TMC Practice Exam 2022 QUESTIONS WITH
COMPLETE SOLUTION (V)
While assessing a physician with a trans thoracic ultrasound exam, you observe an echo-free area
above the patient's diaphragm. Which of the following is most consistent with this finding?
A) pneumothorax
B) pulmonary edema
C) pleural effusion
D) atelectasis Correct Answer: C) pleural effusion
In a B-mode ultrasound exam, the presence of an echo-free or dark zone in a scanned dependent
region (especially at or near the costophrenic angle) indicates a pleural effusion. If the effusion is
large, lung tissue may appear as a solid organ due to compression atelectasis. In real-time, the
consolidated lung tissue may actually be seen as moving in the surrounding effusion fluid as the
chest expands and contracts.
What is the normal range for intracranial pressure (ICP) in a supine adult?
A) -2 to +6 mmHg
B) +7 to +15 mmHg
C) +16 to +24 mmHg
D) +25 to +33 mmHg Correct Answer: B) +7 to +15 mmHg
Ans In supine adults, the mean ICP normally ranges between 7 to 15 mm Hg. An ICP > 20 mm
Hg for more than 5 to 10 minutes is considered abnormally high in an adult, with pressures > 25
mm Hg for a prolonged period of time associated with poor patient outcomes.
A patient involved in a motor vehicle accident presents with respiratory distress. A chest x-ray
confirms the presence of multiple rib fractures on the left side. Which of the following physical
findings would be expected during palpitation of the chest?
A) trachea deviated to the left
B) paradoxical motion of the abdomen
C) paradoxical motion of the left chest
, D) tympany over the right chest Correct Answer: C) paradoxical motion of the left chest
When the chest wall loses the stabilizing support of the ribs (usually two or more ribs broken in
two or more places), it will move in during inspiration and outward during exhalation, i.e.,
exhibit 'paradoxical' motion. This is the one of the clinical findings characterizing a 'flail chest'
injury.
Which of the following breathing patterns would indicate the acute onset of hypoxemia in a
spontaneously breathing adult patient following thoracic surgery?
A) Cheyne-Stokes respiration
B) abdominal respirations
C) bradypnea, periods of apnea
D) tachypnea, decreased tidal volumes Correct Answer: D) tachypnea, decreased tidal volumes
One of the first indications of hypoxemia is an increase in the respiratory rate. Any patient who
has had recent thoracic surgery will exhibit a decreased tidal volume due to pain.
As measured on the Borg scale, which of the following exertion levels is appropriate for titrating
a COPD patient's O2 flows to support exercise?
A) weak / light exertion (rating of 2)
B) somewhat strong exertion (rating of 4)
C) very strong exertion (rating of 7)
D) maximal exertion (rating of 10) Correct Answer: B) somewhat strong exertion (rating of 4)
For patients continuing on, you have them initiate walking and slowly increase their activity until
it replicates the highest intensity they will likely perform in the home environment, usually
equivalent to a 3 to 4 on the Borg rating of perceived exertion.
When performing FVC maneuvers, reproducibility of results can be demonstrated by confirming
that:
A) the two largest FVC measures are within 150 mL of each other
B) the two largest FVC measures are within 250 mL of each other
COMPLETE SOLUTION (V)
While assessing a physician with a trans thoracic ultrasound exam, you observe an echo-free area
above the patient's diaphragm. Which of the following is most consistent with this finding?
A) pneumothorax
B) pulmonary edema
C) pleural effusion
D) atelectasis Correct Answer: C) pleural effusion
In a B-mode ultrasound exam, the presence of an echo-free or dark zone in a scanned dependent
region (especially at or near the costophrenic angle) indicates a pleural effusion. If the effusion is
large, lung tissue may appear as a solid organ due to compression atelectasis. In real-time, the
consolidated lung tissue may actually be seen as moving in the surrounding effusion fluid as the
chest expands and contracts.
What is the normal range for intracranial pressure (ICP) in a supine adult?
A) -2 to +6 mmHg
B) +7 to +15 mmHg
C) +16 to +24 mmHg
D) +25 to +33 mmHg Correct Answer: B) +7 to +15 mmHg
Ans In supine adults, the mean ICP normally ranges between 7 to 15 mm Hg. An ICP > 20 mm
Hg for more than 5 to 10 minutes is considered abnormally high in an adult, with pressures > 25
mm Hg for a prolonged period of time associated with poor patient outcomes.
A patient involved in a motor vehicle accident presents with respiratory distress. A chest x-ray
confirms the presence of multiple rib fractures on the left side. Which of the following physical
findings would be expected during palpitation of the chest?
A) trachea deviated to the left
B) paradoxical motion of the abdomen
C) paradoxical motion of the left chest
, D) tympany over the right chest Correct Answer: C) paradoxical motion of the left chest
When the chest wall loses the stabilizing support of the ribs (usually two or more ribs broken in
two or more places), it will move in during inspiration and outward during exhalation, i.e.,
exhibit 'paradoxical' motion. This is the one of the clinical findings characterizing a 'flail chest'
injury.
Which of the following breathing patterns would indicate the acute onset of hypoxemia in a
spontaneously breathing adult patient following thoracic surgery?
A) Cheyne-Stokes respiration
B) abdominal respirations
C) bradypnea, periods of apnea
D) tachypnea, decreased tidal volumes Correct Answer: D) tachypnea, decreased tidal volumes
One of the first indications of hypoxemia is an increase in the respiratory rate. Any patient who
has had recent thoracic surgery will exhibit a decreased tidal volume due to pain.
As measured on the Borg scale, which of the following exertion levels is appropriate for titrating
a COPD patient's O2 flows to support exercise?
A) weak / light exertion (rating of 2)
B) somewhat strong exertion (rating of 4)
C) very strong exertion (rating of 7)
D) maximal exertion (rating of 10) Correct Answer: B) somewhat strong exertion (rating of 4)
For patients continuing on, you have them initiate walking and slowly increase their activity until
it replicates the highest intensity they will likely perform in the home environment, usually
equivalent to a 3 to 4 on the Borg rating of perceived exertion.
When performing FVC maneuvers, reproducibility of results can be demonstrated by confirming
that:
A) the two largest FVC measures are within 150 mL of each other
B) the two largest FVC measures are within 250 mL of each other
