Chapter 5-8

True or False? Children and adolescents (6-17 yr old) are more physically active than their adult counterparts.

True

True or False? Pregnant women should avoid exercising in the supine position after 16 wk of pregnancy.

True

True or False? Recommendations for exercise testing and prescription for those with low back pain are similar to those for healthy individuals when low back pain is not associated with another serious pathology.

True

True or false. Below, there are three evidence-based benefits of physical activity in the older adult populations: Managing chronic diseases Reducing the risks of physical disability Increasing longevity

True

Using the percentage of heart rate reserve method to prescribe exercise intensity, which of the following is the correct answer given the available test data below? HRrest: 70 beats · min-1 HRmax: 180 beats · min-1 Desired exercise intensity: 50%

125 beats · min-1

True or false. The following three physical performance measures are appropriate for low back pain: 50-Ft walk — the participant walks 50 ft as fast as possible without a walking aid. Time to completion is recorded. 5-Min walk — the participant walks as far as possible in 5 min without a walking aid. Distance is recorded (foot or meter). 1-Minute stair climbing — the participant walks up and down five stairs for 1 min as fast as possible using the rail for support if required. The total amount of steps climbed is recorded.

True

True or false. This is the equation used to measure and maintain normal hydration in hot environments: Measure body weight before and after exercise. Sweat rate (L · h-1 or q · h-1) provides a fluid replacement guide. Active individuals should drink at least 1 pt of fluid for each pound of body weight lost.

True

True or false? A theory is a framework that describes how and why behavior changes for a given population in a particular setting.

True

True or false? Adults who do not meet public health recommendations for physical activity are twice as likely to regain weight as those who do meet recommendations.

True

True or false? An eco-map can be used to illustrate the various environmental and interpersonal interactions that impact behavior.

True

True or false? Pedometers can be used to provide a more objective measure of physical activity than client recall.

True

True or false? Social Cognitive Theory puts great emphasis on a client's thoughts and feelings.

True

True or false? The Small Changes Model is based on the premise that clients will maintain smaller behavior changes more easily and will continue to build upon them over time.

True

True or false? The following four physiologic responses to acute exercise increase during pregnancy as compared to prepregnancy: Tidal volume Minute ventilation Ventilatory equivalent for oxygen Ventilatory equivalent for carbon dioxide

True

True or false? Unsolicited advice can put a client on the defensive and increase resistance to changing his/her behavior.

True

In which stage of change will it be MOST important to raise awareness related to the benefits of exercise? a. Precontemplation b. Preparation c. Contemplation d. Postcontemplation

a. Precontemplation

Which of the following is an example of a supraventricular arrhythmia? a. Premature atrial contraction b. Premature ventricular contraction c. First-degree AV block d. Left bundle-branch block

a. Premature atrial contraction

Which statement regarding frostbite is FALSE? a. Frostbite can occur in ≤30 min on exposed skin in extreme temperatures. b. Frostbite most commonly affects the hands and feet. c. Frostbite cannot occur if the air temperature is above 0° C (32° F). d. Contact frostbite may occur by touching cold objects with bare skin.

b. Frostbite most commonly affects the hands and feet.

Which of the following is a recommendation for special consideration in exercise testing of older adults? a. It may be better to adjust workload by increasing speed instead of grade. b. Initial workload should be <3 METs. c. Treadmill is the preferred mode for testing. d. Workload increments should be 1.0-1.5 METs to advance stages.

b. Initial workload should be <3 METs.

The rate pressure product is calculated by a. SBP × DBP b. SBP × HR c. SBP × DBP × HR d. DBP × HR

b. SBP × HR

The normal electrocardiographic response to exercise includes which of the following? a. Widening of the QRS duration b. Slight decreases in R wave amplitude c. Decreases in septal Q wave amplitude d. Decreases in T wave amplitude

b. Slight decreases in R wave amplitude

Which of the following physiologic responses to acute exercise may decrease during pregnancy as compared to the prepregnancy state? a. Heart rate b. Systolic blood pressure c. Cardiac output d. Stroke volume

b. Systolic blood pressure

A control group in which the subjects do not receive the experimental treatment until after it has been found effective in the experimental group is referred to as: a. Delayed satisfaction group b. Wait-list control group c. Intervention factor group d. Randomized group

b. Wait-list control group

The inability to appropriately increase heart rate during exercise is known as a. a dysrhythmia b. chronotropic incompetence c. inotropy d. ischemia

b. chronotropic incompetence

Older adults can confer greater benefit by holding a stretch for

30s - 60s

All of the following are known to influence clinical exercise test data with the exception of a. pulmonary disease b. elevated levels of physical fitness c. orthopedic limitations d. neurologic disorders

b. elevated levels of physical fitness

Exertional hypotension can be defined as failure of the a. diastolic blood pressure to rise b. systolic blood pressure to rise c. heart rate to fall d. heart rate to rise

b. systolic blood pressure to rise

Which of the following does NOT need to be monitored continuously during a clinical graded exercise test? a. Heart rate b. Blood pressure c. Electrocardiogram d. Signs and symptoms

b. Blood pressure

Under which of the following conditions is it not necessary to have a physician directly supervise an exercise test of a patient? a. Known complex arrhythmias b. Patients undergoing symptom-limited testing following recent acute events (i.e., acute coronary syndrome or MI) c. 1-yr postmyocardial infarction follow-up d. Severe valvular stenosis (e.g., aortic stenosis)

c. 1-yr postmyocardial infarction follow-up

What percentage of patients suffering from a cardiac event fails to return to work? a. 50% b. 5% c. 25% d. 15%

c. 25%

What is the general guideline for submaximal exercise testing of patients before discharge after acute MI? a. 2 wk b. 2 d c. 4-6 d d. Never

c. 4-6 d

An appropriate mechanism to gauge intensity of exercise for older adults as "moderate" is a. 14-16 on an RPE scale of 6-20 b. HRR of 120-130 beats · min-1 c. 5-6 on an RPE scale of 0-10 d. 60%-80% HRR

c. 5-6 on an RPE scale of 0-10

If "moderate intensity" aerobic exercise is prescribed, what are the minimum recommendations for how often an healthy adult should engage in exercise to achieve health/fitness benefits?

5 days per week

A truly positive exercise test requires a hemodynamically significant coronary lesion a. <50% occlusion b. 100% occlusion c. >75% stenosis d. between 50% and 100% stenosis

c. >75% stenosis

A client who has been exercising regularly for the last 4 months is in which stage of change? a. Contemplation b. Preparation c. Action d. Maintenance

c. Action

Which of the following modes of exercise is appropriate for paraplegic patients? a. Rockport Walking Test b. Treadmill c. Arm cycle d. Leg cycle

c. Arm cycle

Which stage of change would be the LEAST benefited by the behavioral strategy of substituting alternatives? a. Maintenance b. Action c. Contemplation d. Preparation

c. Contemplation

Which of the following is an abnormal electrocardiographic response to exercise? a. Changes in P wave morphology b. Superimposition of the P and T waves of successive beats c. Depression of the ST segment d. Increases in septal Q wave amplitude

c. Depression of the ST segment

In a healthy pregnant woman, which of the following is not a valid reason that exercise should be terminated? a. Calf pain or swelling b. Dizziness c. Increased fetal movement d. Headache

c. Increased fetal movement

An action taken to help someone change his/her behavior is called a/an: a. Control variable b. Covariate c. Intervention d. Construct

c. Intervention

Which of these statements is NOT true regarding individuals with low back pain? a. People with subacute low back pain are encouraged to be physically active. b. People with chronic low back pain are encouraged to be physically active. c. Part of the management of low back pain includes frequent bed rest. d. It is good to avoid exercise immediately in the immediate aftermath of an acute and severe episode of low back pain.

c. Part of the management of low back pain includes frequent bed rest.

In patients with left bundle-branch block, a. myocardial ischemia can only be interpreted in the "indicative" leads b. heart rate is often uninterpretable because of the electrical interference c. ST-segment abnormalities that develop during exercise are uninterpretable with respect to evidence of myocardial ischemia d. ST-segment abnormalities can only be interpreted as positive during exercise

c. ST-segment abnormalities that develop during exercise are uninterpretable with respect to evidence of myocardial ischemia

Which of the following types of exercises should healthy pregnant women avoid? a. Cycle ergometry b. Stair climbing c. Soccer d. Jogging

c. Soccer

True or False? Although resistance training is important across the lifespan, it becomes less important with increasing age.

False

True or False? High altitude cerebral edema (HACE) is the most common form of altitude sickness.

False

True or False? Hypothermia occurs when metabolic heat production exceeds heat loss from the body.

False

True or False? Most adolescents (13-18 yr old) participate in adequate amounts of physical activity.

False

True or False? Most cases of low back pain show rapid improvement in pain and symptoms within the first week of symptom occurrence.

False

True or False? Rating of perceived exertion (RPE) is an appropriate primary quantifier of exercise intensity.

False

True or False? When prescribing exercise intensity based on percentage of the age-predicted maximal heart rate, the most accurate formula to use is 220 - age.

False

True or false? "SMALL" goals refer to goals that are self-serving, meaningful, activity-oriented, lifestyle-linked, and long-term.

False

True or false? A theory is a set of beliefs that are stable and established.

False

True or false? An individual who has developed a plan of action toward a behavior change and will be making changes within the upcoming month is in the contemplation stage.

False

True or false? Beating oneself up with negative thoughts can be a powerful motivator for behavior change.

False

True or false? Clients who are collaborators in making decisions that affect their lifestyle are typically the most dissatisfied and least likely to make lasting behavior change.

False

True or false? Feedback must be in person to be effective.

False

The greatest risk for heatstroke exists when wet bulb globe temperature (WBGT) exceeds a. >24° C (75° F) b. >34° C (93° F) c. >37° C (98.7° F) d. >28° C (82° F)

d. >28° C (82° F)

Which of the following are typically NOT monitored during a graded exercise test? a. Symptoms b. Electrocardiogram c. Hemodynamic responses d. Blood gases

d. Blood gases

When progressing in exercise prescription, any of the components of the FITT principal may be manipulated. What is the recommendation as the component to be manipulated in the initial phase (first 4-6 weeks) of an exercise program for an average adult?

Time (duration)

At what interval should heart rate be monitored during a graded exercise test? a. During the last 45 s of each stage b. At any time during a stage c. At the beginning of each stage d. Continuously but recorded during the last 5 s of each minute

d. Continuously but recorded during the last 5 s of each minute

Recommendations for exercise testing of older adults ≥75 yr should NOT include the following? a. A prerequisite exercise test b. Risk stratification c. A medical history and physical examination d. Those free of cardiovascular symptoms and disease may initiate a light intensity exercise program.

a. A prerequisite exercise test

Which of the following would NOT help to build rapport with a client? a. Avoid eye contact b. Dress and act professionally c. Affirm client strengths that you have noted d. Empathize with client's feelings

a. Avoid eye contact

Which of the following is the most commonly used treadmill test protocol? a. Bruce protocol b. Rockport Walking Test c. Ramp protocol d. YMCA branching protocol

a. Bruce protocol

Which of the following is the most important criterion for terminating a clinical exercise test? a. Good judgment on the part of the physician and/or supervising staff b. Age-predicted maximal heart rate c. Failure of the heart rate to rise with incremental exercise d. Systolic blood pressure failing to rise between successive stages

a. Good judgment on the part of the physician and/or supervising staff

Which technique is the LEAST effective way to avoid arguments and reduce resistance with clients? a. Ignore the resistance b. Present a hypothetical scenario c. Listen d. Emphasize success

a. Ignore the resistance

Which of the following statements is FALSE regarding the ST segment on a resting electrocardiogram? a. ST-segment elevation always means acute myocardial infarction confirmed by serial cardiac enzymes. b. Exercise-induced ST-segment elevation on an otherwise normal ECG (except in aVR or V1-V2) generally indicates significant myocardial ischemia and localizes the ischemia to a specific area of myocardium. c. ST-segment elevation (early repolarization) may be seen in the normal resting ECG; increasing HR usually causes these elevated ST segments to return to the isoelectric line. d. Exercise-induced ST-segment elevation in leads with Q waves consistent with a prior myocardial infarction may be indicative of wall motion abnormalities, ischemia, or both.

a. ST-segment elevation always means acute myocardial infarction confirmed by serial cardiac enzymes.

At what interval should signs and symptoms be monitored during a graded exercise test? a. Signs and symptoms should be monitored continuously and recorded as observed. b. During the last 45 s of each stage c. At any time during a stage d. At the beginning of each stage

a. Signs and symptoms should be monitored continuously and recorded as observed.

Which of the following is an ABSOLUTE contraindication for exercise testing? a. Technical difficulties monitoring the ECG or systolic blood pressure b. Arrhythmias other than sustained ventricular tachycardia, including multifocal PVCs, triplets of PVCs, supraventricular tachycardia, heart block, or bradyarrhythmias c. Drop in systolic blood pressure of >20 mm Hg from baseline blood pressure despite an increase in workload, in the absence of other evidence of ischemia d. ST or QRS changes such as excessive ST depression (>2 mm horizontal or downsloping ST-segment depression) or marked axis shift

a. Technical difficulties monitoring the ECG or systolic blood pressure

Which of the following is NOT a reason for exercise testing soon after a patient has suffered a myocardial infarction? a. To evaluate atypical angina b. Evaluation of further medical therapy or interventions c. Prognostic assessment d. Activity prescription

a. To evaluate atypical angina

An adverse prognosis in the postmyocardial infarction patient includes a. an ischemic ST-segment depression at a low level of exercise b. a hypertensive blood pressure response to exercise c. a functional capacity of >5 METs d. an increased left ventricular systolic function

a. an ischemic ST-segment depression at a low level of exercise

In patients on vasodilators, calcium channel blockers, angiotensin-converting enzyme inhibitors, and α- and β-adrenergic blockers, the blood pressure response to exercise is a. variably attenuated and cannot be accurately predicted in the absence of clinical test data b. always decreased during graded exercise testing c. typically normal if the patient is either on the medication or off of it d. always increased in these types of patients

a. variably attenuated and cannot be accurately predicted in the absence of clinical test data

What percentage of individuals -who are asymptomatic for cardiovascular disease actually- have angiographic evidence of disease? a. Between 50% and 75 % b. <10% c. Almost 50% d. Between 10% and 25%

b. <10%

Which of the following is the definition of "predictive value"? a. Conditional probability b. A measure of how accurately a test result (positive or negative) correctly identifies the presence or absence of CVD in tested patients c. The percentage of patients without CVD who demonstrate nonsignificant (i.e., negative) ST-segment changes d. The percentage of patients tested with known CVD who demonstrate significant ST-segment (i.e., positive) changes

b. A measure of how accurately a test result (positive or negative) correctly identifies the presence or absence of CVD in tested patients

Which of the following statements about altitude illness is FALSE? a. Acute mountain sickness is the most common form of altitude sickness. b. Altitude illnesses are commonly associated with rapid descents from high altitude by unacclimatized individuals. c. Altitude acclimatization is the best countermeasure to all altitude sickness. d. High altitude cerebral edema, potentially fatal, is an exacerbation of unresolved severe acute mountain sickness.

b. Altitude illnesses are commonly associated with rapid descents from high altitude by unacclimatized individuals.

Exercise testing for an individual with which of the following conditions is NOT generally used for diagnostic purposes? a. Angiographically documented coronary stenosis b. Atypical chest pain c. Prior coronary revascularization d. Prior myocardial infarction

b. Atypical chest pain

According to the Health Belief Model, the main predictors of behavior change include all of the following EXCEPT: a. Perceived seriousness of a potential health problem b. Being able to state the prevalence rates of various diseases in a given population c. The belief that making the suggested behavior changes will result in decreased risk of consequences d. One's susceptibility to potential health consequences

b. Being able to state the prevalence rates of various diseases in a given population

At what interval should blood pressure be monitored during a graded exercise test? a. During the last 5 s of each stage b. During the last 45 s of each stage c. At the beginning of each stage d. At any time during a stage

b. During the last 45 s of each stage

Although important in some patient populations, which of the following is the least likely to be measured or monitored? a. Blood pressure b. Expired gases c. Heart rate d. Electrocardiogram

b. Expired gases

Which aspect of a successful goal is missing from this client's goal? "I will exercise by walking my dog around my neighborhood on Monday, Wednesday, and Friday." a. The goal is not strenuous enough to be of much benefit. b. The goal is not focused on an activity done with the Personal Trainer. c. The goal is missing specificity regarding the time spent walking. d. The goal is not very realistic.

c. The goal is missing specificity regarding the time spent walking.

Which theory includes the tool of "rolling with resistance?" a. Health Belief Model b. Social Cognitive Theory c. Transtheoretical Model of Change d. Theory of Planned Behavior

c. Transtheoretical Model of Change

What is the most common exercise testing mode in the United States? a. Cycle ergometer b. Arm ergometer c. Treadmill d. Elliptical

c. Treadmill

What is the pretest likelihood that a female aged 35 yr with nonanginal chest pain has atherosclerotic cardiovascular disease? a. High b. Very high c. Very low d. Intermediate

c. Very low

Exercise electrocardiography for diagnostic purposes is less accurate in women largely because of a greater number of a. true positive responses b. true negative responses c. false positive responses d. false negative responses

c. false positive responses

Exercise-induced myocardial ischemia may cause left ventricular dysfunction, exercise intolerance, and a ___________ blood pressure response. a. hypertensive b. normotensive c. hypotensive d. normal

c. hypotensive

What is the most accurate and objective noninvasive indicator of subject effort during a graded exercise stress test, peak? a. rating of perceived exertion b. heart rate c. respiratory exchange ratio d. systolic blood pressure

c. respiratory exchange ratio

The normal blood pressure response to dynamic upright exercise consists of a progressive increase in a. pulse pressure b. mean arterial pressure c. systolic blood pressure d. diastolic blood pressure

c. systolic blood pressure

What is the definition of ventricular tachycardia? a. PVCs lasting 1 min or longer b. PVCs occurring every other beat c. ≥3 PVCs in succession d. >5 PVCs in succession

c. ≥3 PVCs in succession

Interindividual variability for predicting maximal heart rate from age is a. 5 beats · min-1 b. 10 beats · min-1 c. 20 beats · min-1 d. 12 beats · min-1

d. 12 beats · min-1

Because of the smaller muscle mass used during arm ergometry, what percentage of maximal oxygen consumption when compared to treadmill testing can be expected? a. 20%-30% higher b. 10%-20% higher c. 5%-10% lower d. 20%-30% lower

d. 20%-30% lower

At what point is depression of the J point measured on the electrocardiogram? a. 1 s b. 120 ms c. 0.5 s d. 80 ms

d. 80 ms

Which of the following should NOT be discussed with a patient regarding a return to work after a cardiac event? a. Establishing tentative time lines for work evaluation and return to work b. Ascertaining job aerobic requirements and potential cardiac demands c. Individualizing rehabilitation according to job demands d. Establishing early that the patient likely will not return to his or her previous occupation

d. Establishing early that the patient likely will not return to his or her previous occupation

Which of the following is a life-threatening heat-related medical emergency? a. Heat exhaustion b. Heat syncope c. Heat cramps d. Exertional heatstroke

d. Exertional heatstroke

Which of the following is a RELATIVE contraindication for exercise testing? a. Increasing nervous system symptoms (e.g., ataxia, dizziness, near syncope) b. Technical difficulties monitoring the ECG or systolic blood pressure c. Drop in systolic blood pressure of >10 mm Hg from baseline blood pressure despite an increase in workload, when accompanied by other evidence of ischemia d. Fatigue, shortness of breath, wheezing, leg cramps, or claudication

d. Fatigue, shortness of breath, wheezing, leg cramps, or claudication

Which of the following is NOT a hemodynamic response to clinical exercise testing? a. Heart rate b. Systolic blood pressure c. Diastolic blood pressure d. Gas exchange and ventilatory responses

d. Gas exchange and ventilatory responses

Which of the following physiologic responses to acute exercise is higher in children as compared to adults? a. Cardiac output b. Stroke volume c. Systolic blood pressure d. Heart rate

d. Heart rate

What is the pretest likelihood that a male aged 40 yr with typical angina pectoris has atherosclerotic cardiovascular disease? a. Very low b. Low c. Intermediate d. High

d. High

The Theory of Planned Behavior suggests that a client's level of intent is shaped by all of the following EXCEPT: a. Perceived behavior control b. Subjective norms c. Attitude toward the behavior d. Knowledge of disease risk

d. Knowledge of disease risk

Which of the following electrocardiogram changes are known to affect test interpretation of ischemic coronary artery disease? a. Three premature atrial contractions in 1 min b. A single unifocal premature ventricular contraction c. Left atrial hypertrophy d. Left ventricular hypertrophy

d. Left ventricular hypertrophy

In which stage of change will it be MOST important to create plans to avoid relapse? a. Contemplation b. Preparation c. Action d. Maintenance

d. Maintenance

Which of the following is NOT a recommendation regarding exercise for healthy women who are pregnant? a. Preferably exercise 3-4 d · wk-1. b. Avoid contact sports and sports/activities that may cause loss of balance or trauma to the mother or fetus. c. Avoid exercising in a hot humid environment, be well hydrated, and dressed appropriately to avoid heat stress. d. Maximal exercise testing to determine appropriate exercise intensity is recommended.

d. Maximal exercise testing to determine appropriate exercise intensity is recommended.

Which of the following is NOT an advantage of using the ramp protocol for treadmill exercise testing? a. Avoidance of large and unequal increments in workload b. More accurate estimates of exercise capacity and ventilatory threshold c. Uniform increase in hemodynamic and physiologic responses d. Protocol cannot be individualized

d. Protocol cannot be individualized

Bayes' theorem states that the posttest probability of having disease is determined by the disease probability ________ the test and the probability that the test will provide a true result. a. during b. within the first minute of c. after d. before

d. before

A delayed decrease in heart rate early in recovery after a symptom-limited maximal exercise test (e.g., <12 beats · min-1 decrease after the first minute in recovery) is a powerful predictor of a. ventricular incompetence b. gender bias c. being physically fit d. overall mortality

d. overall mortality

Although QRS duration tends to decrease slightly with exercise (and increasing HR) in healthy people, it may increase in a. patients with acute myocardial infarction b. individuals with low back pain c. the presence of ventricular arrhythmia d. patients with either angina or left ventricular dysfunction

d. patients with either angina or left ventricular dysfunction

The magnitude of ischemia caused by a coronary lesion generally is proportional to a. the nonobstructive atherosclerotic plaque Incorrect b. just one electrocardiogram lead c. a short duration of ST-segment depression on the electrocardiogram in recovery d. the degree of ST-segment depression on the electrocardiogram

d. the degree of ST-segment depression on the electrocardiogram

The standard minimum criterion for a positive exercise test is a. ST-segment elevation in the presence of left bundle branch block b. ≥2.0 mm (0.2 mV) of horizontal or downsloping ST segment at the J point extending for 60-80 ms c. upsloping ST-segment depression d. ≥1.0 mm (0.1 mV) of horizontal or downsloping ST segment at the J point extending for 60-80 ms

d. ≥1.0 mm (0.1 mV) of horizontal or downsloping ST segment at the J point extending for 60-80 ms