TMC Practice Exam
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1. A 48 year-old female is admitted to the ED with di- Heart failure
aphoresis, jugular venous distension, and 3+ pitting
edema in the ankles. These findings are consistent
with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances
2. A patient is admitted to the ED following a motor Needle aspirate the 2nd
vehicle accident. On physical exam, the respiratory left intercostal space.
therapist discovers that breath sounds are absent in
the left chest with a hyperresonant percussion note.
The trachea is shifted to the right. The patient's heart
rate is 45/min, respiratory rate is 30/min, and blood
pressure is 60/40 mm Hg. What action should the
therapist recommend first?
A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate
the patient.
3. All of the following strategies are likely to decrease the monitoring intracuff pres-
likelihood of damage to the tracheal mucosa EXCEPT sures.
A. maintaining cuff pressures between 20 and 25 mm
Hg.
, TMC Practice Exam
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B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures.
4. A 52 year-old post-operative cholecystectomy pa- deep breathing and
tient's breath sounds become more coarse upon com- coughing to clear secre-
pletion of postural drainage with percussion. The res- tions.
piratory therapist should recommend
A. continuing the therapy until breath sounds im-
prove.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear secretions.
5. A 65 kg spinal cord injured patient has developed IPPB with normal saline
atelectasis. His inspiratory capacity is 30% of his pre-
dicted value. What bronchial hygiene therapy would
be most appropriate initially?
A. IS / SMI
B. IPPB with normal saline
C. postural drainage and percussion
D. PEP therapy
6. A patient on VC ventilation has demonstrated 1, 2, and 3 only
auto-PEEP on ventilator graphics. Which of the fol-
lowing controls, when adjusted independently, would
increase expiratory time?
1. Tidal volume
, TMC Practice Exam
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2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity
7. Which of the following would be the most appropri- Insert a chest tube
ate therapy for a dyspneic patient who has crepitus
with tracheal deviation to the left and absent breath
sounds on the right?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube
8. A 55 year-old post cardiac surgery patient has the 5.0 vol%
following ABG results: pH 7.50, PaCO2 30 torr, PaO2
62 torr, HCO3 25 mEq/L, SaO2 92%, HB 14 g/dL, BE +2.
Venous blood gas results are pH 7.39, PvCO2 43 torr,
PvO2 37 torr, and SvO2 66%. Calculate the patient's
C(a-v)O2.
A. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
D. 5.5 vol%
9. A patient on VC, SIMV with a VT of 500 mL has a PIP 50 mL/cm H2O
of 25 cm H2O, Pplat of 15 cm H2O and PEEP of 5 cm
H2O. What is the patient's static lung compliance
A. 25 mL/cm H2O
, TMC Practice Exam
Study online at https://quizlet.com/_71o322
B. 35 mL/cm H2O
C. 45 mL/cm H2O
D. 50 mL/cm H2O
10. Immediately after extubation of a patient in the ICU, reintubation
the respiratory therapist observes increasing respira-
tory distress with intercostal retractions and marked
stridor. The SpO2 on 40% oxygen is noted to be 86%.
Which of the following would be most appropriate at
this time?
A. cool mist aerosol treatment
B. aerosolized racemic epinephrine
C. manual ventilation with resuscitation bag and
mask
D. reintubation
11. Which of the following patients would most likely ben- A patient on SIMV with a
efit from pressure support ventilation? set rate of 12/min and to-
tal rate of 24/min.
A. An intubated patient with an absent respiratory
drive.
B. A patient on SIMV with a set rate of 12/min and total
rate of 24/min.
C. A patient with acute lung injury.
D. A patient who requires short-term post-operative
ventilatory support.
12. A patient receiving mechanical ventilation has devel- Obtain a sputum gram
oped a temperature of 99.9° F with purulent secre- stain.
tions over the last 12 hours. The respiratory therapist
has also noted a steady increase in peak inspirato-
Study online at https://quizlet.com/_71o322
1. A 48 year-old female is admitted to the ED with di- Heart failure
aphoresis, jugular venous distension, and 3+ pitting
edema in the ankles. These findings are consistent
with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances
2. A patient is admitted to the ED following a motor Needle aspirate the 2nd
vehicle accident. On physical exam, the respiratory left intercostal space.
therapist discovers that breath sounds are absent in
the left chest with a hyperresonant percussion note.
The trachea is shifted to the right. The patient's heart
rate is 45/min, respiratory rate is 30/min, and blood
pressure is 60/40 mm Hg. What action should the
therapist recommend first?
A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate
the patient.
3. All of the following strategies are likely to decrease the monitoring intracuff pres-
likelihood of damage to the tracheal mucosa EXCEPT sures.
A. maintaining cuff pressures between 20 and 25 mm
Hg.
, TMC Practice Exam
Study online at https://quizlet.com/_71o322
B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures.
4. A 52 year-old post-operative cholecystectomy pa- deep breathing and
tient's breath sounds become more coarse upon com- coughing to clear secre-
pletion of postural drainage with percussion. The res- tions.
piratory therapist should recommend
A. continuing the therapy until breath sounds im-
prove.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear secretions.
5. A 65 kg spinal cord injured patient has developed IPPB with normal saline
atelectasis. His inspiratory capacity is 30% of his pre-
dicted value. What bronchial hygiene therapy would
be most appropriate initially?
A. IS / SMI
B. IPPB with normal saline
C. postural drainage and percussion
D. PEP therapy
6. A patient on VC ventilation has demonstrated 1, 2, and 3 only
auto-PEEP on ventilator graphics. Which of the fol-
lowing controls, when adjusted independently, would
increase expiratory time?
1. Tidal volume
, TMC Practice Exam
Study online at https://quizlet.com/_71o322
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity
7. Which of the following would be the most appropri- Insert a chest tube
ate therapy for a dyspneic patient who has crepitus
with tracheal deviation to the left and absent breath
sounds on the right?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube
8. A 55 year-old post cardiac surgery patient has the 5.0 vol%
following ABG results: pH 7.50, PaCO2 30 torr, PaO2
62 torr, HCO3 25 mEq/L, SaO2 92%, HB 14 g/dL, BE +2.
Venous blood gas results are pH 7.39, PvCO2 43 torr,
PvO2 37 torr, and SvO2 66%. Calculate the patient's
C(a-v)O2.
A. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
D. 5.5 vol%
9. A patient on VC, SIMV with a VT of 500 mL has a PIP 50 mL/cm H2O
of 25 cm H2O, Pplat of 15 cm H2O and PEEP of 5 cm
H2O. What is the patient's static lung compliance
A. 25 mL/cm H2O
, TMC Practice Exam
Study online at https://quizlet.com/_71o322
B. 35 mL/cm H2O
C. 45 mL/cm H2O
D. 50 mL/cm H2O
10. Immediately after extubation of a patient in the ICU, reintubation
the respiratory therapist observes increasing respira-
tory distress with intercostal retractions and marked
stridor. The SpO2 on 40% oxygen is noted to be 86%.
Which of the following would be most appropriate at
this time?
A. cool mist aerosol treatment
B. aerosolized racemic epinephrine
C. manual ventilation with resuscitation bag and
mask
D. reintubation
11. Which of the following patients would most likely ben- A patient on SIMV with a
efit from pressure support ventilation? set rate of 12/min and to-
tal rate of 24/min.
A. An intubated patient with an absent respiratory
drive.
B. A patient on SIMV with a set rate of 12/min and total
rate of 24/min.
C. A patient with acute lung injury.
D. A patient who requires short-term post-operative
ventilatory support.
12. A patient receiving mechanical ventilation has devel- Obtain a sputum gram
oped a temperature of 99.9° F with purulent secre- stain.
tions over the last 12 hours. The respiratory therapist
has also noted a steady increase in peak inspirato-
