Test Bank for Ruppel’s Manual of Pulmonary Function Testing
12th Edition, By Mottram
Chapter 1 - 13 Updated
,Chapter 1: Indications for Pulmonary Function Testing Test Bank
MULTIPLE CHOICE
1. Who first popularized spirometry for the evaluation of pulmonary function?
a. August and Marie Krogh
b. Alvan Barach
c. John Severinghaus
d. John Hutchinson
ANS: D
Hutchinson popularized the concept of using VC to assess lung function, and the names he
gave to several other lung compartments are still used today.
DIF: 1 REF: p. 2 OBJ: None MSC: NBRC: None
2. Which of the following are indications for performing spirometry?
1. Assess the risk of lung resection.
2. Determine the response to bronchodilator therapy.
3. Assess the severity of restrictive lung disease.
4. Quantify the extent of COPD.
a. 1 and 4
b. 2 and 3
c. 1 , 2, and 4
d. 2 , 3, and 4
ANS: C
Spirometry cannot assess severity of restriction; for that you need to measure lung volumes (
see Box 1-2, Chapter 1).
DIF: 1 REF: p. 7 OBJ: EL-2 MSC: NBRC: None
,3. The main indication for the measurement of lung volumes is to do which of the following?
a. Diagnose or assess the severity of restriction.
b. Evaluate the severity of pulmonary hypertension.
c. Determine the level of cardiopulmonary fitness.
d. Assess the risk of abdominal surgical procedures.
ANS: A
The most common reason for measuring lung volumes is to identify restrictive lung
disease. DIF: 1 REF: p. 35 OBJ: EL-2 MSC: NBRC: None
4. DLCO measurements may be indicated to evaluate pulmonary involvement in which of
the following systemic diseases?
a. Asthma
b. Sarcoidosis
c. Exertional hypoxemia
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d. Guillain-Barré syndrome
ANS: B
Sarcoidosis is the only systemic disease listed that affects gas exchange.
DIF: 1 REF: p. 9 | p. 19 | p. 21 | p. 35 OBJ: EL-2 MSC: NBRC: None
5. Blood gas analysis is used with patients with COPD to do which of the
following?
a. Monitor airway responsiveness.
b. Determine level of cardiopulmonary fitness.
c. Detect pulmonary hypertension.
d. Assess need for supplementary O2.
ANS: D
Blood gas analysis is most commonly used to determine the need for supplemental oxygen
and to manage patients who require ventilatory support.
DIF: 2 REF: p. 15 OBJ: EL-1
MSC: NBRC: CPFT 2A-2
6. Which of the following cause emphysema?
1. 1- Antitrypsin deficiency
2. Exposure to environmental pollutants
3. Radiation therapy
4. Cigarette smoking
a. 1 and 2
b. 3 and 4
c. 1 , 2, and 4
d. 2 , 3, and 4
ANS: C
Emphysema is caused primarily by cigarette smoking. Some emphysema is caused by the
absence of a protective enzyme. Chronic exposure to environmental pollutants can also
contribute to the development of emphysema.
DIF: 1 REF: p. 11 OBJ: EL-3 | AL-2 MSC: NBRC: None
7. An adult patient complains of chest tightness and cough whenever he jogs in cold
weather. These symptoms are consistent with which of the following?
a. Cystic fibrosis
b. Asthma
c. Pulmonary hypertension
d. Idiopathic pulmonary fibrosis
|
, ANS: B
Agents or events that cause an asthmatic episode are called triggers (see Box 1-7, Chapter
1). Antigens such as animal dander, pollens, and dusts are the most common triggers.
Other common triggers include exposure to air pollutants and exercise in cold or dry air.
DIF: 2 REF: p. 16 OBJ: EL-3 MSC: NBRC: None
8. Which of the following statements concerning tumors in the upper airway is true?
a. There may be variable or fixed obstruction.
b. Fixed obstruction will be present.
c. Variable obstruction will be present.
d. Small airway obstruction will result.
ANS: A
Tumors involving the upper airway may cause variable or fixed obstruction.
DIF: 2 REF: p. 19 OBJ: EL-2
MSC: NBRC: CPFT 3C-3
9. Sarcoidosis is a systemic disorder that usually causes which of the following?
a. A restrictive ventilatory defect
b. An obstructive ventilatory defect
c. Hyperreactive airways
d. Primary pulmonary hypertension
ANS: A
Restriction is often associated with the following: interstitial lung diseases, including
idiopathic fibrosis, pneumoconioses, and sarcoidosis.
DIF: 1 REF: p. 19 | p. 21 OBJ: EL-3 MSC: NBRC: None
10. For which of the following conditions might pulmonary function testing be contraindicated?
a. Vocal cord dysfunction
b. Untreated pneumothorax
c. Congestive heart failure (CHF)
d. Bronchiolitis obliterans
ANS: B
Pulmonary function tests are usually contraindicated in the presence of pneumothorax.
However, undiagnosed pneumothorax may present a risk if pulmonary function studies are
performed.
DIF: 1 REF: p. 23 OBJ: EL-4
MSC: NBRC: CPFT 2B-6
d.
,11. Which of the following correctly describe(s) appropriate physical measurements
before pulmonary function testing?
1. Actual body weight should be used to calculate predicted values.
2. Standing height should be measured when the patient is barefoot.
3. Arm span should be used instead of height for a patient with kyphosis.
4. Age should be recorded to the nearest decade (10 years ).
a. 1 only
b. 2 and 3
c. 1 , 2, and 4
d. 1 , 2, 3, and 4
ANS: B
Various physical measurements are required for estimating each patient’s expected level of
pulmonary function. Age to the nearest month, height to the nearest 0.1 cm, and weight are
usually recorded in addition to the patient’s gender. Race or ethnic origin should also be
recorded. (Although body weight is recorded, it is not used to calculate predicted values.)
DIF: 1 REF: p. 29 OBJ: None
MSC: NBRC: CPFT 3A-20
12. In addition to explaining the procedure for each pulmonary function test to the patient,
the pulmonary function technologist should do which of the following?
a. Briefly explain the physiologic basis of the test.
b. Demonstrate the correct performance of the test maneuver.
c. Limit feedback to the patient to reduce the placebo effect.
d. Explain the exact number of efforts that will be required for each test.
ANS: B
In addition to a description of the test, the maneuver should always be demonstrated.
DIF: 1 REF: p. 32 OBJ: None
MSC: NBRC: CPFT 2B-6
13. The single-breath diffusing capacity test was first described by:
a. John Severinghaus
b. August and Marie Krogh
c. Robert Hyatt
d. Leland Clark
ANS: B
The basis for the modern single-breath diffusing capacity (DLCO) test was described by
August and Marie Krogh in 1911.
DIF: 1 REF: p. 5 OBJ: None MSC: NBRC: None
|
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14. DLCO tmeasurements tmay tbe tindicated tto tevaluate tgas texchange tabnormality tin
twhich tof tthe tfollowing?
a. Ketoacidosis
b. Myasthenia tgravis
c. Interstitial tlung tdisease
d. Bronchitis
ANS: tC
The tother toptions tdo tnot taffect tthe talveolar tcapillary tmembrane
tinterface. tDIF: 1 REF: p. t9 OBJ: EL-2 MSC: tNBRC:
tNone
15. Vocal tcord tdysfunction twill ttypically taffect tthe tflow-volume tloop tin twhat tway?
a. Blunt tthe texpiratory tportion tof tthe tcurve
b. Blunt tboth tthe tinspiratory tand texpiratory tportions tof tthe tcurve
c. Blunt tthe tinspiratory tportion tof tthe tcurve
Have tno teffect ton tthe tcurve tbut tcause tinspiratory tstridor
d.
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ANS:
C
The tvocal tcords tare tnormally theld topen tor tabducted tduring tinspiration. tWhen
tdamaged, tthe tvocal tcords tmove ttoward tthe tmidline, tnarrowing tthe tairway topening.
tThis ttype tof tobstruction tlimits tflow tprimarily tduring tinspiration.
DIF: 2 REF: p. t18 OBJ: EL-4
tMSC: tNBRC: tCPFT t3C-3
16. All tof tthe tfollowing tdisease tprocesses tare tpotential tcauses tof ta trestrictive tpattern texcept:
a. Interstitial tlung tdisease t(e.g., tfibrosis, tsarcoidosis)
b. Kyphoscoliosis
c. Asthma
d. Neuromuscular tdisorders
ANS: tC
Asthma tcauses tairway tobstruction.
DIF: 1 REF: p. t21 t| tp. t22 t| tp. t23 OBJ: EL-3
tMSC: tNBRC: tNone
17. The tfollowing tdata tare tobtained tfrom ta tsubject tcomplaining tof tshortness tof tbreath:
Predicted Found % tPred
TLCpl 5.76 3.18 55
RVpl 2.38 1.18 50
FVC 3.38 2.10 62
FEV1 2.63 1.88 71
FEV1/FVC 78 89
DLCO 23.1 6.0 26
These tdata tare tmost tconsistent twith twhich tdisease tentity?
a. Pulmonary tfibrosis
d.
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b. Kyphoscoliosis
c. Obesity
d. Emphysema
ANS: tA
Excerpt tfrom tthe trestrictive tdisease tdiscussion: tThese treductions tin tVC tand tTLC toccur tas
tfibrosis tcauses tthe tlungs tto tbecome tstiff. tPulmonary tfibrosis tis tthe tonly tdisease tentity
tlisted tthat tcauses ta treduction tin tlung tvolumes tand taffects tthe talveolar tcapillary
tinterface t(e.g., treduced tDLCO).
DIF: 3 REF: p. t20 OBJ: EL-3
d.
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ANS:
MSC: tNBRC: tRPFT t3C-4b
18. Lou tGehrig, ta tfamous tNew tYork tYankee tbaseball tplayer, tis toften tassociated twith
twhich tneuromuscular tdisease?
a. Amyotrophic tlateral tsclerosis
b. Guillain-Barré tsyndrome
c. Diaphragm tparalysis
tsyndrome tMyasthenia tgravis
A
Amyotrophic tlateral tsclerosis t(ALS, tor tLou tGehrig’s tdisease) taffects tthe tanterior thorn
tcells tof tthe tspinal tcord t(motor tneurons).
DIF: 1 REF: p. t24 OBJ: EL-3 MSC: tNBRC: tNone
19. The tfollowing tdata tare tobtained tfrom ta tsubject tcomplaining tof tshortness tof tbreath:
Predicted Found % tPred
TLCpl 6.59 4.12 63
RVpl 2.43 3.01 124
FVC 4.16 1.14 28
FEV1 3.16 1.16 37
FEV1/FVC 76 99
MEP +190 63 33
MIP -101 -56 55
These tdata tare tmost tconsistent twith twhich tdisease tentity?
a. Obesity
b. Pectus texcavatum
c. Pulmonary tfibrosis
d. Myasthenia tgravis
ANS: tD
Progression tof ta tmyasthenic tcrisis tcan tbe tassessed tusing tVC tand trespiratory
tpressures. tResults twould tyield ta treduction tin tlung tvolumes tand trespiratory tmuscle
tpressures, tas tseen tin tthis tcase.
DIF: 3 REF: p. t24 OBJ: EL-3
tMSC: tNBRC: tRPFT t3C-4b
20. All tof tthe tfollowing tpulmonary tfunction ttests tmay tbe tused tto tfollow tthe teffect tof
d.
12th Edition, By Mottram
Chapter 1 - 13 Updated
,Chapter 1: Indications for Pulmonary Function Testing Test Bank
MULTIPLE CHOICE
1. Who first popularized spirometry for the evaluation of pulmonary function?
a. August and Marie Krogh
b. Alvan Barach
c. John Severinghaus
d. John Hutchinson
ANS: D
Hutchinson popularized the concept of using VC to assess lung function, and the names he
gave to several other lung compartments are still used today.
DIF: 1 REF: p. 2 OBJ: None MSC: NBRC: None
2. Which of the following are indications for performing spirometry?
1. Assess the risk of lung resection.
2. Determine the response to bronchodilator therapy.
3. Assess the severity of restrictive lung disease.
4. Quantify the extent of COPD.
a. 1 and 4
b. 2 and 3
c. 1 , 2, and 4
d. 2 , 3, and 4
ANS: C
Spirometry cannot assess severity of restriction; for that you need to measure lung volumes (
see Box 1-2, Chapter 1).
DIF: 1 REF: p. 7 OBJ: EL-2 MSC: NBRC: None
,3. The main indication for the measurement of lung volumes is to do which of the following?
a. Diagnose or assess the severity of restriction.
b. Evaluate the severity of pulmonary hypertension.
c. Determine the level of cardiopulmonary fitness.
d. Assess the risk of abdominal surgical procedures.
ANS: A
The most common reason for measuring lung volumes is to identify restrictive lung
disease. DIF: 1 REF: p. 35 OBJ: EL-2 MSC: NBRC: None
4. DLCO measurements may be indicated to evaluate pulmonary involvement in which of
the following systemic diseases?
a. Asthma
b. Sarcoidosis
c. Exertional hypoxemia
,Stuvia.com - The Marketplace to Buy and Sell your Study Material
d. Guillain-Barré syndrome
ANS: B
Sarcoidosis is the only systemic disease listed that affects gas exchange.
DIF: 1 REF: p. 9 | p. 19 | p. 21 | p. 35 OBJ: EL-2 MSC: NBRC: None
5. Blood gas analysis is used with patients with COPD to do which of the
following?
a. Monitor airway responsiveness.
b. Determine level of cardiopulmonary fitness.
c. Detect pulmonary hypertension.
d. Assess need for supplementary O2.
ANS: D
Blood gas analysis is most commonly used to determine the need for supplemental oxygen
and to manage patients who require ventilatory support.
DIF: 2 REF: p. 15 OBJ: EL-1
MSC: NBRC: CPFT 2A-2
6. Which of the following cause emphysema?
1. 1- Antitrypsin deficiency
2. Exposure to environmental pollutants
3. Radiation therapy
4. Cigarette smoking
a. 1 and 2
b. 3 and 4
c. 1 , 2, and 4
d. 2 , 3, and 4
ANS: C
Emphysema is caused primarily by cigarette smoking. Some emphysema is caused by the
absence of a protective enzyme. Chronic exposure to environmental pollutants can also
contribute to the development of emphysema.
DIF: 1 REF: p. 11 OBJ: EL-3 | AL-2 MSC: NBRC: None
7. An adult patient complains of chest tightness and cough whenever he jogs in cold
weather. These symptoms are consistent with which of the following?
a. Cystic fibrosis
b. Asthma
c. Pulmonary hypertension
d. Idiopathic pulmonary fibrosis
|
, ANS: B
Agents or events that cause an asthmatic episode are called triggers (see Box 1-7, Chapter
1). Antigens such as animal dander, pollens, and dusts are the most common triggers.
Other common triggers include exposure to air pollutants and exercise in cold or dry air.
DIF: 2 REF: p. 16 OBJ: EL-3 MSC: NBRC: None
8. Which of the following statements concerning tumors in the upper airway is true?
a. There may be variable or fixed obstruction.
b. Fixed obstruction will be present.
c. Variable obstruction will be present.
d. Small airway obstruction will result.
ANS: A
Tumors involving the upper airway may cause variable or fixed obstruction.
DIF: 2 REF: p. 19 OBJ: EL-2
MSC: NBRC: CPFT 3C-3
9. Sarcoidosis is a systemic disorder that usually causes which of the following?
a. A restrictive ventilatory defect
b. An obstructive ventilatory defect
c. Hyperreactive airways
d. Primary pulmonary hypertension
ANS: A
Restriction is often associated with the following: interstitial lung diseases, including
idiopathic fibrosis, pneumoconioses, and sarcoidosis.
DIF: 1 REF: p. 19 | p. 21 OBJ: EL-3 MSC: NBRC: None
10. For which of the following conditions might pulmonary function testing be contraindicated?
a. Vocal cord dysfunction
b. Untreated pneumothorax
c. Congestive heart failure (CHF)
d. Bronchiolitis obliterans
ANS: B
Pulmonary function tests are usually contraindicated in the presence of pneumothorax.
However, undiagnosed pneumothorax may present a risk if pulmonary function studies are
performed.
DIF: 1 REF: p. 23 OBJ: EL-4
MSC: NBRC: CPFT 2B-6
d.
,11. Which of the following correctly describe(s) appropriate physical measurements
before pulmonary function testing?
1. Actual body weight should be used to calculate predicted values.
2. Standing height should be measured when the patient is barefoot.
3. Arm span should be used instead of height for a patient with kyphosis.
4. Age should be recorded to the nearest decade (10 years ).
a. 1 only
b. 2 and 3
c. 1 , 2, and 4
d. 1 , 2, 3, and 4
ANS: B
Various physical measurements are required for estimating each patient’s expected level of
pulmonary function. Age to the nearest month, height to the nearest 0.1 cm, and weight are
usually recorded in addition to the patient’s gender. Race or ethnic origin should also be
recorded. (Although body weight is recorded, it is not used to calculate predicted values.)
DIF: 1 REF: p. 29 OBJ: None
MSC: NBRC: CPFT 3A-20
12. In addition to explaining the procedure for each pulmonary function test to the patient,
the pulmonary function technologist should do which of the following?
a. Briefly explain the physiologic basis of the test.
b. Demonstrate the correct performance of the test maneuver.
c. Limit feedback to the patient to reduce the placebo effect.
d. Explain the exact number of efforts that will be required for each test.
ANS: B
In addition to a description of the test, the maneuver should always be demonstrated.
DIF: 1 REF: p. 32 OBJ: None
MSC: NBRC: CPFT 2B-6
13. The single-breath diffusing capacity test was first described by:
a. John Severinghaus
b. August and Marie Krogh
c. Robert Hyatt
d. Leland Clark
ANS: B
The basis for the modern single-breath diffusing capacity (DLCO) test was described by
August and Marie Krogh in 1911.
DIF: 1 REF: p. 5 OBJ: None MSC: NBRC: None
|
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
14. DLCO tmeasurements tmay tbe tindicated tto tevaluate tgas texchange tabnormality tin
twhich tof tthe tfollowing?
a. Ketoacidosis
b. Myasthenia tgravis
c. Interstitial tlung tdisease
d. Bronchitis
ANS: tC
The tother toptions tdo tnot taffect tthe talveolar tcapillary tmembrane
tinterface. tDIF: 1 REF: p. t9 OBJ: EL-2 MSC: tNBRC:
tNone
15. Vocal tcord tdysfunction twill ttypically taffect tthe tflow-volume tloop tin twhat tway?
a. Blunt tthe texpiratory tportion tof tthe tcurve
b. Blunt tboth tthe tinspiratory tand texpiratory tportions tof tthe tcurve
c. Blunt tthe tinspiratory tportion tof tthe tcurve
Have tno teffect ton tthe tcurve tbut tcause tinspiratory tstridor
d.
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
ANS:
C
The tvocal tcords tare tnormally theld topen tor tabducted tduring tinspiration. tWhen
tdamaged, tthe tvocal tcords tmove ttoward tthe tmidline, tnarrowing tthe tairway topening.
tThis ttype tof tobstruction tlimits tflow tprimarily tduring tinspiration.
DIF: 2 REF: p. t18 OBJ: EL-4
tMSC: tNBRC: tCPFT t3C-3
16. All tof tthe tfollowing tdisease tprocesses tare tpotential tcauses tof ta trestrictive tpattern texcept:
a. Interstitial tlung tdisease t(e.g., tfibrosis, tsarcoidosis)
b. Kyphoscoliosis
c. Asthma
d. Neuromuscular tdisorders
ANS: tC
Asthma tcauses tairway tobstruction.
DIF: 1 REF: p. t21 t| tp. t22 t| tp. t23 OBJ: EL-3
tMSC: tNBRC: tNone
17. The tfollowing tdata tare tobtained tfrom ta tsubject tcomplaining tof tshortness tof tbreath:
Predicted Found % tPred
TLCpl 5.76 3.18 55
RVpl 2.38 1.18 50
FVC 3.38 2.10 62
FEV1 2.63 1.88 71
FEV1/FVC 78 89
DLCO 23.1 6.0 26
These tdata tare tmost tconsistent twith twhich tdisease tentity?
a. Pulmonary tfibrosis
d.
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
b. Kyphoscoliosis
c. Obesity
d. Emphysema
ANS: tA
Excerpt tfrom tthe trestrictive tdisease tdiscussion: tThese treductions tin tVC tand tTLC toccur tas
tfibrosis tcauses tthe tlungs tto tbecome tstiff. tPulmonary tfibrosis tis tthe tonly tdisease tentity
tlisted tthat tcauses ta treduction tin tlung tvolumes tand taffects tthe talveolar tcapillary
tinterface t(e.g., treduced tDLCO).
DIF: 3 REF: p. t20 OBJ: EL-3
d.
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
ANS:
MSC: tNBRC: tRPFT t3C-4b
18. Lou tGehrig, ta tfamous tNew tYork tYankee tbaseball tplayer, tis toften tassociated twith
twhich tneuromuscular tdisease?
a. Amyotrophic tlateral tsclerosis
b. Guillain-Barré tsyndrome
c. Diaphragm tparalysis
tsyndrome tMyasthenia tgravis
A
Amyotrophic tlateral tsclerosis t(ALS, tor tLou tGehrig’s tdisease) taffects tthe tanterior thorn
tcells tof tthe tspinal tcord t(motor tneurons).
DIF: 1 REF: p. t24 OBJ: EL-3 MSC: tNBRC: tNone
19. The tfollowing tdata tare tobtained tfrom ta tsubject tcomplaining tof tshortness tof tbreath:
Predicted Found % tPred
TLCpl 6.59 4.12 63
RVpl 2.43 3.01 124
FVC 4.16 1.14 28
FEV1 3.16 1.16 37
FEV1/FVC 76 99
MEP +190 63 33
MIP -101 -56 55
These tdata tare tmost tconsistent twith twhich tdisease tentity?
a. Obesity
b. Pectus texcavatum
c. Pulmonary tfibrosis
d. Myasthenia tgravis
ANS: tD
Progression tof ta tmyasthenic tcrisis tcan tbe tassessed tusing tVC tand trespiratory
tpressures. tResults twould tyield ta treduction tin tlung tvolumes tand trespiratory tmuscle
tpressures, tas tseen tin tthis tcase.
DIF: 3 REF: p. t24 OBJ: EL-3
tMSC: tNBRC: tRPFT t3C-4b
20. All tof tthe tfollowing tpulmonary tfunction ttests tmay tbe tused tto tfollow tthe teffect tof
d.
