ACSM-EP Behavior Change & Client Communication 5 — Questions and Answers
Question 1: Which construct of Social Cognitive Theory describes a client's expectations about the outcomes of exercise?
- Self-efficacy
- Outcome expectations (Correct answer)
- Observational learning
- Behavioral capability
Correct answer: Outcome expectations
Outcome expectations are beliefs about the likely results of performing a behavior, such as expecting that exercise will improve energy levels.
Question 2: A client is ambivalent about starting an exercise program. Which motivational interviewing response BEST helps resolve ambivalence?
- Listing all the reasons the client should exercise immediately
- Asking the client to explore both the pros and cons of changing (Correct answer)
- Assuring the client that exercise is safe and not difficult
- Prescribing an exercise program and monitoring compliance
Correct answer: Asking the client to explore both the pros and cons of changing
Exploring both sides of ambivalence through a decisional balance exercise helps clients reach their own conclusions about the value of change.
Question 3: Which behavior change technique involves having a client track their daily physical activity in a log or app?
- Stimulus control
- Self-monitoring (Correct answer)
- Cognitive restructuring
- Social support mobilization
Correct answer: Self-monitoring
Self-monitoring through activity logs or apps increases awareness of behavior patterns and is one of the most effective techniques for supporting behavior change.
Question 4: A certified exercise physiologist suspects a client may be experiencing depression that is affecting exercise adherence. The MOST appropriate next step is to:
- Continue the exercise program as prescribed and monitor progress
- Screen with a validated tool and refer to a mental health professional if indicated (Correct answer)
- Prescribe aerobic exercise as an adjunct treatment for depression
- Discontinue the exercise program until the client's mental health improves
Correct answer: Screen with a validated tool and refer to a mental health professional if indicated
Exercise physiologists should use validated screening tools and refer appropriately, as managing depression is outside the scope of practice of an exercise physiologist.
Question 5: Which statement BEST describes the difference between intrinsic and extrinsic motivation in the context of exercise adherence?
- Intrinsic motivation is less stable over time than extrinsic motivation
- Intrinsic motivation arises from personal enjoyment and is associated with better long-term adherence (Correct answer)
- Extrinsic rewards such as prizes are the most effective long-term motivators
- Intrinsic and extrinsic motivation have equal effects on exercise adherence
Correct answer: Intrinsic motivation arises from personal enjoyment and is associated with better long-term adherence
Intrinsic motivation — driven by enjoyment, interest, or personal values — is consistently associated with greater long-term exercise adherence than extrinsic motivation.
Question 6: An exercise physiologist asks, 'On a scale from 0 to 10, how important is it to you to become more active?' This is an example of which motivational interviewing tool?
- Readiness ruler
- Importance ruler (Correct answer)
- Confidence ruler
- Change talk elicitation
Correct answer: Importance ruler
The importance ruler assesses how important the client perceives the change to be, helping the practitioner tailor their approach accordingly.
Question 7: Which communication style is MOST likely to elicit 'sustain talk' (reasons not to change) from a client?
- Using open-ended questions about the client's values
- Confronting the client directly about their unhealthy behavior (Correct answer)
- Reflecting the client's positive change statements
- Summarizing the client's ambivalence empathetically
Correct answer: Confronting the client directly about their unhealthy behavior
Direct confrontation tends to trigger defensiveness and sustain talk, as clients naturally argue against perceived threats to their autonomy.
ACSM-EP Behavior Change & Client Communication 5
Which construct of Social Cognitive Theory describes a client's expectations about the outcomes of exercise?