ACSM Health Assessment 2 — Questions and Answers
Question 1: Which component of the health history is most important to review before conducting a maximal exercise test?
- Surgical history
- Cardiovascular symptoms and risk factors (Correct answer)
- Family income and occupation
- Sleep patterns over the past month
Correct answer: Cardiovascular symptoms and risk factors
Cardiovascular symptoms and risk factors directly affect the safety and appropriateness of maximal exercise testing.
Question 2: A client's resting blood pressure reads 148/92 mmHg on two separate occasions. According to ACSM guidelines, how should this be classified?
- Normal
- Elevated
- Stage 1 Hypertension (Correct answer)
- Stage 2 Hypertension
Correct answer: Stage 1 Hypertension
Stage 1 Hypertension is defined as systolic 130–139 mmHg or diastolic 80–89 mmHg; 148/92 falls in Stage 2 (≥140/90), but per updated 2017 ACC/AHA guidelines adopted by ACSM, 148/92 is Stage 2 Hypertension.
Question 3: During a health appraisal, a 52-year-old male reports smoking 1 pack per day for 30 years. How does this factor into ACSM cardiovascular risk stratification?
- It is not a cardiovascular risk factor
- It counts as one positive risk factor (Correct answer)
- It counts as two positive risk factors due to duration
- It automatically requires physician clearance
Correct answer: It counts as one positive risk factor
Current cigarette smoking (or quitting within the past 6 months) counts as one positive cardiovascular disease risk factor regardless of pack-year history.
Question 4: What is the primary purpose of the Physical Activity Readiness Questionnaire (PAR-Q+)?
- To measure aerobic capacity
- To screen for contraindications before initiating exercise (Correct answer)
- To assess dietary habits
- To evaluate musculoskeletal strength
Correct answer: To screen for contraindications before initiating exercise
The PAR-Q+ is a self-administered pre-exercise screening tool designed to identify individuals who may need medical clearance before starting physical activity.
Question 5: When measuring waist circumference, where should the tape measure be placed?
- At the level of the iliac crest (Correct answer)
- At the narrowest point of the torso
- Just above the umbilicus
- At the level of the greater trochanters
Correct answer: At the level of the iliac crest
ACSM recommends measuring waist circumference at the level of the iliac crest, at the end of a normal expiration.
Question 6: A client with a resting heart rate of 88 bpm, BMI of 31, and no other risk factors asks about exercise. What ACSM pre-participation screening recommendation applies?
- Immediate physician referral required
- No risk factors present; begin exercise freely
- Light-to-moderate exercise is acceptable; vigorous exercise requires medical clearance (Correct answer)
- Exercise is contraindicated until BMI is reduced
Correct answer: Light-to-moderate exercise is acceptable; vigorous exercise requires medical clearance
ACSM's 2015 updated guidelines allow low-to-moderate exercise without clearance for most individuals but recommend medical consultation before vigorous exercise if risk factors are present.
Question 7: Which finding during resting ECG would be an absolute contraindication to exercise testing?
- Sinus bradycardia at 55 bpm
- Second-degree AV block Type I (Wenckebach)
- Uncontrolled symptomatic arrhythmia (Correct answer)
- Mild ST-segment depression at rest
Correct answer: Uncontrolled symptomatic arrhythmia
Uncontrolled symptomatic cardiac arrhythmias are an absolute contraindication to exercise testing because they pose an immediate risk of hemodynamic compromise.
ACSM Health Assessment 2
Which component of the health history is most important to review before conducting a maximal exercise test?