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The ACE-CMES exam has 150 questions and runs 3 hours.
These 10 free ACE-CMES questions are organized by exam domain, so you can see how each part of the Certified Medical Exercise Specialist blueprint is tested. Reveal the answer and explanation under each question.
Using CDC STEADI protocols, a 73-year-old woman with diabetic peripheral neuropathy completes the Timed Up and Go in 15.4 seconds with her usual cane. She also completes 12 stands in the 30-Second Chair Stand without using her arms. Both tests were administered correctly. Which interpretation is supported?
Correct answer: D - Her TUG flags increased fall risk despite a chair-stand result that is not below average.
A 61-year-old who smokes and has dyslipidemia and a BMI of 31 kg/m² wants to begin walking after a year without regular exercise. Screening identifies no diagnosed cardiovascular disease, diabetes, or renal disease and no suggestive signs or symptoms. The proposed starting intensity is light to moderate. What does the ACSM preparticipation screening algorithm support?
Correct answer: A - Begin light-to-moderate walking with symptom monitoring and gradual progression, without routine clearance.
A client with previously stable heart failure attributes worsening walking tolerance to missing exercise while caring for his partner. He now needs extra pillows to breathe comfortably at night and has new bilateral ankle swelling. His metoprolol and diuretic doses are unchanged. The ACE-CMES defers the session. Which concern should take precedence over simple deconditioning in the handoff to his healthcare team?
Correct answer: B - Worsening heart-failure congestion affecting breathing and fluid balance.
An exercise prescription calls for 50-60% of heart-rate reserve. Before starting metoprolol, the client reached 180 beats/min on an exercise test. A recent clinician-supervised test on the current, stable dose established a peak heart rate of 140 beats/min; resting heart rate is now 60 beats/min. The clinician has approved training in the prescribed range. Which target should the ACE-CMES use?
Correct answer: B - 100-108 beats/min
A woman with osteoporosis and a healed vertebral compression fracture wants to lift a light laundry basket from a bench. Her clinician has approved appropriately modified resistance exercise, and she has no new pain. Which practice best develops the lifting task while limiting avoidable spinal stress?
Correct answer: C - Practice a hip hinge, keeping the basket close and the spine in neutral alignment.
After pulmonary rehabilitation, a client with stable COPD begins a community exercise program. At the prescribed cycling workload, familiar breathlessness consistently limits continuous bouts; it returns to baseline with brief seated recovery. Oxygen saturation stays within the clinician’s prescribed range on the prescribed oxygen setting. There is no recent symptom change or resting distress. Which adjustment best supports accumulating more aerobic activity?
Correct answer: D - Alternate shorter cycling bouts with recovery periods, leaving the prescribed oxygen setting unchanged.
During a walking session, a client taking glipizide develops shakiness and has a capillary glucose of 58 mg/dL. Exercise is stopped, and the client takes 15 g of glucose. Fifteen minutes later, glucose is 64 mg/dL. The client is alert, can swallow normally, and reports that the shakiness has resolved. How should the specialist respond to this recheck?
Correct answer: A - Give another 15 g of fast-acting carbohydrate and recheck glucose in 15 minutes.
“I want my strength back,” says a client with osteoarthritis, “but every ache makes me wonder whether exercise is damaging my joints.” The specialist chooses to begin with a double-sided reflection. Which reply fits that approach?
Correct answer: A - You’re concerned about what the aches mean, and you also want to regain your strength.
Omar has walked on five days each week for nine months. He has not started resistance training and says, “I intend to start lifting in about three months. I haven’t made any arrangements yet.” How should his stage of change be classified for each behavior?
Correct answer: C - Walking: maintenance; resistance training: contemplation.
An adult collapses, is unresponsive, and takes occasional gasping breaths. A CPR-trained ACE-CMES begins CPR while a coworker calls emergency services and brings the AED. The pads are attached correctly. After rhythm analysis, the AED announces, “No shock advised.” The client remains unresponsive and is still only gasping. What should happen next?
Correct answer: B - Resume CPR immediately, starting with chest compressions, and follow the AED prompts.
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