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Medicine and respiratory therapy are continuously changing

practices. The author and publisher have reviewed all information
in this report with resources believed to be reliable and accurate
and have made every effort to provide information that is up to
date with the best practices at the time of publication. Despite our
best efforts we cannot disregard the possibility of human error
and continual changes in best practices the author, publisher, and
any other party involved in the production of this work can
warrant that the information contained herein is complete or fully
accurate. The author, publisher, and all other parties involved in
this work disclaim all responsibility from any errors contained
within this work and from the results from the use of this
information. Readers are encouraged to check all information in
this book with institutional guidelines, other sources, and up to
date information. Respiratory Therapy Zone is not affiliated with
the NBRC, AARC, or any other group at the time of this
publication.

You can get access to our massive bank of TMC Practice Questions
by Clicking Here. J

Copyright © Respiratory Therapy Zone

Introduction

Why hello there! Thank you for downloading this eBook and getting
access to these practice questions and answers.

By doing so, you’re putting yourself in a great position to pass the

TMC Exam on your next attempt.

Did you know that going through practice questions is one of the
most effective ways to prepare for (and pass) the exam?

It’s a strategy that I recommend to each and every one of my

students. And I can always tell a major difference in students who
use practice questions to prepare and those who do not.

And that’s exactly why we created our TMC Test Bank. It’s our
massive bank of over 1000 practice questions, answers, and
rationale explanations.

It’s similar to the questions in this eBook, however, it DOES also

contain the explanation for each question, which goes into detail
and explains why the answer is the correct answer.

This is absolutely critical when it comes to helping you actually

learn and remember the information that you need to know in
order to pass the exam.

You can view this eBook as a “lite version” of our TMC Test Bank.
That is because it only contains the correct answers, not the
rationales that explain why the answer is correct.

So after you go through the practice questions below, if you like

them and find them to be helpful, I definitely recommend that you
check out the TMC Test Bank which will give you access to many
more practice questions, as well as — of course — the rationales too.
Like I said, they are extremely important if you’re serious about
passing the TMC Exam on your next attempt! Thanks again for
downloading this eBook and I wish you the best of luck!

Now let’s dive into the practice questions! J

1. Within one second after initiating a forced vital capacity (FVC)

maneuver, a patient with normal lungs should be able to exhale
what percent of the FVC?
A. 35-50% of the FVC
B. 50-70% of the FVC
C. 70-83% of the FVC
D. 84-93% of the FVC

2. Simple spirometry CANNOT be used to measure the

A. vital capacity
B. residual volume
C. tidal volume
D. inspiratory reserve volume

3. Which of the following approaches can be used to obtain a

medication history from a patient with a depressed level of
consciousness or who is severely agitated?
A. obtain and review the patient’s past medical history
B. ask the patient’s nurse about the patient’s prescriptions
C. request that the lab run a comprehensive blood drug
screen
D. obtain the patient’s current prescription vials from the
family

4. Which of the following thoracic ultrasound findings is

consistent with the presence of a pneumothorax?
A. presence of gliding sign
B. absence of A-lines
 C. presence of barcode sign
D. presence of seashore sign

5. Which of the following would tend to increase insensible water

loss?
A. hypothermia
B. bypassed upper airway
C. hypoventilation
D. diuretic administration
6. Which of the following would tend to decrease a patient’s
energy expenditure?
A. hypothermia
B. inflammation
C. major trauma
D. agitation/pain

7. A patient has acute respiratory acidosis. You would expect the

base excess (BE) to range between:
A. + 6 mEq/L
B. - 6 mEq/L
C. +/- 2 mEq/L
D. +/- 8 mEq/L

8. Which of the following arterial blood gas results would most

likely be reported for a patient who is having a mild asthma
attack?
A. pH = 7.31 PCO2 = 50 torr PO2 = 60 torr
B. pH = 7.40 PCO2 = 50 torr PO2 = 50 torr
C. pH = 7.47 PCO2 = 32 torr PO2 = 60 torr
D. pH = 7.47 PCO2 = 40 torr PO2 = 50 torr

9. The Apgar score for a normal newborn infant ranges between

A. 1-4
B. 4-7
C. 7-10
D. 10-13
10. On inspection of a patient’s ECG strip, you note no identifiable
P waves; rapid irregular undulations of the isoelectric line; and
an irregular ventricular rhythm. In addition, the precordial
cardiac rate is greater than the peripheral pulse rate. The most
likely problem is:
A. 2nd degree (Wenckebach) heart block
B. ventricular fibrillation
C. atrial fibrillation
D. ventricular tachycardia
11. In inspecting an elderly female patient, you note that her spine
has an abnormal anterposterior (AP) curvature. Which of the
following terms would you use in charting this observation?
A. kyphosis
B. scoliosis
C. kyphoscoliosis
D. pectus excavatum

12. During auscultation of a patient’s chest, you hear intermittent

“bubbling” sounds at the lung bases. Which of the following
chart entries best describe this finding?
A. “bronchial sounds heard at lung bases”
B. “wheezes heard at lung bases”
C. “rhonchi heard at lung bases”
D. “crackles (rales) heard at lung bases”

13. While assessing a patient’s radial pulse, you note that the pulse
feels full and bounding. Which of the following conditions
would be the most probable cause of this finding?
A. hypovolemia
B. hypertension
C. cardiovascular shock
D. low cardiac output

14. A patient is cachexic, exhibits generalized edema and dry skin,

and appears listless. The most likely problem is:
A. heart failure
B. Addison’s disease
 C. renal failure
D. malnutrition

15. Prior to giving an aerosol treatment, you find a note in the

chart that states your patient had pink frothy secretions on
admission to the ED. This is most indicative of:
A. cor pulmonale
B. left ventricular failure
C. an electrolyte imbalance
D. ARDS

16. A doctor orders a changeover to CPAP for a patient receiving

bi-level positive airway pressure (BiPAP) via a device with
separate IPAP and EPAP controls. To effect this change you
would:
A. set IPAP less than EPAP
B. set IPAP greater than EPAP
C. set EPAP = 0 cm H2O
D. set IPAP equal to EPAP

17. How would you characterize the degree of dyspnea of a

patient who walks slower than people of the same age
because of breathlessness?
A. slight
B. moderate
C. severe
D. very severe

18. Upon exam of an acutely dyspneic and hypotensive patient,

you note the following – all on the left side of the chest:
reduced chest expansion, hyperresonance to percussion,
absent of breath sounds and tactile fremitus, and a tracheal
shift to the right. These findings suggest:
A. left-sided pneumothorax
B. left-sided consolidation
C. left lobar obstruction/atelectasis
D. left-sided pleural effusion
19. A patient’s response to an interview question is initially vague
or unclear. Which of the following responses on your part
would be most appropriate?
A. “Please go on”
B. “You seem to be anxious”
C. “I see why you are so upset”
D. “Please explain that to me again”

20. A patient is asked to inhale as deeply as possible and blow out

all his air as hard as they can until empty. What test is being
performed?
A. FVC
B. IC
C. TLC
D. MVV

21. When a patient is receiving positive-pressure ventilation, you

should strive to keep the alveolar (plateau) airway pressure
below:
A. 20 cm H2O
B. 30 cm H2O
C. 40 cm H2O
D. 50 cm H2O

22. 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

23. 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

24. 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%

25. 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

26. 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

27. 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

28. 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

29. 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

30. 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%

31. Prior to intubation in an emergency, injection of air into the

pilot line fails to inflate the cuff. You should
A. check the cuff for leaks
B. check the valve on the pilot line
C. replace the endotracheal tube
D. inspect the pilot line for patency

32. A 15-year-old with cystic fibrosis is receiving pressure control

SIMV with pressure support due to a severe bilateral
 pneumonia. The pulmonologist asks you to administer
aerosolized dornase alfa (Pulmozyme, DNase) in-line with the
ventilator. Which of these devices would you select to
administer this therapy?
A. dry powder inhaler (DPI)
B. vibrating mesh nebulizer
C. metered dose inhaler (MPI)
D. small volume nebulizer

33. Which of the following conditions will cause a DECREASE in

the FIO2 delivered to a patient receiving oxygen at 4 L/min via
a nasal cannula?
A. decrease in patient inspiratory flow
B. increase in patient inspiratory time
C. increase in patient minute ventilation
D. decrease in patient tidal volume

34. You notice that a disposable nebulizer is delivering large water

droplets down the large bore tube. To correct this problem,
you should
A. add a heating collar to the nebulizer
B. replace the nebulizer
C. add water to the nebulizer
D. dismantle and clean the nebulizer

35. Shortly after you replace a jet nebulizer and tubing on a

patient who has a tracheostomy, the SpO2 drops from 98% to
90%. Aerosol is visible throughout inspiration and expiration in
the tracheostomy collar. Which of the following should you do
first to resolve the situation?
A. Decrease the input flow to the nebulizer
B. Ask the patient to breath slower and deeper
C. Check the entrainment setting on the nebulizer
D. Obtain an arterial blood gas sample for analysis

36. Which of the following would you expect to occur AFTER an

unheated bubble diffusion humidifier is set-up and operating?
 A. the reservoir will be warmer than room temperature
B. the reservoir will be cooler than room temperature
C. the reservoir temperature will equal room temperature
D. water will condense on the inside of the delivery tubing

37. During computerized setup of a ventilator, you are prompted

to enter a circuit compliance factor. This information is needed
to:
A. calibrate the flow sensors
B. complete the automated leak test
C. calibrate the pressure transducer
D. compensate for compressed volume loss

38. A bubble humidifier is connected to a flowmeter set and

running at 5 L/min. When you obstruct the outlet of the small-
bore delivery tubing, the pressure pop-off does NOT sound.
Which of the following is the most likely cause of this
observation?
A. excessive flow through the humidifier
B. a leak in the humidifier/delivery system
C. diameter of delivery tubing is too small
D. the flowmeter is not pressure compensated

39. Which of the following analyzers would you select if your

objective were to continuously measure changes in the FIO2
in a ventilator circuit with the fastest possible response time?
A. physical (paramagnetic) analyzer
B. thermal conductivity analyzer
C. galvanic fuel cell analyzer
D. polarographic (Clark) analyzer

40. To maximize the duration of flow/runtime outside the home,

liquid portable O2 systems:
A. hold about three liters of liquid oxygen
B. can be refilled from a liquid O2 base unit
C. incorporate a pulse-dose delivery system
D. include a battery-powered contents indicator
41. You run a control solution through a blood gas analyzer as part
of daily quality control. The measured high PO2 value is 9 torr
outside of the acceptable range. Prior runs were all in range.
You should:
A. report results after compensating for the deviation
B. replace the PO2 electrode and recalibrate the analyzer
C. analyze another control solution for comparison
D. perform a two-point calibration and rerun the control

42. Which of the following is true regarding calibration of exhaled

nitric oxide (NO) gas analyzers?
A. inlet flows should mimic breathing (variable flow/pressure)
B. daily 2-point (zero/high %NO) calibration is required
C. room air can be used as the ‘zero’ calibrating gas
D. daily 1-point using a standardized NO% is sufficient

43. When reviewing statistical quality control data on a blood gas

analyzer, you note a single pH measurement among 30 that
falls below the ± 2 SD “in control” standard for your lab. Which
of the following is the most likely cause of this error?
A. statistical probability/chance
B. contaminated buffer solutions
C. incorrect analysis procedures
D. failure of the pH electrode

44. You are analyzing quality control samples on a blood gas

analyzer as part of a routine quality control program. Multiple
but not successive PCO2 values fall above and below the two
standard deviation limit. You should:
A. record the results as an acceptable
B. record the results as an acceptable after correcting for the
difference in measurements
C. record the results as an acceptable if they are within +/- 2
SD of the mean
D. perform a two-point calibration and reanalyze the control
sample
45. Which of the following blood gas quality control procedures is
designed to assure that the output of the analyzer is both
accurate and linear across the range of measured values?
A. statistical quality control.
B. performance validation
C. control media verification
D. automated calibration

46. When calibrating a portable computerized spirometer, its

volume readings consistently fall outside the ± 3% range.
Which of the following is the most likely cause of this
problem?
A. flow sensor misassembled or damaged
B. failure to remove bacterial filter before calibration
C. flow sensor tubing not connected to computer
D. incorrect selection of prediction equations

47. When reviewing statistical quality control data on a blood gas

analyzer, you note a single PCO2 measurement among 30
that falls below the ± 2 SD “in control” standard for your lab.
Which of the following is the most likely cause of this error?
A. contamination of the sample
B. incorrect calibrating gas %
C. incorrect analysis procedures
D. failure of the PCO2 electrode

48. Which blood gas analysis/hemoximetry quality control

procedure involves plotting the results of control media
analyses on a graph and comparing these plots against
derived range limits?
A. machine calibration
B. statistical quality control
C. preventive maintenance
D. control media verification
49. The reference procedure used to establish accuracy for blood
PO2 and PCO2 measurements is:
A. hemolysis
B. manometry
C. equilibration
D. tonometry

50. Which of the following can cause a hemoximeter’s HbO2

reading to be falsely low?
A. dirty analysis chamber
B. high fetal Hb levels
C. elevated bilirubin levels
D. sickle-cell anemia

51. When suctioning an adult patient using a DISS wall-mounted

regulator system with collection bottle, you would initially set
the vacuum pressure at:
A. -12 to -15 in Hg
B. -80 to -100 mm Hg
C. -5 to -7 in Hg
D. -100 to -120 mm Hg

52. In which of the following clinical situations would a patient

benefit most from deep breathing exercises?
A. myasthenic crisis
B. postop cholecystectomy
C. exacerbation of COPD
D. status asthmaticus

53. What size suction catheter would you select to suction a

patient with a 9.0 mm ID tracheostomy tube?
A. 10 Fr
B. 12 Fr
C. 14 Fr
D. 16 Fr
54. During postural drainage therapy, a patient’s heart rate
remains stable at 92/min and the SpO2 is 97%. However, after
you pre-oxygenate the patient and begin nasotracheal
suctioning, the patient’s heart rate suddenly drops to 40/min.
The most likely reason for this is:
A. severe mucus plugging
B. hypoxemia during suctioning
C. a vago-vagal reflex
D. postural hypotension

55. If tolerated, a specified postural drainage position should be

maintained for at least:
A. 3-5 minutes
B. 5-10 minutes
C. 10-20 minutes
D. 20-30 minutes

56. You are about to suction an infant who has a 3.0 mm (ID)
endotracheal tube in place. What is the MAXIMUM size
catheter you would use in this case?
A. 6 Fr
B. 8 Fr
C. 5 Fr
D. 10 Fr

57. If a patient’s chest X-ray shows infiltrates in the posterior

segments of the lower lobes, postural drainage should be
performed in which of the following positions?
A. head down, patient prone with a pillow under her
abdomen
B. head down, patient supine with a pillow under her knees
C. patient prone with a pillow under her head, bed flat
D. patient supine with a pillow under her knees, bed flat

58. To increase a patient’s maximum expiratory flow when using a

cough assist or mechanical in-exsufflation (MI-E) device, you
would:
 A. increase the inspiratory time
B. decrease the expiratory pressure
C. increase the expiratory time
D. increase the inspiratory pressure

59. Postural drainage would best be indicated for a patient with:

A. pleural effusion
B. asthma
C. pneumonia
D. cystic fibrosis

60. In discussing the goals of IPPB therapy with a postoperative

patient, which of the following explanations would be most
appropriate?
A. “This will prevent pneumonitis.”
B. “This will help you take deep breaths.”
C. “This will prevent atelectasis.”
D. “This will increase your intrathoracic pressure.”

61. A patient who is receiving an aerosol treatment with

acetylcysteine (Mucomyst) and hypertonic saline via a SVN
suddenly becomes dyspneic. The most likely cause of this
problem is:
A. hypercapnia
B. bronchospasm
C. pneumothorax
D. fluid overload

62. A physician orders a 70% He/30% O2 mixture to be delivered to

a patient having an acute asthmatic attack. Which of the
following systems would be most appropriate to deliver this
mixture?
A. nebulizer set at 100% oxygen with aerosol mask
B. tight-fitting nonrebreathing mask with competent valving
C. simple oxygen mask set to deliver 15 L/min oxygen
D. tight-fitting partial rebreathing mask at 12 L/min
63. A doctor orders aerosol therapy for a patient receiving
mechanical ventilation who is being provided humidification
with a heat and moisture exchanger (HME). To assure effective
therapy you must:
A. place the aerosol device proximal to the HME in the stream
of flow
B. remove the HME before aerosol therapy and replace it
afterward
C. place the aerosol device distal to the HME in the stream of
flow
D. switch from an HME to an active heated the
humidification system

64. Which of the following is associated with the administration of

aerosolized epinephrine?
A. tachycardia
B. bradycardia
C. laryngospasm
D. bronchospasm

65. After completing an aerosol drug treatment, which of the

following is the most appropriate chart notation for you to
make?
A. Treatment given as ordered
B. Aerosol therapy given; pulse stable, no changes during
therapy; well tolerated
C. Aerosol therapy given with 0.5 mL albuterol and 3 mL
normal saline; vital signs stable; well tolerated
D. Aerosol therapy given with 0.5 mL albuterol and 3 mL
normal saline; pulse stable at 72/min during therapy; B.P.
stable at 120/80; respiratory rate 10/min; therapy well
tolerated; chest clear on auscultation

66. A physician orders 2.5 mL ipratropium bromide (Atrovent)

0.2% TID for a COPD patient with recurrent bronchospasm.
Which of the following methods would you use to deliver this
drug?
 A. small volume nebulizer with mask
B. ultrasonic nebulizer with mask
C. small volume nebulizer with mouthpiece
D. MDI

67. Which of the following describes the ventilatory pattern that is

best suited for maximum aerosol deposition in the small
airways?
A. slow inhalation, pause, slow exhalation
B. slow inhalation, pause, rapid exhalation
C. rapid inhalation, pause, slow exhalation
D. rapid inhalation, pause, rapid exhalation

68. A doctor orders a metered dose inhaler (MDI) bronchodilator

for a patient receiving mechanical ventilation via a dual-limb
breathing circuit. To maximize aerosol deposition, you would:
A. place the MDI directly in-line on the inspiratory side of the
circuit
B. recommend that a small volume nebulizer be used instead
of the MDI
C. place the MDI plus a spacer in-line on the inspiratory side
of the circuit
D. place the MDI directly in-line on the expiratory side of the
circuit

69. Which of the following patient instructions for using a dry

powder inhaler (DPI) is correct?
A. hold device vertically after loading
B. perform slow (3-4 sec) deep inhalation
C. exhale back into the device
D. seal lips tightly around mouthpiece

70. An increase in a patient’s heart rate during aerosolized

bronchodilator therapy is primarily a result of which of the
following effects of the drug?
A. Alpha only
B. Beta 1 only
 C. Beta 2 only
D. Beta 1 and Beta 2

71. A physician orders supplemental O2 for a patient via nasal

cannula at a flow of 12 L/min. When you ask her what goal she
has in mind, she states that she wants the patient to receive
about 60% oxygen. Which of the following should you
recommend?
A. that the cannula flow be set to 15 L/min instead of 12 L/min
B. that the O2 be given via a partial rebreathing mask at 10
L/min
C. that a nasal catheter at 12 L/min be used instead of the
cannula
D. that the O2 be given via an air entrainment mask set at
60%

72. A patient whose asthma was well-controlled using a short-

acting beta-agonist inhaler PRN and low dose inhaled
corticosteroid BID reports that she recently has been
experiencing shortness of breath almost daily and is
awakened at night with wheezing episodes. Her pea flow,
which had been 83% of her predicted normal is now at 66% of
the predicted value. Which of the following would you
recommend to the patient’s doctor as possible changes to the
current drug regimen?
A. discontinue the short-acting beta agonist inhaler
B. add a leukotriene modifier to the regimen
C. switch the short-acting beta agonist from PRN to Q4H
D. switch from inhaled to oral corticosteroid therapy

73. In assessing a patient receiving ventilatory support, you note

that her white blood cell count is 18,000/mm3 and her
temperature is 102 °F. In addition, her secretions have become
more tenacious and yellow over the past 24 hours. Which of
the following would you suggest to the attending physician?
A. that her humidifier temperature be lowered to below 30 °C
B. that a regimen of aerosolized carbenicillin be started ASAP
 C. that a sputum sample be obtained for culture and
sensitivity
D. that the frequency of suctioning be increased to every half
hour

74. A clinical condition characterized by a history of a productive

cough for at least three months a year for two consecutive
years best describes:
A. panlobular emphysema
B. status asthmaticus
C. centrilobular emphysema
D. chronic bronchitis

75. After bronchodilator therapy, you record the following PFT

data on a 67 year old male COPD patient with chronic cough
and sputum production: FEV1/FVC = 65%; FEV1 = 82%
predicted. You would characterize the stage of the patient’s
COPD as:
A. mild
B. moderate
C. severe
D. very severe

76. A doctor institutes volume control ventilation for a 70 kg ARDS

patient with a targeted tidal volume of 420 mL. To maintain
adequate ventilation with this tidal volume, you would allow a
machine respiratory rate as high as:
A. 20/min
B. 25/min
C. 30/min
D. 35/min

77. Any sudden occurrence of pulmonary or cardiac distress in

older, bed-ridden patients and those having undergone
extensive abdominal or pelvic surgery suggest a diagnosis of:
A. coronary artery disease
B. pulmonary thromboembolism
 C. anaphylactic shock
D. acute left ventricular failure

78. Which of the following is the most common indication for

home CPAP therapy?
A. sleep apnea-hypopnea syndrome (SAHS)
B. bronchospasm associated with asthma
C. chronic hypoxemia
D. neuromuscular disorders

79. The doctor is concerned that his ARDS patient on pressure

control ventilation has high plateau pressures (> 30 cm H2O)
and that this may be causing further lung injury. Which of the
following modes of ventilation would you consider as an
alternative?
A. volume control ventilation
B. pressure support ventilation
C. airway pressure release ventilation
D. continuous positive airway pressure

80. Which of the following observations indicate that an infant’s

work of breathing may be abnormally high?
A. palor
B. digital clubbing
C. acrocyanosis
D. nasal flaring

81. The primary aim in treating cardiogenic pulmonary edema is

to:
A. increase venous return to the heart
B. decrease right heart and systemic venous pressures
C. decrease left heart and pulmonary vascular pressures
D. increase pulmonary fluid and blood volume

82. What is the most common arrhythmia seen with pulmonary

disease?
A. sinus bradycardia
 B. sinus tachycardia
C. atrial fibrillation
D. ventricular tachycardia

83. The primary purpose of oxygen administration in the

management of heart failure is to:
A. increase the force of ventricular contractions
B. decrease resistance to ventricular ejection
C. increase ventricular stroke volume
D. decrease the workload on the myocardium

84. A doctor institutes volume control ventilation for an 80 kg

ARDS patient. Which of the following is the maximum
pressure you would aim to achieve in this patient?
A. 50 cm H2O peak pressure
B. 30 cm H2O plateau pressure
C. 40 cm H2O peak pressure
D. 50 cm H2O plateau pressure

85. You would recommend against using noninvasive positive

pressure ventilation (NPPV) for a patient with:
A. secretions requiring suctioning
B. the need for moderate sedation
C. facial burns or trauma
D. FIO2 needs greater than 40%

86. An alert patient with emphysema and an elevated CO2 level is

given 50% O2 by an air entrainment mask. One hour later the
nurse calls you to evaluate the patient. He is now very
lethargic. Which of the following is the most likely cause of
this?
A. respiratory muscle fatigue
B. cerebral hypoxia
C. hypotension
D. O2-induced hypoventilation
87. Which of the following is a key therapeutic objective in the
management of a patient who has closed head trauma and is
receiving ventilatory support?
A. increase the minute ventilation
B. increase intrathoracic pressure
C. assure patient-ventilator synchrony
D. decrease cerebral perfusion pressure

88. In individuals with disorders characterized by an increase in

airway resistance, such as emphysema, which of the following
breathing patterns results in the minimum work?
A. deep breathing
B. slow breathing
C. shallow breathing
D. rapid breathing

89. Which of the following is true regarding patients in the early

stages of an asthmatic attack?
A. they all exhibit respiratory alkalosis
B. they always have moderate hypoxemia
C. they have decreased expiratory flows
D. they never respond to beta adrenergics

90. A patient whose asthma was well-controlled using a short-

acting beta-agonist inhaler PRN and low dose inhaled
corticosteroid BID reports that she recently has been
experiencing shortness of breath almost daily and is
awakened at night with wheezing episodes. Her peak flow,
which had been 83% of her predicted normal is now at 66% of
the predicted value. Which of the following would you
recommend to the patient’s doctor as possible changes to the
current drug regimen?
A. add a long-acting beta-agonist to the regimen
B. discontinue the short-acting beta agonist inhaler
C. switch the short-acting beta agonist from PRN to Q4H
D. switch from inhaled to oral corticosteroid therapy
91. Maximum inspiratory pressure (MIP; NIF) measurement
provides information about which of the following?
A. airway resistance
B. functional residual capacity
C. inspiratory capacity
D. respiratory muscle strength

92. Which of the following laboratory values is most consistent

with a diagnosis of fluid depletion (dehydration)?
A. increased hematocrit
B. decreased BUN
C. decreased serum osmolality
D. decreased urine specific gravity

93. Which of the following would represent an abnormal V/Q scan

suggesting pulmonary embolism?
A. large segmental areas with normal ventilation and normal
perfusion
B. large segmental areas with no ventilation and no perfusion
C. large segmental areas with normal ventilation but no
perfusion
D. large segmental areas with no ventilation but normal
perfusion

94. During the administration of an aerosol treatment, the

patient’s respiratory rate drops from 15 breaths/min to 6
breaths/min. Identify this breathing pattern.
A. bradypnea
B. Biot’s breathing
C. apnea
D. hyperpnea

95. You measure the blood pressure of an adult patient as 88/53

mm Hg. Which of the following chart entries would you use in
describing this finding?
A. patient is hypertensive
B. patient is hypotensive
 C. patient has low pulse pressure
D. patient has high pulse pressure

96. While assisting a physician with a transthoracic ultrasound

exam, you observe gliding or shimmering of the pleural layer
during breathing. This observation
A. is consistent with the interstitial syndrome
B. rules out an underlying pneumothorax
C. indicates the presence of pleural adhesions
D. confirms an underlying pneumothorax

97. Your review of a patient’s chart notes an admission diagnosis

of fluid depletion/ dehydration. Which of the following
findings would be most likely on bedside assessment of the
patient?
A. inspissated secretions
B. pitting edema
C. venous distension
D. crackle on auscultation

98. Which of the following thoracic ultrasound findings is

consistent with the presence of a pneumothorax?
A. presence of gliding sign
B. absence of A-lines
C. presence of barcode sign
D. presence of seashore sign

99. In observing a patient, you note that her breathing is

extremely deep and fast. Which of the following terms would
you use in charting this observation?
A. Kussmaul’s breathing
B. Biot’s breathing
C. Cheyne-Stokes breathing
D. apneustic breathing

Copyright © Respiratory Therapy Zone

Conclusion

That wraps up this eBook! Thanks again for downloading and

making it all the way to the end. If you’re reading this far, then I
know you have what it takes to pass the TMC Exam on your next
attempt.

Like I said, going through practice questions is one of the best

strategies for those who truly want to pass the exam.

The practice questions found in this eBook are helpful, but I’ll be
honest with you. They only scratch the surface of what can be
found inside of our TMC Test Bank.

And thankfully, thousands of students have already used it to pass

the TMC Exam!

So if you’re ready to pass the exam too, I definitely recommend

that you consider checking it out.

Click Here to Learn More About the TMC Test Bank!

One more thing!
How would you like to get new TMC Practice Questions sent to
your inbox every single day?

If this is something that sounds interesting to you, Click Here to

learn more.

As I mentioned before, going through practice questions is one of

the most effective strategies when it comes to passing the TMC
Exam.

Well now, you can get new practice questions delivered straight to
your inbox on a daily basis.

This way, over time, you can master every single topic that you
need to know to increase your chances of passing the exam on
your first (or next) attempt.

Let’s go through an example so that you can see what I’m talking
about.

Here’s an example of a TMC Practice Question:

A 50-year-old man is intubated and receiving mechanical

ventilation with a size 8.0 mm endotracheal tube that is secured
in place. The patient’s cuff pressure is measured at 36 cm H2O.
What would you recommend in this situation?
A. Withdraw the tube 1-2 cm and reassess the patient’s breath
sounds
B. Recommend reintubation with a smaller endotracheal tube
C. Lower the cuff pressure to < 30 cm H2O
D. Recommend ventilation via a tracheostomy instead
Do you know the answer? Not to worry, let’s break it down!

The explanation that you get along with each practice question is
the most important part!

In order to answer this one correctly, you have to know what the
normal values are for cuff pressure. And in this case, you must
know that 36 cm H2O is way too high and could potentially cause
tracheal damage.

So your first action should be to lower the cuff pressure to < 30 cm

H2O and check to make sure that there are not any leaks.

Remember, the cuff pressure should stay between 20–30 cm H2O.

There is no indication to withdraw the tube, and using a smaller

tube would only cause the patient’s peak pressure to increase,
which is something that we do not want.

And also, there is no indication for the insertion of a tracheostomy,

so this tells us that the correct answer has to be C.

The correct answer is: C. Lower the cuff pressure to < 30 cm H2O

Well, what did you think? Do you see how valuable this
information can be??

Are you ready to start receiving these practice questions and

explanations every day?

If so, just click on the link below:

Click Here to Get Daily TMC Practice Questions
References

1. AARC Clinical Practice Guidelines, (2002-2019) Respirator Care.

[Link].

2. Egan’s Fundamentals of Respiratory Care. (2010) 11th Edition.

Kacmarek, RM, Stoller, JK, Heur, AH. Elsevier.

3. Mosby’s Respiratory Care Equipment. Cairo, JM. (2014) 9th

Edition. Elsevier.

4. Pilbeam’s Mechanical Ventilation. (2012) Cairo, JM. Physiological

and Clinical Applications. 5th Edition. Saunders, Elsevier.

5. Ruppel’s Manual of Pulmonary Function Testing. (2013) Mottram,

C. 10th Edition. Elsevier.

6. Rau’s Respiratory Care Pharmacology. (2012) Gardenhire, DS. 8th

Edition. Elsevier.

7. Perinatal and Pediatric Respiratory Care. (2010) Walsh, BK,

Czervinske, MP, DiBlasi, RM. 3rd Edition. Saunders.

8. Wilkins’ Clinical Assessment in Respiratory Care (2013) Heuer, Al.

7th Edition. Saunders. Elsevier.

9. Clinical Manifestations and Assessment of Respiratory Disease.

(2010) Des Jardins, T, & Burton, GG. 6th edition. Elsevier.

10. Neonatal and Pediatric Respiratory Care. (2014) Walsh, Brian K.

4th edition. RRT. Elsevier.

11. Clinical Application of Mechanical Ventilation (2013) Chang,

David W. 4th edition. Cengage Learning.