Cardiopulmonary Physical Therapy
Exam Questions
Course Introduction
Cardiopulmonary Physical Therapy focuses on the assessment, management, and rehabilitation of individuals with cardiovascular and pulmonary disorders. This course covers the underlying physiological principles of cardiopulmonary function, explores common conditions such as chronic obstructive pulmonary disease (COPD), asthma, and congestive heart failure, and emphasizes evidence-based therapeutic interventions including breathing exercises, airway clearance techniques, endurance training, and patient education. Through lectures, case studies, and practical sessions, students will develop skills in patient evaluation, formulation of individualized treatment plans, and interprofessional collaboration to optimize functional outcomes and improve quality of life for patients with cardiopulmonary impairments.
Recommended Textbook
Essentials of Cardiopulmonary Physical Therapy 4th Edition by Ellen Hillegass
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Page 2
Chapter 1: Anatomy of the Cardiovascular and Pulmonary Systems
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Q1) The right upper lobe bronchus divides into which of the following?
A)Lateral and medial segment
B)Superior segment to the upper portion
C)Apical,posterior,and anterior segments
D)Lower lobe bronchus to the medial basal segment
Answer: C
Q2) Which of the following functions does the myocardium layer of the heart serve?
A)Forms a continuous lining with the tissue of the valves.
B)Minimizes friction during cardiac contraction.
C)Provides a tough fibrous layer of dense irregular connective tissue.
D)Facilitates the pumping action of the heart.
Answer: D
Q3) Which of the following veins empties into the left atrium?
A)Superior vena cava
B)Inferior vena cava
C)Pulmonary vein
D)Coronary sinus vein
Answer: C
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Chapter 2: Physiology of the Cardiovascular and Pulmonary Systems
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Q1) In the systemic arteries,at a partial pressure of 100 mm Hg,the percent of hemoglobin should be:
A)85%.
B)97%.
C)74%.
D)21%.
Answer: B
Q2) In patients with congestive heart failure,which of the following positions should be avoided to minimize the preload on a failing heart?
A)Sitting up in a bedside chair
B)Standing at a support surface
C)Semireclined on an exercise mat
D)Supine with lower extremities elevated
Answer: D
Q3) The total volume of air that is inhaled or exhaled in 1 minute is termed:
A)tidal volume.
B)minute ventilation.
C)inspiratory reserve volume.
D)inspiratory capacity.
Answer: B
4
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Chapter 3: Ischemic Cardiovascular Conditions and Other Vascular Pathologies
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Q1) Which of the following layers of the coronary arteries is selectively permeable to low-density lipoprotein (LDL)leading to the possible development of myocardial ischemia?
A)Adventitia
B)Media
C)Intima
D)None of the above
Answer: C
Q2) Which of the following factors is defined as a type of amino acid found in blood that when elevated has been linked to increased risk for development of cardiovascular diseases?
A)C-reactive protein
B)Homocysteine
C)Factor VII
D)Lipoprotein a (Lpa)
Answer: B
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Page 5
Chapter 4: Cardiac Muscle Dysfunction and Failure
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Q1) Which of the following medications prescribed for heart failure is noted to provide a positive inotropic effect evidenced by an increased left ventricular ejection fraction?
A)Diuretics
B)Dobutamine
C)Nitroglycerin
D)Topral
Q2) Mitral valve insufficiency frequently dilates which of the following heart chambers?
A)Left ventricle
B)Right ventricle
C)Left atrium
D)Right atrium
Q3) An accumulation of fluid in the lungs along with hypoxemia and tachypnea BEST describes which of the following pulmonary edema stages?
A)Stage I
B)Stage II
C)Stage III
D)Stage IV
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Chapter 5: Restrictive Lung Dysfunction
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Q1) On a chest radiograph,the classic finding of an elevated hemidiaphragm indicates which of the following musculoskeletal causes of restrictive lung dysfunction?
A)Kyphoscoliosis
B)Ankylosing spondylitis
C)Diaphragmatic paresis
D)Pectus excavatum
Q2) Hallmark symptoms of restrictive lung disease include dyspnea,an emaciated appearance,and which of the following?
A)Chest wall pain
B)Wet,productive cough
C)Dry,nonproductive cough
D)Fatigue
Q3) A patient with restrictive lung disease develops a rise in pulmonary circulation pressure subsequently increasing the work of the right ventricle.This is BEST described as: A)tachypnea.
B)hypoxemia.
C)pulmonary hypertension.
D)low lung volume.
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Chapter 6: Chronic Obstructive Pulmonary Diseases
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Q1) What is the minimum age a child can perform pulmonary function tests (PFTs)reliably?
A)3
B)6
C)8
D)10
Q2) Increased work of breathing and fatigue in a patient with asthma is BEST explained by which of the following physiological changes?
A)Narrowing of peripheral airways at all levels of the tracheobronchial tree
B)Increase in residual volume
C)Suboptimal length-tension curve of diaphragm/intercostals muscles
D)Ventilation/perfusion mismatching
Q3) Which of the following tests is considered the "gold standard" for diagnosing COPD and monitoring its progression?
A)Arterial blood gases (ABGs)
B)Pulmonary function tests (PFTs)
C)Chest radiograph
D)CT scans
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Chapter 7: Cardiopulmonary Implications of Specific Diseases
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Q1) The presence of an irreversible hypoventilation due to weakness of the intercostal muscles and diaphragm MOST likely occurs in which of the following neurological disorders?
A)Parkinson's disease
B)Amyotrophic lateral sclerosis
C)Multiple sclerosis
D)Myasthenia gravis
Q2) Impaired glucose tolerance is defined by which of the following values?
A)Blood glucose of 85 mg/dL after ingestion of 75 g glucose during a 2-hour oral glucose tolerance test
B)Blood glucose of 100 mg/dL after ingestion of 75 g glucose during a 2-hour oral glucose tolerance test
C)Blood glucose of 130 mg/dL after ingestion of 75 g glucose during a 2-hour oral glucose tolerance test
D)Blood glucose of 210 mg/dL after ingestion of 75 g glucose during a 2-hour oral glucose tolerance test
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9
Chapter 8: Cardiovascular Diagnostic Tests and Procedures
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Q1) An imaging modality that detects calcium in the coronary arteries and is a noninvasive method to detect and quantify coronary atherosclerosis BEST describes which of the following?
A)Computed tomography
B)Single-photon emission computed tomography
C)Electron beam computed tomography
D)Magnetic resonance imaging
Q2) Which of the following biomarkers is MOST conclusive for myocardial injury?
A)CK-MB
B)CK-MM
C)CK-BB
D)All of the above
Q3) Which of the following statements is FALSE regarding elevated troponin levels?
A)Elevated troponin levels assist the clinician in identifying the specific cause.
B)The higher the troponin levels,the greater the damage to cardiac tissue.
C)Critically ill patients with sepsis may have increased troponin levels.
D)Troponin levels remain elevated for 10 days after injury.
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Page 10
Chapter 9: Electrocardiography
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Q1) The development of mural thrombi secondary to the coagulation of blood in the heart chamber subsequently leading to a potential stroke occurs in which of the following heart arrhythmias?
A)Atrial flutter
B)Atrial fibrillation
C)Atrial tachycardia
D)Sinus pause or block
Q2) Increased sympathetic activity through the release of norepinephrine and epinephrine from the adrenal gland results in which of the following changes in the heart?
A)Reduces conduction velocity throughout the atrioventricular node.
B)Decreases the irritability of the heart.
C)Increases the contractility of the heart muscle.
D)Depresses the automaticity of the heart.
Q3) Which of the following components of the ECG impulse represents the ventricular depolarization?
A)P wave
B)P-R segment
C)QRS complex
D)ST segment
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Chapter 10: Pulmonary Diagnostic Tests and Procedures
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Q1) Which of the following conditions BEST describes metabolic acidosis?
A)Low bicarbonate level (HCO -)
B)High partial pressure CO (PaCO )
C)Alveolar hypoventilation
D)High bicarbonate level (HCO -)
Q2) A patient has the following arterial blood gas values:pH = 7.49,PaCO = 31,PaO = 90,and HCO - = 24.Which of the following statements is the MOST accurate interpretation?
A)Uncompensated metabolic alkalosis
B)Uncompensated respiratory alkalosis
C)Partially compensated metabolic alkalosis
D)Partially compensated respiratory alkalosis
Q3) Which of the following abnormal findings would be MOST likely in a chest radiograph of a patient with moderate to severe chronic obstructive pulmonary disease?
A)Tracheal deviation toward the contralateral side
B)Opacification of the costophrenic angles
C)Flattened hemidiaphragms
D)Increased vascular markings
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12
Chapter 11: Cardiovascular and Thoracic Interventions
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Q1) Which of the following therapeutic interventions would be MOST appropriate for a patient who had a thoracoabdominal incision?
A)Segmental breathing
B)Side bending stretching
C)Thoracic extension
D)Specific trunk mobility is contraindicated
Q2) Common risk factors for thoracic aortic aneurysms include which of the following factors?
A)Hypertension
B)Hypercholesteremia
C)Prior tobacco use
D)All of the above
Q3) Which of the following vessels used in a coronary artery bypass graft is preferable due to its ability to resist atherosclerosis?
A)Saphenous vein
B)Internal mammary artery
C)External mammary artery
D)None of the above
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Chapter 12: Thoracic Organ Transplantation: Heart, Heart
Lung, and Lung
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Q1) Which of the following solid-organ transplants has the highest acute rejection rate?
A)Heart
B)Lung
C)Kidney
D)Liver
Q2) High-intensity exercise is encouraged when possible for a patient postoperative a lung transplant in a pulmonary rehabilitation program.
A)True
B)False
Q3) Which of the following goals is appropriate at discharge of a lung transplant recipient?
A)The patient will be modified independent with basic activities of daily living.
B)The patient will demonstrate independence in secretion clearance.
C)The patient will demonstrate a 10% increase in the 6-minute walk distance.
D)All of the above goals are appropriate for a lung transplant recipient.
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14
Chapter 13: Monitoring and Life Support Equipment
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Q1) The physical therapist is scheduled to see a patient mid-afternoon who completed hemodialysis that morning.Which of the following monitoring and intervention pairings would be MOST appropriate?
A)Monitor patient fatigue,complete bedside active range of motion exercise with patient in supine position.
B)Monitor patient symptoms,perform one set of active range of motion extremity exercises in bed and then progress patient to sitting on the edge of the bed.
C)Monitor vital signs and patient symptoms before,during,and after mobility to edge of bed,active exercise in sitting,and low-intensity ambulation.
D)Monitor vital signs and patient symptoms at rest.If stable,assist the patient with mobility out of bed and hall ambulation as tolerated.
Q2) Which of the following masks is typically used in conjunction with a nebulizer to humidify the gas being administered?
A)Nasal cannula
B)Simple mask
C)Aerosol mask
D)Venturi mask
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Page 15
Chapter 14: Cardiovascular Medications
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Q1) Which of the following tissue types has an affinity for MOSTLY extracellular calcium?
A)Striated muscle
B)Smooth muscle
C)Myocardium
D)Coronary veins
Q2) If a patient in a physical therapy clinic takes a sublingual nitroglycerin tablet,which of the following side effects would MOST likely lead the physical therapist to encourage the patient to sit in a chair first?
A)Headache
B)Reflex tachycardia
C)Hypotension
D)Flushing of the skin
Q3) Which of the following physiological changes is considered a negative effect of a prescribed nonselective beta-blocker to decrease myocardial oxygen demand?
A)Enhancing bronchospasm
B)Decreasing heart rate
C)Decreasing heart contractility
D)Decreasing blood pressure
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16
Chapter 15: Pulmonary Medications
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Q1) The administration of an alpha adrenoceptor antagonist results in which of the following effects?
A)Prevention of reduction in camp
B)Bronchodilation
C)Fall in blood pressure
D)All of the above
Q2) Which of the following drug classes would be MOST appropriate to reduce vagal tone and acetylcholine release associated with bronchoconstriction?
A)Muscarinic antagonists
B)Nicotinic antagonists
C)Alpha adrenoceptor antagonists
D)Beta antagonists
Q3) Which of the following normal respiratory functions are inhibited by the presence of bronchoconstriction?
A)Mucociliary transport
B)Removal of secretions
C)Alveolar ventilation and oxygenation
D)All of the above
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17
Chapter 16: Examination and Assessment Procedures
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Q1) Which of the following symptoms should be considered a cardiac symptom until cardiac dysfunction is ruled out?
A)Chest tightness or pressure
B)Shortness of breath
C)Burning or indigestion
D)All of the above
Q2) Which of the following clinical symptoms is MOST indicative of angina chest discomfort?
A)Muscle soreness and/or joint soreness is evoked by palpation or deep breathing.
B)Minimal additional symptoms present.
C)No evidence of ST-segment depression present.
D)Discomfort is relieved by nitroglycerin within 1 minute.
Q3) The effectiveness of a cough is assessed by using which of the following factors?
A)The strength of the cough
B)The depth of the cough
C)The length of the cough
D)All of the above
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18
Chapter 17: Interventions for Acute Cardiopulmonary Conditions
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Q1) Improved inspiratory breathing effort is achieved BEST using which of the following techniques?
A)The patient is instructed to inhale while performing shoulder extension,adduction,and internal rotation.
B)The patient is instructed to inhale while leaning forward in preparation for the movement of sit to stand.
C)The patient is instructed to inhale while performing shoulder flexion,abduction,external rotation,and slight trunk extension.
D)The patient is instructed to inhale while rolling to one side in preparation for moving from side lying to sitting on the edge of the bed.
Q2) Which of the following positions for a pulmonary patient MOST likely leads to pooling of secretions in the lungs and a reduced functional residual volume?
A)Prone
B)Side lying
C)Supine
D)Sitting
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Chapter 18: Interventions and Prevention Measures for
Individuals With Cardiovascular Disease, or Risk of Disease
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Q1) From a diet and nutritional viewpoint,which of the following changes in cholesterol levels will MOST likely result in a decreased risk of coronary artery disease and progression?
A)Decrease levels of HDL,LDL,total cholesterol,and triglycerides
B)Increase levels of HDL and decrease levels of LDL,total cholesterol,and triglycerides
C)Decrease levels of LDL and total cholesterol
D)None of the above
Q2) Which of the following are considered precautions with regard to safety in the cardiac rehabilitation?
A)Avoid exercise within 1 to 2 hours after meals.
B)Avoid isometric exercise and breath holding during exercise.
C)Add warm-up and extended cool-down periods.
D)All of the above should be precautions.
Q3) Which of the following is considered a sign of an abnormal response to exercise?
A)Undue dyspnea
B)Pallor
C)Excessive fatigue
D)Severe leg claudication
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Chapter 19: Pulmonary Rehabilitation
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Q1) Which of the following conditions tends to occur with or contribute to postural changes in a patient with pulmonary disease?
A)Loss of chest mobility
B)Adoption of propping postures
C)Use of accessory breathing muscles of shoulders and cervical and thoracic spine
D)All of the above
Q2) A pulmonary patient who is unable to tolerate an extended session of moderate- to high-intensity aerobic endurance training is able to MOST likely improve exercise endurance using which of the following alternative methods of training?
A)Interval training,alternating periods of high and low intensity (or rest)
B)Lower intensity training (<40% of maximal work rate)for 10 minutes,daily
C)Participating in daily activities of living
D)Use of transcutaneous electrical nerve stimulation (TENS)on lower extremities
Q3) Pulmonary function test data are exclusively used when determining a patient candidacy for pulmonary rehabilitation.
A)True
B)False
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Chapter 20: Pediatric Cardiopulmonary Physical Therapy
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Q1) If a child is afraid of moving after surgery,which of the following techniques may result in the MOST success for motivating the child out of bed post surgery?
A)Request the nurse pre-medicate the patient and have a second therapist assist.
B)Have the parents attempt to get the child out of bed between therapy sessions.
C)Use a medical play doll to help the child cope with experiences.
D)Bribe the child and encourage.
Q2) Which of the following techniques would be considered an intervention used as a tone-inhibiting technique to facilitate proper breathing mechanics in a pediatric patient?
A)Lying supine over a ball
B)A corner stretch
C)Positioning the child in flexion with rhythmic rocking
D)Manual facilitation of the spinal extensors during sitting
Q3) Which of the following physiological changes related to cardiovascular/endurance training would NOT be considered a reason to terminate the exercise?
A)Pale or ashen appearance
B)Dyspnea score of 2
C)Heart rate greater than 80% of maximal heart rate
D)Oxygen saturation below 90%
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Page 22
Chapter 21: The Lymphatic System
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Q1) Which of the following factors contribute the MOST to reduced lymphatic function in the cardiovascular system leading to the formation of atherosclerosis?
A)Sedentary lifestyle
B)Decreased vital capacity
C)Obesity
D)All of the above
Q2) Which of the following pathological conditions results in primary lymphedema?
A)Infection
B)Radiation therapy
C)Hypoplasia of the lymphatic system
D)Chronic venous insufficiency
Q3) The pressure caused by proteins in the capillaries that results in water being attracted and pulled into the capillary (reabsorption)BEST describes which of the four pressures of Starling's law?
A)Plasma hydrostatic pressure
B)Plasma colloidal osmotic pressure
C)Interstitial fluid hydrostatic pressure
D)Interstitial colloidal osmotic pressure
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Chapter 22: Outcome Measures:a Guide for the Evidence
Based Practice of Cardiopulmonary Physical Therapy
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Q1) Which of the following factors would be considered a nonclinical factor affecting patient outcomes?
A)Principle diagnosis
B)Comorbidity
C)Patient attitude
D)Age
Q2) Depression and anxiety have been linked to cardiac surgery and coronary artery disease and have predicted which of the following aspects of recovery?
A)High mortality rate
B)Poor ability to make progress in rehabilitation
C)Less compliance during cardiac rehabilitation
D)Low functional capacity
Q3) Within the core component of an overall management in a cardiac rehabilitation program,which of the following indicators would BEST assess the service aspect?
A)Health-related quality of life
B)Patient satisfaction
C)Risk factor profile
D)Appropriate response to symptoms
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