Covers patient assessment and medical history, administering and interpreting exercise tests, developing exercise prescriptions, training and leadership, patient education, and legal responsibilities.
12 free sample questions135 in the full practice test
Patient Assessment · Resting Biometric Data Assessment
During an intake assessment for an outpatient cardiac rehabilitation program, an ACSM-CEP reviews the medical record of a 62-year-old male with Heart Failure with reduced Ejection Fraction (HFrEF). The patient is currently prescribed carvedilol and lisinopril. The baseline resting 12-lead ECG reveals a PR interval of 0.24 seconds with a 1:1 P-to-QRS ratio. The patient is asymptomatic. What is the most appropriate interpretation and subsequent action?
Answer and explanation
Correct answer: C
A PR interval > 0.20 seconds with a 1:1 P-to-QRS ratio indicates a first-degree AV block. This is a common, often benign finding in patients taking beta-blockers (like carvedilol) which slow AV nodal conduction. It is not an absolute or relative contraindication to exercise testing or training unless accompanied by significant symptoms or higher-degree blocks.
Q2Question 2
Intermediate
Patient Assessment · Preparticipation Health Screening and Monitoring Level Determination
A 65-year-old male is referred to Phase II Cardiac Rehabilitation following a Non-ST-Elevation Myocardial Infarction (NSTEMI) and subsequent placement of two drug-eluting stents.
During the intake interview, the ACSM-CEP reviews his medical records. His left ventricular ejection fraction (LVEF) is 45%. He experienced an episode of ventricular tachycardia during his hospitalization that required pharmacological intervention, but he has been in normal sinus rhythm since. He currently reports no angina at rest or during activities of daily living. His functional capacity on a recent symptom-limited stress test was 4.5 METs.
Based on the AACVPR risk stratification criteria, how should this patient be classified, and what level of continuous ECG monitoring is indicated during his initial exercise sessions?
flowchart TD
Start([Start Risk Stratification]) --> EF{LVEF Level}
EF -->|< 40%| High[High Risk]
EF -->|40-49%| Mod[Moderate Risk]
EF -->|>= 50%| Low{Other Factors}
Low --> Arrhythmia{Complex Arrhythmia?}
Arrhythmia -->|Yes| High2[High Risk]
Arrhythmia -->|No| Angina{Angina at low METs?}
Mod --> Arrhythmia2{Complex Arrhythmia?}
Arrhythmia2 -->|Yes| High3[High Risk]
High --> Monitor[Continuous ECG Monitoring Required]
High2 --> Monitor
High3 --> Monitor
Answer and explanation
Correct answer: C
According to AACVPR guidelines, the presence of a complex ventricular dysrhythmia (such as ventricular tachycardia requiring intervention) during hospitalization, combined with an LVEF of 45% and low functional capacity (<5 METs), places the patient in the High Risk category. High-risk patients require continuous telemetry ECG monitoring during the initial phases of cardiac rehabilitation.
Q3Question 3
Beginner
Patient Assessment · Patient Goals, Needs, and Motivation Assessment
Which of the following validated screening tools is most appropriate for an ACSM-CEP to administer when assessing a patient for the presence and severity of depressive symptoms during a clinical intake assessment?
Answer and explanation
Correct answer: D
The Patient Health Questionnaire-9 (PHQ-9) is a validated, widely used clinical screening tool specifically designed to assess the presence and severity of depressive symptoms. The PAR-Q+ is for physical activity readiness, the SF-36 measures general health-related quality of life, and the Duke Score is a prognostic treadmill score.
Q4Question 4
IntermediateMultiple answers
Patient Assessment · Preparticipation Health Screening and Monitoring Level Determination
When reviewing a patient's preparticipation health screening and medical history, an ACSM-CEP must identify contraindications to exercise testing. Which TWO of the following conditions represent ABSOLUTE contraindications to symptom-limited maximal exercise testing? (Select TWO)
Answer and explanation
Correct answers: A, D
Ongoing unstable angina is an absolute contraindication to exercise testing because the myocardium is actively ischemic, and the stress of exercise could provoke a myocardial infarction. Acute systemic infection is also an absolute contraindication as it places undue metabolic stress on the body. Left main coronary stenosis and severe arterial hypertension are considered relative contraindications.
Acute systemic infection, accompanied by fever and body aches, is an absolute contraindication. Exercise testing should not proceed until the infection has resolved. Ongoing unstable angina is the other absolute contraindication in this list.
Q5Question 5
Intermediate
Patient Assessment · Resting Biometric Data Assessment
During a pre-exercise vital sign assessment for a pulmonary rehabilitation program, a patient with severe COPD presents with a resting SpO2 of 86% on room air. The patient appears comfortable and denies acute dyspnea. What is the most appropriate clinical decision?
Answer and explanation
Correct answer: C
According to AACVPR and GOLD guidelines, an SpO2 < 88% indicates significant hypoxemia. Exercise should be withheld until supplemental oxygen is administered (per physician orders) to bring the saturation to at least 88-90% to prevent exercise-induced hypoxia and associated complications.
Q6Question 6
Beginner
Patient Assessment · Medical Record Assessment
True or False: HITRUST is a certification framework that provides a comprehensive approach to regulatory compliance and risk management, standardizing requirements across multiple regulations including HIPAA.
Answer and explanation
Correct answer: A
True. The Health Information Trust Alliance (HITRUST) provides a certifiable framework (CSF) that harmonizes multiple compliance requirements, including HIPAA, to help healthcare organizations manage data security and risk. ACSM-CEPs must understand these frameworks when handling electronic medical records.
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