CCRP AACVPR COMPREHENSIVE 2026 EXAM
QUESTIONS AND ANSWERS RATED A+
✔✔If proper balance is not maintained due to heat stress, physical responses include -
✔✔heat cramps, heat syncope, dehydration, heat exhaustion, heat stroke
✔✔Signs and symptoms of being overheated - ✔✔dizziness, agitation, nausea,
hyperventilation, low blood pressure, chills, pale skin, cramps
✔✔In the situation of cold exposure the body - ✔✔generates heat as a result of the
metabolic demands of activity which causes a challenge of balancing heat gained
through metabolism and the heat loss to the environment
✔✔systemic consequences to extreme cold - ✔✔hypothermia
✔✔local consequences to extreme cold - ✔✔frost bite
✔✔Signs and symptoms of cold exposure - ✔✔chills, numbness, tingling, itching,
burning
✔✔PA at high elevation - ✔✔decreases in atmospheric pressure leads to decrease
arterial oxygen levels
✔✔Adverse symptoms to high altitude - ✔✔shortness of breath, peripheral edema,
headaches, nausea, fatigue
✔✔Common comorbid conditions that are a barrier to PA - ✔✔arthritis, PAD,
neurological disorders, cognitive, hearing, and vision deficits, pulmonary disease
✔✔For those with CAD, when exercising HR and BP rise and may exceed supply and
provoke - ✔✔coronary ischemia
✔✔Two methods to assess physical activity - ✔✔1- subjective and relines on an
individuals self-report
2- objective or direct measuring of physical activity
✔✔Subjective measures of physical activity involve - ✔✔recording activities as they are
performed or relying on recall - diaries/logs
✔✔Direct measures of physical activity involve - ✔✔using wearable devices
(pedometer, accelerometer)
✔✔to maximize caloric expenditure what type of exercise should be prioritized -
✔✔weight baring
,✔✔A step goal of less than 5000 steps per day indicates - ✔✔sedentary lifestyle
✔✔Psychosocial considerations encountered by CR staff - ✔✔Depression, anxiety,
social isolation, cognitive impairment, insomnia, poor regulation of healthy behaviors
✔✔Most frequently encountered psychosocial problem with heart disease -
✔✔depression
✔✔Depression risk stresses and pathophysiology - ✔✔increase risk of developing CV
and the pathophysiology and stresses associated with heart disease contribute to
development of depression
✔✔9-key symptoms os depression - ✔✔-depressed or sad mood
-loss of interest in activities that were previously pleasurable
-changes in appetite or weight
-changes in sleep
-marked reduced psychomotor activity or agitation
-fatigue
-guilty or worthless feeling
-concentration or thinking problems
-suicidal thoughts or behaviors
✔✔Qualifying patients of depression diagnosis after MI - ✔✔40%
✔✔Treatments for depression - ✔✔pharmacological, psychotherapy, and physical
exercise
✔✔Antidepressant contraindicated for heart patients - ✔✔tricyclic antidepressants
✔✔Medications for depression safe for CV patients - ✔✔SSRI (Selective serotonin re-
uptake inhibitor)
✔✔Structured exercise (for depression) has been shown to - ✔✔be as effective for
depression as SSRI medication in healthy older adults
✔✔Anxiety disorders - ✔✔generalized anxiety disorder
panic disorder
OCD
PTSD
Social anxiety disorder
specific phobias
,✔✔Type A behavior pattern - ✔✔the tendency toward easily aroused hostility,
impatience, a sense of time urgency, and competitive achievement strivings
✔✔Effect of social support on post MI mortality - ✔✔following MI, patients who were
socially isolated or lacked a close confidant were more likely to die than those with
social support
✔✔Most of psychosocial management is - ✔✔assessment, documentation, patient
education, and counseling and knowing when to refer patients to specialists
✔✔Smoking is associated with increased risk of - ✔✔CVD events, MI, SCD, restenosis
after PCI
✔✔In patients with CVD, smoking cessation is associated with a - ✔✔36% reduction of
risk of mortality
✔✔Two components of effective smoking cessation counseling - ✔✔Practical
counseling (problem solving/skill training)
Social support
✔✔7 first line medications reliable to increase smoking abstinence - ✔✔-nicotine gum
-nicotine inhaler
-nicotine lozenge
-nicotine nasal spray
-nicotine patch
-Bupropion DR
-Varenicline
✔✔Effects of nicotine - ✔✔promotes catecholamine release, constricts peripheral
arteries, releases carbon monoxide, effects blood lipids and leads to atherogensis
✔✔Nicotine promotes catecholamine realize which effects include - ✔✔Increased HR
and BP due to increased myocardial oxygen demand
✔✔Nicotine constricts peripheral arteries which effects include - ✔✔-interference of
blood flow to tissues
-decrease threshold for v-fib
-increase platelet activation
✔✔Nicotine leads to atherogenesis due to - ✔✔a decrease in HDL and increase of
oxygenation of LDL
✔✔Smoking releases carbon monoxide which causes - ✔✔-injuries to vascular
endothelium
, -interferes with red blood cells ability to carry oxygen which decreases the amount go
oxygen delivered to heart muscle
✔✔Carbon monoxide - ✔✔byproduct of nicotine
✔✔When carbon monoxide is interferes with red blood cells ability to carry oxygen how
is the heart affected - ✔✔a decreased amount of oxygen is delivered to the heart
muscle
✔✔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
QUESTIONS AND ANSWERS RATED A+
✔✔If proper balance is not maintained due to heat stress, physical responses include -
✔✔heat cramps, heat syncope, dehydration, heat exhaustion, heat stroke
✔✔Signs and symptoms of being overheated - ✔✔dizziness, agitation, nausea,
hyperventilation, low blood pressure, chills, pale skin, cramps
✔✔In the situation of cold exposure the body - ✔✔generates heat as a result of the
metabolic demands of activity which causes a challenge of balancing heat gained
through metabolism and the heat loss to the environment
✔✔systemic consequences to extreme cold - ✔✔hypothermia
✔✔local consequences to extreme cold - ✔✔frost bite
✔✔Signs and symptoms of cold exposure - ✔✔chills, numbness, tingling, itching,
burning
✔✔PA at high elevation - ✔✔decreases in atmospheric pressure leads to decrease
arterial oxygen levels
✔✔Adverse symptoms to high altitude - ✔✔shortness of breath, peripheral edema,
headaches, nausea, fatigue
✔✔Common comorbid conditions that are a barrier to PA - ✔✔arthritis, PAD,
neurological disorders, cognitive, hearing, and vision deficits, pulmonary disease
✔✔For those with CAD, when exercising HR and BP rise and may exceed supply and
provoke - ✔✔coronary ischemia
✔✔Two methods to assess physical activity - ✔✔1- subjective and relines on an
individuals self-report
2- objective or direct measuring of physical activity
✔✔Subjective measures of physical activity involve - ✔✔recording activities as they are
performed or relying on recall - diaries/logs
✔✔Direct measures of physical activity involve - ✔✔using wearable devices
(pedometer, accelerometer)
✔✔to maximize caloric expenditure what type of exercise should be prioritized -
✔✔weight baring
,✔✔A step goal of less than 5000 steps per day indicates - ✔✔sedentary lifestyle
✔✔Psychosocial considerations encountered by CR staff - ✔✔Depression, anxiety,
social isolation, cognitive impairment, insomnia, poor regulation of healthy behaviors
✔✔Most frequently encountered psychosocial problem with heart disease -
✔✔depression
✔✔Depression risk stresses and pathophysiology - ✔✔increase risk of developing CV
and the pathophysiology and stresses associated with heart disease contribute to
development of depression
✔✔9-key symptoms os depression - ✔✔-depressed or sad mood
-loss of interest in activities that were previously pleasurable
-changes in appetite or weight
-changes in sleep
-marked reduced psychomotor activity or agitation
-fatigue
-guilty or worthless feeling
-concentration or thinking problems
-suicidal thoughts or behaviors
✔✔Qualifying patients of depression diagnosis after MI - ✔✔40%
✔✔Treatments for depression - ✔✔pharmacological, psychotherapy, and physical
exercise
✔✔Antidepressant contraindicated for heart patients - ✔✔tricyclic antidepressants
✔✔Medications for depression safe for CV patients - ✔✔SSRI (Selective serotonin re-
uptake inhibitor)
✔✔Structured exercise (for depression) has been shown to - ✔✔be as effective for
depression as SSRI medication in healthy older adults
✔✔Anxiety disorders - ✔✔generalized anxiety disorder
panic disorder
OCD
PTSD
Social anxiety disorder
specific phobias
,✔✔Type A behavior pattern - ✔✔the tendency toward easily aroused hostility,
impatience, a sense of time urgency, and competitive achievement strivings
✔✔Effect of social support on post MI mortality - ✔✔following MI, patients who were
socially isolated or lacked a close confidant were more likely to die than those with
social support
✔✔Most of psychosocial management is - ✔✔assessment, documentation, patient
education, and counseling and knowing when to refer patients to specialists
✔✔Smoking is associated with increased risk of - ✔✔CVD events, MI, SCD, restenosis
after PCI
✔✔In patients with CVD, smoking cessation is associated with a - ✔✔36% reduction of
risk of mortality
✔✔Two components of effective smoking cessation counseling - ✔✔Practical
counseling (problem solving/skill training)
Social support
✔✔7 first line medications reliable to increase smoking abstinence - ✔✔-nicotine gum
-nicotine inhaler
-nicotine lozenge
-nicotine nasal spray
-nicotine patch
-Bupropion DR
-Varenicline
✔✔Effects of nicotine - ✔✔promotes catecholamine release, constricts peripheral
arteries, releases carbon monoxide, effects blood lipids and leads to atherogensis
✔✔Nicotine promotes catecholamine realize which effects include - ✔✔Increased HR
and BP due to increased myocardial oxygen demand
✔✔Nicotine constricts peripheral arteries which effects include - ✔✔-interference of
blood flow to tissues
-decrease threshold for v-fib
-increase platelet activation
✔✔Nicotine leads to atherogenesis due to - ✔✔a decrease in HDL and increase of
oxygenation of LDL
✔✔Smoking releases carbon monoxide which causes - ✔✔-injuries to vascular
endothelium
, -interferes with red blood cells ability to carry oxygen which decreases the amount go
oxygen delivered to heart muscle
✔✔Carbon monoxide - ✔✔byproduct of nicotine
✔✔When carbon monoxide is interferes with red blood cells ability to carry oxygen how
is the heart affected - ✔✔a decreased amount of oxygen is delivered to the heart
muscle
✔✔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
