Download NBRC TMC EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS LATEST UPDATE (2025/2026) and more Exams Nursing in PDF only on Docsity!
NBRC
NBRC TMC EXAM QUESTIONS WITH CORRECT
VERIFIED ANSWERS LATEST UPDATE
(202 5 /202 6 ) GUARANTEED PASS
Mallampati class I - ANS ✓Soft palate, uvula, fauces, pillars visible Mallampati Class II - ANS ✓Soft palate, uvula, fauces visible Mallampati class III - ANS ✓Soft palate, base of uvula visible Mallampati class IV - ANS ✓Hard palate only visible Normal pulse - ANS ✓ 60 - 100 bpm Tachycardia - ANS ✓> 100 bpm (hypoxemia, anxiety, stress, give O2) Bradycardia - ANS ✓< 60 bpm (heart failure, shock, code emergency, give atropine) Adverse reaction indicator - ANS ✓Change in HR of more than 20 beats/min Paradoxical pulse/pulsus paradoxus - ANS ✓Pulse/blood pressure varies with respiration. EMERGENT Paradoxical pulse/pulsus paradoxus symptom of... - ANS ✓May indicate severe air trapping (status asthmaticus, tension pneumothorax, cardic tampanade)-felt on exhalation EMERGENT
NBRC
Tracheal deviation (pulled) - ANS ✓Is PULLED to abnormal side (toward pathology) in... Atalectasis Pneumonectomy Diaphragmatic paralysis Tracheal deviation (pushed) - ANS ✓Is PUSHED to normal side (away from pathology) in... Massive pleural effusion Tension pneumothorax Mediastinal mass Neck or thyroid tumors Tactile fremitus definition - ANS ✓Vibrations felt by hand on chest wall *Vocal fremitus - voice vibrations felt thru chest wall *Pleural rub fremitus - grating sensation felt, roughened pleural surfaces rubbing together *Rhonchal fremitus - palpable rhonchi Crepitus - ANS ✓Air under the skin, subcutaneous emphysema Normal air filled lung percussion sound - ANS ✓Resonant, hollow sound Atelectactic lung percussion sound - ANS ✓Flat Dull - pleural effusion or pneumonia can cause this Hyperinflated lung percussion sound - ANS ✓Tympanic, drum-like sound Hyperresonant, booming (emphysema, pneumothorax)
NBRC
Epiglottitis - ANS ✓Inflammation of the epiglottis *Supra (above) glottic swelling (thumb sign) Croup (laryngotracheobronchitis) - ANS ✓Sub (below) glottic swelling *steeple sign *picket fence sign *pencil point sign *hourglass sign Stertor - ANS ✓Low-pitched snoring noise *CAUSED BY SECRETIONS OR VIBRATING TISSUE THAT IS RELAXED OR FLABBY Pleural friction rub - ANS ✓Coarse, grating, raspy, or crunching sound *Visceral & parietal pleura rubbing *PLEURISY, TB, PNEUMONIA, PULMONARY INFARCTION, CANCER *Treat with steroids & antibiotics First sound (S1) lub - ANS ✓Normal, closure of the mitral & tricuspid valves, beginning of ventricular contraction Second sound (S2) dub - ANS ✓Normal, ventricles relax and pulmonic & aortic valves close Third sound (S3) - ANS ✓Abnormal in adults & may suggest HF Fourth sound (S4) - ANS ✓Indicitive of cardiac abnormality; uncontrolled htn or aortic stenosis
NBRC
Presence of S3 & S4 can indicate... - ANS ✓A heart murmur (blood pushed through an abnormal opening such as an ASD or PDA Systolic acceptable range - ANS ✓ 90 - 140 mmHg Diastolic acceptable range - ANS ✓ 60 - 90 mmHg Normal right hemidiaphragm position - ANS ✓Sixth anterior rib Location of aortic knob - ANS ✓45 degree line to carina, 3 - 5 cm above PREPP - ANS ✓Position Rotation Exposure Penetration Periphery Mantra - ANS ✓ A well penetrated (exposed) chest xray... - ANS ✓The intervertebral disc spaces are visible behind the heart, thru the mediastinal shadow An underexposed chest xray... - ANS ✓Will not show the intervertebral discs thru the heart shadow Key normal finding in a chest xray - ANS ✓The space between the vertebrae is equal, visible, distinct Correct placement of an ETT - ANS ✓ 2 - 6 cm above carina
NBRC
Infliltrate on a CXR - ANS ✓Any ill-defined radiodensity *Atelectasis Consolidation on a CXR - ANS ✓Solid white area *Pneumonia/pleural effusion Hyperlucency in CXR - ANS ✓Extra pulmonary air (too much) *COPD, asthma attack, pneumothorax Vascular markings on CXR - ANS ✓Lymphatics, vessels, lung tissue *Increased with CHF, absent with a pneumothorax Diffuse on a CXR - ANS ✓Spread throughout *Pna, atelectasis Opaque - ANS ✓Fluid, solid *Consolidation Pulmonary edema/CHF on a CXR - ANS ✓Fluffy infiltrates Butterfly pattern Batwing pattern Atelectasis on a CXR - ANS ✓Patchy infiltrates Platelike infiltrates Air bronchograms ARDS on a CXR - ANS ✓Ground glass
NBRC
Honeycomb pattern Diffuse BILATERAL opacity Pleural effusion on a CXR - ANS ✓Blunted costophrenic angles "Martini glass" appearance Pneumonia (inflammation or fluid) on a CXR - ANS ✓Air bronchograms Pulmonary embolus on a CXR - ANS ✓Peripheral wedge-shaped infiltrate May also be normal TB on a CXR - ANS ✓Cavitation in the apical areas Gold standard for diagnosis of a PE - ANS ✓Spiral CT with contrast Best imaging for determining locations of tumors, soft tissue abnormalities, & involvement of surrounding structures - ANS ✓MRI (no radiation) No steel in the room d/t high powered magnet V/Q scan - ANS ✓Ventilation-perfusion scan - radioactive test of lung ventilation & blood perfusion throughout the lung capillaries (lung scan) *Normal ventilation with abnormal perfusion can indicated PE Barium swallow - ANS ✓Diagnoses dysphasia *Gastroscopy also used Bronchography (bronchogram) - ANS ✓By outlining the airways it will identify obstructing lesions (i.e. tumors) & bronchiectasis (main indication)
NBRC
*temp induces cerebral vasoconstriction; lasts min to hours Ways to lower JV pressure - ANS ✓Helps keep ICP down *HOB at 30 deg *Minimize retching, straining, coughing *Decrease PEEP Drugs to reduces ICP - ANS ✓Osmotic agents: *Mannitol (diuretic, commonly used to reduce ICP) *Hypertonic saline CPP - ANS ✓Cerebral perfusion pressure, determines cerebral perfusion CPP formula - ANS ✓CPP = MAP - ICP Normal CPP - ANS ✓ 70 - 90 mmHg *Must be at lease 70 mmHg FEno testing - ANS ✓Measurement of exhaled NO *Monitors pt response to corticosteroid treatments *Useful in monitoring asthma, CF, COPD FEco - ANS ✓Exhaled carbon monoxide *Normal biproduct of RBC destruction *Used to measure smoking abstinence *Non-smokers < 7 (definately under 10) *Heavy smoker > 20
NBRC
PE eval order of diagnostics - ANS ✓1. Spiral CT
- V/Q scan (nuclear med study)
- Pulm angiogram RBC norm - ANS ✓ 4 - 6 (5 x 3 x 3 rule Hemoglobin (Hb) norm - ANS ✓ 12 - 16 (5 x 3 x 3) rule Hematocrit (Hct) norm - ANS ✓ 40 - 50% (5 x 3 x 3) rule Normal WBC - ANS ✓5,000-10, Increased WBC - ANS ✓Leukocytosis (bacterial infection) Decreased WBC - ANS ✓Leukopenia (viral infection) Bands - ANS ✓Immature neutrophils *Increased with bacterial infections *norm 4% of WBC Segs - ANS ✓Mature neutrophils *Decreased with bacterial infections *norm 60% of WBC Eosinophils - ANS ✓Associated with asthma *norm 2% of WBC
NBRC
Hyperkalemia - ANS ✓High potassium *metabolic acidosis (spiked T-waves on EKG), kidney failure indicator Hyponatremia - ANS ✓Low sodium *fluid loss from diuretics, vomiting, diarrhea, fluid gain from CHF, IVs Hypernatremia - ANS ✓High sodium *dehydration (releases K+ to hold on to Na+) Hypochloremia - ANS ✓Low chloride *Metabolic alkalosis Hyperchloremia - ANS ✓High chloride *Metabolic acidosis Gram stain test - ANS ✓Identifies gram pos or neg bacteria *1st test done, fast --> results in 1hr Clotting time norm - ANS ✓Up to 6 min Platelet count - ANS ✓Done to detect coagulation defect *norm 150,000 - 400, *decreased platelet count could be a result of bone marrow defect or sepsis Activated partial thromboplastin time (APTT) - ANS ✓Length of time it takes plasma to form a fibrin clot *24-32 seconds
NBRC
Alveolar Air Equation - ANS ✓FiO2(Pbar-47)-(PaCO2/0.8) Prothombin time (PT) - ANS ✓Normal 12 - 15 sec *used to monitor Warfarin thera Troponin - ANS ✓Protein found in myocardial cells *Acute MI will have elevated troponin *>0.1ng/mL = high risk of death from MI Brain natriuretic peptide (BNP) - ANS ✓Secreted by cardiac muscles when HF develops or worsens *Elevated BNP = CHF (helps to determine if symptoms are COPD or CHF) *Normal = < 100 pg/mL *Severe = > 900 pg/mL Mantoux test - ANS ✓Tuberculin skin test *Most reliable TB test Normal HR - ANS ✓ 60 - 100 bpm Flutter - ANS ✓Rapid but regular contractions, usually of the atria
200 Fibrillation - ANS ✓Chaotic, irregular contractions of the heart, as in atrial or ventricular fibrillation *too fast to count Oscilloscope - ANS ✓Provides continuous heart activity on a monitor (ECG monitor)
NBRC
Age of "term" infant - ANS ✓ 38 - 42 weeks LGA - ANS ✓Large for gestational age SGA - ANS ✓Small for gestational age TPAL - ANS ✓Term, Preterm, Abortion (spontaneous or elective), Living APGAR - ANS ✓Appearance, Pulse, Grimice, Activity, Respirations *0 = Real bad *1 = Bad *2 = Good APGAR score & actions - ANS ✓Appearance, Pulse, Grimice, Activity, Respiratory effort *0 - 3 = resuscitation *4 - 6 = support, stimulate, warm, O *7 - 10 = monitor, routine care Normal infant temp - ANS ✓36.5 C Normal infant HR - ANS ✓ 110 - 160
170 = Tachy
- < 100 = Brady *Can only increase CO by increasing HR Norm infant RR - ANS ✓ 30 - 60
NBRC
*Resp pause: apnea = 5 - 10 sec --> normal *Short apnea = 10 - 20 sec - -> May be normal *Long apnea = > 20 sec --> always abnormal Norm infant BP - ANS ✓60/ Preterm = 50/ Norm infant weight - ANS ✓> 3000g (3kg) *28 wk GA = 1000g Acrocyanosis - ANS ✓Bluish extremities *Not true cyanosis Signs of infant resp distress - ANS ✓Grunting, retractions, nasal flaring Silverman score - ANS ✓ 0 - 10, assessment of resp distress *The higher the score, the greater the distress Dubowitz or Ballard score - ANS ✓Assessment of GA *differentiates between preterm infant & one that is small for their GA New Ballard score - ANS ✓Modified Ballard score *estimates GA in very low birth weight infants *do not choose if infant in severe distress Pre & post ductal blood gas - ANS ✓If pre-ductal (R radial artery) PaO2 is 15torr or higher than post-ductal umbillical then there is a PDA with R to L shunt
NBRC
*x = O2 flow *add O2 flow to 3x flow L ventricle serves ... circulatory branch - ANS ✓Systemic arteries R atrium serves ... circulatory branch - ANS ✓Systemic veins R ventricle serves ... circulatory branch - ANS ✓Pulmonary arteries L atrium serves ... circulatory branch - ANS ✓Pulmonary veins Normal human BSA - ANS ✓2m squared CI norm & calculation - ANS ✓Cardiac index norm = 2.5 - 4 L/min/m2. *CI = Qt (CO)/BSA SVR norm & calculation - ANS ✓< 20mmHg/L/min or 1600 dynes/sec/cm5 (x 80 to get dynes) *SVR = (MPAP - PCWP)/CO OPA indications - ANS ✓Oropharyngeal airway *Unconcious pt *Support base of tongue *Bite block *facilitate oral suctioning NPA indications - ANS ✓Nasopharyngeal airway *Conscious pt
NBRC
*Support base of tongue *Facilitate NT suctioning/decreases trauma from NT sxn If self-inflating bag fills rapidly & collapses easily ... - ANS ✓Check inlet valve Max flow for manual resuscitation (self-inflating) bag - ANS ✓15L/min Used for manual resuscitation of neonates - ANS ✓Anesthesia (flow-inflating) bag PIP is controlled by what with an anesthesia bag - ANS ✓Flow to bag Adjustment of flow control valve Pressure of squeeze on bag *should be kept half full between breaths Anesthesia bag will not inflate if ... - ANS ✓Leaks Low flow to bag Open flow control valve Open pop-valve Most common indication for oral or nasal intubation - ANS ✓MV Medications that can be directly instilled into the ETT if no IV access - ANS ✓V. A. N. E. Versed, Atropine, Narcan, Epinephrine *double IV dose, flush w/saline, hyperventilate Mainstem intubation happens at what ETT depth - ANS ✓> 25cmH2O
