,NSG 550 Exam 2 | Diagnostic Reasoning for NP
(2026) Actual Q&A PDF | Wilkes
1. The primary purpose of ordering pulmonary function tests (PFTs) is to:
A) Evaluate lung function, differentiate obstructive from restrictive disease, and
assess response to therapy
B) Diagnose lung cancer
C) Visualize the tracheobronchial tree directly
D) Measure arterial blood gases
Correct Answer: Evaluate lung function, differentiate obstructive from
restrictive disease, and assess response to therapy
Rationale: PFTs assess lung volumes, airflow, and capacity to diagnose and
monitor pulmonary conditions. They are not used for direct visualization or
blood gas measurement.
2. Which factor does NOT cause variability in spirometry results?
A) Age
B) Blood type
C) Sex
D) Height
Correct Answer: Blood type
,Rationale: Spirometry values are influenced by age, sex, height, and weight.
Blood type has no effect on lung function measurements.
3. The FEV1/FVC ratio is decreased in which type of pulmonary disease?
A) Restrictive
B) Normal
C) Obstructive
D) None
Correct Answer: Obstructive
Rationale: In obstructive diseases such as asthma and COPD, airflow limitation
reduces the FEV1/FVC ratio. In restrictive disease, both FEV1 and FVC are
reduced, keeping the ratio normal or elevated.
4. Which of the following is a contraindication to spirometry?
A) Stable angina
B) Mild hypertension
C) Asthma
D) Recent myocardial infarction
Correct Answer: Recent myocardial infarction
Rationale: Recent MI, pneumothorax, active hemoptysis, and recent surgery are
contraindications because forced expiratory maneuvers can increase
intrathoracic pressure and stress the cardiovascular system.
, 5. Polysomnography is most commonly used to diagnose:
A) Sleep apnea
B) Narcolepsy only
C) Insomnia
D) Restless legs syndrome
Correct Answer: Sleep apnea
Rationale: Polysomnography records multiple physiological parameters during
sleep and is the gold standard for diagnosing obstructive sleep apnea. It also
evaluates other sleep disorders.
6. The NP is interpreting spirometry results. A patient with asthma would most
likely show:
A) Normal FEV1/FVC ratio
B) Reduced FEV1/FVC ratio with reversibility after bronchodilator
C) Reduced FVC only
D) No change after bronchodilator
Correct Answer: Reduced FEV1/FVC ratio with reversibility after bronchodilator
Rationale: Asthma is an obstructive disease with reversible airflow limitation. A
significant increase in FEV1 or FVC after bronchodilator confirms the diagnosis.
7. Which test directly visualizes the tracheobronchial tree?
(2026) Actual Q&A PDF | Wilkes
1. The primary purpose of ordering pulmonary function tests (PFTs) is to:
A) Evaluate lung function, differentiate obstructive from restrictive disease, and
assess response to therapy
B) Diagnose lung cancer
C) Visualize the tracheobronchial tree directly
D) Measure arterial blood gases
Correct Answer: Evaluate lung function, differentiate obstructive from
restrictive disease, and assess response to therapy
Rationale: PFTs assess lung volumes, airflow, and capacity to diagnose and
monitor pulmonary conditions. They are not used for direct visualization or
blood gas measurement.
2. Which factor does NOT cause variability in spirometry results?
A) Age
B) Blood type
C) Sex
D) Height
Correct Answer: Blood type
,Rationale: Spirometry values are influenced by age, sex, height, and weight.
Blood type has no effect on lung function measurements.
3. The FEV1/FVC ratio is decreased in which type of pulmonary disease?
A) Restrictive
B) Normal
C) Obstructive
D) None
Correct Answer: Obstructive
Rationale: In obstructive diseases such as asthma and COPD, airflow limitation
reduces the FEV1/FVC ratio. In restrictive disease, both FEV1 and FVC are
reduced, keeping the ratio normal or elevated.
4. Which of the following is a contraindication to spirometry?
A) Stable angina
B) Mild hypertension
C) Asthma
D) Recent myocardial infarction
Correct Answer: Recent myocardial infarction
Rationale: Recent MI, pneumothorax, active hemoptysis, and recent surgery are
contraindications because forced expiratory maneuvers can increase
intrathoracic pressure and stress the cardiovascular system.
, 5. Polysomnography is most commonly used to diagnose:
A) Sleep apnea
B) Narcolepsy only
C) Insomnia
D) Restless legs syndrome
Correct Answer: Sleep apnea
Rationale: Polysomnography records multiple physiological parameters during
sleep and is the gold standard for diagnosing obstructive sleep apnea. It also
evaluates other sleep disorders.
6. The NP is interpreting spirometry results. A patient with asthma would most
likely show:
A) Normal FEV1/FVC ratio
B) Reduced FEV1/FVC ratio with reversibility after bronchodilator
C) Reduced FVC only
D) No change after bronchodilator
Correct Answer: Reduced FEV1/FVC ratio with reversibility after bronchodilator
Rationale: Asthma is an obstructive disease with reversible airflow limitation. A
significant increase in FEV1 or FVC after bronchodilator confirms the diagnosis.
7. Which test directly visualizes the tracheobronchial tree?
