TMC Mock Exam
1. Although treated with several antiar- apply cardioversion
rhythmic drugs, a patient with ventric-
ular tachycardia begins to exhibit hy- *If drug management fails, if the
potension and decreased conscious- ventricular rate exceeds 150/min,
ness. Which of the following actions or if the patient becomes hemo-
would you recommend at this time? dynamically unstable, synchro-
nous cardioversion is indicated.
immediately initiate CPR
apply cardioversion
administer epinephrine
defibrillate the patient
2. A physician orders intubation and vol- rate/min: 15; VT (mL): 500
ume-controlled A/C ventilation for a
6-foot, 3-inch tall 190-lb (86-kg) adult Tidal volume 6ml/kg IBW
male patient with ARDS. Which of the
following ventilator settings would you 6ft 3= 85kg IBW
aim for to support this patient? Vt= 500
Rate= 10 to 20
rate/min: 10; VT (mL): 800
rate/min: 15; VT (mL): 500
rate/min: 20; VT (mL): 900
rate/min: 8; VT (mL): 1200
3. A doctor institutes volume-controlled 35/min
ventilation for a 70-kg ARDS patient
with a targeted tidal volume of 420 mL
To maintain adequate ventilation with
this tidal volume, the maximum respira-
tory rate you would allow is:
25/min
35/min
20/min
30/min
4. Which of the following PaCO2 levels at least 60 mm Hg
would be considered a positive result
for brain death determination at the end or 20+ from baseline CO2
, TMC Mock Exam
of an apnea test?
-at least 50 mm Hg
-at least 45 mm Hg
-at least 60 mm Hg
-at least 55 mm Hg
5. A COPD patient receiving volume-con- 2 and 3 only
trolled A/C ventilation at a rate of 15 and
a VT of 650 mL exhibits signs of air trap- * Adding an end-inspiratory
ping (auto-PEEP). Which of the follow- pause would cause more airtrap-
ing alternatives would you recommend ping
to help overcome this problem?
1. add an end-inspiratory pause
2. switch to SIMV and decrease the rate
3. increase the inspiratory flow
2 and 3 only
1, 2, and 3
1 and 3 only
1 and 2 only
6. A patient who just underwent major the patient has a bronchopleural
thoracic surgery is placed on pres- fistula
sure-controlled A/C ventilation with 10
cmH2O PEEP. You observe continuous * Constant bubbling indicates a
bubbling in the water seal chamber of leak; either in the patient or in the
his pleural drainage system. Which of tubing/chamber system.
the following is the most likely cause of
this observation?
-the patient has a pleural effusion
-the suction/ vacuum pressure is too
low
-the drainage system is obstructed
-the patient has a bronchopleural fistula
7. To measure the amount of auto-PEEP measure pressure during an
present in a patient receiving ventilato- end-expiratory pause
, TMC Mock Exam
ry support, you would:
-measure pressure during an end-expi-
ratory pause
-measure expiratory flow before and af-
ter bronchodilator
-measure pressure at volume incre-
ments using a super syringe
-measure pressure during an end-inspi-
ratory pause
8. Which of the following indicate that 1 and 2
a pleural drainage system is working
properly? * Suction control should bub-
1. the water seal chamber level rises ble continuously and water seal
and falls with breathing chamber should rise and fall.
2. there is continuous bubbling in the
suction control chamber * Continuous bubbling in the wa-
3. there is continuous bubbling in the ter seal chamber= leak.
water seal chamber
1, 2, and 3
1 only
1 and 2
3 only
9. A physician wants to calculate the stat- 36 mL/cmH2O
ic lung compliance for a 110-kg patient
receiving volume controlled ventilation. *VT/(Plat-PEEP)
Patient settings and monitoring data
are as follows: Vt 900 ml, Rate 14/min,
Peak pressure 50 cmH2O, Plateau pres-
sure 35 cmH2O, PEEP 10 cmH2O, Me-
chanical dead space 100ml. The pa-
tient's static lung compliance is:
22 mL/cmH2O
26 mL/cmH2O
, TMC Mock Exam
18 mL/cmH2O
36 mL/cmH2O
10. A physician has attempted on sever- insert a chest tube into the right
al occasions to insert a central ve- pleural space
nous catheter into the right subclavian
vein of a patient receiving mechani- * Pneumothorax is a complication
cal ventilation. Suddenly the ventila- of central venous catheter.
tor's high-pressure alarm sounds, the
patient's blood pressure drops, and the
SPO2 value drips from 96% to 84%.
Breath sounds are greatly diminished
over the right-lung field. What action
should you recommend?
-insert a chest tube into the right pleural
space
-insert a pulmonary artery catheter
-pull the ET back 2-3 cm into the trachea
-insert a chest tube into the left pleural
space
11. A 48-year-old 180-lb male is orally intu- replace the endotracheal tube
bated receiving mechanical ventilation with a larger size
with a 6.0 mm endotracheal tube se-
cured in place, which requires a cuff *Most common cause of high ET
pressure of 38 cm H2O to prevent sig- tube cuff pressure is the tube is
nificant volume loss. Which of the fol- too small
lowing actions would be appropriate in
this case?
-accept the large volume loss during
inspiration
-deflate and reinflate the cuff with 20 ml
of air
-replace the endotracheal tube with a
larger size
1. Although treated with several antiar- apply cardioversion
rhythmic drugs, a patient with ventric-
ular tachycardia begins to exhibit hy- *If drug management fails, if the
potension and decreased conscious- ventricular rate exceeds 150/min,
ness. Which of the following actions or if the patient becomes hemo-
would you recommend at this time? dynamically unstable, synchro-
nous cardioversion is indicated.
immediately initiate CPR
apply cardioversion
administer epinephrine
defibrillate the patient
2. A physician orders intubation and vol- rate/min: 15; VT (mL): 500
ume-controlled A/C ventilation for a
6-foot, 3-inch tall 190-lb (86-kg) adult Tidal volume 6ml/kg IBW
male patient with ARDS. Which of the
following ventilator settings would you 6ft 3= 85kg IBW
aim for to support this patient? Vt= 500
Rate= 10 to 20
rate/min: 10; VT (mL): 800
rate/min: 15; VT (mL): 500
rate/min: 20; VT (mL): 900
rate/min: 8; VT (mL): 1200
3. A doctor institutes volume-controlled 35/min
ventilation for a 70-kg ARDS patient
with a targeted tidal volume of 420 mL
To maintain adequate ventilation with
this tidal volume, the maximum respira-
tory rate you would allow is:
25/min
35/min
20/min
30/min
4. Which of the following PaCO2 levels at least 60 mm Hg
would be considered a positive result
for brain death determination at the end or 20+ from baseline CO2
, TMC Mock Exam
of an apnea test?
-at least 50 mm Hg
-at least 45 mm Hg
-at least 60 mm Hg
-at least 55 mm Hg
5. A COPD patient receiving volume-con- 2 and 3 only
trolled A/C ventilation at a rate of 15 and
a VT of 650 mL exhibits signs of air trap- * Adding an end-inspiratory
ping (auto-PEEP). Which of the follow- pause would cause more airtrap-
ing alternatives would you recommend ping
to help overcome this problem?
1. add an end-inspiratory pause
2. switch to SIMV and decrease the rate
3. increase the inspiratory flow
2 and 3 only
1, 2, and 3
1 and 3 only
1 and 2 only
6. A patient who just underwent major the patient has a bronchopleural
thoracic surgery is placed on pres- fistula
sure-controlled A/C ventilation with 10
cmH2O PEEP. You observe continuous * Constant bubbling indicates a
bubbling in the water seal chamber of leak; either in the patient or in the
his pleural drainage system. Which of tubing/chamber system.
the following is the most likely cause of
this observation?
-the patient has a pleural effusion
-the suction/ vacuum pressure is too
low
-the drainage system is obstructed
-the patient has a bronchopleural fistula
7. To measure the amount of auto-PEEP measure pressure during an
present in a patient receiving ventilato- end-expiratory pause
, TMC Mock Exam
ry support, you would:
-measure pressure during an end-expi-
ratory pause
-measure expiratory flow before and af-
ter bronchodilator
-measure pressure at volume incre-
ments using a super syringe
-measure pressure during an end-inspi-
ratory pause
8. Which of the following indicate that 1 and 2
a pleural drainage system is working
properly? * Suction control should bub-
1. the water seal chamber level rises ble continuously and water seal
and falls with breathing chamber should rise and fall.
2. there is continuous bubbling in the
suction control chamber * Continuous bubbling in the wa-
3. there is continuous bubbling in the ter seal chamber= leak.
water seal chamber
1, 2, and 3
1 only
1 and 2
3 only
9. A physician wants to calculate the stat- 36 mL/cmH2O
ic lung compliance for a 110-kg patient
receiving volume controlled ventilation. *VT/(Plat-PEEP)
Patient settings and monitoring data
are as follows: Vt 900 ml, Rate 14/min,
Peak pressure 50 cmH2O, Plateau pres-
sure 35 cmH2O, PEEP 10 cmH2O, Me-
chanical dead space 100ml. The pa-
tient's static lung compliance is:
22 mL/cmH2O
26 mL/cmH2O
, TMC Mock Exam
18 mL/cmH2O
36 mL/cmH2O
10. A physician has attempted on sever- insert a chest tube into the right
al occasions to insert a central ve- pleural space
nous catheter into the right subclavian
vein of a patient receiving mechani- * Pneumothorax is a complication
cal ventilation. Suddenly the ventila- of central venous catheter.
tor's high-pressure alarm sounds, the
patient's blood pressure drops, and the
SPO2 value drips from 96% to 84%.
Breath sounds are greatly diminished
over the right-lung field. What action
should you recommend?
-insert a chest tube into the right pleural
space
-insert a pulmonary artery catheter
-pull the ET back 2-3 cm into the trachea
-insert a chest tube into the left pleural
space
11. A 48-year-old 180-lb male is orally intu- replace the endotracheal tube
bated receiving mechanical ventilation with a larger size
with a 6.0 mm endotracheal tube se-
cured in place, which requires a cuff *Most common cause of high ET
pressure of 38 cm H2O to prevent sig- tube cuff pressure is the tube is
nificant volume loss. Which of the fol- too small
lowing actions would be appropriate in
this case?
-accept the large volume loss during
inspiration
-deflate and reinflate the cuff with 20 ml
of air
-replace the endotracheal tube with a
larger size
