CCRP Exam Blueprint

The CCRP Exam Blueprint outlines the content that the Certified Cardiac Rehabilitation Professional (CCRP) exam will address. Candidates are required to demonstrate proficiency by answering exam questions that evaluate their knowledge of facts, concepts and processes required to complete the tasks described below. Additional information regarding the exams is made available in the 2015 CCRP Candidate Handbook.

Domain (Duties and Tasks)

% of exam

1. Patient Assessment

14%

1.1 Explain cardiovascular system anatomy and physiology

 

1.2 Recognize pathophysiology of cardiovascular diseases (e.g., atherosclerosis, valvular heart disease, chronic heart failure)

 

1.3 Identify risk factors contributing to atherosclerotic heart disease

 

1.4 Recognize cardiac dysrhythmias and potential implications during physical activity

 

1.5 Identify cardiovascular interventions and device therapies (e.g., bypass surgery, valve replacement/repair, pacemakers/ICDs, LVADs)

 

1.6 Review results of cardiovascular assessments, diagnostic tests, and procedures (e.g., 12-lead ECG, heart catheterization, echocardiogram, stress tests)

 

1.7 Recognize signs and symptoms associated with cardiovascular diseases

 

1.8 Recognize pharmacologic management plans and potential side effects

 

1.9 Identify comorbidities  thatinfluence function or treatment strategies

 

1.10 Identify potential psychosocial factors associated with CVD

 

1.11 Conduct an assessment of functional capacity

 

1.12 Conduct pain assessment

 

1.13 Conduct psychosocial assessment

 

1.14 Conduct patient learning assessment (e.g., preferred learning style, literacy level, and barriers to learning)

 

1.15 Conduct nutrition assessment

 

1.16 Stratify patients for risk of adverse events and disease progression using the AACVPR criteria

 

1.17 Recognize patient cultural barriers and/or spirituality needs

 

1.18 Collaborate with patient and family to establish goals

 

1.19 Share decision-making and management with patient, family, providers and other staff

 

1.20 Develop evidence-based individualized treatment plan

 

2. Nutrition Management

9%

2.1 Recognize role and impact of diet on CVD progression and risk factor management

 

2.2 Assess dietary habits that influence disease development and progression

 

2.3 Identify evidence-based nutritionrecommendations for CVD

 

2.4 Identify evidence-based nutrition recommendations for dyslipidemia

 

2.5 Identify evidence-based nutrition recommendations for obesity

 

2.6 Identify evidence-based nutrition recommendations for hypertension

 

2.7 Identify evidence-based nutrition recommendations for diabetes

 

2.8 Identify evidence-based nutrition recommendations for heart failure

 

2.9 Recognize effective behavior change strategies that impact dietary modifications

 

2.10 Recognize when to refer a patient or consult with other professional(s) for nutritional management

 

3. Weight Management

10%

3.1 Assess body weight status (overweight and obesity), body fat percentage, waist measurement, and body fat distribution

 

3.2 Recognize the physiologic and pathologic effects of overweight/obesity and that of low body weight

 

3.3 Identify methods that affect energy balance (caloric intake vs. caloric expenditure)

 

3.4 Apply weight management strategies through the balance of caloric intake and caloric expenditure (e.g., diet strategies, physical activity strategies)

 

3.5 Incorporate evidence-based guidelines and recommendations for healthy body weight

 

3.6 Employ weight loss interventions that promote gradual, sustainable weight loss (5%–10%) over 3-6 months

 

3.7 Recognize effective behavior change strategies that impact weight management

 

3.8 Recognize when to refer a patient or consult with other professional(s) for weight management

 

4. Blood Pressure Management

7%

4.1 Recognize the etiology and pathophysiology of hypertension as a risk factor for CVD

 

4.2 Recognize the role of the kidney in blood pressure control

 

4.3 Explain the physiology of BP (at rest and during exercise)

 

4.4 Classify blood pressure according to current guidelines, including secondary prevention targets

 

4.5 Identify symptomatic hypotension

 

4.6 Manage patient with hypotension

 

4.7 Identify management strategies for patients with hypertension

 

4.8 Measure BP using an appropriately sized arm cuff with an aneroid sphygmomanometer or alternative devices

 

4.9 Perform accurate BP measurements at rest and during exercise

 

4.10 Educate patients on home BP monitoring and management

 

4.11 Reinforce to patients the importance of BP medication adherence

 

4.12 Recognize effective behavior change strategies that impact BP management

 

4.13 Recognize when to refer a patient or consult with other professional(s) for BP management

 

4.14 Address psychosocial issues that affect BP and BP management

 

4.15 Identify antihypertensive medications, common side effects, and possible effects on the acute responses to exercise

 

4.16 Educate patients on the role of sodium and alcohol restrictions in BP control

 

4.17 Emphasize the importance of a multifactorial approach to BP management

 

5. Blood Lipid Management

8%

5.1 Explain the components of a blood lipid profile (i.e., LDL-C, HDL-C, VLDL-C, TG, non-HDL-C)

 

5.2 Identify optimal blood lipid values based on evidence-based guidelines

 

5.3 Reinforce regular blood lipid assessments

 

5.4 Describe the physiologic role of lipids and inflammation in the atherosclerotic disease process

 

5.5 Reinforce the effect of various diets on blood lipids (e.g., TLC diet, Mediterranean diet, DASH diet)

 

5.6 Identify lipid lowering medications and common side effects

 

5.7 Describe the effects that dietary fats and simple carbohydrates have on blood lipid levels

 

5.8 Educate patients on the use of food labels related to the types and amounts of dietary fats

 

5.9 Explain the influence of type II diabetes on blood lipids

 

5.10 Describe the importance and efficacy of pharmacological approaches to control blood lipids

 

5.11 Describe the importance and efficacy of non-pharmacological approaches to control blood lipids (e.g., exercise, weight management, smoking cessation, alcohol consumption)

 

5.12 Reinforce to patients the importance of lipid lowering medication adherence

 

5.13 Recognize effective behavior change strategies that impact blood lipid management

 

5.14 Recognize when to refer a patient or consult with other professional(s) for blood lipid management

 

6. Diabetes Management

9%

6.1 Recognize the etiology and pathophysiology of type I and type II  Diabetes Mellitus (DM)

 

6.2 Identify recommended fasting and non-fasting blood glucose values which define hypoglycemia and hyperglycemia

 

6.3 Recognize the clinical importance and recommended target value for glycosolated hemoglobin (HbA1c) in diabetic patients

 

6.4 Identify signs/symptoms of hypoglycemia and hyperglycemia

 

6.5 Explain appropriate responses to hypoglycemic and hyperglycemic events

 

6.6 Identify glucose lowering medications and common side effects

 

6.7 Reiterate the clinical importance of monitoring blood glucose values before and after exercise training sessions

 

6.8 Identify contraindications for beginning exercise based on blood glucose values

 

6.9 Identify the components of the metabolic syndrome

 

6.10 Modify exercise plan to accommodate for complications of DM (e.g., peripheral neuropathy, PAD, CAD/CVA, diabetic retinopathy)

 

6.11 Emphasize proper foot care for persons with DM

 

6.12 Describe the importance and efficacy of non-pharmacological approaches to control DM (e.g., exercise, weight management, reduced alcohol consumption)

 

6.13 Educate patients on the proper use of glucometers

 

6.14 Reinforce to patients the importance of DM medication adherence

 

6.15 Recognize effective behavior change strategies that impact DM management

 

6.16 Recognize when to refer a patient or consult with other professional(s) for DM  management

 

6.17 Address psychosocial issues that affect DM management

 

7. Tobacco Cessation

7%

7.1 Incorporate current guidelines for treating tobacco use into patient plan of care

 

7.2 Identify the biochemical and physiologic consequences of tobacco use

 

7.3 Identify the physiologic and psychological aspects of nicotine addiction

 

7.4 Identify the risk for the development of CVD from secondhand smoke

 

7.5 Identify the risks for relapse and strategies for preventing relapse

 

7.6 Address psychosocial issues that affect tobacco cessation

 

7.7 Recognize effective behavior change strategies that impact tobacco cessation

 

7.8 Recognize when to refer a patient to or consult with other professional(s) for tobacco cessation

 

7.9 Reinforce to patients the importance of tobacco pharmacologic therapy and medication adherence

 

7.10 Provide patients with national and local resources for tobacco cessation

 

7.11 Identify tobacco cessation medications and common side effects

 

8. Psychosocial Management

9%

8.1 Recognize the influence of psychosocial risk factors on the pathophysiology of CVD

 

8.2 Recognize symptoms associated with psychosocial disorders

 

8.3 Recognize the influence of psychosocial risk factors on rehabilitation and compliance

 

8.4 Identify the important considerations in selecting tool(s) to screen for psychosocial risk factors

 

8.5 Incorporate psychosocial outcome measures to guide treatment

 

8.6 Recognize the association of psychosocial factors (i.e., anxiety, depression, anger/hostility, social isolation and substance abuse) with recurrent CVD events and negative outcomes

 

8.7 Implement AHA recommendation to screen for depression

 

8.8 Instruct patients on extrinsic chronic and acute psychosocial stressors (e.g., socioeconomic, work, marital, caregiving)

 

8.9 Explain to patients the interaction between psychosocial risk factors and other health issues (e.g., GI, chronic pain, impaired immune response, sleep disturbances)

 

8.10 Incorporate relaxation techniques, including deep breathing and progressive muscle relaxation

 

8.11 Reinforce to patients the importance of adhering to medication(s) used to manage psychosocial issues

 

8.12 Identify medications used for psychosocial issues and common side effects

 

8.13 Recognize effective behavior change strategies that impact psychosocial issues

 

8.14 Recognize when to refer a patient or consult with other professional(s) for psychosocial management

 

9. Physical Activity Counseling

13%

9.1 Differentiate between physical activity and exercise

 

9.2 Identify methods to assess physical activity (subjective and objective)

 

9.3 Recognize pros and cons of different types of physical activity assessment methodologies

 

9.4 Interpret physical activity assessment results

 

9.5 Recognize the lack of regular physical activity and sedentary behavior as risk factors for CVD morbidity and mortality

 

9.6 Counsel patients regarding current evidence-based recommendations for regular physical activity (intensity, frequency, and accumulate daily duration) for adults and older adults

 

9.7 Emphasize the importance of physical activity progression for previously sedentary or irregularly active adults

 

9.8 Consider modification of physical activity recommendations based on preexisting conditions (e.g., musculoskeletal and neuromuscular)

 

9.9 Identify physical activities that may increase the risk for an adverse event

 

9.10 Identify environmental conditions that increase the risk for an adverse event while performing physical activity

 

9.11 Recognize barriers to increasing physical activity

 

9.12 Counsel patients on metabolic requirements for common activities (e.g., recreational, occupational, sexual)

 

9.13 Differentiate between the physiologic demands of upper and lower body physical activities

 

9.14 Recognize effective behavior change strategies that impact physical activity

 

9.15 Recognize when to refer a patient or consult with other professional(s) to assist with physical activity limitations (e.g., physical therapy, occupational therapy, orthopedic)

 

9.16 Incorporate the use of goal setting to support physical activity behavior change

 

9.17 Advise patients on the benefits and usage of activity monitoring devices for increasing physical activity (e.g., pedometers, heart rate monitors)

 

9.18 Address interrelationship between psychosocial health and physical activity

 

10. Exercise Training

14%

10.1 Identify absolute and relative contraindications for exercise

 

10.2 Identify absolute and relative indications for stopping exercise

 

10.3 Recognize serious dysrhythmias (e.g., ventricular couplets, ventricular fibrillation, ventricular tachycardia, bundle branch block, atrial fibrillation)

 

10.4 Recognize ECG changes and symptoms for myocardial ischemia and infarction

 

10.5 Specify the components of health-related physical fitness

 

10.6 Consider the importance of various cardiovascular physiologic measures (e.g., metabolic equivalents METs, rate pressure product RPP, oxygen uptake VO2, ejection fraction EF)

 

10.7 Recognize normal acute physiologic responses to aerobic exercise

 

10.8 Respond to adverse events during exercise

 

10.9 Recognize the effect medications have on exercise responses

 

10.10 Recognize normal chronic adaptations to aerobic exercise training

 

10.11 Recommend individualized, safe and effective modes, intensity, frequency, duration, and progression of the aerobic exercise prescription for cardiac patients

 

10.12 Consider modification of exercise prescription to accommodate existing comorbidities

 

10.13 Design an aerobic exercise training session (i.e., warm-up, exercise, cool-down and stretching)

 

10.14 Coach proper techniques for improving flexibility, balance, and strength

 

10.15 Prescribe individualized resistance training program (e.g., repetitions, sets, frequency, correct technique, and progression)

 

10.16 Instruct patients on proper skin preparation and electrode placement for ECG telemetry monitoring

 

10.17 Maintain and calibrate exercise equipment

 

10.18 Recognize effective behavior change strategies that impact the exercise training