NBRC TMC PRACTICE QUESTIONS WITH 430 COMPLETE
QUESTIONS AND VERIFIED AND DETAILED ANSWERS NEW
UPDATE LATEST 2026-2027
While receiving ventilatory support by a non-invasive ventilator, a patient vomits
into the full inflatable mask. Although not known, it is believed that the patient
may have aspirated. The following arterial blood gases are determined 20 minutes
after the event while receiving ventilatory support on IPAP 25 cm H2O, EPAP 5
cm H2O:
ABGs pH 7.38PaCO2 42 torrPaO2 81 torrHCO3- 24 mEq/LBE +1 mEq/L
The respiratory therapist should
A. switch to a nasal mask.
B. continue therapy, monitor the patient's temperature.
C. perform bronchoalveolar lavage (BAL)
D. institute invasive mechanical ventilation. - ANS... -D.
Because it is believed that the patient may have aspirated, airway protection going
forward is of paramount importance. Additionally, since the ABGs appear
acceptable with the previous level of ventilatory support, continued ventilatory
assistance is likely needed. Thus, invasive ventilation is the most appropriate
option.
A patient undergoing pulmonary function testing is having difficulty understating
verbal directions regarding performance of the maneuver. What should the
therapist do to help the patient understand?
A. ask the patient to repeat the instructions
B. demonstrate the maneuver
C. switch to written communication
D. draw an illustration - ANS... -B
A patient with a chest tube drainage system in place, with the chest tube inserted
into the 5th interspace, mid-axillary line, has had no significant accumulation of
drainage for 24 hrs. A chest radiograph shows vascular markings on the right. The
,physician is considering discontinuing and removing the drainage tube. Which of
the following should the respiratory therapist suggest?
A. Examine the system for a leak.
B. Clamp the chest tube proximal to the patient.
C. Massage the chest tube proximal to the patient.
D. Replace the chest tube. - ANS... -B.
The presence of vascular markings indicates that the lung tissue is expanded. Once
drainage appears to have virtually stopped, the next step is to clamp the chest tube
and monitor the patient for ventilatory difficulty. If no difficulty is observed, chest
tubes can probably be discontinued and removed.
What is the minimum flow rate that should be set on a volume-controlled ventilator
with the following settings?
Rate 14 VT 500 mLI:E 1:2FIO2 0.40PEEP 5 cm H2O
A. 25 L/min
B. 30 L/min
C. 50 L/min
D. 40 L/min - ANS... -A.
Minimum flow rate on a ventilator is determined by the following formula: (I+E) x
minute ventilation. In this case, (1 + 2) = 3. Minute ventilation = 500 mL x 14 = 7
L. Minimum flow = 3 x 7 L = 21 L. Of the options offered, 25 L/min is the lowest
flow rate that will exceed the inspiratory demand of the patient.
Which of the following is needed to calculate alveolar oxygen tension?
A. VD/VT, PAO2
B. BP and FiO2
C. PetCO2 and PaO2
D. QS/QT, deadspace - ANS... -B.
Barometric pressure, FiO2, and PaO2 are all included in the formula (BP stands for
barometric pressure)
L/min/m2 is the unit of measure for:
A. Systemic vascular resistance
B. Cardiac output
C. Cardiac index
D. Stroke volume - ANS... -C.
A spontaneously breathing patient has the following arterial blood gas results:
pH 7.38 PaCO2 42 mmHgPaO2 76 mmHgHCO3- 24 mEq/LBE 0 mEq/L
,Which of the following supplemental oxygen levels is most appropriate?
A. 2 L/min nasal cannula
B. 5 L/min nasal cannula
C. non-rebreathing mask
D. Venturi mask at 30% - ANS... -B.
A patient who is showing signs of hypoxemia should receive supplemental oxygen.
If the patient is not a COPD patient and the situation is not an emergency, then the
proper supplemental oxygen is an adult therapeutic dose, which is 40% to 55%. Of
the options available only 5 L/min nasal cannula will approach this. Other options
are either insufficient or too much.
Left heart failure would be manifested in which of the following values?
A. CVP and mPAP
B. mPAP and wedge pressure
C. MAP and SVR
D. cardiac output and wedge pressure - ANS... -D.
The function of the left heart, specifically the left ventricle, is best assessed
hemodynamically by looking at those values that precede and come after the left
heart. In this case pulmonary capillary wedge pressure and cardiac output (or
cardiac index) are the values found before and after the left heart.
Which of the following findings is most closely associated with increased airway
resistance?
A. reduced SpO2
B. accessory muscle use
C. altered P50
D. increased PetCO2 - ANS... -B.
Of the options given, use of accessory muscles is most closely associated with an
increase in airway resistance. This is especially true with patients who have asthma
or other types of upper airway inflammation or bronchoconstriction.
For a patient receiving volume-controlled mechanical ventilation, the lower
inflection point on a pressure-volume loop can best be described as:
A. amount of pressure required to keep the alveoli and small airways open
B. optimal PEEP
C. minimal PEEP
D. upper limit of residual volume - ANS... -A.
The lowest inflection point on a pressure-volume ventilator graphic is an indication
of the minimum pressure needed to keep alveoli open.
, The results of a V/Q scan shows poor perfusion with adequate ventilation. A chest
radiograph shows a wedge-shaped infiltrate over the right lung field. The patient
most likely has
A. fluid overload
B. ARDS
C. a pulmonary embolism
D. pneumonia - ANS... -C.
A VQ scan that shows poor perfusion but adequate ventilation is most closely
associated with a pulmonary embolism. Supportive data is found in the
radiological report of wedge-shaped infiltrates.
The respiratory therapist notes in the medical record of a 65-year-old male that the
patient is ordered to receive bronchodilator therapy with Albuterol. The therapist
also notes the patient is receiving beta-blocker medication. The therapist should
recommend
A. Administer Dexamethasone (Decadron) in place of Albuterol
B. Add Xopenex to the bronchodilator regimen
C. Replace Albuterol with Beclamethasone (Beclovent)
D. Switch from Albuterol to ipratropium bromide (Atrovent) - ANS... -D.
Because albuterol is a beta-agonist medication, patients who are taking beta-
blockers should utilize other bronchodilation medication.
A hospital has an extremely low incidence of ventilator-associated pneumonia. To
which of the following reasons may this be attributed?
A. periodic discontinuation of sedation
B. use of respiratory precautions with the population
C. diversion of infectious patients to other facilities
D. broad use of prophylactic antibiotics - ANS... -A.
The incidence of ventilator-associated pneumonia, or VAP, is lowered by using a
closed system suction catheter, periodically discontinuing sedation, keeping the
patient and semi-Fowler's position, and proper handwashing among caregivers. All
are correct.
A pressure-volume loop ventilator graphic shows no rise in pressure for the first
200 mL of delivered volume. The therapist should
A. increase inspiratory flow rate
B. increase PEEP
C. decrease tidal volume
D. decrease inspiratory flow rate - ANS... -B.
QUESTIONS AND VERIFIED AND DETAILED ANSWERS NEW
UPDATE LATEST 2026-2027
While receiving ventilatory support by a non-invasive ventilator, a patient vomits
into the full inflatable mask. Although not known, it is believed that the patient
may have aspirated. The following arterial blood gases are determined 20 minutes
after the event while receiving ventilatory support on IPAP 25 cm H2O, EPAP 5
cm H2O:
ABGs pH 7.38PaCO2 42 torrPaO2 81 torrHCO3- 24 mEq/LBE +1 mEq/L
The respiratory therapist should
A. switch to a nasal mask.
B. continue therapy, monitor the patient's temperature.
C. perform bronchoalveolar lavage (BAL)
D. institute invasive mechanical ventilation. - ANS... -D.
Because it is believed that the patient may have aspirated, airway protection going
forward is of paramount importance. Additionally, since the ABGs appear
acceptable with the previous level of ventilatory support, continued ventilatory
assistance is likely needed. Thus, invasive ventilation is the most appropriate
option.
A patient undergoing pulmonary function testing is having difficulty understating
verbal directions regarding performance of the maneuver. What should the
therapist do to help the patient understand?
A. ask the patient to repeat the instructions
B. demonstrate the maneuver
C. switch to written communication
D. draw an illustration - ANS... -B
A patient with a chest tube drainage system in place, with the chest tube inserted
into the 5th interspace, mid-axillary line, has had no significant accumulation of
drainage for 24 hrs. A chest radiograph shows vascular markings on the right. The
,physician is considering discontinuing and removing the drainage tube. Which of
the following should the respiratory therapist suggest?
A. Examine the system for a leak.
B. Clamp the chest tube proximal to the patient.
C. Massage the chest tube proximal to the patient.
D. Replace the chest tube. - ANS... -B.
The presence of vascular markings indicates that the lung tissue is expanded. Once
drainage appears to have virtually stopped, the next step is to clamp the chest tube
and monitor the patient for ventilatory difficulty. If no difficulty is observed, chest
tubes can probably be discontinued and removed.
What is the minimum flow rate that should be set on a volume-controlled ventilator
with the following settings?
Rate 14 VT 500 mLI:E 1:2FIO2 0.40PEEP 5 cm H2O
A. 25 L/min
B. 30 L/min
C. 50 L/min
D. 40 L/min - ANS... -A.
Minimum flow rate on a ventilator is determined by the following formula: (I+E) x
minute ventilation. In this case, (1 + 2) = 3. Minute ventilation = 500 mL x 14 = 7
L. Minimum flow = 3 x 7 L = 21 L. Of the options offered, 25 L/min is the lowest
flow rate that will exceed the inspiratory demand of the patient.
Which of the following is needed to calculate alveolar oxygen tension?
A. VD/VT, PAO2
B. BP and FiO2
C. PetCO2 and PaO2
D. QS/QT, deadspace - ANS... -B.
Barometric pressure, FiO2, and PaO2 are all included in the formula (BP stands for
barometric pressure)
L/min/m2 is the unit of measure for:
A. Systemic vascular resistance
B. Cardiac output
C. Cardiac index
D. Stroke volume - ANS... -C.
A spontaneously breathing patient has the following arterial blood gas results:
pH 7.38 PaCO2 42 mmHgPaO2 76 mmHgHCO3- 24 mEq/LBE 0 mEq/L
,Which of the following supplemental oxygen levels is most appropriate?
A. 2 L/min nasal cannula
B. 5 L/min nasal cannula
C. non-rebreathing mask
D. Venturi mask at 30% - ANS... -B.
A patient who is showing signs of hypoxemia should receive supplemental oxygen.
If the patient is not a COPD patient and the situation is not an emergency, then the
proper supplemental oxygen is an adult therapeutic dose, which is 40% to 55%. Of
the options available only 5 L/min nasal cannula will approach this. Other options
are either insufficient or too much.
Left heart failure would be manifested in which of the following values?
A. CVP and mPAP
B. mPAP and wedge pressure
C. MAP and SVR
D. cardiac output and wedge pressure - ANS... -D.
The function of the left heart, specifically the left ventricle, is best assessed
hemodynamically by looking at those values that precede and come after the left
heart. In this case pulmonary capillary wedge pressure and cardiac output (or
cardiac index) are the values found before and after the left heart.
Which of the following findings is most closely associated with increased airway
resistance?
A. reduced SpO2
B. accessory muscle use
C. altered P50
D. increased PetCO2 - ANS... -B.
Of the options given, use of accessory muscles is most closely associated with an
increase in airway resistance. This is especially true with patients who have asthma
or other types of upper airway inflammation or bronchoconstriction.
For a patient receiving volume-controlled mechanical ventilation, the lower
inflection point on a pressure-volume loop can best be described as:
A. amount of pressure required to keep the alveoli and small airways open
B. optimal PEEP
C. minimal PEEP
D. upper limit of residual volume - ANS... -A.
The lowest inflection point on a pressure-volume ventilator graphic is an indication
of the minimum pressure needed to keep alveoli open.
, The results of a V/Q scan shows poor perfusion with adequate ventilation. A chest
radiograph shows a wedge-shaped infiltrate over the right lung field. The patient
most likely has
A. fluid overload
B. ARDS
C. a pulmonary embolism
D. pneumonia - ANS... -C.
A VQ scan that shows poor perfusion but adequate ventilation is most closely
associated with a pulmonary embolism. Supportive data is found in the
radiological report of wedge-shaped infiltrates.
The respiratory therapist notes in the medical record of a 65-year-old male that the
patient is ordered to receive bronchodilator therapy with Albuterol. The therapist
also notes the patient is receiving beta-blocker medication. The therapist should
recommend
A. Administer Dexamethasone (Decadron) in place of Albuterol
B. Add Xopenex to the bronchodilator regimen
C. Replace Albuterol with Beclamethasone (Beclovent)
D. Switch from Albuterol to ipratropium bromide (Atrovent) - ANS... -D.
Because albuterol is a beta-agonist medication, patients who are taking beta-
blockers should utilize other bronchodilation medication.
A hospital has an extremely low incidence of ventilator-associated pneumonia. To
which of the following reasons may this be attributed?
A. periodic discontinuation of sedation
B. use of respiratory precautions with the population
C. diversion of infectious patients to other facilities
D. broad use of prophylactic antibiotics - ANS... -A.
The incidence of ventilator-associated pneumonia, or VAP, is lowered by using a
closed system suction catheter, periodically discontinuing sedation, keeping the
patient and semi-Fowler's position, and proper handwashing among caregivers. All
are correct.
A pressure-volume loop ventilator graphic shows no rise in pressure for the first
200 mL of delivered volume. The therapist should
A. increase inspiratory flow rate
B. increase PEEP
C. decrease tidal volume
D. decrease inspiratory flow rate - ANS... -B.
