National Physical Therapy Examination (NPTE) Practice Exam 2025 – The All-in-One Guide to Exam Success!

Patients with advanced emphysema experience difficulty breathing during exercise primarily due to the structural changes in the lungs, particularly alveolar dilation. Emphysema is characterized by the destruction of the alveoli or air sacs in the lungs, leading to greater compliance but reduced elasticity. As a result, when individuals with emphysema attempt to exercise, their compromised lung function means they cannot effectively exchange gases. The hyperinflation and enlarged air spaces reduce the surface area available for gas exchange, which results in lower oxygen levels and higher carbon dioxide retention, making it challenging to breathe during physical activity.

The other options do not accurately represent the primary physiological basis for the breathing difficulties in these patients. Hypocapnia refers to decreased carbon dioxide levels, which is not a characteristic of advanced emphysema; patients often experience hypercapnia instead. Atrophy of secondary breathing muscles is not a common finding in emphysema; the primary issue lies within the lungs themselves. Damage to the phrenic nerve would result in more severe respiratory issues and is not a predominant factor in the breathing difficulties of emphysema specifically.