TEST BANK FOR RUPPEL’S MANUAL OF PULMONARY FUNCTION TESTING

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Chapter 1: Indications for Pulmonary Function Testing
r r r r r r r

Test Bank
r




MULTIPLErCHOICE

1. Whorfirstrpopularizedrspirometryrforrtherevaluationrofrpulmonaryrfunction?
a. AugustrandrMarierKrogh
b. AlvanrBarach
c. JohnrSeveringhaus
d. JohnrHutchinson
ANS:r D
HutchinsonrpopularizedrtherconceptrofrusingrVCrtorassessrlungrfunction,randrthernamesrhergav
ertorseveralrotherrlungrcompartmentsrarerstillrusedrtoday.

DIF: 1 REF: p.r2 OBJ: None MSC:r NBRC:rNone

2. Whichrofrtherfollowingrarerindicationsrforrperformingrspirometry?
1. Assessrtherriskrofrlungrresection.
2. Determinertherresponsertorbronchodilatorrtherapy.
3. Assessrtherseverityrofrrestrictiverlungrdisease.
4. QuantifyrtherextentrofrCOPD.
a. 1randr4
b. 2randr3
c. 1,r2,randr4
d. 2,r3,randr4
ANS:r C
Spirometryrcannotrassessrseverityrofrrestriction;rforrthatryourneedrtormeasurerlungrvolumesr(se
erBoxr1-2,rChapterr1).

DIF: 1 REF: p.r7 OBJ: EL-2 MSC:r NBRC:rNone

3. Thermainrindicationrforrthermeasurementrofrlungrvolumesrisrtordorwhichrofrtherfollowing?
a. Diagnoserorrassessrtherseverityrofrrestriction.
b. Evaluatertherseverityrofrpulmonaryrhypertension.
c. Determinertherlevelrofrcardiopulmonaryrfitness.
d. Assessrtherriskrofrabdominalrsurgicalrprocedures.
ANS:r A
Thermostrcommonrreasonrforrmeasuringrlungrvolumesrisrtoridentifyrrestrictiverlungrdisease.rDI

F: 1 REF: p.r35 OBJ: EL-2 MSC:r NBRC:rNone

4. DLCOrmeasurementsrmayrberindicatedrtorevaluaterpulmonaryrinvolvementrinrwhichrofrtherfol
lowingrsystemicrdiseases?
a. Asthma
b. Sarcoidosis
c. Exertionalrhypoxemia




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d. Guillain-Barrérsyndrome
ANS:r B
Sarcoidosisrisrtheronlyrsystemicrdiseaserlistedrthatraffectsrgasrexchange.

DIF: 1 REF: p.r9r|rp.r19r|rp.r21r|rp.r35 OBJ: EL-
2rMSC:r NBRC:rNone

5. BloodrgasranalysisrisrusedrwithrpatientsrwithrCOPDrtordorwhichrofrtherfollowing?
a. Monitorrairwayrresponsiveness.
b. Determinerlevelrofrcardiopulmonaryrfitness.
c. Detectrpulmonaryrhypertension.
d. AssessrneedrforrsupplementaryrO2.
ANS:r D
Bloodrgasranalysisrisrmostrcommonlyrusedrtordeterminertherneedrforrsupplementalroxygenrand
rtormanagerpatientsrwhorrequirerventilatoryrsupport.




DIF: 2 REF: p.r15 OBJ: EL-
1rMSC:r NBRC:rCPFTr2A-2

6. Whichrofrtherfollowingrcauseremphysema?
1. 1-Antitrypsinrdeficiency
2. Exposurertorenvironmentalrpollutants
3. Radiationrtherapy
4. Cigarettersmoking
a. 1randr2
b. 3randr4
c. 1,r2,randr4
d. 2,r3,randr4
ANS:r C
Emphysemarisrcausedrprimarilyrbyrcigarettersmoking.rSomeremphysemarisrcausedrbyrtherabs
encerofrarprotectiverenzyme.rChronicrexposurertorenvironmentalrpollutantsrcanralsorcontribu
tertortherdevelopmentrofremphysema.

DIF: 1 REF: p.r11 OBJ: EL-3r|rAL-2 MSC:r NBRC:rNone

7. Anradultrpatientrcomplainsrofrchestrtightnessrandrcoughrwheneverrherjogsrinrcoldrweather.rThe
sersymptomsrarerconsistentrwithrwhichrofrtherfollowing?
a. Cysticrfibrosis
b. Asthma
c. Pulmonaryrhypertension
d. Idiopathicrpulmonaryrfibrosis
ANS:r B
Agentsrorreventsrthatrcauseranrasthmaticrepisoderarercalledrtriggersr(seerBoxr1-
7,rChapterr1).rAntigensrsuchrasranimalrdander,rpollens,randrdustsrarerthermostrcommonrtriggers
.rOtherrcommonrtriggersrincluderexposurertorairrpollutantsrandrexerciserinrcoldrorrdryrair.

DIF: 2 REF: p.r16 OBJ: EL-3 MSC:r NBRC:rNone




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8. Whichrofrtherfollowingrstatementsrconcerningrtumorsrinrtherupperrairwayrisrtrue?
a. Therermayrbervariablerorrfixedrobstruction.
b. Fixedrobstructionrwillrberpresent.
c. Variablerobstructionrwillrberpresent.
d. Smallrairwayrobstructionrwillrresult.
ANS:r A
Tumorsrinvolvingrtherupperrairwayrmayrcauservariablerorrfixedrobstruction.

DIF: 2 REF: p.r19 OBJ: EL-
2rMSC:r NBRC:rCPFTr3C-3

9. Sarcoidosisrisrarsystemicrdisorderrthatrusuallyrcausesrwhichrofrtherfollowing?
a. Arrestrictiverventilatoryrdefect
b. Anrobstructiverventilatoryrdefect
c. Hyperreactiverairways
d. Primaryrpulmonaryrhypertension
ANS:r A
Restrictionrisroftenrassociatedrwithrtherfollowing:rinterstitialrlungrdiseases,rincludingridi
opathicrfibrosis,rpneumoconioses,randrsarcoidosis.

DIF: 1 REF: p.r19r|rp.r21 OBJ: EL-3 MSC:r NBRC:rNone

10. Forrwhichrofrtherfollowingrconditionsrmightrpulmonaryrfunctionrtestingrbercontraindicated?
a. Vocalrcordrdysfunction
b. Untreatedrpneumothorax
c. Congestiverheartrfailurer(CHF)
d. Bronchiolitisrobliterans
ANS:r B
Pulmonaryrfunctionrtestsrarerusuallyrcontraindicatedrinrtherpresencerofrpneumothorax.rHowe
ver,rundiagnosedrpneumothoraxrmayrpresentrarriskrifrpulmonaryrfunctionrstudiesrarerperforme
d.

DIF: 1 REF: p.r23 OBJ: EL-
4rMSC:r NBRC:rCPFTr2B-6

11. Whichrofrtherfollowingrcorrectlyrdescribe(s)rappropriaterphysicalrmeasurementsrbeforerpu
lmonaryrfunctionrtesting?
1. Actualrbodyrweightrshouldrberusedrtorcalculaterpredictedrvalues.
2. Standingrheightrshouldrbermeasuredrwhenrtherpatientrisrbarefoot.
3. Armrspanrshouldrberusedrinsteadrofrheightrforrarpatientrwithrkyphosis.
4. Agershouldrberrecordedrtorthernearestrdecader(10ryears).
a. 1ronly
b. 2randr3
c. 1,r2,randr4
d.r1,r2,r3,randr4rA
NS:r B




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Variousrphysicalrmeasurementsrarerrequiredrforrestimatingreachrpatient’srexpectedrlevelrofrpul
monaryrfunction.rAgertorthernearestrmonth,rheightrtorthernearestr0.1rcm,randrweightrarerusuallyr
recordedrinradditionrtortherpatient’srgender.rRacerorrethnicroriginrshouldralsorberrecorded.r(Alt
houghrbodyrweightrisrrecorded,ritrisrnotrusedrtorcalculaterpredictedrvalues.)

DIF: 1 REF: p.r29 OBJ:
NoneM
r SC:r NBRC:rCPFTr3A-20

12. Inradditionrtorexplainingrtherprocedurerforreachrpulmonaryrfunctionrtestrtortherpatient,rtherpul
monaryrfunctionrtechnologistrshouldrdorwhichrofrtherfollowing?
a. Brieflyrexplainrtherphysiologicrbasisrofrthertest.
b. Demonstraterthercorrectrperformancerofrthertestrmaneuver.
c. Limitrfeedbackrtortherpatientrtorreducertherplaceboreffect.
d. Explainrtherexactrnumberrofreffortsrthatrwillrberrequiredrforreachrtest.
ANS:r B
Inradditionrtorardescriptionrofrthertest,rthermaneuverrshouldralwaysrberdemonstrated.

DIF: 1 REF: p.r32 OBJ:
NoneM
r SC:r NBRC:rCPFTr2B-6

13. Thersingle-breathrdiffusingrcapacityrtestrwasrfirstrdescribedrby:
a. JohnrSeveringhaus
b. AugustrandrMarierKrogh
c. RobertrHyatt
d. LelandrClark
ANS:r B
Therbasisrforrthermodernrsingle-
breathrdiffusingrcapacityr(DLCO)rtestrwasrdescribedrbyrAugustrandrMarierKroghrinr1911.

DIF: 1 REF: p.r5 OBJ: None MSC:r NBRC:rNone

14. DLCOrmeasurementsrmayrberindicatedrtorevaluatergasrexchangerabnormalityrinrwhichrofrtherfoll
owing?
a. Ketoacidosis
b. Myastheniargravis
c. Interstitialrlungrdisease
d. Bronchitis
ANS:r C
Therotherroptionsrdornotraffectrtheralveolarrcapillaryrmembranerinterface.

DIF: 1 REF: p.r9 OBJ: EL-2 MSC:r NBRC:rNone

15. Vocalrcordrdysfunctionrwillrtypicallyraffectrtherflow-volumerlooprinrwhatrway?
a. Bluntrtherexpiratoryrportionrofrthercurve
b. Bluntrbothrtherinspiratoryrandrexpiratoryrportionsrofrthercurve
c. Bluntrtherinspiratoryrportionrofrthercurve
d. Havernoreffectronrthercurverbutrcauserinspiratoryrstridor




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