Chapter 9: Client Consultation and Health Appraisal

Question 1

Scope of Practice

Answer 1

Legal boundaries that determine the extent of a personal trainer’s professional duties. (NSCA CPT, pg. 165)

Question 2

Health Appraisal

Answer 2

Process to screen a client for risk factors and symptoms of chronic cardiovascular, pulmonary, metabolic, and orthopedic diseases in order to optimize safety during exercise testing and participation. (NSCA CPT, pg. 166)

Question 3

PAR-Q

Answer 3

An assessment tool to initially screen apparently healthy clients who want to engage in low-intensity exercise and identify clients who require additional medical screening. (NSCA CPT, pg. 167)

Question 4

Coronary Risk Factors

Answer 4

A characteristic, trait, or behavior that affects the probability of developing cardiovascular disease. (NSCA CPT, pg. 167)

Question 5

Assumption of Risk

Answer 5

A defense for the personal trainer whereby the client knows that there are inherent risks with participation in an activity but still voluntarily decides to participate. (NSCA CPT, pg. 168)

Question 6

Coronary Artery Disease

Answer 6

A condition or dysfunction of the cardiovascular system (e.g., atherosclerosis, myocardial infarction, angina). (NSCA CPT, pg. 169)

Question 7

Atherosclerosis

Answer 7

A progressive degenerative process through which the interior lining of the arterial walls becomes hardened and inelastic. (NSCA CPT, pg. 169)

Question 8

Myocardial Infarction

Answer 8

A result of the death of heart tissue due to an occluded blood supply; also referred to as a heart attack. (NSCA CPT, pg. 169)

Question 9

Chronic Obstructive Pulmonary Disease

Answer 9

A condition or dysfunction of the pulmonary system (e.g., chronic bronchitis, emphysema, asthma). (NSCA CPT, pg. 173)

Question 10

Thrombotic Occlusion

Answer 10

Blockage due to a blood clot. (NSCA CPT, pg. 173)

Question 11

Sudden Cardiac Death

Answer 11

Death occurring unexpectedly and instantaneously or within 1 hour of the onset of symptoms in a patient with or without known preexisting heart disease. (NSCA CPT, pg. 173)

Question 12

Hypertrophic Cardiomyopathy

Answer 12

Condition of unknown cause resulting in thickening in a part of the muscle of the heart. (NSCA CPT, pg. 173)

Question 13

Aortic Stenosis

Answer 13

Narrowing of the aorta. (NSCA CPT, pg. 173)

Question 14

Marfan Syndrome

Answer 14

Genetic disorder of the connective tissue; symptoms include irregular and unsteady gait, tall lean body type with long extremities including fingers and toes, abnormal joint flexibility, flat feet, stooped shoulders, and dislocation of the optic lens. Complications include a weakened aorta, which may rupture if not treated. (NSCA CPT, pg. 173)

Question 15

Mitral Valve Prolapse

Answer 15

Valvular heart disease characterized by the displacement of an abnormally thickened mitral valve leaflet into the left atrium during systole. (NSCA CPT, pg. 173)

Question 16

Myocarditis

Answer 16

Inflammation of the heart muscle. (NSCA CPT, pg. 173)

Question 17

Medical Clearance

Answer 17

Approval by a physician indicating that the client is fit for exercise. (NSCA CPT, pg. 177)

Question 18

Risk Stratification

Answer 18

A method to initially classify clients as being at low, moderate, or high risk for coronary, peripheral vascular, or metabolic disease. (NSCA CPT, pg. 176)

Question 19

M in MATER

Answer 19

personal trainers MOTIVATE performance and compliance. (NSCA CPT, pg. 166)

Question 20

A in MATER

Answer 20

personal trainers ASSESS health status. (NSCA CPT, pg. 166)

Question 21

T in MATER

Answer 21

personal trainers TRAIN clients safely and effectively to meet individual objectives. (NSCA CPT, pg. 166)

Question 22

E in MATER

Answer 22

personal trainers EDUCATE clients to be informed consumers. (NSCA CPT, pg. 166)

Question 23

R in MATER

Answer 23

personal trainers REFER clients to health care professionals when necessary. (NSCA CPT, pg. 166)

Question 24

Client Consultation Steps

Answer 24

1. Schedule interview appointment.
2. Conduct interview.
3. Implement and complete health appraisal forms.
4. Evaluate for coronary risk factors, diagnosed disease, and lifestyle. 5. Assess and interpret results.
5. Refer to an allied health professional when necessary.
6. Obtain medical clearance and program recommendations. (NSCA CPT, pg. 166)

Question 25

Lifestyle inventory

Answer 25

Usually consisting of questions to evaluate personal choices and patterns related to dietary intake, stress management, physical activity, and other health practices. (NSCA CPT, pg. 168)

Question 26

Informed Consent

Answer 26

Gives clients information about the content and process of the program delivery system. (NSCA CPT, pg. 168)

Question 27

Age positive risk factor criteria

Answer 27

Men ≥45 years; women ≥55 years. (NSCA CPT, pg. 170)

Question 28

Family history positive risk factor criteria

Answer 28

Myocardial infarction, coronary revascularization, or sudden death before 55 years of age in biological father or other male first-degree relative, or before 65 years of age in biological mother or other female first-degree relative. (NSCA CPT, pg. 170)

Question 29

Cigarette Smoking positive risk factor criteria

Answer 29

Current cigarette smoker or someone who quit within the previous six months, or
exposure to environmental tobacco smoke. (NSCA CPT, pg. 170)

Question 30

Sedentary Lifestyle positive risk factor criteria

Answer 30

Not participating in at least 30 min of moderate intensity (40-60% V O2Reserve) physical activity on at least three days of the week for at least three months (47). (NSCA CPT, pg. 170)

Question 31

Obesity positive risk factor criteria

Answer 31

Body mass index of ≥30 kg/m2 or waist girth of >102 cm (40 in.) for men and >88 cm (35 in.) for women (17). (NSCA CPT, pg. 170)

Question 32

Hypertension positive risk factor criteria

Answer 32

Systolic blood pressure ≥140 mmHg and/or diastolic ≥90 mmHg, confirmed by measurements on at least two separate occasions, or on antihypertensive medication. (NSCA CPT, pg. 170)

Question 33

Dyslipidemia positive risk factor criteria

Answer 33

Low-density lipoprotein cholesterol (LDL-C) ≥130 mg/dl (3.37 mmol/L) or high-density lipoprotein cholesterol (HDL-C) of <40 mg/dl (1.04 mmol/L), or on lipid-lowering medi- cation. If total serum cholesterol is all that is available, use ≥200 mg/dl (5.18 mmol/L). (NSCA CPT, pg. 170)

Question 34

Pre-diabetes positive risk factor criteria

Answer 34

Impaired fasting glucose (IFG) = fasting plasma glucose ≥100 mg/dl (5.50 mmol/L) but <126 mg/dl (6.93 mmol/L) or impaired glucose tolerance (IGT) = 2-h values in oral glucose tolerance test (OGTT) ≥140 mg/dl (7.70 mmol/L) but <200 mg/dl (11.00
mmol/L), confirmed by measurements on at least two separate occasions. (NSCA CPT, pg. 170)

Question 35

High serum HDL cholesterol negative risk factor criteria

Answer 35

≥60 mg/dl (1.55 mmol/L) (NSCA CPT, pg. 170)

Question 36

Low risk classification

Answer 36

Asymptomatic people with one or less CVD risk factors. (NSCA CPT, pg. 176)

Question 37

Moderate risk classification

Answer 37

Asymptomatic people with 2 or more risk factors. (NSCA CPT, pg. 176)

Question 38

High Risk

Answer 38

Symptomatic regardless of risk factors. (NSCA CPT, pg. 176)