MES Pharmacology & Medication Effects on Exercise 2 — Questions and Answers
Question 1: A client with asthma uses a short-acting beta-2 agonist (e.g., albuterol) before exercise. The MES should understand this medication primarily:
- Significantly increases heart rate during exercise
- Causes bronchoconstriction after exercise ceases
- Dilates the airways to prevent exercise-induced bronchoconstriction (Correct answer)
- Reduces cardiac output during exercise
Correct answer: Dilates the airways to prevent exercise-induced bronchoconstriction
Short-acting beta-2 agonists like albuterol cause bronchodilation, preventing exercise-induced bronchoconstriction in clients with asthma.
Question 2: Long-term use of systemic corticosteroids (e.g., prednisone) most significantly impacts exercise programming by causing:
- Hypoglycemia during exercise
- Muscle atrophy, bone loss, and increased infection risk (Correct answer)
- Decreased resting heart rate
- Bronchodilation and improved exercise tolerance
Correct answer: Muscle atrophy, bone loss, and increased infection risk
Chronic corticosteroid use leads to muscle wasting, osteoporosis, and immunosuppression, requiring careful program design with low-impact resistance training.
Question 3: A client taking warfarin (an anticoagulant) should avoid which type of activity due to the greatest risk?
- Low-intensity aerobic walking
- Flexibility and stretching exercises
- High-impact or contact activities with bruising/bleeding risk (Correct answer)
- Water-based exercise
Correct answer: High-impact or contact activities with bruising/bleeding risk
Warfarin impairs blood clotting, so high-impact or contact sports dramatically increase the risk of dangerous bruising or internal bleeding.
Question 4: Metformin, commonly used for Type 2 diabetes, carries a rare risk of lactic acidosis. Which exercise condition would most increase this risk?
- Low-intensity walking for 30 minutes
- High-intensity exercise causing tissue hypoxia (Correct answer)
- Flexibility training
- Light resistance training with long rest intervals
Correct answer: High-intensity exercise causing tissue hypoxia
High-intensity exercise reduces tissue oxygenation and elevates lactate production; combined with metformin, this can rarely contribute to lactic acidosis.
Question 5: SSRIs (selective serotonin reuptake inhibitors) used for depression may create which exercise-related concern during prolonged endurance events?
- Significantly increased blood pressure during exercise
- Hyponatremia risk with excessive fluid intake (Correct answer)
- Blunted heart rate response to exercise
- Severe hypoglycemia in non-diabetic clients
Correct answer: Hyponatremia risk with excessive fluid intake
SSRIs can contribute to SIADH (syndrome of inappropriate antidiuretic hormone secretion), increasing hyponatremia risk when clients over-hydrate during prolonged exercise.
Question 6: Alpha-1 blockers (e.g., doxazosin) used for hypertension increase the risk of which exercise-related event?
- Severe hypertension during peak exercise
- Orthostatic hypotension and dizziness, especially post-exercise (Correct answer)
- Exercise-induced bronchospasm
- Hypoglycemia during prolonged exercise
Correct answer: Orthostatic hypotension and dizziness, especially post-exercise
Alpha-1 blockers cause vasodilation, and combined with blood pooling in muscles post-exercise, can produce significant blood pressure drops and dizziness.
Question 7: A client's physician has prescribed sublingual nitroglycerin for angina. The most important exercise consideration is:
- Monitor for exercise-induced hypoglycemia
- Avoid all exercise until angina is completely resolved
- Monitor for severe hypotension, especially during cool-down (Correct answer)
- Increase exercise intensity to improve coronary circulation
Correct answer: Monitor for severe hypotension, especially during cool-down
Nitroglycerin causes vasodilation; combined with decreased venous return during cool-down, it can result in significant hypotension requiring a gradual, prolonged cool-down.
MES Pharmacology & Medication Effects on Exercise 2
A client with asthma uses a short-acting beta-2 agonist (e.g., albuterol) before exercise.
The MES should understand this medication primarily: