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Kettering TMC Exam C |2026/2027 Update |
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Q: Which of the following statements is consistent with a high-quality radiographic
image?
- Head of clavicles are level.
- Spaces between vertebrae are distinct.
- Lung parenchyma appear black and without blood vessels.
- Cervical vertebral spaces are smaller than thoracic vertebral spaces. Answer 1 and 2 only
Q: An elevated brain natriuretic protein (BNP) level would be consistent with a
diagnosis of.... Answer Congestive Heart Failure
Q: While monitoring the pressure waveform during insertion of a Swan-Ganz catheter,
the RT notes the presence of a dicrotic notch. This finding indicates that the tip of the catheter is inside the.... Answer Pulmonary Artery
Q: The RT has measured the exhaled nitric oxide concentration (FENO) of a patient
with asthma. The therapist notes a decrease in the patient's FENO levels from his last visit one month ago. These results would be consistent with increased use of.... Answer Corticosteroids
Q: The RT discovers that a patient has dyspnea and diminished breath sounds with a
flat percussion note on the left. The chest radiograph indicates a tracheal shift to the right. What disease state should the therapist suspect is affecting the patient? Answer Pleural Effusion
Q: A patient is being monitored with a pulmonary artery catheter. The following
measurements are recorded: Answer
I-time: 0.6 seconds
Q: The RT notices the TcPO2 reading suddenly drops 39 torr. There have been no
changes in the vent settings, however the patient is cyanotic, the trachea is deviated to the right and the breath sounds are absent on the left. A tympanic percussion note is detected over the left thorax. The RT should recommend what? Answer Transillumination to detect a pneumothorax
Q: Following insertion of a nasal endotracheal tube, the RT should inflate the cuff to:
Answer 22 mmHg
Q: Which suction catheter would be most appropriate to use for a patient with a size
7.5 mm ID ETT? Answer (ID size / 2) x 3 7.5/2= 3.75 x 3 = 11. Round down to 10 Fr
Q: While manually ventilating a 42-year-old woman following endotracheal
intubation, the RT notices that the manual resuscitation bag fills rapidly and collapses with minimal pressure. The therapist also observes that the patient's chest has limited bilateral movement. The therapist should... Answer Use another form of ventilation.
Q: What is the most appropriate position for an obese patient with dyspnea?
Answer Lateral Fowlers
Q: While administering IPPB therapy to a 58-year-old man who recently underwent a
colon resection, the RT notes that the peak inspiratory pressure is not reaching the set value. This is most likely the result of.... Answer insufficient inspiratory flow
Q: After attaching a bubble humidifier to an O2 flowmeter, setting the flow at 5 L/min,
and occluding the humidifier outlet, the RT hears a whistling sound from the humidifier. This would indicate....
PEEP: 10
PIP: 58
Plat: 50 ABG: pH 7.30, PaCO2 43, PaO2 45, HCO3 21, SaO2 82% The patient's condition is most likely related to: Venous admixture
Q: Estimate the shunt fraction for a patient with the following available data:
Answer A-aDO2: 200 torr C(a-v)O2: 3.6 vol% P/F Ratio: 400 torr For each 100 mmHg in A-a, a 5% shunt occurs. Add 5% more to that answer (due to normal shunting). 200 torr = 10% + 5% = 15% shunt
Q: An 80kg (176 lb) patient in the post-anesthesia care unit following lower abdominal
surgery is receiving mechanical ventilation. Ventilator settings are as follows: Answer VC, SIMV Vt: 550 mL f: 15/min FiO2: 70%
PEEP: 15
ABG: pH 7.35, PaCO2 44 torr, PaO2 85 torr, HCO3 23, SaO2 99%, C(a-v)O2 10 vol% The RT should: Reduce the PEEP setting.
Q: In preparation for assisting a pulmonologist with a fiberoptic bronchoscopy for a
50 - year-old woman receiving mechanical ventilation, the RT notices that the patient appears to be anxious about undergoing the procedure. The therapist should recommend administration of: Answer Midaxolam
Q: The parameter that starts the inspiratory phase of a positive pressure breath is
referred to as the Answer trigger variable
Q: While evaluating a patient receiving mechanical ventilation, the RT observes a
persistent high pressure alarm. What could cause that situation? Answer
Q: Side effects of inhaled nitric oxide include:
Answer Methemoglobinemia, formation of nitrogen dioxide
Q: A patient with a left-sided pneumothorax has been treated with a chest tube
attached to a 3-bottle water seal drainage system. The RT notes continuous bubbling in the suction control bottle. This would indicate: Answer Correct setting of the vacuum regulator
Q: A 55-year-old, 90 kg man is undergoing polysomnography. The RT observes that
the patient continues to have obstructive apneic events on nasal CPAP at 4 cmH2O. The therapist should.... Answer increase the CPAP pressure
Q: A 70-year-old woman with COPD is receiving home O2 therapy at 2 L/min via NC.
The O2 is provided by a molecular sieve device. The patient calls the equipment provider to report that she does not feel any O2 coming out of the cannula. This situation could be caused by all of the following EXCEPT: A. a power interruption B. disconnected tubing C. low water level in the humidifier
D. incorrect flow setting Answer C. low water level in the humidifier
Q: After analyzing an arterial blood sample, the RT drops the syringe on the lab
counter and 4 mL of blood leaks out. After wiping up the blood with a paper towel, the therapist should disinfect the counter using Answer a bleach solution.
Q: Pack years
Answer
of packs a day x # of years smoked
Q: If intake of fluid exceeds output, this could result in
Answer weight gain electrolyte imbalance increased hemodynamic pressures decreased lung compliance
Egophony Answer The patient is instructed to say "E" and it sounds like "A". This would indicate consolidation of the lung tissue as with a pneumonia-like condition. Abnormal breath sounds Answer Adventitious Coarse Crackles Answer Large airway secretions
- suction patient or instruct to cough Medium Crackles Answer Recommend bronchial hygiene
Fine Crackles Answer Fluid at the alveolar level (associated with CHF or pulmonary edema)
- O2 therapy
- positive pressure therapy
- positive inotropic agents
- diuretics Stridor- Answer Upper airway obstruction
- supraglottic swelling (epiglottitis)
- subglottic swelling (croup)
- foreign body aspiration Treat with racemic epinephrine Lateral decubitus Answer
- patient lying on affected side
- valuable for detecting small pleural effusions
Radiolucent Answer
- dark pattern, air normal for lungs Radiodense/opacity White pattern, solid, fluid Normal for bones, organs Infiltrate Any ill-defined radiodensity Atelectasis Consolidation Solid white area Pneumonia/pleural effusion Hyperlucency Extra-pulmonary air COPD, asthma attack, pneumothorax
Vascular markings lymphatics, vessels, lung tissue Increased in CHF, absent with pneumothorax Diffuse spread throughout atelectasis/pneumonia Opaque fluid/solid consolidation Pulmonary Edema
- fluffy infiltrates, butterfly pattern, batwing pattern
- diffuse whiteness
- diuretics, digitalis, digoxin Atelectasis
- patchy or plate-like infiltrates, crowded pulmonary vessels, crowded air bronchograms
- scattered, thin-layered densities
- lung expansion therapy
- cavity formation
- often in upper lobes
- antitubercular agents What is a Computed Tomography (CT) Scan useful in detecting?
- presence of mediastinal, pleural and parenchymal masses
- pulmonary nodules and lesions not visualized on CXR What is Magnetic Resonance Imaging (MRI) useful in detecting? thoracic aneurysms, congenital anomalies of the aorta and major thoracic vessels Pulmonary Ventilation/Perfusion Scan (V/Q Scan) A normal ventilation scan with an abnormal perfusion scan indicates a pulmonary embolus. Positron Emission Tomography (PET Scan) Useful in determining the presence of cancer, brain disorders and heart disease Bronchography (Bronchogram) By outlining the airways it will identify obstructing lesions (i.e. tumors) and bronchiectasis (main indication)
Indications for EEG Brain tumors, traumatic brain injuries, loss of brain function, epilepsy/seizures, evaluation of sleep disorders Pulmonary Angiography A pulmonary arteriogram or angiograph is a test to diagnose a pulmonary embolism Indications: high clinical suspicion for PE; inconclusive V/Q scan and/or CT scan Indications for Echocardiogram (Ultrasound of the heart) Valvular disease or dysfunction; myocardial disease; abnormalities of cardiac blood flow; cardiac anomalies in the infant; abnormal heart sounds Intracranial Pressure (ICP) monitoring Normal is 5 - 10 mmHg
- recommend initiating treatment if >20 mmHg
- therapy to reduce ICP: hyperventilation: target PaCO2 = 25 - 30 torr Electrolytes: K+, Na+, Cl, HCO3 (CO2 content)
- Elements required by the body for normal metabolism
- Abnormal electrolyte levels indicate abnormal body function
- Closely associated with fluid levels, muscle function (cardiac) and kidney function
- muscle weakness, soreness, nausea, mental changes, lethargy, dizziness
