TMC Practice Questions A- Kettering exam
A 48 year-old female is admitted to the ED with diaphoresis, jugular venous
distension, and 3+ pitting edema in the ankles. These findings are consistent with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances. - ANS
C. heart failure.
A patient is admitted to the ED following a motor vehicle accident. On physical
exam, the respiratory therapist discovers that breath sounds are absent in the left
chest with a hyperresonant percussion note. The trachea is shifted to the right.
The patient's heart rate is 45/min, respiratory rate is 30/min, and blood pressure is
60/40 mm Hg. What action should the therapist recommend first?
A. Call for a ST AT chest x-ray .
B. Insert a chest tube into the left chest.
C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate the patient. - ANS C.
Needle aspirate the 2nd left intercostal space. All of the following strategies are likely to decrease the likelihood of damage to
the tracheal mucosa EXCEPT
A. maintaining cuff pressures between 20 and 25 mm Hg.
B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures. - ANS C. using a low-residual-volume,
low-compliance cuff.
A 52 year-old post-operative cholecystectomy patient's breath sounds become
more coarse upon completion of postural drainage with percussion. The
respiratory therapist should recommend
A. continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy .
D. deep breathing and coughing to clear secretions. - ANS
D. deep breathing
and coughing to clear secretions.
A 65 kg spinal cord injured patient has developed atelectasis. His inspiratory
capacity is 30% of his predicted value. What bronchial hygiene therapy would be
most appropriate initially? A. IS / SMI
B. IPPB with normal saline
C. postural drainage and percussion
D. PEP therapy - ANS B. IPPB with normal saline
A healthy adult female can exhale what portion of her forced vital capacity in the
first second?
A. 50%
B. 60%
C. 70%
D. 80% - ANS
C. 70%
A patient on VC ventilation has demonstrated auto-PEEP on ventilator graphics.
Which of the following controls, when adjusted independently , would increase
expiratory time?
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity A. 1, 2, and 3 only
B. 1, 2, and 4 only
C. 1, 3, and 4 only
D. 2, 3, and 4 only - ANS A. 1, 2, and 3 only
Which of the following would be the most appropriate therapy for a dyspneic
patient who has crepitus with tracheal deviation to the left and absent breath
sounds on the right?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube - ANS
D. Insert a chest
tube
A 55 year-old post cardiac surgery patient has the following ABG results: pH 7.50,
PaCO2 30 torr , PaO2 62 torr , HCO3 25 mEq/L, SaO2 92%, HB 14 g/dL, BE +2.
Venous blood gas results are pH 7.39, PvCO2 43 torr , PvO2 37 torr , and SvO2
66%. Calculate the patient's C(a-v)O2.
A. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
D. 5.5 vol% - ANS
C. 5.0 vol%
A 48 year-old female is admitted to the ED with diaphoresis, jugular venous
distension, and 3+ pitting edema in the ankles. These findings are consistent with
A. liver failure.
B. pulmonary embolism.
C. heart failure.
D. electrolyte imbalances. - ANS
C. heart failure.
A patient is admitted to the ED following a motor vehicle accident. On physical
exam, the respiratory therapist discovers that breath sounds are absent in the left
chest with a hyperresonant percussion note. The trachea is shifted to the right.
The patient's heart rate is 45/min, respiratory rate is 30/min, and blood pressure is
60/40 mm Hg. What action should the therapist recommend first?
A. Call for a ST AT chest x-ray .
B. Insert a chest tube into the left chest.
C. Needle aspirate the 2nd left intercostal space.
D. Activate the medical emergency team to intubate the patient. - ANS C.
Needle aspirate the 2nd left intercostal space. All of the following strategies are likely to decrease the likelihood of damage to
the tracheal mucosa EXCEPT
A. maintaining cuff pressures between 20 and 25 mm Hg.
B. using the minimal leak technique for inflation.
C. using a low-residual-volume, low-compliance cuff.
D. monitoring intracuff pressures. - ANS C. using a low-residual-volume,
low-compliance cuff.
A 52 year-old post-operative cholecystectomy patient's breath sounds become
more coarse upon completion of postural drainage with percussion. The
respiratory therapist should recommend
A. continuing the therapy until breath sounds improve.
B. administering dornase alpha.
C. administering albuterol therapy .
D. deep breathing and coughing to clear secretions. - ANS
D. deep breathing
and coughing to clear secretions.
A 65 kg spinal cord injured patient has developed atelectasis. His inspiratory
capacity is 30% of his predicted value. What bronchial hygiene therapy would be
most appropriate initially? A. IS / SMI
B. IPPB with normal saline
C. postural drainage and percussion
D. PEP therapy - ANS B. IPPB with normal saline
A healthy adult female can exhale what portion of her forced vital capacity in the
first second?
A. 50%
B. 60%
C. 70%
D. 80% - ANS
C. 70%
A patient on VC ventilation has demonstrated auto-PEEP on ventilator graphics.
Which of the following controls, when adjusted independently , would increase
expiratory time?
1. Tidal volume
2. Respiratory Rate
3. Inspiratory flow
4. Sensitivity A. 1, 2, and 3 only
B. 1, 2, and 4 only
C. 1, 3, and 4 only
D. 2, 3, and 4 only - ANS A. 1, 2, and 3 only
Which of the following would be the most appropriate therapy for a dyspneic
patient who has crepitus with tracheal deviation to the left and absent breath
sounds on the right?
A. Perform chest physiotherapy
B. Administer an IPPB treatment
C. Insert an endotracheal tube
D. Insert a chest tube - ANS
D. Insert a chest
tube
A 55 year-old post cardiac surgery patient has the following ABG results: pH 7.50,
PaCO2 30 torr , PaO2 62 torr , HCO3 25 mEq/L, SaO2 92%, HB 14 g/dL, BE +2.
Venous blood gas results are pH 7.39, PvCO2 43 torr , PvO2 37 torr , and SvO2
66%. Calculate the patient's C(a-v)O2.
A. 2.5 vol%
B. 4.0 vol%
C. 5.0 vol%
D. 5.5 vol% - ANS
C. 5.0 vol%
