Exercise Physiology in Physical Therapy
Final Exam Questions
Course Introduction
Exercise Physiology in Physical Therapy explores the physiological responses and adaptations of the human body to physical activity, with a focus on applications relevant to rehabilitation and clinical practice. This course covers key concepts such as energy systems, cardiovascular and respiratory function, muscle physiology, and the impact of exercise on different populations, including individuals with chronic diseases or injuries. Students will learn to design, implement, and evaluate therapeutic exercise programs tailored to patient needs, utilizing evidence-based strategies to enhance functional outcomes and promote overall health. Emphasis is placed on integrating theoretical knowledge with practical skills essential for effective physical therapy interventions.
Recommended Textbook
Cardiovascular and Pulmonary Physical Therapy Evidence to Practice 5th Edition by
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Donna Frownfelter
Chapter 1: Epidemiology As a Basis for Informing Contemporary
Physical Therapy Practice
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Q1) Comprehensive management of an individual regardless of age who is overweight and has abnormal blood sugars includes which of the following approaches for the physical therapy practitioner?
A) Weight reduction and spiritual counseling
B) Blood pressure control and work-capacity evaluations
C) Regular physical activity and exercise recommendations
D) Vision and hearing screening and avoidance of tobacco
Answer: C
Q2) The leading cause of premature mortality and disability in industrialized countries is: A) cancer.
B) diabetes.
C) obstructive lung disease.
D) ischemic heart disease.
Answer: D
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Chapter 2: Oxygen Transport: the Basis of Cardiovascular and Pulmonary Physical Therapy
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Q1) Considering the following equation,CO = SV ¥ HR,a change in preload would translate into an initial modification in which variable?
A) Cardiac output
B) Heart rate
C) Stroke volume
D) Myocardial contractility
Answer: C
Q2) Oxygen transport can be affected by fluid balance.All of the following conditions would create a disturbance in fluid balance and ultimately affect oxygen transport except:
A) blood plasma excess.
B) sodium excess.
C) water deficit.
D) sodium deficit.
Answer: A
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Page 4
Chapter 3: Cardiovascular and Pulmonary Anatomy
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Q1) The phrenic nerve passes through the diaphragm along with the inferior vena cava.Both of these structures pierce the diaphragm and create which opening?
A) Vena caval opening
B) Esophageal opening
C) Aortic opening
D) Lymphatic opening
Answer: A
Q2) The heart is composed of four chambers and three layers of muscle.The thickest layer of the heart is the:
A) epicardium.
B) myocardium.
C) endocardium.
D) endothelium.
Answer: B
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Chapter 4: Cardiovascular and Pulmonary Physiology
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Q1) A patient with a history of smoking has a recent decrease in oxygen saturation and is seen for a wellness program.The physical therapist determines that the PCO level is normal but the PO level is decreased.All other measures of the pulmonary system taken that day appear normal; this patient likely has a problem with:
A) perfusion.
B) diffusion.
C) ventilation.
D) none of the above.
Q2) Considering the oxyhemoglobin dissociation curve,a shift in the curve to the left results in decreased oxygen affinity and a greater dissociation of oxygen and hemoglobin.What condition might have this effect on the curve?
A) Skeletal muscle at rest
B) Anemia
C) Polycythemia
D) None of the above
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6
Chapter 5: Cardiovascular and Pulmonary Pathophysiology
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Q1) Hypercholesterolemia can lead to other cardiovascular diagnoses because:
A) it is always associated with atherosclerotic disease.
B) it increases the blood coagulation rate and increases the risk of blood clot formation.
C) it changes the structure and function of endothelial tissue.
D) it changes the heart rate.
Q2) Identifying risk factors is an important step in educating patients and clients about their overall health.Of the risk factors associated with atherosclerosis,some are considered primary and others secondary.All of the following listed are primary risk factors EXCEPT:
A) high blood pressure.
B) cigarette smoking.
C) race or ethnicity.
D) hyperlipidemia.
Q3) Bullae present in the lungs of patients with chronic obstructive pulmonary disease (COPD)because of:
A) increased elasticity and compliance in the lung
B) decreased elasticity and alveolar hyperinflation
C) increased elasticity and alveolar hypoinflation
D) decreased elasticity and compliance in the lung
Page 7
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Chapter 6: Cardiovascular and Pulmonary Manifestations of Systemic Conditions
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Q1) A patient with a diagnosis of HIV is complaining of dyspnea and hemoptysis.The patient describes the presence of a cough,and plain radiographs demonstrate diffuse pulmonary infiltrates.This patient has had several bouts of pneumonia within the past year; he has sought treatment but finds it difficult to stay on a regimen given his travel (the patient resides abroad).He is likely to be diagnosed with which condition?
A) Pneumocystis carinii pneumonia
B) Tuberculosis
C) Klebsiella pneumonia
D) Legionella pneumonia
Q2) A young female athlete is seen by a physical therapist.The athlete's primary complaints are fatigue and an inability to catch her breath.The therapist determines that she has a nutritional disorder,anorexia nervosa.All of the following would be consistent with this diagnosis EXCEPT:
A) obstructive sleep apnea.
B) ineffective cough.
C) respiratory muscle weakness.
D) cardiac dysrhythmias.
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Page 8
Chapter 7: Measurement and Documentation
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Q1) Which is true regarding variability?
A) The characteristic being measured may demonstrate a certain degree of variability.
B) Testing instruments will not have an impact.
C) Low interrater reliability will not impact the long-term changes in a patient.
D) High intrarater reliability will have a negative impact of showing changes in a patient over time.
Q2) When selecting tests and measures,which is most accurate?
A) Characteristics or qualities of measurements, such as reliability and validity, should not influence the therapist's decision.
B) The risk-to-benefit ratio implies that the risk is always worth the data collected.
C) Selected tests and measures should be relevant as measured by their potential ability to impact the direction of the examination and intervention.
D) Environmental or personal factors do not influence the selection.
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9
Chapter 8: History
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Q1) In regards to pulmonary hypertension,which of the following is not true?
A) Sitting up and leaning forward or lying on the right side often relieves the pain.
B) Chest pain related to pulmonary hypertension may mimic angina pectoris.
C) It is usually found in patients with mitral stenosis.
D) It is believed to result from dilation of the pulmonary artery or from right ventricular ischemia.
Q2) What is the measurement of the internal surface of the lungs?
A) 50 to 100 m³
B) 100 to 150 m³
C) 10 to 50 m³
D) 500 to 1000 m³
Q3) Which is not a cause of coughing?
A) Congestive heart failure
B) Aortic aneurysms decreasing pressure on the bronchi
C) A large left atrium displacing the left mainstem bronchus upward
D) Acute left-side heart failure
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Chapter 9: Pulmonary Function Tests
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Q1) Which of the following is true?
A) Additional contributing factors, such as morbid obesity, pregnancy, an enlarged heart, and pulmonary effusion, may involve increase of expansion of the lungs.
B) Residual volume (RV) is the volume of gas that remains in the lungs at the beginning of a maximum expiration.
C) A decrease in vital capacity (VC) may also be seen without primary lung disease or airway obstruction.
D) Functional residual capacity (FRC) is the volume of air remaining in the lungs at the resting expiratory level. It contains the expiratory reserve volume (ERV) and the inspiration capacity (IC).
Q2) What is maximum voluntary ventilation?
A) A measure of the maximum breathing capacity of the patient
B) The maximum amount of air that can be inspired when starting at the resting expiratory level
C) The maximum amount of gas that can be expelled from the lungs by forceful effort after a maximum inspiration
D) The volume of gas that remains in the lungs at the end of a maximum expiration
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Chapter 10: Arterial Blood Gases
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Q1) Which of the following is true regarding the partial pressure of carbon dioxide (Pco )?
A) If the Pco is above 45 mm Hg, the patient is hyperventilating.
B) If the Pco is below 35 mm Hg, the patient is said to be hypoventilating.
C) If the Pco is below 35 mm Hg, the patient is said to be hyperventilating.
D) Normal Pco values are 55 to 65 mm Hg.
Q2) How should physical therapists use arterial blood gas measurements?
A) Use the measurement with oximeter readings to get an overall status of the patient's condition
B) To prescribe external oxygen
C) To titrate oxygen levels
D) To determine when to remove external oxygen
Q3) What is the percentage of oxygen in the atmosphere?
A) 79%
B) 10%
C) 20.9%
D) 100%
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12
Chapter 11: Imaging of the Chest
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Q1) Which of the following is considered the standard views for chest radiographs?
A) A superoanterior (PA) and a left lateral view
B) A posteroanterior (PA) and a left lateral view
C) A posteroanterior (PA) and a right lateral view
D) A superoanterior (PA) and a right lateral view
Q2) Which of the following is not an initial step when evaluating a radiograph?
A) Check that the information identifying the patient has been properly provided on the image and that the image is indeed of the patient in question.
B) Check that the part of the body in question is the part that was imaged.
C) Check that there are three images, one for each plane of movement.
D) Check the overall exposure of the film.
Q3) How does a PET scan work?
A) Uses magnetic energy to align the cells and measures the density of tissue
B) Measures the uptake of radiolabeled glucose in the tissue
C) Uses standard ionizing radiation to generate images or slices of the body
D) Uses standard ionizing isotopes to measure the density of tissue to crease a single image
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Page 13
Chapter 12: Electrocardiogram Identification
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Q1) The QRS complex occurs within which time frame listed below?
A) 0.01 to 012 seconds
B) 0.02 to 0.1 seconds
C) 0.04 to 0.016 seconds
D) 0.04 to 0.12 seconds
Q2) What is the normal spontaneous depolarization of the SA node?
A) 60 to 100 beats/min
B) 80 to 100 beats/min
C) 60 to 120 beats/min
D) 80 to 120 beats/min
Q3) Where do supraventricular dysrhythmias occur?
A) At the level of the SA node
B) Above the level of the atria
C) Above the level of the ventricles
D) At the level of the AV node
Q4) What is the normal timing of the P-R interval?
A) 0.01 seconds
B) 0.12 to 0.2 seconds
C) >0.2 seconds
D) <0.1 seconds
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Chapter 13: Multisystem Assessment and Laboratory Investigations
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Q1) What is a normal total cholesterol level for a man younger than the age of 40 years?
A) 50 mg/dL
B) 100 mg/dL
C) 150 mg/dL
D) 300 mg/dL
Q2) Which test is used to diagnose and monitor the treatment of acute pancreatitis?
A) CBC
B) Amylase test
C) Electrolyte levels
D) Creatinine test
Q3) Which hormone produced by the pancreas regulates carbohydrate metabolism and is responsible for maintaining a constant level of blood glucose?
A) Adrenaline
B) Insulin
C) Testosterone
D) Cortisol
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Chapter 14: Special Tests
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Q1) Which of the following-the modality of choice for pericardium evaluation-also allows the measurement of right and left ventricular volumes,ejection fraction,and cardiac output?
A) CT
B) MRI
C) Radiography
D) Echocardiography
Q2) What type of imaging is valuable in delineating myocardial areas with reversible and irreversible injury and uses short scanning times of 5" to 35"?
A) SPECT
B) PET
C) Planar
D) TEE
Q3) Which of the following is primarily used to assess the extent of regurgitant jets across "leaky valves?"
A) Color-flow Doppler echocardiography
B) Computed tomography
C) Cardiac ventriculography
D) PET scan
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Page 16
Chapter 15: Clinical Evaluation and Assessment of the
Cardiovascular and Pulmonary
Systems
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Q1) Which adventitious breath sounds are described as discontinuous,low-pitched sounds?
A) Crackles
B) Rhonchi
C) Wheezes
D) Whistles
Q2) Which kind of question is likely to give the most valuable information?
A) A yes/no question directed toward a patient
B) An open-ended question directed toward a patient
C) A yes/no question directed toward a patient's family
D) An open-ended question directed toward a patient's family
Q3) Which voice sound phenomenon distorts the "e" sound so that an "aaa" sound is heard over the peripheral lung area?
A) Bronchophony
B) Egophony
C) Whispered pectoriloquy
D) Wheezing
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Page 17
Chapter 16: Monitoring Systems, catheters, and Devices in the Intensive Care Unit
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Q1) Which of the following may cause fluid and electrolyte imbalances in the form of deficits?
A) Diaphoresis and wounds
B) Diarrhea and vomiting
C) Hemorrhage
D) All of the above
Q2) What percentage of intravascular fluid deficit must develop before blood pressure drops significantly?
A) 5% to10%
B) 10% to15%
C) 15% to 25%
D) 25% to 35%
Q3) Which of the following is an example of upper motor neuron involvement?
A) Progressive muscle weakness
B) The Babinski sign
C) Hyperreflexia
D) All of the above
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Page 18
Chapter 17: Maximizing Outcomes: Relating Interventions to an
Individuals Needs
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Q1) The factors that can impair oxygen transport directly or can threaten it fall into four primary categories:
A) prognosis, intervention, cognitive, and psychosocial.
B) cognitive, psychosocial, nutritional, and neurologic.
C) examination, evaluation, diagnosis, and prognosis.
D) restricted mobility, intrinsic factors, extrinsic factors, and cardiopulmonary pathophysiology.
Q2) Considering that clinical decision making is based largely on the results of tests and measurements,it is essential that:
A) measurements need not have certain characteristics.
B) measurements can be adjusted to fit the therapist's needs.
C) measurements can fall under various different categories.
D) measurements have certain characteristics.
Q3) The prescription must be reviewed at each treatment session and:
A) changed whether or not improvement has been made.
B) changed only if the patient requests.
C) kept the same as the previous week for a 4-week period.
D) modified accordingly.
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Chapter 18: Mobilization and Exercise: Physiological Basis for Assessment,
evaluation, and Training
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Q1) For patients who are critically ill,the goal is to evaluate their oxygen transport reserve capacity and use it as a bias for:
A) estimating the limits of the patient's physiological tolerance for mobilization.
B) identifying the specific effects of exercise required.
C) adapting the prescription based on the patient's needs.
D) defining the optimal therapeutic stimulus.
Q2) Whenever possible,mobilization is performed in the:
A) supine position.
B) prone position.
C) upright position.
D) recumbent position.
Q3) The increase in systemic cardiac output results in increased:
A) oxygen transport.
B) hypertension.
C) venous return and pulmonary cardiac output.
D) anaerobic metabolism.
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Chapter 19: Mobilization and Exercise: Testing and Training
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Q1) An increase in intrathoracic blood volume in the supine position also contributes to a(n):
A) higher risk of blood clots.
B) airway closure.
C) reduction in functional residual capacity (FRC) and lung compliance and to increase airway resistance.
D) hypotension.
Q2) The distribution of ventilation is determined primarily by:
A) functional residual capacity.
B) blood pressure.
C) heart rate.
D) the effect of gravity.
Q3) Body positions that simulate the normal physiological effects of gravity and position change on oxygen transport are:
A) the clinical priority.
B) the patient's objective.
C) the principles for prescribing therapeutic body positioning.
D) the specific indications for body positioning.
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21
Chapter 20: Body Positioning
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Q1) An indication for airway clearance is:
A) nonproductive cough.
B) atelectasis.
C) respiratory muscle weakness.
D) asthma.
Q2) The Trendelenburg position is contraindicated for the treatment of neonates with all of the following conditions or pathologies EXCEPT:
A) recent eye or intracranial surgery.
B) acute heart failure or cor pulmonale.
C) excessive crying.
D) untreated tension pneumothorax.
Q3) ACT is the acronym for:
A) advanced cardiac treatment.
B) avascular coronary treatment.
C) airway clearance techniques.
D) always clear trachea.
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Chapter 21: Airway Clearance Techniques
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Q1) Preparation for any secretion removal technique should include:
A) evaluation of the patient's pulmonary status.
B) preparation of the surrounding area.
C) removal of all jewelry.
D) review of the patient's medical history.
Q2) The three-phased repeated active cycle of breathing technique (ACBT)includes all of the following EXCEPT:
A) active percussive reflex.
B) the forced expiratory technique.
C) breathing control.
D) thoracic expansion.
Q3) Complications that occur as a result of a technique or precautions associated with a particular method should guide a patient or caregiver to:
A) find an alternate technique.
B) seek additional training.
C) find a new therapist.
D) contact the vendor.
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Chapter 22: Facilitating Airway Clearance With Coughing Techniques
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Q1) For both assisted and self-assisted coughs,initial positioning and ventilator strategies are of utmost importance to the:
A) success of insufflation technique.
B) success of exsufflation technique.
C) success of the airway clearance technique.
D) success of upper respiratory therapies.
Q2) One of the two assisted cough techniques is:
A) intrathoracic assisted.
B) self-assisted.
C) manually assisted.
D) intraabdominal assisted.
Q3) A complete lack of glottal closure will not produce any cough or sound because:
A) pulmonary function has been compromised.
B) the vocal folds are not approximating (adducting).
C) respiratory function has been compromised.
D) the focal folds are not separating (abducting).
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24
Chapter 23: Facilitating Ventilation Patterns and Breathing Strategies
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Q1) If it is necessary for a patient to undergo extended time in bed,a major emphasis must be placed on mobilization in an effort to prevent:
A) weight gain.
B) pressure sores.
C) anxiety.
D) immobility.
Q2) Patients with either primary pulmonary dysfunction or secondary pulmonary dysfunction can benefit from:
A) chest mobilization.
B) pectoralis facilitation.
C) scalene facilitation.
D) spinal mobilization.
Q3) What is the leading cause of death in patients with spinal cord injury with tetraplegia?
A) Pressure sores
B) Cardiovascular insult
C) Pneumonia
D) Infection
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Chapter 24: Exercise Testing and Training: Primary
Cardiopulmonary Dysfunction
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Q1) Intermittent claudication is the symptom of exercise-induced muscle ischemia of:
A) peripheral venous disease.
B) peripheral arterial disease.
C) central venous disease.
D) central arterial disease.
Q2) Over the past 20 years,heart transplant had become an accepted therapy for: A) end-stage heart failure.
B) multivalve failure.
C) conduction blocks.
D) increasing ejection fractions.
Q3) Noninvasive cardiac and pulmonary rehabilitation is more cost effective than medical and surgical treatments.All of the following are considered noninvasive EXCEPT:
A) smoking cessation.
B) angioplasty.
C) nutrition and weight control.
D) self-management training.
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26
Chapter 25: Exercise Testing and Training: Secondary
Cardiopulmonary Dysfunction
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Q1) Besides altered hemodynamic responses to exercise,individuals with spinal cord injury also are affected by:
A) temperature stress.
B) fluid stress.
C) pulmonary stress.
D) positional stress.
Q2) Management of patients with systemic atherosclerosis and circulatory dysfunction is similar to management of patients with which of the following pathologies?
A) Stroke
B) Heart and lung failure
C) End-stage renal disease
D) Hypertension
Q3) Compared with the general population,what two things are more common in persons with Down syndrome?
A) Cardiac defects and sleep apnea
B) Cardiac defects and diabetes
C) Pulmonary dysfunction and sleep apnea
D) Pulmonary dysfunction and anemia
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Chapter 26: Respiratory Muscle Training
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Q1) Inspiratory or expiratory muscle training is a means of enhancing inspiratory or expiratory muscle function in individuals with:
A) quadriplegia.
B) asthma.
C) chronic bronchitis.
D) acute respiratory failure.
Q2) Inspiratory and expiratory training enhances the:
A) respiratory muscle in patients with Parkinson disease.
B) neuromuscular junction in patients with neuromuscular disease (NMD).
C) respiratory muscle performance in patients with chronic heart failure (CAD).
D) respiratory muscle performance in patients with neuromuscular disease (NMD).
Q3) The capacity of the respiratory muscle pump is vital for the movement of air to the level of gas exchange in the respiratory system.Failure could result in all but which of the following?
A) Gas exchange
B) Ventilation
C) Tissue repair
D) Diaphragmatic movement
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Chapter 27: Complementary Therapies As
Cardiopulmonary Physical Therapy Interventions
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Q1) Osteopathic medicine stresses the importance of:
A) believing that illness and disease result from vertebral misalignment and regular manipulation can maintain energy flow to organs and the body/mind
B) using light touch to balance energy flow, partly by balancing the flow of cerebral spinal fluid during its circulation around the meninges of the cranium and down the spinal column
C) holistic health, nutrition and joint mobilization to maintain proper balance and homeostasis
D) using hands-on therapy to enhance relaxation and emotional awareness
Q2) Psychosocial management has been identified as a:
A) mind/body technique that that includes cognitive behavioral interventions
B) pathophysiological basis for applying CAM therapies to cardiovascular conditions
C) specific intervention that addresses psychological stress and hypertension
D) core component of cardiac rehabilitation/secondary prevention programs
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Chapter 28: Patient Education
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Q1) When a clinician uses the learning needs assessment survey,it allows for:
A) mistakes to be easily caught.
B) facilitation of optimal learning in a given patient or group.
C) less of a chance for the patient to reinjure themselves.
D) a quicker rehabilitation time.
Q2) Physical therapists are responsible for:
A) posting their credentials.
B) turning in their paperwork in a timely manner.
C) getting to know the patient's family.
D) evaluating and documenting the results of their patients' education activities.
Q3) The teacher-learner relationship that develops between a physical therapist and a patient is mainly caused by:
A) communication between the two in the context of culture.
B) interpretation of hidden messages.
C) being able to define culture.
D) how open the educational setting is.
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Chapter 29: Individuals With Acute Medical Conditions
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Q1) Which of the following would NOT be considered typical treatment for an individual with COPD?
A) Beta-blockers
B) Supplemental oxygen
C) Bronchodilators
D) Antibiotics
Q2) Which of the following strategies will help a patient during an asthma attack?
A) Attempt to have the patient increase his or her ventilatory rate.
B) Attempt use of a CO rebreathing bag.
C) Increase the patient's activity.
D) Provide environmental stimulation.
Q3) You are treating a 4-year-old child diagnosed with acute bacterial pneumonia.She is currently an inpatient at a children's hospital,and you have been consulted to evaluate and treat her.Which of the following treatment techniques would be LEAST appropriate to focus on with this patient?
A) Blowing bubbles to increase tidal volumes
B) Percussion to assist with airway clearance
C) Postural drainage to target involved segments
D) Low-intensity aerobic conditioning
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Chapter 30: Individuals With Acute Surgical Conditions
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Q1) Which of the following is TRUE regarding the typical pattern of breathing after surgery?
A) Spontaneous deep breaths are normal.
B) Tachypnea and tachycardia are rare.
C) Breath sounds are decreased and lung bases.
D) Mucus is not heard typically on auscultation.
Q2) Which of the following statements is TRUE about thoracic and cardiovascular surgery?
A) Patients are at increased risk of aspiration postoperatively.
B) Irritation or compression of the phrenic nerve is not possible during surgery.
C) Artificial airways decrease the risk of postoperative complications.
D) Blood gasses do not indicate the need for mechanical ventilation.
Q3) You are performing preoperative counseling with a patient who will undergo coronary artery bypass grafting x 3 at the end of the week.Which of the following would be MOST appropriate preoperative counseling?
A) Review of modifiable patient risk factors
B) A detailed description of the surgical procedure
C) Preoperative informed consent
D) An overview of the risks associated with the surgical procedure
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Page 32
Chapter 31: Individuals With Chronic Primary
Cardiovascular and Pulmonary
Dysfunction
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Q1) All of the following are typical symptoms of valve disease EXCEPT:
A) dyspnea.
B) fatigue.
C) fluid retention.
D) angina.
Q2) Valve dysfunction is:
A) congenital or acquired.
B) a consequence of rheumatic fever.
C) caused by calcification of the valves.
D) all of the above.
Q3) All of the following diagnoses typically fall under the umbrella of chronic airflow limitation EXCEPT:
A) asthma.
B) bronchiectasis.
C) chronic bronchitis.
D) emphysema.
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Chapter 32: Individuals With Chronic Secondary
Cardiovascular and Pulmonary Dysfunction
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Q1) All of the following are examples of musculoskeletal thoracic deformities that can affect breathing or coughing EXCEPT:
A) scoliosis.
B) rib fractures.
C) spondylolisthesis.
D) ankylosing spondylitis.
Q2) Which of the following is NOT typically seen in patients with cerebral palsy (CP)?
A) Hydrocephalus
B) Hyperreflexia
C) Spasticity
D) Musculoskeletal deformity
Q3) Stroke or hemiplegia has which of the following effects of the cardiovascular and pulmonary system?
A) Increases cardiac output
B) Decreases chest wall movement
C) Increases alveolar ventilation
D) Decreases residual volume
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Page 34
Chapter 33: Comprehensive Management of Individuals in the Intensive Care Unit
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Q1) Which of the following is not a relative contraindication of manual airway clearance interventions?
A) Hemorrhage
B) Acute chest trauma
C) Gastric reflux
D) All of these are relative contraindications
Q2) Which of the following is not included in the tripod approach to patient management?
A) Clinical experience
B) Diagnostic skills
C) Knowledge of underlying pathophysiology
D) Physiologic and scientific evidence for treatment interventions
Q3) Which monitoring system give the therapist information of fluid loading and the ability of the right side of the heart to cope with changes in circulating body fluids?
A) Central venous pressure
B) Swan-Ganz catheter
C) ECG
D) Cardiovascular stress alert
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Chapter 34: Intensive Care Management of Individuals
With Primary Cardiovascular and Pulmonary Dysfunction
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Q1) What intervention should the therapist concentrate on during a session of physical therapy with the cardiac patient including a short period of restricted mobility?
A) Aggressive coughing exercises
B) Positioning with the foot of the bed elevated
C) Rhythmic breathing exercises
D) Bed exercises while moving bilateral lower extremities at the same time.
Q2) Which of the following is not a common complication related to a patient's premorbid status before open heart surgery?
A) Lung collapse
B) Deep vein thrombosis
C) Stroke
D) Pulmonary emboli
Q3) What condition is described with the pathophysiological features of marked airway resistance secondary to bronchospasm,edema,and mucous secretion and retention?
A) Acute respiratory failure
B) Obstructive lung disease
C) Status asthmaticus
D) COPD
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Chapter 35: Intensive Care Management of Individuals
With Secondary Cardiovascular and Pulmonary Dysfunction
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Q1) Which of the following findings would you not expect with a patient with a flail chest segment?
A) Increased elevation of chest segment during inspiration
B) Instability of the chest wall
C) Chest depression over segment during inspiration
D) Asynchronous movement of the chest wall
Q2) While working with a patient,the patient begins to experience deterioration in level of consciousness,pupillary reflexes,ocular reflexes,pattern of respiration,and exaggerated muscle tone and posture.What do you suspect is occurring with this patient?
A) Fatigue from therapy session
B) Cerebral edema with increased intracranial pressure
C) Myocardial infarction
D) Hemorrhage
Q3) Which of the following is the optimal resting position for a morbidly obese patient?
A) In bed, supine with extra pillows
B) In bed, with head of bed elevated
C) In bed, prone
D) In bed, side-lying
Page 37
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Chapter 36: Intensive Care Management of Medical and Surgical Complications
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Q1) Which of the following is a not a condition that predisposes a patient to multiorgan system failure (MOSF)?
A) Sepsis
B) Overwhelming infection
C) Shock
D) Tissue perfusion deficits
Q2) Which of the following is a complication from surgery that may arise with a patient in intensive care?
A) Pulmonary dysfunction
B) Cardiac dysrhythmias
C) Metabolic dysfunction
D) Deep vein thrombosis
Q3) Facilitating mucociliary transport is a primary goal with postoperative patients.One way to reach this goal is with body positioning.Which positional treatment would not be beneficial?
A) Positioning the patient upright
B) Performing 360-degree axial turns
C) Performing multiple position changes throughout the day
D) All of these would be beneficial
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Chapter 37: Infants and Children With Cardiovascular and Pulmonary Concerns
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Q1) In a patient with Duchenne muscular dystrophy (DMD),what would not be a possible cause of end-stage respiratory failure?
A) Lumbar deformity
B) Respiratory muscle weakness
C) Reduced lung compliance
D) Hypoxemia
Q2) What condition occurs because of lung immaturity,an insufficient number of alveoli,and an inadequate amount of surfactant?
A) Asthma
B) Respiratory distress syndrome
C) Tetralogy of Fallot
D) Patent ductus arteriosus
Q3) You are creating an exercise program for a 5-year-old patient with cystic fibrosis (CF).What components should be included in your pre-exercise examination and evaluation?
A) Complete chest evaluation
B) Evaluation of ADL tolerance and limitations
C) Evaluation of ROM, strength and posture
D) All of these should be assessed
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Chapter 38: The Aging Patient
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Q1) Physical therapists working with elderly adults may be more interested in the responses of frail or sick patients rather than a healthy patient the same age because of which of the following?
A) This is the patient population referred to therapy.
B) Healthier people tend to be more active able to function without assistance.
C) The sedentary lifestyle of many older adults results in disuse and often a decline in function.
D) All of the above
Q2) Although the improvements in increasing VO max in elderly people are not clear,which of one the following is consistent?
A) Improvement in thoracic mobility leading to better O saturation with lung expansion
B) Greater extraction of oxygen caused by wider arteriovenous oxygen content
C) Decreases in O demands in the peripheral muscles
D) An increase in maximum heart rate
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Chapter 39: Multisystem Clinical Implications of Impaired
Breathing Mechanics and Postural Control
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Q1) Which anatomical valves represent the superior and inferior valves of the soda can model of respiratory and postural control?
A) The vocal cords and pelvic floor
B) The vocal cords and the diaphragm
C) The diaphragm and the pelvic floor
D) All of the above
Q2) Patients with which form(s)of compensatory breathing patterns need assistance from a ventilator?
A) Type I paradoxical
B) Paradoxical Type II paradoxical
C) Asymmetrical
D) Lateral or gravity eliminated
Q3) Breathing for an infant from 3 to 6 months of age includes which of the following?
A) Continues to be primarily in one plane
B) Has expanded to more than one plane
C) Has fully matured to all three planes
D) Is more restricted in all three planes
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Page 41
Chapter 40: The Transplant Patient
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Q1) The lung allocation score is based on which factors?
A) Posttransplant survival and wait list urgency
B) Posttransplant survival and transplant benefit measure
C) Wait list urgency, pretransplant health screening, and transplant benefit measure
D) None of the above
Q2) What type of medication is often used after transplant surgery for the lung patient to ensure proper function of the lungs?
A) Vitamins and supplements
B) Diuretics
C) Antipsychotics
D) Paralytics
Q3) What time frame is provided for weaning of patients from mechanical ventilation after heart transplant surgery?
A) 12 to 24 hours
B) 24 to 36 hours
C) 12 to 36 hours
D) 24 to 48 hours
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Chapter 41: The Patient in the Community
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Q1) Vital signs and oximetry should be performed during the evaluation in which position first?
A) Standing
B) Sitting
C) Walking
D) Supine
Q2) To increase functional gains made during therapy,the rehabilitation team should perform which of the following?
A) Encourage the patient during therapy to work as hard as possible.
B) Help the patient complete tasks even if patient effort is minimal.
C) Incorporate therapy goals into all aspects of care.
D) Set goals that just out of reach to help the patient strive.
Q3) Positive self-management involves the combination of which of the following?
A) Positive emotional outlook
B) Active involvement in decision making
C) Maintenance of a lifestyle that is as optimal as possible
D) All of the above
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Chapter 42: Body Mechanics: Positioning and Moving Patients
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Q1) Which position of the trunk in sitting is most apt to increase respiratory muscle endurance in patients with COPD?
A) Posterior inclination with arms outstretched behind the patient
B) Completely upright posture with arms at the patient's sides
C) Anterior inclination with arms braced in front of the patient
D) Left lateral inclination, leaning on the patient's left elbow
Q2) In a patient with right lower lung pneumonia or atelectasis,which position is recommended to improve oxygenation?
A) Supine
B) Right side-lying
C) Left side-lying
D) Prone
Q3) Which patient position limits the effect of gravity on anterior expansion of the lungs?
A) Supine
B) Side-lying
C) Hook-lying
D) Prone
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Page 44
Chapter 43: Respiratory Care Practice Review
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Q1) Which term refers to breathing through a ventilator circuit without assistance?
A) Intermittent mandatory ventilation
B) Spontaneous breathing
C) Controlled mechanical ventilation
D) Assist control of ventilation
Q2) Which of the following is a visual or audio feedback device that encourages slow,deep inspiration?
A) Nonrebreathing mask
B) E cylinder
C) CPAP
D) Incentive spirometry
Q3) Which of the following is used to ensure mandatory minute ventilation?
A) Pressure support ventilation
B) Triggers
C) Incentive spirometry
D) None of the above
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Chapter
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Q1) Before suctioning an artificial airway,how many hyperoxygenating breaths with a manual resuscitation bag should be provided?
A) 1 to 2
B) 3 to 5
C) 10 to 15
D) 30 to 40
Q2) Which is a purpose for an artificial airway?
A) To bypass upper airway obstruction
B) To assist or control respirations over prolonged periods
C) To prevent aspiration of oral and gastric secretions
D) All of the above
Q3) How often should the pressure of a tracheostomy tube cuff be checked?
A) Once per day
B) Twice per day
C) Every 4 to 8 hours
D) Every 30 minutes
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46
Chapter 45: Respiratory and Cardiovascular Drug Actions
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Q1) Which drug is an anticholinergic with bronchodilatory effects useful in patients with asthma?
A) Ipratropium
B) Carbachol
C) Pilocarpine
D) None of the above
Q2) Which cholinergic drug has a short duration of action if administered parentally?
A) Bethanechol
B) Carbachol
C) Pilocarpine
D) Acetylcholine
Q3) Which class of drugs are being increasingly used as alternatives to low-dose inhaled steroids in patients with mild persistent asthma?
A) Antileukotrienes
B) Anticholinergics
C) Anticholinesterase drugs
D) Cholinergic drugs
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