TMC EXAM/ LATEST TMC EXIT EXAM 2026 COMPLETE
ACCURATE EXAM APPROVED QUESTIONS AND CORRECT
DETAILED ANSWERS (100% CORRECT VERIFIED
SOLUTIONS) CURRENTLY UPDATED VERSION 2026
EDITION |GUARANTEED SUCCESS A+ (BRAND NEW!)
|INSTANT DOWNLOAD PDF |APPROVED TMC EXIT ACTUAL
EXAM 2026
Question 1
A 56-year-old male with a 40-pack-year history presents with worsening
dyspnea on exertion and a chronic cough. Spirometry shows an
FEV1/FVC ratio of 0.68 and an FEV1 of 45% of predicted. Which of the
following is the most appropriate next step in management?
A) Prescribe oral prednisone daily
B) Initiate long-acting beta-agonist plus inhaled corticosteroid
C) CORRECT ANSWER: Long-acting muscarinic antagonist (LAMA)
monotherapy
D) Refer for lung volume reduction surgery
Question 2
During a mechanical ventilation check, you note a patient has auto-
PEEP of 8 cm H2O. Which ventilator adjustment would most directly
reduce intrinsic PEEP?
A) Increase the respiratory rate
B) CORRECT ANSWER: Decrease the inspiratory time
C) Increase the tidal volume
D) Decrease the flow rate
,Question 3
A patient receiving bi-level positive airway pressure (BiPAP) for acute
hypercapnic respiratory failure has a SpO2 of 89% on FiO2 0.40. ABG
shows pH 7.32, PaCO2 58 mm Hg, PaO2 65 mm Hg. What is the
priority ventilator setting change?
A) Increase expiratory positive airway pressure (EPAP)
B) CORRECT ANSWER: Increase inspiratory positive airway pressure
(IPAP)
C) Increase FiO2 to 0.50
D) Decrease backup respiratory rate
Question 4
Which of the following is the most reliable indicator of adequate tissue
oxygenation during shock resuscitation?
A) Central venous pressure (CVP) of 12 mm Hg
B) Mean arterial pressure (MAP) of 65 mm Hg
C) CORRECT ANSWER: Venous oxygen saturation (SvO2) >70%
D) Lactate level of 4 mmol/L
Question 5
A 72-year-old with COPD is being weaned from mechanical ventilation.
Spontaneous breathing trial (SBT) on T-piece shows respiratory rate
32/min, heart rate 130 bpm, SpO2 88%, and use of accessory muscles.
What is the most appropriate action?
,A) Continue SBT for another 30 minutes
B) CORRECT ANSWER: Terminate SBT and return to previous vent
settings
C) Administer a bronchodilator and continue SBT
D) Extubate to noninvasive ventilation
Question 6
In a patient with acute respiratory distress syndrome (ARDS) on
volume-controlled ventilation, plateau pressure is 32 cm H2O. Which
change best reduces plateau pressure?
A) Increase PEEP to 15 cm H2O
B) CORRECT ANSWER: Decrease tidal volume to 6 mL/kg PBW
C) Increase inspiratory flow to 80 L/min
D) Change to pressure-controlled ventilation
Question 7
Which of the following findings on chest radiograph is most
characteristic of left ventricular failure with pulmonary edema?
A) CORRECT ANSWER: Kerley B lines and perihilar batwing
opacities
B) Unilateral hyperlucent hemithorax
C) Apical fibrobullous changes
D) Wide mediastinum
Question 8
, During patient-ventilator asynchrony, you observe that the ventilator
delivers a breath immediately after the patient begins to exhale. This is
most consistent with:
A) Trigger asynchrony
B) CORRECT ANSWER: Cycle asynchrony (premature cycling)
C) Flow asynchrony
D) Mode asynchrony
Question 9
A patient with asthma has an end-tidal CO2 of 30 mm Hg and PaCO2 of
48 mm Hg. The difference is most likely due to:
A) Increased metabolic rate
B) CORRECT ANSWER: Increased alveolar dead space ventilation
C) Left-to-right shunt
D) Hyperventilation
Question 10
Which of the following is a contraindication to noninvasive positive
pressure ventilation (NPPV)?
A) Obesity hypoventilation syndrome
B) Acute cardiogenic pulmonary edema
C) CORRECT ANSWER: Facial burns or trauma
D) COPD exacerbation with pH 7.32
ACCURATE EXAM APPROVED QUESTIONS AND CORRECT
DETAILED ANSWERS (100% CORRECT VERIFIED
SOLUTIONS) CURRENTLY UPDATED VERSION 2026
EDITION |GUARANTEED SUCCESS A+ (BRAND NEW!)
|INSTANT DOWNLOAD PDF |APPROVED TMC EXIT ACTUAL
EXAM 2026
Question 1
A 56-year-old male with a 40-pack-year history presents with worsening
dyspnea on exertion and a chronic cough. Spirometry shows an
FEV1/FVC ratio of 0.68 and an FEV1 of 45% of predicted. Which of the
following is the most appropriate next step in management?
A) Prescribe oral prednisone daily
B) Initiate long-acting beta-agonist plus inhaled corticosteroid
C) CORRECT ANSWER: Long-acting muscarinic antagonist (LAMA)
monotherapy
D) Refer for lung volume reduction surgery
Question 2
During a mechanical ventilation check, you note a patient has auto-
PEEP of 8 cm H2O. Which ventilator adjustment would most directly
reduce intrinsic PEEP?
A) Increase the respiratory rate
B) CORRECT ANSWER: Decrease the inspiratory time
C) Increase the tidal volume
D) Decrease the flow rate
,Question 3
A patient receiving bi-level positive airway pressure (BiPAP) for acute
hypercapnic respiratory failure has a SpO2 of 89% on FiO2 0.40. ABG
shows pH 7.32, PaCO2 58 mm Hg, PaO2 65 mm Hg. What is the
priority ventilator setting change?
A) Increase expiratory positive airway pressure (EPAP)
B) CORRECT ANSWER: Increase inspiratory positive airway pressure
(IPAP)
C) Increase FiO2 to 0.50
D) Decrease backup respiratory rate
Question 4
Which of the following is the most reliable indicator of adequate tissue
oxygenation during shock resuscitation?
A) Central venous pressure (CVP) of 12 mm Hg
B) Mean arterial pressure (MAP) of 65 mm Hg
C) CORRECT ANSWER: Venous oxygen saturation (SvO2) >70%
D) Lactate level of 4 mmol/L
Question 5
A 72-year-old with COPD is being weaned from mechanical ventilation.
Spontaneous breathing trial (SBT) on T-piece shows respiratory rate
32/min, heart rate 130 bpm, SpO2 88%, and use of accessory muscles.
What is the most appropriate action?
,A) Continue SBT for another 30 minutes
B) CORRECT ANSWER: Terminate SBT and return to previous vent
settings
C) Administer a bronchodilator and continue SBT
D) Extubate to noninvasive ventilation
Question 6
In a patient with acute respiratory distress syndrome (ARDS) on
volume-controlled ventilation, plateau pressure is 32 cm H2O. Which
change best reduces plateau pressure?
A) Increase PEEP to 15 cm H2O
B) CORRECT ANSWER: Decrease tidal volume to 6 mL/kg PBW
C) Increase inspiratory flow to 80 L/min
D) Change to pressure-controlled ventilation
Question 7
Which of the following findings on chest radiograph is most
characteristic of left ventricular failure with pulmonary edema?
A) CORRECT ANSWER: Kerley B lines and perihilar batwing
opacities
B) Unilateral hyperlucent hemithorax
C) Apical fibrobullous changes
D) Wide mediastinum
Question 8
, During patient-ventilator asynchrony, you observe that the ventilator
delivers a breath immediately after the patient begins to exhale. This is
most consistent with:
A) Trigger asynchrony
B) CORRECT ANSWER: Cycle asynchrony (premature cycling)
C) Flow asynchrony
D) Mode asynchrony
Question 9
A patient with asthma has an end-tidal CO2 of 30 mm Hg and PaCO2 of
48 mm Hg. The difference is most likely due to:
A) Increased metabolic rate
B) CORRECT ANSWER: Increased alveolar dead space ventilation
C) Left-to-right shunt
D) Hyperventilation
Question 10
Which of the following is a contraindication to noninvasive positive
pressure ventilation (NPPV)?
A) Obesity hypoventilation syndrome
B) Acute cardiogenic pulmonary edema
C) CORRECT ANSWER: Facial burns or trauma
D) COPD exacerbation with pH 7.32
