Download NBRC TMC FINAL EXAM AND STUDY GUIDE|ACTUAL 400+QUESTIONS AND VERIFIED ANSWERS|2026-2026|A+ and more Exams Health sciences in PDF only on Docsity!
NBRC TMC FINAL EXAM AND STUDY GUIDE|ACTUAL 400+
QUESTIONS AND CORRECT VERIFIED ANSWERS|2025-
2026|ALREADY GRADED A+
FINAL EXAM
A patient with ARDS is receiving mechanical ventilatory support. An end-tidal CO monitor shows a PetCO2 of 59 torr. The therapist should A. increase minute ventilation B. obtain an arterial blood gas C. recalibrate the capnography D. continue current therapy and ventilator settings ANSWER:->>> A Which of following parameters indicate a patient is ready to wean? A. A-aDO2 of 410 mm Hg B. PEEP of 10 cm H2O C. pulmonary shunt of 16% D. MIP of - 18 cm H2O ANSWER:->>> C Which of the following data is needed to calculate minute alveolar ventilation? A. IBW, VD/VT B. PECO2, VT C. RR, VT, weight in lbs D. RSBI, VD/VT ANSWER:->>> C A respiratory therapist notes a pressure-volume loop on a patient receiving mechanical ventilation has a pronounced beak. What strategy is useful in this case? A. increasing PEEP B. decreasing tidal volume C. decreasing flow D. increasing flow
ANSWER:->>> B
The respiratory therapist is making a plan of care for a patient with mycoplasma pneumonia who needs assistance with airway clearance of secretions. In which order should therapy be performed? A. percussion, postural drainage, bronchodilator, coach coughing B. bronchodilator, percussion, postural drainage, coach coughing C. coach coughing, bronchodilator, percussion, postural drainage D. postural drainage, percussion, bronchodilator, coach coughing ANSWER:->>> B Which of the following is an appropriate strategy when caring for a patient with ARDS who is receiving mechanical ventilation? A. strive for C.I. values less than 2.0 L/min/m B. keep the patient in reverse trendelenburg position C. keep PEEP as high as possible D. keep FIO2 at 60% or below if possible ANSWER:->>> D Which of the following is an important strategy when caring for a patient with adult respiratory distress syndrome? A. ventilate in Control mode with paralytics B. promote AutoPEEP C. keep mean airway pressures as low as possible D. keep FIO2 higher than 0. ANSWER:->>> C Which of the following transdermal nicotine preparations might the respiratory therapist recommend to help a patient stop smoking? A. gum B. MDI C. patch D. spray
Which of the following would be most helpful in determining if a patient regularly smokes tobacco products? A. COHb B. DLCO C. end-tidal carbon dioxide D. pulse oximetery ANSWER:->>> A A 75-kg (165-lb) male is receiving mechanical ventilation by a volume-controlled ventilator in the assist/control mode on the following settings: Mandatory rate 12/min VT 500 mL FIO2 0. PEEP 8 cm H2O Arterial blood gas results: pH 7. PaCO2 52 mm Hg PO2 65 mm Hg HCO3- 27 mEq/L BE +3 mEq/L Which of the following represents the most appropriate action? A. increase FIO2 to 1. B. increase rate to 14 C. increase PEEP to 10 cmH2O D. increase tidal volume to 600 mL ANSWER:->>> B A pulmonary rehabilitation patient is having difficulty complying with a smoking cessation program. A physical and psychological screen reveals a heavy physiological dependence and a low psychological dependence on smoking. Which of the following is appropriate? A. Versed B. nicotine replacement therapy
C. psychological counseling D. Valium ANSWER:->>> B A COPD patient is receiving oxygen at 2 L/min by a pulse-dose oxygen delivery device. The patient complains of shortness of breath and feels she is not getting enough oxygen. The home care respiratory therapist should A. switch to a Venturi mask at 40% B. encourage the patient to relax and call her physician C. increase the flow rate D. switch to a continuous oxygen regulator and normal nasal cannul a ANSWER:->>> D A physician orders a chest radiograph on an ambulatory patient in the emergency department (ED) in response to a suspicion of pneumonia. Which of the following should be ordered? A. PA radiograph B. apical lordotic C. series of oblique-angle radiographs D. AP radiograph ANSWER:->>> A Which of the following could result from the application of positive end-expiratory pressure? A. reduced cardiac index B. reduced alveolar ventilation C. reduced intra-thoracic pressure D. increased A-aDO ANSWER:->>> A The supply of flu vaccination is limited. The respiratory therapist would suggest prioritizing the administration of the vaccine to which of the following groups of people?
A patient with a history of hyper-reactive airway disease is having difficulty expectorating because the sputum is thick and tenacious. Which of the following medications should the respiratory therapist recommend? A. Spiriva (tiotropium bromide) B. Acetylcysteine (mucomyst) C. Solu-Mederol D. Beclamethasone (Beclovent) ANSWER:->>> B A physician suspects a patient has a cancerous mass in the right lobe as identified by a PA chest radiography. Which of the following should the therapist recommend to examine the nature and size of the mass? A. series of oblique chest radiographs B. A-P chest radiograph C. V/Q scan D. pulmonary angiography ANSWER:->>> A A patient receiving volume-controlled ventilation weighs 75 kg (165 lb) and is 5 ft, 7 in (170 cm) tall and within ideal body weight. The following clinical data is available: Mode SIMV Mandatory rate 12 Total rate 32 FIO2 0. VT 500 mL Exhaled minute volume 9.6 L pH 7. PaCO2 32 torr PaO2 97 torr HCO3- 22 mEq/L BE +1 mEq/L Which of the following changes should the respiratory therapist recommend? A. Reduce mandatory rate to 6
B. Add inspiratory pause C. Administer sedative medication D. Institute pressure support of 5 cm H2O ANSWER:->>> D A modified Allen's test is performed on the patient's right radial artery before performing an arterial puncture. When the ulnar artery occlusion is released, a pink color returns in 35 seconds. Based on this result, the respiratory therapist should A. perform an Allen's test on the left radial artery B. perform a right brachial artery puncture C. perform a femoral artery puncture D. proceed with the puncture of the right radial artery ANSWER:->>> A A patient receives heliox therapy with a mixture of 80% / 20% by nonrebreathing mask to reduce airway resistance during an asthmatic episode. The respiratory therapist notes that the patient seems to be experiencing moderate respiratory distress. The therapist also observes that the reservoir bag completely collapses with each inspiration. The therapist should A. discontinue heliox therapy B. switch to a 60%/40% heliox mixture C. increase the total flow of gas mixture to the mask D. switch to a Venturi mask set at the highest possible FIO2 setting ANSWER:->>> C A physician has ordered the administration of 80% / 20% heliox therapy to a spontaneously breathing patient. Which of the following gas delivery devices should the respiratory therapist plan on using? A. air-entrainment mask B. simple mask C. nasal cannula D. nonrebreathing mask ANSWER:->>> D
D. Utilize reverse Trendelenburg position ANSWER:->>> B While administering an aerosolized bronchodilator with IPPB, the therapist notices that the pressure manometer has a significant negative deflection with each breath. The patient appears to be showing signs of fatigue. The respiratory therapist should A. increase sensitivity B. decrease pressure C. increase inspiratory flow rate D. increase pressure ANSWER:->>> A A 62-year-old man admitted to the emergency room with chest pain complains of shortness of breath after a bronchodilator treatment. Further examination reveals the patient is diaphoretic. The ECG wave form shows occasional PVCs. Which of the following would be most helpful in further determining the cause of the patient's condition? A. 12-lead ECG B. cardiac stress test with Adenosine C. cardiac catheterization with fluoroscopy D. arterial blood gas analysis ANSWER:->>> A Following abdominal surgery, a patient attempts to perform sustained maximal inhalation (incentive spirometry) but repeatedly falls asleep during the procedure. Which of the following ways should the therapist modify the therapy? A. intubate and begin mechanical ventilation B. hold therapy until the patient becomes more alert C. administer Narcan D. switch to IPPB with face mask ANSWER:->>> D
After two aerosolized Albuterol treatments with a small-volume jet nebulizer, the patient's breathing sounds changed from diminished to profuse wheezing bilaterally. The respiratory rate has decreased from 32 to 26. The respiratory therapist should A. discontinue current therapy B. administer 80/20% Heliox gas mixture C. continue with bronchodilator therapy D. intubate the patient ANSWER:->>> C The respiratory therapist working in a clinic receives a call from a patient who has asthma and is only able to achieve 60% of their normal baseline peak flow measurement. The therapist should advise the patient to A. check flows again in one hour, call if less than 50%of expected B. take a rescue medication every 15 minutes for 2 hours, recheck flows C. call the doctor immediately D. take a rescue medication, check flows in one hour ANSWER:->>> C A 32-year-old 81-kg (178-lb) adult male is receiving mechanical ventilatory support. Settings are as follows: Mode Assist/control Mandatory rate 10 Total rate 18 Tidal volume 450 mL FIO2 0. PEEP 5 cm H2O The patient is cyanotic and anxious. Which of the following will the respiratory therapist recommend? A. increase FIO B. decrease mandatory rate C. increase tidal volume D. increase inspiratory flow rate ANSWER:->>> C
Pplat (cm H2O) 15 - 17 Set VT (L) 0.6 - 0. PEEP (cm H2O) 5 - 5 Which of the following is most consistent with these data? A. the patient has ARDS B. the patient has atelectasis C. the patient's pulmonary compliance is significantly decreasing D. the patient requires endotracheal suctioning ANSWER:->>> D A patient with cystic fibrosis is receiving routine postural drainage and percussion. Which of the following may be used to determine the effectiveness of therapy? A. Sputum analysis B. Arterial blood gas analysis C. Chest radiograph D. DLCO measurements ANSWER:->>> C A patient is being weaned from mechanical ventilation after being placed on the ventilator 3 days prior due to complications from a pulmonary infection. Which of the following would be most helpful in determining the status of the infection prior to weaning? A. CBC B. evaluate color of sputum C. ABG D. temperature ANSWER:->>> A A COPD patient is in the emergency room. A quick assessment reveals a respiratory rate of 28, spontaneous tidal volume of 200 mL, use of accessory muscles, and venous distension. The patient is receiving oxygen by nasal cannula at 2 L/min and oxygen saturation by pulse oximetry is 88%. Which of the following would provide most help to the patient at this time? A. flutter valve therapy
B. non-rebreathing mask C. NIPPV D. adult mechanical ventilation ANSWER:->>> C A patient receiving mechanical ventilator support is on the following settings and has the following clinical data: Mode SIMV Mandatory rate 14 VT 500 mL FIO2 0. PEEP 20 cm H2O Arterial blood gas results pH 7. PaCO2 43 torr PaO2 68 torr HCO3- 26 mEq/L BE +2 mEq/L Which of the following should the respiratory therapist recommend? A. increase FIO2 to 1. B. increase PEEP to 22 cm H2O C. increase FIO2 to 0. D. decrease PEEP to 18 cm H2O, increase FIO2 to 1. ANSWER:->>> B The respiratory therapist notices the PtcO2 value on a transcutaneous monitor has suddenly jumped within the last minute. The therapist should suspect a problem with A. Development of skin burns B. Adherence of the electrode to the skin C. Overheating of the electrode D. Insufficient heating of the electrode ANSWER:->>> B
A patient with Status Asthmaticus has an airway resistance (Raw) of 3. cmH2O/L/sec. The patient's respiratory rate is 28/min, and tidal volume gradually falls. Saturation is 94% on 3 L/min. Which of the following would be most beneficial to the patient? A. mechanical ventilation with pressure support B. helium/oxygen mixture 80%/20% C. helium/oxygen mixture 70%/30% D. increase oxygen to 4 L/min ANSWER:->>> C A chest x-ray radiology report indicates that the radio-opaque line's end on an oral endotracheal tube rests 1 cm above the carina. The respiratory therapist should suggest A. advance the ET tube 2 cm B. withdraw the ET tube 2 cm C. advance the ET tube 1 cm D. withdraw the ET tube 5 cm ANSWER:->>> B To assist in preventing ventilator-acquired pneumonia (VAP), you should: A. Use the minimal leak technique to inflate the tracheal tube cuff B. Change the ventilator circuit and humidifier every 48 hours C. Maintain the patient in the prone position whenever possible D. Implement daily sedation vacations or SBT's ANSWER:->>> D Which of the following devices would be used to obtain a PCWP measurement? A. pulmonary artery catheter B. indwelling arterial catheter C. double lumen catheter D. central venous catheter ANSWER:->>> A
A patient with adult respiratory distress syndrome is receiving mechanical ventilation with a pressure-cycled ventilator. Which of the following alarms is most important? A. I:E ratio alarm B. low pressure alarm C. high pressure alarm D. low-volume alarm ANSWER:->>> D A pulmonary function study reveals a forced vital capacity (FVC) that is greater than a slow vital capacity (SVC). To which of the following can this be attributed? A. chronic air-trapping B. partial diaphragmatic paralysis C. poor patient effort on the SVC maneuver D. excessive effort on the FVC maneuver ANSWER:->>> C An infant born 24 hours prior is experiencing frequent periods of apnea lasting more than 60 seconds. Which of the following medications would help stimulate the infant's respiratory drive? A. Fluticasone B. hormone C. Aminophylline D. Exosurf ANSWER:->>> C While transporting a patient from a helicopter landing pad to the emergency department (ED), the respiratory therapist notices the ET tube has become unsecured. To best confirm to location of the ET tube, the therapist should recommend A. auscultate breath sounds B. observe chest rise C. chest radiograph D. palpate the trachea
An 18-year-old male patient is admitted to the emergency department (ED) after being rescued from an area lake in the middle of the winter. Their core body temperature is 32 degrees C. (90 degrees F). He has the following blood gas values on room air. The blood gas values are not corrected for temperature: pH 7. PaCO2 46 mmHg PaO2 60 mmHg HCO3- 24 mEq/L BE 0 mEq/L The respiratory therapist should A. provide a warming blanket to the patient B. provide manual resuscitation C. start a heated aerosol by mask set at 45% D. place the patient on mechanical ventilation ANSWER:->>> C A patient in the intensive care unit has the following clinical and laboratory data: PB 747 mm Hg PH2O 47 mm Hg pH 7. PaCO2 52 mm Hg PaO2 70 mm Hg HCO3- 27 mEq/L BE +2 mEq/L FIO2 0. SaO2 1. CvO2 12 vol% CaO2 17 vol% Hb 15 gm/dL Which of the following represents the C(a-v)O2? A. 5 vol% B. 200 vol% C. 2 vol% D. 25 vol%
ANSWER:->>> A
An infant remains cyanotic after the administration of high-level supplemental oxygen. The physician is concerned about the presence of a condition, patent ductus arteriosis, and asks the respiratory therapist to gather data to confirm or rule out that condition. Which of the following data will the therapist require? A. chest radiography B. blood gases from the umbilical and radial arteries C. CT scan with contrast D. blood glucose ANSWER:->>> B A patient has a balloon-tipped, flow-directed catheter in place in the pulmonary artery. Which pressure can the respiratory therapist expect to obtain from the distal lumen? A. MAP B. SVR C. CVP D. PAP ANSWER:->>> D Over the last two hours, the respiratory therapist has noticed that the peak pressure of a patient receiving volume-controlled mechanical ventilatory support has risen from 22 to 31 cm H2O. Plateau pressures have remained steady at 14 cmH2O. Which of the following is the most likely explanation for these changes? A. secretions in the airway B. pulmonary fibrosis C. ARDS D. reticulogranular changes on the chest radiograph ANSWER:->>> A
