A physical therapist assistant is monitoring a 64-year-old man during a treadmill session in phase 2 cardiac rehabilitation. His resting blood pressure was 132/82 mm Hg. As the treadmill speed increases his blood pressure is 118/80, and he reports feeling lightheaded. Which of the following is the MOST appropriate action?

Stop the exercise, seat the patient, continue monitoring, and report the response to the supervising physical therapist

Continue the session, since a decrease in blood pressure shows the exercise is lowering his hypertension

Increase the treadmill incline to raise the blood pressure back to baseline

Have the patient perform a Valsalva maneuver to stabilize the blood pressure

A physical therapist assistant is leading a group exercise session in a phase 3 cardiac rehabilitation program. A 70-year-old woman with a history of myocardial infarction develops pressure in her chest that spreads to her left jaw during a cycling interval. Which of the following is the MOST appropriate FIRST action?

Stop the exercise immediately, have her sit and rest, and follow the facility's emergency protocol including her prescribed nitroglycerin if available and emergency medical services if the pain does not resolve

Reduce the cycling resistance by half and ask her to continue at a slower pace

Apply a cold pack to the chest to relieve the pressure

Instruct her to perform diaphragmatic breathing and finish the interval

A physical therapist assistant is performing bed mobility and transfer training with a 68-year-old man on postoperative day three after coronary artery bypass grafting through a median sternotomy. The supervising PT's plan of care lists sternal precautions. Which of the following transfer techniques is MOST appropriate?

Have the patient log roll to side-lying, lower the legs while pushing up gently with the arms close to the body, and stand by pushing through the legs without pulling on the walker

Have the patient push up from the bed with both arms to stand, then pull on the walker to steady himself

Have the patient grasp the PTA's shoulders and pull himself to standing

Have the patient cross his arms over his chest and perform a sit-up to the edge of the bed

A physical therapist assistant is treating a 72-year-old woman with chronic obstructive pulmonary disease in a pulmonary rehabilitation program. The supervising PT's plan of care includes walking on a treadmill with supplemental oxygen at 2 liters per minute and states that oxygen saturation should remain at or above 88 percent. During the walk her pulse oximeter reads 85 percent and she is breathing rapidly. Which of the following is the MOST appropriate action?

Stop the treadmill, have her rest in a supported position, coach pursed-lip breathing, and allow saturation to recover before deciding whether to resume at a lower intensity

Increase the oxygen flow to 6 liters per minute and continue the walk

Remove the supplemental oxygen, since chronic obstructive pulmonary disease patients should not rely on oxygen during exercise

Continue the walk, since an oxygen saturation of 85 percent is normal for a patient with lung disease

A physical therapist assistant is providing airway clearance for a 24-year-old man with cystic fibrosis, per the supervising PT's plan of care, which includes postural drainage with percussion and vibration. Which of the following positions is MOST appropriate for draining the posterior basal segments of the lower lobes?

Prone with the foot of the bed elevated so the head is lower than the hips

Sitting upright and leaning forward over a pillow

Supine with the head of the bed elevated 45 degrees

Side-lying on the affected side with the bed flat

A physical therapist assistant arrives for a home health session with a 78-year-old woman with chronic heart failure whose plan of care includes a progressive walking program. She reports that she has gained three pounds since yesterday, her ankles are more swollen than usual, and she needed to sleep sitting up in a recliner last night because she could not breathe lying flat. Which of the following is the MOST appropriate action?

Hold the exercise session, document the findings, and contact the supervising physical therapist and the patient's physician promptly, because these are signs of worsening heart failure

Proceed with the walking program at a reduced distance, since exercise helps the body eliminate excess fluid

Elevate her legs for twenty minutes and then proceed with the full walking program

Instruct her to drink more water to flush the retained fluid

A physical therapist assistant is prescribing a walking intensity for a 61-year-old man in cardiac rehabilitation, within the parameters set by the supervising PT. The patient takes metoprolol, a beta-blocker. The PT's plan of care notes that the exercise prescription should account for his medication. Which of the following is the MOST appropriate way to monitor exercise intensity for this patient?

Use the rating of perceived exertion scale along with symptoms, because the beta-blocker blunts his heart rate response

Use a target heart rate calculated as 70 percent of 220 minus his age

Rely on heart rate alone, since beta-blockers do not affect the exercise heart rate

Have the patient skip the metoprolol before each session so the heart rate can be used

A physical therapist assistant is working with an 82-year-old man in an acute care setting two days after admission for pneumonia. He has been on bed rest, and the supervising PT's plan of care includes progressive mobilization. When the PTA brings him from supine to sitting at the edge of the bed, his blood pressure falls from 128/78 to 102/64 mm Hg and he reports dizziness. Which of the following is the MOST appropriate response?

Keep him seated with support, allow time for the blood pressure to stabilize, encourage ankle pumps, and recheck before progressing to standing, reporting the response to the supervising PT

Return him to supine immediately and cancel the session for the day

Stand him up quickly so the leg muscles can pump blood back to the heart

Ignore the reading, since blood pressure always drops when a patient sits up

A physical therapist assistant is treating a 69-year-old man with emphysema whose plan of care includes breathing retraining. He becomes short of breath climbing a flight of stairs and begins taking rapid, shallow breaths with his shoulders elevated. Which of the following instructions is MOST appropriate to help him recover?

Stop, lean forward with the forearms supported on the rail or thighs, and breathe in through the nose and out slowly through pursed lips with a longer exhale than inhale

Hold the breath for ten seconds after each inhale to increase oxygen uptake

Breathe as fast and deeply as possible to catch up on oxygen

Lie flat on the floor to reduce the work of breathing

A physical therapist assistant is seeing a 57-year-old woman five days after a total knee arthroplasty for gait training per the supervising PT's plan of care. Before the session the patient reports new pain in her calf on the operated side, and the PTA observes that the calf is warm, swollen, and tender compared with the other leg. Which of the following is the MOST appropriate action?

Hold the session, keep the patient resting, and contact the supervising physical therapist and the medical team immediately, because the findings suggest a deep vein thrombosis

Perform calf massage and ankle pumps to relieve the muscle cramp before walking

Apply a hot pack to the calf and proceed with gait training

Proceed with gait training, since walking is the best treatment for a swollen leg

10 Free NPTE-PTA Cardiopulmonary Practice Questions (2026)

About This Content Area

NPTE-PTA Cardiopulmonary Content Breakdown

The cardiovascular and pulmonary systems account for 20 to 27 of the 140 scored items on the NPTE-PTA per the official FSBPT NPTE-PTA content outline, effective January 2024, the third largest content area after musculoskeletal and neuromuscular. The Federation of State Boards of Physical Therapy splits those items into physical therapy data collection (5 to 8 items), diseases and conditions that impact effective treatment (7 to 9), and interventions (8 to 10). Try our free 20-question NPTE-PTA practice test, Musculoskeletal practice questions, or the 10 general NPTE-PTA practice questions to see how this content sits alongside the rest of the exam.

What the PTA cardiopulmonary section covers

→Data collection: vital signs (heart rate, blood pressure, respiratory rate, oxygen saturation, temperature), rating of perceived exertion, auscultation for crackles and wheezes, breathing pattern and rib cage excursion, the six-minute walk test, and the pulmonary function test values (vital capacity, FEV1) and ECG basics the PTA reads in the chart

→Anatomy and physiology of the cardiovascular and pulmonary systems as they relate to tests, measures, and exercise responses

→Diseases and conditions: coronary artery disease, myocardial infarction, congestive heart failure and pulmonary edema, hypertension, peripheral vascular disease, deep vein thrombosis and pulmonary embolism, chronic obstructive pulmonary disease (emphysema and chronic bronchitis) and COPD exacerbation, asthma, pneumonia, cystic fibrosis, restrictive lung disease

→Medical management that changes the plan: cardiac surgery and sternal precautions, pacemakers and defibrillators, oxygen therapy, arterial blood gases, lab values, and medications such as beta blockers, diuretics, nitroglycerin, and bronchodilators

→Interventions: cardiac rehabilitation phases, pulmonary rehabilitation, aerobic exercise intensity within the plan, diaphragmatic breathing and pursed-lip breathing retraining, airway clearance and postural drainage, energy conservation, positioning

→Adverse effects and complications, including responses to interventions on other systems

The PTA frame is what separates this page from the NPTE-PT cardiopulmonary questions. The PT exam asks you to interpret an electrocardiogram strip, select the exercise prescription, and decide the phase of cardiac rehabilitation. The PTA exam asks whether you can monitor the patient inside the parameters the PT set, recognize the normal and abnormal responses, carry out the breathing and airway techniques in the plan, and escalate the findings that need the PT or the medical team. See our full NPTE-PTA exam format breakdown for how these items fit into the 180-question structure.

The numbers the cardiopulmonary section expects you to know

→Normal exercise response: systolic blood pressure rises with workload, diastolic stays roughly flat, heart rate rises in proportion to exercise intensity, and cardiac output (stroke volume times heart rate) climbs to meet demand

→Stop criteria: systolic pressure falling below resting with increasing work, new angina, serious arrhythmia, signs of poor perfusion, severe dyspnea, patient request

→Orthostatic hypotension: a systolic drop of 20 mm Hg or more, or a diastolic drop of 10 or more, within a few minutes of standing

→Oxygen saturation: the floor is written into the plan, commonly 88 to 90 percent, compared with the patient’s own resting baseline

→Rating of perceived exertion: 11 to 13 on the 6 to 20 Borg scale for moderate intensity, the primary intensity guide when a beta-blocker blunts heart rate

→Heart failure red flags: weight gain of 2 to 3 pounds in a day or 5 in a week, increasing edema, new orthopnea or paroxysmal nocturnal dyspnea, and crackles at the lung bases that signal pulmonary edema

→Auscultation: crackles point to fluid (pulmonary edema, pneumonia), wheezes point to narrowed airways (asthma, COPD exacerbation), and a new finding is reported before the session proceeds

→Arterial blood gases: a rising PaCO2 with a falling pH is respiratory acidosis, the pattern of a chronic carbon dioxide retainer in COPD and the reason high-flow oxygen therapy is used cautiously

→Hypertension: a resting blood pressure above about 180/110 mm Hg is a reason to hold exercise and report, and antihypertensive medications shape the orthostatic and heart rate responses the PTA watches

The pattern to recognize

Cardiopulmonary vignettes signal trouble by direction, not magnitude: a blood pressure that moves the wrong way as work increases, a weight that jumps overnight, a saturation that falls through the floor in the plan, pain that appears with exertion and does not leave with rest. Normal responses move with the workload and resolve when it stops. When a finding moves against the workload or refuses to resolve, the answer is stop, position, monitor, and escalate, never modify and continue.

Cross-Content Reasoning

Where Cardiopulmonary Content Connects Across the NPTE-PTA

The monitoring skills on this page are the layer under every other section. Gait training after a hip fracture in the musculoskeletal section is a cardiopulmonary question the moment the patient is deconditioned or on a beta-blocker, and the sternal precautions tested here are a musculoskeletal precaution applied to a cardiac surgery. The deep vein thrombosis vignette is the same recognize-and-escalate judgment the non-systems section tests under safety and emergency preparedness, and the oxygen delivery devices and pulse oximeter fall under its equipment and devices category.

The pulmonary half of the section has its own vocabulary worth owning: the pulmonary function test distinguishes obstructive disease (reduced FEV1, air trapping, normal or high total lung capacity) from restrictive disease (reduced vital capacity with a normal ratio), chronic bronchitis and emphysema sit under the COPD umbrella with different breathing patterns, and a COPD exacerbation with new wheezes, crackles, or a change in sputum is a reason to hold and report. The neuromuscular section supplies the patients whose cardiovascular responses are abnormal by design: the spinal cord injury patient with orthostatic hypotension and autonomic dysreflexia, the stroke survivor with cardiac risk factors, and the patient with Guillain-Barre syndrome whose autonomic instability changes every vital sign reading. The other systems items overlap through diabetes, which alters exercise response and wound healing, and through the lymphatic and integumentary consequences of vascular disease.

And the pharmacology thread ties it together: beta-blockers blunt the heart rate, nitrates and antihypertensives cause orthostatic drops, diuretics change fluid and potassium, bronchodilators raise heart rate, and anticoagulants after a thrombosis raise bleeding risk in every fall. The exam does not ask a PTA to prescribe, but it asks on nearly every page how a medication changes what the PTA watches for.

Study tip

Build a two-column card: normal exercise responses on the left, the termination criteria on the right, with the orthostatic numbers, the saturation floor, and the heart failure weight thresholds underneath. Then make one line per condition (COPD, congestive heart failure, post-MI, post-CABG, DVT, pneumonia, cystic fibrosis) with the single rule that changes the session, and one line per drug class (beta blockers, diuretics, nitroglycerin, bronchodilators) with the vital sign it changes. That card covers most of the recall this section demands, and our complete NPTE-PTA study guide shows how to fold it into a full study plan.

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