Cardiopulmonary pathology is the study of diseases that affect the heart and lungs. Some examples include:

  • Congestive heart failure (CHF)
  • Asthma
  • COPD
  • Pneumonia
  • Cystic fibrosis

Respiratory therapists are responsible for treating patients with these conditions, which is why students develop a strong understanding of each type.

In this guide, we’ve listed some sample TMC practice questions on the topic of cardiopulmonary pathology. This can help you practice and prepare with questions similar to what you’ll see on the licensure exam offered by the NBRC.

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Note: We didn’t include the correct answers on this page so that you can test your knowledge. If you want to see the correct answers (with detailed rationales), just simply download the digital study guide.

Pathology Sample TMC Practice Questions:

1. A new patient was admitted and has been diagnosed with pneumonia. The patient has an oxygen saturation of 87% on 2 L/min nasal cannula. Which of the following would cause the patient to be hypoxemic?
1. Capillary shunting
2. Diffusion defect
3. Alveolar consolidation
4. Hypoventilation
Select all that apply:
A. 1 and 2
B. 2 and 3
C. 1 and 3
D. All of the above

2. A 16-year-old patient has been admitted and shows signs of poor body development. Upon assessment, you also noted digital clubbing, hyperresonance to percussion, and a productive cough. It has also been reported that the patient has foul-smelling stools. Which of the following conditions are these findings consistent with?
A. Acute respiratory distress syndrome
B. Heart failure
C. Acute bronchitis
D. Cystic fibrosis

3. While reviewing the chest x-ray of a 57-year-old male patient, you noted blunting of the left costophrenic angle. It also states in the patient’s chart that he has a history of CHF. Which of the following best describes this finding?
A. There is a pneumothorax on the left side
B. There is a pleural effusion on the left side
C. There is pulmonary edema in the left lung
D. There is pneumonia in the left lower lobe

4. You were called by the physician to perform a Tensilon test on a new patient. This test is commonly used to confirm the diagnosis for which of the following conditions?
A. Myasthenia gravis
B. Guillain-Barré syndrome
C. Multiple sclerosis
D. Poliomyelitis

5. While assessing a 49-year-old male patient, you notice swelling in the lower limbs. This is most likely indicative of which of the following?
A. Hypovolemia
B. Chronic hypertension
C. Right ventricular insufficiency
D. Left ventricular insufficiency

6. A patient would have reduced tactile fremitus in all of the following conditions except?
A. COPD
B. Pneumothorax
C. Pulmonary edema
D. Pleural effusion

7. A 56-year-old male patient has been admitted and diagnosed with Guillain-Barré syndrome. In order to determine the patient’s need for ventilatory support, which of the following values is the most critical to monitor?
A. Residual volume
B. Inspiratory capacity
C. Peak inspiratory flow
D. Expiratory reserve volume

8. A sweat chloride test can be used to diagnose which of the following conditions?
A. Muscular dystrophy
B. Amyotrophic lateral sclerosis
C. Poliomyelitis
D. Cystic fibrosis

9. A 61-year-old female patient is receiving mechanical ventilation. Over the last three days, her fluid intake has stayed the same but her output fluid level measurements have been decreasing. Her peak airway pressure has been steadily increasing over this same time period. Which of the following is the most likely cause of this problem?
A. Ventilator-associated pneumonia
B. Acute respiratory distress syndrome
C. Pulmonary arterial hypertension
D. Cardiogenic pulmonary edema

10. A 69-year-old female patient has been diagnosed with pneumonia. The physician asks you to assess the patient. Which of the following breath sounds would you expect to hear upon auscultation?
A. Wheezing
B. Bronchial
C. Vesicular
D. Hyperresonance

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11. A 64-year old female patient was admitted and the physician suspects that a pneumothorax is present. Which of the following percussion notes would you expect to find in this patient?
A. Increased resonance
B. Flat percussion note
C. Dull percussion note
D. Hyperresonant percussion note

12. It has been determined that a patient in the ICU that is receiving mechanical ventilation has ARDS. Which of the following would you expect to find in this patient?
A. Refractory hypoxemia
B. Metabolic alkalosis
C. Increased lung volumes
D. Increased compliance

13. A 66-year-old female patient arrives in the emergency room with chest tightness, dyspnea, and shortness of breath. The doctor ordered a blood test to check troponin and BNP but the results were negative. Her ABG results show partially compensated respiratory acidosis. Which of the following is likely the issue in this case?
A. Pneumonia
B. CHF
C. Exacerbation of COPD
D. Myocardial infarction

14. The physician ordered a V/Q scan on a 59-year-old patient. Which of the following conditions would a ventilation scan appear normal but a perfusion scan reveals areas of absent blood flow?
A. Pneumonia
B. Lung cancer
C. Pulmonary embolism
D. Emphysema

15. You are called to help treat a patient with a neuromuscular condition. The patient is showing signs of paralysis that started in the feet but has extended upwards throughout the remainder of the body. Which of the following conditions is most likely present?
A. Guillain-Barré syndrome
B. Myasthenia gravis
C. Stroke
D. Drug overdose

16. A recent post-operative patient is being treated with incentive spirometry. The patient’s inspiratory capacity has decreased over the past few days and their level of dyspnea has been increasing. The chest x-ray shows consolidation in the lung bases with no shift of the trachea. Which of the following has most likely developed?
A. Pneumonia
B. Pleural effusion
C. Atelectasis
D. Pneumothorax

17. While reviewing a patient’s chest x-ray, it shows that there is a shift of the trachea and mediastinum to the left side. There is also a complete opacification on the left side as well. These findings indicate which of the following?
A. Diffuse pulmonary emphysema
B. Right-sided pleural effusion
C. A pneumothorax of the right lung
D. Atelectasis of the left lung

18. While reviewing the chest x-ray of a 47-year-old male patient, you note that the heart is shifted to the patient’s right. Which of the following is the most likely cause of this finding?
A. Atelectasis of the left side
B. Tension pneumothorax on the left side
C. Tension pneumothorax on the right side
D. Pleural effusion on the right side

19. While listening to the breath sounds of a 55-year-old patient, you hear a creaking or grating sound. The sound gets louder with deep breathing but is not affected by coughing. Which of the following conditions is most likely present?
A. Atelectasis
B. Pleurisy
C. Chronic bronchitis
D. Pulmonary edema

20. You are called to perform a chest assessment of a new patient. Upon assessment, you notice that the patient has a paradoxical chest wall movement. Which of the following best describes this finding?
A. Chronic bronchitis
B. Flail chest
C. Exacerbation of COPD
D. Tension pneumothorax

21. A new patient just finished a cardiothoracic surgery procedure. Upon assessment, you noticed that the patient has a paradoxical pulse. Which of the following conditions is most likely?
A. Pericarditis
B. COPD exacerbation
C. Myocardial infarction
D. Cardiac tamponade

22. While assessing a female patient on her posterior side, palpitation reveals minimal diaphragmatic movement on the right side as she takes a deep breath. Her movement on the left side is normal. Which of the following conditions best explains this finding?
A. Pulmonary emphysema
B. Atelectasis in the left lower lobe
C. Phrenic nerve paralysis on the left side
D. A pleural effusion on the right side

23. A 68-year-old female patient was admitted to the emergency department with shortness of breath and low blood pressure. Upon initial assessment, you note the following: Reduced chest expansion, hyperresonance to percussion, absent breath sounds, tactile fremitus, and a tracheal shift to the right. Which of the following do these findings suggest?
A. Pleural effusion on the left side
B. Pneumothorax on the left side
C. Atelectasis on the left side
D. Consolidation on the left side

24. You are asked to assess a 39-year-old man that was admitted through the emergency department with an abrupt onset of fever and chills. The man shows signs of bilateral rhonchi with a productive cough and his SpO2 is 88% on room air. What should you recommend?
A. Intubate and provide mechanical ventilation with 40% oxygen
B. Provide noninvasive positive pressure ventilation using a full face mask
C. Implement postural drainage and percussion with directed coughing
D. Provide oxygen therapy, give an antibiotic, and obtain a sputum sample for Culture and Sensitivity

25. You heard bronchial breath sounds over the patient’s right middle lobe while performing a routine assessment. Due to this finding, which of the following conditions would you expect to be present?
A. Asthma
B. Pneumonia
C. Emphysema
D. Pleural effusion

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26. Upon assessment of a new patient who was just admitted, you noticed that they have frothy pink secretions. This most likely indicates which of the following:
A. ARDS
B. Cor pulmonale
C. Left ventricular failure
D. An electrolyte imbalance

27. The most likely cause of stridor in an adult patient would be which of the following?
A. Croup
B. Asthma
C. Epiglottitis
D. Post-extubation edema

28. After reviewing the chest radiograph of a 71-year-old male, you noticed a large area of consolidation in the right lung. Which of the following is the most likely cause of this problem?
A. Pulmonary barotrauma
B. Tension pneumothorax
C. Interstitial emphysema
D. Lobar pneumonia

29. A 60-year-old patient has been admitted and is showing signs of fever, diaphoresis, use of accessory muscles, and a respiratory rate or 22 breaths/min. Auscultation revealed rhonchi in the lower lobes. Which of the following would you suspect?
A. Heart attack
B. Pneumothorax
C. COPD exacerbation
D. Bacterial pneumonia

30. You have a patient that complains of left-sided chest pain while receiving mechanical ventilation. While assessing the patient, you note tachypnea, a weak and thready pulse, tracheal deviation to the right, decreased breath sounds, and hyperresonance on the left. Which of the following would you recommend?
A. Suctioning
B. A bronchoscopy
C. The insertion of a chest tube
D. A thoracentesis

31. You received an order from a new resident to administer an albuterol treatment to a CHF patient with acute pulmonary edema for wheezing. What should you do in this case?
A. Recommend acetylcysteine instead of albuterol
B. Perform the therapy with supplemental oxygen
C. Perform the treatment as ordered
D. Recommend a diuretic and oxygen therapy

32. A patient in the emergency room is suspected of having a pulmonary embolism. In order to confirm this suspicion, which of the following laboratory tests would you recommend?
A. Hematocrit
B. Troponin I
C. D-dimer
D. Arterial blood gas

33. While assessing a 54-year-old male patient, you note that he has diminished breath sounds in the right lower lobe with a trachea that has shifted to the right. What is most likely the cause of these findings?
A. Pneumothorax on the left side
B. Pneumonia on the left side
C. Pneumothorax on the right side
D. Atelectasis on the right side

34. In which of the following conditions would postural drainage be most helpful?
A. Pleural effusion
B. Cystic fibrosis
C. Pneumonia
D. Asthma

35. Which of the following procedures would be most beneficial in preventing atelectasis in a 59-year-old female patient that is less than 24 hours post-surgery?
A. Albuterol via SVN four times daily
B. Pursed-lip breathing as needed
C. Inspiratory resistance exercises three times daily
D. Incentive spirometry maneuver 10 times per hour

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Final Thoughts

As previously mentioned, respiratory therapists (and students) must develop an understanding of the diseases that affect the heart and lungs. Hopefully, this guide with sample TMC practice questions can help make the learning process easier.

If you want to increase your chances of passing the TMC exam on your first (or next) attempt, be sure to check out some of our other helpful resources:

You can join thousands of our other previous students who passed both board exams to earn their RRT credentials . Best of luck, and thanks for reading!

Medical Disclaimer: This content is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please consult with a physician with any questions that you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you read in this article. We strive for 100% accuracy, but errors may occur, and medications, protocols, and treatment methods may change over time.

References

The following are the sources that were used while doing research for this article:

  • Egan’s Fundamentals of Respiratory Care. 12th ed., Mosby, 2020.
  • Clinical Application of Mechanical Ventilation. 4th ed., Cengage Learning, 2013.
  • Pilbeam’s Mechanical Ventilation: Physiological and Clinical Applications. 6th ed., Mosby, 2015.
  • Mosby’s Respiratory Care Equipment. 10th ed., Mosby, 2017.
  • Rau’s Respiratory Care Pharmacology. 10th ed., Mosby, 2019.
  • Wilkins’ Clinical Assessment in Respiratory Care. 8th ed., Mosby, 2017.
  • Cardiopulmonary Anatomy & Physiology: Essentials of Respiratory Care. 7th ed., Cengage Learning, 2019.
  • Clinical Manifestations and Assessment of Respiratory Disease. 8th ed., Mosby, 2019.
  • Ruppel’s Manual of Pulmonary Function Testing. 11th ed., Mosby, 2017.
  • Neonatal and Pediatric Respiratory Care. 5th ed., Saunders, 2018.

Medical Disclaimer: The information provided by Respiratory Therapy Zone is for educational and informational purposes only. It should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult with a physician with any questions that you may have regarding a medical condition.