Chapter 1: Indications for Pulmonary Function Testing T
d d d d d d d
est Bank
d
MULTIPLEdCHOICE
1. Whodfirstdpopularizeddspirometrydfordthedevaluationdofdpulmonarydfunction?
a. AugustdanddMariedKrogh
b. AlvandBarach
c. JohndSeveringhaus
d. JohndHutchinson
ANS:d D
HutchinsondpopularizeddthedconceptdofdusingdVCdtodassessdlungdfunction,danddthednamesdhedga
vedtodseveraldotherdlungdcompartmentsdaredstillduseddtoday.
DIF: 1 REF: p.d2 OBJ: None MSC:d NBRC:dNone
2. Whichdofdthedfollowingdaredindicationsdfordperformingdspirometry?
1. Assessdthedriskdofdlungdresection.
2. Determinedthedresponsedtodbronchodilatordtherapy.
3. Assessdthedseveritydofdrestrictivedlungddisease.
4. QuantifydthedextentdofdCOPD.
a. 1dandd4
b. 2dandd3
c. 1,d2,dandd4
d. 2,d3,dandd4
ANS:d C
Spirometrydcannotdassessdseveritydofdrestriction;dfordthatdyoudneeddtodmeasuredlungdvolumesd(s
eedBoxd1-2,dChapterd1).
DIF: 1 REF: p.d7 OBJ: EL-2 MSC:d NBRC:dNone
3. Thedmaindindicationdfordthedmeasurementdofdlungdvolumesdisdtoddodwhichdofdthedfollowing?
a. Diagnosedordassessdthedseveritydofdrestriction.
b. Evaluatedthedseveritydofdpulmonarydhypertension.
c. Determinedthedleveldofdcardiopulmonarydfitness.
d. Assessdthedriskdofdabdominaldsurgicaldprocedures.
ANS:d A
Thedmostdcommondreasondfordmeasuringdlungdvolumesdisdtodidentifydrestrictivedlungddisease.d
DIF: 1 REF: p.d35 OBJ: EL-2 MSC:d NBRC:dNone
4. DLCOdmeasurementsdmaydbedindicateddtodevaluatedpulmonarydinvolvementdindwhichdofdthedf
ollowingdsystemicddiseases?
a. Asthma
b. Sarcoidosis
c. Exertionaldhypoxemia
, d. Guillain-Barrédsyndrome
ANS:d B
Sarcoidosisdisdthedonlydsystemicddiseasedlisteddthatdaffectsdgasdexchange.
DIF: 1 REF: p.d9d|dp.d19d|dp.d21d|dp.d35 OBJ: EL-
2dMSC:d NBRC:dNone
5. BlooddgasdanalysisdisduseddwithdpatientsdwithdCOPDdtoddodwhichdofdthedfollowing?
a. Monitordairwaydresponsiveness.
b. Determinedleveldofdcardiopulmonarydfitness.
c. Detectdpulmonarydhypertension.
d. AssessdneeddfordsupplementarydO2.
ANS:d D
Blooddgasdanalysisdisdmostdcommonlyduseddtoddeterminedthedneeddfordsupplementaldoxygendan
ddtodmanagedpatientsdwhodrequiredventilatorydsupport.
DIF: 2 REF: p.d15 OBJ: EL-
1dMSC:d NBRC:dCPFTd2A-2
6. Whichdofdthedfollowingdcausedemphysema?
1. 1-Antitrypsinddeficiency
2. Exposuredtodenvironmentaldpollutants
3. Radiationdtherapy
4. Cigarettedsmoking
a. 1dandd2
b. 3dandd4
c. 1,d2,dandd4
d. 2,d3,dandd4
ANS:d C
Emphysemadisdcauseddprimarilydbydcigarettedsmoking.dSomedemphysemadisdcauseddbydthedabsen
cedofdadprotectivedenzyme.dChronicdexposuredtodenvironmentaldpollutantsdcandalsodcontributedtodt
heddevelopmentdofdemphysema.
DIF: 1 REF: p.d11 OBJ: EL-3d|dAL-2 MSC:d NBRC:dNone
7. Andadultdpatientdcomplainsdofdchestdtightnessdanddcoughdwheneverdhedjogsdindcolddweather.d
Thesedsymptomsdaredconsistentdwithdwhichdofdthedfollowing?
a. Cysticdfibrosis
b. Asthma
c. Pulmonarydhypertension
d. Idiopathicdpulmonarydfibrosis
ANS:d B
Agentsdordeventsdthatdcausedandasthmaticdepisodedaredcalleddtriggersd(seedBoxd1-
7,dChapterd1).dAntigensdsuchdasdanimalddander,dpollens,dandddustsdaredthedmostdcommondtrigge
rs.dOtherdcommondtriggersdincludedexposuredtodairdpollutantsdanddexercisedindcolddorddrydair.
DIF: 2 REF: p.d16 OBJ: EL-3 MSC:d NBRC:dNone
, 8. Whichdofdthedfollowingdstatementsdconcerningdtumorsdindthedupperdairwaydisdtrue?
a. Theredmaydbedvariabledordfixeddobstruction.
b. Fixeddobstructiondwilldbedpresent.
c. Variabledobstructiondwilldbedpresent.
d. Smalldairwaydobstructiondwilldresult.
ANS:d A
Tumorsdinvolvingdthedupperdairwaydmaydcausedvariabledordfixeddobstruction.
DIF: 2 REF: p.d19 OBJ: EL-
2dMSC:d NBRC:dCPFTd3C-3
9. Sarcoidosisdisdadsystemicddisorderdthatdusuallydcausesdwhichdofdthedfollowing?
a. Adrestrictivedventilatoryddefect
b. Andobstructivedventilatoryddefect
c. Hyperreactivedairways
d. Primarydpulmonarydhypertension
ANS:d A
Restrictiondisdoftendassociateddwithdthedfollowing:dinterstitialdlungddiseases,dincludingdidiopat
hicdfibrosis,dpneumoconioses,danddsarcoidosis.
DIF: 1 REF: p.d19d|dp.d21 OBJ: EL-3 MSC:d NBRC:dNone
10. Fordwhichdofdthedfollowingdconditionsdmightdpulmonarydfunctiondtestingdbedcontraindicated?
a. Vocaldcordddysfunction
b. Untreateddpneumothorax
c. Congestivedheartdfailured(CHF)
d. Bronchiolitisdobliterans
ANS:d B
Pulmonarydfunctiondtestsdaredusuallydcontraindicateddindthedpresencedofdpneumothorax.dHoweve
r,dundiagnoseddpneumothoraxdmaydpresentdadriskdifdpulmonarydfunctiondstudiesdaredperformed.
DIF: 1 REF: p.d23 OBJ: EL-
4dMSC:d NBRC:dCPFTd2B-6
11. Whichdofdthedfollowingdcorrectlyddescribe(s)dappropriatedphysicaldmeasurementsdbefored
pulmonarydfunctiondtesting?
1. Actualdbodydweightdshoulddbeduseddtodcalculatedpredicteddvalues.
2. Standingdheightdshoulddbedmeasureddwhendthedpatientdisdbarefoot.
3. Armdspandshoulddbeduseddinsteaddofdheightdfordadpatientdwithdkyphosis.
4. Agedshoulddbedrecordeddtodthednearestddecaded(10dyears).
a. 1donly
b. 2dandd3
c. 1,d2,dandd4
d. 1,d2,d3,dandd4d
ANS:d B
, Variousdphysicaldmeasurementsdaredrequireddfordestimatingdeachdpatient’sdexpecteddleveldofdpul
monarydfunction.dAgedtodthednearestdmonth,dheightdtodthednearestd0.1dcm,danddweightdaredusuallyd
recordeddindadditiondtodthedpatient’sdgender.dRacedordethnicdorigindshoulddalsodbedrecorded.d(Alth
oughdbodydweightdisdrecorded,ditdisdnotduseddtodcalculatedpredicteddvalues.)
DIF: 1 REF: p.d29 OBJ:
NonedMSC:d NBRC:dCPFTd3A-20
12. Indadditiondtodexplainingdthedproceduredfordeachdpulmonarydfunctiondtestdtodthedpatient,dthedp
ulmonarydfunctiondtechnologistdshouldddodwhichdofdthedfollowing?
a. Brieflydexplaindthedphysiologicdbasisdofdthedtest.
b. Demonstratedthedcorrectdperformancedofdthedtestdmaneuver.
c. Limitdfeedbackdtodthedpatientdtodreducedthedplacebodeffect.
d. Explaindthedexactdnumberdofdeffortsdthatdwilldbedrequireddfordeachdtest.
ANS:d B
Indadditiondtodaddescriptiondofdthedtest,dthedmaneuverdshoulddalwaysdbeddemonstrated.
DIF: 1 REF: p.d32 OBJ:
NonedMSC:d NBRC:dCPFTd2B-6
13. Thedsingle-breathddiffusingdcapacitydtestdwasdfirstddescribeddby:
a. JohndSeveringhaus
b. AugustdanddMariedKrogh
c. RobertdHyatt
d. LelanddClark
ANS:d B
Thedbasisdfordthedmoderndsingle-
breathddiffusingdcapacityd(DLCO)dtestdwasddescribeddbydAugustdanddMariedKroghdind1911.
DIF: 1 REF: p.d5 OBJ: None MSC:d NBRC:dNone
14. DLCOdmeasurementsdmaydbedindicateddtodevaluatedgasdexchangedabnormalitydindwhichdofdthedf
ollowing?
a. Ketoacidosis
b. Myastheniadgravis
c. Interstitialdlungddisease
d. Bronchitis
ANS:d C
Thedotherdoptionsddodnotdaffectdthedalveolardcapillarydmembranedinterface.
DIF: 1 REF: p.d9 OBJ: EL-2 MSC:d NBRC:dNone
15. Vocaldcordddysfunctiondwilldtypicallydaffectdthedflow-volumedloopdindwhatdway?
a. Bluntdthedexpiratorydportiondofdthedcurve
b. Bluntdbothdthedinspiratorydanddexpiratorydportionsdofdthedcurve
c. Bluntdthedinspiratorydportiondofdthedcurve
d. Havednodeffectdondthedcurvedbutdcausedinspiratorydstridor
d d d d d d d
est Bank
d
MULTIPLEdCHOICE
1. Whodfirstdpopularizeddspirometrydfordthedevaluationdofdpulmonarydfunction?
a. AugustdanddMariedKrogh
b. AlvandBarach
c. JohndSeveringhaus
d. JohndHutchinson
ANS:d D
HutchinsondpopularizeddthedconceptdofdusingdVCdtodassessdlungdfunction,danddthednamesdhedga
vedtodseveraldotherdlungdcompartmentsdaredstillduseddtoday.
DIF: 1 REF: p.d2 OBJ: None MSC:d NBRC:dNone
2. Whichdofdthedfollowingdaredindicationsdfordperformingdspirometry?
1. Assessdthedriskdofdlungdresection.
2. Determinedthedresponsedtodbronchodilatordtherapy.
3. Assessdthedseveritydofdrestrictivedlungddisease.
4. QuantifydthedextentdofdCOPD.
a. 1dandd4
b. 2dandd3
c. 1,d2,dandd4
d. 2,d3,dandd4
ANS:d C
Spirometrydcannotdassessdseveritydofdrestriction;dfordthatdyoudneeddtodmeasuredlungdvolumesd(s
eedBoxd1-2,dChapterd1).
DIF: 1 REF: p.d7 OBJ: EL-2 MSC:d NBRC:dNone
3. Thedmaindindicationdfordthedmeasurementdofdlungdvolumesdisdtoddodwhichdofdthedfollowing?
a. Diagnosedordassessdthedseveritydofdrestriction.
b. Evaluatedthedseveritydofdpulmonarydhypertension.
c. Determinedthedleveldofdcardiopulmonarydfitness.
d. Assessdthedriskdofdabdominaldsurgicaldprocedures.
ANS:d A
Thedmostdcommondreasondfordmeasuringdlungdvolumesdisdtodidentifydrestrictivedlungddisease.d
DIF: 1 REF: p.d35 OBJ: EL-2 MSC:d NBRC:dNone
4. DLCOdmeasurementsdmaydbedindicateddtodevaluatedpulmonarydinvolvementdindwhichdofdthedf
ollowingdsystemicddiseases?
a. Asthma
b. Sarcoidosis
c. Exertionaldhypoxemia
, d. Guillain-Barrédsyndrome
ANS:d B
Sarcoidosisdisdthedonlydsystemicddiseasedlisteddthatdaffectsdgasdexchange.
DIF: 1 REF: p.d9d|dp.d19d|dp.d21d|dp.d35 OBJ: EL-
2dMSC:d NBRC:dNone
5. BlooddgasdanalysisdisduseddwithdpatientsdwithdCOPDdtoddodwhichdofdthedfollowing?
a. Monitordairwaydresponsiveness.
b. Determinedleveldofdcardiopulmonarydfitness.
c. Detectdpulmonarydhypertension.
d. AssessdneeddfordsupplementarydO2.
ANS:d D
Blooddgasdanalysisdisdmostdcommonlyduseddtoddeterminedthedneeddfordsupplementaldoxygendan
ddtodmanagedpatientsdwhodrequiredventilatorydsupport.
DIF: 2 REF: p.d15 OBJ: EL-
1dMSC:d NBRC:dCPFTd2A-2
6. Whichdofdthedfollowingdcausedemphysema?
1. 1-Antitrypsinddeficiency
2. Exposuredtodenvironmentaldpollutants
3. Radiationdtherapy
4. Cigarettedsmoking
a. 1dandd2
b. 3dandd4
c. 1,d2,dandd4
d. 2,d3,dandd4
ANS:d C
Emphysemadisdcauseddprimarilydbydcigarettedsmoking.dSomedemphysemadisdcauseddbydthedabsen
cedofdadprotectivedenzyme.dChronicdexposuredtodenvironmentaldpollutantsdcandalsodcontributedtodt
heddevelopmentdofdemphysema.
DIF: 1 REF: p.d11 OBJ: EL-3d|dAL-2 MSC:d NBRC:dNone
7. Andadultdpatientdcomplainsdofdchestdtightnessdanddcoughdwheneverdhedjogsdindcolddweather.d
Thesedsymptomsdaredconsistentdwithdwhichdofdthedfollowing?
a. Cysticdfibrosis
b. Asthma
c. Pulmonarydhypertension
d. Idiopathicdpulmonarydfibrosis
ANS:d B
Agentsdordeventsdthatdcausedandasthmaticdepisodedaredcalleddtriggersd(seedBoxd1-
7,dChapterd1).dAntigensdsuchdasdanimalddander,dpollens,dandddustsdaredthedmostdcommondtrigge
rs.dOtherdcommondtriggersdincludedexposuredtodairdpollutantsdanddexercisedindcolddorddrydair.
DIF: 2 REF: p.d16 OBJ: EL-3 MSC:d NBRC:dNone
, 8. Whichdofdthedfollowingdstatementsdconcerningdtumorsdindthedupperdairwaydisdtrue?
a. Theredmaydbedvariabledordfixeddobstruction.
b. Fixeddobstructiondwilldbedpresent.
c. Variabledobstructiondwilldbedpresent.
d. Smalldairwaydobstructiondwilldresult.
ANS:d A
Tumorsdinvolvingdthedupperdairwaydmaydcausedvariabledordfixeddobstruction.
DIF: 2 REF: p.d19 OBJ: EL-
2dMSC:d NBRC:dCPFTd3C-3
9. Sarcoidosisdisdadsystemicddisorderdthatdusuallydcausesdwhichdofdthedfollowing?
a. Adrestrictivedventilatoryddefect
b. Andobstructivedventilatoryddefect
c. Hyperreactivedairways
d. Primarydpulmonarydhypertension
ANS:d A
Restrictiondisdoftendassociateddwithdthedfollowing:dinterstitialdlungddiseases,dincludingdidiopat
hicdfibrosis,dpneumoconioses,danddsarcoidosis.
DIF: 1 REF: p.d19d|dp.d21 OBJ: EL-3 MSC:d NBRC:dNone
10. Fordwhichdofdthedfollowingdconditionsdmightdpulmonarydfunctiondtestingdbedcontraindicated?
a. Vocaldcordddysfunction
b. Untreateddpneumothorax
c. Congestivedheartdfailured(CHF)
d. Bronchiolitisdobliterans
ANS:d B
Pulmonarydfunctiondtestsdaredusuallydcontraindicateddindthedpresencedofdpneumothorax.dHoweve
r,dundiagnoseddpneumothoraxdmaydpresentdadriskdifdpulmonarydfunctiondstudiesdaredperformed.
DIF: 1 REF: p.d23 OBJ: EL-
4dMSC:d NBRC:dCPFTd2B-6
11. Whichdofdthedfollowingdcorrectlyddescribe(s)dappropriatedphysicaldmeasurementsdbefored
pulmonarydfunctiondtesting?
1. Actualdbodydweightdshoulddbeduseddtodcalculatedpredicteddvalues.
2. Standingdheightdshoulddbedmeasureddwhendthedpatientdisdbarefoot.
3. Armdspandshoulddbeduseddinsteaddofdheightdfordadpatientdwithdkyphosis.
4. Agedshoulddbedrecordeddtodthednearestddecaded(10dyears).
a. 1donly
b. 2dandd3
c. 1,d2,dandd4
d. 1,d2,d3,dandd4d
ANS:d B
, Variousdphysicaldmeasurementsdaredrequireddfordestimatingdeachdpatient’sdexpecteddleveldofdpul
monarydfunction.dAgedtodthednearestdmonth,dheightdtodthednearestd0.1dcm,danddweightdaredusuallyd
recordeddindadditiondtodthedpatient’sdgender.dRacedordethnicdorigindshoulddalsodbedrecorded.d(Alth
oughdbodydweightdisdrecorded,ditdisdnotduseddtodcalculatedpredicteddvalues.)
DIF: 1 REF: p.d29 OBJ:
NonedMSC:d NBRC:dCPFTd3A-20
12. Indadditiondtodexplainingdthedproceduredfordeachdpulmonarydfunctiondtestdtodthedpatient,dthedp
ulmonarydfunctiondtechnologistdshouldddodwhichdofdthedfollowing?
a. Brieflydexplaindthedphysiologicdbasisdofdthedtest.
b. Demonstratedthedcorrectdperformancedofdthedtestdmaneuver.
c. Limitdfeedbackdtodthedpatientdtodreducedthedplacebodeffect.
d. Explaindthedexactdnumberdofdeffortsdthatdwilldbedrequireddfordeachdtest.
ANS:d B
Indadditiondtodaddescriptiondofdthedtest,dthedmaneuverdshoulddalwaysdbeddemonstrated.
DIF: 1 REF: p.d32 OBJ:
NonedMSC:d NBRC:dCPFTd2B-6
13. Thedsingle-breathddiffusingdcapacitydtestdwasdfirstddescribeddby:
a. JohndSeveringhaus
b. AugustdanddMariedKrogh
c. RobertdHyatt
d. LelanddClark
ANS:d B
Thedbasisdfordthedmoderndsingle-
breathddiffusingdcapacityd(DLCO)dtestdwasddescribeddbydAugustdanddMariedKroghdind1911.
DIF: 1 REF: p.d5 OBJ: None MSC:d NBRC:dNone
14. DLCOdmeasurementsdmaydbedindicateddtodevaluatedgasdexchangedabnormalitydindwhichdofdthedf
ollowing?
a. Ketoacidosis
b. Myastheniadgravis
c. Interstitialdlungddisease
d. Bronchitis
ANS:d C
Thedotherdoptionsddodnotdaffectdthedalveolardcapillarydmembranedinterface.
DIF: 1 REF: p.d9 OBJ: EL-2 MSC:d NBRC:dNone
15. Vocaldcordddysfunctiondwilldtypicallydaffectdthedflow-volumedloopdindwhatdway?
a. Bluntdthedexpiratorydportiondofdthedcurve
b. Bluntdbothdthedinspiratorydanddexpiratorydportionsdofdthedcurve
c. Bluntdthedinspiratorydportiondofdthedcurve
d. Havednodeffectdondthedcurvedbutdcausedinspiratorydstridor
