A patient's electrocardiogram report describes the presence of significant Q waves. This
finding is suggestive of which of the following conditions?
1.Premature atrial complex
2.Myocardial infarction
3.Supraventricular tachycardia
4.Atrial fibrillation
ANSWER
2.Myocardial infarction
1. A premature atrial complex is indicated by an R wave that is close to the preceding R
wave, and the P wave of the early beat is shaped differently from normal P waves (p. 317).
2. A prominent, pathological Q wave is indicative of a transmural myocardial infarction (pp.
330-331).
3. Supraventricular tachycardia is associated with P waves that can be merged into T waves.
The QRS complexes are typically identical in shape and normal in duration. (p. 319)
4. Atrial fibrillation is characterized by inconsistent, irregular R-R intervals (p. 321).
A chart review of an adult female patient indicates a hematocrit value of 42% following
minor elective surgery. This value is indicative of:
1.anemia.
2.inflammation.
3.infection.
4.normal findings.
ANSWER
4.normal findings.
,A hematocrit value of 42% is within normal range for adult females (normal range: 36% to
47%) (p. 268).
A patient who has chronic obstructive pulmonary disease becomes short of breath when
walking 5 feet (1.5 m) with a rolling walker. Which of the following techniques would be
MOST appropriate in order to increase the distance the patient is able to walk without
becoming short of breath?
1.Incentive spirometry
2.Pacing
3.Diaphragmatic breathing
4.Segmental breathing
ANSWER
2.Pacing
1. Incentive spirometry uses visual feedback to encourage the performance of sustained
maximal inspiration. Incentive spirometry has been used to reduce postoperative pulmonary
complications following abdominal or thoracic surgery, but its effectiveness is controversial.
(Malone)
2. Using pacing, the patient would learn to work within his or her exercise tolerance. This
may mean walking slower or walking with breaks and would allow greater total walking
distance without shortness of breath. (O'Sullivan)
3. Diaphragmatic breathing is used to decrease the work of breathing and improve
diaphragmatic movement, not to improve exercise tolerance (Hillegass).
4. Segmental breathing is used for patients with chest hypomobility to augment localized
lung expansion (Malone). Chest hypomobility is not usually an issue in patients who have
chronic obstructive pulmonary disease.
During a bedside evaluation, a patient shows a sudden increase in the rate and depth of
respirations, followed by a gradual decrease in respirations and periods of apnea. Which of
the following respiratory patterns is the patient exhibiting?
1.Hyperventilation
, 2.Paradoxical breathing
3.Tachypnea
4.Cheyne-Stokes
ANSWER
4.Cheyne-Stokes
1. Hyperventilation is characterized by rapid deep breathing (p. 517).
2. Paradoxical breathing is characterized by inward abdominal or chest wall movements with
inspiration and outward movement with expiration (p. 518).
3. Tachypnea is characterized by rapid shallow breathing (p. 517).
4. Cheyne-Stokes respiration is breathing that waxes and wanes cyclically so that periods of
deep breathing alternate with periods of apnea (no breathing) (pp. 98, 517, 550).
A physical therapist is providing supervised exercise to a patient who has been restricted to
extended bed rest. After 2 weeks of intervention, which of the following measures would
BEST reflect cardiopulmonary system improvement?
1.Delayed cardiovascular response upon rising from supine position
2.Decreased heart rate response to exercise
3.Decreased respiratory rate in response to exercise
4.Increased cardiovascular peripheral resistance
ANSWER
2.Decreased heart rate response to exercise
2. Exercise will increase the patient's stroke volume secondary to increased myocardial
contractility. The increased stroke volume will result in a reduced heart rate response with
exercise. The intensity of the exercises is directly correlated to the heart rate response.
(Kisner, p. 256)
3. Early mobilization will result in improved respiratory response (Paz, p. 106).
finding is suggestive of which of the following conditions?
1.Premature atrial complex
2.Myocardial infarction
3.Supraventricular tachycardia
4.Atrial fibrillation
ANSWER
2.Myocardial infarction
1. A premature atrial complex is indicated by an R wave that is close to the preceding R
wave, and the P wave of the early beat is shaped differently from normal P waves (p. 317).
2. A prominent, pathological Q wave is indicative of a transmural myocardial infarction (pp.
330-331).
3. Supraventricular tachycardia is associated with P waves that can be merged into T waves.
The QRS complexes are typically identical in shape and normal in duration. (p. 319)
4. Atrial fibrillation is characterized by inconsistent, irregular R-R intervals (p. 321).
A chart review of an adult female patient indicates a hematocrit value of 42% following
minor elective surgery. This value is indicative of:
1.anemia.
2.inflammation.
3.infection.
4.normal findings.
ANSWER
4.normal findings.
,A hematocrit value of 42% is within normal range for adult females (normal range: 36% to
47%) (p. 268).
A patient who has chronic obstructive pulmonary disease becomes short of breath when
walking 5 feet (1.5 m) with a rolling walker. Which of the following techniques would be
MOST appropriate in order to increase the distance the patient is able to walk without
becoming short of breath?
1.Incentive spirometry
2.Pacing
3.Diaphragmatic breathing
4.Segmental breathing
ANSWER
2.Pacing
1. Incentive spirometry uses visual feedback to encourage the performance of sustained
maximal inspiration. Incentive spirometry has been used to reduce postoperative pulmonary
complications following abdominal or thoracic surgery, but its effectiveness is controversial.
(Malone)
2. Using pacing, the patient would learn to work within his or her exercise tolerance. This
may mean walking slower or walking with breaks and would allow greater total walking
distance without shortness of breath. (O'Sullivan)
3. Diaphragmatic breathing is used to decrease the work of breathing and improve
diaphragmatic movement, not to improve exercise tolerance (Hillegass).
4. Segmental breathing is used for patients with chest hypomobility to augment localized
lung expansion (Malone). Chest hypomobility is not usually an issue in patients who have
chronic obstructive pulmonary disease.
During a bedside evaluation, a patient shows a sudden increase in the rate and depth of
respirations, followed by a gradual decrease in respirations and periods of apnea. Which of
the following respiratory patterns is the patient exhibiting?
1.Hyperventilation
, 2.Paradoxical breathing
3.Tachypnea
4.Cheyne-Stokes
ANSWER
4.Cheyne-Stokes
1. Hyperventilation is characterized by rapid deep breathing (p. 517).
2. Paradoxical breathing is characterized by inward abdominal or chest wall movements with
inspiration and outward movement with expiration (p. 518).
3. Tachypnea is characterized by rapid shallow breathing (p. 517).
4. Cheyne-Stokes respiration is breathing that waxes and wanes cyclically so that periods of
deep breathing alternate with periods of apnea (no breathing) (pp. 98, 517, 550).
A physical therapist is providing supervised exercise to a patient who has been restricted to
extended bed rest. After 2 weeks of intervention, which of the following measures would
BEST reflect cardiopulmonary system improvement?
1.Delayed cardiovascular response upon rising from supine position
2.Decreased heart rate response to exercise
3.Decreased respiratory rate in response to exercise
4.Increased cardiovascular peripheral resistance
ANSWER
2.Decreased heart rate response to exercise
2. Exercise will increase the patient's stroke volume secondary to increased myocardial
contractility. The increased stroke volume will result in a reduced heart rate response with
exercise. The intensity of the exercises is directly correlated to the heart rate response.
(Kisner, p. 256)
3. Early mobilization will result in improved respiratory response (Paz, p. 106).
