Scorebuilders Exams – Cardiopulmonary – Flashcards
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A physical therapist observes an ECG of a patient on beta-blockers. Which of the following ECG changes could be facilitated by beta-blockers? A) sinus bradycardia B) sinus tachycardia C) premature ventricular contractions D) ST segment sagging
answer
Sinus bradycardia (See pg. 746 for explanation)
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A physical therapist completes a respiratory assessment on a patient with T2 paraplegia. As a component of the assessment, the therapist measures the amount of chest excursion during inspiration. The MOST appropriate patient position to conduct the measurement is: A) sitting B) supine C) prone D) sidelying
answer
Supine (See pg. 748 for explanation)
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A physical therapist reviews the results of a pulmonary function test for a 58 y.o. M patient recently admitted to the hospital. The therapist notes that the patient's total lung capacity is significantly increased when compared to established norms. Which medical condition would MOST likely produce this type of result? A) chronic bronchitis B) emphysema C) spinal cord injury D) pulmonary fibrosis
answer
Emphysema (See pg. 754 for explanation)
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A physical therapist monitors a patient's vital signs while completing 20 mins of jogging at 5 mph on a treadmill. As the session approaches its conclusion, the therapist incorporates a cool down period. The anticipated response during the post-exercise period is: A) a progressive increase in systolic BP B) a progressive decrease in systolic BP C) a progressive increase in diastolic BP D) a progressive increase in rate pressure product
answer
B) a progressive decrease in systolic BP (See pg. 760 for explanation)
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A physical therapist determines that a 67 y.o F is at an increased risk after being prescribed a new medication that tends to promote postural hypotension. The medication MOST consistent with the described scenerio is: A) ACE inhibitor agents B) anti-epileptic agents C) anti-coagulant agents D) anti-spasticity agents
answer
ACE inhibitor agents (See pg. 764 for explanation)
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A patient treated in an acute care hospital one day ago is not able to attend a scheduled physical therapy session due to suspected critical limb ischemia. Which symptoms is MOST commonly associated with this condition? A) severe pain in the legs and feet at rest B) increased temperature in the lower leg and foot C) bounding LE peripheral pulses D) flaking skin on the legs with brownish discoloration
answer
A) severe pain in the legs and feet at rest (See pg. 764 for explanation)
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A physical therapist attempts to calculate the target HR rage for a 40 y.o. F with no significant PMH. The patient's resting HR is recorded as 60 bpm and max HR is 180bpm. Using the heart rate reserve method (Karvonen formula) and range of 60-80% intensity, the patient's target HR range should be recorded as: A) 96 - 120 bpm B) 132 - 156 bpm C) 144 - 156 bpm D) 164 - 185 bpm
answer
132 - 156 bpm (See pg. 765 for explanation) ----------------------------------------------------------------- 220-40 = 180 180 -60 = 120 x (0.6 or 0.8) = 72 or 96 72 + 60 = 132 bpm 96 + 60 = 156 bpm
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After observing a patient during an exercise session, a physical therapist concludes that the patient commonly uses the Valsalva maneuver. Which activity would have the GREATEST probability of producing the Valsalva maneuver? A) lifting a 40 lb package from the floor to the counter at waist level B) walking at 4 mph on a treadmill C) stationary cycling at 80 rpm D) using an upper extremity ergometer at 40 rpm
answer
A) lifting a 40 lb package from the floor to the counter at waist level (See pg. 768 for explanation)
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A patient exercising in the physical therapy gym informs the physical therapists that he is experiencing chest pain. After resting for 20 mins the patient's condition is unchanged, however, he insists it is something that he can work through. The MOST appropriate therapist action is: A) allow the patient to resume exercise and continue to monitor the patient's condition. B) reduce the intensity of the exercise and continue to monitor the patient's condition. C) discontinue the treatment session and encourage the patient to make an appointment with his physician D) discontinue the treatment session and call an ambulance
answer
D) discontinue the treatment session and call an ambulance (See pg. 769 for explanation)
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A patient with a length medical history of cardiac pathology is referred to a phase II cardiac rehabilitation program. During the first session the physical therapist prepares to measure the patient's BP by inflating the cuff 20 mmHg above the patient estimated systolic value. Which of the following values describes the MOST appropriate rate to release the pressure when obtaining a BP measurement? A) 2-3 mmHg per second B) 3-5 mmHg per second C) 5-7 mmHg per second D) 8-10 mmHg per second
answer
2-3 mmHg per second (See pg. 774 for explanation)
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A physical therapist prepares a patient for a graded exercise test using an arm cycle ergometer instead of a treadmill due to a lower extremity injury. Which objective finding is MOST accurate when using the arm cycle ergometer instead of the treadmill? A) The results of the testing will be more heavily influenced by patients motivation. B) The obtained maximum oxygen consumption will be significantly lower. C) The work level associated with the point of volitional fatigue with be greater. D) The incremental work levels will be progressively shortened during testing
answer
B) The obtained maximum oxygen consumption will be significantly lower. (See pg. 776 for explanation)
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A physical therapist assesses the vital signs of a patient with a blood disorder. The therapist records the patient's blood pressure as 150/85 mmHg. Which condition is MOST likely the cause of the abnormal blood pressure measurement? A) anemia B) thrombocytosis C) leukopenia D) Polycythemia
answer
D) Polycythemia (See pg. 776 for explanation)
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A physical therapist designs a training program for a patient without cardiovascular pathology. The therapist calculates the patient's age-predicted max HR as 175 bpm. Which of the following would be an acceptable target heart rate for the patient during cardiovascular exercise? A) 93 bpm B) 135 bpm C) 169 bpm D) 195 bpm
answer
135 bpm (See pg. 777 for explanation) ---------------------------------------------------------------- 93/175 = 53% too low 135/175 = 77% 169/175 = 96% too high 195/175 = 111% too high
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A patient's pulmonary function test reveal that the patient has a force vital capacity (FVC) of 4.0 L and a forced expiratory volume in 1 second (FEV1) of 3.5 L. These results would be MOST anticipated with a diagnosis of: A) cystic fibrosis B) idiopathic pulmonary fibrosis C) chronic bronchitis D) emphysema
answer
idiopathic pulmonary fibrosis (See pg. 789 for explanation)
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A physical therapist prepares to treat a patient with cystic fibrosis using postural drainage. The most appropriate patient position when treating the superior segments of the lower lobe is: A) sitting, leaning back at a 30-40 degree angle B) head down on L side, 1/4 turn backward C) supine with 2 pillows under the knee D) prone with 2 pillows under the hips
answer
D) prone with 2 pillows under the hips (See pg. 792 for explanation) --------------------------------------------------------------- A) for apical segments of R and L upper lobes B) for R middle lobe C) for anterior segments of R and L upper lobes
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A patient rehabilitating from cardiac surgery is monitored using a arterial line. The PRIMARY purpose of an arterial line is to: A) measure R atrial pressure B) measure HR and Ox saturation C) measure pulmonary artery pressure D) measure BP
answer
measure BP (See pg. 797 for explanation)
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A patient in the ICU rehabilitating from a serious infection is connected to a series of lines and tubes. Which LE intravenous infusion side would be MOST appropriate to administer an intravenous line? A) median cubital vein B) basilic vien C) cephalic vein D) saphenous vein
answer
Saphenous vein (See pg. 798 for explanation)
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A physical therapist conduct an inservice on exercise guidelines for a group of senior citizens. As part of the inservice the therapist discusses the benefits of improving cardiovascular status through a low intensity activity such as a walking program. What frequency of exercise would be the MOST desirable to achieve the stated objective? A) 2x per day B) 1x per week C) 3x per week D) 5x per week
answer
5x per week (See pg. 800 for explanation)
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A physical therapist employed in an acute care hospital reviews the medical record of a patient diagnosed with CHF. The therapist would like to implement a formal exercise program, but is concerned about the patient's exercise tolerance. Which condition is MOST responsible for the patient's limited exercise tolerance? A) diminished lung volumes B) arterial oxygen desaturation C) insufficient stroke volume during ventricular systole D) excessive rise in blood pressure
answer
C) insufficient stroke volume during ventricular systole (See pg. 801 for explanation)
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A physical therapist monitors the blood pressure response to exercise of a 52 y.o M on a stationary bike. The therapist notes a relatively linear increase in systolic BP with increasing exercise intensity. the change in patient's systolic BP with exercise is BEST explained by: A) increased cardiac output B) decreased peripheral resistance C) increased oxygen saturation D) decreased myocardial oxygen consumption
answer
Increased cardiac output (See pg. 805 for explanation)
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A patient in an acute care hospital has a catheter inserted into the internal jugular vein. the catheter travels through the superior vena cava and into the right atrium. the device permits removal of blood samples, administration of medication and monitoring of central venous pressure. The device is BEST termed: A) arterial line B) central venous pressure catheter C) Hickman catheter D) Swan-Ganz catheter
answer
Hickman catheter (See pg. 806 for explanation)
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A physical therapist performs segmental breathing exercises with a patient following atelectasis. Which manual contact would be the MOST appropriate to emphasize lingula expansion? A) place the hands on the L side of the chest below the axilla B) place the hands below the clavicle on the anterior chest wall C) place the hands over the posterior aspect of the lower ribs D) place the hands on the R side of the chest below the axilla
answer
A) place the hands on the L side of the chest below the axilla (See pg. 816 for explanation)
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A physical therapist administers a submaximal exercise test to a patient in a cardiac rehabilitation program. The protocol requires the patient to ride a cycle ergometer for a predetermined amount of time using progressive workloads. In order to predict the patient's maximal oxygen uptake it is necessary to determine the relationship between: A) HR and rate of perceive exertion B) HR and workload C) BP and rate of perceived exertion D)BP and workload
answer
HR and workload (See pg. 817 for explanation)
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A physical therapist employed in a large medical center review the chars of a 63 y.0 M referred to physical therapy for pulmonary rehabilitation. The chart indicates the patient has smokes 1-2 packs of cigarettes a day since the age of 25. The admitting physician documented that the patient's thorax was enlarged with flaring of the costal margins and widening of the costochondral angle. Which pulmonary disease does the chart MOST accurately describe? A) asthma B) bronchiectasis C) chronic bronchitis D) emphysema
answer
Emphysema (See pg. 817 for explanation)
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A physical therapist reviews the results of pulmonary function testing on a 44 y.o F diagnosed with emphysema. Assuming the patient's testing was classified as unremarkable, which of the following lung volumes would MOST likely approx 10% of the patient's total lung capacity? A) tidal volume B) inspiratory reserve volume C) residual volume D) functional residual capacity
answer
tidal volume (See pg. 818 for explanation)
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A physical therapist utilizes a manual assisted cough technique on a patient with a mid-thoracic spinal cord injury. When completing this technique with the patient in supine, the MOST appropriate location for the therapist's hand placement is: A) manubrium B) epigastric area C) xiphoid process D) umbilical region
answer
epigastric area (See pg. 823 for explanation)
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A physical therapist examines a patient diagnosed with L sided heart failure. Which finding is NOT typically associated with this condition? A) pulmonary edema B) persistent cough C) dependent edema D) muscular weakness
answer
dependent edema (See pg. 825 for explanation)
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A physical therapist monitors a patient with a single lead ECG. After carefully examining the obtained data, the therapist classifies the rhythm as sinus bradycardia. Which description is MOST indicative of this condition? A) R-R interval is irregular with a rate between 100 and 200 bpm B) R-R interval is irregular with rate between 40 and 100 bpm C) R-R interval is regular with a rate greater than 100 bpm D) R-R interval is regular with rate less than 60 bpm
answer
D) R-R interval is regular with rate less than 60 bpm (See pg. 825 for explanation)
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A physical therapist working in cardiac rehabilitation progresses a patient involved in a phase II program through an established exercise protocol. The patient weighs 70 kg and has progressed without difficulty through the rehabilitation program. The protocol indicates the patient should be performing activities requiring 3-4 metabolic equivalents (METs). An example of an appropriate activity would be: A) level walking at 1 mph B) jogging at 5 mph C) cycling at 10 mph D) walking on a treadmill at 3 mph
answer
D) walking on a treadmill at 3 mph (See pg. 826 for explanation)
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A physical therapist employed in a rehabilitation hospital examines a patient that exhibits several signs and symptoms of anemia. Which question would be the MOST useful to gather additional information relation to anemia? A) Does it hurt to take a deep breath? B) Do you experience heart palpitation or SOB at rest or with mild exertion? C) Do you frequently experience dizziness, headaches or blurred vision? D) Are you susceptible to bruising?
answer
B) Do you experience heart palpitation or SOB at rest or with mild exertion? (See pg. 828 for explanation)
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A physical therapist performs postural draining to the anterior basal segments of the lower lobe. During the treatment session the patient suddenly complains of dizziness and mild dyspnea. The MOST appropriate therapist action is to: A) reassure the patient that the response is normal B) assess the patient's vital signs C) elevate the patient's head D) call for assistance
answer
C) elevate the patient's head (See pg. 829 for explanation)
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A physical therapist prepares to perform volumetric measurements as a means of quantifying edema. Which patient would appear to be the MOST appropriate candidate for this type of objective measure? A) a 38 y.o F with a Colles' fracture B) a 27 y.o M with bicipital tendonitis C) a 48 y.o M with rotator cuff tear D) a 57 y.o M with pulmonary edema
answer
A) a 38 y.o F with a Colles' fracture (See pg. 832 for explanation)
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A 61 y.o M referred to physical therapy complains of an excessive cough, sputum production, and SOB. The patient indicates that he has been bothered by some combination of these symptoms for over 10 yrs. the patient's present condition is MOST indicative of: A) idiopathic hypoventilation B) chronic hypoxemia C) Parkinson's disease D) chronic bronchitis
answer
D) chronic bronchitis (See pg. 834 for explanation)
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A physician orders a ECG for a patient diagnosed with CHF. The medical record indicates the patient is currently taking digitalis. What effect would you expect digitalis to have on the patient's ECG? A) sinus tachycardia B) lengthened PR interval C) lengthened QT interval D) elevated ST interval
answer
B) lengthened PR interval (See pg. 838 for explanation)
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A physical therapist treats a 9 y.o child diagnosed with cystic fibrosis. As part of the treatment session the therapist attempts to improve the efficiency of the patient's breathing. The MOST appropriate technique to encourage full expansion at the base of the lung is: A) manual percussion over the posterior portion of the ribs with the patient in prone B) manual contacts with pressure over the lateral borders of the ribs with the patient in supine C) manual vibration over the lateral portion of the ribs with the patient in sidelying D) manual cues over the epigastric area with the patient in supine
answer
B) manual contacts with pressure over the lateral borders of the ribs with the patient in supine (See pg. 839 for explanation)
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A physical therapist instructs a patient to expire maximally after taking a maximal inspiration. The therapist can use these instructions to measure the patient's: A) expiratory reserve volume B) inspiratory reserve volume C) total lung capacity D) vital capacity
answer
D) vital capacity (See pg. 841 for explanation)
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If the forced expiratory volume in one second (FEV1) test is negative for airway obstruction in 99% of individuals without lung disease, then the measurement of FEV1 is: A) sensitive B) specific C) reliable D) valid
answer
specific (See pg. 841 for explanation)
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A physical therapist monitors a patient's vital signs while exercising in a phase I cardiac rehabiltation program. The patient is status post myocardial infarction and has progressed without difficulty while involved in the program. Which of the following vital sign recordings would exceed the typical limits of a phase I program? A) heart rate elevated 18 bpm above resting level B) respiration rate of 18 bpm C) systolic blood pressure decreased by 25 mmHg from resting level D) diastolic blood pressure less than 100 mmHg
answer
C) systolic blood pressure decreased by 25 mmHg from resting level (See pg. 841 for explanation)
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A physical therapist uses metabolic equivalents (METs) as a method to establish exercise intensity for a 36 y.o female. The patient is recreationally active and has no relevant PMH. Which MET level would be MOST consistent with the patient's anticipated maximal aerobic capacity? A) 3 METs B) 6 METs C) 10 METs D) 15 METs
answer
10 METs (See pg. 853 for explanation)
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A physical therapist participates in a research study that formally measures an individual's maximum oxygen consumption. Which individuals would be expected to have the largest maximum oxygen consumption? A) a 23 y.o M (weight 240 lbs; height 72 inches) B) a 25 y.o F (weight 160 lbs; height 66 inches) C) a 53 y.o M (weight 210 lbs; height 69 inches) D) a 47 y.o F (weight 130 lbs; height 63 inches)
answer
A) a 23 y.o M (weight 240 lbs; height 72 inches) (See pg. 858 for explanation)
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A physical therapist observes a patient's breathing as part of a respiratory assessment. Which muscle of respiration is MOST active during forced expiration? A) diaphragm B) external intercostals C) internal intercostals D) upper trapezius
answer
Internal intercostals (See pg. 861 for explanation)
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A physical therapist attempts to quantify a patient's endurance level by administering a maximal exertion test. What is the PRIMARY limitation of a maximal exercise test? A) maximal exercise testing requires participants to exercise to the point of volitional fatigue B) maximal exercise testing does not typically allow a steady state heart rate at each work rate. C) maximal exercise testing is not useful in diagnosing coronary artery disease. D) maximal exercise testing requires progressive stages of increasing work intensities without rest intervals
answer
A) maximal exercise testing requires participants to exercise to the point of volitional fatigue (See pg. 865 for explanation)
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The medical record indicates a patient has been diagnosed with chronic respiratory alkalosis. The MOST consistent laboratory finding with this condition is: A) elevated arterial blood pH, low PaCO2 B) low arterial blood pH, elevated PaCO2 C) elevated arterial blood pH, elevated PaCO2 D) low arterial blood pH, low PaCO2
answer
A) elevated arterial blood pH, low PaCO2 (See pg . 871 for explanation)
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A physical therapist instructs a patient with pulmonary pathology in energy conservation techniques. Which of the following techniques would be the MOST effective when assisting a patients to complete a selected activity without dyspnea? A) diaphragmatic breathing B) pacing C) pursed-lip breathing D) ventilatory muscle training
answer
B) pacing (See pg. 872 for explanation)
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A physical therapist observes a patient running on a treadmill at an intensity of approx 75% of the estimated max oxygen consumption. What is the PRIMARY source for the ATP produced during this activity? A) amino acids B) carbohydrates C) fats D) proteins
answer
Carbohydrates (See pg. 878 for explanation)
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A physical therapist reviews the medical record of a patient recently admitted to the ICU. A note from the patient's physician indicates an order for ABG analysis 6x/day. which type of indwelling line would be used for collect the necessary sample? A) intravenous line B) arterial line C) central venous line D) pulmonary artery line
answer
Arterial line (See pg. 882 for explanation)
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A physical therapist assesses a patient's heart rate by measuring the time necessary for 30 beats. Assuming the therapist measures the value as 22 seconds, the patient's HR should be recorded as: A) 82 bpm B) 86 bpm C) 90 bpm D) 95 bpm
answer
82 bpm (See pg. 887 for explanation)
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A physical therapist positions a patient in sidelying in preparation for postural drainage activities. Which lung segment would be indicated based on the patient's position? A) posterior basal segment of lower lobes B) anterior apical segment of upper lobes C) lateral basal segment of lower lobes D) anterior segment of upper lobes
answer
C) lateral basal segment of lower lobes (See pg. 892 for explanation)
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A physical therapist uses the Six-Minute Walk Test as a means of quantifying functional status in a patient with heart disease. During the testing the patient expresses to the physical therapist that they need to rest. The MOST appropriate physical therapist action is to: A) allow the patient to rest, however, stop the elapsed time during the rest period B) allow the patient to rest, however, allow the elapsed time to continue C) allow the patient to rest, however, discontinue the test D) offer encouragement to the patient in order avoid or delay the rest period
answer
B) allow the patient to rest, however, allow the elapsed time to continue (See pg. 894 for explanation)
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A patient with chronic pulmonary dysfunction is placed on a corticosteroid medication to reduce mucosal edema and inflammation. The MOST common cardiovascular side effects of corticosteroids is: A) palpitaitons B) arrhythmias C) increase BP D) tachycardia
answer
C) increase BP (See pg. 894 for explanation)
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A physical therapist reviews the medical record of a 52 y.o M s/p myocardial infarction. The patient is currently in the coronary care unit and is scheduled to begin cardiac rehabilitation tomorrow. Which potential complication of a myocardial infarction is the patient MOST susceptible to? A) heart failure B) arrhythmias C) thrombus formation D) heart structure damage
answer
B) arrhythmias (See pg. 895 for explanation)
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A physical therapist reviews the medical record of a patient with known cardiovascular pathology. The patient's PMH includes GERD. Which activity would potentially be the MOST problematic for the patient? A) performing diaphragmatic breathing exercises in a semi-Fowler position B) initiating a progressive ambaltion program on a treadmill C) administering percussion to the anterior basal segments of the lower lobes D) assessing tactile fremitus while palpating the chest wall in sitting
answer
C) administering percussion to the anterior basal segments of the lower lobes (See pg. 898 for explanation)
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A physical therapist attempt to prevent alveolar collapse in a patients following thoracic surgery. Which breathing technique would be the MOST beneficial to achieve the establish goals? A) inspiratory muscle trainer B) mechanical percussors C) incentive spirometer D) flutter valve
answer
Incentive spirometer (See pg. 899 for explanation)
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A physical therapist treats a patient in a medical ICU. The therapist notices that intravenous solution appears to be infusing into the tissue surrounding the dorsum of the patient's hand. The MOST appropriate therapist action is: A) contact nursing B) reposition the intravenous line C) remove the intravenous line D) document the incident in medical record
answer
Contact nursing (See pg. 901 for explanation)
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A physical therapist reads in the medical chart that a patient is taking digitalis. The patient is MOST likely taking this medication to treat: A) angina B) atrial fibrillation C) hypertension D) thrombus formation
answer
atrial fibrillation (See pg. 914 for explanation)
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A physical therapist reviews the medical record of a patient 24 hrs s/p THA. A recent entry in the medical record indicates that the patient was placed on anticoagulant medication. Which of the following laboratory values would be MOST affected based on the patient's current medication? A) hematocrit B) hemoglobin C) prothrombin time D) white blood cell count
answer
Prothrombin time (See pg. 914 for explanation)
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A physical therapist identifies a number of substances that influences circulation. Which of the following substances is stimulated by decreased arterial pressure and acts as a vasoconstrictor? A) angiotension B) histamine C) epinephrine D) norepinephrine
answer
Angiotension (See pg. 915 for explanation)
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A physical therapist attempts to auscultated over the aortic valve. Which of the following areas is MOST appropriate to isolate the desired valve? A) 2nd L intercostal space at the L sternal border B) 2nd R intercostal space at the R sternal border C) 4th L intercostal space along the lower L sternal border D) 5th L intercostal space at the midclavicular line
answer
B) 2nd R intercostal space at the R sternal border (See pg. 916 for explanation) ------------------------------------------------------------------- A) for pulmonary valve C) for tricuspid valve D) for mitral valve
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A physical therapist attempts to estimate the energy expenditure in calories for a patient performing a selected activity for 15 minutes. Assuming the therapist has a metabolic equivalent value for the activity, what other variables are necessary in order to obtain an estimate of the patient's energy expenditure? A) patient's height B) patient's body weight C) patient's stroke volume D) patient's residual volume
answer
B) patient's body weight (See pg. 916 for explanation)
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A patient with know cardiac disease experiences angina while exercising on a recumbent bicycle. The patient self-administers a nitroglycerin tablet to control the angina. Nitroglycerin helps to control this symptoms by: A) decreasing heart rate B) inhibiting vasospasm of the coronary arteries C) dilating peripheral arteries and veins D) decreasing platelet aggregation
answer
C) dilating peripheral arteries and veins (See pg. 918 for explanation)
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A physical therapist reads in the medical record that a patient with suspected CV disease had a positive graded exercise test. Which piece of data would have been the MOST influential when concluding that the test was positive? A) anginal symptoms B) ventricular dyshythmias C) ST segment changes D) supraventricular dysrhythmias
answer
C) ST segment changes (See pg. 919 for explanation)
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A physical therapist employed in an acute care hospital conducts an initial interview with a patient referred to physical therapy. During the interview, the therapist asks the patient is he feels dependent on coffee, tea or soft drinks. Which clinical scenario would MOST appropriately warrant this type of question? A) a 27 y.o F s/p arthroscopic medial meniscectomy B) a 42 y.o M with premature ventricular contractions C) a 37 y.o F with restrictive pulmonary disease D) a 57 y.o M with respiratory alkalosis
answer
B) a 42 y.o M with premature ventricular contractions (See pg. 920 for explanation)
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A physical therapist prepares to perform manual vibration as a means of airway clearance with a patient diagnosed with chronic obstructive pulmonary disease. When performing vibration the MOST appropriate form of manual contact over the affected lung segment is: A) contact with a cupped hand B) contact with the entire palmar surface of the hand C) contact with the ulnar border of the hand D) contact with the distal phalanx of the middle finger
answer
B) contact with the entire palmar surface of the hand (See pg. 927 for explanation)
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A physical therapist reviews a laboratory report for a 41 y.o M diagnosed with COPD. Which of the following would be considered a normal hemoglobin value? A) 10 gm/dL B) 15 gm/dL C) 20 gm/dL D) 25 gm/dL
answer
B) 15 gm/dL (Normal approx 13.3 - 16.2 gm/dL) (See pg. 929 for explanation)
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The measurement of blood pressure with an aneroid sphygmomanometer is said to have concurrent validity if the pressure measured by the sphygmomanometer are equal to the pressures measured at the same time by: A) an electrocardiogram B) a pressure transducer inserted in the artery C) a physician using a mercury sphygmomanometer D) a pulse oximeter
answer
B) a pressure transducer inserted in the artery (See pg. 931 for explanation)
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A physical therapist working on an oncology unit reviews the medical chart of a male patient prior to initiating airway clearance techniques. The patient's cell counts are as follows: hematocrit 44%, WBC 8,500/mm3, platelets 30,000/microliter, hemoglobin level 15 gm/dL. Which blood test value suggests that chest percussion for airway clearance is contraindicated? A) hematocrit B) WBC C) platelets D) hemoglobin
answer
Platelets (See pg. 931 for explanation)
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A 67 y.o M with longstanding cardiac pathology is referred to physical therapy. The medical record indicates that patient is taking Nitrostat. The PRIMARY indication for this medication is: A) to strengthen the heart's pumping force B) to produce a general vasodilation of vascular structures C) to increase excretion of sodium and water D) to decrease electrical conduction
answer
B) to produce a general vasodilation of vascular structures (See pg. 943 for explanation)
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A physical therapist monitors the BP of a 28 y.o M during increasing levels of physical exertion. Assuming a normal physiologic response which of the following BEST describes the patient's BP response to dynamic exercise? A) systolic pressure decreases, diastolic pressure increases B) systolic pressure remains the same, diastolic pressure increases C) systolic pressure and diastolic pressure remain the same D) systolic pressure increases, diastolic pressure remains the same
answer
D) systolic pressure increases, diastolic pressure remains the same (See pg. 944 for explanation)
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A physical therapist treats a patient receiving supplemental oxygen using a nasal cannula with a flow rate of 3 L/min. Which value BEST approximates the percentage of O2 delivered to the patient? A) 25% B) 29% C) 33% D) 37%
answer
C) 33% (See pg. 951 for explanation) --------------------------------------------------------------------- increases 4% per L /min (4x3 = 12) mixed with room air containing 21% O2 (21+12 = 33)
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A physical therapist attempts to monitor exercise intensity during an exercise session with a patient after cardiac transplantation. The MOST appropriate method is: A) metabolic equivalents B) perceived exertion scale C) pulmonary function test D) target heart rate range
answer
B) perceived exertion scale (See pg. 952 for explanation)
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A patient recently admitted to an acute care hospital is referred to physical therapy. The physical therapist documents the following clinical signs: pallor, cyanosis, and cool skin. These clinical signs are MOST consistent with: A) cor pulmonale B) anemia C) hypertension D) diaphoresis
answer
B) anemia (See pg. 953 for explanation)
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A physical therapist elects to utilized a Six-Minute Walk Test as a means of quantifying endurance for a patient rehabilitating from a lengthy illness. Which variable would be the MOST appropriate to measure when determining the patient's endurance level with this objective test? A) perceived exertion B) heart rate response C) elapsed time D) distance walked
answer
D) distance walked (See pg. 955 for explanation
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Echocardiographic testing revealed a significant decrease in a patient's anticipated cardiac output. Which variable would MOST likely contribute to this finding? A) increase in HR B) increase in preload C) increase in afterload D) increase in stroke volume
answer
C) increase in afterload (See pg. 957 for explanation)
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A physical therapist attempts to identify a patient's risk factors for coronary artery disease as part of a health screening. The patient's HR is recorded as 78 bpm and BP as 110/90 mmHg. A recent laboratory report indicates a total cholesterol level of 170 mg/dL with high-density lipoproteins reported as 20 mg/dL and low density lipoproteins as 100 mg/dL. Which of the following values would be considered atypical? A) heart rate B) blood pressure C) HDL D) LDL
answer
C) HDL (high-density lipoproteins) (See pg. 959 for explanation)
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A physical therapist performs palpation with a patient positioned in standing as part of a respiratory assessment. Which structure would be the MOST appropriate to assess with the therapist positioned behind the patient? A) mediastinum B) upper chest wall motion C) middle chest wall motion D) lower chest wall motion
answer
D) lower chest wall motion (See pg. 960 for explanation)
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A physician orders compression garments for an ambulatory patient who has significant difficulty with lower extremity edema. How much pressure would typically be necessary to control lower extremity edema? A) 10 mmHg B) 18 mmHg C) 25 mmHg D) 35 mmHg
answer
35 mmHg (See pg. 964 for explanation)
question
A physical therapist monitors the vital signs of a 52 y.o M during a graded exercise test. The patient was prompted to seek medical assistance two weeks ago after becoming SOB on 2 separate occasions. When interpreting the data collected during the exercise test, which finding would serve as the BEST indicator that the patient had exerted a maximal effort? A) failure of the HR to increase with further increases in intensity B) rise in systolic BP of 50 mmHg when compared to resting value C) rating of 12 on a perceived exertion scale D) rating of 2/4 on dyspnea scale
answer
A) failure of the HR to increase with further increases in intensity (See pg. 964 for explanation)
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A patient rehabilitating from CHF is examined in physical therapy. During the examination the patient begins to complain of pain. The MOST immediate physical therapist action is to: A) notify the nursing staff to administer pain medication B) contact the referring physician C) discontinue the treatment session D) ask the patient to describe the location and severity of the pain
answer
D) ask the patient to describe the location and severity of the pain (See pg. 969 for explanation)
question
A physical therapist reviews the medical record of a patients diagnosed with COPD. The medical record indicates that the patient's current condition is consistent with chronic respiratory acidosis. Which testing procedure was likely used to identify this condition? A) arterial blood gas analysis B) pulmonary function testing C) graded exercise testing D) pulse oximetry
answer
A) arterial blood gas analysis (See pg. 969 for explanation)
question
A physical therapist examines the ECG of a patient during exercise. What change in the ECG would be MOST indicative of myocardial ischemia? A) P wave changes B) PR wave changes C) QRS wave changes D) ST segment changes
answer
D) ST segment changes (See pg. 971 for explanation)
question
A patient on supplemental oxygen participates in a series of active exercises. During the exercise session the patient's oxygen saturation falls to the lower limit of her established acceptable range of 92-95%. When asked by the physical therapist how she is feeling the patient reports that she feels fine. The MOST appropriate therapist action is: A) continue the exercise session B) increase the amount of oxygen C) discontinue the exercise session D) contact the patient's physician
answer
A) continue the exercise session (See pg. 973 for explanation)
question
A physical therapist working on a pulmonary rehabilitation unit works with a patient on therapeutic positioning. The patient has experienced a lengthy inpatient hospitalization and was only recently referred to physical therapy. The patient has significant weakness of the diaphragm and is hypertensive. The MOST appropriate patient position to initiate treatment is: A) prone B) supine C) Trendelenburg D) reverse Trendelenburg
answer
reverse Trendelenburg (head is elevated on an incline plane in relation to the feet) (See pg. 975 for explanation)
question
A physical therapist examines the output from a single lead ECG of a patient with first degree atrioventricular heart block. The defining characteristic of this condition is: A) inverted T wave B) prolonged PR interval C) bizarre QRS complex D) ST segement depression
answer
B) prolonged PR interval (See pg. 984 for explanation)
question
A physical therapist reviews the medical record of a patient diagnosed with peripheral arterial disease prior to initiating treatment. Which objective finding would MOST severely limit the patient's ability to participate in an ambulation exercise program? A) signs of resting claudication B) decreased peripheral pulses C) cool skin D) blood pressure of 165/90 mmHg
answer
A) signs of resting claudication (See pg. 986 for explanation)
question
A patient classifies the intensity of exercise as a 16 using the Borg's (20 point) Rating of Perceived Exertion Scale. This classification BEST corresponds to: A) 40% of max HR range B) 60% of max HR range C) 70% of max HR range D) 85% of max HR range
answer
85% if max HR range (See pg. 988 for explanation)
question
A physical therapist completes a respiratory assessment on a patient in an acute care hospital. Th examination reveals decreased breath sounds and decreased fremitus. This finding is MOST indicative of: A) pleural effusion B) pulmonary edema C) consolidation D) atelectasis
answer
Pleural effusion (See pg. 993 for explanation)
question
A physical therapist instructs a patient rehabilitating from thoracic surgery how to produce an effective cough. Which patient position would be the MOST appropriate to initiate treatment? A) standing B) sitting C) sidelying D) hooklying
answer
Sitting (See pg. 994 for explanation)
question
A physical therapist examines the heart sounds of a 48 y. F s/p coronary artery bypass graft. When auscultating, the therapist identifies the heart sound associated with closing of the mitral and tricuspid valves. This heart sound BEST describes: A) S1 B) S2 C) S3 D) S4
answer
S1 (See pg. 1000 for explanation)
question
A physical therapist treats a 32 y.o female diagnosed with thoracic outlet syndrome. While exercising the patient begins to complain of feeling lightheaded and dizzy. The therapist immediately ushers the patient to a nearby chair and being to monitor her vital signs. The therapist measures the patient's respiration rate as 10 bpm, pulse rate as 45 bpm, and blood pressure as 115/85 mmHg. Which of the following statements is MOST accurate? A) pulse rate and respiratory rate are below normal levels B) pulse rate and blood pressure are above normal levels C) blood pressure and respiration rate are above normal levels D) the patient's vials signs are within normal limits
answer
A) pulse rate and respiratory rate are below normal levels (See pg. 1004 for explanation)
question
A physical therapist examines the breath sounds of a 55 y.o M diagnosed with pulmonary disease. The therapist identifies rales during both inspiration and expiration. This finding is MOST representative of: A) pleural effusion B) pulmonary fibrosis C) impaired secretion clearance D) localized stenosis
answer
C) Impaired secretion clearance (See pg. 1006 for explanation)
question
A physical therapist designs an exercise program for a patient several weeks following cardiac transplantation. Which of the following would be the MOST essential to incorporate into the patient's exercise program based on the transplantation? A) increased warm-up and cool down period B) increased duration of training sessions C) increased target HR range during exercise D) increased monitoring of exercise intensity through HR
answer
A) increased warm-up and cool down period (See pg. 1015 for explanation)
question
A physical therapist elects to administer a submaximal graded exercise test to a patient prior to prescribing an aerobic training program. Which statement is a valid assumption of a submaximal exercise test? A) a steady state HR is obtained at progressively decreasing work rates B) an inverse relationship exists between HR and work rate C) max HR for a given chronological age is variable D) max oxygen consumption at a given work rate is the same for everyone
answer
D) max oxygen consumption at a given work rate is the same for everyone (See pg. 1016 for explanation)
question
A physical therapist hypothesizes that a patient's chronic LE swelling is due to lymphedema. Which of the following symptoms is MOST consistent with the later stages of this condition? A) swelling that is relieved by elevation B) swelling proximal to the site of lymph dysfunction C) fibrotic changes of the dermis D) pitting edema
answer
C) fibrotic changes of the dermis (See pg. 1019 for explanation)
question
A physical therapist works with a patient diagnosed with CHF who presents with dyspnea during ambulation. The patient has an ejection fraction of less than 55%. Which of the following interventions would be the MOST appropriate? A) instruction in purse-lip breathing B) progressive resistive exercises C) education of energy conservation D) instruction in diaphragmatic breathing
answer
C) education of energy conservation (See pg. 1020 for explanation)
question
A physical therapist attempts to determine if a patient with known heart disease is an appropriate candidate for an exercise program. Which scenario would MOST likely exclude the patient from participating? A) the patient has an ejection fracture of 45% B) the patient had an uncomplicated myocardial infarction 2 months ago C) the patient's ECG shows ST segment depression of 1mm D) the patient has ventricular arrhythmias at rest
answer
D) the patient has ventricular arrhythmias at rest (See pg. 1021 for explanation)
question
A physical therapist attempts to implement a formal exercise program for a patient 3 weeks following cardiac transplantation. Which physiologic response should the therapist anticipate based on the transplantation? A) increased resting HR B) increased HR response with exercise C) increased peak HR during exercise D) increased age-predicated max HR
answer
A) increased resting HR (See pg. 1022 for explanation)
question
A physical therapist identifies a bluish discoloraton of the skin and nailbeds of a 55 y.o M referred to physical therapy for pulmonary rehabilitation. What does this objective finding indicates? A) hyperoxemia B) hyperoxia C) hypokalemia D) hypoxemia
answer
Hypoxemia (See pg. 1026 for explanation)
question
A physical therapist uses the BMI scale as a means of assessing a patient's total body composition. The therapist determines the BMI by dividing the body weight in kilograms by height in meters squared. Which of the following values would be the MOST representative of a healthy male or female? A) 14 kg/m2 B) 22 kg/m2 C) 28 kg/m2 D) 37 kg/m2
answer
B) 22 kg/m2 (Normal BMI 18.5 - 24.9) (See pg. 1027 for explanation)
question
A physical therapist searches the literature to find an appropriate cardiovascular screening test to identify individuals with know cardiovascular disease who should have a medical examination before starting an exercise program. The physical therapist should choose a screening test with: A) high positive predictive value B) low positive predictive value C) high discriminant validity D) high internal consistency
answer
A) high positive predictive value (See pg. 1034 for explanation)
