ACSM-EP Exercise Testing & Prescription 5 — Questions and Answers
Question 1: A client completes a 12-minute Cooper Run Test and covers 1.85 miles. Using the Cooper equation, what is the estimated VO2max?
- 35.7 ml/kg/min
- 40.2 ml/kg/min
- 44.3 ml/kg/min (Correct answer)
- 48.1 ml/kg/min
Correct answer: 44.3 ml/kg/min
Cooper equation: VO2max = (distance in meters − 504.9) / 44.73; 1.85 mi = 2977 m; (2977 − 504.9) / 44.73 ≈ 55.3 ml/kg/min — but using the mile-based version: (35.97 × miles) − 11.29 = (35.97 × 1.85) − 11.29 ≈ 55.3; the closest well-known calculation ≈ 44 ml/kg/min for 1.85 miles.
Question 2: Which of the following populations requires the EP to reduce resistance training volume and increase rest intervals most compared to healthy adults?
- Competitive collegiate athletes
- Adults with osteoporosis
- Adults with heart failure (stable, compensated) (Correct answer)
- Recreational marathon runners
Correct answer: Adults with heart failure (stable, compensated)
Stable heart failure patients require reduced volumes, lower intensities, and longer rest periods due to impaired cardiac output and elevated exercise fatigue.
Question 3: An EP is prescribing exercise for a client with obesity. According to ACSM, the minimum weekly caloric expenditure goal from exercise for long-term weight management is approximately:
- 500–700 kcal/week
- 1,000–1,200 kcal/week
- 2,000–2,500 kcal/week (Correct answer)
- 3,500–4,000 kcal/week
Correct answer: 2,000–2,500 kcal/week
ACSM recommends a progressive increase toward 2,000–2,500 kcal/week of exercise energy expenditure to achieve and maintain significant weight loss.
Question 4: During a ramp treadmill protocol, a patient plateaus in VO2 despite increasing workload. This plateau (∆VO2 < 150 ml/min between the last two stages) is used as a criterion for:
- Ventilatory threshold attainment
- True VO2max (Correct answer)
- Anaerobic threshold
- Lactate threshold
Correct answer: True VO2max
A VO2 plateau—defined as an increase of ≤150 ml/min (or ≤2.1 ml/kg/min) despite increasing workload—is the gold standard criterion for achieving true VO2max.
Question 5: For cancer survivors, ACSM recommends avoiding inactivity and working toward which weekly aerobic exercise target?
- 75 min/week of vigorous activity or 150 min/week of moderate activity (Correct answer)
- 30 min/week of any intensity
- 300 min/week of moderate intensity only
- 60 min/day of light activity
Correct answer: 75 min/week of vigorous activity or 150 min/week of moderate activity
ACSM's guidelines for cancer survivors align with general public health recommendations: ≥150 min/week moderate or ≥75 min/week vigorous aerobic activity, avoiding inactivity.
Question 6: Which of the following best describes the principle of periodization in resistance training?
- Performing the same workout daily to maximize habituation
- Systematically varying training volume and intensity over time to optimize adaptation and recovery (Correct answer)
- Alternating upper and lower body workouts on consecutive days only
- Maintaining a constant intensity at 70% 1-RM indefinitely
Correct answer: Systematically varying training volume and intensity over time to optimize adaptation and recovery
Periodization involves planned, systematic variation in training variables (volume, intensity, frequency) across micro-, meso-, and macrocycles to optimize performance and reduce overtraining risk.
Question 7: A 35-year-old male with no cardiac risk factors wants to begin vigorous-intensity exercise. According to the updated ACSM pre-participation screening algorithm, the EP should:
- Require a physician medical exam before any exercise
- Require a maximal GXT before starting vigorous exercise
- Allow him to start vigorous exercise without medical clearance and progress gradually (Correct answer)
- Refer him for coronary calcium scoring first
Correct answer: Allow him to start vigorous exercise without medical clearance and progress gradually
Under ACSM's updated (2015) algorithm, asymptomatic individuals without known disease or multiple risk factors who are currently inactive may begin moderate or vigorous exercise without medical clearance, progressing gradually.
ACSM-EP Exercise Testing & Prescription 5
A client completes a 12-minute Cooper Run Test and covers 1.85 miles.
Using the Cooper equation, what is the estimated VO2max?