Introduction to Cardiopulmonary Rehabilitation
Exam Answer Key
Course Introduction
Introduction to Cardiopulmonary Rehabilitation provides students with a comprehensive overview of the principles and practices involved in rehabilitating individuals with cardiac and pulmonary conditions. The course covers the physiological basis of cardiopulmonary diseases, assessment techniques, exercise prescription, risk factor modification, and the psychological and educational components of rehabilitation. Emphasis is placed on interdisciplinary approaches, patient safety, and evidence-based strategies to improve functional capacity, quality of life, and long-term health outcomes. Students will also explore current guidelines and standards of care, along with considerations for specific patient populations.
Recommended Textbook
Essentials of Cardiopulmonary Physical Therapy 4th Edition by Ellen Hillegass
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Chapter 1: Anatomy of the Cardiovascular and Pulmonary Systems
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Q1) Which of the following chest wall structures is located level with the second costal cartilage anteriorly and thoracic vertebra T4 and T5 posteriorly?
A)Sternal angle
B)Jugular notch
C)Xiphoid process
D)Third costal cartilage
Answer: A
Q2) The point at which the nerves,vessels,and primary bronchi penetrate the parenchyma of each lung is termed the:
A)root.
B)fissure.
C)hilus.
D)segment.
Answer: C
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Chapter 2: Physiology of the Cardiovascular and Pulmonary Systems
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Q1) Which of the following factors act to decrease airway resistance?
A)The presence of mucus and edema
B)Smaller airway diameter
C)Parasympathetic nervous system
D)Sympathetic nervous system
Answer: D
Q2) To facilitate the diffusion of oxygen from alveoli to pulmonary capillary,which of the following must occur?
A)The alveolar walls become thicker.
B)Concentration of oxygen is high in the pulmonary artery.
C)Concentration of oxygen is high in the alveoli.
D)Partial pressure of oxygen must equal 20.93%.
Answer: C
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
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Chapter 3: Ischemic Cardiovascular Conditions and Other Vascular Pathologies
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Q1) A pathological permanent dilation of an artery wall that is usually uniform in shape,but can resemble a sac or outpouching,is termed:
A)stenosis.
B)aneurysm.
C)atherosclerosis.
D)bruit.
Answer: B
Q2) In a patient with diabetes,which of the following physiological changes is a result of increased glycosylation?
A)Increase sensitivity to enzymes
B)Elevated high-density lipoprotein
C)Enhanced fibrin degrading by fibrinogen
D)Enhanced thrombus formation
Answer: D
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Chapter 4: Cardiac Muscle Dysfunction and Failure
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Q1) A noncompliant left ventricle that occurs as blood passively fills a poorly relaxing ventricle during early diastole and is considered the hallmark of congestive heart failure describes which of the following heart sounds?
A)S1
B)S2
C)S3
D)S4
Q2) A breathing pattern characterized by waxing and waning depths of respiration with recurring periods of apnea is termed which of the following?
A)Paroxysmal nocturnal dyspnea
B)Tachypnea
C)Cheyne-Stokes respiration
D)Orthopnea
Q3) Dilated cardiomyopathy is caused by which of the following factors?
A)Long-term alcohol abuse
B)Malalignment of myocardial fibers
C)Myocardial fibrosis
D)Abnormal sympathetic stimulation
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Chapter 5: Restrictive Lung Dysfunction
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Q1) A 59-year-old male has fallen off a ladder at his home and hit a retaining wall on the way down fracturing several ribs on the right side.He was admitted to the hospital for pain control,close observation,and physical therapy.The primary goal for physical therapy is which of the following?
A)The patient will demonstrate appropriate splinting using a small pillow to reduce pain.
B)The patient will demonstrate log roll to the left side with contact guard assist to improve bed mobility.
C)The patient will ambulate in the hall 150 feet with supervision.
D)The patient will perform deep breathing using incentive spirometry to reestablish a normal breathing pattern.
Q2) In a patient with adult respiratory distress syndrome (ARDS),fat emboli would be categorized as which of the following types of causes for ARDS?
A)Inhaled toxin
B)Trauma
C)Shock
D)Metabolic
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Chapter 6: Chronic Obstructive Pulmonary Diseases
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Q1) Which of the pulmonary function test findings BEST indicates COPD?
A)High FEV ,high FEV /FVC,low residual volume
B)High FEV ,no change in FEV /FVC,low residual volume
C)Low FEV ,low FEV /FVC,high residual volume
D)Low FEV ,no change in FEV /FVC,no change in residual volume
Q2) 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
Q3) What abnormal physiological change develops in response to the presence of arterial hypoxemia in a patient with COPD?
A)Polycythemia
B)Tachypnea
C)Thrombocythemia
D)Anemia
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Chapter 7: Cardiopulmonary Implications of Specific Diseases
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Q1) Cardiovascular disease is the MOST common cause of death in patients with which of the following types of connective tissue diseases?
A)Rheumatoid arthritis
B)Systemic lupus erythematosus
C)Scleroderma
D)Ankylosing spondylitis
Q2) The MOST common cardiovascular problem in patients with human immunodeficiency virus (HIV)is which of the following?
A)Pericardial effusion
B)Biventricular hypertrophy
C)Hypertension
D)Cardiac arrhythmias
Q3) Which of the following components secreted by adipose tissue is considered a cytokine that may promote atherosclerosis and increase insulin resistance?
A)Adiponectin
B)Angiotensinogen
C)Interleukin 6
D)Resistin
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Chapter 8: Cardiovascular Diagnostic Tests and Procedures
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Q1) Which of the following tests is MOST useful for identifying the high-risk patient?
A)Low-level testing
B)Maximal stress test
C)Submaximal test
D)Pulse recovery test
Q2) Which of the following reasons are considered indications for a Holter monitor?
A)Identifying symptoms caused by arrhythmias
B)Describing the arrhythmias noted with activity
C)Evaluating antiarrhythmic therapy or pacemaker functioning
D)All of the above
Q3) Which of the following pharmacological cardiac testing procedures is BEST for confirming coronary artery spasm?
A)Administration of adenosine
B)Administration of dobutamine
C)Administration of regadenoson
D)Administration of ergonovine
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Chapter 9: Electrocardiography
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Q1) A single-lead tracing or rhythm strip can be used to determine all of the following EXCEPT:
A)heart rate.
B)heart rhythm.
C)presence of arrhythmia.
D)presence of ischemia.
Q2) Which of the following sites is associated with a second-degree AV block,type II?
A)High in the AV junction
B)Impulse delayed between the SA and AV nodes
C)Above the ventricles
D)Below the bundle of His
Q3) On an ECG,a large R wave in V1 and V2 and ST-segment depression BEST indicate an infarction in which of the following regions of the heart
A)Anterior wall
B)Inferior wall
C)Lateral wall
D)Posterior wall
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Chapter 10: Pulmonary Diagnostic Tests and Procedures
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Q1) Which of the following statements is TRUE about a volatile type of acid?
A)An example is lactic acid.
B)A type of acid that cannot change to gaseous form.
C)Most of this type of acid is metabolized by the liver.
D)This type of acid is regulated by the lungs.
Q2) A patient has the following arterial blood gas values:pH = 7.32,PaCO = 68,PaO = 60,and HCO - = 28.Which of the following statements is the MOST accurate interpretation?
A)Uncompensated respiratory acidosis
B)Partially compensated respiratory acidosis
C)Uncompensated metabolic acidosis
D)Partially compensated metabolic acidosis
Q3) Which of the following conditions BEST describes respiratory alkalosis?
A)High bicarbonate level (HCO -)
B)Low partial pressure CO (PaCO )
C)Hypocapnia
D)Low bicarbonate level (HCO -)
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Chapter 11: Cardiovascular and Thoracic Interventions
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Q1) Which of the following revascularization procedures is the BEST option when all three vessels of the coronary arterial supply are severely occluded?
A)Percutaneous transluminal coronary angioplasty
B)Directional coronary arthrectomy
C)Endoluminal stent
D)Coronary artery bypass graft
Q2) The implantable cardioverter defibrillator is BEST indicated in which of the following heart conditions?
A)Permanent to respond to life-threatening arrhythmias such as tachycardia
B)Temporary to control transient arrhythmias
C)Temporary control of increased vagal control after cardiac surgery
D)Permanent to control chronic arrhythmias such as second-degree heart block
Q3) If atherosclerosis is diagnosed in the carotid arteries,which of the following arteries may also be atherosclerotic secondary to the nature of the disease process?
A)Coronary arteries
B)Peripheral arteries
C)Renal arteries
D)All of the above
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Chapter 12: Thoracic Organ Transplantation: Heart, Heart
Lung, and Lung
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Q1) Medications provided postoperative heart or lung transplantation that inhibit cytokine synthesis,interleukin-1,and T-cell activation and act as an anti-inflammatory agent BEST describes which of the following drug classes?
A)Calcineurin inhibitors
B)Corticosteroids
C)Antiproliferative agents
D)Antithymocyte globulin
Q2) Which of the following therapy techniques is MOST important for a patient who is 1 day postoperative lung transplant candidate in which it is common the donor lung tissue is denervated?
A)Active cycle of breathing
B)Manual hyperinflation
C)Use of a flutter valve
D)Cough on a scheduled basis
Q3) Research evidence does not support the benefits of preoperative rehabilitation for heart and lung transplant candidates to improve function and activity tolerance.
A)True
B)False
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Chapter 13: Monitoring and Life Support Equipment
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Q1) Which of the following oxygen delivery devices is generally intended for lower flow rates of oxygen between 1 and 6 L/min?
A)Nasal cannula
B)Simple mask
C)Aerosol mask
D)Venturi mask
Q2) Which of the following statements is TRUE about mean arterial pressure (MAP)readings?
A)The MAP reading does not vary significantly with motion artifact or movement.
B)The MAP is useful clinically as it relates to cardiac output and systemic vascular resistance.
C)An MAP value of <60 mm Hg may indicate inadequate tissue perfusion.
D)All of the above are true statements.
Q3) Which of the following bispectral index monitor (BIS)reading value ranges indicates light to moderate sedation?
A)90 to 100
B)70 to 85
C)60 to 70
D)40 to 55
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Chapter 14: Cardiovascular Medications
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Q1) Impairment of effective drug elimination in an elderly patient is MOST likely related to poor functioning in which of the following organs?
A)Cardiac conduction system
B)Liver
C)Kidney
D)Body composition
Q2) Administering a medication at certain time intervals throughout the day by any route BEST describes which of the following components of pharmacokinetics?
A)Bioavailability
B)Distribution
C)Clearance
D)Dosage
Q3) Which of the following BEST describes the advantage of parenteral drugs in the management of hemodynamic instability in an emergence or critical care settings?
A)Bioavailability is greater.
B)The first pass effect is greater.
C)Onset of drug action is slower.
D)Drug clearance is slow.
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Chapter 15: Pulmonary Medications
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Q1) If the breathing patterns of a patient receiving supplemental oxygen deviate from the norm,which of the following interventions would MOST likely ensure that the patient is receiving the intended fraction of inspired oxygen?
A)Increase the oxygen flow via a nasal cannula.
B)Have the patient wear a moderate- to high-flow face mask.
C)Educate the patient to inspire via the nose and expire by the mouth.
D)Have the patient rest semi-reclined in bed.
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) Long-acting beta adrenergic agonists (LABAs)provide which of the following benefits?
A)Prescribed as a reliever medication.
B)Provides quick relief from symptoms of shortness of breath.
C)Prevents or decreases symptoms of bronchospasm.
D)Used as a maintenance drug and provides stable airways day to day.
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Chapter 16: Examination and Assessment Procedures
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Q1) Egophony is BEST described by which of the following in a patient with emphysema?
A)The said phrase "99" is heard more loudly than normal.
B)The said phrase "E" is heard much softer than normal as "A."
C)Whispered words are heard more loudly than normal.
D)The said phase "E" is heard more loudly than normal as "A."
Q2) Which of the following actions done by the physical therapists enhances trust and rapport with that patient during the initial evaluation session?
A)Knowledge of the patient's medical history after a thorough review of the medical chart
B)Completing a highly structured interview of questions
C)Joking around with the patient prior to the interview
D)Having the patient complete a questionnaire prior to the physical therapy visit
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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Chapter 17: Interventions for Acute Cardiopulmonary
Conditions
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Q1) An assistive device capable of performing a wide range of support for the act of breathing is which of the following?
A)Mechanical percussor
B)High-frequency chest wall oscillation
C)Mechanical ventilator
D)Positive expiratory pressure
Q2) Postural drainage is BEST defined by which of the following statements?
A)Rhythmical clapping with cupped hands over the affected lung segment.
B)Clinician's hands are used to exert pressure on the patient's chest wall with oscillations at the end of deep inspiration through expiration.
C)The assumption of one or more body positions that allow gravity to assist with draining secretions from each lung segment.
D)A series of maneuvers performed by the patient to emphasize independence in secretion clearance and thoracic expansion.
Q3) The technique of airway suctioning is effective in removing secretions from all of the lungs areas including the small airways.
A)True
B)False
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Chapter 18: Interventions and Prevention Measures for
Individuals With Cardiovascular Disease, or Risk of Disease
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Q1) Which of the following environmental factors results in vasodilation creating an increase in heart rate to maintain adequate cardiac output?
A)Altitude
B)Cold temperature
C)Heat
D)Humidity
Q2) Patients with low functional capacity are generally not good candidates for cardiac rehabilitation due to failure to make reasonable progress.
A)True
B)False
Q3) Measuring a patient's ability to recognize signs and symptoms is considered an outcome targeting which of the following domains?
A)Clinical
B)Health
C)Behavioral
D)Service
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Chapter 19: Pulmonary Rehabilitation
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Q1) Which of the following anatomical areas of the body lose range of motion (ROM)as a result of progressive lung disease,poor posture,and accessory breathing muscle use?
A)Rib cage
B)Shoulders
C)Spine
D)All of the above
Q2) Which of the following activities would be considered an intervention to enhance energy conservation?
A)Pursed-lip breathing.
B)Avoid bending over at the waist during an activity.
C)Use of adaptive equipment to simplify tasks.
D)Practice of yoga postures.
Q3) Which of the following outcomes is NOT considered one of the major outcome areas that need to be measured in pulmonary rehabilitation?
A)Exercise capacity
B)Patient satisfaction
C)Symptoms
D)Health-related quality of life
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Chapter 20: Pediatric Cardiopulmonary Physical Therapy
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Q1) Which of the following techniques would be MOST productive when retaining a pediatric patient's diaphragmatic breathing?
A)Verbalize and demonstrate diaphragmatic breathing.
B)Provide a visual cue such as a stuffed animal on belly while in a supine position.
C)Manual facilitation techniques such as quick stretch.
D)Tactile cueing of the diaphragm or inhibition of accessory muscles.
Q2) Placing a cotton ball in the middle of a table and having the child blow the cotton ball off the table facilitates improvements in which of the following functions?
A)Deep breathing
B)Coughing
C)Expiratory strength
D)Inspiratory strength
Q3) Which of the following characteristics is MOST associated with cyanotic lesions of the heart?
A)Flow is known as left to right.
B)Associated with polycythemia.
C)Pulmonary blood flow is increased.
D)Associated with low stroke volume.
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Chapter 21: The Lymphatic System
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Q1) The lymphatic system is similar to the venous system in which of the following ways?
A)The presence of one-way valves
B)The ability of a vessel to contract via the autonomic nervous system
C)Immune defense
D)Key function is waste removal
Q2) The pressure caused by proteins present in the interstitium that results in water being attracted and pulled into the interstitium (filtration)describes BEST 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
Q3) Which of the following conditions related to poor functioning of the lymphatic system MOST likely contributes to the risk for atherosclerosis?
A)Filtration of lipoproteins is increased.
B)Risk of oxidative damage is greater.
C)Risk of lipoprotein entrapment is decreased.
D)Diminished time arterial intima is exposed lipoproteins.
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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 questionnaires would be MOST appropriate to measure symptoms in patients with a previous myocardial infarction,previous vascularization surgery,chest pain,or abnormal results during testing,and acute or chronic disease?
A)The Walking Impairment Questionnaire
B)The Seattle Angina Questionnaire (SAQ)
C)The Kansas City Cardiomyopathy Questionnaire
D)The Chronic Respiratory Disease Questionnaire
Q2) The more specific the tool is to the population,the less sensitive the tool will be toward change.
A)True
B)False
Q3) The amount of change a clinician needs to see in an outcome measurement to determine if true clinical change has been attained refers to which of the following terms?
A)Minimally clinically important difference
B)Minimal detectable change
C)Sensitivity
D)Reliability
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