Chapter 2: Spirometry Test Bank

Chapter 2: Spirometry

Test Bank

MULTIPLE CHOICE

1.A subject who complains of shortness of breath has an FVC of 2.57 L, but her VC is 2.99 L.These findings suggest which of the following?a.Pulmonary fibrosis b.Chest wall abnormality c.Emphysema d.Fixed upper airway obstruction

ANS:C

FVC is often lower than VC in patients with obstructive diseases if forced expiration causes airway collapse. This pattern is often seen in emphysema because of loss of tethering support of the airways.DIF:2 REF:p. 48 OBJ:EL-1

MSC:NBRC: CPFT 3B-3

2.A 47-year-old man with a history of cough has the following spirometry results: MeasuredPredicted

FVC (L BTPS) 3.85 4.01

FEV1 (L BTPS) 2.14 3.33

These findings show the presence of which of the following?a.Reversible airway obstruction b.Moderate obstructive disease c.Normal lung function d.Incorrectly selected predicted values

ANS:B

While the ratio of FEV1/VC defines obstruction, the severity of obstruction is defined by the degree to which the FEV1 is reduced. Moderate FEV1= 60% to 69% of predicted; 2.14 

3.33 = 64%.

DIF:2 REF:p. 51 OBJ:EL-2

MSC:NBRC: CPFT 3C-3

3.A 22-year-old patient with dyspnea performs three spirometry trials.Trial 1Trial 2Trial 3

FVC (L BTPS) 4.214.494.65

FEV1 (L BTPS) 3.883.913.93

The pulmonary function technologist should do which of the following?a.Report the values from Trial 3.b.Report the largest sum of FVC and FEV1.c.Average the data from Trials 2 and 3.d.Perform at least one more maneuver.

ANS:D

The two largest values for both FVC and FEV1 should be within 150 ml (or within 100 ml if the FVC is 1 L or less). The second largest value is simply subtracted from the largest value for both FVC and FEV1 to determine repeatability. If repeatability is not met, additional acceptable trials should be performed.DIF:3 REF:p. 53 OBJ:EL-1

MSC:NBRC: CPFT 2C-6

4.Why should all values from a series of peak flow measurements be reported?a.PEF may decrease with repeated efforts.b.A minimum of three values must be averaged.c.Peak flowmeters do not need to be precise.d.Forced exhalation produces a bronchodilator effect.

ANS:A

At least three maneuvers should be performed and recorded, along with the order in which the values were obtained. All readings are recorded to detect effort-induced bronchospasm.DIF:2 REF:p. 62 OBJ:None

MSC:NBRC: CPFT 2B-9

5.Which of the following determines the shape of the “effort-independent” portion of the expiratory F-V curve?

• Abdominal pressure during forced expiration
• Elastic recoil of the lung
• Flow resistance in the small airways
• Cross-sectional area of the trachea

a.1 and 2 b.2 and 3 c.1, 3, and 4 d.4 only

ANS:B

Elastic recoil determines the pressure applied to gas in the lung during a forced expiration.This pressure is determined by the recoil of the lung and chest wall. Resistance to flow in the airways is the second factor affecting the shape of the flow-volume curve.DIF:1 REF:p. 55 OBJ:AL-3 MSC:NBRC: None 6.A patient being evaluated for disability has the following spirometry results: Measured Predicted

FVC (L) 4.00 4.10

FEV1 (L) 2.00 3.30

MVV (L/min) 105 110 What do these findings indicate?a.The patient has moderate obstructive disease.b.The patient has restriction.c.The patient’s FEV1 is larger than measured.d.The patient did not make a good effort on the MVV.

ANS:A

While the ratio of FEV1/FVC defines obstruction, the severity of obstruction is defined by the degree to which the FEV1 is reduced. Moderate FEV1= 60% to 69% of predicted; 2.00 

3.30 = 61%.

DIF:2 REF:p. 51 OBJ:AL-2

MSC:NBRC: CPFT 3C-3

7.Before bronchodilator studies, inhaled -adrenergic agents should be withheld for how long?a.0.5 to 1.5 hours unless corticosteroids are being used b.4 to 12 hours for regular or long-acting preparations c.24 hours for most inhalers d.24 to 48 hours

ANS:B

See Table 2-2, Chapter 2.DIF:1 REF:p. 66 OBJ:EL-4

MSC:NBRC: CPFT 2A-6

8.Which answer is consistent with the following flow-volume curve?a.Normal forced expiratory flow pattern b.Variable intrathoracic obstruction c.Airways obstruction d.Fixed large airway obstruction

ANS:C

See Interpretive Strategies 2-3, Chapter 2.DIF:2 REF:p. 58 OBJ:AL-3

MSC:NBRC: CPFT 3C-3

9.A subject has spirometry repeated before and after inhaled bronchodilators. The following

data are obtained:

PredictedBefore DrugAfter Drug

FVC 5.20 4.90 5.30

FEV1 4.10 3.10 3.30

PEF 9.20 7.77 8.92

Which of the following statements best describes these findings?a.There is mild obstruction with significant response to bronchodilators.b.There is mild obstruction without significant change after bronchodilators.c.There is a paradoxical response to bronchodilators.d.Spirometry is within normal limits.

ANS:B

While the ratio of FEV1/VC defines obstruction, the severity of obstruction is defined by the degree to which the FEV1 is reduced. Mild FEV1 is greater than 70% predicted (3.10 4.10 = 75%). Bronchodilator response is significant if the percent change is 12% or there is an absolute increase greater than 200 ml.DIF:3 REF:p. 51 | p. 68OBJ:EL-4

MSC:NBRC: RPFT 3C-3

10.A 50-year-old woman with dyspnea has the following spirometry results:

MeasuredPredicted

FVC (L BTPS) 3.99 4.10

FEV1 (L BTPS) 3.44 3.33

These findings are consistent with which of the following?a.Reversible airway obstruction b.Mild obstructive disease c.Normal lung function d.Invalid predicted values

ANS:C

Data are within normal limits. (FEV1/FVC 86%; FEV1 97% of predicted.) DIF:2 REF:p. 51 OBJ:EL-2

MSC:NBRC: CPFT 3C-3

11.A 17-year-old patient with asthma performs three spirometry trials:

Trial 1Trial 2Trial 3

FVC (L BTPS) 3.213.44 3.49

FEV1 (L BTPS) 2.88 2.91 2.93

The pulmonary function technologist should do which of the following?a.Report the values from Trial 3.b.Average the data from Trials 2 and 3.c.Calibrate the spirometer and repeat all three trials.d.Perform at least one more maneuver.

ANS:A

Spirometry acceptability and repeatability criteria were achieved. Report the largest FVC and FEV1.DIF:3 REF:p. 62 OBJ:EL-1

MSC:NBRC: CPFT 2C-6