Exam (elaborations)
NBRC EXAM, Part I questions and answers
- Course
- Institution
NBRC EXAM, Part I questions and answers
[Show more]
Content preview
NBRC EXAM, Part IA 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 - questions and answersSince 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 16-year-old male patient involved in a motorcycle accident presents to the ER with massive
maxillary and nasal trauma. Which of the following devices would be most appropriate for
maintaining the patient's airway?
A. nasal endotracheal tube
B. fenestrated tracheostomy tube
C. oral pharyngeal airway
D. oral endotracheal tube - questions and answersPatient with massive maxillary and nasal
trauma would be difficult to intubate; you might need to bypass the face completely, so
ANSWER is B, fenestrated tracheostomy tube (could be fenestrated or not fenestrated, either
would work).
A 2 kg (4.4 lb) neonate requires transportation to a tertiary care center for cardiac surgery. The
infant has a heart rate of 140 and a BP of 60/30.The neonate is intubated with a size 2.5 mm
uncuffed endotracheal tube and ventilation is being assisted manually at a rate of 40/min. Which
of the following should the respiratory therapist recommend?
A. postpone the transport until the neonate has spontaneous respirations
B. prepare for the transport immediately
C. delay the transport and stabilize the patient
D. wait 24 hours and then reassess the patient - questions and answersAnswer 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 - questions and answersUnilateral 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 24-year-old post-operative male patient is receiving intermittent positive pressure therapy at
20 cm H2O. The patient complains that the machine is cycling off too soon. The patient's
post-operative spontaneous vital capacity is 3.5 L. Which of the following should the respiratory
therapist recommend?
A. Increase the pressure to 25 cm H2O
B. Discontinue therapy, encourage deep breathing and coughing frequently on his own
C. Switch to a volume incentive spirometry device
D. Recommend decreasing the flow - questions and answersThe key is that the patient's
post-operative spontaneous vital capacity is 3.5L, which shows he can take a pretty good deep
breath on his own, so the simplest, easiest ANSWER is B, discontinue therapy, encourage deep
breathing and coughing frequently on his own. If they can do it on their own, that's the best
therapy of all.
A 26-week gestational age infant requires intensive monitoring and care in the NICU. Which
device would be most appropriate for maintaining a neutral thermal environment for this infant?
A. radiant warmer
B. isolette
C. croupette
D. bassinet - questions and answersBoth the isolette and the radiant warmer can be neutral
thermal environments. The key to this question, making one better than the other, is access to
the patient since this baby requires continuous monitoring. Supposedly, the radiant warmer
provides better access to the baby than the isolette.
A 26-year-old patient with shortness of breath is admitted to the emergency room. The patient
states that he was running in Central Park with a friend and could not catch his breath. Bedside
assessment reveals the following data:
Pulse: 120
Respirations: 25 br/min
Color: pale
SpO2: 89% on room air
Breath sounds: slightly diminished on the right
The respiratory therapist should:
A. request a STAT chest x-ray.
B. administer 100% oxygen.
C. insert a large bore needle into the 2nd intercostal space on the right side in the midclavicular
line.
D. insert a chest tube into the 2nd intercostal space on the right side in the midclavicular line. -
questions and answersRequest a STAT x-ray is good but the patient currently has shortness of
breath and is uncomfortable, so what would you do FIRST, ANSWER is B, administer 100%
oxygen
,A 27-week gestation age neonate with respiratory distress syndrome is receiving high frequency
oscillatory ventilation at the following settings:
PIP: 20 cm H2O
Frequency: 12 Hz
I time: 30%
FIO2: 0.55
PEEP: 4 cm H2O
Blood gas results from an umbillical artery line are as follows:
pH: 7.15
PaCO2: 62 torr
PaO2: 46 torr
HCO3-: 22 mEq/L
The respiratory therapist should increase the
A. PEEP.
B. FIO2.
C. frequency.
D. amplitude. - questions and answersThis baby is not being ventilated or oxygenated properly.
Always fix ventilation first or the oxygen won't get where it is supposed to anyway. Amplitude
means "pressure",
so ANSWER is D, Increase Amplitude
A 28-week gestational age infant with severe respiratory distress syndrome is being
mechanically ventilated in the PC, SIMV mode at the following settings:
Flow rate: 6 L/min
Set rate: 32 br/min.
PIP: 28 cmH2O
FIO2: 0.70
PEEP: 5 cm H2O
I time: 0.8 seconds
Umbilical arterial blood gas results reveal:
pH: 7.40
PCO2: 39 torr
PO2: 42 torr
HCO3-: 23 mEq/L
Based on the above information, the respiratory therapist should change the
A. I time to 1.0 second.
, B. PEEP to 7 cm H2O.
C. FIO2 to 0.75.
D. PIP to 30 cm H2O. - questions and answersVentilation is good on baby, PO2 is bad (less
than 60), so we have an oxygenation problem. Baby is already on high level of oxygen and they
are already on PEEP therapy, but they are still shunting (they are on 70% FiO2 and still bad
oxygenation with good ventilation) so inch up the PEEP (never above 8),
so ANSWER is B, PEEP to 7 cm H2O.
A 28-week gestational age neonate is experiencing frequent apneic episodes with bradycardia.
Which of the following should the respiratory therapist recommend?
A. An FIO2 of 0.40 via oxyhood
B. Suctioning the neonate during apnea episode
C. Administering beclomethasone
D. Administering theophylline - questions and answersAnswer is D. Beclomethasone is a steroid
given to mother before birth to get more surfactant for the child so wouldn't help with stimulating
the baby to breath. Theophylline is a respiratory stimulant so would help the baby with apnea.
A 3-year-old child with cystic fibrosis is being mechanically ventilated at the following settings:
PIP: 34 cm H2O
I time: 1.0 second
Rate: 22 /min.
FIO2: 0.60
PEEP: 6 cm H2O
Mode: PC, SIMV
Arterial blood gas results show:
pH: 7.36
PaCO2: 44 torr
PaO2: 49 torr
HCO3-: 24 mEq/L
The respiratory therapist should adjust the
A. PEEP to 8 cm H2O.
B. FIO2 to 0.65.
C. set rate to 24 /min.
D. PIP to 36 cm H2O. - questions and answersThey are extremely hypoxic and shunting (since
they have bad oxygen while on FiO2 of 60%), so raising FiO2 would not help.
So ANSWER is A, Increase PEEP to 8
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.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller lizmwikali72. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
81298 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now