Respiratory pharmacology is the study of the effects of drugs on the lungs and pulmonary system. Respiratory therapists are required to know which drugs should be administered to patients with certain respiratory diseases.

This means that respiratory therapy students must develop a strong understanding of pharmacology.

In this guide, we’ve listed some sample TMC practice questions on the topic of airway pharmacology. 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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Pharmacology Sample TMC Practice Questions:

1. A 34-year-old female patient just arrived to the emergency room and the nurse is unable to start an intravenous line during CPR. The doctor wants to administer Naloxone because it is believed that the patient is suffering from a narcotic overdose. Which of the following is an appropriate alternative route of administration?
A. Through the feeding tube
B. Aerosolized via SVN
C. Through the nasogastric tube
D. Through the endotracheal tube

2. A 50-year-old male patient was just admitted for asthma. After obtaining the patient’s medication history, which of the following would you consider least important?
A. Self-administration techniques
B. Frequency of rescue inhaler usage
C. Use of generic vs. brand name medications
D. Patient understanding of controllers vs. relievers

3. An infant with severe RSV has just been admitted. The physician has ordered ribavirin (Virazole) to be administered by aerosol. Which of the following devices would you recommend in this situation?
A. Small particle aerosol generator
B. Small volume jet nebulizer
C. Vibrating mesh nebulizer
D. Dry powder inhaler

4. Which of the following would not be recommended for a critically ill patient with signs and symptoms of fluid overload?
A. The initiation of diuretic therapy
B. The administration of corticosteroids
C. The administration of dialysis for renal failure
D. The restriction and close monitoring of fluid intake

5. You are called to administer aerosolized albuterol to a 38-year-old patient. Which of the following side effects would you expect to see?
A. Hypotension
B. Bradycardia
C. Bronchospasm
D. Shaking and tremors

6. A 19-year-old male just arrived to the emergency room with bilateral expiratory wheezing. Which of the following treatments would you recommend?
A. Aerosolized cromolyn sodium
B. Aerosolized bronchodilator
C. Aerosolized normal saline solution
D. IV furosemide (Lasix)

7. You are called to provide a STAT bronchodilator treatment for a male patient that is having a severe asthma attack. While confirming the physician’s written order, you are not sure if the note says “5 mL of Albuterol” or “0.5 mL of Albuterol.” The prescribing doctor is busy overseeing a code and is unable to respond. What action should you take?
A. Have the nurse review the note and clarify the order
B. Cross out the prohibited notations and initial and date the changes
C. Wait until the physician is done with the code so that you can clarify the improper notation and the correct order
D. Administer the treatment using the standard albuterol dosage of 0.5 mL and clarify the order as soon as possible thereafter

8. A male patient arrives to the emergency department in excruciating pain after a motor vehicle accident. The patient is screaming and appears to have multiple broken bones in his legs. Which of the following medications would you recommend for sedation?
A. Ibuprofen
B. Ipratropium bromide
C. Morphine sulfate
D. Succinylcholine

9. A patient with fluid overload was just given a dose of furosemide via IV. Afterwards, the patient displayed an arrhythmia on the EKG that was not there before the dose was given. Which of the following would you recommend at this time?
A. Defibrillate the patient
B. Administer another dose of furosemide
C. Administer a dose of epinephrine
D. Check the patient’s potassium level

10. While monitoring a 67-year-old patient that is receiving volume controlled SIMV, you note that the patient has bilateral wheezes upon auscultation with an increased peak pressure. Which of the following would be appropriate for this patient?
A. Suction the patient’s airway
B. Order a stat chest X-ray
C. Check the cuff pressure
D. Administer their prescribed bronchodilators

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11. The physician has ordered a dry powder inhaler for a patient that is being discharged. The patient has never used an inhaler before. Which of the following instructions is correct for using a dry powder inhaler?
A. Blow slowly into the device
B. Hold the device vertically after loading
C. Inhale rapidly for 1-2 seconds
D. Breathe normally in and out of the device

12. A 26-year-old female patient has arrived to the emergency room with signs of status asthmaticus. Which of the following drugs would you recommend for administration via nebulization?
A. Albuterol
B. Montelukast
C. Beclomethasone
D. Magnesium sulfate

13. A 54-year-old male patient who was just extubated is complaining of a sore throat. Inspiratory stridor can be heard on auscultation. Which of the following drugs would you recommend in order to treat this problem?
A. Levalbuterol
B. Isoetharine
C. Racemic Epinephrine
D. Acetylcysteine

14. An 11-year-old boy has just arrived in the ER with cystic fibrosis and a pulmonary infection. Upon assessment, you note very thick secretions. Which of the following drugs would you recommend for this patient?
A. Nebulized acetylcysteine
B. Nebulized dornase alpha
C. Nebulized 0.9% saline
D. Direct instillation of acetylcysteine into the lungs

15. You are called to administer a nebulized albuterol treatment to a 47-year-old female patient that is receiving oxygen via binasal cannula at 2 L/min. Her pretreatment heart rate was recorded at 84 beats/min. You would stop the treatment if the patient’s heart rate were to reach which of the following:
A. 89 beats/min
B. 99 beats/min
C. 109 beats/min
D. 119 beats/min

16. A COPD patient is being discharged and the doctor wants to prescribe a controller-type bronchodilator for home use. Which of the following would you recommend?
A. Albuterol
B. Levalbuterol
C. Metaproterenol
D. Brovana

17. A 55-year-old patient that is receiving aerosol therapy with 0.9% saline is unable to produce an acceptable volume of sputum for a sample. Which of the following would you recommend at this time?
A. Initiate chest physiotherapy
B. Administer the aerosol continuously
C. Change to hypertonic saline
D. Perform nasotracheal suctioning

18. You are called to instruct an 8-year-old girl with asthma on how to use an albuterol metered dose inhaler. Which of the following can be done in order to increase the deposition of the bronchodilator?
A. Add a spacer or holding chamber to the MDI
B. Remove the mouthpiece from the MDI
C. Have the child inhale as quickly as possible
D. Switch from an MDI to a DPI

19. A male patient was just prescribed an inhaled corticosteroid via MDI for two puffs twice a day. In order to decrease the likelihood of an oral infection, which of the following would you recommend that the patient do?
A. Receive concurrent bronchodilator therapy
B. Be prescribed an appropriate antibiotic
C. Decrease the frequency to once per day
D. Rinse his mouth and gargle with water after inhalation

20. The physician has ordered acetylcysteine for a COPD patient with a large amount of secretions. Upon assessment, you noticed that the patient has an inadequate cough. Which of the following would you recommend?
A. Perform a bronchoalveolar lavage
B. Nasotracheal suctioning after treatment
C. Postpone therapy until the patient can cough effectively
D. Give dornase alpha instead of acetylcysteine

21. While administering an aerosolized albuterol breathing treatment to a 61-year-old patient, you should be on guard for which of the following adverse effects?
A. Tachycardia
B. Bradycardia
C. Vagovagal reflex
D. Laryngospasm

22. You are called to administer acetylcysteine to a 66-year-old female patient. This drug can be helpful in treating which of the following conditions?
A. Bronchospasm
B. Mucous plugs
C. Pleural effusion
D. Pulmonary hypertension

23. A 15-year-old male patient has been diagnosed with asthma and you are called to recommend medications to help prevent future asthma attacks. All of the following drugs would be helpful EXCEPT:
A. Cromolyn sodium
B. Zafirlukast
C. Epinephrine
D. Zileuton

24. While assessing a 72-year-old postoperative patient, you noted distinct wheezing in both lung fields. Which of the following would you recommend for this condition?
A. Give the patient a bronchodilator
B. Administer incentive spirometry
C. Giver the patient a mucolytic agent
D. Administer chest physiotherapy

25. You have just administered a routine breathing treatment with albuterol via small volume nebulizer. Which of the following is the best documentation that must be added to the patient’s chart?
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 via SVN; heart rate of 74 beats/min during therapy; B.P. stable at 120/80; respiratory rate 16/min; therapy well tolerated; chest clear on auscultation

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26. The physician ordered 2.5 mL ipratropium bromide TID for a 70-year-old female COPD patient with bronchospasm. Which of the following methods would you use in order to deliver this medication?
A. Dry powder inhaler
B. Ultrasonic nebulizer with mask
C. Small volume nebulizer with mask
D. Small volume nebulizer with mouthpiece

27. The doctor ordered a metered-dose inhaler bronchodilator for a 59-year-old female patient that is receiving mechanical ventilation. You should do which of the following in order to maximize aerosol deposition?
A. Place the MDI directly in-line on the expiratory side of the circuit
B. Place the MDI directly in-line on the inspiratory side of the circuit
C. Recommend that a small volume nebulizer be used instead of an MDI
D. Place the MDI plus a spacer in-line on the inspiratory side of the circuit

28. You are called to give an aerosolized breathing treatment with albuterol to a 41-year-old male patient. If the patient’s heart rate were to increase during the treatment, that would be a result of which of the following?
A. Alpha only
B. Beta 1 only
C. Beta 2 only
D. Beta 1 and Beta 2

29. Which of the following side effects can be expected after the administration of aerosolized epinephrine?
A. Laryngospasm
B. Bronchospasm
C. Tachycardia
D. Bradycardia

30. A 22-year-old female patient has just arrived to the emergency department with acute bronchospasm. Which of the following medications would you recommend?
A. Albuterol (Proventil)
B. Racemic epinephrine
C. Cromolyn sodium (lntal)
D. Acetylcysteine (Mucomyst)

31. While administering an adrenergic aerosol bronchodilator treatment to an adult female patient, you notice an increase in her pulse rate from 81 beats/min to 125 beats/min after two minutes. Which of the following actions should you take?
A. Use half of the standard dosage next time
B. Add more diluent to the nebulizer chamber
C. Temporarily stop the treatment until the patient’s heart rate decreases
D. Stop the treatment and notify the physician

32. A 51-year-old male patient with asthma has been prescribed an albuterol breathing treatment via small volume nebulizer. Before initiating the therapy, you note from the chart that the patient is severely hypertensive and has been experiencing episodes of supraventricular tachycardia. Which of the following actions should you take at this time?
A. Provide acetylcysteine instead of albuterol
B. Dilute the albuterol with extra normal saline
C. Postpone the treatment and consult the physician
D. Administer the treatment as ordered

33. A patient in the ICU is receiving mechanical ventilation but appears to be breathing asynchronously with the ventilator. Which of the following medications would you recommend?
A. Fluoxetine (Prozac)
B. Midazolam (Versed)
C. Dextroamphetamine (Dexedrine)
D. Cisatracurium (Nimbex)

34. A patient has arrived to the emergency department with an apparent opiate narcotic overdose. The doctor asks for your recommendation to help reverse the effects of the narcotic and enable the patient’s breathing to return to normal. Which of the following medications would you recommend?
A. Naloxone (Narcan)
B. Fentanyl (Sublimaze)
C. Indomethacin (Indocin)
D. Vecuronium (Norcuron)

35. A 64-year-old male patient is receiving an aerosol treatment with acetylcysteine and hypertonic saline via a small volume nebulizer. After only a few minutes, the patient suddenly becomes dyspneic. Which of the following is the most likely cause of this problem?
A. Hypercapnia
B. Pneumothorax
C. Fluid overload
D. Bronchospasm

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Final Thoughts

As previously mentioned, respiratory pharmacology is the study of the effects of drugs on the lungs and pulmonary system. It is important for respiratory therapists to have a strong understanding of pharmacology so that they can administer the appropriate drugs to patients in respiratory distress.

This guide has provided you with some sample TMC practice questions on airway pharmacology 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!

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

Disclosure: The links to the textbooks are affiliate links which means, at no additional cost to you, we will earn a commission if you click through and make a purchase.

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.