TMC Test Practice Questions and Correct
Answers
Which of the following staining procedures is used to broadly categorize bacteria into
two major groups according to differences in the chemical composition of their cell
wall?
Select one:
A. carbolfusin stain
B. acid-fast stain
C. methylene blue stain
D. Gram stain
✓ ~~~ D. Gram stain
In reviewing a transthoracic ultrasound scan you note a prominent shadow occurring
beneath a rib. What does this shadow signify?
Select one:
A. pneumothorax
B. pulmonary edema
C. atelectasis
D. normal finding
✓ ~~~ D. normal finding
A patient has a pH of 7.22 and a PaCO2 of 38 torr. Based on these data, what is the
primary acid-base disturbance?
Select one:
A. respiratory alkalosis
B. metabolic acidosis
C. respiratory acidosis
D. metabolic alkalosis
✓ ~~~ B. metabolic acidosis
For which of the following purposes would you recommend a V/Q scan?
[To diagnose a] [To predict] [To measure]
[pulmonary] [post-lobectomy] [the physiologic]
[embolism] [lung function] [deadspace]
A. Yes Yes Yes
B. Yes No Yes
C. No Yes Yes
D. Yes Yes No
Select one:
A. A
B. B
,C. C
D. D
✓ ~~~ D. D
Which of the following conditions is most likely to cause an elevated white blood
count?
Select one:
A. pulmonary fibrosis
B. bacterial bronchitis
C. pneumothorax
D. hypertension
✓ ~~~ B. bacterial bronchitis
Which of the following echocardiogram findings are consistent with a diagnosis of
systolic heart failure?
Select one:
A. decreased LV ejection fraction (< 45%)
B. decreased LV chamber compliance
C. decreased LV end-diastolic volume
D. increased pulmonary artery pressure
✓ ~~~ A. decreased LV ejection fraction (< 45%)
Which of the following measures would indicate to you that an adult patient may not
be ready to wean from mechanical ventilation?
Select one:
A. vital capacity = 2500 mL
B. MIP/NIF = -l0 cm H2O
C. respiratory rate = 23/min
D. PaO2/FIO2 (P/F ratio) = 350
✓ ~~~ B. MIP/NIF = -l0 cm H2O
What is the normal range for arterial base excess (BE)?
Select one:
A. 22 to 26 mEq/L
B. -2 to +2 mEq/L
C. 45 to 55 mEq/L
D. -10 to +10 mEq/L
✓ ~~~ B. -2 to +2 mEq/L
While inspecting a spontaneously breathing adult patient's thorax, you note
paradoxical movement of the right chest wall. This observation is most consistent
with which of the following conditions?
Select one:
A. pulmonary emphysema
,B. phrenic nerve dysfunction
C. pulmonary embolism
D. pulmonary fibrosis
✓ ~~~ B. phrenic nerve dysfunction
Upon exam of an acutely dyspneic and hypotensive patient, you note the following
(all limited to the left hemithorax): reduced chest expansion, hyperresonance to
percussion, absent of breath sounds and tactile fremitus, and a tracheal shift to the
right. These findings suggest:
Select one:
A. left-sided pleural effusion
B. left-sided consolidation
C. left lobar obstruction/atelectasis
D. left-sided pneumothorax
✓ ~~~ D. left-sided pneumothorax
A patient is asked to inhale as deeply as possible and blow out all his air as hard as
they can until empty. What test is being performed?
Select one:
A. FVC
B. IC
C. TLC
D. MVV
✓ ~~~ A. FVC
Which of the following findings would you expect to observe on the AP chest
radiograph of a patient suffering from advanced stages of pulmonary emphysema?
Select one:
A. increased vascular markings
B. flattening of the diaphragms
C. decreased radiolucency
D. increased C/T ratio
✓ ~~~ B. flattening of the diaphragms
Activity of the respiratory accessory muscles indicates:
Select one:
A. normal ventilation
B. increased pulmonary compliance
C. increased airway resistance
D. decreased work of breathing
✓ ~~~ C. increased airway resistance
Inspection of a patient reveals jugular venous distention. Which of the following is the
most likely cause of this observation?
Select one:
, A. right heart failure
B. hypovolemia
C. pulmonary hypotension
D. dehydration
✓ ~~~ A. right heart failure
When inspecting the X-ray of a patient in ICU, you note radiolucent streaks within the
soft tissues of the chest wall/neck. Which of the following is the most likely problem?
Select one:
A. subcutaneous emphysema
B. pneumomediastinum
C. pneumothorax
D. interstitial infiltration
✓ ~~~ A. subcutaneous emphysema
You are reviewing the chest X-ray of a 32 year-old female receiving ventilatory
support via an oral endotracheal (ET) tube. To assure proper placement of the tube,
you would look for its tip to be positioned
Select one:
A. at the same level as the carina
B. not more than 2 cm above the carina
C. between the 2nd and 4th thoracic vertebra
D. level with the fifth cervical vertebra
✓ ~~~ C. between the 2nd and 4th thoracic vertebra
The best way to determine whether or not a patient has learned the information
needed to understand how her disease impacts on lung function would be to:
Select one:
A. have her take a multiple choice quiz
B. discuss the information with patient's family
C. have her "teach" the information back to you
D. have her perform a return demonstration
✓ ~~~ C. have her "teach" the information back to you
On physical examination of a patient with chronic bronchitis, you would expect to find
which of the following?
[Course] [Weight loss/] [Signs of cor] [Increased AP]
[bilateral] [cachexia] [pulmonale] [chest diameter]
[rhonchi]
A. Yes Yes Yes Yes
B. No Yes Yes No
C. Yes Yes No Yes
D. Yes No Yes No
Answers
Which of the following staining procedures is used to broadly categorize bacteria into
two major groups according to differences in the chemical composition of their cell
wall?
Select one:
A. carbolfusin stain
B. acid-fast stain
C. methylene blue stain
D. Gram stain
✓ ~~~ D. Gram stain
In reviewing a transthoracic ultrasound scan you note a prominent shadow occurring
beneath a rib. What does this shadow signify?
Select one:
A. pneumothorax
B. pulmonary edema
C. atelectasis
D. normal finding
✓ ~~~ D. normal finding
A patient has a pH of 7.22 and a PaCO2 of 38 torr. Based on these data, what is the
primary acid-base disturbance?
Select one:
A. respiratory alkalosis
B. metabolic acidosis
C. respiratory acidosis
D. metabolic alkalosis
✓ ~~~ B. metabolic acidosis
For which of the following purposes would you recommend a V/Q scan?
[To diagnose a] [To predict] [To measure]
[pulmonary] [post-lobectomy] [the physiologic]
[embolism] [lung function] [deadspace]
A. Yes Yes Yes
B. Yes No Yes
C. No Yes Yes
D. Yes Yes No
Select one:
A. A
B. B
,C. C
D. D
✓ ~~~ D. D
Which of the following conditions is most likely to cause an elevated white blood
count?
Select one:
A. pulmonary fibrosis
B. bacterial bronchitis
C. pneumothorax
D. hypertension
✓ ~~~ B. bacterial bronchitis
Which of the following echocardiogram findings are consistent with a diagnosis of
systolic heart failure?
Select one:
A. decreased LV ejection fraction (< 45%)
B. decreased LV chamber compliance
C. decreased LV end-diastolic volume
D. increased pulmonary artery pressure
✓ ~~~ A. decreased LV ejection fraction (< 45%)
Which of the following measures would indicate to you that an adult patient may not
be ready to wean from mechanical ventilation?
Select one:
A. vital capacity = 2500 mL
B. MIP/NIF = -l0 cm H2O
C. respiratory rate = 23/min
D. PaO2/FIO2 (P/F ratio) = 350
✓ ~~~ B. MIP/NIF = -l0 cm H2O
What is the normal range for arterial base excess (BE)?
Select one:
A. 22 to 26 mEq/L
B. -2 to +2 mEq/L
C. 45 to 55 mEq/L
D. -10 to +10 mEq/L
✓ ~~~ B. -2 to +2 mEq/L
While inspecting a spontaneously breathing adult patient's thorax, you note
paradoxical movement of the right chest wall. This observation is most consistent
with which of the following conditions?
Select one:
A. pulmonary emphysema
,B. phrenic nerve dysfunction
C. pulmonary embolism
D. pulmonary fibrosis
✓ ~~~ B. phrenic nerve dysfunction
Upon exam of an acutely dyspneic and hypotensive patient, you note the following
(all limited to the left hemithorax): reduced chest expansion, hyperresonance to
percussion, absent of breath sounds and tactile fremitus, and a tracheal shift to the
right. These findings suggest:
Select one:
A. left-sided pleural effusion
B. left-sided consolidation
C. left lobar obstruction/atelectasis
D. left-sided pneumothorax
✓ ~~~ D. left-sided pneumothorax
A patient is asked to inhale as deeply as possible and blow out all his air as hard as
they can until empty. What test is being performed?
Select one:
A. FVC
B. IC
C. TLC
D. MVV
✓ ~~~ A. FVC
Which of the following findings would you expect to observe on the AP chest
radiograph of a patient suffering from advanced stages of pulmonary emphysema?
Select one:
A. increased vascular markings
B. flattening of the diaphragms
C. decreased radiolucency
D. increased C/T ratio
✓ ~~~ B. flattening of the diaphragms
Activity of the respiratory accessory muscles indicates:
Select one:
A. normal ventilation
B. increased pulmonary compliance
C. increased airway resistance
D. decreased work of breathing
✓ ~~~ C. increased airway resistance
Inspection of a patient reveals jugular venous distention. Which of the following is the
most likely cause of this observation?
Select one:
, A. right heart failure
B. hypovolemia
C. pulmonary hypotension
D. dehydration
✓ ~~~ A. right heart failure
When inspecting the X-ray of a patient in ICU, you note radiolucent streaks within the
soft tissues of the chest wall/neck. Which of the following is the most likely problem?
Select one:
A. subcutaneous emphysema
B. pneumomediastinum
C. pneumothorax
D. interstitial infiltration
✓ ~~~ A. subcutaneous emphysema
You are reviewing the chest X-ray of a 32 year-old female receiving ventilatory
support via an oral endotracheal (ET) tube. To assure proper placement of the tube,
you would look for its tip to be positioned
Select one:
A. at the same level as the carina
B. not more than 2 cm above the carina
C. between the 2nd and 4th thoracic vertebra
D. level with the fifth cervical vertebra
✓ ~~~ C. between the 2nd and 4th thoracic vertebra
The best way to determine whether or not a patient has learned the information
needed to understand how her disease impacts on lung function would be to:
Select one:
A. have her take a multiple choice quiz
B. discuss the information with patient's family
C. have her "teach" the information back to you
D. have her perform a return demonstration
✓ ~~~ C. have her "teach" the information back to you
On physical examination of a patient with chronic bronchitis, you would expect to find
which of the following?
[Course] [Weight loss/] [Signs of cor] [Increased AP]
[bilateral] [cachexia] [pulmonale] [chest diameter]
[rhonchi]
A. Yes Yes Yes Yes
B. No Yes Yes No
C. Yes Yes No Yes
D. Yes No Yes No
