ACSM EP COMPREHENSIVE EXAM 2026/2027 QUESTIONS
AND SOLUTIONS RATED A+
✔✔An individual with a resting blood pressure of 110/70 mm Hg would have a mean
arterial pressure of:
a. 40 mm Hg
b. 83.2 mm Hg
c. 90.5 mm Hg
d. 150.8 mm Hg - ✔✔b. 83.2 mm Hg
✔✔Which of the following is an acute response to cardiorespiratory exercise?
a. Decrease in cardiac output
b. Increase in stroke volume
c. Increase in resting heart rate
d. Decrease in blood pressure - ✔✔b. Increase in stroke volume
✔✔Which of the following activities requires the creatine phosphate system to be
utilized?
a. The long jump
b. 400-meter sprint
c. 800-meter sprint
d. 10 repetitions maximum bench press - ✔✔a. The long jump
✔✔Which of the following is considered a normal hemodynamic response to exercise?
a. Diastolic blood pressure will increase slightly
b. Total peripheral resistance will increase slightly
c. Systolic blood pressure will increase exponentially with workload
d. Diastolic blood pressure will remain the same or slightly decrease - ✔✔d. Diastolic
blood pressure will remain the same or slightly decrease
✔✔Which of the following activities requires anaerobic glycolysis as an energy source?
a. 200-meter sprint
b. 100-meter hurdles
c. Discus throw
d. 1-RM squat - ✔✔a. 200-meter sprint
✔✔Which of the following activities relies predominantly on anaerobic glycolysis for
energy?
a. Marathon
b. Javelin throw
c. 400-meter run
d. 5-kilometer run - ✔✔c. 400-meter run
,✔✔When a client quits exercising for long periods of time, the principle of reversibility
dictates that:
a. Any improvements gained will reverse and decrease.
b. Gains in resistance training will decrease by 50% and cardiovascular gains by 70%.
c. Approximately 30% of gains made will be lost each year the training ceases.
d. It will take two to four weeks to return to the client's previous fitness level once
exercise is resumed. - ✔✔a. Any improvements gained will reverse and decrease.
✔✔Which of the following is considered an intrinsic risk factor for musculoskeletal
injury?
a. Inadequate conditioning
b. Adverse environmental conditions
c. Speed of movement
d. Training errors - ✔✔a. Inadequate conditioning
✔✔Which of the following hemodynamic variables have a linear relationship and are
heavily influenced by one another during exercise?
a. Mean arterial pressure and cardiac output
b. Mean arterial pressure and peak VO2
c. Systolic blood pressure and peak VO2
d. Systolic blood pressure and cardiac output - ✔✔d. Systolic blood pressure and
cardiac output
✔✔During graded exercise, which of the following occurs due to large muscle
vasodilation?
a. Total peripheral resistance may drop slightly
b. Total peripheral resistance may increase exponentially to compensate
c. Systolic blood pressure will decrease
d. Diastolic blood pressure will increase - ✔✔a. Total peripheral resistance may drop
slightly
✔✔In the general population, stroke volume has been shown to plateau at what
percentage of VO2 max?
a. 10%-20%
b. 20%-40%
c. 40%-60%
d. 60%-80% - ✔✔c. 40%-60%
✔✔In general, how many days of training are recommended for heat acclimatization?
a. 3-4 days
b. 10 days
c. 7 days
d. 21 days - ✔✔b. 10 days
,✔✔What is produced when carbohydrates are broken down during anaerobic
glycolysis?
a. Acetyl CoA
b. Lactate
c. Ketones
d. Pyruvate - ✔✔d. Pyruvate
✔✔Which of the following is a primary disadvantage of utilizing field tests to predict
VO2max?
a. They are dependent on client effort
b. Outdoor testing is limited by environmental conditions
c. More personnel may be required depending on the size of the group
d. Some field tests may require advanced motor skills to complete - ✔✔a. They are
dependent on client effort
✔✔A common strategy of altitude training used by athletes to improve performance is
known as:
a. Live high, train low.
b. Train low, live low.
c. Live high, train high.
d. Train high, live low. - ✔✔a. Live high, train low.
✔✔Heart rate drift or cardiovascular drift occurs when:
a. Heart rate increases due to a decrease in stroke volume.
b. Heart rate decreases due to an increased blood flow to the working muscle.
c. Heart rate increases due to increased mean arterial pressure.
d. Heart rate decreases due to a decrease in stroke volume. - ✔✔a. Heart rate
increases due to a decrease in stroke volume.
✔✔Which energy system is primarily responsible for resynthesizing ATP during
submaximal exercise lasting longer than three minutes?
a. Creatine phosphate
b. Anaerobic glycolysis
c. Oxidative phosphorylation
d. Aerobic glycolysis - ✔✔c. Oxidative phosphorylation
✔✔Which energy system is predominantly utilized for a 100-meter sprint?
a. Creatine phosphate
b. Oxidative
c. Aerobic glycolysis
d. Anaerobic glycolysis - ✔✔a. Creatine phosphate
✔✔Which of the following is the gold standard for assessing cardiorespiratory fitness?
a. 1.5 mile walk/run test
, b. Cooper 12-Minute Walk/Run Test
c. Open circuit spirometry during graded exercise to fatigue
d. Astrand-Rhyming Cycle Ergometer Test - ✔✔c. Open circuit spirometry during
graded exercise to fatigue
✔✔Which of the following is a physiological adaptation of heat acclimatization?
a. Lower core body temperature
b. Lower sweat rates
c. Higher skin temperature
d. Higher sodium concentration of plasma - ✔✔a. Lower core body temperature
✔✔According to the FITT principle, healthy individuals should accumulate at LEAST:
a. 60 minutes per week of moderate-intensity exercise.
b. 75 minutes per week of vigorous-intensity exercise.
c. 75 minutes per week of moderate-intensity exercise.
d. 60 minutes per week of vigorous-intensity exercise. - ✔✔b. 75 minutes per week of
vigorous-intensity exercise.
✔✔A direct result of increased sweat rates during exercise in a hot environment is:
a. A decrease in heart rate.
b. A decrease in stroke volume.
c. A decrease in blood pressure.
d. An increase in stroke volume. - ✔✔b. A decrease in stroke volume.
✔✔Which of the following is most likely during the initial adjustment to high altitude?
a. Muscle soreness
b. Weight gain
c. Sleep disturbance
d. Increased appetite - ✔✔c. Sleep disturbance
✔✔Per the FITT principle, the MINIMUM threshold of frequency for aerobic exercise is:
a. Combination of moderate- and vigorous-intensity aerobic exercise, five days per
week.
b. Moderate-intensity aerobic exercise, five days per week.
c. Moderate-intensity aerobic exercise, three days per week.
d. Vigorous-intensity aerobic exercise, five days per week. - ✔✔c. Moderate-intensity
aerobic exercise, three days per week.
✔✔If an individual is exercising at an absolute VO2 of 4.1 L/min for 30 minutes, how
many kilocalories will the individual utilize during the activity?
a. 20.5 kcal
b. 120 kcal
c. 615 kcal
d. 1,080 kcal - ✔✔c. 615 kcal
AND SOLUTIONS RATED A+
✔✔An individual with a resting blood pressure of 110/70 mm Hg would have a mean
arterial pressure of:
a. 40 mm Hg
b. 83.2 mm Hg
c. 90.5 mm Hg
d. 150.8 mm Hg - ✔✔b. 83.2 mm Hg
✔✔Which of the following is an acute response to cardiorespiratory exercise?
a. Decrease in cardiac output
b. Increase in stroke volume
c. Increase in resting heart rate
d. Decrease in blood pressure - ✔✔b. Increase in stroke volume
✔✔Which of the following activities requires the creatine phosphate system to be
utilized?
a. The long jump
b. 400-meter sprint
c. 800-meter sprint
d. 10 repetitions maximum bench press - ✔✔a. The long jump
✔✔Which of the following is considered a normal hemodynamic response to exercise?
a. Diastolic blood pressure will increase slightly
b. Total peripheral resistance will increase slightly
c. Systolic blood pressure will increase exponentially with workload
d. Diastolic blood pressure will remain the same or slightly decrease - ✔✔d. Diastolic
blood pressure will remain the same or slightly decrease
✔✔Which of the following activities requires anaerobic glycolysis as an energy source?
a. 200-meter sprint
b. 100-meter hurdles
c. Discus throw
d. 1-RM squat - ✔✔a. 200-meter sprint
✔✔Which of the following activities relies predominantly on anaerobic glycolysis for
energy?
a. Marathon
b. Javelin throw
c. 400-meter run
d. 5-kilometer run - ✔✔c. 400-meter run
,✔✔When a client quits exercising for long periods of time, the principle of reversibility
dictates that:
a. Any improvements gained will reverse and decrease.
b. Gains in resistance training will decrease by 50% and cardiovascular gains by 70%.
c. Approximately 30% of gains made will be lost each year the training ceases.
d. It will take two to four weeks to return to the client's previous fitness level once
exercise is resumed. - ✔✔a. Any improvements gained will reverse and decrease.
✔✔Which of the following is considered an intrinsic risk factor for musculoskeletal
injury?
a. Inadequate conditioning
b. Adverse environmental conditions
c. Speed of movement
d. Training errors - ✔✔a. Inadequate conditioning
✔✔Which of the following hemodynamic variables have a linear relationship and are
heavily influenced by one another during exercise?
a. Mean arterial pressure and cardiac output
b. Mean arterial pressure and peak VO2
c. Systolic blood pressure and peak VO2
d. Systolic blood pressure and cardiac output - ✔✔d. Systolic blood pressure and
cardiac output
✔✔During graded exercise, which of the following occurs due to large muscle
vasodilation?
a. Total peripheral resistance may drop slightly
b. Total peripheral resistance may increase exponentially to compensate
c. Systolic blood pressure will decrease
d. Diastolic blood pressure will increase - ✔✔a. Total peripheral resistance may drop
slightly
✔✔In the general population, stroke volume has been shown to plateau at what
percentage of VO2 max?
a. 10%-20%
b. 20%-40%
c. 40%-60%
d. 60%-80% - ✔✔c. 40%-60%
✔✔In general, how many days of training are recommended for heat acclimatization?
a. 3-4 days
b. 10 days
c. 7 days
d. 21 days - ✔✔b. 10 days
,✔✔What is produced when carbohydrates are broken down during anaerobic
glycolysis?
a. Acetyl CoA
b. Lactate
c. Ketones
d. Pyruvate - ✔✔d. Pyruvate
✔✔Which of the following is a primary disadvantage of utilizing field tests to predict
VO2max?
a. They are dependent on client effort
b. Outdoor testing is limited by environmental conditions
c. More personnel may be required depending on the size of the group
d. Some field tests may require advanced motor skills to complete - ✔✔a. They are
dependent on client effort
✔✔A common strategy of altitude training used by athletes to improve performance is
known as:
a. Live high, train low.
b. Train low, live low.
c. Live high, train high.
d. Train high, live low. - ✔✔a. Live high, train low.
✔✔Heart rate drift or cardiovascular drift occurs when:
a. Heart rate increases due to a decrease in stroke volume.
b. Heart rate decreases due to an increased blood flow to the working muscle.
c. Heart rate increases due to increased mean arterial pressure.
d. Heart rate decreases due to a decrease in stroke volume. - ✔✔a. Heart rate
increases due to a decrease in stroke volume.
✔✔Which energy system is primarily responsible for resynthesizing ATP during
submaximal exercise lasting longer than three minutes?
a. Creatine phosphate
b. Anaerobic glycolysis
c. Oxidative phosphorylation
d. Aerobic glycolysis - ✔✔c. Oxidative phosphorylation
✔✔Which energy system is predominantly utilized for a 100-meter sprint?
a. Creatine phosphate
b. Oxidative
c. Aerobic glycolysis
d. Anaerobic glycolysis - ✔✔a. Creatine phosphate
✔✔Which of the following is the gold standard for assessing cardiorespiratory fitness?
a. 1.5 mile walk/run test
, b. Cooper 12-Minute Walk/Run Test
c. Open circuit spirometry during graded exercise to fatigue
d. Astrand-Rhyming Cycle Ergometer Test - ✔✔c. Open circuit spirometry during
graded exercise to fatigue
✔✔Which of the following is a physiological adaptation of heat acclimatization?
a. Lower core body temperature
b. Lower sweat rates
c. Higher skin temperature
d. Higher sodium concentration of plasma - ✔✔a. Lower core body temperature
✔✔According to the FITT principle, healthy individuals should accumulate at LEAST:
a. 60 minutes per week of moderate-intensity exercise.
b. 75 minutes per week of vigorous-intensity exercise.
c. 75 minutes per week of moderate-intensity exercise.
d. 60 minutes per week of vigorous-intensity exercise. - ✔✔b. 75 minutes per week of
vigorous-intensity exercise.
✔✔A direct result of increased sweat rates during exercise in a hot environment is:
a. A decrease in heart rate.
b. A decrease in stroke volume.
c. A decrease in blood pressure.
d. An increase in stroke volume. - ✔✔b. A decrease in stroke volume.
✔✔Which of the following is most likely during the initial adjustment to high altitude?
a. Muscle soreness
b. Weight gain
c. Sleep disturbance
d. Increased appetite - ✔✔c. Sleep disturbance
✔✔Per the FITT principle, the MINIMUM threshold of frequency for aerobic exercise is:
a. Combination of moderate- and vigorous-intensity aerobic exercise, five days per
week.
b. Moderate-intensity aerobic exercise, five days per week.
c. Moderate-intensity aerobic exercise, three days per week.
d. Vigorous-intensity aerobic exercise, five days per week. - ✔✔c. Moderate-intensity
aerobic exercise, three days per week.
✔✔If an individual is exercising at an absolute VO2 of 4.1 L/min for 30 minutes, how
many kilocalories will the individual utilize during the activity?
a. 20.5 kcal
b. 120 kcal
c. 615 kcal
d. 1,080 kcal - ✔✔c. 615 kcal
