TMC practice exam 2| 140 QUESTIONS (20 PAGES)|
WITH COMPLETE SOLUTIONS (Vii)
maintain current therapy and continue to monitor Correct Answer: A 36 weeks gestation, 4 hour
post delivery neonate has the following arterial blood gas results while on a 35% oxyhood
PH: 7.34
Paco2: 47 mmhg
HCO3: 25 mEq/L
Pao2: 57 mmhg
on the basis of these results, the respiratory therapist should recommend which of the following?
SIMV: Rate 8/min, VT 400 ml, FIO2 0.30 Correct Answer: A respiratory therapist is asked to
initiate mechanical ventilation on a 67 year old 55kg (121 lb) female patient who has a long
standing history of chronic obstructive pulmonary disease. The therapist should suggest which of
the following?
implement therapy as ordered Correct Answer: a physician has ordered the following ventilator
settings for a 57 year old, 75kg (165 lb) postoperative pneumonectomy patient:
Mode: A/C
FIO2: 0.40
VT: 300 ML
Rate: 12/min
PEEP: 0 cmH2O
based on this information, the respiratory therapist should do which of the following?
reinstitute mechanical ventilation Correct Answer: The data below are recorded for a patient
being weaned from mechanical ventilation via a 30% T-Piece setup:
prior to weaning:
pulse: 88/min
respirations: 16/min
PH: 7.41
Paco2: 38 mmhg
HCO3: 25 mEq/l
PaO2: 79 mmhg
15 minutes on T-Piece:
pulse: 110/min
respirations: 27/min
,PH: 7.29
PaCO2: 56 mmhg
HCO3: 26 mEq/L
PaO2: 68 mmhg
on the basis of this information, the respiratory therapist should:
Patient C Correct Answer: data recorded for 4 patients who are being weaned from mechanical
ventilation are below. Which patient should NOT be weaned at this time?
Patient A: Qs/Qt: 0.14, VD/VT: 0.43 MIP: -38 cmH2O
Patient B: Qs/Qt: 0.18, VD/VT: 0.49, MIP: -46 cmH2O
Patient C: Qs/Qt: 0.26, VD/VT: 0.27, MIP: -29 cmH2O
Patient D: Qs/Qt: 0.11, VD/VT: 0.33, MIP: -32 cmH2O
increased deadspace Correct Answer: The following data were recorded for a 2 day
postoperative cholecystectomy patient who is receiving an FIO2 of 0.28:
minute ventilation: 17 L/min
PH: 7.48
PaCO2: 33 mmHg
HCO3: 24 mEq/L
PaO2: 79 mmHg
These data are most consistent with which of the following?
compensated respiratory acidosis with uncorrected hypoxemia Correct Answer: A patient
receiving 3 L/min nasal oxygen has the following arterial blood gas results:
PH: 7.37
PaCO2: 61 mmHg
HCO3: 34 mEq/L
PaO2: 59 mmHg
The correct interpretation of these results is:
vital capacity Correct Answer: Which of the following should be evaluated prior to changing a
patient from mechanical ventilation to a T piece?
perform orotracheal intubation Correct Answer: a neonate has an Apgar score of 3 and is
experiencing prolonged periods of apnea. Which of the following would be appropriate?
, a nasopharyngeal airway Correct Answer: A comatose patient who needs frequent suctioning
would benefit from which of the following?
activation of the I:E ratio alarm Correct Answer: The accumulation of a significant amount of
secretions in the endotracheal tube of a patient being ventilated via a volume ventilator will
result in all of the following EXCEPT:
continue with the present therapy Correct Answer: A patient with end state COPD has been
admitted to the ED for acute exacerbation of his condition. An arterial blood gas sample was
drawn while the patient was breathing room air. The patient was then placed on 3 L/min nasal
oxygen and a repeat arterial blood gas was drawn. Both sets of arterial blood gas results are as
follows:
Room air:
PH: 7.27
PaCO2: 82 mmhg
HCO3: 36 mEq/L
PaO2: 42 mmhg
3 L/min nasal oxygen:
PH: 7.35
PaCO2: 65 mmHg
HCO3: 35 mEq/L
PaO2: 58 mmHg
The most appropriate change in this patients therapy would be to:
bring a distressed patient to a tertiary care center in stable condition Correct Answer: The major
goal of members participating in land/air patient transport from an outlying hospital to a tertiary
care center is to:
lateral decubitus xray Correct Answer: The respiratory therapist has been called to asses a
patient complaining of lower right chest pain, shortness of breath, and dry cough. while
percussing the right anterior and lateral chest, the respiratory therapist observes that the
percussion note changes from resonance to hyperresonance to dullness as she percusses
downward on the chest. To further evaluate the patients condition, the therapist should
recommend which of the following?
the neonates pulmonary condition has deteriorated Correct Answer: a respiratory therapist is
caring for a neonatal patient who has a transcutaneous PO2 electrode in place on the right chest.
Over the last 6 hours, the therapist observes that the transcutaneous PO2 measurement has
decreased from 79 mmHg to 62 mmHg. The most likely cause for this situation is:
the cardiac output has decreased Correct Answer: a significant increase in C(a-v)O2 would most
likely indicate which of the following?
WITH COMPLETE SOLUTIONS (Vii)
maintain current therapy and continue to monitor Correct Answer: A 36 weeks gestation, 4 hour
post delivery neonate has the following arterial blood gas results while on a 35% oxyhood
PH: 7.34
Paco2: 47 mmhg
HCO3: 25 mEq/L
Pao2: 57 mmhg
on the basis of these results, the respiratory therapist should recommend which of the following?
SIMV: Rate 8/min, VT 400 ml, FIO2 0.30 Correct Answer: A respiratory therapist is asked to
initiate mechanical ventilation on a 67 year old 55kg (121 lb) female patient who has a long
standing history of chronic obstructive pulmonary disease. The therapist should suggest which of
the following?
implement therapy as ordered Correct Answer: a physician has ordered the following ventilator
settings for a 57 year old, 75kg (165 lb) postoperative pneumonectomy patient:
Mode: A/C
FIO2: 0.40
VT: 300 ML
Rate: 12/min
PEEP: 0 cmH2O
based on this information, the respiratory therapist should do which of the following?
reinstitute mechanical ventilation Correct Answer: The data below are recorded for a patient
being weaned from mechanical ventilation via a 30% T-Piece setup:
prior to weaning:
pulse: 88/min
respirations: 16/min
PH: 7.41
Paco2: 38 mmhg
HCO3: 25 mEq/l
PaO2: 79 mmhg
15 minutes on T-Piece:
pulse: 110/min
respirations: 27/min
,PH: 7.29
PaCO2: 56 mmhg
HCO3: 26 mEq/L
PaO2: 68 mmhg
on the basis of this information, the respiratory therapist should:
Patient C Correct Answer: data recorded for 4 patients who are being weaned from mechanical
ventilation are below. Which patient should NOT be weaned at this time?
Patient A: Qs/Qt: 0.14, VD/VT: 0.43 MIP: -38 cmH2O
Patient B: Qs/Qt: 0.18, VD/VT: 0.49, MIP: -46 cmH2O
Patient C: Qs/Qt: 0.26, VD/VT: 0.27, MIP: -29 cmH2O
Patient D: Qs/Qt: 0.11, VD/VT: 0.33, MIP: -32 cmH2O
increased deadspace Correct Answer: The following data were recorded for a 2 day
postoperative cholecystectomy patient who is receiving an FIO2 of 0.28:
minute ventilation: 17 L/min
PH: 7.48
PaCO2: 33 mmHg
HCO3: 24 mEq/L
PaO2: 79 mmHg
These data are most consistent with which of the following?
compensated respiratory acidosis with uncorrected hypoxemia Correct Answer: A patient
receiving 3 L/min nasal oxygen has the following arterial blood gas results:
PH: 7.37
PaCO2: 61 mmHg
HCO3: 34 mEq/L
PaO2: 59 mmHg
The correct interpretation of these results is:
vital capacity Correct Answer: Which of the following should be evaluated prior to changing a
patient from mechanical ventilation to a T piece?
perform orotracheal intubation Correct Answer: a neonate has an Apgar score of 3 and is
experiencing prolonged periods of apnea. Which of the following would be appropriate?
, a nasopharyngeal airway Correct Answer: A comatose patient who needs frequent suctioning
would benefit from which of the following?
activation of the I:E ratio alarm Correct Answer: The accumulation of a significant amount of
secretions in the endotracheal tube of a patient being ventilated via a volume ventilator will
result in all of the following EXCEPT:
continue with the present therapy Correct Answer: A patient with end state COPD has been
admitted to the ED for acute exacerbation of his condition. An arterial blood gas sample was
drawn while the patient was breathing room air. The patient was then placed on 3 L/min nasal
oxygen and a repeat arterial blood gas was drawn. Both sets of arterial blood gas results are as
follows:
Room air:
PH: 7.27
PaCO2: 82 mmhg
HCO3: 36 mEq/L
PaO2: 42 mmhg
3 L/min nasal oxygen:
PH: 7.35
PaCO2: 65 mmHg
HCO3: 35 mEq/L
PaO2: 58 mmHg
The most appropriate change in this patients therapy would be to:
bring a distressed patient to a tertiary care center in stable condition Correct Answer: The major
goal of members participating in land/air patient transport from an outlying hospital to a tertiary
care center is to:
lateral decubitus xray Correct Answer: The respiratory therapist has been called to asses a
patient complaining of lower right chest pain, shortness of breath, and dry cough. while
percussing the right anterior and lateral chest, the respiratory therapist observes that the
percussion note changes from resonance to hyperresonance to dullness as she percusses
downward on the chest. To further evaluate the patients condition, the therapist should
recommend which of the following?
the neonates pulmonary condition has deteriorated Correct Answer: a respiratory therapist is
caring for a neonatal patient who has a transcutaneous PO2 electrode in place on the right chest.
Over the last 6 hours, the therapist observes that the transcutaneous PO2 measurement has
decreased from 79 mmHg to 62 mmHg. The most likely cause for this situation is:
the cardiac output has decreased Correct Answer: a significant increase in C(a-v)O2 would most
likely indicate which of the following?
