RESPIRATORY THERAPIST TMC
BOARD EXAM PREP REVIEW
QUESTIONS AND ANSWERS
1. A 65-year-old patient with CHF presents with a CVP of 12 mmHg, a PAP of 40/22 mmHg,
and a PCWP of 20 mmHg. The Cardiac Output is 3.2 L/min. Which of the following conditions
is most likely present?
A. Left-sided heart failure
B. Pulmonary hypertension
C. Right-sided heart failure
D. Pulmonary embolism
Answer: A
Conceptual Explanation: Elevated PCWP (>18 mmHg) and CVP, combined with low
cardiac output, are classic indicators of left-sided heart failure or cardiogenic pulmonary
edema.
,2. A patient on a ventilator has a PaCO2 of 58 mmHg and a pH of 7.28. Current settings: Mode
A/C, Rate 12, VT 450 mL. To normalize the PaCO2, which of the following changes should be
made?
A. Decrease the tidal volume
B. Increase the respiratory rate
C. Increase the FIO2
D. Decrease the respiratory rate
Answer: B
Conceptual Explanation: The patient has respiratory acidosis due to hypercapnia.
Increasing the respiratory rate will increase minute ventilation and lower the PaCO2.
3. While monitoring a patient in the ICU, you notice the Pressure-Volume loop on the
ventilator screen is shifting to the right and flattening. This indicates:
A. Increased compliance
B. Decreased airway resistance
C. Increased surfactant production
D. Decreased compliance
Answer: D
, Conceptual Explanation: A shift toward the pressure axis (right) and a decrease in slope
(flattening) indicates that more pressure is required for the same volume, representing
decreased lung compliance.
4. An ABG shows: pH 7.36, PaCO2 62 mmHg, PaO2 55 mmHg, HCO3 34 mEq/L. This
interpretation is:
A. Acute respiratory acidosis
B. Compensated metabolic alkalosis
C. Compensated respiratory acidosis
D. Partially compensated metabolic acidosis
Answer: C
Conceptual Explanation: The pH is within normal range (compensated), and the high
PaCO2 paired with high HCO3 indicates the kidneys have compensated for a chronic
respiratory condition.
5. Calculate the VD/VT ratio given the following: PaCO2 = 45 mmHg, PeCO2 = 30 mmHg.
A. 0.25
B. 0.5
C. 0.33
D. 0.66
Answer: C
BOARD EXAM PREP REVIEW
QUESTIONS AND ANSWERS
1. A 65-year-old patient with CHF presents with a CVP of 12 mmHg, a PAP of 40/22 mmHg,
and a PCWP of 20 mmHg. The Cardiac Output is 3.2 L/min. Which of the following conditions
is most likely present?
A. Left-sided heart failure
B. Pulmonary hypertension
C. Right-sided heart failure
D. Pulmonary embolism
Answer: A
Conceptual Explanation: Elevated PCWP (>18 mmHg) and CVP, combined with low
cardiac output, are classic indicators of left-sided heart failure or cardiogenic pulmonary
edema.
,2. A patient on a ventilator has a PaCO2 of 58 mmHg and a pH of 7.28. Current settings: Mode
A/C, Rate 12, VT 450 mL. To normalize the PaCO2, which of the following changes should be
made?
A. Decrease the tidal volume
B. Increase the respiratory rate
C. Increase the FIO2
D. Decrease the respiratory rate
Answer: B
Conceptual Explanation: The patient has respiratory acidosis due to hypercapnia.
Increasing the respiratory rate will increase minute ventilation and lower the PaCO2.
3. While monitoring a patient in the ICU, you notice the Pressure-Volume loop on the
ventilator screen is shifting to the right and flattening. This indicates:
A. Increased compliance
B. Decreased airway resistance
C. Increased surfactant production
D. Decreased compliance
Answer: D
, Conceptual Explanation: A shift toward the pressure axis (right) and a decrease in slope
(flattening) indicates that more pressure is required for the same volume, representing
decreased lung compliance.
4. An ABG shows: pH 7.36, PaCO2 62 mmHg, PaO2 55 mmHg, HCO3 34 mEq/L. This
interpretation is:
A. Acute respiratory acidosis
B. Compensated metabolic alkalosis
C. Compensated respiratory acidosis
D. Partially compensated metabolic acidosis
Answer: C
Conceptual Explanation: The pH is within normal range (compensated), and the high
PaCO2 paired with high HCO3 indicates the kidneys have compensated for a chronic
respiratory condition.
5. Calculate the VD/VT ratio given the following: PaCO2 = 45 mmHg, PeCO2 = 30 mmHg.
A. 0.25
B. 0.5
C. 0.33
D. 0.66
Answer: C
