Free BCB-PMD Practice Questions

Question 1

During biofeedback for confirmed dyssynergic defecation, a patient expels a practice balloon comfortably for the first time. The abdominal EMG channel rises during the push, while the anal EMG channel falls toward its resting level. Breathing remains unforced. How should the clinician use this successful trial?

Accepted Answer

Reinforce the coordinated abdominal push and anal relaxation, then repeat.

Answer

Repeat expulsion while maintaining a quiet abdominal channel.

Answer

Add an anal squeeze during propulsion.

Answer

Suspend expulsion training until the increased abdominal activity has been medically evaluated.

Question 2

During initial training to isolate a pelvic floor contraction, the largest peaks on a patient's perianal surface EMG trace occur when the patient squeezes the thighs together. Releasing the thighs produces a smaller trace, but examination confirms a distinct pelvic contraction and complete release. Electrode contact and position are unchanged. Which performance should receive reinforcement?

Accepted Answer

The smaller trace with confirmed pelvic contraction and less accessory-muscle recruitment.

Answer

The largest trace, because its amplitude identifies the strongest pelvic floor contraction.

Answer

The thigh-assisted contraction, because it demonstrates coordinated pelvic recruitment.

Answer

Neither performance until the smaller trace reaches the earlier peak amplitude.

Question 3

A pelvic floor assessment is recorded as P4/E3/R4/F8 using the PERFECT scheme. The patient relaxes fully between efforts, has no pain, and completes the recorded fast contractions without substitution. Which exercise emphasis best addresses the limitation demonstrated by this assessment?

Accepted Answer

Build endurance from three-second holds, allowing recovery between repetitions.

Answer

Prioritize rapid one-second contractions to correct the principal deficit in contraction speed.

Answer

Lower resting activity before attempting further sustained contractions or endurance work.

Answer

Increase peak squeeze force while keeping the duration of each contraction unchanged.

Question 4

A filling cystometry study shows intravesical pressure of 30 cm H2O and abdominal pressure of 20 cm H2O immediately before a cough. At the cough peak, the simultaneous pressures are 80 and 70 cm H2O, respectively, and urine leakage is observed. Pressure transmission is satisfactory, with no independent detrusor contraction before or after the cough. Which interpretation belongs in the report?

Accepted Answer

Detrusor pressure remains 10 cm H2O; the observed event supports urodynamic stress incontinence.

Answer

Detrusor pressure reaches 80 cm H2O, indicating an involuntary bladder contraction.

Answer

Detrusor pressure increases by 50 cm H2O, indicating cough-provoked detrusor overactivity during filling.

Answer

Detrusor pressure remains 10 cm H2O, establishing detrusor underactivity as the cause of leakage.

Question 5

A 42-year-old man with eight months of perineal pain has negative urine cultures and no evidence of urinary retention. Pelvic muscle palpation reproduces his familiar pain. He can generate a firm squeeze, but release is delayed, and repeated holds increase his symptoms. He asks whether doubling his exercises would speed recovery. The immediate biofeedback goal should be to:

Accepted Answer

Restore comfortable release and coordination before progressing the load of contraction exercises.

Answer

Build endurance with longer submaximal holds.

Answer

Use brief maximal squeezes to fatigue the muscles and reduce their resting activity.

Answer

Maintain a gentle pelvic contraction during sitting to stabilize the painful region.

Question 6

A postpartum referral describes a repaired tear involving both the external and internal anal sphincters. The operative note specifically states that the anorectal mucosa was intact. Which classification accurately describes the injury?

Accepted Answer

Third-degree tear, grade 3c

Answer

Third-degree tear, grade 3a

Answer

Third-degree tear, grade 3b

Answer

Fourth-degree tear

Question 7

An otherwise serviceable surface EMG system in a U.S. clinic develops prominent 60-Hz interference during quiet recording. The contact check identifies poor coupling at one perianal adhesive electrode; the other contact is satisfactory, and the leads are intact. Before changing the feedback target, what should the clinician correct?

Accepted Answer

Reprepare the faulty contact and recheck signal quality.

Answer

Raise the contraction reward threshold.

Answer

Increase 60-Hz notch filtering while retaining the current electrode contacts.

Answer

Lengthen the averaging interval until the resting display becomes steady.

Question 8

An adult meets the symptom and duration requirements for Rome IV functional constipation. During repeated attempts to defecate, both anorectal manometry and anal surface EMG show inappropriate outlet contraction. Balloon expulsion is normal for the laboratory protocol, and defecography shows complete evacuation. Under Rome IV, what conclusion is justified?

Accepted Answer

The required objective evidence for a functional defecation disorder has not been established.

Answer

The two abnormal tests establish dyssynergic defecation despite normal balloon expulsion and imaging.

Answer

The findings establish inadequate defecatory propulsion rather than inappropriate contraction of the pelvic floor.

Answer

Normal defecography excludes pelvic floor involvement in the constipation.

Question 9

A woman reports urgency, frequent small voids, and occasional leakage before reaching the toilet. Evaluation identifies no infection, retention, hematuria, pain, or neurological disorder. Filling cystometry performed elsewhere did not demonstrate detrusor overactivity. She asks whether that result makes bladder training pointless. Which explanation should accompany her treatment plan?

Accepted Answer

Overactive bladder is a symptom syndrome, so bladder training can still be appropriate.

Answer

Bladder training should wait until repeat cystometry reproduces an involuntary detrusor contraction.

Answer

The absence of detrusor overactivity shifts the treatment focus to stress-incontinence strengthening.

Answer

A normal study favors more frequent precautionary voiding rather than attempts to defer urgency.

Question 10

Care staff report that an 82-year-old resident with mild cognitive impairment and slow transfers often wets while trying to reach the bathroom. Medical evaluation finds no infection or retention. The resident forgets to request assistance but usually stays dry when staff offer toileting and help with transfers. Which care plan addresses the demonstrated barriers?

Accepted Answer

Use caregiver prompts and assisted transfers at planned toileting times.

Answer

Begin intensive strengthening before changing the resident's toileting schedule.

Answer

Extend voiding intervals so a stronger bladder sensation triggers a request for help.

Answer

Postpone active continence care until formal cognitive rehabilitation improves independent learning.

Free BCB-PMD Practice Questions

Domain 1: Applied Psychophysiology & Biofeedback

Question 1

Question 2

Domain 2: Pelvic Floor Anatomy, Surface EMG Assessment of Pelvic Floor Musculature and Clinical Practice Procedures

Question 3

Question 4

Question 5

Domain 3: Clinical Disorders: Bladder Dysfunction

Question 6

Question 7

Domain 4: Clinical Disorders: Bowel Dysfunction

Question 8

Question 9

Domain 5: Clinical Disorders: Chronic Pelvic Pain Syndromes

Question 10

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