Per the NBRC, the TMC exam’s Initiation and Modification of Interventions section is broken into nine subcategories, each with their own areas of focus. There are 10 questions requiring recall of knowledge, 30 focused on application of knowledge and 30 asking applicants for analysis. The general topics covered include: Maintain A Patent Airway Including the Care of Artificial Airways Proper positioning of a patient Recognition of a difficult airway Establishing and managing a patient’s airway Performing tracheostomy care Exchanging artificial airways Maintaining adequate humidification Initiating protocols to prevent ventilator associated infections Performing extubation Perform Airway Clearance and Lung Expansion Techniques Postural drainage, percussion or vibration Suctioning Mechanical devices Assisted cough Hyperinflation therapy Inspiratory muscle training Support Oxygenation and Ventilation Initiating and adjusting oxygen therapy Minimizing hypoxemia Initiating and adjusting mask or nasal CPAP Initiating and adjusting mechanical ventilation settings Correcting patient-ventilator dyssynchrony Utilizing ventilator graphics Performing lung recruitment maneuvers Liberating patients from mechanical ventilation Administer Medications and Specialty Gases Aerosolized preparations Endotracheal instillation Specialty gases Ensure Modifications are Made to the Respiratory Care Plan Treatment termination Recommendations Recommendations for changes Recommendations for pharmacological interventions Utilize Evidence-Based Practice Classification of disease severity Recommendations for changes in a therapeutic planwhen indicated Application of guidelines Provide Respiratory Care Techniques in High-Risk Situations Emergency Interprofessional communication Patient Transport Assist a Physician/Provider in Performing Procedures Intubation Bronchoscopy Specialized bronchoscopy Thoracentesis Tracheostomy Chest tube insertion Insertion of arterial or venous catheters Moderate sedation Cardioversion Withdrawal of life support Conduct Patient and Family Education Safety and infection control Home care and equipment Lifestyle changes Pulmonary rehabilitation Disease/condition management