 25% relative humidity because 11 mg is 25% of 44.
For a patient receiving volume-controlled ventilation, which of the following will not results in increased
mean airway pressure?
A. decrease in mandatory rate
B. use of inspiratory pause
C. use of an expiratory retard
D. decrease in inspiratory flow rate
- ANS :A
Decreasing inspiratory flowrate, use of an expiratory retard, and use of inspiratory pause will all cause an
increase in mean airway pressure. Decreasing rate will lower mean airway pressure.
A patient is demonstrating increased work of breathing and remains hypoxic in spite of supplemental
oxygen by nonrebreathing mask. The patient is anxious. Which of the following should the respiratory
therapist recommend?
A. non-invasive positive pressure ventilation (NIPPV)
B. administer Ativan to the patient
C. institute full mechanical ventilatory support
D. start CPAP therapy
, QUALITYT TEST BANK
- ANS :A.
Noninvasive positive pressure ventilation is often used to decrease work of breathing and to resolve
hypoxemia by supplying continuous positive airway pressure.
A respiratory therapist is assisting a physician with a bronchoscopy procedure for the purpose of
pulmonary tissue extraction and analysis for cancerous cells. The patient is alert and breathing
spontaneously. Which of the following complication should the therapist prepare for prior to the
procedure?
A. significant stimulation of the cough reflex
B. decreased pulmonary compliance during the procedure
C. hypotension
D. increased risk for nosocomial infection
- ANS :A.
Using a bronchoscope on an alert patient would most likely elicit a significant cough reflex. This would be
the primary side effect of the treatment and could cause a profound state of hypoxemia. To minimize the
cough reflex, aerosolized lidocaine is often administered prior to the procedure.
A patient with decreasing pulmonary compliance is receiving volume-controlled ventilation with an I:E
ratio of 1:2. A chest radiograph shows increased atelectasis. Blood gases show signs of refractory
hypoxemia. Which of the following is an appropriate change for this patient?
A. increase inspiratory pressure limit
B. decrease PEEP
C. increase expiratory time
D. decrease inspiratory flow rate
- ANS :D.
Atelectasis and refractory hypoxemia while, receiving mechanical ventilatory support, is most closely
associated with adult respiratory distress syndrome. Patients with this disease benefit most from
increased inspiratory time to allow better distribution of gases in the lungs. That is why patients with
ARDS are often given an inverse I:E ratio. In order to increase inspiratory time the inspiratory flow rate
must be decreased. That is the best option.
A patient is receiving hyperinflation therapy with an IPPB machine and a mouth seal. The respiratory
therapist notices the pressure manometer needle falls back to -10 cm H2O before the pressure-
supported breath begins. Which of the following can the respiratory therapist do to help this situation?
A. Increase sensitivity
B. Decrease inspiratory pressure
C. Push the air-mix knob in
D. Increase flow
- ANS :A.
The negative deflection of the pressure needle to -10 cmH2O before the machine cycles into inhalation is
too significant and will ultimately increase the work of breathing for the patient. To counteract the
amount of pressure needed to cycle the machine, sensitivity should be increased.
A respiratory therapist is treating all patients in the intensive care unit as if they have HIV and hepatitis.
This approach is called
, QUALITYT TEST BANK
A. patient discrimination.
B. enteric isolation.
C. co-horting.
D. standard precautions.
- ANS :D.
The standard precautions (also called universal precautions) approach includes treating all patient as if
they are infectious.
What is indicated by an increasing gap between SaO2 values and SvO2 values while the C(a-v)O2 is also
increasing?
A. an increase in cardiac index
B. decreasing oxygen consumption at the tissue level
C. an increase in SVRI
D. a decrease in cardiac output
- ANS :D.
The following clinical information is available for a patient with chronic congestive heart failure being
considered for home oxygen needs. What is the appropriate oxygen treatment plan for home?
SpO2 #1: room air, resting: 89%
SpO2 #2: 2 L/min NC resting: 95%
A. further evaluation is needed
B. room air
C. continuous supplemental oxygen
D. oxygen as needed
- ANS :C.
Home oxygen therapy is indicated for CHF patients to maintain oxygen saturations above 90%. While 89%
may be acceptable for COPD patients, it is insufficient for patients with heart disease.
The following patient data is observed:
Blood gas and CO-oximeter results
pH 7.35
PaCO2 27 torr
PaO2 40 torr
Hemoglobin 14.0 g/dL
Oxyhemoglobin 96%
HCO3- 13 mEq/L
Carboxyhemoglobin 2%
Methemoglobin 2%
SaO2 76%
BE -11 mEq/L
The respiratory therapist should
A. report SaO2 as 76%
TMC NBRC ACTUAL EXAM, PRACTICE EXAM
AND STUDYGUIDE (ALL IN ONE DOCUMENT)
NEWEST 2025 ACTUAL EXAM COMPLETE
550 QUESTIONS AND CORRECT ANSWERS
with DETAILED RATIONALES GRADED A+
GUARANTEED PASS- ACE YOUR EXAM
Chapter 1 : Introduction
A respiratory therapist is called to stand by at the delivery of a newborn that has experienced cardiac
decelerations during labor. After the baby is delivered and presented to the warmer, the respiratory
therapist should assess
A. radiograph
B. gestational age
C. age of the mother
D. APGAR –
ANS :The correct answer is : D
One minute after delivery by c-section, the respiratory therapist does NOT do which of the following on a
neonate?
A. check heart rate
B. assess general appearance
C. auscultate the lungs
D. view color
- ANS :The correct answer is : C
Which of the following medications should the respiratory therapist suggest to promote bronchodilation
for a patient who is not responding to beta-agonist bronchodilator medication?
A. Pirbuterol (Maxair)
B. Salmeterol (Serevent)
C. Aminophylline
D. Xopenx
- ANS :C.
, QUALITYT TEST BANK
A patient that is not responding to a beta agonist medication, such as Albuterol, may benefit from other
bronchodilator medications that have different modes of action. Xanthine medications may be helpful to
reduce bronchoconstriction. One such medication in this classification is Aminophylline.
While monitoring a patient receiving mechanical ventilation, the respiratory therapist notices the low-
pressure and low exhaled volume alarms are sounding. Which of the following could be the cause?
A. herniated endotracheal tube cuff
B. kinked endotracheal tube
C. excess water in the inspiratory limb of the circuit
D. disconnected thermistor line
- ANS :D.
If you have a low pressure or low exhaled volume ventilator alarm, you must look for the problem that
could cause that specific type of alarm. If you look at the answers, a kink in the endotracheal tube would
cause a high-pressure alarm so that cannot be the cause. Excess water in the limbs of the circuit would do
the same. A high-pressure alarm would also develope if there is a herniated endotracheal tube cuff. This
leaves the only possible answer which is a disconnected thermistor line.
What is the relative humidity of the inspired gas of a patient who is intubated if the humidity deficit is 33
mg/L?
A. 50%
B. 75%
C. 25%
D. 100%
- ANS :C.
There are 44 mg of water per liter of gas if the gas is at 100% relative humidity. If you have only 11 mg/L
of gas (deficit of 33 mg) then you have only 25% relative humidity because 11 mg is 25% of 44.
For a patient receiving volume-controlled ventilation, which of the following will not results in increased
mean airway pressure?
A. decrease in mandatory rate
B. use of inspiratory pause
C. use of an expiratory retard
D. decrease in inspiratory flow rate
- ANS :A
Decreasing inspiratory flowrate, use of an expiratory retard, and use of inspiratory pause will all cause an
increase in mean airway pressure. Decreasing rate will lower mean airway pressure.
A patient is demonstrating increased work of breathing and remains hypoxic in spite of supplemental
oxygen by nonrebreathing mask. The patient is anxious. Which of the following should the respiratory
therapist recommend?
A. non-invasive positive pressure ventilation (NIPPV)
B. administer Ativan to the patient
C. institute full mechanical ventilatory support
D. start CPAP therapy
, QUALITYT TEST BANK
- ANS :A.
Noninvasive positive pressure ventilation is often used to decrease work of breathing and to resolve
hypoxemia by supplying continuous positive airway pressure.
A respiratory therapist is assisting a physician with a bronchoscopy procedure for the purpose of
pulmonary tissue extraction and analysis for cancerous cells. The patient is alert and breathing
spontaneously. Which of the following complication should the therapist prepare for prior to the
procedure?
A. significant stimulation of the cough reflex
B. decreased pulmonary compliance during the procedure
C. hypotension
D. increased risk for nosocomial infection
- ANS :A.
Using a bronchoscope on an alert patient would most likely elicit a significant cough reflex. This would be
the primary side effect of the treatment and could cause a profound state of hypoxemia. To minimize the
cough reflex, aerosolized lidocaine is often administered prior to the procedure.
A patient with decreasing pulmonary compliance is receiving volume-controlled ventilation with an I:E
ratio of 1:2. A chest radiograph shows increased atelectasis. Blood gases show signs of refractory
hypoxemia. Which of the following is an appropriate change for this patient?
A. increase inspiratory pressure limit
B. decrease PEEP
C. increase expiratory time
D. decrease inspiratory flow rate
- ANS :D.
Atelectasis and refractory hypoxemia while, receiving mechanical ventilatory support, is most closely
associated with adult respiratory distress syndrome. Patients with this disease benefit most from
increased inspiratory time to allow better distribution of gases in the lungs. That is why patients with
ARDS are often given an inverse I:E ratio. In order to increase inspiratory time the inspiratory flow rate
must be decreased. That is the best option.
A patient is receiving hyperinflation therapy with an IPPB machine and a mouth seal. The respiratory
therapist notices the pressure manometer needle falls back to -10 cm H2O before the pressure-
supported breath begins. Which of the following can the respiratory therapist do to help this situation?
A. Increase sensitivity
B. Decrease inspiratory pressure
C. Push the air-mix knob in
D. Increase flow
- ANS :A.
The negative deflection of the pressure needle to -10 cmH2O before the machine cycles into inhalation is
too significant and will ultimately increase the work of breathing for the patient. To counteract the
amount of pressure needed to cycle the machine, sensitivity should be increased.
A respiratory therapist is treating all patients in the intensive care unit as if they have HIV and hepatitis.
This approach is called
, QUALITYT TEST BANK
A. patient discrimination.
B. enteric isolation.
C. co-horting.
D. standard precautions.
- ANS :D.
The standard precautions (also called universal precautions) approach includes treating all patient as if
they are infectious.
What is indicated by an increasing gap between SaO2 values and SvO2 values while the C(a-v)O2 is also
increasing?
A. an increase in cardiac index
B. decreasing oxygen consumption at the tissue level
C. an increase in SVRI
D. a decrease in cardiac output
- ANS :D.
The following clinical information is available for a patient with chronic congestive heart failure being
considered for home oxygen needs. What is the appropriate oxygen treatment plan for home?
SpO2 #1: room air, resting: 89%
SpO2 #2: 2 L/min NC resting: 95%
A. further evaluation is needed
B. room air
C. continuous supplemental oxygen
D. oxygen as needed
- ANS :C.
Home oxygen therapy is indicated for CHF patients to maintain oxygen saturations above 90%. While 89%
may be acceptable for COPD patients, it is insufficient for patients with heart disease.
The following patient data is observed:
Blood gas and CO-oximeter results
pH 7.35
PaCO2 27 torr
PaO2 40 torr
Hemoglobin 14.0 g/dL
Oxyhemoglobin 96%
HCO3- 13 mEq/L
Carboxyhemoglobin 2%
Methemoglobin 2%
SaO2 76%
BE -11 mEq/L
The respiratory therapist should
A. report SaO2 as 76%
