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TMC
TMC PRACTICE EXAM QUESTIONS WITH CORRECT
VERIFIED SOLUTIONS 100% GUARANTEED PASS
(LATEST UPDATE)
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. - ANS ✓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. - ANS ✓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
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D. mixed obstructive/restrictive disorder - ANS ✓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. D. terminate the procedure immediately. - ANS ✓terminate the procedure immediately. At 1 minute post-delivery, a newborn has blue extremities with a pink body, heart rate is 90/min, respiratory rate is 20/min with a weak cry, cough reflex is present, and there is some flexion of the extremities. At 5 minutes post-delivery, the infant is completely pink, heart rate is 140/min, respiratory rate is 40/min, cough reflex is present, and the baby is active with a strong cry. What APGAR scores should be assigned? A. 4 & 8 B. 5 & 9 C. 5 & 10 D. 6 & 10 - ANS ✓6 & 10 The respiratory therapist is asked to administer 2.5 mg of albuterol to a patient via small volume nebulizer. The medication is available in a 0.5% solution. What volume of albuterol should be administered? A. 0.25 mL B. 0.50 mL
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C. Wright respirometer. D. pneumotachometer. - ANS ✓3.0 L syringe. While performing diagnostic chest percussion, the respiratory therapist notes decreased resonance to percussion. Which of the following are potential causes of this finding?
- pneumothorax
- pleural effusion
- pneumonia
- atelectasis - ANS ✓2, 3, and 4 only A 19-year-old patient is brought to the emergency department after taking a handful of pills. The patient is obtunded but is making regular, sonorous respiratory efforts. Auscultation reveals coarse rhonchi bilaterally. Which of the following should be done FIRST to assess this patient? A. Obtain a sputum specimen. B. Obtain an ABG. C. Measure peak expiratory flow. D. Determine the Glasgow Coma Score. - ANS ✓Obtain an ABG. A 60 year-old male is admitted to the ED with chest pain. The CBC and electrolytes are normal. Troponin level is 0.4 ng/mL. The physician should report to the patient that he is suffering from A. pulmonary embolism. B. gastroesophageal reflux. C. myocardial infarction. D. valvular stenosis. - ANS ✓myocardial infarction.
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A young healthy adult with complaints of intermittent wheezing is seen in the pulmonary clinic. A pre/post bronchodilator spirometry reveals a normal study with no reversibility. Which of the following should the RT recommend? A. Helium dilution study B. DLCO C. Plethysmography D. Bronchial provocation - ANS ✓Bronchial provocation Twenty-four hours after a patient was intubated, she develops a fever of 99.9°F, a right lower lobe infiltrate, and her white blood cell count is 12, per mm3. The respiratory therapist should recommend A. antiviral therapy. B. blood transfusion. C. SABA by small volume nebulizer. D. antibiotic therapy. - ANS ✓antibiotic therapy. A tracheostomy tube has just been inserted percutaneously into a patient with a C3 fracture. How much air should the respiratory therapist initially inject into the cuff? A. Enough to achieve a pressure of 25-35 cmH2O. B. Enough to achieve a minimal occluding volume. C. A minimum of 20 mL. D. Until firm tension is felt in the pilot balloon. - ANS ✓Enough to achieve a pressure of 25-35 cmH2O.
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A. Decelerating B. Square wave C. Constant D. Accelerating - ANS ✓Decelerating An intubated patient receiving 30% oxygen has a SpO2 of 80% and ETCO of 40 torr. After administration of 50% oxygen for 30 minutes, the respiratory therapist notes that the SpO2 rises to 98% and the ETCO remains stable at 40 torr. The major cause of hypoxemia in this patient is A. hypoventilation. B. shunt. C. ventilation/perfusion mismatch. D. increased deadspace. - ANS ✓ventilation/perfusion mismatch. A 16 year-old patient with cystic fibrosis attends public high school. Which of the following bronchial hygiene therapies would be most appropriate for this patient? A. intrapulmonary percussive ventilation B. dornase alpha therapy C. vibratory / oscillatory PEP D. postural drainage and manual percussion - ANS ✓vibratory / oscillatory PEP A patient reports that he has difficulty breathing while lying in a supine position and prefers to sleep sitting in a chair. The respiratory therapist should record this complaint in the medical record as A. orthopnea. B. platypnea.
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C. eupnea. D. Kussmaul breathing. - ANS ✓orthopnea. A home care patient calls in the middle of the night and reports that the oxygen supply tubing will not stay attached to her transtracheal catheter. The flow rate to the transtracheal catheter is set at 0.5 L/min. The patient has attempted to flush the catheter with saline and push a cleaning rod through it without success. The respiratory therapist should instruct the patient to A. tape the connection securely. B. increase the flow to the catheter. C. decrease the flow to the catheter. D. switch to a nasal cannula. - ANS ✓switch to a nasal cannula. A patient with copious amounts of secretions has required nasotracheal suctioning for the past 36 hours and has now developed mild epistaxis. Which of the following should the respiratory therapist recommend? A. Insert a laryngeal mask airway (LMA) to facilitate suctioning. B. Discontinue nasotracheal suctioning for 24 hours and reassess the patient. C. Insert a nasopharyngeal airway after bleeding has been controlled. D. Insert an oral endotracheal tube to allow for better airway access. - ANS ✓Insert a nasopharyngeal airway after bleeding has been controlled. The most probable cause of air bronchograms and increased density on a chest x-ray is A. pneumonia. B. pulmonary edema.
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C. Manually assisted coughing D. Regular coughing and deep breathing - ANS ✓Regular coughing and deep breathing The respiratory therapist has obtained a blood gas sample from the patient's radial artery and applied pressure to the site for 10 minutes. After removing any excess air from the syringe, the next step for proper handling of the blood sample is A. adding liquid heparin to the sample. B. placing the syringe in an ice bath. C. shaking the sample continuously. D. applying a pressure bandage. - ANS ✓placing the syringe in an ice bath. Which of the following findings is LEAST compatible with hyperlucency as seen on a chest x-ray? A. Increased fremitus B. Decreased intensity of breath sounds C. Diminished diaphragmatic excursion D. Hyperresonance to percussion - ANS ✓Increased fremitus A spontaneous breathing trial was initiated on an intubated, awake, and alert 70 kg (154 lb) patient. After 30 minutes on an FIO2 of 0.30, ABG results are as follows: pH 7.39, PaCO2 44 torr, PaO2 85 torr, and HCO3- 24 mEq/L. The patient's vital signs have remained stable throughout the trial. Which of the following is the most appropriate recommendation? A. Maintain current therapy. B. Initiate NPPV. C. Add 5 cm H2O CPAP.
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D. Extubate the patient. - ANS ✓Extubate the patient. After assisting with bronchoalveolar lavage and lung biopsy on a mechanically ventilated patient, the respiratory therapist notes the activation of a high pressure alarm. Peak inspiratory pressure has increased from 32 cm H2O before the procedure to 45 cm H2O after the procedure. Possible causes for the increased pressure include
- bronchospasm.
- pneumothorax.
- pulmonary hemorrhage. - ANS ✓1, 2, and 3 A 52 year-old post-operative patient's chest radiograph demonstrates infiltrates in the posterior basal segments of the lower lobes. Which of the following is the appropriate postural drainage position? A. Head down, patient supine with a pillow under knees B. Patient prone with a pillow under head, bed flat C. Patient supine with a pillow under knees, bed flat D. Head down, patient prone with a pillow under hips - ANS ✓Head down, patient prone with a pillow under hips A 72 year-old female post stem cell transplant patient in the ICU is complaining of difficulty breathing and is noted to have diffuse fluffy infiltrates on chest X-ray. The B-type Natriuretic Peptide (BNP) test result demonstrates 700 pg/mL. What is the patient's possible condition? A. severe heart failure B. respiratory distress syndrome C. severe renal failure D. moderate heart failure - ANS ✓moderate heart failure
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D. thoracentesis - ANS ✓lung expansion therapy A 42 year-old trauma patient in the ED has been intubated with a 6.5 mm oral endotracheal tube equipped with a high-residual-volume, low- pressure cuff. The respiratory therapist notes that a cuff pressure of 42 cm H2O is necessary to achieve a minimal occluding volume. This would indicate that the A. tube is not of the appropriate size. B. pilot balloon and line are obstructed. C. pressure manometer is defective. D. cuff has herniated over the tip of the tube. - ANS ✓tube is not of the appropriate size. A patient is receiving oxygen via nasal cannula at 2 L/min and has the following ABG results: pH 7.37, PaCO2 42 torr, PaO2 80, HCO3 38 mEq/L. The most likely explanation for these results is that A. the sample was not iced properly. B. there was excess heparin in the syringe. C. the numbers were not reported correctly. D. The sample contains venous blood. - ANS ✓the numbers were not reported correctly. The respiratory therapist is completing oxygen rounds on the ward and checking oxygen saturations on a number of patients. What solution would be most appropriate for disinfecting the surface of the pulse oximeter between patients? A. 70% ethyl alchohol B. Warm soapy water C. Bleach
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D. Acid glutaraldehyde - ANS ✓70% ethyl alchohol Evaluation of a spontaneously breathing patient reveals tachypnea, tracheal deviation to the right and an absence of breath sounds on the left. The most likely etiology would be A. bronchiectasis. B. myasthenia gravis. C. acute asthmatic attack. D. left tension pneumothorax. - ANS ✓left tension pneumothorax. The most serious complication associated with airway suctioning is A. hypoxemia. B. bradycardia. C. mucosal trauma. D. gag reflex stimulation. - ANS ✓hypoxemia. What is the most appropriate position for a female patient who is 5'3" tall, weighs 200 kg and is complaining of difficulty breathing? A. Sims B. Trendelenburg C. lateral Fowlers D. Fowlers - ANS ✓lateral Fowlers Which of the following values for arterial carbon dioxide tension is consistent with significant alveolar hypoventilation?
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C. V/Q mismatch. D. alveolar gas that has participated in gas exchange. - ANS ✓alveolar gas that has participated in gas exchange. A sudden decrease in end-tidal CO2 occurs in a mechanically ventilated patient. A repeat analysis yields the same results. Which of the following situations might have accounted for these readings? A. The ventilator circuit has become disconnected. B. There is a leak around the endotracheal tube. C. There is an increase in alveolar dead space. D. The carbon dioxide absorber is exhausted. - ANS ✓The ventilator circuit has become disconnected. A patient has mild stridor immediately after extubation. This finding is most often associated with A. lower airway obstruction. B. secretions in the large airways. C. upper airway obstruction. D. bronchial spasm. - ANS ✓upper airway obstruction. The primary reason for the use of respiratory care protocols is to A. decrease the patient workload for therapists. B. standardize provision of care. C. enhance departmental efficiency. D. increase the autonomy of therapists. - ANS ✓standardize provision of care. What is normal urine output in an adult patient?
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A. 10 mL/hr B. 20 mL/hr C. 30 mL/hr D. 40 mL/hr - ANS ✓40 mL/hr A patient with a closed head injury has had a cuffed tracheostomy tube in place for several weeks. The physician wishes to decannulate the patient but maintain the patency of the stoma for secretion removal. Which of the following devices would facilitate this request? A. fenestrated trach tube B. transtracheal catheter C. laryngectomy tube D. tracheostomy button - ANS ✓tracheostomy button A patient with chronic bronchitis is seen in the pulmonary clinic with complaints of frequent cough and secretion production. Despite completing a round of Keflex® as prescribed, the patient continues to have scattered infiltrates on his chest X-ray. Which of the following tests should the respiratory therapist recommend? A. thoracentesis B. polysomnography C. flexible bronchoscopy D. plethysmography - ANS ✓flexible bronchoscopy A 60 kg (132 lb) female patient with congestive heart failure is receiving NPPV with an IPAP of 16 cm H2O, EPAP of 10 cm H2O, and FIO2 of 0.70. Available laboratory data includes: pH 7.40, PaCO2 42 torr; PaO2 145 torr; HCO3 26 mEq/L, SaO2 99%, CVP 10 cm H2O. Breath sounds reveal a few fine bibasilar crackles. This situation should be described as
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A. Post-traumatic chest trauma B. Community-acquired pneumonia C. Spinal cord injury D. Chronic bronchitis - ANS ✓Chronic bronchitis A post-operative thoracic surgery patient is having difficulty developing an effective cough. The respiratory therapist should recommend all of the following techniques to aid this patient in generating a more effective cough EXCEPT: A. coordinating coughing with pain medication. B. performing serial coughs. C. applying pressure to patient's abdomen during exhalation. D. "splinting" the incision area. - ANS ✓applying pressure to patient's abdomen during exhalation. Which of the following should the respiratory therapist consider when preparing for helicopter transport of a patient receiving mechanical ventilation?
- Select a ventilator that uses demand valves rather than a reservoir IMV system.
- Calculate oxygen cylinder duration of flow.
- Selecting a ventilator that incorporates an internal air compressor. - ANS ✓1 and 2 only A 65 year-old female patient with advanced emphysema comes to the ED and is placed on a nasal cannula at 6 L/min. On inspection, the respiratory therapist finds that the patient has become drowsy and less responsive since the oxygen therapy was initiated an hour ago. ABG on 6 L/min are: pH 7.33, PaCO2 64 torr, PaO2 85 torr, HCO3 35 mEq/L. Which of the following should the therapist recommend?
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A. Leave the patient on the cannula and continue to monitor. B. Change to a 24% Venti-mask and repeat ABG. C. Change to a simple oxygen mask and repeat ABG. D. Prepare the patient for endotracheal intubation. - ANS ✓Change to a 24% Venti-mask and repeat ABG. A patient receiving warfarin (Coumadin®) has a prothrombin time (PT) of 20 seconds. These findings indicate a A. high likelihood of excessive bleeding. B. normal clotting ability. C. propensity for increased clotting. D. decrease in bone marrow function. - ANS ✓high likelihood of excessive bleeding. A mechanically ventilated patient with a tracheostomy tube is on the following settings: PC, SIMV, PIP 30 cmH2O, f 20/min, FIO2 0.60, PEEP 5 cmH2O. The ventilator alarm suddenly begins to sound and on quick examination, the respiratory therapist notices a generalized decrease in breath sounds and a reduction in delivered tidal volume from 650 mL to 500 mL. Which of the following conditions is most likely? A. The patient has been disconnected. B. Complete obstruction of the tracheostomy tube. C. Development of a left-sided pneumothorax. D. Partial obstruction of the tracheostomy tube. - ANS ✓Partial obstruction of the tracheostomy tube.
