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Free Therapist Multiple-Choice Examination Practice Questions

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Sample Practice Questions

Try these 10 sample questions from the Therapist Multiple-Choice Examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

  1. 1A respiratory therapist reviews blood gases from a patient with worsening hypoventilation. Which measured variable directly evaluates the adequacy of ventilation?

    1. A. PaO2
    2. B. PaCO2
    3. C. pH
    4. D. SaO2

    Answer: B

    Explanation: The guideline identifies "ventilatory (PaCO2), acid-base (pH), and oxygenation (PaO2 and oxyhemoglobin saturation)". PaCO2 directly evaluates ventilation; the other variables evaluate acid-base status or oxygenation.

    Reference: AARC Clinical Practice Guideline: Blood Gas Analysis and Hemoximetry: 2013 — BGA 3.1.1, p. 1695

  2. 2A therapist investigates poor delivery from a dry-powder inhaler in a patient with respiratory distress. Which patient-generated variable is essential for dispersing and drawing the powder into the airways?

    1. A. Expiratory flow
    2. B. Inspiratory flow
    3. C. Expiratory pressure
    4. D. Inspiratory pause

    Answer: B

    Explanation: The guideline states, "The patient’s inspiratory flow disperses the dry particles and draws them from the device into the lower airways." Insufficient inspiratory flow can account for poor powder delivery in this patient.

    Reference: Aerosol Delivery Device Selection for Spontaneously Breathing Patients: 2012 — ADS 1.4 Dry-Powder Inhaler, p. 615

  3. 3An endotracheal tube bypasses the upper airway during invasive ventilation. Approximately what percentage of the heat and moisture normally supplied to the alveoli comes from the bypassed region?

    1. A. 25%
    2. B. 50%
    3. C. 75%
    4. D. 100%

    Answer: C

    Explanation: The AARC guideline states, "The upper airway provides 75% of the heat and moisture supplied to the alveoli." Because intubation bypasses this region, the therapist must provide conditioning of inspired gas.

    Reference: Humidification During Invasive and Noninvasive Mechanical Ventilation: 2012 — HMV 1.0 Description, p. 782

  4. 4During chemotherapy, an adult's record lists hemoglobin 8.0 g/dL, carboxyhemoglobin 1%, methemoglobin 0.5%, and oxyhemoglobin saturation 98%. Which blood measurement specifically requires adjustment of the DLCO reference value to interpret the patient's reduced gas transfer?

    1. A. Measured hemoglobin concentration
    2. B. Measured carboxyhemoglobin concentration
    3. C. Measured methemoglobin concentration
    4. D. Measured oxyhemoglobin concentration

    Answer: A

    Explanation: The interpretive standard states, "It is recommended that the reference value be adjusted for measured haemoglobin concentration." The DLCO measurement standard specifies that "an adjustment for COHb is only recommended for interpretative purposes when COHb levels are known to be elevated or levels above 2% are suspected." The markedly low total hemoglobin is the relevant adjustment here; COHb is within the endogenous range, and the other listed results do not establish this anemia-related correction.

    Reference: ERS/ATS technical standard on interpretive strategies for routine lung function tests — Special considerations for DLCO

  5. 5An aerosol generator produces high-frequency vibrations in a piezoelectric crystal and transfers them to the solution surface. Which device is being checked?

    1. A. Jet nebulizer
    2. B. Mesh nebulizer
    3. C. Ultrasonic nebulizer
    4. D. Dry-powder inhaler

    Answer: C

    Explanation: The guideline states, "Ultrasonic nebulizer is also powered by electricity to create high frequency vibrations in a piezo crystal, which are transferred to the surface of the solution, creating a standing wave that generates aerosol." This generator mechanism identifies the ultrasonic nebulizer.

    Reference: Aerosol Delivery Device Selection for Spontaneously Breathing Patients: 2012 — ADS 1.1 Small-Volume Nebulizer, p. 614

  6. 6A therapist selects a heat and moisture exchanger for an invasively ventilated patient without contraindications. What minimum absolute humidity does the AARC recommendation specify for passive humidification?

    1. A. 25 mg H2O/L
    2. B. 30 mg H2O/L
    3. C. 33 mg H2O/L
    4. D. 44 mg H2O/L

    Answer: B

    Explanation: The guideline recommends that "the HME provide a minimum of 30 mg H2O/L." This is the passive-humidification minimum; the other values relate to different humidity thresholds or active and fully saturated gas conditioning.

    Reference: Humidification During Invasive and Noninvasive Mechanical Ventilation: 2012 — Abstract, recommendation 4, p. 782

  7. 7An adult's technically acceptable spirometry shows a reduced FVC and a preserved FEV1/FVC ratio. Which additional result is needed to confirm a restrictive ventilatory impairment?

    1. A. A reduced total lung capacity
    2. B. An increased residual volume
    3. C. An increased airway resistance
    4. D. A reduced expiratory reserve volume

    Answer: A

    Explanation: The standard states, "However, measurement of a low TLC is necessary to confirm restriction." A low FVC alone does not establish restriction; the confirmation requires reduced total lung capacity.

    Reference: ERS/ATS technical standard on interpretive strategies for routine lung function tests — The non-specific pattern: a low FEV1 and FVC with normal FEV1/FVC

  8. 8A therapist is checking a mesh nebulizer because its aerosol particle size has changed. Which physical feature directly determines the particle size generated by this device?

    1. A. Diameter of the medication reservoir
    2. B. Diameter of the mesh aperture
    3. C. Diameter of the reservoir neck
    4. D. Diameter of the patient mouthpiece

    Answer: B

    Explanation: The guideline states, "The diameter of the mesh or aperture determines the size of the particle generated." The aperture dimension, rather than reservoir or interface dimensions, directly controls particle generation.

    Reference: Aerosol Delivery Device Selection for Spontaneously Breathing Patients: 2012 — ADS 1.1 Small-Volume Nebulizer, p. 614

  9. 9An intubated patient’s cuff is underinflated. Which complication is directly associated with an insufficient cuff seal?

    1. A. Tracheal mucosal ischemia
    2. B. Microaspiration of oral secretions
    3. C. Increased apparatus dead space
    4. D. Alveolar overdistention injury

    Answer: B

    Explanation: The assessment guideline states, "There is concern that insufficient cuff inflation (low cuff pressure) can result in microaspiration of oral secretions and increase the risk of VAP." The insufficient cuff seal permits microaspiration; overinflation instead risks tracheal mucosal injury.

    Reference: AARC Clinical Practice Guideline: Patient-Ventilator Assessment — Artificial Airways, Cuffs, and Skin Integrity, background

  10. 10A therapist reviews spirometric indices in a patient suspected of small airway disease. Which index is specifically described by ATS/ERS as highly variable and poorly reproducible for this purpose?

    1. A. FEF25–75%
    2. B. FEV1/FVC
    3. C. FEV1
    4. D. FVC

    Answer: A

    Explanation: The standard describes mid-range flows as "highly variable, poorly reproducible and not specific for small airway disease in individuals". This limitation applies to FEF25–75%, the average flow during the middle half of forced expiration.

    Reference: ERS/ATS technical standard on interpretive strategies for routine lung function tests — Airflow limitation and airflow obstruction

Topics in this practice bank

These topics describe the available practice for Therapist Multiple-Choice Examination. Review the examination outline and its sources for scope and allocation details.

  • I. PATIENT DATA (50 of 140 scored items; Recall 15, Application 27, Analysis 8)
    • I.A. Evaluate Data in the Patient Record (10 of 50 section items; Recall 4, Application 6, Analysis 0) — 1. Patient history, for example, history of present illness (HPI), orders, medication reconciliation, progress notes, DNR status / advance directives, social, family, and medical history; 2. Physical examination relative to the cardiopulmonary system; 3. Lines, drains, and airways, for example, chest tube, vascular lines, artificial airway; 4. Laboratory results, for example, CBC, electrolytes, coagulation studies, sputum culture and sensitivities, cardiac biomarkers; 5. Blood gas analysis and / or hemoximetry (CO-oximetry) results; 6. Pulmonary function testing results, for example spirometry, lung volumes, DLCO; 7. 6-minute walk test results; 8. Imaging study results, for example, chest radiograph, CT scan, ultrasonography and / or echocardiography, PET scan, ventilation / perfusion scan; 9. Maternal and perinatal / neonatal history, for example, APGAR scores, gestational age, L / S ratio; 10. Sleep study results, for example, apnea-hypopnea index (AHI); 11. Trends in monitoring results: a. fluid balance; b. vital signs; c. intracranial pressure; d. ventilator liberation parameters; e. pulmonary mechanics; f. noninvasive, for example, pulse oximetry, capnography, transcutaneous; g. cardiac evaluation / monitoring results, for example, ECG, hemodynamic parameters; 12. Determination of a patient's pathophysiological state
    • I.B. Perform Clinical Assessment (10 of 50 section items; Recall 3, Application 6, Analysis 1) — 1. Interviewing a patient to assess a. level of consciousness and orientation, emotional state, and ability to cooperate; b. level of pain; c. shortness of breath, sputum production, and exercise tolerance; d. smoking history; e. environmental exposures; f. activities of daily living; g. learning needs, for example, literacy, preferred learning style, social / cultural; 2. Performing inspection to assess a. general appearance; b. characteristics of the airway, for example, patency, Mallampati classification, tracheal shift; c. cough, sputum amount and character; d. status of a neonate, for example, APGAR score, gestational age; e. skin integrity, for example, pressure ulcers, stoma site; 3. Palpating to assess a. pulse, rhythm, intensity; b. accessory muscle activity; c. asymmetrical chest movements, tactile fremitus, crepitus, tenderness, tactile rhonchi, and / or tracheal deviation; 4. Performing diagnostic chest percussion; 5. Auscultating to assess a. breath sounds; b. heart sounds and rhythm; c. blood pressure; 6. Reviewing a chest radiograph to assess a. quality of imaging, for example, patient positioning, penetration, lung inflation; b. presence and position of airways, lines, and drains; c. presence of foreign bodies; d. heart size and position; e. presence of, or change in, (i) cardiopulmonary abnormalities, for example, pneumothorax, consolidation, pleural effusion, pulmonary edema, pulmonary artery size; (ii) diaphragm, mediastinum, and / or trachea
    • I.C. Perform Procedures to Gather Clinical Information (12 of 50 section items; Recall 4, Application 7, Analysis 1) — 1. 12-lead ECG; 2. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 3. Peak flow; 4. Mechanics of spontaneous ventilation linked to tidal volume, minute volume, maximal inspiratory pressure, and vital capacity; 5. Blood gas sample collection; 6. Blood gas analysis and / or hemoximetry (CO-oximetry); 7. Oxygen titration with exercise; 8. Cardiopulmonary calculations, for example, P(A-a)O2, VD / VT, P/F, OI; 9. Hemodynamic monitoring; 10. Pulmonary compliance and airways resistance; 11. Plateau pressure; 12. Auto-PEEP determination; 13. Spontaneous breathing trial (SBT); 14. Apnea monitoring; 15. Apnea test (brain death determination); 16. Overnight pulse oximetry; 17. CPAP / NPPV titration during sleep; 18. Cuff management, for example, tracheal, laryngeal; 19. Sputum induction; 20. Cardiopulmonary stress testing; 21. 6-minute walk test; 22. Spirometry outside or inside a pulmonary function laboratory; 23. DLCO inside a pulmonary function laboratory; 24. Lung volumes inside a pulmonary function laboratory; 25. Tests of respiratory muscle strength - MIP and MEP; 26. Therapeutic bronchoscopy
    • I.D. Evaluate Procedure Results (10 of 50 section items; Recall 2, Application 4, Analysis 4) — 1. 12-lead ECG; 2. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 3. Peak flow; 4. Mechanics of spontaneous ventilation linked to tidal volume, minute volume, maximal inspiratory pressure, and vital capacity; 5. Blood gas analysis and / or hemoximetry (CO-oximetry); 6. Oxygen titration with exercise; 7. Cardiopulmonary calculations, for example, P(A-a)O2, VD / VT, P/F, OI; 8. Hemodynamic monitoring; 9. Pulmonary compliance and airways resistance; 10. Plateau pressure; 11. Auto-PEEP; 12. Spontaneous breathing trial (SBT); 13. Apnea monitoring; 14. Apnea test (brain death determination); 15. Overnight pulse oximetry; 16. CPAP / NPPV titration during sleep; 17. Cuff status, for example, laryngeal, tracheal; 18. Cardiopulmonary stress testing; 19. 6-minute walk test; 20. Spirometry outside or inside a pulmonary function laboratory; 21. DLCO inside a pulmonary function laboratory; 22. Lung volumes inside a pulmonary function laboratory; 23. Tests of respiratory muscle strength - MIP and MEP
    • I.E. Recommend Diagnostic Procedures (8 of 50 section items; Recall 2, Application 4, Analysis 2) — 1. Testing for tuberculosis; 2. Laboratory tests, for example, CBC, electrolytes, coagulation studies, sputum culture and sensitivities, cardiac biomarkers; 3. Imaging studies; 4. Bronchoscopy a. diagnostic; b. therapeutic; 5. Bronchoalveolar lavage (BAL); 6. Pulmonary function testing; 7. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 8. Blood gas and/or hemoximetry (CO-oximetry); 9. ECG; 10. Exhaled gas analysis, for example, CO2, CO, FENO; 11. Hemodynamic monitoring; 12. Sleep studies; 13. Thoracentesis
  • II. TROUBLESHOOTING AND QUALITY CONTROL OF DEVICES, AND INFECTION CONTROL (20 of 140 scored items; Recall 8, Application 9, Analysis 3)
    • II.A. Assemble / Troubleshoot Devices (15 of 20 section items; Recall 4, Application 8, Analysis 3) — 1. Medical gas delivery interfaces, for example, mask, cannula, heated high-flow nasal cannula; 2. Long-term oxygen therapy; 3. Medical gas delivery, metering, and /or clinical analyzing devices, for example, concentrator, liquid system, flowmeter, regulator, gas cylinder, blender, air compressor, gas analyzers; 4. CPAP / NPPV with patient interfaces; 5. Humidifiers; 6. Nebulizers; 7. Metered-dose inhalers, spacers, and valved holding chambers; 8. Dry-powder inhalers (DPI); 9. Resuscitation equipment, for example, self-inflating resuscitator, flow-inflating resuscitator, AED; 10. Mechanical ventilators; 11. Intubation equipment; 12. Artificial airways; 13. Suctioning equipment, for example, regulator, canister, tubing, catheter; 14. Blood analyzers, for example, hemoximetry (CO-oximetry), point-of-care, blood gas; 15. Patient breathing circuits; 16. Hyperinflation devices; 17. Secretion clearance devices; 18. Heliox delivery device; 19. Portable spirometer; 20. Testing equipment in a pulmonary function laboratory; 21. Pleural drainage; 22. Noninvasive monitoring, for example, pulse oximeter, capnometer, transcutaneous; 23. Bronchoscopes and light sources; 24. Hemodynamic monitoring a. pressure transducers; b. catheters, for example, arterial, pulmonary artery
    • II.B. Ensure Infection Prevention (2 of 20 section items; Recall 2, Application 0, Analysis 0) — 1. Adhering to infection prevention policies and procedures, for example, Standard Precautions, donning/doffing, isolation; 2. Adhering to disinfection policies and procedures; 3. Proper handling of biohazardous materials
    • II.C. Perform Quality Control Procedures (3 of 20 section items; Recall 2, Application 1, Analysis 0) — 1. Blood analyzers; 2. Gas analyzers; 3. Pulmonary function equipment for testing a. spirometry results; b. lung volumes; c. diffusing capacity (DLCO); 4. Mechanical ventilators; 5. Noninvasive monitors
  • III. INITIATION AND MODIFICATION OF INTERVENTIONS (70 of 140 scored items; Recall 10, Application 30, Analysis 30)
    • III.A. Maintain a Patent Airway Including the Care of Artificial Airways (10 of 70 section items; Recall 3, Application 4, Analysis 3) — 1. Proper positioning of a patient; 2. Recognition of a difficult airway; 3. Establishing and managing a patient's airway a. nasopharyngeal airway; b. oropharyngeal airway; c. esophagealtracheal tubes / supraglottic airways; d. endotracheal tube; e. tracheostomy tube; f. laryngectomy tube; g. speaking valves; h. devices that assist with intubation, for example, endotracheal tube exchanger, video laryngoscopy; 4. Performing tracheostomy care; 5. Exchanging artificial airways; 6. Maintaining adequate humidification; 7. Initiating protocols to prevent ventilator-associated infections; 8. Performing extubation
    • III.B. Perform Airway Clearance and Lung Expansion Techniques (5 of 70 section items; Recall 2, Application 2, Analysis 1) — 1. Postural drainage, percussion, or vibration; 2. Suctioning, for example, nasotracheal, oropharyngeal; 3. Mechanical devices, for example, high-frequency chest wall oscillation, vibratory PEP, intrapulmonary percussive ventilation, insufflation / exsufflation; 4. Assisted cough, for example, huff, abdominal thrust; 5. Hyperinflation therapy; 6. Inspiratory muscle training
    • III.C. Support Oxygenation and Ventilation (15 of 70 section items; Recall 1, Application 5, Analysis 9) — 1. Initiating and adjusting oxygen therapy; 2. Minimizing hypoxemia, for example, patient positioning, secretion removal; 3. Initiating and adjusting mask or nasal CPAP; 4. Initiating and adjusting mechanical ventilation settings a. continuous mechanical ventilation; b. noninvasive ventilation; c. high-frequency ventilation; d. alarms; 5. Recognizing and correcting patient-ventilator dyssynchrony; 6. Utilizing ventilator graphics; 7. Performing lung recruitment maneuvers; 8. Liberating a patient from mechanical ventilation
    • III.D. Administer Medications and Specialty Gases (4 of 70 section items; Recall 1, Application 3, Analysis 0) — 1. Aerosolized preparations a. antimicrobials; b. pulmonary vasodilators; c. bronchodilators; d. mucolytics / proteolytics; e. steroids; 2. Endotracheal instillation; 3. Specialty gases, for example, heliox, inhaled NO
    • III.E. Ensure Modifications are Made to the Respiratory Care Plan (18 of 70 section items; Recall 1, Application 7, Analysis 10) — 1. Treatment termination, for example, life-threatening adverse event; 2. Recommendations a. starting treatment based on patient response; b. treatment of pneumothorax; c. adjustment of fluid balance; d. adjustment of electrolyte therapy; e. insertion or change of artificial airway; f. liberating from mechanical ventilation; g. extubation; h. discontinuing treatment based on patient response; i. consultation from a physician specialist; 3. Recommendations for changes a. patient position; b. oxygen therapy; c. humidification; d. airway clearance; e. hyperinflation; f. mechanical ventilation; 4. Recommendations for pharmacologic interventions a. bronchodilators; b. anti-inflammatory drugs; c. mucolytics and proteolytics; d. aerosolized antibiotics; e. inhaled pulmonary vasodilators; f. cardiovascular; g. antimicrobials; h. sedatives and hypnotics; i. analgesics; j. narcotic antagonists; k. benzodiazepine antagonists; l. neuromuscular blocking agents; m. diuretics; n. surfactants; o. changes to drug, dosage, administration frequency, mode, or concentration
    • III.F. Utilize Evidence-Based Practice (6 of 70 section items; Recall 0, Application 2, Analysis 4) — 1. Classification of disease severity; 2. Recommendations for changes in a therapeutic plan when indicated; 3. Application of guidelines, for example, ARDSNet, NAEPP, GOLD
    • III.G. Provide Respiratory Care in High-Risk Situations (5 of 70 section items; Recall 0, Application 2, Analysis 3) — 1. Emergency a. cardiopulmonary emergencies, excluding CPR; b. disaster management; c. medical emergency team (MET) / rapid response team; 2. Interprofessional communication; 3. Patient transport a. land / air between hospitals; b. within a hospital
    • III.H. Assist a Physician / Provider in Performing Procedures (4 of 70 section items; Recall 1, Application 3, Analysis 0) — 1. Intubation; 2. Bronchoscopy; 3. Specialized bronchoscopy, for example, endobronchial ultrasound (EBUS), navigational bronchoscopy (ENB); 4. Thoracentesis; 5. Tracheotomy; 6. Chest tube insertion; 7. Insertion of arterial or venous catheters; 8. Moderate (conscious) sedation; 9. Cardioversion; 10. Withdrawal of life support
    • III.I. Conduct Patient and Family Education (3 of 70 section items; Recall 1, Application 2, Analysis 0) — 1. Safety and infection control; 2. Home care and related equipment; 3. Lifestyle changes, for example, smoking cessation, exercise; 4. Pulmonary rehabilitation; 5. Disease / condition management, for example, asthma, COPD, CF, tracheostomy care, ventilator dependent

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