Kettering TMC Exam Practice (2026) –
400+ Practice Questions & Answers for
Respiratory Therapist TMC Board Exam
Prep Review (PDF)
SECTION 1: EMERGENCY & CRITICAL CARE
Question 1
A patient is admitted to the ED following a motor vehicle accident. On physical exam, 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) Obtain a stat chest X-ray
B) Insert a chest tube in the left 5th intercostal space
C) Needle aspirate the 2nd left intercostal space
D) Administer high-flow oxygen via non-rebreather mask
Correct Answer: C) Needle aspirate the 2nd left intercostal space
Rationale: This is a classic presentation of a tension pneumothorax: absent breath sounds,
hyperresonance, tracheal deviation to the contralateral side, hypotension, and bradycardia. Immediate
needle decompression at the 2nd intercostal space, midclavicular line on the affected side, is the life-
saving intervention .
Question 2
A patient is found in full cardiopulmonary arrest. CPR is started and the patient is orally intubated with
an EtCO2 monitor attached. Which of the following EtCO2 patterns would the respiratory therapist
expect to observe on the monitor?
A) Initially high, then falling
B) Initially low, then rising
C) Initially high, stays high
D) Initially low, stays low
Correct Answer: B) Initially low, then rising
Rationale: During cardiac arrest, EtCO2 is initially low due to minimal pulmonary blood flow. As effective
CPR is established and cardiac output improves, EtCO2 should rise. If EtCO2 remains low or falls, it
,suggests poor perfusion and may indicate the need to improve CPR quality. A sudden rise in EtCO2 may
indicate ROSC .
Question 3
A patient in the intensive care unit has the following hemodynamic measurements:
• CVP: 6 mmHg
• Mean PAP: 13 mmHg
• PCWP: 7 mmHg
• MAP: 86 mmHg
• Cardiac output: 4.0 L/min
• Cardiac index: 2.1 L/min
What is the systemic vascular resistance (SVR)?
A) 800 dynes/s/cm
B) 1300 dynes/s/cm
C) 1600 dynes/s/cm
D) 2100 dynes/s/cm
Correct Answer: B) 1300 dynes/s/cm
Rationale: SVR is calculated using the formula: [(MAP - CVP) × 80] / CO. Plugging in the values: [(86 - 6) ×
80] / 4.0 = (80 × 80) / 4.0 = .0 = 1600 dynes/s/cm. The key is recognizing that SVR is elevated
when CO is low and MAP is normal .
Question 4
A 44-year-old male patient receives mechanical ventilation with a volume-cycled ventilator. The
respiratory therapist observes that there is insufficient time for the patient to exhale completely. The
therapist should:
A) Increase inspiratory flow
B) Decrease minute volume
C) Add pressure support
D) Remove mechanical deadspace
Correct Answer: A) Increase inspiratory flow
Rationale: Insufficient exhalation time (air trapping/auto-PEEP) occurs when the inspiratory time is too
long relative to the expiratory time. Increasing inspiratory flow shortens the inspiratory time, thereby
lengthening the expiratory time and allowing more complete exhalation .
,SECTION 2: MECHANICAL VENTILATION
Question 5
A 75 kg (165 lb) male patient receives mechanical ventilation following coronary artery bypass surgery.
The following data is recorded:
• Mode: VC, A/C
• Tidal Volume: 650 mL
• Set Rate: 10 br/min
• Total Rate: 14 br/min
• FIO2: 0.40
• PEEP: 8 cm H2O
Arterial blood gas results show: pH: 7.36, PCO2: 44 torr, PO2: 85 torr, HCO3-: 23 mEq/L. Which of the
following should the respiratory therapist recommend?
A) Decrease the FIO2
B) Decrease the set rate to 8 br/min
C) Increase the PEEP to 10 cm H2O
D) Maintain the current settings
Correct Answer: D) Maintain the current settings
Rationale: The ABG values are within normal limits: pH 7.35-7.45, PaCO2 35-45 mmHg, PaO2 80-100
mmHg, HCO3 22-26 mEq/L. The patient is adequately ventilated and oxygenated on the current settings.
No changes are indicated .
Question 6
An 80 kg (176 lb) male suffering from acute respiratory distress syndrome is mechanically ventilated at
the following settings:
• Mode: VC, A/C
• Tidal Volume: 500 mL
• Set Rate: 10/min
• PIP: 68 cm H2O
• FIO2: 0.60
• PEEP: 8 cm H2O
The following patient information is available:
, • pH: 7.36
• PaCO2: 45 torr
• PaO2: 89 torr
• HCO3-: 22 mEq/L
The respiratory therapist should:
A) Decrease PEEP
B) Change to SIMV
C) Add pressure support
D) Change to pressure control
Correct Answer: D) Change to pressure control
Rationale: The patient has a high peak inspiratory pressure (PIP of 68 cm H2O) with ARDS. Changing to
pressure control ventilation can help limit peak pressures and reduce the risk of barotrauma. The ABG is
adequate, so the issue is the high PIP .
Question 7
A patient on volume-control ventilation triggers a high-pressure alarm. Breath sounds are diminished on
the left. What should be done first?
A) Suction the airway
B) Check for a pneumothorax
C) Administer a sedative
D) Increase tidal volume
Correct Answer: B) Check for a pneumothorax
Rationale: Unilateral diminished breath sounds with a high-pressure alarm suggest pneumothorax,
which requires urgent assessment (e.g., chest X-ray). Suctioning (A) is for secretions, sedation (C)
addresses agitation, and increasing tidal volume (D) worsens pressure .
Question 8
Which of the following is considered an absolute indication for continuous mechanical ventilation?
A) Increased work of breathing
B) Acute ventilatory failure
C) Ciliary dyskinesia/dysfunction
D) Resolution of underlying disease
Correct Answer: B) Acute ventilatory failure
400+ Practice Questions & Answers for
Respiratory Therapist TMC Board Exam
Prep Review (PDF)
SECTION 1: EMERGENCY & CRITICAL CARE
Question 1
A patient is admitted to the ED following a motor vehicle accident. On physical exam, 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) Obtain a stat chest X-ray
B) Insert a chest tube in the left 5th intercostal space
C) Needle aspirate the 2nd left intercostal space
D) Administer high-flow oxygen via non-rebreather mask
Correct Answer: C) Needle aspirate the 2nd left intercostal space
Rationale: This is a classic presentation of a tension pneumothorax: absent breath sounds,
hyperresonance, tracheal deviation to the contralateral side, hypotension, and bradycardia. Immediate
needle decompression at the 2nd intercostal space, midclavicular line on the affected side, is the life-
saving intervention .
Question 2
A patient is found in full cardiopulmonary arrest. CPR is started and the patient is orally intubated with
an EtCO2 monitor attached. Which of the following EtCO2 patterns would the respiratory therapist
expect to observe on the monitor?
A) Initially high, then falling
B) Initially low, then rising
C) Initially high, stays high
D) Initially low, stays low
Correct Answer: B) Initially low, then rising
Rationale: During cardiac arrest, EtCO2 is initially low due to minimal pulmonary blood flow. As effective
CPR is established and cardiac output improves, EtCO2 should rise. If EtCO2 remains low or falls, it
,suggests poor perfusion and may indicate the need to improve CPR quality. A sudden rise in EtCO2 may
indicate ROSC .
Question 3
A patient in the intensive care unit has the following hemodynamic measurements:
• CVP: 6 mmHg
• Mean PAP: 13 mmHg
• PCWP: 7 mmHg
• MAP: 86 mmHg
• Cardiac output: 4.0 L/min
• Cardiac index: 2.1 L/min
What is the systemic vascular resistance (SVR)?
A) 800 dynes/s/cm
B) 1300 dynes/s/cm
C) 1600 dynes/s/cm
D) 2100 dynes/s/cm
Correct Answer: B) 1300 dynes/s/cm
Rationale: SVR is calculated using the formula: [(MAP - CVP) × 80] / CO. Plugging in the values: [(86 - 6) ×
80] / 4.0 = (80 × 80) / 4.0 = .0 = 1600 dynes/s/cm. The key is recognizing that SVR is elevated
when CO is low and MAP is normal .
Question 4
A 44-year-old male patient receives mechanical ventilation with a volume-cycled ventilator. The
respiratory therapist observes that there is insufficient time for the patient to exhale completely. The
therapist should:
A) Increase inspiratory flow
B) Decrease minute volume
C) Add pressure support
D) Remove mechanical deadspace
Correct Answer: A) Increase inspiratory flow
Rationale: Insufficient exhalation time (air trapping/auto-PEEP) occurs when the inspiratory time is too
long relative to the expiratory time. Increasing inspiratory flow shortens the inspiratory time, thereby
lengthening the expiratory time and allowing more complete exhalation .
,SECTION 2: MECHANICAL VENTILATION
Question 5
A 75 kg (165 lb) male patient receives mechanical ventilation following coronary artery bypass surgery.
The following data is recorded:
• Mode: VC, A/C
• Tidal Volume: 650 mL
• Set Rate: 10 br/min
• Total Rate: 14 br/min
• FIO2: 0.40
• PEEP: 8 cm H2O
Arterial blood gas results show: pH: 7.36, PCO2: 44 torr, PO2: 85 torr, HCO3-: 23 mEq/L. Which of the
following should the respiratory therapist recommend?
A) Decrease the FIO2
B) Decrease the set rate to 8 br/min
C) Increase the PEEP to 10 cm H2O
D) Maintain the current settings
Correct Answer: D) Maintain the current settings
Rationale: The ABG values are within normal limits: pH 7.35-7.45, PaCO2 35-45 mmHg, PaO2 80-100
mmHg, HCO3 22-26 mEq/L. The patient is adequately ventilated and oxygenated on the current settings.
No changes are indicated .
Question 6
An 80 kg (176 lb) male suffering from acute respiratory distress syndrome is mechanically ventilated at
the following settings:
• Mode: VC, A/C
• Tidal Volume: 500 mL
• Set Rate: 10/min
• PIP: 68 cm H2O
• FIO2: 0.60
• PEEP: 8 cm H2O
The following patient information is available:
, • pH: 7.36
• PaCO2: 45 torr
• PaO2: 89 torr
• HCO3-: 22 mEq/L
The respiratory therapist should:
A) Decrease PEEP
B) Change to SIMV
C) Add pressure support
D) Change to pressure control
Correct Answer: D) Change to pressure control
Rationale: The patient has a high peak inspiratory pressure (PIP of 68 cm H2O) with ARDS. Changing to
pressure control ventilation can help limit peak pressures and reduce the risk of barotrauma. The ABG is
adequate, so the issue is the high PIP .
Question 7
A patient on volume-control ventilation triggers a high-pressure alarm. Breath sounds are diminished on
the left. What should be done first?
A) Suction the airway
B) Check for a pneumothorax
C) Administer a sedative
D) Increase tidal volume
Correct Answer: B) Check for a pneumothorax
Rationale: Unilateral diminished breath sounds with a high-pressure alarm suggest pneumothorax,
which requires urgent assessment (e.g., chest X-ray). Suctioning (A) is for secretions, sedation (C)
addresses agitation, and increasing tidal volume (D) worsens pressure .
Question 8
Which of the following is considered an absolute indication for continuous mechanical ventilation?
A) Increased work of breathing
B) Acute ventilatory failure
C) Ciliary dyskinesia/dysfunction
D) Resolution of underlying disease
Correct Answer: B) Acute ventilatory failure
