RuppelΓÇÖs Manual of Pulmonary Function Testing 10th Edition by Carl Mottram – Test Bank

Complete Test Bank With Answers

 

 

Sample Questions Posted Below

 

Chapter 5: Ventilation and Ventilatory Control Tests

Test Bank

MULTIPLE CHOICE

1. A circuit is set up to perform a CO2 rebreathing response test. The reservoir bag in the

circuit should contain which of the following?

a. Room air

b. 3% CO2 in air

c. 7% CO2 in O2

d. 100% O2

ANS: C

The patient rebreathes from a reservoir (usually an anesthesia bag) of 7% CO2 in O2.

DIF: 1 REF: p. 140 OBJ: None MSC: NBRC: None

2. A subject has the following results after 4.0 minutes of a CO2 rebreathing test:

Time (min) 0 4

PETCO2 37 57

(L/min) 5.0 12.5

3. These findings are consistent with which of the following?

a. Normal lung function

b. Obesity-hypoventilation syndrome

c. Chronic asthma

d. Interstitial pulmonary fibrosis

ANS: B

The response to an increase in PaCO2 in a healthy individual is a linear increase in E of

approximately 3 L/min/mm Hg (PCO2).

DIF: 3 REF: p. 143 OBJ: EL-2

Exhaled gas is collected for 5 minutes; the mixed expired PCO2 is measured. Blood gases

are drawn during the last minute of gas collection, and the following data are recorded:

PECO2 24 mm Hg

pH 7.38

PaCO2 32

PaO2 71

What is this subject’s VD/VT ratio?

a. 0.75

b. 0.33

c. 0.25

d. 0.11

ANS: C

VD/VT = (PaCO2 PECO2) PaCO2; (32 24) 32 = 0.25.4. 5. 6. 7. DIF: 2 REF: p. 139 OBJ: EL-3 MSC: NBRC: None

The measurement of a patient’s respiratory dead space is 0.3 L (BTPS). If she is breathing at

a rate of 22 breaths/min with a VT of 0.7 L (BTPS), what is her A?

a. 22.0 L (BTPS)

b. 15.4 L (BTPS)

c. 8.8 L (BTPS)

d. 6.6 L (BTPS)

ANS: C

A = fB(VT VD); 22(0.7 0.3) = 8.8 L.

DIF: 2 REF: p. 139 OBJ: None

A patient with COPD has the following data recorded:

E 7.6 L/min (BTPS)

Respiratory rate 18/min

What is this subject’s VT?

a. 0.42 L (BTPS)

b. 0.33 L (BTPS)

c. 0.23 L (BTPS)

d. 0.14 L (BTPS)

ANS: A

VT = E/frequency; 7.6 18 = 0.42.

DIF: 2 REF: p. 136 OBJ: EL-1

The VD/VT ratio may be estimated noninvasively by measuring which of the following?

a. b. d. VT and mixed expired PCO2

Mixed expired PCO2 and end-tidal PCO2

c. End-tidal PCO2 and VT

Arterial PCO2 and mixed expired PCO2

ANS: B

The VD/VT ratio can be calculated if arterial and mixed-expired PCO2 values are known. It

can also be estimated noninvasively.

DIF: 1 REF: p. 139 OBJ: AL-1 MSC: NBRC: None

Which of the following measurements confirm the diagnosis of hypoventilation?

1. Respiratory rate of 7/min

2. Ventilation of 4.0 L/min (BTPS)

3. PaCO2 of 49 mm Hg

4. pH of 7.29

a. 2 only

b. 3 only

c. 1 and 2d. 3 and 4

ANS: D

Low VA associated with acute respiratory acidosis (PaCO2 greater than 45 and pH less than

7.35 in healthy patients) defines hypoventilation.

DIF: 1 REF: p. 137 OBJ: EL-2 MSC: NBRC: None

8. P100 is the:

a. b. c. d. Ventilation in liters per minute when the patient is breathing 100% O2

PETCO2 when the subject is breathing 100 L/min

Pressure developed during the first 100 msec of an occluded breath

Mean alveolar pressure extrapolated to a respiratory rate of 100/min

9. 10. ANS: C

Occlusion pressure (P100 or P0.1) is the pressure generated at the mouth during the first 100

msec of an inspiratory effort against an occluded airway.

DIF: 1 REF: p. 141 OBJ: None MSC: NBRC: None

A rebreathing CO2 response test should be terminated in which of the following situations?

1. When the PETCO2 exceeds 9% in the circuit

2. If the FIO2 drops below 0.21

3. When the subject has rebreathed for 4 minutes

4. As soon as the P100 has been measured

a. 1 only

b. 2 and 3

c. 1, 2, and 3

d. 1, 2, 3, and 4

ANS: C

The patient rebreathes until the concentration of PETCO2 exceeds 9% or until 4 minutes

have elapsed. If for some reason the FIO2 were to fall below 0.21, the test would be

terminated too.

DIF: 2 REF: p. 136 OBJ: None MSC: NBRC: None

A subject has the following data recorded during a rebreathing O2 (hypoxic) response test:

Time (min) 0 1 2 3 4

PETCO2 (mm Hg) 38 39 39 38 37

SpO2 (%) 95 94 92 88 85

E (L/min) 4.1 5.2 9.5 20.4 44.5

These findings are consistent with which of the following?

a. A normal ventilatory response to hypoxemia

b. A blunted ventilatory response to hypoxemia

c. An improperly calibrated pneumotachometer

d. A malfunctioning end-tidal CO2 analyzer

ANS: A

See Interpretive Strategies 5-3, Chapter 5.11. 12. DIF: 2 REF: p. 143 OBJ: None MSC: NBRC: None

A subject performing a closed-circuit hypoxic response test abruptly stops the test and

complains of dizziness. This is most likely because of:

a. Inadequate scrubbing of CO2

b. Failure to maintain eucapnia

c. Incomplete gas mixing in the circuit

d. Excessive resistance in the circuit

ANS: A

The closed circuit technique uses a CO2 scrubber to remove CO2. Increasing CO2 levels in a

circuit with a dysfunctional scrubber would cause symptoms of dizziness. Figure 5-1 (see

Chapter 5) describes the system.

DIF: 2 REF: p. 142 OBJ: AL-3 MSC: NBRC: None

A subject has the following results after 4 minutes of a CO2 rebreathing test:

Time (min) 0 4

PETCO2 (mm Hg) 40 56

E (L/min) 6 48

13. These findings are consistent with a ventilatory response that is:

a. Markedly reduced

b. Slightly reduced

c. Normal

d. Extremely high

ANS: C

The response to an increase in PaCO2 in a healthy individual is a linear increase in E of

approximately 3 L/min/mm Hg (PCO2).

DIF: 3 REF: p. 143 OBJ: None MSC: NBRC: None

A subject’s exhaled gas is collected in a meteorologic balloon for 5 minutes, then analyzed

for PO2, PCO2, and volume expired. Blood gases are drawn simultaneously and the

following data are recorded:

Temperature: 25° C

BTPS correction factor: 1.011

PB: 750 mm Hg

Volume expired: 27.5 L (ATPS)

FECO2: 0.046 (4.6%)

Respiratory rate: 12/min (average)

pH: 7.38

PCO2: 44

PO2: 71

What is this subject’s E?

a. 1.27 L (BTPS)

b. 2.29 L (BTPS)

c. 5.91 L (BTPS)d. 7.73 L (BTPS)

ANS: C

E = Collected expired volume/5 minutes times BTPS correction factor.

DIF: 3 REF: p. 138 OBJ: EL-1 MSC: NBRC: None

14. What is the subject’s tidal volume (VT)?

a. 493 ml (BTPS)

b. 577 ml (BTPS)

c. 1011 ml (BTPS)

d. 2292 ml (BTPS)

ANS: A

VT = E/frequency

DIF: 3 REF: p. 136 OBJ: EL-1 MSC: NBRC: None

15. What is the subject’s VD/VT%?

a. 15%

b. 25%

c. 33%

d. 40%

ANS: B

VD/VT = (PaCO2 PECO2) PaCO2.

DIF: 3 REF: p. 139 OBJ: AL-1 MSC: NBRC: None

16. What is the subject’s E?

a. 3.37 L/min (BTPS)

b. 4.61 L/min (BTPS)

c. 7.73 L/min (BTPS)

d. 8.19 L/min (BTPS)

ANS: B

E = fB(VT – VD)

DIF: 3 REF: pp. 139-140 OBJ: None MSC: NBRC: None

17. To calculate respiratory dead space (VD), which of the following are required?

1. VT

2. E

3. PaCO2

4. PECO2

a. 1 and 3

b. 2 and 4

c. 1, 3, and 4

d. 3 and 418. 19. 20. 21. ANS: C

VD/VT = (PaCO2 PECO2) PaCO2.

DIF: 2 REF: p. 139 OBJ: AL-1 MSC: NBRC: None

Hyperventilation can be defined by:

1. A respiratory rate greater than 25/min

2. Ventilation greater than 25 L/min (BTPS)

3. PaCO2 less than 35 mm Hg

4. pH greater than 7.45

a. 1 and 2

b. 3 and 4

c. 2 and 4

d. 1, 2, and 3

ANS: B

hyperventilation.

Excessive VA (PaCO2 less than 35 and pH greater than 7.45 in healthy patients) defines

DIF: 1 REF: p. 141 OBJ: None MSC: NBRC: None

Which of the following parameters should be measured to assess the adequacy of the output

of the respiratory centers?

a. PaCO2

b. PaO2

c. VD/VT

d. P100

ANS: D

The output of the central respiratory centers is sometimes also measured as the pressure

developed during the first tenth of a second when the airway is blocked (P100 or P0.1).

DIF: 1 REF: p. 136 OBJ: None MSC: NBRC: None

Which of the following tests requires a variable CO2 scrubbing device in the breathing

circuit?

a. Dead space determination

b. Closed-circuit O2 response test

c. Closed-circuit CO2 response test

d. Open-circuit CO2 response test

ANS: B

Closed-circuit technique (progressive hypoxemia). The patient rebreathes from a system

similar to that used for the closed-circuit CO2 response, but the system contains a CO2

scrubber.

DIF: 1 REF: p. 142 OBJ: AL-3 MSC: NBRC: None

A subject has the following data recorded during a rebreathing CO2 response test:

Time (min) 0 1 2 3 422. 23. 24. PETCO2 (mm Hg) 38 41 48 54 61

E (L/min) 5.1 5.2 5.5 5.4 5.5

These findings are consistent with:

a. A decreased ventilatory response

b. A normal ventilatory response

c. An improperly calibrated pneumotachometer

d. A malfunctioning end-tidal CO2 analyzer

ANS: A

The response to an increase in PaCO2 in a healthy individual is a linear increase in approximately 3 L/min/mm Hg (PCO2).

E of

DIF: 3 REF: p. 143 OBJ: None MSC: NBRC: None

Sodium hydroxide crystals (Sodasorb) are used to scrub CO2 from a rebreathing circuit.

What is the color these crystals change to when they are fully depleted?

a. Violet

b. Blue

c. Red

d. White

ANS: A

Sodasorb changes from off-white to violet when it is exhausted.

DIF: 1 REF: p. 137 OBJ: AL-3

MSC: NBRC: CPFT 1B-11

A subject’s tidal breathing is measured at 720 ml, with a respiratory rate of 12. Assuming a

dead space of 150 ml, what is the subject’s alveolar volume?

Temperature 19 C BTPS conversion factor 1.111

a. 7.60 L

b. 6.84 L

c. 8.64 L

d. 9.60 L

ANS: A

VA = fB(VT VD).

DIF: 2 REF: p. 139 OBJ: None MSC: NBRC: None

What is the calculated VD/VT ratio, given the following variables?

P CO2 38 mm Hg

Respiratory rate 15

PaCO2 42 mm Hg

E 7.8 L

Temp 19 C BTPS conversion factor 1.111

a. 10.7%

b. 9.6%25. 26. 27. 28. c. 12%

d. 15%

ANS: B

VD/VT = (PaCO2 PECO2) PaCO2.

DIF: 2 REF: p. 139 OBJ: AL-1 MSC: NBRC: None

Which of the following statements best describes the measurement P100 or P0.1?

a. b. c. d. Pressure measure at 100 mm Hg during CO2 response test

Occlusion pressure measured at 10 msec during a hypoxic challenge test

Pressure measured at 100 msec during a CO2 response test

The oxygen saturation level at which the partial pressure of oxygen is 100 mm Hg

ANS: C

Occlusion pressure (P100 or P0.1) is the pressure generated at the mouth during the first 100

msec of an inspiratory effort against an occluded airway during a response test.

DIF: 1 REF: p. 136 OBJ: None MSC: NBRC: None

When preparing for a CO2 response test, the technologist should fill the rebreathing bag with

which of the following concentrations?

a. Oxygen 21%, CO2 7%, Balance N2

b. Oxygen 90%, CO2 10%

c. Oxygen 93%, CO2 7%

d. Oxygen 21%, CO2 10%, Balance N2

ANS: C

The patient rebreathes from a reservoir (usually an anesthesia bag) of 7% CO2, 93% O2.

DIF: 1 REF: p. 141 OBJ: None MSC: NBRC: None

All of the following are end-of-test criteria for a CO2 response except:

a. Test duration of 4 minutes

b. PETCO2 9%

c. Patient intolerance

d. End-tidal CO2 75 mm Hg

ANS: D

have elapsed.

The patient rebreathes until the concentration of PETCO2 exceeds 9% or until 4 minutes

DIF: 1 REF: p. 141 OBJ: None MSC: NBRC: None

What formula can you use to estimate dead space?

a. b. c. d. 1 ml per pound of ideal body weight

2 ml per pound of ideal body weight

1 ml per kg of ideal body weight

5 ml per kg of ideal body weight

ANS: A29. 30. 31. Dead space consists of anatomic and alveolar components. Anatomic dead space is usually

estimated from body weight (1 ml/lb of ideal body weight).

DIF: 1 REF: p. 139 OBJ: None MSC: NBRC: None

The diagram shows the graphic data from a CO2 response test. On the basis of the gross

change, what physiologic response do these data represent?

a. Blunted CO2 response

b. 3.5 L/min/mm Hg

c. Normal response

d. 0.5 L/min/mm Hg

ANS: C

The response to an increase in PaCO2 in a healthy individual is a linear increase in approximately 3 L/min/mm Hg (PCO2).

E of

DIF: 3 REF: p. 143 OBJ: None MSC: NBRC: None

All of the following would cause an increased VD/VT ratio except:

a. Exercise

b. COPD

c. Pulmonary hypertension

d. Pulmonary embolism

ANS: A

Exercise causes a decreased VD/VT ratio. In healthy individuals, the VT increases more than

the VD, so the ratio decreases.

DIF: 1 REF: p. 141 OBJ: AL-2 MSC: NBRC: None

The high altitude simulation test is used to predict hypoxemia in individuals:a. Climbing mountains to 2000 ft

b. Climbing mountains to 4000 ft

c. Flying at 6000 ft

d. Flying at 8000 ft

ANS: D

The high altitude simulation test exercise is used to emulate high altitude in subjects

susceptible to hypoxia during air travel. The test is designed to predict hypoxemia at the

maximum allowable aircraft cabin pressure altitude of 8000 ft.

DIF: 1 REF: p. 145 OBJ: AL-4 MSC: NBRC: None