KETTERING TMC EXAM PRACTICE
PRACTICE QUESTIONS & ANSWERS
FOR RESPIRATORY THERAPIST TMC
BOARD EXAM PREP REVIEW 2026/2027
1. A patient with ARDS is being ventilated with a PEEP of 15 cm H2O. The therapist notices a
sudden drop in blood pressure and an increase in heart rate. Which of the following is the
most likely cause?
A. Improved lung compliance
B. Development of metabolic alkalosis
C. Increased cardiac output
D. Reduced venous return to the heart
Answer: D
Conceptual Explanation: High PEEP increases intrathoracic pressure, which can compress
the vena cava, reducing venous return (preload) and subsequently decreasing cardiac
output and blood pressure.
,2. Which of the following values represents a normal Alveolar-arterial oxygen gradient [P(A-
a)O2] for a 25-year-old patient breathing room air?
A. 20 - 30 mm Hg
B. 5 - 15 mm Hg
C. 35 - 45 mm Hg
D. Over 50 mm Hg
Answer: B
Conceptual Explanation: The normal A-a gradient for a healthy young adult on room air
typically ranges from 5 to 15 mm Hg, increasing slightly with age.
3. A 65-kg (143 lb) male patient is being mechanically ventilated. Current settings: VC/AC
mode, Rate 12, Vt 450 mL, FiO2 0.40, PEEP 5. ABG: pH 7.28, PaCO2 54 mm Hg, PaO2 72 mm
Hg, HCO3 25 mEq/L. What action should be taken?
A. Increase the FiO2
B. Increase the Tidal Volume
C. Increase the PEEP
D. Decrease the respiratory rate
Answer: B
, Conceptual Explanation: The patient has respiratory acidosis (high PaCO2, low pH). To
lower the PaCO2, minute ventilation must be increased. Since Vt is at the lower end of the
range for this weight, increasing Vt is a valid option.
4. Calculate the Static Compliance (Cs) given the following: Vt 500 mL, Plateau Pressure 25 cm
H2O, PEEP 5 cm H2O.
A. 25 mL/cm H2O
B. 20 mL/cm H2O
C. 33 mL/cm H2O
D. 50 mL/cm H2O
Answer: A
Conceptual Explanation: Static Compliance = Vt / (Plateau - PEEP). 500 / (25 - 5) = 500 /
20 = 25 mL/cm H2O.
5. During a bedside PFT, a patient has a FEV1/FVC ratio of 55% of predicted. This is most
characteristic of:
A. Restrictive lung disease
B. Normal lung function
C. Obstructive lung disease
D. Chest wall deformity
Answer: C
PRACTICE QUESTIONS & ANSWERS
FOR RESPIRATORY THERAPIST TMC
BOARD EXAM PREP REVIEW 2026/2027
1. A patient with ARDS is being ventilated with a PEEP of 15 cm H2O. The therapist notices a
sudden drop in blood pressure and an increase in heart rate. Which of the following is the
most likely cause?
A. Improved lung compliance
B. Development of metabolic alkalosis
C. Increased cardiac output
D. Reduced venous return to the heart
Answer: D
Conceptual Explanation: High PEEP increases intrathoracic pressure, which can compress
the vena cava, reducing venous return (preload) and subsequently decreasing cardiac
output and blood pressure.
,2. Which of the following values represents a normal Alveolar-arterial oxygen gradient [P(A-
a)O2] for a 25-year-old patient breathing room air?
A. 20 - 30 mm Hg
B. 5 - 15 mm Hg
C. 35 - 45 mm Hg
D. Over 50 mm Hg
Answer: B
Conceptual Explanation: The normal A-a gradient for a healthy young adult on room air
typically ranges from 5 to 15 mm Hg, increasing slightly with age.
3. A 65-kg (143 lb) male patient is being mechanically ventilated. Current settings: VC/AC
mode, Rate 12, Vt 450 mL, FiO2 0.40, PEEP 5. ABG: pH 7.28, PaCO2 54 mm Hg, PaO2 72 mm
Hg, HCO3 25 mEq/L. What action should be taken?
A. Increase the FiO2
B. Increase the Tidal Volume
C. Increase the PEEP
D. Decrease the respiratory rate
Answer: B
, Conceptual Explanation: The patient has respiratory acidosis (high PaCO2, low pH). To
lower the PaCO2, minute ventilation must be increased. Since Vt is at the lower end of the
range for this weight, increasing Vt is a valid option.
4. Calculate the Static Compliance (Cs) given the following: Vt 500 mL, Plateau Pressure 25 cm
H2O, PEEP 5 cm H2O.
A. 25 mL/cm H2O
B. 20 mL/cm H2O
C. 33 mL/cm H2O
D. 50 mL/cm H2O
Answer: A
Conceptual Explanation: Static Compliance = Vt / (Plateau - PEEP). 500 / (25 - 5) = 500 /
20 = 25 mL/cm H2O.
5. During a bedside PFT, a patient has a FEV1/FVC ratio of 55% of predicted. This is most
characteristic of:
A. Restrictive lung disease
B. Normal lung function
C. Obstructive lung disease
D. Chest wall deformity
Answer: C
