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Quiz Session - Attempts With Random Questions

ACSM-CEP Exam Questions

Page 3 of 25

41.

A patient tells you that he had a cold recently and is taking codeine. Which of the following side effects might the patient experience?

  • Drowsiness, constipation, lethargy

  • Weight gain, edema

  • Confusion, nausea

  • Ulcers, bleeding

Correct answer: Drowsiness, constipation, lethargy

Codeine is derived from opioids. For this reason, one can expect the typical side effects of opioid medications such as drowsiness, constipation, lethargy, and, in some cases, addictive behavior.

Weight gain and edema could occur from many drugs, such as thiazolidinediones; however, these symptoms are not typical side effects associated with codeine. Confusion and nausea could be a side effect of many different medications, such as dopamine receptor agonists. Ulcers and bleeding are associated with NSAIDs.

42.

When interviewing a patient before initiating exercise, the CEP asks him about his family's health history. Why is this information important to know?

  • Some conditions can be inherited from family members or may put patients at higher risk of developing certain diseases themselves

  • By evaluating the health of a patient's family, the CEP may be able to encourage the patient to get his family members to sign up for training sessions as well, increasing business for the CEP

  • Knowing a few key details from patient's family history can provide the CEP with an easy way of calculating a predicted VO2max for the patient

  • If the patient has family members who have lost weight in the past, this might help to encourage the patient to lose weight as well

Correct answer: Some conditions can be inherited from family members or may put patients at higher risk of developing certain diseases themselves

Family history can provide an indication of whether or not a patient is likely to develop certain conditions or diseases. While the CEP may not directly use this information when formulating an exercise prescription, it's always good to have as much medical data as possible when performing an intake.

While business considerations are important, the CEP should not be concerned about increasing business when evaluating and testing a patient. There is no equation that can predict VO2max based solely on family history. While motivation may come from past weight-loss success in family members, this portion of the patient's health history is more important for evaluating disease risk.

43.

Which of the following is an example of a lapse in physical activity?

  • A client stops exercising for a week during the Christmas holiday

  • A client stops exercising completely and refuses to resume her exercise sessions after being fired from her job

  • A client modifies his exercise plan while on vacation by asking the CEP for ways to effectively exercise in a hotel room

  • A client decides to perform jumping jacks in her apartment instead of going for her usual walk due to a severe storm warning

Correct answer: A client stops exercising for a week during the Christmas holiday

This is an example of a lapse that could lead to a full relapse towards a sedentary lifestyle. If the CEP doesn't develop a plan with the client prior to this time off, the client may have great difficulty resuming exercise sessions the following week.

A client who stops exercising completely and refuses to resume exercise sessions is said to have relapsed. A client who modifies his exercise plan while on vacation has not experienced a lapse or a relapse. A client who decides to perform exercise indoors due to inclement weather has not experienced a lapse or relapse; rather, she has made a sensible modification to her exercise plan in order to remain safe.

44.

A patient is performing an exercise in standing. She lifts her arm toward the ceiling at a 35 degree angle anterior to the frontal plane. What plane is she moving in?

  • The scapular plane

  • The sagittal plane

  • The transverse plane

  • The coronal plane

Correct answer: The scapular plane

At 30 to 40 degrees anterior to the frontal plane lies the scapular plane. The movement described is known as scaption.

The sagittal plane includes motions such as flexion and extension. The transverse plane includes rotational movements. The coronal plane is another name for the frontal plane.

45.

When comparing a treadmill-based exercise test and a cycle ergometer-based exercise test, which of the following is true?

  • Walking/running tests tend to produce a higher maximum MET level as compared to cycling tests

  • Cycling tests tend to produce a higher maximum MET level as compared to treadmill tests

  • Walking/running tests tend to elicit a lower maximum heart rate as compared to cycling tests

  • It is impossible to take an accurate blood pressure reading during a treadmill test

Correct answer: Walking/running tests tend to produce a higher maximum MET level as compared to cycling tests

Treadmill-based exercise tests often result in higher maximum MET levels when compared to cycling. This is thought to be due to the fact that walking and running use more muscle mass than cycling does.

While it can be difficult to obtain a blood pressure measurement during treadmill tests, it is not impossible. Walking/running tends to elicit higher maximum heart rate values as compared to cycling tests.

46.

Which of the following tests to determine fall risk would be most appropriate for a patient who is 95 years old and who only walks very short distances but has a goal to be able to walk further?

  • The Timed-Up and Go (TUG)

  • The 30 second sit-to-stand test

  • The Six Minute Walk Test

  • The Modified Bruce Protocol

Correct answer: The Timed-Up and Go (TUG)

The TUG is an excellent functional test for balance and gait capability. For the patient in question, it only requires him to stand and walk for a very short distance, and he is able to use an assistive device, if needed.

The 30 second sit-to-stand test is an option for this patient, but it doesn't include the gait component inherent in the TUG. The Six Minute Walk Test is designed to test cardiorespiratory endurance. The Modified Bruce Protocol tests cardiorespiratory endurance and would likely be far too intense for this patient.

47.

Which of the following is not considered a cardiovascular disease (CVD)?

  • Diabetes mellitus type II

  • Hypertension

  • Stroke

  • Peripheral artery disease

Correct answer: Diabetes mellitus type II

DM is an endocrine disorder. While DM interacts with the cardiovascular system and is associated with various heart issues, it is not considered a CVD. 

All of the other choices listed directly affect the vessels and/or the heart itself.

48.

Mary is 40 years old and an avid runner. She has been running regularly since she was on the cross country team in college. However, she has never lifted weights before. Her goal is to learn how to effectively perform resistance training so that she can improve her overall exercise habits. She is moving soon, and has time for two sessions with her CEP. 

In general, what should her two exercise sessions consist of?

  • Explanation of basic exercises, how to structure her program to reach her long and short-term goals, and things to avoid to reduce the risk of injury

  • 40% cardiovascular exercise, 40% resistance training, and 20% flexibility exercise

  • The CEP should spend much of the time encouraging the client to start biking instead of running to protect her joints

  • How to perform Olympic lifts and power/plyometric exercises

Correct answer: Explanation of basic exercises, how to structure her program to reach her long and short-term goals, and things to avoid to reduce the risk of injury

While long-term relationships make it easier to establish rapport with patients and address all areas of fitness and health, there will be times when the CEP has to prioritize certain things with a client. 

Because this client reports a long history of running and that she currently runs, the focus of the exercise sessions should be on her immediate goals. Teaching her the basics of resistance training will help her to feel more confident in this area of health and will help her achieve her goal. This client may not be ready for Olympic lifts yet, as she is new to resistance training. While discussions of joint health may be appropriate, the major focus of her two sessions should be on her stated goals.

49.

When testing a client across a variety of health-related domains, which of the following tests should be completed first?

  • Resting heart rate

  • Cardiovascular endurance testing

  • One-rep max testing

  • Flexibility testing

Correct answer: Resting heart rate

Resting heart rate needs to be obtained before the patient completes any physical tests, as the measurement cannot be accurately assessed once the patient has started exercising.

Cardiovascular endurance testing should follow resting measurements and body composition tests. Muscular strength and endurance tests should typically follow tests of cardiorespiratory endurance. Flexibility should be assessed last.

50.

Which of the following tests would provide the most data regarding fall risk for a patient who has dementia and uses a walker to ambulate?

  • The Timed Up and Go (TUG)

  • The Bruce protocol treadmill test

  • A fall history written questionnaire

  • The YMCA bike test

Correct answer: The Timed Up and Go (TUG)

The TUG is a validated test which allows the patient to use an assistive device and provides excellent data pertaining to fall risk.

The Bruce protocol treadmill test does not assess fall risk. A fall history questionnaire could be problematic for this patient due to the diagnosis of dementia. The YMCA bike test does not assess fall risk.

51.

An 80-year-old, sedentary, male patient is planning to begin an exercise program with a CEP.  Regarding the patient's age, which of the following should the CEP consider when designing an exercise program for this patient?

  • This patient likely has a VO2 max roughly 40% lower than it was in his peak years

  • There is no association between this patient's lean muscle mass and his aerobic capacity

  • This patient is likely to have very high cardiac output as a result of a higher max heart rate and a higher stroke volume compared to younger individuals

  • With training, it's likely that this patient can achieve a VO2max similar to the average levels observed in patients in their 30s

Correct answer: This patient likely has a VO2 max roughly 40% lower than it was in his peak years

VO2max steadily declines as we age, especially in sedentary individuals. According to research, VO2max is roughly 35% to 40% lower in sedentary men compared to peak levels seen earlier in life.

There is a positive association between lean mass and aerobic capacity in this population. This patient will likely have very low cardiac output as a result of a lower max heart rate and a lower stroke volume as compared to younger individuals. Even with training, it is unlikely that this individual would be able to improve his VO2max to the same average level of patients in their 30s.

52.

Regarding preparticipation health screenings and diagnosed pulmonary disease, which of the following is true?

  • The ACSM recommends that patients with known pulmonary disease do not need to be referred for medical clearance prior to beginning exercise 

  • The ACSM recommends that all patients with known pulmonary disease be referred for medical clearance prior to beginning exercise

  • Patients with COPD who currently smoke have a low likelihood of cardiovascular events

  • In general, pulmonary diseases increase the risk of adverse cardiac events while exercising

Correct answer: The ACSM recommends that patients with known pulmonary disease do not need to be referred for medical clearance prior to beginning exercise 

As of 2015, the ACSM has updated their guidance to reflect that patients with known pulmonary disease do not need to be automatically referred to a medical provider prior to initiating exercise.

Patients with COPD who currently smoke or formerly smoked are at risk for cardiovascular events. In general, pulmonary diseases do not increase the risk of adverse cardiac events during or after exercise.

53.

Which of the following is true of the Duke Index?

  • It is a clinical exercise test scoring tool used to compare exercise capacity with angina and ST segment elevation

  • It is a diagnostic tool used before a patient completes an exercise test to determine relative risk of exercise

  • It is a therapeutic tool used to measure how much anaerobic strength patients have gained as a result of exercise interventions

  • It is an outdated prognostic tool that should no longer be used by clinicians

Correct answer: It is a clinical exercise test scoring tool used to compare exercise capacity with angina and ST segment elevation

This tool awards points corresponding to the minutes a person was able to exercise during the test. At the same time, points are deducted for angina and ST segment depression. By using this tool, clinicians can calculate prognosis for 5 year survival probability in the patient.

54.

Which of the following is true regarding children and VO2max testing?

  • True VO2max values in children are hard to measure for a variety of reasons, so these values are usually reported as VO2peak

  • It is easier to measure VO2max in children than it is in adults

  • For children, timed or shuttle runs should only be used as a last resort when traditional VO2max testing methods are inappropriate

  • VO2max values in children are roughly 10% higher on the stationary bike than they are on treadmill tests

Correct answer: True VO2max values in children are hard to measure for a variety of reasons, so these values are usually reported as VO2peak

Due to the need for smaller equipment, unsteady gaits, and decreased motivation (among other factors), it can be very difficult to measure true VO2max in children. Therefore, researchers often report VO2peak.

It is harder to measure VO2max in children than it is in adults. Timed and shuttle runs are great ways to measure aerobic capabilities in children. VO2peak values in children, much like in adults, are 5% to 15% higher when on the treadmill than when on the exercise bike.

55.

A patient arrives at the clinic for spirometry testing. Upon interviewing the patient, the clinician finds out that the patient has just had a pacemaker implanted. The patient can't remember the exact date of the surgery off-hand, but thinks it was about a week ago. This patient looks very healthy, and is showing no signs of distress. 

How should the clinician interpret this information and proceed?

  • Pacemaker implantation is a relative contraindication for spirometry testing. The clinician should contact the surgeon's office for guidance and to confirm the date of the surgery.

  • Pacemaker implantation is an absolute contraindication for spirometry testing. The clinician should not test this patient under any circumstances.

  • Pacemaker implantation is a relative contraindication, but since this patient seems healthy, the clinician should move forward with the testing and doesn't need to investigate the matter any further

  • The clinician should instruct the patient to only take shallow breaths during the spirometry testing

Correct answer: Pacemaker implantation is a relative contraindication for spirometry testing. The clinician should contact the surgeon's office for guidance and to confirm the date of the surgery.

As with any relative contraindications, the clinician needs to be absolutely certain that the benefits of testing outweigh the risks. It is essential that the client follows up with the surgeon's office before proceeding. If the surgery was more than 3 weeks prior, there is likely no issue. However, sometimes there are miscommunications and patients may not understand their doctor's instructions.

The patient "seeming healthy" is not enough information to base this decision on. Shallow breaths during spirometry testing would not produce any usable data.

56.

Which of the following is true of insulin resistance?

  • Insulin resistance in skeletal muscles is thought to be the main contributor to the development of type II diabetes mellitus

  • Insulin resistance only occurs in skeletal muscle

  • Insulin resistance is a normal bodily process that is rarely a cause for concern

  • Insulin resistance is unrelated to osteopenia

Correct answer: Insulin resistance in skeletal muscles is thought to be the main contributor to the development of type II diabetes mellitus

Besides diabetes, insulin resistance also seems to be associated with obesity, high cholesterol, and high blood pressure.

Insulin resistance can also occur in the brain, liver, and other tissues. Insulin resistance can lead to many different diseases and should be treated once identified. Insulin resistance seems to be associated with osteopenia and bone loss.

57.

Severe hypothermia is diagnosed when a patient records a temperature in which of the following ranges?

  • 77°F-90°F

  • 94°F-95°F

  • Hypothermia is not diagnosed by body temperature but, rather, by a cluster of symptoms and other diagnostic tests

  • 97°F-99°F

Correct answer: 77°F-90°F

Severe hypothermia is diagnosed when patients internal body temperature is recorded as 77°F to 90°F.

Mild hypothermia is diagnosed when patients record a temperature of 94°F to 95°F. Temperature is one of the easiest ways to diagnose this condition. 97°F to 99°F is a normal range for body temperature.

58.

Which of the following would be an appropriate reason to stop an exercise test early?

  • The client asked to stop

  • Systolic blood pressure increased linearly with the workload

  • Heart rate increased by 10 BPM for every one MET increase in intensity

  • Diastolic blood pressure changed very little during the test

Correct answer: The client asked to stop

If a person wants to stop participating in an exercise test at any time, they have the right to do so. It is an absolute contraindication to continue an exercise testing session if a client has requested to stop.

Systolic blood pressure increasing linearly with the workload is a normal finding and would not be a reason for stopping an exercise test. Heart rate increasing by 10 BPM for every one MET increase in intensity is a normal finding and would not be a reason for stopping an exercise test. Diastolic blood pressure should remain stable during exercise and exercise testing. 

59.

Which of the following workouts would most likely lead to improved upper body muscular endurance?

  • Three sets of 15 pushups

  • Five sets of 15 squats

  • Three sets of three reps of bench press at 85% of one rep max

  • Three sets of five medicine ball slams

Correct answer: Three sets of 15 pushups

Higher repetition exercises with less weight tend to improve muscular endurance more than lower repetition exercises with more weight.

Squats are not an upper body exercise. Three reps of an exercise with heavy weights will more likely lead to improvements in muscular strength. Medicine ball slams are more likely to lead to increased muscular power.

60.

A client who holds a stretch for 30 seconds in a position of mild discomfort is said to be performing which of the following types of stretching?

  • Static stretching

  • Dynamic stretching

  • Ballistic stretching

  • PNF stretching

Correct answer: Static stretching

Static stretching is a safe form of flexibility training that can lead to increased range of motion. Generally, static stretching is not appropriate for a warm up, but can be included in an exercise session alongside resistance training and cardiovascular exercise modes.

Dynamic stretching refers to movements where the stretch is not held for long (if at all) and the movements are performed through a full range of motion, such as walking while gently pulling one's knees toward one's chest in an alternating manner. Ballistic stretching includes short bursts of stretch performed through a partial range of motion. Ballistic stretching is inappropriate for most clients. PNF stretching is a specialized form of flexibility training that utilizes reflexes in the tendons and muscles of the body.

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