Deck 9: Pulmonary Function Testing

Question 1

Which of the following is the most common cause of erroneous forced vital capacity (FVC) test results?

A) Maximal inspiratory effort
B) Age of the patient
C) Age of the equipment
D) Suboptimal coaching

Answer 1

Suboptimal coaching

Question 2

A loss of elasticity of the lung tissue will cause the FRC to:

A) increase.
B) decrease.
C) stay the same.
D) none of the above.

Answer 2

increase.

Question 3

The total lung capacity (TLC) is a function of which of the following?
1) Age
2) Weight
3) Gender
4) Size

A)1 and 2
B)3 and 4
C)1, 3, and 4
D)2, 3, and 4

Answer 3

1, 3, and 4

Question 4

Which of the following are considered general purposes of performing pulmonary function tests (PFTs)?
1) The functional status of the lungs
2) The diffusion characteristics of the alveolar-capillary membrane
3) How much and how fast gas can be moved into and out of the lungs
4) The specific diagnosis of pulmonary disease

A)1 and 4
B)2 and 3
C)1, 2, and 3
D)2, 3, and 4

Question 5

In which of the following diseases will the open-circuit nitrogen washout method tend to underestimate the total lung volume?

A) Asthma
B) Emphysema
C) Cystic fibrosis
D) Chronic bronchitis

Question 6

The body plethysmograph uses which of the following gas laws?

A) Boyle's law
B) Charles' law
C) Gay-Lussac's law
D) Combined gas law

Question 7

Which of the following are parameters that have been studied to establish normal values for PFTs?
1) Gender
2) Height
3) Race
4) Weight

A)1 and 4
B)2 and 3
C)1, 2, and 3
D)2, 3, and 4

Question 8

The ERV is limited in clinical usefulness. It may be reduced in which of the following cases?
1) Obesity
2) Restrictive disorders
3) Obstructive disorders
4) Patients making a poor effort during testing

A)1 and 2
B)3 and 4
C)1, 2, and 4
D)2, 3, and 4

Question 9

Which level of VC is associated with an increased risk of respiratory failure?

A) <50 mL/kg
B) <40 mL/kg
C) <20 mL/kg
D) <15 mL/kg

Question 10

What is the normal minute ventilation of an average person at rest?

A) <5 L/min
B) 5 to 10 L/min
C) 5 to 15 L/min
D) >15 L/min

Question 11

Which level of vital capacity (VC) is associated with an increased risk of postoperative respiratory complications?

A) <50 mL/kg
B) <40 mL/kg
C) <20 mL/kg
D) <15 mL/kg

Question 12

Which of the following factors has the greatest influence on lung size and predicted PFT values?

A) Gender
B) Height
C) Race
D) Weight

Question 13

The closed-system helium dilution method is used to measure:

A) TLC.
B) FVC.
C) FRC.
D) TV.

Question 14

Which of the following associations' standards should be met before PFT equipment is purchased and used?

A) The American Lung Association
B) The American College of Chest Physicians
C) The Joint Commission
D) The American Thoracic Society

Question 15

Which of the following typically decreases the FVC in a patient with an obstructive lung disorder?

A) A decrease in lung size
B) An increase in residual volume (RV)
C) A decrease in expiratory muscle mass
D) An increase in airway resistance caused by the disease

Question 16

Which of the following is considered standard equipment that is used in a pulmonary function laboratory?
1) Spirometer
2) Gas analyzer
3) Oxygen source
4) Body plethysmograph

A)1 and 2
B)3 and 4
C)1, 2, and 4
D)2, 3, and 4

Question 17

What may cause the FVC to decrease in a patient with a restrictive lung disorder?

A) A decrease in lung size
B) An increase in the expiratory reserve volume (ERV)
C) A decrease in expiratory muscle mass
D) An increase in airway resistance caused by the disease

Question 18

The presence of an FVC that is significantly smaller than the slow vital capacity (SVC) is consistent with:

A) poor inspiratory effort.
B) use of a bronchodilator.
C) air trapping.
D) forced exhalation.

Question 19

Which of the following is considered the primary instrument used in performing PFTs?

A) Spirometer
B) Flowmeter
C) Thermistor
D) Spirograph

Question 20

The volume of air inhaled and exhaled during quiet breathing is known as the:

A) resting volume.
B) tidal volume.
C) inspiratory volume.
D) inspiratory capacity.

Question 21

The normal FEV₃ to FVC ratio is approximately:

A) 50%.
B) 66%.
C) 75%.
D) 95%.

Question 22

The FEV₃ measurement is an indicator of flow in which airways?

A) Large
B) Medium
C) Small
D) Medium and small

Question 23

The closing-volume (CV) test is used for early diagnosis of obstruction of airways of which of the following airway size(s)?

A) Large
B) Medium
C) Small
D) Large and medium

Question 24

Which of the following tests would be used to determine whether there is gross misdistribution of ventilation in the lungs of a patient given a diagnosis of emphysema?

A) DLCO
B) Helium dilution
C) Closing volume
D) Nitrogen washout

Question 25

Which of the following tests is often used preoperatively to evaluate whether the patient may have postoperative complications?

A) ABG analysis
B) IC measurement
C) MVV test
D) PEF test

Question 26

To determine whether there is a positive response to bronchodilator therapy, improvement must be seen in which of the following values?
1) FVC
2) FEV₁
3) FEF_{25% to 75%}
4) FEF_{75% to 85%}

A)1 and 4
B)2 and 3
C)1, 2, and 3
D)2, 3, and 4

Question 27

In a patient with an exacerbation of asthma, airway resistance will be:

A) normal.
B) increased.
C) decreased.
D) impossible to measure.

Question 28

The concentration of carbon monoxide used in a DLCO study is approximately:

A) 0.1%.
B) 0.4%.
C) 1.4%.
D) 10%.

Question 29

The maximal voluntary ventilation (MVV) test usually is performed over a period of:

A) 5 to 10 breaths.
B) 12 to 15 s.
C) 1 to 2 min.
D) 5 to 10 min.

Question 30

How would the inspiratory reserve volume and the inspiratory reserve capacity be described in a patient with a mild-to-moderate restrictive disorder?

A) Normal
B) Abnormally increased
C) Abnormally decreased
D) Not measured

Question 31

Which of the following tests is more sensitive than the FEV₁ in detecting airway obstruction?

A) FVC
B) FEV₁/FVC
C) FEV₃
D) FEF_{25% to 75%}

Question 32

The normal FEV₁ to FVC ratio is approximately:

A) 50%.
B) 66%.
C) 75%.
D) 90%.

Question 33

The MVV reflects which of the following?
1) Airway resistance
2) Condition of respiratory muscles
3) Condition of lung tissue
4) Compliance of the lungs and thorax

A)1 and 2
B)3 and 4
C)1, 2, and 4
D)2, 3, and 4

Question 34

Which of the following diseases are associated with a reduced DLCO?
1) Emphysema
2) Chronic bronchitis
3) Pulmonary embolus
4) Pulmonary fibrosis

A)1 only
B)2 and 3
C)1, 3, and 4
D)2, 3, and 4

Question 35

Which of the following tests are considered for exercise testing?
1) Stress ECG
2) Ventilatory capacity
3) Anaerobic threshold
4) DLCO

A)1 and 4
B)2 and 3
C)1, 2, and 3
D)2, 3, and 4

Question 36

The forced expiratory volume in 1 s (FEV₁) usually is expressed as a percentage of the observed:

A) PEF.
B) TLC.
C) FEV₃.
D) FVC.

Question 37

The DLCO is a test that is used to measure the:

A) amount of carbon monoxide in the blood.
B) thickness of the alveolar-capillary membrane.
C) diffusion coefficient of carbon monoxide in the lungs.
D) ability of a gas to move across the alveolar-capillary membrane.

Question 38

The reason why carbon monoxide is used in DLCO studies instead of oxygen is because carbon monoxide is:

A) more readily available than oxygen.
B) neither diffusion nor perfusion limited.
C) perfusion limited and not diffusion limited.
D) diffusion limited and not perfusion limited.

Question 39

Which of the following conditions are determinants of gas exchange across the membrane?
1) Amount of oxygen in the blood
2) Thickness of the alveolar-capillary membrane
3) Diffusion coefficient of carbon monoxide in the lungs
4) Surface area of the membrane

A)1 and 4
B)2 and 3
C)1, 2, and 3
D)2, 3, and 4

Question 40

What will happen to the static lung compliance of a postoperative heart patient with left lower lobe atelectasis?

A) It will be normal.
B) It will be less than normal.
C) It will be greater than normal.
D) It will be equal to the dynamic lung compliance.

Question 41

Which of the following conditions are common causes of restrictive lung disease?
1) Atelectasis and obesity
2) Interstitial lung disease and lung scarring
3) Chest wall dysfunction and neurologic disease
4) Asthma and emphysema

A)1 and 4
B)2 and 3
C)2, 3, and 4
D)1, 2, and 3

Question 42

To protect oneself from infection, pulmonary function testing should be conducted using which of the following precautions?
1) Standard precautions on all patients
2) Airborne precautions on all patients
3) Handwashing in between patients
4) Handwashing after handling used circuit components

A)1 and 2
B)3 and 4
C)1, 3, and 4
D)2, 3, and 4

Question 43

Which of the following values are needed to determine a patient's minute volume?
1) Respiratory rate
2) Tidal volume
3) Forced vital capacity
4) Maximal voluntary ventilation

A)1 and 2
B)3 and 4
C)1, 3, and 4
D)2, 3, and 4

Question 44

Which of the following tests would be used to determine at what point oxygen consumption reaches its peak?

A) Exercise challenge
B) Ventilatory capacity
C) Anaerobic threshold
D) Maximal oxygen uptake (O₂max)

Question 45

Which of the following conditions is associated with a low FVC, low FEV₁ but normal FEV₁/FVC, small TLC, low DLCO, and no response to a bronchodilator?

A) Emphysema
B) Chronic bronchitis
C) Pulmonary fibrosis
D) Pulmonary embolus

Question 46

When bronchoprovocation testing is used, the FEV₁ needs to decrease by what percentage before a diagnosis of hyperactive airways is made?

A) 10%
B) 20%
C) 50%
D) 66%

Question 47

When assessing the effect of a surgical intervention what percent increase in a 6-min walk test distance is indicative of treatment effectiveness?

A) 5% to 10%
B) 10% to 20%
C) 20% to 30%
D) 30% to 40%

Question 48

Why is the exhaled fraction of NO (F_ENO) useful in the diagnosis and management of asthma?

A) It is a chemical mediator exclusive to lymphocytes and helps diagnosis asthma.
B) Its concentration increasing in the presence of airway inflammation.
C) It helps identify the lymphophilic asthma phenotype.
D) Can easily be measured with a standard end-tidal CO₂ detector.

Question 49

A restrictive defect is present when lung volumes are reduced to less than what percentage of predicted levels?

A) 60%
B) 70%
C) 80%
D) 90%

Question 50

Which of the following tests would be used to determine at what point oxygen demand exceeds oxygen consumption during hard exercise?

A) Exercise challenge
B) Ventilatory capacity
C) Anaerobic threshold
D) Maximal oxygen uptake (O₂max)

Question 51

Which of the following medications is used most commonly during bronchoprovocation testing?

A) Methacholine
B) Isoproterenol
C) Methylene blue
D) Metaproterenol

Question 52

Obstructive lung disorders are characterized by a reduction in:

A) lung capacities.
B) lung volumes.
C) expiratory flows.
D) inspiratory flows.