Here lately, I’ve had several students who were interested in our TMC Test Bank, but didn’t quite know what to expect. So below, we’ve listed out few TMC Practice Questions just to give you a sample of what’s inside.
For those of you who don’t know, our TMC Test Bank is our MASSIVE bank of practice questions for the TMC Exam. It contains over 1000 practice questions, answers, and detailed rationales that give in-depth explanations as to why the answer is correct.
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It’s our job (and #1 goal) to help Respiratory Therapy Students pass the board exams. And one of the best strategies that students are using is going through practice questions exactly like the ones that are on the exam.
That is exactly why we created this article that you’re reading now — to show you just how valuable our practice questions can be.
So go ahead and read through the TMC Practice Questions that are listed for you below. Be sure to watch the videos as well.
But I’ll be honest with you.
This only scratches the surface of what’s inside! So if you’re ready, let’s go ahead and dive right in.
Sample TMC Practice Questions:
1. You are called to examine an acutely dyspneic and hypotensive patient and you note the following: reduced chest expansion on the left side, hyperresonant percussion note and tactile fremitus on the left side, absent breath sounds on the left side, and a tracheal shift to the right. What 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
By assessing this patient, you can quickly determine that the correct answer is a left-sided pneumothorax.
The unilateral findings of reduced chest expansion, a hyperresonant percussion note, absent breath sounds and tactile fremitus all on the left side. That to go along with a tracheal shift to the right — this indicates that the patient has most likely suffered a large pneumothorax on the left side.
Remember, for a pneumothorax, the trachea will shift away from the affected side. You can rule out left-sided atelectasis because the trachea would shift to that side. And also, if the pneumothorax is severe enough, it can disrupt cardiac function which can cause the blood pressure to decrease. That explains why this patient is hypotensive.
The correct answer is: B. Pneumothorax on the left side
2. 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
Based on the information provided, we can easily figure out that D is the correct answer.
The likely problem is some type of bacterial pneumonia because it tells us that the patient has fever and chills. That is why you would want to obtain a sputum sample.
Antibiotics and oxygen therapy would be the proper initial treatment in this case, and the sputum sample is needed to help identify the type of organism.
Intubation nor NPPV is indicated in this case. And postural drainage and percussion are not recommended either. So we know that there can only be one correct answers, and it’s D.
The correct answer is: D. Provide oxygen therapy, give an antibiotic, and obtain a sputum sample for Culture and Sensitivity
3. 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
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
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4. While making a routine equipment check, you hear the patient’s bubble humidifier is making a whistling noise. Which of the following is the most likely cause of this problem?
A. There is an obstruction in the delivery tube
B. There is a rise in the patient’s ventilation
C. There is a clogged system diffuser
D. The wall outlet pressure is set too high
If you’ve ever accidentally stepped on the tubing when a bubble humidifier is being used, then you will automatically know that the correct answer is A.
The relief valve of a humidifier sounds when the pressure in the reservoir container exceeds the valve’s threshold pressure. And of course, the most common reason for this to occur is when there is a downstream obstruction to outflow.
Flowmeter restriction prevents high wall outlet pressures from affecting the pressure in the humidifier because it is limited at 50 psig. Changes in patient ventilation would have no effect on the pressure in the humidifier. So we know that there can only be one correct answer and it’s A.
The correct answer is: A. There is an obstruction in the delivery tube
5. A forced expiratory measurement obtained after the administration of a bronchodilator shows an increase in the patient’s FEV1 from 60% to 80% of the predicted value. What does this indicate?
A. A fixed airway obstruction
B. A reversible airway obstruction
C. A normal diffusion capacity
D. A restrictive process
As you can see, the patient’s airway obstruction was relieved because the FEV1 increased from 60% to 80% of the predicted value. But was it enough to classify it as a reversible obstruction?
In order to achieve clinical significance, the post-bronchodilator results of an FVC, FEV1 or FEV1/FVC% should be at least 12-15% greater than the pre-bronchodilator value.
So in this case, there was a 20% increase, which means — yes — the increase was enough and this indicates that there is a reversible airway obstruction.
We can rule out all of the other answer choices because we know that the correct answer has to be B.
The correct answer is: B. A reversible airway obstruction
6. You are called to assess an intubated patient that is breathing asynchronously with the ventilator. Her breath sounds are absent on the left, with dullness to percussion and a left shift of the trachea. Which of the following is the most likely explanation of the problem?
A. A tracheoesophageal fistula has developed
B. A tension pneumothorax has developed on the left side
C. The endotracheal tube is in the right mainstem bronchus
D. The patient is experiencing diffuse bronchospasm
This is a question that we can determine the correct answer right away by looking at the information that they give us in the question.
It states that the patient has a dull percussion note on the left side, tracheal shift toward the left side, and absent breath sounds on the left side. These are all signs of atelectasis!
So now you have to think, “What would cause atelectasis?” In this instance, slippage of the endotracheal tube into the right mainstem bronchus would be the most likely cause left-sided atelectasis.
Diffuse bronchospasm would cause bilateral wheezing and a left-sided pneumothorax would cause a hyperresonant percussion note, not a dull percussion note. So we know that there can only be one correct answer, and it’s C.
The correct answer is: C. The endotracheal tube is in the right mainstem bronchus
7. A 63-year-old female patient is receiving pressure controlled A/C mechanical ventilation. Which of the following changes would occur if her compliance were to decrease?
A. Her delivered volume will decrease
B. Her peak pressure will increase
C. Her inspiratory time will increase
D. Her PEEP level will decrease
To get this one correct, you must have an understanding of lung compliance. You also have to take into account that the ventilator is in the pressure control mode, which means that the pressure is preset.
If there is a decrease in lung compliance when the ventilator is operating in the pressure control mode, the machine will continue delivering a constant pressure. But, since the lungs don’t expand as much when there is decreased compliance, it reaches the set pressure limit much faster. That means that there will be a decreased tidal volume.
In this case, the inspiratory time will decrease and the PEEP levels should not be affected. The correct answer has to be A.
The correct answer is: A. Her delivered volume will decrease
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8. You are called to assess a patient on the ventilator that is currently in volume control mode. After performing endotracheal suctioning, which of the following would indicate effective clearance of retained secretions?
A. A smaller tidal volume
B. A decreased inspiratory time
C. A lower plateau pressure
D. A lower peak pressure
Generally, you should remember that retained secretions will increase the patient’s airway resistance and peak airway pressure during volume control ventilation.
So taking that into consideration, the effective clearance of secretions via suctioning should effectively decrease the patient’s peak airway pressure.
On the other hand, if the patient had been receiving pressure control ventilation, you would expect an increase in delivered volume once secretions are cleared.
None of the other answer choices make sense in this situation, so you know that the correct answer has to be D.
The correct answer is: D. A lower peak pressure
9. 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, and decreased breath sounds and hyperresonance on the left. Which of the following would you recommend?
B. A bronchoscopy
C. The insertion of a chest tube
D. A thoracentesis
For this one, you have to be able to interpret the patient’s signs that were given in the question.
All of the physical assessment signs detected here are consistent with a tension pneumothorax.
Remember, patients with a pneumothorax will typically show tracheal deviation away from the affected side. They will also show decreased breath sounds and hyperresonance on the affected side as well.
So in the case of a tension pneumothorax, the patient requires the immediate insertion of a chest tube on the affected side. That means we know the correct answer has to be C.
The correct answer is: C. The insertion of a chest tube
10. 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
Once you begin working as a Respiratory Therapist, this is something you will run into far too often. A nurse or new physician will hear wheezing and automatically request for the RT to provide a breathing treatment for the patient.
It’s frustrating because wheezing in CHF is usually due to fluid overload or edema, and not due to bronchospasm.
So in general, acute pulmonary edema is best managed with a diuretic such as Lasix. Oxygen therapy may be indicated as well for hypoxemia. And BiPAP may also be indicated in some cases.
We can rule out the other answer choices and determine that the best answer in this case is D.
The correct answer is: D. Recommend a diuretic and oxygen therapy
So there you have it! Thank you so much for reading all the way to the end. I truly hope that these sample TMC Practice Questions were helpful for you.
If so, definitely consider getting access to our TMC Test Bank. Like many other student, you can instantly boost your chances of passing the exam just by going through our premium practice questions.
Thanks again for reading and as always, breathe easy my friend. 🙂
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