EXAM: TMC Practice Exam with Certified 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
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances Correct Answer-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?
A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
, EXAM: TMC Practice Exam with Certified Solutions
C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate the patient. Correct 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
A. maintaining cuff pressures between 20 and 25 mm Hg.
B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures. Correct Answer-monitoring intracuff pressures.
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
, EXAM: TMC Practice Exam with Certified Solutions
A. continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear secretions. Correct Answer-deep breathing and
coughing to clear secretions.
A 65 kg spinal cord injured patient has developed atelectasis. His inspiratory capacity is 30%
of his predicted value. What bronchial hygiene therapy would be most appropriate initially?
A. IS / SMI
B. IPPB with normal saline
C. postural drainage and percussion
D. PEP therapy Correct Answer-IPPB with normal saline
A patient on VC ventilation has demonstrated auto-PEEP on ventilator graphics. Which of the
following controls, when adjusted independently, would increase expiratory time?
, EXAM: TMC Practice Exam with Certified Solutions
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity Correct 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?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube Correct Answer-Insert a chest tube
A 55 year-old post cardiac surgery 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.
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
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances Correct Answer-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?
A. Call for a STAT chest x-ray.
B. Insert a chest tube into the left chest.
, EXAM: TMC Practice Exam with Certified Solutions
C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate the patient. Correct 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
A. maintaining cuff pressures between 20 and 25 mm Hg.
B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures. Correct Answer-monitoring intracuff pressures.
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
, EXAM: TMC Practice Exam with Certified Solutions
A. continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy.
D. deep breathing and coughing to clear secretions. Correct Answer-deep breathing and
coughing to clear secretions.
A 65 kg spinal cord injured patient has developed atelectasis. His inspiratory capacity is 30%
of his predicted value. What bronchial hygiene therapy would be most appropriate initially?
A. IS / SMI
B. IPPB with normal saline
C. postural drainage and percussion
D. PEP therapy Correct Answer-IPPB with normal saline
A patient on VC ventilation has demonstrated auto-PEEP on ventilator graphics. Which of the
following controls, when adjusted independently, would increase expiratory time?
, EXAM: TMC Practice Exam with Certified Solutions
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity Correct 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?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube Correct Answer-Insert a chest tube
A 55 year-old post cardiac surgery 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.
