TMC PRACTICE COMPREHENSIVE
STUDY GUIDE 2026 FULL QUESTIONS
AND SOLUTIONS GRADED A+
◍ PATIENT ASSESSMENT:All the following could cause capnography to go
from 3 6 to 30 EXCEPT:
A. Endotracheal tube positioned in the right mainstream bronchus
B. Hyperventilation
C. pulmonary emboli
D. Hypovolemia.
Answer: Endotracheal tube positioned in right mainstem bronchus is a
problem but the co2 reading would not change, so ANSWER is A.
◍ A 48 year-old female is admitted to the ED with diaphoresis, jugular venous
distension, and 3+ pitting edema in the ankles. These findings are consistent
with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances.
Answer: Heart failure
◍ A patient is admitted to the ED following a motor vehicle accident. On
physical exam, the respiratory therapist discovers that breath sounds are
absent in the left chest with a hyperresonant percussion note. The trachea is
shifted to the right. The patient's heart rate is 45/min, respiratory rate is
30/min, and blood pressure is 60/40 mm Hg. What action should the
therapist recommend first?
A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
, C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate the patient..
Answer: Needle aspirate the 2nd left intercostal space.
◍ What is the target Vt for individual on mechanical ventilation.
Answer: 6-8 ml/kg (of ideal body weight) This is new strategy as of January
2015
◍ All of the following strategies are likely to decrease the likelihood of
damage to the tracheal mucosa EXCEPT
A. maintaining cuff pressures between 20 and 25 mm Hg.
B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures..
Answer: monitoring intracuff pressures.
◍ Is the following Static OR Dynamic Compliance:Means flow throughout the
respiratory system has stopped and all ventilatory muscle activity is absent.
_______ conditions can be imposed with an inspiratory pause when a
patient is sedated and mechanically ventilated..
Answer: Static Compliance
◍ Is the following Static OR Dynamic Compliance:Flow at airway opening is
zero. Mechanics are evaluated under ______ conditions, when
non-intubated patient breathes spontaneously..
Answer: Dynamic Compliance
◍ A balloon tipped flow directed catheter is positioned in the pulmonary artery
with the balloon deflated. Which of the following pressures will be
measured by the proximal lumen:a. Cvpb. Papc. Pwpd. Map.
Answer: ANSWER is A. Cvp = deflated/proximal lumenPap =
deflated/distalPwp = inflated/wedged
◍ A 52 year-old post-operative cholecystectomy patient's breath sounds
become more coarse upon completion of postural drainage with percussion.
The respiratory therapist should recommend
, A. continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear secretions..
Answer: deep breathing and coughing to clear secretions.
◍ All of the following will affect the accuracy of a capnography EXCEPTa.
Long sampling lineb. Low sampling flowc. Condensation in the tubingd.
Use of desiccant.
Answer: Gas will pass through and out of a long sampling line before
reaching analyzer so, low sampling flow will not give you enough
information for a good reading, and condensation as a rule is always a
problem especially in analyzers. Dessicant removes moisture from the gas,
which is a good thing, so ANSWER is D
◍ A 65 kg spinal cord injured patient has developed atelectasis. His inspiratory
capacity is 30% of his predicted value. What bronchial hygiene therapy
would be most appropriate initially?
A. IS / SMI
B. IPPB with normal saline
C. postural drainage and percussion
D. PEP therapy.
Answer: IPPB with normal saline
◍ A patient on VC ventilation has demonstrated auto-PEEP on ventilator
graphics. Which of the following controls, when adjusted independently,
would increase expiratory time? 1. Tidal volume 2. Respiratory Rate 3.
Inspiratory flow 4. Sensitivity.
Answer: 1, 2, and 3 only
◍ A 1000 g neonate (normal baby is 3000 g) is stable in nicu. Which of the
following should the respiratory therapist use to monitor the neonates
overall cardiopulmonary status.a. TcPCO2 and TcPO2 monitorb. Arterial
blood gas analysis Q4c. SpO2 monitord. Capillary gas analysis Q8.
Answer: Since the baby is stable, go less invasive, also go continuous
, monitoring (not 4 hour or 8 hour), Transcutaneous (Tc) continuous
monitoring of CO2 and O2 is the best. Answer is A
◍ Which of the following would be the most appropriate therapy for a
dyspneic patient who has crepitus with tracheal deviation to the left and
absent breath sounds on the right?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube.
Answer: Insert a chest tube
◍ A unilateral wheeze would most likely indicate which of the following.a.
Asthmab. Atelectasisc. Foreign body aspirationd. Epiglottitis.
Answer: You wouldn't have asthma on just one side (unilateral), atelectasis
would cause diminished breath sounds, with epiglottitis you would get
stridor, since you are only hearing wheezing on one side, you are hearing it
on the side where you aspirated something, so ANSWER is C
◍ All of the following would be associated with the presence of a
pneumothorax EXCEPTa. Tracheal deviationb. Dull percussionc. Absent
breath soundsd. Respiratory distress.
Answer: With pneumothorax you would hear a high pitch hyperresonnance,
breath sounds would be absent, and respiratory distress could be present.
Dull percussion would NOT be present, so ANSWER is B.
◍ What should you recommend FIRST for a patient with multifocal pvc'sa.
Administration of lidocaineb. Administration of 100% oxygenc.
Administration of atropined. Administration of epinephrine.
Answer: Multiple pvc's coming from multiple locations (multifocal) is a real
problem and you should administer oxygen FIRST, so ANSWER is B.
lidocaine will help reduce irritability of heart and help with pvc's but would
not be first option, atropine is used for bradycardia and cardiac irregularities
but not pvc's, epinephrine is emergency drug not for pvc's but more for
pulseless ventricular tachycardia or ventricular fibrilation where heart is not
STUDY GUIDE 2026 FULL QUESTIONS
AND SOLUTIONS GRADED A+
◍ PATIENT ASSESSMENT:All the following could cause capnography to go
from 3 6 to 30 EXCEPT:
A. Endotracheal tube positioned in the right mainstream bronchus
B. Hyperventilation
C. pulmonary emboli
D. Hypovolemia.
Answer: Endotracheal tube positioned in right mainstem bronchus is a
problem but the co2 reading would not change, so ANSWER is A.
◍ A 48 year-old female is admitted to the ED with diaphoresis, jugular venous
distension, and 3+ pitting edema in the ankles. These findings are consistent
with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances.
Answer: Heart failure
◍ A patient is admitted to the ED following a motor vehicle accident. On
physical exam, the respiratory therapist discovers that breath sounds are
absent in the left chest with a hyperresonant percussion note. The trachea is
shifted to the right. The patient's heart rate is 45/min, respiratory rate is
30/min, and blood pressure is 60/40 mm Hg. What action should the
therapist recommend first?
A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
, C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate the patient..
Answer: Needle aspirate the 2nd left intercostal space.
◍ What is the target Vt for individual on mechanical ventilation.
Answer: 6-8 ml/kg (of ideal body weight) This is new strategy as of January
2015
◍ All of the following strategies are likely to decrease the likelihood of
damage to the tracheal mucosa EXCEPT
A. maintaining cuff pressures between 20 and 25 mm Hg.
B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures..
Answer: monitoring intracuff pressures.
◍ Is the following Static OR Dynamic Compliance:Means flow throughout the
respiratory system has stopped and all ventilatory muscle activity is absent.
_______ conditions can be imposed with an inspiratory pause when a
patient is sedated and mechanically ventilated..
Answer: Static Compliance
◍ Is the following Static OR Dynamic Compliance:Flow at airway opening is
zero. Mechanics are evaluated under ______ conditions, when
non-intubated patient breathes spontaneously..
Answer: Dynamic Compliance
◍ A balloon tipped flow directed catheter is positioned in the pulmonary artery
with the balloon deflated. Which of the following pressures will be
measured by the proximal lumen:a. Cvpb. Papc. Pwpd. Map.
Answer: ANSWER is A. Cvp = deflated/proximal lumenPap =
deflated/distalPwp = inflated/wedged
◍ A 52 year-old post-operative cholecystectomy patient's breath sounds
become more coarse upon completion of postural drainage with percussion.
The respiratory therapist should recommend
, A. continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear secretions..
Answer: deep breathing and coughing to clear secretions.
◍ All of the following will affect the accuracy of a capnography EXCEPTa.
Long sampling lineb. Low sampling flowc. Condensation in the tubingd.
Use of desiccant.
Answer: Gas will pass through and out of a long sampling line before
reaching analyzer so, low sampling flow will not give you enough
information for a good reading, and condensation as a rule is always a
problem especially in analyzers. Dessicant removes moisture from the gas,
which is a good thing, so ANSWER is D
◍ A 65 kg spinal cord injured patient has developed atelectasis. His inspiratory
capacity is 30% of his predicted value. What bronchial hygiene therapy
would be most appropriate initially?
A. IS / SMI
B. IPPB with normal saline
C. postural drainage and percussion
D. PEP therapy.
Answer: IPPB with normal saline
◍ A patient on VC ventilation has demonstrated auto-PEEP on ventilator
graphics. Which of the following controls, when adjusted independently,
would increase expiratory time? 1. Tidal volume 2. Respiratory Rate 3.
Inspiratory flow 4. Sensitivity.
Answer: 1, 2, and 3 only
◍ A 1000 g neonate (normal baby is 3000 g) is stable in nicu. Which of the
following should the respiratory therapist use to monitor the neonates
overall cardiopulmonary status.a. TcPCO2 and TcPO2 monitorb. Arterial
blood gas analysis Q4c. SpO2 monitord. Capillary gas analysis Q8.
Answer: Since the baby is stable, go less invasive, also go continuous
, monitoring (not 4 hour or 8 hour), Transcutaneous (Tc) continuous
monitoring of CO2 and O2 is the best. Answer is A
◍ Which of the following would be the most appropriate therapy for a
dyspneic patient who has crepitus with tracheal deviation to the left and
absent breath sounds on the right?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube.
Answer: Insert a chest tube
◍ A unilateral wheeze would most likely indicate which of the following.a.
Asthmab. Atelectasisc. Foreign body aspirationd. Epiglottitis.
Answer: You wouldn't have asthma on just one side (unilateral), atelectasis
would cause diminished breath sounds, with epiglottitis you would get
stridor, since you are only hearing wheezing on one side, you are hearing it
on the side where you aspirated something, so ANSWER is C
◍ All of the following would be associated with the presence of a
pneumothorax EXCEPTa. Tracheal deviationb. Dull percussionc. Absent
breath soundsd. Respiratory distress.
Answer: With pneumothorax you would hear a high pitch hyperresonnance,
breath sounds would be absent, and respiratory distress could be present.
Dull percussion would NOT be present, so ANSWER is B.
◍ What should you recommend FIRST for a patient with multifocal pvc'sa.
Administration of lidocaineb. Administration of 100% oxygenc.
Administration of atropined. Administration of epinephrine.
Answer: Multiple pvc's coming from multiple locations (multifocal) is a real
problem and you should administer oxygen FIRST, so ANSWER is B.
lidocaine will help reduce irritability of heart and help with pvc's but would
not be first option, atropine is used for bradycardia and cardiac irregularities
but not pvc's, epinephrine is emergency drug not for pvc's but more for
pulseless ventricular tachycardia or ventricular fibrilation where heart is not
