Scorebuilders 1

Practice Questions

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A phys physica icall therap therapist ist revi reviews ews the the medic medical al recor record d of a pati patient ent with with veno venous us insuf insuffic ficien iency cy.. A rece recent nt entry entry in in the medical record indicates that the physician ordered diagnostic testing in an attempt to rule out deep venous thrombosis. Which diagnostic test would be most beneficial beneficial to accomplish the physician’s physician’s objective? 1. opp opple lerr ultr ultras ason onog ogra raph phy y !. hematocrit ". part partia iall thro thromb mbop opla last stin in time time #. pulmo pulmona nary ry func functio tion n test testss

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A phys physica icall therapi therapist st revie reviews ws the resu results lts of a comp complete lete bloo blood d count count ta$en ta$en on a %&'y %&'year ear'old 'old male male rec recent ently ly admitte admitted d to the hospital. Which of the following lab values may be considered a precaution for therapeutic e(ercise? 1. white white bloo blood d cell cell coun count) t) &*& &*&++ ++ ( 1+ 1+" mm" !. hema hemato tocr crit it)) #% #% ml,d ml,d". hemo hemogl glob obin in))  gm gm,d ,d#. plat platel elet et coun count) t) !&+* !&+*++ +++ + mm mm"

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A patie patient nt diagn diagnose osed d with with low bac$ bac$ pain pain is refer referred red to phys physica icall therap therapy y. uring uring the the e(am e(amina ination tion the phy physic sical al therapist as$s if the patient had any formal diagnostic screening. /he patient states that she had an ('ray and a test where dye was injected into the spinal spinal canal. /his description most closely resembles) 1. arthrography !. 0yelography ". comp comput uted ed tomo tomogr grap aphy hy #. magn magnet etic ic res reson onan ance ce ima imagin ging g

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A phys physica icall therapi therapist st obtain obtainss the past past medica medicall history history of of a patien patientt recent recently ly refer referred red to phys physica icall therapy therapy afte afterr being being diagnosed with adhesive capsulitis. capsulitis. Which medical condition is associated with an increased increased incidence of adhesive adhesive capsulitis? 1. diab diabeetes tes mell mellit itus us !. hemophilia ". peri periph pher eral al vasc vascul ular ar dis disea ease se #. osteo teomala malaccia

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A phys physica icall therap therapist ist wor$i wor$ing ng on an oncol oncology ogy unit unit revi reviews ews the the medic medical al char chartt of a patie patient nt prior prior to initiat initiating ing an an e(ercise program. /he patient’s patient’s cell counts are as follows) follows) hematocrit !# ml,d-* white blood cells !*&++ ( 1+" mm"* platelet +*+++ mm"* hemoglobin  gm,d-. 2ased on the patient’s patient’s blood counts* which of the following would be the most accurate statement regarding the patient’s allowable e(ercise level? 1. no e(er e(erci cise se is allo allowe wed d !. light light e(er e(erci cise se is allow allowed ed ". activ activee e(e e(erc rcis isee is is allo allowe wed d #. resi resist stiv ivee e(er e(erci cise se is is allo allowe wed d

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A phys physica icall therap therapist ist rece receive ivess a refer referral ral for for a #'y #'year ear'old 'old fema female le diagn diagnose osed d with lung cance cancerr. /he pati patient ent repo reports rts smo$ing three pac$s of cigarettes a day for the last !& years. Assuming the patient was diagnosed with cancer two years ago* which of the following pieces of data would provide the therapist with the most valuable information when establishing the plan of care and the associated goals? 1. prem premor orbi bid d lif lifes esty tyle le !. stag stagin ing g of of ca cancer  ncer  ". past past medi medica call his histo tory ry #. mo moti tiva vattion ion le level vel

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A phys physica icall therap therapist ist empl employe oyed d in an outpa outpatien tientt clinic clinic discu discusse ssess the dail daily y treatm treatment ent prog program ram with with a patie patient nt three three wee$s status post medial meniscectomy. meniscectomy. uring the discussion the patient indicates that that she is able to e(ercise* however* did e(perience e(perience a low'grade temperature three days ago. Assuming the therapist measures and records the  patient’s temperature temperature as 3.3+4* the most appropriate therapist action would be to) 1. continu continuee with treatme treatment nt as planne planned d !. continue continue with treatment* treatment* however however** avoid avoid active e(ercise e(ercise ". refer refer the the patien patientt to her her primar primary y care care physi physicia cian n #. contact contact the patient’ patient’ss surge surgeon on to discuss discuss the situatio situation n

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Practice Questions

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A phys physica icall therap therapist ist revi reviews ews the the medic medical al recor record d of a #%'ye #%'year ar'old 'old female female diag diagnos nosed ed with with myast myasthen henia ia gravi gravis. s. A recent physician entry indicates that the patient patient is currently ta$ing immunosuppressive medication. Which laboratory test should be the most fre5uently monitored based on the patient’s medication? 1. hematocrit !. hemoglobin ". plate latele lett cou count #. whil whilee blo blood od cell cell cou count nt

3.

A phys physica icall therap therapist ist e(am e(amine iness a !'y !'year ear'ol 'old d female female with lower lower leg leg pain. pain. /he patien patientt was was refer referred red to physi physical cal therapy after diagnostic imaging rules out out the possibility of a stress fracture. fracture. Which imaging techni5ue would be the most appropriate when attempting attempti ng to identify a stress fracture? 1. arthr thrography !. bone bone dens densit itom omet etry ry ". bone scan #. ('ray

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A physical physical therap therapist ist e(amine e(aminess a patient patient with with an an acute acute grade grade 66 latera laterall an$le an$le sprain sprain.. /he most common mechanism mechanism for an anterior talofibular ligament sprain is 1. inver inversio sion n and and dor dorsi sifl fle( e(ion ion !. inver inversio sion n and and plant plantar arfl fle( e(io ion n ". inversion #. ever eversio sion n and and dors dorsif ifle le(io (ion n

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A physical physical thera therapist pist reviews reviews a laborat laboratory ory report report for for a patient patient recen recently tly admitted admitted to the the hospita hospital. l. /he patient patient sustained burns over !& percent of her body in a fire. Assuming the patient e(hibits hypovolemia* which of the following laboratory values would be t he most significantly affected? 1. hematocrit !. hemoglobin ". o(yg o(ygen en sat satur urat atio ion n rate rate #. pro prothr throm ombi bin n tim timee

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A physical physical therap therapist ist participa participates tes in a community community based based screening screening program program design designed ed to to identify identify individuals individuals with osteoporosis. Which group would have the highest highest ris$ for developing osteoporosis? osteoporosis? 1. white white fema female less ov over er the the age age of of %+ !. blac$ blac$ fem femal ales es ove overr the the age age of %+ ". white white fema female less over over the the age age of #+ #. blac$ blac$ fem femal ales es ove overr the the age age of #+

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A #%'year'o #%'year'old ld male male with with high high blood blood pressure pressure is placed placed on diuret diuretics ics in an attempt attempt to lower his blood blood pressure. pressure. What is the most serious complication of diuretic therapy? 1. hype hypern rnaatre tremia mia !. hypo$alem lemia ". hype hyperc rcal alccemia emia #. hypocythe themia

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A physical physical therapis therapistt employed employed in an outpatie outpatient nt orthoped orthopedic ic clinic clinic wor$s wor$s with an an 1'year 1'year'old 'old female female diagnosed diagnosed with iliotibial band syndrome. After treating the patient for several several wee$s* the therapist suspects suspects that the patient is  bulimic. /he most appropriate therapist action is to) 1. discus discusss the the situa situation tion with the patien patientt !. re5ues re5uestt an immedia immediate te meeting meeting with with the patie patient’ nt’ss family family ". schedu schedule le the pati patient ent for for a dieta dietary ry consu consultat ltation ion #. continue continue to monitor monitor the patient’ patient’ss behavior behavior during during schedule scheduled d therapy therapy sessions sessions

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A patient patient with coronary coronary artery artery disease disease is placed placed on medicatio medication n in order order to control control severe severe hypertensio hypertension. n. Which antihypertensive drug category functions by decreasing myocardial force and rate of contraction? 1. diuretics !. vasodila ilators ". angiot angiotens ensin in conve converti rting ng en7y en7yme me inhib inhibitor itorss #. calc calcium ium chan channe nell blo bloc$ c$er erss "%"!#+".doc

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Practice Questions

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A phys physica icall therap therapist ist revi reviews ews the the medic medical al recor record d of a #%'ye #%'year ar'old 'old female female diag diagnos nosed ed with with myast myasthen henia ia gravi gravis. s. A recent physician entry indicates that the patient patient is currently ta$ing immunosuppressive medication. Which laboratory test should be the most fre5uently monitored based on the patient’s medication? 1. hematocrit !. hemoglobin ". plate latele lett cou count #. whil whilee blo blood od cell cell cou count nt

3.

A phys physica icall therap therapist ist e(am e(amine iness a !'y !'year ear'ol 'old d female female with lower lower leg leg pain. pain. /he patien patientt was was refer referred red to physi physical cal therapy after diagnostic imaging rules out out the possibility of a stress fracture. fracture. Which imaging techni5ue would be the most appropriate when attempting attempti ng to identify a stress fracture? 1. arthr thrography !. bone bone dens densit itom omet etry ry ". bone scan #. ('ray

1+.

A physical physical therap therapist ist e(amine e(aminess a patient patient with with an an acute acute grade grade 66 latera laterall an$le an$le sprain sprain.. /he most common mechanism mechanism for an anterior talofibular ligament sprain is 1. inver inversio sion n and and dor dorsi sifl fle( e(ion ion !. inver inversio sion n and and plant plantar arfl fle( e(io ion n ". inversion #. ever eversio sion n and and dors dorsif ifle le(io (ion n

11.

A physical physical thera therapist pist reviews reviews a laborat laboratory ory report report for for a patient patient recen recently tly admitted admitted to the the hospita hospital. l. /he patient patient sustained burns over !& percent of her body in a fire. Assuming the patient e(hibits hypovolemia* which of the following laboratory values would be t he most significantly affected? 1. hematocrit !. hemoglobin ". o(yg o(ygen en sat satur urat atio ion n rate rate #. pro prothr throm ombi bin n tim timee

1!.

A physical physical therap therapist ist participa participates tes in a community community based based screening screening program program design designed ed to to identify identify individuals individuals with osteoporosis. Which group would have the highest highest ris$ for developing osteoporosis? osteoporosis? 1. white white fema female less ov over er the the age age of of %+ !. blac$ blac$ fem femal ales es ove overr the the age age of %+ ". white white fema female less over over the the age age of #+ #. blac$ blac$ fem femal ales es ove overr the the age age of #+

1".

A #%'year'o #%'year'old ld male male with with high high blood blood pressure pressure is placed placed on diuret diuretics ics in an attempt attempt to lower his blood blood pressure. pressure. What is the most serious complication of diuretic therapy? 1. hype hypern rnaatre tremia mia !. hypo$alem lemia ". hype hyperc rcal alccemia emia #. hypocythe themia

1#.

A physical physical therapis therapistt employed employed in an outpatie outpatient nt orthoped orthopedic ic clinic clinic wor$s wor$s with an an 1'year 1'year'old 'old female female diagnosed diagnosed with iliotibial band syndrome. After treating the patient for several several wee$s* the therapist suspects suspects that the patient is  bulimic. /he most appropriate therapist action is to) 1. discus discusss the the situa situation tion with the patien patientt !. re5ues re5uestt an immedia immediate te meeting meeting with with the patie patient’ nt’ss family family ". schedu schedule le the pati patient ent for for a dieta dietary ry consu consultat ltation ion #. continue continue to monitor monitor the patient’ patient’ss behavior behavior during during schedule scheduled d therapy therapy sessions sessions

1&.

A patient patient with coronary coronary artery artery disease disease is placed placed on medicatio medication n in order order to control control severe severe hypertensio hypertension. n. Which antihypertensive drug category functions by decreasing myocardial force and rate of contraction? 1. diuretics !. vasodila ilators ". angiot angiotens ensin in conve converti rting ng en7y en7yme me inhib inhibitor itorss #. calc calcium ium chan channe nell blo bloc$ c$er erss "%"!#+".doc

Practice Questions

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A patient patient employed employed in a machine machine shop shop is referred referred to physica physicall therapy therapy with with a diagno diagnosis sis of of carpal carpal tunnel tunnel syndro syndrome. me. /he patient indicates that he is scheduled for a diagnostic test that may help to confirm the diagnosis. Which of the following electrodiagnostic tests would be t he most appropriate? 1. elec electr troe oenc ncep epha halo logr grap aphy hy !. evo$e vo$ed d pote potent ntia ials ls ". nerv nervee con condu duct ctio ion n vel veloc ocity ity #. elec electr trom omyo yogr grap aphy hy

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A patient patient complains complains of sharp sharp pain in the the abdomen abdomen that has been present present for for at at least least eight eight hours hours.. Physical Physical e(amination reveals tenderness in the left upper 5uadrant of the abdomen. Which structure is located within this region? 1. appendi( !. gallb llblad ladder  ". liver #. spleen

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A physica physicall therapist therapist interv interviews iews a !1'ye !1'year' ar'old old football football player player referre referred d to physical physical thera therapy py after after sustaining sustaining a grade grade 66 acromioclavicular sprain. Which of the following patient descriptions descriptions best describes the injury mechanism mechanism associated with an acromioclavicular sprain? 1. 86 was was being being tac$led tac$led and and landed landed directly directly on on my shoulder shoulder.9 .9 !. 86 fell fell with my arm e(tende e(tended d and anothe anotherr player player fell fell on top top of me.9 me.9 ". 80y arm arm was was hit with with a helme helmett while while 6 was throw throwing ing the the ball.9 ball.9 #. 80y arm arm was was steppe stepped d on while while 6 was lyin lying g on the grou ground. nd.99

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A patient patient diagnos diagnosed ed with with an anterio anteriorr crucia cruciate te ligamen ligamentt injury injury is e(amined e(amined in physic physical al thera therapy py.. uring uring the the e(amination* the patient as$s the physical therapist why the physician would order ('rays after already diagnosing the ligament injury. /he primary purpose for ordering the radiographs radiographs would be to) 1. confir confirm m the the phys physicia ician’ n’ss d diag iagnos nosis is !. chec$ chec$ for for poss possible ible menisc meniscal al invo involve lvemen mentt ". e(amin e(aminee the patien patient’ t’ss s$eleta s$eletall maturi maturity ty #. rule rule out out the the poss possibil ibility ity of a fract fracture ure..

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A self'refe self'referred rred patient patient is e(amined e(amined in phys physical ical therapy therapy.. /he physical physical therap therapist ist as$s as$s the patient patient a variety variety of 5uestions in an attempt to rule out systemic systemic involvement. Which of the following 5uestions would provide provide the most direct information on the presence of a brain tumor? 1. :ave you had had any any unusual unusual headaches headaches or change changess in your your vision? vision? !. ;an you thin$ of any time during the ne(t ne(t wee$ when when you may may have have fallen fallen or been been injured? injured? ". :ave you you had had any sudden sudden weight weight loss in the last three three wee$s wee$s without without dieting? dieting? #. :ave you you noticed noticed any any change change in in your bowel moveme movements nts or flow of urination? urination?

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A physical physical therapist therapist attempts attempts to place a patient’ patient’ss hip in the the resting resting position position prior prior to to assessi assessing ng joint joint play play.. Which  position would be most consistent with the therapist’s objective? 1. 1++ fle(ion* 1&+ abduction* slight medial rotation !. "++ fle(ion* "++ abduction* slight lateral rotation ". "++ fle(ion* "++ adduction* !++ lateral rotation #. 1++ e(tension* !++ adduction* !++ medial rotation

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A physical physical therap therapist ist complete completess a manual manual muscle muscle test test on a patient patient that that sustain sustained ed a laceration laceration in in the anterior anterior surfac surfacee of the forearm. When performing a test on the fle(or pollicis brevis* the therapist should direct the force) 1. along the volar volar aspec aspectt of the pro(imal pro(imal phalan( phalan( of the thumb thumb !. along along the the volar volar aspec aspectt of the dista distall phalan( phalan( of of the thumb thumb ". along the dorsal dorsal aspect aspect of the pro(ima pro(imall phalan( phalan( of of the thumb #. along along the the dorsal dorsal aspe aspect ct of the the distal distal phala phalan( n( of the the thumb thumb

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Practice Questions

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A physical physical thera therapist pist e(amines e(amines a patient patient referred referred to physic physical al thera therapy py with with sacro sacroiliac iliac pain. As part of the e(amination* the therapist assesses the position of the sacrum by palpating the inferior lateral angles. Which spinal level is most consistent with the inferior lateral angles? 1. <1 !. <" ". <# #. <&

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A physical physical thera therapist pist performs performs a manual manual muscle test on a patient patient with with bilater bilateral al upper upper e(tremity e(tremity wea$ness. wea$ness. /he therapist should test the patient’s scapular adductors with the patient positioned in) 1. prone !. sidelying ". standing #. supine

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A physical physical thera therapist pist completes completes an upper e(tremity e(tremity goniometric goniometric e(amination. e(amination. /he therapist therapist records records right elbow range of motion as 1&'+'1&+ 1&'+'1&+ degrees. /he total available range of motion for this patient is) 1. 1"& de degrees !. 1&+ de degrees ". 1%& de degrees #. 1+ de degrees

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A physical physical therap therapist ist classif classifies ies a patient’ patient’ss end'fe end'feel el as soft after completing completing a specif specific ic passive passive movement. movement. Which of the following joint motions would typically produce a soft end'feel? 1. hip fle fle(io (ion n with with the $ne $neee e(te e(tend nded ed !. $nee fle( le(ion ion ". elbo elbow w e(te e(tens nsio ion n #. fore forear arm m supi supina nati tion on

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A physical physical therapis therapistt completes completes a series series of specia speciall tests designed designed to e(amine e(amine the the ligamentou ligamentouss integrity integrity of a patient’ patient’ss $nee. After completing the tests* the therapist is unsure if the la(ity is normal or if it is indicative of a li gamentous injury. /he most appropriate step to gather more information is to) 1. attempt to to 5uantify 5uantify the millimeters millimeters of la(ity la(ity and and compare compare the values values with with establishe established d norms !. contact contact the physician physician and suggest suggest a refer referral ral for magnetic magnetic resonanc resonancee imaging imaging ". directly directly compare compare the la(ity la(ity in the the involved involved $nee $nee to the la(ity la(ity in the the uninvolve uninvolved d $nee #. attempt to identify identify other other special special tests that can can offer more more information information on the ligamentou ligamentouss integrity integrity of the $nee

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A physical physical therap therapist ist recor records ds grip grip strengt strength h measure measurements ments on a patient patient diagnose diagnosed d with with bilatera bilaterall carpal carpal tunnel tunnel syndrome. Which description does not accurately describe typical results when using a handheld dynamometer? 1. a bell curve is seen seen when charting charting multiple multiple recordings recordings from from adjustable adjustable hand spacings spacings in consecu consecutive tive order  order  !. !+ to !& percent percent difference differencess in grip strength strength may be observed observed between between the dominant dominant and non'domin non'dominant ant hand ". discrepanc discrepancies ies of more than !& percen percentt is a test'retest test'retest situation situation may indicate indicate the patient patient is not e(erting e(erting ma(imal force. #. an individual individual who does does not e(ert e(ert ma(imal ma(imal force force for each each test will not show show the typical typical bell curve curve

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A physical physical therapis therapistt e(amines e(amines the motor motor compone component nt of the trigemin trigeminal al nerve nerve by by observin observing g a patient patient open and close close his mouth repeatedly. repeatedly. Which clinical finding would be most indicative of wea$ness of the right pterygoid muscles? 1. right right devia deviation tion of of the jaw jaw during during openi opening ng of the the mouth mouth !. left left deviatio deviation n of the the jaw durin during g openin opening g of the the mouth mouth ". difficulty difficulty depressin depressing g the mandible mandible during during opening opening of the the mouth mouth #. audibl audiblee crepita crepitation tion during during open opening ing of of the mout mouth h

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A physical physical therap therapist ist assess assesses es $inesthesia $inesthesia in a %1'year %1'year'old 'old male patient patient with Par$inson’ Par$inson’ss disease disease.. Which of the following patient responses would be the most appropriate during the testing? 1. my arm arm is mov moving ing up toward toward the ceiling ceiling !. my arm arm is is para paralle llell with with the the floo floor  r  ". my arm arm jus justt sta start rted ed movin moving g #. my arm arm is in appro(im appro(imately ately the same same positio position n as my other other arm arm

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Practice Questions

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A physical therapist performs a test to measure the strength of a patient’s lower abdominal muscles. /he most appropriate techni5ue to e(amine the strength of the abdominals is 1. partial sit'up !. full sit'up with rotation ". single leg lowering test #. double leg lowering test

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A physical therapist performs a manual muscle test of the peroneus tertius on a patient diagnosed with anterior compartment syndrome. When providing resistance to the peroneus tertius* the physical therapist should direct  pressure towards 1. dorsifle(ion and eversion !. dorsifle(ion and inversion ". plantarfle(ion and eversion #. plantarfle(ion and inversion

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A patient diagnosed with right bicipital tendinitis performs upper e(tremity resistance e(ercises using a piece of elastic tubing. What muscle is emphasi7ed when laterally rotating the involved e(tremity against resistance? 1. teres minor   !. pectoralis major  ". teres major   #. subscapularis

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A physical therapist e(amines a patient diagnosed with a ;& disc herniation. uring the e(amination the therapist identifies a diminished deep tendon refle( response. /he most li$ely refle(es affected would be the 1. biceps and brachioradialis refle( !. biceps and triceps refle( ". brachioradialis and supinator refle( #. triceps and brachioradialis refle(

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A physical therapist e(amines a #+'year'old female referred to physical therapy after spraining her an$le playing volleyball. uring the e(amination* the patient e(hibits e(treme tenderness to palpation over the sinus tarsi. What ligament is most often associated with tenderness in this case? 1. anterior talofibular  !. calcaneofibular  ". deltoid #. posterior talofibular 

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A physical therapist completes a sensory e(amination on a patient with incomplete /'/ paraplegia. /he therapist e(amines the patient’s sensation using a piece of cotton. /he therapist applies the cotton in a random fashion and the patient is as$ed to indicate when she feels the stimulus. /his method of sensory testing is used to e(amine 1. $inesthesia !. light touch ". proprioception #. superficial pain

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A physical therapist determines that a patient has a one half'inch leg length discrepancy. /he therapist suspects the  patient’s leg length discrepancy may be due to tibial shortening. /he most appropriate measurement to confirm the therapist’s suspicion is from the 1. anterior superior iliac spine to the medial malleolus !. iliac crest to the lateral malleolus ". medial $nee joint line to the medial malleolus #. lateral $nee joint line to the medial malleolus

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Practice Questions

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A physical therapist e(amines a patient with limited cervical range of motion. As part of the e(amination* the therapist attempts to screen the patient for possible vertebral artery involvement* but is unable to position the  patient’s head and nec$ in the recommended test position. /he most appropriate action is to 1. complete the vertebral artery test with the head and nec$ positioned in appro(imately &+ percent of the available cervical range of motion !. complete the vertebral artery test as far into the available cervical range of motion as tolerated ". avoid completing the vertebral artery test until the patient has full cervical range of motion #. avoid all direct cervical treatment techni5ues until the vertebral artery test can be assessed at the limits of normal cervical range of motion

"3.

A physical therapist positions a patient in prone on a plinth and passively fle(es her $nee. As the $nee fle(es* the  patient’s hip on the same side also begins to fle(. /his clinical finding is most indicative of a 1. tight iliopsoas !. tight rectus femoris ". tight tensor fasciae latae #. tight hamstrings

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A physical therapist assesses a patient’s lower e(tremity deep tendon refle(es using a refle( hammer. Which of the following refle(es would provide the therapist with the most information on the -"'-# neurologic level? 1. patellar refle( !. lateral hamstrings refle( ". posterior tibial refle( #. Achilles refle(

#1.

A physical therapist monitors a patient’s blood pressure using the brachial artery. What effect would you e(pect to see on the measured blood pressure value if t he therapist selects a blood pressure cuff that is too narrow in relation to the circumference of the patient’s arm? 1. systolic values will be higher and diastolic values will be lower  !. systolic values will be lower and diastolic values will be higher  ". systolic and diastolic values will be higher  #. systolic and diastolic values will be lower 

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A physical therapist assesses a one'month'old infant. uring the treatment session the therapist stro$es the chee$ of the infant causing the infant to turn its mouth towards the stimulus. /his action is utili7ed to assess the 1. 0oro refle( !. rooting refle( ". startle refle( #. righting refle(

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A patient with cardiac disease rates the intensity of e(ercise as a 1! using 2org’s =riginal >ate of Perceived (ertion
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A physical therapist completes a gait analysis on a patient diagnosed with Par$inson’s disease. As part of the e(amination the therapist measures the distance between right heel stri$e and the ne(t consecutive left hell stri$e. /his measurement is used to measure 1. left stride length !. right stride length ". left step length #. right step length

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Practice Questions

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A physical therapist attempts to assess the dorsal pedal pulse of a patient diagnosed with peripheral vascular disease. /o locate the dorsal pedal pulse the therapist should palpate 1. between the e(tensor hallucis longus and the e(tensor digitorum longus tendons on the dorsum of the foot !. between the fle(or digitorum longus and the fle(or hallucis longus tendons on the dorsum of the foot ". immediately posterior to the medial malleolus #. immediately posterior to the lateral malleolus

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A patient with an irregular heart rate is monitored using a single lead electrocardiogram during e(ercise. Which of the following techni5ues would provide t he physical therapist with the most accurate measurement of heart rate? 1. count the number of Q>< comple(es that occur in si(ty seconds !. count the number of > waves that occur in thirty seconds and multiply by two ". count the number of P waves that occur in fifteen seconds and multiply by four  #. count the number of / waves that occur in si( seconds and multiply by ten

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A physical therapist e(amines a patient diagnosed with an acute posterior cruciate sprain. /he most common mechanism of injury for the posterior cruciate is 1. a forceful landing on the anterior tibia with the $nee hyperfle(ed !. an anteriorly directed force applied to the tibia when the foot is fi(ed ". a valgus force applied to the $nee when the foot is fi(ed #. hypere(tension and medial rotation of the leg with lateral rotation of the body

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A &%'year'old female diagnosed with emphysema is referred to physical therapy. As part of the e(amination the  physical therapist assesses tactile fremitus by as$ing the patient to repeat the term 9ninety'nine9 several times in succession. /he most appropriate method when assessing tactile fremitus is 1. e(amine voice sounds through auscultation !. e(amine vibration using the ulnar border of the hand ". e(amine chest e(cursion with tape measure #. e(amine the intensity and clarity of spo$en words using a recording device

#3.

A physical therapist e(amines the viscosity and color of a sputum sample after completing postural drainage activities. /he sputum is yellowish'greenish color and is very thic$. /he therapist can best describe the sputum as 1. fetid !. frothy ". mucoid #. purulent

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A physical therapist enters the room of a patient in an acute care hospital and observes that the patient is having a formal diagnostic test. /he patient was admitted to the hospital three days ago after being diagnosed with  peripheral arterial disease. 2ased on the supplied picture* the diagnostic testing was most li$ely being administered to determine the patient’s 1. rate of arterial perfusion !. o(ygen saturation rate ". prothrombin time #. ma(imum o(ygen consumption

&1.

A physical therapist wor$s with a patient status post stro$e on a mat program. /he therapist assists the patient in lateral weight shifting activities while positioned in prone on elbows. Which therapeutic e(ercise techni5ue would allow the patient to improve dynamic stability with this activity? 1. alternating isometrics !. appro(imation ". rhythmic initiation #. timing for emphasis

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Practice Questions

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A physical therapist performs a capillary refill test on a patient diagnosed with bronchitis by applying direct  pressure to the nailbeds of the fingers. Which finding would be most indicative of a normal response after releasing the direct pressure? 1. blanching should appear in less than two seconds !. blanching should appear in less than four seconds ". blanching should resolve in less than two seconds #. blanching should resolve in less than four seconds

&".

A physical therapist presents a community inservice on ris$ factors associated with coronary artery disease. Which of the following individuals would be at greatest ris$? 1. a #&'year'old male with a cholesterol level of !%+ mg,d-. !. a "3'year'old female with a cholesterol level of 1+ mg,d- and a family history of cardiac disease ". a #!'year'old male with a cholesterol level of !++ mg,d- and hypertension #. a #'year'old female with a cholesterol level of 1+ mg,d-* moderate hypotension* and a family history of cardiac disease

&#.

A physical therapist performs auscultation on a patient with $nown cardiac pathology. When attempting to assess the pulmonic valve the therapist should position the stethoscope 1. in the second right intercostal space at the right sternal margin !. in the second left intercostal space at the left sternal margin ". in the fifth left intercostal space in line with the middle of the clavicle #. in the fourth left intercostal space along the lower left sternal border 

&&.

A patient with $nown cardiac involvement performs upper e(tremity active range of motion e(ercises on a tilt table. /he patient’s medical record indicates he is currently ta$ing beta'bloc$ers. Which of the following is the most appropriate subjective measure to monitor the pati ent’s response to e(ercise? 1. heart rate !. respiration rate ". blood pressure #. perceived e(ertion

&%.

A physical therapist assesses a patient’s voice sounds as part of a respiratory e(amination. /he therapist positions the stethoscope over the thora( and as$s the patient to say 8ninety'nine9. Which type of voice sound is assessed using this techni5ue? 1. bronchophony !. egophony ". pectorilo5uy #. pneumophony

&.

A physical therapist prepares to initiate an e(ercise program for a patient with diabetes mellitus. Which objective measure would be the most appropriate to e(amine in order to avoid significant complications from e(ercise? 1. systolic blood pressure !. respiratory rate ". blood glucose values #. o(ygen saturation rate

&.

A physical therapist observes the electrocardiogram of a patient during e(ercise. Which of the following ;@ changes would be considered abnormal during e(ercise? 1. increase in amplitude of P wave !. shortening of P> interval ".
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Practice Questions

3

&3.

A physical therapist reviews the medial record of a patient recently diagnosed with peripheral vascular disease. A note in the medical record indicates that the patient’s an$le'brachial inde( A26B was within normal limits. /he value most consistent with this measure is 1. .& !. . ". 1.+ #. 1."

%+.

A "!'year'old female is admitted to the hospital after sustaining e(tensive burns to her trun$ and right upper e(tremity. Which of the following burn classifications would most li$ely re5uire the use of a graft? 1. superficial burn !. superficial partial thic$ness burn ". deep partial thic$ness burn #. full thic$ness burn

%1.

A physical therapist reviews the medical record of a patient admitted to the hospital. A recent entry in the medical record indicates the patient has a lesion affecting the facial motor nucleus. 2ased on the patient’s diagnosis* the most probable clinical presentation is) 1. facial muscle wea$ness ipsilateral to the lesion !. facial muscle wea$ness contralateral to the lesion ". impaired facial sensation ipsilateral to the lesion #. impaired facial sensation contralateral to the lesion

%!.

A physical therapist completes an e(amination on a 1#'year'old male with a genetic disorder caused by a chromosomal abnormality. /he patient appears to be 5uite tall with a slender build and proportionately long arms. :e is alert and oriented* however* appears to possess below average intelligence. /his type of clinical presentation is most consistent with) 1. own syndrome !. dward’s syndrome ". Clinefelter’s syndrome #. /urner’s syndrome

%".

A physical therapist is growing increasingly concerned about a patient that is demonstrating symptoms that are consistent with neoplastic activity. What is the most significant symptom of a rapidly growing neoplasm? 1. fatigue !. swelling ". tenderness to palpation #. pain

%#.

A physical therapist employed in a rehabilitation hospital performs an e(amination on a &!'year'old male diagnosed with amyotrophic lateral sclerosis. Which of the following signs and symptoms is not consistent with this disease? 1. mental deterioration !. hyperactive deep tendon refle(es ". wea$ness of the forearms and hands #. impaired speech

%&.

A physical therapist e(amines a patient with /1 paraplegia. As the therapist and patient perform balance activities in sitting* the patient begins to complain of a pounding headache. /he patient e(hibits profuse sweating above the /1 lesion* and blotching of the s$in. /he therapist should immediately identify this as 1. orthostatic hypotension !. autonomic dysrefle(ia ". -owe’s syndrome #. homonymous hemianopsia

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  1+

Practice Questions

%%.

A physical therapist reviews the results of a patient’s arterial blood gases. /he report indicates the following) Pa=! D #& mm:g* Pa;=! D && mm:g* :;=" D !# m5,-* p: D .!+. /hese values are most indicative of) 1. respiratory acidosis !. respiratory al$alosis ". metabolic acidosis #. metabolic al$alosis

%.

A physical therapist reviews the results of a pulmonary function test for a patient with chronic obstructive  pulmonary disease. Which of the following results is typical with chronic obstructive pulmonary disease? 1. decreased functional residual capacity !. increased vital capacity ". increased residual volume #. increased forced e(piratory volume in one second

%.

A physical therapist e(amines a !'year'old male with burns covering "+ percent of his body. /he patient sustained the burns appro(imately !# hours earlier in a house fire. /he medical record indicates an unremar$able medical history with the e(ception of a benign cardiac arrhythmia. Which of the following emergent conditions is the  patient most susceptible to? 1. aortic aneurysm !. autonomic dysrefle(ia ". diabetic coma #. shoc$  

%3.

A physical therapist administers a series of cranial nerve tests to a patient with a confirmed lower motor neuron disease. Assuming the patient has a lesion impacting the left hypoglossal nerve* which clinical presentation would  be most li$ely? 1. right'sided tongue atrophy and deviation toward the left with tongue protrusion !. right'sided tongue atrophy and deviation toward the right with tongue protrusion ". left'sided tongue atrophy and deviation toward the left with tongue protrusion #. left'sided tongue atrophy and deviation toward the right with tongue protrusion

+.

A physical therapist e(amines a five'year'old child’s gait. /he therapist notes that the child is unsteady and uses a wide base of support. /he child appears to lurch at times with minimal truncal bobbing in an anterior and posterior direction. /he child cannot maintain a standing position with the feet placed together for more than five seconds. /he area of the brain most li$ely affected is the 1. corticospinal tracts !. basal ganglia ". substantia nigra #. cerebellum

1.

A !'year'old male diagnosed with a medial meniscus injury is referred to physical therapy following arthroscopic surgery. uring the e(amination the physical therapist identifies decreased range of motion in the involved $nee. /his objective finding is best termed a,an) 1. pathology !. impairment ". functional limitation #. disability

!.

A physical therapist e(amines a patient with low bac$ pain. iagnostic imaging reveals the patient has a mild dis$  protrusion at the -#'-& level. Physical e(amination reveals a diminished lumbar curve and the presence of a lateral shift. /he most appropriate treatment intervention is 1. instruct the patient in active e(tension e(ercises !. instruct the patient in passive e(tension e(ercises ". attempt to correct the lateral shift #. apply palliative modalities

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Practice Questions

11

".

A 1"'year'old boy is referred to physical therapy after being diagnosed with an injury to the pro(imal tibial epiphysis. /he boy was hit by a car and sustained a severe hypere(tension force applied to the left $nee. What is the most serious complication of this injury? 1. lesion of the common peroneal nerve !. tear of the posterior cruciate ligament ". damage to the popliteal artery #. patellar instability

#.

A physical therapist e(amines the gait of a %!'year'old male with peripheral neuropathy. /he therapist observes that the patient’s right foot has a tendency to slap the ground during the loading response. /he observation can best  be e(plained by wea$ness of the 1. iliopsoas !. tibialis anterior  ". tibialis posterior  #. gastrocnemius

&.

ocumentation from an orthopedic surgeon’s report indicates that a patient sustained damage to several structures that provide anterolateral stability to the $nee. Which of the following structures would most li$ely be involved? 1. anterior cruciate ligament* posterior obli5ue ligament* iliotibial band !. anterior cruciate ligament* medial collateral ligament* medial meniscus ". anterior cruciate ligament* lateral collateral ligament* iliotibial band #. posterior cruciate ligament* lateral collateral ligament* biceps femoris tendon

%.

A patient rehabilitating from a ;EA is referred to physical therapy. /he medical record indicates the ;EA primarily involved the right hemisphere of the brain. Which of the following objective findings would be least li$ely when e(amining the patient? 1. diminished motor control of the left side of the body !. impaired awareness of the right side of the body ". impaired spatial ability #. diminished awareness of disability

.

A physical therapist discusses a patient care plan with a physical therapist assistant in preparation for treatment. /he physical therapist indicates that the patient has ideomotor apra(ia. /his condition is most consistent with 1. difficulty performing se5uenced motor acts !. inability to carry out purposeful movement on command ". failure to recogni7e familiar objects #. inability to respond to stimuli presented contralateral to the side of a brain lesion

.

A physical therapist e(amines a patient who complains of occasional difficulty maintaining her balance when wal$ing and fre5uent episodes of vertigo. /he most li$ely cause of the patient’s difficulty is a disorder of the 1. visual system !. proprioceptive system ". auditory system #. vestibular system

3.

A physical therapist determines that a patient has diminished calf sensation and an absent Achilles refle( on the right lower e(tremity. arlier the patient had communicated to the therapist that she e(perienced difficulty controlling her bowel movement. /he neurologic level of most concern is 1. -! !. -# ". -& #.
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  1!

Practice Questions

+.

A physical therapist receives a referral for a patient who is one wee$ status post ;EA. When observing the patient lying in bed* the therapist notes that the patient’s calf and foot are edematous. /he patient reports that the area is somewhat painful. /he therapist should 1. discontinue the e(amination and hope the patient’s leg is better tomorrow !. consider ordering compression stoc$ings for the patient ". continue with the e(amination and disregard the patient’s condition. #. inform the physician of the situation and discontinue the e(amination

1.

A physical therapist completes a family training session with a patient rehabilitating from a spinal cord injury. uring the training the family as$s a 5uestion regarding the functional ability of the patient following rehabilitation. /he most appropriate therapist response is to 1. e(plain to the family that it is difficult to predict since all patients progress differently !. provide information on the e(pected prognosis based on the nature and severity of the injury ". refer the family to the director of rehabilitation #. refer the family to the patient’s physiatrist

!.

A "!'year'old male of Portuguese descent is referred to physical therapy for instruction in a home e(ercise  program. /he physician referral indicates that the patient is approved for one visit. What is the li$elihood that the  patient will comprehend the home e(ercise program in the allotted time? 1. the patient will re5uire e(ternal assistance such as the use of an interpreter to comprehend the home e(ercise  program !. the patient will comprehend the home e(ercise program ". the patient will not be able to comprehend the home e(ercise program #. the physical therapist cannot ta$e a prediction based on the supplied information

".

A physical therapist determines that a patient rehabilitating from an anterior cruciate ligament reconstruction is not ready to return to athletic competition. Which of the following best supports the therapist’s decision? 1. a !+ percent 5uadriceps pea$ tor5ue deficit at %+ degrees per second !. trace effusion in the $nee after a therapy session ". a & degree limitation in $nee fle(ion #. inability to complete a functional progression

#.

A physical therapist develops a chart detailing e(pected functional outcomes for a variety of spinal cord injuries. Which is the highest spinal level at which independent transfers with a sliding board would be feasible? 1. ;# !. ;% ". /1 #. /"

&.

A patient rehabilitating from a grade 6 medial collateral ligament injury 5uestions a physical therapist about his e(pected functional activity level following rehabilitation. /he most accurate predictor of the patient’s e(pected functional activity level is the 1. patient’s age and past medical history !. patient’s previous functional activity level ". duration of physical therapy services #. patient’s compliance with the established home e(ercise program

%.

A patient with anterior cruciate ligament insufficiency* who elects not to have surgical reconstruction* could  probably e(pect to reach which minimal functional level? 1. able to participate in all sports !. able to participate in light recreational sports ". cannot play any type of sport #. problems with normal wal$ing

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Practice Questions

1"

.

A physical therapist treats a patient referred to physical therapy after sustaining a comminuted ;olle’s fracture. /he fracture was stabili7ed with an e(ternal fi(ator device. Which post'operative time frame best represents the amount of time the e(ternal fi(ator device will be utili7ed? 1. !'# wee$s !. %' wee$s ". 1+'1! wee$s #. 1#'1% wee$s

.

A patient demonstrates di77iness and nausea during vertebral artery testing. /he physical therapist should pay  particular attention when treating the patient to avoid positioning the nec$ in 1. e(tension and e(treme of rotation !. fle(ion and slight rotation ". fle(ion and e(treme sidebending #. e(tension and slight sidebending

3.

A physical therapist treats a patient status post surgical repair of the ulnar collateral ligament of the thumb. /he  patient injured the thumb appro(imately three wee$s ago while s$iing. Which of the following would be the most realistic post'operative time frame for the patient to resume unrestricted activity? 1. % wee$s !. 1! wee$s ". 1 wee$s #. !# wee$s

3+.

A physical therapist treats a patient rehabilitating from a chemical burn sustained in a wor$'related injury. /he  patient has been in the hospital for nearly a month and as a result the therapist is concerned about the patient’s cardiovascular status. Which of the following would serve as the best indicator that the patient does not need to  participate in a formal cardiovascular rehabilitation program? 1. arterial blood gas analysis within normal limits !. functional capacity greater than 1+ metabolic e5uivalents ". o(ygen saturation rate greater than 3+ percent #. resting heart rate of & beats per minutes

31.

A physical therapist treats a "!'year'old female rehabilitating from a closed head injury presently functioning at >ancho -os Amigos -evel 6E. /he therapist treats the patient in her home for %+ minute sessions* three times per wee$. >ecently the therapist has noticed that the patient becomes increasingly combative as the session progresses and believes the deterioration in behavior is lin$ed to the patient becoming fatigued. /he most appropriate treatment modification is 1. reduce the treatment sessions to "+ minutes three times per wee$  !. reduce the fre5uency of the treatment sessions to two times per wee$  ". increase the rest periods during e(isting treatment sessions #. increase the treatment sessions to 3+ minutes* two times per wee$ 

3!.

A physical therapist reviews the medical record of a patient with :odg$in’s disease. /he patient is a #&'year'old male who recently began chemotherapy treatment. What effect will chemotherapy have on the patient’s ability to  participate in a rehabilitation program? 1. the patient may be susceptible to infection !. the patient may e(perience e(cessive fatigue ". the patient may demonstrate cardiac anomalies #. the patient may e(hibit signs and symptoms of gastrointestinal distress

3".

A physical therapist that recently returned from maternity leave reviews her daily patient schedule. :er first patient is a #%'year'old male that is referred to physical therapy for wound debridement. /he patient’s medical record indicates that he is :6E positive. /he most appropriate therapist action is 1. have support personnel complete the treatment under direct supervision !. as$ another therapist to treat the patient ". treat the patient #. contact the referring physician to discuss the treatment orders

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  1#

Practice Questions

3#.

A patient in a rehabilitation hospital returns to physical therapy after a meeting with his physiatrist. /he patient indicates that during the meeting the physiatrist discussed the effect of his spinal cord injury on se(ual function. Which of the following statements is typically F=/ accurate for a male patient with complete / paraplegia? 1. /he patient will be able to achieve an erection !. /he patient will be able to ejaculate ". /he patient’s fertility will be diminished #. /he patient’s medications may affect his se(ual function

3&.

A patient diagnosed with peripheral vascular disease is e(amined in physical therapy. Which of the following objective findings would result in an ambulation e(ercise program being contraindicated? 1. decreased peripheral pulses !. resting claudication ". increased resting systolic blood pressure #. decreased lower e(tremity strength

3%.

A physical therapist treats a patient rehabilitating from total hip replacement surgery. As part of the session* the therapist discusses the importance of preventing deep venous thrombosis. Which finding is the best indicator that the patient is at a reduced ris$ for ac5uiring a deep venous thrombosis? 1. ability to perform an$le pumps and muscle setting e(ercises !. ability to achieve full hip range of motion within the allowable limits ". ability to utili7e pneumatic compression devices and elastic stoc$ings #. ability to ambulate on a fre5uent schedule

3.

A physical therapist e(amines a !'year'old female four wee$s status post ;EA. /he therapist informs the patient that she could benefit from having physical therapy services to improve her ambulatory status. /he patient e(plains that she is no longer able to drive and does not have access to any other form of transportation. /he patient lives alone* however* is currently receiving some assistance from a neighbor. /he most appropriate setting for continued therapy would be 1. outpatient rehabilitation !. s$illed nursing facility ". home health services #. inpatient rehabilitation

3.

A patient successfully advance through a series of short'term goals* but is unable to attain the associated long'term goal. /he therapist’s most appropriate response is to 1. develop another more attainable long'term goal !. develop additional short'term goals that facilitate achievement of the established long'term goals ". contact the referring physician to discuss the patient’s lac$ of progress #. discharge the patient since he is no longer ma$ing progress toward the established long'term goal

33.

A patient originally referred to physical therapy for si( wee$s of treatment has achieved all of the established short and long'term goals in less than three wee$s. /he patient is completely asymptomatic and has returned to all  previously performed activities of daily living. /he physical therapist’s most appropriate action is to 1. continue to treat the patient three times a wee$ for the remaining three wee$s !. reduce the fre5uency of the patient’s appointments to twice a wee$  ". reduce the fre5uency of the patient’s appointments to once a wee$  #. discharge the patient and send a copy of the discharge summary to the referring physician

1++.

A physical therapist treats a patient with ;&';% tetraplegia. uring the treatment session the patient’s spouse as$s a 5uestion regarding the patient’s ability to transfer independently following rehabilitation. /he most appropriate therapist response is to 1. refer the spouse to the director of rehabilitation !. refer the spouse to the patient’s primary physician ". refer the spouse to the patient’s primary nurse #. answer the spouse’s 5uestion

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Practice Questions

1&

1+1.

A wor$ site e(amination is scheduled for a patient rehabilitating from a closed head injury eight wee$s ago. /he  patient presents with mild dysarthria and right'sided hemiparesis with moderate upper e(tremity involvement. /he  patient’s job duties are secretarial including answering phones* filing and organi7ing the office. /he most appropriate provider to participate in the wor$ and e(amination is a,an 1. physical therapist !. occupational therapist ". speech therapist #. social wor$er 

1+!.

A physical therapist wor$s on bed mobility e(ercises with a patient recently diagnosed with terminal cancer. /he  patient is e(tremely upset and tells the therapist 86 $now 6 will nerve get better9. /he therapist’s most appropriate response would be 1. 8>adiation treatments will ma$e you feel much better9. !. 80any people have overcome larger obstacles9. ". 8:aving cancer must be very difficult for you to deal with9. #. 8Physical therapy can improve your condition9.

1+".

A physical therapist suspects a patient may be under the influence of alcohol during a treatment session. /he therapist has been treating the patient for over five wee$s and during that time has failed to recogni7e any signs or symptoms of substance abuse. /he therapist’s most immediate action would be to 1. contact the referring physician and discuss the patient’s problem !. as$ the patient if they have been drin$ing ". discharge the patient from physical therapy #. refer the patient to a local Alcoholics Anonymous group

1+#.

A physical therapist prepares a presentation on presession conditioning for a group of high school athletes. /o ma(imi7e the effectiveness of the presentation the therapist should 1. develop specific learning objectives !. utili7e a variety of audiovisual e5uipment ". assess the needs of the target audience. #. provide an outline

1+&.

A physical therapist treats a patient one day status post posterior hip dislocation. /he injury was treated using closed reduction. As part of the treatment session the therapist educates the patient on hip precautions to avoid the recurrence of dislocation and implements an e(ercise program including gl uteal sets* 5uadriceps sets* hamstrings sets* an$le pumps* upper e(tremity e(ercises* and bed mobility. Which activity would be the most essential for the  physical therapy session the following day? 1. review the e(ercise program !. initiate straight leg raises ". begin ambulation activities #. start active'assisted range of motion

1+%.

A physical therapist treats a %1'year'old male at home following thoracic surgery. As part of treatment* the therapist designs a general e(ercise program for the patient. /he patient is e(tremely eager to begin the e(ercise  program* however his spouse e(presses serious doubt about the program’s importance. /he most appropriate therapist action is to 1. e(plain to the patient and spouse why the e(ercise program is an essential part of rehabilitation !. redesign the e(ercise program to address the spouse’s concerns ". as$ the spouse to leave the room during treatment sessions #. discharge the patient from physical therapy

1+.

An orthopedic surgeon instructs a patient to remain non'weight bearing for three wee$s following a medial meniscus repair. uring the e(amination it becomes obvious that the patient has not adhered to the prescribed weight bearing status. /he most immediate physical therapist action is to 1. contact the orthopedic surgeon !. e(plain to the patient the potential conse5uences of ignoring the weight bearing restriction ". draft a letter to the patient’s third party payer  #. complete an incident report

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  1%

Practice Questions

1+.

A physical therapist treats a five'year'old with cerebral palsy. 6nitially the therapist was frustrated by the child’s  poor participation in therapy and as a result developed a reward system that enables the child to earn a stic$er for good behavior.
1+3.

A five'year'old patient is e(amined in physical therapy. /he patient seems very uncomfortable during the e(amination and offers little useful information concerning her injury. /he most appropriate physical therapist action is to 1. spea$ loudly and directly to the patient !. re5uest that the patient’s parents come into the treatment room ". e(plain to the patient the importance of physical therapy #. inform the patient that effective communication involves more than one individual

11+.

A patient with osteoarthritis in the right $nee is referred to physical therapy. (amination reveals moderate inflammation in the involved $nee and significant muscle wea$ness particularly in the 5uadriceps. /he patient rates the intensity of pain in the $nee as a # on a scale of + to 1+. /he most appropriate activity to address the muscle impairment is 1. isometric 5uadriceps contraction !. straight leg raises with an$le weights ". limited range active $nee e(tension in short sitting #. avoid strengthening e(ercises until the patient is pain free

111.

A physical therapist treats a 1&'year'old female of
11!.

A physical therapist employed in an acute care hospital returns to wor$ after a brief vacation and finds a number of items that re5uire her immediate attention. Which of the following items should be given the highest priority? 1. a message to call a physician !. a patient referral from two days ago ". a laboratory test report #. a patient record that has not been completed

11".

A physical therapist reviews the medical record of a patient rehabilitating from $nee surgery. A recent entry in the medical record uses the term effusion. Which description most appropriately defines this term? 1. increased volume of fluid !. increased volume of fluid within the joint capsule ". increased volume of fluid in the soft tissue e(ternal to the joint #. increased volume of fluid in the joint capsule and the soft tissue e(ternal to the joint

11#.

A patient diagnosed with impingement syndrome is referred to physical therapy. uring the e(amination the  physical therapist identifies several clinical findings that indicate the possibility of a small rotator cuff tear. /he therapist’s most appropriate action would be to 1. contact the referring physician to discuss the clinical findings !. treat the patient as diagnosed on the referral ". refer the patient bac$ to the physician #. discharge the patient from physical therapy

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Practice Questions

1

11&.

A female diagnosed with a cervical spine injury reports to physical therapy for a scheduled treatment session. While wal$ing with the patient to the treatment area the physical therapist notices that the patient’s cervical orthosis is very loose. /he most appropriate therapist action is 1. document the observation in the medical record !. reapply the orthosis correctly at the conclusion of the treatment session ". remind the patient of the donning instructions for the orthosis #. contact the referring physician

11%.

A physical therapist e(amines a #"'year'old female diagnosed with a nondisplaced fracture of the humerus. uring the e(amination the patient tells the therapist she has $ept her arm in a sling sporadically* but would li$e the therapist’s permission to stop using it. An appropriate course of action would be to 1. instruct the patient to wear the sling at all times !. instruct the patient not to use the sling because it will inhibit her range of motion ". use their best judgment based on how the referring physician usually treats humerus fractures #. contact the physician and as$ what instructions were given to the patient.

11.

A physical therapist prepares a presentation on proper body mechanics for a group of 1++ autowor$ers. Which of the following media would be most effective to ma(imi7e learning during the presentation? 1. lecture* handouts !. lecture* charts* statistics ". lecture* handouts* demonstration #. lecture* statistics

11.

A physical therapist prepares an inservice on repetitive use injuries for a group of administrative assistants. As part of the presentation* the therapist develops learning objectives. Which of the following objectives would be considered in the cognitive domain? 1. -ist three potential conse5uences of all improperly designed wor$station !. ;orrectly adjust the level of a computer $eyboard ". evote five minutes in the morning and afternoon for stretching e(ercises #. emonstrate proper posture when sitting at a des$ 

113.

A physical therapist receives an order to devise a home program for a nine'year'old boy diagnosed with chondromalacia patella. As the therapist starts to e(plain the e(ercise instructions* it becomes obvious that the boy is not interested. Which of the following would be the most appropriate action to improve compliance with the home e(ercise program? 1. /ell the boy he can leave because it is very difficult to help someone who does not want to be helped !. ;ontinue with the instructions hoping that the boy is a better listener than he appears to be ". -ecture the boy on the importance of compliance with the home program #. As$ a family member to come into the room while you e(plain the home program

1!+.

A physical therapist transports a patient with a brain injury to the physical therapy gym. ach day after arriving in the gym* the patient as$s the therapist* 8Where am 69? >ecogni7ing the patient for short'term memory loss* the therapist’s most appropriate response should be 1. Gou $now where you are. !. Gou are in the same place you were yesterday at this time. ". Gou are in the physical therapy gym for your treatment session. #. Gou are in the hospital because of your injury

1!1.

A physical therapist treats a #'year'old female with diminished lower e(tremity range of motion due to hamstring tightness. As part of the treatment program* the therapist attempts to identify an appropriate active e(ercise techni5ue to improve range of motion. Which objective finding would result in contract'rela( being an undesirable treatment option? 1. the limitation of movement is accompanied by pain !. the limitation of movement is greater than &+H of the normal available range ". the limitation of movement involved multiple planes #. the limitation of movement occurs in a non'capsular pattern

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  1

Practice Questions

1!!.

A physical therapist administers a subma(imal e(ercise test using the G0;A ;ycle rgometry Protocol. /he test consists of a variable number of three minute stages of continuous e(ercise and re5uires the e(aminer to raise the  patient’s steady state heart rate to 11+'1&+ beats per minute for two consecutive stages. Which of the following would be the most accurate guideline for terminating a subma(imal e(ercise test? 1. the subject reaches &H of their age'predicted ma(imal heart rate !. the subject reaches +H of their age'predicted ma(imal heart rate ". the subject reaches &H of their age'predicted ma(imal heart rate #. the subject reaches 3+H of their age'predicted ma(imal heart rate

1!".

A patient diagnosed with right shoulder adhesive capsulitis is limited to !& degrees of lateral rotation. Which mobili7ation techni5ue would be indicated based on the patient’s limitation? 1. lateral distraction and anterior glide !. medial distraction and posterior glide ". lateral distraction and posterior glide #. medial distraction and inferior glide

1!#.

A 1!'year'old female that became ano(ic in a near drowning performs dynamic activities in 5uadruped. /he ne(t  posture to attain in the developmental se5uence would be 1. half $neeling !. tall $neeling ". plantigrade #. standing

1!&.

A physical therapist implements an a5uatic program for a patient rehabilitating from a total hip replacement. uring the treatment session the patient indicates how much easier it is to wal$ in the water compared to on land. what factor is responsible for the pati ent’s ability to wal$ in water? 1. buoyancy !. pressure ". cohesion #. viscosity

1!%.

A patient is limited to && degrees in an active straight leg raise. When using the contract'rela( techni5ue to improve the patient’s active range of motion* the t herapist should emphasi7e contraction of the 1. abductors and hip fle(ors !. hamstrings and hip e(tensors ". 5uadriceps and hip fle(ors #. adductors and hip e(tensors

1!.

A physical therapist designs an e(ercise program for a patient rehabilitating from a prolonged illness. Which of the following e(ercises is indicated for coordination t raining? 1. 2uerger'Allen e(ercises !. ;odman’s e(ercises ". e-orme’s e(ercises #. 4ren$el’s e(ercises

1!.

A physical therapist prepares a home e(ercise program for a patient rehabilitating from a dis$ protrusion in the lumbar spine. Assuming the patient successfully completes the pictured e(ercises prone on handsB* which activity would be ne(t to occur in the e(tension progression? 1. single $nee to chest !. double $nee to chest ". prone on elbows #. e(tension e(ercises in standing

"%"!#+".doc

Practice Questions

13

1!3.

A physical therapist employed in a rehabilitation hospital wor$s with a patient diagnosed with Par$inson’s disease on perambulation activities. As part of the program the physical therapist focuses on improving the patient’s lower trun$ rotation. /he most appropriate patient position accomplish this goal is 1. bridging !. hoo$lying ". prone on elbows #. 5uadruped

1"+.

A physical therapist discusses how to perform pelvic floor muscle strengthening e(ercises with a "%'year'old female diagnosed with stress incontinence. /he patient describes involuntary lea$age of urine when she coughs* snee7es or e(ercises. /he most appropriate ratio of rest to hold time when initiating pelvic floor muscle strengthening is 1. 1)! !. 1)& ". !)1 #. &)1

1"1.

A physical therapist treats a patient status post ;EA. Which action would be most li$ely to facilitate elbow e(tension in a patient with hemiplegia? 1. turn the head to the affected side !. turn the head to the unaffected side ". e(tend the lower e(tremities #. fle( the lower e(tremities

1"!.

A physical therapist administers a subma(imal e(ercise test using a cycle ergometer. /he test consists of a warm' up followed by three stages of increasing increments of wor$ each lasting three minutes* and a cool down. uring the second stage of the e(ercise test the therapist records the patient’s heart rate as 1!! beats per minute after two minutes and 1"# beats per minute after three minutes. Which of the following would be the most appropriate therapist action? 1. administer a rating of perceived e(ertion scale !. maintain the present wor$ rate for an additional minute ". progress to the specified wor$ rate for the third stage #. discontinue the subma(imal e(ercise test

1"".

A physical therapist administers a subma(imal e(ercise test on a patient using a cycle ergometer. /he test consists of four stages* each lasting three minutes in duration at increasing e(ercise intensities. /he e(ercise intensities for the stages were recorded as &+* &* 1++ and 1!& watts respectively. 6f the therapist elects to have the patient cool down using the cycle ergometer* which e(ercise intensity would be the most appropriate to select? 1. #+ watts !. %+ watts ". + watts #. 1++ watts

1"#.

A patient two wee$s status post anterior cruciate ligament reconstruction using a patellar tendon autograft is e(amined in physical therapy. When designing the patient’s rehabilitation program the physical therapist focuses on avoiding activities that place shearing stress on the reconstructed ligament. Which e(ercise would be the least desirable to include in the e(ercise program? 1. straight leg raises in supine from +'%+ degrees of hip fle(ion !. standing hamstrings curls from +'3+ degrees of $nee fle(ion ". supine short arc 5uadriceps e(ercises using a bolster  #. gravity assisted $nee e(tension in supine

1"&.

A patient with patellar trac$ing dysfunction is e(amined in physical therapy. Physical e(amination reveals diminished vastus medialis obli5uus activity. /he most appropriate method to selectively train the vastus medialis obli5uus is 1. 5uadriceps setting e(ercises and biofeedbac$  !. full arc terminal e(tension with manual resistance ". straight leg raises with leg weights #. multiple angle isometric e(ercises "%"!#+".doc

  !+

Practice Questions

1"%.

A physical therapist employed in an acute care hospital prepares to perform suctioning on a patient that is intubated. What type of protective e5uipment woul d be necessary in order for the therapist to administer suctioning? 1. non'sterile gloves !. sterile gloves ". sterile gloves* gown #. sterile gloves* gown* mas$ 

1".

Which of the following goals is F=/ realistic upon discharge from a phase 6 cardiac rehabilitation program for a  patient status post coronary artery bypass graft? 1. ambulate 1++ feet on level surfaces !. wal$ up and down a flight of stairs ". locate and recogni7e changes in pulse rate #. range of motion and e(ercise at % metabolic e5uivalents

1".

A physical therapist is treating a patient with a diagnosis of chronic arterial insufficiency. Assuming the patient does not demonstrate pain at rest* which of the following treatment techni5ues would be contraindicated for this  patient? 1. ambulation with an assistive device !. patient education regarding proper s$in care ". stationary cycling #. an$le pumps with legs elevated

1"3.

A physical therapist determines that a patient is limited in right hip range of motion in a capsular pattern. 6f the therapist elects to focus on increasing hip fle(ion* which mobili7ation techni5ues would be indicated? 1. anterior glide !. posterior glide ". lateral glide #. medial glide

1#+.

A physical therapist utili7es joint mobili7ation techni5ues for pain control and muscle rela(ation at the shoulder. 6f the therapist begins by mobili7ing the glenohumeral joint in this resting position* the limb should be positioned in 1. && degrees of abduction* "+ degrees of hori7ontal adduction !. "+ degrees of abduction* 1+ degrees of hori7ontal adduction ". !& degrees of abduction* & degrees of hori7ontal abduction #. 1+ degrees of adduction* & degrees of hori7ontal abduction

1#1.

A physical therapist orders a wheelchair for a patient with /3 paraplegia. Which wheelchair option would F=/ be necessary for the patient? 1. detachable legrests !. pneumatic tires ". removable arms #. wheel rim projections

1#!.

A &'year'lld female diagnosed with peripheral neuropathy return from an appointment with an orthotist wearing a  posterior leaf spring an$le'foot orthosis. Which of the following clinical descriptions would most warrant the use of this particular type of orthosis? 1. foot drop without medial or lateral instability !. wea$ plantarfle(ors during swing phase ". diminished $nee stability #. foot drop with multi'plane instability

1#".

A patient rehabilitating from a tibial plateau fracture is referred to physical therapy for instruction in gait training. /he patient has been cleared by his physician for weight bearing up to 1+ lbs. Assuming the patient has no significant balance or coordination deficits* which gait pattern would be the most appropriate? 1. two'point !. four'point ". three'point #. swing through

"%"!#+".doc

Practice Questions

!1

1##.

A physical therapist e(amines a patient seated in a wheelchair. After completing the e(amination the therapist determines the wheelchair has inade5uate seat width. Which of the following is the most li$ely conse5uence? 1. e(cessive pressure under the distal thigh !. e(cessive pressure under the ischial tuberosities ". e(cessive pressure in the popliteal fossa #. e(cessive pressure on the greater trochanters

1#&.

A patient five days status post anterior cruciate ligament reconstruction using a patellar tendon autograft is referred to physical therapy. /he patient uses a postsurgical rehabilitative brace that consists of a metal offset hinge with medial and lateral plastic supports. 6t is applied directly over the s$in and is secured using a series of velcro straps. /he brace has a fle(ion and e(tension setti ng and comes in si( different si7es based on a series of circumferential measurements. the primary purpose of the brace is to 1. reduce post'operative edema !. increase anterior and posterior stability ". enhance 5uadriceps activation time #. limit $nee fle(ion and e(tension

1#%.

A !%'year'old male involved in a motorcycle accident sustains a /1+ vertebral fracture. /he patient’s physician attempts to restrict forward thoracic fle(ion by using an e(ternally applied device. Which of the following would  be the most appropriate selection? 1. 0inerva cervical thoracic orthosis !. Philadelphia collar  ". sternal'occipital'mandibular immobili7er  #. thoraco'lumbar'sacral orthosis

1#.

A &+'year'old male rehabilitating from a recent stro$e has good strength in the affected lower e(tremity with the e(ception of trace to poor strength in the right an$le joint. /he patient’s sensation is severely impaired for deep  pressure* light touch* and sharp stimuli. /he patient also has severe fluctuating edema at the an$le. the most appropriate orthosis for the patient is 1. metal upright an$le'foot orthosis !. polypropylene solid an$le'foot orthosis ". prefabricated posterior leaf orthosis #. metal upright $nee'an$le foot orthosis

1#.

A physical therapist receives orders for a patient that was recently injured in a motor vehicle accident. /he patient’s injuries include a ;olle’s fracture and a right tibial plateau fracture. /he patient is mentally alert and does not e(hibit any balance or coordination deficits. Assuming the patient is touchdown weight bearing* the most appropriate assistive device for the patient is 1. -ofstrand crutches !. rolling wal$er with platform attachments ". a(illary crutch and a straight cane #. wal$er with a platform attachment

1#3.

A physical therapist instructs a %!'year'old female rehabilitating from an an$le sprain in the use of a straight cane. /he patient is confused as to why it is necessary to use the cane in the left hand since it is her right an$le that is injured. /he most appropriate e(planation would be 1. using the cane in the left hand will increase your base of support !. using the cane in the left hand will improve your coordination and balance ". using the cane in the left hand will reduce the pressure over your injured an$le #. using the cane in the left hand will allow more weight bearing on your injured an$le and will therefore accelerate your rehabilitation time

1&+.

A physical therapist e(amines a small area of redness over the lateral portion of the lower leg of a patient diagnosed with peripheral neuropathy. /he therapist is concerned that the s$in irritation may have been caused by the leather calf band of the patient’s metal upright an$le'foot orthosis. /he most appropriate location for the calf band is 1. immediately inferior to the fibular head !. immediately superior to the fibular head ". immediately inferior to the tibial plateau #. immediately superior to the tibial plateau "%"!#+".doc

  !!

Practice Questions

1&1.

A physical therapist employed in a rehabilitation hospital e(amines a patient prior to ordering a wheelchair. After completing the e(amination the therapist concludes that the patient would receive the greatest benefit from a tilt'in space wheelchair. Which patient would be the best suited for this type of wheelchair? 1. a "'year'old male incapable of independent pressure relief  !. a #!'year'old female with contractures at the hips and $nees ". a &'year'old male with poor upper e(tremity strength #. a &'year'old female with significant impaired sitting balance

1&!.

A physical therapist selects an assistive device for a patient rehabilitating from an an$le injury. Which of the following would serve as the most significant obstacle to independent ambulation with a(illary crutches? 1. cognitive impairment !. weight bearing restrictions ". architectural barriers #. unilateral lower e(tremity wea$ness

1&".

A physical therapist observes a patient with a transfemoral amputation during gait training. /he therapist identifies mar$ed lateral rotation of the prosthesis at heel stri$e. Which of the following would F=/ be a contributing factor to the patient’s gait deviation? 1. wea$ hip medial rotators !. inade5uate suspension ". e(cessive toe'out built into the prosthesis #. prosthesis is too short

1&#.

A patient diagnosed with /& paraplegia is discharged from a rehabilitation hospital following 1% wee$s of therapy. Assuming a normal recovery* which of the following most accurately describes the status of the patient’s bathroom transfers? 1. independent with the presence of an attendant !. independent with adaptive devices and a sliding board ". independent with bathroom adaptation #. independent

1&&.

A physical therapist orders a wheelchair with anti'tip tubes for a patient in preparation for discharge from a rehabilitation hospital. Which patient would most significantly benefit from this option? 1. a patient with @uillain'2arre syndrome !. a patient with ;& tetraplegia ". a patient with hemiparesis #. a patient with amyotrophic lateral sclerosis

1&%.

A physical therapist instructs a patient who is unable to perform a standing transfer how to utili7e a sliding board. When using the sliding board to transfer from a wheelchair to a bed* which wheelchair option is most desirable? 1. swing'away detachable legrests !. elevating legrests ". full length detachable armrests #. adjustable height armrests

1&.

A 1%'year'old patient with a complete ;& spinal cord injury is two wee$s status post injury. /he patient presently tolerates only "+ degrees on the tilt table secondary to orthostatic hypotension. Which transfer would be the most appropriate tot utili7e when moving the patient from bed to the tilt table? 1. hydraulic lift !. sliding transfer with draw sheet ". two person lift #. dependent standing pivot transfer 

"%"!#+".doc

Practice Questions

!"

1&.

A physical therapist begins gait training with a patient who recently received an an$le'foot orthosis to assist with foot drop and sensory loss. A reddened area over the lateral malleolus persists after ambulating si(ty feet. /he most appropriate therapist response is to 1. direct the patient to wear the orthosis at all times because the body will eventually get used to it !. direct the patient to ma$e an appointment with the orthotist and continue to wear the orthosis until that time ". direct the patient not to wear the orthosis until modifications are made #. direct the patient to ma$e an appointment with the physician

1&3.

A patient in a wor$ hardening program is re5uired to lift pac$ages weighing appro(imately "+ pounds overhead to a conveyor belt. /he patient can complete the tas$* but is unable to prevent e(cessive lumbar hypere(tension while reaching for the conveyor belt. Which of the following assumptions is most accurate? 1. additional weight should be added to the pac$ages that will promote lumbar stability !. the patient should continue lifting the "+'pound pac$ages because he will gradually become stronger  ". the tas$ is too easy for the patient #. the tas$ is too difficult for the patient

1%+.

A physical therapist instructs a patient how to rise from a chair before beginning ambulation activities with a wal$er. Which of the following instructions would be helpful to the patient? 1. place both hands on the wal$er and pull yourself to a standing position !. push up on the chair with one hand and place the other hand on the edge of the wal$er for balance ". push up on the chair with both hands and reach for the wal$er once your are standing #. push up on the chair with both hands and reach for the wal$er while rising

1%1.

A physical therapist treats a patient with emphysema. As part of the treatment session the therapist teaches the  patient to perform diaphragmatic breathing e(ercises. /he primary goal for diaphragmatic breathing is to 1. decrease tidal ventilation !. increase respiration rate ". decrease accessory muscle use #. decrease o(ygenation

1%!.

A patient status post spinal fusion is referred for chest physical therapy. /he physical therapist instructs the patient in diaphragmatic breathing e(ercises. 6nstructions are given to the patient to place his dominant hand over the midrectus abdominis area and his non'dominant hand over the midsternal area. As the patient inhales slowly through the nose the therapist encourages the patient to 1. direct air so that the non'dominant hand rises during inspiration !. direct air so that the dominant hand rises during inspiration ". direct air so that both hands rise e5ually during inspiration #. direct air so that both hands do not move during inspiration

1%".

A physician refers a patient rehabilitating from an intertrochanteric fracture to physical therapy. =n the referral form the physician specifies the use of conti nuous ultrasound at !.# W,cm! over the fracture site. /he most appropriate physical therapist action is to 1. treat the patient as indicated on the referral form !. re5uest that the patient obtain a new referral from the physician ". use another more acceptable modality #. contact the referring physician

1%#.

A &&'year'old female diagnosed with a right hip intertrochanteric fracture is eight wee$s status post open reduction and internal fi(ation with a plate and pinning. /he patient has pain with active hip fle(ion and abduction. Acceptable modalities for the patient include all of the following I;P/ 1. hot pac$s !. whirlpool ". pulsed ultrasound #. shortwave diathermy

"%"!#+".doc

  !#

Practice Questions

1%&.

A patient that sustained a lower e(tremity burn three months ago is treated in an outpatient physical therapy clinic. /he patient’s burns appear to be fully healed* however* the patient e(hibits decreased $nee fle(ion due to the scar tissue. As part of the treatment program the physical therapist performs passive stretching activities in an attempt to promote collagen e(tensibility. Which thermal agent would be the most beneficial to enhance the effectiveness of the treatment session? 1. pulse ultrasound !. continuous ultrasound ". hydrotherapy #. fluidotherapy

1%%.

An 1'year'old male si( wee$s status post open reduction of a ;olle’s fracture is referred to physical therapy. (amination reveals mild swelling on the dorsum of the hand and limited fle(ion of the metacarpophalangeal joints in all digits. /he most appropriate heating agent for the patient is 1. paraffin !. hot pac$s ". vapocoolant sprays #. ultrasound

1%.

A physical therapist applies electrical stimulation to a patient rehabilitating from an Achilles tendon rupture. Which of the following types of current has the lowest total average current? 1. low'volt !. high'volt ". >ussian #. interferential

1%.

A physical therapist e(plains the benefits of using electrical stimulation for muscle re'education. /he patient appears to understand the therapist’s e(planation* however* seems e(tremely frightened and as$s the therapist not use the electrical device. /he most appropriate therapist action is to 1. reassure the patient that the electrical stimulation will not be harmful !. use only small amounts of current ". select another appropriate treatment techni5ue #. discharge the patient from physical therapy

1%3.

A physical therapist prepares to treat a patient using ultraviolet light by determining the patient’s minimal erythemal dose. /he most common location for testing is 1. on the posterior aspect of the upper arm !. on the anterior aspect of the forearm ". on the anterior aspect of the thigh #. on the posterior aspect of the lower leg

1+.

A physical therapist administers ultrasound to a patient rehabilitating from a burn in an attempt to increase range of motion and decrease joint stiffness in the foot. When applying ultrasound to the dorsum of the foot* the patient complains of significant discomfort from the soundhead contacting the s$in. /he most appropriate treatment modification is 1. decrease the intensity of the ultrasound beam !. reduce the si7e of the area being sonated ". utili7e an underwater techni5ue #. select another thermal agent

11.

A patient with chronic obstructive pulmonary disease receives two liters per minute of supplemental o(ygen using a nasal cannula. /he most relevant indicator for the use of supplemental o(ygen for the patient would be 1. arterial saturation D &H !. partial pressure of arterial o(ygen D + mm:g ". partial pressure of carbon dio(ide D #+ mm:g #. p: D .#+

"%"!#+".doc

Practice Questions

!&

1!.

A physical therapist positions a patient in prone with two pillows under the hips in preparation for bronchial drainage. 6f the therapist’s goal is to perform bronchial drainage to the superior segments of the lower lobes* where should the therapist’s force be directed? 1. between the clavicle and nipple on each side !. over the area between the clavicle and top of the scapula on each side ". over the lower ribs on each side #. over the middle of the bac$ at the tip of the scapula on each side

1".

A %#'year'old male diagnosed with chronic bronchitis was admitted to the hospital three days ago after e(periencing an acute e(acerbation. While assessing the patient’s vital signs the physical therapist determines the respiratory rate is ! breaths per minute. Which breathing techni5ue would be the most appropriate to decrease the  patient’s respiratory rate? 1. glossopharyngeal breathing !. diaphragmatic breathing ". segmental breathing #. pursed'lip breathing

1#.

A patient with a low bac$ injury rings a call bell and informs the physical therapist that the hot pac$ is too intense. Assuming the patient has had the hot pac$ on for three minutes* the most appropriate initial action is to 1. chec$ the patient’s s$in !. add additional towel layers ". select another superficial heating agent #. document the incident in the medical record

1&.

A physical therapist administers neuromuscular electrical stimulation to the 5uadriceps using a bipolar electrode configuration. After observing the muscle contraction* the therapist decides to modify the treatment set up in order to increase the depth of current penetration. /he most appropriate action is to 1. utili7e carbon'rubber electrodes !. increase the si7e of the electrodes ". utili7e additional electrodes using a bifurcated lead #. increase the distance between the electrodes

1%.

A home assessment is performed for a patient that will utili7e a wheelchair. /he patient’s home presently does not  possess a ramp and therefore is inaccessible. /he distance from the ground to the front doorway is appro(imately three feet. 6n order for the patient to enter and e(it the home safely and independently* the ramp should be at least 1. ! feet long !. "+ feet long ". "% feet long #. #& feet long

1.

A patient who is comatose due to a recent head injury receives chest physical therapy. When performing this treatment* the physical therapist should avoid placing the patient in 1. partial sitting using the head of the bed for support !. sidelying ". /rendelenburg position #. prone

1.

A physical therapist receives a referral to instruct a patient diagnosed with peroneal tendonitis in a home e(ercise  program. As part of the home e(ercise program* the therapist would li$e the patient to apply superficial heat to the injured area before beginning a stretching regimen. Which of the following modalities would be the most effective for the patient to incorporate into the program? 1. diathermy !. paraffin ". pulsed ultrasound #. warm water bath

"%"!#+".doc

  !%

Practice Questions

13.

An order for chest physical therapy is received for an !'year'old female. /he patient recently underwent surgery for a hip fracture and has been ta$ing ;oumadin post'operatively.
1+.

A patient who sustained a deep laceration in the antecubital fossa is treated in physical therapy. /he patient’s wound has been healing poorly secondary to motion occurring at the elbow joint. Which type of dressing would be the most appropriate to facilitate wound healing? 1. wet !. dry ". occlusive #. rigid

11.

A group of physical therapy students presents a research project entitled 8ffects of Jltrasound on 2lood 4low and  Ferve ;onduction Eelocity9. /he dependent variables in the students’ study is,are 1. ultrasound !. ultrasound and blood flow ". ultrasound and nerve conduction velocity #. blood flow and nerve conduction velocity

1!.

A physical therapist receives orders to design an e(ercise program for a 1"'year'old boy recovering from thoracic surgery. /he therapist e(plains the purpose and inherent ris$s of the e(ercise session as outlined in an informed consent from to the boy and his parents. After as$ing several additional 5uestions the boy and his parents indicate that they would li$e to move forward with the session. /he most appropriate therapist action is 1. as$ the boy to sign the informed consent form !. as$ one of the boy’s parents to sign the informed consent form ". initiate the e(ercise program #. confirm the parameters of the e(ercise session with the referring physician

1".

A patient in rehabilitation hospital confides to a physical therapist that she has been physically abused by her husband in the past and is concerned about returning home following discharge. /he most appropriate therapist action is to 1. report the findings to a law enforcement agency !. contact the patient’s physician ". as$ the patient to leave her husband #. 5uestion the patient’s spouse

1#.

A physical therapist observes a patient in the physical therapy waiting room that appears to e(periencing a heart attac$. /he most significant sign of a heart attac$ is 1. shortness of breath !. chest pain ". sweating #. nausea

1&.

A physical therapist wor$ing in an acute care hospital attempts to determine the effectiveness of treating psoriatic lesions with ultraviolet. /he most appropriate initial action is to 1. design a research study which e(amines the effectiveness of treating psoriatic lesions with ultraviolet !. determine if the current patient population would allow for an ade5uate sample si7e for a research study ". submit a research proposal to the hospital’s institutional review board #. conduct a literary search for research related to treating psoriatic lesions with ultraviolet

"%"!#+".doc

Practice Questions

!

1%.

A physical therapist treating a patient overhears two of his colleagues discussing another patient’s case in the charting area. /he therapist is concerned that patients may overhear the same conversation. /he most appropriate action is to 1. discuss the situation with the director of rehabilitation !. discuss confidentiality issues at the ne(t department meeting ". move the patient away from the charting area #. inform the physical therapists that their conversation may be audible to patients

1.

A patient completing an e(ercise program starts to demonstrate signs of an insulin reaction including di77iness* vision difficulties* and a change in the level of consciousness. /he most appropriate response for a conscious victim would include 1. give the patient sugar* candy or juice !. monitor airway* breathing* and circulation ". treat the patient for shoc$  #. continue to supervise the patient* however* do not intervene

1.

While performing high'level balance activities* a patient falls into a piece of e5uipment that causes a deep laceration to the calf. 6mmediate first aid includes direct pressure to the area and elevation* however* the bleeding does not stop. /he physical therapist should continue to administer first aid by providing 1. heat to the laceration site !. ice to the laceration site ". pressure to the dorsalis pedis artery pressure point #. pressure to the femoral artery pressure point

13.

A physical therapy department designs a study e(amining rehabilitation outcomes in patients who have undergone anterior cruciate ligament reconstruction. /he study will include a sample of patient from !& orthopedic surgeons in the local region. 6f the physical therapists compile a list of all eligible patients and select every third patient to  participate in the study* what type of sampling was used? 1. simple random sampling !. stratified sampling ". systematic sampling #. cluster sampling

13+.

A physical therapist e(amines a si('month'old infant with spina bifida. /he infant suddenly begins to act strangely at the conclusion of treatment. A primary survey reveals the infant is not breathing* but does have a pulse. /he most immediate response would be to 1. begin chest compressions !. begin mouth to mouth breathing ". begin mouth to nose breathing #. begin mouth to mouth and nose breathing

131.

A physical therapist prepares to administer a dressing change on a patient rehabilitating from a deep partial' thic$ness burn over the dorsal surface of the forearm and hand. /he patient’s current regiment consists of dressing changes twice daily and reapplication of a topical antibiotic. When se5uencing the activities associated with the dressing change* which activity would occur second? 1. gentle debridement in a hydrotherapy tan$  !. reapplication of the topical antibiotic ". application of gau7e wraps in a distal to pro(imal pattern #. removal of current dressings

13!.

A patient begins to demonstrate signs and symptoms of a sei7ure including uncontrollable muscular movements* convulsions* and confused behavior. Appropriate intervention would include 1. attempt to chec$ airway* breathing* and circulation !. place a soft object between the patient’s teeth ". hold or restrain the patient #. protect the victim from injury* but do not restrain

"%"!#+".doc

  !

Practice Questions

13".

A physical therapist conducts a home health visit for a patient status post transtibial amputation that lives in a two' room efficiency. /he therapist treats the patient for a small would on the anterior surface of the residual limb. After completing the treatment session* the therapist would li$e to wash her hands. Which of the following actions would be the most inappropriate? 1. wash hands thoroughly in the $itchen sin$  !. utili7e li5uid soap instead of bar soap ". use paper towels to turn the faucets on and off  #. rub hands together under flowing water with soap for at least 1+ seconds

13#.

A patient that collapsed in the physical therapy gym fails to e(hibit a pulse. Jpon viewing the patient’s mouth it  becomes obvious that the patient has dentures. /he physical therapist is hesitant to remove the dentures since they seem secure* however* does not want them to interfere with rescue breathing. /he most appropriate action is to 1. leave the dentures in place !. loosen the dentures ". remove the dentures #. remove the dentures and utili7e a mas$ to limit direct pressure on the patient’s mouth

13&.

A patient who recently tested positive for hepatitis 2 has a one'inch diameter wound on the anterior surface of her forearm. Jpon inspection* the borders of the wound are slightly raised and a small amount of drainage is visible. When changing the dressing on the wound the most appropriate protective e5uipment to utili7e would be 1. gloves !. gloves* gown ". gloves* gown* mas$  #. gloves* gown* mas$* protective eyewear 

13%.

A physical therapist enters a remote storage area to retrieve a piece of e5uipment and observes flames and smo$e throughout the room. /he most appropriate immediate action is 1. attempt to e(tinguish the fire !. remove patients from the physical therapy area ". announce the code for fire over the facility’s public address system #. attempt to contain the fire to the storage room

13.

A physical therapist attempts to obtain consent to participate in a formal a5uatic e(ercise program from a patient rehabilitating from multiple lower e(tremity injuries sustained in a motor vehicle accident. /he therapist’s action is most representative of the ethical principle termed 1. autonomy !. beneficence ". nonmaleficence #. justice

13.

A physical therapist and a physical therapist assistant employed in an acute care hospital are responsible for  providing wee$end therapy coverage. After e(amining the patient treatment list* the therapists attempt to develop an action plan. Which of the following activities would be the least appropriate for the physical therapist assistant? 1. instruct a patient in prosthetic donning and doffing !. assist a patient with ambulation activities ". e(amine a patient referred to physical therapy for instruction in a home e(ercise program #. perform goniometric measurements on a patient two day status post anterior cruciate ligament reconstruction

133.

A patient rehabilitating from a fractured humerus has completed si( wee$s of physical therapy and is ready to be discharged with a home e(ercise program. /he patient is e(tremely pleased with his progress in therapy and gives the physical therapist a chec$ for K&+.++ as a to$en of his appreciation. /he most appropriate therapist action is to 1. accept the gift !. accept the gift and donate it to charity ". accept the gift and donate it to the department’s general e(pense fund #. e(plain to the patient that you are not permitted to accept the gift

"%"!#+".doc

Practice Questions

!++.

!3

A physical therapist awaiting the arrival of her ne(t patient observes another patient ambulating independently in the parallel bars. /he patient appears to lac$ the necessary strength and coordination re5uired to complete the activity independently. /he therapist’s most appropriate response would be to 1. inform the patient’s therapist of her observations !. assist the patient bac$ to a chair and contact the patient’s therapist ". as$ the patient if she is having difficulty or needs any assistance #. continue to observe the patient* but do not interfere

"%"!#+".doc

"+

"%"!#+".doc

Answers

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oppler ultrasonography is a diagnostic techni5ue that uses ultrasound to produce an image or photograph of an organ or tissue. /he non'invasive test is commonly used to evaluate blood flow in the major veins and arteries of the upper and lower e(tremities as well as in the e(tracranial cerebrovascular system.

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:emoglobin refers to an iron based pigment that binds and transports o(ygen in blood. /he typical reference range for a male is 1#'1 gm,d-* therefore a value of  gm,d- may result i n decreased e(ercise tolerance* fatigue and tachycardia

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2. 0yelography can be used to detect dis$ herniation* nerve root entrapment* spinal stenosis* and tumors of the spinal cord.

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1. Adhesive capsulitis refers to an inflammation and adherence of the articular capsule resulting in limited joint  play and restricted active and passive movement. /he condition is more common in women than in men and tends to appear in the fourth* fifth* and si(th decades of life. Patients with diabetes mellitus are particularly susceptible to this condition and often e(perience a longer duration of symptoms and greater limitation of motion.

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/he patient’s lab values for hematocrit* white blood cells* platelet* and hemoglobin are significantly below acceptable ranges. As a result e(ercise is not indicated.

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1. A temperature of 3.3 degrees 4ahrenheit represents a slightly elevated temperature when compared to the average temperature of 3.% degrees 4ahrenheit.
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4. 6mmunosuppressive pharmacological agents are desirable when the body loses its ability to differentiate  between the body’s own tissues and pathogenic tissues. While blood cell count provides valuable information related to the degree of immunosuppression.

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A bone scan can identify bone disease or stress fractures with as little as #'H bone loss. /raditional radiographs are far less sensitive than bone scans* re5uiring "+'&+H bone loss.

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2. /he anterior talofibular ligament runs from the anterior portion of the lateral malleolus to the lateral aspect of the talar nec$. /he ligament is placed under stress with inversion and plantarfle(ion. /he anterior talofibular* calcaneofibular* and posterior talofibular li gaments ma$e up the lateral collateral ligaments of the an$le comple(.

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:ematocrit is the volume percentage of red blood cells in whole blood. /he hematocrit rises immediately after a severe burn and gradually decreased with fluid replacement.

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1. =steoporosis is a metabolic bone disease characteri7ed by increased bone resorption resulting in a reduction in  bone mass. =steoporosis is more prevalent in females than in males* in older more than younger individuals* and in whites more than in blac$s.

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iuretics function by increasing the formation and e(cretion of urine and as a result serve to decrease the volume of fluid in the vascular system.
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/he patient is 1 years ole and is therefore considered to be an adult. As a result* the most appropriate physical therapist action would be to discuss the situation with the patient. 6t would be inappropriate to schedule a dietary consult prior to discussing the information with the patient and since the patient has been treated for 8several wee$s9 it would be of little benefit to continue to monitor the patient.

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;alcium channel bloc$ers selectively bloc$ calcium entry into vascular smooth muscle. /his action serves to inhibit the contractile process resulting i n vasodilation and decreased peripheral resistance.

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Answers

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3. ;arpal tunnel syndrome results from repetitive compression of the median nerve where it passes through the carpal tunnel at the wrist. Ferve conduction velocity can be e(tremely useful in diagnosing the condition. -ess formal methods to assist in identifying carpal tunnel syndrome include Phalen’s test and /inel’s sign.

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4. /he spleen is located in the left upper 5uadrant of the abdomen while the appendi(* gallbladder* and liver are located on the right side of the body.

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1. /he injury mechanism associated with an acromioclavicular injury is a direct blow to the tip of the shoulder that serves to displace the acromion inferior to the clavicle.

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1. :eadaches occur in "+H'&+H of patients with brain tumors. Eisual changes can be caused by space occupying tumors.

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/he hip is a ball and soc$et joint whose resting position is "+ degrees fle(ion* "+ degrees abduction* and slight lateral rotation. /he close pac$ed position is e(tension and medial rotation.

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/he fle(or pollicis brevis inserts on the volar aspect of the base of the pro(imal phalan( of the thumb. /he muscle fle(es the metacarpophalangeal and carpometacarpal joints of the thumb and assists in opposition.

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/he end'feel associated with $nee fle(ion is typically described as soft due to contact between the posterior calf and thigh or between the heel and buttoc$s.

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Performing ligamentous testing on an uninvolved joint provides a physical therapist with a valuable baseline that can then be compared to the involved joint.

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Although ('rays can be used to assess s$eletal maturity* the primary purpose would be to rule out a fracture.

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/he inferior lateral angles of the sacrum are formed by the transverse processes of <&

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@rip strength my vary by &'1+H when comparing the dominant and non'dominant hands

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/he trigeminal nerve innervates the primary muscles of mastication including the pterygoids. /he pterygoids on one side function to open the jaw and cause the jaw to deviate to the opposite side. As a result* if the right  pterygoids are wea$* the jaw will deviate to the right with opening.

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1. Cinesthesia refers to the ability to perceive the e(tent of direction of movement. An appropriate patient response must include an indication of the direction of movement while the physical therapist actively moves the  patient’s e(tremity.

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4. /he double leg lowering test assesses the strength of the lower abdominals. /he test is performed by slowly lowering the legs from a vertical position with the $nees e(tended.

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4. /he peroneus tertius acts to dorsifle( the an$le joint and evert the foot. As a result* resistance should be applied against the lateral side of the dorsal surface of the foot in the direction of plantarfle(ion and inversion. /he deep  peroneal nerve innervates the peroneus tertius.

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1. /he teres minor is a lateral rotator of the shoulder while the pectoralis major* teres major* and subscapularis are medial rotators of the shoulder.

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1. /he biceps is innervated by the musculocutaneous nerve via ;&';% and the brachioradialis refle( is innervated  by the radial nerve via ;&';%

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Answers

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1. /he sinus tarsi area is located immediately anterior to the lateral malleolus. /he soft tissue depression consists of a tunnel between the calcaneus and talus. /he anterior talofibular ligament is often the first ligament affected by an inversion an$le injury.

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3. 0easuring from the medial $nee joint line to the medial malleolus allows for an independent assessment of tibial length and also avoids any potential asymmetries due to leg girth.

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/he therapist should perform the test and clear the patient’s vertebral artery for their available range of motion. As the patient gains additional range of motion* the test can be readministered. 6t is possible to observe findings such as nystagmus and slurring of speech prior to achieving full rotation* e(tension and l ateral fle(ion.

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2. /his scenario describes ly’s test which* if positive* is indicative of tight ness of the rectus femoris two joint hip fle(orB.

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3. A blood pressure cuff that is too narrow in relation to a patient’s arm will tend to artificially increase measured values. /he width of the bladder should be #+H of the circumference of the midpoint of the limb. An average si7e adult re5uires a bladder that is &'% inches wide.

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2. /he rooting refle( is a primitive refle( that is normally present from ! wee$s gestation through three months of  age. /he refle( assists the mother when feeding an infant.

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2. >ating on a perceived e(ertion scale provides a subjective measure of e(ercise intensity. A rating of 1! on 2org’s >ate of Perceived (ertion
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/he dorsal pedal artery is located between the tendons of the e(tensor hallucis longus and the e(tensor digitorum longus. /he pulse can be absent in up to 1&H of the population.

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/he posterior cruciate ligament is responsible for preventing posterior displacement of the tibia on the femur. /he ligament is most often injured by a direct force on the tibia* which displaces it in a posterior direction in relation to the femur.

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/actile fremitus is often e(amined by using a hand or portion of a hand to assess the vibration associated with spo$en words. /he e(amination techni5ue can be used to provide information on the density of the lungs and thoracic cavity.

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4. A sputum sample classified as purulent is described as a viscous fluid e(udate that is often yellow or green and may be associated with acute or chronic infection.

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/he an$le'brachial inde( A26B is a common diagnostic test used to assess the rate of vascular perfusion. /he A26 is determined by dividing the systolic pressure of the lower e(tremity by the systolic pressure of the upper e(tremity.

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2. Appro(imation is a therapeutic e(ercise techni5ue designed to facilitate contraction and stability through joint compression.

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2lanching or whitening of the nailbeds occurs due to the interruption in circulation caused by the physical therapist’s direct pressure. /he capillary refill test is often used as a gross indicator of vascular perfusion.

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Patellar* -"'-#* lateral hamstrings <1'

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0easurement error decreases as the time associated with data collection increases.

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Answers

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3. Positive ris$ factors for coronary artery disease include age* male gender* family history* current cigarette smo$ing* hypertension* :ypercholesterolemia* diabetes mellitus* and sedentary lifestyle. :ypertension combined with borderline cholesterol levels places the #!'year'old male at the greatest ris$ for coronary artery disease.

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2. /he pulmonic valve is located between the right ventricle and the opening of the pulmonary artery. Auscultation should be performed in the second left intercostal space at the left sternal margin.

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4. :eart rate and perceived e(ertion are the most appropriate measures to monitor the patient’s response to e(ercise* however* perceived e(ertion is the only subjective measure. 6n addition* the patient’s heart rate response would be diminished due to the effect of the beta bloc$ers.

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1. 2ronchophony can be assessed by as$ing the patient to say 8ninety'nine9 while the therapist auscultates over the entire chest. ;onsolidated tissue will typically yield stronger* louder sounds while hyperinflation results in softer sounds.

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iabetes mellitus is a disorder of carbohydrate metabolism that results from inade5uate production or upta$e of insulin.
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/he an$le'brachial inde( A26B is a ratio that is calculated by dividing the lower e(tremity pressure by the upper  e(tremity pressure. Formal values for the A26 are 1.+ or slightly higher. Ealues less than .&+ are indicative of severe arterial disease.

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4ull'thic$ness burns are characteri7ed by complete destruction of the epidermis and dermis with or without damage to the subcutaneous fat layer.
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1. A lesion involving the motor component of the facial nerve from damage to the nucleus is considered a lower motor neuron lesion. /he most li$ely clinical presentation is facial muscle wea$ness ipsilateral to the lesion.

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3. Clinefelter’s syndrome is characteri7ed by the presence of an e(tra I chromosome. 6ndividuals with this syndrome are characteri7ed by small testes* abnormally long limbs* and below average intelligence. /he syndrome is estimated to occur in one of ++ live male births.

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4. A rapidly growing neoplasm often results in pain due to direct pressure displacement of specific nerves. Pain can also occur due to interference with blood supply or from bloc$age within an organ.
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Amyotrophic lateral sclerosis is a progressive syndrome mar$ed by muscular wea$ness and atrophy with spasticity and hyperrefle(ia due to degeneration of the motor neurons of the spinal cord* medulla* and corte(. /he disease is commonly referred to as -ou @ehrig’s disease and is not associated wit h mental deterioration.

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Autonomic dysrefle(ia is a condition that occurs in patients with spinal cord injuries above the /% level. /he condition is triggered when a no(ious stimuli is present followed by an increase in autonomic responses.
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>espiratory acidosis is characteri7ed by decreased p:* increased Pa;=! and :;=" that is within normal limits.

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;hronic obstructive pulmonary disease is characteri7ed by progressive reduction in e(piratory flow rates. :yperinflation of the lungs results in an increase in residual volume.

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/he primary cause of shoc$ related to burns is hypovolemia or less of circulating fluid.
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3. /he hypoglossal nerve innervates the primary muscles of the tongue. As a result* a lower motor neuron disease affecting the left hypoglossal nerve will cause wea$ness and resultant deviation of the tongue to the left toward the side of wea$nessB. 0uscle atrophy is a common finding in lower motor neuron lesions.

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4. /he cerebellum is the area of the brain responsible for modulation of movement. -esions to the cerebellum may  produce hypotonia* tremor* impaired refle(es* ata(ic gait* and nystagmus.

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2. An impairment is defined as a loss or abnormality of physiological* psychological or anatomic structure or function.

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3. amage to an artery can create a life threatening emergency that re5uires immediate medical attention. /he term epiphysis refers to a center for ossification at the end of a long bone.

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/he tibialis anterior acts to dorsifle( the an$le joint and invert the foot. 6njury to the deep peroneal nerve -#* -&* <1B may produce dramatic wea$ness in dorsifle(ion and resultant foot drop.

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/he anterior cruciate ligament* lateral collateral ligament* and iliotibial band provide anterolateral stability to the $nee.

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2. A patient rehabilitating from a ;EA with right hemisphere involvement and resultant left hemiplegia would most li$ely e(hibit impaired awareness of the left side of the body. =ther characteristics of this patient may include poor  attention span* left hemianopsia* and impulsive behaviors.

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6deomotor apra(ia refers to an inability to perform movements necessary to use objects properly on command* although in some instances automatic movement may occur.

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4. Abnormalities of the vestibular system result in di77iness and impaired balance. /he vestibular system itself is stimulated by the position of the head in space and changes in the direction of movement of the head.

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4. /he Achilles refle( is from the <1 spinal level.
6f possible* the lateral shift should be corrected prior to any form of active and passive e(ercise.

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/he patient’s signs and symptoms are consistent with the presence of a deep venous thrombosis. >eferral for additional medical e(amination is necessary.

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/he physical therapist should answer 5uestions as$ed by the family as long as they are within the therapist’s scope of practice. A therapist should possess a basic understanding of e(pected functional outcomes of patients with spinal cord injuries.

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/he cultural bac$ground of a patient without additional information offers little indication as to the patient’s ability to comprehend a home e(ercise program.

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A functional progression is a series of progressive active movements designed to simulate a selected sport or activity. 4ailure to successfully complete a functional progression often indicates that a patient is not ready to return to competition.

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Cey muscles that are partially or fully innervated at the ;% level include the brachialis* biceps* trape7ius* deltoids* rhomboids* latissimus dorsi* rotator cuff* serratus anterior* and e(tensor carpi radialis.

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/he patient should return to his previous functional activity level in a matter of wee$s following a grade 6 medial collateral ligament sprain.

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2. Although there is a wide range of outcomes with non'operative anterior cruciate ligament injuries* most individuals are able to return to a minimum level of light recreational sports. /herapeutic management of an anterior cruciate ligament injury includes range of motion* progressive resistive e(ercises* functional activities* and  bracing.

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Answers

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2. /he rate and amount of bone healing as determined through radiographs determines the actual amount of time an e(ternal fi(ation device is applied. A general estimate of the necessary time would be at %' wee$s.

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Positioning the nec$ in e(tension and e(tremes of rotation places the vertebral artery in a compromised position. (tension* sidebending* and rotation are components of the vertebral artery test.

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2. 0any patients on e(tended bed rest following a burn e(perience significant cardiovascular complications. A functional capacity of 1+ or more metabolic e5uivalents is a good indication that a formal cardiovascular rehabilitation program is not necessary. An intensity of 1+ 0/s corresponds to running at si( miles per hour.

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A patient functioning at >ancho -os Amigos -evel 6E* confused agitated* may be particularly susceptible to changes in behavior based on fatigue. 6deally the physical therapist should attempt to maintain the integrity of the current treatment regimen* however* if increased rest periods do not produce an observable change in the patient’s  behavior it may be appropriate to modify other parameters such as the fre5uency or length of treatment.

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;hemotherapy uses to(ic chemicals to destroy cancerous cells in an attempt to reduce the si7e of a tumor for resection or palliative care. ;hemotherapy is a systemic intervention usually administered by an intravenous line. (cessive fatigue caused by chemotherapy can considerably limit t he patient’s ability to participate in a formal e(ercise program.

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3. /herapists should treat all patients as if they have a potentially transmissible or infectious disease. /herapists have the responsibility to treat patients regardless of their particular medical diagnosis.

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2. A patient with complete paraplegia would li$ely be able to achieve a refle(ogenic erection* but would be less li$ely to ejaculate.

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A patient with peripheral vascular disease that presents with resting claudication is not a candidate for an ambulation e(ercise program.

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Activities re5uiring increased circulation through muscle pumping can significantly reduce the incidence for ac5uiring a deep venous thrombosis. Although an$le pumps and muscle setting e(ercises are commonly prescribed following surgery* higher level activities such as ambulation on a fre5uent schedule will be more effective to achieve the stated objective.
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/he patient appears to ba ma$ing progress through the established short'term goals and by developing additional* perhaps more appropriate* short'term goals it may facilitate achievement of the established long'term goal. Fot enough information is given to assume the long'term goal is unrealistic particularly since the patient is ma$ing progress.

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/he patient has achieved all established short and long'term goals and has returned to his previous lifestyle. /here is no longer a need for physical therapy services.

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4. /he 5uestion as$ed by the spouse falls within the therapist’s scope of practice and should therefore be answered directly.

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2. =ccupational therapists focus on activities of daily living* wor$ and leisure s$ills* and as a result may be best suited to address the obstacles that impact the patient’s ability to return to wor$.

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:ome health services are warranted based on the patient’s homebound status and present functional level.

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Answers

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3. /he statement 8having cancer must be very difficult for you to deal with9 ac$nowledges the patient’s present condition without providing a false sense of hope. /his type of approach is particularly important with patients who have recently been diagnosed with a terminal disease.

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2. A physical therapist should attempt to determine if a patient is under the influence of alcohol. Alcohol consumption can significantly influence a patient’s ability to tolerate treatment. As$ing the patient directly is an immediate step that can be used to gather additional information.

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6t is often advisable to review an e(ercise program with a patient. 6t is particularly essential in the given scenario since failure to perform the e(ercises correctly could have a detrimental effect on the patient’s condition. Although some of the other presented options may be appropriate* they would not offer the same degree of benefit for the patient.

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A supportive spouse can be e(tremely helpful to a patient completing a home e(ercise program. 6n order for the spouse to be an asset* she must first recogni7e the value of the program.

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2. 2y addressing the issue directly with the patient* the physical therapist may improve compliance with the weight  bearing restrictions and therefore promote a better environment for tissue healing.

6t is essential to assess the needs of the target audience prior to designing a formal or informal presentation.

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2. =perant conditioning is a form of learning where a particular action or behavior is followed by the administration of a reward positive reinforcementB. 2. 4. <$inner first publici7ed this learning approach.

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1. 6sometric e(ercises are often the strengthening e(ercise of choice for patients with acute osteoarthritis. /his form of e(ercise limits muscle atrophy while avoiding unnecessary stress on the joint. Avoiding strengthening e(ercises until the patient is pain free is unrealistic given the diagnosis of osteoarthritis.

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/he presence of parents can often be reassuring to a young child when confronted with a new e(perience.

/he patient’s inability to communicate using the nglish language necessitates the use of an interpreter.

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Although each of the options is a viable answer* the therapist’s primary responsibility is direct patient care. 4ailure to provide physical therapy services to a patient for this period of time in an acute care environment could  pose a serious problem.

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ffusion is defined as an increased volume of fluid within the joint capsule. dema is defined as an increased volume of fluid in the soft tissue e(ternal to the joint.

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/he therapist’s hypothesis necessitates contact with the referring physician* however* does not indicate the need to discontinue physical therapy services.

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3. >eminding the patient of the donning instructions for the orthosis provides the patient with the best opportunity to learn the correct techni5ue. Although reapplying the orthosis correctly at the conclusion of the treatment session is appropriate* the action does not provide any specific feedbac$ to the patient.

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-ecture* handouts* and demonstration provide not only verbal and written information* but provide the target audience with the opportunity to observe an actual demonstration. /his multi'tiered approach accommodates for a variety of learning styles.

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1. omains of learning include cognitive* affective* and psychomotor. 2loom’s /a(onomy of ducation =bjectives identifies si( levels of cognitive domain) $nowledge* comprehension* application* analysis* synthesis* and evaluation. -isting potential complications of improperly designed wor$station re5uires $nowledge and is therefore considered to be in the cognitive domain.

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4. ue to the patient’s age it would be appropriate to as$ a family member to come into the room. /o reprimand the boy in any form may only serve to diminish compliance.

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/he physician is responsible to determining when the sling can be discontinued.

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Answers

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3. A patient’s 5uestion should be answered in a direct and forthcoming manner whenever possible. 4re5uent repetition is a component of any treatment plan for patients with short term memory loss.

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6n contract'rela( the build up of tension is immediate and may therefore be problematic when the limitation in movement is accompanied by pain. 6n contrast* hold'rela( re5uires a radial build up of tension over a period several seconds and is therefore often the treatment of choice when pain is present.

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3. /ermination guidelines for subma(imal e(ercise testing indicate that a subject should not e(ceed &H of his,her age'predicted ma(imal heart rate.

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/he glenohumeral joint is a ball and soc$et joint consisting of the conve( head of the humerus articulating with the concave glenoid fossa of the scapula. -ateral distraction and anterior glide of the glenohumeral joint can be utili7ed to increase lateral rotation and e(tension.

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2. /all $neeling follows the 5uadruped position in the developmental se5uence. /all $neeling emphasi7es hip e(tension in combination with $nee fle(ion and serves to promote stability.

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Archimedes’ principle of buoyancy states that a body immersed in a li5uid e(periences an upward force e5ual to the weight of the displaced li5uid. 6n a5uatic therapy* a patient may e(perience greater ease of movement due to the buoyant force of the water.

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2. ;ontract'rela( is a therapeutic techni5ue designed to increase range of motion in muscles on one side of a joint. /ightness of the hamstrings and hip e(tensors would serve to limit a straight leg raise.

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4ren$el’s e(ercises are designed to improve coordination by emphasi7ing the use of vision and hearing to compensate for altered or impaired proprioception.

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/he traditional progression from lowest to highest level is) lie in prone on a firm surface* prone on elbows*  prone press'up* e(tension e(ercises in standing.

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2. :oo$lying is a term used to describe a position where a patient is in supine with the hips and $nees fle(ed and the feet in contact with the floor. 6n this position the physical therapist can facilitate lower trun$ rotation by moving the lower e(tremities across the midline.

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/he asymmetrical tonic nec$ refle( may produce e(tension of the affected upper e(tremity by turning the  patient’s head toward the affected side.

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1. A cool down or recovery period should occur at an intensity e5ual to or lower than the intensity of the first stage of the e(ercise test protocol.

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/he amount of muscle force generated by short arc 5uadriceps e(ercises causes and anterior gliding force on the tibia and may plan an undesirable amount of stress on the pati ent’s reconstructed ligament given his post'operative status.

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1. Quadriceps setting e(ercises and biofeedbac$ provide an e(cellent opportunity for the patient to selectively train the vastus medialis obli5uus E0=B. 2iofeedbac$ can offer the patient auditory or visual feedbac$ that can assist the patient to enhance E0= activity.

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6nsertion of the catheter into the patient’s trachea necessitates the use of sterile gloves.

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Activities in a phase 6 cardiac rehabilitation program typically progress up to " 0/s.

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4. Patients with chronic arterial insufficiency typically have diminished blood flow and resultant ischemia. Positioning with the legs elevated will serve to e(acerbate the patient’s symptoms.

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A posterior glide of the femur on the acetabulum is indicated to increase hip fle(ion and medial rotation.

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/he glenohumeral joint is a ball and soc$et joint that has three a(es and three degrees of freedom. /he close  pac$ed position is full abduction and lateral rotation* while the open pac$ed or resting position is && degrees of abduction and "+ degrees of hori7ontal adduction.

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4. A patient with paraplegia does not re5uire the use of projection wheel rims due to full innervation of the upper e(tremities. Patients with ;&';% tetraplegia utili7e projection handrims in order to assist with normal wheelchair  propulsion.

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A posterior leaf spring an$le'foot orthosis is a plastic insert with a semirigid posterior upright that yields slightly at heel contact and recoils when the brace is unloaded during the swing phase. 6t is used to assist with dorsifle(ion* however* does not promote medial or lateral stability.

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/he patient would li$ely utili7e a three'point gait pattern using a(illary crutches. A three'point gait pattern can accommodate different levels of weight bearing.

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6nade5uate seat width results in difficulty changing positions* pressure on the greater trochanters* and difficulty wearing bul$y clothing or orthoses.

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4. >ehabilitative braces with fle(ion and e(tension settings are designed to allow controlled motion within a specified range of motion. /he braces function to protect the injured limb during the early phases of rehabilitation.

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4. /horaco'lumbar'sacral orthoses limit spinal motion of the lower thoracic and upper lumbar spine and are commonly used following surgery or as a result of an injury to the spine.

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0inimal contact with the s$in allows a metal upright an$le foot orthosis to accommodate for fluctuating edema while providing the appropriate support to the an$le joint.

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A wal$er provides the necessary stability for a patient that is touchdown weight bearing. /he platform attachment permits weight bearing through the involved arm without placing undue stress on the distal radius. A rolling wal$er may not provide enough stability given the patient’s weight bearing status.

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Jsing the cane in the left hand will allow the patient to shift her center of gravity away from the involved lower e(tremity and therefore reduce the pressure on the injured an$le.

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/he calf band of an an$le'foot orthosis should be placed immediately inferior to the fibular head. A calf band superior to the level of the fibular head may interfere with the normal function of the $nee* while placement directly over the fibular head may result in impingement of the peroneal nerve.

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A tilt'in'space wheelchair is designed to provide pressure relief without shearing forces. /he wheelchair has a fi(ed seat to bac$ angle even when reclined and as a result is often able to accommodate customi7ed seating systems. /he wheelchair is commonly prescribed for patients unable to perform independent pressure relief.

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4. A prosthesis with insufficient length would not be responsible for e(cessive lateral rotation of the prosthesis upon heel stri$e. /he deviation may be caused by wea$ hip medial rotators* poor suspension of the prosthesis or e(cessive toe'out of the prosthesis.

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A significant cognitive impairment may result in a patient being unable to safely use a(illary crutches.

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A patient with /& paraplegia should be able to complete bathroom transfers using adaptive devices such as grab  bars. /he patient would possess full upper e(tremity innervation and limited trun$ control.

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Anti'tip tubes are designed to prevent a patient from tipping over while in a wheelchair during activities of daily living. A patient with ;& tetraplegia would be the most li$ely candidate to benefit from this option based on the  patient’s e(pected level of function following discharge from the rehabilitation hospital.

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3. etachable armrests will ma$e it easier for the patient to correctly position the sliding board and successfully transfer from the wheelchair to the bed.

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A sliding transfer with draw sheet is the only transfer that will allow the patient to maintain a position of less than "+ degrees of upper body elevation.

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4. /he pac$ages may be too heavy or the conveyor belt may be too high. 6n both cases the tas$ is too difficult for the patient.

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3. Pushing up on the chair with both hands provides the most stable base to achieve a standing position. 6t is important not to reach for the wal$er while standing since the action may have a tendency to move the patient’s center of gravity outside their base of support.

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3. iaphragmatic breathing is often used as a method to increase activity of the diaphragm during inspiration* while diminishing the reliance of accessory muscles.

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2. 6n diaphragmatic breathing* the patient’s hand placed over the midrectus area should rise during inspiration and fall during e(piration.

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;ontinuous ultrasound at !'# W,cm! over a fracture site is e(cessive and can be potentially dangerous to the  patient.

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6nternal or e(ternal metallic objects* including surgical metal implants* are contraindications for shortwave diathermy. 4ailure to recogni7e the presence of a surgical metal implant may result in e(cessive heat production and subse5uent tissue damage.

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;ontinuous ultrasound is commonly used to treat patients with healed burns due to its ability to increase the e(tensibility of collagen and decrease pain.

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Paraffin is a superficial heating agent that is commonly used to treat the distal e(tremities. ue to the number of   joints involved* immersion in paraffin is an appropriate and practical selection.

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2. :igh'voltage current is characteri7ed by monophasic waveform usually delivered in spi$e pulse pairs. :igh' voltage current utili7es an e(tremely short pulse duration and voltage greater than 1&+ voltsN as a result the total average current is 5uite low. :igh'voltage current is most often used to provide sensory level stimulation.

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/he anterior aspect of the forearm is a common site utili7ed for determining the minimal erythemal dose since it is relatively easy to determine mild reddening of the s$in in this area. 6t may at times* however* be more appropriate to determine the minimal erythemal dose on the area to be treated.

A physical therapist should not administer any form of treatment without patient consent.

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3. Jltrasound using the underwater techni5ue eliminates the need for contact between the soundhead and the area  being sonated.

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4. /he supplied description accurately describes the position and techni5ue associated with bronchial drainage to the superior segments of the lower lobes.

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Pursed'lip breathing is a techni5ue designed to improve ventilation and o(ygenation.
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1. A physical therapist should always chec$ the patient’s s$in prior to adjusting the number of towel layers utili7ed with a hot pac$.

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/he greater the distance between the electrodes the deeper the current can penetrate. When electrodes are placed in close pro(imity the current will flow superficially and current density will be greatest to the s$in between the electrodes.

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3. /he /rendelenburg position is an inclined position in which the body and legs are elevated in relation to the head. /his position is not recommended for patients with a $nown or suspected head injury secondary to an increase in intracranial pressure.

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A warm water bath is the most appropriate superficial heating agent to incorporate into the home program since it is readily available and easily applied to the lower leg and foot.

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3. Percussion is a techni5ue that can be used to mobili7e retained secretions. /he techni5ue involves direct contact over a given segment of the lung and should therefore be used with caution based on the patient’s past medical history.

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/he dependent variable is defined as the conditions or characteristics that appear* disappear or change as the e(perimenter introduces* removes or changes the independent variable. 6n this particular study ultrasound is the independent variable* while blood flow and nerve conduction velocity are the dependent variables.

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1. Physical therapists are re5uired to report $nown or suspected abuse to enforcement agencies. /hese agencies include* but are not limited to* adult protective services and local state law enforcement.

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2. All of the presented options are signs of a heart attac$* however* chest pain is considered the most significant. 6n addition to chest pain* patients may e(perience pain in the arm* nec$* and shoulder.

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6t is essential to ascertain if research e(ists on the effectiveness of treating psoriatic lesions with ultraviolet prior to initiating a formal research project.

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/he physical therapist must ta$e immediate action to resolve the situation by spea$ing directly to the involved therapists. Patient information should not be discussed in or around a public area.

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1. An insulin reaction is often associated with hypoglycemia or low blood sugar. /reatment for hypoglycemia includes the administration of food or drin$ containing sugar.

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3. A systematic sample is often used in place of random sample when a population can be accurately listed or is finite. 0embers of the sample are automatically selected once the first subject has been chosen.

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1. /he correct se5uence is as follows) removal of current dressings* gentle debridement in a hydrotherapy tan$* reapplication of the topical antibiotic* application of gau7e wraps in a distal to pro(imal pattern.

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4. A sei7ure occurs as a result of abnormal stimulation of brain cells. 6ntervention should be initially limited to  protecting the patient from injury. A sei7ure typically lasts less than two minutes.

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4or each inch of vertical rise a properly constructed ramp will have 1! inches of length.

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A rigid dressing will serve to immobili7e the injured area and offer protection from outside contaminants.

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A legal guardian or parent must sign the informed consent form for a minor.

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Pressure applied to an artery pro(imal to an injury site may be helpful to control bleeding.

0outh to mouth and nose breathing is appropriate for an infant less than one year oldB.

/he $itchen sin$ is often the site for food preparation and other essential functions of daily living. As a result* it is an inappropriate site for hand washing due to the potential to spread infectious material. 1.

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1. entures that are not loose should not be removed during rescue breathing since then can assist the therapist to form an appropriate seal around the patient’s mouth.

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/he location and si7e of the wound combined with a limited amount of drainage ma$e gloves the most appropriate form of medical asepsis when changing the dressing.

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A physical therapist will be much more efficient and effective in responding to an emergency with the assistance of other trained professionals. /he 5uestion provides little information on the number of patients within the treatment area or the si7e of the health care facilityN as a result the most appropriate response is to see$ assistance  by using the public address system. Although attempting to contain the fire through a specific action such as closing the door is very appropriate* other methods of containment such as attempting to e(tinguish the fire could further jeopardi7e the safety of the therapist and patient.

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1. Autonomy is defined as independent functioning. As an ethical term it refers to the patient’s freedom to decide or freedom to act.

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3. Physical therapist assistants perform procedures and related tas$s that have been selected and delegated by the supervising physical therapist. 6t is not appropriate to delegate an e(amination.

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/he ;ode of thics states that physical therapists see$ reimbursement for their services that is deserved and reasonable. Accepting a chec$ from a patient* regardless of its use* is unacceptable.

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/he therapist has made a judgment that the patient 8lac$s the necessary strength and coordination re5uired to complete the activity independently9. /he only method to resolve the situation and be sure the patient is unharmed is to become directly involved.

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