TMC PRACTICE EXAM 2026 TEST BANK
PROVIDING SOLVED ITEMS AND
COMPLETE ANSWER KEY
⫸ Needle aspirate the 2nd left intercostal space. Answer: A patient is
admitted to the ED following a motor vehicle accident. On physical
exam, the respiratory therapist discovers that breath sounds are absent in
the left chest with a hyperresonant percussion note. The trachea is
shifted to the right. The patient's heart rate is 45/min, respiratory rate is
30/min, and blood pressure is 60/40 mm Hg. What action should the
therapist recommend first?
⫸ 1. Use the minimal leak technique for inflation. 2. Use a low-
residual-volume, low-compliance cuff. 3. Monitor intracuff pressures..
Answer: All of the following strategies are likely to decrease the
likelihood of damage to the tracheal mucosa:
⫸ Deep breathing and coughing to clear secretions.. Answer: A 52 year-
old post-operative cholecystectomy (surgical removal of the gallbladder)
patient's breath sounds become more coarse upon completion of postural
drainage with percussion. The respiratory therapist should recommend...
⫸ Intermittent positive pressure breathing (IPPB). Answer: A 65 kg
spinal cord injured patient develops atelectasis. His inspiratory capacity
is 30% of his predicted value. What bronchial hygiene therapy (a broad
term used to describe various airway clearance technique) would be
most appropriate initially?
,⫸ 70%. Answer: A healthy adult female can exhale what portion of her
forced vital capacity in the first second?
⫸ 1. Tidal volume 2. Respiratory Rate 3. Inspiratory flow. Answer: A
patient on VC ventilation demonstrates auto-PEEP on ventilator
graphics. What controls, when adjusted independently, would increase
expiratory time?
⫸ Insert a chest tube. Answer: What would be the most appropriate
therapy for a dyspneic patient who has crepitus with tracheal deviation
to the left and absent breath sounds on the right?
⫸ 5.0 vol%. Answer: 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.
⫸ 50 mL/cm H2O. Answer: A patient on VC, SIMV with a VT of 500
mL has a PIP of 25 cm H2O, Pplat of 15 cm H2O and PEEP of 5 cm
H2O. What is the patient's static lung compliance?
⫸ Reintubation. Answer: Immediately after extubation of a patient in
the ICU, the respiratory therapist observes increasing respiratory distress
with intercostal retractions and marked stridor. The SpO2 on 40%
oxygen is noted to be 76%. Which of the following would be most
appropriate at this time?
,⫸ A patient on SIMV with a mandatory rate of 12/min and total rate of
24/min. Answer: What type of patient would most likely benefit from
pressure support ventilation?
⫸ Obtain a sputum gram stain. Answer: A patient receiving mechanical
ventilation has developed a temperature of 99.9° F with purulent
secretions over the last 12 hours. The respiratory therapist has also noted
a steady increase in peak inspiratory pressure. What initial
recommendation should be made to address these changes?
⫸ 1. FEV1 2. PEFR. Answer: What information may be obtained from
a FVC maneuver during bedside pulmonary function testing?
⫸ Retard bacterial growth. Answer: The respiratory therapist provides
education for a patient who is being discharged home on aerosol
therapy. The most important reason for the patient to follow the
recommended cleaning procedures using a vinegar/water solution is that
this solution will...
⫸ Pleural effusion. Answer: A patient who complains of dyspnea is
noted to have a dry, non-productive cough. On physical examination,
breath sounds are diminished on the right, tactile fremitus is decreased
and there is dullness to percussion over the right lower lobe. The
respiratory therapist should suspect that the patient is suffering from
⫸ 12 Fr. Answer: What size suction catheters would be appropriate to
use for a patient with a size 8.0 mm ID endotracheal tube?
, ⫸ The endotracheal tube has slipped into the right main stem bronchus..
Answer: A patient who is receiving continuous mechanical ventilation is
fighting the ventilator. His breath sounds are markedly diminished on
the left, there is dullness to percussion on the left, and the trachea is
shifted to the left. The most likely explanation for the problem is that...
⫸ Apply pressure to the site.. Answer: The respiratory therapist notes a
developing hematoma after an arterial blood gas was drawn from the
right radial artery. The immediate response is to...
⫸ Elevated intracranial pressure. Answer: A patient's breathing pattern
irregularly increases and decreases and is interspersed with periods of
apnea up to 1 minute. Which of the following conditions is the most
likely cause of this problem?
⫸ 5 to 15. Answer: What value for the apnea-hypopnea index (AHI) is
consistent with mild obstructive sleep apnea?
⫸ Air leak around the sensor. Answer: While monitoring a newborn
utilizing a transcutaneous monitor, the respiratory therapist notices a
change in PtcO2 from 60 to 142 torr and simultaneously the PtcCO2
changes from 37 to 2 torr. What is the most likely explanation for these
changes?
⫸ 55 L/min. Answer: A patient on the general medical ward receives
oxygen via 28% air entrainment mask with the flowmeter set at 5 L/min.
What is the total flow delivered to the patient?
PROVIDING SOLVED ITEMS AND
COMPLETE ANSWER KEY
⫸ Needle aspirate the 2nd left intercostal space. Answer: A patient is
admitted to the ED following a motor vehicle accident. On physical
exam, the respiratory therapist discovers that breath sounds are absent in
the left chest with a hyperresonant percussion note. The trachea is
shifted to the right. The patient's heart rate is 45/min, respiratory rate is
30/min, and blood pressure is 60/40 mm Hg. What action should the
therapist recommend first?
⫸ 1. Use the minimal leak technique for inflation. 2. Use a low-
residual-volume, low-compliance cuff. 3. Monitor intracuff pressures..
Answer: All of the following strategies are likely to decrease the
likelihood of damage to the tracheal mucosa:
⫸ Deep breathing and coughing to clear secretions.. Answer: A 52 year-
old post-operative cholecystectomy (surgical removal of the gallbladder)
patient's breath sounds become more coarse upon completion of postural
drainage with percussion. The respiratory therapist should recommend...
⫸ Intermittent positive pressure breathing (IPPB). Answer: A 65 kg
spinal cord injured patient develops atelectasis. His inspiratory capacity
is 30% of his predicted value. What bronchial hygiene therapy (a broad
term used to describe various airway clearance technique) would be
most appropriate initially?
,⫸ 70%. Answer: A healthy adult female can exhale what portion of her
forced vital capacity in the first second?
⫸ 1. Tidal volume 2. Respiratory Rate 3. Inspiratory flow. Answer: A
patient on VC ventilation demonstrates auto-PEEP on ventilator
graphics. What controls, when adjusted independently, would increase
expiratory time?
⫸ Insert a chest tube. Answer: What would be the most appropriate
therapy for a dyspneic patient who has crepitus with tracheal deviation
to the left and absent breath sounds on the right?
⫸ 5.0 vol%. Answer: 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.
⫸ 50 mL/cm H2O. Answer: A patient on VC, SIMV with a VT of 500
mL has a PIP of 25 cm H2O, Pplat of 15 cm H2O and PEEP of 5 cm
H2O. What is the patient's static lung compliance?
⫸ Reintubation. Answer: Immediately after extubation of a patient in
the ICU, the respiratory therapist observes increasing respiratory distress
with intercostal retractions and marked stridor. The SpO2 on 40%
oxygen is noted to be 76%. Which of the following would be most
appropriate at this time?
,⫸ A patient on SIMV with a mandatory rate of 12/min and total rate of
24/min. Answer: What type of patient would most likely benefit from
pressure support ventilation?
⫸ Obtain a sputum gram stain. Answer: A patient receiving mechanical
ventilation has developed a temperature of 99.9° F with purulent
secretions over the last 12 hours. The respiratory therapist has also noted
a steady increase in peak inspiratory pressure. What initial
recommendation should be made to address these changes?
⫸ 1. FEV1 2. PEFR. Answer: What information may be obtained from
a FVC maneuver during bedside pulmonary function testing?
⫸ Retard bacterial growth. Answer: The respiratory therapist provides
education for a patient who is being discharged home on aerosol
therapy. The most important reason for the patient to follow the
recommended cleaning procedures using a vinegar/water solution is that
this solution will...
⫸ Pleural effusion. Answer: A patient who complains of dyspnea is
noted to have a dry, non-productive cough. On physical examination,
breath sounds are diminished on the right, tactile fremitus is decreased
and there is dullness to percussion over the right lower lobe. The
respiratory therapist should suspect that the patient is suffering from
⫸ 12 Fr. Answer: What size suction catheters would be appropriate to
use for a patient with a size 8.0 mm ID endotracheal tube?
, ⫸ The endotracheal tube has slipped into the right main stem bronchus..
Answer: A patient who is receiving continuous mechanical ventilation is
fighting the ventilator. His breath sounds are markedly diminished on
the left, there is dullness to percussion on the left, and the trachea is
shifted to the left. The most likely explanation for the problem is that...
⫸ Apply pressure to the site.. Answer: The respiratory therapist notes a
developing hematoma after an arterial blood gas was drawn from the
right radial artery. The immediate response is to...
⫸ Elevated intracranial pressure. Answer: A patient's breathing pattern
irregularly increases and decreases and is interspersed with periods of
apnea up to 1 minute. Which of the following conditions is the most
likely cause of this problem?
⫸ 5 to 15. Answer: What value for the apnea-hypopnea index (AHI) is
consistent with mild obstructive sleep apnea?
⫸ Air leak around the sensor. Answer: While monitoring a newborn
utilizing a transcutaneous monitor, the respiratory therapist notices a
change in PtcO2 from 60 to 142 torr and simultaneously the PtcCO2
changes from 37 to 2 torr. What is the most likely explanation for these
changes?
⫸ 55 L/min. Answer: A patient on the general medical ward receives
oxygen via 28% air entrainment mask with the flowmeter set at 5 L/min.
What is the total flow delivered to the patient?
