PCE PCE Cardiopulmonary and Special Populations 1 — Questions and Answers
Question 1: When assessing a patient with COPD, which outcome measure best quantifies functional exercise capacity in a clinical setting?
- Forced vital capacity (FVC) alone
- Six-Minute Walk Test (6MWT) (Correct answer)
- Passive range of motion of the shoulder
- Berg Balance Scale
Correct answer: Six-Minute Walk Test (6MWT)
The Six-Minute Walk Test is a validated, reliable measure of submaximal functional exercise capacity widely used in COPD and cardiopulmonary rehabilitation.
Question 2: A physiotherapist is treating a pregnant patient in her third trimester. Which exercise position should be avoided due to the risk of supine hypotensive syndrome?
- Side-lying left lateral decubitus
- Sitting upright on a stability ball
- Supine lying for more than brief periods (Correct answer)
- Standing with wide base of support
Correct answer: Supine lying for more than brief periods
After the first trimester, prolonged supine positioning compresses the inferior vena cava, reducing venous return and potentially causing supine hypotensive syndrome.
Question 3: According to ACSM guidelines, which absolute contraindication would require a physiotherapist to stop an exercise session immediately?
- Mild muscle soreness from the previous session
- Resting systolic blood pressure of 160 mmHg in a hypertensive patient
- Acute myocardial infarction within the past 2 days (Correct answer)
- Mild dyspnea at the start of warm-up
Correct answer: Acute myocardial infarction within the past 2 days
An acute myocardial infarction is an absolute contraindication to exercise, and any patient with a recent MI should not participate in active exercise rehabilitation without medical clearance.
Question 4: Postural drainage in a patient with bronchiectasis is most effective when performed:
- Immediately after a large meal to aid digestion
- In positions that use gravity to drain specific lung segments (Correct answer)
- Only in the supine position regardless of affected lobe
- During peak fever to increase secretion mobilization
Correct answer: In positions that use gravity to drain specific lung segments
Postural drainage uses gravity-assisted positioning specific to the affected lung segment to facilitate mucus drainage toward the central airways for expectoration.
Question 5: A physiotherapist is working with a pediatric patient with cerebral palsy (spastic diplegia). Which intervention most directly addresses spasticity management and functional mobility?
- High-intensity isometric strengthening of spastic muscles
- Prolonged static stretching combined with functional task practice (Correct answer)
- Electrical stimulation applied to antagonist muscles only
- Splinting all joints in full extension continuously
Correct answer: Prolonged static stretching combined with functional task practice
Prolonged static stretching reduces spastic muscle tone while functional task training improves motor control and overall mobility in children with spastic cerebral palsy.
Question 6: Which breathing technique is most appropriate to teach a COPD patient to reduce dynamic hyperinflation during activity?
- Rapid shallow chest breathing
- Pursed-lip breathing (Correct answer)
- Valsalva maneuver
- Hyperventilation technique
Correct answer: Pursed-lip breathing
Pursed-lip breathing slows expiratory flow, reduces dynamic airway collapse, promotes complete exhalation, and decreases hyperinflation in COPD patients during exertion.
PCE PCE Cardiopulmonary and Special Populations 1
When assessing a patient with COPD, which outcome measure best quantifies functional exercise capacity in a clinical setting?