NBRC CSE Exam
Weakening and permanent enlargement of the air Emphysema/ Chronic Bronchitis
spaces distal to the terminal bronchioles, often
accompanied by hypertrophy of the goblet cells and
mucus glands. Characterized by dyspnea on exertion
with significant hypercapnea
What are 5 terms/phrases that are used to describe a 1. Chronic Ventilatory Failure
patient with COPD 2. Chronic Hypercapnea
3. Increased lung compliance
4. Loss of elastic recoil
5. Chronic CO2 retention
What would the general appearance of someone with Barrel chested, Clubbing and cyanosis
COPD/ Chronic bronchiectasis look like
What would the respiratory pattern of someone with Dyspnea, accessory muscle use, pursed-lip breathing
COPD/ Chronic bronchiectasis be
What would the breath sounds of someone with COPD/ Diminished aeration with bilateral expiratory wheeze
Chronic bronchiectasis sound like
During patient assessment what would be a fast easy Diagnostic chest percussion - tympanic or hyper resonant
diagnostic test for someone with COPD/ Chronic
bronchiectasis
What would the cough of someone with COPD/ Chronic Congested, Productive of thick sputum
bronchiectasis consist of
What would be 3 diagnostic tests used to diagnose 1. Chest X-ray
COPD/ Chronic bronchiectasis 2. ABG
3. PFT
What would the X-ray of someone with COPD/ Chronic Hyperlucency, hyperinflation, increased A-P diameter, flattened diaphragm
bronchiectasis look like
What would be effected in a PFT for a patient with Decreased flows
COPD/ Chronic bronchiectasis
What SpO2 do you want for a patient with COPD/ 88-92% (Treat with Low O2)
Chronic bronchiectasis
What kind of aerosolized bronchodilators can be used for SABA- Albuterol or Levalbuterol
patients with COPD/ Chronic bronchiectasis LABA- Salmeterol, formoterol (Must be given with corticosteroid- budesonide,
Fluticasone)
Anticholinergic- Ipratropium, Tiotropium
For an acute exacerbation of ventilatory failure in a NPPV
patient with COPD/ Chronic bronchiectasis what should
be done to support them
A chronic inflammatory, obstructive, non-contagious Asthma
airway disease with varying levels of severity,
characterized by exacerbations of wheezing and
coughing
What would the general appearance of someone with an Pursed-lip breathing, chest tightness, increased A-P diameter during episode,
asthma exacerbation look like Diaphoresis
, NBRC CSE Exam
What would the breathing pattern of someone with an Accessory muscle usage, Retractions (especially in children)
asthma exacerbation look like
What would diagnostic Chest percussion sound like in Hyperresonant/tympanic note
someone with an asthma exacerbation
What would breath sounds be in someone with an Diffuse wheeze, diminished breath sounds, prolonged expiration
asthma exacerbation
What would the vital signs be in someone with an Tachycardia, Tachypnea, pulsus paradoxus during severe episode (Drop in BP
asthma exacerbation when breathing in)
What 3 diagnostic tests would help diagnosis someone 1. X-ray
with asthma 2. ABG
3. PFT
What would the x-ray of someone with asthma look like During acute episode increased A-P diameter, translucent (dark) lung fields,
depressed or flattened diaphragms
What would the PFT of someone with asthma look like 1. Spirometry shows reduced flow rates
2. Post bronchodilator spirometry increases FEV1 at least 12% and 200 ml
3. Bronchial provocation test: FEV1 decreases significantly when provocation
agent, such as methacholine is inhaled
What would the treatment be for someone with an acute -O2
asthma exacerbation -Aerosol Therapy with SABA and anticholinergic agents (Albuterol or
Levalbuterol, Ipratropium or Tiotropium) consider continuous aerosol Therapy
-Corticosteroids (Oral or IV)
-Intubation and mechanical ventilation if ventilatory or respiratory arrest occur
-Consider adjunct therapies: Heliox therapy, magnesium sulfate, subcutaneous
epinephrine
What are control medications for asthma LABA: Salmeterol, formoterol (Must be given with corticosteroid- budesonide,
Fluticasone)
Mast cell stabilizers: Cromolyn
Leukotriene inhibitors: montelukast
In an asthma action plan what peak flow indicates you 80-100%
are in the green zone
In an asthma action plan what peak flow indicates you 50-80%
are in the yellow zone
In an asthma action plan what peak flow indicates you Less than 50%
are in the red zone
Chronic dilation and distortion of one or more bronchi as Bronchiectasis
a result of excessive inflammation and destruction of
bronchial walls, blood vessels, elastic tissue and smooth
muscle
Results in impaired mucociliary clearance causing Bronchiectasis
accumulation of copious amounts of bronchial
secretions, one or both lungs may be involved,
commonly limited to a lobe or segment
A patient with Bronchiectasis is likely to have a history of pulmonary infections or cystic fibrosis
, NBRC CSE Exam
What would the general appearance of someone with Cyanosis, barrel chest, clubbing
Bronchiectasis be
What would the Respiratory pattern be for someone with Tachypnea, dyspnea, accessory muscle use, pursed-lip breathing
Bronchiectasis
What would breath sounds be for someone with Wheezing, diminished breath sounds
Bronchiectasis
What would diagnostic chest percussion sound like for Hypperresonant or tympanic notes
someone with Bronchiectasis
What would the cough of someone with Bronchiectasis Productive of purulent (pus), foul-smelling secretions, hemoptysis, sputum
consist of separate into 3 layers
What would be 4 diagnostic tests for Bronchiectasis be 1. Chest X-ray
2. ABG
3. PFT
4. Bronchogram or CT
What would the chest X-ray look like in a patient with Hyperlucent lung fields, depressed or flattened diaphragm, enlarged or elongated
Bronchiectasis heart
A PFT of a patient with Bronchiectasis would show what Decreased Flows, severe cases may also have decreased volumes
A bronchogram or CT scan in a patient with Dilated bronchi, increased bronchial wall opacity
Bronchiectasis would show what
What is the treatment for someone with Bronchiectasis -O2
-Bronchopulmonary hygiene
-Lung expansion therapy
-Antibiotics for acute infections
-Expectorants (Much active agent)
-Aerosolized SABA and anticholinergic
-Surgical resection of involved portions as necessary
An inherited, genetic disorder involving the exocrine Cystic Fibrosis (Mucoviscidosis)
glands. Results in think, viscous mucus accumulation in
the lungs, blocks passageways of the pancreas, and
prohibits enzymes from reaching the intestines leading to
inhibition of digestion of protein and fat and deficiencies
of vitamins A, D, E and K
What would the past medical history of someone with Positive Family history, meconium ileus as a newborn, recurrent respiratory
Cystic Fibrosis consist of infections, failure to thrive
What would the general appearance for someone with Barrel chest, cyanosis, clubbing, small for age, malnutrition, poor body
Cystic Fibrosis look like development, peripheral edema
What would the respiratory pattern be for someone with Tachypnea, dyspnea on exertion, pursed-lip breathing, use of accessory muscles
Cystic Fibrosis of inspiration and expiration, cough productive of large amount of thick purulent
secretions.
Weakening and permanent enlargement of the air Emphysema/ Chronic Bronchitis
spaces distal to the terminal bronchioles, often
accompanied by hypertrophy of the goblet cells and
mucus glands. Characterized by dyspnea on exertion
with significant hypercapnea
What are 5 terms/phrases that are used to describe a 1. Chronic Ventilatory Failure
patient with COPD 2. Chronic Hypercapnea
3. Increased lung compliance
4. Loss of elastic recoil
5. Chronic CO2 retention
What would the general appearance of someone with Barrel chested, Clubbing and cyanosis
COPD/ Chronic bronchiectasis look like
What would the respiratory pattern of someone with Dyspnea, accessory muscle use, pursed-lip breathing
COPD/ Chronic bronchiectasis be
What would the breath sounds of someone with COPD/ Diminished aeration with bilateral expiratory wheeze
Chronic bronchiectasis sound like
During patient assessment what would be a fast easy Diagnostic chest percussion - tympanic or hyper resonant
diagnostic test for someone with COPD/ Chronic
bronchiectasis
What would the cough of someone with COPD/ Chronic Congested, Productive of thick sputum
bronchiectasis consist of
What would be 3 diagnostic tests used to diagnose 1. Chest X-ray
COPD/ Chronic bronchiectasis 2. ABG
3. PFT
What would the X-ray of someone with COPD/ Chronic Hyperlucency, hyperinflation, increased A-P diameter, flattened diaphragm
bronchiectasis look like
What would be effected in a PFT for a patient with Decreased flows
COPD/ Chronic bronchiectasis
What SpO2 do you want for a patient with COPD/ 88-92% (Treat with Low O2)
Chronic bronchiectasis
What kind of aerosolized bronchodilators can be used for SABA- Albuterol or Levalbuterol
patients with COPD/ Chronic bronchiectasis LABA- Salmeterol, formoterol (Must be given with corticosteroid- budesonide,
Fluticasone)
Anticholinergic- Ipratropium, Tiotropium
For an acute exacerbation of ventilatory failure in a NPPV
patient with COPD/ Chronic bronchiectasis what should
be done to support them
A chronic inflammatory, obstructive, non-contagious Asthma
airway disease with varying levels of severity,
characterized by exacerbations of wheezing and
coughing
What would the general appearance of someone with an Pursed-lip breathing, chest tightness, increased A-P diameter during episode,
asthma exacerbation look like Diaphoresis
, NBRC CSE Exam
What would the breathing pattern of someone with an Accessory muscle usage, Retractions (especially in children)
asthma exacerbation look like
What would diagnostic Chest percussion sound like in Hyperresonant/tympanic note
someone with an asthma exacerbation
What would breath sounds be in someone with an Diffuse wheeze, diminished breath sounds, prolonged expiration
asthma exacerbation
What would the vital signs be in someone with an Tachycardia, Tachypnea, pulsus paradoxus during severe episode (Drop in BP
asthma exacerbation when breathing in)
What 3 diagnostic tests would help diagnosis someone 1. X-ray
with asthma 2. ABG
3. PFT
What would the x-ray of someone with asthma look like During acute episode increased A-P diameter, translucent (dark) lung fields,
depressed or flattened diaphragms
What would the PFT of someone with asthma look like 1. Spirometry shows reduced flow rates
2. Post bronchodilator spirometry increases FEV1 at least 12% and 200 ml
3. Bronchial provocation test: FEV1 decreases significantly when provocation
agent, such as methacholine is inhaled
What would the treatment be for someone with an acute -O2
asthma exacerbation -Aerosol Therapy with SABA and anticholinergic agents (Albuterol or
Levalbuterol, Ipratropium or Tiotropium) consider continuous aerosol Therapy
-Corticosteroids (Oral or IV)
-Intubation and mechanical ventilation if ventilatory or respiratory arrest occur
-Consider adjunct therapies: Heliox therapy, magnesium sulfate, subcutaneous
epinephrine
What are control medications for asthma LABA: Salmeterol, formoterol (Must be given with corticosteroid- budesonide,
Fluticasone)
Mast cell stabilizers: Cromolyn
Leukotriene inhibitors: montelukast
In an asthma action plan what peak flow indicates you 80-100%
are in the green zone
In an asthma action plan what peak flow indicates you 50-80%
are in the yellow zone
In an asthma action plan what peak flow indicates you Less than 50%
are in the red zone
Chronic dilation and distortion of one or more bronchi as Bronchiectasis
a result of excessive inflammation and destruction of
bronchial walls, blood vessels, elastic tissue and smooth
muscle
Results in impaired mucociliary clearance causing Bronchiectasis
accumulation of copious amounts of bronchial
secretions, one or both lungs may be involved,
commonly limited to a lobe or segment
A patient with Bronchiectasis is likely to have a history of pulmonary infections or cystic fibrosis
, NBRC CSE Exam
What would the general appearance of someone with Cyanosis, barrel chest, clubbing
Bronchiectasis be
What would the Respiratory pattern be for someone with Tachypnea, dyspnea, accessory muscle use, pursed-lip breathing
Bronchiectasis
What would breath sounds be for someone with Wheezing, diminished breath sounds
Bronchiectasis
What would diagnostic chest percussion sound like for Hypperresonant or tympanic notes
someone with Bronchiectasis
What would the cough of someone with Bronchiectasis Productive of purulent (pus), foul-smelling secretions, hemoptysis, sputum
consist of separate into 3 layers
What would be 4 diagnostic tests for Bronchiectasis be 1. Chest X-ray
2. ABG
3. PFT
4. Bronchogram or CT
What would the chest X-ray look like in a patient with Hyperlucent lung fields, depressed or flattened diaphragm, enlarged or elongated
Bronchiectasis heart
A PFT of a patient with Bronchiectasis would show what Decreased Flows, severe cases may also have decreased volumes
A bronchogram or CT scan in a patient with Dilated bronchi, increased bronchial wall opacity
Bronchiectasis would show what
What is the treatment for someone with Bronchiectasis -O2
-Bronchopulmonary hygiene
-Lung expansion therapy
-Antibiotics for acute infections
-Expectorants (Much active agent)
-Aerosolized SABA and anticholinergic
-Surgical resection of involved portions as necessary
An inherited, genetic disorder involving the exocrine Cystic Fibrosis (Mucoviscidosis)
glands. Results in think, viscous mucus accumulation in
the lungs, blocks passageways of the pancreas, and
prohibits enzymes from reaching the intestines leading to
inhibition of digestion of protein and fat and deficiencies
of vitamins A, D, E and K
What would the past medical history of someone with Positive Family history, meconium ileus as a newborn, recurrent respiratory
Cystic Fibrosis consist of infections, failure to thrive
What would the general appearance for someone with Barrel chest, cyanosis, clubbing, small for age, malnutrition, poor body
Cystic Fibrosis look like development, peripheral edema
What would the respiratory pattern be for someone with Tachypnea, dyspnea on exertion, pursed-lip breathing, use of accessory muscles
Cystic Fibrosis of inspiration and expiration, cough productive of large amount of thick purulent
secretions.
