ACSM-EP Professional Ethics & Conduct — Questions and Answers
Question 1: An exercise physiologist earns a commission from an equipment company for each client who buys its products. A client asks which equipment to buy. What is the MOST ethical action?
- Recommend the brand and keep the commission private
- Recommend the brand and disclose the commission after the sale
- Recommend the brand only if the client does not ask about commissions
- Disclose the financial relationship and base the recommendation on the client's needs (Correct answer)
Correct answer: Disclose the financial relationship and base the recommendation on the client's needs
Financial conflicts of interest must be disclosed up front so the client can make an informed decision.
Professional standards require that financial or other interests that could bias a recommendation be disclosed before the client decides. Disclosing the commission and basing advice on the client's needs protects the client's autonomy and the professional's integrity. Hiding the commission or disclosing it after the sale denies the client the information needed for informed choice. If the conflict cannot be managed, the professional should decline to make the recommendation.
Question 2: A client's physician phones and requests the client's fitness assessment results and health history. What should the exercise physiologist do FIRST?
- Obtain the client's signed written authorization before releasing information (Correct answer)
- Release the full record because physicians are health professionals
- Share only the results verbally over the phone
- Release the results only if the physician is a family friend
Correct answer: Obtain the client's signed written authorization before releasing information
Client health information may be released only with the client's written authorization (HIPAA-type privacy protections).
Client health and fitness data are confidential, and release to third parties, including physicians, requires the client's written, signed authorization. Being a health professional does not remove this requirement. Verbal or partial release still discloses protected information. Records should also be stored securely, and each release documented.
Question 3: A gym manager asks an exercise physiologist to skip preparticipation health screening for new members to speed up enrollment. What is the BEST response?
- Comply to maintain a good working relationship
- Decline, continue screening according to ACSM standards, and document the request (Correct answer)
- Screen only members who appear unhealthy
- Replace screening with a signed liability waiver
Correct answer: Decline, continue screening according to ACSM standards, and document the request
Preparticipation screening is a standard of care, so the professional should uphold it and document the pressure.
ACSM recommends preparticipation health screening to identify individuals at risk and guide appropriate exercise, and it is a professional standard of care. The professional should uphold the standard and keep a written record of the request. A waiver does not remove the need for screening or the duty of care, and judging health by appearance is unreliable. Complying would expose members to avoidable risk and the professional to liability.
Question 4: During a training session, a client reports chest tightness and lightheadedness. What is the most appropriate immediate action?
- Reduce the intensity and continue the session
- Stop exercise, have the client sit, and activate the emergency action plan and EMS (Correct answer)
- Have the client walk slowly for 10 minutes and then reassess
- Finish the session and recommend a physician visit next week
Correct answer: Stop exercise, have the client sit, and activate the emergency action plan and EMS
Possible cardiac symptoms require stopping exercise, seating the client, and activating the emergency action plan.
Chest discomfort with lightheadedness may signal a cardiovascular event, so exercise stops immediately, the client is seated or reclined, and the emergency action plan and EMS are activated. Continuing exercise at any intensity increases risk. Staff should know the emergency plan and be trained in CPR and AED use. The event and response must be documented afterward.
Question 5: A client with type 1 diabetes asks her exercise physiologist to adjust her insulin dose for a new exercise program. What is the CORRECT response?
- Decline to change the dose and refer her to her physician or diabetes care team, coordinating exercise timing (Correct answer)
- Adjust the dose slightly based on her body weight
- Tell her to stop using insulin on exercise days
- Adjust the dose only if she has done so before
Correct answer: Decline to change the dose and refer her to her physician or diabetes care team, coordinating exercise timing
Medication changes are outside the exercise physiologist's scope, so the client should be referred to her physician.
Exercise physiologists work within scope of practice and do not prescribe or adjust medications such as insulin. The correct action is to refer to the physician or diabetes team while coordinating exercise timing, glucose monitoring, and carbohydrate availability. Adjusting or stopping insulin could cause dangerous hypoglycemia or hyperglycemia. Staying within competence protects the client and the professional.
Question 6: Before a client's first exercise test, which element is required for valid informed consent?
- The client's signature alone
- An explanation of the test purpose, procedures, risks, and the right to stop at any time (Correct answer)
- Verbal agreement from a family member
- A statement waiving all rights to legal action
Correct answer: An explanation of the test purpose, procedures, risks, and the right to stop at any time
Informed consent requires explaining purpose, procedures, risks, and the right to withdraw before the client agrees.
Informed consent is a process in which the client is told the purpose, procedures, possible risks and benefits, and the right to ask questions and stop at any time, then voluntarily agrees. A signature without explanation is not informed. Family members cannot consent for a competent adult, and a waiver of legal rights is not a substitute for consent. The signed form should be documented and stored securely.
