10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
These 10 free PM&R questions are organized by exam domain, so you can see how each part of the Certification in Physical Medicine & Rehabilitation (PM&R) blueprint is tested. Reveal the answer and explanation under each question.
Domain 1: Rehabilitation of Brain, Spinal Cord/Muscle, and Connective Tissue Disorders (27-31%)
Question 1
A referral labels a 48-year-old man's six-week history of left foot drop as common fibular nerve compression. Examination also finds weak ankle inversion and hip abduction. Superficial fibular and sural sensory responses are preserved. Needle examination shows active denervation in the tibialis anterior, tibialis posterior, gluteus medius, and lower lumbar paraspinals. He has never undergone lumbar surgery. Where does this pattern localize the lesion?
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Correct answer: C - L5 nerve root
Question 2
Hand hygiene is the main concern for a woman with chronic right hemiparesis after stroke. Her wrist and fingers remain flexed, with a catch during rapid stretch, but slow passive movement permits full opening. Daily stretching and splinting have not made care comfortable. Increasing oral baclofen previously caused somnolence and impaired transfers; she uses right-leg extensor tone to stand. Which treatment most directly addresses her hygiene goal while preserving that useful function?
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Correct answer: B - Inject botulinum toxin into the overactive wrist and finger flexors
Question 3
An ISNCSCI examination establishes a single neurological level of C5 and preserved voluntary anal contraction. Strength is normal through C5. On each side, the wrist extensors, elbow extensors, finger flexors, and little-finger abductors are grade 2. Bilateral hip flexors, knee extensors, and ankle dorsiflexors are grade 4; great-toe extensors and ankle plantarflexors are grade 2 bilaterally. All key muscles are testable without confounding pain or peripheral nerve injury. What ASIA Impairment Scale grade follows from this examination?
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Correct answer: C - AIS C
Domain 2: Interventional Therapeutics: Spine and Osteopathic Manipulative Treatment and Pain (25-29%)
Question 4
The structural examination documents T8 as flexed, rotated left, and sidebent left. A direct muscle-energy technique is selected. Before asking the patient to contract against resistance, the physician should engage the restrictive barriers by positioning the segment in:
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Correct answer: A - Extension, right rotation, and right sidebending
Question 5
Eight weeks after a distal-radius fracture has healed, a patient has disproportionate regional hand pain. She reports sensitivity to light touch, intermittent color and temperature changes, swelling, and stiffness. No better diagnosis explains the presentation. So far, the examiner has documented pinprick hyperalgesia and brush allodynia. Which additional finding would supply the missing objective-sign category required by the Budapest clinical criteria?
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Correct answer: D - A measured hand-temperature asymmetry of 1.6 °C
Question 6
Diagnostic nerve blocks are planned to assess the right L5-S1 zygapophyseal joint as a possible pain generator. To cover the sensory innervation of that joint, which pair should be targeted?
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Correct answer: D - Right L4 medial branch and L5 dorsal ramus
Domain 3: Prosthetics, Orthotics, Sports Medicine, Orthopedic disorders, MSK disorders, Occupational-Industrial, Return to Work and Assistive Devices (24-28%)
Question 7
A Medicare beneficiary with a transfemoral amputation is assessed as a K2 ambulator. His team documents recurrent near-falls, the expected daily-function benefits of a microprocessor knee, and why lower-level knee systems do not meet his needs. The proposed knee is indicated for K2 use and has stumble-recovery technology. He can charge it daily and respond to its alarms. Under Medicare's Lower Limb Prostheses coverage policy, how should the team handle his K2 designation?
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Correct answer: D - Consider coverage under the additional criteria for selected K2 beneficiaries
Question 8
After twisting her foot and ankle during tennis, a 31-year-old has midfoot pain and point tenderness over the navicular, together with mild anterolateral ankle pain. She took four steps immediately after the injury and can do so at examination. Neither malleolus is tender along its posterior distal edge or tip, and the base of the fifth metatarsal is nontender. Select the radiographic study indicated by the Ottawa ankle and foot rules.
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Correct answer: A - Foot radiographs only
Domain 4: Special Populations (16-20%)
Question 9
The parents of a nine-year-old with cerebral palsy are encouraged that he can take six unsupported steps in a quiet therapy room. At home and school, however, he normally walks with a posterior walker without hands-on assistance. He uses a wheelchair for community distances. For the GMFCS Expanded & Revised 6-to-12-year age band, which classification best represents his mobility?
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Correct answer: B - Level III, based on his usual walker-assisted indoor mobility
Question 10
A 71-year-old postmenopausal woman's technically valid DXA report gives a lumbar-spine T-score of -0.8 and a femoral-neck T-score of -2.8. She has no known fragility fracture. How should these findings be documented?
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Correct answer: A - Densitometric osteoporosis, based on the femoral-neck result
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