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 measurements may be indicated to evaluate gas exchange abnormality in
which of the following?
a. Ketoacidosis
b. Myasthenia gravis
c. Interstitial lung disease
d. Bronchitis
ANS: C
The other options do not affect the alveolar capillary membrane
interface. DIF: 1 REF: p. 9 OBJ: EL-2 MSC: NBRC:
None
15. Vocal cord dysfunction will typically affect the flow-volume loop in what way?
a. Blunt the expiratory portion of the curve
b. Blunt both the inspiratory and expiratory portions of the curve
c. Blunt the inspiratory portion of the curve
Have no effect on the curve but cause inspiratory stridor
d.
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ANS:
C
The vocal cords are normally held open or abducted during inspiration. When
damaged, the vocal cords move toward the midline, narrowing the airway
opening. This type of obstruction limits flow primarily during inspiration.
DIF: 2 REF: p. 18 OBJ: EL-4
MSC: NBRC: CPFT 3C-3
16. All of the following disease processes are potential causes of a restrictive pattern
except:
a. Interstitial lung disease (e.g., fibrosis, sarcoidosis)
b. Kyphoscoliosis
c. Asthma
d. Neuromuscular disorders
ANS: C
Asthma causes airway obstruction.
DIF: 1 REF: p. 21 | p. 22 | p. 23 OBJ: EL-3
MSC: NBRC: None
17. The following data are obtained from a subject complaining of shortness of breath:
Predicted Found % Pred
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 data are most consistent with which disease entity?
a. Pulmonary fibrosis
b. Kyphoscoliosis
c. Obesity
d. Emphysema
ANS: A
Excerpt from the restrictive disease discussion: These reductions in VC and TLC
occur as fibrosis causes the lungs to become stiff. Pulmonary fibrosis is the only
disease entity listed that causes a reduction in lung volumes and affects the alveolar
d.
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capillary interface (e.g., reduced DLCO).
DIF: 3 REF: p. 20 OBJ: EL-3
d.