NSCA CSPS Exam Questions

Correct answer: Unilateral exercise movements

When a client has had a stroke and there are limitations in motor control and sensory awareness on one side of the body, this will necessitate the inclusion of unilateral exercise movements in the exercise program. 

By training the affected side of the body independent of the unaffected side, conditioning of the region or regions that are most compromised can be ensured.

Correct answer: Sedentary lifestyles

One of the leading cause of preventable death is a sedentary lifestyle. Avoiding physical activity has been shown to increase the risk of developing numerous diseases including cardiovascular disease, diabetes, hypertension, obesity, osteoporosis, and lipid disorders. 

Correct answer: Women

Studies show that women are the most at risk for hypothyroidism, with an estimated 3% of U.S. women suffering from it. In fact, hypothyroidism is seven times more prevalent in women than in men.

Worldwide, it is estimated that 7% to 10% of the population has subclinical hypothyroidism, which is when an individual has low serum thyroid-stimulating hormone in the presence of normal levels of triiodothyronine and thyroxine.

It is important to recognize the symptoms of hypothyroidism, especially in female clients, because this will help the trainer refer the client to a medical professional, if necessary, and create an appropriate exercise program.

Correct answer: ≥ 3 days per week / Jogging / 40-80% VO2 / 20-60 minutes

If you are working with a client with prior myocardial infarction, the following acute variables are recommended for a standard aerobic exercise program:

• ≥ 3 days per week
• Large muscle group activities such as walking, jogging, or cycling
• 40-80% VO2 or heart rate reserve; or 12-16 RPE (on Borg 6- to 20-point scale)
• 20 to 60 minutes or more of either continuous or accumulated exercise throughout the day; for example, the client can perform two to six bouts of 10 minutes each
• 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: Elevated level of blood glucose

Other than chronic muscular pain and fatigue, common symptoms associated with fibromyalgia include the following:

• Generalized stiffness
• Anxiety
• Depression
• Non-restorative sleep
• Heightened pain perception
• Gastrointestinal distress
• Headaches
• Sensitivity to light
• Joint swelling
• Mood swings
• Cognitive impairments (a.k.a. “fibro fog”)
• Irritable bowel and bladder syndrome
• Raynaud’s phenomenon, a condition that involves the narrowing of blood vessels when a person is cold or feeling strong emotions

An elevated level of blood glucose is not a common symptom of fibromyalgia.

It is imperative that the trainer becomes familiar with these symptoms as they can directly impact assessments and exercise sessions.

Correct answer: Unexplained weight loss

When the thyroid gland, which is located in the anterior neck region, does not produce enough of the hormone thyroxine, this is a condition known as hypothyroidism. Symptoms of hypothyroidism, also known as an underactive thyroid, include the following:

• Fatigue
• Cold intolerance
• Dry skin
• Unexplained weight gain
• Puffy face
• Hoarseness
• Muscle aches and weakness
• Elevated blood cholesterol
• Stiff and painful joints
• Loss of bone mineral density
• Hair loss
• Depression
• Slowed heart rate, and impaired memory

Correct answer: Two or three 5- to 15-min bouts / Large muscles groups / 40-50% heart rate reserve / 15-30 min

For clients with hyperthyroidism or hypothyroidism, the recommended exercise guidelines essentially follow the guidelines for apparently healthy persons. The caveat is that the client must have hormone replacement results in a euthyroid state. What's more, if your client has led a sedentary lifestyle, you will need to regress many of the general recommendations that would be appropriate for a client with some fitness experience.

When assigning an aerobic exercise program to a sedentary client with hypothyroidism or hyperthyroidism, be sure to focus on the following acute variables:

• Start your client with two or three 5- to 15-min bouts of aerobic activity with the goal of achieving a minimum of 5-6 days per week; 7 days per week if weight loss is needed.
• Focus on large muscle groups.
• Start on the lower end of the 40-85% heart rate reserve, gradually increasing intensity as the client progresses.
• A minimum of 150 min of moderate intensity (40% to < 60% heart rate reserve) or 75 min of vigorous intensity (≥ 60%-90% heart rate reserve) or a combination of both.
• If weight loss is needed and your client is progressing accordingly, the weekly goal should be 300 minutes for additional benefits.

The personal trainer must know the signs and symptoms of thyroid disease and adjust the exercise program accordingly. A medical referral might also be necessary.

Correct answer: Medical clearance

Exercise is beneficial for the recovery of a grade 1 sprain. Specifically, the treatment for grade 1 sprains includes strengthening, range of motion, and flexibility as tolerated. With that said, exercise should only be initiated once a physician or other health care professional’s clearance has been obtained. 

What's more, it is ideal if the initial healing phase (typically two or three days), denoted by lack of pain and swelling, is complete as well.

Correct answer: Tricyclic drugs

Clients with with spinal cord injuries also experience neurogenic pain. For this pain, doctors usually prescribe tricyclic drugs, which are known to cause the following side effects that could interfere with an exercise session:

• Nausea
• Drowsiness
• Sedation
• Light-headedness
• Dizziness
• Muscle weakness

Correct answer: Rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease, which means immune cells attack healthy tissue. In this case, RA causes chronic inflammation of the joints of the body.

It typically develops after the age of 40, and the long-term impacts of this condition include atrophy of muscles, joint deformity, and disability.

Correct answer: 4-7 days per week / Cycling / 40-80% VO2 / 20-60 minutes

If you are working with a client with coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA), the following acute variables are recommended for a standard aerobic exercise program:

• 4-7 days per week
• Large muscle group activities such as walking, jogging, or cycling
• 40-80% VO2; or 12-16 RPE (on Borg 6- to 20-point scale)
• 20 to 60 minutes or more of either continuous or accumulated exercise throughout the day; for example, the client can perform two to six bouts of 10 minutes each
• 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: Severe post-exertional fatigue

Despite the benefits of exercise such as improved health and psyche and ability to perform functional activities, individuals with chronic fatigue syndrome (CFS) often complain of about severe post-exertional fatigue or malaise. 

It is because of this that many individuals with CFS avoid physical exertion. Unfortunately, avoiding physical activity and exercise can worsen fatigue and lead to significant reductions in overall health, fitness, functional ability, and quality of life.

Correct answer: Muscular tremors

Parkinson’s disease (PD) is a progressive neurological disorder that influences volitional movement. It is the second most common neurodegenerative disease, and it is caused by the death or impairment of neurons in the substantia nigra region of the brain. The most common symptom of PD is muscular tremors.

Other symptoms of PD include the following:

• Muscular stiffness
• Slow movements
• Lack of facial expression
• Lack of arm swing during walking
• Slurred speech

Correct answer: 6-Minute Walk Test

The majority of fitness assessments are able to be performed by most individuals within a special population. With that said, you will find that some of your clients have extreme limitations. For a client with very little experience in physical fitness and extremely limited cardiovascular endurance, the most appropriate test for cardiovascular endurance is the 6-Minute Walk Test.

1. Signalling "go," the exercise professional starts two stopwatches.
2. The client begins walking counterclockwise as fast as possible (not running) around the course, covering as much distance as possible in the 6-minute time limit.
3. One way to keep track of the distance walked is to provide a lap marker to the client every time a lap of the course is completed.
4. At the end of the 6-minute test period, clients should stop, stand next to the closest 5-yard (4.6 m) segment tape marker on their right, and keep moving in place for a 1-minute cooldown.

Correct answer: Environmental stressors

Frailty is generally considered the result of a multi-factorial interaction of the following three conditions:

1. Age-related deficits in various physiological and psychological systems
2. Nutritional deficiencies
3. Environmental stressors

Correct answer: Stable angina

Angina is described as chest pain that occurs in response to myocardial ischemia or reduced blood flow to the myocardium. There are two forms of angina: stable and unstable.

1. Stable angina: This happens when the individual performs a specific level of stress such as physical activity. It is predictable, and it is rapidly alleviated with rest or nitroglycerin.
2. Unstable angina: This condition is far less predictable. Unstable angina can occur, and often does, while resting.

Since there are a number of forms of unstable angina associated with acute coronary events, individuals with this condition are typically not candidates for exercise programming until after the acute event has been stabilized.

Correct answer: Intermittent claudication

Intermittent claudication (IC) is an aching feeling in the legs, calves, and buttocks brought on by exercise. Not all clients with peripheral arterial disease will have intermittent claudication. However, clients that do have IC will often be limited in how much exercise and activity they can perform. In fact, the amount of exercise that a client with IC can do is usually low in comparison to clients without IC.

With that said, exercise can improve and increase the amount of work a client with IC can perform before the pain sets in.

Correct answer: CVD

Given the fact that dyslipidemia is primarily based on lifestyle choices, there is a high probability that a client with dyslipidemia may also have secondary conditions such as CVD, type 2 diabetes, or hypertension. If there is a chance that your client has dyslipidemia along with a secondary condition, a medical clearance is required before exercise can begin. 

Even after medical clearance is obtained, it is essential for the exercise professional to emphasize that the client focuses on lifestyle changes including weight loss, a healthy diet low in saturated and trans fat and high in fiber, and regular aerobic and resistance exercise. These three factors have been found to be the most effective strategy to improve dyslipidemia.

Correct answer: Aerobic exercise

Studies show that in the absence of insulin, daily exercise provides an alternative mechanism for blood glucose disposal. While all forms of physical activity and exercise are encouraged for clients with diabetes, aerobic exercise has been shown to best enhance glucose delivery to exercising muscle. Aerobic exercise also provides the following benefits:

• Stimulates translocation of glucose transporter protein 4 to the cell surface
• Improves insulin receptor sensitivity
• Increases phosphorylation and utilization of glucose intracellularly
• Triggers glucose uptake after exercise and into the recovery period

Correct answer: Hypoxic cardiopulmonary disease

It is common for clients with pulmonary hypertension to also have one of several hypoxic cardiopulmonary diseases, including COPD (chronic obstructive pulmonary disease)and diffuse parenchymal lung diseases.

It is important for a trainer to be aware of the associations with pulmonary hypertension as a client might have a severe case of the condition and need to be referred to a medical professional for a fitness assessment and exercise program.