NBRC TMC Practice QUESTIONS, ANSWERS and
Rationale COMPREHENSIVE VERSION WITHTHE
MOST RECENT AND VERIFIED ANSWERS
GUARANTEED PASS
An infant with pneumonia is placed on CPAP with the initial level is 6 cm H20. After the patient
is placed on the system, the respiratory therapist notices that the pressure falls to 2 cm H20
with each inspiration. What should be done to correct the problem?
a. Tell the patient to relax and breath more slowly
b. Give the patient diazepam (Valium)
c. Increase the CPAP level to 8 cm H20
d. Increase the flow through the system
Increase the flow through the system
RATIONALS: Decreasing pressure with inspiration indicates inadequate gas flow. Increasing the
flow should meet the patient's inspiratory flow needs and stabilize the CPAP pressure.
A respiratory therapist is called to the ED for a 1-year-old with difficulty breathing. Severe
suprasternal, subcostal and substernal retraction are observed. The child has a harsh, barking
cough. Stridor is present. The therapist should anticipate treatment for
Choose only ONE best answer.
,a. Cystic Fibrosis
b. Pneumonia
c. Croup
d. Asthma
Croup
RATIONALS: The patient has some degree of upper airway obstruction caused by some viral
illness. The barky cough is a classic finding for patients experiencing croup.
The polysomnography sleep laboratory is full scheduled for several weeks. The physician wants
to know if there is another option to determine if a patient has sleep apnea. What should be
recommended?
a. Overnight pulse oximetry
b. Nasal air flow monitoring
c. Holter monitoring for 48 hours
d. Chest-wall and abdominal-wall impedance comparison
Overnight pulse oximetry
RATIONALS: Overnight pulse oximetry can be used to screen patients with suspected
obstructive sleep apnea. The patient's oxygen saturation is found to decrease during apnea
episodes.
,A respiratory therapist is assessing a 168-cm (5-ft 6-in), 73-kg (161-lb), a 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
Sp02 86%
A respiratory therapist should do first.
a. Initiate oxygen at 4L/min by cannula
b. Record the results in the medical record
c. Obtain an arterial blood gas sample
d. Validate the Sp02 reading at a different site
Validate the Sp02 reading at a different site
RATIONALS: The saturation may not be accurate and should be measured at a different site.
A 47-year-old male with a BMI of 50 kg/m is undergoing a sleep study with titration of CPAP. The
patient's baseline AHI is 59. At a CPAP level of 7 cm H20, the AHI is 9. A respiratory therapist
should recommend
a. Maintain the current level of CPAP
b. Decreasing the CPAP
c. Increasing the CPAP
, d. Changing to bilevel PAP
Increasing the CPAP
RATIONALS: The goal of CPAP intervention is to completely eliminate apnea and hypopnea
episodes, standard protocol is to incrementally increase the CPAP level until this occurs.
An arterial puncture has been performed to obtain blood for analysis of 02, C02, and pH. What
is the best way to manage the blood sample?
a. Warm the sample to keep it at body temperature
b. Place it into a mix of ice and water
c. Let the blood naturally cool to room temperature
d. Shake the sample to hemolyze the blood
Place it into a mix of ice and water
RATIONALS: Placing the blood sample into ice water will prevent the blood from consuming the
O2 within the sample.
A 26-year-old patient who weighs 80 kg (171 lb) received injuries in a motor vehicle crash. The
patient was intubated with a 6.0-mm ID endotracheal tube and is receiving volume-controlled
ventilation. Twenty-four hours later, the patient has clear breath sounds but cannot tolerate
weaning the mandatory rate below 8 in the SIMV mode with 15 cm H20 pressure support. The
respiratory therapist should recommend.
a. Increasing the peak inspiratory flow
b. Raising the VT
Rationale COMPREHENSIVE VERSION WITHTHE
MOST RECENT AND VERIFIED ANSWERS
GUARANTEED PASS
An infant with pneumonia is placed on CPAP with the initial level is 6 cm H20. After the patient
is placed on the system, the respiratory therapist notices that the pressure falls to 2 cm H20
with each inspiration. What should be done to correct the problem?
a. Tell the patient to relax and breath more slowly
b. Give the patient diazepam (Valium)
c. Increase the CPAP level to 8 cm H20
d. Increase the flow through the system
Increase the flow through the system
RATIONALS: Decreasing pressure with inspiration indicates inadequate gas flow. Increasing the
flow should meet the patient's inspiratory flow needs and stabilize the CPAP pressure.
A respiratory therapist is called to the ED for a 1-year-old with difficulty breathing. Severe
suprasternal, subcostal and substernal retraction are observed. The child has a harsh, barking
cough. Stridor is present. The therapist should anticipate treatment for
Choose only ONE best answer.
,a. Cystic Fibrosis
b. Pneumonia
c. Croup
d. Asthma
Croup
RATIONALS: The patient has some degree of upper airway obstruction caused by some viral
illness. The barky cough is a classic finding for patients experiencing croup.
The polysomnography sleep laboratory is full scheduled for several weeks. The physician wants
to know if there is another option to determine if a patient has sleep apnea. What should be
recommended?
a. Overnight pulse oximetry
b. Nasal air flow monitoring
c. Holter monitoring for 48 hours
d. Chest-wall and abdominal-wall impedance comparison
Overnight pulse oximetry
RATIONALS: Overnight pulse oximetry can be used to screen patients with suspected
obstructive sleep apnea. The patient's oxygen saturation is found to decrease during apnea
episodes.
,A respiratory therapist is assessing a 168-cm (5-ft 6-in), 73-kg (161-lb), a 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
Sp02 86%
A respiratory therapist should do first.
a. Initiate oxygen at 4L/min by cannula
b. Record the results in the medical record
c. Obtain an arterial blood gas sample
d. Validate the Sp02 reading at a different site
Validate the Sp02 reading at a different site
RATIONALS: The saturation may not be accurate and should be measured at a different site.
A 47-year-old male with a BMI of 50 kg/m is undergoing a sleep study with titration of CPAP. The
patient's baseline AHI is 59. At a CPAP level of 7 cm H20, the AHI is 9. A respiratory therapist
should recommend
a. Maintain the current level of CPAP
b. Decreasing the CPAP
c. Increasing the CPAP
, d. Changing to bilevel PAP
Increasing the CPAP
RATIONALS: The goal of CPAP intervention is to completely eliminate apnea and hypopnea
episodes, standard protocol is to incrementally increase the CPAP level until this occurs.
An arterial puncture has been performed to obtain blood for analysis of 02, C02, and pH. What
is the best way to manage the blood sample?
a. Warm the sample to keep it at body temperature
b. Place it into a mix of ice and water
c. Let the blood naturally cool to room temperature
d. Shake the sample to hemolyze the blood
Place it into a mix of ice and water
RATIONALS: Placing the blood sample into ice water will prevent the blood from consuming the
O2 within the sample.
A 26-year-old patient who weighs 80 kg (171 lb) received injuries in a motor vehicle crash. The
patient was intubated with a 6.0-mm ID endotracheal tube and is receiving volume-controlled
ventilation. Twenty-four hours later, the patient has clear breath sounds but cannot tolerate
weaning the mandatory rate below 8 in the SIMV mode with 15 cm H20 pressure support. The
respiratory therapist should recommend.
a. Increasing the peak inspiratory flow
b. Raising the VT
