TMC-Kettering practice exam 1 with correct
answers
Ab48byearboldbfemalebisbadmittedbtobthebEDbwithbdiaphoresis,bjugularbvenousbdistention,bandb3+bpittingbed
emabinbthebankles.bThesebfindingsbarebconsistentbwith
A.bliverbfailure
B.bpulmonarybembolism
C.bheartbfailure
D.belectrolytebimbalanceb-bcorrectbanswer-C.bHeartbFailure
AbpatientbisbadmittedbtobthebEDbfollowingbabmotorbvehiclebaccident.bOnbphysicalbexam,bthebrespiratorybthe
rapistbdiscoversbthatbthebbreathbsoundsbarebabsentbinbthebleftbchestbwithbhyperresonantbpercussionbnote.b
Thebtracheabisbshiftedbtobthebright.bThebpatient'sbheartbratebisb45/min,brespiratorybratebisb30/min,bandbbloo
dbpressurebisb60/40bmmHg.bWhatbactionbshouldbthebtherapistbrecommendbfirst?
A.bcallbforbabSTATbchestbX-RAY
B.bInsertbabchestbtubebintobthebleftbchest
C.bNeedlebaspiratebtheb2ndbleftbintercostalbspace
D.bActivatebthebmedicalbemergencybteambtobintubatebthebpatientb-bcorrectbanswer-
C.bNeedlebaspiratebtheb2ndbleftbintercostalbspace
AllbofbthebfollowingbstrategiesbareblikelybtobdecreasebtheblikelihoodbofbdamagebtobthebtrachealbmucosabEXC
EPT
A.bmaintainingbcuffbpressuresbbetweenb20bandb25bmmHg
B.busingbthebminimalbleakbtechniquebforbinflation
C.busingbablowbresidualbvolume,blowbcompliancebcuff
D.bmonitoringbintracuffbpressuresb-bcorrectbanswer-C.busingbablowbresidualbvolume,blowbcompliancebcuff
,Ab52byearboldbpostboperativebcholecystectomybpatient'sbbreathbsoundsbbecomebmorebcoarsebuponbcompl
etionbofbposturalbdrainagebwithbpercussion.bThebrespiratorybtherapistbshouldbrecommend
A.bcontinuingbthebtherapybuntilbbreathbsoundsbimproveb
B.badministeringbdornasebalpha
C.badministeringbalbuterolbtherapy
D.bdeepbbreathingbandbcoughingbtobclearbsecretionsb-bcorrectbanswer-
D.bdeepbbreathingbandbcoughingbtobclearbsecretions
Ab65bkgbspinalbcordbinjuredbpatientbdevelopsbatelectasis.bHisbinspiratorybcapacitybisb30%bofbhisbpredictedbv
alue.bWhatbbronchialbhygienebtherapybwouldbbebthebmostbappropriatebinitially?b
A.bincentivebspirometryb
B.bIPPB
C.bPosturalbdrainagebandbpercussion
D.bPEPbtherapyb-bcorrectbanswer-B.bIPPB
Abhealthybadultbfemalebcanbexhalebwhatbportionbofbherbforcedbvitalbcapacitybinbthebfirstbsecond?
A.b50%
B.b60%
C.b70%
D.b80%b-bcorrectbanswer-C.b70%
AbpatientbonbVCbventilationbdemonstratesbauto-
PEEPbonbventilatorbgraphics.bWhichbofbthebfollowingbcontrols,bwhenbadjustedbindependently,bwouldbincre
asebexpiratorybtime?
1.btidalbvolume
2.brespiratorybrate
,3.binspiratorybflow
4.bsensitivityb
A.b1,2,bandb3bonly
B.b1,b2,bandb4bonly
C.b1,b3,bandb4bonlyb
D.b2,3,bandb4bonlyb-bcorrectbanswer-A.b1,2,bandb3bonly
Whichbofbthebfollowingbwouldbbebthebmostbappropriatebforbabdyspneicbpatientbwhobhasbcrepitusbwithbtrac
healbdeviationbtobthebleftbandbabsentbbreathbsoundsbonbthebright?
A.bperformbchestbphysiotherapy
B.badministerbanbIPPBbtreatment
C.binsertbanbendotrachealbtubeb
D.binsertbabchestbtubeb-bcorrectbanswer-D.binsertbabchestbtube
Followingbcardiacbsurgery,bab55byearboldbpatientbhasbthebfollowingbABGbresults;bpHb7.50,bPaCO2b30btorr,bPa
O2b62btorr,bHCO3b25bmEq/L,bSaO2b92%,bHBb14g/dL,bBE+2.bVenousbbloodbgasbresultsbarebpHb7.39,bPvCO2b4
3btorr,bPvO2b37btorr,bandbSvO2b66%.bCalculatebthebpatient'sbC(a-v)O2
A.b2.5bvol%
B.b4.0bvol%
C.b5.0bvol%
D.b5.5bvol%b-bcorrectbanswer-C.b5.0bvol%
AbpatientbonbVC,bSIMVbwithbabVtbofb500mLbhasbabPIPbofb25bcmbH2O,bPplatbofb15bcmbH2ObandbPEEPbofb5cmb
H2O.bWhatbisbthebpatient'sbstaticblungbcompliance
A.b25bmL/cmbH2O
B.b35bmL/cmbH2O
, C.b45bmL/cmbH2O
D.b50bmL/cmbH2Ob-bcorrectbanswer-D.b50bmL/cmbH2O
ImmediatelybafterbextubationbofbabpatientbinbthebICU,bthebrespiratorybtherapistbobservesbincreasingbrespir
atorybdistressbwithbintercostalbretractionsbandbmarkedbstridor.bThebSpO2bonb40%boxygenbisbnotedbtobbeb76
%.bWhichbofbthebfollowingbwouldbbebmostbappropriatebatbthisbtime?
A.bCoolbmistbaerosolbtreatmentb
B.bAerosolizedbracemicbepinephrine
C.bManualbventilationbwithbresuscitationbbagbandbmask
D.breintubationb-bcorrectbanswer-D.breintubation
Whichbofbthebfollowingbpatientsbwouldbmostblikelybbenefitbpressurebsupportbventilation?
A.banbintubatedbwithbanbabsentbrespiratorybdriveb
B.babpatientbonbSIMVbwithbmandatorybratebofb12/minbandbtotalbratebofb24/bmin
C.babpatientbwithbacuteblungbinjuryb
D.babpatientbwhobrequiresbshort-termbpost-operativebventilatorybsupportb-bcorrectbanswer-
B.bAbpatientbonbSIMVbwithbmandatorybratebofb12/minbandbtotalbratebofb24/bmin
Abpatientbreceivingbmechanicalbventilationbhasbdevelopedbabtemperaturebofb99.9bFbwithbpurulentbsecretio
nsboverbtheblastb12bhours.bThebrespiratorybtherapistbhasbalsobnotedbabsteadybincreasebinbpeakbinspiratorybp
ressure.bWhatbinitialbrecommendationbshouldbbebmadebtobaddressbthesebchanges?
A.binitiatebbronchialbhygienebtherapyb
B.bobtainbabsputumbgrambstainb
C.badministerbIPV
D.binsertbabCASSbtubeb-bcorrectbanswer-B.bobtainbabsputumbgrambstain
WhichbofbthebfollowingbinformationbmaybbebobtainedbfrombFVCbmaneuverbduringbbedsidebpulmonarybfun
ctionbtesting?
answers
Ab48byearboldbfemalebisbadmittedbtobthebEDbwithbdiaphoresis,bjugularbvenousbdistention,bandb3+bpittingbed
emabinbthebankles.bThesebfindingsbarebconsistentbwith
A.bliverbfailure
B.bpulmonarybembolism
C.bheartbfailure
D.belectrolytebimbalanceb-bcorrectbanswer-C.bHeartbFailure
AbpatientbisbadmittedbtobthebEDbfollowingbabmotorbvehiclebaccident.bOnbphysicalbexam,bthebrespiratorybthe
rapistbdiscoversbthatbthebbreathbsoundsbarebabsentbinbthebleftbchestbwithbhyperresonantbpercussionbnote.b
Thebtracheabisbshiftedbtobthebright.bThebpatient'sbheartbratebisb45/min,brespiratorybratebisb30/min,bandbbloo
dbpressurebisb60/40bmmHg.bWhatbactionbshouldbthebtherapistbrecommendbfirst?
A.bcallbforbabSTATbchestbX-RAY
B.bInsertbabchestbtubebintobthebleftbchest
C.bNeedlebaspiratebtheb2ndbleftbintercostalbspace
D.bActivatebthebmedicalbemergencybteambtobintubatebthebpatientb-bcorrectbanswer-
C.bNeedlebaspiratebtheb2ndbleftbintercostalbspace
AllbofbthebfollowingbstrategiesbareblikelybtobdecreasebtheblikelihoodbofbdamagebtobthebtrachealbmucosabEXC
EPT
A.bmaintainingbcuffbpressuresbbetweenb20bandb25bmmHg
B.busingbthebminimalbleakbtechniquebforbinflation
C.busingbablowbresidualbvolume,blowbcompliancebcuff
D.bmonitoringbintracuffbpressuresb-bcorrectbanswer-C.busingbablowbresidualbvolume,blowbcompliancebcuff
,Ab52byearboldbpostboperativebcholecystectomybpatient'sbbreathbsoundsbbecomebmorebcoarsebuponbcompl
etionbofbposturalbdrainagebwithbpercussion.bThebrespiratorybtherapistbshouldbrecommend
A.bcontinuingbthebtherapybuntilbbreathbsoundsbimproveb
B.badministeringbdornasebalpha
C.badministeringbalbuterolbtherapy
D.bdeepbbreathingbandbcoughingbtobclearbsecretionsb-bcorrectbanswer-
D.bdeepbbreathingbandbcoughingbtobclearbsecretions
Ab65bkgbspinalbcordbinjuredbpatientbdevelopsbatelectasis.bHisbinspiratorybcapacitybisb30%bofbhisbpredictedbv
alue.bWhatbbronchialbhygienebtherapybwouldbbebthebmostbappropriatebinitially?b
A.bincentivebspirometryb
B.bIPPB
C.bPosturalbdrainagebandbpercussion
D.bPEPbtherapyb-bcorrectbanswer-B.bIPPB
Abhealthybadultbfemalebcanbexhalebwhatbportionbofbherbforcedbvitalbcapacitybinbthebfirstbsecond?
A.b50%
B.b60%
C.b70%
D.b80%b-bcorrectbanswer-C.b70%
AbpatientbonbVCbventilationbdemonstratesbauto-
PEEPbonbventilatorbgraphics.bWhichbofbthebfollowingbcontrols,bwhenbadjustedbindependently,bwouldbincre
asebexpiratorybtime?
1.btidalbvolume
2.brespiratorybrate
,3.binspiratorybflow
4.bsensitivityb
A.b1,2,bandb3bonly
B.b1,b2,bandb4bonly
C.b1,b3,bandb4bonlyb
D.b2,3,bandb4bonlyb-bcorrectbanswer-A.b1,2,bandb3bonly
Whichbofbthebfollowingbwouldbbebthebmostbappropriatebforbabdyspneicbpatientbwhobhasbcrepitusbwithbtrac
healbdeviationbtobthebleftbandbabsentbbreathbsoundsbonbthebright?
A.bperformbchestbphysiotherapy
B.badministerbanbIPPBbtreatment
C.binsertbanbendotrachealbtubeb
D.binsertbabchestbtubeb-bcorrectbanswer-D.binsertbabchestbtube
Followingbcardiacbsurgery,bab55byearboldbpatientbhasbthebfollowingbABGbresults;bpHb7.50,bPaCO2b30btorr,bPa
O2b62btorr,bHCO3b25bmEq/L,bSaO2b92%,bHBb14g/dL,bBE+2.bVenousbbloodbgasbresultsbarebpHb7.39,bPvCO2b4
3btorr,bPvO2b37btorr,bandbSvO2b66%.bCalculatebthebpatient'sbC(a-v)O2
A.b2.5bvol%
B.b4.0bvol%
C.b5.0bvol%
D.b5.5bvol%b-bcorrectbanswer-C.b5.0bvol%
AbpatientbonbVC,bSIMVbwithbabVtbofb500mLbhasbabPIPbofb25bcmbH2O,bPplatbofb15bcmbH2ObandbPEEPbofb5cmb
H2O.bWhatbisbthebpatient'sbstaticblungbcompliance
A.b25bmL/cmbH2O
B.b35bmL/cmbH2O
, C.b45bmL/cmbH2O
D.b50bmL/cmbH2Ob-bcorrectbanswer-D.b50bmL/cmbH2O
ImmediatelybafterbextubationbofbabpatientbinbthebICU,bthebrespiratorybtherapistbobservesbincreasingbrespir
atorybdistressbwithbintercostalbretractionsbandbmarkedbstridor.bThebSpO2bonb40%boxygenbisbnotedbtobbeb76
%.bWhichbofbthebfollowingbwouldbbebmostbappropriatebatbthisbtime?
A.bCoolbmistbaerosolbtreatmentb
B.bAerosolizedbracemicbepinephrine
C.bManualbventilationbwithbresuscitationbbagbandbmask
D.breintubationb-bcorrectbanswer-D.breintubation
Whichbofbthebfollowingbpatientsbwouldbmostblikelybbenefitbpressurebsupportbventilation?
A.banbintubatedbwithbanbabsentbrespiratorybdriveb
B.babpatientbonbSIMVbwithbmandatorybratebofb12/minbandbtotalbratebofb24/bmin
C.babpatientbwithbacuteblungbinjuryb
D.babpatientbwhobrequiresbshort-termbpost-operativebventilatorybsupportb-bcorrectbanswer-
B.bAbpatientbonbSIMVbwithbmandatorybratebofb12/minbandbtotalbratebofb24/bmin
Abpatientbreceivingbmechanicalbventilationbhasbdevelopedbabtemperaturebofb99.9bFbwithbpurulentbsecretio
nsboverbtheblastb12bhours.bThebrespiratorybtherapistbhasbalsobnotedbabsteadybincreasebinbpeakbinspiratorybp
ressure.bWhatbinitialbrecommendationbshouldbbebmadebtobaddressbthesebchanges?
A.binitiatebbronchialbhygienebtherapyb
B.bobtainbabsputumbgrambstainb
C.badministerbIPV
D.binsertbabCASSbtubeb-bcorrectbanswer-B.bobtainbabsputumbgrambstain
WhichbofbthebfollowingbinformationbmaybbebobtainedbfrombFVCbmaneuverbduringbbedsidebpulmonarybfun
ctionbtesting?
