Question 1

Which of the following techniques are used to measure residual volume?
1) Helium dilution
2) Body plethysmography
3) Nitrogen washout
4) Flow-volume loops

Accepted Answer

Residual volume can be measured using Helium dilution, Body plethysmography, and Nitrogen washout. Flow-volume loops are not used to measure residual volume.

Question 2

In both the helium dilution test and nitrogen washout functional residual capacity (FRC) determinations, at what point should the patient normally be connected to the system to begin the test?

Accepted Answer

The valve is turned to connect the patient to the breathing circuit usually at the resting expiratory level of the FRC.

Question 3

What shape of the flow-volume loop is typical for the patient with a fixed upper airway obstruction?

Accepted Answer

Compared with the normal flow-volume loop, a fixed upper airway obstruction produces a curve that appears box-shaped.

Question 4

What is the predicted normal forced vital capacity (FVC) for the average 20-year-old man?

Accepted Answer

The predicted normal FVC for a 20-year-old, 180-cm man approaches 5.60 L.

Question 5

Which of the following volumes or capacities cannot be measured by simple spirometry?
1) Functional residual capacity (FRC)
2) Expiratory reserve volume (ERV)
3) Residual volume (RV)
4) Inspiratory reserve volume (IRV)

Accepted Answer

FRC and RV cannot be measured by simple spirometry as they require additional techniques such as gas dilution or body plethysmography. ERV and IRV can both be measured by simple spirometry.

Question 6

After a resting expiration, air still remains in the lungs. What is this volume called?

Accepted Answer

The four lung capacities are TLC, inspiratory capacity (IC), FRC, and the VC. These volumes and capacities are shown in Figure 20-10. The lung volumes that can be measured directly with a spirometer or pneumotachometer include V_T, IC, IRV, ERV, and VC.

Question 7

Which of the following statements is false about the FEV₁ measurement?

Accepted Answer

The FEV₁ is a measurement of the volume exhaled in the first second of the FVC. To ensure validity of the FEV₁, the measurement must originate from a set of three acceptable FVC trials. The first second of forced exhalation begins at the zero time point To ensure reliability of the FEV₁, the largest FEV₁ and second largest FEV₁ from the acceptable trials should not vary by more than 0.150 L. Consistent with its definition, the largest FEV₁ (body temperature, ambient pressure, saturated [BTPS]) measured is the patient's FEV₁. The largest FEV₁ sometimes comes from a different trial than the largest FVC.

Question 8

What is the predicted normal for the peak expiratory flow (PEF) in the average man?

Accepted Answer

Typical normal values for the adult male: PEF is 9.5 L/sec.

Question 9

What pulmonary function test presents the highest risk for fainting?

Accepted Answer

Because of the potential for acute hyperventilation and fainting or coughing during maximum voluntary ventilation testing, the patient should be seated.

Question 10

You are examining the expiratory flow tracing during the patient's forced vital capacity (FVC) maneuver. At what point during the exhalation can you generally begin to see flow from the bronchioles?

Accepted Answer

Any flow measured in the first half of the FVC reflects on the bronchi; any flow measured beyond 50% of the vital capacity reflects on the bronchioles.

Question 11

What is the most common lung volume measured during spirometry?

Accepted Answer

The vital capacity is the most commonly measured lung volume.

Question 12

Which of the following is a true statement?

Accepted Answer

VC (Vital Capacity) is the total volume of air that can be exhaled after a maximal inhalation, which includes the Inspiratory Reserve Volume (IRV), the Expiratory Reserve Volume (ERV), and the Tidal Volume (TV, represented here as V_T for the purposes of this question).

Question 13

You have just given your patient a 0.03 mg/ml dose of methacholine to assess for asthma. The subsequent forced vital capacity (FVC) shows no change. What should you do next?

Accepted Answer

If a positive response does not occur, the methacholine dosage is doubled to 0.06 mg/ml, and then the FVC maneuver is repeated.

Question 14

Which of the following is equal to total lung capacity (TLC)?

Accepted Answer

Total Lung Capacity (TLC) is the sum of Vital Capacity (VC) and Residual Volume (RV). VC is composed of Tidal Volume (TV), Inspiratory Reserve Volume (IRV), and Expiratory Reserve Volume (ERV). Therefore, TLC equals TV + IRV + ERV + RV, which matches the components listed in option A.

Question 15

Normal healthy people can exhale what percentage of the forced vital capacity in 1 sec?

Accepted Answer

In general, individuals without airway obstruction will be able to exhale at least 70% of their vital capacity in the first second.

Question 16

When evaluating a forced vital capacity maneuver postbronchodilator use to determine the reversibility of any airway obstruction, what percent increase in FEV₁ is needed to be able to say the treatment was effective?

Accepted Answer

Although improvements in other measurements of pulmonary function are sometimes used, reversibility is defined as a 15% or greater improvement in FEV₁.

Question 17

A patient has an expired minute ventilation of 14.2 L and a ventilatory rate of 25/min. What is the average V_T?

Accepted Answer

An alternate approach is to measure the total volume of air exhaled for 1 min (E) and then divide by the breathing frequency (f) counted during the same period. The following formula can be used to calculate the tidal volume: V_T = E/f.

Question 18

How can you ensure reliability when measuring the expiratory reserve volume (ERV)?

Accepted Answer

To ensure reliability, the ERV should be measured at least twice and the two largest measurements should agree within 5%.

Question 19

What is the predicted normal FEV₁ for the average 20-year-old man?

Accepted Answer

The predicted normal FEV₁ for a 20-year-old, 180-cm man approaches 4.70 L.

Question 20

What is the minimum objective standard for the volume exhaled during the final 1 sec of an acceptable forced vital capacity effort?

Accepted Answer

An end-expiratory plateau must be obvious in the volume-time curve; the objective standard is less than 0.025 L exhaled during the final second of exhalation.

Quiz 20: Pulmonary Function Testing

Which of the following techniques are used to measure residual volume? 1) Helium dilution 2) Body plethysmography 3) Nitrogen washout 4) Flow-volume loops

In both the helium dilution test and nitrogen washout functional residual capacity (FRC) determinations, at what point should the patient normally be connected to the system to begin the test?

What shape of the flow-volume loop is typical for the patient with a fixed upper airway obstruction?

What is the predicted normal forced vital capacity (FVC) for the average 20-year-old man?

Which of the following volumes or capacities cannot be measured by simple spirometry? 1) Functional residual capacity (FRC) 2) Expiratory reserve volume (ERV) 3) Residual volume (RV) 4) Inspiratory reserve volume (IRV)

After a resting expiration, air still remains in the lungs. What is this volume called?

Which of the following statements is false about the FEV₁ measurement?

What is the predicted normal for the peak expiratory flow (PEF) in the average man?

What pulmonary function test presents the highest risk for fainting?

You are examining the expiratory flow tracing during the patient's forced vital capacity (FVC) maneuver. At what point during the exhalation can you generally begin to see flow from the bronchioles?

What is the most common lung volume measured during spirometry?

Which of the following is a true statement?

You have just given your patient a 0.03 mg/ml dose of methacholine to assess for asthma. The subsequent forced vital capacity (FVC) shows no change. What should you do next?

Which of the following is equal to total lung capacity (TLC) ?

Normal healthy people can exhale what percentage of the forced vital capacity in 1 sec?

When evaluating a forced vital capacity maneuver postbronchodilator use to determine the reversibility of any airway obstruction, what percent increase in FEV₁ is needed to be able to say the treatment was effective?

A patient has an expired minute ventilation of 14.2 L and a ventilatory rate of 25/min. What is the average V_T?

How can you ensure reliability when measuring the expiratory reserve volume (ERV) ?

What is the predicted normal FEV₁ for the average 20-year-old man?

What is the minimum objective standard for the volume exhaled during the final 1 sec of an acceptable forced vital capacity effort?

Quiz 20: Pulmonary Function Testing

Which of the following techniques are used to measure residual volume? 1) Helium dilution 2) Body plethysmography 3) Nitrogen washout 4) Flow-volume loops

In both the helium dilution test and nitrogen washout functional residual capacity (FRC) determinations, at what point should the patient normally be connected to the system to begin the test?

What shape of the flow-volume loop is typical for the patient with a fixed upper airway obstruction?

What is the predicted normal forced vital capacity (FVC) for the average 20-year-old man?

Which of the following volumes or capacities cannot be measured by simple spirometry? 1) Functional residual capacity (FRC) 2) Expiratory reserve volume (ERV) 3) Residual volume (RV) 4) Inspiratory reserve volume (IRV)

After a resting expiration, air still remains in the lungs. What is this volume called?

Which of the following statements is false about the FEV1 measurement?

What is the predicted normal for the peak expiratory flow (PEF) in the average man?

What pulmonary function test presents the highest risk for fainting?

You are examining the expiratory flow tracing during the patient's forced vital capacity (FVC) maneuver. At what point during the exhalation can you generally begin to see flow from the bronchioles?

What is the most common lung volume measured during spirometry?

Which of the following is a true statement?

You have just given your patient a 0.03 mg/ml dose of methacholine to assess for asthma. The subsequent forced vital capacity (FVC) shows no change. What should you do next?

Which of the following is equal to total lung capacity (TLC) ?

Normal healthy people can exhale what percentage of the forced vital capacity in 1 sec?

When evaluating a forced vital capacity maneuver postbronchodilator use to determine the reversibility of any airway obstruction, what percent increase in FEV1 is needed to be able to say the treatment was effective?

A patient has an expired minute ventilation of 14.2 L and a ventilatory rate of 25/min. What is the average VT?

How can you ensure reliability when measuring the expiratory reserve volume (ERV) ?

What is the predicted normal FEV1 for the average 20-year-old man?

What is the minimum objective standard for the volume exhaled during the final 1 sec of an acceptable forced vital capacity effort?

Which of the following statements is false about the FEV₁ measurement?

When evaluating a forced vital capacity maneuver postbronchodilator use to determine the reversibility of any airway obstruction, what percent increase in FEV₁ is needed to be able to say the treatment was effective?

A patient has an expired minute ventilation of 14.2 L and a ventilatory rate of 25/min. What is the average V_T?

What is the predicted normal FEV₁ for the average 20-year-old man?