Therapist Multiple Choice (TMC) Examination – LJU Version 2
Question 1:
Quality control data for an arterial blood gas analyzer is plotted within ±2 standard
deviations (SD) from the mean. The plotted points gradually increase from below the
mean to above it while staying within the 2 SD range. The respiratory supervisor
should:
A. Consult the medical director for instructions.
B. Decommission the machine.
C. Replace the electrodes.
D. Closely monitor the device.
Answer: D. Closely monitor the device.
Explanation: While the points are within the acceptable range, the observed upward
trend indicates the need for vigilance. Trends could lead to values exceeding control
limits, so monitoring is necessary. No maintenance or removal from service is
required at this stage.
Question 2:
A high-pressure ventilator alarm activates while a patient on volume-controlled
ventilation shows an endotracheal tube positioned at 27 cm at the teeth. Breath sounds
are absent in the left lung field. The respiratory therapist should:
A. Prepare to place chest tubes on the left side.
B. Reposition the endotracheal tube until breath sounds are equal bilaterally.
C. Advance the tube until left lung sounds are audible.
D. Assess the pressure in the cuff.
Answer: B. Reposition the endotracheal tube until breath sounds are equal
bilaterally.
Explanation: The tube appears to have entered the right main bronchus due to its
depth, which is excessive. Adjusting the tube position to restore bilateral breath
sounds resolves this issue.
Question 3:
To minimize the risk of hospital-acquired infections in patients on mechanical
ventilation, ventilator circuits should be changed:
A. Monthly.
B. Weekly.
C. Only when visibly soiled.
D. Daily.
, Answer: C. Only when visibly soiled.
Explanation: Circuit changes should align with infection control practices,
emphasizing cleanliness rather than routine replacement to avoid unnecessary
disruptions.
Question 4:
In which scenario should a heat and moisture exchanger (HME) be swapped for
heated humidity?
A. A patient with asthma.
B. Presence of thick secretions.
C. A patient who is hyperthermic.
D. Afebrile conditions.
Answer: B. Presence of thick secretions.
Explanation: HMEs are unsuitable when patients have thick secretions or reduced
exhaled moisture (e.g., hypothermia). Heated humidity is more effective in these
cases.
Question 5:
What should be monitored in a ventilator-dependent neonate with infant respiratory
distress syndrome (IRDS)?
A. Input and output of fluids.
B. Gas distribution in the lungs (SBN2).
C. Blood pH levels.
D. Urine specific gravity.
Answer: A. Input and output of fluids.
Explanation: While all options are important, tracking fluid intake and output is
critical to managing the delicate fluid balance in ventilator-dependent neonates with
IRDS.
Question 6:
A written education plan for a child with chronic asthma should emphasize:
A. Measuring oxygen saturation.
B. Adjusting oxygen levels.
C. Monitoring peak expiratory flow rate (PEFR) and correct use of an MDI.
D. Determining bronchodilator dosage adjustments.
Answer: C. Monitoring peak expiratory flow rate (PEFR) and correct use of an
MDI.
Explanation: Asthma management includes regular PEFR monitoring and ensuring
Question 1:
Quality control data for an arterial blood gas analyzer is plotted within ±2 standard
deviations (SD) from the mean. The plotted points gradually increase from below the
mean to above it while staying within the 2 SD range. The respiratory supervisor
should:
A. Consult the medical director for instructions.
B. Decommission the machine.
C. Replace the electrodes.
D. Closely monitor the device.
Answer: D. Closely monitor the device.
Explanation: While the points are within the acceptable range, the observed upward
trend indicates the need for vigilance. Trends could lead to values exceeding control
limits, so monitoring is necessary. No maintenance or removal from service is
required at this stage.
Question 2:
A high-pressure ventilator alarm activates while a patient on volume-controlled
ventilation shows an endotracheal tube positioned at 27 cm at the teeth. Breath sounds
are absent in the left lung field. The respiratory therapist should:
A. Prepare to place chest tubes on the left side.
B. Reposition the endotracheal tube until breath sounds are equal bilaterally.
C. Advance the tube until left lung sounds are audible.
D. Assess the pressure in the cuff.
Answer: B. Reposition the endotracheal tube until breath sounds are equal
bilaterally.
Explanation: The tube appears to have entered the right main bronchus due to its
depth, which is excessive. Adjusting the tube position to restore bilateral breath
sounds resolves this issue.
Question 3:
To minimize the risk of hospital-acquired infections in patients on mechanical
ventilation, ventilator circuits should be changed:
A. Monthly.
B. Weekly.
C. Only when visibly soiled.
D. Daily.
, Answer: C. Only when visibly soiled.
Explanation: Circuit changes should align with infection control practices,
emphasizing cleanliness rather than routine replacement to avoid unnecessary
disruptions.
Question 4:
In which scenario should a heat and moisture exchanger (HME) be swapped for
heated humidity?
A. A patient with asthma.
B. Presence of thick secretions.
C. A patient who is hyperthermic.
D. Afebrile conditions.
Answer: B. Presence of thick secretions.
Explanation: HMEs are unsuitable when patients have thick secretions or reduced
exhaled moisture (e.g., hypothermia). Heated humidity is more effective in these
cases.
Question 5:
What should be monitored in a ventilator-dependent neonate with infant respiratory
distress syndrome (IRDS)?
A. Input and output of fluids.
B. Gas distribution in the lungs (SBN2).
C. Blood pH levels.
D. Urine specific gravity.
Answer: A. Input and output of fluids.
Explanation: While all options are important, tracking fluid intake and output is
critical to managing the delicate fluid balance in ventilator-dependent neonates with
IRDS.
Question 6:
A written education plan for a child with chronic asthma should emphasize:
A. Measuring oxygen saturation.
B. Adjusting oxygen levels.
C. Monitoring peak expiratory flow rate (PEFR) and correct use of an MDI.
D. Determining bronchodilator dosage adjustments.
Answer: C. Monitoring peak expiratory flow rate (PEFR) and correct use of an
MDI.
Explanation: Asthma management includes regular PEFR monitoring and ensuring
