NBRC TMC EXAM REVIEW (2026) –
COMPREHENSIVE STUDY GUIDE
QUESTIONS AND ANSWERS
1. A patient in the ICU has a CVP of 12 mmHg, a PAP of 45/25 mmHg, and a PCWP of 8 mmHg.
Which of the following conditions is most likely?
A. Left heart failure
B. Hypovolemia
C. Pulmonary hypertension
D. Cardiac tamponade
Answer: C
Conceptual Explanation: The CVP is high (normal 2-6), PAP is high (normal 25/10), but
the PCWP is normal (normal 4-12). This indicates a problem between the right heart and
the lungs, such as pulmonary hypertension or pulmonary embolism.
,2. Calculate the static compliance (Cstat) for a patient with a tidal volume of 500 mL, a peak
inspiratory pressure (PIP) of 40 cmH2O, a plateau pressure (Pplat) of 25 cmH2O, and PEEP of
5 cmH2O.
A. 20 mL/cmH2O
B. 14 mL/cmH2O
C. 33 mL/cmH2O
D. 25 mL/cmH2O
Answer: D
Conceptual Explanation: Cstat = VT / (Pplat - PEEP). 500 / (25 - 5) = = 25
mL/cmH2O.
3. A 65-year-old patient with COPD has a pH of 7.36, PaCO2 of 62 mmHg, and HCO3- of 34
mEq/L. How should this be interpreted?
A. Acute respiratory acidosis
B. Partially compensated metabolic alkalosis
C. Compensated respiratory acidosis
D. Chronic metabolic acidosis
Answer: C
, Conceptual Explanation: The pH is within the normal range but on the acidic side, the
PaCO2 is high, and the HCO3- is high, indicating the kidneys have compensated for the
chronic CO2 retention.
4. Which of the following PFT results is most indicative of a restrictive lung disease?
A. FEV1/FVC ratio of 60%
B. FVC less than 80% of predicted
C. Increased TLC
D. Decreased FEF 25-75%
Answer: B
Conceptual Explanation: Restrictive diseases are characterized by reduced lung volumes
(TLC, FVC) and a normal or elevated FEV1/FVC ratio.
5. A patient is receiving volume-controlled ventilation. The PIP has increased from 30 cmH2O
to 45 cmH2O over the last hour, while the Plateau pressure has remained at 20 cmH2O. What
is the most likely cause?
A. Increased airway resistance
B. Pneumothorax
C. Decreasing lung compliance
D. Pulmonary edema
Answer: A
COMPREHENSIVE STUDY GUIDE
QUESTIONS AND ANSWERS
1. A patient in the ICU has a CVP of 12 mmHg, a PAP of 45/25 mmHg, and a PCWP of 8 mmHg.
Which of the following conditions is most likely?
A. Left heart failure
B. Hypovolemia
C. Pulmonary hypertension
D. Cardiac tamponade
Answer: C
Conceptual Explanation: The CVP is high (normal 2-6), PAP is high (normal 25/10), but
the PCWP is normal (normal 4-12). This indicates a problem between the right heart and
the lungs, such as pulmonary hypertension or pulmonary embolism.
,2. Calculate the static compliance (Cstat) for a patient with a tidal volume of 500 mL, a peak
inspiratory pressure (PIP) of 40 cmH2O, a plateau pressure (Pplat) of 25 cmH2O, and PEEP of
5 cmH2O.
A. 20 mL/cmH2O
B. 14 mL/cmH2O
C. 33 mL/cmH2O
D. 25 mL/cmH2O
Answer: D
Conceptual Explanation: Cstat = VT / (Pplat - PEEP). 500 / (25 - 5) = = 25
mL/cmH2O.
3. A 65-year-old patient with COPD has a pH of 7.36, PaCO2 of 62 mmHg, and HCO3- of 34
mEq/L. How should this be interpreted?
A. Acute respiratory acidosis
B. Partially compensated metabolic alkalosis
C. Compensated respiratory acidosis
D. Chronic metabolic acidosis
Answer: C
, Conceptual Explanation: The pH is within the normal range but on the acidic side, the
PaCO2 is high, and the HCO3- is high, indicating the kidneys have compensated for the
chronic CO2 retention.
4. Which of the following PFT results is most indicative of a restrictive lung disease?
A. FEV1/FVC ratio of 60%
B. FVC less than 80% of predicted
C. Increased TLC
D. Decreased FEF 25-75%
Answer: B
Conceptual Explanation: Restrictive diseases are characterized by reduced lung volumes
(TLC, FVC) and a normal or elevated FEV1/FVC ratio.
5. A patient is receiving volume-controlled ventilation. The PIP has increased from 30 cmH2O
to 45 cmH2O over the last hour, while the Plateau pressure has remained at 20 cmH2O. What
is the most likely cause?
A. Increased airway resistance
B. Pneumothorax
C. Decreasing lung compliance
D. Pulmonary edema
Answer: A
