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TMC NBRC ACTUAL PRACTICE EXAM 1
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LATEST 2025 ACTUAL EXAM COMPLETE 550
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The emergency room physician is concerned about a patient who was in involved in a
multiple-vehicle accident. The patient is unconscious and has obvious signs of aspiration of
gastric contents. A quick assessment reveals significant trauma to the neck and the area of
the trachea. To protect the airway, the respiratory therapist should recommend which of the
following?
A. insertion of an oral airway
B. blind nasal intubation
C. insertion of a nasopharyngeal airway
D. oral intubation with a bronchoscope
A+ TEST BANK 1
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D.
Because this patient is unconscious, and has obviously been vomiting, a primary concern is
that of aspiration. This may be prevented by establishing an airway through oral intubation.
Because the patient has obvious trauma to the neck and trachea this intubation would be
considered complex and therefore should be done with the assistance of a bronchoscope or
in surgery where an emergency tracheotomy could be done if needed.
While providing manual ventilation with a bag-valve assembly to a patient immediately
following oral intubation, the respiratory therapist notices there is very little chest movement
with each manual inspiration, the bag-valve is easier than normal to squeeze, and a "hissing"
sound can be heard during manual inspiratory attempts. The respiratory therapist should
A. obtain another bag-valve device
B. remove the inlet valve on the resuscitation bag device
C. increase the oxygen flow to the bag-valve device
D. extubate and begin bag-valve ventilation with an inflatable mask
A.
This bag-valve is obviously not functioning correctly. When this happens, the first, quickest,
and best action is to replace the device altogether. If this is not possible then some minor
troubleshooting may be done if it can be done quickly.
A post-op adult patient achieved an inspiratory capacity of 1800 cc with an incentive
spirometer prior to surgery. After the surgery, the patient appears to be confused on how to
use the incentive spirometer. The therapist notes the patient is having difficulty getting the
balls to rise. The therapist should
A. administer oxygen at 5 L/min nasal cannula
B. coach the patient more diligently
C. switch to a volume-type device
D. assess the patient for the cause of the confusion
A+ TEST BANK 2
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C.
Incentive spirometry comes in two types: a flow type, which requires keeping balls floating,
and the volume type, which simply measures inspiratory capacity. The volume type of
incentive spirometer is considered to be the easiest. It is appropriate to switch to a volume
spirometer when the patient is having difficulty with a flow type spirometer.
Which of the following is the correct postural position for drainage of the right lateral
segment?
A. right side, HOB down 12 inches
B. left side, HOB down 18 inches
C. flat on stomach, HOB down 18 inches
D. supine and slightly rotated to the left, HOB down 12 inches
B.
The right lateral segment is drained with the head of bed down 18 inches with the patient
lying on the left side.
A respiratory supervisor is calculating appropriate staffing levels for a shift. Which of the
following should be included in calculation?
A. staff member preferences
B. patient medical history
C. patient areas and locations
D. frequency of refused therapy
C.
To plan for patient care, staffing must be appropriate. Conditions that affect the amount of
staff needed include location of patients (how far staff must travel to get to patients),
frequency of ordered therapy (how frequently staff must visit the patient), and the type of
therapy (how long the therapy will take). The patient's medical history will not likely affect
staffing.
A+ TEST BANK 3
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A 183-cm (6-ft), 78-kg (171-lb) male patient with ARDS has the following ABGs while receiving
PC, A/C ventilatory support:
pH 7.28 PaCO2 52 mm HgPaO2 62 mm HgHCO3- 27 mEq/LBE -5 mEq/L Ventilator settings: FIO2
0.6PEEP 18 cm H2OVT(exhaled) 400 mLIP 36 cm H2OIT% 33%(f) 16/min
The respiratory therapist should recommend
A. increasing the inspiratory pressure.
B. increasing FIO2.
C. increasing PEEP.
D. reducing the rate.
A
Which of following calculations will determine inspiratory capacity (IC)?
A. TLC - VT - ERV
B. TLC - FRC
C. ERV + VT + IRV
D. IRV - TLC - RV
B.
These types of questions can be difficult. Memorizing pulmonary function volume chart is a
good place to start. To find a solution to this problem you generally have to take each answer
one by one, do the calculation, and determine if the correct result can be achieved. In this
case, inspiratory capacity can be calculated by subtracting the FRC from the TLC.
A patient is transferred to the intensive care unit after abdominal surgery. Vital signs are
observed within 20 minutes of arrival. BP 90/58 mm Hg and SpO2 97% on a 40% air-
entrainment mask. The patient's color is dusky. The respiratory therapist should
A. check Hb level
B. administer anticoagulant therapy
C. assess INR
D. institute volume ventilation
A+ TEST BANK 4