NBRC TMC EXAM ACTUAL 500 QUESTIONS AND

Page 1 of 250

SUCCESS!

1

NBRC TMC EXAM ACTUAL 500 QUESTIONS AND

CORRECT DETAILED ANSWERS LATEST UPDATE -

Disadvantages of noninvasive ventilation include which one of the following?

• costs more than invasive ventilation
• requires heavy patient sedation
• limits direct access to lower airway
• increases the likelihood of VAP - ANSWER✔✔Disadvantages of noninvasive ventilation (NPPV)

include the following: it can only be

used in cooperative patients; it does not provide direct airway access (thus increasing the risk of secretion retention), and more therapist time is needed during the initial period of use. On the other hand NPPV may help decrease the incidence of VAP and typically costs less than invasive ventilation.

The correct answer is: limits direct access to lower airway

On a patient receiving volume control AC ventilation, you observe a flow-volume with a sawtooth pattern on exhalation. Which of the following actions would you consider most appropriate?

• recommend administering a bronchodilator 1 / 4

Page 2 of 250

SUCCESS!

2

• assess the patient's need for suctioning
• measure the endotracheal tube cuff pressure
• switch to pressure control ventilation - ANSWER✔✔The flow-volume loop reveals irregular

sawtooth- like oscillations, primarily in the expiratory portion of the loop. This indicates either 1) accumulation of airway secretions in the trachea/large airways (requiring suctioning), or 2) condensate partially blocking the expiratory limb of the ventilator circuit proximal to the expiratory flow sensor. Auscultation of rhonchi or tactile fremitus over the trachea would confirm excess secretions as the problem.

The correct answer is: assess the patient's need for suctioning

A 30 year-old male was found supine and unresponsive. In the ER it was confirmed he had aspirated while on his back. After the patient is transferred to ICU his physician orders postural drainage and percussion every 4 hours. What is the best position to place him in to drain the affected area?

• prone with a pillow under his hips
• prone with feet elevated 30 degrees
• supine with a pillow under his hips
• supine with feet elevated 30 degrees - ANSWER✔✔This patient aspirated while lying flat on

his back. Most commonly, this affects the 2 / 4

Page 3 of 250

SUCCESS!

3 superior segments of both lower lobes. The position which facilitates drainage from this lung region is a prone position with a pillow under the patient's hips.

The correct answer is: prone with a pillow under his hips

You need to perform nasotracheal suctioning on a patient with retained secretions. As compared to suctioning via a tracheal airway, which of the following complications are unique to this procedure?

• hypotension
• gagging/aspiration
• hypoxemia
• increased ICP - ANSWER✔✔Complication/hazards common to both tracheobronchial and

nasotracheal suctioning include hypoxemia, cardiac dysrhythmias, bradycardia, hyper-/hypotension, bronchospasm, atelectasis, increased intracranial pressure and the potential for contamination/infection. Unique complications of nasotracheal suctioning include nasal trauma/epistaxis, pharyngeal trauma, gagging (with potential 241 vomiting/aspiration), and laryngospasm. Also misdirection of the catheter is more common with nasotracheal suctioning. 3 / 4

Page 4 of 250

SUCCESS!

4

Which of the following indicates a deficit in fluid balance

• Pedal edema
• Poor skin turgor
• cap refill
• JVD - ANSWER✔✔Poor skin turgor

ARDS patient, what should RT use to evaluate oxygen delivery for optimal PEEP

A. ABG

• mixed venous
• serum lactate
• CO - ANSWER✔✔mixed venous

RT performing a high calibration on a nitric oxide, expected value is

• 45
• 10
• 25

D. 80 - ANSWER✔✔45

• / 4