NBRC TMC Exam Study Guide 2026 Prepare for CRT Certification and RRT Clinical Simulation (CSE)

NBRC TMC Exam Study Guide 2026 Prepare for CRT Certification and RRT Clinical Simulation (CSE) A 48 year-old female is admitted to the ED with diaphoresis, jugular venous distension, and 3+ pitting edema in the ankles. These findings are consistent with Heart failure A. liver failure. B. pulmonary embolism. C. heart failure. D. electrolyte imbalances A patient is admitted to the ED following a motor vehicle accident. On physical exam, the respiratory therapist discovers that breath sounds are absent in the left chest with a hyperresonant percussion note. The trachea is shifted to the right. The patient's heart rate is 45/min, respiratory rate is 30/min, and blood pressure is 60/40 mm Hg. What action should the therapist recommend first? Needle aspirate the 2nd left intercostal space. A. Call for a STAT chest x-ray. B. Insert a chest tube into the left chest. C. Needle aspirate the 2nd left intercostal space. D. Activate the medical emergency team to intubate the patient. All of the following strategies are likely to decrease the likelihood of damage to the tracheal mucosa EXCEPT monitoring intracuff pressures. A. maintaining cuff pressures between 20 and 25 mm Hg. B. using the minimal leak technique for inflation. C. using a low-residual-volume, lowcompliance cuff. D. monitoring intracuff pressures. A 52 year-old post-operative cholecystectomy patient's breath sounds become more coarse upon completion of postural drainage with percussion. The respiratory therapist should recommend deep breathing and coughing to clear secretions. A. continuing the therapy until breath sounds improve. B. administering dornase alpha. C. administering albuterol therapy. D. deep breathing and coughing to clear secretions. A 65 kg spinal cord injured patient has developed atelectasis. His inspiratory capacity is 30% of his predicted value. What bronchial hygiene therapy would be most appropriate initially? IPPB with normal saline A. IS / SMI B. IPPB with normal saline C. postural drainage and percussion D. PEP therapy A patient on VC ventilation has 1, 2, and 3 only demonstrated auto-PEEP on ventilator graphics. Which of the following controls, when adjusted independently, would increase expiratory time? 1. Tidal volume 2. Respiratory Rate 3. Inspiratory flow 4. Sensitivity Which of the following would be the most appropriate therapy for a dyspneic patient who has crepitus with tracheal deviation to the left and absent breath sounds on the right? Insert a chest tube A. Perform chest physiotherapy B. Administer an IPPB treatment C. Insert an endotracheal tube D. Insert a chest tube A 55 year-old post cardiac surgery patient has the following ABG results: pH 7.50, PaCO2 30 torr, PaO2 62 torr, HCO3 25 mEq/L, SaO2 92%, HB 14 g/dL, BE +2. Venous blood gas results are pH 7.39, PvCO2 43 torr, PvO2 37 torr, and SvO2 66%. Calculate the patient's C(a-v)O2. 5.0 vol% A. 2.5 vol% B. 4.0 vol% C. 5.0 vol% D. 5.5 vol% A patient on VC, SIMV with a VT of 500 mL has a PIP of 25 cm H2O, Pplat of 15 cm H2O and PEEP of 5 cm H2O. What is the patient's static lung compliance 50 mL/cm H2O A. 25 mL/cm H2O B. 35 mL/cm H2O C. 45 mL/cm H2O D. 50 mL/cm H2O Immediately after extubation of a patient in the ICU, the respiratory therapist observes increasing respiratory distress with intercostal retractions and marked stridor. The SpO2 on 40% oxygen is noted to be 86%. Which of the following would be most appropriate at this time? reintubation A. cool mist aerosol treatment B. aerosolized racemic epinephrine C. manual ventilation with resuscitation bag and mask D. reintubation Which of the following patients would most likely benefit from pressure support ventilation? A patient on SIMV with a set rate of 12/min and total rate of 24/min. A. An intubated patient with an absent respiratory drive. B. A patient on SIMV with a set rate of 12/min and total rate of 24/min. C. A patient with acute lung injury. D. A patient who requires short-term post-operative ventilatory support. A patient receiving mechanical ventilation has developed a temperature of 99.9° F with purulent secretions over the last 12 hours. The respiratory therapist has also noted a steady increase in peak inspiratory pressure. What initial recommendation should be made to address these changes? Obtain a sputum gram stain. A. Initiate bronchial hygiene