Kettering TMC Exam Practice (2026) -
500+ Practice Questions & Answers for
Respiratory Therapist TMC Board
Exam Prep Review (PDF) | Verified
Kettering TMC Exam Practice (2026) - 500+ | Comprehensive
Examination
Kettering TMC Exam Practice (2026) - 500+ Practice
Questions & Answers for Respiratory Therapist TMC Board
Exam Prep Review (PDF) actual exam preparation document
INTRODUCTION
This document is an important and very helpful preparation
resource for Kettering TMC Exam Practice (2026) - 500+
Practice Questions & Answers for Respiratory Therapist TMC
Board Exam Prep Review (PDF). Every item uses a focused
exam stem, four response options, a keyed response, and a clear
rationale, making it easier to understand the subject, spot
distractors, and build real exam confidence.
Page 1
, Question 1
A patient receiving volume-controlled ventilation has the following data: set
VT 500 mL, PIP 45 cm H2O, Pplat 35 cm H2O, auto-PEEP 5 cm H2O. Which
of the following best explains the elevated peak-to-plateau pressure gradient?
A. Decreased compliance
B. Increased airway resistance
C. Auto-PEEP
D. Increased chest wall compliance
Correct Answer: B - Increased airway resistance
RATIONALE
A peak-to-plateau pressure gradient >10 cm H2O indicates increased
airway resistance (e.g., bronchospasm, secretions, small ETT).
Decreased compliance would elevate both PIP and Pplat equally.
Auto-PEEP affects both but does not primarily widen the gradient.
Question 2
An adult patient with COPD has an ABG: pH 7.36, PaCO2 60 mm Hg, HCO3-
32 mEq/L. Which of the following best describes the acid-base status?
A. Acute respiratory acidosis
B. Chronic respiratory acidosis with metabolic compensation
C. Acute respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: B - Chronic respiratory acidosis with metabolic
compensation
RATIONALE
The elevated PaCO2 with near-normal pH and elevated HCO3-
indicates chronic respiratory acidosis with renal compensation. Acute
respiratory acidosis would have a normal HCO3- and lower pH. The
HCO3- elevation rules out alkalosis.
Page 2
, Question 3
A patient on a ventilator has a sudden drop in SpO2 from 98% to 85%, with
decreased breath sounds on the right and tracheal deviation to the left. Which
of the following is the most appropriate immediate action?
A. Increase PEEP
B. Perform needle decompression
C. Obtain a chest X-ray
D. Suction the airway
Correct Answer: B - Perform needle decompression
RATIONALE
These findings suggest tension pneumothorax, a life-threatening
emergency requiring immediate needle decompression. Waiting for
imaging or other interventions can be fatal. Increasing PEEP or
suctioning would worsen the condition.
Question 4
Which of the following aerosol delivery devices is most appropriate for a
patient with a tracheostomy who requires frequent bronchodilator treatments
and has poor coordination?
A. Metered-dose inhaler (MDI) with spacer
B. Small-volume nebulizer (SVN) with T-piece
C. Dry powder inhaler (DPI)
D. Soft mist inhaler
Correct Answer: B - Small-volume nebulizer (SVN) with T-piece
RATIONALE
A small-volume nebulizer with T-piece is ideal for tracheostomy
patients because it does not require coordination and can be used
continuously with the tracheostomy. MDIs and DPIs require adequate
inspiratory effort and coordination, which may be difficult.
Page 3
, Question 5
A patient with ARDS is on volume-controlled ventilation with VT 6 mL/kg
predicted body weight, PEEP 15 cm H2O, and FiO2 0.6. ABG: pH 7.28,
PaCO2 55 mm Hg, PaO2 60 mm Hg. Which of the following is the most
appropriate next step?
A. Increase VT to 8 mL/kg
B. Increase PEEP to 20 cm H2O
C. Increase respiratory rate
D. Decrease FiO2 to 0.5
Correct Answer: C - Increase respiratory rate
RATIONALE
In ARDS, lung-protective ventilation with low VT is essential.
Permissive hypercapnia is acceptable; increasing respiratory rate can
help normalize pH without increasing VT. Increasing VT or PEEP
may cause lung injury.
Question 6
A patient's pulmonary function test shows: FEV1/FVC 0.65, FEV1 70%
predicted, FVC 85% predicted, TLC 110% predicted. Which of the following
patterns is most consistent with these findings?
A. Restrictive
B. Obstructive
C. Mixed
D. Normal
Correct Answer: B - Obstructive
Page 4
500+ Practice Questions & Answers for
Respiratory Therapist TMC Board
Exam Prep Review (PDF) | Verified
Kettering TMC Exam Practice (2026) - 500+ | Comprehensive
Examination
Kettering TMC Exam Practice (2026) - 500+ Practice
Questions & Answers for Respiratory Therapist TMC Board
Exam Prep Review (PDF) actual exam preparation document
INTRODUCTION
This document is an important and very helpful preparation
resource for Kettering TMC Exam Practice (2026) - 500+
Practice Questions & Answers for Respiratory Therapist TMC
Board Exam Prep Review (PDF). Every item uses a focused
exam stem, four response options, a keyed response, and a clear
rationale, making it easier to understand the subject, spot
distractors, and build real exam confidence.
Page 1
, Question 1
A patient receiving volume-controlled ventilation has the following data: set
VT 500 mL, PIP 45 cm H2O, Pplat 35 cm H2O, auto-PEEP 5 cm H2O. Which
of the following best explains the elevated peak-to-plateau pressure gradient?
A. Decreased compliance
B. Increased airway resistance
C. Auto-PEEP
D. Increased chest wall compliance
Correct Answer: B - Increased airway resistance
RATIONALE
A peak-to-plateau pressure gradient >10 cm H2O indicates increased
airway resistance (e.g., bronchospasm, secretions, small ETT).
Decreased compliance would elevate both PIP and Pplat equally.
Auto-PEEP affects both but does not primarily widen the gradient.
Question 2
An adult patient with COPD has an ABG: pH 7.36, PaCO2 60 mm Hg, HCO3-
32 mEq/L. Which of the following best describes the acid-base status?
A. Acute respiratory acidosis
B. Chronic respiratory acidosis with metabolic compensation
C. Acute respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: B - Chronic respiratory acidosis with metabolic
compensation
RATIONALE
The elevated PaCO2 with near-normal pH and elevated HCO3-
indicates chronic respiratory acidosis with renal compensation. Acute
respiratory acidosis would have a normal HCO3- and lower pH. The
HCO3- elevation rules out alkalosis.
Page 2
, Question 3
A patient on a ventilator has a sudden drop in SpO2 from 98% to 85%, with
decreased breath sounds on the right and tracheal deviation to the left. Which
of the following is the most appropriate immediate action?
A. Increase PEEP
B. Perform needle decompression
C. Obtain a chest X-ray
D. Suction the airway
Correct Answer: B - Perform needle decompression
RATIONALE
These findings suggest tension pneumothorax, a life-threatening
emergency requiring immediate needle decompression. Waiting for
imaging or other interventions can be fatal. Increasing PEEP or
suctioning would worsen the condition.
Question 4
Which of the following aerosol delivery devices is most appropriate for a
patient with a tracheostomy who requires frequent bronchodilator treatments
and has poor coordination?
A. Metered-dose inhaler (MDI) with spacer
B. Small-volume nebulizer (SVN) with T-piece
C. Dry powder inhaler (DPI)
D. Soft mist inhaler
Correct Answer: B - Small-volume nebulizer (SVN) with T-piece
RATIONALE
A small-volume nebulizer with T-piece is ideal for tracheostomy
patients because it does not require coordination and can be used
continuously with the tracheostomy. MDIs and DPIs require adequate
inspiratory effort and coordination, which may be difficult.
Page 3
, Question 5
A patient with ARDS is on volume-controlled ventilation with VT 6 mL/kg
predicted body weight, PEEP 15 cm H2O, and FiO2 0.6. ABG: pH 7.28,
PaCO2 55 mm Hg, PaO2 60 mm Hg. Which of the following is the most
appropriate next step?
A. Increase VT to 8 mL/kg
B. Increase PEEP to 20 cm H2O
C. Increase respiratory rate
D. Decrease FiO2 to 0.5
Correct Answer: C - Increase respiratory rate
RATIONALE
In ARDS, lung-protective ventilation with low VT is essential.
Permissive hypercapnia is acceptable; increasing respiratory rate can
help normalize pH without increasing VT. Increasing VT or PEEP
may cause lung injury.
Question 6
A patient's pulmonary function test shows: FEV1/FVC 0.65, FEV1 70%
predicted, FVC 85% predicted, TLC 110% predicted. Which of the following
patterns is most consistent with these findings?
A. Restrictive
B. Obstructive
C. Mixed
D. Normal
Correct Answer: B - Obstructive
Page 4
