NR 507 Edapt Week 3 Obstructive and
Restrictive Lung Diseases/ Chronic Obstructive
Pulmonary Disease/ Asthma/ Interstitial Lung
Disease | Questions and Answers | Update 2026 |
100% Accurate
NR 507 EDAPT WEEK 3
Obstructive & Restrictive Lung Diseases
Total Questions: 200
Topics: COPD, Asthma, Interstitial Lung Disease, Pulmonary Pathophysiology
Format: Multiple Choice
Passing Score: 85%
Time Limit: 4 hours
Section 1: Obstructive vs. Restrictive Lung Disease – Fundamentals (Questions 1–
20)
1. Which of the following best defines an obstructive lung disease?
A) Decreased total lung capacity (TLC) with normal FEV1/FVC
B) Airflow limitation due to airway narrowing, with reduced FEV1/FVC ratio
(<0.70)
C) Normal FEV1 with increased TLC
D) Increased diffusion capacity (DLCO)
Answer: B
*Rationale: Obstructive diseases (COPD, asthma, bronchiectasis) cause difficulty
exhaling due to airway obstruction, leading to a reduced FEV1/FVC ratio (<0.70
post-bronchodilator). TLC may be normal or increased (hyperinflation).*
2. A restrictive lung disease is characterized by:
A) Increased FEV1/FVC ratio (>0.80)
B) Decreased total lung capacity (TLC) with normal or increased FEV1/FVC
,C) Increased residual volume (RV)
D) Normal TLC with decreased FEV1
Answer: B
*Rationale: Restrictive diseases (interstitial lung disease, neuromuscular
weakness, chest wall disorders) cause reduced lung volumes (TLC, FVC) but
FEV1/FVC is normal or increased (>0.80) because airways are not obstructed.*
3. Which pulmonary function test (PFT) finding is most consistent with COPD?
A) FEV1/FVC 0.65, TLC increased, RV increased
B) FEV1/FVC 0.80, TLC decreased, RV normal
C) FEV1/FVC 0.75, TLC normal, DLCO normal
D) FEV1/FVC 0.55, TLC decreased, DLCO increased
Answer: A
*Rationale: COPD shows irreversible airflow obstruction (FEV1/FVC <0.70), air
trapping (increased RV), and hyperinflation (increased TLC). DLCO is often
reduced due to emphysema (loss of alveolar-capillary surface area).*
4. Which of the following is a primary feature of asthma?
A) Fixed airflow obstruction
B) Reversible bronchoconstriction with variable airflow limitation
C) Progressive destruction of alveolar walls
D) Restrictive pattern on PFTs
Answer: B
Rationale: Asthma is characterized by variable and reversible airflow obstruction,
often with bronchial hyperresponsiveness. Reversibility is demonstrated by
improvement in FEV1 ≥12% and ≥200 mL after bronchodilator.
5. The primary pathological abnormality in emphysema is:
A) Mucus hypersecretion and goblet cell hyperplasia
B) Destruction of alveolar walls without fibrosis
C) Fibrosis of the interstitium
D) Eosinophilic infiltration of airways
Answer: B
Rationale: Emphysema involves irreversible destruction of alveolar septa (loss of
elastin) leading to enlarged airspaces, reduced elastic recoil, and airflow
obstruction. Chronic bronchitis involves mucus hypersecretion.
,6. Which of the following is a key feature of chronic bronchitis?
A) Alveolar destruction
B) Chronic cough with sputum production for at least 3 months in 2 consecutive
years
C) Restrictive physiology
D) Increased DLCO
Answer: B
Rationale: Chronic bronchitis is clinically defined by cough and sputum production
on most days for ≥3 months in ≥2 consecutive years, due to mucus gland
hyperplasia and airway inflammation.
7. Which cell type is most prominent in the airway inflammation of asthma?
A) Neutrophils
B) Eosinophils
C) Macrophages
D) Plasma cells
Answer: B
*Rationale: Allergic (eosinophilic) asthma is characterized by eosinophilic
infiltration, Th2 cytokine response (IL-4, IL-5, IL-13), and IgE production.
Neutrophilic asthma occurs in some phenotypes.*
8. The most common cause of COPD worldwide is:
A) Alpha-1 antitrypsin deficiency
B) Tobacco smoke exposure
C) Biomass fuel exposure
D) Occupational dust
Answer: B
*Rationale: Tobacco smoke is the primary risk factor for COPD (80-90% of cases).
Alpha-1 antitrypsin deficiency is a genetic cause (<1% of COPD). Biomass fuel
exposure is significant in developing countries.*
9. Alpha-1 antitrypsin deficiency causes emphysema due to:
A) Excessive protease (neutrophil elastase) activity unopposed by AAT
B) Increased collagen deposition
C) Autoimmune destruction of alveoli
D) Mucus plugging
, Answer: A
Rationale: AAT inhibits neutrophil elastase. Deficiency leads to uncontrolled
elastase activity, destroying alveolar walls (panacinar emphysema, lower lobe
predominant).
10. Which of the following PFT findings is most consistent with interstitial lung
disease (ILD)?
A) FEV1/FVC normal or increased, TLC decreased, DLCO decreased
B) FEV1/FVC decreased, TLC increased, DLCO normal
C) FEV1/FVC decreased, TLC normal, DLCO increased
D) FEV1/FVC normal, TLC increased, DLCO normal
Answer: A
*Rationale: ILD is restrictive: decreased TLC and FVC, normal or increased
FEV1/FVC ratio, and decreased DLCO due to thickened alveolar-capillary
membrane.*
11. The primary pathophysiological mechanism of hypoxemia in COPD is:
A) Right-to-left shunt
B) V/Q mismatch (low V/Q areas)
C) Diffusion impairment only
D) Hypoventilation
Answer: B
Rationale: V/Q mismatch is the dominant cause of hypoxemia in COPD (areas of
low ventilation relative to perfusion). Hypoventilation occurs in advanced disease,
causing hypercapnia.
12. Which of the following is NOT a component of the pathophysiology of
asthma?
A) Bronchial smooth muscle contraction
B) Airway edema and inflammation
C) Alveolar wall destruction
D) Mucus hypersecretion
Answer: C
Rationale: Asthma involves reversible bronchoconstriction, airway inflammation,
edema, and mucus plugging. Alveolar wall destruction (emphysema) is not part of
asthma pathophysiology.
Restrictive Lung Diseases/ Chronic Obstructive
Pulmonary Disease/ Asthma/ Interstitial Lung
Disease | Questions and Answers | Update 2026 |
100% Accurate
NR 507 EDAPT WEEK 3
Obstructive & Restrictive Lung Diseases
Total Questions: 200
Topics: COPD, Asthma, Interstitial Lung Disease, Pulmonary Pathophysiology
Format: Multiple Choice
Passing Score: 85%
Time Limit: 4 hours
Section 1: Obstructive vs. Restrictive Lung Disease – Fundamentals (Questions 1–
20)
1. Which of the following best defines an obstructive lung disease?
A) Decreased total lung capacity (TLC) with normal FEV1/FVC
B) Airflow limitation due to airway narrowing, with reduced FEV1/FVC ratio
(<0.70)
C) Normal FEV1 with increased TLC
D) Increased diffusion capacity (DLCO)
Answer: B
*Rationale: Obstructive diseases (COPD, asthma, bronchiectasis) cause difficulty
exhaling due to airway obstruction, leading to a reduced FEV1/FVC ratio (<0.70
post-bronchodilator). TLC may be normal or increased (hyperinflation).*
2. A restrictive lung disease is characterized by:
A) Increased FEV1/FVC ratio (>0.80)
B) Decreased total lung capacity (TLC) with normal or increased FEV1/FVC
,C) Increased residual volume (RV)
D) Normal TLC with decreased FEV1
Answer: B
*Rationale: Restrictive diseases (interstitial lung disease, neuromuscular
weakness, chest wall disorders) cause reduced lung volumes (TLC, FVC) but
FEV1/FVC is normal or increased (>0.80) because airways are not obstructed.*
3. Which pulmonary function test (PFT) finding is most consistent with COPD?
A) FEV1/FVC 0.65, TLC increased, RV increased
B) FEV1/FVC 0.80, TLC decreased, RV normal
C) FEV1/FVC 0.75, TLC normal, DLCO normal
D) FEV1/FVC 0.55, TLC decreased, DLCO increased
Answer: A
*Rationale: COPD shows irreversible airflow obstruction (FEV1/FVC <0.70), air
trapping (increased RV), and hyperinflation (increased TLC). DLCO is often
reduced due to emphysema (loss of alveolar-capillary surface area).*
4. Which of the following is a primary feature of asthma?
A) Fixed airflow obstruction
B) Reversible bronchoconstriction with variable airflow limitation
C) Progressive destruction of alveolar walls
D) Restrictive pattern on PFTs
Answer: B
Rationale: Asthma is characterized by variable and reversible airflow obstruction,
often with bronchial hyperresponsiveness. Reversibility is demonstrated by
improvement in FEV1 ≥12% and ≥200 mL after bronchodilator.
5. The primary pathological abnormality in emphysema is:
A) Mucus hypersecretion and goblet cell hyperplasia
B) Destruction of alveolar walls without fibrosis
C) Fibrosis of the interstitium
D) Eosinophilic infiltration of airways
Answer: B
Rationale: Emphysema involves irreversible destruction of alveolar septa (loss of
elastin) leading to enlarged airspaces, reduced elastic recoil, and airflow
obstruction. Chronic bronchitis involves mucus hypersecretion.
,6. Which of the following is a key feature of chronic bronchitis?
A) Alveolar destruction
B) Chronic cough with sputum production for at least 3 months in 2 consecutive
years
C) Restrictive physiology
D) Increased DLCO
Answer: B
Rationale: Chronic bronchitis is clinically defined by cough and sputum production
on most days for ≥3 months in ≥2 consecutive years, due to mucus gland
hyperplasia and airway inflammation.
7. Which cell type is most prominent in the airway inflammation of asthma?
A) Neutrophils
B) Eosinophils
C) Macrophages
D) Plasma cells
Answer: B
*Rationale: Allergic (eosinophilic) asthma is characterized by eosinophilic
infiltration, Th2 cytokine response (IL-4, IL-5, IL-13), and IgE production.
Neutrophilic asthma occurs in some phenotypes.*
8. The most common cause of COPD worldwide is:
A) Alpha-1 antitrypsin deficiency
B) Tobacco smoke exposure
C) Biomass fuel exposure
D) Occupational dust
Answer: B
*Rationale: Tobacco smoke is the primary risk factor for COPD (80-90% of cases).
Alpha-1 antitrypsin deficiency is a genetic cause (<1% of COPD). Biomass fuel
exposure is significant in developing countries.*
9. Alpha-1 antitrypsin deficiency causes emphysema due to:
A) Excessive protease (neutrophil elastase) activity unopposed by AAT
B) Increased collagen deposition
C) Autoimmune destruction of alveoli
D) Mucus plugging
, Answer: A
Rationale: AAT inhibits neutrophil elastase. Deficiency leads to uncontrolled
elastase activity, destroying alveolar walls (panacinar emphysema, lower lobe
predominant).
10. Which of the following PFT findings is most consistent with interstitial lung
disease (ILD)?
A) FEV1/FVC normal or increased, TLC decreased, DLCO decreased
B) FEV1/FVC decreased, TLC increased, DLCO normal
C) FEV1/FVC decreased, TLC normal, DLCO increased
D) FEV1/FVC normal, TLC increased, DLCO normal
Answer: A
*Rationale: ILD is restrictive: decreased TLC and FVC, normal or increased
FEV1/FVC ratio, and decreased DLCO due to thickened alveolar-capillary
membrane.*
11. The primary pathophysiological mechanism of hypoxemia in COPD is:
A) Right-to-left shunt
B) V/Q mismatch (low V/Q areas)
C) Diffusion impairment only
D) Hypoventilation
Answer: B
Rationale: V/Q mismatch is the dominant cause of hypoxemia in COPD (areas of
low ventilation relative to perfusion). Hypoventilation occurs in advanced disease,
causing hypercapnia.
12. Which of the following is NOT a component of the pathophysiology of
asthma?
A) Bronchial smooth muscle contraction
B) Airway edema and inflammation
C) Alveolar wall destruction
D) Mucus hypersecretion
Answer: C
Rationale: Asthma involves reversible bronchoconstriction, airway inflammation,
edema, and mucus plugging. Alveolar wall destruction (emphysema) is not part of
asthma pathophysiology.
