DUNAWAY B Flashcards
A therapist is treating a patient with an injury at the T8 level and compromised function of the diaphragm, If no abdominal binder is available, what is the most likely position of comfort to allow him to breathe most efficiently?
A. Sitting position
B. Semi-fowler position
C. Standing
D. Supine
Supine
A therapist is assisting a patient with an injury at the C5 level in performing an effective cough.
The patient has experienced significant neurologic damage and is unable to perform an independent, effective cough. If the patient is in supine position, which of the following methods is most likely to produce an effective cough?
A. The therapist places the heel of one hand just above the xiphoid process, instructs the patient to take a deep breath while pressing down moderately on the sternum and instructs the patient to cough.
B. The therapist places the heel of one hand, reinforced with the other hand, just above the xiphoid process; instructs the patient to take a deep breath; instructs the patient to hold the breath, and presses moderately as the patient coughs.
C. The therapist places the heel of one had on the area just above the umbilicus, instructs the patient to take a deep breath, applies moderate pressure; and releases pressure just before the patient attempts to cough.
D. The therapist places the heel of one hand just above the umbilicus, instructs the patient to take a deep breath, and applies moderate pressure as the patient is instructed to cough.
The therapist places the heel of one hand just above the umbilicus, instructs the patient to take a deep breath, and applies moderate pressure as the patient is instructed to cough
A patient with dysarthria and dysphagia is being treated by physical and speech therapy services.
The physical therapist can assist the patient in which of the following ways?
A. Provide posture control exercise; teach the patient swallowing techniques of thin liquids; provide facial musculature exercises; provide good verbal interaction
B. Teach the patient to have good eye contact, provide facial muscular exercises; teach increased head and trunk control
C. Provide posture control exercises, provide multiple sources of stimuli during exercise sessions; teach the patient swallowing techniques of thin liquids; teach the patient swallowing techniques for prescribed medications in capsular form
D. None of the above lists is completely correct
Teach the patient to have good eye contact, provide facial muscular exercises; teach increased head and trunk control
A 30-year-old man is referred to physical therapy after a recent motor vehicle accident that resulted in total loss of motor control of both legs Trunk and bilateral upper extremity control allows independent sitting at bedside. The patient is to be discharged from the hospital and will return home a few hours after the physical therapy session. The therapist notices, from the history in the chart, that the patient lives alone and has little or no outside support from family members. The patient also suffers from severe obesity. The therapist decides to practice transter from the bed to the wheelchair. Which assistive device should the therapist use for this transfer attempt?
A. Hoyer lift (pneumatic lift)
B. Sliding board
C. Geriatric chair (using a slide sheet transfer)
D. Trapeze bar
Sliding board
A therapist should consider using a form of treatment other than moist heat application on the posterior lumbar region of all of the following patients except
A. Patient with a history of hemophilia
B. Patient with a history of malignant cancer under the site of heat application
C. Patient with a history of Raynaud’s phenomenon
D. Patient with a history including many years of steroid therapy
Patient with a history of Raynaud’s phenomenon
A 50-year-old woman has been receiving treatment in the hospital for increased edema in the right upper extremity, The therapist has treated the patient for the past 3 weeks with an intermittent compression pump equipped with a multicompartment compression sleeve. The patient’s average blood pressure is 135/80 mmH. The daily sessions are 3 hours in duration. The pump is set at 50 mmHg, 40 mmg, and 30 mmg (distal to proximal) for 30 seconds, on and off for 15 seconds.
The therapist decides to change the parameters. Of the following changes, which is the most likely to increase the efficiency of treatment?
A. Patient in a seated position with the right upper extremity in a dependent position versus supine and elevated.
B. Increase the maximal pressure from 50 mmH to 60 mmHg
C. Change the on/off time to 15 seconds on and 45 seconds off
D. Equalize the sleeve compartments versus having greater pressure distally
Increase the maximal pressure from 50 mmH to 60 mmHg
A therapist chose to work with her patient using fluidotherapy rather than paraffin wax The patient has lack of range of motion and also needs to decrease hypersensitivity. There are no open wounds on the had to be treated. Which of the following would not be an advantage of using fluidotherapy versus paraffin wax in the above scenario?
A. The therapist can assist range of motion manually while the patient has his hand in the fluidotherapy and not while in the paraffin wax.
B. The fluidotherapy can be used to assist in desensitization by adjusting air intensity.
C. The fluidotherapy can be provided at the same time as dynamic splinting, and this cannot be done while in paraffin wax.
D. The fingers can be bound, to assist gaining finger flexion, with tape while in fluidotherapy and not in paraffin wax.
The fingers can be bound, to assist gaining finger flexion, with tape while in fluidotherapy and not in paraffin wax.
The terms below refer to properties of water that make hydrotherapy valuable to a variety of patient populations. Match the following terms with the statement that best relates to each term.
1. Viscosity
2. Buoyancy
3. Relative density
4. Hydrostatic pressure
a. This property can assist in prevention of blood pooling in the lower extremites of a patent in
the pool above waist level
b. This property makes it harder to walk faster through water.
c. A person with a higher amount of body fat can float more easily than a lean person because
of this property.
d. This property makes it easier to move a body part to the surlace of the water and harder to
move a part away from the surface
A. 1-6, 2-6, 3-d, 4-a
B. 1-b, 2-d, 3-c, 4-a
C. 1-6, 2-b, 3-a, 4-d
D. 1-a, 2-c, 3-b, 4-d
1-b, 2-d, 3-c, 4-a
Which of the following statements is false about treatment with infrared lamps?
A. Near infrared heats deeper than far infrared.
B. Infrared lamps heat both sides of an extremity at one time.
C. The therapist can change the intensity of the heat by changing the angle between the beam and the body part being treated.
D. The therapist can change the intensity by placing the lamp closer to the part being treated
Infrared lamps heat both sides of an extremity at one time.
A patient is referred to physical therapy because of hypertension. The physician has ordered relaxation training. The therapist first chooses to instruct the patient in the technique of diaphragmatic breathing. Which of the below is the correct set of instructions?
A. Slow breathing rate to 8-12 breaths per minute, increase movement of the upper chest, and decrease movement in the abdominal region.
B. Slow breathing rate to 12-16 breaths per minute, increase movement of the abdominal region and decrease movement in the upper chest.
C. Slow breathing rate to 8-12 breaths per minute, increase movement of the abdominal region and decrease movement in the upper chest.
D. Slow breathing rate to 12-16 breaths per minute, increase movement of the upper chest and decrease movement in the abdominal region.
Slow breathing rate to 8-12 breaths per minute, increase movement of the abdominal region and decrease movement in the upper chest.
An acute care physical therapist is ordered to evaluate and treat a patient who has suffered a right hip fracture in a recent fall During the evaluation, the family informs the therapist that the patient suffered a stroke approximately 1 week before the fall. The patient’s chart has no record of the recent stroke. What should the physical therapist do first?
A. Immediately call the referring physician and request a magnetic resonance scan
B. Evaluate and treat the patient as ordered.
C. Immediately call the referring physician and request a computed tomography scan.
D. Immediately call the referring physician for an occupational therapy referral
Evaluate and treat the patient as ordered.
A physical therapist in an outpatient clinic is called into a room to assist an infant who is unconscious and not breathing. The therapist opens the airway of the infant and attempts ventilation. The breaths do not make the chest rise. After the infant’s head is repositioned, the breaths still do not cause the chest to move. What should the therapist do next?
A. Give five back blows
B. Look into the throat for a foreign body
C. Have someone call 911
D. Perform a blind finger sweep of the throat
Give five back blows
A physical therapist is assessing a 40-year-old man’s balance and coordination. The following instructions are given to the patient “Stand normally, with your eyes open. After fifteen seconds, close your eyes and maintain a normal standing posture” Several seconds after closing his eyes, the patient nearly falls. What type of test did the patient fail?
A. Nonequilibrium test
B. Equilibrium test
C. Romberg test
D. B and C
B and C
A patient presents to an outpatient clinic with a diagnosis of reflex sympathetic dystrophy (RSD) of the left upper extremity. The physician’s order is to evaluate and treat. While obtaining a subjective history, the therapist is informed that the patient has along-standing diagnosis of carpal tunnel syndrome. Left upper extremity signs and symptoms include constant burning pain, abnormal fast hair and nail growth, decrease range of motion, and increased sensitivity to pain and/or light touch. The patient is most likely in what stage of RSD?
A. Acute
B. Dystrophic
C. Atrophic
D. Chronic
Acute
A physician has ordered a physical therapist to treat a patient with chronic low back pain. The order is to “increase gluteal muscle function by decreasing trigger points in the quadratus (umborum” What is the first technique that should be used by the physical therapist?
A. Isometric gluteal strengthening
B. Posture program
C. Soft tissue massage
D. Muscle reeducation
Soft tissue massage
A physical therapist is ordered to evaluate a 65-year-old woman who has suffered a recent stroke, The occupational therapist informs the physical therapist that the patient has apraxia. She cannot brush her teeth on command. However, she can point out the toothbrush and verbalize the purpose of the brush. From this information, what sort of apraxia does this patient have? How should the physical therapist approach treatment?
A. Ideomotor apraxia. The physical therapist should speak in short, concise sentences.
B. Ideomotor apraxia. The physical therapist should always give the patient 3-step commands.
C. Ideomotor apraxia. The physical therapist should always give the patient 5-step commands.
D. Ideational apraxia. The physical therapist should speak in short, concise sentences.
Ideomotor apraxia. The physical therapist should speak in short, concise sentences.
A 60-year-old woman who has suffered a recent stroke has right-side homonymous hemianopsia
Which of the following statements is true about placement of eating utensils in early rehabilitation?
A. The utensils should be placed on the left side of the plate.
B. The utensils should be placed on the right side of the plate.
C. The utensils should be placed on both sides of the plate.
D. The plate and utensils should be placed slightly to the right.
The utensils should be placed on the left side of the plate.
The physical therapist has just given the patient a custom wheelchair The patient has a longstanding history of hamstring contractures resulting in fixation of the knees into 60° of flexion, The patient is also prone to develop decubitus ulcers. Which of the following is incorrect advice to give the family and patient?
A. Keep the patients buttocks clean and dry.
B. Make sure that the wheelchair cushion is always in the wheelchair seat.
C. Keep the leg rests of the wheelchair fully elevated.
D. Never transfer using a sliding board from one surface to another.
Keep the leg rests of the wheelchair fully elevated.
This increases weight on the ischial tuberosities since the hamstring contracture would most likely result in posterior pelvic tilt
Which of the following circumstances would normally decrease body temperature in a healthy
person?
A. Exercising on a treadmill.
B. Pregnancy
C. Normal ovulation
D. Reaching age of 65 years or older
Reaching age of 65 years or older
Which of the following statements is false about cardiovascular response to exercise in trained and/or sedentary patients?
A. If exercise intensities are equal, the sedentary patient’s heart rate will increase faster than the trained patient’s heart rate. F
B. Cardiovascular response to increased workload will increase at the same rate for sedentary as it will for trained patients.
C. Trained patients will have a larger stroke volume during exercise.
D. The sedentary patient will reach anaerobic threshold faster than the trained patient, if workloads are equal
Cardiovascular response to increased workload will increase at the same rate for sedentary as it will for trained patients.
Use of shortwave diathermy and microwave diathermy is not contraindicated in which of the following conditions?
A. On a patient who has a pacemaker.
B. Over the site of a metal implant.
C. On a patient who has hemophilia.
D. Using pulse shortwave over an acute injury.
Using pulse shortwave over an acute injury.
A therapist is treating a 35-year-old man who has suffered loss of motor control in the right lower extremity due to peripheral neuropathy. The therapist applies biofeedback electrodes to the right quadriceps in an effort to increase control and strength of this muscle group. The biofeedback can help achieve this goal in all of the following ways except
A. Providing visual input for the patient to know how hard he is contracting the right quadriceps.
B. Assisting the patient in recruitment of more motor units in the right quadriceps.
C. Providing the measure of torque in the right quadriceps.
D. Providing the therapist input on the patients ability and effort in contracting the right quadriceps.
Providing the measure of torque in the right quadriceps.
When using electrical stimulation with a unit that plugs into the wall, the therapist must take many different safety precautions. Which of the following precautions probably would not increase safety to the patient and therapist?
A. Never placing the unit in close proximity to water pipes while treating the patient
B. Never using an extension cord when using a plug-in unit.
C. Always adjusting the intensity of stimulation during the off portion of the cycle.
D. Both A and C are measures that are not likely to increase safety.
Always adjusting the intensity of stimulation during the off portion of the cycle.
A patient is receiving electrical stimulation for muscle strengthening of the left quadriceps. One electrode from one lead wire, 4 x 4 inches in size, is place on the anterior proximal portion of the left quadriceps. Each of two other electrodes from one lead wire is 2 x 2 inches in size. One of the electrodes is placed on the inferior medial side of the left quadriceps and one on the inferior lateral side of the left quadriceps. This is an example of what type of electrode configuration?
A. Monopolar
B. Bipolar
C. Tripolar
D. Quadripolar
Bipolar
A 60-year-old woman is referred to outpatient physical therapy services for rehabilitation after receiving a left total knee replacement 4 weeks ago. The patient is currently ambulating with a standard walker with a severely antalgic gait pattern. Before the recent surgery the patient was ambulating independently without an assistive device. Left knee flexion was measured in the initial evaluation and found to be 85° actively and 94 passively. The patient also lacked 10° of full passive extension and 17° of full active extension. Which of the following does the therapist need to first address?
A. Lack of passive left knee flexion
B. Lack of passive left knee extension
C. Lack of active left knee extension
D. Ability to ambulate with a lesser assistive device.
Lack of passive left knee extension
In comparing the use of cold pack and hot pack treatments, which of the following statements is false?
A. Cold packs penetrate more deeply than hot packs.
B. Cold increases the viscosity of fluid and heat decreases the viscosity of blood.
C. Cold decreases spasm by decreasing sensitivity to muscle spindles and heat decreases spasm by decreasing nerve conduction velocity.
D. Cold decreases the rate of oxygen uptake, and heat increases the rate of oxygen uptake.
Cold decreases spasm by decreasing sensitivity to muscle spindles and heat decreases spasm by decreasing nerve conduction velocity.
A home health physical therapist is sent to evaluate a 56-year-old man who has suffered a recent stroke The patient is sitting in a lift chair, accompanied by his 14-year-old nephew. He seems confused several times throughout the evaluation. The nephew is unable to assist in clarifying much of the subjective history. The patient reports to the therapist that he is independent in ambulation with a standard walker as an assistive device and in all transfers without an assistive device. Based on the above information, which of the following sequence of events, chosen by the therapist, is in the correct order?
A. Ambulate with the standard walker with the wheelchair in close proximity; transfer sit to stand in front of the wheelchair, transfer wheelchair to bed, assess range of motion and strength of all extremities in supine position.
B. Ambulate with the standard walker with the wheelchair in close proximity, transfer wheelchair to bed, assess range of motion and strength of all extremities in supine position; transfer sit to stand at bedside.
C. Assess range of motion and strength of all extremities in the lift chair, transfer sit to stand in front of the lift chair, ambulate with the standard walker with the wheelchair in close proximity; transfer wheelchair to bed.
D. Assess range of motion and strength of all extremities in the lift chair, ambulate with the standard walker with the wheelchair in close proximity, transfer sit to stand in front of the wheelchair, transfer wheelchair to bed.
Assess range of motion and strength of all extremities in the lift chair, transfer sit to stand in front of the lift chair, ambulate with the standard walker with the wheelchair in close proximity; transfer wheelchair to bed.
A therapist is evaluating a patient with poor motor coordination. The therapist observes that when the patient is standing erect and still, she does not respond appropriately when correcting a backward sway of the body. With the body in a fully erect position, a slight backward sway should be corrected by the body firing specific muscles in a specific order. Which list is the correct firing order?
A. Bilateral abdominals, bilateral quadriceps, bilateral tibialis anterior.
B. Bilateral abdominals, bilateral tibialis anterior, bilateral quadriceps
C. Bilateral tibialis anterior, bilateral abdominals, bilateral quadriceps
D. Bilateral tibialis anterior, bilateral quadriceps, bilateral abdominals.
Bilateral tibialis anterior, bilateral quadriceps, bilateral abdominals.
A therapist is assessing a patient’s ability to perform basic activities of daily living. The assessment tool chose by the therapist measures bathing, toileting, dressing, transfers, continence and feeding. The tool does not assess the patient’s ability to maneuver in a wheelchair. The therapist is using which of the following tests?
A. Barthel Index
B. Katz Index of Activities of Daily Living
C. Kenny Self-Care Evaluation
D. Functional Status Index
Katz Index of Activities of Daily Living
A physical therapist is performing electromyograhic testing. During a maximal output test of the patient’s quadriceps muscle, 35% of the motor unit potential is polyphasic. What is the significance of this finding?
A. It is normal in the quadriceps.
B. It is normal in the triceps brachi, not in the quadriceps
C. It is normal in the biceps brachi, not in the quadriceps
D. It is abnormal in any muscle.
It is abnormal in any muscle.
A physical therapist is ordered to evaluate a patient in the late stages of amyotrophic lateral Sclerosis. In the patient’s chart is an electromyography report and nerve conduction velocity test
What should the physical therapist not expect to find in these test results?
A. Fibrillation potentials
B. Polyphasic motor unit potentials
C. Decreased sensory evoked potentials
D. A and B only
Decreased sensory evoked potentials
A 27-year-old man with a diagnosis of incomplete spinal cord injury at the L4 level is being evaluated by a physical therapist. The patient is nearing discharge from the rehabilitation unit.
Manual muscle testing reveals the following: right hip flexion = 3+/5, right hip adduction = 5/5,
right knee flexion = 2/5, right knee extension = 3+/5, right ankle plantarflexion = 1/5, and right ankle
dorsiflexion = 2-15; left hip flexion = 4+/5, left hip adduction = 4+/5, left knee flexion = 2+/5, left knee
extension = 3+/5, left ankle plantarflexion = 2-15, and left ankle dorsiflexion = 2-15. What is the
appropriate orthotic for this patient? What is his most likely functional outcome?
A. Hip-knee-ankle-foot orthosis (HKAFO) with forearm crutches - household ambulator.
B. Knee-ankle-foot orthosis (KAFO) with forearm crutches - household ambulator.
C. KAFO with forearm crutches - functional ambulator
D. HKAFO with forearm crutches - functional ambulator.
KAFO with forearm crutches - functional ambulator
Which of the following should a therapist evaluate first when performing a job-site analysis?
A. Job description and duties
B. Bathroom accessibility
C. Lighting conditions
D. Parking conditions
Job description and duties
A physical therapist is treating a patient with balance deficits During treatment the physical therapist notes that large-amplitude changes in center of mass cause the patient to lose balance.
The patient, however, can accurately compensate for small changes nearly every time a change Is introduced. What muscles most likely need to be strengthened to help alleviate this dysfunction?
A. Tibialis anterior, gastrocnemius
B. Peroneus longs/brevis, tibialis posterior
C. Rectus abdominis, erector spinae
D. Iliopsoas, gluteus maximus
Iliopsoas, gluteus maximus
A physical therapist is treating a patient who is participating in cardiac rehabilitation. Because the patient complains of chest pain, the therapist attempts to assess heart sounds with a stethoscope.
Which of the following is true about the first sound during auscultation of the heart?
A. The first sound is of the closure of the aortic and pulmonic valves.
B. The first sound is of the closure of the mitral and tricuspid valves.
C. The first sound is of the beginning of ventricular systole.
D. B and C
B and C
A 15-year-old girl with no reports of trauma or radiculopathy presents to an outpatient physical therapy clinic with complaints of low back pain The physical therapist decides to measure leg dength of each side from the anterior superior iliac spine (ASIS) to the medial malleolus. The measurements are equal. However, when measurements are taken from the umbilicus to the medial malleolus, the right lower extremity is 2.5 cm longer than the left lower extremity. Based on the above information, which of the following would most directly address the source of this patient’s problem?
A. Ask the patient if she has ever had a femur fracture.
B. Ask the patient is she has ever been diagnosed with cerebral palsy or avascular necrosis.
C. Ask the patient if she has ever been diagnosed with scoliosis.
D. Ask the patient to perform active motion to assess lumbar range of motion.
Ask the patient if she has ever been diagnosed with scoliosis.
How often does the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
require that all electrical equipment in hospitals be inspected?
A. Every 3 months
B. Every 6 months
C. Every 12 months
D. Every 3 years
Every 12 months
A physical therapist is setting up a portable whirlpool unit in the room of a severely immobile patient. What is the most important task of the physical therapist before the patient is placed in the whirlpool?
A. Check for a ground fault circuit interruption outlet.
B. Check to make sure the water temperature is below 110°
C. Make sure the whirlpool agitator is immersed in the water.
D. Obtain the appropriate assistance to perform a transfer.
Check for a ground fault circuit interruption outlet.
A 37-year-old man fell and struck his left temple area on the corner of a mat table. He begins to bleed profusely but remains conscious and alert. Attempts to stop blood flow with direct pressure to the area of injury are unsuccessful. Of the following, which is an additional area to which pressure should be applied to stop bleeding?
A. Left parietal bone one inch posterior to the ear.
B. Left temporal bone just anterior to the ear.
C. Zygomatic arch of the frontal bone
D. Zygomatic arch superior to the mastoid process.
Left temporal bone just anterior to the ear.
A physical therapist is ordered to provide gait training for an 18-year-old girl who received a partial medial meniscectomy of the right knee one day earlier. The patient was independent in ambulation without an assistive device before surgery and has no cognitive deficits. The patient’s weight bearing status is currently partial weight bearing on the involved lower extremity. Which of the following is the most appropriate assistive device and gait pattern?
A. Crutches, three-point gait pattern
B. Standard walker, three-point gait pattern
C. Standard walker, four-point gait pattern
D. Crutches, swing-to gait pattern
Crutches, three-point gait pattern
A physical therapist is treating a 72-year-old woman with a diagnosis of Parkinson’s disease 3 times/week at an outpatient facility. The patient is taking 500 mg/day of a medication designed to decrease spasticity. The therapist notices that the patient is performing well on certain days and poorly on others Which of the following ways can the therapist possibly improve the patient’s performance on the days when she performs poorly?
A. The therapist can encourage the patient to increase her daily dosage of medication to 600 mg/day on the days she usually performs poorly.
B. The therapist can encourage the patient to decrease her daily dosage of medication to 100 mg/day on the days she usually performs poorly.
C. The therapist can schedule sessions so that there are fewer sessions on the days the patient performs poorly.
D. The therapist should call the physician to suggest another medication.
The therapist can schedule sessions so that there are fewer sessions on the days the patient performs poorly.
A patient is receiving crutch training 1 day after a right knee arthroscopic surgery. The patient’s weight bearing status is toe-touch weight bearing on the right lower extremity, The therapist first chooses to instruct the patient how to perform a correct sit to stand transfer. Which of the following is the most correct set of instructions?
A. (1) Slide forward to the edge of the chair, (2) put both the crutches in front of you and hold both grips together with the right hand; (3) press on the left arm rest with the left hand and the grips with the right hand; (4) lean forward; (5) stand up, placing your weight on the left lower extremity; (6) place one crutch slowly under the left arm, then under the right arm
B. (1) Slide forward, (2) put one crutch in each hand, holding the grips; (3) place crutches in a vertical position; (4) press down on the grips; (5) stand up, placing more weight on the left lower extremity
C. (1) Slide forward to the edge of the chair; (2) put both the crutches in front of you and hold both grips with the left hand; (4) lean forward; (5) stand up placing your weight on the left lower extremity; (6) place one crutch slowly under the right arm, then under the left arm.
D. (1) Place crutches in close proximity; (2) slide forward, (3) place hands on the arm rests; (4) press down and stand up; (5) place weight on the left lower extremity; (6) reach slowly for the crutches and place under the axila
(1) Slide forward to the edge of the chair, (2) put both the crutches in front of you and hold both grips together with the right hand; (3) press on the left arm rest with the left hand and the grips with the right hand; (4) lean forward; (5) stand up, placing your weight on the left lower extremity; (6) place one crutch slowly under the left arm, then under the right arm
A physical therapist is asked by a co-worker to finish evaluating a patient because an emergency requires the therapist to leave. The co-worker agrees and resumes the examination. The first therapist left notes titled, “sensory assessment’ Two wooden blocks identical in appearance but 11 ound different in weight are on the table in front of the patient What test was the prior therapist (most likely performing?
A. Barognosis test
B. Stereognosis test
C. Graphesthesia test
D. Texture recognition
Barognosis test
A therapist places a pen in front of a patient and asks him to pick it up and hold it as he normally would to write. The patient picks the pen up and holds it between the pad of the thumb and the middle and index fingers. Why type of grasp or prehension is the patient using?
A. Palmar prehension
B. Fingertip prehension
C. Lateral prehension
D. Hook grasp
Palmar prehension
A therapist is sent to the intensive care unit to evaluate a patient who has suffered a severe recent head injury. While reviewing the patient’s chart, he discovers that the patient exhibits decerebrate rigidity. The therapist is likely to find this patient in which of the following positions?
A. The patient will be positioned with all extremities extended and the wrist and fingers flexed
B. The patient will be positioned with the upper extremities flexed, the lower extremities hyperextended, and the fingers tightly flexed
C. The patient will be positioned with all extremities flexed and wrist and fingers extended
D. The patient will be positioned with the upper extremities extended, the lower extremities flexed and the fingers hyperextended.
The patient will be positioned with all extremities extended and the wrist and fingers flexed
A therapist is preparing a poster that will clarify some of the data in an inservice presentation) The poster reflects the mode, median, and mean of a set of data. The data consist of the numbers 2, 2, 4, 9, and 13. If presented in the above order (mode, median mean), which of the following is the correct list of answers calculated from the data?
A. 4, 2, 6
B. 2,4, 6
C. 6, 2, 4
D. 6, 4, 2
2,4, 6
- A patient with a spinal cord injury is being treated by physical therapy in an acute rehabilitation setting. The patient has been involved in a motor vehicle accident that resulted in a complete C8 spinal cord lesion. The patient is a 20-year-old man who has expressed concern to the therapist about his future sexual function. Which of the following is the most correct information to convey to the patient?
A. Psychogenic erection is possible, reflexogenic erection is not possible, and ejaculation is possible.
B. Psychogenic erection is not possible, reflexogenic erection is not possible, and ejaculation is not possible.
C. Psychogenic erection is possible, reflexogenic erection is possible, and ejaculation is possible.
D. Psychogenic erection is not possible, reflexogenic erection is possible, and ejaculation is not possible.
Psychogenic erection is not possible, reflexogenic erection is possible, and ejaculation is not possible.
A therapist is treating a patient with cystic fibrosis who has just walked 75 feet before experiencing significant breathing difficulties. In an effort to assist the patient in regaining her normal breathing rate, the therapist gives a set of instructions. Which of the following set of instructions is appropriate?
A. “Take a slow deep breath through pursed lips and exhale slowly through your nose only’
B. Take small breaths through your nose only and exhale quickly through pursed lips”
C. “Breath in through your nose and exhale slowly through pursed lips”
D. “Breath in through pursed lips and breath out slowly through pursed lips”
“Breath in through your nose and exhale slowly through pursed lips”
A therapist is massaging the upper trapezius of a patient One of the techniques involves lifting and kneading of the tissues. What is the correct name of this technique?
A. Tapotement massage
B. Effleurage massage
C. Petrissage massage
D. Friction massage
Petrissage massage
A therapist is assessing a patient in an attempt to discover the source of her pain. She positions the patient’s cervical spine in different directions in an attempt to elicit the patient’s symptoms. In one such direction, the patient reports return of symptoms, including pain located at the right posterior scapular region, which extends down the posterior side of the right upper extremity to the ends of the fingers, and tingling in the second, third, and fourth digits. The patient also indicates that she often has decrease in sensation on the dorsal side of the second and third digits. She also has noticeable weakness in the right triceps. Which nerve root is most likely involved?
A. Fourth cervical root
B. Fifth cervical root
C. Sixth cervical root
D. Seventh cervical root
Seventh cervical root
A patient is being treated with iontophoresis, driving dexamethasone, for inflammation around the lateral epicondyle of the left elbow. The therapist is careful when setting the parameters and with cleaning the site of electrode application to prevent a possible blister. This possibility is not as strong with some other forms of electrical stimulation, but with iontophoresis using a form of_____________,
precautions must be taken to ensure that the patient does not receive a mild burn or
blister during the treatment session. Fill in the blank
A. Alternating current
B. Direct current
C. Pulsed current
D. Transcutaneous electrical nerve stimulation
Direct current
A physical therapist is beginning the evaluation of a patient with AIDS. The patient was admitted to the acute floor of the hospital on the previous night after receiving a right total hip replacement.
The physician has ordered gait training and dressing change of the surgical site. Of the following precautions, which is the least necessary?
A. Mask
B. Gloves
C. Handwashing
D. Gown
Mask
An outpatient physical therapist notices that a large number of patients with impingement of the rotator cuff have been treated in the past 6 months. The clinic finds that most patients are employed at a new auto manufacturing plant. The therapist is invited to the plant to perform an ergonomic assessment and finds that a certain number of the employees must work with their shoulders at 120° of elevation and internal rotation. Which of the following recommendation would decrease the occurrence of impingement?
A. Provide the employees a step stool to perform their tasks.
B. Raise the employees’ work surface.
C. Adjust their tasks so that overhead activities are performed with palm of the hand downward
D. A and B are correct
Provide the employees a step stool to perform their tasks.
A physical therapist is treating a 17-year-old boy with an incomplete T11 spinal cord injury. The patient was treated for 2 months in the rehabilitation unit of the hospital before beginning outpatient physical therapy. He is currently ambulating with standard walker with maximal assist of two. The therapist sets an initial long-term goal of “ambulation with a standard walker with minimum assist of 1 for a distance of 50 feet, with no loss of balance, on a level surface - in 8 weeks.” If the patient achieves the long-term goal in 4 weeks, which of the following courses of action should be taken by the therapist?
A. Discharge the patient secondary to completion of goals.
B. Set another long-term goal regarding ambulation and continue treatment.
C. Return the patient to the rehabilitation unit of the hospital for more intensive treatment.
D. Call the patient’s physician and ask for further instructions.
Set another long-term goal regarding ambulation and continue treatment.
A physical therapist is ordered to evaluate a 74-year-old man who has suffered a recent stroke.
The therapist performs a chart review before performing the evaluation. Which of the following is of the least importance to the physical therapist in assessing the patient’s chart?
A. Nursing assessment
B. Physician’s orders/notes
C. Respiratory assessment
D. Dietary assessment
Dietary assessment
A 47-year-old man with end-stage renal disease arrives at an outpatient facility. He has a physician’s order to evaluate and treat 3 times/week for 4 weeks secondary to lower extremity weakness The patient also attends dialysis 3 times/week. If the clinic is open Monday through Friday, which of the following schedule is appropriate?
A. On the days that the patient has dialysis, schedule the therapy session before the dialysis appointment.
B. On the days that the patient has dialysis, schedule the therapy session after the dialysis appointment.
C. Contact the physician and obtain a new order to decrease the frequency to 2 times/week,
D. A and C are correct
A and C are correct
A physical therapist is performing a functional capacity evaluation on a patient with a L4L5 herniated disc. Part of the evaluation consists of performing floor to waist lifts using 30 pounds as resistance. During the first trial, the physical therapist notices that patient exhibits decreased anterior pelvic tilt. What should the physical therapist do during the second trial?
A. Correct the deviation verbally before the lift
B. Correct the deviation with manual contact during the lift
C. Correct the deviation both verbally and manually during the lift
D. None of the above
None of the above
A 20-year old man with anterior cruciate ligament reconstruction with allograft presents to an outpatient physical therapy clinic. The patient’s surgery was 5 days ago. The patient is independent in ambulation with crutches. He also currently has 53° of active knee flexion and 67° of passive knee flexion and lacks 10° of full knee extension actively and 5° passively. What is the most significant deficit on which the physical therapist should focus treatment?
A. Lack of active knee extension
B. Lack of passive knee extension
C. Lack of active knee flexion
D. Lack of passive knee flexion
Lack of passive knee extension
A physical therapist is ordered to evaluate and treat in the acute setting a patient who received a left total knee replacement 1 day ago. Before surgery, the patient was independent in all activities of daily living, transfers, and ambulation with an assistive device. The family reports that ambulation was slow and guarded because of knee pain. The physician’s orders are to ambulate with partial weight bearing on the left lower extremity and to increase strength/range of motion. At this point, bed-to-wheelchair transfers, sit-to-stand transfers, and wheelchair-to-toilet transfers require the minimal assistance of one person. The left knee has 63° of active flexion and 77° of passive flexion. The left knee also lacks 7° of full extension actively and 3° passively. Right hip
strength is recorded as follows: hip flexion and abduction = 4+/5, hip adduction and extension =
5/5, knee flexion = 4+/5, knee extension = 5/5, ankle plantarflexion = 4+/5, and dorsiflexion = 5/5.
Left lower extremity strength is recorded as follows: hip flexion = 3/5, hip abduction and adduction
= 3+5, hip extension = 3/5, knee flexion and extension = 3-15, ankle dorsiflexion = 3+/5, and
plantarflexion = 3+/5. The patient is currently able to ambulate 30 feet × 2 with a standard walker and minimal assist of one person on level surfaces. She also ambulates with a flexed knee throughout the gait cycle. According to the physician, she most likely will be discharged to home (with home health services), where she lives alone, within the next 2 - 3 days. Of the choices below, which is the most important long-term goal in the acute setting?
A. In three days the patient will be independent in all transfers.
B. In three days the patient will ambulate with a quad cane independently, with no gait deviation on level surfaces 50 feet x 3 F
C. In three days the patient will increase all left lower extremity manual muscle testing grades by one half grade
D. In three days the patient will have active left knee range of motion from 0 to 90° and passive range of motion from 0 to 95°
In three days the patient will be independent in all transfers
A physical therapist is in a rehabilitation team meeting about a 58-year-old man with Parkinson’s disease. The physician notes that the patient’s recent decrease in level of function may be caused by long-term use of a certain drug. The physician plans to take the patient off the medication for 2 weeks. Which of the following medication is the patient probably taking?
A. Cardizem
B. Cortisone
C. Epinephrine
D. Levodopa
Levodopa
A physical therapist is reviewing the chart of a 49-year-old woman who recently suffered a myocardial infarction. The lab reports reveal that this particular patient has a hematocrit of 41% How should the therapist proceed?
A. Continue with the evaluation and treatment.
B. Do not perform this evaluation due to the hematocrit level
C. Inform nursing of this lab report
D. Check nursing notes to determine the last time the patient received a beta-blocker.
Continue with the evaluation and treatment
A physical therapist is treating a 24-year-old woman with lumbar muscle spasm. Part of the patient’s treatment involves receiving instruction on correct sleeping positions. Which of the following would be most comfortable?
A. Supine with no pillows under the head or extremities
B. Prone with a pillow under the head only.
C. Sidelying with a pillow between flexed knees.
D. A and C are equally correct
Sidelying with a pillow between flexed knees.
The physical therapist is reading the physician’s interpretation of an x-ray that was taken of the left humerus of a 7-year-old patient. The physician notes in the report the presence of an incomplete fracture on the convex side of the humerus. Which type of fracture is the physician describing?
A. Comminuted
B. Avulsion
C. Greenstick
D. Segmental
Greenstick
A patient is referred to physical therapy with a history of temporomandibular joint pain. The therapist notices that the patient is having difficulty closing his mouth against minimal resistance.
With this information, which of the following muscles would not be a target for strengthening exercise to correct this deficit?
A. Medial pterygoid muscle
B. Temporalis
C. Masseter
D. Lateral pterygoid muscle
Lateral pterygoid muscle
An infant is being examined by a physical therapist. The therapist is resisting movement of the right upper extremity and notices involuntary movement of the left upper extremity. Which of the following is displayed by the infant?
A. Landau reaction
B. Startle reflex
C. Moro reflex
D. Associated reaction
Associated reaction
A therapist is evaluating an infant with the mother present. The therapist suddenly seems to temporarily lose grip of the infant, causing him to be startled and begin to cry. The infants mother is noticeable upset but is reassured that startling the infant was part of the assessment. Which of the following may the therapist have been assessing?
A. Landau response
B. Symmetric tonic neck reflex
C. Labyrinthine head righting
D. Moro reflex
Moro reflex
A 25-year-old man suffered C4 quadriplegia in a motor vehicle accident. The injury is acute, and the patient is beginning to work on increasing upright tolerance in the sitting position with an abdominal binder. He is looking to the therapist for encouragement. The therapist is attempting to convey realistic long-term goals for self-care ability and overall mobility. Of the below listed goals, what can this patient reasonably expect at his highest level of function in the future?
A. Transfer from wheelchair to bed independently with a sliding board
B. Use of a power wheelchair
C. Independent feeding with an assistive device.
D. Donning a shirt independently and pants with minimal assistance.
Use of a power wheelchair
A 17-year-old boy presents to therapy after being involved in a motor vehicle accident resulting in
C7 quadriplegia. The therapist is setting long-term goals for the patient Which of the following goals represents the most reasonable and highest level of function that the patient should achieve?
A. Use of a wheelchair with power hand controls on even terrain.
B. Negotiation of uneven terrain with a manual wheelchair.
C. Ambulation for short distances on level surfaces with knee-ankle-foot orthoses
D. Use of a power wheelchair with head or chin controls on even surfaces
Negotiation of uneven terrain with a manual wheelchair.
A therapist is treating a patient with spinal cord injury. The therapist is discharging the patient after completion of all physical therapy goals. One of the completed long-term goals involved the ability to dress and bathe independently with assistive devices. This would be a most challenging but obtainable goal for which of the following?
A. C5 quadriplegia
B. C7 quadriplegia
C. T1 paraplegia
D. C4 quadriplegia
C7 quadriplegia
A therapist is treating a new patient in an outpatient facility. The patient has recently been diagnosed with type I insulin-dependent diabetes mellitus The patient asks the therapist the differences between type I insulin-dependent diabetes mellitus and type I non-insulin-dependent diabetes mellitus. Which of the following statements is true?
A. There is usually some insulin present in the blood in type I and none in type ll
B. Ketoacidosis is a symptom of type lI
C. The age of diagnosis with type I is usually younger than the age of diagnosis with type Il
D. Both conditions can be managed with a strict diet only without taking insulin.
The age of diagnosis with type I is usually younger than the age of diagnosis with type Il
At a team meeting. the respiratory therapist informs the rest of the team that the patient, just admitted to the subacute floor, experienced breathing difficulty in the acute care department. The respiratory therapist describes the breathing problem as a pause before exhaling after a full inspiration. Which of the following is the therapist describing?
A. Apnea
B. Orthopnea
C. Eupnea
D. Apneusis
Apneusis
A therapist is asked to evaluate a patient in the intensive care unit. The patient is comatose but breathing independently, During the assessment of range of motion in the right upper extremity the therapist notices that the patient is breathing unusually. The pattern is an increase in breathing rate and depth followed by brief pauses in breathing. The therapist should notify the appropriate personnel that the patient is exhibiting which of the following patterns?
A. Biot’s
B. Cheyne-Stokes
C. Kussmaul’s
D. Paroxysmal nocturnal dyspea
Cheyne-Stokes
A patient presents to therapy with poor motor control of the lower extremities. The therapist determines that to work efficiently toward the goal of returning the patient to his prior level of ambulation, he must work in the following order regarding stages of control:
A. Mobility, Controlled mobility, stability, skill
B. Stability, controlled stablity, mobility, skil
C. Skill, controlled stability, controlled mobility
D. Mobility, stability, controlled mobility, skill
Mobility, stability, controlled mobility, skill
A physical therapist is ordered to evaluate a patient in the intensive care unit who recently suffered a stroke. The evaluation reveals the following signs and symptoms: contralateral hemiplegia (upper extremity involvement greater than lower extremities), homonymous hemianopsia, aphasia (due to the dominant hemisphere being involved), and contralateral loss of sensation in the upper extremities. Which of the following arteries is the most likely location of the lesion?
A. Middle cerebral artery
B. Anterior cerebral artery
C. Internal carotid artery
D. Posterior cerebral artery
Middle cerebral artery
A physical therapist is treating a patient with significant burns over the limbs and upper trunk.
Which of the following statements is false about some of the changes initially experienced after the burn?
A. This patient initially experienced an increase in the number of white blood cells.
B. This patient initially experienced an increase in the number of red blood cells
C. This patient initially experienced an increase in the number of free fatty acids
D. This patient initially experienced a decrease in fibrinogen
This patient initially experienced an increase in the number of red blood cells
Each of the following choices consists of a list of two summaries of some of the principles in the code of ethics of the American Physical Therapy Association. Which of the answers below is a false summary?
A. (1) Obey regulations governing physical therapists, and (2) maintain high standards when providing therapy.
B. (1) Respect the rights of patients, and (2) inform people appropriately of the services provided.
C. (1) Maintain high standards when providing therapy, and (2) provide services for the length of time ordered.
D. (1) Assist the public when there are public health needs, and (2) accept fair monetary compensation for services.
(1) Maintain high standards when providing therapy, and (2) provide services for the length of time ordered.
A physical therapist is evaluating a patient with muscular dystrophy. The patient seems to waddle” when she walks. She rolls the right hip forward when advancing the right lower extremity and the left hip forward when advancing the left lower extremity. Which of the following gait patterns is the patient demonstrating?
A. Gluteus maximus gait
B. Dystrophic gait
C. Arthrogenic gait
D. Antalgic gait
Dystrophic gait
Which of the following statements is not a common physiologic change of aging?
A. Blood pressure taken at rest and during exercise increases
B. Maximal oxygen uptake decreases
C. Residual volume decreases
D. Bone mass decreases
Residual volume decreases
A physical therapist is speaking to a group of pregnant women about maintaining fitness level during pregnancy. Which of the following statements contain incorrect information?
A. Perform regular exercise routines at least three times per week.
B. Perform at least fifteen minutes per day of abdominal exercises in supine position, during the second and third trimesters.,
C. Increase caloric intake by 300 per day
D. Exercise decreases constipation during pregnancy
Perform at least fifteen minutes per day of abdominal exercises in supine position, during the second and third trimesters.,
A physical therapist is ordered to provide gait training to a 78-year-old man who received a right
Cemented total knee replacement 24 hours earlier. The patient also had a traumatic amputation of the left upper extremity 3 inches above the elbow 40 years ago. If the patient lives at home alone, which of the following is an appropriate assistive device?
A. Rolling walker
B. Standard walker
C. Hemi-walker
D. Wheelchair for 2 weeks.
Hemi-walker