TMC PRACTICE EXAM GUIDE
QUESTIONS AND ANSWERS
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 - ANSWER-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. - ANSWER-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. - ANSWER-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 - ANSWER-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. - ANSWER-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. - ANSWER-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
B. Renal failure
C. Metabolic acidosis
D. Elevated intracranial pressure - ANSWER-Elevated intracranial pressure
What value for the apnea-hypopnea index (AHI) is consistent with mild obstructive sleep
apnea?
A. Less than 5
B. 5 to 15
C. 16 to 30
D. Greater than 30 - ANSWER-5 to 15
While monitoring a newborn utilizing a transcutaneous monitor, you notice 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?
A. Upper airway obstruction
B. Poor peripheral perfusion
C. Air leak around the sensor
D. Device is out of range - ANSWER-Air leak around the sensor
A patient on the general medical ward is on a 28% air entrainment mask with the
flowmeter set at 5 L/min. What is the total flow delivered to the patient?
A. 5 L/min
B. 55 L/min
C. 88 L/min
,D. 140 L/min - ANSWER-55/Lmin
Which of the following measurements is most indicative of pulmonary edema?
A. Heart rate of 120/min
B. Blood pressure of 92/72 mm Hg
C. Pulmonary artery pressure of 25/10 mm Hg
D. Pulmonary capillary wedge pressure of 30 mm Hg - ANSWER-Pulmonary capillary
wedge pressure of 30 mm Hg
Sleep apnea can be defined as repeated episodes of complete cessation of airflow for
A. 5 seconds or longer.
B. 10 seconds or longer.
C. 15 seconds or longer.
D. 20 seconds or longer. - ANSWER-10 seconds or longer
A patient in the ICU receiving mechanical ventilation has just undergone a fiberoptic
bronchoscopy procedure in 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
A. hypoxemia.
B. pneumothorax.
C. pulmonary hemorrhage.
D. bronchospasm/laryngospasm. - ANSWER-hypoxemia
What size endotracheal tube would be appropriate for an adult female patient?
A. 6.0 to 6.5 mm
B. 6.5 to 7.0 mm
C. 7.0 to 7.5 mm
D. 7.5 to 8.0 mm - ANSWER-7.0 to 7.5 mm
The respiratory therapist has been asked to measure Auto-PEEP on a patient receiving
mechanical ventilation. In order to do this, the therapist should
A. initiate an inspiratory hold just after the next ventilator-delivered breath.
B. initiate an expiratory hold just prior to the next ventilator-delivered breath.
C. subtract Pplat from Pdyn.
D. subtract set PEEP from the measured Pplat. - ANSWER-initiate an expiratory hold
just prior to the next ventilator-delivered breath.
A patient who suffered trauma in an ATV accident is being monitored in the ICU. A
pulmonary artery catheter has been placed and the following data is available:
, PvO2 46 torr
PCWP 19 mm Hg
PAP (mean) 10 mm Hg
CVP 12 cm H2O
Cardiac Output 3L/min
The respiratory therapist should recommend
1. IV fluid challenge
2. positive inotropic agent
3. inhaled nitric oxide
4. diuretic therapy - ANSWER-2 and 4
What is the primary advantage of volume-controlled ventilation as compared to
pressure-controlled ventilation?
A. VC limits and controls PIP.
B. VC provides a constant minute ventilation.
C. VC ensures better patient-ventilator synchrony.
D. VC delivers a decelerating flow pattern. - ANSWER-VC provides a constant minute
ventilation.
Bronchial breath sounds heard over the lung periphery indicate
A. narrowed airways.
B. obstructed bronchi.
C. lung consolidation.
D. pulmonary edema. - ANSWER-lung consolidation.
During a pre-operative evaluation, bedside spirometry results are as follows: FVC 88%
of predicted, FEV1 85% of predicted, FEV1/FVC 82% of predicted and FEF25-75 81%
of predicted. How should the respiratory therapist interpret these results?
A. a mild restrictive disorder
B. a mild obstructive disorder
C. normal lung function
D. mixed obstructive/restrictive disorder - ANSWER-normal lung function
A 55 year-old male patient is being evaluated for pulmonary rehabilitation. During a
cycle ergometer cardiopulmonary stress procedure, the patient has a heart rate of
100/min and a respiratory rate of 20/min. He suddenly begins to complain of chest pain
and severe shortness of breath. The respiratory therapist should
A. reduce the speed of the bike.
B. administer supplemental oxygen.
C. gradually reduce the workload and monitor closely.
QUESTIONS AND ANSWERS
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 - ANSWER-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. - ANSWER-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. - ANSWER-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 - ANSWER-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. - ANSWER-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. - ANSWER-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
B. Renal failure
C. Metabolic acidosis
D. Elevated intracranial pressure - ANSWER-Elevated intracranial pressure
What value for the apnea-hypopnea index (AHI) is consistent with mild obstructive sleep
apnea?
A. Less than 5
B. 5 to 15
C. 16 to 30
D. Greater than 30 - ANSWER-5 to 15
While monitoring a newborn utilizing a transcutaneous monitor, you notice 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?
A. Upper airway obstruction
B. Poor peripheral perfusion
C. Air leak around the sensor
D. Device is out of range - ANSWER-Air leak around the sensor
A patient on the general medical ward is on a 28% air entrainment mask with the
flowmeter set at 5 L/min. What is the total flow delivered to the patient?
A. 5 L/min
B. 55 L/min
C. 88 L/min
,D. 140 L/min - ANSWER-55/Lmin
Which of the following measurements is most indicative of pulmonary edema?
A. Heart rate of 120/min
B. Blood pressure of 92/72 mm Hg
C. Pulmonary artery pressure of 25/10 mm Hg
D. Pulmonary capillary wedge pressure of 30 mm Hg - ANSWER-Pulmonary capillary
wedge pressure of 30 mm Hg
Sleep apnea can be defined as repeated episodes of complete cessation of airflow for
A. 5 seconds or longer.
B. 10 seconds or longer.
C. 15 seconds or longer.
D. 20 seconds or longer. - ANSWER-10 seconds or longer
A patient in the ICU receiving mechanical ventilation has just undergone a fiberoptic
bronchoscopy procedure in 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
A. hypoxemia.
B. pneumothorax.
C. pulmonary hemorrhage.
D. bronchospasm/laryngospasm. - ANSWER-hypoxemia
What size endotracheal tube would be appropriate for an adult female patient?
A. 6.0 to 6.5 mm
B. 6.5 to 7.0 mm
C. 7.0 to 7.5 mm
D. 7.5 to 8.0 mm - ANSWER-7.0 to 7.5 mm
The respiratory therapist has been asked to measure Auto-PEEP on a patient receiving
mechanical ventilation. In order to do this, the therapist should
A. initiate an inspiratory hold just after the next ventilator-delivered breath.
B. initiate an expiratory hold just prior to the next ventilator-delivered breath.
C. subtract Pplat from Pdyn.
D. subtract set PEEP from the measured Pplat. - ANSWER-initiate an expiratory hold
just prior to the next ventilator-delivered breath.
A patient who suffered trauma in an ATV accident is being monitored in the ICU. A
pulmonary artery catheter has been placed and the following data is available:
, PvO2 46 torr
PCWP 19 mm Hg
PAP (mean) 10 mm Hg
CVP 12 cm H2O
Cardiac Output 3L/min
The respiratory therapist should recommend
1. IV fluid challenge
2. positive inotropic agent
3. inhaled nitric oxide
4. diuretic therapy - ANSWER-2 and 4
What is the primary advantage of volume-controlled ventilation as compared to
pressure-controlled ventilation?
A. VC limits and controls PIP.
B. VC provides a constant minute ventilation.
C. VC ensures better patient-ventilator synchrony.
D. VC delivers a decelerating flow pattern. - ANSWER-VC provides a constant minute
ventilation.
Bronchial breath sounds heard over the lung periphery indicate
A. narrowed airways.
B. obstructed bronchi.
C. lung consolidation.
D. pulmonary edema. - ANSWER-lung consolidation.
During a pre-operative evaluation, bedside spirometry results are as follows: FVC 88%
of predicted, FEV1 85% of predicted, FEV1/FVC 82% of predicted and FEF25-75 81%
of predicted. How should the respiratory therapist interpret these results?
A. a mild restrictive disorder
B. a mild obstructive disorder
C. normal lung function
D. mixed obstructive/restrictive disorder - ANSWER-normal lung function
A 55 year-old male patient is being evaluated for pulmonary rehabilitation. During a
cycle ergometer cardiopulmonary stress procedure, the patient has a heart rate of
100/min and a respiratory rate of 20/min. He suddenly begins to complain of chest pain
and severe shortness of breath. The respiratory therapist should
A. reduce the speed of the bike.
B. administer supplemental oxygen.
C. gradually reduce the workload and monitor closely.
