RESPIRATORY THERAPIST TMC
BOARD EXAM REVIEW QUESTIONS
AND ANSWERS
1. A 65-year-old male with a history of COPD presents to the ED with increased dyspnea. His
ABG on room air shows: pH 7.28, PaCO2 68 mmHg, PaO2 52 mmHg, HCO3 32 mEq/L. Which of
the following describes this acid-base status?
A. Chronic respiratory acidosis with acute exacerbation
B. Partially compensated metabolic alkalosis
C. Acute respiratory acidosis
D. Compensated respiratory alkalosis
Answer: A
Conceptual Explanation: The pH is acidic, PaCO2 is high (respiratory acidosis), and the
HCO3 is elevated, suggesting chronic compensation. However, the pH is still significantly
below 7.35, indicating an acute worsening of the chronic condition.
,2. Calculate the Static Compliance (Cstat) for a patient with the following ventilator settings:
Vt 500 mL, PIP 35 cmH2O, Pplat 25 cmH2O, PEEP 5 cmH2O.
A. 25 mL/cmH2O
B. 20 mL/cmH2O
C. 14 mL/cmH2O
D. 50 mL/cmH2O
Answer: A
Conceptual Explanation: Static Compliance = Vt / (Pplat - PEEP). 500 / (25 - 5) =
= 25 mL/cmH2O.
3. A patient in the ICU has a Swan-Ganz catheter in place. The following values are obtained:
CVP 12 mmHg, PAP 45/25 mmHg, PCWP 22 mmHg, CI 1.8 L/min/m2. These findings are most
consistent with:
A. Left heart failure
B. Septic shock
C. Hypovolemic shock
D. Pulmonary embolism
Answer: A
, Conceptual Explanation: Elevated PCWP (>18 mmHg) and low Cardiac Index (CI) suggest
cardiogenic shock or left-sided heart failure. CVP and PAP are also elevated due to back-
pressure.
4. What is the correct treatment for a patient displaying a ‘shark-fin’ appearance on the
capnography waveform?
A. Increase PEEP
B. Check for a circuit leak
C. Administer a bronchodilator
D. Decrease the respiratory rate
Answer: C
Conceptual Explanation: A ‘shark-fin’ waveform indicates obstructive outflow or
bronchospasm. Bronchodilators are indicated to resolve the airway obstruction.
5. Calculate the Alveolar-Oxygen Tension (PAO2) for a patient breathing 40% oxygen at sea
level with a PaCO2 of 40 mmHg. (Assume R = 0.8)
A. 235 mmHg
B. 100 mmHg
C. 285 mmHg
D. 315 mmHg
Answer: A
BOARD EXAM REVIEW QUESTIONS
AND ANSWERS
1. A 65-year-old male with a history of COPD presents to the ED with increased dyspnea. His
ABG on room air shows: pH 7.28, PaCO2 68 mmHg, PaO2 52 mmHg, HCO3 32 mEq/L. Which of
the following describes this acid-base status?
A. Chronic respiratory acidosis with acute exacerbation
B. Partially compensated metabolic alkalosis
C. Acute respiratory acidosis
D. Compensated respiratory alkalosis
Answer: A
Conceptual Explanation: The pH is acidic, PaCO2 is high (respiratory acidosis), and the
HCO3 is elevated, suggesting chronic compensation. However, the pH is still significantly
below 7.35, indicating an acute worsening of the chronic condition.
,2. Calculate the Static Compliance (Cstat) for a patient with the following ventilator settings:
Vt 500 mL, PIP 35 cmH2O, Pplat 25 cmH2O, PEEP 5 cmH2O.
A. 25 mL/cmH2O
B. 20 mL/cmH2O
C. 14 mL/cmH2O
D. 50 mL/cmH2O
Answer: A
Conceptual Explanation: Static Compliance = Vt / (Pplat - PEEP). 500 / (25 - 5) =
= 25 mL/cmH2O.
3. A patient in the ICU has a Swan-Ganz catheter in place. The following values are obtained:
CVP 12 mmHg, PAP 45/25 mmHg, PCWP 22 mmHg, CI 1.8 L/min/m2. These findings are most
consistent with:
A. Left heart failure
B. Septic shock
C. Hypovolemic shock
D. Pulmonary embolism
Answer: A
, Conceptual Explanation: Elevated PCWP (>18 mmHg) and low Cardiac Index (CI) suggest
cardiogenic shock or left-sided heart failure. CVP and PAP are also elevated due to back-
pressure.
4. What is the correct treatment for a patient displaying a ‘shark-fin’ appearance on the
capnography waveform?
A. Increase PEEP
B. Check for a circuit leak
C. Administer a bronchodilator
D. Decrease the respiratory rate
Answer: C
Conceptual Explanation: A ‘shark-fin’ waveform indicates obstructive outflow or
bronchospasm. Bronchodilators are indicated to resolve the airway obstruction.
5. Calculate the Alveolar-Oxygen Tension (PAO2) for a patient breathing 40% oxygen at sea
level with a PaCO2 of 40 mmHg. (Assume R = 0.8)
A. 235 mmHg
B. 100 mmHg
C. 285 mmHg
D. 315 mmHg
Answer: A
