CCRP Exercise Testing 1 — Questions and Answers
Question 1: What is the primary purpose of graded exercise testing (GXT) in cardiac rehabilitation?
- Assess functional capacity and cardiovascular response to exercise (Correct answer)
- Determine resting cardiac output
- Evaluate pulmonary function at rest
- Measure body composition changes
Correct answer: Assess functional capacity and cardiovascular response to exercise
GXT assesses a patient's functional capacity and cardiovascular response to increasing workloads to guide exercise prescription and identify potential ischemia.
Question 2: Which Bruce Protocol stage corresponds to approximately 7 METs of workload?
- Stage 1 (1.7 mph, 10% grade)
- Stage 2 (2.5 mph, 12% grade) (Correct answer)
- Stage 3 (3.4 mph, 14% grade)
- Stage 4 (4.2 mph, 16% grade)
Correct answer: Stage 2 (2.5 mph, 12% grade)
Bruce Protocol Stage 2 (2.5 mph at 12% grade) corresponds to approximately 7 METs of metabolic workload.
Question 3: On the Borg 6-20 RPE scale, which rating corresponds to 'somewhat hard' exercise intensity?
- 11
- 13 (Correct answer)
- 15
- 17
Correct answer: 13
A rating of 13 on the Borg 6-20 RPE scale corresponds to 'somewhat hard,' which is often within the target intensity range for cardiac rehabilitation exercise.
Question 4: Which ECG finding during exercise testing is most diagnostic of myocardial ischemia?
- Upsloping ST elevation of 1 mm
- Horizontal or downsloping ST depression 1 mm or greater (Correct answer)
- Transient right bundle branch block
- Peaked T waves in precordial leads
Correct answer: Horizontal or downsloping ST depression 1 mm or greater
Horizontal or downsloping ST depression of 1 mm or more measured at 80 ms after the J-point during exercise is the classic ECG indicator of exercise-induced myocardial ischemia.
Question 5: According to AHA guidelines, what level of ST depression is a relative indication to terminate an exercise stress test?
- 0.5 mm or more horizontal ST depression
- 1 mm or more upsloping ST depression
- 2 mm or more horizontal or downsloping ST depression (Correct answer)
- 1 mm or more ST elevation in all leads
Correct answer: 2 mm or more horizontal or downsloping ST depression
2 mm or more of horizontal or downsloping ST depression is a relative indication for test termination per AHA/ACC guidelines, reflecting a level of ischemia that poses significant patient risk.
Question 6: The 6-Minute Walk Test (6MWT) is most appropriate for assessing functional capacity in which patient population?
- Athletes returning to competitive sport after cardiac events
- Patients with moderate-to-severe functional limitations who cannot perform treadmill testing (Correct answer)
- Asymptomatic patients undergoing routine cardiac screening
- Patients requiring precise VO2 max quantification
Correct answer: Patients with moderate-to-severe functional limitations who cannot perform treadmill testing
The 6MWT is a simple, submaximal test ideal for patients with moderate-to-severe functional limitations, providing a practical measure of exercise tolerance without requiring maximal effort.
Question 7: During cardiopulmonary exercise testing (CPET), a respiratory exchange ratio (RER) of 1.10 or greater indicates what?
- Submaximal effort by the patient
- A near-maximal or maximal exercise effort (Correct answer)
- Respiratory failure requiring immediate test termination
- Metabolic alkalosis at rest
Correct answer: A near-maximal or maximal exercise effort
An RER of 1.10 or greater during CPET confirms a near-maximal or maximal effort, as excess CO2 from lactate buffering exceeds O2 consumption, validating peak VO2 as a true maximum.
CCRP Exercise Testing 1
What is the primary purpose of graded exercise testing (GXT) in cardiac rehabilitation?