NBRC EXAM, Part I STUDY QUESTIONS AND ANSWER WITH COMPLETE VERIFIED SOLUTIONS 2024 GRADED A

PATIENT ASSESSMENT: All the following could cause capnography to go from 3 6 to 30 EXCEPT: A. Endotracheal tube positioned in the right mainstream bronchus B. Hyperventilation C. pulmonary emboli D. Hypovolemia - Endotracheal tube positioned in right mainstem bronchus is a problem but the co2 reading would not change, so ANSWER is A. What is the target Vt for individual on mechanical ventilation - 6-8 ml/kg (of ideal body weight) This is new strategy as of January 2015 Is the following Static OR Dynamic Compliance: Means flow throughout the respiratory system has stopped and all ventilatory muscle activity is absent. _______ conditions can be imposed with an inspiratory pause when a patient is sedated and mechanically ventilated. - Static Compliance Is the following Static OR Dynamic Compliance: Flow at airway opening is zero. Mechanics are evaluated under ______ conditions, when non-intubated patient breathes spontaneously. - Dynamic Compliance A balloon tipped flow directed catheter is positioned in the pulmonary artery with the balloon deflated. Which of the following pressures will be measured by the proximal lumen: a. Cvp b. Pap c. Pwp d. Map - ANSWER is A. Cvp = deflated/proximal lumen Pap = deflated/distal Pwp = inflated/wedged All of the following will affect the accuracy of a capnography EXCEPT a. Long sampling line b. Low sampling flow c. Condensation in the tubing d. Use of desiccant - Gas will pass through and out of a long sampling line before reaching analyzer so, low sampling flow will not give you enough information for a good reading, and condensation as a rule is always a problem especially in analyzers. Dessicant removes moisture from the gas, which is a good thing, so ANSWER is D A 1000 g neonate (normal baby is 3000 g) is stable in nicu. Which of the following should the respiratory therapist use to monitor the neonates overall cardiopulmonary status. a. TcPCO2 and TcPO2 monitor b. Arterial blood gas analysis Q4 c. SpO2 monitor d. Capillary gas analysis Q8 - Since the baby is stable, go less invasive, also go continuous monitoring (not 4 hour or 8 hour), Transcutaneous (Tc) continuous monitoring of CO2 and O2 is the best. Answer is A A unilateral wheeze would most likely indicate which of the following. a. Asthma b. Atelectasis c. Foreign body aspiration d. Epiglottitis - You wouldn't have asthma on just one side (unilateral), atelectasis would cause diminished breath sounds, with epiglottitis you would get stridor, since you are only hearing wheezing on one side, you are hearing it on the side where you aspirated something, so ANSWER is C All of the following would be associated with the presence of a pneumothorax EXCEPT a. Tracheal deviation b. Dull percussion c. Absent breath sounds d. Respiratory distress - With pneumothorax you would hear a high pitch hyperresonnance, breath sounds would be absent, and respiratory distress could be present. Dull percussion would NOT be present, so ANSWER is B. What should you recommend FIRST for a patient with multifocal pvc's a. Administration of lidocaine b. Administration of 100% oxygen c. Administration of atropine d. Administration of epinephrine - Multiple pvc's coming from multiple locations (multifocal) is a real problem and you should administer oxygen FIRST, so ANSWER is B. lidocaine will help reduce irritability of heart and help with pvc's but would not be first option, atropine is used for bradycardia and cardiac irregularities but not pvc's, epinephrine is emergency drug not for pvc's but more for pulseless ventricular tachycardia or ventricular fibrilation where heart is not responding . What is the normal range for the mean pulmonary artery pressure in an adult a. 2-6 mm Hg b. 4-12 mmHg c. 9-18 mmHg d. 21-28 mmHg - Mean pulmonary artery pressure in an adult should be in the teens so best ANSWER is C A patient in the emergency dept has frothy secretions, moist crackles, and tachypnea. The patient has marked dyspnea and a history of heart disease. Which of the following should the respiratory therapist recommend. on immediately ister 100% oxygen in Fowlers position ister furosemide - This is an emergency, they are having heart problems, dyspnea, frothy secretions indicating severe pulmonary edema, etc. so 100% oxygen immediately, having the patient in the Fowlers position (an upright position) will help pull fluid down away from the lungs, furosemide is a lasix (loop diuretic) which gets rid of excess fluid. You do NOT suction someone with frothy secretions and heart problems, this just delays appropriate therapy. So ANSWER is 2,3,4 Fine crepitant crackles are most commonly associated with which of the following conditions. a. Bronchiectasis b. Congestive heart failure c. Pneumonia d. Croup - Crackles are associated with fluid so a, b, and c would be good answers, but "fine crepitant" crackles indicates fluid entering alveoli (pulmonary edema) which is most often caused by heart failure so the best ANSWER is B. (with croup you would hear more of a stridor sound). A patient is found in full cardiopulmonary arrest. CPR is started and the patient is orally intubated with an EtCO2 monitor attached. Which of the following EtCO2 patterns would the respiratory therapist expect to observe on the monitor? a. Initially high, then falling b. Initially low, then rising c. Initially high, stays high d. Initially low, stays low - Full cardiac arrest will cause the CO2 in the lungs to slowly dissipate out because no blood is flowing, then during CPR when you get blood flowing, the CO2 should slowly rise back up; so ANSWER is B If the blood pressure obtained from the arterial line is higher than the blood pressure obtained from a sphygmomanometer (cuff pressure). Based upon this information, the respiratory therapist should conclude that.