TMC EXAM B KETTERING 60 QUESTIONS WITH 100%
CORRECT ANSWERS / A+ GRADE
Which of the following statements is consistent with a high-quality radiographic
image?
1. Head of clavicles are level.
2. Spaces between vertebrae are distinct.
3. Lung parenchyma appear black and without blood vessels.
4. Cervical vertebral spaces are smaller than thoracic vertebral spaces. - ANSWER: 1
and 2 only
An elevated brain natriuretic protein (BNP) level would be consistent with a
diagnosis of.... - ANSWER: Congestive Heart Failure
While monitoring the pressure waveform during insertion of a Swan-Ganz catheter,
the RT notes the presence of a dicrotic notch. This finding indicates that the tip of
the catheter is inside the.... - ANSWER: Pulmonary Artery
The RT has measured the exhaled nitric oxide concentration (FENO) of a patient with
asthma. The therapist notes a decrease in the patient's FENO levels from his last visit
one month ago. These results would be consistent with increased use of.... -
ANSWER: Corticosteroids
The RT discovers that a patient has dyspnea and diminished breath sounds with a flat
percussion note on the left. The chest radiograph indicates a tracheal shift to the
right. What disease state should the therapist suspect is affecting the patient? -
ANSWER: Pleural Effusion
A patient is being monitored with a pulmonary artery catheter. The following
measurements are recorded:
CVP: 4 mmHg
Mean PAP: 18 mmHg
MAP: 84 mmHg
Cardiac Output: 4 L/min
What is the patient's systemic vascular resistance? - ANSWER: (MAP-CVP) / Cardiac
Output
(84 - 4) / 4
80/4 = 20
Convert to dynes: multiply answer by 80
20 x 80 = 1,600 dynes/s/cm
A 32-week gestation age infant is receiving mechanical ventilation with a time-
cycled, pressure-limited ventilator at the following settings:
,SIMV
PIP: 28 cmH2O
RR: 22/min
FiO2: 60%
PEEP: 6
Flow: 6 l/min
I-time: 0.6 seconds
The RT notices the TcPO2 reading suddenly drops 39 torr. There have been no
changes in the vent settings, however the patient is cyanotic, the trachea is deviated
to the right and the breath sounds are absent on the left. A tympanic percussion
note is detected over the left thorax. The RT should recommend what? - ANSWER:
Transillumination to detect a pneumothorax
Following insertion of a nasal endotracheal tube, the RT should inflate the cuff to: -
ANSWER: 22 mmHg
Which suction catheter would be most appropriate to use for a patient with a size
7.5 mm ID ETT? - ANSWER: (ID size / 2) x 3
7.5/2= 3.75 x 3 = 11.25
Round down to 10 Fr
While manually ventilating a 42-year-old woman following endotracheal intubation,
the RT notices that the manual resuscitation bag fills rapidly and collapses with
minimal pressure. The therapist also observes that the patient's chest has limited
bilateral movement. The therapist should... - ANSWER: Use another form of
ventilation.
What is the most appropriate position for an obese patient with dyspnea? -
ANSWER: Lateral Fowlers
While administering IPPB therapy to a 58-year-old man who recently underwent a
colon resection, the RT notes that the peak inspiratory pressure is not reaching the
set value. This is most likely the result of.... - ANSWER: insufficient inspiratory flow
After attaching a bubble humidifier to an O2 flowmeter, setting the flow at 5 L/min,
and occluding the humidifier outlet, the RT hears a whistling sound from the
humidifier. This would indicate.... - ANSWER: proper function of the humidifier
A patient suffering from carbon monoxide poisoning is receiving 100% O2 via non-
rebreather mask at a set O2 flow of 15 L/min. Each time the patient inhales, the
reservoir bag on the mask remains fully inflated. The therapist should - ANSWER:
seal the mask against the patient's face
What value for oxygenation index would indicate the need for ECMO in a newborn? -
ANSWER: 44
, A 44-year-old male has been admitted to the hospital after being involved in a sky
diving accident. He is 193 cm (6ft 4 in) tall and weighs 82 kg (182 lbs). The patient has
been orally intubated with a size 8.5 ETT. A CXR reveals bilateral opacification of all
lung fields. Mechanical ventilation has been established with a volume ventilator at
the following settings:
Mode: VC, SIMV
Vt: 650 mL
RR: 12/min
FiO2: 0.65
PEEP: 10
PIP: 58
Plat: 50
ABG: pH 7.30, PaCO2 43, PaO2 45, HCO3 21, SaO2 82%
The patient's condition is most likely related to: - ANSWER: Venous admixture
Estimate the shunt fraction for a patient with the following available data:
A-aDO2: 200 torr
C(a-v)O2: 3.6 vol%
P/F Ratio: 400 torr - ANSWER: For each 100 mmHg in A-a, a 5% shunt occurs. Add 5%
more to that answer (due to normal shunting).
200 torr = 10% + 5% = 15% shunt
An 80kg (176 lb) patient in the post-anesthesia care unit following lower abdominal
surgery is receiving mechanical ventilation. Ventilator settings are as follows:
VC, SIMV
Vt: 550 mL
f: 15/min
FiO2: 70%
PEEP: 15
ABG: pH 7.35, PaCO2 44 torr, PaO2 85 torr, HCO3 23, SaO2 99%, C(a-v)O2 10 vol%
The RT should: - ANSWER: Reduce the PEEP setting.
In preparation for assisting a pulmonologist with a fiberoptic bronchoscopy for a 50-
year-old woman receiving mechanical ventilation, the RT notices that the patient
appears to be anxious about undergoing the procedure. The therapist should
recommend administration of: - ANSWER: Midaxolam
The parameter that starts the inspiratory phase of a positive pressure breath is
referred to as the - ANSWER: trigger variable
While evaluating a patient receiving mechanical ventilation, the RT observes a
persistent high pressure alarm. What could cause that situation? - ANSWER:
Excessive secretions
What would be the most appropriate initial ventilator settings for a patient recently
intubated for myasthenia gravis? The patient is 178cm (5'10") and weighs 70 kg.
A. PC, SIMV; PIP 50 cm H2O, f 8/min, FiO2 .50, PEEP 2
CORRECT ANSWERS / A+ GRADE
Which of the following statements is consistent with a high-quality radiographic
image?
1. Head of clavicles are level.
2. Spaces between vertebrae are distinct.
3. Lung parenchyma appear black and without blood vessels.
4. Cervical vertebral spaces are smaller than thoracic vertebral spaces. - ANSWER: 1
and 2 only
An elevated brain natriuretic protein (BNP) level would be consistent with a
diagnosis of.... - ANSWER: Congestive Heart Failure
While monitoring the pressure waveform during insertion of a Swan-Ganz catheter,
the RT notes the presence of a dicrotic notch. This finding indicates that the tip of
the catheter is inside the.... - ANSWER: Pulmonary Artery
The RT has measured the exhaled nitric oxide concentration (FENO) of a patient with
asthma. The therapist notes a decrease in the patient's FENO levels from his last visit
one month ago. These results would be consistent with increased use of.... -
ANSWER: Corticosteroids
The RT discovers that a patient has dyspnea and diminished breath sounds with a flat
percussion note on the left. The chest radiograph indicates a tracheal shift to the
right. What disease state should the therapist suspect is affecting the patient? -
ANSWER: Pleural Effusion
A patient is being monitored with a pulmonary artery catheter. The following
measurements are recorded:
CVP: 4 mmHg
Mean PAP: 18 mmHg
MAP: 84 mmHg
Cardiac Output: 4 L/min
What is the patient's systemic vascular resistance? - ANSWER: (MAP-CVP) / Cardiac
Output
(84 - 4) / 4
80/4 = 20
Convert to dynes: multiply answer by 80
20 x 80 = 1,600 dynes/s/cm
A 32-week gestation age infant is receiving mechanical ventilation with a time-
cycled, pressure-limited ventilator at the following settings:
,SIMV
PIP: 28 cmH2O
RR: 22/min
FiO2: 60%
PEEP: 6
Flow: 6 l/min
I-time: 0.6 seconds
The RT notices the TcPO2 reading suddenly drops 39 torr. There have been no
changes in the vent settings, however the patient is cyanotic, the trachea is deviated
to the right and the breath sounds are absent on the left. A tympanic percussion
note is detected over the left thorax. The RT should recommend what? - ANSWER:
Transillumination to detect a pneumothorax
Following insertion of a nasal endotracheal tube, the RT should inflate the cuff to: -
ANSWER: 22 mmHg
Which suction catheter would be most appropriate to use for a patient with a size
7.5 mm ID ETT? - ANSWER: (ID size / 2) x 3
7.5/2= 3.75 x 3 = 11.25
Round down to 10 Fr
While manually ventilating a 42-year-old woman following endotracheal intubation,
the RT notices that the manual resuscitation bag fills rapidly and collapses with
minimal pressure. The therapist also observes that the patient's chest has limited
bilateral movement. The therapist should... - ANSWER: Use another form of
ventilation.
What is the most appropriate position for an obese patient with dyspnea? -
ANSWER: Lateral Fowlers
While administering IPPB therapy to a 58-year-old man who recently underwent a
colon resection, the RT notes that the peak inspiratory pressure is not reaching the
set value. This is most likely the result of.... - ANSWER: insufficient inspiratory flow
After attaching a bubble humidifier to an O2 flowmeter, setting the flow at 5 L/min,
and occluding the humidifier outlet, the RT hears a whistling sound from the
humidifier. This would indicate.... - ANSWER: proper function of the humidifier
A patient suffering from carbon monoxide poisoning is receiving 100% O2 via non-
rebreather mask at a set O2 flow of 15 L/min. Each time the patient inhales, the
reservoir bag on the mask remains fully inflated. The therapist should - ANSWER:
seal the mask against the patient's face
What value for oxygenation index would indicate the need for ECMO in a newborn? -
ANSWER: 44
, A 44-year-old male has been admitted to the hospital after being involved in a sky
diving accident. He is 193 cm (6ft 4 in) tall and weighs 82 kg (182 lbs). The patient has
been orally intubated with a size 8.5 ETT. A CXR reveals bilateral opacification of all
lung fields. Mechanical ventilation has been established with a volume ventilator at
the following settings:
Mode: VC, SIMV
Vt: 650 mL
RR: 12/min
FiO2: 0.65
PEEP: 10
PIP: 58
Plat: 50
ABG: pH 7.30, PaCO2 43, PaO2 45, HCO3 21, SaO2 82%
The patient's condition is most likely related to: - ANSWER: Venous admixture
Estimate the shunt fraction for a patient with the following available data:
A-aDO2: 200 torr
C(a-v)O2: 3.6 vol%
P/F Ratio: 400 torr - ANSWER: For each 100 mmHg in A-a, a 5% shunt occurs. Add 5%
more to that answer (due to normal shunting).
200 torr = 10% + 5% = 15% shunt
An 80kg (176 lb) patient in the post-anesthesia care unit following lower abdominal
surgery is receiving mechanical ventilation. Ventilator settings are as follows:
VC, SIMV
Vt: 550 mL
f: 15/min
FiO2: 70%
PEEP: 15
ABG: pH 7.35, PaCO2 44 torr, PaO2 85 torr, HCO3 23, SaO2 99%, C(a-v)O2 10 vol%
The RT should: - ANSWER: Reduce the PEEP setting.
In preparation for assisting a pulmonologist with a fiberoptic bronchoscopy for a 50-
year-old woman receiving mechanical ventilation, the RT notices that the patient
appears to be anxious about undergoing the procedure. The therapist should
recommend administration of: - ANSWER: Midaxolam
The parameter that starts the inspiratory phase of a positive pressure breath is
referred to as the - ANSWER: trigger variable
While evaluating a patient receiving mechanical ventilation, the RT observes a
persistent high pressure alarm. What could cause that situation? - ANSWER:
Excessive secretions
What would be the most appropriate initial ventilator settings for a patient recently
intubated for myasthenia gravis? The patient is 178cm (5'10") and weighs 70 kg.
A. PC, SIMV; PIP 50 cm H2O, f 8/min, FiO2 .50, PEEP 2
