Download NBRC TMC STUDY GUIDE EXAM QUESTIONS WITH CORRECT VERIFIED SOLUTIONS 100% PASS 2025/2026 and more Exams Nursing in PDF only on Docsity!
NBRC
NBRC TMC STUDY GUIDE EXAM QUESTIONS WITH
CORRECT VERIFIED SOLUTIONS 100% PASS
When assessing the airway of a patient prior to intubation, a Mallampati score of 4 is observed. What should the RT recommend to facilitate intubation? - ANS ✓Video Laryngoscopy (Bronchoscope) An adult patient who weighs 62kg (136lb) requires a minute ventilation of 15L/min to maintain a PaCO2 of 36mmHg while receiving mechanical ventilation. What could explain these ventilatory requirements? - ANS ✓1. Excessive caloric intake
- Increased dead space ventilation
- Febrile patient While performing beside spirometry on a patient, the following FEV values are obtained from 3 maneuvers:
What should the RT conclude about these results? - ANS ✓The effort was inconsistent An RT is assisting a physician with a needle biopsy of a lung mass during fiberoptic bronchoscopy. The biopsy site begins to hemorrhage. What should the RT have ready for instillation? - ANS ✓Iced saline
NBRC
An adult patient with a tracheostomy tube is receiving a heated aerosol with an FiO2 of 0.30 by T-piece. An RT observes that the t-piece often becomes disconnected from the tracheostomy tube. What should the the therapist do> - ANS ✓Exchange the T-piece for a tracheostomy collar An RT will assist a physician perform cardioversion for a spontaneously breathing patient with supraventricular tachycardia. The patient is alert and awake. What steps should be performed in preparation for this procedure? - ANS ✓ 1. Supplemental O
- Gather airway equipment
- Sedate the patient Do NOT intubate the patient What should a tracheostomy stoma site be cleaned with? - ANS ✓Normal saline Which device provides 100% humidity at body temperature? - ANS ✓Heated-wick humidifier While examining a chest radiograph from an adult patient an RT notes the presence of air bronchograms. What is the most likely cause? - ANS ✓Pneumonia A patient who is 188cm (6ft2in) tall is intubated with an 8.0mm ID endotracheal tube that is secured with a 18-cm mark adjacent to the incisor. An RT hears a gurgling sound with each inhalation and observes the exhaled VT is 300mL less than the inhaled VT. The RT increases the cuff pressure from 16cm to 24cm. There is no change in the sound or exhaled VT. What should the RT do? - ANS ✓Deflate the cuff before advancing the tube 4cm
NBRC
The patient is currently on continuous norepinephrine infusion and the SpO2 monitor does not consistently display a waveform or saturation value. What should the RT do first? - ANS ✓Change to a forehead sensor The RT notes a prolonged inspiratory time and variable cycling to exhalation for a patient receiving PS ventilation. The circuit is verified to be intact. What should the RT do next? - ANS ✓Check for the integrity of the endotracheal tube cuff Results of a sleep study reveal a patient has OSA with marked oxygen desaturation. What therapy should be recommended for the patient during sleep? - ANS ✓Nasal CPAP 5 minutes after starting a 2.5mg albuterol nebulizer treatment a patient complains of palpitations, headache and tremors. What should the RT do? - ANS ✓Terminate the treatment A suction canister from the bronchoscopy suite was used for a patient with Hep B. How should the canister be disposed? - ANS ✓Place it in a biohazard waste bag A patient with cystic fibrosis, who usually expectorates white sputum, complains of increased cough and dark yellow sputum production. She is febrile and a CXR reveals a right middle lobe infiltrate. What do these clinical findings suggest? - ANS ✓Pneumonia A patient is receiving PC AC ventilation. The RT is assisting with an uncomplicated thoracentesis during which 1200mL of fluid is drained from the patient's pleural space. What change should the RT expect to observe? - ANS ✓Increased VT A 58 year-old male who is 175cm (5ft9in) tall and weighs 85kg (187lb) is receiving VC SIMV with the following settings
NBRC
FiO2 40% Mandatory Rate 8 Total Rate 12 VT 565 PS 5 PEEP + The physician asks the RT to change the settings to reduce the patient's PCO2, but prefers to keep the mandatory rate at 8. What should the RT offer? - ANS ✓Increase PS Which of the following pulmonary function tests measures FRC, RV and TLC? A. DLCO B. Spirometry C. MVV D. Body Plethysmography - ANS ✓D. Body Plethysmography According to ACLS guidelines, the correct placement for a needle during decompression of a tension pneumothorax is where? - ANS ✓Over the third rib in the mid-clavicular line 4 hours post-CABG a patient is receiving supplemental oxygen through a nasal cannula at 2L/min. What is the most appropriate method for an RT to evaluate the patient's response to the oxygen therapy? - ANS ✓Measure the SpO An RT is performing postural drainage and percussion to the lateral basal segment of the right lower lobe for a patient with chronic bronchitis. The patient complains of shortness of breath after being positioned for 10
NBRC
1. PRVC SIMV: VT 350/RR 12/PEEP +
2. PRVC SIMV: VT 300/RR 16/ PEEP +
3. VC AC: VT 450/RR 10/PEEP +
4. VC SIMV: VT 400/RR 20/PEEP +5 - ANS ✓2. PRVC SIMV: VT 300/RR 16/
PEEP +
A 22-year-old patient is being considered for extubation after being treated with status asthmaticus for the last 48 hours. BS are clear and no current distress is noted. While receiving FiO2 40%/PS 10/PEEP +5 her vital signs are: HR 87 RR 18 SpO2 96% After breathing through a T-Piece for 30 minutes with an FiO2 of 40% vital signs reveal: HR 95 RR 20 SpO2 90% What should the RT conclude? - ANS ✓The patient is ready for extubation A 1400g, 28-week gestational age infant was delivered after a precipitous vaginal delivery. The infant is receiving nasal CPAP with an FiO2 of 50% in the delivery room and has an SpO2 of 85%. What is the most appropriate next course of treatment? - ANS ✓Administer surfactant
NBRC
While performing MVV maneuvers a patient repeatedly terminates the test between 8 to 10 seconds. What should the RT do? - ANS ✓Reschedule testing at a later time A 68-year old man with a history of COPD is admitted to the hospital for increasing shortness of breath and a nonproductive cough. Chest auscultation reveals expiratory wheezes. What the most appropriate choice to improve the patient's clinical condition? - ANS ✓Ipratropium (Atrovent) What is the best instruction for a patient receiving a small-volume nebulizer bronchodilator therapy? - ANS ✓Breath normally with an occasional deep inspiratory hold What is the most simple method of preventing postoperative atelectasis in a patient with no preoperative pulmonary problems? - ANS ✓Cough and deep breathing What are the potential complications associated with obtaining an ABG through an indwelling radial arterial catheter? - ANS ✓1. Infection
- Arteriospasm
- Finger Ischemia What is the amount of the air that can be forcibly exhaled from the lungs after taking the deepest breath possible? - ANS ✓FVC An 18-year old male with muscular dystrophy is receiving treatment for recurrent pneumonia and atelectasis. What should the RT recommend in addition to HFCWO? - ANS ✓Mechanical insufflation and exsufflation An RT is checking a jet nebulizer with an entrainment setting 35%. A properly calibrated oxygen analyzer measures the concentration at 45%. What best explains this finding? - ANS ✓Water in the tubing
NBRC
FiO2 80% Mandatory Rate 10 Total Rate 32 Set VT 650 Spontaneous VT 100 PS 5 PEEP + What should the RT increase?
- PEEP
- VT
- Mechanical Deadspace
- Pressure Support - ANS ✓4. Pressure Support A 56-year-old female with a diagnosis of bilateral basilar pneumonia is in the ICU and receiving VC AC ventilation. A respiratory therapist observes that her SpO2 has dropped from 95% to 84%. Her current FiO2 is 50% with +12 PEEP. Her PaCO2 values have remained within normal range. What should the RT increase first? - ANS ✓Increase the FiO A patient requires frequent nasotracheal suctioning. The patient begins to cough violently after an RT places a nasopharyngeal airway. Which of the following actions should the therapist recommend?
- Wait 10 minutes for the patient to adapt to the airway
- Wait until the patient falls asleep to insert an airway
- Insert a nasal airway that is wider
- Insert a nasal airway that has a shorter length - ANS ✓4. Insert a nasal airway that has a shorter length
NBRC
Common emotional manifestations of chronic pulmonary disability could include what? - ANS ✓Depression Anger Hostility A 71 year-old male with COPD is admitted to the ED with shortness of breath, tachypnea, and confusion. Oxygen is initiated at 2L/min by nasal cannula and the ABG reveals: 7.32/80/50/41 11 85% What should the RT recommend? - ANS ✓Initiate bilevel ventilation A 41-year-old female who is 168cm (5ft6in) and weighs 70kg (154lb) is receiving PS ventilation with the following settings: FiO2 30% Exhaled VT 525 PEEP + PS 5 Following a 45 minute SBT the following information is obtained: RR 24 Minute Ventilation 8. What should the RT recommend? - ANS ✓Extubating the patient
NBRC
A 183cm (6ft) 80kg (176lb) male was receiving PSV with an FiO2 of 35% before surgery. After surgery the following data is obtained while the patient is receiving VC AC Ventilation? FiO2 75% Mandatory rate 16 VT 600ml PEEP + 7.32/45/50/23 - 3 85% What should the RT recommend? - ANS ✓A lung recruitment maneuver A 32-year old 168cm(5ft6in) 60kg (132lb) female with Guillain-Barre syndrome is receiving intravenous immunoglobulin (IVIg) and an FiO2 of 24% by air entrainment mask. Day 1: Vital Capacity= 950 MIP= - 24 Day 2: Vital Capacity= 850 MIP= - 20 Day 3: Vital Capacity= 700 MIP= - 18 What should the RT do?
NBRC
- Initiate bilevel NPPV
- Maintain current care
- Perform nasotracheal suctioning
- Recommend a tracheostomy - ANS ✓1. Initiate bilevel NPPV One day following a cholecystectomy, a 25-year old male with muscular dystrophy is returned to his home settings for NPPV in spontaneous mode. He is receiving intravenous hydromorphone (Dilaudid) for pain management. The follow data is available: FiO2 21% IPAP 18 EPE 8 HR 100/RR 6 7.26/70/60/31/ +2 91% What should the RT recommend? - ANS ✓Administer Naloxone HCl (Narcan) In a healthy adult, which of the following pulmonary measurements is the largest?
- Vital Capacity
- Inspiratory Capacity
- Functional Residual Capacity
- Expiratory Reserve Volume - ANS ✓1. Vital Capacity
NBRC
A patient presents with fever and left lower lobe necrotizing pneumonia. The following ABG is obtained while on room air: 7.46/33/53/23 0 87% Broad spectrum antibiotic therapy is started. What additional therapy is appropriate? - ANS ✓Titrate oxygen to maintain SpO2 greater than 92% An RT is assisting with triage following a bus crash. Which of the following patients should receive priority for mechanical ventilation?
- 14 y/o with open skull fracture and GCS of 5
- 56 y/o who is receiving CPR for cardiac arrest
- 28 y/o with flail chest w/multiple pulmonary contusions
- 75 y/o with 3rd degree burns over 25% of BSA - ANS ✓3. 28 y/o with flail chest w/multiple pulmonary contusions An RT is performing high calibration on a nitric oxide analyzer. What is the expected ppm value? - ANS ✓45= high Starts at 20ppm Which of the following should be used to administer 80/20 heliox to a 9 y/o boy
- Nasal Cannula
- Air-Entrainment Mask
- Simple Mask
- Nonrebreathing Mask - ANS ✓4. Nonrebreathing Mask
NBRC
What is the best position for drainage of the anterior segments of the upper lobes on a patient who is able to tolerate position hanges? - ANS ✓- Supine with pillow under knees *Trying to drain from front upper to middle of chest A 56 - year-old female is admitted to the ED following a motor vehicle crash. The RT notes the HR is 130 and RR 33. ABG: 7.44/35/52/24 0 97% The RT should anticipate orders for what? - ANS ✓A chest x-ray What particle sizes should a nebulizer produce to allow proper deposition of albuterol? - ANS ✓ 3 - 5 micrometers A 29-year-old male presents to the ED with complaints of frequent vomiting. ABG: 7.54/37/102/32 +9 98% Which electrolyte levels corresponds with the ABG?
- K+ 3.1 & Cl- 83
- K+ 3.1 & Cl- 114
- K+ 4.6 & Cl- 83
- K+ 4.6 & Cl- 114 - ANS ✓1. K+ 3.1 & Cl- 83 An RT is assessing a 178cm(5ft10in) 75kg (165lb) male who is receiving VC SIMV on the following settings
NBRC
Breath sounds are decreased bilaterally in the bases and there is decreased resonance to percussion bilaterally in the bases. The patient has a strong dry cough and a CXR indicates atelectasis in both bases. What should the RT initiate? - ANS ✓PEP Therapy A patient with pulmonary emphysema has been receiving 24% O2 for 30 minutes. PaCO2 has increased from 45 to 48 and PaO2 has increased from 45 to 60. What should the RT do next? - ANS ✓Continue the current O therapy A 45 y/o female is receiving oxygen therapy by a HHFNC set to an FiO2 of 90% at a flow of 50L/min, vital signs: HR 118 RR 28 BP 120/ SpO2 96% 7.42/38/93/25 +1 97% - ANS ✓Reduce the FiO2 to 80% A patient is receiving continuous mechanical ventilation, to monitor and ass lung compliance and airway resistance the following data is collected. 8am: Delivered VT= 600 Inspiratory flow= 60 PEEP= + Peak Airway Pressure= 30 Static Airway Pressure= 20
NBRC
10am: Delivered VT= 600 Inspiratory flow= 60 PEEP= + Peak Airway Pressure= 40 Static Airway Pressure= 30 What should the RT do next? - ANS ✓Request a CXR Which of the following serum sodium values is typical for a healthy adult?
- 141
- 131
- 121
- 111 - ANS ✓1. 141 A 72 y/o female in the ICU is receiving VC AC ventilation. She is agitated and has deteriorating vital signs. Her SpO2 is 79% What should the RT recommend first? - ANS ✓Perform needle decompression What is suggestive of dehydration?
- Pedal Edema
- Bradycardia
- Poor Skin Turgor
- Jugular Venous Distension - ANS ✓3. Poor Skin Turgor
