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TMC Practice Exam B Kettering
160 Questions and Answers
(Already GRADED A)
Exam Structure:
Subject: Respiratory Therapy
Source: RRT Exam (Kettering TMC Practice Exam B)
Format: Multiple Choice
1. After a patient undergoes a thoracentesis, the respiratory therapist
notes that the obtained pleural fluid is clear with a slight straw color.
This fluid is most likely the result of:
A. empyema
B. congestive heart failure
C. lung carcinoma
D. hemothorax
Correct Answer: B. congestive heart failure
Rationale:
1. Clear, straw-colored pleural fluid is a transudate, which occurs in
conditions like congestive heart failure due to increased hydrostatic
pressure.
2. Empyema produces purulent fluid; lung carcinoma often produces
bloody or serosanguinous fluid; hemothorax produces grossly bloody
fluid.
2. Which of the following would be most important to evaluate for a
patient who is entering a smoking cessation program?
A. Height
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B. Smoking history
C. Weight
D. Diet
Correct Answer: B. Smoking history
Rationale:
1. Smoking history (pack-years, duration, quit attempts) is essential for
assessing risk and tailoring cessation interventions.
2. Height, weight, and diet are less directly relevant to smoking cessation
success.
3. The respiratory therapist is calibrating a spirometer and checking
the volume with a 3.0 liter super syringe. The volumes recorded are:
2.85 L, 2.8 L, and 2.8 L. Based upon the information obtained which of
the following is a correct statement?
A. Another syringe needs to be used
B. Spirometer is accurate
C. The plunger was advanced too slowly
D. Spirometer may have a leak
Correct Answer: D. Spirometer may have a leak
Rationale:
1. The measured volumes are consistently less than the 3.0 L syringe
volume, suggesting a leak or calibration error.
2. A leak in the spirometer would cause underestimation of delivered
volume.
4. Which of the following is an indication for high frequency jet
ventilation?
A. Bronchopleural fistula
B. Wilson-Mikity syndrome
C. Necrotizing lesion of right lung
D. Centrilobular emphysema
Correct Answer: A. Bronchopleural fistula
Rationale:
1. High-frequency jet ventilation (HFJV) is indicated for bronchopleural
fistula because it uses low tidal volumes and high frequencies, reducing
air leak.
2. HFJV minimizes peak airway pressures, allowing the fistula to heal.
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5. A 43-year-old female patient has just undergone a total abdominal
hysterectomy. The patient arrives in the post anesthesia care unit
obtunded with minimal response to painful stimulus. What treatment
should the respiratory therapist recommend for this patient?
A. Initiate assisted ventilation
B. Insert oropharyngeal airway
C. Obtain positron emission tomography
D. Initiate noninvasive capnography
Correct Answer: B. Insert oropharyngeal airway
Rationale:
1. An obtunded patient with minimal response is at risk for airway
obstruction from the tongue falling back.
2. An oropharyngeal airway lifts the tongue off the posterior pharynx,
maintaining airway patency.
6. A 44 week gestational age infant has just been delivered via C-
section and is gasping, grunting, and has tachycardia and tachypnea.
At one minute his Apgar score is 4 and at 5 minutes the score is 5. The
infant is most likely suffering from:
A. transient tachypnea of the newborn
B. meconium aspiration
C. bronchopulmonary dysplasia
D. apnea of prematurity
Correct Answer: B. meconium aspiration
Rationale:
1. Post-term infants (44 weeks) are at risk for meconium aspiration
syndrome.
2. Symptoms include respiratory distress (gasping, grunting, tachypnea)
and low Apgar scores.
7. What is the normal VD/VT ratio for a patient breathing room air?
A. 5 – 15%
B. 20 – 40%
C. 45 – 55%
D. 65 – 75%
Correct Answer: B. 20 – 40%
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Rationale:
1. Normal physiologic dead space to tidal volume ratio (VD/VT) is 0.20-
0.40 (20-40%).
2. It represents the fraction of each breath that does not participate in gas
exchange.
8. A heat moisture exchanger is indicated for humidification in which
of the following situations?
A. Mechanical ventilation in a long-term care facility
B. Transport to a tertiary care center
C. Patient with tenacious secretions
D. Delivery of aerosolized bronchodilators
Correct Answer: B. Transport to a tertiary care center
Rationale:
1. Heat moisture exchangers (HMEs) are lightweight, portable, and
require no external power, making them ideal for transport.
2. They are not recommended for patients with thick, bloody, or tenacious
secretions.
9. All of the following could cause a patient's right-hemidiaphragm to
be elevated, EXCEPT:
A. right lower lobe atelectasis
B. right side hyperlucency, absent vascular markings
C. hepatomegaly
D. right lower lobe consolidation with air bronchograms
Correct Answer: B. right side hyperlucency, absent vascular markings
Rationale:
1. Right side hyperlucency with absent vascular markings suggests a
pneumothorax, which would cause the diaphragm to appear lower, not
elevated.
2. Atelectasis, hepatomegaly, and consolidation can all cause ipsilateral
diaphragm elevation due to mass effect or loss of lung volume.
10. A 64-year-old, 70 kg (154 lb) man with severe COPD is receiving
independent (differential) lung ventilation following thoracotomy and
right lower lobectomy. Which of the following setting combinations
would be most appropriate for this patient?
TMC Practice Exam B Kettering
160 Questions and Answers
(Already GRADED A)
Exam Structure:
Subject: Respiratory Therapy
Source: RRT Exam (Kettering TMC Practice Exam B)
Format: Multiple Choice
1. After a patient undergoes a thoracentesis, the respiratory therapist
notes that the obtained pleural fluid is clear with a slight straw color.
This fluid is most likely the result of:
A. empyema
B. congestive heart failure
C. lung carcinoma
D. hemothorax
Correct Answer: B. congestive heart failure
Rationale:
1. Clear, straw-colored pleural fluid is a transudate, which occurs in
conditions like congestive heart failure due to increased hydrostatic
pressure.
2. Empyema produces purulent fluid; lung carcinoma often produces
bloody or serosanguinous fluid; hemothorax produces grossly bloody
fluid.
2. Which of the following would be most important to evaluate for a
patient who is entering a smoking cessation program?
A. Height
, 2|Page
B. Smoking history
C. Weight
D. Diet
Correct Answer: B. Smoking history
Rationale:
1. Smoking history (pack-years, duration, quit attempts) is essential for
assessing risk and tailoring cessation interventions.
2. Height, weight, and diet are less directly relevant to smoking cessation
success.
3. The respiratory therapist is calibrating a spirometer and checking
the volume with a 3.0 liter super syringe. The volumes recorded are:
2.85 L, 2.8 L, and 2.8 L. Based upon the information obtained which of
the following is a correct statement?
A. Another syringe needs to be used
B. Spirometer is accurate
C. The plunger was advanced too slowly
D. Spirometer may have a leak
Correct Answer: D. Spirometer may have a leak
Rationale:
1. The measured volumes are consistently less than the 3.0 L syringe
volume, suggesting a leak or calibration error.
2. A leak in the spirometer would cause underestimation of delivered
volume.
4. Which of the following is an indication for high frequency jet
ventilation?
A. Bronchopleural fistula
B. Wilson-Mikity syndrome
C. Necrotizing lesion of right lung
D. Centrilobular emphysema
Correct Answer: A. Bronchopleural fistula
Rationale:
1. High-frequency jet ventilation (HFJV) is indicated for bronchopleural
fistula because it uses low tidal volumes and high frequencies, reducing
air leak.
2. HFJV minimizes peak airway pressures, allowing the fistula to heal.
, 3|Page
5. A 43-year-old female patient has just undergone a total abdominal
hysterectomy. The patient arrives in the post anesthesia care unit
obtunded with minimal response to painful stimulus. What treatment
should the respiratory therapist recommend for this patient?
A. Initiate assisted ventilation
B. Insert oropharyngeal airway
C. Obtain positron emission tomography
D. Initiate noninvasive capnography
Correct Answer: B. Insert oropharyngeal airway
Rationale:
1. An obtunded patient with minimal response is at risk for airway
obstruction from the tongue falling back.
2. An oropharyngeal airway lifts the tongue off the posterior pharynx,
maintaining airway patency.
6. A 44 week gestational age infant has just been delivered via C-
section and is gasping, grunting, and has tachycardia and tachypnea.
At one minute his Apgar score is 4 and at 5 minutes the score is 5. The
infant is most likely suffering from:
A. transient tachypnea of the newborn
B. meconium aspiration
C. bronchopulmonary dysplasia
D. apnea of prematurity
Correct Answer: B. meconium aspiration
Rationale:
1. Post-term infants (44 weeks) are at risk for meconium aspiration
syndrome.
2. Symptoms include respiratory distress (gasping, grunting, tachypnea)
and low Apgar scores.
7. What is the normal VD/VT ratio for a patient breathing room air?
A. 5 – 15%
B. 20 – 40%
C. 45 – 55%
D. 65 – 75%
Correct Answer: B. 20 – 40%
, 4|Page
Rationale:
1. Normal physiologic dead space to tidal volume ratio (VD/VT) is 0.20-
0.40 (20-40%).
2. It represents the fraction of each breath that does not participate in gas
exchange.
8. A heat moisture exchanger is indicated for humidification in which
of the following situations?
A. Mechanical ventilation in a long-term care facility
B. Transport to a tertiary care center
C. Patient with tenacious secretions
D. Delivery of aerosolized bronchodilators
Correct Answer: B. Transport to a tertiary care center
Rationale:
1. Heat moisture exchangers (HMEs) are lightweight, portable, and
require no external power, making them ideal for transport.
2. They are not recommended for patients with thick, bloody, or tenacious
secretions.
9. All of the following could cause a patient's right-hemidiaphragm to
be elevated, EXCEPT:
A. right lower lobe atelectasis
B. right side hyperlucency, absent vascular markings
C. hepatomegaly
D. right lower lobe consolidation with air bronchograms
Correct Answer: B. right side hyperlucency, absent vascular markings
Rationale:
1. Right side hyperlucency with absent vascular markings suggests a
pneumothorax, which would cause the diaphragm to appear lower, not
elevated.
2. Atelectasis, hepatomegaly, and consolidation can all cause ipsilateral
diaphragm elevation due to mass effect or loss of lung volume.
10. A 64-year-old, 70 kg (154 lb) man with severe COPD is receiving
independent (differential) lung ventilation following thoracotomy and
right lower lobectomy. Which of the following setting combinations
would be most appropriate for this patient?
