Spirometry Test Spirometry Test Please Enter Your Contact Information 1 / 55 What is the primary function of the respiratory system? Gas exchange. Air filtration. Defense against infection and environmental pollution. Circulate blood through the pulmonary vasculature. 2 / 55 Which of the following is a lung defense mechanism? Bronchodilation. Cough reflex. Elastic recoil. Surfactant. 3 / 55 The principle inspiratory muscle is the: External intercostals. Diaphragm. Accessory muscles. Abdominal muscles. 4 / 55 The Forced Vital Capacity (FVC) is: The maximum amount of air that can be inhaled. The volume of air inhaled and exhaled during quiet, normal breathing. The maximum volume of air that can be exhaled forcefully after maximal inhalation. The amount of air remaining in the lungs after a complete forced exhalation. 5 / 55 The FEV1 is: The time necessary to forcefully exhale one liter. The volume of air exhaled during the first second of a forced expiration. The maximum flow rate exhaled in one second. The volume of air exhaled after the first second of normal expiration. 6 / 55 A 45-year-old iron worker’s test has 3 acceptable curves with the following results: Trial 1 Trial 2 Trial 3 FVC 3.10 L 4.15 L 4.25 L FEV1 2.85 L 3.65 L 3.50 L What should you do next? Perform another trial. Report the FVC and FEV1 from trial 3. Report the FVC and FEV1 from trial 2. Report the FVC from trial 3 and the FEV1 from trial 2. 7 / 55 How should the measured values for FEV1 and FVC be expressed? In milliliters. In liters rounded to two decimal places. As a percent rounded to one decimal place. In liters/second rounded to two decimal places. 8 / 55 The observed FEV1/FVC ratio can be greater than 100%. True. False. 9 / 55 The BTPS correction adjusts the measured result obtained in the spirometer to: The ambient temperature for the surrounding air. The volume that was originally in the lungs. The barometric pressure at the altitude where the testing is conducted. The relative humidity in the testing room. 10 / 55 According to the ATS/ERS 2019 Standards, which of these should be visible during testing? Volume-time and flow-volume graphs. BTPS correction factor and temperature. Calibration factor and factory test date. Ethnicity and correction factor. 11 / 55 A spirometer that is used every day for testing should have its volume accuracy checked: Daily. Weekly. Quarterly. Annually. 12 / 55 Upon inspection of your flow sensor, you notice a crack in the pneumotach screen or one of the vanes of the turbine is broken. What should you do? Carefully guide the broken screen part into its correct position with a pair of fine tweezers and repeat the calibration check routine. Glue the broken vane together and carefully line-up the edges. File all rough edges with a fine-grade emery board and repeat the calibration check routine. Use the last calibration check information, continue testing, and multiply your results by a correction factor of 1.05. Replace the sensor and notify the physician that all tests performed after the last successful calibration need to be repeated. 13 / 55 Which of the following statements is true? Zero flow errors may appear in volume collecting spirometers. Zero flow is normally set only during daily calibration. Zero flow errors can increase or decrease FVC. Manufacturers can program software to correct zero flow errors. 14 / 55 What impairment causes the FEV1/FVC ratio to fall below the lower limit of the normal range (LLN)? Restrictive. Obstructive. Obesity. Pulmonary fibrosis. 15 / 55 An employee performed five acceptable FVC maneuvers in one test session. What do the following results most likely demonstrate? Trial 1 Trial 2 Trial 3 Trial 4 Trial 5 FEV1 4.43 4.20 4.00 3.80 3.34 Maneuver induced bronchospasm. Failure to understand test instructions. Not wearing nose clips. Leak or negative zero flow error. 16 / 55 Despite repeated maximal efforts, your employee is unable to reach a plateau. What might this be an indication of? Obstructive lung disease. Restrictive lung disease. Sub-maximal subject effort. Failure of BTPS conversion. 17 / 55 What is a typical spirometry result in a worker with an obstructive pattern? The FEV1 is increased. The FEV1/FVC ratio is decreased. The FVC is increased. The FEV1/FVC is increased. 18 / 55 Sources of inhaled particles that can cause hypersensitivity pneumonitis include. Fungus that grows in air conditioners and humidifiers. Bird droppings. Mold that grows in hay, straw, or grain. All of the above. 19 / 55 Lung volumes are reduced in obstructive impairment. True. False. 20 / 55 Which of the following worker characteristics is not used to determine a predicted normal FVC? Height. Weight. Sex. Race. 21 / 55 Which reference values are most commonly used for spirometry testing of adult occupational workers in the United States? GLI 2012. Crapo 1981. Knudson 1983. NHANES III (Hankinson 1999). 22 / 55 The primary values used for spirometry interpretation should be: FVC, FEV6, and PEF. FVC, FEV6, and SVC. SVC, FEV1, and FEV1/FVC. FVC, FEV1, and FEV1/FVC. 23 / 55 Why does NIOSH recommend having a Spirometry Procedure Manual? To replace hands-on training of new staff. To provide a central place for keeping forms, logs, and lab policy/procedures. To replace a manufacturer’s manual. To substitute for periodic calibration checks. 24 / 55 According to national standards, at minimum, how often must you verify the volume measuring accuracy of your spirometer during heavy use? Before every test. Every 4 hours. Daily. Quarterly. 25 / 55 When using a 3.00 L syringe to check spirometer calibration, what range of results is acceptable? 2.00 to 3.00 L 2.91 to 3.09 L 2.96 to 3.04 L 2.99 to 3.01 L 26 / 55 When a flow spirometer’s calibration is checked, how much measurement error is allowed? 0% 3.0% 5.3% 10% 27 / 55 Which of the following would you expect to be altered if the sensor of a flow measuring spirometer moves while it is determining zero flow? BTPS correction. Predicted values. FVC and FEV1. Calibration factor. 28 / 55 How should you check the calibration of flow-measuring spirometers? Use a flow-calibrator device at 6 speeds (9 sec, 6 sec, 4 sec, 3 sec, 2 sec, 1 sec) Use a 1.00 L calibration syringe at three speeds (6 sec, 3 sec, and 0.5–1 sec.) Inject 3.00 L using slow, medium, and fast strokes (6 sec, 3 sec, and 0.5–1 sec.) Inject 3.00 L in 10 sec., 2.00 L in 6 sec., 1.00 L in 3 sec. 29 / 55 The calibration syringe should be: Stored in a cabinet or closet away from the spirometer. Checked for leaks at least monthly. Examined by the technician for damage and cracks at least yearly. Cleaned with a 1:10 bleach solution. 30 / 55 The technician notices the first recorded FVC is 150 percent of predicted. Upon visual inspection of the curve, how can the error be corrected before another maneuver is performed? Check for a partially obstructed mouthpiece. Use nose clips. Demonstrate correct posture. Coach faster initial blast. 31 / 55 Which flow-volume loop is the most acceptable? 1 2 3 4 32 / 55 Proper positioning of the body, chin, and neck allows for the most forceful expiration possible. The worker should be instructed to: Sit or stand up straight, elevate the chin, and extend the neck slightly. Look towards the floor, causing the chin to point downward. Bend forward as far as possible as you blow out. Tuck chin slightly and extend the neck dramatically. 33 / 55 What are the minimum number of forced expiratory maneuvers required to meet acceptability and repeatability criteria for FVC and FEV1? 8 acceptable, with 3 of those being repeatable. 2 acceptable, with 2 of those being repeatable. 3 acceptable, with 3 of those being repeatable. 3 acceptable, with 2 of those being repeatable. 34 / 55 A spirogram is considered unacceptable if the graphs display. An obstructive component. A sharp peak flow. Incomplete expiration. A decreased FVC. 35 / 55 Which of the following is an acceptable reason to postpone spirometry testing? Active respiratory infection. Vigorous exercise 3 hours prior to testing. The worker has asthma. The worker is obese. 36 / 55 According to the ATS/ERS 2019 Standards, the end of forced expiration (EOFE) criteria for a plateau is defined as: Less than a 0.025 L change in volume for 0.5 seconds. Less than a 0.040 L change in volume for 2.0 seconds. Less than a 50 ml change in volume for 1.0 second. Less than a 0.025 L change in volume for 1 second. 37 / 55 If the worker does not take a maximal inspiration before the maximal forced exhalation, the spirometry maneuver will show: A large extrapolated volume. A falsely reduced FVC. A falsely increased FVC. A decreased FEV1/FVC ratio. 38 / 55 If a worker hesitates before they BLAST all their air out, it may result in a large extrapolated volume to be recorded for that maneuver. True False 39 / 55 The acceptability of a forced expiratory maneuver should first be determined by the: Technician only after obtaining three maneuvers from the subject. Technician after each maneuver. Physician interpreting the employee’s test. Automated spirometer software. 40 / 55 Which spirometry test value is affected by excessive back extrapolation? FVC FEV1 FEF 25-75% PEF 41 / 55 The worker performs two forced expiratory maneuvers. The first flow-volume and volume-time curves are larger than the second as seen below. What corrective instruction should you give the worker? Blast the air out harder at the beginning. Blast the air out faster at the beginning. Take a maximal breath in before BLASTING the air out. Blow out as long and slow as possible throughout the test. 42 / 55 How can excess extrapolated volume be prevented? Exhale until plateau is reached. Wear nose clips to prevent extra breaths. Blast faster – don’t hesitate after maximum inspiration. Keep tongue or loose dentures from obstructing mouthpiece. 43 / 55 The 2019 ATS/ERS criteria for repeatable spirograms state that: In 3 out of 5 maneuvers the FVC and FEV1 must agree within 100 ml. The 2 largest values for FVC and FEV1 cannot exceed 5% or 100 ml. From a minimum of 3 acceptable curves, the 2 largest values for FVC and FEV1 must be within 150 ml. The FVC and FEV1 values from 2 out of 3 acceptable curves must agree within 5%. 44 / 55 Match the appropriate message with the following graph: Excellent. Try again. Take the deepest possible breath before the next trial. Blast out harder. Blast without hesitating. Avoid coughing. 45 / 55 Match the appropriate message with the following graph: Excellent. Try again. Take the deepest possible breath before the next trial. Blast out harder. Blast without hesitating. Avoid coughing. 46 / 55 Match the appropriate message with the following graph: Excellent. Try again. Take the deepest possible breath before the next trial. Blast out harder. Blast without hesitating. Avoid coughing. 47 / 55 Match the appropriate message with the following graph: Excellent. Try again. Take the deepest possible breath before the next trial. Blast out harder. Blast without hesitating. Avoid coughing. 48 / 55 Match the appropriate error with the following graph: Positive zero flow error. Acceptable maneuver. Partially obstructed mouthpiece. Early termination. Breath hold or glottic closure. 49 / 55 Match the appropriate error with the following graph: Positive zero flow error. Acceptable maneuver. Partially obstructed mouthpiece. Early termination and Breath hold or glottic closure. 50 / 55 Match the appropriate error with the following graph: Positive zero flow error. Acceptable maneuver. Partially obstructed mouthpiece. Early termination. Breath hold or glottic closure. 51 / 55 Match the appropriate error with the following graph: Positive zero flow error. Acceptable maneuver. Partially obstructed mouthpiece. Early termination and Breath hold or glottic closure. 52 / 55 Match the appropriate error with the following graph: Positive zero flow error. Acceptable maneuver. Partially obstructed mouthpiece. Early termination. Breath hold or glottic closure. 53 / 55 Which of the following record retention practices are required by Federal regulations? Retention of medical records for certain workplace exposures are 30+ years following the date of an employee’s termination. Spirometric test results and tracings cannot be retained by a contracted healthcare provider. Retention of medical records for certain workplace exposures are 10+ years following the date of an employee’s termination. Spirometry results are not part of the medical record, so do not need to be retained. 54 / 55 Which of the following is an objective of a occupational health and safety surveillance program? To identify working conditions that are dangerous to keep workers away from those hazards. To reduce the economic cost of healthcare for the employer. To reject an applicant for employment on medical consideration. To detect occupational and non-occupational lung function decline in its earliest stages when reduction of exposure is likely to be most effective. 55 / 55 Spirometric evaluation is always required by OSHA regulations if an employee uses a respirator for any amount of days per year? True False Your score isThe average score is 63% 0%
