NBRC Practice TMC Exam Questions &
Answers
Question 1
A patient shows a right sided pleural effusion. Which of the following should the
respiratory therapist recommend?
A. sputum culture and gram stain
B. diagnostic bronchoscopy
C. pleurodesis
D. thoracentesis
Correct Answer
D. Thoracentesis
Thoracentesis - a medical procedure that involves inserting a needle or catheter into
the chest wall to remove fluid or air from the pleural space, the space between the
lungs and chest wall.
Question 2
A pt with exacerbation of COPD is receiving NPPV in spontaneous mode with a nasal
mask. The following data are available:
FiO2 : 0.24 RR : 28/min IPAP : 12 cmH2O EPAP: 6 cmH2O
One hour later, the following data are available:
pH : 7.27 PaCO2 : 76 mmHg PaO2 : 62 mmHg HCO3- : 35 mEq/L BE : +5 mEq/L
SaO2(calc) : 90%
The inspiratory phase is prolonged and dyssynchrony is noted. Which of the following
should a RT do FIRST?
A. Increase the FiO2 to 0.28
B. Increase to EPAP 8 cmH2O
C. Change to a full-face mask
D. Change the ventilator circuit
Correct Answer
C. Change to a full-face mask
Page 1 of 38
,Question 3
A pt who is 6'2" tall and weighs 98kg is receiving VC ventilation with Vt 600mL. A RT
observes the low exhaled volume and low pressure alarms activating with each
breath. The following data are available: Vte: 340-390mL; ETT size: 8.5mm; ETT cuff
pressure: 19cmH2O; ETT position: 18cm@incisor; HR 98; RR 32; SpO2 83%
Which of the following should the RT do?
A. advance the ETT @22cm
B. adjust the cuff pressure to 30cmH2O
C. increase the Vt to 700mL
D. reintubate with a larger ETT
Correct Answer
A. advance the ETT @22cm
Advance ETT before adjusting cuff pressure
Question 4
A RT is assisting a physician with insertion of a chest tube in a pt with a pleural
effusion. After the tube is place and the chest drainage system is functioning properly,
which of the following should be observed in the water-seal chamber?
A. Continuous bubbling
B. Water level functioning with breathing
C. The water becoming cloudy
D. No visible liquid
Correct Answer
B. Water level functioning with breathing
Question 5
A mini-bronchoalveolar lavage procedure is recommended for diagnosis?
A. ventilator associated pneumonia
B. pleural effusion
C. pulmonary embolism
D. idiopathic pulmonary fibrosis
Correct Answer
A. ventilator associated pneumonia (VAP)
Page 2 of 38
,Question 6
A 44yo pt who underwent abdominal surgery is receiving vibratory PEP therapy. After
24hr of q4h therapy, the patient can ambulate independently while breathing air. A
respiratory therapist should recommend?
A. discontinuing therapy
B. obtaining an ABG analysis
C. performing a 6MWT
D. changing frequency of therapy to q8h
Correct Answer
A. discontinuing therapy
Question 7
A RT is reviewing a chart of a 60yo male who is 5'10" tall, weighs 73kg and has
moderate dyspnea. The CXR reports indicates the pt has flattened diaphragm, severe
hyperinflation, and small cardiothoracic ratio. The PFT results are as follows: FVC
2.45L; FEV1/FVC% 48%; FEF25-75% 1.25L/sec; FRC by Helium dilution: 3.75L; RV/TLC%
45%; DLCO 12mL/min/mmHg
Which of the following should the RT review to further evaluate the extent of air
trapping?
A. flow-volume loop
B. post bronchodilator therapy
C. nitrogen washout
D. body plethysmography
Correct Answer
A. flow-volume loop
Question 8
Which of the following devices best measures the accuracy of an air/O2 blender?
A. capnometer
B. pressure manometer
C. O2 flowmeter
D. polargraphic analyzer
Correct Answer
D. polargraphic analyzer
Page 3 of 38
, Question 9
Before initiating tracheostomy tube change, the respiratory therapist should
A. check the new tracheostomy tube cuff
B. recommend sedating the pt
C. administer intratracheal lidocaine HCl
D. obtain a larger tracheostomy tube.
Correct Answer
A. check the new tracheostomy tube cuff
Question 10
A 38yo male is being considered for possible extubation after receiving treatment for
an asthma exacerbation over the last 36hrs. Breath sounds are clear, and no current
distress is noted. While receiving an FiO2 of 0.40, PS of 15cmH2O, and 8cmH2O PEEP,
physiologic data are: HR 88; RR 20; SpO2 97%. An SBT is initiated by T-piece with an
FiO2 of 0.40. Fifteen minutes into the trial, physiologic data are: HR 119; RR 25; SpO2
93%. A RT should conclude the:
A. patient is ready for extubation
B. patient has failed the SBT
C. patient's trial should be continued
D. patient requires VC, AC ventilation
Correct Answer
B. patient has failed the SBT
Question 11
Which of the following treatment options is most effective for a patient with the
diagnosis with central sleep apnea?
A. continuous positive airway pressure
B. uvulopalatopharyngoplasty
C. bilevel positive airway pressure
D. prone position
Correct Answer
C. bilevel positive airway pressure
Page 4 of 38
Answers
Question 1
A patient shows a right sided pleural effusion. Which of the following should the
respiratory therapist recommend?
A. sputum culture and gram stain
B. diagnostic bronchoscopy
C. pleurodesis
D. thoracentesis
Correct Answer
D. Thoracentesis
Thoracentesis - a medical procedure that involves inserting a needle or catheter into
the chest wall to remove fluid or air from the pleural space, the space between the
lungs and chest wall.
Question 2
A pt with exacerbation of COPD is receiving NPPV in spontaneous mode with a nasal
mask. The following data are available:
FiO2 : 0.24 RR : 28/min IPAP : 12 cmH2O EPAP: 6 cmH2O
One hour later, the following data are available:
pH : 7.27 PaCO2 : 76 mmHg PaO2 : 62 mmHg HCO3- : 35 mEq/L BE : +5 mEq/L
SaO2(calc) : 90%
The inspiratory phase is prolonged and dyssynchrony is noted. Which of the following
should a RT do FIRST?
A. Increase the FiO2 to 0.28
B. Increase to EPAP 8 cmH2O
C. Change to a full-face mask
D. Change the ventilator circuit
Correct Answer
C. Change to a full-face mask
Page 1 of 38
,Question 3
A pt who is 6'2" tall and weighs 98kg is receiving VC ventilation with Vt 600mL. A RT
observes the low exhaled volume and low pressure alarms activating with each
breath. The following data are available: Vte: 340-390mL; ETT size: 8.5mm; ETT cuff
pressure: 19cmH2O; ETT position: 18cm@incisor; HR 98; RR 32; SpO2 83%
Which of the following should the RT do?
A. advance the ETT @22cm
B. adjust the cuff pressure to 30cmH2O
C. increase the Vt to 700mL
D. reintubate with a larger ETT
Correct Answer
A. advance the ETT @22cm
Advance ETT before adjusting cuff pressure
Question 4
A RT is assisting a physician with insertion of a chest tube in a pt with a pleural
effusion. After the tube is place and the chest drainage system is functioning properly,
which of the following should be observed in the water-seal chamber?
A. Continuous bubbling
B. Water level functioning with breathing
C. The water becoming cloudy
D. No visible liquid
Correct Answer
B. Water level functioning with breathing
Question 5
A mini-bronchoalveolar lavage procedure is recommended for diagnosis?
A. ventilator associated pneumonia
B. pleural effusion
C. pulmonary embolism
D. idiopathic pulmonary fibrosis
Correct Answer
A. ventilator associated pneumonia (VAP)
Page 2 of 38
,Question 6
A 44yo pt who underwent abdominal surgery is receiving vibratory PEP therapy. After
24hr of q4h therapy, the patient can ambulate independently while breathing air. A
respiratory therapist should recommend?
A. discontinuing therapy
B. obtaining an ABG analysis
C. performing a 6MWT
D. changing frequency of therapy to q8h
Correct Answer
A. discontinuing therapy
Question 7
A RT is reviewing a chart of a 60yo male who is 5'10" tall, weighs 73kg and has
moderate dyspnea. The CXR reports indicates the pt has flattened diaphragm, severe
hyperinflation, and small cardiothoracic ratio. The PFT results are as follows: FVC
2.45L; FEV1/FVC% 48%; FEF25-75% 1.25L/sec; FRC by Helium dilution: 3.75L; RV/TLC%
45%; DLCO 12mL/min/mmHg
Which of the following should the RT review to further evaluate the extent of air
trapping?
A. flow-volume loop
B. post bronchodilator therapy
C. nitrogen washout
D. body plethysmography
Correct Answer
A. flow-volume loop
Question 8
Which of the following devices best measures the accuracy of an air/O2 blender?
A. capnometer
B. pressure manometer
C. O2 flowmeter
D. polargraphic analyzer
Correct Answer
D. polargraphic analyzer
Page 3 of 38
, Question 9
Before initiating tracheostomy tube change, the respiratory therapist should
A. check the new tracheostomy tube cuff
B. recommend sedating the pt
C. administer intratracheal lidocaine HCl
D. obtain a larger tracheostomy tube.
Correct Answer
A. check the new tracheostomy tube cuff
Question 10
A 38yo male is being considered for possible extubation after receiving treatment for
an asthma exacerbation over the last 36hrs. Breath sounds are clear, and no current
distress is noted. While receiving an FiO2 of 0.40, PS of 15cmH2O, and 8cmH2O PEEP,
physiologic data are: HR 88; RR 20; SpO2 97%. An SBT is initiated by T-piece with an
FiO2 of 0.40. Fifteen minutes into the trial, physiologic data are: HR 119; RR 25; SpO2
93%. A RT should conclude the:
A. patient is ready for extubation
B. patient has failed the SBT
C. patient's trial should be continued
D. patient requires VC, AC ventilation
Correct Answer
B. patient has failed the SBT
Question 11
Which of the following treatment options is most effective for a patient with the
diagnosis with central sleep apnea?
A. continuous positive airway pressure
B. uvulopalatopharyngoplasty
C. bilevel positive airway pressure
D. prone position
Correct Answer
C. bilevel positive airway pressure
Page 4 of 38
