WC prescription
A patient with bilateral hip weakness is being fitted for a wheelchair. The seat width is measured exactly equal to the patient’s hip width. What is the MOST likely outcome?
A. Improved propulsion efficiency
B. Better posture
C. Increased trunk control
D. Skin breakdown due to pressure
D) Skin breakdown due to pressure
Seat should have 2 extra inches wider than hips. Too narrow can cause skin breakdown and pressure.
A patient’s Foley catheter bag is placed on the bed during transfer. What is the risk?
A. Backflow and infection
B. Increased output
C. Dehydration
D. No risk
A) Backflow and infection
Bag must remain below bladder level to prevent reflux → infection risk.
A patient demonstrates poor tolerance to an orthosis. Which findings suggest the need for modification? (Select all that apply)
A. Skin breakdown
B. Persistent redness
C. Pain
D. Improved gait
E. Numbness
A) Skin breakdown
B) Persistent redness
C) Pain
E)numbnessAll indicate improper fit
A patient is NWB on the right LE following ankle surgery. The patient has, fair balance, moderate UE strength, difficulty coordinating complex movements.Which is the BEST assistive device?
A. Axillary crutches
B. Rolling walker
C. Standard walker
D. Single-point cane
C) Standard walker
Provides maximum support and strict NWB with simple sequencing.
A patient vaults on the intact limb during gait. What is the MOST likely cause?
A. Prosthesis too long
B. Prosthesis too short
C. Strong muscles
D. Good alignment
A) Prosthesis too long
Patient vaulting to clear the limb.
A tall patient with long femurs is using a wheelchair and reports fatigue and poor support in sitting. You observe a large gap between the seat and the popliteal fossa. What is the BEST intervention?
A. Decrease seat depth
B. Increase seat width
C. Increase seat depth
D. Raise armrests
C) Increase seat depth
Longer femurs need increased seat depth for increased thigh support.
A central line is accidentally pulled during transfer. What is the priority?
A. Continue therapy
B. Clamp
C. Ignore
D. Apply pressure and notify nurse
D) Apply pressure and notify nurse
Prevent bleeding/air embolism, urgent medical issue.
A patient complains of increased difficulty walking due to an orthosis that limits movement across multiple joints unnecessarily. What is the MOST likely issue?
A. Orthosis too flexible
B. Poor balance
C. Weak muscles
D. Orthosis too restrictive for impairment level
D) Orthosis too restrictive for impairment level.
Over prescription can reduce function
A patient previously required a standard walker. Now presents with Improved balance, minimal assistance required, good sequencing. Which is the BEST next progression?
A. Wheelchair
B. Axillary crutches
C. Quad cane
D. No device
C) Quad cane
Gradual decrease in support
Which patient will have the LOWEST energy expenditure during ambulation?
A. Bilateral transfemoral amputee
B. Unilateral transfemoral amputee
C. Unilateral transtibial amputee
D. Hip disarticulation
C) Unilateral transitibial amputee
A patient has posterior pelvic tilt in sitting. BEST intervention?
A. Increase seat depth
B. Add lumbar support
C. Remove backrest
D. Raise footrests
B) Add lumbar support
Promotes neutral spine and upright posture
A patient is ambulating with supplemental oxygen. Which actions are appropriate? (Select ALL that apply)
A. Monitor SpO₂ continuously
B. Increase oxygen flow independently if patient is fatigued
C. Observe for signs of respiratory distress
D. Ensure tubing does not create fall risk
E. Encourage pacing and rest breaks
F. Discontinue oxygen if patient feels better
A)Monitor SpO2 continuously
C)observe for signs of respiratory distress
D)ensure tubing does not create fall risk
E)encourage pacing and rest breaks
A patient with foot drop is not using an orthosis and demonstrates compensatory hip hiking. What is the PRIMARY benefit of adding an AFO?
A. Increase strength
B. Improve gait ROM
C. Increase gait efficiency
D. Improve endurance directly
C) Increase gait efficiency
Reducing compensations can increase efficiency.
During gait training with a cane, a patient demonstrates fatigue, decreased coordination, slower reaction time. What is the BEST action?
A. Continue training for endurance
B. Increase assistance but continue
C. Stop and allow rest
D. Remove device
C) Stop and allow rest
Prevents injuries/falls
A patient demonstrates lateral whip during swing phase.What is the MOST likely cause?
A. Proper alignment
B. Good balance
C. Strong hip muscles
D. Sock misalignment
D) Sock misalignment
A patient’s footrests are positioned too high. What is the MOST likely result?
A. Increased pressure under thighs
B. Posterior pelvic tilt
C. Decreased hip flexion
D. Improved posture
A) Increased pressure under thighs
A patient accidentally pulls out their arterial line. What complication is MOST concerning?
A. Infection
B. Severe bleeding
C. Hypoxia
D. Dehydration
B) Severe bleeding
Arterial lines have high pressure which can rapidly lose blood.
A patient with poor trunk control is prescribed a TLSO. What functional improvements are expected? (Select all that apply)
A. Improved sitting posture
B. Increased spinal stability
C. Better breathing mechanics
D. Improved ankle control
A) Improved sitting posture
B) Increased spinal stability
C) Better breathing mechanics
A patient progresses from Moderate assist → supervision, improved balance, still inconsistent sequencing. What is the BEST next step?
A. Progress to quad cane
B. Continue with walker until sequencing improves
C. Discontinue device
D. Switch to crutches
B) Continue with walker until sequencing improves.
Progress when safe and consistent
Which deviations are associated with alignment issues? (Select all that apply)
A. Medial whip
B. Lateral whip
C. Pistoning
D. Knee instability
E. Toe drag
A) Medial whip
B) Lateral whip
D) Knee instability
A 68-year-old patient with a C5 spinal cord injury has poor trunk control, limited ability to perform independent pressure relief, and a history of stage II pressure ulcers over the ischial tuberosities. Which wheelchair feature is MOST appropriate to address these impairments?
A. Reclining wheelchair
B. Standard lightweight wheelchair
C. Tilt-in-space wheelchair
D. Wheelchair without armrests
C) Tilt in space wheelchair
Promotes pressure redistribution and postural support for poor trunk control.
A patient in the ICU has a Swan-Ganz catheter via the internal jugular vein. You are preparing for edge-of-bed sitting. What is the MOST important precaution?
A. Monitor urine output
B. Avoid excessive neck/torso movement that may dislodge the catheter
C. Clamp the catheter before movement
D. Remove telemetry leads
B) Avoid excessive neck/torso movement that may dislodge the catheter.
Swan-Ganz catheter is threaded into pulmonary artery → high risk if displaced
A patient is using a KAFO. What are expected benefits? (Select all that apply)
A. Knee stability
B. Ankle control
C. Hip stabilization
D. Improved standing balance
E. All of the above
A) Knee stability
B) Ankle control
D) Improved standing balance
A,B: primary benefits
D: secondary functional benefit
A patient uses a cane on the correct side but demonstrates poor timing and decreased balance. Best intervention?
A. Adjust height
B. Remove cane
C. Switch device
D. Reinforce gait sequence
D) Reinforce gait sequence
Which gait deviations may be caused by a prosthesis that is too long? (Select all that apply)
A. Vaulting
B. Hip hiking
C. Circumduction
D. Knee buckling
E. Trunk flexion
A) Vaulting
B)Hip hiking
C) Circumduction