RESPIRATORY THERAPY – TMC
PRACTICE EXAMINATION
QUESTIONS WITH CORRECT
ANSWERS PLUS RATIONALES
2026/2027 EDITION WITH INSTANT
PDF DOWNLOAD
1.
A patient with acute respiratory distress has a respiratory rate of
34/min, shallow respirations, and an oxygen saturation of 88% on
room air. Which assessment finding most strongly indicates
increased work of breathing?
A. Respiratory rate of 18/min
B. Use of accessory muscles
C. Heart rate of 72/min
D. Warm, dry skin
Rationale: Use of the sternocleidomastoid, scalene, and
intercostal muscles indicates that the patient is recruiting
additional muscles to increase ventilation. This is a classic
sign of increased work of breathing and respiratory distress.
2.
,Which arterial blood gas (ABG) pattern is most consistent with
acute respiratory acidosis?
A. pH 7.48, PaCO₂ 30 mmHg, HCO₃⁻ 22 mEq/L
B. pH 7.50, PaCO₂ 48 mmHg, HCO₃⁻ 35 mEq/L
C. pH 7.28, PaCO₂ 58 mmHg, HCO₃⁻ 25 mEq/L
D. pH 7.30, PaCO₂ 30 mmHg, HCO₃⁻ 15 mEq/L
Rationale: Respiratory acidosis is characterized by a
decreased pH and elevated PaCO₂. In an acute process,
bicarbonate has not had sufficient time to increase
substantially, making a near-normal HCO₃⁻ expected.
3.
A patient with COPD has a chronic PaCO₂ of 55 mmHg. Which
renal response is expected with chronic respiratory acidosis?
A. Decreased bicarbonate retention
B. Increased bicarbonate excretion
C. Increased renal bicarbonate retention
D. Increased hydrogen ion excretion into the blood
Rationale: Chronic respiratory acidosis causes the kidneys to
compensate by retaining bicarbonate and increasing
hydrogen ion excretion. This helps move the pH toward the
normal range.
4.
Which oxygen-delivery device provides the most precise and
consistent FiO₂ for a spontaneously breathing patient?
,A. Nasal cannula
B. Simple oxygen mask
C. Nonrebreather mask
D. Air-entrainment mask
Rationale: An air-entrainment mask uses the Venturi principle
to deliver a controlled oxygen concentration by entraining a
predictable amount of room air. It is particularly useful when
precise FiO₂ control is needed.
5.
A patient receiving oxygen through a nasal cannula develops
increasing somnolence and a rising PaCO₂. Which condition
should the respiratory therapist suspect?
A. Metabolic alkalosis
B. Oxygen-induced hypoventilation in a susceptible patient
C. Respiratory alkalosis
D. Increased alveolar ventilation
Rationale: Some patients with severe chronic obstructive lung
disease may experience worsening hypercapnia after
excessive oxygen administration. Oxygen should be carefully
titrated while monitoring oxygenation and ventilation.
6.
Which pulmonary function measurement represents the
maximum amount of air that can be exhaled after a maximal
inspiration?
, A. Functional residual capacity
B. Residual volume
C. Inspiratory reserve volume
D. Vital capacity
Rationale: Vital capacity is the maximum volume exhaled
following a maximal inspiration. It consists of tidal volume,
inspiratory reserve volume, and expiratory reserve volume.
7.
A patient has a decreased FEV₁/FVC ratio. This finding is most
characteristic of:
A. Restrictive lung disease
B. Normal pulmonary function
C. Obstructive lung disease
D. Neuromuscular weakness only
Rationale: Obstructive diseases increase resistance to
expiratory airflow, producing a disproportionately reduced
FEV₁ and therefore a decreased FEV₁/FVC ratio.
8.
Which spirometry pattern is most consistent with restrictive
disease?
A. Low FEV₁, normal FVC, reduced FEV₁/FVC
B. Reduced FEV₁ and FVC with a normal or increased FEV₁/FVC
C. Increased FEV₁ and decreased FVC
D. Increased residual volume with a markedly decreased
FEV₁/FVC
PRACTICE EXAMINATION
QUESTIONS WITH CORRECT
ANSWERS PLUS RATIONALES
2026/2027 EDITION WITH INSTANT
PDF DOWNLOAD
1.
A patient with acute respiratory distress has a respiratory rate of
34/min, shallow respirations, and an oxygen saturation of 88% on
room air. Which assessment finding most strongly indicates
increased work of breathing?
A. Respiratory rate of 18/min
B. Use of accessory muscles
C. Heart rate of 72/min
D. Warm, dry skin
Rationale: Use of the sternocleidomastoid, scalene, and
intercostal muscles indicates that the patient is recruiting
additional muscles to increase ventilation. This is a classic
sign of increased work of breathing and respiratory distress.
2.
,Which arterial blood gas (ABG) pattern is most consistent with
acute respiratory acidosis?
A. pH 7.48, PaCO₂ 30 mmHg, HCO₃⁻ 22 mEq/L
B. pH 7.50, PaCO₂ 48 mmHg, HCO₃⁻ 35 mEq/L
C. pH 7.28, PaCO₂ 58 mmHg, HCO₃⁻ 25 mEq/L
D. pH 7.30, PaCO₂ 30 mmHg, HCO₃⁻ 15 mEq/L
Rationale: Respiratory acidosis is characterized by a
decreased pH and elevated PaCO₂. In an acute process,
bicarbonate has not had sufficient time to increase
substantially, making a near-normal HCO₃⁻ expected.
3.
A patient with COPD has a chronic PaCO₂ of 55 mmHg. Which
renal response is expected with chronic respiratory acidosis?
A. Decreased bicarbonate retention
B. Increased bicarbonate excretion
C. Increased renal bicarbonate retention
D. Increased hydrogen ion excretion into the blood
Rationale: Chronic respiratory acidosis causes the kidneys to
compensate by retaining bicarbonate and increasing
hydrogen ion excretion. This helps move the pH toward the
normal range.
4.
Which oxygen-delivery device provides the most precise and
consistent FiO₂ for a spontaneously breathing patient?
,A. Nasal cannula
B. Simple oxygen mask
C. Nonrebreather mask
D. Air-entrainment mask
Rationale: An air-entrainment mask uses the Venturi principle
to deliver a controlled oxygen concentration by entraining a
predictable amount of room air. It is particularly useful when
precise FiO₂ control is needed.
5.
A patient receiving oxygen through a nasal cannula develops
increasing somnolence and a rising PaCO₂. Which condition
should the respiratory therapist suspect?
A. Metabolic alkalosis
B. Oxygen-induced hypoventilation in a susceptible patient
C. Respiratory alkalosis
D. Increased alveolar ventilation
Rationale: Some patients with severe chronic obstructive lung
disease may experience worsening hypercapnia after
excessive oxygen administration. Oxygen should be carefully
titrated while monitoring oxygenation and ventilation.
6.
Which pulmonary function measurement represents the
maximum amount of air that can be exhaled after a maximal
inspiration?
, A. Functional residual capacity
B. Residual volume
C. Inspiratory reserve volume
D. Vital capacity
Rationale: Vital capacity is the maximum volume exhaled
following a maximal inspiration. It consists of tidal volume,
inspiratory reserve volume, and expiratory reserve volume.
7.
A patient has a decreased FEV₁/FVC ratio. This finding is most
characteristic of:
A. Restrictive lung disease
B. Normal pulmonary function
C. Obstructive lung disease
D. Neuromuscular weakness only
Rationale: Obstructive diseases increase resistance to
expiratory airflow, producing a disproportionately reduced
FEV₁ and therefore a decreased FEV₁/FVC ratio.
8.
Which spirometry pattern is most consistent with restrictive
disease?
A. Low FEV₁, normal FVC, reduced FEV₁/FVC
B. Reduced FEV₁ and FVC with a normal or increased FEV₁/FVC
C. Increased FEV₁ and decreased FVC
D. Increased residual volume with a markedly decreased
FEV₁/FVC
