TMC EXAM A QUESTIONS AND ANSWERS GRADE A+ SOLUTIONS

A 48 year-old female is admitted to the ED with diaphoresis, jugular
venous distension, and 3+ pitting edema in the ankles. These findings
are consistent with
heart failure
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?
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
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
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?
IPPB
A healthy adult female can exhale what portion of her forced vital
capacity in the first second?
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
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?
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.
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?
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?
Reintubation
Which of the following patients would most likely benefit from
pressure support ventilation?
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?
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
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
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
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?
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
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
apply pressure to the site
A patient's breathing pattern irregularly increases and decreases and
is interspersed with periods of apnea up to 1 minute. Which of the
following conditions is the most likely cause of this problem?
elevated intracranial pressure
What value for the apnea-hypopnea index (AHI) is consistent with mild
obstructive sleep apnea?
5 to 15
While monitoring a newborn utilizing a transcutaneous monitor, the
respiratory therapist notices a change in PtcO2 from 60 to 142 torr
and simultaneously the PtcCO2 changes from 37 to 2 torr. What is the
most likely explanation for these changes?
air leak around the sensor
A patient on the general medical ward receives oxygen via 28% air
entrainment mask with the flowmeter set at 5 L/min. What is the total
flow delivered to the patient?
55 L/min
Which of the following measurements is most indicative of congestive
heart failure?
pulmonary capillary wedge pressure of 30 mmHg
Sleep apnea can be defined as repeated episodes of complete cessation
of airflow for
10 seconds or longer
A patient in the ICU receiving mechanical ventilation underwent
fiberoptic bronchoscopy during which a tissue biopsy was collected.
Immediately following the procedure, the respiratory therapist notes
that the peak inspiratory pressure on the ventilator has increased.
Potential causes for this include all of the following EXCEPT
hypoxemia