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Cardiopulmonary 3 2010

Minimum Passing Grade: 75%

There are 50 questions in this exam. You have 1 hour to finish the exam. There are
23 cardiovascular questions in the NPTE. 5 questions for Clinical Application, 4
for Examination, 7 for Differential

Time Allowed for Exam: 1 hrs 0 mins

1. 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 work loads. In order to predict the
patient’s maximum oxygen uptake, it is necessary to determine the relationship between:

a) Heart rate and perceived exertion.


b) Heart rate and oxygen uptake
c) Perceived exertion and blood pressure.
d) Blood pressure and oxygen up take.

2. Which side effect of Digoxin warrants medical attention?

a) memory loss
b) bradycardia
c) confusion
d) weakness and palpitations

3. After pneumonectomy, which changes will not occur?

a) tracheal deviation
b) decreased breath sounds
c) decreased residual volume
d) increased tidal volume

4. 4 weeks post myocardial infarction, when are resistive exercise appropriate?

a) Resistive Exercises are not appropriate at this time


b) if they can tolerate 5 METS as long as there are no anginal symptoms
c) Resistive exercises can be performed without restriction
d) if they can tolerate 10 METS as long as there are no anginal symptoms

5. All of these are signs and symptoms of respiratory alkalosis except:

a) disorientation
b) tingling or numbness of the extremities
c) dizziness or lightheadedness
d) hyperreflexia
6. You are treating an elderly patient with a cardiac history. He presents with initial
symptoms of mental confusion, shortness of breath and generalized weakness. What do
you suspect?

a) pneumonia
b) transient ischemic attack
c) COPD
d) myocardial infarction

7. The combined signs and symptoms of absent breath sounds, sudden onset of chest
pain and shortness of breath may indicate:

a) bronchitis
b) pneumothorax
c) cystic fibrosis
d) pneumonia

8. Your patient's ECG shows ST segment depression is present during comfortable,


stable rest. He has history of a myocardial infarction. You should inform the physician to
rule out:

a) nothing is wrong with this patient


b) ventricular tachycardia
c) cardiac arrest
d) silent ischemia

9. A patient with a C5 spinal cord injury will not have the abdominal musculature
necessary to return the diaphragm to a high domed position during exhalation. Which
position will best help the patient?

a) prone
b) supine
c) sitting
d) sidelying

10. A patient in the intensive care unit rehabilitating from a serious infection is connected
to a series of lines and tubes. Which lower extremity intravenous site would be most
appropriate to administer an intravenous line ?

a) Antecubital vein
b) Basilic vein
c) Cephalic vein
d) Saphenous vein

11. A physical therapist examines a patient diagnosed with left-sided heart failure. Which
finding is NOT typically associated with this condition?

a) pulmonary edema
b) persistent cough
c) dependent edema
d) muscular weakness
12. This is used to improve ventilation to hypoventilated lung segments, alter regional
distribution of gas, maintain or restore functional regional capacity, maintain or improve
mobility of chest wall and prevent pulmonary compromise.

a) Segmental Breathing
b) Sustained Maximal Inspiration
c) Active Cycle Breathing
d) Diaphragmatic breathing

13. The recommended time duration for endotracheal suctioning is:

a) 5 seconds
b) 10 seconds
c) 20 seconds
d) 30 seconds

14. Your patient reports a dull ache, tightness, or pain in the calf. What should you
suspect?

a) deep venous thrombosis


b) arterial insufficiency
c) venous insufficiency
d) muscle strain

15. A physical therapist monitors the blood pressure of a 28 - year- old male during
increasing levels of physical exertion. Assuming a normal physiologic response to
exercise, what effect would this have ?

a) Systolic pressure decreases, diastolic pressure increases.


b) Systolic pressure remains the same.
c) Systolic pressure and diastolic pressure remain the same.
d) Systolic pressure increases, diastolic pressure remains the same.

16. Patients with congestive heart failure tend to have excessive fluid retention in the
pulmonary and systemic circulation. As a result, a diet high in what is prescribed?

a) fiber
b) sodium
c) calcium
d) potassium

17. Which technique that can allow patients to complete functional activities without
shortness of breath or dyspnea?

a) Activity pacing
b) Pursed lip breathing
c) Meditation
d) Yoga
18. A physical therapist reviews the medical record of a 60-year-old male status post
myocardial infarction. Which potential complication of a myocardial infarction is the
patient MOST susceptible to?

a) heart failure
b) arrhythmias
c) thrombus formation
d) heart structural damage

19. This is an obstructive pulmonary disease, often a sequela of premature infants with
respiratory distress syndrome.

a) Bronchopulmonary Dysplasia
b) Asthma
c) Bronchiectasis
d) SARS

20. A physical therapist attempts to obtain information on a patient's endurance level by


administering a low-level exercise test on a treadmill. Which of the following
measurement methods would provide the therapist with an objective measurement of
endurance?

a) facial color
b) facial expression
c) rating on a perceived exertion scale
d) respiration rate

21. A physical therapist identifies a number of substances that influence circulation.


Which of the following substances is stimulated by decreased arterial pressure and acts
as a vasoconstrictor?

a) angiotensin
b) histamine
c) epinephrine
d) norepinephrine

22. A physician orders the nursing staff to administer digitalis to a patient diagnosed with
congestive heart failure. The physician's PRIMARY goal using this medication is to:

a) increase cardiac pumping ability


b) increase cellular metabolism
c) regulate fluid and electrolyte levels
d) regulate glucose metabolism
23. A physical therapist reviews the results of pulmonary function testing on a 44-year-
old female diagnosed with emphysema. Assuming the patient's testing was classified as
unremarkable, which of the following lung volumes would MOST likely approximate 10%
of the patient's total lung capacity?

a) tidal volume
b) inspiratory reserve volume
c) residual volume
d) functional residual capacity

24. A physical therapist monitors a patient's respiration rate during exercise. Which of
the following would be considered a normal response?

a) the respiration rate declines during exercise as the intensity of exercise increases
b) the respiration rate does not increase during exercise
c) the rhythm of the respiration pattern becomes irregular during exercise
d) the respiration rate decreases as the intensity of the exercise plateaus

25. This is used with patients who are unable to cough on command, such as infants,
patients following brain injury or stroke.

a) Cough
b) Endotracheal suctioning
c) Assisted cough
d) Tracheal stimulation

26. A physical therapist reviews the results of a pulmonary function test. Assuming
normal values, which of the following measurements would you expect to be the
GREATEST?

a) vital capacity
b) tidal volume
c) residual volume
d) inspiratory reserve volume

27. The physical therapist prepares an educational program for an individual with chronic
venous insufficiency. Which of the following would not be appropriate to include in the
patient education program?

a) Wear shoes that accommodate to size and shape of your feet


b) Observe you skin daily for breakdown.
c) Wear your compression stockings only at night.
d) Keep your feet elevated as much as possible through out the day.
28. A physical therapist designs a training program for a patient without cardiovascular
pathology. The therapist calculates the patient's age-predicted maximal heart rate as
180 beats per minute. Which of the following would be an acceptable target heart rate
for the patient during cardiovascular exercise?

a) 93 beats per minute


b) 122 beats per minute
c) 169 beats per minute
d) 195 beats per minute

29. A physical therapist instructs the patient to expire maximally after taking a maximal
inspiration. The therapist can use these instructions to measure:

a) Expiratory reserve volume


b) Inspiratory reserve volume
c) Total lung capacity
d) Vital capacity

30. A physical therapist positions a patient in sitting prior to administering bronchial


drainage. Which lung segment would require the patient to be in this position.

a) Anterior basal segments of the lower lobes


b) Posterior apical segments of the upper lobes
c) Posterior segments of the lower lobes
d) Right middle lobe.

31. A physical therapist performs palpation with a patient positioned in standing as part
of a respiratory assessment. Which structure would be Most appropriate to assess with
the therapist positioned behind the patient?

a) Mediastinum
b) Upper lobes
c) Right middle lobe
d) Lower lobes

32. What is the potential space between the two pleura that maintains the approximation
of the ribcage and lungs?

a) Upper airways
b) Intrapleural space
c) Visceral Pleura
d) Parietal Pleura

33. This is part of the heart chamber that receives blood from the RA and pumps blood
via the pulmonary artery to the lungs for oxygenation.

a) Left Atrium
b) Right Ventricle
c) Right Atrium
d) Left Ventricle
34. A physical therapist listens to the lung sounds of a 56-year-old male with chronic
bronchitis. While performing auscultation the therapist identifies distinct lung sounds with
a high constant pitch during exhalation. This type of sound is MOST consistent with:

a) crackles
b) rales
c) rhonchi
d) wheezes

35. The physical therapist claps between the clavicle and nipple bilaterally on a patient.
The patient is in supine with a pillow under the knees. The This technique is utilized for
postural drainage of the:

a) anterior segments of the upper lobes


b) anterior basal segments of the lower lobes
c) superior segments of the lower lobes
d) posterior basal segments of the lower lobes

36. A patient with cardiopulmonary pathology 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) atelectasis
d) diaphoresis

37. A physical therapist examines the breath sounds of a 62-year-old male diagnosed
with lung problems. 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

38. A physical therapist elects to utilize the 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
39. The medical record of your patient indicates that he is currently taking digitalis. What
effect would you expect digitalis to have on the patient's ECG?

a) lengthened ventricular activation time


b) increased refractory period of AV node
c) lengthened QT interval
d) elevated ST segment

40. This is part of the heart chamber that receives blood from systemic circulation, from
the superior and inferior vena cavae.

a) Left Atrium
b) Right Ventricle
c) Right Atrium
d) Left Ventricle

41. 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

42. A physical therapist observes an electrocardiogram of a patient on beta-blockers.


Which of the following ECG changes could be facilitated by beta-blockers?

a) bradycardia
b) tachycardia
c) increased AV conduction time
d) ST segment sagging

43. These are valves which prevent backflow of blood from aorta and pulmonary arteries
into the ventricles during diastole.

a) Heart Tissue
b) Heart Chambers
c) Semilunar Valves
d) Atrioventricular valves

44. Your patient has difficulty clearing out secretions through coughing alone. Which
other technique would you implement to help him clear the more peripheral secretions?

a) Cough
b) Endotracheal suctioning
c) Active Cycle Breathing
d) Tracheal stimulation
45. This is an independent program using an external device that vibrates the airways on
exhalation to improve airway clearance.

a) Autogenic Drainage
b) The Flutter device
c) Active Cycle Breathing
d) Tracheal stimulation

46. This is a genetically inherited disease characterized by thickening of secretions of all


exocrine glands, leading to obstruction.

a) Cystic Fibrosis
b) Asthma
c) Bronchiectasis
d) SARS

47. Which of the following should NOT be done when controlling external bleeding?

a) Wear gloves
b) Apply gauze pads using firm pressure
c) Elevate the bleeding part if possible
d) Perform CPR

48. You are in a restaurant, when suddenly you overheard that someone is choking. You
arrive at the scene and note that the patient is unconscious. What should NOT be done
when the patient is unconscious?

e) Check airway
f) Use Heimlich maneuver
g) Give two breaths
h) Perform CPR

49. You are treating a 50 year old patient with a total knee replacement. She suddenly
complains of chest pain and shortness of breath. She is at risk for:

a) Pleural Effusion
b) Myocardial Infarction
c) Pulmonary embolism
d) Pneumonia

50. You are treating a patient with no active abdominal muscle strength. He is also not
able to follow directions. You want to clear his lungs from secretions. Which technique
would you choose?

a) Cough
b) Endotracheal suctioning
c) Assisted cough
d) Tracheal stimulation

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