TMC Test Bank NBRC
g g g
1. Disadvantagesgofgnoninvasivegventilationgincludegwhichgonegofgthegfollow-
g ing?
A. costsgmoregthanginvasivegventilation
B. requiresgheavygpatientgsedation
C. limitsgdirectgaccessgtoglowergairway
D. increasesgtheglikelihoodgofgVAP:gDisadvantagesgofgnoninvasivegventilationg
(NPPV)gincludegthegfollowing:gitgcangonlygbe
usedgingcooperativegpatients;gitgdoesgnotgprovidegdirectgairwaygaccessg(thusgincreas-
ing
g
thegriskgofgsecretiongretention),gandgmoregtherapistgtimegisgneededgduringgtheginitialg
periodgofguse.gOngthegotherghandgNPPVgmayghelpgdecreasegthegincidencegofgVAPg
and
typicallygcostsglessgthanginvasivegventilation.
Thegcorrectganswergis:glimitsgdirectgaccessgtoglowergairway
2. OngagpatientgreceivinggvolumegcontrolgACgventilation,gyougobservega
g flow-volume
withgagsawtoothgpatterngongexhalation.gWhichgofgthegfollowinggactionsgwould
1g/g222
,you
considergmostgappropriate?
A. recommendgadministeringgagbronchodilator
B. assessgthegpatient'sgneedgforgsuctioning
C. measuregthegendotrachealgtubegcuffgpressure
D. switchgtogpressuregcontrolgventilation:gThegflow-
volumegloopgrevealsgirregulargsawtooth-glikegoscillations,gprimarilygingthe
expiratorygportiongofgthegloop.gThisgindicatesgeitherg1)gaccumulationgofgairwaygsecre
onsgingthegtrachea/largegairwaysg(requiringgsuctioning),gorg2)gcondensategpartially
blockinggthegexpiratoryglimbgofgthegventilatorgcircuitgproximalgtogthegexpiratorygflowg
sensor.gAuscultationgofgrhonchigorgtactilegfremitusgovergthegtracheagwouldgconfirmg
excessgsecretionsgasgthegproblem.
Thegcorrectganswergis:gassessgthegpatient'sgneedgforgsuctioning
3. Ag30gyear-
oldgmalegwasgfoundgsupinegandgunresponsive.gIngthegERgitgwasgconfirmedgh
eghadgaspiratedgwhilegonghisgback.gAftergthegpatientgisgtransferredgto
ICUghisgphysiciangordersgposturalgdrainagegandgpercussiongeveryg4ghours.
Whatgis
thegbestgpositiongtogplaceghimgingtogdraingthegaffectedgarea?
A. pronegwithgagpillowgunderghisghips
2g/g222
,B. pronegwithgfeetgelevatedg30gdegrees
C. supinegwithgagpillowgunderghisghips
D. supinegwithgfeetgelevatedg30gdegrees:gThisgpatientgaspiratedgwhileglyinggflatg
onghisgback.gMostgcommonly,gthisgaffectsgthe
superiorgsegmentsgofgbothglowerglobes.gThegpositiongwhichgfacilitatesgdrainagegfromgth
lunggregiongisgagpronegpositiongwithgagpillowgundergthegpatient'sghips.
g
Thegcorrectganswergis:gpronegwithgagpillowgunderghisghips
4. Yougneedgtogperformgnasotrachealgsuctioninggongagpatientgwithgretained
g secretions.gAsgcomparedgtogsuctioninggviagagtrachealgairway,gwhichgofgth
egfollowinggcomplicationsgareguniquegtogthisgprocedure?
A. hypotension
B. gagging/aspiration
C. hypoxemia
D. increasedgICP:gComplication/hazardsgcommongtogbothgtracheobronchialgandg
nasotrachealgsuctioning
includeghypoxemia,gcardiacgdysrhythmias,gbradycardia,ghyper-
/hypotension,gbronchospasm,gatelectasis,gincreasedgintracranialgpressuregandgthegp
otentialgforgcontamination/infection.gUniquegcomplicationsgofgnasotrachealgsuctionin
includegnasalgtrauma/epistaxis,gpharyngealgtrauma,ggaggingg(withgpotential
241
vomiting/aspiration),gandglaryngospasm.gAlsogmisdirectiongofgthegcathetergisgmoregco
mmongwithgnasotrachealgsuctioning.
5. Whichgofgthegfollowinggindicatesgagdeficitgingfluidgbalance
A. Pedalgedema
B. Poorgskingturgor
3g/g222
, C. capgrefill
D. JVD:gPoorgskingturgor
6. ARDSgpatient,gwhatgshouldgRTgusegtogevaluategoxygengdeliverygforgoptimal
PEEP
g
A. ABG
B. mixedgvenous
C. serumglactate
D. CO:gmixedgvenous
7. RTgperforminggaghighgcalibrationgongagnitricgoxide,gexpectedgvaluegis
A. 45
B. 10
C. 25
D. 80:g45
4g/g222
g g g
1. Disadvantagesgofgnoninvasivegventilationgincludegwhichgonegofgthegfollow-
g ing?
A. costsgmoregthanginvasivegventilation
B. requiresgheavygpatientgsedation
C. limitsgdirectgaccessgtoglowergairway
D. increasesgtheglikelihoodgofgVAP:gDisadvantagesgofgnoninvasivegventilationg
(NPPV)gincludegthegfollowing:gitgcangonlygbe
usedgingcooperativegpatients;gitgdoesgnotgprovidegdirectgairwaygaccessg(thusgincreas-
ing
g
thegriskgofgsecretiongretention),gandgmoregtherapistgtimegisgneededgduringgtheginitialg
periodgofguse.gOngthegotherghandgNPPVgmayghelpgdecreasegthegincidencegofgVAPg
and
typicallygcostsglessgthanginvasivegventilation.
Thegcorrectganswergis:glimitsgdirectgaccessgtoglowergairway
2. OngagpatientgreceivinggvolumegcontrolgACgventilation,gyougobservega
g flow-volume
withgagsawtoothgpatterngongexhalation.gWhichgofgthegfollowinggactionsgwould
1g/g222
,you
considergmostgappropriate?
A. recommendgadministeringgagbronchodilator
B. assessgthegpatient'sgneedgforgsuctioning
C. measuregthegendotrachealgtubegcuffgpressure
D. switchgtogpressuregcontrolgventilation:gThegflow-
volumegloopgrevealsgirregulargsawtooth-glikegoscillations,gprimarilygingthe
expiratorygportiongofgthegloop.gThisgindicatesgeitherg1)gaccumulationgofgairwaygsecre
onsgingthegtrachea/largegairwaysg(requiringgsuctioning),gorg2)gcondensategpartially
blockinggthegexpiratoryglimbgofgthegventilatorgcircuitgproximalgtogthegexpiratorygflowg
sensor.gAuscultationgofgrhonchigorgtactilegfremitusgovergthegtracheagwouldgconfirmg
excessgsecretionsgasgthegproblem.
Thegcorrectganswergis:gassessgthegpatient'sgneedgforgsuctioning
3. Ag30gyear-
oldgmalegwasgfoundgsupinegandgunresponsive.gIngthegERgitgwasgconfirmedgh
eghadgaspiratedgwhilegonghisgback.gAftergthegpatientgisgtransferredgto
ICUghisgphysiciangordersgposturalgdrainagegandgpercussiongeveryg4ghours.
Whatgis
thegbestgpositiongtogplaceghimgingtogdraingthegaffectedgarea?
A. pronegwithgagpillowgunderghisghips
2g/g222
,B. pronegwithgfeetgelevatedg30gdegrees
C. supinegwithgagpillowgunderghisghips
D. supinegwithgfeetgelevatedg30gdegrees:gThisgpatientgaspiratedgwhileglyinggflatg
onghisgback.gMostgcommonly,gthisgaffectsgthe
superiorgsegmentsgofgbothglowerglobes.gThegpositiongwhichgfacilitatesgdrainagegfromgth
lunggregiongisgagpronegpositiongwithgagpillowgundergthegpatient'sghips.
g
Thegcorrectganswergis:gpronegwithgagpillowgunderghisghips
4. Yougneedgtogperformgnasotrachealgsuctioninggongagpatientgwithgretained
g secretions.gAsgcomparedgtogsuctioninggviagagtrachealgairway,gwhichgofgth
egfollowinggcomplicationsgareguniquegtogthisgprocedure?
A. hypotension
B. gagging/aspiration
C. hypoxemia
D. increasedgICP:gComplication/hazardsgcommongtogbothgtracheobronchialgandg
nasotrachealgsuctioning
includeghypoxemia,gcardiacgdysrhythmias,gbradycardia,ghyper-
/hypotension,gbronchospasm,gatelectasis,gincreasedgintracranialgpressuregandgthegp
otentialgforgcontamination/infection.gUniquegcomplicationsgofgnasotrachealgsuctionin
includegnasalgtrauma/epistaxis,gpharyngealgtrauma,ggaggingg(withgpotential
241
vomiting/aspiration),gandglaryngospasm.gAlsogmisdirectiongofgthegcathetergisgmoregco
mmongwithgnasotrachealgsuctioning.
5. Whichgofgthegfollowinggindicatesgagdeficitgingfluidgbalance
A. Pedalgedema
B. Poorgskingturgor
3g/g222
, C. capgrefill
D. JVD:gPoorgskingturgor
6. ARDSgpatient,gwhatgshouldgRTgusegtogevaluategoxygengdeliverygforgoptimal
PEEP
g
A. ABG
B. mixedgvenous
C. serumglactate
D. CO:gmixedgvenous
7. RTgperforminggaghighgcalibrationgongagnitricgoxide,gexpectedgvaluegis
A. 45
B. 10
C. 25
D. 80:g45
4g/g222
