TMC PRACTICE CERTIFICATION
SCRIPT 2026 QUESTIONS WITH
SOLUTIONS GRADED A+
◍ An infant with pneumonia is placed on CPAP with the initial level is 6 cm
H20. After the patient is placed on the system, the respiratory therapist
notices that the pressure falls to 2 cm H20 with each inspiration. What
should be done to correct the problem?a. Tell the patient to relax and breath
more slowlyb. Give the patient diazepam (Valium)c. Increase the CPAP
level to 8 cm H20d. Increase the flow through the system.
Answer: Increase the flow through the systemExplain: Decreasing pressure
with inspiration indicates inadequate gas flow. Increasing the flow should
meet the patient's inspiratory flow needs and stabilize the CPAP pressure.
◍ A respiratory therapist is called to the ED for a 1-year-old with difficulty
breathing. Severe suprasternal, subcostal and substernal retraction are
observed. The child has a harsh, barking cough. Stridor is present. The
therapist should anticipate treatment forChoose only ONE best answer.a.
Cystic Fibrosisb. Pneumoniac. Croupd. Asthma.
Answer: CroupExplain: The patient has some degree of upper airway
obstruction caused by some viral illness. The barky cough is a classic
finding for patients experiencing croup.
◍ The polysomnography sleep laboratory is full scheduled for several weeks.
The physician wants to know if there is another option to determine if a
patient has sleep apnea. What should be recommended?a. Overnight pulse
oximetryb. Nasal air flow monitoringc. Holter monitoring for 48 hoursd.
Chest-wall and abdominal-wall impedance comparison.
Answer: Overnight pulse oximetryExplain: Overnight pulse oximetry can be
used to screen patients with suspected obstructive sleep apnea. The patient's
, oxygen saturation is found to decrease during apnea episodes.
◍ Within one second after initiating a forced vital capacity (FVC) maneuver, a
patient with normal lungs should be able to exhale what percent of the FVC?
A. 35-50% of the FVC
B. 50-70% of the FVC
C. 70-83% of the FVC
D. 84-93% of the FVC.
Answer: c. 70-83% of FVC
◍ A respiratory therapist is assessing a 168-cm (5-ft 6-in), 73-kg (161-lb), a
41-year-old female who was admitted 12 hours ago for an aspirin overdose.
The following information is obtained as the patient breathes air:HR
89/minRR 15/minBP 110/70 mm HgSp02 86%A respiratory therapist
should do first.a. Initiate oxygen at 4L/min by cannulab. Record the results
in the medical recordc. Obtain an arterial blood gas sampled. Validate the
Sp02 reading at a different site.
Answer: Validate the Sp02 reading at a different siteExplain: The saturation
may not be accurate and should be measured at a different site.
◍ Simple spirometry CANNOT be used to measure the
A. vital capacity
B. residual volume
C. tidal volume
D. inspiratory reserve volume.
Answer: b. residual volume
◍ A 47-year-old male with a BMI of 50 kg/m is undergoing a sleep study with
titration of CPA
P. The patient's baseline AHI is 59. At a CPAP level of 7 cm H20, the AHI
is 9. A respiratory therapist should recommenda. Maintain the current level
of CPAPb. Decreasing the CPAPc. Increasing the CPAPd. Changing to
bilevel PAP.
Answer: Increasing the CPAPExplain: The goal of CPAP intervention is to
completely eliminate apnea and hypopnea episodes, standard protocol is to
, incrementally increase the CPAP level until this occurs.
◍ An arterial puncture has been performed to obtain blood for analysis of 02,
C02, and p
H. What is the best way to manage the blood sample?a. Warm the sample to
keep it at body temperatureb. Place it into a mix of ice and waterc. Let the
blood naturally cool to room temperatured. Shake the sample to hemolyze
the blood.
Answer: Place it into a mix of ice and waterExplain: Placing the blood
sample into ice water will prevent the blood from consuming the O2 within
the sample.
◍ A 26-year-old patient who weighs 80 kg (171 lb) received injuries in a
motor vehicle crash. The patient was intubated with a 6.0-mm ID
endotracheal tube and is receiving volume-controlled ventilation.
Twenty-four hours later, the patient has clear breath sounds but cannot
tolerate weaning the mandatory rate below 8 in the SIMV mode with 15 cm
H20 pressure support. The respiratory therapist should recommend.a.
Increasing the peak inspiratory flowb. Raising the VTc. Setting the
mandatory rate to 10d. Reintubating with a larger endotracheal tube.
Answer: Reintubating with a larger endotracheal tubeExplain: The small
endotracheal tube compromises spontaneous breathing because of increased
airways resistance. This can be resolved only by a larger tube or extubation.
◍ During nasotracheal suctioning, a patient exhibits a gag reflex but doesn't
cough. Watery secretions are aspirated through the catheter. Which of the
following should the respiratory therapist do next?a. Insert an oropharyngeal
airway and repeat the procedureb. Hyperextend the patient's next when
passing the catheterc. Ask the patient to swallow while passing the
catheterd. Increase the suction pressure and repeat the procedure.
Answer: Hyperextend the patient's next when passing the catheterExplain:
Aspiration of watery secretions would indicate catheter position in either the
oropharynx or the esophagus. Hyperextending the neck will better direct the
catheter to the trachea.
, ◍ Which of the following approaches can be used to obtain a medication
history from a patient with a depressed level of consciousness or who is
severely agitated?
A. obtain and review the patient's past medical history
B. ask the patient's nurse about the patient's prescriptions
C. request that the lab run a comprehensive blood drug screen
D. obtain the patient's current prescription vials from the family.
Answer: d. obtain the patient's current prescription vials from the family
◍ A 24-year-old female presents with a history of nasal stuffiness, episodes of
daytime dyspnea, and a cough that occurs every summer. Which of the
following drug classifications should a respiratory therapist recommend to
control the patient's symptoms?a. Leukotriene inhibitorb. IgE
immunoglobulin antagonistc. Beta-adrenergic agonistd. Anticholinergic.
Answer: Leukotriene inhibitorExplain: The patient has allergic rhinitis and,
at most, mild persistent asthma. A leukotriene inhibitor, such as montelukast
(Singulair), are indicated to control mild asthma and allergic rhinitis.
◍ Which of the following thoracic ultrasound findings is consistent with the
presence of a pneumothorax?
A. presence of gliding sign
B. absence of A-lines
C. presence of barcode sign
D. presence of seashore sign.
Answer: c. presence of barcode lines
◍ A patient with pulmonary edema receives furosemide (Lasix), dopamine
(Intropin), and 02. Flattened T-waves and occasional PVC's are observed on
the monitor. Which of the following should a respiratory therapist initially
recommend to evaluate the effect of these medications?1. End-tidal C022.
Pulse oximetry3. Echocardiogram4. ElectrolytesChoose the best answera. 1
and 2 onlyb. 1 and 3 onlyc. 2 and 4 onlyd. 3 and 4 only.
Answer: 2 and 4 onlyExplain: 1. False. End-tidal CO2 would not be related
to diuresis, electrolyte imbalance, or hypoxemia.2. True. Myocardial
SCRIPT 2026 QUESTIONS WITH
SOLUTIONS GRADED A+
◍ An infant with pneumonia is placed on CPAP with the initial level is 6 cm
H20. After the patient is placed on the system, the respiratory therapist
notices that the pressure falls to 2 cm H20 with each inspiration. What
should be done to correct the problem?a. Tell the patient to relax and breath
more slowlyb. Give the patient diazepam (Valium)c. Increase the CPAP
level to 8 cm H20d. Increase the flow through the system.
Answer: Increase the flow through the systemExplain: Decreasing pressure
with inspiration indicates inadequate gas flow. Increasing the flow should
meet the patient's inspiratory flow needs and stabilize the CPAP pressure.
◍ A respiratory therapist is called to the ED for a 1-year-old with difficulty
breathing. Severe suprasternal, subcostal and substernal retraction are
observed. The child has a harsh, barking cough. Stridor is present. The
therapist should anticipate treatment forChoose only ONE best answer.a.
Cystic Fibrosisb. Pneumoniac. Croupd. Asthma.
Answer: CroupExplain: The patient has some degree of upper airway
obstruction caused by some viral illness. The barky cough is a classic
finding for patients experiencing croup.
◍ The polysomnography sleep laboratory is full scheduled for several weeks.
The physician wants to know if there is another option to determine if a
patient has sleep apnea. What should be recommended?a. Overnight pulse
oximetryb. Nasal air flow monitoringc. Holter monitoring for 48 hoursd.
Chest-wall and abdominal-wall impedance comparison.
Answer: Overnight pulse oximetryExplain: Overnight pulse oximetry can be
used to screen patients with suspected obstructive sleep apnea. The patient's
, oxygen saturation is found to decrease during apnea episodes.
◍ Within one second after initiating a forced vital capacity (FVC) maneuver, a
patient with normal lungs should be able to exhale what percent of the FVC?
A. 35-50% of the FVC
B. 50-70% of the FVC
C. 70-83% of the FVC
D. 84-93% of the FVC.
Answer: c. 70-83% of FVC
◍ A respiratory therapist is assessing a 168-cm (5-ft 6-in), 73-kg (161-lb), a
41-year-old female who was admitted 12 hours ago for an aspirin overdose.
The following information is obtained as the patient breathes air:HR
89/minRR 15/minBP 110/70 mm HgSp02 86%A respiratory therapist
should do first.a. Initiate oxygen at 4L/min by cannulab. Record the results
in the medical recordc. Obtain an arterial blood gas sampled. Validate the
Sp02 reading at a different site.
Answer: Validate the Sp02 reading at a different siteExplain: The saturation
may not be accurate and should be measured at a different site.
◍ Simple spirometry CANNOT be used to measure the
A. vital capacity
B. residual volume
C. tidal volume
D. inspiratory reserve volume.
Answer: b. residual volume
◍ A 47-year-old male with a BMI of 50 kg/m is undergoing a sleep study with
titration of CPA
P. The patient's baseline AHI is 59. At a CPAP level of 7 cm H20, the AHI
is 9. A respiratory therapist should recommenda. Maintain the current level
of CPAPb. Decreasing the CPAPc. Increasing the CPAPd. Changing to
bilevel PAP.
Answer: Increasing the CPAPExplain: The goal of CPAP intervention is to
completely eliminate apnea and hypopnea episodes, standard protocol is to
, incrementally increase the CPAP level until this occurs.
◍ An arterial puncture has been performed to obtain blood for analysis of 02,
C02, and p
H. What is the best way to manage the blood sample?a. Warm the sample to
keep it at body temperatureb. Place it into a mix of ice and waterc. Let the
blood naturally cool to room temperatured. Shake the sample to hemolyze
the blood.
Answer: Place it into a mix of ice and waterExplain: Placing the blood
sample into ice water will prevent the blood from consuming the O2 within
the sample.
◍ A 26-year-old patient who weighs 80 kg (171 lb) received injuries in a
motor vehicle crash. The patient was intubated with a 6.0-mm ID
endotracheal tube and is receiving volume-controlled ventilation.
Twenty-four hours later, the patient has clear breath sounds but cannot
tolerate weaning the mandatory rate below 8 in the SIMV mode with 15 cm
H20 pressure support. The respiratory therapist should recommend.a.
Increasing the peak inspiratory flowb. Raising the VTc. Setting the
mandatory rate to 10d. Reintubating with a larger endotracheal tube.
Answer: Reintubating with a larger endotracheal tubeExplain: The small
endotracheal tube compromises spontaneous breathing because of increased
airways resistance. This can be resolved only by a larger tube or extubation.
◍ During nasotracheal suctioning, a patient exhibits a gag reflex but doesn't
cough. Watery secretions are aspirated through the catheter. Which of the
following should the respiratory therapist do next?a. Insert an oropharyngeal
airway and repeat the procedureb. Hyperextend the patient's next when
passing the catheterc. Ask the patient to swallow while passing the
catheterd. Increase the suction pressure and repeat the procedure.
Answer: Hyperextend the patient's next when passing the catheterExplain:
Aspiration of watery secretions would indicate catheter position in either the
oropharynx or the esophagus. Hyperextending the neck will better direct the
catheter to the trachea.
, ◍ Which of the following approaches can be used to obtain a medication
history from a patient with a depressed level of consciousness or who is
severely agitated?
A. obtain and review the patient's past medical history
B. ask the patient's nurse about the patient's prescriptions
C. request that the lab run a comprehensive blood drug screen
D. obtain the patient's current prescription vials from the family.
Answer: d. obtain the patient's current prescription vials from the family
◍ A 24-year-old female presents with a history of nasal stuffiness, episodes of
daytime dyspnea, and a cough that occurs every summer. Which of the
following drug classifications should a respiratory therapist recommend to
control the patient's symptoms?a. Leukotriene inhibitorb. IgE
immunoglobulin antagonistc. Beta-adrenergic agonistd. Anticholinergic.
Answer: Leukotriene inhibitorExplain: The patient has allergic rhinitis and,
at most, mild persistent asthma. A leukotriene inhibitor, such as montelukast
(Singulair), are indicated to control mild asthma and allergic rhinitis.
◍ Which of the following thoracic ultrasound findings is consistent with the
presence of a pneumothorax?
A. presence of gliding sign
B. absence of A-lines
C. presence of barcode sign
D. presence of seashore sign.
Answer: c. presence of barcode lines
◍ A patient with pulmonary edema receives furosemide (Lasix), dopamine
(Intropin), and 02. Flattened T-waves and occasional PVC's are observed on
the monitor. Which of the following should a respiratory therapist initially
recommend to evaluate the effect of these medications?1. End-tidal C022.
Pulse oximetry3. Echocardiogram4. ElectrolytesChoose the best answera. 1
and 2 onlyb. 1 and 3 onlyc. 2 and 4 onlyd. 3 and 4 only.
Answer: 2 and 4 onlyExplain: 1. False. End-tidal CO2 would not be related
to diuresis, electrolyte imbalance, or hypoxemia.2. True. Myocardial
