TMC Practice Exam B Kettering
After a patient undergoes a thoracentesis, the respiratory therapist notes that the
obtained pleural fluid is clear with a slight straw color. This fluid is most likely the result
of
A. empyema.
B. congestive heart failure.
C. lung carcinoma.
D. hemothorax. - ANSWER B. congestive heart failure.
Which of the following would be most important to evaluate for a patient who is entering
a smoking cessation program?
A. Height
B. Smoking history
C. Weight
D. Diet - ANSWER B. Smoking history
The respiratory therapist is calibrating a spirometer and checking the volume with a 3.0
liter super syringe. The volumes recorded are: 2.85 L, 2.8 L, and 2.8 L. Based upon the
information obtained which of the following is a correct statement?
A. Another syringe needs to be used
B. Spirometer is accurate
C. The plunger was advanced too slowly
D. Spirometer may have a leak - ANSWER D. Spirometer may have a leak
Which of the following is an indication for high frequency jet ventilation?
A. Bronchopleural fistula
B. Wilson Mikity syndrome
C. Necrotizing lesion of right lung
D. Centrilobular emphysema - ANSWER A. Bronchopleural fistula
A 43-year-old female patient has just undergone a total abdominal hysterectomy. The
patient arrives in the post anesthesia care unit obtunded with minimal response to
painful stimulus. What treatment should the respiratory therapist recommend for this
patient?
A. Initiate assisted ventilation
B. Insert oropharyngeal airway
C. Obtain positron emission tomography
,D. Initiate noninvasive capnography - ANSWER B. Insert oropharyngeal airway
A 44 week gestational age infant has just been delivered via C-section and is gasping,
grunting, and has tachycardia and tachypnea. At one minute his Apgar score is 4 and at
5 minutes the score is 5. The infant is most likely suffering from
A. transient tachypnea of the newborn.
B. meconium aspiration.
C. bronchopulmonary dysplasia.
D. apnea of prematurity. - ANSWER B. meconium aspiration.
What is the normal VD/VT ratio for a patient breathing room air?
A. 5 - 15%
B. 20 - 40%
C. 45 - 55%
D. 65 - 75% - ANSWER B. 20 - 40%
A heat moisture exchanger is indicated for humidification in which of the following
situations?
A. Mechanical ventilation in a long-term care facility.
B. Transport to a tertiary care center.
C. Patient with tenacious secretions.
D. Delivery of aerosolized bronchodilators. - ANSWER B. Transport to a tertiary care
center.
All of the following could cause a patient's right-hemidiaphragm to be elevated,
EXCEPT
A. right lower lobe atelectasis.
B. right side hyperlucency, absent vascular markings.
C. hepatomegaly.
D. right lower lobe consolidation with air bronchograms. - ANSWER B. right side
hyperlucency, absent vascular markings
A 64-year-old, 70 kg (154 lb) man with severe COPD is receiving independent
(differential) lung ventilation following thoracotomy and right lower lobectomy. Which of
the following setting combinations would be most appropriate for this patient?
A. Right lung 50 mL; left lung 650 mL
B. Right lung 150 mL; left lung 550 mL
C. Right lung 350 mL; left lung 350 mL
D. Right lung 550 mL; left lung 150 mL - ANSWER B. Right lung 150 mL; left lung 550
mL
,A patient in the intensive care unit has the following hemodynamic measurements:
CVP (mm Hg) 5
PAP (mm Hg) 29/8
PCWP (mm Hg) 8
BP (mm Hg) 130/70
Cardiac output (L/min) 5.1
Cardiac index (L/min/m2) 2.7
What is the pulse pressure?
A. 15 mm Hg
B. 21 mm Hg
C. 60 mm Hg
D. 90 mm Hg - ANSWER C. 60 mm Hg
A 2-year-old child with croup has been intubated for 4 days with a 4 mm ID uncuffed
endotracheal tube. Heated aerosol at an FIO2 of 0.30 has been delivered to the patient.
The physician asks the respiratory therapist to evaluate the patient for possible
extubation. Which of the following would most likely indicate that the patient is ready for
extubation?
A. The patient is making normal quiet ventilatory efforts.
B. A negative sputum culture and sensitivity has been reported.
C. The patient's ABG are within normal range.
D. Breath sounds are heard around the tube on auscultation. - ANSWER D. Breath
sounds are heard around the tube on auscultation.
A patient is seen in the Emergency Department for complaints of nausea and vomiting.
A nasogastric tube has been inserted and the patient is started on lasix. Which of the
following should the respiratory therapist monitor?
A. Cardiac enzymes
B. Serum electrolytes
C. Arterial blood gases
D. Cell hydration level - ANSWER B. Serum electrolytes
While instructing a patient prior to a vital capacity maneuver, the respiratory therapist
should direct the patient to
A. exhale to residual volume and inhale to inspiratory capacity.
B. inhale to total lung capacity then exhale to residual volume.
C. exhale normally then inhale to total lung capacity.
, D. inhale normally then exhale to functional residual capacity. - ANSWER B. inhale to
total lung capacity then exhale to residual volume.
A patient involved in an automobile accident is brought to the ED with tachypnea,
tracheal deviation to the right, splinting, asymmetrical chest movement, and decreased
breath sounds on the left side. The respiratory therapist should initially
A. insert a chest tube.
B. administer 100% oxygen via mask.
C. perform endotracheal intubation.
D. initiate non-invasive positive pressure ventilation. - ANSWER B. administer 100%
oxygen via mask.
A 77-year-old male patient is admitted to the emergency room with shortness of breath,
fine basilar crackles, +2 pitting edema and a chest radiogram with a butterfly pattern.
These results are most consistent with which of the following?
A. Pulmonary edema
B. Pulmonary interstitial emphysema
C. Pneumothorax
D. Emphysema - ANSWER A. Pulmonary edema
Which of the following formulas will determine the total flow being delivered to a patient
with a 28% venturi mask running at 6 L/min?
A. total flow = 6 x 2
B. total flow = 6 x 4
C. total flow = 6 x 5
D. total flow = 6 x 11 - ANSWER D. total flow = 6 x 11
Fine crepitant crackles are most commonly associated with which of the following
conditions?
A. Bronchitis
B. Pulmonary edema
C. Pneumonia
D. Foreign body aspiration - ANSWER B. Pulmonary edema
A patient with end-stage pulmonary fibrosis is receiving oxygen at 2 L/min via a
transtracheal oxygen catheter. The patient experiences an increased work of breathing
and shortness of breath. The respiratory therapist should
A. manually ventilate the patient with a resuscitation bag.
B. increase the flow to the transtracheal catheter to 6 L/min.
C. evaluate the SpO2 with a pulse oximeter.
After a patient undergoes a thoracentesis, the respiratory therapist notes that the
obtained pleural fluid is clear with a slight straw color. This fluid is most likely the result
of
A. empyema.
B. congestive heart failure.
C. lung carcinoma.
D. hemothorax. - ANSWER B. congestive heart failure.
Which of the following would be most important to evaluate for a patient who is entering
a smoking cessation program?
A. Height
B. Smoking history
C. Weight
D. Diet - ANSWER B. Smoking history
The respiratory therapist is calibrating a spirometer and checking the volume with a 3.0
liter super syringe. The volumes recorded are: 2.85 L, 2.8 L, and 2.8 L. Based upon the
information obtained which of the following is a correct statement?
A. Another syringe needs to be used
B. Spirometer is accurate
C. The plunger was advanced too slowly
D. Spirometer may have a leak - ANSWER D. Spirometer may have a leak
Which of the following is an indication for high frequency jet ventilation?
A. Bronchopleural fistula
B. Wilson Mikity syndrome
C. Necrotizing lesion of right lung
D. Centrilobular emphysema - ANSWER A. Bronchopleural fistula
A 43-year-old female patient has just undergone a total abdominal hysterectomy. The
patient arrives in the post anesthesia care unit obtunded with minimal response to
painful stimulus. What treatment should the respiratory therapist recommend for this
patient?
A. Initiate assisted ventilation
B. Insert oropharyngeal airway
C. Obtain positron emission tomography
,D. Initiate noninvasive capnography - ANSWER B. Insert oropharyngeal airway
A 44 week gestational age infant has just been delivered via C-section and is gasping,
grunting, and has tachycardia and tachypnea. At one minute his Apgar score is 4 and at
5 minutes the score is 5. The infant is most likely suffering from
A. transient tachypnea of the newborn.
B. meconium aspiration.
C. bronchopulmonary dysplasia.
D. apnea of prematurity. - ANSWER B. meconium aspiration.
What is the normal VD/VT ratio for a patient breathing room air?
A. 5 - 15%
B. 20 - 40%
C. 45 - 55%
D. 65 - 75% - ANSWER B. 20 - 40%
A heat moisture exchanger is indicated for humidification in which of the following
situations?
A. Mechanical ventilation in a long-term care facility.
B. Transport to a tertiary care center.
C. Patient with tenacious secretions.
D. Delivery of aerosolized bronchodilators. - ANSWER B. Transport to a tertiary care
center.
All of the following could cause a patient's right-hemidiaphragm to be elevated,
EXCEPT
A. right lower lobe atelectasis.
B. right side hyperlucency, absent vascular markings.
C. hepatomegaly.
D. right lower lobe consolidation with air bronchograms. - ANSWER B. right side
hyperlucency, absent vascular markings
A 64-year-old, 70 kg (154 lb) man with severe COPD is receiving independent
(differential) lung ventilation following thoracotomy and right lower lobectomy. Which of
the following setting combinations would be most appropriate for this patient?
A. Right lung 50 mL; left lung 650 mL
B. Right lung 150 mL; left lung 550 mL
C. Right lung 350 mL; left lung 350 mL
D. Right lung 550 mL; left lung 150 mL - ANSWER B. Right lung 150 mL; left lung 550
mL
,A patient in the intensive care unit has the following hemodynamic measurements:
CVP (mm Hg) 5
PAP (mm Hg) 29/8
PCWP (mm Hg) 8
BP (mm Hg) 130/70
Cardiac output (L/min) 5.1
Cardiac index (L/min/m2) 2.7
What is the pulse pressure?
A. 15 mm Hg
B. 21 mm Hg
C. 60 mm Hg
D. 90 mm Hg - ANSWER C. 60 mm Hg
A 2-year-old child with croup has been intubated for 4 days with a 4 mm ID uncuffed
endotracheal tube. Heated aerosol at an FIO2 of 0.30 has been delivered to the patient.
The physician asks the respiratory therapist to evaluate the patient for possible
extubation. Which of the following would most likely indicate that the patient is ready for
extubation?
A. The patient is making normal quiet ventilatory efforts.
B. A negative sputum culture and sensitivity has been reported.
C. The patient's ABG are within normal range.
D. Breath sounds are heard around the tube on auscultation. - ANSWER D. Breath
sounds are heard around the tube on auscultation.
A patient is seen in the Emergency Department for complaints of nausea and vomiting.
A nasogastric tube has been inserted and the patient is started on lasix. Which of the
following should the respiratory therapist monitor?
A. Cardiac enzymes
B. Serum electrolytes
C. Arterial blood gases
D. Cell hydration level - ANSWER B. Serum electrolytes
While instructing a patient prior to a vital capacity maneuver, the respiratory therapist
should direct the patient to
A. exhale to residual volume and inhale to inspiratory capacity.
B. inhale to total lung capacity then exhale to residual volume.
C. exhale normally then inhale to total lung capacity.
, D. inhale normally then exhale to functional residual capacity. - ANSWER B. inhale to
total lung capacity then exhale to residual volume.
A patient involved in an automobile accident is brought to the ED with tachypnea,
tracheal deviation to the right, splinting, asymmetrical chest movement, and decreased
breath sounds on the left side. The respiratory therapist should initially
A. insert a chest tube.
B. administer 100% oxygen via mask.
C. perform endotracheal intubation.
D. initiate non-invasive positive pressure ventilation. - ANSWER B. administer 100%
oxygen via mask.
A 77-year-old male patient is admitted to the emergency room with shortness of breath,
fine basilar crackles, +2 pitting edema and a chest radiogram with a butterfly pattern.
These results are most consistent with which of the following?
A. Pulmonary edema
B. Pulmonary interstitial emphysema
C. Pneumothorax
D. Emphysema - ANSWER A. Pulmonary edema
Which of the following formulas will determine the total flow being delivered to a patient
with a 28% venturi mask running at 6 L/min?
A. total flow = 6 x 2
B. total flow = 6 x 4
C. total flow = 6 x 5
D. total flow = 6 x 11 - ANSWER D. total flow = 6 x 11
Fine crepitant crackles are most commonly associated with which of the following
conditions?
A. Bronchitis
B. Pulmonary edema
C. Pneumonia
D. Foreign body aspiration - ANSWER B. Pulmonary edema
A patient with end-stage pulmonary fibrosis is receiving oxygen at 2 L/min via a
transtracheal oxygen catheter. The patient experiences an increased work of breathing
and shortness of breath. The respiratory therapist should
A. manually ventilate the patient with a resuscitation bag.
B. increase the flow to the transtracheal catheter to 6 L/min.
C. evaluate the SpO2 with a pulse oximeter.
