NBRC Study Guide (National Board of
Respiratory Care) Questions and
Answers with Verified Solutions
The four steps for respiratory mgmt ✔✔1. tx *ventilation *first (should problem exist)
2. *oxygenation*
3. *circulation*
4. *perfusion*
problems at one step will adversely affect each process that follows it within sequence
External respiration
vs.
Internal respiration ✔✔External = exchange of O2 and CO2 across AC membrane
- depends on diffusion capacity of AC membrane & ventilation
Internal = exchange of O2 & CO2 across blood and tissue cells
- depends on circulation
,Signs
vs.
Symptoms ✔✔*Signs = Objective information*; can be seen, measured, heard, or felt
- Color, pulse, edema
*Symptoms = Subjective information*
- Dyspnea, pain, nausea
Steps in Assessment: ✔✔1. *Visual examination*
- General appearance, sensorum, chest movement, posture, skin color
2. *Bedside exam*
- BS, VS, auscultate, percussion, PMH, cap refill
3. *Lab exam *
- ABG, CBC, CXR, lytes
4. *Specials*
- urinalysis, gram stain, MIP, VC
Skin Appearance
,- color
- condition ✔✔- *Normal:* Race specific
- *Decrease in color* = ashen, pallor → anemia, blood loss
- *Jaundice: *↑ bilirubin levels → liver failure
- *Erythema: *Redness of the skin → *hypercarbia, COHb, inflammation*
- *Cyanosis: *Bluish → Hypoxia (this is a poor assessment of hypoxia bc it shows up late! Only
appears after 5 gram% of Hb is desaturated...)
- *diaphroesis:* sweating
- *turgor*: slowed response shows dehydration → either through hypernatremia or/and
hypovolemia
Smoking history
- Calculating Pack-year
- Verifying if pt is compliant w/smoking cessation program ✔✔Pack Years = *(packs per day) x
(# years smoked)*
Measure pt's COHb to see if they actually are quitting smoking
COHb be levels should ↓ from their baseline to non-smoking normals of < 1%
, Terms for Describing Sensorium/Neuro (LOC)
- Conscious
- Confused
- Disoriented
- Lethargic
- Obtunded
- Stuporous
- Comatose ✔✔- *Conscious*: alert to time, place, and person; responds appropriately
-* Confused: *can't think clearly, responds inappropriately
-* Disoriented: *disoriented to time/place; starting loss of conscience
-* Lethargic: *sleepy, but will wake; still oriented (can be early sign of increased ICP)
-* Obtunded:*hard to wake; slowed response but appropriate
- *Stuporous: *doesn't awaken completely; only responds to painful stimuli
- *Comatose*: unconscious; doesn't respond to any stimuli
Glasgow Coma Scale (GCS) ✔✔To measure level of consciousness (LOC)
Respiratory Care) Questions and
Answers with Verified Solutions
The four steps for respiratory mgmt ✔✔1. tx *ventilation *first (should problem exist)
2. *oxygenation*
3. *circulation*
4. *perfusion*
problems at one step will adversely affect each process that follows it within sequence
External respiration
vs.
Internal respiration ✔✔External = exchange of O2 and CO2 across AC membrane
- depends on diffusion capacity of AC membrane & ventilation
Internal = exchange of O2 & CO2 across blood and tissue cells
- depends on circulation
,Signs
vs.
Symptoms ✔✔*Signs = Objective information*; can be seen, measured, heard, or felt
- Color, pulse, edema
*Symptoms = Subjective information*
- Dyspnea, pain, nausea
Steps in Assessment: ✔✔1. *Visual examination*
- General appearance, sensorum, chest movement, posture, skin color
2. *Bedside exam*
- BS, VS, auscultate, percussion, PMH, cap refill
3. *Lab exam *
- ABG, CBC, CXR, lytes
4. *Specials*
- urinalysis, gram stain, MIP, VC
Skin Appearance
,- color
- condition ✔✔- *Normal:* Race specific
- *Decrease in color* = ashen, pallor → anemia, blood loss
- *Jaundice: *↑ bilirubin levels → liver failure
- *Erythema: *Redness of the skin → *hypercarbia, COHb, inflammation*
- *Cyanosis: *Bluish → Hypoxia (this is a poor assessment of hypoxia bc it shows up late! Only
appears after 5 gram% of Hb is desaturated...)
- *diaphroesis:* sweating
- *turgor*: slowed response shows dehydration → either through hypernatremia or/and
hypovolemia
Smoking history
- Calculating Pack-year
- Verifying if pt is compliant w/smoking cessation program ✔✔Pack Years = *(packs per day) x
(# years smoked)*
Measure pt's COHb to see if they actually are quitting smoking
COHb be levels should ↓ from their baseline to non-smoking normals of < 1%
, Terms for Describing Sensorium/Neuro (LOC)
- Conscious
- Confused
- Disoriented
- Lethargic
- Obtunded
- Stuporous
- Comatose ✔✔- *Conscious*: alert to time, place, and person; responds appropriately
-* Confused: *can't think clearly, responds inappropriately
-* Disoriented: *disoriented to time/place; starting loss of conscience
-* Lethargic: *sleepy, but will wake; still oriented (can be early sign of increased ICP)
-* Obtunded:*hard to wake; slowed response but appropriate
- *Stuporous: *doesn't awaken completely; only responds to painful stimuli
- *Comatose*: unconscious; doesn't respond to any stimuli
Glasgow Coma Scale (GCS) ✔✔To measure level of consciousness (LOC)
