NBRC EXAM, Part I
PATIENT ASSESSMENT:
All the subsequent may want to purpose capnography to go from 3 6 to 30 EXCEPT:
A. Endotracheal tube located in the proper mainstream bronchus
B. Hyperventilation
C. Pulmonary emboli
D. Hypovolemia - ANSEndotracheal tube placed in right mainstem bronchus is a hassle
however the co2 studying might no longer trade, so
ANSWER is A.
What is the goal Vt for character on mechanical air flow - ANS6-8 ml/kg (of ideal frame
weight) This is new method as of January 2015
Is the following Static OR Dynamic Compliance:
Means float at some stage in the respiratory device has stopped and all ventilatory muscle
hobby is absent. _______ conditions may be imposed with an inspiratory pause when a
patient is sedated and automatically ventilated. - ANSStatic Compliance
Is the subsequent Static OR Dynamic Compliance:
Flow at airway opening is zero. Mechanics are evaluated underneath ______ conditions,
while non-intubated affected person breathes spontaneously. - ANSDynamic Compliance
A balloon tipped float directed catheter is located inside the pulmonary artery with the
balloon deflated. Which of the following pressures could be measured through 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 glide
c. Condensation inside the tubing
d. Use of desiccant - ANSGas will skip through and out of a long sampling line before
reaching analyzer so, low sampling float will no longer provide you with sufficient records for
a very good analyzing, and condensation mainly is always a trouble specially in analyzers.
Dessicant eliminates moisture from the gasoline, which is a good thing, so
ANSWER is D
,A a thousand g neonate (everyday baby is 3000 g) is stable in nicu. Which of the
subsequent need to the respiratory therapist use to monitor the neonates basic
cardiopulmonary status.
A. TcPCO2 and TcPO2 reveal
b. Arterial blood gas evaluation Q4
c. SpO2 reveal
d. Capillary fuel evaluation Q8 - ANSSince the infant is strong, move much less invasive,
also go non-stop monitoring (now not four hour or eight hour), Transcutaneous (Tc) non-stop
tracking of CO2 and O2 is the best. Answer is A
A unilateral wheeze could maximum possibly suggest which of the subsequent.
A. Asthma
b. Atelectasis
c. Foreign body aspiration
d. Epiglottitis - ANSYou would not have allergies on simply one facet (unilateral), atelectasis
might reason faded breath sounds, with epiglottitis you'll get stridor, because you are
handiest listening to wheezing on one aspect, you are listening to it at the facet where you
aspirated something,
so ANSWER is C
All of the subsequent could be associated with the presence of a pneumothorax EXCEPT
a. Tracheal deviation
b. Dull percussion
c. Absent breath sounds
d. Respiratory misery - ANSWith pneumothorax you'll pay attention a excessive pitch
hyperresonnance, breath sounds might be absent, and respiration misery could be present.
Dull percussion could NOT be gift,
so ANSWER is B.
What have to you propose FIRST for a affected person with multifocal p.C's
a. Administration of lidocaine
b. Administration of a hundred% oxygen
c. Administration of atropine
d. Administration of epinephrine - ANSMultiple p.C's coming from multiple places (multifocal)
is a real trouble and also you ought to administer oxygen FIRST, so ANSWER is B.
Lidocaine will help reduce irritability of coronary heart and assist with percent's however
would not be first alternative, atropine is used for bradycardia and cardiac irregularities but
no longer percent's, epinephrine is emergency drug no longer for p.C's however greater for
pulseless ventricular tachycardia or ventricular fibrilation in which coronary heart is not
responding .
What is the ordinary range for the imply pulmonary artery pressure in an adult
a. 2-6 mm Hg
b. Four-12 mmHg
c. 9-18 mmHg
d. 21-28 mmHg - ANSMean pulmonary artery pressure in an grownup must be within the
teenagers
,so nice ANSWER is C
A affected person inside the emergency dept has frothy secretions, moist crackles, and
tachypnea. The affected person has marked dyspnea and a records of heart ailment. Which
of the following need to the breathing therapist propose.
1.Suction immediately
2.Administer one hundred% oxygen
three.Region in Fowlers position
four.Administer furosemide - ANSThis is an emergency, they may be having coronary heart
problems, dyspnea, frothy secretions indicating severe pulmonary edema, and so forth. So a
hundred% oxygen without delay, having the affected person in the Fowlers role (an upright
role) will assist pull fluid down away from the lungs, furosemide is a lasix (loop diuretic)
which gets rid of extra fluid. You do NOT suction someone with frothy secretions and
coronary heart problems, this simply delays suitable remedy. So ANSWER is 2,3,four
Fine crepitant crackles are maximum commonly related to which of the subsequent
conditions.
A. Bronchiectasis
b. Congestive coronary heart failure
c. Pneumonia
d. Croup - ANSCrackles are associated with fluid so a, b, and c could be exact solutions,
however "first-rate crepitant" crackles suggests fluid entering alveoli (pulmonary edema) that
is most usually as a result of heart failure so the fine ANSWER is B. (with croup you would
hear greater of a stridor sound).
A affected person is determined in complete cardiopulmonary arrest. CPR is started out and
the affected person is orally intubated with an EtCO2 monitor attached. Which of the
following EtCO2 patterns could the breathing therapist assume to take a look at on the
reveal?
A. Initially excessive, then falling
b. Initially low, then rising
c. Initially excessive, remains excessive
d. Initially low, remains low - ANSFull cardiac arrest will purpose the CO2 inside the lungs to
slowly expend out because no blood is flowing, then in the course of CPR when you get
blood flowing, the CO2 should slowly upward thrust back up;
so ANSWER is B
If the blood strain obtained from the arterial line is better than the blood stress obtained from
a sphygmomanometer (cuff pressure). Based upon this facts, the respiration therapist ought
to finish that.
A. Non-compliant tubing is being used
b. Transducer is positioned too low
c. Patient became lying flat at some stage in the dimension of the arterial line stress
d. Transducer dome contained air bubbles - ANSArterial line BP and cuff stress have to be
the identical, so there's a problem. Non-compliant tubing is a good aspect because it's a stiff
tubing, if transducer is positioned too high (above the coronary heart), the flood will ought to
cross uphill and you may get a decrease pressure; transducer dome contained air bubbles
, would provide you with erratic readings but not a better analyzing, but if the transducer is
located too low (under coronary heart), the blood is flowing downhill & will give a better strain
analyzing, so ANSWER is B
A 2-12 months vintage child enters the emergency room. The mom states that the kid
become playing with pals and developed violent coughing and unilateral wheezing. Physical
examination exhibits a hyperresonant percussion observe on the left and resonant
percussion at the right. Inspiratory and expiratory chest films imply air trapping without a
foreign our bodies "stated." The breathing therapist need to suspect the kid has.
A.Pneumothorax
b.Orthopnea
c.Aspirated a overseas object
d.Tachyphylaxis - ANSUnilateral wheezing indicates aspirated item and reality that the child
become gambling with buddies reasons you to accept as true with the child inhaled a small
toy or some thing, hyperresonant percussion shows air trapping, so you are thinking foreign
object however x-ray says no foreign our bodies "mentioned." Just as it says "referred to"
does no longer imply some thing is not there, it just approach it couldn't be seen at 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 ache. A nasogastric tube
has been inserted to help relieve the nausea. The affected person was began on Lasix and
nitroglycerin. Which of the following should be monitored to intently perceive aspect
consequences at this time.
A. Cardiac enzymes
b. Serum electrolytes
c. Arterial blood gases
d. Digitalis stages - ANSSince the patient acquired Lasix and nasogastric tube, they are
losing fluids, and a aspect effect of fluid loss is a decrease in electrolytes, so ANSWER is B
(there is not enough proof of coronary heart attack to justify cardiac enzymes, also they're
used to confirm a heart assault).
Which of the subsequent will decide aortic pulse pressure.
A. Systolic + systolic + diastolic/three
b. Diastolic + pulse stress/3
c. Systolic pressure - diastolic stress
d. Stroke volume x heart fee x 10. - ANSAortic pulse strain is just the difference among
systolic and diastolic strain, so ANSWER is C
A 32-week gestational age infant is receiving mechanical air flow for hyaline membrane
ailment. The patient required a chest tube for a chronic pneumothorax. Two days later the
chest radiograph exhibits bilateral radiolucency, midline mediastinum, and the proper
hemidiaphragm slightly increased. This would indicate
A. Atelectasis.
B. Bronchopulmonary dysplasia.
C. Fluid overload.
D. Decision of a pneumothorax. - ANSbilateral means both aspects, radiolucency refers to
darkish, midline mediastinum is proper in which is ought to be, the proper hemidiaphragm