What maximum flow would you apply to an 8 year-old child receiving O2 therapy via a high flow nasal cannula? close contact with active TB cases, such as a family member. In addition, patients Following a myocardial infarction, a 60-year-old patient with congestive heart failure is being mechanically ventilated. However, either imaging modality can be, A. thoracic ultrasound C. Preventive maintenance C. Airway resistance A. B. A pulse oximeter reveals an Sp02 of 99%. C. 30 to 40 cm H2O downstream resistance, less air is entrained and the delivered FIO2 rises. D. Fully occlude the ET tube while you quickly it out, 21. You are called to assess an intubated COPD patient who is receiving humidified O2 via T-tube and B. And when you have those, they are tied into hypoxemia." 3rd left intercostal space, anterior axillary line C. 5th right intercostal space, midclavicular line D. 5th left intercostal space, midclavicular line, 27. D. A jet nebulizer, 71. Upon admission for any procedure, it is important to ensure that an informed consent has been signed and the patient verifies they understand what is going to happen to them. profound hypoxemia. C. 1 and 4 only Incorrect placement can worsen airway obstruction A. Which *C. measure pressure during an end-expiratory pause You will then be asked to store all personal items in a secure locker. Yes Yes No D. The alveolar ventilation per minute will remain constant, 43. D. 1, 2 and 3, 63. B. C. Aspiration B. Pneumomediastinum A Spiral/Helical CT takes less than 30 minutes to complete. The most Based on this change, you should The patients blood pressure is 95/60 mm Hg. pneumothorax. Mr. Rench, a National Merit Scholar, graduated magna cum laude with a Bachelor of Science in Mechanical Engineering and a minor in mathematics from Texas A&M University. Which of the following is the first procedure you should perform to maintain an open airway in this patient? weakened or flaccid diaphragm being "sucked up into the thorax, causing inward motion of the, abdomen. A. Nasal tubes are less likely to cause trauma B. a patient whose first language is not English diagnosis of this problem. Which of the following endotracheal tube malfunctions could require extubation and reintubation with a new tube to allow effective positive pressure ventilation of the patient? C. This therapy will help you take deep breaths and expand your lungs D. The large #1 pharyngeal cuff must be deflated before laryngoscopy, 54. A. By increasing the flow rate, you can decrease the I: Time. B. obtain an arterial blood gas and measure the SaO2 using a CO-oximeter D. septic shock, General Feedback: Cor pulmonale is right heart failure due to chronic lung disease. D. The large 41 pharyngeal cuff must be deflated before laryngoscopy, 23. (including SIRS), sepsis, major trauma (including burns), shivering, seizures, agitation/anxiety/pain, *A. gurgling Once your personal items are stored, you will be led into the testing room and given a short tutorial on the testing system. A 150-lb. PDF Prophecy Healthcare Nursing Specialty Exams Did you know that using sample practice questions is one of the best ways to prepare for (and pass) the TMC Exam? TMC T. 0 cm H2O resuscitator, your first action should be to squeeze the bag more slowly. D. Acute upper airway obstruction, 41. rate against either a manually palpated pulse or that measured by an ECG monitor. The pressure manometer is out of calibration 1. Faarc, Cairo J. PhD Rrt. C. Right ventricular hypertrophy D. 400 m 430 m, A. expands during inspiration. Based on these data, what is the primary acid-base disturbance? A neck X-ray will show a column of air around the epiglottis and a "thumbs up sign.". anaerobic threshold (if it can be reached), but a reduced breathing reserve. 1.diagnostics 2.chronic disease state management 3.evidence-based medicine and respiratory care protocols 4.patient assessment 5.leadership 6.emergency and critical care 7.therapeutics C. 15 L/min circuit and the patient's airway will have which of the following effects? Steaming and boiling the equipment can sometimes damage equipment and is not recommended. To minimize the risk of aspiration of glottic secretions or cord damage during the removal of an oral endotracheal tube, you should: D. component materials, General Feedback: Flow resistance through an endotracheal tube depends on both the tube's inside abdominal paradox. 7th ed., Mosby, 2019. C. decrease in circuit compliance A. Tracheomalacia Which of the following are FALSE regarding oropharyngeal airways? B. Sensitivity for confirming ('rule in') a diagnosis of pulmonary embolism. In most instances, analysis of the pleural fluid yields valuable diagnostic information or To change the level of negative pressure delivered by a pleural drainage system, you would C. Chronic airways obstruction 1 and 2 B. I, ll and Ill only B. cuff compliance B. pleural effusion The unscored questions are called pretest questions and are used to validate questions for future versions of the exam. Right heart failure negative if they have: Due to her patient's minimal response to the standard prescription for an aerosolized bronchodilator, a B. serial P(A-a)O2 measurements Stack #121029 (7 . A patient has a pH of 7.58 and a PaCO2 of 25 torr. D. diaphoresis, General Feedback: Normally, as secretions pool in the oropharynx, the cough reflex is stimulated to aid, General Feedback: On inspection of an adult, inspiration (I) should normally be shorter than expiration For each question you answer correctly, you will receive one point toward your score. What is your interpretation of this display data? As the lungs become less compliant, less volume can be accommodated, thus increasing the pressure in the lungs as lung volumes are trying to be maintained. They adjust to changes in volume and pressure relatively easy. C. the reservoir temperature will equal room temperature C. Apply the probe more tightly C. administering oxygen via nasal cannula at 5 L/min C. Nor mal Increased Increased *D. end of a normal resting exhalation, General Feedback: The validity of FRC measurement via either helium dilution or nitrogen depends on *B. In reviewing a sleep study, you note 20 to 25 episodes per hour like that depicted in example 'A' in the The respiratory therapist is treating a patient with pulmonary emphysema. C. 3 and 4 only B. measure pressure at volume increments using a super syringe an increase in cardiac rate of 15/min III. 1 and 2 only B. All the above. You can also select the uncuffed ET tube with an internal diameter of 2.5 mm tube for infants less than 1 kg weight, 3.5 mm for neonates up to 1 year of age. An internal diameter of 3.0 mm should be used for neonates over 3.5 kg and less than a year old. C. Keep the tube cuff pressure below 25-30 cm H20 A. A. The case worker is responsible for ensuring the patient has what they need when they go home to ensure proper care is continued. C. Order a chest X-ray 2 minutes B. Right heart failure causes venous, A. asthma Other available arteries are too small to easily puncture When inspecting the x-ray of a patient in ICU, you note a large area of radiolucency between the left lung border and chest wall and increased density of left lung. C. An ultrasonic nebulizer The decrease in lung volumes and compliance increases the patient's spontaneous work To avoid preanalytic errors associated with air contamination of a blood gas sample, all of the following are appropriate EXCEPT: B. bronchoscopy D. increased cardiac output, Patient Pre-Program 6MWD Post-Program 6MWD expired PCO 2 of 35 torr. 215 mL 1 and 3 only B. Which of the following specialized imaging tests would be most useful in confirming a diagnosis a Check the cuff inflation 1 and 2 only definitively establishes the cause of the pleural effusion. need mechanical ventilation. 1. John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. Thanks for reading, and I wish you the best of luck! Which of the following actions would you take at this time? Measurement of the patient's vital capacity also can be useful as a, A. no known risk factors for tuberculosis C. decrease the delivered O2 concentration concentrator Which of the following is the most likely problem? Sign Up Now! Which of the following would you recommend for a patient with obstructive sleep apnea for whom Pressure above 30 cm H2O can cause tracheal injury and pressure below 20 cm H2O can increase the You observe the following on the bedside capnograph display of a patient receiving ventilatory support. 6-10 cm D. Interstitial infiltration, 70. A. Blots breathing Ai Tactile Fremitus is a palpable increase in vocal vibrations transmitted through the chest wall. B. A patient suddenly loses consciousness. 5 L/min Take this free Respiratory Therapist practice exam to test your knowledge of respiratory therapy subjects. To confirm this, an, A. serial end-expired PCO2 measurements C. increased compliance Neither the outside diameter, component, Portable O B. Which of the following is the most likely underlying problem? at least a 10-20% improvement in the 6MWD to consider the treatment effective. B. pneumonia A. B. But with a combination of hard work, dedication, and the right resources, I have faith that you will be successful. C. Precision gas mixtures (02/002) A. A. II and IV only There is no, General Feedback: Although all patients have PCO2s above 50 torr, only patient B has a life-threatening A. measure pressure during an end-inspiratory pause Which of the following is the most likely problem? Straight with the torso, with the neck hyperextended D. water will condense on the inside of the delivery tubing, General Feedback: In all humidifiers, heat is lost due to evaporative cooling. Water and Hydrogen Peroxide can be used to soak the inner cannula of a Trach to loosen dried and tenacious secretions and then cleanse it with a brush, but it does not disinfect the equipment. D. 1, 2 and 3, 37. C. Tilted forward toward the chest Get complex subjects broken down into easily understandable concepts. The name on your registration must match the name on your identification. During inspiration, air is heard at the mouth. Keep RR high to keep PaCO2 levels between 25 and 30 mmHg and PIP below 30 cmH2O to avoid suctioning and causing coughing which raises ICP. 1 atmosphere C. 5-6% or more Decreased Nor mal Nor mal All of the following cause false HIGH Sp02 readings when using a pulse oximeter EXCEPT C. Nonrebreathing mask During oral intubation of an adult, the endotracheal tube should be advanced into the trachea about how far? Thoracentesis is urgent when hemothorax or empyema is suspected (requiring chest, pressure (MEP)Max expiratory capacityVital Max inspiratorypressure (MIP), A. C. the oxygen flowmeter setting is too high While using an ICU ventilator with its optional air compressor running, you note that the low air pressure alarm suddenly sounds. I. an increase in respiratory rates of 20/min II. . D. Initiate inverse ratio ventilation, 48. of the following laboratory studies would provide the most useful information? There are 160 multiple-choice questions on the exam. media), have smooth walls and gradually taper as they continue to branch. D. the ventilator rate mechanism has malfunctioned, A. the reservoir will be warmer than room temperature A. D. atelectasis, General Feedback: Normally, the heart width is less than 50% of the width of the thoracic cage. C. Patient C pressure monitoring provides essentially no information regarding right heart performance. The nurse indicates that the patient has become increasingly drowsy Increased need for . Oximetry is also a device that gives you data, but it is on Oxygen, not End Tidal CO2. The proper starting point for FRC measurement via helium dilution or nitrogen washout is: A 20-year-old woman with diabetes who takes insulin has the following ABG results while breathing C. Cystic fibrosis Rule-based procedures designed to help detect, respond to and correct blood gas analyzer or hemoximeter errors over time best describe: You must have at least an associate degree from an accredited respiratory therapy education program. A "normal" chest wall would have no feelings of bubbling, cracking or vibration with speech beneath your hands or fingers. Provide 100% oxygen for 1-2 minute before extubation by Mometrix Test Preparation | This Page Last Updated: February 16, 2023. the patient's name, 2) the drug name, 3) the drug dosage, 4) the frequency of administration, 5) the A. sedation/analgesics, muscle paralysis, shock/hypovolemia, hypothermia/cooling, hypothyroidism, A. FRC In the sniffing position unknown origin. A. Diffuse interstitial fibrosis A. "COVID-19 affects the lung interstitium," Cahill said. 10 L/min Carbon monoxides high affinity for hemoglobin will cause C. Small airways obstruction C. carbon monoxide diffusing capacity (DLco) C. 7.9 L/min D. measure expiratory flow before and after bronchodilator, General Feedback: One can quantify the amount of auto-PEEP present by measuring the airway pressure, A. D. < 10 cm H2O. Observed changes in the apnea-hypopnea index (AHI) are then correlated with the various CPAP 20 to 30 cm H2O The format of the TMC Exam is multiple-choice, with 160 questions that must be completed within three hours. You do not give the "correct" dose and then confirm the order afterwards. C. The radial artery has the highest systolic pressure available Which of the following can provide ambulatory patients on long-term oxygen therapy with mobility Possible reasons for this discrepancy include. A. A 68 year-old female patient with severe COPD has been provided with educational materials describing essential self-management activities to help her control her disease. Pass the TMC Exam using practice questions, quizzes, and real-life practice exams. C. simple pneumothorax The alveolar ventilation per minute will decrease For both delivery methods (on-site and remote), you should arrive or be logged in 30 minutes before your testing appointment. Drug name and dose D. Inflate cuff until the leak ceases at < 25-30 cm H20, 64. *C. CT pulmonary angiography B. Gastric insufflation with a cardiovascular limitation to exercise will exhibit a decreased anaerobic threshold, but may have a *B. pneumothorax A. Airway Clearance Therapy Lung Expansion Therapy Medical Gas Therapy Humidity and Bland Aerosol Therapy Flexible Bronchoscopy Intermittent Positive Pressure Breathing (IPPB) Smoking Cessation Hemodynamic Monitoring Extracorporeal Life Support Ambulation Cardiopulmonary Rehabilitation Chest Physiotherapy (CPT) Acapella Flutter Valve Respiratory alkalosis inspiratory and expiratory pressures. You hear a high-pitched sound coming from the pressure relief valve on a patients bubble-type humidifier. Gas can be felt coming from the valve. 4.6 L/min To minimize the risk of aspiration of glottic secretions or cord damage during removal of an oral endotracheal tube, you should C. Patient C Which of the following statements regarding CENTRAL cyanosis is FALSE? Which of the following are potential causes of this problem? The NBRC evaluates the competency of respiratory therapists and ensures that graduates of accredited respiratory care education programs have every opportunity to earn the RRT credential. Which of the following of the following inspiratory/expiratory ratios would indicate an abnormally The normal I:E ratio for an infant with normal lung compliance and an infant with obstructive lung disease is the same: 1:1.5 to 1: 2. On the day of your exam, ensure that your testing area is clear of reference materials, your cell phone, and food or drink containers. In reviewing the chart of a 55 year old male patient, you note the following symptoms: obesity, loud snoring and insomnia. Secretions from pulmonary edema are often thin and frothy. As the patient tires the spontaneous breathing rate becomes rapid and shallow and it is necessary to evaluate muscle fatigue. D. Standardized buffer solutions, 66. 21-23 cm marks at teeth A. 1-2 cm These findings are most consistent with which of the following diagnoses? increase the risk of accidental extubation. Face tent This is the quick method to determine size. Compliance = Change in Volume/Change in Pressure. Which of these patients is most in Which of the following would deliver the most particulate water to a patients airway? You can also increase PEEP level to match Auto-PEEP if other measures do not resolve the issues. You do not give a medication order that is not correct. Which of the following could cause this problem? A. Tracheomalacia B. You can assess respiratory muscle strength by measuring the patient's maximum D. 1034 cm H2O, 59. The total number of these desaturation events per hour is the oxygen you would need to measure the pulmonary artery wedge pressure (PAWP or PCWP). If the FiO2 is not 60% or over then increase the FiO2 first until you reach 60%, then adjust your PEEP. The PH is acidic-less than 7.35, PCO2 is high-greater than 45 mmHg demonstrated hypoventilation, and there is a normal HCO3. increase downstream flow resistance and create back-pressure. Crepitus is a crackling feeling beneath the skin when your fingertips press on an area. B. C. Frequency of administration D. Contraindications, 20. With Over 1000+ Successful Respiratory Therapy Students, You Can Join The #1 Online Respiratory Test Preparation Program at Only $7.75 (USD) per month when paid annually (limited time). Pneumonia Bronchodilators and suctioning remove obstruction of the airway due to secretions or edema. Obstructive Lung Disease will cause a higher than predicted increase in values of FRC, RV and TLC. B. of 40/min. A patient has a minute volume of 7.50 L/min and is breathing at a rate of 16 breaths/min. B. The cuff pilot balloon and line is obstructed When sealing the cuff to achieve a minimal occluding volume, you note a cuff pressure of 45 cm H20 What is the most likely problem? In most blood gas analyzers, what media is used to calibrate the pH electrode? To verify that you are getting a good reading, you would: To measure the amount of auto-PEEP present in a patient receiving ventilatory support, you would: The recommended range for tracheal tube cuff pressures is: To assess gas exchange at the tissues you would sample blood from which of the following? A. Tracheal granuloma Yes No Yes Clinical Application of Mechanical Ventilation. Based on the results of cardiopulmonary exercise testing, which of the following patients most likely Conversely, fever, Inflammation B. Hypercapnia (impaired CO2 removal) cough reflex? During a single-breath capnogram, the sharp downstroke and return to baseline that normally occurs after the end-tidal point indicate:
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