Download TMC REAL ACTUAL EXAM 2025 – LATEST PRACTICE QUESTIONS AND ANSWER GRADED A (100% VERIFIED) and more Exams Nursing in PDF only on Docsity!
TMC REAL ACTUAL EXAM 2025 – LATEST
PRACTICE QUESTIONS AND ANSWER
GRADED A (100% VERIFIED) COMPLETE
150 QUESTIONS
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 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? 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. 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 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. monitoring intracuff pressures. 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.
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 Insert a chest tube 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%
5.0 vol% 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 50 mL/cm H2O 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
Which of the following information may be obtained from a FVC maneuver during bedside pulmonary function testing?
- FEV
- PEFR
- FRC
- RV 1 and 2 only 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. 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 A. pneumonia. B. pulmonary embolism. C. pleural effusion. D. bronchiolitis. 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? A. 8 Fr B. 10 Fr C. 12 Fr D. 14 Fr 12 Fr In order to verify the accuracy of a lab-based spirometer device, the respiratory therapist should utilize a
B. Obtain an ABG. C. Measure peak expiratory flow. D. Determine the Glasgow Coma Score. Obtain an ABG. 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 A. pulmonary embolism. B. gastroesophageal reflux. C. myocardial infarction. D. valvular stenosis. 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 RT recommend? A. Helium dilution study B. DLCO C. Plethysmography
D. Bronchial provocation 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. 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. Enough to achieve a pressure of 25-35 cmH2O.
B. intubating and initiating mechanical ventilation. C. administering sodium bicarbonate intravenously. D. initiating non-invasive ventilation. 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? A. Decelerating B. Square wave C. Constant D. Accelerating Decelerating An intubated patient receiving 30% oxygen has a SpO2 of 80% and ETCO2 of 40 torr. After administration of 50% oxygen for 30 minutes, the respiratory therapist notes that the SpO2 rises to 98% and the ETCO2 remains stable at 40 torr. The major cause of hypoxemia in this patient is A. hypoventilation. B. shunt. C. ventilation/perfusion mismatch.
D. increased deadspace. ventilation/perfusion mismatch. A 16 year-old patient with cystic fibrosis attends public high school. Which of the following bronchial hygiene therapies would be most appropriate for this patient? A. intrapulmonary percussive ventilation B. dornase alpha therapy C. vibratory / oscillatory PEP D. postural drainage and manual percussion vibratory / oscillatory PEP A patient reports that he has difficulty breathing while lying in a supine position and prefers to sleep sitting in a chair. The respiratory therapist should record this complaint in the medical record as A. orthopnea. B. platypnea. C. eupnea. D. Kussmaul breathing. orthopnea.
The most probable cause of air bronchograms and increased density on a chest x-ray is A. pneumonia. B. pulmonary edema. C. pulmonary embolism. D. pleural effusion. pneumonia. A post-operative patient is receiving mechanical ventilation in the ICU at the following settings: VC, A/C; VT 550 mL, respiratory rate 14/min, FIO2 0.50 and 10 cm H2O PEEP. Bedside monitoring results demonstrate that the PvO2 is 35 mm Hg and the SpO2 is 90%. The patient is alert and oriented with stable vital signs. Which of the following should the respiratory therapist recommend? A. Decrease the PEEP. B. Increase the FIO2. C. Initiation diuretic therapy. D. Continue to monitor closely. Increase the FIO2. The primary source of infection in the health care setting is A. use of medical equipment for multiple patients.
B. poor handwashing techniques of personnel. C. food and/or water intake by the patient. D. patient rooms not cleaned appropriately. 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? A. Pre/post bronchodilator study B. Ultrasonic nebulizer treatments C. Manually assisted coughing D. Regular coughing and deep breathing Regular coughing and deep breathing The respiratory therapist has obtained a blood gas sample from the patient's radial artery and applied 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 A. adding liquid heparin to the sample. B. placing the syringe in an ice bath. C. shaking the sample continuously.
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. 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? A. Head down, patient supine with a pillow under knees B. Patient prone with a pillow under head, bed flat C. Patient supine with a pillow under knees, bed flat D. Head down, patient prone with a pillow under hips Head down, patient prone with a pillow under hips
A 72 year-old female post stem cell transplant patient in the ICU is complaining 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? A. severe heart failure B. respiratory distress syndrome C. severe renal failure D. moderate heart failure moderate heart failure Following blunt chest trauma, a 3 5 - 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 thoracic expansion of the left chest. There are diminished breath sounds in the left lung compared to the right lung. These findings most likely indicate which of the following? A. flail chest on right thorax B. right tension pneumothorax C. endobronchial intubation D. subcutaneous emphysema endobronchial intubation
