Key Takeaways
- The TMC exam has three main content domains: Patient Data Evaluation (36%), Troubleshooting & Infection Control (14%), and Interventions (50%)
- Patient Data Evaluation covers approximately 50 questions on the scored portion of the exam
- Troubleshooting & Infection Control accounts for approximately 20 scored questions
- Interventions is the largest domain with approximately 70 scored questions
- Questions are classified as either Recall, Application, or Analysis level
- The majority of TMC questions are at the Application and Analysis levels, requiring clinical reasoning
- Content spans all patient populations: adult, pediatric, and neonatal
Content Domains & Weight Distribution
The NBRC TMC exam is organized into three major content domains. Understanding the weight and scope of each domain is critical for allocating your study time effectively. The Interventions domain alone accounts for half of the exam, making it the most important area to master.
TMC Content Domain Overview
| Domain | Weight | Approximate Scored Questions |
|---|---|---|
| I. Patient Data Evaluation | ~36% | ~50 of 140 scored items |
| II. Troubleshooting & Infection Control | ~14% | ~20 of 140 scored items |
| III. Interventions | ~50% | ~70 of 140 scored items |
Domain I: Patient Data Evaluation (~36%)
This domain tests your ability to gather, interpret, and evaluate patient data. Key topics include:
- Patient history and physical examination: Interview techniques, auscultation, inspection, palpation, percussion
- Arterial blood gas (ABG) interpretation: Acid-base balance, oxygenation status, compensation
- Pulmonary function testing: Spirometry (FEV1, FVC, FEV1/FVC), lung volumes, diffusion capacity
- Imaging interpretation: Chest X-ray (CXR) findings, CT scan basics
- Hemodynamic monitoring: Central venous pressure (CVP), pulmonary artery pressures, cardiac output
- Laboratory data: CBC, BMP, coagulation studies, sputum cultures, cardiac biomarkers
- Monitoring devices: Pulse oximetry, capnography, ventilator waveform analysis
Domain II: Troubleshooting & Infection Control (~14%)
This is the smallest domain but is high-yield because questions are often straightforward:
- Equipment troubleshooting: Ventilator alarms, oxygen delivery problems, suction equipment
- Infection control: Standard precautions, transmission-based precautions, hand hygiene
- VAP prevention: Ventilator-associated pneumonia bundles
- Equipment maintenance: Sterilization, disinfection, quality control
- Safety protocols: Fire safety, electrical safety, compressed gas handling
Domain III: Interventions (~50%)
The largest domain, covering the treatments and procedures respiratory therapists perform:
- Mechanical ventilation: Modes, settings, adjustments, weaning (the single largest subcategory)
- Airway management: Intubation, tracheostomy care, suctioning, airway adjuncts
- Oxygen therapy: Delivery devices, FiO2 calculations, titration
- Pharmacology: Bronchodilators, corticosteroids, mucolytics, surfactant, sedation
- Cardiopulmonary resuscitation: BLS/ACLS protocols, emergency procedures
- Hyperinflation therapy: Incentive spirometry, IPPB
- Chest physiotherapy: Postural drainage, percussion, vibration, PEP therapy
- Patient education: Disease management, medication use, home equipment
Question Cognitive Levels
TMC questions are written at three cognitive levels:
| Level | Description | Approximate Percentage |
|---|---|---|
| Recall | Remembering facts, definitions, and normal values | ~15-20% |
| Application | Applying knowledge to clinical scenarios | ~45-50% |
| Analysis | Evaluating complex data and making clinical decisions | ~30-35% |
Most TMC questions require you to apply knowledge or analyze clinical data, not simply recall facts. This is why practice with clinical scenarios is more effective than memorizing textbook definitions.
Which TMC content domain accounts for the largest portion of the exam?
Match each TMC content domain to its approximate weight on the exam.
Match each item on the left with the correct item on the right
What cognitive level do the MAJORITY of TMC exam questions test?
Mechanical ventilation questions make up approximately what portion of the total TMC exam?