NBRC TMC ACTUAL EXAM 500
QUESTIONS WITH DETAILED
VERIFIED ANSWERS (100% CORRECT
ANSWERS) AND RATIONALES
ALREADY GRADED A+ GUARANTEED
PASS
"Which of the following would be the most effective, appropriate method for resolving
atelectasis in a spontaneously breathing, post operative patient who is under the influence of
sedation and will not respond to verbal stimuli?
A. IPPB
B. sustained maximal inhalation (incentive spirometer)
C. deep breathing coaching
D. intubation and mechanical ventilation - CORRECT ANSWER=> A.
A postoperative patient under sedation, and possibly in pain, may be tempted to breathe less,
causing respiratory acidosis and atelectasis. To correct this problem, IPPB therapy is most
appropriate. Incentive spirometry would also help but the patient is unable to respond to verbal
stimuli. This alone is an indication for IPPB therapy."
"After performing minimum occluding volume technique with a 65-kg (143-lb) patient who is
orally intubated with a 7.0-mm ET tube, the respiratory therapist should NEXT
A. check ET tube cuff pressure
B. perform tracheal palpation
C. order a chest radiograph
D. document ET tube markings at the lips - CORRECT ANSWER=> A.
The ET tube cuff pressure may be adjusted correctly by several techniques including minimum
leak technique (also called minimum occluding volume, minimal seal technique, and the use of
a pressure manometer called a cuffalator. If minimum seal or minimal leak technique is used,
1|Page
,the respiratory therapist is still required to monitor the pressure after the technique is
performed. Although this is often not done in real life, it is technically part of the procedure."
"The respiratory therapist observes an ECG wave form on a patient that is consistent with atrial
tachycardia. The patient is complaining of chest pain, dizziness, and nausea. The respiratory
therapist should recommend
A. unsynchronized defibrillation
B. Atropine sulfate
C. epinephrine
D. cardioversion - CORRECT ANSWER=> D.
Non-deadly arrhythmias, such as this one, may be addressed through cardioversion.
Cardioversion is a form of defibrillation with low wattage and with the synchronization set to
"active". This allows the shock to be synchronized to the R wave."
"A 38-year-old male presents in the emergency department (ED) complaining of frequent
vomiting. The following laboratory data is available: Arterial blood gases
pH 7.55 PaCO2 42 torrPaO2 85 torrHCO3- 31 mEq/LBE +7 mEq/LFIO2 0.21K+ 3.0 mEq/LCl- 95
mEq/LNa+ 135 mEq/L
Which of the following should the respiratory therapist recommend?
A. administer NaCL
B. administer NaHCO3-
C. administer KCL
D. administer volume-expanding fluids - CORRECT ANSWER=> C.
This patient has a CO2 of 42 mmHg, which suggests adequate ventilation. However, the high pH
is associated with alkalosis. Because the CO2 is normal, the cause of the alkalosis must be
metabolic in nature. One treatment for metabolic alkalosis is to administer potassium chloride
or KCl."
"A patient is receiving volume-controlled ventilation following bariatric surgery for obesity.
Which of the following medications should the respiratory therapist recommend to ensure the
patient's comfort and assist in ventilator management?
A. Pronestyl
B. morphine sulfate
C. vecuronium bromide (Norcuron)
D. Mestinon - CORRECT ANSWER=> B.
Morphine sulfate is one of the best medications to administer to patients receiving mechanical
ventilatory support to help the patient rest pain-free and to generally sedate and relax the
patient."
2|Page
,"A patient has idiopathic pneumonia with consolidation in the right lower lobe. The physician
suspects a bacterial infection. Which of the following will provide conclusive data to rule out the
physician's suspicions?
A. WBC
B. color of sputum
C. sputum acid-fast stain
D. oral temperature - CORRECT ANSWER=> A.
A bacterial infection is diagnosed primarily by examining the white blood cell count, also called
the leukocyte count. An elevated temperature and yellow sputum indicate the possibility of an
infection but are not confirming in nature."
"After making the universal sign of choking, a person collapses. The observer should FIRST
A. check for a pulse
B. call for help
C. perform abdominal thrusts
D. administer 2 rescue breaths - CORRECT ANSWER=> C.
When a person indicates the universal sign of choking, they are unable to verbalize because
there is likely something caught in their airway. The person responding must first focus on
removing the obstruction, which is done by performing abdominal thrusts. Administering rescue
breaths would not be appropriate because the airway is obstructed. Calling for help is tempting
but is only related to two-man CPR. The patient is not yet at that point. Performing abdominal
thrusts is a one-man maneuver and therefore obtaining additional help is not the first concern."
"A home care patient calls into the clinic and complains that his oxygen concentrator is not
working even though the machine is plugged in and the switch is in the 'on'. Position. After
ensuring the patient is receiving oxygen from a reliable alternate source, the therapist should
advise the patient to
A. check and replace the internal in-line fuse
B. find the reset switch in the machine and press it
C. ensure the circuit breaker is in the on position
D. change the filters and cycle the machine off then on again - CORRECT ANSWER=> C.
When a homecare patient reports a problem with their oxygen concentrator, the first action
should be to ensure the patient is receiving oxygen from an alternate source (an E cylinder).
After that is accomplished, the respiratory therapist may instruct the patient in some basic
troubleshooting. This includes ensuring the device is plugged in, changing the filter, and
checking the circuit breaker. All other troubleshooting should be done by a professional."
3|Page
, "An adult patient with asthma is receiving Albuterol by small volume nebulizer Q.I.D. at a
dosage of 0.5 mL. The patient complains of dizziness, tingling in his fingers, and anxiety with
each treatment. The therapist should
A. increase dosage to 1.0 mL
B. decrease dosage to 0.15 mL
C. switch to Xopenex 0.63 mg
D. switch to Mucomyst 20% - CORRECT ANSWER=> C.
When a patient experiences an adverse reaction, the first step is to stop the therapy and then
modify the therapy to accomplish the same objective. In this case, decreasing the dose of
Xopenex is suitable because 0.63 mg is still in the adult therapeutic range."
"Which of the following conditions would benefit most from a thoracentesis?
A. atelectasis
B. complete opacification of the right lung
C. small pneumothorax
D. pericardial contusion - CORRECT ANSWER=> C.
A thoracentesis is a procedure that removes air or fluid from the pleural space. This would be
appropriate with a small pneumothorax. A large pneumothorax, however, would require chest
tubes."
"ASK***** A patient with ARDS and asthma could benefit from which of the following
medications?
A. Spiriva and decadron
B. exogenous surfactant
C. Tobramycin and albuterol
D. cromolyn sodium - CORRECT ANSWER=> B.
A patient with adult respiratory distress syndrome could benefit from surfactant therapy to
decrease the surface tension of the alveoli."
"The respiratory therapist should look to which of the following clinical data to determine the
effectiveness of incentive spirometry?
A. Arterial blood gas analysis pre and post treatment
B. Breath sounds before and after every treatment
C. Inspiratory capacity predicted volume
D. Maximum voluntary ventilation done periodically - CORRECT ANSWER=> B.
The effectiveness of incentive spirometry can best be determined by auscultating breath sounds
before and after the treatment and noting changes in air movement. While achieving inspiratory
4|Page
QUESTIONS WITH DETAILED
VERIFIED ANSWERS (100% CORRECT
ANSWERS) AND RATIONALES
ALREADY GRADED A+ GUARANTEED
PASS
"Which of the following would be the most effective, appropriate method for resolving
atelectasis in a spontaneously breathing, post operative patient who is under the influence of
sedation and will not respond to verbal stimuli?
A. IPPB
B. sustained maximal inhalation (incentive spirometer)
C. deep breathing coaching
D. intubation and mechanical ventilation - CORRECT ANSWER=> A.
A postoperative patient under sedation, and possibly in pain, may be tempted to breathe less,
causing respiratory acidosis and atelectasis. To correct this problem, IPPB therapy is most
appropriate. Incentive spirometry would also help but the patient is unable to respond to verbal
stimuli. This alone is an indication for IPPB therapy."
"After performing minimum occluding volume technique with a 65-kg (143-lb) patient who is
orally intubated with a 7.0-mm ET tube, the respiratory therapist should NEXT
A. check ET tube cuff pressure
B. perform tracheal palpation
C. order a chest radiograph
D. document ET tube markings at the lips - CORRECT ANSWER=> A.
The ET tube cuff pressure may be adjusted correctly by several techniques including minimum
leak technique (also called minimum occluding volume, minimal seal technique, and the use of
a pressure manometer called a cuffalator. If minimum seal or minimal leak technique is used,
1|Page
,the respiratory therapist is still required to monitor the pressure after the technique is
performed. Although this is often not done in real life, it is technically part of the procedure."
"The respiratory therapist observes an ECG wave form on a patient that is consistent with atrial
tachycardia. The patient is complaining of chest pain, dizziness, and nausea. The respiratory
therapist should recommend
A. unsynchronized defibrillation
B. Atropine sulfate
C. epinephrine
D. cardioversion - CORRECT ANSWER=> D.
Non-deadly arrhythmias, such as this one, may be addressed through cardioversion.
Cardioversion is a form of defibrillation with low wattage and with the synchronization set to
"active". This allows the shock to be synchronized to the R wave."
"A 38-year-old male presents in the emergency department (ED) complaining of frequent
vomiting. The following laboratory data is available: Arterial blood gases
pH 7.55 PaCO2 42 torrPaO2 85 torrHCO3- 31 mEq/LBE +7 mEq/LFIO2 0.21K+ 3.0 mEq/LCl- 95
mEq/LNa+ 135 mEq/L
Which of the following should the respiratory therapist recommend?
A. administer NaCL
B. administer NaHCO3-
C. administer KCL
D. administer volume-expanding fluids - CORRECT ANSWER=> C.
This patient has a CO2 of 42 mmHg, which suggests adequate ventilation. However, the high pH
is associated with alkalosis. Because the CO2 is normal, the cause of the alkalosis must be
metabolic in nature. One treatment for metabolic alkalosis is to administer potassium chloride
or KCl."
"A patient is receiving volume-controlled ventilation following bariatric surgery for obesity.
Which of the following medications should the respiratory therapist recommend to ensure the
patient's comfort and assist in ventilator management?
A. Pronestyl
B. morphine sulfate
C. vecuronium bromide (Norcuron)
D. Mestinon - CORRECT ANSWER=> B.
Morphine sulfate is one of the best medications to administer to patients receiving mechanical
ventilatory support to help the patient rest pain-free and to generally sedate and relax the
patient."
2|Page
,"A patient has idiopathic pneumonia with consolidation in the right lower lobe. The physician
suspects a bacterial infection. Which of the following will provide conclusive data to rule out the
physician's suspicions?
A. WBC
B. color of sputum
C. sputum acid-fast stain
D. oral temperature - CORRECT ANSWER=> A.
A bacterial infection is diagnosed primarily by examining the white blood cell count, also called
the leukocyte count. An elevated temperature and yellow sputum indicate the possibility of an
infection but are not confirming in nature."
"After making the universal sign of choking, a person collapses. The observer should FIRST
A. check for a pulse
B. call for help
C. perform abdominal thrusts
D. administer 2 rescue breaths - CORRECT ANSWER=> C.
When a person indicates the universal sign of choking, they are unable to verbalize because
there is likely something caught in their airway. The person responding must first focus on
removing the obstruction, which is done by performing abdominal thrusts. Administering rescue
breaths would not be appropriate because the airway is obstructed. Calling for help is tempting
but is only related to two-man CPR. The patient is not yet at that point. Performing abdominal
thrusts is a one-man maneuver and therefore obtaining additional help is not the first concern."
"A home care patient calls into the clinic and complains that his oxygen concentrator is not
working even though the machine is plugged in and the switch is in the 'on'. Position. After
ensuring the patient is receiving oxygen from a reliable alternate source, the therapist should
advise the patient to
A. check and replace the internal in-line fuse
B. find the reset switch in the machine and press it
C. ensure the circuit breaker is in the on position
D. change the filters and cycle the machine off then on again - CORRECT ANSWER=> C.
When a homecare patient reports a problem with their oxygen concentrator, the first action
should be to ensure the patient is receiving oxygen from an alternate source (an E cylinder).
After that is accomplished, the respiratory therapist may instruct the patient in some basic
troubleshooting. This includes ensuring the device is plugged in, changing the filter, and
checking the circuit breaker. All other troubleshooting should be done by a professional."
3|Page
, "An adult patient with asthma is receiving Albuterol by small volume nebulizer Q.I.D. at a
dosage of 0.5 mL. The patient complains of dizziness, tingling in his fingers, and anxiety with
each treatment. The therapist should
A. increase dosage to 1.0 mL
B. decrease dosage to 0.15 mL
C. switch to Xopenex 0.63 mg
D. switch to Mucomyst 20% - CORRECT ANSWER=> C.
When a patient experiences an adverse reaction, the first step is to stop the therapy and then
modify the therapy to accomplish the same objective. In this case, decreasing the dose of
Xopenex is suitable because 0.63 mg is still in the adult therapeutic range."
"Which of the following conditions would benefit most from a thoracentesis?
A. atelectasis
B. complete opacification of the right lung
C. small pneumothorax
D. pericardial contusion - CORRECT ANSWER=> C.
A thoracentesis is a procedure that removes air or fluid from the pleural space. This would be
appropriate with a small pneumothorax. A large pneumothorax, however, would require chest
tubes."
"ASK***** A patient with ARDS and asthma could benefit from which of the following
medications?
A. Spiriva and decadron
B. exogenous surfactant
C. Tobramycin and albuterol
D. cromolyn sodium - CORRECT ANSWER=> B.
A patient with adult respiratory distress syndrome could benefit from surfactant therapy to
decrease the surface tension of the alveoli."
"The respiratory therapist should look to which of the following clinical data to determine the
effectiveness of incentive spirometry?
A. Arterial blood gas analysis pre and post treatment
B. Breath sounds before and after every treatment
C. Inspiratory capacity predicted volume
D. Maximum voluntary ventilation done periodically - CORRECT ANSWER=> B.
The effectiveness of incentive spirometry can best be determined by auscultating breath sounds
before and after the treatment and noting changes in air movement. While achieving inspiratory
4|Page
