TMC PRACTICE EXAM 2 QUESTIONS AND
ANSWERS WITH SOLUTIONS 2024
After a patient undergoes a thoracentesis, the respiratory therapist notes that the obtained pleural fluid
is clear with a slight straw color. This fluid is most likely the result of
A.empyema.
B.congestive heart failure.
C.lung carcinoma.
D.hemothorax. - ANSWER B.congestive heart failure.
Which of the following would be most important to evaluate for a patient who is entering a smoking
cessation program?
A.Height
B.Smoking history
C.Weight
D.Diet - ANSWER B.Smoking history
The respiratory therapist calibrates a spirometer and checks the volume with a 3.0 liter super syringe.
The volumes recorded are: 2.85 L, 2.8 L, and 2.8 L. Based upon the information obtained which of the
following is a correct statement?
A.Another syringe needs to be used
B.Spirometer is accurate
C.The plunger was advanced too slowly
D.Spirometer may have a leak - ANSWER D.Spirometer may have a leak
Which of the following is an indication for high frequency jet ventilation?
A.Bronchopleural fistula
B.Wilson Mikity syndrome
C.Necrotizing lesion of right lung
D.Centrilobular emphysema - ANSWER A.Bronchopleural fistula
,A 43-year-old female patient undergoes a total abdominal hysterectomy. The patient arrives in the Post
Anesthesia Care Unit obtunded with minimal response to painful stimulus. What treatment should the
respiratory therapist recommend for this patient?
A.Initiate assisted ventilation
B.Insert oropharyngeal airway
C.Obtain positron emission tomography
D.Initiate noninvasive capnography - ANSWER B.Insert oropharyngeal airway
A 44-week gestational age infant is delivered via C-section and is gasping, grunting, and has tachycardia
and tachypnea. At one minute his Apgar score is 4 and at 5 minutes the score is 5. The infant is most
likely suffering from
A.transient tachypnea of the newborn.
B.meconium aspiration.
C.bronchopulmonary dysplasia.
D.apnea of prematurity. - ANSWER B.meconium aspiration.
What is the normal VD/VT ratio for a patient breathing room air?
A.5 - 15%
B.20 - 40%
C.45 - 55%
D.65 - 75% - ANSWER B.20 - 40%
A heat moisture exchanger is indicated for humidification in which of the following situations?
A.Mechanical ventilation in a long-term care facility.
B.Transport to a tertiary care center.
C.Patient with tenacious secretions.
D.Delivery of aerosolized bronchodilators. - ANSWER B.Transport to a tertiary care center.
All of the following could cause a patient's right-hemidiaphragm to be elevated, EXCEPT
A.right lower lobe atelectasis.
,B.right side hyperlucency, absent vascular markings.
C.hepatomegaly.
D.right lower lobe consolidation with air bronchograms. - ANSWER B.right side hyperlucency, absent
vascular markings.
A 64-year-old, 70 kg (154 lb) man with severe COPD receives independent (differential) lung ventilation
following thoracotomy and right lower lobectomy. Which of the following setting combinations would be
most appropriate for this patient?
A.Right lung 50 mL; left lung 450 mL
B.Right lung 150 mL; left lung 350 mL
C.Right lung 250 mL; left lung 250 mL
D.Right lung 350 mL; left lung 150 mL - ANSWER B.Right lung 150 mL; left lung 350 mL
A patient in the intensive care unit has the following hemodynamic measurements:CVP (mm Hg)5PAP
(mm Hg)29/8PCWP (mm Hg)8BP (mm Hg)130/70Cardiac output (L/min)5.1Cardiac index
(L/min/m2)2.7What is the pulse pressure?
A.15 mm Hg
B.21 mm Hg
C.60 mm Hg
D.90 mm Hg - ANSWER C.60 mm Hg
A 2-year-old child with croup has been intubated for 4 days with a 4 mm ID uncuffed endotracheal tube.
Heated aerosol at an FIO2 of 0.30 has been delivered to the patient. The physician asks the respiratory
therapist to evaluate the patient for possible extubation. Which of the following would most likely
indicate that the patient is ready for extubation?
A.The patient is making normal quiet ventilatory efforts.
B.A negative sputum culture and sensitivity has been reported.
C.The patient's ABG are within normal range.
D.Breath sounds are heard around the tube on auscultation. - ANSWER D.Breath sounds are heard
around the tube on auscultation.
, A patient is seen in the Emergency Department for complaints of nausea and vomiting. A nasogastric
tube has been inserted and the patient is started on lasix. Which of the following should the respiratory
therapist monitor?
A.Cardiac enzymes
B.Serum electrolytes
C.Arterial blood gases
D.Cell hydration level - ANSWER B.Serum electrolytes
While instructing a patient prior to a vital capacity maneuver, the respiratory therapist should direct the
patient to
A.exhale to residual volume and inhale to inspiratory capacity.
B.inhale to total lung capacity then exhale to residual volume.
C.exhale normally then inhale to total lung capacity.
D.inhale normally then exhale to functional residual capacity. - ANSWER B.inhale to total lung capacity
then exhale to residual volume.
A patient involved in an automobile accident is brought to the ED with tachypnea, tracheal deviation to
the right, splinting, asymmetrical chest movement, and decreased breath sounds on the left side. The
respiratory therapist should initially
A.insert a chest tube.
B.administer 100% oxygen via mask.
C.perform endotracheal intubation.
D.initiate non-invasive positive pressure ventilation. - ANSWER B.administer 100% oxygen via mask.
A 77-year-old male patient is admitted to the emergency room with shortness of breath, fine basilar
crackles, +2 pitting edema and a chest radiogram with a butterfly pattern. These results are most
consistent with which of the following?
A.Pulmonary edema
B.Pulmonary interstitial emphysema
C.Pneumothorax
D.Emphysema - ANSWER A.Pulmonary edema
ANSWERS WITH SOLUTIONS 2024
After a patient undergoes a thoracentesis, the respiratory therapist notes that the obtained pleural fluid
is clear with a slight straw color. This fluid is most likely the result of
A.empyema.
B.congestive heart failure.
C.lung carcinoma.
D.hemothorax. - ANSWER B.congestive heart failure.
Which of the following would be most important to evaluate for a patient who is entering a smoking
cessation program?
A.Height
B.Smoking history
C.Weight
D.Diet - ANSWER B.Smoking history
The respiratory therapist calibrates a spirometer and checks the volume with a 3.0 liter super syringe.
The volumes recorded are: 2.85 L, 2.8 L, and 2.8 L. Based upon the information obtained which of the
following is a correct statement?
A.Another syringe needs to be used
B.Spirometer is accurate
C.The plunger was advanced too slowly
D.Spirometer may have a leak - ANSWER D.Spirometer may have a leak
Which of the following is an indication for high frequency jet ventilation?
A.Bronchopleural fistula
B.Wilson Mikity syndrome
C.Necrotizing lesion of right lung
D.Centrilobular emphysema - ANSWER A.Bronchopleural fistula
,A 43-year-old female patient undergoes a total abdominal hysterectomy. The patient arrives in the Post
Anesthesia Care Unit obtunded with minimal response to painful stimulus. What treatment should the
respiratory therapist recommend for this patient?
A.Initiate assisted ventilation
B.Insert oropharyngeal airway
C.Obtain positron emission tomography
D.Initiate noninvasive capnography - ANSWER B.Insert oropharyngeal airway
A 44-week gestational age infant is delivered via C-section and is gasping, grunting, and has tachycardia
and tachypnea. At one minute his Apgar score is 4 and at 5 minutes the score is 5. The infant is most
likely suffering from
A.transient tachypnea of the newborn.
B.meconium aspiration.
C.bronchopulmonary dysplasia.
D.apnea of prematurity. - ANSWER B.meconium aspiration.
What is the normal VD/VT ratio for a patient breathing room air?
A.5 - 15%
B.20 - 40%
C.45 - 55%
D.65 - 75% - ANSWER B.20 - 40%
A heat moisture exchanger is indicated for humidification in which of the following situations?
A.Mechanical ventilation in a long-term care facility.
B.Transport to a tertiary care center.
C.Patient with tenacious secretions.
D.Delivery of aerosolized bronchodilators. - ANSWER B.Transport to a tertiary care center.
All of the following could cause a patient's right-hemidiaphragm to be elevated, EXCEPT
A.right lower lobe atelectasis.
,B.right side hyperlucency, absent vascular markings.
C.hepatomegaly.
D.right lower lobe consolidation with air bronchograms. - ANSWER B.right side hyperlucency, absent
vascular markings.
A 64-year-old, 70 kg (154 lb) man with severe COPD receives independent (differential) lung ventilation
following thoracotomy and right lower lobectomy. Which of the following setting combinations would be
most appropriate for this patient?
A.Right lung 50 mL; left lung 450 mL
B.Right lung 150 mL; left lung 350 mL
C.Right lung 250 mL; left lung 250 mL
D.Right lung 350 mL; left lung 150 mL - ANSWER B.Right lung 150 mL; left lung 350 mL
A patient in the intensive care unit has the following hemodynamic measurements:CVP (mm Hg)5PAP
(mm Hg)29/8PCWP (mm Hg)8BP (mm Hg)130/70Cardiac output (L/min)5.1Cardiac index
(L/min/m2)2.7What is the pulse pressure?
A.15 mm Hg
B.21 mm Hg
C.60 mm Hg
D.90 mm Hg - ANSWER C.60 mm Hg
A 2-year-old child with croup has been intubated for 4 days with a 4 mm ID uncuffed endotracheal tube.
Heated aerosol at an FIO2 of 0.30 has been delivered to the patient. The physician asks the respiratory
therapist to evaluate the patient for possible extubation. Which of the following would most likely
indicate that the patient is ready for extubation?
A.The patient is making normal quiet ventilatory efforts.
B.A negative sputum culture and sensitivity has been reported.
C.The patient's ABG are within normal range.
D.Breath sounds are heard around the tube on auscultation. - ANSWER D.Breath sounds are heard
around the tube on auscultation.
, A patient is seen in the Emergency Department for complaints of nausea and vomiting. A nasogastric
tube has been inserted and the patient is started on lasix. Which of the following should the respiratory
therapist monitor?
A.Cardiac enzymes
B.Serum electrolytes
C.Arterial blood gases
D.Cell hydration level - ANSWER B.Serum electrolytes
While instructing a patient prior to a vital capacity maneuver, the respiratory therapist should direct the
patient to
A.exhale to residual volume and inhale to inspiratory capacity.
B.inhale to total lung capacity then exhale to residual volume.
C.exhale normally then inhale to total lung capacity.
D.inhale normally then exhale to functional residual capacity. - ANSWER B.inhale to total lung capacity
then exhale to residual volume.
A patient involved in an automobile accident is brought to the ED with tachypnea, tracheal deviation to
the right, splinting, asymmetrical chest movement, and decreased breath sounds on the left side. The
respiratory therapist should initially
A.insert a chest tube.
B.administer 100% oxygen via mask.
C.perform endotracheal intubation.
D.initiate non-invasive positive pressure ventilation. - ANSWER B.administer 100% oxygen via mask.
A 77-year-old male patient is admitted to the emergency room with shortness of breath, fine basilar
crackles, +2 pitting edema and a chest radiogram with a butterfly pattern. These results are most
consistent with which of the following?
A.Pulmonary edema
B.Pulmonary interstitial emphysema
C.Pneumothorax
D.Emphysema - ANSWER A.Pulmonary edema
