ACSM Health Assessment 5 — Questions and Answers
Question 1: A 60-year-old female client reports a sedentary lifestyle and has a family history of heart disease. She denies symptoms. How many positive CVD risk factors does she have per ACSM?
- 1
- 2 (Correct answer)
- 3
- 4
Correct answer: 2
She has two positive risk factors: age (≥55 for women) and family history of premature CVD; sedentary lifestyle is also a risk factor, making it potentially 3, but age alone qualifies her for one.
Question 2: Which exercise test endpoint is considered an absolute indication to stop a graded exercise test?
- Heart rate reaching 85% of age-predicted maximum
- Subject requests to stop due to leg fatigue
- Drop in systolic BP >10 mmHg from baseline with signs of ischemia (Correct answer)
- RPE reaching 17 on the Borg 6–20 scale
Correct answer: Drop in systolic BP >10 mmHg from baseline with signs of ischemia
A drop in systolic blood pressure ≥10 mmHg from baseline accompanied by ischemic signs is an absolute indication to terminate the exercise test immediately.
Question 3: In the ACSM risk classification framework, which condition automatically places a client in the 'known disease' category?
- Hypertension treated with medication
- Diagnosed peripheral arterial disease (Correct answer)
- Family history of myocardial infarction
- Obesity with BMI >30
Correct answer: Diagnosed peripheral arterial disease
Peripheral arterial disease is a cardiovascular disease that automatically places the client in ACSM's 'known cardiovascular, metabolic, or renal disease' category.
Question 4: What does the YMCA step test measure, and what variable is recorded to estimate aerobic fitness?
- Muscular endurance; number of steps completed
- Aerobic capacity; heart rate during stepping
- Aerobic capacity; heart rate recovery after stepping (Correct answer)
- Flexibility; time to complete the protocol
Correct answer: Aerobic capacity; heart rate recovery after stepping
The YMCA 3-minute step test estimates aerobic fitness by recording a 1-minute recovery heart rate after stepping; a lower recovery HR indicates better aerobic conditioning.
Question 5: When performing the ACSM health appraisal, which medical history item would most directly indicate a need for a physician's medical clearance before vigorous exercise?
- Prior ankle sprain requiring physical therapy
- Recent history of syncope during physical exertion (Correct answer)
- Mild seasonal allergies controlled with antihistamines
- A history of childhood asthma, currently asymptomatic
Correct answer: Recent history of syncope during physical exertion
Exertional syncope is a red-flag symptom suggesting possible cardiac or neurological cause and requires medical evaluation before vigorous exercise is prescribed.
Question 6: Which assessment method uses bioelectrical impedance to estimate body composition and is most affected by hydration status?
- Dual-energy X-ray absorptiometry (DEXA)
- Air displacement plethysmography (ADP)
- Bioelectrical impedance analysis (BIA) (Correct answer)
- Hydrostatic weighing
Correct answer: Bioelectrical impedance analysis (BIA)
BIA estimates fat-free mass by measuring electrical resistance; hydration level directly affects conductivity and can cause significant error in body fat estimates.
Question 7: During health assessment, a client's LDL cholesterol is measured at 142 mg/dL. According to ACSM CVD risk factor thresholds, how should this be classified?
- Optimal; no risk factor
- Borderline; monitor closely
- Positive risk factor for CVD (Correct answer)
- Negative (protective) risk factor
Correct answer: Positive risk factor for CVD
ACSM identifies LDL ≥130 mg/dL as a positive CVD risk factor; a value of 142 mg/dL exceeds this threshold and counts as one positive risk factor.
ACSM Health Assessment 5
A 60-year-old female client reports a sedentary lifestyle and has a family history of heart disease.
She denies symptoms.
How many positive CVD risk factors does she have per ACSM?