NBRC TMC COMPREHENSIVE
PRACTICE EXAM 2026/2027 QUESTIONS
AND ANSWERS
1. A 68-year-old male patient with CHF has a PCWP of 25 mmHg and a CVP of 12 mmHg. The
patient is currently experiencing shortness of breath and fine crackles. Which of the following
is the most appropriate initial treatment?
A. Administer a bolus of normal saline
B. Start a vasopressor like Norepinephrine
C. Administer a loop diuretic like Furosemide
D. Perform an immediate thoracentesis
Answer: C
Conceptual Explanation: An elevated PCWP (Normal: 4-12 mmHg) and CVP (Normal: 2-6
mmHg) in a CHF patient suggests fluid overload and pulmonary edema. Diuretics are
indicated to reduce preload.
,2. When evaluating a patient’s PFT results, you note an FEV1/FVC ratio of 55%. This finding is
most indicative of:
A. Restrictive lung disease
B. A normal pulmonary function
C. Chest wall deformity
D. Obstructive lung disease
Answer: D
Conceptual Explanation: An FEV1/FVC ratio less than 70% is the hallmark sign of
obstructive lung disease (e.g., Asthma, COPD).
3. A patient is being ventilated in Volume Control mode. The high pressure alarm is triggered.
The peak inspiratory pressure (PIP) has increased from 25 to 40 cmH2O, but the plateau
pressure remains unchanged at 18 cmH2O. What is the most likely cause?
A. Decreased lung compliance
B. Pneumothorax
C. Increased airway resistance
D. Pulmonary edema
Answer: C
, Conceptual Explanation: When PIP increases but Plateau pressure remains stable, the
transairway pressure increases, indicating an increase in airway resistance (e.g., secretions,
bronchospasm, or biting the tube).
4. Calculate the RSBI for a patient with a spontaneous respiratory rate of 25 breaths/min and
a tidal volume of 350 mL.
A. 14
B. 8.75
C. 0.07
D. 71
Answer: D
Conceptual Explanation: RSBI = Frequency / Tidal Volume (in Liters). .35 = 71.4.
Values < 105 generally indicate weaning readiness.
5. An ABG shows the following: pH 7.25, PaCO2 60 mmHg, PaO2 55 mmHg, HCO3 26 mEq/L.
How would you interpret this result?
A. Compensated Metabolic Acidosis
B. Uncompensated Respiratory Acidosis
C. Partially compensated Respiratory Alkalosis
D. Uncompensated Metabolic Alkalosis
Answer: B
PRACTICE EXAM 2026/2027 QUESTIONS
AND ANSWERS
1. A 68-year-old male patient with CHF has a PCWP of 25 mmHg and a CVP of 12 mmHg. The
patient is currently experiencing shortness of breath and fine crackles. Which of the following
is the most appropriate initial treatment?
A. Administer a bolus of normal saline
B. Start a vasopressor like Norepinephrine
C. Administer a loop diuretic like Furosemide
D. Perform an immediate thoracentesis
Answer: C
Conceptual Explanation: An elevated PCWP (Normal: 4-12 mmHg) and CVP (Normal: 2-6
mmHg) in a CHF patient suggests fluid overload and pulmonary edema. Diuretics are
indicated to reduce preload.
,2. When evaluating a patient’s PFT results, you note an FEV1/FVC ratio of 55%. This finding is
most indicative of:
A. Restrictive lung disease
B. A normal pulmonary function
C. Chest wall deformity
D. Obstructive lung disease
Answer: D
Conceptual Explanation: An FEV1/FVC ratio less than 70% is the hallmark sign of
obstructive lung disease (e.g., Asthma, COPD).
3. A patient is being ventilated in Volume Control mode. The high pressure alarm is triggered.
The peak inspiratory pressure (PIP) has increased from 25 to 40 cmH2O, but the plateau
pressure remains unchanged at 18 cmH2O. What is the most likely cause?
A. Decreased lung compliance
B. Pneumothorax
C. Increased airway resistance
D. Pulmonary edema
Answer: C
, Conceptual Explanation: When PIP increases but Plateau pressure remains stable, the
transairway pressure increases, indicating an increase in airway resistance (e.g., secretions,
bronchospasm, or biting the tube).
4. Calculate the RSBI for a patient with a spontaneous respiratory rate of 25 breaths/min and
a tidal volume of 350 mL.
A. 14
B. 8.75
C. 0.07
D. 71
Answer: D
Conceptual Explanation: RSBI = Frequency / Tidal Volume (in Liters). .35 = 71.4.
Values < 105 generally indicate weaning readiness.
5. An ABG shows the following: pH 7.25, PaCO2 60 mmHg, PaO2 55 mmHg, HCO3 26 mEq/L.
How would you interpret this result?
A. Compensated Metabolic Acidosis
B. Uncompensated Respiratory Acidosis
C. Partially compensated Respiratory Alkalosis
D. Uncompensated Metabolic Alkalosis
Answer: B
