NBRC EXAM, Part I Latest Update -

NBRC EXAM, Part I Latest Update - Actual Exam from Credible Sources with 155 Questions and Verified Correct Answers Golden Ticket to Guaranteed A+ Verified by Professor

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.

• TcPCO2 and TcPO2 monitor
• Arterial blood gas analysis Q4
• SpO2 monitor
• Capillary gas analysis Q8 - CORRECT 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 16-year-old male patient involved in a motorcycle accident presents to the ER with massive maxillary and nasal trauma. Which of the following devices would be most appropriate for maintaining the patient's airway?

• nasal endotracheal tube
• fenestrated tracheostomy tube
• oral pharyngeal airway

D. oral endotracheal tube - CORRECT ANSWER: Patient with massive maxillary and

nasal trauma would be difficult to intubate; you might need to bypass the face completely, so ANSWER is B, fenestrated tracheostomy tube (could be fenestrated or not fenestrated, either would work).

A 2 kg (4.4 lb) neonate requires transportation to a tertiary care center for cardiac surgery. The infant has a heart rate of 140 and a BP of 60/30.The neonate is intubated with a size 2.5 mm uncuffed endotracheal tube and ventilation is being assisted manually at a rate of 40/min. Which of the following should the respiratory therapist recommend?

• postpone the transport until the neonate has spontaneous respirations 1 / 4

• prepare for the transport immediately
• delay the transport and stabilize the patient

D. wait 24 hours and then reassess the patient - CORRECT ANSWER: Answer is B.

A 2-year old child enters the emergency room. The mother states that the child was playing with friends and developed violent coughing and unilateral wheezing. Physical examination reveals a hyperresonant percussion note on the left and resonant percussion on the right. Inspiratory and expiratory chest films indicate air trapping with no foreign bodies "noted." The respiratory therapist should suspect the child has.a.pneumothorax b.orthopnea c.aspirated a foreign object d.tachyphylaxis - CORRECT ANSWER: Unilateral wheezing indicates aspirated object and fact that the child was playing with friends causes you to believe the child inhaled a small toy or something, hyperresonant percussion indicates air trapping, so you are thinking foreign object but x-ray says no foreign bodies "noted." Just because it says "noted" does not mean something is not there, it just means it could not be seen on the xray, also if the child had swallowed a small plastic toy, "plastic" does not show up on xrays (radiolucent). The ANSWER is C

A 24-year-old post-operative male patient is receiving intermittent positive pressure therapy at 20 cm H2O. The patient complains that the machine is cycling off too soon.The patient's post-operative spontaneous vital capacity is 3.5 L. Which of the following should the respiratory therapist recommend?

• Increase the pressure to 25 cm H2O
• Discontinue therapy, encourage deep breathing and coughing frequently on his own
• Switch to a volume incentive spirometry device
• Recommend decreasing the flow - CORRECT ANSWER: The key is that the patient's

post-operative spontaneous vital capacity is 3.5L, which shows he can take a pretty good deep breath on his own, so the simplest, easiest ANSWER is B, discontinue therapy, encourage deep breathing and coughing frequently on his own. If they can do it on their own, that's the best therapy of all.

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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?

• radiant warmer
• isolette
• croupette

D. bassinet - CORRECT ANSWER: 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.

A 26-year-old patient with shortness of breath is admitted to the emergency room. The patient states that he was running in Central Park with a friend and could not catch his

breath. Bedside assessment reveals the following data:

Pulse: 120

Respirations: 25 br/min

Color: pale

SpO2: 89% on room air

Breath sounds: slightly diminished on the right

The respiratory therapist should:

• request a STAT chest x-ray.
• administer 100% oxygen.
• insert a large bore needle into the 2nd intercostal space on the right side in the

midclavicular line.

• insert a chest tube into the 2nd intercostal space on the right side in the midclavicular

line. - CORRECT ANSWER: Request a STAT x-ray is good but the patient currently has shortness of breath and is uncomfortable, so what would you do FIRST, ANSWER is B, administer 100% oxygen

A 27-week gestation age neonate with respiratory distress syndrome is receiving high

frequency oscillatory ventilation at the following settings:

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PIP: 20 cm H2O

Frequency: 12 Hz

I time: 30%

FIO2: 0.55

PEEP: 4 cm H2O

Blood gas results from an umbillical artery line are as follows:

pH: 7.15

PaCO2: 62 torr

PaO2: 46 torr

HCO3-: 22 mEq/L

The respiratory therapist should increase the

A. PEEP.

B. FIO2.

• frequency.

D. amplitude. - CORRECT ANSWER: This baby is not being ventilated or oxygenated

properly. Always fix ventilation first or the oxygen won't get where it is supposed to anyway. Amplitude means "pressure", so ANSWER is D, Increase Amplitude

A 28-week gestational age infant with severe respiratory distress syndrome is being

mechanically ventilated in the PC, SIMV mode at the following settings:

Flow rate: 6 L/min

Set rate: 32 br/min.

PIP: 28 cmH2O

FIO2: 0.70

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