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 PRM questions are organized by exam domain, so you can see how each part of the Pediatric Rehabilitation Medicine blueprint is tested. Reveal the answer and explanation under each question.
Domain 1: Neurologic Disorders 50% of exam
Question 1
A 7-year-old with right hemiparetic cerebral palsy has persistent right forefoot contact and frequent tripping despite a well-fitting ankle-foot orthosis and gait therapy. With the knee extended, slow passive stretch permits 15 degrees of ankle dorsiflexion, but rapid stretch produces a catch at 20 degrees of plantarflexion. Active dorsiflexion is present, and there is no dystonia or fixed skeletal deformity. Which intervention most directly addresses the impairment limiting heel contact?
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Correct answer: B - Focal botulinum toxin type A injection with goal-directed gait training
Question 2
While supine for stretching, a 10-year-old with a chronic T4 spinal cord injury develops a pounding headache, facial flushing, and sweating. Blood pressure is 126/78 mmHg, compared with a usual 88/54 mmHg, and the pulse is 58/min. An abdominal binder is in place, and the urinary drainage bag has remained empty during the session. Monitoring and urgent clinical assistance are initiated. What should be done immediately?
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Correct answer: C - Sit the child upright, loosen the binder, and check catheter drainage
Question 3
A school therapist reports that a 9-year-old with bilateral spastic cerebral palsy can take six unsupported steps on a smooth clinic floor. At home and in nearly all school settings, the child walks with a posterior walker and requires adult assistance on stairs. A manual wheelchair is used for long community distances; sitting balance is independent. Which Gross Motor Function Classification System level best describes the child's current mobility?
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Correct answer: C - Level III
Question 4
Six weeks after a spinal cord injury, a cooperative 16-year-old has an ISNCSCI examination with bilateral sensory and motor levels of T10. Deep anal pressure is preserved, but S4-S5 light touch, pinprick, and voluntary anal contraction are absent. Both L2 hip flexors and the right L3 knee extensor are graded 3/5; all seven remaining key lower-extremity muscle functions are graded 0-2/5. No non-spinal condition limits testing. Which ASIA Impairment Scale grade applies?
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Correct answer: C - AIS C
Domain 2: Musculoskeletal Disorders 21% of exam
Question 5
For a 12-year-old receiving long-term glucocorticoids for Duchenne muscular dystrophy, new mid-back pain prompts imaging. Radiographs confirm two vertebral compression fractures; there has been no trauma, and no focal destructive bone lesion is present. A technically valid lumbar DXA, interpreted with appropriate pediatric size adjustment, gives a bone mineral density Z-score of -1.3. How should these findings be classified?
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Correct answer: D - Osteoporosis established by the atraumatic vertebral compression fractures
Question 6
A 13-year-old with obesity is sent to rehabilitation for persistent left knee pain. The knee examination is normal, but hip internal rotation is markedly limited and the leg rotates outward when the hip is flexed. The child can still walk with crutches and has no fever. What disposition is warranted before beginning a rehabilitation program?
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Correct answer: A - Stop weight bearing and arrange urgent orthopedic assessment
Domain 3: Cancer 5% of exam
Question 7
An 11-year-old being treated for acute lymphoblastic leukemia develops foot slap and difficulty climbing stairs. The regimen includes vincristine, dexamethasone, and intrathecal methotrexate. Ankle dorsiflexion is 2/5 bilaterally, ankle reflexes are absent, vibration is reduced at the great toes, and constipation has recently worsened. Hip flexion is 4/5 and hip motion is painless. Which treatment complication best accounts for this combination?
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Correct answer: B - Vincristine-associated peripheral neuropathy
Domain 4: Pain, Functional Syndromes, and Activity Intolerance 7% of exam
Question 8
During assessment of a 14-year-old's right-leg weakness, voluntary hip extension is markedly reduced but becomes strong when the opposite hip flexes against resistance. The leg also supports weight normally during an automatic stepping task. Sensation and reflexes are normal, pain does not limit testing, and the neurologist has explained the positive findings as a functional motor disorder. What should the physical therapist emphasize to restore walking?
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Correct answer: A - Task-oriented gait retraining using preserved automatic movement
Domain 5: Growth and Development 8% of exam
Question 9
An infant born at 28 weeks' gestation is seen in developmental follow-up 36 weeks after birth. The infant rolls from prone to supine, reaches equally with both hands, and sits while leaning on the hands, but cannot yet sit independently. Growth is steady, the neurologic examination is symmetric, and no skills have been lost. Which age-based interpretation is appropriate?
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Correct answer: A - 24 weeks corrected; supported sitting is consistent with expected motor development
Domain 6: Genetic Disorders 9% of exam
Question 10
A 3-year-6-month-old with Down syndrome is establishing rehabilitation care. The parents report restful sleep without snoring or witnessed apnea. The child has never had a sleep study. Thyroid, hearing, and vision surveillance are current, and there is no neck pain, swallowing difficulty, gait change, or abnormal neurologic finding. Which study is nevertheless indicated as routine health supervision?
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Correct answer: D - Overnight laboratory polysomnography
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