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TMC Exam E Questions with correct answers | latest update | Complete Solution 2024
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TMC Exam E Questions with correct answers | latest update | Complete Solution 2024
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TMC Exam E110. A patient is found to have the following rhythm on the ECG monitor.
Which of the following is the best initial action of the respiratory therapist?
a. Provide cardiac pacing
b. Defibrillate at 50 joules
✅✅
c. Administer cardiac chronotropic medication
d. Administer cardiac inotropic medication - -a. Provide cardiac pacing
129. The following data is available for a patient receiving mechanical
ventilation:
2pm 4pm
Ppeak 24 30
Static AW pressure 12 12
Delivered VT 550 550
Inspiratory flow 40 40
PEEP 5 5
Which of the following may explain these results
a. Deflated endotracheal tube cuff
b. Excess water in the ventilator circuit
✅✅
c. Leak in the ventilator circuit
d. Decreasing pulmonary compliance - -b. Excess water in the ventilator
circuit
A 1000 g, 28-week gestational age infant has the following umbilical artery
blood gas results:
7. / / +1
Which of the following should the respiratory therapist recommend to monitor
the infant's oxygenation?
a. Arterial blood gas analysis
b. Pulse oximetry
✅✅
c. Capillary blood gas analysis
d. Transcutaneous PCO2 monitor - -b. Pulse oximetry
A 3 day-old premature infant has a heart rate of 50/min. Which of the following
medications would be most beneficial to the patient?
a. Administer 0.2 mg Atropine sulfate
b. Administer racemic epinephrine
c. Administer dopamine HCL
,d. Administer subcutaneous epinephrine 1:10,000 - ✅✅-a. Administer 0.2
mg Atropine sulfate
A 32 year-old female patient reports to the emergency room complaining of a
sudden onset of coughing. She indicates the coughing started when she was
eating. Which of the following would most definitively rule out a cancerous
mass in the lungs:
a. V/Q scan
b. Lateral neck radiograph
✅✅
c. Spiral CT scan
d. BUN - -c. Spiral CT scan
A 32-gestational week newborn is receiving mechanical ventilation via a 3.0
mm endotracheal tube. Which of the following are associated with ongoing
assessment of renal function?
a. Diaper weight and blood draw volumes are recorded
b. mPAP
✅✅
c. PCWP
d. Humidification is maintained at a non-invasive temperature - -a.
Diaper weight and blood draw volumes are recorded
A 32-year old patient is receiving an initial small-volume nebulizer treatment
with Albuterol. Prior to administration, the patient's pulse was 74/min. During
the treatment the pulse rises to 88/min and remains steady. The respiratory
therapist should
a. Contact the physician to obtain direction
b. Decrease future doses to half strength
✅✅
c. Complete the treatment, continue to monitor pulse rate
d. Discontinue the treatment, assess the patient in 15 minutes - -c.
Complete the treatment, continue to monitor pulse rate
A 34 week gestational age infant was born 20 minutes ago and had a
five-minute APGAR score of 6. A chest radiograph shows bilateral haziness
and a reticulogranular pattern. Which of the following would be most beneficial
to the patient?
a. Transillumination
b. Surfactant therapy
✅✅
c. Echocardiography
d. Aerosolized bronchodilator therapy - -b. Surfactant therapy
,A 48-year-old patient has just been orally intubated prior to being placed on
volume-controlled ventilation. The respiratory therapist should do which of the
following to best confirm proper placement of the endotracheal tube?
a. Auscultate breath sounds
b. Assess chest rise symmetry
✅✅
c. Examine tube markings near the lips
d. Obtain a chest radiograph - -d. Obtain a chest radiograph
A 5-year old child in the emergency department is demonstrating wheezing on
the right side while breath sounds are normal on the left. The respiratory
therapist should FIRST do which of the following?
a. Perform beside pulmonary function testing
b. Order a spiral CT scan
✅✅
c. Perform an ABG
d. Obtain a chest radiograph - -d. Obtain a chest radiograph
A 58-year-old female admitted for mycoplasma pneumonia with significant
infiltrates throughout all lung fields has a PaO2 of 58 torr while on FIO2 0.60
and PEEP of 15 cm H2O and is receiving volume-controlled ventilation. Which
of the following should the respiratory therapist recommend FIRST to improve
the patient's oxygenation?
a. Increase PEEP to 20 cmH2O
b. Switch to pressure-controlled ventilation
✅✅
c. Administer tetracycline
d. Increase FiO2 to 1.0 - -a. Increase PEEP to 20 cmH2O
A 60-year-old patient with COPD is brought to the emergency department in
ventilatory distress. The patient is current receiving supplemental oxygen at
50% via Venturi mask. The respiratory therapist notes the patient is difficult to
arouse and has short, shallow respirations. Which of the following should the
therapist do?
a. Obtain a A-P chest radiograph
b. Manually ventilate the patient
✅✅
c. Obtain arterial blood for a blood gas analysis
d. Calculate C(adv.)DO2 - -c. Obtain arterial blood for a blood gas
analysis
A 62-kg (136 lb.) male is receiving volume-controlled ventilation on the
following settings:
Mode SIMV
, Mand. rate 10
Total rate 6
Tidal volume 400 mL
Pressure support 6 cmH2O
VT (spont.) 400 mL
PEEP 10 cmH2O
Arterial blood gas analysis reveals:
7. / / -1
Based on this data, the first recommendation of the respiratory therapist
should be to
a. Increase pressure support to 10 cmH2O
b. Increase tidal volume to 550 mL
✅✅
c. Remove deadspace
d. Increase mandatory rate to 18 - -d. Increase mandatory rate to 18
A 64 kg (141 lb.) female patient is admitted to the intensive care unit after
undergoing a pneumonectomy of the left lung. The patient is receiving oxygen
at 100% via bag-valve mask. There are no spontaneous respirations. SpO2 is
97%. Which of the following would be appropriate initial ventilator settings?
a. PC, SIMV, rate 8, IP 34 cm H2O, I-time 1.0 sec, FIO2 0.5, no PEEP
b. VC, A/C, rate 16, FIO2 1.0, VT 275 mL, PEEP 5 cmH2O
✅✅
c. VC, SIMV, rate 10, FIO2 1.0, VT 500 mL, PEEP 5 cmH2O
d. VC, SIMV, rate 12, FIO2 1.0, VT 650 mL, PEEP 5 cm H2O - -b. VC,
A/C, rate 16, FIO2 1.0, VT 275 mL, PEEP 5 cmH2O
A 64-year-old patient with meningitis has received volume-controlled
ventilation for 11 weeks. In an attempt to slowly wean the patient from
dependence on mechanical ventilatory support, spontaneous breathing trials
with a T-tube have been done over the last few days. The following data is
available:
30min 1hr 2hr
Pulse rate 89 112 122
SpO2 97 87 84
MIP -30 -19 -17
Vital Capacity (L) 1.7 0.9 0.7
Respiratory rate 20 30 36
The respiratory therapist should recommend
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