TMC Practice Exam: Questions &
Answers
A 48year-old female is admitted to the ED with diaphoresis, jugular venous distension, and 3+ pitting edema in the ankles. These findings are consistent with
- liver failure.
- pulmonary embolism.
- heart failure.
- electrolyte imbalances.
(Ans- C. heart failure.
A patient is admitted to the ED following a motor vehicle accident. On physical exam, the respiratory therapist discovers that 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?
- Call for a STAT chest x-ray.
- Insert a chest tube into the left chest.
- Needle aspirate the 2nd left intercostal space.
- Activate the medical emergency team to intubate the patient.
(Ans- C. Needle aspirate the 2nd left intercostal space.
All of the following strategies are likely to decrease the likelihood of damage to the tracheal mucosa EXCEPT
- maintaining cuff pressures between 20 and 25 mm Hg.
- using the minimal leak technique for inflation.
- using a low-residual-volume, low-compliance cuff.
- monitoring intracuff pressures. 1 / 4
(Ans- C. using a low-residual-volume, low-compliance cuff.
A 52 year-old post-operative cholecystectomy patient's breath sounds become more coarse upon completion of postural drainage with percussion. The respiratory therapist should recommend
- continuing the therapy until breath sounds improve.
- administering dornase alpha.
- administering albuterol therapy.
- deep breathing and coughing to clear secretions.
(Ans- D. deep breathing and coughing to clear secretions.
A 65 kg spinal cord injured patient has developed atelectasis. His inspiratory capacity is 30% of his predicted value. What bronchial hygiene therapy would be most appropriate initially?
A. IS / SMI
- IPPB with normal saline
- postural drainage and percussion
- PEP therapy
(Ans- B. IPPB with normal saline
A healthy adult female can exhale what portion of her forced vital capacity in the first second?
A. 50%
B. 60%
C. 70%
D. 80%
(Ans- C. 70%
A patient on VC ventilation has demonstrated auto-PEEP on ventilator graphics. Which of the following controls, when adjusted independently, would increase expiratory time?
- / 4
- Tidal volume
- Respiratory Rate
- Inspiratory flow
- Sensitivity
- 1, 2, and 3 only
- 1, 2, and 4 only
- 1, 3, and 4 only
- 2, 3, and 4 only
(Ans- A. 1, 2, and 3 only
Which of the following would be the most appropriate therapy for a dyspneic patient who has crepitus with tracheal deviation to the left and absent breath sounds on the right?
- Perform chest physiotherapy
- Administer an IPPB treatment
- Insert an endotracheal tube
- Insert a chest tube
(Ans- D. Insert a chest tube
A 55 year-old post cardiac surgery patient has the following ABG results:
pH 7.50, PaCO2 30 torr, PaO2 62 torr, HCO3 25 mEq/L, SaO2 92%, HB 14 g/dL, BE +2. Venous blood gas results are pH 7.39, PvCO2 43 torr, PvO2 37 torr, and SvO2 66%. Calculate the patient's C(a-v)O2.
- 2.5 vol%
- 4.0 vol%
- 5.0 vol%
- 5.5 vol%
(Ans- C. 5.0 vol%
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A patient on VC, SIMV with a VT of 500 mL has a PIP of 25 cm H2O, Pplat of 15 cm H2O and PEEP of 5 cm H2O. What is the patient's static lung compliance?
- 25 mL/cm H2O
- 35 mL/cm H2O
- 45 mL/cm H2O
- 50 mL/cm H2O
(Ans- D. 50 mL/cm H2O
Immediately after extubation of a patient in the ICU, the respiratory therapist observes increasing respiratory distress with intercostal retractions and marked stridor. The SpO2 on 40% oxygen is noted to be 86%. Which of the following would be most appropriate at this time?
- cool mist aerosol treatment
- aerosolized racemic epinephrine
- manual ventilation with resuscitation bag and mask
- reintubation
(Ans- D. reintubation
Which of the following patients would most likely benefit from pressure support ventilation?
- An intubated patient with an absent respiratory drive.
- A patient on SIMV with a set rate of 12/min and total rate of 24/min.
- A patient with acute lung injury.
- A patient who requires short-term post-operative ventilatory support.
(Ans- B. A patient on SIMV with a set rate of 12/min and total rate of 24/min.
A patient receiving mechanical ventilation has developed a temperature of 99.9° F with purulent secretions over the last 12 hours. The respiratory therapist has also noted a steady increase in peak inspiratory pressure.What initial recommendation should be made to address these changes?
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