CSEP CEP PRACTICAL EXAM 2026 EXAM PREP
SCRIPT FULL QUESTION SET APPROVED
◉ Why may BORG and RPE be used in elderly patients vs HR/BP.
Answer: May be taking medications that can impact the response to
exercise
◉ What are some considerations when working with cancer
patients? Answer: Avoid dislodging PICC lines or catheters
May experience muscle weakness
Vestibular issues
Limited ROM due to surgeries
No exercise if chemo was received in past 24 hours
Radiation may impact cardiac function (reduced diastolic volume)
Radiation increases stiffness
Increased risk of fracture with advanced disease
Exercise tolerance will vary from session to session
◉ Name some contraindications when working with cancer patients
Answer: Monitor hematologic abnormalities (low platelets,
hemoglobin level)
MSK disorders (recent bone/back/neck pain; muscular weakness;
extreme fatigue)
,GI disorders (severe nausea, vomiting/diarrhea)
CV disorders (chest pain, elevated resting HR, elevated BP, irregular
heartbeat, lymphedema)
Pulmonary disorders (severe difficulty breathing,
coughing/wheezing)
Neurological disorders (decline in cognitive status, dizziness,
disorientation, blurred vision)
◉ What is a ventilatory impairment? Answer: Restrictive lung
expansion, resulting in decreased lung volume, increased work of
breathing, and inadequate ventilation
◉ What is a gas exchange impairment? Answer: Excess or deficit in
oxygenation or CO2 elimination at alveolar-capillary membrane
Abnormal arterial blood gasses, abnormal arterial pH, decreased
CO2, dyspnea, elevated BP, hypoxia
◉ What is an obstructive lung disease? Answer: Airway obstruction
causes increase in resistance; volume of each breath gets smaller
(asthma, bronchitis), air is trapped in the lungs (results in
hyperinflation)
◉ How are the volumes and capacities changed in an obstructive
lung disease? Answer: Increase RV, TLC
Decreased ERV
,◉ What is restrictive lung disease? Answer: Compliance of lung is
reduced, increases stiffness of lung and limits expansion; greater
pressure than normal required to give the same increase in volume
◉ How are the volumes and capacities changed in a restrictive lung
disease? Answer: All capacities are reduced due to reduced
compliance of the lung
◉ What is FEV1 in restrictive and obstructive diseases? Answer:
Obstructive: reduced
Restrictive: slightly reduced
◉ What is FEV1 in a normal patient? Answer: 0.8
◉ What is FVC in obstructive and restrictive lung disease? Answer:
Obstructive: slightly decreased or unchanged
Restrictive: decreased
◉ What is FVC in a normal patient? Answer: 0.8
◉ What is the FEV1/FVC ratio? Answer: Comparison of volume of air
exhaled in one second vs total volume
Used to test for obstructive disease
, ◉ What is a normal FEV1/FVC ration? Answer: Anything over 0.7
◉ What is diffusion capacity? Answer: Measures the diffusion of air
in and out of the lungs
◉ What is expiratory flow limitation? Answer: Expiratory flow
cannot increase despite increasing expiratory efforts
Predisposes to hyperinflation due to air trapping
Presents commonly in obstructive diseases (slope of expiration is
decreased because of obstruction)
◉ What is dynamic hyperinflation? Answer: Increase in end-
expiratory lung volume (EELV) that may occur in patients with
airflow limitation when minute ventilation increases (exercise)
Due to reduced elastic recoil of lungs
◉ How does obstructive disease shift the flow volume loop? Answer:
Shifted to the left (RV is increased due to air trapping)
Expiration is not as steep (FEV1 decreased due to obstruction)
Expiration is decreased (Reduced ERV)
◉ How does restrictive disease shift the flow volume loop? Answer:
Shifted to the right (reduced RV)
SCRIPT FULL QUESTION SET APPROVED
◉ Why may BORG and RPE be used in elderly patients vs HR/BP.
Answer: May be taking medications that can impact the response to
exercise
◉ What are some considerations when working with cancer
patients? Answer: Avoid dislodging PICC lines or catheters
May experience muscle weakness
Vestibular issues
Limited ROM due to surgeries
No exercise if chemo was received in past 24 hours
Radiation may impact cardiac function (reduced diastolic volume)
Radiation increases stiffness
Increased risk of fracture with advanced disease
Exercise tolerance will vary from session to session
◉ Name some contraindications when working with cancer patients
Answer: Monitor hematologic abnormalities (low platelets,
hemoglobin level)
MSK disorders (recent bone/back/neck pain; muscular weakness;
extreme fatigue)
,GI disorders (severe nausea, vomiting/diarrhea)
CV disorders (chest pain, elevated resting HR, elevated BP, irregular
heartbeat, lymphedema)
Pulmonary disorders (severe difficulty breathing,
coughing/wheezing)
Neurological disorders (decline in cognitive status, dizziness,
disorientation, blurred vision)
◉ What is a ventilatory impairment? Answer: Restrictive lung
expansion, resulting in decreased lung volume, increased work of
breathing, and inadequate ventilation
◉ What is a gas exchange impairment? Answer: Excess or deficit in
oxygenation or CO2 elimination at alveolar-capillary membrane
Abnormal arterial blood gasses, abnormal arterial pH, decreased
CO2, dyspnea, elevated BP, hypoxia
◉ What is an obstructive lung disease? Answer: Airway obstruction
causes increase in resistance; volume of each breath gets smaller
(asthma, bronchitis), air is trapped in the lungs (results in
hyperinflation)
◉ How are the volumes and capacities changed in an obstructive
lung disease? Answer: Increase RV, TLC
Decreased ERV
,◉ What is restrictive lung disease? Answer: Compliance of lung is
reduced, increases stiffness of lung and limits expansion; greater
pressure than normal required to give the same increase in volume
◉ How are the volumes and capacities changed in a restrictive lung
disease? Answer: All capacities are reduced due to reduced
compliance of the lung
◉ What is FEV1 in restrictive and obstructive diseases? Answer:
Obstructive: reduced
Restrictive: slightly reduced
◉ What is FEV1 in a normal patient? Answer: 0.8
◉ What is FVC in obstructive and restrictive lung disease? Answer:
Obstructive: slightly decreased or unchanged
Restrictive: decreased
◉ What is FVC in a normal patient? Answer: 0.8
◉ What is the FEV1/FVC ratio? Answer: Comparison of volume of air
exhaled in one second vs total volume
Used to test for obstructive disease
, ◉ What is a normal FEV1/FVC ration? Answer: Anything over 0.7
◉ What is diffusion capacity? Answer: Measures the diffusion of air
in and out of the lungs
◉ What is expiratory flow limitation? Answer: Expiratory flow
cannot increase despite increasing expiratory efforts
Predisposes to hyperinflation due to air trapping
Presents commonly in obstructive diseases (slope of expiration is
decreased because of obstruction)
◉ What is dynamic hyperinflation? Answer: Increase in end-
expiratory lung volume (EELV) that may occur in patients with
airflow limitation when minute ventilation increases (exercise)
Due to reduced elastic recoil of lungs
◉ How does obstructive disease shift the flow volume loop? Answer:
Shifted to the left (RV is increased due to air trapping)
Expiration is not as steep (FEV1 decreased due to obstruction)
Expiration is decreased (Reduced ERV)
◉ How does restrictive disease shift the flow volume loop? Answer:
Shifted to the right (reduced RV)
