NBRC TMC PRACTICE QUESTIONS STUDY GUIDE / ACTUAL EXAM QUESTIONS | ACCURATE EXPERT VERIFIED FOR GUARANTEED PASS |
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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.
A patient who is showing signs of hypoxemia should receive supplemental oxygen. If the patient is not a COPD patient and the situation is not
an emergency, then the proper supplemental oxygen is an adult therapeutic dose, which is 40% to 55%. Of the options available only 5 L/min
nasal cannula will approach this. Other options are either insufficient or too much.
Left heart failure would be manifested in which of the following values?
A. CVP and mPAP
B. mPAP and wedge pressure
C. MAP and SVR
D. cardiac output and wedge pressure ✔️D.
The function of the left heart, specifically the left ventricle, is best assessed hemodynamically by looking at those values that precede and come
after the left heart. In this case pulmonary capillary wedge pressure and cardiac output (or cardiac index) are the values found before and after
the left heart.
Which of the following findings is most closely associated with increased airway resistance?
A. reduced SpO2
B. accessory muscle use
C. altered P50
D. increased PetCO2 ✔️B.
,Of the options given, use of accessory muscles is most closely associated with an increase in airway resistance. This is especially true with
patients who have asthma or other types of upper airway inflammation or bronchoconstriction.
For a patient receiving volume-controlled mechanical ventilation, the lower inflection point on a pressure-volume loop can best be described
as:
A. amount of pressure required to keep the alveoli and small airways open
B. optimal PEEP
C. minimal PEEP
D. upper limit of residual volume ✔️A.
The lowest inflection point on a pressure-volume ventilator graphic is an indication of the minimum pressure needed to keep alveoli open.
The results of a V/Q scan shows poor perfusion with adequate ventilation. A chest radiograph shows a wedge-shaped infiltrate over the right
lung field. The patient most likely has
A. fluid overload
B. ARDS
C. a pulmonary embolism
D. pneumonia ✔️C.
A VQ scan that shows poor perfusion but adequate ventilation is most closely associated with a pulmonary embolism. Supportive data is found
in the radiological report of wedge-shaped infiltrates.
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
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.
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.
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.
, A patient is receiving volume-controlled ventilation following bariatric surgery for obesity. Which of the following medications should the
respiratory therapist recommend to ensure the patient's comfort and assist in ventilator management?
A. Pronestyl
B. morphine sulfate
C. vecuronium bromide (Norcuron)
D. Mestinon ✔️B.
Morphine sulfate is one of the best medications to administer to patients receiving mechanical ventilatory support to help the patient rest pain-
free and to generally sedate and relax the patient.
A patient has idiopathic pneumonia with consolidation in the right lower lobe. The physician suspects a bacterial infection. Which of the
following will provide conclusive data to rule out the physician's suspicions?
A. WBC
B. color of sputum
C. sputum acid-fast stain
D. oral temperature ✔️A.
A bacterial infection is diagnosed primarily by examining the white blood cell count, also called the leukocyte count. An elevated temperature
and yellow sputum indicate the possibility of an infection but are not confirming in nature.
After making the universal sign of choking, a person collapses. The observer should FIRST
A. check for a pulse
B. call for help
C. perform abdominal thrusts
D. administer 2 rescue breaths ✔️C.
When a person indicates the universal sign of choking, they are unable to verbalize because there is likely something caught in their airway. The
person responding must first focus on removing the obstruction, which is done by performing abdominal thrusts. Administering rescue breaths
would not be appropriate because the airway is obstructed. Calling for help is tempting but is only related to two-man CPR. The patient is not
yet at that point. Performing abdominal thrusts is a one-man maneuver and therefore obtaining additional help is not the first concern.
A home care patient calls into the clinic and complains that his oxygen concentrator is not working even though the machine is plugged in and
the switch is in the 'on'. Position. After ensuring the patient is receiving oxygen from a reliable alternate source, the therapist should advise the
patient to
A. check and replace the internal in-line fuse
B. find the reset switch in the machine and press it
C. ensure the circuit breaker is in the on position
D. change the filters and cycle the machine off then on again ✔️C.
When a homecare patient reports a problem with their oxygen concentrator, the first action should be to ensure the patient is receiving oxygen
from an alternate source (an E cylinder). After that is accomplished, the respiratory therapist may instruct the patient in some basic
troubleshooting. This includes ensuring the device is plugged in, changing the filter, and checking the circuit breaker. All other troubleshooting
should be done by a professional.
An adult patient with asthma is receiving Albuterol by small volume nebulizer Q.I.D. at a dosage of 0.5 mL. The patient complains of dizziness,
tingling in his fingers, and anxiety with each treatment. The therapist should
A. increase dosage to 1.0 mL
B. decrease dosage to 0.15 mL
LATEST UPDATE
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.
A patient who is showing signs of hypoxemia should receive supplemental oxygen. If the patient is not a COPD patient and the situation is not
an emergency, then the proper supplemental oxygen is an adult therapeutic dose, which is 40% to 55%. Of the options available only 5 L/min
nasal cannula will approach this. Other options are either insufficient or too much.
Left heart failure would be manifested in which of the following values?
A. CVP and mPAP
B. mPAP and wedge pressure
C. MAP and SVR
D. cardiac output and wedge pressure ✔️D.
The function of the left heart, specifically the left ventricle, is best assessed hemodynamically by looking at those values that precede and come
after the left heart. In this case pulmonary capillary wedge pressure and cardiac output (or cardiac index) are the values found before and after
the left heart.
Which of the following findings is most closely associated with increased airway resistance?
A. reduced SpO2
B. accessory muscle use
C. altered P50
D. increased PetCO2 ✔️B.
,Of the options given, use of accessory muscles is most closely associated with an increase in airway resistance. This is especially true with
patients who have asthma or other types of upper airway inflammation or bronchoconstriction.
For a patient receiving volume-controlled mechanical ventilation, the lower inflection point on a pressure-volume loop can best be described
as:
A. amount of pressure required to keep the alveoli and small airways open
B. optimal PEEP
C. minimal PEEP
D. upper limit of residual volume ✔️A.
The lowest inflection point on a pressure-volume ventilator graphic is an indication of the minimum pressure needed to keep alveoli open.
The results of a V/Q scan shows poor perfusion with adequate ventilation. A chest radiograph shows a wedge-shaped infiltrate over the right
lung field. The patient most likely has
A. fluid overload
B. ARDS
C. a pulmonary embolism
D. pneumonia ✔️C.
A VQ scan that shows poor perfusion but adequate ventilation is most closely associated with a pulmonary embolism. Supportive data is found
in the radiological report of wedge-shaped infiltrates.
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
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.
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.
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.
, A patient is receiving volume-controlled ventilation following bariatric surgery for obesity. Which of the following medications should the
respiratory therapist recommend to ensure the patient's comfort and assist in ventilator management?
A. Pronestyl
B. morphine sulfate
C. vecuronium bromide (Norcuron)
D. Mestinon ✔️B.
Morphine sulfate is one of the best medications to administer to patients receiving mechanical ventilatory support to help the patient rest pain-
free and to generally sedate and relax the patient.
A patient has idiopathic pneumonia with consolidation in the right lower lobe. The physician suspects a bacterial infection. Which of the
following will provide conclusive data to rule out the physician's suspicions?
A. WBC
B. color of sputum
C. sputum acid-fast stain
D. oral temperature ✔️A.
A bacterial infection is diagnosed primarily by examining the white blood cell count, also called the leukocyte count. An elevated temperature
and yellow sputum indicate the possibility of an infection but are not confirming in nature.
After making the universal sign of choking, a person collapses. The observer should FIRST
A. check for a pulse
B. call for help
C. perform abdominal thrusts
D. administer 2 rescue breaths ✔️C.
When a person indicates the universal sign of choking, they are unable to verbalize because there is likely something caught in their airway. The
person responding must first focus on removing the obstruction, which is done by performing abdominal thrusts. Administering rescue breaths
would not be appropriate because the airway is obstructed. Calling for help is tempting but is only related to two-man CPR. The patient is not
yet at that point. Performing abdominal thrusts is a one-man maneuver and therefore obtaining additional help is not the first concern.
A home care patient calls into the clinic and complains that his oxygen concentrator is not working even though the machine is plugged in and
the switch is in the 'on'. Position. After ensuring the patient is receiving oxygen from a reliable alternate source, the therapist should advise the
patient to
A. check and replace the internal in-line fuse
B. find the reset switch in the machine and press it
C. ensure the circuit breaker is in the on position
D. change the filters and cycle the machine off then on again ✔️C.
When a homecare patient reports a problem with their oxygen concentrator, the first action should be to ensure the patient is receiving oxygen
from an alternate source (an E cylinder). After that is accomplished, the respiratory therapist may instruct the patient in some basic
troubleshooting. This includes ensuring the device is plugged in, changing the filter, and checking the circuit breaker. All other troubleshooting
should be done by a professional.
An adult patient with asthma is receiving Albuterol by small volume nebulizer Q.I.D. at a dosage of 0.5 mL. The patient complains of dizziness,
tingling in his fingers, and anxiety with each treatment. The therapist should
A. increase dosage to 1.0 mL
B. decrease dosage to 0.15 mL
