You have a 62 y.o. patient who had an ischemic stroke 2 years ago and is coming to you because she fell and broke her hip 8 weeks ago and thinks she is weak. She has 4 steps to enter her home and lives by herself. On assessment, you notice that she has an AFO on the R foot and evident flexion contracture in her R hand/UE. What are some treatment techniques worth considering? (select all that apply)

Consider activities involving upper extremity WB in order to increase bone strength

Consider FES to facilitate decreased spasticity in R hand/UE

Consider cardiovascular training with emphasis on decreasing BP

Consider aquatic therapy as the hydrostatic pressure may increase her BP as well as her strength

Two athletes competing to win a one mile race separate. One stays at sea level, and one goes to the top of Mt. Everest. After 6 months of training at their respective locations, the Mt. Everest athlete comes back to sea level to compete. What are some possible scenarios? (select all that apply)

The Mt. Everest athlete loses because his blood is too viscous from increased hemoglobin and hematocrit after having lived in elevation for that long and the blood cannot circulate fast enough to provide energy to his muscles.

The Mt. Everest athlete loses because the air was so thin, lacking density and resistance, at Mt. Everest that his respiratory muscles are now weak.

The Mt. Everest athlete wins because everybody knows that when you train at high altitudes you always win because your muscles have been trained with low oxygen and now there is a ton of oxygen at sea level.

The Mt. Everest athlete wins because the lack of Oxygen at high altitudes leads to increased concentric hypertrophy of muscles

Exercise for people with CHF can be as beneficial if not more beneficial than the best drug therapies. What is the main goal of exercise programs designed for patients with CHF? (select one answer)

Exercise at an intensity of 80% VO2 max for 10 minutes with 2 minute rest breaks

For which condition(s) would a power lifting prescription be contraindicated? (select one answer)

Pulmonary dysfunction under discretion of the physician

Your patient has COPD and has landed in the hospital due to hypoxia where he recently passed out and was brought to the ER. At your first visit, you could educate your patient on some techniques to allow for increased oxygen intake EXCEPT? (select one answer)

Recommend increased supplemental oxygen at all times in order to keep O2 sats at 100%.

Take small walks within moderate range on RPE scale instructing patient to stay between 2 and 3 and if he starts feeling winded, to stop and catch his breath

Instruct patient on pursed lip breathing

Recommend patient get oximeter for home use and use during your treatment session so patient can understand how to use it

Al is a healthy 68-year-old man who has noticed himself becoming weaker as he has gotten older. What type of exercise would likely be the most beneficial for improving his functionality as he ages? (select one answer)

Performing squats and coming up to standing as fast as he safely can

Performing slow and controlled leg exercises with resistance bands

Spending 30 minutes on an exercise bike set to low resistance

Performing glute squeeze exercises while he sits in his chair, being mindful to hold the muscle contraction for 5 seconds each time

Which of the following statements are true about the typical changes seen in muscle as people age? (select all that apply)

There is an overall decrease in strength and power

There is a greater proportion of Type IIB muscle fibers

There are fewer muscle fibers to a motor neuron

You are checking vitals as part of evaluation for a patient with obesity who uses a CPAP machine at night, who wishes to start an exercise program. What lung sounds are you most likely to hear during auscultation, and what is the most appropriate exercise recommendation? (single best answer)

Decreased sound transmission, and a walking program within the 55-60% VO2 max range, for 30 minutes a day.

Bronchophony, and a walking program of 10 minute bouts, 10-30x a week

Decreased sound transmission, and a strength training program for UE 2x a week, LE 3x a week.

Rhonchi, and a HITT program in 10 minute bouts, 10-30x a week.

You are treating an elderly patient who suffered from a fall, combined with a history of cervical stenosis resulting in a SCI at C6. Your patient suddenly starts to present a flushed face and neck, and complains of headache and blurred vision. What is happening to the nervous system and circulatory system and what might you check on the patient to address autonomic dysreflexia? (single best answer)

There is a sympathetic response below the level of injury causing vasoconstriction and increased blood pressure, which descending control from the brain cannot regulate. Check for noxious stimuli below level of injury, like bladder/bowel fullness.

There is a sympathetic response below the level of injury, which is causing vasodilation and decreased blood pressure, which descending control from the brain cannot regulate. Check for noxious stimuli below level of injury, like bladder/bowel fullness.

There is a sympathetic response to positional change above the level of injury, which is causing vasoconstriction and increased blood pressure. Check for spasticity in UE.

There is a parasympathetic response below the level of injury, which is causing vasodilation and decreased blood pressure which descending control from the brain cannot regulate. Check for spasticity in LE.

You have a patient who is 75 years old and a fall risk, who does not believe strength training will help their condition, telling you, “I’m just getting old.” Which of the following is the most scientifically accurate argument that strength training will help them (single best answer):

Yes, as we age we lose motor neurons and motor units, but some of these effects are reversible. Resistance training "as fast as you can" with moderate loads will increase muscle fiber size and improve balance.

Showing the patient pictures of elderly athletes and telling them “You can do it too!”

Yes, as we age we lose motor neurons and motor units, but some of these effects are reversible. If you strength train with heavy resistance at a slow speed, you can grow back the powerful muscles you had in your twenties.

Yes, as we age we lose motor neurons and motor units, but some of these effects are reversible. The resistance provided from water during swimming is enough to improve muscle strength and balance on land.

Comparing a successful professional 100m dash sprinter with a successful professional marathon runner, we would expect to see:

Higher glycogen stores in the sprinter; more capillaries, oxidative enzymes, and mitochondria in the marathon runner.

Higher glycogen stores and more capillaries in the sprinter, higher oxidative enzymes and mitochondria in the marathon runner.

More capillaries and mitochondria in the sprinter, higher glycogen stores and oxidative enzymes in the marathon runner.

More capillaries, oxidative enzymes and mitochondria in the sprinter; higher glycogen stores in the marathon runner.

Skylar has experienced a spinal cord injury (SCI) at the level of T4. What treatment option(s) would be appropriate to give to your patient? Select all that apply.

Functional electrical stimulation (FES)

When exercising a patient, which of the following is NOT a sign that you should immediately cease the exercise session?

A 61-year-old patient reaches a heart rate of 148 beats per minute

O2 saturation levels drop below 85%

Systolic BP decreases more than 10 mmHg after the onset of activity

You should immediately make the patient stop exercising in all of these situations

A patient with exercise induced asthma has a 15-20% decrease in FEV1/FVC estimated with a peak flow meter

Patients with the following condition should be given exercise prescriptions that primarily involve only aerobic exercises of the lower extremities.

Chronic Obstructive Pulmonary disease

A group of friends decide they want to challenge each other during a workout competition to see who can get the most sore. Out of the following scenarios, which person will have the most delayed onset muscle soreness? (Select the single best answer)

Friend who runs on flat terrain

Friend who does a combination of the three (uphill, downhill, and flat terrain)

An athlete comes into the PT clinic 10 weeks post-op from his ACL reconstruction. He has been progressing as expected since his surgery at another clinic, and is transitioning to your clinic after his family moved. Which of the following would you instruct as his PT regarding resistance training? (Select the single best answer)

Use free weights as they require greater accessory muscle activity to stabilize the load and therefore are more functional

Use machines because they load other muscles/bones too

Use machines because they will isolate one single muscle group

Use free weights because they allow for increased load on cartilage

A 56 y/o patient comes into the clinic who you have never seen before. She is recovering from a left femur fracture after falling in her backyard (no other health conditions). You are attempting to prescribe the correct amount of load for her resistance training exercises. Which of the following should you use? (Select the single best answer)

7-10RM because of her age and diagnosis

1-RM because it is the most accurate measure of strength

5RM since it is between the 1 rep maximum and 10 rep maximum and she is middle-aged and moderately healthy

She should perform as many reps as she can every exercise session to overload the muscle

You are working in the inpatient cardiac rehab unit and are about to see a patient who had an MI 3 days ago and coronary artery bypass graft (CABG). Which of the following considerations should you follow? (Choose all that apply)

Use analgesics before exercise to reduce incisional pain leading to shallow breathing

Do not use the arms to get in/out of the bed, chair, or front wheel walker

Relaxation during low intensity exercise (1-2 METS)

Avoid lifting over >20 lbs for 6-8 weeks

Light aerobic exercise on the treadmill immediately to prevent the formation of clots

You Think You Know Everything About Physics? This Quiz Will Prove You Wrong

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1/72 Questions

You have a 62 y.o. patient who had an ischemic stroke 2 years ago and is coming to you because she fell and broke her hip 8 weeks ago and thinks she is weak. She has 4 steps to enter her home and lives by herself. On assessment, you notice that she has an AFO on the R foot and evident flexion contracture in her R hand/UE. What are some treatment techniques worth considering? (select all that apply)
- Consider activities involving upper extremity WB in order to increase bone strength
- Consider aquatic therapy as the hydrostatic pressure may increase her BP as well as her strength
- Consider FES to facilitate decreased spasticity in R hand/UE
- Consider cardiovascular training with emphasis on decreasing BP

About This Quiz

Physics is the natural science that studies matter, its motion and behavior through space and time, and the related entities of energy and force.
You Think You Know Everything About Physics? This Quiz Will Prove You Wrong
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2.

Two athletes competing to win a one mile race separate. One stays at sea level, and one goes to the top of Mt. Everest. After 6 months of training at their respective locations, the Mt. Everest athlete comes back to sea level to compete. What are some possible scenarios? (select all that apply)
- The Mt. Everest athlete wins because everybody knows that when you train at high altitudes you always win because your muscles have been trained with low oxygen and now there is a ton of oxygen at sea level.
- The Mt. Everest athlete loses because his blood is too viscous from increased hemoglobin and hematocrit after having lived in elevation for that long and the blood cannot circulate fast enough to provide energy to his muscles.
- The Mt. Everest athlete loses because the air was so thin, lacking density and resistance, at Mt. Everest that his respiratory muscles are now weak.
- The Mt. Everest athlete wins because the lack of Oxygen at high altitudes leads to increased concentric hypertrophy of muscles
Correct Answer(s)

A. The Mt. Everest athlete loses because his blood is too viscous from increased hemoglobin and hematocrit after having lived in elevation for that long and the blood cannot circulate fast enough to provide energy to his muscles.
A. The Mt. Everest athlete loses because the air was so thin, lacking density and resistance, at Mt. Everest that his respiratory muscles are now weak.

Explanation

The Mt. Everest athlete loses because his blood is too viscous from increased hemoglobin and hematocrit after having lived in elevation for that long and the blood cannot circulate fast enough to provide energy to his muscles. Additionally, the Mt. Everest athlete loses because the air was so thin, lacking density and resistance, at Mt. Everest that his respiratory muscles are now weak. Training at high altitudes can lead to physiological adaptations such as increased red blood cell production, but it can also have negative effects on the body's ability to perform at lower altitudes due to changes in blood viscosity and respiratory muscle weakness.

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3.

Exercise for people with CHF can be as beneficial if not more beneficial than the best drug therapies. What is the main goal of exercise programs designed for patients with CHF? (select one answer)
- Increase anaerobic metabolism
- Decrease aerobic metabolism
- Decrease anaerobic metabolism
- Exercise at an intensity of 80% VO2 max for 10 minutes with 2 minute rest breaks
Correct Answer

A. Decrease anaerobic metabolism

Explanation

The main goal of exercise programs designed for patients with CHF is to decrease anaerobic metabolism. This is because CHF is characterized by a reduced ability of the heart to pump blood effectively, leading to inadequate oxygen supply to the muscles. By decreasing anaerobic metabolism, the exercise programs aim to improve the efficiency of oxygen utilization in the muscles, thereby reducing the strain on the heart and improving overall cardiovascular function.

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4.

For which condition(s) would a power lifting prescription be contraindicated? (select one answer)
- CHF
- Pulmonary dysfunction under discretion of the physician
- 77 yo with balance deficits
- 82 yo with strength deficits
Correct Answer

A. CHF

Explanation

A power lifting prescription would be contraindicated for individuals with Congestive Heart Failure (CHF). Power lifting involves heavy lifting and intense exertion, which can put a significant strain on the cardiovascular system. CHF is a condition where the heart is unable to pump blood effectively, and the added stress from power lifting could worsen the condition and potentially lead to complications. Therefore, it is not recommended for individuals with CHF to engage in power lifting activities.

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5.

Your patient has COPD and has landed in the hospital due to hypoxia where he recently passed out and was brought to the ER. At your first visit, you could educate your patient on some techniques to allow for increased oxygen intake EXCEPT? (select one answer)
- Recommend increased supplemental oxygen at all times in order to keep O2 sats at 100%.
- Take small walks within moderate range on RPE scale instructing patient to stay between 2 and 3 and if he starts feeling winded, to stop and catch his breath
- Instruct patient on pursed lip breathing
- Recommend patient get oximeter for home use and use during your treatment session so patient can understand how to use it
Correct Answer

A. Recommend increased supplemental oxygen at all times in order to keep O2 sats at 100%.

Explanation

It is not recommended to recommend increased supplemental oxygen at all times in order to keep O2 sats at 100% for a patient with COPD. This can lead to oxygen toxicity and can suppress the patient's respiratory drive. It is important to maintain O2 sats within a safe range, but not necessarily at 100%.

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6.

Barb is an elite hockey player in training for the next Olympics. Her coach has told her she needs to work on her quick shots to beat the goalie. She has been training for 3 weeks, and without warm up, she steps on the ice and takes a snap shot into the upper left hand corner of the net, and then proceeds to do that 10 times in a row without missing. Her coach applauds all her hard work. (select one answer) This is an example of:
- Reversibility principle
- Specificity principle
- Overload principle
- None of the above
Correct Answer

A. Specificity principle

Explanation

The specificity principle states that training should be specific to the desired outcome or goal. In this scenario, Barb's coach has identified that she needs to work on her quick shots to beat the goalie. Barb has been specifically training for this skill for 3 weeks and is able to consistently execute the desired shot without missing. This demonstrates the application of the specificity principle in her training.

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7.

Al is a healthy 68-year-old man who has noticed himself becoming weaker as he has gotten older. What type of exercise would likely be the most beneficial for improving his functionality as he ages? (select one answer)
- Performing slow and controlled leg exercises with resistance bands
- Performing squats and coming up to standing as fast as he safely can
- Spending 30 minutes on an exercise bike set to low resistance
- Performing glute squeeze exercises while he sits in his chair, being mindful to hold the muscle contraction for 5 seconds each time
Correct Answer

A. Performing squats and coming up to standing as fast as he safely can

Explanation

Performing squats and coming up to standing as fast as he safely can would likely be the most beneficial for improving his functionality as he ages. This type of exercise helps to improve strength, power, and balance, which are important for maintaining functionality and preventing falls in older adults. Additionally, the fast movement helps to improve reaction time and agility, which can also be beneficial for overall functionality.

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8.

Which of the following statements are true about the typical changes seen in muscle as people age? (select all that apply)
- There is an overall decrease in strength and power
- There is a greater proportion of Type IIB muscle fibers
- There are fewer muscle fibers to a motor neuron
- Endurance increases
Correct Answer(s)

A. There is an overall decrease in strength and power
A. Endurance increases

Explanation

As people age, there is a natural decline in muscle strength and power. This is due to various factors such as a decrease in muscle mass and a decline in the efficiency of muscle contraction. On the other hand, endurance tends to increase with age. This is because the body adapts to the aging process by relying more on slow-twitch muscle fibers, which are better suited for endurance activities. Therefore, the statement "There is an overall decrease in strength and power" and "Endurance increases" are both true about the typical changes seen in muscle as people age.

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9.

You are checking vitals as part of evaluation for a patient with obesity who uses a CPAP machine at night, who wishes to start an exercise program. What lung sounds are you most likely to hear during auscultation, and what is the most appropriate exercise recommendation? (single best answer)
- Decreased sound transmission, and a walking program within the 55-60% VO2 max range, for 30 minutes a day.
- Bronchophony, and a walking program of 10 minute bouts, 10-30x a week
- Decreased sound transmission, and a strength training program for UE 2x a week, LE 3x a week.
- Rhonchi, and a HITT program in 10 minute bouts, 10-30x a week.
Correct Answer

A. Decreased sound transmission, and a walking program within the 55-60% VO2 max range, for 30 minutes a day.

Explanation

The most likely lung sounds to be heard during auscultation in a patient with obesity who uses a CPAP machine at night would be decreased sound transmission. This is because obesity can lead to excess fat accumulation around the chest and abdomen, which can make it harder for sound to travel through the lungs. The most appropriate exercise recommendation for this patient would be a walking program within the 55-60% VO2 max range for 30 minutes a day. Walking is a low-impact exercise that can help improve cardiovascular fitness, and exercising within the VO2 max range ensures that the patient is working at an intensity that is beneficial for their overall health.

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10.

You are treating an elderly patient who suffered from a fall, combined with a history of cervical stenosis resulting in a SCI at C6. Your patient suddenly starts to present a flushed face and neck, and complains of headache and blurred vision. What is happening to the nervous system and circulatory system and what might you check on the patient to address autonomic dysreflexia? (single best answer)
- There is a sympathetic response below the level of injury, which is causing vasodilation and decreased blood pressure, which descending control from the brain cannot regulate. Check for noxious stimuli below level of injury, like bladder/bowel fullness.
- There is a sympathetic response to positional change above the level of injury, which is causing vasoconstriction and increased blood pressure. Check for spasticity in UE.
- There is a sympathetic response below the level of injury causing vasoconstriction and increased blood pressure, which descending control from the brain cannot regulate. Check for noxious stimuli below level of injury, like bladder/bowel fullness.
- There is a parasympathetic response below the level of injury, which is causing vasodilation and decreased blood pressure which descending control from the brain cannot regulate. Check for spasticity in LE.
Correct Answer

A. There is a sympathetic response below the level of injury causing vasoconstriction and increased blood pressure, which descending control from the brain cannot regulate. Check for noxious stimuli below level of injury, like bladder/bowel fullness.

Explanation

The correct answer explains that the patient is experiencing autonomic dysreflexia, which is characterized by a sympathetic response below the level of injury causing vasoconstriction and increased blood pressure. This response is not regulated by descending control from the brain. To address autonomic dysreflexia, the healthcare provider should check for noxious stimuli below the level of injury, such as bladder or bowel fullness.

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11.

You have a patient who is 75 years old and a fall risk, who does not believe strength training will help their condition, telling you, “I’m just getting old.” Which of the following is the most scientifically accurate argument that strength training will help them (single best answer):
- Showing the patient pictures of elderly athletes and telling them “You can do it too!”
- Yes, as we age we lose motor neurons and motor units, but some of these effects are reversible. If you strength train with heavy resistance at a slow speed, you can grow back the powerful muscles you had in your twenties.
- Yes, as we age we lose motor neurons and motor units, but some of these effects are reversible. The resistance provided from water during swimming is enough to improve muscle strength and balance on land.
- Yes, as we age we lose motor neurons and motor units, but some of these effects are reversible. Resistance training "as fast as you can" with moderate loads will increase muscle fiber size and improve balance.
Correct Answer

A. Yes, as we age we lose motor neurons and motor units, but some of these effects are reversible. Resistance training "as fast as you can" with moderate loads will increase muscle fiber size and improve balance.

Explanation

As we age, we naturally lose motor neurons and motor units, but it is possible to reverse some of these effects through strength training. Resistance training, specifically using moderate loads and performing the exercises as fast as possible, can increase muscle fiber size and improve balance. By engaging in strength training, the patient can regain some of the powerful muscles they had in their twenties, contrary to the belief that they are simply getting old.

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12.

Comparing a successful professional 100m dash sprinter with a successful professional marathon runner, we would expect to see:
- Higher glycogen stores and more capillaries in the sprinter, higher oxidative enzymes and mitochondria in the marathon runner.
- Higher glycogen stores in the sprinter; more capillaries, oxidative enzymes, and mitochondria in the marathon runner.
- More capillaries and mitochondria in the sprinter, higher glycogen stores and oxidative enzymes in the marathon runner.
- More capillaries, oxidative enzymes and mitochondria in the sprinter; higher glycogen stores in the marathon runner.
Correct Answer

A. Higher glycogen stores in the sprinter; more capillaries, oxidative enzymes, and mitochondria in the marathon runner.

Explanation

Sprinting is an anaerobic activity that relies on stored glycogen for energy, so a successful professional sprinter would have higher glycogen stores. On the other hand, marathon running is an aerobic activity that requires endurance, so a successful professional marathon runner would have more capillaries to deliver oxygen to the muscles, as well as higher levels of oxidative enzymes and mitochondria to produce energy aerobically.

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13.

For which of the following patient populations, is pulmonary function or capacity NOT a limiting factor in aerobic performance?
- Elite athlete
- typical untrained client
- client with emphysema
- Client with cystic fibrosis
Correct Answer

A. typical untrained client

Explanation

Pulmonary function or capacity refers to the ability of the lungs to take in oxygen and remove carbon dioxide. In an elite athlete, their well-trained lungs are able to efficiently perform these functions, making it not a limiting factor in their aerobic performance. However, for a typical untrained client, their lung capacity may not be optimized, and therefore it can be a limiting factor in their aerobic performance. Therefore, the correct answer is "typical untrained client".

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14.

Who can potentially benefit from pursed lip breathing?
- patients with asthma
- patients with COPD
- patients with emphysema
- all of these patients
Correct Answer

A. all of these patients

Explanation

Pursed lip breathing is a breathing technique that involves inhaling through the nose and exhaling slowly through pursed lips. This technique can be beneficial for patients with asthma, COPD (chronic obstructive pulmonary disease), and emphysema. Patients with these conditions often experience difficulty breathing and pursed lip breathing can help to improve lung function, increase oxygen intake, and reduce shortness of breath. Therefore, all of these patients can potentially benefit from pursed lip breathing.

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15.

Skylar has experienced a spinal cord injury (SCI) at the level of T4. What treatment option(s) would be appropriate to give to your patient? Select all that apply.
- Functional electrical stimulation (FES)
- Decrease muscle tone
- Avoid stretching
- Practice motor retraining
Correct Answer(s)

A. Functional electrical stimulation (FES)
A. Decrease muscle tone
A. Practice motor retraining

Explanation

Given that Skylar has experienced a spinal cord injury at the level of T4, there are several treatment options that would be appropriate for the patient. Functional electrical stimulation (FES) can be used to activate the muscles and improve function. Decreasing muscle tone can help manage spasticity and improve mobility. Practice motor retraining can help Skylar regain motor skills and improve overall function. Avoiding stretching may not be necessary or appropriate for this specific patient.

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16.

When exercising a patient, which of the following is NOT a sign that you should immediately cease the exercise session?
- O2 saturation levels drop below 85%
- Systolic BP decreases more than 10 mmHg after the onset of activity
- A 61-year-old patient reaches a heart rate of 148 beats per minute
- You should immediately make the patient stop exercising in all of these situations
- A patient with exercise induced asthma has a 15-20% decrease in FEV1/FVC estimated with a peak flow meter
Correct Answer

A. A 61-year-old patient reaches a heart rate of 148 beats per minute

Explanation

A heart rate of 148 beats per minute in a 61-year-old patient is not a sign that you should immediately cease the exercise session. While it is important to monitor heart rate during exercise, a heart rate of 148 beats per minute is within a normal range for a 61-year-old individual. Therefore, it does not indicate any immediate danger or need to stop the exercise session.

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17.

Patients with the following condition should be given exercise prescriptions that primarily involve only aerobic exercises of the lower extremities.
- Chronic Obstructive Pulmonary disease
- Coronary artery disease
- Duchenne muscular dystrophy
- Osteoporosis
Correct Answer

A. Coronary artery disease

Explanation

Patients with coronary artery disease should be given exercise prescriptions that primarily involve only aerobic exercises of the lower extremities. This is because aerobic exercises help improve cardiovascular health, increase heart and lung function, and lower the risk of heart-related complications. By focusing on lower extremity exercises, such as walking, jogging, or cycling, the workload on the heart is increased, promoting better blood flow to the heart and reducing the risk of heart attacks. Additionally, lower extremity exercises help improve leg strength and endurance, which can further enhance overall cardiovascular fitness.

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18.

A group of friends decide they want to challenge each other during a workout competition to see who can get the most sore. Out of the following scenarios, which person will have the most delayed onset muscle soreness? (Select the single best answer)
- Friend who runs uphill
- Friend who runs downhill
- Friend who runs on flat terrain
- Friend who does a combination of the three (uphill, downhill, and flat terrain)
Correct Answer

A. Friend who runs downhill
19.

An athlete comes into the PT clinic 10 weeks post-op from his ACL reconstruction. He has been progressing as expected since his surgery at another clinic, and is transitioning to your clinic after his family moved. Which of the following would you instruct as his PT regarding resistance training? (Select the single best answer)
- Use free weights as they require greater accessory muscle activity to stabilize the load and therefore are more functional
- Use machines because they load other muscles/bones too
- Use machines because they will isolate one single muscle group
- Use free weights because they allow for increased load on cartilage
Correct Answer

A. Use free weights as they require greater accessory muscle activity to stabilize the load and therefore are more functional

Explanation

Free weights require greater accessory muscle activity to stabilize the load, which makes them more functional. This is important for the athlete who is recovering from ACL reconstruction as it helps to improve overall strength and stability in the affected leg. Using machines may load other muscles and bones, but they do not provide the same level of functional training as free weights. Additionally, using free weights allows for increased load on cartilage, which can help to improve joint stability and strength.

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20.

A 56 y/o patient comes into the clinic who you have never seen before. She is recovering from a left femur fracture after falling in her backyard (no other health conditions). You are attempting to prescribe the correct amount of load for her resistance training exercises. Which of the following should you use? (Select the single best answer)
- 1-RM because it is the most accurate measure of strength
- 7-10RM because of her age and diagnosis
- 5RM since it is between the 1 rep maximum and 10 rep maximum and she is middle-aged and moderately healthy
- She should perform as many reps as she can every exercise session to overload the muscle
Correct Answer

A. 7-10RM because of her age and diagnosis

Explanation

The correct answer is 7-10RM because of her age and diagnosis. This recommendation takes into consideration the patient's age and the fact that she is recovering from a femur fracture. Using a 7-10RM (repetition maximum) allows for a moderate intensity level that is appropriate for her condition. It balances the need for strength training without putting excessive strain on the healing fracture. This approach ensures a safe and effective resistance training program for the patient.

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21.

What are the most effective PT interventions for knee osteoarthritis? (Choose all that apply)
- Aerobic exercise
- Strengthening
- Aquatic exercise
- Flexibility
- Manual therapy
Correct Answer(s)

A. Aerobic exercise
A. Strengthening
A. Aquatic exercise

Explanation

The most effective PT interventions for knee osteoarthritis include aerobic exercise, strengthening, and aquatic exercise. Aerobic exercise helps improve cardiovascular fitness and reduces pain and stiffness in the knee joint. Strengthening exercises focus on building muscle strength around the knee, which helps support and stabilize the joint. Aquatic exercise, done in water, reduces the impact on the knee joint while providing resistance for muscle strengthening. These interventions have been found to be effective in managing symptoms and improving function in individuals with knee osteoarthritis.

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22.

A 30 y/o female with a diagnosis of right shoulder dislocation comes into the clinic and you are taking her vitals at rest. Which of the following is not an appropriate vital sign and could potentially be a reason to delay exercise? (Select the single best answer)
- Sp02 < 90%
- RR: 19 breaths/min
- BP: 130/80
- HR: 65
Correct Answer

A. Sp02 < 90%
23.

You are working in the inpatient cardiac rehab unit and are about to see a patient who had an MI 3 days ago and coronary artery bypass graft (CABG). Which of the following considerations should you follow? (Choose all that apply)
- Use analgesics before exercise to reduce incisional pain leading to shallow breathing
- Avoid lifting over >20 lbs for 6-8 weeks
- Do not use the arms to get in/out of the bed, chair, or front wheel walker
- Relaxation during low intensity exercise (1-2 METS)
- Light aerobic exercise on the treadmill immediately to prevent the formation of clots
Correct Answer(s)

A. Use analgesics before exercise to reduce incisional pain leading to shallow breathing
A. Do not use the arms to get in/out of the bed, chair, or front wheel walker
A. Relaxation during low intensity exercise (1-2 METS)

Explanation

After a myocardial infarction (MI) and coronary artery bypass graft (CABG), the patient may experience incisional pain, which can lead to shallow breathing. Using analgesics before exercise can help reduce this pain, allowing the patient to breathe more deeply. Additionally, the patient should avoid using their arms to get in/out of bed, chair, or front wheel walker to prevent strain on the incision site. Relaxation during low-intensity exercise is important to prevent overexertion and allow the patient to gradually build up their exercise tolerance. Light aerobic exercise on the treadmill immediately after surgery is not recommended as it can increase the risk of clot formation.

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24.

During lung auscultation, crackles are heard in:
- Cystic fibrosis
- Pulmonary fibrosis
- Musculoskeletal deformities
- Pneumothorax
Correct Answer

A. Pulmonary fibrosis

Explanation

Pulmonary fibrosis is a condition characterized by the formation of scar tissue in the lungs, which can lead to breathing difficulties. Crackles are abnormal lung sounds that can be heard during auscultation and are often associated with conditions involving the lungs, such as pulmonary fibrosis. The crackles in pulmonary fibrosis are caused by the presence of stiff and damaged lung tissue, which disrupts the flow of air and creates the characteristic crackling sound.

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25.

During lung auscultation, wheezes are heard in:
- Cystic fibrosis
- Pulmonary fibrosis
- Musculoskeletal deformities
- Pneumothorax
Correct Answer

A. Cystic fibrosis

Explanation

Cystic fibrosis is a genetic disorder that affects the lungs and causes the production of thick, sticky mucus. This mucus can block the airways and lead to wheezing sounds during lung auscultation. Wheezes are typically caused by narrowed airways due to inflammation or obstruction, which is a common symptom in individuals with cystic fibrosis. Therefore, wheezes are heard in cystic fibrosis during lung auscultation.

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26.

During lung auscultation, diminished or absent breath sounds are heard in:
- Cystic fibrosis
- Pulmonary fibrosis
- Musculoskeletal deformities
- Pneumothorax
Correct Answer

A. Musculoskeletal deformities

Explanation

Musculoskeletal deformities can cause diminished or absent breath sounds during lung auscultation. This is because these deformities can restrict the movement of the chest wall and limit the expansion of the lungs. As a result, there may be a decrease in the intensity of breath sounds or they may not be audible at all. This can make it difficult for air to flow in and out of the lungs properly, leading to diminished or absent breath sounds.

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27.

Which pulse location provides the most accurate reading?
- Apical Pulse
- Brachial Pulse
- L Radial Pulse
- Carotid artery
Correct Answer

A. Apical Pulse

Explanation

The apical pulse provides the most accurate reading because it is taken directly over the apex of the heart, which allows for a more precise measurement of the heart's rhythm and rate. This location eliminates any potential for errors caused by peripheral pulses, such as the radial pulse, which may be affected by factors like peripheral vascular disease or irregularities in the arterial wall. Similarly, the brachial pulse may not accurately reflect the heart's activity. The carotid artery is also close to the heart, but it is not as reliable as the apical pulse due to the potential for variability in blood flow to the brain.

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28.

What is an appropriate submaximal exercise test for baseline aerobic capacity?
- 6 minute walk test
- 2 minute walk test
- Dynamic Gait Index
- Borg RPE training range and teach Pt. to self pace
- Timed sit to stand
Correct Answer

A. 6 minute walk test

Explanation

The 6 minute walk test is an appropriate submaximal exercise test for baseline aerobic capacity. This test measures the distance an individual can walk in 6 minutes, which is a good indicator of their aerobic endurance. It is a simple and easy test to administer, making it suitable for a wide range of individuals. By performing this test, healthcare professionals can assess a person's aerobic capacity and determine their baseline fitness level.

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29.

Why would a 2 minute step test be better tolerated by a geriatric client than a 6 minute test? (select all that apply)
- 2 minute tests are less metabolically taxing
- Safer for patients with balance and gait dysfunction
- 6 minute tests are a functionally appropriate assessment of baseline aerobic capacity
- These steady state tests assess different aspects of objective exercise intolerance
Correct Answer(s)

A. 2 minute tests are less metabolically taxing
A. Safer for patients with balance and gait dysfunction

Explanation

A 2 minute step test would be better tolerated by a geriatric client than a 6 minute test because it is less metabolically taxing. This means that the client would not have to exert as much energy during the shorter test, making it easier for them to complete. Additionally, the 2 minute test would be safer for patients with balance and gait dysfunction as it requires less time on their feet and reduces the risk of falls or other accidents.

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30.

A 4mm depression that disappears in 10-15 seconds is considered ___________________ pitting edema grade
- 0
- 1+
- 2+
- 3+
- 4+
Correct Answer

A. 2+

Explanation

A 4mm depression that disappears in 10-15 seconds is considered 2+ pitting edema grade. Pitting edema is a condition where there is swelling in the body due to the accumulation of fluid. The grading system for pitting edema ranges from 1+ to 4+. In this case, a 4mm depression that disappears within 10-15 seconds indicates moderate pitting edema, which is classified as 2+.

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31.

The formula for max HR is:
- 220 - age
- HR / 90% VO2 max
- (VO2 max * 1000)/weight
- (15 * max HR)/Resting HR
Correct Answer

A. 220 - age

Explanation

The given formula for max HR is 220 minus the person's age. This formula is commonly used to estimate the maximum heart rate a person can achieve during exercise. It is based on the observation that as a person ages, their maximum heart rate tends to decrease. By subtracting the age from 220, we can estimate the maximum heart rate for an individual.

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32.

The Bruce Protocol is an example of what kind of exercise test?
- Submaximal
- Maximal
- Symptom Limited
- Objectivitely-limited
- Incremental
Correct Answer(s)

A. Objectivitely-limited
A. Incremental

Explanation

The Bruce Protocol is an example of an incremental exercise test that is also objectivity-limited. Incremental exercise tests involve gradually increasing the intensity of the exercise over time, typically by increasing the speed and incline on a treadmill. Objectivity-limited means that the test is designed to reach a predetermined endpoint, such as a certain heart rate or level of exertion, rather than being limited by the participant's symptoms or fatigue.

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33.

Lactic acid is a buffer, energy source. Select the statement about lactic acid that is TRUE.
- Lactic acid signals oxidative pathways beginning in the ECF once O2 is present
- Lactic acid is used for various cells and tissues in the bloodstream
- Lactic acid is formed from pyruvate and participates in the TCA cycle when O2 isn’t present
- Lactic acid may buffer the muscle against increased extracellular NA+ concentrations during fatigue.
Correct Answer

A. Lactic acid is used for various cells and tissues in the bloodstream

Explanation

Lactic acid is used for various cells and tissues in the bloodstream. This means that lactic acid serves as a source of energy for different cells and tissues in the bloodstream.

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34.

Which modification(s) to a therapeutic exercise is most appropriate for a client with osteoarthritis? (select all that apply)
- Resistance exercises for quads, hams, transverse abdominis
- Interval walking for 1-5 minutes followed by 2-10 minutes of rest
- Lower extremity endurance at 60% max work rate
- ROM for knees bilaterally
Correct Answer(s)

A. Resistance exercises for quads, hams, transverse abdominis
A. ROM for knees bilaterally

Explanation

The most appropriate modifications for a client with osteoarthritis would be resistance exercises for the quads, hams, and transverse abdominis to help strengthen the muscles and provide stability to the affected joints. Additionally, performing range of motion exercises for the knees bilaterally can help improve flexibility and reduce stiffness in the joint. These modifications can help manage symptoms and improve overall function for individuals with osteoarthritis.

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35.

When considering exercise for patients with obesity, exercise intensity to reach the ‘fat burning zone’ should be:
- Generally between 40-60% max HR and 55-60% VO2 max
- Generally between 60-80% max HR and 55-60% VO2 max
- Generally between 40-60% max HR and 65-70% VO2 max
- Generally between 60-80% max HR and 65-70% VO2 max
Correct Answer

A. Generally between 60-80% max HR and 55-60% VO2 max

Explanation

The correct answer is generally between 60-80% max HR and 55-60% VO2 max. This is because exercising at this intensity range allows the body to burn a higher percentage of calories from fat. While exercising at a lower intensity may primarily burn fat, it does not burn as many overall calories. On the other hand, exercising at a higher intensity burns more calories overall, but a smaller percentage of those calories come from fat. Therefore, the recommended intensity range strikes a balance between burning a higher percentage of fat calories and burning a sufficient number of total calories.

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36.

What does EPOC stand for?
- Exercise pre-oxygen consumption
- Excess pre-oxygen consumption
- Excess post-exercise oxygen consumption
- Exercise post-excess oxygen consumption
Correct Answer

A. Excess post-exercise oxygen consumption

Explanation

EPOC stands for Excess post-exercise oxygen consumption. This term refers to the increased rate of oxygen intake that occurs after a strenuous workout or exercise session. During intense physical activity, the body consumes more oxygen to meet the increased energy demands. After the exercise is completed, the body continues to consume oxygen at an elevated rate to restore energy levels, repair tissues, and remove metabolic waste products. This increased oxygen consumption post-exercise helps to replenish energy stores and aids in recovery.

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37.

When muscle contracts upon stimulation, calcium ions bind to _______, which exposes the binding sites for the myosin cross bridges to attach to
- Actin
- Myosin
- Troponin
Correct Answer

A. Troponin

Explanation

When a muscle contracts upon stimulation, calcium ions bind to troponin. Troponin is a protein complex that is located on the actin filament of the muscle. When calcium ions bind to troponin, it causes a conformational change in the troponin-tropomyosin complex, exposing the binding sites on the actin filament. This allows the myosin cross bridges to attach to the actin filament, initiating the sliding of the filaments and muscle contraction.

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38.

ATP can be made in muscles from stored glucose. In muscles, glucose is stored in the form of
- Energy
- Creatine
- Pyruvate
- Glycogen
Correct Answer

A. Glycogen

Explanation

Glycogen is the correct answer because it is a complex carbohydrate that serves as the primary storage form of glucose in the body. When ATP is needed for energy, glycogen is broken down through a process called glycogenolysis to release glucose molecules. These glucose molecules are then used to produce ATP, providing energy for muscle contractions. Therefore, glycogen acts as a readily available source of glucose in muscles, allowing ATP to be made efficiently when needed.

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39.

Which of the following is the correct sequence for the production of ATP for muscle contraction:
- Anaerobic respiration, CP, aerobic respiration
- Aerobic respiration, CP, anaerobic respiration
- CP, anaerobic respiration, aerobic respiration
Correct Answer

A. CP, anaerobic respiration, aerobic respiration

Explanation

The correct sequence for the production of ATP for muscle contraction is CP (creatine phosphate), which provides immediate energy for short bursts of activity, followed by anaerobic respiration, which produces ATP in the absence of oxygen but is less efficient, and finally aerobic respiration, which is the most efficient way to produce ATP and requires oxygen.

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40.

ATP is required for muscles to contract. Which of the following statements is incorrect?
- ATP is used to get cross bridges to bind to actin
- ATP is used to get cross bridges to disconnect from actin
- ATP is used to get the troponin-tropomyosin complex to move in such a manner to expose the binding site.
Correct Answer

A. ATP is used to get the troponin-tropomyosin complex to move in such a manner to expose the binding site.

Explanation

ATP is not used to get the troponin-tropomyosin complex to move in such a manner to expose the binding site. Instead, ATP is used to get the cross bridges to disconnect from actin, allowing the troponin-tropomyosin complex to move and expose the binding site.

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41.

When is lactic acid NOT produced in the series of reactions?
- Glycolysis
- Aerobic respiration
- Anaerobic respiration
Correct Answer

A. Glycolysis

Explanation

Lactic acid is not produced in the series of reactions during glycolysis. Glycolysis is the first step in cellular respiration that breaks down glucose into pyruvate molecules. In the absence of oxygen, pyruvate is converted into lactic acid through a process called anaerobic respiration. However, in glycolysis, lactic acid is not produced as pyruvate is further metabolized in the presence of oxygen during aerobic respiration.

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42.

Angina, chest pain from mild coronary ischemia, produces referral pain along which afferent innervation patterns
- C1-T5
- T5-C8
- C2-C7
- T1-T6
Correct Answer

A. C1-T5

Explanation

Angina, chest pain from mild coronary ischemia, produces referral pain along the afferent innervation patterns of C1-T5. This means that the pain is referred to areas that are innervated by the spinal nerves originating from the cervical (C1-C8) and thoracic (T1-T5) regions of the spinal cord. Therefore, the correct answer is C1-T5.

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43.

For which condition is resistance training contraindicated? (Select all that apply)
- DMD
- Unstable Angina
- CAD
- PAD
- Early Post MI
Correct Answer(s)

A. DMD
A. Unstable Angina
A. Early Post MI

Explanation

Resistance training is contraindicated for individuals with DMD (Duchenne muscular dystrophy) because it is a progressive muscle-wasting disease, and resistance training can further damage the weakened muscles. It is also contraindicated for individuals with unstable angina, as resistance training can put additional strain on the heart, potentially triggering a heart attack. Similarly, individuals with early post MI (myocardial infarction) should avoid resistance training as it can strain the healing heart tissue and increase the risk of further damage. However, resistance training can be beneficial for individuals with CAD (coronary artery disease) and PAD (peripheral artery disease) as it helps improve cardiovascular health and muscle strength.

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44.

Which VO2 Max test is better for sedentary, untrained individuals?
- YMCA Bike Test
- Submax VO2 II
- Submax VO@ III
- Timed it to Stand Test
Correct Answer

A. YMCA Bike Test

Explanation

The YMCA Bike Test is better for sedentary, untrained individuals because it is designed to be less intense and more suitable for individuals who may not be accustomed to high levels of exercise. This test involves cycling on a stationary bike at a moderate intensity for a set period of time, making it more accessible for those who are not physically active. The other options, Submax VO2 II and Submax VO2 III, are likely more suitable for individuals who are already moderately active or have some level of fitness. The Timed it to Stand Test is not a VO2 Max test and is not directly related to measuring aerobic capacity.

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45.

Functional Reserve is defined as:
- Volume of one breath, or the amount of air moved into and out of the lungs during quiet breathing
- Amount of air moved into the lungs during a forced inspiration (beyond tidal inspiration)
- Volume remaining after a normal, passive, exhalation.
- Amount of air moved out of lungs during forced expiration (beyond tidal expiration)
- The volume of air in the lungs upon the maximum effort of inspiration.
Correct Answer

A. Volume remaining after a normal, passive, exhalation.

Explanation

The correct answer is "volume remaining after a normal, passive, exhalation." This refers to the amount of air that is left in the lungs after a normal breath out, without any extra effort or force. It represents the amount of air that can still be exhaled after a regular breath.

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46.

For which client(s) is pulmonary function not limiting (select all that apply)
- Elite Athletes
- Typical Clients
- Clients with treated asthma
- Clients with untreated asthma
- Chronic Bronchitis
Correct Answer(s)

A. Typical Clients
A. Clients with treated asthma

Explanation

The pulmonary function is not limiting for typical clients because they do not have any underlying respiratory conditions that would affect their lung capacity. Additionally, clients with treated asthma have their condition managed through medication and treatment, which allows them to have normal pulmonary function. However, clients with untreated asthma may have limited pulmonary function due to the uncontrolled inflammation and constriction of their airways. Chronic bronchitis, on the other hand, can cause long-term damage to the airways, leading to limited pulmonary function.

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47.

Which vital(s) would you monitor for a COPD Client and Client with CHF during Exercise?
- RPE
- BP
- SPO2
- HR
- RPE Dyspnea
Correct Answer(s)

A. SPO2
A. RPE Dyspnea

Explanation

During exercise, it is important to monitor the oxygen saturation levels (sPO2) in both COPD and CHF clients as it indicates the amount of oxygen being delivered to the body. Additionally, monitoring the rating of perceived exertion (RPE) dyspnea is crucial as it helps assess the client's subjective experience of breathlessness during exercise. These vital signs provide valuable information about the respiratory and cardiovascular status of the clients, allowing for appropriate interventions and adjustments in the exercise program if necessary.

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48.

What provides the heart’s energy at rest?
- Lactate
- FFA
- Triglycerides
- A & B only
- All of the above are correct
Correct Answer

A. FFA

Explanation

FFA, also known as free fatty acids, provide the heart's energy at rest. Free fatty acids are a major source of fuel for the heart, especially during periods of rest or low-intensity exercise. They are released from stored triglycerides in adipose tissue and transported to the heart for energy production. Lactate and triglycerides are not the primary sources of energy for the heart at rest, making options A and C incorrect. Option D is also incorrect as it only includes lactate and FFA, while option E is the correct answer as it includes all of the above sources of energy for the heart at rest.

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49.

Which of the following are exercise goals for a patient with PAD- select all that apply
- Increased vasodilation
- Increased collateralization
- Increased walking tolerance
- Decreased vasodilation
Correct Answer(s)

A. Increased vasodilation
A. Increased collateralization
A. Increased walking tolerance

Explanation

The exercise goals for a patient with PAD (Peripheral Arterial Disease) include increased vasodilation, increased collateralization, and increased walking tolerance. Increased vasodilation helps to improve blood flow to the affected limbs, while increased collateralization refers to the development of new blood vessels to bypass blocked arteries. Both of these goals aim to improve circulation and reduce symptoms. Increased walking tolerance is also important as it helps to improve cardiovascular fitness and overall endurance, allowing the patient to engage in more physical activity without experiencing pain or discomfort. Decreased vasodilation is not a goal for a patient with PAD, as it would further restrict blood flow and worsen symptoms.

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Current Version
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Quiz Edited by
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Jun 07, 2021

Quiz Created by
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You Think You Know Everything About Physics? This Quiz Will Prove You Wrong

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Two athletes competing to win a one mile race separate. One stays at sea level, and one goes to the top of Mt. Everest. After 6 months of training at their respective locations, the Mt. Everest athlete comes back to sea level to compete. What are some possible scenarios? (select all that apply)

Exercise for people with CHF can be as beneficial if not more beneficial than the best drug therapies. What is the main goal of exercise programs designed for patients with CHF? (select one answer)

For which condition(s) would a power lifting prescription be contraindicated? (select one answer)

Your patient has COPD and has landed in the hospital due to hypoxia where he recently passed out and was brought to the ER. At your first visit, you could educate your patient on some techniques to allow for increased oxygen intake EXCEPT? (select one answer)

Al is a healthy 68-year-old man who has noticed himself becoming weaker as he has gotten older. What type of exercise would likely be the most beneficial for improving his functionality as he ages? (select one answer)

Which of the following statements are true about the typical changes seen in muscle as people age? (select all that apply)

You are checking vitals as part of evaluation for a patient with obesity who uses a CPAP machine at night, who wishes to start an exercise program. What lung sounds are you most likely to hear during auscultation, and what is the most appropriate exercise recommendation? (single best answer)

You have a patient who is 75 years old and a fall risk, who does not believe strength training will help their condition, telling you, “I’m just getting old.” Which of the following is the most scientifically accurate argument that strength training will help them (single best answer):

Comparing a successful professional 100m dash sprinter with a successful professional marathon runner, we would expect to see:

For which of the following patient populations, is pulmonary function or capacity NOT a limiting factor in aerobic performance?

Who can potentially benefit from pursed lip breathing?

Skylar has experienced a spinal cord injury (SCI) at the level of T4. What treatment option(s) would be appropriate to give to your patient? Select all that apply.

When exercising a patient, which of the following is NOT a sign that you should immediately cease the exercise session?

Patients with the following condition should be given exercise prescriptions that primarily involve only aerobic exercises of the lower extremities.

A group of friends decide they want to challenge each other during a workout competition to see who can get the most sore. Out of the following scenarios, which person will have the most delayed onset muscle soreness? (Select the single best answer)

What are the most effective PT interventions for knee osteoarthritis? (Choose all that apply)

A 30 y/o female with a diagnosis of right shoulder dislocation comes into the clinic and you are taking her vitals at rest. Which of the following is not an appropriate vital sign and could potentially be a reason to delay exercise? (Select the single best answer)

You are working in the inpatient cardiac rehab unit and are about to see a patient who had an MI 3 days ago and coronary artery bypass graft (CABG). Which of the following considerations should you follow? (Choose all that apply)

During lung auscultation, crackles are heard in:

During lung auscultation, wheezes are heard in:

During lung auscultation, diminished or absent breath sounds are heard in:

Which pulse location provides the most accurate reading?

What is an appropriate submaximal exercise test for baseline aerobic capacity?

Why would a 2 minute step test be better tolerated by a geriatric client than a 6 minute test? (select all that apply)

A 4mm depression that disappears in 10-15 seconds is considered ___________________ pitting edema grade

The formula for max HR is:

The Bruce Protocol is an example of what kind of exercise test?

Lactic acid is a buffer, energy source. Select the statement about lactic acid that is TRUE.

Which modification(s) to a therapeutic exercise is most appropriate for a client with osteoarthritis? (select all that apply)

When considering exercise for patients with obesity, exercise intensity to reach the ‘fat burning zone’ should be:

What does EPOC stand for?

When muscle contracts upon stimulation, calcium ions bind to _______, which exposes the binding sites for the myosin cross bridges to attach to

ATP can be made in muscles from stored glucose. In muscles, glucose is stored in the form of

Which of the following is the correct sequence for the production of ATP for muscle contraction:

ATP is required for muscles to contract. Which of the following statements is incorrect?

When is lactic acid NOT produced in the series of reactions?

Angina, chest pain from mild coronary ischemia, produces referral pain along which afferent innervation patterns

For which condition is resistance training contraindicated? (Select all that apply)

Which VO2 Max test is better for sedentary, untrained individuals?

Functional Reserve is defined as:

For which client(s) is pulmonary function not limiting (select all that apply)

Which vital(s) would you monitor for a COPD Client and Client with CHF during Exercise?

What provides the heart’s energy at rest?

Which of the following are exercise goals for a patient with PAD- select all that apply