ACSM-CEP Practice Questions
Prepare for ACSM-CEP with more than an answer.
- Passing score
- 550 (scaled score) (scale 200-800)
- Level
- Advanced Clinical
- Valid for
- 3 years
Domains covered on the exam 6
- Patient Assessment18%
- Exercise Testing18%
- Exercise Prescription22%
- Exercise Training and Leadership24%
- Education and Behavior Change13%
- Legal and Professional Responsibilities5%
- 1
When selecting a symptom-limited maximal exercise test protocol for a highly deconditioned patient with severe left ventricular dysfunction, why is the Naughton protocol preferred over the standard Bruce protocol?
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Correct answer: B
The standard Bruce protocol increases workload by roughly 3 METs per stage, which can be too aggressive for highly deconditioned or heart failure patients, causing premature termination due to localized leg fatigue. The Naughton protocol increases by approximately 1 MET per 2-minute stage, allowing for better physiological adaptation and more accurate determination of ischemic thresholds or peak VO2.
- 2
During a 6-minute walk test (6MWT) with a patient suffering from pulmonary arterial hypertension, which TWO of the following signs or symptoms should prompt the clinician to immediately terminate the test? (Select TWO)
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Correct answer: A, D
Severe angina-like chest pain and signs of poor perfusion (diaphoresis, pallor) are absolute indications to terminate any exercise test, including a 6MWT. Mild dyspnea or an RPE of 15 are expected responses. SpO2 dropping to 89% may require slowing down or supplemental O2 depending on protocol, but typically absolute termination is reserved for SpO2 < 80% or accompanied by severe symptoms.
flowchart TD A["During 6MWT"] --> B{"Observe for Signs"} B -->|"Severe Chest Pain"| C["Absolute STOP"] B -->|"Pallor, Diaphoresis"| C B -->|"Mild Dyspnea"| D["Continue"] B -->|"SpO2 89%"| E["Monitor Closely"] C --> F["Terminate Test Assess Vitals Notify Provider"] E --> G["Reassess Symptoms"]Severe angina-like chest pain and signs of poor perfusion (diaphoresis, pallor) are absolute indications to terminate any exercise test, including a 6MWT. Mild dyspnea or an RPE of 15 are expected responses. SpO2 dropping to 89% may require slowing down or supplemental O2 depending on protocol, but typically absolute termination is reserved for SpO2 < 80% or accompanied by severe symptoms.
- 3
A 58-year-old male completes a Bruce protocol stress test. He exercises for 8 minutes. The ECG shows a maximum ST-segment deviation of 2 mm. He experiences non-limiting angina during the test (Angina index = 1).
Using the Duke Treadmill Score (DTS) formula:
DTS = Exercise Time (min) - (5 × ST deviation in mm) - (4 × Angina Index)What is his calculated score, and what risk category does this place him in?
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Correct answer: D
- 4
During the intake process for a Phase II cardiac rehabilitation program, a patient presents with a medication list that includes Metoprolol, Lisinopril, and Atorvastatin. When obtaining resting biometric data, the Clinical Exercise Physiologist notes a resting heart rate of 52 bpm and a blood pressure of 108/68 mmHg. Which of the following is the most appropriate clinical reasoning for these findings?
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Correct answer: B
Metoprolol is a beta-blocker that decreases resting and exercise heart rate and blood pressure. Lisinopril is an ACE inhibitor that lowers blood pressure. A resting HR of 52 bpm and BP of 108/68 mmHg are expected, well-controlled therapeutic responses in a cardiac patient on this regimen, not a medical emergency.
- 5
A 68-year-old female with a history of chronic obstructive pulmonary disease (COPD) and osteoarthritis is referred to an exercise program. During the initial interview, the clinician utilizes open-ended inquiry. Which of the following questions best exemplifies this technique to assess her physical activity readiness?
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Correct answer: C
Open-ended questions require more than a 'yes' or 'no' response and encourage the patient to share their narrative, providing deeper insight into their perceived barriers and readiness. The other options are closed-ended questions.
- 6
When reviewing a patient's medical record prior to an exercise test, which TWO of the following findings represent absolute contraindications to symptom-limited maximal exercise testing according to current guidelines? (Select TWO)
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Correct answer: B, C
An acute MI within 2 days is an absolute contraindication. Ongoing unstable angina is also an absolute contraindication. Left main coronary stenosis and tachyarrhythmias with uncontrolled rates are considered relative contraindications.
An acute MI within 2 days is an absolute contraindication. Ongoing unstable angina is also an absolute contraindication. Left main coronary stenosis and tachyarrhythmias with uncontrolled rates are considered relative contraindications.
