TMC Exam (Latest 2022/2023) Verified Answers by Expert

TMC Exam A 13 year -old patient in the ED is complaining of dyspnea, chest tightness, and a loose productive cough. The patient has a respiratory rate of 28 breaths/minute and bilateral wheezing in the lungs. What treatment should the respiratory therapist initiate? A. levalbuterol B. oxygen C. salmeterol D. PEP - THE CORRECT ASNWER IS oxygen A 16 year -old patient with cystic fibrosis attends public high school. Which of the following bronchial hygiene therapies would be most appropriate for this patient? A. intra pulmonary percussive ventilation B. dornase alpha therapy C. vibratory / oscillatory PEP D. postural drainage and manual percussion - THE CORRECT ASNWER IS vibratory / oscillatory PEP A 19-year-old patient is brought to the emergency department after taki ng a handful of pills. The patient is obtunded but is making regular, sonorous respiratory efforts. Auscultation reveals coarse rhonchi bilaterally. Which of the following should be done FIRST to assess this patient? A. Obtain a sputum specimen. B. Obtain an ABG. C. Measure peak expiratory flow. D. Determine the Glasgow Coma Score. - THE CORRECT ASNWER IS Obtain an ABG. A 28 year -old female has just been admitted through the ED with suspected CO poisoning. She is receiving oxygen by non -rebreather mask at 10 L/min. Upon entering the patient's room, the respiratory therapist notes that the reservoir bag of the mask collapses during inspiration. This is most likely the result of A. faulty one -way valves. B. tight seal between the mask and the patient's face . C. presence of a bubble humidifier. D. insufficient flow to the reservoir bag. - THE CORRECT ASNWER IS insufficient flow to the reservoir bag. A 30 year old male with bronchitis has coarse bilateral rales with a SpO2 of 90%. Despite a good cough effort, he has great difficulty in removing his thick secretions. The respiratory therapist should initiate A. aerosol treatments with 3 cc normal saline every 4 hours. B. sputum induction for gram stain. C. a heated humidifier and oxygen therapy. D. continuous ultrasonic via aerosol mask. - THE CORRECT ASNWER IS a heated humidifier and oxygen therapy. A 36 year -old fireman was trapped and subsequently rescued from the collapse of a burning building. Which of the following devices would be appropriate to accurately assess his oxygenation status? A. capnograph B. pulse oximeter C. blood gas analyzer D. hemoximeter - THE CORRECT ASNWER IS hemoximeter A 36 year -old patient is admitted to the ED with a temper ature of 38.5° C and suspected pneumonia. The patient has no history of pulmonary disease. Auscultation reveal medium crackles throughout both lungs. Which of the following should be recommended for management of this patient? A. Pre/post bronchodilator s tudy B. Ultrasonic nebulizer treatments C. Manually assisted coughing D. Regular coughing and deep breathing - THE CORRECT ASNWER IS Regular coughing and deep breathing A 42 year -old trauma patient in the ED has been intubated with a 6.5 mm oral endotrach eal tube equipped with a high -residual -volume, low -pressure cuff. The respiratory therapist notes that a cuff pressure of 42 cm H2O is necessary to achieve a minimal occluding volume. This would indicate that the A. tube is not of the appropriate size. B. pilot balloon and line are obstructed. C. pressure manometer is defective. D. cuff has herniated over the tip of the tube. - THE CORRECT ASNWER IS tube is not of the appropriate size. A 44 year -old patient who suffered a cerebral vascular accident has be en moved from Neuro -ICU to the step -down unit. He becomes diaphoretic and his SpO2 suddenly drops from 95% to 88% on a 32% tracheostomy collar. His heart rate is 115/min, respiratory rate is 42/min and his breath sounds are very diminished. The respiratory therapist is unsuccessful in attempting to pass a 12 Fr suction catheter. The therapist should A. increase the suction pressure to 120 mm Hg. B. change to a 10 Fr suction catheter. C. replace the tracheostomy tube. D. orally intubate the patient. - THE CORRECT ASNWER IS Replace the tracheostomy tube. A 48 year -old female is admitted to the ED with diaphoresis, jugular venous distension, and 3+ pitting edema in the ankles. These findings are consistent with A. live r failure. B. pulmonary embolism. C. heart failure. D. electrolyte imbalances - THE CORRECT ASNWER IS Heart failure A 50 kg (110 lb) patient is being mechanically ventilated with the following settings: VC, A/C, VT 400 mL, respiratory rate 14/min, FIO2 0. 60 and 10 cm H2O PEEP. The chest radiograph demonstrates diffuse bilateral radiopacity. ABG results are: pH 7.36, PaCO2 47 torr, PaO2 50 torr, and HCO3 - 28 mEq/L. The respiratory therapist should increase the A. PEEP. B. FIO2. C. expiratory time. D. respi ratory rate. - THE CORRECT ASNWER IS PEEP A 52 year -old post -operative cholecystectomy patient's breath sounds become more coarse upon completion of postural drainage with percussion. The respiratory therapist should recommend A. continuing the therapy until breath sounds improve. B. administering dornase alpha. C. administering albuterol therapy. D. deep breathing and coughing to clear secretions. - THE CORRECT ASNWER IS deep breathing and coughing to clear secretions. A 52 year -old post -operative pati ent's chest radiograph demonstrates infiltrates in the posterior basal segments of the lower lobes. Which of the following is the appropriate postural drainage position? A. Head down, patient supine with a pillow under knees B. Patient prone with a pillow under head, bed flat C. Patient supine with a pillow under knees, bed flat D. Head down, patient prone with a pillow under hips - THE CORRECT ASNWER IS Head down, patient prone with a pillow under hips A 55 year -old male patient is being evaluated for pulmonary rehabilitation. During a cycle ergometer cardiopulmonary stress procedure, the patient has a heart rate of 100/min and a respiratory rate of 20/min. He suddenly be gins to complain of chest pain and severe shortness of breath. The respiratory therapist should A. reduce the speed of the bike. B. administer supplemental oxygen. C. gradually reduce the workload and monitor closely. D. terminate the procedure immediatel y. - THE CORRECT ASNWER IS terminate the procedure immediately. A 55 year -old post cardiac surgery patient has the 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 7.3 9, 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% - THE CORRECT ASNWER IS 5.0 vol% A 58 year -old male patient is receiving mechanical ventilation in the ICU on the following s ettings: VC,SIMV, VT 650 mL, f 12/min, FIO2 0.65, PEEP 10 cmH2O. He has a large amount of thick, yellow secretions. How should the respiratory therapist suction this patient? A. Limit suction time to 5 seconds or less. B. Use a closed -system suction cathe ter. C. Suction Q1H and PRN. D. Use a 10 Fr suction catheter. - THE CORRECT ASNWER IS Use a closed -system suction catheter. A 59 year -old post CABG patient has a C(a -v)O2 that has increased from 5 mL/dL to 8 mL/dL. The respiratory therapist should report to the physician that the patient's A. hemoglobin is increasing. B. cardiac output is decreasing. C. VD/VT ratio has increased. D. oxygen consumption has decreased. - THE CORRECT ASNWER IS cardiac output is decreasing.