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A comprehensive set of practice questions and answers for the acsm certified exercise physiologist (cep) examination. It covers various topics related to exercise physiology, including contraindications to exercise testing, exercise test monitoring, special considerations for different populations, and more. Designed to help individuals prepare for the cep exam by providing a realistic assessment of their knowledge and understanding of key concepts.
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Absolute Contraindications to Exercise Testing - Correct Answer • A recent significant change in the resting ECG suggesting significant ischemia, recent MI (within 2 d), or other acute cardiac event
Relative Contraindications to Exercise Testing - Correct Answer • Left main coronary stenosis
General Indications for Stopping an Exercise Test - Correct Answer • Onset of angina or angina-like symptoms
Absolute Indications for stopping an exercise test - Correct Answer • Drop in SBP ≥10 mmHg with an increase in work rate, or if SBP decreases below the value obtained in the same position prior to testing when accompanied by other evidence of ischemia
Relative Indications for stopping an exercise test - Correct Answer • Drop in SBP ≥10 mmHg with an increase in work rate, or if SBP below the value obtained in the same position prior to testing
ST segment depression - Correct Answer ≥1 mm of horizontal or down sloping ST↓ 60-80 ms beyond the J point suggesting myocardial ischemia
Chronotropic incompetence - Correct Answer 1. Peak exercise HR about 20 BPM below the age predicted HRmax or an inability to achieve > 85% of the age predicted HRmax for subjects limited by volitional fatigue.
Heart Rate Recovery - Correct Answer less than or equal to 12 BPM at 1 minute for walking, or less than or equal to 22 BPM at 2 mins for supine position
Sensitivity - Correct Answer % of pts. tested with known CVD who demonstrate significant ST segment changes. Exercise EKG sensitivity usually requires greater than or equal to 70% stenosis
True Positive - Correct Answer Horizontal or down sloping ST segment depression of ≥1.0 mm and correctly identifies a patient with CVD
False Negative - Correct Answer test shows no or non-diagnostic ECG changes and fails to identify patients with underlying CVD
Specificity - Correct Answer % of pts. without CVD who demonstrate non significant ST segment changes
True Negative - Correct Answer Correctly identifies an individual without CVD
Causes of False Negative Test Results - Correct Answer • Failure to reach an ischemic threshold
Predictive Value - Correct Answer A measure of how accurately a test result (positive or negative) correctly identifies the presence or absence of CVD in tested patients.
Absolute Contraindications to Resistance training - Correct Answer • Unstable CHD
Low Back Pain Special Considerations - Correct Answer 1. Promote spinal stabilization
Arthritis Special Considerations - Correct Answer 1. Avoid strenuous exercises during acute flare ups and periods of inflammation
Cancer Special Considerations - Correct Answer 1. Up to 90% of all cancer survivors will experience cancer related fatigue
Cerebral Palsy Special Considerations - Correct Answer 1. FITT principle is unclear
Diabetes Special Considerations - Correct Answer 1. Hypoglycemia- most serious problem
Dyslipidemia Special Considerations - Correct Answer Individuals taking lipid lowering meds that have the potential to cause muscle damage (statins and fibric acid) may experience soreness
Fibromyalgia Special Considerations - Correct Answer 1. Teach the correct form for exercises to reduce injury
HIV Special Considerations - Correct Answer 1. No contraindications for exercise
HTN Special Considerations - Correct Answer 1. Pts. with uncontrolled severe HTN (SBP ≥180 mmHg and/or DBP ≥110 mmHg) should add exercise training to their treatment plan only after first being evaluated by their physician
Intellectual Disability and Down Syndrome Special Considerations - Correct Answer 1. ID-Require more encouragement
Kidney Disease Special Considerations - Correct Answer 1. Progress to greater exercise volume over time
Hot Environment Considerations - Correct Answer 1. Hyperthermia- metabolic heat > heat loss
Exertional Heatstroke - Correct Answer Signs and symps: disorientation, dizziness, irrational behavior, apathy, headache, nausea, vomiting, hyperventialtion, wet skin Mental Status: disoriented, unresponsive Core temp elevation: >40° C
Exertional Heat Exhaustion - Correct Answer Signs and Symps: Low BP, elevated HR and respiratory rates, skin is wet and pale, headache, weakness, dizziness, decreased muscle coordination, chills, nausea, vomiting, diarrhea Mental Status: Agitated Core Temp Elevation:None to moderate (37°-40° C)
Heat Syncope - Correct Answer Signs/symps: HR and breathing rates are slow; skin is pale; patient may experience sensations of weakness, tunnel vision, vertigo, or nausea before syncope Mental Status: Brief fainting episode Core temp elevation: little to none
Exertional Heat Cramps - Correct Answer Signs/ symps: Begins as feeble, localized, wandering spasms that may progress to debilitating cramps Core temp elevation: Moderate (37°-40° C)
THR in the heat - Correct Answer Will be achieved at a lower workload
Heat Acclimatization - Correct Answer Improved heat transfer from the body's core to the external environment, improved CV function, more effective sweating, improved heat tolerance
WBGT Children <75.0 - Correct Answer All activities are allowed
WBGT Children 75- 78.6 - Correct Answer Longer rest periods in the shade; enforce drinking every 15 mins
WBGT Children 79-84 - Correct Answer Stop activity of unacclimitized individuals and those in high risk categories; limit activities of all other
WBGT Children >85.0 - Correct Answer Cancel all athletic activities
Frostbite - Correct Answer 1. Most common in exposed skin (nose, ears, cheeks)
High Altitude - Correct Answer o Ascent to higher altitudes reduces the partial pressure of oxygen in the inspired air, resulting in decreased arterial oxygen levels. Immediate compensatory responses include increased ventilation and cardiac output (usually through elevated HR)
o Acclimatization occurs at ≥1 week
Acute Mountain Sickness - Correct Answer Most common Symps: headache, nausea, fatigue, decreased appetite, poor sleep, poor balance Can progress to HACE
High Altitude Cerebral Edema - Correct Answer Exacerbation of unresolved AMS Occurs in <2% of individuals ascending >12,000 ft
High Altitude Pulmonary Edema - Correct Answer -Occurs in <10% of individuals ascending >12,000 ft -Individuals making repeated ascents and descents >12,000 ft and who exercise strenuously early in exposure have an increased susceptibility to HAPE -Blue lips and nail beds may be present
Social Cognitive Theory - Correct Answer Triadic reciprocation: The individual (emotion, personality, cognition, biology), behavior, and environment all interact to influence future behavior
Self Efficacy - Correct Answer One's belief in their capacity to successfully complete a course of action such as exercise
Task Self Efficacy - Correct Answer Belief in capability to physically complete the task; the measure must be specific to the task
Barriers Self Efficacy - Correct Answer Belief in the capability to exercise regularly in the face of common barriers
Outcome Expectations - Correct Answer Anticipatory results of a behavior; if specific outcomes are valued, then behavior change is more likely to occur
Transtheoretical Model - Correct Answer Developed as a framework for understanding behavior change. 5 stages: Precontemplation, contemplation, preparation, action, maintenance
Precontemplation to contemplation - Correct Answer Processes Focus: Consciousness raising, environmental reevaluation, dramatic relief Decisional Balance: Pros < Cons Self Efficacy: Low
Contemplation to Preparation - Correct Answer Processes Focus: Consciousness raising, environmental reevaluation, self reevaluation, dramatic relief Decision Balance: Pros>Cons Self Efficacy: increasing
Preparation to Action - Correct Answer Processes Focus: Self Liberation Decision balance: Pros>>Cons Self Efficacy: high
Action to Maintenance - Correct Answer Processes Focus: stimulus control, reinforcement management, counterconditioning, helping relationships Decision balance: Pros >>Cons Self Efficacy: high
Health Belief Model - Correct Answer An individual's beliefs about whether or not he/she is susceptible to disease, and his/her perceptions of the benefits of trying to avoid it, influence his/her readiness to act
Self Determination Theory - Correct Answer 3 primary psycho social needs that need to be satisfied: relatedness, competence (mastery) , and autonomy (self determination)