1
TMC EXAM B (RESPIRATORY THERAPY ZONE) | 2025 UPDATED 160
COMPLETE QUESTIONS & ANSWERS | 100% RATED CORRECT &
GRADED A+ | 100% VERFIED
1. You are called to examine a dyspneic and hypotensive patient. You note:
Reduced chest expansion on the left
Hyperresonant percussion
Absent breath sounds
Tracheal shift to the right What
is the most likely diagnosis?
A) Pleural effusion on the left
B) Pneumothorax on the left
C) Atelectasis on the left
D) Consolidation on the left
• Rationale: All findings point to a left-sided pneumothorax with mediastinal shift.
, 2
2. A 39-year-old man has fever, chills, bilateral rhonchi, productive cough, and SpO₂ = 88%
(room air). What is the best course of action?
A) Intubate with 40% oxygen
B) Start noninvasive ventilation
C) Postural drainage with directed cough
D) Oxygen, antibiotics, and sputum for culture
• Rationale: Suspected pneumonia requires oxygen, C&S, and antibiotics — not intubation
yet.
3. A mechanically ventilated patient has a cuff pressure of 36 cm H₂O. What should you do?
A) Withdraw the tube
B) Reintubate with a smaller tube
C) Reduce cuff pressure to < 30 cm H₂O
D) Recommend tracheostomy
• Rationale: High cuff pressures can cause tracheal damage. Lower to 20–30 cm H₂O.
, 3
4. A bubble humidifier is making a whistling noise. What’s the likely cause?
A) Obstructed delivery tubing
B) Patient’s ventilation increased
C) Clogged system diffuser
D) Wall outlet pressure too high
• Rationale: Whistling = back pressure, usually from tubing obstruction.
5. FEV₁ increased from 60% to 80% after bronchodilator use. This indicates:
A) Fixed airway obstruction
B) Reversible airway obstruction
C) Restrictive process
D) Normal diffusion capacity
• Rationale: A 20% improvement post-bronchodilator confirms reversibility (e.g., asthma).
, 4
6. Intubated patient is asynchronous with ventilator. Absent left breath sounds, dull percussion,
tracheal shift left. What’s likely?
A) Tracheoesophageal fistula
B) Left-sided tension pneumothorax
C) Right mainstem intubation
D) Diffuse bronchospasm
• Rationale: Right mainstem intubation often leads to absent left breath sounds.
7. Patient on pressure control A/C ventilation shows ↓ compliance. What happens?
A) Delivered volume will decrease
B) Peak pressure will rise
C) Inspiratory time increases
D) PEEP will drop
• Rationale: In pressure control, volume depends on compliance — ↓ compliance = ↓
volume.
TMC EXAM B (RESPIRATORY THERAPY ZONE) | 2025 UPDATED 160
COMPLETE QUESTIONS & ANSWERS | 100% RATED CORRECT &
GRADED A+ | 100% VERFIED
1. You are called to examine a dyspneic and hypotensive patient. You note:
Reduced chest expansion on the left
Hyperresonant percussion
Absent breath sounds
Tracheal shift to the right What
is the most likely diagnosis?
A) Pleural effusion on the left
B) Pneumothorax on the left
C) Atelectasis on the left
D) Consolidation on the left
• Rationale: All findings point to a left-sided pneumothorax with mediastinal shift.
, 2
2. A 39-year-old man has fever, chills, bilateral rhonchi, productive cough, and SpO₂ = 88%
(room air). What is the best course of action?
A) Intubate with 40% oxygen
B) Start noninvasive ventilation
C) Postural drainage with directed cough
D) Oxygen, antibiotics, and sputum for culture
• Rationale: Suspected pneumonia requires oxygen, C&S, and antibiotics — not intubation
yet.
3. A mechanically ventilated patient has a cuff pressure of 36 cm H₂O. What should you do?
A) Withdraw the tube
B) Reintubate with a smaller tube
C) Reduce cuff pressure to < 30 cm H₂O
D) Recommend tracheostomy
• Rationale: High cuff pressures can cause tracheal damage. Lower to 20–30 cm H₂O.
, 3
4. A bubble humidifier is making a whistling noise. What’s the likely cause?
A) Obstructed delivery tubing
B) Patient’s ventilation increased
C) Clogged system diffuser
D) Wall outlet pressure too high
• Rationale: Whistling = back pressure, usually from tubing obstruction.
5. FEV₁ increased from 60% to 80% after bronchodilator use. This indicates:
A) Fixed airway obstruction
B) Reversible airway obstruction
C) Restrictive process
D) Normal diffusion capacity
• Rationale: A 20% improvement post-bronchodilator confirms reversibility (e.g., asthma).
, 4
6. Intubated patient is asynchronous with ventilator. Absent left breath sounds, dull percussion,
tracheal shift left. What’s likely?
A) Tracheoesophageal fistula
B) Left-sided tension pneumothorax
C) Right mainstem intubation
D) Diffuse bronchospasm
• Rationale: Right mainstem intubation often leads to absent left breath sounds.
7. Patient on pressure control A/C ventilation shows ↓ compliance. What happens?
A) Delivered volume will decrease
B) Peak pressure will rise
C) Inspiratory time increases
D) PEEP will drop
• Rationale: In pressure control, volume depends on compliance — ↓ compliance = ↓
volume.
