TMC 2nd practice Exam Questions With Verified Answers

TMC 2nd practice Exam Questions With
Verified Answers

A patient with a PBW of 55 kg (121 lb) is receiving VC, A/C ventilation. Ventilator settings and
blood gas analysis results are:


FIO2 0.70
Mandatory rate 14
VT 350 mL
PEEP 5 cm H2O


pH 7.35
PaCO2 35 mm Hg
PaO2 40 mm Hg
HCO3- 19 mEq/L
BE -6 mEq/L
SO2 (calc) 74%


A respiratory therapist should recommend


A.
changing to SIMV mode.
B.
increasing to 10 cm H2O PEEP.
C.
changing to 5 cm H2O CPAP.


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,D.

increasing to 400 mL VT. - answer✔✔B. √
increasing to 10 cm H2O PEEP.
EXPLANATIONS


(h) A. Changing to SIMV will not treat the hypoxemia. It may also cause a decrease in minute
ventilation and adverse changes in the acid-base status.


(c) B. The increase in PEEP will increase FRC, decrease the intrapulmonary shunt, and address
the hypoxemia.


(h) C. Changing to CPAP may decrease minute ventilation causing adverse changes in the acid-
base status.


(u) D. Increasing the tidal volume will further decrease the PaCO2. It will not significantly
improve oxygenation.
When instructing a patient on the administration of umeclidinium/vilanterol (Anoro Ellipta),
which of the following is most important to emphasize?


A.
Gargle immediately after use.
B.
Inhale slowly with a breath hold.
C.
Breathe in fast and deep.
D.

Shake medication vigorously before use. - answer✔✔C.
Breathe in fast and deep.
EXPLANATIONS:




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,(u) A. Umeclidinium/vilanterol (Anoro Ellipta) is not an inhaled steroid and, thus, does not
require gargling after use.


(u) B. Umeclidinium/vilanterol (Anoro Ellipta) is a DPI that requires rapid inhalation.


(c) C. Breathing in fast and deep is the proper method of administration for
umeclidinium/vilanterol (Anoro Ellipta).


(u) D. Umeclidinium/vilanterol (Anoro Ellipta) is a DPI and does not require shaking before use.
Following placement of a tracheostomy tube for long-term mechanical ventilation, which of the
following patient positions best prevents ventilator-associated pneumonia?


A.
prone
B.
Trendelenburg
C.
supine
D.

semi-Fowler - answer✔✔d. semi- fowler
EXPLANATIONS:


(h) A. Prone positioning is contraindicated following tracheostomy placement.


(h) B. Use of Trendelenburg positioning may increase the risk of aspiration.


(u) C. A decreased incidence of ventilator-associated pneumonia has been observed with an
elevated head of bed as compared to supine.




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, (c) D. Routine use of semi-Fowler positioning with the head of the bed elevated at an angle of
30-45 degrees has been shown to decrease rates of ventilator-associated pneumonia.
Which of the following is used to monitor the partial pressure of transcutaneous carbon dioxide?


A.
red-light absorption sensor
B.
electromechanical transducer
C.
infrared analyzer
D.

Stow-Severinghaus electrode - answer✔✔d. stow-severinghaus electrode
EXPLANATIONS:


(u) A. A red-light absorption sensor is used in a pulse oximeter.


(u) B. An electromechanical transducer measures airway pressure.


(u) C. An infrared analyzer is used in a capnometer.


(c) D. A Stow-Severinghaus blood gas electrode is used in transcutaneous monitors.
An adult patient requires frequent blood sampling and medication administrations through an IV
for 1 month. The preferred vascular access is a


A.
peripherally inserted central catheter.
B.
subclavian central vascular line.
C.


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