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CEP Exam Questions With Complete Solutions A 35 year-old female client asks the exercise physiologist to estimate her energy expend-ture. She weighs 110 lb and pedals the cycle ergometer at 50 rpm with a resistance of 2.5 kp for 60 min. The physiologist should report which of the following caloric values? Correct Answers 510 cal (see ACSM booklet page 163 for steps) a 47-year-old female with no prior history of regular exercise recently completed a 12-wk exercise training program. Her routine consisted of walking and/or bike riding three times per week at approximately 6-7 METS for 30 min. Originally, Jane found that going up the stairs was rather difficult, often leaving her short of breath. Jane is now able to walk up multiple flights of stairs with ease. Her increase in exercise volume (went from being inactive to performing 540-630 MET • min-. wk*') and aerobic capacity (increased peak oxyten uptake by 15%) over 12 weeks is an example of what type of relationship? Correct Answers Dose-response relationship A 55-year-old cardiac rehabilitation patient returned from vacation with the following complaints: elevation in BP, slight chest pain, shortness of breath with chest wheez-ing, and dryness and burning of the mouth and throat. Based on this information, the exercise physiologist would suspect that the patient was exposed to which of the following environments? Correct Answers Extreme cold A cardiac patient is taking a beta blocker medication. During an exercise test, you would expect Correct Answers An increase
in the anginal threshold compared with a test without the medication A patient weighing 200 lb sets the treadmill at 4.0 mph with a 5% grade. At peak exercise, his BP is 150/90 mm Hg, HR is 150 bpm, and respiratory quotient is 1.0. What is his estimated absolute energy expenditure? Correct Answers 2.17 L/min (see ACSM booklet page 159 for steps) A reversible or transient perfusion defect on a myocardial perfusion imaging test is diagnostic for which of the following? Correct Answers Exertional myocardial ischemia A supraventricular ectopic rhythm that results from a focus of automaticity located in the bundle of His is an example of Correct Answers Junctional arrhythmia According to ACSM's Guidelines for Exercise Testing and Prescription, 11th ed., moderate intensity exercise is defined as Correct Answers 40%-59% HRR or VOR, 3-<6 METS, RPE 12-13, an intensity that causes noticeable increases in HR and breathing According to the Theory of Reasoned Action, _________ to perform a behavior is the central determinant of whether or not an individual engages in that behavior. Correct Answers Intention All of the following statements regarding the clinical exercise physiologist administering clinical exercise tests are true except Correct Answers The clinical exercise
When performing an exercise test on individuals with predialysis CKD, standard procedures can be followed Assume that in another situation as described above the individual begins to complain of dizziness and shortness of breath. What should the CEP do under those circumstances? Correct Answers Stop the training session immediately and get the individual evaluated by a healthcare professional as soon as possible At a set workload (e.g., 4 METs), myocardial oxygen consumption of a patient with coronary artery disease is reduced following endurance training as evidenced by a decrease in Correct Answers HR Bilateral ankle edema that is most evident at night is a characteristic sign of Correct Answers Congestive heart failure Both the American College of Sports Medicine (ACSM)/American Heart Association (AHA) Primary Physical Activity Recommendation and the Primary Physical Activity Recommendations from the 2018 Physical Activity Guidelines Committee Report suggest that healthy adults should participate in which of the following exercise prescriptions for aerobic activity? Correct Answers 30 min per day, five times a week or 150 min per week of moderate intensity exercise Cardiac impulses originating in the sinoatrial node and then spreading to both atria, causing atrial depolarization, are represented on the electrocardiogram (ECG) as a Correct Answers P wave
Compared with data obtained during a previous graded exercise test when no medications were taken, a patient now taking propranolol (Inderal) would have which of the following response to the same submaximal exercise intensity during a second test? Correct Answers Lower HR Data obtained from a clinical exercise test can be useful for all of the following except Correct Answers Determining a return to work date prior to a patient undergoing CABG surgery During a medical emergency, which of the following medications is an endogenous catecholamine that can be used to increase blood flow to the heart and brain? Correct Answers Epinephrine During a training session with an apparently healthy individual, the CEP noticed that the individual's heart rate began to fluctuate dramatically. Which of the following would be an appropriate response Correct Answers Check to make sure that the device is working properly and if so then advise the individual to get medical clearance before continuing any more exercise sessions During which times should the most caution be taken when beginning an exercise program with an individual with diabetes? Correct Answers Early morning and late evening Exercise has been shown to reduce mortality in people with coronary artery disease. Which of the following mechanisms is
From the options given which of the following tests can evaluate the endurance of the upper body muscles Correct Answers Push-up test Greater oxygen delivery is provided to the myocardium in all of the following situations except Correct Answers Severe coronary artery disease Healthy, untrained individuals have an anaerobic threshold at approximately whatpercentage of their maximal volume of oxygen consumed per unit of time (VOzmax)? Correct Answers 55% If a healthy young man who weighs 80 kg exercises at an intensity of 45 ml • kg-' min' for 30 min, five times per week, how long (assuming an isocaloric diet) would it take him to lose 10 lb? Correct Answers 13 weeks (see ACSM booklet for how to do this math problem) If an individual is in the action stage of the "stages of motivational readiness," he or she Correct Answers Has been physically active on a regular basis for <6 months In an ECG recording, the presence of certain combinations of ST-segment abnormalities (i.e., elevation and/or depression) and significant Q waves may be suggestive of what condition? Correct Answers Acute MI In patients with a new implantable cardio-verter defibrillator CD), mild upper body extremity range of motion (ROM)
activities can be initiated how soon after device implantation? Correct Answers After the first 24 hours In the "readiness to change model." which stage is it recommended to use multiple resources to stress the importance of a desired change? Correct Answers Precontemplation In the stages of change model, the ___________ stage includes individuals who are inactive but are thinking about becoming active Correct Answers Contemplation Individuals with diabetes should follow exercise guidelines to avoid unnecessary risks. The following list of recommenda- tions should include all of the following except Correct Answers Exercising only when temperature and humidity are moderate Jane is thinking about joining a local running group. The group meets twice per week and one of the times conflicts with another leisure-time activity she enjoys. To figure out whether she will join the running group, Jane writes down all of the positive and negative factors associated with making this new change in her life. In doing so, Jane is engaging in: Correct Answers A decisional balance Long-term conditioning results in adaptations of the cardiovascular system. When measured at the same submaximal exercise intensity, these adaptations result in a decrease in Correct Answers HR
are recommended way to build rapport? Correct Answers Ask opened ended questions, convey interest and empathy Select the option that is not included in the Health Belief Model: Correct Answers Pereived loss Self-efficacy can be improved by observing others perform the activity. This is known as: Correct Answers Vicarious experience or modeling Social Ecology Theory (sometimes known as the ecological perspective) emphasizes multiple influences on behavior. These include: Correct Answers Intrapersonal factors, interpersonal factors, environmental factors Sounds heard during measurement of BP are produced by Correct Answers Turbulent blood flow ST-segment elevation may occur in all of the following except Correct Answers Subendocardial ischemia Studies show the least physically active populations to include all of the following except Correct Answers Upper middle class The best measurement or (METs) is obtained by which of the following? Correct Answers Using open-circuit indirect spirometry to determine maximal oxygen uptake (VO2) The cardiac rehabilitation's medical director orders a pre- rehabilitation ECG on a 50-year-old man. The exercise
physiologist performing the ECG notes the machine error message reads artifact in the precor-dial lead V4. To correct the artifact, an exercise physiologist would check which of the following lead positions for adhesive contact? Correct Answers Midclavicular line, fifth intercostal space The exercise physiologist is orienting a 60-year-old patient entering cardiac rehabilitation after having CABG 3 wk ago. All of the following statements are correct except Correct Answers The patient should avoid upper body resistance training because of sternal and leg wounds for 4-6 months. The primary effects of chronic exercise training on blood lipids include Correct Answers Decreased TG and increased HDL The process by which one maintains long-term behavior change by anticipating potentially high-risk situations and devising strategies to cope with these situations is called Correct Answers Relapse prevention The progressive ascent to higher altitudes will result in which two acute physiological responses? Correct Answers Decreased arterial oxygen levels and increased cardiac output The progressive overload principle is defined as Correct Answers Performing more sets per muscle group and increasing the number of days per week muscle groups are trained What does flow-resistive training (a type
When implementing a physical activity program, it is important to focus on individuals initial feelings of self-efficacy and to help to increase their outcome expectations through shaping early successes. Which of the following will not help with this? Correct Answers Having physical activity goals be the same for each participant When prescribing exercise for patients with atherosclerosis, which of the following is true? Correct Answers Patients with peripheral arterial disease should exercise to leg pain level 3 (on 4 point scale), with intermittent rest periods When setting goals, it is recommended that the goal should be specific. Which of the following is an example of a specific goal? Correct Answers I would like to lose 15 lbs When working with an individual with a cerebrovascular accident (stroke), which of the following should be avoided Correct Answers The valsalva maneuver when performing resistance training Which behavioral change model is often used in cardiac rehabilitation and diabetes management programs because it suggests that individuals who perceive they are susceptible to serious disease are more likely to engage in behaviors to prevent the health problem from occurring? Correct Answers Health belief model Which exertional heat illness occurs when the body cannot sustain the level of needed to support skin blood flow for
thermoregulation and blood flow for metabolic requirements of exercise? Correct Answers Heat exhaustion Which method of determining exercise intensity is mostly recommended for individuals with autonomic neuropathy? Correct Answers RPE Which of the following are not included in relapse preparation plans: Correct Answers Exercise by yourself so you can set the time and location Which of the following cardiac indices increases curvilinearly with the work rate until it reaches near maximum at a level equivalent to approximately 50% of aerobic capacity, increasing only slightly thereafter? Correct Answers Stroke volume Which of the following cold-weather activities has been shown to increase HR up to 97% HRmax and systolic BP up to 200 mm Hg, resulting in a potentially dangerous increase in risk of morbidity and mortality for individuals with cardiovascular disease (CVD)? Correct Answers Shoveling snow Which of the following ECG interpretations involves a QRS complex duration that exceeds 0.11 s and a P wave precedes the QRS complex if it is present? Correct Answers Supraventricular aberrant conduction
vasoconstriction results in pulmonary hypertension? Correct Answers Bronchitis Which of the following is classified as a characteristic of sedentary behavior? Correct Answers Sedentary behavior is defined by both a posture (lying or sitting) and energy expenditure (<1.5 METS). Which of the following is correct related to emergency preparedness in facilities performing exercise testing. Correct Answers All personnel involved with exercise testing and supervision in a clinical exer- cise setting should be certified in basic CPR A skills and practice session with the AED is recommended every 3-6 months There should be a physician immedi- ately available at all times when maximal sign or symptom-limited exercise testing is performed on high-risk individuals. Which of the following is generally true of the hemodynamic exercise response in a patient who has received a cardiac transplant when compared to age-matched healthy individuals? Correct Answers HR returns to rest slower Which of the following is most likely to represent nonischemic or atypical chest pain? Correct Answers Pain in the left submammary or hemithorax area
Which of the following is not a characteristic of ventricular tachycardia? Correct Answers Flutter waves at a rate of 250- 350 atrial depolarizations per minute Which of the following is not associated with exercise-induced myocardial ischemia? Correct Answers Decreased RPP Which of the following is not included in motivational interviewing which is a patient-centered counseling technique: Correct Answers Confronting resistance to change Which of the following is not true for an individual who suffered a cerebral vascular accident and wishes to return to work? Correct Answers They should not be encouraged to return to work Which of the following is the minimum that will improve muscular strength, particularly among novice participants? Correct Answers One set 8-12 repetitions of a resistance training exercise Which of the following is the proper emergency response for a patient who has experienced a cardiac arrest but now is breathing and has a palpable pulse? Correct Answers Place the patient in the recovery position with the head to the side to prevent airway obstruction Which of the following is the thickest, middle layer of the artery wall that is composed predominantly of smooth muscle cells and
Which of the following statements are false concerning stroke volume in healthy adults? Correct Answers Stroke volume is equal to the ratio of end-diastolic volume to end-systolic volume Which of the following statements best describes the exercise precautions for patients with an automatic implantable cardioverter defibrillator (AICD)? Correct Answers Persons with AICD must be monitored closely during exercise, keeping the heart rate (HR) 10 beats or more below the activation rate for a shock. Which of the following statements concerning the surgical treatment of coronary artery disease is true? Correct Answers A coronary artery stent carries a lower rate of revascularization than does PTCA. Which of the following statements is (are) true in relation to emergency risk management Correct Answers Facilities offering exercise services must have written emergency response system policies and procedures that are reviewed and rehearsed regularly and include documentation of these activities Exercise facilities in the health/fitness or community setting must have as part of their written emergency response system a public access defibrillation program Exercise facilities must have in place a written system for sharing information with users and employees or independent contractors regarding the handling of potentially hazardous
materials including the handling of bodily fluids by the facility's staff in accordance with the standards of OSHA. Which of the following statements regarding an emergency plan is true? Correct Answers All emergency situations must be documented with dates, times, actions, people involved, and outcomes. Which of the following statements regarding BP and resistance exercise (weightlifting) is correct? Correct Answers BP elevations are highest during isometric muscular actions Which of the following statements regarding contraindications to graded exercise testing is accurate? Correct Answers - Some individuals have risk factors that outweigh the potential benefits from exercise testing and the information that may be obtained
- Absolute contraindications refer to individuals for who exercise testing should not be performed until the situation or condition has stabilized
- Relative contraindications include patients who might be tested if the potential benefit from exercise testing outweighs the relative risk Which of the following techniques can be used to diagnose coronary artery disease and assess heart wall motion abnormalities, ejection fraction, and cardiac output? Correct Answers Echocardiography Which of the following tests would give the best confirmation of diabetes? Correct Answers Glycolated hemoglobin (HbA1C)
