TMC Practice Exam A + B Questions and
Answers
1. 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.: D. deep
breathing and coughing to clear secretions.
See Patient Assessment
2. A healthy adult female can exhale what portion of her
forced vital capacity in the first second?: 70%
3. Following cardiac surgery, a 55 year-old 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 7.39, PvCO2
43 torr, PvO2
,37 torr, and SvO2 66%. Calculate the patient's C(a-v)O2.: 5%
volume
4. What value for the apnea-hypopnea index (AHI) is
consistent with mild obstructive sleep apnea?: 5 to 15
5. The respiratory therapist is asked to evaluate the presence
of Auto-PEEP on a patient receiving mechanical ventilation. In
order to do this, what should the RT do?: Initiate an expiratory
hold just prior to the next ventilator-delivered breath
6. What do bronchial breath sounds heard over the lung
periphery indicate?-
: lung consolidation (pneumonia)
Rationale: should be vesicular in periphery
7. A 60 kg (132 lb) patient is mechanically ventilated at the
following settings: VC, A/C; VT 500 mL, respiratory rate
12/min, FIO2 1.00 and 10 cm H2O PEEP. The patient's peak
airway pressure is 60 cm H2O and his SpO2 is 85%. A current
chest x-ray shows diffuse bilateral infiltrates. Which of the
following is the most appropriate action in order to reduce
peak airway pressure?
A. Increase the frequency.
, B. Change to airway pressure release ventilation. C.
Decrease the inspiratory time.
D. Increase PEEP to 15 cm H2O.: B. Change to airway pressure
release ventila- tion.
8. A 19-year-old patient is brought to the Emergency
Department after taking 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.: B. Obtain an ABG.
9. A young healthy adult with complaints of intermittent
wheezing is seen in the pulmonary clinic. A pre/post
bronchodilator spirometry reveals a normal study with no
reversibility. Which of the following should the respiratory
therapist recommend?
A. Helium dilution study
B. DLCO
C. Plethysmography
Answers
1. 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.: D. deep
breathing and coughing to clear secretions.
See Patient Assessment
2. A healthy adult female can exhale what portion of her
forced vital capacity in the first second?: 70%
3. Following cardiac surgery, a 55 year-old 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 7.39, PvCO2
43 torr, PvO2
,37 torr, and SvO2 66%. Calculate the patient's C(a-v)O2.: 5%
volume
4. What value for the apnea-hypopnea index (AHI) is
consistent with mild obstructive sleep apnea?: 5 to 15
5. The respiratory therapist is asked to evaluate the presence
of Auto-PEEP on a patient receiving mechanical ventilation. In
order to do this, what should the RT do?: Initiate an expiratory
hold just prior to the next ventilator-delivered breath
6. What do bronchial breath sounds heard over the lung
periphery indicate?-
: lung consolidation (pneumonia)
Rationale: should be vesicular in periphery
7. A 60 kg (132 lb) patient is mechanically ventilated at the
following settings: VC, A/C; VT 500 mL, respiratory rate
12/min, FIO2 1.00 and 10 cm H2O PEEP. The patient's peak
airway pressure is 60 cm H2O and his SpO2 is 85%. A current
chest x-ray shows diffuse bilateral infiltrates. Which of the
following is the most appropriate action in order to reduce
peak airway pressure?
A. Increase the frequency.
, B. Change to airway pressure release ventilation. C.
Decrease the inspiratory time.
D. Increase PEEP to 15 cm H2O.: B. Change to airway pressure
release ventila- tion.
8. A 19-year-old patient is brought to the Emergency
Department after taking 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.: B. Obtain an ABG.
9. A young healthy adult with complaints of intermittent
wheezing is seen in the pulmonary clinic. A pre/post
bronchodilator spirometry reveals a normal study with no
reversibility. Which of the following should the respiratory
therapist recommend?
A. Helium dilution study
B. DLCO
C. Plethysmography
