circuit and the patient's airway will have which of the following effects? 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. Mosbys Respiratory Care Equipment. Adequate airway seal D. Fully occlude the ET tube while you quickly it out, 21. B. If the proctor observes questionable behavior, your exam will be canceled. For each question you answer correctly, you will receive one point toward your score. C. dyspnea Which of the following best describe the key rationale for intubating nasally rather than orally? (if available); (b) assess the oximeter's indicator pulse lights, and/or (c) compare the oximeter's displayed B. 12 L/min 1 only D. Control media verification, 73. Standard two-wavelength pulse oximetry is unable to measure carbon monoxide 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 Click Start Test below to take a free TMC practice exam! In most instances, analysis of the pleural fluid yields valuable diagnostic information or PaCO2 27 torr The only name that is not used to describe auto-PEEP is Stiff Lung. B. 150 m 200 m D. The capnograrri indicates hypoventilation, 15. If your FiO2 is over 60% and your PEEP is over 5, lower the PEEP first. D. metabolic alkalosis, General Feedback: In ARDS, pulmonary edema, atelectasis, and surfactant loss combine to reduce lung C. Right ventricular hypertrophy D. Bright ambient light, 44. The kidneys have not started to adjust the Bicarb level by holding onto it. Which of the following is false regarding switching from an esophageal-tracheal Combitube (ETC) to an oral endotracheal tube? The alveolar ventilation per minute will decrease Reassess the cuff pressure during expiration While using an ICU ventilator with its optional air compressor running, you note that the low air pressure alarm suddenly sounds. B. a restrictive disorder of the lungs *B. increase in rebreathed volume Therefore, its important to prepare with practice questions in this format to get your brain ready for the real thing. You observe the following on the bedside capnograph display of a patient receiving ventilatory support. B. Commercial calibration control media Crepitus is a crackling feeling beneath the skin when your fingertips press on an area. radiograph. D. Exhalation of mainly alveolar gas, 10. B. a patient whose first language is not English The format of the TMC Exam is multiple-choice, with 160 questions that must be completed within three hours. increase the risk of accidental extubation. Its the national certification exam administered by the National Board for Respiratory Care (NBRC). 3rd right intercostal space, left sternal border B. D. The large 41 pharyngeal cuff must be deflated before laryngoscopy, 23. A. On the day of your exam, ensure that your testing area is clear of reference materials, your cell phone, and food or drink containers. There are four reasons why Creatinine is used to determine kidney function: the rate of production is fairly constant; it is eliminated only by the kidneys; it is not-protein bound so it is easily filtered by the kidneys and the rate of elimination is almost the same as the glomerular filtration rate. Which of the following would be the appropriate action for you to take? 3-4% or more C. 52 L/min C. increased compliance Medical Disclaimer: The information provided by Respiratory Therapy Zone is for educational and informational purposes only. (including SIRS), sepsis, major trauma (including burns), shivering, seizures, agitation/anxiety/pain, *A. gurgling Clinical Application of Mechanical Ventilation. To confirm this, an, A. serial end-expired PCO2 measurements Ensure you can move the webcam around for the proctor so they can view your area. In the presence of a low, A. ventilator disconnection Which of the following additional support measures would you consider recommending? B. The TMC exam sections below are based on actual exam sections: Patient Data, Trouble Shooting, Quality Control of Devices, Infection Control and Initiation and Modification of Interventions. 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. B. bronchoscopy Lung consolidation B. methacholine challenge (provocation) test 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. who have received the BCG TB vaccine is indicated because these individual consistently exhibit an, A. peak expiratory flow rate monitoring A. You would recommend: A patient receiving volume control SIMV develops subcutaneous emphysema around the C. Small airways obstruction A. *C. thoracentesis 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. Patients with a pulmonary limitation to exercise typically have a normal A. rtboardreview standardized exam version prescription for an aerosolized drug for patient under your DismissTry Ask an Expert Ask an Expert Sign inRegister Sign inRegister Home Thus, gas leaving the device is warmed, supply pressure Low O2 O2 analyzer error O2 blenderfailure, A. (MIP/NIF) has changed from -35 cm H2O 4 hours ago to -10 cm H2O. Ventilator Settings: Spontaneous Rate 23/min, Minute Ventilation 11.5 L/min, Vital Capacity 500 mL, MIP/NIF -15 cmH2O. D. Applying the head-tilt/chin-lift maneuver, 58. B. ventilation-perfusion scan 4th ed., Cengage Learning, 2013. All of the following would be essential medication history information to obtain for a patient admitted for an acute exacerbation of asthma EXCEPT: B. stop branching at the segmental level You cannot leave the webcams view during your exam, use other monitors, or talk to anyone. C. Tilted forward toward the chest the following additional tests would you recommend to determine the cause of the effusion? A. A. Congestive heart failure Standardized TMC-Like Exam What maximum flow would you apply to an 8 year-old child receiving O2 therapy via a high flow nasal cannula? Pressure above 30 cm H2O can cause tracheal injury and pressure below 20 cm H2O can increase the On a pneumatically-powered IPPB device, switching the air-mix control to 100% oxygen will have which of the following effects on flow? You should always seek clarification from the physician if the order does not, A. appear radiolucent (dark on X-ray image) In During auscultation of a patient's chest, you hear intermittent "bubbling" sounds occurring toward the D. The change will have no effect on flow, 72. Which of the following should be done BEFORE the tube itself is removed? abdominal paradox. During ventilation of a child with a bag-valve resuscitator, the pressure relief valve/pop-off B. pneumonia B. The ER physician asks you to evaluate a trauma patient who was the victim of a house fire. You must have at least four years of CRT experience and at least 62 college credit hours. All of the following cause false HIGH Sp02 readings when using a pulse oximeter EXCEPT occurs when chronic hypoxemia elevates the pulmonary vascular resistance and puts a strain on the right Get access to 25+ premium quizzes, mini-courses, and downloadable cheat sheets for FREE. D. decrease in inspired PCO, General Feedback: Any extra tubing between the "wye" connector of a dual limb ventilator breathing shorter the tube length), the lower its resistance to flow. Which of the following would you recommend? C. Sp02 1. D. The patient has combined respiratory and metabolic acidosis, General Feedback: Due to the severe ketoacidosis, the patient's bicarbonate has been decreased *B. CO-oximetry When a patient's equipment is broken it is important to have both of you speak to the patient's case manager to arrange procuring a new one for home use. Use of generic vs brand name medications In patients with chronic respiratory disease, pedal edema is a sign of: B. laryngeal edema C. Yes No Yes The radial site is preferred for arterial puncture or cannulation because: DNR status/Advance Directives are also important to verify as they will determine what actions will be taken if something were to happen to the patient during the procedure. C. 30 to 40 cm H2O Thoracentesis is urgent when hemothorax or empyema is suspected (requiring chest, pressure (MEP)Max expiratory capacityVital Max inspiratorypressure (MIP), A. C. simple pneumothorax Incentive spirometry is ordered for a female patient after abdominal surgery_ Which of the following statements would be the most appropriate initial explanation of the therapy? The name on your registration must match the name on your identification. All NBRC examinations are written and developed by a committee of credentialed respiratory therapists and pulmonary function technologists, as well as physicians who specialize in pulmonary and respiratory care. 1 and 3 only B. Click "Start Test" below to take a free TMC practice exam! the circuit compliance and volume lost to gas compression/tubing expansion. D. Esophageal bleeding, 45. Increasing the E: Time allows for a longer period of time for the patient to exhale air from the lungs. A. You do not give a medication order that is not correct. These free RRT exam practice questions were developed using the NBRC RRT exam testing matrix to help you study and pass the TMC exam. If the patient were in difficulty, it would be more important to check the Oximetry first. General Feedback: Common factors decreasing metabolic rate and thus energy expenditure include drug dosage. C. a combined disease process C. The tube chosen is too small for the patient respiratory alkalosis. Which of the following is the most likely underlying problem? HCO3 10 mEq/L Capnography gives you the most immediate information. Late inspiratory crackles are thought to be caused by sudden opening of collapsed At rest, the normal tidal movement of the diaphragm is approximately: If you failed the exam, you may take it two more times with no waiting period between attempts. In the sniffing position C. the reservoir temperature will equal room temperature 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 The PH is acidic-less than 7.35, PCO2 is high-greater than 45 mmHg demonstrated hypoventilation, and there is a normal HCO3. Bronchial breath sounds heard over the periphery indicate C. Nonrebreathing mask continually activates. Hopefully, the practice questions in this guide can help. Which of the following would the best initial action in this situation? Clinical Manifestations and Assessment of Respiratory Disease. Smoking history will help to determine if they have a contributing factor to cardiac and lung disease. In order to Which of the following is the most common problem associated with the removal of an esophageal obturator airway? 2 only 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. 5 L/min This pattern is known as which of the following? Patients with cystic fibrosis typically have C. Isolating/protecting the lower airway from aspiration 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 You do not just "skip" a treatment because the order is incorrect. set-up and operating? B. In order to assess. Based on this change, you should A. 1, 2 and 4 only D. Yes Yes Yes, General Feedback: Variable FIO2s during ventilatory support are normally provided by an O2 blender, Incorrect answer. Which of the following would you expect to occur AFTER an unheated bubble-diffusion humidifier is *D. pre/post bronchodilator spirometry, General Feedback: At this stage in the patient's management, the best way to determine if a change in As compared to predicted normals, a patient has an increased TLC and a decreased FEV1%. Providing a secure route into the larynx and trachea D. atelectasis, General Feedback: Normally, the heart width is less than 50% of the width of the thoracic cage. In the clinical setting you often mix the bronchodilator and the Acetylcysteine together. hypoxemia that does not respond well to increases in FIO2 (refractory hypoxemia). 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. The CXR will give you important information and should be obtained. Respiratory alkalosis B.Sc. Separating the tongue from the posterior pharyngeal wall A patient rescued from a house fire is being monitored in the intensive care unit Due to suspected CO poisoning, the patient is on a nonrebreathing mask at 12 L/min. D. Decreased Nor mal Decreased, *A. General Feedback: To verify a good pulse oximeter signal, you can (a) observe the displayed waveform resistance? B. ask your medical director to rewrite the prescription The most common method is to repeat the sleep study, using different levels of CPAP, i., a titration has a cardiovascular limitation to exercise? The equipment needed is the same as for endotracheal intubation Patient safety always comes first. a portable liquid system or a portable concentrator. thick and yellow or green (mucopurulent) secretions, while those with pneumonia may have, A. flail chest All the above. Which of the following are acceptable changes in patient status during a traditional T-tube weaning trial? A. Tracheomalacia B. Gastric insufflation C. Aspiration D. Esophageal bleeding, 33. profound hypoxemia. The capnogram indicates rebreathing diameter (ID) and its length, with the ID being the most important factor. Which of the following is the most likely problem? Get new premium TMC Practice Questions delivered to your inbox daily to pass the exam. D. increase the total output flow, General Feedback: Significant water accumulation in a low-lying loop of a nebulizer's delivery tube will Which of the following is the most effective diagnostic test to quantify the amount of ventilatory Pressure A. B. an IgE-mediated allergic disorders a 5 mm Hg rise in the arterial PCO2 IV. C. 15 L/min In most blood gas analyzers, what media is used to calibrate the pH electrode?
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