MES Chronic Disease Management & Exercise Prescription 1 — Questions and Answers
Question 1: According to ACSM guidelines, what is the recommended target heart rate range for moderate-intensity aerobic exercise in clients with stable coronary artery disease?
- 30–40% HRR
- 40–60% HRR (Correct answer)
- 70–85% HRR
- Above 85% HRR
Correct answer: 40–60% HRR
ACSM recommends 40–60% heart rate reserve for moderate-intensity aerobic exercise in stable CAD clients to provide cardiovascular benefit while minimizing risk.
Question 2: Which exercise modality is most appropriate as an initial intervention for a deconditioned client with stage 3 chronic kidney disease (CKD)?
- High-intensity interval training (HIIT)
- Low-to-moderate intensity aerobic exercise with gradual progression (Correct answer)
- Maximal resistance training to failure
- Plyometric jump training
Correct answer: Low-to-moderate intensity aerobic exercise with gradual progression
Low-to-moderate intensity aerobic exercise allows safe cardiovascular and functional improvement without placing excessive metabolic or blood pressure stress on impaired kidneys.
Question 3: What is the most important pre-exercise precaution for a client with type 1 diabetes beginning an exercise program?
- Increasing insulin dose immediately before exercise
- Monitoring blood glucose and having fast-acting carbohydrates available (Correct answer)
- Exercising only in a fasted state
- Avoiding all exercise above moderate intensity
Correct answer: Monitoring blood glucose and having fast-acting carbohydrates available
Blood glucose monitoring before, during, and after exercise — along with access to fast-acting carbohydrates — is essential to prevent exercise-induced hypoglycemia in type 1 diabetes.
Question 4: Which symptom during exercise warrants immediate termination and physician referral for a client with cardiovascular disease?
- Mild dyspnea at 60% HRR
- Chest pain, pressure, or radiation to the arm or jaw (Correct answer)
- Slight increase in systolic blood pressure
- Transient muscle fatigue in the quadriceps
Correct answer: Chest pain, pressure, or radiation to the arm or jaw
Chest pain, pressure, or pain radiating to the arm or jaw during exercise is a cardinal warning sign of myocardial ischemia requiring immediate cessation and emergency evaluation.
Question 5: For a client with COPD, which parameter should be used alongside heart rate to guide exercise intensity?
- Body mass index
- Rating of Perceived Exertion (RPE) and dyspnea scale (Correct answer)
- Blood glucose level
- Serum lactate
Correct answer: Rating of Perceived Exertion (RPE) and dyspnea scale
RPE combined with a dyspnea scale (such as the modified Borg) provides a reliable, client-centered method to regulate intensity when heart rate may be blunted by medications or disease.
Question 6: What is the recommended rest period guideline between sets for clients with hypertension performing resistance training?
- 15–30 seconds
- At least 60–90 seconds to allow blood pressure recovery (Correct answer)
- 5 minutes between all sets
- No rest; circuit training only
Correct answer: At least 60–90 seconds to allow blood pressure recovery
Rest periods of at least 60–90 seconds between resistance sets allow blood pressure to recover toward baseline and reduce cumulative cardiovascular stress in hypertensive clients.
MES Chronic Disease Management & Exercise Prescription 1
According to ACSM guidelines, what is the recommended target heart rate range for moderate-intensity aerobic exercise in clients with stable coronary artery disease?