TMC Exam Review (extensive explanations) 2024/2025 with 100% correct answers
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Course
TMC
Institution
TMC
You come upon a patient who is unresponsive and is not breathing. You had heard from her nurse that she had discussed a do not resuscitate (DNR) order with her physician. You should:
A) Check the patient's chart for a DNR order/advanced directive
B) Immediately call a code and begin resuscit...
You come upon a patient who is unresponsive and is not breathing. You had heard from her nurse that
she had discussed a do not resuscitate (DNR) order with her physician. You should:
A) Check the patient's chart for a DNR order/advanced directive
B) Immediately call a code and begin resuscitation efforts
C) Contact the nurses' station and ask how best to proceed
D) Call a "slow code," i.e., apply basic CPR, but not ACLS correct answersThe correct answer is:
*Immediately call a code and begin resuscitation efforts*
If there is any doubt regarding a do not resuscitate (DNR) order or when written orders are not present,
resuscitation efforts should begin. Formal or informal directives such as "slow code" or "code gray"
bypass the patient's rights and are generally inappropriate.
Which of the following determine the amount of oxygen delivered to the tissues?
1. Venous O2 Content (CvO2)
2. Cardiac Output (CO)
3. Arterial O2 Content (CaO2)
A) 1 and 2
B) 1 and 3
C) 2 and 3
,D) 1, 2, and 3 correct answersC) 2 and 3
Oxygen delivery to the tissues is a function of both the total arterial oxygen content and the cardiac
output: Oxygen Delivery (mL/min) = CO (dL/min) x CaO2 (mL/dL)
A polysomnography report indicates an average of 2-3 mainly obstructive apnea/hypopnea events per
hour. Which of the following statements is most consistent with this observation?
A) since there are less than 5 events per hour, the findings are inconclusive
B) the findings confirm a diagnosis of mild obstructive sleep apnea
C) the findings confirm a diagnosis of moderate obstructive sleep apnea
D) the findings confirm a diagnosis of severe obstructive sleep apnea correct answersA) since there are
less than 5 events per hour, the findings are inconclusive
In adults, a diagnosis of obstructive sleep apnea (OSA) is confirmed if the number of abnormal
respiratory events is > 5/hour. The severity of OSA is graded as follows Mild: 5-15 abnormal events/hour;
Moderate: 15-30 abnormal events/hour; Severe: > 30 abnormal events/hour. In this case since there are
less than 5 events per hour, the findings are inconclusive.
The normal range of adult blood pressure (systolic/diastolic) is about:
A) 80-100/40-70 mm Hg
B) 100-140/60-90 mm Hg
C) 120-140/90-100 mm Hg
D) 130-150/100-110 mm Hg correct answersB) 100-140/60-90 mm Hg
,Normal systolic pressure range from 100 to 140 mm Hg, with an average of 120 mm Hg. Normal diastolic
pressures range from 60 to 90 mm Hg, with an average of 80 mm Hg. The blood pressure is recorded
with systolic listed over diastolic; i.e., 120/80 mm Hg.
A patient is admitted to the ICU from a post-operative surgical unit with a hospital-acquired lobar
pneumonia. A sputum Gram stain reveals Gram-positive organisms. Which of the following is the most
likely cause of the pneumonia?
The most common bacteria causing nosocomial pneumonia are the Gram-negative organisms
Pseudomonas aeruginosa, Haemophilus influenzae, Escherichia coli,and Klebsiella and Acinetobacter
species and the Gram-positiveorganisms Staphylococcus aureus (especially methicillin-resistant S aureus
or MRSA) and Streptococcus pneumoniae.
Which of the following is the best index of oxygen transport for a patient who has been resuscitated
after carbon monoxide poisoning?
, The best index of oxygen transport is the total arterial oxygen content (CaO2) which is the sum of the
oxygen carried on hemoglobin (SaO2 x Hb) plus the oxygen dissolved in the plasma (.003 x PaO2). By far
the most important index of O2 transport is the amount of oxygen carried on hemoglobin, as measured
by CO-oximetry. Because it represents such a small portion of the total CaO2, the PaO2 is almost
irrelevant in these patients.
To what section of a patient's chart should you refer to understand any important cultural or religious
influences on the provision of care?
A) social history
B) advance directives
C) family disease history
D) chief complaint correct answersA) social history
A patient's social history typically includes the following elements: education, employment, finances;
marital status; diet and exercise; cultural background and religious influences; living situation and social
support; social activities, hobbies and recreation; tobacco, alcohol or drug use; satisfaction/stress with
life situation, finances, relationships; and recent travel or other event that might impact health.
In assessing a patient in the acute phase of ARDS, you would expect to find:
In ARDS, pulmonary edema, atelectasis, and surfactant loss combine to reduce lung volumes and
compliance and cause severe hypoxemia that does not respond well to increases in FIO2 (refractory
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