Page 1 of 116
NBRC TMC/CRT/RRT EXAM LATEST ALL 300
QUESTIONS WITH CORRECT RATIONALIZED
SOLUTIONS JUST RELEASED
1. A 65-year-old male with a history of COPD is admitted with increased dyspnea. Which finding is most
indicative of impending respiratory failure?
A. Heart rate 90 bpm
B. Respiratory rate 28 breaths/min
C. Use of accessory muscles and paradoxical abdominal breathing
D. Oxygen saturation 90% on room air
Answer: C
Paradoxical abdominal breathing (abdominal wall moves inward during inspiration) indicates
diaphragmatic fatigue and impending respiratory failure. Accessory muscle use alone is common in COPD,
but paradoxical motion is a late, ominous sign.
2. During auscultation, you hear high-pitched, musical sounds on expiration in a patient with a history
of asthma. These sounds are best described as:
A. Crackles
B. Rhonchi
C. Wheezes
D. Stridor
Answer: C
Wheezes are high-pitched, musical sounds typically heard on expiration in patients with asthma or COPD.
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They result from airflow through narrowed airways. Crackles are discontinuous sounds; rhonchi are low-
pitched; stridor is inspiratory and indicates upper airway obstruction.
3. A patient with suspected pulmonary embolism presents with sudden onset of dyspnea and pleuritic
chest pain. Which additional finding would most support this diagnosis?
A. Hemoptysis
B. Bradycardia
C. Hypocapnia
D. Wheezing
Answer: A
Hemoptysis, along with sudden dyspnea and pleuritic chest pain, is classic for pulmonary embolism.
Tachycardia (not bradycardia), tachypnea, and hypoxemia are also common. Wheezing is not typical for
PE.
4. A patient with COPD presents with a barrel chest and prolonged expiration. Which underlying
pathophysiology explains these findings?
A. Air trapping due to loss of elastic recoil
B. Increased surfactant production
C. Bronchospasm
D. Pulmonary fibrosis
Answer: A
In COPD, particularly emphysema, destruction of alveolar walls leads to loss of elastic recoil. This causes
air trapping, hyperinflation, and the characteristic barrel chest appearance.
5. A 72-year-old patient with heart failure presents with pink, frothy sputum and crackles on
auscultation. Which condition is most likely?
, Page 3 of 116
A. Pneumonia
B. Pulmonary edema
C. COPD exacerbation
D. Pulmonary embolism
Answer: B
Pink, frothy sputum is classic for pulmonary edema. Crackles (rales) are also typical. In heart failure,
increased hydrostatic pressure causes fluid to leak into the alveoli.
6. A patient with a history of asthma is receiving bronchodilator therapy. Which assessment finding
indicates impending respiratory failure?
A. PaCO2 rising from 38 to 48 mmHg
B. Respiratory rate 22 breaths/min
C. Heart rate 100 bpm
D. Wheezing on expiration
Answer: A
A rising PaCO2 in an asthmatic patient indicates fatigue and impending respiratory failure. Normally,
asthma causes initial hypocapnia (low PaCO2) due to hyperventilation; a rising PaCO2 is a late and
dangerous sign.
7. A patient with a pneumothorax has decreased tactile fremitus on the affected side. This finding is
due to:
A. Increased lung density
B. Air in the pleural space
C. Consolidation
D. Pleural effusion
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Answer: B
Tactile fremitus is decreased when air or fluid separates the lung from the chest wall. In pneumothorax,
air in the pleural space dampens vibration transmission.
8. A patient with COPD is sitting in a tripod position. This position is used to:
A. Increase cardiac output
B. Decrease work of breathing
C. Improve oxygenation
D. Reduce anxiety
Answer: B
The tripod position (leaning forward with arms braced) helps recruit accessory muscles and improves
diaphragmatic function, reducing the work of breathing.
9. A patient with pulmonary fibrosis would most likely have which auscultatory finding?
A. Wheezes
B. Rhonchi
C. Velcro crackles
D. Stridor
Answer: C
Velcro crackles (fine, late inspiratory crackles) are characteristic of pulmonary fibrosis and interstitial lung
disease.
10. A patient with liver cirrhosis and abdominal ascites is at risk for which respiratory complication?
A. Pneumothorax
B. Pleural effusion
NBRC TMC/CRT/RRT EXAM LATEST ALL 300
QUESTIONS WITH CORRECT RATIONALIZED
SOLUTIONS JUST RELEASED
1. A 65-year-old male with a history of COPD is admitted with increased dyspnea. Which finding is most
indicative of impending respiratory failure?
A. Heart rate 90 bpm
B. Respiratory rate 28 breaths/min
C. Use of accessory muscles and paradoxical abdominal breathing
D. Oxygen saturation 90% on room air
Answer: C
Paradoxical abdominal breathing (abdominal wall moves inward during inspiration) indicates
diaphragmatic fatigue and impending respiratory failure. Accessory muscle use alone is common in COPD,
but paradoxical motion is a late, ominous sign.
2. During auscultation, you hear high-pitched, musical sounds on expiration in a patient with a history
of asthma. These sounds are best described as:
A. Crackles
B. Rhonchi
C. Wheezes
D. Stridor
Answer: C
Wheezes are high-pitched, musical sounds typically heard on expiration in patients with asthma or COPD.
, Page 2 of 116
They result from airflow through narrowed airways. Crackles are discontinuous sounds; rhonchi are low-
pitched; stridor is inspiratory and indicates upper airway obstruction.
3. A patient with suspected pulmonary embolism presents with sudden onset of dyspnea and pleuritic
chest pain. Which additional finding would most support this diagnosis?
A. Hemoptysis
B. Bradycardia
C. Hypocapnia
D. Wheezing
Answer: A
Hemoptysis, along with sudden dyspnea and pleuritic chest pain, is classic for pulmonary embolism.
Tachycardia (not bradycardia), tachypnea, and hypoxemia are also common. Wheezing is not typical for
PE.
4. A patient with COPD presents with a barrel chest and prolonged expiration. Which underlying
pathophysiology explains these findings?
A. Air trapping due to loss of elastic recoil
B. Increased surfactant production
C. Bronchospasm
D. Pulmonary fibrosis
Answer: A
In COPD, particularly emphysema, destruction of alveolar walls leads to loss of elastic recoil. This causes
air trapping, hyperinflation, and the characteristic barrel chest appearance.
5. A 72-year-old patient with heart failure presents with pink, frothy sputum and crackles on
auscultation. Which condition is most likely?
, Page 3 of 116
A. Pneumonia
B. Pulmonary edema
C. COPD exacerbation
D. Pulmonary embolism
Answer: B
Pink, frothy sputum is classic for pulmonary edema. Crackles (rales) are also typical. In heart failure,
increased hydrostatic pressure causes fluid to leak into the alveoli.
6. A patient with a history of asthma is receiving bronchodilator therapy. Which assessment finding
indicates impending respiratory failure?
A. PaCO2 rising from 38 to 48 mmHg
B. Respiratory rate 22 breaths/min
C. Heart rate 100 bpm
D. Wheezing on expiration
Answer: A
A rising PaCO2 in an asthmatic patient indicates fatigue and impending respiratory failure. Normally,
asthma causes initial hypocapnia (low PaCO2) due to hyperventilation; a rising PaCO2 is a late and
dangerous sign.
7. A patient with a pneumothorax has decreased tactile fremitus on the affected side. This finding is
due to:
A. Increased lung density
B. Air in the pleural space
C. Consolidation
D. Pleural effusion
, Page 4 of 116
Answer: B
Tactile fremitus is decreased when air or fluid separates the lung from the chest wall. In pneumothorax,
air in the pleural space dampens vibration transmission.
8. A patient with COPD is sitting in a tripod position. This position is used to:
A. Increase cardiac output
B. Decrease work of breathing
C. Improve oxygenation
D. Reduce anxiety
Answer: B
The tripod position (leaning forward with arms braced) helps recruit accessory muscles and improves
diaphragmatic function, reducing the work of breathing.
9. A patient with pulmonary fibrosis would most likely have which auscultatory finding?
A. Wheezes
B. Rhonchi
C. Velcro crackles
D. Stridor
Answer: C
Velcro crackles (fine, late inspiratory crackles) are characteristic of pulmonary fibrosis and interstitial lung
disease.
10. A patient with liver cirrhosis and abdominal ascites is at risk for which respiratory complication?
A. Pneumothorax
B. Pleural effusion
