CRRN Cardiac and Pulmonary Rehabilitation 2 — Questions and Answers
Question 1: A patient with heart failure (HF) is discharged from inpatient rehabilitation. Which daily monitoring instruction is MOST important for early detection of decompensation?
- Measure blood glucose every morning
- Weigh daily at the same time and report a gain of 2–3 lbs in 24 hours or 5 lbs in a week (Correct answer)
- Check pulse oximetry only when symptomatic
- Monitor urine color for hydration status
Correct answer: Weigh daily at the same time and report a gain of 2–3 lbs in 24 hours or 5 lbs in a week
Daily weights detect fluid retention early in HF; a weight gain of 2–3 lbs in 24 hours or 5 lbs in a week signals impending decompensation requiring immediate medical contact.
Question 2: A patient with chronic obstructive pulmonary disease is performing diaphragmatic breathing exercises. Which cue is MOST appropriate for the nurse to provide?
- Breathe with your chest, keeping your belly still
- Place one hand on your chest and one on your belly; let your belly rise first (Correct answer)
- Breathe as fast as possible to increase tidal volume
- Hold your breath for 10 seconds between each breath
Correct answer: Place one hand on your chest and one on your belly; let your belly rise first
Diaphragmatic breathing training cues the patient to use the diaphragm by expanding the abdomen (belly) rather than the chest during inhalation.
Question 3: A patient with peripheral arterial disease (PAD) begins supervised exercise rehabilitation. Which type of exercise has the STRONGEST evidence for improving walking distance?
- Swimming laps in a heated pool
- Supervised treadmill walking to the point of moderate claudication pain, then rest (Correct answer)
- Stationary cycling at low resistance
- Arm ergometry only to avoid leg pain
Correct answer: Supervised treadmill walking to the point of moderate claudication pain, then rest
Supervised treadmill walking to the threshold of claudication pain followed by rest is the most evidence-based exercise intervention for improving walking distance in PAD.
Question 4: A rehabilitation nurse is teaching a patient with atrial fibrillation about anticoagulation therapy with warfarin. Which food should the patient be educated to maintain at a CONSISTENT level in their diet?
- Red meat
- Vitamin K-rich foods such as leafy green vegetables (Correct answer)
- Dairy products
- High-glycemic carbohydrates
Correct answer: Vitamin K-rich foods such as leafy green vegetables
Vitamin K affects warfarin metabolism; consistent (not eliminated) consumption of Vitamin K-rich foods is key to maintaining a stable INR.
Question 5: When documenting a cardiac rehabilitation patient's exercise tolerance using METs (metabolic equivalents), which MET level corresponds to light household activities such as slow walking?
- 8–10 METs
- 1–2 METs (Correct answer)
- 5–6 METs
- 12–14 METs
Correct answer: 1–2 METs
Light household activities and slow walking require approximately 1–2 METs, which is used as a baseline for graded activity prescriptions in cardiac rehab.
Question 6: A pulmonary rehabilitation patient asks about the benefits of respiratory muscle training. Which response by the CRRN is MOST accurate?
- Respiratory muscle training cures COPD by reversing airway obstruction
- It can improve inspiratory muscle strength, reduce dyspnea, and enhance exercise capacity (Correct answer)
- It is only beneficial in patients on mechanical ventilation
- It increases FEV1 to normal levels in most patients
Correct answer: It can improve inspiratory muscle strength, reduce dyspnea, and enhance exercise capacity
Inspiratory muscle training strengthens the respiratory muscles, which reduces dyspnea perception and improves functional exercise capacity, though it does not reverse underlying COPD pathology.
CRRN Cardiac and Pulmonary Rehabilitation 2
A patient with heart failure (HF) is discharged from inpatient rehabilitation.
Which daily monitoring instruction is MOST important for early detection of decompensation?