du++on 2 Flashcards
You are stretching the pectoralis minor muscle of a patient diagnosed with thoracic outlet syndrome. All of the following are correct statements about the pectoralis minor, except:
A. It is supplied by the medial pectoral nerve only
B. It inserts into the middle third of the clavicle
C. It arises from ribs 3 through 5
D. It is a small somewhat triangular muscle
Correct Answer: B
Rationale: The pectoralis minor inserts into the medial border and superior surface of the coracoid process of the scapula
You are designing a strengthening program for a patient with weak hip muscles. Each of the following muscles can produce movement of the hip, except:
A. Rectus femoris
B. Obturator internus
C. Quadratus femoris
D. Vastus medialis
Correct Answer: D
Rationale: The vastus medialis does not cross the hip joint.
You are applying massage to a muscle within the femoral triangle. Which of the following muscles is not found in the femoral triangle?
A. Adductor magnus
B. Adductor longus
C. Pectineus
D. Sartorius
Correct Answer: A
Rationale: The adductor magnus is not found within the femoral triangle.
You are part of a rehab team that is to recommend environmental modifications to a 76 year-old patient’s bathroom at his home. The patient, who is wheelchair dependent, is scheduled to be discharged next week. All of the following would be appropriate recommendations, except:
A. Bathroom sink not greater than 40 inches from floor to bottom of mirror or paper dispenser
B. Grab bars by the toilet should be 1¼-1½ in diameter
C. Minimum width of doorway to be 32 inches
D. Horizontal grab bars to be positioned at 40 inches from floor level
Correct Answer: D
Rationale: horizontal grab bars in tub should be positioned at 33-36 inches from floor level
. You are teaching a patient who fractured his right tibia how to use crutches using a four-point gait pattern. Which of the following describes this pattern?
A. (L) crutch, (R) foot, (R) crutch, (L) foot
B. (R) crutch, (L) foot, (L) crutch, (R) foot
C. (L) crutch, (R) foot, (L) foot, (R) crutch
D. (L) crutch, (L) foot, (R) crutch, (R) foot
Correct Answer: B
Rationale: With the 4-point gait pattern the crutch is moved with the opposite leg
You are instructing a patient that is partial weight bearing on the left lower extremity to ascend stairs using axillary crutches. Your first instruction should be:
A. place your left leg on the first step
B. place your left leg and right crutch on the first step
C. place your right leg on the first step
D. place your right leg and left crutch on the first ste
Correct Answer: C
Rationale: Remember the adage: Up with the good, down with the bad–when going up the stairs lead with the good (uninvolved) leg, when going down the stairs lead with the bad (involved) leg.
You are asked by a colleague who must take an important phone call to continue postural drainage activities on a patient. When you enter the room, the patient is positioned in sidelying. Which of the following lung segments is most likely being treated based on the patient’s position?
A. posterior basal segment of the lower lobes
B. apical segment of the upper lobes
C. lateral basal segment of the lower lobes
D. anterior segment of the upper lobes
Correct Answer: C
Rationale: This is the position best suited to treat the basal segment of the lower lobes.
You have been asked to provide an assistive device to a 90-year-old female who lives alone and is partial weight bearing on the right lower extremity. Her upper extremity strength is 3+/5. Which assistive device would you recommend for this patient?
A. Lofstrand crutches
B. axillary crutches
C. large base quad cane
D. walker
D
Rationale: A walker would be the safest assistive device for this patient as it provides the widest base of support.
You have been asked to provide a recommendation for a wheelchair for a patient with C4 tetraplegia. Which wheelchair would be the most appropriate for the patient?
A. manual wheelchair with friction surface handrims
B. manual wheelchair with handrim projections
C. power wheelchair with sip-and-puff controls
D. power wheelchair with joystick controls
C
Rationale: A patient with a diagnosis of C4 tetraplegia would not be able to independently operate a manual wheelchair or joystick controls.
You are treating a 60-year-old male diagnosed with Parkinson’s disease. Due to the effects of the disease, the patient is unable to perform basic activities of daily living without assistance from family members. Your most appropriate treatment objective is:
A. improve upper and lower extremity strength
B. improve respiratory capacity
C. improve initiation of movement
D. improve upper and lower extremity range of motion
C
Rationale: While the other alternatives are reasonable objectives, improving initiation of movement is more specific to Parkinson’s disease.
You are treating a patient who is rehabilitating from a spinal cord injury. The patient’s feet often become dislodged from the wheelchair footrests due to significant lower extremity spasticity. The most appropriate modification to address this problem would be to attach:
A. fixed leg rests and foot plates
B. elevating footrests
C. heel loops and/or toe loops
D. detachable swing-away legrests
Correct Answer: C
Rationale: Of the options listed, attaching heel loops and/or toe loops would best address the spasticity issue.
You are applying a manual assisted cough technique on a supine patient with a T 6-7 spinal cord injury. Which of the following is the most appropriate location for yuor hand placement?
A. diaphragm
B. upper abdomen area
C. xiphoid process
D. umbilicus region
Correct Answer: B
Rationale: The clinician should place both hands flat against patient’s upper abdomen directly below the xiphoid process. With each cough the clinician applies manual pressure inwardly and superiorly
An extremely obese patient has a diabetic ulcer on his right foot. Although the ulcer is in a chronic state of tissue inflammation, it is is not infected. The patient is unable to ambulate without applying pressure to the region. Which of the following interventions would be the most beneficial for this patient?
A. Whirlpool 10 minutes followed by sharps debridement
B. Fit the patient with an orthotic to offload pressures on the involved region
C. Review the role of glucose levels and impact on tissue healing with the patient
D. Prescribe axillary crutches for the patient and instruct them on NWB gait using the crutches
Correct Answer: C
Rationale: The focus of your intervention should be to use patient education to prevent the ulcer worsening. Given the patient’s extreme obesity, ambulation would not be a priority at this time
Upon examination of a patient, you detect a restricted right joint facet at the T8 level. Following a joint mobilization to the involved joint, which of the following movements would be the best movement to teach the patient to stretch the joint?
A. Trunk rotation to the left and trunk extension
B. Trunk rotation to the left and trunk flexion
C. Trunk rotation to the right and trunk extension
D. Trunk rotation to the right and trunk flexion
Correct Answer: B
Rationale: The combination of trunk rotation to the left and trunk flexion will stretch the right joint facet
Your patient, who has a history of severe chronic obstructive pulmonary disease (COPD), is getting discharged to home. The patient’s family are very concerned about the patient’s ability to breath easily once they are discharged. Which of the following would be the best instruction for this patient?
A. Deep breathing exercises combined with postural stabilization training and education about body mechanics
B. Encourage the patient to cough regularly and deeply to clear airway passages
C. Encourage the patient to cough
D. None of the above would be appropriate
Correct Answer: A
Rationale: Deep breathing exercises combined with postural stabilization training and education about body mechanics would be the most appropriate intervention from this list.
A patient presents with dysfunction of the medial longitudinal arch due to depression of the subtalar joint. The appropriate shoe insert for this patient is:
A. scaphoid pad
B. Heel lift
C. pad over the transverse arch
D. Thomas heel
Correct Answer: A
Rationale: The scaphoid pad is designed to prevent depression of the subtalar joint by posting the sustentaculum tali and the navicular tuberosity.
You are working with a child with Down Syndrome who frequently uses a W sitting position. The main reason to discourage sitting in this manner is that it may:
A. cause femoral anteversion and knee strain
B. delay the development of normal sitting
C. increase abnormally low tone
D. increase abnormally high tone
Correct Answer: A
Rationale: The W sit position fixes the hip in ananteverted position while simultaneously placing strain on the ligaments of the knee.
Which of the following end-feels is always an absolute CONTRAINDICATION for joint mobilization?
A. empty end-feel.
B. soft end-feel.
C. springy end-feel.
D. firm end-feel.
Correct Answer: A
Rationale: An empty end feel highlights that the patient is unable to tolerate further motion due to severe pain.
All of the following are indications for mechanical traction, except
A. Spinal nerve root impingement
B. Hypomobility of spinal joints
C. Joint instability
D. Muscle spasm or guarding
Correct Answer: C
Rationale: Traction should not be performed in the presence of joint instability.
You are designing an aerobic exercise program for a healthy 64 year old using the age-adjusted target heart range method. Which of the following heart rates would be the most appropriate for this patient? A. 160 bpm B. 150 bpm C. 140 bpm D. 130 bpm
Correct Answer: D
Rationale: The patient’s max heart rate is calculated at 220-64=156. The appropriate range would be 60-90% of 156 – 93.6 to 140.4.
You are progressing a patient with a diagnosis of traumatic brain injury through a developmental sequence while performing dynamic activities. The patient is currently performing activities in the quadruped position. Which of the following would be the next posture to attain in the developmental sequence?
A. prone on elbows
B. Tall kneeling
C. Standing
D. Long sitting
Correct Answer: B
Rationale: Tall kneeling follows the quadruped position in the developmental sequence
You are designing a program to improve coordination for patient with a history of cerebellar disease. Which of the following exercises would be the best to include? A. McKenzie B. Frenkel’s C. Borg’s D. Rhythmic stabilization
Correct Answer: B
Rationale: Frenkel’s exercises are designed to improve coordination.
You are treating a hemiplegic patient status post traumatic brain injury. You are trying to promote elbow extension in the patient using the asymmetrical tonic neck reflex. Which of the following actions would best facilitate elbow extension?
A. Have the patient turn the head to the involved side
B. Have the patient turn the head to the uninvolved side
C. Have the patient flex the neck
D. Have the patient extend the neck
Correct Answer: A
Rationale: The asymmetrical tonic neck reflex may produce extension of the involved upper extremity by turning the patient’s head toward the involved side
You are instructing a patient how to rise from a chair so that they can begin ambulation using a walker. Which of the following instructions should you give the patient?
A. While holding the walker with one hand push up on the chair with the other hand
B. Push up on the chair with both hands and reach for the walker once you are standing
C. Place both hands on the walker and pull yourself into the standing position
D. Push up on the chair using both hands and reach for the walker while rising
Correct Answer: B
Rationale: It is important that the patient does not reach for the walker until they are standing to prevent the walker from tipping over.
Which of the following breathing techniques decreases the patient’s respiratory rate, prolongs the expiratory phase, and increases the excretion of carbon dioxide? A. Pursed lip breathing B. Diaphragmatic breathing C. Stacking breaths D. Segmental breathing
Correct Answer: B
Rationale: Diaphragmatic breathing is designed to decrease the patient’s respiratory rate, prolongs the expiratory phase, and increases the excretion of carbon dioxide.
You are explaining Ohm’s law to a physical therapy student. As the current flow is directly proportional to the voltage and inversely proportional to the resistance, all of the following are true, except:
A. When resistance decreases, current increases
B. When voltage increases, current increases
C. When voltage is 0, current is 0
D. When voltage increases, current decreases
Correct Answer: D
Rationale: When voltage decreases, current decreases.
. You are instructing a patient about precautions following a total hip replacement involving an anterolateral surgical approach. Which of the following motions should the patient avoid during the initial phase of rehabilitation?
A. Hip external rotation
B. Hip internal rotation
C. Hip flexion
D. All of these motions would be safe to perform
Correct Answer: A
Rationale: Failure to avoid external rotation of the hip can result in hip dislocation or subluxation following and anterolateral approach
You are treating a patient with right hemiplegia . You give the patient a comb and ask him to comb his head. Instead the patient uses the comb to brush his teeth. How would you document this finding? A. Ideomotor apraxia B. Ideational apraxia C. Dyspraxia D. Aphasia
Correct Answer: B
Rationale: Ideational apraxia involves errors in concepts and sequencing of tasks
. You are treating a patient who has suffered a CVA eight weeks ago. The patient is demonstrating Isolated joint movements that are performed with coordination. According to Brunnstrom, which stage of recovery is the patient in? A. Three B. Four C. Five D. Six
Correct Answer: D
Rationale: Isolated joint movements are performed with coordination in stage six.
. You are treating a patient who demonstrates a 5° limitation in knee extension. You decide to use a joint mobilization technique to regain the last 5° of extension. Which of the following mobilization techniques would be indicated?
A. Anterior glide of the tibia on the femur
B. Posterior glide of the tibia on the femur
C. Inferior glide of the patella
D. Superior glide of the patella
Correct Answer: A
Rationale: Although a superior glide of the patella is involved in knee extension, there is little engagement of the patella during the last 5° of extension. Therefore the best answer is anterior glide of the concave tibia on the convex femur.
You are treating a patient with a diagnosis of pulmonary disease. Which of the following breathing techniques would help the patient perfom ADLs without dyspnea A. Paced breathing B. Diaphragmatic breathing C. Stacking breaths D. Segmental breathing
Correct Answer: A
Rationale: Paced breathing uses a combination of pursed-lip breathing and diaphragmatic breathing performed at the normal 1:2 ratio of inspiration to expiration during functional activities
You are treating a patient with a diagnosis of an avulsion fracture of the ischial tuberosity. Which of the following would be the most likely mechanism of injury?
A. Forceful extension of the hip with the knee extended
B. Forceful flexion of the hip with the knee extended
C. Forceful extension of the hip with the knee flexed
D. Forceful flexion of the hip with the knee flexed
Correct Answer: B
Rationale: Forceful flexion of the hip with the knee extendedplaces significant forces through the hamstrings, which can result in an avulsion fracture.
You are treating a patient diagnosed with multiple sclerosis . All of the following would be included in your design for the intervention, except:
A. Scheduling late morning sessions
B. Aggressive stretching
C. Energy conservation and stress management techniques
D. High intensity exercise
Correct Answer: D
Rationale: Fatigue is a common component associated with multiple sclerosis therefore the exercise should be at a moderate level and not high-intensity.
You are designing a strengthening program for a patient recovering from an anterior shoulder dislocation. Which of the following muscle groups should be emphasized?
A. Shoulder adductors and internal rotators
B. Shoulder abductors and external rotators
C. Shoulder adductors and external rotators
D. Shoulder abductors and internal rotators
Correct Answer: A
Rationale: The shoulder adductors and internal rotators provide support for the anterior joint capsule
You are currently treating a patient who recently underwent an above knee amputation. According to the psychiatrist report, the patient is in the third stage of the grieving process. Which stage of the grieving process is the patient most likely exhibiting? A. Bargaining B. Anger C. Depression D. Acceptance
Correct Answer: A
Rationale: The five stages of grieving are (in order from first to last) denial, anger, bargaining, depression, and acceptance
You are treating a patient who traumatically dislocated the tibia directly posteriorly. Which of the following structures is the least likely to be injured? A. Tibial nerve B. Common fibularis (peroneal) nerve C. Anterior cruciate ligament D. Popliteal artery
Correct Answer: B
Rationale: The common fibularis (peroneal) nerve travels over the lateral aspect of the knee and is therefore the least likely to be injured.
You are treating a patient who recently suffered a stroke and has been diagnosed with right sided homonymous hemianopsia. Which of the following statements is true about placement of objects in the early rehabilitation period?
A. The objects should be placed on the left side of the patient
B. The object should be placed on the right side of the patient
C. The object should be placed on both sides of the patient
D. The object should be placed slightly to the right of the patient
Correct Answer: A
Rationale: Initially, the objects should be placed on the left side of the patient As perception improves, the objects should be moved into the area of the deficit.
You are treating a patient who underwent a left total knee replacement five weeks ago. Range of motion measurements for the left knee are 85° actively and 95° passively for flexion, and -12° of full passive extension and -18° of full active extension. Which of the following should you address first?
A. The lack of passive left knee extension
B. The lack of active left knee extension
C. The lack of passive left knee extension
D. The lack of passive left knee flexion
Correct Answer: C
Rationale: You should address the lack of passive left knee extension first because the patient has to achieve passive knee extension before she can gain full active knee extension.
You are treating a patient who requires a whirlpool treatment. Because the patient is severely immobile, you need to set up a portable whirlpool unit in the patient’s room. Which is the most important factor you must consider before this patient is placed in the whirlpool?
A. Make sure the whirlpool unit is plugged into a ground fault circuit interruption outlet
B. Check to make sure the water temperature is below 100°F
C. Obtain the appropriate assistance to perform the transfer
D. Check to make sure the patient is stabilized properly in the chair
Correct Answer: A
Rationale: A ground fault interruption circuit protects the patient from a potentially life-threatening situation
You have been asked to tape an athlete’s ankle prophylactically before a basketball game to prevent ankle sprain. In what position should the ankle be slightly positioned in before taping to provide the most protection?
A. Inversion, plantarflexion, adduction
B. Eversion, dorsiflexion, abduction
C. Eversion, plantarflexion, adduction
D. Inversion, dorsiflexion, abduction
Correct Answer: D
Rationale: This position limits inversion, plantarflexion, and adduction.