ACSM-EP Health Appraisal & Risk Assessment 3 — Questions and Answers
Question 1: Which lipoprotein value, if elevated, is considered a NEGATIVE (protective) risk factor in ACSM cardiovascular risk stratification?
- LDL-C ≥ 130 mg/dL
- Total cholesterol ≥ 200 mg/dL
- HDL-C ≥ 60 mg/dL (Correct answer)
- Triglycerides ≥ 150 mg/dL
Correct answer: HDL-C ≥ 60 mg/dL
HDL-C ≥ 60 mg/dL is the only negative (protective) risk factor in ACSM's CVD risk factor threshold list, which removes one positive risk factor from the total count.
Question 2: An exercise physiologist is reviewing a client's waist circumference measurement. For a male client, which value exceeds the ACSM obesity risk threshold?
- > 88 cm (35 inches)
- > 94 cm (37 inches)
- > 102 cm (40 inches) (Correct answer)
- > 110 cm (43 inches)
Correct answer: > 102 cm (40 inches)
ACSM identifies waist circumference > 102 cm (40 inches) for men and > 88 cm (35 inches) for women as thresholds indicating increased health risk.
Question 3: During a resting ECG obtained as part of pre-exercise health appraisal, which finding would most warrant immediate physician referral before exercise testing?
- Sinus bradycardia with heart rate of 52 bpm
- Left bundle branch block (Correct answer)
- PR interval of 0.18 seconds
- Early repolarization pattern
Correct answer: Left bundle branch block
Left bundle branch block is an abnormal ECG finding that warrants medical evaluation before exercise testing, as it can mask ischemic changes.
Question 4: A client reports taking a beta-blocker medication. How should the exercise physiologist account for this during health appraisal?
- It has no effect on exercise prescription or testing
- It may attenuate heart rate response, affecting target HR calculations (Correct answer)
- It increases maximal heart rate, requiring higher intensity targets
- It only affects blood pressure, not heart rate during exercise
Correct answer: It may attenuate heart rate response, affecting target HR calculations
Beta-blockers blunt the heart rate response to exercise, requiring use of RPE rather than heart rate targets for exercise prescription.
Question 5: When assessing a client's readiness for exercise using the Transtheoretical Model, a person who has been exercising regularly for 3 weeks is in which stage?
- Contemplation
- Preparation
- Action (Correct answer)
- Maintenance
Correct answer: Action
The Action stage is defined by actively performing the target behavior (regular exercise) for less than 6 months.
Question 6: Which of the following is the MOST appropriate initial assessment tool for identifying fall risk in an older adult client during health appraisal?
- Sit-and-reach flexibility test
- Timed Up and Go (TUG) test (Correct answer)
- 6-Minute Walk Test
- Rockport Walking Test
Correct answer: Timed Up and Go (TUG) test
The Timed Up and Go (TUG) test assesses mobility, balance, and fall risk by timing a person rising from a chair, walking 3 meters, and returning.
Question 7: A client discloses they are currently pregnant (16 weeks). Which absolute contraindication to exercise, if present, would require immediate cessation of an exercise program?
- Mild nausea during morning hours
- Incompetent cervix or cerclage (Correct answer)
- Pre-pregnancy BMI of 24 kg/m²
- Mild lower back discomfort
Correct answer: Incompetent cervix or cerclage
Incompetent cervix or cerclage is an ACOG/ACSM absolute contraindication to exercise during pregnancy, requiring program discontinuation.
ACSM-EP Health Appraisal & Risk Assessment 3
Which lipoprotein value, if elevated, is considered a NEGATIVE (protective) risk factor in ACSM cardiovascular risk stratification?