NBRC Book Exam Review Questions With 100% Correct Answers
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Course
NBRC
Institution
NBRC
NBRC Book Exam Review Questions With 100% Correct Answers
VCV for ARDS patients leads to high ____ and an increased potential of barotrauma by ______.
-peak pressures
-overdistention of the alveoli
A patient with pneumonia is performing PEP therapy. A PEP level of 17 cm H2O is generated dur...
NBRC Book Exam Review Questions With
100% Correct Answers
VCV for ARDS patients leads to high ____ and an increased potential of barotrauma by ______.
-peak pressures
-overdistention of the alveoli
A patient with pneumonia is performing PEP therapy. A PEP level of 17 cm H2O is generated during
each exhalation. The therapist should:
-maintain current therapy
Normal level is between 10-20cmH2O
For ARDS patients, using inspiratory pressures that deliver lower _____ and maintaining plateau
pressures at ____ will reduce the risk of _____.
-tidal volumes (4-6mL/kg)
-30cmH2O or less
-overdistention of the alveoli
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If little resistance occurs when the bag is compress and the chest rises minimally when you are
manually resuscitating or "bagging" the patient what is indicated?
-Where might the problem be located?
-a leak is indicated
Can be around the ETT cuff, mask, exhalation valve, or bag inlet valve
A side effect of bland aerosol administration is _____, especially in asthmatic patients. Replacing the
nebulizer with a _____ is necessary, since it produces water vapor (not particulate water that is more
irritating to the airway).
-bronchospasm
-humidifier
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For neonates a PaO2 greater than 80mmHg can result in ___ which can lead to detachment of the
artery and _____.
-vasoconstriction of the retinal arteries
-blindness
Normal neonate PaO2 is 50-70mmHg
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What is the determining factor of obstructive vs restrictive disease?
FEV1/FVC
Anytime FEV1/FVC is <75% the disease process is obstructive
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Anytime FEV1/FVC is <75% the disease process what?
-obstructive
Plenty of air getting in during inspiration but the FEV1 is reduced because of airflow obstruction.
Obstructive disease patients generally don't have problems getting air in
Anytime we see "patient with severe COPD" we may think we need to alter oxygen levels because the
patients _____. This is often true but not during _____. The patients lungs must be ventilated with
____% oxygen so that the PaO2 _____. To deliver 100% during resuscitation, the bag should have a
______ attachment and a flow rate of ____.
-chronic hypoxemia
-resuscitation
-100%
-returns to the "normal" range
-reservoir
-15L/min
Normal PaO2 for severe COPD is 50-65mmHg
Posterior Lobes, what direction do you want to put them for postural drainage?
-prone postion
Think the two Ps. Posterior segments drain anteriorly therefore the patient needs to be placed on
their stomach (prone)
What direction do you want to put a patient for postural drainage when the anterior lobes are the
issue?
supine position
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Lucency is defined as ____ areas on a CXR
black areas
,Hyperlucency indicates excessive ______ areas on a CXR. Air is _____ on a CXR therefore there is
more air present than normal. This is caused by _____, _____ (due to ____), and a _____
-black areas
-black
-hyperinflation
-emphysema due to air trapping
-pneumothorax
When a pneumothorax is present, the lung _____ and ____ enters into the _____. The excessive air in
the pleural space results in _____ on a CXR.
-collapses
-air
-pleural space
-hyperlucency
What is the first step to make sure there is flow passing through a nasal cannula?
-have the patient remove the NC and place it in a cup of water
-if there is flow then bubbling will occur
If there is no bubbling then the patient should make sure the NC is attached to the flowmeter outlet
and the flowmeter is turned on. If there is any doubt, the patient should connect the NC to the
cylinder back-up and call the home care company
In regards to ARDS patients, lung protective strategies such as _____ Vt, resulting in lower ____ levels
help prevent further lung damage.
low (4-6 mL/kg)
PIP
Explain Permissive Hypercapnia:
-using lower Vt will cause the PaCO2 to increase but as long as the pH remains above 7.20 it's safe
-beneficial in reducing the mortality in ARDS patients
An alert, spontaneously breathing patient has a PaCO2 of 33 and a PaO2 of 55 while receiving an
FiO2 .70. What is an appropriate way to increase the patients PaO2?
Answer = Apply CPAP at 60% O2
Explanation: ABG indicates the patient is hyperventilating with hypoxemia while receiving 70%
oxygen, this indicates an intrapulmonary shunt and refractory hypoxemia with a dangerously high O2
level.
On the exams try to maintain adequate oxygen without exceeding ____ O2.
-60%
If CPAP is applied, FRC will increase and oxygenation should improve. This will allow the oxygen level
to be reduced to a safer level
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, A patient has a pH of 7.18 and PaCO2 of 24. Which of the following can be concluded regarding this
ABG?
a.) respiratory acidosis is present
b.) the patient is hypoventilating
c.) metabolic acidosis is present
d.) the base excess must be increased
Answer = metabolic acidosis is present
The PaCO2 is low, which results in an alkalotic pH.
Explanation: there are two instances when the pH is acidotic (1) when the PacO2 is increased or (2)
HCO3 is decreased. In this question the PaCO2 is low, which results in an alkalotic pH, so we know
that the PaCO2 is not responsible for the low pH. Therefore, a metabolic acidosis is present.
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If the patient is on less than 50% O2 the board exams will want you to increase _____.
the O2 level
For hypotensive or head trauma patients will you increase PEEP?
no don't increase PEEP
that may worsen their situation
PEEP increases FRC by recruiting ______. This results in a decrease in the _____ (pressure needed to
ventilate the lungs) and an increase in ______. When more alveoli are opened, more oxygen will
diffuse into the blood, which will increase the _____ and result in a decrease in the_____.
-collapsed alveoli
-plateau pressure
-lung compliance
-PaO2
-A-a gradient
The SIMV mode is used as a weaning technique, to allow the patient to begin to do what?
to begin breathing on their own while the ventilator rate is reduced
What is the definition of plateau pressure?
the pressure needed to ventilate the lungs
Since mechanical ventilation has been initiated, it's not important to determine the patients FVC and
MIP. It's more important to determine what?
the required minute ventilation which is RR and Vt that is necessary for the patient
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