Therapist Multiple-Choice (TMC) CERTIFICATION TEST STUDY GUIDE 2025/2026 QUESTIONS BANK AND VERIFIED CORRECT SOLUTIONS WITH RATIONALES || 100% GUARANTEED PASS RECENT VERSION

Therapist Multiple-Choice (TMC) CERTIFICATION TEST STUDY GUIDE 2025/2026 QUESTIONS BANK AND VERIFIED CORRECT SOLUTIONS WITH RATIONALES || 100% GUARANTEED PASS RECENT VERSION 1. The physician orders a 35% aerosol mask to be set up for a patient who requires an inspiratory flow of 42 L/min. What is the minimum flow rate to which the flowmeter must be set to meet this patient's in- spiratory flow demands? A. 6 L/min B. 8 L/min C. 10 L/min D. 12 L/min - ANSWER B, The air/O2ratio for a 35% oxygen mixture is 5 : 1. To calculate total flow output from this device, add the ratio parts together and multiply by the liter flow: 6 ×6 = 36 L/min, 6 ×8 = 48 L/min, 6 × 10 = 60 L/min, 6 ×12 = 72 L/min. Total flow needed: 42 L/min. The minimum flow necessary is 8, giving a total flow of 48 L/min. (Analysis) 2. A premature 3-week-old infant is receiving 1 L/min of O via a nasal cannula and has a PaO of 43 torr22 and a PaCO2 of 40 torr. The respiratory therapist should recommend which of the following? A. Increase the cannula flow to 2 L/min. B. Intubate and institute mechanical ventilation C. Initiate CPAP of 4 cm H2O and 50% O2 D. Increase the cannula flow to 5 L/min. - ANSWER A, A PaO2 of 43 torr represents hypoxemia. The normal PaO2 for an infant is 50-70 torr. Increasing the cannula flow by 1 L/min is the most appropriate choice to return the PaO2 to normal. With a normal PaCO2 of 40 torr, mechanical ventilation is not indicated. (Analysis) 3. What is normal PaO2 for infant ? - ANSWER 50-70 torr. 4. A patient arrives in the emergency department after being pulled from a burning house. The respiratory therapist should recommend obtaining which of the following measurements to best determine the sever- ity of the patient's smoke inhalation? A. SpO2 B. HbCO C. PaO2 D. Hb - ANSWER B, To best determine the severity of smoke inhalation, an HbCO level should be determined with a co-oximeter. The SpO2 value should never be evaluated on a patient suspected of CO poisoning because a pulse oximeter is not capable of determining what is bound to hemoglobin. 5. Pulse oximeters work on the principle of spectrophotometry where lightweight probes direct filtered light of specific wavelengths through the skin or digit. The light absorbed differs for saturated and desaturated blood, whether it's saturated with oxygen or a combination of oxygen and carbon monoxide. Therefore the reading will be erroneously high when HbCO is present. (Analysis) 6. To best determine the severity of smoke inhalation, an HbCO level should be determined with ? - ANSWER co-oximeter 7. A 48-year-old, 75-kg (165-lb) woman is in the ICU after coronary bypass surgery. The patient is to receive mechanical ventilation. As you connect the patient to the ventilator, you notice the PIP is registering only 10 cm H2O on the manom- eter and the exhaled volume display is showing 300 mL less than the ventilator volume setting. Which of the following could be causing this problem? A. Kink in the tubing B. Patient needs to be suctioned C. Leak around the HME D. Increased airway resistance - ANSWER C, When less volume is being recorded on the exhaled volume display than the set machine volume, a leak is present. Leaks can occur at tubing connections, the humidifier or HME, the ET-tube cuff, or through chest tubes 8. During ventilator checks 6 hours later, you notice the PIP has been gradually increasing. What could be the cause of this occurrence? A. Bronchospasm B. Decreasing plateau pressure C. Decreasing airway resistance D. Increasing CL - ANSWER A, Increasing plateau pressures with volume-controlled ventilation indicate decreasing lung compliance (stiffer lungs). Increasing airway resistance is indicated when PIP increases but plateau remains unchanged. Increased airway resistance results as the gas meets a resistance to flow caused by H2O in the tubing circuit, secretions in the airway, bronchospasm, or coughing 9. The following day, the patient begins a spontaneous breathing trial. During the trial, the patient's respiratory rate increases to 30/min and her blood pressure begins to drop. What is the appropriate measure to take at this time? A. Initiate SIMV at a rate of 12/min B. Obtain an immediate chest film C. Initiate CPAP D. Institute control mode at a rate of 10/min - ANSWER A, The patient was not ready for T-tube weaning and should have SIMV initiated to allow for spontaneous breathing along with ventilator breaths. A postoperative patient such as this one should not be receiving mechanical ventilation for long unless unforeseen problems arise; therefore SIMV is indicated 10. The patient's condition has deteriorated, and mechanical ventilation is initiated. What ventilation parameters should the respiratory therapist determine at this time? 1. VT required by patient2. Patient's FVC3. Patient's MIP4. Minute ventilation required by patient A. 1 and 2 only B. 2 and 3 only C. 1 and 4 only D. 1, 2, and 3 only - ANSWER C, Because mechanical ventilation is to be initiated, it is not important to determine the patient's FVC or MIP. Most important is to determine the required minute ventilation (rate and VT) necessary for the patient. 11. pulmonary edema -on x-ray -how to fix - ANSWER -fluffy infiltrates -diurectics 12. atelecatasis -on x-ray -how to fix - ANSWER -patchy infiltrate -lung expansion therapy 13. ARDS -on x-ray -how to fix - ANSWER -ground glass -oxygen -low Vt & PIP -PEEP 14. pleural effusion -on x-ray -how to fix - ANSWER -costophrenic angle chest tube -thoracentesis -antibiotics 15. pneumonia -on x-ray -how to fix - ANSWER -air bronchogram -antibiotics 16. what causes tracheal deviation (towards pathology) - ANSWER 1. atelectasis 2. pneumoectomy 3. diaphragm paralysis 17. what causes tracheal deviation (away from pathology) - ANSWER 1. pleural effusion 2. pneumothorax 4. thyriod tumor 5. mediastinal mass 18. sounds (no air) - ANSWER flat dull