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NBRC TMC PRACTICE QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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NBRC TMC PRACTICE QUESTIONS ANDANSWERS WITH SOLUTIONS 2024
Which of the following is needed to calculate alveolar oxygen tension?
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A. VD/VT, PAO2
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B. BP and FiO2
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C. PetCO2 and PaO2
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D. QS/QT, deadspace - ANSWER B.
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Barometric pressure, FiO2, and PaO2 are all included in the formula (BP stands for barometric pressure)
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L/min/m2 is the unit of measure for: Z Z Z Z Z Z
A. Systemic vascular resistance
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B. Cardiac output
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C. Cardiac index
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D. Stroke volume - ANSWER C.
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A spontaneously breathing patient has the following arterial blood gas results:
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pH 7.38 PaCO2 42 mmHgPaO2 76 mmHgHCO3- 24 mEq/LBE 0 mEq/L
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Which of the following supplemental oxygen levels is most appropriate?
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A. 2 L/min nasal cannula
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B. 5 L/min nasal cannula
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C. non-rebreathing mask
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D. Venturi mask at 30% - ANSWER B.
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A patient who is showing signs of hypoxemia should receive supplemental oxygen. If the patient is not a CO
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PD patient and the situation is not an emergency, then the proper supplemental oxygen is an adult therape
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utic dose, which is 40% to 55%. Of the options available only 5 L/min nasal cannula will approach this. Othe
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r options are either insufficient or too much.
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Left heart failure would be manifested in which of the following values?
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A. CVP and mPAP
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B. mPAP and wedge pressure
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,C. MAP and SVR
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D. cardiac output and wedge pressure - ANSWER D.
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The function of the left heart, specifically the left ventricle, is best assessed hemodynamically by looking at
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those values that precede and come after the left heart. In this case pulmonary capillary wedge pressure a
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nd cardiac output (or cardiac index) are the values found before and after the left heart.
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Which of the following findings is most closely associated with increased airway resistance?
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A. reduced SpO2
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B. accessory muscle use
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C. altered P50
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D. increased PetCO2 - ANSWER B.
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Of the options given, use of accessory muscles is most closely associated with an increase in airway resista
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nce. This is especially true with patients who have asthma or other types of upper airway inflammation or
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bronchoconstriction.
For a patient receiving volume-controlled mechanical ventilation, the lower inflection point on a pressure-
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volume loop can best be described as:
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A. amount of pressure required to keep the alveoli and small airways open
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B. optimal PEEP
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C. minimal PEEP
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D. upper limit of residual volume - ANSWER A.
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The lowest inflection point on a pressure-
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volume ventilator graphic is an indication of the minimum pressure needed to keep alveoli open.
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The results of a V/Q scan shows poor perfusion with adequate ventilation. A chest radiograph shows a wed
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ge-shaped infiltrate over the right lung field. The patient most likely has
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A. fluid overload
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B. ARDS
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C. a pulmonary embolism
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D. pneumonia - ANSWER C.
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A VQ scan that shows poor perfusion but adequate ventilation is most closely associated with a pulmonary
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embolism. Supportive data is found in the radiological report of wedge-shaped infiltrates.
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,The respiratory therapist notes in the medical record of a 65-year-
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old male that the patient is ordered to receive bronchodilator therapy with Albuterol. The therapist also no
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tes the patient is receiving beta-blocker medication. The therapist should recommend
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A. Administer Dexamethasone (Decadron) in place of Albuterol
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B. Add Xopenex to the bronchodilator regimen
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C. Replace Albuterol with Beclamethasone (Beclovent)
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D. Switch from Albuterol to ipratropium bromide (Atrovent) - ANSWER D.
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Because albuterol is a beta-agonist medication, patients who are taking beta-
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blockers should utilize other bronchodilation medication.
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A hospital has an extremely low incidence of ventilator-
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associated pneumonia. To which of the following reasons may this be attributed?
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A. periodic discontinuation of sedation
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B. use of respiratory precautions with the population
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C. diversion of infectious patients to other facilities
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D. broad use of prophylactic antibiotics - ANSWER A.
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The incidence of ventilator-
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associated pneumonia, or VAP, is lowered by using a closed system suction catheter, periodically discontinu
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ing sedation, keeping the patient and semi-
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Fowler's position, and proper handwashing among caregivers. All are correct.
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A pressure-
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volume loop ventilator graphic shows no rise in pressure for the first 200 mL of delivered volume. The thera
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pist should Z
A. increase inspiratory flow rate
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B. increase PEEP
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C. decrease tidal volume
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D. decrease inspiratory flow rate - ANSWER B.
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In this question the description of the pressure volume loop would indicate a flat bottom as manifested by
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no rise in pressure with the first 200 mL of delivered volume. We call this a "flat football". The solution is to
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increase PEEP to a level that the pressure begins to rise immediately as volume is introduced.
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, Which of the following would be the most effective, appropriate method for resolving atelectasis in a spont
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aneously breathing, post operative patient who is under the influence of sedation and will not respond to v
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erbal stimuli? Z
A. IPPB
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B. sustained maximal inhalation (incentive spirometer)
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C. deep breathing coaching
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D. intubation and mechanical ventilation - ANSWER A.
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A postoperative patient under sedation, and possibly in pain, may be tempted to breathe less, causing resp
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iratory acidosis and atelectasis. To correct this problem, IPPB therapy is most appropriate. Incentive spirom
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etry would also help but the patient is unable to respond to verbal stimuli. This alone is an indication for IPP
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B therapy.
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After performing minimum occluding volume technique with a 65-kg (143-
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lb) patient who is orally intubated with a 7.0-mm ET tube, the respiratory therapist should NEXT
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A. check ET tube cuff pressure
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B. perform tracheal palpation
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C. order a chest radiograph
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D. document ET tube markings at the lips - ANSWER A.
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The ET tube cuff pressure may be adjusted correctly by several techniques including minimum leak techniq
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ue (also called minimum occluding volume, minimal seal technique, and the use of a pressure manometer
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called a cuffalator. If minimum seal or minimal leak technique is used, the respiratory therapist is still requir
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ed to monitor the pressure after the technique is performed. Although this is often not done in real life, it is
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technically part of the procedure.
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The respiratory therapist observes an ECG wave form on a patient that is consistent with atrial tachycardia.
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The patient is complaining of chest pain, dizziness, and nausea. The respiratory therapist should recomme
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nd
A. unsynchronized defibrillation
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B. Atropine sulfate
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C. epinephrine
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D. cardioversion - ANSWER D.
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Non-
deadly arrhythmias, such as this one, may be addressed through cardioversion. Cardioversion is a form of d
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