ACE Risk Assessment & Management 2 — Questions and Answers
Question 1: A client reports taking a beta-blocker medication. How does this affect heart rate monitoring during exercise?
- Heart rate will be artificially elevated
- Heart rate response will be blunted, making HR-based intensity unreliable (Correct answer)
- Heart rate will fluctuate unpredictably
- Beta-blockers have no effect on exercise heart rate
Correct answer: Heart rate response will be blunted, making HR-based intensity unreliable
Beta-blockers blunt the heart rate response to exercise, making target heart rate zones inaccurate; RPE is preferred for intensity monitoring.
Question 2: Which of the following is considered a POSITIVE risk factor for cardiovascular disease in the ACE risk stratification model?
- HDL cholesterol ≥ 60 mg/dL
- Resting blood pressure of 138/88 mmHg (Correct answer)
- BMI of 22 kg/m²
- Non-smoking status for 5 years
Correct answer: Resting blood pressure of 138/88 mmHg
A resting blood pressure ≥ 130/80 mmHg is considered a positive (adverse) cardiovascular risk factor per ACE guidelines.
Question 3: A 55-year-old male client has two positive CVD risk factors and no known disease. Per ACE risk stratification, he is classified as:
- Low risk
- Moderate risk (Correct answer)
- High risk
- Very high risk
Correct answer: Moderate risk
Men ≥ 45 years with ≥ 2 CVD risk factors fall into the moderate-risk category per ACE stratification.
Question 4: Which document should an ACE-certified personal trainer use to screen clients for exercise readiness?
- SOAP notes
- PAR-Q+ or ACE Health History Questionnaire (Correct answer)
- FITT-VP protocol
- ACSM Exercise Prescription Guidelines
Correct answer: PAR-Q+ or ACE Health History Questionnaire
The PAR-Q+ and ACE Health History Questionnaire are the standard pre-participation screening tools for identifying exercise risks.
Question 5: During a submaximal cycle ergometer test, a client's heart rate fails to stabilize between workloads. The trainer should:
- Increase resistance to challenge the client
- Continue and record the unstable values
- Terminate the test and refer the client to a physician (Correct answer)
- Switch to a treadmill protocol immediately
Correct answer: Terminate the test and refer the client to a physician
An inability to achieve steady-state heart rate is an absolute indication to stop exercise testing and seek medical evaluation.
Question 6: High-density lipoprotein (HDL) cholesterol at what level is considered a NEGATIVE (protective) risk factor?
- ≥ 40 mg/dL
- ≥ 50 mg/dL
- ≥ 60 mg/dL (Correct answer)
- ≥ 70 mg/dL
Correct answer: ≥ 60 mg/dL
An HDL ≥ 60 mg/dL is considered a negative (protective) risk factor that cancels one positive CVD risk factor.
Question 7: A client experiences sudden dizziness and nausea 10 minutes into a workout. The FIRST action the personal trainer should take is:
- Have the client sit or lie down immediately and discontinue exercise (Correct answer)
- Increase water intake and continue at a lower intensity
- Check blood pressure and resume after 5 minutes
- Call 911 immediately without assessing the client
Correct answer: Have the client sit or lie down immediately and discontinue exercise
The immediate priority is to stop exercise and ensure the client is safe by having them sit or lie down before further assessment.
ACE Risk Assessment & Management 2
A client reports taking a beta-blocker medication.
How does this affect heart rate monitoring during exercise?