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TMC Exam Review Questions and Answers
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TMC Exam Review Questions and Answers
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TMC Exam ReviewA respiratory therapist is assisting a physician with endotracheal intubation. Which of the following
should be used INITIALLY to confirm tracheal intubation ?
A. cm marking of ET tube
B. observe condensation in the tube
C. pulse oximetry
D. Colorimetric capnography - Answer -D. Colormetric capnography
assesses the presence of CO2 and provides confirmation of tracheal intubation when CO2 is detected
A respiratory therapist is asked to review a newborn's history. The following information is available
about the first few minutes after birth :
1 min - acrocyanosis, 70/min, cough, weak muscle tone, RR 20
5 min - pink - 110/min, cough, active motion, RR 40/min
A. 4 & 8
B. 5 & 8
,C. 6 & 10
D. 7 & 10 - Answer -C. 6 & 10
acrocyanosis = 1, Hr of 70 = 1, cough = 2, weak activity = 1, RR of 20 = 1.
pink = 2, HR of 110 = 2, cough = 2, active motion = 2, RR of 40 = 2
A 58 year old female was diagnosed with bronchiectasis 3 years ago. She reports increased cough and
difficulty clearing secretions for the past 4 weeks. A chest radiograph shows no significant changes.
Which of the following should the respiratory therapist recommend FIRST ?
a. transtracheal aspiration
b. airway clearance therapy
c. bronchodilator treatments
d. respiratory isolation - Answer -b. airway clearance therapy
the history, clinical presentation, and chest radiograph findings suggest worsening bronchiectasis. the
treatment of bronchiectasis includes techniques to loosen and mobilize viscid secretions. postural
drainage ( + HFCWO) enhances sputum clearance
A 24 year old female is diagnosed with exercise-induced asthma and albuterol pro is ordered. A
respiratory therapist should NEXT
a. refer patient for allergy skin testing
b. educate the patient on obtaining daily peak flow measurements
c. instruct the patient to use albuterol 15 minutes before exercising
d. suggest the patient use purse lip breathing while exercising - Answer -C. instruct the patient to use
albuterol 15 mins before exercising
Patient understanding of their disease process and triggers is important part of patient education, as
well as knowing when and which medication should be taken.
,In which of the following circumstances with tracheal secretions tend to dry in an intubated patients ?
A. a water vapor pressure of 47 mmHg
B. a relative humidity of 100% at 22*C ( 71.6* F)
C. a dew point of 37*C (98.6*F)
D. an absolute humidity of 44 mg/L - Answer -B. absolute humidity at this temperature is inadequate
a water vapor pressure of 47 mmHg provides 100% humidity at body temperature
a dew point of 37*C(98.6*F) indicates the gas is completely saturated at that temperature
the absolute tracheal humidity must be grater than or equal to 30 mg/L
Prior to suction the ET tube of an adult patient who is receiving ventilation with an Fio2 of 40%, a
respiratory therapist should FIRST
a. lubricate the catheter
b. hyper oxygenate the patient
c. cleanse the catheter with water
d. administer an FiO2 of 40% by T-piece - Answer -B. the FiO2 should be increased prior to each
suctioning attempt to minimize hyperoxemia
lubrication of catheter is not necessary unless nasotracheal suctioning will be performed
sterile suction catheters do not need to be cleansed prior to use
, administration of the same fiO2 without positive pressure will compromise the patient's oxygenation
and ventilation
A 25 year old patient with apnea is receiving PC ventilation. An ABG analysis results are as follows:
pH 7.20
CO2 65
PO2 70
HCO3 25
BE -4
SO2 (calc) 94%
A respiratory therapist should recommend increasing the
a. set inspiratory pressure
b. expiratory time
c. sensitivity
d. peak flow - Answer -a. set inspiratory pressure
^-- in PC ventilation, increasing the inspiratory pressure will result in an increased tidal volume and
minute ventilation, potentially causing a decrease in PCO2
increasing expiratory time will decrease tidal volume and minute ventilation, potentially causing
increase in PCO2 and further decrease in pH
increasing sensitivity will not increase ventilation in this patient
peak flow cannot be set in PC ventilation
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