Practice Questions
1
1.
An eleve eleven-m n-mont onth-o h-old ld chil child d with with cerebr cerebral al palsy palsy atte attempt mptss to main maintai tain n a quadru quadruped ped posi positio tion. n. Which Which refl reflex ex would would interfere with this activity if it was N! inte"rated# 1. $alant lant refle eflex x %. symmet symmetric rical al tonic tonic nec& nec& ref reflex lex '. plan planta tarr "ras "rasp p refl reflex ex (. posi positi tive ve supp suppor ortt ref refle lex x
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A phys physic ical al ther therap apis istt atte attemp mpts ts to sche schedu dule le a pati patien entt for for an addi additi tion onal al ther therap apy y sess sessio ion n afte afterr comp comple leti tin" n" the the examination. !he physician referral referral indicates indicates the patient is is to be seen two times a wee&. wee&. !he therapist su""ests several possible times to the patient) but the patient insists she can only come in Wednesday Wednesday at (*'+. !he therapist would li&e to accommodate accommodate the patient) but already has two patients scheduled scheduled at that time. !he most appropriate appropriate action is to 1. schedu schedule le the the patien patientt on Wedn Wednesd esday ay at (*'+ (*'+ %. attempt attempt to move move one of the patient patient,,s scheduled scheduled on Wedne Wednesday sday at (*'+ (*'+ to a different different time. time. '. schedule schedule the the patient patient with with another another therapis therapistt on Wednes Wednesday day at (*'+. (*'+. (. inform inform the referri referrin" n" physician physician the patient patient will will only be seen seen once this this wee& in therap therapy y.
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A phys physica icall therap therapist ist cons consul ults ts with with an ortho orthotis tistt re"ard re"ardin" in" the the need need for an an&le an&le-fo -foot ot ortho orthosis sis for for a patien patientt status status post post A. A. !he patient has difficulty movin" from sittin" sittin" to standin" when wearin" a prefabricated an&le-foot orthosis. !he therapist indicates the patient has poor stren"th at the an&le) intact sensation) and does not have any edema or tonal influence. !he most appropriate type of an&le-foot orthosis orthosis for the patient would incorporate* 1. an arti articul culati ation on at at the the an&le an&le /oint /oint %. tone tone redu reduci cin" n" feat featur ures es '. metal etal upri upri"h "hts ts (. dors dorsif ifle lexi xion on ass assis istt spri sprin" n"
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A physi physica call ther therap apis istt prov provid ides es pre-o pre-ope pera rati tive ve inst instru ruct ctio ion n for for a pati patien entt sche schedu dule led d for for ante anteri rior or crucia cruciate te li"a li"ame ment nt reconstructive reconstructive sur"ery. sur"ery. 0urin" the treatment session) the patient expresses expresses to the therapist a sincere fear of dyin" durin" sur"ery. sur"ery. !he therapist,s therapist,s most appropriate response would be 1. !his !his sur"er sur"ery y is done done many many times times ever every y day. day. %. have have never never had had a pati patient ent die die yet. yet. '. 2ur"er 2ur"ery y can be a very very fri" fri"hte htenin nin" " thou"h thou"ht. t. (. 3ou will will be bac& bac& to to athlet athletics ics before before you &now it.
4.
A physi physica call ther therap apis istt usin usin" " an elect electri rica call stim stimul ulat atio ion n devi device ce attem attempt ptss to quant quantif ify y seve severa rall char charac acte teri rist stic icss of a monophasic waveform. waveform. When measurin" phase char"e) the standard standard unit of measure is the 1. coulomb %. ampere '. ohm (. second
5.
A physi physical cal ther therapi apist st assess assesses es the funct function ional al stren" stren"th th of a patient patient,,s hip extens extensors ors while while obser observin vin" " the patien patientt move from standin" to sittin". What type of contraction occurs in the hip extensors durin" this activity# activity# 1. concentric %. eccentric '. isometric (. isotonic
6.
A pati patient ent refe referre rred d to physica physicall thera therapy py with with chroni chronicc low bac& bac& pain pain has fail failed ed to ma&e ma&e any any pro"res pro"resss toward toward meeti meetin" n" established "oals in over three wee&s of treatment. treatment. !he physical therapist has employed employed a variety of treatment techniques) but has yet to observe any si"n of sub/ective sub/ective or ob/ective improvement improvement in the patient,s patient,s condition. !he most appropriate action would be to 1. transfer transfer the the patient patient to another another thera therapist pist,,s schedule. schedule. %. re-exami re-examine ne the the patient patient and establis establish h new new "oals '. continue continue to modify modify the the patient patient,,s treatm treatment ent plan (. alert alert the referrin" referrin" physician physician to the the patient patient,,s status status
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Practice Questions
7.
A pati patient ent with with car cardio diopul pulmon monary ary path patholo olo"y "y is ref referr erred ed to phys physica icall thera therapy py.. !he phys physica icall therap therapist ist docu documen ments ts the the followin" clinical clinical si"ns* pallor) pallor) cyanosis) and cool s&in. !hese clinical si"ns si"ns are most consistent with* with* 1. cor pu pulmonale %. anemia '. atelectasis (. diaphoresis
8.
A phys physica icall therap therapist ist empl employe oyed d by a home home hea health lth care care a"en a"ency cy &noc& &noc&ss on the the door door of of a patien patientt that that has a schedu scheduled led therapy therapy session. session. After After waitin" waitin" several minutes minutes)) the therapist therapist concludes concludes the patient patient is not at home. home. !he most appropriate therapist action is 1. contac contactt the the patie patient nt and and resc resched hedule ule %. notify notify the the patie patient, nt,ss insuran insurance ce provi provider der '. notify notify the referr referrin" in" physic physician ian (. discha dischar" r"ee the patie patient nt from from physi physical cal ther therapy apy
1+.
A pre"n pre"nant ant patie patient nt in her her third third trime trimeste sterr comple completes tes a serie seriess of exerc exercise isess in supine supine.. n order order to pre preven ventt vena cava cava compression durin" the exercise session) the therapist should 1. place a folded folded towel towel under under the ri"ht side of of the patie patient, nt,ss pelvis pelvis %. place a folded folded towel towel under under the left side side of the the patient patient,,s pelvis pelvis '. comple complete te the the exer exercis cises es in in sidel sidelyin yin" " (. elevat elevatee the patien patient, t,ss feet feet 1% inches inches
11.
A physical physical thera therapist pist receives receives a referr referral al for a two-mon two-month-o th-old ld infant infant dia"nosed dia"nosed with osteo"ene osteo"enesis sis imper imperfecta fecta.. After After completin" the examination) the therapist discusses discusses the physical therapy plan of care with the infant,s infant,s parents. !he primary "oal of therapy should be 1. improv improvee muscle muscle str stren" en"th th and and dimini diminish sh tone tone %. facili facilitat tatee prote protecte cted d wei"h wei"htt bearin bearin" " '. promot promotee safe safe hand handlin lin" " and and posit position ionin" in" (. dimini diminish sh pulmon pulmonar ary y secret secretion ionss
1%.
A physic physical al therap therapist ist elect electss to utili9 utili9ee the 2ix-:in 2ix-:inute ute Wal& Wal& !est !est as a means of quanti quantifyi fyin" n" enduran endurance ce for a patien patientt rehabilitatin" from a len"thy illness. illness. Which variable would be the most appropriate to measure when determinin" determinin" the patient,s endurance level with this ob/ective test# 1. perc percei eive ved d exe exert rtio ion n %. hear heartt rat ratee res respo pons nsee '. elapsed time (. dis distanc tancee wal wal&e &ed d
1'.
ommun ommunica icatio tion n and perce perceptu ptual al probl problems ems are are extreme extremely ly common common in in patien patients ts with with hemip hemiple" le"ia. ia. Which Which clinic clinical al problem would be characteristic characteristic of a patient status post ri"ht ri"ht A# A# 1. inability inability to reco"ni9 reco"ni9ee symbols symbols and perform perform basic basic math math problem problemss %. inability inability to plan plan and and perform perform seria seriall steps steps in activiti activities es '. distor distorted ted awaren awareness ess of self self-im -ima"e a"e (. dimi dimini nish shed ed func functi tion onal al spee speech ch
1(.
A physician physician orders orders an electroc electrocardi ardio"ram o"ram for a patien patientt dia"nose dia"nosed d with with con"es con"estive tive heart heart failure failure.. !he medical medical record record indicates the patient is currently ta&in" di"italis. What effect would you expect di"italis to have on the patient,s ;$# 1. len"th len"thene ened d ventric ventricula ularr activa activatio tion n time time %. increa increased sed refra refracto ctory ry period period of A node node '. len" len"th then ened ed Q! inte interv rval al (. elev elevat ated ed 2! se"m se"men entt
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Practice Questions
7.
A pati patient ent with with car cardio diopul pulmon monary ary path patholo olo"y "y is ref referr erred ed to phys physica icall thera therapy py.. !he phys physica icall therap therapist ist docu documen ments ts the the followin" clinical clinical si"ns* pallor) pallor) cyanosis) and cool s&in. !hese clinical si"ns si"ns are most consistent with* with* 1. cor pu pulmonale %. anemia '. atelectasis (. diaphoresis
8.
A phys physica icall therap therapist ist empl employe oyed d by a home home hea health lth care care a"en a"ency cy &noc& &noc&ss on the the door door of of a patien patientt that that has a schedu scheduled led therapy therapy session. session. After After waitin" waitin" several minutes minutes)) the therapist therapist concludes concludes the patient patient is not at home. home. !he most appropriate therapist action is 1. contac contactt the the patie patient nt and and resc resched hedule ule %. notify notify the the patie patient, nt,ss insuran insurance ce provi provider der '. notify notify the referr referrin" in" physic physician ian (. discha dischar" r"ee the patie patient nt from from physi physical cal ther therapy apy
1+.
A pre"n pre"nant ant patie patient nt in her her third third trime trimeste sterr comple completes tes a serie seriess of exerc exercise isess in supine supine.. n order order to pre preven ventt vena cava cava compression durin" the exercise session) the therapist should 1. place a folded folded towel towel under under the ri"ht side of of the patie patient, nt,ss pelvis pelvis %. place a folded folded towel towel under under the left side side of the the patient patient,,s pelvis pelvis '. comple complete te the the exer exercis cises es in in sidel sidelyin yin" " (. elevat elevatee the patien patient, t,ss feet feet 1% inches inches
11.
A physical physical thera therapist pist receives receives a referr referral al for a two-mon two-month-o th-old ld infant infant dia"nosed dia"nosed with osteo"ene osteo"enesis sis imper imperfecta fecta.. After After completin" the examination) the therapist discusses discusses the physical therapy plan of care with the infant,s infant,s parents. !he primary "oal of therapy should be 1. improv improvee muscle muscle str stren" en"th th and and dimini diminish sh tone tone %. facili facilitat tatee prote protecte cted d wei"h wei"htt bearin bearin" " '. promot promotee safe safe hand handlin lin" " and and posit position ionin" in" (. dimini diminish sh pulmon pulmonar ary y secret secretion ionss
1%.
A physic physical al therap therapist ist elect electss to utili9 utili9ee the 2ix-:in 2ix-:inute ute Wal& Wal& !est !est as a means of quanti quantifyi fyin" n" enduran endurance ce for a patien patientt rehabilitatin" from a len"thy illness. illness. Which variable would be the most appropriate to measure when determinin" determinin" the patient,s endurance level with this ob/ective test# 1. perc percei eive ved d exe exert rtio ion n %. hear heartt rat ratee res respo pons nsee '. elapsed time (. dis distanc tancee wal wal&e &ed d
1'.
ommun ommunica icatio tion n and perce perceptu ptual al probl problems ems are are extreme extremely ly common common in in patien patients ts with with hemip hemiple" le"ia. ia. Which Which clinic clinical al problem would be characteristic characteristic of a patient status post ri"ht ri"ht A# A# 1. inability inability to reco"ni9 reco"ni9ee symbols symbols and perform perform basic basic math math problem problemss %. inability inability to plan plan and and perform perform seria seriall steps steps in activiti activities es '. distor distorted ted awaren awareness ess of self self-im -ima"e a"e (. dimi dimini nish shed ed func functi tion onal al spee speech ch
1(.
A physician physician orders orders an electroc electrocardi ardio"ram o"ram for a patien patientt dia"nose dia"nosed d with with con"es con"estive tive heart heart failure failure.. !he medical medical record record indicates the patient is currently ta&in" di"italis. What effect would you expect di"italis to have on the patient,s ;$# 1. len"th len"thene ened d ventric ventricula ularr activa activatio tion n time time %. increa increased sed refra refracto ctory ry period period of A node node '. len" len"th then ened ed Q! inte interv rval al (. elev elevat ated ed 2! se"m se"men entt
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Practice Questions
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14. 14.
A physic physical al ther therap apis istt comp comple lete tess an exam examin inat atio ion n on a five five-y -yea earr-ol old d boy boy dia" dia"no nose sed d with with 0uche 0uchenn nnee musc muscul ular ar dystrophy. dystrophy. !he referral indicates indicates that the boy was dia"nosed with with the disease less than one year a"o. Assumin" a normal pro"ression) which of the followin" findin"s would be the first to occur# 1. dist distal al musc muscle le wea& wea&ne ness ss %. prox proxim imal al musc muscle le wea wea&n &nes esss '. impair impaired ed respir respirato atory ry functi function on (. inability inability to perfo perform rm activi activities ties of daily daily livin" livin"
15.
A physic physical al therap therapist ist obtain obtainss an x-ray x-ray of a 1(-yea 1(-yearr-old old femal femalee recentl recently y referred referred to physica physicall therapy therapy follow followin" in" activity. activity. !he patient previously previously participated in competitive "ymnastics) "ymnastics) however) however) states her bac& was unable to tolerate the intensity of trainin". trainin".
the therapist would would expect the patient,s medical dia"nosis to be 1. spondylitis %. spon spondy dyllolys olysiis '. spon spondy dylo loli list sthe hesi siss (. spon spondy dyllopto optossis
16.
A physi physica call therapi therapist st comple completes tes a develo developme pmenta ntall assessm assessment ent on a five-m five-mont onth-o h-old ld infant infant.. f the thera therapis pistt elects elects to examine the infant,s palmar "rasp reflex) which of the followin" stimuli is the most appropriate# 1. contact contact to the pall of the the foot foot in in upri"ht upri"ht standin" standin" %. mainta maintaine ined d pressu pressure re to to the the palm palm of the the hand hand '. noxiou noxiouss stimu stimulus lus to the the palm palm of of the the hand hand (. sudden sudden chan"e chan"e in the the posi positio tion n of the hand hand
17.
A physi physical cal thera therapis pistt treats treats a 4(-year 4(-year-ol -old d male rehab rehabili ilitat tatin" in" from from a tibial tibial platea plateau u fractur fracture. e. While While comple completin tin" "a resistive exercise exercise the patient indicates that liftin" wei"hts wei"hts often causes him to void small amounts of urine. !he most appropriate therapist action is 1. refer refer the the pati patient ent to a suppor supportt "roup "roup %. instruct instruct the the patient patient in pelvic pelvic floor floor muscle muscle stren" stren"theni thenin" n" exercise exercisess '. discontin discontinue ue resisti resistive ve exercise exercisess as part of of the establi established shed plan plan of care care (. educat educatee the pati patient ent abou aboutt incon incontin tinenc encee
18.
A physical physical thera therapist pist treat treatss a nine-ye nine-yearar-old old child child dia"n dia"nosed osed with with cystic cystic fibrosis. fibrosis. As part part of the treat treatment ment session session the the therapist attempts to improve the efficiency efficiency of the patient,s patient,s breathin". !he most appropriate technique to encoura"e full expansion at the base of the lun"s is 1. manual manual percussi percussion on on the poster posterior ior portion portion of the the ribs ribs with the the patient patient in prone prone %. manual manual contacts contacts with with pressure pressure on the latera laterall borders borders of the ribs with with the patient patient in supine supine '. manual manual vibration vibration on the the lateral lateral portion portion of of the ribs ribs with the the patient patient in sidel sidelyin" yin" (. manual manual cues cues on the epi"astric epi"astric area with with the the patient patient in in supine. supine.
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A physi physicia cian n discus discusses ses a patie patient, nt,ss plan plan of care care with with a physica physicall thera therapis pist. t. !he pati patient ent is is a %8-year %8-year-ol -old d male male that that sustained sustained deep partial-thi partial-thic&nes c&nesss burns to the anterior anterior surface of his upper le"s. !he physician physician discusses discusses the possibility of discontinuin" use of the topical antibiotic silver sulfadia9ine after identifyin" an irre"ularity irre"ularity in the patient,s patient,s laboratory results. results. Which findin"s could could be most related related to the use use of silver sulfadia9ine# sulfadia9ine# 1. leu&openia %. per periphe ipherral ede edem ma '. hypo&alemia (. alte altere red d p? p? bal balan ance ce
%1.
A patient patient recen recently tly admitt admitted ed to the hospit hospital al with with an acute acute illnes illnesss is refer referred red to physical physical thera therapy py.. 0urin" 0urin" a schedul scheduled ed treatment session the patient as&s what effect anemia will have on his ability to complete a formal exercise pro"ram. !he most appropriate appropriate therapist therapist response is 1. you may may feel feel as as thou"h thou"h your your musc muscles les are are wea& wea& %. you may experi experienc encee freq frequen uentt nause nauseaa '. your your aerob aerobic ic capa capacit city y may may be reduce reduced d (. you may may have have a tende tendency ncy to to become become fati fati"ue "ued d
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Practice Questions
%%.
When perfor performin" min" ran"e ran"e of motion motion exercis exercises es with with a patient patient who who sustain sustained ed a head head in/ury in/ury)) a physica physicall therapist therapist notes notes that the patient lac&s full elbow extension and classifies classifies the end-feel as hard. !he most li&ely cause is 1. hete hetero roto topi picc ossi ossifi fica cati tion on %. spas spasti tici city ty of the the bic bicep epss '. ante anteri rior or caps capsul ular ar ti"h ti"htn tnes esss (. tric tricep epss wea& wea&ne ness ss
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A physical physical thera therapist pist develo develops ps a probl problem em list list after after examini examinin" n" a patien patientt with with a transt transtibial ibial amputation amputation.. Which Which of the the followin" would be the most appropriate entry in the patient problem list# 1. donnin" donnin" and and doff doffin" in" prosthesis prosthesis requires requires verbal verbal cues cues %. donnin" donnin" and doffin" doffin" prosthe prosthesis sis requir requires es verbal verbal cures cures and minimal minimal assis assistt of one '. depend dependenc encee with donni donnin" n" and doff doffin" in" prost prosthes hesis is (. independe independent nt donnin" donnin" and doffi doffin" n" prosthe prosthesis sis in in one wee&
%(.
A (%-yea (%-yearr-old old fema female le status status post abdom abdomina inall sur"er sur"ery y is unable unable to satisf satisfac actor torily ily contro controll the retenti retention on and release release of urine. Which type of urinary catheter would N! be appropriate appropriate for the patient# 1. indw indwel elli lin" n" urin urinar ary y cathe cathete ter r %. exte extern rnal al uri urina nary ry cat cathe hete ter r '. @ole @oley y cat cathe hete ter r (. supr suprap apub ubic ic cat cathe hete ter r
%4.
A physical physical thera therapist pist monit monitors ors a 5 foot foot ' inch) inch) %64 %64 pound) pound) male, male,ss blood blood pressur pressuree usin" usin" the brach brachial ial arter artery y. Which Which of the followin" is most important when selectin" an appropriate si9e blood pressure cuff for the patient# 1. patient a" a"e %. per percent ent bod body y fat fat '. somatotype (. extr extrem emit ity y cir circu cumf mfer eren ence ce
%5.
A patient patient informs informs a physical physical thera therapist pist that that he has to use the the bathroo bathroom m immedia immediately tely after after bein" bein" transpor transported ted outsid outsidee the hospital hospital to practice practice car transfers. transfers. !he physical physical therapis therapist, t,ss most appropriat appropriatee response response to meet the patient, patient,ss physical need is to 1. as& the patien patientt if it is is an emer emer"en "ency cy %. complete complete the transf transfer er trainin" trainin" as quic&ly quic&ly as possib possible le and allow allow the patient patient to use the the bathroom bathroom '. transport transport the the patient patient bac& bac& into into the hospit hospital al to use use the bathr bathroom oom (. instruct instruct the patient patient that in the future future he should should use the bathroom bathroom before before be"innin" be"innin" physical physical therapy therapy
%6.
A physi physical cal thera therapis pistt examine examiness a patient patient four four days statu statuss post total total hip hip replace replacemen ment. t. !he !he patient patient,,s medical medical recor record d indicates the sur"eon utili9ed utili9ed an anterolateral sur"ical approach. approach. Which of the followin" motions would be the most important to restrict durin" the initial phase of rehabilitation# rehabilitation# 1. &nee &nee exte xtensi nsion %. &nee flexion '. hip hip late latera rall rota rotati tion on (. hip hip med media iall rot rotat atio ion n
%7.
A patient patient infor informs ms a physical physical therapist therapist how frustr frustrated ated she feels feels after after bein" bein" exami examined ned by by her physician. physician. !he patient patient explains that she becomes so nervous) she cannot as& any questions durin" scheduled scheduled office visits. !he therapist,s therapist,s most appropriate response is to 1. offer offer to "o with with the the patient patient to to her next next schedule scheduled d physician physician visit visit.. %. offer offer to call call the the physici physician an and and as& any relevan relevantt questio questions ns '. su""est su""est that the patient patient write write down questio questions ns for the physicia physician n and brin" them with with her to the next schedule scheduled d visit. (. tell the the patient patient it is a very very normal normal response response to to be nervous nervous in the the presence presence of a physici physician an
%8.
A physi physical cal thera therapis pistt observe observess an electro electrocar cardio dio"ra "ram m of a patient patient on beta-b beta-bloc loc&er &ers. s. Which Which of the follo followin win" " ;$ chan"es could be facilitated by beta-bloc&ers# 1. bradycardia %. tachycardia '. increa increased sed A cond conduct uction ion time time (. 2! se"m se"men entt sa" sa""i "in" n" '5'6%6(+6.doc
Practice Questions
4
'+.
An athlete is forced to contemplate &nee sur"ery after sprainin" the anterior cruciate li"ament while playin" soccer. Which situation would provide the most direct support for an anterior cruciate li"ament reconstruction# 1. "rade A) and "rade P in/ury %. "rade A sprain with a lateral meniscus tear '. "rade A sprain with a medial meniscus tear (. functional instability
'1.
A physical therapist examines a patient that recently sustained a cervical hyperextension in/ury. Besults of the examination reveal a loss of proprioception and two-point discrimination with intact motor function. !his type of incomplete spinal cord in/ury is most appropriately termed 1. anterior cord syndrome %.
'%.
A physical therapist employed in a lon"-term care settin" attempts to identify a screenin" tool that examines a patient,s ability to perform a variety of activities of daily livin" independently. !he therapist would li&e to readminister the tool to assess patient pro"ress. !he most appropriate screenin" tool is the 1.
''.
A patient rehabilitatin" from a lower extremity in/ury is referred to physical therapy for hydrotherapy treatments. !he physical therapist would li&e the patient to fully extend the involved lower extremity while in the hydrotherapy tan&. Which type of whirlpool would not allow the patient to extend the involved lower extremity# 1. ?ubbard tan& %. hi"hboy tan& '. lowboy tan& (. wal& tan&
'(.
A patient recoverin" in the hospital from a total &nee replacement is examined by a physical therapist. Assumin" an uncomplicated recovery) how much &nee ran"e of motion is anticipated prior to dischar"e# 1. +-4+ de"rees %. +-8+ de"rees '. 14-8+ de"rees (. 14-1+4 de"rees
'4.
A physical therapist inspects a wound over the sacrum of a 47-year-old female. !he therapist would most accurately classify the presented wound =picture of a wound with the muscle exposed> as* 1. sta"e %. sta"e '. sta"e (. sta"e
'5.
A physical therapist observes a patient,s breathin" as part of a respiratory assessment. Which muscle of respiration is most active durin" forced expiration# 1. diaphra"m %. external intercostals '. internal intercostals (. upper trape9ius
'6.
A physical therapist performs a manual muscle test on a patient with unilateral upper extremity wea&ness. !he patient is able to complete 64C of the available ran"e of motion with "ravity eliminated. !he therapist should record the muscle "rade as* 1. poor plus %. poor '. poor minus (. trace plus '5'6%6(+6.doc
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Practice Questions
'7.
A physical therapist measures a patient for a strai"ht cane prior to be"innin" ambulation activities. Which "ross measurement method would provide the best estimate of cane len"th# 1. measurin" from the head of the fibula strai"ht to the floor and multiplyin" by two %. measurin" from the iliac crest strai"ht to the floor '. measurin" from the "reater trochanter strai"ht to the floor (. dividin" the patient,s hei"ht by two and addin" three inches
'8.
A physical therapist recommends a wheelchair for a patient rehabilitatin" from a A with the "oal of independent mobility. !he left upper and lower extremities are flaccid and present with edema. !here is normal stren"th on the ri"ht) however) the patient,s trun& is hypotonic. !he patient is co"nitively intact. !he most appropriate wheelchair for the patient is 1. solid seat) solid bac&. elevatin" le"rests) and anti-tippers %. slin" seat) slin" bac&) arm board) and elevatin" le"rests '. li"ht wei"ht) solid seat) solid bac&) arm board) and elevatin" le"rests (. li"ht wei"ht) solid seat) solid bac&) arm board and standard footrests
(+.
A physical therapist reviews the results of a pulmonary function test for a 47-year-old male patient recently admitted to the hospital. !he therapist notes that the patient,s total lun" capacity is si"nificantly increased when compared to established norms. Which medical condition would most li&ely produce this type of result# 1. chronic bronchitis %. emphysema '. spinal cord in/ury (. pulmonary fibrosis
(1.
A physical therapist observes a patient,s s&in shortly after applyin" moist heat to the low bac&. !he therapist identifies several si"ns of heat intolerance includin" uneven blotchin" and a surface rash. !he most appropriate action is to 1. continue with the present treatment %. select an alternate superficial heatin" a"ent '. limit moist heat exposure to five minutes (. discontinue the moist heat and document the findin"s
(%.
A physical therapist wor&s with a patient rehabilitatin" from a traumatic brain in/ury on a mat pro"ram. !he pro"ram emphasi9es various developmental positions to prepare the patient for ambulation activities. Which developmental position would be the most demandin"# 1. hoo&lyin" %. quadruped '. &neelin" (. modified planti"rade
('.
A physical therapist prepares a patient status post A with "lobal aphasia for dischar"e from a rehabilitation hospital. !he patient will be returnin" home with her husband and dau"hter. !he most appropriate form of education to facilitate safe dischar"e is to 1. perform hands-on trainin" sessions with the patient and family members %. videotape the patient performin" transfers and A0 '. provide written instructions on all A0s and functional tas&s (. meet with family members to discuss the patient,s present status and abilities
((.
A physical therapist treats a '5-year-old male status post &nee sur"ery. !he therapist performs "oniometric measurements to quantify the extent of the patient,s extension la". Which of the followin" would not provide a plausible rationale for the extension la"# 1. muscle wea&ness %. bony obstruction '. inhibition by pain (. patient apprehension
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Practice Questions
6
(4.
A patient successfully completes ten anterior lun"es. !he physical therapist would li&e to modify the activity to maximally challen"e the patient in the sa"ittal plane. Which of the followin" modifications would be the most appropriate# 1. anterior lun"e with concurrent bilateral elbow flexion to (4 de"rees with five pound wei"hts %. anterior lun"e with concurrent bilateral shoulder flexion to 8+ de"rees with five pound wei"hts '. anterior lun"e with concurrent unilateral shoulder flexion to 8+ de"rees with a five pound wei"ht (. anterior lun"e with concurrent bilateral shoulder abduction to (4 de"rees with five pound wei"hts
(5.
A physical therapist teaches a patient positioned in supine to posteriorly rotate her pelvis. !he patient has full active and passive ran"e of motion in the upper extremities) but is unable to achieve full shoulder flexion while maintainin" the posterior pelvic tilt. Which of the followin" could best explain these findin"s# 1. capsular ti"htness %. latissimus dorsi ti"htness '. pectoralis minor ti"htness (. quadratus lumborum ti"htness
(6.
A patient with paraple"ia is interested in learnin" how to perform a wheelie to assist with community mobility. !he patient is independent with basic wheelchair propulsion. When instructin" the patient to perform a wheelie) the physical therapist first should teach the patient to 1. ma&e small ad/ustments =forward and bac&ward> after bein" placed in the wheelie position %. move into the wheelie position '. perform turns while holdin" the wheelie (. statically hold the wheelie position after bein" placed in it by the therapist
(7.
A physical therapist observes a burn on the dorsal surface of a patient,s arm. !he wound area is mottled red with a number of blisters. !he therapist informs the patient that healin" should ta&e place in less than three wee&s. !his description is most indicative of a 1. superficial burn %. superficial partial-thic&ness burn '. deep partial-thic&ness burn (. full-thic&ness burn
(8.
A "roup of physical therapists develops a research pro/ect that examines the effect of increased abdominal muscle stren"th on forced vital capacity and forced expiratory volume. n order to conduct the study) the therapists are required to have the approval of the ?ospital nstitutional Beview
4+.
:embers of a community health tas& force evaluate a proposal for a new adolescent screenin" pro"ram. 2everal members of the tas& force raise questions as to the validity of the screenin" instrument. Which measure of validity examines the instrument,s ability to identify diseased persons by comparin" the true positives# 1. adaptability %. selectivity '. sensitivity (. specificity
41.
A physical therapist attempts to quantify a patient,s endurance level by administerin" a maximal exercise test. What is the primary limitation of maximal exercise test# 1. :aximal exercise testin" requires participants to exercise only to the point of volitional fati"ue %. :aximal exercise testin" does not typically allow a steady state heart rate at each wor& rate. '. :aximal exercise testin" is not useful in dia"nosin" coronary artery disease. (. :aximal exercise testin" requires pro"ressive sta"es of increasin" wor& intensities without rest intervals.
'5'6%6(+6.doc
7
Practice Questions
4%.
A physical therapist prepares to complete a formal sensory examination on a patient rehabilitatin" from a lower extremity burn. Which of the followin" would serve as the best predictor of altered sensation# 1. presence of a s&in "raft %. depth of burn in/ury '. percenta"e of body surface affected (. extent of hypertrophic scarrin"
4'.
An 17-year-old male status post fractured ri"ht femur with open reduction and internal fixation is referred to physical therapy. After the initial session the patient states that therapy is a waste of time and he will not return for any additional appointments. !he most immediate response would be to 1. inform the referrin" physician of the patient,s decision %. instruct the patient to return for one additional treatment session '. discuss the importance of physical therapy with the patient (. dischar"e the patient from physical therapy
4(.
A physical therapist instructs a physical therapist assistant to be"in "ait trainin" with a patient one day status post non-cemented total hip replacement. Assumin" the patient has not had any si"nificant problems postoperatively) the most li&ely wei"ht bearin" status would be 1. wheelchair use only %. toe touch wei"ht bearin" '. wei"ht bearin" as tolerated (. full wei"ht bearin"
44.
A physical therapist completes a manual muscle test on the ri"ht lower trape9ius muscle. n order to properly assess the muscle) the therapist should position the patient in 1. supine %. prone '. ri"ht sidelyin" (. left sidelyin"
45.
A physical therapist attempts to have a patient with ri"ht hemiple"ia brush his teeth while wor&in" on standin" tolerance. !he therapist notices that the patient attempts to put the toothpaste directly in his mouth and hair. !he therapist would document this findin" as 1. ideomotor apraxia %. ideational apraxia '. constructional apraxia (. conduction aphasia
46.
A physical therapist monitors the vital si"ns of a 4%-year-old male durin" a "raded exercise test. !he patient was prompted to see& medical assistance two wee&s a"o after becomin" short of breath on two separate occasions. When interpretin" the data collected durin" the exercise test) which findin" would serve as the best indicator that the patient had exerted a maximal effort# 1. failure of the heart rate to increase with further increases in intensity %. rise in systolic blood pressure of 4+ mm?" when compared to the restin" value '. ratin" of 1% on a perceived exertion scale (. decrease in diastolic blood pressure of %+ mm?" when compared to restin" value
47.
A physical therapist instructs a patient in residual limb wrappin". Which banda"e would be the most appropriate to utili9e for a patient with transfemoral amputation# 1. two-inch %. four-inch '. six-inch (. ei"ht-inch
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Practice Questions
8
48.
A physical therapist performs an examination on a patient with hip-&nee-an&le-foot orthoses. !he patient can ambulated independently with the orthoses and ofstrand crutchesD however) due to the hi"h ener"y expenditure often becomes fati"ued very rapidly. Which disorder would be most consistent with this scenario# 1. amyotrophic lateral sclerosis %. peripheral neuritis '. neuro"enic arthropathy (. spina bifida
5+.
A physical therapist examines a patient,s hamstrin"s len"th usin" a passive strai"ht le" raise. While raisin" the tested lower extremity) the physical therapist attempts to stabili9e the contralateral limb. f the patient has ti"ht hip flexors which result in an excessive anterior pelvic tilt) what can the physical therapist conclude about the patient,s measured hamstrin"s len"th# 1. actual len"th is "reater than measured len"th %. actual len"th is less than measured len"th '. shortened hip flexors do not influence apparent hamstrin"s len"th (. the apparent len"th measured is the actual len"th
51.
A physician orders electromyo"raphy for a patient with a brachial plexus in/ury to ob/ectively determine the extent of patholo"y. Which of the followin" responses is most indicative of a normal muscle at rest# 1. electrical silence %. spontaneous potentials '. polyphasic potentials (. occasional motor unit potentials
5%.
A physical therapist examines a patient dia"nosed with acromioclavicular /oint dysfunction. !he therapist instructs the patient to abduct his arm in a coronal plane to 17+ de"rees. Which portion of the ran"e of motion would you most expect to elicit pain in the acromioclavicular /oint# 1. '+-6+ de"rees %. 4+-8+ de"rees '. 8+-1%+ de"rees (. 1%+-17+ de"rees
5'.
A physical therapist completes a quantitative "ait analysis on a patient rehabilitatin" from a lower extremity in/ury. As part of the examination the therapist measures the number of steps ta&en by the patient in a '+ second period. !his measurement technique can be used to measure 1. acceleration %. cadence '. velocity (. speed
5(.
:embers of a health promotion tas& force desi"n a pro"ram that annually will screen individuals in selected retirement communities for osteoporosis. Which screenin" tool would be the most cost effective and reliable to incorporate as part of the pro"ram# 1. physical activity survey %. dietary analysis '. measurin" hei"ht (. urinalysis screenin"
54.
A cardiac patient under"oes a low-level symptom limited exercise treadmill test that be"ins at 1)4 :;!s and pro"resses to ( :;!s. Which of the followin" activities would require an ener"y expenditure of approximately ( :;!s# 1. sittin" quietly at rest %. level wal&in" at 1 mph '. level wal&in" at ' mph (. level wal&in" at 4 mph
'5'6%6(+6.doc
1+
Practice Questions
55.
A physical therapist prepares a patient for prosthetic trainin". Which of the followin" amputations would require the hi"hest ener"y expenditure when usin" the appropriate prosthesis# 1. bilateral transtibial amputations %. unilateral transtibial amputation '. unilateral transfemoral amputation (. 2yme,s amputation
56.
A physical therapist positions a patient in prone with the &nee flexed to 6+ de"rees prior to completin" a manual muscle test of the hamstrin"s. !o isolate the biceps femoris the therapist should 1. place the thi"h in sli"ht lateral rotation and the lower le" in sli"ht lateral rotation on the thi"h %. place the thi"h in sli"ht medial rotation and the lower le" in sli"ht medial rotation on the thi"h '. position the &nee in 8+ de"rees of flexion (. position the &nee in 11+ de"rees of flexion
57.
A physical therapist reviews a patient,s blood "as analysis. !he therapist identifies that the Pa % is elevated and the p? is below the normal level. !hese findin"s are most representative of 1. respiratory acidosis %. respiratory al&alosis '. metabolic acidosis (. metabolic al&alosis
58.
A physical therapist stron"ly suspects a patient is intoxicated after arrivin" for his treatment session. When as&ed if he has been drin&in") the patient indicates he consumed six or seven alcoholic bevera"es before drivin" to therapy. !he therapist,s most appropriate action is to 1. continue to treat the patient assumin" he can remain inoffensive to other patients %. modify the patient,s present treatment pro"ram to minimi9e the effects of alcohol '. contact a member of the patient,s family to ta&e the patient home (. instruct the patient to leave the clinic
6+.
A physical therapist instructs a patient to complete a biceps stren"thenin" exercise usin" a ten pound dumbbell in standin". !he exercise requires the patient to maximally flex her elbow twelve times without movin" the trun&. While observin" the patient performin" the exercise) it becomes apparent that the patient is unable to maintain her trun& in a stationary position. Which of the followin" modifications would be the most appropriate# 1. decrease the number of repetitions to six %. decrease the dumbbell wei"ht to five pounds '. instruct the patient to perform the exercise while sittin" on a stool (. no modifications are necessary
61.
A physical therapist receives a referral to instruct a patient in pelvic floor muscle stren"thenin" exercises. Which of the followin" explanations would be the most effective to assist the patient to perform a pelvic floor contraction# 1. ti"hten your muscles li&e you were tryin" to expel a lar"e amount of urine in a very short amount of time %. pull your muscles up and in li&e when you have to "o to the bathroom) but there is no toilet '. ti"hten your abdominal muscles and anteriorly rotate your pelvis (. "ently push out as if you had to pass "as
6%.
A physical therapist orders a wheelchair with a reclinin" bac& for a patient in a rehabilitation hospital. Which type of le"rests would be the most appropriate for the wheelchair# 1. swin"-away %. detachable '. elevatin" (. fixed
6'.
A physical therapy department attempts to establish a quality assurance pro"ram. !he first step in developin" the pro"ram should be to 1. identify important aspects of patient care provided by the department %. collect and analy9e data for each established indicator '. identify quality indicators that will allow the department to monitor selected aspects of patient care (. determine a percenta"e of occurrence that will dictate a specified action
'5'6%6(+6.doc
Practice Questions
11
6(.
A patient rehabilitatin" from cardiac sur"ery is monitored usin" an arterial line. !he primary purpose of an arterial line is to 1. measure ri"ht arterial pressure %. measure heart rate and oxy"en saturation '. measure pulmonary artery pressure (. measure blood pressure
64.
A patient with complete 4 tetraple"ia wor&s on a forward raise for pressure relief. !he patient utili9es loops that are attached to the bac& of the wheelchair to assist with the forward raise. Which muscles need to be particularly stron" in order for the patient to be successful with the forward raise# 1. brachioradialis) brachialis %. rhomboids) levator scapulae '. biceps) deltoids (. triceps) flexor di"itorum
65.
A physical therapist uses rhythmic initiation to assist a patient in learnin" to roll from supine to prone. !he therapist,s initial command should be 1. E2lowly roll over by yourselfF %. E?elp me roll you overF '. E2top me from rollin" your overF (. E Belax and let me move youF
66.
A physical therapist employed in an outpatient clinic treats a 47-year-old female dia"nosed with a traumatic anterior shoulder dislocation. !he patient has no past history of shoulder instability) however) has been treated for impin"ement syndrome. Gpon readin" the physician referral the therapist is surprised that the period of shoulder immobili9ation was less than two wee&s. Which of the followin" variables would have been the most si"nificant when determinin" the len"th of immobili9ation# 1. a"e %. sex '. vocation (. social history
67.
A physical therapist uses proprioceptive neuromuscular facilitation to increase /oint ran"e of motion usin" the holdrelax technique. Which type of contraction is utili9ed at the end point of the available ran"e of motion# 1. isotonic %. isometric '. iso&inetic (. eccentric
68.
A physical therapist prepares to select an assistive device for a patient rehabilitatin" from a lower extremity in/ury. Which of the followin" would be of least importance when selectin" an assistive device#H 1. the patient,s level of understandin" %. the patient,s hei"ht and wei"ht '. the patient,s upper and lower extremity stren"th (. the patient,s level of coordination
7+.
A patient sustained a fracture of the acetabulum that was treated with open reduction and internal fixation. !he in/ury occurred in a motor vehicle accident approximately seven wee&s a"o. Which ob/ective measure would be the most influential variable when determinin" the patient,s wei"ht bearin" status# 1. visual analo"ue pain scale ratin" %. radio"raphic confirmation of bone healin" '. lower extremity manual muscle testin" (. balance and coordination assessment
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1%
Practice Questions
71.
A patient with hemiple"ia ambulates with an an&le-foot orthosis. !he physical therapist notes that the patient,s involved foot frequently dra"s durin" the initial swin" phase of "ait. !o treat this problem most effectively the therapist should emphasi9e 1. eccentric stren"thenin" of the hamstrin"s %. eccentric stren"thenin" of the "luteus medius '. concentric stren"thenin" of the plantarflexors (. concentric stren"thenin" of the iliopsoasIrectus femoris
7%.
A physical therapist usin" the upper extremity 01 extension proprioceptive neuromuscular facilitation pattern resists elbow extension with the "oal of increasin" the patient,s ability to extend her wrist. !his is an example of 1. reciprocal excitation %. successive induction '. irradiation (. quic& stretch
7'.
A patient who has suffered a A four wee&s a"o is be"innin" to show the ability to produce movement patterns outside of limb syner"ies. Accordin" to
7(.
A physical therapist wor&s with a patient to improve bed mobility. Which of the followin" techniques would be the most effective to increase the patient,s hip stability# 1. lower trun& rotation in the hoo&lyin" position %. brid"in" '. assisted hip and &nee flexion in supine (. hip abduction and adduction in the hoo&lyin" position
74.
A physical therapist completes a posture screenin" and a "ross ran"e of motion test on a patient referred to therapy with patella tendonitis. !he therapist determines that the patient has extremely limited lower extremity flexibility) most notably in the hip flexors. What common structural deformity is often associated with ti"ht hip flexors# 1. scoliosis %. &yphosis '. lordosis (. spondylosis
75.
A patient two wee&s status post transtibial amputation is instructed by his physician to remain at rest for two days after contractin" bronchitis. !he most appropriate position for the patient in bed is 1. supine with a pillow under the patient,s &nees %. supine with a pillow under the patient,s thi"hs and &nees '. supine with the le"s extended (. sidelyin" in the fetal position
76.
A physical therapist tests a small area of s&in for hypersensitivity prior to usin" a cold immersion bath. !he patient be"ins to demonstrate evidence of cold intolerance within 5+ seconds after cold application. !he most appropriate response is to 1. limit cold exposure to ten minutes or less %. select an alternative cryotherapeutic a"ent '. continue with the cold immersion bath (. discontinue cold application and document your findin"s
77.
A %6-year-old female dia"nosed with anterior compartment syndrome reports to an outpatient clinic for physical therapy services. While reviewin" the physician referral supplied by the patient) the physical therapist identifies that the referral form is over 8+ days old. !he most appropriate therapist action is 1. continue with the session since the existin" referral is acceptable %. attempt to contact the physician,s office by telephone to receive verbal orders '. send the physician written correspondence requestin" an updated referral (. discontinue the session until the patient secures an updated referral '5'6%6(+6.doc
Practice Questions
1'
78.
A physical therapist assesses the deep tendon reflexes of a patient as part of a lower quarter screenin" examination. !he therapist determines that the ri"ht and left patellar tendon reflex and the left Achilles tendon reflex is %J) while the ri"ht Achilles tendon reflex is absent. !he clinical condition that could best explain this findin" is 1. cerebral palsy %. multiple sclerosis '. peripheral neuropathy (. vascular claudication
8+.
A physical therapist completes an examination on a patient dia"nosed with facet impin"ement in the lumbar spine. !he patient appears to be somewhat fixed in a position of sidebendin" to the ri"ht and rotation to the left. When assessin" lumbar ran"e of motion) which motions would you expect to be most restricted# 1. sidebendin" to the ri"ht and rotation to the left %. sidebendin" to the ri"ht and rotation to the ri"ht '. sidebendin" to the left and rotation to the ri"ht (. sidebendin" to the left and rotation to the left
81.
An employee with a disclosed disability informs her employer that she is unable to perform an essential function of her /ob unless her wor&station is modified. Which of the followin" would provide the employer with a le"itimate reason for not "rantin" the employee,s request# 1. the accommodation would cost hundreds of dollars %. the accommodation would require an expansion of the employee,s present wor&station '. the accommodation would fundamentally alter the operation of the business (. the accommodation would not address the needs of other employees
8%.
A "roup of health care professionals participates in a family conference for a patient with a spinal cord in/ury. 0urin" the conference one of the participants summari9es the patient,s pro"ress with bathin" and dressin" activities. !his type of information is typically conveyed by aIan 1. nurse %. physical therapist '. occupational therapist (. case mana"er
8'.
A physical therapist attempts to palpate the tibialis posterior tendon. !o facilitate palpation of this structure the therapist should 1. as& the patient to invert and plantarflex the foot %. as& the patient to evert and dorsiflex the foot '. as& the patient to invert and dorsiflex the foot (. passively evert and plantarflex the foot
8(.
A patient dia"nosed with spinal stenosis is referred to physical therapy three times a wee& for six wee&s. 0urin" the examination the patient informs the physical therapist that the commute to therapy is over 8+ miles. !he most appropriate therapist action is to 1. schedule the patient once a wee& %. schedule the patient three times a wee& '. attempt to locate a physical therapy clinic closer to the patient,s home (. dischar"e the patient with a home exercise pro"ram.
84.
0urin" a balance assessment of a patient with left hemiple"ia) it is noted that in sittin" the patient requires minimal assistance to maintain the position and cannot accept any additional challen"e. !he physical therapist would appropriately document the patient,s sittin" balance as 1. normal %. "ood '. fair (. poor
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1(
Practice Questions
85.
A short-term "oal for a patient with a neurolo"ical deficit is as follows* !he patient will transfer from tall &neelin" to half &neelin" with supervision. !his activity is an example of 1. mobility %. stability '. controlled mobility (. s&ill
86.
A physical therapist is treatin" a patient with a head in/ury who be"ins to perseverate. n order to refocus the patient and achieve the desired therapeutic outcome) the therapist should 1. focus on the topic of perseveration for a short period of time in order to appease the patient %. "uide the patient into an interestin" new activity and reward successful completion of the tas& '. ta&e the patient bac& to his room for quiet time and attempt to resume therapy once he has stopped perseveratin" (. continue with repetitive verbal cues to cease perseveration
87.
!he "oals for a patient status post total &nee replacement include "eneral conditionin" and independent household mobility. Which component of the patient,s treatment would be the most appropriate to dele"ate to a physical therapy aide# 1. stair trainin" %. pro"ressive "ait trainin" with a strai"ht cane '. patient education re"ardin" the sur"ical procedure (. ambulation with a wal&er for endurance
88.
A complete medical history should be conducted on all patients prior to initiatin" treatment. Questions as&ed durin" the patient history should not lead the patient. Which of the followin" questions would not be considered leadin"# 1. 0oes this increase your pain# %. 0oes this alter your pain in any way# '. 0oes you pain increase at ni"ht# (. 0oes your pain decrease with activity#
1++.
A physical therapist examines the heart sounds of a (7-year-old female status post coronary artery bypass "raft. When auscultatin") the therapist identifies the heart sound associated with closin" of the mitral and tricuspid valves. !his heart sound best describes 1. 21 %. 2% '. 2' (. 2(
1+1.
A physical therapist employed in a wor& hardenin" pro"ram performs an examination on a patient dia"nosed with fibromyal"ia. 0urin" the examination the therapist identifies an inconsistency between the measured lumbar ran"e of motion and the amount of lumbar ran"e of motion observed while liftin" a mil& crate from the floor to a table. !he most appropriate therapist action is 1. avoid discussin" the identified inconsistency with the patient %. confront the patient with the identified inconsistency '. discuss the identified inconsistency with the referrin" physician (. dischar"e the patient from physical therapy
1+%.
A patient is referred to physical therapy dia"nosed with ri"ht hip trochanteric bursitis. Which clinical findin" is usually not associated with trochanteric bursitis# 1. resisted abduction reproduces symptoms %. full hip active ran"e of motion '. positive ber test (. /oint play motions are limited in a capsular pattern.
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Practice Questions
14
1+'.
A patient is referred to physical therapy after sur"ery to repair a lar"e rotator cuff tear. Which of the followin" motions would you initially expect to be the most restricted# 1. extension %. abduction '. medial rotation (. lateral rotation
1+(.
A physical therapist attempts to select an appropriate intervention to treat a patient with a 1+ de"ree limitation in &nee extension. Which of the followin" mobili9ation techniques would be indicated# 1. lateral "lide of the patella %. caudal "lide of the patella '. posterior "lide of the tibia (. anterior "lide of the tibia
1+4.
A physical therapist performs passive ran"e of motion on a patient with 6 tetraple"ia. !he patient,s bilateral strai"ht le" raise is measured passively to 8+ de"rees. What should the therapist conclude about the patient,s ability to perform activities of daily livin"# 1. !he patient requires a strai"ht le" raise of 11+-1%+ de"rees in order to perform lon" sit and activities of daily livin" %. !he patient is at a functional ran"e to perform lon" sit and activities of daily livin". '. !he patient,s ran"e of motion is beyond the expected limit for lon" sit and activities of daily livin". (. !he patient requires a strai"ht le" raise of 14+ de"rees in order to perform lon" sit and activities of daily livin".
1+5.
A note in a patient,s medical record indicates a specific dru" is ta&en throu"h enteral administration. Which of the followin" is an example of enteral administration# 1. inhalation %. in/ection '. topical (. oral
1+6.
A patient is positioned in supine with the hips flexed to 8+ de"rees and the &nees extended. As the patient slowly lowers her extended le"s toward the hori9ontal) there is an increase in lordosis of the low bac&. !his findin" is indicative of wea&ness of the 1. hip flexors %. bac& extensors '. hip extensors (. abdominals
1+7.
A patient with ( tetraple"ia requires a custom wheelchair upon dischar"e from the hospital. !he patient,s diaphra"m is partially innervated. !he most appropriate recommendation for proper seatin" is 1. li"ht wei"ht manual wheelchair) upri"ht frame) seat and bac& cushions %. foldin" reclinin" wheelchair) power chin control) seat and bac& cushions '. non-foldin" reclinin" wheelchair) power ton"ue control) underslun" tray for ventilator (. upri"ht power wheelchair) /oystic& hand control) seat cushion
1+8.
A therapist examines a patient with a 5 spinal cord in/ury. Which muscle would not be innervated based on the patient,s level of in/ury# 1. biceps %. deltoids '. triceps (. diaphra"m
'5'6%6(+6.doc
15
Practice Questions
11+.
A physical therapist attempts to assess the inte"rity of the vestibulocochlear nerve by administerin" the Binne test on a patient with a suspected upper motor neuron lesion. After stri&in" the tine of the tunin" for& to be"in vibration) which bony prominence should the therapist utili9e to position the stem of the tunin" for&# 1. apex of the s&ull %. occipital protuberance '. inion (. mastoid process
111.
A physical therapist prepares to apply a topical antibiotic to a small portion of the upper arm of a patient with a deep partial thic&ness burn. When applyin" the topical antibiotic the therapist should utili9e which form of medical asepsis# 1. "loves %. sterile "loves '. sterile "loves) "own (. sterile "loves) "own) mas&
11%.
A physical therapist attempts to obtain information on a patient,s endurance level by administerin" a low-level exercise test on a treadmill. Which of the followin" measurement methods would provide the therapist with an ob/ective measurement of endurance# 1. facial color %. facial expression '. ratin" on a perceived exertion scale (. respiration rate
11'.
A physical therapist examines a patient status post stro&e with a flaccid left side. n order to facilitate muscular activity) the treatment plan should include* 1. wei"ht bearin") tappin") elevation %. vibration) tappin") prolon"ed stretch '. wei"ht bearin") tappin") approximation (. approximation) elevation) prolon"ed stretch
11(.
A patient with a ri"ht radial head fracture is examined in physical therapy. !he patient,s involved elbow ran"e of motion be"ins at 14 de"rees of flexion and ends at 8+ de"rees of flexion. !he physical therapist should record the patient,s elbow ran"e of motion as* 1. +-14-8+ %. 14-+-8+ '. 14-8+ (. +-8+
114.
A physical therapist reviews the medical record of a patient with
115.
A patient involved in a motor vehicle accident sustains a proximal fibula fracture. !he fracture dama"es the motor component of the common peroneal nerve. An&le dorsiflexion and eversion are tested as %I4. !he most appropriate intervention to assist the patient with activities of daily livin" would be* 1. electrical stimulation %. orthosis '. exercise pro"ram (. aquatic pro"ram
'5'6%6(+6.doc
Practice Questions
16
116.
A 6%-year old female involved in a motor vehicle accident fractures the middle third of her femoral shaft. !he patient,s physician is concerned about the effects of prolon"ed bed rest and would li&e the patient to be"in wal&in" as soon as possible. Which form of treatment would facilitate early wei"ht bearin" throu"h the involved extremity# 1. immobili9ation in a hip spica cast %. internal fixation with an intramedullary nail '. external mobili9ation (. s&eletal traction
117.
A physical therapist discusses the importance of a proper diet with a patient dia"nosed with con"estive heart failure. Which of the followin" substances would most li&ely be restricted in the patient,s diet# 1. hi"h density lipoproteins %. low density lipoproteins '. sodium (. tri"lycerides
118.
A physical therapist instructs a patient with a pulmonary disease in ener"y conservation techniques. Which of the followin" techniques would be the most effective when assistin" the patient to complete a selected activity without dyspnea# 1. diaphra"matic breathin" %. pacin" '. pursed-lip breathin" (. ventilatory muscle trainin"
1%+.
A physical therapist attempts to assist a patient to clear secretions after performin" postural draina"e by cou"hin". What position would allow the patient to produce the most forceful cou"h# 1. prone %. sidelyin" '. supine (. upri"ht sittin"
1%1.
A physical therapist observes excessive &nee flexion from heel stri&e to midstance while observin" a patient with a transtibial amputation durin" "ait trainin". A possible cause for the deviation is* 1. the foot is set in neutral %. the soc&et is set posterior in relation to the foot '. the prosthesis is too short (. the soc&et is ali"ned in excessive flexion
1%%.
A physical therapist attempts to improve a patient,s lower extremity stren"th. Which proprioceptive neuromuscular facilitation technique would be the most appropriate to achieve the therapist,s "oals# 1. contract-relax %. repeated contractions '. rhythmic stabili9ation (. hold-relax
1%'.
A physical therapist instructs a patient dia"nosed with rotator cuff tendonitis in transverse plan resistive exercises. Which motions would be appropriate based on the "iven information# 1. abduction and adduction %. flexion and extension '. medial and lateral rotation (. pronation and supination
1%(.
A patient is limited in passive an&le dorsiflexion when the &nee is extended) but is not limited when the &nee is flexed. !he most lo"ical explanation is 1. the "astrocnemius is responsible for the limitation %. the soleus is responsible for the limitation '. the popliteus is responsible for the limitation (. the "astrocnemius and soleus are both responsible for the limitation
'5'6%6(+6.doc
17
Practice Questions
1%4.
A patient with a 5 spinal cord in/ury relies on tenodesis to assist with functional activities. Which condition will reduce the benefits of tenodesis# 1. len"thenin" of the lon" fin"er flexors %. excessive hamstrin"s len"th '. insufficient hamstrin"s len"th (. transferrin" with the fin"ers flexed
1%5.
A patient is treated in physical therapy after in/urin" his hamstrin"s. !he medical chart describes the in/ury as an avulsion fracture of the ischial tuberosity. !his in/ury usually results from* 1. forceful extension of the hip with an extended &nee %. forceful extension of the hip with a flexed &nee '. forceful flexion of the hip with an extended &nee (. forceful flexion of the hip with a flexed &nee
1%6.
A physical therapist attempts to "ain information on the li"amentous inte"rity of the &nee. Which of the followin" special tests would not provide the therapist with the desired information# 1. anterior drawer test %. apprehension test '. achman test (. pivot shift test
1%7.
A physical therapist reviews the medical record of a patient %( hours status post total hip replacement. A recent entry in the medical record indicates that the patient was placed on anticoa"ulant medication. Which of the followin" laboratory values would be most affected based on the patient,s current medication# 1. hematocrit %. hemo"lobin '. prothrombin time (. white blood cell count
1%8.
A physical therapist discusses the plan of care for a 51-year old male dia"nosed with spinal stenosis with the referrin" physician. 0urin" the discussion the physician shows the therapist a picture of the patient,s spine obtained throu"h computed tomo"raphy. What color would vertebrae appear when usin" this ima"in" technique# 1. blac& %. li"ht "ray '. dar& "ray (. white
1'+.
A physical therapist performs the talar tilt test on a %%-year old female rehabilitatin" from an inversion an&le sprain. Which li"ament does the talar tilt test examine# 1. anterior tibiofibular %. calcaneofibular '. deltoid (. posterior tibiofibular
1'1.
A physical therapist completes a developmental assessment on a 6-month old infant. development) which of the followin" reflexes would not be inte"rated# 1. asymmetrical tonic nec& reflex %. :oro reflex '. andau reflex (. symmetrical tonic nec& reflex
1'%.
A patient is referred to physical therapy after bein" dia"nosed with a partial tear of the ulnar collateral li"ament of the thumb. Which ob/ective findin" would be most consistent with this type of in/ury# 1. excessive an"ulation of the metacarpophalan"eal /oint of the thumb with val"us stress %. excessive an"ulation of the metacarpophalan"eal /oint of the thumb with varus stress '. excessive an"ulation of the carpometacarpal /oint of the thumb with radially directed stress (. excessive an"ulation of the carpometacarpal /oint of the thumb with ulnarly directed stress
'5'6%6(+6.doc
Assumin" normal
Practice Questions
18
1''.
A (%-year old female is admitted to a rehabilitation hospital after sustainin" a stro&e. 0urin" the examination the physical therapist identifies si"nificant sensory deficits in the anterolateral spinothalamic system. Which sensation would be most affected# 1. baro"nosis %. &inesthesia '. "raphesthesia (. temperature
1'(.
A physical therapist identifies a number of substances that influence circulation. Which of the followin" substances is stimulated by decreased arterial pressure and acts as a vasoconstrictor# 1. an"iotensin %. histamine '. epinephrine (. norepinephrine
1'4.
A physical therapist records the vital si"ns of individuals at a health and wellness fair desi"ned to promote physical therapy wee&. Which a"e "roup should the therapist expect to have the hi"hest restin" pulse rate# 1. infants %. children '. teena"ers (. adults
1'5.
A 1'-year old "irl discusses the possibility of anterior cruciate li"ament reconstruction with an orthopedic sur"eon. !he "irl in/ured her &nee while playin" soccer and is concerned about the future impact of the in/ury on her athletic career. Which of the followin" factors would have the "reatest influence on her candidacy for sur"ery# 1. anthropometric measurements %. hamstrin"sIquadriceps stren"th ratio '. s&eletal maturity (. somatotype
1'6.
A patient dia"nosed with 4 quadriple"ia receives physical therapy services in a rehabilitation hospital. !he patient has made "ood pro"ress in therapy and is scheduled for dischar"e in one wee&. 0urin" a treatment session the patient informs the physical therapist that one day in the future he will wal& a"ain. !he most appropriate therapist response is* 1. 3our level of in/ury ma&es wal&in" unrealistic. %. @uture advances in spinal cord research may ma&e your "oal a reality. '. 3ou can have a rewardin" life even if confined to a wheelchair. (. ompletin" your exercises on a re"ular basis will help you to wal&.
1'7.
A physical therapist performs several surface palpations on a patient dia"nosed with an acromioclavicular in/ury. Which anatomical landmar& is most consistent with the location of the therapist,s fin"er# 1. manubrium %. sternoclavicular /oint '. suprasternal notch (. xiphoid process
1'8.
A physical therapist discusses the plan of care for a patient rehabilitatin" from total hip replacement sur"ery with the patient,s sur"eon. 0urin" the discussion the sur"eon indicates that he would li&e the patient to continue to wear a &nee immobili9er in order to help prevent hip dislocation. !he primary rationale for this action is* 1. !he &nee immobili9er serves as a constant reminder to the patient that the hip is susceptible to in/ury. %. !he &nee immobili9er reduces hip flexion by maintainin" &nee extension. '. !he &nee immobili9er facilitates quadriceps contraction durin" wei"ht bearin" activities. (. !he &nee immobili9er limits post-operative edema and as a result promotes lower extremity stability.
'5'6%6(+6.doc
%+
Practice Questions
1(+.
A physical therapist treats a patient that is on a waitin" list for a heart transplant. !he patient has a len"thy history of cardiac patholo"y and recently received a ri"ht ventricular assistive device due to persistent ventricular failure. Which two structures would house the tubes for this device# 1. left atrium and aorta %. left atrium and pulmonary artery '. ri"ht atrium and aorta (. ri"ht atrium and pulmonary artery
1(1.
A physical therapist treats a 6%-year old female who fractured her le" two wee&s a"o after losin" her balance and fallin" to the floor in a nursin" home. !he patient,s spouse died three years a"o and left her with no appreciable assets or re"ular income. !he patient has been a resident of the nursin" home for ei"ht years. Which form of insurance is the most li&ely to pay for the patient,s daily care# 1. private insurance %. wor&ers, compensation '. :edicaid (. :edicare
1(%.
A physical therapist administers a submaximal exercise test to a patient in a cardiac rehabilitation pro"ram. !he protocol requires the patient to ride a cycle er"ometer for a predetermined amount of time usin" pro"ressive wor&loads. n order to predict the patient,s maximum oxy"en upta&e it is necessary to determine the relationship between* 1. heart rate and perceived exertion %. heart rate and oxy"en upta&e '. perceived exertion and blood pressure (. blood pressure and oxy"en upta&e.
1('.
A physician orders the nursin" staff to administer di"italis to a patient dia"nosed with con"estive heart failure. !he physician,s primary "oal usin" this medication is to* 1. increase cardiac pumpin" ability %. increase cellular metabolism '. re"ulate fluid and electrolyte levels (. re"ulate "lucose metabolism
1((.
A physical therapist identifies a bluish discoloration of the s&in and nailbed of a 44-year old male referred to physical therapy for pulmonary rehabilitation. What does this ob/ective findin" indicate# 1. hyperoxemia %. hyperoxia '. hypo&alemia (. hypoxemia
1(4.
A physical therapist employed in a lar"e medical center reviews the chart of a 5'-year old male referred to physical therapy for pulmonary rehabilitation. !he chart indicates the patient has smo&ed 1-% pac&s of ci"arettes a day since the a"e of %4. !he admittin" physician documented that the patient,s thorax was enlar"ed with flarin" of the costal mar"ins and widenin" of the costochondral an"le. Which pulmonary disease does the chart most accurately describe# 1. asthma %. bronchiectasis '. chronic bronchitis (. emphysema
1(5.
A physical therapist reviews the results of pulmonary function testin" on a ((-year-old female dia"nosed with emphysema. Assumin" the patient,s testin" was classified as unremar&able) which of the followin" lun" volumes would most li&ely approximate 1+C of the patient,s total lun" capacity# 1. tidal volume %. inspiratory reserve volume '. residual volume (. functional residual capacity
'5'6%6(+6.doc
Practice Questions
%1
1(6.
A %5-year old female is referred to physical therapy after bein" dia"nosed with impin"ement syndrome. !he patient is a competitive swimmer who complains of shoulder pain when performin" stro&es that require overhead motion. Which of the followin" results would be the most typical durin" the examination of the shoulder# 1. excessive medial rotation %. diminished cutaneous sensation '. restricted posterior capsule (. wea&ness in the deltoid muscle
1(7.
A patient rehabilitatin" from a spinal cord in/ury wor&s on self-ran"e of motion activities in sittin". 2uddenly) the patient be"ins to demonstrate si"ns and symptoms of autonomic dysreflexia. !he most appropriate physical therapist action is to* 1. &eep the patient in sittin") monitor blood pressure) and chec& the bowel and bladder for impairment %. lie the patient flat) monitor blood pressure) and chec& the bowel and bladder for impairment '. lie the patient flat) monitor blood pressure) and "ive the patient fluids (. place the patient in sidelyin") monitor blood pressure) and wait for medical assistance.
1(8.
A physical therapist administers the
14+.
A patient dia"nosed with patellofemoral syndrome discusses his past medical history with a physical therapist. !he patient reports havin" anterior cruciate li"ament reconstructive sur"ery in his ri"ht &nee two years a"o) however) the therapist is not able to identify a scar over the anterior surface of the ri"ht &nee. Assumin" the sur"eon utili9ed an auto"raft for the reconstruction) which of the followin" would be the most li&ely "raft site# 1. semitendinosus and semimembranosus %. semitendinosus and "racilis '. semimembranosus and "racilis (. semitendinosus and biceps femoris
141.
A patient four wee&s status post arthroscopic medial meniscectomy is limited in &nee flexion ran"e of motion. Which mobili9ation technique would be the most beneficial to increase &nee flexion# 1. anterior "lide of the tibia %. superior "lide of the patella '. posterior "lide of the tibia (. anterior "lide of the fibula head
14%.
After examinin" the respiratory status of a patient with a 5 spinal cord in/ury) which of the followin" clinical findin"s would you expect to be the most accurate# 1. partial innervation of the diaphra"m %. full epi"astric rise in supine '. a ventilator is required for assisted breathin" (. normal ventilatory reserve
14'.
A physical therapist instructs a patient with ti"ht calf muscles to complete a closed &inematic chain standin" wall stretch. Prior to be"innin" the stretch) the therapist positions a folded towel under the medial arch of the patient,s foot. !he primary purpose of this action is to limit 1. talocrural dorsiflexion %. talocrural plantarflexion '. subtalar supination (. subtalar pronation.
'5'6%6(+6.doc
%%
Practice Questions
14(.
A patient rehabilitatin" from a motor vehicle accident completes a series of closed &inetic chain exercises. ne of the exercises requires the patient to perform a mini squat in an erect position with the center of "ravity placed directly over the &nee /oint. f the physical therapist modifies the activity by as&in" the patient to move the buttoc&s posteriorly in relation to the &nees) what muscle "roup is the therapist attemptin" to emphasi9e# 1. &nee extensors %. &nee flexors '. hip extensors (. hip flexors
144.
A physical therapist reviews a physician referral form that includes only the patient,s name and the referrin" physician,s si"nature. !he therapist as&s an administrative assistant to contact the physician,s office to secure additional information while he be"ins the examination. 0urin" the examination the patient indicates that she had &nee sur"ery two wee&s a"o) however) is unable to provide more specific information. After completin" the examination the therapist chec&s with the administrative assistant who indicates that she was unable to reach anyone at the physician,s office. !he most appropriate therapist action is 1. initiate treatment based on the results of the examination %. initiate treatment based on an established protocol followin" &nee sur"ery '. initiate treatment) however) avoid resistive exercises and hi"h-level functional activities. (. delay treatment until orders are received from the referrin" physician.
145.
A physical therapist employed in an acute care hospital reviews the results of recent laboratory testin" for one of his patients. A note in the medical record indicates that the patient was dehydrated at the time the blood sample was ta&en. Which findin" would be most li&ely based on the patient,s hydration status# 1. increased coa"ulation time %. decreased hematocrit level '. increased blood urea nitro"en level (. decreased hemo"lobin level
146.
A treatment pro"ram is desi"ned to include late mornin" sessions involvin" a""ressive stretchin") moderate exercise) ener"y conservation and stress mana"ement techniques. !his pro"ram would be most appropriate for which dia"nosis# 1. $uillain-
147.
A %7-year old male referred to physical therapy by his primary physician complains of recurrent an&le pain. As part of the treatment pro"ram) the therapist uses ultrasound over the peroneus lon"us and brevis tendons. !he most appropriate location for ultrasound application is* 1. inferior to the sustentaculum tali %. over the sinus tarsi '. posterior to the lateral malleolus (. anterior to the lateral malleolus
148.
A physical therapist positions a patient in supine prior to performin" a manual muscle test of the supinator. !o isolate the supinator and minimi9e the action of the biceps the therapist should position the patient,s elbow in* 1. '+ de"rees of elbow flexion %. 5+ de"rees of elbow flexion '. 8+ de"rees of elbow flexion (. terminal elbow flexion
15+.
A physical therapist reviews the sur"ical report of a patient that sustained extensive burns in a fire. !he report indicates that at the time of primary excision) cadaver s&in was utili9ed to close the wound. !his type of "raft is termed* 1. allo"raft %. auto"raft '. hetero"raft (. xeno"raft
'5'6%6(+6.doc
Practice Questions
%'
151.
A physician completes a physical examination on a 15-year-old male who in/ured his &nee while playin" in a soccer contest yesterday. !he physician,s preliminary dia"nosis is a "rade anterior cruciate li"ament in/ury with probable meniscal involvement. Which of the followin" dia"nostic tools would be the most appropriate in the immediate medical mana"ement of the patient# 1. bone scan %. computeri9ed tomo"raphy '. ma"netic resonance ima"in" (. x-rays
15%.
A physical therapist performs "oniometric measurements on a '7-year old female rehabilitatin" from an acromioplasty. !he therapist attempts to stabili9e the scapula while measurin" "lenohumeral abduction. @ailure to stabili9e the scapula will lead to 1. downward rotation and elevation of the scapula %. downward rotation and depression of the scapula '. upward rotation and elevation of the scapula (. upward rotation and depression of the scapula
15'.
A physical therapist measures a patient,s shoulder medial rotation with the patient positioned in supine) "lenohumeral /oint in 8+ de"rees of abduction) and the elbow in 8+ de"rees of flexion. !he therapist records the patient,s shoulder medial rotation as +-6+ de"rees and classifies the end-feel as firm. Which portion of the /oint capsule is primarily responsible for the firm end-feel# 1. anterior /oint capsule %. posterior /oint capsule '. inferior /oint capsule (. superior /oint capsule
15(.
A physician suspects a stress fracture in a 15-year old distance runner after completin" a physical examination. Assumin" the physician,s preliminary dia"nosis is correct) which of the followin" dia"nostic tests would be the most appropriate to identify the stress fracture# 1. bone scan %. ma"netic resonance ima"in" '. telethermo"raphy (. ultrasound scan
154.
A physical therapist performs an examination on a (5-year old male patient dia"nosed with piriformis syndrome. !he patient indicates he has experienced pain in his lower bac& and buttoc& re"ion for the last three wee&s. Which motions would you expect to be wea& and painful durin" muscle testin" based on the patient,s dia"nosis# 1. abduction and lateral rotation of the thi"h %. abduction and medial rotation of the thi"h '. adduction and lateral rotation of the thi"h (. adduction and medial rotation of the thi"h
155.
A physical therapist examines a patient with a dorsal scapular nerve in/ury. Which muscles would you expect to be most affected by this condition# 1. serratus anterior) pectoralis minor %. levator scapulae) rhomboids '. latissimus dorsi) teres ma/or (. supraspinatus) infraspinatus
156.
A physical therapist positions a patient in prone to measure passive &nee flexion. Ban"e of motion may be limited in this position due to 1. active insufficiency of the &nee extensors %. active insufficiency of the &nee flexors '. passive insufficiency of the &nee extensors (. passive insufficiency of the &nee flexors
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%(
Practice Questions
157.
A physical therapist examines a four-month old infant. 0urin" mat activities the infant suddenly becomes unconscious. !he most appropriate location to chec& the infant,s pulse is the 1. radial artery %. brachial artery '. popliteal artery (. carotid artery
158.
A physical therapist observes a patient durin" "ait trainin". !he patient has normal stren"th and equal le" len"th. As the patient passes midstance he sli"htly vaults and has early toe off. !he most li&ely cause of this deviation is 1. patient has excessive forefoot pronation %. patient has limited hamstrin"s len"th '. patient has limited plantarflexion (. patient has limited dorsiflexion
16+.
A patient status post A with abnormal tone on the ri"ht side lies supine in bed. !he patient,s physical therapist discoura"es her from lyin" supine for lon" periods of time because* 1. the position can cause shoulder hand syndrome %. the position increases inferior subluxation '. the position encoura"es tonic nec& and labyrinthine reflexes (. the position increases tone in the pectoralis
161.
A physical therapist conducts a "oniometric assessment of a patient,s upper extremities. Which of the followin" values is most indicative of normal passive "lenohumeral abduction# 1. 7+ de"rees %. 1%+ de"rees '. 144 de"rees (. 17+ de"rees
16%.
A physical therapist monitors a patient,s respiration rate durin" exercise. Which of the followin" would be considered a normal response# 1. the respiration rate declines durin" exercise as the intensity of exercise increases %. the respiration rate does not increase durin" exercise '. the rhythm of the respiration pattern becomes irre"ular durin" exercise (. the respiration rate decreases as the intensity of the exercise plateaus
16'.
A physical therapist reviews the results of a pulmonary function test. Assumin" normal values) which of the followin" measurements would you expect to be the "reatest# 1. vital capacity %. tidal volume '. residual volume (. inspiratory reserve volume
16(.
A patient involved in a motor vehicle accident sustains an in/ury to the posterior cord of the brachial plexus. Which muscle would not be affected by the in/ury# 1. infraspinatus %. subscapularis '. latissimus dorsi (. teres ma/or
164.
A physical therapist desi"ns a trainin" pro"ram for a patient without cardiovascular patholo"y. !he therapist calculates the patient,s a"e-predicted maximal heart rate as 164 beats per minute. Which of the followin" would be an acceptable tar"et heart rate for the patient durin" cardiovascular exercise# 1. 8' bpm %. 1%% bpm '. 158 bpm (. 184 bpm
'5'6%6(+6.doc
Practice Questions
%4
165.
A 1'-year-old female dia"nosed with cerebral palsy is referred to physical therapy. !he patient exhibits slow) involuntary) continuous writhin" movements of the upper and lower extremities. !his type of motor disturbance is most representative of 1. spasticity %. ataxia '. hypotonia (. athetosis
166.
A physician refers a patient rehabilitatin" from a fractured femur to physical therapy for "ait trainin". Which of the followin" would not be the responsibility of the physical therapist# 1. assessin" balance %. determinin" wei"ht bearin" status '. selectin" an assistive device (. assessin" endurance
167.
A physical therapist instructs a 44-year-old patient with si"nificant bilateral lower extremity paresis to transfer from a wheelchair to a mat table. !he patient has normal upper extremity stren"th and has no other &nown medical problems. !he most appropriate transfer technique is a* 1. dependent standin" pivot %. slidin" board transfer '. two-person carry (. hydraulic lift
168.
A physical therapist instructs a patient to ma&e a fist. !he patient can ma&e a fist) but is unable to flex the distal phalanx of the rin" fin"er. !his clinical findin" can best be explained by 1. a ruptured flexor carpi radialis tendon %. a ruptured flexor di"itorum superficialis tendon '. a ruptured flexor di"itorum profundus tendon (. a ruptured extensor di"itorum communis tendon
17+.
A patient with a confirmed posterior cruciate li"ament tear is able to return to full dynamic activities followin" rehabilitation. Which of the followin" does not serve as a secondary restraint to the posterior cruciate li"ament# 1. iliotibial band %. popliteus tendon '. lateral collateral li"ament (. medial collateral li"ament
171.
A 56-year-old patient is examined in physical therapy after havin" sutures removed followin" a transtibial amputation. !he patient resides in a retirement community and describes herself as socially active. 2he is presently usin" a temporary prosthesis consistin" of a plastic soc&et) a pylon) and a solid an&le cushion heel foot. When discussin" a permanent prosthesis with the physical therapist the patient expresses concern that the device will loo& awful and will be obvious to everyone in her retirement community. Which type of prosthetic components would be the most appropriate for the patient# 1. endos&eletal shan& and sin"le-axis articular foot-an&le assembly %. endos&eletal shan& and solid an&le cushion heel foot '. exos&eletal shan& and sin"le-axis articulated foot-an&le assembly (. exos&eletal shan& and solid an&le cushion heel foot
17%.
A physical therapist measures forearm supination ran"e of motion on a patient rehabilitatin" from a radial head fracture. !he patient is ea"er to show pro"ress in therapy and as a result often attempts to substitute for his limited ran"e of motion by manipulatin" his body. Which of the followin" motions would most often be used to substitute for limitation in supination# 1. shoulder abduction and lateral rotation %. shoulder abduction and medial rotation '. shoulder adduction and lateral rotation (. shoulder adduction and medial rotation
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%5
Practice Questions
17'.
A physical therapist develops an aquatic therapy pro"ram for a patient dia"nosed with a lower extremity in/ury. !he therapist plans to monitor the patient,s response to exercise usin" heart rate) however) is concerned about the influence of the water on the patient,s heart rate response. Which of the followin" best describes the effect of immersion in water on heart rate response when compared to traditional land activities# 1. heart rate response is increased durin" low intensity exercise in water %. heart rate response is decreased durin" low intensity exercise in water '. heart rate response is increased durin" hi"h intensity exercise in water (. heart rate response is decreased durin" hi"h intensity exercise in water
17(.
A physical therapist measures passive forearm pronation and concludes that the results are within pronation and concludes that the results are within normal limits. Which measurement would be classified as within normal limits# 1. 5+ de"rees %. 7+ de"rees '. 1++ de"rees (. 1%+ de"rees
174.
A physical therapist treats a patient rehabilitatin" from a fracture at the distal end of the humerus. !he therapist notes that the patient,s elbow is "rossly swollen. Which position of the elbow would best accommodate the increased fluid# 1. full extension %. 14 de"rees of flexion '. 6+ de"rees of flexion (. 1%+ de"rees of flexion
175.
A physical therapist discusses the importance of proper posture with a patient rehabilitatin" from bac& sur"ery. Which body position would place the most pressure on the lumbar spine# 1. standin" in the anatomical position %. standin" with (4 de"rees of hip flexion '. sittin" in a chair (. sittin" in a chair with reduced lumbar lordosis
176.
A physical therapist wor&s on transfer activities with a patient dia"nosed with a complete 4 spinal cord in/ury. Which of the followin" muscles would the patient be able to utili9e durin" the trainin" session# 1. brachioradialis %. pronator teres '. extensor carpi radialis brevis (. latissimus dorsi
177.
A physical therapist treats a '%-year-old female dia"nosed with thoracic outlet syndrome. While exercisin" the patient be"ins to complain of feelin" li"htheaded and di99y. !he therapist immediately ushers the patient to a nearby chair and be"ins to monitor her vital si"ns. !he therapist measures the patient,s respiration rate as 1+ breaths per minute) pulse rate of (4 beats per minute) and blood pressure of 114I74 mm ?". Which of the followin" statements is most accurate# 1. pulse rate and respiration rate are below normal levels %. pulse rate and blood pressure are above normal levels '. blood pressure and respiration rate are above normal levels (. the patient,s vital si"ns are within normal limits
178.
A physical therapy treatment plan for a patient rehabilitatin" from an anterior shoulder dislocation includes pro"ressive resistive exercises. Which muscle "roups should be emphasi9ed durin" rehabilitation# 1. abductors) lateral rotators %. adductors) lateral rotators '. abductors) medial rotators (. adductors) medial rotators
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Practice Questions
%6
18+.
A physical therapist wor&s with a patient dia"nosed with anterior cruciate li"ament insufficiency. !he physician referral specifies closed &inematic chain rehabilitation. Which exercise would not be appropriate based on the physician order# 1. exercise on a stair machine %. limited squats to (4 de"rees '. wal&in" bac&wards on a treadmill (. iso&inetic &nee extension and flexion
181.
A patient paraly9ed from the waist down discusses accessibility issues with an employer in preparation for her return to wor&. !he patient is concerned about her ability to navi"ate a wheelchair in certain areas of the buildin". What is the minimum space required to turn 17+ de"rees in a standard wheelchair# 1. '% inches %. (7 inches '. 5+ inches (. 6% inches
18%.
A patient is referred to physical therapy followin" sur"ery to repair a torn rotator cuff. !he physician referral does not include post-operative "uidelines and also does not classify the extent or si9e of the tear. !he physical therapist,s most appropriate action is to 1. consult various medical resources that discuss physical therapy mana"ement of rotator cuff repairs %. consult various protocols of other sur"eons in the area '. contact the referrin" physician and discuss the patient,s care (. discuss the patient,s care with other staff members who are more experienced in treatin" rotator cuff repairs
18'.
A 4%-year-old) self-referred male is examined in physical therapy. !he patient states that over the last three months he has experienced increasin" nec& stiffness and pain at ni"ht. ?e also communicates that within the past wee& he has had several episodes of di99iness. !he patient has a family history of cancer and has smo&ed two pac&s of ci"arettes a day for the last twenty years. !he patient denies any other si"nificant past medical history and lists the date of his last medical examination as ten years a"o. !he physical therapist,s most appropriate action is to* 1. treat the patient conservatively and document any chan"es in the patient,s status %. inform the patient that he is not a candidate for physical therapy '. refer the patient to an oncolo"ist (. refer the patient to his primary care physician.
18(.
A patient is scheduled to under"o a transtibial amputation secondary to poor healin" of an ulcer on his left foot. n addition) the patient is two months status post ri"ht &nee replacement due to osteoarthritis. $iven the patient,s past and current medical history) the physical therapist can expect which of the followin" tas&s to be the most difficult for the patient followin" his amputation# 1. rollin" from supine to sidelyin" %. movin" from sittin" to supine '. movin" from sittin" to standin" (. ambulatin" in the parallel bars
184.
A physical therapist wears sterile protective clothin" while treatin" a patient. Which area of the protective clothin" would not be considered sterile even before comin" in contact with non-sterile ob/ect# 1. "loves %. sleeves of the "own '. front of the "own above waist level (. front of the "own below waist level
185.
A patient two days status post transfemoral amputation demonstrates decreased stren"th and "enerali9ed deconditionin". Which of the followin" positions should be utili9ed when wrappin" the patient,s residual limb# 1. sidelyin" %. standin" '. supine (. prone
'5'6%6(+6.doc
%7
Practice Questions
186.
A physical therapist transports a patient with multiple sclerosis to the "ym for her treatment session. !he patient is wheelchair dependent and uses a urinary catheter. When transportin" the patient) the most appropriate location to secure the collection ba" is 1. in the patient,s lap %. on the patient,s lower abdomen '. on the wheelchair armrest (. on the wheelchair cross brace beneath the seat
187.
A physical therapist employed by a home health a"ency visits a patient status post total &nee replacement. !he patient was dischar"ed from the hospital yesterday and accordin" to the medical record had an unremar&able recovery. !he physician orders include the use of a continuous passive motion machine. !he most appropriate rate of motion for the patient would be 1. % cycles per minute %. ( cycles per minute '. 5 cycles per minute (. 7 cycles per minute
188.
A physical therapist attempts to examine the extent of ataxia in a patient,s upper extremities. !he preferred method to examine and document ataxia is 1. manual muscle test %. sensory test for li"ht touch '. functional assessment for rollin" in bed (. fin"er to nose
%++.
A physical therapist treats a patient with Par&inson,s disease. n order to improve the patient,s motor control) the therapist should incorporate which of the followin" techniques into the treatment session# 1. alternatin" isometrics %. rhythmic initiation '. manual resisted exercise (. lumbar stabili9ation exercises in quadruped.
'5'6%6(+6.doc
Practice Questions
1.
%.
2. ?ead positionin" is the stimulus for the symmetrical tonic nec& reflex. extremities flex and the lower extremities extend. When the head extends lower extremities flex. !he reaction of the extremities would not allow position. 3. 2chedulin" with another therapist will allow the patient to be seen two referral and will accommodate the patient,s schedule.
%8
When the head is flexed) the upper the upper extremities extend and the the infant to maintain a quadruped times per wee&s as indicated on the
'.
An articulation at the an&le /oint would allow the tibia to advance forward over the fixed foot. !his would assist with wei"ht shiftin" durin" the sit to stand transfer as well as durin" ambulation.
(.
!he response Esur"ery can be a very fri"htenin" thou"htF is an empathetic response that demonstrates respect and ac&nowled"ement for the patient,s feelin"s.
4.
1.
5.
!he "luteus maximus and the hamstrin"s function as primary hip extensors. !hese muscles function in an eccentric fashion when movin" from standin" to sittin".
6.
4. !he physician should be informed about the patient,s lac& of pro"ress. !he patient may be dischar"ed from physical therapy or referred bac& to the physician.
7.
2. Anemia refers to a reduction in the number of circulatin" red blood cells. 2ymptoms may include pallor) cyanosis) cool s&in) verti"o) wea&ness) headache) and "eneral malaise.
8.
!he question does not present enou"h information to determine why the patient was not at home. As a result) the physical therapist should document the missed appointment and contact the patient to reschedule.
1+.
!urnin" the patient sli"htly to the left by placin" a towel under the ri"ht side of the patient,s pelvis will tend to lessen the effects of uterine compression abdominal vessels and improve cardiac output.
11.
3. steo"enesis imperfecta is an autosomal disorder of colla"en synthesis that affects bone metabolism. As a result) an infant with this condition is extremely susceptible to fractures durin" even basic activities such as bein" carried or bathin". !he most common characteristic of osteo"enesis imperfecta is bone fra"ility resultin" in fractures.
1%.
4. !he 5-minute wal& test provides an indirect measure of cardiovascular endurance by examinin" the distance a patient can wal& in six minutes. Patients are instructed to wal& as far and as fast as possible in 5 minutes.
1.
3.
Phase char"e is represented by the area under a sin"le phase waveform. !he unit of measure is a coulomb.
2.
1.
1.
1'.
3.
Patients with ri"ht A and left hemiple"ia commonly have a distorted awareness of self-ima"e.
1(.
2. 0i"italis is used to alleviate symptoms of con"estive heart failure. !he dru" increases the force of myocardial contraction and increases the refractory period of the A node. !he refractory period is the time the A node is incapable of respondin" to an action potential.
14.
2. A patient with 0uchenne muscular dystrophy often exhibits si"nificant proximal muscle wea&ness) particularly in the shoulders and pelvic "irdle. As the condition advances) the muscular wea&ness encompasses the distal musculature and interferes with activities of daily livin".
15.
3. 2pondylolisthesis refers to the forward displacement of one vertebra over another. !he x-ray involves spondylolisthesis at the 4-21 level. ndividuals involved in physical activities such as wei"htliftin") "ymnastics or football are particularly susceptible to this condition. !he severity of the spondylolisthesis is classified on a scale of 1-4 based on how much a "iven vertebral body has slipped forward over the vertebral body beneath it.
16.
2. !he palmar "rasp reflex is elicited throu"h maintained pressure to the palm of the hand resultin" in fin"er flexion. !he reflex be"ins at birth and is inte"rated at approximately four to six months.
'5'6%6(+6.doc
Answers
'+
17.
4. ncontinence refers to an inability to control the release of urine) feces or "as. ;ducation may include basic information related to incontinence as well as referral to the patient,s primary care provider. A vast ma/ority of patients with incontinence can be successfully treated with non-invasive techniques such as pelvic floor exercises) however) without more definitive medical information this action would be premature.
18.
Applyin" direct pressure with the hands on the lateral borders of the ribs with the patient in supine can promote a more efficient breathin" pattern. Physical therapy mana"ement for a child with cystic fibrosis may include bronchial draina"e techniques) chest percussion) vibration) and suctionin".
%+.
1. 2ilver sulfadia9ine is a sulfa dru" that can produce a decrease in the number of circulatin" white blood cells =leu&openia>. !he topical antibiotic wor&s by interferin" with bacterial nucleic acid production by disruptin" folic acid synthesis in susceptible bacteria. Additional problems encountered with sulfa dru"s include "astrointestinal distress and aller"ic reactions.
%1.
Anemia is defined as a reduction in the number of circulatin" red blood cells per cubic millimeter. 2ymptoms of anemia include pallor of the s&in) verti"o) and "eneral malaise. Althou"h a patient may sense that his muscles are wea&) fati"ue will have a "reater impact on the patient,s ability to complete a formal exercise pro"ram.
%%.
1. ?eterotopic ossification refers to abnormal bone "rowth in tissue. 2i"ns and symptoms include decreased ran"e of motion) local swellin") and warmth. ?eterotopic ossification often occurs in patients followin" a head in/ury.
%'.
!he problem list should summari9e the si"nificant findin"s from the examination. 2ince the problem list relates bac& to the sub/ective and ob/ective portion of the note each entry should be described in broad terms.
%(.
2.
%4.
!he width of a bladder should be approximately (+C of the circumference of the midpoint of the limb.
%5.
3.
%6.
A patient status post total hip replacement usin" an anterolateral sur"ical approach would be most restricted in lateral rotation. @ailure to restrict lateral rotation may result in hip dislocation or subluxation. ?ip medial rotation would be most restricted usin" a posterolateral sur"ical approach.
%7.
2u""estin" the patient write down questions for the physician is a practical and realistic option that will assist her in future interactions.
%8.
'+.
4. :any individuals are able to continue to function at hi"h levels despite a variety of li"amentous and meniscal in/uries) therefore functional instability provides the most direct support for an anterior cruciate li"ament reconstruction.
'1.
Posterior cord syndrome is a relatively rare form of incomplete spinal cord in/ury that is characteri9ed by a loss of proprioception) two-point discrimination) and stereo"nosis with preserved motor function. !he in/ury is typically classified as a cervical hyperextension in/ury.
'%.
!he
''.
!he len"th of a hi"hboy tan& does not permit a patient to fully extend the lower extremitiesD however) its depth permits immersion to the midthoracic re"ion.
2.
4.
3.
;xternal urinary catheters are applied over the shaft of the penis and therefore inappropriate for females.
4.
!he only viable solution to meet the patient,s physical need is to allow him to use the bathroom.
3.
3.
1.
n an
4.
1.
2.
'5'6%6(+6.doc
Answers
'1
'(.
2. Ban"e of motion activities are performed almost immediately followin" a total &nee replacement. !he patient ideally would be able to attain full extension ran"e of motion and up to 8+ de"rees of &nee flexion prior to dischar"e.
'4.
3. A sta"e ulcer is characteri9ed by full thic&ness s&in loss involvin" dama"e or necrosis of subcutaneous tissue that may extend down to) but not throu"h) underlyin" fascia. !he ulcer presents clinically as a deep crater with or without involvement of ad/acent tissue.
'5.
3.
'6.
!he ability to move throu"h partial ran"e of motion in a "ravity-eliminated position is consistent with a muscle "rade of poor minus.
'7.
3.
'8.
ndependent propulsion is facilitated by the use of a li"htwei"ht wheelchairD while a solid seatin" system assists with posture and transfer activities. An arm board allows the flaccid upper extremity to be supported and elevatin" le"rests assist to decrease dependent edema.
(+.
2. ;mphysema is a chronic obstructive pulmonary disease characteri9ed by an increase in the si9e of air spaces distal to the terminal bronchiole accompanied by destructive chan"es in their walls. As a result) the lun"s become hyperinflated and the chest wall becomes fixed in a hyperinflated position. !otal lun" capacity and dead space in the lun"s si"nificantly increase.
(1.
!reatment should be discontinued when there is any si"n of heat intolerance. t is important to document the incident in order to alert other possible providers to the patient,s reaction and to ma&e the incident part of the permanent medical record.
(%.
4. !he modified planti"rade position requires patients to possess control of equilibrium and proprioceptive reactions. !he position offers a small base of support and hi"h center of "ravity with wei"ht bearin" occurrin" throu"h the lower extremities.
('.
?ands-on trainin" sessions provide unique opportunities for the therapist to assess the competence of family members in a structured environment.
((.
2. Patients that demonstrate an extension la" have "reater passive extension than active extension. !he difference in the passive and active extension ran"e of motion is used to quantify the amount of the la".
(4.
!he sa"ittal plane divides the body into left and ri"ht halves. :otions in the sa"ittal plane include flexion and extension.
(5.
2hortenin" of the latissimus dorsi often presents as a limitation of shoulder flexion of abduction due to the muscles ori"in on the external tip of the iliac crest and its insertion on the ntertubercular "roove of the humerus.
(6.
?oldin" the wheelie position after bein" placed into it by the therapist requires the least s&ill and therefore provides the patient with the opportunity to "ain a sense of balance before movin" on to more difficult activities.
(7.
2. A superficial partial thic&ness burn involves the epidermis and a portion of the dermis. ?ealin" typically occurs in approximately three wee&s with little or no scarrin".
(8.
2. nstitutional review boards are responsible for assurin" the welfare and safety of patients and establishin" that ethical) moral and le"al standards are not compromised by proposed research activities.
4+.
2ensitivity is the percenta"e of individuals with a particular dia"nosis who are correctly identifies as positive by a test.
!he internal intercostals act to depress the ribs durin" forceful expiration.
3.
!he hand"rip of a proper fittin" cane should be at the level of the "reater trochanter.
3.
4.
1.
2.
2.
4.
3.
'5'6%6(+6.doc
'%
Answers
41.
1. Physical therapists "ain information on a patient,s response to exercise throu"h various sub/ective and ob/ective measures) however) remain dependent on a patient,s willin"ness to exert a maximal effort in order to collect meanin"ful data.
4%.
2. Patients with burns often experience a number of sensory chan"es. !hese chan"es can include impaired sensation of increased sensitivity. Althou"h many factors contribute to sensory alteration) the depth of the burn appears to be the best predictor.
4'.
!he physical therapist must determine whether the patient understands the importance of physical therapy. f the patient continues to refuse treatment) the therapist should inform him of the expected consequences.
4(.
2. !otal hip replacement usin" noncemented fixation requires toe touch wei"ht bearin" for a minimum of six wee&s in order to allow adequate time for tissue and bone "rowth around the prosthesis.
44.
2. !o perform a manual muscle test of the lower trape9ius) the patient should be positioned in prone with the shoulder abducted "reater than 1%+ de"rees. Pressure should be applied a"ainst the forearm in a direction towards the floor.
45.
2. deational apraxia is most commonly due to a lesion in the patient,s dominant parietal lobe of the cerebrum. !he condition deals with errors in concepts and sequencin" of tas&s.
46.
1. @ailure of the heart rate to increase with further increases in intensity occurs when a patient is no lon"er able to meet the demands imposed by a "iven exercise intensity. !his ob/ective findin" often si"nifies that the patient has produced a maximal effort.
47.
3. A six-inch ace wrap is the most appropriate banda"e for wrappin" the residual limb of a patient with a transfemoral amputation. !he six-inch wrap adequately covers the lar"er surface area of the residual limb.
48.
4. 2pina bifida is a neural tube defect characteri9ed by a defective closure of the vertebral column. Althou"h the exact clinical presentation of spina bifida can very considerably) hip-&nee-an&le-foot orthoses =?LA@> are often employed to assist pediatric patients with ambulation activities. !he hi"h ener"y cost of ambulatin" with the orthoses often ma&es community ambulation difficult.
5+.
1. !i"ht hip flexors result in excessive anterior tilt of the pelvisD as a result actual hamstrin"s len"th will be "reater than the measured len"th.
51.
!he process of electromyo"raphy involves as&in" the patient to utili9e a particular muscle so that voluntary potentials can be recorded. !here should not be any recorded electrical activity in a muscle at rest.
5%.
Acromioclavicular dysfunction often results in a painful arc from 1%+-17+ de"rees of abduction. A painful arc from 8+-1%+ de"rees may be indicative of subacromial bursitis) calcium deposits or tendonitis of the rotator cuff muscles.
5'.
2.
5(.
3. steoporosis refers to a disease process that results in a reduction of bone mass. :easurin" a person,s hei"ht is an inexpensive method to screen for this disease process.
54.
Wal&in" at ' mph) bicyclin" at 5 mph or playin" "olf while pull a wal&in" cart are activities that require '-( :;!s.
55.
A patient wal&in" at a comfortable pace with a transfemoral prosthesis requires nearly 4+C more oxy"en than normal. !his value is si"nificantly hi"her than the other stated options.
56.
1. !he test for the lateral hamstrin"s is described with the &nee in 4+-6+ de"rees of flexion with the thi"h in sli"ht lateral rotation on the thi"h. Pressure should be applied a"ainst the lower le" proximal to the an&le in the direction of &nee extension.
3.
1.
4.
adence is defined as the number of steps ta&en by a person per unit of time.
3.
3.
'5'6%6(+6.doc
Answers
''
57.
1. Bespiratory acidosis is caused by retention of carbon dioxide due to pulmonary insufficiency. 2i"ns and symptoms include di99iness) tin"lin") and syncope.
58.
!he patient is li&ely to be intoxicated if he has consumed six or seven alcoholic bevera"es. ontactin" a member of the family will prevent the possibility of the patient attemptin" to drive.
6+.
Beducin" the wei"ht to five pounds will allow the patient to maintain the inte"rity of the ori"inally prescribed exercise) while allowin" the patient to perform the exercise correctly.
61.
2. orrect technique includes pullin" the muscles up and in. Placin" a downward pressure on the pelvic floor serves to exacerbate the patient,s condition. Besearch indicates that nearly 4+C of patients who receive verbal instructions for pelvic floor contractions perform the exercises incorrectly.
6%.
3.
3.
2.
;levatin" le"rests promote patient comfort and stability when the wheelchair is in a reclined position.
6'.
Quality improvement pro"rams are desi"ned to assess the services provided and the outcomes achieved for the purpose of improvin" patient care. Prior to collectin") analy9in" or interpretin" specific data it is essential to identify the important aspects of patient care provided by the department.
6(.
4. An arterial line is inserted directly into an artery and is used to continuously monitor blood pressure or to obtain blood samples.
1.
64.
A forward raise for pressure relief requires adequate stren"th of the biceps for elbow flexion and the deltoids for movement at the shoulder in the directions of flexion and extension.
65.
!he rhythmic initiation technique should be"in with passive movement of the patient by the physical therapist. Pro"ression usin" this technique would include active-assistive movement) active movement) and finally resisted movement.
66.
Patients over (+ years old are more susceptible to shoulder stiffness with prolon"ed immobili9ation and as a result physicians tend to limit the len"th of the immobili9ation period. n addition) the recurrence rate for dislocation is relatively low in this a"e "roup. 2everal of the other listed variables are relevant) however) would not typically be as si"nificant as a"e when determinin" the len"th of immobili9ation.
67.
!he hold-relax technique utili9es an isometric contraction at the end of available ran"e of motion. !he patient is ten told to relax as the physical therapist moves the extremity into newly "ained ran"e.
68.
2.
3.
4.
1.
2.
Assistive devices can easily be ad/usted to accommodate individuals of various hei"ht and wei"ht.
7+.
!he status of bone healin" as determined throu"h a radio"raph would provide the physician with the best information on the stability of the acetabulum. t is important to emphasi9e that the physician is the health care provider responsible for determinin" wei"ht bearin" status.
71.
!he hip is required to flex durin" initial swin" to allow for proper clearance and advancement of the limb durin" "ait. Normally) dorsiflexion also occurs. Without the use of the dorsiflexors the hip flexors need to be stren"thened in order to attain proper clearance.
7%.
3. When resistance is applied a"ainst a stron" component of a pattern it can result in irradiation or overflow of impulses from the stron"er muscle "roup to the wea&er muscle "roup.
7'.
2ta"e four in
7(.
74.
Patients with ti"ht hip flexors often exhibit increased lordosis. 2hortened hip flexors is often identified in standin" as lumbar lordosis or throu"h a special test such as the !homas test.
3.
4.
3.
2.
3.
'5'6%6(+6.doc
'(
Answers
75.
3. t is extremely important for a patient with transtibial amputation to &eep the &nee in an extended position in order to avoid a &nee flexion contracture.
76.
2i"ns of cold intolerance include pain) cyanosis) wheals) mottlin") increased pulse rate) and a si"nificant drop in blood pressure. A physical therapist should immediately stop the application of cold when any si"n of cold intolerance is observed.
77.
2. A physical therapist should attempt to secure an updated physician referral prior to administerin" formal treatment. ontactin" the physician,s office by telephone provides the fastest) most direct method to update the referral without further delayin" treatment.
78.
3. Peripheral neuropathy is a broad term that describes a lesion to a peripheral nerve. !he condition can be caused by a multitude of factors includin" diabetes) compression) trauma or nutritional deficiencies. Patients with peripheral neuropathy may exhibit motor) sensory) and autonomic chan"es includin" extreme sensitivity to touch) loss of sensation) muscle wea&ness) and loss of vasomotor tone. 0eep tendon reflexes may be asymmetrical based on the location of the involved peripheral nerve and usually present as diminished or absent.
4.
8+.
@acet impin"ement often results in a patient bein" loc&ed in a selected position. n the thoracic and lumbar spine the position involves sidebendin" and rotation occurrin" in opposite directions. !he patient will experience the "reatest discomfort and restriction of movement when movin" away from the loc&ed position.
81.
3. An accommodation that would fundamentally alter the operation of a business may not be considered reasonable. t is unli&ely) however) that a modification to a wor&station would fall into this cate"ory.
8%.
ccupational therapy is described as the art and science of helpin" people perform day to day activities. Althou"h professional boundaries differ from facility to facility) bathin" and dressin" activities are typically addressed by occupational therapists.
8'.
1. !he tendon of the tibialis posterior is most prominent when the foot is inverted and plantarflexed. !he tendon can be palpated posterior and inferior to the medial malleolus.
8(.
!he distance to the clinic is excessive) particularly when sittin" for prolon"ed periods of time may exacerbate the patient,s condition. !he patient should receive therapy services at a clinic closer to home.
84.
4.
85.
ontrolled mobility is the sta"e in motor control where a patient is able to have some mobility while maintainin" postural stability. !all &neelin" represents static control) while the transfer to half &neelin" requires the mobility to wei"ht shift and chan"e position.
86.
2. Perseveration is the continued repetition of a word) phrase or movement. nitiatin" a new activity durin" therapy may allow the patient to redirect attention and subsequently receive positive reinforcement for attendin" to a selected tas&.
87.
4. A physical therapy aide is a non-licensed wor&er) trained under the direction of a physical therapist) who requires continuous on-site supervision. A physical therapist may dele"ate ambulation activities to an aide if the physical therapist feels the aide,s trainin" is adequate to complete the activity. Ambulation for endurance implies that the patient may already possess some level of basic competence with the activity.
88.
2. eadin" questions often bias a patient toward a specific response. !he question E0oes this alter your pain in any way#F provides the patient with the opportunity to provide additional insi"ht into hisIher present condition.
1++.
21 M closin" of the mitral and tricuspid valves. 2% M closin" of the aortic and pulmonic valves. 2' M early ventricular fillin"D noncompliant left ventricle. 2( M rapid ventricular fillin" that occurs after atrial contraction.
1+1.
2ymptom ma"nification is best identified by inconsistencies in the presentation of function. Althou"h the physical therapist has identified a "iven inconsistency) it would be inappropriate to immediately confront the patient. !he therapist would be better served by continuin" the examination and "atherin" additional information durin" future treatment sessions.
3.
3.
3.
nability to sit unsupported without assistance is indicative of poor sittin" balance.
3.
1.
1.
'5'6%6(+6.doc
Answers
'4
1+%.
4. apsular patterns of restriction result from loss of mobility of the entire /oint capsule. n trochanteric bursitis) passive and active ran"e of motion are typically preserved) althou"h there is often pain at end ran"e with selected motions such as abduction.
1+'.
4. Post-operative care of a rotator cuff repair often includes immobili9ation in abduction and medial rotation usin" an abduction splint. ateral rotation is often restricted durin" the initial sta"es of rehabilitation since the position tends to place the repaired structures on stretch.
1+(.
!he tibiofemoral articulation consists of a concave tibial plateau articulatin" with the convex femoral condyles. An anterior "lide of the tibia on the femur is indicated to increase &nee extension.
1+4.
1. A patient with 6 tetraple"ia will not be able to independently perform activities of daily livin" secondary to inadequate hamstrin"s len"th. A patient requires between 11+-1%+ de"rees of strai"ht le" raise in order to reach forward and don clothin".
1+5.
A dru" that enters the body throu"h the alimentary canal is defined as enteral administrationD therefore ta&in" medication orally would fall into this cate"ory.
1+6.
4. !he supplied description is a standard method to assess the stren"th of the lower abdominal muscles. @ailure to maintain the low bac& flat on the treatment table as the le"s are lowered is indicative of muscle wea&ness.
1+7.
2. A patient with ( tetraple"ia is appropriate for power reclinin" wheelchair with chin controls since the nec& muscles are innervated.
1+8.
3.
11+.
!he Binne test is performed by placin" the stem of the tunin" for& on the mastoid process. !he test is desi"ned to compare bone conduction hearin" with air conduction hearin".
111.
2. !opical antibiotics are often utili9ed in the treatment of burns. !hey serve to reduce bacterial count) provide a coverin" for the wound) reduce stiffness) and reduce evaporative loss. 2ince topical antibiotics are applied directly to the affected area sterile "loves should be worn. 0ue to the limited si9e of the wound additional medical asepsis would not be necessary.
11%.
4. Bespiratory rate is an ob/ective measure that is used to assess endurance. Bespiratory rate typically increases as a patient becomes fati"ued.
11'.
Normali9ation of tone is a priority in stro&e rehabilitation. @acilitation techniques are utili9ed when hypotonia exists. @acilitation techniques include vibration) wei"ht bearin") approximation) tappin") and quic& stretch.
11(.
2ince the patient,s elbow ran"e of motion be"ins at 14 de"rees of flexion and ends at 8+ de"rees of flexion) the measurement should be recorded as 14-8+ de"rees of ri"ht elbow flexion. !he amount of available ran"e of motion is considered hypomobile.
114.
2.
115.
2.
!he use of an orthosis would ensure adequate foot clearance and stability durin" activities of daily livin".
116.
2.
nternal fixation provides the fracture site with the necessary stability to allow early protected wei"ht bearin".
117.
3. Patients with con"estive heart failure tend to have excessive fluid retention in the pulmonary and systemic circulation. As a result a diet hi"h in potassium is prescribed) while items hi"h in sodium are restricted.
118.
Pacin" is a technique that can allow patients to complete functional activities without shortness of breath or dyspnea.
4.
4.
!he triceps muscle is innervated by the radial nerve =6-7>.
4.
3.
3.
2.
'5'6%6(+6.doc
'5
Answers
1%+.
4. Gpri"ht sittin" in a forward leanin" posture with the nec& flexed and arms supported is the optimal position to produce a forceful cou"h.
1%1.
When the soc&et of a transtibial prosthesis is ali"ned in excessive flexion it may cause exa""erated &nee flexion durin" stance phase resultin" in instability.
1%%.
Bepeated contractions is a technique that focuses on movement on one side of the /oint. !he technique is facilitated by quic& stretch and utili9es an isotonic contraction. Providin" resistance at the point of wea&ness can enhance repeated contractions.
1%'.
3.
1%(.
1.
1%4.
1. A patient with 5 tetraple"ia relies on "rasp throu"h tenodesis. !he "rasp occurs throu"h tension of the fin"er flexors when the wrist is extended. !enodesis cannot occur if the fin"er flexors are stretched or len"thened.
1%5.
3. !he medial and lateral hamstrin"s ori"inate on the ischial tuberosity. @orceful hip flexion and &nee extension places si"nificant stress on the ischial tuberosity and can result in an avulsion fracture.
1%6.
Apprehension tests are provocative tests that attempt to simulate the mechanism of in/ury associated with a selected in/ury. !he primary indication for an apprehension test is to assist with dia"nosis. ommon apprehension tests include anterior shoulder dislocation and patellar dislocation.
1%7.
3. Anticoa"ulant dru"s are often prescribed post-operatively for patients at ris& for acquirin" deep venous thrombosis. Prothrombin time is often used as a screenin" procedure to examine extrinsic coa"ulation factors and to determine the effectiveness of oral anticoa"ulant therapy.
1%8.
4. omputed tomo"raphy produces cross-sectional ima"es based on x-ray attenuation. 2ince vertebrae are made of bone and are extremely dense) they appear to be white. 2oft tissue structures appear in various shades of "ray while cerebrospinal fluid is blac&.
1'+.
2.
1'1.
!he andau reflex is an equilibrium response that occurs when a child responds to prone suspension by ali"nin" hisIher head and extremities in line with the plane of the body. Althou"h this response be"ins around three months of a"e) it is not fully inte"rated until the child,s second year.
1'%.
1. A complete tear of the ulnar collateral li"ament of the thumb is often termed E"ame&eeper,s thumbF or Es&ier,s thumbF. !he function of the li"ament is to limit val"us stress at the metacarpophalan"eal /oint of the thumb.
1''.
!he anterolateral spinothalamic system is involved with the transmission of discriminative sensations such as pain and temperature. !he system is activated by mechanoreceptors) thermoreceptors) and nociceptors.
1'(.
An"iotensin is a polypeptide in the blood that causes vasoconstriction) increased blood pressure) and the release of aldosterone from the adrenal cortex. Belease of an"iotensin is stimulated by decreased arterial pressure.
1'4.
1.
1'5.
0ue to the potential impact on future bone "rowth) lac& of s&eletal maturity can be a contraindication to anterior cruciate li"ament reconstruction sur"ery.
1'6.
2. !he patient is ma&in" a "eneral statement about his desire to wal& a"ain in the future. Althou"h ambulation would not currently be realistic due to the level of in/ury) it would be inappropriate to dismiss the future chances of the patient bein" able to wal&.
1'7.
3.
4.
2.
2houlder medial and lateral rotation occur in a transverse plane around a lon"itudinal axis.
2.
!he talar tilt test can be used to identify the presence of a calcaneofibular li"ament sprain.
3.
4.
1.
nfants have restin" pulse rates of approximately 1%4-1'4 beats per minute.
3.
!he suprasternal notch refers to the EF shaped notch at the top of the sternum. '5'6%6(+6.doc
Answers
'6
1'8.
2. ?ip flexion "reater than 8+ de"rees is often considered a contraindication followin" total hip replacement sur"ery. !he &nee immobili9er limits hip flexion by maintainin" the &nee in an extended position.
1(+.
A ri"ht ventricular assistive device is desi"ned to pump a percenta"e of the pulmonic blood flow around the ri"ht ventricle in order to decrease the wor&load on the myocardium. !he ri"ht atrium would house one tube because it functions as a primer for the ri"ht ventricle and the other tube would be located in the pulmonary artery since its function is to deliver blood from the ri"ht ventricle to the lun"s.
1(1.
:edicaid is the lar"est insurer of lon"-term care in the Gnited 2tates coverin" over two-thirds of nursin" home residents.
1(%.
2. !he purpose of submaximal exercise testin" is to determine the relationship between heart rate and oxy"en upta&e in order to predict maximum oxy"en upta&e. n order to do this it is necessary determine the relationship between heart rate and oxy"en upta&e at two or more different submaximal exercise intensities.
1('.
0i"italis is utili9ed in the treatment of con"estive heart failure. 0i"italis wor&s directly on electrolytes to improve the force and contractility of the heart.
1((.
4.
1(4.
;mphysema is an obstructive pulmonary disease characteri9ed by overinflation and destructive chan"es in alveolar walls. Althou"h closely related to other obstructive pulmonary diseases) the presence of a barrel chest is most characteristic of emphysema.
1(5.
!idal volume is defined as the amount of air inspired and expired per breath and is approximately (4+-5++ ml in an adult. !his value represents approximately 1+C of the total lun" capacity.
1(6.
Athletes performin" repetitive overhead activities are often sub/ect to adaptive chan"es such as acquired anterior laxity) and a loss of flexibility in the posterior capsule and posterior muscles.
1(7.
1. !he most immediate response in treatin" autonomic dysreflexia is to support the patient in a sittin" position in an attempt to lower blood pressure. !he patient,s bowel and bladder should be assessed and vital si"ns should be monitored.
1(8.
2.
14+.
!he semitendinosus and "racilis are acceptable "rafts for anterior cruciate li"ament reconstruction sur"ery. !he "rafts result in a decreased incidence of post-operative patellofemoral &nee pain) however) provide wea&er initial fixation.
141.
3. !he tibiofemoral articulation consists of a concave tibial plateau articulatin" with the convex femoral condyles. A posterior "lide of the tibia on the femur is indicated to increase &nee flexion.
14%.
A patient with 5 tetraple"ia should demonstrate full epi"astric rise secondary to complete innervation of the diaphra"m.
14'.
2upportin" the subtalar /oint in a neutral or sli"htly supinated position limits subtalar pronation and promotes optimal stretchin" of the calf muscles.
14(.
3. :ovin" the buttoc&s posteriorly in relation to the &nees causes the patient,s center of "ravity to move behind the &nees. As a result) the patient relies on eccentric contraction of the hip extensors to control the movement.
144.
4. !reatin" a patient followin" sur"ery without havin" specific information from the referrin" physician could be considered a ne"li"ent act. n this particular instance the physical therapist &nows only that the patient had &nee sur"ery two wee&s a"o.
145.
Grea is the metabolic byproduct of the brea&down of amino acids used for ener"y production. !he level of urea in the blood provides a "ross estimate of &idney function. An increased blood urea nitro"en level can be indicative of dehydration) pre-renal failure or renal failure. Normal blood urea nitro"en levels for adults are 1+-%+ m"Id.
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?ypoxemia refers to a deficiency of oxy"en in arterial blood.
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A desirable ran"e of men and women accordin" to the
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'7
Answers
146.
4. :ultiple sclerosis is a pro"ressive central nervous system disease mar&ed by intermittent dama"e to the myelin sheath. Patients with multiple sclerosis tend to fati"ue in the afternoon and as a result mornin" sessions are optimal. 2tretchin") exercise) ener"y conservation) and stress mana"ement are valuable components of a comprehensive plan of care of a patient with multiple sclerosis.
147.
!he peroneus lon"us and brevis tendons pass posterior to the lateral malleolus. !he lon"us inserts on the lateral side of the base of the first metatarsal and first cuneiform) while the brevis inserts on the tuberosity of the fifth metatarsal.
148.
4. Placin" the biceps in a maximally shortened position si"nificantly limits the muscle,s ability to function as a supinator.
15+.
1.
151.
4. mmediate medical mana"ement should focus on identifyin" potential complications such as a fracture. -rays are a cost effective dia"nostic tool commonly utili9ed with orthopedic in/uries.
15%.
@ailure to stabili9e the scapula when measurin" "lenohumeral abduction will result in upward rotation and elevation of the scapula. When measurin" shoulder complex abduction the thorax should be stabili9ed to prevent lateral flexion of the trun&.
15'.
2. !he humeral head slides posteriorly on the "lenoid fossa durin" shoulder complex medial rotation and as a result places pressure on the posterior capsule.
15(.
A bone scan is a dia"nostic test that utili9es radioactive isotopes to identify areas of bone that are hypervascular or have an increased rate of bone mineral turnover.
154.
1. Piriformis syndrome is caused by hypertrophy or spasm of the piriformis muscle causin" pressure on the sciatic nerve. Abduction and lateral rotation would li&ely be wea& and painful since the motions serve as the prime function of the piriformis. !he piriformis ori"inates on the anterior surface of the sacrum and the sacrotuberous li"ament and inserts on the "reater trochanter of the femur. !he muscle is innervated by sacral nerves 21 and 2%.
155.
2. !he dorsal scapular nerve innervates the levator scapulae and rhomboids. !he levator scapulae function to elevate the scapula while the rhomboids adduct the scapula.
156.
Passive insufficiency occurs when a two-/oint muscle is stretched across two /oints at the same time. When performin" passive &nee flexion the two /oint &nee extensors are placed on stretch and therefore in the presence of insufficient len"th may contribute to a limitation in &nee flexion.
3.
An allo"raft refers to a "raft or tissue between two "enetically dissimilar individuals of the same species.
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157.
2.
An infant,s pulse is often assessed at the brachial artery) while the radial artery is utili9ed for an older child.
158.
4. A patient with limited dorsiflexion may present with a vault or bounce throu"h mid to late stance. !en to twenty de"rees of dorsiflexion is required for late stance throu"h toe off.
16+.
3. A patient status post A should avoid prolon"ed supine positionin" in bed. A supine position encoura"es abnormal reflexes includin" asymmetrical tonic nec& reflex) symmetrical tonic nec& reflex) and labyrinthine reflexes.
161.
2. Passive shoulder complex abduction is approximately 17+ de"rees) however) "lenohumeral abduction is 1%+ de"rees with approximately 5+ de"rees of motion occurrin" at the scapulothoracic articulation.
16%.
4. As the intensity of exercise plateaus) a patient will accommodate to the level of exercise and hisIher respiration rate will tend to decrease.
16'.
ital capacity is defined as the amount of air that can be exhaled followin" a maximal inspiratory effort. ital capacity varies directly with hei"ht and indirectly with a"e. 1.
'5'6%6(+6.doc
Answers
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16(.
1. !he infraspinatus muscle is innervated by the suprascapular nerve =() 4) 5> that extends from the superior trun& of the brachial plexus.
164.
!he American olle"e of 2ports :edicine recommends prescribin" the intensity of exercise as 5+ to 8+C of maximum heart rate of 4+-74C of %max or heart rate reserve.
165.
Athetosis refers to involuntary movements characteri9ed as slow) irre"ular) and twistin". !his type of motor disturbance ma&es it extremely difficult to maintain a static body position.
166.
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0eterminin" wei"ht bearin" status is the responsibility of the referrin" physician.
167.
A slidin" board transfer is possible based on the patient,s upper extremity stren"th. !he transfer will allow the patient to maintain a hi"h level of independence.
168.
3. !he flexor di"itorum profundus is responsible for flexin" the distal interphalan"eal /oint of the four fin"ers and assistin" with flexion of the proximal interphalan"eal and metacarpophalan"eal /oints.
17+.
!he iliotibial band serves as a secondary restraint to the anterior cruciate li"ament) not the posterior cruciate li"ament.
171.
An endos&eleton or modular shan& is desi"ned to incorporate a synthetic foam cover shaped li&e the opposite le". As a result the device is more cosmetically attractive and would li&ely ma&e the patient more comfortable in her social settin". A solid an&le cushion heel is the most frequently prescribed foot-an&le assembly. t is considered to be a nonarticulated foot since it does not incorporate a mechanical /oint at the an&le.
17%.
n order to secure valid measurements of available ran"e of motion physical therapists should not permit any type of substitution. n addition to shoulder adduction and lateral rotation) patients can also attempt to substitute for limited supination by ipsilateral trun& sidebendin".
17'.
?eart rate response when immersed in water appears to be similar to the response expected for land activities durin" periods of rest and durin" periods of low intensity exercise) however) durin" periods of hi"h intensity exercise the response is diminished.
17(.
2.
174.
3. A position of 6+ de"rees of elbow flexion allows the elbow to reach its maximum volume and therefore accommodates the swellin" with less discomfort. !he de"ree of elbow flexion is consistent with the amount of flexion present in the restin" position of the ulnohumeral /oint.
175.
Accordin" to a study performed by Nachemson) intradis&al pressure is "reatest when sittin" in a chair with reduced lumbar lordosis.
176.
1. A patient with 4 quadriple"ia would be able to utili9e muscles innervated at or above the 4 spinal level. !he patient should be able to utili9e the brachioradialis to flex the elbow since the muscle is innervated at the 4-5 spinal level.
2.
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4.
Accordin" to the American Academy of rthopedic 2ur"eons) normal pronation of the forearm is 7+ de"rees.
4.
177.
1.
Normal ran"e for pulse rate is 5+-1++ beats per minute) while respiration rate is 1%-17 breaths per minute.
178.
!he shoulder medial rotators and adductors provide support for the anterior /oint capsule and as a result stren"thenin" of these muscles is an essential component of a rehabilitation pro"ram followin" anterior shoulder dislocation.
18+.
4. so&inetic &nee extension and flexion require the distal se"ment to move freely in space) as a result the exercise is considered to be an open &inematic chain exercise.
181.
Accordin" to the Americans with 0isabilities Act Accessibility $uidelines the space necessary for a 17+ de"ree turn usin" a wheelchair is 5+ inches.
18%.
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0irect personal contact with the referrin" physician is necessary to plan an effective care plan for the patient. '5'6%6(+6.doc
