TMC Application Style Question

When you are going through your patient’s home medication use under inhaled medications you see Pentamidine isethionate 300mg every 4 weeks. What would the patient receiving this for?

  1. Cystic fibrosis
  2. Pulmonary fibrosis
  3. HIV/Aids
  4. Severe asthma with an eosinophilic phenotype

The correct answer is 3, HIV/ Aids Pentamidine is used to prevent PCP an infection caused by HIV/Aids. This is an example of an application type of TMC question. For more information on the types of questions on the TMC and how to study for each click here.

TMC Style Question and Explanation 3

After surgery a 170 lb male is receiving mechanical ventilation using the following settings:

  • Mode AC/VC
  • TV 450
  • F 12
  • FIO2 .45
  • Peep 5

ABGs are just resulted:

  • pH 7.16
  • PCO2 69
  • Po2 58
  • HCO3- 23
  • Sao2 91

Which should the respiratory therapist recommend?

  1. Increase fio2 to 55%
  2. Increase rate to 14
  3. Increase peep to 7
  4. Increase TV to 580

First evaluate the scenario and the laboratory results.  The patient is receiving mechanical ventilation following surgery, no pulmonary history is given. The patient’s pH,co2 and Po2 are abnormal.  Ventilation is necessary for survival so we need to address this before the hypoxia is addressed. The two ways to address the ventilation are to increase the TV and increase the RR. You always want to adjust the tidal volume first before adjusting the rr.