C-NPT Test Questions with Correct Answers Latest Update 2025
Normal pH - Answers 7.35-7.45
Normal CO2 - Answers 35-45 mmHg
normal bicarbonate levels - Answers 22-26 mEq/L
Every 0.1 increase in pH is a change in K+today - Answers Every 0.1 increase in pH is a 0.6 decrease in K+
Every increase in PaCO2 by 10 change in pH - Answers Every Change in PaCo2 of increase by 10
decreases pH by 0.08
Every increase in HCO3 by 10 change pH - Answers Every increase in HCO3 by 10 increases pH by 0.15
oxyhemoglobin dissociation curve shift right - Answers increase temp, increase dpg, increase CO2,
increase PaO2, decrease pH, decrease SaO2
oxyhemoglobin dissociation curve shift left - Answers decrease temp, decrease DPG, decrease CO2,
decrease PaO2, increase pH, increase SaO2
oxyhemoglobin dissociation curve shift right - Answers reduce affinity for O2
oxyhemoglobin dissociation curve shift left - Answers increase affinity for O2
2,3-DPG - Answers This enzyme stimulates oxygen release from hemoglobin when blood pH is low
(hypoxic/acidotic).
Winters formula - Answers Pco2 = 1.5 [HCO3-] + 8 +/- 2
Winters formula - Answers Respiratory compensation in response to metabolic acidosis can be
quantified w/ this formula: PCO2 = 1.5(HCO3-) + 8 +/-2 (gives you an "expected" value for PCO2 --< use
this to tell if the respiratory response is adequate.)
respiratory failure (RF) - Answers also known as respiratory acidosis, is a condition in which the level of
oxygen in the blood becomes dangerously low (hypoxemia) or the level of carbon dioxide becomes
dangerously high (hypercapnia). It is a medical emergency that can result from a chronic condition or
develop suddenly. PaO2 < 60. PaCO2 > 50
blood transfusion and 2,3-DPG - Answers Citric Acid in PRBCs kill off the 2,3-DPG. hgb losses ability to
release oxygen to tissues and drives oxyhemoglobin curve to the left causing hypoxia
resuscitation should be based on? - Answers lactate and base deficit levels
Lactate levels - Answers Normal: 4.5-19.8 mg/dl
,Indicated in shock, heart failure, lung disease, and intense exercise
Lactate Levels - Answers The normal blood lactate concentration in unstressed patients is 0.5-1 mmol/L.
Patients with critical illness can be considered to have normal lactate concentrations of less than 2
mmol/L. Hyperlactatemia is defined as a mild to moderate persistent increase in blood lactate
concentration (2-4 mmol/L) without metabolic
The Bohr Effect to - Answers Hbg oxygen binding affinity inversely related to both acidity and
concentrations of CO2 ( in presence of increased acid, the Hgb will lose its affinity for oxygen and will
dump it into the tissues= high PaO2 and lower SaO2)
RSV early stage of shock - Answers Respiratory Alkalosis due to increased RR
Metabolic Acidosis which electrolyte falsely elevated - Answers K+, Met Acidosis shifts K+ out of the cell
into the blood.
PRBC does what to 2,3-DPG - Answers PRBC transfusions deplete 2,3-DPG leading to shift to left on
oxyhemoglobin curve, hgb increases affintity for oxygen
Constant NG suction - Answers Metabolic Alkalosis
SpO2 is - Answers Amount of Oxygen bound to Hgb (% hgb saturated)
Acute Respiratory Failure - Answers PaO2 <, PCO2 >50
Increase VO2, decrease oxygen consumption, and pH = Shock - Answers Septic shock in early phases
Oxgyen delivery increased but the tissues cannot extract and use the oxgyen= consumption decreased
and venous oxygen increased.
[1.34 x Hgb x (SaO2)] + PaO2 x 0.003 = - Answers Oxygen content in arteries= oxgyen delivered per
minute
drugs with bronchitis dilator effects - Answers Ketamine, terbutaline, Albuterol
needle thoracostomy not successful - Answers shift of trachea away from needle after procedure,
increased MAP, decreased CO
Albuterol effects - Answers Selectively activate beta-2 receptors with little or no beta- 1 cardiac effects.
However, vasodilatation will occur due to muscle pooling, reducing TPR thereby stimulating reflex
increases in heart rate. (also some anxiety if not aerosolized. tachycardia, hypertension
croupp - Answers an acute respiratory syndrome in children and infants characterized by obstruction of
the larynx, hoarseness, and a barking cough
Ketamine - Answers a dissociative anesthetic drug, similar to PCP, that acts as an NMDA receptor
antagonist, bronchodilator effects, use for sedation with Asthma patient. Monitor for hypersalivation.
can give Atropine 0.02 mg/kg
, respiratory acidosis Priority - Answers improve avelor ventilation
ARDS poor prognosis - Answers elevated lactate. indicator of stress. goal see lactate clearance and
reduction. body stress is improving
oxygen delivery DO2 product of - Answers SaO2, Hgb, CO
SaO2 - Answers amount of oxygen bound to hemoglobin in the blood
PaO2 - Answers 2% oxygen in plasma
CO to - Answers how well heart is pumping the blood with hgb and oxygen attached
SVO2 - Answers oxygen reserve and what is left over after tissues have extrated the oxygen
MAP - Answers calculation refecting organ tissue perfusion.
Asthma Respiratory Distress blood gas - Answers decreased pH, increased CO2, normal PaO2
Cyanide inhalation - Answers Worsening respiratory symptoms, cough, and with high flow O2 after a
fire. Treat with Amyl Nitrate and Na Tiosulfate
Pre oxygenate for RSI strategy - Answers For Nitrogen washout Nitrogen 78% of air
ETT Depth - Answers 3 x size of tube
pPlat - Answers plateau pressure (maintain <30 in ARDS) >30 increase risk ventilator lung injury.
Elevated PIP with normal pPlat - Answers obstruction above the carina, upper airway involvement:
volume, flow, Airway constriction, pulmonary toilet, ETT kink, vent circuit kink
Disadvantage pressure limiting vent - Answers No have a guaranteed minute ventilation (Ve) and higher
risk for hypoventilation.
SIMV - Answers Synchronized Intermittent Mandatory Ventilation
A preset rate and tidal volume are set, but the machine allows the patient to initiate AND perform their
own breaths as well. Positive pressure is applied to ASSIST with the breath, but it is the patient doing the
WOB. The ventilator synchronizes the automated breaths with the patient's own breaths.
For Neonates: Set spontaneous breaths >75% of controlled set Vt
Volume control ventilation - Answers *Volume control modes
1) CMV (continuous mandatory ventilation) has a set rate and set tidal volume which does not allow
spontaneous breathing by the patient. Patient-ventilator asynchrony is a big problem, and therefore
CMV is rarely used.
Normal pH - Answers 7.35-7.45
Normal CO2 - Answers 35-45 mmHg
normal bicarbonate levels - Answers 22-26 mEq/L
Every 0.1 increase in pH is a change in K+today - Answers Every 0.1 increase in pH is a 0.6 decrease in K+
Every increase in PaCO2 by 10 change in pH - Answers Every Change in PaCo2 of increase by 10
decreases pH by 0.08
Every increase in HCO3 by 10 change pH - Answers Every increase in HCO3 by 10 increases pH by 0.15
oxyhemoglobin dissociation curve shift right - Answers increase temp, increase dpg, increase CO2,
increase PaO2, decrease pH, decrease SaO2
oxyhemoglobin dissociation curve shift left - Answers decrease temp, decrease DPG, decrease CO2,
decrease PaO2, increase pH, increase SaO2
oxyhemoglobin dissociation curve shift right - Answers reduce affinity for O2
oxyhemoglobin dissociation curve shift left - Answers increase affinity for O2
2,3-DPG - Answers This enzyme stimulates oxygen release from hemoglobin when blood pH is low
(hypoxic/acidotic).
Winters formula - Answers Pco2 = 1.5 [HCO3-] + 8 +/- 2
Winters formula - Answers Respiratory compensation in response to metabolic acidosis can be
quantified w/ this formula: PCO2 = 1.5(HCO3-) + 8 +/-2 (gives you an "expected" value for PCO2 --< use
this to tell if the respiratory response is adequate.)
respiratory failure (RF) - Answers also known as respiratory acidosis, is a condition in which the level of
oxygen in the blood becomes dangerously low (hypoxemia) or the level of carbon dioxide becomes
dangerously high (hypercapnia). It is a medical emergency that can result from a chronic condition or
develop suddenly. PaO2 < 60. PaCO2 > 50
blood transfusion and 2,3-DPG - Answers Citric Acid in PRBCs kill off the 2,3-DPG. hgb losses ability to
release oxygen to tissues and drives oxyhemoglobin curve to the left causing hypoxia
resuscitation should be based on? - Answers lactate and base deficit levels
Lactate levels - Answers Normal: 4.5-19.8 mg/dl
,Indicated in shock, heart failure, lung disease, and intense exercise
Lactate Levels - Answers The normal blood lactate concentration in unstressed patients is 0.5-1 mmol/L.
Patients with critical illness can be considered to have normal lactate concentrations of less than 2
mmol/L. Hyperlactatemia is defined as a mild to moderate persistent increase in blood lactate
concentration (2-4 mmol/L) without metabolic
The Bohr Effect to - Answers Hbg oxygen binding affinity inversely related to both acidity and
concentrations of CO2 ( in presence of increased acid, the Hgb will lose its affinity for oxygen and will
dump it into the tissues= high PaO2 and lower SaO2)
RSV early stage of shock - Answers Respiratory Alkalosis due to increased RR
Metabolic Acidosis which electrolyte falsely elevated - Answers K+, Met Acidosis shifts K+ out of the cell
into the blood.
PRBC does what to 2,3-DPG - Answers PRBC transfusions deplete 2,3-DPG leading to shift to left on
oxyhemoglobin curve, hgb increases affintity for oxygen
Constant NG suction - Answers Metabolic Alkalosis
SpO2 is - Answers Amount of Oxygen bound to Hgb (% hgb saturated)
Acute Respiratory Failure - Answers PaO2 <, PCO2 >50
Increase VO2, decrease oxygen consumption, and pH = Shock - Answers Septic shock in early phases
Oxgyen delivery increased but the tissues cannot extract and use the oxgyen= consumption decreased
and venous oxygen increased.
[1.34 x Hgb x (SaO2)] + PaO2 x 0.003 = - Answers Oxygen content in arteries= oxgyen delivered per
minute
drugs with bronchitis dilator effects - Answers Ketamine, terbutaline, Albuterol
needle thoracostomy not successful - Answers shift of trachea away from needle after procedure,
increased MAP, decreased CO
Albuterol effects - Answers Selectively activate beta-2 receptors with little or no beta- 1 cardiac effects.
However, vasodilatation will occur due to muscle pooling, reducing TPR thereby stimulating reflex
increases in heart rate. (also some anxiety if not aerosolized. tachycardia, hypertension
croupp - Answers an acute respiratory syndrome in children and infants characterized by obstruction of
the larynx, hoarseness, and a barking cough
Ketamine - Answers a dissociative anesthetic drug, similar to PCP, that acts as an NMDA receptor
antagonist, bronchodilator effects, use for sedation with Asthma patient. Monitor for hypersalivation.
can give Atropine 0.02 mg/kg
, respiratory acidosis Priority - Answers improve avelor ventilation
ARDS poor prognosis - Answers elevated lactate. indicator of stress. goal see lactate clearance and
reduction. body stress is improving
oxygen delivery DO2 product of - Answers SaO2, Hgb, CO
SaO2 - Answers amount of oxygen bound to hemoglobin in the blood
PaO2 - Answers 2% oxygen in plasma
CO to - Answers how well heart is pumping the blood with hgb and oxygen attached
SVO2 - Answers oxygen reserve and what is left over after tissues have extrated the oxygen
MAP - Answers calculation refecting organ tissue perfusion.
Asthma Respiratory Distress blood gas - Answers decreased pH, increased CO2, normal PaO2
Cyanide inhalation - Answers Worsening respiratory symptoms, cough, and with high flow O2 after a
fire. Treat with Amyl Nitrate and Na Tiosulfate
Pre oxygenate for RSI strategy - Answers For Nitrogen washout Nitrogen 78% of air
ETT Depth - Answers 3 x size of tube
pPlat - Answers plateau pressure (maintain <30 in ARDS) >30 increase risk ventilator lung injury.
Elevated PIP with normal pPlat - Answers obstruction above the carina, upper airway involvement:
volume, flow, Airway constriction, pulmonary toilet, ETT kink, vent circuit kink
Disadvantage pressure limiting vent - Answers No have a guaranteed minute ventilation (Ve) and higher
risk for hypoventilation.
SIMV - Answers Synchronized Intermittent Mandatory Ventilation
A preset rate and tidal volume are set, but the machine allows the patient to initiate AND perform their
own breaths as well. Positive pressure is applied to ASSIST with the breath, but it is the patient doing the
WOB. The ventilator synchronizes the automated breaths with the patient's own breaths.
For Neonates: Set spontaneous breaths >75% of controlled set Vt
Volume control ventilation - Answers *Volume control modes
1) CMV (continuous mandatory ventilation) has a set rate and set tidal volume which does not allow
spontaneous breathing by the patient. Patient-ventilator asynchrony is a big problem, and therefore
CMV is rarely used.
