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Pulmonary Edapt Questions and Answers
The NP reviews the results of a patient’s pulmonary function tests and notes that the FEV1, FVC, and total lung
capacity (TLC) are reduced. The FEV1/FVC ratio is normal. Based on interpretation, this reflects:
Obstructive lung disease.
Restrictive lung disease.
Combined obstructive-restrictive lung disease.
The test is invalid.
Simple spirometry can be used to measure any of the following EXCEPT:
Residual volume.
Vital capacity.
Inspiratory reserve volume.
Tidal volume.
The NP notes that a patient’s FEV1/FVC ratio is severely reduced. Which of the following conditions is most likely the
patient’s pulmonary issue?
Chronic asthma.
Pulmonary hypertension.
Pneumonia.
Morbid obesity.
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The NP is seeing a patient with chronic bronchitis that needs spirometry on today’s visit. What pulmonary function
test (PFT) findings are anticipated based on the diagnosis of chronic bronchitis?
Decreased total lung capacity (TLC).
Increased lung compliance.
Decreased forced expiratory flow (FEV1).
Decreased diffusing capacity.
A patient with normal lungs should be able to exhale 80% of the forced vital capacity within the first second.
Chronic bronchitis will decrease which of the following parameters?
Decreased total lung capacity.
Increased lung compliance.
Decreased diffusing capacity.
Decreased forced expiratory flow (FEV1).
Simple spirometry includes a measure of residual capacity.
True
False
Which of the following spirometry results indicate restrictive lung disease?
FEV1, FEV, and total lung capacity normal: FEV1/FVC ratio normal.
FEV1 reduced, FVC normal, total lung capacity reduced; FEV1/FVC ratio normal.
FEV1, FVC, and total lung capacity reduced; FEV1/FVC ratio normal.
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FEV1, FEV, and total lung capacity reduced; FEV1/FVC ratio reduced.
In order to classify the respiratory issue as either obstructive, restrictive or normal., the NP starts by
looking at the FEV1/FVC ratio.
Obstructive pattern: If the FEV1/FVC ratio is less than 70% or less than the lower limit of normal for the
patient. FEV1 also falls to a greater degree than the FVC.
Restrictive pattern: If the FEV1/FVC ratio is greater than 70% or greater than the lower limit of normal,
then the spirometry test is either normal, or a restrictive respiratory abnormality is present. To make
this distinction, the NP must look at the TLC. In restrictive disorders, the percent predicted of TLC is
<80%, where 80-120% represents a normal range.
The following table compares PFT values in terms of obstructive and restrictive:
Measurement Obstructive Restrictive
Forced vital capacity (FVC) Decreased or normal Decreased
Forced expiratory volume in 1 second (FEV1): Normal is > 80% Decreased Decreased
FEV1/FVC ratio: Normal is 70% or less than the lower limit of normal Less than 70% Normal or >
for the patient 70%
Total lung capacity (TLC): Normal range is 80-120% of predicted >120% (represents <80%
hyperinflation)
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Obstructive Disorders
Obstructive disorders are characterized by obstruction to airflow during expiration. This can be related to conditions
that increase mucus production leading to mucus plugs as in the case of chronic bronchitis or the loss of surface
area of the lung that decreases areas of gas exchange as a result in inflammatory processes that destroys the lung’s
elastic resulting in decreased recoil. Regardless of the cause of the obstruction, there is an increased work of
breathing (WOB), which requires more energy and effort to create airflow. This eventually results in a ventilation-
mismatch where not enough CO2 is being expelled and not enough oxygen being brought in for gas exchange. In
using emphysema as an example, the defect is destruction of the lung’s elastic tissue caused by inflammation after
the person has been exposed to smoking and other irritants over a long period of time. The lung is infiltrated with
inflammatory cells that release cytokines that contribute to airway damage and mucus production. When elastin is
destroyed, the lung loses its recoil ability that is necessary to expel air out. This leads to air trapping and enlarged
alveoli that results in increased lung compliance and decreased elasticity. Ultimately, the lungs become
overstretched without the ability to recoil. Individuals with an obstructive disorder will have less than 70% on their
PFT. Both the FEV1 and FVC will be decreased.
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Pulmonary Edapt Questions and Answers
The NP reviews the results of a patient’s pulmonary function tests and notes that the FEV1, FVC, and total lung
capacity (TLC) are reduced. The FEV1/FVC ratio is normal. Based on interpretation, this reflects:
Obstructive lung disease.
Restrictive lung disease.
Combined obstructive-restrictive lung disease.
The test is invalid.
Simple spirometry can be used to measure any of the following EXCEPT:
Residual volume.
Vital capacity.
Inspiratory reserve volume.
Tidal volume.
The NP notes that a patient’s FEV1/FVC ratio is severely reduced. Which of the following conditions is most likely the
patient’s pulmonary issue?
Chronic asthma.
Pulmonary hypertension.
Pneumonia.
Morbid obesity.
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The NP is seeing a patient with chronic bronchitis that needs spirometry on today’s visit. What pulmonary function
test (PFT) findings are anticipated based on the diagnosis of chronic bronchitis?
Decreased total lung capacity (TLC).
Increased lung compliance.
Decreased forced expiratory flow (FEV1).
Decreased diffusing capacity.
A patient with normal lungs should be able to exhale 80% of the forced vital capacity within the first second.
Chronic bronchitis will decrease which of the following parameters?
Decreased total lung capacity.
Increased lung compliance.
Decreased diffusing capacity.
Decreased forced expiratory flow (FEV1).
Simple spirometry includes a measure of residual capacity.
True
False
Which of the following spirometry results indicate restrictive lung disease?
FEV1, FEV, and total lung capacity normal: FEV1/FVC ratio normal.
FEV1 reduced, FVC normal, total lung capacity reduced; FEV1/FVC ratio normal.
FEV1, FVC, and total lung capacity reduced; FEV1/FVC ratio normal.
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FEV1, FEV, and total lung capacity reduced; FEV1/FVC ratio reduced.
In order to classify the respiratory issue as either obstructive, restrictive or normal., the NP starts by
looking at the FEV1/FVC ratio.
Obstructive pattern: If the FEV1/FVC ratio is less than 70% or less than the lower limit of normal for the
patient. FEV1 also falls to a greater degree than the FVC.
Restrictive pattern: If the FEV1/FVC ratio is greater than 70% or greater than the lower limit of normal,
then the spirometry test is either normal, or a restrictive respiratory abnormality is present. To make
this distinction, the NP must look at the TLC. In restrictive disorders, the percent predicted of TLC is
<80%, where 80-120% represents a normal range.
The following table compares PFT values in terms of obstructive and restrictive:
Measurement Obstructive Restrictive
Forced vital capacity (FVC) Decreased or normal Decreased
Forced expiratory volume in 1 second (FEV1): Normal is > 80% Decreased Decreased
FEV1/FVC ratio: Normal is 70% or less than the lower limit of normal Less than 70% Normal or >
for the patient 70%
Total lung capacity (TLC): Normal range is 80-120% of predicted >120% (represents <80%
hyperinflation)
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Obstructive Disorders
Obstructive disorders are characterized by obstruction to airflow during expiration. This can be related to conditions
that increase mucus production leading to mucus plugs as in the case of chronic bronchitis or the loss of surface
area of the lung that decreases areas of gas exchange as a result in inflammatory processes that destroys the lung’s
elastic resulting in decreased recoil. Regardless of the cause of the obstruction, there is an increased work of
breathing (WOB), which requires more energy and effort to create airflow. This eventually results in a ventilation-
mismatch where not enough CO2 is being expelled and not enough oxygen being brought in for gas exchange. In
using emphysema as an example, the defect is destruction of the lung’s elastic tissue caused by inflammation after
the person has been exposed to smoking and other irritants over a long period of time. The lung is infiltrated with
inflammatory cells that release cytokines that contribute to airway damage and mucus production. When elastin is
destroyed, the lung loses its recoil ability that is necessary to expel air out. This leads to air trapping and enlarged
alveoli that results in increased lung compliance and decreased elasticity. Ultimately, the lungs become
overstretched without the ability to recoil. Individuals with an obstructive disorder will have less than 70% on their
PFT. Both the FEV1 and FVC will be decreased.
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