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Midterm Exam: NR 571/ NR571 (Latest 2026/ 2027 Update) Complex Diagnosis & Management in Acute Care Practicum Guide| Q/A | Grade A| 100% Correct (Verified Answers) -Chamberlain

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Midterm Exam: NR 571/ NR571 (Latest 2026/ 2027 Update) Complex Diagnosis & Management in Acute Care Practicum Guide| Q/A | Grade A| 100% Correct (Verified Answers) -Chamberlain QUESTION Low FEV1/FVC ratio indicates Answer: obstructive lung disease Classification of Pulmonary Disorders Based On PFT Restrictive Lung Disease Restrictive lung disease is diagnosed by a decrease in the total volume of air that the lungs can hold. It often results from a decrease in the elasticity of the lungs or may be related to the inability of the chest wall to expand during inhalation. Conditions that are associated with restrictive lung function include: interstitial lung disease such as idiopathic pulmonary fibrosis sarcoidosis obesity, including obesity hypoventilation syndrome scoliosis neuromuscular diseases such as muscular dystrophy or amateur amyotrophic lateral sclerosis (ALS) Obstructive Lung Disease Obstructive lung diseases are conditions that impede exhaled air from the lungs due to the narrowing of the airways or actual damage to the lung parenchyma. Conditions associated with obstructive lung function include: asthma chronic obstructive pulmonary disease (COPD) cystic fibrosis bronchiectasis Diagnostic Approach The provider's ability to accurately interpret PFTs does improve with experience but is best performed when a systematic approach is used. A systematic approach is helpful to accurately interpret PFTs and includes the following steps: Determine if the FEV1/FVC ratio is low. This finding will indicate that there is an obstructive defect present. Determine if the FVC is low. This finding will indicate a restrictive pattern indicating restrictive lung disease, a mixed pattern, or pure obstructive lung disease with air trapping. Grade the severity of the abnormality. If there is an obstructive defect, restrictive pattern, or mix pattern, you should grade the severity of the abnormality based on the FEV1 percentage predicted based on the American Thoracic Society's (ATS) system for QUESTION Low FEV1/FVC ratio indicates Answer: obstructive lung disease QUESTION Low FVC indicates Answer: restrictive pulmonary disease, a mixed pattern, or pure obstructive lung disease with air trapping QUESTION American thoracic society's (ATS) system for grading PFT abnormalities Answer: If there is an obstructive defect, restrictive pattern, or mixed pattern, you should grade the severity of the abnormality based on the FEV1 % predicted based on ATS's system QUESTION Determine the reversibility of obstructive defect by Answer: The increase in FEV1 or FVC after bronchodilator treatment. If FEV or FEV1 increases by 12%, obstructive pattern is reversible. QUESTION PFTs pre-procedure Answer: If the patient has underlying chronic respiratory disorders, such as COPD or moderate to severe asthma Purpose to evaluate the need additional respiratory support or design treatment plan for patient who may need mechanical ventilation. QUESTION Obstructive PFTs Answer: Characterized by low FEV1/FVC ratio. 70% QUESTION Restrictive PFTs Answer: Reduced FEV1 and FVC with preserved FEV1/FVC ratio QUESTION Bronchoprovocation testing Answer: Used when exercise or allergen induced asthma may be causing the abnormality. If FEV1 70% predicted on Spirometry, this test uses methacholine or mannitol inhalation challenge to confirm. QUESTION GOLD grading system Answer: Used to assess severity of COPD (the disease not the exacerbation) Global-initiative Obstructive Lung Disease (GOLD) Based on symptoms, number of exacerbations, COPD-related hospitalizations, and Spirometry results QUESTION COPD diagnosis Answer: FEV1/FVC ratio 0.7 or 70% on Spirometry QUESTION COPD treatment Answer: Long acting B2 agonist (LABA), long, acting, antimuscarinic agent (LAMA), inhaled corticosteroids (ICS), systemic corticosteroids, antibiotics when signs of bacterial infection exist. Short acting beta agonists (SABA) with or without short acting anticholinergics. QUESTION Mild to moderate asthma

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Midterml Exam:l NRl 571/l NR571l (Latestl
2026/l 2027l Update)l Complexl Diagnosisl &l
Managementl inl Acutel Carel Practicuml
Guide|l Q/Al |l Gradel A|l 100%l Correctl
(Verifiedl Answers)l -Chamberlain

Q:l Lowl FEV1/FVCl ratiol indicates
Answer:
obstructivel lungl disease
Classificationl ofl Pulmonaryl Disordersl Basedl Onl PFT

Restrictivel Lungl Disease

Restrictivel lungl diseasel isl diagnosedl byl al decreasel inl thel totall volumel ofl airl thatl thel
lungsl canl hold.l Itl oftenl resultsl froml al decreasel inl thel elasticityl ofl thel lungsl orl mayl
bel relatedl tol thel inabilityl ofl thel chestl walll tol expandl duringl inhalation.l Conditionsl thatl
arel associatedl withl restrictivel lungl functionl include:

l interstitiall lungl diseasel suchl asl idiopathicl pulmonaryl fibrosis
l sarcoidosis
l obesity,l includingl obesityl hypoventilationl syndrome
l scoliosis
l neuromuscularl diseasesl suchl asl muscularl dystrophyl orl amateurl amyotrophicl laterall
sclerosisl (ALS)

Obstructivel Lungl Disease

Obstructivel lungl diseasesl arel conditionsl thatl impedel exhaledl airl froml thel lungsl duel tol
thel narrowingl ofl thel airwaysl orl actuall damagel tol thel lungl parenchyma.l Conditionsl
associatedl withl obstructivel lungl functionl include:

l asthma

,l chronicl obstructivel pulmonaryl diseasel (COPD)
l cysticl fibrosis
l bronchiectasis

Diagnosticl Approach

Thel provider'sl abilityl tol accuratelyl interpretl PFTsl doesl improvel withl experiencel butl isl
bestl performedl whenl al systematicl approachl isl used.

Al systematicl approachl isl helpfull tol accuratelyl interpretl PFTsl andl includesl thel followingl
steps:

l Determinel ifl thel FEV1/FVCl ratiol isl low.l Thisl findingl willl indicatel thatl therel isl anl
obstructivel defectl present.
l Determinel ifl thel FVCl isl low.l Thisl findingl willl indicatel al restrictivel patternl indicatingl
restrictivel lungl disease,l al mixedl pattern,l orl purel obstructivel lungl diseasel withl airl
trapping.
l Gradel thel severityl ofl thel abnormality.l Ifl therel isl anl obstructivel defect,l restrictivel
pattern,l orl mixl pattern,l youl shouldl gradel thel severityl ofl thel abnormalityl basedl onl thel
FEV1l percentagel predictedl basedl onl thel Americanl Thoracicl Society'sl (ATS)l systeml for



Q:l Lowl FEV1/FVCl ratiol indicates
Answer:
obstructivel lungl disease



Q:l Lowl FVCl indicates
Answer:
restrictivel pulmonaryl disease,l al mixedl pattern,l orl purel obstructivel lungl diseasel withl airl
trapping



Q:l Americanl thoracicl society'sl (ATS)l systeml forl gradingl PFTl abnormalities
Answer:

,Ifl therel isl anl obstructivel defect,l restrictivel pattern,l orl mixedl pattern,l youl shouldl gradel
thel severityl ofl thel abnormalityl basedl onl thel FEV1l %l predictedl basedl onl ATS'sl system



Q:l Determinel thel reversibilityl ofl obstructivel defectl by
Answer:
Thel increasel inl FEV1l orl FVCl afterl bronchodilatorl treatment.
Ifl FEVl orl FEV1l increasesl byl 12%,l obstructivel patternl isl reversible.



Q:l PFTsl pre-procedure
Answer:
Ifl thel patientl hasl underlyingl chronicl respiratoryl disorders,l suchl asl COPDl orl moderatel
tol severel asthma
Purposel tol evaluatel thel needl additionall respiratoryl supportl orl designl treatmentl planl forl
patientl whol mayl needl mechanicall ventilation.



Q:l Obstructivel PFTs
Answer:
Characterizedl byl lowl FEV1/FVCl ratio.l <70%



Q:l Restrictivel PFTs
Answer:
Reducedl FEV1l andl FVCl withl preservedl FEV1/FVCl ratio



Q:l Bronchoprovocationl testing
Answer:
Usedl whenl exercisel orl allergenl inducedl asthmal mayl bel causingl thel abnormality.l Ifl
FEV1l <70%l predictedl onl Spirometry,l thisl testl usesl methacholinel orl mannitoll inhalationl
challengel tol confirm.

, Q:l GOLDl gradingl system
Answer:
Usedl tol assessl severityl ofl COPDl (thel diseasel notl thel exacerbation)
Global-initiativel Obstructivel Lungl Diseasel (GOLD)
Basedl onl symptoms,l numberl ofl exacerbations,l COPD-relatedl hospitalizations,l andl
Spirometryl results



Q:l COPDl diagnosis
Answer:
FEV1/FVCl ratiol <l 0.7l orl 70%l onl Spirometry



Q:l COPDl treatment
Answer:
Longl actingl B2l agonistl (LABA),l long,l acting,l antimuscarinicl agentl (LAMA),l inhaledl
corticosteroidsl (ICS),l systemicl corticosteroids,l antibioticsl whenl signsl ofl bacteriall
infectionl exist.l Shortl actingl betal agonistsl (SABA)l withl orl withoutl shortl actingl
anticholinergics.



Q:l Mildl tol moderatel asthma
Answer:
Talksl andl phrases,l prefersl tol sitl ratherl thanl lyingl down,l notl agitated,l nol accessoryl
musclel use,l heartl ratel 100l tol 120,l O2l saturationl 90l tol 95%l onl rooml air.l >l 50%l ofl
predictedl orl personall best



Q:l Severel asthma
Answer:

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