Chapter 20 - Pulmonary Function Testing
Kacmarek et al.: Egan’s Fundamentals of Respiratory Care, 11th Edition
MULTIPLE CHOICE
1. Which of the following are indications for assessing pulmonary function?
1. Screen for pulmonary disease.
2. Evaluate patients for surgical risk.
3. Assess the progression of disease.
4. Assist in diagnosing cardiac disability.
a. 1, 2, and 3 only
b. 2 and 4 only
c. 1 and 3 only
d. 2, 3, and 4 only
ANS: A
The indications for pulmonary function testing are:
To identify and quantify changes in pulmonary function. The most common purposes of
pulmonary function testing are to detect the presence or absence of pulmonary disease, to
classify the type of disease as either obstructive or restrictive, and to quantify the severity of
pulmonary impairment as mild, moderate, severe, or very severe. Over time pulmonary
function tests help quantify the progress or the reversibility of the disease.
To evaluate need and quantify therapeutic effectiveness. Pulmonary function tests may aid
clinicians in selecting or modifying a specific therapeutic regimen or technique (e.g.,
bronchodilator medication, airway clearance therapy, rehabilitation exercise protocol).
Clinicians and researchers use pulmonary function tests to objectively measure changes in
lung function before and after treatments.
To perform epidemiologic surveillance for pulmonary disease. Screening programs may
detect pulmonary abnormalities caused by disease or environmental factors in general
populations, occupational settings, smokers, or other high-risk groups. In addition, researchers
have determined what normal pulmonary function is by measuring the pulmonary function of
the healthy population.
To assess patients for risk of postoperative pulmonary complications. Preoperative testing
can identify those patients who may have an increased risk of pulmonary complications after
surgery. Sometimes the risk of complications can be reduced by preoperative respiratory care,
and sometimes the risk may be so significant to rule out surgery.
To determine pulmonary disability. Pulmonary function tests can also determine the degree
of disability caused by lung diseases, including occupational diseases such as pneumoconiosis
of coal workers. Some federal entitlement programs and insurance policies rely on pulmonary
function tests to confirm claims for financial compensation.
DIF: Recall REF: p. 401 OBJ: 2
2. What do relative contraindications for lung volume determinations include?
1. Recent cataract removal surgery
, 2. Unstable cardiovascular status
3. Treated pneumothorax
4. Hemoptysis of unknown origin
a. 1, 2, and 3 only
b. 2 and 4 only
c. 3 and 4 only
d. 1, 2, and 4 only
ANS: D
Patients with acute, unstable cardiopulmonary problems such as hemoptysis, pneumothorax,
myocardial infarction, and pulmonary embolism and patients with acute chest or abdominal
pain should not be tested. Testing could be harmful, if needed treatment would be delayed.
Patients who have nausea and who are vomiting should not be tested; there is a risk of
aspiration. Testing for patients who have had recent cataract removal surgery should be
delayed; changes in ocular pressure may be harmful to the eye.
DIF: Recall REF: p. 402 OBJ: 2
3. What is the primary problem in obstructive lung disease?
a. Increased airway resistance
b. Low lung volumes
c. Increased pulmonary capillary pressure
d. Reduced lung diffusion
ANS: A
The primary problem in obstructive pulmonary disease is an increased airway resistance.
DIF: Recall REF: p. 402 OBJ: 3
4. Which of the following measure is typically increased in patients with restrictive lung
disease?
a. Lung compliance
b. Lung volumes
c. Pressure needed to expand the lung
d. Airway resistance
ANS: C
The primary problem in restrictive lung disease is reduced lung compliance, thoracic
compliance, or both lung and thoracic compliances. Compliance is the volume of gas inspired
per the amount of inspiratory effort; effort is measured as the amount of pressure created in
the lung or in the pleural space when the inspiratory muscles contract. Compliance is
calculated according to the following formula: C = V/P.
DIF: Recall REF: p. 402 OBJ: 3
5. You perform a series of pulmonary function tests on a patient with a potentially infectious
disease carried via the airborne route. Which of the following infection-control procedures
should you implement?
1. Wear a respirator or close-fitting surgical mask.
, 2. Dispose of, sterilize, or disinfect the tubing circuit after testing.
3. Clean the interior surface of the spirometer before the next test.
a. 1 only
b. 1 and 2 only
c. 2 and 3 only
d. 1, 2, and 3
ANS: B
When performing procedures on patients with potentially infectious airborne diseases,
practitioners should wear a personal respirator or a close-fitting surgical mask, especially if
the testing induces coughing. Practitioners should always wash their hands between testing
patients and after contact with testing equipment. Although it is unnecessary to routinely clean
the interior surfaces of the testing instruments between patients, the mouthpiece, nose clips,
tubing, and any parts of the instrument that come into direct contact with a patient should be
disposed, sterilized, or disinfected between patients.
DIF: Application REF: p. 403 OBJ: 3
6. Which of the following pulmonary function devices directly collect and measure gas
volumes?
1. Water-sealed spirometer
2. Dry rolling-seal spirometer
3. Bellows spirometer
4. Pneumotachometer
a. 3 and 4 only
b. 1 and 2 only
c. 1, 2, and 3 only
d. 2, 3, and 4 only
ANS: C
Flow measuring devices are commonly called pneumotachometers.
DIF: Recall REF: p. 403 OBJ: 4
7. To what does the range or limit of a device’s measuring ability refer?
a. Capacity
b. Accuracy
c. Error
d. Precision
ANS: A
The capacity of an instrument refers to the range or limits of how much it can measure.
DIF: Recall REF: p. 404 OBJ: 4
8. How closely a device measures a certain reference value refers to what quality?
a. Capacity
b. Accuracy
c. Linearity
Kacmarek et al.: Egan’s Fundamentals of Respiratory Care, 11th Edition
MULTIPLE CHOICE
1. Which of the following are indications for assessing pulmonary function?
1. Screen for pulmonary disease.
2. Evaluate patients for surgical risk.
3. Assess the progression of disease.
4. Assist in diagnosing cardiac disability.
a. 1, 2, and 3 only
b. 2 and 4 only
c. 1 and 3 only
d. 2, 3, and 4 only
ANS: A
The indications for pulmonary function testing are:
To identify and quantify changes in pulmonary function. The most common purposes of
pulmonary function testing are to detect the presence or absence of pulmonary disease, to
classify the type of disease as either obstructive or restrictive, and to quantify the severity of
pulmonary impairment as mild, moderate, severe, or very severe. Over time pulmonary
function tests help quantify the progress or the reversibility of the disease.
To evaluate need and quantify therapeutic effectiveness. Pulmonary function tests may aid
clinicians in selecting or modifying a specific therapeutic regimen or technique (e.g.,
bronchodilator medication, airway clearance therapy, rehabilitation exercise protocol).
Clinicians and researchers use pulmonary function tests to objectively measure changes in
lung function before and after treatments.
To perform epidemiologic surveillance for pulmonary disease. Screening programs may
detect pulmonary abnormalities caused by disease or environmental factors in general
populations, occupational settings, smokers, or other high-risk groups. In addition, researchers
have determined what normal pulmonary function is by measuring the pulmonary function of
the healthy population.
To assess patients for risk of postoperative pulmonary complications. Preoperative testing
can identify those patients who may have an increased risk of pulmonary complications after
surgery. Sometimes the risk of complications can be reduced by preoperative respiratory care,
and sometimes the risk may be so significant to rule out surgery.
To determine pulmonary disability. Pulmonary function tests can also determine the degree
of disability caused by lung diseases, including occupational diseases such as pneumoconiosis
of coal workers. Some federal entitlement programs and insurance policies rely on pulmonary
function tests to confirm claims for financial compensation.
DIF: Recall REF: p. 401 OBJ: 2
2. What do relative contraindications for lung volume determinations include?
1. Recent cataract removal surgery
, 2. Unstable cardiovascular status
3. Treated pneumothorax
4. Hemoptysis of unknown origin
a. 1, 2, and 3 only
b. 2 and 4 only
c. 3 and 4 only
d. 1, 2, and 4 only
ANS: D
Patients with acute, unstable cardiopulmonary problems such as hemoptysis, pneumothorax,
myocardial infarction, and pulmonary embolism and patients with acute chest or abdominal
pain should not be tested. Testing could be harmful, if needed treatment would be delayed.
Patients who have nausea and who are vomiting should not be tested; there is a risk of
aspiration. Testing for patients who have had recent cataract removal surgery should be
delayed; changes in ocular pressure may be harmful to the eye.
DIF: Recall REF: p. 402 OBJ: 2
3. What is the primary problem in obstructive lung disease?
a. Increased airway resistance
b. Low lung volumes
c. Increased pulmonary capillary pressure
d. Reduced lung diffusion
ANS: A
The primary problem in obstructive pulmonary disease is an increased airway resistance.
DIF: Recall REF: p. 402 OBJ: 3
4. Which of the following measure is typically increased in patients with restrictive lung
disease?
a. Lung compliance
b. Lung volumes
c. Pressure needed to expand the lung
d. Airway resistance
ANS: C
The primary problem in restrictive lung disease is reduced lung compliance, thoracic
compliance, or both lung and thoracic compliances. Compliance is the volume of gas inspired
per the amount of inspiratory effort; effort is measured as the amount of pressure created in
the lung or in the pleural space when the inspiratory muscles contract. Compliance is
calculated according to the following formula: C = V/P.
DIF: Recall REF: p. 402 OBJ: 3
5. You perform a series of pulmonary function tests on a patient with a potentially infectious
disease carried via the airborne route. Which of the following infection-control procedures
should you implement?
1. Wear a respirator or close-fitting surgical mask.
, 2. Dispose of, sterilize, or disinfect the tubing circuit after testing.
3. Clean the interior surface of the spirometer before the next test.
a. 1 only
b. 1 and 2 only
c. 2 and 3 only
d. 1, 2, and 3
ANS: B
When performing procedures on patients with potentially infectious airborne diseases,
practitioners should wear a personal respirator or a close-fitting surgical mask, especially if
the testing induces coughing. Practitioners should always wash their hands between testing
patients and after contact with testing equipment. Although it is unnecessary to routinely clean
the interior surfaces of the testing instruments between patients, the mouthpiece, nose clips,
tubing, and any parts of the instrument that come into direct contact with a patient should be
disposed, sterilized, or disinfected between patients.
DIF: Application REF: p. 403 OBJ: 3
6. Which of the following pulmonary function devices directly collect and measure gas
volumes?
1. Water-sealed spirometer
2. Dry rolling-seal spirometer
3. Bellows spirometer
4. Pneumotachometer
a. 3 and 4 only
b. 1 and 2 only
c. 1, 2, and 3 only
d. 2, 3, and 4 only
ANS: C
Flow measuring devices are commonly called pneumotachometers.
DIF: Recall REF: p. 403 OBJ: 4
7. To what does the range or limit of a device’s measuring ability refer?
a. Capacity
b. Accuracy
c. Error
d. Precision
ANS: A
The capacity of an instrument refers to the range or limits of how much it can measure.
DIF: Recall REF: p. 404 OBJ: 4
8. How closely a device measures a certain reference value refers to what quality?
a. Capacity
b. Accuracy
c. Linearity
