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A set of multiple-choice questions and answers related to the nbrc mock tmc exam. It covers various topics relevant to respiratory therapy, including airway management, ventilation, suctioning, and chest tube management. The document aims to help students prepare for the nbrc mock tmc exam by providing practice questions and verified solutions.
Typology: Exams
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To minimize an increased airway resistance produced by high-density aerosol inhalation, the RT should recommend which of the following? A. Administer a bronchodilator along with the aerosol B. Instruct the patient to breathe through the nose C. Use a heated nebulizer to deliver the aerosol D. Perform chest physiotherapy after the aerosol treatment - ANS ✓A. Administer a bronchodilator along with the aerosol The RT is asked to recommend a humidifier that will be able to provide the highest water vapor content to the patient's airway. Which of the following humidifiers should the therapist select? A. Pass-over B. HME C. Heated wick D. Bubble - ANS ✓C. Heated wick A heated humidifier is delivering 100% body humidity to a patient's airway. What volume of water is being delivered? A. 24 mg/L B. 37 mg/L
C. 44 mg/L D. 47 mg/L - ANS ✓C. 44 mg/L A patient is experiencing cardiac arrhythmias and muscle weakness. An arterial blood gas determines that the patient is in metabolic alkalosis. Which of the following is the most appropriate lab value to assess at this time? A. WBC B. BUN C. Plasma protein D. Potassium - ANS ✓D. Potassium The term used to describe a condition is which a patient has difficulty breathing while in the supine position is which of the following? A. Orthopnea B. Hypopnea C. Eupnea D. Bradypnea - ANS ✓A. Orthopnea A patient enters the emergency department, and on initial examination the RT observes paradoxical chest movement. Which of the following should the therapist suspect? A. Pulmonary edema B. Pneumonia C. Flail chest D. Pleural effusion - ANS ✓C. Flail chest
The RT is reviewing the chart of a patient suspected of having congestive heart failure. This condition would best be indicated with an elevation in which of the following cardiac biomarkers? A. Troponin B. Myoglobin C. Creatine kinase (CK) D. B-type natriuretic peptide (BNP) - ANS ✓BNP > 500 = CHF D. B-type natriuretic peptide (BNP) A patient is suspected of suffering acute myocardial infarction. Which of the following lab values would be increased in the patient's blood? A. Hematocrit B. CK-MB C. BNP D. Albumin - ANS ✓B. CK-MB The RT notes a respiratory rate of 36 breaths/min in an adult patient's chart. The patient's breathing pattern is best described by which of the following? A. Hyperventilation B. Dyspnea C. Hypoventilation D. Tachypnea - ANS ✓D. Tachypnea
The RT is assessing a patient with severe emphysema and observes pedal edema and jugular venous distention. The therapist should note in the patient's chart that these signs are most likely the result of: A. Systemic hypertension B. Hypercapnia C. Pulmonary infection D. Right ventricular hypertrophy - ANS ✓D. Right ventricular hypertrophy A patient has just been intubated, and the CO2 detector placed on the proximal end of the ETT reads 1.5%. The RT should suspect which of the following? A. The tube is in the trachea B. The tube is in the right mainstem bronchus and should be withdrawn 4 cm C. The tube is in the esophagus D. The tube is at the level of the carina and should be withdrawn 2 cm - ANS ✓C. The tube is in the esophagus Which of the following statements is true regarding the King Airway? A. It is double-lumen tube placed in the esophagus to ventilate difficult-to- intubate patients. B. The airway can be used only on patients at least 5 feet tall C. The airway utilizes one cuff, which is inflated with 45-90 mL of air to block off the oropharynx D. Because of the length of the airway, it is unlikely that the trachea can be intubated inadvertently - ANS ✓D. Because of the length of the airway, it is unlikely that the trachea can be intubated inadvertently
You want to pass a suction catheter into the patient's left lung to obtain a sputum specimen. What is the most appropriate method of accomplishing this? A. Have the patient turn his or her head to the left B. Have the patient turn his or her head to the right C. Use a coude suction catheter D. Use a catheter that is one half the internal diameter of the patient's airway - ANS ✓C. Use a coude suction catheter The RT is using a 12-French suction catheter to suction a female patient who is intubated with a 7.0-mm ET tube and is having difficulty removing the thick secretions. The suction pressure used is - 120 mm Hg. Which of the following should be recommended to correct this problem? A. Increase the suction pressure to - 140 mm Hg B. Instill 5 mL of normal saline down the ET tube C. Change to a 14 French suction catheter D. Change to a coude-tipped suction catheter - ANS ✓A. Increase the suction pressure to - 140 mm Hg The RT is called to pediatric ICU to suction a 6-year-old ventilator patient with pneumonia who is intubated with a 5.0 mm ET tube. Which of the following represents the most appropriate catheter size and suction pressure to use on this patient? A. 8-Fr catheter, - 100mm Hg B. 10-Fr catheter, - 60mm Hg C. 8-Fr catheter, - 60mm Hg D. 10-Fr catheter, - 100mm Hg - ANS ✓A. 8-Fr catheter, - 100mm Hg
Which of the following will increase the possibility of the ET tube cuff causing tracheal mucosa damage?
To aid in the evacuation of air from the pleural space, a chest tube should be inserted at what level? A. Supraclavicular space B. Second intercostal space anteriorly at the midclavicular level C. Sixth intercostal space anteriorly D. Eighth intercostal space anteriorly - ANS ✓B. Second intercostal space anteriorly at the midclavicular level The RT notices on a patient's chest tube drainage system that there is fluctuation of the water level in the water-seal chamber with each patient breath, and that air bubbles are seen only in the suction control chamber, which has a suction pressure of - 20 cm H2O. The most appropriate action is which of the following? A. Clamp the chest tube and check for leaks B. Insert - ANS ✓ Which of the following ventilator waveforms best enables a RT to evaluate the presence of auto-peep in a patient? A. flow/time B. flow/volume C. pressure/time D. volume/pressure - ANS ✓A. flow/time The following data are obtained for a patient who is receiving VC, A/C ventilation: Peak pressure: 30 cm H2O Plateau pressure: 20 cm H2O
Set Vt: 800 mL Exhaled Vt: 700 mL PEEP: 10 cm H2O What is the static compliance? A. 35 B. 40 C. 27 D. 70 - ANS ✓D. 70 A patient is receiving O2 from an E cylinder at 4 L/min through a nasal cannula. The cylinder pressure is 1900 psig. How long will the cylinder run until it is empty? A. 47 min B. 1.7 h C. 2.2 h D. 3.6 h - ANS ✓E cylinder = 0. 1900x0.28/4 = 133/60 = 2. Answer: C. 2 hours, 21 minutes After the Respiratory Therapist sets up a nonrebreathing mask on a patient at a flow rate of 10 L/min, the reservoir bag collapses before the patient finishes inspiring. The RT should do which of the following? A. Change to a simple mask at a flow rate of 10 L/min B. Remove the one-way valve from the exhalation port. C. Place the patient on continuous positive airway pressure (CPAP)
PaO2: 88 mmHg HCO3: 26 mEq/L SaO2: 95% Hb: 14 g/dL A. 12 mL/dL B. 14 mL/dL C. 16 mL/dL D. 18 mL/dL - ANS ✓(Hb x 1.36 x SaO2) + (0.003 x PaO2) (14 x 1.36 x 0.95) + (0.003 x 88) 18.088 + 0. = 18. Answer: D. 18 mL/dL The respiratory therapist receives an order to set up a moderate level of O on a patient who arrives in the ED breathing at a rate of 35 breaths/min. Which of the following O2 delivery devices is most appropriate to use in this situation? A. Simple O2 mask at 10 L/min B. Nasal cannula at 4 L/min C. NRB Mask at 15 L/min D. Air-entrainment mask at 40% O2 - ANS ✓D. Air-entrainment mask at 40% O A severe COPD patient arrives in the emergency department on a 2 L/min nasal cannula. Arterial blood gas results follow: pH: 7.
PaCO2: 67 mmHg PaO2: 62 mmHg HCO3: 38 mEq/L Which of the following is the most appropriate recommendation? A. Increase the liter flow to 4 L/min B. Maintain the current O2 level C. Institute noninvasive positive pressure ventilation (NPPV) D. Place on a NRB mask at 12 L/min - ANS ✓B. Maintain the current O2 level The physician has ordered O2 to be set up on a patient who has a spontaneous tidal volume of 500 mL and an inspiratory time of 1 second. Which of the following O2 delivery devices will deliver a flow that meets or exceeds this patient's inspiratory flow? A. 35% air-entrainment mask at 6 L/min B. 60% aerosol mask at 12 L/min C. NRB mask at 15 L/min D. Simple O2 mask at 10 L/min - ANS ✓500 mL = 0.5 L 0.5/1 = 0.5 L/s (change L/s to ?/min by multiplying by 60 0.5 L x 60= 30 L/min Select the device that delivers a flow of at least 30L/min A. 35% air-entrainment mask at 6 L/min A patient breathing 50% oxygen has a PaO2 of 248 torr. Which of the following should the RT recommend? A. Discontinue O2 therapy
D. 48 mg H2O per liter of gas - ANS ✓B. 32 mg H2O per liter of gas A patient receiving 38 mg H2O per liter of gas from a nebulizer has a humidity deficit of which of the following? A. 6 mg/L B. 9 mg/L C. 12 mg/L D. 18 mg/L - ANS ✓ 44 - 38= 6 A. 6 mg/L After connecting a nasal cannula to the humidifier outlet, you kink the tubing and hear a whistling noise coming from the humidifier. Which of the following most likely has caused this? A. The humidifier jar is cracked B. The capillary tube in the humidifier is disconnected C. The humidifier has no leaks D. The top of the humidifier is not screwed on tightly - ANS ✓C. The humidifier has no leaks You notice that the patient's secretions have become thicker and more difficult to suction since the ventilator humidifier was replaced with an HME. The RT should recommend which of the following? A. Increase inspiratory flow B. Decrease the temperature to the HME C. Replace with a new HME
D. Replace the HME with a conventional heated humidifier - ANS ✓D. Replace the HME with a conventional heated humidifier Which of the following are indications for cool, bland aerosol therapy?