NPTE-PT Cardiopulmonary Assessment and Management 3 — Questions and Answers
Question 1: Which parameter BEST reflects a patient's ventilatory reserve during a cardiopulmonary exercise test?
- Maximum heart rate achieved
- Breathing reserve (MVV minus peak VE) (Correct answer)
- Oxygen pulse at peak exercise
- Anaerobic threshold
Correct answer: Breathing reserve (MVV minus peak VE)
Breathing reserve (MVV − peak VE) indicates how close a patient is to their maximum ventilatory capacity, reflecting ventilatory limitation.
Question 2: A 6-Minute Walk Test is performed on a patient with pulmonary fibrosis. The MOST important physiologic variable to monitor during this test is:
- Blood pressure
- Rate of perceived exertion only
- Oxygen saturation via pulse oximetry (Correct answer)
- Respiratory rate
Correct answer: Oxygen saturation via pulse oximetry
Patients with pulmonary fibrosis are prone to severe exercise-induced desaturation, making continuous SpO2 monitoring essential during the 6MWT.
Question 3: The Borg RPE scale is used during cardiopulmonary rehabilitation. A patient reports an RPE of 13. This corresponds to which perceived exertion level?
- Light
- Somewhat hard (Correct answer)
- Hard
- Very hard
Correct answer: Somewhat hard
On the original Borg 6–20 scale, a rating of 13 corresponds to 'somewhat hard,' which is a moderate intensity typically targeted in cardiac rehab.
Question 4: A patient with a recent MI is in Phase I cardiac rehabilitation. Which activity is MOST appropriate during this phase?
- Treadmill walking at 3.5 METs
- Low-intensity ADLs and bedside range of motion (Correct answer)
- Stationary cycling at 70% of max heart rate
- Stair climbing with moderate resistance
Correct answer: Low-intensity ADLs and bedside range of motion
Phase I (inpatient) cardiac rehab focuses on low-intensity activities (1–2 METs) such as ADLs and gentle range of motion to prevent deconditioning without stressing the heart.
Question 5: A therapist reviews a chest X-ray and notes opacification of the right lower lobe with an air bronchogram. This radiographic finding is MOST consistent with:
- Pneumothorax
- Pleural effusion
- Lobar pneumonia (Correct answer)
- Pulmonary embolism
Correct answer: Lobar pneumonia
Air bronchograms within an area of opacification indicate air-filled bronchi surrounded by consolidated (fluid-filled) lung tissue, characteristic of lobar pneumonia.
Question 6: During a physical therapy session, a patient suddenly develops tracheal deviation toward the right side, absent breath sounds on the left, and hypotension. The therapist should suspect:
- Left-sided pneumonia
- Right-sided pleural effusion
- Left-sided tension pneumothorax (Correct answer)
- Pulmonary embolism
Correct answer: Left-sided tension pneumothorax
Tension pneumothorax causes tracheal deviation away from the affected side due to mediastinal shift, along with absent breath sounds and hemodynamic compromise.
Question 7: Which diaphragmatic breathing technique MOST effectively reduces accessory muscle use in a patient with COPD?
- Pursed-lip breathing combined with diaphragmatic breathing (Correct answer)
- Glossopharyngeal breathing
- Incentive spirometry
- Controlled coughing technique
Correct answer: Pursed-lip breathing combined with diaphragmatic breathing
Pursed-lip breathing slows expiration and maintains positive airway pressure to prevent dynamic airway collapse, and when combined with diaphragmatic breathing reduces accessory muscle recruitment.
NPTE-PT Cardiopulmonary Assessment and Management 3
Which parameter BEST reflects a patient's ventilatory reserve during a cardiopulmonary exercise test?