NBRC PRACTICE TMC UPDATE|EXAM
QUESTIONS WITH MULTIPLE
CHOICES |VERIFIED & REVISED
ANSWERS (NEW)!!!
Ampatientmshowsmamrightmsidedmpleuralmeffusion.mWhichmofmthemfollowingmshouldmthemrespirat
orymtherapistmrecommend?
sputummculturemandmgrammstain
diagnosticmbronchoscopy
pleurodesis
thoracentesism-mCORRECTmANSWERmD.mThoracentesis
Thoracentesism-
mammedicalmproceduremthatminvolvesminsertingmamneedlemormcathetermintomthemchestmwallmtomr
emovemfluidmormairmfrommthempleuralmspace,mthemspacembetweenmthemlungsmandmchestmwall.
AmptmwithmexacerbationmofmCOPDmismreceivingmNPPVminmspontaneousmmodemwithmamnasalmma
sk.mThemfollowingmdatamaremavailable:m
FiO2m:m0.24mRRm:m28/minmIPAPm:m12mcmH2OmEPAP:m6mcmH2Om
Onemhourmlater,mthemfollowingmdatamaremavailable:m
pHm:m7.27mPaCO2m:m76mmmHgmPaO2m:m62mmmHgmHCO3-
m:m35mmEq/LmBEm:m+5mmEq/LmSaO2(calc)m:m90%m
Theminspiratorymphasemismprolongedmandmdyssynchronymismnoted.mWhichmofmthemfollowingmsh
ouldmamRTmdomFIRST?
IncreasemthemFiO2mtom0.28m
IncreasemtomEPAPm8mcmH2Om
, Changemtomamfull-facemmaskm
Changemthemventilatormcircuitm-mCORRECTmANSWERmC.mChangemtomamfull-facemmask
Amptmwhomism6'2"mtallmandmweighsm98kgmismreceivingmVCmventilationmwithmVtm600mL.mAmRTmobs
ervesmthemlowmexhaledmvolumemandmlowmpressuremalarmsmactivatingmwithmeachmbreath.mThemf
ollowingmdatamaremavailable:mVte:m340-
390mL;mETTmsize:m8.5mm;mETTmcuffmpressure:m19cmH2O;mETTmposition:m18cm@incisor;mHRm9
8;mRRm32;mSpO2m83%
WhichmofmthemfollowingmshouldmthemRTmdo?
advancemthemETTm@22cm
adjustmthemcuffmpressuremtom30cmH2O
increasemthemVtmtom700mL
reintubatemwithmamlargermETTm-mCORRECTmANSWERmA.madvancemthemETTm@22cm
AdvancemETTmbeforemadjustingmcuffmpressure
AmRTmismassistingmamphysicianmwithminsertionmofmamchestmtubeminmamptmwithmampleuralmeffusion.
mAftermthemtubemismplacemandmthemchestmdrainagemsystemmismfunctioningmproperly,mwhichmofmt
hemfollowingmshouldmbemobservedminmthemwater-sealmchamber?
Continuousmbubblingm
Watermlevelmfunctioningmwithmbreathingm
Themwatermbecomingmcloudym
Nomvisiblemliquidm-mCORRECTmANSWERmB.mWatermlevelmfunctioningmwithmbreathing
Ammini-bronchoalveolarmlavagemproceduremismrecommendedmformdiagnosis?
, ventilatormassociatedmpneumonia
pleuralmeffusion
pulmonarymembolism
idiopathicmpulmonarymfibrosism-
mCORRECTmANSWERmA.mventilatormassociatedmpneumoniam(VAP)
Am44yomptmwhomunderwentmabdominalmsurgerymismreceivingmvibratorymPEPmtherapy.mAfterm24
hrmofmq4hmtherapy,mthempatientmcanmambulatemindependentlymwhilembreathingmair.mAmrespirat
orymtherapistmshouldmrecommend?
discontinuingmtherapy
obtainingmanmABGmanalysis
performingmam6MWT
changingmfrequencymofmtherapymtomq8hm-
mCORRECTmANSWERmA.mdiscontinuingmtherapy
AmRTmismreviewingmamchartmofmam60yommalemwhomism5'10"mtall,mweighsm73kgmandmhasmmoderat
emdyspnea.mThemCXRmreportsmindicatesmthemptmhasmflattenedmdiaphragm,mseveremhyperinflati
on,mandmsmallmcardiothoracicmratio.mThemPFTmresultsmaremasmfollows:mFVCm2.45L;mFEV1/FVC%m
48%;mFEF25-
75%m1.25L/sec;mFRCmbymHeliummdilution:m3.75L;mRV/TLC%m45%;mDLCOm12mL/min/mmHg
WhichmofmthemfollowingmshouldmthemRTmreviewmtomfurthermevaluatemthemextentmofmairmtrappin
g?
flow-volumemloop
postmbronchodilatormtherapy
nitrogenmwashout
bodymplethysmographym-mCORRECTmANSWERmA.mflow-volumemloop
, Whichmofmthemfollowingmdevicesmbestmmeasuresmthemaccuracymofmanmair/O2mblender?
capnometer
pressuremmanometer
O2mflowmeter
polargraphicmanalyzerm-mCORRECTmANSWERmD.mpolargraphicmanalyzer
Beforeminitiatingmtracheostomymtubemchange,mthemrespiratorymtherapistmshould
checkmthemnewmtracheostomymtubemcuff
recommendmsedatingmthempt
administermintratrachealmlidocainemHCl
obtainmamlargermtracheostomymtube.m-
mCORRECTmANSWERmA.mcheckmthemnewmtracheostomymtubemcuff
Am38yommalemismbeingmconsideredmformpossiblemextubationmaftermreceivingmtreatmentmformanm
asthmamexacerbationmovermthemlastm36hrs.mBreathmsoundsmaremclear,mandmnomcurrentmdistress
mismnoted.mWhilemreceivingmanmFiO2mofm0.40,mPSmofm15cmH2O,mandm8cmH2OmPEEP,mphysiologi
cmdatamare:mHRm88;mRRm20;mSpO2m97%.mAnmSBTmisminitiatedmbymT-
piecemwithmanmFiO2mofm0.40.mFifteenmminutesmintomthemtrial,mphysiologicmdatamare:mHRm119;mR
Rm25;mSpO2m93%.mAmRTmshouldmconcludemthe:
patientmismreadymformextubation
patientmhasmfailedmthemSBT
patient'smtrialmshouldmbemcontinued
patientmrequiresmVC,mACmventilationm-
mCORRECTmANSWERmB.mpatientmhasmfailedmthemSBT
QUESTIONS WITH MULTIPLE
CHOICES |VERIFIED & REVISED
ANSWERS (NEW)!!!
Ampatientmshowsmamrightmsidedmpleuralmeffusion.mWhichmofmthemfollowingmshouldmthemrespirat
orymtherapistmrecommend?
sputummculturemandmgrammstain
diagnosticmbronchoscopy
pleurodesis
thoracentesism-mCORRECTmANSWERmD.mThoracentesis
Thoracentesism-
mammedicalmproceduremthatminvolvesminsertingmamneedlemormcathetermintomthemchestmwallmtomr
emovemfluidmormairmfrommthempleuralmspace,mthemspacembetweenmthemlungsmandmchestmwall.
AmptmwithmexacerbationmofmCOPDmismreceivingmNPPVminmspontaneousmmodemwithmamnasalmma
sk.mThemfollowingmdatamaremavailable:m
FiO2m:m0.24mRRm:m28/minmIPAPm:m12mcmH2OmEPAP:m6mcmH2Om
Onemhourmlater,mthemfollowingmdatamaremavailable:m
pHm:m7.27mPaCO2m:m76mmmHgmPaO2m:m62mmmHgmHCO3-
m:m35mmEq/LmBEm:m+5mmEq/LmSaO2(calc)m:m90%m
Theminspiratorymphasemismprolongedmandmdyssynchronymismnoted.mWhichmofmthemfollowingmsh
ouldmamRTmdomFIRST?
IncreasemthemFiO2mtom0.28m
IncreasemtomEPAPm8mcmH2Om
, Changemtomamfull-facemmaskm
Changemthemventilatormcircuitm-mCORRECTmANSWERmC.mChangemtomamfull-facemmask
Amptmwhomism6'2"mtallmandmweighsm98kgmismreceivingmVCmventilationmwithmVtm600mL.mAmRTmobs
ervesmthemlowmexhaledmvolumemandmlowmpressuremalarmsmactivatingmwithmeachmbreath.mThemf
ollowingmdatamaremavailable:mVte:m340-
390mL;mETTmsize:m8.5mm;mETTmcuffmpressure:m19cmH2O;mETTmposition:m18cm@incisor;mHRm9
8;mRRm32;mSpO2m83%
WhichmofmthemfollowingmshouldmthemRTmdo?
advancemthemETTm@22cm
adjustmthemcuffmpressuremtom30cmH2O
increasemthemVtmtom700mL
reintubatemwithmamlargermETTm-mCORRECTmANSWERmA.madvancemthemETTm@22cm
AdvancemETTmbeforemadjustingmcuffmpressure
AmRTmismassistingmamphysicianmwithminsertionmofmamchestmtubeminmamptmwithmampleuralmeffusion.
mAftermthemtubemismplacemandmthemchestmdrainagemsystemmismfunctioningmproperly,mwhichmofmt
hemfollowingmshouldmbemobservedminmthemwater-sealmchamber?
Continuousmbubblingm
Watermlevelmfunctioningmwithmbreathingm
Themwatermbecomingmcloudym
Nomvisiblemliquidm-mCORRECTmANSWERmB.mWatermlevelmfunctioningmwithmbreathing
Ammini-bronchoalveolarmlavagemproceduremismrecommendedmformdiagnosis?
, ventilatormassociatedmpneumonia
pleuralmeffusion
pulmonarymembolism
idiopathicmpulmonarymfibrosism-
mCORRECTmANSWERmA.mventilatormassociatedmpneumoniam(VAP)
Am44yomptmwhomunderwentmabdominalmsurgerymismreceivingmvibratorymPEPmtherapy.mAfterm24
hrmofmq4hmtherapy,mthempatientmcanmambulatemindependentlymwhilembreathingmair.mAmrespirat
orymtherapistmshouldmrecommend?
discontinuingmtherapy
obtainingmanmABGmanalysis
performingmam6MWT
changingmfrequencymofmtherapymtomq8hm-
mCORRECTmANSWERmA.mdiscontinuingmtherapy
AmRTmismreviewingmamchartmofmam60yommalemwhomism5'10"mtall,mweighsm73kgmandmhasmmoderat
emdyspnea.mThemCXRmreportsmindicatesmthemptmhasmflattenedmdiaphragm,mseveremhyperinflati
on,mandmsmallmcardiothoracicmratio.mThemPFTmresultsmaremasmfollows:mFVCm2.45L;mFEV1/FVC%m
48%;mFEF25-
75%m1.25L/sec;mFRCmbymHeliummdilution:m3.75L;mRV/TLC%m45%;mDLCOm12mL/min/mmHg
WhichmofmthemfollowingmshouldmthemRTmreviewmtomfurthermevaluatemthemextentmofmairmtrappin
g?
flow-volumemloop
postmbronchodilatormtherapy
nitrogenmwashout
bodymplethysmographym-mCORRECTmANSWERmA.mflow-volumemloop
, Whichmofmthemfollowingmdevicesmbestmmeasuresmthemaccuracymofmanmair/O2mblender?
capnometer
pressuremmanometer
O2mflowmeter
polargraphicmanalyzerm-mCORRECTmANSWERmD.mpolargraphicmanalyzer
Beforeminitiatingmtracheostomymtubemchange,mthemrespiratorymtherapistmshould
checkmthemnewmtracheostomymtubemcuff
recommendmsedatingmthempt
administermintratrachealmlidocainemHCl
obtainmamlargermtracheostomymtube.m-
mCORRECTmANSWERmA.mcheckmthemnewmtracheostomymtubemcuff
Am38yommalemismbeingmconsideredmformpossiblemextubationmaftermreceivingmtreatmentmformanm
asthmamexacerbationmovermthemlastm36hrs.mBreathmsoundsmaremclear,mandmnomcurrentmdistress
mismnoted.mWhilemreceivingmanmFiO2mofm0.40,mPSmofm15cmH2O,mandm8cmH2OmPEEP,mphysiologi
cmdatamare:mHRm88;mRRm20;mSpO2m97%.mAnmSBTmisminitiatedmbymT-
piecemwithmanmFiO2mofm0.40.mFifteenmminutesmintomthemtrial,mphysiologicmdatamare:mHRm119;mR
Rm25;mSpO2m93%.mAmRTmshouldmconcludemthe:
patientmismreadymformextubation
patientmhasmfailedmthemSBT
patient'smtrialmshouldmbemcontinued
patientmrequiresmVC,mACmventilationm-
mCORRECTmANSWERmB.mpatientmhasmfailedmthemSBT
