TMC PRACTICE ACTUAL EXAM PAPER
2026 QUESTIONS WITH ANSWERS
GRADED A+
◍ Which of the following equipment is most helpful at measuring FRC in a
patient who has significant non-ventilated lung spaces?.
Answer: plethysmographYou can determine FRC in three different ways -
body box, nitrogen washout, or helium dilution. If someone has
non-ventilated lung space, nitrogen washout and helium dilution are not
helpful and may be inaccurate. FRC determined by body box will be higher
because it can access non-ventilated lung space and therefore is more
accurate.
◍ The respiratory therapist is making a home visit to evaluate an
oxygen-dependent patient. The patient has 3+ pitting peripheral edema and
has not followed the physician's orders to limit fluid intake. You would
expect which of the following hemodynamic values?.
Answer: elevated right sided preload with a normal to low right ventricular
after loadRight-sided preload is another name for CVP (central venous
pressure). Peripheral edema is one of the signs associated with right heart
failure, which results in an elevated CVP with a normal or low pulmonary
artery pressure (PAP), a.k.a. right ventricular afterload.
◍ A ventilator-dependent patient is scheduled for an MRI, which will require a
transport of 90 minutes. The patient is receiving humidification with a
heated- humidification system. A transport ventilator is available. How
should a respiratory therapist assure that humidification will be provided to
the patient during the MRI procedure?.
Answer: Provide an HMEA heat moisture exchanger (HME) is appropriate
for a transport of only 90 min. Furthermore, the scenario does not suggest
, that the patient has thick, retained secretions, therefore an HME may be
applied.
◍ which of the following can accurately be stated about a widening
alveolar-arterial oxygen gradient?.
Answer: increased intrapulmonary shuntingA normal alveolar arterial
oxygen gradient is below 65 mmHg. When that gradient rises to 200, 300,
400, or more, then you have what is called shunting. If the A-a gradient is
less than 300 it's technically called a ventilation perfusion (VQ) mismatch.
But generally speaking, as the gradient widens it can properly be said that
there is an increase in pulmonary shunting.
◍ Which of the following is needed to calculate alveolar oxygen tension?
A. VD/VT, PAO2
B. BP and FiO2
C. PetCO2 and PaO2
D. QS/QT, deadspace.
Answer: B.Barometric pressure, FiO2, and PaO2 are all included in the
formula (BP stands for barometric pressure)
◍ L/min/m2 is the unit of measure for:
A. Systemic vascular resistance
B. Cardiac output
C. Cardiac index
D. Stroke volume.
Answer: C.
◍ A spontaneously breathing patient has the following arterial blood gas
results:pH 7.38 PaCO2 42 mmHgPaO2 76 mmHgHCO3- 24 mEq/LBE 0
mEq/LWhich of the following supplemental oxygen levels is most
appropriate?
A. 2 L/min nasal cannula
B. 5 L/min nasal cannula
C. non-rebreathing mask
D. Venturi mask at 30%.
, Answer: B. A patient who is showing signs of hypoxemia should receive
supplemental oxygen. If the patient is not a COPD patient and the situation
is not an emergency, then the proper supplemental oxygen is an adult
therapeutic dose, which is 40% to 55%. Of the options available only 5
L/min nasal cannula will approach this. Other options are either insufficient
or too much.
◍ How many hours will an H cylinder with 1400 psi last for a patient
receiving oxygen at 7 lpm?.
Answer: 10hrsAnd H cylinder has a tank factor of 3.14. 3.14x1400 PSI =
4396 L. 4396 L / 7 L per minute = 628 min. 628 min./ 60 min.= 10.4 hours,
or about 10 hours. When you get an answer that is not exact, pick the closest
number possible. It is common on the exam not see the exact answer
◍ A bronchopleural fistula on a patient receiving mechanical ventilation with a
chest tube drainage system in place would be most likely be indicated by
which of the following observations?.
Answer: excess bubbling in the water seal chamberA bronchopleural fistula
is essentially a leak from the airway in the lungs to the pleural space. This
condition can result in two things - one) a low-pressure or low-volume
alarm, 2) excess bubbling in the water seal chamber of the chest tube
drainage system. When you look at the answers, a leak would not cause a
high pressure alarm
◍ Left heart failure would be manifested in which of the following values?
A. CVP and mPAP
B. mPAP and wedge pressure
C. MAP and SVR
D. cardiac output and wedge pressure.
Answer: D. The function of the left heart, specifically the left ventricle, is
best assessed hemodynamically by looking at those values that precede and
come after the left heart. In this case pulmonary capillary wedge pressure
and cardiac output (or cardiac index) are the values found before and after
the left heart.
, ◍ Which of the following findings is most closely associated with increased
airway resistance?
A. reduced SpO2
B. accessory muscle use
C. altered P50
D. increased PetCO2.
Answer: B.Of the options given, use of accessory muscles is most closely
associated with an increase in airway resistance. This is especially true with
patients who have asthma or other types of upper airway inflammation or
bronchoconstriction.
◍ The best test determination for a forced vital capacity maneuver is done by
which of the following calculations?.
Answer: FEV1 + FVCTo determine the best trial or best patient effort for a
forced vital capacity maneuver, the trial with the highest sum of the FEV1
and FVC is considered to be the patient's best effort.
◍ For a patient receiving volume-controlled mechanical ventilation, the lower
inflection point on a pressure-volume loop can best be described as:
A. amount of pressure required to keep the alveoli and small airways open
B. optimal PEEP
C. minimal PEEP
D. upper limit of residual volume.
Answer: A. The lowest inflection point on a pressure-volume ventilator
graphic is an indication of the minimum pressure needed to keep alveoli
open.
◍ The results of a V/Q scan shows poor perfusion with adequate ventilation. A
chest radiograph shows a wedge-shaped infiltrate over the right lung field.
The patient most likely has
A. fluid overload
B. ARDS
C. a pulmonary embolism
D. pneumonia.
2026 QUESTIONS WITH ANSWERS
GRADED A+
◍ Which of the following equipment is most helpful at measuring FRC in a
patient who has significant non-ventilated lung spaces?.
Answer: plethysmographYou can determine FRC in three different ways -
body box, nitrogen washout, or helium dilution. If someone has
non-ventilated lung space, nitrogen washout and helium dilution are not
helpful and may be inaccurate. FRC determined by body box will be higher
because it can access non-ventilated lung space and therefore is more
accurate.
◍ The respiratory therapist is making a home visit to evaluate an
oxygen-dependent patient. The patient has 3+ pitting peripheral edema and
has not followed the physician's orders to limit fluid intake. You would
expect which of the following hemodynamic values?.
Answer: elevated right sided preload with a normal to low right ventricular
after loadRight-sided preload is another name for CVP (central venous
pressure). Peripheral edema is one of the signs associated with right heart
failure, which results in an elevated CVP with a normal or low pulmonary
artery pressure (PAP), a.k.a. right ventricular afterload.
◍ A ventilator-dependent patient is scheduled for an MRI, which will require a
transport of 90 minutes. The patient is receiving humidification with a
heated- humidification system. A transport ventilator is available. How
should a respiratory therapist assure that humidification will be provided to
the patient during the MRI procedure?.
Answer: Provide an HMEA heat moisture exchanger (HME) is appropriate
for a transport of only 90 min. Furthermore, the scenario does not suggest
, that the patient has thick, retained secretions, therefore an HME may be
applied.
◍ which of the following can accurately be stated about a widening
alveolar-arterial oxygen gradient?.
Answer: increased intrapulmonary shuntingA normal alveolar arterial
oxygen gradient is below 65 mmHg. When that gradient rises to 200, 300,
400, or more, then you have what is called shunting. If the A-a gradient is
less than 300 it's technically called a ventilation perfusion (VQ) mismatch.
But generally speaking, as the gradient widens it can properly be said that
there is an increase in pulmonary shunting.
◍ Which of the following is needed to calculate alveolar oxygen tension?
A. VD/VT, PAO2
B. BP and FiO2
C. PetCO2 and PaO2
D. QS/QT, deadspace.
Answer: B.Barometric pressure, FiO2, and PaO2 are all included in the
formula (BP stands for barometric pressure)
◍ L/min/m2 is the unit of measure for:
A. Systemic vascular resistance
B. Cardiac output
C. Cardiac index
D. Stroke volume.
Answer: C.
◍ A spontaneously breathing patient has the following arterial blood gas
results:pH 7.38 PaCO2 42 mmHgPaO2 76 mmHgHCO3- 24 mEq/LBE 0
mEq/LWhich of the following supplemental oxygen levels is most
appropriate?
A. 2 L/min nasal cannula
B. 5 L/min nasal cannula
C. non-rebreathing mask
D. Venturi mask at 30%.
, Answer: B. A patient who is showing signs of hypoxemia should receive
supplemental oxygen. If the patient is not a COPD patient and the situation
is not an emergency, then the proper supplemental oxygen is an adult
therapeutic dose, which is 40% to 55%. Of the options available only 5
L/min nasal cannula will approach this. Other options are either insufficient
or too much.
◍ How many hours will an H cylinder with 1400 psi last for a patient
receiving oxygen at 7 lpm?.
Answer: 10hrsAnd H cylinder has a tank factor of 3.14. 3.14x1400 PSI =
4396 L. 4396 L / 7 L per minute = 628 min. 628 min./ 60 min.= 10.4 hours,
or about 10 hours. When you get an answer that is not exact, pick the closest
number possible. It is common on the exam not see the exact answer
◍ A bronchopleural fistula on a patient receiving mechanical ventilation with a
chest tube drainage system in place would be most likely be indicated by
which of the following observations?.
Answer: excess bubbling in the water seal chamberA bronchopleural fistula
is essentially a leak from the airway in the lungs to the pleural space. This
condition can result in two things - one) a low-pressure or low-volume
alarm, 2) excess bubbling in the water seal chamber of the chest tube
drainage system. When you look at the answers, a leak would not cause a
high pressure alarm
◍ Left heart failure would be manifested in which of the following values?
A. CVP and mPAP
B. mPAP and wedge pressure
C. MAP and SVR
D. cardiac output and wedge pressure.
Answer: D. The function of the left heart, specifically the left ventricle, is
best assessed hemodynamically by looking at those values that precede and
come after the left heart. In this case pulmonary capillary wedge pressure
and cardiac output (or cardiac index) are the values found before and after
the left heart.
, ◍ Which of the following findings is most closely associated with increased
airway resistance?
A. reduced SpO2
B. accessory muscle use
C. altered P50
D. increased PetCO2.
Answer: B.Of the options given, use of accessory muscles is most closely
associated with an increase in airway resistance. This is especially true with
patients who have asthma or other types of upper airway inflammation or
bronchoconstriction.
◍ The best test determination for a forced vital capacity maneuver is done by
which of the following calculations?.
Answer: FEV1 + FVCTo determine the best trial or best patient effort for a
forced vital capacity maneuver, the trial with the highest sum of the FEV1
and FVC is considered to be the patient's best effort.
◍ For a patient receiving volume-controlled mechanical ventilation, the lower
inflection point on a pressure-volume loop can best be described as:
A. amount of pressure required to keep the alveoli and small airways open
B. optimal PEEP
C. minimal PEEP
D. upper limit of residual volume.
Answer: A. The lowest inflection point on a pressure-volume ventilator
graphic is an indication of the minimum pressure needed to keep alveoli
open.
◍ The results of a V/Q scan shows poor perfusion with adequate ventilation. A
chest radiograph shows a wedge-shaped infiltrate over the right lung field.
The patient most likely has
A. fluid overload
B. ARDS
C. a pulmonary embolism
D. pneumonia.
