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ACE EXAM 2019 > Investigation Stage > Flashcards

Investigation Stage Flashcards

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1
Q

What are the 3 attributes for successful relationships to build rapport?

A
  1. warmth- unconditional positive regard/respect/safety/acceptance
  2. genuine- real, open and honest, authentic
  3. empathy- experiencing one’s world as if it were your own
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2
Q

What happens during the investigation stage?

A

identify the comprehensive needs as well as readiness and stage of behavior change, personality style, collect safety and health information, lifestyle preferences, interests, attitudes, behaviors, previous experiences AND conducting assessments

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3
Q

What is the goal during the planning stage?

A

To promote adherence and motivation

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4
Q

What happens in the action stage?

A

successful implementation of all programming, w/ appropriate progression and feedback
*instruction, demonstration, monitoring, implementing

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5
Q

How much space should you give someone when interviewing?

A

1.5 to 4 feet of distance

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6
Q

What is cognitive vs. affective messaging?

A

cognitive refers to facts, while affective is focused on feelings

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7
Q

What are the interviewing techniques?

A
  1. Minimal Encouragers- “please explain this”
  2. Paraphrasing- restating the essence
  3. Probing- “please tell me more about”
  4. Reflecting- restating essence but using different words
  5. Clarifying- verifying an understanding of the content
  6. Informing- expanding upon shared info (i.e., if client is worried about an asthma attack, trainer can offer fact on how to avoid)
  7. Confronting- use mild to strong feedback w/ a client to promote accountability
  8. Questioning- directing open-ended and closed-ended Qs
  9. Deflecting- changing the focus from one individual to another (ill-advised unless necessary to share a similar experience)
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8
Q

What are the 4 types of communication styles?

A
  1. Preaching- judgemental, lecture-type
  2. Educating- informational, relevant, allows client to make informed decision
  3. Counseling- supportive, problem-solving (most effective style)
  4. Directing-more instructive and directive
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9
Q

Why is motivational interviewing important?

A

helps the client feel that they have control, it is a “client-centered and directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence” , careful listening, strategic questioning, helps PT determine level of readiness of client

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10
Q

What the components of the Health History Questionnaire?

A
  1. past and present physical activity info
  2. medications and supplements
  3. recent illnesses or injuries, acute or chronic pain
  4. surgery/injury history
  5. Family medical history
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11
Q

What is the purpose of the PAR-Q

A

The PAR-Q has two purposes:

1) Build self awareness at the participant level and
2) Help to inform the leader of participant needs and concerns and see if they should be talking to their DR before they exercise

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12
Q

Health Risk Appraisal- what are the components?

A
  1. identify CAD RFs
  2. Risk stratification
  3. Determine recommendations
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13
Q

What is considered low risk, and what does this mean for the participant?

A

This means they have LESS than 2 RFs

They do not need a medical exam, exercise test, or DR supervision regardless of intensity level of exercise

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14
Q

What is considered moderate risk, and what does this mean for the participant?

A

This means they have 2 OR MORE RFs

They need to have a medical exam before participating in vigorous exercise, but that is it

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15
Q

What is considered high risk, and what does this mean for the participant?

A

They are symptomatic, or have known CV, pulmonary, renal, or metabolic disease
They need a medical exam, exercise test, and Doctor supervision for sub-max OR max exercise

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16
Q

What is the exercise history and attitude questionnaire?

A
  1. previous exercise experience

2. can help w/ goal setting, designing programs, implementing strategies to improve motivation and adherence

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17
Q

What are the 9 categories for CAD RFs?

A

Age, Family History, Smoking, Sedentary lifestyle, Obesity, Hypertension, Dyslipidemia, Prediabetes, HDL cholesterol

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18
Q

What is a positive RF for age?

A

Men is 45 or older

Women is 55 or older

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19
Q

What is a positive RF for Family History?

A

MI, CR, sudden death:
Before 55 in father or 1st degree
Before 65 in mother or 1st degree

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20
Q

What is a positive RF for smoking?

A

Current smoker or has quit within last 6 months, or regularly exposed to second-hand smoke

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21
Q

What is a positive RF for a sedentary lifestyle?

A

Less than 30 minutes of moderate activity (40-60% VO2) 3x per week for 3 months

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22
Q

What is a positive RF for Obesity?

A

BMI 30 or above
Women over 35in waist gerth
Men over 40in waist gerth

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23
Q

What is a positive RF for Hypertension?

A

SBP at or above 140 mmHg, DBP at or above 90 mmHg OR on hypertensive meds

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24
Q

What is a positive RF for Dyslipidemia

A

LDL at or above 130 mg/dL
HDL less than 40 mg/dL
Total serum cholesterol of 200 mg/dL or more
OR on lipid meds

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25
Q

What is a positive RF for Prediabetes?

A

Fasting plasma glucose 100-125 mg/dL

Glucose tolerance test 140 mg-199 mg/dL

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26
Q

What is a negative RF for HDL?

A

60 mg/dL or MORE

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27
Q

Does an informed consent form include liability protection?

A

No, the client would need to sign an agreement/release of liability waiver (which still wouldn’t protect from negligence suit)

28
Q

What symptoms are out of the scope of practice?

A
  1. ankle edema
  2. ischemic pain
  3. Dyspnea (difficulty breathing at rest/mild exertion)
  4. Orthopnea (Dyspnea in a reclined position)
  5. Palpitations/Tachycardia
  6. Claudication
  7. known heart murmur
  8. unusal fatigue
  9. trouble breathing
  10. syncope (faint/temporary loss of consciousness due to drop in BP)
29
Q

4 Sites that Hypertensive medications affect:

A
  1. the heart to reduce force of contraction
  2. peripheral blood vessels to dilate
  3. the brain to reduce sympathetic nerve outflow
  4. the kidneys to reduce blood volume
30
Q

What are beta blockers?

A

(beta-andrenergic blocking agents) block receptors and limit Sympathetic tone (blocks effects of Catecholamines)
-reduces resting, exercise, and max HRs (the only med to lower max), so RPE is better to use than HR for clients

31
Q

What are calcium channel blockers?

A

prevent calcium dependent contraction of the smooth muscle in the arteries, causing them to dilate to lower BP

  • also used for angina and other heart dysrhythmias
  • depending on the type, will increase, decrease, or not change resting/exercise HR, but will not change max
32
Q

What are ACE inhibitors?

A

(Angiotensin converting enzyme) inhibitors- block an enzyme secreted by kidneys to prevent hormone creation that constricts the blood vessels–> so vessels dilate
-they will not affect HR, but but will decrease BP at rest and during exercise

33
Q

What are Angiotensin-2 Receptor Antagonists?

A

bind to type 1 receptors, do not adversely affect blood lipid profiles or cause “rebound hypertension”

34
Q

What are diuretics?

A

increase the excretion of water and electrolytes through the kidney

  • prescribed for high BP and/or when a person is accumulating too much fluid
  • do not effect HR, but can cause water/electrolyte imbalances and can decrease BV
35
Q

What symptoms require termination and referral?

A

Angina/Chest pain
excessive rise or decrease in BP
shortness of breath, wheezing, signs of poor perfusion
Ataxia (loss of full control of body movements), confusion, dizziness
legs cramping or claudication
severe fatigue

36
Q

What is the ideal exercise temp/environment?

A

68-72 degrees F (20-22 C) w/ relative humidity below 60%

37
Q

What are the appropriate sites for HR assessment?

A 
Radial Artery (thumb side)
Ulnar artery (pinky side)
Carotid artery (lateral to trachea, just don't cause a vagal response which lowers HR)
38
Q

What is Sinus Bradycardia, Normal sinus, and Tachycardia

A

Sinus Brady= less than 60 bpm
Normal= 60-100 bpm
Tachy= over 100 bpm

39
Q

What is the average resting HR for men vs. women and why?

A 
OVERALL= 70-72 bpm
Men= 60-70 bpm
Women= 72-80 bpm (generally have smaller heart)
40
Q

How long should client avoid stimulants or depressants before exercise testing?

A

min 12 hours before assessment

41
Q

Where is BP normally determined?

A

via Brachial artery

42
Q

How to take BP readings:

A
  • need sphygmomanometer (BP monitor + cuff)
  • stethoscope
  • chair
  • usually R arm, seated for 2min
  • wrap cuff around lower margin about 1 inch from antecubital space (tubes should cross the antecubital space)
  • arm should be at 0-45 degrees
  • inflate to 160 mmHg or 20-30 mmHg above point where pulse can no longer be felt, release at 2 mmHg per sec and need 60s between trials if you do multiple
43
Q

What is normal blood pressure, pre-hypertensive, and Hypertensive

A 
Normal= below 120 SBP, below 80 DBP
Prehypertensive= SBP 120-139, DBP 80-89
Hypertension
Stage 1= SBP 140-159, DBP 90-99
Stage 2= SBP at or above 160, DBP at or above 100
44
Q

What is the 0-10 ratio scale?

A 
0 Nothing
.5 very very weak
1 very weak
2 weak
3 moderate
4 somewhat strong
5 strong
6
7 very strong
8
9
10 very very strong
*Maximal
45
Q

What is the Borg 15 point scale?

A 
6= HR 60 bpm
12= HR 120 bpm
20= HR at 200 bpm
6
7 very very light
8
9 very light
10
11 fairly light
12
13 somewhat hard
14
15 hard
16
17 very hard
18 
19 very very hard
20
46
Q

When should the Borg scale be used?

A

when HR measurement is not accurate (especially when client is on meds that would affect HR)

47
Q

Components of the Exercise-Induced Feeling Inventory

A
  1. positive engagement
  2. revitalization
  3. Tranquility
  4. Physical Exhaustion
    - each section can earn 4 points, plot progress
    - should be given at initial interview and shortly after completing workout, overtime do less often
48
Q

What are the 3 components of muscular balance?

A
  1. bilateral symmetry
  2. proportional strength ratios
  3. balance in flexibility/ROM is achieved but not exceeded
49
Q

What are the 3 ways trunk muscles contribute to core stability?

A
  1. intra-abdominal pressure
  2. spinal compressive forces
  3. hip and trunk muscle siffness (capacity to resist external loads)
50
Q

What is ankle pronation?

A

Subtalar joint pronation, eversion of foot, internal rotation of knee (internal Tibia movement)–> internal rotation of femur

51
Q

What is ankle supination?

A

Subtalar supination, inversion of foot, external rotation of knee–> ext rotation of femur

52
Q

Explain excess anterior tilt of the ASIS

A

tight hip flexors/erector spinae

lengthened hamstrings, rectus abdominis

53
Q

Explain the excess posterior tilt of the ASIS

A

tight rectus abdominis/hamstrings

lengthened hip flexors/erector spinae

54
Q

Explain the potential results of the Thomas Test

A

to assess length of muscles involved in hip flexion
-client lies flat on back, thigh is half way on table, client keeps knees at 90 degree angle, pulls one knee toward chest until low back is flat
-observe if back of lowered thigh leaves the table (is knee of lowered leg at 80 degrees of flexion while hips are positioned in 10 degrees of extension). if the back of thigh doesnt touch AND knee does not flex to 80, usually tight primary hip flexors are to blame
if lowered thigh does not touch table, but knee does flex to 80, usually a tight iliopsoas
if knee DOES touch, but knee wont flex to 80, usually tight rectus femorus is to blame

55
Q

What causes winging during the push-up movement?

A

likely inability of serratus, traps, levator scap, rhomboids to stabilize scapula against rib cage

56
Q

What are the categories for body-fat percentage in women?

A 
Essential 10-13%
Athletes 14-20%
Fitness 21-24%
Average 25-31%
Obese 32% and higher
57
Q

What are the categories for body-fat percentage in men?

A 
Essential 2-5%
Athletes 6-13%
Fitness 14-17%
Average 18-24%
Obese 25% and higher
58
Q

Where should skinfold measurements be taken on a woman?

A

Triceps, thigh, suprailium

59
Q

Where should skinfold measurements be taken on a man?

A

Chest, thigh, abdomen

60
Q

Skinfold Procedure requirements

A

Take measurements on R side of body, grasp site w/ L hand, hold calipers w/ R thumb and index finger open 8cm and positioned 1 cm above measurement site, pull away, read to .5mm, measure each side 2x, if a diff score of 2mm happens, 3rd measurement is necessary

61
Q

What are the specifics of the BMI reference chart?

A 
underweight= les than 18.5
normal is 18.5-24.9
overweight is 25-29.9
Grade 1 obesity is 30-34.9
Grade 2 obesity is 35-39.9
Grade 3 obesity is over 40
62
Q

Where should girth measurements be taken?

A

Abdomen at umbilicus level, arm around the tricep, butt/hips at max circumference, calf, forearm, midthigh at 90 degrees and one leg standing, upper thigh at max circumference, waist at most narrow point (measure site only 1x, then repeat after 20-30s, recorded values between 5 mm or redo

63
Q

What is a gynoid shape?

A

pear shaped

64
Q

what is an android shape?

A

apple shaped

65
Q

For every one inch increase in waist circumference in men…

A 
BP increases 10%
blood cholesterol increases 8%
HDL decreases by 15%
Triglycerides increase by 18%
metabolic risk syndrome risk increases by 18%

ACE EXAM 2019 (7 decks)

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