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Quiz Session - Attempts With Random Questions

ACSM-CEP Exam Questions

Page 7 of 25

121.

Which of the following is true regarding cardiorespiratory ability in girls and boys during adolescence?

  • Boys tend to have higher cardiac output than girls in adolescence

  • Girls tend to have more muscle mass than boys in adolescence

  • Girls tend to have a higher concentration of hemoglobin than boys in adolescence

  • Both girls and boys tend to experience worse exercise economy as they transition from childhood to adolescence

Correct answer: Boys tend to have higher cardiac output than girls in adolescence

In this stage of development, boys often have higher cardiac output than girls.

Boys tend to have more muscle mass than girls in adolescence. Boys tend to have a higher concentration of hemoglobin than girls in adolescence. Both girls and boys tend to experience better exercise economy as they transition from childhood to adolescence.

122.

How does the modified Bruce Protocol differ from the original Bruce Protocol?

  • Either the speed, grade, or both increase during each minute of the modified Bruce Protocol, whereas the original Bruce Protocol maintains the same speed and grade for three minutes during each stage

  • The original Bruce Protocol takes longer than the modified version

  • The modified Bruce Protocol takes longer than the original version

  • The modified Bruce Protocol reaches a higher grade and speed during the final stage

Correct answer: Either the speed, grade, or both increase during each minute of the modified Bruce Protocol, whereas the original Bruce Protocol maintains the same speed and grade for three minutes during each stage

The modified Bruce Protocol increases the difficulty of the test every minute, while the original Bruce Protocol is divided into separate three minute stages in which the grade and speed are kept constant.

Both versions of the test take 18 minutes to complete if the patient makes it to the final stage. Both versions of the test max out at 5.5 MPH and 20% grade.

123.

A client tells her CEP that she used to love riding horses when she was younger and would be so excited if she could get in shape enough to ride again. What exercises would best help the client achieve this specific goal of returning to riding horses?

  • Seated balance/core exercises on a physio ball, hip adductor strengthening exercise

  • Cardio kickboxing exercises

  • Shoulder presses, bench presses, dumbbell rows

  • Jumping rope

Correct answer: Seated balance/core exercises on a physio ball, hip adductor strengthening exercise

Sitting on a moving horse requires good balance and hip adductor strength. Of course, any exercises on this list could potentially help the patient improve her fitness level in a variety of ways. However, balance exercises and hip adductor strengthening movements are the most specific exercises related to the goal in question.

124.

Which of the following people would be considered a participatory social support for a client starting an exercise regimen?

  • A friend who accompanies the client in completing a group exercise class every Tuesday

  • A CEP who demonstrates how a client should perform a bench press exercise

  • The client's mother who calls every week to check in and congratulate the client on her progress

  • A friend who makes a spreadsheet that enables the client to easily track her weekly workouts

Correct answer: A friend who accompanies the client in completing a group exercise class every Tuesday

Someone who physically participates in the physical activity or exercise in question alongside the client is considered a participatory social support.

A CEP who demonstrates how a client should perform an exercise is a knowledgeable social support. The client's mother who calls to check in and congratulate her daughter is a motivational social support. A friend who makes a spreadsheet to help the client track her exercise sessions is considered a practical social support.

125.

Which of the following is the appropriate BMI classification for a client who is 5'4" tall and 165 pounds?

  • Overweight

  • Normal weight

  • Class 1 obesity

  • Class 2 obesity

Correct answer: Overweight

This patient has a BMI of 28.3, placing him in the overweight range. Patients who are considered overweight have BMI measurements between 25 kg/m^2 and < 30 kg/m^2.

Normal weight consists of a BMI of 18.5 kg/m^2 - < 25 kg/m^2. Class 1 obesity consists of a BMI of 30 kg/m^2 - < 35 kg/m^2. Class 2 obesity consists of a BMI of 35 kg/m^2 - < 40 kg/m^2.

126.

Which of the following is true regarding water exercise?

  • Water exercise tends to be easier on the joints than land-based exercise such as walking

  • Obese individuals do not benefit from water exercise

  • There is no way to increase muscular strength through water exercise

  • Water exercise may increase the stress on joints as compared to land-based exercise such as walking

Correct answer: Water exercise tends to be easier on the joints than land-based exercise such as walking

The buoyancy of water helps to decrease stress on joints and makes walking in the water much easier as compared to walking on land.

Obese individuals are often able to exercise more effectively in the water due to the buoyancy effect. Muscular strength can be increased with water exercise through using the resistance of water appropriately. Water exercise tends to decrease the stress on joints, and many people with osteoarthritis, joint pain, or injuries in general can achieve a much better workout in the water.

127.

Which of the following is an example of an "assumption of risk"?

  • A CEP advises a client that he is not ready for a powerlifting competition, but the client competes anyway and ruptures his bicep

  • A CEP fails to spot a client while he is performing a 1-rep max squat, leading to the client injuring his spine

  • A client threatens to punch a CEP

  • A CEP takes a client's money but never provides the training sessions promised in the contract

Correct answer: A CEP advises a client that he is not ready for a powerlifting competition, but the client competes anyway and ruptures his bicep

In this case, the CEP discouraged the client from competing because of the risk of injury, but the client competed anyway. Therefore, the client assumed the risk and voluntarily exposed himself to harm.

A client injuring his spine because the trainer wasn't properly spotting is an example of negligence. A client threatening to punch a CEP is an example of assault. A CEP taking a client's money without providing the agreed-upon training sessions is a breach of contract.

128.

Which of the following is true regarding Cystic Fibrosis (CF)?

  • CF causes patients to produce extremely salty sweat and thick mucous that plugs their ducts

  • CF is primarily a disease of the nervous system

  • CF is extremely common in those of Japanese ancestry

  • The survival rate for people with CF has dropped significantly over the past few decades

Correct answer: CF causes patients to produce extremely salty sweat and thick mucous that plugs their ducts

CF is a condition that blocks many of the different passageways in the body with thickened mucous and very concentrated sweat.

CF affects the pulmonary, GI, and reproductive systems, along with the pancreas and liver. CF is rarely seen in those of African or Asian ancestry. The survival rate for people with CF has risen considerably over the past few decades.

129.

If a client is now able to perform 25 consecutive pushups on his knees with good form, which of the following would be the most appropriate progression?

  • Performing pushups with his toes on the ground

  • Performing pushups with his toes on an elevated surface

  • Performing assisted pull ups

  • Performing handstand pushups

Correct answer: Performing pushups with his toes on the ground

If the client is now able to easily perform knee pushups, the most logical progression is to have him perform pushups on his toes. This will increase the moment arm of the movement and thus, the difficulty of the exercise.

Performing pushups with his toes on an elevated surface may be too difficult for this patient, as he has just mastered performing knee pushups. Pull ups would be a great exercise to add to his routine, but they are not a progression of knee pushups. Handstand pushups are an extremely advanced exercise, and it is unlikely that this patient would be able to perform this movement yet.

130.

When conducting a skinfold measurement, which of the following is the most accurate description of how to take the measurement at the triceps?

  • Take a vertical fold on the posterior upper arm at midline, half the distance between the acromion and the olecranon. The patient's arm should hang loosely during the test.

  • Take a horizontal fold on the distal one-third of the upper arm with the patient's arm hanging loosely at his or her side

  • Take a vertical fold on the proximal one-third of the upper arm with the patient's elbow bent to 90-degrees

  • Take a horizontal fold on the midline of the posterior upper arm with the patient's elbow bent to at least 100 degrees

Correct answer: Take a vertical fold on the posterior upper arm at midline, half the distance between the acromion and the olecranon. The patient's arm should hang loosely during the test.

The triceps skinfold measurement often requires instruction from the clinician, as patients typically want to flex their arm during the test. To standardize the data, the test should be performed as described above.

A horizontal fold would be inappropriate for this skinfold measurement. The test should be performed on the midline of the posterior upper arm, between the olecranon and the acromion, not on the distal or proximal one-third of the arm. The arm should remain straight and hanging loosely in order to keep the measurement consistent with test protocols. 

131.

Which of the following is true of postmenopausal women?

  • Postmenopausal women tend to have decreased size and cross-sectional area of type II muscle fibers compared to type I muscle fibers

  • Postmenopausal women tend to have increased size and cross-sectional area of type II muscle fibers compared to type I muscle fibers

  • Estrogen replacement therapy for postmenopausal women has no effect on muscle strength

  • Postmenopausal women tend to lose lean mass and fat mass in equal proportion

Correct answer: Postmenopausal women tend to have decreased size and cross-sectional area of type II muscle fibers compared to type I muscle fibers

Type two muscle fibers are responsible for power and strength. When these fibers begin to decrease in size, a corresponding loss in strength is often noted in this patient population.

Estrogen replacement therapy for postmenopausal women can improve strength by as much as 5% as compared to postmenopausal women who do not receive the treatment. Postmenopausal women tend to lose lean mass and gain fat mass.

132.

A CEP is working with a client who has had a heart transplant. After the client has finished exercising, the CEP takes a heart rate and finds that the client's heart rate is still markedly elevated, even a few minutes after finishing the workout. 

How should the CEP respond to this finding?

  • The CEP should continue to monitor the client's heart rate, but should consider this a normal finding, as transplanted hearts take longer to return to resting

  • The CEP should activate the emergency response system and lay the client in the recovery position

  • The CEP should assume that the client forgot to take his heart medication and remind him of the importance of taking his pills as prescribed

  • The CEP shouldn't be monitoring the client's heart rate; this is the role of medical staff, such as nurses and physicians, when working with a highly involved client

Correct answer: The CEP should continue to monitor the client's heart rate, but should consider this a normal finding, as transplanted hearts take longer to return to resting

When a client has undergone a heart transplant, there is no parasympathetic connection. Therefore, it takes longer than normal for heart rate to respond to resting values after exercise. The CEP should continue to monitor the client's HR and symptoms, but this is not immediately a cause for concern.

133.

Which of the following is true of anxiety disorders?

  • The sympathetic nervous system is typically highly active in individuals with anxiety disorders

  • Men are more likely to suffer from anxiety disorders than women

  • Generalized anxiety disorder is an acute condition that usually resolves within three months

  • Patients with obsessive compulsive disorder almost never realize that their compulsions are unnecessary

Correct answer: The sympathetic nervous system is typically highly active in individuals with anxiety disorders

The sympathetic nervous system is typically active when we are under threat of an attack or danger of some kind. In patients with anxiety disorders, this system is often overly active.

Women are at double the risk of developing anxiety disorders as compared to men. Generalized anxiety disorder is a chronic condition that lasts for six months or longer. Patients with obsessive compulsive disorder usually realize that their compulsions are unnecessary, but they are unable to stop performing their rituals.

134.

A patient is performing a step down test with her right leg on the step. While the patient performs the test, the CEP notices that the right knee collapses inward as the patient steps down. 

Which of the following is the most accurate summary of this finding?

  • The patient is demonstrating dynamic knee valgus and likely has weak hip muscles

  • This is a normal finding during this test and indicates that the patient has good strength in her lower body

  • The patient is likely suffering from weakness in her rectus abdominis which has led to knee varus

  • This patient is demonstrating knee varus and likely has weak gastrocnemius muscles

Correct answer: The patient is demonstrating dynamic knee valgus and likely has weak hip muscles

When the knee collapses inward during movement, this is referred to as dynamic knee valgus. Generally, knee valgus is the result of weak hip muscles which are unable to stabilize the femur during exercise and motion.

Knee valgus is not a normal finding and could lead to an injury down the road. The rectus abdominis has little to do with the step down test. The patient is demonstrating valgus, not varus.

135.

Which of the following is the best description of atherosclerosis?

  • Lesions develop inside arteries, impeding blood flow

  • An area of dead tissue

  • Impaired blood glucose levels

  • Pain and cramping in the legs with activity

Correct answer: Lesions develop inside arteries, impeding blood flow

Atherosclerosis is a development of plaques forming inside arteries causing decreased blood flow. 

An area of dead tissue is known as necrotic tissue. Impaired blood glucose levels is related to diabetes mellitus. Pain and cramping in the legs with activity is most closely related to intermittent claudication.

136.

A female patient reports that every time she enters the cold section of the supermarket, she notices pain and discoloration in her hands. Which of the following diagnoses is most likely, based on this information?

  • Raynaud's disease

  • Cotard's syndrome

  • Valsalva's disease

  • Peters anomaly

Correct answer: Raynaud's disease

Raynaud's disease is a condition that affects the heart and vascular systems. It is found much more commonly in women than in men, and causes pain and discoloration in the hands/feet.

Cotard's syndrome is the incorrect belief that a person is dead or that a part of their body is missing. The valsalva maneuver is a lifting technique used to increase intraabdominal/intrathoracic pressure. Peters anomaly is a condition that affects the eyes.

137.

If a person tests positive on a certain laboratory test for heart disease, and the test is said to have high specificity, which of the following is true?

  • The clinician can rule in the diagnosis of heart disease

  • The clinician can rule out the diagnosis of heart disease

  • The clinician can trust the results of this test completely and does not need to use any other measures to confirm the diagnosis of heart disease

  • This information is of little value to the clinician

Correct answer: The clinician can rule in the diagnosis of heart disease

Highly specific tests mean that clinicians can safely rule in a condition when a patient tests positive. 

Highly sensitive tests mean that clinicians can rule out conditions when patients test negative. The clinician should always confirm the results of a single test with other findings and use their clinical judgement to make a diagnosis. This information is very valuable to the clinician, but should not be the only information that the clinician relies upon during their evaluation of this patient.

138.

Which of the following is true regarding grip strength and aging?

  • Grip strength can increase until age 30 in many individuals

  • Grip strength usually begins to decline after age 18

  • Grip strength increases until age 13, then is maintained for the rest of one's life

  • Grip strength is not usually measured in most fitness assessments, as it is not applicable to daily life, aging, or health

Correct answer: Grip strength can increase until age 30 in many individuals

Grip strength is an important component of health and is included in most fitness assessments, where applicable. According to research, grip strength (along with some other muscle groups) tends to increase until one turns 30. This is in contrast to most muscle groups of the body, where peak strength is achieved in adolescence and remains the same until roughly the age of 40.

139.

Which of the following is true regarding very low calorie diets?

  • Very low calorie diets are often associated with bariatric clinics or hospitals

  • Very low calorie diets typically force patients to consume 1500 to 1800 calories a day

  • An average very low calorie diet will last for 3 to 4 years

  • Very low calorie diets usually emphasize carbohydrate calories over protein and fat

Correct answer: Very low calorie diets are often associated with bariatric clinics or hospitals

Because patients on very low calorie diets need close monitoring, the programs are generally conducted through medical facilities.

Very low calorie diets typically force patients to consume 500 to 800 calories a day, max. An average very low calorie diet typically lasts for 12 to 26 weeks. Very low calorie diets usually emphasize protein calories over fats and carbohydrates.

140.

A CEP is working with a collegiate runner who just finished an all-out sprint to end her session. She is very out of breath and has trouble speaking for a few seconds after finishing the sprint. Within a minute, she is speaking and breathing much more comfortably. 

How should the CEP interpret this finding?

  • The athlete is demonstrating appropriate levels of fatigue and dyspnea based on the athletic effort she just put forth. The CEP should not be concerned.

  • The athlete has dyspnea, which is indicative of lung disease. She should be referred to her doctor for further testing.

  • The athlete is likely to experience a heart attack any minute. Emergency services should be called immediately.

  • The athlete is displaying signs of orthostatic hypotension. The CEP should not be worried, but should take note of this finding.

Correct answer: The athlete is demonstrating appropriate levels of fatigue and dyspnea based on the athletic effort she just put forth. The CEP should not be concerned.

Shortness of breath, or dyspnea, is concerning when clients are working at very low levels of exertion. For an athlete completing an all-out effort sprint, it is completely normal to see dyspnea.

There is no need to refer this client out or contact emergency services. Orthostatic hypotension refers to a drop in blood pressure that does not correct quickly when a person changes position (such as going from sitting to standing).

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