TMC EXAM 4 Latest Actual Questions

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112 TMC EXAM 4 Latest Actual Questions & Verified Answers Correctly 1.Which of the following equipment is most helpful at measuring FRC in a patient who has significant non-ventilated lung spaces?A.nitrogen analyzer for a nitrogen washout test B.helium analyzer for a helium dilution test C.plethysmograph D.peak flow meter

Answer: C

Explanation: You can determine FRC in three different ways - body box,

nitrogen washout, or helium dilution. If someone has non-ventilated lung space, nitrogen washout and helium dilution are not helpful and may be inaccurate. FRC determined by body box will be higher because it can access non-ventilated lung space and therefore is more accurate.

2.The respiratory therapist is making a home visit to evaluate an oxygen- de- pendent patient. The patient has 3+ pitting peripheral edema and has not followed the physician's orders to limit fluid intake. You would expect which of the following hemodynamic values?A.elevated PCWP with a low cardiac output 1 / 4

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112 B.low mean arterial pressure C.elevated right sided preload with a normal to low right ventricular after load D.reduced cardiac index

Answer: C

Explanation: Right-sided preload is another name for CVP (central venous

pres- sure). Peripheral edema is one of the signs associated with right heart failure, which results in an elevated CVP with a normal or low pulmonary artery pressure (PAP), a.k.a. right ventricular afterload.

3.A ventilator-dependent patient is scheduled for an MRI, which will require a transport of 90 minutes. The patient is receiving humidification with a heat- ed- humidification system. A transport ventilator is available. How should a respiratory therapist assure that humidification will be provided to the patient during the MRI procedure?A.Provide a pass-over humidifier B.Provide an HME C.Provide ventilation with a manual resuscitator D.Use the same humidification system in use on the primary ventilator

Answer: B

Explanation: A heat moisture exchanger (HME) is appropriate for a

transport of only 90 min. Furthermore, the scenario does not suggest that the patient has thick, retained secretions, therefore an HME may be applied. 2 / 4

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112 4.Which of the following conditions would benefit most from polysomnogra- phy?

A.COPD

B.congestive heart failure C.suspected increased airway resistance D.obesity with increased day-time sleepiness

Answer: D

Explanation: Polysomnography is another word for sleep study. An obese

patient who has daytime sleepiness would benefit most from polysomnography. Keep in mind that Polysomnography is the study of the problem - not the solution. But it must be done for diagnostic purposes and in order to find the adequate CPAP setting.

5.Which of the following can accurately be stated about a widening alveo- lar-arterial oxygen gradient?A.decreased venous admixture B.onset of oxygen toxicity C.increased intrapulmonary shunting D.improving V/Q mismatch

Answer: C

Explanation: A normal alveolar arterial oxygen gradient is below 65 3 / 4

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112 mmHg. When that gradient rises to 200, 300, 400, or more, then you have what is called shunting. If the A-a gradient is less than 300 it's technically called a ventilation perfusion (VQ) mismatch. But generally speaking, as the gradient widens it can properly be said that there is an increase in pulmonary shunting.

6.How many hours will an H cylinder with 1400 psi last for a patient receiving oxygen at 7 lpm?A.6 hours B.less than 1 hour C.10 hours D.4 hours

Answer: C

Explanation: And H cylinder has a tank factor of 3.14. 3.14x1400 PSI =

4396 L. 4396 L / 7 L per minute = 628 min. 628 min./ 60 min.= 10.4 hours, or about 10 hours. When you get an answer that is not exact, pick the closest number possible. It is common on the exam not see the exact answer from your calculation. This is because the NBRC knows that you're estimating.

7.The respiratory therapist notes a fall in pulse from 80/min to 60/min with a proportional drop in blood pressure during a suction procedure. Which of the following would be the most likely cause of these observations?

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