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TMC Exam 2024 Questions and Answers 2024 / 2025 (Verified Answers by Expert)
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TMC Exam 2024 Questions and Answers 2024 / 2025 (Verified Answers by Expert)
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TMC Exam Questions.pdf file:///C:/Users/HP/Desktop/TYPA%20NEW/TMC%20Exam%20QueTMC Exam Questions
1. During the assessment of a 64-year-old female patient, you note the follow- ing signs:
dyspnea, hypotension, and a tracheal shift to the right.The patient also has absent breath
sounds, reduced chest expansion, and a hyperreso- nant percussion note all on the left
side.These findings suggest which of the following?
A. A pleural effusion on the left side
B. A pneumothorax on the left side
C. Atelectasis on the left side
D. Consolidation on the left side:
ANSB. A pneumothorax on the left side
To get this one correct, you needed to be able to interpret the signs that were given about the
patient in the question. This is a common type of question for the TMC Exam.
The question tells us that the patient has reduced chest expansion, a hyperresonant percussion
note, and absent breath sounds all on the left side.That to go along with a tracheal shift to the
right. This indicates that the patient has a pneumothorax on the left side.
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Remember that, when a pneumothorax is present, the trachea will shift away from the affected
side. That means you can rule out left-sided atelectasis because the trachea would shift to that
side.
A pleural effusion and consolidation would cause a dull percussion note, not a hyperresonant
note, so we can rule out those two as well.
2. A 39-year-old male patient was admitted to the emergency department with a fever and
SpO2 of 87% on room air. Upon auscultation, rhonchi is heard and the patient 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
C. Implement postural drainage and percussion with directed coughing
D. Provide oxygen therapy and obtain a sputum sample for culture and sensi- tivity:
ANSD. Provide oxygen therapy and obtain a sputum sample for culture and sensitivity
To get this one correct, you needed to be able to recognize that the patient has some type of
infection, such as pneumonia.
You know this because the question states that the patient is hypoxemic, has a fever, and rhonchi
breath sounds. So in this case, you would want to obtain a sputum
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sample for culture and sensitivity in order to identify the type of organism. Oxygen therapy is
indicated for the hypoxemia.
Intubation and NPPV would not be indicated in this case. Postural drainage and percussion are
not recommended either. So by breaking down the question, the best answer clearly is D.
3. A 50-year-old male patient is intubated with a size 8 endotracheal tube and is 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. Withdraw the tube 1-2 cm and reassess the patient's breath sounds
B. Recommend reintubation with a smaller endotracheal tube
C. Lower the cuff pressure to < 30 cm H2O
D. Recommend ventilation via a tracheostomy instead: The correct answer is:
C. Lower the cuff pressure to < 30 cm H2O
In order to get this one right, you needed to know the normal values for cuff pressure. And in this
case, you needed to recognize that 38 cm H2O is way too high and could potentially be dangerous
for the patient's trachea.
So your first action should be to lower the cuff pressure to < 30 cm H2O and then check to
make sure that there are not any leaks. For the TMC Exam, you need to remember that the
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cuff pressure normal range is between 20-30 cm H2O.
There is no indication to withdraw the tube and using a smaller tube would only cause the
patient's peak pressure to increase which is something that we do not want. Also, nothing in the
question indicates that a tracheostomy is needed, so we know that the correct answer has to be
C.
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. There patient's ventilation has increased
C. There is a clogged system diffuser
D. The flowmeter pressure is set too high:
ANSA. There is an obstruction in the delivery tube
If you've ever accidentally stepped on the tubing when a bubble humidifier is being used, then
you will automatically know that the correct answer is A.
The relief valve of a bubble humidifier sounds when the pressure in the reservoir
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