NBRC Registered Respiratory Therapist

Case 001 (Pharmacologic and Special Gases): In an emergency department resuscitation bay, a severe bronchospasm patient needs repeated bronchodilator therapy during cross-coverage handoff. Which action BEST matches safe exam-level practice?

• AContinue special-gas therapy without monitoring response metrics.
• BVerify indication, dose, and delivery setup for inhaled medication or special gas, then m…
• CMix incompatible medications in a single nebulizer without verification.
• DUse fixed treatment intervals despite documented adverse effects.

Case 002 (Hemodynamic and Special Procedures): In a long-term acute care setting, a critically ill patient develops hypotension during ventilator adjustment while reassessing response to current therapy. What should the therapist do FIRST?

• ADelay escalation until procedure completion despite clear instability signs.
• BApply identical procedural settings despite major status changes.
• CCoordinate respiratory interventions with hemodynamic monitoring and escalate immediately…
• DPrioritize equipment setup over patient physiologic reassessment.

Case 003 (Quality Control): In an emergency department resuscitation bay, a blood gas analyzer QC check is out of range at shift start as the team considers escalation of care. Which response is MOST appropriate now?

• AShare previous shift's QC result as proof for today's use.
• BAdjust patient settings to compensate for known QC drift.
• CSkip post-maintenance QC checks when the device powers on normally.
• DComplete required quality-control verification and documentation before clinical use, and…

Case 004 (Quality Control): In a pulmonary rehabilitation clinic, a capnograph was serviced and returned to unit stock while preparing the next treatment cycle. Which action BEST matches safe exam-level practice?

• AUse equipment first and complete QC documentation later if time permits.
• BComplete required quality-control verification and documentation before clinical use, and…
• CAccept borderline QC values without repeating verification.
• DContinue clinical use after QC failure if backup equipment is limited.

Case 005 (Pharmacologic and Special Gases): In a neurocritical care unit, the team requests inhaled vasodilator support during hypoxemia during a multidisciplinary bedside update. What should the therapist do FIRST?

• AContinue special-gas therapy without monitoring response metrics.
• BMix incompatible medications in a single nebulizer without verification.
• CVerify indication, dose, and delivery setup for inhaled medication or special gas, then m…
• DUse fixed treatment intervals despite documented adverse effects.

Case 006 (Airway Clearance and Lung Expansion): In a step-down respiratory unit, a post-op patient shows shallow breathing and basal crackles during a rapid status change. What should the therapist do FIRST?

• AUse the same airway-clearance method for all patients regardless of indication.
• BIncrease treatment intensity despite clear intolerance signs.
• CChoose airway-clearance or lung-expansion therapy based on secretion burden, mechanics, c…
• DDelay secretion-management interventions until radiographic worsening is severe.

Case 007 (Oxygenation and Ventilation Support): In an emergency department resuscitation bay, a COPD exacerbation patient remains dyspneic on baseline oxygen during cross-coverage handoff. Which response is MOST appropriate now?

• ATarget saturation above ordered range without considering retention risk.
• BDelay reassessment after major support adjustments.
• CEscalate support without checking interface fit and patient synchrony first.
• DTitrate oxygen or ventilatory support to ordered targets with continuous monitoring, reas…

Case 008 (Clinical Assessment): In a step-down respiratory unit, the patient reports sudden increase in breathlessness at rest while reassessing response to current therapy. What is the MOST appropriate respiratory therapist action?

• APerform a focused bedside assessment (inspection, breath sounds, work of breathing, vital…
• BSkip auscultation because prior shift notes already describe lung sounds.
• CDelay assessment until after routine medication rounds are complete.
• DAssume anxiety is the primary cause without objective exam findings.

Case 009 (Patient Record Evaluation): In a cardiopulmonary intermediate care unit, the night team documented increasing oxygen needs as the team considers escalation of care. Which action BEST matches safe exam-level practice?

• ADocument a treatment recommendation before confirming provider orders.
• BReview current orders, prior RT documentation, code status, and trend data before suggest…
• CAssume code status is unchanged and skip verification during handoff.
• DUse verbal report only and skip direct review of charted objective data.

Case 010 (Recommend Diagnostics): In a telemetry unit during evening coverage, the patient has new unilateral breath-sound reduction while preparing the next treatment cycle. What should the therapist do FIRST?

• ADelay diagnostic recommendations until discharge planning begins.
• BSelect tests based on convenience rather than pathophysiologic suspicion.
• CRecommend targeted diagnostic testing that addresses the current clinical question and is…
• DOrder broad testing panels without a clear management question.

Case 011 (Patient Record Evaluation): In a step-down respiratory unit, the provider added a new bronchodilator order during a multidisciplinary bedside update. What is the MOST appropriate respiratory therapist action?

• AReview current orders, prior RT documentation, code status, and trend data before suggest…
• BPrioritize room turnover and defer chart review until after treatment is started.
• CRely on a single data point and ignore trend direction across the shift.
• DDocument a treatment recommendation before confirming provider orders.

Case 012 (Hemodynamic and Special Procedures): In a neurocritical care unit, post-intubation blood pressure and perfusion become unstable during a rapid status change. Which action BEST matches safe exam-level practice?

• ADelay escalation until procedure completion despite clear instability signs.
• BCoordinate respiratory interventions with hemodynamic monitoring and escalate immediately…
• CApply identical procedural settings despite major status changes.
• DPrioritize equipment setup over patient physiologic reassessment.

Case 013 (Hemodynamic and Special Procedures): In a high-acuity medical floor, a bronchoscopy support case shows rising cardiopulmonary risk markers during cross-coverage handoff. Which response is MOST appropriate now?

• AAssume invasive monitoring data are unnecessary when pulse oximetry is present.
• BProceed with special procedures without baseline hemodynamic assessment.
• CIgnore blood-pressure and perfusion trends during respiratory interventions.
• DCoordinate respiratory interventions with hemodynamic monitoring and escalate immediately…

Case 014 (Infection Prevention and Control): In a cardiopulmonary intermediate care unit, the patient is on contact-plus isolation for enteric infection while reassessing response to current therapy. What should the therapist do FIRST?

• ADelay contaminated equipment replacement until the end of shift.
• BUse the same suction setup across patients if no visible soil is present.
• CApply hand hygiene, correct PPE, aseptic handling, and protocol-based device change/clean…
• DPrioritize speed over isolation-precaution sequencing.

Case 015 (Patient Record Evaluation): In a long-term acute care setting, the chart shows repeated desaturation alarms overnight as the team considers escalation of care. Which action BEST matches safe exam-level practice?

• APrioritize room turnover and defer chart review until after treatment is started.
• BReview current orders, prior RT documentation, code status, and trend data before suggest…
• CRely on a single data point and ignore trend direction across the shift.
• DDocument a treatment recommendation before confirming provider orders.

Case 016 (Quality Control): In a neurocritical care unit, an oxygen analyzer calibration timestamp has expired while preparing the next treatment cycle. What should the therapist do FIRST?

• AContinue clinical use after QC failure if backup equipment is limited.
• BShare previous shift's QC result as proof for today's use.
• CComplete required quality-control verification and documentation before clinical use, and…
• DAdjust patient settings to compensate for known QC drift.

Case 017 (Device Assembly and Troubleshooting): In an emergency department resuscitation bay, a ventilator fails pre-use checks in a high-acuity room during a multidisciplinary bedside update. Which action BEST matches safe exam-level practice?

• AChange multiple settings simultaneously without isolating the fault.
• BUse a stepwise troubleshooting sequence: verify gas/power sources, circuit integrity, cal…
• CSilence persistent alarms and continue therapy without root-cause checks.
• DReplace only the visible component while skipping source and calibration checks.

Case 018 (Quality Control): In an adult ICU, a spirometry module fails routine verification criteria during a rapid status change. Which action BEST matches safe exam-level practice?

• AUse equipment first and complete QC documentation later if time permits.
• BComplete required quality-control verification and documentation before clinical use, and…
• CAccept borderline QC values without repeating verification.
• DContinue clinical use after QC failure if backup equipment is limited.

Case 019 (Pharmacologic and Special Gases): In an emergency department resuscitation bay, a patient develops tremor and tachycardia after aerosol treatment during cross-coverage handoff. Which action BEST matches safe exam-level practice?

• ADocument therapeutic response without post-treatment reassessment.
• BVerify indication, dose, and delivery setup for inhaled medication or special gas, then m…
• CDeliver aerosol medication without confirming route-specific dosing.
• DContinue special-gas therapy without monitoring response metrics.

Case 020 (Recommend Diagnostics): In a long-term acute care setting, oxygen needs rise without a clear bedside explanation while reassessing response to current therapy. Which action BEST matches safe exam-level practice?

• ADelay diagnostic recommendations until discharge planning begins.
• BRecommend targeted diagnostic testing that addresses the current clinical question and is…
• CSelect tests based on convenience rather than pathophysiologic suspicion.
• DOrder broad testing panels without a clear management question.

Case 021 (Patient Record Evaluation): In a post-op surgical floor, the patient has conflicting oxygen targets in two notes as the team considers escalation of care. What is the MOST appropriate respiratory therapist action?

• AReview current orders, prior RT documentation, code status, and trend data before suggest…
• BDocument a treatment recommendation before confirming provider orders.
• CAssume code status is unchanged and skip verification during handoff.
• DUse verbal report only and skip direct review of charted objective data.

Case 022 (Oxygenation and Ventilation Support): In a cardiopulmonary intermediate care unit, a patient on noninvasive support has persistent tachypnea while preparing the next treatment cycle. Which response is MOST appropriate now?

• AKeep oxygen and ventilation settings fixed regardless of patient response.
• BTarget saturation above ordered range without considering retention risk.
• CDelay reassessment after major support adjustments.
• DTitrate oxygen or ventilatory support to ordered targets with continuous monitoring, reas…

Case 023 (Pharmacologic and Special Gases): In a neurocritical care unit, there is uncertainty about humidification during special-gas delivery during a multidisciplinary bedside update. What should the therapist do FIRST?

• ADocument therapeutic response without post-treatment reassessment.
• BDeliver aerosol medication without confirming route-specific dosing.
• CVerify indication, dose, and delivery setup for inhaled medication or special gas, then m…
• DContinue special-gas therapy without monitoring response metrics.