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Quiz Session - Attempts With Random Questions

ACSM-CEP Exam Questions

Page 5 of 25

81.

Which of the following is a potential consequence of an inadequate cool down after exercise?

  • Blood pooling in the lower extremities

  • For most healthy individuals, there is no harm in skipping the cool down period

  • Increased cerebral blood flow

  • Increased max heart rate

Correct answer: Blood pooling in the lower extremities

By skipping or not performing an adequate cool down after exercise, blood can pool in the lower extremities. This can make it more difficult for blood to get back to the heart and the circulatory system, and may cause mild symptoms such as lightheadedness or even more severe symptoms such as syncope.

Everyone should cool down after exercise to reduce the risk of complications. Cerebral blood flow can be temporarily decreased if the cool down is inadequate. Max heart rate is unaffected by cool down.

82.

A patient has a resting heart rate of 130 beats per minute (BPM). How should the CEP interpret this finding?

  • This patient has resting tachycardia

  • This patient has resting bradycardia

  • This patient has hypertension

  • This patient is likely to have a heart attack in the next six months

Correct answer: This patient has resting tachycardia

A normal heart rate is considered to be between 60 and 100 BPM. Resting tachycardia is the term for a patient who demonstrates a resting heart rate above 100 BPM.

Bradycardia is a heart rate below 60 BPM. Hypertension is the technical term for high blood pressure and cannot be determined from heart rate alone. It's impossible to say from the information given whether or not this patient is likely to suffer from a heart attack in the next six months.

83.

A female client is riding an exercise bike for a warm up. After just a few minutes of very light exercise, the patient stops pedaling and reports to her CEP that she is feeling intense neck and jaw pain. She is also sweating much more than she usually does at this point in the warm up. After a few more minutes of resting in a chair, the pain isn't going away, and the client begins to panic. 

What is this patient likely experiencing, and how should the CEP respond?

  • This client may be demonstrating signs of a heart attack. Emergency services should be called immediately.

  • This client is likely just having a bad day. The CEP should encourage her to rest for as long as she needs, then resume exercise when she's ready.

  • This client probably pulled a muscle in her neck while she was warming up. The CEP should show her some stretches and see if she can continue to exercise while protecting the painful area.

  • This client is likely experiencing symptoms of emotional distress. The CEP should cancel the session for the day and encourage the client to seek counseling.

Correct answer: This client may be demonstrating signs of a heart attack. Emergency services should be called immediately.

With very light exercise, the patient experiences abnormal sweating, a sense of panic, and neck/jaw pain. This patient may be quickly heading toward a major cardiac emergency. The CEP should immediately contact emergency services and do everything possible to keep the client calm. The quicker she can get to the hospital, the better. Women tend to demonstrate slightly different signs of a heart attack as compared to men. For instance, many heart attacks in women aren't accompanied by chest pain. Rather, they may experience pain in other areas such as the neck, shoulders, or jaw. This can lead to misdiagnosis if the clinician doesn't look at the whole picture.

84.

A patient is assessed using the BODE index. His results are as follows:

  • FEV1 (% of predicted) 54
  • 180 meters walked in 6 minutes
  • MMRC dyspnea scale score of 3
  • BMI of 19

What is his BODE index score?

  • 6/10

  • 4/10

  • 3/10

  • 9/10

Correct answer: 6/10

The BODE index is a measure of mortality risk and disease severity. It accounts for FEV1, distance walked in a 6 minute period, BMI, and dyspnea based on the MMRC dyspnea scale. Higher scores put a patient at higher risk for mortality, while lower scores indicate the opposite.

85.

Dana is currently inactive, has asymptomatic, diagnosed heart disease, and is hoping to start into a high-intensity exercise program like the ones she sees on TV. Which of the following are the most appropriate steps for the CEP to take regarding this client?

  • Refer this client for medical clearance, then begin light-to-moderate exercise, progressing as she is able within the ACSM guidelines

  • Initiate a light-to-moderate intensity exercise program, progressing as she is able within the ACSM guidelines

  • Immediately initiate moderate-to-high intensity exercise, to meet the client's goals

  • Initiate resistance training exercise only for this client, waiting until she is cleared by a physician to begin aerobic exercise

Correct answer: Refer this client for medical clearance, then begin light-to-moderate exercise, progressing as she is able within the ACSM guidelines

Because this client has known heart disease and is currently inactive, she needs to be cleared by a physician before starting exercise.

Initiating a light-to-moderate intensity program and progressing as tolerated without medical clearance would be appropriate for clients without diagnosed heart disease. An inactive client should never immediately start into high intensity exercise, especially one with diagnosed disease. No exercise mode should be initiated with this patient until she has been cleared by her physician.

86.

During the eccentric phase of the squat, the knees are doing which of the following?

  • Flexing

  • Extending

  • Plantarflexing

  • Protracting

Correct answer: Flexing

During a squat, the knees extend during the concentric phase and flex during the eccentric phase. This muscle action primarily involves the quadriceps.

87.

A CEP is working with a patient who has recently been diagnosed with lung cancer. Which of the following is important for the CEP to keep in mind when designing an exercise prescription for this patient?

  • Lung cancers are often detected late, and treatments are aimed mostly at reducing symptoms and extending life rather than curing the disease

  • Lung cancers are often detected early and most patients make a full recovery

  • Lung cancer has a low rate of recurrence once the patient has undergone successful treatment

  • Lung cancers and the treatments patients receive for them may affect muscular strength, but they have little effect on aerobic exercise capacity

Correct answer: Lung cancers are often detected late, and treatments are aimed mostly at reducing symptoms and extending life rather than curing the disease

Unfortunately, most patients will not be diagnosed with lung cancer until very late in the disease process. For this reason, most of the treatments for lung cancer are designed to increase the comfort of the patient and extend their life as long as possible, rather than eliminating the cancer completely.

Lung cancer has a high rate of recurrence. Lung cancers often have dramatic effects on lung function and, in turn, will often affect cardiorespiratory ability in patients. 

88.

Which of the following best describes tetraplegia?

  • A spinal cord injury at or above the spinal level T1

  • A spinal cord injury below the spinal level T1

  • Only the legs and a small part of the trunk are affected by tetraplegia

  • The hands and feet are the only areas affected by tetraplegia

Correct answer: A spinal cord injury at or above the spinal level T1

Tetraplegia affects the trunk, legs, and pelvic structures, as well as the arms and hands. The extent to which these areas are affected depends on a number of factors, including the completeness of the lesion in question.

A spinal cord injury below spinal level T1 leads to paraplegia. The legs, arms, hands, trunk, and pelvis are all affected by tetraplegia.

89.

Which of the following is true of longitudinal and cross-sectional studies?

  • Longitudinal studies are often harder to conduct than cross-sectional studies due to the time commitment and expense required with longitudinal research

  • Cross-sectional studies tend to be more expensive than longitudinal studies

  • Cross-sectional studies enable researchers to observe study participants as they age

  • Cross-sectional data is essentially useless when studying age-related changes

Correct answer: Longitudinal studies are often harder to conduct than cross-sectional studies due to the time commitment and expense required with longitudinal research

In an ideal world, we would be able to conduct as many longitudinal studies as we wanted to, measuring a variety of different factors. However, cost and time commitment are concerns with longitudinal studies that need to be considered when designing a research project. 

Cross-sectional studies are very useful, as they allow us to compare differences between age groups, but some questions are hard to answer without well-designed and implemented longitudinal studies.

90.

Which of the following is true of Forward Head Posture (FHP)?

  • FHP is associated with tight suboccipital muscles and weakness of the deep cervical flexors

  • FHP is a serious condition that requires emergency treatment once detected

  • Chin tuck exercises should be avoided in patients with FHP

  • FHP can lead to fecal incontinence

Correct answer: FHP is associated with tight suboccipital muscles and weakness of the deep cervical flexors

FHP often leads to the chin protruding forward, the shoulders rounding, and the head tilting back slightly. The condition is typically the result of long-term postural issues.

FHP is not an emergent condition, but it can cause pain and dysfunction. Chin tuck exercises can help to strengthen the deep cervical flexors and decrease the symptoms of FHP. FHP rarely causes any serious or systemic symptoms besides pain and decreased range of motion.

91.

Which of the following is not an example of an Activity of Daily Living (ADL)?

  • Painting the house

  • Taking a shower

  • Putting on socks and underwear

  • Using the restroom

Correct answer: Painting the house

Painting the house might be an activity that one performs on a given day, but it is not considered an ADL. There are six recognized ADLs which include bathing, eating, transferring, continence, dressing, and toileting. Each of the options on this list falls into one of these categories except for "painting the house".

92.

Which of the following is true regarding menopause?

  • Menopause typically occurs when a woman is in her 50s

  • Smoking has no effect on menopause

  • Lead exposure throughout a woman's life can increase menopause age by up to 2 years

  • Menopause can only occur due to natural ovarian aging

Correct answer: Menopause typically occurs when a woman is in her 50s

The average age of menopause is around 50 and many women report the end of menses by the age of 55.

Smoking tends to lower the age at which women experience menopause by 1 year. Lead exposure can decrease menopause age by as many as 1.2 years. Menopause can occur due to natural aging or as a result of surgical removal of the ovaries.

93.

Which of the following is true regarding snow shoveling?

  • It can significantly increase heart rate and blood pressure, leading to a higher possibility of cardiovascular events

  • It is equally as demanding as any activities performed in the cold weather as a result of cold weather's effect on the body

  • It is a great way for anyone, at any level of fitness, to achieve a great workout in the winter months

  • No warm-up should be performed prior to shoveling snow, as the shock of the cold may cause cold-related illness if the body was too warm initially

Correct answer: It can significantly increase heart rate and blood pressure, leading to a higher possibility of cardiovascular events

In some cases, patients have reached nearly 97% of their heart rate max while shoveling snow. Furthermore, systolic blood pressure readings have shown values as high as 200 mm Hg in patients while they were shoveling snow.

Shoveling snow is more demanding than many other cold weather activities (not including high-level athletic pursuits). When considering shoveling snow, caution should be taken by those with comorbidities involving the cardiovascular system or any metabolic diseases (especially those who are sedentary and deconditioned). A warm-up is a good idea before any exercise or physical activity.

94.

Which of the following is false regarding anti-obesity drugs?

  • There are no side effects associated with the drug orlistat

  • Anti-obesity drugs are known as anorectics

  • There are currently four drugs approved for the treatment of chronic obesity

  • Lorcaserin can cause cardiovascular and cognitive issues in patients

Correct answer: There are no side effects associated with the drug orlistat

Orlistat can cause flatulence, oily stools, and other gastrointestinal issues.

Another name for anti-obesity drugs is anorectics. There are more drugs approved for the short-term treatment of obesity, but only four approved for long-term treatment. Lorcaserin can cause an irregular heart beat, as well as cognitive issues.

95.

A patient reports pain in the left submammary region. What is the most likely cause of chest pain in this area?

  • A strained muscle in the pectoral region or trunk

  • Ischemia

  • Referred pain from the liver

  • A strained quadriceps muscle

Correct answer: A strained muscle in the pectoral region or trunk

Pain in this area is typically not associated with ischemia. A strained muscle in this region is the most likely cause.

Ischemic pain can occur in the arms, substernally, or in other regions. Referred pain from the liver can usually be felt in the right shoulder or the right upper abdominal region. A strained quadriceps muscle would be very unlikely to cause pain in the submammary region.

96.

Which of the following is true regarding patients who are unable to complete exercise stress testing?

  • Medications such as vasodilators or dobutamine can be used to simulate the effects of exercise on the heart

  • All patients can exercise to some degree, the CEP just needs to pick the correct protocol

  • Dobutamine creates almost no side effects

  • The diagnostic criteria are completely different during pharmacological stress testing as opposed to exercise stress testing

Correct answer: Medications such as vasodilators or dobutamine can be used to simulate the effects of exercise on the heart

Pharmacological stress testing is not usually ideal and can be very uncomfortable for the patient, but it provides a method to obtain good data even when patients are unable to exercise.

Not all patients are able to exercise for various reasons. Dobutamine leads to heart palpitations, angina, and other symptoms in about 75% of cases. The diagnostic criteria for a pharmacological stress test and an exercise stress test are the same.

97.

A patient who is being treated for prostate cancer is experiencing fatigue, cognitive issues, vasomotor symptoms, impotence, anemia, loss of muscle and bone mass, and depression. Which of the following treatment options is most likely responsible for the majority of these symptoms?

  • Hormone therapy

  • Active surveillance

  • Prostatectomy

  • Radiation therapy

Correct answer: Hormone therapy

While radiation therapy and surgery can cause some of the symptoms listed, hormone therapy is associated with all of the aforementioned symptoms. Often, patients will receive hormone therapy in conjunction with other methods of treatment when dealing with prostate cancer. For example, a patient may undergo surgery after receiving a short bout of hormone injections.

98.

A CEP is working with a client who reports having trouble getting much exercise or physical activity outside of formal exercise sessions. This client does not make very much money, and is hesitant to spend any of her funds. 

Based only on the information provided, which of the following would be the best suggestion for increasing this client's exercise outside of her formal sessions with the CEP?

  • Suggesting that the client make small changes, such as taking the stairs instead of the elevator and parking far away when shopping

  • Suggesting that the client purchase an activity tracker

  • Suggesting that the client adopt a dog so that she can take it on walks

  • Suggesting that the client joins a 24-hour gym so that she can exercise any time she wants

Correct answer: Suggesting that the client make small changes, such as taking the stairs instead of the elevator and parking far away when shopping

Even small changes can have a beneficial effect on health and can lead to more physical activity overall. For a client with limited income, who desires to spend as little money as possible, these options represent cost-free options for increasing physical activity, without engaging in formal exercise sessions outside of the ones she is already completing with the CEP.

99.

Which of the following movements describes pronation?

  • Starting with his palm facing forward, with arms down by his sides, the patient rotates his forearm until his palm is facing backward

  • Starting with his arm down by his side and his elbow straight, the patient bends his elbow as far as he can

  • Standing on his right leg, with his left leg straight, the patient bends his left knee as far as he can

  • Seated in a chair, with his knees bent, the patient straightens both of his knees as far as he can in front of him

Correct answer: Starting with his palm facing forward, with arms down by his sides, the patient rotates his forearm until his palm is facing backward

Pronation is a specialized rotational movement specific to the forearm and ankle. Its antagonistic movement is known as supination.

Bending the elbow from a straightened position is known as elbow flexion. Bending the knee from a straightened position is known as knee flexion. Straightening the knees from a bent position is known as knee extension.

100.

When asked about her cardiovascular disease (CVD) risk factors, a client reports the following:

  • She is 59 years old
  • Her husband smokes two packs a day in the house, but she does not smoke herself
  • She has a blood pressure of 110/70 mm Hg
  • She goes for a 20 minute walk two times a week

Based only on the information given, how many positive risk factors for the development of CVD does this client have?

  • 3

  • 4

  • 2

  • 1

Correct answer: 3

This client's positive risk factors include age > 54 (as a female), environmental tobacco smoke exposure, and physical inactivity by not achieving at least 30 minutes of moderate PA 3 days a week for 3 months or longer. Her blood pressure does not put her at increased risk for CVD.

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