NBRC PRACTICE QUESTIONS AND
ANSWERS WITH VERIFIED SOLUTIONS
100% CORRECT
A 16-year old male has been receiving VC, AC ventilation for 24
hours following admission for a drug overdose. The pt is alert
and oriented, and has been weaned to PSV of 5 cm H2O and an
FiO2 of 0.4. The following data are collected after 30 minutes:
pH 7.47
pCO2 34 mm Hg
pO2 121 mm Hg
HCO3 25 mEq/L
BE + 2 mEq/L
SaO2 98%
Spontaneous Vt 465 mL
MIP -36 cm H2O
HR 98 b/m
RR 18 b/m
,Which of the following should an RT recommend?
A. continue with PSV with current settings
B. return to VC, AC ventilation
C. decrease PS to 3 cm H2O
D. extubate the pt - correct answer- Correct answer:
D. extubate the pt
Explanation:
The pt's ABG analysis and pulmonary mechanics results are
currently acceptable. There is no need to wait for extubation.
The pt is already on minimal PS settings and the VC, AC
ventilation is no longer required. Continuing to stay on MV will
increase the pt's chances of nosocomial infection.
A 20-year old pt with an acute asthma exacerbation is receiving
2.5 mg albuterol by hand-held nebulizer. During the treatment,
the pt complains of palpitations and has a HR of 140 b/min.
Which of the following should the RT recommend for the next
treatment?
,A. change to fluticasone/salmeterol (Advair HFA)
B. change to 0.63 mg of levalbuterol (Xopenex)
C. change to 3 puffs of beclomethasone dipropionate (QVAR)
D. Administer the treatment with saline - correct
answer- Correct answer:
B. change to 0.63 mg of levalbuterol (Xopenex)
Explanation:
A. changing to an inhaled steroid and long acting beta agonist is
not appropriate for a pt with acute asthma exacerbation
B. changing to Xopenex may decrease the incidence of cardiac
side effects
C. beclomethasone dipropionate is not a bronchodilator and will
not provide acute relief to the pt
D. administering saline will not provide treatment for the pt's
condition (adding saline to albuterol will only prolong the tx)
A 21-year old man arrives to the ED after rescue from a house
fire. Physical examination reveals burns on the upper chest and
face, and marked edema of the face and oropharynx. Analysis
results of an ABG sample obtained while the pt was breathing air
are:
, pH 7.55
pCO2 26 mm Hg
pO2 105 mm Hg
HCO3 23 mEq/L
BE +2 mEq/L
SaO2 98%
Which of the following should an RT recommend?
A. intubate the pt
B. sedate the pt
C. initiate Xopenex therapy
D. administer cool aerosol therapy - correct answer-
Correct answer:
A. intubate the pt
Explanation:
A. Facial burns with edema indicate upper airway burns and the
potential for airway obstruction. Intubation is necessary to
ensure airway patency.
ANSWERS WITH VERIFIED SOLUTIONS
100% CORRECT
A 16-year old male has been receiving VC, AC ventilation for 24
hours following admission for a drug overdose. The pt is alert
and oriented, and has been weaned to PSV of 5 cm H2O and an
FiO2 of 0.4. The following data are collected after 30 minutes:
pH 7.47
pCO2 34 mm Hg
pO2 121 mm Hg
HCO3 25 mEq/L
BE + 2 mEq/L
SaO2 98%
Spontaneous Vt 465 mL
MIP -36 cm H2O
HR 98 b/m
RR 18 b/m
,Which of the following should an RT recommend?
A. continue with PSV with current settings
B. return to VC, AC ventilation
C. decrease PS to 3 cm H2O
D. extubate the pt - correct answer- Correct answer:
D. extubate the pt
Explanation:
The pt's ABG analysis and pulmonary mechanics results are
currently acceptable. There is no need to wait for extubation.
The pt is already on minimal PS settings and the VC, AC
ventilation is no longer required. Continuing to stay on MV will
increase the pt's chances of nosocomial infection.
A 20-year old pt with an acute asthma exacerbation is receiving
2.5 mg albuterol by hand-held nebulizer. During the treatment,
the pt complains of palpitations and has a HR of 140 b/min.
Which of the following should the RT recommend for the next
treatment?
,A. change to fluticasone/salmeterol (Advair HFA)
B. change to 0.63 mg of levalbuterol (Xopenex)
C. change to 3 puffs of beclomethasone dipropionate (QVAR)
D. Administer the treatment with saline - correct
answer- Correct answer:
B. change to 0.63 mg of levalbuterol (Xopenex)
Explanation:
A. changing to an inhaled steroid and long acting beta agonist is
not appropriate for a pt with acute asthma exacerbation
B. changing to Xopenex may decrease the incidence of cardiac
side effects
C. beclomethasone dipropionate is not a bronchodilator and will
not provide acute relief to the pt
D. administering saline will not provide treatment for the pt's
condition (adding saline to albuterol will only prolong the tx)
A 21-year old man arrives to the ED after rescue from a house
fire. Physical examination reveals burns on the upper chest and
face, and marked edema of the face and oropharynx. Analysis
results of an ABG sample obtained while the pt was breathing air
are:
, pH 7.55
pCO2 26 mm Hg
pO2 105 mm Hg
HCO3 23 mEq/L
BE +2 mEq/L
SaO2 98%
Which of the following should an RT recommend?
A. intubate the pt
B. sedate the pt
C. initiate Xopenex therapy
D. administer cool aerosol therapy - correct answer-
Correct answer:
A. intubate the pt
Explanation:
A. Facial burns with edema indicate upper airway burns and the
potential for airway obstruction. Intubation is necessary to
ensure airway patency.
