NBRC MOCK TMC EXAM 2026 EXAM SCRIPT
WITH VERIFIED SOLUTIONS
◉ Biot's breathing. Answer: groups of quick, shallow inspirations
followed by regular or irregular periods of apnea
◉ Biots cause. Answer: CNS problems
◉ Kussmaul's. Answer: Increased RR (>20 breaths/min), increased
depth, irregular rhythm, breathing sounds labored
◉ Kussmaul causes. Answer: hypoxemia, DKA, metabolic acidosis,
renal failure
◉ Normal muscles of ventilation. Answer: Diaphragm
External intercostals
Exhalation is normally passive
◉ Accesory muscles of ventilation (WOB indicator). Answer:
Internal intercostals, scalene, sternalcleidomastoid, pectoralis major
Abdominal muscles (oblique, rectus abdominus, ect)
,◉ Muscle conditions. Answer: Atrophy - wasting, loss of tone
Hypertrophy - increase in size (occurs with excessive use in COPD)
◉ Retractions definition. Answer: when chest moves inward instead
of out during inspiratory effort
◉ Retractions cause. Answer: severe obstruction or distress
◉ Nasal flaring. Answer: Enlargement of nostrils with breathing
(sign of respiratory distress in infants)
◉ Mallampati class I. Answer: Soft palate, uvula, fauces, pillars
visible
◉ Mallampati Class II. Answer: Soft palate, uvula, fauces visible
◉ Mallampati class III. Answer: Soft palate, base of uvula visible
◉ Mallampati class IV. Answer: Hard palate only visible
◉ Normal pulse. Answer: 60-100 bpm
,◉ Tachycardia. Answer: > 100 bpm (hypoxemia, anxiety, stress, give
O2)
◉ Bradycardia. Answer: < 60 bpm (heart failure, shock, code
emergency, give atropine)
◉ Adverse reaction indicator. Answer: Change in HR of more than 20
beats/min
◉ Paradoxical pulse/pulsus paradoxus. Answer: Pulse/blood
pressure varies with respiration. EMERGENT
◉ Paradoxical pulse/pulsus paradoxus symptom of.... Answer: May
indicate severe air trapping (status asthmaticus, tension
pneumothorax, cardic tampanade)-felt on exhalation EMERGENT
◉ Tracheal deviation (pulled). Answer: Is PULLED to abnormal side
(toward pathology) in...
Atalectasis
Pneumonectomy
Diaphragmatic paralysis
◉ Tracheal deviation (pushed). Answer: Is PUSHED to normal side
(away from pathology) in...
, Massive pleural effusion
Tension pneumothorax Mediastinal mass
Neck or thyroid tumors
◉ Tactile fremitus definition. Answer: Vibrations felt by hand on
chest wall
*Vocal fremitus - voice vibrations felt thru chest wall
*Pleural rub fremitus - grating sensation felt, roughened pleural
surfaces rubbing together
*Rhonchal fremitus - palpable rhonchi
◉ Crepitus. Answer: Air under the skin, subcutaneous emphysema
◉ Normal air filled lung percussion sound. Answer: Resonant,
hollow sound
◉ Atelectactic lung percussion sound. Answer: Flat
Dull - pleural effusion or pneumonia can cause this
◉ Hyperinflated lung percussion sound. Answer: Tympanic, drum-
like sound
Hyperresonant, booming (emphysema, pneumothorax)
WITH VERIFIED SOLUTIONS
◉ Biot's breathing. Answer: groups of quick, shallow inspirations
followed by regular or irregular periods of apnea
◉ Biots cause. Answer: CNS problems
◉ Kussmaul's. Answer: Increased RR (>20 breaths/min), increased
depth, irregular rhythm, breathing sounds labored
◉ Kussmaul causes. Answer: hypoxemia, DKA, metabolic acidosis,
renal failure
◉ Normal muscles of ventilation. Answer: Diaphragm
External intercostals
Exhalation is normally passive
◉ Accesory muscles of ventilation (WOB indicator). Answer:
Internal intercostals, scalene, sternalcleidomastoid, pectoralis major
Abdominal muscles (oblique, rectus abdominus, ect)
,◉ Muscle conditions. Answer: Atrophy - wasting, loss of tone
Hypertrophy - increase in size (occurs with excessive use in COPD)
◉ Retractions definition. Answer: when chest moves inward instead
of out during inspiratory effort
◉ Retractions cause. Answer: severe obstruction or distress
◉ Nasal flaring. Answer: Enlargement of nostrils with breathing
(sign of respiratory distress in infants)
◉ Mallampati class I. Answer: Soft palate, uvula, fauces, pillars
visible
◉ Mallampati Class II. Answer: Soft palate, uvula, fauces visible
◉ Mallampati class III. Answer: Soft palate, base of uvula visible
◉ Mallampati class IV. Answer: Hard palate only visible
◉ Normal pulse. Answer: 60-100 bpm
,◉ Tachycardia. Answer: > 100 bpm (hypoxemia, anxiety, stress, give
O2)
◉ Bradycardia. Answer: < 60 bpm (heart failure, shock, code
emergency, give atropine)
◉ Adverse reaction indicator. Answer: Change in HR of more than 20
beats/min
◉ Paradoxical pulse/pulsus paradoxus. Answer: Pulse/blood
pressure varies with respiration. EMERGENT
◉ Paradoxical pulse/pulsus paradoxus symptom of.... Answer: May
indicate severe air trapping (status asthmaticus, tension
pneumothorax, cardic tampanade)-felt on exhalation EMERGENT
◉ Tracheal deviation (pulled). Answer: Is PULLED to abnormal side
(toward pathology) in...
Atalectasis
Pneumonectomy
Diaphragmatic paralysis
◉ Tracheal deviation (pushed). Answer: Is PUSHED to normal side
(away from pathology) in...
, Massive pleural effusion
Tension pneumothorax Mediastinal mass
Neck or thyroid tumors
◉ Tactile fremitus definition. Answer: Vibrations felt by hand on
chest wall
*Vocal fremitus - voice vibrations felt thru chest wall
*Pleural rub fremitus - grating sensation felt, roughened pleural
surfaces rubbing together
*Rhonchal fremitus - palpable rhonchi
◉ Crepitus. Answer: Air under the skin, subcutaneous emphysema
◉ Normal air filled lung percussion sound. Answer: Resonant,
hollow sound
◉ Atelectactic lung percussion sound. Answer: Flat
Dull - pleural effusion or pneumonia can cause this
◉ Hyperinflated lung percussion sound. Answer: Tympanic, drum-
like sound
Hyperresonant, booming (emphysema, pneumothorax)
