TEXAS RESPIRATORY THERAPIST LICENSING
LEVEL IV EXAM QUESTIONS WITH CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD,:
1. Which of the following is the most accurate method to measure a
patient’s oxygen saturation continuously?
A. Arterial blood gas (ABG)
B. Pulse oximetry
C. Capnography
D. Peak flow meter
B. Pulse oximetry
Pulse oximetry provides non-invasive continuous monitoring of oxygen
saturation, making it practical for ongoing assessment.
2. A patient with COPD has a PaCO₂ of 60 mmHg. What is the best
initial intervention?
A. Increase FiO₂ to 100%
B. Administer bronchodilator therapy
C. Initiate non-invasive positive pressure ventilation (NIPPV)
D. Perform immediate intubation
C. Initiate non-invasive positive pressure ventilation (NIPPV)
NIPPV can reduce hypercapnia and improve alveolar ventilation without
the risks of intubation.
,3. Which inhaled medication class works by blocking muscarinic
receptors in the airways?
A. Beta-2 agonists
B. Anticholinergics
C. Corticosteroids
D. Leukotriene inhibitors
B. Anticholinergics
Anticholinergics block acetylcholine at muscarinic receptors, leading to
bronchodilation.
4. What is the primary goal of low tidal volume ventilation in ARDS?
A. Increase oxygenation
B. Prevent barotrauma
C. Reduce CO₂
D. Improve cardiac output
B. Prevent barotrauma
Low tidal volume ventilation reduces alveolar overdistension and the
risk of ventilator-induced lung injury.
5. The most common complication of suctioning a mechanically
ventilated patient is:
A. Pneumothorax
B. Hypoxemia
C. Arrhythmia
D. Hypercapnia
B. Hypoxemia
,Suctioning can temporarily remove oxygen and cause desaturation; pre-
oxygenation is recommended.
6. Which device is best suited for delivering high FiO₂ to a
spontaneously breathing patient?
A. Nasal cannula
B. Simple mask
C. Non-rebreather mask
D. Venturi mask
C. Non-rebreather mask
Non-rebreather masks can deliver up to 90–100% FiO₂ in spontaneously
breathing patients.
7. A patient with acute asthma is not responding to nebulized
albuterol. What is the next step?
A. Administer IV corticosteroids
B. Intubate immediately
C. Start inhaled ipratropium bromide
D. Observe for 1 hour
A. Administer IV corticosteroids
Corticosteroids reduce airway inflammation and are critical in severe,
unresponsive asthma.
8. What is the most sensitive indicator of early hypoxemia in a patient
receiving oxygen therapy?
A. Respiratory rate
B. Heart rate
, C. PaO₂
D. SpO₂
B. Heart rate
Tachycardia often precedes changes in oxygen saturation and can
indicate early hypoxemia.
9. Which mode of mechanical ventilation allows spontaneous breaths
but delivers a set pressure support?
A. Assist-Control (A/C)
B. Synchronized Intermittent Mandatory Ventilation (SIMV)
C. Pressure Support Ventilation (PSV)
D. Continuous Mandatory Ventilation (CMV)
C. Pressure Support Ventilation (PSV)
PSV augments the patient’s spontaneous breaths with a preset
pressure.
10. Which of the following is a contraindication to using a non-
rebreather mask?
A. Hypoxemia
B. Hypercapnia
C. Severe agitation
D. Asthma exacerbation
C. Severe agitation
Patients who cannot tolerate the mask or remove it repeatedly are poor
candidates for non-rebreather therapy.
11. What is the normal range for PaCO₂ in arterial blood gas?
LEVEL IV EXAM QUESTIONS WITH CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD,:
1. Which of the following is the most accurate method to measure a
patient’s oxygen saturation continuously?
A. Arterial blood gas (ABG)
B. Pulse oximetry
C. Capnography
D. Peak flow meter
B. Pulse oximetry
Pulse oximetry provides non-invasive continuous monitoring of oxygen
saturation, making it practical for ongoing assessment.
2. A patient with COPD has a PaCO₂ of 60 mmHg. What is the best
initial intervention?
A. Increase FiO₂ to 100%
B. Administer bronchodilator therapy
C. Initiate non-invasive positive pressure ventilation (NIPPV)
D. Perform immediate intubation
C. Initiate non-invasive positive pressure ventilation (NIPPV)
NIPPV can reduce hypercapnia and improve alveolar ventilation without
the risks of intubation.
,3. Which inhaled medication class works by blocking muscarinic
receptors in the airways?
A. Beta-2 agonists
B. Anticholinergics
C. Corticosteroids
D. Leukotriene inhibitors
B. Anticholinergics
Anticholinergics block acetylcholine at muscarinic receptors, leading to
bronchodilation.
4. What is the primary goal of low tidal volume ventilation in ARDS?
A. Increase oxygenation
B. Prevent barotrauma
C. Reduce CO₂
D. Improve cardiac output
B. Prevent barotrauma
Low tidal volume ventilation reduces alveolar overdistension and the
risk of ventilator-induced lung injury.
5. The most common complication of suctioning a mechanically
ventilated patient is:
A. Pneumothorax
B. Hypoxemia
C. Arrhythmia
D. Hypercapnia
B. Hypoxemia
,Suctioning can temporarily remove oxygen and cause desaturation; pre-
oxygenation is recommended.
6. Which device is best suited for delivering high FiO₂ to a
spontaneously breathing patient?
A. Nasal cannula
B. Simple mask
C. Non-rebreather mask
D. Venturi mask
C. Non-rebreather mask
Non-rebreather masks can deliver up to 90–100% FiO₂ in spontaneously
breathing patients.
7. A patient with acute asthma is not responding to nebulized
albuterol. What is the next step?
A. Administer IV corticosteroids
B. Intubate immediately
C. Start inhaled ipratropium bromide
D. Observe for 1 hour
A. Administer IV corticosteroids
Corticosteroids reduce airway inflammation and are critical in severe,
unresponsive asthma.
8. What is the most sensitive indicator of early hypoxemia in a patient
receiving oxygen therapy?
A. Respiratory rate
B. Heart rate
, C. PaO₂
D. SpO₂
B. Heart rate
Tachycardia often precedes changes in oxygen saturation and can
indicate early hypoxemia.
9. Which mode of mechanical ventilation allows spontaneous breaths
but delivers a set pressure support?
A. Assist-Control (A/C)
B. Synchronized Intermittent Mandatory Ventilation (SIMV)
C. Pressure Support Ventilation (PSV)
D. Continuous Mandatory Ventilation (CMV)
C. Pressure Support Ventilation (PSV)
PSV augments the patient’s spontaneous breaths with a preset
pressure.
10. Which of the following is a contraindication to using a non-
rebreather mask?
A. Hypoxemia
B. Hypercapnia
C. Severe agitation
D. Asthma exacerbation
C. Severe agitation
Patients who cannot tolerate the mask or remove it repeatedly are poor
candidates for non-rebreather therapy.
11. What is the normal range for PaCO₂ in arterial blood gas?
