SPEC Chiropractic Practice Exam

These questions are part of the practice quiz. Start practicing

• What is the recommended initial step when a subpoena requests patient records?
• In a patient with ankylosing spondylitis presenting with acute low back pain, what is the recommended course of action for the chiropractor?
• The C7 nerve root controls which movement pattern?
• Fosamax is the brand name for which drug?
• Temporal arteritis commonly presents with jaw claudication and scalp tenderness in patients over 50; which lab finding is often elevated?
• Knee swelling with warmth and erythema and first MTP pain is most consistent with which condition?
• Which class of antidepressants may increase bleeding risk?
• Under Medicare, which type of care is reimbursed?
• Which tissues are most relevant when interpreting spinal MRI for signs of nerve compression?
• Which condition corresponds to the letter T in VOMIT red flags?
• Which statement best illustrates a maintenance care justification in documentation?
• Pain that worsens with walking and eases with leaning forward is most consistent with which condition?
• A court order to compel production of documents is called what?
• In a healthcare setting, which scenario constitutes battery?
• The 'Thompson Drop' within FAT AD refers to which technique?
• Which of the following is not listed as a FAT AD component?
• Which movement is primarily associated with the L4 nerve root?
• An SLR performed to 45 degrees or less indicates irritation of which disc levels?
• Which statement about prognosis is true when centralization is present?
• Which combination suggests meningitis?
• In the VOMIT acronym used for red flags, what directive is indicated?
• Which option describes Unbundling?
• When terminating care, which action is recommended to avoid abandonment?
• Which ligament injury is commonly evaluated with the anterior drawer test of the ankle?
• Lateral leg and great toe extension is primarily associated with which spinal nerve root?
• Pain walking > standing still is most typical of which condition?
• Which tissues would you expect MRI to describe when documenting spinal pathology affecting both the disc and adjacent neural elements?
• For patients taking anticoagulants (e.g., Warfarin, Eliquis, Xarelto), which adjustment is contraindicated?
• A forced plantarflexion injury with positive anterior drawer test and marked instability corresponds to which grade of ATFL tear?
• A positive Tinel's sign at the elbow suggests entrapment of which nerve?
• Which provocative test is described for Carpal Tunnel syndrome?
• What is required to avoid abandonment when discontinuing care?
• Chiropractic Biophysics (CBP) is best described as which technique?
• Which tissue categories are routinely considered in interpreting an MRI scan of the spine?
• Progressive neurological deficit in a patient with suspected spinal cord involvement necessitates which immediate step?
• During spinal MRI analysis, which structures constitute the primary soft tissue elements of interest?
• To document subluxation on examination, you must demonstrate at least how many of the following criteria: pain or tenderness, asymmetry, ROM abnormality, tissue tone changes?
• Spurling's Test is used to assess for which condition?
• Patients taking corticosteroids like prednisone have increased risk of which issues?
• Which elements are typically documented to indicate subluxation in a chiropractic note?
• Subpoena Duces Tecum refers to what court action?
• Which nerve root level primarily mediates hip flexion of the anterior thigh?
• Which sensory distribution corresponds to the C6 nerve root?
• What does the SOFE acronym stand for in this practice framework?
• In evaluating a suspected spinal canal stenosis via MRI, which tissue groups are central to the assessment?
• Which setting is most appropriate for emergent evaluation of a patient with fever, intravenous drug use, and severe back pain?
• What is a recommended action when terminating a patient, besides documenting the reason?
• Flexion-Distraction is indicated for which conditions?
• Which statement best justifies maintenance care for sustaining a specific functional goal?
• In the Red Flag COLD SPAN acronym, what does the letter D stand for?
• Which statement best defines abandonment in clinical practice?
• What term describes unauthorized touching of a patient, even if no harm occurs?
• Which test is used to assess IT Band tightness?
• Which statement about centralization is true?
• Peripheralization of symptoms during care for disc herniation indicates neural irritation and suggests what about the current technique?
• In the FAT AD framework, the acronym is used to categorize what?
• In lumbar spine MRI, which tissue combination is most relevant for detecting degenerative changes?
• After four weeks with no improvement, which action should be taken?
• During Neer's test, pain with forward flexion most strongly suggests which condition?
• Which presentation indicates Cauda Equina Syndrome?
• Which nerve root is associated with sensations in the anterior/ medial thigh and the patellar reflex, as described?
• Activator / Low-Force technique is particularly suitable for which patient group?
• If there is a progressive neurological deficit suggesting possible cord compression, what is the appropriate next step?
• Which headache type presents as unilateral, orbital headaches with autonomic symptoms such as lacrimation and rhinorrhea?
• For pre-surgical planning of complex fractures, which imaging modality is preferred?
• During care for disc herniation, where does peripheralization of symptoms indicate pain is moving?
• Which finding most strongly indicates urgent MRI and surgical consultation for possible spinal cord compression?
• For suspected cancer with metastasis, occult fracture, or infection causing unexplained bone pain, which imaging is best?
• Which action best illustrates abandonment?
• Which combination of symptoms is most suggestive of a malignancy requiring oncology referral?
• Which tissues are highlighted by MRI when assessing the cervical spine for soft tissue abnormalities?
• The T1 myotome is associated with which motor function?
• Disc herniation presents with radicular pain and a positive straight-leg raise, with MRI showing disc protrusion or extrusion. Which condition is described?
• Adson's Test is used to evaluate for which condition?
• In the Red Flag acronym COLD SPAN, what does S stand for?
• Which condition warrants avoidance of cervical manipulation and referral for neurosurgical evaluation?
• Which finding alone should prompt oncology referral in an appropriate clinical context?
• McMurray's test is most consistent with which knee pathology?
• Which condition requires avoiding HVLA due to risk of epidural hematoma?
• In the VOMIT red flags, which condition corresponds to the letter O?
• For a comprehensive spinal MRI interpretation, which tissues are central to assessing soft tissue involvement?
• Which condition corresponds to the letter I in VOMIT red flags?
• Which imaging is most appropriate to evaluate disc herniation with cord compression or cauda equina symptoms?
• What does CBP require to implement effectively?
• What is the strongest predictor of a successful return-to-work outcome for a patient with mechanical low back pain?
• When progress plateaus before goals are met, what is an appropriate course of action?
• Knee extension is primarily controlled by which myotome?
• If you change the technique during treatment, what must you obtain from the patient?
• Which scenario is an example of negligence?
• A positive FABER (Patrick's) test most strongly suggests pathology in which region?
• For a patient with radicular symptoms, which tissues are most pertinent on spinal MRI?
• Which movement is primarily associated with the L5 nerve root?
• Which of the following best describes Fee Splitting?
• Sertraline and Fluoxetine belong to which class of antidepressants?
• Temporal arteritis typically presents with unilateral scalp tenderness and jaw claudication in patients older than 50; which finding is commonly elevated?
• Which nerve root is associated with the lateral foot and Achilles reflex?
• Which may be filed to secure payment in a personal injury claim?
• Which diagnosis is indicated by lateral elbow pain with gripping and a positive resisted wrist extension test?
• Which two selective serotonin reuptake inhibitors are explicitly named in the material?
• Tearing chest pain with a blood pressure differential between arms indicates which emergent condition?
• Contralateral Straight-Leg Raise is highly specific for which condition?
• Chiropractic Biophysics (CBP) is primarily focused on which objective?
• Which area is affected by radial nerve compression?
• The Positive Empty Can Test primarily assesses pathology of which structure?
• Which condition is listed as a primary contraindication to HVLA due to the risk of neurological compromise?
• Which of the following is considered a good prognostic sign in nerve-related pain management?
• Which finding is most consistent with a complete tear of the ATFL?
• Which coding system is used for diagnoses in SOAP A?
• X-ray imaging primarily assesses bone integrity and fractures.
• Which technique is indicated for pelvic imbalances and cranial dysfunction and requires specific training?
• Ober's test assesses tightness of which structures?
• X-ray requirements as per guidelines: which statement is true?
• Which combination is classic for spinal epidural abscess requiring emergent evaluation in the emergency department?
• In the Red Flag acronym COLD SPAN, what does A stand for?
• Which statement best describes Anti-Kickback?
• Which elements belong to the SOAP O (Objective) component?
• HVLA (Diversified) is typically used for what type of joint dysfunction?
• In the FAT AD schema, the 'Activator' technique is indicated for which patient characteristics?
• Who is responsible for payment for maintenance care?
• The primary rationale for flexion-distraction is to open the posterior annulus and reduce intradiscal pressure by what mechanism?
• Which scenario is a valid reason to order an X-ray in a chiropractic assessment?
• Activator / Low-Force Contraindication is what?
• Which condition is a contraindication for HVLA due to bleeding risk?
• When no improvement after a trial period, which adjustment to the care plan is recommended?
• When outlining MRI findings of the spine, which tissues are commonly described together?
• Yeoman's test is primarily used to assess which condition?
• Which advertising guideline is correct when promoting chiropractic services?
• What is required for the SOT approach?
• Which test is NOT used to assess shoulder pathology but is used to evaluate sacroiliac joint dysfunction?
• When treating patients on opioid medications such as oxycodone or hydrocodone, what should clinicians monitor?
• When advertising spinal decompression, which statement is correct?
• A positive Tinel's sign at the wrist indicates compression of which nerve?
• Chronic low back pain with morning stiffness in a young man suggests which diagnosis?
• Gaenslen's test is primarily used to assess which condition?
• Which technique is most associated with postural correction and structural rehabilitation but requires specific training and equipment?
• C7 sensory distribution is best described by which digit?
• Renting space to a medical doctor: which statement describes a fee-splitting concern?
• In a patient with acute low back pain and a 20-year history of ankylosing spondylitis, what is the recommended chiropractor's action?
• Spondylolysis is best described as which of the following?
• Which agreement is required for third-party vendors handling PHI?
• What does the SOAP A (Assessment) component typically include?
• Res Ipsa Loquitur describes a situation in which negligence is obvious.
• What is the recommended action when you receive a subpoena for patient records?
• The Drop Arm test is positive when the patient cannot maintain abduction due to what underlying pathology?
• What should records document in a personal injury case?
• Which of the following is a risk factor for pulmonary embolism?
• Which sequence correctly matches nerve roots to their corresponding movements (L4, L5, S1)?
• Spondylolysis is best described as what on imaging?
• Lysis is best defined as which of the following?
• In a case study of spinal injury, which tissues are typically identified on MRI as the primary structures of interest?
• When leaving a voicemail that includes clinical details, what is required to protect patient privacy?
• Which statement best describes the Thompson Terminal Point concept?
• How should osteoporosis influence adjusting technique?
• Which headache is unilateral, occipital, associated with neck pain, with variable duration?
• Which imaging modality is best for detailed bony detail in complex fractures or when MRI is contraindicated, including trauma and pre-surgical planning?
• Which tear is described as the most common ankle sprain?
• Deep gluteal pain aggravated by sitting with a trigger point reproducing radicular-like symptoms down the posterior thigh is most characteristic of which condition?
• Respondeat Superior establishes which party's liability?
• If you receive a subpoena for patient records, what is the proper action?
• The lateral foot and Achilles reflex plantar flexion corresponds to which nerve root?
• In headaches with neck pain after trauma, which assessment should be ruled out first?
• Which arthritis is characterized by psoriasis with DIP joint involvement?
• Which condition corresponds to the letter M in VOMIT red flags?
• Which action is most closely associated with the C6 nerve root?
• Which reflex is most commonly associated with the C6 nerve root?
• Which of the following is Nimmo Receptor-Tonus?
• Which autoimmune disease is classically associated with a butterfly (malar) rash, joint pain, and photosensitivity?
• Which patient right allows requesting corrections to medical records?
• Which presentation indicates Vertebral Artery Dissection risk?
• Spurling's test is used to suggest which condition when positive?
• Which is a component of medical necessity requirements?
• In the COLD SPAN acronym, which term represents Drug use?
• Fee splitting: which describes illegal practice?
• Flexion-Distraction Contraindication includes which of the following?
• Which sign is associated with Vertebral Artery Dissection presenting after neck manipulation?
• Which condition is listed as a contraindication to Thompson Drop therapy, mirroring HVLA contraindications?
• Regarding radiographs, when are X-rays required?
• Who do patient records belong to?
• In the VOMIT red flags, which term corresponds to the letter T?
• Which tissues are part of the standard MRI assessment in spinal pathology related to chronic back pain?
• When discussing a patient's case with their spouse when the patient is not present, which is required?
• Which myotome is tested by great toe extension?
• In the Red Flag COLD SPAN acronym, which term corresponds to systemic conditions other than cancer?
• Simply closing without notice constitutes which of the following?
• If a chiropractor changes the adjusting technique, what must occur?
• Lumbar radiculopathy would typically present with which finding?
• In the context of disc herniation treatment, what is the effect of a protocol that emphasizes frequent flexion-distraction with extension avoidance?
• Which term describes unauthorized physical contact in a healthcare setting that is harmful or offensive?
• SOFE framework: which is the last component?
• What condition is characterized as an inflammatory spondyloarthropathy with progressive spinal fusion?
• For a non-licensed individual performing therapeutic modalities under indirect supervision, what is the most critical legal requirement?
• The patellar reflex corresponds to which spinal nerve root?
• Statute of Limitations refers to what?
• Which statement best describes segmental instability in the spine as it relates to HVLA safety?
• Which finding best indicates shoulder impingement during the Hawkins-Kennedy test?
• In the SOAP O section, which items are typically recorded?
• When a solo practitioner closes for two weeks for continuing education, which action maintains continuity of care?
• Which condition is defined by vertebral slippage on the lateral X-ray view with grading I-V?
• Which scenario best illustrates res ipsa loquitur?
• Which headache is unilateral, orbital, severe with lacrimation, rhinorrhea, and ptosis, typically occurring in clusters lasting 15 minutes to 3 hours?
• Neck pain with Horner's syndrome after manipulation suggests which urgent diagnosis?
• Segmental instability, such as Grade III/IV spondylolisthesis or traumatic/post-surgical instability, is a primary contraindication to HVLA manipulation because it may ...
• Delayed care for mechanical low back pain is associated with which outcome?
• A physician orders an MRI to assess a suspected disc herniation. Which tissue set does MRI best evaluate?
• The C5 nerve root is most closely associated with which movement?
• Listhesis refers to which spinal concept?
• What action is recommended when there is no improvement after four weeks?
• Which statement describes Stark Law?
• Which presentation best indicates aortic dissection?
• Which condition is a contraindication to HVLA (Diversified) techniques?
• Which finding helps differentiate piriformis syndrome from lumbar radiculopathy?
• In the Red Flag acronym COLD SPAN, what does N stand for?
• Which headache type presents with bilateral, band-like pressure and no nausea or photophobia, lasting hours to days?
• Which doctrine holds an employer responsible for the actions of its employees?
• What is a key rule when advertising FDA clearance for chiropractic service?
• Which technique uses an adjusting instrument to deliver a preset force to the pisiform to correct a subluxation of the lunate?
• The Statute of Limitations defines what aspect of a lawsuit?
• What positioning is recommended for pregnant patients during chiropractic care?
• Which area is primarily supplied by the C5 sensory fibers?
• Which nerve is affected in Carpal Tunnel syndrome?
• What does informed consent entail?
• What term describes touching a patient without consent?
• The S2-4 nerve distribution corresponds to which anatomical area commonly referred to as the saddle area?
• In the COLD SPAN acronym, which term represents Cancer?
• Failure to exercise reasonable care resulting in harm is called?
• Is authorization required to discuss a patient's case with a specialist or other medical provider for treatment purposes under the TPO exception?
• Which risk is specifically associated with manual manipulation of the spine?
• Before initiating treatment for a new episode of care, what type of examination is required?
• A Positive Empty Can Test is most closely associated with a Rotator Cuff tear.
• Which scenario would constitute fee splitting?
• Paresthesias in the lateral three digits with provocative wrist symptoms indicates compression of which nerve?
• The FAT AD component 'Flexion Distraction' is primarily used for which condition?
• If active care for a lumbar disc herniation shows increased peripheralization after manipulation, what should the chiropractor do?
• Stare Decisis is the principle of standing by things decided; what does it establish?
• In the Red Flag COLD SPAN acronym, what does the letter L stand for?
• Alendronate (Fosamax) is a member of which class of osteoporosis medications?
• Which movement is primarily controlled by the L4 myotome?
• Benign paroxysmal positional vertigo (BPPV) is most closely associated with which mechanism?
• Which nerve root corresponds to finger abduction of the medial arm?
• Which test assesses sacroiliac joint dysfunction and is described as producing pain with hip extension?
• Positive Dix-Hallpike test reproduces dizziness and nystagmus with head rotation and extension. This finding indicates which condition?
• Which sensory complaint is most consistent with ulnar nerve compression?
• For soft tissue issues with neurological deficit or suspected cauda equina, which imaging is best?
• In privacy terminology, the acronym TPO stands for which three activities?
• The Adson's maneuver tests for compression of which artery?
• Which finding most strongly indicates possible spinal cord compression requiring urgent imaging and specialty referral?
• Which statement correctly describes the effect of flexion-distraction on neural elements?
• Which nerve root is associated with hip flexion of the anterior thigh?
• In the Red Flag COLD SPAN acronym, what does the letter C stand for?
• In ankylosing spondylitis, why is spinal fracture risk increased even with minor trauma?
• In the mnemonic BNA, what does 'Battery' signify?
• Numbness with wrist flexion is most consistent with which condition?
• Which technique is known as the Thompson Terminal Point?
• In spinal MRI, which tissues are primarily evaluated for degenerative changes and pathology?
• Which statement best describes Upcoding?
• In SOAP notes, which component ensures alignment between subjective complaints and objective findings when forming the assessment?
• The Anterior Drawer test of the ankle primarily assesses injury to which ligament?
• During a transition of care when terminating treatment, should emergency coverage be offered?
• When terminating a patient, what is a recommended action besides documenting the reason for termination?
• In screening for spinal pathology with MRI, which tissue categories should be documented as findings?
• The Ober's Test assesses tightness of which structures?
• Which scenario illustrates negligence in a clinical setting?
• Which term describes the condition of vertebral slippage?
• Which legal doctrine describes negligence that is obvious and does not require expert testimony?
• In the VOMIT red flags, which term corresponds to the letter O?
• Which movement is primarily associated with the S1 nerve root?
• Who is legally responsible for the care provided by a non-licensed individual performing modalities under indirect supervision?
• Which statement about national provider identifiers (NPIs) is correct for chiropractors?
• A patient presents with acute pleuritic chest pain, tachycardia, and tachypnea. Which condition should be suspected?
• Which technique corresponds to Nimmo Receptor-Tonus?
• Who may request medical records with authorization in a personal injury/insurance context?
• The anterior/medial thigh patellar reflex corresponds to which spinal nerve root?
• Numbness in the medial thigh with a diminished patellar reflex is most consistent with involvement of which nerve root?
• In SOAP notes, what best describes the S (Subjective) component?
• Is authorization needed to discuss payment or billing with the insurance company under the TPO exception?
• An X-ray exam is typically used to evaluate which of the following in a patient with suspected spinal injury?
• What is required to terminate care according to the material?
• What is a potential consequence of coding fraud such as Upcoding or Unbundling?
• To justify maintenance care, what must documentation demonstrate?
• Technique Selection in chiropractic practice is based on what principle?
• When a practitioner closes for continuing education, what ethical obligation regarding patient care is most appropriate?
• Medicare pays for which type of chiropractic care?
• In FAT AD, the 'Active' component aligns with which adjustment style?
• Peripheralization is defined as pain moving in which direction along the limb?
• Which test is used to diagnose lateral epicondylitis?
• Paresthesia in the lateral three digits with a positive Tinel’s sign at the wrist indicates compression of which nerve?
• When is Thompson Drop used?
• What is the billing stance described for modalities such as spinal manipulative therapy and adjunctive therapies?
• Cauda equina syndrome is most accurately identified by which triad?
• The 'Red Flag FAT AD D' term indicates which concept?
• Which test is NOT used to assess shoulder pathology but is used to evaluate sacroiliac joint dysfunction?
• Flexion-distraction applies repetitive, non-rotary flexion to the lumbar spine. Which statement about this technique is true?
• The technique used for patients who dislike manual thrust is which?
• SOT stands for Sacro- Occipital Technique and addresses what?
• In the VOMIT red flags, which term corresponds to the letter M?
• In the VOMIT red flags, which term corresponds to the letter I?
• CBP stands for Chiropractic Biophysics and focuses on what?
• In the Red Flag acronym COLD SPAN, what does P stand for?
• What does the term Stare Decisis refer to in the legal system?
• When peripheralization of symptoms occurs, which technique modification is recommended?
• Which statement best reflects IRS guidelines in employment classification?
• Spinal stenosis presents with neurogenic claudication relieved by leaning forward; MRI shows a narrowed canal. Which condition is described?
• For a pregnant patient, what is the recommended positioning during adjustments?
• Which signs best describe Cauda Equina and require urgent ER referral?
• A forced plantarflexion injury with a positive anterior drawer test, moderate swelling, ecchymosis, and point tenderness indicates which grade of ATFL sprain?
• What transition period is typically recommended when terminating care?
• The CUB acronym is associated with which concept?
• Which imaging modality provides best evaluation for suspected rotator cuff tears when persistent symptoms remain after initial management?
• Which condition is a VOMIT red flag requiring immediate referral due to potential vertebral artery dissection?
• Which action is NOT appropriate when Cauda Equina signs are suspected?
• C8 nerve root corresponds to which finger movement?
• Which statement about anticoagulated patients and HVLA is true?
• In a pregnant patient, what is recommended regarding positioning during adjustments?
• Which scenario would trigger an ER stroke alert related to Vertebral Artery Dissection?
• Crossed straight-leg raise is particularly specific for which MRI finding?
• L5 radiculopathy would typically present with weakness in which movement?
• Informed consent is a process; when should you re-consent?
• What is the primary biomechanical goal of flexion-distraction technique for a symptomatic lumbar disc bulge?
• The statute of limitations defines the time limit to file a lawsuit, which varies by which jurisdiction?
• Which chiropractic technique is associated with Nimmo Receptor-Tonus?
• Which statement best describes adjunctive therapies billing in relation to CMT according to the notes?
• Which combination is characteristic of Cauda Equina Syndrome?
• Which statement best defines negligence in a clinical context?
• What does a chiropractor use to create a treatment plan with frequency, duration, and goals?
• Spondylolisthesis is defined as vertebral slippage with grading I-V on X-ray lateral view. Which option describes this finding?
• Which headache is characterized by unilateral, throbbing pain with nausea and photophobia lasting hours to days?
• Which of the following is NOT a component of the SOFE framework?
• Which term describes billing separately for services that should be bundled?
• Which osteoporosis medication is associated with increased fracture risk when high-velocity, low-amplitude manipulation (HVLA) is performed?
• Chronic use of NSAIDs such as ibuprofen or naproxen is associated with which risks?