TMC Questions
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TMC Questions and Correct Answers
After reviewing the results of a patient's PFT, you note that the FEV1, FVC, and total
lung capacity are all reduced. The FEV1/FVC ratio is normal. That is the
interpretation based on these findings?
A) Restrictive lung disease
B) Obstructive lung disease
C) Combined obstructive-restrictive lung disease
D) The test is invalid
✓ ~~~ A) Restrictive lung disease.
(Since this pt has a normal FEV1/FVC ratio, this indicates that there is not an
obstructive disease. REMEMBER, the FEV1/ FVC ratio would be decreased if there
were an obstructive disease present. AND since the FEV1,FVC and TLC are ALL
reduced, this indicates that the patient has a restrictive disease).
You are instructing a pt on how to perform an FVC maneuver. After looking at the
results of an attempt, you determine that it took too long for the patient to reach the
peak expiratory flow. Before another attempt, which of the following instructions
should you give the patient?
A) "Take a deeper breath"
B) "Don't hesitate"
C) " Blast the sir out faster"
D) "Blow out longer"
✓ ~~~ C) "Blast the air out faster"
(It took the patient too long to reach the peak expiratory flow, which means that the
patient simply isn't exhaling fast enough. This can cause invalid results. In this case,
you should simply instruct the patient to blast the air out faster at the beginning of the
maneuver and this will correct the issue. Taking a deeper breath will not fix the issue
and the patient doesn't seem to have a problem hesitating. Blowing out longer isn't
going to fix the issue either).
After reviewing your work order for the day, you notice that you have a patient with
chronic bronchitis and another patient with emphysema. Which of the following PFT
findings would you expect for these patients?
A) Increased lung compliance
B) Decreased forced expiratory flows
C) Decreased total lung capacity
D) Decreased diffusing capacity
✓ ~~~ B) Decreased forced expiratory flows
* BOTH diseases that were mentioned are obstructive diseases.
(We know that with obstructive diseases, the patient will have decreases expiratory
flow rates. Their FEV1% will be less than 70%. Air trapping is also common in
, obstructive diseases which will cause the TLC to be increased. A decreased
diffusing capacity tends to occur only in emphysema).
Simple spirometry can be used to measure any of the following EXCEPT:
A) Tidal Volume
B) Vital Capacity
C) Inspiratory reserve volume
D) Residual Volume
✓ ~~~ D) Residual Volume
(A spirometer is a device that measures exhaled flow rates and volumes. It can be
used to obtain measurements such as tidal volume, vital capacity, and FEV1. To get
this one right, you have to know what Residual Volume is. It is the amount of air that
is left in the lungs after a full exhalation. The residual volume cannot be exhaled. And
because that is the case, it cannot be measured by simple spirometry).
(Tidal volume, vital capacity, and IRV all can be measured with a spirometer. You
would need a Plethysmography, aka a body box, in order to measure the residual
volume).
You are assessing a patient with chronic asthma. She has a SVC of 3,500mL and a
FVC of 2,500mL. Which of the following best explains this difference?
A) Increased compliance during a forced expiration
B) Poor instruction by the previous respiratory therapist
C) Muscle fatigue during a forced expiration
D) Air trapping during a forced expiration
✓ ~~~ D) Air trapping during a forced expiration
( The first thing that should stand out is that the patient has asthma, which is an
obstructive disease. And we know that air trapping is a commonality in obstructive
diseases. If a patient has a significant difference between their slow vital capacity
and forced vital capacity, this also indicates that air is trapped in the lungs when the
patient exhales forcefully).
( Because they airways are obstructed or constricted, as with bronchospasm in
asthma, all of the air can be expelled if the patient exhales slowly, it just takes
longer. This explains why the values are slower with the FVC as compared to the
SVC).
While reviewing the patients medical record, you note that the FEV1/FVC ratio
reported as being severely reduced. Which of the following is most consistent with
this finding?
A) Pulmonary hypertension
B) Morbid obesity
C) Chronic asthma
D) Pneumonia
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