A
VI
TU
IS
M
O
TMC STUDY GUIDE 2024:
A
QUESTIONS AND ANSWERS
N
ALL VERIFIED AND
JP
GUARANTEED SUCCESS
,1. During the assessment of a 64-year-old female patient, you note the following signs:
dyspnea, hypotension, and a tracheal shift to the right. The patient also has absent
breath sounds, reduced chest expansion, and a hyperresonant percussion note all on
the left side. These findings suggest which of the following?
A. A pleural effusion on the left side
A
B. A pneumothorax on the left side
C. Atelectasis on the left side
D. Consolidation on the left side - ANSWER B. A pneumothorax on the left side
VI
2. A 39-year-old male patient was admitted to the emergency department with a fever
and an SpO2 of 87% on room air. Upon auscultation, rhonchi is heard and the patient
TU
has a productive cough. Which of the following would you recommend?
A. Intubate and provide mechanical ventilation with 40% oxygen
B. Provide noninvasive positive pressure ventilation using a full face mask
IS
C. Implement postural drainage and percussion with directed coughing
D. Provide oxygen therapy and obtain a sputum sample for culture and sensitivity -
ANSWER D. Provide oxygen therapy and obtain a sputum sample for culture and
M
sensitivity
3. A 50-year-old male patient is intubated with a size 8 endotracheal tube and is
O
receiving volume-controlled A/C ventilation. Upon assessment, you note that the
patient's cuff pressure is measured at 38 cm H2O. Which of the following would you
recommend?
A
A. Withdraw the tube 1-2 cm and reassess the patient's breath sounds
N
B. Recommend reintubation with a smaller endotracheal tube
C. Lower the cuff pressure to < 30 cm H2O
JP
D. Recommend ventilation via a tracheostomy instead - ANSWER C. Lower the cuff
pressure to < 30 cm H2O
4. During the assessment of a 52-year-old female patient that is receiving oxygen via
nasal cannula at 4 L/min, you hear the bubble humidifier making a whistling noise.
Which of the following is the most likely cause of this finding?
A. There is an obstruction in the delivery tube
B. The patient's ventilation has increased
,C. There is a clogged system diffuser
D. The flowmeter pressure is set too high - ANSWER A. There is an obstruction in
the delivery tube
5. A pre and post bronchodilator test was ordered on a 48-year-old female patient. The
forced expiratory measurement that was obtained after the bronchodilator was given
shows an increase in the patient's FEV1 from 60% to 80% of the predicted value. This
finding suggests which of the following?
A
A. A fixed airway obstruction
B. A reversible airway obstruction
VI
C. A normal diffusion capacity
D. A restrictive process - ANSWER B. A reversible airway obstruction
TU
6. A 58-year-old female patient is intubated and appears to be breathing
asynchronously with the ventilator. Her breath sounds are absent on the left side and
the trachea appears to be shifted to the left. The patient has a dull percussion note on
the left side as well. Which of the following is the most likely explanation of these
IS
findings?
A. A tracheoesophageal fistula has developed
B. A tension pneumothorax has developed on the left side
M
C. The endotracheal tube is in the right mainstem bronchus
D. The patient is experiencing diffuse bronchospasm - ANSWER C. The
O
endotracheal tube is in the right mainstem bronchus
7. A 63-year-old female patient is intubated and receiving mechanical ventilation in the
A
pressure controlled A/C mode. If the patient's compliance were to decrease, which of
the following would you expect to occur?
N
A. Her delivered volume will decrease
B. Her peak pressure will increase
JP
C. Her inspiratory time will increase
D. Her PEEP level will decrease - ANSWER A. Her delivered volume will decrease
8. A 70-year-old male patient is intubated and receiving mechanical ventilation in the
volume controlled A/C mode. After performing endotracheal suctioning, which of the
following would indicate the effective clearance of retained secretions?
A. An increased tidal volume
, B. A decreased inspiratory time
C. A decreased plateau pressure
D. A decreased peak pressure - ANSWER D. A decreased peak pressure
9. An adult patient who is receiving mechanical ventilation suddenly started showing
signs of tachypnea. Upon assessment, you note tracheal deviation to the right and
decreased breath sounds and hyperresonance on the left. Which of the following would
you recommend?
A
A. The patient needs suctioning
B. The patient needs a bronchoscopy
VI
C. The insertion of a chest tube
D. The patient needs a thoracentesis - ANSWER C. The insertion of a chest tube
TU
10. A 57-year-old female patient with acute pulmonary edema is dyspneic and appears
to be wheezing. The resident physician has ordered an albuterol breathing treatment via
SVN. Which of the following would you recommend?
IS
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 - ANSWER D. Recommend a diuretic
M
and oxygen therapy
O
11. A 39-year-old female patient who is intubated was admitted to the emergency
department and the nurse was unable to start an intravenous line during CPR. It is
believed that the patient is suffering from a narcotic overdose and the physician wants
A
to administer Naloxone. Which of the following is an alternative route that can be used
to deliver this medication?
N
A. Through the feeding tube
B. Aerosolized via SVN
JP
C. Through the nasogastric tube
D. Through the endotracheal tube - ANSWER D. Through the endotracheal tube
12. A 176 lb male patient is intubated and receiving volume control A/C ventilation with
the following settings: FiO2 of 40%, Rate of 12/min, and Tidal Volume of 550 mL. An
ABG was analyzed and the following results were obtained:
pH 7.39
PaCO2 37
VI
TU
IS
M
O
TMC STUDY GUIDE 2024:
A
QUESTIONS AND ANSWERS
N
ALL VERIFIED AND
JP
GUARANTEED SUCCESS
,1. During the assessment of a 64-year-old female patient, you note the following signs:
dyspnea, hypotension, and a tracheal shift to the right. The patient also has absent
breath sounds, reduced chest expansion, and a hyperresonant percussion note all on
the left side. These findings suggest which of the following?
A. A pleural effusion on the left side
A
B. A pneumothorax on the left side
C. Atelectasis on the left side
D. Consolidation on the left side - ANSWER B. A pneumothorax on the left side
VI
2. A 39-year-old male patient was admitted to the emergency department with a fever
and an SpO2 of 87% on room air. Upon auscultation, rhonchi is heard and the patient
TU
has a productive cough. Which of the following would you recommend?
A. Intubate and provide mechanical ventilation with 40% oxygen
B. Provide noninvasive positive pressure ventilation using a full face mask
IS
C. Implement postural drainage and percussion with directed coughing
D. Provide oxygen therapy and obtain a sputum sample for culture and sensitivity -
ANSWER D. Provide oxygen therapy and obtain a sputum sample for culture and
M
sensitivity
3. A 50-year-old male patient is intubated with a size 8 endotracheal tube and is
O
receiving volume-controlled A/C ventilation. Upon assessment, you note that the
patient's cuff pressure is measured at 38 cm H2O. Which of the following would you
recommend?
A
A. Withdraw the tube 1-2 cm and reassess the patient's breath sounds
N
B. Recommend reintubation with a smaller endotracheal tube
C. Lower the cuff pressure to < 30 cm H2O
JP
D. Recommend ventilation via a tracheostomy instead - ANSWER C. Lower the cuff
pressure to < 30 cm H2O
4. During the assessment of a 52-year-old female patient that is receiving oxygen via
nasal cannula at 4 L/min, you hear the bubble humidifier making a whistling noise.
Which of the following is the most likely cause of this finding?
A. There is an obstruction in the delivery tube
B. The patient's ventilation has increased
,C. There is a clogged system diffuser
D. The flowmeter pressure is set too high - ANSWER A. There is an obstruction in
the delivery tube
5. A pre and post bronchodilator test was ordered on a 48-year-old female patient. The
forced expiratory measurement that was obtained after the bronchodilator was given
shows an increase in the patient's FEV1 from 60% to 80% of the predicted value. This
finding suggests which of the following?
A
A. A fixed airway obstruction
B. A reversible airway obstruction
VI
C. A normal diffusion capacity
D. A restrictive process - ANSWER B. A reversible airway obstruction
TU
6. A 58-year-old female patient is intubated and appears to be breathing
asynchronously with the ventilator. Her breath sounds are absent on the left side and
the trachea appears to be shifted to the left. The patient has a dull percussion note on
the left side as well. Which of the following is the most likely explanation of these
IS
findings?
A. A tracheoesophageal fistula has developed
B. A tension pneumothorax has developed on the left side
M
C. The endotracheal tube is in the right mainstem bronchus
D. The patient is experiencing diffuse bronchospasm - ANSWER C. The
O
endotracheal tube is in the right mainstem bronchus
7. A 63-year-old female patient is intubated and receiving mechanical ventilation in the
A
pressure controlled A/C mode. If the patient's compliance were to decrease, which of
the following would you expect to occur?
N
A. Her delivered volume will decrease
B. Her peak pressure will increase
JP
C. Her inspiratory time will increase
D. Her PEEP level will decrease - ANSWER A. Her delivered volume will decrease
8. A 70-year-old male patient is intubated and receiving mechanical ventilation in the
volume controlled A/C mode. After performing endotracheal suctioning, which of the
following would indicate the effective clearance of retained secretions?
A. An increased tidal volume
, B. A decreased inspiratory time
C. A decreased plateau pressure
D. A decreased peak pressure - ANSWER D. A decreased peak pressure
9. An adult patient who is receiving mechanical ventilation suddenly started showing
signs of tachypnea. Upon assessment, you note tracheal deviation to the right and
decreased breath sounds and hyperresonance on the left. Which of the following would
you recommend?
A
A. The patient needs suctioning
B. The patient needs a bronchoscopy
VI
C. The insertion of a chest tube
D. The patient needs a thoracentesis - ANSWER C. The insertion of a chest tube
TU
10. A 57-year-old female patient with acute pulmonary edema is dyspneic and appears
to be wheezing. The resident physician has ordered an albuterol breathing treatment via
SVN. Which of the following would you recommend?
IS
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 - ANSWER D. Recommend a diuretic
M
and oxygen therapy
O
11. A 39-year-old female patient who is intubated was admitted to the emergency
department and the nurse was unable to start an intravenous line during CPR. It is
believed that the patient is suffering from a narcotic overdose and the physician wants
A
to administer Naloxone. Which of the following is an alternative route that can be used
to deliver this medication?
N
A. Through the feeding tube
B. Aerosolized via SVN
JP
C. Through the nasogastric tube
D. Through the endotracheal tube - ANSWER D. Through the endotracheal tube
12. A 176 lb male patient is intubated and receiving volume control A/C ventilation with
the following settings: FiO2 of 40%, Rate of 12/min, and Tidal Volume of 550 mL. An
ABG was analyzed and the following results were obtained:
pH 7.39
PaCO2 37
