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NBRC TMC SELF-ASSESSMENT EXAM 2025
LATEST 3 VERISON EXAM QUESTION WITH
ANSWERS COMPLETE 480 QUESTIONS
(VERIFIED EXAM)
Which of the following is needed to calculate alveolar oxygen tension? A. VD/VT, PAO B. BP and FiO C. PetCO2 and PaO D. QS/QT, deadspace B. Barometric pressure, FiO2, and PaO2 are all included in the formula (BP stands for barometric pressure) L/min/m2 is the unit of measure for: A. Systemic vascular resistance B. Cardiac output C. Cardiac index D. Stroke volume C.
A spontaneously breathing patient has the following arterial blood gas results: pH 7.38 PaCO2 42 mmHgPaO2 76 mmHgHCO3- 24 mEq/LBE 0 mEq/L Which of the following supplemental oxygen levels is most appropriate? A. 2 L/min nasal cannula B. 5 L/min nasal cannula C. non-rebreathing mask D. Venturi mask at 30% B. A patient who is showing signs of hypoxemia should receive supplemental oxygen. If the patient is not a COPD patient and the situation is not an emergency, then the proper supplemental oxygen is an adult therapeutic dose, which is 40% to 55%. Of the options available only 5 L/min nasal cannula will approach this. Other options are either insufficient or too much. Left heart failure would be manifested in which of the following values? A. CVP and mPAP B. mPAP and wedge pressure C. MAP and SVR D. cardiac output and wedge pressure D. The function of the left heart, specifically the left ventricle, is best assessed hemodynamically by looking at those values that precede and come after the left heart. In this case pulmonary capillary wedge pressure and cardiac output (or cardiac index) are the values found before and after the left heart.
A. fluid overload B. ARDS C. a pulmonary embolism D. pneumonia C. A VQ scan that shows poor perfusion but adequate ventilation is most closely associated with a pulmonary embolism. Supportive data is found in the radiological report of wedge-shaped infiltrates. The respiratory therapist notes in the medical record of a 65-year-old male that the patient is ordered to receive bronchodilator therapy with Albuterol. The therapist also notes the patient is receiving beta-blocker medication. The therapist should recommend A. Administer Dexamethasone (Decadron) in place of Albuterol B. Add Xopenex to the bronchodilator regimen C. Replace Albuterol with Beclamethasone (Beclovent) D. Switch from Albuterol to ipratropium bromide (Atrovent) D. Because albuterol is a beta-agonist medication, patients who are taking beta-blockers should utilize other bronchodilation medication. A hospital has an extremely low incidence of ventilator-associated pneumonia. To which of the following reasons may this be attributed? A. periodic discontinuation of sedation B. use of respiratory precautions with the population
C. diversion of infectious patients to other facilities D. broad use of prophylactic antibiotics A. The incidence of ventilator-associated pneumonia, or VAP, is lowered by using a closed system suction catheter, periodically discontinuing sedation, keeping the patient and semi-Fowler's position, and proper handwashing among caregivers. All are correct. A pressure-volume loop ventilator graphic shows no rise in pressure for the first 200 mL of delivered volume. The therapist should A. increase inspiratory flow rate B. increase PEEP C. decrease tidal volume D. decrease inspiratory flow rate B. In this question the description of the pressure volume loop would indicate a flat bottom as manifested by no rise in pressure with the first 200 mL of delivered volume. We call this a "flat football". The solution is to increase PEEP to a level that the pressure begins to rise immediately as volume is introduced. Which of the following would be the most effective, appropriate method for resolving atelectasis in a spontaneously breathing, post operative patient who is under the influence of sedation and will not respond to verbal stimuli? A. IPPB B. sustained maximal inhalation (incentive spirometer) C. deep breathing coaching
C. epinephrine D. cardioversion D. Non-deadly arrhythmias, such as this one, may be addressed through cardioversion. Cardioversion is a form of defibrillation with low wattage and with the synchronization set to "active". This allows the shock to be synchronized to the R wave. A 38-year-old male presents in the emergency department (ED) complaining of frequent vomiting. The following laboratory data is available: Arterial blood gases pH 7.55 PaCO2 42 torrPaO2 85 torrHCO3- 31 mEq/LBE +7 mEq/LFIO2 0.21K+ 3.0 mEq/LCl- 95 mEq/LNa+ 135 mEq/L Which of the following should the respiratory therapist recommend? A. administer NaCL B. administer NaHCO3- C. administer KCL D. administer volume-expanding fluids C. This patient has a CO2 of 42 mmHg, which suggests adequate ventilation. However, the high pH is associated with alkalosis. Because the CO2 is normal, the cause of the alkalosis must be metabolic in nature. One treatment for metabolic alkalosis is to administer potassium chloride or KCl. A patient is receiving volume-controlled ventilation following bariatric surgery for obesity. Which of the following medications should the respiratory therapist recommend to ensure the patient's comfort and assist in ventilator management?
A. Pronestyl B. morphine sulfate C. vecuronium bromide (Norcuron) D. Mestinon B. Morphine sulfate is one of the best medications to administer to patients receiving mechanical ventilatory support to help the patient rest pain-free and to generally sedate and relax the patient. A patient has idiopathic pneumonia with consolidation in the right lower lobe. The physician suspects a bacterial infection. Which of the following will provide conclusive data to rule out the physician's suspicions? A. WBC B. color of sputum C. sputum acid-fast stain D. oral temperature A. A bacterial infection is diagnosed primarily by examining the white blood cell count, also called the leukocyte count. An elevated temperature and yellow sputum indicate the possibility of an infection but are not confirming in nature. After making the universal sign of choking, a person collapses. The observer should FIRST A. check for a pulse B. call for help
An adult patient with asthma is receiving Albuterol by small volume nebulizer Q.I.D. at a dosage of 0.5 mL. The patient complains of dizziness, tingling in his fingers, and anxiety with each treatment. The therapist should A. increase dosage to 1.0 mL B. decrease dosage to 0.15 mL C. switch to Xopenex 0.63 mg D. switch to Mucomyst 20% C. When a patient experiences an adverse reaction, the first step is to stop the therapy and then modify the therapy to accomplish the same objective. In this case, decreasing the dose of Xopenex is suitable because 0.63 mg is still in the adult therapeutic range. Which of the following conditions would benefit most from a thoracentesis? A. atelectasis B. complete opacification of the right lung C. small pneumothorax D. pericardial contusion C. A thoracentesis is a procedure that removes air or fluid from the pleural space. This would be appropriate with a small pneumothorax. A large pneumothorax, however, would require chest tubes. ASK***** A patient with ARDS and asthma could benefit from which of the following medications?
A. Spiriva and decadron B. exogenous surfactant C. Tobramycin and albuterol D. cromolyn sodium B. A patient with adult respiratory distress syndrome could benefit from surfactant therapy to decrease the surface tension of the alveoli. The respiratory therapist should look to which of the following clinical data to determine the effectiveness of incentive spirometry? A. Arterial blood gas analysis pre and post treatment B. Breath sounds before and after every treatment C. Inspiratory capacity predicted volume D. Maximum voluntary ventilation done periodically B. The effectiveness of incentive spirometry can best be determined by auscultating breath sounds before and after the treatment and noting changes in air movement. While achieving inspiratory capacity is the goal, the real goal is to increase lung volume, improve alveolar recruitment, and prevent consolidation of sputum in the lungs. increased labor of breathing. The mandatory rate is 14/min. Which of the following would most likely help the patient? A. Use of pressure support B. Switch to pressure control ventilation
A. Hyperlucency in the soft tissues B. Diffuse pulmonary hyperlucency C. Tracheal shift from midline D. Scattered patchy infiltrates A. Hyperlucency, seen on a chest x-ray is darker in color. Air is radiolucent. Therefore, air located in the soft tissue, as seen with subcutaneous emphysema would result in a hyperlucent X-ray over soft tissue areas. Subcutaneous emphysema by itself will not shift the trachea from midline. Scattered patchy infiltrates are associated with ARDS, not subcutaneous emphysema. Placement of a pulmonary artery catheter is associated with which of the following most common complications? A. hypotension B. pulmonic valve damage C. cardiac arrhythmias D. internal bleeding C. Several complications may arise from the placement of a pulmonary artery catheter, otherwise called a Swan-Ganz catheter. The development of cardiac arrhythmias is the most common complication of the options offered. Another serious complication is perforation of a vessel or cardiac muscle during the insertion. A galvanic fuel cell oxygen analyzer may read erroneously high under which of the following conditions? A. when the analyzer batteries are depleted
B. during a sudden increase in the partial pressure of oxygen C. when a volume-controlled ventilator at high inspiratory pressures D. when liquid gets on the membrane C. A galvanic fuel-cell oxygen analyzer may read erroneously when ambient pressures change significantly, such as when a patient is receiving high inspiratory pressure or when a patient changes altitude quickly. Results of a quality control maneuver for a spirometer using a 3.0 L calibration syringe as follows: Volume 1 2.65 L Volume 2 2.68 LVolume 3 2.66 L According to ATS Standards, the spirometer is A. inaccurate B. proof that the syringe requires calibration C. lacking in precision D. operating correctly A. These calibration results are all very close together, indicating the machine is very precise. However, the results are too far from the 3.0 L of gas introduced by the calibration syringe. The maximum variance is 2.85 L - 3.15 L. Therefore, although the machine is precise, it is considered inaccurate and should not be used for patient testing and reporting. Which of the following will be most helpful at preventing complications for a 48-year-old male patient who has just undergone bariatric surgery for obesity?
A. Discontinue therapy and notify the physician B. Add Albuterol to the nebulizer treatment C. Switch to normal saline D. Switch to hypotonic saline A. Adverse reactions during any therapy should be responded to initially by discontinuing therapy and notifying the physician. In preparation for a helium dilution study, a respiratory therapist is calibrating the helium analyzer. While exposing the analyzer to ambient room air, what will the analyzer read for helium concentration? A. 21% B. 0% C. 2% D. 79% B. To calibrate a helium analyzer, sometimes called a Wheatstone Bridge, the device must be calibrated to room air for the low calibration and to a known level of helium for the high calibration. Because room air has no significant level of helium, helium analyzers should read 0% when exposed to ambient room air conditions. Which of the following will result in a decrease in mean airway pressure for a patient on a mechanical ventilator in the assist/control mode? A. use of expiratory retard
B. institution of a 1.0 sec inspiratory plateau C. decrease in inspiratory time D. decreasing inspiratory flow C. Decreasing inspiratory time will lower the amount of time a patient is exposed to positive pressure and will therefore result in a decrease in mean airway pressure. Use of expiratory retard, increasing inspiratory flow, and institution of an inspiratory plateau will all lead to increased mean airway pressure. A chest radiograph of an abdominal post-operative patient shows abnormal elevation of the left hemidiaphragm. Which of the following conditions explains the observation? A. pneumothorax on the left B. herniation of the left hemidiaphragm C. hemothorax D. atelectasis in the left lower lobe D. Abnormal elevation of the left hemidiaphragm is an indication that the lung on that side is smaller for some reason. This could be due to a partial pneumothorax or profound atelectasis. Oftentimes, atelectasis can develop as a result of surgery. Therefore, the raised hemidiaphragm, combined with the postoperative status of the patient, indicate the most likely problem is atelectasis in the left lower lobe. Immediately following oral endotracheal intubation, the respiratory therapist should confirm proper placement by doing which of the following? A. Assess end-tidal CO2 with a colorimetric capnometer
A 65-kg (143-lb) male patient is in the intensive care unit after being found unconscious and unresponsive with a suspected drug overdose. The following ABG and clinical data are observed.
- pH: 7.
- PaCO2: 50 mmHg
- PaO2: 82 mmHg
- HCO3-: 24 mEq/L
- BE: 0 mEq/L
- RR: 24 breaths per min
- VT: 260 mL The respiratory therapist should recommend which of the following: A. Intubate, VC, A/C ventilation B. Oral intubation, CPAP 5 cm H2O, PS 6 cm H2O C. Non-invasive ventilation with IPAP 10 cm H2O, EPAP 5 cm H2O D. Manual resuscitation administer Narcan (naloxone) B. Which of the following is an emergency and requires that the patient receive 100% oxygen supplementation? A. Impending ventilatory failure B. Massive loss of blood C. Ventilatory failure
D. Vital capacity below 1.0 L B. Which of the following is an indication for the use of FiO2 1.0 on a patient? A. Evidence of pulmonary embolism B. Ventilatory failure C. Impending ventilatory failure D. Myasthenia gravis A. Of the options listed, only the suspicion and evidence of pulmonary embolism is suggestive of and emergency and necessitates the use of FiO2 1. For a patient who is unconscious, due to ingestional error of barbiturates, which of the following assessments is the most important? A. Arterial blood gas analysis B. The patient's ability to protect their airway C. Tension test D. A drug toxicology screen B.
