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Vigorous = 14–17; moderate = 12–13; light = 9–11. RPE correlates with HRR and is useful when HR is affected by meds or conditions.

ACSM-EP screening emphasizes current activity level, presence of known disease, desired intensity, and signs/symptoms. This client is currently active at a moderate intensity (≥30 min, ≥3 days/week, ≥3 months). He has a known cardiovascular-related condition (hypertension) but denies signs/symptoms and is controlled on medication. For active individuals with known disease who are asymptomatic, ACSM permits continuation of moderate exercise but recommends medical clearance before advancing to vigorous intensity. A routine exercise test is not universally required absent symptoms; decisions about testing are left to the medical provider. Completely prohibiting exercise until “normal” blood pressure is achieved is unnecessary; well-managed hypertension allows moderate activity. Therefore, the prudent and ACSM-consistent path is to maintain current moderate training and obtain medical clearance prior to initiating vigorous jogging. This reduces risk during the higher cardiovascular demands of vigorous work while supporting continuity of beneficial activity and adherence to the EP scope of practice regarding referral and shared decision making.

According to ACSM/ACC-AHA:

•Normal: <120/<80

•Elevated: 120–129/<80

•Stage 1: 130–139 or 80–89

•Stage 2: ≥140 or ≥90.

Thus, 150/96 = Stage 2. This requires referral and monitoring.

SMART = Specific, Measurable, Achievable, Relevant, Time-bound. Process goals (behaviors) are under client control. Outcome goals (weight loss) are less effective for adherence.

ACSM emphasizes tailoring strategies to individual circumstances. Behavior change techniques include problem-solving, action planning, and environmental restructuring. Option B reflects collaborative planning, identifying realistic alternatives (e.g., 15-minute home circuits, stroller walks, online sessions). This enhances adherence by addressing barriers without judgment. Options A, C, and D are impractical or authoritarian, undermining autonomy and rapport. Effective EPs use motivational interviewing and SMART goals to co-create flexible routines, reinforcing mastery and self-efficacy despite life demands.