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Quiz Session - Attempts With Random Questions

ACSM-CEP Exam Questions

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21.

Which of the following is true regarding knee pain?

  • Generalized anterior knee pain is the most common knee injury

  • Patellofemoral pain syndrome (PFPS) occurs most commonly in men aged 70 to 79

  • A man's narrower pelvis contributes to increased complaints of knee pain

  • Most cases of knee pain have nothing to do with the hips or ankles

Correct answer: Generalized anterior knee pain is the most common knee injury

By far, the most common knee symptoms occur in the anterior knee. 

PFPS occurs most commonly in women aged 50 to 59. A woman's wider pelvis can contribute to increased complaints of knee pain. Most cases of knee pain are thought to be related to hip and/or ankle issues.

22.

Which of the following is an appropriate exercise consideration for a patient who is currently undergoing radiation therapy and has experienced a severe tissue reaction on the skin of his lower back?

  • Exercises should be performed primarily in prone or standing

  • Exercises should only be performed in supine

  • This patient should avoid all free weight exercises

  • There are no modifications or special considerations that need to be made for this patient's exercise prescription

Correct answer: Exercises should be performed primarily in prone or standing

A patient who has experienced a severe tissue reaction on the skin of his lower back may have difficulty/pain with lying down or putting pressure on this area. Therefore, exercises in prone or standing may be more appropriate for this patient. However, all patients should be considered on a case by case basis, and the CEP should communicate with the supervising physician if there are any areas of concern related to exercise.

23.

Flexion and extension movements occur in which plane of the body?

  • The sagittal plane

  • The frontal plane

  • The coronal plane

  • The transverse plane

Correct answer: The sagittal plane

The sagittal plane divides the body into right and left halves. Flexion and extension movements occur within the sagittal plane.

The frontal plane divides the body into anterior and posterior halves; abduction and adduction occur in this plane. The coronal plane is another term for the frontal plane, usually used to describe structures near the cranium. The transverse plane divides the body into superior and inferior halves; rotational movements occur in this plane.

24.

Which of the following is true regarding Sickle Cell Disease?

  • Patients with Sickle Cell Disease have better protection against malaria

  • Patients with Sickle Cell Disease tend to function better at high altitudes

  • While it can lead to discomfort, Sickle Cell Disease is not life-threatening

  • Moderate to high intensity exercise programs seem to benefit patients with Sickle Cell Disease more than low-intensity programs

Correct answer: Patients with Sickle Cell Disease have better protection against malaria

The condition is found primarily in those of sub-Saharan or Central American ancestry, and other areas where malaria is prevalent.

Patients with Sickle Cell Disease tend to struggle at high altitudes. Sickle Cell Disease is a life-threatening condition, especially when the patient is exercising or participating in a sport. Patients with Sickle Cell Disease should be prescribed low intensity exercise to avoid complications.

25.

Which of the following is true regarding preparticipation health screenings?

  • Screenings should serve to limit referring patients to health care providers unless absolutely necessary, as this can create a barrier to exercise

  • The primary purpose of preparticipation health screenings is to determine how serious the person is about committing to an exercise program

  • Preparticipation screenings need to be updated in order to encourage more referrals to physicians prior to starting exercise

  • The use of a preparticipation exercise screening form essentially replaces the clinical judgement of the CEP

Correct answer: Screenings should serve to limit referring patients to health care providers unless absolutely necessary, as this can create a barrier to exercise

In the past, health screenings have led to excessive referrals which have frustrated clients and sometimes caused them financial issues. Health screenings should provide a quick way to assess whether or not a patient needs further testing or whether they can safely initiate exercise.

The primary purpose of a screening is to ensure that the person is at low risk for injury and to decide whether a physician should evaluate said person prior to her beginning exercise. Preparticipation screenings do not need to encourage more referrals, but should only cause CEPs to make referrals when the patient is at risk for injury due to exercise and needs clearance. The CEP should always use sound judgement, and no screening tool can serve as a replacement for this judgement.

26.

Which of the following options would be the best way for a CEP to help a client avoid relapsing?

  • Working with the client to make a plan to exercise as soon as possible after a vacation

  • Encouraging the client to exercise whenever they feel like it, rather than having a defined exercise schedule

  • Discouraging the client from exercising in a group setting to increase focus and self-reliance

  • Prescribing exercises that the client actively dislikes to increase mental toughness and discipline

Correct answer: Working with the client to make a plan to exercise as soon as possible after a vacation

Throughout the time a CEP is working with a client, there will often be periods where the client is on vacation or otherwise unable to hold a session. When this happens, the CEP should encourage the client to make a plan to exercise and get back on track as soon as possible after the short lapse.

Exercise sessions should be scheduled regularly, as relying on exercise only when a client feels like it may lead to long stretches without exercise and eventual relapse. Group exercise settings are often helpful for preventing relapse, as the client is then accountable to another group of people. Most clients will not respond well to being encouraged to only perform exercises that they don't like and may drop off as a result.

27.

Which of the following muscles attach to the achilles tendon?

  • Soleus and gastrocnemius

  • Tibialis anterior and peroneus longus

  • Rectus femoris and hamstrings

  • Biceps femoris and vastus lateralis

Correct answer: Soleus and gastrocnemius

The thick achilles tendon lies on the back of the ankle and serves as an attachment point for the calf muscles (the gastrocnemius and soleus). This is an area that is commonly tight in athletes and sedentary individuals alike. Tightness and weakness in this area can often lead to injury, and exercise prescriptions of all kinds should include techniques to keep this area flexible and strong.

28.

Which of the following is true regarding genetics and exercise?

  • Genetics seems to influence roughly half of the body's training response to both endurance exercise and resistance exercise

  • Genetics seems to play no role in the body's response to cardiovascular exercise, but may have some effect on the response to resistance training

  • Genetics seems to play no role in the body's response to resistance training exercise, but may have some effect on the response to cardiovascular exercise

  • Genetics seems to be the most important factor when predicting how well a client will respond to exercise of any kind

Correct answer: Genetics seems to influence roughly half of the body's training response to both endurance exercise and resistance exercise

Genetics influences roughly 50% of the body's response to cardiovascular exercise and about 47% of the body's response to resistance training. 

Genetics appears to influence both resistance training and cardiovascular exercise responses in roughly equal ways. While genetics is important in predicting how well a patient will respond to exercise, it is far from the only important factor. The CEP needs to consider environment, disease processes, and many other factors.

29.

Which of the following is true of patients with spinal cord injuries (SCI)?

  • The higher the level of the spinal cord injury, the worse the impairment will usually be

  • The lower the level of the spinal cord injury, the worse the impairment will usually be

  • Spinal cord injuries always involve both sides of the body

  • The level of L4 is considered to be the worst area to incur a spinal cord injury

Correct answer: The higher the level of the spinal cord injury, the worse the impairment will usually be

The higher levels of the spinal cord are responsible for more control over the body. This is especially true in the cervical spine, in which control of breathing and other visceral functions can be impaired from a spinal cord injury. In many cases, severe injuries to the cervical spine can lead to death or severe impairment.

30.

Using the equation 220-age, a CEP can get a rough estimate of which of the following metrics in a client?

  • Max heart rate

  • Resting heart rate

  • BMI

  • Systolic blood pressure

Correct answer: Max heart rate

220-age provides an estimate of an individual's max heart rate. There are more accurate ways of determining max heart rate, but this is a very quick and easy method to give the CEP a starting point.

Resting heart rate can vary widely and needs to be measured in each individual client. BMI is calculated by dividing one's weight by his height squared. Systolic blood pressure cannot be accurately predicted through an equation and needs to be measured in each individual client.

31.

Which of the following is a true statement regarding skeletal muscle?

  • Most skeletal muscle strength is lost after the age of 50

  • There is a linear decrease in skeletal muscle strength after the age of 30

  • Skeletal muscle is found around most organs of the body

  • Cardiac muscle and skeletal muscle are almost identical when observed under a microscope

Correct answer: Most skeletal muscle strength is lost after the age of 50

Age 50 and beyond signals the start of the majority of muscle loss in most individuals. By the time a person turns 80, nearly 35% of muscle may be lost.

The loss of strength that occurs after the age of 30 is not linear. Smooth muscle is found in and around organs of the body. Cardiac muscle and skeletal muscle have significant differences which are apparent on a microscopic examination.

32.

Which of the following is true regarding muscle protein synthesis in middle-aged adults?

  • Both aerobic exercise and resistance training can stimulate muscle protein synthesis in middle-aged adults

  • Only resistance training can stimulate muscle protein synthesis in middle-aged adults 

  • Only aerobic training can stimulate muscle protein synthesis in middle-aged adults

  • By midlife, testosterone levels are too low in most individuals for any muscle protein synthesis to take place

Correct answer: Both aerobic exercise and resistance training can stimulate muscle protein synthesis in middle-aged adults

Regardless of the type of exercise, middle-aged individuals can encourage muscle protein synthesis during this time of life by increasing their activity. 

While resistance training may provide better results in terms of muscle protein synthesis, cardiovascular exercise is effective as well. Testosterone levels often begin to fall during this time of life, but this does not mean that hypertrophy of both type I and type II fibers is impossible for this age group. 

33.

Which of the following is not a way in which physical activity trackers encourage movement in those who wear them?

  • By forcing wearers to exercise for a certain amount of time each day

  • By holding users accountable to meet specific daily movement goals

  • By linking up with other technology to increase support from CEPs, family, and friends

  • By reminding users that it's time to exercise

Correct answer: By forcing wearers to exercise for a certain amount of time each day

Activity trackers are a very useful invention for encouraging activity in wearers. However, they cannot force users to be more active. Instead, they can remind them when it's time to exercise, help them be accountable by allowing for goal input, and increase social connection by being compatible with social media platforms and other technology sources.

34.

A patient arrives at her training session after just having completed blood work and a variety of other tests. She shows her CEP some of the results on her phone:

  • Triglycerides: 220 mg/dL
  • Total Cholesterol: 250 mg/dL
  • HDL: 20 mg/dL

How should the CEP interpret these results?

  • Her triglyceride levels are high, her total cholesterol is high, and her HDL levels are low

  • Her triglyceride levels are normal, her total cholesterol is high, and her HDL levels are low

  • Her triglyceride levels are normal, her total cholesterol is normal, and her HDL levels are high

  • Her triglyceride levels are borderline high, her total cholesterol is high, and her HDL levels are high

Correct answer: Her triglyceride levels are high, her total cholesterol is high, and her HDL levels are low

Cholesterol levels (in mg/dL) are classified as follows:

  • LDL
    • < 100: optimal
    • 100-128: near optimal
    • 130-159: borderline high
    • 160-189: high
    • > 189: very high
  • Total Cholesterol
    • < 200: desirable
    • 200-239: borderline high
    • > 239: high
  • HDL
    • < 40: low
    • > 59: high
  • Triglycerides
    • < 150: normal
    • 150-199: borderline high
    • 200-499: high
    • > 499: very high

35.

Which of the following options best describes the process of protein turnover?

  • Muscle protein is broken down, then synthesis of muscle occurs

  • When a person eats an excess of dietary protein, some of it is converted into fat

  • As amino acids begin to form a protein, the protein structure slowly "turns over" on itself

  • When a person eats an excess of dietary protein, some of it is converted into carbohydrates

 Correct answer: Muscle protein is broken down, then synthesis of muscle occurs

After resistance training exercise, both muscle breakdown and synthesis occur. This feedback loop involving breakdown and buildup is known as protein turnover. As a person begins to increase their training frequency, protein synthesis surpasses protein breakdown. This, in turn, leads to muscle hypertrophy.

36.

What is the difference between eccentric and concentric muscle contractions?

  • Eccentric muscle contractions involve the lengthening of muscle under tension; concentric muscle contractions involve the shortening of muscle under tension

  • Eccentric muscle contractions involve the shortening of muscle under tension; concentric muscle contractions involve the lengthening of muscle under tension

  • Eccentric muscle contractions involve a variable amount of force with no change in joint angle; concentric muscle contractions involve the shortening or lengthening of muscle with a constant speed

  • Eccentric muscle contractions involve an explosive movement; concentric muscle contractions involve the lengthening of muscle under tension

Correct answer: Eccentric muscle contractions involve the lengthening of muscle under tension; concentric muscle contractions involve the shortening of muscle under tension

When discussing eccentric and concentric muscle contractions, one can most easily envision the movements with regard to "standard" lifting exercises. For instance, the concentric phase of a bicep curl is when the weight moves up and the elbow bends, while the eccentric phase is when the weight is slowly lowered back down and the elbow straightens.

A variable amount of force with no change in joint angle most nearly describes isometric contractions. Explosive movements relate to plyometric exercise. Constant speed refers to isokinetic movements.

37.

Which of the following is true regarding cardiovascular responses to exercise?

  • Resting heart rate may decrease in response to consistent aerobic exercise

  • Max heart rate may increase in response to consistent aerobic exercise

  • Resting heart rate will always decrease in response to long-term weight lifting and resistance exercise

  • Cardiac output will decrease in response to regular aerobic exercise

Correct answer: Resting heart rate may decrease in response to consistent aerobic exercise

In many cases, resting heart rate will decrease over time as clients' cardiovascular systems become more efficient with long-term aerobic exercise.

Max heart rate does not change in response to the type or intensity of training. Resting heart rate may decrease in response to long-term resistance training, but not always. Cardiac output will increase in response to regular aerobic exercise.

38.

Excessive movement of the patient, improperly prepared skin, and the use of electrodes that are no longer viable could result in which of the following findings on ECG?

  • Artifact

  • Digitalis Effect

  • Consistently inverted T-waves

  • ST-segment elevation

Correct answer: Artifact

When patients are exercising, or there is some reason why a consistent reading can't be obtained, the examiner will often see artifacts on the ECG.

The Digitalis Effect is characterized by U-shaped dips in the ST-segment, and is caused by the medication Digitalis. Consistently inverted T-waves is a sign of a "strain pattern". ST-segment elevation is typically a sign of ischemia or myocardial infarction.

39.

When prescribing exercise and developing a long-term plan for a client, which of the following is the least appropriate consideration?

  • How many sessions the client will be able to pay for to generate the most revenue for the CEP

  • The client's initial starting point across multiple domains of health

  • The client's exercise preferences

  • The client's goals

Correct answer: How many sessions the client will be able to pay for to generate the most revenue for the CEP

While money is an important consideration, it shouldn't be the driving force behind an exercise prescription. CEPs should attempt to develop goals and exercise prescriptions that will most benefit their clients, regardless of the financial considerations involved.

The client's baseline status is critical for exercise prescription and long-term planning. Exercise preferences can help to mold a client's exercise plan in a way to prevent relapses and help the client reach their goals. Goals drive much of the exercise plan and help the CEP develop a prescription that will assist the client.

40.

For a patient who works at a desk job 5 days a week, for 8 to 10 hours a day, which of the following recommendations would be appropriate to give tactile feedback for better seated posture?

  • Placing a rolled up towel behind his low back while he is seated

  • Taking frequent breaks to walk around during the day

  • Placing a note on his computer monitor that says "SIT UP STRAIGHT" which he can see all day long

  • Hanging up a picture in his office of the ideal seated posture to remind him of how to sit during the day

Correct answer: Placing a rolled up towel behind his low back while he is seated

Tactile feedback must include contact of some kind. By placing a towel behind the patient's back while he is seated, he will feel the pressure from the towel every time he tries to slouch. This will remind him to sit up straight all day long.

Taking frequent walking breaks is an excellent recommendation, but not one that includes any tactile feedback for better seated posture. Placing a note on his computer reminding him to sit up straight would be a visual cue, not a tactile cue. Hanging up a picture of the ideal seated posture would provide a visual cue, not a tactile cue.

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