NBRC TMC Practice Questions Latest Update 2024-2025 Exam 450 Questions and 100% Verified Correct Answers Guaranteed A+
A 'flat' sound is heard when performing diagnostic chest percussion. This sound is most closely associated with
- empty, air-filled space.
- fatty tissue.
- bone.
D. consolidation. - CORRECT ANSWER: C.
A 'flat' sound is heard when percussing over bone.
A 12-year-old patient diagnosed with bronchiectasis is receiving postural drainage and percussion to drain the basal segments of the right lung. While draining with the head of the bed down 30 degrees, the patient begins to exhibit signs of distress including frequent PVCs and a decrease in oxygen saturation. After discontinuing the therapy, the respiratory therapist should recommend
- Provide percussion with the bed flat
- Provide percussion with the head of bed up in semi-fowlers position
- Placing head of bed down only 15 degrees
- Administering therapy with an external percussive device (Vest) - CORRECT
ANSWER: D.
Because this patient is having difficulty tolerating the head of bed and down during postural drainage and percussion, the therapy should be modified. When modifying therapy, one must be careful not to dysfunctionalize the therapy. For example, simply raising the head of bed and continuing therapy would not be appropriate because the head of bed must be down 30° to drain the basal segments. Rather, a more appropriate modification of therapy would be to use an alternate therapy that accomplishes the same objective. In this case, using an external percussive device, such as Vest therapy, is most appropriate.
A 12-year-old patient who has no known allergies seems to experience increased asthma exacerbations during stressful times at school. This is most closely associated
with:
- Intrinsic asthma
- Allergic asthma
- Extrinsic asthma
D. Childhood asthma - CORRECT ANSWER: A.
Asthma that is not caused by exposure to the environment, but, rather, by internal feelings and stress, is to be considered to be intrinsic
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A 12-year-old patient with asthma is taking Albuterol by MDI to treat bronchoconstriction. Additionally, the patient is taking Beclovent (beclomethasone). The Belcovent will serve which of the following purposes?
- to prevent the release of histamines
- as a controller medication
- as a systemic steroid
D. as a short-term bronchodilator - CORRECT ANSWER: B.
Beclovent is a corticosteroid (not a systemic steroid) that is used as a long-term controller medication. It works by continuously abating inflammation.
A 132-kg, 168-cm female who underwent a tracheotomy 2 weeks ago remains in the ICU receiving VC ventilation. After the patient is repositioned in the bed, the ventilator high-pressure alarm sounds with each breath. The suction catheter can be passed only 10 cm into the tracheostomy tube and no secretions are evident. SpO2 is 80%. Which of the following should a respiratory therapist do first?
- Recommend a chest x-ray
- Initiate bag-mask ventilation
- Remove the tracheostomy tube
D. Evaluate cuff pressure - CORRECT ANSWER: C.
A 14-year-old female patient with status asthmaticus has persistent tachycardia while receiving 70%/30% helium-oxygen therapy by nonrebreather mask while the oxygen flow meter indicates a flow of 10 L/min. The respiratory therapist should
- increase the flow rate to 12 L/min.
- utilize a heliox-calibrated flow meter.
- switch to a 60%/40% heliox mixture.
D. discontinue heliox. - CORRECT ANSWER: C.
Persistent tachycardia is evidence of hypoxemia. To increase oxygen delivery, while maintaining decreased airway resistance, 60%/40% heliox is appropriate. This change will increase FIO2.
A 15-year-old patient with muscular dystrophy and pneumonia continue having difficulty expectorating secretions. Which of the following would provide most assistance with bronchial hygiene?
- postural drainage and percussion
- huff coughing
- vibratory PEP therapy
D. IPPV - CORRECT ANSWER: D.
The problem with muscular dystrophy is that the patient may have significant difficulty inspiring enough tidal volume to then generate a forceful exhalation and an effective cough. This can be assisted with IPPV, which will help increase inspired volume and increase the effectiveness of a cough.
A 150-lb (68-kg), 5-ft 6-in (168 cm) female patient is receiving mechanical ventilation as
follows: 2 / 4
Mode Assist/control Alveolar minute ventilation 7.5 L/minTotal Rate 15PB 734 mm Hg What is the patient's set tidal volume?
- 700 mL
- 550 mL
- 500 mL
D. 350 mL - CORRECT ANSWER: C.
Tidal volume is calculated by dividing the minute ventilation by the respiratory rate. By knowing any two of these three data, one can calculate the third. For example, to calculate minute ventilation, multiply the tidal volume by the respiratory rate. To calculate respiratory rate, divide minute ventilation by tidal volume.
A 16-year-old child is admitted to the emergency room with a medical history of asthma.The physician has ordered a rescue bronchodilator to address bronchoconstriction.Which of the following medications should the respiratory therapist recommend to address issues with airway inflammation?
- Prednisone
- Xopenex
- Atrovent
D. Pirbuterol - CORRECT ANSWER: A.
There are three components to asthma. The first is bronchoconstriction, which should be resolved through bronchodilator medication. The second is inflammation, which should be addressed through anti-inflammatory medication. The third is secretions, which should be addressed by therapies that mobilize and remove secretions. Of the options offered, the administration of prednisone is most helpful at decreasing inflammation of airways
A 173-cm (5 ft, 8 in), 64-kg (141-lb) female is receiving VC, A/C ventilation on the
following settings:
FIO2 0.60 PEEP 18 cm H2Of 14/minVT 550 mL
Laboratory data shows:
pH 7.36 PaCO2 45 torrPaO2 58 torrHCO3- 23 mEq/LBE -2 mEq/LSAO2 88%mPAP 25 mm HgCVP 5 mm HgPCWP 17 mm HgC.I. 1.8 L/min/m2
The respiratory therapist should first
- increase FIO2 to 1.0.
- administer Dopamine, IV.
- flush the PA catheter.
D. decrease PEEP. - CORRECT ANSWER: D.
Although the patient is obviously hypoxic and further increase in PEEP would be normally appropriate, in this case, an increase in PEEP would cause further degradation in the hemodynamic status of the patient. The current hemodynamic values show that 3 / 4
cardiac index is less than 2 - 4 L/min/m2, suggesting that the current PEEP level is excessive and should be lowered. Although this will cause a further problem with hypoxemia, reduced cardiac output should be addressed first.
A 173-cm (5-ft 8-in), 65-kg (143-lb) male is receiving PC, A/C ventilation on the
following settings:
PEEP 15 cm H2O Set inspiratory pressure 22 cm H2OMandatory rate 16Total rate 16FIO2 0.50I:E 1:3VT (exhaled) 725 mL
ABG are as follows:
pH 7.54 PaCO2 25 torrPaO2 108 torrHCO3- 22 mEq/LBE +1 mEq/L
A respiratory therapist should recommend a decrease in which of the following?
- inspiratory pressure
- mandatory rate
C. I:E
D. PEEP - CORRECT ANSWER: A.
Examination of this blood gas reveals a key finding consistent with hypocapnia, or decreased arterial CO2. This is suggestive of hyperventilation. Because this patient is receiving pressure control ventilation, the key method required to decrease arterial CO2 is to lower inspiratory pressure.
A 180-cm (5 ft, 11 in), 75-kg (165-lb) male is receiving VC, A/C ventilation on the
following settings:
FIO2 0.60 PEEP 16 cm H2Of 16/minVT 700 mL
Laboratory data shows:
pH 7.36 PaCO2 44 torrPaO2 57 torrHCO3- 24 mEq/LBE -1 mEq/LSAO2 87%mPAP 24 mm HgCVP 4 mm HgPCWP 18 mm HgCO 3.4 L/min
The respiratory therapist should
- increase FIO2 to 1.0.
- administer prostacyclin, IV.
- increase PEEP to 18 cm H2O.
D. start iNO therapy. - CORRECT ANSWER: A.
Although the patient is obviously hypoxic and further increase in PEEP would be normally appropriate, in this case, an increase in PEEP would cause further degradation in the hemodynamic status of the patient and therefore should be avoided. The current hemodynamic values show that cardiac output is less than 4 - 8 L/min. Although a best
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