KETTERING TMC EXAM PRACTICE:
COMPREHENSIVE RESPIRATORY
THERAPY BOARD EXAM
1. A 65-year-old male with COPD is receiving oxygen via a 28% Venturi mask. His ABG results
show: pH 7.36, PaCO2 62 mmHg, PaO2 54 mmHg, and HCO3 34 mEq/L. Which of the following
is the most appropriate action?
A. Increase the oxygen to 35% Venturi mask
B. Initiate Non-Invasive Positive Pressure Ventilation (NIPPV)
C. Intubate and initiate mechanical ventilation
D. Maintain current therapy
Answer: D
Conceptual Explanation: The ABG shows compensated respiratory acidosis with
moderate hypoxemia, which is typical for a chronic CO2 retainer. As long as the pH is in the
normal range (7.35-7.45), the patient is stable and current therapy should be maintained.
,2. While monitoring a patient on mechanical ventilation, the respiratory therapist notes the
peak inspiratory pressure (PIP) has increased from 25 to 40 cmH2O, while the plateau
pressure remains at 15 cmH2O. This indicates:
A. A decrease in lung compliance
B. An increase in airway resistance
C. Development of a pneumothorax
D. Pulmonary edema
Answer: B
Conceptual Explanation: An increase in PIP without a corresponding increase in plateau
pressure indicates an increase in transairway pressure, which is caused by increased
airway resistance (e.g., secretions, bronchospasm, or biting the tube).
3. A patient with a suspected narcotic overdose is brought to the ER. The patient is semi-
comatose and has a respiratory rate of 6 breaths/minute. Which of the following should the
therapist recommend first?
A. Manual ventilation with a bag-valve-mask
B. Perform a stat chest X-ray
C. Administer Albuterol via nebulizer
D. Draw an arterial blood gas
Answer: A
, Conceptual Explanation: Immediate airway management and ventilation are the
priorities for a patient with severe bradypnea and altered mental status. Manual ventilation
provides support until more definitive measures can be taken.
4. The therapist is performing a bedside assessment of a patient’s spontaneous breathing.
The patient has a spontaneous tidal volume of 400 mL and a respiratory rate of 25
breaths/min. What is the calculated Rapid Shallow Breathing Index (RSBI)?
A. 62.5
B. 16
C. 100
D. 0.06
Answer: A
Conceptual Explanation: RSBI = Frequency (f) / Tidal Volume (Vt in Liters). .4 =
62.5. An RSBI less than 105 is generally a good predictor of weaning success.
5. Which of the following drugs is a short-acting beta-agonist (SABA) indicated for the quick
relief of bronchospasm?
A. Salmeterol
B. Albuterol
C. Tiotropium
D. Fluticasone
COMPREHENSIVE RESPIRATORY
THERAPY BOARD EXAM
1. A 65-year-old male with COPD is receiving oxygen via a 28% Venturi mask. His ABG results
show: pH 7.36, PaCO2 62 mmHg, PaO2 54 mmHg, and HCO3 34 mEq/L. Which of the following
is the most appropriate action?
A. Increase the oxygen to 35% Venturi mask
B. Initiate Non-Invasive Positive Pressure Ventilation (NIPPV)
C. Intubate and initiate mechanical ventilation
D. Maintain current therapy
Answer: D
Conceptual Explanation: The ABG shows compensated respiratory acidosis with
moderate hypoxemia, which is typical for a chronic CO2 retainer. As long as the pH is in the
normal range (7.35-7.45), the patient is stable and current therapy should be maintained.
,2. While monitoring a patient on mechanical ventilation, the respiratory therapist notes the
peak inspiratory pressure (PIP) has increased from 25 to 40 cmH2O, while the plateau
pressure remains at 15 cmH2O. This indicates:
A. A decrease in lung compliance
B. An increase in airway resistance
C. Development of a pneumothorax
D. Pulmonary edema
Answer: B
Conceptual Explanation: An increase in PIP without a corresponding increase in plateau
pressure indicates an increase in transairway pressure, which is caused by increased
airway resistance (e.g., secretions, bronchospasm, or biting the tube).
3. A patient with a suspected narcotic overdose is brought to the ER. The patient is semi-
comatose and has a respiratory rate of 6 breaths/minute. Which of the following should the
therapist recommend first?
A. Manual ventilation with a bag-valve-mask
B. Perform a stat chest X-ray
C. Administer Albuterol via nebulizer
D. Draw an arterial blood gas
Answer: A
, Conceptual Explanation: Immediate airway management and ventilation are the
priorities for a patient with severe bradypnea and altered mental status. Manual ventilation
provides support until more definitive measures can be taken.
4. The therapist is performing a bedside assessment of a patient’s spontaneous breathing.
The patient has a spontaneous tidal volume of 400 mL and a respiratory rate of 25
breaths/min. What is the calculated Rapid Shallow Breathing Index (RSBI)?
A. 62.5
B. 16
C. 100
D. 0.06
Answer: A
Conceptual Explanation: RSBI = Frequency (f) / Tidal Volume (Vt in Liters). .4 =
62.5. An RSBI less than 105 is generally a good predictor of weaning success.
5. Which of the following drugs is a short-acting beta-agonist (SABA) indicated for the quick
relief of bronchospasm?
A. Salmeterol
B. Albuterol
C. Tiotropium
D. Fluticasone
