TMC Practice Exam 2022 | 150 Questions And
Answers
A 48 year-old female is admitted to the ED with diaphoresis, jugular venous
distension, and 3+ pitting edema in the ankles. These findings are consistent
with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances Correct Ans ➡ Heart failure
A patient is admitted to the ED following a motor vehicle accident. On
physical exam, the respiratory therapist discovers that breath sounds are
absent in the left chest with a hyperresonant percussion note. The trachea is
shifted to the right. The patient's heart rate is 45/min, respiratory rate is
30/min, and blood pressure is 60/40 mm Hg. What action should the
therapist recommend first?
A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate the patient. Correct
Ans ➡ Needle aspirate the 2nd left intercostal space.
All of the following strategies are likely to decrease the likelihood of damage
to the tracheal mucosa EXCEPT
A. maintaining cuff pressures between 20 and 25 mm Hg.
B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures. Correct Ans ➡ monitoring intracuff
pressures.
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 Ans ➡
deep breathing and coughing to clear secretions.
A 65 kg spinal cord injured patient has developed atelectasis. His inspiratory
capacity is 30% of his predicted value. What bronchial hygiene therapy
would be most appropriate initially?
A. IS / SMI
B. IPPB with normal saline
C. postural drainage and percussion
D. PEP therapy Correct Ans ➡ IPPB with normal saline
A patient on VC ventilation has demonstrated auto-PEEP on ventilator
graphics. Which of the following controls, when adjusted independently,
would increase expiratory time?
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity Correct Ans ➡ 1, 2, and 3 only
Which of the following would be the most appropriate therapy for a dyspneic
patient who has crepitus with tracheal deviation to the left and absent breath
sounds on the right?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube Correct Ans ➡ Insert a chest tube
A 55 year-old post cardiac surgery 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.
A. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
D. 5.5 vol% Correct Ans ➡ 5.0 vol%
A patient on VC, SIMV with a VT of 500 mL has a PIP of 25 cm H2O, Pplat of
15 cm H2O and PEEP of 5 cm H2O. What is the patient's static lung
compliance
,A. 25 mL/cm H2O
B. 35 mL/cm H2O
C. 45 mL/cm H2O
D. 50 mL/cm H2O Correct Ans ➡ 50 mL/cm H2O
Immediately after extubation of a patient in the ICU, the respiratory therapist
observes increasing respiratory distress with intercostal retractions and
marked stridor. The SpO2 on 40% oxygen is noted to be 86%. Which of the
following would be most appropriate at this time?
A. cool mist aerosol treatment
B. aerosolized racemic epinephrine
C. manual ventilation with resuscitation bag and mask
D. reintubation Correct Ans ➡ reintubation
Which of the following patients would most likely benefit from pressure
support ventilation?
A. An intubated patient with an absent respiratory drive.
B. A patient on SIMV with a set rate of 12/min and total rate of 24/min.
C. A patient with acute lung injury.
D. A patient who requires short-term post-operative ventilatory support.
Correct Ans ➡ A patient on SIMV with a set rate of 12/min and total rate of
24/min.
A patient receiving mechanical ventilation has developed a temperature of
99.9° F with purulent secretions over the last 12 hours. The respiratory
therapist has also noted a steady increase in peak inspiratory pressure. What
initial recommendation should be made to address these changes?
A. Initiate bronchial hygiene therapy.
B. Obtain a sputum gram stain.
C. Administer IPV.
D. Insert a CASS tube. Correct Ans ➡ Obtain a sputum gram stain.
Which of the following information may be obtained from a FVC maneuver
during bedside pulmonary function testing?
1. FEV1
2. PEFR
3. FRC
4. RV Correct Ans ➡ 1 and 2 only
, The respiratory therapist is providing patient education for a patient who is
being discharged home on aerosol therapy. The most important reason for
the patient to follow the recommended cleaning procedures using a
vinegar/water solution is that this solution will
A. sterilize the equipment.
B. retard bacterial growth.
C. kill all micro-organisms and spores.
D. extend the equipment life. Correct Ans ➡ Retard bacterial growth
A patient who complains of dyspnea is noted to have a dry, non-productive
cough. On physical examination, breath sounds are diminished on the right,
tactile fremitus is decreased and there is dullness to percussion over the
right lower lobe. The respiratory therapist should suspect that the patient is
suffering from
A. pneumonia.
B. pulmonary embolism.
C. pleural effusion.
D. bronchiolitis. Correct Ans ➡ pleural effusion
Which of the following suction catheters would be appropriate to use for a
patient with a size 8.0 mm ID endotracheal tube?
A. 8 Fr
B. 10 Fr
C. 12 Fr
D. 14 Fr Correct Ans ➡ 12 Fr
A patient who is receiving continuous mechanical ventilation is fighting the
ventilator. His breath sounds are markedly diminished on the left, there is
dullness to percussion on the left, and the trachea is shifted to the left. The
most likely explanation for the problem is that
A. the patient is disconnected from the ventilator.
B. the patient is experiencing diffuse bronchospasm.
C. the endotracheal tube has slipped into the right main stem bronchus.
D. the patient has developed a left tension pneumothorax. Correct Ans ➡
the endotracheal tube has slipped into the right main stem bronchus
The respiratory therapist notes a developing hematoma after an arterial
blood gas was drawn from the right radial artery. The immediate response is
to
A. notify the charge nurse.
B. apply a pressure dressing.
Answers
A 48 year-old female is admitted to the ED with diaphoresis, jugular venous
distension, and 3+ pitting edema in the ankles. These findings are consistent
with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances Correct Ans ➡ Heart failure
A patient is admitted to the ED following a motor vehicle accident. On
physical exam, the respiratory therapist discovers that breath sounds are
absent in the left chest with a hyperresonant percussion note. The trachea is
shifted to the right. The patient's heart rate is 45/min, respiratory rate is
30/min, and blood pressure is 60/40 mm Hg. What action should the
therapist recommend first?
A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate the patient. Correct
Ans ➡ Needle aspirate the 2nd left intercostal space.
All of the following strategies are likely to decrease the likelihood of damage
to the tracheal mucosa EXCEPT
A. maintaining cuff pressures between 20 and 25 mm Hg.
B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures. Correct Ans ➡ monitoring intracuff
pressures.
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 Ans ➡
deep breathing and coughing to clear secretions.
A 65 kg spinal cord injured patient has developed atelectasis. His inspiratory
capacity is 30% of his predicted value. What bronchial hygiene therapy
would be most appropriate initially?
A. IS / SMI
B. IPPB with normal saline
C. postural drainage and percussion
D. PEP therapy Correct Ans ➡ IPPB with normal saline
A patient on VC ventilation has demonstrated auto-PEEP on ventilator
graphics. Which of the following controls, when adjusted independently,
would increase expiratory time?
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity Correct Ans ➡ 1, 2, and 3 only
Which of the following would be the most appropriate therapy for a dyspneic
patient who has crepitus with tracheal deviation to the left and absent breath
sounds on the right?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube Correct Ans ➡ Insert a chest tube
A 55 year-old post cardiac surgery 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.
A. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
D. 5.5 vol% Correct Ans ➡ 5.0 vol%
A patient on VC, SIMV with a VT of 500 mL has a PIP of 25 cm H2O, Pplat of
15 cm H2O and PEEP of 5 cm H2O. What is the patient's static lung
compliance
,A. 25 mL/cm H2O
B. 35 mL/cm H2O
C. 45 mL/cm H2O
D. 50 mL/cm H2O Correct Ans ➡ 50 mL/cm H2O
Immediately after extubation of a patient in the ICU, the respiratory therapist
observes increasing respiratory distress with intercostal retractions and
marked stridor. The SpO2 on 40% oxygen is noted to be 86%. Which of the
following would be most appropriate at this time?
A. cool mist aerosol treatment
B. aerosolized racemic epinephrine
C. manual ventilation with resuscitation bag and mask
D. reintubation Correct Ans ➡ reintubation
Which of the following patients would most likely benefit from pressure
support ventilation?
A. An intubated patient with an absent respiratory drive.
B. A patient on SIMV with a set rate of 12/min and total rate of 24/min.
C. A patient with acute lung injury.
D. A patient who requires short-term post-operative ventilatory support.
Correct Ans ➡ A patient on SIMV with a set rate of 12/min and total rate of
24/min.
A patient receiving mechanical ventilation has developed a temperature of
99.9° F with purulent secretions over the last 12 hours. The respiratory
therapist has also noted a steady increase in peak inspiratory pressure. What
initial recommendation should be made to address these changes?
A. Initiate bronchial hygiene therapy.
B. Obtain a sputum gram stain.
C. Administer IPV.
D. Insert a CASS tube. Correct Ans ➡ Obtain a sputum gram stain.
Which of the following information may be obtained from a FVC maneuver
during bedside pulmonary function testing?
1. FEV1
2. PEFR
3. FRC
4. RV Correct Ans ➡ 1 and 2 only
, The respiratory therapist is providing patient education for a patient who is
being discharged home on aerosol therapy. The most important reason for
the patient to follow the recommended cleaning procedures using a
vinegar/water solution is that this solution will
A. sterilize the equipment.
B. retard bacterial growth.
C. kill all micro-organisms and spores.
D. extend the equipment life. Correct Ans ➡ Retard bacterial growth
A patient who complains of dyspnea is noted to have a dry, non-productive
cough. On physical examination, breath sounds are diminished on the right,
tactile fremitus is decreased and there is dullness to percussion over the
right lower lobe. The respiratory therapist should suspect that the patient is
suffering from
A. pneumonia.
B. pulmonary embolism.
C. pleural effusion.
D. bronchiolitis. Correct Ans ➡ pleural effusion
Which of the following suction catheters would be appropriate to use for a
patient with a size 8.0 mm ID endotracheal tube?
A. 8 Fr
B. 10 Fr
C. 12 Fr
D. 14 Fr Correct Ans ➡ 12 Fr
A patient who is receiving continuous mechanical ventilation is fighting the
ventilator. His breath sounds are markedly diminished on the left, there is
dullness to percussion on the left, and the trachea is shifted to the left. The
most likely explanation for the problem is that
A. the patient is disconnected from the ventilator.
B. the patient is experiencing diffuse bronchospasm.
C. the endotracheal tube has slipped into the right main stem bronchus.
D. the patient has developed a left tension pneumothorax. Correct Ans ➡
the endotracheal tube has slipped into the right main stem bronchus
The respiratory therapist notes a developing hematoma after an arterial
blood gas was drawn from the right radial artery. The immediate response is
to
A. notify the charge nurse.
B. apply a pressure dressing.
