NBRC TMC Practice Exam Prep
NBRC TMC PRACTICE EXAM PREP NEWEST 2026/2027 ACTUAL
EXAM COMPLETE 250 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) WITH DETAILED RATIONALES
|ALREADY GRADED A+|BRAND NEW VERSION!!
A 22-year-old woman with asthma was transported to the hospital after being
found unconscious from a heroin overdose. She was nasally intubated and is
receiving mechanical ventilation. Naloxone (Narcan) was administered. Twenty-
four hours later, the patient is awake, alert, and agitated. She is motioning that
she wants the endotracheal tube removed. Which of the following should a
respiratory therapist recommend?
a. Gradually reduce the level of ventilatory support
b. Extubate the patient
c. Sedate the patient
d. Change to noninvasive mechanical ventilation
Extubate the patient
Explain:
A. A patient who is intubated for acute ventilatory failure due to drug overdose
does not need gradual withdrawal from mechanical ventilation.
B. Once the need for mechanical ventilation is resolved, ventilator use can be
discontinued in a patient with a narcotic drug overdose.
C. Sedation is contraindicated.
D. While noninvasive mechanical ventilation may not harm the patient, it is not
indicated in this case.
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, NBRC TMC Practice Exam Prep
A 3 year old is receiving VC ventilation. A respiratory therapist is preparing to
administer aerosolized dornase alfa (Pulmozyme) in-line with the ventilator.
Which of the following devices should the therapist select to administer the
therapy?
a. DPI
b. MDI
c. Ultrasonic nebulizer
d. Vibrating mesh nebulizer
Vibrating mesh nebulizer
Explain:
A. Dornase alfa (Pulmozyme) is not available in DPI form.
B. Dornase alfa (Pulmozyme) is not available in MDI form.
C. An ultrasonic nebulizer may alter the configuration of the medication.
D. A vibrating mesh nebulizer will not alter the configuration of the medication
and will not increase volume delivery to the patient.
While administering an IPV treatment at 20 cm H2O to a patient with cystic
fibrosis, a respiratory therapist notes the patient has suddenly become very short
of breath and cyanotic. The therapist's most appropriate action is to
a. Suction the patient
b. Terminate the treatment
c. Decrease the peak pressure to 10 cm H2O
d. Stop the treatment for 10 to 20 minutes
Terminate the treatment
Explain:
A. There is neither evidence of increased secretions, nor the patient's inability to
2|Page
, NBRC TMC Practice Exam Prep
cough effectively. Therefore, suctioning this patient is not indicated.
B. The treatment should be discontinued because the patient is demonstrating
severe respiratory distress of unknown etiology. Determining the cause of the
distress is of the utmost importance.
C. Decreasing the peak pressure will not identify the cause of the distress.
Continuing the treatment, even at a lower pressure, may worsen the patient's
condition.
D. Temporarily stopping the treatment will not determine the cause of the
respiratory distress.
After recovering from an accidental drug overdose, the physician believes an alert
28-year-old patient can be weaned from mechanical ventilation. Which method
should the respiratory therapist recommend be tried FIRST?
a. T-piece adapter with reservoir
b. Pressure support
c. CPAP on a free-standing system
d. SIMV
T-piece adapter with reservoir
Explain:
A. The T-piece (Briggs) adapter with reservoir is often used in a spontaneous
breathing trial (SBT) to wean patients requiring mechanical ventilation for only a
short time. If the patient fails the SBT, another weaning method, such as pressure
support, CPAP, SIMV, or automatic tube compensation, should be considered.
B. Most short-term, recovered ventilator patients can be successfully weaned on a
T-piece in a spontaneous breathing trial (SBT). Pressure support may be needed if
the patient fails the SBT and has significantly increased airway resistance from the
endotracheal tube.
C. Most short-term, recovered ventilator patients can be successfully weaned on a
T-piece in a spontaneous breathing trial (SBT). CPAP may be needed if the patient
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, NBRC TMC Practice Exam Prep
fails the SBT and has a decreased functional residual capacity.
D. Most short-term, recovered ventilator patients can be successfully weaned on a
T-piece in a spontaneous breathing trial (SBT). SIMV provides partial ventilatory
support and may be needed to wean a patient who has required mechanical
ventilation for a prolonged time.
A respiratory therapist examines a patient and notes coarse crackles over both
lung fields. Which of the following does this most likely indicate?
a. Subcutaneous emphysema
b. Pleurisy
c. Bronchospasm
d. Secretions
Secretions
Explain:
A. Subcutaneous emphysema is demonstrated by the presence of crepitus during
chest wall palpation.
B. Pleurisy is a symptom of pain while breathing, typically associated with
inspiration. There are often no physical findings for pleurisy.
C. Bronchospasm is noted as a wheezing sound from narrowed airways.
D. Secretions in the airway produce low-pitched, discontinuous lung sounds
described as coarse crackles upon auscultation.
A patient has received postural drainage, chest percussion, and bronchodilator
therapy for 48 hours. Sputum production has decreased, but the patient is now
coughing up blood-tinged secretions. Breath sounds are decreased and crackles
are present in the left lower lobe. Which of the following diagnostic studies should
a respiratory therapist recommend?
a. Coagulation studies
4|Page
NBRC TMC PRACTICE EXAM PREP NEWEST 2026/2027 ACTUAL
EXAM COMPLETE 250 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) WITH DETAILED RATIONALES
|ALREADY GRADED A+|BRAND NEW VERSION!!
A 22-year-old woman with asthma was transported to the hospital after being
found unconscious from a heroin overdose. She was nasally intubated and is
receiving mechanical ventilation. Naloxone (Narcan) was administered. Twenty-
four hours later, the patient is awake, alert, and agitated. She is motioning that
she wants the endotracheal tube removed. Which of the following should a
respiratory therapist recommend?
a. Gradually reduce the level of ventilatory support
b. Extubate the patient
c. Sedate the patient
d. Change to noninvasive mechanical ventilation
Extubate the patient
Explain:
A. A patient who is intubated for acute ventilatory failure due to drug overdose
does not need gradual withdrawal from mechanical ventilation.
B. Once the need for mechanical ventilation is resolved, ventilator use can be
discontinued in a patient with a narcotic drug overdose.
C. Sedation is contraindicated.
D. While noninvasive mechanical ventilation may not harm the patient, it is not
indicated in this case.
1|Page
, NBRC TMC Practice Exam Prep
A 3 year old is receiving VC ventilation. A respiratory therapist is preparing to
administer aerosolized dornase alfa (Pulmozyme) in-line with the ventilator.
Which of the following devices should the therapist select to administer the
therapy?
a. DPI
b. MDI
c. Ultrasonic nebulizer
d. Vibrating mesh nebulizer
Vibrating mesh nebulizer
Explain:
A. Dornase alfa (Pulmozyme) is not available in DPI form.
B. Dornase alfa (Pulmozyme) is not available in MDI form.
C. An ultrasonic nebulizer may alter the configuration of the medication.
D. A vibrating mesh nebulizer will not alter the configuration of the medication
and will not increase volume delivery to the patient.
While administering an IPV treatment at 20 cm H2O to a patient with cystic
fibrosis, a respiratory therapist notes the patient has suddenly become very short
of breath and cyanotic. The therapist's most appropriate action is to
a. Suction the patient
b. Terminate the treatment
c. Decrease the peak pressure to 10 cm H2O
d. Stop the treatment for 10 to 20 minutes
Terminate the treatment
Explain:
A. There is neither evidence of increased secretions, nor the patient's inability to
2|Page
, NBRC TMC Practice Exam Prep
cough effectively. Therefore, suctioning this patient is not indicated.
B. The treatment should be discontinued because the patient is demonstrating
severe respiratory distress of unknown etiology. Determining the cause of the
distress is of the utmost importance.
C. Decreasing the peak pressure will not identify the cause of the distress.
Continuing the treatment, even at a lower pressure, may worsen the patient's
condition.
D. Temporarily stopping the treatment will not determine the cause of the
respiratory distress.
After recovering from an accidental drug overdose, the physician believes an alert
28-year-old patient can be weaned from mechanical ventilation. Which method
should the respiratory therapist recommend be tried FIRST?
a. T-piece adapter with reservoir
b. Pressure support
c. CPAP on a free-standing system
d. SIMV
T-piece adapter with reservoir
Explain:
A. The T-piece (Briggs) adapter with reservoir is often used in a spontaneous
breathing trial (SBT) to wean patients requiring mechanical ventilation for only a
short time. If the patient fails the SBT, another weaning method, such as pressure
support, CPAP, SIMV, or automatic tube compensation, should be considered.
B. Most short-term, recovered ventilator patients can be successfully weaned on a
T-piece in a spontaneous breathing trial (SBT). Pressure support may be needed if
the patient fails the SBT and has significantly increased airway resistance from the
endotracheal tube.
C. Most short-term, recovered ventilator patients can be successfully weaned on a
T-piece in a spontaneous breathing trial (SBT). CPAP may be needed if the patient
3|Page
, NBRC TMC Practice Exam Prep
fails the SBT and has a decreased functional residual capacity.
D. Most short-term, recovered ventilator patients can be successfully weaned on a
T-piece in a spontaneous breathing trial (SBT). SIMV provides partial ventilatory
support and may be needed to wean a patient who has required mechanical
ventilation for a prolonged time.
A respiratory therapist examines a patient and notes coarse crackles over both
lung fields. Which of the following does this most likely indicate?
a. Subcutaneous emphysema
b. Pleurisy
c. Bronchospasm
d. Secretions
Secretions
Explain:
A. Subcutaneous emphysema is demonstrated by the presence of crepitus during
chest wall palpation.
B. Pleurisy is a symptom of pain while breathing, typically associated with
inspiration. There are often no physical findings for pleurisy.
C. Bronchospasm is noted as a wheezing sound from narrowed airways.
D. Secretions in the airway produce low-pitched, discontinuous lung sounds
described as coarse crackles upon auscultation.
A patient has received postural drainage, chest percussion, and bronchodilator
therapy for 48 hours. Sputum production has decreased, but the patient is now
coughing up blood-tinged secretions. Breath sounds are decreased and crackles
are present in the left lower lobe. Which of the following diagnostic studies should
a respiratory therapist recommend?
a. Coagulation studies
4|Page
