TMC EXAM B KETTERING Exam Study
Guide Questions And Answers Verified
100% Correct
A post-operative thoracotomy patient is receiving incentive spirometry therapy Q2H.
Breath sounds are diminished in the bases of the lungs with scattered crackles. The
patient's inspiratory capacity has decreased over the past 2 days. A chest radiograph
indicates thin-layered basilar densities. Which of the following has most likely occurred?
A. Atelectasis
B. Pneumonia
C. Pulmonary edema
D. Consolidation - answer A. Atelectasis
A patient is in full cardiopulmonary arrest and after several attempts, the patient is orally
intubated with a size 7 mm ID endotracheal tube. The nurse is unable to establish IV
access. The ECG monitor shows sinus bradycardia. Which of the following drugs should
be administered through the endotracheal tube?
A. Lidocaine
B. Epinephrine
C. Atropine
D. Dobutamine - answer C. Atropine
The results of a patient's spirometry are recorded as follows:
Predicted Observed
FVC (L) 3.5 2.1
FEV1 (L) 2.7 2.6
FRC (L) 2.5 1.7
TLC (L) 5.6 4.2
These results are indicative of
A. normal lung function.
,B. sarcoidosis.
C. acute bronchitis.
D. cystic fibrosis. - answer B. sarcoidosis.
The respiratory therapist is in charge of transporting a patient with multiple trauma to a
regional trauma center in a fixed wing aircraft. Which of the following should the
therapist be most concerned about during the transport?
A. Tissue oxygenation
B. Pneumothorax
C. Pulmonary embolus
D. Humidification of the inspired gas - answer A. Tissue oxygenation
Transcutaneous monitoring of PO2 values will correlate well with arterial blood gas PO2
values in which of the following situations?
1. Hypotension
2. Hypothermia
3. Pneumonia
A. 1 only
B. 3 only
C. 1 and 2 only
D. 2 and 3 only - answer B. 3 only
A patient is being ventilated in the intensive care unit. The following data is obtained:
Mode VC, SIMV
Mandatory rate 12 b/min
Total rate 18 b/min
VT 800 mL
FIO2 0.60
PIP 31 cm H2O
PEEP 10 cm H2O
pH 7.41
PaCO2 40 torr
PaO2 95 torr
SaO2 96%
,HCO3- 23 mEq/L
BE +1 mEq/L
PECO2 30 torr
Hb 15 g/dL
What should the respiratory therapist report as the VD/VT ratio?
A. 15%
B. 25%
C. 40%
D. 50% - answer B. 25%
What is the air-to-oxygen ratio for an air entrainment device delivering 60% oxygen?
A. 1:1
B. 3:1
C. 4:1
D. 10:1 - answer A. 1:1
Following surgery to correct an abdominal aortic aneurysm, a 54-year-old female patient
suddenly develops intense substernal chest pain with severe dyspnea. The pain does
not appear to be aggravated by her respirations. Auscultation reveals bilateral, basilar,
moist, crepitant rales. The patient appears pale, cold and clammy. Which of the
following should the respiratory therapist recommend for initial assessment of this
patient?
A. Serum electrolytes
B. Chest x-ray
C. Complete blood cell count
D. Electrocardiograph - answer D. Electrocardiograph
An adult patient is intubated with a 7.0 mm ID endotracheal tube. What size suction
catheter should be used to suction this patient?
A. 8 French
B. 10 French
C. 12 French
D. 14 French - answer B. 10 French
Which of the following would be the most appropriate test to evaluate partial vocal cord
, paralysis in a patient complaining of difficulty swallowing?
A. SB nitrogen elimination
B. Maximum voluntary ventilation
C. Flow volume loop
D. Diffusing capacity - answer C. Flow volume loop
In order to reduce a patient's PaCO2 from 40 torr to 32 torr, all of the following could be
increased EXCEPT
A. tidal volume.
B. alveolar ventilation.
C. respiratory rate.
D. physiologic deadspace - answer D. physiologic deadspace
While examining the chest drainage system of a mechanically-ventilated patient
following thoracotomy, the respiratory therapist observes bubbling in the water-seal
chamber during inspiration. This would indicate
A. a leak in the chest drainage system.
B. air leaving the pleural space.
C. excessive pressure from the suction regulator.
D. inadequate water level in the water-seal chamber. - answer B. air leaving the pleural
space.
A patient develops ascites and shortness of breath. Where is tissue edema most likely
to show up first?
A. Ankles
B. Abdomen
C. Thorax
D. Hands - answer B. Abdomen
An acceptable level of PEEP therapy can be identified by all of the following EXCEPT
A. the lower inflection point of a volume-pressure loop graphic.
B. acceptable oxygenation without cardiovascular side effects.
C. increasing oxygenation with increasing plateau pressure.
D. increasing static compliance with acceptable oxygenation - answer C. increasing
oxygenation with increasing plateau pressure.
Guide Questions And Answers Verified
100% Correct
A post-operative thoracotomy patient is receiving incentive spirometry therapy Q2H.
Breath sounds are diminished in the bases of the lungs with scattered crackles. The
patient's inspiratory capacity has decreased over the past 2 days. A chest radiograph
indicates thin-layered basilar densities. Which of the following has most likely occurred?
A. Atelectasis
B. Pneumonia
C. Pulmonary edema
D. Consolidation - answer A. Atelectasis
A patient is in full cardiopulmonary arrest and after several attempts, the patient is orally
intubated with a size 7 mm ID endotracheal tube. The nurse is unable to establish IV
access. The ECG monitor shows sinus bradycardia. Which of the following drugs should
be administered through the endotracheal tube?
A. Lidocaine
B. Epinephrine
C. Atropine
D. Dobutamine - answer C. Atropine
The results of a patient's spirometry are recorded as follows:
Predicted Observed
FVC (L) 3.5 2.1
FEV1 (L) 2.7 2.6
FRC (L) 2.5 1.7
TLC (L) 5.6 4.2
These results are indicative of
A. normal lung function.
,B. sarcoidosis.
C. acute bronchitis.
D. cystic fibrosis. - answer B. sarcoidosis.
The respiratory therapist is in charge of transporting a patient with multiple trauma to a
regional trauma center in a fixed wing aircraft. Which of the following should the
therapist be most concerned about during the transport?
A. Tissue oxygenation
B. Pneumothorax
C. Pulmonary embolus
D. Humidification of the inspired gas - answer A. Tissue oxygenation
Transcutaneous monitoring of PO2 values will correlate well with arterial blood gas PO2
values in which of the following situations?
1. Hypotension
2. Hypothermia
3. Pneumonia
A. 1 only
B. 3 only
C. 1 and 2 only
D. 2 and 3 only - answer B. 3 only
A patient is being ventilated in the intensive care unit. The following data is obtained:
Mode VC, SIMV
Mandatory rate 12 b/min
Total rate 18 b/min
VT 800 mL
FIO2 0.60
PIP 31 cm H2O
PEEP 10 cm H2O
pH 7.41
PaCO2 40 torr
PaO2 95 torr
SaO2 96%
,HCO3- 23 mEq/L
BE +1 mEq/L
PECO2 30 torr
Hb 15 g/dL
What should the respiratory therapist report as the VD/VT ratio?
A. 15%
B. 25%
C. 40%
D. 50% - answer B. 25%
What is the air-to-oxygen ratio for an air entrainment device delivering 60% oxygen?
A. 1:1
B. 3:1
C. 4:1
D. 10:1 - answer A. 1:1
Following surgery to correct an abdominal aortic aneurysm, a 54-year-old female patient
suddenly develops intense substernal chest pain with severe dyspnea. The pain does
not appear to be aggravated by her respirations. Auscultation reveals bilateral, basilar,
moist, crepitant rales. The patient appears pale, cold and clammy. Which of the
following should the respiratory therapist recommend for initial assessment of this
patient?
A. Serum electrolytes
B. Chest x-ray
C. Complete blood cell count
D. Electrocardiograph - answer D. Electrocardiograph
An adult patient is intubated with a 7.0 mm ID endotracheal tube. What size suction
catheter should be used to suction this patient?
A. 8 French
B. 10 French
C. 12 French
D. 14 French - answer B. 10 French
Which of the following would be the most appropriate test to evaluate partial vocal cord
, paralysis in a patient complaining of difficulty swallowing?
A. SB nitrogen elimination
B. Maximum voluntary ventilation
C. Flow volume loop
D. Diffusing capacity - answer C. Flow volume loop
In order to reduce a patient's PaCO2 from 40 torr to 32 torr, all of the following could be
increased EXCEPT
A. tidal volume.
B. alveolar ventilation.
C. respiratory rate.
D. physiologic deadspace - answer D. physiologic deadspace
While examining the chest drainage system of a mechanically-ventilated patient
following thoracotomy, the respiratory therapist observes bubbling in the water-seal
chamber during inspiration. This would indicate
A. a leak in the chest drainage system.
B. air leaving the pleural space.
C. excessive pressure from the suction regulator.
D. inadequate water level in the water-seal chamber. - answer B. air leaving the pleural
space.
A patient develops ascites and shortness of breath. Where is tissue edema most likely
to show up first?
A. Ankles
B. Abdomen
C. Thorax
D. Hands - answer B. Abdomen
An acceptable level of PEEP therapy can be identified by all of the following EXCEPT
A. the lower inflection point of a volume-pressure loop graphic.
B. acceptable oxygenation without cardiovascular side effects.
C. increasing oxygenation with increasing plateau pressure.
D. increasing static compliance with acceptable oxygenation - answer C. increasing
oxygenation with increasing plateau pressure.
