Benefits of Physical Activity
Which of the following symptoms would indicate the need for medical clearance before exercise?
a) Occasional mild headaches
b) Chest pain (angina) during exertion
c) Slight muscle soreness after a workout
d) Feeling tired after a long day at work
b) Chest pain (angina) during exertion
Which GXT protocol is most commonly used but may not be ideal for individuals with cardiovascular disease (CVD)?
a) Modified Bruce Protocol
b) Bruce Protocol
c) Naughton Protocol
d) Åstrand-Rhyming Protocol
b) Bruce Protocol
Which method can be used to determine heart rate from an EKG when the rhythm is regular?
a) 6-second strip method
b) 300 rule
c) 10-second rule
b) 300 rule
A patient has a heart rate of 110 bpm, regular rhythm, and normal PR and QRS intervals. What is the likely diagnosis?
a) Sinus bradycardia
b) Sinus arrhythmia
c) Sinus tachycardia
d) Sinus arrest
c) Sinus tachycardia
Which of the following is the most common adverse event associated with exercise?
a) Sudden cardiac death
b) Hypertension
c) Musculoskeletal injuries
d) Stroke
c) Musculoskeletal injuries
What is the primary advantage of using a treadmill for GXT compared to a cycle ergometer?
a) It allows for better control of heart rate responses
b) It uses more muscle mass, resulting in a higher MET level
c) It is more cost-effective and portable
d) It prevents musculoskeletal fatigue
b) It uses more muscle mass, resulting in a higher MET level
Which of the following is a normal QRS axis range?
a) -90° to 0°
b) -30° to +90°
c) +90° to +180°
d) 0° to +180°
b) -30° to +90°
Which statement is TRUE about sinus block?
a) The SA node fails to fire, and no escape beat occurs
b) The rhythm picks up exactly on time after the block
c) The P wave disappears permanently
d) The QRS complex becomes abnormally wide
b) The rhythm picks up exactly on time after the block
Which of the following is NOT one of the risk modulators in the ACSM Preparticipation Health Screening Algorithm?
a) Physical activity status
b) Presence of known cardiovascular, metabolic, or renal disease
c) Symptoms suggestive of cardiovascular disease
d) CVD risk factors
d) CVD risk factors
*** Double Points***
Which of the following is considered an abnormal blood pressure response during exercise?
a) SBP increases ~10 mm Hg per MET increase
b) DBP remains the same or slightly decreases
c) A drop in SBP below resting value or >10 mm Hg after an initial rise
d) HR recovery decreases by at least 12 bpm in the first minute
c) A drop in SBP below resting value or >10 mm Hg after an initial rise
Which leads are primarily used to determine QRS axis?
a) V1 and V6
b) Leads I and aVF
c) Leads III and aVR
d) V3 and aVL
b) Leads I and aVF
What does ST segment elevation indicate?
a) Myocardial ischemia
b) Myocardial infarction
c) Left atrial enlargement
d) Sinus bradycardia
b) Myocardial infarction
A 55-year-old sedentary male with no known disease reports experiencing dizziness and shortness of breath during mild exertion. What is the appropriate recommendation?
a) He can start a vigorous exercise program without medical clearance
b) He should undergo medical clearance before starting an exercise program
c) He should avoid all forms of exercise permanently
d) He should only perform moderate-intensity exercise to overcome symptoms
b) He should undergo medical clearance before starting an exercise program
Which of the following is NOT an assumption for a valid submaximal test?
a) A linear relationship exists between HR and work rate
b) HR remains steady for each exercise work rate
c) VO₂max is always directly measured during a submaximal test
d) The individual is not under the influence of caffeine or medications affecting HR
c) VO₂max is always directly measured during a submaximal test
If Lead I is positive and Lead aVF is negative, what should you check next to confirm left axis deviation (LAD)?
a) Lead V1
b) Lead II
c) Lead III
d) Lead aVR
b) Lead II
What ECG finding is most indicative of right atrial enlargement (RAE)?
a) Tall, peaked P waves in Lead II
b) Wide, Notched P waves in Lead II
c) Prolonged PR interval
d) Depressed ST segment
a) Tall, peaked P waves in Lead II
*** Double Points***
A 45-year-old physically active woman with hypertension, but no other risk factors, wants to start a moderate-intensity exercise program. Should she get medical clearance?
a) Yes, because she has hypertension
b) No, because she is already active and has no symptoms
c) Yes, because all adults over 40 need clearance
d) No, because hypertension is not a risk factor for exercise participation
b) No, because she is already active and has no symptoms
A 60-year-old patient is undergoing a GXT. Their HR fails to increase with increased workload, and their RPE is 19 on the 6–20 scale. What does this suggest?
a) They have excellent cardiovascular fitness
b) The test is a valid maximal effort
c) The test should be terminated due to an abnormal response
d) The patient needs encouragement to continue
c) The test should be terminated due to an abnormal response
*** Double Points***
What might cause left axis deviation (LAD)?
a) Right ventricular hypertrophy (RVH)
b) Left ventricular hypertrophy (LVH)
c) Myocardial infarction on the left side
d) Sinus tachycardia
b) Left ventricular hypertrophy (LVH)
*** Double Points***
What is a common ECG finding in right ventricular hypertrophy (RVH)?
a) Large S wave in V1
b) R wave greater than S wave in V1
c) Depressed PR segment in all leads
d) Widened QRS complex
b) R wave greater than S wave in V1