SECURE COMPREHENSIVE THERAPIST SAE| TMC EXAM QUESTIONS
AND ANSWERS
1. A patient with COPD on 2 L/min via nasal cannula has a PaO2 of 45 mm Hg and a PaCO2 of 65
mm Hg. The most appropriate initial action is to:
ANSWER: Apply noninvasive positive pressure ventilation (NIPPV/BiPAP).
2. What is the primary mechanism of action of albuterol?
ANSWER: Beta-2 adrenergic receptor agonist, causing bronchodilation.
3. A post-operative patient develops sudden dyspnea and tachycardia. Breath sounds are absent
on the left side. The immediate action is to:
ANSWER: Suspect a tension pneumothorax and perform needle decompression.
4. The normal range for anion gap is:
ANSWER: 8-16 mEq/L.
5. Which arterial blood gas result indicates fully compensated respiratory acidosis?
ANSWER: pH 7.36, PaCO2 55 mm Hg, HCO3- 30 mEq/L.
6. A patient with a tracheostomy tube develops respiratory distress. Suctioning reveals thick,
white secretions. The first action should be to:
ANSWER: Administer 100% oxygen and instill 5-10 mL of sterile normal saline before suctioning.
7. The primary hazard associated with high FiO2 in premature infants is:
ANSWER: Retinopathy of prematurity (ROP).
8. What is the correct compression-to-ventilation ratio for adult single-rescuer CPR?
,ANSWER: 30 compressions to 2 ventilations.
9. A patient's pulmonary function tests show: FEV1/FVC = 65%, increased TLC, and decreased
DLCO. This is most consistent with:
ANSWER: Emphysema.
10. The recommended initial ventilator setting for tidal volume in an adult with ARDS is:
ANSWER: 6-8 mL/kg of predicted body weight.
11. Which finding is an early sign of hypoxemia?
ANSWER: Tachycardia.
12. A patient with myasthenia gravis is admitted with acute respiratory failure. The most likely
blood gas finding is:
ANSWER: Respiratory acidosis with hypoxemia.
13. The purpose of "sigh" breaths on a mechanical ventilator is to:
ANSWER: Prevent atelectasis by periodically providing a larger tidal volume.
14. What is the primary indication for administering exogenous surfactant?
ANSWER: Neonatal Respiratory Distress Syndrome (RDS).
15. A patient on a volume ventilator has a peak pressure of 45 cm H2O and a plateau pressure
of 20 cm H2O. This indicates:
ANSWER: High airway resistance.
16. The most reliable method for confirming endotracheal tube placement is:
ANSWER: Waveform capnography.
, 17. A patient with CHF has crackles bilaterally and pink, frothy sputum. The most appropriate
initial ventilator setting to improve oxygenation is:
ANSWER: Apply PEEP.
18. What is the primary side effect of N-acetylcysteine (Mucomyst)?
ANSWER: Bronchospasm.
19. The normal pulmonary artery wedge pressure (PAWP) is:
ANSWER: 6-12 mm Hg.
20. A patient with a head injury has a PaCO2 of 30 mm Hg. The therapeutic goal for this patient
is to:
ANSWER: Maintain this PaCO2 to reduce intracranial pressure (ICP).
21. What is the primary contraindication for chest physiotherapy (CPT)?
ANSWER: Uncontrolled intracranial pressure (ICP).
22. The "100% O2 test" is used to differentiate between:
ANSWER: Intrapulmonary shunt and V/Q mismatch.
23. A patient with COPD should primarily receive oxygen via:
ANSWER: Low-flow nasal cannula to achieve a target SpO2 of 88-92%.
24. The drug of choice for treating status asthmaticus is:
ANSWER: Systemic corticosteroids.
25. What does a "shark fin" waveform on a ventilator indicate?
AND ANSWERS
1. A patient with COPD on 2 L/min via nasal cannula has a PaO2 of 45 mm Hg and a PaCO2 of 65
mm Hg. The most appropriate initial action is to:
ANSWER: Apply noninvasive positive pressure ventilation (NIPPV/BiPAP).
2. What is the primary mechanism of action of albuterol?
ANSWER: Beta-2 adrenergic receptor agonist, causing bronchodilation.
3. A post-operative patient develops sudden dyspnea and tachycardia. Breath sounds are absent
on the left side. The immediate action is to:
ANSWER: Suspect a tension pneumothorax and perform needle decompression.
4. The normal range for anion gap is:
ANSWER: 8-16 mEq/L.
5. Which arterial blood gas result indicates fully compensated respiratory acidosis?
ANSWER: pH 7.36, PaCO2 55 mm Hg, HCO3- 30 mEq/L.
6. A patient with a tracheostomy tube develops respiratory distress. Suctioning reveals thick,
white secretions. The first action should be to:
ANSWER: Administer 100% oxygen and instill 5-10 mL of sterile normal saline before suctioning.
7. The primary hazard associated with high FiO2 in premature infants is:
ANSWER: Retinopathy of prematurity (ROP).
8. What is the correct compression-to-ventilation ratio for adult single-rescuer CPR?
,ANSWER: 30 compressions to 2 ventilations.
9. A patient's pulmonary function tests show: FEV1/FVC = 65%, increased TLC, and decreased
DLCO. This is most consistent with:
ANSWER: Emphysema.
10. The recommended initial ventilator setting for tidal volume in an adult with ARDS is:
ANSWER: 6-8 mL/kg of predicted body weight.
11. Which finding is an early sign of hypoxemia?
ANSWER: Tachycardia.
12. A patient with myasthenia gravis is admitted with acute respiratory failure. The most likely
blood gas finding is:
ANSWER: Respiratory acidosis with hypoxemia.
13. The purpose of "sigh" breaths on a mechanical ventilator is to:
ANSWER: Prevent atelectasis by periodically providing a larger tidal volume.
14. What is the primary indication for administering exogenous surfactant?
ANSWER: Neonatal Respiratory Distress Syndrome (RDS).
15. A patient on a volume ventilator has a peak pressure of 45 cm H2O and a plateau pressure
of 20 cm H2O. This indicates:
ANSWER: High airway resistance.
16. The most reliable method for confirming endotracheal tube placement is:
ANSWER: Waveform capnography.
, 17. A patient with CHF has crackles bilaterally and pink, frothy sputum. The most appropriate
initial ventilator setting to improve oxygenation is:
ANSWER: Apply PEEP.
18. What is the primary side effect of N-acetylcysteine (Mucomyst)?
ANSWER: Bronchospasm.
19. The normal pulmonary artery wedge pressure (PAWP) is:
ANSWER: 6-12 mm Hg.
20. A patient with a head injury has a PaCO2 of 30 mm Hg. The therapeutic goal for this patient
is to:
ANSWER: Maintain this PaCO2 to reduce intracranial pressure (ICP).
21. What is the primary contraindication for chest physiotherapy (CPT)?
ANSWER: Uncontrolled intracranial pressure (ICP).
22. The "100% O2 test" is used to differentiate between:
ANSWER: Intrapulmonary shunt and V/Q mismatch.
23. A patient with COPD should primarily receive oxygen via:
ANSWER: Low-flow nasal cannula to achieve a target SpO2 of 88-92%.
24. The drug of choice for treating status asthmaticus is:
ANSWER: Systemic corticosteroids.
25. What does a "shark fin" waveform on a ventilator indicate?
