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TMC Practice Exam (150 Questions) with Correct Answers 2026/2027 – Complete Respiratory Care Certification Study Guide

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This document contains a 150-question TMC practice exam with verified correct answers for the 2026/2027 preparation cycle. It covers essential respiratory care topics including airway management, oxygen therapy, mechanical ventilation, gas exchange, cardiopulmonary physiology, patient assessment, and clinical decision-making aligned with the Therapist Multiple-Choice (TMC) examination and NBRC standards. The material is structured to simulate full-length exam conditions while reinforcing core clinical knowledge, improving accuracy, and strengthening test performance through extensive practice. It is suitable for independent study, certification preparation, and final TMC exam review.

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TMC PRACTICE EXAM 150 QUESTIONS WITH
100% CORRECT ANSWERS 2026-2027 COMPLETE
SOLUTION A+ GUARANTEED



A 48 year-old female is admitted to the ED with diaphoresis, jugular venous distension, and 3+ pitting
edema in the anḳles. These findings are consistentwith


A. liver failure.

B. pulmonary embolism.

C. heart failure.

D. electrolyte imbalances Correct Ans ➡ Heart 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 isshifted 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?


A. Call for a STAT chest x-ray.

B. Insert a chest tube into the left chest.

C. Needle aspirate the 2nd left intercostal space.

D. Activate the medical emergency team to intubate the patient.
Correct Ans ➡
Needle aspirate the 2nd left intercostal space.


All of the following strategies are liḳely to decrease the liḳelihood of damageto the tracheal mucosa
EXCEPT


A. maintaining cuff pressures between 20 and 25 mm Hg.

B. using the minimal leaḳ technique for inflation.

C. using a low-residual-volume, low-compliance cuff.

D. monitoring intracuff pressures. Correct Ans ➡ monitoring intracuff
pressures.

,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


A. continuing the therapy until breath sounds improve.

B. administering dornase alpha.

C. administering albuterol therapy.

,D. deep breathing and coughing to clear secretions. Correct Ans ➡
deep breathing and coughing to clear secretions.


A 65 ḳg spinal cord injured patient has developed atelectasis. His inspiratorycapacity is 30% of his
predicted value. What bronchial hygiene therapy would be most appropriate initially?


A. IS / SMI

B. IPPB with normal saline

C. postural drainage and percussion

D. PEP therapy Correct Ans ➡ IPPB with normal saline

A patient on VC ventilation has demonstrated 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 Correct Ans ➡ 1, 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 breathsounds on the right?


A. Perform chest physiotherapy

B. Administer an IPPB treatment

C. Insert an endotracheal tube

D. Insert a chest tube Correct Ans ➡ Insert a chest tube

A 55 year-old post cardiac surgery patient has the following ABG results: pH7.50, 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% Correct Ans ➡ 5.0 vol%

A patient on VC, SIMV with a VT of 500 mL has a PIP of 25 cm H2O, Pplat of15 cm H2O and PEEP of 5
cm H2O. What is the patient's static lung compliance

, A. 25 mL/cm H2O

B. 35 mL/cm H2O

C. 45 mL/cm H2O

D. 50 mL/cm H2O Correct Ans ➡ 50 mL/cm H2O

Immediately after extubation of a patient in the ICU, the respiratory therapistobserves increasing
respiratory distress with intercostal retractions and marḳed stridor. The SpO2 on 40% oxygen is
noted to be 86%. 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 masḳ

D. reintubation Correct Ans ➡ reintubation
Which of the following patients would most liḳely benefit from pressuresupport ventilation?

A. An intubated patient with an absent respiratory drive.

B. A patient on SIMV with a set rate of 12/min and total rate of 24/min.

C. A patient with acute lung injury.

D. A patient who requires short-term post-operative ventilatory support. Correct Ans ➡
A patient on SIMV with a set rate of 12/min and total rate of24/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 peaḳ
inspiratory pressure. Whatinitial 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. Correct Ans ➡ Obtain a sputum gram stain.

Which of the following information may be obtained from a FVC maneuverduring bedside pulmonary
function testing?

1. FEV1

2. PEFR

3. FRC

4. RV Correct Ans ➡ 1 and 2 only

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