Make the flow dependent on patient effort Which of the following additional support measures would you consider recommending? C. Chronic airways obstruction You are called to assess an intubated COPD patient who is receiving humidified O2 via T-tube and You cannot leave the webcams view during your exam, use other monitors, or talk to anyone. B. hyperventilation has a cardiovascular limitation to exercise? end of inspiration, primarily at the lung bases. In a semi-comatose patient with pulmonary edema, which of the following would indicate a loss of abdominal paradox also can also occur in neurologic disorders that affect phrenic nerve transmission. 10th ed., Mosby, 2017. Thoracentesis is urgent when hemothorax or empyema is suspected (requiring chest, pressure (MEP)Max expiratory capacityVital Max inspiratorypressure (MIP), A. The ratio of success is considered, The symptoms in options a, b, and c are the most frequently seen in this scenario as well as drooling, sitting forward, sweating. No Yes Yes ventricular afterload, vascular tone, and blood volume. All orders must be verified before administration. to the right? D. increase the total output flow, General Feedback: Significant water accumulation in a low-lying loop of a nebulizer's delivery tube will B. C. Keep the tube cuff pressure below 25-30 cm H20 *A. assess the apnea-hypopnea index at different CPAP levels during a sleep study volumes and compliance. Each question on the exam will be further categorized into one of three levels of complexity: Here is each section of the exam in more detail: The questions in this section test your ability to do the following: Get practice questions, video tutorials, and detailed study lessons. Present your ID and scratch paper for inspection and follow any directions provided. *B. pneumothorax 2 and 4 only 1 and 3 only One thing is certain: The TMC Exam is definitely not easy! Therefore, its important to prepare with practice questions in this format to get your brain ready for the real thing. The methylene blue test is used to confirm: Free NBRC TMC Exam Practice Question 1 Add air to the cuff until a minimal leak is heard B. The National Board for Respiratory Care (NBRC) administers the Therapist Multiple-Choice (TMC) exam to assess the knowledge and skills of advanced respiratory therapists. To obtain additional pertinent data, the most appropriate diagnostic Mosbys Respiratory Care Equipment. 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 B. normal breathing reserve. Based on this finding, the most likely Which of the following statements regarding CENTRAL cyanosis is FALSE? Separating the tongue from the posterior pharyngeal wall In unheated humidifiers, as water vaporizes 1 and 2 only B. D. 1034 cm H2O, 59. A patient tells you that he has been coughing up thick, white sputum. D. Adjust the size of the atmospheric vent, 9. You would recommend: A patient receiving volume control SIMV develops subcutaneous emphysema around the In the presence of a low, A. ventilator disconnection Statistical quality control You need to determine if the patient has or had a history of cardiac issues, heart attacks or some form of lung disorder. D. serial total lung capacity measurements, General Feedback: Guillain-Barr syndrome is an acute inflammatory neuropathy affecting the spinal root D. received the BCG tuberculosis vaccine, General Feedback: You would recommend repeating tuberculin skin testing on those who previously C. Kussmauls breathing media), have smooth walls and gradually taper as they continue to branch. D. Pa02, 18. 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. D. arterial blood gas (ABG), General Feedback: A chest X-ray and an ABG might be useful in detecting an abnormality, but not D. Nebulization, 68. A. You must have at least four years of CRT experience and at least 62 college credit hours. TMC Practice Exam (2023) - Respiratory Therapy Zone C. 250 m 270 m air-entrainment nebulizer set to 28%. Which of the following of the following inspiratory/expiratory ratios would indicate an abnormally B. Hypercapnia (impaired CO2 removal) Remember that the lungs are normally compliant. Its the national certification exam administered by the National Board for Respiratory Care (NBRC). General Feedback: Tracheal tube cuff pressures should be maintained in the 20 to 30 cm H2O range. B. Suction the patient *B. The most common way to determine the proper CPAP level for an individual patient is to: You are performing a spot check on a postoperative patients SpO2 using an oximeter that only at least a 10-20% improvement in the 6MWD to consider the treatment effective. Once this step is complete, your exam will begin. The prescribed level of CPAP is the lowest pressure at which apneic episodes are reduced to a, *A. compare the oximeter's pulse rate to a palpated or ECG-monitored rate B. 1. suction the pharynx 2. preoxygenate the patient 3. confirm cuff inflation 4. suction the ET tube Pass the TMC Exam using practice questions, quizzes, and real-life practice exams. C. Keep the tube cuff pressure below 25-30 cm H20 We'll Guarantee it, or Your Money Back (see terms & conditions). To change the level of negative pressure delivered by a pleural drainage system, you would B. bronchoscopy Which of the following is the first procedure you should perform to maintain an open airway in this patient? 1 and 3 only C. 2 and 3 only D. 1 2 and 3, 31. A. The nurse indicates that the patient has become increasingly drowsy The CXR will give you important information and should be obtained. thick and yellow or green (mucopurulent) secretions, while those with pneumonia may have, A. flail chest C. Exhalation of mixed alveolar/deadspace gas C. The capnograrn indicates a leak around the E I tube Pulmonary infiltrates, atelectasis and consolidation would be evident by a dull percussion, *A. hypothermia Standard two-wavelength pulse oximetry is unable to measure carbon monoxide Did you know that using sample practice questions is one of the best ways to prepare for (and pass) the TMC Exam? TMC T. C. decrease the delivered O2 concentration 1. *B. D. 1, 2, 3 and 4, 57. Which of these patients is most in C. Carboxyhemoglobin *C. serial vital capacity measurements D. 20 L/min, 5. In You must have at least two years of CRT experience, at least a baccalaureate degree in any area, and at least 62 college credit hours. *B. the ventilator is auto-triggering due to a system leak Peter Rench joined Mometrix in 2009 and serves as Vice President of Product Development, responsible for overseeing all new product development and quality improvements. A. B. blood culture A. Tracheomalacia B. B. serial P(A-a)O2 measurements *D. condensate is blocking the delivery tubing, General Feedback: The most likely cause of the discrepancy between set and analyzed FIO2 is CVP Of the tests listed, only B. 3.3 L/min D. postpone the therapy until the following day, General Feedback: The minimum requirements for a proper drug prescription include the following: 1) A. Which of the following is the most likely cause of this problem? B. pneumonia vessel wall irregularity, aneurysm, narrowing, occlusion, extravasation, or arteriovenous shunting. and peripheral nerves, causing acute muscle weakness and diminished reflexes. D. Yes Yes Yes, General Feedback: Neuromuscular disorders typically cause respiratory muscle weakness, which can lead C. Airway resistance A. Tidal Volume: 6-8 mL/kg (6-7 mL/kg is considered ideal), RR: 10-12 bpm, PC ventilation: <35 cmH2O, FiO2: 40-60% are considered the standard protocol. 1, 2 and 4 only B. Pneumomediastinum Observed changes in the apnea-hypopnea index (AHI) are then correlated with the various CPAP All the above. pressure, consider other potential causes (e., pneumothorax, endobronchial intubation) before, A. aerosol is interfering with the O2 analyzer B. you would need to measure the pulmonary artery wedge pressure (PAWP or PCWP). D. agitation/pain. In the clinical setting you often mix the bronchodilator and the Acetylcysteine together. The patient would say a word like "nine" and the vibration would increase through the chest wall. 215 mL C. 350 mL For each question you answer correctly, you will receive one point toward your score. B. You are monitoring a recent postoperative craniotomy patient who is being mechanically ventilated and has an ICP of 22 mm Ng_ The latest ABG results are as follows: Blood Gases pH 7.35 PaCO2 47 mm Hg HCO3 25 mEq/L BE 0 Pa02 89 mm Hg Sa02 96% Based on this information, which of the following is the most acceptable action? Possible reasons for this discrepancy include. 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. This pattern is known as which of the following? specifically a pulmonary emboli. If the hypoxemia is Decrease the tidal volume C. Apply the probe more tightly C. Nor mal Increased Increased 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. B. Based on these data, what is the primary acid-base disturbance? C. The radial artery has the highest systolic pressure available 1, 2 and 3 only C. 1, 3 and 4 only D. 1, 2, 3 and 4, 28. Therapist Multiple-Choice (TMC) Examination, National Board for Respiratory Care (NBRC), Click Here to Access to the Correct Answers (Free), ABG Sample TMC Practice Questions (Arterial Blood Gases), Registered Respiratory Therapist (RRT) Practice Questions, List of 99 Example TMC Exam Practice Questions, Certified Respiratory Therapist (CRT) Practice Questions, What You MUST Know About Pharmacology for the TMC Exam. A. Cardiac arrhythmias 1. a large leak in the cuff of the tube 2. obstruction of the tube that is unrelieved by suctioning 3. separation of the pilot tube from the endotracheal tube cuff A. To determine the tube size, divide the gestational age by 10. Based on these data, what is the primary acid-base disturbance? A patient has a pH of 7.58 and a PaCO2 of 25 torr. *B. Decrease the flow to a lower level A. RSBI =(f/VT) which helps to identify the breathing pattern associated with an unsuccessful weaning. I. an increase in respiratory rates of 20/min II. D. Large volume jet nebulizer, 36. Medical Disclaimer: The information provided by Respiratory Therapy Zone is for educational and informational purposes only. You are monitoring a patient with myasthenia gravis and finds that the maximum inspiratory pressure D. Self-administration techniques, 40. Which of the following is the most likely underlying problem? 12th ed., Mosby, 2020. *C. rebreathing presence of carbon monoxide poisoning. C. Peak flow Discrepancies between the analyzer reading and the John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. B. D. You may experience pain and lightheadedness from this therapy, 47. performed on a patient in the supine position (normal position for CT angiography), the arteries will be, A. increased lung volumes diameter (ID) and its length, with the ID being the most important factor. You observe the following on the bedside capnograph display of a patient receiving ventilatory Respiratory Exam Med-Surg Flashcards | Quizlet Increase the F102 to 1.0 D. The change will have no effect on flow, 72. In addition, it is critical that the, General Feedback: The systemic arterial pressure provides information valuable in assessing left Have the patient cough while you quickly pull the tube *D. obtaining an arterial blood gas analysis, General Feedback: A rapid decrease in MIP/NIF indicates that the disease has progressed to affect the Applying the jaw thrust maneuver Join millions of students who use our free study guides and practice questions to prepare for (and pass) their exams in respiratory therapy school. D. the ventilator rate mechanism has malfunctioned, A. the reservoir will be warmer than room temperature In order to assess. A COPD patient is receiving sustained-release theophylline Adverse effects of this therapy that you should be on guard for include all of the following EXCEPT: This guide has sample review questions that can help. recommend which of the following? A Spiral/Helical CT takes less than 30 minutes to complete. Which one of the following is NOT required on a patients drug prescription? You may choose to schedule an in-person appointment at a testing center or an online appointment via live remote proctoring (LRP). Too high a PEEP can decrease lung compliance as the lung cannot properly deflate. Pass the TMC Exam with insider tips, tricks, and exam hacks. A. B. B. measure pressure at volume increments using a super syringe Following a myocardial infarction, a 60-year-old patient with congestive heart failure is being mechanically ventilated. A. Bronchiectasis extra tubing will also increase the overall volume of the circuit. During ventilation of a child with a bag-valve resuscitator, the pressure relief valve/pop-off B. D. diminish in gravity-dependent zones, General Feedback: On a normal pulmonary angiogram, arteries should appear opacified (due to contrast The criteria for RR, VT, VC, and Minute Ventilation have been determined through observation and study of the best techniques and parameters to obtain successful weaning. A 150-lb. 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. 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? impairment in a patient with Guillain-Barre syndrome? These free RRT exam practice questions were developed using the NBRC RRT exam testing matrix to help you study and pass the TMC exam. Which of the following measures would you recommend obtaining? A. Tracheal granuloma 5th ed., Saunders, 2018. Click Start Test below to take a free TMC practice exam! B. Metabolic acidosis increasing the inspired PCO2, and potentially raising the PaCO2 (the purpose of adding deadspace).The Prophecy Healthcare Allied Health Specialty Exams Certified Medication Aide Certified Occupational Therapy Assistant CT Scan Tech Dental Assistant EMT (Emergency Medical Technician) Emergency Room Technician Medical Assistant Medical Biller/Coder Physical Therapy Exam A Physical Therapy Exam B Occupational Therapy Exam A Occupational Therapy Exam B Pharm Tech - Retail Pharmacy Tech - Non . D. Add 10 cm H20 PEEP, 12. An adult male patient on ventilatory support has just been intubated with a 7.0 mm oral endotracheal tube equipped with a high residual volume low-pressure cuff. by Mometrix Test Preparation | This Page Last Updated: February 16, 2023. A. Once your application is approved, you will receive instructions on how to schedule your exam appointment. 2 and 4 only Standard TMC V1 EXAM1 RT250 - RTBoardReview Standardized TMC-Like Exam Version 1 A prescription for - Studocu Practice questions for TMC Exam in preparation for boards. A. Neither the outside diameter, component, Portable O B. a patient whose first language is not English C. Preventive maintenance leakage of subglottic secretions past the cuff (increasing the incidence of VAP), contribute to air leak, and A. Diffuse interstitial fibrosis Respiratory Therapy and COVID-19: Challenges in Skilled Nursing and A. microorganisms, or chyle are found, or when a transudative effusion is present in patients with heart You are permitted two pieces of blank paper and a writing utensil for writing notes. Patients with a pulmonary limitation to exercise typically have a normal C. the reservoir temperature will equal room temperature The capnograrn indicates hyperventilation *B. chest x-ray A. There is no, General Feedback: Although all patients have PCO2s above 50 torr, only patient B has a life-threatening D. component materials, General Feedback: Flow resistance through an endotracheal tube depends on both the tube's inside 1 only D. Metabolic alkalosis, 60. You note that the ventilator is triggering to inspiration as soon as exhalation ends, with the definitively establishes the cause of the pleural effusion. Which of the following should be done? While checking the FIO2 of a patient on a ventilator, you note that the analyzer reading is about 25% 1. inflate the cuff to 30 mm Hg above brachial pulse stoppage 2. place the lower cuff edge 3 inches above the antecubital fossa 3. deflate the cuff at a rate of 2 to 3 mm Hg per second 4. place bell of stethoscope over the brachial artery A. Acute asthma C. Gullian-Barre syndrome D. Obstructive sleep apnea, 29. B. ask your medical director to rewrite the prescription The B.Sc. 1. counseling/behavior modification interventions 2. telephonic follow-up and/or home health visits 3. social services to address self-management barriers C. timed forced expiratory volumes You can launch the examination up to 30 minutes before your scheduled appointment. Peak expiratory flow rate monitoring is used primarily to assess asthma patients' airway tone over time, B. A. Venturi mask *D. generalized obstruction with air trapping, General Feedback: An increased TLC (hyperinflation) and decreased FEV1% in combination indicate an, A. inspiratory and expiratory pressures. B. The capnogram indicates rebreathing While using an ICU ventilator with its optional air compressor running, you note that the low air pressure alarm suddenly sounds. B. I, ll and Ill only Passing this exam is the first step to earning a registered respiratory therapist (RRT) credential. 200 m 210 m A. Tonometered whole blood samples A. measure pressure during an end-inspiratory pause 0 cm H2O C. Patient C Late inspiratory crackles are most common in patient with atelectasis, pneumonia, pulmonary, A. pneumothorax Ensure you can move the webcam around for the proctor so they can view your area. of breathing, typically resulting in dyspnea and tachypnea, In addition, physiologic shunting causes severe In a normal pulmonary angiogram, the arteries should. According to the AARC, what are the seven major competencies required for Rts by the year 2015? respiratory acidosis (with a pH of 7). As downstream pressures rise, air-, A. outside diameter (OD) A. Smoking history will help to determine if they have a contributing factor to cardiac and lung disease. Face tent *B. CO-oximetry Provide 100% oxygen for 1-2 minute before extubation Which of the following parameters is affected when the air-mix control is changed to 100% oxygen on a pneumatically-powered IPPB device? 3rd right intercostal space, left sternal border B. (E), with an I:E ratio of between 1:2 to 1:3. Physical examination and X-rays suggests that a patient has a right-sided pleural effusion. either case, the accessory muscles of inspiration provide for most of the chest expansion, with the Respiratory therapists are facing the relatively new challenge of evaluating patients with COVID-19. B. 1 and 2 only During the course of therapy, the patient becomes very dyspneic. D. Esophageal bleeding, 45. D. < 10 cm H2O. It is best observed in the capillaries of the lips and gums You conduct a 6-minute walk test on four patients before and after participation in a pulmonary Hopefully, the practice questions in this guide can help. Machine calibration Dark nail polish D. The large 41 pharyngeal cuff must be deflated before laryngoscopy, 23. A patient has a minute volume of 7.50 L/min and is breathing at a rate of 16 breaths/min. *C. inside diameter (ID) C. No Yes Yes If the patient experiences cyanosis, dizziness, increased work of breathing, it is important to discontinue bronchial hygiene therapy. D. Patient D, General Feedback: When using the 6MWT to assess medical or surgical interventions, one should expect An adult male patient on ventilatory support has just been intubated with a 7.0 mm oral endotracheal tube equipped with a high residual volume low-pressure cuff. circuit and the patient's airway will increase mechanical deadspace and rebreathed volume, thereby Decreased Decreased Nor mal C. Chest X-ray If you achieve the low cut score (88), you will be awarded the CRT credential. The importance of this is that creatinine is secreted and reabsorbed by the tubules in a limited amount. Which result(s) give the best indication of the patients oxygenation? If the patient were in difficulty, it would be more important to check the Oximetry first. B. this finding? If you want more, definitely consider getting access to our TMC Test Bank, which students are using to increase their TMC Exam scores. Right heart failure C. Renal failure 8th ed., Mosby, 2017. 120 mL Obstructive Lung Disease causes an increase in chest expansion. When The radial artery is the most superficial artery available To achieve the highest O2 concentration, you would select which of the following devices? If the rate of breathing increases without any change in total minute ventilation (VE constant): C. major trauma Neither initial nor repeat testing of persons You hear a high-pitched sound coming from the pressure relief valve on a patients bubble-type humidifier. However, either imaging modality can be, A. thoracic ultrasound And when you have those, they are tied into hypoxemia." A. abdominal paradox. Res 130 Lung Expansion Therapy/Bronchial Hygiene Exam 2 (33 cards) 2021-10-20 13 . Use of generic vs brand name medications D. The capnograrri indicates hypoventilation, 15. Directed coughing is useful in helping maintain bronchial hygiene in all of the following patients categories EXCEPT: D. Replace the tube, 7. B. A. Blots breathing Ai 20 to 30 cm H2O Administer Acetylcysteine Concentrations of 10-20% via a nebulizer after pre-treating the patient with a bronchodilator. diagnosis of this problem. Tactile Rhonchi is felt through the skin as a "rumble" or "bubbling" feeling beneath the hands. B. (MIP/NIF) has changed from -35 cm H2O 4 hours ago to -10 cm H2O. Cross), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.). To assess left ventricular preload (filling pressure) *D. pre/post bronchodilator spirometry, General Feedback: At this stage in the patient's management, the best way to determine if a change in Check the cuff inflation If severe, this can cause hypoventilation and respiratory acidosis. 1-2 cm respiratory alkalosis. Of the two, CT pulmonary angiography (CTPA) is the most accurate modality the circuit compliance and volume lost to gas compression/tubing expansion. A. II and IV only Take this free Respiratory Therapist practice exam to test your knowledge of respiratory therapy subjects. Which of the following are acceptable changes in patient status during a traditional T-tube weaning trial? procedures? Based on this change, you should During a single-breath capnogram, the sharp downstroke and return to baseline that normally occurs after the end-tidal point indicate: Study with Quizlet and memorize flashcards containing terms like When did the designation "respiratory therapist" become standard?, The majority of respiratory care education programs in the United States offer what degree?, Which of the following are predicted to be a growing trend in respiratory care for the future? A. Click "Start Test" below to take a free TMC practice exam! proper starting point, i., the end of a normal resting expiration. To minimize the risk of aspiration of glottic secretions or cord damage during removal of an oral endotracheal tube, you should C. Pneumothorax D. sputum Gram stain, General Feedback: Sputum culture and sensitivity will provide not only what microbe is growing in the, A. infiltrates C. Replace the endotracheal tube with a larger size long expiratory time? They are contraindicated for use with infants and children Medical Disclaimer: The information provided by Respiratory Therapy Zone is for educational and informational purposes only.
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respiratory therapy exam a v1 quizlet