1
TMC Practice Exam Actual Exam 2026/2027
– Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
[SECTION 1: Patient Data Evaluation & Clinical Assessment — Questions 1-30]
Q1: While assessing a patient with pleural effusion, which of the following percussion notes
would you expect to find over the fluid accumulation?
A. Hyperresonance
B. Resonance
C. Tympany
D. Dullness
D. Dullness [CORRECT]
Correct Answer: D
Rationale: Pleural effusion involves the accumulation of fluid in the pleural space, which
dampens the sound produced during percussion, resulting in a dull note. Hyperresonance (Option
A) is associated with air trapping as seen in pneumothorax or COPD. Resonance (Option B) is
the normal sound over healthy lung tissue. Tympany (Option C) is typically heard over the
stomach or trapped air (gastric distension).
Q2: You are reviewing a chest radiograph of an intubated patient. The tip of the endotracheal
tube is visualized 2 cm above the carina. You should recommend:
A. Withdrawing the tube by 2-3 cm.
B. Advancing the tube by 2-3 cm.
C. Leaving the tube in its current position.
D. Removing the tube and reintubating.
A. Withdrawing the tube by 2-3 cm. [CORRECT]
,2
Correct Answer: A
Rationale: The correct placement for an endotracheal tube tip is generally between 3 and 5 cm
above the carina (or 2-3 cm per some newer guidelines to prevent mainstem intubation during
neck flexion). A position of only 2 cm above the carina is too deep and risks inadvertent
mainstem intubation, especially if the patient's neck is flexed. Advancing (Option B) would
likely cause a mainstem intubation. Leaving it (Option C) is unsafe. Reintubation (Option D) is
unnecessary as simple retraction is sufficient.
Q3: A patient with emphysema presents with a barrel chest and use of accessory muscles. During
palpation, you would expect to find:
A. Increased tactile fremitus.
B. Decreased tactile fremitus.
C. Normal tactile fremitus.
D. Tender spots on the chest wall.
B. Decreased tactile fremitus. [CORRECT]
Correct Answer: B
Rationale: Emphysema involves the destruction of alveolar walls and air trapping, leading to
hyperinflation and increased density of the lung tissue (or rather, poor transmission of sound due
to air). This results in decreased tactile fremitus. Increased fremitus (Option A) occurs in
conditions like consolidation (pneumonia). Option C is incorrect for emphysema. Option D is
non-specific and not a classic sign of emphysema.
Q4: Which of the following bedside assessment findings is most consistent with a diagnosis of
left-sided heart failure?
A. Orthopnea and crackles
B. Wheezing and stridor
C. Hyperresonance and dry cough
D. Decreased tactile fremitus and fever
A. Orthopnea and crackles [CORRECT]
,3
Correct Answer: A
Rationale: Left-sided heart failure causes pulmonary congestion and edema, leading to crackles
(rales) in the lung bases and orthopnea (shortness of breath when lying flat) due to fluid
redistribution. Wheezing (Option B) is more associated with asthma or COPD (cardiac asthma
can occur but crackles are more specific for failure). Hyperresonance (Option C) suggests air
trapping. Decreased fremitus and fever (Option D) suggests pleural effusion or pneumonia.
Q5: While performing a physical assessment, you hear a high-pitched, crowing sound
predominantly during inspiration. This sound is best described as:
A. Wheezing.
B. Stridor.
C. Rhonchi.
D. Pleural friction rub.
B. Stridor. [CORRECT]
Correct Answer: B
Rationale: Stridor is a high-pitched, crowing sound caused by upper airway obstruction (larynx,
trachea) and is typically heard loudest during inspiration. Wheezing (Option A) is usually
expiratory and caused by lower airway obstruction. Rhonchi (Option C) are low-pitched
rumbling sounds caused by secretions in larger airways. A pleural friction rub (Option D) is a
dry, grating sound caused by inflamed pleural surfaces.
Q6: You are evaluating a patient's ABG results: pH 7.30, PaCO2 50 mm Hg, HCO3- 24 mEq/L.
How would you interpret this acid-base status?
A. Fully compensated respiratory acidosis
B. Uncompensated respiratory acidosis
C. Uncompensated metabolic acidosis
D. Partially compensated respiratory acidosis
D. Partially compensated respiratory acidosis [CORRECT]
, 4
Correct Answer: D
Q7: A patient's SpO2 drops from 96% to 88% while receiving oxygen via nasal cannula at 2
L/min. The patient is drowsy. What is the most appropriate initial action?
A. Increase the FiO2 to 6 L/min NC.
B. Prepare for immediate intubation.
C. Assess the patient's airway patency and breathing effort.
D. Obtain an arterial blood gas.
C. Assess the patient's airway patency and breathing effort. [CORRECT]
Correct Answer: C
Rationale: The primary assessment in any deteriorating patient follows the ABCs (Airway,
Breathing, Circulation). Before changing equipment or invasively monitoring, the therapist must
ensure the airway is not obstructed and determine if the patient is breathing adequately.
Increasing oxygen (Option A) might be necessary later, but assessment comes first. Intubation
(Option B) may be needed but assessment determines the urgency. ABG (Option D) provides
data but does not treat the immediate desaturation/drowsiness.
Q8: On a chest X-ray, you observe a "ground-glass" appearance. This pattern is most
characteristic of:
A. Pneumothorax.
B. Large pleural effusion.
C. Pulmonary edema or interstitial lung disease.
D. Atelectasis.
C. Pulmonary edema or interstitial lung disease. [CORRECT]
Correct Answer: C
Rationale: Ground-glass opacity refers to hazy increased lung attenuation that does not obscure
the underlying pulmonary vessels. It is classic for pulmonary edema (cardiogenic or non-
cardiogenic), pneumonia (early stages), or interstitial lung diseases. Pneumothorax (Option A)
TMC Practice Exam Actual Exam 2026/2027
– Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
[SECTION 1: Patient Data Evaluation & Clinical Assessment — Questions 1-30]
Q1: While assessing a patient with pleural effusion, which of the following percussion notes
would you expect to find over the fluid accumulation?
A. Hyperresonance
B. Resonance
C. Tympany
D. Dullness
D. Dullness [CORRECT]
Correct Answer: D
Rationale: Pleural effusion involves the accumulation of fluid in the pleural space, which
dampens the sound produced during percussion, resulting in a dull note. Hyperresonance (Option
A) is associated with air trapping as seen in pneumothorax or COPD. Resonance (Option B) is
the normal sound over healthy lung tissue. Tympany (Option C) is typically heard over the
stomach or trapped air (gastric distension).
Q2: You are reviewing a chest radiograph of an intubated patient. The tip of the endotracheal
tube is visualized 2 cm above the carina. You should recommend:
A. Withdrawing the tube by 2-3 cm.
B. Advancing the tube by 2-3 cm.
C. Leaving the tube in its current position.
D. Removing the tube and reintubating.
A. Withdrawing the tube by 2-3 cm. [CORRECT]
,2
Correct Answer: A
Rationale: The correct placement for an endotracheal tube tip is generally between 3 and 5 cm
above the carina (or 2-3 cm per some newer guidelines to prevent mainstem intubation during
neck flexion). A position of only 2 cm above the carina is too deep and risks inadvertent
mainstem intubation, especially if the patient's neck is flexed. Advancing (Option B) would
likely cause a mainstem intubation. Leaving it (Option C) is unsafe. Reintubation (Option D) is
unnecessary as simple retraction is sufficient.
Q3: A patient with emphysema presents with a barrel chest and use of accessory muscles. During
palpation, you would expect to find:
A. Increased tactile fremitus.
B. Decreased tactile fremitus.
C. Normal tactile fremitus.
D. Tender spots on the chest wall.
B. Decreased tactile fremitus. [CORRECT]
Correct Answer: B
Rationale: Emphysema involves the destruction of alveolar walls and air trapping, leading to
hyperinflation and increased density of the lung tissue (or rather, poor transmission of sound due
to air). This results in decreased tactile fremitus. Increased fremitus (Option A) occurs in
conditions like consolidation (pneumonia). Option C is incorrect for emphysema. Option D is
non-specific and not a classic sign of emphysema.
Q4: Which of the following bedside assessment findings is most consistent with a diagnosis of
left-sided heart failure?
A. Orthopnea and crackles
B. Wheezing and stridor
C. Hyperresonance and dry cough
D. Decreased tactile fremitus and fever
A. Orthopnea and crackles [CORRECT]
,3
Correct Answer: A
Rationale: Left-sided heart failure causes pulmonary congestion and edema, leading to crackles
(rales) in the lung bases and orthopnea (shortness of breath when lying flat) due to fluid
redistribution. Wheezing (Option B) is more associated with asthma or COPD (cardiac asthma
can occur but crackles are more specific for failure). Hyperresonance (Option C) suggests air
trapping. Decreased fremitus and fever (Option D) suggests pleural effusion or pneumonia.
Q5: While performing a physical assessment, you hear a high-pitched, crowing sound
predominantly during inspiration. This sound is best described as:
A. Wheezing.
B. Stridor.
C. Rhonchi.
D. Pleural friction rub.
B. Stridor. [CORRECT]
Correct Answer: B
Rationale: Stridor is a high-pitched, crowing sound caused by upper airway obstruction (larynx,
trachea) and is typically heard loudest during inspiration. Wheezing (Option A) is usually
expiratory and caused by lower airway obstruction. Rhonchi (Option C) are low-pitched
rumbling sounds caused by secretions in larger airways. A pleural friction rub (Option D) is a
dry, grating sound caused by inflamed pleural surfaces.
Q6: You are evaluating a patient's ABG results: pH 7.30, PaCO2 50 mm Hg, HCO3- 24 mEq/L.
How would you interpret this acid-base status?
A. Fully compensated respiratory acidosis
B. Uncompensated respiratory acidosis
C. Uncompensated metabolic acidosis
D. Partially compensated respiratory acidosis
D. Partially compensated respiratory acidosis [CORRECT]
, 4
Correct Answer: D
Q7: A patient's SpO2 drops from 96% to 88% while receiving oxygen via nasal cannula at 2
L/min. The patient is drowsy. What is the most appropriate initial action?
A. Increase the FiO2 to 6 L/min NC.
B. Prepare for immediate intubation.
C. Assess the patient's airway patency and breathing effort.
D. Obtain an arterial blood gas.
C. Assess the patient's airway patency and breathing effort. [CORRECT]
Correct Answer: C
Rationale: The primary assessment in any deteriorating patient follows the ABCs (Airway,
Breathing, Circulation). Before changing equipment or invasively monitoring, the therapist must
ensure the airway is not obstructed and determine if the patient is breathing adequately.
Increasing oxygen (Option A) might be necessary later, but assessment comes first. Intubation
(Option B) may be needed but assessment determines the urgency. ABG (Option D) provides
data but does not treat the immediate desaturation/drowsiness.
Q8: On a chest X-ray, you observe a "ground-glass" appearance. This pattern is most
characteristic of:
A. Pneumothorax.
B. Large pleural effusion.
C. Pulmonary edema or interstitial lung disease.
D. Atelectasis.
C. Pulmonary edema or interstitial lung disease. [CORRECT]
Correct Answer: C
Rationale: Ground-glass opacity refers to hazy increased lung attenuation that does not obscure
the underlying pulmonary vessels. It is classic for pulmonary edema (cardiogenic or non-
cardiogenic), pneumonia (early stages), or interstitial lung diseases. Pneumothorax (Option A)
