NSCA CSPS Exam Questions

Correct answer: Peripheral arterial disease (PAD)

A narrowing of noncardiac arteries that may result in a reduction of blood flow is known as peripheral arterial disease (PAD). In particular, this condition is caused by fatty deposits and calcium building up in the walls of the arteries. It is common for clients with PAD to complain of leg pain, especially during exercise.

Correct answer: Doctor's orders

The biomedical staff and the family have the best intentions in mind when they recommend sedentary habits to the patient or loved one who is going through cancer treatment. Despite wanting to protect the individual, this lack of physical activity may lead to the development of the self-perpetuating fatigue cycle. This vicious cycle results in a higher and higher level of catabolic processes on the physical, emotional, and social levels.

Correct answer: 3 days per week; 3 sessions of 10 minutes; light to moderate intensity

Begin with at least three sessions per week of light to moderate intensity aerobic exercise. This can be expressed as 30% to < 60% VO2 or heart rate reserve or 55% to < 75% maximal heart rate [MHR], or RPE of 9-13 on Borg 6- to 20-point scale.

Three or more times per day, the client should perform at least 10 minutes of aerobic exercise per session. Acceptable modes of aerobic exercise include walking, jogging, running, swimming, and other aquatic exercise.

Correct answer: Increase one-repetition maximum

Frailty is associated with the muscular system. While there is no set definition of what a "frail" client is, there are general characteristics that many people share including:

• Typically older people are frail
• Increases with age
• Low muscular strength
• One symptom of a combination of poor health symptoms
• Reduced ability to participate in daily living activities

Exercise professionals should focus on functional goals for frail clients including working to reduce the risk of falling and improve functional capacity.

Attempting to increase the one-repetition maximum of a frail client would not be appropriate or safe.

Correct answer: Traumatic brain injury

When a sudden traumatic force to the head causes damage to the brain tissue, this is called a traumatic brain injury (TBI). This type of injury can occur when an external force strikes the head or when the head traumatically makes contact with an object. 

If the skull is penetrated by an object, causing damage to specific regions of the brain tissue, this is called an open head injury. If the skull is not fractured or penetrated during the event, then the injury is referred to as a closed head injury.

Correct answer: Acquired immune deficiency syndrome

Clients that have tested positive for human immunodeficiency virus (HIV) will develop acquired immune deficiency syndrome, better known as AIDS. As the name implies, this disease destroys the immune system, making it difficult to effectively fight off opportunistic infections. Clients with AIDS are more prone to unusual cancers and other abnormalities.

When a personal trainer is designing a program for a client with AIDS, the prescribed exercises will be based on the stage of immunodeficiency. 

While clients are in stage 1 of HIV, they are typically asymptomatic, meaning they have no symptoms and relatively few training restrictions. As the disease progresses, exercise capacity may steadily diminish, making physical exhaustion and muscular fatigue a greater concern.

Correct answer: 1 day per week / Aerobic dance / 30% to < 60% VO2 / 10-20 min sessions

If you are working with a client who has a cognitive condition or disorder, there are two options for the acute variables of an intermediate-level aerobic exercise program:

• 5 days per week
• Based on client tolerance, modes of training should include treadmill walking, cycling, arm and leg cycling, rowing, aquatic exercise, and aerobic dance
• Intensity: 40% to < 60% VO2
• Begin with 30- to 60-minute sessions

The other option is:

• 3 days per week
• Based on client tolerance, modes of training should include treadmill walking, cycling, arm and leg cycling, rowing, aquatic exercise, and aerobic dance
• Intensity: 60% to < 90% VO2
• Begin with 20- to 60-minute sessions

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: Below costal margin; above inferior gluteal folds

Low back pain (LBP) involves varying degrees of pain and discomfort that is localized below the costal margin and above the inferior gluteal folds. Leg pain tends to accompany low back pain, but not always.

Correct answer: Dyslipidemia

Dyslipidemia is a condition involving abnormal blood lipoprotein concentrations. When an individual has an elevated blood level of low-density lipoproteins, elevated serum triglyceride concentrations, or an abnormally low level of high-density lipoproteins, he or she is said to have dyslipidemia.

More specifically, excess cholesterol, particularly oxidized low-density lipoproteins (LDLs), becomes trapped within the inner lining of arteries and eventually builds to the point that the lumen is narrowed and blood flow is impaired.

Dyslipidemia is considered a major risk factor for atherosclerosis, heart attack, and stroke.

Correct answer: 3-5 days / Cycling / 40-70% of peak heart rate / 20-30 min

Studies show the importance of having clients with cystic fibrosis follow an aerobic-focused training program to reduce symptoms and improve their quality of life. Resistance training can also be helpful, but it should be tailored to a client's abilities and severity of the condition.

When assigning an aerobic exercise program to a client with cystic fibrosis, be sure to focus on the following acute variables:

• 3-5 days per week
• Walking, treadmill or cycling
• 40-70% of peak heart rate
• 20-30 min per session

As the client improves, the trainer can consider increasing duration and intensity.

Correct answer: 2-3 days per week / Total body / 1-4 sets / 8-12 repetitions / 60% to 80% 1RM

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

• 2-3 days per week
• Total body exercises
• 1 to 4 sets
• 8 to 12 repetitions
• Moderate intensity: 60% to 80% of one repetition maximum (1RM)

While the following variables have been shown to work well for most clients with hypertension, some clients might benefit more from lighter intensity (40% to 60% 1RM) and higher volume (up to 15 repetitions).

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

Correct answer: Medication side effects

When a sudden traumatic force to the head causes damage to the brain tissue, this is called a traumatic brain injury (TBI). This type of injury can occur when an external force strikes the head or when the head traumatically makes contact with an object.

The most common causes of traumatic brain injuries (TBIs) are falls, motor vehicle accidents, being struck by objects, and assaults.

Side effects from prescribed medications are not attributed to traumatic brain injuries.

It is important to determine whether or not your client has ever had a TBI, even as something as seemingly insignificant as a concussion, as there could be undiagnosed issues that affect training.

Correct answer: No cure; only management of symptoms

Unfortunately, there is no cure for chronic fatigue syndrome; there is only proper management of the condition and its symptoms. Commonly used management strategies include the following:

• Pharmacological intervention (e.g., antidepressants, stimulants, etc.)
• Stress management
• Counseling
• Proper nutrition
• Nutritional supplementation
• Educational interventions
• Group therapy
• Energy conservation
• Regular physical activity

As a trainer, it is important to collect a full list of the management strategies that have been assigned to your client by their doctor. This will ensure you can create a safe and effective assessment and exercise program.

Correct answer: Parkinson’s disease

A progressive neurological disorder that influences volitional movement is known as Parkinson’s disease (PD). 

The second most common neurodegenerative disease, Parkinson’s disease is a progressive brain disorder caused by the death or impairment of neurons in the substantia nigra region of the brain. It is slow to develop and it's most common in older people.

Correct answer: Aquatic exercise

When working with a client with multiple sclerosis, symptoms and severity of those symptoms can be unpredictable during an exercise session. Therefore, a popular form of aerobic exercise that is efficient and safe is aquatic exercise. Whether swimming laps or participating in cardiovascular or resistance training in the pool, aquatic exercise is an appropriate form of exercise for all training levels.

Correct answer: 3-7 days per week / Large muscle groups / 40% to < 60% VO2 / ≥ 10 min per session / Goal is ≥ 150 min per week

When designing an aerobic 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 exercise has been shown to be most effective for achieving this goal.

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

• Large muscle groups and rhythmical movements (e.g., walking, jogging, biking, swimming, stair stepping)
• 3-7 days per week (with ≤ 2 days between training days)
• Moderate intensity (40% to < 60% VO2 or heart rate reserve)
• ≥10 min (per session); goal is ≥ 150 min (per week)

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

Correct answer: 1 day per week / Arm crank exercise / 30% to < 60% VO2 / 15-20 min sessions

If you are working with a client who has sustained a stroke, the following acute variables are recommended for a standard aerobic exercise program:

• 1 day per week (eventually work up to 2-3 days per week)
• Based on client tolerance, modes of training should include cycling, rowing, arm crank exercise, reciprocal press–pull exercise, treadmill walking.
• Intensity: 30% to < 60% VO2
• Begin with 15- to 20-minute sessions; progress up to 30-minute sessions
• An overall increase in daily living activities

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: 3-7 times per week / Mild discomfort / 15-30 seconds

When designing a flexibility exercise program for a frail client, the focus should be to promote healthy movement patterns, continued independence, and activities of daily living. Static stretches should be performed on all or most days, focusing on holding the stretch to a point of mild discomfort for 15 to 30 seconds each.

Aside from static stretches, the trainer should also incorporate neuromuscular exercises and functionally based exercises that increase coordination, balance, and gait in order to reduce the risk of falls and associated increased morbidity and mortality. Examples include the chair stand, one-foot stand, or tandem gait.

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

Correct answer: Aerobic exercise and resistance training

Recent studies have shown that combining aerobic exercise with resistance training leads to superior benefits on insulin resistance and glycemic control in individuals with type 2 diabetes.

One study found that glycated (or glycosylated) hemoglobin (HbA1c) levels—a long-term measure of blood glucose—improved significantly more in a combined resistance training and aerobic training group compared to resistance training–only and aerobic training–only groups.

A proper aerobic exercise program for a sedentary client with type 2 diabetes should begin with two or three 10-minute bouts of aerobic activity per day. If you are working with a client who has some experience with aerobic exercise, you can progress that client or have them start with 30 minutes of continuous aerobic activity on 5 to 7 days per week.

An ideal resistance training program for a new client with type 2 diabetes will include the following acute variables:

• 2-3 days per week
• 10-12 multi-joint exercises
• 50-70% 1RM
• 2-3 sets
• 8-12 repetitions
• 30-60 min per session

Correct answer: Hypertrophy

When hypothyroidism is left unchecked, it can lead to more severe conditions; two of the most common include the following:

1. Goiter: An enlarged thyroid gland
2. Myxedema: The swelling of the skin and underlying tissues

Both of these conditions can be fatal, which is why it's so important for the client to do what is necessary to treat hypothyroidism. It goes without saying that before exercise can begin, medical clearance is required.

Hypertrophy refers to the increase in muscle size. When a client has hypothyroidism, one of the side effects can be muscle loss.