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RRT TMC EXAM QUESTIONS WITH CORRECT
VERIFIED SOLUTIONS 100% GUARANTEED
PASS (2025/2026)
While at the bedside of a patient receiving volume control ventilation, you suddenly notice the simultaneous sounding of the high pressure and low volume alarms. Which of following is the most likely cause of this problem?
- ANS ✓a mucous plug in the ET tube While feeling a patient's radial pulse, you note that the pulse feels bounding and full. Which of the following conditions would likely be the cause of this finding? - ANS ✓hypertension The physician calls you over to examine the ABG results of a 52 kg female patient who is receiving volume control A/C ventilation. Currently the patient has a tidal volume of 400 mL, rate of 10/min, and 35% O2. Her blood gas results are as follows: pH 7.31 PaCO2 49 torr HCO3 24 mEq/L BE - 2 mEq/L PaO2 74 torr SaO2 95% Based on these values, which of the following changes is appropriate? - ANS ✓increase the set rate Your patient has a large pneumothorax and also displays hypotension. What is most likely the cause of this finding? - ANS ✓decreased venous return to the heart A patient in intensive care unit suddenly start to deteriorate. The attending physician wants to rule out an acute pulmonary embolism as the cause. Which of the following laboratory tests would you recommend? - ANS ✓d- dimer A ventilator operating in the volume controlled A/C mode incorporates an inspiratory time limit control as a safety backup to its normal cycling. If the
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time needed to deliver the volume increases to the preset limit, which of the following will occur? - ANS ✓the ventilator will automatically cycle to end inspiration While reviewing the chart of a 63-year-old patient diagnosed with COPD and chronic hypoxemia, you would expect to find which of the following? - ANS ✓secondary polycythemia Which of the following PFT findings are common in patients with chronic bronchitis and also found in those with emphysema? - ANS ✓decreased forced expiratory flows A 1-year-old child is admitted to the Emergency Department with severe asthmatic symptoms. The doctor orders a bronchodilator that is available in solution and MDI preparations. Which of the following would be the best delivery system for this drug to this patient? - ANS ✓MDI with holding chamber and a mask Of the following patients undergoing a cardiopulmonary exercise test, for which would you recommend extra precautions? - ANS ✓a patient with a resting systolic BP > 200 mm Hg While reviewing the flow sheet of a patient receiving artificial ventilatory support, you note a progressive rise in heart rate over the last two hours. Which of the following actions would you recommend to help identify the cause of this problem? - ANS ✓draw and analyze an arterial blood gas After obtaining a medication history from a patient admitted for asthma, which of the following information would you consider least important? - ANS ✓use of generic vs. brand name medications Which of the following valves in a typical high frequency oscillation ventilator is used to regulate the mean airway pressure? - ANS ✓Control valve
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Lukens trap. When applying suction after entering the airway, the mucus should: - ANS ✓pass through the suction catheter and then enter the Lukens trap You hear wheezing while auscultating a patient's chest. This may indicate the presence of which of the following? - ANS ✓Aspirated Foreign Body While performing a routine patient-ventilator check, you note the following settings and parameters: Exhaled tidal volume 650 mL Peak inspiratory pressure 33 cm H2O High pressure limit 60 cm H2O Low pressure alarm 20 cm H2O Low tidal volume alarm 500 mL Which of the following change would you make? - ANS ✓decrease the high pressure limit to 45-50 cm H2O Which of the following are acceptable changes in a patient's status during a spontaneous breathing trial for weaning from mechanical ventilation? - ANS ✓heart rate rises from 103 to 118/min An apnea monitor alarm is sounding continuously but your initial assessment of the patient reveals that they are breathing normally. You next action should be to: - ANS ✓Check the electrode connections on the patient If a patient develops a paradoxical pulse following trauma or cardiothoracic surgery, especially in connection with increasing venous pressure and heart rate, it would suggest which of the following? - ANS ✓cardiac tamponade While performing a routine ventilator check on a patient receiving volume controlled ventilation, you note that the peak airway pressure has decreased from a prior value of 52 cm H2O to 32 cm H2O. There have been no changes to the ventilator settings. Which of the following actions would be appropriate at this time? - ANS ✓check the patient-ventilator circuit for system leaks
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A doctor orders O2 titration with exercise for a patient with a chief complaint of dyspnea on exertion. The patient's baseline SpO2 is 84% on room air. You would: - ANS ✓terminate the protocol and contact the doctor What is the purpose of the pilot balloon on an endotracheal or tracheostomy tube? - ANS ✓monitor cuff integrity and pressure If you were to instruct a patient to take a maximum deep breath and then exhale completely, which maneuver is being measured? - ANS ✓vital capacity (VC) Which of the following ECG leads should be placed in the 5th intercostal space? - ANS ✓V A 16-year-old patient with cystic fibrosis is receiving pressure control SIMV with pressure support due to a severe bilateral pneumonia. The pulmonologist asks you to administer aerosolized dornase alfa (Pulmozyme) in-line with the ventilator. Which of these devices would you select to administer this therapy? - ANS ✓vibrating mesh nebulizer Atelectasis has been diagnosed via a chest x-ray on an unconscious patient who had a recent open heart surgery. Before surgery, the patient's best FVC value was 55% of the predicted. What would you recommend in order to treat the patient's atelectasis? - ANS ✓IPPB For your patient receiving volume control AC ventilation, you observe a flow-volume loop with a sawtooth pattern on exhalation. Which of the following actions would you consider most appropriate? - ANS ✓assess the patient's need for suctioning A patient is stabilized with adequate oxygenation and ventilation on volume control ventilation (VC) with the following settings: rate = 15/min, tidal volume = 550 mL, peak inspiratory pressure (PIP) = 45 cm H2O, plateau pressure = 30 H2O and PEEP = 10 cm H2O. The doctor orders a
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A patient in intensive care unit is suspected of having developed a bacterial ventilator associated pneumonia. Which of the following procedures would you recommend in order to diagnose the cause of this problem? - ANS ✓bronchoalveolar lavage A male patient with a smaller than normal trach tube is placed on volume control SIMV at a rate of 8/min. Over the last hour, you note the patient increasing use of his accessory muscles during spontaneous breaths, accompanied by some abdominal paradox. Which of the following would be the best way to overcome this problem? - ANS ✓add or increase pressure support Before intubation in an emergency situation, injection of air into the pilot line fails to inflate the cuff. Which of the following should you do? - ANS ✓replace the endotracheal tube In assessing a patient in the acute phase of ARDS, which of the following would you expect to find? - ANS ✓refractory hypoxemia A nurse who recently set up a pleural drainage system on a patient with a pneumothorax complains that she doesn't see any bubbling in the suction control chamber. After checking the suction control regulator to confirm that it is on, which of the following would you recommend that she do next?
- ANS ✓check the connecting tubing for leaks or obstructions To provide long-term positive pressure ventilation, a cuffed artificial airway is needed in order to: - ANS ✓prevent gas leaks and aspiration While inspecting an elderly female patient, you note that she has an abnormal anteroposterior (AP) curvature of the spine. This best describes which of the following? - ANS ✓kyphosis You are called to check on a patient receiving volume controlled A/C ventilation. You note that both the low tidal volume and high pressure limit
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alarms are sounding on each inspiration. You first action should be which of the following? - ANS ✓disconnect patient and provide manual ventilation with 100% O A 54 year-old patient is on a ventilator in the volume control mode. After you perform endotracheal suctioning, which of the following would indicate effective clearance of retained secretions? - ANS ✓lower peak pressure Which of the following conditions would a ventilation scan appear normal but a perfusion scan reveal areas of absent blood flow? - ANS ✓pulmonary embolism A patient is considered to have sufficient respiratory muscle strength to maintain adequate ventilation and prevent secretion retention when the maximum inspiratory pressure (MIP; NIF) is more negative than which of the following? - ANS ✓-20 cm H2O Which of the following selections in a patient's medical history would be least important to consider in evaluating their pulmonary condition? - ANS ✓dietary habits A normal 5-foot 4-inch tall staff member serves as a biologic control for the PFT lab. Her established FVC is 3.81 L with a SD of ±0.13 L. During quality control testing of a spirometer, she produces the following FVC results: FVC #1 = 3.73 L, FVC #2 = 3.88 L, FVC #3 = 3.71 L. You should conclude that the - ANS ✓the spirometer is performing within acceptable limits After opening the valve on an E cylinder which has a regulator attached, you hear a hissing noise. The flowmeter/gauge is turned off. Which of the following corrective actions should you take? - ANS ✓tighten the regulator connection
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If you were to hear bronchial breath sounds over the patient's right middle lobe, what condition would you suspect is probably present? - ANS ✓pneumonia You are called to evaluate a patient's breathing pattern. You see that the patient's tidal volumes go from small to large to small and then stop for 10 seconds before starting again and it repeats itself. Which of the following would best describe this breathing pattern? - ANS ✓cheyne-stokes respiration A trauma patient has been receiving volume controlled SIMV via an endotracheal tube for the past three days. The attending surgeon anticipates that the patient will likely be on the ventilator for another 4 to 5 days. Which of the following actions would you recommend? - ANS ✓maintain the endotracheal tube in place You are monitoring a mechanically ventilated patient 36 hours post- craniotomy who has an ICP of 20 mmHg but is otherwise stable. The latest ABG results are as follows: pH 7.39 PaCO2 43 mm Hg HCO3 24 mEq/L BE 0 PaO2 88 mm Hg SaO2 95% Based on this information, which of the following is the most acceptable action? - ANS ✓maintain the current settings While assessing a patient who is receiving ventilatory support, you note significant weakening of the pulse during the inspiration of machine-given breaths. Which of the following is the most likely cause of this finding? - ANS ✓decrease stroke volume during positive pressure Which of the following would you recommend to help guide a physician in locating the appropriate needle insertion site for thoracentesis performed at the bedside? - ANS ✓ultrasound Of the following statements, which is TRUE regarding capillary blood gas sampling? - ANS ✓sample pH and PCO2 correlate well with standard ABGs
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You notice over a 2-hour period, the plateau pressure of a patient receiving volume controlled ventilation has remained stable, but her peak pressure has steadily increased. Which of the following is most likely the reason for this observation? - ANS ✓the patient's airway resistance has increased A 58-year-old postoperative male who weighs 78 kg (172 lb) is receiving volume control A/C ventilation at a rate of 14/min with a tidal volume of 650 mL and an FIO2 of 0.4. Results of arterial blood gas analysis are as follows: pH 7.51 PaCO2 30 torr HCO3 23 mEq/L BE - 1 PaO2 117 torr SaO 99% Based on this information, you should recommend which of the following? - ANS ✓decrease the minute ventilation Which of the following will tend to cause false LOW readings when using a pulse oximeter? - ANS ✓vascular dyes In assessing a new admission to the Intensive Care Unit, you note a spontaneous respiratory rate of 37/minute. The most likely cause of this observation is: - ANS ✓metabolic acidosis If the patient complains of difficulty in starting the IPPB treatment, which control should you adjust? - ANS ✓Sensitivity You have a patient that is receiving pressure controlled A/C ventilation. Which of the following changes would you expect to occur if the patient's lung compliance were to decrease? - ANS ✓delivered volume will decrease What type of laryngoscope blade would you select when performing an emergency intubation on an infant? - ANS ✓miller The attending physician requests that you increase the expiratory time on a patient receiving volume control ventilation, but not alter the minute ventilation. Which of the following settings would you adjust to fulfill this request? - ANS ✓inspiratory flow
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Which of the following should be asked in order to help determine if a patient has orthopnea? - ANS ✓"Do you need to use extra pillows when you sleep?" While auscultating a patient's lungs, you hear bronchial breath sounds over the left lower lobe area. This would indicate which of the following? - ANS ✓Consolidation in the patient's left lower lobe After assessing your patient, they are acutely dyspneic and hypotensive, you note the following (all limited to the left hemithorax): reduced chest expansion, hyperresonance to percussion, absent of breath sounds and tactile fremitus, and a tracheal shift to the right. Which of the following would these findings suggest? - ANS ✓left-sided pneumothorax While observing the AP chest radiograph of a patient suffering from advanced stages of pulmonary emphysema, which of the following finding would you expect to see? - ANS ✓flattening of the diaphragms A 53-year-old female patient with chronic bronchitis is receiving volume controlled A/C ventilation. Wheezing is heard over all lung fields and rhonchial fremitus is felt over the central airways. Also, her secretions are very thick. The patient's peak pressure is 45 cm H2O and plateau pressure is 20 cm H2O. Which of the following would be useful to treat the patient's condition? - ANS ✓levalbuterol (Xopenex) Before giving an aerosol treatment, you see a note in the chart that states your patient had pink frothy secretions on admission to the emergency department. This is most likely indicates which of the following: - ANS ✓left ventricular failure After assessing an acutely dyspneic and hypotensive patient, you note the following, all on the left side of the chest: reduced chest expansion, hyperresonance to percussion, absent of breath sounds and tactile fremitus, and a tracheal shift to the right. These findings most likely suggest: - ANS ✓left-sided pneumothorax
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Which of the following should you do when the reservoir bag of a nonrebreathing mask collapses completely during inspiration? - ANS ✓increase the flow to the bag You should recommend AGAINST performing a diagnostic bronchoscopy procedure on a patient with which of the following? - ANS ✓severe hypoxemia The normal range for the pulmonary capillary wedge pressure (PCWP) as measured via the distal port of a pulmonary artery or Swan-Ganz catheter (with the balloon inflated) is: - ANS ✓ 6 - 12 mm Hg Which of the following would most likely cause a misleading or incorrect pulse oximetry reading? - ANS ✓Excessive probe movement For a patient receiving positive-pressure ventilation, you should strive to keep the alveolar (plateau) airway pressure below which of the following? - ANS ✓30 cm H2O A patient is being ventilated in the volume-control mode when suddenly the high pressure alarm begins to sound. Which of the following actions would likely correct this problem? - ANS ✓suction the airway A patient's bedside spirometry results are as follows: FVC decreased, FEV normal, FEV1% increased. What is the most likely problem? - ANS ✓a restrictive disorder Bedside spirometry performed on a patient reveals the following: Respiratory rate = 21, Tidal volume = 350 mL, Dead space = 155 mL, Vital capacity = 1.0 L. Based on this data, what is the patient's minute ventilation? - ANS ✓7.4 L/min
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recommend which of the following tests to confirm or rule-out this diagnosis? - ANS ✓tissue biopsy via fiberoptic bronchoscopy In order to initiate weaning, you change the patient from volume control A/C ventilation to pressure support. After 30 minutes on pressure support, the high respiratory rate alarm sounds, with the patient breathing at a rate of 25 to 30 per minute. What change should you make to the ventilator settings? - ANS ✓increase the high rate alarm to 30- 35 Ventilatory support may be indicated when the pulmonary R-L shunt fraction (Qs/Qt) rises above what level? - ANS ✓ 20 - 25% A patient in intensive care unit develops a supraventricular tachycardia at a rate of 162/min. Which of the following effects would this have on cardiac function? - ANS ✓decreased end-diastolic volume A patient with asthma is in acute respiratory distress and presents to the emergency room with diminished breath sounds. After bronchodilator therapy, auscultation of the chest reveals rhonchi and wheezing. This change suggests which of the following? - ANS ✓improvement of the air flow You are called to the emergency department to help care for a patient who was in a vehicle accident and has chest injuries including broken ribs. Crepitations are felt while palpitating the patient's neck. What is most likely the cause of this? - ANS ✓The patient's lung has an air leak A forced expiratory measurement obtained after the administration of a bronchodilator shows an increase in FEV1 from 60% to 80% of predicted. This indicates a: - ANS ✓Reversible airway obstruction During capnography monitoring of a mechanically ventilated patient, you note that the end-tidal PCO2 (PetCO2) has dropped to 0 mm Hg. This finding may indicate: - ANS ✓complete airway obstruction
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An unconscious apneic patient with a full stomach cannot be orally intubated in the emergency room. Which of the following would your recommend be? - ANS ✓inserting an esophageal-tracheal combitube While establishing initial ventilatory support settings for a new patient, the most important consideration is the: - ANS ✓patients size and clinical condition A male patient has a lower than normal mixed venous O2 content. Which of the following is the most likely cause of this condition? - ANS ✓Fever (hyperthermia) You are trying to wean an alert intubated patient off full ventilatory support using the CPAP protocol with 40% O2. Early in the initial effort her respiratory rate increases from 24 to 30/min and you start to observe some use of her accessory muscles while breathing. Which of the following would be your first action at this time? - ANS ✓apply 5-10 cm H20 pressure support What is the approximate duration of flow of an oxygen E-cylinder at 1000 psi running at 4 L/min? - ANS ✓70 minutes While using a Yankauer device to suction an adult patient, you are unable to remove thick secretions. The regulator attached to the oropharyngeal suctioning device displays a reading of - 70 mm Hg. Which of the following actions should you take at this time? - ANS ✓increase the suction pressure to - 120 mm Hg While setting up a 12-lead EKG on a patient, you are unable obtain any electrical signal. The batteries are fully charged and the device was able to power-on. The most likely cause of this problem is which of the following? - ANS ✓a missing lead
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Which of the following is the best bedside measurement for assessing the integrated function of the respiratory muscles and mechanical properties of the lungs and thorax? - ANS ✓Vital Capacity (VC) While inspecting an EKG rhythm strip from an adult patient, you note the following: rate of 148; regular rhythm; normal P waves, P-R intervals, and QRS complexes. What is most likely the problem? - ANS ✓Sinus Tachycardia Which of the following is a prerequisite for discharging a ventilator- dependent patient to the homecare setting? - ANS ✓whether the patient is stable on low FiO2s and PEEP You would need which of the following equipment in order to calibrate a portable bedside spirometer? - ANS ✓a large volume (3 L) calibration syringe A physician orders a blind bronchoalveolar lavage procedure for a patient in intensive care unit. What is the most likely potential diagnosis that the doctor is trying to confirm with this procedure? - ANS ✓Ventilator-associated pneumonia (VAP) An AP X-ray of a 4-year-old child with wheezing and stridor shows an area of prominent subglottic edema, but the lateral neck X-ray appears normal. The most likely problem is? - ANS ✓croup If noted on inspiration, which of the following respiratory signs of an adult patient would be considered abnormal? - ANS ✓sternocleidomastoid muscles used at rest While reviewing the chest X-ray of a 30-year-old male receiving ventilatory support via an oral endotracheal tube. To assure proper placement of the tube, you would look for its tip to be positioned - ANS ✓between the 2nd and 4th thoracic vertebra
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Defibrillation should be done immediately in which of the following patient situations? - ANS ✓pulseless ventricular tachycardia An intubated adult 65-year-old male patient with severe expiratory airway obstruction requires ventilatory support. Which of the following capabilities would be most important in selecting a ventilator for this patient? - ANS ✓variable flow control and adjustable I:E ratios You are called to obtain a bedside vital capacity (VC) of 450 ml on a 122 lb female patient receiving ventilatory support in the CMV mode. Which of the following can you draw from this finding? - ANS ✓the patient cannot sustain prolonged spontaneous ventilation Which of the following is the most common problem encountered when applying assist-control mode during ventilation? - ANS ✓hyperventilation/hypocapnia A bubble humidifier is not bubbling during oxygen therapy, despite the flowmeter set and running at 5 L/min. Which of the following should you check? - ANS ✓flowmeter-humidifier connection for leaks Which of the following would cause an increase in a patient's peak airway pressure while receiving volume control ventilation? - ANS ✓bronchospasm After review a patient's chart, you note that an admission diagnosis of fluid depletion/dehydration. Which of the following findings would be most likely on bedside assessment of this patient? - ANS ✓inspissated secretions You are called to help a nurse in ICU measure a patient's central venous pressure (CVP) with a strain-gauge pressure transducer. The pressure transducer appears to be positioned well above the middle of the patient's lateral chest wall. What effect if any would this have on the measurement? - ANS ✓it would underestimate the CVP
