NSG 550 Exam 2: (Latest 2026/2027 Update) Pulmonary Function,
Cardiovascular Diagnostics, GI, & Vascular Studies | Q&A | Grade A |
100% Correct (Verified Answers) – Nursing Program
Subject: NSG 550 – Advanced Diagnostics / Systems-Based Assessment
Source: NSG 550 Exam 2 Blueprint 2026/2027 Format: Q&A Guide with Rationale | Verified Grade A
1. What factors influence pulmonary function test/spirometry results?
Correct Answer: Age, sex, height, and weight (all affect predicted normal values)
1. Predicted values are calculated based on age, sex, height, and race (weight less impact).
2. Normal values typically 80-120% of predicted; lower values indicate impairment.
3. Reference equations (NHANES III) updated for contemporary populations.
2. What is the purpose of pulmonary function testing/spirometry?
Correct Answer: To evaluate lung and pulmonary reserve, response to bronchodilator therapy, differentiate
restrictive vs obstructive pulmonary disease, determine lung capacity, and assess for inhalation allergy
1. Spirometry distinguishes obstructive (FEV1/FVC <0.70) from restrictive (FVC reduced, FEV1/FVC normal or increased).
2. Bronchodilator response: >12% and >200 mL improvement suggests reversible component (asthma).
3. Contraindications: recent MI, hemoptysis, pneumothorax, uncontrolled hypertension.
3. What is Forced Vital Capacity (FVC)?
Correct Answer: Amount of air that can be forcefully expelled from a maximally inflated lung position
1. Normal FVC >80% of predicted; reduced in both obstructive and restrictive disease.p>2. Obstructive: FVC often
normal or slightly reduced; restrictive: FVC significantly reduced.
3. Measurement requires good effort (reproducible within 150 mL).
4. What is FEV1 (Forced Expiratory Volume in 1 second) and what does it show in obstructive disease?
Correct Answer: Volume of air expelled during first second of FVC; in obstructive disease, airways narrowed and
resistance high → FEV1 less than predicted (reduced)
1. Obstructive: FEV1 decreased, FEV1/FVC ratio <0.70 (air trapping, slow exhalation).
2. Restrictive: both FEV1 and FVC reduced proportionally → FEV1/FVC ≥0.80.
3. COPD severity graded by FEV1% predicted: GOLD 1 ≥80%, 2 50-79%, 3 30-49%, 4 <30%.
5. What is normal FEV1/FVC ratio in restrictive vs obstructive lung disease?
Correct Answer: Restrictive: 80% or higher (normal or increased); Obstructive: less than 80%
1. Restrictive diseases (pulmonary fibrosis, chest wall deformity) reduce lung volumes without airflow limitation.
2. Obstructive diseases (COPD, asthma, bronchiectasis) reduce expiratory flow with air trapping.
3. FEV1/FVC <0.70 post-bronchodilator confirms COPD diagnosis.
6. How much improvement with bronchodilator suggests reversible obstruction?
Correct Answer: 20% improvement (or >12% and >200 mL absolute increase) suggests spastic component
(asthma)
1. Significant bronchodilator response is characteristic of asthma rather than COPD.
2. Criteria: FEV1 increase of ≥12% and ≥200 mL from baseline.
3. Repeat testing after 4 puffs of albuterol via spacer.
, 7. What are the diagnostic criteria for COPD by spirometry?
Correct Answer: Post-bronchodilator FEV1/FVC less than 70% (persistent airflow limitation)
1. COPD diagnosis requires demonstration of persistent airflow limitation after bronchodilator.
2. Severity classified by FEV1% predicted (GOLD grades 1-4).
3. Repeat testing if borderline; single test sufficient if obvious obstruction.
8. What are the risk factors for COPD?
Correct Answer: Smoking, pollution exposure, and genetic predisposition (alpha-1 antitrypsin deficiency)
1. Cigarette smoking is primary risk factor (causes 80-90% of COPD deaths).
2. Occupational exposures (coal, silica, cadmium) and biomass fuel use also causative.
3. Alpha-1 antitrypsin deficiency is the only known genetic risk factor.
9. How does COPD compare with asthma?
Correct Answer: COPD has later onset in life, slower progression of symptoms, and poorer response to inhaled
therapy (less reversible)
1. Asthma typically childhood/adolescent onset, episodic symptoms, fully reversible obstruction.
2. COPD develops after age 40, progressive symptoms, incompletely reversible obstruction.
3. Overlap syndrome (ACO) has features of both.
10. What is polysomnography and when is it indicated?
Correct Answer: Sleep study; indicated for excessive snoring, narcolepsy, excessive daytime sleepiness, insomnia,
motor spasms during sleep, or cardiac rhythm disturbances during sleep; most commonly diagnoses sleep apnea
1. Polysomnography monitors EEG, EOG, EMG, ECG, airflow, respiratory effort, SpO2, and leg movements.
2. Apnea-hypopnea index (AHI) ≥5 with symptoms or ≥15 without = OSA diagnosis.
3. Home sleep apnea testing (HSAT) alternative for high-risk patients without comorbidities.
11. What is actigraphy?
Correct Answer: A watch-like device worn for several nights at home to measure movement and sleep-wake
patterns
1. Actigraphy estimates sleep parameters (total sleep time, wake after sleep onset).
2. Useful for insomnia assessment and circadian rhythm disorders.
3. Not a substitute for polysomnography for sleep apnea diagnosis.
12. What is a bronchoscopy and what procedures can be performed?
Correct Answer: Visualization of tracheobronchial tree; used for diagnostic/therapeutic procedures including
transbronchial/endobronchial biopsy, bronchoalveolar lavage (BAL), removal of foreign bodies, clots, mucus plugs,
stent deployment, aspiration of deep sputum, and bleeding control
1. Indications: hemoptysis, malignancy, interstitial lung disease, pulmonary infections, pleural effusion.
2. BAL samples distal airway for infection (PJP, TB) or cytology.
3. Endobronchial ultrasound (EBUS) enables transbronchial needle aspiration (TBNA) of lymph nodes.
13. Why would you use a pleural tap (thoracentesis)?
Correct Answer: To determine the cause of an unexplained pleural effusion and/or to relieve intrathoracic pressure
that accumulates with large volume fluid and inhibits respiration
1. Diagnostic: differentiate transudate vs exudate (Light's criteria).
2. Therapeutic: remove fluid for symptomatic relief (dyspnea, hypoxia).
14. What are transudates most frequently caused by and what is their appearance?
Correct Answer: Causes: congestive heart failure, cirrhosis, nephrotic syndrome, hypoproteinemia; Appearance:
clear/serous, protein <3 g/dL
1. Transudate mechanism: increased hydrostatic pressure or decreased oncotic pressure.
2. Light's criteria: transudate exudate if at least one of: pleural fluid protein/serum >0.5, LDH/serum >0.6, pleural LDH
>2/3 upper limit.
3. CHF is most common cause of transudative effusion.
Cardiovascular Diagnostics, GI, & Vascular Studies | Q&A | Grade A |
100% Correct (Verified Answers) – Nursing Program
Subject: NSG 550 – Advanced Diagnostics / Systems-Based Assessment
Source: NSG 550 Exam 2 Blueprint 2026/2027 Format: Q&A Guide with Rationale | Verified Grade A
1. What factors influence pulmonary function test/spirometry results?
Correct Answer: Age, sex, height, and weight (all affect predicted normal values)
1. Predicted values are calculated based on age, sex, height, and race (weight less impact).
2. Normal values typically 80-120% of predicted; lower values indicate impairment.
3. Reference equations (NHANES III) updated for contemporary populations.
2. What is the purpose of pulmonary function testing/spirometry?
Correct Answer: To evaluate lung and pulmonary reserve, response to bronchodilator therapy, differentiate
restrictive vs obstructive pulmonary disease, determine lung capacity, and assess for inhalation allergy
1. Spirometry distinguishes obstructive (FEV1/FVC <0.70) from restrictive (FVC reduced, FEV1/FVC normal or increased).
2. Bronchodilator response: >12% and >200 mL improvement suggests reversible component (asthma).
3. Contraindications: recent MI, hemoptysis, pneumothorax, uncontrolled hypertension.
3. What is Forced Vital Capacity (FVC)?
Correct Answer: Amount of air that can be forcefully expelled from a maximally inflated lung position
1. Normal FVC >80% of predicted; reduced in both obstructive and restrictive disease.p>2. Obstructive: FVC often
normal or slightly reduced; restrictive: FVC significantly reduced.
3. Measurement requires good effort (reproducible within 150 mL).
4. What is FEV1 (Forced Expiratory Volume in 1 second) and what does it show in obstructive disease?
Correct Answer: Volume of air expelled during first second of FVC; in obstructive disease, airways narrowed and
resistance high → FEV1 less than predicted (reduced)
1. Obstructive: FEV1 decreased, FEV1/FVC ratio <0.70 (air trapping, slow exhalation).
2. Restrictive: both FEV1 and FVC reduced proportionally → FEV1/FVC ≥0.80.
3. COPD severity graded by FEV1% predicted: GOLD 1 ≥80%, 2 50-79%, 3 30-49%, 4 <30%.
5. What is normal FEV1/FVC ratio in restrictive vs obstructive lung disease?
Correct Answer: Restrictive: 80% or higher (normal or increased); Obstructive: less than 80%
1. Restrictive diseases (pulmonary fibrosis, chest wall deformity) reduce lung volumes without airflow limitation.
2. Obstructive diseases (COPD, asthma, bronchiectasis) reduce expiratory flow with air trapping.
3. FEV1/FVC <0.70 post-bronchodilator confirms COPD diagnosis.
6. How much improvement with bronchodilator suggests reversible obstruction?
Correct Answer: 20% improvement (or >12% and >200 mL absolute increase) suggests spastic component
(asthma)
1. Significant bronchodilator response is characteristic of asthma rather than COPD.
2. Criteria: FEV1 increase of ≥12% and ≥200 mL from baseline.
3. Repeat testing after 4 puffs of albuterol via spacer.
, 7. What are the diagnostic criteria for COPD by spirometry?
Correct Answer: Post-bronchodilator FEV1/FVC less than 70% (persistent airflow limitation)
1. COPD diagnosis requires demonstration of persistent airflow limitation after bronchodilator.
2. Severity classified by FEV1% predicted (GOLD grades 1-4).
3. Repeat testing if borderline; single test sufficient if obvious obstruction.
8. What are the risk factors for COPD?
Correct Answer: Smoking, pollution exposure, and genetic predisposition (alpha-1 antitrypsin deficiency)
1. Cigarette smoking is primary risk factor (causes 80-90% of COPD deaths).
2. Occupational exposures (coal, silica, cadmium) and biomass fuel use also causative.
3. Alpha-1 antitrypsin deficiency is the only known genetic risk factor.
9. How does COPD compare with asthma?
Correct Answer: COPD has later onset in life, slower progression of symptoms, and poorer response to inhaled
therapy (less reversible)
1. Asthma typically childhood/adolescent onset, episodic symptoms, fully reversible obstruction.
2. COPD develops after age 40, progressive symptoms, incompletely reversible obstruction.
3. Overlap syndrome (ACO) has features of both.
10. What is polysomnography and when is it indicated?
Correct Answer: Sleep study; indicated for excessive snoring, narcolepsy, excessive daytime sleepiness, insomnia,
motor spasms during sleep, or cardiac rhythm disturbances during sleep; most commonly diagnoses sleep apnea
1. Polysomnography monitors EEG, EOG, EMG, ECG, airflow, respiratory effort, SpO2, and leg movements.
2. Apnea-hypopnea index (AHI) ≥5 with symptoms or ≥15 without = OSA diagnosis.
3. Home sleep apnea testing (HSAT) alternative for high-risk patients without comorbidities.
11. What is actigraphy?
Correct Answer: A watch-like device worn for several nights at home to measure movement and sleep-wake
patterns
1. Actigraphy estimates sleep parameters (total sleep time, wake after sleep onset).
2. Useful for insomnia assessment and circadian rhythm disorders.
3. Not a substitute for polysomnography for sleep apnea diagnosis.
12. What is a bronchoscopy and what procedures can be performed?
Correct Answer: Visualization of tracheobronchial tree; used for diagnostic/therapeutic procedures including
transbronchial/endobronchial biopsy, bronchoalveolar lavage (BAL), removal of foreign bodies, clots, mucus plugs,
stent deployment, aspiration of deep sputum, and bleeding control
1. Indications: hemoptysis, malignancy, interstitial lung disease, pulmonary infections, pleural effusion.
2. BAL samples distal airway for infection (PJP, TB) or cytology.
3. Endobronchial ultrasound (EBUS) enables transbronchial needle aspiration (TBNA) of lymph nodes.
13. Why would you use a pleural tap (thoracentesis)?
Correct Answer: To determine the cause of an unexplained pleural effusion and/or to relieve intrathoracic pressure
that accumulates with large volume fluid and inhibits respiration
1. Diagnostic: differentiate transudate vs exudate (Light's criteria).
2. Therapeutic: remove fluid for symptomatic relief (dyspnea, hypoxia).
14. What are transudates most frequently caused by and what is their appearance?
Correct Answer: Causes: congestive heart failure, cirrhosis, nephrotic syndrome, hypoproteinemia; Appearance:
clear/serous, protein <3 g/dL
1. Transudate mechanism: increased hydrostatic pressure or decreased oncotic pressure.
2. Light's criteria: transudate exudate if at least one of: pleural fluid protein/serum >0.5, LDH/serum >0.6, pleural LDH
>2/3 upper limit.
3. CHF is most common cause of transudative effusion.
