ACE Answers

Technically, everything in the manual can appear on the exam, however, we recommend spending more time focusing on the main ideas versus memorizing each step of the protocol. Know the objective or purpose of each assessment, for whom it is appropriate and any contraindications, and what the outcome reveals about the client. We also recommend reviewing the following blog posts:

• Physiological Assessments: Cardiovascular Assessments
• Posture and Movement Assessments

Preparation
Most of the time, if someone has made the effort to meet with a fitness professional, he or she has at least reached the preparation stage. However, you may encounter someone who is still in the pre-contemplation or contemplation stage. When this happens, that person has usually been prompted to meet with you by his or her doctor or a loved one.

Pre-contemplation
If a person is in pre-contemplation, he or she typically does not want to be there and does not believe that exercise can have an impact on health. In this case, it's important for you to take the appropriate steps to get the potential exerciser thinking about inactivity as a relevant issue and to start thinking about becoming more physically active. Some of the interventions used during this stage include providing information about the risks of inactivity and the benefits of activity, acknowledging that there is a lack of readiness to change and reevaluating current behaviors. The reason why it's important to recognize individuals in this stage of change is because people in pre-contemplation aren't necessarily open to the idea of exercise. Therefore, you could potentially increase resistance to physical activity by pushing the idea that they must exercise. However, if you provide information on how exercise can benefit them and then offer your expertise as a resource, while encouraging questions or allowing them to voice their concerns, you can essentially "plant the seed" so that they may consider exercise (moving them to contemplation).

A practical tool the fitness professional can use to determine if someone is in contemplation or pre-contemplation is to ask the following question: "On a scale of 1 to 10 how ready do you believe you are to make this change or adopt this healthy behavior?" If the potential client provides a response below 4, he or she is most likely in the pre-contemplation stage.

Contemplation
A person in the contemplation stage, however, knows the value of exercise, but for whatever reason is not regularly engaging in it. A contemplator is starting to consider the importance of becoming more physically active and has begun to recognize the implications of being inactive. He or she might have an internal dialogue that sounds like this: "I know I should exercise, but I just don't have the time, energy, etc." At this point, the person is allowing the cons of engaging in exercise to outweigh the pros of becoming more physically active. This is the point where we want to encourage the potential client to introduce some type of activity into their day, even if it means starting small, like walking for 10 minutes twice a day. Successfully achieving small tasks related to exercise may get them to realize that regular physical activity can be a part of their life if they can take the appropriate steps to commit. During this stage it is important to help clients explore options (like preferences for physical activity), and provide cues to action, some basic structure and design (such as how often and how long to be active), and opportunities to ask questions.

Tools a fitness professional may use with someone in this stage include the evaluation of the pros and cons of making the change and removing barriers to becoming more active, such as offering a free gym trial.

Operant conditioning is a learning theory that considers how personal actions are influenced by their consequences.

As an exercise and health professional, effectively applying this principle may help facilitate changes in clients’ lifestyle behaviors. The key is to identify factors (antecedents) that may trigger a client’s behavior versus addressing only the behavior.

Take, for example, a client who is prone to overeating (behavior), which contributes to the client having obesity (consequence). Through motivational interviewing, it is discovered that the client’s job is quite stressful, which leads him or her to seek food for emotional comfort. Consequentially, this results in the client consuming an excess of daily calories, which is a factor in the client having obesity. 

So, here you learn the stimulus that triggers overeating is stress on the job. Therefore, to facilitate changes in behavior, an exercise and health professional may address the client’s job stress (antecedent).

Ideally, once the stress (stimuli) is effectively managed, we would hope that the client’s desire to overeat (behavior) would cease, thus resulting in a decrease in daily caloric intake, ultimately leading to weight loss (consequence).

As the client begins to lose weight and recognizes that managing his or her stress decreases the desire to overeat, the stress-management behavior is rewarded, thereby the behavior increases (positive reinforcement). 

In this activity, we’re going to use a wall to represent the planes, and all motions you make must be parallel to that wall to occur in that plane:

Frontal Plane
Back yourself up to a wall so that your entire backside is against the wall. Pretend this wall is in your center, dividing you into anterior and posterior halves. This imaginary wall represents the frontal plane. To practice the motions that occur in this plane, you must keep your entire backside and limbs against the wall behind you. Motions in this plane would include movements like making snow angels (adduction/abduction) and elevating and depressing the shoulders. Notice, if you try to do a biceps curl, you would have to lift your forearm off of the wall, so this indicates that flexion and extension do not occur in the frontal plane.

Sagittal Plane:
Turn to one side and place your side against the wall (your arm might have to be slightly in front of the body to get hip against the wall). Pretend this wall is in your center, dividing you into right and left halves. This wall represents the sagittal plane. For this plane, you must keep your side against the wall. Movements in the sagittal plane would include biceps curls (that is, flexion and extension), deadlifts, and squats. Any movement where you can keep the side of your body parallel to the wall takes place in the sagittal plane. Notice, if you try to do the motions described for the frontal plane (abduction and adduction or elevation and depression) or any twisting motion, you would have to lift your side off of the wall or move through the wall.

Transverse Plane
This one is a little harder to imagine, but it can be represented by visualizing your body is divided into top and bottom halves and then placing your torso on top of a table and your lower extremities below the table. Movements that occur in this plane should keep the body or a specific joint parallel to the table. This would include movements like rotation of the trunk, pronation, and supination of the forearm, and circumduction of the thumb. Notice, performing any of the activities previously mentioned in the other planes would cause you to intersect with the “table.”

For more information, please refer to the blog The Planes of Motion Explained and the video The Planes of Motion.

Many texts use varied terminology related to the metabolic markers used to describe the physiological response to cardiorespiratory exercise. In the ACE manuals, VT1 and VT2 will be used, but it is important to recognize the other commonly used terms when reviewing the literature:

• The first ventilatory threshold (VT1) is also referred to as the lactate threshold and the anaerobic threshold.
• The second ventilatory threshold (VT2) is also referred to as the respiratory compensation threshold and the onset of blood lactate accumulation (OBLA).

Another potential source of confusion involves the term "anaerobic threshold," which has come to mean different things in various parts of the world based on the way it was used in early research on the topic. This is another reason ACE has chosen to utilize VT1 and VT2 throughout this manual.

Autogenic inhibition involves stimulation of the Golgi tendon organ (GTO) during a muscular contraction. The GTO is a proprioceptor responsible for sensing increases in tension during both concentric and eccentric actions. Performing a muscular action activates the GTO causing that muscle’s fibers (specifically, the agonist’s fibers) to relax. Under GTO activation, the agonist muscle is inhibited causing the fibers to lengthen.

A practical example of autogenic inhibition is observed during static stretching. During a static stretch muscle tension temporarily increases and after holding the stretch for 7 to 10 seconds the GTO is activated. When the GTO is activated, the muscle spindle is inhibited. The muscle spindle protects us from overstretching, so if this function is inhibited we can move into a deeper stretch.

Reciprocal inhibition involves stimulation of the muscle spindle during the stretching of muscle fibers. The muscle spindle wraps around the muscle fibers in a parallel fashion and will stretch as muscle fibers stretch. When a muscle group is stretched, the muscle spindle activates causing the stretched muscle (agonist) to contract and the antagonist muscle group to relax. Reciprocal inhibition is also known as the stretch reflex.

A practical example of reciprocal inhibition occurs during proprioceptive neuromuscular facilitation (PNF). During this stretching technique, a low grade muscular contraction of the antagonist muscle (in this case, the muscle group opposite of the muscle group targeted to receive the stretch) is held for 6 to 15 seconds. This low grade muscle contraction inhibits the muscle spindle activity in the agonist muscle (in this case, the muscle targeted to be stretched) allowing that muscle to be stretched further.

Phosphagen System (short-acting)

The most immediate source of energy at the onset of activity or upon increased intensity is the phosphagen system, which uses creatine phosphate (CP) to produce ATP. CP is a high-energy compound that is rapidly produced but is quickly depleted during muscular contraction; thus it is available for only a limited amount of time—usually 10-30 seconds—before it is exhausted. How quickly it is used depends on the intensity of the exercise. Activities such as plyometric exercise use the phosphagen system for ATP production.

Anaerobic Glycolysis (intermediate)

Anaerobic (without oxygen) glycolysis is a process that uses glycogen (stored glucose) for ATP production. Glycogen is available in greater quantities and for longer periods than CP—up to 3 minutes for activities such as moderate-intensity resistance training. During endurance activities, fuel needs are met by anaerobic glycolysis prior to approaching steady-state aerobic metabolism.

Aerobic System (long-acting)

The aerobic system takes over during endurance activities after the anaerobic systems become depleted, and fats and carbohydrates emerge as the primary sources for ATP production. During aerobic activity, there is an abundance of oxygen readily available to be used in the process of metabolizing carbohydrates and fat. This allows activities to be sustained for 30-60 minutes or more at moderate intensity. Cycling at a moderate intensity for 30 minutes, for example, primarily uses the aerobic system for ATP production.

During physical activity, these systems may be used at any time, working together to contribute to the total energy needs of the body. They do not work independently of each other; however, one system will dominate depending on the intensity of the activity and the demands placed on the body.

Activities performed for extended periods, which typically rely on the aerobic system, can also utilize the anaerobic system.

For example, in distance running, the aerobic system is the most dominant source of ATP production. However, during periods where the runner accelerates, and the intensity increases, one of the anaerobic systems will become more prevalent in ATP production.

For further reading, please see The Three Primary Energy Pathways Explained

Note: Both the phosphagen and anaerobic glycolysis systems are considered anaerobic, as they both produce energy in the absence of oxygen.

This important screening document is regularly updated and revised and there are different versions depending on the clientele with whom you are working. The PAR-Q+ and ePARmed-X (for clients who have had a positive response to the PAR-Q+ or have been referred to use this more comprehensive form by a healthcare professional) were created to reduce barriers for all individuals to become more physically active. These forms are updated on a regular basis. The PAR-Q+ Collaboration makes these publicly available on their website. Visit the following website to find the most up-to-date version of each questionnaire before using it with clients:

• eparmedx.com

Please note: When guidelines are updated, ACE takes steps to ensure that candidates have a fair opportunity to pass an exam that is not negatively impacted by the updates. As a professional standard, all health coaches and exercise professionals should do their best to stay up-to-date on industry guidelines and standards of care.

Please refer to the McGill's Torso Test video.

The McGill's Torso Muscular Endurance Test Battery assesses the endurance of three torso muscle groups and is comprised of the following tests:

1. Trunk Flexor Endurance Test: assesses the muscular endurance of the deep core muscles.
2. Trunk Lateral Endurance Test: also called the side bridge test, assesses the muscular endurance of the lateral core muscles.
3. Trunk Extensor Endurance Test: assesses the muscular endurance of the torso extensor muscles.

Poor endurance of the torso muscles or an imbalance between the three muscle groups can contribute to low back pain and core instability

The tests are performed individually and involve a static, timed, isometric contraction of the core muscles stabilizing the spine until the individual exhibits fatigue. The results are evaluated collectively in the following ratios to indicate balanced endurance among the muscle groups:

Flexion: Extension

• For the muscular balance between the front and back of the torso, the ratio should be less than 1.0 (ratio means dividing the two numbers).
• In this case, the ratio refers to the number of seconds held in each position or flexion time/extension time.

Right-side bridge (RSB): Left-side bridge (LSB)

• Right-side bridge time/left-side bridge time
• For the muscular balance between the sides of the torso, the score should be no greater than 0.05 from a balanced score of 1.0 (that is, an acceptable range would be a score somewhere between 0.95 to 1.05).

Side bridge (SB) (either side): Extension

• One-side bridge time/extension time
• For muscular balance between one side and the back of the torso, the score should be less than 0.75.

Let's work through an example. A client completed the three tests with the following results:

Flexor Test: 120 seconds
RS Bridge: 88 seconds
Extension Test: 150 seconds
LS Bridge: 92 seconds

Scoring and Evaluation

Flexion: Extension

• 120 seconds:150 seconds = 120/150 = 0.8
• The score of 0.8 fits within the criteria of <1.0 for muscular balance between the front and back of the torso.

RSB: LSB

• 88 seconds:92 seconds = 88/92 = 0.96 (0.956 rounded up)
• This score fits within the 0.05 range from 1.0 (that is, it falls between 0.95 and 1.05), indicating muscular balance between the right and left sides of the torso.

Side bridge (choose one side at a time, but remember to perform the ratio calculation for both sides): Extension

• RSB = 88 seconds:150 seconds = 88/150 = 0.59 (0.586 rounded up)
• This score fits within the criteria of <0.75 for muscular balance between the right side and the back of the torso.

Side bridge: Extension

• LSB = 92 seconds:150 seconds = 92/150 = 0.61 (0.613 rounded down)
• This score fits within the criteria of <0.75 for muscular balance between the right side and the back of the torso.

The results show that this client has well-balanced torso muscles.

The talk test is a method for monitoring and controlling exercise intensity, using respiration effort, and the ability to speak.  An individual, being able to speak comfortably with more than a few words indicates that he or she is likely below the first ventilatory threshold, VT1.  When using the talk test, it is not required that the heart rate be measured, as the objective is to observe respiratory (breathing) effort and the ability to speak.

The individual is evaluated by having them recite a familiar passage or phrase like the pledge of allegiance, and then asking if they can speak.

In contrast to the simplicity of the Talk Test, the Submaximal Talk Test for VT1 is a formal assessment used to determine heart rate at VT1. This test requires preparation and equipment and continuous monitoring of heart rate to avoid missing VT1. The intensity is gradually increased until the ability to talk continuously is compromised, and like the talk test uses a familiar passage or phrase to evaluate effort and ability to speak.

In summary, the talk test method is used to measure exercise intensity but does not require the measurement of heart rate. While the submaximal talk test for VT1 is a formal assessment where heart rate is measured at VT1 and requires the use of equipment and preparation, to administer the test.

For the physiological assessments section, there are numerous amounts of information, from the administration of assessments and accompanying charts, tables, and equations.  The key to approaching this section is to be strategic. Since there is no practical component to the exam, you are not expected to memorize the exact protocol of each assessment or all the information presented in the tables and charts.  However, understanding what information you are gathering from the assessment concerning the client is essential.

One helpful way to tackle the content is to categorize the information. Ask the questions:

• What is the purpose/objective of this assessment?
• For whom is the assessment most appropriate?
• What are the outcomes that I am seeking to observe?
• Are there any contraindications?
• What do the results mean?

Gathering this information will allow you to remain organized as you complete this section of the course. While you are not expected to memorize the chart and table information, you also do not want to disregard them. For example, recognizing that for BMI, a score of ≥ 30 mg/m² places a client in the obesity category, is an essential factor to remember. On the other hand, memorizing all the data on the Rockport Fitness Walking test would not be the most effective use of your time.

The process of selecting assessments is dependent on several factors and is not always a black-and-white or linear process. Different assessments may be administered throughout the course of the client-health and exercise professional relationship and factors like health history, current fitness level, lifestyle factors, and goals determine which assessments may be most appropriate for the client.

Prior to performing any physical assessments—in the initial investigation stage—information about the client is gathered via the pre-participation health screening, using forms like a health-history questionnaire and PAR-Q to identify risk factors. This allows the health and exercise professional to determine if a physician’s clearance is needed or if there are any specific programming recommendations to be considered (e.g., considerations related to injury or chronic conditions like diabetes and hypertension).

Example of selecting appropriate assessments for a client with a shoulder condition and weight-loss goal:

Client: John

Age: 45

Pre-participation screen: Generally healthy with no chronic conditions. He previously tore his rotator cuff and has had surgery to repair the injury. He completed physical therapy over the past 4 months. He is not experiencing any pain or discomfort.

Physician recommendations: Cleared to exercise. Continue with exercises from physical therapy and improve shoulder mobility.

Goals: He has struggled with weight loss and desires to lose 40 pounds and improve strength in his shoulder.

Assessments: Prior to developing an exercise program, the following assessments were performed. To establish baseline measurements for his weight loss goal, anthropometric assessments are performed [i.e., body mass index (BMI) and girth measurements]. A skinfold assessment may not be appropriate since John is currently 40 lb. overweight. In addition, a postural assessment and shoulder mobility tests (i.e., internal and external shoulder rotation and Apley’s scratch test) are performed to determine John’s current joint function. The results of these assessments may be used to design a safe and effective, individualized exercise program for John.

Generally, health and exercise professionals may choose to perform postural and/or movement-based assessments to determine the client’s level of functionality and/or the presence of any muscular imbalances before designing and implementing an exercise program. Additional assessments such as body composition, cardiorespiratory fitness, and sports skills may also be administered, depending on the client’s goals. These assessments allow the health and exercise professional to establish a baseline to compare against for tracking progress in a client’s program.

While assessments may be beneficial initially to create a personalized program for a client, it is important that the appropriate assessment is selected at the appropriate time. Not all clients will need or be receptive to assessments, as they may cause some people to become discouraged and demotivated, particularly if they are severely deconditioned or have overweight or obesity. To minimize client distress, be empathetic when selecting assessments, and consider the needs and goals of the individual.

As a certified fitness professional, it is outside of your scope of practice to design and implement nutrition plans or diets. Your role as a fitness professional is to educate your clients on nutrition and share your knowledge of healthy choices to help them adopt more healthful behaviors. This can include showing them how to utilize tools available at www.choosemyplate.gov or educating them about USDA Dietary Guidelines recommendations. If your client needs specific advice or a diet plan, refer them to a registered dietitian.

Within Scope of Practice for Fitness Professionals

• Principles of healthy nutrition and food preparation
• Food to be included in a balanced daily diet
• Essential nutrients needed by the body
• Actions of nutrients on the body
• Effects of deficiencies or excesses of nutrients
• How nutrient requirements vary through the lifecycle
• Information about nutrients contained in foods or supplements

Outside Scope of Practice for Fitness Professionals

• Individualized nutrition recommendations or meal planning other than that which is available through government guidelines and recommendations, or has been developed and endorsed by a registered dietitian or physician
• Nutritional assessment to determine nutritional needs and nutritional status
• Specific recommendations or programming for nutrient or nutritional intake, caloric intake or specialty diets
• Nutritional counseling, education, or advice aimed to prevent, treat, or cure a disease or condition, or other acts that may be perceived as medical nutrition therapy
• Development, administration, evaluation, and consultation regarding nutritional care standards or the nutrition care process
• Recommending, prescribing, selling or supplying nutritional supplements to clients
• Promotion or identification of oneself as a “nutritionist” or “dietitian”

For more information, please read the following:

• Scope of Practice for Fitness Professionals
• Nutrition Scope of Practice - What You Can Do as a Personal Trainer

During submaximal exercise, ventilation (or breathing rate) parallels oxygen uptake, and there is a linear increase between intensity and ventilation. This linear increase continues until exercise approaches the lactate threshold. At this point, ventilation begins to increase in a non-linear fashion, and ventilation is no longer directly linked with oxygen demand. This first disproportionate increase in oxygen consumption represents VT1 and occurs in response to an initial accumulation of metabolic by-products in the blood.

As exercise intensity continues to increase, there is a second disproportionate increase in ventilation that is associated with increased lactate production, which coincides with acidosis. Exercise immediately below VT2 represents the highest sustainable exercise intensity. Exercise above VT2 represents an intensity that cannot be sustained for long periods, and speech is not possible other than single words.

Follow this link for more information on this topic: What is the Difference Between VT1, VT2, & VO2 max?

The following information will help you navigate through your eBook by explaining the toolbar functions, the navigation hot keys / shortcut keys and other usability functions.

To zoom the publication in and out, either click in the area of the page you wish to zoom in on, or use the zoom button on the toolbar, which will automatically zoom on the center of the pages you are viewing. Then select your preferred level of zoom using the zoom scale, which will appear on the toolbar once the publication is zoomed in.

To move the page around, click and drag the publication or use the scroll bars found at the right hand side and the bottom of the page.

If you are reading on a PC and you have a wheel on your mouse you can use this to scroll up and down.

Click on the publication or zoom icon again to zoom out (a minus sign will appear in the icon for zooming out).

PAGE BROWSING
To turn the page, click on the bottom right corner of the publication or use the arrow buttons on the tool bar for instant page display. You can also move instantly to the first or last page using the keys with a single vertical line, next to the arrow keys.
The page you are viewing will be displayed in the white window, in the middle of the toolbar. You can also type the page you require into this page display, to move instantly.
You can also use the contents drop down menu on the right hand side of the toolbar to select the page you require.

HOTKEYS
To navigate through the publication using hot keys instead of a mouse, use the following keys:
To select items on the menu bar use the TAB key to move through the selections. A yellow box will highlight your selection. To activate the selection hit the space bar.
 - To turn to the next page, press the full stop key.
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 - You can increase or decrease the zoom level by pressing the + or - keys.
 - Once zoomed in, press A to scroll left.
 - Press D to scroll right.
 - Press W to scroll up.
 - Press S to scroll down.

SEARCH
There is a contextual search facility on the far right of the toolbar. Type your search word or term into the box and click the GO button to start the search. A dropdown menu of results will appear under the search box. Click the page you require from the menu and you will be delivered directly to that page. Your keyword or search term will be highlighted in green.

STICKY NOTES
You can add notes to the page for future reference by clicking on the note icon on the toolbar and selecting the area you wish to annotate. Write your notes in the yellow box. Once you have finished, a yellow note icon will be pasted on the selected area. When you wish to view your notes again, simply scroll over the yellow note icon when required.

BOOKMARKING
You can add bookmarks to your eBook that will allow you to return easily to specific pages. ACE eBooks allow for multiple page bookmarking, using different colored bookmarks for each page.
You can also reference each bookmark with a short description.
The bookmarks will remain on your publication if you view the publication from the same computer. You can also save an offline version of your publication to your desktop, which will also save your bookmarks and referencing.

CONTENTS
You can click on the contents button on the left of the toolbar to view a dropdown menu of the publication's contents. Clicking on the page you require will move you directly to that page. You can also click to view thumbnails of each page in the publication.

The test contains math-based questions to determine if you can use basic mathematics (addition, subtraction, multiplication, and division) to apply what you are learning to real-life scenarios. These questions will require calculations and memorization of some fitness formulas. However, you only need to know a few formulas for the exam, and they can all be found on this Helpful Fitness Formulas sheet. While all of these formulas are useful to know as a fitness professional, they may not all be specific to your test. It is recommended you cross-reference the equations on the handout with what is covered in your text. The exam program itself will have a calculator function, and you will also have access to scratch paper and a pencil.

Ask yourself the following questions:

• Have I thoroughly used all of the materials I have available?
• Have I reviewed the appropriate exam preparation blogs?
• Have I practiced the assessments or teaching strategies on a friend or family member?
• Have I tried to explain the topics out loud to see if I actually understand them?
• Have I reached out to a study coach with my specific questions?
• Have I reviewed the Exam Content Outline?

We generally advise spending 3 to 4 months studying and preparing yourself to not only pass the exam but also to prepare yourself to become a health and fitness professional. We suggest spending 12 to 15 hours on every lesson, which generally equates to taking 5 to 7 days to cover the videos, reading, study companion, and quiz.

We highly recommend reviewing your Exam Content Outline, as this is essentially the "blueprint" for the exam. This will divide the information into multiple domains, and each domain has a set list of tasks that you will be expected to understand. Use the "knowledge of" and "skills in" sections to guide you and make sure you feel very comfortable with those sections. An excellent way to tell if you're comfortable with a topic is to try to explain it to someone else. If you feel confident that you could explain it to a client or class participant, then you're probably proficient with that topic; if you're not quite sure, then you'll probably want to review that topic.

1. Determine if you have a retake voucher.
   1. If you have a retake voucher, it is important to know when it expires to understand how much time you have available to review before your next exam.
   2. If you don’t have a retake voucher, you can purchase an additional exam at a discounted retake fee. This price is valid for one year after your initial test date.
2. Determine a date for your retake exam.
   1. When choosing a date, we recommend giving yourself about one week of review time for every ten points you are away from a passing score. For example, if your score is 480 out of a possible 800 and you are 20 points away from the minimum passing score of 500, allow about two weeks of review before your next exam.
3. Analyze your performance and consider any topics on the exam for which you felt underprepared.
4. Review your exam score report and compare your domain performance to the Exam Content Outline. Review each domain and determine what areas need improvement.
   1. Focus on improving the domains in which you scored the lowest, but also continue to briefly review the other domains to ensure that you keep all the content fresh in your mind.
5. Use all your study materials.
   1. Be sure to use all the resources that are available to you. These could be in the form of books, online content, live and recorded webinars, facilitated study groups, peer-to-peer interaction on the ACE Fitness Certification Study Center Facebook page, and the ACE Answers Landing Page.
6. Consider what went well during your initial studies and what you might do differently.
7. Create a game plan for everything you want to do before you retake the exam. Writing down your plan may help create accountability.
8. Join the ACE Study Coaches for a webinar (available with specific study packages) or a tutoring session to get your specific questions answered.

While the practice tests can be completed as many times as you would like, we do not recommend taking them repeatedly, as this may lead to memorization of correct answers, rather than a deeper understanding of the content.  Instead, try the tips and strategies shared below to get the most out of your certification exam practice tests.

1. Review your answers.
   1. Look at the questions that were incorrect and go back to review the material. The goal is to understand the “why” behind the question and the correct answer. Try to explain why the correct answers are correct and why the other options are incorrect. A helpful way to use this strategy is to imagine you are teaching someone else why an answer is correct.
   2. Look at the questions that were correct but were only guessed correctly. Review the corresponding content.
   3. This is a great time for self-reflection. These practice tests are meant to serve as a diagnostic tool to identify what your strengths are and what areas need the most improvement. Be honest with yourself when reviewing the questions— determine whether you guessed the correct answer or if you really know why the correct answer is correct.
   4. Review your overall practice test score report and compare your results to each domain of the Exam Content Outline.
2. After reviewing the practice test and studying your answers, clear out your answers from the practice test and go through it again. Look for changes in your score related to increased knowledge and understanding as opposed to memorization.  If questions are missed on the second attempt, it is important to again ask yourself why you might have marked them incorrectly.  Now move on to your next practice test and follow the same steps as above.