A 61-year-old male, three days post uncomplicated myocardial infarction, is participating in phase 1 (inpatient) cardiac rehabilitation. Which of the following BEST describes appropriate activity parameters at this stage?

Low-intensity activities of roughly 1 to 4 METs — self-care, short walks, low-step stairs — with heart rate kept within about 20 beats above resting and RPE in the light range, monitoring vitals and symptoms before, during, and after

Moderate treadmill jogging at 70% of age-predicted maximum heart rate

Strict bed rest until discharge to prevent reinfarction

Maximal graded exercise testing daily to track recovery

A 67-year-old female is five days post coronary artery bypass grafting via median sternotomy. Which of the following instructions is MOST consistent with standard sternal precautions during early recovery?

Avoid lifting more than roughly 5 to 10 pounds, avoid pushing or pulling through the arms (including pushing up from chairs), and hug a pillow to splint the sternum when coughing

Begin resisted bilateral overhead pressing to restore shoulder strength quickly

Use the arms maximally for all transfers to protect the legs

Avoid all shoulder movement of any kind for 12 weeks

During a phase 2 cardiac rehabilitation session, a therapist monitors a 63-year-old male post-MI patient on a cycle ergometer. Which of the following findings MOST clearly requires immediate termination of exercise?

New chest pressure radiating to the jaw, accompanied by a DROP in systolic blood pressure below the resting value despite increasing workload

A gradual heart rate increase proportional to workload

Mild sweating and RPE of 12 at the prescribed intensity

A systolic blood pressure rise from 128 to 156 mm Hg during the work interval

A 54-year-old male, four months post orthotopic heart transplantation, begins outpatient cardiac rehabilitation. Which of the following BEST describes the expected exercise physiology of his transplanted heart and the corresponding prescription adjustment?

The denervated heart responds sluggishly — resting heart rate is elevated, heart rate rises slowly via circulating catecholamines rather than neural input, and recovery is delayed — so prolonged warm-up and cool-down are used and intensity is guided by RPE rather than heart rate

The transplanted heart responds normally to exercise, so standard heart rate prescriptions apply without modification

The transplanted heart cannot increase output at all, so only passive range of motion is appropriate

Heart rate spikes instantly with exertion, so the priority is suppressing rate response with rest breaks

During a phase 3 community-based exercise session, a 66-year-old male with known stable angina develops his typical chest tightness. He carries prescribed sublingual nitroglycerin. Which of the following is the MOST appropriate management sequence?

Stop exercise, seat the patient, administer one sublingual dose per his prescription; if pain persists after 5 minutes, activate EMS and continue dosing per protocol up to a maximum of three doses

Have him walk slowly to "work through" the angina before considering medication

Give three nitroglycerin doses immediately in rapid succession for faster relief

Withhold the nitroglycerin, since medications may only be administered by nursing staff, and drive him to the hospital

A 72-year-old female with chronic heart failure (reduced ejection fraction) arrives for her outpatient exercise session and mentions she has gained 4 pounds since yesterday, her ankles are more swollen than usual, and she needed an extra pillow to sleep last night. Which of the following is the MOST appropriate action?

Defer the exercise session and ensure prompt communication with her physician — rapid weight gain, increasing edema, and new orthopnea signal decompensating heart failure

Proceed with the session at reduced intensity, since exercise helps mobilize fluid

Recommend she drink more water to thin the retained fluid

Add lower extremity resistance exercise to pump the swelling out

A therapist tracks blood pressure across a graded treadmill session for a 59-year-old male in phase 2 cardiac rehabilitation. Which of the following patterns represents a NORMAL hemodynamic response to progressive aerobic exercise?

Systolic pressure rises progressively with workload while diastolic pressure stays roughly constant or changes only slightly

Systolic pressure falls steadily as workload increases

Both systolic and diastolic pressures rise sharply and in parallel

Systolic pressure remains completely unchanged regardless of workload

A 64-year-old male with an implantable cardioverter-defibrillator (ICD) set to detect ventricular tachycardia at 150 bpm is beginning outpatient cardiac rehabilitation. Which of the following exercise prescription principles is MOST important for this patient?

Keep his exercise heart rate safely below the device's detection threshold — commonly cited as at least 10 to 20 beats below — confirming the programmed settings with cardiology before prescribing

Push heart rate above 150 bpm periodically to test that the device is functioning

Avoid all aerobic exercise permanently, since exertion triggers defibrillation

Ignore the device settings, since the ICD only activates during cardiac arrest

A therapist insists that every patient in the cardiac rehabilitation program complete a gradual, active cool-down of at least 5 to 10 minutes rather than stopping exercise abruptly. Which of the following BEST explains why the cool-down is particularly important in CARDIAC populations?

Abrupt cessation allows blood to pool in vasodilated leg vessels while catecholamine levels remain high — a combination that can produce hypotension, reduced coronary perfusion, and arrhythmias in vulnerable hearts

Cool-downs exist mainly to prevent next-day muscle soreness

The cool-down is a courtesy period with no physiologic rationale

Cool-downs raise blood pressure back to safe levels after exercise lowers it

10 Free NPTE Cardiac Rehab Practice Questions (2026) - Practitionr

About This Topic

How Cardiac Rehab Is Tested on the NPTE

Cardiac rehabilitation sits inside the cardiovascular and pulmonary content of the FSBPT content outline, spanning examination, exercise prescription, monitoring, and safety across the rehab phases. Try our free 20-question timed NPTE practice test, Cardiopulmonary practice questions, or Lab Values practice questions to see the surrounding cardiovascular content.

The cardiac rehab rules the exam tests

→Phase 1 — low METs, HR within ~20 of resting, light RPE, monitor everything

→Sternal precautions — 5-10 lb lifting limit, no push/pull through the arms, pillow splinting

→Termination — new angina, falling systolic BP, serious arrhythmia, poor perfusion signs

→Karvonen — (HRmax − HRrest) × % + HRrest

→Transplant — elevated resting HR, delayed response, prescribe by RPE, long warm-up

→Angina — stop, sit, nitroglycerin per protocol, EMS if unrelieved

→Heart failure — daily weights; rapid gain, edema, and orthopnea mean defer and call

→Normal BP response — systolic rises with work, diastolic roughly steady

→ICD — know the detection threshold and prescribe well below it

→Cool-down — prevents pooling-plus-catecholamine hypotension and arrhythmia

The special populations each modify one variable of the standard prescription: beta-blockers and transplantation break the heart rate signal (shift to RPE), devices impose a rate ceiling, heart failure adds a daily go/no-go gate, and surgery adds mechanical precautions. Learn the standard prescription first, then each population as a single edit to it. See our full NPTE exam format breakdown for how these items fit into the 225-question structure.

The pattern to recognize

Cardiac vignettes signal danger through DIRECTION, not magnitude: a systolic pressure that falls as work rises, a weight that jumps overnight, symptoms that appear at rest rather than exertion, pain that persists after the trigger is removed. Normal responses move WITH the workload; alarming responses move against it or refuse to resolve when the workload stops. When a finding moves the wrong direction, the answer is stop, defer, or escalate — never modify and continue.

Cross-Content Reasoning

Where Cardiac Rehab Connects Across the Exam

Cardiac rehab is the applied end of the cardiopulmonary section, and the pharmacology thread runs through every prescription decision on this page: beta-blockers blunt the heart rate signal, nitrates carry the hypotension warning, diuretics connect to the potassium and volume story of the lab values page, and anticoagulants shade every fall-risk judgment. Troponin — the do-not-mobilize marker from the lab values page — is the acute gate that phase 1 waits behind.

The monitoring skills generalize outward: the same vital sign vigilance governs exercising the diabetic patient, the anemic patient, and the SCI patient with impaired autonomic responses — cardiac rehab is simply where the exam teaches the template. Stroke shares the risk-factor upstream (hypertension, atrial fibrillation) covered on the Stroke page, and the energy-cost reasoning behind MET prescriptions is the same currency used to judge orthotic ambulation demands and functional activity tolerance everywhere else.

And the emergency-response thread ties back to the non-systems section: the angina protocol, the termination criteria, and the decompensation deferral are all the same recognize-and-escalate judgment the exam tests with lab values, red flags, and safety vignettes — here with the added time pressure of an organ that keeps its own schedule.

Study tip

Build three cards. Card one: the phases — setting, MET range, monitoring level, and goal for phases 1 through 3. Card two: the stopping rules — termination criteria on one side, the angina and decompensation protocols on the other. Card three: the special populations as one-line edits (beta-blocker → RPE; transplant → RPE plus long warm-up; ICD → rate ceiling; heart failure → daily weight gate; sternotomy → lifting and push-pull limits). Add the Karvonen formula worked through one example, and our complete NPTE study guide covers how to fold it all into a full study plan.

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