ACSM-EP Health Appraisal & Risk Assessment 4 — Questions and Answers
Question 1: When obtaining resting blood pressure, how long should a client be seated quietly before the measurement is taken?
- 1 minute
- 3–5 minutes (Correct answer)
- 10–15 minutes
- 30 minutes
Correct answer: 3–5 minutes
ACSM recommends the client sit quietly for a minimum of 5 minutes in a chair with feet flat on the floor before resting blood pressure is measured.
Question 2: A client's health history reveals they have metabolic syndrome. Which combination of findings would confirm this diagnosis using NCEP ATP III criteria?
- BMI > 30, LDL > 160 mg/dL, and fasting glucose > 126 mg/dL
- Three or more of: large waist circumference, high triglycerides, low HDL, high BP, high fasting glucose (Correct answer)
- Hypertension plus type 2 diabetes and obesity
- Elevated total cholesterol and two cardiovascular risk factors
Correct answer: Three or more of: large waist circumference, high triglycerides, low HDL, high BP, high fasting glucose
Metabolic syndrome is diagnosed when ≥3 of 5 criteria are met: abdominal obesity, elevated triglycerides, reduced HDL-C, elevated BP, and elevated fasting glucose.
Question 3: During body composition assessment using skinfold calipers, the technician should take each skinfold measurement:
- Immediately after exercise to maximize skin pliability
- On the left side of the body per standardized protocol
- In a rotating order, taking each site twice and averaging if measurements are within 1–2 mm
- Only on the right side of the body per ACSM standardization (Correct answer)
Correct answer: Only on the right side of the body per ACSM standardization
ACSM standardizes skinfold measurements on the right side of the body, with each site measured at least twice (in rotation) and averaged if within 1–2 mm.
Question 4: A client presents with a resting oxygen saturation (SpO2) of 91% measured by pulse oximetry. The appropriate response is to:
- Proceed with maximal exercise testing as planned
- Have the client breathe faster to increase SpO2 before testing
- Refer to a physician before conducting exercise testing (Correct answer)
- Administer supplemental oxygen and begin the test
Correct answer: Refer to a physician before conducting exercise testing
SpO2 below 95% at rest may indicate a pulmonary or cardiovascular condition that warrants physician evaluation before exercise testing.
Question 5: Which of the following best describes the purpose of the ACSM medical history questionnaire in health appraisal?
- To diagnose medical conditions and prescribe medications
- To identify known diseases, signs/symptoms, and CVD risk factors before exercise participation (Correct answer)
- To determine a client's exercise performance baseline
- To replace physician evaluation for all clients
Correct answer: To identify known diseases, signs/symptoms, and CVD risk factors before exercise participation
The medical history questionnaire identifies existing diagnoses, relevant signs and symptoms, and cardiovascular risk factors to guide safe exercise participation decisions.
Question 6: A 62-year-old sedentary client reports occasional lightheadedness and palpitations. Under the updated ACSM preparticipation screening guidelines, the MOST appropriate next step is to:
- Begin a light walking program immediately with no restrictions
- Refer to a physician prior to initiating any exercise program (Correct answer)
- Conduct a maximal graded exercise test before physician clearance
- Administer the PAR-Q+ and proceed if all answers are 'no'
Correct answer: Refer to a physician prior to initiating any exercise program
Signs and symptoms suggestive of cardiovascular or pulmonary disease (lightheadedness, palpitations) require physician clearance before exercise participation.
Question 7: When measuring waist circumference, where should the tape measure be placed according to ACSM standardized protocol?
- At the widest point of the hips
- At the level of the umbilicus (belly button)
- At the narrowest point of the torso, just above the iliac crest
- At the midpoint between the lowest rib and the iliac crest (Correct answer)
Correct answer: At the midpoint between the lowest rib and the iliac crest
ACSM protocol places the tape measure horizontally at the midpoint between the lowest rib and the iliac crest (superior border) to measure waist circumference.
ACSM-EP Health Appraisal & Risk Assessment 4
When obtaining resting blood pressure, how long should a client be seated quietly before the measurement is taken?