ACSM practice test

C

1. A. Run a submaximal exercise test first, then decide from the result whether clearance is needed

   The current algorithm does not use an exercise test to decide clearance; an inactive client with known metabolic disease is referred for clearance before testing or training.

2. B. Count CVD risk factors and refer for clearance if two or more are present

   Counting risk factors was the pre-2015 risk-stratification approach; the current algorithm is driven by activity status, known disease and symptoms.

3. D. Begin light activity now and seek clearance before adding vigorous training

   Clearance before vigorous work applies to regularly active clients with known disease; an inactive client with diabetes needs clearance before starting.

4. C. Obtain medical clearance before beginning an exercise program

   Under the 2015+ ACSM preparticipation algorithm, an inactive person with known metabolic disease (diabetes) is advised to obtain medical clearance before starting, even when asymptomatic. After clearance, light-to-moderate intensity is recommended with gradual progression.

D

1. A. Measure now and subtract about 10 mmHg to correct for the stairs

   There is no valid correction factor for recent activity; the client needs to rest before measuring.

2. B. Check both arms quickly and record the arm with the lower reading

   When arms differ consistently, the higher arm is used, and quick readings after stairs are not resting values on either arm.

3. C. Have the client lie supine for 1 minute, then take the reading

   One minute is too short a rest, and changing to supine changes the standard seated conditions.

4. D. Wait at least 5 minutes of quiet seated rest with the arm at heart level

   Recent exertion raises blood pressure, so a resting value requires at least 5 minutes of quiet seated rest with the back supported and the arm supported at heart level before measuring.

C

1. A. The reassessment value, by averaging it with the baseline

   Averaging a sloped measurement with a horizontal one blends two techniques; the tape alignment itself must be fixed.

2. B. Tape tension, pulling it tight enough to compress the skin

   Compressing the skin is itself a technique error; the tape should be snug but not indenting.

3. D. The baseline, remeasuring it with the tape angled to match

   Copying the error makes both values wrong; the standard horizontal technique should be used.

4. C. Tape alignment, keeping it horizontal at the same landmark both times

   The tape should be horizontal and snug without compressing the skin, at the same documented landmark each visit. Correcting the alignment at reassessment restores comparability with the baseline.

A

1. B. Transverse plane

   The transverse plane describes rotation and horizontal movements, such as horizontal abduction.

2. C. Scapular plane

   The scapular plane lies about 30° anterior to the frontal plane (scaption); straight sideways raising is frontal.

3. D. Sagittal plane

   The sagittal plane contains forward and backward motions such as flexion and extension.

4. A. Frontal plane

   Raising the arm directly out to the side is shoulder abduction, which occurs in the frontal plane about an anteroposterior axis.

A

1. B. A rise in maximal heart rate that lowers relative effort

   Maximal heart rate is largely age-related and stays the same or falls slightly with training.

2. C. Reduced blood volume that eases cardiac workload

   Endurance training expands blood (plasma) volume rather than reducing it.

3. D. Increased sympathetic drive at the same walking speed

   Trained individuals show lower sympathetic drive at a given submaximal workload.

4. A. Greater stroke volume at that submaximal workload

   Aerobic training increases plasma volume and left-ventricular filling, raising stroke volume. Because submaximal cardiac output stays about the same, heart rate at the same walking speed falls.

B

1. A. Have a family member guard while the trainer scores from across the room

   Guarding is the trainer's responsibility; a family member is not trained to prevent a fall during testing.

2. C. Allow the handrail but compare the score with unassisted norms

   Handrail-assisted scores cannot be compared with norms collected without support.

3. D. Allow the handrail for practice trials and remove it for the scored trial

   Removing support for the scored trial exposes a hesitant older adult to fall risk and changes the conditions from practice.

4. B. Use a guarded, safe protocol and record the handrail use

   For an older adult, the assessment should be safe and guarded. If a handrail is used, it is recorded so later scores are compared under the same conditions and not against unassisted norms.

D

1. A. 1.22

   100 ÷ 82 = 1.22: hip was divided by waist, the reverse of the specified ratio.

2. B. 0.80

   82 ÷ 100 = 0.8200; rounding to one decimal (0.80) ignores the two-decimal instruction.

3. C. 0.45

   82 ÷ (82 + 100) = 0.45: waist was divided by the sum of both circumferences.

4. D. 0.82

   82 / 100 = 0.82. This is a ratio, not a diagnosis.

A

1. B. 126 bpm

   21 × 6 = 126: a factor of 6 is for a 10-second count, but this count lasted 15 seconds.

2. C. 63 bpm

   21 × 3 = 63: a factor of 3 is for a 20-second count, but this count lasted 15 seconds.

3. D. 42 bpm

   21 × 2 = 42: a factor of 2 is for a 30-second count, but this count lasted 15 seconds.

4. A. 84 bpm

   21 × (60/15) = 84 bpm. A short count has measurement error.

B

1. A. Add a fourth walk and lengthen each walk by 5 minutes this week

   This changes frequency and duration in the same week, so weekly volume rises sharply and the cause of any problem is unclear.

2. C. Repeat a submaximal fitness test before changing the plan

   Good tolerance and recovery already show readiness; a formal retest is not needed before a small duration increase.

3. D. Hold the current plan for about 12 weeks before changing it

   Easy tolerance with good recovery is the cue to progress; leaving the dose unchanged for three months lets the overload stimulus fade.

4. B. Add about 5 minutes per walk for the next 1–2 weeks

   ACSM suggests that early aerobic progression come mainly from duration, roughly 5–10 minutes per session every 1–2 weeks during the first 4–6 weeks, with tolerance and recovery monitored before intensity is raised.

B

1. A. Leg-strength circuits as the main weekly training session

   Leg strength supports cycling, but strength circuits do not build the sustained aerobic endurance a long ride requires.

2. C. Short high-intensity rides as the main weekly session, keeping distance low

   High-intensity work can raise fitness, but short rides do not build the sustained endurance and saddle tolerance a long ride requires.

3. D. Ride the full target distance once a week from the first week

   This trains the right activity, but starting at the full distance skips gradual progression and invites excessive fatigue and discomfort early on.

4. B. Gradually lengthen rides toward the target distance

   By the principle of specificity, sustained cycling performance improves most when the training progressively rehearses longer rides.

C

1. A. Add a pause at the bottom of the full-depth lunge to build control there

   A pause lengthens time in the very position where control is lost.

2. B. Cue the client to look straight ahead while lunging to full depth

   A gaze cue may help posture, but it does not address control at the bottom of the range.

3. D. Reduce the reps per set while keeping the full lunge depth

   Fewer repetitions reduce volume but keep the full depth, which is the range the client cannot yet control.

4. C. Work in the range the client controls, then extend it gradually

   Because the client controls a shorter lunge well, training in that range and extending it gradually builds control before the hardest part of the range is loaded.

A

1. B. Holding the planned range for the full 30 seconds

   Completing the planned hold ignores the discomfort the client is showing now.

2. C. The trainer's judgment of normal range for that joint

   Normal ranges vary between people; the client's response, not a textbook value, sets the limit.

3. D. The consent the client gave at the start of the session

   Consent is ongoing and can be withdrawn; earlier agreement does not cover continuing once the client appears uncomfortable.

4. A. The client's ongoing feedback and consent in the moment

   During assisted mobility work, the client's ongoing feedback and consent guide the trainer, who eases off when the client appears or reports discomfort.

D

1. A. Seated rest for a few minutes to see whether symptoms pass

   Resting without checking or treating can let glucose keep falling while time passes.

2. B. Stopping and giving a high-fat snack such as nuts

   Fat slows absorption, so a high-fat snack raises glucose too slowly to treat hypoglycemia.

3. C. Completing the cool-down before checking glucose

   The cool-down is still exercise and delays assessment and treatment.

4. D. Stopping and following the plan: check, treat, recheck

   When symptoms suggest hypoglycemia, stopping exercise and following the agreed plan (check glucose, treat with fast-acting carbohydrate, recheck in about 15 minutes) takes priority over finishing the workout.

B

1. A. Confirm the pre-exercise dose was taken, then store the inhaler in the locker room so the session is not interrupted

   The pre-dose is right, but an inhaler left in the locker room delays treatment if symptoms start during the session.

2. C. Shorten the warm-up to save the client's energy for the main set

   A gradual, longer warm-up can reduce exercise-induced bronchoconstriction; shortening it removes that protection.

3. D. Keep the inhaler within reach, but hold the prescribed pre-exercise puffs unless breathing tightens

   Keeping it within reach is right, but waiting for symptoms skips the pre-exercise dose that the medical instructions call for.

4. B. Check that prescribed pre-exercise medication was used and the inhaler is within reach

   Safe preparation means the client has taken any pre-exercise medication exactly as prescribed, keeps the rescue inhaler within reach, and does a gradual, longer warm-up, which can reduce exercise-induced bronchoconstriction.

A

1. B. Ask the client to describe foot position aloud during each repetition

   A verbal description does not let the trainer see a loss of balance or unsafe foot placement as it happens.

2. C. Move the client closer to the camera so facial cues of effort are visible

   Moving closer narrows the view further and still leaves the feet unseen.

3. D. Continue, and review a recording of the session afterward for foot faults

   Reviewing a recording later cannot prevent a fall during the session.

4. A. Reposition the camera to show the full body and confirm space and support

   Remote balance work needs a full-body camera view, a clear space and a sturdy support such as a counter or chair within reach. The trainer fixes the view before continuing so loss of balance can be seen and addressed in real time.

D

1. A. 140 min

   120 + 20 = 140 adds the raw minutes without counting vigorous minutes double.

2. B. 130 min

   120 + 20 ÷ 2 = 130 halves the vigorous minutes instead of doubling them.

3. C. 260 min

   2 × 120 + 20 = 260 doubles the moderate minutes instead of the vigorous ones.

4. D. 160 min

   120 + 2 × 20 = 160 moderate-equivalent minutes.

A

1. B. Reassure the client that regular exercise will soon raise their energy

   Reassurance offered this early skips over the client's experience and can feel dismissive, even when well meant.

2. C. Suggest shorter sessions this week so exercise fits the schedule

   Shorter sessions may help later, but proposing a fix before understanding the concern is problem-solving, not listening.

3. D. Share how you handled a similarly demanding period in your own life

   Self-disclosure shifts the focus to the trainer at the moment the client is describing their own experience.

4. A. Reflect the sense of exhaustion and invite the client to say more

   Active listening starts by reflecting what the client said and felt, then inviting elaboration. This checks understanding and lets the client explain the concern before any advice or solution is offered.

C

1. A. Be more active during the workweek

   'More active' does not define the activity, amount or timing.

2. B. Feel less tired by the end of the week

   This describes a hoped-for feeling, not a behavior the client will carry out.

3. D. Try to fit in some exercise on most days, depending on how work goes

   'Some exercise' and 'most days' leave the activity, dose and days open, and the work condition makes it easy to drop.

4. C. A 15-minute circuit before dinner on Tue, Thu and Sat

   The most specific behavioral goal states the activity, its duration and the days and time it will happen, which makes it easy to plan and to self-monitor.

B

1. A. Explain the purpose of each exercise in detail, then keep the plan as written

   A clear rationale is helpful, but keeping the plan unchanged still gives the client no say in a program they feel was imposed.

2. C. Let the client choose the music and exercise order while the exercise selection stays fixed

   Choices over minor details do not give the client a say in the program itself; autonomy support means meaningful options about what the program contains.

3. D. Add a weekly reward for completing the prescribed sessions

   Rewards for compliance are a controlling, external motivator and can further undermine autonomous motivation.

4. B. Offer meaningful options within the goal and ask about preferences

   Autonomy-supportive coaching gives the client genuine choices within safe, goal-consistent options and invites their input, which increases ownership of the plan.

B

1. A. Say "great job" to keep the mood positive

   General praise is pleasant but does not tell the client which action to repeat.

2. C. Move straight to correcting the next technique flaw while the client is attentive

   Correction has its place, but skipping over the improvement gives the client no information about what to repeat.

3. D. Rate the repetition out of 10 so the client can track progress numerically

   A score shows that something improved but not what changed or why it matters, so it is less useful than naming the specific improvement.

4. B. Name the specific improvement and why it matters

   Specific, informational feedback tells the client exactly what improved and why, which reinforces the behavior and supports competence.