NBRC EXAM Part 1 REDUCED, Questions and answers. Reviewed. Latest 2022. Rated A+

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Is the following Static OR Dynamic Compliance: Means flow throughout the respiratory system has stopped and all ventilatory muscle activity is absent. _______ conditions can be imposed with an inspir... atory pause when a patient is sedated and mechanically ventilated. - ✔✔Static Compliance Is the following Static OR Dynamic Compliance: Flow at airway opening is zero. Mechanics are evaluated under ______ conditions, when non-intubated patient breathes spontaneously. - ✔✔Dynamic Compliance A balloon tipped flow directed catheter is positioned in the pulmonary artery with the balloon deflated. Which of the following pressures will be measured by the proximal lumen: a. Cvp b. Pap c. Pwp d. Map - ✔✔ANSWER is A. Cvp = deflated/proximal lumen Pap = deflated/distal Pwp = inflated/wedged All of the following will affect the accuracy of a capnography EXCEPT a. Long sampling line b. Low sampling flow c. Condensation in the tubing d. Use of desiccant - ✔✔Gas will pass through and out of a long sampling line before reaching analyzer so, low sampling flow will not give you enough information for a good reading, and condensation as a rule is always a problem especially in analyzers. Dessicant removes moisture from the gas, which is a good thing, so ANSWER is D What should you recommend FIRST for a patient with multifocal pvc's a. Administration of lidocaine b. Administration of 100% oxygen c. Administration of atropine d. Administration of epinephrine - ✔✔Multiple pvc's coming from multiple locations (multifocal) is a real problem and you should administer oxygen FIRST, so ANSWER is B. lidocaine will help reduce irritability of heart and help with pvc's but would not be first option, atropine is used for bradycardia and cardiac irregularities but not pvc's, epinephrine is emergency drug not for pvc's but more for pulseless ventricular tachycardia or ventricular fibrilation where heart is not responding . What is the normal range for the mean pulmonary artery pressure in an adult a. 2-6 mm Hg b. 4-12 mmHg c. 9-18 mmHg d. 21-28 mmHg - ✔✔Mean pulmonary artery pressure in an adult should be in the teens so best ANSWER is C A patient in the emergency dept has frothy secretions, moist crackles, and tachypnea. The patient has marked dyspnea and a history of heart disease. Which of the following should the respiratory therapist recommend. 1.suction immediately 2.administer 100% oxygen 3.place in Fowlers position 4.administer furosemide - ✔✔This is an emergency, they are having heart problems, dyspnea, frothy secretions indicating severe pulmonary edema, etc. so 100% oxygen immediately, having the patient in the Fowlers position (an upright position) will help pull fluid down away from the lungs, furosemide is a lasix (loop diuretic) which gets rid of excess fluid. You do NOT suction someone with frothy secretions and heart problems, this just delays appropriate therapy. So ANSWER is 2,3,4 Which of the following will determine aortic pulse pressure. a. systolic + systolic + diastolic/3 b. diastolic + pulse pressure/3 c. systolic pressure - diastolic pressure d. stroke volume x heart rate x 10. - ✔✔Aortic pulse pressure is just the difference between systolic and diastolic pressure, so ANSWER is C What is the normal range for the pulmonary artery systolic pressure in an adult? A. 2-6 mm Hg B. 4-12 mm Hg C. 9-18 mm Hg D. 21-28 mm Hg - ✔✔The normal pressure is 25 mm Hg, so the ANSWER is D 21-28 mm Hg A multiple trauma victim with internal hemorrhage is being monitored via pulse oximetry. Which of the following conditions would affect the accuracy of her SpO2 readings? A. hypotension B. hyperoxia C. hypocarbia D. hyperthermia - ✔✔Since the SpO2 measures the color of the blood and the ability to shine a light through the blood, the only answer that would affect the accuracy of the SpO2 reading would be ANSWER A hypotension because hypotension causes less profusion (needed for the SpO2 reading) The respiratory therapist notices a dampened waveform on a pulmonary arterial line. The therapist's first action should be to A. attempt to draw blood from the line. B. check the transducer dome for air bubbles. C. flush the catheter with heparin solution. D. check the position of the transducer. - ✔✔Dampened wave form is when you aren't getting a nice sharp reading, you should get a clear systolic and diastolic pattern; the most common cause is a blood clot, flushing the catheter with heparin might push the blood clot into the lung at this point (not a good idea), another common cause of a dampened wave form is air bubbles in the transducer dome, so the ANSWER is B. A patient in the intensive care unit is suffering left heart failure. Which of the following drugs will increase the strength of contraction and improve cardiac output? A. digitalis B. atropine C. isuprel D. lidocaine - ✔✔Atropine is used for bradycardia and increases output but not strength, Isuprel treats bradycardia and output but not strength, Lidocaine reduces irritability of heart, but Digitalis is a cardiac glycoside that increases cardiac output and strengthens cardiac contraction, so ANSWER is A The respiratory therapist has been paged to the ICU to assist in the treatment of a 98 kg (215 lb) man. The patient is pale, diaphoretic, and suddenly loses consciousness. No palpable pulse or blood pressure is measured. The ECG monitor displays the following sinus bradycardia with a rate of 45): The respiratory therapist should: A. confirm the ECG in another lead. B. begin chest compressions. C. perform cardioversion. D. perform defibrillation. - ✔✔ECG is showing sinus bradycardia with a rate of 45, all this leads up to begin chest compressions, so ANSWER is B. Do not perform cardioversion or defribulation because there is no arrhythmia so we don't want to mess with anything electrical in the heart, just want to help it out mechanically. The respiratory therapist is assessing a patient's vital signs and notes that the pulse feels weak and thready. This would most likely be associated with which of the following conditions? A. Hypervolemia B. Shock C. Increased cardiac output D. Increased systemic vascular resistance - ✔✔A weak and thread pulse can be associated with conditions that decrease the blood pressure like shock or hypovalemia, so the ANSWER is B shock. A patient who recently underwent a total abdominal hysterectomy is complaining of chills and purulent sputum. Breath sounds reveal coarse rales and rhonchi. The results of the CBC indicate a WBC count of 19,000. The most likely diagnosis is that the patient has developed: A. atelectasis B. pneumonia C. hemothorax D. bacterial infection - ✔✔Bacterial infections cause purulent sputum which is increased WBC's; viral infections do not. It might be pneumonia, but we do not know without more information, so the best answer is D bacterial infection, After injecting a small amount of air into the balloon of a pulmonary artery catheter, the respiratory therapist sees a small amplitude change with the mean pressure reading 2 points below the PA end-diastolic pressure. Based upon this information, the therapist should conclude that A. there is pressure dampening. B. the transducer is placed too high. C. there is an obstruction in the catheter. D. this is a normal wedge tracing. - ✔✔A small amplitude change is normal and the mean pressure reading 2 points below the pulmonary artery end-diastolic pressure is also normal, so the ANSWER is D. Methacholine Challenge Test Tensilon Challenge Test - ✔✔Methacholine Challenge Test is a pulmonary function test used to check the reactivity of a patients airways, it will induce bronchospasm; Tensilon Challenge Test is specifically for Myasthenia Gravis, it helps them breath right away but only lasts a few minutes While assessing a patient's breath sounds the respiratory therapist notes that when the patient says "ninety-nine", it sounds very loud through the stethescope. This would be associated with which of the following conditions? A. Pneumothorax B. Pneumonia C. Pleural effusion D. Epiglottitis - ✔✔99 is a sound that produces vibrations in the lung, if 99 sounds very loud through the stethoscope you know consolidation is present, so the ANSWER is B. Pleural effusion you don't usually hear anything. A 47-year-old patient admitted for sepsis has a CaO2 value of 12.5 vol%. The patient does not appear cyanotic. Which of the following would be the most important to further evaluate the patient's oxygenation status? A. PaO2 B. SaO2 C. Hb D. PAO2 - ✔✔CaO2 IS best measurement of oxy delivered to the tissues, normal is 18-20%, this patient's is 12.5% which is low so patient is suffering from anemia (not enough oxy rich hemoglobin). So ANSWER is C. The respiratory therapist is called to the emergency department to evaluate a patient who was brought in via an ambulance due to a motor vehicle accident. The patient is cold and clammy with a blood pressure of 82/46 mm Hg. The ECG monitor shows sinus tachycardia with occasional PVC. Which of the following should the therapist evaluate at this time? A. Serum electrolytes B. Cardiac enzymes C. Hb and Hct levels D. 12 lead ECG - ✔✔Patient seems to be experiencing shock, serum electrolytes would be a good choice, cardiac enzymes would be good but very expensive, 12 lead ECG is another good test but more appropriate if we were mainly concerned with the heart; Hb and Hct most closely corresponds to shock because you know the patient was in an accident and probably had a lot of blood loss, so ANSWER is C Hb and Hct Which of the following drugs should the respiratory therapist recommend to lower a patient's blood pressure as well as decrease his ventricular afterload? A. Norepinephrine B. Propranolol C. Procainamide D. Sodium nitroprusside - ✔✔Norepinephrine will increase blood pressure and afterload; Propranolol will slow the heart down but doesn't do anything for the afterload; Procainamide is an antirhythmic agent; Sodium Nitroprusside is a vasodilator, which will reduce blood pressure and decrease the afterload. A 40-year-old patient who smokes 2 packs of cigarettes per day has a carboxyhemoglobin level of 6.4%. These results are most consistent with A. Severe COPD B. History of dyspnea on exertion C. Need for supplemental oxygen D. Expected level for this patient - ✔✔Nothing about COPD will give you a carboxyhemoglobin level of 6.4%; 6.4% is a typical level for a heavy smoker so ANSWER is D, Expected level for this patient. A 43-week gestational age infant has just been delivered and is stained with meconium. The physician has asked that the baby be intubated and suctioned immediately. The respiratory therapist should recommend intubating the baby with which of the following size endotracheal tubes? A. 2.0 mm B. 2.5 mm C. 3.0 mm D. 4.0 mm - ✔✔This baby is post-term (by 3 weeks) so the baby probably weighs about 3,000 grams at full term so you can go a full-size airway at 3.0mm ANSWER is C, 3.0 mm. You wouldn't use a 4.0mm until the baby is about 1 year old. A patient being mechanically ventilated requires endotracheal suctioning. The patient is on high levels of PEEP therapy and has periods of hypotension. The respiratory therapist hyperoxygenates the patient before beginning the procedure. As the therapist disconnects the patient from the ventilator circuit, the following pattern is seen on the ECG monitor: Which of the following could be the cause of this patient's ECG pattern? Bradycardia rythm A. loss of PEEP B. inadequate hyperoxygenation time C. vagus nerve stimulation D. normal response to suctioning - ✔✔Answer is A, Loss of PEEP A patient is diagnosed with a necrotizing pulmonary fistula in the right lung. The physician has requested that the right lung be ventilated at a pressure 10 cmH2O lower than the left lung. The respiratory therapist should recommend providing this type of ventilation via a: A. Transtracheal catheter device B. Double-lumen endobronchial tube C. Cricothyroidotomy D. 14 gauge endotracheal catheter - ✔✔The physician wants independent lung ventilation (you would need two ventilators to do this); and with a double-lumen endobronchial tube, one lumen will go to the right lung and one would go to the left, so the ANSWER is B. While performing orotracheal intubation for a patient in respiratory arrest, the respiratory therapist notices that the stylet has advanced from its original position. The respiratory therapist should A. continue with the intubation procedure. B. stop the procedure, manually ventilate the patient, and reposition the stylet. C. retract the stylet immediately. D. remove the stylet and continue with the procedure. - ✔✔Retract stylet immediately...this answer just stops. But ANSWER B, stop procedure, manually ventilate the patient, and reposition the sytlet is the best "complete" answer. Which of the following is the best method to minimize damage to the tracheal wall caused by an endotracheal tube cuff? A. Measuring the volume used to inflate the cuff B. Palpating the inflation of the pilot balloon C. Utilizing a cuff pressure manometer D. Using minimal occluding volume to seal the airway - ✔✔Using minimal occluding volume to seal the airway is an older standard (may be used in practice but not for this test), so, ANSWER is C, Utilizing a cuff pressure manometer. An H cylinder of oxygen has 1200 psi remaining in the tank. How long will it take to decrease to 200 psi if the flow is 5 LPM? A. 1 hour B. 10 hours C. 60 hours D. 600 hours - ✔✔An "H" cylinder has 1200 psi minus 200 psi = how long to use 1000 psi at 5 lpm. Take 1000 x 3.14 (tank factor) = 3000 liters / 5 lpm = 600 min. / 60 min. = 10 hours, so ANSWER is B, 10 hours An air flowmeter and an oxygen flowmeter are being used to deliver 40% oxygen to a patient via a non-rebreathing mask. A total flow of 12 LPM is required to prevent the non-rebreathing bag from deflating. How many liters of air and how many liters of oxygen should the therapist use? A. 2 LPM air, 6 LPM oxygen B. 4 LPM air, 8 LPM oxygen C. 6 LPM air, 6 LPM oxygen D. 9 LPM air, 3 LPM oxygen - ✔✔air flowmeter and oxygen flowmeter must equal 12 lpm, with 40% oxygen, so air must be 60%; this is a ratio of 3 to 1 (this is a common ratio), so ANSWER is D 9 lpm air, 3 lpm oxygen (which is 3 to 1) A 26-week gestational age infant requires intensive monitoring and care in the NICU. Which device would be most appropriate for maintaining a neutral thermal environment for this infant? A. radiant warmer B. isolette C. croupette D. bassinet - ✔✔Both the isolette and the radiant warmer can be neutral thermal environments. The key to this question, making one better than the other, is access to the patient since this baby requires continuous monitoring. Supposedly, the radiant warmer provides better access to the baby than the isolette. Which of the following formulas will calculate the number of hours an E cylinder will provide oxygen to a patient? A. tank pressure (PSI) x 0.3 / flowrate (LPM) B. flowrate (LPM) x 0.3 / tank pressure (PSI) C. [tank pressure (PSI) x 0.3 / flowrate (LPM)] / 60 D. [flowrate (LPM) x 0.3 / tank pressure (PSI)] / 60 - ✔✔Question 2 of 15 - psi x 0.3 / flowrate / 60 (to give you the hours) A patient is receiving IPPB by mouthpiece. The therapist notes that the machine fails to cycle into the expiratory phase. The respiratory therapist should A. increase the flow. B. decrease the sensitivity. C. adjust the apnea timer. D. increase the pressure. - ✔✔IPPB machines are pressure cycled and have to reach a preset pressure to turn off inspiration and go into the expiratory phase. Two reasons a machine would not reach a preset pressure, 1) there is a leak, 2) not enough flow, so ANSWER is A, increase the flow. Decreasing sensitivity only controls the machine turning on; and don't increase pressure because the machine would have to reach an even higher preset pressure to go into the expiratory phase. What total flow is delivered to a patient if the air entrainment mask is set at 35% oxygen and the flowmeter is set at 6 L/min? A. 20 - 25 L/min [Show More]

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