NBRC Exam questions with correct answers
Normal Urine Output Answer ✔✔ 40mL/hr (approximatley 1 Liter a day)
Intake exceeds output Answer ✔✔ -weight gain
-electrolyte imbalance
-increased hemodynamic pressures
-decreased lung compliance
Central Venous Pressure (CVP) Answer ✔✔ can indicate changes in fluid balance
Normal CVP Answer ✔✔ 2-6mmHg or 4-12cmH20
-decreased CVP can indicate hypovalemia (fluid therapy)
-increased CVP can indicate hypervalemia (diuretics)
Stuporous, confused , sleepy Answer ✔✔ consider sleep apnea or excessive O2
therapy (COPD patient)
Semicomatose Answer ✔✔ responds only to painful stimuli
Obtunded Answer ✔✔ drowsy state, may have decreased cough or gag reflux
(protect airway)
Coma Answer ✔✔ does not respond to painful stimuli
Electrolyte Imbalance Traits Answer ✔✔ anger, combative, irritable
Drug Overdose Traits Answer ✔✔ Euphoria-intense feelings of emotions (joy)
Panic Traits Answer ✔✔ severe hypoxemia, tension pnemothorax, status
asthmaticus, or possibly AAA (abdominal aortic anerysm)
Activites of Daily Living (ADL) Scoring Answer ✔✔ Katz Scoring System
0-dependent
6-independent
Orthopnea Answer ✔✔ difficulty breathing except in the upright position (CHF)
Genreal malaise Answer ✔✔ run down feeling, nausea, weakness, fatique,
headache (consider electrolyte imbalance)
COPD diet Answer ✔✔ high fats, low carbs (carbs causes higher CO2)
Edema Answer ✔✔ caused by CHF and renal failure
occurs primarily in arms and ankles
Ascites Answer ✔✔ accumulation of fluid in the abdomen generally caused by
liver failure
Clubbing of fingers Answer ✔✔ caused by chronic hypoxemia
presence of clubbing suggests pulmonary disease
Venous distension or Jugular venous distension (JVD) Answer ✔✔ occurs with
CHF
seen during exhalation in patients with obstructive lung disease
Capillary refill Answer ✔✔ indication of peripheral circulation
color should return within 3 seconds
Diaphoresis Answer ✔✔ heart failure (recommend diuretics, positive inotropic
agents)
fever, infection (recommend antibiotics)
anxiety, nervousness (recommend sedatives)
tuberculosis/night sweats (recommend antitubercular drugs)
Cheyne-Stokes Breathing Answer ✔✔ gradually increasing then decreasing rate
and depth in a cycle lasting from 30-180 seconds, with periods of apnea lasting up
to 60 seconds
Cause: Increased intracranial pressure, brainstem inury, drug overdose
Biot’s Breathing Answer ✔✔ increased respiratory rate and depth with irregular
periods of apnea. Each breath has the same depth
Cause: CNS problem
Kussmaul’s breathing Answer ✔✔ increased respiratory rate (usually over 20
breaths/min), increased depth, irregular rhythm, breathing sounds labored
Cause: metabolic acidosis, renal failure, diabetic ketoacidosis
Dry or nonproductive cough may indicate Answer ✔✔ a tumor in the lungs
Productive cough may indicate Answer ✔✔ an infection or chronic lung disease
NBRC EXAM, Part I questions with correct
answers
PATIENT ASSESSMENT:
All the following could cause capnography to go from 3 6 to 30 EXCEPT:
A. Endotracheal tube positioned in the right mainstream bronchus
B. Hyperventilation
C. pulmonary emboli
D. Hypovolemia Answer ✔✔ Endotracheal tube positioned in right mainstem
bronchus is a problem but the co2 reading would not change, so
ANSWER is A.
What is the target Vt for individual on mechanical ventilation Answer ✔✔ 6-8
ml/kg (of ideal body weight) This is new strategy as of January 2015
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 inspiratory
pause when a patient is sedated and mechanically ventilated. Answer ✔✔ 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. Answer ✔✔ 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 ✔✔ 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 Answer ✔✔ 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
A 1000 g neonate (normal baby is 3000 g) is stable in nicu. Which of the following
should the respiratory therapist use to monitor the neonates overall
cardiopulmonary status.
a. TcPCO2 and TcPO2 monitor
b. Arterial blood gas analysis Q4
c. SpO2 monitor
d. Capillary gas analysis Q8 Answer ✔✔ Since the baby is stable, go less invasive,
also go continuous monitoring (not 4 hour or 8 hour), Transcutaneous (Tc)
continuous monitoring of CO2 and O2 is the best. Answer is A
A unilateral wheeze would most likely indicate which of the following.
a. Asthma
b. Atelectasis
c. Foreign body aspiration
d. Epiglottitis Answer ✔✔ You wouldn’t have asthma on just one side (unilateral),
atelectasis would cause diminished breath sounds, with epiglottitis you would get
stridor, since you are only hearing wheezing on one side, you are hearing it on the
side where you aspirated something,
so ANSWER is C
All of the following would be associated with the presence of a pneumothorax
EXCEPT
a. Tracheal deviation
b. Dull percussion
c. Absent breath sounds
d. Respiratory distress Answer ✔✔ With pneumothorax you would hear a high
pitch hyperresonnance, breath sounds would be absent, and respiratory distress
could be present. Dull percussion would NOT be present,
so ANSWER is B.
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 Answer ✔✔ 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 Answer ✔✔ 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 Answer ✔✔ 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
NBRC Practice Test #2 questions with
correct answers
After a patient undergoes a thoracentesis, the respiratory therapist notes that the
obtained pleural fluid is clear with a slight straw color. This fluid is most likely the
result of
A. empyema.
B. congestive heart failure.
C. lung carcinoma.
D. hemothorax. Answer ✔✔ Congestive Heart Failure
The respiratory therapist is calibrating a spirometer and checking the volume with
a 3.0 liter super syringe. the volumes recorded are 2.85L, 2.8L and 2.8L. Based
upon the information obtained, which of the following is a correct statement?
A. Another syringe needs to be used
B. Spirometer is accurate
C. The plunger was advanced too slowly
D. Spirometer may have a leak Answer ✔✔ D. Spirometer may have a leak
Which of the following is an indication for high frequency jet ventilation?
A. Bronchopleural fistula
B. Wilson Mikity syndrome
C Necrotizing lesion of right lung
D. Centrilobular emphysema Answer ✔✔ Bronchopleural Fistula
**(because it uses mean airway pressures & low tidal volumes to improve
oxygenation and we do not want to worsen bp fistula)
A 43 y/o female patient has just undergone a total abdominal hysterectomy. The pt
arrives in the post anesthesia care unit obtunded with minimal response to painful
stimulus. what treatment should the RT recommend for this pt? Answer ✔✔ Insert
OPA (b/c they are unresponsive)
What is the normal VD/VT ratio for a patient breathing room air? Answer ✔✔ 20-
40%
All of the following could cause a patient’s right-hemidiaphragm to be elevated,
EXCEPT:
A. right lower lobe atelectasis
B. right side hyperlucency, absent vascular markings
C. hepatomegaly
D. right lower lobe consolidation with air bronchograms Answer ✔✔ B. right side
hyperlucency, absent vascular markings (pneumothorax)
A 2 y/o child with croup has been intubated for 4 days with a 4mm ID uncuffed
ETT. Heated aerosol at an FiO2 of 30% has been delivered to the patient. The
physician asks the RT to evaluate the pt for possible extubation. Which of the
following would most likely indicate that the pt is ready for extubation?
A. Pt is making normal quiet ventilatory efforts
B. Negative sputum culture and sensitivity has been reported
C. Pt’s ABG are within normal range
D. Breath sounds are heard around the tube on auscultation Answer ✔✔ D. Breath
sounds are heard around the tube on auscultation
A pt is senn inthe ER for complaints of nausea and vomiting. A NGT has been
inserted and the pt is started on lasix. Which of the following should the RT
monitor?
A. Cardiac enzymes
B. Serum electrolytes
C. ABG
D. Cell hydration level Answer ✔✔ B. Serum electrolytes (because of loss of
fluids)
While instructing a pt prior to a vital capacity maneuver, the RT should direct the
pt to:
A. exhale to RV and inhale to IC
B. inhale to TLC then exhale to RV
C. exhale normally then inhale to TLC
D. inhale normally then exhale to FRC Answer ✔✔ B. inhale to TLC then exhale
to RV
A 77 y/o male patient is admitted to the ER with shortness of breath, fine basilar
crackles, +2 pitting edema and a chest X-ray with a butterfly pattern. These results
are most consistent with which of the following?
A. Pulmonary edema
B. Pulmonary interstitial emphysema
NBRC questions with correct answers
The physician orders a 60% Tpiece be set up for a patient who requires a
inspiratory flow of 12lpm .what is the minimum flow rate that the flow meter must
be set to meet this inspiratory flow demands. Answer ✔✔ 2×12=24 which does not
meet a pt demand of 30 so 2×15 will meet the pt demand
The physician orders a 40% piece to be set up for a patient who requires a
inspiratory flow of 6 lpm what must the flow meter be set at? Answer ✔✔ 4×6=24
not meeting pt demand so 4×8=32 meeting the patient demand
After a patient received a broncho dilator therapy the rt attempts to perform
nasotracheal suction on the patient as the catheter enters the oropharynx th most
likely ekg would look like? Answer ✔✔ Vagal nerve stimulation
Increase heart rate Increase work of breathing is caused by Answer ✔✔
hypoxemia
What is the drug would be best to use to temporarily paralyze a patient to facilitate
tracheal intubation Answer ✔✔ Succinylcholine
While making o2 rounds you discover that the 6 inch tubing on a t piece setup has
fallen off what may result from this Answer ✔✔ delivered fio2 would decrease,
the patient would entrain room air during inspiration,
a patient has been paralyzed with veuronium and is recieving mechanical
ventilation which of the following ventilator monitoring alarms would be sounding
Answer ✔✔ low pressure
Inspiratory stridor is a major clinical sign of what airway condition? Answer ✔✔
glottic edema
A patient with COPD is in the emergency room and is complaining of shortness of
breath ABG results of the patient breathing room air : PH 7.31 PaCo2 62 torr PaO2
44 HCO3 35, what is the appropriate recommendation for o2 therapy ? Answer
✔✔ Air Entrainment mask at 28%
A patient with marked stridor what do you do Answer ✔✔ reintubate.
Failure to hyperoxygenate a patient on a ventilator before ET suctioning may result
in:
a. hypocarbia
b. hypoxemia
c. hypertension
d. bradycardia
(there are two answers to this question) Answer ✔✔ Hypoxemia and Bradycardia
If not cleaned properly, which one of the following devices is most likely to
contaminate a patient’s airway with bacteria?
a. bubble humidifier
b. heated wick humidifier
c. hydrosphere
d. heated jet nebulizer Answer ✔✔ heated jet nebulizer
A 58 year old patient with emphysema enters the emergency department on a 2 lit
nasal cannula blood for a bag drawn and after the results are evaluated the o2 flow
is increased to 5 liter .2LITER PH 7.34 PACO2 62 PAO2 44 and at 5 LITER PH
SDS Exam – NBRC questions with correct
answers
The recommended HFF for recording electocardiograph channel is Answer ✔✔
70Hz
Which of the following would best describe rhythmic movement disorder?
- Minimum frequency of 0.3Hz
- Max frequency of 2.0Hz
- Min number of 4 rhythmic movements
a.1,2
b.2,3
c.1,3
d.1,2,3 Answer ✔✔ b
A 14 year old boy is undergoing an overnight sleep study and has been stared on
CPAP. The pt is currently on 8cmH2O CPAP. What is the recommended max
CPAP pressure for this pt Answer ✔✔ 20cmH2O
What is max CPAP for pts under 12 years old? Answer ✔✔ 15cmH2O
A pt recently completed an MSLT having obtained a total score of 10. Which of
the following would best describe managing the pts daytime sleepiness? Answer
✔✔ Troublesome
Classify the following MSLT scores:
0 – 5 minutes…
6 – 10 minutes…
11 – 15 minutes…
16 – 20 minutes… Answer ✔✔ …Severe
…Troublesome
…Manageable
…Excellent
During an MSLT a pt has had 5 naps w/o onset of REM…what should be done
next?
a. End the study
b. Have pt take 6th nap Answer ✔✔ b. 6th nap
MSLT is a seris of _ to _naps, each ____min long, hours apart.
naps will be suffieicent if sleep onset REM has occurred in 2 naps. Answer
✔✔ 4 to 5 each 20min long and 2 hours apart
4
In MSLT the 1st nap begins to hours after the overnight PSG has concluded Answer ✔✔ 1.5 to 3 hours MSLT is not recommended the morning after what type of study Answer ✔✔ Split MSLT is not used to diagnose narcolepsy if the TST on the prior night study was less than _ hours Answer ✔✔ 6
State 2 methods for ending a nap in an MSLT Answer ✔✔ 1. No sleep onset after
20min
- After 15min of continuous recording following sleep onset
List channels used in sleep montage for an MSLT Answer ✔✔ EEG (2 leads:
Central and Occipital)
2 Reference Leads (M1 and M2)
E1 and E2 (Eyes)
2 EMG leads (chin and 2 submentalis only)
ECG
List 3 items that must be scored for MSLT Answer ✔✔ 1. Sleep latencies for each
nap - MSLT for the entire test (avg of ALL naps)
- SOREM periods
Correct postion for and esophageal pH monitoring catheter is… Answer ✔✔
advance catheter until pH< 4.0 and then withdraw 5cm, tape and record tube
placement at nostril
Describe the anatomic position an esophageal pH catheter should be placed
Answer ✔✔ Cather tip should be 5cm above the upper border of the lower
esophgeal sphincter
Another name for the disinfecting agent Cidex?
How long for this agent to disinfect?
How long for this agent to sterilize Answer ✔✔ Alkaline gluteraldeyde
10 min
10 hours
NBRC CRT Practice Test #1 questions with
correct answers
A patient is admitted to the ED following a vehicle accident. On physical exam,
the RT discovers that breath sounds are absent in the left chest with a hyper
resonant percussion note. The trachea is shifted to the right. The patient’s heart rate
is 45/min, RR is 30/min and BP is 60/40 mmHg. What action should the therapist
reccomend first? Answer ✔✔ Needle aspirate the 2nd left intercostal space
A 65kg spinal cord injured patient has developed atelectasis. His inspiratory
capacity is 30% of his predicted value. What bronchial hygiene therapy would be
most appropriate initially? Answer ✔✔ IPPB with normal saline
A healthy adult female can exhale what portion of her forced vital capacity in the
first second? Answer ✔✔ 70%
A patient on VC ventilation has demonstrated auto-PEEP on ventilator graphics.
Which of the following controls, when adjusted independently, would increase
expiratory time? Answer ✔✔ Tidal volume, Respiratory Rate and Inspiratory flow
A 55 y/o post cardiac surgery patient has the following ABG results: pH 7.50,
PaCO2 30 torr, PaO2 62 torr, HCO3 25 mEq/L, SaO2 92%, HB 14 g;dL, BE +2.
Venous blood gas results are pH 7.39, PvCO2 43 torr, PvO2 37 torr, and SvO2
66%. Calculate the patient’s C(a-v)O2. Answer ✔✔ 4.0 vol%
TO SOLVE:
- Use formula: C(a-v)O2 = CaO2 – CvO2
- CaO2 = (Hb x 1.34 x SaO2) + (PaO2 x 0.003)
**Normal amounts are 4-5%
Immediately after extubation of a patient in the ICU, the RT observes increasing
respiratory distress with intercostal retractions and marked stridor. The SpO2 on
40% O2 is noted to be 86%. What would be the most appropriate response at this
time? Answer ✔✔ Reintubation (due to marked stridor)
What may be obtained from a FVC maneuver during beside PFTs? Answer ✔✔
FEV1 and PEFR
What suction catheter would be appropriate for a patient with a size 8.0mm ID
ETT? Answer ✔✔ 12 Fr
- Use formula ID size/2 X 3
The RT notes a developing hematoma after and ABG was drawn from the right
radial artery. The immediate response is to: Answer ✔✔ apply pressure to the site
A patient on the general medical ward is on a 28% air entrainment mask with the
flowmeter set at 5L/min. What is the total flow delivered to the patient? Answer
✔✔ 55L/min
TO SOLVE - 28% –> 10:1 ratio –> 11 total flow factor
- Total flow factor x set values for L/min (so 5L/min x 11 = 55L/min)
What measurement is most indicative of pulmonary edema? - HR 120/min
NBRC Exam – Patient Assessment questions with
correct answers
What do you review in the patient’s history? Answer ✔✔ – History
- Admission data
- Progress notes
- Diagnosis
- Respiratory care orders
- Medication history
- Do not resuscitate (DNR) status and advance
directives - Social history
What do you note in patient history? Answer ✔✔ 1. Date of history taking
- Patient data: name, age, gender, race, and
occupation - Primary complaints
- Secondary complaints
- Present illness history and symptoms
- Family history
- Medical history of cardiopulmonary disease(s),
including smoking history, cough, sputum
production, allergies, and activities of daily living - Review of body systems
The attending physician writes up his or her key findings and how they are related
to the reason the patient was admitted to the hospital. What is this information
called? Answer ✔✔ Admission data
What do you do it the physician notes a change in the patient’s care plan? Answer
✔✔ Check for new patient care orders
True or false: You should review the physician’s, nurse’s, and respiratory therapist’s
patient progress notes before seeing the patient and beginning the therapeutic
procedure. Answer ✔✔ True
When reviewing progress notes, what is the respiratory therapist looking for?
Answer ✔✔ Any cardiopulmonary or other organ-system changes that will have
an impact on the patient’s ability to take the treatment.
After the medical history, physical exam, and laboratory tests are completed, the
patient will be placed in one of four diagnostic categories. What are these
categories? Answer ✔✔ – Crisis/acute onset of illness
- Intermittent but repeated illness
- Progressive worsening
- Mixed patterns/multiple problems
What must physician orders have? Answer ✔✔ – Patient’s name - The date
- The time
- Complete and proper orders for each
therapeutic procedure - The physician’s signature
NBRC Exam Patient Assessment questions
with correct answers
What action should be recommended if the APGAR score is 3 Answer ✔✔
Resuscitate
What action should be recommended if the APGAR score is 8? Answer ✔✔
Monitor routine care
Orthopnea Answer ✔✔ Difficult breathing except in the upright position (CHF)
General malise Answer ✔✔ Run down feeling, nausea, weakness. fatigue.
headache (check electrolyte imbalance)
Dyspnea Answer ✔✔ A feeling of shortness of breath or difficulty breathing
Dysphagia Answer ✔✔ Difficulty swallowing and hoarseness are common
symptoms
Peripheral Edema Answer ✔✔ Fluid in the arms and legs
Recommend a Diuretic
Pathology: Presence of excessive fluid in the tissue as pitting edema caused by
CHF and renal failure
Ascites Answer ✔✔ Accumulation of fluid in the abdomen generally caused by
liver failure.
Pathology: Abdominal infection
Clubbing of fingers Answer ✔✔ Caused by chronic hypoxemia
Pathology: Pulmonary disease COPD, CHF
The thumb and first fingers are affected.
Venous Distention Answer ✔✔ Increased venous distention, jugular distention
(JVD) temporal veins popping out
Pathology: occurs with CHF, seen during exhalation in patients with COPD.
Capillary refill Answer ✔✔ Indication of peripheral circulation
Pathology: blanching the hand and watch for color return
Color should return within 3 seconds
Diaphoresis Answer ✔✔ A state of profuse/heavy sweating, heart failure
recommend diuretics. positive inotropic agents.
Pathology: fever infection (recommend antibiotics), anxiety nervousness
(recommend sedatives), tuberculosis/night sweats (recommend antitubular gram
stain)
Ashen/pallor Answer ✔✔ Abnormal
Indicates: anemia, blood loss, (vasoconstriction will cause color change by
reducing blood)
Erythema Answer ✔✔ Redness of the skin
Indicates: due to capillary congestion, inflammation or infection
Cyanosis Answer ✔✔ Blue or blue-gray dusky discoloration of the skin and
mucous membranes.
Indicates: hypoxia from increased amount of reduced hemoglobin
Chest configuration Kyphosiscoliosis Answer ✔✔ Convex curvature of the spine
with a lateral curvature of the skin
- causes a restrictive pattern and reduced lung volumes.
Describe symmetrical chest movement Answer ✔✔ When both sides of the chest
are moving equally at the same time
List five underlying pathologies that can contribute to a patient displaying
asymmetrical chest movement Answer ✔✔ Post lung resection, post
pneumonectomy
Atelectasis (hyperinflation recruitment maneuver
Flail chest
Pneumothorax
Endotracheal tube inserted in right or left mainstem bronchi
Eupnea Answer ✔✔ Normal respiratory rate, depth and rhythm
Condition: normal respiratory rate for an adult 12-20bpm
Tachypnea Answer ✔✔ Increased respiratory rate >20bpm
Condition: hypoxia, fever, pain, CNS problem
Bradypnea Answer ✔✔ Decreased respiratory rate <12bpm
Condition: sleep, drugs, alcohol, metabolic disorder