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TMC practice exam 2022/2023 | 100
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QUESTIONS| WITH COMPLETE SOLUTION
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Sp
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Within one second after initiating a forced vital capacity (FVC) maneuver, a patient with normal
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lungs should be able to exhale what percent of the FVC?
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sh
A. 35-50% of the FVC
Sp
B. 50-70% of the FVC
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C. 70-83% of the FVC
la
D. 84-93% of the FVC Correct Answer: c. 70-83% of FVC
tz
sh
Sp
Simple spirometry CANNOT be used to measure the
ne
A. vital capacity
la
B. residual volume
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C. tidal volume
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Sp
D. inspiratory reserve volume Correct Answer: b. residual volume
ne
la
Which of the following approaches can be used to obtain a medication history from a patient
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with a depressed level of consciousness or who is severely agitated?
sh
Sp
A. obtain and review the patient's past medical history
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B. ask the patient's nurse about the patient's prescriptions
la
C. request that the lab run a comprehensive blood drug screen
tz
D. obtain the patient's current prescription vials from the family Correct Answer: d. obtain the
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Sp
patient's current prescription vials from the family
ne
la
Which of the following thoracic ultrasound findings is consistent with the presence of a
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pneumothorax?
sh
Sp
A. presence of gliding sign
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B. absence of A-lines
la
C. presence of barcode sign
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D. presence of seashore sign Correct Answer: c. presence of barcode lines
sh
Sp
ne
Which of the following would tend to increase insensible water loss?
A. hypothermia
la
tz
B. bypassed upper airway
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Sp
C. hypoventilation
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D. diuretic administration Correct Answer: b. bypassed upper airway
la
tz
Which of the following would tend to decrease a patient's energy expenditure?
sh
A. hypothermia
Sp
ne
B. inflammation
C. major trauma
la
D. agitation/pain Correct Answer: a. hypothermia
tz
sh
Sp
A patient has acute respiratory acidosis. You would expect the base excess (BE) to range
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between:
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Sp
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Sp
, ne
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A. + 6 mEq/L la
B. - 6 mEq/L
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C. +/- 2 mEq/L
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Sp
D. +/- 8 mEq/L Correct Answer: c. +/- 2 mEq/L
ne
la
Which of the following arterial blood gas results would most likely be reported for a patient who
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is having a mild asthma attack?
sh
Sp
A. pH = 7.31 PCO2 = 50 torr PO2 = 60 torr
ne
B. pH = 7.40 PCO2 = 50 torr PO2 = 50 torr
C. pH = 7.47 PCO2 = 32 torr PO2 = 60 torr
la
tz
D. pH = 7.47 PCO2 = 40 torr PO2 = 50 torr Correct Answer: c. pH= 7.47 PCO2= 32 torr PO2=
sh
60 torr
Sp
ne
The Apgar score for a normal newborn infant ranges between
la
A. 1-4
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B. 4-7
Sp
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C. 7-10
D. 10-13 Correct Answer: c. 7-10
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On inspection of a patient's ECG strip, you note no identifiable P waves; rapid irregular
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undulations of the isoelectric line; and an irregular ventricular rhythm. In addition, the precordial
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cardiac rate is greater than the peripheral pulse rate. The most likely problem is:
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A. 2nd degree (Wenckebach) heart block
tz
sh
B. ventricular fibrillation
Sp
C. atrial fibrillation
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D. ventricular tachycardia Correct Answer: c. atrial fibrillation
la
tz
sh
In inspecting an elderly female patient, you note that her spine has an abnormal anterposterior
Sp
(AP) curvature. Which of the following terms would you use in charting this observation?
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A. kyphosis
la
B. scoliosis
C. kyphoscoliosis
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sh
Sp
D. pectus excavatum Correct Answer: a. kyphosis
ne
la
During auscultation of a patient's chest, you hear intermittent "bubbling" sounds at the lung
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bases. Which of the following chart entries best describe this finding?
sh
Sp
A. "bronchial sounds heard at lung bases"
ne
B. "wheezes heard at lung bases"
la
C. "rhonchi heard at lung bases"
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D. "crackles (rales) heard at lung bases" Correct Answer: d. "crackles (rales) heard at lung
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Sp
bases"
ne
la
While assessing a patient's radial pulse, you note that the pulse feels full and bounding. Which of
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the following conditions would be the most probable cause of this finding?
sh
Sp
A. hypovolemia
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B. hypertension
la
sh
Sp
la
Sp
, ne
tz
sh
ne
C. cardiovascular shock
la
D. low cardiac output Correct Answer: b. hypertension
tz
sh
Sp
A patient is cachexic, exhibits generalized edema and dry skin, and appears listless. The most
likely problem is:
ne
la
A. heart failure
tz
B. Addison's disease
sh
Sp
C. renal failure
ne
D. malnutrition Correct Answer: d. malnutrition
la
tz
Prior to giving an aerosol treatment, you find a note in the chart that states your patient had pink
sh
frothy secretions on admission to the ED. This is most indicative of:
Sp
ne
A. cor pulmonale
B. left ventricular failure
la
C. an electrolyte imbalance
tz
sh
D. ARDS Correct Answer: b. left ventricular failure
Sp
ne
A doctor orders a changeover to CPAP for a patient receiving bi-level positive airway pressure
la
(BiPAP) via a device with separate IPAP and EPAP controls. To effect this change you would:
tz
sh
A. set IPAP less than EPAP
Sp
B. set IPAP greater than EPAP
ne
C. set EPAP = 0 cm H2O
la
D. set IPAP equal to EPAP Correct Answer: a. set IPAP less than EPAP
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sh
Sp
How would you characterize the degree of dyspnea of a patient who walks slower than people of
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the same age because of breathlessness?
la
A. slight
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B. moderate
sh
Sp
C. severe
ne
D. very severe Correct Answer: b. moderate
la
tz
Upon exam of an acutely dyspneic and hypotensive patient, you note the following - all on the
sh
Sp
left side of the chest: reduced chest expansion, hyperresonance to percussion, absent of breath
ne
sounds and tactile fremitus, and a tracheal shift to the right. These findings suggest:
la
A. left-sided pneumothorax
tz
B. left-sided consolidation
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Sp
C. left lobar obstruction/atelectasis
ne
D. left-sided pleural effusion Correct Answer: a. left-sided pneumothorax
la
tz
A patient's response to an interview question is initially vague or unclear. Which of the following
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Sp
responses on your part would be most appropriate?
ne
A. "Please go on"
la
B. "You seem to be anxious"
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C. "I see why you are so upset"
sh
Sp
D. "Please explain that to me again" Correct Answer: d. "please explain that to me again"
ne
la
sh
Sp
la
Sp
tz
sh
ne
TMC practice exam 2022/2023 | 100
la
tz
QUESTIONS| WITH COMPLETE SOLUTION
sh
Sp
ne
Within one second after initiating a forced vital capacity (FVC) maneuver, a patient with normal
la
lungs should be able to exhale what percent of the FVC?
tz
sh
A. 35-50% of the FVC
Sp
B. 50-70% of the FVC
ne
C. 70-83% of the FVC
la
D. 84-93% of the FVC Correct Answer: c. 70-83% of FVC
tz
sh
Sp
Simple spirometry CANNOT be used to measure the
ne
A. vital capacity
la
B. residual volume
tz
C. tidal volume
sh
Sp
D. inspiratory reserve volume Correct Answer: b. residual volume
ne
la
Which of the following approaches can be used to obtain a medication history from a patient
tz
with a depressed level of consciousness or who is severely agitated?
sh
Sp
A. obtain and review the patient's past medical history
ne
B. ask the patient's nurse about the patient's prescriptions
la
C. request that the lab run a comprehensive blood drug screen
tz
D. obtain the patient's current prescription vials from the family Correct Answer: d. obtain the
sh
Sp
patient's current prescription vials from the family
ne
la
Which of the following thoracic ultrasound findings is consistent with the presence of a
tz
pneumothorax?
sh
Sp
A. presence of gliding sign
ne
B. absence of A-lines
la
C. presence of barcode sign
tz
D. presence of seashore sign Correct Answer: c. presence of barcode lines
sh
Sp
ne
Which of the following would tend to increase insensible water loss?
A. hypothermia
la
tz
B. bypassed upper airway
sh
Sp
C. hypoventilation
ne
D. diuretic administration Correct Answer: b. bypassed upper airway
la
tz
Which of the following would tend to decrease a patient's energy expenditure?
sh
A. hypothermia
Sp
ne
B. inflammation
C. major trauma
la
D. agitation/pain Correct Answer: a. hypothermia
tz
sh
Sp
A patient has acute respiratory acidosis. You would expect the base excess (BE) to range
ne
between:
la
sh
Sp
la
Sp
, ne
tz
sh
ne
A. + 6 mEq/L la
B. - 6 mEq/L
tz
C. +/- 2 mEq/L
sh
Sp
D. +/- 8 mEq/L Correct Answer: c. +/- 2 mEq/L
ne
la
Which of the following arterial blood gas results would most likely be reported for a patient who
tz
is having a mild asthma attack?
sh
Sp
A. pH = 7.31 PCO2 = 50 torr PO2 = 60 torr
ne
B. pH = 7.40 PCO2 = 50 torr PO2 = 50 torr
C. pH = 7.47 PCO2 = 32 torr PO2 = 60 torr
la
tz
D. pH = 7.47 PCO2 = 40 torr PO2 = 50 torr Correct Answer: c. pH= 7.47 PCO2= 32 torr PO2=
sh
60 torr
Sp
ne
The Apgar score for a normal newborn infant ranges between
la
A. 1-4
tz
sh
B. 4-7
Sp
ne
C. 7-10
D. 10-13 Correct Answer: c. 7-10
la
tz
sh
On inspection of a patient's ECG strip, you note no identifiable P waves; rapid irregular
Sp
undulations of the isoelectric line; and an irregular ventricular rhythm. In addition, the precordial
ne
cardiac rate is greater than the peripheral pulse rate. The most likely problem is:
la
A. 2nd degree (Wenckebach) heart block
tz
sh
B. ventricular fibrillation
Sp
C. atrial fibrillation
ne
D. ventricular tachycardia Correct Answer: c. atrial fibrillation
la
tz
sh
In inspecting an elderly female patient, you note that her spine has an abnormal anterposterior
Sp
(AP) curvature. Which of the following terms would you use in charting this observation?
ne
A. kyphosis
la
B. scoliosis
C. kyphoscoliosis
tz
sh
Sp
D. pectus excavatum Correct Answer: a. kyphosis
ne
la
During auscultation of a patient's chest, you hear intermittent "bubbling" sounds at the lung
tz
bases. Which of the following chart entries best describe this finding?
sh
Sp
A. "bronchial sounds heard at lung bases"
ne
B. "wheezes heard at lung bases"
la
C. "rhonchi heard at lung bases"
tz
D. "crackles (rales) heard at lung bases" Correct Answer: d. "crackles (rales) heard at lung
sh
Sp
bases"
ne
la
While assessing a patient's radial pulse, you note that the pulse feels full and bounding. Which of
tz
the following conditions would be the most probable cause of this finding?
sh
Sp
A. hypovolemia
ne
B. hypertension
la
sh
Sp
la
Sp
, ne
tz
sh
ne
C. cardiovascular shock
la
D. low cardiac output Correct Answer: b. hypertension
tz
sh
Sp
A patient is cachexic, exhibits generalized edema and dry skin, and appears listless. The most
likely problem is:
ne
la
A. heart failure
tz
B. Addison's disease
sh
Sp
C. renal failure
ne
D. malnutrition Correct Answer: d. malnutrition
la
tz
Prior to giving an aerosol treatment, you find a note in the chart that states your patient had pink
sh
frothy secretions on admission to the ED. This is most indicative of:
Sp
ne
A. cor pulmonale
B. left ventricular failure
la
C. an electrolyte imbalance
tz
sh
D. ARDS Correct Answer: b. left ventricular failure
Sp
ne
A doctor orders a changeover to CPAP for a patient receiving bi-level positive airway pressure
la
(BiPAP) via a device with separate IPAP and EPAP controls. To effect this change you would:
tz
sh
A. set IPAP less than EPAP
Sp
B. set IPAP greater than EPAP
ne
C. set EPAP = 0 cm H2O
la
D. set IPAP equal to EPAP Correct Answer: a. set IPAP less than EPAP
tz
sh
Sp
How would you characterize the degree of dyspnea of a patient who walks slower than people of
ne
the same age because of breathlessness?
la
A. slight
tz
B. moderate
sh
Sp
C. severe
ne
D. very severe Correct Answer: b. moderate
la
tz
Upon exam of an acutely dyspneic and hypotensive patient, you note the following - all on the
sh
Sp
left side of the chest: reduced chest expansion, hyperresonance to percussion, absent of breath
ne
sounds and tactile fremitus, and a tracheal shift to the right. These findings suggest:
la
A. left-sided pneumothorax
tz
B. left-sided consolidation
sh
Sp
C. left lobar obstruction/atelectasis
ne
D. left-sided pleural effusion Correct Answer: a. left-sided pneumothorax
la
tz
A patient's response to an interview question is initially vague or unclear. Which of the following
sh
Sp
responses on your part would be most appropriate?
ne
A. "Please go on"
la
B. "You seem to be anxious"
tz
C. "I see why you are so upset"
sh
Sp
D. "Please explain that to me again" Correct Answer: d. "please explain that to me again"
ne
la
sh
Sp
la
Sp
