A registered respiratory therapist (RRT) is an RT that has obtained the high-level credential granted by the NBRC. This is the highest standard requirement a respiratory therapist needs to apply for a license to practice respiratory care.
The first step in earning the RRT credential involves passing the TMC exam with a high-cut score. This will reward you with the certified respiratory therapist (CRT) credential and make you eligible to take the clinical simulations exam (CSE).
Upon successful completion of the CSE, you will be awarded the registered respiratory therapist (RRT) credential.
This guide has sample practice questions for the TMC Exam. Hopefully, they can help you pass with the high-cut score, which will award you with both the CRT and RRT credentials.
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, you can download them for FREE using the link below.
RRT Practice Questions for the TMC Exam:
1. A 150-lb (IBW) patient has a tidal volume of 500 ml and a ventilatory rate of 12 breaths/minute. Calculate the patient’s alveolar minute ventilation.
A. 1.8 liters/minute
B. 4.2 liters/minute
C. 2.3 liters/minute
D. 6.0 liters/minute
2. A 164-lb patient has a measured tidal volume of 600 ml and is breathing 18 times per minute. What is the estimated alveolar minute ventilation for this patient?
A. 7848 ml
B. 6920 ml
C. 5965 ml
D. 4130 ml
3. A 40-year-old patient is recovering from ARDS is receiving mechanical ventilation with a tidal volume of 650 ml. The patient has a pulmonary artery catheter and capnometry for monitoring. The following information is collected; PaCO2 – 43 torr, PaO2 – 79 torr, PvO2 – 32 torr, and PeCO2 – 22 torr. Calculate the patient’s Vd (physiologic dead space volume).
A. 273 ml
B. 317 ml
C. 338 ml
D. 384 ml
4. A 55-year-old man was admitted to the hospital for shortness of breath. The following results were obtained: PaCO2 = 50 mmHg, PECO2 = 30 mmHg and tidal volume of 600 ml. What is the patient’s physiologic deadspace (Vd)?
A. 150 ml
B. 175 ml
C. 240 ml
D. 310 ml
5. A 70 kg patient receiving mechanical ventilation has a tidal volume of 900 ml, frequency of 12, PIP of 45 and PEEP of 10. When an inspiratory hold plateau of .5 sec is activated, the static pressure is 35 cmH2O. Determine the patient’s static compliance.
A. 36.18 ml/cmH2O
B. 30.48 ml/cmH2O
C. 22.65 ml/cmH2O
D. 15.72 ml/cmH2O
6. A 70 kg patient receiving mechanical ventilation has a tidal volume of 900 ml, frequency of 12, PIP of 45 and PEEP of 10. When an inspiratory hold plateau of .5 sec is activated, the static pressure is 35 cmH2O. Determine the patient’s dynamic compliance.
A. 15.21 ml/cmH2O
B. 25.71 ml/cmH2O
C. 29.46 ml/cmH2O
D. 32.09 ml/cmH2O
7. Reviewing the chart of a newly admitted patient, the respiratory therapist finds that the patient has COPD, a 70 pack year smoking history, and was admitted for dyspnea. The patient is unresponsive and has a BP of 180/100 mm Hg and a respiratory rate of 40/min. Which of the following should the therapist review next?
A. Chest radiograph report
8. A patient complains of the following symptoms:
Excessive daytime fatigue
Headaches upon awakening
Decreased ability to concentrate
Which of the following test is appropriate for this patient?
B. Pre and post-bronchodilator study
C. Sleep study with overnight pulse oximetry
D. Bronchoprovocation testing
9. A patient receiving mechanical ventilation with the following settings:
PIP 55 cmH2O
PEEP 10 cmH2O
Peak inspiratory flow rate: 60 L/min
Tidal volume: 800 ml
Plateau pressure: 35 cm H2O
Calculate the airway resistance for this patient:
A. 10 cmH2O/L/sec
B. 20 cmH2O/L/sec
C. 30 cmH2O/L/sec
D. 40 cmH2O/L/sec
10. A patient suspect of having carbon monoxide poisoning presents to the ER. CO-oximeter results reveal the following:
17.5 g total HB
4.7 g COHb
1.0 g MetHb
Based on this information, the patient’s saturation of arterial blood should be:
11. A patient who is on a volume ventilator has the following measurements: corrected tidal volume = 780 ml, peak airway pressure = 55 cmH2O, plateau pressure = 35 cmH20, and PEEP of 10 cmH2O. What is the dynamic compliance?
A. 17.3 ml/cmH2O
B. 22.3 ml/cmH2O
C. 14.2 ml/cmH2O
D. 31.2 ml/cmH2O
12. All of the following are methods to reduce auto-PEEP EXCEPT:
A. Decreasing the inspiratory time
B. Decreasing the tidal volume
C. Increasing the flow rate
D. Increasing the rate
13. Calculate the estimated airway resistance of a patient whose peak airway pressure is 25 cmH2O, plateau pressure of 10 cmH2O, and ventilator flow rate is set at 60 L/min.
A. 15 cmH2O/L/sec, normal
B. 15 cmH2O/L/sec, abnormal
C. 10 cmH2O/L/sec, normal
D. 10 cmH2O/L/sec, abnormal
14. Calculate the alveolar oxygen tension (PAO2) given the following values: PB = 750 mmHg, FiO2 – 30%, and PaCO2 – 40.
A. 100 mmHg
B. 130 mmHg
C. 161 mmHg
D. 190 mmHg
15. Exhaled volumes are collected from a patient over a 1-minute interval; during this time, it is determined that the average tidal volume is 714 ml with a total minute ventilation of 10 L. What is the patient’s frequency?
A. 10 breaths per minute
B. 14 breaths per minute
C. 18 breaths per minute
D. 24 breaths per minute
16. Given the data below, calculate the patient’s dead space/tidal volume ratio:
PaO2 75 torr
PaCO2 49 torr
PeCO2 32 torr
17. Given the following values for room air: PAO2 – 105 mmHg, PaO2 – 70 mmHg, what is the P(A-a)O2? Is it normal?
A. 70 mmHg; normal
B. 70 mmHg; abnormal
C. 35 mmHg; normal
D. 35 mmHg; abnormal
18. Given the following ventilation parameters; corrected tidal volume of 700 ml, plateau pressure of 30 cmH2O, peak inspiratory pressure of 50 cmH2O, and 10 cmH2O PEEP, calculate the patient’s static lung compliance.
A. 20 ml/cm H2O
B. 35 ml/cm HO
C. 15 ml/cm H2O
D. 23 ml/cm H2O
19. Given the following measurements: Spontaneous tidal volume = 247 ml/min, spontaneous respiratory rate = 17/min. What is the calculated RSBI? Does the RSBI indicate a successful outcome when weaning?
A. 24 breaths/min/L, yes
B. 24 breaths/min/L, no
C. 69 breaths/min/L, yes
D. 69 breaths/min/l, no
20. Heavy smokers commonly have HbCO levels as high as:
B. 96.0 L
C. 96.0 ml
D. 960 ml
22. If a patient weighing 140 lbs has a tidal volume of 400 and a ventilatory frequency of 14 breaths/minute what is the patient’s minute ventilation?
A. 5.6 L
B. 560 ml
C. 56.0 L
D. 4.0 L
23. If a patient’s PaO2 is 540 mmHg and PAO2 is calculated to be 642 mmHg, what is the alveolar-arterial oxygen tension difference? The patient is on 100% FiO2.
A. 102 mmHg
B. 540 mmHg
C. 320 mmHg
D. 265 mmHg
24. The RRT is asked to evaluate the results of a diagnostic sleep study. Which of the following guidelines would the RRT use to determine the existence of sleep apnea?
A. Three or more apneic episodes per hour, each lasting at least 6 seconds
B. Five or more apneic episodes per hour, each lasting at least 10 seconds
C. Five or more apneic episodes per hour, each lasting at least 3 seconds
D. Eight or more apneic episodes per hour, each lasting at least 8 seconds
25. Which of the following devices should be used to effectively deliver a 70% helium/ 30% oxygen mixture to a patient?
A. Simple mask
B. Oxygen hood
C. Nasal cannula
D. Nonrebreathing mask
26. The spontaneous minute ventilation and respiratory rate of a mechanically ventilated patient are 6.2 L/in and 30/min. Calculate the average spontaneous tidal volume and the RSBI. Does the calculated RSBI indicate a successful weaning outcome?
A. Spontaneous Vt = .207 L; RSBI = 90/breaths/min/L; Yes
B. Spontaneous Vt = .207 L; RSBI = 145 breaths/min/L; No
C. Spontaneous Vt = .319 L; RSBI = 90 breaths/min/L; Yes
D. Spontaneous Vt = .319; RSBI = 137 breaths/min/L; No
27. When a volume-limited ventilator is used, the peak airway pressure is directly related to the:
A. Patient’s airway resistance
B. Patient’s lung compliance
C. Respiratory rate
28. When a volume-limited ventilator is used, the plateau (lung) pressure is directly related to the:
A. Patient’s airway resistance
B. Patient’s lung compliance
C. Respiratory rate
29. The respiratory therapist is participating in the resuscitation of a patient. After 5 minutes of CPR, the ECG shows ventricular fibrillation. Attempted defibrillation with 200 joules has been ineffective. The therapist’s next recommendation should be to:
A. Perform a precordial thump.
B. Perform endotracheal intubation.
C. Implement cardioversion with 300 joules.
D. Implement defibrillation with 300 joules.
30. A patient being mechanically ventilated is intubated with an 8mm endotracheal tube. While suctioning the patient with a 12 Fr catheter after pre-oxygenation, the respiratory therapist notes the patient shows bradycardia, and the oxygen saturation decreases. The therapist should recommend changing to a:
A. 10 mm catheter.
B. Closed-suction system.
C. 14 Fr whistle-tip catheter.
D. Suctioning frequency of q4h.
31. While using continuous apnea monitoring for infants, the low heart rate should be set to alarm if the heart rate decreases to _____ and an apneic period of _____ seconds occurs.
A. 80, 5 subglottic
B. 80, 10
C. 130, 30
D. 100, 20
32. You just finished analyzing an arterial blood sample in the laboratory and the co-oximeter shows total hemoglobin of 15 grams/100ml with a carboxyhemoglobin of 2 grams and methemoglobin of 2 grams. The amount of functional hemoglobin in this sample would be _____ grams.
33. Given the following results: PB = 760 mmHg, FiO2 = 70%, and PaCO2 = 40 mmHg. What is the calculated alveolar oxygen tension (PAO2)?
A. 449 mmHg
B. 370 mmHg
C. 100 mmHg
D. 268 mmHg
34. After obtaining an arterial blood example from a patient’s artery, the respiratory therapist notes a purple subcutaneous wheal developing at the puncture site. Which of the following would be the FIRST action to take?
A. Perform an Allen’s test.
B. Immediately notify the nurse.
C. Apply pressure to the puncture site.
D. Recommend subcutaneous epinephrine at the site.
35. You are monitoring a mechanically ventilated patient with ARDS in the SIMV mode. At 7:00 am the following is noted; PIP of 30 cmH2O and Plateau pressure of 25 cmH2O. At your next check, you note that the PIP is now 42 cmH2O and Plateau is 30 cmH2O. What action would you recommend?
A. Change to pressure control mode
B. Suction the patient’s airway
C. Continue SIMV mode and reduce the tidal volume
D. Recommend that a bronchodilator be administered
36. A 34 week gestational age infant is receiving mechanical ventilation and the chest is being transilluminated. The transillumination device produces a small halo appearance at the point of contact with the skin. This indicates which of the following?
D. Normal lung appearance
37. A patient with an oral endotracheal tube is being suctioned using 80 mm Hg suction pressure. As suction is applied to the catheter, secretions enter the catheter, but do not advance more than 3cm. The respiratory therapist should:
A. Increase suction pressure.
B. Instill saline down the suction catheter.
C. Instruct the patient to cough during suctioning.
D. Apply intermittent suction pressure to the catheter.
38. It is determined that a patient has a tidal volume of 750 ml and a respiratory rate of 16. What is the patient’s minute ventilation?
A. 12 L
B. 11.2 L
C. 9.75 L
D. 7.5 L
39. The respiratory therapist is suctioning a mechanically ventilated patient q4h with a 12 Fr suction catheter. The patient has a 7.0 mm oral endotracheal tube in place. The amount of secretions seems to be increasing. Which of the following is the most appropriate action?
A. Suction more frequently.
B. Use a Coude suction catheter.
C. Use a size 14 Fr suction catheter.
D. Increase the suction pressure to-150mm Hg.
40. During the initial assessment of a patient with a closed-head injury, the patient only opens his eyes in response to pain. On a follow-up examination, the patient opens his eyes to verbal commands. These observations indicate which of the following?
A. The level of consciousness is increased.
B. Intracranial pressure has increased.
C. Cerebral perfusion has decreased.
D. Seizure activity is increased.
41. Increased dynamic compliance and stable static compliance would indicate:
A. A problem in the airway
B. Stiff lung tissue due to atelectasis
C. A pneumothorax
D. Patient has developed pulmonary edema
42. A mechanically ventilated patient has previously had both increased peak and plateau pressures. The next ventilator check reveals a decrease in both peak and plateau pressures. What does this indicate about the patient’s lung characteristics?
A. Dynamic and static compliance have improved
B. Dynamic and static compliance have worsened
C. Only dynamic compliance has improved
D. Only static lung compliance has improved
43. The respiratory therapist performs an assessment prior to initiating aerosol and chest physiotherapy. During the interview, the patient states, “I seem to breath fast and lift my shoulders a lot, but I feel like I am getting enough air. I sleep through the night and only use one pillow.” The therapist can conclude that the patient likely has:
C. Increased work of breathing
D. A decreased level of consciousness
44. A COPD patient is being cared for via home health visits. A RCP visits the patient and determines that the patient is losing muscle mass and weight. Which of the following recommendations should the RCP make to this patient to prevent further muscle wasting?
A. Eat several small meals a day
B. Eat only when you feel hungry
C. Wear your nasal cannula at 2 lpm while you eat
D. Lift heavy weights at the gym
45. A RCP is assessing a patient with chronic bronchitis. The patient states that his secretions are thick and pale yellow in color. The RCP would chart this finding as:
46. A RCP is called to assess a patient with chest pain. Auscultation reveals a pleural friction rub. The patient has been hospitalized for 2 days and has shown no improvement. The RCP should consider which of the following as possible diagnosis for this patient?
A. The patient has developed pleurisy
B. The patient is experiencing angina pectoris
C. The patient has broken ribs
D. The patient has developed an area of atelectasis
47. A loud, continuous, high-pitched sound heard during auscultation of the larynx and trachea is called:
48. A near-drowning patient is brought to the ER. The RCP is asked to assist in assessing the patient for immediate care. A neurological assessment is performed. It is determined that during pain stimulus the patient opens his eyes and exhibits limb extension to painful stimuli. The patient responds with inappropriate word usage. According to this information, what Glasgow coma scale score should be assigned to the patient?
49. When an oropharyngeal suction device becomes obstructed while suctioning vomitus from a patient’s mouth, the respiratory therapist should:
A. Increase the vacuum pressure.
B. Change to a suction catheter.
C. Clear the device of particulate matter.
D. Check the wall outlet vacuum pressure.
50. An afebrile patient who has been ventilated with a volume ventilator with a heat moisture exchanger for the past 24 hours is having progressive increases in peak inspiratory pressure. After suctioning the trachea and determining there is no pathological reason for the increased pressure, the respiratory therapist should do which of the following?
A. Reduce the tidal volume.
B. Change the flow pattern of the ventilator.
C. Replace the heat moisture exchanger.
D. Increase the heat moisture exchanger temperature.
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A. Operator error
B. Pigmentation of the patient’s skin
C. Presence of increased COHb
D. Oximeter out of calibration
52. A 21-year-old man arrives at the emergency department (ED) after being rescued from a house fire. Physical examination reveals burns on the upper chest and face, and marked edema of the face and oropharynx. The results of an arterial blood gas example drawn while the patient was breathing room air are below:
pH – 7.55
PaCO2 – 26 torr
PaO2 – 105 torr
HCO3 – 22 mEq/L
BE – 0 mEq/l
The respiratory therapist is reviewing a postoperative patient’s care plan. The physician has changed the patient’s therapy from incentive spirometry to IPPB. What is the most likely goal, for this change?
A. Delivery of aerosolized bronchodilators.
B. Improvement in alveolar oxygenation.
C. Prevention of lower lobe atelectasis.
D. Promotion of airway clearance.
53. Which of the following humidifiers would most consistently deliver the highest water vapor to a patient’s airway?
C. Heated wick
D. Heat moisture exchanger
54. A physician orders an FiO2 of 0.40 for a premature infant in an Isolette. To deliver the prescribed FiO2 the respiratory therapist should select:
A. A 40% air entrainment mask.
B. An oxygen hood
C. An infant nasal cannula at 1 L/min
D. A simple mask at 4 L/min
55. A 7-day-old infant of 28 weeks gestational age is having frequent periods of apnea, with desaturation. The respiratory therapist should recommend which of the following?
A. Racemic epinephrine (Vaponefrin)
B. Naloxone (Narcan)
C. Surfactant (Survanta)
D. Theophylline (Aminophylline)
56. A conscious, spontaneously breathing patient is admitted to the emergency department (ED) with suspected carbon monoxide poisoning. The respiratory therapist’s most appropriate INITIAL action would be to:
A. Perform an arterial blood gas analysis.
B. Intubate and apply CPAP with 50% oxygen.
C. Administer oxygen by a 40% air-entrainment mask.
D. Administer 100% oxygen by a nonrebreathing mask.
57. A patient presents in the emergency department (ED) with massive facial trauma involving the nose and mouth. Which of the following is most appropriate for managing the patient’s airway?
A. Nasotracheal tube
B. Tracheostomy tube
C. Oral endotracheal tube
D. Laryngeal mask airway
58. Which of the following allows immediate determination of the lowest FiO2 needed to achieve satisfactory oxygenation?
A. Capillary refill
B. Pulse oximetry
C. Nail bed color
D. Shunt studies
59. The pressure control knob on a pressure-cycled ventilator will determine the:
A. Pressure at which inspiration ends.
B. Gradient from the artificial airway to the alveoli.
C. Effort required to initiate gas flow.
D. Pressure required to activate the pop-off mechanism.
60. An 18-year-old patient who is having a severe asthmatic episode is being mechanically ventilated. The pressure limit alarm is frequently sounding. The patient is very agitated, and his respiratory rate is 36/min. Bilateral breath sounds with minimal wheezing are noted. Which of the following should the respiratory therapist recommend?
A. Midazolam (Versed)
B. Beclomethasone (Vanceril)
C. N-acetylcysteine (Mucomyst)
D. Cromolyn (Intal)
61. All of the following are true concerning the use of a transcutaneous PO2 monitor EXCEPT:
A. A low calibration point is done with a “zero” solution or gas.
B. The site should be changed every 3 to 4 hours.
C. Skin temperature control should be set at 37C.
D. PtcO2 values should be correlated with arterial blood samples periodically.
62. The respiratory therapist is working with a patient with COPD who is in a smoking cessation program. The patient complains of irritability, anxiety, difficulty concentrating, craving for tobacco, and weight gain. The therapist should recommend which of the following?
A. Using a sedative
B. Using nicotine patches
C. Returning to smoke, but only half as much as previously
D. Continuing the program because these complaints are expected
63. A patient with neuromuscular disease has been receiving ventilatory support for 4 months by tracheostomy. The patient is being weaned during the day, but is still mechanically ventilated at night. Which of the following devices will best meet both needs of the patient?
A. Tracheostomy button
B. Bivona tracheostomy tube
C. Cuffed, fenestrated tracheostomy tube
D. Uncuffed, standard tracheostomy tube
64. When performing simple spirometry, which of the following results would best denote an obstructive pattern?
A. Decreased FEV1/FVC Ratio
B. Increased FEV1
C. Increased tidal volume
D. Decreased inspiratory reserve volume
65. During the weaning trial of a patient with a tracheostomy, the mist disappears at the T-piece early in inspiratory respiratory therapist should do which of the following?
A. Add dead space between the T-Piece and the patient.
B. Direct the patient to inhale more slowly.
C. Decrease the length of tubing from the aerosol generator.
D. Increase the flow the aerosol generator.
66. Moist, crepitant crackles indicate which of the following?
A. Pulmonary edema
C. Pleural effusion
67. Which of the following would be most important to assess a patient’s ability to perform metered dose inhaler (MDI) therapy?
A. Ability to follow instructions
B. Overall general appearance
C. Adequacy of oxygenation
D. Exercise tolerance
68. While administering acetylcysteine (Mucomyst) with a hand-held nebulizer, the respiratory therapist notes that the patient is developing marked congestion with copious sputum production. The therapist’s most appropriate action would be to:
A. Dilute the acetylcysteine with saline.
B. Terminate the therapy and clear secretions.
C. Increase the dose of acetylcysteine to help thin the secretions.
D. Administer the acetylcysteine with a positive pressure breathing machine
69. The addition of an inspiratory plateau during continuous mechanical ventilation may be CONTRAINDICATED in patients with:
C. Poor gas distribution
D. Pulmonary edema
70. When the respiratory therapist initiates an IPPB treatment, the patient’s pulse is 80/min. Five minutes after the therapy is started, the patient’s pulse increases to 95/min. The therapist should:
A. Continue the treatment as ordered
B. Terminate the treatment and notify the charge nurse
C. Decreases the nebulizer output
D. Decrease the system pressure
71. During manual bag-valve ventilation by an endotracheal tube, inadequate ventilation is noted. This may be caused by which of the following:
I. Deflated endotracheal tube cuff
II. Excessive oxygen flow
III. Absent bag-valve diaphragm
IV. Improper tube placement
A. I and II only
B. I and III only
C. I, III and IV only
D. II, III, and IV only
72. The respiratory therapist is assisting the physician with a tracheostomy on a patient who is receiving mechanical ventilation. The therapist notes an increase in peak respiratory pressure and heart rate, a decrease in exhaled tidal volume, and distant breath sounds over the right chest. This most likely indicates a:
A. Circuit air leak
B. Right pneumothorax
C. Lacerated blood vessel
D. Unilateral intubation
73. A 13-month-old infant is apneic and cyanotic. The physician asks the respiratory therapist to prepare a tray for oral intubation. The therapist should select all of the following equipment EXCEPT:
A. Magill forceps
B. A Macintosh (curved) laryngoscope blade.
C. A Miller (straight) laryngoscope blade
D. A Yankauer suction tube
74. Which of the following is the most appropriate radiograph techniques to confirm the presence of free pleural fluid?
B. Apical projection
C. Decubitus projection
D. Oblique projection
75. The most common complication associated with the placement of a pulmonary artery catheter is:
A. Myocardial infarction
B. Pulmonary artery rupture
C. Pulmonary thrombosis
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A. Minute ventilation is greater than 15 L/min
B. Heating element is not functioning
C. Flow is set too low
D. Room temperature is lower than normal
77. Which of the following drugs would be most appropriate to recommend as a substitute for metaproterenol sulfate (Alupent) for a patient who has bronchospasm and whose cardiac rate increases by 60/beats/min with each treatment?
A. Acetylcysteine (Mucomyst)
B. Beclomethasone (Vanceril)
C. Racemic epinephrine (Vaponephrin)
D. Albuterol (Proventil)
78. The respiratory therapist is explaining the objectives of a pulmonary rehabilitation program to a 55-year-old patient with emphysema. Which of the following outcomes would allow the patient to participate in evaluating the achievement of the therapeutic plan?
A. Reduction of airway resistance
B. Improvement in arterial blood gas values
C. Improvement in results of pulmonary function studies
D. Increased ability to perform activities of daily living
79. When administering an IPPB treatment with a pressure-cycled ventilator, the respiratory therapist observes that the patient’s tidal volume is adequate, but the inspiratory time is too long. To correct this situation, the therapist should:
A. Increase the flow
B. Increase the pressure
C. Adjust the sensitivity
D. Decrease the nebulizer flow
80. A patient is receiving oxygen by a nonrebreathing mask at 8 L/min. The respiratory therapist notices that the reservoir bag on the mask empties during inspiration. The therapist should immediately:
A. Change the partial rebreathing mask
B. Remove the mask
C. Increase the flow
D. Intubate the patient
81. A patient with an endotracheal tube in place is receiving oxygen enrichment by a heated all-purpose nebulizer. Water is collecting in the delivery hose. The respiratory therapist should:
A. Reduce the oxygen flow
B. Drain the tubing frequently
C. Unplug the theater
D. Position the tubing so that the condensate drains back into the reservoir
82. The patient with a head injury is being mechanically ventilated at a rate of 18 /min. The delivered tidal volume is 900 mL. The patient’s current arterial blood gas results are below:
pH – 7.50
PaCO2 – 28 torr
PaO2 – 90 torr
HCO3 – 21 mEq/L
BE – -1 mEq/L
The most appropriate recommendation for this patient would be to:
A. Maintain the present settings
B. Decrease the ventilator rate
C. Decrease the tidal volume
D. Add mechanical dead space
83. At an FiO2 of 0.30 a pulse oximeter attached to the right index finger or a 6-week old neonate displays an SaO2 of 87% and a pulse of 64/min. A heart monitor reads a simultaneous heart rate of 120/min. Which of the following would be the most appropriate action?
A. Suction the neonate
B. Increase the FiO2 to 0.40
C Reposition the pulse oximeter
D. Ventilate the neonate with 100% 02
84. A patient complains of sudden, right-sided chest pain. Breath sounds are absent over the right lung field and percussion reveals hyperresonance. The respiratory therapist should recommend:
A. Placing the patient on her right side and administering chest percussion.
B. Initiating mechanical ventilation in the assist/control mode.
C. Administering an IPPB treatment with a bronchodilator.
D. Inserting a chest tube on the right side.
85. The respiratory therapist is asked to assess a patient with sleep apnea who is receiving CPAP by a nasal mask. The patient’s snoring is becoming progressively louder with longer periods of apnea. The therapist should initially do which of the following?
A. Obtain a blood gas sample
B. Decrease the gas flow
C. Reposition the nasal mask
D. Perform an ECG
86. A patient who is receiving mechanical ventilation requires an FiO2 of 0.70 and a PEEP of 10cm H2O to maintain an acceptable PaO2. The patient has become disconnected from the ventilator several times while trying to remove her restraints. During each period of disconnection, the patient experiences cardiac rhythm disturbances, which require additional treatment. The respiratory therapist should recommend:
A. Sedating the patient
B. Decreasing the PEEP level
C. Extubating the patient and using a rebreathing mask.
D. Attempting to wean the patient with a T-piece with an FiO2 of 0.80
87. The aerosol from an ultrasonic nebulizer is being produced in short, rapid puffs. To correct the problem, the respiratory therapist should:
A. Reduce the volume of water in the reservoir.
B. Increase the blower flow
C. Clear the water from the delivery tube
D. Replace the corrugated tubing with smooth bore tubing
88. A 90 kg (198 lb) patient remains intubated in the post-anesthesia care unit (PACU) following abdominal surgery. The patient has no fully awakened from the anesthesia, although he is taking a few spontaneous breaths. The patient is currently being ventilated with a manual resuscitator. Which of the following should the therapist do?
A. Continue manual ventilation until the patient is awake.
B. Initiate 5 cm H2O CPAP.
C. Initiate mechanical ventilation in the SIMV mode
D. Initiate mechanical ventilation in the pressure support mode
89. A 1-week old neonate with RDS currently receiving 10 cm H2O CPAP through nasal sprongs with an FiO2 of 0.60. Evaluation reveals intercostal and sternal retractions and an SpO2 of 88%. The neonate is breathing at a rate of 68/min. Which of the following should the respiratory therapist recommend?
A. Change to mask CPAP
B. Institute mechanical ventilation
C. Make no changes at the present time
D. Increase the CPAC level to 12cm H2O
90. Reinserting a flow meter into an oxygen wall outlet has failed to correct a massive gas leak in a patient’s room. Which of the following should be done NEXT?
A. Check the pressure relief valve on the humidifier reservoir.
B. Evacuate the patients from the floor.
C. Have engineering shut off the hospital’s master oxygen valve.
D. Provide necessary supplemental oxygen and close the zone valve.
91. While administering an IPPB treatment, the respiratory therapist notices that the pressure rises slowly toward the set pressure, but reaches the set pressure only when the patient actively exhales. Which of the following is the most likely explanation?
A. The inspiratory flow is too high.
B. The nebulizer driveline is kinked.
C. There is a leak in the expiratory valve.
D. The expiratory valve sticks before opening.
92. The administration of aerosolized acetylcysteine (Mucomyst) would be most appropriate for the treatment of which of the following?
A. Pulmonary thermal injury
C. Humidity deficit
D. Mucus plugs
93. A 25-year-old patient is brought to the emergency department (ED) with respiratory depression caused by an acute drug overdose. An arterial blood gas analysis indicates a pH of 7.20 and a PaCO2 of 80 torr. The respiratory therapist is asked to initiate continuous mechanical ventilation. Which of the following should the therapist do?
A. Recommend IPPB treatments q2h to reduce the patient’s PaCO2.
B. Adjust the ventilators so that the patient’s PaCO2 will be decreased to 40 torr very gradually over 36 hours.
C. Adjust the ventilator so that the patient’s PaCO2 will be decreased to 40 torr within 1 hour.
D. Adjust the ventilator so that the patient’s PaCO2 will be decreased to 60 torr to prevent respiratory alkalosis.
94. A neonate is receiving pressure limited, time cycled mechanical ventilation. The PaO2 decreases from 65 to 50 torr and the physician request an increase in mean airway pressure. The respiratory therapist should recommend increasing the:
I. Inspiratory time
II. Pressure limit
III. Expiratory time
A. I only
B. III only
C. I and II only
D. II and III only
95. When a Yankauer device becomes obstructed while suctioning vomitus from a patient’s mouth, the respiratory therapist should first:
A. Increase the vacuum pressure
B. Change to a suction catheter
C. Clear the device of particulate matter
D. Change the collection bottle
96. 60 year old, 68 kg (150 lb) woman arrives in the ICU after coronary bypass surgery. She has a 54 pack year history of smoking and currently smokes 2 packs a day. An order is written to initiate mechanical ventilation. Which of the following should the respiratory therapist adjust prior to initiating mechanical ventilation for the patient?
I. Respiratory rate
II. Expiratory resistance
III. Oxygen concentration
IV. Tidal volume
V. Sighs per hour
A. I and II only
B. III and V only
C. I, III and IV only
D. II, IV, and V only
97. The respiratory therapist is reviewing a postoperative patient’s care plan. The physician has changed the patient’s therapy from incentive spirometry to IPPB. What is the most likely goal, for this change?
A. Delivery of aerosolized bronchodilators.
B. Improvement in alveolar oxygenation.
C. Prevention of lower lobe atelectasis.
D. Promotion of airway clearance.
98. An ultrasonic nebulizer, though showing aerosol in the chamber, is not delivering any aerosol to the patient. The most likely cause is:
A. The electrical cord is disconnected.
B. There is insufficient fluid in the cup.
C. The amplitude and frequency need adjustment.
D. The fan moving air through the chamber is not functioning.
99. A patient is receiving an IPPB treatment by mask. The desired preset pressure is not being achieved. The respiratory therapist should:
A. Increase the flow
B. Decrease the pressure
C. Decrease the terminal flow
D. Increase the sensitivity
100. A beta-adrenergic bronchodilator has been administered to a 56-year-old male patient. All of the following are side effects associated with this drug except:
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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.
The following are the sources that were used while doing research for this article:
- Faarc, Kacmarek Robert PhD Rrt, et al. Egan’s Fundamentals of Respiratory Care. 12th ed., Mosby, 2020.
- Chang, David. Clinical Application of Mechanical Ventilation. 4th ed., Cengage Learning, 2013.
- Rrt, Cairo J. PhD. Pilbeam’s Mechanical Ventilation: Physiological and Clinical Applications. 7th ed., Mosby, 2019.
- Faarc, Cairo J. PhD Rrt. Mosby’s Respiratory Care Equipment. 10th ed., Mosby, 2017.
- Faarc, Gardenhire Douglas EdD Rrt-Nps. Rau’s Respiratory Care Pharmacology. 10th ed., Mosby, 2019.
- Faarc, Heuer Al PhD Mba Rrt Rpft. Wilkins’ Clinical Assessment in Respiratory Care. 8th ed., Mosby, 2017.
- Cardiopulmonary Anatomy & Physiology: Essentials of Respiratory Care
- Rrt, Des Terry Jardins MEd, and Burton George Md Facp Fccp Faarc. Clinical Manifestations and Assessment of Respiratory Disease. 8th ed., Mosby, 2019.
- Faarc, Mottram Carl Ba Rrt Rpft. Ruppel’s Manual of Pulmonary Function Testing. 11th ed., Mosby, 2017.
- Faarc, Walsh Brian Rrt-Nps Accs. 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.