TMC test bank NBRC - 450 Questions and Answers
4 life functions (in order) & assessment for them - ANSWER Ventilation - RR, VT,
BS, chest. movement, PaCO2, EtCO2
Oxygenation - HR, Skin Color, Sensorium, PaO2, SpO2
Circulation - HR & strength, CO
Perfusion - BP, sensorium, temp, urine output, hemodynamics
Tobacco use, smoking status - ANSWER # packs per day X # of years smoked =
pack years
Pysical inspection (IPPA) - ANSWER Inspection
Palpation
Percussion
Auscaltation
Normal urine output - ANSWER 40mL/hr = 1L/day
Sensible water loss reasons - ANSWER urine, vomiting
Insensible water loss - ANSWER Lungs, skin
Affects of intake exceeding output - ANSWER Weight gain, electrolyte imbalance,
increased hemodynamic pressures, decreased lung cst
Normal CVP (central venous pressure) - ANSWER 2-6 mmHg
Decreased CVP & indications - ANSWER < 2 mmHg = hypovolemia = fluid therapy
Increased CVP & indications - ANSWER > 6 mmHg = diuretics (furosemide aka
Lasix)
Orientation x3 - ANSWER Time, Place, Person
Orthopnea is: - ANSWER difficulty breathing while lying down (CHF)
Dyspnea grades - ANSWER Grade I: unusual exertion
Grade II: up hills or stairs
Grade III: walking at normal speed
Grade IV: slowly, walking short distance
Grade V: at rest, shaving, dressing, etc.
Proper interviewing techniques - ANSWER Open-ended questions
,Patient education - ANSWER process of influencing the patient's behavior to effect
changes in knowledge, attitudes, & skills needed to maintain & improve health
Effective education - ANSWER begins with an assessment of the patient's & family's
learning needs to determine what learning needs to occur & how the learning can
best occur.
Peripheral edema causes, locations - ANSWER CHF, renal failure; arms & ankles
Acites - ANSWER accumulation of fluid in the abdomen, generally caused by liver
failure
Clubbing definition; causes - ANSWER When angle of the nail bed & skin increases;
chronic hypoxemia caused by COPD, CHF, CF, pulmonary diseases
Cap refill - ANSWER Color should return within 3 seconds
JVD - ANSWER jugular venous distention
CHF (left-sided heart failure)
On exhalation in patients with air trapping (decrease venous return)
Diaphoretic - ANSWER profuse sweating
heart failure (diuretics, positive inotropics)
fever, infection (antibiotics)
anxiety, nervousness (sedatives)
TB (antitubercular drugs)
Erythema - ANSWER redness of the skin (flushed, cap congestion, inflammation,
infection)
Cyanosis (definition) - ANSWER 5g decrease in hemoglobin
Pectus carinatum - ANSWER forward protrusion of the sternum
Pectus excavatum - ANSWER depression of part or all of the sternum
Kyphosis (dowager's hump) - ANSWER convex curvature of the spine (lean forward)
Scoliosis - ANSWER a lateral or side-to-side curvature of the spine
Kyphoscoliosis - ANSWER combination of kyphosis & scolisis
restrictive lung pattern (reduced lung volumes)
barrel chest - ANSWER increased AP diameter
result of chronic air trapping (COPD)
tripod breathing - ANSWER sitting or standing, leaning forward and supporting the
upper body with hands on the knees or on another surface.
sign of respiratory distress
, symetrical chest movement - ANSWER when both sides of the chest move an equal
distance at the same time
Eupnea is: - ANSWER normal respiratory rate, depth & rhythm
Normal respiratory rate - ANSWER 12-20 breaths per minute (adults)
*20 commonly used
Tachypnea - ANSWER greater than 20 respiratory rate (rapid & shallow)
Bradypnea - ANSWER aka oligopnea, less than 12 respiratory rate, variable depth &
irregular rhythm
Hyperpnea - ANSWER increase in depth, rate, and regular rhythm of breathing
(deeper, sometimes faster than normal)
*causes: metabolic disorder, CNS disorders
Cheyne-Stokes - ANSWER Gradually increase then decreasing rate and depth in a
cycle lasting from 30-180 seconds, with apnea lasting up to 60 seconds
Cheyne-Stokes causes - ANSWER Increases ICP, brainstem injury, drug OD
Biot's breathing - ANSWER groups of quick, shallow inspirations followed by regular
or irregular periods of apnea
Biots cause - ANSWER CNS problems
Kussmaul's - ANSWER Increased RR (>20 breaths/min), increased depth, irregular
rhythm, breathing sounds labored
Kussmaul causes - ANSWER hypoxemia, DKA, metabolic acidosis, renal failure
Normal muscles of ventilation - ANSWER Diaphragm
External intercostals
Exhalation is normally passive
Accesory muscles of ventilation (WOB indicator) - ANSWER Internal intercostals,
scalene, sternalcleidomastoid, pectoralis major
Abdominal muscles (oblique, rectus abdominus, ect)
Muscle conditions - ANSWER Atrophy - wasting, loss of tone
Hypertrophy - increase in size (occurs with excessive use in COPD)
Retractions definition - ANSWER when chest moves inward instead of out during
inspiratory effort
Retractions cause - ANSWER severe obstruction or distress
Nasal flaring - ANSWER Enlargement of nostrils with breathing (sign of respiratory
distress in infants)
4 life functions (in order) & assessment for them - ANSWER Ventilation - RR, VT,
BS, chest. movement, PaCO2, EtCO2
Oxygenation - HR, Skin Color, Sensorium, PaO2, SpO2
Circulation - HR & strength, CO
Perfusion - BP, sensorium, temp, urine output, hemodynamics
Tobacco use, smoking status - ANSWER # packs per day X # of years smoked =
pack years
Pysical inspection (IPPA) - ANSWER Inspection
Palpation
Percussion
Auscaltation
Normal urine output - ANSWER 40mL/hr = 1L/day
Sensible water loss reasons - ANSWER urine, vomiting
Insensible water loss - ANSWER Lungs, skin
Affects of intake exceeding output - ANSWER Weight gain, electrolyte imbalance,
increased hemodynamic pressures, decreased lung cst
Normal CVP (central venous pressure) - ANSWER 2-6 mmHg
Decreased CVP & indications - ANSWER < 2 mmHg = hypovolemia = fluid therapy
Increased CVP & indications - ANSWER > 6 mmHg = diuretics (furosemide aka
Lasix)
Orientation x3 - ANSWER Time, Place, Person
Orthopnea is: - ANSWER difficulty breathing while lying down (CHF)
Dyspnea grades - ANSWER Grade I: unusual exertion
Grade II: up hills or stairs
Grade III: walking at normal speed
Grade IV: slowly, walking short distance
Grade V: at rest, shaving, dressing, etc.
Proper interviewing techniques - ANSWER Open-ended questions
,Patient education - ANSWER process of influencing the patient's behavior to effect
changes in knowledge, attitudes, & skills needed to maintain & improve health
Effective education - ANSWER begins with an assessment of the patient's & family's
learning needs to determine what learning needs to occur & how the learning can
best occur.
Peripheral edema causes, locations - ANSWER CHF, renal failure; arms & ankles
Acites - ANSWER accumulation of fluid in the abdomen, generally caused by liver
failure
Clubbing definition; causes - ANSWER When angle of the nail bed & skin increases;
chronic hypoxemia caused by COPD, CHF, CF, pulmonary diseases
Cap refill - ANSWER Color should return within 3 seconds
JVD - ANSWER jugular venous distention
CHF (left-sided heart failure)
On exhalation in patients with air trapping (decrease venous return)
Diaphoretic - ANSWER profuse sweating
heart failure (diuretics, positive inotropics)
fever, infection (antibiotics)
anxiety, nervousness (sedatives)
TB (antitubercular drugs)
Erythema - ANSWER redness of the skin (flushed, cap congestion, inflammation,
infection)
Cyanosis (definition) - ANSWER 5g decrease in hemoglobin
Pectus carinatum - ANSWER forward protrusion of the sternum
Pectus excavatum - ANSWER depression of part or all of the sternum
Kyphosis (dowager's hump) - ANSWER convex curvature of the spine (lean forward)
Scoliosis - ANSWER a lateral or side-to-side curvature of the spine
Kyphoscoliosis - ANSWER combination of kyphosis & scolisis
restrictive lung pattern (reduced lung volumes)
barrel chest - ANSWER increased AP diameter
result of chronic air trapping (COPD)
tripod breathing - ANSWER sitting or standing, leaning forward and supporting the
upper body with hands on the knees or on another surface.
sign of respiratory distress
, symetrical chest movement - ANSWER when both sides of the chest move an equal
distance at the same time
Eupnea is: - ANSWER normal respiratory rate, depth & rhythm
Normal respiratory rate - ANSWER 12-20 breaths per minute (adults)
*20 commonly used
Tachypnea - ANSWER greater than 20 respiratory rate (rapid & shallow)
Bradypnea - ANSWER aka oligopnea, less than 12 respiratory rate, variable depth &
irregular rhythm
Hyperpnea - ANSWER increase in depth, rate, and regular rhythm of breathing
(deeper, sometimes faster than normal)
*causes: metabolic disorder, CNS disorders
Cheyne-Stokes - ANSWER Gradually increase then decreasing rate and depth in a
cycle lasting from 30-180 seconds, with apnea lasting up to 60 seconds
Cheyne-Stokes causes - ANSWER Increases ICP, brainstem injury, drug OD
Biot's breathing - ANSWER groups of quick, shallow inspirations followed by regular
or irregular periods of apnea
Biots cause - ANSWER CNS problems
Kussmaul's - ANSWER Increased RR (>20 breaths/min), increased depth, irregular
rhythm, breathing sounds labored
Kussmaul causes - ANSWER hypoxemia, DKA, metabolic acidosis, renal failure
Normal muscles of ventilation - ANSWER Diaphragm
External intercostals
Exhalation is normally passive
Accesory muscles of ventilation (WOB indicator) - ANSWER Internal intercostals,
scalene, sternalcleidomastoid, pectoralis major
Abdominal muscles (oblique, rectus abdominus, ect)
Muscle conditions - ANSWER Atrophy - wasting, loss of tone
Hypertrophy - increase in size (occurs with excessive use in COPD)
Retractions definition - ANSWER when chest moves inward instead of out during
inspiratory effort
Retractions cause - ANSWER severe obstruction or distress
Nasal flaring - ANSWER Enlargement of nostrils with breathing (sign of respiratory
distress in infants)
