CPFT Sample Questions & Answers
Selecting and performing test procedures, then judging whether the results are valid, carries the most weight, ahead of setting up, calibrating and troubleshooting equipment with quality control, and calculating results and their clinical implications.
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- Question 1Beginner
Procedures · Select Test Protocols and Equipment
A 68-year-old patient with severe kyphoscoliosis presents to the PFT lab. Standing height measurement is physically impossible due to the patient's spinal curvature. Which of the following is the most accepted surrogate measurement to estimate standing height for the purpose of calculating predicted values?
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Correct answer: B
In patients with severe spinal deformities like kyphoscoliosis, standing height is falsely reduced, which would lead to underestimation of predicted lung volumes. Arm span (measured from fingertip to fingertip with arms outstretched) is the standard surrogate used to estimate what the patient's true standing height would be without the deformity.
- Question 2Advanced
Procedures · Evaluate Validity of Result
A technologist draws an arterial blood gas (ABG) sample on room air but leaves a significant air bubble in the syringe. The sample sits at room temperature for 20 minutes before analysis. How will the air bubble affect the measured PaO2 and PaCO2 values?
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Correct answer: B
Room air has a PO2 of approximately 150 mmHg and a PCO2 of essentially 0 mmHg. If a significant air bubble is left in the syringe, gas exchange occurs between the blood and the air bubble. The blood's PaO2 will move toward 150 mmHg (increasing if the patient was hypoxemic, or decreasing if the patient was on high O2), and the PaCO2 will decrease as CO2 diffuses into the bubble.
- Question 3Beginner
Data Management · Calculate Results, Select Reference Ranges and Data
The ATS 2023 Statement on Race and Ethnicity in Pulmonary Function Testing strongly recommends which of the following changes to how reference values are selected and applied?
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Correct answer: B
The ATS 2023 statement recommends replacing race-specific reference equations with race-neutral average reference equations (like the GLI Global composite) for all patients. This change aims to reduce health disparities, as race is a social construct rather than a biological determinant of lung size.
- Question 4Intermediate
Data Management · ECG analysis
While monitoring a patient's 12-lead ECG during a maximal exercise test, the technologist observes a new, horizontal ST-segment depression of 2.5 mm in leads V4, V5, and V6. The patient complains of chest tightness. What clinical implication does this ECG pattern most likely indicate?
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Correct answer: B
Significant horizontal or downsloping ST-segment depression (≥ 1 mm) during exercise, especially accompanied by chest pain, is a classic ECG sign of myocardial ischemia (inadequate blood supply to the heart muscle). This is an absolute indication to terminate the exercise test immediately.
- Question 5Advanced
Procedures · Select Test Protocols and Equipment
A 65-year-old patient with a history of heart failure (NYHA Class II) is scheduled for a Cardiopulmonary Exercise Test (CPET) to differentiate between cardiac and pulmonary causes of their exertional dyspnea.
When selecting the exercise protocol for this patient on a cycle ergometer, which approach is most appropriate to ensure valid diagnostic data?
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Correct answer: B
The goal of a diagnostic CPET is to bring the patient to maximal exertion within an optimal window of 8 to 12 minutes. If the protocol is too aggressive (e.g., standard Bruce protocol or large step increases), the patient will stop early due to localized muscle fatigue before their cardiovascular or pulmonary systems are maximally stressed. A continuous ramp protocol on a cycle ergometer with a gentle, steady increase (10-15 W/min for heart failure patients) allows for optimal physiological adaptation and data collection.
- Question 6IntermediateSelect 2
Procedures · Select Test Protocols and Equipment
Prior to beginning a maximal Cardiopulmonary Exercise Test (CPET), the technologist reviews the patient's medical record and current vital signs. Which TWO of the following findings are considered absolute contraindications for performing a maximal exercise test? (Select TWO)
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Correct answers: A, B
According to ATS/ACCP guidelines, absolute contraindications to maximal exercise testing include acute myocardial infarction (within 3-5 days), unstable angina, uncontrolled arrhythmias causing symptoms or hemodynamic compromise, syncope, active endocarditis/myocarditis, and severe symptomatic aortic stenosis. Resting SpO2 of 91% and severe COPD are indications for testing (though O2 may be required). Untreated severe hypertension (e.g., >200/120) is a relative contraindication, but a resting BP of 150/90 is not an absolute contraindication.
According to ATS/ACCP guidelines, absolute contraindications to maximal exercise testing include acute myocardial infarction (within 3-5 days), unstable angina, uncontrolled arrhythmias causing symptoms or hemodynamic compromise, syncope, active endocarditis/myocarditis, and severe symptomatic aortic stenosis. Resting SpO2 of 91% and severe COPD are indications for testing (though O2 may be required). Untreated severe hypertension (e.g., >200/120) is a relative contraindication, but a resting BP of 150/90 is not an absolute contraindication.
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