TEXAS ATHLETIC TRAINING LICENSE EXAM PREPARATORY
QUESTIONS & RATIONALES SCENARIO-BASED PRACTICE
QUESTIONS WITH 100% VERIFIED ANSWERS AND DETAILED
EXPLANATIONS
1. A high school football player in Texas collapses from exertional heat stroke with
a rectal temperature of 106°F (41.1°C). What is the most critical immediate
action?
A) Transport to the nearest emergency room
B) Administer intravenous fluids
C) Cold-water immersion (CWI) until temperature drops to <102°F
D) Apply ice packs to neck, axillae, and groin
Correct Answer: C
Rationale: Texas heat and high humidity increase exertional heat stroke risk.
Evidence-based guidelines mandate rapid cooling via CWI (or tarp-assisted cooling
if CWI unavailable) before transport. Cooling must continue until rectal temp
reaches ~102°F; stopping earlier risks rebound hyperthermia. Ice packs alone are
far slower and less effective.
2. Under Texas Occupations Code Chapter 451 (Athletic Trainers), which of the
following is outside the scope of practice for a licensed athletic trainer (AT)?
A) Performing a manual muscle test on a post-op ACL patient
B) Providing a written return-to-play note for a concussion
C) Diagnosing a medial meniscus tear using McMurray’s test
D) Taping an ankle for chronic instability
Correct Answer: C
Rationale: Texas law prohibits ATs from making medical diagnoses—only
physicians, chiropractors (within their scope), and certain other licensed providers
,may diagnose. McMurray’s test is an assessment tool, but interpreting it as a
definitive diagnosis constitutes practicing medicine without a license.
3. A soccer player sustains a blow to the forehead and loses consciousness for 10
seconds. On field, they are confused and amnestic. According to Texas’s “Return-
to-Play” (RTP) law (Nataasha’s Law – HB 2038, now codified), which action is
mandatory?
A) Immediate transport to a hospital by EMS
B) Removal from play for the remainder of the day, followed by medical clearance
from a physician
C) Sideline SCAT6 assessment; if normal, allow return after 20 minutes
D) Written parental consent to continue playing
Correct Answer: B
Rationale: Under Texas law (Education Code §38.158), any athlete suspected of
concussion must be removed immediately and cannot return until evaluated and
cleared in writing by a physician (MD or DO). Loss of consciousness mandates
removal; no same-day RTP is allowed regardless of symptom resolution.
4. Which of the following is required for Texas AT license renewal?
A) 20 hours of CEUs every year, including 2 hours of ethics
B) 40 hours of CEUs every 2 years, including 2 hours of evidence-based practice
and 2 hours of ethics
C) 30 hours of CEUs every 2 years, with at least 1 hour of human trafficking
prevention
D) 50 hours of CEUs every 2 years, no ethics required
Correct Answer: B
Rationale: Texas Advisory Board of Athletic Trainers requires 40 CEUs per 2-year
renewal cycle, including at least 2 hours in ethics and 2 hours in evidence-based
practice (per 22 TAC §881.42). Human trafficking training is required for other
healthcare licenses in Texas (e.g., nurses, physicians) but not currently for ATs.
,5. An AT in a Texas clinic is asked by a supervising physician to perform dry
needling on a patient with myofascial pain. Which statement is TRUE regarding
Texas law?
A) Dry needling is prohibited for ATs under any circumstances
B) Dry needling is allowed only if the AT completes a 50-hour course approved by
the Texas Board of Athletic Trainers
C) Dry needling is within AT scope if the AT has specific training and the physician
delegates it, but the Texas Medical Board restricts dry needling to PTs and
acupuncturists
D) Dry needling is allowed without restrictions for licensed ATs
Correct Answer: C
Rationale: The Texas Medical Board has explicitly ruled that dry needling
constitutes acupuncture (practicing medicine) unless done by licensed
acupuncturists or physical therapists with specific training. ATs cannot perform dry
needling in Texas, even under physician delegation, because it is not listed in the
AT Practice Act.
6. During preseason screening, an AT identifies a 17-year-old athlete with a heart
murmur and a family history of sudden cardiac death. Which is the most
appropriate next step?
A) Clear the athlete for all sports because the murmur is likely innocent
B) Recommend an echocardiogram and restrict from sports until cardiology
evaluation
C) Perform a 12-lead ECG in the training room
D) Have the athlete sign a waiver of liability
Correct Answer: B
Rationale: Texas preparticipation physical evaluation (PPE) guidelines (based on
AHA/ACC) mandate that concerning murmur + family history of sudden death
(especially from conditions like HCM) requires cardiac evaluation
, (echocardiogram) and restriction from athletics until clearance. ATs cannot
interpret ECGs for diagnosis.
7. A Texas AT changes jobs and moves from Houston to Dallas. What is the
deadline to update their address with the Texas Advisory Board of Athletic
Trainers?
A) Within 10 days
B) Within 30 days
C) Within 90 days
D) Before the next renewal period
Correct Answer: B
Rationale: 22 TAC §881.22 requires ATs to notify the board of any address change
within 30 days. Failure can result in administrative penalties or missed renewal
notices.
8. Which of the following is an example of an activity that could lead to
disciplinary action by the Texas Board due to unprofessional conduct?
A) Refusing to treat a patient who is verbally abusive
B) Failing to report suspected child abuse to Child Protective Services (CPS)
C) Providing free athletic training services at a charity marathon
D) Taping an athlete’s ankle without a physician’s order
Correct Answer: B
Rationale: Texas Family Code §261.101 mandates that any professional (including
ATs) who suspects child abuse must report within 48 hours. Failure is a criminal
offense and grounds for board discipline. Taping without an order is within AT
scope if no diagnosis is made.
9. A football player is tackled and feels immediate posterior knee pain and
popping. On exam: knee effusion, posterior sag sign, and positive dial test at 90°.
What is the most likely diagnosis, and what is the initial management?
QUESTIONS & RATIONALES SCENARIO-BASED PRACTICE
QUESTIONS WITH 100% VERIFIED ANSWERS AND DETAILED
EXPLANATIONS
1. A high school football player in Texas collapses from exertional heat stroke with
a rectal temperature of 106°F (41.1°C). What is the most critical immediate
action?
A) Transport to the nearest emergency room
B) Administer intravenous fluids
C) Cold-water immersion (CWI) until temperature drops to <102°F
D) Apply ice packs to neck, axillae, and groin
Correct Answer: C
Rationale: Texas heat and high humidity increase exertional heat stroke risk.
Evidence-based guidelines mandate rapid cooling via CWI (or tarp-assisted cooling
if CWI unavailable) before transport. Cooling must continue until rectal temp
reaches ~102°F; stopping earlier risks rebound hyperthermia. Ice packs alone are
far slower and less effective.
2. Under Texas Occupations Code Chapter 451 (Athletic Trainers), which of the
following is outside the scope of practice for a licensed athletic trainer (AT)?
A) Performing a manual muscle test on a post-op ACL patient
B) Providing a written return-to-play note for a concussion
C) Diagnosing a medial meniscus tear using McMurray’s test
D) Taping an ankle for chronic instability
Correct Answer: C
Rationale: Texas law prohibits ATs from making medical diagnoses—only
physicians, chiropractors (within their scope), and certain other licensed providers
,may diagnose. McMurray’s test is an assessment tool, but interpreting it as a
definitive diagnosis constitutes practicing medicine without a license.
3. A soccer player sustains a blow to the forehead and loses consciousness for 10
seconds. On field, they are confused and amnestic. According to Texas’s “Return-
to-Play” (RTP) law (Nataasha’s Law – HB 2038, now codified), which action is
mandatory?
A) Immediate transport to a hospital by EMS
B) Removal from play for the remainder of the day, followed by medical clearance
from a physician
C) Sideline SCAT6 assessment; if normal, allow return after 20 minutes
D) Written parental consent to continue playing
Correct Answer: B
Rationale: Under Texas law (Education Code §38.158), any athlete suspected of
concussion must be removed immediately and cannot return until evaluated and
cleared in writing by a physician (MD or DO). Loss of consciousness mandates
removal; no same-day RTP is allowed regardless of symptom resolution.
4. Which of the following is required for Texas AT license renewal?
A) 20 hours of CEUs every year, including 2 hours of ethics
B) 40 hours of CEUs every 2 years, including 2 hours of evidence-based practice
and 2 hours of ethics
C) 30 hours of CEUs every 2 years, with at least 1 hour of human trafficking
prevention
D) 50 hours of CEUs every 2 years, no ethics required
Correct Answer: B
Rationale: Texas Advisory Board of Athletic Trainers requires 40 CEUs per 2-year
renewal cycle, including at least 2 hours in ethics and 2 hours in evidence-based
practice (per 22 TAC §881.42). Human trafficking training is required for other
healthcare licenses in Texas (e.g., nurses, physicians) but not currently for ATs.
,5. An AT in a Texas clinic is asked by a supervising physician to perform dry
needling on a patient with myofascial pain. Which statement is TRUE regarding
Texas law?
A) Dry needling is prohibited for ATs under any circumstances
B) Dry needling is allowed only if the AT completes a 50-hour course approved by
the Texas Board of Athletic Trainers
C) Dry needling is within AT scope if the AT has specific training and the physician
delegates it, but the Texas Medical Board restricts dry needling to PTs and
acupuncturists
D) Dry needling is allowed without restrictions for licensed ATs
Correct Answer: C
Rationale: The Texas Medical Board has explicitly ruled that dry needling
constitutes acupuncture (practicing medicine) unless done by licensed
acupuncturists or physical therapists with specific training. ATs cannot perform dry
needling in Texas, even under physician delegation, because it is not listed in the
AT Practice Act.
6. During preseason screening, an AT identifies a 17-year-old athlete with a heart
murmur and a family history of sudden cardiac death. Which is the most
appropriate next step?
A) Clear the athlete for all sports because the murmur is likely innocent
B) Recommend an echocardiogram and restrict from sports until cardiology
evaluation
C) Perform a 12-lead ECG in the training room
D) Have the athlete sign a waiver of liability
Correct Answer: B
Rationale: Texas preparticipation physical evaluation (PPE) guidelines (based on
AHA/ACC) mandate that concerning murmur + family history of sudden death
(especially from conditions like HCM) requires cardiac evaluation
, (echocardiogram) and restriction from athletics until clearance. ATs cannot
interpret ECGs for diagnosis.
7. A Texas AT changes jobs and moves from Houston to Dallas. What is the
deadline to update their address with the Texas Advisory Board of Athletic
Trainers?
A) Within 10 days
B) Within 30 days
C) Within 90 days
D) Before the next renewal period
Correct Answer: B
Rationale: 22 TAC §881.22 requires ATs to notify the board of any address change
within 30 days. Failure can result in administrative penalties or missed renewal
notices.
8. Which of the following is an example of an activity that could lead to
disciplinary action by the Texas Board due to unprofessional conduct?
A) Refusing to treat a patient who is verbally abusive
B) Failing to report suspected child abuse to Child Protective Services (CPS)
C) Providing free athletic training services at a charity marathon
D) Taping an athlete’s ankle without a physician’s order
Correct Answer: B
Rationale: Texas Family Code §261.101 mandates that any professional (including
ATs) who suspects child abuse must report within 48 hours. Failure is a criminal
offense and grounds for board discipline. Taping without an order is within AT
scope if no diagnosis is made.
9. A football player is tackled and feels immediate posterior knee pain and
popping. On exam: knee effusion, posterior sag sign, and positive dial test at 90°.
What is the most likely diagnosis, and what is the initial management?
