CCRP AACVPR SOLVED WITH COMPLETE
SOLUTIONS ALREADY GRADED A+
Introduction
This practice set mirrors the Certified Cardiac Rehabilitation Professional (CCRP)
examination developed by the American Association of Cardiovascular and Pulmonary
Rehabilitation (AACVPR). It is constructed to assess mastery of:
• Evidence-based patient assessment and risk stratification
• Exercise testing and individualized prescription
• Cardiovascular risk-factor management (lipids, hypertension, diabetes, obesity,
tobacco)
• Psychosocial screening and intervention
• Medical management and pharmacology relevant to rehabilitation
• Program administration, quality improvement, and outcomes evaluation per
AACVPR Core Components and Guidelines
All items are original, scenario-driven, and aligned with the 2024-2025 AACVPR CCRP
content outline. Work through each explanation to solidify high-level clinical decision-
making for the proctored certification examination and for daily program leadership.
Question 1
A 62-year-old male post-STEMI (Day 4) is referred to cardiac rehab. LVEF 45 %, TIMI 3
flow after PCI, no arrhythmias. According to AACVPR risk-stratification tables he is:
A. Low risk
B. Moderate risk
C. High risk
D. Unstable
Answer: B. Moderate risk
Solution: LVEF 35-49 % with successful reperfusion places patient in moderate-risk
category (Table 3, AACVPR 2024). LVEF ≥ 50 % = low risk; LVEF < 35 % or heart-failure
symptoms at rest = high risk.
Question 2
Which sub-maximal exercise test is AACVPR-approved for low-risk patients unable to
perform standard Bruce?
A. 6-minute walk test (6MWT) alone
B. Modified Bruce (Stage II)
C. Naughton protocol
D. YMCA cycle ergometer test
pg. 1
,Answer: D. YMCA cycle ergometer test
Solution: AACVPR recognizes YMCA and modified Bruce for sub-maximal estimation.
6MWT (A) is functional capacity, not protocol-based MET estimation; Naughton (C) is
high-risk screening tool.
Question 3
During a symptom-limited treadmill test a patient reaches 7 METs without ischemia.
Target training intensity using 60-70 % METs method is:
A. 4.2-4.9 METs
B. 5.0-5.5 METs
C. 6.0-6.5 METs
D. 7.0 METs
Answer: A. 4.2-4.9 METs
Solution: 60 % × 7 = 4.2 METs; 70 % × 7 = 4.9 METs. AACVPR endorses 40-85 % of peak
METs depending on risk stratum.
Question 4
A patient on high-intensity statin (atorvastatin 80 mg) reports new-onset myalgia with
CK 800 IU/L (ULN 200). AACVPR-guided recommendation is:
A. Stop statin immediately and refer to prescriber
B. Continue rehab; advise patient to stretch more
C. Reduce atorvastatin to 40 mg without physician contact
D. Switch to niacin
Answer: A. Stop statin immediately and refer to prescriber
Solution: CK > 3× ULN with symptoms = statin-associated myositis; hold drug and notify
clinician (2022 AHA/ACC cholesterol guideline). Rehab staff cannot titrate or substitute
lipid agents.
Question 5
Which psychosocial screening tool is AACVPR-mandated for program entry?
A. PHQ-9
B. GAD-7
C. Hospital Anxiety and Depression Scale
D. Any validated tool covering depression and anxiety domains
Answer: D. Any validated tool covering depression and anxiety domains
Solution: AACVPR Core Component 4 requires systematic screening; no single tool is
mandated—programs may choose validated instruments that assess both domains
(PHQ-9, GAD-7, HADS, BDI-II, etc.).
Question 6
A diabetic patient in rehab has HbA1c 10.2 %. AACVPR risk classification for exercise
supervision is:
A. Low—routine telemetry not required
pg. 2
, B. Moderate—telemetry first 1-2 sessions
C. High—physician on-site first session
D. Unstable—defer exercise
Answer: C. High—physician on-site first session
Solution: HbA1c > 9 % is listed as high-risk unstable glycemic control (AACVPR Risk
Table 2024). Physician must be immediately available during initial exercise.
Question 7
During exercise a patient’s SBP drops 15 mmHg from baseline despite increasing
workload. Staff should:
A. Continue session; reassess at cool-down
B. Stop exercise and place patient in supine position
C. Reduce intensity by 2 METs and monitor
D. Terminate session and obtain 12-lead ECG
Answer: D. Terminate session and obtain 12-lead ECG
Solution: Drop ≥ 10 mmHg is an absolute stop criterion (AACVPR Box 5-2) and may
indicate ischemia or LV dysfunction; ECG and physician evaluation required.
Question 8
Which outcome measure is AACVPR-designated as a “Clinical Performance Measure” for
all cardiac rehab programs?
A. 6MWT distance
B. HbA1c < 7 %
C. Patient-reported physical function score
D. Program completion rate ≥ 70 %
Answer: D. Program completion rate ≥ 70 %
Solution: AACVPR CPRM (2024) sets benchmark ≥ 70 % completion. Other metrics are
tracked but not designated universal performance measures.
Question 9
A patient asks about high-intensity interval training (HIIT) after phase II graduation.
Current AACVPR stance is:
A. Contraindicated in all cardiac patients
B. May be considered in low- to moderate-risk patients with physician clearance and
ECG-monitored introduction
C. Approved only for patients ≥ 10 METs
D. Must be supervised by exercise physiologist with ACSM cancer certification
Answer: B. May be considered in low- to moderate-risk patients with physician
clearance and ECG-monitored introduction
Solution: 2024 AACVPR statement: HIIT safe and effective in selected patients; requires
medical clearance, risk stratification, and gradual progression under professional
supervision.
pg. 3
SOLUTIONS ALREADY GRADED A+
Introduction
This practice set mirrors the Certified Cardiac Rehabilitation Professional (CCRP)
examination developed by the American Association of Cardiovascular and Pulmonary
Rehabilitation (AACVPR). It is constructed to assess mastery of:
• Evidence-based patient assessment and risk stratification
• Exercise testing and individualized prescription
• Cardiovascular risk-factor management (lipids, hypertension, diabetes, obesity,
tobacco)
• Psychosocial screening and intervention
• Medical management and pharmacology relevant to rehabilitation
• Program administration, quality improvement, and outcomes evaluation per
AACVPR Core Components and Guidelines
All items are original, scenario-driven, and aligned with the 2024-2025 AACVPR CCRP
content outline. Work through each explanation to solidify high-level clinical decision-
making for the proctored certification examination and for daily program leadership.
Question 1
A 62-year-old male post-STEMI (Day 4) is referred to cardiac rehab. LVEF 45 %, TIMI 3
flow after PCI, no arrhythmias. According to AACVPR risk-stratification tables he is:
A. Low risk
B. Moderate risk
C. High risk
D. Unstable
Answer: B. Moderate risk
Solution: LVEF 35-49 % with successful reperfusion places patient in moderate-risk
category (Table 3, AACVPR 2024). LVEF ≥ 50 % = low risk; LVEF < 35 % or heart-failure
symptoms at rest = high risk.
Question 2
Which sub-maximal exercise test is AACVPR-approved for low-risk patients unable to
perform standard Bruce?
A. 6-minute walk test (6MWT) alone
B. Modified Bruce (Stage II)
C. Naughton protocol
D. YMCA cycle ergometer test
pg. 1
,Answer: D. YMCA cycle ergometer test
Solution: AACVPR recognizes YMCA and modified Bruce for sub-maximal estimation.
6MWT (A) is functional capacity, not protocol-based MET estimation; Naughton (C) is
high-risk screening tool.
Question 3
During a symptom-limited treadmill test a patient reaches 7 METs without ischemia.
Target training intensity using 60-70 % METs method is:
A. 4.2-4.9 METs
B. 5.0-5.5 METs
C. 6.0-6.5 METs
D. 7.0 METs
Answer: A. 4.2-4.9 METs
Solution: 60 % × 7 = 4.2 METs; 70 % × 7 = 4.9 METs. AACVPR endorses 40-85 % of peak
METs depending on risk stratum.
Question 4
A patient on high-intensity statin (atorvastatin 80 mg) reports new-onset myalgia with
CK 800 IU/L (ULN 200). AACVPR-guided recommendation is:
A. Stop statin immediately and refer to prescriber
B. Continue rehab; advise patient to stretch more
C. Reduce atorvastatin to 40 mg without physician contact
D. Switch to niacin
Answer: A. Stop statin immediately and refer to prescriber
Solution: CK > 3× ULN with symptoms = statin-associated myositis; hold drug and notify
clinician (2022 AHA/ACC cholesterol guideline). Rehab staff cannot titrate or substitute
lipid agents.
Question 5
Which psychosocial screening tool is AACVPR-mandated for program entry?
A. PHQ-9
B. GAD-7
C. Hospital Anxiety and Depression Scale
D. Any validated tool covering depression and anxiety domains
Answer: D. Any validated tool covering depression and anxiety domains
Solution: AACVPR Core Component 4 requires systematic screening; no single tool is
mandated—programs may choose validated instruments that assess both domains
(PHQ-9, GAD-7, HADS, BDI-II, etc.).
Question 6
A diabetic patient in rehab has HbA1c 10.2 %. AACVPR risk classification for exercise
supervision is:
A. Low—routine telemetry not required
pg. 2
, B. Moderate—telemetry first 1-2 sessions
C. High—physician on-site first session
D. Unstable—defer exercise
Answer: C. High—physician on-site first session
Solution: HbA1c > 9 % is listed as high-risk unstable glycemic control (AACVPR Risk
Table 2024). Physician must be immediately available during initial exercise.
Question 7
During exercise a patient’s SBP drops 15 mmHg from baseline despite increasing
workload. Staff should:
A. Continue session; reassess at cool-down
B. Stop exercise and place patient in supine position
C. Reduce intensity by 2 METs and monitor
D. Terminate session and obtain 12-lead ECG
Answer: D. Terminate session and obtain 12-lead ECG
Solution: Drop ≥ 10 mmHg is an absolute stop criterion (AACVPR Box 5-2) and may
indicate ischemia or LV dysfunction; ECG and physician evaluation required.
Question 8
Which outcome measure is AACVPR-designated as a “Clinical Performance Measure” for
all cardiac rehab programs?
A. 6MWT distance
B. HbA1c < 7 %
C. Patient-reported physical function score
D. Program completion rate ≥ 70 %
Answer: D. Program completion rate ≥ 70 %
Solution: AACVPR CPRM (2024) sets benchmark ≥ 70 % completion. Other metrics are
tracked but not designated universal performance measures.
Question 9
A patient asks about high-intensity interval training (HIIT) after phase II graduation.
Current AACVPR stance is:
A. Contraindicated in all cardiac patients
B. May be considered in low- to moderate-risk patients with physician clearance and
ECG-monitored introduction
C. Approved only for patients ≥ 10 METs
D. Must be supervised by exercise physiologist with ACSM cancer certification
Answer: B. May be considered in low- to moderate-risk patients with physician
clearance and ECG-monitored introduction
Solution: 2024 AACVPR statement: HIIT safe and effective in selected patients; requires
medical clearance, risk stratification, and gradual progression under professional
supervision.
pg. 3
