TMC - Therapist Multiple-Choice , National Board for Respiratory Care (NBRC), Certified Respiratory Therapist (CRT) Exam with Frequently asked Questions and Verified Answers

TMC - Therapist Multiple-Choice , National Board for Respiratory Care (NBRC), Certified Respiratory Therapist (CRT) Exam with Frequently asked Questions and Verified Answers A 68-year-old patient with a 50-pack-year smoking history presents with increasing dyspnea and chronic productive cough. Arterial blood gas results are pH 7.36, PaCO₂ 58 mm Hg, HCO₃⁻ 32 mEq/L, and PaO₂ 60 mm Hg on room air. Which interpretation is most appropriate? a. Acute respiratory acidosis without compensation b. Chronic respiratory acidosis with metabolic compensation c. Metabolic alkalosis with respiratory compensation d. Mixed respiratory alkalosis and metabolic acidosis Correct Answer: b. Chronic respiratory acidosis with metabolic compensation Rationale: The elevated PaCO₂ indicates respiratory acidosis. The elevated HCO₃⁻ demonstrates renal compensation, and the near-normal pH suggests a chronic compensated condition, commonly seen in chronic obstructive pulmonary disease (COPD). A respiratory therapist assesses a patient with suspected upper airway obstruction. Which physical finding is most indicative of this condition? a. Fine crackles at the lung bases b. Expiratory wheezing throughout both lungs c. Inspiratory stridor over the neck d. Diminished breath sounds in one lower lobe Correct Answer: c. Inspiratory stridor over the neck Rationale: Inspiratory stridor is a high-pitched sound associated with upper airway narrowing or obstruction and is best heard over the neck.