Risk reduction, wellness and health literacy

A high school soccer coach reports that players skip the separate injury-prevention session. What should the athletic trainer recommend to MOST improve adherence?

1. Run the program in preseason only
   Preseason-only use stops the program when the season begins, and the protective effect fades without continued sessions.
2. Assign the exercises as homework
   Home workouts move the program outside supervised time, and adherence drops further.
3. Use the program as the team warm-up
   Running the program as the team warm-up builds it into practice time, which is how adherence to programs like the FIFA 11+ is kept high.
4. Hold a longer session once a week
   One longer weekly session still competes with practice and loses the frequent exposure these programs rely on.

Which on-site measurement should the athletic trainer use to decide when to modify an outdoor practice for heat?

1. Relative humidity alone
   Relative humidity alone says nothing about air temperature or sun exposure.
2. Heat index from a weather app
   A heat index from an app is not measured at the field and leaves out radiant heat from sun and turf.
3. Dry-bulb air temperature
   Dry-bulb air temperature ignores humidity and radiant load, so it underestimates heat stress.
4. Wet-bulb globe temperature
   Wet-bulb globe temperature combines air temperature, humidity, radiant heat and air movement, and activity-modification tables are built on it.

An athletic trainer is developing a mental-health plan for a university athletic department. Which component is MOST essential under the interassociation consensus on psychological concerns?

1. An annual team talk on stress management
   A yearly talk on stress is education, not a plan for identifying and referring athletes in distress.
2. A written referral plan to licensed providers
   The interassociation consensus centers on a written plan that routes athletes with psychological concerns to licensed mental-health providers.
3. Weekly counseling sessions with the athletic trainer
   Ongoing counseling by the athletic trainer is outside the athletic trainer's role; the plan sends the athlete to a licensed provider.
4. Screening conducted and scored by coaches
   Screening scored by coaches puts confidential health data with nonclinical staff and adds no referral path.

Which mouthguard should the athletic trainer recommend to give a field hockey player the BEST protection against dental injury?

1. Custom-made from a dental impression
   A custom mouthguard made from a dental impression fits closely, stays in place and gives the best protection.
2. Stock ready-to-wear, sized S-M-L
   A stock ready-to-wear guard fits worst and has to be held in place by clenching.
3. Custom-made, covering only the lower teeth
   A lower-only guard leaves the more exposed upper teeth unprotected, even though it is custom-made.
4. Boil-and-bite, trimmed to the front teeth
   A boil-and-bite guard trimmed to the front teeth fits poorly and leaves the back teeth uncovered.

A 15-year-old softball player with a peanut allergy has a prescribed epinephrine auto-injector. What should the athletic trainer's emergency plan require for away games?

1. One auto-injector stored in the home locker room
   An auto-injector stored in the home locker room does nothing at an away game.
2. Two auto-injectors at every practice and game
   Two auto-injectors should travel with the athlete to every practice and game, because a second dose is sometimes needed.
3. One auto-injector kept on the team bus
   A single auto-injector on the bus is not at the field when a reaction starts and leaves no second dose.
4. An oral antihistamine as first-line treatment
   An oral antihistamine does not treat airway or circulatory symptoms; epinephrine is the first-line treatment for anaphylaxis.

A 16-year-old basketball player has best-corrected vision of 20/200 in the left eye and 20/20 in the right. What is the MOST appropriate recommendation?

1. Disqualify from all contact sports
   Disqualification from all contact sports is not required; protective eyewear lets a functionally one-eyed athlete play most sports.
2. Play in regular prescription glasses
   Regular prescription glasses can shatter and do not meet sports-eyewear impact standards.
3. Play with polycarbonate sports goggles
   Best-corrected vision of 20/200 in one eye makes the athlete functionally one-eyed, and polycarbonate sports goggles protect the good eye during play.
4. Limit play to noncontact drills
   Restricting play to noncontact drills is unnecessary when certified goggles protect the good eye.

An athletic trainer notices that several athletes from a low-income neighborhood often skip breakfast before morning practice. Which intervention BEST addresses this social determinant of health?

1. Present a talk on breakfast benefits
   A talk on breakfast benefits targets knowledge, but the barrier here is access to food.
2. Hold athletes who skip breakfast out
   Holding athletes out punishes them for a barrier they cannot control and does not feed them.
3. Require signed breakfast logs
   Breakfast logs add a requirement without giving the athletes any food.
4. Connect athletes to a free food program
   Linking athletes to a free food program removes the access barrier behind skipped breakfasts.

During one season, a women's lacrosse team recorded 12 time-loss injuries over 4,000 athlete-exposures. What was the injury rate per 1,000 athlete-exposures?

1. 0.3
   0.3 comes from multiplying by 100 instead of 1,000.
2. 12.0
   12.0 is the raw injury count, not a rate per 1,000 exposures.
3. 30.0
   30.0 comes from multiplying by 10,000 instead of 1,000.
4. 3.0
   Rate = 12 injuries ÷ 4,000 exposures × 1,000 = 3.0 per 1,000 athlete-exposures.

During a preparticipation history, which finding in a collegiate female distance runner MOST suggests risk for the Female Athlete Triad?

1. Menarche at 12 years of age
   Menarche at 12 is within the normal range; delayed menarche (15 or later) would raise concern.
2. A vegetarian diet with adequate intake
   A vegetarian diet with adequate intake meets energy needs and is not a Triad risk on its own.
3. Fewer than six periods in the past year
   Fewer than six periods in a year is menstrual dysfunction, a core sign of low energy availability in the Triad.
4. A 3-lb (1.4-kg) weight gain over summer
   A small weight gain over summer does not point to low energy availability.

An athletic trainer wants to screen a women's soccer team for jump-landing mechanics associated with ACL injury, such as knee valgus and limited knee flexion. Which tool is MOST appropriate?

1. Landing Error Scoring System
   The Landing Error Scoring System scores a jump-landing for errors such as knee valgus and limited knee flexion.
2. Single-leg hop test for distance
   The single-leg hop for distance measures performance and limb symmetry, not landing errors.
3. Y-Balance Test
   The Y-Balance Test measures dynamic reach balance, not jump-landing mechanics.
4. Functional Movement Screen
   The Functional Movement Screen scores general movement patterns and has no jump-landing task.

Using the 'neck check' for athletes with a respiratory illness, which presentation should lead the athletic trainer to hold the athlete from training?

1. Nasal congestion with frequent sneezing
   Nasal congestion with sneezing is above the neck, so a trial of light activity is allowed.
2. Fever with generalized muscle aches
   Fever and generalized muscle aches are below-the-neck symptoms, and the neck check holds the athlete out.
3. A runny nose and watery, itchy eyes
   A runny nose and itchy eyes are above-the-neck symptoms that allow a trial of reduced activity.
4. A mild sore throat without fever
   A mild sore throat without fever is above the neck and does not by itself require holding the athlete out.

According to the stress–injury model, which athlete profile carries the GREATEST injury risk?

1. High life stress, strong social support
   Strong social support buffers high life stress, so this profile carries less risk.
2. Moderate stress, strong coping skills
   Moderate stress with strong coping skills is a protected profile.
3. Low life stress, high competitive anxiety
   Low life stress with competitive anxiety is a weaker combination than high stress with poor coping.
4. High life stress, poor coping resources
   In the stress–injury model, high life stress plus poor coping resources produces the largest stress response and the highest risk.

Preseason screening of a college pitcher shows 25 degrees less internal rotation in the throwing shoulder than the non-throwing shoulder, with reduced total arc of motion. Which intervention is MOST appropriate?

1. Anterior capsule stretching
   Anterior capsule stretching adds laxity where throwers already have it and does not restore internal rotation.
2. Six weeks of rest from throwing
   Six weeks without throwing does not lengthen the tight posterior tissues and costs throwing conditioning.
3. Cross-body posterior shoulder stretching
   Internal rotation loss with a reduced total arc points to posterior shoulder tightness, which cross-body posterior stretching targets.
4. External rotation stretching at 90° abduction
   External rotation stretching at 90° abduction stretches the anterior structures, which are already lax in throwers.

After treating a patient, an athletic trainer's hands are visibly soiled with blood. Which hand hygiene is MOST appropriate?

1. Wash with soap and running water
   Visibly soiled hands need washing with soap and running water, which removes organic material.
2. Wipe with a disinfectant towelette
   Disinfectant towelettes are made for surfaces, not for hand hygiene after blood contact.
3. Rinse thoroughly with water only
   Water alone does not remove blood and pathogens as well as washing with soap.
4. Use an alcohol-based hand rub only
   Alcohol rub does not remove blood or organic matter, so it is not enough when hands are visibly soiled.

An athletic trainer has drafted a heat-illness handout for parents and wants to check its reading grade level before distribution. Which tool is MOST appropriate?

1. Teach-back conversation with one parent
   Teach-back checks one listener's understanding, not the reading level of the handout.
2. Flesch-Kincaid readability formula
   The Flesch-Kincaid formula scores the reading grade level of the written handout itself.
3. Newest Vital Sign literacy screen
   The Newest Vital Sign screens a person's health literacy; it does not grade a document.
4. REALM word-recognition screening test
   REALM measures a patient's word recognition, not the readability of a handout.

Which index should the athletic trainer use to decide when frostbite risk requires modifying an outdoor practice?

1. Dew point
   Dew point relates to moisture in the air and does not express cold exposure on skin.
2. Wind chill
   Wind chill combines temperature and wind speed into the effective cold on skin, which drives frostbite risk.
3. Heat index
   The heat index measures heat stress, not cold injury.
4. Barometric pressure
   Barometric pressure signals weather changes but does not measure frostbite risk.

A university adds resting 12-lead ECGs to preparticipation cardiac screening. Which interpretation approach BEST limits false-positive referrals?

1. Athlete-specific international ECG criteria
   Athlete-specific international criteria separate training-related ECG changes from abnormal ones, which cuts false-positive referrals.
2. Refer every athlete who shows sinus bradycardia
   Sinus bradycardia is a normal training adaptation, so referring every case creates false positives.
3. Standard adult criteria designed for nonathletes
   Standard adult criteria flag normal athletic adaptations as abnormal and raise false positives.
4. Automated machine interpretation alone
   Automated interpretation is not tuned to athletes and overcalls training-related findings.

A soccer player's first-morning urine specific gravity during preseason is 1.028. How should the athletic trainer interpret this value?

1. Hypohydration
   A urine specific gravity of 1.028 is above the euhydrated range (about 1.020 or less), which indicates hypohydration.
2. Not interpretable without urine color
   Specific gravity is interpretable on its own; urine color is only a rougher estimate of the same thing.
3. Overhydration
   Overhydration produces dilute urine with a low specific gravity, the opposite of 1.028.
4. Euhydration
   Euhydration corresponds to a specific gravity of about 1.020 or below, not 1.028.