LINDSEY JONES TMC STUDY GUIDE 2026
COMPLETE QUESTIONS AND SOLUTIONS
GRADED A+
⩥ The following arterial blood gas results are available for a patient
receiving volume controlled ventilation.
pH 7.21 PaCO2 53 torrPaO2 72 torrHCO3- 23 mEq/LBE -2 mEq/L
Current ventilator settings are:
Mode Assist/control VT 550 mL Mandatory rate 12Total rate 12FIO2
1.0PEEP 20 cm H2O
The respiratory therapist should recommend:
A. increasing PEEP
B. decreasing tidal volume
C. decreasing FIO2
D. increasing mandatory rate. Answer: D. This patient's blood gas
reveals hypoventilation and hypoxemia. Of these two problems,
ventilation should be addressed first. Because PaCO2 is off target by
more than 4 mmHg the best option would be to increase mandatory rate.
⩥ A decreasing CvO2 while CaO2 remains constant is most closely
associated with
,A. increasing tissue oxygen consumption
B. decreasing SVR
C. increasing PVR
D. decreasing oxygen consumption. Answer: A. If CvO2 is decreasing
while CaO2 remains the same, there is a widening between the arterial
and venous oxygen content difference C(a-v)O2. A bigger gap between
these numbers, or an increase in the C(a-v)O2, is associated with
decreasing tissue oxygen consumption which is also associated with a
decrease in cardiac output.
⩥ What is the static compliance in mL/cm H2O, given the following
data on a patient receiving VC AC ventilation?
Plateau pressure 15 cm H2O Peak pressure 25 cm H2OVT 500 mLPEEP
5 cm H2O
A. 25
B. 20
C. 50
D. 33. Answer: C. To determine static compliance, tidal volume is
divided by plateau pressure after subtracting any PEEP. In this case,
(500/(15-5) = 50 cm H2O.
,⩥ A homeless patient reports to a clinic with hemoptysis and emaciation,
as well as other symptoms consistent with tuberculosis. Which of the
following exams would be most appropriate to further assess the patient?
A. Mantoux test
B. eosinophil count
C. FeNO exhaled gas analysis
D. serum creatinine blood level. Answer: A. A Mantoux test (also called
a TB test) is helpful in determining the patient's exposure to the tubercle
bacilli. Although not diagnostic for TB, it is a quick screening method
that is appropriate.
⩥ A patient with confirmed Guillain-Barre' Syndrome is being
monitored every 4 hours. The following data is available:
10 am 2 pm 6 pm VC (L) 1.6 1.4 0.8VT (mL) 500 485 260MIP (cm
H2O) -48 -35 -24
The respiratory therapist should recommend
A. intubate and initiate mechanical ventilatory support
B. administer systemic steroid medication
C. continue to monitor the patient closely
, D. check the protein level in the spinal fluid. Answer: A. A patient with
Guillain-Barre' Syndrome experiences a slow onset of paralysis of the
ventilatory muscles and will ultimately require mechanical ventilatory
support. The point at which ventilatory support is needed is when vital
capacity falls below 1 L. In this case, vital capacity is 0.8 L indicating
the patient should be intubated and receive mechanical ventilatory
support.
⩥ A patient with a history of hyper-reactive airway disease is having
difficulty expectorating because the sputum is thick and tenacious.
Which of the following medications should the respiratory therapist
recommend?
A. Solu-Mederol
B. Acetylcysteine (mucomyst)
C. Spiriva (tiotropium bromide)
D. Beclamethasone (Beclovent). Answer: B. Hyperactive airway disease
is associated with diseases such as asthma and consist of
bronchoconstriction and inflammation. This patient appears to have
difficulty with bronchoconstriction and thick secretions. Therefore, a
mucolytic, such as acetylcysteine, and Solu-Medrol are appropriate.
⩥ A patient with a tracheostomy is receiving supplemental oxygen via
tracheostomy collar connected to a large volume nebulizer set at 40%.
The respiratory therapist analyzes the FIO2 at the tracheostomy collar
with a galvanic fuel cell analyzer. The analysis shows the FIO2 to be
55%. Which of the following could be the cause of the increase in FIO2?
COMPLETE QUESTIONS AND SOLUTIONS
GRADED A+
⩥ The following arterial blood gas results are available for a patient
receiving volume controlled ventilation.
pH 7.21 PaCO2 53 torrPaO2 72 torrHCO3- 23 mEq/LBE -2 mEq/L
Current ventilator settings are:
Mode Assist/control VT 550 mL Mandatory rate 12Total rate 12FIO2
1.0PEEP 20 cm H2O
The respiratory therapist should recommend:
A. increasing PEEP
B. decreasing tidal volume
C. decreasing FIO2
D. increasing mandatory rate. Answer: D. This patient's blood gas
reveals hypoventilation and hypoxemia. Of these two problems,
ventilation should be addressed first. Because PaCO2 is off target by
more than 4 mmHg the best option would be to increase mandatory rate.
⩥ A decreasing CvO2 while CaO2 remains constant is most closely
associated with
,A. increasing tissue oxygen consumption
B. decreasing SVR
C. increasing PVR
D. decreasing oxygen consumption. Answer: A. If CvO2 is decreasing
while CaO2 remains the same, there is a widening between the arterial
and venous oxygen content difference C(a-v)O2. A bigger gap between
these numbers, or an increase in the C(a-v)O2, is associated with
decreasing tissue oxygen consumption which is also associated with a
decrease in cardiac output.
⩥ What is the static compliance in mL/cm H2O, given the following
data on a patient receiving VC AC ventilation?
Plateau pressure 15 cm H2O Peak pressure 25 cm H2OVT 500 mLPEEP
5 cm H2O
A. 25
B. 20
C. 50
D. 33. Answer: C. To determine static compliance, tidal volume is
divided by plateau pressure after subtracting any PEEP. In this case,
(500/(15-5) = 50 cm H2O.
,⩥ A homeless patient reports to a clinic with hemoptysis and emaciation,
as well as other symptoms consistent with tuberculosis. Which of the
following exams would be most appropriate to further assess the patient?
A. Mantoux test
B. eosinophil count
C. FeNO exhaled gas analysis
D. serum creatinine blood level. Answer: A. A Mantoux test (also called
a TB test) is helpful in determining the patient's exposure to the tubercle
bacilli. Although not diagnostic for TB, it is a quick screening method
that is appropriate.
⩥ A patient with confirmed Guillain-Barre' Syndrome is being
monitored every 4 hours. The following data is available:
10 am 2 pm 6 pm VC (L) 1.6 1.4 0.8VT (mL) 500 485 260MIP (cm
H2O) -48 -35 -24
The respiratory therapist should recommend
A. intubate and initiate mechanical ventilatory support
B. administer systemic steroid medication
C. continue to monitor the patient closely
, D. check the protein level in the spinal fluid. Answer: A. A patient with
Guillain-Barre' Syndrome experiences a slow onset of paralysis of the
ventilatory muscles and will ultimately require mechanical ventilatory
support. The point at which ventilatory support is needed is when vital
capacity falls below 1 L. In this case, vital capacity is 0.8 L indicating
the patient should be intubated and receive mechanical ventilatory
support.
⩥ A patient with a history of hyper-reactive airway disease is having
difficulty expectorating because the sputum is thick and tenacious.
Which of the following medications should the respiratory therapist
recommend?
A. Solu-Mederol
B. Acetylcysteine (mucomyst)
C. Spiriva (tiotropium bromide)
D. Beclamethasone (Beclovent). Answer: B. Hyperactive airway disease
is associated with diseases such as asthma and consist of
bronchoconstriction and inflammation. This patient appears to have
difficulty with bronchoconstriction and thick secretions. Therefore, a
mucolytic, such as acetylcysteine, and Solu-Medrol are appropriate.
⩥ A patient with a tracheostomy is receiving supplemental oxygen via
tracheostomy collar connected to a large volume nebulizer set at 40%.
The respiratory therapist analyzes the FIO2 at the tracheostomy collar
with a galvanic fuel cell analyzer. The analysis shows the FIO2 to be
55%. Which of the following could be the cause of the increase in FIO2?
