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TECHNOLOGIST PRACTICE TEST Practice Exam
Question 1. Which of the following lung volumes is measured directly by spirometry? A) Functional residual capacity B) Residual volume C) Inspiratory reserve volume D) Total lung capacity Answer: C Explanation: Spirometry measures volumes that involve airflow, such as tidal volume, inspiratory reserve volume, and expiratory reserve volume. Functional residual capacity, residual volume, and total lung capacity require plethysmography or gas dilution techniques because they include the non‑communicating residual volume. Question 2. The primary purpose of the calibration syringe in a pulmonary function laboratory is to: A) Verify the accuracy of flow measurements B) Clean the pneumotachograph C) Adjust the patient’s breathing pattern D) Measure gas concentrations Answer: A Explanation: A calibration syringe of known volume (usually 3 L) is used to check that the spirometer’s flow‑volume loop accurately reflects the volume of air delivered, ensuring the device’s accuracy.
TECHNOLOGIST PRACTICE TEST Practice Exam
Question 3. In a flow‑volume loop, an obstructive pattern is most likely to show: A) Decreased peak expiratory flow with a scooped‑out expiratory limb B) A parallel upward shift of both inspiratory and expiratory limbs C) A reduced vital capacity with a normal shape D) Increased total lung capacity with a normal loop shape Answer: A Explanation: Obstructive disease causes reduced maximal flow rates, especially during the middle portion of expiration, creating a concave (scooped) appearance on the expiratory limb. Question 4. The diffusion capacity of the lung for carbon monoxide (DLCO) is primarily influenced by: A) Airway resistance B) Alveolar surface area and capillary blood volume C) Respiratory muscle strength D) Pleural pressure Answer: B Explanation: DLCO reflects the ability of gas to diffuse across the alveolar‑capillary membrane, which depends on the surface area available for diffusion and the volume of blood in pulmonary capillaries.
TECHNOLOGIST PRACTICE TEST Practice Exam
Question 7. A patient’s FEV1/FVC ratio is 0.68 (68%) and the predicted FEV is 55% of predicted. Which pattern does this most likely represent? A) Normal B) Restrictive C) Obstructive D) Mixed obstructive‑restrictive Answer: C Explanation: A reduced FEV1/FVC ratio (<0.70) with a reduced FEV1 indicates airflow limitation typical of an obstructive pattern. Question 8. Which of the following is a contraindication to performing a methacholine challenge test? A) Chronic cough B) Recent myocardial infarction (within 6 weeks) C) Well‑controlled asthma D) Mild hypertension Answer: B Explanation: Recent myocardial infarction poses a risk of bronchospasm‑induced cardiac stress; methacholine challenges are contraindicated in patients with recent cardiac events.
TECHNOLOGIST PRACTICE TEST Practice Exam
Question 9. In arterial blood gas (ABG) analysis, a PaCO2 of 55 mm Hg with a pH of 7.30 indicates: A) Respiratory alkalosis B) Metabolic acidosis C) Respiratory acidosis (acute) D) Metabolic alkalosis Answer: C Explanation: Elevated PaCO2 (hypercapnia) with a low pH signifies respiratory acidosis. The acute nature is suggested by the relatively modest compensation (bicarbonate not markedly elevated). Question 10. The term “air trapping” on a lung volume measurement is most closely associated with: A) Decreased residual volume B) Increased functional residual capacity and residual volume C) Decreased total lung capacity D) Normal diffusion capacity Answer: B Explanation: Air trapping reflects incomplete emptying of alveoli, leading to elevated residual volume (RV) and functional residual capacity (FRC).
TECHNOLOGIST PRACTICE TEST Practice Exam
Question 13. Which of the following is the most appropriate method for measuring exhaled nitric oxide (FeNO) in a patient with suspected asthma? A) Using a spirometer with a high‑flow valve B) A chemiluminescence analyzer with a constant flow of 50 mL/s C) A handheld capnograph D) A body plethysmograph Answer: B Explanation: FeNO is measured using a chemiluminescence detector that samples exhaled air at a constant low flow (≈50 mL/s) to standardize concentration readings. Question 14. A patient’s static lung volumes reveal a total lung capacity (TLC) of 110% predicted, residual volume (RV) of 150% predicted, and normal diffusion capacity. The most likely diagnosis is: A) Pulmonary fibrosis B) Chronic obstructive pulmonary disease with emphysema C) Restrictive chest wall disease D) Normal aging changes Answer: B Explanation: Elevated TLC and markedly increased RV suggest hyperinflation and air trapping, characteristic of emphysema, an obstructive disease. Normal DLCO may be seen early in COPD.
TECHNOLOGIST PRACTICE TEST Practice Exam
Question 15. The term “hyperinflation” on a chest radiograph correlates best with which pulmonary function finding? A) Decreased FEV1/FVC ratio B) Increased diffusing capacity C) Decreased residual volume D) Increased inspiratory capacity only Answer: A Explanation: Hyperinflation reflects air trapping and loss of elastic recoil, which manifests as a reduced FEV1/FVC ratio in obstructive lung disease. Question 16. In the context of quality control for spirometry, a “repeatability” criterion requires that at least two of the three best FEV1 values be within what percentage of each other? A) 5% B) 10% C) 15% D) 20% Answer: B Explanation: ATS/ERS guidelines state that the two highest FEV1 values must be within 150 mL (or 10% if FEV1 <1 L) of each other to meet repeatability standards.
TECHNOLOGIST PRACTICE TEST Practice Exam
Question 19. Which of the following gases is used in the single‑breath DLCO test to calculate alveolar‑capillary membrane conductance? A) Helium B) Nitrogen C) Carbon monoxide D) Oxygen Answer: C Explanation: Carbon monoxide diffuses rapidly across the alveolar‑capillary membrane and binds hemoglobin, making it ideal for measuring diffusing capacity (DLCO). Question 20. In a patient with restrictive lung disease, which of the following patterns is expected on spirometry? A) Normal FEV1/FVC ratio with reduced FVC and FEV B) Decreased FEV1/FVC ratio with normal FVC C) Increased total lung capacity D) Elevated residual volume Answer: A Explanation: Restrictive disease reduces lung volumes proportionally, so both FVC and FEV1 are decreased, but the ratio remains normal or may be slightly increased.
TECHNOLOGIST PRACTICE TEST Practice Exam
Question 21. The “Bronchial Provocation Test” with methacholine is primarily used to assess: A) Airway hyperresponsiveness B) Diffusion capacity C) Lung compliance D) Upper airway obstruction Answer: A Explanation: Methacholine causes dose‑dependent bronchoconstriction; a heightened response indicates airway hyperreactivity, a hallmark of asthma. Question 22. Which of the following statements regarding the “Maximal Voluntary Ventilation” (MVV) test is correct? A) It measures the total lung capacity directly. B) It is a submaximal effort test lasting 12 seconds. C) It reflects the combined capacity of the respiratory muscles and airway resistance. D) It is not affected by patient effort. Answer: C Explanation: MVV assesses the highest volume of air that can be inhaled and exhaled within a minute, reflecting respiratory muscle performance and airway resistance; it requires maximal effort.
TECHNOLOGIST PRACTICE TEST Practice Exam
Question 25. The “Bronchial Thermoplasty” procedure is primarily indicated for patients with: A) Severe chronic obstructive pulmonary disease B) Moderate to severe asthma refractory to medical therapy C) Pulmonary hypertension D) Cystic fibrosis Answer: B Explanation: Bronchial thermoplasty reduces airway smooth‑muscle mass and is used in patients with severe, refractory asthma. Question 26. Which of the following best explains why a patient with a high hemoglobin concentration may have an elevated DLCO? A) Increased alveolar surface area B) Greater capillary blood volume for CO binding C) Reduced airway resistance D) Higher lung compliance Answer: B Explanation: DLCO depends on the amount of hemoglobin available to bind CO; higher hemoglobin concentrations increase the capacity for CO uptake, raising DLCO values.
TECHNOLOGIST PRACTICE TEST Practice Exam
Question 27. In pulmonary function testing, the “inspiratory capacity” (IC) is calculated as: A) TLC – RV B) FRC + RV C) FVC + RV D) FEV1 + FRC Answer: A Explanation: Inspiratory capacity equals the total lung capacity minus residual volume, representing the maximal volume that can be inhaled after a normal exhalation. Question 28. A patient’s post‑bronchodilator spirometry shows an increase in FVC of 300 mL but no significant change in FEV1. This pattern suggests: A) Pure obstructive disease B) Pure restrictive disease C) Mixed disease with predominant restriction D) Normal response Answer: C Explanation: An increase in FVC without FEV1 improvement indicates that bronchodilation helped to open airways enough to allow more volume, typical of a mixed pattern where restriction limits flow.
TECHNOLOGIST PRACTICE TEST Practice Exam
Question 31. Which of the following gases is most appropriate for calibrating a pneumotachograph’s flow sensor? A) Helium (He) B) Nitrogen (N₂) C) Carbon dioxide (CO₂) D) Oxygen (O₂) Answer: A Explanation: Helium is inert, has low density, and does not react with sensor components, making it ideal for flow calibration. Question 32. In a pediatric patient, which maneuver is recommended to obtain reliable spirometry results? A) Forced exhalation for 6 seconds B) Use of a “child‑appropriate” incentive spirometer with visual feedback C) Performing the test in the supine position D) Asking the child to hold breath for 20 seconds Answer: B Explanation: Visual incentives (e.g., cartoon characters) improve cooperation and effort in children, leading to more accurate spirometric measurements. Question 33. During a bronchospirometry test, a sudden drop in measured volume occurs after 2 L have been exhaled. The most likely cause is:
TECHNOLOGIST PRACTICE TEST Practice Exam
A) Patient fatigue B) Device malfunction C) Air leak around the mouthpiece D) Inadequate nose clip Answer: C Explanation: An air leak allows exhaled air to escape without being measured, causing an abrupt decrease in recorded volume. Question 34. Which of the following statements about “airway resistance” (Raw) measured by body plethysmography is true? A) Raw is highest in obstructive diseases and lowest in restrictive diseases. B) Raw is independent of lung volume. C) Raw is calculated using the equation: Raw = ΔP / ΔV̇. D) Raw cannot be measured in patients with tracheostomies. Answer: C Explanation: Airway resistance is derived from the pressure change (ΔP) across the airway divided by the flow change (ΔV̇). It is elevated in obstructive disease but also affected by lung volume. Question 35. A patient with a known diagnosis of interstitial lung disease has a DLCO of 45% predicted. Which of the following is the most likely explanation? A) Decreased alveolar surface area due to fibrosis
TECHNOLOGIST PRACTICE TEST Practice Exam
C) Using a spirometer during normal tidal breathing D) Recording the pressure during a cough Answer: A Explanation: MIP is obtained by having the patient inhale maximally from residual volume against a closed valve, measured with a calibrated manometer. Question 38. A 55‑year‑old woman with systemic sclerosis undergoes pulmonary function testing. Her TLC is 70% predicted, FVC 68% predicted, and FEV1/FVC ratio is 0.82. The most likely interpretation is: A) Obstructive lung disease B) Restrictive lung disease C) Mixed disease D) Normal lung function Answer: B Explanation: Reduced TLC and FVC with a normal or elevated FEV1/FVC ratio are characteristic of a restrictive pattern, common in systemic sclerosis. Question 39. Which of the following best describes the “Washout Test” used in the measurement of lung volumes? A) It determines the maximal volume of air the lungs can hold. B) It measures the rate of nitrogen elimination to calculate functional residual capacity.
TECHNOLOGIST PRACTICE TEST Practice Exam
C) It assesses the diffusion capacity of the alveolar membrane. D) It evaluates airway resistance during rapid breathing. Answer: B Explanation: The nitrogen washout technique involves breathing 100% oxygen; the rate at which nitrogen is eliminated allows calculation of FRC and other lung volumes. Question 40. The most common cause of an elevated “peak expiratory flow” (PEF) reading in a healthy adult is: A) Performing the maneuver with a forced inspiratory effort first B) Using a mouthpiece that is too large C) Inadequate patient effort D) Performing the maneuver in a seated position Answer: A Explanation: A “pre‑inspiratory” effort can generate a higher initial flow, artificially inflating the PEF value. Question 41. Which of the following is the primary purpose of the “Bronchial Hygiene” technique during pulmonary function testing? A) To increase DLCO values B) To reduce airway resistance by mobilizing secretions C) To improve patient comfort during testing
