TMC Practice Exam QUESTIONS WITH 100% CORRECT ANSWERS
COMPLETE SOLUTION
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) - ✅
✅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.
C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate the patient. (Correct) - ✅✅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) - ✅✅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
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) - ✅✅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) - ✅ ✅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?
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
, TMC Practice Exam QUESTIONS WITH 100% CORRECT ANSWERS
COMPLETE SOLUTION
4. Sensitivity (Correct) - ✅
✅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) - ✅✅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. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
D. 5.5 vol% (Correct) - ✅✅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
A. 25 mL/cm H2O
B. 35 mL/cm H2O
C. 45 mL/cm H2O
D. 50 mL/cm H2O (Correct) - ✅
✅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 86%. Which of the following would be most appropriate at this time?
A. cool mist aerosol treatment
B. aerosolized racemic epinephrine
C. manual ventilation with resuscitation bag and mask
D. reintubation (Correct) - ✅ ✅reintubation
Which of the following patients would most likely benefit from pressure support ventilation?
A. An intubated patient with an absent respiratory drive.
B. A patient on SIMV with a set rate of 12/min and total rate of 24/min.
C. A patient with acute lung injury.
D. A patient who requires short-term post-operative ventilatory support. (Correct) - ✅✅A patient on
SIMV with a set 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?
A. Initiate bronchial hygiene therapy.
B. Obtain a sputum gram stain.
C. Administer IPV.
D. Insert a CASS tube. (Correct) - ✅ ✅Obtain a sputum gram stain.
, TMC Practice Exam QUESTIONS WITH 100% CORRECT ANSWERS
COMPLETE SOLUTION
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 (Correct) - ✅✅1 and 2 only
The respiratory therapist is providing patient 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
A. sterilize the equipment.
B. retard bacterial growth.
C. kill all micro-organisms and spores.
D. extend the equipment life. (Correct) - ✅✅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
A. pneumonia.
B. pulmonary embolism.
C. pleural effusion.
D. bronchiolitis. (Correct) - ✅✅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?
A. 8 Fr
B. 10 Fr
C. 12 Fr
D. 14 Fr (Correct) - ✅
✅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
A. the patient is disconnected from the ventilator.
B. the patient is experiencing diffuse bronchospasm.
C. the endotracheal tube has slipped into the right main stem bronchus.
D. the patient has developed a left tension pneumothorax. (Correct) - ✅✅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
A. notify the charge nurse.
B. apply a pressure dressing.
C. apply pressure to the site.
D. perform a modified Allen's test. (Correct) - ✅✅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?
A. Diabetes insipidus
COMPLETE SOLUTION
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) - ✅
✅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.
C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate the patient. (Correct) - ✅✅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) - ✅✅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
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) - ✅✅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) - ✅ ✅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?
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
, TMC Practice Exam QUESTIONS WITH 100% CORRECT ANSWERS
COMPLETE SOLUTION
4. Sensitivity (Correct) - ✅
✅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) - ✅✅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. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
D. 5.5 vol% (Correct) - ✅✅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
A. 25 mL/cm H2O
B. 35 mL/cm H2O
C. 45 mL/cm H2O
D. 50 mL/cm H2O (Correct) - ✅
✅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 86%. Which of the following would be most appropriate at this time?
A. cool mist aerosol treatment
B. aerosolized racemic epinephrine
C. manual ventilation with resuscitation bag and mask
D. reintubation (Correct) - ✅ ✅reintubation
Which of the following patients would most likely benefit from pressure support ventilation?
A. An intubated patient with an absent respiratory drive.
B. A patient on SIMV with a set rate of 12/min and total rate of 24/min.
C. A patient with acute lung injury.
D. A patient who requires short-term post-operative ventilatory support. (Correct) - ✅✅A patient on
SIMV with a set 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?
A. Initiate bronchial hygiene therapy.
B. Obtain a sputum gram stain.
C. Administer IPV.
D. Insert a CASS tube. (Correct) - ✅ ✅Obtain a sputum gram stain.
, TMC Practice Exam QUESTIONS WITH 100% CORRECT ANSWERS
COMPLETE SOLUTION
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 (Correct) - ✅✅1 and 2 only
The respiratory therapist is providing patient 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
A. sterilize the equipment.
B. retard bacterial growth.
C. kill all micro-organisms and spores.
D. extend the equipment life. (Correct) - ✅✅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
A. pneumonia.
B. pulmonary embolism.
C. pleural effusion.
D. bronchiolitis. (Correct) - ✅✅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?
A. 8 Fr
B. 10 Fr
C. 12 Fr
D. 14 Fr (Correct) - ✅
✅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
A. the patient is disconnected from the ventilator.
B. the patient is experiencing diffuse bronchospasm.
C. the endotracheal tube has slipped into the right main stem bronchus.
D. the patient has developed a left tension pneumothorax. (Correct) - ✅✅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
A. notify the charge nurse.
B. apply a pressure dressing.
C. apply pressure to the site.
D. perform a modified Allen's test. (Correct) - ✅✅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?
A. Diabetes insipidus
