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Kettering TMC Exam B |2026/2027 Update |
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Q: 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 A. liver failure. B. pulmonary embolism. C. heart failure. D. electrolyte imbalances. C. heart failure.
Q: 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? A. Call for a STAT chest x-ray. B. Insert a chest tube into the left chest. C. Needle aspirate the 2nd left intercostal space. D. Activate the medical emergency team to intubate the patient. C. Needle aspirate the 2nd left intercostal space.
Q: All of the following strategies are likely to decrease the likelihood of damage to the
tracheal mucosa EXCEPT A. maintaining cuff pressures between 20 and 25 mm Hg. B. using the minimal leak technique for inflation. C. using a low-residual-volume, low-compliance cuff. D. monitoring intracuff pressures. C. using a low-residual-volume, low-compliance cuff.
Q: 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 A. continuing the therapy until breath sounds improve. B. administering dornase alpha. C. administering albuterol therapy. D. deep breathing and coughing to clear secretions. D. deep breathing and coughing to clear secretions.
- Sensitivity A. 1, 2, and 3 only B. 1, 2, and 4 only C. 1, 3, and 4 only D. 2, 3, and 4 only A. 1, 2, and 3 only
Q: 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? A. Perform chest physiotherapy B. Administer an IPPB treatment C. Insert an endotracheal tube D. Insert a chest tube D. Insert a chest tube
Q: 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. A. 2.5 vol% B. 4.0 vol% C. 5.0 vol%
D. 5.5 vol% C. 5.0 vol%
Q: 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? A. 25 mL/cm H2O B. 35 mL/cm H2O C. 45 mL/cm H2O D. 50 mL/cm H2O D. 50 mL/cm H2O
Q: 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? A. cool mist aerosol treatment B. aerosolized racemic epinephrine C. manual ventilation with resuscitation bag and mask D. reintubation D. reintubation
4. RV
A. 1 and 2 only B. 1 and 3 only C. 2 and 4 only D. 3 and 4 only A. 1 and 2 only
Q: The respiratory therapist is providing patient 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 A. sterilize the equipment. B. retard bacterial growth. C. kill all micro-organisms and spores. D. extend the equipment life. B. retard bacterial growth.
Q: 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 right lower lobe. The respiratory therapist should suspect that the patient is suffering from A. pneumonia. B. pulmonary embolism.
C. pleural effusion. D. bronchiolitis. C. pleural effusion.
Q: Which of the following suction catheters would be appropriate to use for a patient
with a size 8.0 mm ID endotracheal tube? A. 8 Fr B. 10 Fr C. 12 Fr D. 14 Fr C. 12 Fr
Q: A patient who is receiving continuous mechanical ventilation is fighting the
ventilator. His breath sounds are markedly diminished on the left, there is dullness to percussion on the left, and the trachea is shifted to the left. The most likely explanation for the problem is that A. the patient is disconnected from the ventilator. B. the patient is experiencing diffuse bronchospasm. C. the endotracheal tube has slipped into the right main stem bronchus. D. the patient has developed a left tension pneumothorax. C. the endotracheal tube has slipped into the right main stem bronchus.
B. 5 to 15 While monitoring a newborn utilizing a transcutaneous monitor, you notice a change in PtcO2 from 60 to 142 torr and simultaneously the (PtcCO2) changes from 37 to 2 torr. What is the most likely explanation for these changes? A. Upper airway obstruction B. Poor peripheral perfusion C. Air leak around the sensor D. Device is out of range C. Air leak around the sensor A patient on the general medical ward is on a 28% air entrainment mask with the flowmeter set at 5 L/min. What is the total flow delivered to the patient? A. 5 L/min B. 55 L/min C. 88 L/min D. 140 L/min B. 55 L/min Which of the following measurements is most indicative of pulmonary edema? A. Heart rate of 120/min B. Blood pressure of 92/72 mm Hg
C. Pulmonary artery pressure of 25/10 mm Hg D. Pulmonary capillary wedge pressure of 30 mm Hg D. Pulmonary capillary wedge pressure of 30 mm Hg Sleep apnea can be defined as repeated episodes of complete cessation of airflow for A. 5 seconds or longer. B. 10 seconds or longer. C. 15 seconds or longer. D. 20 seconds or longer. B. 10 seconds or longer. A patient in the ICU receiving mechanical ventilation has just undergone a fiberoptic bronchoscopy procedure in which a tissue biopsy was collected. Immediately following the procedure, the respiratory therapist notes that the peak inspiratory pressure on the ventilator has increased. Potential causes for this include all of the following EXCEPT A. hypoxemia. B. pneumothorax. C. pulmonary hemorrhage. D. bronchospasm/laryngospasm. A. hypoxemia.
The respiratory therapist should recommend
- IV fluid challenge
- positive inotropic agent
- inhaled nitric oxide
- diuretic therapy A. 1 and 3 B. 2 and 4 C. 3 and 4 D. 1 and 2 B. 2 and 4 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. B. 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. C. 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 D. mixed obstructive/restrictive disorder C. 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.
A. continue the current treatment plan. B. report the change in treatment plan to the next shift. C. check the electronic medical record for new physician orders. D. disregard the information until notified by the shift supervisor. C. check the electronic medical record for new physician orders. A 60 kg (132 lb) patient is being mechanically ventilated with the following settings: VC, A/C; VT 500 mL, respiratory rate 12/min, FIO2 1.00 and 10 cm H2O PEEP. The patient's peak airway pressure is 60 cm H2O and his SpO2 is 85%. A current chest x-ray shows diffuse bilateral infiltrates. Which of the following is the most appropriate action in order to reduce peak airway pressure? A. Increase the frequency. B. Change to airway pressure release ventilation. C. Decrease the inspiratory time. D. Increase PEEP to 15 cm H2O. B. Change to airway pressure release ventilation. In order to verify the accuracy of a lab-based spirometer device, the respiratory therapist should utilize a A. rotameter. B. 3.0 L syringe. C. Wright respirometer. D. pneumotachometer. B. 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 A. 1 and 3 only B. 2 and 4 only C. 2, 3, and 4 only D. 1, 2, 3, and 4 C. 2, 3, and 4 only A post-operative patient on volume-control ventilation has a chest tube in the left pleural space. While inspecting the chest drainage system, the respiratory therapist notes bubbling in the water seal chamber during the inspiratory phase. The therapist should report this to the physician as A. a persistent bronchopleural fistula. B. a resolved pneumothorax. C. back-pressure from the suction chamber. D. normal function of the water seal chamber. A. a persistent bronchopleural fistula.
D. Bronchial provocation D. 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 12,000 per mm3. The respiratory therapist should recommend A. antiviral therapy. B. blood transfusion. C. SABA by small volume nebulizer. D. antibiotic therapy. D. antibiotic therapy. A tracheostomy tube has just been inserted percutaneously into a patient with a C 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. A. Enough to achieve a pressure of 25-35 cmH2O. All of the following conditions can be treated with hyperbaric oxygen (HBO) therapy EXCEPT A. carbon monoxide poisoning.
B. decompression sickness. C. anaerobic infections. D. pulmonary hypertension. D. pulmonary hypertension. Which of the following factors are determinants of cardiac output? A. ventricular filling and heart rate B. stroke volume and heart rate C. stroke volume and respiratory rate D. heart rate and tidal volume B. stroke volume and heart rate The following ABG results are reported for a patient in the ED on room air: pH 7.20; PaCO2 24 torr; PaO2 95 torr; HCO3 8 mEq/L; SaO2 95%; BE - 15 mEq/L. The respiratory therapist should recommend A. initiating oxygen therapy via nasal cannula at 4 L/min. B. intubating and initiating mechanical ventilation. C. administering sodium bicarbonate intravenously. D. initiating non-invasive ventilation. C. administering sodium bicarbonate intravenously. The physician asks the respiratory therapist to set ventilator parameters that will deliver the lowest peak inspiratory pressure possible. Which of the following inspiratory flow patterns will enable the therapist to fulfill the physician's request?
