lOMoARcPSD|64024314
TMC PRACTICE EXAM UPDATE
VERIFIED QUESTIONS & DETAILED
EXPLANATIONS GRADED A+
A 60 year-old male has just been extubated following coronary artery bypass grafting.
His chest X-ray demonstrates platelike infiltrates with scattered densities and he is
noted to have decreased chest expansion with an increased respiratory rate. Which of
the following treatments should be recommended for this patient?
A. diuretics
B. antibiotics
C. lung expansion therapy
D. thoracentesis - ANSWER- lung expansion therapy
A 42 year-old trauma patient in the ED has been intubated with a 6.5 mm oral
endotracheal tube equipped with a high-residual-volume, low-pressure cuff. The
respiratory therapist notes that a cuff pressure of 42 cm H2O is necessary to achieve a
minimal occluding volume. This would indicate that the
A. tube is not of the appropriate size.
B. pilot balloon and line are obstructed.
C. pressure manometer is defective.
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D. cuff has herniated over the tip of the tube. - ANSWER- tube is not of the appropriate
size.
A patient is receiving oxygen via nasal cannula at 2 L/min and has the following ABG
results: pH 7.37, PaCO2 42 torr, PaO2 80, HCO3 38 mEq/L. The most likely
explanation for these results is that
A. the sample was not iced properly.
B. there was excess heparin in the syringe.
C. the numbers were not reported correctly.
D. The sample contains venous blood. - ANSWER- the numbers were not reported
correctly.
The respiratory therapist is completing oxygen rounds on the ward and checking oxygen
saturations on a number of patients. What solution would be most appropriate for
disinfecting the surface of the pulse oximeter between patients?
A. 70% ethyl alchohol
B. Warm soapy water
C. Bleach
D. Acid glutaraldehyde - ANSWER- 70% ethyl alchohol
Evaluation of a spontaneously breathing patient reveals tachypnea, tracheal deviation to
the right and an absence of breath sounds on the left. The most likely etiology would be
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A. bronchiectasis.
B. myasthenia gravis.
C. acute asthmatic attack.
D. left tension pneumothorax. - ANSWER- left tension pneumothorax.
A 48 year-old female is admitted to the ED with diaphoresis, jugular venous distension,
and 3+ pitting edema in the ankles. These findings are consistent with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances - ANSWER- 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 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?
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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.
Downloaded by derrick maina ()
TMC PRACTICE EXAM UPDATE
VERIFIED QUESTIONS & DETAILED
EXPLANATIONS GRADED A+
A 60 year-old male has just been extubated following coronary artery bypass grafting.
His chest X-ray demonstrates platelike infiltrates with scattered densities and he is
noted to have decreased chest expansion with an increased respiratory rate. Which of
the following treatments should be recommended for this patient?
A. diuretics
B. antibiotics
C. lung expansion therapy
D. thoracentesis - ANSWER- lung expansion therapy
A 42 year-old trauma patient in the ED has been intubated with a 6.5 mm oral
endotracheal tube equipped with a high-residual-volume, low-pressure cuff. The
respiratory therapist notes that a cuff pressure of 42 cm H2O is necessary to achieve a
minimal occluding volume. This would indicate that the
A. tube is not of the appropriate size.
B. pilot balloon and line are obstructed.
C. pressure manometer is defective.
Downloaded by derrick maina ()
, lOMoARcPSD|64024314
D. cuff has herniated over the tip of the tube. - ANSWER- tube is not of the appropriate
size.
A patient is receiving oxygen via nasal cannula at 2 L/min and has the following ABG
results: pH 7.37, PaCO2 42 torr, PaO2 80, HCO3 38 mEq/L. The most likely
explanation for these results is that
A. the sample was not iced properly.
B. there was excess heparin in the syringe.
C. the numbers were not reported correctly.
D. The sample contains venous blood. - ANSWER- the numbers were not reported
correctly.
The respiratory therapist is completing oxygen rounds on the ward and checking oxygen
saturations on a number of patients. What solution would be most appropriate for
disinfecting the surface of the pulse oximeter between patients?
A. 70% ethyl alchohol
B. Warm soapy water
C. Bleach
D. Acid glutaraldehyde - ANSWER- 70% ethyl alchohol
Evaluation of a spontaneously breathing patient reveals tachypnea, tracheal deviation to
the right and an absence of breath sounds on the left. The most likely etiology would be
Downloaded by derrick maina ()
, lOMoARcPSD|64024314
A. bronchiectasis.
B. myasthenia gravis.
C. acute asthmatic attack.
D. left tension pneumothorax. - ANSWER- left tension pneumothorax.
A 48 year-old female is admitted to the ED with diaphoresis, jugular venous distension,
and 3+ pitting edema in the ankles. These findings are consistent with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances - ANSWER- 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 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?
Downloaded by derrick maina ()
, lOMoARcPSD|64024314
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.
Downloaded by derrick maina ()
