Final answer:
The client's total score for atherosclerotic cardiovascular disease using the ACSM risk factor thresholds is 3. This score is based on their family history of cardiovascular disease, physical inactivity, and dyslipidemia due to the elevated LDL levels.
Step-by-step explanation:
To assess the total score for atherosclerotic cardiovascular disease risk factors using the American College of Sports Medicine (ACSM) criteria, we can look at the information provided about the client. The risk factors include family history of cardiovascular disease, personal history of smoking, current level of exercise, body mass index (BMI), blood pressure, total serum cholesterol, LDL levels, HDL levels, and fasting plasma glucose. According to the ACSM, the thresholds for risk factors are:
- Family history: History of cardiovascular disease in first-degree relative (male <55 years or female <65 years) (+1 risk factor)
- Smoking: Quitting smoking over 6 months ago does not count as a risk factor.
- Physical inactivity: Not meeting the minimum of 30 minutes of moderate exercise on most days of the week (+1 risk factor)
- Obesity: BMI > 30kg/m² (+1 risk factor; however for this client, BMI is 29kg/m², which is considered to be 'overweight' but not 'obese', thus it is not counted as a risk factor)
- Hypertension: BP > 140/90 mmHg (+1 risk factor; the client has a BP of 132/86 mmHg, which is classified as 'pre-hypertensive' but not hypertensive by the ACSM standards, therefore it is not counted as a risk factor)
- Dyslipidemia: Total cholesterol > 200 mg/dL or LDL > 130mg/dL or HDL < 40mg/dL (+1 risk factor due to LDL being 138mg/dL)
- Diabetes: Fasting plasma glucose > 126mg/dL (No risk factor as the client's level is 94mg/dL)
Considering these criteria, the client has a score of:
- +1 for family history
- +1 for physical inactivity
- +1 for dyslipidemia
Therefore, the answer is 3.