TEST BANK FOR RUPPEL’S MANUAL OF PULMONARY FUNCTION TESTING 12 TH EDITION BY MOTTRAM

TEST BANK FOR RUPPEL’S MANUAL OF PULMONARY FUNCTION TESTING 12 TH EDITION BY MOTTRAM ANS: A d. Perform at least one more maneuver. Spirometry acceptability and repeatability criteria were achieved. Report the largest FVC and FEV DIF: 3 REF: p. 62 OBJ: EL-1 MSC: NBRC: CPFT 2C-6 1 12. A subject being tested for possible environmental exposure to asbestos produces the following spirometry results: Measured Predicted FVC (L) 4.00 4.07 FEV (L) 3.44 3.37 MVV (L/min) 52 135 1 The pulmonary function technologist may conclude that: a. The patient has restriction. ANS: D b. The patient has moderate obstructive disease. c. The patient‟s FEV 1 is not valid. d. The patient did not make a good effort on the MVV. If the measured MVV is less than 80% of (FEV DIF: 3 REF: p. 66 OBJ: EL-1 MSC: NBRC: CPFT 2C-6 1 .  40), poor patient effort or neuromuscular weakness may be suspected. 13. Which of the following diagnoses is consistent with the following flow-volume curve? ANS: D a. Variable intrathoracic obstruction b. Fixed extrathoracic obstruction c. Small airway obstruction d. Normal expiratory and inspiratory flows See Interpretive Strategies 2-3, Chapter 2. DIF: 2 REF: p. 58 OBJ: AL-3 MSC: NBRC: CPFT 3C-3 14. Which answer is consistent with the following three superimposed flow-volume loops? ANS: D a. Normal airway function b. Small airway obstruction c. Variable intrathoracic restriction d. Fixed extrathoracic obstruction See Interpretive Strategies 2-3 and Figure 2-14, Chapter 2. DIF: 2 REF: p. 58 | p. 61 OBJ: AL-3 MSC: NBRC: CPFT 3C-3 15. A subject has an FVC of 1.8L(39% of predicted) The same individual has a slow VC of 2.7 L. Which of the following might explain these findings? 1. Normal findings in severe restrictive disease 2. Airway compression in obstructive lung disease 3. Poor effort or early termination of the FVC 4. Representative findings in early small airway disease a. 1, 3, and 4 b. 2 and 3 ANS: B c. 1 and 4 d. 2 only FVC is often lower than VC in patients with obstructive diseases, if forced expiration causes airway collapse. This pattern is often seen in emphysema because of loss of tethering support of the airways. Poor effort during the FVC maneuver can also affect the results. DIF: 3 REF: p. 48 OBJ: EL-3 MSC: NBRC: RPFT 3C-3 16. A subject produces the following simple spirometry results: Measured Predicted FVC (L, BTPS) 4.5 4.0 FEV (L, BTPS) 3.6 3.2 These findings are consistent with: ANS: C 1 a. Combined obstruction and restriction b. Moderate obstructive disease c. Normal lung function d. Incorrectly selected predicted values Data are within normal limits. (FEV 1 /FVC 80%; FEV 113% of predicted.) DIF: 3 REF: p. 51 OBJ: EL-2 MSC: NBRC: RPFT 3C-3 1 17. A subject referred for pulmonary function tests because of shortness of breath has an FEV of 98%. This finding is suggestive of: a. Restrictive lung disease b. Obstructive lung disease 1 ANS: C c. Normal lung function d. Upper airway abnormality Data are within normal limits. DIF: 3 REF: p. 51 OBJ: AL-2 MSC: NBRC: RPFT 3C-3 ANS: A FEF 25%-75% 18. The FEF a. FVC b. PEF 25%-75% c. FEV1 d. FEV1% depends on which of the following? is measured from a segment of the FVC. DIF: 1 REF: p. 52 OBJ: None MSC: NBRC: None 19. In diseases that cause obstruction of the small airways, the MEFV curve may assume a concave appearance because of: 1. Loss of elastic recoil 2. Turbulent gas flow patterns 3. Increased specific conductance 4. Increased airway resistance a. 1, 2, and 3 b. 2, 3, and 4 c. 2 and 3 d. 1 and 4 ANS: D The degree of concavity increases because of reduced flows resulting from loss of elastic recoil. Increased airway resistance would also cause flow limitation. DIF: 2 REF: p. 58 OBJ: AL-4 MSC: NBRC: None 20. A patient produces the following spirometry results: These findings indicate that: ANS: C While the ratio of FEV Actual Predicted FVC (L) 4.0 4.1 FEV ( L) 2.0 3.3 MVV (L/min) 45 110 1 1. Obstruction is present. 2. Restriction is present. 3. The FEV 1 is overestimated. 4. The MVV is underestimated. a. 1, 2, and 3 b. 2, 3, and 4 c. 1 and 4 d. 2 and 3 /VC defines obstruction (50%), the severity of obstruction is defined by the degree to which the FEV 1 1 is reduced. Moderate FEV 1 = 60% to 69% of predicted; 2.00  3.30 = 61%. If the measured MVV is less than 80% of (FEV  40), poor patient effort or neuromuscular weakness may be suspected. DIF: 3 REF: p. 51 | p. 58 OBJ: AL-2 MSC: NBRC: CPFT 2C-6 1 ANS: A 21. In addition to the FEV spirometry? a. PEF b. FEF50% c. FEF25%-75% d. max25 1 and FVC, which of the following is useful in gauging subject effort during Other methods of selecting the best test have been suggested and are sometimes used. PEF may be used to assess patient effort for an FVC maneuver. DIF: 1 REF: p. 55 OBJ: EL-1 MSC: NBRC: CPFT 2C-6 22. Which answer is consistent with the flow-volume curve shown? a. Normal forced expiratory flow pattern b. Variable intrathoracic obstruction c. Airway obstruction d. Fixed extrathoracic obstruction ANS: C See Interpretive Strategies 2-3, Chapter 2. DIF: 2 REF: p. 58 OBJ: AL-3 MSC: NBRC: CPFT 3C-3 ANS: C 23. According to the 2005 ATS-ERS repeatability standards, of the three acceptable tracings, the two largest FVC values and the two largest FEV values in a subject with a vital capacity greater or equal to 1.0 L should be within how many milliliters? a. 50 b. 100 c. 150 d. 200 The two largest acceptable values for both FVC and FEV 1 1 should be within 150 ml (or within 100 ml if the FVC is 1 L or less). The second largest value is simply subtracted from the largest value for both FVC and FEV to determine repeatability. DIF: 1 REF: p. 47 OBJ: EL-1 MSC: NBRC: CPFT 2C-6 ANS: B 1 24. Back extrapolation is the method used to determine “time zero” when measuring which of the following parameters? a. FVC b. FEV 1 c. FEF25%-75% d. MVV To accurately determine FEV , the back-extrapolated volume should be less than 5% of the FVC or less than 150 ml, whichever is greater. 1 DIF: 1 REF: p. 47 OBJ: EL-1 MSC: NBRC: CPFT 2C-6 25. A subject performed four acceptable FVC maneuvers. Predicted Maneuver 1 Maneuver 2 Maneuver 3 FEV1 4.80 4.83 4.60 4.23 4.03 What do the results most likely represent? a. Variable effort ANS: D b. Malingering c. Inability to understand the test d. Maneuver-induced bronchospasm Maneuver 4 Positioning loops side by side or superimposing can also help detect decreasing flows with repeated efforts. This pattern may be seen because FVC maneuvers can induce bronchospasm. DIF: 2 REF: p. 55 OBJ: EL-1 MSC: NBRC: CPFT 2C-6 26. A 62-year-old female complaining of shortness of breath has the following spirometry results. Ambient temperature is 26 C (conversion factor = 1.068). FEV1 FVC Trial 1 2.10 2.65 Trial 2 1.96 N 3.11 Trial 3 1.99 2.99 What is the subject‟s reportable FEV ANS: C b. 2.17 L c. 2.24 L d. 2.65 L 1 in BTPS conditions? a. 2.10 L The data appear acceptable and repeatable. The largest FEV should be reported, which is 2.10. Multiply this value by the BTPS correction factor (2.10  1.068 = 2.24 L). DIF: 3 REF: p. 64 OBJ: AL-1 MSC: NBRC: CPFT 3A-4 1 27. What are the recommended dosages for assessing bronchodilator response, according to the ATSERS spirometry guidelines? a. Four doses of albuterol (100 µg) or ipratropium bromide (40 µg) b. Two doses of albuterol (100 µg) or ipratropium bromide (80 µg) c. Four doses of albuterol (80 µg) or ipratropium bromide (80 µg) d. Two doses of albuterol (80 µg) or ipratropium bromide (40 µg) ANS: A The ATS-ERS guidelines‟ recommended dose of albuterol is 400 µg, delivered as four inhalations of 100 µg each by MDI, separated by 30-second intervals. For ipratropium bromide, the recommended dose is 160 µg, delivered as four inhalations of 40 µg each by MDI. DIF: 1 REF: p. 66 OBJ: AL-1 MSC: NBRC: CPFT 2A-1 28. What is the calculated bronchodilator response in this subject? Pre-Drug Post-Dilator FVC 4.5 4.8 FEV 2.8 3.9 ANS: A a. 39% b. 6% c. 1.1 L d. 71% Percent change in FEV  100 = 39%). 1 is calculated. Post-FEV DIF: 2 REF: p. 67 OBJ: EL-4 MSC: NBRC: CPFT 3C-11a ANS: C 1 –pre-FEV 1 /pre-FEV 1 ([(3.9 – 2.8)  2.8] 29. According to the ATS-ERS recommendations, what are the criteria for measuring an accurate height in a subject before testing? 1. Shoes off 2. Feet apart 3. Heels flat against wall 4. Standing upright a. 1 and 4 b. 1, 2, and 4 c. 1, 3, and 4 d. All of the above The height should be measured without shoes, with the feet together, standing upright ,with shoulders, buttocks, and heels flat against the wall or stadiometer, and the head tilted so that the lower orbital level and the external auditory meatus (Frankfurt plane) are level; measurements should be recorded to the nearest 0.1 cm. DIF: 1 REF: p. 29 ch 1 OBJ: None MSC: NBRC: CPFT 2A-6 30. Which of the following would be considered key components of the FVC maneuver? a. Maximal inspiration, blast of expiration, and complete exhalation b. Maximal inspiration and exhalation for at least 6 seconds c. Forceful exhalation, exhalation for at least 6 seconds in adults and 3 seconds in children younger than the age of 10