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NBRC TMC A QUESTIONS AND ANSWERS 2025/2026, Exams of Nursing

NBRC TMC A QUESTIONS AND ANSWERS 2025/2026 1. Three months after lung transplantation, a patient develops shortness of breath and requires invasive mechanical ventilation. A chest radiograph shows diffuse alveolar infiltrates. Which of the following diagnostic tests should a respiratory therapist recommend?: bronchoscopy with BAL 2. The accuracy of a spirometer should be assessed using a: 3-liter syringe 3. A respiratory therapist is assessing a 168-cm (5-ft 6-in), 73-kg (161-lb), 41-year-old female who was admitted 12 hours ago for an aspirin overdose. The following information is obtained as the patient breathes air: HR 89/min RR 15/min BP 110/70 mm Hg SpO2 86% A respiratory therapist should FIRST: A. validate the SpO2 reading at a different site 4. A respiratory therapist is caring for a patient who has ARDS. Blood pressure is 90/60 mm Hg. The patient is receiving PC, A/C ventilation with the following settings: FIO2 1.0

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2024/2025

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Science/ Medicine/ Pulmonology NBRC TMC A QUESTIONS AND ANSWERS 2025/2026 1. Three months after lung transplantation, a patient develaps shortness of breath and requires invasive mechanical ventilation. A chest radiograph shows diffusc alvcolar infiltrates. Which of the following diagnostic tests should a respiratory therapist recommend?: bronchoscopy with BAL 2. The accuracy of a spirometer should be assessed using a: 3—liter syringe 3. A respiratory therapist is asscssing a 168—cm (5—ft 6-in), 73-kg (161-Ib), 41—ycar—old female who was admitted 12 hours ago for an aspirin overdose. The following information is obtained as the paticnt breathes air: HR 89/min RR 15/min BP 110/70 mm Hg SpO02 86% A respiratory therapist should FIRST: A. validate the SpO2 reading at a different site 4, A respiratory therapist is caring for a patient who has ARDS. Blood pressure is 90/60 mm Hg. The patient is receiving PC, A/C ventilation with the following settings: TFIO2 1.0 Mandatory rate 14 PIP 30 cm H20 PEEP 18 cm H20 ABG analysis shows the following: pH 7.36 PCO2 44 mm Hg PO2 50 mm Hg HCO3— 25 mita/L. BE -1 mEq/L S02 (calc) 85% A chest radiograph shows bilateral lower lobe infiltrates. Which of the following should the therapist do?: D. Place the patient prone b. When following CDC droplet isolation precautions, which of the following must a paticnt don before being transported within the hospital?: 3. surgical mask 6. The following data are obtained for an adult patient who is receiving VC ventilation with a VT of 600 mL: 10 AM 12 PM Peak airway pressure 38 cm H20 45 cm H20 Plateau pressure 34 cm H20 34 cm H20 These data indicate: B. increased airways resistance 7. A 175-em (5-ft 9-in), 113-kg (250-Ib), 56-ycar—old male with a 48 pack— year smoking history is being prepared for abdominal surgery. Which of the following should be done preoperatively to assess the patient's risk for respiratory complications following abdominal surgery?: Perform spirometry D. adding ipratropium (Atrovent).: D. adding ipratropium (Atrovent) 13. or a patient recciving noninvasive ventilation through a dual—limb circuit, an increase in which of the following will decrease work of breathing associated with spontaneous breathing? A, inspiratory time B. ramp time C. PEEP D. pressure support: D. pressure support 14. The primary reason lo evaluale maximum inspiralory pressure is lo determine A, muscle strength. B. oxygenation. C. ventilation. D. V/Q ratio.: A. muscle strength. 15. A respiratory therapist is administering an 80/20 heliox mixture to an adult female. When using a flowmeter calibrated for oxygen, the actual flow is how many times greater than the indicated flow? A. 1.4 B. 1.6 C. 1.8 ). 2.0: C. The conversion factor for a 80/20 hcliox mixture is 1.8 16. The following patient data are noted: RR 12/min Sp02 97% Ixhaled VT 450 mL FEV1 3.25 1 ve 4.00 L What is the minute ventilation (1./min)? A, 4.80 B. 8.70 C. 3.90 D. 5.40: D. 5.40 L/min 17. A 3 year old is recciving VC ventilation. A respiratory therapist is preparing to administer acrosolized dornasc alfa (Pulmozyme) in-line with the ventilator. Which of the follawing devices should the therapist select lo administer the therapy? A. DPI B. MDI C. ultrasonic nebulizer D. vibrating mesh nebulizer: D. vibrating mesh nebulizer 18, Which of the following may be caused by the administration of acrosolized pentlamidine isethionate (NebuPent)? A, tachycardia B. bradycardia C. branchospasm A, liquid oxygen system B. I. cylinders C. oxygen concentrator D. transtracheal oxygen: C. oxygen concentrator 22, A respiratory therapist is revicwing a chest radiograph of a paticnt with a hemothorax and sces the end of a chest tube. On returning to the paticnt's bedside, where should the therapist expect ta see the Lube as it enlers the chest wall? A, third intercostal space at the mid—clavicular line GB. fifth intercostal space at the mid—axillary linc C. second intercostal space at the mid—clavicular line D. fourth intercostal space at the mid—axillary line: B. fifth intercostal space at the mid—axillary linc 23. A respiratory therapist is called to the ID to assess an adult male with increased work of breathing. The paticnt is recciving oxygen by a nonrebreathing mask at 8 I./min. The reservoir bag completcly deflates during inspiration. Which of the following should the therapist do? A, Remove the one-way valve between the mask and reservoir bag. 3. Switch to a simple mask. C. Connect the mask to a bubble humidifier. D. Increase the oxygen flow to 15 L/min.: D. Increase the oxygen flow to 15 L/min. 24, The use of respiratory accessory muscles is frequently the result of an increase in A. alvcolar ventilation. B. lung compliance, C, airways resistance, D. cardiac output.: C. airways resistance 25. A patient who has undergone CABG surgery is receiving VC, A/C ventilation. Radial arterial and pulmonary arlery calheters are in place for monitoring. Which of the following should a respiratory therapist use to cvaluate tissuc oxygenation in this patient? A, ABG analysis B. mixed venous analysis C. serum lactate Ievel D. cardiac output: B. mixed venous analysis 26, A patient with a pulmonary artery catheter in place has the following hemadynamic valucs before and after infusion of 500 mL IV normal saline: Before After BP 100/70 mm Hg 105/72 mm Hg CVP 10 mm Hg 15 mm Hg PCWP 13 mm Hg 19 mm Hg CL. 2.00 L/min/m2 2.05 1./min/m2 laint crackles are heard in the lung bases with no change in urine output. The moasl appropriate aclion is lo A, change IV fluid to DOW. LB. infuse an additional bolus of normal salinc. C. administer albumin. 30, A respiratory therapist instructed a patient to take a decp breath and then exhale as quickly as possible. The therapist observed a recording of the fastest air movement, What was measured? A. peak flaw B. vilal capacity C. FEVI D. VE: A, Peak Flow 31, The most commonly used bedside measurement to monitor the progression of ventilatory impairment in a paticnt with Guillain-Barré syndrome is A, end-tidal CO2. B. PaCo2, C, vital capacity. D. peak flow.: vital capacity 32, A respiratory therapist observes the following chest radiograph: Which of the following are evident? A, pneumothorax and pleural cffusion GB. tracheostomy tube and chest tube C. chest tube and pncumothorax D. pleural effusion and trachcastomy tube: D. pleural cffusion and trachcostomy tube 33. A 62-year-old male with COPD is prescribed compressed oxygen by a pulse—flow delivery system. During a follow-up home visil, Lhe patient reports to a respiratory therapist that oxygen is being delivered continuously. The therapist should FIRST A, check the regulator setting. GB. calibrate the oxygen sensor. C. replace the nasal cannula. D. increase the flow.: A. check the regulator sctting 34, Digital clubbing can be most casily assessed by A, palpating the proximal digital joints. B. inspecting the appearance of the nail bed. C. examining the fingers for evidence of discoloration. D. comparing the symmetry of the fingers between both hands: LB. inspecting the appearance of the nail bed 35. A 173-cm (5—-ft 8-in), 111-kg (245—-lb), 73-year-old male is intubated with a size 7.5 endotracheal tube and recciving mechanical ventilation. He has a history of 70 pack—ycars of smoking. A capnograph shows the following waveform: A. emphysema, B. morbid obesity. C. pulmonary emboli. D. mainstem intubation: A. emphysema 36, A 32—-ycar—old female is brought to the ED with third-degree burns to the face, neck, and chest involving 50% of total body surface area. ABG analysis obtained while the patient receives an F102 of 1.0 reveals: pH 7.48 PCO2 33 mm Hg PO2 381 mm Hg A, Switch to a nonrebreathing mask. LB. Initiate noninvasive ventilation, C, Change to a simple mask. D. Titrate nasal cannula flow.: D. Titrate nasal cannula flow 39. Following a motor vchicle crash, an adult patient who weighs 80 kg (176 Ib) was intubated with a size 8.0-—mm ID endotracheal tube for continuous ventilatory support. For the last week, culf pressures af 30-34 cm J120 have been required lo obtain minimal occluding volume. Recurrent aspiralion and abdominal distentian are observed. Which of the following should a respiratory therapist recommend? A. Select a larger endotracheal tube. GB. Maintain the cuff at a higher pressure. C. I'valuate for a trachcocsophagcal fistula. D, Administer a glucocorticosteriod by IV.: C. ’valuate for a trachcocsophagcal fistula 40, A spontancously breathing patient with an cxacerbation of CHI is receiving an 102 of 0.40 and has the following ABG analysis results: pH 7.46 PCO2 33 mm Hg PO2 48 mm Hg HCO3— 23 mla/L. BE O mitq/L S02 (calc) 83% Which of the following should be donc NEXT? A, Scdate the patient. GB. Intubate the paticnt. C. Initiate mask CPAP. D. Increase the F102 to 1.0.: C. Initiate mask CPAP 41. A 37-ycar—old male with a BMI of 43 kg/m2 is admitted to the ED with fever, productive cough, and shortness of breath. The patient's vital signs arc stable, and he is awake and alert. After initiation of bronchodilator therapy and antibiotics, results for scrial ABG analyses reveal: 1 PM 2PM F102 0.21 0.50 pH 7.28 7.23 PCO2 76 mm Hg 85 mm Hg PO2 43 mm Hg 53 mm Hg HCO3— 36 mld/L 36 mliq/L BE +6 miq/L +5 mlia/I. SO2 (calc) 78% 87% The patient's clinical condition remains unchanged. Which of the following should a respiratory therapist da NEXT? A. Maintain current therapy. B. Recommend NPPY. C. Decrease the FIOZ lo 0.45. 1D. Administer vibratory PEP.: B. Recommend NPPV 42. A patient with recently diagnosed cystic fibrasis is admilted due ta an exacerbation, A respiratory therapist reviews the home carc plan: albutcrol QID HIFCWO TID dornasce alfa (Pulmozyme) BID 45, The following data are obtained while a 48—ycar—old paticnt reccives VC ventilation with an IIO2 of 0.50: 1300 1315 1330 1345 PEEP (cm H20) 5 10 15 20 BP (mm Hg) 140/90 130/90 120/80 110/80 SpO2 (%) 75 90 94 95 Static compliance 20 40 60 55 Which of the follawing levels of PEEP should a respiratory therapist chaase? A. 5 cm 1120 B. 10 em 1120 C.15 em 1120 D. 20 cm H20: C. 15 em H20 46. An adull patient is receiving an FIO2 of 0.28 and PS of 5 cm II20 witha PEEP of 5 cm H20, The patient is alert and oriented. Vital signs and ABG analysis results arc: HR 86/min RR 24/min pH 7.43P COZ 32 mm Hg PO2 91 mm Hg HCO3— 21 miid/I. BE -2 mliq/I. SO2 (meas) 97% Which of the following is a respiratory therapist's most apprapriale action? A, Recommend extubation of the patient. B. Assess pulmonary mechanics. C. Titrate the F102 to an SO2 of 93% D. Maintain current scttings.: Recommend extubation of the paticnt. 47, A respiratory therapist determined a paticnt recciving mechanical ventilation developed aute—PEIEP due to dynamic airflow obstruction. Which of the following should the therapist do? A, Add an inspiratory plateau. 13. Add mechanical deadspacc. C. Decrease the mandatory rate. D. Deerease the inspiratory flow.: C. Decrease the mandatory rate 48, Which of the following factors will influence the oxygen concentration delivered by a sclf—inflating manual resuscitator? A, oxygen flow and reservoir size B. PEEP setting and oxygen flaw C. bag size and PEEP setting D. reservoir size and bag size: A. axygen flow and reservoir size 49, A new blood gas analyzer was calibrated by the manufacturer at sca Icvel. On recciving the analyzer at a higher altitude, a respiratory therapist should A, proceed to quality control assessment. B. set the barometric pressure at sea level. C. replace the electrodes. D. recalibrate Lhe blood gas analyzer.: ID. recalibrate the blood gas analyzer Tone some flexion limp Respiratory rate irregular slow What APGAR scores should Rt expect to see for this nconate? 1-minute 5—minute 1.63 2, BB 3.42 4.32: A.] 53. A patient presents with a history of loud snoring and daytime slecpincss. Which of the following is mast important for a respiratory therapist to cvaluatc while the patient is sleeping? A. breathing pattern B. peripheral perfusion C. breath sounds D. cardiac rate: A. breathing pattern 54, Rapid assessment of the oxygenation status of a new patient is best achieved by CBG analysis. pulse oximetry. ABG analysis. transcutaneous monitoring: pulse oximetry 55, A 19-ycar—old patient with muscular dystrophy is scen in the ID following a 2-day history of increasing shortness of breath, Blood gas analysis results obtained while the patient is breathing air are: pil 7.32 PaCOQ2 62 mm IIg PaOQ2 56 mm IIg HCO3— 32 mEq/I. BE +4 mla/L. SaO02 (calc) 89% A respiratory therapist should recommend A, initiating invasive mechanical ventilation. GB. measuring vital capacity. C, performing airway clearance. D, initiating noninvasive ventilation.: D. initiating noninvasive ventilation 56, A respiratory therapist is calibrating a hclium analyzer. What should the analyzer read when calibrated in air? A, 0% B. 79% C. 100% D. 21%: A. 0% 57. In a patient with postopcrative atelectasis, PEP therapy is likely to: increase functional residual capacity