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Quiz Session - Attempts With Random Questions

ACSM-EP Exam Questions

Page 8 of 25

141.

Which type of stretching is characterized by a slow and constant stretch with no assistance from a trainer or partner?

  • Self

  • Passive

  • Active

  • Isometric

Correct answer: Self

Self-stretching is characterized by a slow and constant stretch with no assistance.

The traditional flexibility training modes include the following:

  • Static flexibility focuses on slow and constant motion that is held at the point of mild discomfort for about 10 to 30 seconds.
  • Proprioceptive Neuromuscular Facilitation (PNF) involves contraction and release techniques.
  • Ballistic stretching focuses on rapid and bounce-like movements. The momentum from the bouncing helps to push the joint through the full range of motion.

Of the three traditional flexibility training modes, static flexibility is the most common, and it can be broken down into three types:

  • Passive: Slow and constant stretch with a partner
  • Self: Slow and constant stretch with no assistance
  • Isometric: Slow and constant stretch against a stationary object

Active stretching may or may not involve the assistance of a partner.

142.

Which of the following is an absolute contraindication to exercise testing?

  • Symptomatic severe aortic stenosis

  • Resting hypertension with systolic > 200 mm Hg or diastolic > 110 mm Hg

  • Uncorrected medical conditions, such as significant anemia, significant electrolyte imbalance, and hyperthroidism

  • Recent stroke or transient ischemia attack

Correct answer: Symptomatic severe aortic stenosis

There are certain clinical characteristics of an individual that make physical activity risky or contraindicated. Most are related to cardiovascular health. Absolute contraindications refer to conditions that will absolutely not allow for exercise testing, while relative contradictions refer to conditions that might allow for testing, depending on the client's doctor's recommendations.

The following are relative contraindications:

  • Tachyarrhythmias with uncontrolled ventricular rates
  • Recent stroke or transient ischemia attack
  • Known obstructive left main artery stenosis
  • Moderate to severe aortic stenosis
  • Mental impairment with limited ability to cooperate
  • Resting hypertension with systolic > 200 mm Hg or diastolic > 110 mm Hg
  • Uncorrected medical conditions, such as significant anemia, significant electrolyte imbalance, and hyperthroidism

Symptomatic severe aortic stenosis is considered an absolute contraindication.

143.

What is the first step in the IDEA Method?

  • Pinpointing what the barrier is

  • Coming up with a list of potential solutions

  • Deciding on a course of action 

  • Moving forward with a solution

Correct answer: Pinpointing what the barrier is

Exercise physiologists can use the IDEA method as a practical framework to facilitate an action plan for problem solving barriers to physical exercise. The first step of the IDEA method is to identify the barrier. It's important that the client is specific and thorough when describing the challenge and the effect that the barrier has on physical fitness.

The remaining steps include the following:

  • Identify the barrier—Be specific and thorough when describing the challenge and the effect that it has on physical fitness.
  • Develop a list of potential solutions—Brainstorm in a creative way.
  • Evaluate the solutions—Select one that seems to be appropriate and works the best.
  • Act on the solution—Assess how well the plan works and decide what can be done differently or if another potential solution should be tried.

It's crucial that the client directs this process. Giving advice can backfire and increase resistance. More importantly, your client will learn the skill of problem solving on their own, reducing the chance of barriers in the future.

144.

A client suffers an ankle injury. After completing a few weeks of rehab, she reports that she feels back to 100%. Which of the following issues is likely still present? 

  • Disturbances in motor control

  • Lack of motivation

  • Weakness in trunk musculature 

  • Severely compromised cardiovascular fitness

Correct answer: Disturbances in motor control

Disturbances in motor control often follow injury and leave residual effects. Even though the client might be pain-free, mobility and stability problems and sensory deficits remain. This is problematic because what follows could be a perpetuating cycle of motor control impairment and mobility and stability limitations.

145.

If a client has a strength and/or mobility limitation with their thoracic spine mobility in extension, which of the following exercises would be ideal as a corrective measure?

  • Modified cobra stretch

  • Bird dog

  • Upper trap stretch 

  • Abdominal crunches 

Correct answer: Modified cobra stretch

If you have a client who is initially unable to perform rolling patterns due to a strength or mobility limitation, there are a number of corrections that you can recommend based on where the limitation is occurring.

If a client has a strength and/or mobility limitation with their thoracic spine mobility in extension, it would be recommended to perform the modified cobra stretch. 

Bird dogs are a good choice for an unstable spine. Upper trap stretches are good for mobility limitations in sidebending and rotation of the cervical spine. Abdominal crunches can help to increase flexion of the lumbar and thoracic spine.

146.

Which of the following is not a useful example of a strategy to facilitate the transition from contemplation to preparation within the Transtheoretical Model (TTM)?

  • Encourage ways to substitute sedentary behavior for activity

  • Explore potential solutions to their physical activity barriers

  • Assess level of self-efficacy and begin techniques to build efficacy

  • Emphasize the importance of even small steps in progressing toward the goal of being regularly active

Correct answer: Encourage ways to substitute sedentary behavior for activity

The TransTheoretical Model (TTM) is used to explain a variety of health behaviors, understand physical acitivity behaviors, and create appropriate interventions. According to this model, behaviors and cognitive processes occur as individuals move through these stages of change. Here are the five stages of change of the TTM:

  1. Precontemplation: Currently inactive and not intending to take action in the next 6 months
  2. Contemplation: Currently inactive but intending to take action within six months
  3. Preparation: Slightly physically active but not meeting ACSM guidelines—wants to increase physical activity
  4. Action: Does enough physical activity to meet ACSM guidelines—less than 6 months at this stage
  5. Maintenance: Maintaining physical activity level—exercises for more than 6 months

When transitioning from contemplation to preparation, you can use the following example strategies:

  • Explore potential solutions to their physical activity barriers
  • Assess level of self-efficacy and begin techniques to build efficacy
  • Emphasize the importance of even small steps in progressing toward the goal of being regularly active
  • Encourage viewing oneself as a healthy, physically active person

Encouraging ways to substitute sedentary behavior for activity is more appropriate for moving from preparation to action.

147.

Which of the following factors would classify a client as moderate risk for a cardiac event?

  • Signs and symptoms of angina when exercising at an RPE of 4-7/10

  • Survivor of cardiac arrest or sudden death

  • Left ventricular ejection fraction > 50%

  • Normal hemodynamic and ECG responses with exercise and in recovery

Correct answer: Signs and symptoms of angina when exercising at an RPE of 4-7/10

The greatest challenge of ACSM preparticipation physical screening is potentially overlooking a sign or symptom of ongoing cardiovascular disease, and this mistake leads to a client experiencing a cardiac event. This is why it's best to err on the side of caution, obtain as much medical history as possible, and make an educated decision based on minimizing risk.

If a client has any one or more of the following factors present, they are considered at moderate risk for a cardiac event:

  • Left ventricular ejection fraction = 40% - 50%
  • Signs and symptoms of angina at moderate levels of exercise
  • Mild to moderate silent ischemia

All the other options would classify the client as either low or high risk for a cardiac event.

148.

Abduction of the shoulder occurs in which of the following movement planes?

  • Frontal 

  • Sagittal 

  • Transverse 

  • Rotational

Correct answer: Frontal

The frontal plane allows for movements such as abduction and adduction.

The sagittal plane allows for flexion and extension. The transverse or rotational plane allows for rotational movements around an axis.

149.

Synovial, when used as a description of joints in the body, refers to which of the following?

  • Freely movable joints

  • Fixed, immobile joints 

  • Fused joints

  • Diseased joints 

Correct answer: Freely movable joints

A person's range of motion is determined by several factors, including the following:

  • Muscle properties: The current flexibility status of your muscle tissue. This is able to be improved through flexibility training.
  • Physical activity and exercise: The degree to which the client is engaging in physical activities that promote a full range of motion
  • Anatomical structures: The degree of flexibility in your joints and tissues
  • Age and gender: Older adults have less collagen, and this can impact flexibility. Females tend to be more flexible than males.

Freely moveable joints are called synovial joints, and they are classified into one of six groups, each with a specific permissible plane or planes of movement.

150.

It's raining and your client believes they aren't able to go for their usual daily walk. What can you do as an exercise physiologist to help them with this perceived obstacle?

  • Encourage the client to workout on their exercise bike 

  • Ask your client to come into the gym during inclement weather

  • Rearrange the exercise schedule so your client can have a day off

  • Adjust the client's meal program to account for the lack of activity on that day

Correct answer: Encourage the client to workout on their exercise bike

If your client has a daily habit of walking, but on this particular day, it's raining, the last thing you want is for them to throw in the towel and continue sedentary behavior. Many people do this because they believe there is no other option other than the one they've been doing for weeks or months. 

As an exercise physiologist, it's your responsibility to help clients with this perceived obstacle. You must help your clients see and understand that additional options are always available, such as taking a walk at the mall, taking a group fitness class, or working out on an exercise bike.

151.

You are working with a client, focusing on improving functional movement patterns. Your client is apparently healthy, and they have been progressing effectively for a few months. They are currently comfortable with farmer carries while holding objects in both hands. 

What is the next appropriate progression?

  • Farmer carries with unilateral loading

  • Standing and adding in hip hinging

  • Standing and adding in hands above the head

  • Throwing and advanced plyometrics 

Correct answer: Farmer carries with unilateral loading

Posture is going to be a critical element to consider during functional movement assessments and exercise programming. There are six stages for neutral posture to consider based on the client's experience, medical history, and current status:

  1. Lying on the ground
  2. Seated
  3. Standing
  4. Standing and adding in hip hinging
  5. Farmer carries with bilateral loading
  6. Farmer carries with unilateral loading

If your client is currently comfortable with farmer carries with bilateral loading, you can progress them to farmer carries with unilateral loading.

152.

Flexibility gains are lost within 4 to 8 weeks after ceasing flexibility exercises due to a hamstring injury. This demonstrates which of the following principles?

  • Principle of reversibility

  • Principle of injury and maintenance

  • Principle of autogenic inhibition

  • Principle of regression

Correct answer: Principle of reversibility

Flexibility gains are lost within 4 to 8 weeks after ceasing flexibility exercises, which demonstrates the principle of reversibility.

Also called the "use it or lose it" principle, the idea behind the principle of reversibility is that if cardiorespiratory training is decreased or stopped for a significant period of time, usually two to four weeks, the previous improvements will reverse and decrease, and the body will readjust to the demands of the reduced physiological stimuli. In other words, those hard-earned gains can be lost if the training stimulus is removed and, as the trainer, this means that you will have to readjust the programming.

153.

When the volume and training intensity of a training program changes progressively over time, in a consistent pattern (e.g., from month to month), this is referred to as which of the following?

  • Linear periodization

  • Undulating periodization

  • Mesocycle periodization

  • Macrocycle periodization

Correct answer: Linear periodization

When the volume and training intensity of a training program changes over time, this is referred to as linear periodization. On the other hand, when the volume and training intensity of a training program changes from workout to workout, this is referred to as undulating periodization.

The general concept of periodization is to prioritize training goals and then develop a long-term plan that varies throughout the year. In general, the year is divided into specific training cycles:

  • Macrocycle: One year of specific goals and training programs
  • Mesocycle: One month of specific goals and training programs
  • Microcycle: One week of specific goals and training programs

154.

As it relates to proprioception, running and walking are the best examples of which of the following salient features of proprioceptive acuity?

  • Production of coordinated gait patterns

  • Precise calibration of limb position in space

  • Discrimination of object weight

  • Timing of muscular contraction for dynamic stabilization and multisegmental movement

Correct answer: Production of coordinated gait patterns

Proprioception is the sense of knowing where one's body is in space and, as it relates to fitness, it allows the client to do many things, even with their eyes closed. Running is an example of the production of coordinated gait patterns.

The full list of salient features includes the following:

  • Postural control
  • Precise calibration of limb position in space
  • Maintenance of steady muscle force production / movement amplitudes
  • Discrimination of object weight
  • Production of coordinated gait patterns
  • Controlling the timing of muscular contraction for dynamic stabilization and multisegmental movement
  • Feedback and feed-forward motor control

155.

For most joints, when using a goniometer to measure range of motion, where should you place the axis of the device?

  • In contact with the center of the joint being measured

  • Distal to the joint being measured

  • Promixal to the joint being measured

  • Hovering above the joint being measured

Correct answer: In contact with the center of the joint being measured

The most useful method for measuring joint flexibility is using a goniometer. Similar to a protractor, a goniometer expresses the range of motion in degrees. 

When performing a flexibility assessment with a goniometer, you should focus on placing the device at the center of the joint being measured.

Be sure to follow all the steps when measuring flexibility:

  1. Have the client perform a short warm-up.
  2. Place the goniometer at the center of the joint being measured. The fixed arm of the goniometer should be aligned with the appropriate bony landmark of the stationary body part.
  3. The moveable arm of the goniometer should be aligned with the specific bony landmark that is going to be moving.
  4. Record the range of motion in degrees.
  5. It is recommended that you perform three measurements.

156.

A client reports that her muscles have been very sore for the past two days after her last workout with you. Which of the following is the most likely cause of this soreness? 

  • DOMS

  • Multiple muscle tears 

  • Ligament strains in various joints 

  • Rhabdomyolysis 

Correct answer: DOMS

Delayed Onset Muscle Soreness, or DOMS, is a normal phenomenon that occurs after exercise in both trained and untrained individuals. This issue is not a cause for concern, and it usually resolves within a few days after training.

157.

The American College of Sports Medicine has identified 35 fundamental standards relating to risk management and emergency procedures. As it pertains to new members, which of the following is not one of those fundamental standards?

  • Provide information regarding the handling of hazardous materials to staff

  • Provide an open communication setting for new members to discuss questions

  • Provide a general orientation to the facility

  • Provide a means for new members to obtain assistance during workouts

Correct answer: Provide information regarding the handling of hazardous materials to staff 

The American College of Sports Medicine has identified 35 fundamental standards relating to risk management and emergency procedures. As an exercise physiologist, you will be training clients in a variety of locations and, therefore, it's important to take basic precautions that these fundamental standards lay out.

As it pertains to new members, the following are required:

  • Provide an open communication setting for new members to discuss questions
  • Provide a general orientation to the facility
  • Provide a means for new members to obtain assistance during workouts

Facilities must have a written system for sharing information with members and staff regarding hazardous materials such as bodily fluid.

158.

A client reveals they have active endocarditis. Which form of contraindication is this?

  • Absolute

  • Subjective 

  • Relative

  • Benign 

Correct answer: Absolute

There are certain clinical characteristics of an individual that make physical activity risky, or contraindicated. Most are related to cardiovascular health. Absolute contraindications refer to conditions that will absolutely not allow for exercise testing, while relative contraindications refer to conditions that might allow for testing, depending on the client's doctor's recommendations.

The following are absolute contraindications:

  • Acute myocardial infarction within two days
  • Active endocarditis
  • Ongoing unstable angina
  • Uncontrolled cardiac arrthymia with hemodynamic compromise
  • Symptomatic severe aortic stensosis
  • Decompensated heart failure
  • Acute pulmonary embolism, pulmonary infarction, or deep venous thrombosis
  • Acute myocarditis or pericarditis
  • Acute aortic dissection
  • Physical disability that precludes safe and adequate testing

159.

When teaching the bodyweight squat to a client, the trainer stands on the side of the client in order to observe the movement. Which of the following could the trainer not observe effectively from this vantage point?

  • Knee valgus 

  • Spinal flexion 

  • Heel rise 

  • Knee flexion angle 

Correct answer: Knee valgus

From the side, the trainer can observe deviations occurring in the sagittal plane. These include heel rise, knee flexion angles, and spinal flexion angle. However, it is difficult to observe frontal plane deviations from this position, such as knee valgus.

160.

Which of the following is an example of a strategy of social liberation for a client going through a change in exercise habits?

  • Have the client list the equipment available for workouts at the local park

  • Have the client read books and magazines about fitness

  • Have the client consider the impact of their decisions on family and friends

  • Have the client consider how they feel when they are not exercising versus when they are

Correct answer: Have the client list the equipment available for workouts at the local park

Processes of change can be broken down into experiential processes and behavioral processes. Both are recommended to help increase self-efficacy and facilitate the required transition from precontemplation to action to maintenance.

To guide a client through the social liberation process of change, you can have the client identify changes in the neighborhood that support exercise, such as walking paths and outdoor exercise stations.

Other types of experiential processes include the following:

  • Dramatic relief
  • Environmental reevaluation
  • Self-reevaluation
  • Consciousness raising
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