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NBRC TMC - CRT, RRT EXAM ACTUAL PREP
QUESTIONS AND WELL REVISED ANSWERS -
LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS – ASSURES PASS
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) - 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 - 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
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B. increase PEEP
C. decrease tidal volume
D. decrease inspiratory flow rate - 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 - 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 - A.
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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
D. cardioversion - D.
Non-deadly arrhythmias, such as this one, may be addressed through
cardioversion. Cardioversion is a form of defibrillation with low wattage and with
the synchronization set to "active". This allows the shock to be synchronized to the
R wave.
A 38-year-old male presents in the emergency department (ED) complaining of
frequent vomiting. The following laboratory data is available: Arterial blood gases
pH 7.55 PaCO2 42 torrPaO2 85 torrHCO3- 31 mEq/LBE +7 mEq/LFIO2 0.21K+
3.0
mEq/LCl- 95 mEq/LNa+ 135 mEq/L
Which of the following should the respiratory therapist recommend?
A. administer NaCL
B. administer NaHCO3-
C. administer KCL
D. administer volume-expanding fluids - C.
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This patient has a CO2 of 42 mmHg, which suggests adequate ventilation.
However, the high pH is associated with alkalosis. Because the CO2 is normal, the
cause of the alkalosis must be metabolic in nature. One treatment for metabolic
alkalosis is to administer potassium chloride or KCl.
Which of the following is needed to calculate alveolar oxygen tension?
A. VD/VT, PAO2
B. BP and FiO2
C. PetCO2 and PaO2
D. QS/QT, deadspace - B.
Barometric pressure, FiO2, and PaO2 are all included in the formula (BP stands for
barometric pressure)
L/min/m2 is the unit of measure for:
A. Systemic vascular resistance
B. Cardiac output
C. Cardiac index
D. Stroke volume - C.
A spontaneously breathing patient has the following arterial blood gas results: pH
7.38 PaCO2 42 mmHgPaO2 76 mmHgHCO3- 24 mEq/LBE 0 mEq/L Which of the
following supplemental oxygen levels is most appropriate?
A. 2 L/min nasal cannula
B. 5 L/min nasal cannula
C. non-rebreathing mask
D. Venturi mask at 30% - B.
NBRC TMC - CRT, RRT EXAM ACTUAL PREP
QUESTIONS AND WELL REVISED ANSWERS -
LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS – ASSURES PASS
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) - 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 - 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
,2|Page
B. increase PEEP
C. decrease tidal volume
D. decrease inspiratory flow rate - 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 - 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 - A.
,3|Page
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
D. cardioversion - D.
Non-deadly arrhythmias, such as this one, may be addressed through
cardioversion. Cardioversion is a form of defibrillation with low wattage and with
the synchronization set to "active". This allows the shock to be synchronized to the
R wave.
A 38-year-old male presents in the emergency department (ED) complaining of
frequent vomiting. The following laboratory data is available: Arterial blood gases
pH 7.55 PaCO2 42 torrPaO2 85 torrHCO3- 31 mEq/LBE +7 mEq/LFIO2 0.21K+
3.0
mEq/LCl- 95 mEq/LNa+ 135 mEq/L
Which of the following should the respiratory therapist recommend?
A. administer NaCL
B. administer NaHCO3-
C. administer KCL
D. administer volume-expanding fluids - C.
, 4|Page
This patient has a CO2 of 42 mmHg, which suggests adequate ventilation.
However, the high pH is associated with alkalosis. Because the CO2 is normal, the
cause of the alkalosis must be metabolic in nature. One treatment for metabolic
alkalosis is to administer potassium chloride or KCl.
Which of the following is needed to calculate alveolar oxygen tension?
A. VD/VT, PAO2
B. BP and FiO2
C. PetCO2 and PaO2
D. QS/QT, deadspace - B.
Barometric pressure, FiO2, and PaO2 are all included in the formula (BP stands for
barometric pressure)
L/min/m2 is the unit of measure for:
A. Systemic vascular resistance
B. Cardiac output
C. Cardiac index
D. Stroke volume - C.
A spontaneously breathing patient has the following arterial blood gas results: pH
7.38 PaCO2 42 mmHgPaO2 76 mmHgHCO3- 24 mEq/LBE 0 mEq/L Which of the
following supplemental oxygen levels is most appropriate?
A. 2 L/min nasal cannula
B. 5 L/min nasal cannula
C. non-rebreathing mask
D. Venturi mask at 30% - B.
