TMC Exam E Questions & Verified
Answers
1.A patient with a history of chronic bronchitis is post-operative for an ex-
ploratory laparotomy. Review of the medical record suggests the physician
has concern about difficulty clearing secretions after the procedure. To
assist the patient with mobilization and removal of secretions, the
respiratory thera- pist should recommend
a. MDI therapy with an anti-inflammatory corticosteroid
b. Administer tetracycline
c. Administer cromolyn sodium
d. Instruction on deep breathing and coughing techniques
Answer d. Instruction on deep breathing and coughing techniques
2.Which of the following conditions would be a contraindication for IPPB?
a. Untreated pneumothorax
b. Pulmonary edema
c. A patient requiring bronchodilation AND lung expansion
d. Fractured ribs
Answer a. Untreated pneumothorax
3.The respiratory therapist has an order to cap a patient with a fenestrated
tracheostomy tube in preparation for speech therapy. Prior to applying the
cap on the end of the tube, the therapist should also ensure
,a. The inner cannula is removed and the cuff inflated
b. The inner cannula is removed and the cuff deflated
c. The inner cannula is in place and the cuff deflated
d. The inner cannula is in placed and the cuff inflated
Answer b. The inner cannula is removed and the cuff deflated
4.A 75-kg (165-lbs) male is in acute ventilatory failure. In preparation for
mechanical ventilatory support, the patient is to be orally intubated. Which
of the following artificial airways would be most appropriate for this patient?
a. Size 7.0 mm ET tube with a large volume, low pressure cuff
b. Size 7.5 mm fenestrated tracheostomy tube
c. Size 8.0 mm ET tube with a small volume, high pressure cuff
d. Jackson tracheostomy tube
Answer a. Size 7.0 mm ET tube with a large volume, low pressure cuff
5.Which of the following devices is needed to determine a patient's
airway resistance?
a. Turbine pneumotachometer
b. Wheatstone bridge helium analyzer
c. Body box
d. Geissler tube nitrogen analyzer
Answer c. Body box
6.A patient is receiving manual ventilatory support with a bag-valve
connect- ed to a size 8.0 mm ET tube. While transporting the patient from CT
,scan back
to the intensive care unit, the respiratory therapist notices oxygen
saturation has dropped to 88% and that the bag-valve is easier to squeeze
than normal. Suspecting mal-positioning of the ET tube, the respiratory
therapist should first
a. Perform diagnostic chest percussion
b. Obtain an arterial blood gas
c. Call for a chest radiograph
d. Examine chest rise and auscultate breath sounds
Answer d. Examine chest rise and auscultate breath sounds
7.A 48-year-old patient has just been orally intubated prior to being placed
on volume-controlled ventilation. The respiratory therapist should do which
of the following to best confirm proper placement of the endotracheal
tube?
a. Auscultate breath sounds
b. Assess chest rise symmetry
c. Examine tube markings near the lips
d. Obtain a chest radiograph
Answer d. Obtain a chest radiograph
8.After 20 minutes into a spontaneous breathing trial (SBT) a
mechanically ventilated female patient becomes anxious. Her baseline
heart rate has in- creased by 20 /min. What should the respiratory
therapist do?
, a. Calculate the RSBI
b. Increase the FiO2 and continue to monitor
c. Measure MIP
d. Return to full mechanical ventilation
Answer d. Return to full mechanical ventilation
9.What is needed to determine arterial oxygen content?
a. PvO2
b. Hemoglobin level
c. Oxygen index
d. P/F ratio
Answer b. Hemoglobin level
10.A patient presents to the emergency room with fulminating pulmonary
edema. Which of the following would be experienced with this
emergency?
a. Hypovolemia
b. A good response to supplemental O2
c. Elevated left ventricular filling pressure with low QT
d. CVP 10 torr and PAP 10 torr
Answer c. Elevated left ventricular filling pressure with low QT
11.Which of the following conditions would benefit most from a
thoracente- sis?
a. Pericardial contusion
Answers
1.A patient with a history of chronic bronchitis is post-operative for an ex-
ploratory laparotomy. Review of the medical record suggests the physician
has concern about difficulty clearing secretions after the procedure. To
assist the patient with mobilization and removal of secretions, the
respiratory thera- pist should recommend
a. MDI therapy with an anti-inflammatory corticosteroid
b. Administer tetracycline
c. Administer cromolyn sodium
d. Instruction on deep breathing and coughing techniques
Answer d. Instruction on deep breathing and coughing techniques
2.Which of the following conditions would be a contraindication for IPPB?
a. Untreated pneumothorax
b. Pulmonary edema
c. A patient requiring bronchodilation AND lung expansion
d. Fractured ribs
Answer a. Untreated pneumothorax
3.The respiratory therapist has an order to cap a patient with a fenestrated
tracheostomy tube in preparation for speech therapy. Prior to applying the
cap on the end of the tube, the therapist should also ensure
,a. The inner cannula is removed and the cuff inflated
b. The inner cannula is removed and the cuff deflated
c. The inner cannula is in place and the cuff deflated
d. The inner cannula is in placed and the cuff inflated
Answer b. The inner cannula is removed and the cuff deflated
4.A 75-kg (165-lbs) male is in acute ventilatory failure. In preparation for
mechanical ventilatory support, the patient is to be orally intubated. Which
of the following artificial airways would be most appropriate for this patient?
a. Size 7.0 mm ET tube with a large volume, low pressure cuff
b. Size 7.5 mm fenestrated tracheostomy tube
c. Size 8.0 mm ET tube with a small volume, high pressure cuff
d. Jackson tracheostomy tube
Answer a. Size 7.0 mm ET tube with a large volume, low pressure cuff
5.Which of the following devices is needed to determine a patient's
airway resistance?
a. Turbine pneumotachometer
b. Wheatstone bridge helium analyzer
c. Body box
d. Geissler tube nitrogen analyzer
Answer c. Body box
6.A patient is receiving manual ventilatory support with a bag-valve
connect- ed to a size 8.0 mm ET tube. While transporting the patient from CT
,scan back
to the intensive care unit, the respiratory therapist notices oxygen
saturation has dropped to 88% and that the bag-valve is easier to squeeze
than normal. Suspecting mal-positioning of the ET tube, the respiratory
therapist should first
a. Perform diagnostic chest percussion
b. Obtain an arterial blood gas
c. Call for a chest radiograph
d. Examine chest rise and auscultate breath sounds
Answer d. Examine chest rise and auscultate breath sounds
7.A 48-year-old patient has just been orally intubated prior to being placed
on volume-controlled ventilation. The respiratory therapist should do which
of the following to best confirm proper placement of the endotracheal
tube?
a. Auscultate breath sounds
b. Assess chest rise symmetry
c. Examine tube markings near the lips
d. Obtain a chest radiograph
Answer d. Obtain a chest radiograph
8.After 20 minutes into a spontaneous breathing trial (SBT) a
mechanically ventilated female patient becomes anxious. Her baseline
heart rate has in- creased by 20 /min. What should the respiratory
therapist do?
, a. Calculate the RSBI
b. Increase the FiO2 and continue to monitor
c. Measure MIP
d. Return to full mechanical ventilation
Answer d. Return to full mechanical ventilation
9.What is needed to determine arterial oxygen content?
a. PvO2
b. Hemoglobin level
c. Oxygen index
d. P/F ratio
Answer b. Hemoglobin level
10.A patient presents to the emergency room with fulminating pulmonary
edema. Which of the following would be experienced with this
emergency?
a. Hypovolemia
b. A good response to supplemental O2
c. Elevated left ventricular filling pressure with low QT
d. CVP 10 torr and PAP 10 torr
Answer c. Elevated left ventricular filling pressure with low QT
11.Which of the following conditions would benefit most from a
thoracente- sis?
a. Pericardial contusion
