10 free, exam-style Respiratory Therapy Examination / TMC path (TMC) practice questions with answers and explanations. No signup required. Work through them below, then take the full free TMC practice test to study every exam domain.
The TMC exam has 160 questions and runs 3 hours.
These 10 free TMC questions are organized by exam domain, so you can see how each part of the Respiratory Therapy Examination / TMC path blueprint is tested. Reveal the answer and explanation under each question.
A patient with a long history of COPD presents to the emergency department. The arterial blood gas on room air shows: pH 7.36, PaCO2 62 mmHg, HCO3 34 mEq/L, PaO2 58 mmHg. This blood gas is BEST interpreted as:
Correct answer: C - Fully compensated respiratory acidosis with moderate hypoxemia
A mechanically ventilated patient has a PaO2 of 72 mmHg on an FiO2 of 0.90 with a PEEP of 10 cmH2O. Based on the P/F ratio, this patient's oxygenation status is consistent with:
Correct answer: D - Severe ARDS
During a readiness assessment, a patient breathing spontaneously on minimal pressure support has a respiratory rate of 32 breaths/min and an average tidal volume of 250 mL. Based on the rapid shallow breathing index, the therapist should conclude that the patient:
Correct answer: C - Is likely to fail weaning and is not yet ready for liberation
A patient with COPD and chronic CO2 retention requires supplemental oxygen. The physician wants to deliver a precise, consistent FiO2 that will not vary with the patient's changing breathing pattern. Which device is MOST appropriate?
Correct answer: C - Air-entrainment (Venturi) mask
A patient receiving volume-controlled ventilation triggers the high peak-pressure alarm. The plateau pressure is unchanged from baseline, but the peak inspiratory pressure has risen sharply. This pattern is MOST consistent with:
Correct answer: D - Secretions in the airway increasing resistance
A patient with severe asthma is being mechanically ventilated. The flow-time waveform shows that expiratory flow does not return to baseline before the next breath is delivered, and the measured auto-PEEP is rising. Which adjustment is the MOST effective FIRST step to correct this?
Correct answer: A - Decrease the respiratory rate to lengthen expiratory time
A mechanically ventilated trauma patient suddenly becomes hypotensive and difficult to ventilate. The therapist notes absent breath sounds on the left, tracheal deviation toward the right, and a rapidly rising peak inspiratory pressure. The therapist should FIRST recommend:
Correct answer: D - Needle decompression of the left chest
Midway through an albuterol small-volume nebulizer treatment, a patient's heart rate increases from 88 to 132 beats/min and the patient reports palpitations and feeling shaky. The MOST appropriate action by the therapist is to:
Correct answer: B - Stop the treatment and monitor the patient, then notify the provider
A male patient who is 70 inches (178 cm) tall is being initiated on the lung-protective ventilation strategy for ARDS. Using a predicted body weight of approximately 73 kg, which initial tidal volume is consistent with the ARDSNet protocol?
Correct answer: A - 440 mL
A newborn remains apneic with a heart rate of 80 beats/min after the initial steps of resuscitation (warming, drying, stimulation, and positioning). According to neonatal resuscitation guidelines, the MOST appropriate next action is to:
Correct answer: B - Initiate effective positive pressure ventilation
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