Exercise Testing B

Question 1

Normal response to stress testing: blood pressure

Answer 1

Systolic: 120 to 250

Diastolic from 80 to 95

Question 2

Normal response to stress testing: Max heart rate is ___.

A high heart rate with no ECG changes are commonly seen in patients who are ___.

Answer 2

Up to 200

Deconditioned

Question 3

Normal response to stress testing: Maximum number of PVC’s during stress testing.

Answer 3

10 per minute.

PVC’s are commonly seen during exercise testing.

Question 4

During stress testing, if systolic BP doesn’t rise or the diastolic pressure falls rapidly, what should you do? What does this indicate?

Answer 4

Terminate the test and call the doctor.

It indicates that the patient’s cardiac output is not increasing appropriately.

Question 5

Normal response to stress testing: What is a normal RER? (Respiratory exchange ratio)

Answer 5

0.8 is normal RER.

Question 6

Normal response to stress testing: pH will (rise or fall) because of hyperventilation.
pH will (rise or fall) when anaerobic threshold is reached.

Answer 6

Rise with hyperventilation.

Fall when anaerobic threshold is reached.

Question 7

Normal response to stress testing: Dead space (VD/VT) will normally (increase or decrease) during stress testing.

Answer 7

Deadspace will decrease as a result of increased pulmonary perfusion.

Question 8

Normal response to stress testing: Pulmonary artery pressure will (Rise or fall) during stress testing.

Answer 8

It will stay the same. This is the result of recruitment and distension of vessels in the pulmonary vascular system.

Question 9

Normal response to stress testing: What does an increase in PAP indicate?

Answer 9

Ventilatory limitations due to lung disease or vascular impairment.

Question 10

You should end the test if minute volume (FEV1) is ___.

Answer 10

35

Question 11

Poor conditioning can be indicated by an increased heart rate with ___ watts. ECG will be ___.

Answer 11

Increased heart rate at low to moderate watts with normal ECG. (This question was in bold print in textbook. Know it!)

Question 12

To identify poor effort on a stress test, look at ___, ___, and ___. They will be normal. You can also look at the ___, which is less than ___ of the MVV. Also, ___ will not have been achieved.

Answer 12

ECG, SaO2, and heart rate are normal
MV is less than 70% of the MVV.
Anaerobic threshold has not been achieved. (Know this!)

Question 13

ECG changes that mean you should end the stress test: ST segment ___ or ___, Inverted ___ waves, Pathological ___ waves, multifocal ___.

Answer 13

elevation or depression
T waves
Q waves (very large Q waves)
Multifocal PVC’s

Question 14

If patient has angina during the test, what should you do?

Answer 14

End the test.

Question 15

If patient looks really pale and sweaty during the test, what should you do?

Answer 15

End the test.

Question 16

On the flow volume loop, a normal response to exercise will demonstrate a decrease in ___ and ___.

Answer 16

IRV and ERV

Question 17

The objective of a 6 min walk test (6MWT) is for the patient to ___.
What unit of measurement is used?

Answer 17

Walk as far as possible (meters) in 6 min.

Question 18

If SpO2 decreased lower that ___ during a 6 min walk test (6MWT), stop the test.
(True or false) The patient may slow down or stop to rest during the test.

Answer 18

85%

True

Question 19

Perodic re-testing of the 6 min walk test (6MWT) can measure changes in patient progress. A __% improvement is considered significant for patients with COPD.

Answer 19

10%

Question 20

What is the normal measurement of the central venous pressure? (mmHg and cm H2O)

Answer 20

2-6 mm Hg

4-12 cm H2O

Question 21

Central venous pressure may also be referred to as ___.

There’s 4 answers

Answer 21

Right side pre-load
Right atrial pressure
Right ventricular filling pressure
Right ventricular end-diastolic pressure

Question 22

The pulmonary artery pressure (PAP) is the same thing as ___.

Answer 22

Wedge pressure

Question 23

What is the normal pressure for the pulmonary artery pressure?

Answer 23

25/8
Mean: 14
(Remember PAP is the same thing as wedge pressure)

Question 24

When drawing a blood sample from the Swan-Ganz, what must you do first?
If you draw if with the balloon inflated, what will happen?

Answer 24

Deflate the balloon.

The blood will be arterial blood.

Question 25

PAP or wedge pressure may also be referred to as: (x5)

Answer 25

Left side preload
Left atrial pressure
Left atrial filling pressure
Left ventricular filling pressure
Left ventricular end-diastolic pressure

Question 26

You should terminate the stress test if the PaO2 decreases lower than ___.

Answer 26

55 torr

Question 27

In healthy people, the A-a gradient will be ___ during exercise.

Answer 27

20-30 torr

Question 28

Normal dead space is ___. During exercise, it will (increase or decrease?)

Answer 28

0.2 to 0.4.

Decrease

Question 29

Anaerobic threshold may not be reached in patients with ____.

Answer 29

Severe pulmonary disease

Question 30

According to the NBRC, what is the normal rate of breathing while at rest? (It’s not 12-20!)

Answer 30

8-12. (For testing purposes only!)

Question 31

When detecting poor effort, you can look at these three values. If they are less than ___ of the MVV, that’s poor conditioning.

Answer 31

Respiratory rate, tidal volume, and minute volume less than 70% of MVV.