TMC CERTIFICATION EVALUATION 2026
TESTED QUESTIONS SOLVED
◉ 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. Answer:
Needle aspirate the 2nd left intercostal space
◉ All of the following strategies are likely to decrease the likelihood
of damage to the tracheal mucosa EXCEPT. Answer: using a low
residual volume, low compliance cuff
◉ 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.
Answer: deep breathing & coughing to clear secretions
◉ A 65 kg spinal cord injured patient develops atelectasis. His
inspiratory capacity is 30% of his predicted value. What bronchial
hygiene therapy would be most appropriate initially?. Answer: IPPB
,◉ A healthy adult female can exhale what portion of her forced vital
capacity in the first second?. Answer: 70%
◉ A patient on VC ventilation demonstrates 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. Answer: 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?. Answer: insert a chest
tube
◉ Following cardiac surgery, a 55 year-old 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.. Answer: 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?. Answer: 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 76%. Which of the following would be most
appropriate at this time?. Answer: Reintubation
◉ Which of the following patients would most likely benefit from
pressure support ventilation?. Answer: A patient on SIMV with a
mandatory rate of 12/min and total rate of 24/min.
◉ A patient receiving mechanical ventilation has developed a
temperature of 99.9° F with purulent secretions over the last 12
hours. The respiratory therapist has also noted a steady increase in
peak inspiratory pressure. What initial recommendation should be
made to address these changes?. Answer: obtain a sputum gram
stain
◉ Which of the following information may be obtained from a FVC
maneuver during bedside pulmonary function testing?
1. FEV1
2. PEFR
3. FRC
4. RV. Answer: 1 & 2 only
, ◉ The respiratory therapist provides education for a patient who is
being discharged home on aerosol therapy. The most important
reason for the patient to follow the recommended cleaning
procedures using a vinegar/water solution is that this solution will.
Answer: retard bacterial growth
◉ A patient who complains of dyspnea is noted to have a dry, non-
productive cough. On physical examination, breath sounds are
diminished on the right, tactile fremitus is decreased and there is
dullness to percussion over the right lower lobe. The respiratory
therapist should suspect that the patient is suffering from. Answer:
pleural effusion
◉ Which of the following suction catheters would be appropriate to
use for a patient with a size 8.0 mm ID endotracheal tube?. Answer:
12 Fr
◉ A patient who is receiving continuous mechanical ventilation is
fighting the ventilator. His breath sounds are markedly diminished
on the left, there is dullness to percussion on the left, and the
trachea is shifted to the left. The most likely explanation for the
problem is that. Answer: the endotracheal tube has slipped into the
right main stem bronchus.
◉ The respiratory therapist notes a developing hematoma after an
arterial blood gas was drawn from the right radial artery. The
immediate response is to. Answer: apply pressure to the site
TESTED QUESTIONS SOLVED
◉ 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. Answer:
Needle aspirate the 2nd left intercostal space
◉ All of the following strategies are likely to decrease the likelihood
of damage to the tracheal mucosa EXCEPT. Answer: using a low
residual volume, low compliance cuff
◉ 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.
Answer: deep breathing & coughing to clear secretions
◉ A 65 kg spinal cord injured patient develops atelectasis. His
inspiratory capacity is 30% of his predicted value. What bronchial
hygiene therapy would be most appropriate initially?. Answer: IPPB
,◉ A healthy adult female can exhale what portion of her forced vital
capacity in the first second?. Answer: 70%
◉ A patient on VC ventilation demonstrates 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. Answer: 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?. Answer: insert a chest
tube
◉ Following cardiac surgery, a 55 year-old 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.. Answer: 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?. Answer: 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 76%. Which of the following would be most
appropriate at this time?. Answer: Reintubation
◉ Which of the following patients would most likely benefit from
pressure support ventilation?. Answer: A patient on SIMV with a
mandatory rate of 12/min and total rate of 24/min.
◉ A patient receiving mechanical ventilation has developed a
temperature of 99.9° F with purulent secretions over the last 12
hours. The respiratory therapist has also noted a steady increase in
peak inspiratory pressure. What initial recommendation should be
made to address these changes?. Answer: obtain a sputum gram
stain
◉ Which of the following information may be obtained from a FVC
maneuver during bedside pulmonary function testing?
1. FEV1
2. PEFR
3. FRC
4. RV. Answer: 1 & 2 only
, ◉ The respiratory therapist provides education for a patient who is
being discharged home on aerosol therapy. The most important
reason for the patient to follow the recommended cleaning
procedures using a vinegar/water solution is that this solution will.
Answer: retard bacterial growth
◉ A patient who complains of dyspnea is noted to have a dry, non-
productive cough. On physical examination, breath sounds are
diminished on the right, tactile fremitus is decreased and there is
dullness to percussion over the right lower lobe. The respiratory
therapist should suspect that the patient is suffering from. Answer:
pleural effusion
◉ Which of the following suction catheters would be appropriate to
use for a patient with a size 8.0 mm ID endotracheal tube?. Answer:
12 Fr
◉ A patient who is receiving continuous mechanical ventilation is
fighting the ventilator. His breath sounds are markedly diminished
on the left, there is dullness to percussion on the left, and the
trachea is shifted to the left. The most likely explanation for the
problem is that. Answer: the endotracheal tube has slipped into the
right main stem bronchus.
◉ The respiratory therapist notes a developing hematoma after an
arterial blood gas was drawn from the right radial artery. The
immediate response is to. Answer: apply pressure to the site
