Deck 22: Outcome Measures:a Guide for the Evidence Based Practice of Cardiopulmonary Physical Therapy

Question 1

A patient who is found to have an ankle-brachial index of 0.45 is consistent with which of the following interpretations?

A)Considered a normal finding
B)Considered to have peripheral arterial disease
C)Anticipated to present with some form of claudication
D)Considered to be critical limb ischemia with rest pain,atrophy,and pulselessness

Answer 1

D
Ankle-brachial index values <0.5 are usually considered to be critical limb ischemia and may be accompanied by rest pain,atrophy,pulselessness,or wounds on the lower extremities.

Question 2

The amount of change a clinician needs to see in an outcome measurement to determine if true clinical change has been attained refers to which of the following terms?

A)Minimally clinically important difference
B)Minimal detectable change
C)Sensitivity
D)Reliability

Answer 2

A
Minimally clinically important difference refers to the amount of change you need to see in an outcome measurement to determine if true clinical change has been attained.

Question 3

Depression and anxiety have been linked to cardiac surgery and coronary artery disease and have predicted which of the following aspects of recovery?

A)High mortality rate
B)Poor ability to make progress in rehabilitation
C)Less compliance during cardiac rehabilitation
D)Low functional capacity

Answer 3

C
Depression and anxiety have not only been linked to cardiac surgery and coronary artery disease,but have also been found to predict less compliance during phase II cardiac rehabilitation.

Question 4

Within the core component of an overall management in a cardiac rehabilitation program,which of the following indicators would BEST assess the service aspect?

A)Health-related quality of life
B)Patient satisfaction
C)Risk factor profile
D)Appropriate response to symptoms

Question 5

Which of the following exercise recommendations is associated with reduction in LDL and triglycerides,improvements in HDL,decrease in blood pressure,improvements in insulin sensitivity,reduction in weight,and improvements in hemodynamic regulation?

A)Light exercise 20 minutes per day,5 days per week
B)Moderate exercise 30 minutes per day,most days per week
C)Vigorous exercise 30 minutes per day,3 days per week
D)Light exercise 10 minutes,three times per day,at least 4 days per week

Question 6

Which of the following actions done during the administration of a 6-minute walk test would MOST likely affect the validity of the examination?

A)The examiner starts the stopwatch when the patient starts the test.
B)The examiner encourages the patient throughout the test.
C)The examiner stands in the general area of the test and supervises the patient.
D)The examiner allows the patient to take rest breaks.

Question 7

Which of the following characteristics of an outcome measure tool should a physical therapist consider when determining which tool to utilize?

A)The tool should be able to inform clinical decision making.
B)The tool should be able to discriminate in treatment decisions.
C)The tool quantifies change better if disease specific.
D)All of the above.

Question 8

Which of the following questionnaires would be MOST appropriate to measure symptoms in patients with a previous myocardial infarction,previous vascularization surgery,chest pain,or abnormal results during testing,and acute or chronic disease?

A)The Walking Impairment Questionnaire
B)The Seattle Angina Questionnaire (SAQ)
C)The Kansas City Cardiomyopathy Questionnaire
D)The Chronic Respiratory Disease Questionnaire

Question 9

Which of the following factors would be considered a nonclinical factor affecting patient outcomes?

A)Principle diagnosis
B)Comorbidity
C)Patient attitude
D)Age

Question 10

The categorical measure for assessing the impact of a disease on the life of a patient is considered which of the following data components?

A)Biological
B)Functional
C)Quality of life
D)Physiological

Question 11

The Center for Medicare & Medicaid Services (CMS)prefers quality measures to focus on which of the following areas?

A)Psychological function
B)Patient satisfaction
C)Transition of the patient across settings
D)Length of stay

Question 12

Which of the following instruments would be MOST appropriate to screen and measure outcomes in patients with peripheral arterial disease across a variety of settings?

A)The Kansas City Cardiomyopathy Questionnaire
B)The Chronic Respiratory Disease Questionnaire
C)The Walking Impairment Questionnaire
D)The Seattle Angina Questionnaire

Question 13

Which of the following benefits is MOST associated with a disease-specific health-related quality of life instrument?

A)Apply to heterogeneous population.
B)Allow cross-population comparisons.
C)Address issues related to clinical manifestations of a disorder.
D)Address multiple issues related to limitations in health status.

Question 14

Which of the following clinical symptoms would lead to the end of a modified shuttle walk test or 6-minute walk test?

A)Patient is unable to continue per self-report.
B)Oxygen saturation is below a safe level for continued exertion.
C)Patient attains 85% of maximal predicted heart rate.
D)All of the above are valid reasons to end the test.

Question 15

Intraclass correlation coefficient (ICC)measures which of the following psychometric properties?

A)Internal consistency
B)Test-retest reliability
C)Validity
D)Sensitivity to change

Question 16

Which of the following changes is a reflection of management decision making enhanced by outcome data?

A)Redistribution of program resources to improve care delivery
B)Hiring new practitioners
C)Maintaining existing protocols
D)All of the above

Question 17

Health-related quality of life (HRQOL)assessment will assist the physical therapist with which of the following aspects of rehabilitation?

A)Choosing the most appropriate treatment intervention
B)Modifying treatment interventions
C)Measuring the results as a reflection of quality of care
D)All of the above

Question 18

Which of the following psychometric properties reflects knowing if the test does in fact measure what it intends to by comparing it to a gold standard?

A)Intended population
B)Validity
C)Reliability
D)Minimal detectable change

Question 19

Which of the following psychometric properties refers to the idea that if groups of questions are attempting to measure the same concept the consistent answers should be found among those specific questions?

A)Sensitivity to change
B)Test-retest reliability
C)Internal consistency
D)Validity

Question 20

Which of the following factors is considered a clinical patient outcome?

A)Survival
B)Cost of care
C)Satisfaction
D)Resource utilization

Question 21

Which of the following functional outcome measures provides a good prediction of the type of location in which a patient would optimally function after hospitalization?

A)6-minute walk test
B)Timed up and go
C)Gait speed
D)Maximum oxygen consumption test

Question 22

Which of the following test characteristics results in the modified shuttle walk test having a greater cardiovascular response on a patient as compared to the 6-minute walk test?

A)Self-paced test.
B)Incremental and progressive exercise.
C)More encouragement is provided.
D)Ascending and descending steps are included.

Question 23

If a change in an outcome measure falls within the error measurement of the tool,as calculated considering the standard deviation of the measurement,the true clinical change has been achieved.

Question 24

Which of the following variables collected at the time of a patient's initial evaluation is considered a demographic data factor?

A)Blood pressure
B)Hemodynamic regulation
C)Blood lipid levels
D)Comorbidities

Question 25

Payers such as the Center for Medicare and Medicaid Services (CMS)and regulatory agencies such as the Joint Commission on the Accreditation of Health Care Organizations (JCAHO)are MOST concerned with which of the following factors related to health care delivery?

A)Number of patients treated
B)Proper documentation for each treatment billed
C)Quality of care delivered
D)Type of patients treated

Question 26

The more specific the tool is to the population,the less sensitive the tool will be toward change.

Question 27

The question,if a test is administered by multiple individuals on various occasions will the same results be found,is BEST answered by which psychometric property?

A)Internal consistency reliability
B)Test-retest reliability
C)Validity
D)Sensitivity to change

Question 28

The gold standard for measurement of functional exercise capacity is which of the following outcome measures?

A)6-minute walk test
B)Modified shuttle test
C)Oxygen consumption test
D)200-meter walk test

Question 29

Which of the following reasons supports the need to determine and measure outcomes of a rehabilitation program?

A)Mandated by regulatory groups
B)Mandated by payor groups
C)Demonstrate accountability
D)Improve the number of referrals

Question 30

Which of the following risk factors should be present when the completion of an ankle-brachial index is indicated?

A)Diabetes
B)High HDL
C)Anorexia
D)Asthma