420 Test
A maximal MET level less than _____ is associated with a significantly increased risk of mortality.
5
Assume you are conducting a GXT on a low risk adult client with not physician supervision. For which of the following should you stop the test?
A noticeable change in heart rhythm
Most complications during graded exercise testing occur:
Above 85% age-predicted HR max
When performing a clinical GXT, you will measure resting blood pressure prior to conducting a GXT using which of the following procedures?
cuff?
Which of the following is an absolute indication for terminating a clinical GXT?
cyanosis
During the GXT pretesting procedures, when interpreting the patient's EKG you notice a bradyarrhythmia. You conclude that a patient will not be able to conduct the GXT because the bradyarrhythmia is an absolute contraindication to conducting a GXT.
false
Prognosis is an assessment of the probable future course and presents of a cardiovascular disease symptoms.
false
Stenosis of which coronary artery is considered a relative contraindication to performing GXT?
left main coronary
Purposes of clinical exercise testing include:
to assess for CAD (and its severity) and make a prognosis of the likelihood of future cardiac events
A person who is experiencing chest pressure/tightness in the chest/shortness of breath/pain radiating down the left arm at much lower activity levels than previously reported is exhibiting unstable angina.
true
A treadmill test elicits 20-25% higher VO2max and peak HR than ergometer test.
true
A 42 year old patient with a resting HR of 82 bpm discontinued a GXT at 6 minutes 30 seconds with a peak heart rate of 182 bpm, RPE 17 and blood pressure 168/92. Based on the information provided how would you classify the chronotropic reserve? (Peak HR - Rest HR) / 220 - age - rest HR
1.04
Assume you are conducting a clinical GXT with a physician present. which of the following is an absolute indication for terminating the test?
Drop in systolic blood pressure > 10 mm Hg with an increase in workload and evidence of ischemia
A patient reporting a level 3 on the angina scale during a GXT is considered to have a relative indication for terminating a GXT. angina
False - absolute put
A patient completed a clinical GXT it was determined that it was a positive CAD. However, when they went on for further testing (angiogram), it was determined that there was no evidence of CAD. How would you classify the results of the GXT?
False??
A 40 year old patient discontinued their GXT at 4:00 of the Bruce Protocol due to a severe cramp in their right calf. There were no other symptoms reported, no significant EKG changes, normal hemodynamic response, achieved 78% of APMHR, and the RPE when GXT ended was 11. Based on the information provided, the GXT was sufficient enough to be considered a maximal GXT.
NO
You are preparing to perform a GXT on a severely deconditioned patient who has complained of external chest pain at low levels of activity in the past week. When deciding on a GXT protocol, which of the protocols listed below has, the lowest staring MET level would be most appropriate?
Naughton
A patient has been referred to your lab for a GXT to evaluate chest pain. During your initial evaluation it is apparent that they are not capable of walking on a treadmill. You will refer the patient for which test to evaluate their chest pain:
PIS?
On a risk stratification form, a client indicates that they recently started having an unpleasant awareness of forceful or rapid beating of the heart. The client is likely experiencing?
Palpitations
A blockage in which coronary artery will have the greatest impact on blood flow to the heart?
Proximal left coronary artery
A cardinal manifestation of cardiac disease is chest, neck, jaw, or arm pain/discomfort or angina equivalent. Which of the following is a key feature against an ischemic origin:
Sharp, stabbing aggravated by respiration
What is a slotted, stainless steel tube that acts as a scaffold to hold the walls of a coronary artery open, thereby improving blood flow and relieving the symptoms of coronary artery disease?
Stent
A high measured exercise capacity is considered a good prognostic indicator.
TRUE
Diagnosis is the determination of the presence of a disease or condition.
TRUE
Peak exercise blood pressure is measured at the termination of a GXT up to 15 seconds post exercise.
TRUE
For a client who has a contraindication to exercise testing but could benefit greatly from the information gained through testing, which of the following is true?
The contraindication is considered to be a relative contraindication.
Which of the following statements regarding GXT modalities is false?
Treadmill and cycle ergometer tests elicit similar VO2 max values.
A GXT protocol should select to allow the patient to achieve 50% of estimated VO2max in 8-12 minutes.
True?
Patients taking Beta blockers will have an attenuated HR response and will have normal chronotropic response to the increase in exercise intensity during a GXT.
True?
All of the following are absolute contraindications to graded exercise testing EXCEPT:
•Acute myocardial infarction within 2 days •Ongoing unstable angina •Uncontrolled cardiac arrhythmia with hemodynamic compromise •Active endocarditis •Symptomatic severe aortic stenosis •Decompensated heart failure •Acute pulmonary embolus, pulmonary infarction, or deep venous thrombosis •Acute myocarditis or pericarditis •Acute aortic dissection •Physical disability that precludes safe and adequate testing Ventricular aneurysm
A drop in SBP or a failure of SBP to increase with increased exercise intensity, can be associated with?
•CAD, valvular heart disease, cardiomyopathies •Associated with LV dysfunction
Which of the following are clinically accepted reasons for performing a graded exercise test?
•Extension of the history and physical exam (I) •Evaluate exertional discomfort (I) •Chest discomfort •Dyspnea •Leg discomfort •Palpitations •Cerebral symptoms •Evaluate presence of occult coronary artery disease (CAD) (Ia, IIB) •Risk stratification in patients with known CAD (I) •Follow-up therapy (IIa) •Exercise prescription (IIb)
