Deck 8: Assessment of Pulmonary Function

Question 1

What speed should be used for the rotating drum of a water-sealed spirometer to measure volume changes during a forced vital capacity maneuver?

A) 16 mm/min
B) 32 mm/min
C) 160 mm/min
D) 1920 mm/min

Answer 1

D
The fastest speed (1920 mm/min)is used for recording volume changes during forced vital capacity maneuvers.

Question 2

The bell factor for a 9-L water-sealed spirometer bell is _____ mL/mm.

A) 13.5
B) 29.3
C) 20.93
D) 41.73

Answer 2

C
The bell factor is the number of milliliters of gas that must be displaced to cause the kymographic pen to move 1 mm.The bell factor for a 9-L bell is 20.93 mL/mm.

Question 3

"An aluminum bell suspended by a chain-and-pulley mechanism with a weight that counterbalances the weight of the bell" describes which of the following?

A) Dry rolling spirometer
B) Water-sealed spirometer
C) Bellows spirometer
D) Pneumotachograph

Answer 3

B
This is the description of a water-sealed spirometer.

Question 4

Which type of flow-measuring device uses struts to create a partial obstruction to gas flow,causing whirlpools to be produced when gas flows through it?

A) Monel pneumotachograph
B) Ceramic pneumotachograph
C) Vortex ultrasonic flowmeter
D) Variable-orifice pneumotachograph

Question 5

What is the volume displacement when the pen of a 13.5-L water-sealed spirometer moves 28 mm?

A) 0.378 L
B) 0.563 L
C) 0.586 L
D) 1.168 L

Question 6

The visual picture of volume and flow measurements is known as which of the following?

A) Spirogram
B) Spirometer
C) Kymograph
D) Turbine flowmeter

Question 7

Which of the following is a volume-collecting device?

A) Turbine flowmeter
B) Thermal anemometer
C) Dry rolling seal spirometer
D) Pressure pneumotachograph

Question 8

Which of the following devices is bidirectional?

A) Turbine flowmeter
B) Screen pneumotachograph
C) Vortex ultrasonic flowmeter
D) Variable-orifice pneumotachograph

Question 9

Peak flowmeters are calibrated in which of the following units?

A) liters/second
B) liters/minute
C) milliliters/second
D) millimeters/minute

Question 10

________ is used to measure lung-volume changes by collecting exhaled gas into an expandable wedge-shaped device.

A) A bellows spirometer
B) A water-sealed spirometer
C) A vortex pneumotachometer
D) A screen pneumotachometer

Question 11

The accuracy of an instrument depends on which of the following?
1)The standard deviation of repeated measurements
2)The instrument's linearity and frequency response
3)The instrument's ability to reproduce a measurement
4)The instrument's sensitivity to environmental conditions

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

Question 12

What is the tidal volume measurement when the pen of a 9-L water-sealed spirometer moves 25 mm?

A) 0.338 L
B) 0.523 L
C) 0.843 L
D) 1.043 L

Question 13

Which statement is true concerning thermal flowmeters?

A) Gas flow can be measured bidirectionally.
B) Gas velocity affects the amount of cooling.
C) Cooling increases the resistance of a heated wire.
D) Cooling decreases the resistance of a thermistor bead.

Question 14

Speed settings of 32 and 160 mm/min on a water-sealed spirometer can be used to measure which of the following?
1)Minute ventilation
2)Peak expiratory flows
3)Maximum voluntary ventilation
4)Forced vital capacity maneuvers

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

Question 15

The rotating motor-driven drum used to document the bell movement of a water-sealed spirometer is known as which of the following?

A) Spirograph
B) Kymograph
C) Anemometer
D) Pneumotachograph

Question 16

Which of the following is true concerning the Stead-Wells spirometer?

A) Counterweights are necessary.
B) The pen and bell move in opposite directions.
C) The pen recorder is attached directly to the bell.
D) On exhalation, the bell and pen move downward.

Question 17

The precision of an instrument depends on:

A) linearity.
B) calibration.
C) repeatability.
D) frequency of response.

Question 18

The principle that gas flow is proportional to the pressure drop across a known resistance is used by which of the following devices?

A) Turbine flowmeter
B) Thermal flowmeter
C) Fleisch pneumotachograph
D) Ultrasonic pneumotachograph

Question 19

Airflow is measured by which of the following?

A) "Hot-wire" anemometer
B) Bellows spirometer
C) Water-sealed spirometer
D) Dry rolling seal spirometer

Question 20

When a patient inhales while connected to a water-sealed spirometer,the bell moves _____ and the pen moves _____.

A) Up; up
B) Up; down
C) Down; up
D) Down; down

Question 21

The bedside respiratory mechanics of mechanically ventilated patients can be measured with which of the following?
1)VenTrak system
2)Tissot spirometer
3)BICORE CP-100 system
4)Stead-Wells spirometer

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

Question 22

The best method for accurately measuring the thoracic gas volume of a patient with emphysema is:

A) helium dilution.
B) nitrogen washout.
C) pressure plethysmography.
D) chemiluminescence monitoring.

Question 23

A screen pneumotachograph is:

A) built with metal struts.
B) expensive and non-disposable.
C) bidirectional and very accurate.
D) heated to prevent condensation.

Question 24

Body plethysmography is based on which of the following gas laws?

A) Boyle's
B) Charles'
C) Dalton's
D) Gay-Lussac's

Question 25

Which of the following are factors that influence the partial pressure of alveolar carbon dioxide (PACO₂)?
1)Diffusion
2)Ventilation
3)CO₂ production
4)Perfusion of the lungs

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

Question 26

Which of the following represents the relationship used by body plethysmography to calculate functional residual capacity?

A) $V_{F R C}=\Delta V \div \Delta P \times\left(P_{B}-P_{H 2 O}\right)$
B) $\mathrm{V}_{\mathrm{FRC}}=\Delta \mathrm{P} \div \Delta \mathrm{V} \times\left(\mathrm{P}_{\mathrm{B}}-\mathrm{P}_{\mathrm{H} 2 \mathrm{O}}\right)$
C) $\mathrm{V}_{\mathrm{FRC}}=\Delta \mathrm{V} \div \Delta \mathrm{T} \times\left(\mathrm{P}_{\mathrm{B}}-\mathrm{P}_{\mathrm{H} 2 \mathrm{O}}\right)$
D) $\mathrm { V } _ { \mathrm { FRC } } = \left( \mathrm { P } _ { \mathrm { B } } - \mathrm { P } _ { \mathrm { H } 2 \mathrm { O } } \right) \times \Delta \mathrm { V }$

Question 27

The parents of a newborn sent home with an apnea monitor call the respiratory therapist to report several periods of apnea as noted by the monitor's alarm system.The respiratory therapist should check which of the following to ensure that the baby's movement was not the cause of these alarms?

A) Sensitivity of the monitor
B) Placement of the electrodes
C) Amount of electrical current
D) Frequency of the vibrations

Question 28

Which type of pressure-measurement device is best suited to measure arterial blood pressure through an arterial catheter?

A) Bourdon gauge
B) Aneroid manometer
C) Variable inductance
D) Variable capacitance

Question 29

Which of the following equipment is necessary to perform a nitrogen washout test?

A) Pneumotachometer
B) Carbon dioxide (CO₂) absorber
C) Drying column
D) Pressure transducer

Question 30

The standard for repeatability for forced expiratory volume in 1 second (FEV₁)is ___ mL.

A) 100
B) 150
C) 200
D) 250

Question 31

Which of the following might cause an apnea monitor to fail to alert the clinician to the presence of apnea?

A) Tachycardia
B) Changes in blood volume
C) Upper airway obstruction
D) Inadequate Sensitivity settings

Question 32

"Opposition to the flow of an alternating current" is the definition of:

A) electrical resistance.
B) variable capacitance.
C) electrical impedance.
D) variable inductance.

Question 33

Impedance plethysmographs operate by using _____-frequency,_____-amplitude electrical current.

A) Low; low
B) High; low
C) Low; high
D) High; high

Question 34

Which type of pneumotachograph uses the Doppler effect to measure airflow velocity?

A) Fleisch
B) Screen type
C) Nonvortex
D) Variable-orifice

Question 35

Which of the following is true concerning the triple-lumen esophageal catheter used with the BICORE CP-100 Pulmonary Monitoring System?

A) It can measure intrapleural pressure indirectly.
B) Its ideal position is the upper third of the esophagus.
C) When the catheter enters the stomach, a negative pressure is recorded.
D) The catheter can be positioned by observing the markings on its side.

Question 36

One type of ventilatory pattern necessary for calculating functional residual capacity through the use of a body plethysmograph is:

A) deep breathing with a breath hold.
B) rapid, shallow breathing.
C) deep, rapid breathing.
D) slow, deep breathing.

Question 37

The end point of a helium dilution test occurs when:

A) nitrogen is washed out.
B) there is no more helium.
C) the change in pressure remains steady.
D) the helium percentage remains steady for 2 minutes.

Question 38

A comparison of functional residual capacity measured by body plethysmography with that measured by nitrogen washout reveals that the measurement obtained during the nitrogen washout test is less than that during body plethysmography.This discrepancy is most likely caused by which of the following?

A) Poor technique
B) Severe air-trapping
C) Restrictive lung disease
D) Directional valve malfunction

Question 39

Which type of pressure-measurement device is used to measure a patient's maximum inspiratory pressure?

A) Variable inductance
B) Aneroid manometer
C) Plethysmograph
D) Strain gauge

Question 40

Aneroid manometers use ________ to measure pressure.

A) a vacuum chamber with a flexible diaphragm
B) capacitance and changes in output voltage
C) changes in inductance of two coils
D) a Wheatstone bridge circuit

Question 41

Patients with restrictive pulmonary disease demonstrate a decrease in which of the following measurements?
1)Vital capacity
2)Total lung capacity
3)Forced expiratory flow from 25% to 75% of the vital capacity (FEF₂₅₋₇₅)
4)Ratio of forced expiratory volume in 1 second to vital capacity (FEV₁/VC)

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

Question 42

While working in the neonatal intensive care unit,a respiratory therapist notices that a baby with an apnea monitor is not breathing,but the apnea alarm is not ringing.Which of the following might cause this failure?
1)Tachypnea
2)Bradycardia
3)Excessive movement
4)Upper airway obstruction

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

Question 43

If a patient's minute volume is 8.5 L/min and his respiratory rate is 15 breaths/min,his average tidal volume is ____ L.

A) 0.125
B) 0.570
C) 0.060
D) 5.700

Question 44

Total lung capacity is a result of:

A) vital capacity plus residual volume.
B) inspiratory capacity plus residual volume.
C) inspiratory capacity plus expiratory residual volume.
D) inspiratory reserve volume plus functional residual capacity.

Question 45

What type of device is used in an ICU to detect respiratory muscle fatigue?

A) Aneroid manometer
B) Pressure plethysmograph
C) Inductive plethysmograph
D) Electromechanical transducer

Question 46

Which device would be appropriate for monitoring respiratory rate and tidal volume during a sleep study?

A) Capnograph
B) Mass spectrometer
C) Pneumotachograph
D) Inductive plethysmograph

Question 47

Secretions in the airway of a mechanically ventilated patient could be indicated by a(n):

A) increase in inspiratory capacity.
B) increase in breathing frequency.
C) increase in peak inspiratory pressure.
D) decrease in forced expiratory flow rates.

Question 48

Which of the following devices can a patient with asthma use in the home to monitor daily variations in Raw?

A) Thermal flowmeter
B) Fleisch pneumotachograph
C) Screen pneumotachograph
D) Vortex ultrasonic flowmeter

Question 49

Which of the following values is not measured directly?

A) FEV₁
B) Airway resistance (Raw)
C) Peak expiratory flows
D) Maximum inspiratory pressure

Question 50

As measured by inductive plethysmography,rib cage movement plus abdominal movement equals:

A) tidal volume.
B) inspiratory capacity.
C) expiratory reserve volume.
D) functional residual capacity.

Question 51

Newer ventilators can make tidal volume and minute volume measurements by incorporating which of the following?

A) Capnograph
B) Anemometer
C) Flow transducer
D) Pressure transducer

Question 52

To set up a pulmonary function laboratory that can measure all standard and dynamic lung volumes,which of the following equipment is necessary?

A) Screen pneumotachograph and inductive plethysmograph
B) Fleisch pneumotachograph and peak flowmeter
C) Vortex ultrasonic flowmeter and inductive plethysmograph
D) Stead-Wells spirometer and constant-volume plethysmograph

Question 53

The results of pulmonary function testing show a normal total lung capacity and decreased,but reversible,FEV₁ and FEV₂₅₋₇₅.The patient is a 22-year-old,nonsmoking man with a history of intermittent "noisy breathing." Which of the following is most likely the cause of his problem?

A) Asthma
B) Emphysema
C) Pulmonary fibrosis
D) Severe restrictive pulmonary disease

Question 54

The most appropriate lung volume to measure for a mechanically ventilated patient is _____ volume.

A) minute
B) residual
C) expiratory reserve
D) inspiratory reserve

Question 55

Increased alveolar ventilation is associated with which of the following?

A) Hyperthermia
B) Bronchospasm
C) Decreased metabolic rate
D) Respiratory muscle fatigue

Question 56

The principle that the respiratory system moves with 2 degrees of freedom describes the basis for which of the following?

A) Inductive plethysmography
B) Volume plethysmography
C) Strain gauge transducer
D) Nitrogen washout

Question 57

Which of the following variables can be measured directly?

A) Lung compliance
B) Work of breathing
C) Raw
D) Pₚₗₐₜₑₐᵤ

Question 58

Vital capacity is the sum of which of the following?
1)Residual volume
2)Inspiratory capacity
3)Expiratory reserve volume
4)Inspiratory reserve volume
5)Functional residual capacity

A) 2 and 3
B) 1 and 4
C) 2 and 5
D) 3 and 4

Question 59

Expiratory residual volume plus residual volume equals:

A) functional residual capacity.
B) inspiratory capacity.
C) total lung capacity.
D) vital capacity.

Question 60

What is the minute volume of a patient if her respiratory rate is 12 breaths/min and her tidal volume is 750 mL?

A) 0.06 L
B) 9.00 L
C) 6.25 L
D) 9.00 L

Question 61

Which oxygen analyzer uses a semipermeable polytetrafluoroethylene membrane to separate oxygen from a potassium hydroxide bath containing a gold cathode and a lead anode?

A) Paramagnetic
B) Galvanic
C) Electrical
D) Polarographic

Question 62

Which device is appropriate for assessing a patient's response to bronchodilator therapy at the bedside?

A) Stead-Wells spirometer
B) Mainstream capnograph
C) Inductive plethysmograph
D) Rotating-vane flowmeter

Question 63

Which of the following pathophysiologic conditions can increase both the peak inspiratory pressure and the Pₚₗₐₜₑₐᵤ of a ventilated patient?

A) Asthma
B) Atelectasis
C) Kyphoscoliosis
D) Pulmonary interstitial fibrosis

Question 64

The respiratory system compliance of a patient receiving mechanical ventilation when the returned tidal volume is 650 mL,the static pressure is 35 cm H₂O,and the positive end-expiratory pressure is 8 cm H₂O is _____ mL/cm H₂O.

A) 0.04
B) 18.6
C) 53.9
D) 24

Question 65

Which of the following variables in the formula describing Poiseuille's law can be altered in the clinical setting to improve Raw?
1)Radius of the airways
2)Viscosity of the inspired gas
3)Flow rate of the inspired gas
4)Temperature of the inspired gas
5)Length of the tracheobronchial tree

A) 1 and 3
B) 1,4,and 5
C) 2,3,and 5
D) 1,2,and 3

Question 66

The amount of pressure required by a ventilator to maintain tidal volume when there is no gas flow is known as:

A) Pₚₗₐₜₑₐᵤ.
B) peak inspiratory pressure.
C) peak expiratory pressure.
D) Maximum inspiratory pressure.

Question 67

A(n)______ analyzer is an oxygen analyzer that uses paramagnetism to measure oxygen concentration.

A) Galvanic
B) Electrical
C) Paramagnetic
D) Polarographic

Question 68

Normal Raw of the respiratory system is _____ cm H₂O/L/s.

A) 1 to 3
B) 2 to 5
C) 4 to 8
D) 6 to 10

Question 69

Occlusion of the expiratory valve of the ventilator at the end of a tidal inspiration enables measurement of which of the following?

A) Pₚₗₐₜₑₐᵤ
B) Peak airway pressure
C) Maximum inspiratory pressure
D) Maximum expiratory pressure

Question 70

Which type of oxygen analyzer will give erroneous concentration levels in the presence of contaminant gases?

A) Polarographic
B) Electrical
C) Galvanic
D) Physical

Question 71

The oxygen analyzer that is no longer commonly used is the ____ analyzer.

A) Paramagnetic
B) Galvanic
C) Electrical
D) Polarographic

Question 72

Electrical analyzers operate by using which of the following?

A) Clark electrodes
B) Pauling's principle
C) Thermal conductivity
D) Oxygen-mediated chemical reaction

Question 73

What is the pressure reading on the anemometer of a ventilator during an inspiratory hold maneuver?

A) Pₚₗₐₜₑₐᵤ.
B) Peak inspiratory pressure
C) Mean inspiratory pressure
D) Maximum inspiratory pressure

Question 74

Which device can be incorporated into a ventilator to provide continuous recordings of airway pressure during the breathing cycle?

A) Variable capacitance transducer
B) Inductive plethysmograph
C) Strain gauge transducer
D) Aneroid manometer

Question 75

Which of the following happen to the wire within a Wheatstone bridge when it is exposed to oxygen concentrations higher than room air?
1)Its resistance decreases.
2)Its resistance increases.
3)It cools down.
4)It heats up.

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

Question 76

Which of the following is a complication of performing peak expiratory flows maneuvers?

A) Increased static pressure
B) Increased airway resistance
C) Decreased chest compliance
D) Decreased mean airway pressure

Question 77

A(n)______ analyzer is an oxygen analyzer that can display both partial pressure (in millimeters of mercury)and the percentage of oxygen concentration.

A) Paramagnetic
B) Galvanic
C) Electrical
D) Polarographic

Question 78

If the chest wall compliance of a mechanically ventilated patient decreases,which of the following will occur?

A) Maximum inspiratory pressure will decrease.
B) Peak inspiratory pressure will decrease.
C) Pₚₗₐₜₑₐᵤ will increase.
D) Tidal volume will increase.

Question 79

Which type of oxygen analyzer should not be used in the presence of anesthetic gases?

A) Polarographic
B) Paramagnetic
C) Electrical
D) Galvanic

Question 80

Which gas law is applicable when considering Raw?

A) Boyle's
B) Charles'
C) Poiseuille's
D) Avogadro's