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NBRC TMC PRACTICE EXAM WITH
RATIONALES ACTUAL PREP QUESTIONS AND
WELL REVISED ANSWERS - LATEST AND
COMPLETE UPDATE WITH VERIFIED
SOLUTIONS – ASSURES PASS
An infant with pneumonia is placed on CPAP with the initial level is 6 cm H20.
After the patient is placed on the system, the respiratory therapist notices that the
pressure falls to 2 cm H20 with each inspiration. What should be done to correct
the problem?
a. Tell the patient to relax and breath more slowly
b. Give the patient diazepam (Valium)
c. Increase the CPAP level to 8 cm H20
d. Increase the flow through the system
Increase the flow through the system
Explain: Decreasing pressure with inspiration indicates inadequate gas flow.
Increasing the flow should meet the patient's inspiratory flow needs and stabilize
the CPAP pressure.
A respiratory therapist is called to the ED for a 1-year-old with difficulty
breathing. Severe suprasternal, subcostal and substernal retraction are observed.
The child has a harsh, barking cough. Stridor is present. The therapist should
anticipate treatment for
Choose only ONE best answer.
a. Cystic Fibrosis
b. Pneumonia
c. Croup
d. Asthma
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Croup
Explain: The patient has some degree of upper airway obstruction caused by some
viral illness. The barky cough is a classic finding for patients experiencing croup.
The polysomnography sleep laboratory is full scheduled for several weeks. The
physician wants to know if there is another option to determine if a patient has
sleep apnea. What should be recommended?
a. Overnight pulse oximetry
b. Nasal air flow monitoring
c. Holter monitoring for 48 hours
d. Chest-wall and abdominal-wall impedance comparison
Overnight pulse oximetry
Explain: Overnight pulse oximetry can be used to screen patients with suspected
obstructive sleep apnea. The patient's oxygen saturation is found to decrease during
apnea episodes.
A respiratory therapist is assessing a 168-cm (5-ft 6-in), 73-kg (161-lb), a 41-year-
old female who was admitted 12 hours ago for an aspirin overdose. The following
information is obtained as the patient breathes air:
HR 89/min
RR 15/min
BP 110/70 mm Hg
Sp02 86%
A respiratory therapist should do first.
a. Initiate oxygen at 4L/min by cannula
b. Record the results in the medical record
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c. Obtain an arterial blood gas sample
d. Validate the Sp02 reading at a different site
Validate the Sp02 reading at a different site
Explain: The saturation may not be accurate and should be measured at a different
site.
A 47-year-old male with a BMI of 50 kg/m is undergoing a sleep study with
titration of CPAP. The patient's baseline AHI is 59. At a CPAP level of 7 cm H20,
the AHI is 9. A respiratory therapist should recommend
a. Maintain the current level of CPAP
b. Decreasing the CPAP
c. Increasing the CPAP
d. Changing to bilevel PAP
Increasing the CPAP
Explain: The goal of CPAP intervention is to completely eliminate apnea and
hypopnea episodes, standard protocol is to incrementally increase the CPAP level
until this occurs.
An arterial puncture has been performed to obtain blood for analysis of 02, C02,
and pH. What is the best way to manage the blood sample?
a. Warm the sample to keep it at body temperature
b. Place it into a mix of ice and water
c. Let the blood naturally cool to room temperature
d. Shake the sample to hemolyze the blood
Place it into a mix of ice and water
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Explain: Placing the blood sample into ice water will prevent the blood from
consuming the O2 within the sample.
A 26-year-old patient who weighs 80 kg (171 lb) received injuries in a motor
vehicle crash. The patient was intubated with a 6.0-mm ID endotracheal tube and is
receiving volume-controlled ventilation. Twenty-four hours later, the patient has
clear breath sounds but cannot tolerate weaning the mandatory rate below 8 in the
SIMV mode with 15 cm H20 pressure support. The respiratory therapist should
recommend.
a. Increasing the peak inspiratory flow
b. Raising the VT
c. Setting the mandatory rate to 10
d. Reintubating with a larger endotracheal tube
Reintubating with a larger endotracheal tube
Explain: The small endotracheal tube compromises spontaneous breathing because
of increased airways resistance. This can be resolved only by a larger tube or
extubation.
During nasotracheal suctioning, a patient exhibits a gag reflex but doesn't cough.
Watery secretions are aspirated through the catheter. Which of the following
should the respiratory therapist do next?
a. Insert an oropharyngeal airway and repeat the procedure
b. Hyperextend the patient's next when passing the catheter
c. Ask the patient to swallow while passing the catheter
d. Increase the suction pressure and repeat the procedure
Hyperextend the patient's next when passing the catheter
NBRC TMC PRACTICE EXAM WITH
RATIONALES ACTUAL PREP QUESTIONS AND
WELL REVISED ANSWERS - LATEST AND
COMPLETE UPDATE WITH VERIFIED
SOLUTIONS – ASSURES PASS
An infant with pneumonia is placed on CPAP with the initial level is 6 cm H20.
After the patient is placed on the system, the respiratory therapist notices that the
pressure falls to 2 cm H20 with each inspiration. What should be done to correct
the problem?
a. Tell the patient to relax and breath more slowly
b. Give the patient diazepam (Valium)
c. Increase the CPAP level to 8 cm H20
d. Increase the flow through the system
Increase the flow through the system
Explain: Decreasing pressure with inspiration indicates inadequate gas flow.
Increasing the flow should meet the patient's inspiratory flow needs and stabilize
the CPAP pressure.
A respiratory therapist is called to the ED for a 1-year-old with difficulty
breathing. Severe suprasternal, subcostal and substernal retraction are observed.
The child has a harsh, barking cough. Stridor is present. The therapist should
anticipate treatment for
Choose only ONE best answer.
a. Cystic Fibrosis
b. Pneumonia
c. Croup
d. Asthma
,2|Page
Croup
Explain: The patient has some degree of upper airway obstruction caused by some
viral illness. The barky cough is a classic finding for patients experiencing croup.
The polysomnography sleep laboratory is full scheduled for several weeks. The
physician wants to know if there is another option to determine if a patient has
sleep apnea. What should be recommended?
a. Overnight pulse oximetry
b. Nasal air flow monitoring
c. Holter monitoring for 48 hours
d. Chest-wall and abdominal-wall impedance comparison
Overnight pulse oximetry
Explain: Overnight pulse oximetry can be used to screen patients with suspected
obstructive sleep apnea. The patient's oxygen saturation is found to decrease during
apnea episodes.
A respiratory therapist is assessing a 168-cm (5-ft 6-in), 73-kg (161-lb), a 41-year-
old female who was admitted 12 hours ago for an aspirin overdose. The following
information is obtained as the patient breathes air:
HR 89/min
RR 15/min
BP 110/70 mm Hg
Sp02 86%
A respiratory therapist should do first.
a. Initiate oxygen at 4L/min by cannula
b. Record the results in the medical record
,3|Page
c. Obtain an arterial blood gas sample
d. Validate the Sp02 reading at a different site
Validate the Sp02 reading at a different site
Explain: The saturation may not be accurate and should be measured at a different
site.
A 47-year-old male with a BMI of 50 kg/m is undergoing a sleep study with
titration of CPAP. The patient's baseline AHI is 59. At a CPAP level of 7 cm H20,
the AHI is 9. A respiratory therapist should recommend
a. Maintain the current level of CPAP
b. Decreasing the CPAP
c. Increasing the CPAP
d. Changing to bilevel PAP
Increasing the CPAP
Explain: The goal of CPAP intervention is to completely eliminate apnea and
hypopnea episodes, standard protocol is to incrementally increase the CPAP level
until this occurs.
An arterial puncture has been performed to obtain blood for analysis of 02, C02,
and pH. What is the best way to manage the blood sample?
a. Warm the sample to keep it at body temperature
b. Place it into a mix of ice and water
c. Let the blood naturally cool to room temperature
d. Shake the sample to hemolyze the blood
Place it into a mix of ice and water
, 4|Page
Explain: Placing the blood sample into ice water will prevent the blood from
consuming the O2 within the sample.
A 26-year-old patient who weighs 80 kg (171 lb) received injuries in a motor
vehicle crash. The patient was intubated with a 6.0-mm ID endotracheal tube and is
receiving volume-controlled ventilation. Twenty-four hours later, the patient has
clear breath sounds but cannot tolerate weaning the mandatory rate below 8 in the
SIMV mode with 15 cm H20 pressure support. The respiratory therapist should
recommend.
a. Increasing the peak inspiratory flow
b. Raising the VT
c. Setting the mandatory rate to 10
d. Reintubating with a larger endotracheal tube
Reintubating with a larger endotracheal tube
Explain: The small endotracheal tube compromises spontaneous breathing because
of increased airways resistance. This can be resolved only by a larger tube or
extubation.
During nasotracheal suctioning, a patient exhibits a gag reflex but doesn't cough.
Watery secretions are aspirated through the catheter. Which of the following
should the respiratory therapist do next?
a. Insert an oropharyngeal airway and repeat the procedure
b. Hyperextend the patient's next when passing the catheter
c. Ask the patient to swallow while passing the catheter
d. Increase the suction pressure and repeat the procedure
Hyperextend the patient's next when passing the catheter
