National Physical Therapy Examination (NPTE) Practice Exam

A patient with chronic bradycardia and a non-increasing pulse with exercise may need which intervention?

1. Heart transplant

2. Pacemaker implantation

3. Cardiac defibrillator implantation

4. A prescription for digitalis

The correct answer is: Pacemaker implantation

The correct choice indicates a need for pacemaker implantation in a patient exhibiting chronic bradycardia and a non-increasing pulse with exercise. Chronic bradycardia is defined as a consistently slow heart rate, typically below 60 beats per minute, which may cause insufficient blood flow to meet the body's demands, especially during physical activity. In this scenario, the patient’s inability to increase heart rate during exercise implies that the heart's natural pacemaker (the sinoatrial node) is not functioning effectively. A pacemaker serves to artificially stimulate the heart, ensuring it maintains a minimum heart rate and can adequately respond to the body's needs during different levels of activity. As a result, the implantation of a pacemaker can significantly improve the patient’s quality of life, allowing for a more normal physiological response to exercise and daily tasks. The other interventions listed are not appropriate for this specific case. A heart transplant is indicated for end-stage heart disease where the heart can no longer function at all, which is not the situation here. A cardiac defibrillator is used for patients at risk of life-threatening arrhythmias rather than controlling bradycardia. Finally, digitalis is sometimes prescribed for heart rate control, particularly in atrial fibrillation or heart failure