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Quiz Session - Attempts With Random Questions

NBRC CRT Exam Questions

Page 1 of 25

1.

When performing Internal Statistical Quality Control on an ABG analyzer, bias (systemic) errors can occur. Which of the following is NOT a cause of bias errors?

  • Statistical variations

  • Incorrect gas concentrations

  • Component failure

  • Contaminated buffers

Correct answer: Statistical variations

Bias errors, also known as systemic errors, are errors during statistical quality control that are indicated by a recurrent shift of data points outside the statistical limits. Bias errors are caused by a problem with the testing process or device. 

Statistical variations can occur where a value is randomly outside the accepted standard deviations. Statistical variations are an example of an imprecision or random error, not a bias error.

2.

Which of the following is NOT a potential danger of using ethylene oxide gas for sterilization?

  • It cannot be mixed with other gases

  • It is toxic

  • It can cause or increase the risk of cancer

  • It can explode

Correct answer: It cannot be mixed with other gases

Ethylene oxide gas is explosive, toxic, and carcinogenic. 

Ethylene oxide gas can, however, safely be mixed with other gases. It is often mixed with CO2 or Freon to reduce the risk of combustion and explosion.

3.

The respiratory therapist is evaluating a two-year-old female with mumps. The child's parents ask the respiratory therapist why the patient is on isolation precautions. Which of the following answers is CORRECT?

  • "Her infection can be transmitted to others through little droplets that can travel up to six feet."

  • "Her infection can be transmitted to others through particles that remain suspended in the air and can travel a large distance."

  • "Her infection can be transmitted through direct contact with her bodily fluids."

  • "Her infection can be transmitted through her feces."

Correct answer: "Her infection can be transmitted to others through little droplets that can travel up to six feet."

Mumps is an infection that is transmitted by droplets. Describing her infection as something that can be transmitted to others through little droplets that can travel up to six feet is correct. 

Describing her infection as something that can be transmitted to others through particles that remain suspended in the air describes airborne precautions and is incorrect. Describing her infection as something that can be transmitted through direct contact with her bodily fluids or through the fecal-oral route is also incorrect.

4.

A patient who you are evaluating tells you, "I have been coughing up green, foul-smelling mucus." Which of the following does this likely indicate?

  • The patient has a Pseudomonas infection

  • The patient is expectorating old, retained secretions

  • The patient is expectorating normal mucus

  • The patient's sputum contains white blood cells

Correct answer: The patient has a Pseudomonas infection

Green, foul-smelling sputum is normally indicative of a Pseudomonas infection. 

Green sputum without an odor may indicate old, retained secretions. Normal mucus is white and translucent. Sputum containing white blood cells will be yellow or tan and is also called purulent sputum.

5.

Which of the following is an example of a water-borne illness?

  • Cholera

  • Smallpox

  • Rhinovirus

  • Lyme disease

Correct answer: Cholera

Water-borne illnesses are transmitted through water, typically drinking water. Cholera is an example of a water-borne illness and is a common infection acquired from drinking contaminated water while traveling, especially in developing countries.

6.

The respiratory therapist is providing care to a patient who is mechanically ventilated when they note that the patient's endotracheal (ET) tube is moving with a pulsating-type motion. Which of the following should be suspected?

  • Tracheoinnominate artery fistula

  • ET tube migration

  • ET tube obstruction

  • Hyperinflation of the ET tube cuff

Correct answer: Tracheoinnominate artery fistula

Pulsation of the ET tube may indicate the presence of a tracheoinnominate artery fistula and is typically its only indicator prior to exsanguination. 

Hyperinflation of the ET tube cuff could cause a tracheoinnominate artery fistula, but pulsation of the tube is not an indicator of hyperinflation. Pulsation of the ET tube is not likely to occur with migration or obstruction of the tube.

7.

Which of the following is NOT a goal when treating obstructive sleep apnea?

  • Monitor changes in sleeping patterns

  • Eliminate apnea, hypopnea, and snoring

  • Normalize O2 saturation and ventilation

  • Improve sleep architecture and continuity

Correct answer: Monitor changes in sleeping patterns

Monitoring the patient's sleeping patterns and responses to therapy is an essential part of treatment, but a component of treatment is not the same as a goal of treatment. 

Eliminating apnea, hypopnea, and snoring; normalizing O2 saturation and ventilation; and improving sleep architecture and continuity are all goals of treating OSA.

8.

The respiratory therapist is called to the Emergency Department for a 42-year-old male who has a known heroin-use disorder. The patient is in respiratory arrest and "just passed out" according to a friend who was present when he arrested. The friend states that the patient had not used heroin in the last 24 hours. 

Which of the following medications is MOST important for the respiratory therapist to recommend?

  • Naloxone hydrochloride

  • Epinephrine

  • Atropine

  • Lidocaine

Correct answer: Naloxone hydrochloride

The patient may be experiencing an opioid overdose, and naloxone hydrochloride can reverse the effects of an opioid overdose. 

Even though the patient's friend states he has not used heroin, it is unknown if the friend is a reliable historian, and it is safe to administer naloxone hydrochloride even if the patient is not overdosing. Epinephrine, atropine, and lidocaine are used to treat cardiac arrest, not respiratory arrest.

9.

The respiratory therapist is monitoring a patient who is known to have high levels of fetal hemoglobin in their blood. How will this impact their SpO2 reading?

  • It will not affect the patient's SpO2 reading

  • The patient's SpO2 reading will be falsely high

  • The patient's SpO2 reading will be falsely low

  • The patient's SpO2 reading will correctly read lower than normal

Correct answer: It will not affect the patient's SpO2 reading

While the presence of high levels of fetal hemoglobin may affect hemoximetry, it does not have any known effect on pulse oximetry. The patient's true SpO2 reading should not change, and it will not be falsely elevated or depressed.

10.

A patient on a 40% air-entrainment mask has the following ABG levels:

pH 7.41

PaCO2 40 torr

PaO2 102 torr

What is this patient's P(A-a)O2? (PB = 747mm Hg)

  • 128 mm Hg

  • 230 mm Hg

  • 102 mm Hg

  • 13 mm Hg

Correct answer: 128 mm Hg

The exam generally uses a barometric pressure of 747mm Hg, giving a corrected PB of 700mm Hg. The equation for determining PAO2 is: PAO2 = (700xO2%) - (PaCO2*1.25). 

For the parameters given here, the result is  PAO2 = (700x0.4) - (40*1.25) = 280 - 50 = 230. 

P(A-a)O2 is calculated by using the equation: P(A-a)O2 = PAO2 - PaO2. 

The result for this question is: P(A-a)O2 = 230 - 102 = 128 mm Hg.

11.

What is the correct term for apnea that initially is caused by an airway obstruction but develops into the patient failing to initiate respiratory effort?

  • Mixed apnea

  • Obstructive apnea

  • Central apnea

  • Sleep apnea

Correct answer: Mixed apnea

Mixed apnea is a combination of obstructive and central apnea. 

Obstructive apnea is caused when effort to breathe occurs but the airway is obstructed, preventing airflow. Central apnea is apnea that occurs when there is no effort to breathe. Sleep apnea can be either obstructive or central, but it is not the apnea described in the question stem.

12.

Which of the following nonsteroidal anti-asthma medications can be used as both an asthma controller and an asthma reliever?

  • None of these medications

  • Zafirlukast 

  • Zileuton

  • Mepolizumab 

Correct answer: None of these medications

Zafirlukast and zileuton are both antileukotriene medications that are only indicated for the control of asthma. Mepolizumab is a monoclonal antibody that is also only indicated for the control of asthma. Nonsteroidal anti-asthma medications are only used for the control of asthma and should not be used to relieve acute symptoms.

13.

Why can regular and correct use of gloves NOT be used in place of hand hygiene?

  • Gloves have small, invisible defects that can cause contamination

  • Gloves, if used correctly, can be used in the place of hand hygiene

  • Gloves do not provide any protection against pathogens

  • Gloves always cause contamination when they are put on or removed

Correct answer: Gloves have small, invisible defects that can cause contamination

Gloves cannot be used in place of hand hygiene because they have small defects that can lead to contamination. 

While gloves have microscopic defects, they are still very helpful in providing protection against pathogens. Gloves should not cause contamination when they are put on or removed if they are used correctly.

14.

Which of the following is NOT a normal necessary component for a negative-pressure room?

  • An internal and external barometer that compares the pressure differences inside and outside the room

  • The ability of the air system to perform 6 to 12 air changes per hour

  • A high-efficiency particulate air filter system if recirculated air is used

  • A safe external air discharge if recirculated air is not used

Correct answer: An internal and external barometer that compares the pressure differences inside and outside the room

While negative-pressure rooms do need an indicator if the negative pressure is on or not, an internal and external barometer that compares the pressure differences inside and outside the room is not necessary. 

Negative pressure rooms should have the ability to perform 6 to 12 air changes per hour. A high-efficiency particulate air filter system should be used if recirculated air is used. If recirculated air is not used, then air from the room should be discharged into the outside environment safely.

15.

The respiratory therapist is assisting with an intubation where the medical team elects to perform a nasal intubation. Which of the following is a consideration when using nasal endotracheal intubation instead of oral endotracheal intubation?

  • Nasal intubation is more comfortable for long-term use

  • Nasal intubation is more comfortable during the insertion

  • Nasal intubation is faster than oral intubation

  • Nasal intubation is easier than oral intubation

Correct answer: Nasal intubation is more comfortable for long-term use

Oral endotracheal intubation is normally preferred over nasal intubation. Reasons for this include that it is easier to perform, more comfortable during the insertion due to less irritation of the nasal passages, and faster. 

Nasal intubation does, however, have some advantages over oral intubation. One of these advantages is that nasal intubation is more comfortable for long-term use.

16.

Which of the following respiratory conditions would a sweat chloride test be used to diagnose?

  • Cystic fibrosis

  • Pulmonary fibrosis

  • Tuberculosis

  • Pneumonia

Correct answer: Cystic fibrosis

A sweat chloride test tests the chloride content of sweat. Cystic fibrosis is characterized by a genetic defect in cellular chloride channels which prevents normal reabsorption and conservation of chloride levels. An elevated level of chloride in sweat indicates that cystic fibrosis is likely present. 

Pulmonary fibrosis is very different from cystic fibrosis and is caused by scarring of the lung tissues. Both tuberculosis and pneumonia can cause sweating as a symptom, but the chloride content of sweat is not affected, and a chloride sweat test is not used for these conditions.

17.

When diluting a bronchodilating agent, which of the following solutions is BEST for stimulating coughing and inducing sputum production?

  • Hypertonic saline (1.8% NaCl)

  • Hypotonic saline (0.4% NaCl)

  • Normal saline (0.9% NaCl)

  • Sterile distilled water

Correct answer: Hypertonic saline (1.8% NaCl)

The higher concentration of the solution creates larger aerosol particles. These particles irritate the airway, inducing sputum production and stimulating coughing. The higher the concentration of NaCl that a solution has, the larger the aerosol particles will be.

18.

When providing treatments to patients who have a tracheal airway, which of the following factors is caused by this type of airway and does NOT increase these patients' risk of pulmonary infection?

  • Inability to ambulate, leading to secondary respiratory risk factors

  • Increased aspiration of pharyngeal secretions

  • Impaired mucociliary clearance in the trachea

  • Increased mucosal damage

Correct answer: Inability to ambulate, leading to secondary respiratory risk factors

Establishment of a tracheal airway does not cause an inability to ambulate. While many patients with tracheal airways may be bed-bound due to other medical conditions or to the use of sedation, ambulation is encouraged when possible to avoid secondary respiratory risk factors. 

Increased aspiration of pharyngeal secretions, impaired mucociliary clearance in the trachea, and increased mucosal damage are all risk factors with a tracheal airway that can increase these patients' risk of developing pulmonary infections.

19.

Which of the following medical gases does a brown and green medical gas cylinder contain?

  1. Oxygen
  2. Air
  3. Helium
  4. Carbon dioxide
  5. Nitrous oxide

  • 1 & 3

  • 1 & 4

  • 2 & 5

  • 1 & 5

Correct answer: 1 & 3 

Medical gases are stored in medical gas cylinders of different colors to allow clinicians to distinguish between the different types of gasses. The color coding for these five gases is:

  • Oxygen – Green
  • Air – Yellow
  • Helium – Brown
  • Carbon dioxide – Gray
  • Nitrous oxide – Light blue

When helium and oxygen or carbon dioxide and oxygen are stored together, both colors are used on the cylinder to indicate a gas mixture.

20.

When drawing a capillary blood gas specimen, which of the following interventions is INCORRECT?

  • Squeezing a sample from the capillaries once the first drop of blood has been wiped away

  • Warming the site to 42° C

  • Confirming steady state conditions

  • Either chilling the sample after drawing or analyzing it immediately

Correct answer: Squeezing a sample from the capillaries once the first drop of blood has been wiped away

A sample should be acquired after the first drop of blood has been wiped away; however, the site should not be squeezed, as this can contaminate the sample with intracellular or lymphatic fluids. 

The site should be warmed to 42° C before accessing and steady-state conditions should be confirmed. The sample should be chilled or analyzed immediately.

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