Chambrine School of Nursing
RESNA ATP Practice Exam: 100% Verified Questions &
Correct Answers
2026/2027 Edition
Domain 1: Rehabilitation / Evaluation (Assessment)
1. A 42-year-old male with C6 complete tetraplegia (ASIA A) is being evaluated for
a power wheelchair. He has tenodesis grasp, weak wrist extensors, and no triceps
function. What is the MOST appropriate joystick configuration?
A) Horizontal joystick with no hand support
B) Vertical joystick with a hand trough
C) Chin control with proportional input
D) Sip-and-puff with digital switching
Correct Answer: B
Rationale: A vertical joystick with a hand trough allows the client to use available
wrist extension to push the joystick forward. The hand trough stabilizes the wrist
and hand, reducing fatigue and improving control. This is the standard
configuration for C5–C6 tetraplegia.
2. During a seating evaluation, a client with multiple sclerosis presents with
bilateral hip adductor spasticity. The client reports difficulty with perineal care
and positioning. What seating intervention is MOST effective?
A) Increase seat depth
B) Add a contoured abductor pommel
C) Increase seat dump
D) Add a pelvic positioning belt
Correct Answer: B
Rationale: An abductor pommel provides a physical barrier that prevents hip
,adduction, reduces scissoring, and facilitates positioning for hygiene. This is the
most direct intervention for managing adductor spasticity in seating.
3. A client with a T10 spinal cord injury uses a manual wheelchair 14 hours per
day. During a skin assessment, you note a purple discoloration over the right
ischial tuberosity with intact skin. What is the IMMEDIATE course of action?
A) Recommend a higher-profile foam cushion
B) Instruct the client to perform pressure reliefs every 15 minutes
C) Remove the client from the wheelchair and refer to wound care
D) Add a gel overlay to the existing cushion
Correct Answer: C
Rationale: Purple discoloration with intact skin indicates a deep tissue injury
(Stage I pressure injury involving deeper structures). Immediate offloading and
referral to wound care are critical to prevent progression to full-thickness tissue
loss.
4. A 9-year-old with spastic diplegic cerebral palsy (GMFCS Level III) uses a manual
wheelchair. The child has a windswept posture (pelvis shifted right, trunk convex
left). What is the MOST appropriate seating intervention?
A) Symmetrical seating with bilateral lateral supports
B) Asymmetrical seating with a right lateral thoracic support and left hip guide
C) Asymmetrical seating with a left lateral thoracic support and right hip guide
D) Flat seat with no contouring
Correct Answer: B
Rationale: Windswept deformity requires asymmetrical intervention. A right
lateral thoracic support addresses the trunk convexity, while a left hip guide blocks
the shifted pelvis. Symmetrical seating would not correct the fixed asymmetry.
5. A client with ALS presents with forced vital capacity (FVC) of 40% predicted and
reports morning headaches, poor sleep quality, and daytime somnolence. What is
the MOST appropriate recommendation?
,A) High-flow oxygen therapy at night
B) Non-invasive ventilation (BiPAP) with a nasal or oronasal mask
C) Suction machine for nocturnal secretions
D) Mechanical insufflation-exsufflation (Cough Assist)
Correct Answer: B
*Rationale: Morning headaches, poor sleep, and daytime fatigue are hallmark
symptoms of nocturnal hypoventilation in neuromuscular disease. Non-invasive
ventilation (BiPAP) is indicated when FVC is <50% to maintain nocturnal
ventilation and CO₂ clearance.*
6. During a manual wheelchair fitting, the client’s popliteal fossa is positioned 1
inch forward of the front seat rail. What is the MOST likely consequence?
A) Increased pressure on the ischial tuberosities
B) Increased risk of skin breakdown at the popliteal fossa
C) Reduced propulsion efficiency
D) Posterior pelvic tilt
Correct Answer: B
Rationale: The popliteal fossa should be positioned slightly forward of the seat rail
to avoid pressure on the neurovascular structures behind the knee. Contact with
the seat rail creates risk of skin breakdown and vascular compromise.
7. A client with a left transfemoral amputation and right transtibial amputation
requires a manual wheelchair. What frame configuration is MOST appropriate?
A) Standard symmetrical frame with swing-away footrests
B) Standard symmetrical frame with elevating leg rests
C) Asymmetrical frame with left rear wheel axle positioned more posteriorly
D) Asymmetrical frame with right rear wheel axle positioned more anteriorly
Correct Answer: D
Rationale: With a longer residual limb on the right (transtibial), the right rear
wheel axle should be positioned more anteriorly to shift the center of gravity
forward, improving stability and propulsion efficiency. Asymmetrical axle
placement compensates for limb length asymmetry.
, 8. A 55-year-old with Huntington’s disease presents with choreiform movements
(involuntary, jerky) and impulsivity. What is the MOST important consideration
for power wheelchair selection?
A) High maximum speed for community mobility
B) Dynamic seating functions (tilt, recline) to manage tone
C) Joystick with adjustable throw and dampening (low-pass filter)
D) Swing-away lateral supports for easy transfers
Correct Answer: C
Rationale: Choreiform movements cause involuntary joystick inputs. A joystick
with adjustable throw (requiring larger displacement for input) and dampening
filters out involuntary movements, preventing erratic driving and improving
safety.
9. During a seating evaluation, a client with a C7 complete spinal cord injury
presents with a flattened lumbar spine (loss of lordosis) and posterior pelvic tilt.
What cushion modification is MOST appropriate?
A) Flat foam cushion with no contouring
B) Cushion with a built-in posterior pelvic wedge
C) Cushion with a built-in ischial relief trough
D) Air-filled cushion with adjustable cells
Correct Answer: B
Rationale: A posterior pelvic wedge (ramp) positioned under the ischial
tuberosities tilts the pelvis anteriorly, restoring lumbar lordosis and reducing
posterior pelvic tilt. Flat cushions fail to correct the tilt.
10. A client with a right CVA presents with left homonymous hemianopsia
(blindness in left visual field). What is the MOST appropriate training strategy for
power wheelchair use?
A) Mount a convex mirror on the left side
B) Instruct the client to scan visually to the left before turning or moving
RESNA ATP Practice Exam: 100% Verified Questions &
Correct Answers
2026/2027 Edition
Domain 1: Rehabilitation / Evaluation (Assessment)
1. A 42-year-old male with C6 complete tetraplegia (ASIA A) is being evaluated for
a power wheelchair. He has tenodesis grasp, weak wrist extensors, and no triceps
function. What is the MOST appropriate joystick configuration?
A) Horizontal joystick with no hand support
B) Vertical joystick with a hand trough
C) Chin control with proportional input
D) Sip-and-puff with digital switching
Correct Answer: B
Rationale: A vertical joystick with a hand trough allows the client to use available
wrist extension to push the joystick forward. The hand trough stabilizes the wrist
and hand, reducing fatigue and improving control. This is the standard
configuration for C5–C6 tetraplegia.
2. During a seating evaluation, a client with multiple sclerosis presents with
bilateral hip adductor spasticity. The client reports difficulty with perineal care
and positioning. What seating intervention is MOST effective?
A) Increase seat depth
B) Add a contoured abductor pommel
C) Increase seat dump
D) Add a pelvic positioning belt
Correct Answer: B
Rationale: An abductor pommel provides a physical barrier that prevents hip
,adduction, reduces scissoring, and facilitates positioning for hygiene. This is the
most direct intervention for managing adductor spasticity in seating.
3. A client with a T10 spinal cord injury uses a manual wheelchair 14 hours per
day. During a skin assessment, you note a purple discoloration over the right
ischial tuberosity with intact skin. What is the IMMEDIATE course of action?
A) Recommend a higher-profile foam cushion
B) Instruct the client to perform pressure reliefs every 15 minutes
C) Remove the client from the wheelchair and refer to wound care
D) Add a gel overlay to the existing cushion
Correct Answer: C
Rationale: Purple discoloration with intact skin indicates a deep tissue injury
(Stage I pressure injury involving deeper structures). Immediate offloading and
referral to wound care are critical to prevent progression to full-thickness tissue
loss.
4. A 9-year-old with spastic diplegic cerebral palsy (GMFCS Level III) uses a manual
wheelchair. The child has a windswept posture (pelvis shifted right, trunk convex
left). What is the MOST appropriate seating intervention?
A) Symmetrical seating with bilateral lateral supports
B) Asymmetrical seating with a right lateral thoracic support and left hip guide
C) Asymmetrical seating with a left lateral thoracic support and right hip guide
D) Flat seat with no contouring
Correct Answer: B
Rationale: Windswept deformity requires asymmetrical intervention. A right
lateral thoracic support addresses the trunk convexity, while a left hip guide blocks
the shifted pelvis. Symmetrical seating would not correct the fixed asymmetry.
5. A client with ALS presents with forced vital capacity (FVC) of 40% predicted and
reports morning headaches, poor sleep quality, and daytime somnolence. What is
the MOST appropriate recommendation?
,A) High-flow oxygen therapy at night
B) Non-invasive ventilation (BiPAP) with a nasal or oronasal mask
C) Suction machine for nocturnal secretions
D) Mechanical insufflation-exsufflation (Cough Assist)
Correct Answer: B
*Rationale: Morning headaches, poor sleep, and daytime fatigue are hallmark
symptoms of nocturnal hypoventilation in neuromuscular disease. Non-invasive
ventilation (BiPAP) is indicated when FVC is <50% to maintain nocturnal
ventilation and CO₂ clearance.*
6. During a manual wheelchair fitting, the client’s popliteal fossa is positioned 1
inch forward of the front seat rail. What is the MOST likely consequence?
A) Increased pressure on the ischial tuberosities
B) Increased risk of skin breakdown at the popliteal fossa
C) Reduced propulsion efficiency
D) Posterior pelvic tilt
Correct Answer: B
Rationale: The popliteal fossa should be positioned slightly forward of the seat rail
to avoid pressure on the neurovascular structures behind the knee. Contact with
the seat rail creates risk of skin breakdown and vascular compromise.
7. A client with a left transfemoral amputation and right transtibial amputation
requires a manual wheelchair. What frame configuration is MOST appropriate?
A) Standard symmetrical frame with swing-away footrests
B) Standard symmetrical frame with elevating leg rests
C) Asymmetrical frame with left rear wheel axle positioned more posteriorly
D) Asymmetrical frame with right rear wheel axle positioned more anteriorly
Correct Answer: D
Rationale: With a longer residual limb on the right (transtibial), the right rear
wheel axle should be positioned more anteriorly to shift the center of gravity
forward, improving stability and propulsion efficiency. Asymmetrical axle
placement compensates for limb length asymmetry.
, 8. A 55-year-old with Huntington’s disease presents with choreiform movements
(involuntary, jerky) and impulsivity. What is the MOST important consideration
for power wheelchair selection?
A) High maximum speed for community mobility
B) Dynamic seating functions (tilt, recline) to manage tone
C) Joystick with adjustable throw and dampening (low-pass filter)
D) Swing-away lateral supports for easy transfers
Correct Answer: C
Rationale: Choreiform movements cause involuntary joystick inputs. A joystick
with adjustable throw (requiring larger displacement for input) and dampening
filters out involuntary movements, preventing erratic driving and improving
safety.
9. During a seating evaluation, a client with a C7 complete spinal cord injury
presents with a flattened lumbar spine (loss of lordosis) and posterior pelvic tilt.
What cushion modification is MOST appropriate?
A) Flat foam cushion with no contouring
B) Cushion with a built-in posterior pelvic wedge
C) Cushion with a built-in ischial relief trough
D) Air-filled cushion with adjustable cells
Correct Answer: B
Rationale: A posterior pelvic wedge (ramp) positioned under the ischial
tuberosities tilts the pelvis anteriorly, restoring lumbar lordosis and reducing
posterior pelvic tilt. Flat cushions fail to correct the tilt.
10. A client with a right CVA presents with left homonymous hemianopsia
(blindness in left visual field). What is the MOST appropriate training strategy for
power wheelchair use?
A) Mount a convex mirror on the left side
B) Instruct the client to scan visually to the left before turning or moving
