TMC NBRC MOCK EXAM QUESTIONS WITH 100% CORRECT ANSWERS 2024/ A+ GRADE, Exams of Nursing

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TMC NBRC MOCK EXAM QUESTIONS WITH 100%

CORRECT ANSWERS 2024/ A+ GRADE

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 =

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% O 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. PaCO2: 31 mmHg PaO2: 58 mmHg What should the RT recommend at this time? A. Place the patient on CPAP B. Increase the O 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. 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. = 18. Answer: D. 18 mL/dL The respiratory therapist receives an order to set up a moderate level of O 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% O A severe COPD patient arrives in the emergency department on a 2 L/min nasal cannula. Arterial blood gas results follow: pH: 7. 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 O 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
2. 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 SpO 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?

1. Pneumothorax

2. Pleural effusion
3. Pneumonia

A. 1

only B. 2 only C. 1 and 2 only D. 2 and 3 only - Answer - C. 1 and 2 only A chest x-ray film obtained after intubation shows that the tip of the ET tube is resting at the fourth rib. Which of the following actions should be taken? A. The tube should be advanced 2 cm B. The tube should be advanced until equal breath sounds are heard C. The tube should remain at this level D. The tube should be withdrawn 3 cm - Answer - D. The tube should be withdrawn 3 cm The RT is reviewing the chart of a patient suspected of having congestive heart failure. This condition would best be indicated with an elevation in which of the following cardiac biomarkers? A. Troponin B. Myoglobin C. Creatine kinase (CK) D. B-type natriuretic peptide (BNP) - Answer - BNP > 500 = CHF D. B-type natriuretic peptide (BNP) A patient is suspected of suffering acute myocardial infarction. Which of the following lab values would be increased in the patient's blood? A. Hematocrit B. CK-MB C. BNP D. Albumin - Answer - B. CK-MB The RT notes a respiratory rate of 36 breaths/min in an adult patient's chart. The patient's breathing pattern is best described by which of the following? A. Hyperventilation B. Dyspnea C. Hypoventilation D. Tachypnea - Answer - D. Tachypnea The RT is assessing a patient with severe emphysema and observes pedal edema and jugular venous distention. The therapist should note in the patient's chart that these signs are most likely the result of:

A. Systemic hypertension B. Hypercapnia C. Pulmonary infection D. Right ventricular hypertrophy - Answer - D. Right ventricular hypertrophy A patient has just been intubated, and the CO2 detector placed on the proximal end of the ETT reads 1.5%. The RT should suspect which of the following? A. The tube is in the trachea B. The tube is in the right mainstem bronchus and should be withdrawn 4 cm C. The tube is in the esophagus D. The tube is at the level of the carina and should be withdrawn 2 cm - Answer - C. The tube is in the esophagus Which of the following statements is true regarding the King Airway? A. It is double-lumen tube placed in the esophagus to ventilate difficult- to-intubate patients. B. The airway can be used only on patients at least 5 feet tall C. The airway utilizes one cuff, which is inflated with 45-90 mL of air to block off the oropharynx D. Because of the length of the airway, it is unlikely that the trachea can be intubated inadvertently - Answer - D. Because of the length of the airway, it is unlikely that the trachea can be intubated inadvertently Magill forceps are used during which of the following procedures? A. Nasotracheal intubation B. Oral intubation C. Tracheotomy D. Insertion of an esophageal tracheal Combitube (ETC) - Answer - A. Nasotracheal intubation The physician wants to begin weaning a patient from a tracheostomy tube. How can this best be accomplished? A. Deflate the cuff every 2 hours B. Change to a fenstrated trach tube C. Keep the cuff inflated and remove the inner cannula D. Change to a trach tube with a foam cuff - Answer - B. Change to a fenstrated trach tube

You are called to a patient's room because a ventilator alarm is sounding. You hear an audible leak around the patient's ET tube during a ventilator breath and notice the exhaled volume reading is 150 mL less than the set Vt. You check the cuff pressure and find that it is 12cm H2O. Which of the following is the appropriate action to take? A. Maintain the current cuff pressure and increase the patient's Vt to compensate for the leak. B. Instill enough air to maintain a cuff pressure of 30 mm Hg. C. Instill air into the cuff to a pressure of 20- 30 cm H2O. D. Instill enough air until only a slight audible leak is heard. - Answer - C. Instill air into the cuff to a pressure of 20-30 cm H2O. You want to pass a suction catheter into the patient's left lung to obtain a sputum specimen. What is the most appropriate method of accomplishing this? A. Have the patient turn his or her head to the left B. Have the patient turn his or her head to the right C. Use a coude suction catheter D. Use a catheter that is one half the internal diameter of the patient's airway - Answer - C. Use a coude suction catheter The RT is using a 12-French suction catheter to suction a female patient who is intubated with a 7.0-mm ET tube and is having difficulty removing the thick secretions. The suction pressure used is -120 mm Hg. Which of the following should be recommended to correct this problem? A. Increase the suction pressure to - mm Hg B. Instill 5 mL of normal saline down the ET tube C. Change to a 14 French suction catheter D. Change to a coude-tipped suction catheter - Answer - A. Increase the suction pressure to -140 mm Hg The RT is called to pediatric ICU to suction a 6-year-old ventilator patient with pneumonia who is intubated with a 5.0 mm ET tube. Which of the following represents the most appropriate catheter size and suction pressure to use on this patient? A. 8-Fr catheter, -100mm Hg B. 10-Fr catheter, - 60mm Hg C. 8-Fr catheter, -60mm Hg D. 10-Fr catheter, -100mm Hg - Answer - A. 8-Fr catheter, -100mm Hg

Which of the following will increase the possibility of the ET tube cuff causing tracheal mucosa damage?

1. Maintaining intracuff pressure of 38 cm H2O 2. Using minimal leak technique
2. Using a low-volume, high-pressure cuff
3. Using minimal occluding volume technique A. 1 and 3 only B. 2 and 4 only C. 1, 3 and 4 only D. 2, 3, and 4 - Answer - A. 1 and 3 only An intubated patient begins exhibiting severe respiratory distress, and the RT auscultates no breath sounds and determines that there is no gas flow passing through the end of the ET tube. The high pressure alarm is sounding on the ventilator. Which of the following should the therapist do at this time? A. Instill 5 mL of saline down the ET tube and suction B. Extubate and manually ventilate the patient C. Obtain an arterial blood gas D. Recommend a stat chest x-ray - Answer - B. Extubate and manually ventilate the patient Which of the following are complications associated with bronchoscopy?
4. Pulmonary hemorrhage
5. Pneumothorax
6. Hypoxemia A. 1 only B. 2 only C. 1 and 3 only D. 1, 2, and 3 - Answer - D. 1, 2, and 3 While assisting with a bronchoscopy, you note that the physician is having difficulty entering the trachea. This may be the result of which of the following? A. Pneumothorax B. Tracheomalacia C. Laryngospasm D. Pulmonary hemorrhage - Answer - C. Laryngospasm After a bronchoscopy, the RT notes that it is taking more ventilator pressure

to ventilate the patient's lungs than before the procedure. This could be caused by which of the following?

1. Bronchospasm
2. Pneumothorax
3. Hypoxemia
4. Pulmonary hemorrhage A. 1 and 2 only B. 2 and 3 only C. 1, 2, and 4 only D. 2, 3, and 4 only - Answer - C. 1, 2, and 4 only To aid in the evacuation of air from the pleural space, a chest tube should be inserted at what level? A. Supraclavicular space B. Second intercostal space anteriorly at the midclavicular level C. Sixth intercostal space anteriorly D. Eighth intercostal space anteriorly - Answer - B. Second intercostal space anteriorly at the midclavicular level The RT notices on a patient's chest tube drainage system that there is fluctuation of the water level in the water-seal chamber with each patient breath, and that air bubbles are seen only in the suction control chamber, which has a suction pressure of -20 cm H2O. The most appropriate action is which of the following? A. Clamp the chest tube and check for leaks B. Insert - Answer - Which of the following ventilator waveforms best enables a RT to evaluate the presence of auto-peep in a patient? A. flow/time B. flow/volume C. pressure/time D. volume/pressure - Answer - A. flow/time The following data are obtained for a patient who is receiving VC, A/C ventilation: Peak pressure: 30 cm H2O Plateau pressure: 20 cm H2O Set Vt: 800 mL Exhaled Vt: 700 mL PEEP: 10 cm H2O

What is the static compliance?

• A.
• B.
• C.
• D. 70 - Answer - D.