NFHS Exam ACTUAL EXAM 2026/2027 |
National Federation State High School
Associations Certification Prep | Verified
Q&A | Pass Guaranteed - A+ Graded
[Section 1: Concussion Recognition & Management Protocols]
(Questions 1–12)
Q1: During a varsity football game, a linebacker takes a helmet-to-helmet hit and immediately appears
dazed. On the sideline, the athlete reports a headache and says the stadium lights seem "too bright."
The athlete insists, "Coach, I'm fine. Put me back in." What is the coach's correct action per NFHS
concussion protocol?
A. Allow the athlete to return after one play to "shake it off" since they passed the initial sideline
balance test.
B. Remove the athlete from play immediately and prohibit return until cleared by an appropriate
healthcare professional. [CORRECT]
C. Let the athlete self-assess after a 5-minute rest period and return if symptoms improve.
D. Ask the team captain to evaluate the athlete's readiness to return.
Correct Answer: B
Rationale: NFHS mandates immediate removal from play when concussion is suspected, with no same-
day return under any circumstances. Clearance must come from a physician or licensed healthcare
provider trained in concussion management. Allowing a "shake it off" period or self-assessment violates
the "when in doubt, sit them out" principle. Peer evaluation by a captain is never an acceptable
substitute for professional medical assessment.
Q2: A soccer midfielder collides with an opponent while heading the ball. The athlete stumbles when
standing, answers questions slowly, and reports feeling "foggy." Which combination of symptoms most
strongly indicates a concussion requiring immediate removal?
,A. Mild ankle pain and slight fatigue
B. Balance problems, delayed responses, and cognitive fog [CORRECT]
C. Increased thirst and muscle cramping
D. Rapid breathing and elevated heart rate
Correct Answer: B
Rationale: Balance dysfunction, delayed cognitive processing, and mental fogginess are hallmark
concussion signs that trigger immediate removal per NFHS guidelines. Ankle pain and fatigue suggest
musculoskeletal injury. Thirst and cramping indicate dehydration or heat illness. Rapid breathing and
tachycardia may reflect cardiovascular or anxiety responses, not concussion.
Q3: An athlete diagnosed with a concussion reports that symptoms resolved after 24 hours of cognitive
and physical rest. The athlete's parents pressure the coach to allow return to practice. What does NFHS
protocol require before return-to-play?
A. Parental written consent alone is sufficient for return.
B. A gradual, stepwise return-to-play progression supervised by an appropriate healthcare provider after
medical clearance [CORRECT]
C. Immediate full-contact practice to test readiness.
D. Return to non-contact practice once the athlete feels 100% symptom-free.
Correct Answer: B
Rationale: NFHS requires medical clearance followed by a graduated return-to-play protocol: light
aerobic activity, sport-specific exercise, non-contact training, full-contact practice, and finally game play,
each step lasting at least 24 hours with symptom monitoring. Parental consent doesn't replace medical
authority. Immediate full-contact risks second-impact syndrome. Self-assessed symptom resolution
without medical oversight is insufficient.
Q4: During a basketball game, a player falls and hits their head on the floor. The athlete pops up quickly
and says, "I'm good, no headache." The referee did not call a timeout. What is the coach's
responsibility?
A. Trust the athlete's self-assessment and continue play.
B. Stop play immediately by calling a timeout and conduct a sideline concussion evaluation [CORRECT]
C. Wait until halftime to evaluate the athlete quietly.
D. Assume the referee will handle the injury assessment.
Correct Answer: B
Rationale: Coaches have an independent duty to evaluate athletes for concussion regardless of referee
action or athlete self-reporting. "When in doubt, sit them out" applies even when athletes deny
, symptoms, as denial and delayed symptom onset are common. Waiting until halftime risks worsening
injury. Referees manage game flow, not medical decisions.
Q5: A wrestler sustains a blow to the head during a match. The athletic trainer conducts a sideline
evaluation using the Sport Concussion Assessment Tool (SCAT6). The athlete scores normally but reports
mild neck stiffness. What is the most appropriate next step?
A. Clear the athlete for continued competition since the SCAT6 is normal.
B. Remove the athlete from competition due to the mechanism of injury and reported symptoms,
regardless of test score [CORRECT]
C. Allow the athlete to finish the match and re-evaluate afterward.
D. Administer pain medication and return the athlete to the match.
Correct Answer: B
Rationale: No single assessment tool definitively rules out concussion. Mechanism of injury combined
with any reported symptoms warrants removal even with normal screening scores. SCAT6 is a screening
tool, not a diagnostic clearance. Finishing the match risks exacerbating injury. Masking symptoms with
medication prevents accurate assessment and endangers the athlete.
Q6: A quarterback sustains a concussion on Friday night. By Monday morning, the athlete reports no
symptoms and wants to attend weightlifting. What does NFHS recommend regarding academic
accommodations during recovery?
A. The athlete should resume all normal academic and athletic activities immediately.
B. Temporary academic accommodations and light physical activity as tolerated, with monitoring for
symptom recurrence [CORRECT]
C. Complete bed rest with no school attendance for one full week.
D. Return to full-contact practice to maintain team standing.
Correct Answer: B
Rationale: Concussion recovery requires a balanced approach: cognitive rest with academic
accommodations (extended time, reduced screen time, breaks) and gradual reintroduction of light
physical activity while monitoring for symptom return. Immediate full resumption risks setback.
Complete bed rest is outdated and can worsen outcomes. Full-contact practice during recovery is
prohibited and dangerous.
Q7: A cheerleader falls from a stunt and lands on a mat. The athlete appears confused about the date
and repeatedly asks the same question. Which red-flag symptom requires immediate activation of
emergency medical services?
National Federation State High School
Associations Certification Prep | Verified
Q&A | Pass Guaranteed - A+ Graded
[Section 1: Concussion Recognition & Management Protocols]
(Questions 1–12)
Q1: During a varsity football game, a linebacker takes a helmet-to-helmet hit and immediately appears
dazed. On the sideline, the athlete reports a headache and says the stadium lights seem "too bright."
The athlete insists, "Coach, I'm fine. Put me back in." What is the coach's correct action per NFHS
concussion protocol?
A. Allow the athlete to return after one play to "shake it off" since they passed the initial sideline
balance test.
B. Remove the athlete from play immediately and prohibit return until cleared by an appropriate
healthcare professional. [CORRECT]
C. Let the athlete self-assess after a 5-minute rest period and return if symptoms improve.
D. Ask the team captain to evaluate the athlete's readiness to return.
Correct Answer: B
Rationale: NFHS mandates immediate removal from play when concussion is suspected, with no same-
day return under any circumstances. Clearance must come from a physician or licensed healthcare
provider trained in concussion management. Allowing a "shake it off" period or self-assessment violates
the "when in doubt, sit them out" principle. Peer evaluation by a captain is never an acceptable
substitute for professional medical assessment.
Q2: A soccer midfielder collides with an opponent while heading the ball. The athlete stumbles when
standing, answers questions slowly, and reports feeling "foggy." Which combination of symptoms most
strongly indicates a concussion requiring immediate removal?
,A. Mild ankle pain and slight fatigue
B. Balance problems, delayed responses, and cognitive fog [CORRECT]
C. Increased thirst and muscle cramping
D. Rapid breathing and elevated heart rate
Correct Answer: B
Rationale: Balance dysfunction, delayed cognitive processing, and mental fogginess are hallmark
concussion signs that trigger immediate removal per NFHS guidelines. Ankle pain and fatigue suggest
musculoskeletal injury. Thirst and cramping indicate dehydration or heat illness. Rapid breathing and
tachycardia may reflect cardiovascular or anxiety responses, not concussion.
Q3: An athlete diagnosed with a concussion reports that symptoms resolved after 24 hours of cognitive
and physical rest. The athlete's parents pressure the coach to allow return to practice. What does NFHS
protocol require before return-to-play?
A. Parental written consent alone is sufficient for return.
B. A gradual, stepwise return-to-play progression supervised by an appropriate healthcare provider after
medical clearance [CORRECT]
C. Immediate full-contact practice to test readiness.
D. Return to non-contact practice once the athlete feels 100% symptom-free.
Correct Answer: B
Rationale: NFHS requires medical clearance followed by a graduated return-to-play protocol: light
aerobic activity, sport-specific exercise, non-contact training, full-contact practice, and finally game play,
each step lasting at least 24 hours with symptom monitoring. Parental consent doesn't replace medical
authority. Immediate full-contact risks second-impact syndrome. Self-assessed symptom resolution
without medical oversight is insufficient.
Q4: During a basketball game, a player falls and hits their head on the floor. The athlete pops up quickly
and says, "I'm good, no headache." The referee did not call a timeout. What is the coach's
responsibility?
A. Trust the athlete's self-assessment and continue play.
B. Stop play immediately by calling a timeout and conduct a sideline concussion evaluation [CORRECT]
C. Wait until halftime to evaluate the athlete quietly.
D. Assume the referee will handle the injury assessment.
Correct Answer: B
Rationale: Coaches have an independent duty to evaluate athletes for concussion regardless of referee
action or athlete self-reporting. "When in doubt, sit them out" applies even when athletes deny
, symptoms, as denial and delayed symptom onset are common. Waiting until halftime risks worsening
injury. Referees manage game flow, not medical decisions.
Q5: A wrestler sustains a blow to the head during a match. The athletic trainer conducts a sideline
evaluation using the Sport Concussion Assessment Tool (SCAT6). The athlete scores normally but reports
mild neck stiffness. What is the most appropriate next step?
A. Clear the athlete for continued competition since the SCAT6 is normal.
B. Remove the athlete from competition due to the mechanism of injury and reported symptoms,
regardless of test score [CORRECT]
C. Allow the athlete to finish the match and re-evaluate afterward.
D. Administer pain medication and return the athlete to the match.
Correct Answer: B
Rationale: No single assessment tool definitively rules out concussion. Mechanism of injury combined
with any reported symptoms warrants removal even with normal screening scores. SCAT6 is a screening
tool, not a diagnostic clearance. Finishing the match risks exacerbating injury. Masking symptoms with
medication prevents accurate assessment and endangers the athlete.
Q6: A quarterback sustains a concussion on Friday night. By Monday morning, the athlete reports no
symptoms and wants to attend weightlifting. What does NFHS recommend regarding academic
accommodations during recovery?
A. The athlete should resume all normal academic and athletic activities immediately.
B. Temporary academic accommodations and light physical activity as tolerated, with monitoring for
symptom recurrence [CORRECT]
C. Complete bed rest with no school attendance for one full week.
D. Return to full-contact practice to maintain team standing.
Correct Answer: B
Rationale: Concussion recovery requires a balanced approach: cognitive rest with academic
accommodations (extended time, reduced screen time, breaks) and gradual reintroduction of light
physical activity while monitoring for symptom return. Immediate full resumption risks setback.
Complete bed rest is outdated and can worsen outcomes. Full-contact practice during recovery is
prohibited and dangerous.
Q7: A cheerleader falls from a stunt and lands on a mat. The athlete appears confused about the date
and repeatedly asks the same question. Which red-flag symptom requires immediate activation of
emergency medical services?
