NBRC EXAM Part 1 REDUCED With Complete
Solutions Graded A+
Is the following Static OR Dynamic Compliance:
Means flow throughout the respiratory system has stopped and all ventilatory muscle activity is
absent. _______ conditions can be imposed with an inspiratory pause when a patient is sedated and
mechanically ventilated.
Static Compliance
Is the following Static OR Dynamic Compliance:
Flow at airway opening is zero. Mechanics are evaluated under ______ conditions, when non-
intubated patient breathes spontaneously.
Dynamic Compliance
A balloon tipped flow directed catheter is positioned in the pulmonary artery with the balloon
deflated. Which of the following pressures will be measured by the proximal lumen:
a. Cvp
b. Pap
c. Pwp
d. Map
ANSWER is A. Cvp = deflated/proximal lumen
Pap = deflated/distal
Pwp = inflated/wedged
All of the following will affect the accuracy of a capnography EXCEPT
a. Long sampling line
b. Low sampling flow
c. Condensation in the tubing
d. Use of desiccant
Gas will pass through and out of a long sampling line before reaching analyzer so, low sampling flow
will not give you enough information for a good reading, and condensation as a rule is always a
problem especially in analyzers. Dessicant removes moisture from the gas, which is a good thing, so
ANSWER is D
What should you recommend FIRST for a patient with multifocal pvc's
a. Administration of lidocaine
b. Administration of 100% oxygen
c. Administration of atropine
d. Administration of epinephrine
Multiple pvc's coming from multiple locations (multifocal) is a real problem and you should administer
oxygen FIRST, so ANSWER is B. lidocaine will help reduce irritability of heart and help with pvc's but
would not be first option, atropine is used for bradycardia and cardiac irregularities but not pvc's,
epinephrine is emergency drug not for pvc's but more for pulseless ventricular tachycardia or
ventricular fibrilation where heart is not responding .
What is the normal range for the mean pulmonary artery pressure in an adult
a. 2-6 mm Hg
b. 4-12 mmHg
c. 9-18 mmHg
d. 21-28 mmHg
Mean pulmonary artery pressure in an adult should be in the teens
,so best ANSWER is C
A patient in the emergency dept has frothy secretions, moist crackles, and tachypnea. The patient has
marked dyspnea and a history of heart disease. Which of the following should the respiratory
therapist recommend.
1.suction immediately
2.administer 100% oxygen
3.place in Fowlers position
4.administer furosemide
This is an emergency, they are having heart problems, dyspnea, frothy secretions indicating severe
pulmonary edema, etc. so 100% oxygen immediately, having the patient in the Fowlers position (an
upright position) will help pull fluid down away from the lungs, furosemide is a lasix (loop diuretic)
which gets rid of excess fluid. You do NOT suction someone with frothy secretions and heart
problems, this just delays appropriate therapy. So ANSWER is 2,3,4
Which of the following will determine aortic pulse pressure.
a. systolic + systolic + diastolic/3
b. diastolic + pulse pressure/3
c. systolic pressure - diastolic pressure
d. stroke volume x heart rate x 10.
Aortic pulse pressure is just the difference between systolic and diastolic pressure, so ANSWER is C
.
What is the normal range for the pulmonary artery systolic pressure in an adult?
A. 2-6 mm Hg
B. 4-12 mm Hg
C. 9-18 mm Hg
D. 21-28 mm Hg
The normal pressure is 25 mm Hg, so the ANSWER is D 21-28 mm Hg
A multiple trauma victim with internal hemorrhage is being monitored via pulse oximetry. Which of
the following conditions would affect the accuracy of her SpO2 readings?
A. hypotension
B. hyperoxia
C. hypocarbia
D. hyperthermia
Since the SpO2 measures the color of the blood and the ability to shine a light through the blood, the
only answer that would affect the accuracy of the SpO2 reading would be ANSWER A hypotension
because hypotension causes less profusion (needed for the SpO2 reading)
The respiratory therapist notices a dampened waveform on a pulmonary arterial line. The therapist's
first action should be to
A. attempt to draw blood from the line.
B. check the transducer dome for air bubbles.
C. flush the catheter with heparin solution.
D. check the position of the transducer.
Dampened wave form is when you aren't getting a nice sharp reading, you should get a clear systolic
and diastolic pattern; the most common cause is a blood clot, flushing the catheter with heparin
might push the blood clot into the lung at this point (not a good idea), another common cause of a
dampened wave form is air bubbles in the transducer dome, so the ANSWER is B.
, A patient in the intensive care unit is suffering left heart failure. Which of the following drugs will
increase the strength of contraction and improve cardiac output?
A. digitalis
B. atropine
C. isuprel
D. lidocaine
Atropine is used for bradycardia and increases output but not strength, Isuprel treats bradycardia and
output but not strength, Lidocaine reduces irritability of heart, but Digitalis is a cardiac glycoside that
increases cardiac output and strengthens cardiac contraction, so ANSWER is A
The respiratory therapist has been paged to the ICU to assist in the treatment of a 98 kg (215 lb) man.
The patient is pale, diaphoretic, and suddenly loses consciousness. No palpable pulse or blood
pressure is measured. The ECG monitor displays the following sinus bradycardia with a rate of 45):
The respiratory therapist should:
A. confirm the ECG in another lead.
B. begin chest compressions.
C. perform cardioversion.
D. perform defibrillation.
ECG is showing sinus bradycardia with a rate of 45, all this leads up to begin chest compressions, so
ANSWER is B. Do not perform cardioversion or defribulation because there is no arrhythmia so we
don't want to mess with anything electrical in the heart, just want to help it out mechanically.
The respiratory therapist is assessing a patient's vital signs and notes that the pulse feels weak and
thready. This would most likely be associated with which of the following conditions?
A. Hypervolemia
B. Shock
C. Increased cardiac output
D. Increased systemic vascular resistance
A weak and thread pulse can be associated with conditions that decrease the blood pressure like
shock or hypovalemia, so the ANSWER is B shock.
A patient who recently underwent a total abdominal hysterectomy is complaining of chills and
purulent sputum. Breath sounds reveal coarse rales and rhonchi. The results of the CBC indicate a
WBC count of 19,000. The most likely diagnosis is that the patient has developed:
A. atelectasis
B. pneumonia
C. hemothorax
D. bacterial infection
Bacterial infections cause purulent sputum which is increased WBC's; viral infections do not. It might
be pneumonia, but we do not know without more information, so the best answer is D bacterial
infection,
After injecting a small amount of air into the balloon of a pulmonary artery catheter, the respiratory
therapist sees a small amplitude change with the mean pressure reading 2 points below the PA end-
diastolic pressure. Based upon this information, the therapist should conclude that
A. there is pressure dampening.
B. the transducer is placed too high.
C. there is an obstruction in the catheter.
D. this is a normal wedge tracing.
A small amplitude change is normal and the mean pressure reading 2 points below the pulmonary
artery end-diastolic pressure is also normal, so the ANSWER is D.
Solutions Graded A+
Is the following Static OR Dynamic Compliance:
Means flow throughout the respiratory system has stopped and all ventilatory muscle activity is
absent. _______ conditions can be imposed with an inspiratory pause when a patient is sedated and
mechanically ventilated.
Static Compliance
Is the following Static OR Dynamic Compliance:
Flow at airway opening is zero. Mechanics are evaluated under ______ conditions, when non-
intubated patient breathes spontaneously.
Dynamic Compliance
A balloon tipped flow directed catheter is positioned in the pulmonary artery with the balloon
deflated. Which of the following pressures will be measured by the proximal lumen:
a. Cvp
b. Pap
c. Pwp
d. Map
ANSWER is A. Cvp = deflated/proximal lumen
Pap = deflated/distal
Pwp = inflated/wedged
All of the following will affect the accuracy of a capnography EXCEPT
a. Long sampling line
b. Low sampling flow
c. Condensation in the tubing
d. Use of desiccant
Gas will pass through and out of a long sampling line before reaching analyzer so, low sampling flow
will not give you enough information for a good reading, and condensation as a rule is always a
problem especially in analyzers. Dessicant removes moisture from the gas, which is a good thing, so
ANSWER is D
What should you recommend FIRST for a patient with multifocal pvc's
a. Administration of lidocaine
b. Administration of 100% oxygen
c. Administration of atropine
d. Administration of epinephrine
Multiple pvc's coming from multiple locations (multifocal) is a real problem and you should administer
oxygen FIRST, so ANSWER is B. lidocaine will help reduce irritability of heart and help with pvc's but
would not be first option, atropine is used for bradycardia and cardiac irregularities but not pvc's,
epinephrine is emergency drug not for pvc's but more for pulseless ventricular tachycardia or
ventricular fibrilation where heart is not responding .
What is the normal range for the mean pulmonary artery pressure in an adult
a. 2-6 mm Hg
b. 4-12 mmHg
c. 9-18 mmHg
d. 21-28 mmHg
Mean pulmonary artery pressure in an adult should be in the teens
,so best ANSWER is C
A patient in the emergency dept has frothy secretions, moist crackles, and tachypnea. The patient has
marked dyspnea and a history of heart disease. Which of the following should the respiratory
therapist recommend.
1.suction immediately
2.administer 100% oxygen
3.place in Fowlers position
4.administer furosemide
This is an emergency, they are having heart problems, dyspnea, frothy secretions indicating severe
pulmonary edema, etc. so 100% oxygen immediately, having the patient in the Fowlers position (an
upright position) will help pull fluid down away from the lungs, furosemide is a lasix (loop diuretic)
which gets rid of excess fluid. You do NOT suction someone with frothy secretions and heart
problems, this just delays appropriate therapy. So ANSWER is 2,3,4
Which of the following will determine aortic pulse pressure.
a. systolic + systolic + diastolic/3
b. diastolic + pulse pressure/3
c. systolic pressure - diastolic pressure
d. stroke volume x heart rate x 10.
Aortic pulse pressure is just the difference between systolic and diastolic pressure, so ANSWER is C
.
What is the normal range for the pulmonary artery systolic pressure in an adult?
A. 2-6 mm Hg
B. 4-12 mm Hg
C. 9-18 mm Hg
D. 21-28 mm Hg
The normal pressure is 25 mm Hg, so the ANSWER is D 21-28 mm Hg
A multiple trauma victim with internal hemorrhage is being monitored via pulse oximetry. Which of
the following conditions would affect the accuracy of her SpO2 readings?
A. hypotension
B. hyperoxia
C. hypocarbia
D. hyperthermia
Since the SpO2 measures the color of the blood and the ability to shine a light through the blood, the
only answer that would affect the accuracy of the SpO2 reading would be ANSWER A hypotension
because hypotension causes less profusion (needed for the SpO2 reading)
The respiratory therapist notices a dampened waveform on a pulmonary arterial line. The therapist's
first action should be to
A. attempt to draw blood from the line.
B. check the transducer dome for air bubbles.
C. flush the catheter with heparin solution.
D. check the position of the transducer.
Dampened wave form is when you aren't getting a nice sharp reading, you should get a clear systolic
and diastolic pattern; the most common cause is a blood clot, flushing the catheter with heparin
might push the blood clot into the lung at this point (not a good idea), another common cause of a
dampened wave form is air bubbles in the transducer dome, so the ANSWER is B.
, A patient in the intensive care unit is suffering left heart failure. Which of the following drugs will
increase the strength of contraction and improve cardiac output?
A. digitalis
B. atropine
C. isuprel
D. lidocaine
Atropine is used for bradycardia and increases output but not strength, Isuprel treats bradycardia and
output but not strength, Lidocaine reduces irritability of heart, but Digitalis is a cardiac glycoside that
increases cardiac output and strengthens cardiac contraction, so ANSWER is A
The respiratory therapist has been paged to the ICU to assist in the treatment of a 98 kg (215 lb) man.
The patient is pale, diaphoretic, and suddenly loses consciousness. No palpable pulse or blood
pressure is measured. The ECG monitor displays the following sinus bradycardia with a rate of 45):
The respiratory therapist should:
A. confirm the ECG in another lead.
B. begin chest compressions.
C. perform cardioversion.
D. perform defibrillation.
ECG is showing sinus bradycardia with a rate of 45, all this leads up to begin chest compressions, so
ANSWER is B. Do not perform cardioversion or defribulation because there is no arrhythmia so we
don't want to mess with anything electrical in the heart, just want to help it out mechanically.
The respiratory therapist is assessing a patient's vital signs and notes that the pulse feels weak and
thready. This would most likely be associated with which of the following conditions?
A. Hypervolemia
B. Shock
C. Increased cardiac output
D. Increased systemic vascular resistance
A weak and thread pulse can be associated with conditions that decrease the blood pressure like
shock or hypovalemia, so the ANSWER is B shock.
A patient who recently underwent a total abdominal hysterectomy is complaining of chills and
purulent sputum. Breath sounds reveal coarse rales and rhonchi. The results of the CBC indicate a
WBC count of 19,000. The most likely diagnosis is that the patient has developed:
A. atelectasis
B. pneumonia
C. hemothorax
D. bacterial infection
Bacterial infections cause purulent sputum which is increased WBC's; viral infections do not. It might
be pneumonia, but we do not know without more information, so the best answer is D bacterial
infection,
After injecting a small amount of air into the balloon of a pulmonary artery catheter, the respiratory
therapist sees a small amplitude change with the mean pressure reading 2 points below the PA end-
diastolic pressure. Based upon this information, the therapist should conclude that
A. there is pressure dampening.
B. the transducer is placed too high.
C. there is an obstruction in the catheter.
D. this is a normal wedge tracing.
A small amplitude change is normal and the mean pressure reading 2 points below the pulmonary
artery end-diastolic pressure is also normal, so the ANSWER is D.
