ACTUAL TMC EXAM REVIEW
QUESTIONS AND ANSWERS 2026/2027
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. go get help
B. administer oxygen by non-rebreathing mask
C. auscultate breath sounds
D. begin mouth-to-mouth resuscitation - ANSWER-D. 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 reveal
pH 7.49
PaCO2 32 mmHg
PaO2 109 mmHg
HCO3- 24 mEq/L
BE 0 mEq/L
The respiratory therapist should
A. increase mandatory rate
B. decrease PEEP
C. decrease FIO2
D. decrease mandatory rate - ANSWER-B. decrease PEEP
Prior to the removal of chest tubes, which of the following should be done?
A. the chest tube should be exposed to normal atmospheric pressure
B. suction pressure should be increased temporarily
C. flush the chest tube with normal saline
D. clamp the chest tube for 24 hours - ANSWER-D. clamp the chest tube for 24 hours
,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. record and MEP of -28 cmH2O
B. record an MEP of 36 cmH2O
C. record an MEP of 28 cmH2O
D. report the problem to the medical director - ANSWER-B. record an MEP of 36
cmH2O
Which of the following is a strategy that may help reduce or prevent autoPEEP in a
patient with ARDS?
A. sedation of the patient
B. increasing minute ventilation
C. high flow rates
D. matching PEEP - ANSWER-C. high flow rates
Which of the following is the most significant complication of bronchoscopy?
A. coughing
B. vagal nerve stimulation
C. laryngospasms
D. hypotension - ANSWER-C. laryngospasms
A Bronchogram would be most helpful in evaluating and diagnosing which of the
following?
A. chronic bronchitis
B. bronchiectasis
C. ARDS
D. mycoplasma pneumonia - ANSWER-B. bronchiectasis
An infant who is 35 weeks of gestation requires supplemental oxygen at 40%. Which of
the following modalities is most appropriate?
A. nasal CPAP mask
B. nasal cannula at 2 L/min
C. croup tent
D. oxygen hood with an air/oxygen blender - ANSWER-D. oxygen hood with an
air/oxygen blender
A patient has the following input/output history and other clinical information:
, Yesterday Today
IN 1900 cc 1600 cc
OUT 2200 cc 1900 cc
C.O. 5.1 L/min 3.8 L/min
BP 110/80 mm Hg 110/80 mm Hg
CVP 5 mm Hg 5 mm Hg
These data would result in which of the following?
A. increase in PCWP
B. increase in PAP
C. decrease in PVR
D. increase in SVR - ANSWER-D. increase in SVR
This question is tricky. The first observation one must make is that the patient is putting
out more fluid than he is taking in. This will result in dehydration and a decrease in all
hemodynamic values including cardiac output. If cardiac output is decreased, systemic
vascular resistance will increase. One must know the formula for systemic vascular
resistance in order to understand this. Systemic vascular resistance is determined by
subtracting CVP from MAP and dividing it by cardiac output. If cardiac output is
decreased then the final SVR number will increase.
Which of the following would result in an increase in pulmonary capillary wedge
pressure?
A. decrease in pulmonary vascular resistance (PVR)
B. mitral valve stenosis
C. dehydration
D. cor pulmonale - ANSWER-B. mitral valve stenosis
During a difficult intubation, the emergency room physician requests an endotracheal
tube that is smaller than recommended for the patient's height and ideal body weight.
As a result, the respiratory therapist should anticipate
A. a decrease in static compliance
B. increase in PAW
C. an increase in RAW
D. increased I:E ratio - ANSWER-C. an increase in RAW
The results of a V/Q scan shows poor perfusion with adequate ventilation. A chest
radiograph shows a wedge-shaped infiltrate over the right lung field. The patient most
likely has
A. a pulmonary embolism
B. ARDS
QUESTIONS AND ANSWERS 2026/2027
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. go get help
B. administer oxygen by non-rebreathing mask
C. auscultate breath sounds
D. begin mouth-to-mouth resuscitation - ANSWER-D. 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 reveal
pH 7.49
PaCO2 32 mmHg
PaO2 109 mmHg
HCO3- 24 mEq/L
BE 0 mEq/L
The respiratory therapist should
A. increase mandatory rate
B. decrease PEEP
C. decrease FIO2
D. decrease mandatory rate - ANSWER-B. decrease PEEP
Prior to the removal of chest tubes, which of the following should be done?
A. the chest tube should be exposed to normal atmospheric pressure
B. suction pressure should be increased temporarily
C. flush the chest tube with normal saline
D. clamp the chest tube for 24 hours - ANSWER-D. clamp the chest tube for 24 hours
,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. record and MEP of -28 cmH2O
B. record an MEP of 36 cmH2O
C. record an MEP of 28 cmH2O
D. report the problem to the medical director - ANSWER-B. record an MEP of 36
cmH2O
Which of the following is a strategy that may help reduce or prevent autoPEEP in a
patient with ARDS?
A. sedation of the patient
B. increasing minute ventilation
C. high flow rates
D. matching PEEP - ANSWER-C. high flow rates
Which of the following is the most significant complication of bronchoscopy?
A. coughing
B. vagal nerve stimulation
C. laryngospasms
D. hypotension - ANSWER-C. laryngospasms
A Bronchogram would be most helpful in evaluating and diagnosing which of the
following?
A. chronic bronchitis
B. bronchiectasis
C. ARDS
D. mycoplasma pneumonia - ANSWER-B. bronchiectasis
An infant who is 35 weeks of gestation requires supplemental oxygen at 40%. Which of
the following modalities is most appropriate?
A. nasal CPAP mask
B. nasal cannula at 2 L/min
C. croup tent
D. oxygen hood with an air/oxygen blender - ANSWER-D. oxygen hood with an
air/oxygen blender
A patient has the following input/output history and other clinical information:
, Yesterday Today
IN 1900 cc 1600 cc
OUT 2200 cc 1900 cc
C.O. 5.1 L/min 3.8 L/min
BP 110/80 mm Hg 110/80 mm Hg
CVP 5 mm Hg 5 mm Hg
These data would result in which of the following?
A. increase in PCWP
B. increase in PAP
C. decrease in PVR
D. increase in SVR - ANSWER-D. increase in SVR
This question is tricky. The first observation one must make is that the patient is putting
out more fluid than he is taking in. This will result in dehydration and a decrease in all
hemodynamic values including cardiac output. If cardiac output is decreased, systemic
vascular resistance will increase. One must know the formula for systemic vascular
resistance in order to understand this. Systemic vascular resistance is determined by
subtracting CVP from MAP and dividing it by cardiac output. If cardiac output is
decreased then the final SVR number will increase.
Which of the following would result in an increase in pulmonary capillary wedge
pressure?
A. decrease in pulmonary vascular resistance (PVR)
B. mitral valve stenosis
C. dehydration
D. cor pulmonale - ANSWER-B. mitral valve stenosis
During a difficult intubation, the emergency room physician requests an endotracheal
tube that is smaller than recommended for the patient's height and ideal body weight.
As a result, the respiratory therapist should anticipate
A. a decrease in static compliance
B. increase in PAW
C. an increase in RAW
D. increased I:E ratio - ANSWER-C. an increase in RAW
The results of a V/Q scan shows poor perfusion with adequate ventilation. A chest
radiograph shows a wedge-shaped infiltrate over the right lung field. The patient most
likely has
A. a pulmonary embolism
B. ARDS
