TMC Exam 2 Actual Questions With 100 Correct

TMC Exam 2 Actual / Questions With 100% Correct Answers..

Which of the following parameters could be used to calculate tidal volume?

• PetCO2 and alveolar ventilation
• minute ventilation and alveolar ventilation
• minute ventilation and respiratory rate
• PECO2 and VD/VT - -----Answers___The correct answer is

: C

Explanation : If you take a minute ventilation and divide it by

the respiratory rate you get tidal volume.

While running quality control material through a blood gas analyzer, the therapist notes that 4 consecutive data points are beyond 2 SD from the mean. The therapist will

• monitor the machine closely for several days
• report the problem to the medical director
• remove the machine from service
• continue running quality control material until corrected - -

----Answers___The correct answer is : C 1 / 4

Explanation : When monitoring the quality control data for an

arterial blood gas machine the points on the graph, which show the actual values of the quality control material, should be between the upper control limit and the lower control limit (two standard deviations above and below the mean for a total of a 4 standard deviation range). In this case there are several consecutive points that are beyond the two standard deviations and therefore the machine is considered out of control and should not be placed in service but removed. Blood gases should not be run on that machine until the problem has been resolved. More importantly, blood gas data should not be reported as part of the patient's medical record because they are likely inaccurate.

A patient with a history of asthma reports to the emergency department after self-treating bronchoconstriction for the past

• days. Periodic relief has been achieved but the patient is in

current distress and is wheezing bilaterally. Which of the following treatment actions would be most appropriate?

• sildenafil, IV
• administer Sublimaze, PO
• full pulmonary function testing with DLCO measurement
• continuous aerosolized bronchodilator at 7 mg/hr - -----

Answers___The correct answer is : D

Explanation : The patient shown in this question obviously

demonstrates lack of response to bronchodilator therapy. Of 2 / 4

the options offer, IV methylprednisolone and continuous aerosolized bronchodilators are appropriate.

Quality control data for an arterial blood gas analyzer is plotted on a graph that has a range of 4 standard deviations (2 SD up and 2 SD down). Points on the graph show a gradual rise from below the mean to above the mean. All points are within 2 SD of the mean. The respiratory supervisor should

• replace the electrodes
• remove this machine from service
• monitor this machine closely
• call the medical director for direction - -----

Answers___The correct answer is : C

Explanation : Because all points on the blood gas graphs are

within two standard deviations of the mean, the blood gas machine is technically in control. But the use of the word gradual rise means that there is a trend upward. Whenever there's a trend you need to monitor that machine because the trend may ultimately rise above the two standard deviations.You do not need to remove the machine from service or perform any kind of maintenance when a trend is observed - only monitor.

A 75-kg (165-lb) male is receiving mechanical ventilation by a volume-controlled ventilator in the assist/control mode on the

following settings:

• / 4

Mandatory rate 12/min VT 500 mL

FIO2 0.6

PEEP 8 cm H2O

Arterial blood gas results:

pH 7.30 PaCO2 52 mm Hg PO2 65 mm Hg HCO3- 27 mEq/L BE +3 mEq/L

Which of the following represents the most appropriate action?

• increase rate to 14
• increase tidal volume to 600 mL
• increase PEEP to 10 cmH2O
• increase FIO2 to 1.0 - -----Answers___The correct answer

is : A

Explanation : Arterial blood gases show the patient is not

ventilating and is under oxygenating. Because ventilation should be corrected first it is appropriate to either increase the tidal volume or increase the rate. In this case the PaCO2 is off by more than 4 mmHg and therefore should be addressed only with an increase in rate.

• / 4