ACSM Certified Exercise Physiologist Practice Questions
Prepare for ACSM-EP with more than an answer.
- Level
- Professional
- Valid for
- 3 years
Domains covered on the exam 4
- Health and Fitness Assessment33%
- Exercise Prescription and Implementation40%
- Exercise Counseling and Behavior Modification20%
- Risk Management and Professional Responsibilities7%
- 1
During a clinical maximal graded exercise test, the Exercise Physiologist continuously monitors the client's hemodynamic and symptomatic responses. Which of the following are considered ABSOLUTE indications for immediately terminating the exercise test? (Select TWO)
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Correct answer: A, B
A drop in systolic blood pressure greater than 10 mm Hg from baseline despite an increase in workload—when accompanied by other indicators of myocardial ischemia such as angina or ST-segment depression—represents an absolute indication for immediate exercise test termination. This response suggests the myocardium cannot sustain increased oxygen demand, and continued exertion risks myocardial injury. Such findings require physician interpretation and potential cardiac intervention prior to exercise resumption.
Moderate-to-severe angina is an absolute indication for immediate test termination because it represents significant myocardial ischemia and indicates that myocardial oxygen demand exceeds oxygen supply. Continuing exercise when a client experiences angina substantially elevates the risk of acute coronary events or myocardial infarction, making immediate cessation a critical safety protocol in all exercise testing and training scenarios.
- 2
Scenario: A 32-year-old software engineer presents for a comprehensive fitness assessment. He reports experiencing chronic neck stiffness and occasional tension headaches. During the static postural evaluation, the Exercise Physiologist observes a pronounced forward head posture, internally rotated (rounded) shoulders, and excessive thoracic kyphosis.
The physiologist determines that the client is exhibiting classic signs of Upper Crossed Syndrome, a common postural distortion pattern in individuals who spend long hours working at a computer.
Based on this specific postural presentation and biomechanical principles, which of the following muscle groups are most likely shortened/tight and require targeted flexibility training?
graph TD A[Upper Crossed Syndrome] --> B[Tight/Shortened Muscles] A --> C[Weak/Lengthened Muscles] B --> D[Pectoralis Major & Minor] B --> E[Upper Trapezius & Levator Scapulae] C --> F[Deep Cervical Flexors] C --> G[Lower Trapezius & Rhomboids]Show answer details
Correct answer: B
In Upper Crossed Syndrome, a cross pattern exists where muscles on the anterior chest (pectoralis major/minor) and posterior upper neck/shoulders (upper trapezius, levator scapulae) become tight and shortened. Conversely, the deep cervical flexors (anterior neck) and the middle/lower trapezius and rhomboids (mid-back) become lengthened and weak. The tight muscles require stretching/flexibility training, while the weak muscles require strengthening.
- 3
Which of the following client statements or behaviors is a definitive criterion for immediately terminating a submaximal cardiorespiratory fitness test?
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Correct answer: D
An absolute indication to immediately terminate any exercise test is a subject request to stop, regardless of current physiological readings or test stage. The client's safety and autonomy supersede test protocol demands. In contrast, an RPE of 14 represents only a 'somewhat hard' intensity typical of submaximal testing. A heart rate at 75% of age-predicted maximum is below the target 85% threshold for most submax tests, and sweating is normal thermoregulation.
- 4
A 45-year-old male client presents for a fitness assessment. He currently walks 30 minutes a day, 3 days a week, and has done so consistently for the past year. He has medically controlled type 2 diabetes but is entirely asymptomatic. He states that his primary goal is to start a vigorous-intensity running program to prepare for a 10K race. According to the ACSM preparticipation screening algorithm, what is the recommended action for this client?
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Correct answer: D
According to the ACSM preparticipation screening algorithm, individuals with a known metabolic disease such as Type 2 diabetes require medical clearance before initiating vigorous-intensity exercise, even if they are asymptomatic and already active at moderate intensity. The increased cardiovascular demands of vigorous exercise warrant physician evaluation to ensure the prescription is safe given the client's metabolic condition and medication profile.
- 5
During a resting blood pressure assessment, an Exercise Physiologist inflates the sphygmomanometer cuff to 160 mm Hg and then deflates the cuff at a rapid rate of approximately 10 mm Hg per second. How will this rapid deflation rate most likely affect the accuracy of the blood pressure reading?
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Correct answer: C
Deflating the blood pressure cuff too rapidly (standard is 2-3 mm Hg per second) typically causes the clinician to miss the first true Korotkoff sound (Phase I), resulting in a falsely low systolic reading. Conversely, the rapid drop causes the clinician to hear the cessation of sound (Phase V) prematurely or late depending on reaction time, but typically it results in missing the exact point of cessation, often falsely elevating the diastolic reading.
- 6
A 50-year-old female client (Weight: 70 kg) is performing the YMCA cycle ergometer submaximal test to estimate her cardiorespiratory fitness.
During Stage 2 (Work rate: 450 kg·m·min-1), her steady-state heart rate is 115 bpm. During Stage 3 (Work rate: 600 kg·m·min-1), her steady-state heart rate reaches 135 bpm. Her age-predicted maximal heart rate is 170 bpm.
Based on the physiological principles of submaximal testing and the heart rate responses collected so far, which of the following is the MOST appropriate next step for the Exercise Physiologist?
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Correct answer: C
The goal of the YMCA cycle test is to obtain two steady-state heart rates between 110 bpm and 85% of age-predicted HRmax to extrapolate to VO2max. Her 85% HRmax is 144.5 bpm (170 * 0.85). Both 115 bpm and 135 bpm fall perfectly within this required linear range (110 to 144.5). Therefore, the test is complete and can be moved to recovery.
flowchart TD A[Start YMCA Cycle Test] --> B[Obtain HR at Stage End] B --> C{Is HR > 110 bpm?} C -->|Yes| D{Is HR > 85% HRmax?} C -->|No| E[Continue to Next Stage] E --> B D -->|Yes| F[Terminate Test & Recover] D -->|No| G{Do we have two HRs in target zone?} G -->|Yes| F G -->|No| E
