TMC EXAM A 2024 ACTUAL EXAM QUESTIONS DETAILED
VERIFIED ANSWERS WITH RATIONALES /A+ GRADE ASSUR
A patient receiving mechanical ventilation has received Halcion in the last twenty
minutes. The physician orders the institution of spontaeneous breathing trials to
commence immediately. Which of the following medications would be most helpful to
the patient?
a. Meperidine
b. Valium
c. Romazicon (Flumazenil)
d. Morphine Sulfate - Answer- c. Romazicon (Flumazenil)
In preparation for ventilator weaning the physician requests a VD/VT ratio assessment.
Which of the following is needed to determine the deadspace-tidal volume ratio?
a. Single breath nitrogen elimination and caponographic data
b. Helium dilution study and an arterial blood gas
c. Arterial blood gases and capnographic data
d. Helium dilution study and single breath nitrogen elimination - Answer- c. Arterial
blood gases and capnographic data
A respiratory therapist is determining a VD/VT ratio. Which of the following is needed to
complete this analysis?
a. VT and VA
b. PetCO2 and PaCO2
c. FIO2 and PaO2
d. PECO2 and PaO2 - Answer- b. PetCO2 and PaCO2
Which of the following is LEAST likely to promote the spread of nosocomial infection in
a hospital?
a. Poor hand washing among staff
b. Frequent disconnection of a ventilator circuit
c. Changing small volume nebulizer equipment every 48 hours
d. Use of unit dose medication - Answer- d. Use of unit dose medication
Which of the following can be used to estimate the level of Hemoglobin?
a. C(a-v)O2
b. PAO2
c. Theophylline level
d. RBC - Answer- d. RBC
Which of the following alarms would be most important for a patient receiving positive
pressure ventilation by a pressure-cycled ventilator?
a. Low volume
b. I:E ratio
c. Low FIO2
d. High pressure - Answer- a. Low volume
,Patients with large necks who experience frequent dislodging of their tracheostomy
tubes need (a)
a. Longer tracheostomy tube
b. Shorter tracheostomy tube
c. Larger tracheostomy tube
d. Nasal intubation - Answer- a. Longer tracheostomy tube
Which of the following would be most effective at resolving a humidity deficit for a
patient who is intubated with an 8.0-mm endotracheal tube?
a. Large volume nebulizer
b. Concha heated humidifier
c. HME
d. Bubble humidifier - Answer- b. Concha heated humidifier
A patient with suspected myasthenia gravis in the emergency room should receive
which of the following to confirm a diagnosis?
a. Norcuron
b. Edrophonium bromide
c. Neostigmine
d. Meperidine (Demerol) - Answer- b. Edrophonium bromide
Which of the following is an important action when drawing an arterial blood gas
sample?
a. Choose a radial site with adequate ulnar circulation
b. Use a 16 gauge needle
c. Compress the site prior to puncture
d. Run the sample within 15 minutes - Answer- a. Choose a radial site with adequate
ulnar circulation
Which of the following would be most helpful for a patient with fixed upper airway
obstruction?
a. Aerosolized epinephrine
b. Beta II agonist medication
c. Corticosteroids
d. Heliox therapy - Answer- d. Heliox therapy
Which of the following oxygen modalities would be appropriate for a 220-lb (100-kg)
male with diabetic ketoacidosis who requires 40% supplemental oxygen?
a. Air-entrainment mask
b. Non-rebreathing mask
c. Nasal cannula
d. Simple mask - Answer- a. Air-entrainment mask
While administering a treatment with Albuterol to a patient with COPD, the therapist
notes a sudden change in the patient's color to marked cyanosis. The patient appears
, apneic and the heart rate on the pulse oximeter indicates 30/min. The therapist should
FIRST
a. Administer oxygen by non-rebreathing mask
b. Auscultate breath sounds
c. Begin mouth-to-mouth resuscitation
d. Go get help - Answer- c. Begin mouth-to-mouth resuscitation
A 70-kg (154-lb) female patient is receiving mechanical ventilation on the following
settings:
Mode: assist/control
Mandatory rate: 14
Total rate: 14
VT: 500 mL
FiO2: 0.55
PEEP: 12 cmH2O
Arterial blood gases revel
pH 7.49 / PaCO2 32 / PaO2 109 / HCO3 24 / BE 0
The respiratory therapist should
a. Decrease mandatory rate
b. Decrease FIO2
c. Increase mandatory rate
d. Decrease PEEP - Answer- d. Decrease PEEP
Prior to the removal of chest tubes, which of the following should be done?
a. The chest tube should be expose to normal atmospheric pressure
b. Clamp the chest tube for 24 hours
c. Flush the chest tube with normal saline
d. Suction pressure should be increased temporarily - Answer- b. Clamp the chest tube
for 24 hours
Which of the following will help a patent to speak while intubated with a tracheostomy
tube?
a. Pass-Muir valve
b. Inner cannula
c. Double lumen endotracheal tube
d. Obturator - Answer- a. Pass-Muir valve
Prior to obtaining an MEP value with a pressure manometer, the respiratory therapist
notes the needle is pointing at a positive pressure of -4 cmH2O prior to the maneuver.
During the MEP maneuver, the needle reaches 32 cmH2O. The therapist should
a. Report the problem to the medical director
b. Record an MEP of -28 cmH2O
c. Record an MEP of 28 cmH2O
d. Record an MEP of 36 cmH2O - Answer- d. Record an MEP of 36 cmH2O
VERIFIED ANSWERS WITH RATIONALES /A+ GRADE ASSUR
A patient receiving mechanical ventilation has received Halcion in the last twenty
minutes. The physician orders the institution of spontaeneous breathing trials to
commence immediately. Which of the following medications would be most helpful to
the patient?
a. Meperidine
b. Valium
c. Romazicon (Flumazenil)
d. Morphine Sulfate - Answer- c. Romazicon (Flumazenil)
In preparation for ventilator weaning the physician requests a VD/VT ratio assessment.
Which of the following is needed to determine the deadspace-tidal volume ratio?
a. Single breath nitrogen elimination and caponographic data
b. Helium dilution study and an arterial blood gas
c. Arterial blood gases and capnographic data
d. Helium dilution study and single breath nitrogen elimination - Answer- c. Arterial
blood gases and capnographic data
A respiratory therapist is determining a VD/VT ratio. Which of the following is needed to
complete this analysis?
a. VT and VA
b. PetCO2 and PaCO2
c. FIO2 and PaO2
d. PECO2 and PaO2 - Answer- b. PetCO2 and PaCO2
Which of the following is LEAST likely to promote the spread of nosocomial infection in
a hospital?
a. Poor hand washing among staff
b. Frequent disconnection of a ventilator circuit
c. Changing small volume nebulizer equipment every 48 hours
d. Use of unit dose medication - Answer- d. Use of unit dose medication
Which of the following can be used to estimate the level of Hemoglobin?
a. C(a-v)O2
b. PAO2
c. Theophylline level
d. RBC - Answer- d. RBC
Which of the following alarms would be most important for a patient receiving positive
pressure ventilation by a pressure-cycled ventilator?
a. Low volume
b. I:E ratio
c. Low FIO2
d. High pressure - Answer- a. Low volume
,Patients with large necks who experience frequent dislodging of their tracheostomy
tubes need (a)
a. Longer tracheostomy tube
b. Shorter tracheostomy tube
c. Larger tracheostomy tube
d. Nasal intubation - Answer- a. Longer tracheostomy tube
Which of the following would be most effective at resolving a humidity deficit for a
patient who is intubated with an 8.0-mm endotracheal tube?
a. Large volume nebulizer
b. Concha heated humidifier
c. HME
d. Bubble humidifier - Answer- b. Concha heated humidifier
A patient with suspected myasthenia gravis in the emergency room should receive
which of the following to confirm a diagnosis?
a. Norcuron
b. Edrophonium bromide
c. Neostigmine
d. Meperidine (Demerol) - Answer- b. Edrophonium bromide
Which of the following is an important action when drawing an arterial blood gas
sample?
a. Choose a radial site with adequate ulnar circulation
b. Use a 16 gauge needle
c. Compress the site prior to puncture
d. Run the sample within 15 minutes - Answer- a. Choose a radial site with adequate
ulnar circulation
Which of the following would be most helpful for a patient with fixed upper airway
obstruction?
a. Aerosolized epinephrine
b. Beta II agonist medication
c. Corticosteroids
d. Heliox therapy - Answer- d. Heliox therapy
Which of the following oxygen modalities would be appropriate for a 220-lb (100-kg)
male with diabetic ketoacidosis who requires 40% supplemental oxygen?
a. Air-entrainment mask
b. Non-rebreathing mask
c. Nasal cannula
d. Simple mask - Answer- a. Air-entrainment mask
While administering a treatment with Albuterol to a patient with COPD, the therapist
notes a sudden change in the patient's color to marked cyanosis. The patient appears
, apneic and the heart rate on the pulse oximeter indicates 30/min. The therapist should
FIRST
a. Administer oxygen by non-rebreathing mask
b. Auscultate breath sounds
c. Begin mouth-to-mouth resuscitation
d. Go get help - Answer- c. Begin mouth-to-mouth resuscitation
A 70-kg (154-lb) female patient is receiving mechanical ventilation on the following
settings:
Mode: assist/control
Mandatory rate: 14
Total rate: 14
VT: 500 mL
FiO2: 0.55
PEEP: 12 cmH2O
Arterial blood gases revel
pH 7.49 / PaCO2 32 / PaO2 109 / HCO3 24 / BE 0
The respiratory therapist should
a. Decrease mandatory rate
b. Decrease FIO2
c. Increase mandatory rate
d. Decrease PEEP - Answer- d. Decrease PEEP
Prior to the removal of chest tubes, which of the following should be done?
a. The chest tube should be expose to normal atmospheric pressure
b. Clamp the chest tube for 24 hours
c. Flush the chest tube with normal saline
d. Suction pressure should be increased temporarily - Answer- b. Clamp the chest tube
for 24 hours
Which of the following will help a patent to speak while intubated with a tracheostomy
tube?
a. Pass-Muir valve
b. Inner cannula
c. Double lumen endotracheal tube
d. Obturator - Answer- a. Pass-Muir valve
Prior to obtaining an MEP value with a pressure manometer, the respiratory therapist
notes the needle is pointing at a positive pressure of -4 cmH2O prior to the maneuver.
During the MEP maneuver, the needle reaches 32 cmH2O. The therapist should
a. Report the problem to the medical director
b. Record an MEP of -28 cmH2O
c. Record an MEP of 28 cmH2O
d. Record an MEP of 36 cmH2O - Answer- d. Record an MEP of 36 cmH2O
