TEXAS RESPIRATORY THERAPIST
LICENSING LEVEL II EXAM QUESTIONS
WITH CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD,
1. The primary purpose of positive end-expiratory pressure (PEEP) in
mechanical ventilation is to:
A. Decrease cardiac output
B. Improve oxygenation
C. Increase tidal volume
D. Reduce airway resistance
Answer: B
Rationale: PEEP helps prevent alveolar collapse at end expiration,
thereby improving oxygenation.
2. A patient receiving 100% oxygen via non-rebreather mask shows a
PaO₂ of 300 mmHg. What is the most appropriate next step?
A. Decrease oxygen to 60%
B. Maintain 100% oxygen
C. Start CPAP therapy
D. Intubate immediately
Answer: A
Rationale: High oxygen concentrations can cause oxygen toxicity; the
FiO₂ should be titrated to maintain adequate oxygenation.
,3. Which of the following is the most accurate method to measure
cardiac output at the bedside?
A. Pulmonary artery catheter
B. Echocardiography
C. Pulse oximetry
D. Blood pressure cuff
Answer: A
Rationale: Pulmonary artery catheters can provide direct and accurate
measurements of cardiac output.
4. During ventilator weaning, a rapid shallow breathing index (RSBI) <
105 indicates:
A. Likely weaning failure
B. Likely successful weaning
C. Need for sedation
D. Need for immediate intubation
Answer: B
Rationale: An RSBI <105 suggests the patient can sustain spontaneous
breathing and is likely to wean successfully.
5. Which of the following ABG results is consistent with
uncompensated metabolic acidosis?
A. pH 7.25, PaCO₂ 40 mmHg, HCO₃⁻ 18 mEq/L
B. pH 7.45, PaCO₂ 35 mmHg, HCO₃⁻ 28 mEq/L
C. pH 7.50, PaCO₂ 30 mmHg, HCO₃⁻ 24 mEq/L
D. pH 7.35, PaCO₂ 50 mmHg, HCO₃⁻ 24 mEq/L
,Answer: A
Rationale: Low pH and low HCO₃⁻ with normal PaCO₂ indicate metabolic
acidosis without respiratory compensation.
6. A patient with COPD is receiving 2 L/min oxygen via nasal cannula.
PaCO₂ rises from 55 mmHg to 70 mmHg. The most likely explanation
is:
A. Oxygen-induced hypoventilation
B. Pulmonary embolism
C. Metabolic alkalosis
D. Pneumothorax
Answer: A
Rationale: In some COPD patients, high oxygen concentrations reduce
hypoxic drive, leading to CO₂ retention.
7. Which ventilator mode allows the patient to initiate all breaths but
provides pressure support to each?
A. Assist-control (AC)
B. Pressure support ventilation (PSV)
C. SIMV
D. CPAP
Answer: B
Rationale: PSV allows spontaneous breathing with a set pressure to
reduce the work of breathing.
8. Which of the following is the most appropriate initial treatment for
acute pulmonary edema due to left heart failure?
, A. IV diuretics
B. Inhaled bronchodilators
C. Antibiotics
D. Oral corticosteroids
Answer: A
Rationale: Diuretics reduce fluid overload, which is the primary cause of
pulmonary edema in heart failure.
9. The main mechanism of action of albuterol is:
A. Beta-1 receptor stimulation
B. Beta-2 receptor stimulation
C. Muscarinic receptor blockade
D. Alpha-1 receptor stimulation
Answer: B
Rationale: Albuterol is a beta-2 agonist that causes bronchodilation.
10. Which of the following lung volumes is measured by spirometry?
A. Residual volume
B. Functional residual capacity
C. Tidal volume
D. Total lung capacity
Answer: C
Rationale: Spirometry can measure tidal volume, vital capacity, and
other volumes but not residual volume or FRC.
11. Indications for non-invasive positive pressure ventilation (NIPPV)
include all EXCEPT:
LICENSING LEVEL II EXAM QUESTIONS
WITH CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD,
1. The primary purpose of positive end-expiratory pressure (PEEP) in
mechanical ventilation is to:
A. Decrease cardiac output
B. Improve oxygenation
C. Increase tidal volume
D. Reduce airway resistance
Answer: B
Rationale: PEEP helps prevent alveolar collapse at end expiration,
thereby improving oxygenation.
2. A patient receiving 100% oxygen via non-rebreather mask shows a
PaO₂ of 300 mmHg. What is the most appropriate next step?
A. Decrease oxygen to 60%
B. Maintain 100% oxygen
C. Start CPAP therapy
D. Intubate immediately
Answer: A
Rationale: High oxygen concentrations can cause oxygen toxicity; the
FiO₂ should be titrated to maintain adequate oxygenation.
,3. Which of the following is the most accurate method to measure
cardiac output at the bedside?
A. Pulmonary artery catheter
B. Echocardiography
C. Pulse oximetry
D. Blood pressure cuff
Answer: A
Rationale: Pulmonary artery catheters can provide direct and accurate
measurements of cardiac output.
4. During ventilator weaning, a rapid shallow breathing index (RSBI) <
105 indicates:
A. Likely weaning failure
B. Likely successful weaning
C. Need for sedation
D. Need for immediate intubation
Answer: B
Rationale: An RSBI <105 suggests the patient can sustain spontaneous
breathing and is likely to wean successfully.
5. Which of the following ABG results is consistent with
uncompensated metabolic acidosis?
A. pH 7.25, PaCO₂ 40 mmHg, HCO₃⁻ 18 mEq/L
B. pH 7.45, PaCO₂ 35 mmHg, HCO₃⁻ 28 mEq/L
C. pH 7.50, PaCO₂ 30 mmHg, HCO₃⁻ 24 mEq/L
D. pH 7.35, PaCO₂ 50 mmHg, HCO₃⁻ 24 mEq/L
,Answer: A
Rationale: Low pH and low HCO₃⁻ with normal PaCO₂ indicate metabolic
acidosis without respiratory compensation.
6. A patient with COPD is receiving 2 L/min oxygen via nasal cannula.
PaCO₂ rises from 55 mmHg to 70 mmHg. The most likely explanation
is:
A. Oxygen-induced hypoventilation
B. Pulmonary embolism
C. Metabolic alkalosis
D. Pneumothorax
Answer: A
Rationale: In some COPD patients, high oxygen concentrations reduce
hypoxic drive, leading to CO₂ retention.
7. Which ventilator mode allows the patient to initiate all breaths but
provides pressure support to each?
A. Assist-control (AC)
B. Pressure support ventilation (PSV)
C. SIMV
D. CPAP
Answer: B
Rationale: PSV allows spontaneous breathing with a set pressure to
reduce the work of breathing.
8. Which of the following is the most appropriate initial treatment for
acute pulmonary edema due to left heart failure?
, A. IV diuretics
B. Inhaled bronchodilators
C. Antibiotics
D. Oral corticosteroids
Answer: A
Rationale: Diuretics reduce fluid overload, which is the primary cause of
pulmonary edema in heart failure.
9. The main mechanism of action of albuterol is:
A. Beta-1 receptor stimulation
B. Beta-2 receptor stimulation
C. Muscarinic receptor blockade
D. Alpha-1 receptor stimulation
Answer: B
Rationale: Albuterol is a beta-2 agonist that causes bronchodilation.
10. Which of the following lung volumes is measured by spirometry?
A. Residual volume
B. Functional residual capacity
C. Tidal volume
D. Total lung capacity
Answer: C
Rationale: Spirometry can measure tidal volume, vital capacity, and
other volumes but not residual volume or FRC.
11. Indications for non-invasive positive pressure ventilation (NIPPV)
include all EXCEPT:
