Question 1

The potential benefits and risks of an exercise test should be written in what document?

Accepted Answer

The potential benefits and risks of an exercise test should be written in the informed consent form.

Question 2

According to the most recent National Institutes of Health's Clinical Guidelines for the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, recommendations for practical clinical assessment include __________.

Accepted Answer

The NIH Clinical Guidelines recommend determining total body fat through the BMI to assess obesity and determining the degree of abdominal fat and health risk through waist circumference. This approach allows for a more comprehensive assessment of obesity and its associated health risks compared to solely using the waist-to-hip ratio.

Question 3

Which of the following is NOT a principle of low back care?

Accepted Answer

The answer of Which of the following is NOT a...

Question 4

Initial training sessions for a person with severe chronic obstructive pulmonary disease most likely would NOT include __________.

Accepted Answer

Continuous cycling activity at 70% of VO2 max for 30 minutes is too intense for initial training sessions for someone with severe COPD.

Question 5

Special precautions for clients with hypertension include all of the following EXCEPT __________.

Accepted Answer

Muscle strengthening exercises with low resistance are not contraindicated for clients with hypertension. Clients with hypertension should avoid activities that involve the Valsalva maneuver, monitor for arrhythmias if taking diuretics, and avoid exercise if their resting systolic BP is greater than 200 mm Hg or diastolic BP is greater than 115 mm Hg.

Question 6

Chronic soreness and fatigue are symptoms of __________.

Accepted Answer

Chronic soreness and fatigue are common symptoms of overuse injury, which is caused by repetitive motions and strain on the muscles and joints. Hyperglycemia and hypoglycemia are conditions related to blood sugar levels and are not typically associated with soreness and fatigue. Strain can cause acute pain and limited mobility, but chronic soreness and fatigue suggest a longer-term issue such as overuse injury.

Question 7

Symptoms of claudication include __________.

Accepted Answer

Claudication typically presents with cramping, burning, and tightness in the calf muscle that is brought on by activity and relieved with rest. Acute, sharp pain in the foot on palpation is not a typical symptom of claudication. Crepitus in the knee and pitting ankle edema are also not associated with this condition.

Question 8

What is the fitness instructor's primary responsibility in conducting an exercise test?

Accepted Answer

The fitness instructor's primary responsibility during an exercise test is to maintain a safe environment by not putting the client in danger. Accurately collecting data, completing the test, and providing encouragement and support are also important responsibilities, but safety should always come first.

Question 9

Which of the following situations indicates progression to independent and unsupervised exercise for a client after CABG surgery in an outpatient program?

Accepted Answer

A functional capacity of greater than 8 MET with appropriate hemodynamic responses indicates that the client can safely progress to independent and unsupervised exercise. The other options indicate that the client may not be ready for independent exercise due to ongoing cardiac symptoms (option A), noncompliance with important interventions (option C), or inability to monitor exercise intensity (option D).

Question 10

What are some of the risks for musculoskeletal injury?

Accepted Answer

Extrinsic factors such as intensity, terrain, and equipment can contribute to musculoskeletal injuries by affecting the physical demands placed on the body.

Question 11

A 62-year-old, obese factory worker complains of pain in his right shoulder on arm abduction; on evaluation, decreased ROM and strength are noted. You also notice that he is beginning to use accessory muscles to substitute movements and to compensate. These symptoms may indicate __________.

Accepted Answer

The symptoms of pain and decreased range of motion and strength on arm abduction, along with the use of accessory muscles, suggest a rotator cuff strain or impingement. This is a common injury in manual labor jobs, especially in older and obese individuals. Referred pain from a herniated lumbar disk, angina, and advanced stages of multiple sclerosis would typically present with different symptoms and signs.

Question 12

A client with angina exhibits symptoms and a 1mm, down-sloping ST-segment depression at a HR of 129 bpm on his exercise test. His peak exercise target HR should be set at __________.

Accepted Answer

The peak exercise target HR should be set at 10 to 20 bpm below the point at which ST-segment depression occurs, to ensure that the client does not exceed this threshold during exercise. Therefore, in this case, the target HR should be set at 109 to 119 bpm.

Question 13

Documentation offers important __________.

Accepted Answer

Documentation serves as evidence of the care provided by healthcare professionals, which can be used to defend against claims of negligence or malpractice. It also serves as a way to demonstrate that the care provided met the standard of care and that the healthcare professional acted responsibly.

Question 14

Emergency procedures should be __________.

Accepted Answer

Emergency procedures should be easily accessible and visible, such as being posted under each phone, to ensure quick access during an emergency.

Question 15

Treatment for claudication during exercise includes all of the following EXCEPT __________.

Accepted Answer

Stopping activity at the onset of claudication discomfort is not recommended as it does not help in building tolerance or improving circulation. Instead, exercising to the point of maximal tolerable pain with rest periods is encouraged to improve symptoms.

Question 16

What common medication taken by clients with end-stage renal disease requires careful management for those undergoing hemodialysis?

Accepted Answer

Antihypertensive medication requires careful management in patients undergoing hemodialysis because blood pressure can fluctuate significantly during the procedure, and adjustments may be needed to prevent hypotension or other complications.

Question 17

Which of the following issues would you include in discharge education instructions for a client with congestive heart failure to avoid potential emergency situations related to this condition at home?

Accepted Answer

In discharge instructions for a client with congestive heart failure, it is important to include both recording daily body weight and noting signs and symptoms, as both can be indicative of fluid retention and worsening heart failure. Reporting these to a physician can help prevent emergency situations at home. Option A is incomplete, as it only addresses weight gain. Option C is incorrect, as clients should always be taught to monitor their pulse and report any irregularities to their physician.

Question 18

Which of the following is NOT an appropriate treatment activity for inpatient rehabilitation of a client on the second day after coronary artery bypass graft (CABG) surgery?

Accepted Answer

While low-resistance activities and ROM exercises are appropriate for a client on the second day after CABG surgery, upper body exercises with 5-pound weights may be too intense and not appropriate for this stage of rehabilitation. The client's activity level should be gradually increased and monitored for signs of fatigue or discomfort.

Question 19

All of the following are special considerations in prescribing exercise for the client with arthritis EXCEPT __________.

Accepted Answer

Periods of acute inflammation actually result in increased pain and joint stiffness, and may require modifications or temporary cessation of exercise. The other options are special considerations in prescribing exercise for clients with arthritis.

Question 20

A client with type 1 diabetes mellitus checks her fasting morning glucose level on her whole-blood glucose meter (fingerstick method), and the result of 253 mg/dL (14 mmol/L). A urine test is positive for ketones before her exercise session. What action should you take?

Accepted Answer

With a fasting glucose level of 253 mg/dL and positive urine ketones, it is important to not allow her to exercise and notify her physician of the findings. This may indicate diabetic ketoacidosis (DKA), a serious complication of diabetes that requires immediate medical attention. Waiting until the glucose level reaches 300 mg/dL is not safe in this situation. Giving an extra carbohydrate snack before exercise could further increase glucose levels and worsen the condition. Adjusting the insulin regimen may also be necessary but should be done under medical guidance.

Exam 2: ACSM Registered Clinical Exercise Physiologist