TMC (LJU Version 8) UPDATED Exam Questions and CORRECT Answers
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TMC (LJU
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TMC (LJU
TMC (LJU Version 8) UPDATED Exam
Questions and CORRECT Answers
A patient with an ideal body weight of 80-kg (176-lb) is being evaluated for cessation of
mechanical ventilation. The following weaning parameters and clinical data are available:
Vital Capacity 1.2 L
RSBI 50
Spont VT 400 mL
R...
TMC (LJU Version 8) UPDATED Exam
Questions and CORRECT Answers
A patient with an ideal body weight of 80-kg (176-lb) is being evaluated for cessation of
mechanical ventilation. The following weaning parameters and clinical data are available:
Vital Capacity 1.2 L
RSBI 50
Spont VT 400 mL
Resp Rate 20/min
Which of the parameters is the most reliable indicator that the patient is ready for cold
cessation of mechanical ventilation?
A. Spont VT
B. RSBI
C. VC
D. RR - CORRECT ANSWER- The correct answer is : B
Explanation :
The rapid shallow breathing index is the best indicator that the aptient is ready for weaning in
this scenario. RSBI = RR/VT. A result less than 106 is acceptable. 50 is well below and
suggests the patient should be able to successfully wean off mechanical ventilation.
A respiratory therapist is preparing a smoking cessation program to be used in conjunction
with pulmonary rehabilitation. The therapist should include which of the following methods
of support in the plan?
A. Acetylzolamide (Diamox)
B. Daily telephone reminders not to smoke
C. electronic vapor cigarrettes
D. Counseling for associated emotional challenges - CORRECT ANSWER- The correct
answer is : D
Explanation :
,A person trying to stop smoking must conquer both physiological and psychological barriers.
Appropriate methods of support include emotional counseling and nicotine replacement
therapy.
A neonate born 48 hours ago is receiving time-cycled, pressure-limited mechanical
ventilation in the NICU. How should the patient's fluid output be measured?
A. Insert a urinary catheter
B. Weigh the diaper
C. Periodically weigh the neonate
D. Press and assess duration for blanched skin to return to normal - CORRECT ANSWER-
The correct answer is : B
Explanation :
Fluid control is vital in managing the care of a neonate. It may not seem very scientific to
weigh the diaper, but it is the most reliable and practical of the choices offered.
A respiratory therapist is performing endotracheal suctioning of a patient with thick,
tenacious secretions. Suctioning has been difficult and somewhat ineffective. Which of the
following would be most helpful at increasing the effectiveness of suctioning?
A. increasing suction pressure
B. increasing suction catheter size
C. increasing suction catheter length
D. increasing suction duration - CORRECT ANSWER- The correct answer is : B
Explanation :
To increase the effectiveness of suctioning, increasing suction catheter size, increasing
suction pressure, and increasing duration are three methods that may be used. The most
effective method is to increase the suction catheter size. However, caution must be used. The
suction catheter size may not exceed half the diameter of the endotracheal tube. If the patient
is already using a maximum suction catheter size than an increase in suction pressure is the
next choice.
A respiratory therapist is called to the nursery to assess a 36-week gestational age neonate
delivered five hours prior. Supraclavicular retractions are present. Respiratory rate is 70/min
with nasal flaring and grunting. Radiological examination has a honeycomb pattern in the
chest. The respiratory therapist should
,A. intubate and mechanically ventilate
B. intubate and deliver surfactant
C. place the patient on a nasal cannula at 2 L/min
D. place the patient on a 40% oxygen hood - CORRECT ANSWER- The correct answer is :
B
Explanation :
Radiological descriptions such as "honeycomb" or "ground glass" patterns suggest RDS.
These signs along with the respiratory distress of a premature neonate strongly suggest the
need for surfactant therapy, which must be delivered through an endotracheal tube. Intubation
is necessary for delivering surfactant.
A newborn with IRDS is being mechanically ventilated in the time-cycled, pressure-limited
SIMV mode. The physician would like to increase minute ventilation. In order to accomplish
this request, the respiratory therapist would make what modification?
A. Increase I-time
B. Change to a volume-cycled mode
C. Decrease flowrate
D. Increase tidal volume - CORRECT ANSWER- The correct answer is : A
Explanation :
Unlike volume ventilation, time-cycled pressure-limited mechanical ventilation will deliver
more volume per breath when inspiratory time is increased. Because the breath will be
delivered for a longer period of time at a constant flow rate, ventilation will increase. It is not
appropriate to change to a volume-cycled mode on a newborn. Tidal volume is not a direct
control in this mode and therefore is an incorrect answer. Decreasing the flow rate would
result in a reduction in ventilation.
The low exhaled volume alarm is sounding on a patient receiving volume controlled
ventilation. Which of the following could correct the problem?
A. check for a pneumothorax
B. add air to the ET tube cuff
C. drain excess water in the ventilator circuit
D. suction the patient - CORRECT ANSWER- The correct answer is : B
, Explanation :
The solution to this problem is to pick those things that could cause a low volume alarm to
sound. In most cases this would be a leak of some sort. When you examine the answers you
do not directly see the causes of the alarms but you see the possible solutions. You must
examine each solution and determine if the alarm would be a high pressure or a low-pressure
alarm or something else. Suctioning the patient would presumably be because of excess
secretions and would result in a high-pressure alarm. Adding air to the ET tube cuff, if the
cuff was deflated, would result in a low-pressure alarm. So, that option has to be a correct
one. Excess water and the ventilator circuit and the possibility of a pneumothorax would both
result in a high-pressure alarm, and therefore cannot be the correct answer. Two only is the
correct answer.
A patient with cystic fibrosis is receiving oxygen via a nasal cannula set at 5 L/min become
somewhat unresponsive and confused. SpO2 is 99%. The therapist should recommend which
of the following as a first action?
A. Lower the oxygen flow rate
B. Begin mechanical ventilation
C. Increase the oxygen flow
D. Switch to a non-rebreathing mask - CORRECT ANSWER- The correct answer is : A
Explanation :
Cystic fibrosis is a disease associated with chronic obstruction and is therefore considered to
be COPD. Patients with COPD should not receive more than 1-2 liters per minute by nasal
cannula or more than 28% oxygen by any device. Excessive oxygen delivery can lead to
suppression of the ventilatory drive and result in unresponsiveness and confusion. An oxygen
saturation of 94% or less should be maintained.
A patient with COPD is found with shallow respirations and is disoriented to time and place.
The patient is receiving oxygen by Venturi mask set at 45%. SpO2 is 99%. The therapist
should first do which of the following?
A. decrease FIO2 to 0.28
B. switch to a nonrebreathing mask set at 12 L/min
C. institute mechanical ventilation
D. switch to a nasal cannula at 5 L/min - CORRECT ANSWER- The correct answer is : A
Explanation :
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