TMC SELF ASSESSMENT EXAMINATION A
QUESTIONS AND ANSWERS WITH SOLUTIONS
2024
A 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 the endotracheal tube
B. Observable condensation in the tube
C. Pulse oximetry
D. Colorimetric capnography - ANSWER D. Colorimetric Capnography
Explanation: calormetric capnography asseses 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:
Appearance 1 min- acrocyanosis 5 min pink
Heart rate 70/min 110/min
Reflex cough Cough
Muscle tone weak active motion
Respiratory rate 20/min. 40/min
Which of the following APGAR scores should the therapist expect to see for this infant?
1 min / 5 min
1.
2. 5/ 8
3.
4.
A. 1
B. 2
C. 3
,D. 4 - ANSWER C. 3
explanation: score for 1 minute is 6: acrocyanosis= 1, heart rate 70/min =1, cough= 2, weak activity = 1,
RR 20 = 1
Score for 5 mins is 10: pink= 2 HR 110= 2, cough = 2 active motion = 2 respiratory rate 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
Explanations:
A. While a sputum sample may be requesting, transtrscheal aspiration would be unnecessarily invasive
as the patient is able to produce sputum samples on her own.
B. 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 enhances sputum clearance.
C. Bronchodilator therapy alone will not aid in secretion removal
D. There is no indication of this patient having a communicable disease. The diagnosis of bronchiectasis
was established 3 years ago.
A 24 year old female is diagnosed with excercise induced asthma and albuterol prn is ordered. A
respiratory therapist should next:
A. Refer the patient for allergy skin testing
B. Educate the patient on obtaining daily peak flow measurements
C. Instruct the patient to use albuterol 15 mins before exercising
D. Suggest the patient use pursed lip breathing while exercising - ANSWER C. Instruct the patient to use
albuterol 15 mins before exercising
,Explanation: patient understanding 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 will tracheal secretions tend to dry in an intubated patient?
A. A water vapor pressure of 47 mm hg
B. A relative humidity of 100% at 22•C
C. Dew point of 37•C
D. An absolute humidity of 44 mg/L - ANSWER B. A relative humidity of 100% at 22•C
Explanations:
A. Water vapor pressure of 47 mmHg provides 100% humidity at body temperature
B. The absolute humidity at this temperature is inadequate
C. A dew point of 37•C indicates the gas is completely saturated at that temperature
D. The absolute tracheal humidity must be greater than or equal to 30mg/L
Prior to suctioning the endotracheal tube of an adult patient who is receiving ventilation with an FiO2 of
.4 a respiratory therapist should first
A. Lubricate the catheter
B. Hyperoxygenate the patient
C. Cleanse the catheter with water
D. Administer an FiO2 of .4 by t-piece - ANSWER B. Hyperoxygenate the patient
Explanation:
A. Lubricating the catheter is not necessary unless nasotracheal suctioning will be performed
B. The FiO2 should be increased prior to each suctioning attempt to minimize hypoxemia
C. Sterile suction catheters do not need to be cleansed prior to use
D. Administration of the same FiO2 without positive pressure will compromise the patients oxygenation
and ventilation
, A 25-year-old patient with apnea is receiving PC ventilation. ABG analysis results are as follows:
pH 7.20
PCO2 65 mm Hg
PO2 70 mm Hg
HCO3- 25 mEq/L
BE -4 mEq/L
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
EXPLANATIONS:
A. In PC ventilation, increasing the inspiratory pressure will result in an increased tidal volume and
minute ventilation, potentially causing a decrease in the PCO2.
B. Increasing expiratory time will decrease tidal volume and minute ventilation, potentially causing an
increase in PCO2 and a further decrease in pH.
C. Increasing sensitivity will not increase ventilation in this patient.
D. Peak flow cannot be set in PC ventilation.
QUESTIONS AND ANSWERS WITH SOLUTIONS
2024
A 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 the endotracheal tube
B. Observable condensation in the tube
C. Pulse oximetry
D. Colorimetric capnography - ANSWER D. Colorimetric Capnography
Explanation: calormetric capnography asseses 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:
Appearance 1 min- acrocyanosis 5 min pink
Heart rate 70/min 110/min
Reflex cough Cough
Muscle tone weak active motion
Respiratory rate 20/min. 40/min
Which of the following APGAR scores should the therapist expect to see for this infant?
1 min / 5 min
1.
2. 5/ 8
3.
4.
A. 1
B. 2
C. 3
,D. 4 - ANSWER C. 3
explanation: score for 1 minute is 6: acrocyanosis= 1, heart rate 70/min =1, cough= 2, weak activity = 1,
RR 20 = 1
Score for 5 mins is 10: pink= 2 HR 110= 2, cough = 2 active motion = 2 respiratory rate 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
Explanations:
A. While a sputum sample may be requesting, transtrscheal aspiration would be unnecessarily invasive
as the patient is able to produce sputum samples on her own.
B. 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 enhances sputum clearance.
C. Bronchodilator therapy alone will not aid in secretion removal
D. There is no indication of this patient having a communicable disease. The diagnosis of bronchiectasis
was established 3 years ago.
A 24 year old female is diagnosed with excercise induced asthma and albuterol prn is ordered. A
respiratory therapist should next:
A. Refer the patient for allergy skin testing
B. Educate the patient on obtaining daily peak flow measurements
C. Instruct the patient to use albuterol 15 mins before exercising
D. Suggest the patient use pursed lip breathing while exercising - ANSWER C. Instruct the patient to use
albuterol 15 mins before exercising
,Explanation: patient understanding 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 will tracheal secretions tend to dry in an intubated patient?
A. A water vapor pressure of 47 mm hg
B. A relative humidity of 100% at 22•C
C. Dew point of 37•C
D. An absolute humidity of 44 mg/L - ANSWER B. A relative humidity of 100% at 22•C
Explanations:
A. Water vapor pressure of 47 mmHg provides 100% humidity at body temperature
B. The absolute humidity at this temperature is inadequate
C. A dew point of 37•C indicates the gas is completely saturated at that temperature
D. The absolute tracheal humidity must be greater than or equal to 30mg/L
Prior to suctioning the endotracheal tube of an adult patient who is receiving ventilation with an FiO2 of
.4 a respiratory therapist should first
A. Lubricate the catheter
B. Hyperoxygenate the patient
C. Cleanse the catheter with water
D. Administer an FiO2 of .4 by t-piece - ANSWER B. Hyperoxygenate the patient
Explanation:
A. Lubricating the catheter is not necessary unless nasotracheal suctioning will be performed
B. The FiO2 should be increased prior to each suctioning attempt to minimize hypoxemia
C. Sterile suction catheters do not need to be cleansed prior to use
D. Administration of the same FiO2 without positive pressure will compromise the patients oxygenation
and ventilation
, A 25-year-old patient with apnea is receiving PC ventilation. ABG analysis results are as follows:
pH 7.20
PCO2 65 mm Hg
PO2 70 mm Hg
HCO3- 25 mEq/L
BE -4 mEq/L
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
EXPLANATIONS:
A. In PC ventilation, increasing the inspiratory pressure will result in an increased tidal volume and
minute ventilation, potentially causing a decrease in the PCO2.
B. Increasing expiratory time will decrease tidal volume and minute ventilation, potentially causing an
increase in PCO2 and a further decrease in pH.
C. Increasing sensitivity will not increase ventilation in this patient.
D. Peak flow cannot be set in PC ventilation.
