NSCA CSPS Exam Questions

Correct answer: 1-2 days per week / 4-8 single joint exercises / 50-60% 1RM / 1 set / 10-12 reps

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

• Modes of training: Weight training machines, bodyweight resistance, and elastic tubing
• 1-2 days per week (eventually progress to 4 days per week with a split body part routine)
• 4-8 single joint exercises
• 50-60% 1RM
• 1 set per exercise (progress to 2 to 3 sets)
• 10-12 repetitions
• Resting period: Between 1 to 2 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.

Correct answer: Abdominal exercises 

There are two essential reasons that a trainer should include abdominal exercises in a pregnant client's program: First, abdominal exercises improve the muscle strength needed during labor and delivery. Second, and perhaps more importantly, abdominal exercises reduce the risk of diastasis recti, which is when the two sides of the rectus abdominis muscle separate.

Correct answer: 6-minute walk test

By testing functional aerobic capacity, you can gain useful information about your client and the severity of their chronic restrictive pulmonary disease. The most commonly used test for determining aerobic capability is the 6-minute walk test.

It is important to note that when reviewing walk test scores, the trainer must take into consideration factors that can influence test results, such as age and musculoskeletal function. With that said, general recommendations, rather than specific targets, are recommended for understanding the functional capacity of individuals with chronic restrictive pulmonary disease.

What's more, the 6-minute walk test is a great way to measure endurance progress for clients with CRPD. You can use this test periodically as a safe and effective measurement method.

Correct answer: 1 day per week / Arm and leg cycling / 30% to < 60% VO2 / 10-20 minute sessions

If you are working with a client who has multiple sclerosis, 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)
• Low impact and large muscle group activities such as water aerobics, walking, swimming, arm and leg cycling, and biking
• Intensity: light to moderate (30% to < 60% VO2)
• Begin with 10- to 20-min sessions; progress up to 30- to 45-min 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: 2-3 days per week / 8-12 exercises / 60-80% 1RM / 1-2 sets / 10-12 reps

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

• 2-3 days per week
• 8-12 exercises
• Moderate intensity: 60-80% 1RM
• 1-2 sets
• 10-12 repetitions
• Resting period: 30-60 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: Correct abnormal conduction activity

The primary purpose of a pacemaker is to correct abnormal conduction activity in the heart and restore normal rhythm.

There are a variety of types of pacemakers that are available including the following:

• Rate-responsive
• Biventricular pacers
• AV pacers
• Pacemakers combined with implantable cardioverter defibrillator (ICDs)

It is important that you confirm with your client the type of pacemaker they have and how long they have had it. This will help you design an appropriate and effective program for that individual.

Correct answer: Weight management agents

The two main categories of medications used include selective serotonin reuptake inhibitors (SSRIs) and antipsychotic agents. 

• SSRIs are used to address depression, anxiety, and obsessive behaviors. Side effects include insomnia, increased agitation, and weight gain.
• Antipsychotic medications reduce aggressive or self-harming behavior. Antipsychotic medications can have side effects such as sleepiness, tremors, and weight gain.

Correct answer: High-density lipoproteins

High-density lipoproteins (HDLs) are referred to as “good cholesterol” and they are composed of a high proportion of protein with little triglycerides and cholesterol. High-density lipoproteins are involved in reverse cholesterol transport, which returns blood cholesterol to the liver and offers protection against atherosclerosis.

High-density lipoproteins appear in two major subfractions: HDL2 and HDL3. The lipoprotein subfraction, HDL2 is also protective against atherosclerosis.

Correct answer: 1-2 days per week / 8-10 multijoint exercises / 40-60% 1RM / 1 sets / 10-15 reps

If you are working with a client who has fibromyalgia, 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)
• 8-10 multijoint exercises (eventually consider a split body part program)
• 40-60% 1RM
• 1 set per exercise (eventually progress to 3 sets)
• 10-15 repetitions
• Resting period: Between 1 to 2 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.

Correct answer: RA is linked to other diseases

RA is an autoimmune disease, which means immune cells attack healthy tissue resulting in chronic inflammation of the joints and connective tissue. What's more, RA has been found to be linked to other serious conditions including the following:

• Cardiovascular disease
• Anemia
• Lupus
• Interstitial lung disease
• Sjogren's syndrome
• Dry eyes and mouth
• Vasculitis
• Osteoporosis
• Reduced kidney function
• Depression

A trainer must perform a thorough assessment to see if the client has any of these other conditions as it will directly impact the creation of an exercise program.

Correct answer: Pulmonary arterial pressure normally rises during exercise

Since the pulmonary arterial pressure (PAP) normally rises during exercise in healthy individuals, this makes the classification of exercise pulmonary hypertension (PH) more difficult than that for resting PH. 

With that said, you can look for certain characteristics of exercise pulmonary hypertension: Clients with this condition will have a high PAP accompanied by symptoms of pulmonary hypertension, such as breathlessness, which are not present at rest.

There are several categories of pulmonary hypertension, which makes it essential that a trainer becomes familiar with the signs and symptoms of all categories of the condition in order to provide an appropriate exercise program or medical referral.

Correct answer: 2-3 sessions per week / 2-4 sets / 6-12 reps / 60-80% 1RM

When creating a resistance training program for a client with asthma or exercise induced bronchoconstriction (EIB), be sure to focus on the following acute variables:

• 2-3 sessions per week
• 2-4 sets
• 6-12 repetitions
• Moderate intensity (60-80% 1RM)

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

Correct answer: Adopting a low-carbohydrate diet

For clients with CRPD, nonpharmacological treatments will usually be the first step of treatment, depending on the severity of the condition. Nonpharmacological treatments include the following:

• Avoiding airborne irritants (e.g., combustion exhaust and airborne trichloramines from indoor pools)
• Ceasing smoking
• Avoiding exposure to second-hand smoke
• Maintaining blood oxygen levels over 90% (as measured by pulse oximetry)
• Breathing exercises
• Anxiety management
• Nutritional counseling
• Health education
• Flu and pneumonia vaccinations

While a low-carbohydrate could help weight loss, alleviating symptoms related to obesity, it is not a primary nonpharmacological treatments for CRPD.

Correct answer: Low blood pressure

The most common signs and symptoms associated with sickle cell disease are the following:

• Swelling of the hands and feet
• Fatigue and jaundice
• Acute crises associated with certain triggers
• Chronic pain
• Sleep disorders

Low blood pressure is not one of the typical symptoms of sickle cell disease.

Correct answer: Loss of lean body mass

Restricting food consumption is a popular method for weight loss. More often than not, without the proper guidance of a trainer or dietitian, individuals will only focus on food restriction without increasing their physical activity level. Studies show that this usually results in a loss of as much as 20% to 40% of lean body mass. This is problematic as a loss in lean body mass can trigger a reduction in resting metabolic rate (RMR) and the thermic effect of physical activity (EEPA).

Lean body mass increases energy expenditure while at rest. Losing your lean body mass will negatively impact the metabolic response to energy expenditure and it can significantly slow down a client's weight loss progress. An appropriate level of physical activity (EEPA) based on your client's needs and restrictions is required to lose body fat and maintain a healthy amount of lean body mass.

Correct answer: Thyroid replacement therapy

When a client has hypothyroidism, the most commonly prescribed treatment is thyroid replacement therapy. This is when a synthetic version of thyroxine such as levothyroxine is administered. This treatment causes a wide variety of side effects because thyroxine affects almost all of the systems in the body. Common side effects include issues with heart function, nervous system activity, muscle control, and overall metabolism.

It is essential that the personal trainer confirms whether or not the client is undergoing thyroid replacement therapy since it can cause cardiovascular events including elevated blood pressure during a fitness assessment or exercise session.

Correct answer: Prehypertension 

When an individual has a systolic blood pressure between 120 and 139 mmHg and diastolic blood pressure between 80 and 89 mmHg, he or she has prehypertension.

Prehypertension can be looked as a warning sign that, if left untreated, could develop into high blood pressure, which dramatically increases your risk for a number of cardiovascular conditions such as heart disease.

The best way to treat prehypertension is with lifestyle changes such as a healthy diet and exercise program.

Correct answer: Obesity and sedentary lifestyles

The two primary factors placing undue stress on insurance systems, costing over $90 billion annually in the United States, are obesity and sedentary lifestyles.

Given the increase in inactivity and sedentary lifestyle, personal trainers can expect to see a rapid increase in special populations, especially obesity, under-exercised individuals, and cardiovascular issues stemming from weight gain. This is a primary reason why the industry needs trainers who are experts in special populations.

Correct answer: Aromatase inhibitors

Fat tissue in postmenopausal women produces a small quantity of estrogen. Aromatase inhibitors (AIs) block the enzyme aromatase that is found in that fat tissue. 

To be clear, aromatase inhibitors cannot block the normal estrogen production of the ovaries. What they can do is block the enzyme that promotes estrogen production, which lowers the overall amount of estrogen in the body. 

Selective estrogen receptor modulators (SERMs), on the other hand, directly block estrogen; they don't just lower the hormone, the stop it from being produced in the body.

Correct answer: Less than 800 kcal per day

A very low calorie diet (VLCD) contains less than 800 kcal per day. Due to the extreme restrictive nature of this type of diet, there is naturally a concern for safety and effectiveness. Therefore, a very low calorie diet must be prescribed and implemented under medical supervision. It goes without saying that a personal trainer cannot recommend or even discuss this type of diet with a client. A trainer must refer the client to a licensed medical professional.