NBRC THERAPIST MULTIPLE-CHOICE SAE (FORM
2020 A)
A respiratory therapist is assisting a physician with endotracheal intubation. Which of
the following should be used INITIALLY to confirm tracheal intubation?
A. cm marking of the endotracheal tube
B. observable condensation in the tube
C. pulse oximetry
D. colorimetric capnography - Answers :D. colorimetric capnography
Colorimetric capnography assesses the presence of CO2 and provides confirmation of
tracheal intubation when CO2 is detected.
A respiratory therapist is asked to review a newborn's history. The following information
is available about the first few minutes after birth:
1 minute 5 minutes
Appearance acrocyanosis pink
Heart rate 70/min 110/min
Reflex cough cough
Muscle tone weak active motion
Respiratory rate 20/min 40/min
Which of the following
APGAR scores should the therapist expect to see for this infant?
1-minute 5-minute
1. 4 8
2. 5 8
3. 6 10
4. 7 10
A. 1
B. 2
C. 3
D. 4 - Answers :C. 3
The score for 1 minute is 6: acrocyanosis = 1, heart rate of 70/min = 1, cough = 2, weak
activity = 1, respiratory rate of 20/min = 1.
The score for 5 minutes is 10: pink = 2, heart rate of 110/min = 2, cough = 2, active
motion = 2, respiratory rate of 40/min = 2.
A 58-year-old female was diagnosed with bronchiectasis 3 years ago. She reports
increased cough and difficulty clearing secretions for the past 4 weeks. A chest
,radiograph shows no significant changes. Which of the following should the respiratory
therapist recommend FIRST?
A. transtracheal aspiration
B. airway clearance therapy
C. bronchodilator treatments
D. respiratory isolation - Answers :B. airway clearance therapy
The history, clinical presentation, and chest radiograph findings suggest worsening
bronchiectasis. The treatment of bronchiectasis includes techniques to loosen and
mobilize viscid secretions. Postural drainage enhances sputum clearance.
A 24-year-old female is diagnosed with exercise-induced asthma and albuterol prn is
ordered. A respiratory therapist should NEXT
A. refer the patient for allergy skin testing.
B. educate the patient on obtaining daily peak flow measurements.
C. instruct the patient to use albuterol 15 minutes before exercising.
D. suggest the patient use pursed lip breathing while exercising. - Answers :C. instruct
the patient to use albuterol 15 minutes before exercising.
Patient understanding of their disease process and triggers is important part of patient
education, as well as knowing when and which medication should be taken.
In which of the following circumstances will tracheal secretions tend to dry in an
intubated patient?
A. a water vapor pressure of 47 mm Hg
B. a relative humidity of 100% at 22°
C (71.6° F) C. a dew point of 37° C (98.6° F)
D. an absolute humidity of 44 mg/L - Answers :B. a relative humidity of 100% at 22°
The absolute humidity at this temperature is inadequate.
Prior to suctioning the endotracheal tube of an adult patient who is receiving ventilation
with an FIO2 of 0.40, a respiratory therapist should FIRST
A. lubricate the catheter.
B. hyperoxygenate the patient.
C. cleanse the catheter with water.
D. administer an FIO2 of 0.40 by T-piece. - Answers :B. hyperoxygenate the patient.
The FIO2 should be increased prior to each suctioning attempt to minimize hypoxemia
,A respiratory therapist is evaluating a 75-kg (165-lb), 180-cm (5-ft 11-in) male who is
receiving VC, SIMV. The following patient data are obtained:
FIO2 0.40
Mandatory rate 8 Total rate 8
VT 550 mL
PEEP 8 cm H2O
pH 7.27
PaCO2 55 mm Hg
PaO2 94 mm Hg
HCO3 - 25 mEq/L
BE -3 mEq/L
SaO2 (calc) 97%
Which of the following should the therapist recommend?
A. Maintain current settings.
B. Increase the mandatory rate to 12.
C. Decrease the FIO2 to 0.30.
D. Decrease the tidal volume to 450 mL. - Answers :B. Increase the mandatory rate to
12.
Increasing the mandatory rate will increase the V̇E. This should correct the respiratory
acidosis.
A 63-year-old patient with COPD is seen in the pulmonary clinic for a routine
appointment. The analysis results of an ABG sample drawn while the patient is
breathing air are:
pH 7.40
PCO2 57 mm Hg
PO2 42 mm Hg
HCO3 - 35 mEq/L
BE +8 mEq/L
SO2 (calc) 77%
Which of the following is the most appropriate NEXT step?
A. Schedule polysomnography.
B. Initiate supplemental oxygen.
C. Perform a 6-minute walk test.
D. Coach on deep breathing. - Answers :B. Initiate supplemental oxygen.
Administering oxygen and observing the patient is the appropriate therapy for a
hypoxemic patient with COPD, as indicated by the ABG analysis.
, A pulse oximeter can provide an accurate indication of a patient's oxyhemoglobin
saturation in which of the following clinical conditions?
1. congestive heart failure
2. polycythemia
3. pulmonary hypertension
4. carbon monoxide poisoning
A. 1, 2, and 3 only
B. 2, 3, and 4 only
C. 1, 2, and 4 only
D. 1, 3, and 4 only - Answers :A. 1, 2, and 3 only
Carbon monoxide poisoning will result in carboxyhemoglobin. Standard pulse oximetry
is unable to distinguish oxyhemoglobin from carboxyhemoglobin, which will lead to a
falsely elevated SpO2 reading.
A patient receiving mechanical ventilation by a portable ventilator is being transported
from the ED to radiology. Which of the following is required during transport?
A. bag-valve mask resuscitator
B. point-of-care blood gas analyzer
C. demand valve respirator
D. crash cart - Answers :A. bag-valve mask resuscitator
A. A bag-valve mask resuscitator is required in case of transport ventilator failure.
Mechanical ventilation was initiated for a patient, after which the PaCO2 decreased
from 53 to 40 mm Hg. A respiratory therapist should expect which of the following will
increase?
A. HCO3 -
B. pH
C. PETCO2
D. VD/VT - Answers :B. pH
Carbon dioxide and pH move in opposite directions, so a decrease in carbon dioxide will
result in an increase in pH.
According to CLIA standards, quality control must be performed for blood gas analyzers
every
A. 8 hours.
B. 48 hours.
C. 72 hours.
D. 24 hours. - Answers :A. 8 hours.
2020 A)
A respiratory therapist is assisting a physician with endotracheal intubation. Which of
the following should be used INITIALLY to confirm tracheal intubation?
A. cm marking of the endotracheal tube
B. observable condensation in the tube
C. pulse oximetry
D. colorimetric capnography - Answers :D. colorimetric capnography
Colorimetric capnography assesses the presence of CO2 and provides confirmation of
tracheal intubation when CO2 is detected.
A respiratory therapist is asked to review a newborn's history. The following information
is available about the first few minutes after birth:
1 minute 5 minutes
Appearance acrocyanosis pink
Heart rate 70/min 110/min
Reflex cough cough
Muscle tone weak active motion
Respiratory rate 20/min 40/min
Which of the following
APGAR scores should the therapist expect to see for this infant?
1-minute 5-minute
1. 4 8
2. 5 8
3. 6 10
4. 7 10
A. 1
B. 2
C. 3
D. 4 - Answers :C. 3
The score for 1 minute is 6: acrocyanosis = 1, heart rate of 70/min = 1, cough = 2, weak
activity = 1, respiratory rate of 20/min = 1.
The score for 5 minutes is 10: pink = 2, heart rate of 110/min = 2, cough = 2, active
motion = 2, respiratory rate of 40/min = 2.
A 58-year-old female was diagnosed with bronchiectasis 3 years ago. She reports
increased cough and difficulty clearing secretions for the past 4 weeks. A chest
,radiograph shows no significant changes. Which of the following should the respiratory
therapist recommend FIRST?
A. transtracheal aspiration
B. airway clearance therapy
C. bronchodilator treatments
D. respiratory isolation - Answers :B. airway clearance therapy
The history, clinical presentation, and chest radiograph findings suggest worsening
bronchiectasis. The treatment of bronchiectasis includes techniques to loosen and
mobilize viscid secretions. Postural drainage enhances sputum clearance.
A 24-year-old female is diagnosed with exercise-induced asthma and albuterol prn is
ordered. A respiratory therapist should NEXT
A. refer the patient for allergy skin testing.
B. educate the patient on obtaining daily peak flow measurements.
C. instruct the patient to use albuterol 15 minutes before exercising.
D. suggest the patient use pursed lip breathing while exercising. - Answers :C. instruct
the patient to use albuterol 15 minutes before exercising.
Patient understanding of their disease process and triggers is important part of patient
education, as well as knowing when and which medication should be taken.
In which of the following circumstances will tracheal secretions tend to dry in an
intubated patient?
A. a water vapor pressure of 47 mm Hg
B. a relative humidity of 100% at 22°
C (71.6° F) C. a dew point of 37° C (98.6° F)
D. an absolute humidity of 44 mg/L - Answers :B. a relative humidity of 100% at 22°
The absolute humidity at this temperature is inadequate.
Prior to suctioning the endotracheal tube of an adult patient who is receiving ventilation
with an FIO2 of 0.40, a respiratory therapist should FIRST
A. lubricate the catheter.
B. hyperoxygenate the patient.
C. cleanse the catheter with water.
D. administer an FIO2 of 0.40 by T-piece. - Answers :B. hyperoxygenate the patient.
The FIO2 should be increased prior to each suctioning attempt to minimize hypoxemia
,A respiratory therapist is evaluating a 75-kg (165-lb), 180-cm (5-ft 11-in) male who is
receiving VC, SIMV. The following patient data are obtained:
FIO2 0.40
Mandatory rate 8 Total rate 8
VT 550 mL
PEEP 8 cm H2O
pH 7.27
PaCO2 55 mm Hg
PaO2 94 mm Hg
HCO3 - 25 mEq/L
BE -3 mEq/L
SaO2 (calc) 97%
Which of the following should the therapist recommend?
A. Maintain current settings.
B. Increase the mandatory rate to 12.
C. Decrease the FIO2 to 0.30.
D. Decrease the tidal volume to 450 mL. - Answers :B. Increase the mandatory rate to
12.
Increasing the mandatory rate will increase the V̇E. This should correct the respiratory
acidosis.
A 63-year-old patient with COPD is seen in the pulmonary clinic for a routine
appointment. The analysis results of an ABG sample drawn while the patient is
breathing air are:
pH 7.40
PCO2 57 mm Hg
PO2 42 mm Hg
HCO3 - 35 mEq/L
BE +8 mEq/L
SO2 (calc) 77%
Which of the following is the most appropriate NEXT step?
A. Schedule polysomnography.
B. Initiate supplemental oxygen.
C. Perform a 6-minute walk test.
D. Coach on deep breathing. - Answers :B. Initiate supplemental oxygen.
Administering oxygen and observing the patient is the appropriate therapy for a
hypoxemic patient with COPD, as indicated by the ABG analysis.
, A pulse oximeter can provide an accurate indication of a patient's oxyhemoglobin
saturation in which of the following clinical conditions?
1. congestive heart failure
2. polycythemia
3. pulmonary hypertension
4. carbon monoxide poisoning
A. 1, 2, and 3 only
B. 2, 3, and 4 only
C. 1, 2, and 4 only
D. 1, 3, and 4 only - Answers :A. 1, 2, and 3 only
Carbon monoxide poisoning will result in carboxyhemoglobin. Standard pulse oximetry
is unable to distinguish oxyhemoglobin from carboxyhemoglobin, which will lead to a
falsely elevated SpO2 reading.
A patient receiving mechanical ventilation by a portable ventilator is being transported
from the ED to radiology. Which of the following is required during transport?
A. bag-valve mask resuscitator
B. point-of-care blood gas analyzer
C. demand valve respirator
D. crash cart - Answers :A. bag-valve mask resuscitator
A. A bag-valve mask resuscitator is required in case of transport ventilator failure.
Mechanical ventilation was initiated for a patient, after which the PaCO2 decreased
from 53 to 40 mm Hg. A respiratory therapist should expect which of the following will
increase?
A. HCO3 -
B. pH
C. PETCO2
D. VD/VT - Answers :B. pH
Carbon dioxide and pH move in opposite directions, so a decrease in carbon dioxide will
result in an increase in pH.
According to CLIA standards, quality control must be performed for blood gas analyzers
every
A. 8 hours.
B. 48 hours.
C. 72 hours.
D. 24 hours. - Answers :A. 8 hours.
