Scenarios

Question 1

A patient calls and complains that their elbow brace you fit them with earlier in the week is preventing them from flexing their arm to the ROM the brace is set. Which area of the arm could have misplaced a strap?
a. Olecranon
b. Antecubital space
c. Distal Radius

Answer 1

b. Antecubital space

If the brace migrates it could impinge on this area preventing flexion of the arm. The distal strap could impinge on wrist flexion but the questions pertains to the arm flexion.

Question 2

A physician sees the patient immediately post-trauma for a non-displaced midshaft tib/fib fracture, and the physician sends the patent directly to you for a fit and delivery of an off the shelf tibia fracture brace. You should:
a. Immediately fit the patient to prevent swelling
b. refer to the orthotist
c. measure the patient and fit with a boot

Answer 2

b. refer to the orthotist

Initial bracing for long bone fractures are not within the scope of practice for an Orthotic Fitter

Question 3

You receive a faxed prescription for a patient for a hernia belt. You are trying to reach the patient by phone, but are unsuccessful. You may leave a voice message for the patient to make an appointment for a hernia belt fitting; on the phone number you were provided.
a. true
b. false

Answer 3

b. false

From the information given you don’t know who could get the message. Cannot guarantee privacy.

Question 4

A patient arrives to the office for a walker boot and they have grade 3 pitting edema, what should you do?
a. sell the patient compression stockings
b. wrap the patient with an ace wrap
c. call the physician

Answer 4

c. call the physician

Grade 3 is serious enough to call the physician and ask what they want.
Grading edema
1+: slight pitting/2 mm, disappears rapidly,
2+: somewhat deeper pit/4 mm, disappears in 10-15 sec
3+: deep pit/6 mm, may last > 1 minute; dep extremity swollen
4+: very deep pit/8 mm, lasts 2-5 min, dep extremity grossly distorted

Question 5

You fit a patient with a walking boot on their right lower extremity and the patient asks you if they can drive themselves home. You should tell the patient:

a. to remove the boot to drive home
b. to call a taxi
c. to drive with the boot on

Answer 5

b. to call a taxi - would be best answer however A could be an option as well.

The patient would have to remove the boot to go home and if they drove to the office without a boot they can go back home without the boot.
Should discourage/not recommend C.

Question 6

Patient seen by you in office complains that the prescription the doctor gave them is for the wrong brace and they want you to fit them with a different kind, what should you do first?
a. give the client what they want
b. suggest the client go to another facility
c. assess the patient

Answer 6

c. assess the patient

First you should assess the patient before calling the physician.

Question 7

Your company wants to make sure that they are keeping their employees and patients safe, and that they are complying with all safety regulations. Which of these conditions would be found in a safe work environment?
Select one:
a. The adhesives and thinners are kept together close to the oven for convenience.
b. All staff wear personal protective equipment when dealing with blood or body fluids
c. The MSDS sheets are kept in the boss’s office in a locked file drawer
d. They are short-handed, so staff are working lots of long hours of overtime to keep up the workload

Answer 7

b. All staff wear personal protective equipment when dealing with blood or body fluids

Question 8

Your patient is a 75 year old man with dependent edema. The doctor has ordered BK 20 - 30 mmHg compression stockings to deal with his swelling. This patient has some compromise to his cardiovascular system. Which of these components of the cardiovascular system is most likely to be responsible for this patient’s condition?
Select one:
a. The veins in his lower legs
b. The capillaries in his lower legs
c. His heart
d. The arteries in his lower legs

Answer 8

a. The veins in his lower legs

Question 9

Your patient is a 12 year old boy with tendonitis of his left elbow. The doctor has ordered an elbow sleeve to provide compression and warmth to aid with pain relief. Upon examination, you note some swelling. The elbow is also slightly warm to touch. Which of these protective agents is most likely causing these symptoms?
Select one:
a. Specific immunity
b. Action of B cells
c. Non specific immunity
d. Action of T cells

Answer 9

c. Non specific immunity

Question 10

Your patient was fitted with a high profile LSO four weeks ago. On his return visit, you note that he has a painful abrasion on his back at the superior border of the orthotic, bilaterally. What protruding landmarks is the orthotic most likely rubbing on to cause this abrasion?
Select one:
a. Superior border of the scapula
b. ASIS
c. Inferior angle of the scapula
d. Pelvic crest

Answer 10

c. Inferior angle of the scapula

Question 11

Your patient is a 17 year old male who injured his neck at a rock concert. The doctor has placed him in a Soft Cervical Collar for pain associated with mild strain. What sort of control does this orthosis provide?
Select one:
a. Flexion
b. Kinesthetic Reminder
c. Rotation
d. Lateral Bending

Answer 11

b. Kinesthetic Reminder

Question 12

Your patient is a 46 year old man who presents with a Class II ankle sprain. In addition to swelling and bruising, your patient complains of pain. Which of these are untrue about the nerves responsible for his discomfort?
Select one:
a. These are cranial nerves
b. These are somatic nerves
c. These are sensory nerves
d. These are peripheral nerves

Answer 12

a. These are cranial nerves

Question 12

Your patient is a 36 year old visually impaired female. You want to make sure you treat her with respect and dignity. Which of these actions would show respect to your patient?
Select one:
a. Quietly walk out of the room without saying anything when you finish speaking
b. Use normal language, including words like “look”, “see”, and “read”.
c. Tell her the restroom is “down the hall and to the right” when she asks
d. Take her hand and shake it when you enter the room

Answer 12

b. Use normal language, including words like “look”, “see”, and “read”.

Question 13

Your patient is a 14 year old male soccer player. While reading the doctor’s progress notes, you note that he has “inflammation of the underside of the patella and softening of the cartilage”. The doctor has ordered a Patella Tracking Brace. What diagnosis do you expect to see written on the doctor’s prescription?
Select one:
a. Patella Subluxation Syndrome
b. Anterior Cruciate Insufficiency
c. Osgood Schlatter’s
d. Chondromalacia Patella

Answer 13

d. Chondromalacia Patella

Question 14

Your patient is a 57 year old female with a history of pes planus and genu valgum. She has been experiencing arthritic pain in her medial knees which has been increasing in severity for several years. The doctor has ordered an orthosis to redistribute the weight off of her medial knee to help post-pone or avoid knee replacements. Which of these would be the best choice to accomplish this goal?
Select one:
a. Post-op Knee Orthosis
b. Knee Sleeve
c. Hinged Knee Orthosis
d. Prefabricated Unloader Knee Orthosis

Answer 14

d. Prefabricated Unloader Knee Orthosis

Question 15

You submitted a claim and it was rejected. Which of these may be a reason why?
Select one:
a. The physician’s signature was stamped on the prescription
b. The length of need was expressed as “99”
c. The beneficiaries name is correctly spelled
d. The patient’s prescription was 29 days old

Answer 15

a. The physician’s signature was stamped on the prescription

Question 16

Your 87 year old female patient has daily volumetric changes in her feet and lower legs. Which of these orthotic solutions is most likely to be prescribed for this condition?
Select one:
a. Pneumatic CAM Walker
b. Gradient Compression Garments
c. Posterior Leaf Spring Ankle Foot Orthosis
d. Ankle Stabilizing Orthosis

Answer 16

b. Gradient Compression Garments

Question 17

Your patient is a 75 year old female who has been wearing a posterior leaf spring AFO. At your follow-up visit, you note that she has some skin breakdown on her shin. Which of these factors of aging may be responsible for her problem?
Select one:
a. Emphysema
b. Osteoporosis
c. Loss of skin turgor
d. Arthritis

Answer 17

c. Loss of skin turgor

Question 18

Your patient is a 55 year old male with De Quervain’s Syndrome. All of these symptoms are typical of De Quervain’s Syndrome except:
Select one:
a. Numbness in the first three digits of the hand
b. Pain and swelling near the base of the thumb
c. Difficulty moving the thumb and wrist during activities that involve grasping or pinching
d. A “sticking” or “stop‐and‐ go” sensation in the thumb when trying to move it

Answer 18

a. Numbness in the first three digits of the hand

Question 19

Your 72 year old patient is explaining what the doctor told him about his condition. He states that the doctor told him that he has “narrowing of the open spaces within his cervical spine, which put pressure on his spinal cord and the nerves that travel through his spine”. What do you expect to see written on the prescription as your patient’s diagnosis?
Select one:
a. Stenosis of the Cervical Spine
b. Cervical Degenerative Disc Disease
c. Anterior Compression Fracture
d. Whiplash

Answer 19

a. Stenosis of the Cervical Spine

Question 20

Your patient is an 84 year old female. She is post-CVA and non-ambulatory. The staff at the nursing home have attempted to protect her heels from decubitus ulcers, but have noticed that her heels are becoming reddened. They have asked her physician to help. Which orthosis would be the best to prevent this patient from getting heel ulcers?
Select one:
a. Multiligamentus Ankle Support
b. Pressure Relief AFO
c. Posterior Leaf Spring AFO
d. Night Splint

Answer 20

b. Pressure Relief AFO

Question 21

You are interviewing your 35 year old female patient during her initial visit to your facility. You are using the “O.P.Q.R.S.T.” intake method to obtain a solid understanding of the patient’s chief complaint. What does “T” stand for in this method?
Select one:
a. Temperature
b. Timing
c. Treatment
d. Total

Answer 21

b. Timing

“OPQRSTU”
O: Onset
P: Provoking or Palliating Factors Q: Quality
R: Region & Radiation
S: Severity
T: Time
U: Understanding & Impact

Question 22

Your patient is a 64 year old woman with post CVA. She has notable hemiplegia affecting the right side. The doctor has ordered an articulated AFO. Which of these muscles is most likely weakened by the stroke and necessitating the use of the AFO?
Select one:
a. Soleus
b. Gastrocnemius
c. Flexor Hallicus Longus
d. Extensor Hallicus Longus

Answer 22

d. Extensor Hallicus Longus

Question 23

Your patient is a 27 year old female tennis player. She has pain in the epicondyle of her elbow. The doctor has ordered a Tennis Elbow Strap. Where should it be placed?
Select one:
a. Distal to the elbow on the lateral side
b. Proximal to the elbow on the medial side
c. Proximal to the elbow on the lateral side
d. Distal to the elbow on the medial side

Answer 23

a. Distal to the elbow on the lateral side

Question 24

Your referral source has called about a patient that he wants you to see at the hospital. The patient has a bulging disc at L3/4 and a broken tibia secondary to a motor vehicle accident. The prescription calls for a Semi Rigid TLSO and a Sarmiento brace. What do you do?
Select one:
a. Refer the patient to an Orthotist for the Sarmiento Brace
b. Refer the patient to an Orthotist for both of these orthotics
c. Fill the prescription
d. Refer the patient to an Orthotist for the Semi Rigid TLSO

Answer 24

a. Refer the patient to an Orthotist for the Sarmiento Brace

A Sarmiento brace is used to stabilize a fracture in your upper arm while leaving your elbow free, allowing motion in your forearm and hand.

Question 25

Your patient is a 27 year old female post ACL repair. The doctor has ordered a Knee Immobilizer. What sort of range of motion assessment should be done on this knee?
Select one:
a. Active ROM assessment should be done to comfort level
b. No ROM assessment should be done
c. Passive ROM assessment may be done to patient’s comfort level
d. Passive ROM assessment should be done to obtain actual ROM measurements

Answer 25

b. No ROM assessment should be done

Question 26

Your patient is a 48 year old female with carpal tunnel. You placed her in a cock-up wrist splint and gave her thorough wear instructions. She calls you three days later and tells you that her fingers are cyanotic. What is she telling you?
Select one:
a. Her fingers are stiff.
b. Her fingers are warm to the touch.
c. Her fingers hurt.
d. Her fingers are blue.

Answer 26

d. Her fingers are blue.

Question 27

Your 16 year old female patient is seeing you for delivery of her Functional Knee Orthosis. All of the following should be done at this visit except:
Select one:
a. Instruct the patient in how to clean the orthosis
b. Have the patient demonstrate donning and doffing the orthosis
c. Properly fit the Functional Knee Orthosis on her knee
d. Take measurements

Answer 27

d. Take measurements

Question 28

Your 22 year old male patient returns to your office complaining about his functional knee brace. He recently had an ACL repair and the prescription called for a knee brace that allowed full extension, but limited flexion to 20 degrees. At delivery, you set the range of motion joint at 20 degrees of flexion as ordered by the doctor. However, your patient now complains that this interferes with his ability to return to his sports and asks you to adjust the range of motion joint to 60 degrees of flexion. According to the Code of Professional Responsibility, what do you do?
Select one:
a. The customer is always right. Adjust the range of motion joint as the patient requests
b. Refuse to adjust the brace until you receive permission from the doctor
c. Adjust the range of motion joint half as much as the patient requests, and hope this makes him happy
d. Orthotic Fitters are not allowed to adjust braces

Answer 28

b. Refuse to adjust the brace until you receive permission from the doctor

Question 29

Your patient is a 90 year old female who lives alone. You have gone to her home to fit her Articulated AFO. You are concerned about her living alone. Which of these activities of daily living would be considered Basic ADLs?
Select one:
a. Taking her medication
b. Preparing her meals
c. Cleaning her home
d. Bathing

Answer 29

d. Bathing

Question 30

You are documenting on your visit with your last patient. She noticed that her gait pattern was altered from the previous visit. On this visit, you noticed that her cadence had slowed, she had a wider base of support, and she was staying in double limb support through the entire gait cycle. Using the S.O.A.P. form of writing your progress note, where would these findings be noted?
Select one:
a. S
b. O
c. A
d. P

Answer 30

b. O Objective

Question 31

Your patient is a 20 year old male with Cerebral Palsy. He wears a PLS AFO and requires an extra depth shoe to accommodate the device. You use a Brannock Device to measure his foot. Which of these measurements cannot be obtained with the Brannock Device?
Select one:
a. Heel to Toe Length
b. Heel to Ball Length
c. Plantar Foot Pressures
d. Width

Answer 31

c. Plantar Foot Pressures

Question 32

Your patient is a 40 year old female who was injured in an automobile accident. She presents with Cervical Spondylolisthesis. Which orthosis would be the most appropriate for this condition?
Select one:
a. Philadelphia Collar
b. Soft Cervical Collar
c. Halo
d. Aspen Vista Collar

Answer 32

d. Aspen Vista Collar

Question 33

Your patient is a 34 year old male with radioulnar joint pain after a sprain. Which of these movements will most likely cause him the most pain?
Select one:
a. Depression of the scapula
b. Pronation of the hand
c. Supination of the foot
d. Opposition of the thumb

Answer 33

b. Pronation of the hand