Domain 4: Risk Management And Professional Responsibilities Flashcards
Secondary hypertension is typically associated with causes such as:
Renal disease.
Explanation:
Secondary hypertension, which accounts for very few cases, is associated with identifiable causes such as renal disease, stress, drug-induced side effects, sleep apnea, neurologic disorders, and many others.
Heart rate drift or cardiovascular drift occurs when:
Heart rate increases due to a decrease in stroke volume.
Explanation:
Heart rate drift (also known as cardiovascular drift) is a result of a decrease in stroke volume due typically to dehydration. This elevates heart rate at submaximal loads and may decrease performance dramatically in a hot environment.
Which of the following requires a more thorough medical history or examination?
Heart murmur.
Explanation:
While the presence of most of the signs and symptoms of cardiovascular, pulmonary, and metabolic diseases can be detected using a questionnaire, orthopnea, edema, and heart murmur require a more thorough medical history from the client and/or a health care provider exam.
Which of the following is the MOST important behavior as it relates to modeling?
Demonstrating healthy nutritional habits
Explanation:
Most clients are motivated by a trainer who is also a good role model, someone who practices what she preaches. Thus, demonstrating healthy eating habits is important for modeling purposes.
Demonstrating standard of care can BEST be accomplished by:
Maintaining professional certifications and continuing education.
Explanation:
Demonstrating adherence to the standard of care can be best accomplished by closely following and maintaining professional certifications and continuing education credits; this reflects the EP-C’s professionalism and commitment to integrity of the field.
For all facility personnel, which of the following is the skill set that is MOST important?
Screening potential members for health and fitness factors
Explanation:
To lessen the possibility of litigation, facility personnel must be capable of thoroughly screening potential members.
Which of the following is a physiological adaptation of heat acclimatization?
Lower core body temperature
Explanation:
Physiological responses to heat include lower core body temperature, lower skin temperature, higher sweat rate, higher plasma volume, lower heart rate at a specific workload, lower perception of effort, and improved conservation of sodium.
To manage risk, employers must require ____________________ obtain a medical release prior to exercise training.
Men 45 years of age or older
Explanation:
Men 45 years of age or older should undergo a medical examination and possibly a medically supervised exercise test before engaging in vigorous exercise.
The most commonly reported knee injury involves damage to the ________.
Anterior cruciate ligament
Explanation:
Because of its structure and insertion points, the anterior cruciate ligament is more frequently injured compared with the posterior cruciate ligament.
Which of the following is recommended for minimizing liability for an injury to client?
Keeping detailed and specific records of each session.
Explanation:
Keeping detailed records of numbers of repetitions, sets, and weight loads on specific training days provides documentation on how you followed a reasonable plan of progression with the client.
A common strategy of altitude training used by athletes to improve performance is known as:
Live high, train low
Explanation:
Today, many endurance athletes use altitude training to improve their athletic performance by practicing the live high, train low strategy, which is a unique strategy of gaining the benefits of high-altitude acclimatization (live high) and the maintenance of high-intensity training at sea level (train low) to occur in synchrony.
A feature of cardiac disease symptoms that are ischemic in origin is:
Squeezing burning pain.
Explanation:
Key features of cardiac disease symptoms favoring an ischemic origin include constricting, squeezing, burning, or a heavy feeling in the chest.
Once the blood pressure cuff and stethoscope are in place, the next step is to quickly inflate the cuff pressure to __________ above the first Korotkoff sound.
20 mm Hg
Explanation:
The blood pressure cuff should be quickly inflated to a pressure around 20 mm Hg above first Korotkoff sound.
In addition to reviewing and screening a client’s medical record and designing an appropriate exercise plan, the EP-C must also:
Schedule an orientation with the client to review the plan.
Explanation:
An orientation session is scheduled with the client to review the EP-C’s exercise plan and discuss the importance of plan adherence to gain optimal health benefits as well as maintain safety.
What is the most common mechanism for causing an ankle sprain?
Inversion
Explanation:
Ankle sprains most occur during inversion of the foot.
A well-written and implemented medical emergency policy will dictate details as to which staff will:
Meet and direct paramedics to the scene.
Explanation:
An explicit medical emergency policy states that staff are certified in first aid and CPR with AED, and are well rehearsed for a timely response in carrying out the multiple duties expected of them, such as who coordinates the scene, who are first and assistant responders, who takes charge of crowd control, who meets and directs paramedics to the scene, and who is responsible for securing the member’s file along with notifying the nearest relative.
Which of the following applies to federal employees ?
Drug-Free Workplace Act of 1988
Explanation:
The Drug-Free Workplace Act of 1988 and the mandatory guidelines for federal drug testing programs were specifically designed for federal employees in certain sensitive occupations relating to safety and security.
Which of the following is most likely to increase blood pressure in a client with hypertension?
Strength training
Explanation:
High blood pressure is a unique risk factor because it may be aggravated by short-term exercise, such as weight training. Therefore, special consideration is needed when screening for exercise testing or training.
The Certified Exercise Physiologist agrees to adhere to the ACSM Code of Ethics:
When registering for the ACSM Certified Exercise Physiologist certification exam.
Explanation:
All exam candidates are required to read and agree to the ACSM Code of Ethics prior to taking the certification exam. (http://certification.acsm.org/faq28-codeofethics)
Tort law that regulates issues around professional liability for incidents caused due to conditions where training activity takes place is referred to as:
Premises liability.
Explanation:
Refer to ACSM’s Health/Fitness Facility Standards and Guidelines for information on legal guidelines and standards regulated under “premises liability”.
Which of the following is the BEST way to minimize the risk of musculoskeletal injury as a client begins an exercise program?
Set realistic exercise goals for the program.
Explanation:
The best way to minimize musculoskeletal injury from the outset is to set realistic exercise goals to avoid overexercising.
Which of the following is considered a cardiovascular disease risk factor?
Fasting glucose ≥126 mg/dL.
Explanation:
Because hypertension is commonly clustered with several other risk factors associated with CVD such as obesity, dyslipidemia, and diabetes, most hypertensive clients will fall into moderate or high risk categories and medical examination is recommended prior to exercise participation.
Dyspnea is defined as:
Abnormally uncomfortable awareness of breathing.
Explanation:
Dyspnea, one of the principal symptoms of cardiac and pulmonary disease, is defined as an abnormally uncomfortable awareness of breathing.
Which of the following is most likely during the initial adjustment to high altitude?
Sleep disturbance
Explanation:
Changes that could affect exercise performance when transferring to altitude include weight loss and sleep disturbances.
A direct result of increased sweat rates during exercise in a hot environment is:
A decrease in stroke volume.
Explanation:
Increased sweat rates may lead to a decrease in stroke volume, which then prompts an increase in heart rate to maintain cardiac output at submaximal workloads.
Which of the following is considered an intrinsic risk factor for musculoskeletal injury?
Inadequate conditioning
Explanation:
Inadequate conditioning is considered an intrinsic risk factor for musculoskeletal injury.
Once a blood pressure cuff is inflated, pressure should be released at a rate equal to:
2-5 mm Hg per second.
Explanation:
Once the cuff is inflated, slowly release pressure at a rate equal to 2-5 mm Hg per second.
The purpose of written emergency response policies and procedures is to enable staff to:
Respond to basic first-aid and emergency events in an appropriate and timely manner.
Explanation:
Facility operators must have written emergency response policies and procedures, which shall be reviewed regularly and physically rehearsed at least twice annually. These policies shall enable staff to respond to basic first-aid situations and emergency events in an appropriate and timely manner.
What is the most likely type of emergency that may occur in the majority of fitness facilities?
Cardiac event.
Explanation:
The most likely emergency is Code Blue or member down, indicating that a client is having a heart attack, stroke, or some other potentially fatal event. This emphasizes the need for an explicit medical emergency policy in which all staff must be well versed.
Which of the following types of insurance would protect an EP-C from a claim of ordinary negligence?
General liability
Explanation:
The EP-C can obtain a general liability insurance policy, which protects her from ordinary negligence, from a commercial general liability firm (CGL).
Fitness center clients are entitled to, in the eyes of the law, facilities that:
Are reasonably safe.
Explanation:
Courts have consistently held that clients are entitled to “reasonably safe” conditions, which the EP-C can foster by regularly inspecting, correcting, and warning of hazards in and around workout areas.
Syncope during exercise may result from cardiac disorders that prevent the normal rise in:
Cardiac output.
Explanation:
Dizziness and, in particular, syncope during exercise may result from cardiac disorders that prevent the normal rise, or produce an actual fall, in cardiac output.
Which of the following would you expect to see in an individual with unstable angina?
Symptoms of chest pain at rest
Explanation:
Unstable angina is a more severe condition often seen with symptoms of chest pain at rest that occur with little exertional stress.
Upon return to sea level, acclimatization to altitude has been shown to last up to:
3 weeks.
Explanation:
After returning to sea level, the benefits of altitude acclimatization have been shown to last up to 3 weeks.
Which of the following explains enhanced heat production in a cold environment?
Shivering threshold resets to a lower mean skin temperature
Explanation:
Cold acclimatization causes the shivering threshold to be reset to a lower mean skin temperature. This is a positive adaptation as it suggests cold acclimatization enhances the ability to maintain heat production through means besides shivering.
Which of the following is considered an extrinsic risk factor for musculoskeletal injury?
Excessive load on the body
Explanation:
An excessive load on the body is considered an extrinsic risk factor for musculoskeletal injury.
Which of the following BEST determines cardiovascular responses to exercise in an individual with cardiovascular disease?
Rate product pressure
Explanation:
The rate product pressure (RPP) can be useful to the EP-C when performing exercise testing or prescribing exercise to clients with cardiovascular disease who have been medically cleared for exercise. A lower RPP at a given submaximal exercise intensity indicates increased fitness levels.
After assessing blood pressure in both arms, you notice the reading is much higher in one arm. You should:
Use the higher pressure.
Explanation:
Blood pressure should be measured in both arms during the first examination. The higher pressure should be used when there is consistent interarm difference.
Regarding the handling of potentially hazardous materials, a facility must:
Have a written system for sharing information with patrons and employees.
Explanation:
Facility operators must have a written system for sharing information with members and users, employees, and independent contractors regarding the handling of potentially hazardous materials, including the handling of bodily fluids by the facility staff in accordance with the guidelines of the U.S. Occupational Safety and Health Administration (OSHA).
Pregnant women should carefully monitor intensity by using:
The talk test.
Explanation:
Intensity can be monitored by using perceived exertion. On a 6 to 20 scale, moderate intensity is 12 to 14 or an intensity at which a woman can still maintain a conversation.
To minimize musculoskeletal injury from the outset, which of the following should be prioritized?
Making the client aware of early signs of potential injury.
Explanation:
To minimize musculoskeletal injury from the outset, the EP-C should make clients aware of early signs of potential injury and take appropriate precautions. This may include temporarily ceasing the activity, scheduling more frequent rest days, or simply decreasing the frequency, intensity, or duration of exercise.
After job candidates are screened during the initial selection process, they should next proceed to interview with:
Various team members.
Explanation:
A multiple-stage interview process should be applied to each candidate who passes the initial selection process with input from various team members of the facility.
Which of the following questions must be avoided during a job interview?
“Do you have any physical limitations related to the job?”
Explanation:
The Americans with Disabilities Act (ADA) prohibits employment discrimination on the basis of disabilities or perceived disabilities. Thus, employers cannot directly ask whether an applicant has a particular disability or ask questions that are closely related to disability issues at any time during the hiring process.
Which of the following would protect the EP-C against errors and omissions?
Professional indemnity insurance
Explanation:
Professional indemnity insurance (PII), also called professional liability insurance (PLI) but more commonly known as errors and omissions (E&O), protects individuals who provide professional advice and service as part of their job responsibility.
Background checks are typically conducted by fitness facilities to verify which of the following?
Employment history
Explanation:
While background checks are normally conducted by government agencies or private enterprises for a fee, most fitness facilities conduct their own checks and are principally interested in criminal history and past employment verification.
A provoking factor of nonischemic cardiac disease symptoms is:
The completion of exercise.
Explanation:
Key features of cardiac disease symptoms against an ischemic origin include provoking factors of postexercise completion, provided by a specific body motion.
The most frequent claims of violation of scope of practice are in the area of:
Supplements.
Explanation:
Claims related to violations of scope of practice occur most frequently in the area of supplements.
Business owners are legally required to identify and eliminate reasonably foreseeable risks and to:
Warn customers of any persistently-hazardous conditions.
Explanation:
It is the duty of business owners to accommodate known risks adequately; business owners are obligated to identify and eliminate risks that are reasonably foreseeable and to appropriately warn patrons of any persistently hazardous conditions.
The final and critical last step in initial client screening is to:
Refer the client to a physician if warranted.
Explanation:
Step 8 of the initial client screening process is to refer the client to a physician or other health care provider if warranted.
The client screening process can be broken down into three phases comprising risk classification, health history evaluation and related assessments, and:
Medical clearance or referral.
Explanation:
The screening process includes three distinct, but related, phases: risk classification, health history evaluation and related assessments, and medical clearance or referral.
Legally, the duty to anticipate and plan for risks is called:
Foreseeability.
Explanation:
In law, foreseeability is the touchstone for imposing a duty upon someone to anticipate and plan for risks. As required by statute or law relating to foreseeability, every EP-C should implement and document appropriate emergency preparedness policies and procedures.
Which of the following is MOST accurate as it relates to the EP-C working with a client with cardiovascular disease (CVD)?
Upon completion of a cardiac rehabilitation program, the EP-C can provide a setting for CVD clients to continue safe exercise with proper supervision.
Explanation:
After completion of a cardiac rehabilitation program, the EP-C can provide a setting for CVD clients to continue safe exercise with proper supervision.
One benefit of initiating an exercise program for Type 2 diabetics is:
Improved insulin sensitivity.
Explanation:
The most beneficial aspect reported with exercise training is improved insulin sensitivity, which can result in a lower medication requirement and greater control of blood glucose levels.
During the initial adjustment period to high altitude, what physiological change occurs during exercise?
Stroke volume decreases
Explanation:
During the initial days of high-altitude exposure, stroke volume decreases yet heart rate increases to a greater extent, causing an increase in cardiac output at a given submaximal exercise intensity.
To minimize error in assessing blood pressure, the client must:
Refrain from smoking cigarettes or ingesting caffeine for at least 30 minutes preceding the measurement.
Explanation:
The client should refrain from smoking cigarettes or ingesting caffeine for at least 30 minues preceding the measurement.
Which of the following is an ACSM standard for risk management and emergency procedures?
AEDs in a facility shall be located within a 1.5-minute walk to any place in which they could potentially be needed.
Explanation:
So that an AED may be quickly procured in the event of an emergency, AEDs shall be located within a 1.5-minute walk to any place within the facility where it could be needed.
ACSM certified and registered professionals are guided by specific principles and standards set forth by which of the following?
Code of ethics
Explanation:
The ACSM Code of Ethics is intended to aid all certified and registered American College of Sports Medicine Credentialed Professionals (ACSM CP) to establish and maintain a high level of ethical conduct, as defined by standards by which an ACSM CP may determine the appropriateness of her conduct. (http://certification.acsm.org/faq28-codeofethics)
To maximize safety and effectiveness in exercise programming, facility managers should:
Ensure that members receive a formal and comprehensive orientation.
Explanation:
Managers have a primary responsibility to ensure that facility members receive a formal and comprehensive orientation related to effectiveness and safety in exercise programming.
The Occupational Safety and Health Administration (OSHA) requires employers to provide which of the following for employees who may come in contact with potential hazards?
Cautions and warnings through written and posted notices
Explanation:
According to OSHA requirements, employees must be advised and have every right to expect that management will caution them about any potential hazards, whether of a physical or chemical nature.
Which of the following is MOST accurate regarding individuals with disabilities and the fitness industry?
There are many staff positions that can be handled by individuals with disabilities.
Explanation:
Within the fitness industry, there are many staff positions that can be handled by individuals with disabilities. In addition, there are individuals with disabilities who can carry out many of the functions of an EP-C and, in some cases, may be ideal candidates to offer classes for individuals with disabilities.
A new fitness and postrehabilitation center is opening. Management plans to conduct criminal background checks on prospective employees. Management should first:
Consult with legal counsel and verify the legality of this action.
Explanation:
The extent to which a facility’s management may consider one’s criminal history in making a hiring decision varies from state to state. Owing to this wide variation, management should consult a lawyer or do further legal research on state laws before probing into whether or not an applicant does in fact have a criminal past.
Which of the following requires a more thorough medical history or examination?
Heart murmur.
Explanation:
While the presence of most of the signs and symptoms of cardiovascular, pulmonary, and metabolic diseases can be detected using a questionnaire, orthopnea, edema, and heart murmur require a more thorough medical history from the client and/or a health care provider exam.
A characteristic sign of heart failure or bilateral chronic venous insufficiency is:
Bilateral ankle edema.
Explanation:
Bilateral ankle edema that is most evident at night is a characteristic sign of heart failure or bilateral chronic venous insufficiency.
Per the ACSM Code of Ethics for certified and registered professionals, EP-Cs practice within the scope of their:
Knowledge, skills, and abilities.
Explanation:
EP-Cs practice within the scope of their knowledge, skills, and abilities. (http://certification.acsm.org/faq28-codeofethics)
The acronym PRICE stands for:
Protect, rest, ice, compression, elevation.
Explanation:
The EP-C should encourage injured clients to use the PRICE (protect, rest, ice, compression, and elevation) method until clients can get an appointment with a physician.
Which of the following identifies clients who are moderate-to-high risk for cardiovascular disease?
ACSM risk factor thresholds
Explanation:
Using tools such as the ACSM coronary artery disease risk factor thresholds, which delineates which clients are at moderate to high risk based on cardiovascular risk factors, aids in identifying clients that need medical clearance.
Potential clients can be classified into risk levels using health status, symptoms, and risk factor information that places people into:
Low, moderate, or high levels.
Explanation:
Risk classification puts individuals into low, moderate, or high levels to determine who should be cleared by their physician prior to exercise.
Which of the following hormones is released by the kidneys in response to an ascent to altitude?
Erythropoietin
Explanation:
Within hours of ascent to altitude, the kidneys increase the release of the hormone erythropoietin to stimulate erythropoiesis, but this process takes time and the full benefits of erythropoiesis may not take effect for 4 or more weeks.
Which of the following is considered a cardiovascular disease risk factor?
Fasting glucose ≥126 mg/dL.
Explanation:
Because hypertension is commonly clustered with several other risk factors associated with CVD such as obesity, dyslipidemia, and diabetes, most hypertensive clients will fall into moderate or high risk categories and medical examination is recommended prior to exercise participation.
Because clients will have different levels of experience using various machines for exercises, you should:
Provide specific instructions and supervision.
Explanation:
When directing a client to use equipment, provide proper instructions and supervision.
What should you do FIRST with a person who suddenly falls to the floor while exercising?
Assess if the person is conscious.
Explanation:
The first action required when an individual is suspected of losing consciousness is to make sure that the person can “wake up”.
To comply with the ACSM Code of Ethics, a Credentialed Professional is obligated to:
Provide education based on current research as well as industry standards and guidelines.
Explanation:
Per the scope of practice, an ACSM Credentialed Professional provides exercise information in a manner that is consistent with evidence-based science and medicine.
The range of professional activities the EP-C can undertake and the boundaries that limit those activities is referred to as:
Scope of practice.
Explanation:
Scope of practice refers to the range of permissible professional activities that the EP-C may undertake, coupled with an understanding of the boundaries that serve as limits on these activities.
While training your client, the equipment being used is making a strange noise and is not operating smoothly. You should:
Discontinue using the equipment and mark the equipment as out of order.
Explanation:
Certified Exercise Physiologists must exercise reasonable care through a consistent practice of regular inspections and correction of any known hazards such as worn or deficiently maintained equipment.
Your client forgot his athletic shoes and asks to train with you in his work boots. You should:
Not allow him to train with inadequate shoes.
Explanation:
Certified Exercise Physiologists need to check footwear and should not allow clients to train with inadequate shoes because poor fit, excess wear, and unsuitability to the activity all increase risk of injury.
At the minimum, at least _____ staff member(s) shall be trained and certified in the delivery of CPR and on duty during all facility operating hours.
One
Explanation:
A staffed facility must assign at least one staff member to be on duty during all facility operating hours who is currently trained and certified in the delivery of cardiopulmonary resuscitation (CPR) and in the administration of an AED.
An employer decides to pass over an employee for a promotion based on the employee’s credit report. As a result, the employer must:
Provide a copy of the report to the employee so he may challenge the veracity of the report if needed.
Explanation:
The Federal Trade Commission’s Fair Credit Reporting Act (FCRA) states that applicants must give written permission to prospective employers if employers wish to obtain applicants’ credit reports. If an employer decides not to hire an applicant or not to promote an existing employee based on his credit report, then that applicant or employee must be provided a copy of the report, so he may challenge the veracity of the report.
Which of the following applies to federal employees?
Drug-Free Workplace Act of 1988
Explanation:
The Drug-Free Workplace Act of 1988 and the mandatory guidelines for federal drug testing programs were specifically designed for federal employees in certain sensitive occupations relating to safety and security.
Lateral epicondylitis is commonly known as ________.
Tennis elbow
Explanation:
Tennis elbow (lateral epicondylitis), which creates lateral elbow pain, is the most widespread overuse injury of the adult elbow.
An ACSM Certified Exercise Physiologist is deemed proficient in writing exercise recommendations, leading and demonstrating safe and effective exercise, and:
Motivating individuals to start and maintain healthy behaviors.
Explanation:
ACSM Certified Exercise Physiologists are fitness professionals who develop and implement personalized exercise approaches individuals in healthy populations, or those with medical clearance to exercise, and are deemed proficient in motivating clients to begin and continue healthy behaviors.
Appropriate assessments to measure client fitness level include:
Resting and exercise heart rate.
Explanation:
Assessments are tests and measurements that the EP-C uses with clients to evaluate current physical and functional status; only rest/exercise heart rate provides information on fitness level, the other measures relate to health but not necessarily fitness.
Which of the following FITT parameters are the MOST appropriate starting points for a client with cardiovascular disease?
Episodes of 10–15 minutes performed two or three times each day
Explanation:
CVD clients usually have limited functional capacities; therefore, shorter exercise episodes of 10-15 minutes performed two or three times each day may be useful and often result in exercise being better tolerated.
Regular exercise yields which of the following changes as it relates to obesity comorbidities?
Decreased coronary artery disease risk factors
Explanation:
Regular exercise yields improvement in many obesity comorbidities, including decreased fasting blood glucose levels, increased insulin sensitivity, decreased triglyceride levels, and decreased coronary artery disease risk factors.
Which of the following limits heat loss for an individual in a cold environment?
Greater subcutaneous fat
Explanation:
Individuals with greater subcutaneous fat mass have an advantage at limiting heat loss in cold environments, as their thicker subcutaneous fat layer acts as a form of insulation or barrier between the warm blood and the cold environment.
How can increased sweat rates during exercise in a hot environment increase the risk for dehydration?
By reducing plasma volume
Explanation:
Increased sweat rates can cause a reduction in plasma volume and increase the risk of dehydration.
To reduce or eliminate hazards that may cause injury to employees and users of a health/fitness facility, facility operators must:
Ensure that a safety audit is conducted routinely.
Explanation:
Facility operators must ensure that a safety audit is conducted, which routinely inspects all areas of the facility to reduce or eliminate hazards that may cause injury to employees and health/fitness facility members or health/fitness facility users.
