ACSM CEP EXAM Questions and Answers
1.Absolute Contraindications to Exercise Testing: • A recent
significant change in the resting ECG suggesting significant ischemia,
recent MI (within 2 d), or other acute cardiac event
•Unstable angina
•Uncontrolled cardiac dysrhythmias causing symptoms or
hemodynamic compromise
•Symptomatic severe aortic stenosis
•Uncontrolled symptomatic heart failure
•Acute pulmonary embolus or pulmonary infarction
•Acute myocarditis or pericarditis
•Suspected or known dissecting aneurysm
•Acute systemic infection, accompanied by fever, body aches, or
swollen lymph glands
2.Relative Contraindications to Exercise Testing: • Left main
coronary stenosis
•Moderate stenotic valvular heart disease
•Electrolyte abnormalities (hypokalemia or hypomagnesemia)
•Severe arterial hypertension (SBP>200 mmHg and/or DBP >110 mmHg)
at rest
•Tachydysrhythmia or bradydysrhythmia
•Hypertrophic cardiomyopathy and other forms of outflow tract
obstruction
,•Neuromotor, musculoskeletal, or rheumatoid disorders that are
exacerbated by exercise
•High-degree AV block
•Ventricular aneurysm
•Uncontrolled metabolic disease (diabetes, thyrotoxicosis, or myxedema)
•Chronic infectious disease (e.g. HIV)
•Mental or physical impairment leading to inability to exercise adequately
3.General Indications for Stopping an Exercise Test: • Onset of
angina or angina-like symptoms
•Drop in SBP of e10 mmHg with an increase in work rate or if SBP
decreases below the value obtained in the same position prior to testing
•Excessive rise in BP: SBP>250 mmHg and/or DBP>115 mmHg
•Shortness of breath, wheezing, leg cramps, or claudication
•Signs of poor perfusion: light-headedness, confusion, ataxia (loss of
full control of bodily movements), (pallor) unhealthy pale appearance,
cyanosis (bluish skin color), nausea, or cold and clammy skin
•Failure of HR to increase with increased exercise intensity
•Noticeable change in heart rhythm by palpation or auscultation
•Subject requests to stop
•Physical or verbal manifestations of severe fatigue
•Failure of the testing equipment
4.Absolute Indications for stopping an exercise test: • Drop in
SBP e10 mmHg with an increase in work rate, or if SBP decreases below
, the value obtained in the same position prior to testing when
accompanied by other evidence of ischemia
•Moderately severe angina (defined as 3 on standard scale)
•Increasing nervous system symptoms (e.g. ataxia, dizziness, or near
syncope)
•Signs of poor perfusion (cyanosis or pallor)
•Technical difficulties monitoring the ECG or SBP
•Subject's desire to stop
•Sustained ventricular tachycardia
•ST elevation (+1.0 mm) in leads without diagnostic Q waves (other than
V1 or aVR)
5.Relative Indications for stopping an exercise test: • Drop in SBP
e10 mmHg with an increase in work rate, or if SBP below the value
obtained in the same position prior to testing
•ST or QRS changes such as excessive ST depression (>2 mm
horizontal or down sloping ST-segment depression) or marked axis shift
•Arrhythmias other than sustained V Tach, including multifocal PVCs,
triplets of PVCs, SVT, heart block, or bradyarrhythmias
•Fatigue, shortness of breath, wheezing, leg cramps, or claudication
•Development of bundle-branch block or intraventricular conduction
delay that cannot be distinguished from V Tach
•Increasing chest pain
•Hypertensive response (SBP>250 mmHg and/or DBP>115 mmHg)
1.Absolute Contraindications to Exercise Testing: • A recent
significant change in the resting ECG suggesting significant ischemia,
recent MI (within 2 d), or other acute cardiac event
•Unstable angina
•Uncontrolled cardiac dysrhythmias causing symptoms or
hemodynamic compromise
•Symptomatic severe aortic stenosis
•Uncontrolled symptomatic heart failure
•Acute pulmonary embolus or pulmonary infarction
•Acute myocarditis or pericarditis
•Suspected or known dissecting aneurysm
•Acute systemic infection, accompanied by fever, body aches, or
swollen lymph glands
2.Relative Contraindications to Exercise Testing: • Left main
coronary stenosis
•Moderate stenotic valvular heart disease
•Electrolyte abnormalities (hypokalemia or hypomagnesemia)
•Severe arterial hypertension (SBP>200 mmHg and/or DBP >110 mmHg)
at rest
•Tachydysrhythmia or bradydysrhythmia
•Hypertrophic cardiomyopathy and other forms of outflow tract
obstruction
,•Neuromotor, musculoskeletal, or rheumatoid disorders that are
exacerbated by exercise
•High-degree AV block
•Ventricular aneurysm
•Uncontrolled metabolic disease (diabetes, thyrotoxicosis, or myxedema)
•Chronic infectious disease (e.g. HIV)
•Mental or physical impairment leading to inability to exercise adequately
3.General Indications for Stopping an Exercise Test: • Onset of
angina or angina-like symptoms
•Drop in SBP of e10 mmHg with an increase in work rate or if SBP
decreases below the value obtained in the same position prior to testing
•Excessive rise in BP: SBP>250 mmHg and/or DBP>115 mmHg
•Shortness of breath, wheezing, leg cramps, or claudication
•Signs of poor perfusion: light-headedness, confusion, ataxia (loss of
full control of bodily movements), (pallor) unhealthy pale appearance,
cyanosis (bluish skin color), nausea, or cold and clammy skin
•Failure of HR to increase with increased exercise intensity
•Noticeable change in heart rhythm by palpation or auscultation
•Subject requests to stop
•Physical or verbal manifestations of severe fatigue
•Failure of the testing equipment
4.Absolute Indications for stopping an exercise test: • Drop in
SBP e10 mmHg with an increase in work rate, or if SBP decreases below
, the value obtained in the same position prior to testing when
accompanied by other evidence of ischemia
•Moderately severe angina (defined as 3 on standard scale)
•Increasing nervous system symptoms (e.g. ataxia, dizziness, or near
syncope)
•Signs of poor perfusion (cyanosis or pallor)
•Technical difficulties monitoring the ECG or SBP
•Subject's desire to stop
•Sustained ventricular tachycardia
•ST elevation (+1.0 mm) in leads without diagnostic Q waves (other than
V1 or aVR)
5.Relative Indications for stopping an exercise test: • Drop in SBP
e10 mmHg with an increase in work rate, or if SBP below the value
obtained in the same position prior to testing
•ST or QRS changes such as excessive ST depression (>2 mm
horizontal or down sloping ST-segment depression) or marked axis shift
•Arrhythmias other than sustained V Tach, including multifocal PVCs,
triplets of PVCs, SVT, heart block, or bradyarrhythmias
•Fatigue, shortness of breath, wheezing, leg cramps, or claudication
•Development of bundle-branch block or intraventricular conduction
delay that cannot be distinguished from V Tach
•Increasing chest pain
•Hypertensive response (SBP>250 mmHg and/or DBP>115 mmHg)
