NBRC 2026 Practice Questions & Explanations
– Exam Prep | Graded 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 ETT
B. observable condensation in the tube
C. pulse oximetry
D. colorimetric capnography - correct answerCorrect answer:
D. colorimetric capnography
Explanation:
A. the cm mark of the ETT is an indicator of depth of insertion, but does not confirm
placement in the trachea
B. condensation is often associated with intubation, but is not confirmation of correct
placement.
C. pulse ox is an assessment of oxygenation and does not provide confirmation of
tracheal placement
D. colorimetric capnography assesses the presence of CO2 and provides confirmation
of tracheal intubation due to detection of CO2
A respiratory therapist is asked to review a newborn's history. The following information
is available about the first few minutes after birth:
After 1 minute: appearance is acrocyanotic, heart rate is 70 b/m, reflexes include cough,
muscle tone is weak, and RR is 20 br/m.
After 5 minutes: appearance is pink, heart rate is 110 b/m, reflexes include cough,
muscle tone shows active motion, and RR is 40 br/m
Which of the following APGAR scores should the therapist expect to see for this infant?
A. 4 at 1 min, 8 at 5 mins
B. 5 at 1 min, 8 at 5 mins
C. 6 at 1 min, 10 at 5 mins
D. 7 at 1 min, 10 at 5 mins - correct answerCorrect answer:
C. 6 at 1 min, 10 at 5 mins
Explanation:
APGAR = appearance (color), pulse (HR), grimace (reflex/irritability), activity (muscle
tone), and respirations
,According to the scoring chart, the score for 1 minute is acrocyanosis (1) + low HR (1) +
cough (2) + weak activity (1), and low RR (1) = 6
According to the scoring chart, the score for 5 minutes is pink (2), normal HR (2), cough
(2), active motion (2), and normal RR (2) = 10
A 58-year-old female was dx with bronchiectasis 3 years ago. She reports increased
cough and difficulty clearing secretions for the past 4 weeks. A CXR shows no
significant changes. Which of the following should the RT recommend FIRST?
A. transtracheal aspiration
B. airway clearance therapy
C. bronchodilator treatments
D. respiratory isolation - correct answerCorrect answer:
B. airway clearance therapy
Explanation:
A. while a sputum sample may be requested, transtracheal aspiration would be
unnecessarily invasive as the patient is able to produce a sputum sample on her own
B the hx, clinical presentation, and CXR findings suggest worsening bronchiectasis. The
tx of bronchiectasis includes techniques to loosen and mobilize viscid secretions.
Postural drainage enhances sputum clearance.
C. bronchodilator therapy alone will not aid in secretion removal
D. there is no indication of this patient having a communicable disease. The dx of
bronchiectasis was established 3 years ago
A 24-year-old female is dx with exercise-induced asthma and albuterol prn is ordered. A
RT should NEXT:
A. refer the pt for allergy skin testing
B. educate the pt on obtaining daily peak flow measurements
C. instruct the pt to use albuterol 15 mins before exercising
D. suggest that the pt use pursed lip breathing while exercising - correct answerCorrect
answer:
C. instruct the patient to use albuterol 15 mins before exercising
Explanation:
A. allergy skin testing is not a routine part of EIA management
B. daily peak flow measurements will not be helpful for EIA
C. patient understanding of their disease process and triggers is important part of pt
education, as well as knowing when and which medication should be taken and how to
take it
D. pursed lip breathing is not helpful for EIA
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 - correct answerCorrect answer:
B. a relative humidity of 100% at 22*C (71.6*F)
Explanation:
A. a water vapor pressure of 47 mm Hg provides 100% humidity at body temperature
B. the absolute humidity at this temperature is inadequate
C. a dew point of 37*C or 98.6*F indicates that the gas is completely saturated at that
temperature
D. the absolute tracheal humidity must be greater than or equal to 30 mg/L
Prior to suctioning the ETT of an adult patient who is receiving ventilation with an FiO2
of 0.4, an RT should FIRST:
A. lubricate the catheter
B. hyperoxygenate the pt
C. cleanse the catheter with water
D. administer an FiO2 of 0.4 by t-piece - correct answerCorrect answer:
B. hyperoxygenate the pt
Explanation:
A. lubricating the catheter is not necessary unless nasotracheal suctioning (without an
artificial airway in the nare) will be performed
B. the FiO2 should be increased prior to each suctioning attempt to minimize hypoxemia
C. sterile and in-line suction catheters do not need to be cleansed prior to use
D. administration of the same FiO2 without positive pressure will compromise the
patient's oxygenation and ventilation
A 25-year-old patient with apnea is receiving pressure-control ventilation. ABG analysis
results are as follows:
pH 7.2
pCO2 65 mm Hg
pO2 70 mm Hg
HCO3 25 mEq/L
BE -4 mEq/L
SO2 94%
An RT should recommend increasing the ___.
A. set inspiratory pressure
B. expiratory time
C. sensitivity
D. peak flow - correct answerCorrect Answer:
, A. set inspiratory pressure
Explanation:
A. in pressure control ventilation, increasing the inspiratory pressure will result in an
increased Vt and minute ventilation, potentially causing a decrease in pCO2
B. increasing expiratory time is the same thing as decreasing the inspiratory time, which
will decrease Vt and minute ventilation. In this case (respiratory acidosis), we would
want to increase the Vt and minute ventilation. Increasing expiratory time will potentially
cause an increase in pCO2 and further decrease pH
C. increasing sensitivity will not increase ventilation in this patient
D. peak flow cannot be set in pressure control ventilation
A 68-year-old pt who is post-CABG was extubated 4 hours ago and complains of
increasing SOB. The breath sounds are decreased over the right lung field. The
following data are available while the pt receives 4L nasal cannula.
HR 103 b/m
RR 27 br/m
BP 155/90 mm Hg
SpO2 90%
Which of the following studies should a RT recommend FIRST?
A. bedside spirometry
B. chest CT with contrast
C. ventilation/perfusion scan
D. CXR - correct answerCorrect answer:
D. CXR
Explanation:
A. while spirometry may be performed prior to surgery to determine the presence of
pulmonary abnormalities, it will not provide useful diagnostic information this soon
following extubation
B. a CT scan with contrast could identify a pulmonary embolus or fluid collection, but
this would not be the most appropriate next step in evaluating the pt
C. V/Q scans are useful to identify pulmonary embolus in select pt populations, but this
would not be the most appropriate next step in evaluating the pt
D. based on the timing of symptoms, the dyspnea could be due to pneumothorax, chest
tube malfunction, lobar collapse, or accumulation of pleural fluid. A CXR can be
obtained quickly to identify any of these issues
Which of the following medications should a RT use to anesthetize a pt's airway prior to
a flexible bronchoscopy procedure?
A. lidocaine HCl
B. midazolam HCl (versed)
– Exam Prep | Graded 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 ETT
B. observable condensation in the tube
C. pulse oximetry
D. colorimetric capnography - correct answerCorrect answer:
D. colorimetric capnography
Explanation:
A. the cm mark of the ETT is an indicator of depth of insertion, but does not confirm
placement in the trachea
B. condensation is often associated with intubation, but is not confirmation of correct
placement.
C. pulse ox is an assessment of oxygenation and does not provide confirmation of
tracheal placement
D. colorimetric capnography assesses the presence of CO2 and provides confirmation
of tracheal intubation due to detection of CO2
A respiratory therapist is asked to review a newborn's history. The following information
is available about the first few minutes after birth:
After 1 minute: appearance is acrocyanotic, heart rate is 70 b/m, reflexes include cough,
muscle tone is weak, and RR is 20 br/m.
After 5 minutes: appearance is pink, heart rate is 110 b/m, reflexes include cough,
muscle tone shows active motion, and RR is 40 br/m
Which of the following APGAR scores should the therapist expect to see for this infant?
A. 4 at 1 min, 8 at 5 mins
B. 5 at 1 min, 8 at 5 mins
C. 6 at 1 min, 10 at 5 mins
D. 7 at 1 min, 10 at 5 mins - correct answerCorrect answer:
C. 6 at 1 min, 10 at 5 mins
Explanation:
APGAR = appearance (color), pulse (HR), grimace (reflex/irritability), activity (muscle
tone), and respirations
,According to the scoring chart, the score for 1 minute is acrocyanosis (1) + low HR (1) +
cough (2) + weak activity (1), and low RR (1) = 6
According to the scoring chart, the score for 5 minutes is pink (2), normal HR (2), cough
(2), active motion (2), and normal RR (2) = 10
A 58-year-old female was dx with bronchiectasis 3 years ago. She reports increased
cough and difficulty clearing secretions for the past 4 weeks. A CXR shows no
significant changes. Which of the following should the RT recommend FIRST?
A. transtracheal aspiration
B. airway clearance therapy
C. bronchodilator treatments
D. respiratory isolation - correct answerCorrect answer:
B. airway clearance therapy
Explanation:
A. while a sputum sample may be requested, transtracheal aspiration would be
unnecessarily invasive as the patient is able to produce a sputum sample on her own
B the hx, clinical presentation, and CXR findings suggest worsening bronchiectasis. The
tx of bronchiectasis includes techniques to loosen and mobilize viscid secretions.
Postural drainage enhances sputum clearance.
C. bronchodilator therapy alone will not aid in secretion removal
D. there is no indication of this patient having a communicable disease. The dx of
bronchiectasis was established 3 years ago
A 24-year-old female is dx with exercise-induced asthma and albuterol prn is ordered. A
RT should NEXT:
A. refer the pt for allergy skin testing
B. educate the pt on obtaining daily peak flow measurements
C. instruct the pt to use albuterol 15 mins before exercising
D. suggest that the pt use pursed lip breathing while exercising - correct answerCorrect
answer:
C. instruct the patient to use albuterol 15 mins before exercising
Explanation:
A. allergy skin testing is not a routine part of EIA management
B. daily peak flow measurements will not be helpful for EIA
C. patient understanding of their disease process and triggers is important part of pt
education, as well as knowing when and which medication should be taken and how to
take it
D. pursed lip breathing is not helpful for EIA
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 - correct answerCorrect answer:
B. a relative humidity of 100% at 22*C (71.6*F)
Explanation:
A. a water vapor pressure of 47 mm Hg provides 100% humidity at body temperature
B. the absolute humidity at this temperature is inadequate
C. a dew point of 37*C or 98.6*F indicates that the gas is completely saturated at that
temperature
D. the absolute tracheal humidity must be greater than or equal to 30 mg/L
Prior to suctioning the ETT of an adult patient who is receiving ventilation with an FiO2
of 0.4, an RT should FIRST:
A. lubricate the catheter
B. hyperoxygenate the pt
C. cleanse the catheter with water
D. administer an FiO2 of 0.4 by t-piece - correct answerCorrect answer:
B. hyperoxygenate the pt
Explanation:
A. lubricating the catheter is not necessary unless nasotracheal suctioning (without an
artificial airway in the nare) will be performed
B. the FiO2 should be increased prior to each suctioning attempt to minimize hypoxemia
C. sterile and in-line suction catheters do not need to be cleansed prior to use
D. administration of the same FiO2 without positive pressure will compromise the
patient's oxygenation and ventilation
A 25-year-old patient with apnea is receiving pressure-control ventilation. ABG analysis
results are as follows:
pH 7.2
pCO2 65 mm Hg
pO2 70 mm Hg
HCO3 25 mEq/L
BE -4 mEq/L
SO2 94%
An RT should recommend increasing the ___.
A. set inspiratory pressure
B. expiratory time
C. sensitivity
D. peak flow - correct answerCorrect Answer:
, A. set inspiratory pressure
Explanation:
A. in pressure control ventilation, increasing the inspiratory pressure will result in an
increased Vt and minute ventilation, potentially causing a decrease in pCO2
B. increasing expiratory time is the same thing as decreasing the inspiratory time, which
will decrease Vt and minute ventilation. In this case (respiratory acidosis), we would
want to increase the Vt and minute ventilation. Increasing expiratory time will potentially
cause an increase in pCO2 and further decrease pH
C. increasing sensitivity will not increase ventilation in this patient
D. peak flow cannot be set in pressure control ventilation
A 68-year-old pt who is post-CABG was extubated 4 hours ago and complains of
increasing SOB. The breath sounds are decreased over the right lung field. The
following data are available while the pt receives 4L nasal cannula.
HR 103 b/m
RR 27 br/m
BP 155/90 mm Hg
SpO2 90%
Which of the following studies should a RT recommend FIRST?
A. bedside spirometry
B. chest CT with contrast
C. ventilation/perfusion scan
D. CXR - correct answerCorrect answer:
D. CXR
Explanation:
A. while spirometry may be performed prior to surgery to determine the presence of
pulmonary abnormalities, it will not provide useful diagnostic information this soon
following extubation
B. a CT scan with contrast could identify a pulmonary embolus or fluid collection, but
this would not be the most appropriate next step in evaluating the pt
C. V/Q scans are useful to identify pulmonary embolus in select pt populations, but this
would not be the most appropriate next step in evaluating the pt
D. based on the timing of symptoms, the dyspnea could be due to pneumothorax, chest
tube malfunction, lobar collapse, or accumulation of pleural fluid. A CXR can be
obtained quickly to identify any of these issues
Which of the following medications should a RT use to anesthetize a pt's airway prior to
a flexible bronchoscopy procedure?
A. lidocaine HCl
B. midazolam HCl (versed)
