NBRC CSE/ NBRC CSE EXAM PRACTICE QUESTIONS
AND CORRECT DETAILED ANSWERS A NEW UPDATED
VERSION LATEST 2026-2027 ( VERIFIED ANSWERS)
ALREADY GRADED A+
1. A 68-year-old patient with COPD is on 2 L/min NC. SpO₂ is 91%, ABG: pH 7.36, PaCO₂ 57, HCO₃⁻
32. You should:
A. Increase oxygen to 4 L/min
B. Maintain current O₂ and monitor
C. Start mechanical ventilation immediately
D. Give a diuretic
Trap: Many choose “increase O₂,” but in chronic CO₂ retainers, aggressive O₂ can depress hypoxic
drive.
2. A ventilated patient suddenly develops hypotension. Peak pressure rises but plateau pressure is
unchanged. The most likely cause:
A. Decreased compliance
B. Kinked or obstructed ET tube
C. Pneumothorax
D. Hypovolemia
Trap: Plateau pressure is normal → not compliance. High peak = resistance issue.
3. A post-op patient is tachypneic (RR 32), anxious, with fine crackles bilaterally. ABG: pH 7.48,
PaCO₂ 30, PaO₂ 80 on 40% FiO₂. Next best action:
A. Increase oxygen to 60%
B. Assess for pain, anxiety, or hyperventilation
C. Call rapid response for ARDS
D. Start BiPAP immediately
Trap: Oxygen is adequate; the ABG shows respiratory alkalosis → often anxiety/pain, not hypoxemia.
,4. A patient with asthma presents with severe wheezing and exhaustion. ABG: pH 7.30, PaCO₂ 48.
Next step:
A. Increase inhaled beta-agonist frequency
B. Prepare for intubation
C. Give supplemental O₂ only
D. Start corticosteroids only
Trap: Rising CO₂ in asthma = impending respiratory failure. Not just more albuterol.
5. You are weaning a patient from the ventilator. RSBI = 120, VT = 300 mL, RR = 35. Best action:
A. Delay extubation and continue support
B. Proceed with extubation
C. Decrease PEEP and try trial
D. Sedate patient
Trap: RSBI >105 and RR high → patient likely to fail weaning.
6. Patient on CPAP 10 cmH₂O, SpO₂ 88% on 60% FiO₂. Crackles present. Which adjustment is best?
A. Increase FiO₂ only
B. Increase CPAP
C. Decrease CPAP
D. Start BiPAP
Trap: Crackles indicate alveolar collapse → need more pressure, not just O₂.
7. A patient with ARDS is on low tidal volume ventilation. Plateau pressure is 31 cmH₂O. What should
you do first?
A. Increase tidal volume
B. Decrease tidal volume slightly
C. Increase rate
D. Decrease PEEP
Trap: Plateau >30 → risk of barotrauma. High tidal volume may worsen injury.
8. Sudden desaturation on ventilator. SpO₂ 82%, peak pressure increased. Bagging is easy. Most likely
cause:
A. Pneumothorax
B. Secretions
C. Disconnection or leak
D. Bronchospasm
, Trap: Bag easy = not resistance problem → look for leak or disconnection.
9. A patient with pulmonary edema on 40% FiO₂ SpO₂ 90% and RR 28. ABG: pH 7.36, PaCO₂ 40,
PaO₂ 60. Next step:
A. Increase FiO₂
B. Apply PEEP
C. Sedate
D. Start antibiotics
Trap: Oxygen alone won’t fix alveolar flooding; PEEP recruits alveoli.
10. Patient with ARDS, high PEEP, BP drops 80/50. SpO₂ 92%. Best next action:
A. Assess volume status and give fluids
B. Decrease PEEP immediately
C. Give vasopressor without fluids
D. Reduce FiO₂
Trap: High PEEP can reduce venous return → hypotension. Don’t just reduce PEEP immediately.
11. Patient on SIMV develops asynchronous breathing. ABG: pH 7.28, PaCO₂ 55. Best first action:
A. Sedate patient
B. Adjust ventilator settings to match patient effort
C. Increase FiO₂
D. Extubate
Trap: Ventilator dyssynchrony → first fix the ventilator match, not sedation reflexively.
12. Patient with chronic CO₂ retention is hypoxic at 88% SpO₂. You should:
A. Give low-flow O₂ and monitor
B. Increase to 6 L/min NC
C. Intubate immediately
D. Start BiPAP
Trap: Remember chronic hypercapnic patients → avoid hyperoxia.
13. ABG: pH 7.50, PaCO₂ 28, PaO₂ 65. Patient anxious, tachypneic. Best intervention:
A. Give O₂
B. Coach slow breathing / treat anxiety
AND CORRECT DETAILED ANSWERS A NEW UPDATED
VERSION LATEST 2026-2027 ( VERIFIED ANSWERS)
ALREADY GRADED A+
1. A 68-year-old patient with COPD is on 2 L/min NC. SpO₂ is 91%, ABG: pH 7.36, PaCO₂ 57, HCO₃⁻
32. You should:
A. Increase oxygen to 4 L/min
B. Maintain current O₂ and monitor
C. Start mechanical ventilation immediately
D. Give a diuretic
Trap: Many choose “increase O₂,” but in chronic CO₂ retainers, aggressive O₂ can depress hypoxic
drive.
2. A ventilated patient suddenly develops hypotension. Peak pressure rises but plateau pressure is
unchanged. The most likely cause:
A. Decreased compliance
B. Kinked or obstructed ET tube
C. Pneumothorax
D. Hypovolemia
Trap: Plateau pressure is normal → not compliance. High peak = resistance issue.
3. A post-op patient is tachypneic (RR 32), anxious, with fine crackles bilaterally. ABG: pH 7.48,
PaCO₂ 30, PaO₂ 80 on 40% FiO₂. Next best action:
A. Increase oxygen to 60%
B. Assess for pain, anxiety, or hyperventilation
C. Call rapid response for ARDS
D. Start BiPAP immediately
Trap: Oxygen is adequate; the ABG shows respiratory alkalosis → often anxiety/pain, not hypoxemia.
,4. A patient with asthma presents with severe wheezing and exhaustion. ABG: pH 7.30, PaCO₂ 48.
Next step:
A. Increase inhaled beta-agonist frequency
B. Prepare for intubation
C. Give supplemental O₂ only
D. Start corticosteroids only
Trap: Rising CO₂ in asthma = impending respiratory failure. Not just more albuterol.
5. You are weaning a patient from the ventilator. RSBI = 120, VT = 300 mL, RR = 35. Best action:
A. Delay extubation and continue support
B. Proceed with extubation
C. Decrease PEEP and try trial
D. Sedate patient
Trap: RSBI >105 and RR high → patient likely to fail weaning.
6. Patient on CPAP 10 cmH₂O, SpO₂ 88% on 60% FiO₂. Crackles present. Which adjustment is best?
A. Increase FiO₂ only
B. Increase CPAP
C. Decrease CPAP
D. Start BiPAP
Trap: Crackles indicate alveolar collapse → need more pressure, not just O₂.
7. A patient with ARDS is on low tidal volume ventilation. Plateau pressure is 31 cmH₂O. What should
you do first?
A. Increase tidal volume
B. Decrease tidal volume slightly
C. Increase rate
D. Decrease PEEP
Trap: Plateau >30 → risk of barotrauma. High tidal volume may worsen injury.
8. Sudden desaturation on ventilator. SpO₂ 82%, peak pressure increased. Bagging is easy. Most likely
cause:
A. Pneumothorax
B. Secretions
C. Disconnection or leak
D. Bronchospasm
, Trap: Bag easy = not resistance problem → look for leak or disconnection.
9. A patient with pulmonary edema on 40% FiO₂ SpO₂ 90% and RR 28. ABG: pH 7.36, PaCO₂ 40,
PaO₂ 60. Next step:
A. Increase FiO₂
B. Apply PEEP
C. Sedate
D. Start antibiotics
Trap: Oxygen alone won’t fix alveolar flooding; PEEP recruits alveoli.
10. Patient with ARDS, high PEEP, BP drops 80/50. SpO₂ 92%. Best next action:
A. Assess volume status and give fluids
B. Decrease PEEP immediately
C. Give vasopressor without fluids
D. Reduce FiO₂
Trap: High PEEP can reduce venous return → hypotension. Don’t just reduce PEEP immediately.
11. Patient on SIMV develops asynchronous breathing. ABG: pH 7.28, PaCO₂ 55. Best first action:
A. Sedate patient
B. Adjust ventilator settings to match patient effort
C. Increase FiO₂
D. Extubate
Trap: Ventilator dyssynchrony → first fix the ventilator match, not sedation reflexively.
12. Patient with chronic CO₂ retention is hypoxic at 88% SpO₂. You should:
A. Give low-flow O₂ and monitor
B. Increase to 6 L/min NC
C. Intubate immediately
D. Start BiPAP
Trap: Remember chronic hypercapnic patients → avoid hyperoxia.
13. ABG: pH 7.50, PaCO₂ 28, PaO₂ 65. Patient anxious, tachypneic. Best intervention:
A. Give O₂
B. Coach slow breathing / treat anxiety
