Clinical Exercise Physiology
Exam Solutions
Course Introduction
Clinical Exercise Physiology explores the principles and applications of exercise in the prevention, evaluation, and treatment of chronic diseases and disabilities. The course examines the physiological responses and adaptations to physical activity in clinical populations, integrating current research and guidelines for exercise testing and prescription. Students will learn to assess risk factors, design individualized exercise interventions, and develop practical skills for working with patients experiencing cardiovascular, pulmonary, metabolic, and neuromuscular conditions, preparing them for roles in healthcare, rehabilitation, and fitness settings.
Recommended Textbook
Essentials of Cardiopulmonary Physical Therapy 4th Edition by Ellen Hillegass
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22 Chapters
681 Verified Questions
681 Flashcards
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Page 2
Chapter 1: Anatomy of the Cardiovascular and Pulmonary Systems
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) During the administration of suctioning procedures,which of the following may cause an adverse response in the patient?
A)An elicited parasympathetic response
B)The catheter is inserted to the carina level
C)A cough is stimulated
D)The use of a nasal trumpet during suctioning
Answer: A
Q2) Which of the following factors affecting the diaphragm MOST likely will cause an automatic firing of the accessory muscles to trigger inspiration?
A)Stomach fullness
B)Flat and rigid diaphragm
C)Obesity with the presence of pannus
D)Ascites due to liver disease
Answer: B
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Chapter 2: Physiology of the Cardiovascular and Pulmonary Systems
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Sample Questions
Q1) The positive ionotropic effect on myocardial contractility produced by the release of norepinephrine from sympathetic nerve endings is an example of:
A)intrinsic control factor.
B)extrinsic control factor.
C)Frank-Starling mechanism.
D)parasympathetic stimulus.
Answer: B
Q2) Which of the following events occur as a result of the diaphragm and external intercostals contracting to facilitate inspiration?
A)An increase in the volume of the thoracic cavity and lung reducing the intrapulmonary pressure
B)An increase in the pressure within the lung occurring due to Boyle's law
C)A decrease in the volume of the thoracic cavity and lung increasing the intrapulmonary pressure
D)A change in the thoracic cavity and lung volume leading to an intrapulmonary pressure that exceeds the atmospheric pressure
Answer: A
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4
Chapter 3: Ischemic Cardiovascular Conditions and Other Vascular Pathologies
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Sample Questions
Q1) Which of the following layers of the coronary arteries is responsible for making adjustments to the luminal diameter?
A)Adventitia
B)Media
C)Intima
D)All of the above
Answer: B
Q2) Which of the following pathological myocardium changes results in an exaggerated and early peak value of substances such as CK-MB and cardiac-specific troponin T and I?
A)Development of coagulative necrosis with contraction bands in myocardial tissue
B)Occurrence of hemorrhage within zones of irreversibly injured myocytes
C)Mitochondria in necrotic areas developing calcium phosphate deposits
D)Reperfusion of myocardium promotes removal of intracellular proteins
Answer: D
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Chapter 4: Cardiac Muscle Dysfunction and Failure
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33 Verified Questions
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Sample Questions
Q1) A noncompliant left ventricle that occurs as blood passively fills a poorly relaxing ventricle during early diastole and is considered the hallmark of congestive heart failure describes which of the following heart sounds?
A)S1
B)S2
C)S3
D)S4
Q2) The resistance stroke volume encounters after it is ejected from the left ventricle is BEST defined as which of the following?
A)Preload
B)Ventricular end-diastolic volume
C)Pulmonary artery pressure
D)Afterload
Q3) Which of the following statements describes the reason energy expenditure is increased in persons with systemic hypertension?
A)Myocardial contractile fibers become overstretched
B)Increase in afterload
C)Increase in myocardial cell mass
D)Mismatch of cell mass to vasculature
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Chapter 5: Restrictive Lung Dysfunction
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40 Verified Questions
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Sample Questions
Q1) Which of the following pathological changes in lung function is a result of excess soft tissue in the abdominal wall,forcing the diaphragm upward at rest?
A)Decreases the compliance of the thorax.
B)Forces early closure of the small airways and alveoli.
C)Decreases carbon dioxide production from the lungs.
D)Increases ventilator drive.
Q2) The key to medical treatment of pneumonia is which of the following?
A)Determining if it is community acquired or nosocomial
B)Identifying the microbe (virus versus bacteria)
C)Identifying specific risk factors
D)Determining the area of lung affected
Q3) A patient with restrictive lung disease develops a rise in pulmonary circulation pressure subsequently increasing the work of the right ventricle.This is BEST described as: A)tachypnea.
B)hypoxemia.
C)pulmonary hypertension.
D)low lung volume.
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Chapter 6: Chronic Obstructive Pulmonary Diseases
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Sample Questions
Q1) In older children with CF,an enzyme deficiency results in fat and protein maldigestion,producing a distended abdomen and bulky,greasy,foul-smelling stools.This deficiency is associated with which of the following organs?
A)Pancreas
B)Gallbladder
C)Liver
D)Intestine
Q2) Which of the following pathological changes results in lung recoil reduction in a patient with chronic inflammation secondary to inhalation of cigarette smoke?
A)Narrowing of small airways
B)Increased numbers of inflammatory cells
C)Reduction in airway remodeling
D)Loss of alveolar attachments (tethers)
Q3) Which of the following physical examination test results is considered a hallmark of asthma?
A)Reduction in forced expiratory volume in the first second (FEV ).
B)FEV /FVC ratio is low.
C)Maximum mid-expiratory flows (25% to 75% of FVC)is reduced.
D)Improvement in FEV >12% after bronchodilator administration.
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Page 8
Chapter 7: Cardiopulmonary Implications of Specific Diseases
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35 Verified Questions
35 Flashcards
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Sample Questions
Q1) A gastric hormone that signals hunger and is involved in long-term regulation of body weight BEST describes which of the following hormones?
A)Neuropeptide Y
B)Orexin
C)Ghrelin
D)Insulin
Q2) Which of the following components secreted by adipose tissue is considered a cytokine that may promote atherosclerosis and increase insulin resistance?
A)Adiponectin
B)Angiotensinogen
C)Interleukin 6
D)Resistin
Q3) Microangiopathies refer to the thickening or damage to which of the following components of the vascular system?
A)Artery
B)Vein
C)Arterioles
D)Capillary beds
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Chapter 8: Cardiovascular Diagnostic Tests and Procedures
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Sample Questions
Q1) Which of the following biomarkers is MOST conclusive for myocardial injury?
A)CK-MB
B)CK-MM
C)CK-BB
D)All of the above
Q2) Specificity of a diagnostic test is one method of determining the accuracy of a test.Which of the following statements BEST defines specificity?
A)The proportion of those individuals without the disease with a true negative test
B)The proportion of those individuals with the disease who have a true positive test
C)The proportion of individuals who had a positive test and actually have the disease
D)The proportion of individuals who had a negative test and truly do not have the disease
Q3) Elevated CK-MB levels in a patient after a hip surgery confirms the patient experienced some level of myocardial injury.
A)True
B)False
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Chapter 9: Electrocardiography
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Sample Questions
Q1) A single-lead tracing or rhythm strip can be used to determine all of the following EXCEPT:
A)heart rate.
B)heart rhythm.
C)presence of arrhythmia.
D)presence of ischemia.
Q2) The rhythm strip reveals the following findings:all P waves are upright,normal in appearance,and exist before every QRS complex,the P-R interval is between 0.12 and 0.20 second,the QRS complexes are identical and are between 0.04 and 0.10 second,the R-R interval is regular,and the HR is >100 bpm.These findings BEST describe which of the following?
A)Sinus bradycardia
B)Sinus tachycardia
C)Normal sinus rhythm
D)Atrial arrhythmia
Q3) Which of the following types of myocytes have the highest rate of rhythmicity?
A)Mechanical myocytes
B)Nodal myocytes
C)Transitional myocytes
D)Purkinje cells
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Chapter 10: Pulmonary Diagnostic Tests and Procedures
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Sample Questions
Q1) Which of the following pulmonary function tests of gas flow rates reflects the airflow in the large airways?
A)Peak expiratory flow (PEF)
B)Maximum voluntary ventilation (MVV)
C)Forced expiratory volume in 1 second (FEV )
D)Forced vital capacity (FVC)
Q2) Which of the following abnormal findings would be MOST likely in a chest radiograph of a patient with moderate to severe chronic obstructive pulmonary disease?
A)Tracheal deviation toward the contralateral side
B)Opacification of the costophrenic angles
C)Flattened hemidiaphragms
D)Increased vascular markings
Q3) A patient has the following arterial blood gas values:pH = 7.32,PaCO = 68,PaO = 60,and HCO - = 28.Which of the following statements is the MOST accurate interpretation?
A)Uncompensated respiratory acidosis
B)Partially compensated respiratory acidosis
C)Uncompensated metabolic acidosis
D)Partially compensated metabolic acidosis
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Page 12
Chapter 11: Cardiovascular and Thoracic Interventions
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Sample Questions
Q1) Which of the following surgical approaches is MOST commonly used for cardiac procedures?
A)Posterolateral thoracotomy
B)Median sternotomy
C)Thoracoabdominal
D)Subxiphoid
Q2) An example of an atrioventricular nodal arrhythmia of which a pacemaker is indicated is which of the following?
A)Bradyarrhythmia
B)Complete heart block
C)Supraventricular tachycardia
D)Frequent ventricular ectopy
Q3) Common risk factors for thoracic aortic aneurysms include which of the following factors?
A)Hypertension
B)Hypercholesteremia
C)Prior tobacco use
D)All of the above
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13
Chapter 12: Thoracic Organ Transplantation: Heart, Heart
Lung, and Lung
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Sample Questions
Q1) Which of the following exercise routines would be MOST appropriate for a transplant patient who required higher doses of steroid medications to achieve adequate immunosuppression?
A)Lower extremity bed exercises with low weight for 15 to 20 repetitions as tolerated
B)Standing active ROM and semisquats for 8 to 10 repetitions as tolerated
C)Ambulation in hall at low intensity two to three times per day at a pace preferred by the patient
D)Lower extremity resistance exercise with emphasis on proximal muscle groups at moderate intensity for 15 repetitions
Q2) Which of the following cardiac transplantation techniques is referred to as the "piggyback" technique?
A)Total transplantation
B)Biatrial technique
C)Bicaval technique
D)Heterotopic heart
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Chapter 13: Monitoring and Life Support Equipment
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32 Verified Questions
32 Flashcards
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Sample Questions
Q1) Electrocardiogram electrodes are used in continuous monitoring of a patient and provide information on heart rate,heart rhythm,and respiratory rate.
A)True
B)False
Q2) The pulmonary artery end-diastolic pressure measured by a Swan-Ganz catheter is essentially equal to which of the following cardiac pressures?
A)Left ventricular end-diastolic pressure
B)Left atrial pressure
C)Right atrial pressure
D)Systolic pressure
Q3) Which of the following factors associated with a patient is NOT considered a cause of inaccurate pulse oximetry readings?
A)Presence of perspiration or sweat
B)Presence of dark nail polish
C)Anemia
D)Low perfusion states (low cardiac output)
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Chapter 14: Cardiovascular Medications
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Sample Questions
Q1) Which of the following classes of antiarrhythmic agent drugs act as membrane depressants affecting the fast sodium channels?
A)Class I
B)Class II
C)Class III
D)Class IV
Q2) In a heart transplant patient,rejection that occurs in days to weeks after transplantation and is associated with an antibody BEST describes which of the following rejection types?
A)Hyperacute rejection
B)Acute cellular rejection
C)Acute humoral or vascular rejection
D)Chronic rejection
Q3) Which of the following conditions would MOST likely lead to a decrease in myocardial oxygen demand?
A)Exercise
B)Increased systemic vascular resistance
C)Anemia
D)Use of beta-blockers
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Page 16
Chapter 15: Pulmonary Medications
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Sample Questions
Q1) Administration of which of the following sympathomimetic agent would MOST likely produce a quick response and be more specific to the respiratory system?
A)Epinephrine (adrenaline)
B)Ephedrine
C)Short-acting Beta adrenergic agonists (SABAs)
D)Long-acting Beta adrenergic agonists (LABAs)
Q2) Inhibition of microbial protein synthesis is a mechanism of action associated with which of the following antimicrobial agents?
A)Penicillins
B)Tetracyclines
C)Antivirals
D)Cephalosporins
Q3) Which of the following factors if stimulated or administered results in bronchoconstriction?
A)Adrenergic Beta receptor
B)Adrenergic agonists
C)Cholinergic antagonists
D)Muscarinic receptor
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Chapter 16: Examination and Assessment Procedures
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Sample Questions
Q1) Which of the following clinical signs is MOST indicative of early congestive heart failure,specifically right-sided or cor pulmonale?
A)The anteroposterior diameter of the chest wall is equal to the transverse diameter.
B)Presence of hypertrophy or adaptive shortening of the sternocleidomastoid muscles.
C)The rib angles are increased and the intercostal spaces are broader anteriorly.
D)The presence of jugular venous distention in sitting or recumbent positions.
Q2) Which of the following general appearances BEST indicates the presence of low oxygenation and perfusion in the periphery?
A)The patient is leaning forward on the knees or some object to breathe.
B)The patient is using accessory muscles around neck and shoulders to breathe.
C)The patient has noticeable bluish color at the lips and fingernail beds.
D)The patient is resting in a semi-Fowler's position and is not able to tolerate lying flat.
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18
Chapter 17: Interventions for Acute Cardiopulmonary Conditions
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Sample Questions
Q1) The technique of airway suctioning is effective in removing secretions from all of the lungs areas including the small airways.
A)True
B)False
Q2) Postural drainage is BEST defined by which of the following statements?
A)Rhythmical clapping with cupped hands over the affected lung segment.
B)Clinician's hands are used to exert pressure on the patient's chest wall with oscillations at the end of deep inspiration through expiration.
C)The assumption of one or more body positions that allow gravity to assist with draining secretions from each lung segment.
D)A series of maneuvers performed by the patient to emphasize independence in secretion clearance and thoracic expansion.
Q3) Which of the following clinical findings is MOST associated with prolonged immobilization and/or sedentary lifestyle?
A)Elevated resting heart rate
B)Atelectasis
C)Hypoventilation
D)Edema
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Chapter 18: Interventions and Prevention Measures for
Individuals With Cardiovascular Disease, or Risk of Disease
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Q1) A patient with chronic obstructive pulmonary disease may be encouraged to perform which of the following activities to improve use of accessory muscles for breathing and subsequently reduce dyspnea?
A)Perform pursed lip-breathing.
B)Use upper extremity support with exercise.
C)Titrate supplemental oxygen.
D)Slow pace or intensity.
Q2) Use of nonselective beta-blockers may be MOST detrimental to which of the following special patient populations during physical activity?
A)Patients with peripheral arterial disease
B)Patients with chronic obstructive pulmonary disease (COPD)
C)Patients with diabetes mellitus
D)Patients with renal disease
Q3) Which of the following methods for determining intensity would be BEST for a patient who is currently prescribed a beta-blocker?
A)Karoven method for predicted heart rate range
B)Ventilatory threshold
C)Rating of perceived exertion
D)Electrocardiogram
Page 20
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Chapter 19: Pulmonary Rehabilitation
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Sample Questions
Q1) Obesity associated with respiratory disease may result from which of the following conditions?
A)Decreased activity level due to dyspnea and fatigue
B)Malabsorption
C)High energy costs resulting from increased work of breathing
D)Muscle mass depletion
Q2) Which of the following criteria is appropriate to use when determining the time to advance workloads in an exercise prescription for a patient with moderate lung disease?
A)The patient feels like it is time to advance the workload.
B)Each week the workload should be increased per a schedule.
C)Rating of perceived exertion (RPE)and heart rate decrease and exercise time is maintained.
D)The program can be advanced when cleared by the medical director.
Q3) Which of the following MOST likely contributes to reduced flexibility in a pulmonary patient?
A)Inactivity or increased time sitting
B)Posture-forward lean to assist with breathing
C)Hypertrophy of accessory respiratory muscles
D)All of the above
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Page 21
Chapter 20: Pediatric Cardiopulmonary Physical Therapy
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Sample Questions
Q1) Which of the following characteristics BEST describes a premature periodic breathing pattern in an infant?
A)Termed apnea of prematurity
B)Associated with bradycardia
C)Associated with hypoxemia
D)5- to 10-second pause in breathing
Q2) A fetus will not survive if born during which of the following periods of lung maturation?
A)Pseudoglandular period
B)Canalicular period
C)Terminal saccular period
D)Alveolar period
Q3) Which of the following characteristics is MOST associated with cyanotic lesions of the heart?
A)Flow is known as left to right.
B)Associated with polycythemia.
C)Pulmonary blood flow is increased.
D)Associated with low stroke volume.
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22
Chapter 21: The Lymphatic System
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Sample Questions
Q1) Which of the following physiological changes occurs MOST due to graded compression using bandages or garments?
A)Decreasing filtration of fluid into the interstitium.
B)Reduction of the amount of lymph needing to be transported by the lymphatics.
C)Improves efficiency of the muscle pump during contraction of the distal and compressed muscle.
D)Assists in softening hardened fibrotic tissue found in the more advanced stages.
Q2) Which of the following pathological conditions is associated with mechanical insufficiency or low-output (volume)insufficiency?
A)Congestive heart failure
B)Hypoproteinemia
C)Lymphedema
D)Chronic venous insufficiency
Q3) Which of the following pathological conditions results in primary lymphedema?
A)Infection
B)Radiation therapy
C)Hypoplasia of the lymphatic system
D)Chronic venous insufficiency
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Chapter 22: Outcome Measures:a Guide for the Evidence
Based Practice of Cardiopulmonary Physical Therapy
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Sample Questions
Q1) Health-related quality of life (HRQOL)assessment will assist the physical therapist with which of the following aspects of rehabilitation?
A)Choosing the most appropriate treatment intervention
B)Modifying treatment interventions
C)Measuring the results as a reflection of quality of care
D)All of the above
Q2) Which of the following variables collected at the time of a patient's initial evaluation is considered a demographic data factor?
A)Blood pressure
B)Hemodynamic regulation
C)Blood lipid levels
D)Comorbidities
Q3) The gold standard for measurement of functional exercise capacity is which of the following outcome measures?
A)6-minute walk test
B)Modified shuttle test
C)Oxygen consumption test
D)200-meter walk test
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