DAY 5

Question 1

1. A PT is evaluating the gait of a 5-year-old girl. PT notices that the child is unsteady and has a wide base
   support. She appears to lurch at times with minimal truncal bobbing in an anterior and posterior position. The
   child cannot maintain standing position with the feet placed together for more than 5 seconds. The area of the brain MOST LIKELY affected is the
   a. cerebellar hemisphere
   b. substantia nigra
   c. corticospinal tracts
   d. basal gangli

Answer 1

a. cerebellar hemisphere

Question 2

2. A TBI injured patient is sometimes disoriented to time and place, has poor memory for recent events and
   almost no carry over for new learning. The MOST important goal in this case is

a. different daily tasks to increase ease of cognitive retrieval
b. daily structure to reduce distraction
c. independence to tasks with varying environments
d. increase arousal and attention through sensory stimulation

Answer 2

b. daily structure to reduce distraction

Question 3

3. An injury of the median nerve at the level of the wrist and hand can cause the following functional loss EXCEPT
   a. thumb opposition
   b. weak or no pinch
   c. flexion of the little finger
   d. thumb flexion

Answer 3

c. flexion of the little finger (FDM - Ulnar nerve)

Question 4

4. Patients with peripheral nerve injury demonstrate optimal peripheral nerve integrity and muscle performance over the course of months.
   a. 18-24 months
   b. 2-3 months
   c. 9-12 months
   d. 4-8 mont

Answer 4

d. 4-8 months

Question 5

5. A 54 year old female bank executive was referred to the clinic after right breast lumpectomy with axillary
   lymph node dissection. PT noted that scapular control is poor when upper extremity flexion or abduction
   is began. Given the limitation, the PT intervention at this time should focus on .
   a. Active assistive pulley exercises to assist rotator cuff muscles following damage to the
   suprascapular nerve
   b. Strengthening of the right deltoids to help stabilize the shoulder, which compensates for damage to the dorsal scapular nerve
   c. Strengthening of the right rhomboid to promote normal function of the scapula as a result of
   damage to the dorsal scapular nerve
   d. Gravity-assistive right upper extremity exercises to promote scapular control following damage
   to the long thoracic nerve

Answer 5

d. Gravity-assistive right upper extremity exercises to promote scapular control following damage
to the long thoracic nerve

*** “…scapular control is poor when upper extremity flexion or abduction
is began…” => Serratus Ant affectation (LTN)

Question 6

6. A child stimulated for negative support reaction will respond positive through increased .
   a. Extensor tone in lower extremities
   b. Flexor tone in upper extremities
   c. Flexor tone in lower extremities
   d. Extensor tone in upper extremities

Answer 6

c. Flexor tone in lower extremities

(a. Extensor tone in lower extremities = Positive Support Reaction)

Question 7

7. Ultrasound vibrations propagated through the housing of the applicator into the hand of the PT are
   called .
   a. Parasitic vibrations
   b. Oscillating conversion
   c. Ultrasonic conversion
   d. Bactericidal vibrations

Answer 7

a. Parasitic vibrations

Question 8

8. In comparing the clinical features of cerebral artery thrombosis with cerebral embolism, the former
   a. presents an abrupt onset with rapidly developing symptoms
   b. has the most common site of occlusion in the internal carotid artery
   c. usually includes a sudden loss of consciousness
   d. includes more generalized disturbance of cerebral function

Answer 8

b. has the most common site of occlusion in the internal carotid artery

Question 9

9. A patient is on immune suppressants following renal transplantation was referred to the clinic for mobility
   training using crutches. Initial evaluation revealed paresthesia in both lower extremities with peripheral weakness in both hands and feet. PT suspects that patient is MOST LIKELY experiencing
   a. leukopenia
   b. peripheral neuropathy
   c. myopathy
   d. quadriparesis

Answer 9

b. peripheral neuropathy

Question 10

10. The correct sequence in the hierarchy of the criteria of a profession is

a. lifetime commitment, representative organization, specialized education, service to clients, autonomy of judgment
b. representative organization, lifetime commitment, service to clients, specialized education, autonomy of judgment
c. autonomy of judgment, lifetime commitment, specialized education, representative organization, service to clients
d. service to clients, autonomy of judgment, specialized education, representative organization, lifetime
commitment

Answer 10

a. lifetime commitment, representative organization, specialized education, service to clients, autonomy of judgment

Question 11

11. A PT working in the provincial hospital was asked to cover an interscholastic football league competition. During a game, a player is knocked down on the field. The PT rushed to the scene and determines that the player is unconscious. What should be the NEXT action of the PT?
    a. Proceed to give mouth to mouth resuscitation check for shock
    b.Start with the head and determine first if there is any bleeding or fluid coming from the nose, ears, eyes, or mouth
    c.Check the carotid pulse for a heart beat
    d.Check breathing and if it is impaired, clear the airway, and if necessary

Answer 11

d.Check breathing and if it is impaired, clear the airway, and if necessary

Question 12

13. A 63-year-old male CVA patient was applied functional electrical
    stimulation on the affected ankle dorsiflexors in conjunction with her gait training program. The rationale for the application of FES for this case
    is _______.

a. to promote substituting actions
b. all of these
c. used as an orthotic device
d. to delay muscle atrophy

Answer 12

c. used as an orthotic device

Question 13

14. On initial standing, a patient with a chronic stroke is pushing strongly backward, displacing the center of mass at or near the posterior limits of stability. The MOST LIKELY cause of this is ________.
    a. contraction of the hip extensors
    b. contracture of the hamstrings
    c. spasticity of the tibialis anterior
    d. spasticity, of the gastrocnemius soleus

Answer 13

d. spasticity, of the gastrocnemius soleus

Question 14

15. The following impairments may result in patients with a lesion in the temporal lobe of the brain, EXCEPT:
    a. emotional liability
    b. difficulty with memory loss
    c. Wernicke’s aphasia
    d. learning deficits

Answer 14

a. emotional liability (FRONTAL lobe lesion)

Question 15

16. A newborn with whole arm paralysis resulting from a traction injury at birth was referred to physical
    therapy. The initial plan of care for the patient should include
    a. passive mobilization of the shoulder in overhead motions
    b. age-appropriate task training of the upper extremity
    c. splinting the shoulder in abduction and internal rotation
    d. partial immobilization of the limb across the abdomen, followed by gentle ROM after
    immobilization

Answer 15

d. partial immobilization of the limb across the abdomen, followed by gentle ROM after
immobilization

***choices A and C is C/I d/t dislocation or hyper flexibility of the SH jt
choice B will be done LATER

Question 16

17.The functional outcome reporting method of writing notes must be ___________.
a. meaningful, quantifiable, sustainable
b. sustainable, simple, quantifiable
c. meaningful, utilitarian, sustainable
d. utilitarian, meaningful, quantifiable

Answer 16

c. meaningful, utilitarian, sustainable

Question 17

18. This is a tool to asses and treat balance dysfunction but does not assist to diagnose the cause of balance dysfunction. It consists of eight test conditions used in the battery with each leg measured on two counts, the
    time spent in each test position and the number of steps that a patient are performed.
    a. Functional Reach
    b. Berg Balance Scale
    c. Fugl Meyer Sensory Assessment
    d. Fregley Graybiel Ataxia Test Battery

Answer 17

d. Fregley Graybiel Ataxia Test Battery

Question 18

19. A 58-year-old female is recovering from a surgical resection of an acoustic neuroma and presents with
    symptoms of dizziness, vertigo, horizontal nystagmus and postural instability. To manage these problems, the program should include
    a. strengthening exercises focusing on spinal extensors
    b. repetition of movements and positions that provoke dizziness and vertigo
    c. Hallpike’s exercises to improve speed in movement transitions
    d. prolonged bedrest to allow vestibular recovery to occur

Answer 18

b. repetition of movements and positions that provoke dizziness and vertigo

Question 19

20. What is the FIRST step in controlling organizational behavior in a PT Department?
    a. establish system of measuring performance
    b. develop system of review
    c. determine types of jobs and skills needed
    d. monitor performance and provide feedback

Answer 19

c. determine types of jobs and skills needed

Question 20

21.A 75-year-old male patient with persistent balance difficulty and a history of recent falls (2 in the past month) is referred for evaluation and management. During the initial session, it is important to examine
the:
a. level of dyspnea during functional transfers
b. sensory losses and sensory organization of balance
c. spinal musculoskeletal changes secondary to degenerative joint disease (DJD)
d. cardiovascular endurance during a 5-minute walking test

Answer 20

b. sensory losses and sensory organization of balance

Question 21

22. A 64-year-old female patient who underwent a minimally invasive total knee replacement was referred
    to PT. The referring physician stated in the chart that patient ha stage 1 Alzheimer’s disease. The PT will
    therefore NOT expect to find
    a. memory loss
    b. anxiety and irritability
    c. cannot concentrate
    d. profound communication deficit

Answer 21

d. profound communication deficit

Question 22

23. The following are guidelines during vestibulo-ocular retraining EXCEPT

a. Use of gravity, varying surface conditions, visual conditions and environmental cues should
included in therapeutic planning
b. The center of gravity is allowed to move at each stage of treatment
c. Individualize each program based on the patient’s specific impairments (rehabilitation versus compensation training)
d. Use of practice, feedback and repetition are vital for skill refinement

Answer 22

b. The center of gravity is allowed to move (*** it should be CONTROLLED not “allowed to move”) at each stage of treatment

Question 23

24. This inner ear disease that affects balance has the following symptoms: intense vertigo, occasionally unilateral deafness, buzzing or ringing in the ear.

a. otitis media, chronic
b. bulging disc C4-C5
c. otitis externa
d. Meniere’s disease

Answer 23

d. Meniere’s disease

Question 24

25. The primary objective for record keeping in the PT clinic is:
    a. Quality of care assessment
    b. Betterment of patient care
    c. Communication of patient care
    d. Medical-legal issues

Answer 24

b. Betterment of patient care

Question 25

26. In a person with normal balance, the fastest sensory system to provide balance information is the:
    a. Visual system
    b. Vestibular system
    c. Somatosensory system
    d. All 3 systems are equally fast

Answer 25

c. Somatosensory system

Question 26

27.A patient with multiple sclerosis has dysmetria in both upper extremities. The BEST intervention for this problem is
a. 4lb. weight cuffs of wrist during activities of daily living training
b. pool exercises using water temperature more than 85 degrees
c. isokinetic training using low resistance and fast movement speeds
d. PNF patterns with dynamic reversals with carefully graded resistance

Answer 26

d. PNF patterns with dynamic reversals with carefully graded resistance

Question 27

28. While a patient recovering from a spinal cord injury was attending his exercise session, he declared that he will walk again. Which of these injuries would make functional ambulation MOST unrealistic?
    a. Brown-Sequard syndrome
    b. complete T9 paraplegia
    c. posterior cord syndrome
    d. cauda equina injury

Answer 27

b. complete T9 paraplegia

Question 28

29. If a patient has diagnosis of anterior interosseus syndrome, the activity that will be most difficult to
    perform is
    a. opposition
    b. resisted wrist extension with the elbow flexed at 90 degrees p
    c. wrist ulnar deviation with the thumb tucked inside a closed fist
    d. pinching together the tips of the index finger and thumb

Answer 28

d. pinching together the tips of the index finger and thumb

Question 29

30.Which modality causes the greatest increase in tissue temperature?
a. Infrared
b. Ultrasound
c. Moist hot packs
d. Diathermy

Answer 29

d. Diathermy

Question 30

31. The ideal temperature of the water in the whirlpool when treating a patient with severe arterial
    insufficiency is ___.
    a. 90-92 degrees Celcius
    b. 90-92 degrees Fahrenheit
    c. 33.5-35.5 degrees Fahrenheit
    d. 92-96 degrees Fahrenheit

Answer 30

d. 92-96 degrees Fahrenheit (33 - 35.5°C, neutral warmth)

Question 31

32.A CP spastic diplegia patient exhibits weak hip abduction. Which activity will LEAST LIKELY strengthen his abduction?
a. Sidelying with hip raises
b. Supine to prone
c. Prone to supine
d. Kneeling to half-kneeling on either sid

Answer 31

b. Supine to prone (facilitates hip ADDuction)

Question 32

33.A patient with multiple sclerosis has dysmetria in both upper extremities. The BEST intervention for this problem is
a. 4lb. weight cuffs of wrist during activities of daily living training
b. pool exercises using water temperature more than 85 degrees
c. isokinetic training using low resistance and fast movement speeds
d. PNF patterns with dynamic reversals with carefully graded resistance

Answer 32

d. PNF patterns with dynamic reversals with carefully graded resistance

Question 33

34. A PT is evaluating a 50-year-old housewife with vestibular problems. Patient is asked to assume a long
    sitting position with the head turned to the left side. PT then moves the patient backward so that the head is extended over the end of table about 30 degrees below horizontal. This maneuver causes severe dizziness and
    vertigo. A special test with the head turned to the right produces no symptoms. PT document the results as a positive ___________.
    a. sharpened Romberg’s test
    b. positional test
    c. left Dix-Hallpike test
    d. right Dix-Hallpike test

Answer 33

c. left Dix-Hallpike test

Question 34

35. A small company with 15 employees is considering changing the chairs of the work area. In ergonomics, it
    is important to be able to adjust any chair to meet the basic anthropometric dimensions of the worker. The
    guiding principles in the selection of seating are as follows, EXCEPT:

a. The foot support should be used with seats that are higher than normal
b. The seat surface should be 3 to 5 cm above the fold of the knee when the worker is standing
c. The backrest must have a well-formed lumbar pad, which should offer good support at a height of
100 to 200 mm above the lowest point of the seat
d. The depth of the seat should allow disk load rest against the backrest to reduce disk load

Answer 34

b. The seat surface should be 3 to 5 cm above (***BELOW not above) the fold of the knee when the worker is standing

Question 35

12. A PT is preparing a 45-year-old female patient for treatment. The latter asked if she could go to the comfort room. Wondering why patient has not returned to the treatment area after several minutes, PT checked and
    found patient slumped on the floor face down. The appropriate course of action the PT should take is:

a. check level of response, call for help, establish airway and assess breathing
b. check level of response, call for help, assess breathing and establish airway
c. call for help, check level of response, assess breathing and establish airway
d. call for help, check level of response, establish airway and assess breathing

Answer 35

a. check level of response, call for help, establish airway and assess breathing