4/17/25, 6:58 AM nbrc cse practice
NBRC CSE ACTUAL PRACTICE EXAM NEWEST VERSION
2025 COMPLETE EXAM WITH UPDATED QUESTIONS AND
CORRECT DETAILED ANSWERS ||VERIFIED ANSWERS
GUARANTEED PASS ALREADY GRADED A+
Terms in this set (1595)
LEVEL I : Cyanosis, Barrel chest, increased A-P
diameter, Accessory muscle use, Digital clubbing of the
nail beds, Significant history of smoking and/or
occupational exposure to smoke or other pulmonary
Information Gathering - irritant
Emphysema: LEVEL II : Dyspnea, Wheezing breath sounds
LEVEL III : Chest X-ray—flattened diaphragms,
(Abnormal condition of the hyperlucency, diminished pulmonary vascular markings.
alveoli resulting destruction CBC—polycythemia, increased WBC due to
and loss of elasticity.) possible infection. ABGs—Compensated respiratory
acidosis (high PaCO2, normal pH), moderate to
severe hypoxemia.
Sputum culture—often positive for bacteria.
LEVEL IV : FT—flows are decreased especially middle
sized airways (FEF 25-75%) Fev1 and Fev1/FVC%,
reduced DLCO (less than 20).
Oxygen therapy—low FIO2 (0.24 to 0.28) or 1 to
2 lpm nasal cannula Oxygen conserving devices
Descision Making - such as liquid oxygen or trans-tracheal oxygen
Empysema:
Home care education on devices and equipment
cleaning
(Abnormal condition of the
Rehabilitation efforts (specifics not usually required)
alveoli resulting destruction Aids to help quit smoking such as nicotine
and loss of elasticity.) replacement therapy Bronchodilation
medication via MDI or aerosol nebulizers
Antibiotics for infection
Smoking cessation products (nicotine replacement therapy).
1/360
,4/17/25, 6:58 AM nbrc cse practice
LEVEL I : Productive cough, purulent
sputum production Exposure to
pulmonary irritants, like history of
Information Gathering -
Chronic Bronchitis smoking Frequent infections
LEVEL II : Dyspnea
LEVEL III : Chest X-ray—could be normal, or may show
(Defined: Condition where
hyperlucency, diminished, pulmonary markings.
the patient has a productive
CBC—possibly increased WBC due to possible infection.
cough 25% of the year for
ABGs—could be normal or very slight respiratory acidosis and
at least two consecutive hypoxemia
years.) LEVEL IV : PFT—flows are decreased especially middle
sized airways (FEF 25-75%) FEV1, Normal DLCO
Decision Making - Chronic Anything that promotes good pulmonary hygiene such
Bronchitis as chest physiotherapy, hydration therapy when
sputum is thick.
(Defined: Condition where Fluid therapy if dehydrated.Oxygen therapy for hypoxemia
the patient has a productive Aerosolized bronchodilator therapy, Antibiotic Tetracycline may
cough 25% of the year for be preferable
at least two consecutive
years.)
Information Gathering - LEVEL I : Productive cough, often with blood, digital
Bronchiectasis clubbing of the nail beds, significant history if infections
(recurrent)
(Defined: Abnormal condition LEVEL II : Dyspnea
where the bronchi LEVEL III : Chest X-ray—
secrete large volumes of pus generally normal Sputum
during abnormal culture—gram negative
dilation.)
bacteria
LEVEL IV : Bronchogram is the primary test.
Characterized by a "tree in winter pattern"
Decision Making - Anything that promotes good pulmonary hygiene such
Bronchiectasis as chest physiotherapy, hydration therapy when
sputum is thick.
(Defined: Abnormal condition Fluid therapy if dehydrated.Oxygen therapy for hypoxemia
where the bronchi Aerosolized bronchodilator therapy. May have to
secrete large volumes of pus consider surgical intervention on some highly affected
during abnormal segments
dilation.)
2/360
,4/17/25, 6:58 AM nbrc cse practice
LEVEL I : Spouse or bed partner will complain of snoring
Information Gathering - OSA and will often report witnessing periods of apnea that
exceed 10 seconds. Excessive upper airway tissue,
(Defined: the cessation of obesity, thick neck (greater than 16 inch collar size.
breathing during sleep. Ability to fall asleep quickly Sleepiness during daytime
Is usually obstructive in and while watching TV or in front of a computer
nature but sometimes can LEVEL II : Dyspnea, Frequent urination during sleeping hours
be central or a combination LEVEL III : ABGs—could be normal or very slight
of the two (mixed). respiratory acidosis and hypoxemia LEVEL IV :
Polysomnography (sleep study) - determines if
obstructive or central, If no nasal flow AND no chest
movement—then CENTRAL sleep apnea. If no nasal flow
WITH chest movement—then OBSTRUCTIVE sleep apnea
Decision Making - OSA If central, ventilatory stimulant medication may be
used, If obstructive, nocturnal nasal or full-face CPAP or
(Defined: the cessation of BiPAP (NIPPV) is usually initially indicated with follow-
breathing during sleep. up weight loss or upper airway tissue removal through
Is usually obstructive in surgery.
nature but sometimes can Problem must be corrected immediately, so even if
be central or a combination discharging, send devices home with
of the two (mixed). patient. In the absence of a titration study, initially
ordered pressure should be 10 to 20 cmH20.
Information Gathering - LEVEL I : Accessory muscle use, Tachycardia
Asthma LEVEL II : Dyspnea, Wheezing, Congested cough, Wet, clammy
skin
(Defined: Abnormal LEVEL III : ABGs—possible respiratory acidosis, could be
constriction of the hypoxic, Chest X-ray— hyperinflation, scattered
bronchials infiltrates, flattened diaphragms. In allergic cases, may
resulting in sputum see elevated eosinophil count which can cause yellow
productionand narrowed sputum
airways. LEVEL IV : PFT—Decreased flows in FEV1 but diffusion is
normal as manifested by DLCO
3/360
, 4/17/25, 6:58 AM nbrc cse practice
Decision Making - Asthma Oxygen therapy for
hypoxemia Aerosolized
(Defined: Abnormal bronchodilator therapy
constriction of the Continuous bronchodilator therapy,
bronchials Albuterol (7-10 mg/hr) Xanthine
resulting in sputum medication given IV (Aminophylline,
productionand narrowed etc) Promote pulmonary hygiene
airways. Inhaled sterioids such as oral or IV prednisone
LEVEL I : Historically non-responsive to bronchodilators.
Information Gathering - Status Patient will report the need to take many bronchodilator
Asthmaticus
treatments before feeling better. Accessory muscle use
and retractions
(Defined: Asthma that will
Dyspnea, Wheezing, Congested cough,
not respond to
Wet, clammy skin LEVEL II : Pulses
bronchodilation
paradoxus
therapy,usually persists
LEVEL III : ABGs—possible respiratory acidosis when
more
than 24 hours.) tiring, alkalosis at first due to anxiety, could be hypoxic
Chest X-ray—hyperinflation, scattered infiltrates, flattened
diaphragms.
Decision Making - Status May deteriorate quickly, so if progression is shown,
Asthmaticus intubate, mechanically ventilate before full ventilatory
failure.
(Defined: Asthma that will
Use subcutaneous epinephrine—1 mL of 1:1000 strength.
not respond to
May need to give every 20— 30 minutes for up to three
bronchodilation
consecutive doses (if no improvement between doses)
therapy,usually persists
Continuous beta II agonist (bronchodilator medication).
more
Albuterol 7-10 mg/hr.
than 24 hours.)
LEVEL I : May have a history of Myasthenia Gravis if not
Information Gathering :
Myasthenia Gravis a new onset, Droopy facial muscles and eyelids (Ptosis)
LEVEL II : Patient will describe slowly feeling
(Defined: Neuromuscular weakness generally but feels better with rest. Double
abnormality where vision (diplopia)
muscles Dysphagia (difficulty swallowing)
experience paralysis starting Drooping eyelid (Ptosis) Shrinking Vt, VC,
from the head down to the MIP
feet including ventilatory LEVEL IV : Tensilon Challenge Test—positive for
muscles.) Myasthenic crisis if improvement is noted upon the
administration of Tensilon.
4/360
NBRC CSE ACTUAL PRACTICE EXAM NEWEST VERSION
2025 COMPLETE EXAM WITH UPDATED QUESTIONS AND
CORRECT DETAILED ANSWERS ||VERIFIED ANSWERS
GUARANTEED PASS ALREADY GRADED A+
Terms in this set (1595)
LEVEL I : Cyanosis, Barrel chest, increased A-P
diameter, Accessory muscle use, Digital clubbing of the
nail beds, Significant history of smoking and/or
occupational exposure to smoke or other pulmonary
Information Gathering - irritant
Emphysema: LEVEL II : Dyspnea, Wheezing breath sounds
LEVEL III : Chest X-ray—flattened diaphragms,
(Abnormal condition of the hyperlucency, diminished pulmonary vascular markings.
alveoli resulting destruction CBC—polycythemia, increased WBC due to
and loss of elasticity.) possible infection. ABGs—Compensated respiratory
acidosis (high PaCO2, normal pH), moderate to
severe hypoxemia.
Sputum culture—often positive for bacteria.
LEVEL IV : FT—flows are decreased especially middle
sized airways (FEF 25-75%) Fev1 and Fev1/FVC%,
reduced DLCO (less than 20).
Oxygen therapy—low FIO2 (0.24 to 0.28) or 1 to
2 lpm nasal cannula Oxygen conserving devices
Descision Making - such as liquid oxygen or trans-tracheal oxygen
Empysema:
Home care education on devices and equipment
cleaning
(Abnormal condition of the
Rehabilitation efforts (specifics not usually required)
alveoli resulting destruction Aids to help quit smoking such as nicotine
and loss of elasticity.) replacement therapy Bronchodilation
medication via MDI or aerosol nebulizers
Antibiotics for infection
Smoking cessation products (nicotine replacement therapy).
1/360
,4/17/25, 6:58 AM nbrc cse practice
LEVEL I : Productive cough, purulent
sputum production Exposure to
pulmonary irritants, like history of
Information Gathering -
Chronic Bronchitis smoking Frequent infections
LEVEL II : Dyspnea
LEVEL III : Chest X-ray—could be normal, or may show
(Defined: Condition where
hyperlucency, diminished, pulmonary markings.
the patient has a productive
CBC—possibly increased WBC due to possible infection.
cough 25% of the year for
ABGs—could be normal or very slight respiratory acidosis and
at least two consecutive hypoxemia
years.) LEVEL IV : PFT—flows are decreased especially middle
sized airways (FEF 25-75%) FEV1, Normal DLCO
Decision Making - Chronic Anything that promotes good pulmonary hygiene such
Bronchitis as chest physiotherapy, hydration therapy when
sputum is thick.
(Defined: Condition where Fluid therapy if dehydrated.Oxygen therapy for hypoxemia
the patient has a productive Aerosolized bronchodilator therapy, Antibiotic Tetracycline may
cough 25% of the year for be preferable
at least two consecutive
years.)
Information Gathering - LEVEL I : Productive cough, often with blood, digital
Bronchiectasis clubbing of the nail beds, significant history if infections
(recurrent)
(Defined: Abnormal condition LEVEL II : Dyspnea
where the bronchi LEVEL III : Chest X-ray—
secrete large volumes of pus generally normal Sputum
during abnormal culture—gram negative
dilation.)
bacteria
LEVEL IV : Bronchogram is the primary test.
Characterized by a "tree in winter pattern"
Decision Making - Anything that promotes good pulmonary hygiene such
Bronchiectasis as chest physiotherapy, hydration therapy when
sputum is thick.
(Defined: Abnormal condition Fluid therapy if dehydrated.Oxygen therapy for hypoxemia
where the bronchi Aerosolized bronchodilator therapy. May have to
secrete large volumes of pus consider surgical intervention on some highly affected
during abnormal segments
dilation.)
2/360
,4/17/25, 6:58 AM nbrc cse practice
LEVEL I : Spouse or bed partner will complain of snoring
Information Gathering - OSA and will often report witnessing periods of apnea that
exceed 10 seconds. Excessive upper airway tissue,
(Defined: the cessation of obesity, thick neck (greater than 16 inch collar size.
breathing during sleep. Ability to fall asleep quickly Sleepiness during daytime
Is usually obstructive in and while watching TV or in front of a computer
nature but sometimes can LEVEL II : Dyspnea, Frequent urination during sleeping hours
be central or a combination LEVEL III : ABGs—could be normal or very slight
of the two (mixed). respiratory acidosis and hypoxemia LEVEL IV :
Polysomnography (sleep study) - determines if
obstructive or central, If no nasal flow AND no chest
movement—then CENTRAL sleep apnea. If no nasal flow
WITH chest movement—then OBSTRUCTIVE sleep apnea
Decision Making - OSA If central, ventilatory stimulant medication may be
used, If obstructive, nocturnal nasal or full-face CPAP or
(Defined: the cessation of BiPAP (NIPPV) is usually initially indicated with follow-
breathing during sleep. up weight loss or upper airway tissue removal through
Is usually obstructive in surgery.
nature but sometimes can Problem must be corrected immediately, so even if
be central or a combination discharging, send devices home with
of the two (mixed). patient. In the absence of a titration study, initially
ordered pressure should be 10 to 20 cmH20.
Information Gathering - LEVEL I : Accessory muscle use, Tachycardia
Asthma LEVEL II : Dyspnea, Wheezing, Congested cough, Wet, clammy
skin
(Defined: Abnormal LEVEL III : ABGs—possible respiratory acidosis, could be
constriction of the hypoxic, Chest X-ray— hyperinflation, scattered
bronchials infiltrates, flattened diaphragms. In allergic cases, may
resulting in sputum see elevated eosinophil count which can cause yellow
productionand narrowed sputum
airways. LEVEL IV : PFT—Decreased flows in FEV1 but diffusion is
normal as manifested by DLCO
3/360
, 4/17/25, 6:58 AM nbrc cse practice
Decision Making - Asthma Oxygen therapy for
hypoxemia Aerosolized
(Defined: Abnormal bronchodilator therapy
constriction of the Continuous bronchodilator therapy,
bronchials Albuterol (7-10 mg/hr) Xanthine
resulting in sputum medication given IV (Aminophylline,
productionand narrowed etc) Promote pulmonary hygiene
airways. Inhaled sterioids such as oral or IV prednisone
LEVEL I : Historically non-responsive to bronchodilators.
Information Gathering - Status Patient will report the need to take many bronchodilator
Asthmaticus
treatments before feeling better. Accessory muscle use
and retractions
(Defined: Asthma that will
Dyspnea, Wheezing, Congested cough,
not respond to
Wet, clammy skin LEVEL II : Pulses
bronchodilation
paradoxus
therapy,usually persists
LEVEL III : ABGs—possible respiratory acidosis when
more
than 24 hours.) tiring, alkalosis at first due to anxiety, could be hypoxic
Chest X-ray—hyperinflation, scattered infiltrates, flattened
diaphragms.
Decision Making - Status May deteriorate quickly, so if progression is shown,
Asthmaticus intubate, mechanically ventilate before full ventilatory
failure.
(Defined: Asthma that will
Use subcutaneous epinephrine—1 mL of 1:1000 strength.
not respond to
May need to give every 20— 30 minutes for up to three
bronchodilation
consecutive doses (if no improvement between doses)
therapy,usually persists
Continuous beta II agonist (bronchodilator medication).
more
Albuterol 7-10 mg/hr.
than 24 hours.)
LEVEL I : May have a history of Myasthenia Gravis if not
Information Gathering :
Myasthenia Gravis a new onset, Droopy facial muscles and eyelids (Ptosis)
LEVEL II : Patient will describe slowly feeling
(Defined: Neuromuscular weakness generally but feels better with rest. Double
abnormality where vision (diplopia)
muscles Dysphagia (difficulty swallowing)
experience paralysis starting Drooping eyelid (Ptosis) Shrinking Vt, VC,
from the head down to the MIP
feet including ventilatory LEVEL IV : Tensilon Challenge Test—positive for
muscles.) Myasthenic crisis if improvement is noted upon the
administration of Tensilon.
4/360
