NBRC TMC EXAM PART 1- LATEST

NBRC TMC EXAM PART 1- LATEST 2024-2025

PATIENTzASSESSMENT:

Allzthezfollowingzcouldzcausezcapnographyztozgozfromz3z6ztoz30zEXCEPT:

A.zEndotrachealztubezpositionedzinzthezrightzmainstreamzbronchus

B.zHyperventilation

C.zpulmonaryzemboli

D.zHypovolemiaz-zCORRECTzANSWER-
Endotrachealztubezpositionedzinzrightzmainstemzbronchusziszazproblemzbutzthezco2zreadingzwouldznotzch
ange,zsoz



ANSWERziszA.



WhatzisztheztargetzVtzforzindividualzonzmechanicalzventilationz-zCORRECTzANSWER-6-
8zml/kgz(ofzidealzbodyzweight)zThiszisznewzstrategyzaszofzJanuaryz2015



IszthezfollowingzStaticzORzDynamiczCompliance:

Meanszflowzthroughoutzthezrespiratoryzsystemzhaszstoppedzandzallzventilatoryzmusclezactivityziszabsent.z_
______zconditionszcanzbezimposedzwithzanzinspiratoryzpausezwhenzazpatientziszsedatedzandzmechanicallyz
ventilated.z-zCORRECTzANSWER-StaticzCompliance



IszthezfollowingzStaticzORzDynamiczCompliance:

Flowzatzairwayzopeningziszzero.zMechanicszarezevaluatedzunderz______zconditions,zwhenznon-
intubatedzpatientzbreatheszspontaneously.z-zCORRECTzANSWER-DynamiczCompliance



Azballoonztippedzflowzdirectedzcatheterziszpositionedzinzthezpulmonaryzarteryzwithzthezballoonzdeflated.z
Whichzofzthezfollowingzpressureszwillzbezmeasuredzbyzthezproximalzlumen:

a.zCvp

b.zPap

c.zPwp

d.zMapz-zCORRECTzANSWER-ANSWERziszA.zCvpz=zdeflated/proximalzlumen

,Papz=zdeflated/distal

Pwpz=zinflated/wedged



AllzofzthezfollowingzwillzaffectzthezaccuracyzofzazcapnographyzEXCEPT

a.zLongzsamplingzline

b.zLowzsamplingzflow

c.zCondensationzinztheztubing

d.zUsezofzdesiccantz-zCORRECTzANSWER-
Gaszwillzpasszthroughzandzoutzofzazlongzsamplingzlinezbeforezreachingzanalyzerzso,zlowzsamplingzflowzwillz
notzgivezyouzenoughzinformationzforzazgoodzreading,zandzcondensationzaszazruleziszalwayszazproblemzespe
ciallyzinzanalyzers.zDessicantzremoveszmoisturezfromzthezgas,zwhichziszazgoodzthing,zsoz

ANSWERziszD



Az1000zgzneonatez(normalzbabyzisz3000zg)ziszstablezinznicu.zWhichzofzthezfollowingzshouldzthezrespiratoryzt
herapistzuseztozmonitorzthezneonateszoverallzcardiopulmonaryzstatus.

a.zTcPCO2zandzTcPO2zmonitor

b.zArterialzbloodzgaszanalysiszQ4

c.zSpO2zmonitor

d.zCapillaryzgaszanalysiszQ8z-zCORRECTzANSWER-
Sincezthezbabyziszstable,zgozlesszinvasive,zalsozgozcontinuouszmonitoringz(notz4zhourzorz8zhour),zTranscuta
neousz(Tc)zcontinuouszmonitoringzofzCO2zandzO2ziszthezbest.zAnswerziszA



Azunilateralzwheezezwouldzmostzlikelyzindicatezwhichzofzthezfollowing.

a.zAsthma

b.zAtelectasis

c.zForeignzbodyzaspiration

d.zEpiglottitisz-zCORRECTzANSWER-
Youzwouldn'tzhavezasthmazonzjustzonezsidez(unilateral),zatelectasiszwouldzcausezdiminishedzbreathzsound
s,zwithzepiglottitiszyouzwouldzgetzstridor,zsincezyouzarezonlyzhearingzwheezingzonzonezside,zyouzarezhearin
gzitzonzthezsidezwherezyouzaspiratedzsomething,z

sozANSWERziszC

,AllzofzthezfollowingzwouldzbezassociatedzwithzthezpresencezofzazpneumothoraxzEXCEPT

a.zTrachealzdeviation

b.zDullzpercussion

c.zAbsentzbreathzsounds

d.zRespiratoryzdistressz-zCORRECTzANSWER-
Withzpneumothoraxzyouzwouldzhearzazhighzpitchzhyperresonnance,zbreathzsoundszwouldzbezabsent,zandz
respiratoryzdistresszcouldzbezpresent.zDullzpercussionzwouldzNOTzbezpresent,z



sozANSWERziszB.



WhatzshouldzyouzrecommendzFIRSTzforzazpatientzwithzmultifocalzpvc's

a.zAdministrationzofzlidocaine

b.zAdministrationzofz100%zoxygen

c.zAdministrationzofzatropine

d.zAdministrationzofzepinephrinez-zCORRECTzANSWER-
Multiplezpvc'szcomingzfromzmultiplezlocationsz(multifocal)ziszazrealzproblemzandzyouzshouldzadministerzox
ygenzFIRST,zsozANSWERziszB.zlidocainezwillzhelpzreducezirritabilityzofzheartzandzhelpzwithzpvc'szbutzwouldzn
otzbezfirstzoption,zatropineziszusedzforzbradycardiazandzcardiaczirregularitieszbutznotzpvc's,zepinephrinezisz
emergencyzdrugznotzforzpvc'szbutzmorezforzpulselesszventricularztachycardiazorzventricularzfibrilationzwhe
rezheartzisznotzrespondingz.



Whatzisztheznormalzrangezforzthezmeanzpulmonaryzarteryzpressurezinzanzadult

a.z2-6zmmzHg

b.z4-12zmmHg

c.z9-18zmmHg

d.z21-28zmmHgz-zCORRECTzANSWER-Meanzpulmonaryzarteryzpressurezinzanzadultzshouldzbezinzthezteensz



sozbestzANSWERziszC

, Azpatientzinzthezemergencyzdeptzhaszfrothyzsecretions,zmoistzcrackles,zandztachypnea.zThezpatientzhaszma
rkedzdyspneazandzazhistoryzofzheartzdisease.zWhichzofzthezfollowingzshouldzthezrespiratoryztherapistzreco
mmend.

1.suctionzimmediately

2.administerz100%zoxygen

3.placezinzFowlerszposition

4.administerzfurosemidez-zCORRECTzANSWER-
Thisziszanzemergency,ztheyzarezhavingzheartzproblems,zdyspnea,zfrothyzsecretionszindicatingzseverezpulmo
naryzedema,zetc.zsoz100%zoxygenzimmediately,zhavingzthezpatientzinzthezFowlerszpositionz(anzuprightzposi
tion)zwillzhelpzpullzfluidzdownzawayzfromzthezlungs,zfurosemideziszazlasixz(loopzdiuretic)zwhichzgetszridzofze
xcesszfluid.zYouzdozNOTzsuctionzsomeonezwithzfrothyzsecretionszandzheartzproblems,zthiszjustzdelayszappr
opriateztherapy.zSozANSWERzisz2,3,4



Finezcrepitantzcrackleszarezmostzcommonlyzassociatedzwithzwhichzofzthezfollowingzconditions.

a.zBronchiectasis

b.zCongestivezheartzfailure

c.zPneumonia

d.zCroupz-zCORRECTzANSWER-
Crackleszarezassociatedzwithzfluidzsoza,zb,zandzczwouldzbezgoodzanswers,zbutz"finezcrepitant"zcrackleszindic
ateszfluidzenteringzalveoliz(pulmonaryzedema)zwhichziszmostzoftenzcausedzbyzheartzfailurezsozthezbestzANS
WERziszB.z(withzcroupzyouzwouldzhearzmorezofzazstridorzsound).



Azpatientziszfoundzinzfullzcardiopulmonaryzarrest.zCPRziszstartedzandzthezpatientziszorallyzintubatedzwithzan
zEtCO2zmonitorzattached.zWhichzofzthezfollowingzEtCO2zpatternszwouldzthezrespiratoryztherapistzexpectzt

ozobservezonzthezmonitor?

a.zInitiallyzhigh,zthenzfalling

b.zInitiallyzlow,zthenzrising

c.zInitiallyzhigh,zstayszhigh

d.zInitiallyzlow,zstayszlowz-zCORRECTzANSWER-
FullzcardiaczarrestzwillzcausezthezCO2zinzthezlungsztozslowlyzdissipatezoutzbecauseznozbloodziszflowing,zthe
nzduringzCPRzwhenzyouzgetzbloodzflowing,zthezCO2zshouldzslowlyzrisezbackzup;z

sozANSWERziszB