Kettering Study Guide for TMC Exam
What assessments would determine how well a patient is ventilating?
- RR
- Vt
- Chest movement
- Breath Sounds
- PaCO2
- ETCO2
Patient Assessment pg.A-4
How would the therapist determine if a patient has a problem with oxygenation?
- HEART RATE
- Color (cyanosis is a late sign of hypoxemia)
- Sensorium (due to lack of O2 to the brain)
- PaO2
- SpO2
Patient Assessment pg.A-4
What information would help the therapist determine if a patient's circulation is
adequate?
- Heart Rate and strength ( what is the characteristic of the pulse? It is Strong and
bounding or weak and thready).
- Cardiac output
Patient Assessment pg.A-4
What changes might indicate that a patient may not have adequate perfusion
(getting the blood to the final tissue area)?
- Blood pressure (primary assessment for perfusion).
- Sensorium
- Temperature (does the patient feel cold and clammy?)
- Urine output (this is a sign of poor perfusion bc if a pt is not perfusing the kidneys they
won't put out urine and they may not be perfusing other parts of the body either).
term-8
- Hemodynamics
Patient Assessment pg.A-4
TRUE or FALSE
Of the four critical life functions the most common problem is with oxygenation.
TRUE
NOTE: If there is a question on the exam designed to be vague and incomplete and it
asks what would you recommend first as it relates to therapy you would select to give
oxygen, especially if there is no problem with ventilation.
Patient Assessment pg.A-4
What is the difference between a sign and a symptom?
A sign is objective information, things that clinicians can see and measure. A
symptom is subjective information, things that the patient must tell you.
Examples of signs: Color, pulse, edema, blood pressure, and etc.
, Examples of symptoms: Dyspnea, pain, nausea, muscle weakness and etc.
Patient Assessment pg.A-4term-8
What is the first step in Patient Assessment ?
Reviewing the patient's record is the first step to patient's assessment. If you had
a brand new patient you would start by viewing their chart and you would look at their
record and get a background to find out all that you can.
NOTE: When taking the NBRC TMC Exam Remember that the environment is not
reality. You have to answer questions the NBRC way.
Patient Assessment pg.A-4
What are the 5 items that are important to examine when reviewing a patient's
medical record ?
- Admitting diagnosis
- History of present illness
- Chief complaint
- Past Medical History
- Current Medications
Patient Assessment pg.A-4
What is an advanced directive ?
An Advanced Directive is a set of instructions documenting what treatment a
patient would want if he/she was able to make medical decisions.
NOTE: Look for an advanced directive in COPD patients or patients with other
terminal illnesses.
Patient Assessment pg.A-4
What kind of advanced directive is a DNR?
DNR means do not resuscitate. This means the patient does not wish to have any
cardiopulmonary resuscitation performed.
Patient Assessment pg.A-6
According to Kettering, what are life functions?
Getting Oxygen from the air to all of the cells of the body.
Patient Assessment pg.A-4
What are the four critical life functions?
1. Ventilation: The patient needs to be breathing and getting/moving air in and out
of the lungs. If a patient stops breathing (ventilating) are you going to come back
tomorrow ? NO. You are going to treat the before they die.
2. Oxygenation: This getting oxygen to the blood. This is the second priority bc a
patient can be ventilating but still be hypoxic. A patient will not oxygenate if they aren't
ventilating though so ventilation is first priority.
3. Circulation: This is moving the blood through the body. It doesn't matter how
good someone is ventilating/oxygenating if the blood is not moving around in the body.
Imagine if someone has a good ventilation/oxygenation but their heart stops? The
4. Perfusion: This is Getting oxygen into the tissue. Imagine of you give someone a
drug they are allergic to and they go into shock? This will keep the oxygen from getting
to it's final destination (the tissues) and the pt can die from this.
NOTE: These are the four steps in delivering oxygen from the air to every cell in
the body. These steps are listed in order of priority.
Patient Assessment pg.A-4
What assessments would determine how well a patient is ventilating?
- RR
- Vt
- Chest movement
- Breath Sounds
- PaCO2
- ETCO2
Patient Assessment pg.A-4
How would the therapist determine if a patient has a problem with oxygenation?
- HEART RATE
- Color (cyanosis is a late sign of hypoxemia)
- Sensorium (due to lack of O2 to the brain)
- PaO2
- SpO2
Patient Assessment pg.A-4
What information would help the therapist determine if a patient's circulation is
adequate?
- Heart Rate and strength ( what is the characteristic of the pulse? It is Strong and
bounding or weak and thready).
- Cardiac output
Patient Assessment pg.A-4
What changes might indicate that a patient may not have adequate perfusion
(getting the blood to the final tissue area)?
- Blood pressure (primary assessment for perfusion).
- Sensorium
- Temperature (does the patient feel cold and clammy?)
- Urine output (this is a sign of poor perfusion bc if a pt is not perfusing the kidneys they
won't put out urine and they may not be perfusing other parts of the body either).
term-8
- Hemodynamics
Patient Assessment pg.A-4
TRUE or FALSE
Of the four critical life functions the most common problem is with oxygenation.
TRUE
NOTE: If there is a question on the exam designed to be vague and incomplete and it
asks what would you recommend first as it relates to therapy you would select to give
oxygen, especially if there is no problem with ventilation.
Patient Assessment pg.A-4
What is the difference between a sign and a symptom?
A sign is objective information, things that clinicians can see and measure. A
symptom is subjective information, things that the patient must tell you.
Examples of signs: Color, pulse, edema, blood pressure, and etc.
, Examples of symptoms: Dyspnea, pain, nausea, muscle weakness and etc.
Patient Assessment pg.A-4term-8
What is the first step in Patient Assessment ?
Reviewing the patient's record is the first step to patient's assessment. If you had
a brand new patient you would start by viewing their chart and you would look at their
record and get a background to find out all that you can.
NOTE: When taking the NBRC TMC Exam Remember that the environment is not
reality. You have to answer questions the NBRC way.
Patient Assessment pg.A-4
What are the 5 items that are important to examine when reviewing a patient's
medical record ?
- Admitting diagnosis
- History of present illness
- Chief complaint
- Past Medical History
- Current Medications
Patient Assessment pg.A-4
What is an advanced directive ?
An Advanced Directive is a set of instructions documenting what treatment a
patient would want if he/she was able to make medical decisions.
NOTE: Look for an advanced directive in COPD patients or patients with other
terminal illnesses.
Patient Assessment pg.A-4
What kind of advanced directive is a DNR?
DNR means do not resuscitate. This means the patient does not wish to have any
cardiopulmonary resuscitation performed.
Patient Assessment pg.A-6
According to Kettering, what are life functions?
Getting Oxygen from the air to all of the cells of the body.
Patient Assessment pg.A-4
What are the four critical life functions?
1. Ventilation: The patient needs to be breathing and getting/moving air in and out
of the lungs. If a patient stops breathing (ventilating) are you going to come back
tomorrow ? NO. You are going to treat the before they die.
2. Oxygenation: This getting oxygen to the blood. This is the second priority bc a
patient can be ventilating but still be hypoxic. A patient will not oxygenate if they aren't
ventilating though so ventilation is first priority.
3. Circulation: This is moving the blood through the body. It doesn't matter how
good someone is ventilating/oxygenating if the blood is not moving around in the body.
Imagine if someone has a good ventilation/oxygenation but their heart stops? The
4. Perfusion: This is Getting oxygen into the tissue. Imagine of you give someone a
drug they are allergic to and they go into shock? This will keep the oxygen from getting
to it's final destination (the tissues) and the pt can die from this.
NOTE: These are the four steps in delivering oxygen from the air to every cell in
the body. These steps are listed in order of priority.
Patient Assessment pg.A-4
