CHT – Certified Hand Therapist
CHT – CERTIFIED HAND THERAPIST | EXAM QUESTIONS
AND CORRECT ANSWERS | VERIFIED HAND THERAPY
CERTIFICATION LATEST 2026/2027
CHT - Certified Hand Therapist
1. A physician's operative report notes a "Kessler core suture with
epitendinous running repair" for a laceration at the wrist. This
documentation indicates repair of:
A. The extensor retinaculum
B. A flexor tendon
C. A collateral ligament
D. A digital nerve
The Kessler technique is a core suture method specifically used to repair
severed flexor (and extensor) tendons.
2. On chart review, a patient is taking warfarin. Prior to initiating deep
soft tissue mobilization, the therapist should be most cautious about:
A. Increased bruising and bleeding risk
B. Increased risk of tendon rupture
C. Reduced sensory nerve conduction
D. Delayed wound epithelialization
Warfarin is an anticoagulant, so aggressive manual techniques carry
elevated bruising/bleeding risk.
Page 1 of 55
, CHT – Certified Hand Therapist
3. An MRI report describes a "triangular fibrocartilage complex (TFCC)
Palmer Class 1B tear." This classifies the injury as:
A. Degenerative tear with lunotriquetral ligament disruption
B. Degenerative tear with TFCC perforation
C. Traumatic, peripheral ulnar-sided tear
D. Traumatic, central tear
Palmer Class 1B denotes a traumatic tear at the ulnar (peripheral)
attachment of the TFCC, often with distal ulna instability.
4. A referral states the patient underwent a "Dupuytren's fasciectomy
with z-plasty closure." The z-plasty technique is used primarily to:
A. Anchor a tendon graft to bone
B. Improve vascular perfusion to the digit
C. Lengthen a contracted scar line and redistribute tension
D. Reinforce the palmar fascia against recurrence
Z-plasty transposes triangular skin flaps to lengthen a linear scar and
reduce contracture recurrence across flexion creases.
5. A patient's history includes long-term corticosteroid use. This is most
relevant to hand therapy assessment because it can:
A. Increase active range of motion
B. Improve tensile strength of repaired tendons
C. Cause peripheral nerve hyperexcitability
D. Impair collagen synthesis and delay tissue healing
Chronic corticosteroid use suppresses fibroblast activity and collagen
synthesis, slowing wound and tendon healing.
6. A radiology report describes a distal radius fracture as "dorsally
angulated with positive ulnar variance." Positive ulnar variance means:
A. The ulna is relatively longer than the radius
B. The radius and ulna are equal in length
C. The ulna is relatively shorter than the radius
D. The distal radioulnar joint is dislocated
Positive ulnar variance describes the ulna extending distal to the radius,
which can increase ulnocarpal loading.
7. A surgeon's note documents "neurolysis" was performed during
carpal tunnel release. This procedure specifically involves:
Page 2 of 55
, CHT – Certified Hand Therapist
A. Repairing a completely transected nerve
B. Freeing a nerve from surrounding scar or adhesions
C. Grafting a segment of donor nerve
D. Injecting the nerve with corticosteroid
Neurolysis is surgical release of a nerve from constricting scar tissue or
adhesions, without cutting the nerve itself.
8. A patient with diabetes mellitus presents for hand therapy after
flexor tenosynovectomy. This history is clinically relevant because
diabetes is associated with:
A. Accelerated tendon gliding and faster recovery
B. Decreased likelihood of trigger finger
C. Increased risk of tendon adhesion and delayed healing
D. Improved peripheral nerve regeneration rates
Diabetes impairs microvascular circulation and collagen quality, increasing
adhesion formation and slowing healing.
9. During intake, a patient reports pain that worsens at night and is
relieved by shaking the hand. This history is most classically associated
with:
A. Carpal tunnel syndrome
B. De Quervain's tenosynovitis
C. Lateral epicondylalgia
D. Trigger finger
Nocturnal paresthesia relieved by shaking (the "flick sign") is a hallmark
history finding in carpal tunnel syndrome.
10. A patient reports the mechanism of injury as forced hyperextension
of the thumb MCP joint while skiing. The therapist should screen
closely for injury to the:
A. Volar plate of the thumb IP joint
B. Extensor pollicis longus tendon
C. Radial collateral ligament of the index finger
D. Ulnar collateral ligament of the thumb
Forceful radial/hyperextension stress to the thumb classically injures the
ulnar collateral ligament ("skier's thumb").
Page 3 of 55
, CHT – Certified Hand Therapist
11. During the interview, a patient describes their pain as burning, out
of proportion to the injury, with associated skin color changes and
temperature asymmetry. This presentation should raise suspicion for:
A. Localized tendinopathy
B. Simple contact dermatitis
C. Complex regional pain syndrome
D. Mechanical joint stiffness
Disproportionate burning pain with vasomotor and trophic changes is the
classic clinical picture of CRPS.
12. A comprehensive upper limb screen for a patient with hand
symptoms should always include assessment of the cervical spine
primarily to rule out:
A. Carpal bone malalignment
B. Rotator cuff impingement as a primary hand diagnosis
C. A proximal source of referred symptoms, such as radiculopathy
D. Elbow joint effusion
Cervical radiculopathy can refer pain, numbness, or weakness into the hand
and must be screened out before local treatment.
13. When interviewing a patient about occupational demands prior to
establishing goals, the MOST relevant information to gather is:
A. The patient's preferred brand of work gloves
B. The name of the patient's direct supervisor
C. Specific repetitive tasks, load requirements, and duty cycle of the
job
D. The patient's commute distance to work
Understanding task-specific physical demands is essential to set functional,
job-relevant treatment goals.
14. A patient reports catching and locking of the ring finger with
painful popping when extending from a flexed position. This history is
most consistent with:
A. Ulnar nerve palsy
B. Trigger finger (stenosing tenosynovitis)
C. Mallet finger
D. Boutonniere deformity
Page 4 of 55
CHT – CERTIFIED HAND THERAPIST | EXAM QUESTIONS
AND CORRECT ANSWERS | VERIFIED HAND THERAPY
CERTIFICATION LATEST 2026/2027
CHT - Certified Hand Therapist
1. A physician's operative report notes a "Kessler core suture with
epitendinous running repair" for a laceration at the wrist. This
documentation indicates repair of:
A. The extensor retinaculum
B. A flexor tendon
C. A collateral ligament
D. A digital nerve
The Kessler technique is a core suture method specifically used to repair
severed flexor (and extensor) tendons.
2. On chart review, a patient is taking warfarin. Prior to initiating deep
soft tissue mobilization, the therapist should be most cautious about:
A. Increased bruising and bleeding risk
B. Increased risk of tendon rupture
C. Reduced sensory nerve conduction
D. Delayed wound epithelialization
Warfarin is an anticoagulant, so aggressive manual techniques carry
elevated bruising/bleeding risk.
Page 1 of 55
, CHT – Certified Hand Therapist
3. An MRI report describes a "triangular fibrocartilage complex (TFCC)
Palmer Class 1B tear." This classifies the injury as:
A. Degenerative tear with lunotriquetral ligament disruption
B. Degenerative tear with TFCC perforation
C. Traumatic, peripheral ulnar-sided tear
D. Traumatic, central tear
Palmer Class 1B denotes a traumatic tear at the ulnar (peripheral)
attachment of the TFCC, often with distal ulna instability.
4. A referral states the patient underwent a "Dupuytren's fasciectomy
with z-plasty closure." The z-plasty technique is used primarily to:
A. Anchor a tendon graft to bone
B. Improve vascular perfusion to the digit
C. Lengthen a contracted scar line and redistribute tension
D. Reinforce the palmar fascia against recurrence
Z-plasty transposes triangular skin flaps to lengthen a linear scar and
reduce contracture recurrence across flexion creases.
5. A patient's history includes long-term corticosteroid use. This is most
relevant to hand therapy assessment because it can:
A. Increase active range of motion
B. Improve tensile strength of repaired tendons
C. Cause peripheral nerve hyperexcitability
D. Impair collagen synthesis and delay tissue healing
Chronic corticosteroid use suppresses fibroblast activity and collagen
synthesis, slowing wound and tendon healing.
6. A radiology report describes a distal radius fracture as "dorsally
angulated with positive ulnar variance." Positive ulnar variance means:
A. The ulna is relatively longer than the radius
B. The radius and ulna are equal in length
C. The ulna is relatively shorter than the radius
D. The distal radioulnar joint is dislocated
Positive ulnar variance describes the ulna extending distal to the radius,
which can increase ulnocarpal loading.
7. A surgeon's note documents "neurolysis" was performed during
carpal tunnel release. This procedure specifically involves:
Page 2 of 55
, CHT – Certified Hand Therapist
A. Repairing a completely transected nerve
B. Freeing a nerve from surrounding scar or adhesions
C. Grafting a segment of donor nerve
D. Injecting the nerve with corticosteroid
Neurolysis is surgical release of a nerve from constricting scar tissue or
adhesions, without cutting the nerve itself.
8. A patient with diabetes mellitus presents for hand therapy after
flexor tenosynovectomy. This history is clinically relevant because
diabetes is associated with:
A. Accelerated tendon gliding and faster recovery
B. Decreased likelihood of trigger finger
C. Increased risk of tendon adhesion and delayed healing
D. Improved peripheral nerve regeneration rates
Diabetes impairs microvascular circulation and collagen quality, increasing
adhesion formation and slowing healing.
9. During intake, a patient reports pain that worsens at night and is
relieved by shaking the hand. This history is most classically associated
with:
A. Carpal tunnel syndrome
B. De Quervain's tenosynovitis
C. Lateral epicondylalgia
D. Trigger finger
Nocturnal paresthesia relieved by shaking (the "flick sign") is a hallmark
history finding in carpal tunnel syndrome.
10. A patient reports the mechanism of injury as forced hyperextension
of the thumb MCP joint while skiing. The therapist should screen
closely for injury to the:
A. Volar plate of the thumb IP joint
B. Extensor pollicis longus tendon
C. Radial collateral ligament of the index finger
D. Ulnar collateral ligament of the thumb
Forceful radial/hyperextension stress to the thumb classically injures the
ulnar collateral ligament ("skier's thumb").
Page 3 of 55
, CHT – Certified Hand Therapist
11. During the interview, a patient describes their pain as burning, out
of proportion to the injury, with associated skin color changes and
temperature asymmetry. This presentation should raise suspicion for:
A. Localized tendinopathy
B. Simple contact dermatitis
C. Complex regional pain syndrome
D. Mechanical joint stiffness
Disproportionate burning pain with vasomotor and trophic changes is the
classic clinical picture of CRPS.
12. A comprehensive upper limb screen for a patient with hand
symptoms should always include assessment of the cervical spine
primarily to rule out:
A. Carpal bone malalignment
B. Rotator cuff impingement as a primary hand diagnosis
C. A proximal source of referred symptoms, such as radiculopathy
D. Elbow joint effusion
Cervical radiculopathy can refer pain, numbness, or weakness into the hand
and must be screened out before local treatment.
13. When interviewing a patient about occupational demands prior to
establishing goals, the MOST relevant information to gather is:
A. The patient's preferred brand of work gloves
B. The name of the patient's direct supervisor
C. Specific repetitive tasks, load requirements, and duty cycle of the
job
D. The patient's commute distance to work
Understanding task-specific physical demands is essential to set functional,
job-relevant treatment goals.
14. A patient reports catching and locking of the ring finger with
painful popping when extending from a flexed position. This history is
most consistent with:
A. Ulnar nerve palsy
B. Trigger finger (stenosing tenosynovitis)
C. Mallet finger
D. Boutonniere deformity
Page 4 of 55
