NBRC TMC/CRT/RRT Exam — Respiratory Therapy Certification and Clinical Simulation
Assessment
extra pulmonary air indicates: - (ANSWER)-pneumothorax
-pneumoperitoneum
-pneumomediastinum
-pneumopericardium
-sub cu. emphysema
Epiglottitis: - (ANSWER)-above glottis
-confirm with lat. neck cxr; supraglottic narrowing with enlarged flattened epiglottis
-thumb sign
Tx: intubate
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)
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
AP radiograph: - (ANSWER)front to back
PA radiograph - (ANSWER)back to front
Lateral radiograph - (ANSWER)sides
Oblique CXR - (ANSWER)standing/diagonal- lesions
,NBRC TMC/CRT/RRT Exam — Respiratory Therapy Certification and Clinical Simulation
Assessment
Lateral decubitus - (ANSWER)lying on AFFECTED side-- pleural effusions
Apical lordotic - (ANSWER)tops of lungs used to confirm TB
End exp. image - (ANSWER)detect small pnuemos
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
Enlarged Heart in CXR - (ANSWER)cardiomegaly--- CHF- pericardial effusion
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
Blood Pressure - (ANSWER)120/80
90-140 systolic acceptable
60-90 diastolic acceptable
hypertension- O2
hypotension- fluids, hypovolemia, chf
Heart sounds: - (ANSWER)S1- ventricles contract
, NBRC TMC/CRT/RRT Exam — Respiratory Therapy Certification and Clinical Simulation
Assessment
S2-ventricles relax
(LUB-DUB)
S3 & S4 not good; recommend echo
pleural friction rub - (ANSWER)Coarse grating raspy or crushing sound
TB, pneumonia, PE, and hemothorax
Recommend steroids and antibiotics
stertor: - (ANSWER)snoring sound produced when patients are unable to cough up secretions from the
trachea or bronchi
adventitous breath sounds: - (ANSWER)abnormal breath sounds
coarse crackles: - (ANSWER)loud, bubbly noise heard during inspiration; not cleared by a cough
medium crackles - (ANSWER)middle airway- clear with CPT
fine crackles - (ANSWER)alveoli/fluid
indicative: CHF, pulm. edema
Tx: o2, ppv, inotropic therapy, diuretics
Bronchial breath sounds - (ANSWER)normal breath sounds over trachea or bronchi
vesicular breath sounds - (ANSWER)Normal breath sounds made by air moving in and out of the alveoli.
percussion - (ANSWER)tapping on surface
resonant- normal
Assessment
extra pulmonary air indicates: - (ANSWER)-pneumothorax
-pneumoperitoneum
-pneumomediastinum
-pneumopericardium
-sub cu. emphysema
Epiglottitis: - (ANSWER)-above glottis
-confirm with lat. neck cxr; supraglottic narrowing with enlarged flattened epiglottis
-thumb sign
Tx: intubate
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)
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
AP radiograph: - (ANSWER)front to back
PA radiograph - (ANSWER)back to front
Lateral radiograph - (ANSWER)sides
Oblique CXR - (ANSWER)standing/diagonal- lesions
,NBRC TMC/CRT/RRT Exam — Respiratory Therapy Certification and Clinical Simulation
Assessment
Lateral decubitus - (ANSWER)lying on AFFECTED side-- pleural effusions
Apical lordotic - (ANSWER)tops of lungs used to confirm TB
End exp. image - (ANSWER)detect small pnuemos
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
Enlarged Heart in CXR - (ANSWER)cardiomegaly--- CHF- pericardial effusion
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
Blood Pressure - (ANSWER)120/80
90-140 systolic acceptable
60-90 diastolic acceptable
hypertension- O2
hypotension- fluids, hypovolemia, chf
Heart sounds: - (ANSWER)S1- ventricles contract
, NBRC TMC/CRT/RRT Exam — Respiratory Therapy Certification and Clinical Simulation
Assessment
S2-ventricles relax
(LUB-DUB)
S3 & S4 not good; recommend echo
pleural friction rub - (ANSWER)Coarse grating raspy or crushing sound
TB, pneumonia, PE, and hemothorax
Recommend steroids and antibiotics
stertor: - (ANSWER)snoring sound produced when patients are unable to cough up secretions from the
trachea or bronchi
adventitous breath sounds: - (ANSWER)abnormal breath sounds
coarse crackles: - (ANSWER)loud, bubbly noise heard during inspiration; not cleared by a cough
medium crackles - (ANSWER)middle airway- clear with CPT
fine crackles - (ANSWER)alveoli/fluid
indicative: CHF, pulm. edema
Tx: o2, ppv, inotropic therapy, diuretics
Bronchial breath sounds - (ANSWER)normal breath sounds over trachea or bronchi
vesicular breath sounds - (ANSWER)Normal breath sounds made by air moving in and out of the alveoli.
percussion - (ANSWER)tapping on surface
resonant- normal
