CCRP AACVPR STUDY GUIDE 2026 QUESTIONS AND
ANSWERS RATED A+
✔✔fat and diabetes - ✔✔high fat increases insulin resistance
MUFA/PUFA do no increase IR
reduced fat (sat fat) diet reduced A1C
✔✔in patients who take insulin, meals that are high in fat may require _____ insulin
than low fat meals - ✔✔more
✔✔weight loss and diabetes - ✔✔MNT(medical nutrition therapy) improves BP, A1C,
weight loss, and lipids
✔✔heart failure and sodium - ✔✔lower sodium recommendation than gen pop
less than 2000 mg and less than 2 L water consumed
✔✔optimal treatment for HF - ✔✔ACE inhibitors, diuretics, fluid restriciton
restore intracellular volume and renal blood flow
✔✔stage A/B CHF - ✔✔less than or equal to 1500 mg
✔✔stage C/D CHF - ✔✔less than 3000 mg
✔✔HF and water intake - ✔✔1.5-2 L per day
✔✔if HF is on fluid restriction and sweats profusely - ✔✔ask MD to increase fluid
allowance
✔✔HF and weight loss - ✔✔not prioritized for HF patients
✔✔diet patern for HF - ✔✔DASH, low sodium Mediterraean diet
✔✔social cognitive theory and diet - ✔✔personal factors and environment influence
each other
model or observed learning (environmental)
grocery tours, healthy food potlucks, etc
✔✔social determination theory and diet - ✔✔reinforcement
positive (measuring foods)
negative (skipping meals, eating out)
✔✔education and diet - ✔✔education materials for person who is ready or willing to
change
,✔✔goal setting and diet - ✔✔SMART goals
✔✔self-monitoring and diet - ✔✔awareness of healthy decisions
✔✔problem solving and diet - ✔✔identify problem (afternoon snacking) and inquire
what behaviors or steps must the pt make in order to eat candy bar in desk at work and
eliminate that step
✔✔mindful eating and intuitive eating - ✔✔helps with overeating
✔✔SBP increases with exercise more with - ✔✔isometric exercise
elderly
hypertensive
✔✔upper limits of SBP with exercise - ✔✔200-220 mmHg
✔✔DBP typically _____ with substantial exercise because of - ✔✔decreases; peripheral
vasodilation
✔✔hypertensive heart disease can cause - ✔✔LVH, LV systolic dysfunction, CAD, AA
and aortic dissection
✔✔environmental factors that lead to HTN - ✔✔sedentary lifestyle, excessive alcohol
ingestion, excessive sodium intake
✔✔most important risk factor for HTN - ✔✔age
✔✔age 60-69 - ✔✔50% have HTN
✔✔over age 70 - ✔✔75% have HTN
✔✔high systolic BP and old age - ✔✔aorta stiffens with age
✔✔comorbidities of HTN - ✔✔obesity
sleep apnea
intrinsic renal disease
✔✔secondary HTN - ✔✔5% of cases
CKD
renal artery stenosis
pheochromocytoma
sleep apnea
obesity
excessive aldosterone and cortisol secretion
,✔✔HTN pathophysiology - ✔✔sodium retention leads to increased fluid retention,
increased intravascular volumes, increased CO, and consequently raised BP
✔✔peripheral vascular resistance - ✔✔The force exerted against the blood flow and is
determined by the diameter of the vessel. The lower the vascular resistance the less
force is needed to eject the blood out of the heart during systole.
✔✔how does increased PVR happen - ✔✔structural changes in vascular wall -
remodeling of vessel walls and endothelial dysfunction
✔✔endothelium dependent vasodilation is impaired in ____ patients - ✔✔hypertensive
✔✔increased sympathetic tone in essential HTN - ✔✔resetting of peripheral and central
baroreceptors
✔✔elevated BP (one reading) - ✔✔greater than 130/80
d/t physiological stress, pain, acute illness, physiologic derangements
✔✔hypertension - ✔✔three consecutive readings of 130/80+ on different days
✔✔normal BP - ✔✔Systolic <120
Diastolic <80
✔✔Stage 1 HTN - ✔✔130-139/80-89
✔✔Stage 2 HTN - ✔✔>=140 or >=90
✔✔oversized BP cuff causes - ✔✔The low blood pressure reading
✔✔undersized BP cuff causes - ✔✔high BP reading
✔✔the center of the BP cuff should be at _____ level - ✔✔heart
✔✔width of the bladder cuff should equal _____% of arm circumference - ✔✔40
✔✔length of the cuff bladder should be enough to encircle ____% of the arm
circumference - ✔✔80
✔✔use arm with _____ reading if different - ✔✔higher
✔✔Ambulatory BP monitoring - ✔✔Indicated for evaluation of "white-coat" HTN.
Absence of 10-20% BP decrease during sleep may indicate increased CVD risk.
, ✔✔Pseudo-hypertension - ✔✔inaccurately high readings in the elderly due to stiff,
calcified arteries or in the obese due to a cuff that is too small
✔✔effect of hypertension on renal function - ✔✔angiotensin II raises BP by increasing
peripheral resistance and blood volume
✔✔Home blood pressure monitoring - ✔✔improve patient compliance with meds
predictive of adverse outcomes - stroke, MI
can take multiple (not just related to caffeine, stress, smoking, exercise)
✔✔how many times should patients take their BP at home - ✔✔12-14 times per week
(two at night and two in evening for at least three days in a row)
✔✔BP meds with decrease BP how long after dose - ✔✔1-2 hours
✔✔BP highest before _____ of meds - ✔✔next dose
✔✔orthostatic hypotension - ✔✔Decrease in blood pressure related to positional or
postural changes from lying to sitting or standing positions
-common in elderly patients in CR with OCM, valvular stenosis, LV systolic dysfunction
and pts on multiple BP meds
✔✔orthostatic hypotension 2 - ✔✔a drop in over 20 mmHg and over 10 mmHg from
sitting to standing
-dizziness, weakness, postural unsteadiness, fainting
✔✔exercise induced hypotension - ✔✔ischemia, obstruction lesions (valvular stenosis,
obstructive CM, pulmonary HTN)
d/t RV or LV dysfunction during exercise
✔✔post exercise hypotension - ✔✔excessive peripheral vasodilation-working above
anaerobic threshold
-hot environment or clothing causing vasodilation in skin
-dehydration causing reduction in sweat and cooling
✔✔what to tell patients with orthostatic hypotension - ✔✔stand up slowly from laying
down
sit in bed a minute or two before standing up
orthostatic tolerance is lowest in the morning (raise head of bed by 10-20 degrees)
hydrate well throughout the day
with meals - lower CHO content, alcohol intake, large meals
✔✔orthostatic triggers - ✔✔COPD (coughing) and constipation
ANSWERS RATED A+
✔✔fat and diabetes - ✔✔high fat increases insulin resistance
MUFA/PUFA do no increase IR
reduced fat (sat fat) diet reduced A1C
✔✔in patients who take insulin, meals that are high in fat may require _____ insulin
than low fat meals - ✔✔more
✔✔weight loss and diabetes - ✔✔MNT(medical nutrition therapy) improves BP, A1C,
weight loss, and lipids
✔✔heart failure and sodium - ✔✔lower sodium recommendation than gen pop
less than 2000 mg and less than 2 L water consumed
✔✔optimal treatment for HF - ✔✔ACE inhibitors, diuretics, fluid restriciton
restore intracellular volume and renal blood flow
✔✔stage A/B CHF - ✔✔less than or equal to 1500 mg
✔✔stage C/D CHF - ✔✔less than 3000 mg
✔✔HF and water intake - ✔✔1.5-2 L per day
✔✔if HF is on fluid restriction and sweats profusely - ✔✔ask MD to increase fluid
allowance
✔✔HF and weight loss - ✔✔not prioritized for HF patients
✔✔diet patern for HF - ✔✔DASH, low sodium Mediterraean diet
✔✔social cognitive theory and diet - ✔✔personal factors and environment influence
each other
model or observed learning (environmental)
grocery tours, healthy food potlucks, etc
✔✔social determination theory and diet - ✔✔reinforcement
positive (measuring foods)
negative (skipping meals, eating out)
✔✔education and diet - ✔✔education materials for person who is ready or willing to
change
,✔✔goal setting and diet - ✔✔SMART goals
✔✔self-monitoring and diet - ✔✔awareness of healthy decisions
✔✔problem solving and diet - ✔✔identify problem (afternoon snacking) and inquire
what behaviors or steps must the pt make in order to eat candy bar in desk at work and
eliminate that step
✔✔mindful eating and intuitive eating - ✔✔helps with overeating
✔✔SBP increases with exercise more with - ✔✔isometric exercise
elderly
hypertensive
✔✔upper limits of SBP with exercise - ✔✔200-220 mmHg
✔✔DBP typically _____ with substantial exercise because of - ✔✔decreases; peripheral
vasodilation
✔✔hypertensive heart disease can cause - ✔✔LVH, LV systolic dysfunction, CAD, AA
and aortic dissection
✔✔environmental factors that lead to HTN - ✔✔sedentary lifestyle, excessive alcohol
ingestion, excessive sodium intake
✔✔most important risk factor for HTN - ✔✔age
✔✔age 60-69 - ✔✔50% have HTN
✔✔over age 70 - ✔✔75% have HTN
✔✔high systolic BP and old age - ✔✔aorta stiffens with age
✔✔comorbidities of HTN - ✔✔obesity
sleep apnea
intrinsic renal disease
✔✔secondary HTN - ✔✔5% of cases
CKD
renal artery stenosis
pheochromocytoma
sleep apnea
obesity
excessive aldosterone and cortisol secretion
,✔✔HTN pathophysiology - ✔✔sodium retention leads to increased fluid retention,
increased intravascular volumes, increased CO, and consequently raised BP
✔✔peripheral vascular resistance - ✔✔The force exerted against the blood flow and is
determined by the diameter of the vessel. The lower the vascular resistance the less
force is needed to eject the blood out of the heart during systole.
✔✔how does increased PVR happen - ✔✔structural changes in vascular wall -
remodeling of vessel walls and endothelial dysfunction
✔✔endothelium dependent vasodilation is impaired in ____ patients - ✔✔hypertensive
✔✔increased sympathetic tone in essential HTN - ✔✔resetting of peripheral and central
baroreceptors
✔✔elevated BP (one reading) - ✔✔greater than 130/80
d/t physiological stress, pain, acute illness, physiologic derangements
✔✔hypertension - ✔✔three consecutive readings of 130/80+ on different days
✔✔normal BP - ✔✔Systolic <120
Diastolic <80
✔✔Stage 1 HTN - ✔✔130-139/80-89
✔✔Stage 2 HTN - ✔✔>=140 or >=90
✔✔oversized BP cuff causes - ✔✔The low blood pressure reading
✔✔undersized BP cuff causes - ✔✔high BP reading
✔✔the center of the BP cuff should be at _____ level - ✔✔heart
✔✔width of the bladder cuff should equal _____% of arm circumference - ✔✔40
✔✔length of the cuff bladder should be enough to encircle ____% of the arm
circumference - ✔✔80
✔✔use arm with _____ reading if different - ✔✔higher
✔✔Ambulatory BP monitoring - ✔✔Indicated for evaluation of "white-coat" HTN.
Absence of 10-20% BP decrease during sleep may indicate increased CVD risk.
, ✔✔Pseudo-hypertension - ✔✔inaccurately high readings in the elderly due to stiff,
calcified arteries or in the obese due to a cuff that is too small
✔✔effect of hypertension on renal function - ✔✔angiotensin II raises BP by increasing
peripheral resistance and blood volume
✔✔Home blood pressure monitoring - ✔✔improve patient compliance with meds
predictive of adverse outcomes - stroke, MI
can take multiple (not just related to caffeine, stress, smoking, exercise)
✔✔how many times should patients take their BP at home - ✔✔12-14 times per week
(two at night and two in evening for at least three days in a row)
✔✔BP meds with decrease BP how long after dose - ✔✔1-2 hours
✔✔BP highest before _____ of meds - ✔✔next dose
✔✔orthostatic hypotension - ✔✔Decrease in blood pressure related to positional or
postural changes from lying to sitting or standing positions
-common in elderly patients in CR with OCM, valvular stenosis, LV systolic dysfunction
and pts on multiple BP meds
✔✔orthostatic hypotension 2 - ✔✔a drop in over 20 mmHg and over 10 mmHg from
sitting to standing
-dizziness, weakness, postural unsteadiness, fainting
✔✔exercise induced hypotension - ✔✔ischemia, obstruction lesions (valvular stenosis,
obstructive CM, pulmonary HTN)
d/t RV or LV dysfunction during exercise
✔✔post exercise hypotension - ✔✔excessive peripheral vasodilation-working above
anaerobic threshold
-hot environment or clothing causing vasodilation in skin
-dehydration causing reduction in sweat and cooling
✔✔what to tell patients with orthostatic hypotension - ✔✔stand up slowly from laying
down
sit in bed a minute or two before standing up
orthostatic tolerance is lowest in the morning (raise head of bed by 10-20 degrees)
hydrate well throughout the day
with meals - lower CHO content, alcohol intake, large meals
✔✔orthostatic triggers - ✔✔COPD (coughing) and constipation
