CPT Sample Questions Answers

The left ventricle is the chamber of the heart responsible for pumping reoxygenated blood (oxygen-rich blood) to the entire body via the aorta. According to the NASM CPT7 Study Guide, “Left ventricle: receives oxygenated blood from the left atrium and sends it to the body”. Blood enters the left atrium from the lungs through the pulmonary veins, then passes through the mitral valve into the left ventricle. From here, the powerful muscular walls of the left ventricle generate the high pressure needed to push blood into systemic circulation.

This is in contrast to the right ventricle, which sends deoxygenated blood to the lungs; the right atrium, which collects deoxygenated blood from the body; and the left atrium, which only receives oxygenated blood from the lungs but does not pump it systemically. The left ventricle is anatomically the thickest chamber of the heart because it must overcome the systemic vascular resistance of the entire body. This is why its proper function is critical for endurance, performance, and overall cardiovascular health in exercise contexts.

NASM recommends that speed, agility, and quickness (SAQ) training for seniors be safe, low-impact, and fun while still promoting movement efficiency, coordination, and reaction time. The “Red light, green light” drill fits this profile because it uses controlled start-and-stop movements that can be adjusted for speed and range of motion based on ability.

Hurdle stepovers, box drills, and mirror drills involve greater joint stress, faster direction changes, and higher impact, which may not be ideal for all senior clients unless they have advanced fitness levels. Thus, Red light, green light is the most appropriate SAQ drill for this population.

Intrinsic motivation refers to doing an activity because it is inherently satisfying or enjoyable, not because of an external reward. The NASM CPT7 Study Guide lists stress relief, increasing energy, and finding new ways to be challenged physically as examples of intrinsic motivators. Improving mood aligns directly with this definition—it’s a personal, internal benefit of exercise.

By contrast, achieving a weight loss goal (Option A) is an outcome goal that is externally measured, improving posture (Option C) is a functional/physical goal, and increasing overall health (Option D) is an outcome-oriented health objective. While these can be motivating, they are external or outcome-based, whereas improving mood is an internal psychological reward.

For clients with hypertension, NASM recommends low-intensity core stabilization exercises that avoid excessive isometric contractions of large muscle groups, avoid heavy loading, and maintain controlled breathing to prevent excessive blood pressure spikes. The prone isometric abdominal exercise (commonly known as a forearm plank) activates deep core stabilizers, such as the transversus abdominis and multifidus, without requiring high spinal loads or large dynamic movements. The Study Guide emphasizes that “stabilizers… contract isometrically to stabilize the trunk and joints as the body moves” and that core stabilization should be prioritized before progressing to more dynamic exercises. The other options, like two-leg floor bridge or marching, can be useful for core activation but may involve more hip movement and higher intra-abdominal pressure. Standing cobra is a postural endurance exercise for the upper back and shoulders, not specifically a primary core stabilization drill. The prone isometric abdominal exercise thus fits both the physiological safety needs for hypertension and NASM’s progression model.

“Synergistic dominance” is the NASM term for a neuromuscular compensation pattern in which helper muscles (synergists) begin to perform the work that should primarily be done by the prime mover (agonist). This happens when the prime mover is weak, inhibited, or placed at a poor length‑tension relationship. The NASM CPT7 Study Guide explains that“Synergists… assist agonists to produce a movement”and lists common examples (e.g., brachioradialis and brachialis assisting the biceps curl) — but when compensations occur, these assistants can end up taking over the job (). Related mechanisms in the guide that set the stage for synergistic dominance include“Altered length‑tension relationship… reducing the amount of force [a muscle] can produce”() and“Altered reciprocal inhibition… when an overactive agonist muscle decreases the neural drive to its functional antagonist”(). The guide also frames the broader issue as“Muscle imbalance… when muscles on each side of a joint have altered length‑tension relationships”(). In practice, this might look like the hamstrings or erector spinae doing too much hip‑extension work that the gluteus maximus (the agonist) should drive. Whilearthrokinetic dysfunctionrelates to joint surface motion,reciprocal inhibitionis the normal neural relaxation of antagonists during agonist contraction, andautogenic inhibitionis GTO‑mediated tension reduction — none of which by themselves name the compensatory takeover pattern. Thus, the best description of secondary muscles taking over for a weak prime mover issynergistic dominance.

The active kneeling hip flexor stretch falls under active stretching in NASM’s flexibility continuum. Active stretching uses the agonist muscle to move the limb through a range of motion while the antagonist is stretched, typically holding the end range for about 1–2 seconds before returning to the start position. The NASM CPT7 Study Guide specifies that active stretches are performed for 5–10 repetitions, holding each for 1–2 seconds.

This technique is most often applied in the strength level of the OPT model, often following the warm-up and before resistance training to prepare muscles for dynamic activity. Options A and C represent repetition and hold counts more typical of resistance or static stretching, while Option B’s “as quickly as can be controlled” describes dynamic stretching or plyometric work—not an active isolated stretch. Therefore, the correct coaching instruction is to hold for 2 seconds and perform 5–10 repetitions.

NASM’s balance progression principles move from stable → less stable → unstable surfaces, while keeping proper form. A single-leg squat on a Dyna disc is more proprioceptively challenging than doing it on the floor or even on an Airex pad because the Dyna disc creates multidirectional instability.

Two-leg squats, even on unstable surfaces, are less challenging for balance than single-leg squats. Therefore, progressing from single-leg squat on the floor to single-leg squat on a Dyna disc follows the recommended instability progression.

In NASM’s Human Movement Science section, dynamic flexibility distortion patterns are described as abnormal joint motion or posture during movement that can place undue stress on the kinetic chain. The frontal plane movements of the foot and ankle include eversion and inversion. NASM emphasizes that altered motion at the foot—such as excessive eversion—can disrupt alignment up the kinetic chain, impacting the knee, hip, and even shoulder positioning. The Study Guide notes that “the frontal plane… movements… include abduction and adduction of the limbs, lateral flexion of the spine, and eversion and inversion at the foot and ankle complex.” Excessive or poorly controlled eversion creates misalignment, leading to compensations such as knee valgus or excessive internal rotation of the femur. This, in turn, changes forces experienced by the lumbo-pelvic-hip complex (LPHC) and upper body. Such compensatory movement patterns are directly linked to increased injury risk, especially in the knee and lower back, and are common in overuse injuries. In contrast, “neutrality” of the LPHC or scapulae indicates correct posture, and proper patella tracking is a positive alignment characteristic—not a distortion. Therefore, eversion of the foot fits NASM’s definition of a dynamic flexibility distortion pattern that “creates abnormal stress throughout the kinetic chain” by disrupting the optimal length-tension and joint alignment necessary for efficient movement.

NASM defines external feedback as information provided by an outside source — such as a trainer, mirror, video, or device — to help a client understand their performance. A heart rate monitor delivers real-time data from an external device, which the trainer can use to guide intensity adjustments. This differs from internal feedback, which comes from a client’s own sensory awareness (e.g., perceived exertion). External feedback tools are essential in monitoring physiological responses and ensuring clients work within safe and effective training zones .

In the overhead squat assessment (OHSA), one common compensation observed at the lumbo-pelvic-hip complex (LPHC) is excessive lumbar extension, also referred to as “low-back arches.” The NASM CPT7 Study Guide lists this as an indication of overactivity in the hip flexor complex, latissimus dorsi, and erector spinae, and underactivity in the gluteus maximus, hamstrings, and core stabilizers.

Other options—knees moving inward (frontal plane), arms falling forward (upper body compensation), and feet turning out (foot/ankle compensation)—are observed in other kinetic chain checkpoints but not classified under LPHC compensations.

NASM uses the SMART goal framework—Specific, Measurable, Attainable, Realistic, Timely—to help clients set effective goals. The statement “I want to be in better shape in 1 month” is vague because “better shape” is not defined or measurable.

By contrast, the other goals: losing 8 pounds in 1 month (Option A), running a 5K in 1 month (Option B), and going to the gym three times a week for 1 month (Option C) are more specific and measurable. The trainer should clarify vague goals by asking probing questions to define what “better shape” means to the client (e.g., improved strength, endurance, weight loss). Therefore, the goal requiring clarification is Option D.

If a client’s lower back arches during the Overhead Squat Assessment, this indicates excessive lumbar extension and an anterior pelvic tilt, often due to overactive hip flexors and erector spinae, and underactive core stabilizers—especially the transverse abdominis. NASM identifies the transverse abdominis, internal obliques, and multifidus as key local stabilization system muscles that contract isometrically to stabilize the LPHC during movement. Weakness in the transverse abdominis allows the pelvis to tilt forward and the lumbar spine to overextend, which appears as an arch in the lower back. Strengthening this deep abdominal muscle helps maintain a neutral spine under load.

Synergistic dominance occurs when synergist muscles compensate for a weak or inhibited prime mover, taking over its primary function. In this case, the erector spinae—normally a spinal stabilizer—are performing hip extension instead of the gluteus maximus, which is the prime mover for that action.

The NASM CPT7 Study Guide explains that altered length–tension relationships and poor neuromuscular recruitment patterns can cause helper muscles to dominate, leading to inefficient movement and potential injury.

This is distinct from reciprocal inhibition (agonist-antagonist relationship), autogenic inhibition (GTO-mediated relaxation), and neuromuscular efficiency (optimal recruitment patterns).

Proper running form requires maintaining neutral alignment of the lower extremities to optimize stride efficiency and reduce injury risk. The NASM CPT7 Study Guide emphasizes the importance of joint alignment and tracking, particularly keeping the knees aligned with the toes during dynamic movement.

“Lean forward slightly during deceleration” (Option A) may apply in certain braking mechanics but is not a standard form cue for general running. “Head should move into extension” (Option C) would disrupt postural alignment and breathing efficiency. “Ankles should be plantar flexed” (Option D) applies only at specific phases of sprinting push-off, not as a general form cue. Therefore, the most universally applicable and safe auditory cue is “Keep the knees straight ahead.”

Upper crossed syndrome is a common postural distortion pattern characterized by forward head posture, rounded shoulders, and thoracic kyphosis. NASM identifies overactive muscles in this condition as the upper trapezius, levator scapulae, sternocleidomastoid, pectoralis major/minor, and suboccipitals. Underactive muscles include the deep cervical flexors, serratus anterior, lower trapezius, and rhomboids. Corrective exercise strategies involve inhibiting (SMR) and lengthening the overactive muscles—thus the levator scapulae is a primary stretch target. Stretching it helps restore cervical and scapular alignment, improve movement mechanics, and reduce compensations. The other listed muscles—serratus anterior, lower trapezius, and teres minor—are underactive and require strengthening, not stretching.

In the single-leg squat assessment, inward knee movement (knee valgus) indicates a lack of frontal-plane knee stability, often caused by underactivity in the vastus medialis oblique (VMO) and gluteus medius. The NASM CPT7 Study Guide identifies the VMO as a critical stabilizer of the patella and knee joint, especially in terminal extension.

Overactive muscles in this compensation often include the adductor complex and tensor fascia latae (TFL), which pull the knee inward. Strengthening the VMO and gluteus medius improves knee tracking, preventing valgus collapse. Therefore, VMO strengthening is essential for correcting this compensation.

Self-myofascial release (SMR) is a flexibility technique that uses tools like foam rollers to apply gentle, sustained pressure to the myofascial tissues. According to NASM, this technique “stimulates the Golgi tendon organ (GTO), which in turn inhibits muscle spindle activity, decreasing excitation and allowing the muscle to relax.” Muscle spindles are sensory receptors sensitive to changes in muscle length and the rate of that change; they trigger reflexive contractions when they detect rapid stretch. Overactivity of muscle spindles can contribute to tightness and restricted range of motion. SMR works by initiating autogenic inhibition, allowing the targeted muscle to lengthen more effectively. The other options—Golgi tendon organs (inhibited by SMR stimulation), sarcomeres (the contractile units in muscle fibers), and myosin heads (part of the actin–myosin sliding filament mechanism)—are not directly the structures whose excitation is reduced by SMR. Therefore, the correct answer is that SMR decreases excitation of muscle spindles.

The floor cobra is a corrective and postural exercise designed to strengthen the mid and lower trapezius, rhomboids, and rotator cuff muscles while promoting optimal scapular positioning. According to NASM technique cues, the client should lie prone, arms to the sides with thumbs pointing up, and focus on retracting (pulling together) and depressing (pulling downward) the shoulder blades. This encourages proper scapulothoracic motion and reduces overactivity of the upper trapezius and levator scapulae, which are common in postural distortions like upper crossed syndrome. The cue “relax your glutes” is incorrect here—glutes can remain gently active for pelvic stability. “Point your thumbs down” internally rotates the shoulders, counteracting the corrective intent. “Look up and lift your chest” risks cervical extension and lumbar strain rather than maintaining a neutral spine with scapular control.

Dehydration reduces plasma volume, making the heart work harder to circulate blood. NASM notes that fluid loss causes cardiovascular strain, often leading to an increased heart rate to maintain cardiac output during exercise. This is due to decreased stroke volume—less fluid in the bloodstream means less blood pumped per beat, so the heart compensates by beating faster. Other effects include impaired thermoregulation, reduced sweat efficiency, and decreased exercise performance. Increased blood volume is not correct (dehydration decreases it), sweat rate often decreases rather than increases when dehydrated (leading to overheating risk), and blood pressure can drop rather than rise in severe dehydration. Therefore, increased heart rate is the hallmark acute cardiovascular response to dehydration during activity.

The NASM CPT7 Study Guide describes the drawing-in maneuver as an activation technique to engage local core stabilizers such as the transversus abdominis, internal obliques, and multifidus. This involves pulling the navel in toward the spine while maintaining a neutral pelvis and spine.

The “bear down” cue is associated with the Valsalva maneuver, which increases intra-abdominal pressure but does not specifically target local stabilizers. “Retract” usually refers to scapular movement, and “brace” is more about global core stabilization involving simultaneous contraction of the abdominal and low back muscles. For training local stabilizers, the correct verbal cue is “Draw-in.”

The NASM CPT7 Study Guide identifies marching as a suitable core progression from a static plank. Once a client can hold a plank with proper form, progression involves adding dynamic movements that challenge stability further. Marching requires alternately lifting each foot off the ground while maintaining plank alignment, which increases core engagement by adding an anti-rotational component and shifting the center of gravity. This type of progression maintains the isometric trunk stability goal while increasing neuromuscular demand .

The NASM CPT7 Study Guide highlights that fats play key roles beyond energy storage, including regulating the uptake and excretion of nutrients in the cells. Healthy fats, particularly unsaturated fats from sources like olive oil, nuts, and seeds, support hormone production, cell membrane structure, and vitamin absorption. Contrary to option B, olive oil and almonds are sources of unsaturated fats, not saturated. The guide recommends that fats generally make up 20–35% of daily caloric intake, not less than 10% as stated in option C. While fats can be used for energy during low-intensity activities, they are not absorbed quickly for immediate use during high-intensity exercise, making option D incorrect.

The Overhead Squat Assessment (OHSA) is a key movement screening tool in NASM’s assessment protocol. The proper starting position requires the client to stand with feet shoulder-width apart, pointing straight ahead, and arms raised directly overhead with elbows fully extended. This position places the shoulders in full flexion and challenges the client’s ability to maintain posture through the kinetic chain during the squat. The Study Guide specifies that this alignment allows observation of compensations in the ankles, knees, hips, LPHC, and shoulders. Starting with arms forward, crossed, or on the hips would not adequately test upper extremity and spinal stability in relation to lower-body mechanics, and would reduce the assessment’s diagnostic value.

NASM’s scope-of-practice guidelines clearly state that personal trainers must refer clients to qualified medical professionals when they suspect or become aware of any undiagnosed condition that could impact health and exercise safety. Undiagnosed osteoporosis poses significant risks for fractures and requires a physician’s evaluation before beginning or continuing a program. Conversely, diagnosed conditions (like diabetes or hypertension) can be trained for within guidelines, provided the trainer follows physician recommendations.

The NASM OPT model recommends increasing instability to progress stabilization demands, moving from stable → less stable → unstable environments. For a single leg dumbbell overhead press, the next stabilization progression is to maintain the single-leg position but place it on a BOSU ball, which significantly increases balance and proprioceptive challenges.

Increasing dumbbell weight (Option A) changes load, not stability. Standing in a staggered stance (Option B) reduces stability challenge compared to single leg. Standing with two feet on a BOSU ball (Option C) is unstable but less challenging than single leg on BOSU. Therefore, single leg on BOSU is the correct progression.

Knee valgus is the inward collapse of the knees toward the midline during movement, often seen in squats or jumps. The NASM CPT7 Study Guide defines adduction as movement toward the midline of the body in the frontal plane.

This faulty movement pattern typically indicates overactivity in muscles such as the adductor complex and tensor fascia latae, combined with underactivity in the gluteus medius and maximus. The opposite, abduction, would be knees moving outward. Supination and external rotation refer to foot/ankle and rotational movements, not frontal plane knee movement. Thus, knee valgus is classified as adduction.

If a client’s hips drop toward the floor during push-ups, it is typically due to poor core stabilization, especially weakness in the abdominals (rectus abdominis, transverse abdominis, and obliques) and sometimes the glutes. These muscles stabilize the lumbopelvic-hip complex (LPHC), preventing excessive lumbar extension and anterior pelvic tilt. NASM emphasizes that the local stabilization system—including the transverse abdominis and multifidus—must contract isometrically to maintain a neutral spine. Strengthening these muscles through anti-extension core exercises (e.g., planks, stability ball rollouts) will help correct this push-up compensation.

NASM’s scope of practice clearly states that Certified Personal Trainers are not qualified to prescribe specific meal plans unless they hold an additional, recognized nutrition credential and are legally permitted in their jurisdiction.

While CPTs can provide general nutrition guidelines based on public resources (e.g., USDA MyPlate), creating individualized meal plans is outside their professional scope and constitutes a violation of the NASM code of professional conduct.

This is not a HIPAA violation (Option C), as HIPAA relates to handling of private medical data. It is also not fulfilling a duty within the OPT model (Option D) because nutrition planning is not part of OPT without proper credentialing. Therefore, developing a meal plan for a client as a CPT without proper credentials is a code of conduct violation.

A goal of losing 20 lb in 30 days is unrealistic and potentially unsafe. NASM emphasizes setting SMART goals (Specific, Measurable, Attainable, Realistic, Timely) to promote adherence and health.

The first step is to educate the client about safe weight loss rates (generally 1–2 lb per week) and adjust their expectations accordingly. Once realistic goals are set, smaller milestones and training/nutrition plans can be developed. Creating a metabolic workout or calorie deficit comes after ensuring the client understands what is safely achievable.

When conducting a fitness assessment—especially for older adults—NASM stresses the importance of gathering subjective information regarding the client’s medical history, chronic conditions, medications, and lifestyle factors. The NASM CPT7 Study Guide notes that subjective information “is gathered from the client, including health, medical, and lifestyle history” and is critical for risk stratification and tailoring safe exercise programs.

For older adults, this becomes even more important because the prevalence of conditions like cardiovascular disease, type 2 diabetes, arthritis, and osteoporosis increases with age. Knowing these details allows the CPT to adjust exercise intensity, movement selection, and monitoring protocols.

While body fat percentage, BMI, and postural alignment are valuable metrics, they are forms of objective information obtained through testing and observation—not subjective. Subjective health history is the first step in NASM’s assessment process, ensuring safety and compliance with medical clearance when needed. Therefore, for an older adult, identifying chronic medical conditions during the subjective intake is essential before moving to any performance or body composition assessments.

A scaption is a shoulder exercise where the arms are raised in the scapular plane, which is approximately 45 degrees between the frontal and sagittal planes. The NASM CPT7 Study Guide explains that this position aligns the glenohumeral joint and reduces impingement risk.

Lifting directly in front of the shoulders (Option B) is a front raise, and lifting directly out to the sides (Option D) is a lateral raise. A 25-degree angle (Option C) is too narrow to be in the optimal scapular plane. Therefore, the proper cue for a single-leg scaption is to lift at a 45-degree angle.

In NASM’s Exercise Metabolism and Bioenergetics section, glucose is defined as “the simplest form of carbohydrate used by the body for energy.” The Study Guide clearly states that carbohydrates are broken down into glucose, which is the most readily available form of fuel for the brain, nervous system, and muscles. Glucose can be rapidly metabolized through glycolysis to produce ATP, making it essential during both rest and high-intensity activities. Glycogen—its stored form—is limited, but glucose in the bloodstream is immediately accessible, especially to tissues that rely heavily on carbohydrate metabolism, such as the brain (which cannot use fat directly as fuel). The guide also notes that “the fuels used to create ATP are glucose from carbohydrates, free fatty acids from fat, amino acids from protein, and ketone bodies,” but fat oxidation is slower and protein is typically reserved for structural and enzymatic roles. Fiber is a non-digestible carbohydrate and thus not a fuel source. Therefore, glucose is the correct answer as the “most readily available” substrate for immediate energy needs across the nervous and muscular systems, supporting rapid ATP regeneration during movement and cognitive tasks.

When shoulders elevate and the head moves forward during a pushing assessment, NASM identifies overactive muscles including the upper trapezius, sternocleidomastoid, and levator scapulae. These compensations suggest dominance of neck and shoulder elevators combined with underactivity of stabilizers such as the deep cervical flexors and mid/lower trapezius. Corrective strategies involve inhibiting and stretching the overactive muscles, then activating the underactive ones to restore optimal pushing mechanics.

Beta-blockers are commonly prescribed medications for arrhythmias (abnormal heart rhythms), as well as for conditions like hypertension and certain forms of heart failure. The NASM CPT7 Study Guide explains that cardiovascular disease includes “heart rate problems, and arrhythmias”, and medications such as beta-blockers help regulate heart rhythm by blocking the effects of adrenaline on the heart’s beta receptors. This results in a slower, more controlled heart rate and reduced workload on the heart.

In exercise settings, CPTs must be aware that beta-blockers lower both resting and exercise heart rates, which makes heart rate–based training zones less reliable; perceived exertion (RPE) or talk tests are recommended instead for intensity monitoring.

Other listed options—nitrates (for angina), diuretics (for fluid retention in hypertension/heart failure), and bronchodilators (for respiratory conditions)—do not serve as primary rhythm-control agents for arrhythmias. Thus, beta-blockers are the most accurate answer for this question.