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


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