TMC EXAM A QUESTIONS WITH
COMPLETE SOLUTIONS
,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 - ANSWERheart
failure
A patient is admitted to the ED following a motor vehicle accident. On physical exam,
the respiratory therapist discovers that breath sounds are absent in the left chest with a
hyperresonant percussion note. The trachea is shifted to the right. The patient's heart
rate is 45/min, respiratory rate is 30/min, and blood pressure is 60/40 mm Hg. What
action should the therapist recommend first? - ANSWERNeedle aspirate the 2nd left
intercostal space
All of the following strategies are likely to decrease the likelihood of damage to the
tracheal mucosa EXCEPT - ANSWERusing a low residual volume, low compliance cuff
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 - ANSWERdeep breathing & coughing to clear secretions
A 65 kg spinal cord injured patient develops atelectasis. His inspiratory capacity is 30%
of his predicted value. What bronchial hygiene therapy would be most appropriate
initially? - ANSWERIPPB
A healthy adult female can exhale what portion of her forced vital capacity in the first
second? - ANSWER70%
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 - ANSWER1, 2, and 3 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? -
ANSWERinsert 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. - ANSWER5.0 vol %
, A patient on VC, SIMV with a VT of 500 mL has a PIP of 25 cm H2O, Pplat of 15 cm
H2O and PEEP of 5 cm H2O. What is the patient's static lung compliance? -
ANSWER50 mL/cm H2O
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? - ANSWERReintubation
Which of the following patients would most likely benefit from pressure support
ventilation? - ANSWERA patient on SIMV with a mandatory rate of 12/min and total rate
of 24/min.
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? - ANSWERobtain a sputum gram stain
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 - ANSWER1 & 2 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 - ANSWERretard bacterial growth
A patient who complains of dyspnea is noted to have a dry, non-productive cough. On
physical examination, breath sounds are diminished on the right, tactile fremitus is
decreased and there is dullness to percussion over the right lower lobe. The respiratory
therapist should suspect that the patient is suffering from - ANSWERpleural effusion
Which of the following suction catheters would be appropriate to use for a patient with a
size 8.0 mm ID endotracheal tube? - ANSWER12 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 - ANSWERthe endotracheal tube has slipped into the right main stem
bronchus.
COMPLETE SOLUTIONS
,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 - ANSWERheart
failure
A patient is admitted to the ED following a motor vehicle accident. On physical exam,
the respiratory therapist discovers that breath sounds are absent in the left chest with a
hyperresonant percussion note. The trachea is shifted to the right. The patient's heart
rate is 45/min, respiratory rate is 30/min, and blood pressure is 60/40 mm Hg. What
action should the therapist recommend first? - ANSWERNeedle aspirate the 2nd left
intercostal space
All of the following strategies are likely to decrease the likelihood of damage to the
tracheal mucosa EXCEPT - ANSWERusing a low residual volume, low compliance cuff
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 - ANSWERdeep breathing & coughing to clear secretions
A 65 kg spinal cord injured patient develops atelectasis. His inspiratory capacity is 30%
of his predicted value. What bronchial hygiene therapy would be most appropriate
initially? - ANSWERIPPB
A healthy adult female can exhale what portion of her forced vital capacity in the first
second? - ANSWER70%
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 - ANSWER1, 2, and 3 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? -
ANSWERinsert 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. - ANSWER5.0 vol %
, A patient on VC, SIMV with a VT of 500 mL has a PIP of 25 cm H2O, Pplat of 15 cm
H2O and PEEP of 5 cm H2O. What is the patient's static lung compliance? -
ANSWER50 mL/cm H2O
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? - ANSWERReintubation
Which of the following patients would most likely benefit from pressure support
ventilation? - ANSWERA patient on SIMV with a mandatory rate of 12/min and total rate
of 24/min.
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? - ANSWERobtain a sputum gram stain
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 - ANSWER1 & 2 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 - ANSWERretard bacterial growth
A patient who complains of dyspnea is noted to have a dry, non-productive cough. On
physical examination, breath sounds are diminished on the right, tactile fremitus is
decreased and there is dullness to percussion over the right lower lobe. The respiratory
therapist should suspect that the patient is suffering from - ANSWERpleural effusion
Which of the following suction catheters would be appropriate to use for a patient with a
size 8.0 mm ID endotracheal tube? - ANSWER12 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 - ANSWERthe endotracheal tube has slipped into the right main stem
bronchus.
