Disclaimer:

Medicine and respiratory therapy are continuously changing practices. The author and publisher have
reviewed all information in this report with resources believed to be reliable and accurate and have made
every effort to provide information that is up to date with the best practices at the time of publication.
Despite our best efforts we cannot disregard the possibility of human error and continual changes in best
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involved in this work disclaim all responsibility from any errors contained within this work and from the
results from the use of this information. Readers are encouraged to check all information in this book with
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Copyright © Respiratory Therapy Zone

Introduction
Why hello there! Thank you for downloading this little eBook and getting access to the answers to these
practice questions.

By doing so, you’re putting yourself in a great position to pass the TMC Exam.

Did you know that going through practice questions is one of the most effective ways to pass the exam?

It’s a strategy that I recommend to each and every one of my students. And I can always tell a major difference
in students who use practice questions to prepare and those who do not.

And that also explains why we created our TMC Test Bank, which contains over 1000 practice questions,
answers, and rationales.

It’s similar to this little eBook, however, it DOES also contain a rationale for each question that goes into detail
and explains why the answer is the correct answer. This is absolutely crucial in regards to helping you actually
learn and remember the information.

I guess you can look at this eBook as a “lite version” of our TMC Test Bank. That is because it only contains the
correct answers, not the rationales that explain why the answer is correct.

So after you go through the practice questions below, if you like them and find them to be helpful, I definitely
recommend that you check out the TMC Test Bank which will give you access to many more practice
questions (like the ones here). But the best part is, of course, you get the rationales as well.

And like I said, they are extremely important if you’re serious about passing the TMC Exam on your next
attempt! Thanks again for downloading this eBook and I wish you the best of luck!

Now let’s dive into the practice questions! J

1. A 150-lb (IBW) patient has a tidal volume of 500 ml and a ventilatory rate of 12 breath/minute Calculate the
patient’s alveolar minute ventilation. Assume the absence of dead-space disease.
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 recovering from ARDS is receiving mechanical ventilation with a tidal volume of 650
ml. The patient has 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
B. PaCO2
C. SpO2
D. ECG

8. A patient complains of the following symptoms:

Excessive daytime fatigue
Headaches upon awakening
Decreased ability to concentrate
Memory loss
Which of the following test is appropriate for this patient?
A. Bronchoscopy
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:

FiO2 40%
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:
A. 95%
B. 67%
C. 75%
D. 55%

11. A patient who is on a volume ventiltaor has the following measurments: 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,ab normal

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:
FiO2 40%
pH 7.38
PaO2 75 torr
PaCO2 49 torr
PeCO2 32 torr
A. 21%
B. 35%
C. 47%
D. 68%

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:

A. 10%
B. 20%
C. 30%
D. 40%

21. If a patient has a minute ventilation of 9.6 L/min and a ventilator frequency of 10 breaths/min, what is the
patient’s tidal volume?
A. 9.6L
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. The following data is collected from a patient; PaCO2 – 40 mmHg, and PeCO2 – 30 mmHg. Which of the
following is correct concerning his information?
A. The Vd/Vt ratio is 45% and normal
B. The Vd/Vt ratio is 45% and abnormal
C. The Vd/Vt ratio is 25% and normal
D. The Vd/Vt ratio is 25% and abnormal

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
D. FiO2
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
D. FiO2

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 becomes
bradycardiac, 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.
A. 15
B. 13
C. 11
D. 9

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 7:00am 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
tranilluminated. The transillumination device produces a small halo appearance at the point of contract
with the skin. This indicates which of the following?
A. Pneumothorax
B. Pneumomediastinum
C. Pneumopericardium
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 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:
A. Dyspnea
B. Orthopnea
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:
A. Mucoid
B. Frothy
C. Purulent
D. Mucopurulent

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:
A. Rhonchi
B. Wheezing
C. Stridor
D. Crackles

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?
A. 3
B. 9
C. 12
D. 7

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.

51. The respiratory therapist is using a pulse oximeter to monitor SpO2 on a 54 year old man who was
rescued from a fire. The electrode is placed on the left ear lobe. The measured SpO2 is 90%. However, the
patient’s SaO2, obtained from an arterial blood sample analyzed by a co-oximeter is 79%. Which of the
following is the most likely explanation for the difference in saturation?
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?
A. Passover
B. Bubble
C. Heated wick
D. Heat moisture exchanger

54. A physician orders an FiO2 of 0.40 for 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
B. Atelectasis
C. Pleural effusion
D. Asthma

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 acetyl cysteine (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 acetyl cysteine with saline.
B. Terminate the therapy and clear secretions.
C. Increase the dose of acetyl cysteine to help thin the secretions.
D. Administer the acetyl cysteine with a positive pressure breathing machine

69. The addition of an inspiratory plateau during continuous mechanical ventilation may be
CONTRAINDICATED in patient’s with:
A. Hypoxemia
B. Hypotension
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?
A. Bronchogram
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
D. Arrhythmias

76. While checking a ventilator that has a wick humidifier, the respiratory therapist notes that there is very
little condensation in the tubing. The most likely explanation is that he:
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 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 ride 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 drive line 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
B. Bronchospasm
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. 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
Conclusion
That wraps up this eBook! Thanks again for downloading and making it all the way to the end. If you’re
reading this far, then I know you have what it takes to pass the TMC Exam on your next attempt.

Like I said, going through practice questions is one of the best strategies for those who truly want to pass
the exam.

The practice questions found in this eBook are helpful, but I’ll be honest with you. They only scratch the
surface of what can be found inside of our TMC Test Bank.

And thankfully, thousands of students have already used it to pass the TMC Exam!

So if you’re ready to pass the exam too, I definitely recommend that you consider checking it out. I wish you
the best of luck and as always, breathe easy my friend. J

Click Here to Learn More About the TMC Test Bank!

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