# Review 3

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1. Lung compliance is usually measured in patient's with __________?
stiff lungs, e.g. pulmonary fibrosis
2. Airway resistance is usually measured in patient's with ___________?
asthma or chronic bronchitis
3. Bedside spirometry is indicated for:
Patients showing signs of respiratory difficulty & for whom the need for mechanical ventilation is being considered
4. Tidal volume is usually measured by?
Vt and RR are accumulated for one minutes and an average Vt is calculated.
5. Small tidal volumes may be found in patients:
have a low metabolic rate, are sleeping, in a coma, have neuromuscular disease or are alkalotic.
6. Large tidal volumes may be found in patients:
high metabolic rates, have a fever, have a dead-space producing disease (such as pulmonary embolism), increased ICP or are acidotic.
7. Normal I:E Ratio
1.2 to 1.4
8. A prolonged inspiratory time is seen?
in patients with upper airway obstruction
9. A prolonged expiratory time is seen?
in patients with asthma or COPD
10. Calculate the patients Ti and Te when the I:E Ratio is 1:2 and the f = 12
(60 sec/min)/12 bpm = 5 secs per respiration; 5 sec per resp/3 parts I&E = 1.66 sec per part; Ti = 1 part = 1.66sec; Te = 2 parts = 3.32 sec.
11. Calculate a neonate's I:E ratio when the Ti = 0.3 sec and the Te = 0.9 sec.
I:E = 0.3/0.9; I:E = 1/3 = 1:3
12. Normal Minute Volume Is ___?
5-10 lpm
13. Estimated normal anatomic dead space is ___?
1 ml/lbs
14. Calculate the alveolar ventilation of a 154 lb patient with a measured Vt of 500ml.
Vt - (1 ml/lb) = 500 - 154 = 346 ml calculated alveolar ventilation
15. Formula for calculating Minute Alveolar Ventilation
VA = RR x (Vt-Vds)
16. MIP is most commonly used to _____?
determine the weanability of mechanically ventilated pateints
17. Normal MIP
at least -60 cm H2O
18. Normal MEP
at least 80 cm H2O
19. Significance of VC
in general, a decreasing VC is a sign the patient is tiring or ventilatory effort is inadequate
used to access effectiveness of bronchodilators
21. "Green Zone" Peak Flow
22. "Yellow Zone" Peak Flow
50-79% of predicted: not adequately controlled
23. "Red Zone" Peak Flow
less than 50% of predicted: not controlled
24. Exhaled Nitric Oxide (eNO)
measures eosinophilic airway inflammation
25. Indications for screening spirometry
R/O airway obstruction; access presence of airway obstruction in an at-risk patient; access the severity of airway obstruction in a symptomatic patient
26. Critical FEV1/FVC value
• 70%
• If patient's ratio is < 70%, there is an airway obstruction problem
27. Spirometry findings in patients with restrictive disease?
all volumes and capacities are smaller than predicted
28. A small FEF25%-75% with a normal FVC may indicate:
early small airway disease
29. The FEV1 is most commonly used to ____?
judge patient's response to inhaled bd
30. FVC in restrictive lung disease
exhale the FVC more quickly than expected
31. FVC in obstructive lung disease
take longer than expected to exhale the FVC
32. Which is the most important forced expiratory volume test?
FEV1
33. Examples of small airway disease:
asthma, chronic bronchitis, bronchiectasis, CF, emphysema
34. In a flow-volume loop, what sign is characteristic of small airway disease?
A "scooped-out" appearance
35. Examples of restrictive disease:
fibrosis, pleural effusion, pneumothorax, hemothorax, kyphoscoliosis, obesity, pregnancy, ascites
36. Ina flow-volume loop, what sign is characteristic of restrictive disease?
small volumes with right shift.
37. In a flow volume loop, what does a near normal FVC volume and a greatly decreased peak expiratory flow rate suggest?
variable obstruction from tumor or FB
38. In a flow-volume loop, what does a near normal FVC volume and a greatly reduced inspiratory flow rate suggest?
variable extrathoracic obstruction such as vocal cord paralysis, laryngeal tumor or FB
39. In a flow volume loop, what does a near normal FVC volume with reduced inspiratory and expiratory flows suggest?
a fixed obstruction such as a tumor in the trachea or mainstem bronchus
40. What does the Nitrogen Washout Distribution Test (also called the Single-Breath Nitrogen Washout Test) measure?
evenness of the distribution of ventilation into the lungs during inspiration and the emptying rate of lungs during exhalation.
41. What does the Helium Dilution Test measure?
FRC
42. General Rule: TLC > 120% predicted indicates?
obstructive disease
43. General Rule: TLC <80% of predicted indicates?
restrictive disease
44. Indications for a lung compliance test?
Distinguish between overly compliant lungs (emphysema) and noncompliant lungs (fibrosis).
45. DLCO measures:
diffusing capacity of carbon monoxide to diffuse through the lungs into the blood. Indicated in emphysema and fibrosis.
46. RV, FEC & TLC > 120% predicted indicates?
Obstructive disease with air-trapping
47. EV, FRC & TLC <80% predicted indicates?
restrictive lung disease
48. Which of the following statements is true of the MEP test?

A) a pressure of -20 to -25 cm H2O is usually adequate
B) a pressure of +40 cm H2O usually is adequate and it is a good indicator of the patient's ability to cough & the patient should hold the effort for 1 to 3 seconds
C) a pressure of +40 cm H2O is usually adequate & it is a good indicator of the patient's ability to cough
D) a pressure of +40 cm H2O is usually adequate
B) a pressure of +40 cm H2O usually is adequate and it is a good indicator of the patient's ability to cough & the patient should hold the effort for 1 to 3 seconds
(this multiple choice question has been scrambled)
49. The predicted FVC value for African-Americans is:

A) 10-15% higher than for Caucasians
B) 20-25% less than for Caucasians
C) The same as for Caucasians
D) 10% to 15% less than for Caucasians
D) 10% to 15% less than for Caucasians
(this multiple choice question has been scrambled)
50. Which of the following test results are needed to calculate TLC?

A) FRC & Vt only
B) IC & VC only
C) FRC & IC only
D) RV & VC only
D) RV & VC only
(this multiple choice question has been scrambled)
51. A normal MEFV loop would show:

A) Predicted lung diffusion ability
B) FEF50% less than FIF50%
C) FEF50% greater than FIF50%
D) a normal FRC
B) FEF50% less than FIF50%
(this multiple choice question has been scrambled)
52. A person with neuromuscular disease has been having serial bedside spirometry performed. Over the past 4 hours, her VC and MIP values have been decreasing. How should this be interpreted?

A) she is no giving her best effort
B) her condition is worsening
C) her strength is improving
D) she has undiagnosed asthma
B) her condition is worsening
(this multiple choice question has been scrambled)
53. An order is received to perform the following bedside spirometry tests on a patient: Vt, FVC and peak flow. Which device would you take with you to perform the tests?

B) body plethysmograph
C) differential pressure pneumotachometer
D) MIP manometer
C) differential pressure pneumotachometer
(this multiple choice question has been scrambled)
54. Before a patient does an FVC test, the pneumotachometer should have the following done:

A) FRC & Vt only
B) a 3L volume should be pumped into and out of the circuit
C) 20-25% less than for Caucasians
D) the kymograph speeds should be checked
B) a 3L volume should be pumped into and out of the circuit
(this multiple choice question has been scrambled)
55. For help in the diagnosis of a patient with a questionable hx of wheezing and possible asthma, which of the following would be the best test?

A) airway resistance
B) before and after BD study
C) flow volume loop
D) bronchoprovocation test
D) bronchoprovocation test
(this multiple choice question has been scrambled)
56. A patient has just been tested for CL in a body plethysmograph. The patient's compliance was determined to be 0.2 L (200 ml)/cm H2O. Based on this data, the patient most likely has:

A) pulmonary fibrosis
B) asthma
C) normal lungs
D) emphysema
D) emphysema
(this multiple choice question has been scrambled)
57. Calculate a patient's inspiratory and expiratory times when he has an I:E Ratio of 2:1 and a RR of 15 bpm.

A) 2.7 seconds for inspiration and 1.3 seconds for expiration
B) 3.3 seconds for inspiration and 1.7 seconds for expiration
C) 1.3 seconds for inspiration and 2.7 seconds for expiration
D) 1.7 seconds for inspiration and 3.3 seconds for expiration
A) 2.7 seconds for inspiration and 1.3 seconds for expiration
(this multiple choice question has been scrambled)
58. When a patient performs an MEP test, it is important that he or she:

A) breathes in a Vt and blows out hard
B) blows out all air before starting the test
C) inhales to TLC and blows out hard
D) exhales a Vt breath and blows out hard
C) inhales to TLC and blows out hard
(this multiple choice question has been scrambled)
59. A patient weights 45 kg (100 lbs). The patient's predicted Vt would be:

A) 550 ml
B) 250 ml
C) 350 ml
D) 450 ml
C) 350 ml
(this multiple choice question has been scrambled)
60. An order is received to calculate a patient's alveolar ventilation. The patient's RR is 16 and average Vt is 580 ml. The patient weighs 170 lbs. The patient's alveolar ventilation is:

A) 510 ml
B) 410 ml
C) 750 ml
D) 2720 ml
B) 410 ml
(this multiple choice question has been scrambled)
61. A patient has an FEV1 that is calculated to be 80% of her/her FVC. On the basis of this finding, the patient probably:

A) is clinically normal
B) has a fibrotic lung disease
C) has COPD
D) has a laryngeal tumor
A) is clinically normal
(this multiple choice question has been scrambled)
62. The VC is made up of the:

A) RV, RFC & ERV
B) ERV & Vt
C) ERV, Vt and IRV
D) FRC & IC only
C) ERV, Vt and IRV
(this multiple choice question has been scrambled)
63. Which of the following are true of PF measurement?

A) it is usually seen at the end of a patient's FVC effort and it increases with height and decreases with age
B) it increases with height and decreases with age and is usually seen at the beginning of the patient's FVC effort
C) it is usually seen at the end of a patient's FVC effort and increases with height and increases with age
D) it decreases with age and is usually seen at the beginning of the patient's FVC effort
B) it increases with height and decreases with age and is usually seen at the beginning of the patient's FVC effort
(this multiple choice question has been scrambled)
64. An RT is having a patient perform the MIP test. His three attempts produce these results: =15 cm H2O, -45 cm H2O and -20 cm H2O. The best explanation for these values is that:

A) the equipment has a large leak
B) the patient is starting from the RV
C) the patient is starting from the RV
D) the patient is not trying his best every time
D) the patient is not trying his best every time
(this multiple choice question has been scrambled)
65. The physician wants to know whether a new bronchodilator would be helpful to the patient with asthma. The physician orders a new before and after BD study. The patient has the following peak flow values: 7.5 lpm before the medication and 9.4 lpm after the medication. Calculate the percentage change.

A) 80%
B) 25%
C) 1.25%
D) -25%
B) 25%
(this multiple choice question has been scrambled)
66. Complete spirometry is performed on a 50 YO patient, revealing the following data: TLC 137% predicted; RV 164% predicted; FVC 52% predicted; FEF25-75 36% predicted; and FEV1/FVC 27% predicted. How should this data be interpreted?

A) severe restrictive disease
B) mild restrictive disease
C) mild obstructive disease
D) severe obstructive disease
D) severe obstructive disease
(this multiple choice question has been scrambled)
67. A nitrogen washout test for RV has been performed on a patient for 7 minutes and has not reached the desired nitrogen percentage. What could explain this situation?

A) the patient has an abnormally high respiratory exchange ratio
B) there is an oxygen leak into the system
C) nitrogen has been absorbed into the patient's tissues
D) the patient has severe air trapping
D) the patient has severe air trapping
(this multiple choice question has been scrambled)
68. A new patient has been scheduled for a battery of PFT's. He tells you that he is so nervous about the testing that he has smoked 4 cigarettes in the past two hours. Which of the following tests is most likely to be affected by this?

A) lung diffusion
B) Raw
C) FVC
D) FRC
A) lung diffusion
(this multiple choice question has been scrambled)
69. After spirometry is performed, it is important that the patient flow rates be reported at:

A) ATPS
B) ATPD
C) STPD
D) BTPS
D) BTPS
(this multiple choice question has been scrambled)
70. A patient is performing a residual volume test on a water seal spirometer in the PF Lab. After breathing on the system for 1 minute, the patient takes out the mouthpiece and c/o being SOB. What is the most likely problem with the PF system?

A) the CO2 absorber has been left out of the system
B) nose clips were left off the patient
C) the CO2 absorber was accidentally left in the system
D) ther is too much water around the spirometer bell
A) the CO2 absorber has been left out of the system
(this multiple choice question has been scrambled)
71. Which of the following studies produces the most accurate determination of the TLC in a patient with severe emphysema?

A) body plethysmograph test
B) seven minute nitrogen washout test
C) single breath nitrogen washout test
D) helium dilution test
A) body plethysmograph test
(this multiple choice question has been scrambled)
72. The PF Lab has recently acquired an exhaled nitric oxide analyzer. Which patient population should it be used with?

A) asthmatics
B) hx of asbestos exposure
C) hx of ARDS
D) hx of COPD
A) asthmatics
(this multiple choice question has been scrambled)
73. Before a patient performs a FVC test, all of the following should be done to the water sealed spirometer EXCEPT:

A) place CO2 absorbing material in line with the circuit
B) pump a 3 L volume into and out of the circuit to check for leaks
C) check the kymograph speeds
D) make sure the circuit is air-tight
A) place CO2 absorbing material in line with the circuit
(this multiple choice question has been scrambled)
74. A properly performed FVC test will not have:

A) any coughing or leaks or weak patient efforts
B) a weak patient effort or an unsatisfactory start
C) any coughing or leaks or weak patient effort or an unsatisfactory start or exhibit excessive variability among the test results
D) any coughing or leaks or weak patient efforts or excessive variability among the efforts
C) any coughing or leaks or weak patient effort or an unsatisfactory start or exhibit excessive variability among the test results
(this multiple choice question has been scrambled)
75. A patient has the suspected diagnosis of asthma. Which of the following tests would be the LEAST helpful in assessing the patient for this condition?

A) diffusion study
B) bronchoprovocation study
C) before and after BD study
D) flow volume loop
A) diffusion study
(this multiple choice question has been scrambled)
76. A patient with COPD has been admitted. To help clarify the patient's diagnosis as emphysema or asthma, which of the following should be recommended?

A) flow volume loop
B) MVV
C) spirometry before and after an inhaled beta agonist
D) Peak Flow Test
C) spirometry before and after an inhaled beta agonist
(this multiple choice question has been scrambled)
77. As teh therapist in the PF Lab, you have received an order to perform exhaled NO analysis, spirometry and RV testing on a 10 YO girl with a hx of wheezing and chronic cough. First, you perform eNO analysis and find the girl's eNO value to be 35 ppb. How should this information be interpreted?

A) the value is within normal limits and the other testing should continue
B) the patient's value is increased from normal
C) the analyzer must be recalibrated to RA and the test repeated
D) the patient's other tests need to be performed first and the eNO test repeated
B) the patient's value is increased from normal
(this multiple choice question has been scrambled)
78. A wright respirometer can be used for all of the following bedside spirometry tests EXCEPT:

A) MV
B) FVC
C) VC
D) Vt
B) FVC
(this multiple choice question has been scrambled)
 Author: n1297f ID: 315946 Card Set: Review 3 Updated: 2016-02-16 15:43:06 Tags: Review Folders: Description: Review 3 Show Answers: