,NSG 550 Exam 2 | Advanced Pathophysiology
Wilkes University | Q & A | 2026/2027 Edition (PDF)
1. Which of the following best describes the primary purpose of pulmonary function testing?**
A) To directly measure the partial pressure of oxygen in arterial blood
B) To evaluate pulmonary reserve, response to bronchodilators, and differentiate restrictive from
obstructive disease
C) To visualize structural abnormalities of the lung parenchyma
D) To diagnose pulmonary embolism through indirect measurement of airflow
Correct Answer: To evaluate pulmonary reserve, response to bronchodilators, and differentiate
restrictive from obstructive disease
Rationale: Pulmonary function tests evaluate the general health and capability of the lungs (pulmonary
reserve), assess response to bronchodilator therapy, and differentiate between restrictive and
obstructive chronic pulmonary diseases. They do not measure arterial blood gases, visualize structures,
or diagnose pulmonary embolism. Spirometry is the cornerstone of pulmonary function testing.
**2. A 58-year-old patient's pulmonary function test reveals an FEV1/FVC ratio of 65% following
bronchodilator administration. What is the most appropriate diagnostic interpretation?**
A) Normal pulmonary function
B) Restrictive lung disease
C) Chronic Obstructive Pulmonary Disease (COPD)
D) Mixed restrictive and obstructive pattern
Correct Answer: Chronic Obstructive Pulmonary Disease (COPD)
Rationale: Diagnosis of COPD requires demonstrating persistent airflow limitation based on spirometry
testing, specifically an FEV1/FVC ratio of less than 70% following bronchodilator administration. A
restrictive pattern would show a normal or elevated FEV1/FVC ratio with reduced FVC. The post-
bronchodilator ratio confirms irreversible airflow obstruction characteristic of COPD.
,**3. What is the expected improvement in airflow rate following bronchodilator administration that
indicates a significant response?**
A) 5% increase
B) 10% increase
C) 20% increase
D) 30% increase
Correct Answer: 20% increase
Rationale: A bronchodilator can help increase airflow rate by approximately 20% in responsive patients.
This degree of improvement indicates reversible airway obstruction and helps differentiate asthma from
COPD. An improvement of this magnitude typically warrants prescription of bronchodilator therapy and
suggests a spastic component to the obstructive disease.
**4. Which of the following factors is NOT a source of variability in pulmonary function test results?**
A) Age
B) Sex
C) Time of day
D) Height
Correct Answer: Time of day
Rationale: Variability in pulmonary function tests is influenced by age (lung function naturally declines
with age), sex (women typically have smaller lung volumes), height (taller individuals generally have
larger lung volumes), and weight (obesity can restrict lung expansion). Time of day is not a recognized
source of significant variability in PFT interpretation. These factors are used to calculate predicted
normal values.
**5. What is the normal range for arterial pH in an arterial blood gas analysis?**
A) 7.25 – 7.35
B) 7.35 – 7.45
C) 7.45 – 7.55
, D) 7.55 – 7.65
Correct Answer: 7.35 – 7.45
Rationale: The normal range for arterial pH is 7.35 to 7.45. Values below 7.35 indicate acidemia, while
values above 7.45 indicate alkalemia. The body maintains pH within this narrow range through
respiratory and renal compensation mechanisms. Understanding normal pH is fundamental to
interpreting arterial blood gases and identifying acid-base disorders.
**6. In arterial blood gas analysis, which component reflects the metabolic (renal) component of acid-
base homeostasis?**
A) pH
B) PCO2
C) HCO3
D) PO2
Correct Answer: HCO3
Rationale: HCO3 (bicarbonate) is indicative of the metabolic (renal) component of acid-base
homeostasis. PCO2 reflects the respiratory (ventilatory) component. pH is the overall result of both
components working together. PO2 measures the adequacy of oxygenation. The normal range for HCO3
is 22-26 mEq/L.
**7. A patient with COPD presents with confusion and lethargy. Arterial blood gas shows pH 7.30, PCO2
60 mmHg, and HCO3 28 mEq/L. Which acid-base disorder is present?**
A) Acute respiratory alkalosis with metabolic compensation
B) Acute respiratory acidosis with metabolic compensation
C) Metabolic acidosis with respiratory compensation
D) Metabolic alkalosis with respiratory compensation
Correct Answer: Acute respiratory acidosis with metabolic compensation
Wilkes University | Q & A | 2026/2027 Edition (PDF)
1. Which of the following best describes the primary purpose of pulmonary function testing?**
A) To directly measure the partial pressure of oxygen in arterial blood
B) To evaluate pulmonary reserve, response to bronchodilators, and differentiate restrictive from
obstructive disease
C) To visualize structural abnormalities of the lung parenchyma
D) To diagnose pulmonary embolism through indirect measurement of airflow
Correct Answer: To evaluate pulmonary reserve, response to bronchodilators, and differentiate
restrictive from obstructive disease
Rationale: Pulmonary function tests evaluate the general health and capability of the lungs (pulmonary
reserve), assess response to bronchodilator therapy, and differentiate between restrictive and
obstructive chronic pulmonary diseases. They do not measure arterial blood gases, visualize structures,
or diagnose pulmonary embolism. Spirometry is the cornerstone of pulmonary function testing.
**2. A 58-year-old patient's pulmonary function test reveals an FEV1/FVC ratio of 65% following
bronchodilator administration. What is the most appropriate diagnostic interpretation?**
A) Normal pulmonary function
B) Restrictive lung disease
C) Chronic Obstructive Pulmonary Disease (COPD)
D) Mixed restrictive and obstructive pattern
Correct Answer: Chronic Obstructive Pulmonary Disease (COPD)
Rationale: Diagnosis of COPD requires demonstrating persistent airflow limitation based on spirometry
testing, specifically an FEV1/FVC ratio of less than 70% following bronchodilator administration. A
restrictive pattern would show a normal or elevated FEV1/FVC ratio with reduced FVC. The post-
bronchodilator ratio confirms irreversible airflow obstruction characteristic of COPD.
,**3. What is the expected improvement in airflow rate following bronchodilator administration that
indicates a significant response?**
A) 5% increase
B) 10% increase
C) 20% increase
D) 30% increase
Correct Answer: 20% increase
Rationale: A bronchodilator can help increase airflow rate by approximately 20% in responsive patients.
This degree of improvement indicates reversible airway obstruction and helps differentiate asthma from
COPD. An improvement of this magnitude typically warrants prescription of bronchodilator therapy and
suggests a spastic component to the obstructive disease.
**4. Which of the following factors is NOT a source of variability in pulmonary function test results?**
A) Age
B) Sex
C) Time of day
D) Height
Correct Answer: Time of day
Rationale: Variability in pulmonary function tests is influenced by age (lung function naturally declines
with age), sex (women typically have smaller lung volumes), height (taller individuals generally have
larger lung volumes), and weight (obesity can restrict lung expansion). Time of day is not a recognized
source of significant variability in PFT interpretation. These factors are used to calculate predicted
normal values.
**5. What is the normal range for arterial pH in an arterial blood gas analysis?**
A) 7.25 – 7.35
B) 7.35 – 7.45
C) 7.45 – 7.55
, D) 7.55 – 7.65
Correct Answer: 7.35 – 7.45
Rationale: The normal range for arterial pH is 7.35 to 7.45. Values below 7.35 indicate acidemia, while
values above 7.45 indicate alkalemia. The body maintains pH within this narrow range through
respiratory and renal compensation mechanisms. Understanding normal pH is fundamental to
interpreting arterial blood gases and identifying acid-base disorders.
**6. In arterial blood gas analysis, which component reflects the metabolic (renal) component of acid-
base homeostasis?**
A) pH
B) PCO2
C) HCO3
D) PO2
Correct Answer: HCO3
Rationale: HCO3 (bicarbonate) is indicative of the metabolic (renal) component of acid-base
homeostasis. PCO2 reflects the respiratory (ventilatory) component. pH is the overall result of both
components working together. PO2 measures the adequacy of oxygenation. The normal range for HCO3
is 22-26 mEq/L.
**7. A patient with COPD presents with confusion and lethargy. Arterial blood gas shows pH 7.30, PCO2
60 mmHg, and HCO3 28 mEq/L. Which acid-base disorder is present?**
A) Acute respiratory alkalosis with metabolic compensation
B) Acute respiratory acidosis with metabolic compensation
C) Metabolic acidosis with respiratory compensation
D) Metabolic alkalosis with respiratory compensation
Correct Answer: Acute respiratory acidosis with metabolic compensation
