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TMC PRACTICE EXAM ACTUAL PREP
QUESTIONS AND WELL REVISED ANSWERS -
LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS – ASSURES PASS
A 48 year-old female is admitted to the ED with diaphoresis, jugular venous
distension, and 3+ pitting edema in the ankles. These findings are consistent with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances - ANSWERS: Heart failure
A patient is admitted to the ED following a motor vehicle accident. On physical
exam, the respiratory therapist discovers that breath sounds are absent in the left
chest with a hyperresonant percussion note. The trachea is shifted to the right. The
patient's heart rate is 45/min, respiratory rate is 30/min, and blood pressure is 60/40
mm Hg. What action should the therapist recommend first?
A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate the patient. - ANSWERS:
Needle aspirate the 2nd left intercostal space.
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All of the following strategies are likely to decrease the likelihood of damage to
the tracheal mucosa EXCEPT
A. maintaining cuff pressures between 20 and 25 mm Hg.
B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures. - ANSWERS: monitoring intracuff pressures.
A 52 year-old post-operative cholecystectomy patient's breath sounds become
more coarse upon completion of postural drainage with percussion. The respiratory
therapist should recommend
A. continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear secretions. - ANSWERS: deep breathing
and coughing to clear secretions.
A 65 kg spinal cord injured patient has developed atelectasis. His inspiratory
capacity is 30% of his predicted value. What bronchial hygiene therapy would be
most appropriate initially?
A. IS / SMI
B. IPPB with normal saline
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C. postural drainage and percussion
D. PEP therapy - ANSWERS: IPPB with normal saline
A patient on VC ventilation has demonstrated auto-PEEP on ventilator graphics.
Which of the following controls, when adjusted independently, would increase
expiratory time?
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity - ANSWERS: 1, 2, and 3 only
Which of the following would be the most appropriate therapy for a dyspneic
patient who has crepitus with tracheal deviation to the left and absent breath
sounds on the right?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube - ANSWERS: Insert a chest tube
A 55 year-old post cardiac surgery patient has the following ABG results: pH 7.50,
PaCO2 30 torr, PaO2 62 torr, HCO3 25 mEq/L, SaO2 92%, HB 14 g/dL, BE +2.
Venous blood gas results are pH 7.39, PvCO2 43 torr, PvO2 37 torr, and SvO2
66%. Calculate the patient's C(a-v)O2.
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A. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
D. 5.5 vol% - ANSWERS: 5.0 vol%
A patient on VC, SIMV with a VT of 500 mL has a PIP of 25 cm H2O, Pplat of 15
cm H2O and PEEP of 5 cm H2O. What is the patient's static lung compliance
A. 25 mL/cm H2O
B. 35 mL/cm H2O
C. 45 mL/cm H2O
D. 50 mL/cm H2O - ANSWERS: 50 mL/cm H2O
Immediately after extubation of a patient in the ICU, the respiratory therapist
observes increasing respiratory distress with intercostal retractions and marked
stridor. The SpO2 on 40% oxygen is noted to be 86%. Which of the following
would be most appropriate at this time?
A. cool mist aerosol treatment
B. aerosolized racemic epinephrine
C. manual ventilation with resuscitation bag and mask
D. reintubation - ANSWERS: reintubation
Which of the following patients would most likely benefit from pressure support
ventilation?
TMC PRACTICE EXAM ACTUAL PREP
QUESTIONS AND WELL REVISED ANSWERS -
LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS – ASSURES PASS
A 48 year-old female is admitted to the ED with diaphoresis, jugular venous
distension, and 3+ pitting edema in the ankles. These findings are consistent with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances - ANSWERS: Heart failure
A patient is admitted to the ED following a motor vehicle accident. On physical
exam, the respiratory therapist discovers that breath sounds are absent in the left
chest with a hyperresonant percussion note. The trachea is shifted to the right. The
patient's heart rate is 45/min, respiratory rate is 30/min, and blood pressure is 60/40
mm Hg. What action should the therapist recommend first?
A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate the patient. - ANSWERS:
Needle aspirate the 2nd left intercostal space.
,2|Page
All of the following strategies are likely to decrease the likelihood of damage to
the tracheal mucosa EXCEPT
A. maintaining cuff pressures between 20 and 25 mm Hg.
B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures. - ANSWERS: monitoring intracuff pressures.
A 52 year-old post-operative cholecystectomy patient's breath sounds become
more coarse upon completion of postural drainage with percussion. The respiratory
therapist should recommend
A. continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear secretions. - ANSWERS: deep breathing
and coughing to clear secretions.
A 65 kg spinal cord injured patient has developed atelectasis. His inspiratory
capacity is 30% of his predicted value. What bronchial hygiene therapy would be
most appropriate initially?
A. IS / SMI
B. IPPB with normal saline
,3|Page
C. postural drainage and percussion
D. PEP therapy - ANSWERS: IPPB with normal saline
A patient on VC ventilation has demonstrated auto-PEEP on ventilator graphics.
Which of the following controls, when adjusted independently, would increase
expiratory time?
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity - ANSWERS: 1, 2, and 3 only
Which of the following would be the most appropriate therapy for a dyspneic
patient who has crepitus with tracheal deviation to the left and absent breath
sounds on the right?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube - ANSWERS: Insert a chest tube
A 55 year-old post cardiac surgery patient has the following ABG results: pH 7.50,
PaCO2 30 torr, PaO2 62 torr, HCO3 25 mEq/L, SaO2 92%, HB 14 g/dL, BE +2.
Venous blood gas results are pH 7.39, PvCO2 43 torr, PvO2 37 torr, and SvO2
66%. Calculate the patient's C(a-v)O2.
, 4|Page
A. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
D. 5.5 vol% - ANSWERS: 5.0 vol%
A patient on VC, SIMV with a VT of 500 mL has a PIP of 25 cm H2O, Pplat of 15
cm H2O and PEEP of 5 cm H2O. What is the patient's static lung compliance
A. 25 mL/cm H2O
B. 35 mL/cm H2O
C. 45 mL/cm H2O
D. 50 mL/cm H2O - ANSWERS: 50 mL/cm H2O
Immediately after extubation of a patient in the ICU, the respiratory therapist
observes increasing respiratory distress with intercostal retractions and marked
stridor. The SpO2 on 40% oxygen is noted to be 86%. Which of the following
would be most appropriate at this time?
A. cool mist aerosol treatment
B. aerosolized racemic epinephrine
C. manual ventilation with resuscitation bag and mask
D. reintubation - ANSWERS: reintubation
Which of the following patients would most likely benefit from pressure support
ventilation?
