TMC PRACTICE EXAM 150 QUESTIONS WITH 100%
CORRECT ANSWERS 2023-2024 COMPLETE
SOLUTION/A+ GRADE GUARANTEED
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 consistentwith
• liver failure.
• pulmonary embolism.
• heart failure.
• 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
isshifted 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?
• Call for a STAT chest x-ray.
• Insert a chest tube into the left chest.
• Needle aspirate the 2nd left intercostal space.
• 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 damageto the tracheal mucosa EXCEPT
• maintaining cuff pressures between 20 and 25 mm Hg.
• using the minimal leak technique for inflation.
• using a low-residual-volume, low-compliance cuff.
• 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
,• continuing the therapy until breath sounds improve.
• administering dornase alpha.
• administering albuterol therapy.
• 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 inspiratorycapacity is 30% of his predicted
value. What bronchial hygiene therapy would be most appropriate initially?
• IS / SMI
• IPPB with normal saline
• postural drainage and percussion
• 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?
• Tidal volume
• Respiratory Rate
• Inspiratory flow
• 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 breathsounds on the right?
• Perform chest physiotherapy
• Administer an IPPB treatment
• Insert an endotracheal tube
• Insert a chest tube Correct Ans ➡ Insert a chest tube
,A 55 year-old post cardiac surgery patient has the following ABG results: pH7.50, 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.
• 2.5 vol%
• 4.0 vol%
• 5.0 vol%
• 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 of15 cm H2O and PEEP of 5 cm H2O.
What is the patient's static lung compliance
• 25 mL/cm H2O
• 35 mL/cm H2O
• 45 mL/cm H2O
• 50 mL/cm H2O Correct Ans ➡ 50 mL/cm H2O
Immediately after extubation of a patient in the ICU, the respiratory therapistobserves 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?
• cool mist aerosol treatment
• aerosolized racemic epinephrine
• manual ventilation with resuscitation bag and mask
• reintubation Correct Ans ➡ reintubation
Which of the following patients would most likely benefit from pressuresupport ventilation?
• An intubated patient with an absent respiratory drive.
• A patient on SIMV with a set rate of 12/min and total rate of 24/min.
• A patient with acute lung injury.
• 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 of24/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.
Whatinitial recommendation should be made to address these changes?
• Initiate bronchial hygiene therapy.
• Obtain a sputum gram stain.
• Administer IPV.
• Insert a CASS tube. Correct Ans ➡ Obtain a sputum gram stain.
Which of the following information may be obtained from a FVC maneuverduring bedside pulmonary
function testing?
• FEV1
• PEFR
• FRC
• RV Correct Ans ➡ 1 and 2 only
The respiratory therapist is providing patient education for a patient who isbeing 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
• sterilize the equipment.
• retard bacterial growth.
• kill all micro-organisms and spores.
• 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 issuffering from
• pneumonia.
• pulmonary embolism.
• pleural effusion.
CORRECT ANSWERS 2023-2024 COMPLETE
SOLUTION/A+ GRADE GUARANTEED
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 consistentwith
• liver failure.
• pulmonary embolism.
• heart failure.
• 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
isshifted 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?
• Call for a STAT chest x-ray.
• Insert a chest tube into the left chest.
• Needle aspirate the 2nd left intercostal space.
• 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 damageto the tracheal mucosa EXCEPT
• maintaining cuff pressures between 20 and 25 mm Hg.
• using the minimal leak technique for inflation.
• using a low-residual-volume, low-compliance cuff.
• 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
,• continuing the therapy until breath sounds improve.
• administering dornase alpha.
• administering albuterol therapy.
• 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 inspiratorycapacity is 30% of his predicted
value. What bronchial hygiene therapy would be most appropriate initially?
• IS / SMI
• IPPB with normal saline
• postural drainage and percussion
• 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?
• Tidal volume
• Respiratory Rate
• Inspiratory flow
• 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 breathsounds on the right?
• Perform chest physiotherapy
• Administer an IPPB treatment
• Insert an endotracheal tube
• Insert a chest tube Correct Ans ➡ Insert a chest tube
,A 55 year-old post cardiac surgery patient has the following ABG results: pH7.50, 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.
• 2.5 vol%
• 4.0 vol%
• 5.0 vol%
• 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 of15 cm H2O and PEEP of 5 cm H2O.
What is the patient's static lung compliance
• 25 mL/cm H2O
• 35 mL/cm H2O
• 45 mL/cm H2O
• 50 mL/cm H2O Correct Ans ➡ 50 mL/cm H2O
Immediately after extubation of a patient in the ICU, the respiratory therapistobserves 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?
• cool mist aerosol treatment
• aerosolized racemic epinephrine
• manual ventilation with resuscitation bag and mask
• reintubation Correct Ans ➡ reintubation
Which of the following patients would most likely benefit from pressuresupport ventilation?
• An intubated patient with an absent respiratory drive.
• A patient on SIMV with a set rate of 12/min and total rate of 24/min.
• A patient with acute lung injury.
• 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 of24/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.
Whatinitial recommendation should be made to address these changes?
• Initiate bronchial hygiene therapy.
• Obtain a sputum gram stain.
• Administer IPV.
• Insert a CASS tube. Correct Ans ➡ Obtain a sputum gram stain.
Which of the following information may be obtained from a FVC maneuverduring bedside pulmonary
function testing?
• FEV1
• PEFR
• FRC
• RV Correct Ans ➡ 1 and 2 only
The respiratory therapist is providing patient education for a patient who isbeing 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
• sterilize the equipment.
• retard bacterial growth.
• kill all micro-organisms and spores.
• 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 issuffering from
• pneumonia.
• pulmonary embolism.
• pleural effusion.
