ACSM CLINICAL EXERCISE
PHYSIOLOGIST EXAM QUESTIONS
WITH 100% CORRECT ANSWERS |
LATEST VERSION 2025/2026.
1 MET = - ANS 3.5 ml/kg/mig
1 large box - ANS 5mm or 0.2 seconds
1 small box - ANS 1mm or 0.04 sec
1 Rep Max (1RM) Procedure - ANS 1.) warm up with sub max reps (40-60% RM)
2.) 3-5 reps moderate wt (70-80% RM)
3.) 2 min rest then estimated max attempt
4.) 3-5 min rest attempt with added weight until achieved in 3-5 tries
5.) once attempt failed- attempt weight between last 2
Intraventricular conduction delay - ANS - wide QRS = >0.1
- refers to disturbances in the intraventricular propagation of supraventricular impulses
resulting in changes in the QRS complex either in morphology or duration, or both
- abnormal activation the ventricle cause by conduction delay
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,Indicators of an old MI - ANS - Abnormal/significant Q waves
- 1 box wide of > 1/3 of R-wave
Absolute Contraindications to Exercise Testing - ANS 1. recent change in ECG
2. unstable angina
3. uncontrolled dysrhythmia causing sxs
4. symptomatic severe AS
5. uncontrolled HF w/ sxs
6. acute PE or pulmonary infarct
7. acute myocarditis/pericarditis
8. suspected / known dissecting aneurysm
9. acute systemic infection
***Risk of testing outweigh the benefits***
Absolute indications to Terminate Exercise Testing - ANS 1. Drop in SBP > 10 mmHg w/
increased workload
2. Moderately severe angina
3. Increase in Dizziness
4. signs of poor perfusion
5. technical difficulties
6. Sustained V-TAch
7. ST elevation (+1mm) in leads w/o Q waves
Blood Glucose Management with exercise - ANS - Requires balance between hepatic glucose
production, peripheral glucose uptake, combined with effective insulin response
- Continuous monitoring
- Regular PA
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,Dangers of BS of 250-300 mg/dl - ANS - Urinary Ketones form as a result of ineffective fat
metabolism that contribute to diabetic ketoacidosis
Ideal blood glucose post Exercise - ANS > 80 mg/dl
Ideal Blood Glucose before exercise - ANS > 100 mg/dl
Normal BP response to Exercise - ANS - Progressive increase in SBP with workload until
plateau in peak exercise
- No change or slight decrease in SP
Bi-ventricular pacemaker - ANS Deliver innovative therapy- cardiac resynchronization
Used for CHF to decrease symptoms and increase function
Benefits of PA as motivation - ANS - decrease mortality
- decrease risk of metabolic disease
- weight control
- decrease depression and anxiety
- increase body image and self -esteem/ efficacy
- increase ability to do ADL's
Bradychardia - ANS HR < 50 BPM
Bundle Branch Block - ANS - Wide QRS
- usually result from disease in BB's or Ventricular abnormalities, drug use, or electrolyte
imbalance
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, Chronotropic Incompetence - ANS - HR fails to increase with increased workload
- achieving <85 % age predicted max HR
- achieving <62% of age predicted max HR on beta blockers
- Predictive of CAD and increased risk of mortality
EKG Changes from metabolic diseases - ANS - Hypothyroidism: Decreased sinus rate
- Hyperthyroidsm: Increased sinus rate
- Obesity: Increased resting HR, BP; Increased PR, QRS, and QT intervals
- Hypothermia: J-point deflection
EKG lead placement: V1 and V2 - ANS Right and Left Sternal border at the 4th intercostal
space
EKG lead placement: V3 - ANS Midpoint between V2 and V4
EKG Lead placement: V4 - ANS Mid-clavicular line at 5th intercostal space
EKG lead placement: V5 - ANS Anterior axillary line
EKG lead placement: V6 - ANS Mid-axillary line, horizontal to V4 and V5
Effect of Exercise on dyslipidemia - ANS - decrease triglycerides, LDL, total cholesterol
- increase HDL
- can cause angina or claudication
- increase lipoprotein enzyme activity
- increase volume rather then intensity for best results
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
PHYSIOLOGIST EXAM QUESTIONS
WITH 100% CORRECT ANSWERS |
LATEST VERSION 2025/2026.
1 MET = - ANS 3.5 ml/kg/mig
1 large box - ANS 5mm or 0.2 seconds
1 small box - ANS 1mm or 0.04 sec
1 Rep Max (1RM) Procedure - ANS 1.) warm up with sub max reps (40-60% RM)
2.) 3-5 reps moderate wt (70-80% RM)
3.) 2 min rest then estimated max attempt
4.) 3-5 min rest attempt with added weight until achieved in 3-5 tries
5.) once attempt failed- attempt weight between last 2
Intraventricular conduction delay - ANS - wide QRS = >0.1
- refers to disturbances in the intraventricular propagation of supraventricular impulses
resulting in changes in the QRS complex either in morphology or duration, or both
- abnormal activation the ventricle cause by conduction delay
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,Indicators of an old MI - ANS - Abnormal/significant Q waves
- 1 box wide of > 1/3 of R-wave
Absolute Contraindications to Exercise Testing - ANS 1. recent change in ECG
2. unstable angina
3. uncontrolled dysrhythmia causing sxs
4. symptomatic severe AS
5. uncontrolled HF w/ sxs
6. acute PE or pulmonary infarct
7. acute myocarditis/pericarditis
8. suspected / known dissecting aneurysm
9. acute systemic infection
***Risk of testing outweigh the benefits***
Absolute indications to Terminate Exercise Testing - ANS 1. Drop in SBP > 10 mmHg w/
increased workload
2. Moderately severe angina
3. Increase in Dizziness
4. signs of poor perfusion
5. technical difficulties
6. Sustained V-TAch
7. ST elevation (+1mm) in leads w/o Q waves
Blood Glucose Management with exercise - ANS - Requires balance between hepatic glucose
production, peripheral glucose uptake, combined with effective insulin response
- Continuous monitoring
- Regular PA
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,Dangers of BS of 250-300 mg/dl - ANS - Urinary Ketones form as a result of ineffective fat
metabolism that contribute to diabetic ketoacidosis
Ideal blood glucose post Exercise - ANS > 80 mg/dl
Ideal Blood Glucose before exercise - ANS > 100 mg/dl
Normal BP response to Exercise - ANS - Progressive increase in SBP with workload until
plateau in peak exercise
- No change or slight decrease in SP
Bi-ventricular pacemaker - ANS Deliver innovative therapy- cardiac resynchronization
Used for CHF to decrease symptoms and increase function
Benefits of PA as motivation - ANS - decrease mortality
- decrease risk of metabolic disease
- weight control
- decrease depression and anxiety
- increase body image and self -esteem/ efficacy
- increase ability to do ADL's
Bradychardia - ANS HR < 50 BPM
Bundle Branch Block - ANS - Wide QRS
- usually result from disease in BB's or Ventricular abnormalities, drug use, or electrolyte
imbalance
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, Chronotropic Incompetence - ANS - HR fails to increase with increased workload
- achieving <85 % age predicted max HR
- achieving <62% of age predicted max HR on beta blockers
- Predictive of CAD and increased risk of mortality
EKG Changes from metabolic diseases - ANS - Hypothyroidism: Decreased sinus rate
- Hyperthyroidsm: Increased sinus rate
- Obesity: Increased resting HR, BP; Increased PR, QRS, and QT intervals
- Hypothermia: J-point deflection
EKG lead placement: V1 and V2 - ANS Right and Left Sternal border at the 4th intercostal
space
EKG lead placement: V3 - ANS Midpoint between V2 and V4
EKG Lead placement: V4 - ANS Mid-clavicular line at 5th intercostal space
EKG lead placement: V5 - ANS Anterior axillary line
EKG lead placement: V6 - ANS Mid-axillary line, horizontal to V4 and V5
Effect of Exercise on dyslipidemia - ANS - decrease triglycerides, LDL, total cholesterol
- increase HDL
- can cause angina or claudication
- increase lipoprotein enzyme activity
- increase volume rather then intensity for best results
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
