TMC PRACTICE EXAM 2026 FINAL PAPER
WITH DETAILED RATIONALES AND
VERIFIED RESPONSES
⫸ A healthy adult female can exhale what portion of her forced vital
capacity in the first second? Answer: 70%
⫸ Following cardiac surgery, a 55 year-old patient has the following
ABG results: pH 7.50, PaCO2 30 torr, PaO2 62 torr, HCO3 25 mEq/L,
SaO2 92%, HB 14 g/dL, BE +2. Venous blood gas results are pH 7.39,
PvCO2 43 torr, PvO2 37 torr, and SvO2 66%. Calculate the patient's
C(a-v)O2. Answer: 5% volume
⫸ What value for the apnea-hypopnea index (AHI) is consistent with
mild obstructive sleep apnea? Answer: 5 to 15
⫸ The respiratory therapist is asked to evaluate the presence of Auto-
PEEP on a patient receiving mechanical ventilation. In order to do this,
what should the RT do? Answer: Initiate an expiratory hold just prior to
the next ventilator-delivered breath
⫸ What do bronchial breath sounds heard over the lung periphery
indicate? Answer: lung consolidation (pneumonia)
Rationale: should be vesicular in periphery
,⫸ A 60 kg (132 lb) patient is mechanically ventilated at the following
settings: VC, A/C; VT 500 mL, respiratory rate 12/min, FIO2 1.00 and
10 cm H2O PEEP. The patient's peak airway pressure is 60 cm H2O and
his SpO2 is 85%. A current chest x-ray shows diffuse bilateral
infiltrates. Which of the following is the most appropriate action in order
to reduce peak airway pressure?
A. Increase the frequency.
B. Change to airway pressure release ventilation.
C. Decrease the inspiratory time.
D. Increase PEEP to 15 cm H2O. Answer: B. Change to airway pressure
release ventilation.
⫸ A 19-year-old patient is brought to the Emergency Department after
taking a handful of pills. The patient is obtunded but is making regular,
sonorous respiratory efforts. Auscultation reveals coarse rhonchi
bilaterally. Which of the following should be done FIRST to assess this
patient?
A. Obtain a sputum specimen.
B. Obtain an ABG.
C. Measure peak expiratory flow.
D. Determine the Glasgow Coma Score. Answer: B. Obtain an ABG.
⫸ A young healthy adult with complaints of intermittent wheezing is
seen in the pulmonary clinic. A pre/post bronchodilator spirometry
, reveals a normal study with no reversibility. Which of the following
should the respiratory therapist recommend?
A. Helium dilution study
B. DLCO
C. Plethysmography
D. Bronchial provocation Answer: D. Bronchial provocation
⫸ Following abdominal surgery, a 70 year-old patient receives
mechanical ventilation in the ICU at the following settings: VC, A/C;
VT 550 mL, respiratory rate 14/min, FIO2 0.50 and 10 cm H2O PEEP.
Bedside monitoring results demonstrate that the PvO2 is 35 torr and the
SpO2 is 90%. The patient is alert and oriented with stable vital signs.
Which of the following should the respiratory therapist recommend?
A. Decrease the PEEP.
B. Increase the FIO2.
C. Initiation diuretic therapy.
D. Continue to monitor closely. Answer: B. Increase the FIO2.
⫸ The respiratory therapist obtains a blood gas sample from the
patient's radial artery and applies pressure to the site for 10 minutes.
After removing any excess air from the syringe, the next step for proper
handling of the blood sample is:
A. adding liquid heparin to the sample.
WITH DETAILED RATIONALES AND
VERIFIED RESPONSES
⫸ A healthy adult female can exhale what portion of her forced vital
capacity in the first second? Answer: 70%
⫸ Following cardiac surgery, a 55 year-old patient has the following
ABG results: pH 7.50, PaCO2 30 torr, PaO2 62 torr, HCO3 25 mEq/L,
SaO2 92%, HB 14 g/dL, BE +2. Venous blood gas results are pH 7.39,
PvCO2 43 torr, PvO2 37 torr, and SvO2 66%. Calculate the patient's
C(a-v)O2. Answer: 5% volume
⫸ What value for the apnea-hypopnea index (AHI) is consistent with
mild obstructive sleep apnea? Answer: 5 to 15
⫸ The respiratory therapist is asked to evaluate the presence of Auto-
PEEP on a patient receiving mechanical ventilation. In order to do this,
what should the RT do? Answer: Initiate an expiratory hold just prior to
the next ventilator-delivered breath
⫸ What do bronchial breath sounds heard over the lung periphery
indicate? Answer: lung consolidation (pneumonia)
Rationale: should be vesicular in periphery
,⫸ A 60 kg (132 lb) patient is mechanically ventilated at the following
settings: VC, A/C; VT 500 mL, respiratory rate 12/min, FIO2 1.00 and
10 cm H2O PEEP. The patient's peak airway pressure is 60 cm H2O and
his SpO2 is 85%. A current chest x-ray shows diffuse bilateral
infiltrates. Which of the following is the most appropriate action in order
to reduce peak airway pressure?
A. Increase the frequency.
B. Change to airway pressure release ventilation.
C. Decrease the inspiratory time.
D. Increase PEEP to 15 cm H2O. Answer: B. Change to airway pressure
release ventilation.
⫸ A 19-year-old patient is brought to the Emergency Department after
taking a handful of pills. The patient is obtunded but is making regular,
sonorous respiratory efforts. Auscultation reveals coarse rhonchi
bilaterally. Which of the following should be done FIRST to assess this
patient?
A. Obtain a sputum specimen.
B. Obtain an ABG.
C. Measure peak expiratory flow.
D. Determine the Glasgow Coma Score. Answer: B. Obtain an ABG.
⫸ A young healthy adult with complaints of intermittent wheezing is
seen in the pulmonary clinic. A pre/post bronchodilator spirometry
, reveals a normal study with no reversibility. Which of the following
should the respiratory therapist recommend?
A. Helium dilution study
B. DLCO
C. Plethysmography
D. Bronchial provocation Answer: D. Bronchial provocation
⫸ Following abdominal surgery, a 70 year-old patient receives
mechanical ventilation in the ICU at the following settings: VC, A/C;
VT 550 mL, respiratory rate 14/min, FIO2 0.50 and 10 cm H2O PEEP.
Bedside monitoring results demonstrate that the PvO2 is 35 torr and the
SpO2 is 90%. The patient is alert and oriented with stable vital signs.
Which of the following should the respiratory therapist recommend?
A. Decrease the PEEP.
B. Increase the FIO2.
C. Initiation diuretic therapy.
D. Continue to monitor closely. Answer: B. Increase the FIO2.
⫸ The respiratory therapist obtains a blood gas sample from the
patient's radial artery and applies pressure to the site for 10 minutes.
After removing any excess air from the syringe, the next step for proper
handling of the blood sample is:
A. adding liquid heparin to the sample.
