TMC Practice exam Questions and Answers 2023

TMC Practice exam Questions and Answers 2023 A patient on VC ventilation demonstrates auto-PEEP on ventilator graphics. Which of the following controls, when adjusted independently, would increase expiratory time? 1. Tidal volume 2. Respiratory Rate 3. Inspiratory flow 4. Sensitivity *A. 1, 2, and 3 only B. 1, 2, and 4 only C. 1, 3, and 4 only D. 2, 3, and 4 only Which of the following would be the most appropriate therapy for a dyspneic patient who has crepitus with tracheal deviation to the left and absent breath sounds on the right? A. Perform chest physiotherapy B. Administer an IPPB treatment C. Insert an endotracheal tube *D. Insert a chest tube 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. A. 2.5 vol% B. 4.0 vol% *C. 5.0 vol% D. 5.5 vol% Immediately after extubation of a patient in the ICU, the respiratory therapist observes increasing respiratory distress with intercostal retractions and marked stridor. The SpO2 on 40% oxygen is noted to be 76%. Which of the following would be most appropriate at this time? A. Cool mist aerosol treatment B. Aerosolized racemic epinephrine C. Manual ventilation with resuscitation bag and mask *D. Reintubation A patient receiving mechanical ventilation has developed a temperature of 99.9° F with purulent secretions over the last 12 hours. The respiratory therapist has also noted a steady increase in peak inspiratory pressure. What initial recommendation should be made to address these changes? *A. Initiate bronchial hygiene therapy. B. Obtain a sputum gram stain. C. Administer IPV. D. Insert a CASS tube. Which of the following information may be obtained from a FVC maneuver during bedside pulmonary function testing? 1. FEV1 2. PEFR 3. FRC 4. RV *A. 1 and 2 only B. 1 and 3 only C. 2 and 4 only D. 3 and 4 only The respiratory therapist provides education for a patient who is being discharged home on aerosol therapy. The most important reason for the patient to follow the recommended cleaning procedures using a vinegar/water solution is that this solution will A. sterilize the equipment. *B. retard bacterial growth. C. kill all micro-organisms and spores. D. extend the equipment life. Which of the following suction catheters would be appropriate to use for a patient with a size 8.0 mm ID endotracheal tube? A. 8 Fr B. 10 Fr *C. 12 Fr D. 14 Fr A patient who is receiving continuous mechanical ventilation is fighting the ventilator. His breath sounds are markedly diminished on the left, there is dullness to percussion on the left, and the trachea is shifted to the left. The most likely explanation for the problem is that A. the patient is disconnected from the ventilator. B. the patient is experiencing diffuse bronchospasm. *C. the endotracheal tube has slipped into the right main stem bronchus. D. the patient has developed a left tension pneumothorax. A patient's breathing pattern irregularly increases and decreases and is interspersed with periods of apnea up to 1 minute. Which of the following conditions is the most likely cause of this problem? A. Diabetes insipidus B. Renal failure C. Metabolic acidosis *D. Elevated intracranial pressure Kussmauls respiration Increased rate and depth of breathing over a prolonged period of time. Response to metabolic acidosis What value for the apnea-hypopnea index (AHI) is consistent with mild obstructive sleep apnea? A. Less than 5 *B. 5 to 15 C. 16 to 30 D. Greater than 30 While monitoring a newborn utilizing a transcutaneous monitor, the respiratory therapist notices a change in PtcO2 from 60 to 142 torr and simultaneously the PtcCO2 changes from 37 to 2 torr. What is the most likely explanation for these changes? A. Upper airway obstruction B. Poor peripheral perfusion *C. Air leak around the sensor D. Device is out of range Which of the following measurements is most indicative of congestive heart failure? A. Heart rate of 120/min B. Blood pressure of 92/72 mm Hg C. Pulmonary artery pressure of 25/10 mm Hg *D. Pulmonary capillary wedge pressure of 30 mm Hg Normal range for pulmonary capillary wedge pressure 4-12 mmHg Sleep apnea can be defined as repeated episodes of complete cessation of airflow for A. 5 seconds or longer. *B. 10 seconds or longer. C. 15 seconds or longer. D. 20 seconds or longer. A patient in the ICU receiving mechanical ventilation underwent fiberoptic bronchoscopy during which a tissue biopsy was collected. Immediately following the procedure, the respiratory therapist notes that the peak inspiratory pressure on the ventilator has increased. Potential causes for this include all of the following EXCEPT *A. hypoxemia. B. pneumothorax. C. pulmonary hemorrhage. D. bronchospasm/laryngospasm. The respiratory therapist is asked to evaluate the presence of Auto-PEEP on a patient receiving mechanical ventilation. In order to do this, the therapist should A. initiate an inspiratory hold just after the next ventilator-delivered breath. *B. initiate an expiratory hold just prior to the next ventilator-delivered breath. C. subtract Pplat from Pdyn. D. subtract set PEEP from the measured Pplat. A patient who suffered trauma in an ATV accident is being monitored in the ICU. A pulmonary artery catheter has been placed and the following data is available: PCWP 4 mm Hg PAP (mean) 8 mm Hg CVP 2 cm H2O Cardiac Output 3L/min The respiratory therapist should recommend *A. IV fluid challenge B. Positive inotropic agent C. Inhaled nitric oxide D. Diuretic therapy Cheyne-stokes respirations Gradual increase in volume and frequency, followed by a gradual decrease in volume and frequency, with apnea periods of 10 - 30 seconds between cycle. Seen with low cardiac output Biot's respirations Tidal volume is constant. Short episodes of rapid, deep inspirations, followed by 10 to 30 seconds of apnea normal cardiac output 4 to 8 L/min Normal CVP range 2-6 mmHg Bronchial breath sounds heard over the lung periphery indicate A. narrowed airways. B. obstructed bronchi. *C. lung consolidation. D. pulmonary edema. Normal range for FEV1 80 to 120% Normal range for FVC 80 to 120% normal range for TLC 80 to 120% 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. In order to verify the accuracy of a lab-based spirometer device, the respiratory therapist should utilize a A. rotameter. *B. 3.0 L syringe. C. Wright respirometer. D. pneumotachometer. While performing diagnostic chest percussion, the respiratory therapist notes decreased resonance to percussion. Which of the following are potential causes of this finding? 1. Pneumothorax 2. Pleural effusion 3. Pneumonia 4. Atelectasis A. 1 and 3 only B. 2 and 4 only *C. 2, 3, and 4 only D. 1, 2, 3, and 4 A 60 year-old male is admitted to the ED with chest pain. The CBC and electrolytes are normal. Troponin level is 0.4 ng/mL. The physician should report to the patient that he is suffering from A. congestive heart failure. B. pulmonary embolism. *C. myocardial infarction. D. valvular stenosis. 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 *D. Bronchial provocation Normal troponin level 0.1 ng/mL A 77-year-old male patient is admitted to the emergency room with shortness of breath, fine basilar crackles, +2 pitting edema and a chest radiogram with a butterfly pattern. These results are most consistent with which of the following? A. Pulmonary edema* B. Pulmonary interstitial emphysema C. Pneumothorax D. Emphysema