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AACVPR CCRP study materials
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AACVPR CCRP practice questions

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Question 1Cardiac Rehabilitation Foundations and Program Management

One metabolic equivalent (MET) is defined as which resting oxygen consumption?

  1. 7.0 mL O2/kg/min
  2. 3.5 mL O2/kg/min Correct answer.
  3. 5.0 mL O2/kg/min
  4. 2.0 mL O2/kg/min

Explanation

A MET represents resting metabolic rate, standardized as 3.5 mL of oxygen per kilogram per minute. Expressing workload in METs allows exercise capacity to be compared across patients and modalities.

Question 2Cardiac Rehabilitation Foundations and Program Management

Under Medicare, what is the maximum number of cardiac rehabilitation sessions generally covered per episode?

  1. 36 Correct answer.
  2. 24
  3. 48
  4. 12

Explanation

Medicare covers up to 36 sessions of cardiac rehabilitation, usually delivered 2 to 5 times per week over up to 36 weeks. Additional sessions require documentation of medical necessity.

Question 3Cardiac Rehabilitation Foundations and Program Management

The Borg Rating of Perceived Exertion scale ranges from:

  1. 5 to 15
  2. 0 to 10
  3. 6 to 20 Correct answer.
  4. 1 to 10

Explanation

The original Borg RPE scale runs from 6 to 20, with 6 representing no exertion and 20 maximal exertion. A rating of about 11 to 13 generally corresponds to moderate intensity.

Question 4Cardiac Rehabilitation Foundations and Program Management

Which condition is the most common indication for referral to cardiac rehabilitation?

  1. Stable asthma
  2. Chronic kidney disease
  3. Peripheral arterial disease
  4. Recent myocardial infarction Correct answer.

Explanation

Recent myocardial infarction is among the most frequent and well-established indications for cardiac rehabilitation. Asthma, peripheral arterial disease, and chronic kidney disease are not primary cardiac rehabilitation indications.

Question 5Cardiac Rehabilitation Foundations and Program Management

Which is a required core component of cardiac rehabilitation?

  1. Chiropractic care
  2. Sleep hygiene
  3. Tobacco cessation Correct answer.
  4. Occupational therapy

Explanation

Tobacco cessation counseling is one of the required core components of cardiac rehabilitation. Core components also include patient assessment, nutritional counseling, risk factor management, psychosocial management, physical activity counseling, and exercise training.

Question 6Cardiac Rehabilitation Foundations and Program Management

Who is responsible for the medical direction and supervision of a cardiac rehabilitation program?

  1. A physical therapist
  2. An exercise physiologist
  3. A registered nurse
  4. A qualified physician Correct answer.

Explanation

A qualified physician provides medical direction, oversight of policies, and supervision of the cardiac rehabilitation program. Other team members deliver services within their scope but do not hold overall medical direction.

Question 7Cardiac Rehabilitation Foundations and Program Management

Which resting blood pressure value generally contraindicates exercise training in cardiac rehabilitation?

  1. 185/112 mm Hg Correct answer.
  2. 130/80 mm Hg
  3. 160/95 mm Hg
  4. 145/90 mm Hg

Explanation

A resting systolic pressure above 180 mm Hg or diastolic pressure above 110 mm Hg generally warrants deferring exercise training until blood pressure is controlled. Lower values may require monitoring but are not absolute contraindications.

Question 8Cardiac Rehabilitation Foundations and Program Management

What exercise frequency is typically recommended for aerobic training in cardiac rehabilitation?

  1. 3-5 days per week Correct answer.
  2. Only on symptom days
  3. 6-7 days per week
  4. 1-2 days per week

Explanation

Aerobic exercise is typically prescribed 3 to 5 days per week in cardiac rehabilitation. This frequency supports cardiovascular conditioning while allowing adequate recovery between sessions.

Question 9Cardiac Rehabilitation Foundations and Program Management

A patient has a peak heart rate of 180 bpm and a resting heart rate of 70 bpm. Using the Karvonen method, what is the target heart rate at 60% intensity?

  1. 112 bpm
  2. 136 bpm Correct answer.
  3. 126 bpm
  4. 142 bpm

Explanation

The Karvonen method calculates target heart rate as resting heart rate plus the intensity fraction times the heart rate reserve. Here, (180 minus 70) times 0.60 equals 66, and adding the resting rate of 70 gives 136 bpm.

Question 10Cardiac Rehabilitation Foundations and Program Management

Which finding places a patient in the high-risk category for exercise training?

  1. Ejection fraction of 35% Correct answer.
  2. Ejection fraction of 55%
  3. No ischemia on stress testing
  4. Peak functional capacity of 8 METs

Explanation

An ejection fraction below 40% is a recognized high-risk marker in cardiac rehabilitation risk stratification. Preserved ejection fraction, good functional capacity, and absence of ischemia suggest lower risk.

Question 11Cardiac Rehabilitation Foundations and Program Management

What emergency equipment must be immediately available in a cardiac rehabilitation exercise area?

  1. A hemodialysis machine
  2. A defibrillator with emergency drugs Correct answer.
  3. A mechanical ventilator
  4. A diagnostic ultrasound unit

Explanation

A defibrillator and emergency medications must be immediately accessible during exercise sessions. Emergency protocols and trained staff are also required to respond rapidly to cardiac events.

Question 12Cardiac Rehabilitation Foundations and Program Management

Which instrument is commonly used to screen for depression in cardiac rehabilitation?

  1. Morse fall scale
  2. Braden scale
  3. PHQ-9 Correct answer.
  4. MMSE

Explanation

The Patient Health Questionnaire-9 (PHQ-9) is a widely used screening tool for depression. Depression screening is a core psychosocial component of cardiac rehabilitation.

Question 13Cardiac Rehabilitation Foundations and Program Management

The six-minute walk test is used in cardiac rehabilitation primarily to:

  1. Estimate functional capacity Correct answer.
  2. Diagnose coronary artery disease
  3. Determine resting blood pressure
  4. Measure peak oxygen uptake

Explanation

The six-minute walk test is a submaximal field test that estimates functional capacity and tracks response to therapy. It does not directly measure peak oxygen uptake or diagnose coronary disease.

Question 14Cardiac Rehabilitation Foundations and Program Management

How long should the warm-up phase of an exercise session typically last?

  1. 5-10 minutes Correct answer.
  2. 45-60 minutes
  3. 20-30 minutes
  4. 1-2 minutes

Explanation

A warm-up of about 5 to 10 minutes prepares the cardiovascular and musculoskeletal systems for conditioning exercise. It may include low-intensity aerobic activity and flexibility movements.

Question 15Cardiac Rehabilitation Foundations and Program Management

Using the age-predicted formula, what is the estimated maximum heart rate for a 60-year-old patient?

  1. 150 bpm
  2. 140 bpm
  3. 130 bpm
  4. 160 bpm Correct answer.

Explanation

The common age-predicted formula is 220 minus age. For a 60-year-old, 220 minus 60 equals 160 bpm.

Question 16Cardiac Rehabilitation Foundations and Program Management

Which precaution is most important for a patient with diabetes who exercises in cardiac rehabilitation?

  1. Skip insulin before exercise
  2. Avoid all carbohydrates during exercise
  3. Exercise only after a large meal
  4. Check glucose before and after exercise Correct answer.

Explanation

Patients with diabetes should have blood glucose monitored before and after exercise because activity can cause hypoglycemia or hyperglycemia. Insulin doses may need adjustment but should not be routinely withheld without guidance.

Question 17Cardiac Rehabilitation Foundations and Program Management

What blood pressure goal is generally recommended for most adults with hypertension?

  1. <150/95 mm Hg
  2. <120/70 mm Hg
  3. <130/80 mm Hg Correct answer.
  4. <140/90 mm Hg

Explanation

Current guidelines generally recommend a blood pressure goal below 130/80 mm Hg for most adults with hypertension. Individual targets may be individualized for older or frail patients.

Question 18Cardiac Rehabilitation Foundations and Program Management

A patient in cardiac rehabilitation has poorly controlled diabetes and obesity. Which team member is best suited to provide individualized medical nutrition therapy?

  1. Exercise physiologist
  2. Respiratory therapist
  3. Social worker
  4. Registered dietitian nutritionist Correct answer.

Explanation

A registered dietitian nutritionist is trained to provide individualized medical nutrition therapy for diabetes, obesity, and other cardiometabolic conditions. Other team members address exercise, pulmonary care, or psychosocial needs.

Question 19Cardiac Rehabilitation Foundations and Program Management

The rate-pressure product, an indirect index of myocardial oxygen demand, is calculated as:

  1. Heart rate divided by systolic pressure
  2. Systolic minus diastolic pressure
  3. Cardiac output times resistance
  4. Heart rate times systolic pressure Correct answer.

Explanation

The rate-pressure product is heart rate multiplied by systolic blood pressure. It is used as a noninvasive estimate of myocardial oxygen demand and can help identify an ischemic threshold.

Question 20Cardiac Rehabilitation Foundations and Program Management

For a patient starting cardiac rehabilitation, which method is most appropriate for setting aerobic exercise intensity?

  1. A fixed treadmill speed for all patients
  2. A percentage of peak test heart rate Correct answer.
  3. Maximal effort until symptoms occur
  4. The fastest pace tolerated

Explanation

Aerobic intensity is commonly prescribed as a percentage of peak heart rate or heart rate reserve obtained from a recent exercise test. Additional guidance from symptoms and perceived exertion improves safety and individualization.

Question 21Cardiac Rehabilitation Foundations and Program Management

Which heart failure patient meets Medicare criteria for cardiac rehabilitation coverage?

  1. Acute decompensated heart failure
  2. EF 45% with no symptoms
  3. EF 50% with controlled hypertension
  4. EF 35% with symptoms despite therapy Correct answer.

Explanation

Medicare covers cardiac rehabilitation for stable heart failure with an ejection fraction of 35% or less and persistent symptoms despite optimal therapy. Acute decompensated heart failure is unstable and not appropriate for exercise-based rehabilitation.

Question 22Cardiac Rehabilitation Foundations and Program Management

Which measure best reflects the quality of a cardiac rehabilitation program's exercise outcomes?

  1. Brochure distribution count
  2. Waiting room size
  3. Staff meeting frequency
  4. Functional capacity change Correct answer.

Explanation

Change in functional capacity from baseline to discharge reflects the clinical effect of exercise training and is a meaningful outcome measure. Structural or process activities such as meetings and brochures do not capture patient outcomes.

Question 23Cardiac Rehabilitation Foundations and Program Management

Why is severe aortic stenosis considered a contraindication to exercise training?

  1. It limits cardiac output during exertion Correct answer.
  2. It prevents accurate blood pressure measurement
  3. It increases pulmonary diffusion capacity
  4. It causes excessive bradycardia at rest

Explanation

Severe aortic stenosis impairs left ventricular outflow and can limit cardiac output during exertion, provoking syncope, angina, or serious arrhythmias. Exercise training should be deferred until the stenosis is evaluated and treated.

Question 24Cardiac Rehabilitation Foundations and Program Management

Why is heart rate less reliable for prescribing exercise intensity in heart transplant recipients?

  1. Resting heart rate is always above 120 bpm
  2. Aerobic exercise is not permitted
  3. The transplanted heart is denervated Correct answer.
  4. Beta-blockers are always contraindicated

Explanation

The transplanted heart is denervated, so the usual chronotropic response to exercise is blunted or delayed. Perceived exertion and other indicators are often used to guide intensity in these patients.

Question 25Cardiac Rehabilitation Foundations and Program Management

A cardiac rehabilitation program wants to demonstrate adherence to nationally recognized process measures. Which resource is most appropriate?

  1. The AACVPR registry Correct answer.
  2. The cafeteria menu
  3. The treadmill manual
  4. Individual staff opinions

Explanation

The AACVPR registry uses standardized quality indicators that allow programs to benchmark performance and demonstrate adherence to recognized process and outcome measures. Local documents and individual opinions are not standardized benchmarks.

Question 26Cardiac Rehabilitation Foundations and Program Management

Cardiac rehabilitation is best described as which of the following?

  1. A structured exercise class limited to the first 12 weeks after a cardiac event
  2. A comprehensive, multidisciplinary secondary prevention program Correct answer.
  3. A maintenance fitness program only for patients who had cardiac surgery
  4. An inpatient monitoring service that replaces cardiology follow-up

Explanation

AACVPR defines cardiac rehabilitation as a comprehensive, multidisciplinary secondary prevention program that combines exercise training, education, counseling, and risk-factor modification across the phases of recovery. It is not limited to supervised exercise or to a single care setting.

Question 27Cardiac Rehabilitation Foundations and Program Management

Which statement best characterizes phase I (inpatient) cardiac rehabilitation?

  1. It begins after discharge and requires continuous ECG monitoring
  2. It consists of monthly supervised sessions for one year
  3. It begins during the index hospitalization with low-level activity Correct answer.
  4. It is limited to patients who have had coronary artery bypass surgery

Explanation

Phase I begins during the acute hospitalization and focuses on early mobilization, low-level activity, education, and preventing the complications of bed rest. Continuous ECG monitoring and prolonged supervision are characteristic of phase II, not phase I.

Question 28Cardiac Rehabilitation Foundations and Program Management

A patient who completed phase II wishes to continue supervised exercise indefinitely. How is this maintenance phase generally handled under Medicare?

  1. Medicare covers maintenance sessions for as long as the patient attends
  2. Medicare does not cover maintenance-phase cardiac rehabilitation Correct answer.
  3. Medicare covers them after a second qualifying cardiac event
  4. Medicare covers them only when provided in a hospital gym

Explanation

Medicare pays for physician-supervised phase II cardiac rehabilitation for eligible patients but does not reimburse maintenance-phase exercise, which is typically self-pay or offered through community fitness settings. Programs must therefore plan a transition for patients leaving phase II.

Question 29Cardiac Rehabilitation Foundations and Program Management

Under Medicare, how many cardiac rehabilitation sessions is a patient typically eligible for initially?

  1. 12 sessions over 12 weeks
  2. 24 sessions over 24 weeks
  3. 72 sessions over 72 weeks
  4. 36 sessions over 36 weeks Correct answer.

Explanation

Medicare approves up to 36 sessions over a period of up to 36 weeks for eligible patients, with the option of extending to as many as 72 sessions when medical necessity is documented.

Question 30Cardiac Rehabilitation Foundations and Program Management

Under Medicare requirements, how often must the individualized treatment plan be reviewed and signed by a physician?

  1. Every exercise session
  2. Every 90 days
  3. Once, at program entry
  4. At least every 30 days Correct answer.

Explanation

Medicare requires the individualized treatment plan to be established and then reviewed and signed by the supervising physician at least every 30 days, documenting progress and continued medical necessity. A single signature at entry or a 90-day interval does not meet this requirement.

Question 31Cardiac Rehabilitation Foundations and Program Management

Which of the following conditions qualifies a patient for Medicare-covered cardiac rehabilitation?

  1. Asymptomatic premature ventricular complexes
  2. Chronic obstructive pulmonary disease
  3. Newly diagnosed atrial fibrillation
  4. Stable angina pectoris Correct answer.

Explanation

Covered indications include myocardial infarction within the preceding 12 months, coronary artery bypass surgery, percutaneous coronary intervention, valve repair or replacement, stable angina, heart transplant, and stable heart failure with reduced ejection fraction.

Question 32Cardiac Rehabilitation Foundations and Program Management

Before a patient begins exercise testing or training in a phase II program, which document should be obtained?

  1. A signed informed consent form Correct answer.
  2. A physician-signed do-not-resuscitate order
  3. A release of all prior medical records
  4. A copy of the patient's advance directive

Explanation

Informed consent documents that the patient understands the risks, benefits, and alternatives of exercise testing and training and is a standard prerequisite in phase II programming. Advance directives and record releases serve different purposes and are not the entry requirement for exercise participation.

Question 33Cardiac Rehabilitation Foundations and Program Management

According to AACVPR standards, staff supervising exercise in a phase II program should hold which minimum competency?

  1. Current basic and advanced cardiac life support certification Correct answer.
  2. Registration as a dietitian
  3. A master's degree in public health
  4. Certification in cardiac sonography

Explanation

Exercise supervisors must be trained and currently certified in basic and advanced cardiac life support so they can recognize and treat life-threatening arrhythmias and cardiac arrest during sessions.

Question 34Cardiac Rehabilitation Foundations and Program Management

A hospital treats many eligible patients, yet very few enroll in cardiac rehabilitation. Which factor most commonly explains this gap?

  1. The absence of a referral from the treating clinician Correct answer.
  2. Cardiac rehabilitation has little effect on mortality
  3. Few patients are eligible for cardiac rehabilitation after myocardial infarction
  4. Most insurers exclude cardiac rehabilitation from coverage

Explanation

Lack of a clinician referral is the most frequently cited reason eligible patients never enroll, which is why automatic referral and liaison-based enrollment strategies are recommended. Eligibility is broad and coverage for qualifying indications is established.

Question 35Cardiac Rehabilitation Foundations and Program Management

Which resource does AACVPR maintain to allow programs to benchmark outpatient cardiac rehabilitation outcomes?

  1. The AACVPR Outpatient Cardiac Rehabilitation Registry Correct answer.
  2. The National Cardiac Surgery Database
  3. The Hospital Consumer Assessment of Healthcare Providers and Systems
  4. The National Health Interview Survey

Explanation

AACVPR maintains a national outpatient registry that collects standardized data so programs can compare their processes and outcomes with peers and support certification.

Question 36Cardiac Rehabilitation Foundations and Program Management

A program director wants external validation that the program meets national standards for structure and process. Which action best accomplishes this?

  1. Applying for AACVPR program certification Correct answer.
  2. Requiring each staff member to earn the CCRP credential
  3. Submitting claims to Medicare for all enrolled patients
  4. Applying for a business license for the exercise facility

Explanation

AACVPR certification is a voluntary, program-level review that evaluates structure, process, and outcomes against national standards. Individual credentials and payment activity do not evaluate how the program itself is organized and delivered.

Question 37Cardiac Rehabilitation Foundations and Program Management

Which credential is awarded by AACVPR to individual cardiac rehabilitation professionals?

  1. Certified Cardiovascular Technologist (CVT)
  2. Certified Diabetes Care and Education Specialist (CDCES)
  3. Certified Cardiac Rehabilitation Professional (CCRP) Correct answer.
  4. Registered Clinical Exercise Physiologist (RCEP)

Explanation

The CCRP credential is awarded by AACVPR to individual professionals who meet education, experience, and examination requirements in cardiac rehabilitation.

Question 38Cardiac Rehabilitation Foundations and Program Management

Which dietary pattern is most consistent with current recommendations for secondary prevention in cardiac rehabilitation?

  1. A high-protein diet emphasizing red meat
  2. A diet relying on supplements for fat intake
  3. A diet with unrestricted saturated fat
  4. A Mediterranean-style or DASH-style eating pattern Correct answer.

Explanation

Guidelines for secondary prevention emphasize dietary patterns rich in vegetables, fruits, whole grains, legumes, nuts, and unsaturated fats, such as Mediterranean-style and DASH-style patterns.

Question 39Cardiac Rehabilitation Foundations and Program Management

Which approach is most effective for helping a patient stop smoking?

  1. Combining behavioral counseling with cessation pharmacotherapy Correct answer.
  2. Waiting until the exercise program ends
  3. Restricting counseling to patients who ask for it
  4. Advising the patient to quit at a single visit without follow-up

Explanation

Combining counseling with pharmacotherapy produces higher quit rates than either approach alone, and repeated contact over time strengthens the effect.

Question 40Cardiac Rehabilitation Foundations and Program Management

A patient in cardiac rehabilitation screens positive for moderately severe depressive symptoms at intake. What is the most appropriate next step for the program?

  1. Repeating the screen only at the final visit
  2. Reassuring the patient that mood improves with exercise and continuing as planned
  3. Notifying the supervising clinician and facilitating referral for evaluation Correct answer.
  4. Discharging the patient until mood improves

Explanation

A positive screen requires clinical follow-up: the program communicates the finding to the supervising clinician and helps arrange further evaluation and treatment while continuing to support participation. Depression is treatable and is associated with poorer adherence and outcomes when unaddressed.

Question 41Cardiac Rehabilitation Foundations and Program Management

The Duke Activity Status Index is used in cardiac rehabilitation to estimate which of the following?

  1. Left ventricular ejection fraction estimated from symptoms
  2. Functional capacity, from self-reported daily activities Correct answer.
  3. Adherence to prescribed medications
  4. Dietary fat intake over the past week

Explanation

The Duke Activity Status Index is a self-report questionnaire that estimates functional capacity from the patient's ability to perform everyday activities, making it useful when exercise testing is unavailable.

Question 42Cardiac Rehabilitation Foundations and Program Management

A patient recovering from an uncomplicated myocardial infarction asks when sexual activity can resume. Which guidance is most appropriate?

  1. After six months of supervised exercise regardless of symptoms
  2. When the patient can climb two flights of stairs without symptoms Correct answer.
  3. Immediately, because sexual activity places minimal demand on the heart
  4. Only after a repeat cardiac catheterization

Explanation

For uncomplicated recovery, sexual activity is generally safe once the patient can perform moderate exertion, such as climbing two flights of stairs, without cardiac symptoms. Counseling should also address timing relative to meals, nitrates, and symptom recognition.

Question 43Cardiac Rehabilitation Foundations and Program Management

Which statement best describes home-based cardiac rehabilitation as an alternative to center-based programming?

  1. It is appropriate only for patients who have never had a cardiac event
  2. It is not recognized by AACVPR or major payers
  3. It replaces all supervised exercise and removes any need for clinician oversight
  4. It can achieve outcomes similar to center-based care with proper patient selection Correct answer.

Explanation

Evidence supports home-based cardiac rehabilitation as a reasonable option with outcomes comparable to center-based programs when patients are appropriately selected, monitored, and supported with technology and clinician contact.

Question 44Cardiac Rehabilitation Foundations and Program Management

Which patient characteristic is most consistently associated with lower participation in cardiac rehabilitation?

  1. Employment at a desk job
  2. Having a spouse who drives
  3. Female sex and older age Correct answer.
  4. Male sex

Explanation

Enrollment and completion are consistently lower among women, older adults, racial and ethnic minority groups, and patients with low income, depression, or transportation barriers. These disparities drive targeted referral and navigation strategies.

Question 45Cardiac Rehabilitation Foundations and Program Management

In a phase II program, when should outcome measures be collected?

  1. Only when the patient requests them
  2. Only after 36 completed sessions
  3. Only at the final session
  4. At program entry and again at program exit Correct answer.

Explanation

Baseline assessment at entry and reassessment at exit allow the program to document change in functional capacity, risk factors, and psychosocial status and to compare results with benchmarks.

Question 46Cardiac Rehabilitation Foundations and Program Management

A patient nods when told how to take a new medication but cannot repeat the instructions. Which teaching technique best confirms understanding?

  1. Asking the patient to explain the regimen in their own words Correct answer.
  2. Deferring education to the next visit
  3. Speaking more loudly and repeating the same words
  4. Providing a longer written handout

Explanation

Teach-back asks patients to restate instructions in their own words, which reveals gaps in understanding that a nod or a handout alone can hide. It is a core strategy for patients with limited health literacy.

Question 47Cardiac Rehabilitation Foundations and Program Management

What is the primary purpose of the interdisciplinary team conference in cardiac rehabilitation?

  1. To review patient progress and adjust the treatment plan Correct answer.
  2. To schedule equipment maintenance
  3. To assign staff parking spaces
  4. To negotiate insurance contracts

Explanation

The interdisciplinary conference brings physicians, nurses, exercise physiologists, dietitians, and psychosocial staff together to review each patient's progress and revise the individualized treatment plan.

Question 48Cardiac Rehabilitation Foundations and Program Management

A program wants to evaluate its safety performance over time. Which metric is most appropriate?

  1. Total number of patients enrolled each year
  2. Number of staff holding the CCRP credential
  3. Adverse events per patient-exercise hour Correct answer.
  4. Average number of sessions attended per patient

Explanation

Rate-based measures such as adverse events per patient-exercise hour adjust for exposure, allowing valid comparison across time periods and programs. Raw counts and volume measures do not account for how much exercise was delivered.

Question 49Cardiac Rehabilitation Foundations and Program Management

A patient reports chest discomfort during a phase II exercise session. What should staff do first?

  1. Encourage the patient to finish the current exercise interval
  2. Increase the workload to see whether symptoms resolve
  3. Document the complaint and continue monitoring other patients
  4. Stop exercise, assess the patient, and follow the emergency protocol Correct answer.

Explanation

New chest discomfort during exercise requires immediate cessation of activity, clinical assessment, and activation of the program's emergency protocol, including ECG and vital sign evaluation as indicated.

Question 50Cardiac Rehabilitation Foundations and Program Management

Which strategy is most effective for improving medication adherence in cardiac rehabilitation patients?

  1. Providing a written medication list at discharge only
  2. Reviewing medications only when the patient reports a problem
  3. Leaving medication management entirely to family members
  4. Combining education, simplified dosing, and follow-up reminders Correct answer.

Explanation

Adherence improves when education is paired with simplified regimens, reminders, and systematic follow-up rather than a single discharge handout. Medication management is a core component of cardiac rehabilitation and is revisited across the program.