TMC practice exam 2022/2023 | 100
QUESTIONS| WITH COMPLETE SOLUTION
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 Correct Answer: c. 70-83% of FVC
Simple spirometry CANNOT be used to measure the
A. vital capacity
B. residual volume
C. tidal volume
D. inspiratory reserve volume Correct Answer: b. residual volume
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 Correct Answer: d. obtain the
patient's current prescription vials from the family
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 Correct Answer: c. presence of barcode lines
Which of the following would tend to increase insensible water loss?
A. hypothermia
B. bypassed upper airway
C. hypoventilation
D. diuretic administration Correct Answer: b. bypassed upper airway
Which of the following would tend to decrease a patient's energy expenditure?
A. hypothermia
B. inflammation
C. major trauma
D. agitation/pain Correct Answer: a. hypothermia
A patient has acute respiratory acidosis. You would expect the base excess (BE) to range
between:
,A. + 6 mEq/L
B. - 6 mEq/L
C. +/- 2 mEq/L
D. +/- 8 mEq/L Correct Answer: c. +/- 2 mEq/L
Which of the following arterial blood gas results would most likely be reported for a patient who
is having a mild asthma attack?
A. pH = 7.31 PCO2 = 50 torr PO2 = 60 torr
B. pH = 7.40 PCO2 = 50 torr PO2 = 50 torr
C. pH = 7.47 PCO2 = 32 torr PO2 = 60 torr
D. pH = 7.47 PCO2 = 40 torr PO2 = 50 torr Correct Answer: c. pH= 7.47 PCO2= 32 torr PO2=
60 torr
The Apgar score for a normal newborn infant ranges between
A. 1-4
B. 4-7
C. 7-10
D. 10-13 Correct Answer: c. 7-10
On inspection of a patient's ECG strip, you note no identifiable P waves; rapid irregular
undulations of the isoelectric line; and an irregular ventricular rhythm. In addition, the precordial
cardiac rate is greater than the peripheral pulse rate. The most likely problem is:
A. 2nd degree (Wenckebach) heart block
B. ventricular fibrillation
C. atrial fibrillation
D. ventricular tachycardia Correct Answer: c. atrial fibrillation
In inspecting an elderly female patient, you note that her spine has an abnormal anterposterior
(AP) curvature. Which of the following terms would you use in charting this observation?
A. kyphosis
B. scoliosis
C. kyphoscoliosis
D. pectus excavatum Correct Answer: a. kyphosis
During auscultation of a patient's chest, you hear intermittent "bubbling" sounds at the lung
bases. Which of the following chart entries best describe this finding?
A. "bronchial sounds heard at lung bases"
B. "wheezes heard at lung bases"
C. "rhonchi heard at lung bases"
D. "crackles (rales) heard at lung bases" Correct Answer: d. "crackles (rales) heard at lung
bases"
While assessing a patient's radial pulse, you note that the pulse feels full and bounding. Which of
the following conditions would be the most probable cause of this finding?
A. hypovolemia
B. hypertension
, C. cardiovascular shock
D. low cardiac output Correct Answer: b. hypertension
A patient is cachexic, exhibits generalized edema and dry skin, and appears listless. The most
likely problem is:
A. heart failure
B. Addison's disease
C. renal failure
D. malnutrition Correct Answer: d. malnutrition
Prior to giving an aerosol treatment, you find a note in the chart that states your patient had pink
frothy secretions on admission to the ED. This is most indicative of:
A. cor pulmonale
B. left ventricular failure
C. an electrolyte imbalance
D. ARDS Correct Answer: b. left ventricular failure
A doctor orders a changeover to CPAP for a patient receiving bi-level positive airway pressure
(BiPAP) via a device with separate IPAP and EPAP controls. To effect this change you would:
A. set IPAP less than EPAP
B. set IPAP greater than EPAP
C. set EPAP = 0 cm H2O
D. set IPAP equal to EPAP Correct Answer: a. set IPAP less than EPAP
How would you characterize the degree of dyspnea of a patient who walks slower than people of
the same age because of breathlessness?
A. slight
B. moderate
C. severe
D. very severe Correct Answer: b. moderate
Upon exam of an acutely dyspneic and hypotensive patient, you note the following - all on the
left side of the chest: reduced chest expansion, hyperresonance to percussion, absent of breath
sounds and tactile fremitus, and a tracheal shift to the right. These findings suggest:
A. left-sided pneumothorax
B. left-sided consolidation
C. left lobar obstruction/atelectasis
D. left-sided pleural effusion Correct Answer: a. left-sided pneumothorax
A patient's response to an interview question is initially vague or unclear. Which of the following
responses on your part would be most appropriate?
A. "Please go on"
B. "You seem to be anxious"
C. "I see why you are so upset"
D. "Please explain that to me again" Correct Answer: d. "please explain that to me again"
QUESTIONS| WITH COMPLETE SOLUTION
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 Correct Answer: c. 70-83% of FVC
Simple spirometry CANNOT be used to measure the
A. vital capacity
B. residual volume
C. tidal volume
D. inspiratory reserve volume Correct Answer: b. residual volume
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 Correct Answer: d. obtain the
patient's current prescription vials from the family
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 Correct Answer: c. presence of barcode lines
Which of the following would tend to increase insensible water loss?
A. hypothermia
B. bypassed upper airway
C. hypoventilation
D. diuretic administration Correct Answer: b. bypassed upper airway
Which of the following would tend to decrease a patient's energy expenditure?
A. hypothermia
B. inflammation
C. major trauma
D. agitation/pain Correct Answer: a. hypothermia
A patient has acute respiratory acidosis. You would expect the base excess (BE) to range
between:
,A. + 6 mEq/L
B. - 6 mEq/L
C. +/- 2 mEq/L
D. +/- 8 mEq/L Correct Answer: c. +/- 2 mEq/L
Which of the following arterial blood gas results would most likely be reported for a patient who
is having a mild asthma attack?
A. pH = 7.31 PCO2 = 50 torr PO2 = 60 torr
B. pH = 7.40 PCO2 = 50 torr PO2 = 50 torr
C. pH = 7.47 PCO2 = 32 torr PO2 = 60 torr
D. pH = 7.47 PCO2 = 40 torr PO2 = 50 torr Correct Answer: c. pH= 7.47 PCO2= 32 torr PO2=
60 torr
The Apgar score for a normal newborn infant ranges between
A. 1-4
B. 4-7
C. 7-10
D. 10-13 Correct Answer: c. 7-10
On inspection of a patient's ECG strip, you note no identifiable P waves; rapid irregular
undulations of the isoelectric line; and an irregular ventricular rhythm. In addition, the precordial
cardiac rate is greater than the peripheral pulse rate. The most likely problem is:
A. 2nd degree (Wenckebach) heart block
B. ventricular fibrillation
C. atrial fibrillation
D. ventricular tachycardia Correct Answer: c. atrial fibrillation
In inspecting an elderly female patient, you note that her spine has an abnormal anterposterior
(AP) curvature. Which of the following terms would you use in charting this observation?
A. kyphosis
B. scoliosis
C. kyphoscoliosis
D. pectus excavatum Correct Answer: a. kyphosis
During auscultation of a patient's chest, you hear intermittent "bubbling" sounds at the lung
bases. Which of the following chart entries best describe this finding?
A. "bronchial sounds heard at lung bases"
B. "wheezes heard at lung bases"
C. "rhonchi heard at lung bases"
D. "crackles (rales) heard at lung bases" Correct Answer: d. "crackles (rales) heard at lung
bases"
While assessing a patient's radial pulse, you note that the pulse feels full and bounding. Which of
the following conditions would be the most probable cause of this finding?
A. hypovolemia
B. hypertension
, C. cardiovascular shock
D. low cardiac output Correct Answer: b. hypertension
A patient is cachexic, exhibits generalized edema and dry skin, and appears listless. The most
likely problem is:
A. heart failure
B. Addison's disease
C. renal failure
D. malnutrition Correct Answer: d. malnutrition
Prior to giving an aerosol treatment, you find a note in the chart that states your patient had pink
frothy secretions on admission to the ED. This is most indicative of:
A. cor pulmonale
B. left ventricular failure
C. an electrolyte imbalance
D. ARDS Correct Answer: b. left ventricular failure
A doctor orders a changeover to CPAP for a patient receiving bi-level positive airway pressure
(BiPAP) via a device with separate IPAP and EPAP controls. To effect this change you would:
A. set IPAP less than EPAP
B. set IPAP greater than EPAP
C. set EPAP = 0 cm H2O
D. set IPAP equal to EPAP Correct Answer: a. set IPAP less than EPAP
How would you characterize the degree of dyspnea of a patient who walks slower than people of
the same age because of breathlessness?
A. slight
B. moderate
C. severe
D. very severe Correct Answer: b. moderate
Upon exam of an acutely dyspneic and hypotensive patient, you note the following - all on the
left side of the chest: reduced chest expansion, hyperresonance to percussion, absent of breath
sounds and tactile fremitus, and a tracheal shift to the right. These findings suggest:
A. left-sided pneumothorax
B. left-sided consolidation
C. left lobar obstruction/atelectasis
D. left-sided pleural effusion Correct Answer: a. left-sided pneumothorax
A patient's response to an interview question is initially vague or unclear. Which of the following
responses on your part would be most appropriate?
A. "Please go on"
B. "You seem to be anxious"
C. "I see why you are so upset"
D. "Please explain that to me again" Correct Answer: d. "please explain that to me again"
