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SECURE COMPREHENSIVE THERAPIST MULTIPLE-
CHOICE SAE (FORM 2025)
BRANDNEW ACTUAL EXAM WITH 100%
VERIFIED QUESTIONS AND CORRECT
SOLUTIONS| GUARANTEED VALUE PACK| ACE
YOUR GRADES.
TMC EXAM
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 - Correct Answer-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? - Correct Answer-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 - Correct Answer-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 - Correct Answerdeep breathing & 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? - Correct Answer-IPPB
A healthy adult female can exhale what portion of her forced vital capacity in the first second? - Correct Answer-70%
A patient on VC ventilation demonstrates auto-PEEP on ventilator graphics. Which of the following controls, when adjusted independently, would increase expiratory time?
- Tidal volume
- respiratory rate
- inspiratory flow
- sensitivity - Correct Answer-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? - Correct Answer-insert a chest tube
Which of the following information may be obtained from a FVC maneuver during bedside pulmonary function testing?
- FEV
- PEFR
- FRC
- RV - Correct Answer-1 & 2 only
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 - Correct Answer-retard bacterial growth
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 - Correct Answer-pleural effusion
Which of the following suction catheters would be appropriate to use for a patient with a size 8.0 mm ID endotracheal tube? - Correct Answer-12 Fr 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 - Correct Answer-the endotracheal tube has slipped into the right main stem bronchus.
The respiratory therapist notes a developing hematoma after an arterial blood gas was drawn from the right radial artery. The immediate response is to - Correct Answer-apply pressure to the site
A patient's breathing pattern irregularly increases and decreases and is interspersed with periods of apnea up to 1 minute. Which of the following conditions is the most likely cause of this problem? - Correct Answerelevated intracranial pressure
What value for the apnea-hypopnea index (AHI) is consistent with mild obstructive sleep apnea? - Correct Answer-5 to 15
While monitoring a newborn utilizing a transcutaneous monitor, the respiratory therapist notices 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? - Correct Answer-air leak around the sensor
A patient on the general medical ward receives oxygen via 28% air entrainment mask with the flowmeter set at 5 L/min. What is the total flow delivered to the patient? - Correct Answer-55 L/min
PAP (mean) 8 mm Hg
CVP 2 cm H2O
Cardiac Output 3L/min
The respiratory therapist should recommend - Correct Answer-IV fluid challenge
What is the primary advantage of volume-controlled ventilation as compared to pressure-controlled ventilation? - Correct Answer-VC provides a constant minute ventilation
Bronchial breath sounds heard over the lung periphery indicate - Correct Answer-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? - Correct Answer-Normal lung function
A 55 year-old male patient is 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 - Correct Answer-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 postdelivery, 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? - Correct Answer-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? - Correct Answer-0.50 mL
After consulting on management of a patient with pneumonia and atelectasis, the pulmonologist documents a need to change the patient's treatment regimen in the Progress Notes. The respiratory therapist should - Correct Answer-check the medical record for new physician orders
A 60 kg (132 lb) patient is mechanically ventilated at 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? - Correct Answer-change to airway pressure release ventilation
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 - Correct Answer-myocardial infarction
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 respiratory therapist recommend? - Correct Answer-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 - Correct Answerantibiotic 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? - Correct Answer-enough to achieve a pressure of 2535 cm H2O
All of the following conditions can be treated with hyperbaric oxygen (HBO) therapy EXCEPT - Correct Answer-pulmonary hypertension
Which of the following factors are determinants of cardiac output? - Correct Answer-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 10 mEq/L; SaO2 95%; BE 15 mEq/L. The respiratory therapist should recommend - Correct Answeradministering sodium bicarbonate.
The physician asks the respiratory therapist to select 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? - Correct Answer-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 - Correct Answer-ventilation/perfusion mismatch
A 16 year-old patient with cystic fibrosis attends high school. Which of the following bronchial hygiene therapies would be most appropriate for this patient? - Correct Answer-Vibratory/oscillatory PEP
following should the respiratory therapist recommend? - Correct Answerincrease the FiO
The primary source of infection in the health care setting is - Correct Answer-poor handwashing techniques of personnel
A 36 year-old patient is admitted to the ED with a temperature of 38.5° C and suspected pneumonia. The patient has no history of pulmonary disease. Auscultation reveal medium crackles throughout both lungs. Which of the following should be recommended for management of this patient? - Correct Answer-regular coughing and deep breathing
The respiratory therapist obtains a blood gas sample from the patient's radial artery and applies 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 - Correct Answer-placing the syringe in an ice bath
Which of the following findings is LEAST compatible with hyperlucency as seen on a chest x-ray? - Correct Answer-increased fremitus
A spontaneous breathing trial 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, and HCO3- 24 mEq/L. The patient's vital signs remained stable throughout the trial. Which of the
following is the most appropriate recommendation? - Correct Answer- 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. - Correct Answer-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? - Correct AnswerHead down, patient prone with a pillow under hips
A 72 year-old female post stem cell transplant patient in the ICU complains 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? - Correct Answermoderate heart failure
Following blunt chest trauma, a 35-year-old male is orally intubated and continuous mechanical ventilation is initiated. Physical assessment of the neck and chest reveal a midline trachea and significant reduction in
necessary to achieve a minimal occluding volume. This would indicate that the - Correct Answer-tube is not of the appropriate size
A patient receives oxygen via nasal cannula at 2 L/min and has the following ABG results: pH 7.37, PaCO2 42 torr, PaO2 80 torr, HCO3 38 mEq/L. The most likely explanation for these results is that - Correct Answer-the numbers were not reported correctly
The respiratory therapist completes oxygen rounds 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? - Correct Answer-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 - Correct Answer-left tension pneumothorax
The most serious complication associated with airway suctioning is - Correct Answer-hypoxemia
What is the most appropriate position for a female patient who is 5'3" tall, weighs 200 kg and complains of difficulty breathing? - Correct Answerlateral fowlers
Which of the following values for arterial carbon dioxide tension is consistent with significant alveolar hypoventilation? - Correct Answer- torr
The ability to distinguish central apnea from obstructive apnea during a sleep study requires the respiratory therapist to monitor
- electrocardiogram.
- electroencephalogram.
- nasal air flow.
- chest wall impedance. - Correct Answer-3 and 4 only
All of the following statements are TRUE with regard to cuff inflation techniques EXCEPT
A. minimal leak/minimal occlusion volume techniques negate the need for cuff pressure monitoring.
B. minimal leak technique allows a small leak at the end of inspiration. C. at minimal occlusion volume, air leakage around the tube cuff should cease. D. cuff pressure should not exceed 35 cm H2O in order to allow circulation to tracheal mucosa. - Correct Answer-A
A capnograph used for continuous monitoring of a patient on mechanical ventilation should be recalibrated every - Correct Answer-8 hours
following devices would facilitate this request? - Correct AnswerTracheostomy 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 antibiotics as prescribed, the patient continues to have scattered infiltrates on his chest X-ray. Which of the following tests should the respiratory therapist recommend? - Correct Answer-flexible bronchoscopy
A 60 kg (132 lb) female patient with congestive heart failure receives 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 - Correct Answer-hyperoxygenation
Which of the following physiologic values would be present in a patient who has proper fluid balance? - Correct Answer-CVP between 3 and 6 mmHg
The respiratory therapist prepares to assist with bronchoscopy for a patient in the ICU currently receiving mechanical ventilation in the VC,AC mode. The therapist should anticipate addressing all of the following considerations EXCEPT - Correct Answer-the patient's extrinsic PEEP levels will increase.
Dynamic hyperinflation is a major concern when using Volume Control, Assist/Control ventilation in patients with which of the following conditions?
- Correct Answer-chronic bronchitis
A post-operative thoracic surgery patient is having difficulty developing an effective cough. The respiratory therapist could recommend all of the following techniques to aid this patient in generating a more effective cough EXCEPT: - Correct Answer-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. - Correct Answer-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? - Correct Answer-Change to a 24% Venti-mask and repeat ABG.
