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ABC Prosthetics & Orthotics
Certification Exam Prep 2026 |
600+ High-Yield Practice
Questions with Explanations |
Updated for Latest Exam
Blueprint
1. A patient with a T10 spinal cord injury is fitted with KAFOs for ambulation. What is
the primary biomechanical function of the hip joints in this orthosis?
A) To allow free hip flexion during stance
B) To lock the hips in extension for stability
C) To provide hip abduction assistance
D) To allow unrestricted hip rotation
Answer: B
Rationale: For a T10 paraplegic with no hip extensor control, the hip joints must
lock in extension during stance to provide a stable base for standing and swing-
through gait.
2. A patient with a transtibial amputation complains of a "hot spot" over the distal
fibula. Which socket modification is most appropriate?
A) Add a relief over the distal fibula
B) Increase pressure over the patellar tendon
C) Add a medial wedge
D) Increase the socket's posterior trim height
Answer: A
Rationale: The distal fibula is a bony prominence with little soft tissue coverage.
,2|Page
A direct relief (void) in the socket over this area is necessary to offload pressure
and prevent skin breakdown.
3. In a body-powered transradial prosthesis, increasing the tension of the rubber
bands on the terminal device will have what effect?
A) It will make the device easier to open
B) It will increase the prehensile grip force
C) It will decrease the closing speed
D) It will reduce cable wear
Answer: B
Rationale: The rubber bands or springs in a body-powered hook/hand provide
the closing force. Increasing their tension increases the grip strength but also
requires more effort from the patient to open the device.
4. A child with idiopathic scoliosis has a 28-degree right thoracic curve and a Risser
sign of 1. What is the standard of care?
A) Observation only
B) Physical therapy exercises
C) Thoracolumbosacral orthosis (TLSO) bracing
D) Surgical spinal fusion
Answer: C
Rationale: A Risser sign of 1 indicates significant skeletal immaturity. A curve
of 28 degrees in a growing child is within the bracing range (25-45 degrees) to
prevent progression.
5. A patient with a transfemoral amputation has a prosthetic knee that "slaps" into
full extension at the end of swing. What adjustment is needed?
A) Increase the swing-phase flexion resistance
B) Decrease the swing-phase extension assist
C) Increase the terminal damping or extension assist
D) Move the knee joint anteriorly
Answer: C
Rationale: Terminal "slap" or impact occurs when the shank hits the extension
stop too hard. Increasing the terminal damping (or extension assist) cushions
the end of the swing phase.
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6. An orthosis that immobilizes the wrist in neutral, blocks MCP extension, and allows
IP joint motion is most appropriate for which condition?
A) Acute rheumatoid arthritis
B) Distal radius fracture
C) Intrinsic minus hand (claw hand)
D) De Quervain's tenosynovitis
Answer: C
Rationale: An intrinsic minus hand (claw hand) lacks MCP flexion. An anti-claw
splint blocks MCP hyperextension while allowing MCP flexion and IP extension,
improving function.
7. During stance phase, the normal center of pressure (COP) travels from lateral heel
to which point at toe-off?
A) Lateral forefoot
B) Medial forefoot (first ray)
C) Central midfoot
D) Calcaneus
Answer: B
Rationale: The COP moves from lateral heel at initial contact, across the
midfoot, to the medial forefoot (specifically the first metatarsal head) at
terminal stance and toe-off.
8. A patient with a transtibial amputation is fitted with a pin-lock suspension system.
If the patient gains 5 pounds of weight, what is the most likely consequence?
A) The socket will become too loose
B) The socket will become too tight, causing distal discomfort
C) The pin length will need to be changed
D) The foot will need to be realigned
Answer: B
Rationale: Weight gain increases the volume of the residual limb. In a pin-lock
system, the limb is drawn into the socket; increased volume will cause excessive
distal pressure and tightness.
, 4|Page
9. A patient with a C6 spinal cord injury is being evaluated for a wrist-driven
prehension orthosis. What is a prerequisite for this orthosis to function?
A) Active elbow extension
B) Active wrist extension (at least 20 degrees)
C) Active finger flexion
D) Active shoulder abduction
Answer: B
Rationale: A wrist-driven prehension orthosis relies on the patient's active wrist
extension to tension the finger flexors via tenodesis. Without active wrist
extension, the orthosis will not function.
10. A patient with a stroke presents with a spastic equinovarus foot. Which orthotic
design provides the most effective control?
A) A posterior leaf spring AFO
B) A carbon fiber dynamic AFO
C) A solid ankle AFO (SAFO) with a medial-lateral trim line
D) A supramalleolar orthosis (SMO)
Answer: C
Rationale: Spastic equinovarus requires strong mediolateral and sagittal control
to counteract inversion and plantarflexion. A SAFO provides the maximum
stability needed.
11. What is the primary advantage of using a microprocessor-controlled knee (MPK)
over a mechanical hydraulic knee?
A) Lower cost and less maintenance
B) Ability to automatically adapt damping to gait speed and terrain
C) Significantly lighter weight
D) No need for a battery
Answer: B
Rationale: MPKs use sensors to detect stance/swing and adjust hydraulic
resistance in real-time, providing variable cadence, stumble recovery, and
adaptability to different terrains.
12. A patient with a transtibial amputation has a "hard heel strike" gait deviation.
What prosthetic alignment change is indicated?
ABC Prosthetics & Orthotics
Certification Exam Prep 2026 |
600+ High-Yield Practice
Questions with Explanations |
Updated for Latest Exam
Blueprint
1. A patient with a T10 spinal cord injury is fitted with KAFOs for ambulation. What is
the primary biomechanical function of the hip joints in this orthosis?
A) To allow free hip flexion during stance
B) To lock the hips in extension for stability
C) To provide hip abduction assistance
D) To allow unrestricted hip rotation
Answer: B
Rationale: For a T10 paraplegic with no hip extensor control, the hip joints must
lock in extension during stance to provide a stable base for standing and swing-
through gait.
2. A patient with a transtibial amputation complains of a "hot spot" over the distal
fibula. Which socket modification is most appropriate?
A) Add a relief over the distal fibula
B) Increase pressure over the patellar tendon
C) Add a medial wedge
D) Increase the socket's posterior trim height
Answer: A
Rationale: The distal fibula is a bony prominence with little soft tissue coverage.
,2|Page
A direct relief (void) in the socket over this area is necessary to offload pressure
and prevent skin breakdown.
3. In a body-powered transradial prosthesis, increasing the tension of the rubber
bands on the terminal device will have what effect?
A) It will make the device easier to open
B) It will increase the prehensile grip force
C) It will decrease the closing speed
D) It will reduce cable wear
Answer: B
Rationale: The rubber bands or springs in a body-powered hook/hand provide
the closing force. Increasing their tension increases the grip strength but also
requires more effort from the patient to open the device.
4. A child with idiopathic scoliosis has a 28-degree right thoracic curve and a Risser
sign of 1. What is the standard of care?
A) Observation only
B) Physical therapy exercises
C) Thoracolumbosacral orthosis (TLSO) bracing
D) Surgical spinal fusion
Answer: C
Rationale: A Risser sign of 1 indicates significant skeletal immaturity. A curve
of 28 degrees in a growing child is within the bracing range (25-45 degrees) to
prevent progression.
5. A patient with a transfemoral amputation has a prosthetic knee that "slaps" into
full extension at the end of swing. What adjustment is needed?
A) Increase the swing-phase flexion resistance
B) Decrease the swing-phase extension assist
C) Increase the terminal damping or extension assist
D) Move the knee joint anteriorly
Answer: C
Rationale: Terminal "slap" or impact occurs when the shank hits the extension
stop too hard. Increasing the terminal damping (or extension assist) cushions
the end of the swing phase.
,3|Page
6. An orthosis that immobilizes the wrist in neutral, blocks MCP extension, and allows
IP joint motion is most appropriate for which condition?
A) Acute rheumatoid arthritis
B) Distal radius fracture
C) Intrinsic minus hand (claw hand)
D) De Quervain's tenosynovitis
Answer: C
Rationale: An intrinsic minus hand (claw hand) lacks MCP flexion. An anti-claw
splint blocks MCP hyperextension while allowing MCP flexion and IP extension,
improving function.
7. During stance phase, the normal center of pressure (COP) travels from lateral heel
to which point at toe-off?
A) Lateral forefoot
B) Medial forefoot (first ray)
C) Central midfoot
D) Calcaneus
Answer: B
Rationale: The COP moves from lateral heel at initial contact, across the
midfoot, to the medial forefoot (specifically the first metatarsal head) at
terminal stance and toe-off.
8. A patient with a transtibial amputation is fitted with a pin-lock suspension system.
If the patient gains 5 pounds of weight, what is the most likely consequence?
A) The socket will become too loose
B) The socket will become too tight, causing distal discomfort
C) The pin length will need to be changed
D) The foot will need to be realigned
Answer: B
Rationale: Weight gain increases the volume of the residual limb. In a pin-lock
system, the limb is drawn into the socket; increased volume will cause excessive
distal pressure and tightness.
, 4|Page
9. A patient with a C6 spinal cord injury is being evaluated for a wrist-driven
prehension orthosis. What is a prerequisite for this orthosis to function?
A) Active elbow extension
B) Active wrist extension (at least 20 degrees)
C) Active finger flexion
D) Active shoulder abduction
Answer: B
Rationale: A wrist-driven prehension orthosis relies on the patient's active wrist
extension to tension the finger flexors via tenodesis. Without active wrist
extension, the orthosis will not function.
10. A patient with a stroke presents with a spastic equinovarus foot. Which orthotic
design provides the most effective control?
A) A posterior leaf spring AFO
B) A carbon fiber dynamic AFO
C) A solid ankle AFO (SAFO) with a medial-lateral trim line
D) A supramalleolar orthosis (SMO)
Answer: C
Rationale: Spastic equinovarus requires strong mediolateral and sagittal control
to counteract inversion and plantarflexion. A SAFO provides the maximum
stability needed.
11. What is the primary advantage of using a microprocessor-controlled knee (MPK)
over a mechanical hydraulic knee?
A) Lower cost and less maintenance
B) Ability to automatically adapt damping to gait speed and terrain
C) Significantly lighter weight
D) No need for a battery
Answer: B
Rationale: MPKs use sensors to detect stance/swing and adjust hydraulic
resistance in real-time, providing variable cadence, stumble recovery, and
adaptability to different terrains.
12. A patient with a transtibial amputation has a "hard heel strike" gait deviation.
What prosthetic alignment change is indicated?
