NBRC TMC (2026/2027) ACTUAL EXAM WITH
CURRENTLY TESTING EXAM QUESTIONS AND
VERIFIED ANSWERS WITH DETAILED
RATIONALES GRADED A+
1. A patient presents with a barometric pressure of 747
mmHg, an FiO2 of 0.40, a PaCO2 of 45 mmHg, and a PaO2 of
80 mmHg. Which of the following parameters must be
evaluated to determine the patient's alveolar oxygen tension
(PAO2)?
A. QS/QT, VD/VT, and PaO2
B. Barometric pressure, FiO2, and PaCO2
C. PetCO2, PaO2, and pH
D. Cardiac index, SVR, and MAP
Correct Answer: B
Rationale: Alveolar oxygen tension (PAO2) is calculated using the
alveolar gas equation: PAO2 = (PB − PH2O) × FiO2 −
(PaCO2/R). Therefore, barometric pressure (BP/PB), FiO2, and
arterial carbon dioxide tension (PaCO2) are required for the
calculation.
2. A critical care unit monitors hemodynamic status using
body surface area calculations. Which of the following
parameters is expressed in L/min/m²?
,A. Systemic vascular resistance
B. Cardiac output
C. Cardiac index
D. Stroke volume
Correct Answer: C
Rationale: Cardiac index scales cardiac output to body size by
dividing cardiac output (L/min) by body surface area (m²), yielding
the units L/min/m².
3. A spontaneously breathing non-COPD patient exhibits the
following ABG results on room air: pH 7.38, PaCO2 42 mmHg,
PaO2 76 mmHg, HCO3- 24 mEq/L. The patient shows mild
clinical signs of hypoxemia. Which oxygen delivery setup is
most appropriate?
A. Nasal cannula at 2 L/min
B. Nasal cannula at 5 L/min
C. Non-rebreathing mask at 15 L/min
D. Venturi mask at 30%
Correct Answer: B
Rationale: A non-COPD patient demonstrating mild hypoxemia
requires an adult therapeutic FiO2 dose (typically 40%–55%). A
nasal cannula set to 5 L/min delivers approximately 40% FiO2,
which provides adequate oxygenation without excessive
hyperoxia or inadequate delivery.
,4. A patient with suspected left ventricular failure undergoes
hemodynamic monitoring. Which pair of values best reflects
left heart function?
A. Central venous pressure and mean pulmonary artery pressure
B. Mean pulmonary artery pressure and wedge pressure
C. Mean arterial pressure and systemic vascular resistance
D. Cardiac output and pulmonary capillary wedge pressure
Correct Answer: D
Rationale: Left heart performance is assessed by examining
parameters directly upstream (pulmonary capillary wedge
pressure) and downstream (cardiac output/cardiac index) from the
left ventricle.
5. During physical assessment of a patient with suspected
airway obstruction, which finding is most directly associated
with increased airway resistance?
A. Decreased oxygen saturation (SpO2)
B. Use of accessory muscles during inspiration
C. Alteration in blood P50 value
D. Elevation in end-tidal CO2
Correct Answer: B
Rationale: Increased airway resistance significantly elevates the
work of breathing, causing the patient to recruit accessory
muscles (e.g., sternocleidomastoids, scalenes) to assist
ventilation.
, 6. On a pressure-volume loop graphic during volume-
controlled ventilation, what clinical threshold does the lower
inflection point signify?
A. The minimal pressure required to recruit and keep alveoli open
B. The exact optimal PEEP level required for peak oxygenation
C. The maximum limit of residual volume
D. The point of alveolar overdistension
Correct Answer: A
Rationale: The lower inflection point on a pressure-volume loop
marks the critical pressure threshold at which collapsed alveoli
begin to open and remain patent throughout ventilation.
7. A V/Q scan yields results indicating absent pulmonary
perfusion with intact alveolar ventilation. A chest radiograph
demonstrates a classic wedge-shaped infiltrate. What is the
primary diagnosis?
A. Acute respiratory distress syndrome
B. Pulmonary embolism
C. Lobar pneumonia
D. Fluid overload
Correct Answer: C
CURRENTLY TESTING EXAM QUESTIONS AND
VERIFIED ANSWERS WITH DETAILED
RATIONALES GRADED A+
1. A patient presents with a barometric pressure of 747
mmHg, an FiO2 of 0.40, a PaCO2 of 45 mmHg, and a PaO2 of
80 mmHg. Which of the following parameters must be
evaluated to determine the patient's alveolar oxygen tension
(PAO2)?
A. QS/QT, VD/VT, and PaO2
B. Barometric pressure, FiO2, and PaCO2
C. PetCO2, PaO2, and pH
D. Cardiac index, SVR, and MAP
Correct Answer: B
Rationale: Alveolar oxygen tension (PAO2) is calculated using the
alveolar gas equation: PAO2 = (PB − PH2O) × FiO2 −
(PaCO2/R). Therefore, barometric pressure (BP/PB), FiO2, and
arterial carbon dioxide tension (PaCO2) are required for the
calculation.
2. A critical care unit monitors hemodynamic status using
body surface area calculations. Which of the following
parameters is expressed in L/min/m²?
,A. Systemic vascular resistance
B. Cardiac output
C. Cardiac index
D. Stroke volume
Correct Answer: C
Rationale: Cardiac index scales cardiac output to body size by
dividing cardiac output (L/min) by body surface area (m²), yielding
the units L/min/m².
3. A spontaneously breathing non-COPD patient exhibits the
following ABG results on room air: pH 7.38, PaCO2 42 mmHg,
PaO2 76 mmHg, HCO3- 24 mEq/L. The patient shows mild
clinical signs of hypoxemia. Which oxygen delivery setup is
most appropriate?
A. Nasal cannula at 2 L/min
B. Nasal cannula at 5 L/min
C. Non-rebreathing mask at 15 L/min
D. Venturi mask at 30%
Correct Answer: B
Rationale: A non-COPD patient demonstrating mild hypoxemia
requires an adult therapeutic FiO2 dose (typically 40%–55%). A
nasal cannula set to 5 L/min delivers approximately 40% FiO2,
which provides adequate oxygenation without excessive
hyperoxia or inadequate delivery.
,4. A patient with suspected left ventricular failure undergoes
hemodynamic monitoring. Which pair of values best reflects
left heart function?
A. Central venous pressure and mean pulmonary artery pressure
B. Mean pulmonary artery pressure and wedge pressure
C. Mean arterial pressure and systemic vascular resistance
D. Cardiac output and pulmonary capillary wedge pressure
Correct Answer: D
Rationale: Left heart performance is assessed by examining
parameters directly upstream (pulmonary capillary wedge
pressure) and downstream (cardiac output/cardiac index) from the
left ventricle.
5. During physical assessment of a patient with suspected
airway obstruction, which finding is most directly associated
with increased airway resistance?
A. Decreased oxygen saturation (SpO2)
B. Use of accessory muscles during inspiration
C. Alteration in blood P50 value
D. Elevation in end-tidal CO2
Correct Answer: B
Rationale: Increased airway resistance significantly elevates the
work of breathing, causing the patient to recruit accessory
muscles (e.g., sternocleidomastoids, scalenes) to assist
ventilation.
, 6. On a pressure-volume loop graphic during volume-
controlled ventilation, what clinical threshold does the lower
inflection point signify?
A. The minimal pressure required to recruit and keep alveoli open
B. The exact optimal PEEP level required for peak oxygenation
C. The maximum limit of residual volume
D. The point of alveolar overdistension
Correct Answer: A
Rationale: The lower inflection point on a pressure-volume loop
marks the critical pressure threshold at which collapsed alveoli
begin to open and remain patent throughout ventilation.
7. A V/Q scan yields results indicating absent pulmonary
perfusion with intact alveolar ventilation. A chest radiograph
demonstrates a classic wedge-shaped infiltrate. What is the
primary diagnosis?
A. Acute respiratory distress syndrome
B. Pulmonary embolism
C. Lobar pneumonia
D. Fluid overload
Correct Answer: C
