MES Chronic Disease Management & Exercise Prescription 2 — Questions and Answers
Question 1: Which outcome measure is most appropriate for tracking functional progress in a client with Parkinson's disease enrolled in an exercise program?
- 1-repetition maximum bench press
- Timed Up and Go (TUG) test (Correct answer)
- VO2 max treadmill test
- Wingate anaerobic power test
Correct answer: Timed Up and Go (TUG) test
The Timed Up and Go test measures functional mobility, balance, and fall risk — outcomes directly relevant to Parkinson's disease management.
Question 2: In clients with metabolic syndrome, which exercise combination most effectively addresses insulin resistance and dyslipidemia simultaneously?
- Static stretching only
- Combination of moderate aerobic training and resistance training (Correct answer)
- High-volume endurance at low intensity exclusively
- Isolated flexibility and relaxation techniques
Correct answer: Combination of moderate aerobic training and resistance training
Combined aerobic and resistance training improves insulin sensitivity through GLUT-4 upregulation while also reducing triglycerides and improving HDL cholesterol.
Question 3: What is the primary exercise consideration for a client who underwent a coronary artery bypass graft (CABG) surgery 8 weeks ago?
- Avoidance of all upper body exercise indefinitely
- Sternal precautions limiting upper extremity loading until sternotomy heals (Correct answer)
- Immediate return to vigorous aerobic training
- Resistance training of the chest as first priority
Correct answer: Sternal precautions limiting upper extremity loading until sternotomy heals
Sternal precautions typically restrict upper extremity loading for 6–12 weeks post-CABG to allow the sternotomy incision to heal and prevent wound dehiscence.
Question 4: Which exercise modification is most appropriate for a client with peripheral neuropathy who reports reduced foot sensation?
- Barefoot balance training on unstable surfaces
- Seated or supported exercises that reduce fall risk and foot stress (Correct answer)
- Heavy loaded carries to improve proprioceptive feedback
- High-impact jumping to stimulate nerve regeneration
Correct answer: Seated or supported exercises that reduce fall risk and foot stress
Reduced foot sensation impairs balance and injury awareness, making seated or supported exercises safer to prevent falls and undetected skin breakdown.
Question 5: For a client with osteoporosis, which exercise type should be avoided due to high spinal fracture risk?
- Walking on level surfaces
- Forward trunk flexion under load (e.g., loaded crunches, toe touches) (Correct answer)
- Standing hip abduction
- Seated chest press on a machine
Correct answer: Forward trunk flexion under load (e.g., loaded crunches, toe touches)
Loaded spinal flexion creates excessive anterior compressive forces on osteoporotic vertebrae, significantly elevating the risk of compression fractures.
Question 6: Which medication class commonly used in cardiac clients can blunt the heart rate response and limit the utility of heart rate-based exercise intensity prescriptions?
- ACE inhibitors
- Beta-blockers (Correct answer)
- Statins
- Diuretics
Correct answer: Beta-blockers
Beta-blockers reduce heart rate response to exercise by blocking sympathetic stimulation of cardiac beta-1 receptors, necessitating RPE-based intensity monitoring instead.
MES Chronic Disease Management & Exercise Prescription 2
Which outcome measure is most appropriate for tracking functional progress in a client with Parkinson's disease enrolled in an exercise program?