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NBRC TMC Exam Practice Questions and Answers
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NBRC TMC Exam Practice Questions and Answers
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NBRC TMC Practice QuestionsWhich of the following is needed to calculate alveolar oxygen tension?
A. VD/VT, PAO2
B. BP and FiO2
C. PetCO2 and PaO2
D. QS/QT, deadspace - Answer -B.
Barometric pressure, FiO2, and PaO2 are all included in the formula (BP stands for barometric pressure)
L/min/m2 is the unit of measure for:
A. Systemic vascular resistance
B. Cardiac output
C. Cardiac index
D. Stroke volume - Answer -C.
A spontaneously breathing patient has the following arterial blood gas results:
pH 7.38 PaCO2 42 mmHgPaO2 76 mmHgHCO3- 24 mEq/LBE 0 mEq/L
Which of the following supplemental oxygen levels is most appropriate?
A. 2 L/min nasal cannula
B. 5 L/min nasal cannula
C. non-rebreathing mask
,D. Venturi mask at 30% - Answer -B.
A patient who is showing signs of hypoxemia should receive supplemental oxygen. If the patient is not a
COPD patient and the situation is not an emergency, then the proper supplemental oxygen is an adult
therapeutic dose, which is 40% to 55%. Of the options available only 5 L/min nasal cannula will approach
this. Other options are either insufficient or too much.
Left heart failure would be manifested in which of the following values?
A. CVP and mPAP
B. mPAP and wedge pressure
C. MAP and SVR
D. cardiac output and wedge pressure - Answer -D.
The function of the left heart, specifically the left ventricle, is best assessed hemodynamically by looking
at those values that precede and come after the left heart. In this case pulmonary capillary wedge
pressure and cardiac output (or cardiac index) are the values found before and after the left heart.
Which of the following findings is most closely associated with increased airway resistance?
A. reduced SpO2
B. accessory muscle use
C. altered P50
D. increased PetCO2 - Answer -B.
Of the options given, use of accessory muscles is most closely associated with an increase in airway
resistance. This is especially true with patients who have asthma or other types of upper airway
inflammation or bronchoconstriction.
For a patient receiving volume-controlled mechanical ventilation, the lower inflection point on a
pressure-volume loop can best be described as:
A. amount of pressure required to keep the alveoli and small airways open
B. optimal PEEP
C. minimal PEEP
D. upper limit of residual volume - Answer -A.
The lowest inflection point on a pressure-volume ventilator graphic is an indication of the minimum
pressure needed to keep alveoli open.
,The results of a V/Q scan shows poor perfusion with adequate ventilation. A chest radiograph shows a
wedge-shaped infiltrate over the right lung field. The patient most likely has
A. fluid overload
B. ARDS
C. a pulmonary embolism
D. pneumonia - Answer -C.
A VQ scan that shows poor perfusion but adequate ventilation is most closely associated with a
pulmonary embolism. Supportive data is found in the radiological report of wedge-shaped infiltrates.
The respiratory therapist notes in the medical record of a 65-year-old male that the patient is ordered to
receive bronchodilator therapy with Albuterol. The therapist also notes the patient is receiving beta-
blocker medication. The therapist should recommend
A. Administer Dexamethasone (Decadron) in place of Albuterol
B. Add Xopenex to the bronchodilator regimen
C. Replace Albuterol with Beclamethasone (Beclovent)
D. Switch from Albuterol to ipratropium bromide (Atrovent) - Answer -D.
Because albuterol is a beta-agonist medication, patients who are taking beta-blockers should utilize
other bronchodilation medication.
A hospital has an extremely low incidence of ventilator-associated pneumonia. To which of the following
reasons may this be attributed?
A. periodic discontinuation of sedation
B. use of respiratory precautions with the population
C. diversion of infectious patients to other facilities
D. broad use of prophylactic antibiotics - Answer -A.
The incidence of ventilator-associated pneumonia, or VAP, is lowered by using a closed system suction
catheter, periodically discontinuing sedation, keeping the patient and semi-Fowler's position, and proper
handwashing among caregivers. All are correct.
A pressure-volume loop ventilator graphic shows no rise in pressure for the first 200 mL of delivered
volume. The therapist should
, A. increase inspiratory flow rate
B. increase PEEP
C. decrease tidal volume
D. decrease inspiratory flow rate - Answer -B.
In this question the description of the pressure volume loop would indicate a flat bottom as manifested
by no rise in pressure with the first 200 mL of delivered volume. We call this a "flat football". The
solution is to increase PEEP to a level that the pressure begins to rise immediately as volume is
introduced.
Which of the following would be the most effective, appropriate method for resolving atelectasis in a
spontaneously breathing, post operative patient who is under the influence of sedation and will not
respond to verbal stimuli?
A. IPPB
B. sustained maximal inhalation (incentive spirometer)
C. deep breathing coaching
D. intubation and mechanical ventilation - Answer -A.
A postoperative patient under sedation, and possibly in pain, may be tempted to breathe less, causing
respiratory acidosis and atelectasis. To correct this problem, IPPB therapy is most appropriate. Incentive
spirometry would also help but the patient is unable to respond to verbal stimuli. This alone is an
indication for IPPB therapy.
After performing minimum occluding volume technique with a 65-kg (143-lb) patient who is orally
intubated with a 7.0-mm ET tube, the respiratory therapist should NEXT
A. check ET tube cuff pressure
B. perform tracheal palpation
C. order a chest radiograph
D. document ET tube markings at the lips - Answer -A.
The ET tube cuff pressure may be adjusted correctly by several techniques including minimum leak
technique (also called minimum occluding volume, minimal seal technique, and the use of a pressure
manometer called a cuffalator. If minimum seal or minimal leak technique is used, the respiratory
therapist is still required to monitor the pressure after the technique is performed. Although this is often
not done in real life, it is technically part of the procedure.
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