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Cardiac Rehab Final Exam
Terms in this set (110)
During this phase of cardiac rehabilitation, education for the management of cardiovascular disease risk factors is provided, goal identification/setting is discussed, and regular exercise sessions are scheduled?
When risk factors are well managed, cardiovascular disease risk is the same compared to individuals without risk factors.
ACSM's Guidelines for Exercise Testing and Prescription contains guidelines, rather than standards of practice, which means:
Clinical Exercise Physiologists may deviate from the guidelines when deemed necessary and appropriate using independent and prudent judgement.
What is the impact of activity level on the transient risk of exercise?
Is higher in inactive people compared to regularly active individuals.
The overarching purpose of exercise pre-participation health screening is to identify individuals at risk for serious exercise-related cardiovascular events.
What is considered to be the true potential of the human body with regard to projected lifespan?
Which of the following would meet the definition as a cardiovascular risk factor related to family history?
Brother with sudden death at age 52
The incidence of serious cardiovascular events during or shortly after exercise is:
When the presence OR absence of a cardiovascular disease risk factor is not available or unknown, the risk factor counts as a positive risk factor.
Sarcopenia refers to the loss of skeletal muscle that occurs with age.
Which of the following is NOT part of the defining criteria for dyslipidemia when examining positive risk factors for cardiovascular disease?
High-density lipoprotein (HDL-C) ≧ 60 mg/dL
Aerobic training in adolescents provides for all of the following benefits EXCEPT:
Higher insulin resistance
According to the ACSM screening algorithm, what is recommended for a 50-year-old woman with type 1 diabetes who has engaged in regular moderate-intensity exercise for years, but desires to engage in vigorous-intensity exercise now?
Medical clearance is recommended before engaging in vigorous-intensity exercise.
The prevalence of overweight and obesity in adolescents has risen over the past 30 years?
In the ACSM screening algorithm, how is "current participation in regular exercise" defined?
Individual engages in planned, structured moderate-intensity physical activity for at least 30 minutes on at least three days per week for at least the past three months.
Which of the following blood vessels does NOT contain oxygenated blood?
Which of the following affects overall stroke volume?
Afterload, Contractility, Preload
Which of the following is NOT a biomarker to help identify an evolving myocardial infarction?
CABG or PCI eliminates the risk of future myocardial infarction in patients with stable coronary artery disease.
Which of the following are the specialized portions of cell membranes that allow action potentials to pass from one cell to the next, enabling the heart to contract as one unit?
Which of the following are included when referring to acute coronary syndrome (ACS)?
STEMI, NSTEMI, and Unstable Angina
Resistance training for CABG patients:
should initially include range of motion and very light hand weights
How is rate-pressure product (aka double product) calculated?
Heart Rate x Systolic Blood Pressure
Which term is used to describe the load on the heart, measured as the pressure in the left ventricle immediately prior to left ventricular contraction?
Which valves open during ventricular systole?
Aortic and Pulmonary valves
A reduction or interruption in coronary blood flow to the myocardium that is identified on the ECG as either/both ST segment depression and/or T wave inversion:
The symptoms experienced when the heart muscle does not receive enough oxygenated blood due to partial or complete blockage of a coronary artery is collectively known as:
ST segment elevation in two or more anatomically contiguous leads identifies:
What are names of the three major branching coronary arteries?
Left anterior descending, left circumflex, right coronary artery
Which demographic is most likely to experience atypical symptoms of myocardial ischemia (i.e. atypical anginal symptoms)?
What is the most common cause of heart failure that causes irreversible damage to the heart?
A patient enters your cardiac rehabilitation program with a health history including severely diminished ejection fraction (~30%), systolic dysfunction, and decrease physical endurance is most likely suffering from this form of heart disease:
Blood pressure can be assessed for a patient with a left ventricular assist device (LVAD) using a sphygmomanometer and stethoscope (standard blood pressure measures).
Which of the following ankle-brachial indices identify severe disease in patients with peripheral artery disease (PAD)?
Which of the following is the greatest factor that limits participation in outpatient cardiac rehabilitation programs?
Which of the following is NOT known to be a risk factor for hypertension (HTN)?
Ankle-Brachial index is used to help confirm diagnosis of symptomatic peripheral arterial disease and is determined by which of the following?
Highest systolic blood pressure at the ankles divided by the highest systolic blood pressure in the arms
Dilated cardiomyopathy refers to:
This heart failure classification/stage is associated with significant physical activity limitation, stable at rest, and physical symptoms are caused by light intensity activity.
NYHA Class III
Which of the following is TRUE for the heart transplant patient?
Patient experiences a higher resting heart rate.
Your patient in cardiac rehabilitation has demonstrated the following resting blood pressure trend over the past three sessions:
132/84, 136/80, 138/88
According to the 2017 guidelines for blood pressure classification and management, which classification does your patient's blood pressure readings fall under?
Stage 1 Hypertension
The Valsalva maneuver should be avoided in hypertensive individuals as it can cause dangerous spikes in blood pressure.
Exercise should be stopped for all of the following blood pressure responses EXCEPT which of the following?
No change or slight reduction in diastolic blood pressure with exercise
The primary compensatory mechanisms associated with heart failure:
Sympathetic stimulation and fluid retention
An abnormal thickening of the ventricular wall due to chronic pressure overload that is often caused by hypertension is known as:
Left Ventricular Hypertrophy
Which of the following is more characteristic of pericarditis (vs a STEMI)?
ST segment elevation in all leads except aVR
The conduction defect where PR intervals are consistently greater than or equal to 0.20 sec (5 small boxes or one large box):
Sinus Rhythm with 1st Degree AV Block
The P wave represents:
The T wave represents:
When a STEMI occurs, which of the following characteristic is identified during the acute (initial/early) phase?
ST segment elevation
Which of the following heart block dysrhythmias is identified by regular P-P and R-R intervals that are firing at two distinctly different rates?
Third-degree AV block
What term describes the ability of the heart to initiate an electrical impulse without being stimulated by another or independent source ("self-excitability")?
Identify the rhythm using the following criteria:
Regular rhythm, ventricular and atrial rates are 80 beats/minute, P wave precedes each QRS, PR interval and QRS duration within normal limits.
Normal Sinus Rhythm
For lead II, where is the positive pole?
Electrical current heading toward the positive pole of a lead will result in which of the following on the ECG?
Positive (above the baseline) deflection
Which of the following is NOT associated with interpreting left ventricular hypertrophy (LVH)?
Abnormally large R wave in V1 only
What is the rhythm?
What is the rhythm?
Complete Heart Block
What is the rhythm in this figure?
What is the rhythm in this figure?
Diuretics increase which of the following?
Urine flow rate
This classification of cardiovascular medications are prescribed to lower heart rate (and thereby reducing blood pressure) to assist in preventing angina, another heart attack, and sudden death.
This classification of cardiovascular medications are prescribed to prevent/treat angina and reduce the workload on the heart by opening arteries and increasing arterial blood flow:
This classification of cardiovascular medications are prescribed to either prevent blood clots by inhibiting Vitamin K or by inhibiting platelet aggregation (sticky platelets):
For which medication does the consumption of grapefruit or grapefruit juice (within an hour of taking the mediation) typically increase plasma concentration of the medication?
Calcium Channel Blockers
This classification of cardiovascular medications can cause the body to lose or retain potassium and are prescribed to lower blood pressure by assisting in the removal of excess fluid volume (urine) and thereby are used to treat patients with diagnosed heart failure:
All of the following classifications of medication contribute to controlling blood pressure EXCEPT:
Which of the following is increased by nitrate and nitrite medications?
Blood supply to the tissues
Which medication can produce non-specific ST-T wave changes on the resting ECG?
Which of the following is NOT an effect of beta-blockers?
Increase heart contractility
Which of the following cardiovascular medications may mask signs of hypoglycemia?
What is the effect of angiotensin-coverting enzyme inhibitors (ACE-I)?
Decrease blood pressure
What is the mechanism of action of ARBs?
Block angiotensin II type I receptor in cardiac, renal, and vascular smooth muscle cells
The antianginal agent ranolazine (Ranexa) increases which of the following?
QTc interval on the ECG
This classification of cardiovascular medications are prescribed to prevent further accumulation of cholesterol in the arteries and reduce cholesterol in the body.
Allowing handrail support during an exercise test on a treadmill results in an overestimate of exercise capacity.
The difference between the modified Bruce treadmill protocol and the standard Bruce treadmill protocol.
modified protocol includes workload changes each minute which are set to maintain the same rate of workload progression as the standard protocol
The term used for the likelihood of a person with cardiovascular disease to have an abnormal test.
The exercise test mode that tends to elicit the highest max MET level.
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.
Absolute insulin deficiency is associated with type of diabetes.
Type 1 diabetes
The recommended total minutes per week of moderate-to-vigouous physical activity to enhance and maintain weight loss.
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 rate pressure product (HR x Systolic Blood Pressure) at which angina occurs is very reproducible.
This cardiovascular response is typically higher with cycle ergometer tests than treadmill tests.
systolic blood pressure
A fasting plasma glucose of 100-125 mg/dL is NOT a criterion for the diagnosis of diabetes.
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.
Overall, exercise is associated with reduced symptoms of depression and anxiety.
External rewards may be needed as intrinsic reinforcement is low during the initial steps in becoming more...
A complete cessation of behavior change and a return to the previous pattern of behavior.
characteristic of relapse
Dictating an exercise prescription based on published guidelines for a client to follow does not reflect this theory of behavioral health.
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.
Hyperglycemia leads to macro- and microvascular damage by way of this response.
activation of inflammatory pathways
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.
A patient with a left ventricular assist device (LVAD) that is waiting for a heart transplant is receiving this type of therapy with the LVAD.
Bridge to Bridge therapy
Benefits of pediatric cardiac rehabilitation programs include:
better self-image, change in perceptions and feelings about limits imposed by chronic heart disease, and decreased anxiety
This is what OARS stands for in Motivational Interviewing:
Open-ended questions, Affirmation, Reflection, Summarize
A mechanical device that pumps blood from the left ventricle into the aorta.
left ventricular assist device (LVAD)
Reasons an individual would need a balloon angioplasty (PCI)?
-The individual is at high risk for a heart attack
-The individual has atherosclerosis due to a high cholesterol diet
-The individual has ongoing unstable angina?
What symptoms of heart disease often experienced by women?
Discomfort or fullness of chest and breathlessness
Back or jaw pain
Dizziness, nausea, and fatigue
What are three common types of a stroke?
Ischemic, Hemorrhagic, and Transient Ischemic
What is a spontaneous coronary artery dissection (SCAD)?
A rare condition that is represented by a rupturing of the endothelial lining of a coronary artery.
What is arrhythmogenic right ventricular dysplasia (ARVD)?
This is a rare cardiomyopathy in which the right ventricle is replaced by fibrous tissue.
Takotsubo Syndrome is often caused by this:
What is antithrombin III? What does it do?
What are anticholinergics and what do they do?
What are examples of negative inotropic medications?
What are some positive inotropic agents that increase contractility?
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