010-111 · Question #200
Your new client is a 42 year old male who is a stock broker. His health history revealed the following: total cholesterol 185 mg/dL (4.7 mmol/L), HDL 32 mg/dL (0.8 mmol/L), LDL 110 mg/dL (2.8…
The correct answer is B. Begin a vigorous exercise program immediately. This 42-year-old male has only one positive ACSM CVD risk factor, which permits him to begin a vigorous exercise program without requiring prior medical clearance.
Question
Your new client is a 42 year old male who is a stock broker. His health history revealed the following:
total cholesterol 185 mg/dL (4.7 mmol/L), HDL 32 mg/dL (0.8 mmol/L), LDL 110 mg/dL (2.8 mmol/L), resting blood pressure 138/80 mm Hg, waist circumference 98 centimeters. Based on the client's initial risk classification, what is the most appropriate suggestion for the client regarding his exercise program?
Options
- ABegin a low intensity exercise program until medical clearance is obtained.
- BBegin a vigorous exercise program immediately.
- CRefrain from all activity until medical clearance is obtained.
- DRequire a maximal graded exercise test prior to starting the exercise program.
How the community answered
(59 responses)- A2% (1)
- B83% (49)
- C10% (6)
- D5% (3)
Why each option
This 42-year-old male has only one positive ACSM CVD risk factor, which permits him to begin a vigorous exercise program without requiring prior medical clearance.
Restricting the client to low-intensity exercise pending medical clearance is unnecessarily conservative for an individual with only one CVD risk factor and no known disease or symptoms.
Applying ACSM CVD risk factor criteria, this client has only one positive risk factor - low HDL cholesterol (32 mg/dL, below the 40 mg/dL threshold). His age of 42 falls below the male threshold of 45 years, his waist circumference of 98 cm is below the 102 cm male threshold, and his blood pressure of 138/80 mmHg falls below the traditional ACSM threshold of 140/90 mmHg. With fewer than two risk factors and no known cardiovascular, metabolic, or renal disease, ACSM guidelines permit him to begin vigorous exercise immediately without medical clearance.
Complete abstinence from all activity is unwarranted and contradicts ACSM guidelines, which support exercise participation for low-risk individuals without restriction.
A maximal graded exercise test is not indicated for apparently healthy individuals who do not meet the threshold of two or more positive CVD risk factors.
Concept tested: ACSM CVD risk factor counting and exercise clearance threshold
Source: https://www.acsm.org/education-resources/books/guidelines-exercise-testing-prescription
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