NBRC TMC PRACTICE - Which of the following is needed to calculate a...

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NBRC TMC PRACTICE

ACTUAL EXAM WITH CORRECT SOLUTIONS.

Which of the following is needed to calculate alveolar oxygen tension?

A. VD/VT, PAO2

• BP and FiO2
• PetCO2 and PaO2
• QS/QT, deadspace - correct answer- B.

Barometric pressure, FiO2, and PaO2 are all included in the formula (BP stands for barometric pressure)

L/min/m2 is the unit of measure for:

• Systemic vascular resistance
• Cardiac output
• Cardiac index
• Stroke volume - correct answer- C.

A spontaneously breathing patient has the following arterial

blood gas results:

pH 7.38 PaCO2 42 mmHgPaO2 76 mmHgHCO3 - 24 mEq/LBE

• mEq/L 1 / 4

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Which of the following supplemental oxygen levels is most appropriate?

• 2 L/min nasal cannula
• 5 L/min nasal cannula
• non-rebreathing mask
• Venturi mask at 30% - correct answer- B.

A patient who is showing signs of hypoxemia should receive supplemental oxygen. If the patient is not a COPD patient and the situation is not an emergency, then the proper supplemental oxygen is an adult therapeutic dose, which is 40% to 55%. Of the options available only 5 L/min nasal cannula will approach this. Other options are either insufficient or too much.

Left heart failure would be manifested in which of the following values?

• CVP and mPAP
• mPAP and wedge pressure
• MAP and SVR
• cardiac output and wedge pressure - correct answer- D.

The function of the left heart, specifically the left ventricle, is best assessed hemodynamically by looking at those values that precede and come after the left heart. In this case pulmonary capillary wedge pressure and cardiac output (or cardiac index) are the values found before and after the left heart.

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Which of the following findings is most closely associated with increased airway resistance?

• reduced SpO2
• accessory muscle use
• altered P50
• increased PetCO2 - correct answer- B.

Of the options given, use of accessory muscles is most closely associated with an increase in airway resistance. This is especially true with patients who have asthma or other types of upper airway inflammation or bronchoconstriction.

For a patient receiving volume-controlled mechanical ventilation, the lower inflection point on a pressure-volume loop

can best be described as:

• amount of pressure required to keep the alveoli and small

airways open

• optimal PEEP
• minimal PEEP
• upper limit of residual volume - correct answer- A.

The lowest inflection point on a pressure-volume ventilator graphic is an indication of the minimum pressure needed to keep alveoli open.

The results of a V/Q scan shows poor perfusion with adequate ventilation. A chest radiograph shows a wedge-shaped infiltrate over the right lung field. The patient most likely has 3 / 4

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• fluid overload

B. ARDS

• a pulmonary embolism
• pneumonia - correct answer- C.

A VQ scan that shows poor perfusion but adequate ventilation is most closely associated with a pulmonary embolism.Supportive data is found in the radiological report of wedge- shaped infiltrates.

The respiratory therapist notes in the medical record of a 65- year-old male that the patient is ordered to receive bronchodilator therapy with Albuterol. The therapist also notes the patient is receiving beta-blocker medication. The therapist should recommend

• Administer Dexamethasone (Decadron) in place of Albuterol
• Add Xopenex to the bronchodilator regimen
• Replace Albuterol with Beclamethasone (Beclovent)
• Switch from Albuterol to ipratropium bromide (Atrovent) -

correct answer- D.Because albuterol is a beta-agonist medication, patients who are taking beta-blockers should utilize other bronchodilation medication.

A hospital has an extremely low incidence of ventilator- associated pneumonia. To which of the following reasons may this be attributed?

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