A client with type 1 diabetes mellitus checks her fasting morning glucose level on her whole-blood glucose meter (fingerstick method), and the result of 253 mgldL (14 mmol/L). A urine test is positive for ketones before her exercise session. What action should you take?
A. Allow her to exercise as long as her glucose is not greater than 300 mgldL (17 mmol/L).
B. Not allow her to exercise this session, and notify her physician of the findings.
C. Give her an extra carbohydrate snack, and wait 5 minutes before beginning exercise.
D. Readjust her insulin regimen for the remainder of the day to compensate for the high morning glucose level.
According to the most recent National Institutes of Health's Clinical Guidelines for the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, recommendations for practical clinical assessment include.
A. Determining total body fat through the BMI to assess obesity.
B. Determining the degree of abdominal fat and health risk through waist circumference.
C. Using the waist-to-hip ratio as the only definition of obesity and lean muscle mass.
D. Both A and B.
Special precautions for clients with hypertension include all of the following EXCEPT:
A. Avoiding muscle strengthening exercises that involve low resistance.
B. Avoiding activities that involve the Valsalva maneuver.
C. Monitoring a client who is taking diuretics for arrhythmias.
D. Avoiding exercise if resting systolic BP is greater than 200 mm Hg or diastolic BP is greater than 115 mm Hg.
A client with angina exhibits symptoms and a 1mm, down-sloping ST- segment depression at a HR of 129 bpm on his exercise test. His peak exercise target HR should be set at:
A. 128 bpm.
B. 109 to 119 bpm.
C. 129 bpm.
D. 125 to 128 bpm.
Treatment for claudication during exercise includes all of the following EXCEPT
A. Daily exercise sessions.
B. Intensity of activity to maximal tolerable pain, with intermittent rest periods.
C. Cardiorespiratory building activities that are nonweight bearing if the plan is to work on longer duration and higher intensity to elicit a cardiorespiratory training effect.
D. Stopping activity at the onset of claudication discomfort to avoid further vascular damage from ischemia.
Symptoms of claudication include:
A. Cramping, burning, and tightness in the calf muscle, usually triggered by activity and relieved with rest.
B. Acute, sharp pain in the foot on palpation at rest.
C. Crepitus in the knee during cycling.
D. Pitting ankle edema at a rating of 3 +
Initial training sessions for a person with severe chronic obstructive pulmonary disease most likely would NOT include.
A. Continuous cycling activity at 70% ofVo
B. Use of dyspnea scales, RPE scales, and pursed-lip breathing instruction.
C. Intermittent bouts of activity on a variety of modalities (exercise followed by short rest).
D. Encouraging the client to achieve an intensity either at or above the anaerobic threshold.
Which of the following issues would you include in discharge education instructions for a client with congestive heart failure to avoid potential emer- gency situations related to this condition at home?
A. Record body weight daily, and report weight gains to a physician.
B. Note signs and symptoms(e.g., dyspnea, intolerance to activities of daily living), and report them to a physician.
C. Do not palpate the pulse during daily activities or periods of light- headedness, because an irregular pulse is normal and occurs at various times during the day.
D. Both A and B.
Which of the following situations indicates progression to independent and unsupervised exercise for a client after CABG surgery in an outpatient program?
A. The client exhibits mild cardiac symptoms of angina, occurring intermittently during exercise and sometimes at home while reading.
B. The client has a functional capacity of greater than 8 MET with hemodynamic responses appropriate to this level of exercise.
C. The client is noncompliant with smoking cessation and weight loss intervention programs.
D. The client is unable to palpate HR, deliver RPEs, or maintain steady workload intensity during activity.
Which of the following is NOT an appropriate treatment activity for inpatient rehabilitation of a client on the second day after coronary artery bypass graft (CABG) surgery?
A. Limit activities as tolerated to the development of self-care activities, ROM for extremities, and low-resistance activities.
B. Limit upper body activities to biceps curls, horizontal arm adduction, and overhead press using 5-pound weights while sitting on the side of the bed.
C. Progress all activities performed from supine to sitting to standing.
D. Measure vital signs, symptoms, RPE, fatigue, and skin color and perform electrocardiography before, during, and after treatments to assess activity tolerance.
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