, CHAPTER LIST
Chapter 1: Health Versus Disease and Disability
Chapter 2: Mechanisms of Disease
Chapter 3: Cell Injury and Cell Death
Chapter 4: Genetic and Congenital Disorders
Chapter 5: Oncology
Unit II: Infection, Inflammation, and Repair
Chapter 6: Infectious Disease
Chapter 7: Inflammation and Healing
Chapter 8: Immune Response, Hypersensitivity, and Autoimmune Disorders
Unit III: Pathology of the Body Systems
Chapter 9: Skeletal Disorders
Chapter 10: Musculoskeletal Disorders
Chapter 11: Joint and Soft Tissue Disorders
Chapter 12: Central Nervous System Disorders
Chapter 13: Peripheral Nervous System Disorders
Chapter 14: Cardiovascular Disorders
Chapter 15: Blood Disorders
Chapter 16: Lymphatic Disorders
Chapter 17: Integumentary System Disorders
Chapter 18: Respiratory System Disorders
Chapter 19: Digestive System Disorders
Chapter 20: Urinary System Disorders
Chapter 21: Fluid, Electrolyte, and Acid-Base Imbalances
Chapter 22: Endocrine System Disorders
Chapter 23: Male Reproductive System Disorders
Chapter 24: Female Reproductive System Disorders
Unit IV: Environmental Hazards
Chapter 25: Occupational Disorders and Injuries
Chapter 26: Psychological Disorders and the Influence of Stress
Chapter 27: Substance Abuse
Chapter 28: Effects of Immobility
Unit V: Special Populations
Chapter 29: Pediatric Disorders
Chapter 30: Aging and Disease Processes
,Chapter 1: Health Versus Disease and Disability
(ICF Framework) — Test Bank (20 Advanced
MCQs)
Q1.
A 62-year-old with knee osteoarthritis reports pain 6/10 and reduced knee
ROM. They can walk inside the home but avoid church due to stairs and fear of
falling. In ICF terms, “avoiding church due to stairs and fear of falling” is best
classified as:
A. Impairment
B. Activity limitation
C. Participation restriction
D. Pathology
Answer: C
Rationale: Impairments are problems in body structure/function (pain, ROM
loss). Activity limitations are difficulties executing tasks (walking, stair climbing
as a task). Participation restrictions are problems in involvement in life
situations (attending church). The patient’s avoidance of church reflects
reduced participation in a valued social role due to environmental demands
(stairs) and personal factors (fear).
Key words: ICF, participation restriction, life role, osteoarthritis, stairs
Q2.
A patient post-stroke demonstrates increased plantarflexor tone and poor
selective ankle dorsiflexion. They can stand with assistance but cannot clear
the foot during swing and trip often. Which item is the most direct activity
limitation?
A. Increased plantarflexor tone
B. Poor selective dorsiflexion
C. Tripping during community ambulation
D. Inability to clear foot during swing phase
Answer: D
Rationale: Tone and selective motor control deficits are impairments. “Inability
to clear foot during swing” is a task execution problem tied to gait—an activity
limitation. “Tripping during community ambulation” often extends into
participation depending on context, but the clearest activity-level statement
,here is swing-phase foot clearance during walking.
Key words: stroke, impairment vs activity, gait, swing phase, foot clearance
Q3.
A PTA writes: “Patient will reduce pain from 7/10 to 3/10 in 2 weeks.” Which
revision best reflects a function-focused goal aligned with PTA clinical
translation?
A. Patient will demonstrate improved cartilage integrity on imaging
B. Patient will ambulate 300 meters with a cane and pain ≤3/10 to complete
grocery shopping
C. Patient will have decreased inflammatory markers (CRP)
D. Patient will verbalize understanding of osteoarthritis stages
Answer: B
Rationale: Function-focused goals connect symptoms to meaningful tasks and
participation. Imaging and biomarkers are pathology-level and not therapy
outcomes. Education can support goals, but the best revision ties pain change
to functional ambulation and a participation context (grocery shopping).
Key words: functional goal, participation, pain, measurable outcome, PTA
scope
Q4.
A patient with chronic low back pain stops exercising due to fear of reinjury
despite normal neurological exam and stable imaging findings. The fear-driven
avoidance most strongly reflects:
A. Impairment (body function)
B. Activity limitation
C. Participation restriction mediated by personal factors
D. Environmental factor only
Answer: C
Rationale: Fear of reinjury is a personal factor that can amplify participation
restriction (reduced involvement in exercise/roles). While it can contribute to
activity limitation, the vignette emphasizes withdrawal from a life activity
despite stable impairment measures—classic participation limitation shaped by
psychosocial contributors.
Key words: fear-avoidance, personal factors, participation, chronic pain, ICF
,Q5.
Which sequence best matches the ICF pathway from disease to disability in a
typical scenario?
A. Participation restriction → pathology → impairment → activity limitation
B. Pathology → impairment → activity limitation → participation restriction
C. Impairment → pathology → participation restriction → activity limitation
D. Activity limitation → impairment → pathology → participation restriction
Answer: B
Rationale: A health condition (pathology) can cause impairments (body
structure/function), leading to activity limitations (tasks), which can result in
participation restrictions (life roles). The order is not always linear in real life,
but this is the canonical mapping used for clinical reasoning.
Key words: ICF sequence, disease-to-disability model, pathway
Q6.
A patient with COPD can dress independently but needs frequent rests and
cannot keep pace when walking with family at the mall. Which is the best
single ICF classification for “cannot keep pace when walking with family at the
mall”?
A. Activity limitation only
B. Participation restriction only
C. Participation restriction with an activity limitation component
D. Impairment
Answer: C
Rationale: “Keeping pace” relates to walking endurance (activity), but the
context (with family at the mall) implicates social participation. Many real
statements span levels; the most accurate classification acknowledges both—
an activity endurance limitation producing a participation restriction in
family/community outing.
Key words: COPD, endurance, activity vs participation, context
Q7.
A 45-year-old after rotator cuff repair has limited shoulder abduction AROM
and cannot reach overhead shelves at work. Best categorization of “limited
shoulder abduction AROM” is:
A. Pathology
, B. Impairment
C. Activity limitation
D. Participation restriction
Answer: B
Rationale: Limited AROM is a body function/structure deficit → impairment.
Reaching overhead shelves is an activity limitation; inability to perform work
role may be a participation restriction.
Key words: AROM, impairment, rotator cuff, body function
Q8.
A PTA plans an intervention for a patient with diabetic peripheral neuropathy
who reports numbness and has decreased protective sensation. The most
appropriate function-first treatment priority is:
A. Explain diabetes pathophysiology in detail
B. Focus on improving HbA1c through diet counseling
C. Implement balance, gait safety, and foot-care routines to reduce fall and
skin breakdown risk
D. Train maximal sprint interval training to reverse neuropathy
Answer: C
Rationale: PTA care targets function and safety: balance, gait strategies,
environmental modification, and skin protection reduce participation threats
(falls, wounds). HbA1c management and diet counseling are outside PTA
primary scope and typically interdisciplinary. Sprint training is unsafe and not
evidence-aligned for neuropathy severity without screening.
Key words: function-first, diabetic neuropathy, safety, participation risk, PTA
scope
Q9.
Which outcome measure most directly captures participation rather than
impairment?
A. Manual muscle testing (MMT) grade
B. Goniometric knee ROM
C. Six-minute walk test distance
D. Patient report: “I returned to my job as a cashier for 6-hour shifts”
Answer: D
Rationale: Participation is involvement in life roles (work). MMT and ROM are
Chapter 1: Health Versus Disease and Disability
Chapter 2: Mechanisms of Disease
Chapter 3: Cell Injury and Cell Death
Chapter 4: Genetic and Congenital Disorders
Chapter 5: Oncology
Unit II: Infection, Inflammation, and Repair
Chapter 6: Infectious Disease
Chapter 7: Inflammation and Healing
Chapter 8: Immune Response, Hypersensitivity, and Autoimmune Disorders
Unit III: Pathology of the Body Systems
Chapter 9: Skeletal Disorders
Chapter 10: Musculoskeletal Disorders
Chapter 11: Joint and Soft Tissue Disorders
Chapter 12: Central Nervous System Disorders
Chapter 13: Peripheral Nervous System Disorders
Chapter 14: Cardiovascular Disorders
Chapter 15: Blood Disorders
Chapter 16: Lymphatic Disorders
Chapter 17: Integumentary System Disorders
Chapter 18: Respiratory System Disorders
Chapter 19: Digestive System Disorders
Chapter 20: Urinary System Disorders
Chapter 21: Fluid, Electrolyte, and Acid-Base Imbalances
Chapter 22: Endocrine System Disorders
Chapter 23: Male Reproductive System Disorders
Chapter 24: Female Reproductive System Disorders
Unit IV: Environmental Hazards
Chapter 25: Occupational Disorders and Injuries
Chapter 26: Psychological Disorders and the Influence of Stress
Chapter 27: Substance Abuse
Chapter 28: Effects of Immobility
Unit V: Special Populations
Chapter 29: Pediatric Disorders
Chapter 30: Aging and Disease Processes
,Chapter 1: Health Versus Disease and Disability
(ICF Framework) — Test Bank (20 Advanced
MCQs)
Q1.
A 62-year-old with knee osteoarthritis reports pain 6/10 and reduced knee
ROM. They can walk inside the home but avoid church due to stairs and fear of
falling. In ICF terms, “avoiding church due to stairs and fear of falling” is best
classified as:
A. Impairment
B. Activity limitation
C. Participation restriction
D. Pathology
Answer: C
Rationale: Impairments are problems in body structure/function (pain, ROM
loss). Activity limitations are difficulties executing tasks (walking, stair climbing
as a task). Participation restrictions are problems in involvement in life
situations (attending church). The patient’s avoidance of church reflects
reduced participation in a valued social role due to environmental demands
(stairs) and personal factors (fear).
Key words: ICF, participation restriction, life role, osteoarthritis, stairs
Q2.
A patient post-stroke demonstrates increased plantarflexor tone and poor
selective ankle dorsiflexion. They can stand with assistance but cannot clear
the foot during swing and trip often. Which item is the most direct activity
limitation?
A. Increased plantarflexor tone
B. Poor selective dorsiflexion
C. Tripping during community ambulation
D. Inability to clear foot during swing phase
Answer: D
Rationale: Tone and selective motor control deficits are impairments. “Inability
to clear foot during swing” is a task execution problem tied to gait—an activity
limitation. “Tripping during community ambulation” often extends into
participation depending on context, but the clearest activity-level statement
,here is swing-phase foot clearance during walking.
Key words: stroke, impairment vs activity, gait, swing phase, foot clearance
Q3.
A PTA writes: “Patient will reduce pain from 7/10 to 3/10 in 2 weeks.” Which
revision best reflects a function-focused goal aligned with PTA clinical
translation?
A. Patient will demonstrate improved cartilage integrity on imaging
B. Patient will ambulate 300 meters with a cane and pain ≤3/10 to complete
grocery shopping
C. Patient will have decreased inflammatory markers (CRP)
D. Patient will verbalize understanding of osteoarthritis stages
Answer: B
Rationale: Function-focused goals connect symptoms to meaningful tasks and
participation. Imaging and biomarkers are pathology-level and not therapy
outcomes. Education can support goals, but the best revision ties pain change
to functional ambulation and a participation context (grocery shopping).
Key words: functional goal, participation, pain, measurable outcome, PTA
scope
Q4.
A patient with chronic low back pain stops exercising due to fear of reinjury
despite normal neurological exam and stable imaging findings. The fear-driven
avoidance most strongly reflects:
A. Impairment (body function)
B. Activity limitation
C. Participation restriction mediated by personal factors
D. Environmental factor only
Answer: C
Rationale: Fear of reinjury is a personal factor that can amplify participation
restriction (reduced involvement in exercise/roles). While it can contribute to
activity limitation, the vignette emphasizes withdrawal from a life activity
despite stable impairment measures—classic participation limitation shaped by
psychosocial contributors.
Key words: fear-avoidance, personal factors, participation, chronic pain, ICF
,Q5.
Which sequence best matches the ICF pathway from disease to disability in a
typical scenario?
A. Participation restriction → pathology → impairment → activity limitation
B. Pathology → impairment → activity limitation → participation restriction
C. Impairment → pathology → participation restriction → activity limitation
D. Activity limitation → impairment → pathology → participation restriction
Answer: B
Rationale: A health condition (pathology) can cause impairments (body
structure/function), leading to activity limitations (tasks), which can result in
participation restrictions (life roles). The order is not always linear in real life,
but this is the canonical mapping used for clinical reasoning.
Key words: ICF sequence, disease-to-disability model, pathway
Q6.
A patient with COPD can dress independently but needs frequent rests and
cannot keep pace when walking with family at the mall. Which is the best
single ICF classification for “cannot keep pace when walking with family at the
mall”?
A. Activity limitation only
B. Participation restriction only
C. Participation restriction with an activity limitation component
D. Impairment
Answer: C
Rationale: “Keeping pace” relates to walking endurance (activity), but the
context (with family at the mall) implicates social participation. Many real
statements span levels; the most accurate classification acknowledges both—
an activity endurance limitation producing a participation restriction in
family/community outing.
Key words: COPD, endurance, activity vs participation, context
Q7.
A 45-year-old after rotator cuff repair has limited shoulder abduction AROM
and cannot reach overhead shelves at work. Best categorization of “limited
shoulder abduction AROM” is:
A. Pathology
, B. Impairment
C. Activity limitation
D. Participation restriction
Answer: B
Rationale: Limited AROM is a body function/structure deficit → impairment.
Reaching overhead shelves is an activity limitation; inability to perform work
role may be a participation restriction.
Key words: AROM, impairment, rotator cuff, body function
Q8.
A PTA plans an intervention for a patient with diabetic peripheral neuropathy
who reports numbness and has decreased protective sensation. The most
appropriate function-first treatment priority is:
A. Explain diabetes pathophysiology in detail
B. Focus on improving HbA1c through diet counseling
C. Implement balance, gait safety, and foot-care routines to reduce fall and
skin breakdown risk
D. Train maximal sprint interval training to reverse neuropathy
Answer: C
Rationale: PTA care targets function and safety: balance, gait strategies,
environmental modification, and skin protection reduce participation threats
(falls, wounds). HbA1c management and diet counseling are outside PTA
primary scope and typically interdisciplinary. Sprint training is unsafe and not
evidence-aligned for neuropathy severity without screening.
Key words: function-first, diabetic neuropathy, safety, participation risk, PTA
scope
Q9.
Which outcome measure most directly captures participation rather than
impairment?
A. Manual muscle testing (MMT) grade
B. Goniometric knee ROM
C. Six-minute walk test distance
D. Patient report: “I returned to my job as a cashier for 6-hour shifts”
Answer: D
Rationale: Participation is involvement in life roles (work). MMT and ROM are
