KNH 188 LATEST 2026 CORE EXAM MANUAL QUESTIONS
AND SOLUTIONS RATED A+
✔✔PA recommendations for adults - ✔✔should move more, sit less throughout the day,
some PA is better than none.
Aerobic activity: 150 + minutes/week, can be both moderate and vigorous, preferably
spread throughout the week.
Muscular strength: in addition to aerobic activity, should also do at least 2 days/week
muscle-strengthening activities
✔✔PA recommendations for older adults (65 and older) - ✔✔added balance training as
well as aerobic and muscular-strengthening
✔✔PA recommendations for children/adolescents - ✔✔ages 6-17 should do 60 minutes
or more daily, most should be aerobic, muscle-strengthening and bone-strengthening at
least 3 days/week. Age 3-5 physically active through play
✔✔Plato (427-347 BC) - ✔✔"lack of activity destroys the good condition of every human
being, while movement and methodical physical exercise save and preserve it
✔✔History of PA research (Jeremy N. Morris) - ✔✔Morris was first researcher to
connect PA to coronary heart disease. Received medical degree in 1931 at University
College London Medical School.
✔✔Postal workers and CHD - ✔✔Morris did study of postal worker. Compared postmen
who delivered main by walking or riding bicycles to the clerks and telephone operators
behind post office window.
Results: postal carriers had far lower risk of heart attack.
✔✔History PA research (Ralph S. Paffenbarger) - ✔✔Similar research to Morris, but in
U.S. Earned bachelor's from OSU in 1944, graduated Northwestern medical school in
1947. Master's/doctorate in public health. Practiced/taught/researched at Harvard, UC
Berkley, Stanford. In 1950, began long-term study of longshoremen in San Fran,
examined CHD in men who performed strenuous, moderate, and light tasks. 22 year
follow-up. Rish of death was lower for those doing strenuous work
✔✔PA and health (1996) - ✔✔Historical benchmark outlined consensus of scientific
community about beneficial effects of PA on:
mortality, CVD, cancer, type II diabetes, obesity, osteoarthritis, osteoporosis, mental
health
✔✔PA and mortality - ✔✔60-75 minutes/day moderate-intensity activities, or 30-40
minutes/day vigorous-intensity to reduce overall mortality
,✔✔PA and CVD - ✔✔regular PA prevents onset of and reduces CVD risk factors.
Reduced resting systolic/diastolic pressure, reduced body fat, reduced insulin needs,
reduced inflammation, lower risk of CVD incidence and death
✔✔Heart and exercise - ✔✔Heart's capacity to pump blood is crucial when doing PA
(especially for extended time). Heart has two ways to get more blood to muscles:
by beating faster, and by sending more blood with each beat.
More blood pumped per beat, keep HR lower, heart contractions are stronger, heart
cavity size increases (in young adults), BP reduced
✔✔PA and blood - ✔✔PA increases size and number of blood vessels in body. PA
leads to increases in plasma volume, which reduces blood viscosity (thickness),
elevated viscosity increases CV complication risk. Moderate PA decrease both platelet
adhesion (stickiness) and aggregation (clumping)
✔✔Endothelium and PA - ✔✔thin membrane that lines inside of heart and blood
vessels, cells release substances that control vascular relaxation and contraction, as
well as blood clotting. when damaged, arteries don't dilate properly, increased
inflammation, clots and plaques more likely. PA improves this, keeps it functioning as
we age
✔✔PA and blood pressure - ✔✔immediate BP reduction following single bout of
exercise (acute), can last almost 24 hours. More frequent/chronic exercise results in
more sustained reductions in BP
✔✔PA and cholesterol - ✔✔enhances ability of skeletal muscles to utilize lipids as
opposed to glycogen for fuel, PA increase HDL levels.
✔✔PA and diabetes - ✔✔Insulin resistance, regular exercise assists in reduction of
bodily fat. Glucose uptake remains elevated up to 120 minutes after PA, due to increase
in GLUT4 presence in plasma membrane and T-tubules. Effect is acute (short-term),
insulin sensitivity increases at least 16 hours post-exercise. Exercise helps funnel
glucose inside cell independently of insulin. Moderate and vigorous PA increase insulin
sensitivity
✔✔leptin - ✔✔hormone produced by adipose tissue that regulates satiety
✔✔PA and leptin sensitivity - ✔✔PA improves leptin resistance/sensitivity, leads to
better weight maintenance.
✔✔PA inflammation - ✔✔short-term inflammation is good for fighting off illness or
healing injuries. Over time, high levels can damage tissues, like arteries. Acute bouts of
exercise increase it at first, but chronic will reduce levels
, ✔✔PA and disease prevention - ✔✔American college of sports medicine focuses on
two levels of prevention:
primary prevention - interventions to prevent initial occurrence. Ex: PA to prevent
myocardial infarction
Secondary prevention - interventions after first event to prevent another. Ex: PA in form
of cardiac rehab after MI to prevent another heart attack
✔✔cost of being unfit - ✔✔most adults with hypertension recommended prescription
medication with lifestyle modifications. Estimated to face nearly $2000 higher annual
healthcare expenditure compared to those without hypertension.
✔✔PA and brain health - ✔✔improved cognition, reduced risk of dementia, improved
quality of life, reduced risk of depression, reduced anxiety, improved sleep outcomes
✔✔why monitor and assess PA? - ✔✔body's ability to maintain level of exertion
(exercise) for extended time reflects cardiorespiratory fitness. One's level of fitness is
determined by body's ability to take up, distribute, and utilize O2 during activity. Optimal
objective of monitoring is to identify optimal exercise dose to customize exercise
prescription
✔✔Measuring Pa: subjective methods - ✔✔based on or influenced by personal feelings,
tastes, or opinions. methods that necessitate interpretation. Ex: self-reported measures
from questionnaires and diaries
✔✔Measuring PA: objective methods - ✔✔Not influenced by personal feelings or
opinions in considering and representing facts. Methods that are not influenced by
perception. Ex: pedometers, accelerometers, heart rate monitors
✔✔Advantages of subjective method - ✔✔relatively inexpensive, easy to administer,
data collected for many individuals, can be ascertained with a few questions
✔✔disadvantages of subjective method - ✔✔inaccurate recall, fails to capture all types
of activity, not recommended for children under 10
✔✔advantages of objective method - ✔✔not subject to recall error, small and
lightweight, unobtrusive
✔✔disadvantages of objective method - ✔✔specific types of activity not assessed,
extraneous variables may affect results, usually more expensive than questionnaires
✔✔Feasibility - ✔✔degree of being easily or conveniently done. In research, the extent
to which those who implement a research study can practically do so within an identified
authentic setting
AND SOLUTIONS RATED A+
✔✔PA recommendations for adults - ✔✔should move more, sit less throughout the day,
some PA is better than none.
Aerobic activity: 150 + minutes/week, can be both moderate and vigorous, preferably
spread throughout the week.
Muscular strength: in addition to aerobic activity, should also do at least 2 days/week
muscle-strengthening activities
✔✔PA recommendations for older adults (65 and older) - ✔✔added balance training as
well as aerobic and muscular-strengthening
✔✔PA recommendations for children/adolescents - ✔✔ages 6-17 should do 60 minutes
or more daily, most should be aerobic, muscle-strengthening and bone-strengthening at
least 3 days/week. Age 3-5 physically active through play
✔✔Plato (427-347 BC) - ✔✔"lack of activity destroys the good condition of every human
being, while movement and methodical physical exercise save and preserve it
✔✔History of PA research (Jeremy N. Morris) - ✔✔Morris was first researcher to
connect PA to coronary heart disease. Received medical degree in 1931 at University
College London Medical School.
✔✔Postal workers and CHD - ✔✔Morris did study of postal worker. Compared postmen
who delivered main by walking or riding bicycles to the clerks and telephone operators
behind post office window.
Results: postal carriers had far lower risk of heart attack.
✔✔History PA research (Ralph S. Paffenbarger) - ✔✔Similar research to Morris, but in
U.S. Earned bachelor's from OSU in 1944, graduated Northwestern medical school in
1947. Master's/doctorate in public health. Practiced/taught/researched at Harvard, UC
Berkley, Stanford. In 1950, began long-term study of longshoremen in San Fran,
examined CHD in men who performed strenuous, moderate, and light tasks. 22 year
follow-up. Rish of death was lower for those doing strenuous work
✔✔PA and health (1996) - ✔✔Historical benchmark outlined consensus of scientific
community about beneficial effects of PA on:
mortality, CVD, cancer, type II diabetes, obesity, osteoarthritis, osteoporosis, mental
health
✔✔PA and mortality - ✔✔60-75 minutes/day moderate-intensity activities, or 30-40
minutes/day vigorous-intensity to reduce overall mortality
,✔✔PA and CVD - ✔✔regular PA prevents onset of and reduces CVD risk factors.
Reduced resting systolic/diastolic pressure, reduced body fat, reduced insulin needs,
reduced inflammation, lower risk of CVD incidence and death
✔✔Heart and exercise - ✔✔Heart's capacity to pump blood is crucial when doing PA
(especially for extended time). Heart has two ways to get more blood to muscles:
by beating faster, and by sending more blood with each beat.
More blood pumped per beat, keep HR lower, heart contractions are stronger, heart
cavity size increases (in young adults), BP reduced
✔✔PA and blood - ✔✔PA increases size and number of blood vessels in body. PA
leads to increases in plasma volume, which reduces blood viscosity (thickness),
elevated viscosity increases CV complication risk. Moderate PA decrease both platelet
adhesion (stickiness) and aggregation (clumping)
✔✔Endothelium and PA - ✔✔thin membrane that lines inside of heart and blood
vessels, cells release substances that control vascular relaxation and contraction, as
well as blood clotting. when damaged, arteries don't dilate properly, increased
inflammation, clots and plaques more likely. PA improves this, keeps it functioning as
we age
✔✔PA and blood pressure - ✔✔immediate BP reduction following single bout of
exercise (acute), can last almost 24 hours. More frequent/chronic exercise results in
more sustained reductions in BP
✔✔PA and cholesterol - ✔✔enhances ability of skeletal muscles to utilize lipids as
opposed to glycogen for fuel, PA increase HDL levels.
✔✔PA and diabetes - ✔✔Insulin resistance, regular exercise assists in reduction of
bodily fat. Glucose uptake remains elevated up to 120 minutes after PA, due to increase
in GLUT4 presence in plasma membrane and T-tubules. Effect is acute (short-term),
insulin sensitivity increases at least 16 hours post-exercise. Exercise helps funnel
glucose inside cell independently of insulin. Moderate and vigorous PA increase insulin
sensitivity
✔✔leptin - ✔✔hormone produced by adipose tissue that regulates satiety
✔✔PA and leptin sensitivity - ✔✔PA improves leptin resistance/sensitivity, leads to
better weight maintenance.
✔✔PA inflammation - ✔✔short-term inflammation is good for fighting off illness or
healing injuries. Over time, high levels can damage tissues, like arteries. Acute bouts of
exercise increase it at first, but chronic will reduce levels
, ✔✔PA and disease prevention - ✔✔American college of sports medicine focuses on
two levels of prevention:
primary prevention - interventions to prevent initial occurrence. Ex: PA to prevent
myocardial infarction
Secondary prevention - interventions after first event to prevent another. Ex: PA in form
of cardiac rehab after MI to prevent another heart attack
✔✔cost of being unfit - ✔✔most adults with hypertension recommended prescription
medication with lifestyle modifications. Estimated to face nearly $2000 higher annual
healthcare expenditure compared to those without hypertension.
✔✔PA and brain health - ✔✔improved cognition, reduced risk of dementia, improved
quality of life, reduced risk of depression, reduced anxiety, improved sleep outcomes
✔✔why monitor and assess PA? - ✔✔body's ability to maintain level of exertion
(exercise) for extended time reflects cardiorespiratory fitness. One's level of fitness is
determined by body's ability to take up, distribute, and utilize O2 during activity. Optimal
objective of monitoring is to identify optimal exercise dose to customize exercise
prescription
✔✔Measuring Pa: subjective methods - ✔✔based on or influenced by personal feelings,
tastes, or opinions. methods that necessitate interpretation. Ex: self-reported measures
from questionnaires and diaries
✔✔Measuring PA: objective methods - ✔✔Not influenced by personal feelings or
opinions in considering and representing facts. Methods that are not influenced by
perception. Ex: pedometers, accelerometers, heart rate monitors
✔✔Advantages of subjective method - ✔✔relatively inexpensive, easy to administer,
data collected for many individuals, can be ascertained with a few questions
✔✔disadvantages of subjective method - ✔✔inaccurate recall, fails to capture all types
of activity, not recommended for children under 10
✔✔advantages of objective method - ✔✔not subject to recall error, small and
lightweight, unobtrusive
✔✔disadvantages of objective method - ✔✔specific types of activity not assessed,
extraneous variables may affect results, usually more expensive than questionnaires
✔✔Feasibility - ✔✔degree of being easily or conveniently done. In research, the extent
to which those who implement a research study can practically do so within an identified
authentic setting
