List of Example TMC Exam Practice Questions

List of 99 Example TMC Exam Practice Questions (2023)

by | Updated: Sep 18, 2023

Are you preparing for the TMC Exam? If so, did you know that using practice questions is one of the most effective preparation strategies?

That is why, in this article, we provided ninety-nine sample practice questions like the ones that will be on the actual TMC Exam. The questions cover a wide range of topics that the NBRC expects you to know.

Note: We purposefully did not include the correct answers so you can quiz yourself and test your knowledge. However, you can access them for free by clicking the button below.

You can download the answers to these practice questions instantly for FREE.

Example TMC Exam Practice Questions:

1. Within one second after initiating a forced vital capacity (FVC) maneuver, a patient with normal lungs should be able to exhale what percent of the FVC?
A. 35-50% of the FVC
B. 50-70% of the FVC
C. 70-83% of the FVC
D. 84-93% of the FVC

2. Simple spirometry CANNOT be used to measure the
A. vital capacity
B. residual volume
C. tidal volume
D. inspiratory reserve volume

3. Which of the following approaches can be used to obtain a medication history from a patient with a depressed level of consciousness or who is severely agitated?
A. obtain and review the patient’s past medical history
B. ask the patient’s nurse about the patient’s prescriptions
C. request that the lab run a comprehensive blood drug screen
D. obtain the patient’s current prescription vials from the family

4. Which of the following thoracic ultrasound findings is consistent with the presence of a pneumothorax?
A. presence of gliding sign
B. absence of A-lines
C. presence of barcode sign
D. presence of seashore sign

5. Which of the following would tend to increase insensible water loss?
A. hypothermia
B. bypassed upper airway
C. hypoventilation
D. diuretic administration

6. Which of the following would tend to decrease a patient’s energy expenditure?
A. hypothermia
B. inflammation
C. major trauma
D. agitation/pain

7. A patient has acute respiratory acidosis. You would expect the base excess (BE) to range between:
A. + 6 mEq/L
B. – 6 mEq/L
C. +/- 2 mEq/L
D. +/- 8 mEq/L

8. Which of the following arterial blood gas results would most likely be reported for a patient who is having a mild asthma attack?
A. pH = 7.31 PCO2 = 50 torr PO2 = 60 torr
B. pH = 7.40 PCO2 = 50 torr PO2 = 50 torr
C. pH = 7.47 PCO2 = 32 torr PO2 = 60 torr
D. pH = 7.47 PCO2 = 40 torr PO2 = 50 torr

9. The Apgar score for a normal newborn infant ranges between
A. 1-4
B. 4-7
C. 7-10
D. 10-13

10. On inspection of a patient’s ECG strip, you note no identifiable P waves; rapid irregular undulations of the isoelectric line; and an irregular ventricular rhythm. In addition, the precordial cardiac rate is greater than the peripheral pulse rate. The most likely problem is:
A. 2nd degree (Wenckebach) heart block
B. ventricular fibrillation
C. atrial fibrillation
D. ventricular tachycardia

11. In inspecting an elderly female patient, you note that her spine has an abnormal anterposterior (AP) curvature. Which of the following terms would you use in charting this observation?
A. kyphosis
B. scoliosis
C. kyphoscoliosis
D. pectus excavatum

12. During auscultation of a patient’s chest, you hear intermittent “bubbling” sounds at the lung bases. Which of the following chart entries best describe this finding?
A. “bronchial sounds heard at lung bases”
B. “wheezes heard at lung bases”
C. “rhonchi heard at lung bases”
D. “crackles (rales) heard at lung bases”

13. While assessing a patient’s radial pulse, you note that the pulse feels full and bounding. Which of the following conditions would be the most probable cause of this finding?
A. hypovolemia
B. hypertension
C. cardiovascular shock
D. low cardiac output

14. A patient is cachexic, exhibits generalized edema and dry skin, and appears listless. The most likely problem is:
A. heart failure
B. Addison’s disease
C. renal failure
D. malnutrition

15. Prior to giving an aerosol treatment, you find a note in the chart that states your patient had pink frothy secretions on admission to the ED. This is most indicative of:
A. cor pulmonale
B. left ventricular failure
C. an electrolyte imbalance
D. ARDS

16. A doctor orders a changeover to CPAP for a patient receiving bi-level positive airway pressure (BiPAP) via a device with separate IPAP and EPAP controls. To effect this change you would:
A. set IPAP less than EPAP
B. set IPAP greater than EPAP
C. set EPAP = 0 cmH2O
D. set IPAP equal to EPAP

17. How would you characterize the degree of dyspnea of a patient who walks slower than people of the same age because of breathlessness?
A. slight
B. moderate
C. severe
D. very severe

18. Upon exam of an acutely dyspneic and hypotensive patient, you note the following – all on the left side of the chest: reduced chest expansion, hyperresonance to percussion, absent of breath sounds and tactile fremitus, and a tracheal shift to the right. These findings suggest:
A. left-sided pneumothorax
B. left-sided consolidation
C. left lobar obstruction/atelectasis
D. left-sided pleural effusion

19. A patient’s response to an interview question is initially vague or unclear. Which of the following responses on your part would be most appropriate?
A. “Please go on”
B. “You seem to be anxious”
C. “I see why you are so upset”
D. “Please explain that to me again”

20. A patient is asked to inhale as deeply as possible and blow out all his air as hard as they can until empty. What test is being performed?
A. FVC
B. IC
C. TLC
D. MVV

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21. When a patient is receiving positive-pressure ventilation, you should strive to keep the alveolar (plateau) airway pressure below:
A. 20 cmH2O
B. 30 cmH2O
C. 40 cmH2O
D. 50 cmH2O

22. On inspection of an ECG rhythm strip from an adult patient, you note the following: rate of 150; regular rhythm; normal P waves, P-R intervals, and QRS complexes. The most likely problem is:
A. atrial flutter
B. sinus tachycardia
C. ventricular tachycardia
D. atrial fibrillation

23. On inspection of a 12-lead ECG, you note the absence of P waves and a variable R-R interval (> 0.12 sec). Which of the following is the most likely problem?
A. atrial hypertrophy
B. first-degree heart block
C. atrial fibrillation
D. sinus arrhythmia

24. What percent decrease in FEV1 needs to occur to conclude that a methacholine challenge is positive for airway hyperreactivity?
A. 10%
B. 15%
C. 20%
D. 25%

25. A patient is receiving ventilatory support after thoracic surgery. You measure the patient’s maximum inspiratory pressure (MIP/NIF) as -33 cmH2O. Based on this value, the patient has:
A. a need for continued ventilatory support
B. a large leak in their endotracheal tube cuff
C. a normal maximum inspiratory pressure
D. adequate muscle strength to consider weaning

26. During a single-breath capnogram, the sharp downstroke and return to baseline that normally occurs after the end-tidal point indicates:
A. exhalation of mainly deadspace gas
B. inspiration of fresh respiratory gas
C. exhalation of mixed alveolar/deadspace gas
D. exhalation of mainly alveolar gas

27. A patient is considered as having sufficient respiratory muscle strength to maintain adequate ventilation and prevent secretion retention when the maximum inspiratory pressure (MIP; NIF) is more negative than:
A. -5 cmH2O
B. -10 cmH2O
C. -15 cmH2O
D. -20 cmH2O

28. Over a 3 hour period, the plateau pressure of a patient receiving volume controlled ventilation has remained stable, but her peak pressure has been steadily increasing. Which of the following is the best explanation for this observation?
A. the patient’s airway resistance has increased
B. the patient is developing atelectasis
C. the patient’s compliance has decreased
D. the patient is developing pulmonary edema

29. On inspection of an adult patient’s 12-lead ECG, you note a regular R-R interval of 0.40 sec, with no other apparent abnormalities. Which of the following is the most likely problem?
A. ventricular tachycardia
B. sinus bradycardia
C. atrial fibrillation
D. sinus tachycardia

30. Under ideal conditions, pulse oximeter readings patients usually fall with what percent of those obtained via invasive hemoximetry?
A. ±1-2%
B. ±2-3%
C. ±3-5%
D. ±5-7%

31. Prior to intubation in an emergency, injection of air into the pilot line fails to inflate the cuff. You should:
A. check the cuff for leaks
B. check the valve on the pilot line
C. replace the endotracheal tube
D. inspect the pilot line for patency

32. A 15-year-old with cystic fibrosis is receiving pressure control SIMV with pressure support due to a severe bilateral pneumonia. The pulmonologist asks you to administer aerosolized dornase alfa (Pulmozyme, DNase) in-line with the ventilator. Which of these devices would you select to administer this therapy?
A. dry powder inhaler (DPI)
B. vibrating mesh nebulizer
C. metered dose inhaler (MPI)
D. small volume nebulizer

33. Which of the following conditions will cause a DECREASE in the FIO2 delivered to a patient receiving oxygen at 4 L/min via a nasal cannula?
A. decrease in patient inspiratory flow
B. increase in patient inspiratory time
C. increase in patient minute ventilation
D. decrease in patient tidal volume

34. You notice that a disposable nebulizer is delivering large water droplets down the large bore tube. To correct this problem, you should:
A. add a heating collar to the nebulizer
B. replace the nebulizer
C. add water to the nebulizer
D. dismantle and clean the nebulizer

35. Shortly after you replace a jet nebulizer and tubing on a patient who has a tracheostomy, the SpO2 drops from 98% to 90%. Aerosol is visible throughout inspiration and expiration in the tracheostomy collar. Which of the following should you do first to resolve the situation?
A. Decrease the input flow to the nebulizer
B. Ask the patient to breath slower and deeper
C. Check the entrainment setting on the nebulizer
D. Obtain an arterial blood gas sample for analysis

36. Which of the following would you expect to occur AFTER an unheated bubble diffusion humidifier is set-up and operating?
A. the reservoir will be warmer than room temperature
B. the reservoir will be cooler than room temperature
C. the reservoir temperature will equal room temperature
D. water will condense on the inside of the delivery tubing

37. During computerized setup of a ventilator, you are prompted to enter a circuit compliance factor. This information is needed to:
A. calibrate the flow sensors
B. complete the automated leak test
C. calibrate the pressure transducer
D. compensate for compressed volume loss

38. A bubble humidifier is connected to a flowmeter set and running at 5 L/min. When you obstruct the outlet of the small-bore delivery tubing, the pressure pop-off does NOT sound. Which of the following is the most likely cause of this observation?
A. excessive flow through the humidifier
B. a leak in the humidifier/delivery system
C. diameter of delivery tubing is too small
D. the flowmeter is not pressure compensated

39. Which of the following analyzers would you select if your objective were to continuously measure changes in the FIO2 in a ventilator circuit with the fastest possible response time?
A. physical (paramagnetic) analyzer
B. thermal conductivity analyzer
C. galvanic fuel cell analyzer
D. polarographic (Clark) analyzer

40. To maximize the duration of flow/runtime outside the home, liquid portable O2 systems:
A. hold about three liters of liquid oxygen
B. can be refilled from a liquid O2 base unit
C. incorporate a pulse-dose delivery system
D. include a battery-powered contents indicator

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41. You run a control solution through a blood gas analyzer as part of daily quality control. The measured high PO2 value is 9 torr outside of the acceptable range. Prior runs were all in range. You should:
A. report results after compensating for the deviation
B. replace the PO2 electrode and recalibrate the analyzer
C. analyze another control solution for comparison
D. perform a two-point calibration and rerun the control

42. Which of the following is true regarding calibration of exhaled nitric oxide (NO) gas analyzers?
A. inlet flows should mimic breathing (variable flow/pressure)
B. daily 2-point (zero/high %NO) calibration is required
C. room air can be used as the ‘zero’ calibrating gas
D. daily 1-point using a standardized NO% is sufficient

43. When reviewing statistical quality control data on a blood gas analyzer, you note a single pH measurement among 30 that falls below the ± 2 SD “in control” standard for your lab. Which of the following is the most likely cause of this error?
A. statistical probability/chance
B. contaminated buffer solutions
C. incorrect analysis procedures
D. failure of the pH electrode

44. You are analyzing quality control samples on a blood gas analyzer as part of a routine quality control program. Multiple but not successive PCO2 values fall above and below the two standard deviation limit. You should:
A. record the results as an acceptable
B. record the results as an acceptable after correcting for the difference in measurements
C. record the results as an acceptable if they are within +/- 2 SD of the mean
D. perform a two-point calibration and reanalyze the control sample

45. Which of the following blood gas quality control procedures is designed to assure that the output of the analyzer is both accurate and linear across the range of measured values?
A. statistical quality control.
B. performance validation
C. control media verification
D. automated calibration

46. When calibrating a portable computerized spirometer, its volume readings consistently fall outside the ± 3% range. Which of the following is the most likely cause of this problem?
A. flow sensor misassembled or damaged
B. failure to remove bacterial filter before calibration
C. flow sensor tubing not connected to computer
D. incorrect selection of prediction equations

47. When reviewing statistical quality control data on a blood gas analyzer, you note a single PCO2 measurement among 30 that falls below the ± 2 SD “in control” standard for your lab. Which of the following is the most likely cause of this error?
A. contamination of the sample
B. incorrect calibrating gas %
C. incorrect analysis procedures
D. failure of the PCO2 electrode

48. Which blood gas analysis/hemoximetry quality control procedure involves plotting the results of control media analyses on a graph and comparing these plots against derived range limits?
A. machine calibration
B. statistical quality control
C. preventive maintenance
D. control media verification

49. The reference procedure used to establish accuracy for blood PO2 and PCO2 measurements is:
A. hemolysis
B. manometry
C. equilibration
D. tonometry

50. Which of the following can cause a hemoximeter’s HbO2 reading to be falsely low?
A. dirty analysis chamber
B. high fetal Hb levels
C. elevated bilirubin levels
D. sickle-cell anemia

51. When suctioning an adult patient using a DISS wall-mounted regulator system with collection bottle, you would initially set the vacuum pressure at:
A. -12 to -15 in Hg
B. -80 to -100 mm Hg
C. -5 to -7 in Hg
D. -100 to -120 mm Hg

52. In which of the following clinical situations would a patient benefit most from deep breathing exercises?
A. myasthenic crisis
B. postop cholecystectomy
C. exacerbation of COPD
D. status asthmatics

53. What size suction catheter would you select to suction a patient with a 9.0 mm ID tracheostomy tube?
A. 10 Fr
B. 12 Fr
C. 14 Fr
D. 16 Fr

54. During postural drainage therapy, a patient’s heart rate remains stable at 92/min and the SpO2 is 97%. However, after you pre-oxygenate the patient and begin nasotracheal suctioning, the patient’s heart rate suddenly drops to 40/min. The most likely reason for this is:
A. severe mucus plugging
B. hypoxemia during suctioning
C. a vago-vagal reflex
D. postural hypotension

55. If tolerated, a specified postural drainage position should be maintained for at least:
A. 3-5 minutes
B. 5-10 minutes
C. 10-20 minutes
D. 20-30 minutes

56. You are about to suction an infant who has a 3.0 mm (ID) endotracheal tube in place. What is the MAXIMUM size catheter you would use in this case?
A. 6 Fr
B. 8 Fr
C. 5 Fr
D. 10 Fr

57. If a patient’s chest X-ray shows infiltrates in the posterior segments of the lower lobes, postural drainage should be performed in which of the following positions?
A. head down, patient prone with a pillow under her abdomen
B. head down, patient supine with a pillow under her knees
C. patient prone with a pillow under her head, bed flat
D. patient supine with a pillow under her knees, bed flat

58. To increase a patient’s maximum expiratory flow when using a cough assist or mechanical in-exsufflation (MI-E) device, you would:
A. increase the inspiratory time
B. decrease the expiratory pressure
C. increase the expiratory time
D. increase the inspiratory pressure

59. Postural drainage would best be indicated for a patient with:
A. pleural effusion
B. asthma
C. pneumonia
D. cystic fibrosis

60. In discussing the goals of IPPB therapy with a postoperative patient, which of the following explanations would be most appropriate?
A. “This will prevent pneumonitis.”
B. “This will help you take deep breaths.”
C. “This will prevent atelectasis.”
D. “This will increase your intrathoracic pressure.”

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61. A patient who is receiving an aerosol treatment with acetylcysteine (Mucomyst) and hypertonic saline via a SVN suddenly becomes dyspneic. The most likely cause of this problem is:
A. hypercapnia
B. bronchospasm
C. pneumothorax
D. fluid overload

62. A physician orders a 70% He/30% O2 mixture to be delivered to a patient having an acute asthmatic attack. Which of the following systems would be most appropriate to deliver this mixture?
A. nebulizer set at 100% oxygen with aerosol mask
B. tight-fitting nonrebreathing mask with competent valving
C. simple oxygen mask set to deliver 15 L/min oxygen
D. tight-fitting partial rebreathing mask at 12 L/min

63. A doctor orders aerosol therapy for a patient receiving mechanical ventilation who is being provided humidification with a heat and moisture exchanger (HME). To assure effective therapy you must:
A. place the aerosol device proximal to the HME in the stream of flow
B. remove the HME before aerosol therapy and replace it afterward
C. place the aerosol device distal to the HME in the stream of flow
D. switch from an HME to an active heated the humidification system

64. Which of the following is associated with the administration of aerosolized epinephrine?
A. tachycardia
B. bradycardia
C. laryngospasm
D. bronchospasm

65. After completing an aerosol drug treatment, which of the following is the most appropriate chart notation for you to make?
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; pulse stable at 72/min during therapy; B.P. stable at 120/80; respiratory rate 10/min; therapy well tolerated; chest clear on auscultation

66. A physician orders 2.5 mL ipratropium bromide (Atrovent) 0.2% TID for a COPD patient with recurrent bronchospasm. Which of the following methods would you use to deliver this drug?
A. small volume nebulizer with mask
B. ultrasonic nebulizer with mask
C. small volume nebulizer with mouthpiece
D. MDI

67. Which of the following describes the ventilatory pattern that is best suited for maximum aerosol deposition in the small airways?
A. slow inhalation, pause, slow exhalation
B. slow inhalation, pause, rapid exhalation
C. rapid inhalation, pause, slow exhalation
D. rapid inhalation, pause, rapid exhalation

68. A doctor orders a metered dose inhaler (MDI) bronchodilator for a patient receiving mechanical ventilation via a dual-limb breathing circuit. To maximize aerosol deposition, you would:
A. place the MDI directly in-line on the inspiratory side of the circuit
B. recommend that a small volume nebulizer be used instead of the MDI
C. place the MDI plus a spacer in-line on the inspiratory side of the circuit
D. place the MDI directly in-line on the expiratory side of the circuit

69. Which of the following patient instructions for using a dry powder inhaler (DPI) is correct?
A. hold the device vertically after loading
B. perform slow (3-4 sec) deep inhalation
C. exhale back into the device
D. seal lips tightly around the mouthpiece

70. An increase in a patient’s heart rate during aerosolized bronchodilator therapy is primarily a result of which of the following effects of the drug?
A. Alpha only
B. Beta 1 only
C. Beta 2 only
D. Beta 1 and Beta 2

71. A physician orders supplemental O2 for a patient via nasal cannula at a flow of 12 L/min. When you ask her what goal she has in mind, she states that she wants the patient to receive about 60% oxygen. Which of the following should you recommend?
A. that the cannula flow be set to 15 L/min instead of 12 L/min
B. that the O2 be given via a partial rebreathing mask at 10 L/min
C. that a nasal catheter at 12 L/min be used instead of the cannula
D. that the O2 be given via an air entrainment mask set at 60%

72. A patient whose asthma was well-controlled using a short-acting beta-agonist inhaler PRN and low dose inhaled corticosteroid BID reports that she recently has been experiencing shortness of breath almost daily and is awakened at night with wheezing episodes. Her pea flow, which had been 83% of her predicted normal is now at 66% of the predicted value. Which of the following would you recommend to the patient’s doctor as possible changes to the current drug regimen?
A. discontinue the short-acting beta agonist inhaler
B. add a leukotriene modifier to the regimen
C. switch the short-acting beta agonist from PRN to Q4H
D. switch from inhaled to oral corticosteroid therapy

73. In assessing a patient receiving ventilatory support, you note that her white blood cell count is 18,000/mm3 and her temperature is 102 °F. In addition, her secretions have become more tenacious and yellow over the past 24 hours. Which of the following would you suggest to the attending physician?
A. that her humidifier temperature be lowered to below 30 °C
B. that a regimen of aerosolized carbenicillin be started ASAP
C. that a sputum sample be obtained for culture and sensitivity
D. that the frequency of suctioning be increased to every half hour

74. A clinical condition characterized by a history of a productive cough for at least three months a year for two consecutive years best describes:
A. panlobular emphysema
B. status asthmaticus
C. centrilobular emphysema
D. chronic bronchitis

75. After bronchodilator therapy, you record the following PFT data on a 67 year old male COPD patient with chronic cough and sputum production: FEV1/FVC = 65%; FEV1 = 82% predicted. You would characterize the stage of the patient’s COPD as:
A. mild
B. moderate
C. severe
D. very severe

76. A doctor institutes volume control ventilation for a 70 kg ARDS patient with a targeted tidal volume of 420 mL. To maintain adequate ventilation with this tidal volume, you would allow a machine respiratory rate as high as:
A. 20/min
B. 25/min
C. 30/min
D. 35/min

77. Any sudden occurrence of pulmonary or cardiac distress in older, bed-ridden patients and those having undergone extensive abdominal or pelvic surgery suggest a diagnosis of:
A. coronary artery disease
B. pulmonary thromboembolism
C. anaphylactic shock
D. acute left ventricular failure

78. Which of the following is the most common indication for home CPAP therapy?
A. sleep apnea-hypopnea syndrome (SAHS)
B. bronchospasm associated with asthma
C. chronic hypoxemia
D. neuromuscular disorders

79. The doctor is concerned that his ARDS patient on pressure control ventilation has high plateau pressures (> 30 cmH2O) and that this may be causing further lung injury. Which of the following modes of ventilation would you consider as an alternative?
A. volume control ventilation
B. pressure support ventilation
C. airway pressure release ventilation
D. continuous positive airway pressure

80. Which of the following observations indicate that an infant’s work of breathing may be abnormally high?
A. palor
B. digital clubbing
C. acrocyanosis
D. nasal flaring

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81. The primary aim in treating cardiogenic pulmonary edema is to:
A. increase venous return to the heart
B. decrease right heart and systemic venous pressures
C. decrease left heart and pulmonary vascular pressures
D. increase pulmonary fluid and blood volume

82. What is the most common arrhythmia seen with pulmonary disease?
A. sinus bradycardia
B. sinus tachycardia
C. atrial fibrillation
D. ventricular tachycardia

83. The primary purpose of oxygen administration in the management of heart failure is to:
A. increase the force of ventricular contractions
B. decrease resistance to ventricular ejection
C. increase ventricular stroke volume
D. decrease the workload on the myocardium

84. A doctor institutes volume control ventilation for an 80 kg ARDS patient. Which of the following is the maximum pressure you would aim to achieve in this patient?
A. 50 cmH2O peak pressure
B. 30 cmH2O plateau pressure
C. 40 cmH2O peak pressure
D. 50 cmH2O plateau pressure

85. You would recommend against using noninvasive positive pressure ventilation (NPPV) for a patient with:
A. secretions requiring suctioning
B. the need for moderate sedation
C. facial burns or trauma
D. FIO2 needs greater than 40%

86. An alert patient with emphysema and an elevated CO2 level is given 50% O2 by an air entrainment mask. One hour later the nurse calls you to evaluate the patient. He is now very lethargic. Which of the following is the most likely cause of this?
A. respiratory muscle fatigue
B. cerebral hypoxia
C. hypotension
D. O2-induced hypoventilation

87. Which of the following is a key therapeutic objective in the management of a patient who has closed head trauma and is receiving ventilatory support?
A. increase the minute ventilation
B. increase intrathoracic pressure
C. assure patient-ventilator synchrony
D. decrease cerebral perfusion pressure

88. In individuals with disorders characterized by an increase in airway resistance, such as emphysema, which of the following breathing patterns results in the minimum work?
A. deep breathing
B. slow breathing
C. shallow breathing
D. rapid breathing

89. Which of the following is true regarding patients in the early stages of an asthmatic attack?
A. they all exhibit respiratory alkalosis
B. they always have moderate hypoxemia
C. they have decreased expiratory flows
D. they never respond to beta adrenergics

90. A patient whose asthma was well-controlled using a short-acting beta-agonist inhaler PRN and low dose inhaled corticosteroid BID reports that she recently has been experiencing shortness of breath almost daily and is awakened at night with wheezing episodes. Her peak flow, which had been 83% of her predicted normal is now at 66% of the predicted value. Which of the following would you recommend to the patient’s doctor as possible changes to the current drug regimen?
A. add a long-acting beta-agonist to the regimen
B. discontinue the short-acting beta agonist inhaler
C. switch the short-acting beta agonist from PRN to Q4H
D. switch from inhaled to oral corticosteroid therapy

91. Maximum inspiratory pressure (MIP; NIF) measurement provides information about which of the following?
A. airway resistance
B. functional residual capacity
C. inspiratory capacity
D. respiratory muscle strength

92. Which of the following laboratory values is most consistent with a diagnosis of fluid depletion (dehydration)?
A. increased hematocrit
B. decreased BUN
C. decreased serum osmolality
D. decreased urine specific gravity

93. Which of the following would represent an abnormal V/Q scan suggesting pulmonary embolism?
A. large segmental areas with normal ventilation and normal perfusion
B. large segmental areas with no ventilation and no perfusion
C. large segmental areas with normal ventilation but no perfusion
D. large segmental areas with no ventilation but normal perfusion

94. During the administration of an aerosol treatment, the patient’s respiratory rate drops from 15 breaths/min to 6 breaths/min. Identify this breathing pattern.
A. bradypnea
B. Biot’s breathing
C. apnea
D. hyperpnea

95. You measure the blood pressure of an adult patient as 88/53 mm Hg. Which of the following chart entries would you use in describing this finding?
A. patient is hypertensive
B. patient is hypotensive
C. patient has low pulse pressure
D. patient has high pulse pressure

96. While assisting a physician with a transthoracic ultrasound exam, you observe gliding or shimmering of the pleural layer during breathing. This observation
A. is consistent with the interstitial syndrome
B. rules out an underlying pneumothorax
C. indicates the presence of pleural adhesions
D. confirms an underlying pneumothorax

97. Your review of a patient’s chart notes an admission diagnosis of fluid depletion/ dehydration. Which of the following findings would be most likely on bedside assessment of the patient?
A. inspissated secretions
B. pitting edema
C. venous distension
D. crackle on auscultation

98. Which of the following thoracic ultrasound findings is consistent with the presence of a pneumothorax?
A. presence of gliding sign
B. absence of A-lines
C. presence of barcode sign
D. presence of seashore sign

99. In observing a patient, you note that her breathing is extremely deep and fast. Which of the following terms would you use in charting this observation?
A. Kussmaul’s breathing
B. Biot’s breathing
C. Cheyne-Stokes breathing
D. apneustic breathing

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Final Thoughts

As you know, the TMC Exam is definitely not easy! But with a combination of dedication, hard work, and the right resources, I’m confident that you will be successful.

Hopefully, the practice questions in this guide can help.

If you want more, definitely consider getting access to our TMC Test Bank, which students are using to increase their TMC Exam scores.

Thanks for reading, and I wish you the best of luck!

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Respiratory Therapy Zone
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References

  • 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.

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