Certified Respiratory Therapist Practice Exam

Before repeating a spirometry maneuver, what instruction should you give a patient if the back extrapolated volume is excessive?

1. "Inhale deeply"

2. "Exhale slowly"

3. "Breathe in through your nose"

4. "Don't hesitate"

The correct answer is: "Don't hesitate"

In spirometry, the back extrapolated volume refers to the amount of air exhaled before the actual forced expiration begins. An excessive back extrapolated volume can indicate that the patient is hesitating before starting their forced exhalation, which can lead to an inaccurate measurement of lung function. The guidance to "Don't hesitate" is aimed at encouraging the patient to begin their exhalation promptly without any delays. This instruction helps ensure that the patient initiates the forced expiration effectively, allowing for a more accurate assessment of their lung capacity and function. By eliminating hesitation, the patient can produce a more reliable and reproducible spirometry result. In contrast, the other options suggest alternative actions that do not specifically address the problem of excessive back extrapolation. For example, instructing the patient to inhale deeply or breathe in through their nose does not resolve the issue of hesitancy before exhaling. Telling them to exhale slowly might exacerbate the problem rather than correct it. Thus, the instruction to “Don’t hesitate” is the most appropriate and effective direction to improve the spirometry maneuver.