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ACSM 020-222

ACSM Health/Fitness Instructor Exam


Version: 4.0
QUESTION NO: 1


A client's health screening should be administered before


A. Any contact with the client.
B. Any physical activity by the client at your facility.
C. Fitness assessment or programming.
D. The initial "walk-through" showing of a facility.

Answer: B
Explanation:


QUESTION NO: 2


A well-designed consent document developed in consultation with a qualified legal professional
provides your facility with


A. Documentation of a good-faith effort to educate your clients.
B. Legal documentation of a client's understanding of assessment procedures.
C. Legal immunity against lawsuits.
D. No legal benefit.

Answer: A
Explanation:


QUESTION NO: 3


Relative contraindications for exercise testing are conditions for which


A. A physician should be present during the testing procedures.
B. Exercise testing should not be performed until the condition improves.
C. Exercise testing will not provide accurate assessment of health-related fitness.
D. Professional judgment about the risks and benefits of testing should determine whether to
conduct an assessment.

Answer: D
Explanation:


QUESTION NO: 4
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A male client is 42 years old. His father died of a heart attack at age 62. He has a consistent
resting blood pressure (measured over 6 weeks) of 132/86 mm Hg and a total serum cholesterol
of 5.4 mmol/L. Based on his CAD risk stratification, which of the following activities is appropriate?


A. Maximal assessment of cardiorespiratory fitness without a physician supervising.
B. Sub maximal assessment of cardiorespiratory fitness without a physician supervising.
C. Vigorous exercise without a previous medical assessment.
D. Vigorous exercise without a previous physician-supervised exercise test.

Answer: C
Explanation:


QUESTION NO: 5


During calibration of a treadmill, the belt length was found to be 5.5 m. It took 1 minute and 40
seconds for the belt to travel 20 revolutions. What is the treadmill speed?


A. 4 m/min.
B. 66 m/min.
C. 79 m/min.
D. 110 m/min.

Answer: B
Explanation:


QUESTION NO: 6


Which of the following would most appropriately assess a previously sedentary, 40-yearold female
client's muscular strength?


A. Using a 30-pound (18-kg) barbell to perform biceps curls to fatigue.
B. Holding a handgrip dynamometer at 15 pounds (7 kg) to fatigue.
C. Performing modified curl-ups to fatigue.
D. U sing a 5-pound (2.2-kg) dumbbell to perform multiple sets of biceps curls to fatigue.

Answer: A
Explanation:


QUESTION NO: 7

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Flexibility is a measure of the


A. Disease-free ROM about a joint.
B. Effort-free ROM about a joint.
C. Habitually used ROM about a joint.
D. Pain-free ROM about a joint.

Answer: D
Explanation:


QUESTION NO: 8


Which of the following is a FALSE statement regarding informed consent?


A. Informed consent is not a legal document.
B. Informed consent does not provide legal immunity to a facility or individual in the event of injury
to a client.
C. Negligence, improper test administration, inadequate personnel qualifications, and insufficient
safety procedures are all items expressly covered by the informed consent.
D. Informed consent does not relieve the facility or individual of the responsibility to do everything
possible to ensure the safety of the client.

Answer: C
Explanation:


QUESTION NO: 9


Which of the following statements about underwater weighing is TRUE?


A. It can divide the body into bone, muscle, and fat components.
B. It assumes standard densities for bone, muscle, and fat.
C. It can divide the body into visceral and subcutaneous fat components.
D. It is a direct method of assessing body composition.

Answer: B
Explanation:


QUESTION NO: 10


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Which of the following criteria would NOT classify a client as having "increased risk"?


A. Signs and/or symptoms of cardiopulmonary disease.
B. Signs and/or symptoms of metabolic disease.
C. Two or more major risk factors for CAD.
D. Male older than 40 years with a history of clinical depression.

Answer: D
Explanation:


QUESTION NO: 11


A client must be given specific instructions for the days preceding a fitness assessment. Which of
the following is NOT a necessary instruction to a client for a fitness assessment?


A. Men and women should avoid liquids for 12 hours before the test.
B. Clients should be instructed to avoid alcohol, tobacco products, or caffeine at least 3 hours
before the test.
C. Clients should avoid strenuous exercise or physical activity on the day of the test.
D. Men and women should be instructed to get an adequate amount of sleep the night before the
assessment.

Answer: A
Explanation:


QUESTION NO: 12


Hydrodensitometry (hydrostatic weighing, underwater weighing) has several sources of error.
Which of the following is NOT a common source of error when using this technique to determine
body composition?


A. Measurement of the vital capacity of the lungs.
B. Interindividual variability in the amount of air in the gastrointestinal tract.
C. Interindividual variability in the density of the individual lean tissue compartment.
D. Measurement of the residual volume.

Answer: A
Explanation:


QUESTION NO: 13
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The definition of cardiorespiratory fitness is


A. The maximal force that a muscle or muscle group can generate in a single effort.
B. The coordinated capacity of the heart, blood vessels, respiratory system, and tissue metabolic
systems to take in, deliver, and use oxygen.
C. The ability to sustain a held maximal force or to continue repeated sub maximal contractions.
D. The functional ROM about a joint.

Answer: B
Explanation:


QUESTION NO: 14


Which of the following formulae is used for determining workload on a bicycle ergometer?


A. Belt length x resistance x grade.
B. Belt length x resistance x revolutions pedaled per minute.
C. Resistance x distance flywheel traveled per revolution x revolutions per minute.
D. Resistance x distance flywheel traveled per revolution.

Answer: C
Explanation:


QUESTION NO: 15


Adults age physiologically at individual rates. Therefore, adults of any specified age will vary
widely in their physiologic responses to exercise testing. Special consideration should be given to
older adults when giving a fitness test, because


A. Age is often accompanied by de conditioning and disease.
B. Age predisposes older adults to clinical depression and neurologic diseases.
C. Older adults cannot be physically stressed beyond 75% of age-adjusted maximum.
D. Older adults are not as motivated to exercise as those who are younger.

Answer: A
Explanation:


QUESTION NO: 16


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A client with a functional capacity of 7 MET, an ejection fraction of 37%, and an ST -

segment depression of 1 mm below baseline on exertion


A. Should not exercise until his or her ejection fraction is >50%.
B. Is considered to be at low risk.
C. Is considered to be at moderate risk.
D. Is considered to be at high risk.

Answer: C
Explanation:


QUESTION NO: 17


The most accurate screening method for signs and symptoms of CAD is a


A. Maximal exercise test with a 12-lead ECG.
B. Submaximal exercise test with a 12-lead ECG.
C. Discontinuous protocol, stopping at 85% of maximal heart rate.
D. Continuous protocol, stopping at 85% of maximal heart rate.

Answer: A
Explanation:


QUESTION NO: 18


What is the best test to help determine ejection fraction at rest and during exercise?


A. Angiography.
B. Thallium stress test.
C. Single-proton emission computer tomography.
D. MUGA (blood pool imagery) study.

Answer: D
Explanation:


QUESTION NO: 19


A "cold spot" detected in the inferior portion of the left ventricle during a stress test that resolves 3
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hours later most likely indicates


A. An old inferior MI.
B. A MI that is healing.
C. Reversible myocardial ischemia.
D. The need for multiple bypass surgery.

Answer: C
Explanation:


QUESTION NO: 20


What is the best test of cardiovascular function for a client who is obese, has claudication in the
legs, and has limited mobility because of neurologic damage from uncontrolled diabetes?


A. Dipyridamole or dobutamine testing and assessment of cardiovascular variables.
B. Discontinuous treadmill exercise test.
C. Resting echocardiography.
D. Continuous submaximal cycle ergometer test.

Answer: A
Explanation:


QUESTION NO: 21


Although 12-lead testing is the optimal ECG configuration, if only one lead can be used, which one
should it be?


A. Lead II.
B. Lead AVL.
C. Lead V5
D. Lead V1

Answer: C
Explanation:


QUESTION NO: 22


Which of the following is an indication for terminating an exercise test?
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A. The client requests test termination.
B. The respiratory exchange rate exceeds 0.95.
C. The maximal heart rate exceeds 200 bpm.
D. The RPE exceeds 17 on the standard scale.

Answer: A
Explanation:


QUESTION NO: 23


Given the sensitivity of the exercise ECG, stress testing conducted on 100 cardiac rehabilitation
clients with documented CAD would be expected to produce what results?


A. All 100 clients show ECG indicators of CAD.
B. Approximately 50 clients show ECG indicators of CAD.
C. Approximately 30 clients would show ECG indicators of CAD.
D. Approximately 70 clients would show ECG indicators of CAD.

Answer: D
Explanation:


QUESTION NO: 24


What action should you take for a 55-year-old client who has three risk factors for heart disease
and complains of fatigue on exertion?


A. Conduct a submaximal stress test without the presence of a physician.
B. Conduct a maximal diagnostic stress test in the presence of a physician.
C. Use a questionnaire to evaluate activity, and do not conduct a test.
D. Start the client exercising slowly, and test after 6 weeks.

Answer: B
Explanation:


QUESTION NO: 25


For a client taking a -blocker who has lowered resting blood pressure and heart rate, which of the
following statements is TRUE?


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A. A submaximal test will provide the best estimate of the client's fitness.
B. A submaximal test may underestimate the client's fitness.
C. A submaximal test may overestimate the client's fitness.
D. The client should be tested only when not taking the medication.

Answer: C
Explanation:


QUESTION NO: 26


Two individuals have the same body weight, gender, ethnic background, and skinfold
measurement results. One is 25 years old; the other is 45 years. Given this scenmio, which of the
following statements is TRUE?


A. They both have the same percentage of body fat.
B. The 25-year-old individual is fatter.
C. The 45-year-old individual is fatter.
D. Who is fatter cannot be determined from the information given.

Answer: C
Explanation:


QUESTION NO: 27


Lead V is located at the


A. Fifth intercostal space, left sternal border.
B. Midclavicular line, fourth intercostal space.
C. Fourth intercostal space, right sternal border.
D. Midclavicular line, lateral to the xiphoid process.

Answer: C
Explanation:


QUESTION NO: 28


Following termination of a stress test, a 12-lead ECG is


A. Monitored immediately, then every 1 to 2 minutes until exercise-induced changes are at
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baseline.
B. Monitored immediately, then at 2 and ,5 minutes after the test.
C. Monitored immediately only.
D. Monitored and recorded only if any signs or symptoms arise during recovery.

Answer: A
Explanation:


QUESTION NO: 29


For a client who has a contraindication to exercise testing but could benefit greatly from the
information gained through testing, which of the following statements is TRUE?


A. The contraindication is considered to be a relative contraindication.
B. The contraindication is considered to be an absolute contraindication.
C. The client should not be tested until the contraindication is resolved.
D. A submaximal test is the only test that the client should complete.

Answer: A
Explanation:


QUESTION NO: 30


A client who has a measured FVC of 3.5 Land can expel 3.1 L within 1 second has


A. An obstructive defect.
B. A reshictive defect.
C. An FEV of 3.1.
D. An FEV of 89%.

Answer: D
Explanation:


QUESTION NO: 31


The clinical exercise physiologist shares a responsibility to


A. Implement measures to stop disease.
B. Make patients look healthy.
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C. Implement preventive measures to reduce the risk of medical emergencies.
D. Develop a plan to reduce the physical demands of exercise testing.

Answer: C
Explanation:


QUESTION NO: 32


Which of the following is NOT considered to be a benefit of follow- up in an emergency situation?


A. It provides information regarding the patient's current status, which may help to determine the
cause of the emergency.
B. It provides statistics that will help to justify the emergency response program.
C. It allows the staff to finalize the incident report.
D. It provides information to determine the consequences of the staff's actions.

Answer: B
Explanation:


QUESTION NO: 33


Which of the following actions involving termination of exercise testing is correct?


A. Immediately terminate the test if muscular fatigue occurs.
B. Initiate the test termination process when cardiac complications occur.
C. Initiate the test termination process when intermittent premature ventricular contractions are
detected on ECG.
D. Immediately terminate the test when intermittent premature ventricular contractions are
detected on ECG.

Answer: C
Explanation:


QUESTION NO: 34


Safety procedures for clinical staff help protect them from


A. Bloodborne pathogens.
B. Theft.
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C. Violent patients.
D. Work-related injuries.

Answer: A
Explanation:


QUESTION NO: 35


The treatment modality RICES includes all of the following EXCEPT


A. Covering.
B. Ice.
C. Stabilization.
D. Rest.

Answer: A
Explanation:


QUESTION NO: 36


Which of the following statements about emergency equipment is MOST important?


A. Each piece of equipment should be painted a specific color for easy identification.
B. Use of emergency equipment should be practiced routinely.
C. Emergency equipment should include pencils, not pens.
D. Emergency equipment should be kept clean at all times.

Answer: B
Explanation:


QUESTION NO: 37


Identifying a patient's risk of complications is important. Which of the following is NOT considered
to be a common aspect of the risk identification process?


A. Laboratory results.
B. Assessment of cardiac risk.
C. Review of medical history.
D. Assessment of work history.
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Answer: D
Explanation:


QUESTION NO: 38


Symptoms of hyperglycemia include all of the following EXCEPT


A. Tremor.
B. Confusion.
C. Bradycardia.
D. Slurred speech.

Answer: C
Explanation:


QUESTION NO: 39


Emergency procedures and safety include which of the following?


A. Injury prevention.
B. Basic principles for exercise training.
C. Metabolic injuries.
D. Emergency consequences.

Answer: A
Explanation:


QUESTION NO: 40


Category 1 medications include all of the following EXCEPT


A. Lidocaine.
B. Oxygen.
C. Xylocaine.
D. Epinephrine.

Answer: C
Explanation:

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QUESTION NO: 41


The emergency response system (EMS) is:


A. The combination of the ambulance and the emergency room.
B. Critical for the staff to be able to respond adequately to an emergency.
C. The protocol used to practice safety plans.
D. Required by most health departments.

Answer: B
Explanation:


QUESTION NO: 42


In developing an emergency plan, program administrators must take into account all of the
following factors EXCEPT


A. Type of flooring.
B. Type of electrical wiring.
C. Ventilation, temperature, and humidity.
D. Types of exercise equipment.

Answer: D
Explanation:


QUESTION NO: 43


Documentation in the context of emergency response commonly refers to


A. Records of each exercise session.
B. Records of attendance.
C. Records of all emergency situations.
D. Manuals for all emergency equipment.

Answer: C
Explanation:


QUESTION NO: 44

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A patient who exhibits tachycardia, diaphoresis, light-headedness, and visual disturbances may be
experiencing


A. Hypoglycemia.
B. Congestive heart failure.
C. Hyperglycemia.
D. Hypotension.

Answer: A
Explanation:


QUESTION NO: 45


Which of the following is NOT part of an emergency plan?


A. The plan should list the schedule of each staff member so that they can all be accounted for
during an emergency.
B. The plan must be written.
C. The plan should outline each specific action.
D. The staff should be prepared and trained in the plan.

Answer: A
Explanation:


QUESTION NO: 46


The physician's role in an emergency plan is


A. Not important, because most facilities are hospital-based and the emergency room is nearby.
B. Not significant, because a physician is not necessary when testing is conducted.
C. An agency that certifies a managed care organization.
D. Critical, because the physician must be present and can handle any emergency situation.

Answer: C
Explanation:


QUESTION NO: 47


What is OSHA?
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A. A state agency that licenses medical facilities.
B. A federal agency that sets standards for staff and patient safety.
C. An agency that certifies a managed care organization.
D. A state agency that inspects emergency protocols within medical facilities.

Answer: B
Explanation:


QUESTION NO: 48


The preparation of professional staff should include training in


A. Advanced basic life support and ENT.
B. CPR and basic life support.
C. CPR and EMS.
D. Advanced cardiac life support and ENT.

Answer: B
Explanation:


QUESTION NO: 49


Which of the following is NOT considered to be an absolute contraindication to exercise testing?


A. Unstable angina
B. Psychosis.
C. Suspected myocarditis.
D. Moderate valvular heart disease.

Answer: D
Explanation:


QUESTION NO: 50


Which of the following manifestations would be an indication for stopping an exercise test?


A. Low cholesterol 125 mol).
B. Diastolic BP greater than 105 mm Hg.
C. Intermittent premature ventricular contractions.
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D. Low blood sugar 100 mg/dL).

Answer: D
Explanation:


QUESTION NO: 51


Serious complications during an exercise session


A. Occur more often with women.
B. Rarely occur.
C. Occur at a rate of 1 in 3,000 hours of exercise.
D. Occur more often during the late hours because of client fatigue.

Answer: B
Explanation:


QUESTION NO: 52


The exercise staffs role when an injury or emergency occurs should be to:


A. Control the situation by implementing the emergency plan and taking charge.
B. Find someone to implement the emergency plan.
C. Get everyone out of the facility to avoid chaos.
D. Hope that an emergency contact is available to help with the situation.

Answer: A
Explanation:


QUESTION NO: 53


In preventing injuries, hydration is very important, because


A. It controls breathing and the Valsalva maneuver.
B. It helps to regulate carbohydrate utilization during cardiovascular exercise.
C. It helps to regulate body temperature and electrolyte balance. s
D. It helps to prevent blood pooling during the cool-down.

Answer: C
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Explanation:


QUESTION NO: 54


What U.S. legislation is critical for operators of fitness facilities to understand and adhere to
regarding safety?


A. The Americans with Handicaps Act.
B. The Civil Rights Act of 1966.
C. The Health Portability Act of 1996.
D. The Americans with Disabilities Act.

Answer: D
Explanation:


QUESTION NO: 55


What is the most appropriate action in assisting a person suffering from a seizure?


A. Hold the person down so that he or she does not hurt himself or herself.
B. Do not touch the person, but be sure that he or she is in a safe area.
C. Place a wedge in the person's mouth so that he or she does not swallow the tongue.
D. Ignore the person, and allow the seizure to pass.

Answer: B
Explanation:


QUESTION NO: 56


One of the first actions that a fitness instructor should consider in preventing injury is to


A. Teach the client how to warm-up and cool-down.
B. Instruct the client on safety procedureswhen using the facility.
C. Conduct a preparticipation screening.
D. Instruct the client on how to use the exercise equipment safely.

Answer: C
Explanation:

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QUESTION NO: 57


How should a fitness instructor advise a client with regard to progression of the exercise program?


A. The progression should be gradual and slow.
B. The progression should be at specific increments based on a calendar schedule (e.g. add 10%
every 2 weeks).
C. Be aggressive in increasing the program to increase fitness
D. Progress the program only when the client feels ready.

Answer: A
Explanation:


QUESTION NO: 58


How can exercise equipment add to the risk of participation?


A. Because it is e} pensive.
B. Because it is hard to move.
C. Because it is used incorrectly.
D. Because of the time one waits to use it.

Answer: C
Explanation:


QUESTION NO: 59


Prevention strategies of staff and clients must include


A. Following the rules.
B. Keeping the facility clean.
C. Hiring good front-desk staff.
D. Developing clever, unique programs.

Answer: A
Explanation:


QUESTION NO: 60

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An equipment maintenance plan should include


A. A floor plan.
B. A client advisory statement.
C. A document that records maintenance and repair history.
D. Temperature and humidity readings.

Answer: C
Explanation:


QUESTION NO: 61


In cleaning the facility and equipment, what must an operator be aware of?


A. That signs are written clearly.
B. That surfaces are brightly colored.
C. That solutions and cleaning materials are safe for the skin and hypoallergenic.
D. That disinfectants smell pleasant.

Answer: C
Explanation:


QUESTION NO: 62


Which of the following are symptoms of hypoglycemia?


A. Hypotension.
B. Cold, clammy skin.
C. Tachycardia and slurred speech.
D. Bronchospasms and hyperventilation.

Answer: C
Explanation:


QUESTION NO: 63


RICES refers to


A. Relaxation, Ice, Compression, Energy, and Stabilization.
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B. Relaxation, Incremental heat, Care for injury, Energy, and Standardization.
C. Rest, Ice, Common sense, Energy, and Standardization.
D. Rest, Ice, Compression, Elevation, and Stabilization.

Answer: D
Explanation:


QUESTION NO: 64


Complaints of pain in the chest with associated pain radiating down the left arm may be signs of


A. Cardiac crisis.
B. Hypotension.
C. Seizure.
D. Heartburn.

Answer: A
Explanation:


QUESTION NO: 65


Beyond the general safety parameters, such as keeping equipment in good repair, a facility must
create a safe environment for any individual, especially


A. Guest clients.
B. Staff.
C. Health care providers.
D. Special populations.

Answer: D
Explanation:


QUESTION NO: 66


Weight room safety should include


A. A phone.
B. Lifting gloves and back belts.
C. Male trainers to help with spotting.
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D. Safe passageways and use of the buddy system.

Answer: D
Explanation:


QUESTION NO: 67


Fire, bloodborne pathogens, and power outage should all be included in


A. Facility insurance.
B. Safety plans.
C. Maintenance plans.
D. Testing by the facility and staff.

Answer: B
Explanation:


QUESTION NO: 68


The potential benefits and risks of an exercise test should be written in what document?


A. Description of services.
B. Safety plan.
C. Informed consent.
D. Exercise waivers.

Answer: C
Explanation:


QUESTION NO: 69


Documentation offers important


A. Liability and negligence protection.
B. Liability and risk protection.
C. Safety and communication programs.
D. Billing and classification tools.

Answer: A
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Explanation:


QUESTION NO: 70


Emergency procedures should be


A. Given to all clients when they join.
B. Put away in a safe place.
C. Posted under each phone.
D. Posted above each fire extinguisher.

Answer: C
Explanation:


QUESTION NO: 71


Which of the following is NOT a principle of low back care?


A. Abdominal curl-ups/
B. Unloaded flexion/extension of the spine.
C. Neutral spine during all exercises.
D. Controlled leg press or squat with light weights.

Answer: D
Explanation:


QUESTION NO: 72


What is the fitness instructor's primary responsibility in conducting an exercise test?


A. Maintaining a safe environment by not putting the client in danger.
B. Making sure that the data collected are accurate.
C. Completing the test.
D. Encouragement and support.

Answer: A
Explanation:

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QUESTION NO: 73


What are some of the risks for musculoskeletal injury?


A. Poor Signage in the facility.
B. Extrinsic factors intensity, terrain, equipment.
C. Intrinsic factors-frequency, attitude, ender.
D. Membership type

Answer: B
Explanation:


QUESTION NO: 74


Chronic soreness and fatigue are symptoms of


A. Hyperglycemia.
B. Strain.
C. Overuse injury.
D. Hypoglyeemia.

Answer: C
Explanation:


QUESTION NO: 75


Exercise clothing


A. Creates an important fashion statement.
B. Should be bright so that you are easily seen in an aerobics class.
C. Has only one rule: be comfortable.
D. Must be safe and performs appropriately, like the exercise equipment.

Answer: D


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