Pulmonary Function Testing Final Exam (Practice Questions)

Pulmonary function testing (PFT) is critical in diagnosing and managing respiratory conditions. It encompasses a variety of tests that measure lung volume, capacity, rates of flow, and gas exchange, providing essential information about lung function.

This study guide provides a comprehensive overview of the key concepts and procedures involved in PFT, equipping you with the knowledge needed to excel on your final exam.

Additionally, it includes practice questions to test your understanding and reinforce your learning, ensuring you are well-prepared to tackle the exam with confidence.

What is Pulmonary Function Testing?

Pulmonary function testing (PFT) is a series of noninvasive tests that measure how well the lungs are functioning. These tests evaluate lung volume, capacity, flow rates, and gas exchange, providing critical information about the respiratory system’s efficiency.

Common types include spirometry, which measures airflow and lung volumes, and diffusion studies, which assess how well oxygen passes from the lungs into the blood.

PFTs are essential for diagnosing and monitoring respiratory conditions such as asthma, chronic obstructive pulmonary disease (COPD), and other disorders affecting breathing, helping healthcare professionals develop appropriate treatment plans.

PFT Final Exam Practice Questions:

1. A galvanic fuel cell oxygen analyzer fails to reach the proper reading when analyzing an FIO2 of 100%. The respiratory care practitioner should:
A. Continue using the analyzer
B. Replace the analyzer with a new one
C. Change the fuel cell
D. Replace the battery

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?
A. Lower CO2
B. Higher pH
C. Lower PO2
D. All of the above

3. A patient with kyphoscoliosis performs maximum inspiratory and expiratory maneuvers with the following results: MIP +110 MEP -160. The correct interpretation would be:
A. The results are normal
B. The results are invalid and should not be reported
C. The results are normal on inspiration and abnormal on expiration
D. The results are normal on expiration and abnormal on inspiration

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?
A. Cardiac pulsations are recorded by the pressure transducer
B. Inspiration causes a negative pressure deflection
C. Expiration causes a negative pressure deflection
D. No pressure change occurs during inspiration

5. All of the following statements are true concerning the Helium analyzer EXCEPT:
A. Measures percentage of He
B. Are safe to use with flammable gases
C. Are often found in pulmonary function equipment
D. Makes use of thermal conductivity

6. All of the following statements concerning blood-based controls used in the ABG lab are correct EXCEPT:
A. They require refrigeration
B. They consist of human red blood cells
C. They must be run every 8 hours
D. They are packaged in 2-3 ml ampoules

7. At what lung level should a maximum inspiratory pressure maneuver be performed?
A. Functional residual capacity
B. Residual volume
C. End-tidal inspiration
D. Total lung capacity

8. Correct expressions for the relationship between respiratory rate, tidal volume, and minute ventilation include:
A. Rate = VE Vt
B. Vt = VE Rate
C. VE = Rate x Vt
D. All of the above

9. Data used for detecting a blood-gas machine that is out of control is:
A. The + or – 2 standard deviation
B. The + or – 4 standard deviation
C. The + or – 1 standard deviation
D. The + or – 3 standard deviation

10. How would you correct an out of control situation for a blood gas analyzer?
A. Replace the electrode that displays the out of control error
B. Clean the membrane with the out of control error with a pumice stone
C. Nothing is required for an out of control situation, continue to use the blood gas analyzer
D. Remove the blood gas analyzer and replace it with a new one

11. It would be appropriate to use the Wright respirometer to measure which of the following parameters?
A. Tidal volume
B. Vital capacity
C. Minute volume
D. All of the above

12. Running the same sample on one or more other blood gas analyzers in the ABG lab to assure accuracy is known as:
A. Monthly quality assurance
B. Multiple machine analysis
C. Proficiency Testing
D. Preventative maintenance

13. The RRT has been asked to measure a patient’s MIP. Which of the following instruments should be selected to obtain this measurement?
A. Pressure strain-gauge
B. Pneumotachometer
C. Pressure manometer
D. Pressure transducer

14. 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?
A. 132 ml
B. 408 ml
C. 180 ml
D. 735 ml

15. What should the pulmonary function technologist take into consideration with each test before reporting test results?
A. Equipment performance
B. Technologist performance
C. Patient performance
D. All of the above

16. When calibration gas analyzers, which of the following should be calibrated to a 0% reading as the first point (percentage)?
A. Nitrogen
B. Carbon dioxide/Carbon monoxide
C. Helium
D. All of the above

17. When measuring minute ventilation using a Wright’s respirometer:
A. A pressure manometer is needed to determine values
B. The number of breaths taken by the patient should be counted during the measuring period
C. A value obtained by measuring inspiratory volumes will be smaller than expiratory volumes
D. The tidal volume is collected (measured) for three minutes

18. Which agency sets forth standards that must be met to assure accuracy of equipment?
A. ALA (American Lung Association)
B. CGA (Compressed Gas Association)
C. ACCP (American College Chest Physicians)
D. ATS (American Thoracic Society)

19. Which of the following diseases will most likely exhibit an increased compliance?
A. Pulmonary fibrosis
B. Chronic bronchitis
C. Scoliosis
D. Asbestosis

20. Which of the following statements are correct regarding total lung and thoracic compliance?
A. There is less inspired volume per cmH2O in CLT than in either CL or CT alone
B. There is more inspired volume per cmH2O in CT than in CL
C. There is less inspired volume per cmH2O in CT than in CL
D. There is more inspired volume per cmH2O in CLT than in CT alone

21. Which of the following test is used as an indicator of ventilatory inspiratory muscle strength?
A. Forced vital capacity
B. Expiratory reserve volume
C. Maximal inspiratory pressure
D. Maximal expiratory pressure

22. Which of the following types of equipment would enable the measurement of the transpulmonary pressure, which is needed to calculate pulmonary compliance?
A. Fiber-optic bronchoscope
B. Intraesophageal balloon
C. Transcutaneous PO2 electrode
D. Co-oximeter

23. Which of the following is NOT a good indication to perform MIPs and MEPs?
A. Inability to cough effectively
B. Myasthenia gravis
C. Pulmonary hypertension
D. Amothopic lateral sclerosis

24. While working in a PFT lab, you discover that the nitrogen analyzer is not functioning correctly. You would do which of the following?
A. Go ahead and use the analyzer as long as it is working
B. Replace the nitrogen analyzer with a helium analyzer
C. Take the analyzer to Biomedical lab for corrective maintenance
D. Ask a technician to perform preventative maintenance on the analyzer

25. 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.
A. 162 mmHg
B. 125 mmHg
C. 158 mmHg
D. 143 mmHg

26. 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:
A. Accurate
B. Precise
C. Valid
D. Reliable

27. Which of the following is equal to RV?
A. FRC – IRV
B. TLC – VC
C. VC – IRV
D. IC – IRV

28. Which of the following is equal to IC?
A. TLC – RV
B. VC – ERV
C. RLC – IRV
D. VT + ERV

29. A patient has a VC of 4200 ml, an FRC of 3300 ml, and ERV of 1500 ml. What is the patient’s RV?
A. 2700 ml
B. 3700 ml
C. 1500 ml
D. 1800 ml

30. Results of a pulmonary function study on a patient indicate a VC of 3600 ml, an FRC of 2000 ml, and an RV of 1000 ml. What is the TLC?
A. 5500 ml
B. 7000 ml
C. 4600 ml
D. 8600 ml

31. If VT is 650 ml, ERV is 1100 ml, and RV is 1150 ml; FRC would be equal to:
A. 3650 ml
B. 4750 ml
C. 2250 ml
D. 2900 ml

32. Which of the following would be most consistent with an obstructive disorder?
A. FEV1/FVC% greater than 80% predicted
B. 15% improvement in bronchodilator challenge
C. Increased PEFR
D. TLC values of 55% of predicted

33. Compared to predicted normal values, a patient has a normal FEV1/FVC ratio, normal FEF 25-75%, but a markedly reduced FVC. Which of the following is most likely the problem?
A. A combined restrictive and obstructive disorder is present
B. A restrictive disorder is present
C. Poor patient effort during the test procedure
D. An obstructive disorder is present

34. 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?
A. Small airways obstruction is present
B. A restrictive disorder is present
C. An obstructive disorder is present
D. Combined restrictive and obstructive disorder is present

35. A patient has a pre-bronchodilator FEV1 value of 2.5 L/sec and a postbronchodilator value of 3,0 L/sec, what is the percent change?
A. 15%
B. 30%
C. 20%
D. 25%

36. Which 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
A. Silicosis
B. Kyphoscoliosis
C. Pneumothorax
D. Chronic bronchitis

37. Which of the following gases are needed to calibrate a N2 analyzer?
A. 100% CO2
B. 21% O2
C. 79% N2
D. 10% N2

38. A severely 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 failed to make a temperature correction to the ABG analyzer?
A. Higher CO2, and lower O2 and pH than actual results
B. Lower CO2 and O2, higher pH than actual results
C. Elevated CO2 and O2, lower pH than actual results
D. Results would not be affected

39. When calibrating gas analyzers, which of the following should be calibrated back to a 0% reading as the last point?
A. Nitrogen
B. Oxygen
C. Nitric oxide
D. Carbon dioxide/carbon monoxide

40. A medical gas analyzer that is capable of performing breath by breath analysis during a nitrogen washout study is the:
A. Mass spectrometry
B. Infrared analyzer
C. Nitrogen analyzer
D. Gas chromatography

41. 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?
A. Gas chromatograph
B. Thermal conductive
C. Infrared
D. Wheatstone bridge

42. Which of the following is a disadvantage of using the Gas Chromatograph analyzer?
A. Expensive and hard to maintain
B. Requires longer time for analysis
C. Requires a vacuum and an ionization chamber
D. Can analysis several gases at once

43. Which of the following statements are correct regarding airway conductance (Gaw)?
A. Gaw is the same as Ra
B. Normal value is 0.96 to 2.70 L/sec/cmH2O
C. Gaw increases as Raw decreases
D. It is calculated by pressure difference divided by flowrate

44. Which of the following is the correct classification or severity range for a Raw reading of 7.5 cmh2O/L/sec?
A. Severe Raw
B. Mild Raw
C. Moderate Raw
D. Normal Raw

45. A correctly performed nitrogen washout test requires that the test last for:
A. 7 minutes and/or a final N2 concentration of 10% is measured
B. 10 minutes and/or until a final N2 concentration of 5% is measured
C. A final concentration of 10% is measured for 3 successive breaths
D. A final N2 concentration of 1.5% is measured for 3 successive breaths

46. 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:
A. 3.58 Liters
B. 4.26 Liters
C. 1.75 Liters
D. 750 ml

47. 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 into 100% O2?
A. At the end-expiratory level
B. At the beginning of normal expiration
C. At the beginning of normal inspiration
D. At the end-inspiratory level

48. A patient who cannot pant correctly during a body box test should be instructed to:
A. Breathe at a slower rate and tidal volume
B. Place hands on the cheeks and prevent movement during panting maneuver
C. Close the glottis while panting
D. Remove nose clips and continue panting

49. 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:
A. Nitrogen washout
B. Helium dilution
C. Body plethysmography
D. Forced vital capacity

50. A patient’s vital capacity can be calculated by using which of the following equations?
A. TLC – IC
B. IC + FRC
C. IRV + VT + ERV
D. FRC + VT

51. All of the following equations are correct with the EXCEPTION of:
A. IC = IRV + VT
B. VC = IC + FRC
C. VT = IC – IRV
D. ERV = VC – IC

52. All of the following equipment would be necessary for a nitrogen washout test, EXCEPT:
A. Valve that opens to 100% O2
B. He analyzer
C. N2 analyzer
D. Spirometer and recording device

53. All of the following statements are true regarding the use of the body plethysmograph EXCEPT:
A. Patients should be taught correct technique by demonstration prior to testing
B. The body plethysmograph should be calibrated weekly
C. PFT technicians should acquire at least three acceptable panting maneuvers
D. IV’s should be temporarily disconnected prior to testing

54. Body plethysmographs are most beneficial for the determination of:
A. Peak expiratory flowrate
B. Intrathoracic gas volume
C. Inspiratory resistance
D. Intrapulmonary gas diffusion

55. Calculate the IC when the TLC is 5500 ml and the FRC is 2300 ml.
A. 2300 ml
B. 3200 ml
C. 5500 ml
D. 7800 ml

56. Calculate the RV when the TLC is 6200 ml and the VC is 4900 ml.
A. 1200 ml
B. 1100 ml
C. 1300 ml
D. 1400 ml

57. 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:
A. 5%
B. 0.200 liters
C. 7%
D. 10%

58. Given IRV = 2900 ml, Vt = 400 ml, ERV = 1350 ml, and RV = 1400 ml. The FRC would be calculated as:
A. 3300 ml
B. 2750 ml
C. 1600 ml
D. 4650ml

59. Given IRV = 2900 ml, Vt = 400 ml, ERV = 1350 ml, and RV = 1400 ml. The IC would be calculated as:
A. 6050 ml
B. 3300 ml
C. 1400 ml
D. 4650ml

60. Given IRV = 2900 ml, Vt = 400 ml, ERV = 1350 ml, and RV = 1400 ml. The TLC would be calculated as:
A. 2750 ml
B. 3300 ml
C. 1600 ml
D. 6050 ml

61. Given IRV = 3000 ml, VT = 650 ml, ERV = 1100 ml, RV = 1150 ml, FRC is equal to:
A. 3650 ml
B. 2250 ml
C. 2900 ml
D. 4750 ml

62. Given IRV = 3000 ml, VT = 650 ml, ERV = 1100 ml, RV = 1150 ml, IC is equal to:
A. 3650 ml
B. 2250 ml
C. 4750 ml
D. 2900 ml

63. Given IRV = 3000 ml, VT = 650 ml, ERV = 1100 ml, RV = 1150 ml, TLC is equal to:
A. 2900 ml
B. 5900 ml
C. 4800 ml
D. 3650 ml

64. Given IRV = 3000 ml, VT = 650 ml, ERV = 1100 ml, RV = 1150 ml, VC is equal to:
A. 3650 ml
B. 4750 ml
C. 2900 ml
D. 2250 ml

65. Given: IRV = 2900 ml, Vt = 400 ml. ERV = 1350 ml, RV = 1400 ml. The VC would be calculated as:
A. 2750 ml
B. 3300 ml
C. 6050 ml
D. 4650 ml

66. If the IC is 3200 ml, and the VT is 500 ml, what is the IRV?
A. 3200 ml
B. 2700 ml
C. 500 ml
D. 3700 ml

67. Results of a pulmonary function study on a patient report a VC of 3600 ml, an FRC of 6000 ml, and an RV of 1000 ml. What is the total lung capacity?
A. 9600 ml
B. 7000 ml
C. 8600 ml
D. 4600 ml

68. TLC is equal to which of the following?
A. VC + RV
B. IC + FRC
C. VC + FRC
D. IC + ERV

69. 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?
A. Airway resistance
B. Diffusing capacity
C. Residual volume
D. Lung compliance

70. The largest volume of gas that can be expired from a resting end-expiratory level is known as the:
A. Expiratory reserve volume
B. Inspiratory reserve volume
C. Residual volume
D. Vital capacity

71. The largest volume of gas that can be inspired above a normal tidal volume breath is the:
A. Tidal volume
B. Residual volume
C. Inspiratory reserve volume
D. Inspiratory capacity

72. The operation of the body box is based on which of the following laws?
A. Charles’
B. Poiseuille’s
C. Boyle’s
D. Dalton’s

73. The sum of IRV and Vt is equal to:
A. VC
B. FRC
C. TLC
D. IC

74. The total amount of gas in the lungs following a maximum inspiration is described as the:
A. Total lung capacity
B. Vital capacity
C. Inspiratory reserve volume
D. Tidal volume

75. The volume of gas in the lungs that can be exhaled from end-inspiratory level during normal or tidal breathing is the:
A. Expiratory reserve volume
B. Functional residual capacity
C. Residual volume
D. Total lung capacity

76. The volume of gas which remains in the lung at the end of a maximum expiration is known as:
A. Residual Volume
B. Expiratory Reserve Volume
C. Functional Residual Capacity
D. Vital capacity

77. When measuring FRC in the body plethysmograph, the relationship between mouth pressure and body box volume changes occur during:
A. The closed-shutter maneuver
B. The open-shutter maneuver
C. Looping of the mouth pressure signal
D. Hard and fast panting

78. Which of the following are true concerning the measurement of FRC using the multiple-breath closed-circuit helium (He) dilution test:
A. The volume in the spirometer and circuit must be known
B. The test continues until equilibration (change in He concentration < 0.02% over 30 seconds
C. Carbon dioxide must be absorbed
D. All of the above

79. Which of the following could result in inaccurate results during a helium dilution test?
A. Ruptured eardrum
B. “Switch-in” occurred prematurely
C. Failure to use noseclips during test
D. All of the above

80. Which of the following equations is INCORRECT for calculating the total lung capacity?
A. TLC = IRV + VT + ERV
B. TLC = IC + FRC
C. TLC = VC + RV
D. TLC = IRV +VT + ERV+ RV

81. Which of the following is equal to RV?
A. FRC – ERV
B. TLC – IC
C. VC – ERV
D. IC – IRV

82. Which of the following methods of lung volume determination correlates best with body plethysmography in patients with obstructive diseases?
A. Helium dilution
B. Single-breath washout
C. Radiological estimation
D. Nitrogen washout

83. 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?
A. Nitrogen washout
B. Body-box
C. Helium dilution
D. Single breath studies

84. Which of the following parameters cannot be directly obtained from a spirometry tracing?
A. IRV
B. FRC
C. IC
D. ERV

85. Which of the following statements are correct about the measurement of FRC by the nitrogen washout method?
A. A nitrogen analyzer is required
B. The test is continued until alveolar N2 is less than 1.5%
C. Patient breathes 100% O2
D. All of the above

86. Which of the following test can be used to determine FRC?
A. FVC
B. Peak flow
C. Nitrogen Washout
D. Peak flow studies

87. 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?
A. The CO2 scrubber is missing from the circuit
B. The patient has exerted too much effort during expiration
C. The patient has developed bronchospasm
D. The patient is fatigued from testing

88. 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. 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?
A. 2.97 L
B. 4.12 L
C. 3.52 L
D. 3.12 L

89. You instruct your patient to take a maximum inspiration followed by a maximum expiration. You have just instructed your patient to perform a:
A. Inspiratory Reserve Volume
B. Tidal volume breath
C. Vital Capacity
D. Inspiratory Capacity

90. A normal RV/TLC ratio value is indicated by:
A. 25%
B. 40%
C. 45%
D. 15%

91. Carbon monoxide is the recommended gas used in determining DLCO because:
A. It has a greater affinity for HB molecules than O2
B. It will oxidize the iron atoms in the Hb molecules
C. Reduces the solubility of O2 in the plasma
D. It shifts the O2Hb dissociation curve to the right

92. Diffusion studies can be performed by which of the following test?
A. Single-breath technique (DLCOSB)
B. FVC
C. Oxygen consumption
D. Steady-state technique (DLCOSS)

93. Examples of restrictive disease processes include:
A. Emphysema
B. Pulmonary fibrosis
C. Asthma
D. None of the above

94. Factors that can limit the rate of diffusion across the Alveolar/Capillary membrane include:
A. Decreased surface area
B. Increased distance for gas molecules to travel
C. Decreased pressure gradients between air and blood
D. Solubility coefficients of gases in a liquid

95. In patients with emphysema the DL,CO is reduced because of:
A. Low FEV1
B. An increase in lung volume
C. Decreased pulmonary artery pressure
D. Loss of alveolar-capillary membrane surface area

96. In single-breath diffusion capacity, the recommended time for breath holding is:
A. 12 seconds
B. 10 seconds
C. 7 seconds
D. 5 seconds

97. Obstructive disorders with air-trapping display which of the following values
A. Increased RV
B. Increased VC
C. Decreased FRC
D. None of the above

98. Patient conditions that result in increased DLCO values include which of the following?
A. Exercise
B. Left heart failure
C. Asthma
D. All of the above

99. 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:
A. Ventilation
B. Distribution
C. Osmosis
D. Diffusion

100. The volume of gas discarded before collecting the alveolar sample when performing a single breath diffusing capacity is called:
A. Washout volume
B. Compressible gas volume
C. Deadspace volume
D. Back extrapolated volume

101. When performing a DLCOSB, the inspired volume should be at least what percent of the VC to be valid?
A. 85%
B. 100%
C. 70%
D. 80%

102. When performing the single breath CO diffusion capacity (DLCOSB) test, the patient is instructed to inhale to TLC a mixture of:
A. 0.1% CO, 10% helium, 20% O2 and remainder air
B. 0.5% CO, 15% helium and remainder O2
C. 0.5% CO, 10% helium, and remainder nitrogen
D. 0.3% CO, 10% helium, and remainder air

103. When preparing a patient for the administration of a diffusing capacity test
A. The patient should be in the sitting position and wearing nose clips
B. Supplemental O2 should be worn during a DLCO test
C. The patient should sit and rest at least 5 minutes prior to the test
D. All of the above

104. Which of the following are characteristic of a restrictive lung disease when measured volumes are compared with predicted volumes?
A. The VC is increased
B. The FRC is decreased
C. The RV is increased
D. The RV/TLC ratio is increased

105. Which of the following gas analyzers are typically needed to perform DLCO testing?
A. CO analyzer
B. N2 analyzer
C. CO2 analyzer
D. None of the above

106. Which of the following is a normal DLCO measurement?
A. 30 ml CO/min/mmHg STPD
B. 25 ml CO/min/mmHg STPD
C. 35 ml CO/min/mmHg STPD
D. 20 ml CO/min/mmHg STPD

107. 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
A. Chronic Bronchitis
B. Kyphoscoliosis
C. Emphysema
D. Silicosis

108. Which of the following methods can be used to determine lung volumes?
A. Body plethysmograph
B. Nitrogen washout study
C. Helium dilution
D. All of the above

109. Which of the following patient conditions can decrease the DLCO?
A. Decreased HB
B. Exercise
C. Supine position
D. None of the above

110. Which of the following is a normal respiratory exchange ratio (RER)?
A. 0.5
B. 0.6
C. 0.8
D. 0.1

111. 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?
A. VO2
B. VCO2
C. RQ of 1.2
D. Blood pressure of 90/60 after 5 minutes of testing

112. 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?
A. The test was negative
B. The test was positive after the first dose of methacholine
C. The test was positive after the second dose of methacholine
D. The patient does not have asthma

113. A purpose of using the steady-state protocol would be too:
A. Determine response to medication
B. Determine maximum exercise capacity
C. Determine if blockages to heart exist
D. Determine if the patient is a candidate to run a marathon

114. Which of the following statements are true regarding bronchoprovocation studies?
A. Can assess the severity of asthma
B. Most often use Methacholine as the agent that is administered by aerosol
C. Uses 20% decrease in FEV1 as an indicator that a significant bronchoconstriction response has occurred
D. All of the above

115. In bronchial provocation testing, the minimal index of positive response is a:
A. 20% increase in FEV1
B. 10% increase in FEV1
C. 20% decrease in FEV1
D. 10% decrease in FEV1

116. 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?
A. Cardiac stress testing
B. Lung compliance study
C. Cardiopulmonary stress testing
D. Methacholine challenge testing

117. Which of the following statements BEST describes anaerobic threshold?
A. Occurs when heart rate exceeds 175 beats/min
B. Occurs when patient’s minute ventilation equals his MVV
C. Occurs when anaerobic metabolism begins to supplement aerobic metabolism
D. Occurs when S-T changes begin to occur on cardiac monitor

118. The criteria for the termination of an exercise test includes:
A. Chest pain with ST segment changes
B Diastolic pressure change from 88 to 94 mmHg
C. Diaphoresis
D. Increased heart rates with exercise

119. A 57-year old male is scheduled for an exercise stress test using the ergometer exercise bike. Calculate 60% of his maximum heart rate.
A. 160
B. 130
C. 105
D. 98

120. 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?
A. Systolic increases to 200, diastolic to 90
B. Systolic increases to 300, diastolic to 140
C. Systolic increases to 160, diastolic to 130
D. Systolic remains at 120, diastolic decreases to 60

121. It is determined that a patient has an FEV1 of 3.3 L.The patient is unable to perform an MVV maneuver. The estimated MVV would be:
A. 80 Liters
B. 116 Liters
C. 150 Liters
D. 176 Liters

122. In order to ensure safety for methacholine challenge testing, the PFT technologist should:
A. Have a physician readily available if needed
B. Test in a well-ventilated room
C. Warn those in the testing area to sit or stand way from nebulized medication
D. All of the above

123. Which of the following are normal ventilatory responses to exercise?
A. Minute ventilation will increase linearly with exercise
B. Breathing reserve will be decreased in patients with cardiovascular disease
C. Patients with restrictive disease will decrease minute ventilation by decreasing respiratory rate
D. None of the above

124. Relative contraindications for conducting a cardiopulmonary exercise evaluation include all of the following except:
A. Diastolic blood pressure greater than 90 mm Hg
B. Serious cardiac arrhythmias
C. Unstable angina
D. Recent myocardial infarction

125. Contraindications to methacholine challenge testing include:
A. Recent MI
B. Patient unable to comprehend instructions to procedure
C. Uncontrolled hypertension
D. All of the above

126. 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?
A. Slow the speed and grade of treadmill and continue exercising
B. Stop the test and administer oxygen
C. Do nothing, this is normal
D. Stop the test and administer lidocaine

127. The purpose of obtaining an anaerobic threshold is to:
A. Produce respiratory acidosis
B. Prescribe an effective exercise program
C. Increase the respiratory rate
D. Produce metabolic alkalosis

128. 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?
A. Adjusting the speed of pedaling
B. Increased incline and speed of equipment
C. Increasing pedaling frequency and resistance
D. Decreasing incline while increasing speed of device

129. All of the following would be necessary equipment to perform a cardiopulmonary exercise test EXCEPT:
A. Breathing valves
B. Small volume nebulizer
C. Spirometer
D. Emergency equipment

130. What RER suggest that the anaerobic threshold has been reached for a patient performing a cardiopulmonary stress test?
A. 1.0
B. 0.8
C. 0.6
D. 0.4

131. A cardiopulmonary exercise evaluation is conducted on a patient before participation in pulmonary rehabilitation for what purposes?
A. To determine the patient’s baseline exercise capacity
B. To develop an exercise prescription (including target heart rate)
C. To determine how much desaturation occurs with exercise
D. All of the above

132. When preparing a patient for a methacholine challenge study, the PFT technologist should inform the patient to:
A. Not take any bronchodilators prior to the test
B. Avoid antigen exposure at least 24 hours prior to testing
C. Postpone study if patient has had a viral infection in the last 3 weeks
D. All of the above

133. Which of the following exercise protocols would you recommend to implement a maximal symptom-limited incremental protocol?
A. cycle ergometer at 50 watts for 10 minutes
B. A treadmill at a speed of 5 miles/hour with 10% grade increased by 2% every 3 minute
C. A constant treadmill with increasing speed every 8 minutes
D. A cycle ergometer at 50 watts for 8 minutes

134. Absolute contraindications to exercise stress testing include:
A. Ventricular arrhythmias
B. Complaint of dyspnea
C. Unstable angina
D. SpO2 of 75% on room air

135. Which of the following is an indication for cardiopulmonary stress exercise testing?
A. Determine ventilatory limitations to exercise
B. Evaluate patients prior to surgery
C. Evaluate patients with cardiovascular disease
D. All of the above

136. 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:
A. Thoracic gas volume
B. Histamine challenge test
C. Methacholine challenge test
D. Mannitol challenge test

137. The final interpreted report of results from a methacholine challenge study should include:
A. Patient’s SpO2
B. Patient’s weight
C. Provocative substance used
D. Family history

138. Which of the following are normal gas exchange responses to exercise:
A. VO2 (oxygen consumption) increases
B. VCO2 (CO2 production) decreases
C. Physiologic deadspace increases
D. None of the above

139. All of the following should be monitored during a cardiopulmonary exercise evaluation except:
A. Respiratory rate
B. HbO2 saturation
C. ECG and blood pressure
D. Raw

Final Thoughts

Mastering pulmonary function testing (PFT) is essential for both respiratory therapists and students. The practice questions in this guide have covered the fundamental aspects, including the various PFT tests and their uses in respiratory care.

By reviewing the material and practicing with the provided questions, you should feel confident in your ability to apply this knowledge in both clinical settings and examinations.

Remember, thorough understanding and practical application of these tests are crucial for providing optimal patient care and advancing your expertise in the field of respiratory care.