ACSM – CEP EXAM QUESTIONS AND ANSWERS
What is used as a preparticipation health screening tool by a professional for the general (non-clinical) population? - Answer- The ACSM algorithm Sedentary Known CV, metabolic, or renal disease No signs or sx Is medical clearance recommended?At what intensity? - Answer- Medical clearance is recommended Light-moderate, progress as tolerated Sedentary No known CV, metabolic, or renal disease No signs or sx Is medical clearance recommended?At what intensity? - Answer- Medical clearance is not necessary Light to moderate, progress to vig Sedentary Known CV, metabolic, or renal disease Has sign or sx Is medical clearance recommended?At what intensity? - Answer- Medical clearance is recommended Light-moderate, progress as tolerated Active No known CV, metabolic, or renal disease No signs or sx Is medical clearance recommended?At what intensity? - Answer- Medical clearance is not necessary Light to vigorous Active Known CV, metabolic, or renal disease No signs or sx Is medical clearance recommended?At what intensity? - Answer- Medical clearance is not necessary for light to moderate, but necessary before vigorous Active Known CV, metabolic, or renal disease Has sign or sx Is medical clearance recommended?At what intensity? - Answer- Discontinue exercise and seek clearance before continuation 1 / 4
Definition for active vs sedentary - Answer- Exercised for at least 30 min/day, 3 days/wk for last 3 months Light intensity VO2R and HRR - Answer- 30-39% HRR or VO2R Light intensity METs - Answer- 2-2.9 METs Light intensity RPE - Answer- RPE 9-11 Moderate intensity HRR or VO2R - Answer- 40-59% HRR or VO2R Moderate intensity METs - Answer- 3-5.9 METs Moderate intensity RPE - Answer- RPE 12-13 Vigorous intensity VO2R or HRR - Answer- ≥ 60% HRR or VO2R Vigorous intensity METs - Answer- ≥ 6 METs Vigorous intensity RPE - Answer- RPE ≥ 14 CV disease - Answer- cardiac, peripherovascular, or cerebrovascular disease
Metabolic disease - Answer- Any 3 out of 5 of the following:
-increased waist circumference (M ≥ 40in, W ≥ 35in) -increased triglycerides ≥ 150 mg/dL -decreased HDL (M < 40mg/dL, W < 50) -increased BP (SBP ≥ 130 or DBP ≥ 85) -increased fasting glucose ≥ 100mg/dL Signs and symptoms suggestive of CV, renal, and metabolic disease - Answer- -pain/discomfort in neck, chest, jaw, arms -SOB at rest or w/mild exertion -dizziness or syncope -orthopnea or paroxysmal nocturnal dyspnea -ankle edema -palpitations or tachycardia -intermittent claudication -known heart murmur -unusual fatigue or SOB w/usual activities What is used as a preparticipation health screen in absence of a professionals help? - Answer- The 2014 PAR-Q+ 2 / 4
What is used as a pre-participation screening tool by a professional for cardiac rehab and other medical fitness facilities? - Answer- AACVPR risk stratification AACVRP lowest risk components during exercise test and recovery - Answer- -no complex ventricular dysrhythmias -no angina or other sig sx -normal hemodynamics -functional capacity ≥ 7 METs
PT case:
Normal ECG and asymptomatic resting HR 60 resting BP 130/60 peak HR 90 peak BP 150/65 fxnal capacity = 8 METs what risk category according to AACVRP? - Answer- Lowest AACVRP lowest risk components at rest - Answer- -no complex ventricular dysrhythmias -resting EF ≥ 50% -uncomplicated MI or revascularization -no CHF -no signs or sx of post-event/procedure ischemia -no clinical depression *must have all of these* lowest risk EF - Answer- ≥ 50%
Pt case:
Resting EF = 50% normal ECG fxnal capacity 7 METs what risk category according to AACVRP? - Answer- lowest
Pt case:
Normal ECG resting HR 60 resting BP 130/60 peak HR 90 peak BP 150/65 fxnal capacity = 8 METs *angina reported at peak what risk category according to AACVRP? - Answer- Moderate *sx at ≥ 7 METs only 3 / 4
AACVPR moderate risk components during exercise test and recovery - Answer- - angina or other sx only when ≥ 7 METs -mild-moderate silent ischemia (ST↓ < 2 mm) -functional capacity < 5 METs angina or sig sx (unusual SOB, dizziness, or light-headedness) at what WL qualifies a clinical pt for moderate risk? high risk? - Answer- only occurring at high levels of exertion (≥ 7 METs) occurring at low levels or exertion or during recovery (<5 METs) What are considered significant symptoms by the AACVRP standards? - Answer- - angina -unusual SOB -dizziness -light-headedness What amount of silent ischemia qualifies a clinical pt for moderate risk? high risk? - Answer- mild-moderate silent ischemia (ST↓ < 2 mm) high levels of silent ischemia (ST↓ ≥ 2 mm) What functional capacity qualifies a clinical pt for moderate risk? - Answer- < 5 METs
Pt case:
1.5 mm of ST depression functional capacity is 4 METs no symptoms what risk category according to AACVRP? - Answer- moderate AACVPR moderate risk EF - Answer- EF 40-49% AACVPR high risk components during exercise test and recovery - Answer- -complex ventricular dysrhythmias -angina or other sig sx at < 5 METs -abnormal hemodynamics (ie flat or ↓ SBP w/↑ WL or severe post-exe hypotension) -high levels of silent ischemia (ST↓ ≥ 2 mm) Pt has a complex ventricular dysrhythmia during an exercise test. what risk category? - Answer- high pt's SBP does not respond to increased WLs, what risk category? - Answer- high pt's SBP decreased with increased WLs, what risk category? - Answer- high pt's BP drops severely post-exercise. What risk category would that place them? - Answer- high
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