Kacmarek: Egan's Fundamentals of Respiratory Care, 10th 

Edition ​Chapter 24: Interstitial Lung Disease  

Test Bank  

MULTIPLE CHOICE  

1. Which group of disorders is categorized together because of similarities in their clinical 

2. Which of the following interstitial lung diseases (ILDs) is NOT occupationally related? 
a. asbestosis  
b. berylliosis  
c. sarcoidosis  
d. silicosis  

3. What is the primary pathologic change that occurs in interstitial lung disease? 
a. alveolar-capillary membrane structures replaced by fibrotic tissue  
b. bronchial submucosal gland hypertrophy  
c. bronchoconstriction of medium to small airways  
d. increased sputum production  

4. In interstitial lung disease, which of the following mechanisms does NOT contribute to 
impaired gas exchange?  
a. depression of respiratory drive  
b. diffusion defect  
c. shunt  
d. ventilation/perfusion mismatch  

5. What symptoms are most common in the patient with interstitial lung disease? 
a. exertional dyspnea and nonproductive cough  
b. exertional dyspnea and wheezing  
c. nonproductive cough and wheezing  
d. productive cough and increased sputum production  

6. For what reason do patients with interstitial lung disease most commonly seek medical care? 
a. excessive mucus production  
b. hacking cough resulting in chest cage pain  
c. progressive exertional dyspnea  
d. severe wheezing and sense of breathlessness  

 
7. Your patient with interstitial lung disease (ILD) has hypoxemia during exertion and at rest. 
This implies the ILD may be in its early stages.  
a. True  
b. False  

8. What auscultatory finding is most consistent with the diagnosis of interstitial lung disease 
(ILD)?  
a. coarse inspiratory and expiratory crackles  
b. fine bilateral inspiratory crackles  
c. monophonic expiratory wheezes  
d. polyphonic expiratory wheezes  

9. Expiratory wheezing is relatively uncommon in uncomplicated interstitial lung disease. 

10. Which of the following physical exam findings could be considered a late manifestation of 
interstitial lung disease (ILD)?  
a. bronchial wheezing  
b. increased wedge pressure  
c. peripheral cyanosis  
d. pulmonary hypertension  

11. What radiographic technique has the ability to better define the specific parenchymal 
characteristics associated with specific types of interstitial lung disease?  
a. bronchograms  
b. high-resolution CT  
c. MRI  
d. scans  

12. What is the most common cause of interstitial lung disease (ILD)?  
a. asbestosis  
b. berylliosis  
c. idiopathic pulmonary fibrosis (IPF)  
d. sarcoidosis  

13. The classic chest radiographic findings in interstitial lung disease (ILD) are considered to be 
those caused by which of its component diseases?  
a. asbestosis  
b. berylliosis  
c. idiopathic pulmonary fibrosis (IPF)  
d. sarcoidosis  

14. What is the classic radiographic finding present in many end-stage interstitial lung diseases 
(ILDs)?  
a. cystic pattern called honeycombing  
b. pleural disease uncommon  
c. prominent bibasilar infiltrates  
 d. severe hyperinflation  

15. The cystic pattern called honeycombing is a feature of end-stage interstitial lung disease 
(ILD).  
a. True  
b. False 

16. The disease seen in interstitial lung disease is primarily a/an _____ process. 
a. airway constrictive  
b. obstructive  
c. restrictive  
d. supralaryngeal  

17. What are the typical pulmonary function test results in a patient with interstitial lung disease? 
1. decreased airway resistance  
2. decreased forced expiratory volumes  
3. increased airway resistance  
4. normal to elevated FEV​1​/FVC  
a. 1, 2, and 4  
b. 2 and 4  
c. 3  
d. 1, 2, 3, and 4  

18. Which of the following pulmonary function tests is most likely to be normal in the patient 
with interstitial pulmonary fibrosis?  
a. diffusing capacity of the lungs (DLCO)  
b. FEV​1 ​(forced expiratory volume in 1 second)  
c. FEV​1​/FVC  
d. FVC (forced vital capacity)  

19. Which of the following is found almost universally in patients with interstitial lung disease 
(ILD)?  
a. airway dilation 
b. bronchoconstriction  
c. compensatory cytokine release  
d. decreased compliance  

20. The development of interstitial lung disease (ILD) in a patient with emphysema can result in 
normal compliance measurements.  
a. True  
b. False  

21. In smokers with idiopathic pulmonary fibrosis, normal spirometry and lung volumes with a 
reduced diffusion capacity suggest emphysema.  
a. True  
b. False  

 
22. The term “asbestos-related pulmonary disease” may be used to encompass which of the 
following?  
1. asbestosis  
2. coal worker’s pneumoconiosis  
3. sarcoidosis  
4. silicosis  
a. 1, 2, and 4  
b. 1 and 4  
c. 2 only  
d. 1, 2, 3, and 4  

23. The presence of pleural calcification on the chest film is consistent with what type of 
interstitial lung disease (ILD)?  
a. asbestosis  
b. coal worker’s pneumoconiosis  
c. sarcoidosis  
d. silicosis  

24. Most patients with asbestosis have considerable asbestos exposure for many years before 
manifestation of the disease.  
a. True  
b. False  

25. It is determined that a patient has silicosis. What profession is he most likely to have worked 
at?  
a. foundry worker  
b. talc manufacturer employee  
c. carpenter  
d. miller  
26. Indicate the typical chest radiographic findings of a patient with silicosis. 
a. apical nodules 
b. bibasilar reticulogranular appearance  
c. lymphadenopathy  
d. pleural plaque  

27. What disease process is associated with much higher risk of tuberculosis? 
a. asbestosis  
b. coal worker’s pneumoconiosis  
c. sarcoidosis  
d. silicosis  

28. In simple coal worker’s pneumoconiosis, a chest radiograph that is characterized by multiple 
small nodular opacities on the chest x-ray film is most likely to be associated with what 
clinical presentation?  
a. asymptomatic  
b. cough  
c. crackles  
d. shortness of breath  
29. Patients with simple pneumoconiosis of coal workers are often asymptomatic. 
a. True  
b. False  
30. Exacerbations of silicosis are most often treated with what medication? 
a. aerosolized steroids  
b. antibiotics  
c. diuretics  
d. positive inotropes  
31. Which of the following categories of medications is most closely associated with the onset of 
interstitial pulmonary fibrosis?  
a. antiarrhythmic drugs  
b. anticoagulants  
c. bronchodilators  
d. vasodilators 

32. A patient is exposed a second time to an antigen and subsequently seeks medical attention 
with sudden shortness of breath, chest pain, fever, chills, malaise, and a cough that may be 
productive of purulent sputum. What is the most likely cause of this pathology? a. acute 
anaphylactic shock  
b. acute hypersensitivity pneumonitis  
c. allergic congestive heart failure  
d. bronchial asthma  

33. A patient is exposed a second time to an antigen and subsequently seeks medical attention 
with sudden shortness of breath, chest pain, fever, chills, malaise, and a cough that may be 
productive of purulent sputum. Which of the following is the most likely source of for the 
antigen?  
a. bed  
b. foundry  
c. hay field  
d. mine 

34. The first line of treatment for patients with hypersensitivity pneumonitis is to avoid the 
offending agent.  
a. True  
b. False  

35. Scleroderma, rheumatoid arthritis, and systemic lupus erythematosus are all examples of what 
type of disease group?  
a. asbestos-associated illnesses  
b. connective tissue diseases  
c. hypersensitivity pneumonitis  
d. pneumoconiosis  

36. What disease process is the most common cause of interstitial lung disease (ILD) in the 
United States?  
a. asbestosis  
b. coal worker’s pneumoconiosis  
 c. idiopathic pulmonary fibrosis  
d. sarcoidosis  

37. Sarcoidosis is more common among young adults than is idiopathic pulmonary fibrosis (IPF). 
a. True  
b. False  
38. Spontaneous remission rarely occurs with sarcoidosis.  
a. True  
b. False  

39. What is the most common radiographic finding in the chest film of a patient with sarcoidosis? 
a. bibasilar parenchymal opacities  
b. bilateral hilar lymphadenopathy  
c. pleural plaque with calcification  
d. upper-lobe distribution of fibrotic cysts  

40. Idiopathic pulmonary fibrosis (IPF) is most commonly seen in patients during the third decade 
of life.  
a. True  
b. False  

41. A 65-year-old patient with a history of exposure to metal dust comes in to the emergency 
department with chronic cough and exertional dyspnea. HRCT shows bibasilar, peripheral 
reticular abnormalities with focal honeycomb cystic changes. What is the most likely 
diagnosis?  
a. asbestosis 
b. coal worker’s pneumoconiosis  
c. idiopathic pulmonary fibrosis  
d. sarcoidosis  

42. What is the life expectancy of a patient diagnosed with progressive idiopathic pulmonary 
fibrosis?  
a. <2 years  
b. <4 years  
c. <6 years  
d. <7 years  
43. What is the most common treatment for patients with idiopathic pulmonary fibrosis (IPF)? 
a. hyperbaric oxygen treatments  
b. lung transplantation  
c. penicillin  
d. prednisone  

44. A patient with which of the following diseases will have the longest life expectancy? 
a. alveolar proteinosis  
b. idiopathic pulmonary fibrosis  
c. nonspecific interstitial pneumonitis  
d. sarcoidosis  

 
45. The prognosis is much better for nonspecific interstitial pneumonitis (NSIP) than idiopathic 
pulmonary fibrosis (IPF).  
a. True  
b. False  

46. Most patients with organizing pneumonia (OP) will improve if given corticosteroid therapy. 
a. True  
b. False  

47. Which of the interstitial lung diseases will in one third of patients cause a chylothorax? 
a. alveolar proteinosis  
b. idiopathic pulmonary fibrosis  
c. lymphangioleiomyomatosis  
d. nonspecific interstitial pneumonitis  

48. Which of the interstitial lung diseases is directly tied to exposure to first- and second-hand 
tobacco smoke?  
a. alveolar proteinosis  
b. idiopathic pulmonary fibrosis  
c. nonspecific interstitial pneumonitis  
d. pulmonary Langerhans cell histiocytosis (PLCH)  

49. Which of the following medications has been shown to be useful in the treatment of almost all 
interstitial lung diseases?  
a. acetaminophen  
b. aspirin  
c. oxytocin  
d. oxygen  

50. What treatment is most useful in preventing subsequent right-sided heart failure in a patient 
with interstitial lung disease?  
a. bronchodilator  
b. digoxin  
c. oxygen  
d. turbutaline  

51. What treatment is recommended by the Centers for Disease Control and Prevention (CDC) 
guidelines for patients with interstitial lung disease (ILD)?  
a. measles vaccine  
b. mumps vaccine  
c. pneumococcal vaccine  
d. varicella vaccine  

52. What is the only therapy shown to prolong life in patients with end-stage, particularly fibrotic 
interstitial lung disease (ILD)?  
a. corticosteroids  
b. lung transplantation  
c. oxygen therapy  
 d. pulmonary rehabilitation  

53. What use, other than prognostic value, can serial pulmonary function tests provide for the 
management of interstitial lung disease patients?  
a. determine the degree of refractory hypoxemia  
b. establish the need for lung transplantation  
c. guide the type of oxygen therapy delivered  

54. A 45 year-old patient with sarcoidosis complaints of being unable to perform his daily house 
chores due to shortness of breaths despite continued oxygen therapy of 2 lpm N/C. You would 
recommend which of the following to the patient:  
a. increase O2 to 5 lpm  
b. nebulized budesonide BID  
c. pulmonary rehabilitation  
d. lung transplantation  

55. You are called to attend to an ER patient complaining of shortness of breath and severe 
dyspnea on exertion. Patient history is significant for a 30 year-pack smoking history, dry 
non-productive cough and occasional pedal edema. CXR findings are not remarkable except 
for mild cardiomegaly. You want to rule out ILD vs. obstructive lung disease. Which of the 
following tests may help you to differentiate the diagnosis on this patient?  
1. sputum culture and sensitivity  
2. high resolution CT  
3. pulmonary function testing  
4. arterial blood gas analysis  
5. magnetic resolution imaging  
a. 2, 3 and 4 only  
b. 2, 3, 4 and 5 only  
c. 1, 2, 3, 4 and 5 
d. 3 and 4 only  

56. You are called to attend to an ER patient complaining of shortness of breath and severe 
dyspnea on exertion. Patient history is significant for a 30 year-pack smoking history, dry 
non-productive cough and occasional pedal edema. CXR findings are not remarkable except 
for mild cardiomegaly. You want to rule out ILD vs. obstructive lung disease. Results for 
pulmonary function testing are shown below.  
Spirometry Value %Predicted  
FVC (liters) 2.79 63  
SVC (liters) 2.61 59  
FEV1(liters) 2.12 67  
FEV1/FVC (%) 80  
FEF 25-75% (l/min) 4.11 98  
Lung Volume  
RV (liters) 1.20 100  
TLC (liters) 3.99 60  
DLCO  11.35 28  
(ml/min/mm Hg)  
 These results are consistent with:  
a. small airway disease  
b. air-trapping  
c. severe obstructive disease  
d. loss of alveolar capillary surface  

57. You are called to attend to an ER patient complaining of shortness of breath and severe 
dyspnea on exertion. Patient history is significant for a 30 year-pack smoking history, dry 
non-productive cough and occasional pedal edema. CXR findings are not remarkable except 
for mild cardiomegaly. You want to rule out ILD vs. obstructive lung disease. HRCT shows a 
diffused ground glass appearance with the presence of centrilobular nodules. Together with 
the PFT results HRCT finding indicates the presence of: 

a. respiratory bronchiolitis ILD