TMC Practice Exam State Board Exam

TMC Practice Exam ( State Board Exam)

What is normal urine output in an adult patient?(Ans- 40 mL/hr

A spontaneous breathing term-71trial is initiated on an intubated, awake, and alert 70 kg (154 lb) patient.

After 40 minutes on an FIO2 of 0.30, ABG results are as follows:

pH 7.39 PaCO2 44 torr PaO2 85 torr HCO3- 24 mEq/L.

The patient's vital signs remained stable throughout the trial. Which of the following is the most appropriate recommendation?(Ans- Extubate

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 48 year-old female is admitted to the ED with diaphoresis, jugular venous distension, and 3+ pitting edema in the ankles. These findings are consistent with (Ans- heart failure

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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?(Ans- Needle aspirate into 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.

(Ans- 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 (Ans- deep breathing and coughing to clear secretions.

A 65 kg spinal cord injured patient develops atelectasis. His inspiratory capacity is 30% of his predicted value. What bronchial hygiene therapy would be most appropriate initially?(Ans- IPPB

A healthy adult female can exhale what portion of her forced vital capacity in the first second?(Ans- 70%

A patient on VC ventilation demonstrates auto-PEEP on ventilator graphics.Which of the following controls, when adjusted independently, would increase expiratory time?

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• Tidal volume
• Respiratory Rate
• Inspiratory flow
• Sensitivity

(Ans- 1, 2, and 3

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?(Ans- insert a chest tube

Following cardiac surgery, a 55 year-old 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. (Ans- 5.0%

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?(Ans- VT/Plat-PEEP

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 76%. Which of the following would be most appropriate at this time?(Ans- Reintubation

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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 mandatory 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 mandatory 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?(Ans- Obtain a sputum gram stain

Which of the following information may be obtained from a FVC maneuver during bedside pulmonary function testing?

1. FEV1

2. PEFR

3. FRC

4. RV

(Ans- 1 and 2

The respiratory therapist provides education for a patient who is being discharged home on aerosol therapy. The most important reason for the patient to follow the recommended cleaning procedures using a vinegar/water solution is that this solution will (Ans- Slow the growth of bacteria

A patient who complains of dyspnea is noted to have a dry, non-productive cough. On physical examination, breath sounds are diminished on the right, tactile fremitus is decreased and there is dullness to percussion over the

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