TMC Practice Exam A + B QUESTIONS
WITH COMPLETE SOLUTION
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. Correct Answer: D. deep breathing and
coughing to clear secretions.
See Patient Assessment
A healthy adult female can exhale what portion of her forced vital capacity in the first second?
Correct Answer: 70%
Following cardiac surgery, a 55 year-old patient has the following ABG results: pH 7.50, PaCO2
30 torr, PaO2 62 torr, HCO3 25 mEq/L, SaO2 92%, HB 14 g/dL, BE +2. Venous blood gas
results are pH 7.39, PvCO2 43 torr, PvO2 37 torr, and SvO2 66%. Calculate the patient's C(a-
v)O2. Correct Answer: 5% volume
What value for the apnea-hypopnea index (AHI) is consistent with mild obstructive sleep apnea?
Correct Answer: 5 to 15
The respiratory therapist is asked to evaluate the presence of Auto-PEEP on a patient receiving
mechanical ventilation. In order to do this, what should the RT do? Correct Answer: Initiate an
expiratory hold just prior to the next ventilator-delivered breath
What do bronchial breath sounds heard over the lung periphery indicate? Correct Answer: lung
consolidation (pneumonia)
Rationale: should be vesicular in periphery
A 60 kg (132 lb) patient is mechanically ventilated at the following settings: VC, A/C; VT 500
mL, respiratory rate 12/min, FIO2 1.00 and 10 cm H2O PEEP. The patient's peak airway
pressure is 60 cm H2O and his SpO2 is 85%. A current chest x-ray shows diffuse bilateral
infiltrates. Which of the following is the most appropriate action in order to reduce peak airway
pressure?
A. Increase the frequency.
B. Change to airway pressure release ventilation.
C. Decrease the inspiratory time.
, D. Increase PEEP to 15 cm H2O. Correct Answer: B. Change to airway pressure release
ventilation.
A 19-year-old patient is brought to the Emergency Department after taking a handful of pills.
The patient is obtunded but is making regular, sonorous respiratory efforts. Auscultation reveals
coarse rhonchi bilaterally. Which of the following should be done FIRST to assess this patient?
A. Obtain a sputum specimen.
B. Obtain an ABG.
C. Measure peak expiratory flow.
D. Determine the Glasgow Coma Score. Correct Answer: B. Obtain an ABG.
A young healthy adult with complaints of intermittent wheezing is seen in the pulmonary clinic.
A pre/post bronchodilator spirometry reveals a normal study with no reversibility. Which of the
following should the respiratory therapist recommend?
A. Helium dilution study
B. DLCO
C. Plethysmography
D. Bronchial provocation Correct Answer: D. Bronchial provocation
Following abdominal surgery, a 70 year-old patient receives mechanical ventilation in the ICU at
the following settings: VC, A/C; VT 550 mL, respiratory rate 14/min, FIO2 0.50 and 10 cm H2O
PEEP. Bedside monitoring results demonstrate that the PvO2 is 35 torr and the SpO2 is 90%.
The patient is alert and oriented with stable vital signs. Which of the following should the
respiratory therapist recommend?
A. Decrease the PEEP.
B. Increase the FIO2.
C. Initiation diuretic therapy.
D. Continue to monitor closely. Correct Answer: B. Increase the FIO2.
The respiratory therapist obtains a blood gas sample from the patient's radial artery and applies
pressure to the site for 10 minutes. After removing any excess air from the syringe, the next step
for proper handling of the blood sample is:
A. adding liquid heparin to the sample.
B. placing the syringe in an ice bath.
C. shaking the sample continuously.
D. applying a pressure bandage. Correct Answer: B. placing the syringe in an ice bath.
Rationale: it's been over 10 mins and the sample will continue to metabolize/eat up O2 otherwise
A 72 year-old female post stem cell transplant patient in the ICU complains of difficulty
breathing and is noted to have diffuse fluffy infiltrates on chest X-ray. The B-type Natriuretic
Peptide (BNP) test result demonstrates 700 pg/mL. What is the patient's possible condition?
WITH COMPLETE SOLUTION
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. Correct Answer: D. deep breathing and
coughing to clear secretions.
See Patient Assessment
A healthy adult female can exhale what portion of her forced vital capacity in the first second?
Correct Answer: 70%
Following cardiac surgery, a 55 year-old patient has the following ABG results: pH 7.50, PaCO2
30 torr, PaO2 62 torr, HCO3 25 mEq/L, SaO2 92%, HB 14 g/dL, BE +2. Venous blood gas
results are pH 7.39, PvCO2 43 torr, PvO2 37 torr, and SvO2 66%. Calculate the patient's C(a-
v)O2. Correct Answer: 5% volume
What value for the apnea-hypopnea index (AHI) is consistent with mild obstructive sleep apnea?
Correct Answer: 5 to 15
The respiratory therapist is asked to evaluate the presence of Auto-PEEP on a patient receiving
mechanical ventilation. In order to do this, what should the RT do? Correct Answer: Initiate an
expiratory hold just prior to the next ventilator-delivered breath
What do bronchial breath sounds heard over the lung periphery indicate? Correct Answer: lung
consolidation (pneumonia)
Rationale: should be vesicular in periphery
A 60 kg (132 lb) patient is mechanically ventilated at the following settings: VC, A/C; VT 500
mL, respiratory rate 12/min, FIO2 1.00 and 10 cm H2O PEEP. The patient's peak airway
pressure is 60 cm H2O and his SpO2 is 85%. A current chest x-ray shows diffuse bilateral
infiltrates. Which of the following is the most appropriate action in order to reduce peak airway
pressure?
A. Increase the frequency.
B. Change to airway pressure release ventilation.
C. Decrease the inspiratory time.
, D. Increase PEEP to 15 cm H2O. Correct Answer: B. Change to airway pressure release
ventilation.
A 19-year-old patient is brought to the Emergency Department after taking a handful of pills.
The patient is obtunded but is making regular, sonorous respiratory efforts. Auscultation reveals
coarse rhonchi bilaterally. Which of the following should be done FIRST to assess this patient?
A. Obtain a sputum specimen.
B. Obtain an ABG.
C. Measure peak expiratory flow.
D. Determine the Glasgow Coma Score. Correct Answer: B. Obtain an ABG.
A young healthy adult with complaints of intermittent wheezing is seen in the pulmonary clinic.
A pre/post bronchodilator spirometry reveals a normal study with no reversibility. Which of the
following should the respiratory therapist recommend?
A. Helium dilution study
B. DLCO
C. Plethysmography
D. Bronchial provocation Correct Answer: D. Bronchial provocation
Following abdominal surgery, a 70 year-old patient receives mechanical ventilation in the ICU at
the following settings: VC, A/C; VT 550 mL, respiratory rate 14/min, FIO2 0.50 and 10 cm H2O
PEEP. Bedside monitoring results demonstrate that the PvO2 is 35 torr and the SpO2 is 90%.
The patient is alert and oriented with stable vital signs. Which of the following should the
respiratory therapist recommend?
A. Decrease the PEEP.
B. Increase the FIO2.
C. Initiation diuretic therapy.
D. Continue to monitor closely. Correct Answer: B. Increase the FIO2.
The respiratory therapist obtains a blood gas sample from the patient's radial artery and applies
pressure to the site for 10 minutes. After removing any excess air from the syringe, the next step
for proper handling of the blood sample is:
A. adding liquid heparin to the sample.
B. placing the syringe in an ice bath.
C. shaking the sample continuously.
D. applying a pressure bandage. Correct Answer: B. placing the syringe in an ice bath.
Rationale: it's been over 10 mins and the sample will continue to metabolize/eat up O2 otherwise
A 72 year-old female post stem cell transplant patient in the ICU complains of difficulty
breathing and is noted to have diffuse fluffy infiltrates on chest X-ray. The B-type Natriuretic
Peptide (BNP) test result demonstrates 700 pg/mL. What is the patient's possible condition?
