The FNP is seeing a 57-year-old man with chronic shortness o…

The FNP is seeing a 57-year-old man with chronic shortness of breath & cough. The patient reports weight loss, chronic fatigue, and dyspnea for about 6 months. He works on a farm in Missouri. However recently he took a vacation to Florida, where he felt complete resolution in his dyspnea, however now that he has returned he feel short of breath again. VS are in normal ranges. Physical assessment shows a thin cachectic male with coarse breath sounds BL. Pulmonary function tests show an increased FEV1/FVC ratio, a reduced lung capacity, suggesting a restrictive defect pattern. Which of the following is the most likely diagnosis?