NASM-CES Exam Questions

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21.

A client complaining of headaches asks a fitness professional for a referral back to their medical provider. Which of the following statements best describes a cervicogenic headache?

  • Cervicogenic headaches arise from myofascial trigger points from muscles in the head and neck region.

  • Cervicogenic headaches originate from sinus congestion and nasal inflammation.

  • Cervicogenic headaches are primarily triggered by dehydration and lack of fluid intake.

  • Cervicogenic headaches are common in individuals with poor shoulder strength.

Correct answer: Cervicogenic headaches arise from myofascial trigger points from muscles in the head and neck region.

Cervicogenic headaches can occur with neck pain and trigger points from the surrounding muscles. They do not have any affiliation with sinus or nasal inflammation or dehydration. 

Poor shoulder strength may sometimes lead to compensatory behavior and result in the development of trigger points; however, this is not the best way to describe the definition of a cervicogenic headache.

22.

Abnormalities such as scoliosis can affect the body's ability to move efficiently and alter normal muscle activity of the shoulder. Which of the following statements regarding scoliosis is false?

  • Scoliosis can be reversed with tailored exercise.

  • Scoliosis may cause asymmetry in muscle development around the spine and shoulders.

  • Scoliosis describes the sideways curvature of the spine that occurs just before puberty.

  • Scoliosis affects the scapula's ability to articulate with the ribcage

Correct answer: Scoliosis can be reversed with tailored exercise.

Scoliosis often involves a structural curvature of the spine, meaning that the bones of the spine have adopted a permanent deviation from the normal alignment. While exercises, especially those tailored to improve posture and strengthen supporting muscles, can be beneficial for managing symptoms and preventing further progression, they generally cannot reverse the structural deformity.

Scoliosis causes asymmetry in muscle development around the spine and shoulders and typically occurs during the growth spurt right before puberty. Scoliosis changes the shape of the rib cage and affects the scapula's ability to articulate with a sufficient amount of surface area, ultimately affecting upper extremity function.

23.

According to the Corrective Exercise Specialist Assessment flow, which of the following assessments is performed after the Static Postural Assessment? 

  • Overhead Squat Assessment

  • Single leg Squat Assessment

  • Mobility Assessment

  • Goal Setting 

Correct answer: Overhead Squat Assessment

According to the Corrective Exercise Specialist Assessment Flow, the Overhead Squat Assessment follows the Static Postural Assessment. This order ensures that both static and dynamic postural alignments are performed prior to mobility assessments and finally, Corrective Exercise Programming.

24.

Which of the following client training scenarios best describes the consequences of underactive/lengthened muscles? 

  • A client who sits at a desk for the majority of the day has difficulty engaging the gluteal muscles. 

  • A client experiencing reduced muscle soreness and fatigue after a strength training session.

  • A client quickly progresses to advanced yoga poses without any flexibility issues.

  • A client consistently notices reduced force output of shortened hamstrings.

Correct answer: A client who sits at a desk for the majority of the day has difficulty engaging the gluteal muscles. 

In the seated position, the gluteal muscles are in a long-duration stretch while the hip flexors are in a shortened position. This is a common scenario where a client will notice difficulty engaging their gluteal muscles with certain exercises. 

Reduced muscle soreness and fatigue after a strength training session are not typical consequences of underactive/lengthened muscles. In fact, underactive muscles can lead to weakness and imbalances, potentially increasing soreness or discomfort. A client exhibiting flexibility in advanced yoga is not related to the consequences of lengthened muscles. Noticing reduced force output of shortened hamstrings is an example of overactive/shortened muscles, not underactive/lengthened.

25.

Which of the following would be the best cue for a Corrective Exercise Specialist to give a client who is having difficulty achieving an optimal body position while on a roller?

  • Keep your entire spine neutral and shoulders relaxed

  • Maintain an upright posture to avoid slouching 

  • Keep your body completely still and avoid any movement on the roller

  • Rock back and forth vigorously to find the most comfortable position

Correct answer: Keep your entire spine neutral and shoulders relaxed

Clients should be coached to keep their spine neutral from the pelvis all the way to the skull to avoid compensatory movements. 

Cueing a client to maintain an upright posture may cause the client to overcompensate by hyperextending the spine. While stability is important, some movement or rolling along the roller can be beneficial for massaging and releasing muscle tension. Keeping the body completely still might not be the most effective approach for rolling technique. Rocking back and forth vigorously can be unsafe and ineffective. It may lead to instability and make it challenging for the client to maintain proper form on the roller. This is not a recommended cue for achieving optimal body position.

26.

A client performing the Davies Test performs 8 repetitions and has time remaining. However, the client's form starts to break down and the Corrective Exercise Specialist notices the client begin to struggle to complete additional repetitions. 

Which of the following would be the best next step in this scenario? 

  • Instruct the client to stop the test

  • Encourage the client to complete as many repetitions as possible

  • Cue the client to perform a modified Davies Test

  • Give the client additional time to complete an additional repetition

Correct answer: Instruct the client to stop the test

It is the Corrective Exercise Specialist's responsibility to maintain quality of movement and control during the assessment. In this case, the quality of the movement begins to decline, and the client has already performed the maximum number of repetitions without increasing their risk of injury. It would be best practice to stop the exam at this point and move onto the next step of the assessment process. 

Performing a modified Davies Test or giving additional time is not the standard way to administer this test.

27.

A client presents with overactive and shortened soleus and gastrocnemius muscles as indicated by the static and dynamic movement screen. The Corrective Exercise Specialist begins to outline this client's program based on the Corrective Exercise Continuum. 

Which of the following options is programmed to correctly address these muscular impairments?

  • Performing self-myofascial rolling on the area for 30 seconds 

  • Holding a static calf stretch for 60 seconds

  • Performing 18 repetitions of eccentric contractions

  • Performing 5 repetitions of a single leg squat

Correct answer: Performing self-myofascial rolling on the area for 30 seconds 

During the following phases of the Corrective Exercise Continuum, the following programming selections are recommended:

  • Inhibit: Hold the areas of discomfort for 30 to 60 seconds
  • Lengthen: Static holds are performed for 30 seconds
  • Activate: 10-15 repetitions of eccentric contractions, followed by 2 second isometric contraction at end range, and 1 second concentric contraction
  • Integrate: 10-15 repetitions under control

28.

A Corrective Exercise Specialist observes a client performing a shoulder press from behind their neck. The fitness professional provides the client with a few pointers on how to improve their form. 

Which of the following would be the best way to correct and educate this client? 

  • Perform the exercise slightly in front of your head to avoid the shoulder's close-packed position.

  • Perform the exercise slightly in front of your head to increase the shoulder's close-packed position.

  • Maintain the behind the neck position and reduce the range of motion of the exercise. 

  • Maintain the behind the neck position to encourage a close-packed position.

Correct answer: Perform the exercise slightly in front of your head to avoid the shoulder's close-packed position.

The close-packed position is when the joint surfaces are maximally aligned and taught, increasing the total amount of compressive forces across the joint. This position should be avoided with heavy weight lifting to reduce the risk of injury. In the shoulder, this position is behind the neck (full external rotation and 90 degrees of abduction). The client should instead be instructed to perform the exercise with the weights slightly in front of the head to avoid the close-packed position. 

It would be incorrect to encourage the client to continue with the close-packed position as it will increase their risk of injury. 

29.

Which of the following statements regarding kyphotic-lordotic posture is true according to Kendall's posture types? 

  • Individuals with kyphotic-lordotic posture may present with elevated shoulders.

  • Individuals with kyphotic-lordotic posture may present with a neutral cervical spine.

  • Individuals with kyphotic-lordotic posture may present with upper-body posture issues only.

  • Individuals with kyphotic-lordotic posture may present with extended hip joints. 

Correct answer: Individuals with kyphotic-lordotic posture may present with elevated shoulders.

The typical kyphotic-lordotic posture will be demonstrated with the following presentation: 

  •  Forward head with extended cervical spine
  • Thoracic kyphosis
  • Rounded and elevated shoulders
  • Excessive lordosis
  • Flexed hip joints
  • Flexed or hyperextended knee joints
  • Neutral or plantarflexed ankle joints

30.

A client with muscle stiffness complains to their trainer that they have not been seeing improvements in strength with their program. Which of the following statements correctly describes the relationship between tissue stiffness and the word required to create motion?

  • Muscle stiffness increases the force required to create motion.

  • Muscle stiffness is unrelated to the force required to create motion.

  • Muscle stiffness decreases the force required to create motion.

  • Muscle stiffness increases the force required to create motion in male athletes only. 

Correct answer: Muscle stiffness increases the force required to create motion.

When muscles are stiff, they are less pliable and more resistant to stretching. This increases the resistance to motion and increases the overall work and force required to create motion.

There is no difference between genders in the ability of muscle stiffness to affect motion around a joint.

31.

A client undergoes an assessment of the ankle and foot. Which of the following is the best example of closed chain dorsiflexion?

  • Performing a deep squat and allowing the tibia to move anteriorly over the foot

  • Pointing the toes toward the ceiling while sitting on a bench with the feet dangling

  • Lifting the heel off the ground while standing and keeping the foot fixed

  • Stretching the toes toward the floor in a seated position with legs extended

Correct answer: Performing a deep squat and allowing the tibia to move anteriorly over the foot

In a proper squat, the knees travel forward as the hips move back and down, and the tibia (shinbone) tilts slightly forward over the foot. Closed chain indicates that the foot is fixed while the tibial angle between the shin and foot becomes smaller, also known as dorsiflexion. 

Open chain, in contrast, is when the foot is not fixed and the ankle is dorsiflexed in a position where the foot is not on the ground. Lifting the heel off the ground or pointing the toes down is plantarflexion, not dorsiflexion. 

32.

In comparison to a Certified Personal Trainer, how are the techniques and skills of a Corrective Exercise Specialist different?

  • A Corrective Exercise Specialist designs and implements programs to improve movement performance. 

  • A Corrective Exercise Specialist must hold a current CPR and AED certification. 

  • A Corrective Exercise Specialist aims to improve the performance levels of their clientele. 

  • A Corrective Exercise Specialist is the only fitness professional allowed to interface with the other members of the Care and Performance Continuum. 

Correct answer: A Corrective Exercise Specialist designs and implements programs to improve movement performance. 

Fitness professionals, including the Corrective Exercise Specialist, must hold CPR and AED certifications. This is not exclusive to the Corrective Exercise Specialist. Similarly, all fitness professionals share the common goal to improve their client's overall fitness and performance. 

Corrective Exercise Specialists are not the only fitness professionals that interface with the Care and Performance Continuum. Certified personal trainers, group trainers, etc. all have the option to collaborate with other medical professionals.

33.

A Corrective Exercise Specialist is prepared to move on to the third phase of the Corrective Exercise Continuum. Which of the following terms correctly describes the purpose of the third phase?

  • Reeducation of underactive muscles

  • Prevention of injury reoccurrence

  • Diagnostic assessment of movement patterns

  • Integration into functional activities

Correct answer: Reeducation of underactive muscles

The third phase of the Corrective Exercise Continuum is the activation or reeducation of underactive/lengthened myofascial tissue. In this phase, the focus is on addressing muscular imbalances and weaknesses that may have been identified in the earlier phases of the continuum.

Injury prevention and assessment of movement patterns are not steps of the Corrective Exercise Continuum. Integration into functional activities is a component of the fourth stage, not the third stage, of the continuum.

34.

A client performs several multijoint exercises as they near the end of their corrective exercise program. Which of the following statements best describes why multijoint motions are used to promote intermuscular coordination?

  • Multijoint motions require multiple muscle groups to work together, encouraging coordinated efforts and improving overall movement patterns. 

  • Multijoint motions reduce the demand on individual muscles, allowing for better isolation of specific muscle groups.

  • Multijoint motions help to simplify movement patterns, making it easier for the client to perform exercises correctly.

  • Multijoint motions minimize the need for dynamic stability and balance, leading to enhanced muscle coordination.

Correct answer: Multijoint motions require multiple muscle groups to work together, encouraging coordinated efforts and improving overall movement patterns. 

Multijoint motions are designed to engage multiple muscle groups and joints in a coordinated manner. This encourages intermuscular coordination and the development of functional movement patterns. Intermuscular coordination is the ability of different muscles to work together to allow the coordination of global and refined movements. 

Multijoint motions typically engage multiple muscle groups simultaneously, rather than isolating specific muscle groups. Multijoint motions can involve complex movement patterns that require coordination between different muscle groups and joints. While they are effective for promoting intermuscular coordination, they are not necessarily simple to perform. Multijoint motions often require, not minimize, dynamic stability and balance because they involve coordinated movements of multiple joints and muscle groups.

35.

The hamstring is a commonly affected muscle when it comes to impairments at the knee and hip. Which of the following muscles of the hamstring decelerates flexion of the hip?

  • Biceps femoris

  • Semimembranosus

  • Semitendinosus

  • Rectus femoris

Correct answer: Biceps femoris 

The biceps femoris is the main hamstring muscle responsible for eccentrically decelerating the hip in flexion. In contrast, the semitendinosus and semimembranous work together with the biceps femoris to concentrically extend the hip.

The rectus femoris is not a hamstring muscle and is one of the main muscles of the quadriceps. 

36.

A client performing an overhead squat assessment demonstrates a posterior pelvic tilt at the bottom of the squat. Which of the following would you be most likely to observe in the kinetic chain in this scenario?

  • Rounding of the lumbar spine

  • Arching of the lumbar spine 

  • Knee valgus 

  • Excessive forward trunk lean

Correct answer: Rounding of the lumbar spine

A posterior pelvic tilt will cause a rounding of the lower back/lumbar spine. In contrast, an anterior pelvic tilt will cause arching of the lumbar spine. 

Knee valgus will likely be unaffected by this presentation. An excessive forward trunk lean is a resultant of mobility restrictions in the ankle and weight distribution, not pelvic positioning.

37.

A client's primary movement patterns are being assessed during the first session with a Corrective Exercise Specialist. Which of the following is not considered a primary movement pattern?

  • Hip rotation

  • Push

  • Overhead press

  • Squat

Correct answer: Hip rotation

While hip rotation is important for specific tasks and sports, it is not one of the listed primary movement patterns. The primary movement patterns include:

  • Push
  • Pull
  • Overhead Press
  • Trunk Rotation
  • Squat
  • Hinge
  • Split Stance 
  • Single Leg and Stepping

38.

Which of the following scenarios best describes the psychological effects of stretching? 

  • Stretching is often associated with reduced feelings of muscle tension, improved relaxation, and a positive mindset, enhancing an athlete's mental well-being and readiness for competition.

  • Stretching before a game primarily induces feelings of stress and anxiety, impacting an athlete's performance negatively.

  • Stretching can alleviate negative emotions; however, it continues to demonstrate negative effects on athletic performance.

  • Stretching is solely a physical activity and does not affect an athlete's psychological aspects or sports performance.

Correct answer: Stretching is often associated with reduced feelings of muscle tension, improved relaxation, and a positive mindset, enhancing an athlete's mental well-being and readiness for competition.

In an athletic context, stretching can indeed help reduce feelings of muscle tension, improve relaxation, and contribute to a positive mental state in athletes. This psychological effect can enhance an athlete's readiness for competition, as they feel physically prepared and mentally focused.

While it is essential to acknowledge the potential for pre-competition nerves, it is not the primary psychological effect of stretching. It is incorrect to generalize that stretching may demonstrate negative effects on athletic performance, as each individual's experience and protocols may differ. Stretching is not solely a physical activity; it has both physical and psychological aspects. Stretching can positively affect an athlete's psychological state, as explained above.

39.

A client being assessed during their first session with a Corrective Exercise Specialist presents with pes plantus distortion syndrome. Which of the following characteristics would least likely be observed in this client?

  • Thoracic kyphosis 

  • Flat feet

  • Knee internal rotation 

  • Anterior pelvic tilt

Correct answer: Thoracic kyphosis 

Pes plantus distortion syndrome is defined as a postural distortion pattern characterized by flat feet, knee valgus/internal rotation, and an anterior pelvic tilt. While thoracic kyphosis is a possibility due to this presentation pattern, it is the least likely presentation.

40.

A trainer assesses a client and gauges their risk of injury. Which of the following factors would least likely lead to injury?

  • Decreased range of motion

  • Working a desk job

  • Poor exercise form

  • Lack of exercise

Correct answer: Decreased range of motion

Decreased activity and poor movement quality may lead to muscular dysfunction and, ultimately, injury. Working a desk job and a lack of exercise are ways to describe decreased activity. 

Decreased range of motion is not a factor that would lead to injury.