NBRC TMC PRACTICE EXAM with Rationales
Questions and Answers
1.An infant with pneumonia is placed on CPAP with the initial
level is 6 cm H20. After the patient is placed on the system, the
respiratory therapist notices that the pressure falls to 2 cm H20
with each inspiration. What should be done to correct the
problem?
a. Tell the patient to relax and breath more slowly
b. Give the patient diazepam (Valium)
c. Increase the CPAP level to 8 cm H20
d. Increase the flow through the system:
ANS Increase the flow through the system
Explain: Decreasing pressure with inspiration indicates inadequate gas
flow. In- creasing the flow should meet the patient's inspiratory flow
needs and stabilize the CPAP pressure.
2.A respiratory therapist is called to the ED for a 1-year-old
with difficulty breathing. Severe suprasternal, subcostal and
substernal retraction are ob- served. The child has a harsh,
barking cough. Stridor is present. The therapist should
anticipate treatment for
,Choose only ONE best answer.
a. Cystic Fibrosis
b. Pneumonia
c. Croup
d. Asthma:
ANS Croup
Explain: The patient has some degree of upper airway obstruction cause
by some viral illness. The barky cough is a classic finding for patients
experiencing croup.
3.The polysomnography sleep laboratory is full scheduled for
several weeks. The physician wants to know if there is another
option to determine if a patient has sleep apnea. What should
be recommended?
a. Overnight pulse oximetry
b. Nasal air flow monitoring
c. Holter monitoring for 48 hours
d. Chest-wall and abdominal-wall impedance comparison:
ANS Overnight pulse oximetry
Explain: Overnight pulse oximetry can be used to screen patients with
suspected obstructive sleep apnea. The patient's oxygen saturation is
found to decrease during apnea episodes.
,4.A respiratory therapist is assessing a 168-cm (5-ft 6-in), 73-
kg (161-lb), a 41-year-old female who was admitted 12 hours
ago for an aspirin overdose. The following information is
obtained as the patient breathes air:
HR
89/min
RR
15/min
BP 110/70 mm Hg
Sp02 86%
A respiratory therapist should do first.
a. Initiate oxygen at 4L/min by cannula
b. Record the results in the medical record
c. Obtain an arterial blood gas sample
d. Validate the Sp02 reading at a different site:
ANS Validate the Sp02 reading at a different site
Explain: The saturation may not be accurate and should be measured at
different site.
5.A 47-year-old male with a BMI of 50 kg/m is undergoing a
sleep study with titration of CPAP. The patient's baseline AHI is
59. At a CPAP level of 7 cm H20, the AHI is 9. A respiratory
, therapist should recommend
a. Maintain the current level of CPAP
b. Decreasing the CPAP
c. Increasing the CPAP
d. Changing to bilevel PAP:
ANS Increasing the CPAP
Explain: The goal of CPAP intervention is to completely eliminate apnea
and hypop- nea episodes, standard protocol is to incrementally increase
the CPAP level until this occurs.
6.An arterial puncture has been performed to obtain blood for
analysis of 02, C02, and pH. What is the best way to manage
the blood sample?
a. Warm the sample to keep it at body temperature
b. Place it into a mix of ice and water
c. Let the blood naturally cool to room temperature
d. Shake the sample to hemolyze the blood:
ANS Place it into a mix of ice and water
Explain: Placing the blood sample into ice water will prevent the blood
from consum- ing the O2 within the sample.
7.A 26-year-old patient who weighs 80 kg (171 lb) received
Questions and Answers
1.An infant with pneumonia is placed on CPAP with the initial
level is 6 cm H20. After the patient is placed on the system, the
respiratory therapist notices that the pressure falls to 2 cm H20
with each inspiration. What should be done to correct the
problem?
a. Tell the patient to relax and breath more slowly
b. Give the patient diazepam (Valium)
c. Increase the CPAP level to 8 cm H20
d. Increase the flow through the system:
ANS Increase the flow through the system
Explain: Decreasing pressure with inspiration indicates inadequate gas
flow. In- creasing the flow should meet the patient's inspiratory flow
needs and stabilize the CPAP pressure.
2.A respiratory therapist is called to the ED for a 1-year-old
with difficulty breathing. Severe suprasternal, subcostal and
substernal retraction are ob- served. The child has a harsh,
barking cough. Stridor is present. The therapist should
anticipate treatment for
,Choose only ONE best answer.
a. Cystic Fibrosis
b. Pneumonia
c. Croup
d. Asthma:
ANS Croup
Explain: The patient has some degree of upper airway obstruction cause
by some viral illness. The barky cough is a classic finding for patients
experiencing croup.
3.The polysomnography sleep laboratory is full scheduled for
several weeks. The physician wants to know if there is another
option to determine if a patient has sleep apnea. What should
be recommended?
a. Overnight pulse oximetry
b. Nasal air flow monitoring
c. Holter monitoring for 48 hours
d. Chest-wall and abdominal-wall impedance comparison:
ANS Overnight pulse oximetry
Explain: Overnight pulse oximetry can be used to screen patients with
suspected obstructive sleep apnea. The patient's oxygen saturation is
found to decrease during apnea episodes.
,4.A respiratory therapist is assessing a 168-cm (5-ft 6-in), 73-
kg (161-lb), a 41-year-old female who was admitted 12 hours
ago for an aspirin overdose. The following information is
obtained as the patient breathes air:
HR
89/min
RR
15/min
BP 110/70 mm Hg
Sp02 86%
A respiratory therapist should do first.
a. Initiate oxygen at 4L/min by cannula
b. Record the results in the medical record
c. Obtain an arterial blood gas sample
d. Validate the Sp02 reading at a different site:
ANS Validate the Sp02 reading at a different site
Explain: The saturation may not be accurate and should be measured at
different site.
5.A 47-year-old male with a BMI of 50 kg/m is undergoing a
sleep study with titration of CPAP. The patient's baseline AHI is
59. At a CPAP level of 7 cm H20, the AHI is 9. A respiratory
, therapist should recommend
a. Maintain the current level of CPAP
b. Decreasing the CPAP
c. Increasing the CPAP
d. Changing to bilevel PAP:
ANS Increasing the CPAP
Explain: The goal of CPAP intervention is to completely eliminate apnea
and hypop- nea episodes, standard protocol is to incrementally increase
the CPAP level until this occurs.
6.An arterial puncture has been performed to obtain blood for
analysis of 02, C02, and pH. What is the best way to manage
the blood sample?
a. Warm the sample to keep it at body temperature
b. Place it into a mix of ice and water
c. Let the blood naturally cool to room temperature
d. Shake the sample to hemolyze the blood:
ANS Place it into a mix of ice and water
Explain: Placing the blood sample into ice water will prevent the blood
from consum- ing the O2 within the sample.
7.A 26-year-old patient who weighs 80 kg (171 lb) received
