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NBRC Certified Respiratory Therapist Exam Blueprint

Understanding the exact breakdown of the NBRC Certified Respiratory Therapist test will help you know what to expect and how to most effectively prepare. The NBRC Certified Respiratory Therapist has 140 multiple-choice questions The exam will be broken down into the sections below:

NBRC Certified Respiratory Therapist Exam Blueprint
Domain Name % Number of
Questions
PATIENT DATA 35% 49
     Evaluate Data in the Patient Record
     Perform Clinical Assessment
     Perform Procedures to Gather Clinical Information
     Evaluate Procedure Results
     Recommend Diagnostic Procedures
TROUBLESHOOTING AND QUALITY CONTROL OF DEVICES, AND INFECTION CONTROL 15% 21
     Assemble / Troubleshoot Devices
     Ensure Infection Prevention
INITIATION AND MODIFICATION OF INTERVENTIONS 50% 70
     Maintain a Patent Airway Including the Care of Artificial Airways
     Perform Airway Clearance and Lung Expansion Techniques
     Support Oxygenation and Ventilation
     Administer Medications and Specialty Gases
     Ensure Modifications are Made to the Respiratory Care Plan
     Utilize Evidence-Based Practice
     Provide Respiratory Care in High-Risk Situations
     Assist a Physician / Provider in Performing Procedures
     Conduct Patient and Family Education

NBRC Certified Respiratory Therapist - Exam Topics Sample Questions

You must calculate the duration of flow of oxygen for a patient who is going home. He is receiving oxygen from a nasal cannula at 4 L/min. The pressure gage on the cylinder reads 2000 psi. the cylinder factor is 0.28 L/psi. What is the duration of the flow?

Correct Answer:
140 minutes
to determine the duration of oxygen flow for a patient using a nasal cannula, it's essential to understand how to calculate the total available volume of oxygen in the cylinder and how quickly that volume will be depleted based on the flow rate prescribed. here is a step-by-step explanation:

**step 1: calculate the total volume of oxygen in the cylinder** the total volume of oxygen available in the cylinder can be calculated by multiplying the pressure in the cylinder by the cylinder factor. the cylinder factor, which is given as 0.28 l/psi, represents the volume of oxygen (in liters) that is released for each psi of pressure in the cylinder. in this scenario, the cylinder pressure is 2000 psi. therefore, the total volume of oxygen in the cylinder is: \[ \text{total volume} = \text{pressure} \times \text{cylinder factor} = 2000 \, \text{psi} \times 0.28 \, \text{l/psi} = 560 \, \text{l} \]

**step 2: calculate the duration of oxygen flow** the duration of flow is the total time the oxygen in the cylinder can last at a given flow rate. here, the flow rate is 4 l/min, prescribed through a nasal cannula. to find the duration, divide the total volume of oxygen by the flow rate: \[ \text{duration} = \frac{\text{total volume}}{\text{flow rate}} = \frac{560 \, \text{l}}{4 \, \text{l/min}} = 140 \, \text{minutes} \]

**conclusion** the duration of the oxygen flow, based on a cylinder pressure of 2000 psi and a flow rate of 4 l/min with a cylinder factor of 0.28 l/psi, is 140 minutes. this calculation is critical for ensuring that the patient has enough oxygen for the required period without running out unexpectedly.

A patient with COPD is both hypoxemic and hypercarbic. Because these patients are maintained with a moderate hypoxemia, the PaO2 level should be in which of the following ranges?

Correct Answer:
between 50 and 60 mm hg
the correct pao2 (partial pressure of arterial oxygen) level for a patient with chronic obstructive pulmonary disease (copd) who is experiencing both hypoxemia (low levels of oxygen in the blood) and hypercarbia (increased levels of carbon dioxide in the blood) should be maintained between 50 and 60 mm hg. additionally, the corresponding saturation of peripheral oxygen (spo2) should be kept between 88% and 92%.

managing oxygen levels in copd patients requires a delicate balance. normally, the drive to breathe is primarily triggered by rising carbon dioxide levels in the blood. however, in copd patients, especially those with chronic hypercarbia, this mechanism can be blunted. the body may instead rely on low levels of oxygen to stimulate breathing. therefore, administering too much supplemental oxygen can suppress a copd patient's respiratory drive, leading to further increases in carbon dioxide levels, a dangerous condition known as hypercapnic respiratory failure.

keeping the pao2 between 50 and 60 mm hg helps ensure that there is enough oxygen to maintain vital tissue function without reaching levels that might suppress the respiratory drive. although this range is lower than normal pao2 levels (which are typically between 80 and 100 mm hg in healthy individuals), it is considered safe and adequate for patients with severe copd.

it is also important to monitor and avoid further reductions in pao2. severe hypoxemia can lead to complications such as pulmonary hypertension (increased blood pressure in the pulmonary artery, leading to the right side of the heart working harder than normal) and cor pulmonale (right heart failure originating from chronic lung disease). these conditions can significantly worsen the patient's prognosis and quality of life.

in summary, the target range for pao2 in copd patients with concomitant hypoxemia and hypercarbia is 50 to 60 mm hg, and for spo2, it is 88% to 92%. this specific management strategy helps balance the need for adequate oxygenation with the risk of suppressing the natural respiratory drive, thereby avoiding potential complications associated with both hypo- and hyperoxia.