TMC Exams A, B, & C + Mock & Practice Exams
| 2025 Version – Score an A+
1. During the assessment of a 64-year-old female patient, you note the
following signs: dyspnea, hypotension, and a tracheal shift to the right. The
patient also has absent breath sounds, reduced chest expansion, and a
hyperresonant percussion note all on the left side. These findings suggest
which of the following?
A. A pleural effusion on the left side
B. A pneumothorax on the left side
C. Atelectasis on the left side
D. Consolidation on the left side - ANS. B. A pneumothorax on the left side
2. A 39-year-old male patient was admitted to the emergency department
with a fever and an SpO2 of 87% on room air. Upon auscultation, rhonchi is
heard and the patient has a productive cough. Which of the following would
you recommend?
A. Intubate and provide mechanical ventilation with 40% oxygen
B. Provide noninvasive positive pressure ventilation using a full face mask
C. Implement postural drainage and percussion with directed coughing
D. Provide oxygen therapy and obtain a sputum sample for culture and
sensitivity - ANS. D. Provide oxygen therapy and obtain a sputum sample
for culture and sensitivity
3. A 50-year-old male patient is intubated with a size 8 endotracheal tube
and is receiving volume-controlled A/C ventilation. Upon assessment, you
1
,note that the patient's cuff pressure is measured at 38 cm H2O. Which of the
following would you recommend?
A. Withdraw the tube 1-2 cm and reassess the patient's breath sounds
B. Recommend reintubation with a smaller endotracheal tube
C. Lower the cuff pressure to < 30 cm H2O
D. Recommend ventilation via a tracheostomy instead - ANS. C. Lower the
cuff pressure to < 30 cm H2O
4. During the assessment of a 52-year-old female patient that is receiving
oxygen via nasal cannula at 4 L/min, you hear the bubble humidifier making
a whistling noise. Which of the following is the most likely cause of this
finding?
A. There is an obstruction in the delivery tube
B. The patient's ventilation has increased
C. There is a clogged system diffuser
D. The flowmeter pressure is set too high - ANS. A. There is an obstruction
in the delivery tube
5. A pre and post bronchodilator test was ordered on a 48-year-old female
patient. The forced expiratory measurement that was obtained after the
bronchodilator was given shows an increase in the patient's FEV1 from 60%
to 80% of the predicted value. This finding suggests which of the following?
A. A fixed airway obstruction
B. A reversible airway obstruction
C. A normal diffusion capacity
D. A restrictive process - ANS. B. A reversible airway obstruction
2
,6. A 58-year-old female patient is intubated and appears to be breathing
asynchronously with the ventilator. Her breath sounds are absent on the left
side and the trachea appears to be shifted to the left. The patient has a dull
percussion note on the left side as well. Which of the following is the most
likely explanation of these findings?
A. A tracheoesophageal fistula has developed
B. A tension pneumothorax has developed on the left side
C. The endotracheal tube is in the right mainstem bronchus
D. The patient is experiencing diffuse bronchospasm - ANS. C. The
endotracheal tube is in the right mainstem bronchus
7. A 63-year-old female patient is intubated and receiving mechanical
ventilation in the pressure controlled A/C mode. If the patient's compliance
were to decrease, which of the following would you expect to occur?
A. Her delivered volume will decrease
B. Her peak pressure will increase
C. Her inspiratory time will increase
D. Her PEEP level will decrease - ANS. A. Her delivered volume will
decrease
8. A 70-year-old male patient is intubated and receiving mechanical
ventilation in the volume controlled A/C mode. After performing
endotracheal suctioning, which of the following would indicate the effective
clearance of retained secretions?
A. An increased tidal volume
B. A decreased inspiratory time
C. A decreased plateau pressure
3
, D. A decreased peak pressure - ANS. D. A decreased peak pressure
9. An adult patient who is receiving mechanical ventilation suddenly started
showing signs of tachypnea. Upon assessment, you note tracheal deviation
to the right and decreased breath sounds and hyperresonance on the left.
Which of the following would you recommend?
A. The patient needs suctioning
B. The patient needs a bronchoscopy
C. The insertion of a chest tube
D. The patient needs a thoracentesis - ANS. C. The insertion of a chest
tube
10. A 57-year-old female patient with acute pulmonary edema is dyspneic
and appears to be wheezing. The resident physician has ordered an albuterol
breathing treatment via SVN. Which of the following would you recommend?
A. Recommend acetylcysteine instead of albuterol
B. Perform the therapy with supplemental oxygen
C. Perform the treatment as ordered
D. Recommend a diuretic and oxygen therapy - ANS. D. Recommend a
diuretic and oxygen therapy
11. A 39-year-old female patient who is intubated was admitted to the
emergency department and the nurse was unable to start an intravenous
line during CPR. It is believed that the patient is suffering from a narcotic
overdose and the physician wants to administer Naloxone. Which of the
following is an alternative route that can be used to deliver this medication?
A. Through the feeding tube
4
| 2025 Version – Score an A+
1. During the assessment of a 64-year-old female patient, you note the
following signs: dyspnea, hypotension, and a tracheal shift to the right. The
patient also has absent breath sounds, reduced chest expansion, and a
hyperresonant percussion note all on the left side. These findings suggest
which of the following?
A. A pleural effusion on the left side
B. A pneumothorax on the left side
C. Atelectasis on the left side
D. Consolidation on the left side - ANS. B. A pneumothorax on the left side
2. A 39-year-old male patient was admitted to the emergency department
with a fever and an SpO2 of 87% on room air. Upon auscultation, rhonchi is
heard and the patient has a productive cough. Which of the following would
you recommend?
A. Intubate and provide mechanical ventilation with 40% oxygen
B. Provide noninvasive positive pressure ventilation using a full face mask
C. Implement postural drainage and percussion with directed coughing
D. Provide oxygen therapy and obtain a sputum sample for culture and
sensitivity - ANS. D. Provide oxygen therapy and obtain a sputum sample
for culture and sensitivity
3. A 50-year-old male patient is intubated with a size 8 endotracheal tube
and is receiving volume-controlled A/C ventilation. Upon assessment, you
1
,note that the patient's cuff pressure is measured at 38 cm H2O. Which of the
following would you recommend?
A. Withdraw the tube 1-2 cm and reassess the patient's breath sounds
B. Recommend reintubation with a smaller endotracheal tube
C. Lower the cuff pressure to < 30 cm H2O
D. Recommend ventilation via a tracheostomy instead - ANS. C. Lower the
cuff pressure to < 30 cm H2O
4. During the assessment of a 52-year-old female patient that is receiving
oxygen via nasal cannula at 4 L/min, you hear the bubble humidifier making
a whistling noise. Which of the following is the most likely cause of this
finding?
A. There is an obstruction in the delivery tube
B. The patient's ventilation has increased
C. There is a clogged system diffuser
D. The flowmeter pressure is set too high - ANS. A. There is an obstruction
in the delivery tube
5. A pre and post bronchodilator test was ordered on a 48-year-old female
patient. The forced expiratory measurement that was obtained after the
bronchodilator was given shows an increase in the patient's FEV1 from 60%
to 80% of the predicted value. This finding suggests which of the following?
A. A fixed airway obstruction
B. A reversible airway obstruction
C. A normal diffusion capacity
D. A restrictive process - ANS. B. A reversible airway obstruction
2
,6. A 58-year-old female patient is intubated and appears to be breathing
asynchronously with the ventilator. Her breath sounds are absent on the left
side and the trachea appears to be shifted to the left. The patient has a dull
percussion note on the left side as well. Which of the following is the most
likely explanation of these findings?
A. A tracheoesophageal fistula has developed
B. A tension pneumothorax has developed on the left side
C. The endotracheal tube is in the right mainstem bronchus
D. The patient is experiencing diffuse bronchospasm - ANS. C. The
endotracheal tube is in the right mainstem bronchus
7. A 63-year-old female patient is intubated and receiving mechanical
ventilation in the pressure controlled A/C mode. If the patient's compliance
were to decrease, which of the following would you expect to occur?
A. Her delivered volume will decrease
B. Her peak pressure will increase
C. Her inspiratory time will increase
D. Her PEEP level will decrease - ANS. A. Her delivered volume will
decrease
8. A 70-year-old male patient is intubated and receiving mechanical
ventilation in the volume controlled A/C mode. After performing
endotracheal suctioning, which of the following would indicate the effective
clearance of retained secretions?
A. An increased tidal volume
B. A decreased inspiratory time
C. A decreased plateau pressure
3
, D. A decreased peak pressure - ANS. D. A decreased peak pressure
9. An adult patient who is receiving mechanical ventilation suddenly started
showing signs of tachypnea. Upon assessment, you note tracheal deviation
to the right and decreased breath sounds and hyperresonance on the left.
Which of the following would you recommend?
A. The patient needs suctioning
B. The patient needs a bronchoscopy
C. The insertion of a chest tube
D. The patient needs a thoracentesis - ANS. C. The insertion of a chest
tube
10. A 57-year-old female patient with acute pulmonary edema is dyspneic
and appears to be wheezing. The resident physician has ordered an albuterol
breathing treatment via SVN. Which of the following would you recommend?
A. Recommend acetylcysteine instead of albuterol
B. Perform the therapy with supplemental oxygen
C. Perform the treatment as ordered
D. Recommend a diuretic and oxygen therapy - ANS. D. Recommend a
diuretic and oxygen therapy
11. A 39-year-old female patient who is intubated was admitted to the
emergency department and the nurse was unable to start an intravenous
line during CPR. It is believed that the patient is suffering from a narcotic
overdose and the physician wants to administer Naloxone. Which of the
following is an alternative route that can be used to deliver this medication?
A. Through the feeding tube
4
