NBRC TMC Practice Questions (2026) — Free Sample Questions with Answers

Answer: A

Left-sided pneumothorax: Correct. Hyperresonance, absent or diminished breath sounds and tracheal shift away from the affected side after subclavian puncture indicate a (possibly tension) pneumothorax.

Left-sided pleural effusion: An effusion is dull, not hyperresonant, to percussion.

Left lower lobe consolidation: Consolidation is dull to percussion and usually produces bronchial breath sounds without tracheal shift.

Right upper lobe atelectasis: Atelectasis pulls the trachea toward the affected side and is dull to percussion.

Percussion: hyperresonant = air (pneumothorax, hyperinflation); dull = fluid or solid tissue (effusion, consolidation, atelectasis). Tension pneumothorax pushes the trachea away.

Answer: B

Partially compensated respiratory acidosis: Partial compensation would show a bicarbonate clearly above the expected acute rise (about 30 mEq/L or more for this PaCO2); 26 mEq/L reflects only the acute buffer effect.

Acute respiratory acidosis with hypoxemia: Correct. pH is low, PaCO2 is high, and HCO3− rose only about 1 mEq/L per 10 mm Hg PaCO2, as expected acutely; PaO2 58 indicates hypoxemia from hypoventilation.

Metabolic acidosis with respiratory compensation: Metabolic acidosis requires a low HCO3−, and compensation would lower, not raise, the PaCO2.

Combined respiratory and metabolic acidosis: A combined disorder would show a bicarbonate below normal (below about 22 mEq/L); here HCO3− is normal.

Acute respiratory acidosis: HCO3− rises about 1 mEq/L for each 10 mm Hg rise in PaCO2; chronic compensation raises it about 3.5–4 mEq/L per 10 mm Hg.

Answer: A

N95 respirator and airborne isolation room: Correct. TB is spread by droplet nuclei; airborne precautions require a negative-pressure airborne infection isolation room and an N95 or higher respirator.

Surgical mask within three feet, private room: Droplet precautions do not protect against airborne droplet nuclei.

Gown and gloves, standard private room: Contact precautions address organisms spread by touch, not airborne transmission.

Standard precautions only, door left open: Standard precautions alone are inadequate, and an open door defeats isolation.

Airborne diseases (TB, measles, varicella) = N95 + negative-pressure room; droplet = surgical mask; contact = gown and gloves.

Answer: C

308 minutes: 308 is the volume remaining in liters (1,100 × 0.28); it still must be divided by the flow.

275 minutes: This divides psi by flow and leaves out the cylinder factor.

77 minutes: Correct. Duration = (psi × factor) / flow = (1,100 × 0.28) / 4 = 308 L ÷ 4 L/min = 77 minutes.

863 minutes: This uses the H/K cylinder factor (3.14) instead of the E cylinder factor.

Cylinder duration (min) = gauge pressure (psi) × cylinder factor ÷ flow (L/min). Factors: E = 0.28, H/K = 3.14.

Answer: A

16/min: Correct. New rate = (current rate × current PaCO2) / desired PaCO2 = (12 × 60) / 45 = 16/min.

9/min: This inverts the ratio (12 × 45 / 60); lowering the rate would raise PaCO2 further.

20/min: 20/min overshoots, predicting a PaCO2 of about 36 mm Hg.

14/min: 14/min is too small a change and would leave PaCO2 near 51 mm Hg.

PaCO2 is inversely proportional to alveolar ventilation: new rate (or VE) = current rate × current PaCO2 ÷ desired PaCO2.

Answer: B

About 600 mL: This uses actual body weight (100 kg × 6 mL/kg); lung size relates to height, not weight.

About 440 mL: Correct. Male PBW = 50 + 2.3 × (70 − 60) = 73 kg; 6 mL/kg × 73 kg ≈ 440 mL.

About 585 mL: This is 8 mL/kg PBW, the upper starting value rather than the 6 mL/kg target.

About 730 mL: 10 mL/kg PBW is a traditional volume that increases ventilator-induced lung injury in ARDS.

ARDSNet: VT 6 mL/kg predicted body weight (range 4–8), plateau pressure ≤ 30 cm H2O. Male PBW = 50 + 2.3(height in inches − 60); female = 45.5 + 2.3(height in inches − 60).