TMC Practice Exam 2 Rated A+
A 150 kg (330 lb) patient is referred to a sleep center for evaluation of sleep apnea and
daytime drowsiness. Which of the following is the most appropriate diagnostic
procedure?
A.Spirometry
B.Pulse oximetry
C.Polysomnography
D.Body plethysmography - ANSWER-C.Polysomnography
A 1600 g neonate receives oxygen by oxyhood at an FIO2 of 0.60. The flowmeter is set
at 5 L/min. While analyzing the oxygen, the respiratory therapist notices varying FIO2
readings at different locations inside the oxyhood. The therapist should
A.re-calibrate the oxygen analyzing device.
B.increase the flow to the oxyhood.
C.place the neonate in an isolette at an FIO2 of 0.60.
D.check the water level of the humidifier. - ANSWER-B.increase the flow to the
oxyhood.
A 17 year-old patient receives 40% oxygen via a Venturi mask following a motor vehicle
accident. He suddenly develops acute shortness of breath, is diaphoretic and SpO2 is
85%. Breath sounds are vesicular on the right and extremely diminished on the left. The
respiratory therapist should evaluate the patient for the presence of
A.atelectasis.
B.a pneumothorax.
C.arterial hypertension.
D.a myocardial infarction. - ANSWER-B.a pneumothorax.
A 19-year-old patient has a size 7 mm ID nasotracheal tube placed through the right
nare. While attempting to suction the patient with a size 12 Fr catheter, resistance is
met as the catheter is introduced into the endotracheal tube. The respiratory therapist
should
A.lubricate the catheter with petroleum jelly prior to suctioning.
B.instill acetylcysteine into the endotracheal tube.
C.switch to a 10 Fr suction catheter.
D.extubate the patient and reintubate with a size 9 mm ID endotracheal tube. -
ANSWER-C.switch to a 10 Fr suction catheter.
A 2-year-old child recently diagnosed with laryngotracheobronchitis requires the
administration of 40% oxygen. What is the most appropriate method for delivering the
oxygen?
A.Oxyhood connected to a blender
B.Cool aerosol mask
C.Venturi mask
D.Croup tent - ANSWER-B.Cool aerosol mask
,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 2100 g neonate in the NICU is monitored with a TcPO2 monitor. The TcPO2 reads 53
torr with the temperature set at 40oC. The arterial PO2 is 73 torr. Which of the following
would best explain the difference in TcPO2 levels?
A.There was an error in the arterial blood gas analysis.
B.The TcPO2 monitor needs to be repositioned on the neonate.
C.The TcPO2 temperature setting is too low.
D.The TcPO2 monitor has come off the skin. - ANSWER-C.The TcPO2 temperature
setting is too low.
A 25-year-old, 58 kg (130 lb) female is admitted to ICU after an emergency C-section
and receives mechanical ventilation via volume-control ventilator. The current ventilator
settings are:ModeVC, SIMVVT500 mLf12 bpmFIO20.50PEEP5 cm H2OThe following
laboratory data are available:pH7.36PaCO244 torrPaO250 torrHCO3-24
mEq/LSaO282%CVP7 cm H2OPAP13 mm Hg (mean)QT4.5 L/min.The respiratory
therapist should recommend increasing which of the following?
A.Tidal volume
B.PEEP
C.Set rate
D.FIO2 - ANSWER-D.FIO2
A 30-year-old male who weighs 68 kg (150 lb) has a minute ventilation of 9 L/min. and a
respiratory rate of 20/min. What is his alveolar minute volume?
A.4 L/min.
B.6 L/min.
C.8 L/min.
D.12 L/min. - ANSWER-B.6 L/min.
A 32-week gestational age infant is receiving mechanical ventilation for pulmonary
interstitial emphysema. The respiratory therapist suspects that a pneumothorax has
developed. Which of the following diagnostic procedures should the therapist
recommend to confirm this diagnosis?
A.Upper airway x-ray
B.Capillary blood gas
C.Chest radiograph
,D.Pre- & post-ductal blood gases - ANSWER-C.Chest radiograph
A 4-year-old girl is admitted to the Emergency Department with persistent dry coughing.
Chest radiograph results reveal normal inspiration with the right lung remaining
expanded on expiration. Which of the following should the respiratory therapist
recommend at this time?
A.Endobronchial intubation
B.Arterial blood gas analysis
C.Bronchoscopic examination
D.Lateral neck radiograph - ANSWER-C.Bronchoscopic examination
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.
A 48 year-old woman is admitted to the coronary care unit for chest pain, dizziness and
nausea. Her blood pressure is 60/40 mm Hg, respirations are 20/min. The cardiac
monitor shows sinus rhythm at a rate of 50/minute with frequent multifocal PVC. The
respiratory therapist should recommend administration of
A.lidocaine.
B.nitroglycerin.
C.atropine.
D.amiodarone. - ANSWER-C.atropine.
A 55 year-old patient admitted to the Emergency Department has a history of
hypertension. The patient is conscious, diaphoretic and complaining of chest pain. The
respiratory therapist's first response should be to
A.administer oxygen.
B.place the patient on a cardiac monitor.
C.administer nitroglycerin sublingual.
D.insert a peripheral intravenous line. - ANSWER-A.administer oxygen.
A 58 year-old male patient is hypoxic on volume control ventilation and is receiving 15
cm H2O of PEEP on an FIO2 0.60. Shortly after increasing the PEEP therapy to 18 cm
, H2O, the respiratory therapist notes that the systemic blood pressure has fallen from
110/72 mm Hg to 94/50 mm Hg and the cardiac output has fallen from 4.3 L/min. to 2.5
L/min. The most appropriate action at this time would be to
A.maintain the present therapy and re-evaluate the patient in thirty minutes.
B.decrease the PEEP to 15 cm H2O and increase the FIO2 to 0.70.
C.decrease the PEEP to 12 cm H2O and maintain the FIO2 at 0.60.
D.discontinue the PEEP and increase the FIO2 to 0.80. - ANSWER-B.decrease the
PEEP to 15 cm H2O and increase the FIO2 to 0.70.
A 62-year-old female who weighs 60 kg (132 lb) is on mechanical ventilation following
hip replacement surgery.Ventilator settings are as follows:ModeVC, SIMV
FIO20.35
Set rate12 /min.Total rate12 /min.
VT500 mL
Arterial blood gas results are as follows:pH7.50; PaCO230 torr; PaO2105 torr; HCO3-24
mEq/L
The respiratory therapist should
A.switch to pressure control mode.
B.institute pressure support.
C.decrease the minute volume.
D.decrease the FIO2. - ANSWER-C.decrease the minute volume.
A 62-year-old patient with a history of emphysema (body weight 50 kg, 110 lb) requires
mechanical ventilation because of acute respiratory failure. The respiratory therapist
notes the following:ModeVC, SIMVSet rate10 /min.Total rate16 /min.VT 400 mLFIO2
0.28Arterial blood gases are as follows:pH7.37PCO256 torrPO265 torrHCO3-32
mEq/LThe therapist should
A.increase the set rate to 12 /min.
B.increase the FIO2 to 0.30.
C.maintain the current settings.
D.increase the VT to 650 mL. - ANSWER-C.maintain the current settings.
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 7 year-old child suspected of having epiglottitis would exhibit which of the following
signs? Drooling
Hyperextended neck
Stridor
Unilateral wheeze
A 150 kg (330 lb) patient is referred to a sleep center for evaluation of sleep apnea and
daytime drowsiness. Which of the following is the most appropriate diagnostic
procedure?
A.Spirometry
B.Pulse oximetry
C.Polysomnography
D.Body plethysmography - ANSWER-C.Polysomnography
A 1600 g neonate receives oxygen by oxyhood at an FIO2 of 0.60. The flowmeter is set
at 5 L/min. While analyzing the oxygen, the respiratory therapist notices varying FIO2
readings at different locations inside the oxyhood. The therapist should
A.re-calibrate the oxygen analyzing device.
B.increase the flow to the oxyhood.
C.place the neonate in an isolette at an FIO2 of 0.60.
D.check the water level of the humidifier. - ANSWER-B.increase the flow to the
oxyhood.
A 17 year-old patient receives 40% oxygen via a Venturi mask following a motor vehicle
accident. He suddenly develops acute shortness of breath, is diaphoretic and SpO2 is
85%. Breath sounds are vesicular on the right and extremely diminished on the left. The
respiratory therapist should evaluate the patient for the presence of
A.atelectasis.
B.a pneumothorax.
C.arterial hypertension.
D.a myocardial infarction. - ANSWER-B.a pneumothorax.
A 19-year-old patient has a size 7 mm ID nasotracheal tube placed through the right
nare. While attempting to suction the patient with a size 12 Fr catheter, resistance is
met as the catheter is introduced into the endotracheal tube. The respiratory therapist
should
A.lubricate the catheter with petroleum jelly prior to suctioning.
B.instill acetylcysteine into the endotracheal tube.
C.switch to a 10 Fr suction catheter.
D.extubate the patient and reintubate with a size 9 mm ID endotracheal tube. -
ANSWER-C.switch to a 10 Fr suction catheter.
A 2-year-old child recently diagnosed with laryngotracheobronchitis requires the
administration of 40% oxygen. What is the most appropriate method for delivering the
oxygen?
A.Oxyhood connected to a blender
B.Cool aerosol mask
C.Venturi mask
D.Croup tent - ANSWER-B.Cool aerosol mask
,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 2100 g neonate in the NICU is monitored with a TcPO2 monitor. The TcPO2 reads 53
torr with the temperature set at 40oC. The arterial PO2 is 73 torr. Which of the following
would best explain the difference in TcPO2 levels?
A.There was an error in the arterial blood gas analysis.
B.The TcPO2 monitor needs to be repositioned on the neonate.
C.The TcPO2 temperature setting is too low.
D.The TcPO2 monitor has come off the skin. - ANSWER-C.The TcPO2 temperature
setting is too low.
A 25-year-old, 58 kg (130 lb) female is admitted to ICU after an emergency C-section
and receives mechanical ventilation via volume-control ventilator. The current ventilator
settings are:ModeVC, SIMVVT500 mLf12 bpmFIO20.50PEEP5 cm H2OThe following
laboratory data are available:pH7.36PaCO244 torrPaO250 torrHCO3-24
mEq/LSaO282%CVP7 cm H2OPAP13 mm Hg (mean)QT4.5 L/min.The respiratory
therapist should recommend increasing which of the following?
A.Tidal volume
B.PEEP
C.Set rate
D.FIO2 - ANSWER-D.FIO2
A 30-year-old male who weighs 68 kg (150 lb) has a minute ventilation of 9 L/min. and a
respiratory rate of 20/min. What is his alveolar minute volume?
A.4 L/min.
B.6 L/min.
C.8 L/min.
D.12 L/min. - ANSWER-B.6 L/min.
A 32-week gestational age infant is receiving mechanical ventilation for pulmonary
interstitial emphysema. The respiratory therapist suspects that a pneumothorax has
developed. Which of the following diagnostic procedures should the therapist
recommend to confirm this diagnosis?
A.Upper airway x-ray
B.Capillary blood gas
C.Chest radiograph
,D.Pre- & post-ductal blood gases - ANSWER-C.Chest radiograph
A 4-year-old girl is admitted to the Emergency Department with persistent dry coughing.
Chest radiograph results reveal normal inspiration with the right lung remaining
expanded on expiration. Which of the following should the respiratory therapist
recommend at this time?
A.Endobronchial intubation
B.Arterial blood gas analysis
C.Bronchoscopic examination
D.Lateral neck radiograph - ANSWER-C.Bronchoscopic examination
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.
A 48 year-old woman is admitted to the coronary care unit for chest pain, dizziness and
nausea. Her blood pressure is 60/40 mm Hg, respirations are 20/min. The cardiac
monitor shows sinus rhythm at a rate of 50/minute with frequent multifocal PVC. The
respiratory therapist should recommend administration of
A.lidocaine.
B.nitroglycerin.
C.atropine.
D.amiodarone. - ANSWER-C.atropine.
A 55 year-old patient admitted to the Emergency Department has a history of
hypertension. The patient is conscious, diaphoretic and complaining of chest pain. The
respiratory therapist's first response should be to
A.administer oxygen.
B.place the patient on a cardiac monitor.
C.administer nitroglycerin sublingual.
D.insert a peripheral intravenous line. - ANSWER-A.administer oxygen.
A 58 year-old male patient is hypoxic on volume control ventilation and is receiving 15
cm H2O of PEEP on an FIO2 0.60. Shortly after increasing the PEEP therapy to 18 cm
, H2O, the respiratory therapist notes that the systemic blood pressure has fallen from
110/72 mm Hg to 94/50 mm Hg and the cardiac output has fallen from 4.3 L/min. to 2.5
L/min. The most appropriate action at this time would be to
A.maintain the present therapy and re-evaluate the patient in thirty minutes.
B.decrease the PEEP to 15 cm H2O and increase the FIO2 to 0.70.
C.decrease the PEEP to 12 cm H2O and maintain the FIO2 at 0.60.
D.discontinue the PEEP and increase the FIO2 to 0.80. - ANSWER-B.decrease the
PEEP to 15 cm H2O and increase the FIO2 to 0.70.
A 62-year-old female who weighs 60 kg (132 lb) is on mechanical ventilation following
hip replacement surgery.Ventilator settings are as follows:ModeVC, SIMV
FIO20.35
Set rate12 /min.Total rate12 /min.
VT500 mL
Arterial blood gas results are as follows:pH7.50; PaCO230 torr; PaO2105 torr; HCO3-24
mEq/L
The respiratory therapist should
A.switch to pressure control mode.
B.institute pressure support.
C.decrease the minute volume.
D.decrease the FIO2. - ANSWER-C.decrease the minute volume.
A 62-year-old patient with a history of emphysema (body weight 50 kg, 110 lb) requires
mechanical ventilation because of acute respiratory failure. The respiratory therapist
notes the following:ModeVC, SIMVSet rate10 /min.Total rate16 /min.VT 400 mLFIO2
0.28Arterial blood gases are as follows:pH7.37PCO256 torrPO265 torrHCO3-32
mEq/LThe therapist should
A.increase the set rate to 12 /min.
B.increase the FIO2 to 0.30.
C.maintain the current settings.
D.increase the VT to 650 mL. - ANSWER-C.maintain the current settings.
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 7 year-old child suspected of having epiglottitis would exhibit which of the following
signs? Drooling
Hyperextended neck
Stridor
Unilateral wheeze
