CRT NBRC ACTUAL EXAM LATEST 2024/2025 DETAILED
QUESTIONS AND VERIFIED CORRECT ANSWERS/ ALREADY
GRADED A++
A patient is admitted to the ED following a vehicle accident. On physical
exam, the RT discovers that breath sounds are absent in the left chest with
a hyper resonant percussion note. The trachea is shifted to the right. The
patient's heart rate is 45/min, RR is 30/min and BP is 60/40 mmHg. What
action should the therapist reccomend first? - ANSWER Needle aspirate
the 2nd left intercostal space
A 65kg spinal cord injured patient has developed atelectasis. His
inspiratory capacity is 30% of his predicted value. What bronchial hygiene
therapy would be most appropriate initially? - ANSWER IPPB with normal
saline
A healthy adult female can exhale what portion of her forced vital capacity
in the first second? - ANSWER 70%
A patient on VC ventilation has demonstrated auto-PEEP on ventilator
graphics. Which of the following controls, when adjusted independently,
would increase expiratory time? - ANSWER Tidal volume, Respiratory Rate
and Inspiratory flow
A 55 y/o post cardiac surgery patient has the following ABG results: pH
7.50, PaCO2 30 torr, PaO2 62 torr, HCO3 25 mEq/L, SaO2 92%, HB 14
g;dL, BE +2. Venous blood gas results are pH 7.39, PvCO2 43 torr, PvO2
37 torr, and SvO2 66%. Calculate the patient's C(a-v)O2. - ANSWER 4.0
vol%
TO SOLVE:
- Use formula: C(a-v)O2 = CaO2 - CvO2
- CaO2 = (Hb x 1.34 x SaO2) + (PaO2 x 0.003)
**Normal amounts are 4-5%
Immediately after extubation of a patient in the ICU, the RT observes
increasing respiratory distress with intercostal retractions and marked
stridor. The SpO2 on 40% O2 is noted to be 86%. What would be the most
,appropriate response at this time? - ANSWER Reintubation (due to marked
stridor)
What may be obtained from a FVC maneuver during beside PFTs? -
ANSWER FEV1 and PEFR
What suction catheter would be appropriate for a patient with a size 8.0mm
ID ETT? - ANSWER 12 Fr
- Use formula ID size/2 X 3
The RT notes a developing hematoma after and ABG was drawn from the
right radial artery. The immediate response is to: - ANSWER apply
pressure to the site
A patient on the general medical ward is on a 28% air entrainment mask
with the flowmeter set at 5L/min. What is the total flow delivered to the
patient? - ANSWER 55L/min
TO SOLVE
- 28% --> 10:1 ratio --> 11 total flow factor
- Total flow factor x set values for L/min (so 5L/min x 11 = 55L/min)
What measurement is most indicative of pulmonary edema?
- HR 120/min
- BP of 92/72 mmHg
- Pulmonary artery pressure of 25/10 mmHg
- Pulmonary Capillary Wedge Pressure of 30mmHg - ANSWER Pulmonary
capillary wedge pressure of 30mmHg (normal range = 4-12mmHg)
Sleep apnea can be defined as repeated episodes of complete cessation of
airflow for: - ANSWER 10 seconds or longer
A patient in the ICU receiving mechanical ventilation has just undergone a
fiberoptic bronchoscopy procedure in withh a tissue biopsy was collected.
Immediately following the procedure, the RT notes that the peak inspiratory
pressure on the ventilator has increased. Potential causes for this include: -
ANSWER Pneumothorax, pulmonary hemorrhage,
bronchospasm/laryngospasm
,NOT hypoxemia
A patient who suffered trauma in an ATV accident is being monitored in the
ICU. A pulmonary artery catheter has been placed and the following data is
available:
- PvO2 46 torr
- PCWP 19mm Hg
- PAP (mean) 10mm Hg
- CVP 12cm H20
- Qt 3L/min
What should the RT recommend? - ANSWER Positive inotropic agent (b/c
decreased Qt) and diuretic therapy (b/c elevated PCWP)
At 1 minute post-delivery, a newborn has blue extremities with a pink body,
HR is 90/min, RR is 20/min with a weak cry, cough reflex is present, and
there is some flexion of the extremities. At 5 mins post-delivery, the infant is
completely pink, HR is 140/min, RR is 40/min, cough reflex is present and
the baby is active with a strong cry. What APGAR scores should be
assigned? - ANSWER 6 & 10
The RT is asked to administer 2.5 mg of albuterol to a patient via SVN. The
medication is available in a 0.5% solution. What volume of albuterol should
be administered? - ANSWER 0.50 mL
- Use formula: Drug % x 10 = mg/mL (then cross multiplication)
A 60 kg (132 lb) patient is being mechanically ventilated wit hthe following
settings: VC, A/C; VT 500 mL, RR 12/min, FiO2 100% and 10 cm H20
PEEP. The patient's PIP is 60cm H20 and his SpO2 is 85%. A current
chest x-ray shows diffuse bilateral infiltrates. Which of the following is the
most appropriate action in order to reduce PIP? - ANSWER Change to
airway pressure release ventilation (in considering of ARDS, high airway
pressures)
In order to verify the accuracy of a lab-based spirometer device, the RT
should utilize what? - ANSWER 3.0L syringe
, A post-op patient on VC ventilation has a chest tube in the left pleural
space. While inspecting the chest drainage system, the RT notes bubbling
in the water seal chamber during the inspiratory phase. The RT should
report this to the physician as what? - ANSWER A persistent
bronchopleural fistula
A young healthy adult with complaints of intermittent wheezing is seen in
the pulmonary clinic. A pre/post bronchodilator spirometry reveals a normal
study with no reversibility. What should the RT recommend? - ANSWER
Bronchial provocation (methacholine test for asthma)
A tracheostomy tube has just been inserted percutaneously into a patient
with a C3 fracture. How much air should the RT initially inject into the cuff?
- ANSWER Enough to achieve a pressure of 25-35 cm H20
What conditions can be treated with hyperbaric oxygen (HBO) therapy? -
ANSWER Carbon Monoxide poisoning, decompression sickness, and
anaerobic infections
NOT Pulmonary hypertension
The following ABG results are reported for a patient in the ED on room air:
pH 7.20, PaCO2 24 torr, PaO2 95 torr, HCO3 8 mEq/L, SaO2 95%, BE -15
mEq/L. What should the RT recommend? - ANSWER Administering
sodium bicarbonate intravenously
An intubated patient receiving 30% oxygen has a SpO2 of 80% and
ETCO2 of 40 torr. After adminstration of 50% O2 for 30 mins, the RT notes
that the SpO2 rises to 98% and the ETCO2 remains stable at 40 torr. The
major cause of hypoxemia in this patient is - ANSWER ventilation/perfusion
mismatch (they are perfusing, but not ventilating)
A home care patient cal,s in the middle of the night and reports that the O2
supply tubing will not stay attached to her transtracheal catheter. The flow
rate to the transtracheal catheter is set at 0.5 L/min. The patient has
attempted to flush the catheter with saline and push a cleaning rod through
it without success. What should the RT instruct the patient to do? -
ANSWER Switch to a nasal cannula
QUESTIONS AND VERIFIED CORRECT ANSWERS/ ALREADY
GRADED A++
A patient is admitted to the ED following a vehicle accident. On physical
exam, the RT discovers that breath sounds are absent in the left chest with
a hyper resonant percussion note. The trachea is shifted to the right. The
patient's heart rate is 45/min, RR is 30/min and BP is 60/40 mmHg. What
action should the therapist reccomend first? - ANSWER Needle aspirate
the 2nd left intercostal space
A 65kg spinal cord injured patient has developed atelectasis. His
inspiratory capacity is 30% of his predicted value. What bronchial hygiene
therapy would be most appropriate initially? - ANSWER IPPB with normal
saline
A healthy adult female can exhale what portion of her forced vital capacity
in the first second? - ANSWER 70%
A patient on VC ventilation has demonstrated auto-PEEP on ventilator
graphics. Which of the following controls, when adjusted independently,
would increase expiratory time? - ANSWER Tidal volume, Respiratory Rate
and Inspiratory flow
A 55 y/o post cardiac surgery patient has the following ABG results: pH
7.50, PaCO2 30 torr, PaO2 62 torr, HCO3 25 mEq/L, SaO2 92%, HB 14
g;dL, BE +2. Venous blood gas results are pH 7.39, PvCO2 43 torr, PvO2
37 torr, and SvO2 66%. Calculate the patient's C(a-v)O2. - ANSWER 4.0
vol%
TO SOLVE:
- Use formula: C(a-v)O2 = CaO2 - CvO2
- CaO2 = (Hb x 1.34 x SaO2) + (PaO2 x 0.003)
**Normal amounts are 4-5%
Immediately after extubation of a patient in the ICU, the RT observes
increasing respiratory distress with intercostal retractions and marked
stridor. The SpO2 on 40% O2 is noted to be 86%. What would be the most
,appropriate response at this time? - ANSWER Reintubation (due to marked
stridor)
What may be obtained from a FVC maneuver during beside PFTs? -
ANSWER FEV1 and PEFR
What suction catheter would be appropriate for a patient with a size 8.0mm
ID ETT? - ANSWER 12 Fr
- Use formula ID size/2 X 3
The RT notes a developing hematoma after and ABG was drawn from the
right radial artery. The immediate response is to: - ANSWER apply
pressure to the site
A patient on the general medical ward is on a 28% air entrainment mask
with the flowmeter set at 5L/min. What is the total flow delivered to the
patient? - ANSWER 55L/min
TO SOLVE
- 28% --> 10:1 ratio --> 11 total flow factor
- Total flow factor x set values for L/min (so 5L/min x 11 = 55L/min)
What measurement is most indicative of pulmonary edema?
- HR 120/min
- BP of 92/72 mmHg
- Pulmonary artery pressure of 25/10 mmHg
- Pulmonary Capillary Wedge Pressure of 30mmHg - ANSWER Pulmonary
capillary wedge pressure of 30mmHg (normal range = 4-12mmHg)
Sleep apnea can be defined as repeated episodes of complete cessation of
airflow for: - ANSWER 10 seconds or longer
A patient in the ICU receiving mechanical ventilation has just undergone a
fiberoptic bronchoscopy procedure in withh a tissue biopsy was collected.
Immediately following the procedure, the RT notes that the peak inspiratory
pressure on the ventilator has increased. Potential causes for this include: -
ANSWER Pneumothorax, pulmonary hemorrhage,
bronchospasm/laryngospasm
,NOT hypoxemia
A patient who suffered trauma in an ATV accident is being monitored in the
ICU. A pulmonary artery catheter has been placed and the following data is
available:
- PvO2 46 torr
- PCWP 19mm Hg
- PAP (mean) 10mm Hg
- CVP 12cm H20
- Qt 3L/min
What should the RT recommend? - ANSWER Positive inotropic agent (b/c
decreased Qt) and diuretic therapy (b/c elevated PCWP)
At 1 minute post-delivery, a newborn has blue extremities with a pink body,
HR is 90/min, RR is 20/min with a weak cry, cough reflex is present, and
there is some flexion of the extremities. At 5 mins post-delivery, the infant is
completely pink, HR is 140/min, RR is 40/min, cough reflex is present and
the baby is active with a strong cry. What APGAR scores should be
assigned? - ANSWER 6 & 10
The RT is asked to administer 2.5 mg of albuterol to a patient via SVN. The
medication is available in a 0.5% solution. What volume of albuterol should
be administered? - ANSWER 0.50 mL
- Use formula: Drug % x 10 = mg/mL (then cross multiplication)
A 60 kg (132 lb) patient is being mechanically ventilated wit hthe following
settings: VC, A/C; VT 500 mL, RR 12/min, FiO2 100% and 10 cm H20
PEEP. The patient's PIP is 60cm H20 and his SpO2 is 85%. A current
chest x-ray shows diffuse bilateral infiltrates. Which of the following is the
most appropriate action in order to reduce PIP? - ANSWER Change to
airway pressure release ventilation (in considering of ARDS, high airway
pressures)
In order to verify the accuracy of a lab-based spirometer device, the RT
should utilize what? - ANSWER 3.0L syringe
, A post-op patient on VC ventilation has a chest tube in the left pleural
space. While inspecting the chest drainage system, the RT notes bubbling
in the water seal chamber during the inspiratory phase. The RT should
report this to the physician as what? - ANSWER A persistent
bronchopleural fistula
A young healthy adult with complaints of intermittent wheezing is seen in
the pulmonary clinic. A pre/post bronchodilator spirometry reveals a normal
study with no reversibility. What should the RT recommend? - ANSWER
Bronchial provocation (methacholine test for asthma)
A tracheostomy tube has just been inserted percutaneously into a patient
with a C3 fracture. How much air should the RT initially inject into the cuff?
- ANSWER Enough to achieve a pressure of 25-35 cm H20
What conditions can be treated with hyperbaric oxygen (HBO) therapy? -
ANSWER Carbon Monoxide poisoning, decompression sickness, and
anaerobic infections
NOT Pulmonary hypertension
The following ABG results are reported for a patient in the ED on room air:
pH 7.20, PaCO2 24 torr, PaO2 95 torr, HCO3 8 mEq/L, SaO2 95%, BE -15
mEq/L. What should the RT recommend? - ANSWER Administering
sodium bicarbonate intravenously
An intubated patient receiving 30% oxygen has a SpO2 of 80% and
ETCO2 of 40 torr. After adminstration of 50% O2 for 30 mins, the RT notes
that the SpO2 rises to 98% and the ETCO2 remains stable at 40 torr. The
major cause of hypoxemia in this patient is - ANSWER ventilation/perfusion
mismatch (they are perfusing, but not ventilating)
A home care patient cal,s in the middle of the night and reports that the O2
supply tubing will not stay attached to her transtracheal catheter. The flow
rate to the transtracheal catheter is set at 0.5 L/min. The patient has
attempted to flush the catheter with saline and push a cleaning rod through
it without success. What should the RT instruct the patient to do? -
ANSWER Switch to a nasal cannula
