ACE Special Population Considerations 2 — Questions and Answers
Question 1: A client with type 2 diabetes reports a pre-exercise blood glucose of 90 mg/dL. What is the most appropriate action?
- Begin exercise immediately without modification
- Have the client consume 15–20 g of carbohydrate before exercising (Correct answer)
- Cancel the session due to hypoglycemia risk
- Administer insulin before starting the session
Correct answer: Have the client consume 15–20 g of carbohydrate before exercising
A blood glucose below 100 mg/dL before exercise increases hypoglycemia risk, so a small carbohydrate snack is recommended.
Question 2: Which exercise modification is most appropriate for a pregnant client in her second trimester?
- Eliminate all cardiovascular exercise
- Avoid supine positions for prolonged periods (Correct answer)
- Restrict exercise to upper-body movements only
- Limit sessions to 10 minutes to avoid overheating
Correct answer: Avoid supine positions for prolonged periods
After the first trimester, prolonged supine exercise can compress the vena cava and reduce cardiac output, so it should be avoided.
Question 3: When training an older adult with osteoporosis, which exercise type is MOST beneficial for improving bone density?
- Swimming
- Cycling
- Weight-bearing resistance training (Correct answer)
- Seated stretching
Correct answer: Weight-bearing resistance training
Weight-bearing and resistance exercises apply mechanical load to bone, stimulating osteoblast activity and improving bone density.
Question 4: A client with hypertension has a resting blood pressure of 158/96 mmHg today. What should the trainer do?
- Proceed with a high-intensity interval session as planned
- Refer the client to their physician and postpone intense exercise (Correct answer)
- Reduce session duration to 20 minutes and continue
- Have the client perform only flexibility exercises
Correct answer: Refer the client to their physician and postpone intense exercise
A resting BP of ≥160/100 mmHg (Stage 2) warrants physician referral and deferring vigorous exercise until medically cleared.
Question 5: Which RPE (Borg 6–20 scale) range is generally recommended for individuals with chronic obstructive pulmonary disease (COPD) during aerobic exercise?
- 6–9
- 10–13 (Correct answer)
- 14–16
- 17–19
Correct answer: 10–13
An RPE of 10–13 (light to somewhat hard) corresponds to a safe, manageable intensity for individuals with COPD.
Question 6: An adolescent client wants to begin resistance training. Which approach is safest according to ACE guidelines?
- Maximize loads to stimulate growth hormone release
- Focus on bodyweight and light loads with proper technique (Correct answer)
- Avoid resistance training until skeletal maturity
- Use heavy compound lifts three times per week
Correct answer: Focus on bodyweight and light loads with proper technique
Youth resistance training should emphasize proper technique with light-to-moderate loads, as growth plates are vulnerable to heavy compressive forces.
Question 7: A client recovering from a recent myocardial infarction wants to resume exercise. What is the trainer's PRIMARY responsibility?
- Design a cardiac rehabilitation program independently
- Obtain written physician clearance before starting any exercise program (Correct answer)
- Limit the client to walking only for six months
- Test the client's VO2max before designing a program
Correct answer: Obtain written physician clearance before starting any exercise program
Post-MI clients must have physician clearance and ideally supervised cardiac rehabilitation before working with a personal trainer.
ACE Special Population Considerations 2
A client with type 2 diabetes reports a pre-exercise blood glucose of 90 mg/dL.
What is the most appropriate action?