TMC Exam A 2025/2026 | Complete Exam with
150 Verified Questions & 100% Correct Answers
Therapist Multiple-Choice (TMC) Exam – Form A | Key Concepts: Respiratory Care,
Cardiopulmonary Anatomy & Physiology, Mechanical Ventilation, Oxygen & Gas Therapy,
Airway Management, Diagnostic Testing, Pharmacology, and Patient Care Interventions |
Expert-Verified Q&A | Clinical & Exam-Ready
Introduction
This updated 2025/2026 TMC Exam A resource provides 150 fully verified questions with 100%
correct answers. Content covers essential respiratory therapy domains including patient data
evaluation, therapeutic procedures, equipment troubleshooting, and evidence-based
interventions. All answers are graded A+ and include rationales that explain clinical reasoning,
reinforce safe respiratory care practices, and strengthen critical thinking for exam readiness.
Answer Format
All correct answers are highlighted in bold and green, with rationales that explain clinical
reasoning, reinforce safe respiratory care practices, and strengthen critical thinking for exam
readiness.
1. A 60 kg (132 lb) patient is being mechanically ventilated with the
following settings: VC, A/C; VT 500 mL, respiratory rate 12/min, FIO2 1.0,
and 10 cm H2O PEEP. The patient’s peak airway pressure is 60 cm H2O,
and SpO2 is 85%. A chest x-ray shows diffuse bilateral infiltrates. What is
the most appropriate action to reduce peak airway pressure?
a) Increase tidal volume
b) Change to airway pressure release ventilation
c) Decrease PEEP
d) Increase respiratory rate
b) Change to airway pressure release ventilation
Rationale: High peak airway pressure and bilateral infiltrates suggest acute respiratory distress
syndrome (ARDS). Airway pressure release ventilation (APRV) reduces peak pressures while
maintaining oxygenation [Web ID: 0].
2. While calibrating a spirometer with a 3.0 L super syringe, the recorded
volumes are 2.85 L, 2.8 L, and 2.8 L. What is the most likely issue?
a) The plunger was advanced too slowly
b) Another syringe needs to be used
c) The spirometer is accurate
d) The spirometer may have a leak
,d) The spirometer may have a leak
Rationale: Consistently low volumes suggest a leak in the spirometer system [Web ID: 1].
3. During an Albuterol treatment for a COPD patient, the therapist notes
sudden marked cyanosis. What should the therapist do first?
a) Continue the treatment
b) Stop the treatment and assess the patient
c) Increase the Albuterol dose
d) Switch to a different bronchodilator
b) Stop the treatment and assess the patient
Rationale: Sudden cyanosis indicates a potential adverse reaction or deterioration, requiring
immediate assessment [Web ID: 2].
4. A patient arrives in the ED with a respiratory rate of 35 breaths/min.
Which oxygen delivery device is most appropriate?
a) Nasal cannula
b) Simple mask
c) Non-rebreather mask
d) Venturi mask
c) Non-rebreather mask
Rationale: A high respiratory rate suggests severe hypoxemia, requiring high-flow oxygen via a
non-rebreather mask [Web ID: 3].
5. On physical exam, breath sounds are absent in the left chest with a
hyperresonant percussion note. The trachea is shifted to the right, heart
rate is 45/min, respiratory rate is 30/min, and blood pressure is 60/40 mm
Hg. What should the therapist recommend first?
a) Administer bronchodilators
b) Perform needle decompression
c) Order a chest x-ray
d) Initiate mechanical ventilation
b) Perform needle decompression
Rationale: Findings suggest a tension pneumothorax, requiring immediate needle
decompression [Web ID: 4].
6. Which strategy decreases the likelihood of tracheal mucosa damage
during intubation?
a) Using high cuff pressures
b) Maintaining cuff pressures between 20–25 mm Hg
c) Avoiding minimal leak technique
d) Ignoring intracuff pressure monitoring
b) Maintaining cuff pressures between 20–25 mm Hg
Rationale: Proper cuff pressure prevents mucosal ischemia [Web ID: 5].
7. A patient with atelectasis has an inspiratory capacity of 30% of predicted
value. What is the most appropriate initial bronchial hygiene therapy?
,a) Chest physiotherapy
b) Incentive spirometry
c) Nebulized saline
d) Positive expiratory pressure therapy
b) Incentive spirometry
Rationale: Incentive spirometry promotes lung expansion to treat atelectasis [Web ID: 5].
8. The physician orders a 35% aerosol mask with an inspiratory flow of 42
L/min. What is the minimum flow rate for the flowmeter?
a) 6 L/min
b) 8 L/min
c) 10 L/min
d) 12 L/min
b) 8 L/min
Rationale: For a 35% oxygen mixture (air:O2 ratio 5:1), total flow is 6 × flowmeter setting. 6 × 8
= 48 L/min, meeting the 42 L/min demand [Web ID: 6].
9. A patient’s SpO2 drops from 98% to 85% over 2 hours. PIP increases from
36 to 46 cm H2O, and plateau pressure rises from 18 to 28 cm H2O. What is
the likely cause?
a) Bronchospasm
b) Pneumothorax
c) Pulmonary edema
d) Mucus plugging
c) Pulmonary edema
Rationale: Increased PIP and plateau pressure with desaturation suggest pulmonary edema,
increasing lung stiffness [Web ID: 6].
10. An E cylinder at 1900 psig delivers 4 L/min via nasal cannula. How long
will it last?
a) 47 min
b) 1.7 h
c) 2.2 h
d) 3.6 h
c) 2.2 h
Rationale: E cylinder factor is 0.28. Duration = (1900 × 0.28) / 4 = 133 min = 2.2 h [Web ID:
3].
11. A patient’s arterial blood gas (ABG) shows pH 7.32, PaCO2 50 mm Hg,
PaO2 60 mm Hg, HCO3- 25 mEq/L. What is the acid-base status?
a) Compensated respiratory acidosis
b) Uncompensated respiratory acidosis
c) Compensated metabolic acidosis
d) Uncompensated metabolic alkalosis
b) Uncompensated respiratory acidosis
, Rationale: Low pH and high PaCO2 with normal HCO3- indicate uncompensated respiratory
acidosis [Web ID: 9].
12. A patient with COPD has a respiratory rate of 24/min and SpO2 of 88%
on 2 L/min nasal cannula. What should the therapist do?
a) Increase oxygen to 4 L/min
b) Administer a bronchodilator
c) Initiate mechanical ventilation
d) Switch to a non-rebreather mask
b) Administer a bronchodilator
Rationale: Bronchodilators address COPD exacerbations before increasing oxygen [Web ID: 2].
13. What is the primary purpose of positive end-expiratory pressure
(PEEP)?
a) Increase tidal volume
b) Prevent alveolar collapse
c) Reduce respiratory rate
d) Decrease airway resistance
b) Prevent alveolar collapse
Rationale: PEEP maintains alveolar patency, improving oxygenation [Web ID: 0].
14. A patient’s capnography shows a sudden drop in end-tidal CO2. What is
the most likely cause?
a) Hyperventilation
b) Airway obstruction
c) Increased cardiac output
d) Improved lung perfusion
b) Airway obstruction
Rationale: A sudden drop in ETCO2 suggests reduced ventilation, often due to obstruction
[Web ID: 9].
15. A patient on mechanical ventilation has a high-pressure alarm. What
should the therapist check first?
a) Oxygen concentration
b) Airway patency
c) Tidal volume settings
d) PEEP levels
b) Airway patency
Rationale: High-pressure alarms indicate resistance, often due to airway obstruction [Web ID:
0].
16. Which medication is most appropriate for a patient with acute
bronchospasm?
a) Ipratropium bromide
b) Albuterol
c) Prednisone
150 Verified Questions & 100% Correct Answers
Therapist Multiple-Choice (TMC) Exam – Form A | Key Concepts: Respiratory Care,
Cardiopulmonary Anatomy & Physiology, Mechanical Ventilation, Oxygen & Gas Therapy,
Airway Management, Diagnostic Testing, Pharmacology, and Patient Care Interventions |
Expert-Verified Q&A | Clinical & Exam-Ready
Introduction
This updated 2025/2026 TMC Exam A resource provides 150 fully verified questions with 100%
correct answers. Content covers essential respiratory therapy domains including patient data
evaluation, therapeutic procedures, equipment troubleshooting, and evidence-based
interventions. All answers are graded A+ and include rationales that explain clinical reasoning,
reinforce safe respiratory care practices, and strengthen critical thinking for exam readiness.
Answer Format
All correct answers are highlighted in bold and green, with rationales that explain clinical
reasoning, reinforce safe respiratory care practices, and strengthen critical thinking for exam
readiness.
1. A 60 kg (132 lb) patient is being mechanically ventilated with the
following settings: VC, A/C; VT 500 mL, respiratory rate 12/min, FIO2 1.0,
and 10 cm H2O PEEP. The patient’s peak airway pressure is 60 cm H2O,
and SpO2 is 85%. A chest x-ray shows diffuse bilateral infiltrates. What is
the most appropriate action to reduce peak airway pressure?
a) Increase tidal volume
b) Change to airway pressure release ventilation
c) Decrease PEEP
d) Increase respiratory rate
b) Change to airway pressure release ventilation
Rationale: High peak airway pressure and bilateral infiltrates suggest acute respiratory distress
syndrome (ARDS). Airway pressure release ventilation (APRV) reduces peak pressures while
maintaining oxygenation [Web ID: 0].
2. While calibrating a spirometer with a 3.0 L super syringe, the recorded
volumes are 2.85 L, 2.8 L, and 2.8 L. What is the most likely issue?
a) The plunger was advanced too slowly
b) Another syringe needs to be used
c) The spirometer is accurate
d) The spirometer may have a leak
,d) The spirometer may have a leak
Rationale: Consistently low volumes suggest a leak in the spirometer system [Web ID: 1].
3. During an Albuterol treatment for a COPD patient, the therapist notes
sudden marked cyanosis. What should the therapist do first?
a) Continue the treatment
b) Stop the treatment and assess the patient
c) Increase the Albuterol dose
d) Switch to a different bronchodilator
b) Stop the treatment and assess the patient
Rationale: Sudden cyanosis indicates a potential adverse reaction or deterioration, requiring
immediate assessment [Web ID: 2].
4. A patient arrives in the ED with a respiratory rate of 35 breaths/min.
Which oxygen delivery device is most appropriate?
a) Nasal cannula
b) Simple mask
c) Non-rebreather mask
d) Venturi mask
c) Non-rebreather mask
Rationale: A high respiratory rate suggests severe hypoxemia, requiring high-flow oxygen via a
non-rebreather mask [Web ID: 3].
5. On physical exam, breath sounds are absent in the left chest with a
hyperresonant percussion note. The trachea is shifted to the right, heart
rate is 45/min, respiratory rate is 30/min, and blood pressure is 60/40 mm
Hg. What should the therapist recommend first?
a) Administer bronchodilators
b) Perform needle decompression
c) Order a chest x-ray
d) Initiate mechanical ventilation
b) Perform needle decompression
Rationale: Findings suggest a tension pneumothorax, requiring immediate needle
decompression [Web ID: 4].
6. Which strategy decreases the likelihood of tracheal mucosa damage
during intubation?
a) Using high cuff pressures
b) Maintaining cuff pressures between 20–25 mm Hg
c) Avoiding minimal leak technique
d) Ignoring intracuff pressure monitoring
b) Maintaining cuff pressures between 20–25 mm Hg
Rationale: Proper cuff pressure prevents mucosal ischemia [Web ID: 5].
7. A patient with atelectasis has an inspiratory capacity of 30% of predicted
value. What is the most appropriate initial bronchial hygiene therapy?
,a) Chest physiotherapy
b) Incentive spirometry
c) Nebulized saline
d) Positive expiratory pressure therapy
b) Incentive spirometry
Rationale: Incentive spirometry promotes lung expansion to treat atelectasis [Web ID: 5].
8. The physician orders a 35% aerosol mask with an inspiratory flow of 42
L/min. What is the minimum flow rate for the flowmeter?
a) 6 L/min
b) 8 L/min
c) 10 L/min
d) 12 L/min
b) 8 L/min
Rationale: For a 35% oxygen mixture (air:O2 ratio 5:1), total flow is 6 × flowmeter setting. 6 × 8
= 48 L/min, meeting the 42 L/min demand [Web ID: 6].
9. A patient’s SpO2 drops from 98% to 85% over 2 hours. PIP increases from
36 to 46 cm H2O, and plateau pressure rises from 18 to 28 cm H2O. What is
the likely cause?
a) Bronchospasm
b) Pneumothorax
c) Pulmonary edema
d) Mucus plugging
c) Pulmonary edema
Rationale: Increased PIP and plateau pressure with desaturation suggest pulmonary edema,
increasing lung stiffness [Web ID: 6].
10. An E cylinder at 1900 psig delivers 4 L/min via nasal cannula. How long
will it last?
a) 47 min
b) 1.7 h
c) 2.2 h
d) 3.6 h
c) 2.2 h
Rationale: E cylinder factor is 0.28. Duration = (1900 × 0.28) / 4 = 133 min = 2.2 h [Web ID:
3].
11. A patient’s arterial blood gas (ABG) shows pH 7.32, PaCO2 50 mm Hg,
PaO2 60 mm Hg, HCO3- 25 mEq/L. What is the acid-base status?
a) Compensated respiratory acidosis
b) Uncompensated respiratory acidosis
c) Compensated metabolic acidosis
d) Uncompensated metabolic alkalosis
b) Uncompensated respiratory acidosis
, Rationale: Low pH and high PaCO2 with normal HCO3- indicate uncompensated respiratory
acidosis [Web ID: 9].
12. A patient with COPD has a respiratory rate of 24/min and SpO2 of 88%
on 2 L/min nasal cannula. What should the therapist do?
a) Increase oxygen to 4 L/min
b) Administer a bronchodilator
c) Initiate mechanical ventilation
d) Switch to a non-rebreather mask
b) Administer a bronchodilator
Rationale: Bronchodilators address COPD exacerbations before increasing oxygen [Web ID: 2].
13. What is the primary purpose of positive end-expiratory pressure
(PEEP)?
a) Increase tidal volume
b) Prevent alveolar collapse
c) Reduce respiratory rate
d) Decrease airway resistance
b) Prevent alveolar collapse
Rationale: PEEP maintains alveolar patency, improving oxygenation [Web ID: 0].
14. A patient’s capnography shows a sudden drop in end-tidal CO2. What is
the most likely cause?
a) Hyperventilation
b) Airway obstruction
c) Increased cardiac output
d) Improved lung perfusion
b) Airway obstruction
Rationale: A sudden drop in ETCO2 suggests reduced ventilation, often due to obstruction
[Web ID: 9].
15. A patient on mechanical ventilation has a high-pressure alarm. What
should the therapist check first?
a) Oxygen concentration
b) Airway patency
c) Tidal volume settings
d) PEEP levels
b) Airway patency
Rationale: High-pressure alarms indicate resistance, often due to airway obstruction [Web ID:
0].
16. Which medication is most appropriate for a patient with acute
bronchospasm?
a) Ipratropium bromide
b) Albuterol
c) Prednisone
