Mixed Deck — All NBRC Topics Flashcards

Which ventilator setting directly affects the rate of CO2 elimination?

Answer: Minute ventilation (respiratory rate × tidal volume)

CO2 elimination is directly proportional to alveolar minute ventilation; increasing respiratory rate or tidal volume increases CO2 clearance.

Extracorporeal membrane oxygenation (ECMO) provides gas exchange support by:

Answer: Withdrawing blood, oxygenating it externally, and returning it to the patient

ECMO removes blood via cannula, passes it through an oxygenator membrane to add O2 and remove CO2, then returns oxygenated blood to the patient's circulation.

PEEP (positive end-expiratory pressure) is used primarily to:

Answer: Prevent alveolar collapse and improve oxygenation

PEEP maintains alveolar patency at end-expiration, recruits collapsed lung units, and improves V/Q matching and oxygenation.

Which of the following substances is a natural hormone produced by the pineal gland that induces sleep?

Answer: Melatonin

Melatonin is a natural hormone that induces sleep. All the others are medications classified as stimulants.

Which inhaled corticosteroid is most commonly used as maintenance therapy for persistent asthma?

Answer: Fluticasone

Fluticasone (and other inhaled corticosteroids like budesonide and beclomethasone) is used as daily maintenance therapy for persistent asthma to reduce airway inflammation.

Nasopharyngeal airways are contraindicated in patients with:

Answer: Basilar skull fracture

Basilar skull fractures are a contraindication for nasopharyngeal airways because the tube may inadvertently enter the cranial vault through the fracture.

A patient's peak airway pressure suddenly increases with no change in plateau pressure. This suggests:

Answer: Increased airway resistance (e.g., bronchospasm, secretions)

A rise in peak pressure with unchanged plateau pressure indicates increased airway resistance because resistance affects dynamic (peak) but not static (plateau) pressure.

A patient receiving aerosolized pentamidine therapy most likely has which underlying condition?

Answer: Pneumocystis jirovecii pneumonia prophylaxis in HIV

Inhaled pentamidine is used for prophylaxis against Pneumocystis jirovecii pneumonia (PCP) in HIV-infected patients who cannot tolerate trimethoprim-sulfamethoxazole.

Acceptable spirometry requires that the technician ensure the patient performs a maneuver that is:

Answer: Repeatable within 150 mL for the two best FVC and FEV1 values

ATS/ERS acceptability criteria require reproducibility of the best two FVC and FEV1 values within 150 mL to ensure test reliability.

Which of the following best describes the primary function of the alveoli?

Answer: Gas exchange between air and blood

Alveoli are the primary sites of gas exchange where oxygen diffuses into the blood and carbon dioxide diffuses out.

An RRT-NPS candidate is reviewing high-frequency oscillatory ventilation (HFOV). Why is this topic particularly relevant to the NPS examination?

Answer: HFOV is a neonatal and pediatric rescue ventilation mode covered extensively on the NPS exam

HFOV is a specialty ventilation mode most commonly used in neonatal and pediatric patients, making it a core NPS examination topic.

Inhaled nitric oxide (iNO) in neonates is used to treat:

Answer: Persistent pulmonary hypertension of the newborn (PPHN)

iNO selectively dilates pulmonary vasculature, reducing pulmonary vascular resistance and right-to-left shunting in PPHN.

To help determine your patient's level of consciousness, you should ask which of the following questions? 1. Do you you know what day this is? 2. Can I see your identification wristband? 3. Do you know where you are? 4. How are you feeling today? 5. Do you know who the president is?

Answer: 2, 4

To help determine a patient's level of consciousness, it is important to ask questions that assess their orientation to person, place, and time. Question 2, "Can I see your identification wristband?" helps determine if the patient is aware of their own identity and location. Question 4, "How are you feeling today?" helps assess the patient's awareness of their current state and overall well-being. These questions provide valuable information about the patient's cognitive function and level of consciousness.

A tracheostomy tube is indicated for all of the following EXCEPT:

Answer: Short-term airway management during a brief surgery

Tracheostomy is reserved for situations requiring a prolonged or secure airway; an endotracheal tube is preferred for short-term surgical airway needs.

Acute cor pulmonale on the 12-lead ECG may show all of the following EXCEPT:

Answer: Peaked P waves in leads II, III, aVF (P pulmonale)

P pulmonale (peaked P waves) reflects chronic right atrial enlargement from pulmonary hypertension, not the acute ECG changes of sudden right heart strain.

Which of the following sleep disorders is the most prevalent?

Answer: Insomnia.

Approximately 1/3 of American adults have some type of sleep disorder. and insomnia is the most common.

Dornase alfa (Pulmozyme) is primarily indicated for which condition?

Answer: Cystic fibrosis

Dornase alfa is a recombinant human DNase that cleaves extracellular DNA in mucus, reducing viscosity and improving airway clearance in patients with cystic fibrosis.

An RT preparing for the RRT-ACCS examination reviews ventilator-induced lung injury (VILI). Which protective ventilation strategy is most strongly supported by evidence for ARDS patients?

Answer: Tidal volumes of 6 mL/kg IBW with plateau pressure <30 cmH2O

The ARDSNet protocol of 6 mL/kg IBW with plateau pressure limitation to <30 cmH2O is the cornerstone evidence-based lung-protective strategy for ARDS.

Which pulmonary function test result pattern would an RPFT-credentialed technologist most associate with a restrictive lung defect?

Answer: Reduced TLC with normal or elevated FEV1/FVC ratio

Restriction is characterized by a reduced total lung capacity (TLC) while the FEV1/FVC ratio is preserved or elevated due to proportional reductions in both values.

A patient has ABG: pH 7.52, PaCO2 28 mmHg, HCO3 22 mEq/L. This is consistent with:

Answer: Respiratory alkalosis (uncompensated)

pH above 7.45 (alkalosis) with low PaCO2 and near-normal HCO3 indicates uncompensated acute respiratory alkalosis from hyperventilation.