TMC EXAM NBRC- Questions and Answers
100% Verified
Whichzofzthezfollowingziszneededztozcalculatezalveolarzoxygenztension?
A.zVD/VT,zPAO2
B.zBPzandzFiO2
C.zPetCO2zandzPaO2
D.zQS/QT,zdeadspacez-zCORRECTzANSWER-B.
Barometriczpressure,zFiO2,zandzPaO2zarezallzincludedzinzthezformulaz(BPzstandszforzbarometriczpressure)
L/min/m2ziszthezunitzofzmeasurezfor:
A.zSystemiczvascularzresistance
B.zCardiaczoutputz
C.zCardiaczindex
D.zStrokezvolumez-zCORRECTzANSWER-C.
Azspontaneouslyzbreathingzpatientzhaszthezfollowingzarterialzbloodzgaszresults:
pHz7.38zPaCO2z42zmmHgPaO2z76zmmHgHCO3-z24zmEq/LBEz0zmEq/L
Whichzofzthezfollowingzsupplementalzoxygenzlevelsziszmostzappropriate?
z A.z2zL/minznasalzcannula
z B.z5zL/minznasalzcannula
z C.znon-rebreathingzmask
z D.zVenturizmaskzatz30%z-zCORRECTzANSWER-B.z
Azpatientzwhoziszshowingzsignszofzhypoxemiazshouldzreceivezsupplementalzoxygen.zIfzthezpatientzisznotzazC
OPDzpatientzandzthezsituationzisznotzanzemergency,zthenzthezproperzsupplementalzoxygenziszanzadultzther
apeuticzdose,zwhichzisz40%ztoz55%.zOfzthezoptionszavailablezonlyz5zL/minznasalzcannulazwillzapproachzthis.
zOtherzoptionszarezeitherzinsufficientzorztoozmuch.
Leftzheartzfailurezwouldzbezmanifestedzinzwhichzofzthezfollowingzvalues?
,z A.zCVPzandzmPAP
z B.zmPAPzandzwedgezpressure
z C.zMAPzandzSVR
z D.zcardiaczoutputzandzwedgezpressurez-zCORRECTzANSWER-D.z
Thezfunctionzofzthezleftzheart,zspecificallyzthezleftzventricle,ziszbestzassessedzhemodynamicallyzbyzlookingz
atzthosezvalueszthatzprecedezandzcomezafterzthezleftzheart.zInzthiszcasezpulmonaryzcapillaryzwedgezpressu
rezandzcardiaczoutputz(orzcardiaczindex)zarezthezvalueszfoundzbeforezandzafterzthezleftzheart.
Whichzofzthezfollowingzfindingsziszmostzcloselyzassociatedzwithzincreasedzairwayzresistance?
z A.zreducedzSpO2
z B.zaccessoryzmusclezuse
z C.zalteredzP50
z D.zincreasedzPetCO2z-zCORRECTzANSWER-B.
Ofzthezoptionszgiven,zusezofzaccessoryzmusclesziszmostzcloselyzassociatedzwithzanzincreasezinzairwayzresist
ance.zThisziszespeciallyztruezwithzpatientszwhozhavezasthmazorzotherztypeszofzupperzairwayzinflammationz
orzbronchoconstriction.
Forzazpatientzreceivingzvolume-
controlledzmechanicalzventilation,zthezlowerzinflectionzpointzonzazpressure-
volumezloopzcanzbestzbezdescribedzas:
z A.zamountzofzpressurezrequiredztozkeepzthezalveolizandzsmallzairwayszopen
z B.zoptimalzPEEP
z C.zminimalzPEEP
z D.zupperzlimitzofzresidualzvolumez-zCORRECTzANSWER-A.z
Thezlowestzinflectionzpointzonzazpressure-
volumezventilatorzgraphicziszanzindicationzofzthezminimumzpressurezneededztozkeepzalveolizopen.
ThezresultszofzazV/Qzscanzshowszpoorzperfusionzwithzadequatezventilation.zAzchestzradiographzshowszazwe
dge-shapedzinfiltratezoverzthezrightzlungzfield.zThezpatientzmostzlikelyzhas
z A.zfluidzoverload
z B.zARDS
z C.zazpulmonaryzembolism
,z D.zpneumoniaz-zCORRECTzANSWER-C.z
AzVQzscanzthatzshowszpoorzperfusionzbutzadequatezventilationziszmostzcloselyzassociatedzwithzazpulmonar
yzembolism.zSupportivezdataziszfoundzinzthezradiologicalzreportzofzwedge-shapedzinfiltrates.
Thezrespiratoryztherapistznoteszinzthezmedicalzrecordzofzaz65-year-
oldzmalezthatzthezpatientziszorderedztozreceivezbronchodilatorztherapyzwithzAlbuterol.zTheztherapistzalsoz
noteszthezpatientziszreceivingzbeta-blockerzmedication.zTheztherapistzshouldzrecommend
z A.zAdministerzDexamethasonez(Decadron)zinzplacezofzAlbuterol
z B.zAddzXopenexztozthezbronchodilatorzregimen
z C.zReplacezAlbuterolzwithzBeclamethasonez(Beclovent)
z D.zSwitchzfromzAlbuterolztozipratropiumzbromidez(Atrovent)z-zCORRECTzANSWER-D.
Becausezalbuterolziszazbeta-agonistzmedication,zpatientszwhozareztakingzbeta-
blockerszshouldzutilizezotherzbronchodilationzmedication.
Azhospitalzhaszanzextremelyzlowzincidencezofzventilator-
associatedzpneumonia.zTozwhichzofzthezfollowingzreasonszmayzthiszbezattributed?
z A.zperiodiczdiscontinuationzofzsedation
z B.zusezofzrespiratoryzprecautionszwithzthezpopulation
z C.zdiversionzofzinfectiouszpatientsztozotherzfacilities
z D.zbroadzusezofzprophylacticzantibioticsz-zCORRECTzANSWER-A.z
Thezincidencezofzventilator-
associatedzpneumonia,zorzVAP,ziszloweredzbyzusingzazclosedzsystemzsuctionzcatheter,zperiodicallyzdisconti
nuingzsedation,zkeepingzthezpatientzandzsemi-
Fowler'szposition,zandzproperzhandwashingzamongzcaregivers.zAllzarezcorrect.
Azpressure-
volumezloopzventilatorzgraphiczshowsznozrisezinzpressurezforzthezfirstz200zmLzofzdeliveredzvolume.zThezthe
rapistzshould
z A.zincreasezinspiratoryzflowzrate
z B.zincreasezPEEP
z C.zdecreaseztidalzvolume
z D.zdecreasezinspiratoryzflowzratez-zCORRECTzANSWER-B.
, Inzthiszquestionzthezdescriptionzofzthezpressurezvolumezloopzwouldzindicatezazflatzbottomzaszmanifestedzb
yznozrisezinzpressurezwithzthezfirstz200zmLzofzdeliveredzvolume.zWezcallzthiszaz"flatzfootball".zThezsolutionzi
sztozincreasezPEEPztozazlevelzthatzthezpressurezbeginsztozrisezimmediatelyzaszvolumeziszintroduced.
Whichzofzthezfollowingzwouldzbezthezmostzeffective,zappropriatezmethodzforzresolvingzatelectasiszinzazspo
ntaneouslyzbreathing,zpostzoperativezpatientzwhoziszunderzthezinfluencezofzsedationzandzwillznotzrespondz
tozverbalzstimuli?
z A.zIPPB
z B.zsustainedzmaximalzinhalationz(incentivezspirometer)
z C.zdeepzbreathingzcoaching
z D.zintubationzandzmechanicalzventilationz-zCORRECTzANSWER-A.z
Azpostoperativezpatientzunderzsedation,zandzpossiblyzinzpain,zmayzbeztemptedztozbreathezless,zcausingzres
piratoryzacidosiszandzatelectasis.zTozcorrectzthiszproblem,zIPPBztherapyziszmostzappropriate.zIncentivezspir
ometryzwouldzalsozhelpzbutzthezpatientziszunableztozrespondztozverbalzstimuli.zThiszaloneziszanzindicationzf
orzIPPBztherapy.
Afterzperformingzminimumzoccludingzvolumeztechniquezwithzaz65-kgz(143-
lb)zpatientzwhoziszorallyzintubatedzwithzaz7.0-mmzETztube,zthezrespiratoryztherapistzshouldzNEXT
z A.zcheckzETztubezcuffzpressure
z B.zperformztrachealzpalpation
z C.zorderzazchestzradiograph
z D.zdocumentzETztubezmarkingszatzthezlipsz-zCORRECTzANSWER-A.
ThezETztubezcuffzpressurezmayzbezadjustedzcorrectlyzbyzseveralztechniqueszincludingzminimumzleakztechni
quez(alsozcalledzminimumzoccludingzvolume,zminimalzsealztechnique,zandzthezusezofzazpressurezmanomet
erzcalledzazcuffalator.zIfzminimumzsealzorzminimalzleakztechniqueziszused,zthezrespiratoryztherapistziszstillzr
equiredztozmonitorzthezpressurezafterztheztechniqueziszperformed.zAlthoughzthisziszoftenznotzdonezinzrealz
life,zitzisztechnicallyzpartzofzthezprocedure.
ThezrespiratoryztherapistzobserveszanzECGzwavezformzonzazpatientzthatziszconsistentzwithzatrialztachycardi
a.zThezpatientziszcomplainingzofzchestzpain,zdizziness,zandznausea.zThezrespiratoryztherapistzshouldzrecom
mend
z A.zunsynchronizedzdefibrillation
z B.zAtropinezsulfate
z C.zepinephrine
100% Verified
Whichzofzthezfollowingziszneededztozcalculatezalveolarzoxygenztension?
A.zVD/VT,zPAO2
B.zBPzandzFiO2
C.zPetCO2zandzPaO2
D.zQS/QT,zdeadspacez-zCORRECTzANSWER-B.
Barometriczpressure,zFiO2,zandzPaO2zarezallzincludedzinzthezformulaz(BPzstandszforzbarometriczpressure)
L/min/m2ziszthezunitzofzmeasurezfor:
A.zSystemiczvascularzresistance
B.zCardiaczoutputz
C.zCardiaczindex
D.zStrokezvolumez-zCORRECTzANSWER-C.
Azspontaneouslyzbreathingzpatientzhaszthezfollowingzarterialzbloodzgaszresults:
pHz7.38zPaCO2z42zmmHgPaO2z76zmmHgHCO3-z24zmEq/LBEz0zmEq/L
Whichzofzthezfollowingzsupplementalzoxygenzlevelsziszmostzappropriate?
z A.z2zL/minznasalzcannula
z B.z5zL/minznasalzcannula
z C.znon-rebreathingzmask
z D.zVenturizmaskzatz30%z-zCORRECTzANSWER-B.z
Azpatientzwhoziszshowingzsignszofzhypoxemiazshouldzreceivezsupplementalzoxygen.zIfzthezpatientzisznotzazC
OPDzpatientzandzthezsituationzisznotzanzemergency,zthenzthezproperzsupplementalzoxygenziszanzadultzther
apeuticzdose,zwhichzisz40%ztoz55%.zOfzthezoptionszavailablezonlyz5zL/minznasalzcannulazwillzapproachzthis.
zOtherzoptionszarezeitherzinsufficientzorztoozmuch.
Leftzheartzfailurezwouldzbezmanifestedzinzwhichzofzthezfollowingzvalues?
,z A.zCVPzandzmPAP
z B.zmPAPzandzwedgezpressure
z C.zMAPzandzSVR
z D.zcardiaczoutputzandzwedgezpressurez-zCORRECTzANSWER-D.z
Thezfunctionzofzthezleftzheart,zspecificallyzthezleftzventricle,ziszbestzassessedzhemodynamicallyzbyzlookingz
atzthosezvalueszthatzprecedezandzcomezafterzthezleftzheart.zInzthiszcasezpulmonaryzcapillaryzwedgezpressu
rezandzcardiaczoutputz(orzcardiaczindex)zarezthezvalueszfoundzbeforezandzafterzthezleftzheart.
Whichzofzthezfollowingzfindingsziszmostzcloselyzassociatedzwithzincreasedzairwayzresistance?
z A.zreducedzSpO2
z B.zaccessoryzmusclezuse
z C.zalteredzP50
z D.zincreasedzPetCO2z-zCORRECTzANSWER-B.
Ofzthezoptionszgiven,zusezofzaccessoryzmusclesziszmostzcloselyzassociatedzwithzanzincreasezinzairwayzresist
ance.zThisziszespeciallyztruezwithzpatientszwhozhavezasthmazorzotherztypeszofzupperzairwayzinflammationz
orzbronchoconstriction.
Forzazpatientzreceivingzvolume-
controlledzmechanicalzventilation,zthezlowerzinflectionzpointzonzazpressure-
volumezloopzcanzbestzbezdescribedzas:
z A.zamountzofzpressurezrequiredztozkeepzthezalveolizandzsmallzairwayszopen
z B.zoptimalzPEEP
z C.zminimalzPEEP
z D.zupperzlimitzofzresidualzvolumez-zCORRECTzANSWER-A.z
Thezlowestzinflectionzpointzonzazpressure-
volumezventilatorzgraphicziszanzindicationzofzthezminimumzpressurezneededztozkeepzalveolizopen.
ThezresultszofzazV/Qzscanzshowszpoorzperfusionzwithzadequatezventilation.zAzchestzradiographzshowszazwe
dge-shapedzinfiltratezoverzthezrightzlungzfield.zThezpatientzmostzlikelyzhas
z A.zfluidzoverload
z B.zARDS
z C.zazpulmonaryzembolism
,z D.zpneumoniaz-zCORRECTzANSWER-C.z
AzVQzscanzthatzshowszpoorzperfusionzbutzadequatezventilationziszmostzcloselyzassociatedzwithzazpulmonar
yzembolism.zSupportivezdataziszfoundzinzthezradiologicalzreportzofzwedge-shapedzinfiltrates.
Thezrespiratoryztherapistznoteszinzthezmedicalzrecordzofzaz65-year-
oldzmalezthatzthezpatientziszorderedztozreceivezbronchodilatorztherapyzwithzAlbuterol.zTheztherapistzalsoz
noteszthezpatientziszreceivingzbeta-blockerzmedication.zTheztherapistzshouldzrecommend
z A.zAdministerzDexamethasonez(Decadron)zinzplacezofzAlbuterol
z B.zAddzXopenexztozthezbronchodilatorzregimen
z C.zReplacezAlbuterolzwithzBeclamethasonez(Beclovent)
z D.zSwitchzfromzAlbuterolztozipratropiumzbromidez(Atrovent)z-zCORRECTzANSWER-D.
Becausezalbuterolziszazbeta-agonistzmedication,zpatientszwhozareztakingzbeta-
blockerszshouldzutilizezotherzbronchodilationzmedication.
Azhospitalzhaszanzextremelyzlowzincidencezofzventilator-
associatedzpneumonia.zTozwhichzofzthezfollowingzreasonszmayzthiszbezattributed?
z A.zperiodiczdiscontinuationzofzsedation
z B.zusezofzrespiratoryzprecautionszwithzthezpopulation
z C.zdiversionzofzinfectiouszpatientsztozotherzfacilities
z D.zbroadzusezofzprophylacticzantibioticsz-zCORRECTzANSWER-A.z
Thezincidencezofzventilator-
associatedzpneumonia,zorzVAP,ziszloweredzbyzusingzazclosedzsystemzsuctionzcatheter,zperiodicallyzdisconti
nuingzsedation,zkeepingzthezpatientzandzsemi-
Fowler'szposition,zandzproperzhandwashingzamongzcaregivers.zAllzarezcorrect.
Azpressure-
volumezloopzventilatorzgraphiczshowsznozrisezinzpressurezforzthezfirstz200zmLzofzdeliveredzvolume.zThezthe
rapistzshould
z A.zincreasezinspiratoryzflowzrate
z B.zincreasezPEEP
z C.zdecreaseztidalzvolume
z D.zdecreasezinspiratoryzflowzratez-zCORRECTzANSWER-B.
, Inzthiszquestionzthezdescriptionzofzthezpressurezvolumezloopzwouldzindicatezazflatzbottomzaszmanifestedzb
yznozrisezinzpressurezwithzthezfirstz200zmLzofzdeliveredzvolume.zWezcallzthiszaz"flatzfootball".zThezsolutionzi
sztozincreasezPEEPztozazlevelzthatzthezpressurezbeginsztozrisezimmediatelyzaszvolumeziszintroduced.
Whichzofzthezfollowingzwouldzbezthezmostzeffective,zappropriatezmethodzforzresolvingzatelectasiszinzazspo
ntaneouslyzbreathing,zpostzoperativezpatientzwhoziszunderzthezinfluencezofzsedationzandzwillznotzrespondz
tozverbalzstimuli?
z A.zIPPB
z B.zsustainedzmaximalzinhalationz(incentivezspirometer)
z C.zdeepzbreathingzcoaching
z D.zintubationzandzmechanicalzventilationz-zCORRECTzANSWER-A.z
Azpostoperativezpatientzunderzsedation,zandzpossiblyzinzpain,zmayzbeztemptedztozbreathezless,zcausingzres
piratoryzacidosiszandzatelectasis.zTozcorrectzthiszproblem,zIPPBztherapyziszmostzappropriate.zIncentivezspir
ometryzwouldzalsozhelpzbutzthezpatientziszunableztozrespondztozverbalzstimuli.zThiszaloneziszanzindicationzf
orzIPPBztherapy.
Afterzperformingzminimumzoccludingzvolumeztechniquezwithzaz65-kgz(143-
lb)zpatientzwhoziszorallyzintubatedzwithzaz7.0-mmzETztube,zthezrespiratoryztherapistzshouldzNEXT
z A.zcheckzETztubezcuffzpressure
z B.zperformztrachealzpalpation
z C.zorderzazchestzradiograph
z D.zdocumentzETztubezmarkingszatzthezlipsz-zCORRECTzANSWER-A.
ThezETztubezcuffzpressurezmayzbezadjustedzcorrectlyzbyzseveralztechniqueszincludingzminimumzleakztechni
quez(alsozcalledzminimumzoccludingzvolume,zminimalzsealztechnique,zandzthezusezofzazpressurezmanomet
erzcalledzazcuffalator.zIfzminimumzsealzorzminimalzleakztechniqueziszused,zthezrespiratoryztherapistziszstillzr
equiredztozmonitorzthezpressurezafterztheztechniqueziszperformed.zAlthoughzthisziszoftenznotzdonezinzrealz
life,zitzisztechnicallyzpartzofzthezprocedure.
ThezrespiratoryztherapistzobserveszanzECGzwavezformzonzazpatientzthatziszconsistentzwithzatrialztachycardi
a.zThezpatientziszcomplainingzofzchestzpain,zdizziness,zandznausea.zThezrespiratoryztherapistzshouldzrecom
mend
z A.zunsynchronizedzdefibrillation
z B.zAtropinezsulfate
z C.zepinephrine
