CRRN Cardiac and Pulmonary Rehabilitation 1 — Questions and Answers
Question 1: A patient enrolled in Phase II cardiac rehabilitation after MI is exercising on a treadmill. Which heart rate finding is the THRESHOLD for stopping the session?
- Heart rate above 60% of maximum heart rate
- Heart rate exceeding the prescribed target range or symptoms of angina/dyspnea (Correct answer)
- Any increase in heart rate from resting baseline
- Heart rate above 50 bpm
Correct answer: Heart rate exceeding the prescribed target range or symptoms of angina/dyspnea
Cardiac rehab exercise should stop if the patient's heart rate exceeds the individualized prescribed limit or if symptoms such as angina, dyspnea, or dizziness occur.
Question 2: A rehabilitation nurse is educating a patient about the Borg Rating of Perceived Exertion (RPE) scale for home exercise after heart failure. Which RPE level indicates APPROPRIATE exercise intensity?
- RPE 6–8 (nothing to very, very light)
- RPE 11–14 (fairly light to somewhat hard) (Correct answer)
- RPE 17–19 (very hard to extremely hard)
- RPE 20 (maximum exertion)
Correct answer: RPE 11–14 (fairly light to somewhat hard)
An RPE of 11–14 on the 6–20 Borg scale represents moderate exercise intensity, which is safe and therapeutic for most cardiac rehabilitation patients.
Question 3: A patient with COPD is learning pursed-lip breathing in pulmonary rehabilitation. What is the PRIMARY purpose of this technique?
- Increase the respiratory rate to improve oxygenation
- Slow exhalation to reduce air trapping and dynamic hyperinflation (Correct answer)
- Strengthen the diaphragm through resistance
- Deliver higher FiO2 without supplemental oxygen
Correct answer: Slow exhalation to reduce air trapping and dynamic hyperinflation
Pursed-lip breathing creates back-pressure that slows expiratory flow, preventing small airway collapse and reducing dynamic hyperinflation in COPD.
Question 4: A rehabilitation nurse is assessing a patient one week post-coronary artery bypass graft (CABG). Which finding requires IMMEDIATE reporting?
- Mild sternal discomfort with deep breathing
- Sternal clicking with movement and fever of 101.8°F (Correct answer)
- Minor incision site bruising
- Fatigue with low-level activity
Correct answer: Sternal clicking with movement and fever of 101.8°F
Sternal instability (clicking) combined with fever suggests sternal dehiscence or mediastinitis, a life-threatening post-CABG complication requiring emergent evaluation.
Question 5: Which oxygen saturation level during pulmonary rehabilitation exercise REQUIRES supplemental oxygen to be initiated or increased?
- SpO2 ≥ 95%
- SpO2 < 88% (Correct answer)
- SpO2 90–94%
- SpO2 85% at rest only
Correct answer: SpO2 < 88%
An SpO2 below 88% during exercise indicates significant hypoxemia requiring supplemental oxygen to prevent exercise-induced desaturation complications.
Question 6: A patient in cardiac rehab has a resting blood pressure of 180/105 mmHg before the exercise session. What is the APPROPRIATE nursing action?
- Proceed with exercise at reduced intensity
- Withhold exercise and notify the physician (Correct answer)
- Administer an emergency antihypertensive and continue
- Have the patient rest 5 minutes and recheck once
Correct answer: Withhold exercise and notify the physician
A resting BP ≥ 180/110 mmHg is a contraindication to cardiac rehabilitation exercise; the nurse should withhold exercise and notify the supervising physician.
CRRN Cardiac and Pulmonary Rehabilitation 1
A patient enrolled in Phase II cardiac rehabilitation after MI is exercising on a treadmill.
Which heart rate finding is the THRESHOLD for stopping the session?