NATA-BOC Questions and Answers 2 — Questions and Answers

Question 1: What is the recommended ratio of compression to ventilation during adult CPR performed by two healthcare providers?

15:2
30:2 (Correct answer)
15:1
30:1

Correct answer: 30:2

For two-rescuer adult CPR, the recommended compression-to-ventilation ratio is 30:2. This ratio ensures adequate blood flow while providing necessary oxygenation through ventilation.

The American Heart Association (AHA) guidelines recommend a 30:2 compression-to-ventilation ratio for adult CPR, whether performed by one or two rescuers. This ratio was established to maximize the number of uninterrupted compressions and maintain coronary perfusion pressure. For pediatric CPR with two healthcare providers, the ratio changes to 15:2 due to the increased importance of ventilation in the pediatric population (respiratory causes of cardiac arrest are more common). Compressions should be performed at a rate of 100-120 per minute with a depth of 2 to 2.4 inches, allowing full chest recoil between compressions. Minimizing interruptions in compressions is critical — the 'compression fraction' (percentage of time compressions are being delivered) should be at least 60%.

Question 2: An athletic trainer is designing a rehabilitation program for an athlete recovering from ACL reconstruction. During which phase should closed kinetic chain exercises be emphasized?

Acute phase (Week 1-2)
Early rehabilitation (Week 2-6)
Intermediate rehabilitation (Week 6-12) (Correct answer)
Advanced rehabilitation (Week 12+)

Correct answer: Intermediate rehabilitation (Week 6-12)

Closed kinetic chain exercises (squats, leg press, step-ups) are emphasized during the intermediate phase of ACL rehabilitation because they produce less anterior tibial shear force than open chain exercises while promoting functional strength.

ACL reconstruction rehabilitation follows a phased approach. The acute phase focuses on edema control, ROM restoration (especially full extension), and quad activation. Early rehabilitation progresses ROM, begins gentle strengthening, and introduces weight-bearing. The intermediate phase (6-12 weeks) emphasizes closed kinetic chain exercises because they produce co-contraction of the hamstrings and quadriceps, which reduces anterior tibial shear stress on the healing graft. CKC exercises include mini-squats, leg press, step-ups, and wall slides. These exercises are functionally relevant (mimic athletic movements) and safer for the graft than open chain exercises like leg extensions, which produce isolated quad contraction and anterior tibial translation. The advanced phase progresses to sport-specific training, agility, and plyometrics.

Question 3: Which taping technique is most commonly used to prevent recurrent lateral ankle sprains?

McConnell taping
Closed basket weave with heel locks and figure-8s (Correct answer)
Mulligan taping
Kinesiology taping with lymphatic correction

Correct answer: Closed basket weave with heel locks and figure-8s

The closed basket weave technique with heel locks and figure-8s is the standard prophylactic ankle taping method. It provides mechanical support against excessive inversion and eversion while allowing functional dorsiflexion and plantar flexion.

The closed basket weave ankle taping technique is the gold standard for prophylactic ankle support. It consists of: anchors (circumferential strips at the base of the calf and around the foot), stirrups (vertical strips from medial to lateral passing under the heel), horseshoes (horizontal strips connecting the stirrups), heel locks (figure-8 patterns around the calcaneus to prevent inversion/eversion), and figure-8s (additional support crossing the anterior ankle). This technique limits excessive inversion, which is the most common mechanism for lateral ankle sprains. Research shows that tape loses 40-50% of its restrictive force after 20 minutes of exercise, which is why semi-rigid ankle braces are often recommended as an alternative. McConnell taping is used for patellofemoral pain. Kinesiology tape provides proprioceptive input but limited mechanical support.

Question 4: What is the recommended temperature range for a therapeutic whirlpool used for warm water immersion treatment?

90-95 degrees F (32-35 degrees C)
98-104 degrees F (37-40 degrees C) (Correct answer)
105-110 degrees F (40-43 degrees C)
111-115 degrees F (44-46 degrees C)

Correct answer: 98-104 degrees F (37-40 degrees C)

The recommended warm whirlpool temperature is 98-104 degrees F (37-40 degrees C). This range provides therapeutic heating effects while minimizing the risk of burns. Higher temperatures are used for extremity immersion only.

Therapeutic whirlpool temperatures are categorized as: Cold — 55-65 degrees F (13-18 degrees C) for acute injuries; Tepid — 80-92 degrees F (27-33 degrees C) for wound debridement; Warm — 98-104 degrees F (37-40 degrees C) for subacute conditions, ROM improvement; Hot — 104-110 degrees F (40-43 degrees C) for extremities only (never full body). Temperatures above 110 degrees F can cause burns and should never be used. Full body immersion should not exceed 104 degrees F due to the risk of cardiovascular complications. Treatment duration is typically 15-20 minutes. Contraindications include: impaired sensation, acute inflammation, peripheral vascular disease, cardiac insufficiency, and open wounds (depending on purpose). The agitation function of the whirlpool provides additional therapeutic benefits through mechanical debridement and sensory stimulation.

Question 5: An athlete sustains a Grade II MCL sprain. What is the expected timeline for return to full activity?

1-2 weeks
2-4 weeks
4-8 weeks (Correct answer)
8-12 weeks

Correct answer: 4-8 weeks

A Grade II MCL sprain (partial tear) typically requires 4-8 weeks for return to full activity. This accounts for ligament healing, rehabilitation of strength and stability, and functional progression.

MCL sprain recovery timelines by grade: Grade I (ligament stretched, intact fibers) — 1-3 weeks; Grade II (partial tear, increased laxity with firm endpoint) — 4-8 weeks; Grade III (complete rupture, significant laxity with no endpoint) — 8-12+ weeks, may require surgery if combined with other ligament injuries. The MCL has an excellent blood supply and heals well conservatively. Rehabilitation progresses through phases: protection and edema control, ROM restoration, progressive strengthening (especially quadriceps and hamstrings), proprioceptive training, and functional progression. Return-to-play criteria include: full pain-free ROM, at least 90% strength compared to uninvolved side, no effusion, stable valgus stress test, and successful completion of sport-specific functional testing.

Question 6: Which electrotherapy modality uses a continuous waveform to produce deep tissue heating through conversion of electrical energy?

TENS (Transcutaneous Electrical Nerve Stimulation)
Therapeutic ultrasound (Correct answer)
Interferential current
NMES (Neuromuscular Electrical Stimulation)

Correct answer: Therapeutic ultrasound

Therapeutic ultrasound uses continuous high-frequency sound waves that are absorbed by tissues and converted to heat (thermal effect). The continuous mode produces the deep heating effects, while pulsed mode emphasizes non-thermal effects.

Therapeutic ultrasound operates at frequencies of 1 MHz (deeper penetration, 3-5 cm) or 3 MHz (superficial penetration, 1-2 cm). In continuous mode, the uninterrupted delivery of acoustic energy produces thermal effects through friction as molecules vibrate. This raises tissue temperature to therapeutic levels (1-4 degrees C increase), increasing collagen extensibility, blood flow, and metabolic rate. Pulsed mode (20% or 50% duty cycle) emphasizes non-thermal effects: acoustic streaming, cavitation, and microstreaming, which promote tissue healing and reduce inflammation. TENS provides pain modulation through sensory nerve stimulation. IFC uses medium-frequency currents to achieve deeper penetration for pain relief. NMES produces muscle contractions for strengthening and re-education. None of these produce significant deep tissue heating.

NATA-BOC Questions and Answers 2

What is the recommended ratio of compression to ventilation during adult CPR performed by two healthcare providers?