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TMC Practice Exam B Kettering 2022/2023
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After a patient undergoes a thoracentesis, the respiratory therapist notes that the
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obtained pleural fluid is clear with a slight straw color. This fluid is most likely the result
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of
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A. empyema.
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B. congestive heart failure.
C. lung carcinoma.
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D. hemothorax. - correct answer B. congestive heart failure.
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sh
Sp
Which of the following would be most important to evaluate for a patient who is entering
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a smoking cessation program?
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A. Height
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B. Smoking history
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C. Weight
D. Diet - correct answer B. Smoking history
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tz
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The respiratory therapist is calibrating a spirometer and checking the volume with a 3.0
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liter super syringe. The volumes recorded are: 2.85 L, 2.8 L, and 2.8 L. Based upon the
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information obtained which of the following is a correct statement?
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sh
A. Another syringe needs to be used
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B. Spirometer is accurate
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C. The plunger was advanced too slowly
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D. Spirometer may have a leak - correct answer D. Spirometer may have a leak
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sh
Sp
Which of the following is an indication for high frequency jet ventilation?
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A. Bronchopleural fistula
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B. Wilson Mikity syndrome
C. Necrotizing lesion of right lung
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D. Centrilobular emphysema - correct answer A. Bronchopleural fistula
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A 43-year-old female patient has just undergone a total abdominal hysterectomy. The
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patient arrives in the post anesthesia care unit obtunded with minimal response to
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painful stimulus. What treatment should the respiratory therapist recommend for this
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patient?
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A. Initiate assisted ventilation
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B. Insert oropharyngeal airway
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Sp
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, ne
sh
C. Obtain positron emission tomography
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D. Initiate noninvasive capnography - correct answer B. Insert oropharyngeal airway
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A 44 week gestational age infant has just been delivered via C-section and is gasping,
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grunting, and has tachycardia and tachypnea. At one minute his Apgar score is 4 and at
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5 minutes the score is 5. The infant is most likely suffering from
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A. transient tachypnea of the newborn.
B. meconium aspiration.
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C. bronchopulmonary dysplasia.
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D. apnea of prematurity. - correct answer B. meconium aspiration.
la
What is the normal VD/VT ratio for a patient breathing room air?
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sh
Sp
A. 5 - 15%
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B. 20 - 40%
C. 45 - 55%
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D. 65 - 75% - correct answer B. 20 - 40%
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Sp
A heat moisture exchanger is indicated for humidification in which of the following
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situations?
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A. Mechanical ventilation in a long-term care facility.
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B. Transport to a tertiary care center.
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C. Patient with tenacious secretions.
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D. Delivery of aerosolized bronchodilators. - correct answer B. Transport to a tertiary
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care center.
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All of the following could cause a patient's right-hemidiaphragm to be elevated,
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EXCEPT
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A. right lower lobe atelectasis. sh
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B. right side hyperlucency, absent vascular markings.
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C. hepatomegaly.
D. right lower lobe consolidation with air bronchograms. - correct answer B. right side
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hyperlucency, absent vascular markings
sh
Sp
A 64-year-old, 70 kg (154 lb) man with severe COPD is receiving independent
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(differential) lung ventilation following thoracotomy and right lower lobectomy. Which of
the following setting combinations would be most appropriate for this patient?
a
tz
l
sh
A. Right lung 50 mL; left lung 650 mL
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B. Right lung 150 mL; left lung 550 mL
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C. Right lung 350 mL; left lung 350 mL
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sh
Sp
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Sp
, ne
sh
D. Right lung 550 mL; left lung 150 mL - correct answer B. Right lung 150 mL; left lung
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550 mL la
tz
A patient in the intensive care unit has the following hemodynamic measurements:
sh
Sp
CVP (mm Hg) 5
PAP (mm Hg) 29/8
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PCWP (mm Hg) 8
BP (mm Hg) 130/70
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Sp
Cardiac output (L/min) 5.1
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Cardiac index (L/min/m2) 2.7
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What is the pulse pressure?
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sh
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A. 15 mm Hg
B. 21 mm Hg
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C. 60 mm Hg
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D. 90 mm Hg - correct answer C. 60 mm Hg
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A 2-year-old child with croup has been intubated for 4 days with a 4 mm ID uncuffed
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endotracheal tube. Heated aerosol at an FIO2 of 0.30 has been delivered to the patient.
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The physician asks the respiratory therapist to evaluate the patient for possible
sh
extubation. Which of the following would most likely indicate that the patient is ready for
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extubation?
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A. The patient is making normal quiet ventilatory efforts.
B. A negative sputum culture and sensitivity has been reported.
sh
C. The patient's ABG are within normal range.
Sp
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D. Breath sounds are heard around the tube on auscultation. - correct answer D. Breath
sounds are heard around the tube on auscultation.
la
tz
A patient is seen in the Emergency Department for complaints of nausea and vomiting.
sh
Sp
A nasogastric tube has been inserted and the patient is started on lasix. Which of the
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following should the respiratory therapist monitor?
la
A. Cardiac enzymes
sh
B. Serum electrolytes
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C. Arterial blood gases
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D. Cell hydration level - correct answer B. Serum electrolytes
a
tz
While instructing a patient prior to a vital capacity maneuver, the respiratory therapist
l
sh
should direct the patient to
Sp
ne
la
A. exhale to residual volume and inhale to inspiratory capacity.
sh
Sp
la
Sp
, ne
sh
B. inhale to total lung capacity then exhale to residual volume.
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C. exhale normally then inhale to total lung capacity.
la
D. inhale normally then exhale to functional residual capacity. - correct answer B. inhale
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to total lung capacity then exhale to residual volume.
sh
Sp
A patient involved in an automobile accident is brought to the ED with tachypnea,
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tracheal deviation to the right, splinting, asymmetrical chest movement, and decreased
la
breath sounds on the left side. The respiratory therapist should initially
sh
Sp
A. insert a chest tube.
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B. administer 100% oxygen via mask.
C. perform endotracheal intubation.
la
D. initiate non-invasive positive pressure ventilation. - correct answer B. administer
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100% oxygen via mask.
sh
Sp
ne
A 77-year-old male patient is admitted to the emergency room with shortness of breath,
fine basilar crackles, +2 pitting edema and a chest radiogram with a butterfly pattern.
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These results are most consistent with which of the following?
sh
Sp
A. Pulmonary edema
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B. Pulmonary interstitial emphysema
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C. Pneumothorax
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D. Emphysema - correct answer A. Pulmonary edema
sh
Sp
Which of the following formulas will determine the total flow being delivered to a patient
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with a 28% venturi mask running at 6 L/min?
la
A. total flow = 6 x 2
sh
B. total flow = 6 x 4
Sp
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C. total flow = 6 x 5
D. total flow = 6 x 11 - correct answer D. total flow = 6 x 11
la
tz
Fine crepitant crackles are most commonly associated with which of the following
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Sp
conditions?
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A. Bronchitis
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B. Pulmonary edema
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C. Pneumonia
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D. Foreign body aspiration - correct answer B. Pulmonary edema
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A patient with end-stage pulmonary fibrosis is receiving oxygen at 2 L/min via a
a
tz
transtracheal oxygen catheter. The patient experiences an increased work of breathing
l
sh
and shortness of breath. The respiratory therapist should
Sp
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A. manually ventilate the patient with a resuscitation bag.
la
B. increase the flow to the transtracheal catheter to 6 L/min.
sh
Sp
la
Sp
sh
ne
TMC Practice Exam B Kettering 2022/2023
la
tz
sh
Sp
After a patient undergoes a thoracentesis, the respiratory therapist notes that the
ne
obtained pleural fluid is clear with a slight straw color. This fluid is most likely the result
la
of
sh
A. empyema.
Sp
ne
B. congestive heart failure.
C. lung carcinoma.
la
D. hemothorax. - correct answer B. congestive heart failure.
tz
sh
Sp
Which of the following would be most important to evaluate for a patient who is entering
ne
a smoking cessation program?
la
A. Height
sh
Sp
B. Smoking history
ne
C. Weight
D. Diet - correct answer B. Smoking history
la
tz
sh
The respiratory therapist is calibrating a spirometer and checking the volume with a 3.0
Sp
liter super syringe. The volumes recorded are: 2.85 L, 2.8 L, and 2.8 L. Based upon the
ne
information obtained which of the following is a correct statement?
la
sh
A. Another syringe needs to be used
Sp
B. Spirometer is accurate
ne
C. The plunger was advanced too slowly
la
D. Spirometer may have a leak - correct answer D. Spirometer may have a leak
tz
sh
Sp
Which of the following is an indication for high frequency jet ventilation?
ne
A. Bronchopleural fistula
la
B. Wilson Mikity syndrome
C. Necrotizing lesion of right lung
sh
Sp
D. Centrilobular emphysema - correct answer A. Bronchopleural fistula
ne
A 43-year-old female patient has just undergone a total abdominal hysterectomy. The
a
patient arrives in the post anesthesia care unit obtunded with minimal response to
tz
l
sh
painful stimulus. What treatment should the respiratory therapist recommend for this
Sp
patient?
ne
A. Initiate assisted ventilation
la
B. Insert oropharyngeal airway
sh
Sp
la
Sp
, ne
sh
C. Obtain positron emission tomography
ne
D. Initiate noninvasive capnography - correct answer B. Insert oropharyngeal airway
la
tz
A 44 week gestational age infant has just been delivered via C-section and is gasping,
sh
grunting, and has tachycardia and tachypnea. At one minute his Apgar score is 4 and at
Sp
5 minutes the score is 5. The infant is most likely suffering from
ne
la
A. transient tachypnea of the newborn.
B. meconium aspiration.
sh
Sp
C. bronchopulmonary dysplasia.
ne
D. apnea of prematurity. - correct answer B. meconium aspiration.
la
What is the normal VD/VT ratio for a patient breathing room air?
tz
sh
Sp
A. 5 - 15%
ne
B. 20 - 40%
C. 45 - 55%
la
D. 65 - 75% - correct answer B. 20 - 40%
sh
Sp
A heat moisture exchanger is indicated for humidification in which of the following
ne
situations?
la
tz
A. Mechanical ventilation in a long-term care facility.
sh
B. Transport to a tertiary care center.
Sp
C. Patient with tenacious secretions.
ne
D. Delivery of aerosolized bronchodilators. - correct answer B. Transport to a tertiary
la
care center.
sh
All of the following could cause a patient's right-hemidiaphragm to be elevated,
Sp
ne
EXCEPT
la
tz
A. right lower lobe atelectasis. sh
Sp
B. right side hyperlucency, absent vascular markings.
ne
C. hepatomegaly.
D. right lower lobe consolidation with air bronchograms. - correct answer B. right side
la
hyperlucency, absent vascular markings
sh
Sp
A 64-year-old, 70 kg (154 lb) man with severe COPD is receiving independent
ne
(differential) lung ventilation following thoracotomy and right lower lobectomy. Which of
the following setting combinations would be most appropriate for this patient?
a
tz
l
sh
A. Right lung 50 mL; left lung 650 mL
Sp
B. Right lung 150 mL; left lung 550 mL
ne
C. Right lung 350 mL; left lung 350 mL
la
sh
Sp
la
Sp
, ne
sh
D. Right lung 550 mL; left lung 150 mL - correct answer B. Right lung 150 mL; left lung
ne
550 mL la
tz
A patient in the intensive care unit has the following hemodynamic measurements:
sh
Sp
CVP (mm Hg) 5
PAP (mm Hg) 29/8
ne
la
PCWP (mm Hg) 8
BP (mm Hg) 130/70
sh
Sp
Cardiac output (L/min) 5.1
ne
Cardiac index (L/min/m2) 2.7
la
What is the pulse pressure?
tz
sh
Sp
ne
A. 15 mm Hg
B. 21 mm Hg
la
C. 60 mm Hg
sh
D. 90 mm Hg - correct answer C. 60 mm Hg
Sp
ne
A 2-year-old child with croup has been intubated for 4 days with a 4 mm ID uncuffed
la
endotracheal tube. Heated aerosol at an FIO2 of 0.30 has been delivered to the patient.
tz
The physician asks the respiratory therapist to evaluate the patient for possible
sh
extubation. Which of the following would most likely indicate that the patient is ready for
Sp
extubation?
ne
la
A. The patient is making normal quiet ventilatory efforts.
B. A negative sputum culture and sensitivity has been reported.
sh
C. The patient's ABG are within normal range.
Sp
ne
D. Breath sounds are heard around the tube on auscultation. - correct answer D. Breath
sounds are heard around the tube on auscultation.
la
tz
A patient is seen in the Emergency Department for complaints of nausea and vomiting.
sh
Sp
A nasogastric tube has been inserted and the patient is started on lasix. Which of the
ne
following should the respiratory therapist monitor?
la
A. Cardiac enzymes
sh
B. Serum electrolytes
Sp
C. Arterial blood gases
ne
D. Cell hydration level - correct answer B. Serum electrolytes
a
tz
While instructing a patient prior to a vital capacity maneuver, the respiratory therapist
l
sh
should direct the patient to
Sp
ne
la
A. exhale to residual volume and inhale to inspiratory capacity.
sh
Sp
la
Sp
, ne
sh
B. inhale to total lung capacity then exhale to residual volume.
ne
C. exhale normally then inhale to total lung capacity.
la
D. inhale normally then exhale to functional residual capacity. - correct answer B. inhale
tz
to total lung capacity then exhale to residual volume.
sh
Sp
A patient involved in an automobile accident is brought to the ED with tachypnea,
ne
tracheal deviation to the right, splinting, asymmetrical chest movement, and decreased
la
breath sounds on the left side. The respiratory therapist should initially
sh
Sp
A. insert a chest tube.
ne
B. administer 100% oxygen via mask.
C. perform endotracheal intubation.
la
D. initiate non-invasive positive pressure ventilation. - correct answer B. administer
tz
100% oxygen via mask.
sh
Sp
ne
A 77-year-old male patient is admitted to the emergency room with shortness of breath,
fine basilar crackles, +2 pitting edema and a chest radiogram with a butterfly pattern.
la
These results are most consistent with which of the following?
sh
Sp
A. Pulmonary edema
ne
B. Pulmonary interstitial emphysema
la
C. Pneumothorax
tz
D. Emphysema - correct answer A. Pulmonary edema
sh
Sp
Which of the following formulas will determine the total flow being delivered to a patient
ne
with a 28% venturi mask running at 6 L/min?
la
A. total flow = 6 x 2
sh
B. total flow = 6 x 4
Sp
ne
C. total flow = 6 x 5
D. total flow = 6 x 11 - correct answer D. total flow = 6 x 11
la
tz
Fine crepitant crackles are most commonly associated with which of the following
sh
Sp
conditions?
ne
A. Bronchitis
la
B. Pulmonary edema
sh
C. Pneumonia
Sp
D. Foreign body aspiration - correct answer B. Pulmonary edema
ne
A patient with end-stage pulmonary fibrosis is receiving oxygen at 2 L/min via a
a
tz
transtracheal oxygen catheter. The patient experiences an increased work of breathing
l
sh
and shortness of breath. The respiratory therapist should
Sp
ne
A. manually ventilate the patient with a resuscitation bag.
la
B. increase the flow to the transtracheal catheter to 6 L/min.
sh
Sp
la
Sp
