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Question 1

A galvanic fuel cell oxygen analyzer fails to reach the proper reading when analyzing an FIO2 of 100%.The respiratory care practitioner should:

  1. Continue using the analyzer
  2. Replace the analyzer with a new one
  3. Change the fuel cell
  4. Replace the battery

 

Question 2

A patient is diagnosed with septic shock and has a fever of 105 degrees Fahrenheit. The RCP fails to make a temperature correction to the analyzer. How will this make the ABG analysis inaccurate?

  1. Lower pH
  2. Higher PO2
  3. Lower CO2
  4. Higher pH
  5. Lower PO2

 

Question 3

A patient with kyphoscoliosis performs maximum inspiratory and expiratory maneuvers with the following results:MIP +110 MEP -160. The correct interpretation would be:

  1. The results are normal
  2. The results are invalid and should not be reported
  3. The results are normal on inspiration and abnormal on expiration
  4. The results are normal on expiration and abnormal on inspiration

 

Question 4

A patient with pulmonary fibrosis has a compliance study performed. Which of the following indicate that the esophageal balloon is placed correctly in the esophagus?

  1. Cardiac pulsations are recorded by the pressure transducer
  2. Inspiration causes a negative pressure deflection
  3. Expiration causes a negative pressure deflection
  4. No pressure change occurs during inspiration

 

Question 5

All of the following statements are true concerning the Helium analyzer EXCEPT:

  1. Measures percentage of He
  2. Are safe to use with flammable gases
  3. Are often found in pulmonary function equipment
  4. Makes use of thermal conductivity

 

Question 6

All of the following statements concerning blood-based controls used in the ABG lab are correct EXCEPT:

  1. They require refrigeration
  2. They consist of human red blood cells
  3. They must be ran every 8 hours
  4. They are packaged in 2-3 ml ampoules

 

Question 7

At what lung level should a maximum inspiratory pressure maneuver be performed?

  1. Functional residual capacity
  2. Residual volume
  3. End-tidal inspiration
  4. Total lung capacity

 

Question 8

Correct expressions for the relationship between respiratory rate, tidal volume and minute ventilation include:

  1. VE = Vt Rate
  2. Vt = VE Rate
  3. VE = Rate x Vt
  4. Rate = VE Vt

 

Question 9

Data used for detecting a blood-gas machine that is out of control is:

  1. The + or – 2 standard deviation
  2. The + or – 4 standard deviation
  3. The + or – 1 standard deviation
  4. The + or – 3 standard deviation

 

Question 10

How would you correct an out of control situation for a blood gas analyzer?

  1. Replace the electrode that displays the out of control error
  2. Clean the membrane with the out of control error with a pumice stone
  3. Nothing is required for an out of control situation, continue to use the blood gas analyzer
  4. Remove the blood gas analyzer and replace it with a new one

 

Question 11

It would be appropriate to use the Wright respirometer to measure which of the following parameters?

  1. Tidal volume
  2. Vital capacity
  3. Forced expiratory capacity
  4. Peak expiratory flow rate
  5. Minute volume

 

Question 12

Running the same sample on one or more other blood gas analyzers in the ABG lab to assure accuracy is known as:

  1. Monthly quality assurance
  2. Multiple machine analysis
  3. Proficiency Testing
  4. Preventative maintenance

 

Question 13

The RRT has been asked to measure a patient’s MIP. Which of the following instruments should be selected to obtain this measurement?

  1. Pressure strain-gauge
  2. Pneumotachometer
  3. Pressure manometer
  4. Pressure transducer

 

Question 14

The following data is obtained during quality assurance of a blood gas machine. Mean (normal) values are: PO2 – 100, PCO2 – 50, pH – 7.28. The standard deviation is + or – 2 SD.
PO2 PCO2 pH
Day shift 101 49 7.28
Evening shift 102 53 7.26
Night shift 104 51 7.29
Which of the following statements is/are true?

  1. Data indicates no trouble shooting required on day shift
  2. Data indicates need for trouble shooting of the PCO2 electrode on evenings
  3. Data indicates need for trouble shooting of PO2 electrode on nights.

 

Question 15

Tidal volume and minute ventilation must be determined from a patient that has a measured minute volume of 7.35 L and a respiratory rate of 18/minute. What is this patient’s tidal volume value?

  1. 132 ml
  2. 408 ml
  3. 180 ml
  4. 735 ml

 

Question 16

What should the pulmonary function technologist take into consideration with each test before reporting test results?

  1. Equipment performance
  2. Technologist performance
  3. Age of equipment being used
  4. Patient performance

 

Question 17

When calibration gas analyzers, which of the following should be calibrated to a 0% reading as the first point (percentage)?

  1. Nitrogen
  2. Oxygen
  3. Helium
  4. Carbon dioxide/Carbon monoxide

 

Question 18

When measuring minute ventilation using a Wright’s respirometer:

  1. A pressure manometer is needed to determine values
  2. The number of breaths taken by the patient should be counted during the measuring period
  3. A value obtained by measuring inspiratory volumes will be smaller than expiratory volumes
  4. The tidal volume is collected (measured) for three minutes

 

Question 29

Which agency sets forth standards that must be met to assure accuracy of equipment?

  1. ALA (American Lung Association)
  2. CGA (Compressed Gas Association)
  3. ACCP (American College Chest Physicians)
  4. ATS (American Thoracic Society)

 

Question 20

Which of the following diseases will most likely exhibit an increased compliance?

  1. Pulmonary fibrosis
  2. Chronic bronchitis
  3. Bronchiectasis
  4. Asbestosis
Question 21

Which of the following statements are correct regarding total lung and thoracic compliance?

  1. There is less inspired volume per cmH2O in CLT than in either CL or CT alone
  2. There is more inspired volume per cmH2O in CT than in CL
  3. There is less inspired volume per cmH2O in CT than in CL
  4. There is more inspired volume per cmH2O in CLT than in CT alone

 

Question 22

Which of the following test is used as an indicator of ventilatory inspiratory muscle strength?

  1. Forced vital capacity
  2. Expiratory reserve volume
  3. Maximal inspiratory pressure
  4. Maximal expiratory pressure

 

Question 23

Which of the following types of equipment would enable the measurement of the transpulmonary pressure, which is needed to calculate pulmonary compliance?

  1. Fiber-optic bronchoscope
  2. Intraesophageal balloon
  3. Transcutaneous PO2 electrode
  4. Co-oximeter

 

Question 24

Which of the following is NOT a good indication to perform MIPs and MEPs?

  1. Inability to cough effectively
  2. Myasthenia gravis
  3. Pulmonary hypertension
  4. Amothopic lateral sclerosis

 

Question 25

While working in a PFT lab, you discover that the nitrogen analyzer is not functioning correctly. You would do which of the following?

  1. Go ahead and use the analyzer as long as it is working
  2. Replace the nitrogen analyzer with a helium analyzer
  3. Take the analyzer to Biomedical lab for corrective maintenance
  4. Ask a technician to perform preventative maintenance on the analyzer

 

Question 26

You are a respiratory therapist in charge of the ABG lab. One of your responsibilities is calibration of the gases used by the blood gas machines. The tank containing O2 is a 20% concentration. The barometric pressure is 760 mmHg on this particular day. Calculate the concentration of the O2 in mmHg so that you can compare your readouts to assure proper calibration.

  1. 162 mmHg
  2. 125 mmHg
  3. 158 mmHg
  4. 143 mmHg

 

Question 27

You are calibrating a spirometer with a super syringe, and after injecting 3L of air for three consecutive calibrations; the results are 2.8L, 3.0L, and 3.2L.
Based on these results, the spirometer is considered:

  1. Accurate
  2. Precise
  3. Valid
  4. Reliable

 

Question 28

Which of the following is equal to RV?

  1. FRC – ERV
  2. TLC – VC
  3. VC – IRV
  4. IC – IRV

 

Question 29

Which of the following is equal to IC?

  1. TLC – RV
  2. VC – ERV
  3. RLC – IRV
  4. VT + ERV

 

Question 30

A patient has a VC of 4200 ml, an FRC of 3300 ml, and ERV of 1500 ml. What is the patient’s RV?

  1. 2700 ml
  2. 3700 ml
  3. 1500 ml
  4. 1800 ml

 

Question 31

Results of a pulmonary function study on a patient indicate a VC of 3600 ml, a FRC of 2000 ml, and a RV of 1000 ml. What is the TLC?

  1. 5500 ml
  2. 7000 ml
  3. 4600 ml
  4. 8600 ml

 

Question 32

If VT is 650 ml, ERV is 1100 ml, and RV is 1150 ml; FRC would be equal to:

  1. 3650 ml
  2. 4750 ml
  3. 2250 ml
  4. 2900 ml

 

Question 33

Which of the following would be most consistent with an obstructive disorder?

  1. FEV1/FVC% less than 65% predicted
  2. 15% improvement in bronchodilator challenge
  3. Increased PEFR
  4. TLC values of 55% of predicted

 

Question 34

Compared to predicted normals, a patient has a normal FEV1/FVc ratio, normal FEF 25-75%, but a markedly reduced FVC. Which of the folloiwng is most likely the problem?

  1. A combined restrictive and obstructive disorder is present
  2. A restrictive disorder is present
  3. Poor patient effort during the test procedure
  4. An obstructive disorder is present

 

Question 35

Compared to predicted normals, a patient has a reduced FVC, RV, and TLC, and a reduced FEV1 and FEV1/FVC ratio. Which of the following is most likely the problem?

  1. Small airways obstruction is present
  2. A restrictive disorder is present
  3. An obstructive disorder is present
  4. Combined restrictive and obstructive disorder is present

 

Question 36

A patient has a prebronchodilator FEV1 value of 2.5 L/sec and a postbronchodilator value of 3,0 L/sec, what is the percent change?

  1. 15%
  2. 30%
  3. 20%
  4. 25%

 

Question 37

Wh ch of the following is the most likely diagnosis on the basis of the following PFT results?
FVC 80% predicted
FEV1 50% predicted
FEV1/FVC% 55% predicted
FEF 25-75% 40% predicted

  1. Silicosis
  2. Kyphoscoliosis
  3. Pneumothoras
  4. Chronic bronchitis

 

Question 38

Which of the following gases are needed to calibrate a N2 analyzer?

  1. 100% O2
  2. 21% O2
  3. 79% N2
  4. 10% N2

 

Question 39

A severly hypothermic patient is brought to the ER. The patient has a temperature of 82 Degrees F, agonal respirations and a heart rate of 30 beats per minute. CPR is initiated and an ABG is ordered. Which of the following inaccurate results would occur if the RCP failied to make a temperature correction to the ABG analyzer?

  1. Higher CO2, and lower O2 and pH thant acutal results
  2. Lower CO2 and O2, higher pH than actual results
  3. Elevated CO2 and O2, lower pH than actual results
  4. Results would not be affected

 

Question 40

When calibrating gas analyzers, which of the following should be calibrated back to a 0% reading as the last point?

  1. Nitrogen
  2. Oxygen
  3. Helium
  4. Carbon dioxide/carbon monoxide

 

Question 41

A medical gas analyzer that is capable of performing breath by breath analysis during a nitrogen wash out study is the:

  1. Mass spectrometry
  2. Infrared analyzer
  3. Nitrogen analyzer
  4. Gas chromatography

 

Question 42

Which of the following types of analyzers would be appropriate to use for measurement of exhaled CO2 when performing a Vd/Vt study at the bedside?

  1. Gas chromatograph
  2. Thermal conductive
  3. Infrared
  4. Wheatstone bridge

 

Question 43

Which of the following is an disadvantage of using the Gas Chromatgraph analzyer

  1. Expensive and hard to maintain
  2. Requires longer time for analysis
  3. Requires a vacuum and an ionization chamber
  4. Can analysis several gases at once

 

Question 44

Which of the following statements are correct regarding airway conductance (Gaw)?

  1. Gaw is the same as Ra
  2. Normal value is 0.36 o 1.70 L/sec/cmH2O
  3. Gaw increases as Raw decreases
  4. It is calculated by pressure difference divided by flowrate

 

Question 45

Which of the following is the correct classification or severity range for a Raw reading of 7.5 cmh2O/L/sec?

  1. Severe Raw
  2. Mild Raw
  3. Moderate Raw
  4. Normal Raw
Question 1

A correctly performed nitrogen washout test requires that the test last for:

  1. 7 minutes and/or a final N2 concentration of 10% is measured
  2. 10 minutes and/or until a final N2 concentration of 5% is measured
  3. A final concentration of 10% is measured for 3 successive breaths
  4. A final N2 concentration of 1.5% is measured for 3 successive breaths

 

Question 2

A helium dilution study is being performed on a patient with a history of asbestosis’ exposure. After the test is completed, the following information is obtained:A spirometer holding 7 liters of air (Vs) was used with an initial concentration of He analyzing at 10%. Final concentration of He analyzed at 8%. According to the above information, you would record the patient’s FRC to be:

  1. 3.58 Liters
  2. 4.26 Liters
  3. 1.75 Liters
  4. 750 ml

 

Question 3

A patient is to perform a nitrogen washout test for determination of FRC. At what point in the patient’s ventilation should the patient be switched in to 100% O2?

  1. At the end expiratory level
  2. At the beginning of normal expiration
  3. At the beginning of normal inspiration
  4. At the end inspiratory level

 

Question 4

A patient who cannot pant correctly during a body box test should be instructed to:

  1. Breathe at a slower rate and tidal volume
  2. Place hands on the cheeks and prevent movement during panting maneuver
  3. Close the glottis while panting
  4. Remove nose clips and continue panting

 

Question 5

A patient with air trapping must have determination of lung volumes for determination of FRC. The physician asks you to recommend the methods would best determine actual values for this patient. You would suggest:

  1. Nitrogen washout
  2. Helium dilution
  3. Body plethysmography
  4. Radiological estimation

 

Question 6

A patient’s vital capacity can be calculated by using which of the following equations?

  1. TLC – RV
  2. IC + FRC
  3. IRV + VT + ERV
  4. FRC + VT
  5. IC + FRC

 

Question 7

All of the following equations are correct with the EXCEPTION of:

  1. IC = IRV + VT
  2. VC = IC + FRC
  3. VT = IC – IRV
  4. ERV = VC – IC

 

Question 8

All of the following equipment would be necessary for a nitrogen washout test, EXCEPT:

  1. Valve that opens to 100% O2
  2. He analyzer
  3. N2 analyzer
  4. Spirometer and recording device

 

Question 9

All of the following statements are true regarding the use of the body plethysmograph EXCEPT:

  1. Patients should be taught correct technique by demonstration prior to testing
  2. The body plehtysmograph should be calibrated weekly
  3. PFT technicians should acquire at least three acceptable panting maneuvers
  4. IV’s should be temporarily disconnected prior to testing

 

Question 10

Body plethysmographs are most beneficial for the determination of:

  1. Peak expiratory flowrate
  2. Intrathoracic gas volume
  3. Airway resistance
  4. Intrapulmonary gas diffusion

 

Question 11

Calculate the IC when the TLC is 5500 ml and the FRC is 2300 ml.

  1. 2300 ml
  2. 3200 ml
  3. 5500 ml
  4. 7800 ml

 

Question 12

Calculate the RV when the TLC is 6200 ml and the VC is 4900 ml.

  1. 1200 ml
  2. 1100 ml
  3. 1300 ml
  4. 1400 ml

 

Question 13

During the measurement of FRC using the body plethysmograph, at least three to five satisfactory panting maneuvers should be obtained, with at least three FRC values that agree within:

  1. 5%
  2. 0.200 liters
  3. 7%
  4. 10%

 

Question 14

Given IRV = 2900 ml, Vt = 400 ml, ERV = 1350 ml, and RV = 1400 ml. The FRC would be calculated as:

  1. 3300 ml
  2. 2750 ml
  3. 1600 ml
  4. 4650ml

 

Question 15

Given IRV = 2900 ml, Vt = 400 ml, ERV = 1350 ml, and RV = 1400 ml. The IC would be calculated as:

  1. 6050 ml
  2. 3300 ml
  3. 1400 ml
  4. 4650ml

 

Question 16

Given IRV = 2900 ml, Vt = 400 ml, ERV = 1350 ml, and RV = 1400 ml. The TLC would be calculated as:

  1. 2750 ml
  2. 3300 ml
  3. 1600 ml
  4. 6050 ml

 

Question 17

Given IRV = 3000 ml, VT = 650 ml, ERV = 1100 ml, RV = 1150 ml
FRC is equal to:

  1. 3650 ml
  2. 2250 ml
  3. 2900 ml
  4. 4750 ml

 

Question 18

Given IRV = 3000 ml, VT = 650 ml, ERV = 1100 ml, RV = 1150 ml
IC is equal to:

  1. 3650 ml
  2. 2250 ml
  3. 4750 ml
  4. 2900 ml

 

Question 19

Given IRV = 3000 ml, VT = 650 ml, ERV = 1100 ml, RV = 1150 ml
TLC is equal to:

  1. 2900 ml
  2. 5900 ml
  3. 4800 ml
  4. 3650 ml

 

Question 20

Given IRV = 3000 ml, VT = 650 ml, ERV = 1100 ml, RV = 1150 ml
VC is equal to:

  1. 3650 ml
  2. 4750 ml
  3. 2900 ml
  4. 2250 ml

 

Question 21

Given: IRV = 2900 ml, Vt = 400 ml. ERV = 1350 ml, RV = 1400 ml. The VC would be calculated as:

  1. 2750 ml
  2. 3300 ml
  3. 6050 ml
  4. 4650 ml
Question 22

If the IC is 3200 ml, and the VT is 500 ml, what is the IRV?

  1. 3200 ml
  2. 2700 ml
  3. 500 ml
  4. 3700 ml

 

Question 23

Results of a pulmonary function study on a patient report a VC of 3600 ml, a FRC of 6000 ml, and an RV of 1000 ml. What is the total lung capacity?

  1. 9600 ml
  2. 7000 ml
  3. 8600 ml
  4. 4600 ml

 

Question 24

TLC is equal to which of the following?

  1. VC + RV
  2. IC + FRC
  3. VC + FRC
  4. IC + ERV

 

Question 25

The FRC measured by body plethysmography is 30% larger than that measured by Helium dilution. This difference is best explained by an increase in which of the following?

  1. Airway resistance
  2. Diffusing capacity
  3. Residual volume
  4. Lung compliance

 

Question 26

The largest volume of gas that can be expired from a resting end-expiratory level is known as the:

  1. Expiratory reserve volume
  2. Inspiratory reserve volume
  3. Residual volume
  4. Vital capacity

 

Question 27

The largest volume of gas that can be inspired above a normal tidal volume breath is the:

  1. Tidal volume
  2. Residual volume
  3. Inspiratory reserve volume
  4. Inspiratory capacity

 

Question 28

The operation of the body box is based on which of the following laws?

  1. Charles’
  2. Poiseuille’s
  3. Boyle’s
  4. Dalton’s

 

Question 29

The sum of IRV and Vt is equal to:

  1. VC
  2. FRC
  3. TLC
  4. IC

 

Question 30

The total amount of gas in the lungs following a maximum inspiration is described as the:

  1. Total lung capacity
  2. Vital capacity
  3. Inspiratory reserve volume
  4. Tidal volume

 

Question 31

The volume of gas in the lungs that can be exhaled from end-inspiratory level during normal or tidal breathing is the:

  1. Expiratory reserve volume
  2. Functional residual capacity
  3. Residual volume
  4. Total lung capacity

 

Question 32

The volume of gas which remains in the lung at the end of a maximum expiration is known as:

  1. Residual Volume
  2. Expiratory Reserve Volume
  3. Functional Residual Capacity
  4. Vital capacity

 

Question 33

When measuring FRC in the body plethysmograph, the relationship between mouth pressure and body box volume changes occur during:

  1. The closed-shutter maneuver
  2. The open-shutter maneuver
  3. Looping of the mouth pressure signal
  4. Hard and fast panting

 

Question 34

Which of the following are true concerning the measurement of FRC using the multiple-breath closed-circuit helium (He) dilution test:

  1. The volume in the spirometer and circuit must be known
  2. The test continues until equilibration (change in He concentration < 0.02% over 30
    seconds
  3. Nitrogen must be measured continuously
  4. Oxygen must be absorbed
  5. Carbon dioxide must be absorbed

 

Question 35

Which of the following could result in inaccurate results during a helium dilution test?I. Ruptured eardrumII. “Switch-in” occurred prematurelyIII. Failure to use noseclips during test

  1. Ruptured eardrum
  2. “Switch-in” occurred prematurel
  3. Failure to use noseclips during test

 

Question 36

Which of the following equations is INCORRECT for calculating the total lung capacity?

  1. TLC = IRV + VT + ERV
  2. TLC = IC + FRC
  3. TLC = VC + RV
  4. TLC = IRV +VT + ERV+ RV

 

Question 37

Which of the following is equal to RV?

  1. FRC – ERV
  2. TLC – VC
  3. VC – ERV
  4. IC – IRV

 

Question 38

Which of the following methods of lung volume determination correlates best with body plethysmography in patient’s with obstructive diseases?

  1. Helium dilution
  2. Single-breath washout
  3. Radiological estimation
  4. Nitrogen washout

 

Question 39

Which of the following methods would provide the most accurate determination of the volume of gas in the lungs at end-tidal expiration for a patient who has severe emphysema?

  1. Nitrogen washout
  2. Body-box
  3. Helium dilution
  4. Single breath studies

 

Question 40

Which of the following parameters cannot be directly obtained from a spirometry tracing?

  1. IRV
  2. FRC
  3. IC
  4. ERV

 

Question 41

Which of the following statements are correct about the measurement of FRC by the nitrogen washout method?

  1. The patient is required to pant during the maneuver
  2. The test is continued until alveolar N2 is less than 1.5%
  3. Patient breathes 100% O2
  4. A nitrogen analyzer is required

 

Question 42

Which of the following test can be used to determine FRC?

  1. FVC
  2. He Dilution
  3. Nitrogen Washout
  4. Peak flow studies

 

Question 43

While performing a closed-circuit gas dilution test, the patient’s breathing pattern begins to increase and an increase in the patient’s tidal volume is noticed. Which of the following best explains the patient’s symptoms?

  1. The CO2 scrubber is missing from the circuit
  2. The patient has exerted too much effort during expiration
  3. The patient has developed bronchospasm
  4. The patient is fatigued from testing

 

Question 44

You have just completed a Nitrogen washout test to determine a patient’s FRC. The computer has given you an erroneous reading and you wish to calculate the FRC yourself using the following formula: The following results are available:Initial N2 reading – 75%. Final N2 reading – 9%. Exhaled volume in Tissot spirometer – 26 Liters.What would you record as your patient’s FRC?

  1. 2.97 L
  2. 4.12 L
  3. 3.52 L
  4. 3.12 L

 

Question 45

You instruct your patient to take a maximum inspiration followed by a maximum expiration. You have just instructed your patient to perform a:

  1. Inspiratory Reserve Volume
  2. Tidal volume breath
  3. Vital Capacity
  4. Inspiratory Capacity
Question 1

The following pulmonary function test data are measured on a 61 year-old man complaining of shortness of breath:

ParameterPredicted ValueMeasured ValuePredicted
FVC (L)4.222.9269
FEV1 (L)3.252.6681
FEV1/FVC7791
TLC (L)6.543.6355
RV (L)2.781.7964
DL,CO (mL/min/mm Hg)24.211.347

Which disease process is most consistent with these data?

  1. Cystic fibrosis
  2. Emphysema
  3. Interstitial pulmonary fibrosis
  4. Asthma

 

Question 2

A patient has the following lung volume data:

ParameterMeasured%Predicted
SVC (L)2.9571
FRC (L)1.8567
RV (L)1.0375
TLC (L)3.9867

The most likely interpretation of these data is:

  1. Obstructive pattern
  2. Restrictive pattern
  3. Hyperinflation
  4. Normal lung volumes

 

Question 3

A normal RV/TLC ratio value is indicated by:

  1. 25%
  2. 40%
  3. 45%
  4. 15%

 

Question 4

A patient has the following results from spirometry and N2 washout FRC determination:

ParameterPredicted ValueMeasured ValuePredicted
VC4.6L4.7L98%
FRC8.2L3.8L216%
RV4.8L1.5 L186%
TLC10.2L7.5L136%
RV/TLC47%20%

Which of the following best explains these findings?

  1. The patient has severe hyperinflation
  2. The patient has severe air trapping
  3. The patient has normal lung volumes
  4. The patient has severe restriction

 

Question 5

A pulmonary function test is performed on a patient with the following results:

ParameterPredictedActual(Measured)
FVC3.20L1.92L
FEV12.20L1.94L
FEV1/FVC%70%85%
FEF25-75%3.90L2.80L
FRC2.20L1.43L
TLC4.50L2.84L

Which of the following is the appropriate interpretation for these results?

  1. Combined obstructive and restrictive disease
  2. Mild restrictive disease
  3. Mild obstructive disease
  4. Severe obstructive disease

 

Question 6

Carbon monoxide is the recommended gas used in determining DLCO because:

  1. It has a greater affinity for HB molecules than O2
  2. It will oxidize the iron atoms in the Hb molecules
  3. Reduces the solubility of O2 in the plasma
  4. It shifts the O2Hb dissociation curve to the right

 

Question 7

Diffusion studies can be performed by which of the following test?

  1. Single-breath technique (DLCOSB)
  2. FVC
  3. Oxygen consumption
  4. Steady-state technique (DLCOSS)

 

Question 8

Examples of restrictive disease processes include:

  1. Emphysema
  2. Pulmonary fibrosis
  3. Asthma
  4. Histoplasmosis
  5. ARDS

 

Question 9

Factors that can limit the rate of diffusion across the Alveolar/Capillary membrane include:

  1. Decreased surface area
  2. Increased distance for gas molecules to travel
  3. Decreased pressure gradients between air and blood
  4. Solubility coefficients of gases in a liquid

 

Question 10

In patients with emphysema the DL,CO is reduced because of:

  1. Low FEV1
  2. An increase in lung volume
  3. Decreased pulmonary artery pressure
  4. Loss of alveolar-capillary membrane surface area

 

Question 11

In single-breath diffusion capacity, the recommended time for breath holding is:

  1. 12 seconds
  2. 10 seconds
  3. 7 seconds
  4. 5 seconds

 

Question 12

Obstructive disorders with air-trapping display which of the following values

  1. Increased RV
  2. Increased VC
  3. Decreased FRC
  4. Normal TLC

 

Question 13

Patient conditions that result in increased DLCO values include which of the following?

  1. Exercise
  2. Left heart failure
  3. Emphysema
  4. Renal failure
  5. Asthma

 

Question 14

The movement of oxygen in alveolar gas, across the alveolar-capillary membrane, into the blood, and the exchange of carbon dioxide in the reverse direction is caused by:

  1. Ventilation
  2. Distribution
  3. Osmosis
  4. Diffusion

 

Question 15

The results of a patient’s spirometry are as follows:

ParameterPredictedActual%Predicted
FVC3.0L1.9L63%
FEV12.09L1.85L89%
FEV1/FVC%70%97%
FRC2.50L1.70L68%
TLC4.70L3.0L64%

The most appropriate interpretation of the study is:

  1. Patient has emphysema
  2. Patient has sarcoidosis
  3. Patient has asthma
  4. Normal PFT

 

Question 16

The volume of gas discarded before collecting the alveolar sample when performing a single breath diffusing capacity is called:

  1. Washout volume
  2. Compressible gas volume
  3. Deadspace volume
  4. Back extrapolated volume

 

Question 17

When performing a DLCOSB, the inspired volume should be at least what percent of the VC to be valid?

  1. 85%
  2. 100%
  3. 70%
  4. 80%

 

Question 18

When performing the single breath CO diffusion capacity (DLCOSB) test, the patient is instructed to inhale to TLC a mixture of:

  1. 0.1% CO, 10% helium, 20% O2 and remainder air
  2. 0.5% CO, 15% helium and remainder O2
  3. 0.5% CO, 10% helium, and remainder nitrogen
  4. 0.3% CO, 10% helium, and remainder air

 

Question 19

When preparing a patient for the administration of a diffusing capacity test

  1. The patient should be in the sitting position and wearing nose clips
  2. Supplemental O2 should be worn during a DLCO test
  3. The patient should sit and rest at least 5 minutes prior to the test
  4. The patient should refrain from smoking before the test.
  • The patient should eat a full meal prior to testing

 

Question 20

Which of the following are characteristic of a restrictive lung disease when measured volumes are compared with predicted volumes?

  1. The VC is increased
  2. The FRC is decreased
  3. The RV is decreased
  4. The RV/TLC ratio is increased

 

Question 21

Which of the following gas analyzers are typically needed to perform DLCO testing?

  1. CO analyzer
  2. N2 analyzer
  3. He analyzer
  4. CO2 analyzer

 

Question 22

Which of the following is a normal DLCO measurement?

  1. 30 ml CO/min/mmHg STPD
  2. 25 ml CO/min/mmHg STPD
  3. 35 ml CO/min/mmHg STPD
  4. 20 ml CO/min/mmHg STPD

 

Question 23

Which of the following is the most likely diagnosis on the basis of the pulmonary function results below?
FVC 80% of predicted
FEV1 59% of predicted
FEV1/FVC% 55% of predicted
FEF 25-75% 40% of predicted
DLCO 95% of predicted

  1. Chronic Bronchitis
  2. Kyphoscolios
  3. Emphysema
  4. Silicosis

 

Question 24

Which of the following methods can be used to determine lung volumes?

  1. Body plethysmograph
  2. Nitrogen washout study
  3. Bedside spirometry
  4. Helium dilution
Question 25

Which of the following patient conditions can decrease the DLCO?

  1. Decreased HB
  2. Exercise
  3. Supine position
  4. Lung resection
Question 1

Which of the following is a normal respiratory exchange ratio (RER)?

  1. 0.5
  2. 0.6
  3. 0.8
  4. .10

 

Question 2

Which of the following parameters measured during a cardiopulmonary stress test is a good indicator of workload achieved or how well a person can exercise?

  1. VO2
  2. VCO2
  3. RQ of 1.2
  4. Blood pressure of 90/60 after 5 minutes of testing

 

Question 3

A patient with suspected asthma performs a methacholine challenge. The following data are recorded:

Baseline – 4.1L (99% of predicted)
Diluent – 4.0 L
First dose – 0.0625 mg/ml – 3.5 L
Second dose – 0.250 mg/ml – 3.0 L
Third dose – 1.0 mg/ml – 2.7 L
Fourth dose – 4.0 mg/ml – 2.2 L

Which of the following best describes these findings?

  1. The test was negative
  2. The test was positive after the first dose of methacholine
  3. The test was positive after the second dose of methacholine
  4. The patient does not have asthma

 

Question 4

A purpose of using the steady-state protocol would be too:

  1. Determine response to medication
  2. Determine maximum exercise capacity
  3. Determine if blockages to heart exist
  4. Determine if patient is a candidate to run a marathon

 

Question 5

Which of the following statements are true regarding bronchoprovocation studies?

  1. Can assess the severity of asthma
  2. Most often use Methacholine as the agent that is administered by aerosol
  3. Generally uses changes in patient’s PEFR value as an indicator of the
    patient’s response during the test
  4. Uses 20% decrease in FEV1 as an indicator that a significant
    bronchoconstriction response has occurred

 

Question 6

In bronchial provocation testing, the minimal index of positive response is a:

  1. 20% increase in FEV1
  2. 10% increase in FEV1
  3. 20% decrease in FEV1
  4. 10% decrease in FEV1

 

Question 7

A patient is seen by his pulmonologist with chief complaint of being dyspneic most of the time even when he tries to walk to his mailbox. What test would the pulmonologist order for this patient?

  1. Cardiac stress testing
  2. Lung compliance study
  3. Cardiopulmonary stress testing
  4. Methacholine challenge testing

 

Question 8

Which of the following statements BEST describes anaerobic threshold?

  1. Occurs when heart rate exceeds 175 beats/min
  2. Occurs when patient’s minute ventilation equals his MVV
  3. Occurs when anaerobic metabolism begins to supplement aerobic metabolism
  4. Occurs when S-T changes begin to occur on cardiac monitor

 

Question 9

Criteria for termination of an exercise test include:

  1. Chest pain with ST segment changes
  2. Diastolic pressure change from 88 to 94 mmHg
  3. Dizziness
  4. Increased heart rates with exercise

 

Question 10

A 57-year old male is scheduled for an exercise stress test using the ergometer exercise bike. Calculate 60% of his maximum heart rate.

  1. 160
  2. 130
  3. 105
  4. 98

 

Question 11

In a healthy adult subject with a resting BP of 120/80, which of the following responses would be expected during a maximal incremental exercise test?

  1. Systolic increases to 200, diastolic to 90
  2. Systolic increases to 300, diastolic to 140
  3. Systolic increases to 160, diastolic to 130
  4. Systolic remains at 120, diastolic decreases to 60

 

Question 12

It is determined that a patient has a FEV1 of 3.3 L.The patient is unable to perform an MVV maneuver. The estimated MVV would be:

  1. 80 Liters
  2. 116 Liters
  3. 150 Liters
  4. 176 Liters

 

Question 13

In order to ensure safety for methacholine challenge testing, the PFT technologist should:

  1. Have a physician readily available if needed
  2. Test in a well-ventilated room
  3. Warn those in the testing area to sit or stand way from nebulized medication

 

Question 14

Which of the following are normal ventilatory responses to exercise?

  1. Minute ventilation will increase linearly with exercise
  2. Breathing reserve will be decreased in patients with cardiovascular disease
  3. Patietns with restrictive disease will increase minute ventilation by increasing respiratory
    rate

 

Question 15

A relative contraindications for conducting a cardiopulmonary exercise evaluation include all of the following except:

  1. diastolic blood pressure greater than 90 mm Hg
  2. serious cardiac arrhythmias
  3. unstable angina
  4. recent myocardial infarction

 

Question 16

Contraindications to methacholine challenge testing include:

  1. Recent MI
  2. Previous FEV1 test resulting in 70% predicted value
  3. Uncontrolled hypertension
  4. Patient unable to comprehend instructions to procedure

 

Question 17

You are performing an exercise stress test to determine cardiac ability when suddenly your patient develops a second degree heart block and pallor.. What action should you take?

  1. Slow the speed and grade of treadmill and continue exercising
  2. Stop the test and administer oxygen
  3. Do nothing, this is normal
  4. Stop the test and administer lidocaine

 

Question 18

The purpose of obtaining an anaerobic threshold is to:

  1. Produce respiratory acidosis
  2. Prescribe an effective exercise program
  3. Increase the respiratory rate
  4. Produce metabolic alkalosis

 

Question 19

In order to perform cardiopulmonary stress testing, it is decided to exercise a patient using a cycle ergometer. Workload for this piece of equipment would be increased by which of the following?

  1. Adjusting the speed of pedaling
  2. Increased incline and speed of equipment
  3. Increasing pedaling frequency and resistance
  4. Decreasing incline while increasing speed of device

 

Question 20

All of the following would be necessary equipment to perform a cardiopulmonary exercise test EXCEPT:

  1. Breating valves
  2. Small volume nebulizer
  3. Spirometer
  4. Emergency equipment

 

Question 21

What RER suggest that the anaerobic threshold has been reached for a patient performing a cardiopulmonary stress test?

  1. 1.0
  2. 0.8
  3. 0.6
  4. 0.4

 

Question 22

A cardiopulmonary exercise evaluation is conducted on a patient before participation in pulmonary rehabilitation for what purposes?

  1. to determine the patient’s baseline exercise capacity
  2. to develop an exercise prescription (including target heart rate)
  3. to determine how much desaturation occurs with exercise

 

Question 23

When preparing a patient for a methacholine challenge study, the PFT technologist should inform the patient to:

  1. Not take any bronchodilators prior to the test
  2. Avoid caffeinated beverages and smoking at least 24 hours prior to testing
  3. Postpone study if patient has had viral infection in the last 3 weeks
  4. Avoid antigen exposure at least 24 hours prior to testing
Question 24

Which of the following exercise protocols would you recommend to implement a maximal symptom-limited incremental proocol?

  1. cycle ergometer at 50 watts for 10 minutes
  2. A treadmill at a speed of 5 miles/hour with 10% grade increased by 2% every 3 minute
  3. A constant treadmill with increasing speed every 8 minutes
  4. A cycle ergometer at 50 watts for 8 minutes

 

Question 25

Absolute contraindications to exercise stress testing include:

  1. Ventricular arrhythmias
  2. Complaint of dyspnea
  3. Unstable angina
  4. SpO2 of 75% on room air

 

Question 26

Which of the following is an indication for cardiopulmonary stress exercise testing?

  1. Determine ventilatory limitations to exercise
  2. Evaluate patients prior to surgery
  3. Evaluate patients with cardiovascular disease

 

Question 27

A pulmonologist asks you to assess airway responsiveness during a pulmonary function exam. He wants to rule out asthma from chronic bronchitis in a patient complaining of nocturnal wheezing. You should consider all of the following tests EXCEPT:

  1. Thoracic gas volume
  2. Histamine challenge test
  3. Methacholine challenge test
  4. Mannitol challenge test

 

Question 28

The final interpreted report of results from a methacholine challenge study should include:

  1. The PC 20% FEV1
  2. Patient’s weight
  3. Provocative substance used
  4. Family history

 

Question 29

Which of the following are normal gas exchange responses to exercise:

  1. VO2 (oxygen consumption) increases
  2. VCO2 (CO2 production) decreases
  3. Physiologic deadspace increases
  4. Metabolic acidosis can result when PaCO2 exceeds 60% of VO2 max

 

Question 30

All of the following should be monitored during a cardiopulmonary exercise evaluation except:

  1. Respiratory rate
  2. HbO2 saturation
  3. ECG and blood pressure
  4. Raw