Patient assessment refers to the process of gathering information about a patient’s health status in order to make an informed decision about their care. This usually includes:

  • Taking a medical history
  • Performing a physical examination
  • Ordering diagnostic tests

Respiratory therapists are required to know how to perform a patient assessment, which means that students must develop an understanding of this topic.

In this guide, we’ve listed some sample TMC practice questions on the topic of patient assessment. This can help you practice and prepare for the real-life questions that will be featured on the licensure exam offered by the NBRC.

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Patient Assessment Sample TMC Practice Questions:

1. Upon entering a patient’s rooms for a routine assessment, you noticed distinct distention of the patient’s jugular vein in the neck. Which of the following is the most likely cause?
A. Systolic hypertension
B. Hypovolemia
C. Obstruction of pulmonary vein
D. Right ventricular failure

2. You are called for the assessment of a 24-year-old female patient that is in respiratory distress. You would expect to find all of the following except:
A. Diaphoresis
B. A normal respiratory rate
C. Accessory muscle usage
D. Intercostal retractions

3. A 61-year-old patient arrives at the emergency department in a comatose state. The patient is unable to speak or answer questions. Which of the following approaches can be used to obtain the patient’s medication history?
A. Obtain and review the patient’s past medical history
B. Obtain the patient’s current prescription vials from the family
C. Ask the patient’s nurse about the patient’s prescriptions
D. Request that the lab run a comprehensive blood drug screen

4. You are called to perform an EKG on a new patient. While reviewing the results, you note that there are no identifiable P waves with an irregular ventricular rhythm. Which of the following is most likely the problem?
A. Atrial fibrillation
B. Ventricular tachycardia
C. 1st degree heart block
D. 2nd degree heart block

5. While assessing a 64-year-old patient in the ICU, you note a heart rate of 134 beats/min with a regular rhythm. Which of the following is the most likely cause of this assessment?
A. Arterial hypertension
B. Anxiety or agitation
C. Beta-blocker administration
D. Therapeutic hypothermia

6. Which of the following respiratory signs would be considered abnormal in an adult patient at rest?
A. Respiratory rate of 18 breaths per minute
B. Ribs higher posteriorly than anteriorly at end-expiration
C. Scalene muscle usage at rest
D. Costal angle of 90 degrees increases with inspiration

7. You are called to evaluate a patient who appears to be asleep. His respiratory rate is 14 breaths/min and heart rate is 72 beats/min. In order to determine the patient’s level of consciousness, you speak to the patient, but he does not respond. Which of the following should you do first?
A. Call for help
B. Administer a sternal rub
C. Wait 1 hour and then repeat the attempt
D. Gently shake the patient’s arm

8. A new patient has arrived in the emergency department. Upon arrival, you noticed that her breathing is extremely deep and fast. Which of the following best classifies this type of breathing?
A. Apneustic breathing
B. Kussmaul breathing
C. Biot’s breathing
D. Cheyne-Stokes breathing

9. You are called to perform chest physiotherapy on a 62-year-old female patient. Before you begin, she states that “When I breathe l feel like I am getting enough air, but I seem to breathe fast and lift my shoulders a lot. I sleep through the night and use only one pillow.” You can conclude that the patient likely has which of the following?
A. Orthopnea
B. Dyspnea
C. Obstructive sleep apnea
D. Increased work of breathing

10. A patient that is having an asthma attack arrives to the emergency room in respiratory distress with diminished breath sounds. After continuous bronchodilator therapy, auscultation reveals wheezing. This change suggests which of the following?
A. The onset of pneumonia
B. The development of a pneumothorax
C. The improvement of air flow
D. The development of pulmonary edema

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11. While assessing a 51-year-old male patient, you note definitive use of the neck muscles during regular inspiration. Which of the following is this finding consistent with?
A. Pulmonary embolism
B. Myasthenia gravis
C. COPD
D. Orthopnea

12. You are called to collect a sputum sample on a patient in the ICU. Which of the characteristics of the sputum, when assessed at the bedside, should be documented in the patient’s chart?
A. The density
B. The viscosity
C. The DNA content
D. The surface tension

13. While palpating a patient’s radial artery to take the pulse, you note that it feels bounding and full. Which of the following conditions is most likely the cause of this finding?
A. Cardiovascular shock
B. Low cardiac output
C. Hypovolemia
D. Hypertension

14. Which of the following would you expect to see during inspiration to indicate normal diaphragm activity?
A. An inward motion of the abdomen
B. An outward motion of the abdomen
C. Supraclavicular retractions
D. Intercostal retractions

15. While palpating your patient’s radial artery for a 1-minute pulse check, you noticed 95 unevenly spaced beats with a decreased pulse strength during inspiration. Which of the following best describes this patient’s pulse?
A. Bounding pulse
B. Thready pulse
C. Pulsus alternans
D. Pulsus paradoxus

16. A female patient who was in a motor vehicle accident arrives to the emergency department with broken ribs. While palpitating the patient’s neck, crepitations were felt. What is most likely the cause of this finding?
A. The patient has a laryngeal tumor
B. The patient has a pneumothorax
C. Blood is in the back of the patient’s throat
D. The patient has aspirated a tooth

17. A 63-year-old male patient was just admitted to the ICU. While auscultating his lungs, you hear bronchial breath sounds over the right lower lobe. This would indicate which of the following?
A. Pneumothorax
B. Normal lungs
C. Pleural effusion in the patient’s right lower lobe
D. Consolidation in the patient’s right lower lobe

18. Which of the following is a disadvantage of using a pulse oximeter for monitoring the oxygenation status of a patient?
A. Pressure sores at the measuring site
B. False results leading to incorrect decisions
C. Electrical shock at the measuring site
D. Skin burns due to using incompatible probes

19. An unconscious patient arrives to the emergency room with an SpO2 of 95%. After re-checking with a CO-oximeter, it reveals that the patient’s SaO2 is 67%. Which of the following is most likely the cause of this discrepancy?
A. Opiate drug overdose
B. Diabetic ketoacidosis
C. Acute pulmonary edema
D. Carbon monoxide poisoning

20. In general, which of the following radiographic imaging procedures can be used to evaluate a patient’s arteries for abnormalities?
A. PET scan
B. V/Q scanning
C. Angiography
D. Standard radiography

21. While performing a routine chest percussion, you noticed that a 57-year-old male patient has a flat percussion note. Which of the following does this finding indicate?
A. Pneumonia
B. Pneumothorax
C. COPD
D. Atelectasis

22. While performing a 12-lead EKG on a patient, you are unable to obtain an electrical reading. The device is fully charged and working properly. Which of the following is the most likely cause of this problem?
A. Motion artifact
B. Improper filtering
C. A missing lead
D. The patient has too much adipose tissue

23. Which of the following would be your primary reasoning for selecting a high flow nasal cannula system for an adult patient?
A. To provide CPAP therapy
B. To increase the inspired humidity
C. To washout anatomic deadspace
D. To assure the delivery of a stable or fixed FiO2

24. A patient was admitted to the ICU with a severe case of influenza. Before entering the patient’s rooms, in addition to standard precautions, what else must be used?
A. Droplet precautions
B. Universal precautions
C. Contact precautions
D. Airborne precautions

25. While assessing a female patient’s breathing pattern, you see that her tidal volumes go from small to large to small and then stop for 10 seconds before starting again. Which of the following would best describe this breathing pattern?
A. Cheyne-stokes breathing
B. Kussmaul breathing
C. Obstructed expiration
D. Eupnea

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26. While auscultating a 42-year-old male patient, you hear a grating sound on both inspiration and expiration. The patient has been complaining of pain over his lungs. Which of the following is the most likely cause of this problem?
A. Bronchoconstriction
B. Secretions in the airways
C. Pleural friction rub
D. Exacerbation of COPD

27. A nurse calls you to assess a 23-year-old male patient with a severe head cold that is receiving oxygen via nasal cannula at 4 L/min. The patient is complaining that he can’t breathe through his nose. The pulse oximeter reveals that his oxygen saturation is at 83%. Which of the following actions should you take at this time?
A. Increase the oxygen flow until the SpO2 equals or exceeds 90%
B. Decrease the oxygen flow until the patient is more comfortable
C. Change to a simple mask
D. Recommend an ABG before considering any changes

28. A 69-year-old female patient in the ICU is positioned with her head and body raised 45 degrees above her legs. Upon assessment, you note that she has distended external jugular veins. Which of the following is the most likely cause of this finding?
A. The patient is fluid-overloaded
B. The patient is dehydrated
C. The patient has hypertension
D. The patient has emphysema

29. You are called to give a patient an SVN breathing treatment with albuterol for wheezing. While obtaining the patient’s pre-treatment vital signs, her heart rate is 84 beats/min with a respiratory rate of 18 breaths/min. Three minutes into the treatment, the patient’s heart rate climbs to 133 beats/min and her respiratory rate increased to 23 breaths/min. Which of the following actions should you take in this situation?
A. Continue the treatment as ordered to completion
B. Switch to arformoterol (Brovana) and continue the treatment
C. Increase the patient’s FiO2
D. Stop the treatment, monitor the patient, and notify the physician

30. You have a patient that is receiving scheduled aerosol treatments with albuterol every four hours. The patient does not take breathing treatments at home and has no history of smoking. Upon assessment, you note clear breath sounds that are equal bilaterally. Which of the following would you recommend for this patient?
A. Continue the treatments as ordered
B. Discontinue the aerosol treatments
C. Perform postural drainage and percussion
D. Switch to an MDI with albuterol

31. While assessing a 58-year-old female patient that is receiving volume controlled A/C ventilation, you notice that her peak pressure has increased by 10 cm H2O over the last hour while her plateau pressure has not changed. The patient has significant wheezing in both lungs that was not present earlier. Which of the following would you recommend for this patient?
A. Suction the patient’s airway
B. Nebulize a bronchodilator
C. Nebulize a corticosteroid
D. Increasing the tidal by 50 mL

32. A patient that is receiving ventilatory support has a white blood cell count of 17,000/mm3 and a temperature of 102 °F. The patient’s secretions are yellow and have gotten thicker over the past 24 hours. Which of the following would you suggest at this time?
A. Decrease the humidifier temperature
B. Administer an aerosolized bronchodilator
C. Schedule suctioning twice per hour
D. Obtain a sputum sample for culture and sensitivity

33. A 61-year-old female patient has arrived to the emergency department and is complaining of chest tightness with radiating left shoulder pain. Which of the following would you recommend for this patient?
A. Obtain a stat chest X-ray
B. Provide 100% oxygen
C. Administer an albuterol treatment
D. Obtain an ABG sample

34. A 59-year-old female patient has arrived to the emergency department in respiratory distress due to severe hypoxemia. She would most likely exhibit all of the following signs except?
A. Diaphoresis
B. Cyanosis
C. Bradycardia
D. Tachypnea

35. While assessing 50-year-old male patient, you notice that his trachea is not positioned in the midline. Which of the following conditions would be the most likely cause of this finding?
A. Lobar collapse
B. Pulmonary edema
C. Pulmonary fibrosis
D. Chronic bronchitis

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Final Thoughts

As previously mentioned, patient assessment is the process of gathering information about a patient’s condition in order to deliver the best treatment for their needs.

It’s important for respiratory therapists (and students) to have a strong understanding of this topic.

This guide has provided you with some sample TMC practice questions on patient assessment to help you prepare for the NBRC licensure exam.

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!

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.