MIDTERM

Question 1

A ______ helps achieve specific programming objectives with the selected group of participating patients.

Answer 1

good design / program design

Question 2

Key design considerations involve both ___ and ____, with emphasis on patient ___ and ______.

Answer 2

format and content

reconditioning and education

Question 3

Two types of format

Answer 3

open-ended and closed design,

Question 4

Programs can use either an____ or a _____ , with or without _______.

Answer 4

open-ended or a closed design / planned follow-up sessions

Question 5

With an ______ format, patients enter the program and progress through it until they achieve certain predetermined objectives.

Answer 5

open-ended

Question 6

There is no set time frame.

Depending on his or her condition, needs, motivation, and performance, an individual patient can complete an ____ program over weeks or months.

Answer 6

open-ended

Question 7

This format is good for self-directed patients or patients with scheduling dif- ficulties.

Answer 7

open-ended

Question 8

It also may be the best format for patients requiring individual attention.

Answer 8

Open-ended

Question 9

The major drawback of the ____ format is the lack of group support and involvement.

Answer 9

open-ended

Question 10

______ may be a factor when the program is open-ended.

Answer 10

insurance reimbursement

Question 11

The more traditional _____ uses a set time period to cover program content.

Answer 11

closed design

Question 12

These programs usually run 6 to 16 weeks, with classes meeting one to three times a week.

Answer 12

closed design

Question 13

_____ may dictate how many sessions make up the program.

Answer 13

insurance coverage

Question 14

______ covers 36 initial sessions with possible cov- erage of another 36 sessions if the patient qualifies and would benefit from the additional rehabilitation sessions.

Answer 14

Medicare

Question 15

Class sessions usually last up to _____.

Answer 15

2 hours

Question 16

Presentations are more formal and group support involvement is encouraged.

Answer 16

closed design

Question 17

A major draw- back to this format is that the schedule determines program completion, rather than the objectives.

Answer 17

closed design

Question 18

most programs allow patients to____ if the anticipated improvements are not achieved.

Answer 18

reenroll

Question 19

Regardless of the format used, long-term improvements cannot be expected without_______

Answer 19

planned follow-up.

Question 20

_____ must be ongoing and available to all patients who complete the program

Answer 20

Follow-up

Question 21

Frequently, this essential element of the process is difficult, especially when it is not covered by most _______, but program coordinators must ensure that it is routinely ______.

Answer 21

insurance plans / scheduled

Question 22

_______ could be open-ended (available during regular rehabilitation sessions and offering open attendance) or could be scheduled weekly, monthly, bimonthly, or quarterly. The important thing is to have some type of _____ available.

Answer 22

Follow-up or reinforcement / follow-up

Question 23

The _____ of the rehabilitation program usually combines physical reconditioning with education activities.

Answer 23

content

Question 24

Programs providing ________alone are unlikely to be effective.

Answer 24

reconditioning or education

Question 25

the ideal rehabilitation session should last about _____.

Answer 25

2 hours

Question 26

____, ______ and _____dictate session length.

Answer 26

Group size, available equipment, and group interaction

Question 27

Patients should arrive _______ before a scheduled session to allow for infor- mal group interaction and support.

Answer 27

10 to 15 minutes

Question 28

Classes should begin on____ and ______ as scheduled.

Answer 28

time and conclude promptly

Question 29

_______ should be brief and to the point.

Answer 29

Educational presentations

Question 30

The use of ____ or _____ should enhance understanding.

Answer 30

audiovisuals or demonstrations

Question 31

To facilitate patient comprehension, the ______ should be simple and unnecessary technical terms or concepts should be avoided.

Answer 31

language

Question 32

_____ that enhance certain points made during a presenta- tion are both useful and desirable.

Answer 32

Handouts

Question 33

A folder or notebook in which program activities may be recorded and handout materi- als kept should be maintained by_____

Answer 33

each patient.

Question 34

The ______ component of the pulmonary rehabilitation program consists primarily of an exercise prescription with target heart rate based on the results of the patient’s initial exercise evaluation.

Answer 34

physical reconditioning

Question 35

For most patients, an initial target heart rate is set using ________, or estimated as ______ greater than resting rate.

Answer 35

Karvonen’s formula / 20 beats/min

Question 36

Because of the severity of ventilatory impairment, some patients begin exercise recon- ditioning without a _________

Answer 36

prescribed target heart rate.

Question 37

Target heart rate = [(MHR − RHR) × (50% − 70%)] + RHR

Answer 37

Karvonen’s formula

Question 38

the exercise prescription includes the following four related components:

Answer 38

1. Lower extremity (leg) aerobic exercises 2. Timed walking (6- or 12-minute walk) 3. Upper extremity (arm) aerobic exercises 4. Ventilatory muscle training

Question 39

To ensure success with________, patients must actively participate both at the rehabilitation facility and at home.

Answer 39

physical reconditioning

Question 40

While exercising at the facility, patients should be monitored by ______

Answer 40

pulse oximetry

Question 41

______ measurements may also be made, but these are usually done at the start and end of each session unless a patient’s condition dictates other- wise.

Answer 41

Blood pressure

Question 42

exercise sessions should be ____

Answer 42

upbeat

Question 43

_____ helps to maintain a positive atmosphere.

Answer 43

Lively music

Question 44

Clinicians must remember that these patients are ill and require a ______ attitude from team members, family, and the group itself.

Answer 44

nurturing

Question 45

To ensure compliance with the program, a daily __ or ___ is completed.

Answer 45

log or diary sheet

Question 46

These___ or ___ forms are reviewed each time the patient attends a session.

Answer 46

log or diary

Question 47

_____ may include either walking or bicycling.

Answer 47

Lower extremity exercises

Question 48

Patients can walk on a ______ (with set goals for distance or time and grade) or on a ______

Answer 48

stationary treadmill / flat, smooth surface.

Question 49

With the treadmill or stationary bicycle, patients are required to cover a certain ______ every day that they are in the program.

Answer 49

distance or duration

Question 50

Commonly, the duration is set to_______, with patients encouraged to increase both their distance and equipment ten- sion or resistance as tolerated.

Answer 50

30 minutes daily

Question 51

Patients with significant ortho- pedic disabilities can participate in_______.

Answer 51

aerobic aquatic exercises

Question 52

_____ also improves overall conditioning; this usually takes the form of a ______ walk performed once a day, depending on the patient’s condition and tolerance.

Answer 52

Walking / 6- or 12-minute

Question 53

These _____ exercises are a convenient way for patients to carry out a well- defined amount of activity with increasing vigor and results over a number of weeks.

Answer 53

walk

Question 54

During the ______ patients should walk on flat ground for as far as possible.

Answer 54

6 or 12 minutes,

Question 55

If _____ occurs, they should stop and rest, with the rest time included as part of the time interval. After resting briefly, they should try to continue walking at a comfortable pace.

Answer 55

dyspnea

Question 56

The objective is to____ as far as possible during the allotted time.

Answer 56

walk

Question 57

Landmarks such as ____ can be used to quantify progress.

Answer 57

telephone poles, city blocks, or actual distance measures

Question 58

Under adverse weather conditions, _____ can be done indoors in shopping malls, stores, or long hallways.

Answer 58

walking

Question 59

Patients should record their progress in their ___

Answer 59

manuals or diaries.

Question 60

Aerobic _______ improve rehabilitation outcomes for patients whose regular activities involve lifting or raising the arms.

Answer 60

upper extremity exercises

Question 61

______ or rowing machines are available for this purpose; however, simple calisthenics using either a ___ or ____ (by prescription and with training) are a satisfactory alternative.

Answer 61

Arm ergometers / broomstick or free weights

Question 62

Upper body endurance generally is more ___ , with many patients capable of only ______ of daily activity to start.

Answer 62

limited / 2 to 3 minutes

Question 63

This limitation usually is related to the fact that patients may revert to using ______ for breathing while doing the upper body exercise.

Answer 63

accessory muscles

Question 64

Patients need to breathe ______ and perform the ______ at the same time.

Answer 64

diaphragmatically / exercises

Question 65

Arm exercises should get progressively longer, up to _______ if possible.

Answer 65

20 minutes

Question 66

____ conditioning helps patients perform numerous useful activities at home and can increase overall physical endurance.

Answer 66

Upper body

Question 67

Although controversy exists, _________ probably can enhance the benefits of these more traditional exercises.

Answer 67

ventilatory muscle training

Question 68

Ventilatory muscle training is based on the concept of _______

Answer 68

progressive resistance.

Question 69

By imposing progressively greater loads on the inspiratory muscles (mainly the diaphragm) over time, the patient’s ___ and _____ should increase.

Answer 69

strength and endurance

Question 70

These improvements should increase the patient’s ______

Answer 70

exercise tolerance.

Question 71

_______ The device is an adjustable flow resistor with a one-way breathing valve.

Answer 71

inspiratory resistance breathing device.

Question 72

The_____ is created by forcing the patient to inhale through a restricted orifice.

Answer 72

inspiratory load

Question 73

Varying the size of this orifice varies the ______ , as do changes in the patient’s inspiratory flow.

Answer 73

inspiratory load

Question 74

During expiration, gas flows unim- peded out the one-way ______

Answer 74

exhalation valve

Question 75

One model replaces the variable size orifice with an adjustable _______. This valve ensures a constant load regardless of how quickly or slowly the patient breathes.

Answer 75

spring-loaded valve

Question 76

Because variations in breathing strategy during ventilatory muscle training can affect outcomes, proper _____, ____ and _____ are required.

Answer 76

patient evaluation, training and follow-up

Question 77

The RT initially measures the patient’s maximum inspiratory pressure (PImax) using a______

Answer 77

calibrated pressure manometer.

Question 78

Before beginning _______, the patient should assume a position that relaxes the abdominal muscles, such as the position used for cough training.

Answer 78

ventilatory muscle training