Question 1

Every Group Fitness Instructor should be aware of where their facility's First-Aid Kit is located and what it contains. Which is the following is LEAST likely to be included inside a First-Aid Kit.

Accepted Answer

Although automated external defibrillators have found their way into almost all fitness centers, they are not traditionally located in a First-Aid Kit. Rather, they are located in their own case and mounted in a prominent location within the facility. First-Aid Kits include CPR pocket masks, blood pressure cuff, stethoscope, personal protective equipment, sterile gauze, tape, scissors, cold packs, compression wraps and more.

Question 2

One of the methods that fitness facilities use to reduce risk is to make use of screening questionnaires, especially for members who are at high risk for cardiovascular disease. Which of the following is an example of such a screening tool?

Accepted Answer

The Physical Activity Readiness Questionnaire (PAR-Q) is a popular screening tool used by fitness professionals to assess an individual's readiness for exercise. This tool can point-out at-risk individuals who should be referred to their physicians or physical therapists prior to initiation of an exercise program. The Functional Independence Measure (FIM) and the Short Form 36 are both examples of assessments tools used in the rehabilitation field.

Question 3

If a victim is found unresponsive and not breathing and trauma is assumed, which of the following techniques should be used instead of the traditional head tilt-chin lift maneuver?

Accepted Answer

In the Jaw-Thrust Method, the responder places his or her fingers on the jaw angles and lifts the jaw forward in order to move the tongue out of the airway. When a victim is found unresponsive and not breathing and when evidence of trauma is evident (such as a fallen ladder in the vicinity), the responder should not move the victim and should not perform the traditional head tilt-chin lift maneuver to open the airway.

Question 4

In an emergency situation, skin color can provide excellent insight into a victim's health status. Grayish, pale skin is MOST indicative of which of the following:

Accepted Answer

Grayish, pale skin is often an indication of poor circulation. During emergency situations, once the victim is stable, the responder should do a secondary assessment which includes an examination of skin color. Warm skin with pinkish tones tells a better story about the victim's status; it tends to show that both circulation and oxygenation are occurring.

Question 5

During an emergency, one of the secondary assessments that should be made by a responder is the presence or absence of any medical alert jewelry. Medical alert jewelry is LEAST likely to tell the responder the following:

Accepted Answer

Medical alert jewelry -- typically worn as a bracelet or necklace - does not typically list a home address. Instead, it is typically worn to notify rescuers of drug allergies, medical conditions and resuscitation requests of the wearer. Medical alert jewelry is worn to "speak for" those who are unconscious or incapacitated. First responders should check for this jewelry prior to administering drugs or intubating or defibrillating a victim.

Question 6

Which of the following situations is LEAST likely to warrant a call to 9-1-1 (the Emergency Medical Services) by the Group Fitness Instructor? When a victim:

Accepted Answer

Although a broken bone may warrant a trip to the emergency room, it typically does not require activation of the EMS system. When a victim is seriously ill or injured, the Group Fitness Instructor should be prepared to call 9-1-1. Some of these conditions include: chest pain, signs of stroke, severe burn, seizures, electrical shock, poisoning, assault with injury, and trouble breathing.

Question 7

Which of the following is unlikely to be a MAJOR problem with calling in an emergency from a cell phone instead of a land line?

Accepted Answer

Most cell phone coverage includes 9-1-1 services, but there are other major problems with using a cell phone to activate the EMS. Land lines are stable, unlikely to drop calls, and they are tied into the grid, preventing the need for emergency responders to triangulate signals to locate callers. The advent of the cell phone overall has been a blessing for quick activation of the EMS; however, if a land line is readily available, it should be used.

Question 8

Under normal circumstances, brain death will occur in the absence of oxygen in:

Accepted Answer

On average, it takes the Emergency Medical Services (EMS) 7-10 minutes to arrive at the scene which is particularly problematic as brain death will occur in 4-6 minutes in the absence of oxygen. Under unusual circumstances, such as with immersion in cold water, brain damage can be delayed because of the retardation of cellular processes.

Question 9

An asthmatic attack is horrible to view and worse to experience. Which of the following should NOT be done in helping a class member to manage an asthmatic attack?

Accepted Answer

One of the little known steps in managing an asthmatic attack is to have the victim drink a warm liquid, slowly. It is important for a class member to immediately cease activity upon first experiencing symptoms, use emergency inhaler, drink warm fluids and pursue further assistance if the person's coloring is off (blue cast to lips or fingernails) or if breathing remains shallow or air-hungry.

Question 10

During your 5:45 T'ai Chi class, a woman in the third row back (next to the guy in the full-body spandex) succumbs to an episode of syncope. What happened?

Accepted Answer

Syncope is the medical term for a transient loss of consciousness; in other words, syncope is the medical term for fainting. Some of the most common causes for fainting are: orthostatic hypotension (a sudden drop in blood pressure that happens when standing-up), dehydration, overheating and exhaustion. Low blood pressure to the brain, either from positional change or dehydration, creates a "stop" signal, resulting in the brain responding the best way it knows how: laying you out!

Question 11

You enter the locker-room and find a woman having a grand-mal seizure. You clear the area to prevent head trauma, place a soft item under her head, place her in the recovery position, place a non-breakable item in her mouth to prevent her from swallowing her tongue, and have someone activate the EMS. Which of the above was a WRONG choice?

Accepted Answer

It is no longer recommended that victims of grand-mal (clonic) seizures are restrained or that responders place any items in the mouth. After the seizure is over, the individual should be assessed for compromised breathing or trauma and the EMS activated if either is problematic. The responder should be aware of how draining a grand-mal seizure can be; both confusion and fatigue may quickly descend, complicating the situation.

Question 12

During your mini-marathon indoor cycling class, a participant gets into the groove, jumps up high in the saddle, and comes down off-kilter, falling off the bike in the process. He suffers a jagged tear of the skin of his nether regions caused by both shear and tensile forces of contact with the bike on the way down. This tear is BEST described as:

Accepted Answer

A jagged tear of the skin caused by both shear and tensile forces is best described as a laceration. An incision, in contrast, is a clean cut caused from a tensile force alone, typically a sharp edge. A puncture is a penetration of the skin by an object and an abrasion is more of a surface injury, a "scraping" of the tissue. Irrespective of the type of skin injury, the area should be cleaned with water and a dry dressing applied. Pressure should be applied if the dressing is becoming saturated with blood.

Question 13

Departing the club after teaching a particularly stellar Weight Training class, you notice a woman lying at the bottom of the stairs, moaning and clutching her ankle. As the first responder on the scene, you assess the situation and note the following signs and symptoms in the victim's ankle: significant swelling, bruising, an inability to weight bear, and a difference in angle and positioning from the other side. Which of the following is MOST likely to be the cause?

Accepted Answer

Fractures are serious events, both because of the damage to the bone itself and because of the cascade of events that occur as the body responds to the injury. One of the key signs of fracture is a deformity or angulation, especially notable when comparing from side to side. Severe ligamentous tears (not offered as an option in the answers) can cause similar symptoms to a fracture, including: swelling, bruising, an inability to bear weight, an audible noise at the time of injury, severe pain, severe weakness and loss of function. Massive ligamentous tears can even cause joint deformity. Thus, it is essential that the victim seeks medical care to determine the nature of the underlying injury.

Question 14

You are teaching your health club's beloved outdoor Mixed Martial Arts class. A woman in the back row trips and falls -- directly into the path of an oncoming gaggle of cyclists. As you approach, the first thing you notice is a protruding bone in her wrist. You: Keep her still, cut away her shirt sleeve at the wrist, gently place the protruding bone back into place, cover the open area with a clean t-shirt from your duffel bag, and immobilize the limb. Which of these steps was problematic?

Accepted Answer

When a Group Fitness Instructor suspects a fracture, and there is no qualified medical provider nearby, the bone should be immobilized (splinted if possible); it should certainly never be pushed back into place. Moving a fractured bone can increase the risk of infection. The ragged ends of a fractured bone can sever soft tissue (muscle, ligament) or worse (blood vessels or nerves). All of the other steps (removing the dirty sleeve, covering the open area, keeping the victim calm) would have also been appropriate.

Question 15

Few injuries are as eye-popping for the athlete as a "stinger" or "burner." A stinger is a term used to describe:

Accepted Answer

A stinger, a term used relentlessly in commentator booths across the globe, is a term that describes the "stinging" or sharp, burning pain that descends down the arm after sustaining a head or shoulder injury. Stingers are transient, typically lasting 5-15 minutes, and may be accompanied by a short-term loss in function of the arm. Both the sensation and the loss in function can be explained by a temporary injury to the nerve as it passes through the neck and into the brachial plexus in the axilla (armpit).

Question 16

Kyphosis, an exaggerated posterior rounding of the thoracic spine, is a condition common to all the following populations EXCEPT:

Accepted Answer

Kyphosis is not a condition often seen in the world of ballet. It is a condition common to the elderly, especially individuals with osteoporosis or compression fractures, but it is not exclusive to the old. Many youthful, fit athletes (such as swimmers and weight lifters) experience an exaggerated curve in the mid-spine from overdevelopment of the pectoral muscles without concomitant training of the posterior spinal muscles.

Question 17

Over 80% of the adult population will experience back pain at some phase of life. One of the most distressing sources of pain, disk herniation, can create a shooting or burning sensation and/or paresthesias (abnormal sensations, such as tingling) in the buttock, upper and lower leg. Which levels of the spine are the MOST susceptible to herniation?

Accepted Answer

Most disk herniations occur between the two lowest lumbar vertebra (L4 and L5) and between the lumbar-sacral junction (L5 and S1).Not all disk herniations are symptomatic, but the most severe cases can cause weakness in the legs - often experienced as tripping or foot drop -- and a sudden onset of incontinence of bowel or bladder. These later symptoms should be reported to a physician immediately as they may represent central cord compression and create permanent nerve damage.

Question 18

The skillful Group Fitness Instructor will incorporate proper body mechanics into the class setting both through example and through verbal instruction. Which of the following would be an IMPROPER instruction regarding lifting techniques?

Accepted Answer

Breath holding (or inhaling) while lifting can cause a dangerous spike in blood pressure. Instead, cue participants to exhale as they lift their body weight or as they lift a dumbbell or barbell against gravity. Another helpful tip when providing education about lifting is the following: When possible, push instead of pull. Pulling heavy items places the back in a rounded posture where the small muscles of the back are placed in a vulnerable position.

Question 19

One of the greatest considerations when managing an emergency situation is to assess the victim for shock. Shock occurs when the body's natural circulation patterns are disturbed - and the results can be catastrophic. Which of the following are the 4 major types of shock?

Accepted Answer

The 4 major types of shock are: Hypovolemic, obstructive, distributive and cardiogenic. Shock, also known as hypo (low) perfusion, results when the body's natural hemodynamic flow is disturbed. Hypovolemic shock occurs when there isn't enough volume, either due to the victim bleeding out, suffering from severe dehydration or hemorrhaging internally. Obstructive shock occurs when an occlusion, such as a blood clot, prevents natural perfusion of an area. Distributive shock is caused by overly dilated vessels failing to "distribute" their load properly and cardiogenic shock -- often seen after myocardial infarction -- occurs when the heart muscle is not pumping efficiently.

Question 20

Which of the following diseases is NOT communicable through blood or other bodily fluids?

Accepted Answer

Tuberculosis is not transmitted through contact with blood or other bodily fluids. Instead, tuberculosis (TB) spread through the air when people who have an active TB infection cough, sneeze, or otherwise generate water droplets. Although it is hard to spread in well-ventilated spaces, TB is making a comeback in North America, due in part to the influx of immigrants from other countries.

Quiz 6: Emergencies