NBRC TMC/CRT/RRT RESPIRATORY THERAPY
PRACTICE EXAMINATION — STUDY GUIDE | LATEST
UPDATE 2026/2027 | ACTUAL EXAM | PRACTICE
QUESTIONS AND ANSWERS | EXAM REVIEW | 100%
CORRECT ANSWERS | VERIFIED SOLUTIONS
1.
A 68-year-old male with COPD presents with increasing dyspnea and a
productive cough. Which of the following physical examination findings
is most consistent with cor pulmonale?
A) Decreased tactile fremitus
B) Jugular venous distention and peripheral edema
C) Hyperresonance on percussion
D) Diminished breath sounds bilaterally
Correct Answer: B
Cor pulmonale is right heart failure secondary to chronic lung disease.
Jugular venous distention and peripheral edema indicate right
ventricular failure and systemic venous congestion. Hyperresonance,
decreased fremitus, and diminished breath sounds are typical of COPD
but do not specifically indicate cor pulmonale.
2.
A patient's chest radiograph shows blunting of the costophrenic angles
bilaterally. This finding is most suggestive of:
A) Pneumothorax
B) Pulmonary edema
,C) Pleural effusion
D) Atelectasis
Correct Answer: C
Blunting of the costophrenic angles on a chest radiograph is a classic
sign of pleural effusion, as fluid accumulates in the dependent pleural
spaces. Pneumothorax shows absent lung markings; pulmonary edema
shows diffuse infiltrates; atelectasis shows volume loss.
3.
Which of the following hemodynamic values is consistent with a normal
pulmonary artery wedge pressure (PAWP)?
A) 2–6 mm Hg
B) 4–12 mm Hg
C) 15–20 mm Hg
D) 25–30 mm Hg
Correct Answer: B
Normal PAWP is 4–12 mm Hg, reflecting left ventricular end-diastolic
pressure. Values above 18 mm Hg suggest left heart failure or fluid
overload; values below 4 mm Hg may indicate hypovolemia.
4.
A patient with acute respiratory distress syndrome (ARDS) has a PaO₂ of
55 mm Hg on FiO₂ 0.80 and PEEP 10 cm H₂O. What is the PaO₂/FiO₂
ratio?
A) 55
B) 69
C) 80
D) 110
,Correct Answer: B
PaO₂/FiO₂ ratio = .80 = 68.75, approximately 69. This ratio is used
to classify ARDS severity; a ratio less than 100 indicates severe ARDS.
Options A, C, and D are incorrect calculations.
5.
Which of the following is the most common cause of hypoxemia in a
patient with acute respiratory distress syndrome?
A) Hypoventilation
B) Diffusion defect
C) Intrapulmonary shunting
D) Ventilation/perfusion mismatch only
Correct Answer: C
ARDS is characterized by intrapulmonary shunting due to alveolar
collapse and fluid-filled alveoli, where blood passes through
nonventilated lung units. Hypoventilation and diffusion defects are not
the primary mechanisms; V/Q mismatch also occurs but shunting
dominates.
6.
A respiratory therapist notes that a patient's sputum is green, thick, and
foul-smelling. This finding is most indicative of:
A) Viral bronchitis
B) Bacterial pneumonia
C) Pulmonary embolism
D) Congestive heart failure
Correct Answer: B
Green, purulent, foul-smelling sputum suggests bacterial infection,
, commonly seen in pneumonia or bronchiectasis. Viral infections typically
produce clear or white sputum; pulmonary embolism and CHF do not
typically produce purulent sputum.
7.
Which of the following is a normal adult respiratory rate?
A) 6–10 breaths/min
B) 8–12 breaths/min
C) 12–20 breaths/min
D) 20–30 breaths/min
Correct Answer: C
Normal adult respiratory rate is 12–20 breaths per minute. Rates below
12 may indicate hypoventilation; above 20 may indicate tachypnea from
various causes.
8.
A patient with myasthenia gravis is at increased risk for which of the
following?
A) Obstructive sleep apnea
B) Restrictive lung disease and respiratory muscle weakness
C) Pulmonary fibrosis
D) Bronchiectasis only
Correct Answer: B
Myasthenia gravis causes skeletal muscle weakness, including
respiratory muscles, leading to restrictive ventilatory impairment and
hypoventilation. Obstructive sleep apnea is not directly related;
pulmonary fibrosis and bronchiectasis are not typical.
9.
PRACTICE EXAMINATION — STUDY GUIDE | LATEST
UPDATE 2026/2027 | ACTUAL EXAM | PRACTICE
QUESTIONS AND ANSWERS | EXAM REVIEW | 100%
CORRECT ANSWERS | VERIFIED SOLUTIONS
1.
A 68-year-old male with COPD presents with increasing dyspnea and a
productive cough. Which of the following physical examination findings
is most consistent with cor pulmonale?
A) Decreased tactile fremitus
B) Jugular venous distention and peripheral edema
C) Hyperresonance on percussion
D) Diminished breath sounds bilaterally
Correct Answer: B
Cor pulmonale is right heart failure secondary to chronic lung disease.
Jugular venous distention and peripheral edema indicate right
ventricular failure and systemic venous congestion. Hyperresonance,
decreased fremitus, and diminished breath sounds are typical of COPD
but do not specifically indicate cor pulmonale.
2.
A patient's chest radiograph shows blunting of the costophrenic angles
bilaterally. This finding is most suggestive of:
A) Pneumothorax
B) Pulmonary edema
,C) Pleural effusion
D) Atelectasis
Correct Answer: C
Blunting of the costophrenic angles on a chest radiograph is a classic
sign of pleural effusion, as fluid accumulates in the dependent pleural
spaces. Pneumothorax shows absent lung markings; pulmonary edema
shows diffuse infiltrates; atelectasis shows volume loss.
3.
Which of the following hemodynamic values is consistent with a normal
pulmonary artery wedge pressure (PAWP)?
A) 2–6 mm Hg
B) 4–12 mm Hg
C) 15–20 mm Hg
D) 25–30 mm Hg
Correct Answer: B
Normal PAWP is 4–12 mm Hg, reflecting left ventricular end-diastolic
pressure. Values above 18 mm Hg suggest left heart failure or fluid
overload; values below 4 mm Hg may indicate hypovolemia.
4.
A patient with acute respiratory distress syndrome (ARDS) has a PaO₂ of
55 mm Hg on FiO₂ 0.80 and PEEP 10 cm H₂O. What is the PaO₂/FiO₂
ratio?
A) 55
B) 69
C) 80
D) 110
,Correct Answer: B
PaO₂/FiO₂ ratio = .80 = 68.75, approximately 69. This ratio is used
to classify ARDS severity; a ratio less than 100 indicates severe ARDS.
Options A, C, and D are incorrect calculations.
5.
Which of the following is the most common cause of hypoxemia in a
patient with acute respiratory distress syndrome?
A) Hypoventilation
B) Diffusion defect
C) Intrapulmonary shunting
D) Ventilation/perfusion mismatch only
Correct Answer: C
ARDS is characterized by intrapulmonary shunting due to alveolar
collapse and fluid-filled alveoli, where blood passes through
nonventilated lung units. Hypoventilation and diffusion defects are not
the primary mechanisms; V/Q mismatch also occurs but shunting
dominates.
6.
A respiratory therapist notes that a patient's sputum is green, thick, and
foul-smelling. This finding is most indicative of:
A) Viral bronchitis
B) Bacterial pneumonia
C) Pulmonary embolism
D) Congestive heart failure
Correct Answer: B
Green, purulent, foul-smelling sputum suggests bacterial infection,
, commonly seen in pneumonia or bronchiectasis. Viral infections typically
produce clear or white sputum; pulmonary embolism and CHF do not
typically produce purulent sputum.
7.
Which of the following is a normal adult respiratory rate?
A) 6–10 breaths/min
B) 8–12 breaths/min
C) 12–20 breaths/min
D) 20–30 breaths/min
Correct Answer: C
Normal adult respiratory rate is 12–20 breaths per minute. Rates below
12 may indicate hypoventilation; above 20 may indicate tachypnea from
various causes.
8.
A patient with myasthenia gravis is at increased risk for which of the
following?
A) Obstructive sleep apnea
B) Restrictive lung disease and respiratory muscle weakness
C) Pulmonary fibrosis
D) Bronchiectasis only
Correct Answer: B
Myasthenia gravis causes skeletal muscle weakness, including
respiratory muscles, leading to restrictive ventilatory impairment and
hypoventilation. Obstructive sleep apnea is not directly related;
pulmonary fibrosis and bronchiectasis are not typical.
9.
