COMPREHENSIVE NBRC TMC/CRT/RRT
REVIEW EXAM QUESTIONS AND
CORRECT ANSWERS
1. A 58-year-old male with a history of CHF presents with a PCWP of 22 mmHg and a MAP of
60 mmHg. Which of the following drugs would be most appropriate to increase cardiac
contractility?
A. Dobutamine
B. Dopamine
C. Lisinopril
D. Furosemide
Answer: A
Conceptual Explanation: Dobutamine is a positive inotrope that increases myocardial
contractility, which is indicated when PCWP is high and cardiac output is low, whereas
Furosemide is a diuretic to reduce volume.
,2. Which of the following values represents the most significant indicator of a patient’s ability
to be successfully weaned from mechanical ventilation?
A. RSBI of 125
B. Vital Capacity of 8 mL/kg
C. MIP of -15 cmH2O
D. RSBI of 85
Answer: D
Conceptual Explanation: A Rapid Shallow Breathing Index (RSBI) of less than 105 is a
strong predictor of weaning success. 85 is within the successful range, while the other
options are outside weaning thresholds.
3. During bedside monitoring of a patient on a ventilator, the therapist notes that the Pplat
has increased from 25 to 35 cmH2O, while the PIP has increased from 35 to 45 cmH2O. What
is the most likely cause?
A. Increased airway resistance
B. Accumulation of secretions
C. A kinked ventilator circuit
D. Decreased lung compliance
Answer: D
, Conceptual Explanation: When both PIP and Pplat increase equally, the transairway
pressure remains the same, indicating a decrease in lung compliance (e.g., ARDS,
pneumonia).
4. A 2-year-old child is brought to the ED with a ‘barking’ cough and inspiratory stridor. A
lateral neck X-ray shows subglottic narrowing (steeple sign). Which treatment is indicated?
A. Intubation
B. Antibiotics
C. Albuterol
D. Racemic Epinephrine
Answer: D
Conceptual Explanation: The ‘barking’ cough and steeple sign are classic for Croup (LTB).
Racemic epinephrine is used to reduce subglottic edema via mucosal vasoconstriction.
5. Calculate the alveolar oxygen tension (PAO2) for a patient on 40% oxygen at sea level with
a PaCO2 of 50 mmHg and a Respiratory Quotient (R) of 0.8.
A. 180 mmHg
B. 222 mmHg
C. 285 mmHg
D. 250 mmHg
Answer: B
REVIEW EXAM QUESTIONS AND
CORRECT ANSWERS
1. A 58-year-old male with a history of CHF presents with a PCWP of 22 mmHg and a MAP of
60 mmHg. Which of the following drugs would be most appropriate to increase cardiac
contractility?
A. Dobutamine
B. Dopamine
C. Lisinopril
D. Furosemide
Answer: A
Conceptual Explanation: Dobutamine is a positive inotrope that increases myocardial
contractility, which is indicated when PCWP is high and cardiac output is low, whereas
Furosemide is a diuretic to reduce volume.
,2. Which of the following values represents the most significant indicator of a patient’s ability
to be successfully weaned from mechanical ventilation?
A. RSBI of 125
B. Vital Capacity of 8 mL/kg
C. MIP of -15 cmH2O
D. RSBI of 85
Answer: D
Conceptual Explanation: A Rapid Shallow Breathing Index (RSBI) of less than 105 is a
strong predictor of weaning success. 85 is within the successful range, while the other
options are outside weaning thresholds.
3. During bedside monitoring of a patient on a ventilator, the therapist notes that the Pplat
has increased from 25 to 35 cmH2O, while the PIP has increased from 35 to 45 cmH2O. What
is the most likely cause?
A. Increased airway resistance
B. Accumulation of secretions
C. A kinked ventilator circuit
D. Decreased lung compliance
Answer: D
, Conceptual Explanation: When both PIP and Pplat increase equally, the transairway
pressure remains the same, indicating a decrease in lung compliance (e.g., ARDS,
pneumonia).
4. A 2-year-old child is brought to the ED with a ‘barking’ cough and inspiratory stridor. A
lateral neck X-ray shows subglottic narrowing (steeple sign). Which treatment is indicated?
A. Intubation
B. Antibiotics
C. Albuterol
D. Racemic Epinephrine
Answer: D
Conceptual Explanation: The ‘barking’ cough and steeple sign are classic for Croup (LTB).
Racemic epinephrine is used to reduce subglottic edema via mucosal vasoconstriction.
5. Calculate the alveolar oxygen tension (PAO2) for a patient on 40% oxygen at sea level with
a PaCO2 of 50 mmHg and a Respiratory Quotient (R) of 0.8.
A. 180 mmHg
B. 222 mmHg
C. 285 mmHg
D. 250 mmHg
Answer: B
