C&S TMC Exam 1 (Latest 2026) || Most Recent Exam 2026|2027
Actual Complete Real Exam Questions And Correct Answers
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A patient with COPD is receiving oxygen by nasal cannula at 2 L/min.
The patient becomes increasingly somnolent, and an ABG shows pH
7.25, PaCO₂ 68 mm Hg, and HCO₃⁻ 29 mEq/L. Which intervention is
most appropriate?
A. Increase the oxygen flow to 6 L/min
B. Initiate noninvasive positive-pressure ventilation
C. Discontinue oxygen therapy
D. Administer a loop diuretic
Answer: B. Initiate noninvasive positive-pressure ventilation
Rationale: The patient has acute-on-chronic respiratory acidosis with
hypercapnia and altered mental status. Noninvasive ventilation can
improve alveolar ventilation and reduce PaCO₂ when the patient can
protect the airway.
A mechanically ventilated patient has a sudden increase in peak
inspiratory pressure while the plateau pressure remains unchanged.
Which condition is most likely?
A. Increased airway resistance
B. Decreased lung compliance
C. Pulmonary edema
D. Pneumothorax
,Answer: A. Increased airway resistance
Rationale: A rise in peak pressure with an unchanged plateau pressure
indicates increased resistive pressure. Common causes include
bronchospasm, secretions, or a kinked endotracheal tube.
A patient receiving volume-controlled ventilation has a PaCO₂ of 55
mm Hg. Which ventilator adjustment would most directly reduce the
PaCO₂?
A. Decrease PEEP
B. Increase FiO₂
C. Increase minute ventilation
D. Decrease inspiratory flow
Answer: C. Increase minute ventilation
Rationale: PaCO₂ is primarily controlled by alveolar ventilation.
Increasing respiratory rate or tidal volume, within safe limits, increases
minute ventilation and generally lowers PaCO₂.
A patient with severe asthma has markedly diminished breath sounds,
increasing fatigue, and a PaCO₂ that has risen from 32 to 48 mm Hg.
What does this change most strongly suggest?
A. Resolution of bronchospasm
B. Improved alveolar ventilation
C. Mild respiratory alkalosis
D. Impending respiratory failure
,Answer: D. Impending respiratory failure
Rationale: A patient with severe asthma commonly has a low PaCO₂
initially because of tachypnea. A normalizing or rising PaCO₂ in a
fatigued patient can indicate worsening ventilatory failure.
Which measurement is most useful for assessing the patient's ability to
generate an effective cough before extubation?
A. Vital capacity
B. Maximum inspiratory pressure
C. Peak expiratory flow
D. PaO₂
Answer: A. Vital capacity
Rationale: Vital capacity provides information about the patient's
ability to generate adequate inspiratory volume and contribute to an
effective cough. It is one component of assessing readiness for
liberation from mechanical ventilation.
A ventilated patient's SpO₂ suddenly falls from 96% to 82%, and the
high-pressure alarm activates. What should the respiratory therapist
do first?
A. Increase the FiO₂
B. Assess the patient and the ventilator circuit immediately
C. Decrease the respiratory rate
D. Administer a sedative
, Answer: B. Assess the patient and the ventilator circuit immediately
Rationale: A sudden desaturation with a high-pressure alarm may
result from secretions, tube obstruction, bronchospasm,
pneumothorax, or circuit problems. Immediate patient and equipment
assessment is the priority.
Which ABG pattern is consistent with acute respiratory alkalosis?
A. pH 7.28, PaCO₂ 55 mm Hg, HCO₃⁻ 25 mEq/L
B. pH 7.50, PaCO₂ 30 mm Hg, HCO₃⁻ 24 mEq/L
C. pH 7.30, PaCO₂ 30 mm Hg, HCO₃⁻ 15 mEq/L
D. pH 7.48, PaCO₂ 48 mm Hg, HCO₃⁻ 34 mEq/L
Answer: B. pH 7.50, PaCO₂ 30 mm Hg, HCO₃⁻ 24 mEq/L
Rationale: Respiratory alkalosis is characterized by an elevated pH
caused by a reduced PaCO₂. In an acute process, bicarbonate may
remain near normal.
A patient with pulmonary edema has severe dyspnea and diffuse
crackles. Which therapy can improve oxygenation by increasing
functional residual capacity and recruiting alveoli?
A. Continuous positive airway pressure
B. Incentive spirometry alone
C. Low-flow nasal oxygen only
D. Chest percussion alone
Actual Complete Real Exam Questions And Correct Answers
(Verified Answers) Already Graded A+ | Guaranteed Success!
Newest Exam | Just Released!!
A patient with COPD is receiving oxygen by nasal cannula at 2 L/min.
The patient becomes increasingly somnolent, and an ABG shows pH
7.25, PaCO₂ 68 mm Hg, and HCO₃⁻ 29 mEq/L. Which intervention is
most appropriate?
A. Increase the oxygen flow to 6 L/min
B. Initiate noninvasive positive-pressure ventilation
C. Discontinue oxygen therapy
D. Administer a loop diuretic
Answer: B. Initiate noninvasive positive-pressure ventilation
Rationale: The patient has acute-on-chronic respiratory acidosis with
hypercapnia and altered mental status. Noninvasive ventilation can
improve alveolar ventilation and reduce PaCO₂ when the patient can
protect the airway.
A mechanically ventilated patient has a sudden increase in peak
inspiratory pressure while the plateau pressure remains unchanged.
Which condition is most likely?
A. Increased airway resistance
B. Decreased lung compliance
C. Pulmonary edema
D. Pneumothorax
,Answer: A. Increased airway resistance
Rationale: A rise in peak pressure with an unchanged plateau pressure
indicates increased resistive pressure. Common causes include
bronchospasm, secretions, or a kinked endotracheal tube.
A patient receiving volume-controlled ventilation has a PaCO₂ of 55
mm Hg. Which ventilator adjustment would most directly reduce the
PaCO₂?
A. Decrease PEEP
B. Increase FiO₂
C. Increase minute ventilation
D. Decrease inspiratory flow
Answer: C. Increase minute ventilation
Rationale: PaCO₂ is primarily controlled by alveolar ventilation.
Increasing respiratory rate or tidal volume, within safe limits, increases
minute ventilation and generally lowers PaCO₂.
A patient with severe asthma has markedly diminished breath sounds,
increasing fatigue, and a PaCO₂ that has risen from 32 to 48 mm Hg.
What does this change most strongly suggest?
A. Resolution of bronchospasm
B. Improved alveolar ventilation
C. Mild respiratory alkalosis
D. Impending respiratory failure
,Answer: D. Impending respiratory failure
Rationale: A patient with severe asthma commonly has a low PaCO₂
initially because of tachypnea. A normalizing or rising PaCO₂ in a
fatigued patient can indicate worsening ventilatory failure.
Which measurement is most useful for assessing the patient's ability to
generate an effective cough before extubation?
A. Vital capacity
B. Maximum inspiratory pressure
C. Peak expiratory flow
D. PaO₂
Answer: A. Vital capacity
Rationale: Vital capacity provides information about the patient's
ability to generate adequate inspiratory volume and contribute to an
effective cough. It is one component of assessing readiness for
liberation from mechanical ventilation.
A ventilated patient's SpO₂ suddenly falls from 96% to 82%, and the
high-pressure alarm activates. What should the respiratory therapist
do first?
A. Increase the FiO₂
B. Assess the patient and the ventilator circuit immediately
C. Decrease the respiratory rate
D. Administer a sedative
, Answer: B. Assess the patient and the ventilator circuit immediately
Rationale: A sudden desaturation with a high-pressure alarm may
result from secretions, tube obstruction, bronchospasm,
pneumothorax, or circuit problems. Immediate patient and equipment
assessment is the priority.
Which ABG pattern is consistent with acute respiratory alkalosis?
A. pH 7.28, PaCO₂ 55 mm Hg, HCO₃⁻ 25 mEq/L
B. pH 7.50, PaCO₂ 30 mm Hg, HCO₃⁻ 24 mEq/L
C. pH 7.30, PaCO₂ 30 mm Hg, HCO₃⁻ 15 mEq/L
D. pH 7.48, PaCO₂ 48 mm Hg, HCO₃⁻ 34 mEq/L
Answer: B. pH 7.50, PaCO₂ 30 mm Hg, HCO₃⁻ 24 mEq/L
Rationale: Respiratory alkalosis is characterized by an elevated pH
caused by a reduced PaCO₂. In an acute process, bicarbonate may
remain near normal.
A patient with pulmonary edema has severe dyspnea and diffuse
crackles. Which therapy can improve oxygenation by increasing
functional residual capacity and recruiting alveoli?
A. Continuous positive airway pressure
B. Incentive spirometry alone
C. Low-flow nasal oxygen only
D. Chest percussion alone
