Tmc Practice Exam A

TMC PRACTICE EXAM A + B
QUESTIONS AND ANSWERS




A0520year-old0post-
operative0cholecystectomy0patient's0breath0sounds0become0more0coarse0upon0comple
tion0of0postural0drainage0with0percussion.0The0respiratory0therapist0should0recommen
d:

A.0Continuing0the0therapy0until0breath0sounds0improve.
B.0administering0dornase0alpha.
C.0administering0albuterol0therapy.
D.0deep0breathing0and0coughing0to0clear0secretions.0-0answer--
D.0deep0breathing0and0coughing0to0clear0secretions.

See0Patient0Assessment

A0healthy0adult0female0can0exhale0what0portion0of0her0forced0vital0capacity0in0the0first
0second?0-0answer--70%


Following0cardiac0surgery,0a0550year-
old0patient0has0the0following0ABG0results:0pH07.50,0PaCO20300torr,0PaO20620torr,0HC
O30250mEq/L,0SaO2092%,0HB0140g/
dL,0BE0+2.0Venous0blood0gas0results0are0pH07.39,0PvCO20430torr,0PvO20370torr,0and0
SvO2066%.0Calculate0the0patient's0C(a-v)O2.0-0answer--5%0volume

What0value0for0the0apnea-
hypopnea0index0(AHI)0is0consistent0with0mild0obstructive0sleep0apnea?0-0answer--
50to015

The0respiratory0therapist0is0asked0to0evaluate0the0presence0of0Auto-
PEEP0on0a0patient0receiving0mechanical0ventilation.0In0order0to0do0this,0what0should0t
he0RT0do?0-0answer--Initiate0an0expiratory0hold0just0prior0to0the0next0ventilator-
delivered0breath

, What0do0bronchial0breath0sounds0heard0over0the0lung0periphery0indicate?0-0answer--
lung0consolidation0(pneumonia)

Rationale:0should0be0vesicular0in0periphery

A0600kg0(1320lb)0patient0is0mechanically0ventilated0at0the0following0settings:0VC,0A/
C;0VT05000mL,0respiratory0rate012/
min,0FIO201.000and0100cm0H2O0PEEP.0The0patient's0peak0airway0pressure0is0600cm0
H2O0and0his0SpO20is085%.0A0current0chest0x-
ray0shows0diffuse0bilateral0infiltrates.0Which0of0the0following0is0the0most0appropriate0a
ction0in0order0to0reduce0peak0airway0pressure?

A.0Increase0the0frequency.
B.0Change0to0airway0pressure0release0ventilation.
C.0Decrease0the0inspiratory0time.
D.0Increase0PEEP0to0150cm0H2O.0-0answer--
B.0Change0to0airway0pressure0release0ventilation.

A019-year-
old0patient0is0brought0to0the0Emergency0Department0after0taking0a0handful0of0pills.0Th
e0patient0is0obtunded0but0is0making0regular,0sonorous0respiratory0efforts.0Auscultation0
reveals0coarse0rhonchi0bilaterally.0Which0of0the0following0should0be0done0FIRST0to0as
sess0this0patient?

A.0Obtain0a0sputum0specimen.
B.0Obtain0an0ABG.
C.0Measure0peak0expiratory0flow.
D.0Determine0the0Glasgow0Coma0Score.0-0answer--B.0Obtain0an0ABG.

A0young0healthy0adult0with0complaints0of0intermittent0wheezing0is0seen0in0the0pulmon
ary0clinic.0A0pre/
post0bronchodilator0spirometry0reveals0a0normal0study0with0no0reversibility.0Which0of0t
he0following0should0the0respiratory0therapist0recommend?

A.0Helium0dilution0study
B.0DLCO
C.0Plethysmography
D.0Bronchial0provocation0-0answer--D.0Bronchial0provocation

Following0abdominal0surgery,0a0700year-
old0patient0receives0mechanical0ventilation0in0the0ICU0at0the0following0settings:0VC,0A/
C;0VT05500mL,0respiratory0rate014/
min,0FIO200.500and0100cm0H2O0PEEP.0Bedside0monitoring0results0demonstrate0that0t
he0PvO20is0350torr0and0the0SpO20is090%.0The0patient0is0alert0and0oriented0with0stabl
e0vital0signs.0Which0of0the0following0should0the0respiratory0therapist0recommend?