NBRC TMC/CRT/RRT 2025 EXAM AND PRACTICE EXAM LATEST 500 QUESTIONS
AND CORRECT
DETAILED ANSWERS (100% CORRECT) |A+ GRADE ASSURED
,The lowest inflection point on a pressure-volume ventilator graphic is an
indication of the minimum pressure needed to keep alveoli open.
The results of a V/Q scan shows poor perfusion with adequate ventilation. A chest
radiograph shows a wedge-shaped infiltrate over the right lung field. The patient
most likely has
A. fluid overload
B. ARDS
C. a pulmonary embolism
D. pneumonia - ....ANSWER...C.
A VQ scan that shows poor perfusion but adequate ventilation is most closely
associated with a pulmonary embolism.
Supportive data is found in the radiological report of wedge- shaped infiltrates.
The respiratory therapist notes in the medical record of a 65- year-old male that
the patient is ordered to receive bronchodilator therapy with Albuterol. The
therapist also notes the patient is receiving beta-blocker medication. The
therapist should recommend
A. Administer Dexamethasone (Decadron) in place of Albuterol
B. Add Xopenex to the bronchodilator regimen
C. Replace Albuterol with Beclamethasone (Beclovent)
D. Switch from Albuterol to ipratropium bromide (Atrovent)
- ....ANSWER...D.
Because albuterol is a beta-agonist medication, patients who are taking beta-
blockers should utilize other bronchodilation medication.
,A hospital has an extremely low incidence of ventilator- associated pneumonia. To
which of the following reasons may this be attributed?
A. periodic discontinuation of sedation
B. use of respiratory precautions with the population
C. diversion of infectious patients to other facilities
D. broad use of prophylactic antibiotics - ....ANSWER...A. The incidence of
ventilator-associated pneumonia, or VAP, is lowered by using a closed system
suction catheter, periodically discontinuing sedation, keeping the patient and
semi-Fowler's position, and proper handwashing among caregivers. All are
correct.
A pressure-volume loop ventilator graphic shows no rise in pressure for the first
200 mL of delivered volume. The therapist should
A. increase inspiratory flow rate
B. increase PEEP
C. decrease tidal volume
D. decrease inspiratory flow rate - ....ANSWER...B.
In this question the description of the pressure volume loop would indicate a flat
bottom as manifested by no rise in pressure with the first 200 mL of delivered
volume. We call this a "flat football". The solution is to increase PEEP to a level
that the pressure begins to rise immediately as volume is introduced.
Which of the following would be the most effective, appropriate method for
resolving atelectasis in a spontaneously breathing, post operative patient who is
under the influence of sedation and will not respond to verbal stimuli?
A. IPPB
, B. sustained maximal inhalation (incentive spirometer)
C. deep breathing coaching
D. intubation and mechanical ventilation - ....ANSWER...A. A postoperative
patient under sedation, and possibly in pain, may be tempted to breathe less,
causing respiratory acidosis and atelectasis. To correct this problem, IPPB
therapy is most appropriate. Incentive spirometry would also help but the patient
is unable to respond to verbal stimuli. This alone is an indication for IPPB
therapy.
After performing minimum occluding volume technique with a 65-kg (143-lb)
patient who is orally intubated with a 7.0- mm ET tube, the respiratory therapist
should NEXT
A. check ET tube cuff pressure
B. perform tracheal palpation
C. order a chest radiograph
D. document ET tube markings at the lips - ....ANSWER...A. The ET tube cuff
pressure may be adjusted correctly by several techniques including minimum
leak technique (also called minimum occluding volume, minimal seal technique,
and the use of a pressure manometer called a cuffalator. If minimum seal or
minimal leak technique is used, the respiratory therapist is still required to
monitor the pressure after the technique is performed. Although this is often not
done in real life, it is technically part of the procedure.
The respiratory therapist observes an ECG wave form on a patient that is
consistent with atrial tachycardia. The patient is complaining of chest pain,
dizziness, and nausea. The respiratory therapist should recommend
A. unsynchronized defibrillation
B. Atropine sulfate
C. epinephrine
AND CORRECT
DETAILED ANSWERS (100% CORRECT) |A+ GRADE ASSURED
,The lowest inflection point on a pressure-volume ventilator graphic is an
indication of the minimum pressure needed to keep alveoli open.
The results of a V/Q scan shows poor perfusion with adequate ventilation. A chest
radiograph shows a wedge-shaped infiltrate over the right lung field. The patient
most likely has
A. fluid overload
B. ARDS
C. a pulmonary embolism
D. pneumonia - ....ANSWER...C.
A VQ scan that shows poor perfusion but adequate ventilation is most closely
associated with a pulmonary embolism.
Supportive data is found in the radiological report of wedge- shaped infiltrates.
The respiratory therapist notes in the medical record of a 65- year-old male that
the patient is ordered to receive bronchodilator therapy with Albuterol. The
therapist also notes the patient is receiving beta-blocker medication. The
therapist should recommend
A. Administer Dexamethasone (Decadron) in place of Albuterol
B. Add Xopenex to the bronchodilator regimen
C. Replace Albuterol with Beclamethasone (Beclovent)
D. Switch from Albuterol to ipratropium bromide (Atrovent)
- ....ANSWER...D.
Because albuterol is a beta-agonist medication, patients who are taking beta-
blockers should utilize other bronchodilation medication.
,A hospital has an extremely low incidence of ventilator- associated pneumonia. To
which of the following reasons may this be attributed?
A. periodic discontinuation of sedation
B. use of respiratory precautions with the population
C. diversion of infectious patients to other facilities
D. broad use of prophylactic antibiotics - ....ANSWER...A. The incidence of
ventilator-associated pneumonia, or VAP, is lowered by using a closed system
suction catheter, periodically discontinuing sedation, keeping the patient and
semi-Fowler's position, and proper handwashing among caregivers. All are
correct.
A pressure-volume loop ventilator graphic shows no rise in pressure for the first
200 mL of delivered volume. The therapist should
A. increase inspiratory flow rate
B. increase PEEP
C. decrease tidal volume
D. decrease inspiratory flow rate - ....ANSWER...B.
In this question the description of the pressure volume loop would indicate a flat
bottom as manifested by no rise in pressure with the first 200 mL of delivered
volume. We call this a "flat football". The solution is to increase PEEP to a level
that the pressure begins to rise immediately as volume is introduced.
Which of the following would be the most effective, appropriate method for
resolving atelectasis in a spontaneously breathing, post operative patient who is
under the influence of sedation and will not respond to verbal stimuli?
A. IPPB
, B. sustained maximal inhalation (incentive spirometer)
C. deep breathing coaching
D. intubation and mechanical ventilation - ....ANSWER...A. A postoperative
patient under sedation, and possibly in pain, may be tempted to breathe less,
causing respiratory acidosis and atelectasis. To correct this problem, IPPB
therapy is most appropriate. Incentive spirometry would also help but the patient
is unable to respond to verbal stimuli. This alone is an indication for IPPB
therapy.
After performing minimum occluding volume technique with a 65-kg (143-lb)
patient who is orally intubated with a 7.0- mm ET tube, the respiratory therapist
should NEXT
A. check ET tube cuff pressure
B. perform tracheal palpation
C. order a chest radiograph
D. document ET tube markings at the lips - ....ANSWER...A. The ET tube cuff
pressure may be adjusted correctly by several techniques including minimum
leak technique (also called minimum occluding volume, minimal seal technique,
and the use of a pressure manometer called a cuffalator. If minimum seal or
minimal leak technique is used, the respiratory therapist is still required to
monitor the pressure after the technique is performed. Although this is often not
done in real life, it is technically part of the procedure.
The respiratory therapist observes an ECG wave form on a patient that is
consistent with atrial tachycardia. The patient is complaining of chest pain,
dizziness, and nausea. The respiratory therapist should recommend
A. unsynchronized defibrillation
B. Atropine sulfate
C. epinephrine