RESPIRATORY THERAPY LICENSURE
TMC Practice Exam Questions With Complete Solutions. 2026/2027
A+
Complete Blueprint Coverage | NBRC TMC Domains | Verified Rationales
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Patient Data Evaluation and Recommendations
Equipment Troubleshooting, Quality Control, and Infection Control
Oxygen Therapy, Aerosol Therapy, and Humidity
Airway Management and Bronchial Hygiene
Mechanical Ventilation and Critical Care Interventions
STUVIAACTUALEXAM
,PATIENT DATA EVALUATION AND RECOMMENDATIONS
A 58-year-old patient with COPD presents with dyspnea. ABG on room air: pH 7.36, PaCO2 58 mm Hg, PaO2 52 mm Hg,
Q1 HCO3 32 mEq/L. The respiratory therapist should interpret this as:
A. Acute uncompensated respiratory acidosis with severe hypoxemia.
B. Chronic compensated respiratory acidosis with moderate hypoxemia.
C. Acute metabolic alkalosis with normal oxygenation.
D. Fully compensated metabolic acidosis with mild hypoxemia.
Correct Answer: B
Rationale:
Elevated PaCO2 with near-normal pH and elevated HCO3 indicates chronic (compensated) respiratory acidosis. PaO2 of 52 mm Hg is moderate
hypoxemia.
A patient performs spirometry. FEV1 is 1.8 L (predicted 3.6 L) and FVC is 3.0 L (predicted 4.5 L). The FEV1/FVC ratio is
Q2 60%. This pattern is most consistent with:
A. Restrictive lung disease.
B. Obstructive lung disease.
C. Normal spirometry.
D. Mixed defect with predominant restriction.
Correct Answer: B
Rationale:
Reduced FEV1/FVC ratio below 70% with reduced FEV1 defines obstruction. Restriction typically shows reduced FVC with normal or elevated ratio.
While auscultating a post-operative patient, the therapist hears high-pitched continuous sounds on expiration over the lung
Q3 fields. These sounds are best described as:
A. Fine crackles.
B. Wheezes.
C. Pleural friction rub.
D. Stridor.
Correct Answer: B
Rationale:
High-pitched continuous musical sounds on expiration are wheezes, typically associated with airway narrowing. Stridor is usually inspiratory and
upper-airway.
A patient has a peak expiratory flow rate of 180 L/min; predicted is 450 L/min. This finding suggests:
Q4
A. Normal airway function.
B. Severe airflow limitation and possible need for bronchodilator therapy or further evaluation.
C. Restrictive disease only.
D. Adequate response to previous bronchodilator.
Correct Answer: B
Rationale:
PEFR less than 50% of predicted indicates severe obstruction and warrants clinical attention.
An ABG shows pH 7.28, PaCO2 30 mm Hg, PaO2 85 mm Hg, HCO3 14 mEq/L. The primary acid-base disturbance is:
Q5
A. Respiratory acidosis.
B. Metabolic acidosis with respiratory compensation.
C. Metabolic alkalosis.
D. Fully compensated respiratory alkalosis.
Correct Answer: B
Rationale:
Low HCO3 and low pH indicate metabolic acidosis; the decreased PaCO2 reflects compensatory hyperventilation.
, A patient's chest radiograph shows blunting of the costophrenic angle and a meniscus sign. The therapist should suspect:
Q6
A. Pneumothorax.
B. Pleural effusion.
C. Consolidation from pneumonia.
D. Hyperinflation.
Correct Answer: B
Rationale:
Blunting of the costophrenic angle with a meniscus is classic for pleural fluid.
During a patient interview, the therapist notes the patient must stop to catch breath after walking only a few steps. This is
Q7 best documented as:
A. Orthopnea.
B. Dyspnea on exertion, severe.
C. Paroxysmal nocturnal dyspnea.
D. Platypnea.
Correct Answer: B
Rationale:
Dyspnea occurring with minimal exertion reflects significant functional limitation.
A DLCO value is reported as 45% of predicted. This finding is most consistent with:
Q8
A. Normal gas transfer.
B. Impaired gas exchange as seen in emphysema, interstitial disease, or pulmonary vascular disease.
C. Pure airway obstruction without parenchymal involvement.
D. Acute hyperventilation only.
Correct Answer: B
Rationale:
Reduced DLCO indicates impaired alveolar-capillary gas transfer.
A patient with suspected sleep-disordered breathing has an AHI of 32 events per hour. This is classified as:
Q9
A. Normal.
B. Mild OSA.
C. Moderate OSA.
D. Severe OSA.
Correct Answer: C
Rationale:
AHI 15-30 is moderate; ≥30 is severe. 32 events/hour falls into the severe range.
Transcutaneous PCO2 monitoring is being used on a neonate. A sudden rise in tcPCO2 with stable SpO2 most likely
Q10 indicates:
A. Sensor detachment with room-air reading.
B. Hypoventilation or increasing dead-space ventilation.
C. Improved alveolar ventilation.
D. Calibration drift toward low values only.
Correct Answer: B
Rationale:
Rising tcPCO2 with stable oxygenation suggests decreasing ventilation or rising dead space.
A patient's mixed venous oxygen saturation (SvO2) falls from 75% to 55%. Possible causes include:
Q11
A. Decreased oxygen consumption only.
B. Increased oxygen consumption, decreased cardiac output, or decreased arterial oxygen content.
C. Improved tissue perfusion.
D. Hyperoxia from excessive FiO2.
Correct Answer: B
Rationale:
SvO2 falls when oxygen delivery decreases relative to consumption.
STUVIAACTUALEXAM TMC 2026/2027
TMC Practice Exam Questions With Complete Solutions. 2026/2027
A+
Complete Blueprint Coverage | NBRC TMC Domains | Verified Rationales
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Patient Data Evaluation and Recommendations
Equipment Troubleshooting, Quality Control, and Infection Control
Oxygen Therapy, Aerosol Therapy, and Humidity
Airway Management and Bronchial Hygiene
Mechanical Ventilation and Critical Care Interventions
STUVIAACTUALEXAM
,PATIENT DATA EVALUATION AND RECOMMENDATIONS
A 58-year-old patient with COPD presents with dyspnea. ABG on room air: pH 7.36, PaCO2 58 mm Hg, PaO2 52 mm Hg,
Q1 HCO3 32 mEq/L. The respiratory therapist should interpret this as:
A. Acute uncompensated respiratory acidosis with severe hypoxemia.
B. Chronic compensated respiratory acidosis with moderate hypoxemia.
C. Acute metabolic alkalosis with normal oxygenation.
D. Fully compensated metabolic acidosis with mild hypoxemia.
Correct Answer: B
Rationale:
Elevated PaCO2 with near-normal pH and elevated HCO3 indicates chronic (compensated) respiratory acidosis. PaO2 of 52 mm Hg is moderate
hypoxemia.
A patient performs spirometry. FEV1 is 1.8 L (predicted 3.6 L) and FVC is 3.0 L (predicted 4.5 L). The FEV1/FVC ratio is
Q2 60%. This pattern is most consistent with:
A. Restrictive lung disease.
B. Obstructive lung disease.
C. Normal spirometry.
D. Mixed defect with predominant restriction.
Correct Answer: B
Rationale:
Reduced FEV1/FVC ratio below 70% with reduced FEV1 defines obstruction. Restriction typically shows reduced FVC with normal or elevated ratio.
While auscultating a post-operative patient, the therapist hears high-pitched continuous sounds on expiration over the lung
Q3 fields. These sounds are best described as:
A. Fine crackles.
B. Wheezes.
C. Pleural friction rub.
D. Stridor.
Correct Answer: B
Rationale:
High-pitched continuous musical sounds on expiration are wheezes, typically associated with airway narrowing. Stridor is usually inspiratory and
upper-airway.
A patient has a peak expiratory flow rate of 180 L/min; predicted is 450 L/min. This finding suggests:
Q4
A. Normal airway function.
B. Severe airflow limitation and possible need for bronchodilator therapy or further evaluation.
C. Restrictive disease only.
D. Adequate response to previous bronchodilator.
Correct Answer: B
Rationale:
PEFR less than 50% of predicted indicates severe obstruction and warrants clinical attention.
An ABG shows pH 7.28, PaCO2 30 mm Hg, PaO2 85 mm Hg, HCO3 14 mEq/L. The primary acid-base disturbance is:
Q5
A. Respiratory acidosis.
B. Metabolic acidosis with respiratory compensation.
C. Metabolic alkalosis.
D. Fully compensated respiratory alkalosis.
Correct Answer: B
Rationale:
Low HCO3 and low pH indicate metabolic acidosis; the decreased PaCO2 reflects compensatory hyperventilation.
, A patient's chest radiograph shows blunting of the costophrenic angle and a meniscus sign. The therapist should suspect:
Q6
A. Pneumothorax.
B. Pleural effusion.
C. Consolidation from pneumonia.
D. Hyperinflation.
Correct Answer: B
Rationale:
Blunting of the costophrenic angle with a meniscus is classic for pleural fluid.
During a patient interview, the therapist notes the patient must stop to catch breath after walking only a few steps. This is
Q7 best documented as:
A. Orthopnea.
B. Dyspnea on exertion, severe.
C. Paroxysmal nocturnal dyspnea.
D. Platypnea.
Correct Answer: B
Rationale:
Dyspnea occurring with minimal exertion reflects significant functional limitation.
A DLCO value is reported as 45% of predicted. This finding is most consistent with:
Q8
A. Normal gas transfer.
B. Impaired gas exchange as seen in emphysema, interstitial disease, or pulmonary vascular disease.
C. Pure airway obstruction without parenchymal involvement.
D. Acute hyperventilation only.
Correct Answer: B
Rationale:
Reduced DLCO indicates impaired alveolar-capillary gas transfer.
A patient with suspected sleep-disordered breathing has an AHI of 32 events per hour. This is classified as:
Q9
A. Normal.
B. Mild OSA.
C. Moderate OSA.
D. Severe OSA.
Correct Answer: C
Rationale:
AHI 15-30 is moderate; ≥30 is severe. 32 events/hour falls into the severe range.
Transcutaneous PCO2 monitoring is being used on a neonate. A sudden rise in tcPCO2 with stable SpO2 most likely
Q10 indicates:
A. Sensor detachment with room-air reading.
B. Hypoventilation or increasing dead-space ventilation.
C. Improved alveolar ventilation.
D. Calibration drift toward low values only.
Correct Answer: B
Rationale:
Rising tcPCO2 with stable oxygenation suggests decreasing ventilation or rising dead space.
A patient's mixed venous oxygen saturation (SvO2) falls from 75% to 55%. Possible causes include:
Q11
A. Decreased oxygen consumption only.
B. Increased oxygen consumption, decreased cardiac output, or decreased arterial oxygen content.
C. Improved tissue perfusion.
D. Hyperoxia from excessive FiO2.
Correct Answer: B
Rationale:
SvO2 falls when oxygen delivery decreases relative to consumption.
STUVIAACTUALEXAM TMC 2026/2027
