TMC LATEST EXAM REAL ACTUAL PAPER 2026
QUESTIONS WITH SOLUTIONS GRADED A
PLUS COMPLETE REVIEW SET 300 ITEMS
◉ 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?
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..
Answer: Needle aspirate the 2nd left intercostal space.
◉ All of the following strategies are likely to decrease the likelihood
of damage to the tracheal mucosa EXCEPT
A. maintaining cuff pressures between 20 and 25 mm Hg.
,B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures..
Answer: 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..
Answer: deep breathing and coughing to clear secretions.
◉ A 65 kg spinal cord injured patient has developed atelectasis. His
inspiratory capacity 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.
Answer: 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.
Answer: 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 breath sounds on the right?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube.
, Answer: Insert a chest tube
◉ A 55 year-old post cardiac surgery 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.
A. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
D. 5.5 vol%.
Answer: 5.0 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
A. 25 mL/cm H2O
B. 35 mL/cm H2O
C. 45 mL/cm H2O
QUESTIONS WITH SOLUTIONS GRADED A
PLUS COMPLETE REVIEW SET 300 ITEMS
◉ 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?
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..
Answer: Needle aspirate the 2nd left intercostal space.
◉ All of the following strategies are likely to decrease the likelihood
of damage to the tracheal mucosa EXCEPT
A. maintaining cuff pressures between 20 and 25 mm Hg.
,B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures..
Answer: 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..
Answer: deep breathing and coughing to clear secretions.
◉ A 65 kg spinal cord injured patient has developed atelectasis. His
inspiratory capacity 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.
Answer: 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.
Answer: 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 breath sounds on the right?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube.
, Answer: Insert a chest tube
◉ A 55 year-old post cardiac surgery 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.
A. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
D. 5.5 vol%.
Answer: 5.0 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
A. 25 mL/cm H2O
B. 35 mL/cm H2O
C. 45 mL/cm H2O
