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Cardiac Rehab Exam 3
Terms in this set (72)
Which of the following is a relative, rather than absolute, indication for stopping an exercise test?
Increasing chest pain
The rate pressure product at which angina occurs is very reproducible.
What is the term used for the likelihood of a person with cardiovascular disease to have an abnormal test?
Which of the following is used within pharmacological stress testing if a patient cannot exercise AND has contraindications to vasodilators?
Which of the following is typically higher with cycle ergometer tests than treadmill tests?
Systolic blood pressure
What is the difference between the modified Bruce treadmill protocol and the standard Bruce treadmill protocol?
The modified protocol includes workload changes each minute which are set to maintain the same rate of workload progression as the standard protocol.
Which of the following is an abnormal response during recovery from an exercise test?
Heart rate and blood pressure will increase during the first 2 minutes post-exercise followed by sharp drops as the cool-down continues
When determining the Duke Index, what is factored into the ischemic score to determine 5-year survival or average annual mortality?
MET level achieved on an exercise test
What is the recommended monitoring for blood pressure associated with a symptom-limited maximal exercise test?
Before the exercise test, record in supine position and posture of exercise
Allowing handrail support during an exercise test on a treadmill results in an overestimate of exercise capacity?
Of the exercise modes listed, which tends to elicit the highest max MET level?
Which of the following is a normal heart rate response during an exercise test?
Increase in 10 +/- 2 bpm with each MET increase in workload
Mechanically braked cycle ergometers automatically accommodate in pedaling rate to allow exercise at a predetermined power output.
Over 90% of ECG abnormalities occur by the time 85% of age-predicted maximal HR has been reached.
How is the treadmill workload set for the first stage of the modified Balke protocol?
Select the fastest walking speed (2.0, 2.5, 3.0, or 3.5 mph) that is comfortable for the patient with no grade on the treadmill
To prevent or reduce the average 1 to 2 kg per year weight gain in adults, what increase in energy expenditure has been suggested?
Low cardiorespiratory fitness is associated with decreased metabolic abnormalities of the metabolic syndrome
Which of the following best describes the relationship between adiposity and physical activity?
An inverse association exists between adiposity and physical activity.
Given a weight of 143 pounds (65 kg) and a height of 5 feet 5 inches (1.65 m), what is the BMI (in kg∙m−2)?
Considering the guidelines for management of overweight/obesity in adults, which of the following is the recommendation for adults with a BMI of 25 to <30 kg∙m−2?
Engage in behaviors to lose weight
Which of the following reflects the recommended total minutes per week of moderate-to-vigorous physical activity that has been found to enhance the ability to maintain weight loss?
Which of the following is a finding of the Diabetes Prevention Program clinical trial that involved following a group of individuals with impaired glucose tolerance (IGT) for a number of years, comparing the impact of diet and physical activity (lifestyle group) or medication (metformin group) to a control group (placebo)?
The lifestyle group showed the greatest weight loss.
Which of the following is not reduced as a result of exercise training in individuals with type 2 diabetes mellitus?
Type 1 diabetes is classified as a chronic disease associated with:
Absolute insulin deficiency
Leisure-time physical activity appears to have no impact on preventing or postponing the development of type 2 diabetes.
The underlying principle of very low-calorie diets is to deplete the liver and skeletal muscle of carbohydrate stores so that the body is required to metabolize fat stores for energy production.
A BMI of 37 kg∙m−2 is in which weight status category?
Class 2 Obesity
Which of the following is NOT a criterion for the diagnosis of diabetes?
Fasting plasma glucose of 100-125 mg/dL
Which of the following is NOT characteristic of the relationship between physical activity and weight loss?
Physical activity must be of a vigorous nature in order to stimulate fat loss.
Which of the following is decreased within the Mediterranean diet compared to the typical American diet?
Which of the following would be helpful to build a client's self-efficacy?
Explore previous experiences with physical activity
Which of the following is NOT a characteristic of decisional balance as it relates to exercise?
Focus on the positive benefits of exercise only in order to remain encouraging
Most experimental studies on the use of environmental changes to encourage stair use in public buildings have been ineffective in promoting stairway use.
An effective role model is one that is dissimilar to the targeted population in order to promote expanded growth.
Which of the following would be appropriate if a clinical exercise physiologist suspects a client is a risk for suicide?
Directly inquire if the client is thinking of self-harm
Antidepressant pharmacotherapy decreases symptoms immediately with the initial dosage providing an optimal therapeutic effect.
Which type of training involves expanding a behavior (i.e. exercise) to a different setting (i.e. home) to link the behavior with cues or stimuli in the non-exercise facility setting that may help to facilitate ongoing participation.
Intrinsic motivation may be learned when an individual finds personal, self-identified rewards for behavior independent of extrinsic or external reinforcements.
Which of the following reflects active listening?
Reflect back on the underlying meaning of what the client has said
Which of the following is characteristic of an appropriate approach to the initial steps in becoming more physically active?
External rewards may be needed as intrinsic reinforcement is low
Which of the following would NOT reflect self-determination theory as it relates to the interaction of a clinical exercise physiologist with a client?
Dictate an exercise prescription based on published guidelines for the client to follow
Which of the following is considered to be structural support?
Which of the following would NOT be an effective strategy to prepare for lapses in physical activity?
Aspire to achieve prior difficult goals to promote compliance
Which of the following stages of change is best reflected for an individual who has recently started to walk 10 minutes before and after work and has set up an appointment with a clinical exercise physiologist to develop a more comprehensive workout plan?
Overall, exercise is associated with reduced symptoms of depression and anxiety.
Which of the following factors is NOT thought to lead to the development of insulin resistance?
Enhanced lipid metabolism
Which of the following is characteristic of dyslipidemia with HIV inflection?
Reduced HDL cholesterol
Changes in cellular function due to environmental factors, genetics, and lifestyle factors include which of the following?
Increased oxidative stress
Which of the following is NOT associated with excessive adipose tissue?
Lung function enhancement
Which of the following may occur with mitochondrial dysfunction?
Reduced number of mitochondria
Which of the following would NOT be a result from a sedentary lifestyle?
Increased skeletal muscle blood flow
The Health Impact Index has been developed to measure the impact of the existence of multiple comorbidities on self-reported health.
The SBAR format is often used for transitions in care from one provider to another. What does the "S" stand for?
Chronic inflammation is characterized by a continual low-grade activation of the immune system evidenced by depressed levels of inflammatory markers.
Which of the following should be avoided when developing an exercise prescription for individuals with comorbidities?
Default to established standard aerobic and muscular fitness training programs
Patients with chronic kidney disease (CKD) may be at increased risk for hypoglycemia during exercise due to decreased clearance of insulin in the kidneys.
After obtaining the appropriate referral(s), what is the next step the clinical exercise physiologist should take when developing an exercise prescription for a patient with comorbidities?
Review all medical records
Peripheral adaptations to previous exercise training degrade at a faster rate than cardiac function.
How does hyperglycemia lead to macro- and microvascular damage?
Activation of inflammatory pathways
The development of which of the following is NOT associated with insulin resistance?
Type 1 diabetes
This is typically a benefit of using a treadmill for exercise testing when compared with the use of a cycle ergometer.
higher maximal heart rate (and MET level)
Low cardiorespiratory fitness is associated with decreased metabolic abnormalities of the metabolic syndrome.
Excessive abdominal adiposity is associated with greater health risk whether or not an individual is clinically obese.
When weight loss is a goal, the main factor is having a sufficient energy deficit regardless of diet composition.
The SBAR format is often used for transitions in care from one provider to another. SBAR stands for...
Situation, Background, Assessment, Recommendation
This is identified as the most appropriate for long-term method/approach for successful behavior change.
A complete cessation of behavior change and a return to the previous pattern of behavior.
characteristic of relapse
According to the transtheoretical model (TTM), these are the five stages-of-change for health behaviors (as applied to physical activity). Provide brief examples of behavioral responses for each stage of motivational readiness.
Precontemplation: not thinking about changing physical activity
Contemplation: thinking about changing physical activity
Preparation: making small changes in physical activity but not to a degree that meets the desired target
Action: meeting physical activity goals but for fewer than six months
Maintenance: being physically active at the desired level for at least six months
A patient with a primary cancer diagnosis who has received chemotherapy is at a decreased risk for developing cardiovascular disease.
Excessive generation of this substance leads to oxidative stress.
reactive oxygen species (ROS)
In the setting of cardiovascular disease, the myocardium has a reduced mitochondrial capacity for oxidative metabolism and may result in mitochondrial dysfunction due to this...
reduced number of mitochondria
Considering case study 10-1 (in your slides/notes), these factors should be considered with regard to the patient's current physical activity that may elicit a greater weight loss response.
While the patient is engaging in regular physical activity, this physical activity accumulates to approximately 120 minutes per week.
The weight loss that is being observed is consistent with what would be expected with this level of physical activity accumulated across a period of 12 weeks, and this should be conveyed to the patient.
The patient should be congratulated for his loss of 4 lb in 3 months, encouraged to maintain his engagement in physical activity and, if possible, encouraged to increase it as tolerated.
Moreover, the patient should be queried on the intensity of his walking sessions and be encouraged to walk at a brisk pace to ensure that his sessions meet the threshold of moderate-to-vigorous intensity.
The patient should also be counseled that, for his weight loss to continue, and for the weight loss that he achieves to be maintained, he will need to maintain his regular engagement in moderate-to-vigorous physical activity.
What is the intensity of strength?
a decline in performance as a result of stopping training, or a substantial reduction in training volume or intensity.
The key to a healthy vegetarian diet is to eat a variety of foods, including nuts, fruits and vegetables, plenty of leafy greens, whole grain products, seeds and legumes, limiting your intake of sweets and fatty foods.
What is the normal ROM for thumb CMC flexion?
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