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ACSM 030-333

ACSM Exercise Specialist Exam


Version: 4.0
Topic 1, Volume A


QUESTION NO: 1


Which of the following is NOT an appropriate treatment activity for inpatient rehabilitation of a
client on the second day after coronary artery bypass graft (CABG) surgery?


A. Limit activities as tolerated to the development of self-care activities, ROM for extremities, and
low-resistance activities.
B. Limit upper body activities to biceps curls, horizontal arm adduction, and overhead press using
5-pound weights while sitting on the side of the bed.
C. Progress all activities performed from supine to sitting to standing.
D. Measure vital signs, symptoms, RPE, fatigue, and skin color and perform electrocardiography
before, during, and after treatments to assess activity tolerance.

Answer: B
Explanation:


QUESTION NO: 2


Which of the following situations indicates progression to independent and unsupervised exercise
for a client after CABG surgery in an outpatient program?


A. The client exhibits mild cardiac symptoms of angina, occurring intermittently during exercise
and sometimes at home while reading.
B. The client has a functional capacity of greater than 8 MET with hemodynamic responses
appropriate to this level of exercise.
C. The client is noncompliant with smoking cessation and weight loss intervention programs.
D. The client is unable to palpate HR, deliver RPEs, or maintain steady workload intensity during
activity.

Answer: B
Explanation:


QUESTION NO: 3


Which of the following issues would you include in discharge education instructions for a client
with congestive heart failure to avoid potential emergency situations related to this condition at
home?


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A. Record body weight daily, and report weight gains to a physician.
B. Note signs and symptoms (e.g., dyspnea, intolerance to activities of daily living), and report
them to a physician.
C. Do not palpate the pulse during daily activities or periods of light- headedness, because an
irregular pulse is normal and occurs at various times during the day.
D. Both A and B.

Answer: D
Explanation:


QUESTION NO: 4


Initial training sessions for a person with severe chronic obstructive pulmonary disease most likely
would NOT include


A. Continuous cycling activity at 70% of Vo2 max for 30 minutes.
B. Use of dyspnea scales, RPE scales, and pursed-lip breathing instruction.
C. Intermittent bouts of activity on a variety of modalities (exercise followed by short rest).
D. Encouraging the client to achieve an intensity either at or above the anaerobic threshold.

Answer: A
Explanation:


QUESTION NO: 5


Symptoms of claudication include


A. Cramping, burning, and tightness in the calf muscle, usually triggered by activity and relieved
with rest.
B. Acute, sharp pain in the foot on palpation at rest.
C. Crepitus in the knee during cycling.
D. Pitting ankle edema at a rating of 3 +

Answer: A
Explanation:


QUESTION NO: 6


Treatment for claudication during exercise includes all of the following EXCEPT

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A. Daily exercise sessions.
B. Intensity of activity to maximal tolerable pain, with intermittent rest periods.
C. Cardiorespiratory building activities that are nonweight bearing if the plan is to work on longer
duration and higher intensity to elicit a cardiorespiratory training effect.
D. Stopping activity at the onset of claudication discomfort to avoid further vascular damage from
ischemia.

Answer: D
Explanation:


QUESTION NO: 7


A client with angina exhibits symptoms and a 1mm, down-sloping ST- segment depression at a
HR of 129 bpm on his exercise test. His peak exercise target HR should be set at


A. 128 bpm.
B. 109 to 119 bpm.
C. 129 bpm.
D. 125 to 128 bpm.

Answer: B
Explanation:


QUESTION NO: 8


Special precautions for clients with hypertension include all of the following EXCEPT:


A. Avoiding muscle strengthening exercises that involve low resistance.
B. Avoiding activities that involve the Valsalva maneuver.
C. Monitoring a client who is taking diuretics for arrhythmias.
D. Avoiding exercise if resting systolic BP is greater than 200 mm Hg or diastolic BP is greater
than 115 mm Hg.

Answer: A
Explanation:


QUESTION NO: 9


According to the most recent National Institutes of Health's Clinical Guidelines for the

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Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, recommendations
for practical clinical assessment include


A. Determining total body fat through the BMI to assess obesity.
B. Determining the degree of abdominal fat and health risk through waist circumference.
C. Using the waist-to-hip ratio as the only definition of obesity and lean muscle mass.
D. Both A and B.

Answer: D
Explanation:


QUESTION NO: 10


A client with type 1 diabetes mellitus checks her fasting morning glucose level on her whole-blood
glucose meter (fingerstick method), and the result of 253 mgldL (14 mmol/L). A urine test is
positive for ketones before her exercise session. What action should you take?


A. Allow her to exercise as long as her glucose is not greater than 300 mgldL (17 mmol/L).
B. Not allow her to exercise this session, and notify her physician of the findings.
C. Give her an extra carbohydrate snack, and wait 5 minutes before beginning exercise.
D. Readjust her insulin regimen for the remainder of the day to compensate for the high morning
glucose level.

Answer: B
Explanation:


QUESTION NO: 11


A 62-year-old, obese factory worker complains of pain in his right shoulder on arm abduction; on
evaluation, decreased ROM and strength are noted. You also notice that he is beginning to use
accessory muscles to substitute movements and to compensate. These symptoms may indicate


A. A referred pain from a herniated lumbar disk.
B. Rotator cuff strain or impingement.
C. angina.
D. Advanced stages of multiple sclerosis.

Answer: B
Explanation:


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QUESTION NO: 12


All of the following are special considerations inprescribing exercise for the client with arthritis
EXCEPT


A. The possible need to splint painful joints forprotection.
B. Periods of acute inflammation result in decreased pain and joint stiffness.
C. The possibility of gait abnormalities as compensation for pain or stiffness.
D. The need to avoid exercise of warm, swollenjoints.

Answer: B
Explanation:


QUESTION NO: 13


What common medication taken by clients with end-stage renal disease requires careful
management for those undergoing hemodialysis?


A. Antihypertensive medication.
B. Lithium.
C. Cholestyramine.
D. Cromolyn sodium.

Answer: A
Explanation:


QUESTION NO: 14


Which of the following is an appropriate exercise for clients with diabetes and loss of protective
sention in the extremities?


A. Prolonged walking.
B. Jogging.
C. Step-class exercise.
D. Swimming.

Answer: D
Explanation:


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QUESTION NO: 15


A client taking a calcium-channel blocker most likely will exhibit which of the following responses
during exercise?


A. Hypertensive response.
B. Increased ischemia.
C. Improved anginal thresholds.
D. Severe hypotension.

Answer: C
Explanation:


QUESTION NO: 16


During the cool-down phase of an exercise session, clients should be encouraged to


A. Rehydrate.
B. Decrease the intensity of activity quickly to decrease cardiac afterload.
C. Limit the cool-down period to 5 minutes.
D. Increase the number of isometric activities.

Answer: A
Explanation:


QUESTION NO: 17


Muscular endurance training is best accomplished by


A. Performing four to six repetitions per set.
B. Using high resistance.
C. Incorporating high repetitions.
D. Performing isometric exercises only.

Answer: C
Explanation:


QUESTION NO: 18

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Transitional care exercise and rehabilitation programs are NOT appropriate for


A. Clients with functionally limiting chronicdisease.
B. Clients with comorbid disease states.
C. Asymptomatic clients with a functional capacity of 10 MET.
D. Clients at 1 week after CABG surgery.

Answer: C
Explanation:


QUESTION NO: 19


Many clients have WI-mode programmed pacemakers. Which of the following is TRUE regarding
exercise programming with WI pacemakers?


A. Persons with WI pacemakers may be chronotropically (HR) competent with exercise but require
longer warm-up and gradual increase in intensity during the initial exercise portion of their session.
B. Persons who are chronotropically competent are tachycardic at rest and should not exercise at
low intensities.
C. BP response is not a good marker of intensity effort in those with WI pacemakers and need not
be evaluated during an exercise session.
D. Persons with WI pacemakers must avoid exercise on the bicycle ergometer because of the
location of the ventricular lead wire and potential for displacement.

Answer: A
Explanation:


QUESTION NO: 20


Controlling pool water temperature (83-88F), avoiding jarring and weight- bearing activities, and
avoiding movement in swollen, inflamed joints are special considerations for exercise in


A. Clients after atherectomy.
B. Clients with angina.
C. Clients with osteoporosis.
D. Clients with arthritis.

Answer: D
Explanation:


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QUESTION NO: 21


Which of the following is a resistive lung disease?


A. Asthma.
B. Tuberculosis.
C. Cystic fibrosis.
D. Emphysema.

Answer: B
Explanation:


QUESTION NO: 22


A specific benefit of regular exercise for patients with angina is


A. Improved ischemic threshold at which angina symptoms occur.
B. Increased myocardial oxygen demand at the same submaximallevels.
C. Eradication of all symptoms.
D. Elevation of BP.

Answer: A
Explanation:


QUESTION NO: 23


Which of the following is NOT a benefit of increased flexibility?


A. Increased muscle viscosity, allowing easier and smoother contractions.
B. Reduced muscle tension and increased relaxation.
C. Improved coordination by allowing greater ease of movement.
D. Increased ROM.

Answer: A
Explanation:


QUESTION NO: 24


Which of the following statements regarding warm-up is FALSE?
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A. Muscle blood flow is increased as a result of warm-up.
B. Peripheral vasodilation occurs as a result of warm-up.
C. Peripheral vasoconstriction occurs as a result of warm-up.
D. Between 5 and 10 minutes should be allotted for a warm-up period.

Answer: C
Explanation:


QUESTION NO: 25


Which of the following statements regarding cooldown is FALSE?


A. The emphasis should be large muscle activity performed at a low to moderate intensity.
B. Increasing venous return should be a priority during cool-down.
C. The potential for improving flexibility may be improved during cool-down as compared with
warm-up.
D. Between 1 and 2 minutes are recommended for an adequate cool-down.

Answer: D
Explanation:


QUESTION NO: 26


All of the following are examples of aerobic exercise modalities EXCEPT


A. Weight training.
B. Walking.
C. Bicycling.
D. Stair climbing.

Answer: A
Explanation:


QUESTION NO: 27


A target HR equivalent to 85% of HRR for a 25year-old male with a resting HR of 75

bpm would be equal to


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A. 195 bpm.
B. 166 bpm.
C. 177 bpm.
D. 102 bpm.

Answer: C
Explanation:


QUESTION NO: 28


The appropriate exercise HR for an individual on -blocking medication would generally

be


A. 75% of HRR.
B. 30 bpm above the standing resting HR.
C. 40% of HRR.
D. (220 - age) X 0.85.

Answer: A
Explanation:


QUESTION NO: 29


The recommended cardiorespiratory exercise training goal for apparently healthy individuals
should be


A. 15 minutes, six times per week, at 90% of HRR.
B. 30 minutes, three times per week, at 85% of HRR.
C. 60 minutes, three times per week, at 85% of HRR.
D. 30 minutes of weight training, three times per week, at 60% of HRR.

Answer: B
Explanation:


QUESTION NO: 30


In an effort to improve flexibility, the ACSM recommends


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A. Proprioceptive neuromuscular facilitation.
B. Ballistic stretching.
C. The plough and hurdler's stretches.
D. Static stretches held for 10 to 30 seconds per repetition.

Answer: D
Explanation:


QUESTION NO: 31


An appropriate exercise for improving the strength of the low back muscles are


A. Straight leg lifts.
B. Parallel squats.
C. Spinal extension exercises.
D. Sit-ups with feet anchored.

Answer: C
Explanation:


QUESTION NO: 32


Which of the following statements true regarding exercise leadership is FALSE?


A. The exercise leader should be fit enough to exercise with any of his or her participants.
B. Most people are not bored by exercise and can easily find time to participate in an exercise
program.
C. The exercise leader should adjust the exercise intensity based on individual differences in
fitness.
D. Periodic fitness assessment may provide evidence of improvement in fitness for some
participants.

Answer: B
Explanation:


QUESTION NO: 33


Which of the following statements regarding exercise for the elderly is FALSE?


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A. A decrease in maximal HR is responsible for reductions in the maximal oxygen consumption as
we age.
B. A loss of fat-free mass is responsible for the decrease in muscular strength as we age.
C. The ACSM recommends a cardiorespiratory training intensity of 50% to 70% of HRR for older
adults.
D. Resistance exercise training is not recommended for older adults.

Answer: D
Explanation:


QUESTION NO: 34


Which of the following medications have been shown to be most effective in preventing or
reversing exercise-induced asthma?


A. 2-Agonists.
B. -Blockers.
C. Diuretics.
D. Aspirin.

Answer: A
Explanation:


QUESTION NO: 35


The exercise leader or health/fitness instructor should modify exercise sessions for participants
with hypertension by


A. Shortening the cool-down to less than 5 minutes.
B. Eliminating resistance training completely.
C. Prolonging the cool-down.
D. Implementing high-intensity (>85% of HRR), short-duration intervals.

Answer: C
Explanation:


QUESTION NO: 36


Normal values for fasting blood sugar are

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A. Greater than 140 mg/dL.
B. Between 60 and 140 mg/dL.
C. Less than 60 mg/dL.
D. Between 200 and 400 mg/dL.

Answer: B
Explanation:


QUESTION NO: 37


The goal for the obese exercise participant should be to


A. Sweat as much as possible.
B. Exercise at 85% of HRR.
C. Perform resistance exercise three to five times per week.
D. Expend 300 to 500 calories per exercise session.

Answer: D
Explanation:


QUESTION NO: 38


Which of the following statements regarding exercise for persons with controlled cardiovascular
disease is TRUE?


A. Resistance exercise training is dangerous and should be avoided.
B. A physician-supervised exercise test is not necessary to establish exercise intensity.
C. Anginal pain is normal during exercise, and participants should be pushed through the pain.
D. Exercise intensity should be set at an HR of 10 bpm less than the level at which
signs/symptoms were evidenced during an exercise test.

Answer: D
Explanation:


QUESTION NO: 39


All of the following factors are important to consider when determining exercise intensity

EXCEPT

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A. An individual's level of fitness.
B. The risk of cardiovascular or orthopedic injury.
C. Any previous history participating in organized sports.
D. Individual preference and exercise objectives.

Answer: C
Explanation:


QUESTION NO: 40


When determining the intensity level, the RPE is a better indicator than percentage of maximal HR
for all of the following groups EXCEPT


A. Individuals on -blockers.
B. Aerobic classes that involve excessive arm movement.
C. Individuals older than 65 years.
D. Individuals involved in high-intensity exercise.

Answer: D
Explanation:


QUESTION NO: 41


Using the original Borg scale, it is recommended that the exercise intensity elicit an RPE within the
range of


A. 8 to 12.
B. 12 to 16.
C. 14 to 18.
D. 6 to 10.

Answer: B
Explanation:


QUESTION NO: 42


The MINIMAL duration of exercise necessary to achieve improvements in health for deconditioned
individuals is


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A. 20 minutes continuously.
B. 30 minutes continuously.
C. Multiple sessions of more than 10 minutes in duration throughout the day.
D. Two sessions of 20 minutes throughout the day.

Answer: C
Explanation:


QUESTION NO: 43


Which of the following is a method of strength and power training that involves an eccentric
loading of muscles and tendons followed immediately by an explosive concentric contraction?


A. Super sets.
B. Split routines.
C. Plyometrics.
D. Periodization.

Answer: C
Explanation:


QUESTION NO: 44


The safety of resistance exercise is dependent on all of the following except


A. Having a personal trainer.
B. Proper breathing.
C. Speed of movement.
D. Body mechanics.

Answer: A
Explanation:


QUESTION NO: 45


The recommended muscular strength and endurance training program for apparently healthy
individuals should be


A. One set of 8 to 12 reps, 8 to 10 separate exercises, 2 days per week.
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B. Two sets of six to eight reps, 8 to 10 separate exercises, 2 days per week.
C. One set of 8 to 12 reps, 8 to 10 separate exercises, 4 to 5 days per week.
D. Two sets of six to eight reps, 8 to 10 separate exercises, 4 days per week, and alternating days
for legs and upper body.

Answer: A
Explanation:


QUESTION NO: 46


Which the following statements regarding intensity of resistance training is FALSE?


A. The number of repetitions to volitional fatigue will vary inversely with resistance.
B. It is necessary to determine the 1- RM to establish training intensity.
C. Exercise to volitional fatigue is not dangerous from a musculoskeletal standpoint provided that
good exercise form is maintained.
D. Exercise intensity should be similar for males and females.

Answer: B
Explanation:


QUESTION NO: 47


The recommended cardiorespiratory endurance exercise training program for older individuals
should be


A. 40% to 60% of maximum HR, 20 to 30 minutes continuously, 3 days per week.
B. 50% to 70% of HRR, 20 to 30 minutes (multiple sessions of 5-10 min), 3 days per week.
C. 40% to 60% of maximum HR, 20 to 30 minutes (multiple sessions of 5-10 min), 3 days per
week.
D. 50% to 70% of HRR, 20 to 30 minutes continuously, 3 days per week

Answer: B
Explanation:


QUESTION NO: 48


Osteoporosis is more prevalent in


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A. Women who have never been pregnant.
B. African-American women.
C. Women who are involved in activities that place stress on the wrists, hips, or lum bosacral
region.
D. Postmenopausal women.

Answer: D
Explanation:


QUESTION NO: 49


The eating habits of an athlete involved in long distance running should differ from those of a
sedentary individual of the same body weight in what way?


A. The athlete should reduce fat intake to 10% of total calories.
B. The athlete should increase protein intake to threefold the RDA.
C. The athlete should have a greater intake of grains, fruits, vegetables, and lean sources of
protein.
D. There should be no change in calories.

Answer: C
Explanation:


QUESTION NO: 50


Fiber is a type of carbohydrate that is not digestible (e.g., it will pass through the digestive system
without being absorbed). The NCEP ATPIII guidelines recommend that soluble (viscous) fiber be
included in the diet for the prevention and treatment of elevated blood lipid concentrations.
Sources of soluble (viscous) fibers include


A. Fruits, beans, and oats.
B. Meat and dairy foods.
C. Wheat bran and whole wheat products.
D. All of the above.

Answer: A
Explanation:


QUESTION NO: 51

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The BMI is calculated using which of the following formulas?


A. Weight/hip circumference.
B. Weight/height2.
C. Height/weight2.
D. Hip circumference/height.

Answer: B
Explanation:


QUESTION NO: 52


A common measure to assist in the evaluation of body fat distribution is


A. Height/weight charts.
B. Total body weight.
C. WHR.
D. Total body water.

Answer: C
Explanation:


QUESTION NO: 53


Carbohydrate, protein, and fat provide which of the following amounts of energy (kcal/g)?


A. 2, 4, and 6, respectively.
B. 4, 6, and 8, respectively.
C. 6, 8, and 9, respectively.
D. 4, 4, and 9, respectively.

Answer: D
Explanation:


QUESTION NO: 54


If total daily caloric consumption is 2,400 kcal and the total fat in that diet is 30%, how many grams
of fat per day would be consumed?

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A. 80.
B. 70.
C. 90.
D. 75.

Answer: A
Explanation:


QUESTION NO: 55


When the body consumes more calories than it uses, the condition is called


A. Ketogenesis.
B. Positive caloric balance.
C. Positive electrolyte balance.
D. Negative energy balance.

Answer: B
Explanation:


QUESTION NO: 56


Diets high in saturated fat can lead to elevations in blood ______ concentration, which may
increase risk of heart disease. Optimal concentrations of this blood lipoprotein are___


A. Very LDL-C, <120 mg/dL.
B. LDL-C, <125 mg/dL.
C. HDL-C, >30 mg/dL.
D. LDL-C, <100 mg/dL.

Answer: D
Explanation:


QUESTION NO: 57


An ideal weight-loss program should set a goal of _ pounds per week, with an energy intake of not
less than _ kcal/day.


A. 10, 1,600.
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B. 3-5, 1,500.
C. 1-2, 1,200.
D. None of the above.

Answer: C
Explanation:


QUESTION NO: 58


Athletes who exercise in the heat and humidity have a special need for fluid replacement.

Current guidelines suggest that athletes should


A. Consume 16 to 24 fluid ounces of water for every pound of weight lost.
B. Drink nothing but alcoholic beverages after engaging in exercise.
C. Avoid drinking water after exercise because of the danger of cramps.
D. Eat salt tablets with every meal during the hot summer months.

Answer: A
Explanation:


QUESTION NO: 59


When counseling a patient with metabolic syndrome, your emphasis should be on addressing
underlying causes of the syndrome, such as


A. Obesity and physical inactivity.
B. Excessive carbohydrate intake.
C. Elevated LDL-C concentration.
D. Lack of muscular strength.

Answer: A
Explanation:


QUESTION NO: 60


Which of the following medical conditions is NOT part of the female athlete triad?


A. Disordered eating.
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B. Osteoporosis.
C. Amenorrhea.
D. Anemia.

Answer: D
Explanation:


QUESTION NO: 61


Which of the following waist circumference measurements indicates abdominal obesity?


A. 0.98.
B. >29.9
C. 43 inches
D. All of the above.

Answer: C
Explanation:


QUESTION NO: 62


What is the optimal approach for long-term management of body weight?


A. Hypocaloric diet.
B. Daily aerobic exercise.
C. Resistance training.
D. A low-fat, high-fiber diet and daily physical activity.

Answer: D
Explanation:


QUESTION NO: 63


Which eating disorder is marked by an overwhelming fear of becoming fat, a distorted body image,
and extreme restrictive eating?


A. Bulimia.
B. Anorexia nervosa.
C. Chronic dieting.
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D. Yo-yo dieting.

Answer: B
Explanation:


QUESTION NO: 64


Which of the following is not a feature of the metabolic syndrome?


A. Dyslipidemia (low HDL-C, elevated triglycerides).
B. Osteoporosis.
C. Insulin resistance.
D. Elevated blood pressure.

Answer: B
Explanation:


QUESTION NO: 65


All of the following are helpful suggestions for an athlete trying to gain weight EXCEPT


A. Increase portion sizes at meals.
B. Eat more high-calorie foods (e.g., candy bars, soft drinks).
C. Eat one extra meal per day.
D. Snack on energy- and nutrient-dense foods (e.g., fig bars, nuts and dried fruit).

Answer: B
Explanation:


QUESTION NO: 66


Athletes may have protein needs greater than those of sedentary individuals. What level of protein
intake is the recommended UL for athletes?


A. 0.8 g/kg.
B. 1.4 g/kg.
C. 2.2 g/kg.
D. 1.7 g/kg.

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Answer: D
Explanation:


QUESTION NO: 67


What is an appropriate initial weight loss goal for an obese individual desiring weight reduction?


A. 10%initial body weight in first 6 months.
B. 20 pounds in 2 months.
C. 5 pounds per week for the first 6 weeks, then weight maintenance.
D. BMI of less than 18.5.

Answer: A
Explanation:


QUESTION NO: 68


Women are likely to be deficient in both calcium and iron, because


A. They tend to consume less overall energy than men.
B. They tend to consume less dairy products.
C. They tend to consume less protein from meat sources.
D. All of the above.

Answer: D
Explanation:


QUESTION NO: 69


Which of the following foods would be in the group recommended to comprise most of the daily
energy intake according to the Food Guide Pyramid?


A. Oranges.
B. Yogurt.
C. Pasta.
D. Olive oil.

Answer: C
Explanation:
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QUESTION NO: 70


Which of the following diseases is NOT typically associated with obesity?


A. Diabetes.
B. Skin cancer.
C. Coronary artery disease.
D. Colon cancer.

Answer: B
Explanation:


QUESTION NO: 71


To lose one pound (=0.5 kg) of body fat, how much of an energy deficit must be created

by diet and or physical activity?


A. 2,000 kcal.
B. 2,500 kcal.
C. 3,000 kcal.
D. 3,500 kcal.

Answer: D
Explanation:


QUESTION NO: 72


Which fat-soluble vitamin is important for bone formation?


A. Vitamin A.
B. Vitamin D.
C. Vitamin E.
D. Vitamin K.

Answer: B
Explanation:

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QUESTION NO: 73


Which energy source represents the largest potential energy store in the body?


A. Fat.
B. Blood glucose.
C. Muscle glycogen.
D. Protein.

Answer: A
Explanation:


QUESTION NO: 74


In a budget for a clinical exercise rehabilitation program, all of the following are examples of
variable expenses EXCEPT


A. ECG electrodes.
B. Temporary wages.
C. Rental fees for the facility space.
D. Consultant fees.

Answer: C
Explanation:


QUESTION NO: 75


Which of the following statements about a clinical exercise rehabilitation program's mission
statement is NOT correct?


A. Perhaps the most important feature of the mission statement is its clarity or understandability.
B. The mission statement should elucidate the program's goals.
C. There should be a different mission statement for each program or, perhaps, even a different
mission statement for each component of a program.
D. A program's mission statement generally is fixed.

Answer: D
Explanation:


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QUESTION NO: 76


A program's policy and procedures manual should NOT


A. Be stored away for safekeeping.
B. Be revised as the program's policies and/or procedures are modified.
C. Be viewed as a document in progress.
D. Contain program information ranging from the organizational structure to the
facility's maintenance schedule.

Answer: A
Explanation:


QUESTION NO: 77


A comprehensive patient care plan is necessary for effective program management, because it


A. Is required by federal law.
B. Provides a "road map" for interventions.
C. Is a requirement for insurance reimbursement.
D. Provides raw data for analysis in CQI or outcomes assessment.

Answer: B
Explanation:


QUESTION NO: 78


The process of risk stratification often is used for the criteria for clinical exercise rehabilitation
program admission. Which of the following statements about risk stratification is NOT correct?


A. Risk stratification can be modeled after the criteria published by the AACVPR.
B. Risk stratification can be useful for participant entry criteria, exercise testing guidelines, ECG
monitoring, and supervision guidelines.
C. Risk stratification can be tied to insurance reimbursement.
D. Risk stratification often is used to determine the intensity of prescribed exercise.

Answer: D
Explanation:


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QUESTION NO: 79


Which of the following statements about confidentiality is NOT true?


A. All records must be kept by the program director/manager under lock and key.
B. Data must be available to all individuals who need to see it.
C. Data should be kept on file for at least 1 year before being discarded.
D. Sensitive information (e.g., participant's name) needs to be protected.

Answer: C
Explanation:


QUESTION NO: 80


Which of the following statements about injury reporting is NOT correct?


A. A process for injury reporting, backed up with a form, should be developed.
B. The process to be used and the accompanying forms must be part of the P&P manual.
C. Injury reporting forms must be kept under lock and key, just like data records.
D. A physician should sign every injury report form that is filed.

Answer: D
Explanation:


Topic 2, Volume B


QUESTION NO: 81


One important aspect of staff competency is ensuring that staff members are well trained and kept
up to date. Which of the following organizations has recently launched the Registry for Clinical
Exercise Physiologists?


A. AACVPR.
B. American College of Physicians.
C. American Heart Association.
D. ACSM.

Answer: D
Explanation:

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QUESTION NO: 82


Informed consent is best described as


A. A legal form.
B. A process that is backed up by a form.
C. Something that only a lawyer can provide to an exercise program.
D. Being an informed consumer to ensure that one undertakes the proper exercise program.

Answer: B
Explanation:


QUESTION NO: 83


Which of the following elements is NOT part of an emergency plan for a clinical exercise program?


A. Annual practice sessions involving all staff.
B. Emergency plan that constantly refers to national established guidelines (e.g., ACLS) without
addressing unique features of the program.
C. Emergency drills carried out on a regular basis and documented.
D. Scenarios developed to increase the applicability of the emergency plan practice
sessions.

Answer: A
Explanation:


QUESTION NO: 84


Which of the following is a fixed expense?


A. Office supplies.
B. Salaries.
C. Utilities (e.g., telephone).
D. Laboratory charge backs for blood work.

Answer: B
Explanation:


QUESTION NO: 85
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Which type of financial analysis would be appropriate for a not-for-profit program

that wishes to determine the amount of revenue from program fees needed so that no

other sources of revenue are required to meet the program's expenses?


A. Break-down analysis.
B. Break-even analysis.
C. Profitability analysis.
D. Margin analysis.

Answer: B
Explanation:


QUESTION NO: 86


Continuous quality improvement (CQI) is a systematic process of program

evaluation that involves all of the following steps EXCEPT


A. Data analysis.
B. Goals assessment.
C. Outcomes assessment.
D. Budget assessment.

Answer: D
Explanation:


QUESTION NO: 87


Outcome assessment evaluates a program's effectiveness. Which of the following

statements about outcome assessment is NOT true?


A. The client care plan for each individual participant is not used in this process.
B. Data that are subjective or anecdotal in nature can be used in the assessment.
C. Periodic progress reports are valuable and should stimulate the need to collect
objective data to support any subjective findings.
D. Standardized tools should be used for outcome assessment.

Answer: A
Explanation:
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QUESTION NO: 88


According to the AACVPR, elements of successful adult education include all of the

following EXCEPT


A. Goal setting.
B. Rewards.
C. Contracts.
D. Knowledge testing.

Answer: D
Explanation:


QUESTION NO: 89


Which one of the following statements concerning a needs assessment is NOT true?


A. The needs and/or program assessment is a useful tool for gathering data and
support for program implementation.
B. The needs and/or program assessment often must be a creative tool developed inhouse
to meet the program's specific needs.
C. Given that the needs assessment may be developed in-house without the benefit
of external validity, generalizing the results may be difficult.
D. Program planning is an essential step before needs assessment can be performed.

Answer: D
Explanation:


QUESTION NO: 90


A comprehensive clinical exercise rehabilitation program


A. Is based on historical features of program administration.
B. Adapts to trends in program services.
C. Is limited in scope and practice.
D. Is the same for the entire client population served.

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Answer: B
Explanation:


QUESTION NO: 91


Do fitness instructors need management skills?


A. Only if they wish to become floor supervisors or program managers.
B. Yes, because of the natural progression of advancement into management.
C. Yes, because as instructors, they manage client programs and manage the floor
with the clients.
D. No, because they will be trained in management if they become managers.

Answer: C
Explanation:


QUESTION NO: 92


A fitness newsletter, fitness library, and bulletin boards


A. Are part of staff news.
B. Are part of client and staff education.
C. Are part of the facility marketing.
D. Require considerable money and must be budgeted carefully.

Answer: B
Explanation:


QUESTION NO: 93


Why would a fitness facility be interested in public relations?


A. To increase exposure for the facility and sell its services.
B. To become involved in local politics.
C. To improve staff morale.
D. To make the staff work harder.

Answer: A
Explanation:
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QUESTION NO: 94


Why would a fitness instructor have an interest in tort laws?


A. Negligence is breaking a tort law and can ruin an instructor's career.
B. State taxes often are related to profit, which is governed by tort laws.
C. Tort laws are related to worker's compensation regulations.
D. They relate to the Americans with Disabilities Act (ADA)

Answer: A
Explanation:


QUESTION NO: 95


What is the best way that an administrator can educate the fitness staff?


A. Voicing his or her opinion.
B. Joining fitness organizations, and subscribing to fitness journals.
C. Buying fitness videos.
D. Reading the newspaper.

Answer: B
Explanation:


QUESTION NO: 96


What should the manager's involvement be in developing fitness programs?


A. The manager should maintain a hands-off approach.
B. The manager should be involved only in the budgeting and final approval.
C. The manager should be the only person involved in program development.
D. The manager should be active as a program developer as well as a resource,
supporter, and critic for programs developed by other staff.

Answer: D
Explanation:


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QUESTION NO: 97


Budgets are designed to


A. Make management happy.
B. Determine if a program is viable.
C. Save money.
D. Teach managers about cost analysis.

Answer: B
Explanation:


QUESTION NO: 98


The rules and regulations of a facility are commonly referred to as


A. The law.
B. The client rights statement.
C. Policies and procedures.
D. A check and balance for management and clients.

Answer: C
Explanation:


QUESTION NO: 99


A physician's clearance


A. Is not necessary if the client completes the medical history questionnaire.
B. Is a communication tool with little exercise value?.
C. Provides information about the physician's attitude regarding your club.
D. Provides a medical opinion about a client's risk with exercise.

Answer: D
Explanation:


QUESTION NO: 100


Some of the duties in supervising a fitness staff include scheduling, implementing the
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policies and procedures, and


A. Cleaning the equipment.
B. Emergency procedures and evaluations.
C. Marketing and promotions.
D. Managing the fitness billing.

Answer: B
Explanation:


QUESTION NO: 101


What is the primary reason why a manager or director should conduct a needs assessment?


A. To determine the specific needs and interests of the target market.
B. To determine the quality of potential fitness instructor who could be hired in the area.
C. To determine the needs of management before developing the budget.
D. To determine the need for new or different exercise equipment.

Answer: A
Explanation:


QUESTION NO: 102


Policies and procedures are important in a fitness center, because they


A. Explain how to use the fitness equipment properly.
B. Clarify the rights of and risks in being a fitness member.
C. Are general guidelines for operating a fitness program or department.
D. Explain the employee insurance plans and how to use them.

Answer: C
Explanation:


QUESTION NO: 103


What are some of the common sales "rules" in promoting your fitness program?


A. Selling memberships at any cost is key.
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B. You know more than they do, so be aggressive.
C. Honesty and an understanding of the needs of the potential member are always the
best way.
D. Long-term agreements make more money than short-term agreements.

Answer: C
Explanation:


QUESTION NO: 104


Program description, resource availability, and client interest are examples of


A. A business plan.
B. A survey.
C. Management factors.
D. Budget categories.

Answer: C
Explanation:


QUESTION NO: 105


What do effective program administration and management create and/or reduce?


A. They create problems with staff egos.
B. They reduce memberships.
C. They create successful programs and reduce problems.
D. They create more work for the staff and reduce feedback.

Answer: C
Explanation:


QUESTION NO: 106


Incident reports are important, because


A. They inform the manager which employees are performing poorly.
B. They indicate which members are problematic and should be dismissed.
C. They document and give details of any incident or problem that occurs.
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D. State laws often require them.

Answer: C
Explanation:


QUESTION NO: 107


Why are records valuable to a fitness program?


A. They help in evaluation of a program.
B. They offer music not found on tapes or CDs.
C. They help to provide facts in any legal issues.
D. They help the front desk to monitor paid and unpaid clients.

Answer: A
Explanation:


QUESTION NO: 108


Examples of program records include


A. Client progress and outcomes.
B. Member needs.
C. Performance of clients on selected exercises.
D. Member suggestions and any actions taken regarding them.

Answer: A
Explanation:


QUESTION NO: 109


Which of the following is an example of participant interaction as part of the supportive role of a
manager?


A. Offering a shoulder on which to cry.
B. Conducting surveys, and responding to client needs.
C. Encouraging members to "let go" in exercise classes.
D. Having members teach classes.

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Answer: B
Explanation:


QUESTION NO: 110


The manager's role in staff education is


A. Valuable, because it looks good to the owners.
B. To create many opportunities for educating the staff.
C. To let the staff handle their own education but also to encourage it.
D. Not very valuable, because member retention and sales are the key to any program.

Answer: B
Explanation:


QUESTION NO: 111


Staff certification is


A. Not important, because members do not care.
B. Important, primarily because it adds spice to marketing materials.
C. Not a good idea, because certified staff will increase your payroll.
D. Important, primarily because it adds a standard of knowledge and credibility to your facility.

Answer: D
Explanation:


QUESTION NO: 112


Capital budgets


A. Reflect the costs of implementing a program.
B. Reflect the costs to operate a program.
C. Are not necessary with fitness programs.
D. Are part of the balance sheet in financial reports.

Answer: A
Explanation:

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QUESTION NO: 113


What do budgets determine?


A. Fitness equipment costs.
B. If a company is making or losing money.
C. Viability, identification of problems, and a plan for the future of a program.
D. Assets and liabilities of the financial plan.

Answer: C
Explanation:


QUESTION NO: 114


Why should a fitness operator be concerned with state practice laws?


A. State laws help to identify illegal aliens who may apply for a job in your club.
B. State laws may control the number of minority employees working at your club.
C. State laws may affect how much can be charged for a membership.
D. Many states have practice acts that control the behavior and actions of fitness instructors.

Answer: D
Explanation:


QUESTION NO: 115


Why is public relations important to a fitness program?


A. It helps to promote the program and staff to the public.
B. It reduces the risk of legal action against your staff.
C. It lowers your malpractice insurance premium by promoting quality.
D. It makes sure that your clients are happy and getting what they want.

Answer: A
Explanation:


QUESTION NO: 116


What is the relative Y02 of walking on a treadmill at 3.5 mph and a 0% grade?
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A. 9.38 mL. kg-1 . min-1
B. 12.88 mL . kg-1l . min-1
C. 18.76 mL . kg-1 . min-1
D. 22.26 mL . kg-1 . min-1

Answer: B
Explanation:


QUESTION NO: 117


A client is walking on a treadmill at 3.4 mph and a 5% grade. What is her Y02 in relative terms?


A. 9.11 mL . kg-1 . min-1
B. 11.9 mL . kg-1 . min-1
C. 24 mL . kg-1 . min-1
D. 20.81 mL . kg-1 . min-1

Answer: D
Explanation:


QUESTION NO: 118


A 70-kg client is running on a treadmill at 5 mph and a 5% grade. What is his caloric expenditure
rate?


A. 12.7 kcal . min-1
B. 1.271 kcal . min-1
C. 3.633 kcal . min -1
D. 36.33 kcal . min -1

Answer: A
Explanation:


QUESTION NO: 119


What is the relative Yo2 of walking on a treadmill at 3.5 mph and a 10% grade?


A. 181.72 mL . kg-1 . min-1
B. 18.17 mL. kg-1 . min-1
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C. 29.76 mL . kg-1 . min-1
D. 27.96 mL . kg-1 . min-1

Answer: C
Explanation:


QUESTION NO: 120


What is the MET equivalent to level walking on a treadmill at 3.0 mph?


A. 5.59 MET.
B. 3.30 MET.
C. 2.30 MET.
D. 3.02 MET.

Answer: B
Explanation:


QUESTION NO: 121


What is the relative Y02 of running on a treadmill at 6.5 mph and a 0% grade?


A. 34.84 mL . kg-1. min-1
B. 34.48 mL . kg-1. min-1
C. 38.34 mL . kg-1. min-1
D. 43.83 mL . kg-1. min-1

Answer: C
Explanation:


QUESTION NO: 122


What is the relative Y02 of running on a treadmill at 5.5 mph and a 12% grade?


A. 29.48 mL . kg-1 . min-1
B. 45.4 mL . kg-1 . min-1
C. 47.2 mL . kg-1 . min-1
D. 48.9 mL . kg-1 . min-1

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Answer: D
Explanation:


QUESTION NO: 123


A 150-pound male sets the treadmill speed at 5.0 mph and a 5.2% grade. Calculate his MET
value.


A. 36.57 METs.
B. 10.45 METs.
C. 12.25 METs.
D. Not enough information to answer the question.

Answer: B
Explanation:


QUESTION NO: 124


What is a subject's work rate in watts if he pedals on a Monark cycle ergometer at 50 rpm at a
resistance of 2.0 kiloponds?


A. 50W.
B. 100W.
C. 200W.
D. 300W.

Answer: B
Explanation:


QUESTION NO: 125


A 110-pound female pedals a Monark cycle ergometer at 50 rpm against a resistance of 2.5
kiloponds. Calculate her absolute Yo2.


A. 300 mL . min-1
B. 750 mL . min-1
C. 1.25 L . min-1
D. 1.7 L. min-1

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Answer: D
Explanation:


QUESTION NO: 126


How many calories will a 110-pound woman expend if she pedals on a Monark cycle ergometer at
50 rpm against a resistance of 2.5 kiloponds for 60 minutes?


A. 12.87 calories.
B. 31.28 calories.
C. 510 calories.
D. 3,500 calories.

Answer: C
Explanation:


QUESTION NO: 127


A 55-kilogram woman trains on a cycle ergometer by pedaling at 60 rpm against a resistance of
1.5 kiloponds. What is her absolute Yo2?


A. 1.36 L . min-1
B. 2.47 L . min-1
C. 3.62 L . min-1
D. 3600 mL . min-1

Answer: A
Explanation:


QUESTION NO: 128


The same 55-kilogram woman (from question 12) also trains on a Monark arm ergometer at 60
rpm against a resistance of 1.5 kiloponds. What is her absolute Yo2?


A. 1.52 L . min-1
B. 773.0 mL . min-1
C. 0.840 L min-1
D. 0.774 L min-1

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Answer: C
Explanation:


QUESTION NO: 129


If a 70-kg man runs on a treadmill at 8 mph and a 0% grade for 45 minutes, what is his caloric
expenditure?


A. 1,067.07 calories.
B. 392.18 calories.
C. 730.48 calories.
D. Not enough information to answer the question

Answer: C
Explanation:


QUESTION NO: 130


What is the relative oxygen cost of bench stepping at a rate of 24 steps per minute up a l0-inch
stepping box? The individual weighs 140 pounds.


A. 12.91 mL . kg-1 . min-1
B. 14.61 mL . kg-1 . min-1
C. 16.41 mL . kg-1 . min-1
D. 22.89 mL . kg-1 . min-1

Answer: D
Explanation:


QUESTION NO: 131


What stepping rate should a client use if she wishes to exercise at 5 METs? The step box is 6
inches high, and the client weighs 50 kg.


A. 12 steps per minute.
B. 32 steps per minute.
C. 25 steps per minute.
D. 96 steps per minute.

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Answer: C
Explanation:


QUESTION NO: 132


A 143-pound woman regularly exercises on a treadmill at a speed of 5.5 mph and a 2% elevation.
What is her caloric expenditure?


A. 6.78 kcal . min-1
B. 11.58 kcal min-1
C. 20.85 kcal. min-1
D. 25.47 kcal min-1

Answer: B
Explanation:


QUESTION NO: 133


A 143-pound woman regularly exercises on a treadmill at a speed of 5.5 mph and a 2% elevation.
How much weight will she lose weekly if she exercises for a duration of 45 minutes per session,
with a frequency of three sessions per week?


A. 1.5 kg.
B. 2.07 kg.
C. 0.25 pounds.
D. 0.45 pounds.

Answer: D
Explanation:


QUESTION NO: 134


What resistance would you set a cycle ergometer at if your 80-kg client needs to train at 6 METs?
Assume a 50 rpm cycling cadence.


A. 1.5 kg.
B. 2.07 kg.
C. 0.25 pounds.
D. 0.45 pounds.
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Answer: B
Explanation:


QUESTION NO: 135


At what running speed would you set a level treadmill at to elicit an Vo2 of 40 mL .

kg-1 . min-1?


A. 5.0 mph
B. 6.8 mph
C. 18.25 m . min-1
D. 18.25 mph

Answer: B
Explanation:


QUESTION NO: 136


If a healthy young man exercises at an intensity of 45 mL. kg-1.min -1 three times per week for 45
minutes each session, how long would it take him to lose 10 pounds of fat?


A. 4 weeks.
B. 7.14 weeks.
C. 16.5 weeks.
D. 19 weeks.

Answer: C
Explanation:


QUESTION NO: 137


A 35-year-old woman reduces her caloric intake by 1,200 kcal per week. How much weight will
she lose in 26 weeks?


A. 8.9 pounds.
B. 12.0 pounds.
C. 26.0 pounds.
D. 34.3 pounds.
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Answer: A
Explanation:


QUESTION NO: 138


How much weight will the woman (from question 22) lose in 26 weeks if she integrates a 1-mile
walk, taken three times per week, into her weight loss program?


A. 3 pounds.
B. 6 pounds.
C. 11 pounds.
D. 15 pounds.

Answer: C
Explanation:


QUESTION NO: 139


Slow conduction in the A V node is associated with


A. Prolonged PR interval.
B. Prolonged QRS interval.
C. Shortened QT interval.
D. Elevated ST segment.

Answer: A
Explanation:


QUESTION NO: 140


Examine the six extremity leads shown in the figure below. What is the appropriate mean QRS
axis?


A. -30.
B. 60.
C. 90.
D. 120.
(From Goldberger AL: Clinical Electrocardiography: A Simplified Approach, 6th ed. St
Louis, Mosby, 1999, p 55.)
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Answer: B
Explanation:


QUESTION NO: 141


In the ECG shown on the following page, which of the following conduction abnormalities is
indicated?




A. RBBB.
B. Third-degree AV block.
C. First-degree AV block.
D. Mobitz I.

Answer: C
Explanation:


QUESTION NO: 142


What condition can cause ST-segment elevation?


A. Digitalis toxicity.
B. Hypocalcemia.
C. Hypokalemia.
D. Acute pericarditis.

Answer: D
Explanation:


QUESTION NO: 143


In the ECG strip shown below, what disorder is indicated?


A. Acute pericarditis.
B. Inferior MI.
C. Posterior MI.
D. Anterior MI.
(From Goldberger AL: Clinical Electrocardiography: A Simplified Approach, 6th ed. St.
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Louis, Mosby, 1999, p 91.)

Answer: B
Explanation:


QUESTION NO: 144


In the ECG strip shown below, what disorder is indicated?


A. Subendocardial ischemia.
B. Transmural ischemia.
C. Acute inferior MI.
D. Posterior MI
(From Goldberger AL: Clinical Electrocardiography: A Simplified Approach, 6th ed. St.
Louis, Mosby, 1999,p91.)

Answer: D
Explanation:


QUESTION NO: 145


In the ECG strip shown below, what abnormality is indicated?


A. LBBB.
B. Posterior wall MI.
C. RBBB.
D. LVH.
(From Goldberger AL: Clinical Electrocardiography: A Simplified Approach, 6th ed. St.
Louis, Mosby, 1999, p 70.)

Answer: C
Explanation:


QUESTION NO: 146


Subendocardial ischemia usually produces


A. ST-segment elevation.
B. ST -segment depression.
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C. Q waves.
D. U waves.

Answer: B
Explanation:


QUESTION NO: 147


In the ECG strip shown below, which arrhythmia is present?


A. Premature ventricular contractions.
B. Ventricular tachycardia.
C. Ventricular trigeminy.
D. Ventricular bigeminy.
(From Goldberger AL: Clinical Electrocardiography: A Simplified Approach, 6th ed. 51.
Louis, Mosby, 1999, p 167.)

Answer: B
Explanation:


QUESTION NO: 148


In the ECG strip shown below, which arrhythmia is indicated?




A. Atrial flutter.
B. Atrial fibrillation.
C. Premature atrial contractions.
D. Atrial tachycardia.

Answer: A
Explanation:


QUESTION NO: 149


Abnormally tall and peaked T waves suggest which of the following?


A. Hyperkalemia.
B. Acute pericarditis.
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C. Acute MI.
D. Hypokalemia.

Answer: A
Explanation:


QUESTION NO: 150


Which of the following conditions can prolong the QT interval?


A. Hypokalemia and hypercalcemia.
B. Hyperkalemia and hypercalcemia.
C. Hypocalcemia and hypokalemia.
D. Hypocalcemia and hyperkalemia.

Answer: D
Explanation:


QUESTION NO: 151


Differentiation between supraventricular and ventricular rhythm is made on the basis of the


A. Duration (width) of the QRS complex and the presence or absence of P waves.
B. Appearance of the ST segment.
C. Amplitude of the U wave.
D. Duration of the PR interval.

Answer: A
Explanation:


QUESTION NO: 152


Which of the following is one cause of a wide QRS complex?


A. Hypokalemia.
B. Defective intraventricular conduction.
C. Right atrial enlargement.
D. Abnormal ST segment

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Answer: B
Explanation:


QUESTION NO: 153


In response to various stimuli, movements of ions occur, causing the rapid loss of the internal
negative potential. This process is known as


A. Polarization.
B. Repolarization.
C. Automaticity.
D. Depolarization.

Answer: D
Explanation:


QUESTION NO: 154


Digitalis effect refers to


A. Scooped-out depression of the ST segment produced by digitalis.
B. Elevation of the PR interval produced by digitalis.
C. Shortening of the QT interval produced by digitalis.
D. Prolongation of the QRS complex produced by digitalis.

Answer: A
Explanation:


QUESTION NO: 155


Tall, positive T waves may be caused to all of the following EXCEPT


A. Hyperacute phase of MI.
B. LVH.
C. Acute pericarditis.
D. Hypocalcemia.

Answer: D
Explanation:
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QUESTION NO: 156


In the ECG strip sho'ATI1 below, what abnormalities are indicated?


A. Left atrial enlargement and LVH.
B. Right atrial enlargement and right ventricular hypertrophy.
C. Left anterior fascicular block and left posterior h,scicular block.
D. Subendocardial ischemia and infarction
Avr V1 V4
Avl V2 V5
Avf V3 V6

Answer: A
Explanation:


QUESTION NO: 157


Right-axis deviation may be caused by


A. Acute pericarditis.
B. Right atrial enlargement.
C. Chronic obstructive pulmonary disease.
D. Cardiomyopathy.

Answer: C
Explanation:


QUESTION NO: 158


In atrial flutter, the stimulation rate is approximately


A. 75 bpm
B. 125 bpm
C. 200 bpm
D. 300 bpm

Answer: D
Explanation:
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QUESTION NO: 159


Myocardial cells can be excited in response to all of the following stimuli EXCEPT:


A. Electrical
B. Chemical
C. Mechanical
D. Emotional

Answer: D
Explanation:


QUESTION NO: 160


The P wave on the ECG can be


A. Negative
B. Positive
C. Isoelectric
D. Either positive or negative

Answer: D


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