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TMC 2019 NBRC Qs
| Question | Answer |
|---|---|
| Dullness to percussion, decreased tactile fremitus and diminished breath sounds are associated with | Pleural Effusion |
| What is associated with an optimally exposed chest radiograph? | Vertebrae and lung markings are clearly visible. |
| The use of respiratory accessory muscles is frequently the result of | Airway resistance |
| Drug dosage calculation | Change % to decimal. Divide desired dosage by the actual concentration. Ex: desires 1mg / .4mg/ml = 2.5mL |
| A pulsoximeter cannot provide an accurate indication of the oxyhemoglobin saturation in what clinical condition | Carbon monoxide poisoning Explanation: carbon monoxide poisoning will result in carboxyhemoglobin. Standard pulse oximetry is unable to distinguish their differences resulting in high SpO2 readings. |
| Portable ventilators for pt. Transport within the hospital should have the ability to | Sound a disconnect alarm |
| A patient that states they feel they can breathe better when they sleep sitting in a chair is indicative of | Orthopnea Likely related to CHF Orthopnea is dyspnea that occurs when a patient supine |
| This determines a persons rapid-shallow breathing index | Vane Respirometer RSB Index is calculated using the formula: RR/(minute volume)(RR) the vane respirometer determines the minute volume |
| What may be suspected in a trauma patient with multiple fractures to multiple adjacent ribs | Flail chest -During Inspiration, muscled move the chest wall out and the decreased intrapleural pressure pulls in the flail segment creating a paradoxical movement. |
| Absent airflow without chest or abdominal movement indicates what | Central sleep apneas. BiPAP is indicated to provide pressure support augmenting ventilation. |
| Which mask should be used to deliver 70% helium 30% oxygen effectively | Non rebreather |
| What is used to assess the severity of CO poisoning? | Hemoximetry |
| Evaluation of Lung Infiltrates requires further diagnostic studies like | Flexible Bronchoscopy |
| This is a mucolytic that may cause irritation and bronchospasm | N - acetylcysteine |
| This drug is an anticholinergic and provides minimal bronchospasm relief | Ipatropium Bromide |
| This drug is a beta2-agonist and is an appropriate substitute for Albuterol | Levalbuterol |
| A decrease in plateau pressures represents | Improvement in lung compliance |
| An increasing difference between peak and plat pressures indicates | An increase in airway resistance. |
| Pale or blue color, absent HR, no reflex irritability, limp muscle tone and absent respirations indicates what APGAR score? | 0 for each section |
| Baby is pink, HR >100, cry cough sneezing, active, strong cry indicates are related to APGAR scores of | 2 for dad he section |
| Color shows acrocyanosis, HR <100, grimace, some flexion, slow or irregular respirations is APGAR scoring of | 1 for each section |
| FVC and FEV1 May be obtained from a | Forced expiratory spirogram |
| Exacerbation of asthma associated with respiratory distress is best treated with | Continuous albuterol nebulizer |
| Cores crackles over both lung fields indicates | Secretions Secretions produce low pitched discontinuous lung sounds |
| Subcutaneous emphysema is demonstrated by the presence of | Crepitus During chest wall palpation |
| Wheezing sound from narrowed airways | Bronchospasm |
| When in proper position, the tip of the CVP catheter should be in the | lower portion of the superior vena cava. |
| The patient's condition continues to deteriorate, based on increased oxygen requirements and an elevated PaCO2, indicating | NIV or need for assisted ventilation |
| A patient with a history of chronic bronchitis complains of SOB following thoracic surgery. The patient is receiving 30% O2. Rhonchi in the right lower lobe are heard. What therapy is recommended? | Vibratory PEP Deep breathing accompanied by PEP therapy will provide optimal bronchial hygiene to clear secretions |
| Initiation of an expiratory hold just prior to the next ventilator-delivered breath facilitates the measurement of | auto-PEEP Auto-PEEP is measured by subtracting set PEEP from the measured pressure during an expiratory hold. |
| A 65-year-old patient who is post-CABG was extubated 4 hours ago and complains of increasing shortness of breath. Breath sounds are decreased over the right lung field. Wh at should be recommended NEXT? | chest radiograph |
| Patient is diaphoretic and has a pulse of 120 and an SpO2 of 81% with a 28% tracheostomy collar. The therapist is unable to pass a suction catheter. Which of the following should the therapist do FIRST? | Replace the tracheostomy tube. Unable to pass catheter is the key phrase here. Obstructed tube. |
| A decreasing cardiac output will result in | increasing oxygen extraction and an increased C(a-v̄)O2. |
| A previously healthy 30-year-old patient is hospitalized with chills and fever. A chest radiograph is consistent with right upper lobe pneumonia. What is most likely to aid in the patient's management? | Coughing and deep breathing |
| the most appropriate device to administer a controlled oxygen concentration for a patient with a variable respiratory pattern? | Venti Mask |
| Decreasing the peak pressure should result in a decreased | tidal volume and minute ventilation |
| most effective for destroying microorganisms on patient care equipment? | Autoclave Autoclaving uses super-heated steam under pressure and will kill almost all microorganisms. |
| There is no response to bronchodilator therapy. In this instance, in evaluation of a patient who is short of breath, further _____ is required | Further Lunch Measurments |
| the purpose of incentive spirometry after abdominal surgery | Prevent lung collapse The goals of incentive spirometry are to prevent and treat postoperative atelectasis |
| Capnography waveforms resembling shark fins indicates | Airway Obstruction The lack of a plateau and upward sloping shape of the curves demonstrate unequal distribution of inspired gas associated with obstruction |
| A patient with asthma is receiving a treatment with 2.5 mg of albuterol. During the treatment, the patient's heart rate increases from 80 to 138. A respiratory therapist should | Decrease dosage of albuterol as HR increase is likely secondarily related |
| After extubation, marked stridor, labored breathing, intercostal retractions, and an SpO2 of 85% is observed. Aerosolized racemic epinephrine has been delivered without benefit. Which of the following should the therapist recommend | reintubation |
| VT x RR = | Minute Ventilation |
| A patient who is receiving mechanical ventilation is scheduled for a fiberoptic bronchoscopy. Which of the following is the primary threat to adequate ventilation during the procedure? | Airway obstruction Scope may obstruct the tube |
| While administering an IPV treatment at 20 cm H2O to a patient with cystic fibrosis, a respiratory therapist notes the patient has suddenly become very short of breath and cyanotic. The therapist's most appropriate action is to | Terminate the therapy |
| There is no indication for NPPV for a patient in a | Compensated Respiratory Acidosis |
| While counseling a patient during a smoking cessation session, the patient expresses concern about weight gain. A respiratory therapist should address the patient's concern by explaining that this is partially the result of | Decreased Metabolism |
| An elevated pulmonary capillary wedge pressure is an indicator of | Left heart failure caused by edema treat with diuretics |
| Normal (PCWP) Pulm Cap Wedge Pressure | 12 to 16 |
| Where is the radial artery located | The Wrist "rad wrist" |
| Where is the brachial artery located | Inside arm "Brach your arm" |
| The right radial artery should not be punctured when there is insufficient collateral circulation through the | ulnar artery |
| side effect of inhaled nitric oxide | methemoglobinemia |
| the maximum flow during a forced exhalation. | Peak Flow |
| "Bird-beak" patterns are a result of hyperinflation. Decreasing what, will decrease the tidal volume and correct the hyperinflation | Inspiratory also known as Peak pressure |
| The best way to check the accuracy of a spirometer is to use a | 3mL syringe |
| A wait of a few minutes should be expected after application of a transcutaneous electrode before values stabilize. This is associated with | capillary dilatation |
| For a patient receiving noninvasive ventilation through a dual-limb circuit, an increase in what, will most likely reduce the respiratory effort associated with spontaneous breathing? | Pressure Support |
| Pv̄O2 values below this number are too low and related to the need for cardiac output measurement | 35 |
| Medication used to treat apneic conditions and indicates the need for home apnea monitoring in infants | caffeine citrate daily |
| most common side effect of aerosolized albuterol | Tremor |
| Critical infection control step in the home setting | handwashing |
| The treatment for carbon monoxide poisoning is high concentration of oxygen (close as possible to 100%) administered with | nonrebreather mask |
| The most commonly used bedside measurement to monitor the progression of ventilatory impairment in a patient with Guillain-Barré syndrome is | vital capacity |
| A patient complains of a productive cough that started approximately four months ago. The patient most likely has | bronchitis Bronchitis is characterized by cough and sputum production. While pneumonia is similar it is often not chronic. |
| able to directly measure various forms of hemoglobin saturation, including oxyhemoglobin, carboxyhemoglobin, and methemoglobin | hemoximeter |
| Based on an oxyhemoglobin disassociation curve, an SpO2 of 90% with a normal pH is approximately a PaO2 of | 60 |
| A patient is suspected of having an upper airway obstruction. Which test should a respiratory therapist recommend to detect this abnormality | flow volume loop |
| While testing the proper function of a flow-inflating bag, the bag does not fully inflate with occlusion of the patient connector. Which of the following may be the cause of the problem? | open flow control valve |
| Three liters of air are injected into a spirometer from a certified-volume standard syringe. The measured value is 2.6 L. Which of the following should a respiratory therapist conclude? | Leak Difference of 400mL in this instance indicating outside acceptable calibration range |
| History of nasal stuffiness, episodes of daytime dyspnea, and a cough that occurs every summer. Which of the following drug classifications should a respiratory therapist recommend to control the patient's symptoms? | leukotriene inhibitor like montelukast known as Singulair |
| Low PCWP and CVP coupled with a low urine output is characteristic of | Hypovolemia |
| The patient is exhibiting refractory wheezing., diminished breath sounds after the multiple treatments, indicating worsening obstruction, what should be done | increased dosage continuous nebulized bronchodilator therapy |
| The flow-volume loop obtained after bronchodilator administration demonstrates a significant improvement in expiratory flow. What should be recommended? | inhaled bronchodilator therapy |
| A patient was diagnosed with bronchiectasis 3 years ago. The patient reports increased cough and difficulty clearing secretions for the past 4 weeks. A chest radiograph shows cavitary disease. What is recommended? | airway clearance therapy |
| At the beginning of exhalation, the sharp rise in exhaled CO2 on a capnographic tracing represents | washout of dead space |
| A fast-acting beta2-agonist is the appropriate treatment for | acute bronchospasm |
| Which of the following is the most effective aerosolized bronchodilator for a patient with an acute asthma exacerbation | albuterol |
| mechanically ventilated patient developed auto-PEEP. What ventilator settings change should take place | Decrease the rate thereby increasing the expiratory time which in turn decreases air trapping |
| Static Compliance formula | Vt / PEEP (Pplat - PEEP) |
| severe obstructive lung disease is characterized by an FEV1/FVC less than | 70% predicted |
| severe obstructive lung disease is characterized by an FEV1/FVC less than 70% and an FEV1 of | 30 to 50% predicted |
| If a patient becomes tachycardic during albuterol treatment, what drug should be recommended next treatment? | Levalbuterol Xopenex |
| What medication should be used to anesthetize a patient's airway prior to a flexible bronchoscopy procedure? | lidocaine HCl Xylocaine |
| Ventilated pt. has a steady increase in the peak inspiratory pressure over a 12-hour shift. The patient has developed a fever and purulent pulmonary secretions. Which of the following should a respiratory therapist recommend FIRST? | Obtain a sputum Gram stain |
| SBT with a T-piece have been initiated for 4 weeks. With each trial, the patient becomes agitated, dyspneic, and tachypneic, and must be returned to the ventilator. Which of the following should the respiratory therapist recommend? | Pressure Support |
| A premature neonate with RDS receives the first dose of surfactant replacement therapy. Two hours later, FIO2 requirements have increased from 0.35 to 0.70. Which of the following should a respiratory therapist recommend FIRST? | chest radiograph Increase in O2 requirements and the recent administration of surfactant, chest radiograph will help determine the cause of deterioration. |
| Which of the following should be recommended to determine the site of bleeding in a patient with hemoptysis? | bronchoscopy |
| Monitoring serum electrolytes is indicated in patients who are receiving | diuretics |
| For a spontaneously breathing patient, which of the following will provide an elevated baseline pressure during inspiration and expiration? | CPAP |
| After obtaining an arterial blood gas sample, a respiratory therapist should handle the sample by | removing all air from the syringe |
| A gas is saturated with 100% relative humidity at 32.2º C (90º F). As the gas cools to 26.7º C (80º F), the relative humidity will | remain 100% and excess water will rain out |
| Administering dornase alfa Pulmozyme, a patient is developing marked congestion with copious sputum production. The most appropriate action is to pause the treatment and | allow the patient to clear secretions |
| HR 142, RR 24 and BP 78/55 mm Hg. Examining the patient's chest, a respiratory therapist notes an absence of breath sounds in the left chest with a hyperresonant percussion note. What should be done? | Insert a 14-gauge needle in the left chest |
| Hypotension is an adverse effect of | PEEP |
| An increase in the difference between PIP - plateau pressure is | indicative of increased airways resistance |
| During nasotracheal suctioning, a patient exhibits a gag reflex but does not cough. Watery secretions are aspirated through the catheter. Which of the following should a respiratory therapist do before repeating the procedure? | Sniffing position |
| What score is used to determine a neonate's gestational age? | Ballard |
| A respiratory therapist is calibrating a helium analyzer. What should the analyzer read when calibrated in air? | Air contains essentially no helium; therefore, it should read zero |
| What drug is appropriate for the sedation of a 30-year-old patient with status asthmaticus and hypotension who is receiving mechanical ventilation? | lorazepam Ativan |
| The standard frequency for dosing of inhaled tiotropium (Spiriva) is every | 24hrs |
| A right-sided pneumothorax will result in diminished breath sounds on the right and possibly a tracheal shift to the | left |
| Total flow = | air to oxygen entrainment factor X set liter flow to the device |
| A respiratory therapist is asked to position a patient for orotracheal intubation. The therapist should place the patient's head | in the sniffing position |
| Changes in the level of the bed relative to the transducer will make both systolic and diastolic pressures move | same direction |
| drug is most appropriate to paralyze a sedated patient in status asthmaticus who is receiving mechanical ventilation | rocuronium bromide Zemuron |
| What should be done for patient with facial burns, oropharynx edema indicating upper airway burns and the potential for worsening edema and airway obstruction | Intubation |
| Moderate stridor with retractions is noted immediately after extubation of a patient. A respiratory therapist should recommend | nebulized racemic epinephrine |
| Peak expiratory flow measurements are indicated for the measurement of | airways obstruction and asthma |
| A patient's VQ scan indicates an excess of ventilation compared to perfusion in the left lower lobe. These results suggest | pulmonary embolism |
| What classically presents as alveolar unit is normally ventilated, but pulmonary capillary blood flow is impeded causing poor perfusion | pulmonary embolism |
| characteristic during VC ventilation? | Inspiration ends after delivery of a preset volume |
Created by:
jgrisner
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