ACSM Certified Clinical Exercise Physiologist Free Sample Questions

Metoprolol is a beta-1-selective blocker that lowers resting and exercise heart rate and blood pressure (its FDA label lists bradycardia and hypotension), and lisinopril is an ACE inhibitor that lowers blood pressure. A resting HR of 52 bpm and BP of 108/68 mm Hg in a cardiac patient on this regimen are the expected, well-controlled effects of the drugs, not an emergency. Lisinopril does not slow the heart (the beta-blocker does), and an HR of 52 bpm in an asymptomatic, medicated patient is not an absolute contraindication to testing; atorvastatin's muscle-related warning is myopathy, not autonomic neuropathy; and 108/68 mm Hg without symptoms is a low-normal pressure, not a hypotensive crisis.

Open-ended questions require more than a 'yes' or 'no' response and encourage the patient to share their narrative, providing deeper insight into their perceived barriers and readiness. The other options are closed-ended questions.

The AHA exercise standards (Fletcher 2013), used in ACSM's Guidelines, list acute myocardial infarction within 2 days and ongoing unstable angina among the absolute contraindications to symptom-limited exercise testing, so the test must not be done. Known obstructive left main coronary stenosis, tachyarrhythmias with uncontrolled ventricular rates and resting hypertension with systolic pressure above 200 mm Hg (or diastolic above 110 mm Hg) are relative contraindications: testing may still go ahead after a careful review of benefit and risk.

ACSM's preparticipation screening algorithm (Riebe et al. 2015) asks about current exercise participation, signs or symptoms, and known cardiovascular, metabolic (type 1 or type 2 diabetes) or renal disease. A physically inactive person with known metabolic disease should obtain medical clearance before starting an exercise program of any intensity, even when asymptomatic; after clearance, light-to-moderate exercise is recommended with gradual progression. Clearance only before vigorous exercise applies to people who already exercise regularly, and the health care provider (not a mandatory maximal test) decides what evaluation is needed. Peripheral neuropathy does not change the clearance decision but does shape the exercise prescription (foot care, choice of mode).

False. The PHQ-9 is a validated screening tool used to assess the severity of depression, not readiness to change. Tools like decisional balance exercises or the Transtheoretical Model stages of change questionnaires are used for assessing readiness to change.

Spirometry confirms COPD when FEV1/FVC is below 0.70 (here 0.60). GOLD then grades airflow limitation by FEV1 % predicted: GOLD 1 is 80% or more, GOLD 2 is 50-79%, GOLD 3 is 30-49% and GOLD 4 is below 30%, so an FEV1 of 45% is GOLD 3 (severe). With 3 exacerbations in the past year he also falls in GOLD group E, which since 2023 holds every patient with frequent exacerbations whatever the symptom level. Severe airflow limitation and a recent exacerbation put him at high risk of exercise-induced desaturation, so continuous pulse oximetry and a dyspnea scale should be used during testing (GOLD 2025 notes that pulse oximetry can be used to evaluate oxygen saturation and the need for supplemental oxygen). GOLD 1 and GOLD 2 understate his FEV1-based severity, and GOLD 4 is wrong both because 45% is above 30% and because a low FEV1 alone is not a contraindication to exercise testing.