100+ Free SMS Practice Questions

Pass your RESNA SMS Seating and Mobility Specialist exam on the first try — instant access, no signup required.

✓ No registration✓ No credit card✓ No hidden fees✓ Start practicing immediately

Not publicly disclosed Pass Rate

100+ Questions

100% Free

1 / 10

Question 1

Score: 0/0

During a seating and mobility assessment, the clinician observes a client with a fixed posterior pelvic tilt and sacral sitting posture. Which is the MOST critical initial concern?

Reduced ability to self-propel a manual wheelchair

Increased risk of sacral/coccygeal pressure injury

Difficulty reaching overhead objects from the chair

Limited trunk extension range of motion

to track

2026 Statistics

Key Facts: SMS Exam

400

Scaled Passing Score

100-600 scale

165

Exam Questions

Multiple choice

$425

Total Exam Cost

$125 app + $300 exam

1,000

Hours Required

Seating/mobility experience

ATP

Prerequisite

Must hold current ATP

NCCA

Accreditation

National standard

The SMS exam consists of 165 multiple-choice questions administered at Prometric test centers worldwide. A scaled score of 400 (on a 100-600 scale) is required to pass. Candidates must hold current ATP certification and have at least 1,000 hours of seating and mobility service experience. The exam covers client assessment, intervention planning, equipment implementation, outcome evaluation, and professional conduct. RESNA's certification program is NCCA accredited.

Sample SMS Practice Questions

Try these sample questions to test your SMS exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1During a seating and mobility assessment, the clinician observes a client with a fixed posterior pelvic tilt and sacral sitting posture. Which is the MOST critical initial concern?

A.Reduced ability to self-propel a manual wheelchair

B.Increased risk of sacral/coccygeal pressure injury

C.Difficulty reaching overhead objects from the chair

D.Limited trunk extension range of motion

Explanation: A fixed posterior pelvic tilt causes weight bearing over the sacrum and coccyx rather than the ischial tuberosities, dramatically increasing pressure injury risk. While other concerns are valid, skin integrity is the most immediate clinical priority because pressure injuries can become life-threatening. Addressing the pelvic position through seating intervention protects skin and improves overall posture.

2What is the primary purpose of pressure mapping during a seating evaluation?

A.To assess the client's upper extremity strength for propulsion

B.To calculate the exact wheelchair seat width needed for the client

C.To determine the client's body weight distribution for wheelchair frame selection

D.To objectively measure and visualize interface pressure between the client and support surface

Explanation: Pressure mapping provides an objective, visual representation of the pressure distribution at the interface between the client and the seating surface. It identifies areas of high pressure concentration that may lead to tissue breakdown. While the data can inform overall seating decisions, the primary purpose is measuring interface pressure, not determining frame size, seat width, or upper extremity strength.

3A client presents with a flexible kyphotic posture that corrects with manual support. Which seating approach is MOST appropriate?

A.A contoured back support with lateral thoracic supports to facilitate correction

B.No back support modification since the posture is flexible

C.A sling upholstery back that conforms to the kyphosis

D.A rigid flat back support to force upright posture

Explanation: When a kyphotic posture is flexible (correctable), the seating system should facilitate correction rather than accommodate the deformity. A contoured back support with lateral thoracic supports provides the guidance needed to maintain a more upright trunk alignment. A rigid flat back would be uncomfortable and inappropriate; sling upholstery would accommodate and worsen the kyphosis; and no modification would miss the opportunity to improve posture.

4Which measurement is essential to determine proper wheelchair seat depth?

A.Distance from the posterior buttock to the popliteal fossa, minus 1-2 inches

B.Overall thigh length from hip to ankle

C.Hip width measured at the widest point

D.Distance from seat surface to the top of the shoulder

Explanation: Proper seat depth is determined by measuring from the posterior buttock to the popliteal fossa (back of the knee), then subtracting approximately 1-2 inches to prevent pressure behind the knees. This clearance avoids compression of the popliteal vessels and nerves. Hip width determines seat width, not depth. Full thigh-to-ankle length and seat-to-shoulder measurements serve other fitting purposes.

5During a seating evaluation, a client with C5-C6 spinal cord injury demonstrates bilateral wrist extension but no finger flexion. Which power wheelchair access method is MOST appropriate?

A.Sip-and-puff drive control

B.Head array control system

C.Proportional joystick with a U-shaped or goal-post handle

D.Standard proportional joystick with standard knob

Explanation: A client with C5-C6 SCI typically has wrist extension (allowing tenodesis grasp) but limited or absent finger flexion. A proportional joystick with a U-shaped or goal-post handle allows the client to use wrist extension to push the joystick in all directions without requiring grip strength. Standard knobs require grip. Sip-and-puff and head arrays are used for clients with higher-level injuries who cannot use their hands.

6What is the recommended frequency for performing weight shifts (pressure relief) for a wheelchair user at risk for pressure injuries?

A.Every 15-30 minutes for at least 30-60 seconds

B.Only when the client reports discomfort

C.Once per hour for 5 minutes

D.Every 2 hours for at least 1 minute

Explanation: Current clinical practice guidelines recommend performing weight shifts every 15-30 minutes for a duration of at least 30-60 seconds to allow tissue reperfusion. Waiting 2 hours between shifts or relying on client-reported discomfort is insufficient, as tissue damage can occur before pain is perceived. The frequency and duration allow adequate blood flow restoration to compressed tissues.

7A client has a fixed pelvic obliquity with the right side lower than the left. What is the MOST appropriate cushion intervention?

A.A cushion with extra material removed under the lower (right) side to accommodate the obliquity

B.A cushion built up under the right ischial tuberosity to level the pelvis

C.A flat foam cushion to provide uniform support

D.A standard air flotation cushion set to equal pressure

Explanation: For a fixed (non-correctable) pelvic obliquity, the goal is accommodation rather than correction. Removing material or creating a well under the lower side allows the pelvis to sit in its natural position while distributing pressure more evenly. Building up under the lower side would attempt to correct a fixed deformity, causing discomfort and potentially increasing pressure. A flat cushion or standard air cushion would not address the asymmetry.

8Which wheelchair type is classified as Complex Rehab Technology (CRT)?

A.A lightweight folding wheelchair with standard components

B.A transport chair used for short-distance mobility

C.A standard depot wheelchair with fixed armrests

D.An individually configured power wheelchair with tilt-in-space seating

Explanation: Complex Rehab Technology (CRT) includes individually configured manual and power wheelchairs with specialized seating systems designed for people with complex medical conditions. An individually configured power wheelchair with tilt-in-space meets CRT criteria. Standard depot wheelchairs, basic lightweight chairs, and transport chairs are considered standard mobility equipment, not CRT.

9When assessing a client's home environment for wheelchair accessibility, which doorway width is the MINIMUM needed for standard wheelchair passage?

A.24 inches

B.32 inches

C.28 inches

D.36 inches

Explanation: The minimum doorway width for standard wheelchair passage is 32 inches clear opening. The ADA recommends 36 inches for comfortable passage, but 32 inches is the minimum functional width for most wheelchairs. A 24- or 28-inch opening is too narrow for wheelchair access. Environmental assessment includes measuring doorways to determine if modifications are needed or if a narrower wheelchair is required.

10Which factor is MOST important when selecting between a front-wheel drive and a rear-wheel drive power wheelchair for a client?

A.The availability of the wheelchair from the supplier

B.The weight of the wheelchair for transport

C.The client's preferred wheelchair color

D.The primary environments of use and turning radius requirements

Explanation: Drive wheel configuration significantly affects maneuverability and performance. Front-wheel drive chairs have excellent outdoor tracking and can climb obstacles well. Rear-wheel drive chairs offer predictable handling and stability at higher speeds. The primary environments of use (indoor tight spaces vs. outdoor terrain) and turning radius needs are the most important factors in this clinical decision. Color, availability, and transport weight are secondary considerations.

About the SMS Exam

The RESNA Seating and Mobility Specialist (SMS) certification is an advanced credential for professionals working in wheelchair seating, positioning, and mobility. The 165-question exam covers four weighted domains: Assessment of Need (33%), Development of Intervention Strategies (26%), Implementation of Intervention (26%), and Evaluation of Intervention (15%), plus Professional Conduct integrated throughout. It builds on the ATP certification and requires 1,000+ hours of direct seating and mobility experience.

Questions

165 scored questions

Time Limit

Not published (computer-based at Prometric)

Passing Score

400 (scaled, 100-600 range)

Exam Fee

$425 ($125 application + $300 exam) (RESNA / Prometric)

SMS Exam Content Outline

33%

Assessment of Need

Determining referral needs, physical and functional assessment, pressure mapping, skin integrity evaluation, postural analysis, environmental assessment, manual and power mobility evaluation, assistive technology integration, goal setting with clients and stakeholders

26%

Development of Intervention Strategies

Funding resources and coverage, Medicare LCD/NCD requirements, letter of medical necessity, cost-benefit analysis, prior authorization, appeals processes, product selection and justification documentation

26%

Implementation of Intervention

Equipment fitting and setup, manual wheelchair configuration, power wheelchair programming, postural support installation, component integration, client training, caregiver education, troubleshooting, safety verification, documentation

15%

Evaluation of Intervention

Outcome measurement and documentation, goal achievement assessment, equipment performance review, follow-up planning, reassessment triggers, modification of intervention strategies, client satisfaction evaluation

How to Pass the SMS Exam

What You Need to Know

Passing score: 400 (scaled, 100-600 range)
Exam length: 165 questions
Time limit: Not published (computer-based at Prometric)
Exam fee: $425 ($125 application + $300 exam)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

SMS Study Tips from Top Performers

1Focus most study time on Assessment of Need (33%) — master physical assessment, pressure mapping interpretation, and postural analysis techniques

2Learn the Medicare LCD/NCD requirements for complex rehab technology (CRT) — funding justification is heavily tested in the intervention strategies domain

3Understand the differences between manual wheelchair types (standard, lightweight, ultra-lightweight) and when each is clinically appropriate

4Study power wheelchair drive configurations (front-, mid-, rear-wheel drive) and their advantages for different client needs and environments

5Know cushion technologies (air, foam, gel, hybrid) and how to select based on pressure redistribution needs and client factors

6Review ANSI/RESNA wheelchair standards and WC-19 transportation safety standards — these appear throughout the exam

7Practice writing letters of medical necessity and understand what documentation Medicare requires for prior authorization

8Study pediatric seating considerations including growth accommodation and developmental positioning needs

Frequently Asked Questions

What is the RESNA SMS certification exam?

The Seating and Mobility Specialist (SMS) is an advanced specialty certification from RESNA for professionals working in wheelchair seating, positioning, and mobility. The exam consists of 165 multiple-choice questions covering assessment, intervention planning, implementation, outcome evaluation, and professional conduct. It is administered at Prometric test centers and requires a scaled score of 400 (out of 600) to pass.

What are the SMS certification prerequisites?

To sit for the SMS exam, you must hold a current RESNA Assistive Technology Professional (ATP) certification in good standing, have at least 1,000 hours of direct, in-person consumer service delivery experience in seating and mobility, and have completed two types of professional activities within the past 5 years (such as mentoring, presentations, publications, or leadership activities).

How much does the SMS exam cost?

The SMS exam costs a total of $425: a $125 non-refundable application fee plus a $300 exam fee invoiced after application approval. If you need to retake the exam, the retake fee is $150, available for up to one year after your original test date. There is a 90-day waiting period between attempts.

What are the SMS exam content domains?

The 2024 SMS exam blueprint covers four weighted domains: Assessment of Need (33%), Development of Intervention Strategies/Action Plan (26%), Implementation of Intervention (26%), and Evaluation of Intervention/Follow-Up (15%). A fifth domain, Professional Conduct, has no assigned weight but is integrated throughout the exam as an overarching principle.

How is the SMS exam scored?

The SMS exam uses scaled scoring ranging from 100 to 600. You need a score of 400 or above to pass. Your score is based only on the total number of correct answers — there is no penalty for guessing. At the end of the exam, you receive a preliminary pass/fail result. If you do not pass, your score report includes diagnostic information showing performance levels (Proficient, Marginal, Not Proficient) in each domain.

What is the difference between ATP and SMS certification?

The ATP (Assistive Technology Professional) is a broad-based certification covering all major areas of assistive technology. The SMS is a specialty certification focused specifically on seating, positioning, and wheeled mobility. ATP certification is a prerequisite for the SMS. The SMS demonstrates advanced competence in wheelchair assessment, fitting, and follow-up — areas that the ATP covers only at a general level.