TMC Test bank QUESTIONS EXAM |LATEST VERSION |NEW UPDATE |GUARANTEED PASS|2024-2025, Exams of Nursing

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TMC Test bank QUESTIONS EXAM |LATEST

VERSION |NEW UPDATE |GUARANTEED

PASS|2024-2025 |BEST STUDYING MATERIAL

WITH 100+ QUESTIONS

Apatient has a peak expiratory flow rate (PEFR) of 5.2 L/sec before bronchodilator treatment and 6.3 L/sec after treatment. What percent change in PEFR occurred? A. 8% B. 17% C. 21% D. 26%

• ANSWER 21% (pre - post) / pre x 100 All spirometric values obtained under ambient conditions should be converted to: A. ambient temperature and pressure, saturated (ATPS) B. body temperature, ambient pressure, saturated (BTPS) C. standard temperature and pressure, dry (STPD)

D. ambient temperature and pressure, dry (ATPD)

• ANSWER body temperature, ambient pressure, saturated (BTPS) A patient has a systolic arterial pressure of 180 mm Hg and a diastolic value of 90 mm Hg. What is his approximate mean arterial pressure? A. 100 mm Hg B. 110 mm Hg C. 120 mm Hg D. 130 mm Hg
• ANSWER 120 mmHg Which of he following represents proper technique in the auscultatory method of measuring blood pressure? A. inflate the cuff to 120 mm Hg pressure B. place the cuff 3 inches below the brachial artery C. deflate the cuff at a rate of 2 to 3 mm Hg per sec D. place bell of stethoscope over the radial artery
  • ANSWER deflate the cuff at a rate of 2 to 3 mm Hg per sec

Which of the following devices would you select to adjust tracheal tube cuff pressures? A. manometer B. respirometer C. volumeter D. pneumotachometer

• ANSWER volumeter An exercise test can help determine the cause of which of the following? A. chronic cough B. hemoptysis C. wheezing on exertion D. rhonchial fremitus
• ANSWER wheezing on exertion When performing spirometry on an adult patient, which of the following would indicate invalid/unacceptable test results? A. back extrapolated volume 100 mL B. time to peak flow 500 msec C. forced expiratory time > 6.0 sec

D. repeat FVCs match within 150 Ml

• ANSWER time to peak flow 500 msec Which of the following should be obtained and recorded when performing a bedside measure of vital capacity? A. patient's resting minute ventilation B. patient's heart rate before/after testing C. patient's actual and predicted body weight D. patient's height, gender and age
• ANSWER patient's height, gender and age You attach a patient in ICU to the pulse oximeter module on a multichannel bedside monitor. The best way to verify that you are getting a good reading would be to: A. observe for a good pulse pressure waveform on the monitor's display B. compare the oximeter's pulse rate to the ECG-monitored rate C. assess the oximeter's pulse strength/rate LED indicator lights D. perform an Allen's test on the extremity used to monitor the SpO
• ANSWER observe for a good pulse pressure waveform on the monitor's display

A patient is receiving volume controlled ventilation at a rate of 10/min. The percent inspiratory time (%I) control is set at 25%. What is the inspiratory time? A. 1.00 sec B. 1.25 sec C. 1.50 sec D. 1.75 sec

• ANSWER 1.50 sec (I + E) = 60/10 =6 sec I = 0.25 x 6 To avoid preanalytic error caused by air contamination of a blood gas sample, you would: A. place the sample in ice slush B. discard the first 3 mL obtained C. quickly plug the needle tip D. mix only after expelling air
• ANSWER mix only after expelling air

After attaching an apnea monitor to a neonate and confirming good chest motion, you note a weak signal that causes intermittent alarming. Which of the following is the most likely cause of this problem? A. sensor belt not fitted snugly enough B. apnea alarm time limit set too short C. recording memory capacity exceeded D. monitor sensitivity set too high

• ANSWER sensor belt not fitted snugly enough The proper infection control procedures to be used when drawing an arterial blood gas are: A. hand washing and gloves only B. apron and protective eyewear C. mask and protective eyewear D. all CDC standard precautions
• ANSWER all CDC standard precautions

Upon inspection of a portable spirometer's FVC curve obtained on an adult outpatient, you determine that the back extrapolated volume is excessive. Prior to repeating the maneuver, which of the following instructions would you provide to the patent? A. "Don't hesitate" B. "Blast out faster" C. "Blow out longer" D. "Deeper breath"

• ANSWER Don't hesitate Which of the following is being measured if you instruct a patient to take a maximum deep breath and then exhale completely? A. inspiratory force B. vital capacity (VC) C. total lung capacity (TLC) D. residual volume (RV)
• ANSWER VC Which of the following procedures can be performed on a comatose patient? A. maximum voluntary ventilation (MVV) B. maximum inspiratory pressure (MIP)

C. forced expiratory volume in 1 sec (FEV1) D. peak expiratory flow

• ANSWER maximum inspiratory pressure (MIP) In analyzing overnight oximetry data, a desaturation event represents a decrease in SpO2 of: A. 2% or more B. 3% or more C. 4% or more D. 5% or more
  • ANSWER 4% or more Bedside spirometry performed on a patient reveals the following: Respiratory rate = 22 Tidal volume = 360 mL Dead space = 150 mL Inspiratory capacity = 1.0 L Based on these data, what is the patient's minute ventilation? A. 3.3 L/min B. 4.6 L/min

C. 7.9 L/min D. 22.0 L/min

• ANSWER 7.9 L/min F x VT To ensure accurate measurements, before attaching a transcutaneous blood gas monitor sensor to a patient, you should: A. place mineral oil inside the sensor fixation ring B. remove all oils/soaps from the sensor site C. pierce the sensor membrane to facilitate diffusion D. cool the sensor site with an ice pack
• ANSWER remove all oils/soaps from the sensor site You are assisting a nurse in ICU measure a patient's central venous pressure (CVP) with a strain-gauge pressure transducer. You note that the pressure transducer is positioned well above the middle of the patient's lateral chest wall. What effect if any would this have on the CVP measurement? A. it would not affect the measurement B. it would underestimate the CVP

C. it would cause damping of the signal D. it would overestimate the CVP - ANSWER it would underestimate the CVP When running an arterial blood gas on a point-of-care analyzer, the device 'flags' the PCO2 results. You should: A. repeat the analysis using a fresh sample and the same cartridge B. repeat analysis using a fresh sample and new cartridge C. send the sample to the central laboratory for analysis D. repeat the analysis using the same sample and same cartridge - ANSWER send the sample to the central laboratory for analysis To measure the strength of a patient's respiratory muscle effort at the bedside, which of the following devices would you select? A. ergometer B. respirometer C. peak flowmeter D. pressure manometer - ANSWER pressure manometer

A patient is receiving pressure controlled A/C ventilation. Which of the following changes would occur if the patient's compliance were to decrease? A. inspiratory time will increase B. PEEP level will decrease C. peak pressure will increase D. delivered volume will decrease - ANSWER delivered volume will decrease When performing a routine ventilator check on a patient receiving volume controlled ventilation, you note that the peak airway pressure has decreased from a prior value of 50 cm H2O to 30 cm H2O. There has been no change in ventilator settings. Which of the following actions would be appropriate at this time? A. increase the flow until the pressure equals 50 cm H2O B. check the patient-ventilator circuit for system leaks C. increase the volume until the pressure equals 50 cm H2O D. check for increased secretions and suction if needed - ANSWER check the patient-ventilator circuit for system leaks

When used to monitor a patient's oxygenation status, pulse oximetry has the following major disadvantage: A. skin burns due to using incompatible probes B. pressure sores at the measuring site C. false results leading to incorrect decisions D. electrical shock at the measuring site - ANSWER false results leading to incorrect decisions Oxygen exchange at the lung is considered adequate if the arterial hemoglobin saturation (SaO2) can be maintained above: A. 65% B. 70% C. 75% D. 90% - ANSWER 90% Which of the following would likely cause an incorrect or misleading pulse oximetry reading? A. Low Hb concentration B. Incorrect probe size C. Elevated body temperature

D. High cardiac output - ANSWER Incorrect probe size You obtain an SpO2 reading of 90% using an oximeter with an accuracy of ±5%. This could indicate a PO2 as low as: A. 70 mm Hg B. 65 mm Hg C. 60 mm Hg D. 55 mm Hg - ANSWER 55 mmHg While assisting a physician who is inserting a pulmonary artery catheter, you note a changeover on the monitor from pulsatile pressures of about 25/5 mm Hg to pulsatile pressures of 25/15 mm Hg. Which of the following has occurred? A. the catheter has advanced from right atrium to right ventricle B. the catheter has moved from right ventricle to pulmonary artery C. the catheter has advanced into the pulmonary wedge position D. the catheter has moved from the vena cava into the right atrium - ANSWER the catheter has moved from right ventricle to pulmonary artery An unconscious patient admitted to the Emergency Department has a SpO2 of 94% but analysis of an arterial sample on a CO-oximeter reveals a SaO2 of 69%. Which of the following problems is most likely?

A. carbon monoxide poisoning B. opiate drug overdose C. diabetic ketoacidosis D. acute pulmonary edema - ANSWER carbon monoxide poisoning An adult patient with bilateral infiltrates on X-ray is receiving volume control (A/C) ventilation with 60% O2. He has a mean airway pressure (MAP) of 12 cm H2O and a PaO2 of 60 torr. What action would you recommend? A. implementing the ARDSNet protocol B. switching to high frequency oscillation C. switching to pressure control SIMV D. initiating a spontaneous breathing trial - ANSWER implementing the ARDSNet protocol A patient's bedside spirometry results (as compared to normal) are as follows: FVC decreased FEV1 normal FEV1% increased

What is the most likely problem? A. an obstructive disorder B. poor patient effort C. a restrictive disorder D. within normal limits - ANSWER a restrictive disorder A patient has a lower than normal mixed venous O2 content. Which of the following could cause this condition? A. secondary polycythemia B. cyanide (CN) poisoning C. fever/hyperthermia D. hypervolemia - ANSWER fever/hyperthermia Apatient with a normal PaO2 and cardiac output is exhibiting signs and symptoms of tissue hypoxia. What is the most likely cause of her hypoxia? A. a hemoglobin deficiency B. hypoventilation C. a R-L physiologic shunt D. a low ambient PO2 - ANSWER a hemoglobin deficiency Which of the following would likely cause an incorrect or misleading pulse oximetry reading?

A. Low Hb concentration B. Excessive probe movement C. Elevated body temperature D. High cardiac output - ANSWER Excessive probe movement You obtain a bedside vital capacity (VC) of 450 ml on a cooperative 120 lb female patient receiving ventilatory support in the CMV mode. Which of the following conclusions can you draw from this finding? A. the patient's VC is normal for her size and weight B. the patient cannot sustain prolonged spontaneous ventilation C. the patient is in acute hypoxemic respiratory failure D. the patient has a generalized obstructive disease process - ANSWER the patient cannot sustain prolonged spontaneous ventilation A patient is receiving volume control A/C ventilation. The patient has become increasingly agitated and the end-tidal CO2 has decreased from 39 to 28 torr over the last 2 hours. Which of the following is the most likely cause? A. increased cardiac output B. mainstem intubation C. high body temperature D. increased ventilation - ANSWER increased ventilation

You observe the following on the bedside capnograph display of a patient receiving ventilatory support. What is your interpretation of this display data?Select one: A. ventilator disconnection B. hyperventilation C. rebreathing D. increased cardiac output - ANSWER hyperventilation On inspection of an ECG rhythm strip from an adult patient, you note the following: rate of 150; regular rhythm; normal P waves, P-R intervals, and QRS complexes. The most likely problem is: A. atrial flutter B. sinus tachycardia C. ventricular tachycardia D. atrial fibrillation - ANSWER sinus tachycardia On inspection of a 12-lead ECG, you note the absence of P waves and a variable R- R interval (> 0.12 sec). Which of the following is the most likely problem? A. atrial hypertrophy B. first-degree heart block C. atrial fibrillation D. sinus arrhythmia - ANSWER atrial fibrillation

What percent decrease in FEV1 needs to occur to conclude that a methacholine challenge is positive for airway hyperreactivity? A. 10% B. 15% C. 20% D. 25% - ANSWER 20% A patient is receiving ventilatory support after thoracic surgery. You measure the patient's maximum inspiratory pressure (MIP/NIF) as - 33 cm H2O. Based on this value, the patient has: A. a need for continued ventilatory support B. a large leak in their endotracheal tube cuff C. a normal maximum inspiratory pressure D. adequate muscle strength to consider weaning - ANSWER adequate muscle strength to consider weaning During a single-breath capnogram, the sharp downstroke and return to baseline that normally occurs after the end-tidal point indicates: A. exhalation of mainly deadspace gas

B. inspiration of fresh respiratory gas C. exhalation of mixed alveolar/deadspace gas D. exhalation of mainly alveolar gas - ANSWER inspiration of fresh respiratory gas A patient is considered as having sufficient respiratory muscle strength to maintain adequate ventilation and prevent secretion retention when the maximum inspiratory pressure (MIP; NIF) is more negative than: A. - 5 cm H2O B. - 10 cm H2O C. - 15 cm H2O D. - 20 cm H2O - ANSWER - 20 cm H2O Over a 3 hour period, the plateau pressure of a patient receiving volume controlled ventilation has remained stable, but her peak pressure has been steadily increasing. Which of the following is the best explanation for this observation? A. the patient's airway resistance has increased B. the patient is developing atelectasis C. the patient's compliance has decreased

D. the patient is developing pulmonary edema - ANSWER the patient's airway resistance has increased On inspection of an adult patient's 12-lead ECG, you note a regular R-R interval of 0.40 sec, with no other apparent abnormalities. Which of the following is the most likely problem? A. ventricular tachycardia B. sinus bradycardia C. atrial fibrillation D. sinus tachycardia - ANSWER sinus tachycardia Under ideal conditions, pulse oximeter readings patients usually fall with what percent of those obtained via invasive hemoximetry? A. ±1-2% B. ±2-3% C. ±3-5% D. ±5-7% - ANSWER ±3-5% A 48-year-old male is orally intubated, receiving mechanical ventilation with an 8.0 mm endotracheal (ET) tube secured in place. Cuff pressure is measured at 36 cm H2O. You should: A. Recommend reintubation with a smaller ET tube

B. Withdraw the tube 1-2 cm and reassess breath sounds C. Recommend a percutaneous tracheotomy D. Lower cuff pressure to < 30 cm H2O and assess for leaks - ANSWER Lower cuff pressure to < 30 cm H2O and assess for leaks When observing a patient's arterial pressure waveform on a bedside monitor, you note little or no 'notching' and a markedly reduced pulse pressure. Palpation of the patient's peripheral pulse indicates strong pulsations. The most likely cause of this problem is: A. the possibility of a significant pulse deficit, probably due to atrial fibrillation B. partial obstruction of the vascular line, causing damping of the pressure waveform C. improper zeroing or calibration of the attached strain-gauge pressure transducer D. improper positioning of the pressure transducer below the patient's left ventricle Incorrect - ANSWER partial obstruction of the vascular line, causing damping of the pressure waveform

When performing bedside spirometry on a 35-year-old woman who is 5 feet 7 inches tall, you obtain a peak flow measurement of 2.3 L/sec. The best interpretation of this test result is: A. the patient's peak flow is normal B. the patient has expiratory flow obstruction C. the patient has poor gas distribution D. the patient has low compliance - ANSWER the patient has expiratory flow obstruction The following spirogram shows the FVC maneuver for a patient before and after an albuterol (Proventil) treatment. Based on this information, you can conclude that the patient has: A. no evidence of lung disease B. severe restrictive lung disease C. reversible airway obstruction D. received no benefit from the medication - ANSWER reversible airway obstruction

Which of the following would cause an increase in a patient's peak airway pressure while receiving volume control ventilation? A. resolving pulmonary edema B. bronchospasm C. blown ET tube cuff D. ventilator circuit leak - ANSWER bronchospasm You obtain an SpO2 reading of 100% on a patient receiving oxygen via a nonrebreathing mask. What range of arterial PO2s is possible in this patient? A. 60-90 mm Hg B. 90-100 mm Hg C. 100-200 mm Hg D. 100-600 mm Hg - ANSWER 100-600 mm Hg You obtain a sputum sample from a patient using hypertonic saline aerosol. Soon after receipt, the laboratory rejects it, indicating that it contains primarily squamous epithelial cells. Which of the following is the most likely reason for rejecting the sample? A. the sample is contaminated with gastric fluid B. the saline concentration was too high C. the sample is contaminated with saliva

D. the collection container was not sterile - ANSWER the sample is contaminated with saliva On review of an apnea monitor's event recording for a neonate with an estimated gestation age of 34 weeks you note a breathing pattern characterized by numerous respiratory pauses lasting 4-10 seconds with less than 20 seconds of respiration activity between pauses. During these events, there is no change in heart rate. The proper interpretation of this finding is: A. apnea of prematurity B. pathologic apnea C. periodic breathing D. motion/activity artifact - ANSWER periodic breathing A forced expiratory measurement obtained after the administration of a bronchodilator shows an increase in FEV1 from 60% to 80% of predicted. This indicates a A. reversible airway obstruction B. fixed airway obstruction C. restrictive process D. normal diffusion capacity - ANSWER reversible airway obstruction

Normally, an individual can maintain about what percent of their maximum voluntary ventilation (MVV) on maximum exercise? A. 60-70% B. 70-80% C. 80-90% D. 90-100% - ANSWER 60-70% An apnea monitor alarm is sounding continuously but your initial assessment of the patient reveals that they are breathing normally. You next action should be to: A. Check the electrode connections on the patient B. Immediately obtain a replacement monitor C. Silence the alarm and call the equipment supplier D. Replace the lead wires and patient cable - ANSWER Check the electrode connections on the patient Which of the following would cause a sudden increase in the peak pressure during volume controlled ventilation? A. auto-PEEP B. pneumothorax