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ACSM CEP practice questions

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Question 1Clinical Assessment and Risk Stratification

According to ACSM risk factor criteria, a client is considered physically active when reporting which exercise pattern?

  1. 30 minutes of moderate activity on 3 days per week for 3 months Correct answer.
  2. At least 20 minutes of vigorous activity on 2 days per week for 6 weeks
  3. At least 45 minutes of moderate activity on 2 days per week for 1 year
  4. At least 60 minutes of light activity on 5 days per week for 1 month

Explanation

The physical inactivity risk factor is defined as not meeting a threshold of 30 minutes of moderate-intensity activity on at least 3 days per week for at least 3 months. A client who meets that pattern does not carry the inactivity risk factor.

Question 2Clinical Assessment and Risk Stratification

Which high-density lipoprotein cholesterol value meets the ACSM threshold for a positive cardiovascular risk factor?

  1. 38 mg/dL Correct answer.
  2. 52 mg/dL
  3. 66 mg/dL
  4. 45 mg/dL

Explanation

Low HDL cholesterol is defined as less than 40 mg/dL and counts as a positive risk factor. An HDL of 60 mg/dL or greater is instead treated as a negative risk factor.

Question 3Clinical Assessment and Risk Stratification

Which total cholesterol value first meets the ACSM threshold for a positive cardiovascular risk factor?

  1. 200 mg/dL Correct answer.
  2. 185 mg/dL
  3. 175 mg/dL
  4. 165 mg/dL

Explanation

A total cholesterol of 200 mg/dL or greater is counted as a positive risk factor. Values below 200 mg/dL, such as 165, 175, and 185 mg/dL, do not meet the threshold.

Question 4Clinical Assessment and Risk Stratification

Which resting blood pressure meets the ACSM threshold for a positive cardiovascular risk factor?

  1. 126/78 mmHg
  2. 134/86 mmHg Correct answer.
  3. 124/76 mmHg
  4. 118/74 mmHg

Explanation

Current ACSM criteria count a systolic pressure of 130 mmHg or greater, a diastolic pressure of 80 mmHg or greater, or use of antihypertensive medication as a positive risk factor. Only 134/86 mmHg reaches both cut points.

Question 5Clinical Assessment and Risk Stratification

Which body mass index first meets the ACSM threshold for obesity as a cardiovascular risk factor?

  1. 28 kg/m²
  2. 25 kg/m²
  3. 27 kg/m²
  4. 30 kg/m² Correct answer.

Explanation

Obesity is defined as a BMI of 30 kg/m² or greater and is counted as a positive risk factor. Values between 25 and 29.9 kg/m² represent overweight, which does not satisfy this particular criterion.

Question 6Clinical Assessment and Risk Stratification

ACSM waist circumference thresholds for abdominal obesity are which of the following?

  1. Greater than 102 cm (40 in) in men and greater than 88 cm (35 in) in women Correct answer.
  2. Greater than 80 cm (31 in) in men and greater than 94 cm (37 in) in women
  3. Greater than 88 cm (35 in) in men and greater than 102 cm (40 in) in women
  4. Greater than 94 cm (37 in) in men and greater than 80 cm (31 in) in women

Explanation

Abdominal obesity is identified by a waist girth greater than 102 cm (40 in) in men and greater than 88 cm (35 in) in women. These sex-specific cut points reflect the higher visceral fat burden in men at a given waist girth.

Question 7Clinical Assessment and Risk Stratification

A fasting blood glucose of 100 to 125 mg/dL is best classified as which of the following?

  1. Normal glucose tolerance
  2. Hypoglycemia
  3. Prediabetes Correct answer.
  4. Diabetes mellitus

Explanation

Fasting glucose between 100 and 125 mg/dL indicates impaired fasting glucose, or prediabetes, and counts as an ACSM risk factor. Diabetes mellitus is defined by a fasting glucose of 126 mg/dL or greater on repeated measurement.

Question 8Clinical Assessment and Risk Stratification

The ACSM family history risk factor is defined by a myocardial infarction or sudden death in a first-degree male relative before what age?

  1. 65 years
  2. 55 years Correct answer.
  3. 60 years
  4. 45 years

Explanation

Family history is positive when a first-degree male relative experienced myocardial infarction or sudden death before age 55, or a first-degree female relative before age 65. The lower male cut point reflects earlier onset of coronary disease in men.

Question 9Clinical Assessment and Risk Stratification

An asymptomatic 48-year-old man has a total cholesterol of 215 mg/dL and a father who had a myocardial infarction at age 52. He exercises regularly and has no other risk factors. Using ACSM risk stratification, he is classified as:

  1. High risk
  2. Low risk
  3. Cannot be stratified without an exercise test
  4. Moderate risk Correct answer.

Explanation

He has two positive risk factors (elevated total cholesterol and positive family history) and no symptoms, which places him in the moderate-risk category. Low risk requires one or fewer risk factors and high risk requires symptoms or known disease.

Question 10Clinical Assessment and Risk Stratification

A 55-year-old woman has an HDL cholesterol of 68 mg/dL and three other positive cardiovascular risk factors. How many positive risk factors should be counted in her total?

  1. Two Correct answer.
  2. Zero
  3. Three
  4. One

Explanation

An HDL of 60 mg/dL or greater is a negative risk factor that subtracts one from the positive risk factor total. Three positives minus one leaves a net count of two.

Question 11Clinical Assessment and Risk Stratification

A 58-year-old client is asymptomatic at rest and reports a history of coronary artery bypass graft surgery two years ago. Using ACSM risk stratification, this client is classified as:

  1. High risk Correct answer.
  2. Risk cannot be assigned without a stress test
  3. Low risk
  4. Moderate risk

Explanation

Known cardiac, peripheral vascular, or cerebrovascular disease places a client in the high-risk category regardless of current symptom status. High risk requires medical clearance and supervised exercise programming.

Question 12Clinical Assessment and Risk Stratification

Which finding during a preparticipation interview is a sign or symptom suggesting cardiovascular disease?

  1. Chest discomfort that occurs with stair climbing and resolves with rest Correct answer.
  2. Occasional heartburn after spicy meals
  3. A resting heart rate of 58 beats per minute
  4. Bilateral knee pain while walking uphill

Explanation

Exertional chest discomfort relieved by rest is characteristic of angina and is a major sign/symptom of cardiovascular disease. Its presence places the client in the high-risk category and requires medical clearance before exercise.

Question 13Clinical Assessment and Risk Stratification

How many of the five defining criteria must be present to diagnose metabolic syndrome?

  1. Five
  2. Four
  3. Two
  4. Three Correct answer.

Explanation

Metabolic syndrome is diagnosed when at least three of five criteria are met: elevated waist girth, elevated triglycerides, low HDL cholesterol, elevated blood pressure, and elevated fasting glucose. Requiring all five would miss most affected individuals.

Question 14Clinical Assessment and Risk Stratification

A patient with heart failure reports marked limitation of physical activity and becomes symptomatic while walking on level ground at an ordinary pace. This corresponds to which NYHA functional class?

  1. Class IV
  2. Class I
  3. Class III Correct answer.
  4. Class II

Explanation

NYHA class III denotes marked limitation of physical activity with symptoms during less-than-ordinary exertion such as walking on level ground. Class II involves only slight limitation, with symptoms occurring at ordinary levels of activity.

Question 15Clinical Assessment and Risk Stratification

A 62-year-old reports cramping in the calf that appears after walking two blocks and disappears within a few minutes of standing still. This pattern is most consistent with:

  1. Intermittent claudication from peripheral artery disease Correct answer.
  2. Neurogenic claudication from spinal stenosis
  3. Stable angina pectoris
  4. Chronic venous insufficiency

Explanation

Reproducible exertional calf cramping relieved promptly by rest is the classic description of intermittent claudication, a manifestation of peripheral artery disease. Peripheral artery disease counts as known cardiovascular disease and places the client at high risk.

Question 16Clinical Assessment and Risk Stratification

Which symptom reported during screening suggests heart failure and warrants medical evaluation before exercise?

  1. Morning stiffness in the hands
  2. Postprandial bloating
  3. Intermittent ringing in the ears
  4. Dyspnea when lying flat that resolves on sitting up Correct answer.

Explanation

Orthopnea, or dyspnea in the recumbent position relieved by sitting or standing, is a hallmark symptom of heart failure, as is paroxysmal nocturnal dyspnea. Either symptom places the client in the high-risk category requiring medical clearance.

Question 17Clinical Assessment and Risk Stratification

Which condition is an absolute contraindication to exercise testing?

  1. A resting heart rate of 96 beats per minute
  2. Acute myocardial infarction within the past 2 days Correct answer.
  3. Blood pressure of 138/86 mmHg
  4. Stable angina pectoris

Explanation

An acute myocardial infarction within 2 days is an absolute contraindication because the risk of inducing ischemia, arrhythmia, or rupture is unacceptable. Stable angina and mild blood pressure or heart rate elevations are relative considerations handled by clinical judgment.

Question 18Clinical Assessment and Risk Stratification

Which finding during a graded exercise test is an indication to stop the test?

  1. Visible sweating during the later stages of the test
  2. A heart rate reaching 85% of age-predicted maximum
  3. A drop in systolic blood pressure of 15 mmHg from baseline as workload increases Correct answer.
  4. A rating of perceived exertion of 15 on the 6-20 scale

Explanation

A fall in systolic blood pressure with increasing workload, or failure of systolic pressure to rise appropriately, signals an inadequate cardiac output response and is a termination criterion. The remaining findings are normal responses to progressive exercise.

Question 19Clinical Assessment and Risk Stratification

A client taking a beta blocker is scheduled for a submaximal cycle ergometer test. Which adjustment is most appropriate?

  1. Add 10 beats per minute to the age-predicted maximum heart rate
  2. Multiply the target heart rate by 1.2 before applying it
  3. Cancel the test because valid results cannot be obtained
  4. Rely on ratings of perceived exertion and symptom monitoring rather than heart rate alone Correct answer.

Explanation

Beta blockade blunts the chronotropic response, so age-predicted target heart rates overestimate the actual exercise intensity being performed. Ratings of perceived exertion, symptoms, and workload should therefore guide the test.

Question 20Clinical Assessment and Risk Stratification

During an exercise test, 2 mm of horizontal ST-segment depression appears at 6 METs in a client who reports no symptoms. This finding is most suggestive of:

  1. Pericarditis
  2. A normal variant requiring no follow-up
  3. Myocardial ischemia Correct answer.
  4. Hyperkalemia

Explanation

Horizontal or downsloping ST-segment depression of 1 mm or more during exercise is a marker of myocardial ischemia. Testing is generally terminated and the result referred for medical evaluation even when symptoms are absent.

Question 21Clinical Assessment and Risk Stratification

An exercise test has a sensitivity of 70% and a specificity of 80% for coronary artery disease. In a population with a low pretest probability of disease, which interpretation is most accurate?

  1. A positive test almost certainly confirms disease
  2. Most positive results in this population will be false positives Correct answer.
  3. The high specificity makes the test an ideal screening tool for low-risk individuals
  4. The test can be substituted for coronary angiography in this population

Explanation

Predictive value depends on disease prevalence: when pretest probability is low, the small number of true positives is swamped by false positives from the larger disease-free group. A test with 70% sensitivity and 80% specificity therefore yields a low positive predictive value in low-risk populations.

Question 22Clinical Assessment and Risk Stratification

An asymptomatic 50-year-old man has four positive cardiovascular risk factors and wants to begin jogging at a vigorous intensity, approximately 80% of his heart rate reserve. According to the ACSM screening algorithm, he should be:

  1. Cleared to begin immediately because he has no symptoms
  2. Advised to obtain medical clearance before beginning vigorous exercise Correct answer.
  3. Cleared to begin now and screened only if symptoms develop
  4. Restricted to light-intensity activity until he completes a stress test

Explanation

Asymptomatic individuals with two or more risk factors who plan vigorous-intensity exercise should obtain medical clearance before starting. Without such clearance, moderate-intensity exercise may still be initiated.

Question 23Clinical Assessment and Risk Stratification

A 45-year-old man completes a maximal symptom-limited test with a peak heart rate of 152 beats per minute and a resting heart rate of 68 beats per minute. His chronotropic index, expressed as the percentage of heart rate reserve used, is closest to:

  1. 56%
  2. 100%
  3. 79% Correct answer.
  4. 87%

Explanation

Chronotropic index equals (peak heart rate − resting heart rate) divided by (age-predicted maximal heart rate − resting heart rate). Here (152 − 68) ÷ (175 − 68) = 84 ÷ 107, which is approximately 79%.

Question 24Clinical Assessment and Risk Stratification

A 52-year-old woman has a waist circumference of 92 cm, triglycerides of 130 mg/dL, HDL cholesterol of 42 mg/dL, blood pressure of 126/78 mmHg, and fasting glucose of 106 mg/dL. How many metabolic syndrome criteria does she meet?

  1. Four
  2. Two
  3. Five
  4. Three Correct answer.

Explanation

She meets three criteria: waist girth above 88 cm in women, HDL below 50 mg/dL in women, and fasting glucose of 100 mg/dL or greater. Her triglycerides of 130 mg/dL fall below the 150 mg/dL threshold and her blood pressure is below 130/85 mmHg.

Question 25Clinical Assessment and Risk Stratification

A client reports chest tightness when walking uphill or climbing stairs quickly, but no symptoms during ordinary walking on level ground at a normal pace. This best fits which Canadian Cardiovascular Society angina class?

  1. Class IV
  2. Class II Correct answer.
  3. Class III
  4. Class I

Explanation

CCS class II describes slight limitation of ordinary activity, with angina provoked by walking uphill, climbing stairs rapidly, or walking after meals, in cold, or under emotional stress. Ordinary activity at a normal pace on level ground remains symptom free.

Question 26Clinical Assessment and Risk Stratification

One metabolic equivalent (MET) is defined as which oxygen consumption?

  1. 2.0 mL/kg/min
  2. 5.0 mL/kg/min
  3. 3.5 mL/kg/min Correct answer.
  4. 7.0 mL/kg/min

Explanation

One MET represents resting oxygen uptake and is standardized as approximately 3.5 mL/kg/min. MET values are used to express exercise intensity and functional capacity.

Question 27Clinical Assessment and Risk Stratification

A body mass index of 32.5 kg/m2 is classified as which of the following?

  1. Class II obesity
  2. Class I obesity Correct answer.
  3. Overweight
  4. Class III obesity

Explanation

Class I obesity is defined as a BMI of 30.0 to 34.9 kg/m2. Class II is 35.0 to 39.9 kg/m2, and class III is 40 kg/m2 or higher.

Question 28Clinical Assessment and Risk Stratification

An HbA1c of 6.0% is best classified as which of the following?

  1. Prediabetes
  2. Normal glucose tolerance
  3. Diabetes mellitus Correct answer.
  4. Hypoglycemia

Explanation

An HbA1c of 5.7% to 6.4% is classified as prediabetes. Diabetes is diagnosed at 6.5% or higher, and normal is below 5.7%.

Question 29Clinical Assessment and Risk Stratification

A client quit smoking 4 months ago. How is this classified for the ACSM smoking risk factor?

  1. Not a risk factor after cessation
  2. Negative, because smoking stopped
  3. Positive, quit within 6 months Correct answer.
  4. Positive only if >10 pack-years

Explanation

ACSM counts current smoking or smoking cessation within the previous 6 months as a positive risk factor. Pack-years are not the criterion used for this risk factor.

Question 30Clinical Assessment and Risk Stratification

A resting blood pressure of 132/84 mm Hg is classified as which of the following?

  1. Stage 2 hypertension
  2. Stage 1 hypertension Correct answer.
  3. Elevated blood pressure
  4. Normal blood pressure

Explanation

Stage 1 hypertension is a systolic pressure of 130 to 139 mm Hg or a diastolic pressure of 80 to 89 mm Hg. A diastolic value of 84 mm Hg places this reading in stage 1.

Question 31Clinical Assessment and Risk Stratification

Which finding is a relative contraindication to exercise testing?

  1. Resting blood pressure of 205/112 mm Hg Correct answer.
  2. Acute myocardial infarction within 2 days
  3. Acute aortic dissection
  4. Active endocarditis

Explanation

Severe resting hypertension, such as 205/112 mm Hg, is a relative contraindication that warrants clinical judgment and possible treatment before testing. Acute myocardial infarction, active endocarditis, and acute aortic dissection are absolute contraindications.

Question 32Clinical Assessment and Risk Stratification

Which LDL cholesterol value meets the ACSM criterion for a positive dyslipidemia risk factor?

  1. 90 mg/dL
  2. 110 mg/dL
  3. 135 mg/dL Correct answer.
  4. 125 mg/dL

Explanation

The ACSM dyslipidemia risk factor includes an LDL cholesterol of 130 mg/dL or higher. A value of 135 mg/dL therefore meets the criterion.

Question 33Clinical Assessment and Risk Stratification

Which triglyceride level meets the metabolic syndrome criterion?

  1. 200 mg/dL or higher
  2. 150 mg/dL or higher Correct answer.
  3. 125 mg/dL or higher
  4. 100 mg/dL or higher

Explanation

Metabolic syndrome uses a triglyceride threshold of 150 mg/dL or higher, or current drug treatment for elevated triglycerides. The other listed values are either below the threshold or not the defining cutoff.

Question 34Clinical Assessment and Risk Stratification

An ankle-brachial index of 0.82 in a client with exertional leg symptoms is most consistent with which finding?

  1. Normal arterial perfusion
  2. Falsely elevated ABI
  3. Peripheral artery disease Correct answer.
  4. Venous insufficiency

Explanation

An ankle-brachial index of 0.90 or lower is abnormal and suggests peripheral artery disease. Values above 1.4 may indicate noncompressible arteries rather than normal perfusion.

Question 35Clinical Assessment and Risk Stratification

Which change from supine to standing meets the definition of orthostatic hypotension?

  1. Systolic fall of 22 mm Hg Correct answer.
  2. Diastolic fall of 8 mm Hg
  3. Heart rate rise of 15/min
  4. Systolic fall of 12 mm Hg

Explanation

Orthostatic hypotension is defined as a fall in systolic pressure of at least 20 mm Hg or diastolic pressure of at least 10 mm Hg on standing. A systolic fall of 22 mm Hg meets that definition.

Question 36Clinical Assessment and Risk Stratification

A client has a resting heart rate of 70 beats/min and a peak heart rate of 150 beats/min. What is the heart rate reserve?

  1. 150 beats/min
  2. 70 beats/min
  3. 80 beats/min Correct answer.
  4. 220 beats/min

Explanation

Heart rate reserve is calculated as peak heart rate minus resting heart rate. For this client, 150 minus 70 equals 80 beats/min.

Question 37Clinical Assessment and Risk Stratification

A client with heart failure has a left ventricular ejection fraction of 30%. This is classified as which of the following?

  1. Normal left ventricular function
  2. Heart failure with preserved ejection fraction
  3. Heart failure with reduced ejection fraction Correct answer.
  4. Heart failure with mildly reduced ejection fraction

Explanation

Heart failure with reduced ejection fraction is generally defined by an ejection fraction of 40% or lower. An ejection fraction of 30% therefore fits this category.

Question 38Clinical Assessment and Risk Stratification

ST-segment elevation in leads II, III, and aVF most directly indicates injury in which region?

  1. Lateral wall
  2. Anterior wall
  3. Septal wall
  4. Inferior wall Correct answer.

Explanation

Leads II, III, and aVF are inferior leads and reflect the inferior wall of the left ventricle. Anterior injury is seen in V1 through V4, and lateral injury in I, aVL, V5, and V6.

Question 39Clinical Assessment and Risk Stratification

During a graded exercise test, heart rate is 140 beats/min and systolic blood pressure is 180 mm Hg. What is the rate-pressure product?

  1. 25,200 mm Hg·beats/min Correct answer.
  2. 12,600 mm Hg·beats/min
  3. 320 mm Hg·beats/min
  4. 1,260 mm Hg·beats/min

Explanation

Rate-pressure product is calculated as heart rate multiplied by systolic blood pressure. Here, 140 times 180 equals 25,200 mm Hg·beats/min, an index of myocardial oxygen demand.

Question 40Clinical Assessment and Risk Stratification

A client with a resting heart rate of 80 beats/min reaches a peak heart rate of 120 beats/min during a maximal symptom-limited test; predicted maximal heart rate is 180 beats/min. This response is most consistent with which finding?

  1. Normal heart-rate response
  2. Beta-blocker tolerance
  3. Vagal withdrawal
  4. Chronotropic incompetence Correct answer.

Explanation

Chronotropic incompetence is a blunted heart-rate response to exercise, often defined as failure to achieve at least 80% of predicted heart rate reserve or 85% of age-predicted maximal heart rate. This client achieved only 40 of a predicted 100-beat reserve.

Question 41Exercise Testing

During preparticipation screening for an exercise test, which finding most strongly indicates that medical clearance is needed before vigorous testing?

  1. Family history of hypertension
  2. Known coronary artery disease Correct answer.
  3. Age of 45 years
  4. Sedentary lifestyle

Explanation

Current screening approaches use known cardiovascular, metabolic, or renal disease plus current signs or symptoms to determine whether medical clearance is needed. Age alone and sedentary habits do not automatically require clearance. Family history of hypertension is a risk factor but is not itself a clearance trigger.

Question 42Exercise Testing

Which condition is considered an absolute contraindication to performing an exercise test?

  1. Stable angina pectoris
  2. Resting blood pressure of 180/100 mm Hg
  3. Known hypertrophic cardiomyopathy
  4. Acute myocarditis Correct answer.

Explanation

Acute myocarditis is an absolute contraindication because exercise testing could provoke dangerous arrhythmias or clinical decompensation. Stable angina, moderate resting hypertension, and hypertrophic cardiomyopathy are generally relative contraindications that require individualized decision-making.

Question 43Exercise Testing

On the Borg 6-to-20 rating of perceived exertion scale, a rating of 15 is described as:

  1. Hard Correct answer.
  2. Very, very hard
  3. Somewhat hard
  4. Very light

Explanation

The Borg 6-to-20 scale anchors ratings to verbal descriptions: 13 is somewhat hard, 15 is hard, and 17 is very hard. A rating of 15 therefore corresponds to the descriptor hard.

Question 44Exercise Testing

Using the common age-based formula, what is the estimated maximal heart rate for a 40-year-old adult?

  1. 170 bpm
  2. 160 bpm
  3. 175 bpm
  4. 180 bpm Correct answer.

Explanation

The common age-based estimate is 220 minus age. For a 40-year-old, 220 − 40 = 180 bpm. This is an estimate with individual variability.

Question 45Exercise Testing

One metabolic equivalent (1 MET) is defined as:

  1. 5.0 mL O2 per kg per minute
  2. 3.5 mL O2 per kg per minute Correct answer.
  3. 3.5 mL CO2 per kg per minute
  4. 1.0 L O2 per minute

Explanation

One MET represents resting oxygen uptake and is defined as 3.5 mL of oxygen per kilogram of body mass per minute. It is used to express exercise intensity and functional capacity in standardized units.

Question 46Exercise Testing

During progressive dynamic exercise in a healthy adult, the normal diastolic blood pressure response is to:

  1. Fall by more than 20 mm Hg
  2. Remain stable or decrease slightly Correct answer.
  3. Rise in parallel with systolic pressure
  4. Rise by more than 20 mm Hg

Explanation

Systolic pressure normally rises with increasing workload, while diastolic pressure usually remains stable or falls slightly because of peripheral vasodilation. A marked rise in diastolic pressure or an excessive fall is abnormal.

Question 47Exercise Testing

Which finding during an exercise test is an indication to stop the test?

  1. Rating of perceived exertion of 13
  2. Systolic blood pressure rising from 120 to 160 mm Hg
  3. Horizontal ST-segment depression of 3 mm Correct answer.
  4. Heart rate of 110 bpm in a patient taking a beta-blocker

Explanation

Significant horizontal or downsloping ST-segment depression is a recognized indication to terminate exercise testing. A 3 mm depression clearly meets that criterion. The other findings are not stand-alone termination criteria.

Question 48Exercise Testing

Which element is essential in an informed consent document for exercise testing?

  1. A statement that participation is voluntary Correct answer.
  2. The participant's predicted MET level
  3. The technologist's training history
  4. A guarantee that the test will identify heart disease

Explanation

Informed consent should describe the purpose, procedures, risks, benefits, confidentiality protections, and the participant's right to withdraw. Participation must be voluntary and free of coercion. Promises of diagnostic certainty and staff biographies are not required elements.

Question 49Exercise Testing

The first stage of the standard Bruce treadmill protocol uses a speed and grade of:

  1. 2.5 mph at 12% grade
  2. 1.7 mph at 0% grade
  3. 1.7 mph at 10% grade Correct answer.
  4. 3.4 mph at 14% grade

Explanation

The standard Bruce protocol begins at 1.7 mph and 10% grade. Stage 2 increases to 2.5 mph at 12%, and stage 3 increases to 3.4 mph at 14%.

Question 50Exercise Testing

A key assumption when using a submaximal cycle ergometer test to estimate VO2max is that:

  1. Heart rate rises linearly with workload at steady state Correct answer.
  2. Respiratory exchange ratio exceeds 1.10
  3. Systolic blood pressure falls as workload increases
  4. Lactate concentration remains constant throughout exercise

Explanation

Submaximal tests estimate VO2max by extrapolating the linear relationship between steady-state heart rate and workload or oxygen uptake. They assume a consistent heart rate response and a reasonable age-predicted maximum heart rate. An RER above 1.10 suggests maximal effort and is not an assumption of submaximal testing.