NBRC TMC/CRT/RRT Version 3 Exam Questions
And Answers, 100% Guaranteed Success |
2026/2027 |Complete A+ Guide
SECTION 1: PATIENT ASSESSMENT & DIAGNOSTIC TESTING
1. A 58-year-old male with a history of COPD is brought to the emergency
department with worsening dyspnea. An arterial blood gas (ABG) on 2 L/min
nasal cannula shows: pH 7.31, PaCO₂ 68 mmHg, PaO₂ 55 mmHg, HCO₃⁻ 32
mEq/L. What is the primary acid-base disorder?
A) Acute respiratory acidosis
B) Chronic respiratory acidosis
C) Acute-on-chronic respiratory acidosis
D) Metabolic alkalosis with compensation
Answer C: Acute-on-chronic respiratory acidosis
Rationale: The elevated PaCO₂ (>45 mmHg) indicates respiratory acidosis. The
HCO₃⁻ is elevated (32 mEq/L) above the normal range (22-26), showing renal
compensation for a chronic condition. However, the pH is significantly low (7.31),
indicating an acute component to the acidosis.
2. A patient's chest x-ray reveals a "Steeple Sign" or "Hourglass Sign." This
finding is classic for which condition?
A) Epiglottitis
B) Bacterial Pneumonia
,C) Croup (Laryngotracheobronchitis)
D) Pleural Effusion
Answer C: Croup (Laryngotracheobronchitis)
Rationale: The steeple sign refers to subglottic tracheal narrowing seen on an
anteroposterior radiograph and is a classic sign of croup. Epiglottitis typically
presents with a "Thumb Sign".
3. A patient has a pulmonary artery catheter in place. To measure the
Pulmonary Artery Wedge Pressure (PAWP/PCWP), the respiratory therapist
should ensure that the balloon is:
A) Deflated and the distal port is used
B) Deflated and the proximal port is used
C) Inflated to occlude a branch of the pulmonary artery
D) Inflated to float the catheter into the aorta
Answer C: Inflated to occlude a branch of the pulmonary artery
Rationale: The PAWP is measured by inflating the balloon at the distal port to
occlude a branch of the pulmonary artery. This creates a static column of blood
that reflects the pressure in the left atrium.
4. The presence of a "deep sulcus sign" on a chest x-ray is most indicative of:
A) Left lower lobe pneumonia
B) Left pleural effusion
C) Left pneumothorax in a supine patient
,D) Left atelectasis
Answer C: Left pneumothorax in a supine patient
Rationale: The deep sulcus sign is a hyperlucent deep costophrenic angle seen on
an x-ray of a supine patient, which indicates a pneumothorax.
5. A 34-year-old asthmatic patient has a peak flow reading of 180 L/min
(predicted 450 L/min). After three albuterol nebulizer treatments, the peak
flow is 210 L/min. What is the percent improvement?
A) 12%
B) 14%
C) 16.7%
D) 20%
Answer C: 16.7%
Rationale: Percent improvement is calculated as (210 - 180) / 180 x 100 = 30 /
180 x 100 = 16.7%.
6. A patient's ABG shows pH 7.48, PaCO₂ 30 mmHg, and HCO₃⁻ 22 mEq/L.
What is the correct interpretation?
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
Answer B: Respiratory alkalosis
, Rationale: The pH is elevated (>7.45) and the PaCO₂ is low (<35 mmHg), which is
diagnostic of respiratory alkalosis.
7. A patient's ABG shows pH 7.28, PaCO₂ 55 mmHg, and HCO₃⁻ 25 mEq/L.
This indicates:
A) Acute respiratory acidosis
B) Chronic respiratory acidosis
C) Metabolic acidosis with respiratory compensation
D) Mixed acidosis
Answer A: Acute respiratory acidosis
Rationale: The pH is low (<7.35) and the PaCO₂ is elevated (>45 mmHg). The
HCO₃⁻ is normal (22-26), confirming an acute process.
8. A patient is receiving volume-controlled mechanical ventilation. The
plateau pressure is 38 cmH₂O. This reading is a concern because it reflects:
A) High airway resistance
B) Poor lung compliance
C) Auto-PEEP
D) A circuit leak
Answer B: Poor lung compliance
Rationale: Plateau pressure reflects the pressure applied to the alveoli and is a
measure of lung compliance. A pressure >30 cmH₂O increases the risk of
barotrauma.
And Answers, 100% Guaranteed Success |
2026/2027 |Complete A+ Guide
SECTION 1: PATIENT ASSESSMENT & DIAGNOSTIC TESTING
1. A 58-year-old male with a history of COPD is brought to the emergency
department with worsening dyspnea. An arterial blood gas (ABG) on 2 L/min
nasal cannula shows: pH 7.31, PaCO₂ 68 mmHg, PaO₂ 55 mmHg, HCO₃⁻ 32
mEq/L. What is the primary acid-base disorder?
A) Acute respiratory acidosis
B) Chronic respiratory acidosis
C) Acute-on-chronic respiratory acidosis
D) Metabolic alkalosis with compensation
Answer C: Acute-on-chronic respiratory acidosis
Rationale: The elevated PaCO₂ (>45 mmHg) indicates respiratory acidosis. The
HCO₃⁻ is elevated (32 mEq/L) above the normal range (22-26), showing renal
compensation for a chronic condition. However, the pH is significantly low (7.31),
indicating an acute component to the acidosis.
2. A patient's chest x-ray reveals a "Steeple Sign" or "Hourglass Sign." This
finding is classic for which condition?
A) Epiglottitis
B) Bacterial Pneumonia
,C) Croup (Laryngotracheobronchitis)
D) Pleural Effusion
Answer C: Croup (Laryngotracheobronchitis)
Rationale: The steeple sign refers to subglottic tracheal narrowing seen on an
anteroposterior radiograph and is a classic sign of croup. Epiglottitis typically
presents with a "Thumb Sign".
3. A patient has a pulmonary artery catheter in place. To measure the
Pulmonary Artery Wedge Pressure (PAWP/PCWP), the respiratory therapist
should ensure that the balloon is:
A) Deflated and the distal port is used
B) Deflated and the proximal port is used
C) Inflated to occlude a branch of the pulmonary artery
D) Inflated to float the catheter into the aorta
Answer C: Inflated to occlude a branch of the pulmonary artery
Rationale: The PAWP is measured by inflating the balloon at the distal port to
occlude a branch of the pulmonary artery. This creates a static column of blood
that reflects the pressure in the left atrium.
4. The presence of a "deep sulcus sign" on a chest x-ray is most indicative of:
A) Left lower lobe pneumonia
B) Left pleural effusion
C) Left pneumothorax in a supine patient
,D) Left atelectasis
Answer C: Left pneumothorax in a supine patient
Rationale: The deep sulcus sign is a hyperlucent deep costophrenic angle seen on
an x-ray of a supine patient, which indicates a pneumothorax.
5. A 34-year-old asthmatic patient has a peak flow reading of 180 L/min
(predicted 450 L/min). After three albuterol nebulizer treatments, the peak
flow is 210 L/min. What is the percent improvement?
A) 12%
B) 14%
C) 16.7%
D) 20%
Answer C: 16.7%
Rationale: Percent improvement is calculated as (210 - 180) / 180 x 100 = 30 /
180 x 100 = 16.7%.
6. A patient's ABG shows pH 7.48, PaCO₂ 30 mmHg, and HCO₃⁻ 22 mEq/L.
What is the correct interpretation?
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
Answer B: Respiratory alkalosis
, Rationale: The pH is elevated (>7.45) and the PaCO₂ is low (<35 mmHg), which is
diagnostic of respiratory alkalosis.
7. A patient's ABG shows pH 7.28, PaCO₂ 55 mmHg, and HCO₃⁻ 25 mEq/L.
This indicates:
A) Acute respiratory acidosis
B) Chronic respiratory acidosis
C) Metabolic acidosis with respiratory compensation
D) Mixed acidosis
Answer A: Acute respiratory acidosis
Rationale: The pH is low (<7.35) and the PaCO₂ is elevated (>45 mmHg). The
HCO₃⁻ is normal (22-26), confirming an acute process.
8. A patient is receiving volume-controlled mechanical ventilation. The
plateau pressure is 38 cmH₂O. This reading is a concern because it reflects:
A) High airway resistance
B) Poor lung compliance
C) Auto-PEEP
D) A circuit leak
Answer B: Poor lung compliance
Rationale: Plateau pressure reflects the pressure applied to the alveoli and is a
measure of lung compliance. A pressure >30 cmH₂O increases the risk of
barotrauma.
