Question 1

Conventional wisdom would seem to say that replacing traditional exercise floors with a softer material would result in fewer lower extremity injuries. This is not necessarily the case. Which of the following is a potential problem with overly soft flooring?

Accepted Answer

The three major ways that the body works to balance itself on an unstable support surface are called ankle strategies, hip strategies and a widening of the base of support by stepping out. Overly soft floors can create balance challenges by requiring constant corrections and adjustments from ankle and hip muscles. Unless these corrections are produced in a timely matter, this creates a situation where the exerciser is pushing up against the end range of his or her ligaments and must rely on the ligament to provide stability, instead of the muscle groups contracting and co-contracting to do so.

Question 2

Overuse injuries can plague an individual who dives into an exercise program without giving his or her body time to adjust to the new stresses. One of the common complaints seen in the novice exerciser is plantar fasciitis. Which part of the body is injured when there is a diagnosis of plantar fasciitis?

Accepted Answer

The planta fascia is positioned on the bottom or sole of the foot and it is very susceptible to rapid changes in weight bearing. This is of particular note when an individual begins more ballistic movements or movements that position him or her on the ball of the foot repeatedly, such as step aerobics. Common treatment for PF is rest, ice, massage and stretching of the muscle and fascia itself. Also useful is to remind suffers to avoid walking barefoot and - if possible - to wear shoes with supportive arches from the moment of getting out of bed.

Question 3

When instructing an exercise class, one of the fundamental rules is to follow the three S's. What are these common group fitness safety recommendations?

Accepted Answer

The three S's in group exercise safety recommendations stand for: Simplicity, safety and stability. Complex choreography is difficult to master and the novice Group Fitness Instructor will lose control of the class easily by attempting tasks that are too biomechanically complex. GFIs must remember that it takes time for the class to recognize that the instructor has changed movements, to visually assess the new movement, to motor plan that movement, to execute the new motor plan and then to enjoy a feeling of mastery of the movement prior to moving on. Both safety and stability should be seen as core concepts for all exercise components. Neither should ever be sacrificed in an attempt to introduce novelty or excitement to a class.

Question 4

If left to its own devices, the heart would beat at a rate of around 100 beats per minute. This phenomenon is due to the fact that the SA node in the heart has the ability to self-stimulate - it will depolarize and repolarize without outside influence. Fortunately, the heart is constantly tweaked by both sympathetic and parasympathetic systems in response to environmental cues. Which of the following are the CHIEF nerves responsible for transmitting parasympathetic messages to the heart?

Accepted Answer

Two bundles of parasympathetic nerves - known as Vegas nerves - make contact with both the SA and AV nodes of the heart. At their distal or terminal end, they both release acetylcholine; this dampens the activity of both nodes, thus reducing heart rate. In contrast, the cardiac accelerator nerves release epinephrine and norepinephrine, hormones which relay the wishes of the sympathetic nervous system. Typically, the net response of such stimulation of the cardiac accelerator nerves is a faster heart beat and a more powerful contraction.

Question 5

Current yoga fads aside, a hot, humid environment is a very stressful environment for exercise. Which of the following terms would BEST describe the most severe heat-related condition, typified by a complete failure of the heart-regulating mechanisms?

Accepted Answer

Heat stroke is a life-threatening condition typified by body temperatures exceeding104° F. At this temperature, the peripheral blood vessels have maximally vasodilated, spreading the blood volume out over millions of capillaries and reducing the load that returns to the heart. This reduction in heart volume stimulates an increase in heart rate, but the heart can only beat so fast. At a certain point, the heart's ability to self-regulate shuts down and immediate action is needed to sustain life.

Question 6

Exercising at high altitudes can give even the most-seasoned athlete pause. In general, the GREATEST effect of altitude on performance will be noticed:

Accepted Answer

Typically, the ill-effects of altitude sickness maximize on Day 3. At high altitudes (>10,000 feet), the partial pressure of oxygen in the air is noticeably reduced. This means there is less pressure to drive oxygen into blood on its trip through the lungs. The end result is less oxygen in the muscles, brain and organs. Although it can take months to fully acclimate to a higher altitude, the body's ability to cope improves after the first 3 days.

Question 7

Stress fractures TYPICALLY have the following symptoms except:

Accepted Answer

Repeated trauma to a bone region can result in a stress fracture; this can occur in distance runners and athletes and in individuals with low bone bass (osteoporosis). However, stress fractures do not typically result in severe muscle weakness, unless the pain is so great that it produces weakness. Some of the signs of a stress fracture include: progressive pain that is worse with weight-bearing activity, focal pain, and pain at rest.

Question 8

Which of the following is LEAST likely to be a major function of the cardiovascular system?

Accepted Answer

The cardiovascular system is not directly involved with the production of insulin or glucagon; both hormones are produced by the pancreas. The cardiovascular system is perhaps best known for distributing oxygen and nutrients to the cells and removing carbon dioxide and wastes from them. However, the cardiovascular system also performs essential clotting functions, temperature regulation, and first line defense against infection.

Question 9

Which of the following drugs is MOST unlikely to alter heart rate significantly?

Accepted Answer

Non-steroidal anti-inflammatory drugs are unlikely to alter heart rates significantly, although an uncommon side effect may be an elevation in heart rate. In contrast, beta blockers are designed to reduce heart rate while caffeine, nicotine and some cold medicines with sympathomimetic activity can elevate it. Even more troubling, nicotine can create an irregular or uneven heart beat in many people, commonly referred to as an arrhythmia.

Question 10

Which of the following are common early signs of low blood sugar levels (hypoglycemia)?

Accepted Answer

Although hypoglycemia symptoms differ, three of the more frequent symptoms experienced are hunger, irritability and a "shaky" feeling. Additional signs can include confusion, headaches, dizziness, sweating, trembling and anxiety. Later stages of hypoglycemia can result in numbness in the face, around the lip and tongue region. Frequent urination and excessive thirst are signs typically associated with elevated blood sugar; these signs are often the first indication of diabetes.

Question 11

Patients who suffer from cardiovascular disease, such as congestive heart failure, may have a severely limited ability to exercise. In part, this is due to the heart's diminished ability to push blood efficiently. When disease compromises the heart's ability to function, the result is often a reduction in "ejection fraction" (EF). What is a normal value for EF during exercise?

Accepted Answer

During exercise, the percentage of volume ejected from the heart elevates dramatically: As much as 60-80% of the heart's volume is pushed out with each beat. When the muscles of the heart do not work in synchrony, the end result can be a devastating loss in ejection fraction. Some individuals with heart disease can present with ejection fractions in the 30's and 40's which compromises their exercise capacity greatly.

Question 12

There are many circumstances where it may be valuable for the Group Fitness Instructor (GFI) to ensure that class participants have been medically vetted. The PARmed-X for Pregnancy is a screen designed to examine what factor(s)?

Accepted Answer

The PARmedX stands for the Physical Activity Readiness Medical Examination. This 4-page screen is a set of guidelines for health screening for women who are considering participating in a prenatal fitness class. It helps medical and fitness personnel screen for obvious risks and contraindications to exercise. The test does not quantify the risk for miscarriage or any other factors.

Question 13

The medical profession has come full circle on the value of exercise during pregnancy. It is no longer typical for a physician to prohibit all exercise during pregnancy, especially if a woman is healthy and she had been exercising prior to the pregnancy. However, there are some absolute contraindications to aerobic exercise during pregnancy. Which of the following is NOT an absolute contraindication?

Accepted Answer

While uncontrolled hypertension is a precaution for the pregnant woman who wishes to exercise, it is not an absolute contraindication. In contrast, conditions which place the baby at risk - for instance preeclampsia, an incompetent cervix, ruptured membranes, premature labor, or placenta previa after 26 weeks of gestation - are direct and absolute contraindications to exercise.

Question 14

Obesity brings many health risks to the exercise participant. Interestingly, there is at least one disease which is less prevalent among the obese. Which disease?

Accepted Answer

Obese individuals suffer less from osteoporosis than their thin counterparts. Stop to think about it for a minute and it makes sense. The excess weight carried by obese individuals must be supported by their skeletal structure. The body lays down more bone mass in response to the weight-bearing stimulus, thus reducing age-related bone loss (osteopenia or osteoporosis). In contrast, many cancers, heart conditions, and diabetes are exacerbated by obesity and unhealthy eating habits.

Question 15

Aquatic exercise is a popular choice among individuals with disabilities and injuries because of the combined effects of buoyancy, viscosity and hydrostatic pressure. Which justification for choosing water is the LEAST likely to be supported by the evidence?

Accepted Answer

The individual with osteoporosis may benefit more from exercising out of the water because of the effect that weight-bearing has on bone density. Although, the client with osteoporosis would be the least obvious choice for aquatic exercise, there is growing evidence that pool-based exercise can be an appropriate choice for the osteoporotic client, especially if they are in pain. Although weight is reduced in water, it is certainly not absent, thus the exerciser gains bone stimulation through the increased activity and increased muscle pull that occurs when exercising in water.

Question 16

Post-mastectomy patients will often present with a compromised lymphatic system, especially those individuals who went through surgical removal of their lymph nodes. Which of the following functions is MOST likely a valuable function of the lymphatic system?

Accepted Answer

Lymph aids the body by producing immune responses, including the creation of antibodies and the destruction of bacteria and other foreign bodies in the lymph nodes. Lymph fluid is quite similar to blood, except it does not contain red blood cells or platelets. The lymphatic system is partially responsible for preventing edema by preventing excessive protein and fluids from accumulating in the interstitial spaces in the body. The loss of this ability will often manifest as lymphedema, especially if the lymph nodes were surgically sacrificed.

Question 17

Which of the following is MOST unlikely to alter resting and exercise heart rate?

Accepted Answer

While many diseases will alter both resting and exercise heart rates, osteoporosis is not one of them. Patients with cardiopulmonary disease, especially those with a pacemaker implant or those on beta blocker medications, can show dramatic alterations in their heart rate patterns. Smokers, especially heavy smokers, will notice a change in heart rate immediately (from the immediate effects of nicotine) and over time (because of the changes to the cardiorespiratory system caused by smoking).

Question 18

You teach a prepartum exercise class twice a week. One member, who is 20 weeks pregnant, pulls you aside and shares her concern about a 15 bpm increase in her resting heart rate. That change in resting heart rate is LEAST likely due to:

Accepted Answer

During pregnancy, a woman's resting heart rate will elevate as much as 15-20 bpm above her baseline. This is because even in a normal, uncomplicated pregnancy, the body must make adjustments to compensate for a large increase in blood volume (often 40-90% above baseline) and an increase in the cost of bearing weight (because of the sudden increase in body weight). Additionally, rapid alterations in hormone levels, including a dramatic increase in progesterone and estrogen, can increase resting heart rate. Elevated levels of FSH in the blood stream do not affect the resting heart rate.

Question 19

One of the truly great movements for the pregnant woman is when she discovers she is supposed to eat more "for the baby". Hating to burst the bubble, you share the knowledge that MOST pregnant women should only be eating:

Accepted Answer

Pregnant women may be eating for two, but that doesn't mean they should double their caloric intake; an increase of around 300 kcals per day is sufficient. In fact, during the first trimester, most women do not need to add any additional kcals for the energy needs of the still tiny baby are small. It is not until the second trimester that energy needs increase. Women pregnant with twins will need to increase their kcals more than women of singletons, perhaps as much as 300 kcals for each baby.

Quiz 11: Participant Safety