CCRP AACVPR PRACTICE EXAM UPDATED QUESTIONS AND
ANSWERS SURE A+
✔✔Effects of other tobacco constituents on the cardiovascular system - ✔✔-platelet
aggregability
-promotes adherence of platelets to damaged endothelium
✔✔MI risk within 2 years of smoking cessation - ✔✔decreases risk of MI and rate of
restenosis following bypass by 50%
✔✔Chemicals released in the brain 10-12 seconds after inhaling a cigarette - ✔✔-
Dopamine
-Serotonin
-Norepinephrine
-Glutarnate
-Gaba
-B-Endorphin
✔✔Dopamine effects - ✔✔pleasure and appetite suppression
✔✔Serotonin effects - ✔✔antidepressant, regulates anger, mood modulation and
appetite suppression
✔✔Norepinephrine effects - ✔✔stimulates, focus and increases metabolism
✔✔Gaba effects - ✔✔reduces anxiety and tension
✔✔Glutarnate effects - ✔✔memory enhancement
✔✔B-Endorphin effects - ✔✔reduces anxiety and tension
✔✔Goal of therapy in tobacco cessation - ✔✔normalize brain function or
minimize/delete withdrawal symptoms
✔✔Common nicotine withdrawal symptoms - ✔✔-depressive mood
-insomnia/restlessness/fatigue
- increased irritability, frustration, anger and anxiety
-difficulty concentrating
- increased appetite/weight gain
- decreased HR
- cough, chest tightness, constipation/gas
-mental cravings for a cigarettes
,✔✔Short exposures to second hand smoke can - ✔✔cause blood platelets to become
stickier, damage the lining of blood vessels, decrease coronary flow velocity reserves
and reduce HR variability
✔✔The 5 A's model for treating tobacco use and dependence - ✔✔Ask
Advise
Assess
Assist
Arrange
✔✔What is the American College of Chest Physicians Tobacco-Dependence treatment
tool kit - ✔✔The Fragerstrom test for Nicotine Dependence (FTND)
✔✔In patients with CVD, smoking cessation is associated with a - ✔✔
✔✔A score 5 or above on the Fragerstrom test for Nicotine Dependence (FTND) -
✔✔suggests high nicotine dependence and nicotine cessation medications and nicotine
replacement therapy is highly recommended
✔✔Essential skills of motivational interviewing - ✔✔open ended questions
reflective listening
affirmations
summary statements
✔✔The 5-Rs - ✔✔Relevance (why)
Risks (harm)
Rewards (benefits)
Roadblocks (barriers)
Repetition (repeat every visit)
✔✔Behavior change strategies for smoking cessation - ✔✔Physical strategies
(exercise, relaxation, changing habits, healthy substitutes)
Mental and cognitive strategies (remembering reasons why, recognize mental cravings)
✔✔Psychosocial issues that affects tobacco cessation - ✔✔Anxiety and depression
Mental healthy disorders
alcohol abuse
social support
✔✔Slips before quitting - ✔✔most smokers have 6-7 slips before complete cessation
✔✔Withdrawal symptoms duration - ✔✔2-4 weeks after quitting
,✔✔Best way to quit smoking - ✔✔combine smoking cessation medication with a
behavioral program
✔✔Nicotine gum precautions/warnings/contraindications - ✔✔Used with caution with
CV groups including immediate post MI patients (within 2 weeks), those with serious
arrhythmias, and unstable angina
✔✔Nicotine gum side effects - ✔✔mouth soreness, hiccups, dyspepsia and jaw ache
✔✔Nicotine inhaler precautions/warnings/contraindications - ✔✔Used with caution with
CV groups including immediate post MI patients (within 2 weeks), those with serious
arrhythmias, and unstable angina
✔✔Nicotine inhaler side effects - ✔✔local irritation in the mouth and throat, coughing,
rhinitis
✔✔Nicotine lozenge precautions/warnings/contraindications - ✔✔Used with caution with
CV groups including immediate post MI patients (within 2 weeks), those with serious
arrhythmias, and unstable angina
✔✔Nicotine lozenge side effects - ✔✔hiccups and heart burn are most common
increased headaches and coughing
✔✔Nicotine nasal spray precautions/warnings/contraindications - ✔✔Used with caution
with CV groups including immediate post MI patients (within 2 weeks), those with
serious arrhythmias, and unstable angina
✔✔Nicotine nasal spray side effects - ✔✔nasal irritation, nasal congestion, changes in
taste and smell
✔✔Nicotine nasal spray effects on nicotine levels - ✔✔produces the highest peak in
nicotine levels than other NRT and has highest dependence potential
✔✔Nicotine patch precautions/warnings/contraindications - ✔✔Used with caution with
CV groups including immediate post MI patients (within 2 weeks), those with serious
arrhythmias, and unstable angina
✔✔Nicotine patch side effects - ✔✔skin reaction
✔✔Burpropion precautions/warnings - ✔✔Generally well tolerated with CV patients;
occasional reports of HTN
✔✔Burpropion side effects - ✔✔insomnia, dry mouth
, ✔✔Burpropion contraindications - ✔✔contraindicated in those with hx of seizures or
eating disorders, on another form of bupropion or have used an MAO inhibitor in the
past 14 days
✔✔Varenicline precautions - ✔✔not contraindicated for patients with CVD
Use with caution with patients with CKD (creatinine clearance <30 mL/min) or on
dialysis
✔✔Varenicline warning - ✔✔depressed mood, change in behavior, suicidal ideation and
suicide have been reported
✔✔Varenicline side effects - ✔✔nausea, trouble sleeping , abnormal/vivid/strange
dreams, impair ability to drive or operate heavy machinery
✔✔Type I DM - ✔✔insufficient insulin production as the result of autoimmune B-cell
destruction in the pancetta leading to absolute insulin deficiency
✔✔Type II DM - ✔✔decreased sensitivity to available insulin due to insulin resistant
which is a gradual impairment of secretion of insulin and excess glucose production.
✔✔DM - ✔✔effects the body ability to utilize glucose
✔✔Weight loss and exercise have been shown to do what in those with DM -
✔✔improve insulin sensitivity and control hyperglycemia
✔✔Percentage of patients entering CR with DM - ✔✔25-30%
✔✔Glucose - ✔✔produced by the liver and functions as an energy source for cellular
metabolism and is required for daily life
✔✔When glucose enters the blood stream - ✔✔the pancreas releases insulin
✔✔Insulin - ✔✔a hormone produces by the pancreatic islets by B-cells designated to
lower blood glucose
✔✔Clinical features of DM no not become evident until a vital number of B-cells are
destroyed. What percentage - ✔✔70-80%
✔✔Hemoglobin A1c - ✔✔reflects average plasma glucose of the previous 12 weeks
and measures the attachment of glucose to hemoglobin in the blood
✔✔Normal HbA1c - ✔✔<5.7%
✔✔HbA1c diagnosis criteria for DM - ✔✔HbA1c ≥6.5%
ANSWERS SURE A+
✔✔Effects of other tobacco constituents on the cardiovascular system - ✔✔-platelet
aggregability
-promotes adherence of platelets to damaged endothelium
✔✔MI risk within 2 years of smoking cessation - ✔✔decreases risk of MI and rate of
restenosis following bypass by 50%
✔✔Chemicals released in the brain 10-12 seconds after inhaling a cigarette - ✔✔-
Dopamine
-Serotonin
-Norepinephrine
-Glutarnate
-Gaba
-B-Endorphin
✔✔Dopamine effects - ✔✔pleasure and appetite suppression
✔✔Serotonin effects - ✔✔antidepressant, regulates anger, mood modulation and
appetite suppression
✔✔Norepinephrine effects - ✔✔stimulates, focus and increases metabolism
✔✔Gaba effects - ✔✔reduces anxiety and tension
✔✔Glutarnate effects - ✔✔memory enhancement
✔✔B-Endorphin effects - ✔✔reduces anxiety and tension
✔✔Goal of therapy in tobacco cessation - ✔✔normalize brain function or
minimize/delete withdrawal symptoms
✔✔Common nicotine withdrawal symptoms - ✔✔-depressive mood
-insomnia/restlessness/fatigue
- increased irritability, frustration, anger and anxiety
-difficulty concentrating
- increased appetite/weight gain
- decreased HR
- cough, chest tightness, constipation/gas
-mental cravings for a cigarettes
,✔✔Short exposures to second hand smoke can - ✔✔cause blood platelets to become
stickier, damage the lining of blood vessels, decrease coronary flow velocity reserves
and reduce HR variability
✔✔The 5 A's model for treating tobacco use and dependence - ✔✔Ask
Advise
Assess
Assist
Arrange
✔✔What is the American College of Chest Physicians Tobacco-Dependence treatment
tool kit - ✔✔The Fragerstrom test for Nicotine Dependence (FTND)
✔✔In patients with CVD, smoking cessation is associated with a - ✔✔
✔✔A score 5 or above on the Fragerstrom test for Nicotine Dependence (FTND) -
✔✔suggests high nicotine dependence and nicotine cessation medications and nicotine
replacement therapy is highly recommended
✔✔Essential skills of motivational interviewing - ✔✔open ended questions
reflective listening
affirmations
summary statements
✔✔The 5-Rs - ✔✔Relevance (why)
Risks (harm)
Rewards (benefits)
Roadblocks (barriers)
Repetition (repeat every visit)
✔✔Behavior change strategies for smoking cessation - ✔✔Physical strategies
(exercise, relaxation, changing habits, healthy substitutes)
Mental and cognitive strategies (remembering reasons why, recognize mental cravings)
✔✔Psychosocial issues that affects tobacco cessation - ✔✔Anxiety and depression
Mental healthy disorders
alcohol abuse
social support
✔✔Slips before quitting - ✔✔most smokers have 6-7 slips before complete cessation
✔✔Withdrawal symptoms duration - ✔✔2-4 weeks after quitting
,✔✔Best way to quit smoking - ✔✔combine smoking cessation medication with a
behavioral program
✔✔Nicotine gum precautions/warnings/contraindications - ✔✔Used with caution with
CV groups including immediate post MI patients (within 2 weeks), those with serious
arrhythmias, and unstable angina
✔✔Nicotine gum side effects - ✔✔mouth soreness, hiccups, dyspepsia and jaw ache
✔✔Nicotine inhaler precautions/warnings/contraindications - ✔✔Used with caution with
CV groups including immediate post MI patients (within 2 weeks), those with serious
arrhythmias, and unstable angina
✔✔Nicotine inhaler side effects - ✔✔local irritation in the mouth and throat, coughing,
rhinitis
✔✔Nicotine lozenge precautions/warnings/contraindications - ✔✔Used with caution with
CV groups including immediate post MI patients (within 2 weeks), those with serious
arrhythmias, and unstable angina
✔✔Nicotine lozenge side effects - ✔✔hiccups and heart burn are most common
increased headaches and coughing
✔✔Nicotine nasal spray precautions/warnings/contraindications - ✔✔Used with caution
with CV groups including immediate post MI patients (within 2 weeks), those with
serious arrhythmias, and unstable angina
✔✔Nicotine nasal spray side effects - ✔✔nasal irritation, nasal congestion, changes in
taste and smell
✔✔Nicotine nasal spray effects on nicotine levels - ✔✔produces the highest peak in
nicotine levels than other NRT and has highest dependence potential
✔✔Nicotine patch precautions/warnings/contraindications - ✔✔Used with caution with
CV groups including immediate post MI patients (within 2 weeks), those with serious
arrhythmias, and unstable angina
✔✔Nicotine patch side effects - ✔✔skin reaction
✔✔Burpropion precautions/warnings - ✔✔Generally well tolerated with CV patients;
occasional reports of HTN
✔✔Burpropion side effects - ✔✔insomnia, dry mouth
, ✔✔Burpropion contraindications - ✔✔contraindicated in those with hx of seizures or
eating disorders, on another form of bupropion or have used an MAO inhibitor in the
past 14 days
✔✔Varenicline precautions - ✔✔not contraindicated for patients with CVD
Use with caution with patients with CKD (creatinine clearance <30 mL/min) or on
dialysis
✔✔Varenicline warning - ✔✔depressed mood, change in behavior, suicidal ideation and
suicide have been reported
✔✔Varenicline side effects - ✔✔nausea, trouble sleeping , abnormal/vivid/strange
dreams, impair ability to drive or operate heavy machinery
✔✔Type I DM - ✔✔insufficient insulin production as the result of autoimmune B-cell
destruction in the pancetta leading to absolute insulin deficiency
✔✔Type II DM - ✔✔decreased sensitivity to available insulin due to insulin resistant
which is a gradual impairment of secretion of insulin and excess glucose production.
✔✔DM - ✔✔effects the body ability to utilize glucose
✔✔Weight loss and exercise have been shown to do what in those with DM -
✔✔improve insulin sensitivity and control hyperglycemia
✔✔Percentage of patients entering CR with DM - ✔✔25-30%
✔✔Glucose - ✔✔produced by the liver and functions as an energy source for cellular
metabolism and is required for daily life
✔✔When glucose enters the blood stream - ✔✔the pancreas releases insulin
✔✔Insulin - ✔✔a hormone produces by the pancreatic islets by B-cells designated to
lower blood glucose
✔✔Clinical features of DM no not become evident until a vital number of B-cells are
destroyed. What percentage - ✔✔70-80%
✔✔Hemoglobin A1c - ✔✔reflects average plasma glucose of the previous 12 weeks
and measures the attachment of glucose to hemoglobin in the blood
✔✔Normal HbA1c - ✔✔<5.7%
✔✔HbA1c diagnosis criteria for DM - ✔✔HbA1c ≥6.5%
