NBRC MOCK TMC EXAM 2026 EXAM SCRIPT
WITH VERIFIED SOLUTIONS
◉ Paradoxical pulse/pulsus paradoxus. Answer: Pulse/blood
pressure varies with respiration. EMERGENT
◉ Paradoxical pulse/pulsus paradoxus symptom of.... Answer: May
indicate severe air trapping (status asthmaticus, tension
pneumothorax, cardic tampanade)-felt on exhalation EMERGENT
◉ Tracheal deviation (pulled). Answer: Is PULLED to abnormal side
(toward pathology) in...
Atalectasis
Pneumonectomy
Diaphragmatic paralysis
◉ Tracheal deviation (pushed). Answer: Is PUSHED to normal side
(away from pathology) in...
Massive pleural effusion
Tension pneumothorax Mediastinal mass
Neck or thyroid tumors
,◉ Tactile fremitus definition. Answer: 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. Answer: Air under the skin, subcutaneous emphysema
◉ Normal air filled lung percussion sound. Answer: Resonant,
hollow sound
◉ Atelectactic lung percussion sound. Answer: Flat
Dull - pleural effusion or pneumonia can cause this
◉ Hyperinflated lung percussion sound. Answer: Tympanic, drum-
like sound
Hyperresonant, booming (emphysema, pneumothorax)
◉ Normal auscultation BS:. Answer: Vesicular - bilateral
◉ Normal bronchial sounds location:. Answer: Over trachea or
bronchi (rhonchi in the bronchi) = secretions
,*Heard over parenchyma = consolidation
◉ Egophony. Answer: Pt says EEEE but what's heard is AAAA
*Indicates consolidation, pneumonia
◉ Bronchophony, whispered pectoriloquy definition. Answer:
Increased intensity or transmission of the pt's voice = consolidation
& pneumonia
◉ Coarse crackles (rales). Answer: Large airway secretions
*SUCTION, COUGH
◉ Medium crackles/rales. Answer: Middle airway secretions
*BRONCHIAL HYGIENE
◉ Fine crackles (rales). Answer: Alveoli, fluid
*Associated with CHF/pulmonary edema
*OXYGEN, PPV, POS INOTROPIC AGENTS, DIURETICS
◉ Wheeze. Answer: High pitched whistle sound
*Caused by bronchospasm = *BRONCHODILATOR THERAPY FOR
DIFFUSE/BILATERAL
, *UNILATERAL = FOREIGN BODY OBSTRUCTION --> RIGID BRONCH
TO REMOVE
◉ Stridor. Answer: High pitched or crowing sound
*UPPER AIRWAY OBSTRUCTION
◉ Epiglottitis. Answer: Inflammation of the epiglottis *Supra (above)
glottic swelling (thumb sign)
◉ Croup (laryngotracheobronchitis). Answer: Sub (below) glottic
swelling
*steeple sign
*picket fence sign
*pencil point sign
*hourglass sign
◉ Stertor. Answer: Low-pitched snoring noise
*CAUSED BY SECRETIONS OR VIBRATING TISSUE THAT IS RELAXED
OR FLABBY
◉ Pleural friction rub. Answer: Coarse, grating, raspy, or crunching
sound
*Visceral & parietal pleura rubbing
WITH VERIFIED SOLUTIONS
◉ Paradoxical pulse/pulsus paradoxus. Answer: Pulse/blood
pressure varies with respiration. EMERGENT
◉ Paradoxical pulse/pulsus paradoxus symptom of.... Answer: May
indicate severe air trapping (status asthmaticus, tension
pneumothorax, cardic tampanade)-felt on exhalation EMERGENT
◉ Tracheal deviation (pulled). Answer: Is PULLED to abnormal side
(toward pathology) in...
Atalectasis
Pneumonectomy
Diaphragmatic paralysis
◉ Tracheal deviation (pushed). Answer: Is PUSHED to normal side
(away from pathology) in...
Massive pleural effusion
Tension pneumothorax Mediastinal mass
Neck or thyroid tumors
,◉ Tactile fremitus definition. Answer: 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. Answer: Air under the skin, subcutaneous emphysema
◉ Normal air filled lung percussion sound. Answer: Resonant,
hollow sound
◉ Atelectactic lung percussion sound. Answer: Flat
Dull - pleural effusion or pneumonia can cause this
◉ Hyperinflated lung percussion sound. Answer: Tympanic, drum-
like sound
Hyperresonant, booming (emphysema, pneumothorax)
◉ Normal auscultation BS:. Answer: Vesicular - bilateral
◉ Normal bronchial sounds location:. Answer: Over trachea or
bronchi (rhonchi in the bronchi) = secretions
,*Heard over parenchyma = consolidation
◉ Egophony. Answer: Pt says EEEE but what's heard is AAAA
*Indicates consolidation, pneumonia
◉ Bronchophony, whispered pectoriloquy definition. Answer:
Increased intensity or transmission of the pt's voice = consolidation
& pneumonia
◉ Coarse crackles (rales). Answer: Large airway secretions
*SUCTION, COUGH
◉ Medium crackles/rales. Answer: Middle airway secretions
*BRONCHIAL HYGIENE
◉ Fine crackles (rales). Answer: Alveoli, fluid
*Associated with CHF/pulmonary edema
*OXYGEN, PPV, POS INOTROPIC AGENTS, DIURETICS
◉ Wheeze. Answer: High pitched whistle sound
*Caused by bronchospasm = *BRONCHODILATOR THERAPY FOR
DIFFUSE/BILATERAL
, *UNILATERAL = FOREIGN BODY OBSTRUCTION --> RIGID BRONCH
TO REMOVE
◉ Stridor. Answer: High pitched or crowing sound
*UPPER AIRWAY OBSTRUCTION
◉ Epiglottitis. Answer: Inflammation of the epiglottis *Supra (above)
glottic swelling (thumb sign)
◉ Croup (laryngotracheobronchitis). Answer: Sub (below) glottic
swelling
*steeple sign
*picket fence sign
*pencil point sign
*hourglass sign
◉ Stertor. Answer: Low-pitched snoring noise
*CAUSED BY SECRETIONS OR VIBRATING TISSUE THAT IS RELAXED
OR FLABBY
◉ Pleural friction rub. Answer: Coarse, grating, raspy, or crunching
sound
*Visceral & parietal pleura rubbing
