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TMC exam test bank wrong questions 6-10/NBRC new latest version best studying material with verified answers graded A WITH 150+ QUESTIONS
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TMC exam test bank questions 6-10/NBRC new latest version best studying material with verified answers graded A WITH 150+ QUESTIONS

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  • August 30, 2024
  • 57
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • tmc exam
  • tmc test bank questions 6 10nbrc new latest

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TMC test bank wrong questions 6-10/NBRC
new latest version 2024-2025 best studying
material with verified answers graded A
WITH 150+ QUESTIONS
Which of the following is TRUE regarding humidification during high flow nasal

cannula therapy?

A. an unheated large volume nebulizer with large-bore tubing is required

B. a simple unheated wick humidifier provides adequate humidification

C. both a heated humidifier and heated delivery circuit are required

D. extra humidity is not needed because the upper airway is not bypassed

- ANSWER For O2 delivery, a high flow nasal cannula system typically requires the following

equipment: oxygen blender, high flow flowmeter (up to 40 L/min for adults); heated

humidifier (or wick-like cartridge); and O2 analyzer. To prevent condensation, the

delivery tubing also must be heated, either via wires or coaxial flow of warm water.

The correct answer is: both a heated humidifier and heated delivery circuit are

required



To get a better view of the glottis before inserting an ET tube, you could ask the

attending nurse to:

A. place downward pressure on the cricoid cartilage

B. maximally flex the patient's neck and head

C. insert a second laryngoscope in the mouth

D. pass a suction catheter through the nasopharynx

- ANSWER Applying downward pressure to the cricoid cartilage (similar to the Sellick maneuver

used to prevent aspiration) displaces the larynx posteriorly, which may help align the

,laryngopharynx and trachea and provides better visualization of the glottic opening, at

least in some patients. If cricoid pressure fails to improve or worsens the laryngoscopic

view (which also can occur), it should be terminated.

The correct answer is: place downward pressure on the cricoid cartilage



In a neonate, all of the following are indication of HFV except:

A. cleft palate before surgical correction

B. PPHN

C. RDS unresponsive to conventional ventilation

D. mechanical ventilation patient with unresolved pneumothorax

- ANSWER An oral or nasal ET tube is inserted into a patient's airway before a cleft palate is

surgically repaired; a standard neonatal vent is used if needed. There is no special

reason to use HFV. Patients with all of the other clinical situations have been shown to

benefit from HFV.

The correct answer is: cleft palate before surgical correction



Which of the following patients is a poor candidate for IPPB therapy?

A. a post-op female patient with clinically diagnosed atelectasis

B. a chronically hypercapnic patient with full metabolic compensation

C. a patient being treated for acute cardiogenic pulmonary edema

D. a patient with acute-on-chronic respiratory acidosis

- ANSWER Hypercapnic patients with full metabolic compensation are poor candidates for IPPB

therapy. Rapid reduction of the PaCO2 in such patients may impose an acute

"metabolic" alkalosis on top of their compensated state. The best supported

indications for IPPB are for treating 1) clinically diagnosed atelectasis, 2) impending

hypercapnic respiratory failure (acute-on-chronic respiratory acidosis), and 3)

462

decreased compliance in kyphoscoliosis. Note that in most clinical centers BiPAP has

largely replaced IPPB for all of these indications except the treatment of atelectasis.

,The correct answer is: a chronically hypercapnic patient with full metabolic

compensation



Therapeutic gases being delivered to patients need to be humidified because

they:

A. have low specific gravities

B. become less combustible when humidified

C. are supplied at low critical temperatures

D. are supplied in the anhydrous state

- ANSWER The most common use for humidity therapy is to add water vapor to O2 being

administered to patients with normal upper airways. This is necessary because purity

standards require medical gases to be in the dry or anhydrous state. For this reason,

supplemental humidity may also be provided for anesthetic gases, for gases in the

pulmonary function laboratory, or for therapeutic gas mixtures such as oxygen-carbon

dioxide or helium-oxygen mixtures.

The correct answer is: are supplied in the anhydrous state



Continuous positive airway pressure (CPAP) is indicated as a treatment for:

A. post-operative atelectasis

B. acute exacerbation of COPD

C. hypercapnic respiratory failure

D. acute pulmonary emboli

- ANSWER CPAP is indicated to treat hypoxemia due to shunting in patients with adequate

spontaneous ventilation (e.g., ARDS, IRDS). CPAP is also used to treat patients with

atelectasis (intermittent therapy), CHF/pulmonary edema (short term application) and

sleep apnea (nocturnal application). CPAP is contraindicated if the patient cannot

maintain adequate ventilation on their own, e.g., hypercapnic ventilatory failure, acute

exacerbation of COPD.

The correct answer is: post-operative atelectasis

, A patient with chronic bronchitis is receiving volume controlled A/C ventilation.

Wheezing is heard over all lung fields, rhonchial fremitus is felt over the central

airways, and secretions are thick. The patient's peak pressure is 45 cm H2O and

plateau pressure is 20 cm H2O. Which of the following would be useful to treat

the patient's condition?

A. triamcinolone (Azmacort)

B. cromolyn sodium (Intal)

C. pancuronium bromide (Pavulon)

466

D. levalbuterol (Xopenex)

- ANSWER Based on the patient's diagnosis and clinical presentation, the immediate problem is

bronchospasm (wheezing) and thick secretions (rhonchial fremitus) causing an increase

in airway resistance (increased PIP - plateau). A bronchodilator like levalbuterol AND

possibly a mucolytic like acetylcysteine are indicated. Pancuronium is a neuromuscular

blocking agent, triamcinolone a corticosteroid and cromolyn a mast cell stabilizer, none

of which will aid in bronchodilation or secretion clearance.

The correct answer is: levalbuterol (Xopenex



A doctor requests that you increase the expiratory time on a patient receiving

volume control ventilation, but not alter the minute ventilation. Which of the

following settings would you adjust to fulfill the doctor's request?

A. tidal volume

B. rate of breathing

C. trigger sensitivity

D. inspiratory flow

- ANSWER On most ventilators operating in the volume control mode, expiratory time is a

resultant value, i.e., not set directly but dependent on other settings. Since the

expiratory time is essentially the time left over after inspiration, and since the

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