Chapter 19 Pulmonary Function Testing

Chapter 19  Pulmonary Function Testing

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. Which of the following are indications for assessing pulmonary function?
1. screen for pulmonary disease
2. evaluate patients for surgical risk
3. assess the progression of disease
4. assist in determining pulmonary disability
5. modify the therapeutic approach to patient care
a.
1, 3, and 4
b.
2, 4, and 5
c.
1, 2, 3, 4, and 5
d.
2, 4, and 5

ANS: C
The indications for pulmonary function testing are:
• To identify and quantify changes in pulmonary function. The most common purposes of pulmonary function testing are to detect the presence or absence of pulmonary disease, to classify the type of disease as either obstructive or restrictive, and to quantify the severity of pulmonary impairment as mild, moderate, severe, or very severe. Over time pulmonary function tests help quantify the progress or the reversibility of the disease.
• To evaluate need and quantify therapeutic effectiveness. Pulmonary function tests may aid clinicians in selecting or modifying a specific therapeutic regimen or technique (e.g., bronchodilator medication, airway clearance therapy, rehabilitation exercise protocol). Clinicians and researchers use pulmonary function tests to objectively measure changes in lung function before and after treatment.
• To perform epidemiologic surveillance for pulmonary disease. Screening programs may detect pulmonary abnormalities caused by disease or environmental factors in general populations, occupational settings, smokers, or other high-risk groups. In addition, researchers have determined what normal pulmonary function is by measuring the pulmonary function of the healthy population.
• To assess patients for risk of postoperative pulmonary complications. Preoperative testing can identify those patients who may have an increased risk of pulmonary complications after surgery. Sometimes the risk of complications can be reduced by preoperative respiratory care, and sometimes the risk may be so significant to rule out surgery.
• To determine pulmonary disability. Pulmonary function tests can also determine the degree of disability caused by lung diseases, including occupational diseases such as pneumoconiosis of coal workers. Some federal entitlement programs and insurance policies rely on pulmonary function tests to confirm claims for financial compensation.

DIF: Recall REF: p. 418 OBJ: 2

2. What do relative contraindications for lung volume determinations include?
1. recent cataract removal surgery
2. unstable cardiovascular status
3. untreated pneumothorax
4. hemoptysis of unknown origin
a.
1, 2, and 3
b.
2 and 4
c.
1, 3, and 4
d.
1, 2, 3, and 4

ANS: D
Patients with acute, unstable cardiopulmonary problems such as hemoptysis, pneumothorax, myocardial infarction, and pulmonary embolism and patients with acute chest or abdominal pain should not be tested. Testing could be harmful, if needed treatment would be delayed. Patients who have nausea and who are vomiting should not be tested; there is a risk of aspiration. Testing for patients who have had recent cataract removal surgery should be delayed; changes in ocular pressure may be harmful to the eye.

DIF: Recall REF: p. 423 OBJ: 2

3. What is the primary problem in obstructive lung disease?
a.
increased airway resistance
b.
low lung volumes
c.
increased pulmonary capillary pressure
d.
reduced lung diffusion

ANS: A
The primary problem in obstructive pulmonary disease is an increased airway resistance.

DIF: Recall REF: p. 419 OBJ: 3

4. Which of the following is typically elevated in restrictive lung disease?
a.
lung compliance
b.
lung volumes
c.
pressure needed to expand the lung
d.
airway’s resistance

ANS: C
The primary problem in restrictive lung disease is reduced lung compliance, thoracic compliance, or both lung and thoracic compliances. Compliance is the volume of gas inspired per the amount of inspiratory effort; effort is measured as the amount of pressure created in the lung or in the pleural space when the inspiratory muscles contract. Compliance is calculated according to the following formula: C = ΔV/ΔP.

DIF: Recall REF: p. 419 OBJ: 3

5. You perform a series of pulmonary function tests on a patient with a potentially infectious disease carried via the airborne route. Which of the following infection-control procedures should you implement?
1. Wear a respirator or close-fitting surgical mask.
2. Dispose of, sterilize, or disinfect the tubing circuit after testing.
3. Clean the interior surface of the spirometer before the next test.
a.
1
b.
1 and 2
c.
2 and 3
d.
1, 2, and 3

ANS: B
When performing procedures on patients with potentially infectious airborne diseases, practitioners should wear a personal respirator or a close-fitting surgical mask, especially if the testing induces coughing. Practitioners should always wash their hands between testing patients and after contact with testing equipment. Although it is unnecessary to routinely clean the interior surfaces of the testing instruments between patients, the mouthpiece, nose clips, tubing, and any parts of the instrument that come into direct contact with a patient should be disposed, sterilized, or disinfected between patients.

DIF: Application REF: p. 420 OBJ: 3