TEXAS RESPIRATORY THERAPIST LICENSING
LEVEL III EXAM, QUESTIONS WITH CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD,
1. Which of the following is the most appropriate initial mode of
mechanical ventilation for a patient with ARDS?
A. Assist-Control (AC)
B. SIMV
C. CPAP
D. BiPAP
Answer: A. Assist-Control (AC)
AC provides full ventilatory support and allows precise control of tidal
volume and rate, which is crucial in ARDS to maintain adequate
oxygenation and limit lung injury.
2. A patient on a mechanical ventilator has a peak inspiratory
pressure (PIP) of 50 cm H₂O. Which of the following is the most likely
cause?
A. Decreased lung compliance
B. Increased airway resistance
C. Both A and B
D. Decreased tidal volume
,Answer: C. Both A and B
Elevated PIP can result from stiff lungs (decreased compliance) or
increased airway resistance due to secretions, bronchospasm, or kinked
tubing.
3. Which of the following arterial blood gas results indicates
uncompensated metabolic acidosis?
A. pH 7.50, PaCO₂ 40, HCO₃⁻ 32
B. pH 7.25, PaCO₂ 40, HCO₃⁻ 18
C. pH 7.40, PaCO₂ 30, HCO₃⁻ 22
D. pH 7.35, PaCO₂ 50, HCO₃⁻ 30
Answer: B. pH 7.25, PaCO₂ 40, HCO₃⁻ 18
A low pH with low HCO₃⁻ and normal PaCO₂ indicates metabolic acidosis
without respiratory compensation.
4. A patient receiving oxygen via a nasal cannula at 4 L/min is
estimated to be receiving what approximate FiO₂?
A. 24%
B. 28%
C. 36%
D. 40%
Answer: C. 36%
Each liter per minute increases FiO₂ by ~4% above room air (21%), so 4
L/min ≈ 36%.
5. Which of the following is a contraindication to using CPAP in a
patient with acute respiratory failure?
,A. Pulmonary edema
B. Hypotension
C. Obstructive sleep apnea
D. Mild asthma
Answer: B. Hypotension
CPAP can decrease venous return and worsen hypotension, making it
contraindicated in hemodynamically unstable patients.
6. Which of the following medications is commonly used for rapid
reversal of bronchospasm in asthma?
A. Salmeterol
B. Albuterol
C. Montelukast
D. Fluticasone
Answer: B. Albuterol
Albuterol is a short-acting β2-agonist that provides rapid
bronchodilation in acute asthma exacerbations.
7. In which of the following conditions is noninvasive ventilation (NIV)
most likely to be beneficial?
A. Acute hypercapnic respiratory failure in COPD
B. Severe ARDS
C. Facial trauma
D. Uncontrolled vomiting
Answer: A. Acute hypercapnic respiratory failure in COPD
NIV improves CO₂ clearance and reduces work of breathing in COPD
, exacerbations, while contraindicated in severe ARDS, facial trauma, or
risk of aspiration.
8. Which of the following is the primary mechanism of action of
inhaled corticosteroids?
A. Bronchodilation via β2-receptor stimulation
B. Inhibition of inflammatory mediator release
C. Mucolytic activity
D. Direct smooth muscle relaxation
Answer: B. Inhibition of inflammatory mediator release
Inhaled corticosteroids reduce airway inflammation and swelling by
inhibiting cytokine and mediator release.
9. A 70 kg patient is placed on volume-controlled ventilation with a
tidal volume of 8 mL/kg. What is the tidal volume in mL?
A. 560 mL
B. 480 mL
C. 640 mL
D. 720 mL
Answer: A. 560 mL
Tidal volume = 70 kg × 8 mL/kg = 560 mL.
10. Which of the following oxygen delivery devices provides the most
precise FiO₂?
A. Nasal cannula
B. Simple face mask
LEVEL III EXAM, QUESTIONS WITH CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD,
1. Which of the following is the most appropriate initial mode of
mechanical ventilation for a patient with ARDS?
A. Assist-Control (AC)
B. SIMV
C. CPAP
D. BiPAP
Answer: A. Assist-Control (AC)
AC provides full ventilatory support and allows precise control of tidal
volume and rate, which is crucial in ARDS to maintain adequate
oxygenation and limit lung injury.
2. A patient on a mechanical ventilator has a peak inspiratory
pressure (PIP) of 50 cm H₂O. Which of the following is the most likely
cause?
A. Decreased lung compliance
B. Increased airway resistance
C. Both A and B
D. Decreased tidal volume
,Answer: C. Both A and B
Elevated PIP can result from stiff lungs (decreased compliance) or
increased airway resistance due to secretions, bronchospasm, or kinked
tubing.
3. Which of the following arterial blood gas results indicates
uncompensated metabolic acidosis?
A. pH 7.50, PaCO₂ 40, HCO₃⁻ 32
B. pH 7.25, PaCO₂ 40, HCO₃⁻ 18
C. pH 7.40, PaCO₂ 30, HCO₃⁻ 22
D. pH 7.35, PaCO₂ 50, HCO₃⁻ 30
Answer: B. pH 7.25, PaCO₂ 40, HCO₃⁻ 18
A low pH with low HCO₃⁻ and normal PaCO₂ indicates metabolic acidosis
without respiratory compensation.
4. A patient receiving oxygen via a nasal cannula at 4 L/min is
estimated to be receiving what approximate FiO₂?
A. 24%
B. 28%
C. 36%
D. 40%
Answer: C. 36%
Each liter per minute increases FiO₂ by ~4% above room air (21%), so 4
L/min ≈ 36%.
5. Which of the following is a contraindication to using CPAP in a
patient with acute respiratory failure?
,A. Pulmonary edema
B. Hypotension
C. Obstructive sleep apnea
D. Mild asthma
Answer: B. Hypotension
CPAP can decrease venous return and worsen hypotension, making it
contraindicated in hemodynamically unstable patients.
6. Which of the following medications is commonly used for rapid
reversal of bronchospasm in asthma?
A. Salmeterol
B. Albuterol
C. Montelukast
D. Fluticasone
Answer: B. Albuterol
Albuterol is a short-acting β2-agonist that provides rapid
bronchodilation in acute asthma exacerbations.
7. In which of the following conditions is noninvasive ventilation (NIV)
most likely to be beneficial?
A. Acute hypercapnic respiratory failure in COPD
B. Severe ARDS
C. Facial trauma
D. Uncontrolled vomiting
Answer: A. Acute hypercapnic respiratory failure in COPD
NIV improves CO₂ clearance and reduces work of breathing in COPD
, exacerbations, while contraindicated in severe ARDS, facial trauma, or
risk of aspiration.
8. Which of the following is the primary mechanism of action of
inhaled corticosteroids?
A. Bronchodilation via β2-receptor stimulation
B. Inhibition of inflammatory mediator release
C. Mucolytic activity
D. Direct smooth muscle relaxation
Answer: B. Inhibition of inflammatory mediator release
Inhaled corticosteroids reduce airway inflammation and swelling by
inhibiting cytokine and mediator release.
9. A 70 kg patient is placed on volume-controlled ventilation with a
tidal volume of 8 mL/kg. What is the tidal volume in mL?
A. 560 mL
B. 480 mL
C. 640 mL
D. 720 mL
Answer: A. 560 mL
Tidal volume = 70 kg × 8 mL/kg = 560 mL.
10. Which of the following oxygen delivery devices provides the most
precise FiO₂?
A. Nasal cannula
B. Simple face mask
