TMC EXAM B KETTERING 60 QUESTIONS WITH 100%
CORRECT ANSWERS / A+ GRADE
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 -
ANSWER: 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? - ANSWER: 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 - ANSWER: using a low residual volume, low compliance
cuff
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 - ANSWER: deep breathing & coughing to clear
secretions
A 65 kg spinal cord injured patient develops atelectasis. His inspiratory capacity is
30% of his predicted value. What bronchial hygiene therapy would be most
appropriate initially? - ANSWER: IPPB
A healthy adult female can exhale what portion of her forced vital capacity in the
first second? - ANSWER: 70%
A patient on VC ventilation demonstrates 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 - ANSWER: 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? - ANSWER: insert a chest tube
Following cardiac surgery, a 55 year-old 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. - ANSWER: 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? - ANSWER:
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 76%. Which of the following would
be most appropriate at this time? - ANSWER: Reintubation
Which of the following patients would most likely benefit from pressure support
ventilation? - ANSWER: A patient on SIMV with a mandatory 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? - ANSWER: 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 - ANSWER: 1 & 2 only
The respiratory therapist provides 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 - ANSWER: 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 - ANSWER:
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? - ANSWER: 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 - ANSWER: 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 - ANSWER:
apply pressure to the site
A patient's breathing pattern irregularly increases and decreases and is interspersed
with periods of apnea up to 1 minute. Which of the following conditions is the most
likely cause of this problem? - ANSWER: elevated intracranial pressure
What value for the apnea-hypopnea index (AHI) is consistent with mild obstructive
sleep apnea? - ANSWER: 5 to 15
While monitoring a newborn utilizing a transcutaneous monitor, the respiratory
therapist notices a change in PtcO2 from 60 to 142 torr and simultaneously the
PtcCO2 changes from 37 to 2 torr. What is the most likely explanation for these
changes? - ANSWER: air leak around the sensor
A patient on the general medical ward receives oxygen via 28% air entrainment mask
with the flowmeter set at 5 L/min. What is the total flow delivered to the patient? -
ANSWER: 55 L/min
Which of the following measurements is most indicative of congestive heart failure?
- ANSWER: pulmonary capillary wedge pressure of 30 mmHg
Sleep apnea can be defined as repeated episodes of complete cessation of airflow
for - ANSWER: 10 seconds or longer
A patient in the ICU receiving mechanical ventilation underwent fiberoptic
bronchoscopy during which a tissue biopsy was collected. Immediately following the
procedure, the respiratory therapist notes that the peak inspiratory pressure on the
ventilator has increased. Potential causes for this include all of the following EXCEPT
- ANSWER: hypoxemia
What size endotracheal tube would be appropriate for an adult female patient? -
ANSWER: 7.0 to 7.5 mm
The respiratory therapist is asked to evaluate the presence of Auto-PEEP on a patient
receiving mechanical ventilation. In order to do this, the therapist should - ANSWER:
initiate an expiratory hold just prior to the next ventilator-delivered breath.
A patient who suffered trauma in an ATV accident is being monitored in the ICU. A
pulmonary artery catheter has been placed and the following data is available:
PCWP 4 mm Hg
PAP (mean) 8 mm Hg
CVP 2 cm H2O
Cardiac Output 3L/min
The respiratory therapist should recommend - ANSWER: IV fluid challenge
CORRECT ANSWERS / A+ GRADE
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 -
ANSWER: 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? - ANSWER: 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 - ANSWER: using a low residual volume, low compliance
cuff
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 - ANSWER: deep breathing & coughing to clear
secretions
A 65 kg spinal cord injured patient develops atelectasis. His inspiratory capacity is
30% of his predicted value. What bronchial hygiene therapy would be most
appropriate initially? - ANSWER: IPPB
A healthy adult female can exhale what portion of her forced vital capacity in the
first second? - ANSWER: 70%
A patient on VC ventilation demonstrates 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 - ANSWER: 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? - ANSWER: insert a chest tube
Following cardiac surgery, a 55 year-old 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. - ANSWER: 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? - ANSWER:
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 76%. Which of the following would
be most appropriate at this time? - ANSWER: Reintubation
Which of the following patients would most likely benefit from pressure support
ventilation? - ANSWER: A patient on SIMV with a mandatory 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? - ANSWER: 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 - ANSWER: 1 & 2 only
The respiratory therapist provides 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 - ANSWER: 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 - ANSWER:
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? - ANSWER: 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 - ANSWER: 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 - ANSWER:
apply pressure to the site
A patient's breathing pattern irregularly increases and decreases and is interspersed
with periods of apnea up to 1 minute. Which of the following conditions is the most
likely cause of this problem? - ANSWER: elevated intracranial pressure
What value for the apnea-hypopnea index (AHI) is consistent with mild obstructive
sleep apnea? - ANSWER: 5 to 15
While monitoring a newborn utilizing a transcutaneous monitor, the respiratory
therapist notices a change in PtcO2 from 60 to 142 torr and simultaneously the
PtcCO2 changes from 37 to 2 torr. What is the most likely explanation for these
changes? - ANSWER: air leak around the sensor
A patient on the general medical ward receives oxygen via 28% air entrainment mask
with the flowmeter set at 5 L/min. What is the total flow delivered to the patient? -
ANSWER: 55 L/min
Which of the following measurements is most indicative of congestive heart failure?
- ANSWER: pulmonary capillary wedge pressure of 30 mmHg
Sleep apnea can be defined as repeated episodes of complete cessation of airflow
for - ANSWER: 10 seconds or longer
A patient in the ICU receiving mechanical ventilation underwent fiberoptic
bronchoscopy during which a tissue biopsy was collected. Immediately following the
procedure, the respiratory therapist notes that the peak inspiratory pressure on the
ventilator has increased. Potential causes for this include all of the following EXCEPT
- ANSWER: hypoxemia
What size endotracheal tube would be appropriate for an adult female patient? -
ANSWER: 7.0 to 7.5 mm
The respiratory therapist is asked to evaluate the presence of Auto-PEEP on a patient
receiving mechanical ventilation. In order to do this, the therapist should - ANSWER:
initiate an expiratory hold just prior to the next ventilator-delivered breath.
A patient who suffered trauma in an ATV accident is being monitored in the ICU. A
pulmonary artery catheter has been placed and the following data is available:
PCWP 4 mm Hg
PAP (mean) 8 mm Hg
CVP 2 cm H2O
Cardiac Output 3L/min
The respiratory therapist should recommend - ANSWER: IV fluid challenge
