A licensed chiropractor seeking license reinstatement after a six-year lapse is sent a notice from the state board. Who initiates the NBCE SPEC application?
Patient Interview History
Question · Easy
Adult vitals: pick fast
Short
Using OPQRST, what does the 'P' stand for when documenting a new patient's chief complaint?
A 62-year-old patient reports new low back pain, unintentional 15-pound weight loss over three months, and a remote history of breast cancer. What is the most appropriate next step?
Question · Medium
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A 34-year-old patient with acute low back pain reports new urinary retention and saddle-distribution numbness. The most appropriate action is:
Which review-of-systems finding most strongly suggests vertebral osteomyelitis or septic discitis in a patient with new thoracic spine pain?
Within a SOAP note, where is the patient's self-reported pain rating of 6/10 documented?
An 80-year-old patient who fell from standing height onto a tile floor presents with mid-thoracic pain. Which factor most increases concern for occult vertebral fracture?
A patient's goal-oriented question 'Can I return to running by week 6?' is best documented in which SOAP component?
A 45-year-old construction worker reports gradual onset right shoulder pain over six weeks worsening with overhead lifting. Which OPQRST element most directly informs a tendinopathy vs. acute strain differential?
A new patient discloses he is currently taking warfarin for atrial fibrillation. Which documentation element is most critical before HVLA cervical adjusting?
Normal active cervical flexion range of motion in a healthy adult is approximately:
Physical Exam
Normal active lumbar flexion ROM in a healthy adult is approximately:
On the 0-5 manual muscle testing scale, a grade of 3 corresponds to:
An adult patient presents with resting blood pressure of 168/104 mmHg on two repeat measurements. The most appropriate chiropractic action is:
A patient demonstrates a positive Trendelenburg sign when standing on the right leg. Which muscle is most likely weak?
A 30-year-old patient demonstrates active cervical rotation of 50 degrees right and 80 degrees left. Which finding is most consistent with these measurements?
Resting heart rate considered normal for a healthy adult at rest is generally:
When measuring lumbar flexion ROM with a goniometer, which technique reduces hip-flexion contamination of the reading?
Question · Hard
Which examination finding distinguishes structural from functional scoliosis?
A patient presents with a body temperature of 101.4 degrees Fahrenheit and new low back pain. Which initial action is most appropriate?
The C7 dermatome is most reliably tested over which surface?
Neuromusculoskeletal Exam
Weakness of ankle dorsiflexion and great-toe extension with sensory loss over the dorsum of the foot most likely localizes to which nerve root?
A diminished Achilles deep tendon reflex is most consistent with a lesion of which nerve root?
Hyperreflexia, sustained ankle clonus, an upgoing Babinski response, and weakness without atrophy in the lower extremities most likely indicate:
Diagnosis Clinical Impression
A positive Spurling test most strongly suggests:
A positive straight leg raise (SLR) test reproducing radicular pain at 30-70 degrees most likely indicates:
The Lachman test is the most sensitive clinical exam for which structure?
Pain reproduced over the lateral elbow with resisted wrist extension and a positive Cozen test most likely indicates:
FABER (Patrick) test most directly evaluates:
Empty Can (Jobe's) test specifically isolates which rotator cuff muscle?
A positive Phalen's test (wrist flexion held 60 seconds reproducing paresthesia in the thumb, index, and middle fingers) most strongly suggests:
Adson's test is most useful in evaluating:
A patient with suspected meniscal injury demonstrates pain and a palpable click with combined knee flexion, tibial rotation, and slow extension. This describes:
Hoffman's sign — flicking the distal phalanx of the middle finger producing thumb and index flexion — is considered:
Yergason's test most directly evaluates:
Yeoman's test is primarily used to evaluate:
The C6 dermatome is best assessed over which surface?
A patient with weakness of elbow extension and a diminished triceps reflex most likely has involvement of:
A patient has a 4+ deep tendon reflex with non-sustained clonus at the right Achilles. Which grade does this represent?
Drop arm test is most useful in evaluating:
On a lateral cervical radiograph the atlanto-dental interval (ADI) in an adult should not exceed:
Xray Diagnosis
The mnemonic ABCS for systematic radiographic interpretation stands for:
A lateral lumbar radiograph shows L5 displaced anteriorly on S1 by approximately 30%. Using the Meyerding grading system this is:
George's line refers to the smooth contour formed on a lateral cervical radiograph by the:
Schmorl's nodes on a lumbar radiograph represent:
Modic Type I changes on lumbar MRI represent:
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