ACSM CEP CORRECT ACTUAL QUESTIONS AND
ANSWERS SURE A+
✔✔Chronotropic incompetence - ✔✔1. Peak exercise HR about 20 BPM below the age
predicted HRmax or an inability to achieve > 85% of the age predicted HRmax for
subjects limited by volitional fatigue.
2. Chronotropic index <.8
✔✔Heart Rate Recovery - ✔✔less than or equal to 12 BPM at 1 minute for walking, or
less than or equal to 22 BPM at 2 mins for supine position
✔✔Sensitivity - ✔✔% of pts. tested with known CVD who demonstrate significant ST
segment changes.
Exercise EKG sensitivity usually requires greater than or equal to 70% stenosis
✔✔True Positive - ✔✔Horizontal or down sloping ST segment depression of ≥1.0 mm
and correctly identifies a patient with CVD
✔✔False Negative - ✔✔test shows no or non-diagnostic ECG changes and fails to
identify patients with underlying CVD
✔✔Specificity - ✔✔% of pts. without CVD who demonstrate non significant ST segment
changes
, ✔✔True Negative - ✔✔Correctly identifies an individual without CVD
✔✔Causes of False Negative Test Results - ✔✔• Failure to reach an ischemic threshold
• Monitoring an insufficient number of leads to detect ECG changes
• Failure to recognize non-ECG signs and symptoms that may be associated with
underlying CVD
• Angiographically significant CVD compensated by collateral circulation
• Musculoskeletal limitations to exercise preceding cardiac abnormalities
• Technical or observer error
✔✔Predictive Value - ✔✔A measure of how accurately a test result (positive or
negative) correctly identifies the presence or absence of CVD in tested patients.
✔✔Absolute Contraindications to Resistance training - ✔✔• Unstable CHD
• Decompensated HF
• Uncontrolled arrhythmias
• Severe pulmonary HTN
• Severe and symptomatic aortic stenosis
• Acute myocarditis, endocarditis, or pericarditis
• Uncontrolled HTN (>180/110 mmHg)
• Aortic dissection
• Marfan syndrome
• High intensity RT (80-100% of 1-RM) in patients with active proliferative retinopathy or
moderate or worse non-proliferative diabetic retinopathy
✔✔Relative Contraindications to Resistance Training - ✔✔• Major risk factors for CHD
• Diabetes at any age
• Uncontrolled HTN (>160/100 mmHg)
• Low functional capacity (<4 METs)
• Musculoskeletal limitations
• Individuals who have implanted pacemakers or defibrillators
✔✔When to monitor EKG for an Exercise Test - ✔✔Before: Continuously, supine
position and posture of exercise
During: Continuously; last 15 s of each stage or the last 15 s of each 2 min period (ramp
protocols)
After: continuously, immediate postexercise, last 15 s of the 1st minute of recovery and
every 2 minutes after
✔✔When to monitor HR for an exercise test - ✔✔Before: Continuously; supine position,
and posture of exercise
During: Continuously, Last 15 s of each minute
After: Continuously, Last 5 s of each minute
ANSWERS SURE A+
✔✔Chronotropic incompetence - ✔✔1. Peak exercise HR about 20 BPM below the age
predicted HRmax or an inability to achieve > 85% of the age predicted HRmax for
subjects limited by volitional fatigue.
2. Chronotropic index <.8
✔✔Heart Rate Recovery - ✔✔less than or equal to 12 BPM at 1 minute for walking, or
less than or equal to 22 BPM at 2 mins for supine position
✔✔Sensitivity - ✔✔% of pts. tested with known CVD who demonstrate significant ST
segment changes.
Exercise EKG sensitivity usually requires greater than or equal to 70% stenosis
✔✔True Positive - ✔✔Horizontal or down sloping ST segment depression of ≥1.0 mm
and correctly identifies a patient with CVD
✔✔False Negative - ✔✔test shows no or non-diagnostic ECG changes and fails to
identify patients with underlying CVD
✔✔Specificity - ✔✔% of pts. without CVD who demonstrate non significant ST segment
changes
, ✔✔True Negative - ✔✔Correctly identifies an individual without CVD
✔✔Causes of False Negative Test Results - ✔✔• Failure to reach an ischemic threshold
• Monitoring an insufficient number of leads to detect ECG changes
• Failure to recognize non-ECG signs and symptoms that may be associated with
underlying CVD
• Angiographically significant CVD compensated by collateral circulation
• Musculoskeletal limitations to exercise preceding cardiac abnormalities
• Technical or observer error
✔✔Predictive Value - ✔✔A measure of how accurately a test result (positive or
negative) correctly identifies the presence or absence of CVD in tested patients.
✔✔Absolute Contraindications to Resistance training - ✔✔• Unstable CHD
• Decompensated HF
• Uncontrolled arrhythmias
• Severe pulmonary HTN
• Severe and symptomatic aortic stenosis
• Acute myocarditis, endocarditis, or pericarditis
• Uncontrolled HTN (>180/110 mmHg)
• Aortic dissection
• Marfan syndrome
• High intensity RT (80-100% of 1-RM) in patients with active proliferative retinopathy or
moderate or worse non-proliferative diabetic retinopathy
✔✔Relative Contraindications to Resistance Training - ✔✔• Major risk factors for CHD
• Diabetes at any age
• Uncontrolled HTN (>160/100 mmHg)
• Low functional capacity (<4 METs)
• Musculoskeletal limitations
• Individuals who have implanted pacemakers or defibrillators
✔✔When to monitor EKG for an Exercise Test - ✔✔Before: Continuously, supine
position and posture of exercise
During: Continuously; last 15 s of each stage or the last 15 s of each 2 min period (ramp
protocols)
After: continuously, immediate postexercise, last 15 s of the 1st minute of recovery and
every 2 minutes after
✔✔When to monitor HR for an exercise test - ✔✔Before: Continuously; supine position,
and posture of exercise
During: Continuously, Last 15 s of each minute
After: Continuously, Last 5 s of each minute
