TMC Practice Exam B Questions & Answers 2024, Exams of Nursing

Download TMC Practice Exam B Questions & Answers 2024 and more Exams Nursing in PDF only on Docsity! TMC Practice Exam B Question & Answers 2024 After a patient undergoes a thoracentesis, the respiratory therapist notes that the obtained pleural fluid is clear with a slight straw color. This fluid is most likely the result of A. empyema. B. congestive heart failure. C. lung carcinoma. D. hemothorax. - Correct Answers ✅B. congestive heart failure. Which of the following would be most important to evaluate for a patient who is entering a smoking cessation program? A. Height B. Smoking history C. Weight D. Diet - Correct Answers ✅B. Smoking history The respiratory therapist is calibrating a spirometer and checking the volume with a 3.0 liter super syringe. The volumes recorded are: 2.85 L, 2.8 L, and 2.8 L. Based upon the information obtained which of the following is a correct statement? TMC Practice Exam B Question & Answers 2024 A. Another syringe needs to be used B. Spirometer is accurate C. The plunger was advanced too slowly D. Spirometer may have a leak - Correct Answers ✅D. Spirometer may have a leak Which of the following is an indication for high frequency jet ventilation? A. Bronchopleural fistula B. Wilson Mikity syndrome C. Necrotizing lesion of right lung D. Centrilobular emphysema - Correct Answers ✅A. Bronchopleural fistula A 43-year-old female patient has just undergone a total abdominal hysterectomy. The patient arrives in the post anesthesia care unit obtunded with minimal response to painful stimulus. What treatment should the respiratory therapist recommend for this patient? A. Initiate assisted ventilation B. Insert oropharyngeal airway TMC Practice Exam B Question & Answers 2024 A. Right lung 50 mL; left lung 650 mL B. Right lung 150 mL; left lung 550 mL C. Right lung 350 mL; left lung 350 mL D. Right lung 550 mL; left lung 150 mL - Correct Answers ✅B. Right lung 150 mL; left lung 550 mL A patient in the intensive care unit has the following hemodynamic measurements: CVP (mm Hg) 5 PAP (mm Hg) 29/8 PCWP (mm Hg) 8 BP (mm Hg) 130/70 Cardiac output (L/min) 5.1 Cardiac index (L/min/m2) 2.7 What is the pulse pressure? A. 15 mm Hg B. 21 mm Hg TMC Practice Exam B Question & Answers 2024 C. 60 mm Hg D. 90 mm Hg - Correct Answers ✅C. 60 mm Hg A 2-year-old child with croup has been intubated for 4 days with a 4 mm ID uncuffed endotracheal tube. Heated aerosol at an FIO2 of 0.30 has been delivered to the patient. The physician asks the respiratory therapist to evaluate the patient for possible extubation. Which of the following would most likely indicate that the patient is ready for extubation? A. The patient is making normal quiet ventilatory efforts. B. A negative sputum culture and sensitivity has been reported. C. The patient's ABG are within normal range. D. Breath sounds are heard around the tube on auscultation. - Correct Answers ✅D. Breath sounds are heard around the tube on auscultation. A patient is seen in the Emergency Department for complaints of nausea and vomiting. A nasogastric tube has been inserted and the patient is started on lasix. Which of the following should the respiratory therapist monitor? A. Cardiac enzymes B. Serum electrolytes TMC Practice Exam B Question & Answers 2024 C. Arterial blood gases D. Cell hydration level - Correct Answers ✅B. Serum electrolytes While instructing a patient prior to a vital capacity maneuver, the respiratory therapist should direct the patient to A. exhale to residual volume and inhale to inspiratory capacity. B. inhale to total lung capacity then exhale to residual volume. C. exhale normally then inhale to total lung capacity. D. inhale normally then exhale to functional residual capacity. - Correct Answers ✅B. inhale to total lung capacity then exhale to residual volume. A patient involved in an automobile accident is brought to the ED with tachypnea, tracheal deviation to the right, splinting, asymmetrical chest movement, and decreased breath sounds on the left side. The respiratory therapist should initially A. insert a chest tube. B. administer 100% oxygen via mask. C. perform endotracheal intubation. TMC Practice Exam B Question & Answers 2024 C. flush the catheter with heparin solution. D. attempt to draw blood from the arterial line. - Correct Answers ✅B. check the transducer dome for air bubbles. An optimal PEEP study is initiated on a patient receiving mechanical ventilation. The respiratory therapist first places the patient on a PEEP of 10 cm H2O for 20 minutes with no adverse effects. The PEEP is increased to 15 cm H2O and the patient's heart rate rises significantly with a severe fall in the blood pressure. Based upon the above information, the therapist should conclude that the patient is suffering from A. peripheral vasoconstriction. B. hypovolemia. C. increased venous return. D. increased SVR - Correct Answers ✅B. hypovolemia. A post-operative thoracotomy patient is receiving incentive spirometry therapy Q2H. Breath sounds are diminished in the bases of the lungs with scattered crackles. The patient's inspiratory capacity has decreased over the past 2 days. A chest radiograph indicates thin- layered basilar densities. Which of the following has most likely occurred? TMC Practice Exam B Question & Answers 2024 A. Atelectasis B. Pneumonia C. Pulmonary edema D. Consolidation - Correct Answers ✅A. Atelectasis A patient is in full cardiopulmonary arrest and after several attempts, the patient is orally intubated with a size 7 mm ID endotracheal tube. The nurse is unable to establish IV access. The ECG monitor shows sinus bradycardia. Which of the following drugs should be administered through the endotracheal tube? A. Lidocaine B. Epinephrine C. Atropine D. Dobutamine - Correct Answers ✅C. Atropine The results of a patient's spirometry are recorded as follows: Predicted Observed FVC (L) 3.5 2.1 FEV1 (L) 2.7 2.6 FRC (L) 2.5 1.7 TMC Practice Exam B Question & Answers 2024 TLC (L) 5.6 4.2 These results are indicative of A. normal lung function. B. sarcoidosis. C. acute bronchitis. D. cystic fibrosis. - Correct Answers ✅B. sarcoidosis. The respiratory therapist is in charge of transporting a patient with multiple trauma to a regional trauma center in a fixed wing aircraft. Which of the following should the therapist be most concerned about during the transport? A. Tissue oxygenation B. Pneumothorax C. Pulmonary embolus D. Humidification of the inspired gas - Correct Answers ✅A. Tissue oxygenation TMC Practice Exam B Question & Answers 2024 B. 3:1 C. 4:1 D. 10:1 - Correct Answers ✅A. 1:1 Following surgery to correct an abdominal aortic aneurysm, a 54-year- old female patient suddenly develops intense substernal chest pain with severe dyspnea. The pain does not appear to be aggravated by her respirations. Auscultation reveals bilateral, basilar, moist, crepitant rales. The patient appears pale, cold and clammy. Which of the following should the respiratory therapist recommend for initial assessment of this patient? A. Serum electrolytes B. Chest x-ray C. Complete blood cell count D. Electrocardiograph - Correct Answers ✅D. Electrocardiograph An adult patient is intubated with a 7.0 mm ID endotracheal tube. What size suction catheter should be used to suction this patient? A. 8 French B. 10 French C. 12 French TMC Practice Exam B Question & Answers 2024 D. 14 French - Correct Answers ✅B. 10 French Which of the following would be the most appropriate test to evaluate partial vocal cord paralysis in a patient complaining of difficulty swallowing? A. SB nitrogen elimination B. Maximum voluntary ventilation C. Flow volume loop D. Diffusing capacity - Correct Answers ✅C. Flow volume loop In order to reduce a patient's PaCO2 from 40 torr to 32 torr, all of the following could be increased EXCEPT A. tidal volume. B. alveolar ventilation. C. respiratory rate. D. physiologic deadspace - Correct Answers ✅D. physiologic deadspace While examining the chest drainage system of a mechanically- ventilated patient following thoracotomy, the respiratory therapist TMC Practice Exam B Question & Answers 2024 observes bubbling in the water-seal chamber during inspiration. This would indicate A. a leak in the chest drainage system. B. air leaving the pleural space. C. excessive pressure from the suction regulator. D. inadequate water level in the water-seal chamber. - Correct Answers ✅B. air leaving the pleural space. A patient develops ascites and shortness of breath. Where is tissue edema most likely to show up first? A. Ankles B. Abdomen C. Thorax D. Hands - Correct Answers ✅B. Abdomen An acceptable level of PEEP therapy can be identified by all of the following EXCEPT A. the lower inflection point of a volume-pressure loop graphic. B. acceptable oxygenation without cardiovascular side effects. TMC Practice Exam B Question & Answers 2024 received pancuronium bromide. Which of the following ventilator alarms would be most important to set correctly for this patient? A. Peak pressure alarm B. Low PEEP pressure alarm C. I:E ratio alarm D. Low exhaled volume alarm - Correct Answers ✅B. Low PEEP pressure alarm A balloon-tipped, flow-directed catheter is positioned in the pulmonary artery with the balloon deflated. Which of the following pressures will be measured by the distal lumen? A. CVP B. PAP C. PCWP D. MAP - Correct Answers ✅B. PAP A pre-op patient who is at high risk for post-operative complications should be evaluated by obtaining the results of A. VD/VT study. TMC Practice Exam B Question & Answers 2024 B. diffusion studies. C. basic spirometry. D. indirect calorimetry. - Correct Answers ✅C. basic spirometry. A patient is receiving noninvasive positive pressure ventilation by mask. Current settings and arterial blood gas results are as follows: IPAP 10 cm H2O EPAP 5 cm H2O Respiratory rate 12 /min pH 7.31 PaCO2 56 torr PaO2 63 torr HCO3 25 mEq/L BE +1 mEq/L Which of the following should the respiratory therapist recommend? A. Increase the EPAP to 10 cm H2O B. Decrease the EPAP to 3 cm H2O TMC Practice Exam B Question & Answers 2024 C. Increase the IPAP to 20 cm H2O D. Decrease the IPAP to 5 cm H2O - Correct Answers ✅C. Increase the IPAP to 20 cm H2O During recovery from resection of an aortic aneurysm, a 65-year-old female patient suddenly develops severe substernal chest pain with grave dyspnea. The physician describes the bilateral breath sounds as basilar moist crepitant crackles. The patient appears pale, cool and diaphoretic. Which of the following should the respiratory therapist recommend as part of the initial assessment of this patient? A. ECG B. CBC C. Serum electrolytes D. Lateral decubitus radiograph - Correct Answers ✅A. ECG A patient is diagnosed with unilateral lung disease. The physician has requested that the effected lung be ventilated at a pressure 10 cm H2O lower than the normal lung. The respiratory therapist should recommend providing this type of ventilation via A. cricothyroidotomy. B. esophageal combi-tube. TMC Practice Exam B Question & Answers 2024 B. utilize a dry powder inhaler. C. replace the small volume nebulizer every 24 hours. D. wipe the surface of the nebulizer with alcohol every evening. - Correct Answers ✅A. select a metered dose inhaler. Which of the following is a FALSE statement about self-inflating resuscitation devices? A. A reservoir is utilized to increase the delivered oxygen concentration. B. The therapist can sense changes in the patient's lung compliance and airway resistance. C. A compressed gas source is necessary for the device to operate. D. Excessive gas flow may cause the valve to malfunction. - Correct Answers ✅C. A compressed gas source is necessary for the device to operate. A 72-year-old male patient who is 5' 10" tall and weighs 75 kg (165 lb) is receiving mechanical ventilation. The respiratory therapist notes diminished breath sounds in the bases of both lungs. The patient is on the following ventilator settings: Mode VC, A/C VT 600 mL TMC Practice Exam B Question & Answers 2024 Set rate 10 br/min PEEP 10 cm H2O FIO2 0.50 Sigh volume 0.6 L Arterial blood gases show: pH 7.42 PaO2 82 torr PaCO2 38 torr SaO2 93% Based on this information, the respiratory therapist should A. maintain the current settings. B. increase the set rate to 12 br/min. C. decrease the tidal volume to 500 mL. D. increase the sigh volume to 1.0 L. - Correct Answers ✅D. increase the sigh volume to 1.0 L. A patient in the intensive care unit has the following hemodynamic measurements: TMC Practice Exam B Question & Answers 2024 CVP: 12 mm Hg PAP: 48/16 mm Hg PCWP: 15 mm Hg MAP: 99 mm Hg Cardiac Output: 8.0 L/min. Cardiac Index: 4.7 L/min/m2 Which of the following should the respiratory therapist recommend? A. Oxygen B. Dopamine C. Lidocaine D. Furosemide - Correct Answers ✅D. Furosemide The following pulmonary function data was reported for a 45 year old pre-op patient: TLC - 5.4 L RV - 1.0 L IRV - 2.6 L VC - 4.2 L ERV - 1.0 L VT - 0.6 L TMC Practice Exam B Question & Answers 2024 B. This pressure will most likely cause arterial occlusion. C. At this pressure, there is a significant risk of VAP. D. The pressure will cause tracheal necrosis if maintained. - Correct Answers ✅A. The pressure is appropriate for minimal tracheal occlusion. The respiratory therapist receives an order for postural drainage and vibration. With the bed flat, the therapist places the patient in a prone position with pillows under his hips. Which lung segments are being treated with this position? A. Anterior segments of the upper lobes B. Superior segments of the upper lobes C. Posterior basal segments of the lower lobes D. Superior segments of the lower lobes - Correct Answers ✅D. Superior segments of the lower lobes A patient has been admitted to the emergency department via ambulance. The cardiac monitor indicates sinus tachycardia. The patient is orally intubated with a size 7.5 mm ID endotracheal tube and is being manually ventilated. What other point of care monitoring should the respiratory therapist recommend for this patient? A. Arterial blood gas analysis TMC Practice Exam B Question & Answers 2024 B. Transcutaneous monitoring C. Pulse oximetry D. Serum electrolyte analysis - Correct Answers ✅C. Pulse oximetry A patient has 2 mediastinal chest tubes following a thoracotomy. The respiratory therapist notes that there is continuous bubbling in the water seal chamber of the chest drainage system. The therapist should A. check for a leak in the system. B. add water to the water seal chamber. C. increase the amount of suction. D. advance the chest tube 2 cm. - Correct Answers ✅A. check for a leak in the system. For a patient enrolled in a smoking cessation program, which of the following would indicate that the patient is non-compliant? A. COHb level of 7% B. Regular attendance at counseling sessions C. Increased exercise tolerance D. Decreased use of accessory muscles - Correct Answers ✅A. COHb level of 7% TMC Practice Exam B Question & Answers 2024 A patient receiving a loop diuretic such as furosemide (Lasix) would most likely need what type of electrolyte replacement? A. Potassium B. Sodium C. Chloride D. Bicarbonate - Correct Answers ✅A. Potassium The FRC measured by body plethysmography is 30% larger than that measured by helium dilution. This difference is best explained by A. maldistribution of ventilation. B. increased diffusing capacity. C. trapped thoracic gas. D. reduced lung compliance. - Correct Answers ✅C. trapped thoracic gas. While performing a 12-lead electrocardiograph on a 68-year-old male patient, the respiratory therapist notices a sudden increase in artifact on the ECG paper. Upon further investigation, the therapist discovers that the V2 electrode has fallen off the chest. Where on the patient should the therapist place this electrode? TMC Practice Exam B Question & Answers 2024 Mode VC, SIMV Set rate 10 br/min. Total rate 16 br/min VT 400 mL FIO2 0.28 Arterial blood gases are as follows: pH 7.37 PCO2 56 torr PO2 65 torr HCO3- 32 mEq/L The respiratory therapist should A. increase the set rate to 8 br/min. B. increase the FIO2 to 0.30. C. maintain the current settings. D. increase the VT to 650 mL. - Correct Answers ✅C. maintain the current settings. TMC Practice Exam B Question & Answers 2024 A patient with a history of cardiovascular disease has been brought to the emergency department. He is intubated and is being manually ventilated. The ECG monitor shows a sinus rhythm with a rate of 50 beats/min. The patient's pulse is weak and irregular. The nurse has been unable to place a central or peripheral venous catheter. The therapist should recommend endotracheal instillation of A. atropine. B. lidocaine. C. epinephrine. D. naloxone. - Correct Answers ✅A. atropine. The following values are measured on a patient in the outpatient pulmonary function testing center: 1. 2. 3. 4 FVC (L) 3.3 3.4 3.5 3.4 FEV1 (L) 2.3 2.5 2.3 2.4 FEF 25-75% (L/sec) 1.4 1.2 1.3 1.3 TMC Practice Exam B Question & Answers 2024 Which trial should be recorded as the best test? A. Trial 1 B. Trial 2 C. Trial 3 D. Trial 4 - Correct Answers ✅B. Trial 2 A patient is receiving IPPB with a Bird Mark-7. The respiratory therapist notes that the patient is generating negative pressure at the beginning of inspiration although the machine does not switch into the inspiratory phase. The respiratory therapist should A. decrease the flow. B. increase the sensitivity. C. adjust the apnea timer. D. decrease the pressure. - Correct Answers ✅B. increase the sensitivity. A patient is receiving continuous mechanical ventilation through an oral endotracheal tube. The respiratory therapist notes that the high pressure alarm sounds continuously during inspiration and the patient appears to be biting down on the ET tube. Which of the following should the therapist recommend? TMC Practice Exam B Question & Answers 2024 A 4-year-old girl is admitted to the emergency department with persistent dry coughing. Chest radiograph results reveal normal inspiration with the right lung remaining expanded on expiration. Which of the following should the respiratory therapist recommend at this time? A. Endobronchial intubation B. Arterial blood gas analysis C. Bronchoscopic examination D. Lateral neck radiograph - Correct Answers ✅C. Bronchoscopic examination Which of the following would indicate that the lung compliance of a patient on a volume-cycled ventilator is increasing? A. Plateau pressure begins to decrease B. Peak pressure begins to increase C. Blood pressure decreases D. Arterial PCO2 decreases - Correct Answers ✅A. Plateau pressure begins to decrease Heliox therapy is indicated for treatment of patients with post extubation stridor because of the TMC Practice Exam B Question & Answers 2024 A. ability to effectively deliver humidity. B. low density of the gas mixture. C. high molecular weight of the gas mixture. D. low risk of bronchospasm. - Correct Answers ✅B. low density of the gas mixture. A 17 year-old patient is receiving 40% oxygen via a Venturi mask following a motor vehicle accident. He suddenly develops acute shortness of breath, is diaphoretic and SpO2 is 85%. Breath sounds are vesicular on the right and extremely diminished on the left. The respiratory therapist should evaluate the patient for the presence of A. atelectasis. B. a pneumothorax. C. arterial hypertension. D. a myocardial infarction. - Correct Answers ✅B. a pneumothorax. Which of the following would NOT be required to perform a nasal intubation? A. Magill forceps B. Stylet TMC Practice Exam B Question & Answers 2024 C. Laryngoscope D. Endotracheal tube - Correct Answers ✅B. Stylet Which of the following formulas will determine the amount of physiologic deadspace for a patient? A. PAO2 - PaO2 B. CaO2 - CvO2 C. (PaCO2 - PECO2) / PaCO2 D. CcO2 - CaO2 / CcO2 - CvO2 - Correct Answers ✅C. (PaCO2 - PECO2) / PaCO2 A balloon-tipped, flow-directed catheter is positioned in the pulmonary artery with the balloon inflated. Which of the following pressures will be measured by the distal lumen? A. CVP B. PAP C. PCWP D. MAP - Correct Answers ✅C. PCWP TMC Practice Exam B Question & Answers 2024 A. A venous blood sample was drawn. B. The blood gas sample was not cooled prior to analysis. C. The blood gas sample had an air bubble in it. D. The patient's blood gas sample was mixed up with another sample. - Correct Answers ✅C. The blood gas sample had an air bubble in it. Over the last hour a patient being ventilated with a volume cycled ventilator has had a decrease in urine output from 35 mL/hour to 10 mL/hour. The most likely cause of this change would be an increase in the A. respiratory rate. B. delivered FIO2 . C. peak airway pressure. D. inspiratory flow. - Correct Answers ✅C. peak airway pressure. Following administration of oxygen, what additional therapy should the respiratory therapist recommend for a patient with decompression sickness? A. Non-invasive ventilation B. Inhaled nitric oxide C. Hyperbaric oxygen therapy TMC Practice Exam B Question & Answers 2024 D. Extracorporeal membrane oxygenation - Correct Answers ✅C. Hyperbaric oxygen therapy A patient has been participating in Pulmonary Rehabilitation for the past 5 weeks. The patient has recorded the results of his 6 minute walk test each week. The results indicate a steady increase in distance over the 5 week period. These results are consistent with A. need to wear supplemental oxygen while walking. B. need for an additional 6 weeks of rehabilitation. C. improvement in exercise ability. D. early discharge from rehabilitation. - Correct Answers ✅C. improvement in exercise ability. The following measurements were obtained from a patient being monitored with a balloon tipped, flow directed catheter: CVP 2 cmH2O PAP 12 torr (mean) PCWP 3 torr CI 1.2 L/min/m2 BP 110/90 mm Hg TMC Practice Exam B Question & Answers 2024 Based on the above information, all of the following parameters would be decreased EXCEPT A. right ventricular end diastolic pressure. B. left atrial filling pressure. C. systemic vascular resistance. D. cardiac output. - Correct Answers ✅C. systemic vascular resistance. Cardiopulmonary resuscitation has been performed on an adult patient for 15 minutes. The following pattern is seen on the ECG monitor: The respiratory therapist has obtained the following arterial blood gas results: pH 7.02 PaCO2 47 torr PaO2 196 torr HCO3 11 mEq/L SaO2 94% FIO2 1.0 TMC Practice Exam B Question & Answers 2024 A. administer 100% oxygen. B. recommend heparin. C. recommend streptokinase. D. request a chest X-ray. - Correct Answers ✅A. administer 100% oxygen How should the respiratory therapist assemble a Bird Mark 7 respirator to deliver 40% oxygen during an intermittent positive pressure breathing treatment? A. Bleed in oxygen with the air-mix off B. 100% oxygen with the air-mix on C. Air-mix on and attached to a blender set at 40% D. Air-mix off and attached to a blender set at 40% - Correct Answers ✅D. Air-mix off and attached to a blender set at 40% A patient is being ventilated with a high frequency ventilator. The results of an arterial blood gas analysis are as follows: pH 7.29 PaCO2 68 torr TMC Practice Exam B Question & Answers 2024 PaO2 73 torr HCO3- 25 mEq/L BE +1 mEq/L The respiratory therapist should increase the A. driving pressure. B. frequency. C. bias flow. D. I:E ratio. - Correct Answers ✅A. driving pressure. A 48-year-old woman is admitted to the coronary care unit for chest pain, dizziness and nausea. Her blood pressure is 60/40 mm Hg, respirations are 20/min. The cardiac monitor shows sinus rhythm at a rate of 50/minute with frequent multifocal PVC. The respiratory therapist should recommend administration of: A. lidocaine. B. nitroglycerin. C. atropine. D. amiodarone. - Correct Answers ✅C. atropine. TMC Practice Exam B Question & Answers 2024 A patient with a size 8.5 mm ID oral endotracheal tube is transported from the Emergency Department to the Intensive Care Unit. The respiratory therapist suspects the tube has changed position during transport. Which of the following is the first step to assess the tube position? A. Chest radiograph B. Bilateral chest auscultation C. Verify symmetrical chest movement D. Diagnostic chest percussion - Correct Answers ✅C. Verify symmetrical chest movement A newborn infant has an APGAR score of 8 one minute after delivery. The most appropriate action at this time would be to A. intubate and ventilate the infant. B. dry and monitor the infant. C. initiate oxygen therapy. D. begin chest compressions immediately. - Correct Answers ✅B. dry and monitor the infant. Which of the following statements is TRUE concerning positive expiratory pressure (PEP) therapy? TMC Practice Exam B Question & Answers 2024 C. pneumatically powered demand valve resuscitation device. D. non-disposable resuscitation bag. - Correct Answers ✅A. manual resuscitation bag with a non-ferrous PEEP valve assembly. A patient has performed both a forced vital capacity and a slow vital capacity maneuver with the following results: FVC 2.4 L SVC 2.18 L Which of the following statements is TRUE regarding these results? A. The data meets ATS-ERS standards and should be reported. B. The SVC shows poor effort and should be repeated. C. The FVC shows poor effort and should be repeated. D. The patient has obstructive lung disease. - Correct Answers ✅B. The SVC shows poor effort and should be repeated. Which of the following could NOT cause a capnography reading to change from 36 torr to 30 torr? A. Tachypnea B. Hyperventilation TMC Practice Exam B Question & Answers 2024 C. Pulmonary emboli D. Endotracheal tube positioned in the right mainstem bronchus - Correct Answers ✅D. Endotracheal tube positioned in the right mainstem bronchus A tracheostomy tube has just been changed on a patient receiving continuous volume-cycled ventilation. The patient suddenly becomes dyspneic and develops crepitus around the tracheostomy stoma. The respiratory therapist should A. suction the patient. B. insert a larger tracheostomy tube. C. reposition the tracheostomy tube. D. recommend an antihistamine. - Correct Answers ✅C. reposition the tracheostomy tube. A patient's cardiac output is increased and his QS/QT is calculated to be 20%. Based upon this information, the respiratory therapist would inform the physician this patient has A. an elevated shunt. B. a reduced cardiac index. C. increased pulmonary vascular resistance. TMC Practice Exam B Question & Answers 2024 D. normal lung mechanics. - Correct Answers ✅A. an elevated shunt. How long will a full E cylinder of oxygen last if run until empty with a flowrate of 10 L/min? A. 1 hour B. 10 hours C. 33 hours D. 66 hours - Correct Answers ✅A. 1 hour The most common hazard associated with insertion of a central venous catheter is A. pulmonary embolus. B. hypoxemia. C. rupture of the right atrium. D. pneumothorax. - Correct Answers ✅D. pneumothorax. During oral endotracheal intubation, the tip of the Macintosh laryngoscope blade should be placed A. between the soft palate and tongue. TMC Practice Exam B Question & Answers 2024 A 150 kg (330 lb) patient has been referred to a sleep center for evaluation of sleep apnea and daytime drowsiness. Which of the following is the most appropriate diagnostic procedure? A. Spirometry B. Pulse oximetry C. Polysomnography D. Body plethysmography - Correct Answers ✅C. Polysomnography A 2100 g neonate is in the NICU and is being monitored with a TcPO2 monitor. The TcPO2 is reading 53 torr with the temperature set at 40oC. The arterial PO2 is 73 torr. Which of the following would best explain the difference in TcPO2 levels? A. There was an error in the arterial blood gas analysis. B. The TcPO2 monitor needs to be repositioned on the neonate. C. The TcPO2 temperature setting is too low. D. The TcPO2 monitor has come off the skin. - Correct Answers ✅C. The TcPO2 temperature setting is too low. A 1600 g neonate is receiving oxygen by oxyhood at an FIO2 of 0.60. The flowmeter is set at 5 L/min. While analyzing the oxygen, the respiratory therapist notices varying FIO2 readings at different locations TMC Practice Exam B Question & Answers 2024 inside the oxyhood. Which of the following should the therapist do to correct the problem? A. Re-calibrate the oxygen analyzing device B. Increase the flow to the oxyhood C. Place the neonate in an isolette at an FIO2 of 0.60 D. Check the water level of the humidifier - Correct Answers ✅B. Increase the flow to the oxyhood The following measurements were obtained from a patient with a pulmonary artery catheter in place: CVP 1 mm Hg PAP 10 mm Hg (mean) PCWP 8 mm Hg CI 1.6 L/min/m2 BP 110/90 mm Hg Based on the above information, all of the following values would be decreased EXCEPT A. RVEDP. TMC Practice Exam B Question & Answers 2024 B. PVR. C. SVR. D. QT. - Correct Answers ✅C. SVR. A 75 kg (165 lb) male is being mechanically ventilated at the following settings: Mode VC, SIMV Set Rate 12 br/min Total Rate 32 br/min Tidal Volume 600 mL PIP 35 cm H2O Exhaled minute volume 9.2 L FIO2 0.45 PEEP 8 cm H2O The following patient information is available: pH 7.36 PaCO2 45 torr PaO2 89 torr TMC Practice Exam B Question & Answers 2024 B. endobronchial airway. C. oropharyngeal airway. D. nasal oxygen catheter. - Correct Answers ✅A. nasopharyngeal airway. Which of the following will give the most accurate measurement of volume and flow for spirometry? A. Collins water-sealed spirometer B. Vortex-shedding pneumotachometer C. Wright respirometer D. Dry-rolling spirometer - Correct Answers ✅A. Collins water-sealed spirometer A patient who had his chest tube clamped for 18 hours with no apparent respiratory distress is now tachypneic, diaphoretic and complaining of dyspnea and general uneasiness. The respiratory therapist should A. obtain a chest x-ray. B. unclamp the chest tube. C. increase the suction through the system. TMC Practice Exam B Question & Answers 2024 D. add water to the suction control bottle. - Correct Answers ✅B. unclamp the chest tube. If a patient's PvO2 decreased from 30 torr to 20 torr, which of the following should the respiratory therapist assess? A. Cardiac output B. Venous blood gas C. Capillary wedge pressure D. Pulmonary vascular resistance - Correct Answers ✅A. Cardiac output All of the following are TRUE statements about spacers and holding chambers, EXCEPT A. Do not require patient cooperation with their breathing pattern. B. Improve the efficiency of MDI. C. Can be used for drug delivery by MDI to intubated and mechanically ventilated patients. D. If a patient exhales immediately following activation of the inhaler, they will clear the medication from the device and waste the dose - Correct Answers ✅A. Do not require patient cooperation with their breathing pattern. TMC Practice Exam B Question & Answers 2024 A 19-year-old patient has a size 7 mm ID nasotracheal tube placed through the right nare. While attempting to suction the patient with a size 12 Fr catheter, resistance is met as the catheter is introduced into the endotracheal tube. The respiratory therapist should A. lubricate the catheter with petroleum jelly prior to suctioning. B. instill acetylcysteine into the endotracheal tube. C. switch to a 10 Fr suction catheter. D. extubate the patient and reintubate with a size 9 mm ID endotracheal tube. - Correct Answers ✅C. switch to a 10 Fr suction catheter. During cardioversion, the defibrillator will deliver the synchronized electrical shock on the A. P wave. B. Q wave. C. R wave. D. T wave. - Correct Answers ✅C. R wave. A 62-year-old female who weighs 60 kg (132 lb) is on mechanical ventilation following hip replacement surgery. TMC Practice Exam B Question & Answers 2024 CVP 10 cmH2O PAP 33/27 mm Hg PCWP 20 mm Hg BP 108/72 mm Hg Which of the following conditions could be associated with these results? A. Tricuspid valve stenosis B. Right ventricular failure C. Cardiogenic pulmonary edema D. Fluid overload - Correct Answers ✅C. Cardiogenic pulmonary edema During inline suctioning of a patient's endotracheal tube, 100% oxygen is being supplied via the ventilator. The respiratory therapist observes several premature ventricular contractions on the ECG monitor. The therapist should A. decrease the suctioning time per pass. B. use a smaller suction catheter. TMC Practice Exam B Question & Answers 2024 C. increase oxygenation time. D. decrease the suction pressure. - Correct Answers ✅A. decrease the suctioning time per pass. A 25-year-old, 58 kg (130 lb) female is admitted to ICU after an emergency C-section. The patient is receiving mechanical ventilation via volume control ventilator. The current ventilator settings are: Mode VC, SIMV VT 500 mL f 12 bpm FIO2 0.50 PEEP 5 cm H2O The following laboratory data are available: pH 7.36 PaCO2 44 torr PaO2 50 torr HCO3- 22 mEq/L SaO2 82% CVP 7 cm H2O TMC Practice Exam B Question & Answers 2024 PAP 13 mm Hg (mean) QT 4.5 L/min. The respiratory therapist should recommend increasing which of the following? A. Tidal volume to 700 mL B. PEEP to 8 cm H2O C. Set rate to 15 bpm D. FIO2 to .60 - Correct Answers ✅D. FIO2 to .60 When initiating mechanical ventilation for a patient with chronic CO2 retention, the respiratory therapist must assure adequate inspiratory flow in order to prevent A. a decrease in the patient's FRC. B. an increase in blood pressure. C. dynamic hyperinflation. D. an increase in system pressure. - Correct Answers ✅C. dynamic hyperinflation. TMC Practice Exam B Question & Answers 2024 pH 7.41 PaCO2 40 torr PaO2 95 torr SaO2 96% HCO3- 23 mEq/L BE +1 mEq/L PAO2 370 torr C(a-v)O2 3.5 vol% The respiratory therapist should report the A-aDO2 as A. 275 torr. B. 300 torr. C. 345 torr. D. 370 torr. - Correct Answers ✅A. 275 torr. A 32-week gestational age infant is receiving mechanical ventilation for pulmonary interstitial emphysema. The respiratory therapist suspects that a pneumothorax has developed. Which of the following diagnostic procedures should the therapist recommend to confirm this diagnosis? TMC Practice Exam B Question & Answers 2024 A. Upper airway x-ray B. Capillary blood gas C. Chest radiograph D. Pre- & post-ductal blood gases - Correct Answers ✅C. Chest radiograph A patient is receiving mechanical ventilation at the following settings: Mode SIMV Mandatory rate 12 Total rate 12 FIO2 0.50 VT 700 mL Peak flow 50 L/min PEEP 5 cm H2O The following volume-pressure loop is observed. TMC Practice Exam B Question & Answers 2024 Which of the following should the respiratory therapist recommend? A. Increase the PEEP B. Change to assist-control mode C. Increase the VT D. Increase the peak flow - Correct Answers ✅A. Increase the PEEP A nasally intubated patient is receiving mechanical ventilation via volume-cycled ventilator. While performing a patient-ventilator system check, the respiratory therapist notices that the high pressure alarm is sounding. The patient appears cyanotic and his heart rate is 48 beats per minute. The therapist is unable to pass a suction catheter through the nasotracheal tube. The therapist should A. increase the FIO2 to 1.00. B. call the patient's physician. C. obtain a stat arterial blood gas. D. remove the tube and manually ventilate the patient. - Correct Answers ✅D. remove the tube and manually ventilate the patient. A fireman is brought to the Emergency Department after being knocked unconscious in a burning office building. What is the best way to improve the oxygenation status of this patient? TMC Practice Exam B Question & Answers 2024 A. fats. B. proteins. C. sugars. D. carbohydrates. - Correct Answers ✅D. carbohydrates. All of the following could be recommended to treat a patient with severely decreased static lung compliance, EXCEPT A. inverse ratio ventilation. B. appropriate PEEP therapy. C. airway pressure release ventilation. D. aerosolized beta agonist therapy. - Correct Answers ✅D. aerosolized beta agonist therapy. At the local pulmonary function clinic, a patient is seen for an updated spirometry test for disability qualification as a result of pneumoconiosis. Pulse oximetry is performed with a result of 97%. Arterial blood gases are obtained and the measured SaO2 is 85%. These results are most consistent with A. Restrictive disease B. Cigarette smoking TMC Practice Exam B Question & Answers 2024 C. Nocturnal asthma D. Obstructive exacerbation - Correct Answers ✅B. Cigarette smoking A post-operative thoracotomy patient is in the PACU and receiving 60% oxygen via a non-rebreather mask. A pulmonary diagnostic assessment reveals the following information: pH 7.43 PaCO2 34 torr PaO2 56 torr HCO3- 22 mEq/L BE -1 SaO2 90% f 25/min. PAP 49/28 mm Hg PWP 5 mm Hg PVR 400 dynes SVR 1150 dynes To improve the patient's pulmonary status, the respiratory therapist should institute TMC Practice Exam B Question & Answers 2024 A. mechanical ventilation with 100% O2. B. CPAP at 5 cmH2O at 60% O2. C. nitric oxide therapy at 10 ppm. D. heliox therapy at an 80:20 ratio. - Correct Answers ✅B. CPAP at 5 cmH2O at 60% O2. All of the following statements regarding an oxygen concentrator are correct EXCEPT A. Provides an unlimited supply of oxygen. B. Increases alveolar oxygen tension. C. Provides 100% oxygen at high flow rates. D. Removes nitrogen from the room air. - Correct Answers ✅C. Provides 100% oxygen at high flow rates. Which of the following would modify the expiratory time and change the I:E ratio for a patient receiving IPPB therapy? A. Expiratory resistance valve B. Inspiratory flow C. Rate control