NSCA CSPS Exam Questions

Correct answer: Accessibility

Clients who are in the special populations category can face substantial barriers to participation in an exercise program. Depending on the condition, many individuals can be limited or restricted in their accessibility to exercise opportunities. This can occur for two primary reasons: architectural accessibility issues or equipment selection.

As a trainer, it is your duty to ensure accessibility to exercise opportunities through an appropriate architectural assessment and resolving of equipment issues. Above all, you must be there to provide appropriate training supervision.

Correct answer: Medically supervised

For high-risk clients who have medically identified participation restrictions, it is recommended that they partake in medically supervised fitness assessments and exercise programming. This means that the assessments and programming will be directed and monitored by a healthcare professional. These activities must take place in a controlled clinical setting that offers immediate emergency care.

Correct answer: Static and dynamic stretching / 2-3 times per week / Hold to the point of tightness; repeat 2-4 times / 10-30 seconds

When designing a flexibility exercise program for a client with type 1 diabetes, the focus should be on lowering blood glucose levels and avoiding exercises that cause an unnecessary spike in glucose levels. Moderate-intensity aerobic exercise has been shown to be most effective for achieving this goal. However, flexibility training can also help, and it should be a part of a well-designed program.

When assigning a flexibility training exercise program to a client, be sure to focus on the following acute variables:

• Static and dynamic stretching; yoga
• 2-3 days per week
• To the point of tightness; repeat 2-4 times
• Hold a static stretch for 10-30 s; repeat a dynamic stretch for 10-30 s

As the client improves, the trainer can increase duration and intensity.

Correct answer: Assigning high-intensity interval training post-insulin administration

When working with a client who has type 1 diabetes, it is essential to balance the following three factors: the amount and timing of insulin administration, the pre-exercise food (carbohydrate) intake, and the type, duration, and intensity of the exercise session.

There are several ways to accomplish this, ensuring you avoid or mediate during- or post-exercise hypoglycemia:

1. Increase the time between the pre-exercise insulin administration and the beginning of the exercise session
2. Reduce the amount of pre-exercise insulin
3. Increase the amount of carbohydrate consumed before exercising
4. Lower the amount of post-exercise insulin
5. A combination of these tactics

High-intensity interval training would not be recommended for clients who are new to fitness as this type of exercise has been shown to increase blood glucose levels.

Correct answer: Disease-modifying drug

Individuals with multiple sclerosis (MS) are commonly prescribed medications in three primary categories. After they have been diagnosed with MS, a physician will most likely prescribe the first category of medication, a disease-modifying drug. 

This is prescribed first as it can help to reduce the frequency and severity of attacks. In turn, this will decrease the damage to the central nervous system (CNS) and slow the progression of the disease.

It is important to know which category of medication a client with MS is taking as it may impact assessments and exercise sessions.

Correct answer: As tolerated / Passive and static stretching; flexibility exercises / 8-10 stretches / Hold for 30 sec

If you are working with a client with hemophilia, the following acute variables are recommended for a standard flexibility exercise program:

• As tolerated (ideally, every day)
• Focus on passive and static stretching, as well as flexibility exercises
• 8-10 dynamic, low-amplitude stretches
• Hold stretches for 30 seconds as tolerated - Eventually progress to 60 seconds

Keep in mind that these variables might need to be adjusted based on the results of exercise testing and assessments detailing symptom severity in response to exercise intensity and duration.

Correct answer: Increased muscle lactate 

Studies show that the constant activation of both the sympathetic and renin-angiotensin systems and the concomitant reduction in blood flow lead to a shift to anaerobic metabolism. The result is an increase in muscle lactate accumulation. The severe exercise intolerance that is characteristic of clients with chronic heart failure is due in part to lactate accumulation at low exercise levels.

Correct answer: No more than 20% to 30% of daily calories

Dyslipidemia is a condition that is characterized by abnormal blood lipoprotein concentrations. It is a major risk factor for atherosclerosis, heart attack, and stroke. While a trainer cannot provide a meal plan, he or she can provide general nutritional recommendations that are backed up by official sources such as the Center for Disease Control. 

A client with dyslipidemia should consume no more than 20% to 30% of their daily calories from fat sources. What's more, less than 7% of calories should come from saturated fat with little or no trans fat each day.

Correct answer: Motivation and encouragement

In order to avoid legal issues, the personal trainer should become familiar with the profession's scope of practice, which does not include psychological services. Only licensed health care professionals, such as mental health counselors and psychologists, have the appropriate background and training necessary for treatment of psychological issues. 

A personal trainer risks legal trouble if he or she claims to provide counseling services directly related to disordered eating, body image, or other psychologically based issues. With that said, an exercise professional can refer a client to a licensed specialist.

A personal trainer is allowed and encouraged to provide motivation to their clients.

Correct answer: Increase room temperature

Clients with Parkinson's disease (PD) may experience one of the following symptoms during the training session: slower walking speed, decreased ability to pick up their feet, decreased speed of movement, and poor balance. 

Safety is the most important consideration when working with a person with PD. Since clients find it difficult to adapt to a dynamic environment, the following safety precautions are highly recommended:

• Train at times when the facility is not too busy
• Provide a quiet room to exercise in
• Floor should be clear of anything the client could trip over (exercise equipment, area rugs, cords, and so on)
• Train in a well-ventilated area

The temperature of the room should be set to a cooler temperature, not a warmer temperature, as the latter can worsen symptoms.

Correct answer: Combats muscle dysfunction

Studies show that pulmonary hypertension causes muscle dysfunction in those who have it. For this reason, many experts agree that resistance training is recommended in an appropriate exercise program. By performing bodyweight or weighted-exercises, the client can combat the muscle dysfunction symptoms of PH.

However, it is important to focus on light resistance training. Do not allow the client to overexert him/herself. In other words, do not have the client work to a point where he or she feels light-headedness, chest pain, or severe shortness of breath.

Correct answer: Effectiveness of the pacemaker

If a trainer is working with a client who has a pacemaker, the response to training is based on how effectively the pacemaker or ICD functions. If the pacemaker can effectively restore normal or near-normal electrical activity, then the training response will be increased exercise capacity.

Naturally, this increase in exercise capacity has the potential to increase quality of life for individuals with pacemakers. This boost in quality of life will be proportional to their ability to adequately perform activities of daily living. It also depends on the amount of symptom relief of dyspnea, hypotension, lightheadedness, and syncope.

Correct answer: 72% to 90% lower risk

Most metabolic disorders are preventable. Metabolic conditions such as type-II diabetes and obesity can be avoided by following a low-risk lifestyle. Strong evidence suggests that by practicing a low-risk lifestyle, you have a 72% to 90% lower risk of developing a metabolic disorder.

Examples of low-risk lifestyle habits:

• Exercise or physical activity: 30 minutes or more for 5 days per week
• Plant-focused diet with plenty of fiber, lean proteins, and healthy fats
• No smoking
• No excessive alcohol consumption

Correct answer: Preventable diseases

When you increase your levels of physical activity, you reduce the chance of developing certain preventable diseases including the following:

• Cardiovascular disease
• Metabolic disease
• Diabetes mellitus
• Obesity
• Hypertension

On the other hand, if you decrease your level of physical activity, you will increase your risk of developing these diseases.

Correct answer: Small tumor that has not spread

Several classification systems exist to track a cancer's process. The TNM (Tumor, Node, Metastasis) system gives three key pieces of information and is currently the most commonly used method.

A tumor categorized as T1 N0 M0 would be best described as a small tumor that has not spread. For reference, a tumor categorized as T4 N4 M4 would be described as a large tumor that has spread.

Correct answer: 2-3 days per week / Activities depending on ability / Moderate to vigorous intensity / 1 set / 8-12 reps

If you are working with a client who has autism spectrum disorder, the following acute variables are recommended for a resistance training exercise program:

• Modes of training: This will vary from client to client. Choose activities that your client is able to perform and enjoys doing.
• 2-3 days per week
• Moderate to vigorous intensity (physical activity that noticeably increases breathing, sweating, and heart rate)
• 1 set per exercise (progress to 3 sets)
• 8-12 repetitions
• Resting period: As needed

Keep in mind that these variables might need to be adjusted based on the results of exercise testing and assessments detailing symptom severity in response to exercise intensity and duration.

Correct answer: Vigorous exercise

Since a high percentage of individuals with type 2 diabetes also have undiagnosed atherosclerosis of the coronary and peripheral arteries, it is recommended to be particularly cautious with vigorous exercise. This high level of caution stems from the fact that 75% of individuals with type 2 diabetes will die from cardiovascular disease.

Begin with light intensity exercise for a short duration, and gradually progress to the comfort level of your client.

Correct answer: Osteoporosis

The most notable change during menopause and postmenopause is the decrease in the hormone, estrogen. Studies show that a significant decrease in estrogen can negatively impact bone health and fat metabolism. 

In particular, the change in estrogen levels can cause an imbalance in the bone remodeling system. As a result, the bone becomes more porous and brittle, leading to the development of osteoporosis and an increased risk of fractures. 

Women can increase muscular strength and bone density by participating in an exercise program that combines both aerobic and resistance exercise.

Correct answer: Increased inactivity

The most common issue with exercise adherence for individuals with chronic kidney disease is that, due to the progressive nature of the condition, inactivity becomes common. This starts a vicious cycle; the worse the condition becomes, the less physical activity and functioning occurs.

This is a powerful reason why trainers who specialize in this population are so important. Clients with chronic kidney disease need a trained professional who can provide a structured and individualized exercise program that meets their needs.

Correct answer: 1-2 days per week / 4-8 multijoint exercises / Intensity for 15 rep max / 1-3 sets / 10-12 reps

If you are working with a client who has multiple sclerosis, the following acute variables are recommended for a resistance training exercise program:

• 1-2 days per week (eventually progress to 3-4 days per week)
• 4-8 multijoint exercises
• Set the intensity level to match the client's 15 repetition maximum
• 1-3 sets per exercise (progress to 3 to 4 sets)
• 10-12 repetitions
• Resting period: Between 2 to 4 minutes

Keep in mind that these variables might need to be adjusted based on the results of exercise testing and assessments detailing symptom severity in response to exercise intensity and duration.