TMC PRACTICE EXAM
150+ (2026 A+ Graded) Exam-Style Questions | Verified Solutions |
Complete Answer Key
100% Guarantee Pass
📋 DOCUMENT OVERVIEW 151 Qs
This document, "TMC Practice Exam", focuses on critical care and respiratory topics, specifically covering
areas such as heart failure diagnosis, respiratory complications post-surgery, tracheal mucosa damage
prevention, bronchial hygiene therapies, ventilator settings and management, and oxygen delivery systems.
It provides 151 questions with detailed explanations and rationales for each answer, offering a
comprehensive review of these topics. Students can utilize this document to study, review, and understand
complex concepts, enhancing their knowledge and preparation for exams in critical care and respiratory
fields.
✓ Verified Answers ✓ Exam Ready ✓ Study Guide
Trusted by thousands of students and professionals worldwide
EXAM QUESTIONS
Trusted by thousands of students and professionals worldwide Page 1 of 77
, QUESTION 1
A 48 year-old female is admitted to the ED with diaphoresis, jugular venous distension, and 3+ pitting
edema in the ankles. These findings are consistent with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances
CORRECT ANSWER
Heart failure
RATIONALE: The presence of diaphoresis and jugular venous distension indicates a potential issue with the heart's ability to
pump blood effectively, which is a hallmark of heart failure. The 3+ pitting edema in the ankles is also consistent with heart
failure, as fluid buildup in the peripheral tissues is a common complication of decreased cardiac function.
QUESTION 2
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?
A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate the patient.
CORRECT ANSWER
Needle aspirate the 2nd left intercostal space.
RATIONALE: The therapist should recommend needle aspirating the 2nd left intercostal space because this action allows for
immediate assessment of the tension pneumothorax, which is likely given the patient's absent breath sounds,
hyperresonant percussion note, and tracheal shift. By performing the needle aspiration, the therapist can quickly relieve the
pneumothorax and potentially restore blood pressure and heart rate, making it a critical first step in managing this life-
threatening condition.
Trusted by thousands of students and professionals worldwide Page 2 of 77
, QUESTION 3
All of the following strategies are likely to decrease the likelihood of damage to the tracheal mucosa
EXCEPT
A. maintaining cuff pressures between 20 and 25 mm Hg.
B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures.
CORRECT ANSWER
monitoring intracuff pressures.
RATIONALE: Monitoring intracuff pressures would increase the likelihood of damage to the tracheal mucosa because over-
inflation of the cuff can occur if pressures are not being constantly monitored and adjusted, leading to excessive pressure
on the mucosal lining. In contrast, the other options are designed to minimize pressure on the mucosa, making them
strategies that decrease the likelihood of damage.
QUESTION 4
A 52 year-old post-operative cholecystectomy patient's breath sounds become more coarse upon
completion of postural drainage with percussion. The respiratory therapist should recommend
A. continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear secretions.
CORRECT ANSWER
deep breathing and coughing to clear secretions.
RATIONALE: The patient's coarser breath sounds after postural drainage with percussion indicate that the therapy has
successfully mobilized secretions into the airways, but they now need to be cleared to prevent further complications.
Recommending deep breathing and coughing to clear secretions allows the patient to effectively expel the mobilized
secretions, thereby resolving the issue and preventing potential respiratory distress.
Trusted by thousands of students and professionals worldwide Page 3 of 77
, QUESTION 5
A 65 kg spinal cord injured patient has developed atelectasis. His inspiratory capacity is 30% of his
predicted value. What bronchial hygiene therapy would be most appropriate initially?
A. IS / SMI
B. IPPB with normal saline
C. postural drainage and percussion
D. PEP therapy
CORRECT ANSWER
IPPB with normal saline
RATIONALE: The correct answer is "IPPB with normal saline" because the patient has a significantly reduced inspiratory
capacity, making it difficult to achieve adequate inspiratory flow rates for effective mucolytic therapy. In this scenario, IPPB
(Intermittent Positive Pressure Breathing) with normal saline provides a more controlled and efficient method of delivering
bronchodilators and mucolytics directly into the lungs, bypassing the patient's limited inspiratory capabilities.
QUESTION 6
A patient on VC ventilation has demonstrated auto-PEEP on ventilator graphics. Which of the following
controls, when adjusted independently, would increase expiratory time?
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity
CORRECT ANSWER
1, 2, and 3 only
RATIONALE: Increasing expiratory time on VC ventilation is directly related to the duration of exhalation, which can be
controlled by adjusting the rate at which the patient breathes. By decreasing the respiratory rate, the patient has more time
available for exhalation, thereby increasing expiratory time and reducing auto-PEEP.
Trusted by thousands of students and professionals worldwide Page 4 of 77
150+ (2026 A+ Graded) Exam-Style Questions | Verified Solutions |
Complete Answer Key
100% Guarantee Pass
📋 DOCUMENT OVERVIEW 151 Qs
This document, "TMC Practice Exam", focuses on critical care and respiratory topics, specifically covering
areas such as heart failure diagnosis, respiratory complications post-surgery, tracheal mucosa damage
prevention, bronchial hygiene therapies, ventilator settings and management, and oxygen delivery systems.
It provides 151 questions with detailed explanations and rationales for each answer, offering a
comprehensive review of these topics. Students can utilize this document to study, review, and understand
complex concepts, enhancing their knowledge and preparation for exams in critical care and respiratory
fields.
✓ Verified Answers ✓ Exam Ready ✓ Study Guide
Trusted by thousands of students and professionals worldwide
EXAM QUESTIONS
Trusted by thousands of students and professionals worldwide Page 1 of 77
, QUESTION 1
A 48 year-old female is admitted to the ED with diaphoresis, jugular venous distension, and 3+ pitting
edema in the ankles. These findings are consistent with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances
CORRECT ANSWER
Heart failure
RATIONALE: The presence of diaphoresis and jugular venous distension indicates a potential issue with the heart's ability to
pump blood effectively, which is a hallmark of heart failure. The 3+ pitting edema in the ankles is also consistent with heart
failure, as fluid buildup in the peripheral tissues is a common complication of decreased cardiac function.
QUESTION 2
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?
A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate the patient.
CORRECT ANSWER
Needle aspirate the 2nd left intercostal space.
RATIONALE: The therapist should recommend needle aspirating the 2nd left intercostal space because this action allows for
immediate assessment of the tension pneumothorax, which is likely given the patient's absent breath sounds,
hyperresonant percussion note, and tracheal shift. By performing the needle aspiration, the therapist can quickly relieve the
pneumothorax and potentially restore blood pressure and heart rate, making it a critical first step in managing this life-
threatening condition.
Trusted by thousands of students and professionals worldwide Page 2 of 77
, QUESTION 3
All of the following strategies are likely to decrease the likelihood of damage to the tracheal mucosa
EXCEPT
A. maintaining cuff pressures between 20 and 25 mm Hg.
B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures.
CORRECT ANSWER
monitoring intracuff pressures.
RATIONALE: Monitoring intracuff pressures would increase the likelihood of damage to the tracheal mucosa because over-
inflation of the cuff can occur if pressures are not being constantly monitored and adjusted, leading to excessive pressure
on the mucosal lining. In contrast, the other options are designed to minimize pressure on the mucosa, making them
strategies that decrease the likelihood of damage.
QUESTION 4
A 52 year-old post-operative cholecystectomy patient's breath sounds become more coarse upon
completion of postural drainage with percussion. The respiratory therapist should recommend
A. continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear secretions.
CORRECT ANSWER
deep breathing and coughing to clear secretions.
RATIONALE: The patient's coarser breath sounds after postural drainage with percussion indicate that the therapy has
successfully mobilized secretions into the airways, but they now need to be cleared to prevent further complications.
Recommending deep breathing and coughing to clear secretions allows the patient to effectively expel the mobilized
secretions, thereby resolving the issue and preventing potential respiratory distress.
Trusted by thousands of students and professionals worldwide Page 3 of 77
, QUESTION 5
A 65 kg spinal cord injured patient has developed atelectasis. His inspiratory capacity is 30% of his
predicted value. What bronchial hygiene therapy would be most appropriate initially?
A. IS / SMI
B. IPPB with normal saline
C. postural drainage and percussion
D. PEP therapy
CORRECT ANSWER
IPPB with normal saline
RATIONALE: The correct answer is "IPPB with normal saline" because the patient has a significantly reduced inspiratory
capacity, making it difficult to achieve adequate inspiratory flow rates for effective mucolytic therapy. In this scenario, IPPB
(Intermittent Positive Pressure Breathing) with normal saline provides a more controlled and efficient method of delivering
bronchodilators and mucolytics directly into the lungs, bypassing the patient's limited inspiratory capabilities.
QUESTION 6
A patient on VC ventilation has demonstrated auto-PEEP on ventilator graphics. Which of the following
controls, when adjusted independently, would increase expiratory time?
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity
CORRECT ANSWER
1, 2, and 3 only
RATIONALE: Increasing expiratory time on VC ventilation is directly related to the duration of exhalation, which can be
controlled by adjusting the rate at which the patient breathes. By decreasing the respiratory rate, the patient has more time
available for exhalation, thereby increasing expiratory time and reducing auto-PEEP.
Trusted by thousands of students and professionals worldwide Page 4 of 77
