TMC (LJU Version 11) Updated 2023 Questions and
Answers 100% Verified
After several moments of cardiac compressions with a patient suffering from a
complete cardiopulmonary collapse, the patient's cardiac rhythm is consistent
with asystole when compressions are momentarily halted. Which of the following
medications would be most helpful to the patient:
A. epinephrine
B. Lidocaine
C. Romazicon
D. Quinidine
The correct answer is : A
Explanation :
Epinephrine is the drug of choice to treat asystole. The other medications are not used
in the situation.
A patient has been on mechanical ventilator support for 5 days. The physician
would like to consider weaning the patient. The following clinical data is
available:
MIP -34 cmH2O
VT (spont) 450 mL
A-aDO2 220 mmHg
VD/VT 0.70
VC 1.6 L
RR 18/min
Based on this data, the therapist should recommend
A. obtain arterial blood gas analysis
B. perform pulmonary function testing
C. begin weaning with pressure support
D. avoid weaning at this time
The correct answer is : D
Explanation :
All data suggests that the patient is ready to wean except for one piece of data. That is
the VD/VT ratio which is above 60%. It must be below 60% for weaning to be
considered.
What is the minute ventilation (L/min) of a 150-lb (68-kg) male who has a tidal
volume 425 mL and a respiratory rate of 12?
A. 6.2
B. 5.1
,C. 7.4
D. 3.3
The correct answer is : B
Explanation :
To determine the minute ventilation of the patient, one should multiply the tidal volume
by the rate. In this case, tidal volume is expressed in milliliters. Because minute
ventilation should be expressed as L/min, tidal volume must be translated to liters.
Thus, .425 x 12 = 5.1 L.
During bedside spirometry, the respiratory therapist asks the patient to take a
deep breath followed by a maximal, forceful exhalation. The therapist observes
the point on the graph that shows the fastest air movement. Which of the
following is being measured?
A. FEF 200-1200
B. FEV1
C. peak flow
D. forced vital capacity
The correct answer is : C
Explanation :
The maneuver expressed here, which is a deep breath followed by a maximal forceful
exhalation, is called peak flow.
A 52-year-old patient with COPD has been undergoing daily T-piece trails in an
attempt to gradually wean from mechanical ventilation. For three consecutive
days, the patient is unable to tolerate the trials for more than one hour and must
be returned to full ventilatory support. The respiratory therapist should
recommend which of the following?
A. extubate the patient
B. pressure support mode
C. provide Xanax during trails
D. discontinue all weaning trails for one week
The correct answer is : B
Explanation :
COPD patients often have difficulty weaning or liberating from mechanical ventilation. In
this case, the use of pressure support would be most helpful as it augments the
patient's spontaneous tidal volume, thus decreasing the work of breathing overall and
facilitating longer spontaneous breathing trials.
The following data were obtained while an adult patient was receiving VC AC
ventilation with an FIO2 0.60.
1000 1015 1030 1045
HR 90 92 106 110
BP (mm Hg) 135/88 128/86 119/80 101/75
,SpO2 (%) 80 91 94 95
Static Compliance 20 42 61 50
PEEP (cm H2O 5 10 15 20
Which of the following PEEP levels should the respiratory therapist recommend?
A. 15 cm H2O
B. 20 cm H2O
C. 10 cm H2O
D. 5 cm H2O
The correct answer is : A
Explanation :
This group of data shows that with increasing PEEP the patient exhibits improved
oxygen saturation. However, as PEEP is further increased, there is an ultimate
degradation in hemodynamics that may result. According to this data, the patient's
hemodynamic status deteriorates significantly at a PEEP level of 20 cm H2O. This is
manifested by a sudden decrease in pulmonary compliance from 61 to 50 mL/cm H2O
and a corresponding sharp decrease in blood pressure.
After completing arterial puncture and blood extraction into a disposable 3.0 mL
syringe, the respiratory therapist should handle the sample by
A. purging all air from the syringe
B. placing the sample in an ice bath
C. agitating the sample vigorously
D. adding heparin to the syringe
The correct answer is : A
Explanation :
A significant step in the performance of arterial blood extraction is to purge all air from
the syringe after the blood has been extracted. Removing air bubbles prevents
excessive oxygen from dissolving in the blood and producing erroneous results.
A patient with COPD is receiving aerosolized dornase alpha (Pulmozyme) via
hand-held small volume nebulizer. During the treatment the patient begins to
exhibit marked congestion and significant coughing. The most appropriate action
by the therapist is to pause the treatment and
A. assist the patient in clearing secretions though cough coaching
B. provide oxygen by nonrebreather mask
C. reduce the dosage of dornase alpha
D. report the issue to the physician
The correct answer is : A
Explanation :
During the course of a hand-held small volume nebulizer treatment, it is common for the
patient to begin coughing as secretions begin to move. This outcome must not be
, considered an adverse reaction but rather a desirable outcome. Therefore, it is
appropriate to pause the treatment, encourage coughing, and then resume.
A 24-year-old patient is brought to the emergency department after being
retrieved from a 3-alarm residential fire and is currently receiving oxygen by nasal
cannula at 7 L/min. SpO2 is 100%. The patient was found to be alert but confused
and lost when discovered. Arterial blood gas results are as follows:
pH 7.31
PaCO2 29 torr
PaO2 210 torr
HCO3- 15 mEq/L
BE -10 mEq/L
SaO2 99%
O2Hb 77%
COHb 22%
Hb 12.8 g/dL
The respiratory therapist should recommend
A. decreasing oxygen flow rate to 5 L/min NC
B. changing to a nonrebreather mask at 15 L/min
C. switching to a humidified high-flow nasal cannula
D. changing to an air-entrainment mask, FIO2 0.50
The following pressure-volume waveform is observed on a 32-year-old patient
who is receiving VC A/C ventilation following abdominal surgery. When originally
instituted, the waveform demonstrated a small bird's beak pattern. Two hours
later, the beak formation has disappeared. VT has stayed consistent at 8 mL/kg.
SpO2 remains unchanged at 95%. Which of the following can the respiratory
therapist conclude?
A. autoPEEP is developing
B. PEEP is insufficient
C. alveoli have likely been recruited
D. the lung may have become perforated
The correct answer is : C
Explanation :
Regarding the pressure volume loops, it is evident that the first one shows over
distention as manifested by the small beak. However, the beak disappears even though
the tidal volume has remained unchanged. This would suggest that the patient has
developed more lung space, which is likely achieved through alveolar recruitment.
An 18-year-old patient with asthma is receiving a second dose of aerosolized
albuterol. Following the first treatment, the patient demonstrates more audible
wheezing. Ten minutes after the second treatment, the patient's breath sounds
Answers 100% Verified
After several moments of cardiac compressions with a patient suffering from a
complete cardiopulmonary collapse, the patient's cardiac rhythm is consistent
with asystole when compressions are momentarily halted. Which of the following
medications would be most helpful to the patient:
A. epinephrine
B. Lidocaine
C. Romazicon
D. Quinidine
The correct answer is : A
Explanation :
Epinephrine is the drug of choice to treat asystole. The other medications are not used
in the situation.
A patient has been on mechanical ventilator support for 5 days. The physician
would like to consider weaning the patient. The following clinical data is
available:
MIP -34 cmH2O
VT (spont) 450 mL
A-aDO2 220 mmHg
VD/VT 0.70
VC 1.6 L
RR 18/min
Based on this data, the therapist should recommend
A. obtain arterial blood gas analysis
B. perform pulmonary function testing
C. begin weaning with pressure support
D. avoid weaning at this time
The correct answer is : D
Explanation :
All data suggests that the patient is ready to wean except for one piece of data. That is
the VD/VT ratio which is above 60%. It must be below 60% for weaning to be
considered.
What is the minute ventilation (L/min) of a 150-lb (68-kg) male who has a tidal
volume 425 mL and a respiratory rate of 12?
A. 6.2
B. 5.1
,C. 7.4
D. 3.3
The correct answer is : B
Explanation :
To determine the minute ventilation of the patient, one should multiply the tidal volume
by the rate. In this case, tidal volume is expressed in milliliters. Because minute
ventilation should be expressed as L/min, tidal volume must be translated to liters.
Thus, .425 x 12 = 5.1 L.
During bedside spirometry, the respiratory therapist asks the patient to take a
deep breath followed by a maximal, forceful exhalation. The therapist observes
the point on the graph that shows the fastest air movement. Which of the
following is being measured?
A. FEF 200-1200
B. FEV1
C. peak flow
D. forced vital capacity
The correct answer is : C
Explanation :
The maneuver expressed here, which is a deep breath followed by a maximal forceful
exhalation, is called peak flow.
A 52-year-old patient with COPD has been undergoing daily T-piece trails in an
attempt to gradually wean from mechanical ventilation. For three consecutive
days, the patient is unable to tolerate the trials for more than one hour and must
be returned to full ventilatory support. The respiratory therapist should
recommend which of the following?
A. extubate the patient
B. pressure support mode
C. provide Xanax during trails
D. discontinue all weaning trails for one week
The correct answer is : B
Explanation :
COPD patients often have difficulty weaning or liberating from mechanical ventilation. In
this case, the use of pressure support would be most helpful as it augments the
patient's spontaneous tidal volume, thus decreasing the work of breathing overall and
facilitating longer spontaneous breathing trials.
The following data were obtained while an adult patient was receiving VC AC
ventilation with an FIO2 0.60.
1000 1015 1030 1045
HR 90 92 106 110
BP (mm Hg) 135/88 128/86 119/80 101/75
,SpO2 (%) 80 91 94 95
Static Compliance 20 42 61 50
PEEP (cm H2O 5 10 15 20
Which of the following PEEP levels should the respiratory therapist recommend?
A. 15 cm H2O
B. 20 cm H2O
C. 10 cm H2O
D. 5 cm H2O
The correct answer is : A
Explanation :
This group of data shows that with increasing PEEP the patient exhibits improved
oxygen saturation. However, as PEEP is further increased, there is an ultimate
degradation in hemodynamics that may result. According to this data, the patient's
hemodynamic status deteriorates significantly at a PEEP level of 20 cm H2O. This is
manifested by a sudden decrease in pulmonary compliance from 61 to 50 mL/cm H2O
and a corresponding sharp decrease in blood pressure.
After completing arterial puncture and blood extraction into a disposable 3.0 mL
syringe, the respiratory therapist should handle the sample by
A. purging all air from the syringe
B. placing the sample in an ice bath
C. agitating the sample vigorously
D. adding heparin to the syringe
The correct answer is : A
Explanation :
A significant step in the performance of arterial blood extraction is to purge all air from
the syringe after the blood has been extracted. Removing air bubbles prevents
excessive oxygen from dissolving in the blood and producing erroneous results.
A patient with COPD is receiving aerosolized dornase alpha (Pulmozyme) via
hand-held small volume nebulizer. During the treatment the patient begins to
exhibit marked congestion and significant coughing. The most appropriate action
by the therapist is to pause the treatment and
A. assist the patient in clearing secretions though cough coaching
B. provide oxygen by nonrebreather mask
C. reduce the dosage of dornase alpha
D. report the issue to the physician
The correct answer is : A
Explanation :
During the course of a hand-held small volume nebulizer treatment, it is common for the
patient to begin coughing as secretions begin to move. This outcome must not be
, considered an adverse reaction but rather a desirable outcome. Therefore, it is
appropriate to pause the treatment, encourage coughing, and then resume.
A 24-year-old patient is brought to the emergency department after being
retrieved from a 3-alarm residential fire and is currently receiving oxygen by nasal
cannula at 7 L/min. SpO2 is 100%. The patient was found to be alert but confused
and lost when discovered. Arterial blood gas results are as follows:
pH 7.31
PaCO2 29 torr
PaO2 210 torr
HCO3- 15 mEq/L
BE -10 mEq/L
SaO2 99%
O2Hb 77%
COHb 22%
Hb 12.8 g/dL
The respiratory therapist should recommend
A. decreasing oxygen flow rate to 5 L/min NC
B. changing to a nonrebreather mask at 15 L/min
C. switching to a humidified high-flow nasal cannula
D. changing to an air-entrainment mask, FIO2 0.50
The following pressure-volume waveform is observed on a 32-year-old patient
who is receiving VC A/C ventilation following abdominal surgery. When originally
instituted, the waveform demonstrated a small bird's beak pattern. Two hours
later, the beak formation has disappeared. VT has stayed consistent at 8 mL/kg.
SpO2 remains unchanged at 95%. Which of the following can the respiratory
therapist conclude?
A. autoPEEP is developing
B. PEEP is insufficient
C. alveoli have likely been recruited
D. the lung may have become perforated
The correct answer is : C
Explanation :
Regarding the pressure volume loops, it is evident that the first one shows over
distention as manifested by the small beak. However, the beak disappears even though
the tidal volume has remained unchanged. This would suggest that the patient has
developed more lung space, which is likely achieved through alveolar recruitment.
An 18-year-old patient with asthma is receiving a second dose of aerosolized
albuterol. Following the first treatment, the patient demonstrates more audible
wheezing. Ten minutes after the second treatment, the patient's breath sounds
