NASM-CES Exam Questions

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61.

A client with a neutral pelvic tilt upon the static posture assessment demonstrates a posterior pelvic tilt with the overhead squat assessment. Which of the following would you most likely expect to find in the mobility assessment?

  • Shortened hamstrings

  • Lengthened adductor magnus

  • Overactive hip flexors

  • Overactive spinal extensors

Correct answer: Shortened hamstrings

These muscle length and tension deficiencies may not appear in neutral posture and may be more apparent during the movement assessment. In a posterior pelvic tilt, we expect the hip extensors, such as the hamstrings and the adductor magnus. 

The underactive muscles in this scenario would be the hip flexors and spinal extensors. 

62.

Which of the following statements best describes how the compliance of the musculotendinous unit affects muscles and tendons?

  • Increased compliance in the musculotendinous unit results in an increase in the absorbed forces over a longer duration. 

  • Increased compliance in the musculotendinous unit enhances muscle strength and power due to improved elasticity.

  • Reduced compliance in the musculotendinous unit decreases the risk of tendon injuries and improves muscle flexibility.

  • The compliance of the musculotendinous unit has no significant impact on muscle or tendon function.

Correct answer: Increased compliance in the musculotendinous unit results in an increase in the absorbed forces over a longer duration. 

Overall, more compliant (flexible) musculotendinous units will result in more forces absorbed over a longer duration, reducing the peak forces applied to them. Imagine dropping a weight onto a trampoline versus a stiff board and how the forces are distributed across the surface. 

Increased compliance in the musculotendinous unit, which refers to the unit comprising muscles and tendons, does not necessarily enhance muscle strength and power. Reduced compliance in the musculotendinous unit, which implies less elasticity, can increase the risk of tendon injuries and hinder muscle flexibility. The compliance of the musculotendinous unit indeed has a significant impact on muscle and tendon function. It affects how muscles contract and store energy and how tendons transmit forces.

63.

An athlete performing dynamic stretches is instructed to perform each movement at a specific rate. Which of the following options best describes the rate at which each movement should be performed for dynamic stretching?

  • Movements should be performed at a pace of one cycle per second.

  • Movements should be performed as slowly as possible to maximize muscle activation.

  • Movements should be performed rapidly, utilizing a bouncing motion. 

  • Movements should be performed at a pace of two cycles per second.

Correct answer: Movements should be performed at a pace of one cycle per second.

Dynamic stretching is recommended to be performed at a rate of one cycle per second based on the available research. 

Rapid bouncing motions are characteristic of ballistic stretching, not dynamic stretching. Performing a dynamic stretch as slowly as possible does not achieve muscle activation and range of motion benefits.

64.

Which of the following statements regarding Renshaw cells is true?

  • Renshaw cells prevent excessive output of the central nervous system's contraction reflex response. 

  • Renshaw cells are motor neurons responsible for muscle contraction.

  • Renshaw cells are sensory neurons involved in touch perception.

  • Renshaw cells increase the output of the central nervous system's contraction reflex response.

Correct answer: Renshaw cells prevent excessive output of the central nervous system's contraction reflex response. 

Renshaw cells serve this inhibitory role. They form inhibitory synapses onto the same motor neurons that excite the muscle. This self-regulatory feedback mechanism allows Renshaw cells to inhibit the motor neurons that trigger muscle contraction, preventing overexcitation and excessive muscle output. This mechanism prevents excessive output, not increases it. 

Renshaw cells are inhibitory interneurons, not sensory or motor neurons. They are involved in regulating motor neuron activity.

65.

A client performs a transitional movement assessment after the static postural assessment. Which of the following statements regarding transitional movement assessment is true?

  • Transitional movements should be completed in a slow, controlled manner.

  • Transitional movements should be cued by the Corrective Exercise Specialist.

  • Transitional movements evaluate static posture in different positions.

  • Transitional movements assess form during a change in one's base of support.

Correct answer: Transitional movements should be completed in a slow, controlled manner.

Transitional movements should be completed in a slow, controlled manner and performed without any feedback from the Corrective Exercise Specialist. 

They also evaluate dynamic posture without a change in one's base of support. 

66.

A client is instructed to slowly lower the weight during a bicep curl halfway and hold it at 90 degrees for 10 seconds. According to the muscle action spectrum, which of the following muscle contraction types are being utilized in this movement? 

  • Eccentric, isometric

  • Concentric, isokinetic

  • Eccentric, isokinetic

  • Concentric, isometric

Correct answer: Eccentric, isometric

The muscle action spectrum describes the range of muscle contractions used to accelerate, decelerate, and stabilize forces. In this motion, the client is performing an eccentric contraction to slowly lower the weight, then an isometric contraction to hold a position for 10 seconds. 

Eccentric Contraction: This occurs when a muscle lengthens while generating force. In the scenario described, the eccentric contraction takes place as the client slowly lowers the weight during the bicep curl halfway. 

Isometric Contraction: This type of contraction occurs when the length remains constant. During the 10-second hold at 90 degrees, the bicep muscle is working to maintain the arm's position, but there is no change in the length of the muscle. 

Concentric Contraction: This type of contraction is typically associated with the lifting phase of an exercise, where the muscle contracts and shortens to lift a weight.

Isokinetic Contraction: Isokinetic contractions involve maintaining a constant speed or velocity of muscle movement, typically with specialized equipment. This answer is not applicable to the scenario because it does not mention a constant speed of movement.

67.

An athlete throws a ball, generating power and engaging both stabilizer and agonist muscle groups. Which of the following options correctly identifies the categorization of stabilizer and agonist muscles in this action?

  • Stabilizer: Rotator cuff muscles; Agonist: Latissimus dorsi

  • Stabilizer: Biceps; Agonist: Rotator cuff muscles

  • Stabilizer: Gluteus maximus; Agonist: Quadriceps

  • Stabilizer: Erector spinae; Agonist: Latissimus dorsi

Correct answer: Stabilizer: Rotator cuff muscles; Agonist: Latissimus dorsi

Stabilizer muscles are responsible for maintaining joint stability and controlling movement while the prime movers and synergists contract to create movement. In this case, the rotator cuff muscles, which are located in the shoulder region, stabilize the shoulder joint during the throwing motion. These muscles ensure that the shoulder remains in its proper position and that the throw is executed smoothly. The main agonist for this motion is the latissimus dorsi.

The biceps are typically not stabilizer muscles during a throw. The gluteus maximus and quadriceps are primarily involved in lower body movements like standing, squatting, and running. They are not the primary stabilizer or agonist muscles in a throwing motion. The erector spinae muscles are typically involved in maintaining an upright posture and extending the spine.

68.

While a client performs the concentric action of a push-up, which of the following muscles experiences reciprocal inhibition? 

  • Latissimus dorsi

  • Deltoid

  • Pectoralis major

  • Triceps brachii

Correct answer: Latissimus dorsi

During the concentric action of a push-up, the latissimus dorsi is the antagonist muscle experiencing reciprocal inhibition. As the client pushes their body away from the floor, the latissimus dorsi relaxes to allow the opposing muscles (e.g., triceps and pectoralis) to contract effectively.

The deltoid muscle is involved in the push-up but is not typically the antagonist muscle during the concentric action. The pectoralis major plays a significant role in the push-up and typically acts as the agonist, not the antagonist of this action. The triceps brachii is also involved in the push-up. Particularly during the extension phase, it is a prime mover of this multi-joint movement.

69.

Which of the following scenarios would least likely result in an elbow/wrist injury? 

  • Prolonged sitting as a truck driver

  • Poor elbow and wrist posture while typing for work

  • Repeated hammering while working on construction

  • Gripping and carrying heavy objects

Correct answer: Prolonged sitting as a truck driver

Prolonged sitting and driving does not require repeated wrist and elbow movements, nor does it require excessive gripping and carrying of heavy objects. Thus, it would be the least likely scenario to cause elbow and wrist pain. 

Poor elbow and wrist posture while typing is a major cause of many reported wrist pain cases today. These static malalignments cause constant tension and demand from the forearm and elbow musculature, leading to inflammation from repetitive use. 

Repeated hammering, gripping, and carrying heavy objects are well-known scenarios that can lead to increased forearm and elbow pain. These situations cause increased tightness of the elbow flexors and are linked to medial elbow pain. 

70.

Which of the following is not an essential component of motor behavior?

  • Motor integration

  • Motor control

  • Motor learning

  • Motor development

Correct answer: Motor integration

Motor development refers to the process of acquiring and refining motor skills throughout a person's life, from infancy through adulthood. Motor control is the process by which the central nervous system (CNS) coordinates the various systems of the body to produce precise, coordinated movements. Motor learning encompasses the acquisition and refinement of motor skills through practice and experience leading to permanent change in the capacity to product motor behavior over time. 

Motor integration is not a valid phase of the concept of motor behavior. 

71.

A fitness professional will regularly assess the resting and dynamic posture of a client. Which of the following statements regarding posture and human movement is false?

  • Posture is an unchangeable aspect of an individual's physiology, making modifications an important aspect of exercise programming.

  • Resting posture refers to an individual's body position when at complete rest and is critical for identifying potential issues. 

  • Dynamic posture relates to body alignment and movement efficiency during various activities and is essential for functional fitness.

  • Postural assessments can provide valuable insights into an individual's movement patterns and help design effective exercise programs.

Correct answer: Posture is an unchangeable aspect of an individual's physiology, making modifications an important aspect of exercise programming. 

Posture is not an unchangeable aspect of an individual's physiology. Fitness professionals can make modifications through exercise programming to improve posture and address issues related to body alignment and movement efficiency. Posture is the independent and interdependent alignment and function of all components of the human movement system at any given moment. 

Static and dynamic posture are important factors to assess in designing corrective exercise programs to identify potential issues and improve movement efficiency. 

72.

A client presents with decreased hamstring strength and a long history of chronic hamstring strains. Which of the following findings would you most likely expect with this presentation? 

  • Weakness in the gluteus maximus and latissimus dorsi

  • Weakness in the gluteus medius and tibalis anterior 

  • No weakness in any muscle group other than the hamstrings is to be expected

  • Weakness in the thoracolumbar fascia and sacroiliac joint

Correct answer: Weakness in the gluteus maximus and latissimus dorsi

The hamstrings, gluteus maximus, and latissimus dorsi are all members of the posterior oblique subsystem (POS). The weakening of the gluteus maximus, latissimus dorsi, or both can lead to increased tension in the hamstring complex, which is very common for recurrent hamstring strains. 

The tibialis anterior is a member of the deep longitudinal subsystem and is not known to be associated with chronic hamstring strains. The thoracolumbar fascia and sacroiliac joint are components affected by the posterior oblique subsystem, which can be affiliated with hamstring strains. However, it is incorrect to state that those structures are weak, since they are not a muscle group.

73.

The Corrective Exercise Specialist instructs the client to contract the quadriceps muscle for a short period of time before taking the hamstring into a new end range of motion. Which of the following options best describes this type of stretching?

  • Neuromuscular Stretching Contract Relax Agonist Contract 

  • Neuromuscular Stretching Contract Relax Antagonist Contract 

  • Neuromuscular Stretching Contract Relax

  • Active stretching

Correct answer: Neuromuscular Stretching Contract Relax Agonist Contract 

Neuromuscular Stretching Contract Relax Agonist Contract describes the contraction of the agonist of the muscle being stretched. Typically, in this technique, the target muscle is considered the antagonist (hamstrings). The client is instructed to contract the agonist (quads) prior to additional stretching of the target muscle. 

Neuromuscular Stretching Contract Relax involves the contraction of the target muscle (hamstrings). Neuromuscular Stretching Antagonist Relax is currently not an existing stretching technique. Active stretching involves multiple repetitions of a 2-second static stretch and a contraction of the antagonist. While it may sound similar due to the timing and technique, this is an entirely different stretching technique.

74.

The mobility assessment provides additional insight into a client's movement impairments observed in the earlier stages. Which of the following would not be a reason to perform mobility assessments?

  • To determine if lengthened muscles need activation training

  • To determine if shortened or lengthened muscles contribute more to the movement impairment

  • To find out if shortened muscles play a more prominent role in the movement impairment

  • To measure if the client's mobility improves over time

Correct answer: To determine if lengthened muscles need activation training 

The mobility assessment is performed in order to determine if a shortened or lengthened muscle is contributing to the movement impairment. If a shortened muscle is found, then to determine if it plays a role in the movement impairment. It does not test, however, the necessity of activation training for lengthened muscles. 

Mobility assessments can be repeated and used as standards of measurement to capture progress over time.

75.

It is valuable for the fitness professional to be able to anticipate potential deficits if a client has suffered a peripheral or central nerve injury. Which of the following muscles is innervated by a cranial nerve?

  • Sternocleidomastoid

  • Scalenes

  • Anconeus

  • Rhomboids

Correct answer: Sternocleidomastoid

The sternocleidomastoid muscle is innervated by the accessory nerve (cranial nerve XI). It is one of the few skeletal muscles innervated by a cranial nerve.

The scalenes are innervated by the ventral rami (C3-C7). The anconeus muscle is located in the arm and innervated by the radial nerve. The rhomboids are innervated by the dorsal scapular nerve (C4-C5).

76.

Which of the following is not a reason to perform loaded movement assessments?

  • To test muscle strength in different postures

  • To learn if a client can maintain the correct form during common exercises

  • To guide exercise recommendations within their workouts

  • To assess movement quality

Correct answer: To test muscle strength in different postures

Muscle strength testing is not performed during a movement assessment. 

During a loaded movement assessment, the client is tested in different positions with an external load in order to observe movement patterns, and compensations, and further inform exercise recommendations for their Corrective Exercise program.

77.

What is the primary function of the cross-bridge mechanism in a sarcomere during muscle contraction?

  • To generate force by forming temporary connections between myosin and actin filaments

  • To release calcium ions from the sarcoplasmic reticulum

  • To prevent the sliding of myosin and actin filaments

  • To maintain the structural integrity of the sarcomere

Correct answer: To generate force by forming temporary connections between myosin and actin filaments

The primary function of the cross-bridge mechanism is to generate force by forming temporary connections (cross-bridges) between myosin and actin filaments, which results in muscle contraction. When the muscle relaxes, the filaments let go and slide back to a neutral position.

The release of calcium ions from the sarcoplasmic reticulum initiates muscle contraction but is not the primary function of the cross-bridge mechanism. The cross-bridge mechanism does not prevent the sliding of myosin and actin filaments but, in fact, facilitates the opposite. Maintaining the structural integrity of the sarcomere is essential but is not the primary role of the cross-bridge mechanism, which primarily focuses on force generation.

78.

A client was assessed to have excessive thoracic kyphosis during the static postural screen. Which of the following is least likely to be observed as a result of this postural impairment according to Janda's Syndromes?

  • Anterior pelvic tilt

  • Shortened cervical extensors

  • Scapular winging

  • Hyperextension of the cervical spine

Correct answer: Anterior pelvic tilt

Thoracic kyphosis is observed in upper crossed syndrome, where the following observations are typically observed: 

  • Forward head
  • Hyperextended cervical spine 
  • Rounded shoulders
  • Scapular winging
  • Shortened pectoralis major and upper trapezius 
  • Neutral pelvis

79.

Which of the following is the correct amount of time required for a client to complete the Davies Test?

  • 15 seconds for 3 trials

  • 20 seconds for 3 trials

  • 15 seconds for 4 trials 

  • As many repetitions as possible for 3 trials 

Correct answer: 15 seconds for 3 trials

The client should be instructed to perform the testing procedure for as many repetitions as possible for 15 seconds and a total of 3 trials. 

80.

A client sustains a serious injury to the rotator cuff and completely tears their supraspinatus muscle. Which of the following motions would you most likely expect the client to have difficulty with?

  • Inability to initiate shoulder abduction

  • Inability to perform internal rotation

  • Difficulty performing scapular retraction

  • Inability to perform external rotation

Correct answer: Inability to initiate shoulder abduction

The supraspinatus initiates the first 15 degrees of shoulder abduction, followed by deltoid activation for the remainder of the arc of motion. 

The supraspinatus is not responsible for shoulder internal rotation or scapular retraction. While the supraspinatus does perform external rotation, the infraspinatus and teres minor would also perform that motion; thus, the client would not lose the ability to perform external rotation.