TMC EXAM 4 Latest Actual Questions &
Verified Answers Correctly
1.Which of the following equipment is most helpful at measuring FRC in
a patient who has significant non-ventilated lung spaces?
A. nitrogen analyzer for a nitrogen washout test
B. helium analyzer for a helium dilution test
C. plethysmograph
D. peak flow meter
Answer: C
Explanation: You can determine FRC in three different ways - body box,
nitrogen washout, or helium dilution. If someone has non-ventilated lung
space, nitrogen washout and helium dilution are not helpful and may be
inaccurate. FRC determined by body box will be higher because it can
access non-ventilated lung space and therefore is more accurate.
2.The respiratory therapist is making a home visit to evaluate an oxygen-
de- pendent patient. The patient has 3+ pitting peripheral edema and has
not followed the physician's orders to limit fluid intake. You would expect
which of the following hemodynamic values?
A. elevated PCWP with a low cardiac output
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,B. low mean arterial pressure
C. elevated right sided preload with a normal to low right ventricular after loa
D. reduced cardiac index
Answer: C
Explanation: Right-sided preload is another name for CVP (central venou
pres- sure). Peripheral edema is one of the signs associated with right
heart failure, which results in an elevated CVP with a normal or low
pulmonary artery pressure (PAP),
a.k.a. right ventricular afterload.
3.A ventilator-dependent patient is scheduled for an MRI, which will require
a transport of 90 minutes. The patient is receiving humidification with a
heat- ed- humidification system. A transport ventilator is available. How
should a respiratory therapist assure that humidification will be provided to
the patient during the MRI procedure?
A. Provide a pass-over humidifier
B. Provide an HME
C. Provide ventilation with a manual resuscitator
D. Use the same humidification system in use on the primary ventilator
Answer: B
Explanation: A heat moisture exchanger (HME) is appropriate for a
transport of only 90 min. Furthermore, the scenario does not suggest
that the patient has thick, retained secretions, therefore an HME may
be applied.
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,4.Which of the following conditions would benefit most from
polysomnogra- phy?
A. COPD
B. congestive heart failure
C. suspected increased airway resistance
D. obesity with increased day-time sleepiness
Answer: D
Explanation: Polysomnography is another word for sleep study. An obese
patient who has daytime sleepiness would benefit most from
polysomnography. Keep in mind that Polysomnography is the study of th
problem - not the solution. But it must be done for diagnostic purposes
and in order to find the adequate CPAP setting.
5.Which of the following can accurately be stated about a widening
alveo- lar-arterial oxygen gradient?
A. decreased venous admixture
B. onset of oxygen toxicity
C. increased intrapulmonary shunting
D. improving V/Q mismatch
Answer: C
Explanation: A normal alveolar arterial oxygen gradient is below 65
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112
, mmHg. When that gradient rises to 200, 300, 400, or more, then you
have what is called shunting. If the A-a gradient is less than 300 it's
technically called a ventilation perfusion (VQ) mismatch. But generally
speaking, as the gradient widens it can properly be said that there is an
increase in pulmonary shunting.
6.How many hours will an H cylinder with 1400 psi last for a patient
receiving oxygen at 7 lpm?
A. 6 hours
B. less than 1 hour
C. 10 hours
D. 4 hours
Answer: C
Explanation: And H cylinder has a tank factor of 3.14. 3.14x1400 PSI =
4396 L. 4396 L / 7 L per minute = 628 min. 628 min./ 60 min.= 10.4
hours, or about 10 hours. When you get an answer that is not exact,
pick the closest number possible. It is common
on the exam not see the exact answer from your calculation. This is
because the NBRC knows that you're estimating.
7.The respiratory therapist notes a fall in pulse from 80/min to 60/min with a
proportional drop in blood pressure during a suction procedure. Which of
the following would be the most likely cause of these observations?
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112
Verified Answers Correctly
1.Which of the following equipment is most helpful at measuring FRC in
a patient who has significant non-ventilated lung spaces?
A. nitrogen analyzer for a nitrogen washout test
B. helium analyzer for a helium dilution test
C. plethysmograph
D. peak flow meter
Answer: C
Explanation: You can determine FRC in three different ways - body box,
nitrogen washout, or helium dilution. If someone has non-ventilated lung
space, nitrogen washout and helium dilution are not helpful and may be
inaccurate. FRC determined by body box will be higher because it can
access non-ventilated lung space and therefore is more accurate.
2.The respiratory therapist is making a home visit to evaluate an oxygen-
de- pendent patient. The patient has 3+ pitting peripheral edema and has
not followed the physician's orders to limit fluid intake. You would expect
which of the following hemodynamic values?
A. elevated PCWP with a low cardiac output
1/
112
,B. low mean arterial pressure
C. elevated right sided preload with a normal to low right ventricular after loa
D. reduced cardiac index
Answer: C
Explanation: Right-sided preload is another name for CVP (central venou
pres- sure). Peripheral edema is one of the signs associated with right
heart failure, which results in an elevated CVP with a normal or low
pulmonary artery pressure (PAP),
a.k.a. right ventricular afterload.
3.A ventilator-dependent patient is scheduled for an MRI, which will require
a transport of 90 minutes. The patient is receiving humidification with a
heat- ed- humidification system. A transport ventilator is available. How
should a respiratory therapist assure that humidification will be provided to
the patient during the MRI procedure?
A. Provide a pass-over humidifier
B. Provide an HME
C. Provide ventilation with a manual resuscitator
D. Use the same humidification system in use on the primary ventilator
Answer: B
Explanation: A heat moisture exchanger (HME) is appropriate for a
transport of only 90 min. Furthermore, the scenario does not suggest
that the patient has thick, retained secretions, therefore an HME may
be applied.
2/
112
,4.Which of the following conditions would benefit most from
polysomnogra- phy?
A. COPD
B. congestive heart failure
C. suspected increased airway resistance
D. obesity with increased day-time sleepiness
Answer: D
Explanation: Polysomnography is another word for sleep study. An obese
patient who has daytime sleepiness would benefit most from
polysomnography. Keep in mind that Polysomnography is the study of th
problem - not the solution. But it must be done for diagnostic purposes
and in order to find the adequate CPAP setting.
5.Which of the following can accurately be stated about a widening
alveo- lar-arterial oxygen gradient?
A. decreased venous admixture
B. onset of oxygen toxicity
C. increased intrapulmonary shunting
D. improving V/Q mismatch
Answer: C
Explanation: A normal alveolar arterial oxygen gradient is below 65
3/
112
, mmHg. When that gradient rises to 200, 300, 400, or more, then you
have what is called shunting. If the A-a gradient is less than 300 it's
technically called a ventilation perfusion (VQ) mismatch. But generally
speaking, as the gradient widens it can properly be said that there is an
increase in pulmonary shunting.
6.How many hours will an H cylinder with 1400 psi last for a patient
receiving oxygen at 7 lpm?
A. 6 hours
B. less than 1 hour
C. 10 hours
D. 4 hours
Answer: C
Explanation: And H cylinder has a tank factor of 3.14. 3.14x1400 PSI =
4396 L. 4396 L / 7 L per minute = 628 min. 628 min./ 60 min.= 10.4
hours, or about 10 hours. When you get an answer that is not exact,
pick the closest number possible. It is common
on the exam not see the exact answer from your calculation. This is
because the NBRC knows that you're estimating.
7.The respiratory therapist notes a fall in pulse from 80/min to 60/min with a
proportional drop in blood pressure during a suction procedure. Which of
the following would be the most likely cause of these observations?
4/
112
