NBRC TMC FINAL EXAM 2026-2027 MULTIPLE
QUESTIONS AND CORRECT ANSWERS WITH
EXPLANATIONS GRADED A+
For a patient receiving volume-controlled mechanical ventilation, the lower
inflection point on a pressure-volume loop can best be described as:
A. amount of pressure required to keep the alveoli and small airways open
B. optimal PEEP
C. minimal PEEP
D. upper limit of residual volume
A.
The lowest inflection point on a pressure-volume ventilator graphic is an indication
of the minimum pressure needed to keep alveoli open.
The results of a V/Q scan shows poor perfusion with adequate ventilation. A chest
radiograph shows a wedge-shaped infiltrate over the right lung field. The patient
most likely has
A. fluid overload
B. ARDS
C. a pulmonary embolism
D. pneumonia
,C.
A VQ scan that shows poor perfusion but adequate ventilation is most closely
associated with a pulmonary embolism. Supportive data is found in the
radiological report of wedge-shaped infiltrates.
The respiratory therapist notes in the medical record of a 65-year-old male that the
patient is ordered to receive bronchodilator therapy with Albuterol. The therapist
also notes the patient is receiving beta-blocker medication. The therapist should
recommend
A. Administer Dexamethasone (Decadron) in place of Albuterol
B. Add Xopenex to the bronchodilator regimen
C. Replace Albuterol with Beclamethasone (Beclovent)
D. Switch from Albuterol to ipratropium bromide (Atrovent)
D.
Because albuterol is a beta-agonist medication, patients who are taking beta-
blockers should utilize other bronchodilation medication.
A hospital has an extremely low incidence of ventilator-associated pneumonia. To
which of the following reasons may this be attributed?
A. periodic discontinuation of sedation
B. use of respiratory precautions with the population
C. diversion of infectious patients to other facilities
D. broad use of prophylactic antibiotics
,A.
The incidence of ventilator-associated pneumonia, or VAP, is lowered by using a
closed system suction catheter, periodically discontinuing sedation, keeping the
patient and semi-Fowler's position, and proper handwashing among caregivers. All
are correct.
A pressure-volume loop ventilator graphic shows no rise in pressure for the first
200 mL of delivered volume. The therapist should
A. increase inspiratory flow rate
B. increase PEEP
C. decrease tidal volume
D. decrease inspiratory flow rate
B.
In this question the description of the pressure volume loop would indicate a flat
bottom as manifested by no rise in pressure with the first 200 mL of delivered
volume. We call this a "flat football". The solution is to increase PEEP to a level
that the pressure begins to rise immediately as volume is introduced.
Which of the following would be the most effective, appropriate method for
resolving atelectasis in a spontaneously breathing, post operative patient who is
under the influence of sedation and will not respond to verbal stimuli?
A. IPPB
B. sustained maximal inhalation (incentive spirometer)
C. deep breathing coaching
, D. intubation and mechanical ventilation
A.
A postoperative patient under sedation, and possibly in pain, may be tempted to
breathe less, causing respiratory acidosis and atelectasis. To correct this problem,
IPPB therapy is most appropriate. Incentive spirometry would also help but the
patient is unable to respond to verbal stimuli. This alone is an indication for IPPB
therapy.
Which of the following is needed to calculate alveolar oxygen tension?
A. VD/VT, PAO2
B. BP and FiO2
C. PetCO2 and PaO2
D. QS/QT, deadspace
B.
Barometric pressure, FiO2, and PaO2 are all included in the formula (BP stands for
barometric pressure)
L/min/m2 is the unit of measure for:
A. Systemic vascular resistance
B. Cardiac output
C. Cardiac index
D. Stroke volume
C.
QUESTIONS AND CORRECT ANSWERS WITH
EXPLANATIONS GRADED A+
For a patient receiving volume-controlled mechanical ventilation, the lower
inflection point on a pressure-volume loop can best be described as:
A. amount of pressure required to keep the alveoli and small airways open
B. optimal PEEP
C. minimal PEEP
D. upper limit of residual volume
A.
The lowest inflection point on a pressure-volume ventilator graphic is an indication
of the minimum pressure needed to keep alveoli open.
The results of a V/Q scan shows poor perfusion with adequate ventilation. A chest
radiograph shows a wedge-shaped infiltrate over the right lung field. The patient
most likely has
A. fluid overload
B. ARDS
C. a pulmonary embolism
D. pneumonia
,C.
A VQ scan that shows poor perfusion but adequate ventilation is most closely
associated with a pulmonary embolism. Supportive data is found in the
radiological report of wedge-shaped infiltrates.
The respiratory therapist notes in the medical record of a 65-year-old male that the
patient is ordered to receive bronchodilator therapy with Albuterol. The therapist
also notes the patient is receiving beta-blocker medication. The therapist should
recommend
A. Administer Dexamethasone (Decadron) in place of Albuterol
B. Add Xopenex to the bronchodilator regimen
C. Replace Albuterol with Beclamethasone (Beclovent)
D. Switch from Albuterol to ipratropium bromide (Atrovent)
D.
Because albuterol is a beta-agonist medication, patients who are taking beta-
blockers should utilize other bronchodilation medication.
A hospital has an extremely low incidence of ventilator-associated pneumonia. To
which of the following reasons may this be attributed?
A. periodic discontinuation of sedation
B. use of respiratory precautions with the population
C. diversion of infectious patients to other facilities
D. broad use of prophylactic antibiotics
,A.
The incidence of ventilator-associated pneumonia, or VAP, is lowered by using a
closed system suction catheter, periodically discontinuing sedation, keeping the
patient and semi-Fowler's position, and proper handwashing among caregivers. All
are correct.
A pressure-volume loop ventilator graphic shows no rise in pressure for the first
200 mL of delivered volume. The therapist should
A. increase inspiratory flow rate
B. increase PEEP
C. decrease tidal volume
D. decrease inspiratory flow rate
B.
In this question the description of the pressure volume loop would indicate a flat
bottom as manifested by no rise in pressure with the first 200 mL of delivered
volume. We call this a "flat football". The solution is to increase PEEP to a level
that the pressure begins to rise immediately as volume is introduced.
Which of the following would be the most effective, appropriate method for
resolving atelectasis in a spontaneously breathing, post operative patient who is
under the influence of sedation and will not respond to verbal stimuli?
A. IPPB
B. sustained maximal inhalation (incentive spirometer)
C. deep breathing coaching
, D. intubation and mechanical ventilation
A.
A postoperative patient under sedation, and possibly in pain, may be tempted to
breathe less, causing respiratory acidosis and atelectasis. To correct this problem,
IPPB therapy is most appropriate. Incentive spirometry would also help but the
patient is unable to respond to verbal stimuli. This alone is an indication for IPPB
therapy.
Which of the following is needed to calculate alveolar oxygen tension?
A. VD/VT, PAO2
B. BP and FiO2
C. PetCO2 and PaO2
D. QS/QT, deadspace
B.
Barometric pressure, FiO2, and PaO2 are all included in the formula (BP stands for
barometric pressure)
L/min/m2 is the unit of measure for:
A. Systemic vascular resistance
B. Cardiac output
C. Cardiac index
D. Stroke volume
C.
