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NBRC TMC/CRT/RRT Version 3 Exam
Questions And Answers, 100% Guaranteed
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1. A 58-year-old male with COPD is brought to the ED with
worsening dyspnea. ABG on 2 L/min nasal cannula: pH 7.31,
PaCO₂ 68, PaO₂ 55, HCO₃⁻ 32. What is the primary acid-
base disorder?
A) Acute respiratory acidosis
B) Chronic respiratory acidosis
C) Acute on chronic respiratory acidosis
D) Metabolic alkalosis
Answer: C
Rationale: PaCO₂ >45 = respiratory acidosis. Elevated
HCO₃⁻ (32) indicates renal compensation. Expected HCO₃⁻ in
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chronic respiratory acidosis = 24 + 0.4×(ΔPaCO₂) = 24 +
0.4×23 ≈ 33. pH 7.31 (<7.35) shows acute component.
2. A 34-year-old asthmatic has peak flow 180 L/min
(predicted 450). After 3 albuterol nebulizers, peak flow is
210 L/min. What is the percent improvement?
A) 12%
B) 14%
C) 16.7%
D) 20%
Answer: C
Rationale: (210−180)/180 ×100 = 30/180×100 = 16.7%.
<12% indicates poor response; 16.7% is minimal but positive.
3. Which of the following is the BEST indicator of
hypoventilation in a spontaneously breathing patient?
A) PaO₂ 60 mmHg
B) PaCO₂ 55 mmHg
C) SaO₂ 88%
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D) pH 7.32
Answer: B
Rationale: PaCO₂ directly measures alveolar ventilation. >45
mmHg = hypoventilation regardless of O₂.
4. A patient post-cardiac arrest has ETCO₂ 22 mmHg on
capnography. What is the most likely interpretation?
A) Hyperventilation
B) Hypoventilation
C) Normal ventilation
D) Pulmonary embolism
Answer: A
Rationale: Normal ETCO₂ 35–45 mmHg. <35 =
hyperventilation or low cardiac output. Here, hyperventilation
is most likely.
5. A 72-year-old female with pneumonia has a P/F ratio of
180. This indicates:
A) Mild ARDS
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B) Moderate ARDS
C) Severe ARDS
D) No ARDS
Answer: B
Rationale: Berlin criteria: Mild 200–300, Moderate 100–200,
Severe <100. P/F 180 = moderate ARDS.
6. You auscultate bronchial breath sounds over the right lower
lobe. This suggests:
A) Normal lung
B) Consolidation
C) Pleural effusion
D) Pneumothorax
Answer: B
Rationale: Bronchial breath sounds normally heard over
trachea. Over peripheral lung = consolidation (transmitted
from central airways).
NBRC TMC/CRT/RRT Version 3 Exam
Questions And Answers, 100% Guaranteed
Success ||Complete A+ Guide
1. A 58-year-old male with COPD is brought to the ED with
worsening dyspnea. ABG on 2 L/min nasal cannula: pH 7.31,
PaCO₂ 68, PaO₂ 55, HCO₃⁻ 32. What is the primary acid-
base disorder?
A) Acute respiratory acidosis
B) Chronic respiratory acidosis
C) Acute on chronic respiratory acidosis
D) Metabolic alkalosis
Answer: C
Rationale: PaCO₂ >45 = respiratory acidosis. Elevated
HCO₃⁻ (32) indicates renal compensation. Expected HCO₃⁻ in
,Page 2 of 167
chronic respiratory acidosis = 24 + 0.4×(ΔPaCO₂) = 24 +
0.4×23 ≈ 33. pH 7.31 (<7.35) shows acute component.
2. A 34-year-old asthmatic has peak flow 180 L/min
(predicted 450). After 3 albuterol nebulizers, peak flow is
210 L/min. What is the percent improvement?
A) 12%
B) 14%
C) 16.7%
D) 20%
Answer: C
Rationale: (210−180)/180 ×100 = 30/180×100 = 16.7%.
<12% indicates poor response; 16.7% is minimal but positive.
3. Which of the following is the BEST indicator of
hypoventilation in a spontaneously breathing patient?
A) PaO₂ 60 mmHg
B) PaCO₂ 55 mmHg
C) SaO₂ 88%
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D) pH 7.32
Answer: B
Rationale: PaCO₂ directly measures alveolar ventilation. >45
mmHg = hypoventilation regardless of O₂.
4. A patient post-cardiac arrest has ETCO₂ 22 mmHg on
capnography. What is the most likely interpretation?
A) Hyperventilation
B) Hypoventilation
C) Normal ventilation
D) Pulmonary embolism
Answer: A
Rationale: Normal ETCO₂ 35–45 mmHg. <35 =
hyperventilation or low cardiac output. Here, hyperventilation
is most likely.
5. A 72-year-old female with pneumonia has a P/F ratio of
180. This indicates:
A) Mild ARDS
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B) Moderate ARDS
C) Severe ARDS
D) No ARDS
Answer: B
Rationale: Berlin criteria: Mild 200–300, Moderate 100–200,
Severe <100. P/F 180 = moderate ARDS.
6. You auscultate bronchial breath sounds over the right lower
lobe. This suggests:
A) Normal lung
B) Consolidation
C) Pleural effusion
D) Pneumothorax
Answer: B
Rationale: Bronchial breath sounds normally heard over
trachea. Over peripheral lung = consolidation (transmitted
from central airways).
