TMC FINAL EXAM PAPER B 2026
QUESTIONS WITH VERIFIED ANSWERS
COMPLETE STUDY PACK
⩥ When a respiratory therapist asks a patient if she knows where she is
and what day it is, the patient is being assessed for: Answer: Orientation
to place and time
(Rationale:
A. (c) Knowing the hospital name shows an orientation to place, and
knowing the day of the week shows orientation to time.)
⩥ A respiratory therapist should do which of the following for protection
from contamination from a patient who coughs violently during
endotracheal suctioning?
1. Wear a mask.
2. Wear goggles.
3. Restrain the patient.
4. Suction when the patient is asleep. Answer: 1 and 2 only
(Rationale:
A. (c) A mask and goggles will provide protection from secretions
coughed up by the patient.)
,⩥ A 30-week gestational-age neonate needs to have an arterialized
capillary blood sample taken for analysis. Which of the following are
important in this procedure?
1. The puncture site is warmed.
2. The puncture site has a positive modified Allen test.
3. The puncture site is the outer side of the heel.
4. The puncture site is cooled before the puncture.
5. Pressure is applied after the puncture. Answer: 1, 3, and 5 only
(Rationale:
C. (c) The preferred puncture site is the outside area of the infant's heel.
It is warmed to arterialize the blood flow before the sample is taken.
Pressure is then applied to prevent bruising.)
⩥ A patient with pneumonia is being supported with mechanical
ventilation, 45% oxygen, and 8 cm water PEEP. Before the PEEP was
applied the patient's PaO2 was 55 torr and P(A-a) O2 was 275 torr. After
the PEEP was applied, the PaO2 was 73 torr and P(A-a) O2 was 150
torr. What can be concluded from these results? Answer: The patient's
shunt percentage has decreased.
(Rationale:
,C. (c) A reduced P(A-a)O2 difference from 275 torr to 150 torr with the
addition of PEEP indicates that the patient's shunt % (or ventilation to
perfusion mismatch) has decreased.)
⩥ After a successful spontaneous breathing trial, the physician plans to
extubate a 4-year-old child recovering from pneumonia. The physician
wants to provide the highest oxygen percentage possible. What should
be recommended in this situation? Answer: High-flow nasal cannula
(Rationale:
D. (c) A high-flow nasal cannula is the only listed device that can supply
approximately 100% oxygen. In addition, it will provide positive
expiratory pressure, which will increase the functional residual capacity
(FRC) and further improve oxygenation.)
⩥ A mechanically ventilated patient has atelectasis and a small
functional residual capacity (FRC). This has caused hypoxemia. What
would you recommend to help correct the atelectasis and small FRC?
Answer: Add PEEP.
(Rationale:
A. (c) Therapeutic PEEP on the ventilator will increase the FRC and the
patient's O2 level and should help to correct the atelectasis.)
, ⩥ A patient with an upper airway obstruction is receiving helium-oxygen
therapy by a nonrebreathing mask. The respiratory therapist notices that
the reservoir bag is completely collapsing on inspiration. What is the
cause of the problem? Answer: The flow of helium and oxygen is too
low.
(Rationale:
C. (c) Increasing the flow of gas should result in the bag refilling.)
⩥ The physician has made the decision to change a neuromuscular
disease patient's tracheostomy tube to a tracheostomy button. A
tracheostomy button is indicated to Answer: Keep a patent tracheostomy
stoma.
(Rationale:
C. (c) The tracheostomy button maintains the stoma until it is
determined that the opening can safely be allowed to heal over.)
⩥ The respiratory therapist is assisting the physician during a
tracheostomy procedure on a patient with a nasal endotracheal tube.
When should the endotracheal tube be withdrawn? Answer: As the
physician is ready to insert the tracheostomy tube
(Rationale:
QUESTIONS WITH VERIFIED ANSWERS
COMPLETE STUDY PACK
⩥ When a respiratory therapist asks a patient if she knows where she is
and what day it is, the patient is being assessed for: Answer: Orientation
to place and time
(Rationale:
A. (c) Knowing the hospital name shows an orientation to place, and
knowing the day of the week shows orientation to time.)
⩥ A respiratory therapist should do which of the following for protection
from contamination from a patient who coughs violently during
endotracheal suctioning?
1. Wear a mask.
2. Wear goggles.
3. Restrain the patient.
4. Suction when the patient is asleep. Answer: 1 and 2 only
(Rationale:
A. (c) A mask and goggles will provide protection from secretions
coughed up by the patient.)
,⩥ A 30-week gestational-age neonate needs to have an arterialized
capillary blood sample taken for analysis. Which of the following are
important in this procedure?
1. The puncture site is warmed.
2. The puncture site has a positive modified Allen test.
3. The puncture site is the outer side of the heel.
4. The puncture site is cooled before the puncture.
5. Pressure is applied after the puncture. Answer: 1, 3, and 5 only
(Rationale:
C. (c) The preferred puncture site is the outside area of the infant's heel.
It is warmed to arterialize the blood flow before the sample is taken.
Pressure is then applied to prevent bruising.)
⩥ A patient with pneumonia is being supported with mechanical
ventilation, 45% oxygen, and 8 cm water PEEP. Before the PEEP was
applied the patient's PaO2 was 55 torr and P(A-a) O2 was 275 torr. After
the PEEP was applied, the PaO2 was 73 torr and P(A-a) O2 was 150
torr. What can be concluded from these results? Answer: The patient's
shunt percentage has decreased.
(Rationale:
,C. (c) A reduced P(A-a)O2 difference from 275 torr to 150 torr with the
addition of PEEP indicates that the patient's shunt % (or ventilation to
perfusion mismatch) has decreased.)
⩥ After a successful spontaneous breathing trial, the physician plans to
extubate a 4-year-old child recovering from pneumonia. The physician
wants to provide the highest oxygen percentage possible. What should
be recommended in this situation? Answer: High-flow nasal cannula
(Rationale:
D. (c) A high-flow nasal cannula is the only listed device that can supply
approximately 100% oxygen. In addition, it will provide positive
expiratory pressure, which will increase the functional residual capacity
(FRC) and further improve oxygenation.)
⩥ A mechanically ventilated patient has atelectasis and a small
functional residual capacity (FRC). This has caused hypoxemia. What
would you recommend to help correct the atelectasis and small FRC?
Answer: Add PEEP.
(Rationale:
A. (c) Therapeutic PEEP on the ventilator will increase the FRC and the
patient's O2 level and should help to correct the atelectasis.)
, ⩥ A patient with an upper airway obstruction is receiving helium-oxygen
therapy by a nonrebreathing mask. The respiratory therapist notices that
the reservoir bag is completely collapsing on inspiration. What is the
cause of the problem? Answer: The flow of helium and oxygen is too
low.
(Rationale:
C. (c) Increasing the flow of gas should result in the bag refilling.)
⩥ The physician has made the decision to change a neuromuscular
disease patient's tracheostomy tube to a tracheostomy button. A
tracheostomy button is indicated to Answer: Keep a patent tracheostomy
stoma.
(Rationale:
C. (c) The tracheostomy button maintains the stoma until it is
determined that the opening can safely be allowed to heal over.)
⩥ The respiratory therapist is assisting the physician during a
tracheostomy procedure on a patient with a nasal endotracheal tube.
When should the endotracheal tube be withdrawn? Answer: As the
physician is ready to insert the tracheostomy tube
(Rationale:
