NBRC TMC - RRT EXAM ACTUAL PREP
QUESTIONS AND WELL REVISED ANSWERS -
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A patient is receiving hyperinflation therapy with an IPPB machine and a mouth seal. The
respiratory therapist notices the pressure manometer needle falls back to -10 cm H2O before the
pressure-supported breath begins. Which of the following can the respiratory therapist do to help
this situation?
A. Increase sensitivity
B. Decrease inspiratory pressure
C. Push the air-mix knob in
D. Increase flow –
- ANSWER: A.
The negative deflection of the pressure needle to -10 cmH2O before the machine cycles into
inhalation is too significant and will ultimately increase the work of breathing for the patient. To
counteract the amount of pressure needed to cycle the machine, sensitivity should be increased.
A respiratory therapist is treating all patients in the intensive care unit as if they have HIV and
hepatitis. This approach is called
A. patient discrimination.
B. enteric isolation.
C. co-horting.
D. standard precautions. –
- ANSWER: D.
The standard precautions (also called universal precautions) approach includes treating all
patient as if they are infectious.
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What is indicated by an increasing gap between SaO2 values and SvO2 values while the C(a-
v)O2 is also increasing?
A. an increase in cardiac index
B. decreasing oxygen consumption at the tissue level
C. an increase in SVRI
D. a decrease in cardiac output –
- ANSWER: D.
The following clinical information is available for a patient with chronic congestive heart failure
being considered for home oxygen needs. What is the appropriate oxygen treatment plan for
home?
SpO2 #1: room air, resting: 89%
SpO2 #2: 2 L/min NC resting: 95%
A. further evaluation is needed
B. room air
C. continuous supplemental oxygen
D. oxygen as needed –
- ANSWER: C.
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Home oxygen therapy is indicated for CHF patients to maintain oxygen saturations above 90%.
While 89% may be acceptable for COPD patients, it is insufficient for patients with heart
disease.
The following patient data is observed:
Blood gas and CO-oximeter results pH 7.35
PaCO2 27 torr
PaO2 40 torr
Hemoglobin 14.0 g/dL
Oxyhemoglobin 96%
HCO3- 13 mEq/L
Carboxyhemoglobin 2%
Methemoglobin 2%
SaO2 76%
BE -11 mEq/L
The respiratory therapist should
A. report SaO2 as 76%
B. administer sodium bicarbonate
C. perform a calibration of the instrument and repeat the analysis
D. administer potassium chloride, IV –
- ANSWER: C.
A close examination of the blood gas reveals some contrasting information. Oxyhemoglobin is
96% while the O2 sat is only 76%. These data indicate a need to recalibrate the instrument and
repeat the analysis.
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Which of the following could cause focal atelectasis in the right lobe?
A. bacterial pneumonia
B. pneumothorax
C. a pulmonary effusion
D. a foreign body aspirate - ANSWER: D.
Focal atelectasis (in a specific isolated area) would most likely be caused by foreign body
aspiration, compared to the other options listed.
A spontaneously breathing patient is in the emergency room with suspected ingestional error of
barbiturates. Current ABGs show
pH 7.35
PaCO2 45 torr
PaO2 69 torr
FIO2 0.50 by air-entrainment mask
The respiratory therapist should do which of the following?
A. administer Narcan (naloxone)
B. increase FIO2 to 1.0
C. mask CPAP 5 cm H2O
D. induce vomiting - ANSWER: C.