NBRC TMC/CRT/RRT PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION

NBRC TMC/CRT/RRT PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION 1) Extra pulmonary air indicates: - answer -pneumothorax -pneumoperitoneum -pneumomediastinum -pneumopericardium -sub cu. Emphysema 2) epiglottitis: - answer -above glottis -confirm with lat. Neck cxr; supraglottic narrowing with enlarged flattened epiglottis -thumb sign Tx: intubate 3) croup (laryngotracheobronchitis) - answer infection of upper airway characterized by a barky cough seen in children Cxr: tracheal narrowing with subglottic swelling (steeple sign, picket fence, pencil point, hour glass) 4) Treatment: racemic epi and o2 ett placement: - answer 2-6 cm above carina-- level of aortic arch To confirm- first listen to breath sounds, then cxr 5) ap radiograph: - answer front to back 6) pa radiograph - answer back to front 7) lateral radiograph - answer sides 8) oblique cxr - answer standing/diagonal- lesions 9) lateral decubitus - answer lying on affected side-- pleural effusions 10) apical lordotic - answer tops of lungs used to confirm tb 11) end exp. Image - answer detect small pnuemos 12) confirming quality of cxr image - answer - clavicles are level - penetration- vertabrae visible just behind heart -mediastinum- area between lungs, heart, blood vessels and bronchi are found -vascular markings 13) enlarged heart in cxr - answer cardiomegaly--- chf- pericardial effusion 14) normal cxr - answer -hemidiaphragms -r diaphragm elevated (liver underneath) -l diaphragm at level of 6 anterior rib -trachea midline bilateral radiolucent appearance -sharp costophrenic angles - heart not consuming 50% of picture 15) blood pressure - answer 120/80 90-140 systolic acceptable 60-90 diastolic acceptable Hypertension- o2 Hypotension- fluids, hypovolemia, chf 16) heart sounds: - answer s1- ventricles contract S2-ventricles relax (lub-dub) S3 & s4 not good; recommend echo 17) pleural friction rub - answer coarse grating raspy or crushing sound Tb, pneumonia, pe, and hemothorax Recommend steroids and antibiotics 18) stertor: - answer snoring sound produced when patients are unable to cough up secretions from the trachea or bronchi 19) adventitous breath sounds: - answer abnormal breath sounds 20) coarse crackles: - answer loud, bubbly noise heard during inspiration; not cleared by a cough 21) medium crackles - answer middle airway- clear with cpt 22) fine crackles - answer alveoli/fluid Indicative: chf, pulm. Edema Tx: o2, ppv, inotropic therapy, diuretics 23) bronchial breath sounds - answer normal breath sounds over trachea or bronchi 24) vesicular breath sounds - answer normal breath sounds made by air moving in and out of the alveoli. 25) percussion - answer tapping on surface Resonant- normal Flat/dull- less air Tympanic/hyperresonant- high pitch, extra air; copd 26) crepitus - answer bubbles of air under the skin typically subcu emphysema 27) rhonchal fremitus - answer secretions in the airway 28) pleural rub fremitus - answer a grating sensation felt on the chest wall due to roughened pleural surfaces rubbing together 29) vocal fremitus - answer voice vibrations on the chest wall. 30) tactile fremitus - answer vibrations felt on chest wall by hand 31) tracheal deviation: pushed to normal side - answer (away from pathology; outside the lungs) -pleural effusion -pneumothorax -tumor -mass 32) paradoxical pulse - answer pulse and bp varies on respiration Indicative of severe air trapping ;; status asthmaticus, cardiac tamponade 33) change in hr 20 bpm is considered an adverse reaction - answer 34) heart rate - answer normal- 60 to 100 bpm Tachy- 100 bpm; hypoxemia, stress, anxiety (o2) Brady 60 bpm; heart fx, shock, code (atropine) 35) mallampatti classification: - answer 1. Full visibility of tonsils, uvula, soft palate=open 2. Can see uvula, hard palate, soft palate, and upper portion of tonsils=somewhat open 3. Only hard & soft palate and base of vallecula are visible 4. Only hard palate is visible 1&2 good, 3&4 bad. 36) retractions; - answer ask yourself, what is going on? Retractions in adult are bad Caused by upper airway obstruction/ resp distress 37) hypertrophy - answer increase in muscle size 38) apneustic - answer prolonged inspiratory phase with shortened expiratory phase 39) kussmauls - answer deep and fast breathing; often associated with metabolic acidosis 40) biots - answer unpredictable periods of apnea; each breath same depth Cause- cns issue 41) cheyne- stokes - answer gradually increase then decreasing rate and depth in a cycle lasting from 30-180 seconds with periods of apnea lasting up to 60 seconds Cause- increase icp, brainstem injury, od 42) hyperpnea - answer increased depth and rate of breathing Cause- cns disorder or metabolic 43) bradpynea - answer rr12 bpm Cause- sleep (normal), drugs, alcohol, metabolic disorder 44) tachypnea - answer rr20 bpm Cause- fever, hypoxia, pain, cns problem