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NBRC EXAM, Part I (100% verified) A+ grade assured 2024/2025
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NBRC EXAM, Part I (100% verified) A+ grade assured 2024/2025
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NBRC EXAM, Part IPATIENT ASSESSMENT:
All the following could cause capnography to go from 3 6 to 30 EXCEPT:
A. Endotracheal tube positioned in the right mainstream bronchus
B. Hyperventilation
C. pulmonary emboli
D. Hypovolemia - ANSEndotracheal tube positioned in right mainstem bronchus is a problem
but the co2 reading would not change, so
ANSWER is A.
What is the target Vt for individual on mechanical ventilation - ANS6-8 ml/kg (of ideal body
weight) This is new strategy as of January 2015
Is the following Static OR Dynamic Compliance:
Means flow throughout the respiratory system has stopped and all ventilatory muscle activity
is absent. _______ conditions can be imposed with an inspiratory pause when a patient is
sedated and mechanically ventilated. - ANSStatic Compliance
Is the following Static OR Dynamic Compliance:
Flow at airway opening is zero. Mechanics are evaluated under ______ conditions, when
non-intubated patient breathes spontaneously. - ANSDynamic Compliance
A balloon tipped flow directed catheter is positioned in the pulmonary artery with the balloon
deflated. Which of the following pressures will be measured by the proximal lumen:
a. Cvp
b. Pap
c. Pwp
d. Map - ANSANSWER is A. Cvp = deflated/proximal lumen
Pap = deflated/distal
Pwp = inflated/wedged
All of the following will affect the accuracy of a capnography EXCEPT
a. Long sampling line
b. Low sampling flow
c. Condensation in the tubing
d. Use of desiccant - ANSGas will pass through and out of a long sampling line before
reaching analyzer so, low sampling flow will not give you enough information for a good
reading, and condensation as a rule is always a problem especially in analyzers. Dessicant
removes moisture from the gas, which is a good thing, so
ANSWER is D
,A 1000 g neonate (normal baby is 3000 g) is stable in nicu. Which of the following should the
respiratory therapist use to monitor the neonates overall cardiopulmonary status.
a. TcPCO2 and TcPO2 monitor
b. Arterial blood gas analysis Q4
c. SpO2 monitor
d. Capillary gas analysis Q8 - ANSSince the baby is stable, go less invasive, also go
continuous monitoring (not 4 hour or 8 hour), Transcutaneous (Tc) continuous monitoring of
CO2 and O2 is the best. Answer is A
A unilateral wheeze would most likely indicate which of the following.
a. Asthma
b. Atelectasis
c. Foreign body aspiration
d. Epiglottitis - ANSYou wouldn't have asthma on just one side (unilateral), atelectasis would
cause diminished breath sounds, with epiglottitis you would get stridor, since you are only
hearing wheezing on one side, you are hearing it on the side where you aspirated
something,
so ANSWER is C
All of the following would be associated with the presence of a pneumothorax EXCEPT
a. Tracheal deviation
b. Dull percussion
c. Absent breath sounds
d. Respiratory distress - ANSWith pneumothorax you would hear a high pitch
hyperresonnance, breath sounds would be absent, and respiratory distress could be
present. Dull percussion would NOT be present,
so ANSWER is B.
What should you recommend FIRST for a patient with multifocal pvc's
a. Administration of lidocaine
b. Administration of 100% oxygen
c. Administration of atropine
d. Administration of epinephrine - ANSMultiple pvc's coming from multiple locations
(multifocal) is a real problem and you should administer oxygen FIRST, so ANSWER is B.
lidocaine will help reduce irritability of heart and help with pvc's but would not be first option,
atropine is used for bradycardia and cardiac irregularities but not pvc's, epinephrine is
emergency drug not for pvc's but more for pulseless ventricular tachycardia or ventricular
fibrilation where heart is not responding .
What is the normal range for the mean pulmonary artery pressure in an adult
a. 2-6 mm Hg
b. 4-12 mmHg
c. 9-18 mmHg
d. 21-28 mmHg - ANSMean pulmonary artery pressure in an adult should be in the teens
so best ANSWER is C
,A patient in the emergency dept has frothy secretions, moist crackles, and tachypnea. The
patient has marked dyspnea and a history of heart disease. Which of the following should
the respiratory therapist recommend.
1.suction immediately
2.administer 100% oxygen
3.place in Fowlers position
4.administer furosemide - ANSThis is an emergency, they are having heart problems,
dyspnea, frothy secretions indicating severe pulmonary edema, etc. so 100% oxygen
immediately, having the patient in the Fowlers position (an upright position) will help pull fluid
down away from the lungs, furosemide is a lasix (loop diuretic) which gets rid of excess fluid.
You do NOT suction someone with frothy secretions and heart problems, this just delays
appropriate therapy. So ANSWER is 2,3,4
Fine crepitant crackles are most commonly associated with which of the following conditions.
a. Bronchiectasis
b. Congestive heart failure
c. Pneumonia
d. Croup - ANSCrackles are associated with fluid so a, b, and c would be good answers, but
"fine crepitant" crackles indicates fluid entering alveoli (pulmonary edema) which is most
often caused by heart failure so the best ANSWER is B. (with croup you would hear more of
a stridor sound).
A patient is found in full cardiopulmonary arrest. CPR is started and the patient is orally
intubated with an EtCO2 monitor attached. Which of the following EtCO2 patterns would the
respiratory therapist expect to observe on the monitor?
a. Initially high, then falling
b. Initially low, then rising
c. Initially high, stays high
d. Initially low, stays low - ANSFull cardiac arrest will cause the CO2 in the lungs to slowly
dissipate out because no blood is flowing, then during CPR when you get blood flowing, the
CO2 should slowly rise back up;
so ANSWER is B
If the blood pressure obtained from the arterial line is higher than the blood pressure
obtained from a sphygmomanometer (cuff pressure). Based upon this information, the
respiratory therapist should conclude that.
a. Non-compliant tubing is being used
b. Transducer is placed too low
c. Patient was lying flat during the measurement of the arterial line pressure
d. Transducer dome contained air bubbles - ANSArterial line BP and cuff pressure should be
the same, so there is a problem. Non-compliant tubing is a good thing because it's a stiff
tubing, if transducer is placed too high (above the heart), the flood will have to go uphill and
you will get a lower pressure; transducer dome contained air bubbles would give you erratic
readings but not a higher reading, but if the transducer is placed too low (below heart), the
blood is flowing downhill & will give a higher pressure reading, so ANSWER is B
A 2-year old child enters the emergency room. The mother states that the child was playing
with friends and developed violent coughing and unilateral wheezing. Physical examination
, reveals a hyperresonant percussion note on the left and resonant percussion on the right.
Inspiratory and expiratory chest films indicate air trapping with no foreign bodies "noted."
The respiratory therapist should suspect the child has.
a.pneumothorax
b.orthopnea
c.aspirated a foreign object
d.tachyphylaxis - ANSUnilateral wheezing indicates aspirated object and fact that the child
was playing with friends causes you to believe the child inhaled a small toy or something,
hyperresonant percussion indicates air trapping, so you are thinking foreign object but x-ray
says no foreign bodies "noted." Just because it says "noted" does not mean something is not
there, it just means it could not be seen on the xray, also if the child had swallowed a small
plastic toy, "plastic" does not show up on xrays (radiolucent). The ANSWER is C
A patient is admitted to the ICU complaining of nausea and chest pain. A nasogastric tube
has been inserted to help relieve the nausea. The patient was started on Lasix and
nitroglycerin. Which of the following should be monitored to closely identify side effects at
this time.
a. Cardiac enzymes
b. Serum electrolytes
c. Arterial blood gases
d. Digitalis levels - ANSSince the patient received Lasix and nasogastric tube, they are
losing fluids, and a side effect of fluid loss is a decrease in electrolytes, so ANSWER is B
(there isn't enough evidence of heart attack to justify cardiac enzymes, also they are used to
confirm a heart attack).
Which of the following will determine aortic pulse pressure.
a. systolic + systolic + diastolic/3
b. diastolic + pulse pressure/3
c. systolic pressure - diastolic pressure
d. stroke volume x heart rate x 10. - ANSAortic pulse pressure is just the difference between
systolic and diastolic pressure, so ANSWER is C
A 32-week gestational age infant is receiving mechanical ventilation for hyaline membrane
disease. The patient required a chest tube for a persistent pneumothorax. Two days later the
chest radiograph reveals bilateral radiolucency, midline mediastinum, and the right
hemidiaphragm slightly elevated. This would indicate
A. atelectasis.
B. bronchopulmonary dysplasia.
C. fluid overload.
D. resolution of a pneumothorax. - ANSbilateral means both sides, radiolucency refers to
dark, midline mediastinum is right where is should be, the right hemidiaphragm slightly
elevated is normal; so this actually indicates everything is normal. With atelectasis we would
see patchy infiltrates, loss of volume, with bronchopulmonary dysplasia it would look similar
to ARDS, with fluid overload you would see pattern similar to butterfly or batwing similar to
pulmonary edema, so the best
ANSWER is D and the pneumothorax has resolved.
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