NBRC TMC/ CRT/ RRT LATEST EXAM 2024/2025 QUESTIONS
AND VERIFIED CORRECT ANSWERS/ALREADY GRADED
A++
Asthma Patient Assessment -ANSWER Shortness of breath and wheezing
throughout
Pursed-lip breathing
Chest tightness
Tacycardia, Tachypnea, Pulsus Paradoxus (severe)
Diaphoresis
Increased A-P diameter during episode
Hyperresonant/Typmanic note
Diagnostic Testing for Asthma -ANSWER 1.Pulmonary Function - Reduced
flow rates (Peak flow, FEV1, FEV1/FVC)
2. Post Bronchodilator - At least 12% increase or 200 mL
ED:
1. ABG - initially: Hyperventilation (Low PaCO2), overtime patient will tired
out and PaCO2 will start to increase
2. CXR: Increased A-P diameter during Acute episode, Dark lung fields,
depressed or flattened diaphragm
Treatment and Management of Acute Episodes of Asthma -ANSWER 1
Oxygen Therapy
2. SABA and Anticholinergic
3. Corticosteroid
4. Consider HELIOX therapy
5. Intubation and mechanical ventilation if ventilatory failure or respiratory
arrest occurs
Long Term Control of Asthma -ANSWER 1. LABA BID
2. Peak Flow Meter
3. Mast cell stabilizers, Rescue inhaler, Leukotriene inhibitors
4. Avoid Triggers/ Allergy Testing
COPD is characterized by: -ANSWER Dyspnea on exertion and CO2
retention (Hypercapnia)
,Terminology Used to Describe a patient with COPD -ANSWER Chronic
ventilatory failure
Chronic CO2 retention/ Chronic hypercapnia
Increased lung compliance/ Loss of elastic recoil
COPD patient assessment -ANSWER Digital clubbing and cyanosis
Increased A-P diameter
Dyspnea and using accessory muscles
Diminished aeration with bilateral Expiratory wheezing
Hyper-resonant/ tympanic chest percussion
Diagnostic Testing for COPD -ANSWER 1. Pulmonary Function:
Decreased flow (FEV1, FEV1/FVC)
Increased FRC - obstruction
Decreased VC - restrictive
2. ABG: will show compensated respiratory acidosis with hypoxemia and
hypercapnia
3. CXR: Hyperinflation, Hyper-lucency, Increased A-P diameter, Flattened
diaphragm
Treatment for COPD -ANSWER NIPPV
Low flow oxygen
Bronchodilators (B2 and Anticholinergic)
Bronchial Hygiene
ABX
Smoking cessation
Pulmonary Rehab / Educational programs
Patient Assessment of Congestive Heart Failure/ Pulmonary Edema -
ANSWER Peripheral edema, JVD distention
Cyanosis
Orthopnea
Pink Frothy Secretions
Increased Tactile and Focal Fremitus
Diagnosing CHF/ Pulmonary Edema -ANSWER CXR: Fluffy opacities,
butterfly or bat wing pattern, Kerley lines
,ABG: Hypoxemia and respiratory alkalosis
PFT: Reduced volumes and capacity, Nml FEV1/FVC ratio
Cardiac Enzymes: Elevated BNP
Hemodynamics: Increased PCWP, PAP
Treatment of CHF/ Pulmonary Edema -ANSWER 100% on non-rebreather
IPPB
Diuretics - Furosemide
Positive Inotropic agents (Digitalis, Digoxin)
Morphine
Nitroglycerine, Nitroprusside - afterload reduction agents
Fowler's Position (30-45 degrees)
CPAP to support oxygenation
Mechanical Ventilation with PEEP for ventilator failure
Anti-Arrhythmic agents - Procainamide, metoprolol, bretylium
Patient Assessment for MI -ANSWER Diaphoresis
Chest pain with SOB
Tachycardia
Crackles breath sounds if ventricular failure is present
Diagnosis MI -ANSWER 1.EKG
Ischemia- Inverted T wave
Injury - ST segment elevation
Infarction - Significant Q waves
2. Cardiac Enzymes: Troponin > 0.1
3. ABG- hypoxemia
4. Electrolytes: Hyperkalemia or Hypokalemia
Treatment of MI -ANSWER 100% oxygen by non-rebreather mask
OMAN
Defibrillated for pulse-less electrical activity
, Patient Assessment for a patient in Shock -ANSWER Poor perfusion, poor
capillary refill, cool, clammy, lethargic, unresponsive, Pale
Shortness of breath, Tachypnea
Diagnosing Shock -ANSWER Hemodynamics: Decreased CVP, PAP,
PCWP, Qt
Urine Output: Decreased
ABG: Hypoxemia
Treatment for Shock -ANSWER Treat Hypovolemia with IVF
Mechanical Ventilation for ventilatory failure
Vasopressors for Cardiogenic shock
Inotropic agents for heart failure
ABX for infection
Causes of Pulmonary Embolism -ANSWER Venous stasis (immobility/bed
ridden patients)
Recent Surgery
Fractures
Fat/Air embolism
Patient Assessment for Pulmonary Embolism -ANSWER Shortness of
breath, Diaphoresis, cyanotic, anxious
Pleural friction Rub
Possible hemoptysis
Sudden onset of signs and symptoms
Diagnosing Pulmonary Embolism -ANSWER CXR: Wedged shaped
infiltrate
Spiral CT, V/Q scan, Angiogram
Increased VD/VT ratio
Decreasing PetCO2
ABG: Respiratory alkalosis with hypoxemia
Treatment of Pulmonary Embolism -ANSWER Heparin
Compression devices
AND VERIFIED CORRECT ANSWERS/ALREADY GRADED
A++
Asthma Patient Assessment -ANSWER Shortness of breath and wheezing
throughout
Pursed-lip breathing
Chest tightness
Tacycardia, Tachypnea, Pulsus Paradoxus (severe)
Diaphoresis
Increased A-P diameter during episode
Hyperresonant/Typmanic note
Diagnostic Testing for Asthma -ANSWER 1.Pulmonary Function - Reduced
flow rates (Peak flow, FEV1, FEV1/FVC)
2. Post Bronchodilator - At least 12% increase or 200 mL
ED:
1. ABG - initially: Hyperventilation (Low PaCO2), overtime patient will tired
out and PaCO2 will start to increase
2. CXR: Increased A-P diameter during Acute episode, Dark lung fields,
depressed or flattened diaphragm
Treatment and Management of Acute Episodes of Asthma -ANSWER 1
Oxygen Therapy
2. SABA and Anticholinergic
3. Corticosteroid
4. Consider HELIOX therapy
5. Intubation and mechanical ventilation if ventilatory failure or respiratory
arrest occurs
Long Term Control of Asthma -ANSWER 1. LABA BID
2. Peak Flow Meter
3. Mast cell stabilizers, Rescue inhaler, Leukotriene inhibitors
4. Avoid Triggers/ Allergy Testing
COPD is characterized by: -ANSWER Dyspnea on exertion and CO2
retention (Hypercapnia)
,Terminology Used to Describe a patient with COPD -ANSWER Chronic
ventilatory failure
Chronic CO2 retention/ Chronic hypercapnia
Increased lung compliance/ Loss of elastic recoil
COPD patient assessment -ANSWER Digital clubbing and cyanosis
Increased A-P diameter
Dyspnea and using accessory muscles
Diminished aeration with bilateral Expiratory wheezing
Hyper-resonant/ tympanic chest percussion
Diagnostic Testing for COPD -ANSWER 1. Pulmonary Function:
Decreased flow (FEV1, FEV1/FVC)
Increased FRC - obstruction
Decreased VC - restrictive
2. ABG: will show compensated respiratory acidosis with hypoxemia and
hypercapnia
3. CXR: Hyperinflation, Hyper-lucency, Increased A-P diameter, Flattened
diaphragm
Treatment for COPD -ANSWER NIPPV
Low flow oxygen
Bronchodilators (B2 and Anticholinergic)
Bronchial Hygiene
ABX
Smoking cessation
Pulmonary Rehab / Educational programs
Patient Assessment of Congestive Heart Failure/ Pulmonary Edema -
ANSWER Peripheral edema, JVD distention
Cyanosis
Orthopnea
Pink Frothy Secretions
Increased Tactile and Focal Fremitus
Diagnosing CHF/ Pulmonary Edema -ANSWER CXR: Fluffy opacities,
butterfly or bat wing pattern, Kerley lines
,ABG: Hypoxemia and respiratory alkalosis
PFT: Reduced volumes and capacity, Nml FEV1/FVC ratio
Cardiac Enzymes: Elevated BNP
Hemodynamics: Increased PCWP, PAP
Treatment of CHF/ Pulmonary Edema -ANSWER 100% on non-rebreather
IPPB
Diuretics - Furosemide
Positive Inotropic agents (Digitalis, Digoxin)
Morphine
Nitroglycerine, Nitroprusside - afterload reduction agents
Fowler's Position (30-45 degrees)
CPAP to support oxygenation
Mechanical Ventilation with PEEP for ventilator failure
Anti-Arrhythmic agents - Procainamide, metoprolol, bretylium
Patient Assessment for MI -ANSWER Diaphoresis
Chest pain with SOB
Tachycardia
Crackles breath sounds if ventricular failure is present
Diagnosis MI -ANSWER 1.EKG
Ischemia- Inverted T wave
Injury - ST segment elevation
Infarction - Significant Q waves
2. Cardiac Enzymes: Troponin > 0.1
3. ABG- hypoxemia
4. Electrolytes: Hyperkalemia or Hypokalemia
Treatment of MI -ANSWER 100% oxygen by non-rebreather mask
OMAN
Defibrillated for pulse-less electrical activity
, Patient Assessment for a patient in Shock -ANSWER Poor perfusion, poor
capillary refill, cool, clammy, lethargic, unresponsive, Pale
Shortness of breath, Tachypnea
Diagnosing Shock -ANSWER Hemodynamics: Decreased CVP, PAP,
PCWP, Qt
Urine Output: Decreased
ABG: Hypoxemia
Treatment for Shock -ANSWER Treat Hypovolemia with IVF
Mechanical Ventilation for ventilatory failure
Vasopressors for Cardiogenic shock
Inotropic agents for heart failure
ABX for infection
Causes of Pulmonary Embolism -ANSWER Venous stasis (immobility/bed
ridden patients)
Recent Surgery
Fractures
Fat/Air embolism
Patient Assessment for Pulmonary Embolism -ANSWER Shortness of
breath, Diaphoresis, cyanotic, anxious
Pleural friction Rub
Possible hemoptysis
Sudden onset of signs and symptoms
Diagnosing Pulmonary Embolism -ANSWER CXR: Wedged shaped
infiltrate
Spiral CT, V/Q scan, Angiogram
Increased VD/VT ratio
Decreasing PetCO2
ABG: Respiratory alkalosis with hypoxemia
Treatment of Pulmonary Embolism -ANSWER Heparin
Compression devices
