Exam 1 Review Questions Flashcards
Which of the following is a contraindication for Phase I Cardiac Rehabilitation?
- A. Resting systolic blood pressure of 140 mmHg
- B. Active pericarditis or myocarditis
- C. History of stable angina
- D. Completed PCI with no complications
B. Active pericarditis or myocarditis
What is the primary goal of Phase I Cardiac Rehabilitation?
- A. Maximize aerobic capacity
- B. Prevent complications and ensure safe discharge
- C. Begin strength training
- D. Teach advanced exercise techniques
B. Prevent complications and ensure safe discharge
A patient post-MI with a resting heart rate of 70 bpm should not exceed what heart rate during inpatient therapy in the absence of a stress test?
- A. 90 bpm
- B. 110 bpm
- C. 100 bpm
- D. 120 bpm
A. 90 bpm (Post-MI: Resting HR + 20 bpm limit)
Which of the following symptoms would warrant immediate discontinuation of exercise during cardiac rehabilitation?
- A. A drop in systolic blood pressure of 8 mmHg
- B. Heart rate increases within target range
- C. Angina and marked dyspnea
- D. Mild fatigue
C. Angina and marked dyspnea
What is the expected timeline for achieving sternal stability following CABG surgery?
- A. 2-4 weeks
- B. 4-6 weeks
- C. 6-10 weeks
- D. 10-12 weeks
C. 6-10 weeks
True or False
Patients in cardiac rehab Phase I should engage in activities that increase their heart rate by no more than 40 bpm above resting values.
False (Post-op limit is 30 bpm, post-MI is 20 bpm above resting HR).
True or False
Active exercise is contraindicated in patients with resting ST segment elevation greater than 2 mm.
True
True or False
Education about cardiovascular risk factors and self-monitoring is a key component of all phases of cardiac rehabilitation.
True
Scenario: You are seeing a patient with a recent anterior MI in the acute care setting. During therapy, their vitals are as follows: HR 95 bpm, BP 140/88 mmHg, SpO2 96%, and they report mild dizziness.
Question: What is your next step?
- A. Stop treatment and monitor for worsening symptoms.
- B. Adjust activity to reduce intensity.
- C. Continue treatment and monitor vitals closely.
- D. Call for emergency assistance immediately.
A. Stop treatment and monitor for worsening symptoms.
Which of the following patients would be contraindicated for participating in Phase I Cardiac Rehabilitation?
- A. A patient with controlled atrial fibrillation and resting HR of 78 bpm.
- B. A patient with stable angina but no chest pain in the last 24 hours.
- C. A patient with an acute systemic illness and a fever of 101°F.
- D. A patient who has undergone a PCI procedure and is hemodynamically stable.
Correct Answer: C. A patient with an acute systemic illness and a fever of 101°F.
Rationale:
- C: Acute systemic illness or fever is a contraindication for cardiac rehab because it indicates the body is in a stressed state, which increases the risk of complications.
- A: Controlled atrial fibrillation is not a contraindication as long as the patient is hemodynamically stable.
- B: Stable angina without recent chest pain is a common condition in cardiac rehab patients.
- D: PCI patients, once stable, are cleared to begin low-level activity.
Scenario: You are treating a 65-year-old patient post-MI in Phase I Cardiac Rehab. During ambulation, their vitals are as follows: HR 92 bpm (resting HR: 74 bpm), BP 120/80 mmHg, SpO2 96%, and they report no symptoms.
What is your next step?
- A. Continue the activity and monitor closely for any changes.
- B. Stop the activity due to the HR increase.
- C. Increase the intensity to test their cardiovascular limits.
- D. Stop the activity and consult the physician immediately.
Correct Answer: A. Continue the activity and monitor closely for any changes.
Rationale:
- A: The HR increase (18 bpm) is within the acceptable limit (20 bpm above resting for post-MI patients). The vitals are stable, and the patient is asymptomatic.
- B: There is no indication to stop the activity since HR is within the safe range.
- C: Increasing intensity in this phase is contraindicated; the goal is safe, gradual progression.
- D: There is no clinical need to stop and consult a physician as the vitals and symptoms are normal.
During Phase I Cardiac Rehabilitation, which of the following abnormal responses to activity requires immediate cessation of exercise?
- A. Increase in systolic blood pressure by 25 mmHg.
- B. Heart rate increase of 22 bpm above resting in a post-op patient.
- C. Patient reports angina with an intensity of 3/10.
- D. Mild dizziness that resolves within a few seconds.
Correct Answer: C. Patient reports angina with an intensity of 3/10.
Rationale:
- C: Angina, regardless of intensity, is a critical symptom that requires immediate cessation of exercise to prevent further ischemic damage.
- A: A 25 mmHg increase in SBP is not abnormal unless it exceeds 210 mmHg.
- B: An HR increase of 22 bpm in a post-op patient is acceptable as the limit is 30 bpm above resting.
- D: Mild dizziness that resolves quickly is not a reason to stop activity but should be monitored.
Scenario: A 70-year-old patient post-CABG is participating in their first inpatient rehab session. During a 2-minute walk, they report mild sternal discomfort but deny chest pain or dyspnea. Vitals are HR: 88 bpm, BP: 128/82 mmHg, SpO2: 97%.
What is your next step?
- A. Stop activity and report sternal discomfort to the physician.
- B. Continue activity but instruct the patient to monitor their discomfort closely.
- C. Discontinue activity and reassess their sternal precautions.
- D. Increase the intensity to test tolerance to discomfort.
Correct Answer: B. Continue activity but instruct the patient to monitor their discomfort closely.
Rationale:
- B: Mild sternal discomfort is common post-CABG, especially early in rehab. The patient’s vitals are stable, and no other concerning symptoms are present.
- A: Reporting to the physician is unnecessary unless the discomfort worsens or interferes with mobility.
- C: There is no need to stop entirely, as the discomfort is not severe.
- D: Increasing intensity is contraindicated due to the discomfort and early phase of rehab.
A patient in Phase I Cardiac Rehab demonstrates the following during seated exercises: HR 110 bpm, BP 150/88 mmHg, SpO2 95%, and they report dizziness.
What should you do?
- A. Stop the activity and monitor symptoms while resting.
- B. Continue the activity and recheck vitals in 5 minutes.
- C. Adjust the intensity and encourage hydration.
- D. Call for emergency medical assistance immediately.
Correct Answer: A. Stop the activity and monitor symptoms while resting.
Rationale:
- A: Dizziness is a sign of activity intolerance and should prompt immediate cessation to prevent worsening symptoms or adverse events.
- B: Continuing activity despite dizziness could worsen the patient’s condition.
- C: Adjusting intensity does not address the underlying issue and may delay proper response.
- D: Emergency assistance is not needed unless dizziness persists or vitals deteriorate significantly.
Which of the following symptoms during activity requires immediate cessation of exercise in a Phase I cardiac rehab patient?
- A. Heart rate increase of 15 bpm above resting in a post-MI patient.
- B. Diastolic blood pressure of 85 mmHg during activity.
- C. Angina rated 2/10 and dizziness.
- D. Systolic blood pressure increase of 30 mmHg during activity.
Correct Answer: C. Angina rated 2/10 and dizziness.
- C: Angina, regardless of intensity, and dizziness are signs of exercise intolerance that require stopping exercise immediately.
- A: A 15 bpm HR increase is within acceptable limits for post-MI patients.
- B: A DBP of 85 mmHg is within the normal range during activity.
- D: A 30 mmHg SBP increase is not concerning unless it exceeds 210 mmHg.
Scenario: You are treating a patient post-CABG on Day 2 in an ICU setting. During seated exercises, their vitals are: HR 90 bpm, BP 145/85 mmHg, SpO2 94%. The patient reports mild sternal discomfort and denies dyspnea. What is your next step?
- A. Discontinue exercise and consult the physician.
- B. Continue the session but monitor closely for worsening symptoms.
- C. Stop the session and educate the patient on sternal precautions.
- D. Increase intensity to improve exercise tolerance.
Correct Answer: B. Continue the session but monitor closely for worsening symptoms.
- B: Mild sternal discomfort is common post-CABG, and the vitals are stable. Close monitoring is sufficient.
- A: Discontinuation is not necessary unless symptoms worsen or become severe.
- C: Stopping is unnecessary unless there is significant discomfort or a violation of sternal precautions.
- D: Increasing intensity is contraindicated in the early post-operative phase.
A patient in the ICU with a pulmonary artery catheter reports dizziness during activity. Their MAP is 55 mmHg. What is your next step?
- A. Continue exercise but reduce intensity.
- B. Stop exercise and monitor vitals while resting.
- C. Increase intensity to improve MAP.
- D. Adjust the catheter and continue activity.
Correct Answer: B. Stop exercise and monitor vitals while resting.
- B: A MAP < 60 mmHg indicates inadequate tissue perfusion and requires cessation of exercise.
- A: Continuing exercise would worsen the situation.
- C: Increasing intensity is inappropriate in the presence of hemodynamic instability.
- D: Adjusting the catheter is not within the PT scope of practice.
Scenario: A 58-year-old patient with an LVAD begins a low-intensity walking program. Their MAP via Doppler is 65 mmHg, and their RPE is 14. What is your best action?
- A. Stop the session and notify the physician.
- B. Adjust the exercise to lower intensity and continue.
- C. Continue the session at the current intensity.
- D. Increase intensity to target MAP 70 mmHg.
Correct Answer: B. Adjust the exercise to lower intensity and continue.
- B: The MAP is below the recommended range (70–90 mmHg), and the RPE is slightly high. Reducing intensity is appropriate.
- A: Notification is not necessary unless the patient remains symptomatic or MAP fails to improve.
- C: Continuing without adjustment risks worsening hemodynamic status.
- D: Increasing intensity is contraindicated due to the low MAP.
Which of the following is a contraindication to exercise in a Phase I cardiac rehab patient?
- A. Resting HR of 78 bpm.
- B. Resting BP of 135/85 mmHg.
- C. Active pericarditis.
- D. Atrial fibrillation with controlled rate.
Correct Answer: C. Active pericarditis.
- C: Active pericarditis is an absolute contraindication due to the risk of exacerbation and cardiac tamponade.
- A: A resting HR of 78 bpm is within normal limits.
- B: A BP of 135/85 mmHg is not a contraindication.
- D: Atrial fibrillation with controlled rate is not a contraindication.
Scenario: A patient with a pacemaker is starting aerobic exercises. During therapy, their HR does not increase with activity. What is your best action?
- A. Continue therapy and use RPE to monitor intensity.
- B. Stop therapy and notify the cardiologist.
- C. Adjust the intensity to a higher level.
- D. Discharge the patient from cardiac rehab.
Correct Answer: B. Stop therapy and notify the cardiologist.
- B: The pacemaker may not be functioning properly, and cardiologist consultation is needed.
- A: Continuing therapy without addressing the issue is unsafe.
- C: Increasing intensity is contraindicated without appropriate HR response.
- D: Discharge is inappropriate; the issue must first be resolved.
Which of the following parameters is considered normal for a heart transplant patient during exercise?
- A. Resting HR of 70 bpm.
- B. Peak HR of 170 bpm.
- C. Delayed HR increase with activity.
- D. Immediate HR increase with activity.
Correct Answer: C. Delayed HR increase with activity.
- C: Transplanted hearts lack autonomic input, leading to delayed HR response.
- A: Resting HR is typically 95–115 bpm post-transplant.
- B: Peak HR rarely exceeds 150 bpm post-transplant.
- D: Immediate HR response is not typical for transplanted hearts.
Scenario: A patient with PAD experiences claudication at 1/4 on the pain scale during treadmill walking. What is your next step?
- A. Stop the activity immediately and rest.
- B. Continue walking until pain reaches 3/4.
- C. Increase walking speed to improve circulation.
- D. Notify the physician of the pain.
Correct Answer: B. Continue walking until pain reaches 3/4.
- B: Exercise to near-maximal claudication improves collateral circulation and walking tolerance.
- A: Stopping prematurely reduces therapeutic benefits.
- C: Increasing speed may exacerbate symptoms unnecessarily.
- D: Physician notification is not required for expected claudication.
Which is the appropriate method to monitor exercise intensity in a patient on beta-blockers?
- A. Heart rate.
- B. Blood pressure.
- C. Rating of Perceived Exertion (RPE).
- D. Maximum heart rate calculation.
Correct Answer: C. Rating of Perceived Exertion (RPE).
Rationale:
- C: Beta-blockers blunt HR response, making RPE a more reliable measure.
- A: HR is unreliable due to medication effects.
- B: BP monitoring is useful but doesn’t indicate exercise intensity.
- D: HR calculations are inaccurate for patients on beta-blockers.
Scenario: A 70-year-old post-MI patient reports moderate fatigue during seated exercises. Their vitals are HR 82 bpm, BP 138/82 mmHg, SpO2 96%. What is your best action?
- A. Stop the session and allow the patient to rest.
- B. Decrease intensity and monitor closely.
- C. Continue at the same intensity.
- D. Notify the physician immediately.
Correct Answer:** B**. Decrease intensity and monitor closely.
- B: Moderate fatigue is not a contraindication but warrants reduced intensity and monitoring.
- A: Stopping completely is unnecessary unless symptoms worsen.
- C: Continuing without adjustment could increase fatigue.
- D: Physician notification is unnecessary unless symptoms persist or escalate.
BP Cutoff
- At rest = ?
- Exercise = ?
Rest:
- > 200 SBP or > 110 DBP
Exercise:
- > 250 SBP or > 115 DBP
Formulas
- HRR = ?
- HRR % = = ?
HRR = HR max - HR rest
HRR % = (HRR x %) + HR rest
- Low = 30-39%
- Mod = 40-59%
- High = 60-89%
Acute
- MI = HR rest + ?
- CABG = HR rest + ?
- MI = HR rest + 20 bpm
- CABG = HR rest + 30 bpm
Which of the following would indicate the need to terminate exercise in a patient with cardiovascular disease?
- A. SBP increase from 130 mmHg to 190 mmHg.
- B. DBP increase to 120 mmHg.
- C. A drop in SBP by 5 mmHg during activity.
- D. RPE of 14 on the Borg scale.
Correct Answer: B. DBP increase to 120 mmHg.
- B: DBP >115 mmHg is a criterion for stopping exercise due to excessive vascular resistance.
- A: An SBP increase to 190 mmHg is within acceptable limits during exercise.
- C: A drop in SBP >10 mmHg is concerning, but a 5 mmHg drop is not.
- D: An RPE of 14 (moderate to hard) is acceptable for most CVD patients.
Scenario: A 62-year-old patient with CAD reports mild dyspnea and an RPE of 13 during treadmill walking. Their HR is 115 bpm (max HR: 140 bpm), and SBP is 165 mmHg. What is your best action?
- A. Continue exercise at the same intensity and monitor.
- B. Stop exercise immediately and assess symptoms.
- C. Increase intensity to test tolerance.
- D. Reduce speed and observe for improvement.
Correct Answer: A. Continue exercise at the same intensity and monitor.
- A: The patient’s vitals are within acceptable ranges, and mild dyspnea is expected.
- B: Stopping is unnecessary unless symptoms worsen.
- C: Increasing intensity could exacerbate symptoms.
- D: Reducing speed isn’t required with stable vitals and RPE within target range.
What is the appropriate initial exercise intensity for a patient with PAD?
- A. 50-60% HRR with a claudication score of 2/4.
- B. RHR + 40 bpm with a claudication score of 3/4.
- C. 11-14 on the RPE scale with a claudication score of 3/4.
- D. RHR + 20-30 bpm with a claudication score of 4/4.
Correct Answer: C. 11-14 on the RPE scale with a claudication score of 3/4.
- C: Moderate RPE and a 3/4 claudication score are appropriate for PAD patients to improve walking tolerance.
- A: 50-60% HRR may be too aggressive without a GXT.
- B: A claudication score of 3/4 aligns with guidelines, but RHR + 40 bpm exceeds safe limits.
- D: Exercising with a 4/4 claudication score is contraindicated due to severe symptoms.
Scenario: A patient with CHF is exercising on a cycle ergometer at 50% HRR. They report fatigue, and their BP decreases from 130/80 mmHg to 118/78 mmHg. What is your next step?
- A. Stop exercise immediately and monitor.
- B. Continue at the same intensity and recheck BP.
- C. Decrease intensity and monitor closely.
- D. Increase intensity to counteract the drop in BP.
Correct Answer: C. Decrease intensity and monitor closely.
- C: A drop in SBP during exercise is concerning, but the decrease here is not yet critical. Lowering intensity is prudent.
- A: Immediate cessation is unnecessary unless symptoms worsen.
- B: Continuing without adjustment risks further hypotension.
- D: Increasing intensity could exacerbate the drop in BP.
What is a key consideration when prescribing exercise for a patient with diabetes and CVD?
- A. Monitor blood sugar levels to remain above 200 mg/dL.
- B. Encourage high-intensity exercise for rapid glucose uptake.
- C. Provide a 15g carbohydrate snack if blood sugar < 70 mg/dL.
- D. Avoid exercise altogether if blood sugar is < 150 mg/dL.
Correct Answer: C. Provide a 15g carbohydrate snack if blood sugar < 70 mg/dL.
- C: This ensures safety during exercise for hypoglycemic patients.
- A: Blood sugar >200 mg/dL may indicate hyperglycemia and should be avoided.
- B: High-intensity exercise increases hypoglycemic risk.
- D: Exercise is not contraindicated at blood sugar levels < 150 mg/dL if asymptomatic.
Scenario: A patient with CAD begins HIIT with bouts at 85% HRR. After the session, their RPE increases to 17, and they report mild chest tightness. What should you do next?
- A. Continue the program and observe the patient’s tolerance.
- B. Discontinue HIIT and revert to moderate-intensity exercise.
- C. Increase the rest intervals between high-intensity bouts.
- D. Stop the program and notify the physician.
Correct Answer: B. Discontinue HIIT and revert to moderate-intensity exercise.
- B: HIIT is contraindicated for patients with symptoms like chest tightness. Moderate-intensity exercise is safer.
- A: Continuing HIIT could worsen symptoms.
- C: Adjusting rest intervals may not sufficiently reduce risk.
- D: Physician notification isn’t immediately required if symptoms resolve with moderate-intensity exercise.
What is the recommended frequency for initial exercise sessions in PAD patients?
- A. 1x/week for 15 minutes.
- B. 3x/week for 15 minutes per session.
- C. 5x/week for 10 minutes per session.
- D. 7x/week for 20 minutes per session.
Correct Answer: B. 3x/week for 15 minutes per session.
- B: This aligns with guidelines for gradual progression in PAD patients.
- A: Once weekly is insufficient for benefit.
- C: 5x/week may be excessive initially.
- D: Daily exercise is too frequent for early stages of PAD rehab.
Scenario: During a GXT for a patient with CAD, you note ST-segment depression at 7 METs. What does this indicate?
- A. The patient’s aerobic capacity is above average.
- B. Exercise can continue at this intensity.
- C. The patient has reached their anginal threshold.
- D. The patient should stop exercise and rest.
Correct Answer: C. The patient has reached their anginal threshold.
- C: ST-segment depression is a sign of myocardial ischemia and anginal threshold.
- A: Aerobic capacity cannot be inferred from ST changes.
- B: Continuing exercise could exacerbate ischemia.
- D: Rest is not required unless symptoms persist.
What is the primary goal of exercise prescription for patients with CHF?
- A. Achieve a peak HR >150 bpm.
- B. Improve functional capacity and reduce mortality.
- C. Eliminate the need for medications.
- D. Avoid exercise to prevent exacerbation.
Correct Answer: B. Improve functional capacity and reduce mortality.
- B: Exercise reduces mortality and improves quality of life in CHF patients.
- A: A peak HR of >150 bpm is not a goal for CHF patients.
- C: Medications remain essential despite exercise.
- D: Avoidance of exercise is contraindicated.
Scenario: A 70-year-old post-MI patient performs seated exercises. Their HR is 100 bpm (resting HR: 80 bpm), SBP is 140 mmHg, and DBP is 90 mmHg. They report no symptoms. What should you do?
- A. Stop exercise immediately.
- B. Continue exercise at the same intensity.
- C. Reduce exercise intensity.
- D. Increase exercise intensity to test tolerance.
Correct Answer: B. Continue exercise at the same intensity.
- B: HR and BP responses are appropriate, and the patient is asymptomatic.
- A: Stopping exercise isn’t warranted.
- C: Reducing intensity is unnecessary with stable vitals.
- D: Increase exercise intensity to test tolerance - The goal in early post-MI exercise is not to “test limits”
What is a primary goal of Phase III Cardiac Rehabilitation?
- A. Minimize hospital readmissions.
- B. Improve adherence to a cardio-protective lifestyle.
- C. Conduct intensive supervision during exercise.
- D. Diagnose cardiovascular conditions.
Correct Answer: B. Improve adherence to a cardio-protective lifestyle.
- B: This phase focuses on sustaining health through lifestyle modifications and promoting independence.
- A: While hospital readmissions are reduced in earlier phases, this is not the primary focus of Phase III.
- C: Intensive supervision is characteristic of Phase II.
- D: Diagnosis occurs before rehabilitation begins.
Scenario: A 68-year-old participant in Phase IV Cardiac Rehab has been independently exercising but reports decreased adherence due to boredom. What is your best strategy?
- A. Refer them back to Phase II for supervised sessions.
- B. Modify their exercise program to include variety and set new goals.
- C. Emphasize the importance of continuing their current program.
- D. Recommend they discontinue formal exercise.
Correct Answer: B. Modify their exercise program to include variety and set new goals.
- B: Individualizing programs and setting new goals improves adherence by addressing boredom.
- A: Returning to supervised sessions isn’t necessary unless safety becomes a concern.
- C: Reinforcement alone does not address the underlying adherence issue.
- D: Discontinuing exercise contradicts the goals of long-term cardiovascular health.
Which of the following factors most strongly influences exercise adherence in Phase III/IV?
- A. The patient’s socioeconomic status.
- B. Individualized and science-based programming.
- C. The patient’s resting heart rate.
- D. Duration of the rehabilitation program.
Correct Answer: B. Individualized and science-based programming.
- B: Tailoring the program to patient preferences and needs significantly enhances adherence.
- A: Socioeconomic status can influence access, but it is not the strongest factor for adherence.
- C: Resting HR is not directly related to adherence.
- D: Longer programs tend to reduce adherence if not adjusted for variety.
Scenario: A 71-year-old patient with diabetes reports feeling overwhelmed by dietary recommendations during a cardiac rehab session. What approach should you take?
- A. Refer them to a dietitian and discontinue your involvement in dietary education.
- B. Provide simple guidance on using the MyPlate model and encourage small, manageable changes.
- C. Emphasize strict calorie counting and weight loss.
- D. Shift focus entirely to exercise and revisit diet later.
Correct Answer: B. Provide simple guidance on using the MyPlate model and encourage small, manageable changes.
- B: Simplifying dietary advice and promoting gradual changes increases patient confidence and adherence.
- A: Collaboration with a dietitian is helpful, but PTs can provide basic dietary education.
- C: Strict calorie counting may overwhelm the patient further.
- D: Avoiding the issue delays addressing critical cardiovascular risk factors.
Which is a common barrier to exercise adherence in Phase IV Cardiac Rehab?
- A. Lack of physician involvement.
- B. High costs of supervised programs.
- C. Boredom with repetitive exercise routines.
- D. Over-reliance on group settings.
Correct Answer: C. Boredom with repetitive exercise routines.
- C: Patients often lose interest if programs are not varied or updated regularly.
- A: Physician involvement is not typically a barrier in Phase IV.
- B: Costs may impact supervised programs but are less relevant in independent exercise.
- D: Group settings are generally beneficial for adherence.
Scenario: A patient reports walking 5,000 steps per day but struggles to reach 150 minutes of moderate-intensity exercise weekly. What is your best recommendation?
- A. Add short bouts of higher-intensity walking throughout the day.
- B. Encourage them to prioritize strength training instead of walking.
- C. Advise them to increase their walking duration gradually.
- D. Suggest replacing walking with other activities like swimming or cycling.
Correct Answer: C. Advise them to increase their walking duration gradually.
- C: Gradual increases help meet the weekly exercise target without overwhelming the patient.
- A: High-intensity bouts may not be sustainable or appropriate.
- B: Strength training complements but does not replace cardiovascular exercise.
- D: Other activities can be added but shouldn’t replace walking if the patient enjoys it.
Which of the following dietary interventions is supported for managing cardiovascular health?
- A. A ketogenic diet with high saturated fat intake.
- B. A Mediterranean diet emphasizing plant-based foods.
- C. A diet high in refined carbohydrates and processed foods.
- D. Intermittent fasting without caloric considerations.
Correct Answer: B. A Mediterranean diet emphasizing plant-based foods.
- B: The Mediterranean diet is consistently associated with improved cardiovascular outcomes.
- A: High saturated fat intake increases cardiovascular risk.
- C: Refined carbohydrates and processed foods are detrimental to heart health.
- D: Intermittent fasting alone is not a comprehensive cardiovascular strategy.
Scenario: A patient with obesity (BMI 32) and Type 2 Diabetes is struggling with weight loss despite consistent exercise. What additional intervention would you recommend?
- A. Reduce exercise frequency to avoid fatigue.
- B. Incorporate calorie tracking and portion control education.
- C. Eliminate all carbohydrates from their diet.
- D. Focus solely on increasing their exercise intensity.
Correct Answer: B. Incorporate calorie tracking and portion control education.
- B: Educating on calorie balance and portion control complements exercise for weight loss.
- A: Reducing exercise frequency could hinder progress.
- C: Eliminating all carbohydrates is unnecessary and unsustainable.
- D: Exercise alone may not address caloric intake imbalances.
What is a key feature of the SilverSneakers program?
- A. High-intensity, competitive exercises for seniors.
- B. Group-based activities to improve physical and emotional health.
- C. Individualized telehealth-based exercise programs.
- D. Focus on rehabilitation for athletes.
Correct Answer: B. Group-based activities to improve physical and emotional health.
- B: SilverSneakers emphasizes social support and group-based exercises to enhance overall health.
- A: High intensity is not a focus of the program.
- C: Telehealth is not a central component of SilverSneakers.
- D: The program is designed for older adults, not athletes.
Scenario: A 54-year-old patient is attempting to quit smoking but reports relapse after 3 weeks. What is the most effective strategy?
- A. Encourage them to quit cold turkey without further intervention.
- B. Provide behavioral counseling and recommend pharmacologic cessation aids.
- C. Advise them to wait until they are “ready” to quit again.
- D. Suggest reducing cigarette use to half a pack daily.
Correct Answer: B. Provide behavioral counseling and recommend pharmacologic cessation aids.
- B: Combining behavioral counseling and pharmacologic aids improves long-term success rates.
- A: Cold turkey methods are less effective without support.
- C: Waiting delays progress and risks further health complications.
- D: Reducing use may be a step but does not address addiction fully.
