TMC EXAM C 140 QUESTIONS WITH 100%
CORRECT ANSWERS COMPLETE SOLUTION
The respiratory therapist should evaluate which of the following to develop a teaching
plan for a patient who will be using a small volume nebulizer at home?
A. highest grade level achieved in school
B. manual dexterity
C. spousal support
D. english speaking proficiency ...ANSWER...Your answer was : B
The correct answer is : B
Explanation : A patient that is taking nebulizer treatments needs to be able to
demonstrate manual dexterity, and the ability to hold and manipulate the nebulizer.
During the instruction, appropriate language skills are also important but English
proficiency is not required. What is NOT important is the patient's spousal support. This
will have no effect on their ability to self administer nebulizer treatments.
Which of the following would be most beneficial in resolving microatelectasis?
A. Thoracentesis
B. Bronchoscopy
C. Percutaneous ventilation
D. Chest tubes ...ANSWER...Your answer was : B
The correct answer is : B
Explanation : A bronchoscopy would be most beneficial because it can ventilate and
recruit alveoli in the lung. The other options will not decrease atelectasis.
A 45 year-old patient is recovering in the intensive care unit after undergoing a surgical
procedure to repair a hernia. The patient remains unconscious. To prevent soft tissue
obstruction, the respiratory therapist should recommend a(n)
A. double-lumen endobronchial tube
B. nasopharyngeal airway
C. bite block
D. oropharyngeal airway ...ANSWER...Your answer was : D
The correct answer is : D
Explanation : An oral pharyngeal airway is the primary mechanism used to prevent the
time from falling back and obstructing the airway. Although a double lumen
endobronchial tube would also do this, it is far too invasive and not necessary.
,Quality control material has published values for pH of 7.20, PO2 of 65 mmHg.
Documentation indicates the range of pH is 0.5% and is 3% for PO2. Machine results
are as follows:
pH PO2 (mmHg) Run 1 7.19 64Run 2 7.1069Run 3 7.2165
Which quality control run(s) indicate the machine is out of control?
A. Run 2 and 3
B. Run 1 and 2
C. Run 2 only
D. Run 3 only ...ANSWER...Your answer was : C
The correct answer is : C
Explanation : This question involves doing some math. You must look at each pH and
add and subtract 0.5%. You must do the same for the PO2, using 3%. From there you
can look at the results and determine which Run is out of control. In this case only Run
two is out of control.
A respiratory therapist is considering a patient's readiness to wean from mechanical
ventilation. To determine the A-aDO2, the therapist will need which of the following?
A. CaO2 and PAO2
B. VD/VT and PAO2
C. VD/VT and ABG
D. ABG and alveolar oxygen tension ...ANSWER...Your answer was : A
The correct answer is : D
Explanation : This question requires you to remember what is needed to calculate A-a
gradient. You only need two things - the alveolar oxygen tension (PAO2), and the
arterial oxygen tension, determined from an arterial blood gas.
A patient with increased airway resistance from a fixed upper airway obstruction would
benefit most from which of the following?
A. heliox therapy
B. aerosolized atropine
C. epinephrine
D. bronchodilator therapy ...ANSWER...Your answer was : A
The correct answer is : A
Explanation : A fixed upper airway obstruction means air is having difficulty moving both
in and out. It is usually caused by cancer or other non-changeable conditions. In this
case the best thing we can do is decrease airway resistance by using helium or Heliox
therapy.
Evaluating MIP (maximum inspiratory pressure) is most useful in evaluating which of the
following?
A. presence of a restrictive pulmonary defect
B. presence of obstructive pulmonary defect
C. inspiratory muscle strength
D. effectiveness of cough ...ANSWER...Your answer was : C
The correct answer is : C
,Explanation : Maximum inspiratory pressure is most useful in evaluating for inspiratory
muscle strength, or the ability to sustain ventilation. To determine if a patient has a
restricted pulmonary defect one would need to do a pulmonary function test. The
effectiveness of a cough would be assessed through doing a maximum expiratory
pressure maneuver, or MEP.
An air-entrainment jet nebulizer is set at 50%. The respiratory therapist analyzes the
oxygen coming from the end of the tubing and finds it is 60%. Which of the following
most likely explains this finding?
A. excess water in the tubing
B. poorly calibrated analyzer
C. leak in the tubing
D. low flow through the jet orifice ...ANSWER...Your answer was : A
The correct answer is : A
Explanation : When administering oxygen by any device that has a venturi mechanism,
back pressure on the venturi will slow the speed of gas, decrease room air entrainment,
and result in an increase in FIO2. Of the options offered, only excess water in the tubing
would cause this type of back pressure.
During a preoperational test of the ventilator with a test lung, the respiratory therapist
notes a return tidal volume of 600 cc. Ventilator settings are:
Mode Assist/control FIO2 0.50Mandatory rate 10VT 750 mL
What action should the therapist take?
A. Obtain a smaller test lung
B. Examine the ventilator circuit for proper connections
C. Increase the set tidal volume to 900 mL
D. Obtain a larger test lung ...ANSWER...Your answer was : B
The correct answer is : B
Explanation : The purpose of a preoperational test on a ventilator is to ensure proper
connections and assembly of those necessary parts. The reduced return tidal volume
observed would most logically be caused by a failure to make a good connection
between the ventilator circuit in the ventilator.
During the preoperational test of the ventilator, the respiratory therapist notices the
galvanic analyzer on the ventilator is reading erroneously low. Which of the following
can the respiratory therapist do to correct the problem?
A. change the fuel cell
B. replace the analyzer batteries
C. tag the ventilator as non-functional and avoid placing it in service
D. replace the electrolyte solution in the analyzer ...ANSWER...Your answer was : A
The correct answer is : A
Explanation : A galvanic oxygen analyzer will read erroneously under two conditions:
the probe or the fuel cell is depleted or the analyzer requires calibration. In this case the
probe, which provides the energy for the analyzer, is the most likely culprit and should
be changed.
, Which of the following is most likely to increase nosocomial infection in a hospital?
A. use of alcohol-based hand cleaners
B. poor hand washing among staff
C. frequent disconnection in the ventilator circuit
D. use of an HME for 48 hours ...ANSWER...Your answer was : B
The correct answer is : B
Explanation : The most common nosocomial infection source is from poor hand
washing. Although frequent disconnection of a ventilator circuit will also increase
incidence of infection, poor hand washing is by far more common.
While monitoring a patient receiving mechanical ventilation, the respiratory therapist
notices the low-pressure and low exhaled volume alarms are sounding. Which of the
following could be the cause?
A. disconnected thermistor line
B. herniated endotracheal tube cuff
C. kinked endotracheal tube
D. excess water in the inspiratory limb of the circuit ...ANSWER...Your answer was : A
The correct answer is : A
Explanation : If you have a low pressure or low exhaled volume ventilator alarm, you
must look for the problem that could cause that specific type of alarm. If you look at the
answers, a kink in the endotracheal tube would cause a high-pressure alarm so that
cannot be the cause. Excess water in the limbs of the circuit would do the same. A high-
pressure alarm would also develope if there is a herniated endotracheal tube cuff. This
leaves the only possible answer which is a disconnected thermistor line.
A patient receiving positive pressure ventilation has a low-pressure alarm sounding.
Which of the following could be the cause?
A. a fracture in the plastic wye
B. kinked ET tube
C. excess secretions in the airway
D. herniated cuff ...ANSWER...Your answer was : A
The correct answer is : A
Explanation : A low-pressure alarm is caused by a leak or a disconnection or by the
patient if he or she is inhaling at a higher inspiratory demand than that being delivered
by the ventilator. The solution of this problem is to look each of the answers and
determine which one of those things could cause a low-pressure alarm. In this case a
crack in the Y plastic piece would cause a leak. A herniated cuff, excess secretions in
the airway, and a kinked ET tube would all cause high-pressure alarms.
The high pressure alarm is sounding on a patient receiving volume controlled
ventilation. The respiratory therapist should FIRST
A. suction the patient
B. cancel the alarm
C. observe the alarm panel to determine source
D. provide manual ventilation ...ANSWER...Your answer was : D
The correct answer is : D
CORRECT ANSWERS COMPLETE SOLUTION
The respiratory therapist should evaluate which of the following to develop a teaching
plan for a patient who will be using a small volume nebulizer at home?
A. highest grade level achieved in school
B. manual dexterity
C. spousal support
D. english speaking proficiency ...ANSWER...Your answer was : B
The correct answer is : B
Explanation : A patient that is taking nebulizer treatments needs to be able to
demonstrate manual dexterity, and the ability to hold and manipulate the nebulizer.
During the instruction, appropriate language skills are also important but English
proficiency is not required. What is NOT important is the patient's spousal support. This
will have no effect on their ability to self administer nebulizer treatments.
Which of the following would be most beneficial in resolving microatelectasis?
A. Thoracentesis
B. Bronchoscopy
C. Percutaneous ventilation
D. Chest tubes ...ANSWER...Your answer was : B
The correct answer is : B
Explanation : A bronchoscopy would be most beneficial because it can ventilate and
recruit alveoli in the lung. The other options will not decrease atelectasis.
A 45 year-old patient is recovering in the intensive care unit after undergoing a surgical
procedure to repair a hernia. The patient remains unconscious. To prevent soft tissue
obstruction, the respiratory therapist should recommend a(n)
A. double-lumen endobronchial tube
B. nasopharyngeal airway
C. bite block
D. oropharyngeal airway ...ANSWER...Your answer was : D
The correct answer is : D
Explanation : An oral pharyngeal airway is the primary mechanism used to prevent the
time from falling back and obstructing the airway. Although a double lumen
endobronchial tube would also do this, it is far too invasive and not necessary.
,Quality control material has published values for pH of 7.20, PO2 of 65 mmHg.
Documentation indicates the range of pH is 0.5% and is 3% for PO2. Machine results
are as follows:
pH PO2 (mmHg) Run 1 7.19 64Run 2 7.1069Run 3 7.2165
Which quality control run(s) indicate the machine is out of control?
A. Run 2 and 3
B. Run 1 and 2
C. Run 2 only
D. Run 3 only ...ANSWER...Your answer was : C
The correct answer is : C
Explanation : This question involves doing some math. You must look at each pH and
add and subtract 0.5%. You must do the same for the PO2, using 3%. From there you
can look at the results and determine which Run is out of control. In this case only Run
two is out of control.
A respiratory therapist is considering a patient's readiness to wean from mechanical
ventilation. To determine the A-aDO2, the therapist will need which of the following?
A. CaO2 and PAO2
B. VD/VT and PAO2
C. VD/VT and ABG
D. ABG and alveolar oxygen tension ...ANSWER...Your answer was : A
The correct answer is : D
Explanation : This question requires you to remember what is needed to calculate A-a
gradient. You only need two things - the alveolar oxygen tension (PAO2), and the
arterial oxygen tension, determined from an arterial blood gas.
A patient with increased airway resistance from a fixed upper airway obstruction would
benefit most from which of the following?
A. heliox therapy
B. aerosolized atropine
C. epinephrine
D. bronchodilator therapy ...ANSWER...Your answer was : A
The correct answer is : A
Explanation : A fixed upper airway obstruction means air is having difficulty moving both
in and out. It is usually caused by cancer or other non-changeable conditions. In this
case the best thing we can do is decrease airway resistance by using helium or Heliox
therapy.
Evaluating MIP (maximum inspiratory pressure) is most useful in evaluating which of the
following?
A. presence of a restrictive pulmonary defect
B. presence of obstructive pulmonary defect
C. inspiratory muscle strength
D. effectiveness of cough ...ANSWER...Your answer was : C
The correct answer is : C
,Explanation : Maximum inspiratory pressure is most useful in evaluating for inspiratory
muscle strength, or the ability to sustain ventilation. To determine if a patient has a
restricted pulmonary defect one would need to do a pulmonary function test. The
effectiveness of a cough would be assessed through doing a maximum expiratory
pressure maneuver, or MEP.
An air-entrainment jet nebulizer is set at 50%. The respiratory therapist analyzes the
oxygen coming from the end of the tubing and finds it is 60%. Which of the following
most likely explains this finding?
A. excess water in the tubing
B. poorly calibrated analyzer
C. leak in the tubing
D. low flow through the jet orifice ...ANSWER...Your answer was : A
The correct answer is : A
Explanation : When administering oxygen by any device that has a venturi mechanism,
back pressure on the venturi will slow the speed of gas, decrease room air entrainment,
and result in an increase in FIO2. Of the options offered, only excess water in the tubing
would cause this type of back pressure.
During a preoperational test of the ventilator with a test lung, the respiratory therapist
notes a return tidal volume of 600 cc. Ventilator settings are:
Mode Assist/control FIO2 0.50Mandatory rate 10VT 750 mL
What action should the therapist take?
A. Obtain a smaller test lung
B. Examine the ventilator circuit for proper connections
C. Increase the set tidal volume to 900 mL
D. Obtain a larger test lung ...ANSWER...Your answer was : B
The correct answer is : B
Explanation : The purpose of a preoperational test on a ventilator is to ensure proper
connections and assembly of those necessary parts. The reduced return tidal volume
observed would most logically be caused by a failure to make a good connection
between the ventilator circuit in the ventilator.
During the preoperational test of the ventilator, the respiratory therapist notices the
galvanic analyzer on the ventilator is reading erroneously low. Which of the following
can the respiratory therapist do to correct the problem?
A. change the fuel cell
B. replace the analyzer batteries
C. tag the ventilator as non-functional and avoid placing it in service
D. replace the electrolyte solution in the analyzer ...ANSWER...Your answer was : A
The correct answer is : A
Explanation : A galvanic oxygen analyzer will read erroneously under two conditions:
the probe or the fuel cell is depleted or the analyzer requires calibration. In this case the
probe, which provides the energy for the analyzer, is the most likely culprit and should
be changed.
, Which of the following is most likely to increase nosocomial infection in a hospital?
A. use of alcohol-based hand cleaners
B. poor hand washing among staff
C. frequent disconnection in the ventilator circuit
D. use of an HME for 48 hours ...ANSWER...Your answer was : B
The correct answer is : B
Explanation : The most common nosocomial infection source is from poor hand
washing. Although frequent disconnection of a ventilator circuit will also increase
incidence of infection, poor hand washing is by far more common.
While monitoring a patient receiving mechanical ventilation, the respiratory therapist
notices the low-pressure and low exhaled volume alarms are sounding. Which of the
following could be the cause?
A. disconnected thermistor line
B. herniated endotracheal tube cuff
C. kinked endotracheal tube
D. excess water in the inspiratory limb of the circuit ...ANSWER...Your answer was : A
The correct answer is : A
Explanation : If you have a low pressure or low exhaled volume ventilator alarm, you
must look for the problem that could cause that specific type of alarm. If you look at the
answers, a kink in the endotracheal tube would cause a high-pressure alarm so that
cannot be the cause. Excess water in the limbs of the circuit would do the same. A high-
pressure alarm would also develope if there is a herniated endotracheal tube cuff. This
leaves the only possible answer which is a disconnected thermistor line.
A patient receiving positive pressure ventilation has a low-pressure alarm sounding.
Which of the following could be the cause?
A. a fracture in the plastic wye
B. kinked ET tube
C. excess secretions in the airway
D. herniated cuff ...ANSWER...Your answer was : A
The correct answer is : A
Explanation : A low-pressure alarm is caused by a leak or a disconnection or by the
patient if he or she is inhaling at a higher inspiratory demand than that being delivered
by the ventilator. The solution of this problem is to look each of the answers and
determine which one of those things could cause a low-pressure alarm. In this case a
crack in the Y plastic piece would cause a leak. A herniated cuff, excess secretions in
the airway, and a kinked ET tube would all cause high-pressure alarms.
The high pressure alarm is sounding on a patient receiving volume controlled
ventilation. The respiratory therapist should FIRST
A. suction the patient
B. cancel the alarm
C. observe the alarm panel to determine source
D. provide manual ventilation ...ANSWER...Your answer was : D
The correct answer is : D
