Louisiana Chiropractor Exam Practice
Questions And Correct Answers (Verified
Answers) Plus Rationale Q&A Instant
1. A patient presents with acute low back pain and unilateral radiculopathy. The
chiropractor documents a positive straight leg raise at 30 degrees and diminished
Achilles reflex. Which of the following best describes the pathophysiological
mechanism most consistent with these findings?
A. L4 nerve root compression due to disc herniation at L3-L4.
B. S1 nerve root irritation from a posterolateral disc protrusion at L5-S1.
C. L5 nerve root compression from central canal stenosis at L4-L5.
D. Femoral nerve entrapment within the psoas major muscle.
Answer: B. S1 nerve root irritation from a posterolateral disc protrusion at L5-S1.
Rationale: A positive straight leg raise at 30 degrees indicates nerve root tension, and
diminished Achilles reflex is a hallmark of S1 nerve root involvement, commonly from an
L5-S1 disc herniation. L4 compression would affect the patellar reflex, while L5
compression typically affects extensor hallucis longus strength. Femoral nerve entrapment
would present with anterior thigh symptoms and a positive femoral stretch test.
2. Under Louisiana chiropractic jurisprudence, which of the following actions
constitutes an unauthorized practice of chiropractic?
A. Performing manipulative therapy on a patient referred by a medical physician for a
musculoskeletal condition.
B. Utilizing therapeutic ultrasound and electrical stimulation as adjunctive modalities in
a chiropractic treatment plan.
C. Prescribing oral corticosteroids for acute inflammatory pain management without
medical consultation.
D. Ordering plain film radiographs to evaluate spinal alignment and rule out
contraindications to manipulation.
Answer: C. Prescribing oral corticosteroids for acute inflammatory pain management
without medical consultation.
Rationale: Louisiana law restricts chiropractors from prescribing legend drugs or
controlled substances; prescribing oral corticosteroids exceeds the scope of practice.
Page 1 of 76
,Manipulation, adjunctive modalities, and radiography are within the statutory scope when
clinically indicated. Therefore, option C represents an unauthorized practice.
Page 2 of 76
,3. A chiropractor is evaluating a patient with suspected vertebrobasilar insufficiency
prior to cervical manipulation. Which clinical test, when positive, is most specific for
compromised vertebral artery flow?
A. Barre-Lieou sign
B. Hautant's test
C. Underberg's test
D. De Kleyn's test
Answer: C. Underberg's test
Rationale: Underberg's test (also known as the vertebral artery test) involves cervical
rotation and extension with the patient standing; a positive result (dizziness, nystagmus, or
nausea) suggests vertebrobasilar insufficiency. Hautant's test assesses upper cervical
proprioception, while Barre-Lieou and De Kleyn's tests are less specific for vertebral
artery compromise. Underberg's is the most specific screening tool for VBI in this context.
4. Which of the following best describes the biomechanical advantage of using a
high-velocity, low-amplitude (HVLA) thrust in the lumbar spine compared to a
low-velocity, high-amplitude mobilization?
A. HVLA produces greater reflexogenic muscle relaxation via Golgi tendon organ
activation.
B. HVLA generates higher peak forces but shorter duration, targeting specific joint
mechanoreceptors.
C. HVLA increases intra-articular pressure more gradually, reducing risk of cavitation.
D. HVLA relies primarily on patient relaxation, not on thrust speed, for therapeutic
effect.
Answer: B. HVLA generates higher peak forces but shorter duration, targeting
specific joint mechanoreceptors.
Rationale: HVLA thrusts are characterized by a rapid, short-duration force that achieves
joint cavitation and stimulates mechanoreceptors, leading to reflex muscle relaxation and
pain modulation. Low-velocity mobilization applies lower forces over longer durations,
primarily affecting fluid dynamics and tissue creep. The other options incorrectly describe
the force-time characteristics or mechanisms of HVLA.
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, 5. A chiropractor in Louisiana is reviewing documentation requirements for Medicare
claims. Which element is mandatory for a initial visit note to support medical
necessity for spinal manipulation?
A. A copy of the patient's insurance card and referral from a primary care physician.
B. Objective measurable findings, a diagnosis, and a treatment plan with expected
duration.
C. A signed informed consent form and a statement of financial responsibility.
D. A list of all medications the patient is currently taking, including over-the-counter
supplements.
Answer: B. Objective measurable findings, a diagnosis, and a treatment plan with
expected duration.
Rationale: Medicare and Louisiana Medicaid require documentation of objective clinical
findings (e.g., range of motion, orthopedic tests), a specific diagnosis, and a treatment plan
with prognosis to establish medical necessity for chiropractic services. While informed
consent and medication lists are good practice, they are not the core mandatory elements
for claims. Options A and C are administrative but not the primary documentation
requirement.
6. A patient with chronic neck pain reports no improvement after 6 weeks of
chiropractic care. Which of the following best represents the appropriate next step
according to evidence-based practice guidelines?
A. Continue the same treatment plan for another 6 weeks to allow for cumulative effect.
B. Re-evaluate the diagnosis, consider referral for further imaging or specialist
consultation, and modify the treatment approach.
C. Add high-velocity cervical manipulation at a higher frequency to overcome a plateau.
D. Discharge the patient with a home exercise program and advise follow-up only if
symptoms worsen.
Answer: B. Re-evaluate the diagnosis, consider referral for further imaging or
specialist consultation, and modify the treatment approach.
Rationale: When a patient fails to respond to conservative care within a reasonable
timeframe, clinical guidelines recommend reassessment, consideration of advanced
imaging or referral, and modification of the treatment plan. Continuing ineffective care or
increasing manipulation frequency without reassessment is not evidence-based. Discharge
without alternative management may be premature and could delay necessary intervention.
Page 4 of 76
Questions And Correct Answers (Verified
Answers) Plus Rationale Q&A Instant
1. A patient presents with acute low back pain and unilateral radiculopathy. The
chiropractor documents a positive straight leg raise at 30 degrees and diminished
Achilles reflex. Which of the following best describes the pathophysiological
mechanism most consistent with these findings?
A. L4 nerve root compression due to disc herniation at L3-L4.
B. S1 nerve root irritation from a posterolateral disc protrusion at L5-S1.
C. L5 nerve root compression from central canal stenosis at L4-L5.
D. Femoral nerve entrapment within the psoas major muscle.
Answer: B. S1 nerve root irritation from a posterolateral disc protrusion at L5-S1.
Rationale: A positive straight leg raise at 30 degrees indicates nerve root tension, and
diminished Achilles reflex is a hallmark of S1 nerve root involvement, commonly from an
L5-S1 disc herniation. L4 compression would affect the patellar reflex, while L5
compression typically affects extensor hallucis longus strength. Femoral nerve entrapment
would present with anterior thigh symptoms and a positive femoral stretch test.
2. Under Louisiana chiropractic jurisprudence, which of the following actions
constitutes an unauthorized practice of chiropractic?
A. Performing manipulative therapy on a patient referred by a medical physician for a
musculoskeletal condition.
B. Utilizing therapeutic ultrasound and electrical stimulation as adjunctive modalities in
a chiropractic treatment plan.
C. Prescribing oral corticosteroids for acute inflammatory pain management without
medical consultation.
D. Ordering plain film radiographs to evaluate spinal alignment and rule out
contraindications to manipulation.
Answer: C. Prescribing oral corticosteroids for acute inflammatory pain management
without medical consultation.
Rationale: Louisiana law restricts chiropractors from prescribing legend drugs or
controlled substances; prescribing oral corticosteroids exceeds the scope of practice.
Page 1 of 76
,Manipulation, adjunctive modalities, and radiography are within the statutory scope when
clinically indicated. Therefore, option C represents an unauthorized practice.
Page 2 of 76
,3. A chiropractor is evaluating a patient with suspected vertebrobasilar insufficiency
prior to cervical manipulation. Which clinical test, when positive, is most specific for
compromised vertebral artery flow?
A. Barre-Lieou sign
B. Hautant's test
C. Underberg's test
D. De Kleyn's test
Answer: C. Underberg's test
Rationale: Underberg's test (also known as the vertebral artery test) involves cervical
rotation and extension with the patient standing; a positive result (dizziness, nystagmus, or
nausea) suggests vertebrobasilar insufficiency. Hautant's test assesses upper cervical
proprioception, while Barre-Lieou and De Kleyn's tests are less specific for vertebral
artery compromise. Underberg's is the most specific screening tool for VBI in this context.
4. Which of the following best describes the biomechanical advantage of using a
high-velocity, low-amplitude (HVLA) thrust in the lumbar spine compared to a
low-velocity, high-amplitude mobilization?
A. HVLA produces greater reflexogenic muscle relaxation via Golgi tendon organ
activation.
B. HVLA generates higher peak forces but shorter duration, targeting specific joint
mechanoreceptors.
C. HVLA increases intra-articular pressure more gradually, reducing risk of cavitation.
D. HVLA relies primarily on patient relaxation, not on thrust speed, for therapeutic
effect.
Answer: B. HVLA generates higher peak forces but shorter duration, targeting
specific joint mechanoreceptors.
Rationale: HVLA thrusts are characterized by a rapid, short-duration force that achieves
joint cavitation and stimulates mechanoreceptors, leading to reflex muscle relaxation and
pain modulation. Low-velocity mobilization applies lower forces over longer durations,
primarily affecting fluid dynamics and tissue creep. The other options incorrectly describe
the force-time characteristics or mechanisms of HVLA.
Page 3 of 76
, 5. A chiropractor in Louisiana is reviewing documentation requirements for Medicare
claims. Which element is mandatory for a initial visit note to support medical
necessity for spinal manipulation?
A. A copy of the patient's insurance card and referral from a primary care physician.
B. Objective measurable findings, a diagnosis, and a treatment plan with expected
duration.
C. A signed informed consent form and a statement of financial responsibility.
D. A list of all medications the patient is currently taking, including over-the-counter
supplements.
Answer: B. Objective measurable findings, a diagnosis, and a treatment plan with
expected duration.
Rationale: Medicare and Louisiana Medicaid require documentation of objective clinical
findings (e.g., range of motion, orthopedic tests), a specific diagnosis, and a treatment plan
with prognosis to establish medical necessity for chiropractic services. While informed
consent and medication lists are good practice, they are not the core mandatory elements
for claims. Options A and C are administrative but not the primary documentation
requirement.
6. A patient with chronic neck pain reports no improvement after 6 weeks of
chiropractic care. Which of the following best represents the appropriate next step
according to evidence-based practice guidelines?
A. Continue the same treatment plan for another 6 weeks to allow for cumulative effect.
B. Re-evaluate the diagnosis, consider referral for further imaging or specialist
consultation, and modify the treatment approach.
C. Add high-velocity cervical manipulation at a higher frequency to overcome a plateau.
D. Discharge the patient with a home exercise program and advise follow-up only if
symptoms worsen.
Answer: B. Re-evaluate the diagnosis, consider referral for further imaging or
specialist consultation, and modify the treatment approach.
Rationale: When a patient fails to respond to conservative care within a reasonable
timeframe, clinical guidelines recommend reassessment, consideration of advanced
imaging or referral, and modification of the treatment plan. Continuing ineffective care or
increasing manipulation frequency without reassessment is not evidence-based. Discharge
without alternative management may be premature and could delay necessary intervention.
Page 4 of 76
