NBRC Mock TMC Exam Review 2022/2023

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A patient is receiving O2 from an E cylinder at 4 L/min through a nasal cannula. The cylinder pressure is 1900 psig. How long will the cylinder run until it is empty? A. 47 min B. 1.7 h C. 2.2 h ... D. 3.6 h - ANSWER E cylinder = 0.28 1900x0.28/4 = 133/60 = 2.21 Answer: C. 2 hours, 21 minutes After the Respiratory Therapist sets up a nonrebreathing mask on a patient at a flow rate of 10 L/min, the reservoir bag collapses before the patient finishes inspiring. The RT should do which of the following? A. Change to a simple mask at a flow rate of 10 L/min B. Remove the one-way valve from the exhalation port. C. Place the patient on continuous positive airway pressure (CPAP) D. Increase the flow rate to 15 L/min - ANSWER D. Increase the flow rate to 15 L/min A patient with carbon monoxide (CO) poisoning can best be treated with which of the following therapies? A. Nasal Cannula at 6 L/min B. Simple O2 mask at 10 L/min C. CPAP and 60% O2 D. Nonrebreathing mask - ANSWER D. Nonrebreathing mask The following blood gas levels have been obtained from a patient using a 60% aerosol mask. pH: 7.47 PaCO2: 31 mmHg PaO2: 58 mmHg What should the RT recommend at this time? A. Place the patient on CPAP B. Increase the O2 to 70% C. Intubate and place the patient on mechanical ventilation D. Change to a nonrebreathing mask - ANSWER A. Place the patient on CPAP Given the following data, what is the patient's total arterial O2 content? pH: 7.41 PaCO2: 37 mmHg PaO2: 88 mmHg HCO3: 26 mEq/L SaO2: 95% Hb: 14 g/dL A. 12 mL/dL B. 14 mL/dL C. 16 mL/dL D. 18 mL/dL - ANSWER (Hb x 1.36 x SaO2) + (0.003 x PaO2) (14 x 1.36 x 0.95) + (0.003 x 88) 18.088 + 0.264 = 18.352 Answer: D. 18 mL/dL The respiratory therapist receives an order to set up a moderate level of O2 on a patient who arrives in the ED breathing at a rate of 35 breaths/min. Which of the following O2 delivery devices is most appropriate to use in this situation? A. Simple O2 mask at 10 L/min B. Nasal cannula at 4 L/min C. NRB Mask at 15 L/min D. Air-entrainment mask at 40% O2 - ANSWER D. Air-entrainment mask at 40% O2 A severe COPD patient arrives in the emergency department on a 2 L/min nasal cannula. Arterial blood gas results follow: pH: 7.32 PaCO2: 67 mmHg PaO2: 62 mmHg HCO3: 38 mEq/L Which of the following is the most appropriate recommendation? A. Increase the liter flow to 4 L/min B. Maintain the current O2 level C. Institute noninvasive positive pressure ventilation (NPPV) D. Place on a NRB mask at 12 L/min - ANSWER B. Maintain the current O2 level The physician has ordered O2 to be set up on a patient who has a spontaneous tidal volume of 500 mL and an inspiratory time of 1 second. Which of the following O2 delivery devices will deliver a flow that meets or exceeds this patient's inspiratory flow? A. 35% air-entrainment mask at 6 L/min B. 60% aerosol mask at 12 L/min C. NRB mask at 15 L/min D. Simple O2 mask at 10 L/min - ANSWER 500 mL = 0.5 L 0.5/1 = 0.5 L/s (change L/s to ?/min by multiplying by 60 0.5 L x 60= 30 L/min Select the device that delivers a flow of at least 30L/min A. 35% air-entrainment mask at 6 L/min A patient breathing 50% oxygen has a PaO2 of 248 torr. Which of the following should the RT recommend? A. Discontinue O2 therapy B. Decrease the oxygen to 30% C. Titrate oxygen to maintain an SpO2 > 93% D. Repeat the blood gases because the PaO2 is not possible on this FiO2. - ANSWER C. Titrate oxygen to maintain an SpO2 > 93% Explanation: A PaO2 of 250 torr is normal on 50% O2. Remember, to determine the normal PaO2 on any given O2%, multiply the O2% by 5. This is an approximation. If titrate was not a choice, then you would discontinue the oxygen. A patient is receiving 30% oxygen via an air-entrainment mask at a flow of 5 L/min. The total flow delivered by this device is which of the following? A. 36 L/min B. 45 L/min C. 54 L/min D. 60 L/min - ANSWER (*Use 21 with O2 % less than 40%) (100- 30%)/ (30%-*21) = 70/9 = 8/1 or 8:1 ratio 8+1= 9 9x5 = 45 L/min B. 45 L/min Secretions tend to become thicker if the inspired air has which of the following characteristics? A. A relative humidity of 100% at body temperature B. 32 mg H2O per liter of gas C. A water vapor pressure of 47 mmHg D. 48 mg H2O per liter of gas - ANSWER B. 32 mg H2O per liter of gas A patient receiving 38 mg H2O per liter of gas from a nebulizer has a humidity deficit of which of the following? A. 6 mg/L B. 9 mg/L C. 12 mg/L D. 18 mg/L - ANSWER 44-38= 6 A. 6 mg/L After connecting a nasal cannula to the humidifier outlet, you kink the tubing and hear a whistling noise coming from the humidifier. Which of the following most likely has caused this? A. The humidifier jar is cracked B. The capillary tube in the humidifier is disconnected C. The humidifier has no leaks D. The top of the humidifier is not screwed on tightly - ANSWER C. The humidifier has no leaks You notice that the patient's secretions have become thicker and more difficult to suction since the ventilator humidifier was replaced with an HME. The RT should recommend which of the following? A. Increase inspiratory flow B. Decrease the temperature to the HME C. Replace with a new HME D. Replace the HME with a conventional heated humidifier - ANSWER D. Replace the HME with a conventional heated humidifier Which of the following are indications for cool, bland aerosol therapy? 1. A cough must be induced for sputum collection 2. Mobilization of secretions must be improved 3. Postextubation inflammation of the upper airway must be treated A. 1 only B. 1 and 3 only C. 2 and 3 only D. 1, 2, and 3 - ANSWER D. 1, 2, and 3 You notice that very little mist is being produced by a nebulizer attached to an aerosol mask. Which of the following could be responsible for this? 1. The liter flow is too high 2. The nebulizer jet is clogged with lint 3. The filter on the capillary tube is obstructed A. 1 only B. 2 only C. 1 and 3 only D. 2 and 3 only - ANSWER D. 2 and 3 only An autoimmune compromised patient is to be placed on oxygen with a humidity/aerosol device. Which of the following devices is most likely to deliver contaminated water to the patient? A. Heated cascade humidifier B. Bubble humidifier C. Heated wick humidifier D. Heated jet nebulizer - ANSWER D. Heated jet nebulizer To minimize an increased airway resistance produced by high-density aerosol inhalation, the RT should recommend which of the following? A. Administer a bronchodilator along with the aerosol B. Instruct the patient to breathe through the nose C. Use a heated nebulizer to deliver the aerosol D. Perform chest physiotherapy after the aerosol treatment - ANSWER A. Administer a bronchodilator along with the aerosol The RT is asked to recommend a humidifier that will be able to provide the highest water vapor content to the patient's airway. Which of the following humidifiers should the therapist select? A. Pass-over B. HME C. Heated wick D. Bubble - ANSWER C. Heated wick A heated humidifier is delivering 100% body humidity to a patient's airway. What volume of water is being delivered? A. 24 mg/L B. 37 mg/L C. 44 mg/L D. 47 mg/L - ANSWER C. 44 mg/L A patient is experiencing cardiac arrhythmias and muscle weakness. An arterial blood gas determines that the patient is in metabolic alkalosis. Which of the following is the most appropriate lab value to assess at this time? A. WBC B. BUN C. Plasma protein D. Potassium - ANSWER D. Potassium The term used to describe a condition is which a patient has difficulty breathing while in the supine position is which of the following? A. Orthopnea B. Hypopnea C. Eupnea D. Bradypnea - ANSWER A. Orthopnea A patient enters the emergency department, and on initial examination the RT observes paradoxical chest movement. Which of the following should the therapist suspect? A. Pulmonary edema B. Pneumonia C. Flail chest D. Pleural effusion - ANSWER C. Flail chest Perfusion in the extremities may best be determined by which of the following methods? A. Obtaining ABG studies and determining PaO2 level B. Assessing the patients SpO2 C. Assessing capillary refill D. Palpating a brachial pulse - ANSWER C. Assessing capillary refill While palpating the chest, the RT determines that there is decreased fremitus over the right lower lobe. This may be the result of which of the following? [Show More]

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