NBRC TMC PRACTICE WITH RATIONALES AND ANSWERS ALL
GRADED A+
1. An dinfant dwith dpneumonia dis dplaced don dCPAP dwith dthe dinitial dlevel dis d6 dcm
dH20. dAfter dthe dpatient dis dplaced don dthe dsystem, dthe drespiratory dtherapist
dnotices dthat dthe dpressure dfalls dto d2 dcm dH20 dwith deach dinspiration. dWhat
dshould dbe ddone dto dcorrect dthe dproblem?
a. Tell dthe dpatient dto drelax dand dbreath dmore dslowly
b. Give dthe dpatient ddiazepam d(Valium)
c. Increase dthe dCPAP dlevel dto d8 dcm dH20
d. Increase dthe dflow dthrough dthe dsystem: dIncrease dthe dflow dthrough dthe
dsystem
Explain: dDecreasing dpressure dwith dinspiration dindicates dinadequate dgas dflow. dIn
dcreasing dthe dflow dshould dmeet dthe dpatient's dinspiratory dflow dneeds dand dstabilize
dthe dCPAP dpressure.
2. A drespiratory dtherapist dis dcalled dto dthe dED dfor da d1-year-old dwith
ddifficulty dbreathing. dSevere dsuprasternal, dsubcostal dand dsubsternal
dretraction dare dob- dserved.dThe dchild dhas da dharsh, dbarking dcough. dStridor
1 d/ d
211
,is dpresent.dThe dtherapist dshould danticipate dtreatment dfor
d
Choose donly dONE dbest danswer.
a. Cystic dFibrosis
b. Pneumonia
c. Croup
d. Asthma: dCroup
Explain: dThe dpatient dhas dsome ddegree dof dupper dairway dobstruction dcaused dby
dsome dviral dillness. dThe dbarky dcough dis da dclassic dfinding dfor dpatients
dexperiencing dcroup.
3. The dpolysomnography dsleep dlaboratory dis dfull dscheduled dfor dseveral
dweeks. dThe dphysician dwants dto dknow dif dthere dis danother doption dto
ddetermine dif da dpatient dhas dsleep dapnea. dWhat dshould dbe drecommended?
a. Overnight dpulse doximetry
b. Nasal dair dflow dmonitoring
c. Holter dmonitoring dfor d48 dhours
d. Chest-wall dand dabdominal-wall dimpedance dcomparison: dOvernight
dpulse doximetry
Explain: dOvernight dpulse doximetry dcan dbe dused dto dscreen dpatients dwith
dsuspected dobstructive dsleep dapnea.dThe dpatient's doxygen dsaturation dis dfound dto
ddecrease dduring dapnea depisodes.
2 d/ d
211
,4. A drespiratory dtherapist dis dassessing da d168-cm d(5-ft d6-in), d73-kg d(161-
lb), da d41-year-old dfemale dwho dwas dadmitted d12 dhours dago dfor dan daspirin
doverdose. dThe dfollowing dinformation dis dobtained das dthe dpatient
dbreathes dair:
HR
d89/min
dRR
d15/min
BP d110/70 dmm dHg
dSp02 d86%
A drespiratory dtherapist dshould ddo dfirst.
a. Initiate doxygen dat d4L/min dby dcannula
b. Record dthe dresults din dthe dmedical drecord
c. Obtain dan darterial dblood dgas dsample
d. Validate dthe dSp02 dreading dat da ddifferent dsite: dValidate dthe dSp02
dreading dat da ddifferent dsite
Explain: dThe dsaturation dmay dnot dbe daccurate dand dshould dbe dmeasured dat da
ddifferent dsite.
5. A d47-year-old dmale dwith da dBMI dof d50 dkg/m dis dundergoing da dsleep
dstudy dwith dtitration dof dCPAP.dThe dpatient's dbaseline dAHI dis d59. dAt da dCPAP
dlevel dof d7 dcm dH20, dthe dAHI dis d9. dA drespiratory dtherapist dshould
drecommend
a. Maintain dthe dcurrent dlevel dof dCPAP
b. Decreasing dthe dCPAP
c. Increasing dthe dCPAP
d. Changing dto dbilevel dPAP: dIncreasing dthe dCPAP
Explain:dThe dgoal dof dCPAP dintervention dis dto dcompletely deliminate dapnea dand
dhypop- dnea depisodes, dstandard dprotocol dis dto dincrementally dincrease dthe
dCPAP dlevel duntil dthis doccurs.
6. An darterial dpuncture dhas dbeen dperformed dto dobtain dblood dfor danalysis
dof d02, dC02, dand dpH. dWhat dis dthe dbest dway dto dmanage dthe dblood
dsample?
a. Warm dthe dsample dto dkeep dit dat dbody dtemperature
b. Place dit dinto da dmix dof dice dand dwater
3 d/ d
211
, c. Let dthe dblood dnaturally dcool dto droom dtemperature
d. Shake dthe dsample dto dhemolyze dthe dblood: dPlace dit dinto da dmix dof dice dand
dwater
4 d/ d
211
GRADED A+
1. An dinfant dwith dpneumonia dis dplaced don dCPAP dwith dthe dinitial dlevel dis d6 dcm
dH20. dAfter dthe dpatient dis dplaced don dthe dsystem, dthe drespiratory dtherapist
dnotices dthat dthe dpressure dfalls dto d2 dcm dH20 dwith deach dinspiration. dWhat
dshould dbe ddone dto dcorrect dthe dproblem?
a. Tell dthe dpatient dto drelax dand dbreath dmore dslowly
b. Give dthe dpatient ddiazepam d(Valium)
c. Increase dthe dCPAP dlevel dto d8 dcm dH20
d. Increase dthe dflow dthrough dthe dsystem: dIncrease dthe dflow dthrough dthe
dsystem
Explain: dDecreasing dpressure dwith dinspiration dindicates dinadequate dgas dflow. dIn
dcreasing dthe dflow dshould dmeet dthe dpatient's dinspiratory dflow dneeds dand dstabilize
dthe dCPAP dpressure.
2. A drespiratory dtherapist dis dcalled dto dthe dED dfor da d1-year-old dwith
ddifficulty dbreathing. dSevere dsuprasternal, dsubcostal dand dsubsternal
dretraction dare dob- dserved.dThe dchild dhas da dharsh, dbarking dcough. dStridor
1 d/ d
211
,is dpresent.dThe dtherapist dshould danticipate dtreatment dfor
d
Choose donly dONE dbest danswer.
a. Cystic dFibrosis
b. Pneumonia
c. Croup
d. Asthma: dCroup
Explain: dThe dpatient dhas dsome ddegree dof dupper dairway dobstruction dcaused dby
dsome dviral dillness. dThe dbarky dcough dis da dclassic dfinding dfor dpatients
dexperiencing dcroup.
3. The dpolysomnography dsleep dlaboratory dis dfull dscheduled dfor dseveral
dweeks. dThe dphysician dwants dto dknow dif dthere dis danother doption dto
ddetermine dif da dpatient dhas dsleep dapnea. dWhat dshould dbe drecommended?
a. Overnight dpulse doximetry
b. Nasal dair dflow dmonitoring
c. Holter dmonitoring dfor d48 dhours
d. Chest-wall dand dabdominal-wall dimpedance dcomparison: dOvernight
dpulse doximetry
Explain: dOvernight dpulse doximetry dcan dbe dused dto dscreen dpatients dwith
dsuspected dobstructive dsleep dapnea.dThe dpatient's doxygen dsaturation dis dfound dto
ddecrease dduring dapnea depisodes.
2 d/ d
211
,4. A drespiratory dtherapist dis dassessing da d168-cm d(5-ft d6-in), d73-kg d(161-
lb), da d41-year-old dfemale dwho dwas dadmitted d12 dhours dago dfor dan daspirin
doverdose. dThe dfollowing dinformation dis dobtained das dthe dpatient
dbreathes dair:
HR
d89/min
dRR
d15/min
BP d110/70 dmm dHg
dSp02 d86%
A drespiratory dtherapist dshould ddo dfirst.
a. Initiate doxygen dat d4L/min dby dcannula
b. Record dthe dresults din dthe dmedical drecord
c. Obtain dan darterial dblood dgas dsample
d. Validate dthe dSp02 dreading dat da ddifferent dsite: dValidate dthe dSp02
dreading dat da ddifferent dsite
Explain: dThe dsaturation dmay dnot dbe daccurate dand dshould dbe dmeasured dat da
ddifferent dsite.
5. A d47-year-old dmale dwith da dBMI dof d50 dkg/m dis dundergoing da dsleep
dstudy dwith dtitration dof dCPAP.dThe dpatient's dbaseline dAHI dis d59. dAt da dCPAP
dlevel dof d7 dcm dH20, dthe dAHI dis d9. dA drespiratory dtherapist dshould
drecommend
a. Maintain dthe dcurrent dlevel dof dCPAP
b. Decreasing dthe dCPAP
c. Increasing dthe dCPAP
d. Changing dto dbilevel dPAP: dIncreasing dthe dCPAP
Explain:dThe dgoal dof dCPAP dintervention dis dto dcompletely deliminate dapnea dand
dhypop- dnea depisodes, dstandard dprotocol dis dto dincrementally dincrease dthe
dCPAP dlevel duntil dthis doccurs.
6. An darterial dpuncture dhas dbeen dperformed dto dobtain dblood dfor danalysis
dof d02, dC02, dand dpH. dWhat dis dthe dbest dway dto dmanage dthe dblood
dsample?
a. Warm dthe dsample dto dkeep dit dat dbody dtemperature
b. Place dit dinto da dmix dof dice dand dwater
3 d/ d
211
, c. Let dthe dblood dnaturally dcool dto droom dtemperature
d. Shake dthe dsample dto dhemolyze dthe dblood: dPlace dit dinto da dmix dof dice dand
dwater
4 d/ d
211
