NBRC TMC EXAM PREP REVIEW 2026/2027
QUESTIONS AND ANSWERS
1. A 68-year-old patient with congestive heart failure (CHF) presents with an increased CVP,
increased PAP, and increased PCWP. The patient’s cardiac output is decreased. Which of the
following is the most appropriate treatment?
A. Administer a loop diuretic and positive inotropes.
B. Initiate aggressive fluid resuscitation.
C. Administer a beta-blocker immediately.
D. Perform immediate needle decompression.
Answer: A
Conceptual Explanation: High pressures across the CVP, PAP, and PCWP combined with
low CO indicate hypervolemia and heart failure. Diuretics like Lasix and inotropes like
Dobutamine are standard treatments.
2. When interpreting a flow-volume loop, a ‘scooped-out’ appearance on the expiratory limb
is most characteristic of:
A. Restrictive lung disease
,B. Normal lung function
C. Fixed upper airway obstruction
D. Obstructive lung disease
Answer: D
Conceptual Explanation: Obstructive diseases such as asthma or COPD cause a decreased
flow rate at lower lung volumes, resulting in a scooped-out shape on the flow-volume loop.
3. A patient is receiving volume-controlled ventilation. The peak inspiratory pressure (PIP)
has increased from 25 to 40 cm H2O over the last hour, while the plateau pressure remains
constant at 15 cm H2O. What is the most likely cause?
A. Decreased lung compliance
B. Pneumothorax development
C. Increased airway resistance
D. Pulmonary edema
Answer: C
Conceptual Explanation: An increase in PIP without a corresponding increase in plateau
pressure indicates an increase in transairway pressure, which signifies increased airway
resistance (e.g., secretions, bronchospasm).
, 4. What is the most definitive way to diagnose a pulmonary embolism in a hemodynamically
stable patient?
A. V/Q Scan
B. Chest X-ray
C. Bedside ultrasound
D. CT Angiography
Answer: D
Conceptual Explanation: Spiral CT Angiography is currently the gold standard and most
definitive diagnostic tool for pulmonary embolism in the clinical setting.
5. Which of the following ABG results indicates partially compensated respiratory acidosis?
A. pH 7.25, PaCO2 60, HCO3 24
B. pH 7.32, PaCO2 55, HCO3 28
C. pH 7.45, PaCO2 48, HCO3 32
D. pH 7.36, PaCO2 50, HCO3 30
Answer: B
Conceptual Explanation: In partially compensated respiratory acidosis, the pH is low,
PaCO2 is high, and the HCO3 is high as the kidneys attempt to buffer the acid.
QUESTIONS AND ANSWERS
1. A 68-year-old patient with congestive heart failure (CHF) presents with an increased CVP,
increased PAP, and increased PCWP. The patient’s cardiac output is decreased. Which of the
following is the most appropriate treatment?
A. Administer a loop diuretic and positive inotropes.
B. Initiate aggressive fluid resuscitation.
C. Administer a beta-blocker immediately.
D. Perform immediate needle decompression.
Answer: A
Conceptual Explanation: High pressures across the CVP, PAP, and PCWP combined with
low CO indicate hypervolemia and heart failure. Diuretics like Lasix and inotropes like
Dobutamine are standard treatments.
2. When interpreting a flow-volume loop, a ‘scooped-out’ appearance on the expiratory limb
is most characteristic of:
A. Restrictive lung disease
,B. Normal lung function
C. Fixed upper airway obstruction
D. Obstructive lung disease
Answer: D
Conceptual Explanation: Obstructive diseases such as asthma or COPD cause a decreased
flow rate at lower lung volumes, resulting in a scooped-out shape on the flow-volume loop.
3. A patient is receiving volume-controlled ventilation. The peak inspiratory pressure (PIP)
has increased from 25 to 40 cm H2O over the last hour, while the plateau pressure remains
constant at 15 cm H2O. What is the most likely cause?
A. Decreased lung compliance
B. Pneumothorax development
C. Increased airway resistance
D. Pulmonary edema
Answer: C
Conceptual Explanation: An increase in PIP without a corresponding increase in plateau
pressure indicates an increase in transairway pressure, which signifies increased airway
resistance (e.g., secretions, bronchospasm).
, 4. What is the most definitive way to diagnose a pulmonary embolism in a hemodynamically
stable patient?
A. V/Q Scan
B. Chest X-ray
C. Bedside ultrasound
D. CT Angiography
Answer: D
Conceptual Explanation: Spiral CT Angiography is currently the gold standard and most
definitive diagnostic tool for pulmonary embolism in the clinical setting.
5. Which of the following ABG results indicates partially compensated respiratory acidosis?
A. pH 7.25, PaCO2 60, HCO3 24
B. pH 7.32, PaCO2 55, HCO3 28
C. pH 7.45, PaCO2 48, HCO3 32
D. pH 7.36, PaCO2 50, HCO3 30
Answer: B
Conceptual Explanation: In partially compensated respiratory acidosis, the pH is low,
PaCO2 is high, and the HCO3 is high as the kidneys attempt to buffer the acid.
