Cardiopulmonary Quiz
Preview:
A patient recovering from surgery for triple coronary artery bypass grafts is scheduled to begin a phase III cardiac rehabilitation program. During the resistance portion of the circuit training program, whys should the patient be instructed to AVOID the Valsalva maneuver?
A. To avoid elevating the heart rate and blood pressure
B. To avoid accumulation of peripheral fluid and resulting edema
C. Because it may produce slowing of pulse and increased venous pressure
D. Because a cholinergic or vagal response may occur
Which of the following contraindications to joint mobilization is common for patients with chronic pulmonary disease?
A. Reflex muscle guarding
B. Long-term corticosteroid therapy
C. Concurrent inhalation therapy
D. Functional chest wall immobility
A patient who is recovering form surgery is receiving postural drainage as part fo the physical therapy plan of care. When should the physical therapist assistant discuss decreasing the frequency of sessions per day with the physical therapist?
A. If consistency of the sputum changes
B. If the patient becomes febrile
C. When the amount of productive secretions decreases
D. When the patient experiences decreased post operative pain
A physical therapist assistant is working with a patient who has pulmonary disease and is being monitored continuously with a pulse oximeter. The patient’s saturation levels are approximately 92%-94%. The physical therapist assistant should stop treatment and notify the physical therapist when the oximeter reading initially drops below what level?
A. 78%
B. 82%
C. 86%
D. 90%
A women who is 12 weeks pregnant asks a physical therapist assistant if it is safe to continue with her aerobic exercise. Currently she jogs 3 miles three times a week and has done so for the past 10 years and wants to continue throughout her pregnancy. After discussion with the therapist, what is the BEST reply to this client?
A. Jogging is safe as long as the target heart rate does not exceed 140 beats per minute
B. Jogging is safe at mild to moderate intensities whereas vigorous exercise is contraindicated
C. Continue jogging only until the fifth month of pregancy
D. Swimming is preferred over walking or jogging for all phases of pregnancy
What is the appropriate action with a patient who reports feeling lightheaded during use of an incentive spirometer?
A. Take a rest period and only use the device 10 times per hour
B. Take a deeper breath on the following attempt
C. Lie down while using the spirometer
D. Try to use the spirometer more frequently to get used to it
A physical therapist assistant is treating a patient on the tilt table secondary to orthostatic hypotension. The patient has been gradually raised from supine to 60 degrees when the blood pressure begins to suddenly decrease. What is the MOST appropriate manner for the assistant to lower the tilt table?
A. Immediately lower the table to 0 degrees and call the physical therapist for assistance
B. Lower the patient in 5-10 degree increments until the blood pressure stabilizes
C. Return the table to 45 degrees and stay at this level for the remainder of the session
D. Immediately lower the table to 0 degrees and call a medical emergency
A physical therapist assistant working in an outpatient clinic has been assigned a group exercise program with patients in phase III of their cardiac rehabilitation program. For this phase of rehabilitation, which of the following interventions is MOST appropriate?
A. Resistance exercises using less than 15 pounds when in a sitting position
B. Slowly performing active range of motion activities of the upper and lower extremities
C. Walking on a treadmill at 2 mph
D. Running on a treadmill at 5 mph
A physical therapist assistant is following the plan of care for treatment of a patient on the coronary care unit 2 days after a coronary artery bypass surgery. What will an appropriate exercise regiment as this stage of the patient’s recovery include?
A. Ankle pumps and heel slides to increase the heart rate 15 beats over the resting level
B. Shoulder flexion and abduction, and elbow flexion with a 3 pound weight at an intensity to increase the heart rate 15-25 beats per minute
C. Exercises that increase the heart rate 30 beats over the resting level, such as upper-extremity exercises using a 1 pound weight, or marching in place while seated
D. Ankle pumps and marching in place while seated, at an intensity to increase the heart rate 1-15 beats over the resting level
A patient has developed congestive heart failure after a myocardial infarction. What pulmonary signs and symptoms may be present?
A. Inspiratory wheezing and shortness of breath
B. Crackles and cough
C. Cough productive of thick yellow secretions
D. Crackles and barrel chest
A phase 2 outpatient cardiac rehabilitation program uses circuit training with different exercise stations for the 50-minute program. One station uses upper extremity ergometry. What principles hold true when comparing upper extremity exercise to lower extremity exercise, at a given workload?
A. Higher systolic and diastolic BP
B. Exercise capacity is reduced owing to higher stroke volumes
C. Heart rate, systolic, and diastolic blood pressure will all be higher
D. Heart rate will be higher while systolic BP will be lower
A physical therapist assistant is working with a patient who is receiving treatment for a venous thrombosis and notes several areas of ecchymosis on both upper extremities, Which fo the following medications is MOST likely the cause?
A. Heparin
B. Hydrocortisone
C. Dilantin
D. Digoxin
A patient with congestive heart failure is on a regimen of diuretics and calcium channel blockers. What potential side effects should the physical therapist assistant be mindful of?
A. Orthostatic hypotension and dizziness
B. Reflex tachycardia and unstable blood pressure
C. Gastrointestinal upset and extreme fatigue
D. Decreased electrolytes and electrical instability evidenced by increased arrhythmias
Four weeks after a myocardial infarction, a patient enters an outpatient physical therapy cardiac rehabilitation program. Now that the patient is in phase 2, what should be the predominant focus of the exercise sessions?
A. Low-level weight training using a starting weight at one repetition maximum
B. Circuit training using various upper extremity resistance devices
C. Continuous aerobic activities using large muscle groups
D. Recreational activities such as running and basketball
A physical therapist assistant is instructed to begin treating a distance runner who has been referred to physical therapy for ankle pain. Prior to beginning treatment the patient’s blood pressure is 100/60 mm Hg and the resting heart rate is 48 bpm. Which is the BEST conclusion based on the information?
A. The patient is poorly dehydrated, provide water prior to treatment
B. The patient is hypotensive; monitor vitals throughout treatment
C. The patient is aerobically fit; exercise as pain tolerates
D. The patient’s endurance training has resulted in a lower heart rate, the patient will tolerate exercise.
A physical therapist assistant treating a patient with congestive heart failure should be alert fro signs of digitalis toxicity. Which of the following systems will MOST likely be affected?
A. Gastrointestinal and central nervous system
B. Genitourinary and endocrine systems
C. Pulmonary and genitourinary systems
D. Gastrointestinal and integumentary systems
Which intervention is the primary focus for a child with cystic fibrosis?
A. Postural drainage
B. Pursed-lip breathing
C. Assisted cough
D. Diaphragmatic breathing
Which of the following methods will BEST to teach a patient segmental breathing?
A. Place a hand over the area of hypoventilation, apply firm pressure just prior to inspiration then ask the patient to breathe in against the resistance of the hand
B. Place both hands gently over the lower ribs, apply gentle pressure throughout exhalation, and increase pressure at the end of exhalation by asking the patient to inhale against resistance
C. Place a hand over the lower abdomen and apply pressure at or near the end of exhalation
D. Place the incentive spirometer in the patient’s mouth and encourage the patient to breathe in as deeply as possible
While reviewing a patient’s medical record prior to treatment, the physical therapist assistant notes that the patient has a diagnosis of congestive heart failure with right ventricular involvement. Which of the following is the patient MOST likely to present with?
A. Pulmonary edema
B. Progressive dyspnea
C. Dependent edema
D. Renal changes with increasing blood volume
A patient who is 70 pounds overweight is recovering from a myocardial infarction, which occurred 6 weeks ago. The plan of care includes exercise class in conjunction with dietary program to promote weight reduction. Which exercise protocol is MOST appropriate for this patient?
A. Jogging, for 10 minutes at 4 mph
B. Walking, intensity set at 50% target heart rate
C. Walking, intensity set at 75% target heat rate
D. Swimming, intensity set at 75% age-adjusted heart reate
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