DPT Cardiovascular & Pulmonary PT 3 — Questions and Answers
Question 1: During a 6-Minute Walk Test (6MWT), which finding would indicate the test should be stopped immediately?
- Heart rate reaches 70% of age-predicted maximum
- Patient reports dyspnea rated 4/10 on modified Borg scale
- SBP rises from 120 to 160 mmHg during walking
- Patient develops chest pain rated 3/10 with diaphoresis (Correct answer)
Correct answer: Patient develops chest pain rated 3/10 with diaphoresis
Chest pain with diaphoresis suggests possible myocardial ischemia and is an absolute indication to stop the 6MWT immediately.
Question 2: What does a positive hepatojugular reflux test indicate in a patient being evaluated for right heart failure?
- Adequate right ventricular preload reserve
- Elevated right-sided filling pressures and volume overload (Correct answer)
- Left ventricular diastolic dysfunction only
- Hepatic artery stenosis causing portal hypertension
Correct answer: Elevated right-sided filling pressures and volume overload
A positive hepatojugular reflux (jugular vein distension with abdominal compression) indicates elevated right-sided filling pressures consistent with right heart failure.
Question 3: A patient with asthma uses a metered-dose inhaler (MDI) with a spacer. When should the bronchodilator ideally be administered before exercise?
- Immediately before starting exercise (0-1 minute)
- 15-30 minutes before exercise (Correct answer)
- 60-90 minutes before exercise
- 2 hours before exercise for maximum effect
Correct answer: 15-30 minutes before exercise
Short-acting beta-agonist bronchodilators reach peak effect 15-30 minutes after inhalation, providing optimal protection during exercise-induced bronchoconstriction.
Question 4: Which pulmonary rehabilitation outcome measure best assesses functional exercise capacity in patients with chronic lung disease?
- Forced Vital Capacity (FVC)
- Six-Minute Walk Test (6MWT) (Correct answer)
- Maximal Inspiratory Pressure (MIP)
- Peak Expiratory Flow Rate (PEFR)
Correct answer: Six-Minute Walk Test (6MWT)
The 6MWT measures functional walking capacity and is the most commonly used and validated outcome measure in pulmonary rehabilitation.
Question 5: A patient with peripheral artery disease (PAD) reports calf pain at 200 meters during ambulation that resolves with 2 minutes of rest. This describes which Fontaine classification?
- Stage I — asymptomatic
- Stage IIa — intermittent claudication after >200m (Correct answer)
- Stage IIb — intermittent claudication at <200m
- Stage III — rest pain
Correct answer: Stage IIa — intermittent claudication after >200m
Fontaine Stage IIa describes mild claudication with symptoms appearing only after walking more than 200 meters.
Question 6: Which chest percussion finding is most consistent with a large pleural effusion on the right side?
- Hyperresonance over the right lower lobe
- Dullness to percussion over the right lower lobe (Correct answer)
- Tympany throughout the right hemithorax
- Normal resonance throughout with diminished fremitus
Correct answer: Dullness to percussion over the right lower lobe
Pleural effusion accumulates fluid in the pleural space, causing dullness to percussion over the affected area due to fluid density.
Question 7: In cardiac rehabilitation Phase II, what is the recommended minimum frequency of supervised exercise sessions per week per AACVPR guidelines?
- 1 session per week
- 2 sessions per week
- 3 sessions per week (Correct answer)
- 5 sessions per week
Correct answer: 3 sessions per week
AACVPR recommends a minimum of 3 supervised exercise sessions per week during Phase II outpatient cardiac rehabilitation for optimal outcomes.
DPT Cardiovascular & Pulmonary PT 3
During a 6-Minute Walk Test (6MWT), which finding would indicate the test should be stopped immediately?