TMC Actual Exam Questions With Reviewed 100% Correct
Detailed Answers Guaranteed Pass!!
1. The Ballard scale is used After birth, determination of gestational age involves careful assess-
to assess: ment of selected neuromuscular and physical characteristics using
methods developed by Dubowitz and Ballard. This assessment is nor-
mally conducted by a neonatologist or nurse practitioner within 30-40
hours after birth. Although respiratory therapists do not normally con-
duct this assessment, you should be familiar with its components.
The correct answer is: gestational age after birth
2. A patient has a pH of To determine the primary acid-base disturbance, first determine
7.22 and a PaCO2 of whether the pH is low (< 7.35 = acidemia) or high (> 7.45 = alkalemia).
60 torr. Based on these After judging the pH, you then assess the PaCO2. If the pH is low,
data, what is the primary the primary disturbance must be either respiratory acidosis (PaCO2 >
acid-base disturbance? 45 torr) or metabolic acidosis (PaCO2 £ 45 torr). With a high pH, the
primary disturbance must be either respiratory alkalosis (PaCO2 < 35
torr) or metabolic alkalosis (PaCO2 ³ 35 torr).
The correct answer is: respiratory acidosis
3. During the adminis- Bradypnea is a less than normal rate of breathing; narcotic drug over-
tration of an aerosol dose is a common cause. Hypercapnia and hypoxemia are potential
treatment, the patient's problems.
respiratory rate drops The correct answer is: bradypnea
from 15 breaths/min to
6 breaths/min. Identify
this breathing pattern.
4. Full laboratory diagnos- The full laboratory-based, attended PSG exam typically includes at
tic polysomnography re- least 10 channels: 2 electroencephalogram (EEG), 2 electrooculogram
quires at least how many (EOG), 1 electromyogram (EMG), an electrocardiogram (ECG), and
channels? channels for bilateral leg movements, O2 saturation, respiratory ettort
(usually via thoraco-abdominal movements) and nasal or oronasal
airflow. This is the gold standard for diagnosis of sleep disorders.
The correct answer is: 10
, TMC Actual Exam Questions With Reviewed 100% Correct
Detailed Answers Guaranteed Pass!!
5. A patient receiving Many patients receiving long-term positive pressure ventilatory sup-
long-term positive pres- port exhibit significant salt and water retention, as manifested by either
sure ventilatory support a weight gain or failure to lose weight as anticipated. In addition,
exhibits a progressive such patients typically show a reduction in hematocrit, consistent with
weight gain and a reduc- hypervolemia due to water retention.
tion in the hematocrit. The correct answer is: water retention
Which of the following is
the most likely cause of
this problem?
6. On inspection of an The most likely problem is sinus tachycardia. In this arrhythmia, the
ECG rhythm strip from sinus node rate ranges from 100-160/min. The rhythm is regular, with
an adult patient, you normal P waves, P-R intervals, and QRS complexes. Many ditterent
note the following: rate factors can cause sinus tachycardia. Treatment aims at correcting the
of 150; regular rhythm; underlying cause. Drugs used to slow the heart rate include digitalis
normal P waves, P-R in- and beta-adrenergic blockers like propranolol.
tervals, and QRS com- The correct answer is: sinus tachycardia
plexes. The most likely
problem is:
7. You note on inspection An elevated hemidiaphragm indicates phrenic nerve paralysis on the
of an AP chest radi- attected side or hepatomegaly (right side only). Pleural ettusions blunt
ograph that the right the costophrenic angles, whereas hyperinflation tends to flatten the
hemidiaphragm is el- hemidiaphragms, as does tension pneumothorax (on attected side).
evated above normal. The correct answer is: right phrenic nerve paralysis
Which of the following is
the most likely cause of
this abnormality?
8. You hear bronchial Bronchial breath sounds normally are heard only over the trachea.
breath sound over the When heard over the lung periphery, consolidation (due to pneumo-
patient's right middle nia) is present. Consolidation of the lung allows the turbulent flow
, lobe. What condition is sounds of the larger airways to pass directly through the lung as
probably present? attenuation is reduced
The correct answer is: pneumonia
9. While observing a pa- The pattern of breathing in which the the abdomen moves inward as
tient's pattern of breath- the rib cage expands during inspiration during inspiration is termed
ing, you note that the asynchronous breathing or thoracoabdominal paradox. Most com-
abdomen moves inward monly, this pattern is seen with respiratory muscle dysfunction or
as the rib cage ex- increased work of breathing and can be a sign of impending respi-
pands during inspira- ratory failure. Retractions occur when the the skin between or below
tion. Which of the follow- the ribs (intercostal or subcostal retractions) or above the sternum
ing descriptions would (suprasternal) is drawn in during inspiration. Retractions are also a
you note in the respira- sign of increased work of breathing, usually associated with decreased
tory notes? lung compliance or increased airway resistance. Apneustic breathing -
refers to a pattern in which every inspiration is followed by a prolonged
inspiratory pause, and each expiration is followed by a prolonged
expiratory pause (often mistaken for an apnea). This pattern is often
caused by damage to the respiratory center in the brainstem.
The correct answer is: "patient exhibits asynchronous breathing"
10. You are interviewing a Platypnea exists when a patient experiences diflculty breathing while
patient for the first time. in an upright (sitting or standing) position. This is often seen in neuro-
Which of the following muscular patients who have diaphragmatic weakness or paralysis and
would be indicated by prefer to lay flat (supine). This is essentially the opposite of orthopnea,
the patient's comment in which patients experience diflculty breathing when lying flat or in
that he has more diffi- a head-down position. Hyperpnea signals an increase in ventilation
culty breathing upright above normal, whereas dyspnea is the general term that applies to
than when lying down? patients who experience shortenss of breath.
The correct answer is: platypnea
11. When inspecting the Pleural ettusion is commonly associated with cardiac failure, but can
X-ray of a out-pa- also occur with certain infections, metastasis, renal disease (especially
, tient with nephrotic nephrotic syndrome) and collagen vascular disorders. On X-ray, pleural
syndrome, you note ettusion appears as homogeneous areas of increased density that are
a homogeneous area position- dependent. If the patient is upright, fluid will accumulates in
of increased densi- and 'blunt' or obscure the costophrenic angles. If the patient is placed
ty that obscures the in a decubitus position, the ettusion will 'layer out' laterally.
left costophrenic angle. The correct answer is: pleural ettusion
Which of the following is
the most likely problem?
12. patient has an FRC of RV = FRC - ERV = 3000 - 1500 = 1500 mL.
3000 mL, a VC of 4000 The correct answer is: 1500 mL
mL, and an ERV of 1500
mL. What is his function-
al residual volume (RV)?
13. When measuring a pa- Causes of damped pressure waveforms when measuring vascular
tient's arterial pressure pressures include: catheter tip against vessel wall; partial occlusion of
via A-line and mon- tip by clot, and presence of a clot or air bubbles in the system. Complete
itor/transducer system, catheter occlusion and the stopcock being ott to the patient would
you note a damped pres- cause a total loss of waveform. A change in the transducer reference
sure waveform. Which of level would tend to cause unexpectedly high or low pressure readings,
the following is the most but not damping.
likely cause of this prob- The correct answer is: air bubbles in system
lem?
14. The following data are Assuming an anatomic deadspace of one mL every lb of ideal body
available for a 6-foot weight, the above patient has an alveolar tidal volume of (480-180)
3-inch tall male patient: or 300 mL. With a respiratory rate of 20/min, the alveolar volume per
minute would be 20 x 300 = 6000 mL/min or 6.0 L/min.
Weight = 81.8 kg (180 lb) The correct answer is: 6.0 L/min
Respiratory rate =
20/min
Tidal volume = 480 mL
Detailed Answers Guaranteed Pass!!
1. The Ballard scale is used After birth, determination of gestational age involves careful assess-
to assess: ment of selected neuromuscular and physical characteristics using
methods developed by Dubowitz and Ballard. This assessment is nor-
mally conducted by a neonatologist or nurse practitioner within 30-40
hours after birth. Although respiratory therapists do not normally con-
duct this assessment, you should be familiar with its components.
The correct answer is: gestational age after birth
2. A patient has a pH of To determine the primary acid-base disturbance, first determine
7.22 and a PaCO2 of whether the pH is low (< 7.35 = acidemia) or high (> 7.45 = alkalemia).
60 torr. Based on these After judging the pH, you then assess the PaCO2. If the pH is low,
data, what is the primary the primary disturbance must be either respiratory acidosis (PaCO2 >
acid-base disturbance? 45 torr) or metabolic acidosis (PaCO2 £ 45 torr). With a high pH, the
primary disturbance must be either respiratory alkalosis (PaCO2 < 35
torr) or metabolic alkalosis (PaCO2 ³ 35 torr).
The correct answer is: respiratory acidosis
3. During the adminis- Bradypnea is a less than normal rate of breathing; narcotic drug over-
tration of an aerosol dose is a common cause. Hypercapnia and hypoxemia are potential
treatment, the patient's problems.
respiratory rate drops The correct answer is: bradypnea
from 15 breaths/min to
6 breaths/min. Identify
this breathing pattern.
4. Full laboratory diagnos- The full laboratory-based, attended PSG exam typically includes at
tic polysomnography re- least 10 channels: 2 electroencephalogram (EEG), 2 electrooculogram
quires at least how many (EOG), 1 electromyogram (EMG), an electrocardiogram (ECG), and
channels? channels for bilateral leg movements, O2 saturation, respiratory ettort
(usually via thoraco-abdominal movements) and nasal or oronasal
airflow. This is the gold standard for diagnosis of sleep disorders.
The correct answer is: 10
, TMC Actual Exam Questions With Reviewed 100% Correct
Detailed Answers Guaranteed Pass!!
5. A patient receiving Many patients receiving long-term positive pressure ventilatory sup-
long-term positive pres- port exhibit significant salt and water retention, as manifested by either
sure ventilatory support a weight gain or failure to lose weight as anticipated. In addition,
exhibits a progressive such patients typically show a reduction in hematocrit, consistent with
weight gain and a reduc- hypervolemia due to water retention.
tion in the hematocrit. The correct answer is: water retention
Which of the following is
the most likely cause of
this problem?
6. On inspection of an The most likely problem is sinus tachycardia. In this arrhythmia, the
ECG rhythm strip from sinus node rate ranges from 100-160/min. The rhythm is regular, with
an adult patient, you normal P waves, P-R intervals, and QRS complexes. Many ditterent
note the following: rate factors can cause sinus tachycardia. Treatment aims at correcting the
of 150; regular rhythm; underlying cause. Drugs used to slow the heart rate include digitalis
normal P waves, P-R in- and beta-adrenergic blockers like propranolol.
tervals, and QRS com- The correct answer is: sinus tachycardia
plexes. The most likely
problem is:
7. You note on inspection An elevated hemidiaphragm indicates phrenic nerve paralysis on the
of an AP chest radi- attected side or hepatomegaly (right side only). Pleural ettusions blunt
ograph that the right the costophrenic angles, whereas hyperinflation tends to flatten the
hemidiaphragm is el- hemidiaphragms, as does tension pneumothorax (on attected side).
evated above normal. The correct answer is: right phrenic nerve paralysis
Which of the following is
the most likely cause of
this abnormality?
8. You hear bronchial Bronchial breath sounds normally are heard only over the trachea.
breath sound over the When heard over the lung periphery, consolidation (due to pneumo-
patient's right middle nia) is present. Consolidation of the lung allows the turbulent flow
, lobe. What condition is sounds of the larger airways to pass directly through the lung as
probably present? attenuation is reduced
The correct answer is: pneumonia
9. While observing a pa- The pattern of breathing in which the the abdomen moves inward as
tient's pattern of breath- the rib cage expands during inspiration during inspiration is termed
ing, you note that the asynchronous breathing or thoracoabdominal paradox. Most com-
abdomen moves inward monly, this pattern is seen with respiratory muscle dysfunction or
as the rib cage ex- increased work of breathing and can be a sign of impending respi-
pands during inspira- ratory failure. Retractions occur when the the skin between or below
tion. Which of the follow- the ribs (intercostal or subcostal retractions) or above the sternum
ing descriptions would (suprasternal) is drawn in during inspiration. Retractions are also a
you note in the respira- sign of increased work of breathing, usually associated with decreased
tory notes? lung compliance or increased airway resistance. Apneustic breathing -
refers to a pattern in which every inspiration is followed by a prolonged
inspiratory pause, and each expiration is followed by a prolonged
expiratory pause (often mistaken for an apnea). This pattern is often
caused by damage to the respiratory center in the brainstem.
The correct answer is: "patient exhibits asynchronous breathing"
10. You are interviewing a Platypnea exists when a patient experiences diflculty breathing while
patient for the first time. in an upright (sitting or standing) position. This is often seen in neuro-
Which of the following muscular patients who have diaphragmatic weakness or paralysis and
would be indicated by prefer to lay flat (supine). This is essentially the opposite of orthopnea,
the patient's comment in which patients experience diflculty breathing when lying flat or in
that he has more diffi- a head-down position. Hyperpnea signals an increase in ventilation
culty breathing upright above normal, whereas dyspnea is the general term that applies to
than when lying down? patients who experience shortenss of breath.
The correct answer is: platypnea
11. When inspecting the Pleural ettusion is commonly associated with cardiac failure, but can
X-ray of a out-pa- also occur with certain infections, metastasis, renal disease (especially
, tient with nephrotic nephrotic syndrome) and collagen vascular disorders. On X-ray, pleural
syndrome, you note ettusion appears as homogeneous areas of increased density that are
a homogeneous area position- dependent. If the patient is upright, fluid will accumulates in
of increased densi- and 'blunt' or obscure the costophrenic angles. If the patient is placed
ty that obscures the in a decubitus position, the ettusion will 'layer out' laterally.
left costophrenic angle. The correct answer is: pleural ettusion
Which of the following is
the most likely problem?
12. patient has an FRC of RV = FRC - ERV = 3000 - 1500 = 1500 mL.
3000 mL, a VC of 4000 The correct answer is: 1500 mL
mL, and an ERV of 1500
mL. What is his function-
al residual volume (RV)?
13. When measuring a pa- Causes of damped pressure waveforms when measuring vascular
tient's arterial pressure pressures include: catheter tip against vessel wall; partial occlusion of
via A-line and mon- tip by clot, and presence of a clot or air bubbles in the system. Complete
itor/transducer system, catheter occlusion and the stopcock being ott to the patient would
you note a damped pres- cause a total loss of waveform. A change in the transducer reference
sure waveform. Which of level would tend to cause unexpectedly high or low pressure readings,
the following is the most but not damping.
likely cause of this prob- The correct answer is: air bubbles in system
lem?
14. The following data are Assuming an anatomic deadspace of one mL every lb of ideal body
available for a 6-foot weight, the above patient has an alveolar tidal volume of (480-180)
3-inch tall male patient: or 300 mL. With a respiratory rate of 20/min, the alveolar volume per
minute would be 20 x 300 = 6000 mL/min or 6.0 L/min.
Weight = 81.8 kg (180 lb) The correct answer is: 6.0 L/min
Respiratory rate =
20/min
Tidal volume = 480 mL
