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50 Cards in this Set
- Front
- Back
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1. Which test involves: a tight seal with a bite block mouthpiece and noseclips; turning the patient into 100% O2 source at FRC; tidal breathing for 3 - 7 minutes until the dilution gas is <1.5% in the exhaled gas; and measurement of the total exhaled volume
A. body plethysmography B. helium dilution C. nitrogen washout D. DLCO Single Breath E. The Moroccan tolerance test |
C
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2. What is the best explanation for the use of helium to facilitate a dilutional measurement of FRC?
A. Helium is not significantly absorbed in the blood and therefore does not transfer through the AC membrane B. Helium is immediately absorbed by the blood as soon as it transfers through the lung C. Helium is less dense so RAW is decreased D. Helium is immediately taken up by hemoglobin E. B and D |
A
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3. A normal RAW and a decreased SGAW is most consistent with:
A. Emphysema B. normal lungs C. asthma D. Obesity submaximal effort |
A
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4. After the 10-second breath-hold during the single-breath DLCO procedure, why should the first portion of the subject's exhaled gas be excluded from analysis of the collected exhaled sample?
A. the flow is too turbulent B. because it contains 100% oxygen C. because it is the same gas that is in the in the Alveoli D. because it is essentially gas contained in anatomic dead space |
D
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5. Plethysmography is useful
i. where nonventilated areas of the lung exist ii. in measuring FRC iii. in determining the diffusion capacity of the lungs iv. in determining RV A. I and II B. II and IV C. I, II and IV D. I, II and III |
C
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6. A decreased DLCO value may be indicative of:
i. decreased diffusion capacity ii. destruction of alveolar surface area iii. anemia iv. polycythemia A. I, II and III only B. I, II and IV only C. I and IV only D. II and III only |
A
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7. A patient with severe air trapping with uncommunicating blebs has his FRC measured using the closed-circuit method and by plethysmography. The FRC as measured by the gas dilution method would be:
A. smaller than the TGV B. equal to the VTG C. Much larger than the TGV D. The two methods cannot be compared, since each measures a different lung compartment |
A
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8. Which of the following methods of lung volume determination correlates best with body plethysmography in patients with severe obstruction?
A. N2 washout B. He dilution C. radiologic determination of TLC D. single breath washout |
C
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9. The body plethysmograph operates according to which law?
A. Pascal's law B. Guy-Lussac's law C. Boyle's law D. Ohm's law |
c
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10. An abnormally increased blood volume in the pulmonary vasculature will cause measurement error in which of the following tests?
Student Response A. Helium dilution B. Maximum voluntary ventilation C. Slow Vital Capacity D. DLCO |
D
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11. Which of the following devices CANNOT be used to measure a
slow vital capacity Student Response A. Wright respirometer B. Pneumotach C. water seal spirometer D. peak flowmeter |
D
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12. A pressure differential pneumotach has gained in popularity because of:
i. compact size and mechanical simplicity ii. it does not need to be calibrated iii. less risk of cross contamination iv. virtual indestructibility Student Response A. I, III, IV B. I, III C. I, IV D. II, IV E. all of the above |
B
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13. The pressure differential pneumotach works because
Student Response A. pressure drop through a resistive element is proportional to flow B. a flow decrease through a resistive element is proportional to volume increase C. volume is directly measured D. resistance is variable in order to keep pressure constant |
A
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14. This device can be classified as a:
Student Response A. dry rolling seal B. pneumotachometer C. the typical mouthpiece for a volume displacement spirometer D. an ultrasonic flow sensor E. a mosquito zapper |
B
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15. A peakflow meter gives a reasonably good estimation of:
Student Response A. the effort independent portion of the patient's airways B. a restrictive process C. the maximum voluntary ventilation D. the maximum flow attained during a forced exhalation following a maximum inhalation E. a and d |
D
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16. A patient with a decreased FVC, increased FEV1%, narrow flow volume loop, reduced TLC, no bronchodilator response, and a reduced DLCO most likely has:
Student Response A. emphysema B. neuromuscular disease C. asthma D. pulmonary fibrosis E. morbid obesity |
D
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17. The PFT below is most consistent with which of the following
Student Response A. obstruction due primarily to asthma B. obstruction due primarily to emphysema C. restriction due to fibrosis D. combined restriction and obstruction E. uninterpretible due to poor effort |
A
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18. The PFT below is most consistent with which of the following
Student Response A. obstruction due primarily to asthma B. obstruction due primarily to emphysema C. restriction due to fibrosis D. combined restriction and obstruction E. uninterpretible due to poor effort; the expiratory time in the FVC is less than 6 seconds |
E
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19. A positive bronchodilator response according to ATS standards is (are):
i a 12% increase in FVC or FEV1 post bronchodilator ii a flow volume loop that no longer looks too narrow iii a 200 cc increase in FVC or FEV1 post bronchodilator iv a TLC increase above 120% of predicted v a decrease in expiratory time during a FVC of at least 2 seconds Student Response A. i, ii, iii B. ii, iv, v C. i, iii D. iii E. all of the above |
C
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20. The following PFT data best represents a patient who:
Student Response A. has severe obstructive disease because the FEV1 and DLCO is significantly reduced B. had a submaximal effort due to the low MVV C. has a combined obstructive and restrictive process because the FEV1% is elevated and the TLC is reduced D. has a severe restrictive disease because the TLC is markedly reduced. E. is normal but extremely under weight |
D
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A patient with airflow obstruction, a normal TLC, air trapping, a bronchodilator response, and a normal DLCO most likely has:
A: emphysema B: neuromuscular disease C: asthma D: pulmonary fibrosis E: morbid obesity |
C
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28. Regarding the Wright Respirometer, which of the following is
false? Student Response A. it operates using a rotating vane and gears B. it can be used to measure an FEF 25 -75 C. it can be used to measure tidal volumes D. it can be used to measure minute volumes |
B
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29. Which of the following are methods for measuring FRC?
i. N2 wash out ii. radiological estimation iii. he dilution iv. maximal voluntary ventilation v. body plethysmography Student Response A. i, ii, iv B. i, iii, v C. ii, iii, v D. i, ii, iv, v E. i, ii, iii, v |
B
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30. A patient with severe COPD comes to the PFT Lab for a complete study. The patient performs the spirometry but refuses to enter the body box. The patient is a CO2 retainer and very sensitive to hypoxic drive. Given all the required equipment, what other testing method should you choose to complete the study ?
Student Response A. N2 washout B. He dilution C. CO diffusion D. SVC |
B
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31. Diffusing capacity can be decreased in
Student Response A. obstructive disease B. restrictive disease C. c. both obstructive and restrictive disease D. neither obstructive or restrictive disease |
C
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32. When using a plastic syringe to draw a blood gas, you must position the plunger just prior to the actual stick.
Student Response A. down all the way to the needle hub to prevent air bubbles B. out 1.5 to 2 cc to allow for an adequate sample volume C. out about .3cc since this is all the blood gas machine requires D. it makes no difference since the blood pressure always pushes back the plunger |
B
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33. During an ABG attempt you decide to probe for the artery; you should:
Student Response A. withdraw the needle completely out of the skin and start over B. keep the needle at the present position and swing the needle from side to side C. withdraw the needle straight out until the tip is just below the skin and redirect D. rotate the syringe |
C
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34. Which of the following are directly measured during arterial blood gas analysis
i. pH ii. PCO2 iii. PO2 iv. HCO3 v. SaO2 Student Response A. i, ii, v B. i, ii, iii C. ii, iii, iv, v D. ii, iii, iv E. all of the above |
B
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35. Regarding delays in analyzing arterial blood gas samples, which of the following is false?
Student Response A. the effects can be minimized by putting the sample on ice B. the PaO2 will decrease if the delay is long C. the PaCO2 will decrease if the delay is long D. the PaCO2 will increase if the delay is long E. for best results, it should be analyzed within 10 minutes |
C
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36. Hypoventilation will cause:
Student Response A. respiratory acidosis B. hypoxemia C. metabolic acidosis D. respiratory alkalosis E. a. and b. |
E
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37. All of the following are necessary equipment needed for an arterial puncture, except:
Student Response A. heparin (if syringe is not pre-heparinized) B. syringe C. alcohol and betadine wipes D. tourniquet E. sterile gauze pad |
D
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38. Regarding arterial punctures, which of the following is true?
Student Response A. a Doctor's order is needed in order to do one B. the puncture can be painful for the patient C. a hematoma can result from the procedure D. the sample should be put in ice after it is drawn if analysis is not immenent E. all of the above |
E
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39. Which of the following is not one of the three primary sites for an ABG
Student Response A. radial B. brachial C. carotid D. femoral |
C
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40. Air bubbles, if present in an arterial blood gas sample can cause:
I.an increase or decrease in PaO2 II. an increase in PaCO2 III. a decrease in PaCO2 IV. a decrease in HCO3 Student Response A. II, IV B. I, II C. I, III D. I, III, IV E. I, II, III, IV |
C
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41. Possible hazards or complications of an arterial puncture include:
i. infection ii. hematoma iii. laceration of artery iv. vessel spasm v. embolism Student Response A. I, II, V B. II, III, IV C. III, IV, V D. I, III, IV, V E. I, II, III, IV, V |
E
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42. When doing a blood gas you must position the bevel of the needle:
Student Response A. down B. up C. perpendicular to the medial aspect of the radial bone D. makes no difference |
B
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43. You perform an ABG on an alert COPD patient in mild respiratory distress breathing room air. You notice that the dark blood fills the syringe very slowly. The results are.. pH = 7.35, PCO2 = 47 mmHg, and PO2 = 32 mmHg. What would you do next?
Student Response A. notify the nurse and MD that the patient may "Code" at any time. B. Place the patient on a 100% nonrebreather mask to raise the PO2. C. document the result and continue on to your next patient D. repeat the ABG because you suspect a venous sample |
D
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44. When performing a single breath CO diffusion study, at what point should the patient be instructed to begin inhaling the gas mixture?
Student Response A. from FRC B. following a maximal exhalation or RV C. a any point during a ventilatory cycle that "feels right" for the patient D. from the end of a resting, tidal inspiration E. after 90% of the FVC has been exhaled |
B
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45. The following is(are) (an) advantage(s) of the Fleisch or Silverman/Lilly pneumotach:
i. little calibration is necessary ii. accurate at any flowrate iii. small size iv. is especially useful for helium dilution studies without any added equipment v. requires only a "dry seal" Student Response A. iii B. i, ii, iii C. i, iii, v D. all of the above E. iv, v |
A
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46. The patient in the PFT below gave a maximal effort. Which of the following is the best explanation for the difference in the MVV and the FVC?
Student Response A. an extrathoracic airway obstruction that will not effect a forced expiratory maneuver B. an intrathoracic airway obstruction that will not effect a forced expiratory maneuver C. the patient has a pure restrictive disease D. there is a fixed upper airway obstruction |
A
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47. Which of the following is not an advantage of using the radial artery for an arterial blood gas puncture?
Student Response A. presence of collateral circulation B. closeness of the artery to the skin surface C. relative small size of the artery D. a and b |
C
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48. Rationale for obtaining arterial blood gases include:
i. determining electrolyte levels of the patient ii. determining ventilatory status of the patient iii. determining oxygenation status of the patient iv. determining the patient's hematocrit v. determining the acid-base status of the patient Student Response A. I, II B. II, III, V C. II, III, IV D. I, II, III, V E. I, II, III, IV, V |
B
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49. Advantages of using the radial artery for a puncture site include:
i. there is adequate collateral blood flow through the ulnar artery ii. it has a higher PaO2 than other arteries iii. it provides the largest target iv. it is close to the surface of the skin v. it will not spasm Student Response A. I, IV B. III, IV, V C. I, II, III, IV D. I, II, V E. I, II, III, IV, V |
A
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50. Which of the following is not caused by patient anxiety?
Student Response A. hyperventilation B. decreased PaCO2 C. increased pH D. increased metabolism of the sample |
D
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51. Appropriate techniques to use when performing a radial arterial puncture include which of the following:
i. performing a modified Allen's test ii. entering the artery at a 90 degree angle iii. applying pressure on site of puncture for a maximum of 3 min iv. removing all air bubbles from the sample v. cleansing site to be punctured and the fingers being used to palpate site Student Response A. I, III, V B. II, III C. I, IV, V D. II, IV, V E. I, II, III, IV, V |
C
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52. Regarding the use of a local anesthetic when doing an arterial puncture, which of the following is false?
Student Response A. a 50% lidocaine solution should be used B. it should be given before the arterial puncture is performed C. care should be taken to not inject the anesthetic in a blood vessel D. a TB syringe is used to give the anesthetic |
A
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53. Regarding the modified Allen's test, which of the following is false?
A. Initially, both the radial and ulnar arteries are held. B. The hand should "pink up" within 15 seconds after release of the ulnar artery. C. It should be performed before doing a radial puncture. D. It should be performed before doing a brachial puncture. E. it checks the ulnar artery for collateral circulation |
D
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54. After performing a femoral arterial puncture, pressure should be applied for a minimum of:
A. 3 minutes B. 5 minutes C. 10 minutes D. 20 minutes E. 30 minutes |
C
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55. Regarding arterial punctures, which of the following is true?
A. a Doctor's order is needed in order to do one B. the puncture can be painful for the patient C. a hematoma can result from the procedure D. the sample should be put in ice after it is drawn if analysis is not immenent E. all of the above |
E
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56. The femoral artery is preferred during a "code" because:
A. the vessel is large B. it is more superficial than the radial or brachial artery C. it contains more oxygen D. it has better collateral blood flow than the brachial or radial arteries E. it has fewer periarterial veins and nerves than the radial or brachial arteries |
A
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