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Respiratory cram has prepared a series of FREE NBRC TMC exam review questions which includes full rationales for both correct and wrong answers. This content will help you improve efficiency, memory, comprehension skills, test-taking strategies, and reduce mistakes on the actual NBRC certification examination. For a complete review of the TMC and CSE exams checkout our monthly exam prep membership by clicking HERE.

Question 1 of 30

A patient receiving mechanical ventilation has increased peak inspiratory pressures, coarse rhonchi, and a fever. What should the respiratory therapist recommend?

  1. Sputum culture and gram stain
  2. Increase the tidal volume
  3. Chest physiotherapy
  4. Spontaneous breath trial

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Sputum culture and gram stain


  1. Correct. The patient’s fever and coarse rhonchi may indicate the presence of an infection. A sputum culture and gram stain will identify if there is gram positive, or gram negative bacteria present in the sputum.
  2. Increasing the tidal volume will not address the patient’s increased peak airway pressures, airway secretions, and fever.
  3. Chest physiotherapy may help if there is difficulty removing secretions. However, secretions alone are not an indication to begin chest physiotherapy.
  4. There is no evidence from the information given in the question that a spontaneous breathing trial is indicated.