TMC Exam #% Correct: Questions With Answers + Rationale
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Course
TMC
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TMC
TMC Exam #% Correct: Questions With Answers + Rationale
TMC Exam #% Correct: Questions With Answers + Rationale
A Patient With Pulmonary Emphysema Is Unable To Tolerate Postural Drainage And Percussion To The Basal Pulmonary Segments. Which Of The Following Represents An Appropriate Modificat...
A Patient With Pulmonary Emphysema Is Unable To Tolerate Postural Drainage And
Percussion To The Basal Pulmonary Segments. Which Of The Following Represents
An Appropriate Modification In Therapy?
A. Switch To High Frequency Chest Wall Oscillation
B. Administer Aerosolized Albuterol Treatments
C. Administer Aerosolized Mucomyst (Acetylcysteine)
D. Perform Postural Drainage With Bed In Semi-Fowlers Position Only Ans:
ANSWER: A
Feedback: When The Patient Is Receiving Postural Drainage And Percussion To The
Basal Segments It Means They Have Thier Head Of Bed Down Significantly. Often
Patients Cannot Tolerate This. The Respiratory Therapist Must, Therefore, Modify
The Therapy To Something Else That Accomplishes The Same Objective. The
Administration Of The Bronchodilator Or A Mucolytic Medicaion Does Not Actually
Help Secretions Move Out Of The Lungs. Performing Postural Drainage And
Percussion In Semi-Fowler's Position Will Not Drain The Basal Segments And
Therefore Is Inappropriate. So, The Only Acceptable Modification Is The Use Of
High-Frequency Chest Wall Oscillation, Also Called Vest Therapy.
A Postoperative Patient Is Receiving Volume-Controlled Ventilation Following
Abdominal Surgery. Auscultation Of The Chest Reveals Vesicular Breath Sounds In
,The Upper Lobes, But Fine Crackles In The Bases. This Is Most Consistent With
Which Of The Following Conditions?
A. Pleural Friction Rub
B. Atelectasis
C. Sputum In The Mid-Sized Airways
D. Tuberculosis Ans:
ANSWER: B
Feedback: Fine Crackles At The Bases Is Associated With Atelectasis. This Is Not
To Be Confused With Moist Crepitant Rales, Which Is Associated With Fluid
Overload And Chf. In Addition To The Fine Crackles, The Fact That The Patient Has
Undergone Surgery Is Further Supportive Evidence That The Patient Has Atelectasis.
The Respiratory Therapist Should Recommend Which Of The Following To Initially
Check The Placement Of A 7.5 Mm Oral Endotracheal Tube?
A. Chest Radiograph
B. Auscultation Of The Chest Bilaterally
C. Arterial Blood Gas Analysis
D. Palpation Of The Trachea Ans:
ANSWER: B
Feedback: In Order To Check The Position Of An Endotracheal Tube There Are
Several Methods That May Be Used. The Best Method To Initially Assess The
,Location Is To Visualize The Symmetry Of Chest Movement. The Second Best
Method Is To Auscultate Breath Sounds. The Third Best Method For Initial
Assessment Is A Chest X-Ray. The Idea Here Is To Choose The Examination That Is
The Quickest For The Initial Assessment. In This Case A Visual Assessment Is Not
Offered And Therefore Auscultation Of The Chest Bilaterally Is The Quickest
Method For Initially Determining The Location Of The Endotracheal Tube. A Chest
X-Ray Is Time-Consuming But Is Very Confirming. In This Case We Were Not
Asked For Confirming Evidence.
A Patient Has Been On Mechanical Ventilation For 30 Minutes. The Physician Would
Like To Confirm The Adequacy Of Ventilation And Oxygenation. The Respiratory
Therapist Should Suggest Which Of The Following?
A. End-Tidal Co2 Monitoring
B. Arterial Blood Gas Analysis
C. Transcutaneous Co2 And O2 Monitoring
D. Pulse Oximetery Ans:
ANSWER: B
Feedback: The Best Option To Assess Ventilation And Oxygenation Is Arterial
Blood Gas Analysis. Pulse Oximetry Would Only Assess Oxygenation And Is Not
Conclusive. End-Tidal Co2 Monitoring Would Only Assess Ventilation And Is Also
Not Conclusive. Transcutaneous Co2 And O2 Monitoring Is Usually Associated With
Infants And Is Also Not Conclusive.
, A Patient Has Just Undergone Oral Endotracheal Intubation. Which Of The Following
Should Be Examined First To Determine Proper Positioning Of The Et Tube?
A. Breath Sounds
B. Chest Radiograph
C. Tracheal Deviation
D. Symmetry Of Diaphragmatic Excursion Ans:
ANSWER: A
Feedback: To Determine Proper Positioning Of The Endotracheal Tube The
Respiratory Therapist Should First Assess That Which Is Quickest. Of The Options
Given, The Quickest Method Would Be To Auscultate Breath Sounds. This Method Is
Not Conclusive But Is Quick. If Asked To Provide Conclusive Evidence, A Chest
Radiograph Is Most Appropriate.
A Respiratory Therapist Is Called To Stand By At The Delivery Of A Newborn That
Has Experienced Cardiac Decelerations During Labor. After The Baby Is Delivered
And Presented To The Warmer, The Respiratory Therapist Should Assess
A. Gestational Age
B. Radiograph
C. Apgar
D. Age Of The Mother Ans:
ANSWER: C
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