NASM-CES Exam Questions

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81.

A client completes the movement assessment portion of their first session and discusses the findings with the Corrective Exercise Specialist. Which of the following options would be the best way to describe the results of the assessment to the client? 

  • Your body prefers to move in a way that rotates your ankle and knee joints inward. 

  • Your knees present with significant knee valgus and ankle compensation.

  • The postural impairments presenting in your lower body manifest in ankle rotation. 

  • I observed dysfunction in your knees that is translating to your ankles.

Correct answer: Your body prefers to move in a way that rotates your ankle and knee joints inward. 

It is important to not sound too negative, clinical, or serious when explaining movement impairments to the client. This avoids confusion and discouragement. Words such as compensation, dysfunction, and impairment sound negative and should be avoided in these situations. Phrases such as "movement strategies" or "habits that your body prefers" are simpler and friendlier terms to use instead. 

82.

The overhead squat assessment (OHSA) should always be completed first during the dynamic posture assessment phase. Which of the following statements regarding the overhead squat assessment is false? 

  • The OHSA can only be replicated by the same trainer.

  • The OHSA assesses core stability and mobility. 

  • The OHSA serves as a qualifier to determine additional assessments that should be used.

  • The OHSA is a repeatable transitional movement assessment.

Correct answer: The OHSA can only be replicated by the same trainer.

The OHSA is a reliable and repeatable transitional movement assessment that can be used by different professionals and still be a reliable measure to consistently assess progress. For that reason, it is performed first in the order of assessments and is also used as a qualifier to determine additional assessments that should be used.  

83.

A client demonstrates weak ipsilateral hip abduction strength and increased postural sway. Which of the following statements best describes postural sway? 

  • The amount of reflexive movement made around a center of gravity to remain balanced

  • The amount of side-to-side movement of the body while standing upright

  • Enhanced flexibility in the hip muscles during weight-bearing activities

  • The amount of proactive weight shifting made prior to initiating a movement pattern

Correct answer: The amount of reflexive movement made around a center of gravity to remain balanced

Postural sway refers to the reflexive, oscillatory movements made around the body's center of gravity to maintain balance while standing upright. 

When a person demonstrates weak ipsilateral hip abduction strength, it can affect their ability to stabilize the pelvis and control lateral movements, leading to increased side-to-side sway or movement. Postural sway, however, describes the total of reflexive movement patterns, not specifically side-to-side movement or weight shifting.

84.

A client sets a goal to improve their vertical jump through a comprehensive training program. Which of the following options best describes how long-term stretching can have an effect on jumping abilities? 

  • Stretching enhances muscle-tendon compliance, enhancing the ability to store elastic energy. 

  • Stretching decreases the stretch-shortening cycle, improving muscle reaction time. 

  • Stretching enhances the muscle's ability to store static energy. 

  • A stretching program has a negative effect on the ability to produce power.

Correct answer: Stretching enhances muscle-tendon compliance, enhancing the ability to store elastic energy. 

Long-term stretching protocols have the potential to positively affect athletic performance. Stretching can enhance muscle-tendon compliance, which augments, not decreases or negatively affects, the stretch-shortening cycle by enhancing the ability to store elastic energy. 

Static stretching in isolation has been shown to potentially affect power output. However, this question explores the effects of long-term stretching, not static stretching.

85.

A client bends over and picks up a heavy dumbbell from the floor using his right arm and places it onto the waist-height weight rack. Which of the following muscles is the agonist of this movement pattern?

  • Latissimus dorsi

  • Triceps

  • Pectoralis major

  • Rhomboids

Correct answer: Latissimus dorsi

The agonist is the prime mover for a given movement pattern and provides the majority of force generation. In order to pick something up off of the floor and place it at waist height would involve a significant amount of elbow flexion and shoulder adduction. Of these answers, the latissimus dorsi is primarily responsible for shoulder adduction (think about a rowing motion) and would be the agonist of this movement. 

The triceps are primarily responsible for elbow extension, which is not occurring in this motion. Rhomboids are primarily responsible for scapular adduction (bringing the shoulder blades or scapula together). It is not directly responsible for moving the shoulder or upper extremity in this movement. The pectoralis major is responsible for the adduction and internal rotation of the shoulder. This does not occur in the described movement pattern.

86.

A client is training lower body strength one year after ACL surgery and has been cleared by his physical therapist to exercise. The client attempts a single-leg exercise and quickly loses balance. 

Which of the following statements best explains this observation?

  • The client's proprioception may be impaired due to the surgery, due to the physical location of mechanoreceptors in and around the affected joint. 

  • The client's ACL surgery had no impact on balance, and this is a normal reaction to the exercise.

  • The client's lower body strength is impaired and imbalanced. 

  • The client has a weak core due to inactivity. 

Correct answer: The client's proprioception may be impaired due to the surgery, due to the physical location of mechanoreceptors in and around the affected joint. 

ACL surgery can affect proprioception, which is the body's ability to sense the position and movement of its parts. Impaired proprioception of the knee can lead to balance issues.

While it may be possible that the client's lower body and core strength have been impaired since surgery, this would not explain the balance deficits while performing single-leg exercises.

87.

A new client undergoes a traditional movement assessment during their first session. Which of the following statements best describes the definition of a traditional movement assessment?

  • An assessment that involves movement without a change in the base of support

  • An assessment of a client's flexibility and range of motion to tailor corrective exercises to individual mobility needs

  • An in-depth analysis of static posture to guide corrective exercise recommendations

  • An assessment of a client's posture during functional movement patterns

Correct answer: An assessment that involves movement without a change in the base of support 

A traditional movement assessment involves movement without a change in one's base of support. This allows for the assessment of an individual's dynamic posture, quality, and control of movement during a specific movement pattern. 

The goal of the traditional movement assessment is not to observe flexibility and static posture, but rather to observe the movement patterns and dynamic posture of a client in a controlled, not functional, movement.

88.

A Corrective Exercise Specialist assesses a healthy client and notices a potential muscle imbalance affecting the kinetic chain during walking. Which of the following would best describe what they are observing?

  • The client's knee rotates inward during the stance phase of gait

  • The client exhibited decreased cardiovascular endurance

  • The client's high-speed walking pace

  • The client's resistance to exercise and reluctance to engage in physical activity

Correct answer: The client's knee rotates inward during the stance phase of gait

Anomalies in a client's gait pattern or irregularities in movement while walking, stemming from muscle imbalances, may manifest as deviations like inward knee rotation, often caused by weak glutes or limitations in range of motion. It's important to note that imbalances in one segment of the body can propagate disruptions throughout the entire kinetic chain, impacting other areas. 

Cardiovascular endurance is not necessarily related to the observation of a muscle imbalance affecting the kinetic chain during walking. A high-speed walking pace does not necessarily provide insight into the presence of muscle imbalances in the kinetic chain. A client's resistance to exercise or reluctance to engage in physical activity may be a separate issue from the observed muscle imbalance affecting the kinetic chain.

89.

A client presents with excessive pronation of bilateral feet during the movement and static assessment phases. The client performs a Corrective Exercise Program to improve pronation. 

Which of the following best describes the most appropriate activity to perform during the initial phases of the integrate phase? 

  • Reverse lunge

  • Step up to single-leg balance

  • Standing calf stretch

  • Single leg hopping

Correct answer: Reverse lunge

The integration phase should first include uniplanar exercises, such as the sagittal plane, and then progress to multiplanar exercises. They may start with no change in base of support and progress to a more dynamic movement, such as a step up or lunge, to single-leg balance. In this case, the most basic and beginner-friendly integration movement would be a reverse lunge. Plyometrics such as a single leg hop may be for the last stages of the integration phase. 

A calf stretch would be more consistent with the lengthen, not integrate phase.

90.

A geriatric client with mobility difficulties is deciding on a myofascial technique for his program. Which of the following is the best option for this client? 

  • A handheld myofascial roller

  • A myofascial ball

  • A myofascial roller

  • A vibrating myofascial roller

Correct answer: A handheld myofascial roller

A handheld myofascial roller is an easier way for the user to control the amount of pressure applied, and is a great option for a client that may have mobility issues such as getting on/off the ground. Research has shown that, in some situations, handheld rollers appear to be as effective as a traditional roller on the hamstrings. 

A ball may be a convenient option in terms of storage and portability. However, if the client has mobility issues, options such as a ball and a traditional roller, vibrating or not, would be challenging for this client if they had to get on and off of the ground. 

91.

Which of the following would least likely benefit from the skills of a Corrective Exercise Specialist?

  • An injured hockey player who is awaiting clearance

  • An injury-free high school athlete 

  • A sedentary desk worker

  • A teenager who is recovering from a chronic injury and has been cleared by their physical therapist for exercise

Correct answer: An injured hockey player who is awaiting clearance

All clients and athletes, regardless of current activity level, can benefit from the skills of a Corrective Exercise Specialist. As long as the client is cleared to exercise by a medical professional after an injury, it is appropriate for the Corrective Exercise Specialist to work with them. 

In this case, the injured hockey player who is awaiting clearance to exercise is the least appropriate option for the Corrective Exercise Specialist.

92.

Which of the following scenarios is the best example of tissue creep? 

  • Over time, a person's muscles and tendons slowly lengthen as they consistently practice deep stretching exercises

  • A person experiences immediate muscle tightness and discomfort after a strenuous workout and practices static stretching

  • A professional athlete suffers an acute injury to their tendons during a high-impact event, causing ligament laxity

  • A student develops soreness in their muscles after sitting in the same position for an extended period during a long study session

Correct answer: Over time, a person's muscles and tendons slowly lengthen as they consistently practice deep stretching exercises

Tissue creep is a gradual process where muscles and tendons slowly lengthen and deform in response to continuous, sustained mechanical stress or stretching. When a person consistently practices deep stretching exercises, these tissues may slowly adapt by lengthening over time, demonstrating the concept of tissue creep.

Immediate muscle tightness and discomfort after a workout are more likely due to muscle fatigue or muscle soreness, which are immediate responses to exercise and not gradual changes in tissue length or structure. An acute injury to tendons is a sudden, traumatic event rather than a gradual, adaptive change in tissue length over time. The soreness in muscles after sitting in the same position for an extended period is more related to reduced blood flow and muscle tension due to prolonged immobility.

93.

A client with a history of treated lower back pain presents with several postural impairments below the lumbar spine. Which of the following statements best describes how dynamic malalignment can be affected by impairments of the lumopelvic hip complex?

  • Decreased abdominal neuromuscular control may contribute to increased valgus positioning of the lower extremity.

  • Decreased postural control causes structural changes to the lower extremity over time.

  • Multifidus atrophy leads to weakness of the lower extremities.

  • Decreased abdominal neuromuscular control may contribute to increased varus positioning of the lower extremity.

Correct answer: Decreased abdominal neuromuscular control may contribute to increased valgus positioning of the lower extremity.

Increased valgus positioning over time may lead to additional knee, hip, and ankle injuries. Several studies have demonstrated that training the trunk and hip musculature may increase control of hip adduction and internal rotation during functional activities and prevent dynamic misalignments arising from this impaired movement pattern. 

Decreased postural control does not cause structural changes; rather, it would impair muscular firing sequencing, reducing the muscular efficiency of the lower extremities over time. Multifidus atrophy has been associated with patients with lower back pain. However, this is not associated with weakness of the lower extremities and has not been studied in research. 

94.

A client is being treated for plantar fasciitis by a physical therapist and, after being cleared, would like to continue to train with the Corrective Exercise Specialist. The client reports discomfort along the plantar surface of his foot with impact activities. 

Which of the following would be the best activity choice for this client during his session? 

  • Myofascial release of the gastrocnemius

  • Strengthening of the medial arch

  • Strengthening of the gastrocnemius

  • The client must avoid lower body training with the Corrective Exercise Specialist due to the active injury

Correct answer: Myofascial release of the gastrocnemius 

A Corrective Exercise Specialist may continue to help improve ankle and foot mobility by instructing the client in myofascial release of the gastrocnemius. Since the client is already receiving active treatment for his injury and has been cleared for exercise, it is crucial for the client to avoid any impact-related activities that may aggravate his symptoms. 

While strengthening of the medial arch and gastrocnemius may improve the stability of the foot, this is not within the scope of the fitness professional to treat a medical condition. Additionally, these exercises may exacerbate his symptoms if performed incorrectly and, therefore, should be left to the professional to instruct.

95.

Which of the following options best describes the difference between the posterior oblique subsystem (POS) and the anterior oblique subsystem (AOS)?

  • The POS contributes posteriorly to rotational stability, while the AOS stabilizes anteriorly. 

  • The POS primarily involves muscles responsible for lateral (side-to-side) movements, while the AOS focuses on muscles related to forward and backward movements.

  • The POS and AOS serve the same functions in the body.

  • The POS is primarily responsible for flexion movements, while the AOS is involved in extension and back bending motions.

Correct answer: The POS contributes posteriorly to rotational stability, while the AOS stabilizes anteriorly. 

The POS primarily supports rotational stability in the posterior aspect of the body, while the AOS plays a crucial role in stabilizing the anterior aspect, especially in activities that involve trunk rotation.

The POS and AOS are more related to the support and stability of the spine and pelvis, rather than lateral vs. forward/backward movements. While the AOS is related to abdominal and core strength, it's not limited to extension and back bending motions. Both subsystems play essential roles in stabilizing the spine and pelvis. The POS and AOS are distinct subsystems with different functions in providing spinal and pelvic stability.

96.

During neuromuscular stretching, the contraction of the stretched muscle places more mechanical stress on what structure?

  • Tendon

  • Muscle belly

  • Bone

  • Ligament

Correct answer: Tendon

Tendons are the connective tissues that attach muscles to bones. When a muscle contracts during stretching, it pulls on its tendon, transmitting the force from the muscle to the bone.

When the muscle contracts during neuromuscular stretching, it pulls on the tendon, and this results in greater mechanical stress on the tendon. So, the tendon, rather than the muscle belly, is the structure that specifically experiences increased mechanical stress during this type of stretching.

Ligaments are connective tissues that connect bone to bone, not muscle to bone, so they are not directly involved in the mechanical stress experienced during neuromuscular stretching. Bones are not directly involved in the neuromuscular stretching process. They provide structural support for the body and serve as anchors for muscles and tendons.

97.

A Corrective Exercise Specialist has identified weaknesses in the wrist and forearm, affecting their client's ability to lift heavy weights. Which of the following muscles would most likely be targeted by wrist and forearm strengthening exercises?

  • Pronator quadratus

  • Teres major

  • Brachioradialis

  • Deltoid

Correct answer: Pronator quadratus

Pronator quadratus is a muscle located in the forearm that functions to stabilize the radioulnar joint and elbow. The movement that it is primarily responsible for is forearm supination, which is a movement occurring in the wrist. 

The teres major, brachioradialis, and deltoid muscles are all muscles of the upper arm and shoulder, and would not directly be targeted in wrist and forearm strengthening exercises.  

98.

A client presents with poor static posture of the upper back and cervical spine. Which of the following is not a factor that can influence a person's posture?

  • Completely rehabilitated past injuries

  • Acute injuries

  • Repetitive movements

  • Recovery from surgery

Correct answer: Completely rehabilitated past injuries

An incompletely, not completely, rehabilitated past injury is a factor that can influence a person's posture. 

Other factors include: 

  • Chronic suboptimal postures
  • Habitual rehabilitative movements 
  • Acute injuries
  • Recovery from surgery 

99.

A client using a myofascial ball complains about how difficult it is to choose from a wide variety of options. Which of the following statements regarding myofascial balls is false? 

  • Myofascial balls are best suited for the lower extremity.

  • Myofascial balls, such as a lacrosse ball, are more commonly used for sport, not massage.

  • Myofascial balls, such as lacrosse balls, are not for beginners.

  • Myofascial balls elicit more pressure than a roller.

Correct answer: Myofascial balls are best suited for the lower extremity.

Myofascial balls can be used effectively on various body parts, and the choice of which area to target should be based on individual preferences and the specific needs of the client. 

Since a myofascial ball is typically smaller in size than a roller, it can be very uncomfortable and not typically recommended for beginners. Therefore, more dense balls, such as a lacrosse ball, are made for sport, not massage. 

100.

A new client that you are training is reported to have medial tibial stress syndrome. Which of the following statements best describes the presentation of medial tibial stress syndrome (MTSS)?

  • Pain along the front of the tibia during weight-bearing, and is often associated with overload to the tibia and musculature

  • Sharp, shooting pain along the lateral side of the shin during weight-bearing activities

  • Dull, aching discomfort on the anterior aspect of the shin that worsens with rest

  • Pain and tenderness along the posterior edge of the tibia during dorsiflexion and plantarflexion

Correct answer: Pain along the front of the tibia during weight-bearing, and is often associated with overload to the tibia and musculature

MTSS typically involves pain along the inner (medial) side of the shin, not the lateral side. 

MTSS is associated with pain along the inner (medial) border of the shin and tends to worsen with weight-bearing activities, especially during or after exercise, not at rest. MTSS involves pain along the medial aspect of the shin, not the posterior edge.