CTRI EXAM 2026-2027: 200 PRACTICE QUESTIONS WITH
DETAILED ANSWERS & RATIONALES Certified Therapeutic
Riding Instructor (CTRI) Comprehensive Final Exam Based on
PATH International Standards
SECTION 1: EQUINE MANAGEMENT & BEHAVIOR (Questions 1–40)
1. A therapeutic riding instructor notices a horse in the program has swelling
in the bursa and deep flexor tendon area, but no signs of lameness. What is
the most likely cause?
A) Carpitis
B) Capped elbow
C) Dorsal metacarpal disease
D) Windpuffs
Answer: D) Windpuffs
Rationale: Windpuffs are fluid-filled swellings of the digital flexor tendon
sheath or fetlock joint capsule. They are common in horses in therapeutic
programs due to repetitive motion and are typically not painful or associated
with lameness. Carpitis is inflammation of the carpus (knee), capped elbow is
swelling over the olecranon, and dorsal metacarpal disease is a condition of
the cannon bone.
,2. When observing a horse at the trot, what is the correct sequence of
footfalls?
A) 2-4-1-3
B) 2-1-1-2
C) 2-3-1-2
D) 3-4-1-2
Answer: B) 2-1-1-2
Rationale: The trot is a two-beat diagonal gait. The sequence is: left front and
right hind together (1), then right front and left hind together (2). This creates
the rhythm "1-2, 1-2." The notation "2-1-1-2" indicates the diagonal pairs.
3. While warming up a horse at the trot, the instructor notices the horse's
head pops up and then down dramatically with the rhythm of the trot. What
is happening?
A) When the lame foot strikes the ground, the head pops up
B) When the sound foot strikes the ground, the head pops up
C) The horse has an energetic trot; head movement is more pronounced
D) The rider's outside leg is too far behind the girth
**Answer: A) When the lame foot strikes the ground, the head pops up**
**Rationale:** This is a classic sign of lameness. When the lame foot hits the
ground, the horse raises its head to avoid putting weight on the painful limb.
When the sound foot strikes, the head drops. This head nod is a reliable
indicator of which leg is affected.
,4. A horse leader is taking a horse into the ring for warm-up. The instructor
notices the horse is walking behind the leader and taking narrow, shortened
steps. What is the most likely issue?
A) Abscess
B) Sidebone
C) Navicular
D) Arthritis
Answer: C) Navicular
Rationale: Navicular syndrome is a common cause of forelimb lameness,
characterized by shortened, choppy strides and a "walking on eggshells"
appearance. The horse may also stand with the affected foot placed forward.
Arthritis is more generalized and often affects older horses with different gait
abnormalities.
5. During a lesson, the instructor observes a horse swishing its tail, nipping at
people, and pinning its ears. These behaviors could indicate all of the
following EXCEPT:
A) Unbalanced rider
B) Incorrect handling by leader
C) Increased enrichment in class
D) Having too many people in space
Answer: C) Increased enrichment in class
Rationale:Tail swishing, nipping, and ear pinning are signs of irritation, pain,
or stress. They typically indicate an uncomfortable horse due to an
unbalanced rider, poor handling by the leader, or a chaotic environment with
too many people. Increased enrichment (e.g., more stimulating activities)
would not cause these negative behaviors.
, 6. A participant is sweating, breathing rapidly, and refusing to comply. What is
the most likely cause?
A) ADHD
B) Anxiety
C) Sensory processing disorder
D) Bipolar disorder
Answer: B) Anxiety
Rationale: Sweating, rapid breathing, and refusal to comply are classic signs of
an anxiety attack. While other conditions may contribute, the acute
presentation suggests anxiety. The instructor should address the immediate
emotional state before continuing the lesson.
7. Why is an atlantoaxial instability test required for participants with Down
syndrome?
A) Indicates if heart is healthy enough
B) Indicates if vertebra spacing is safe for activity
C) Indicates if gastrointestinal abnormalities
D) Indicates immune disorders
Answer: B) Indicates if vertebra spacing is safe for activity
Rationale: Atlantoaxial instability (AAI) is a condition where the first two
cervical vertebrae are unstable. It is common in individuals with Down
syndrome. If present, activities that involve flexion or extension of the neck
(like riding) can cause spinal cord injury. The test determines if the participant
can safely participate in equine activities.
DETAILED ANSWERS & RATIONALES Certified Therapeutic
Riding Instructor (CTRI) Comprehensive Final Exam Based on
PATH International Standards
SECTION 1: EQUINE MANAGEMENT & BEHAVIOR (Questions 1–40)
1. A therapeutic riding instructor notices a horse in the program has swelling
in the bursa and deep flexor tendon area, but no signs of lameness. What is
the most likely cause?
A) Carpitis
B) Capped elbow
C) Dorsal metacarpal disease
D) Windpuffs
Answer: D) Windpuffs
Rationale: Windpuffs are fluid-filled swellings of the digital flexor tendon
sheath or fetlock joint capsule. They are common in horses in therapeutic
programs due to repetitive motion and are typically not painful or associated
with lameness. Carpitis is inflammation of the carpus (knee), capped elbow is
swelling over the olecranon, and dorsal metacarpal disease is a condition of
the cannon bone.
,2. When observing a horse at the trot, what is the correct sequence of
footfalls?
A) 2-4-1-3
B) 2-1-1-2
C) 2-3-1-2
D) 3-4-1-2
Answer: B) 2-1-1-2
Rationale: The trot is a two-beat diagonal gait. The sequence is: left front and
right hind together (1), then right front and left hind together (2). This creates
the rhythm "1-2, 1-2." The notation "2-1-1-2" indicates the diagonal pairs.
3. While warming up a horse at the trot, the instructor notices the horse's
head pops up and then down dramatically with the rhythm of the trot. What
is happening?
A) When the lame foot strikes the ground, the head pops up
B) When the sound foot strikes the ground, the head pops up
C) The horse has an energetic trot; head movement is more pronounced
D) The rider's outside leg is too far behind the girth
**Answer: A) When the lame foot strikes the ground, the head pops up**
**Rationale:** This is a classic sign of lameness. When the lame foot hits the
ground, the horse raises its head to avoid putting weight on the painful limb.
When the sound foot strikes, the head drops. This head nod is a reliable
indicator of which leg is affected.
,4. A horse leader is taking a horse into the ring for warm-up. The instructor
notices the horse is walking behind the leader and taking narrow, shortened
steps. What is the most likely issue?
A) Abscess
B) Sidebone
C) Navicular
D) Arthritis
Answer: C) Navicular
Rationale: Navicular syndrome is a common cause of forelimb lameness,
characterized by shortened, choppy strides and a "walking on eggshells"
appearance. The horse may also stand with the affected foot placed forward.
Arthritis is more generalized and often affects older horses with different gait
abnormalities.
5. During a lesson, the instructor observes a horse swishing its tail, nipping at
people, and pinning its ears. These behaviors could indicate all of the
following EXCEPT:
A) Unbalanced rider
B) Incorrect handling by leader
C) Increased enrichment in class
D) Having too many people in space
Answer: C) Increased enrichment in class
Rationale:Tail swishing, nipping, and ear pinning are signs of irritation, pain,
or stress. They typically indicate an uncomfortable horse due to an
unbalanced rider, poor handling by the leader, or a chaotic environment with
too many people. Increased enrichment (e.g., more stimulating activities)
would not cause these negative behaviors.
, 6. A participant is sweating, breathing rapidly, and refusing to comply. What is
the most likely cause?
A) ADHD
B) Anxiety
C) Sensory processing disorder
D) Bipolar disorder
Answer: B) Anxiety
Rationale: Sweating, rapid breathing, and refusal to comply are classic signs of
an anxiety attack. While other conditions may contribute, the acute
presentation suggests anxiety. The instructor should address the immediate
emotional state before continuing the lesson.
7. Why is an atlantoaxial instability test required for participants with Down
syndrome?
A) Indicates if heart is healthy enough
B) Indicates if vertebra spacing is safe for activity
C) Indicates if gastrointestinal abnormalities
D) Indicates immune disorders
Answer: B) Indicates if vertebra spacing is safe for activity
Rationale: Atlantoaxial instability (AAI) is a condition where the first two
cervical vertebrae are unstable. It is common in individuals with Down
syndrome. If present, activities that involve flexion or extension of the neck
(like riding) can cause spinal cord injury. The test determines if the participant
can safely participate in equine activities.
