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
A 48-year-old woman is being evaluated by a physical therapist. Her diagnosis is right rotator cuff tendinitis. She reports right shoulder weakness and pain for the past 2 months. The patient describes “pins and needles”, over the lateral right shoulder and upper extremity, extending into the (thumb. She also reports no causative trauma. Manual muscle testing reveals in the right upper
extremity: flexion = 4/5, extension = 3+/5, abduction = 3+/5, adduction = 4/5, internal rotation =
3+5, and external rotation = 3+/5. Manual muscle testing reveals in the left upper extremity:
flexion = 4+/5, extension = 5/5, abduction = 5/5, adduction = 4+/5, internal rotation = 4+/5, and
external rotation = 4+/5. Active and passive shoulder range of motion is within normal limits and
equal bilaterally. All thoracic outlet tests are negative. All shoulder special tests are negative.
Which of the following steps would most likely assess the source of the patient’s problems?
A. Elbow strength and range of motion testing
B. Grip strength testing
C. Cervical spine testing
D. Scapular muscle strength testing
Cervical spine testing
A 23-year-old woman arrives at an outpatient physical therapy clinic with a prescription to evaluate and treat the right hand. One week earlier the patient underwent surgical repair of the flexor tendons of the right hand at zone 2. She also had her cast removed at the physician’s office a few minutes before coming to physical therapy. What is the best course of treatment for this patient?
A. Ultrasound to decrease scarring.
B. Gentle grip strengthening with putty.
C. Splinting the distal interphalangeal joint and proximal interphalangeal joints at neutral
D. Splinting with the use of rubber bands to passively flex the fingers.
Splinting with the use of rubber bands to passively flex the fingers.
A physical therapist is performing an isokinetic test on a 16-year-old boy’s shoulder. This particular test compares the right shoulder with the left shoulder. The patient’s father asks the physical therapist, “What is the purpose of this test?” How should the therapist respond?
A. “This isokinetic test will show changes in concentric and eccentric strength.”
B. “This test will show strength differences between the injured arm and the non-injured arm.”
C. “This test shows differences in external rotation strength at specific ranges in the arc of motion.”
D. This test will provide muscular torque data which will help us to determine when to discontinue therapy
“This test will show strength differences between the injured arm and the non-injured arm.”
A physical therapist in the rehabilitation unit is ordered to evaluate and treat a 3-year-old girl with cerebral palsy. The patient’s supportive family is present during the evaluation. When should the physical therapist explain the treatment plan and possible functional outcomes to the family?
A. During the evaluation
B. After the evaluation
C. After the first full treatment session
D. After the first rehabilitation team conference meeting
After the evaluation
A physical therapist is treating a 65-year-old man with pneumonia. The patient questions the benefits of the flow incentive spirometer left in the room by the respiratory therapist a few minutes ago. Which of the following is an appropriate response to the patients question?
A. “It gives visual feedback on the lung performance”
B. “It helps you maintain current lung volumes”
C. “You need to ask the respiratory therapist this question”
D. A and B are correct responses.
A and B are correct responses.
A 53-vear-old man with chronic obstructive pulmonary disease reports to an outpatient cardiopulmonary rehabilitation facility. Pulmonary testing reveals that forced expiratory volume in 1 second (FEV1) and vital capacity (VC) are within 60% of predicted values. What is the appropriate exercise prescription? NANCE
A. Exercise at 75-80% of the target heart rate 3 times/week.
B. Begin exercise with level of 1.5 METs and increase slowly 3 times/week
C. Exercise at 75-80% of the target heart rate 7 times/week
D. Begin exercise with levels of 1.5 METs and increase slowly 7 times/week.
Begin exercise with levels of 1.5 METs and increase slowly 7 times/week
Which of the following are indications for pulmonary suctioning?
A. Unproductive coughs
B. Breath sounds or wet rales
C. Respiratory distress
D. All of the above
All of the above
Which of the following exercises does not increase strength of the muscles of forceful inspiration?
A. Active cervical flexion exercises
B. Active glenohumeral extension exercises
C. Shoulder shrugs
D. Crunches
Crunches
A clinical instructor is explaining to his student how a muscle contracts. The instructor describes the cycle of cross bridging. He begins stating the first step is that the cross-bridges attach to the thin filament. Which of the following occurs next (in the correct order)?
A. The attachment with the actin filament is lost. The cross-bridge moves into position to attach to the thick filament. Cross-bridge moves, causing the thin filament to move.
B. The cross-bridge moves into position to attach to the thick filament. The attachment with the myosin filament is lost. Cross-bridge moves, causing the thin filament to move.
C. The attachment with the myosin filament is lost. Cross-bridge moves, causing the myosin filament to move. The cross-bridge moves into position to attach to a myosin filament.
D. Cross-bridge moves, causing the actin filament to move. The attachment with the thin filament is lost. The cross-bridge moves into position to attach to an actin filament.
Cross-bridge moves, causing the actin filament to move. The attachment with the thin filament is lost. The cross-bridge moves into position to attach to an actin filament.
A therapist is evaluating a wound in a patient with the following signs: the right foot has a toe that is gangrenous, the skin on the dorsum of the foot is shiny in appearance, and no calluses are present. The patient has what type of ulcer?
A. Venous insufficiency ulcer
B. Arterial insufficiency ulcer
C. Decubitus ulcer
D. Trophic ulcer
Arterial insufficiency ulcer
A physical therapist is beginning an evaluation of a 5-year-old boy. The mother indicates that she ulled the child from a seated position by grasping the wrists The child then experienced immediate pain at the right elbow The physician’s orders are for right elbow range of motion and strengthening. Which of the following is the most likely diagnosis?
A. Radial head fracture
B. Nursemaid’s elbow
C. Erb’s palsy
D. Ulnar coronoid process fracture
Nursemaid’s elbow
A physician has ordered a specific type of electrical stimulation that utilizes a frequency of 2500 Hz with a base frequency at 50 Hz to achieve fused tetany. What type of electrical stimulation has the physician ordered?
A. lontophoresis
B. Transcutaneous electrical nerve stimulation
C. Intermittent flow configuration
D. Russian stimulation
Russian stimulation
A physical therapist who is pregnant has been studying the use of transcutaneous electrical nerve stimulation during labor and birth to decrease pain perception. Which of the following is the most effective technique in this situation?
A. Place the electrodes over the upper abdominals during the first stages of labor and over the lower abdominals during the later stages.
B. Place the electrodes over the paraspinals at the L5 level and S1 level throughout labor and delivery.
C. Place the electrodes in a V pattern above the pubic region during labor and delivery
D. Place the electrodes over the paraspinals at the L1 and S1 level initially during labor, and over the pubic region during the later stages
Place the electrodes over the paraspinals at the L1 and S1 level initially during labor, and over the pubic region during the later stages
A patient with chronic back pain is referred to physical therapy for application of a transcutaneous electrical nerve stimulation unit The parameters chosen by the therapist are set to provide a noxious stimulus described as an acupuncture type of stimulus. Which of the following lists of parameters produces this type of stimulation?
A. Low intensity, duration of 60 msec, and a frequency of 50 Hz
B. High intensity, duration of 150 msec, and a frequency of 100 Hz
C. Low intensity, duration of 150 sec, and a frequency of 100 Hz
D. High intensity, duration of 150 sec, and a frequency of 2 Hz
High intensity, duration of 150 sec, and a frequency of 2 Hz
A 65-vear-old man presents to physical therapy with complaints of pain due to compression fractures of the C2 and C3 vertebrae. The patient has an unusually large cranium. He describes his condition by stating, “Much of my bone tissue is continually decreasing, then reforming”. The patient also indicates that the condition has caused limb deformity.
Which of the following
diseases does he have?
A. Paget’s disease
B. Achondroplastic dwarfism
C. Osteogenesis imperfecta
D. Osteopetrosis
Paget’s disease
A patient informs his therapist that his problem began 3 months after a bout of the flu. The patient originally experienced tingling of the hands and feet. He also reports progressive weakness to the point that he required a ventilator to breathe. He is now recovering rapidly and is expected to return to a normal functional level in 3 more months. From which of the following conditions is the patient most likely suffering?
A. Parkinson’s disease
B. Guillain-Barr syndrome
C. Multiple sclerosis
D. Amyotrophic lateral sclerosis
Guillain-Barr syndrome
A therapist is evaluating a patient in the intensive care unit. The therapist notices that the patient is moving his hands and fingers in slow, writhing motions. Which of the following terms best describes this type of movement?
A. Lead-pipe rigidity
B. Ballismus
C. Chorea
D. Athetosis
Athetosis
A therapist is sent to evaluate a patient with tumor in the mid-thoracic region. In the chart, the therapist notes that the tumor has been staged using the TNM system. With this system, the letters NM represent which of the following in the correct order?
A. Tumor type, number of tumors, tumor metastasis
B. Tumor location, lymph node involved, mass size of the tumor
C. Tumor size, lymph node involvement, tumor metastasis
D. Tumor mass, number of lymph nodes, major organs involved
Tumor size, lymph node involvement, tumor metastasis
A physician ordered a splint for a patient who should keep the thumb of the involved hand in abduction. A new graduate is treating the patient and is confused about the difference between thumb flexion, extension, abduction and adduction. Which of the following lists is correct?
A. Extension is performed in a plane parallel to the palm of the hand, and abduction is performed in a plane perpendicular to the palm of the hand.
B. Flexion is performed in a plane perpendicular to the palm of the hand, and adduction is performed in a plane parallel to the palm of the hand.
C. Extension is performed in a plane perpendicular to the palm of the hand, and adduction is performed in a plane parallel to the palm of the hand.
D. In referring to positions of the thumb, flexion and adduction are used synonymously, and extension and abduction are used synonymously.
Extension is performed in a plane parallel to the palm of the hand, and abduction is performed in a plane perpendicular to the palm of the hand.
A patient is referred to physical therapy with complaints of sensation loss over the area of the radius of the right upper extremity, extending from the elbow joint distally to the wrist. Therapy sessions are focused on assisting the patient in regarding normal sensation. Which of the following nerves is responsible for sensation in this region?
A. Medial antebrachial cutaneous
B. Lateral antebrachial cutaneous
C. Musculocutaneous
D. Both B and C
Both B and C
A therapist is evaluating a patient who suffered brain injury in a motor vehicle accident. The somatosensory cortex is involved, resulting in deficits in sensation in the right upper and lower extremities. The therapist knows from visualizing the homunculus that at least part of the injury is in one of the following locations.
A. Inferior right hemisphere of the somatosensory cortex
B. Superior right hemisphere of the somatosensory cortex
C. Inferior left hemisphere of the somatosensory cortex
D. Superior left hemisphere of the somatosensory cortex
Superior left hemisphere of the somatosensory cortex
While obtaining the subjective history, the therapist learns that the patient was recently hospitalized for malfunction of the anterior pituitary gland. Based on this information alone, the therapist knows that there may be problems with the patient’s ability to produce which of the following hormones?
A. Adrenocorticotropic hormone, thyroid stimulating hormone, growth hormone, follicle stimulating hormone, luteinizing hormone
B. Insulin and glucagons
C. Epinephrine and norepinephrine
D. Cortisol, androgens, and aldosterone
Adrenocorticotropic hormone, thyroid stimulating hormone, growth hormone, follicle stimulating hormone, luteinizing hormone
While evaluating a patient who suffered a complete spinal cord lesion, the therapist notes the
following strength grades with manual muscle testing: wrist extensors = 3+/5, elbow extensors =
2+5, and intrinsic muscles of the hand = 0/5. What is the highest possible level of this lesion?
A. C3
B. C4
C. C5
D. C7
C7
A patient arrives at an outpatient clinic with an order from the physician for whirlpool and wound care to a lower extremity wound The therapist decides to set the temperature in the whirlpool at warm. Which of the following setting in degrees Celsius is appropriate?
A. 27.5° Celsius
B. 35.5° Celsius
C. 49° Celsius
D. 60° Celsius
35.5° Celsius
A supervisor is asked by a hired architect to provide some of the measurements needed to make a new clinic accessible for people who require wheelchairs. Some of the concerns of the architect are the minimal width of the doorways, the steepest slope allowed for the wheelchair ramp at the front entrance, and the minimal height of the bathroom toilet seat. If the supervisor provided measurements based on normal adult size, which of the following lists of measurements would be correct?
A. The minimal doorway with should be 32 inches. The steepest slope allowed is 1:12 (for every 12 feet of horizontal length, the ramp can rise vertically by 1 foot). The minimal toilet seat
height is 17 inches.
B. The minimal doorway with should be 12 inches. The steepest slope allowed is 1:14 (for every 14 feet of horizontal length, the ramp can rise vertically by 1 foot). The minimal tollet seat height is 23 inches.
C. The minimal doorway width should be 30 inches. The steepest slope allowed is 1:12 (for every 12 feet of horizontal length, the ramp can rise vertically by 1 foot). The minimal toilet seat height is 24 inches.
D. The minimal doorway width should be 28 inches. The steepest slope allowed is 1:12 (for every 12 feet of horizontal length, the ramp can rise vertically by 1 foot). The minimal toilet seat height is 15 inches.
The minimal doorway with should be 32 inches. The steepest slope allowed is 1:12 (for every 12 feet of horizontal length, the ramp can rise vertically by 1 foot). The minimal toilet seat
height is 17 inches.
A physical therapist is scheduled to evaluate the shoulder of a patient with hepatitis B. The therapist notices no open wounds or abrasions and also notices that the patient has good hygiene. The physician has ordered passive range of motion to the right shoulder because of adhesive Capsulitis. Which of the following precautions is absolutely necessary to prevent the therapist from being infected?
A. The therapist must wear a gown
B. The therapist must wear a mask
C. The therapist must wear gloves
D. None of the above
None of the above
A therapist is performing chest physiotherapy on a patient who is coughing up a significant amount of sputum The therapist later describes the quality of the sputum in his notes as mucoid. This description tells other personnel which of the following?
A. The sputum is thick
B. The sputum has a foul odor
C. The sputum is clear or white in color
D. The patient has a possible bronchopulmonary infection
The sputum is clear or white in color
A therapist is sent to provide passive range of motion to a patient in the intensive care unit. The chart reveals that the patient is suffering from pulmonary edema. The charge nurse informs the therapist that the patient is coughing up a thin white sputum with a pink tint. Which of the following terms best describes this sputum?
A. Purulent
B. Frothy
C. Mucopurulent
D. Rusty
Frothy
A therapist is screening a patient complaining of pain at the anterior left shoulder region. The pain is increased when the examiner instructs the patient to position the left arm by his side with the elbow flexed at 90° and to actively supinate the forearm against resistance (provided by the examiner). What test is being performed?
A. Froment’s sign
B. Yergason’s test
C. Waldron test
D. Wilson test
Yergason’s test
A physical therapist must have a clear understanding of the normal development of the human body to treat effectively and efficiently. Which of the following principles of treatment is INCORRECT?
A. Early motor activity is influenced primarily by reflexes
B. Motor control develops from proximal to distal and from head to toe
C. Increasing motor ability is independent of motor learning
D. Early motor activity is influenced by spontaneous activity.
Increasing motor ability is independent of motor learning
A patient with cardiac arrythmia is referred to physical therapy services for cardiac rehabilitation.
The therapist is aware that the heart receives nerve impulses that begin in the sinoatrial node of the heart and then proceed to which of the following?
A. Atrioventricular node, then to the Purkinje fibers, and then to the bundle branches
B. Purkinje fibers, then to the bundle branches, and then to the atrioventricular node
C. Atrioventricular node, then to the bundle branches, and then to the Purkinje fibers
D. Bundle branches, then to the atrioventricular node, and then to the Purkinje fibers.
Atrioventricular node, then to the bundle branches, and then to the Purkinje fibers
A physical therapist receives an order from the physician to treat a patient using iontophoresis.
The order indicates that the purpose of the treatment is to attempt to dissolve a calcium deposit in the area of the Achilles tendon. When preparing the patient for treatment, the therapist connects the medicated electrode to the negative pole. Which of the following medications is the therapist most like preparing to administer?
A. Dexamethasone
B. Magnesium sulfate
C. Hydrocortisone
D. Acetic acid
Acetic acid
A therapist is assisting a patient in gaining lateral stability of the knee joint. The therapist is using strengthening exercises to strengthen muscle groups that will increase active restraint on the lateral side of the joint. Which of the following offers the least amount of active lateral restraint?
A. Gastrocnemius
B. Popliteus
C. Biceps femoris
D. Iliotibial band
Gastrocnemius
A clinical instructor is explaining to a physical therapy student the function of the screw home mechanism in the knee joint. Part of the therapist’s explanation involves teaching the student the movement of the tibia and femur during closed chain activities. When the knee joint is extended in a closed-chain activity, which of the following statements is true?
A. The femur laterally rotates on the tibia.
B. The femur medially rotates on the tibia
C. The tibia laterally rotates on the femur
D. The tibia medially rotates on the femur
The femur medially rotates on the tibia
A therapist is evaluating a patient with traumatic injury to the left hand. The therapist asks the patient to place the left hand on the examination table with the palm facing upward. The therapist then holds the second, third, and fifth digits in full extension. The patient is then asked to flex the fourth digit. What movement would be expected by a patient with an uninjured hand, and what muscle or muscles is the therapist restricting?
A. The fourth finger would flex at the distal interphalangeal (DIP) joint only, and the muscle being restricted would be the flexor digitorum superficialis
B. The fourth finger would flex at the proximal interphalangeal (PIP) joint only, and the muscle being restricted would be the flexor digitorum profundus.
C. The fourth finger would flex at the DIP joint only, and the muscles being restricted would be the lumbricals
D. The fourth finger would flex at the PIP joint only, and the muscles being restricted would be the palmar interosseous
The fourth finger would flex at the proximal interphalangeal (PIP) joint only, and the muscle being restricted would be the flexor digitorum profundus.
A 67-year-old man with a below-knee amputation presents to an outpatient clinic. His surgical amputation was 3 weeks ago, and his scars are well healed Which of the following is incorrect information about stump care?
A. Use a light lotion on the stump after bathing each night
B. Continue with use of a shrinker 12 hours per day
C. Wash the stump with mild soap and water
D. Scar massage techniques
Continue with use of a shrinker 12 hours per day
A patient is in prone position with his head rotated to the left side. The left upper extremity is placed at his side and fully internally rotated. The left shoulder is then shrugged toward the chin.
The therapist then grasps the midshaft of the patients left forearm. The patient is then instructed to “try to reach your feet using just your left arm.” This movement is resisted by the therapist. The test is assessing the strength of what muscle?
A. Upper trapezius
B. Posterior deltoid
C. Latissimus dorsi
D. Triceps brachil
Latissimus dorsi
Which of the following is a false statement about below-knee amputations?
A. Gel socket inserts should be left in the prosthesis overnight
B. The therapist should puncture any blisters that appear on the stump
C. Areas of skin irritation on the stump can be covered with a dressing, then a nylon sock before donning the prosthesis.
D. When not in use the prosthesis should be lain on the floor
The therapist should puncture any blisters that appear on the stump
A therapist is assisting a patient with pre-gait activities who has been fitted with a hip disarticulation prosthesis. To ambulate with the most correct gait pattern, what must be mastered first?
A. Forward weight shift on to the prosthesis
B. Swing-through of the prosthesis
C. Maintain stability while in single limb support of the prosthesis
D. Posterior pelvic tilt to advance the prosthesis
Posterior pelvic tilt to advance the prosthesis
A 63-year-old woman presents to physical therapy with a diagnosis of herpes zoster, The physician informs the physical therapist that the L5 dorsal root is involved and that a transcutaneous electrical neuromuscular stimulation (TENS) unit should be used to help control the pain. Where should the TENS unit electrodes be placed?
A. Posterior thigh
B. Lateral hip/greater trochanter area
C. Anterior thigh
D. Anterior lateral tibia
Anterior lateral tibia
A physical therapist is teaching a class in geriatric fitness/strengthening at a local gym. Which of the following is not a general guideline for exercise prescription in this patient population?
A. To increase exercise intensity, increase treadmil speed rather than the grade
B. Start at a low intensity (2-3 METs)
C. Use machines for strength training rather than free weights
D. Set weight resistance so that the patient can perform more than 8 repetitions before fatigue.
To increase exercise intensity, increase treadmil speed rather than the grade
A 63-year-old man presents to an outpatient physical therapy clinic with a diagnosis of sciatica.
The MRI report is negative for lumbar disc involvement During the evaluation the physical therapist cannot reproduce the symptoms of radiculopathy with any test. Lower extremity strength is equal bilaterally and is not weak in any particular pattern. The patient informs the therapist that the pain is bilateral, located in the gastrocnemius area, and increases with prolonged ambulation The pain stops soon after resting in a seated position. What is the most likely source of this patient’s pain?
A. Impingement of the L5 dorsal root
B. Multiple sclerosis
C. Compartment syndrome
D. Intermittent claudication
Intermittent claudication
Which of the following is widely considered the most accurate body composition assessment?
A. Hydrostatic weighing
B. Electrical impedance
C. Anthropometric measurement
D. None of the above
Hydrostatic weighing
A physical therapist is evaluating a 5-day old infant with cerebral palsy. The infant has an abnormal amount of extensor tone. Which of the following is correct positioning advice for the family and nursing staff?
A. Keep the infant in supine position
B. Keep the infant in prone position
C. Keep the infant in sidelying position
D. B and C are correct
B and C are correct
A 76-year-old woman received a cemented right hip arthroplasty (THA) 24 hours ago. The surgeon documented that he used a posterolateral incision. Which of the following suggestions in inappropriate for the next 24 hours?
A. Avoid hip flexion above 30®
B. Avoid hip adduction past midline
C. Avoid any internal rotation: F
D. Avoid abduction past 15°
Avoid abduction past 15°
A physical therapist is treating a 76-year-old woman with left lower extremity hypotonia secondary to a recent stroke. Which of the following is an incorrect method to normalize tone?
A. Rapid irregular movements
B. Approximation
C. Prolonged stretch
D. Tactile cues
Prolonged stretch
An 81-year-old woman with right-side hemiparesis due to stroke is being treated by a physical therapist through home health services. The therapist is attempting to increase the functional reach of the right upper extremity. The patient currently has 120° of active flexion. The therapist decides to use trunk mobility/stability facilitation techniques to help achieve the patient’s functional goals. Which of the following skills need to be mastered by the patient to attain the ability to reach 2 feet in front of her wheelchair and 2 feet to the right of midline at 125° of shoulder flexion with the right upper extremity?
A. Weight shifting to the left buttock and right side trunk elongation
B. Weight shifting to the left buttock and left side trunk elongation
C. Weight shifting to the right buttock and right side trunk elongation
D. Weight shiffing to the right buttock and left side trunk elongation
Weight shifting to the right buttock and right side trunk elongation
Which of the following statements about developmental motor control is incorrect?
A. Isotonic control develops before isometric control
B. Gross motor control develops prior to fine motor control
C. Eccentric movement develops prior to concentric movement
D. Trunk control develops prior to distal extremity control
Isotonic control develops before isometric control
A therapist is attempting to open the spastic and flexed had of a patient who has suffered a recent stroke. Which of the following does not inhibit hand opening?
A. Avoid touching the interossei
B. Apply direct pressure to the thenar eminence
C. Hyperextend the metacarpophalangeal joint
D. A and B
Avoid touching the interossei
A 65-year-old man is scheduled to begin a wellness program. He has no cardiovascular disease, major systemic illness, or musculoskeletal abnormality. However, he is deconditioned because of an extremely sedentary lifestyle. Resting heart rate is 90 beats/minute, and resting blood pressure is 145/92 mmg. Which of the choices below describes the most correct intensity, frequency and duration at which the patient should begin exercise?
A. 75% VOzmax; 30 minutes/day; 3 days/week
B. 40% VO2 max, 30 minutes/day; 5 days/week
C. 40% VO2 max, 10 minutes twice daily; 5 days/week
D. 75% VO2 max; 10 minutes twice daily; 5 days/week
40% VO2 max, 10 minutes twice daily; 5 days/week
Which of the following is the normal end-feel perceived by an examiner assessing wrist flexion?
A. Bone to bone
B. Soft tissue approximation
C. Tissue stretch
D. Empty
Tissue stretch
A physical therapist is beginning an evaluation of a patient with a diagnosis of “knee strain” Range of motion limitation does not follow the normal capsular pattern of the knee. Which of the following are possible causes of the restriction in range of motion?
A. Ligamentous adhesions
B. Internal derangement
C. Extra-articular lesions
D. All of the above
All of the above
A child presents to physical therapy with a diagnosis of right Sever’s disease, What joint should be the focus of the therapists evaluation?
A. Right knee joint
B. Right hip joint
C. Right wrist joint
D. Right ankle joint
Right ankle joint
A physical therapist is reviewing the chart of 24 year-old woman with a diagnosis of L2 incomplete paraplegia. The physician noted that the left quadriceps tendon reflex is 2+.
What does this
information relay to the therapist?
A. No active quadriceps tendon reflex
B. Slight quadriceps contraction with reflex testing
C. Normal quadriceps tendon reflex
D. Exaggerated quadriceps tendon reflex
Normal quadriceps tendon reflex
A physical therapist performs the following test during an evaluation. With the patient lying in supine position, the therapist traces a diamond shape around the patient’s umbilicus with a sharp object. What reflex is being assessed, and what is the significance if the patient’s umbilicus does not move in response to the stimulus provided by the therapist?
A. Cremaster reflex, suggest upper motor neuron involvement
B. Superficial abdominal reflex; suggests upper motor neuron involvement
C. Cremaster reflex, suggests lower motor neuron involvement
D. Superficial abdominal reflex; suggests lower motor neuron involvement
Superficial abdominal reflex; suggests upper motor neuron involvement
A29-year-old woman who is 8 months pregnant presents to an outpatient clinic with complaints of
“pain and tingling over the lateral thigh. She also indicates no traumatic injury. The symptoms increase after she has been sitting for 30 minutes or longer, and the overall intensity of the symptoms has been increasing over the past 2 weeks. The therapist notes that repeated active lumbar flexion does not increase pain, and the patient’s lumbar range of motion is normal for a pregnant woman. There is also no motor weakness in the hip or pelvis, and the sacroiliac joint is not abnormally rotated. What is the most probable diagnosis?
A. L3 disc dysfunction
B. Spondylolisthesis
C. L4 disc dysfunction
D. Meralgia paresthetica
Meralgia paresthetica
The therapist is evaluating a 38-year-old man who complains of right sacroiliac joint pain. The therapist decides to assess leg length discrepancy to supine versus sitting position. When the patient is in supine position, leg lengths are equal; however, when the patient rises to the sitting position, the right lower extremity appears 2 cm. shorter. Which of the following should be a part of the treatment plan?
A. Right posterior S1 mobilization
B. Right anterior S1 mobilization
C. Left posterior S1 mobilization
D. Left anterior S1 mobilization
Right posterior S1 mobilization
In taping an athlete’s ankle prophylactically before a football game, in what position should the ankle be slightly positioned before taping to provide the most protection against an ankle sprain?
A. Inversion, dorsiflexion, abduction
B. Eversion, plantarflexion, adduction
C. Eversion, dorsiflexion, abduction
D. Inversion, plantarflexion, adduction
Eversion, dorsiflexion, abduction
Which of the following is inappropriate for a physical therapist to include in the treatment plan of an infant with a gestational age of 27 weeks and Down’s syndrome?
A. Bottle feeding
B. Encourage sidelying position
C. Tactile stimulation with the entire hand rather than the fingertips of the examiner
D. Prone positioning
Bottle feeding
Which of the following sources of stimulation is least effective in obtaining functional goals when treating an infant with decreased muscular tone?
A. Vestibular
B. Weight-bearing
C. Cutaneous
D. Vibratory
Vibratory
Which of the following is the most important goal in treating pediatric patients with postural reaction deficits?
A. Age-appropriate responses
B. Automatic responses
C. Conscious responses
D. Lower extremity control before upper extremity control
Automatic responses
Which of the following statements best describes lower extremity positioning in standing during the first 2 years of life of a child with no dysfunction?
A. Femoral anteversion, femoral external rotation, foot pronation
B. Femoral anteversion, femoral internal rotation, foot supination
C. Femoral retroversion, femoral external rotation, foot pronation
D. Femoral retroversion, femoral internal rotation, foot supination
Femoral anteversion, femoral external rotation, foot pronation
A10-year-old boy presents to outpatient physical therapy with complaints of diffuse pain in the right hip, thigh, and knee joint. The patient was involved in a motor vehicle accident 3 weeks ago. He is also obese and has significant atrophy in the right quadriceps. The right lower extremity is held by the patient in the position of flexion, abduction and lateral rotation. Which of the following is most likely the source of the patient’s signs and symptoms?
A. Greater trochanteric bursitis
B. Avascular necrosis
C. Slipped femoral capital epiphysis
D. Septic arthritis
Slipped femoral capital epiphysis
A physical therapist is treating a 35-year-old man with traumatic injury to the right hand. The patient has several surgical scars from a tendon repair performed 6 weeks ago. What is the appropriate type of massage for the patient scars?
A. Transverse and longitudinal
B. Circular and longitudinal
C. Transverse and circular
D. Massage is contraindicated after a tendon repair
Transverse and circular
Which of the following statements is true in comparing infants with Down’s syndrome to infants with no known abnormalities?
A. Motor milestones are reached at the same time with both groups.
B. Postural reactions are developed in the same time frame with both groups.
C. Postural reactions and motor milestones are developed slower in patients who have Down’s syndrome, but with the same association as with normal infants
D. Postural reactions and motor milestones are not developed with the same association with patients who have Down’s syndrome as with normal infants
Postural reactions and motor milestones are developed slower in patients who have Down’s syndrome, but with the same association as with normal infants
A high school athlete is considering whether to have an anterior cruciate ligament reconstruction
The therapist explains the importance of this ligament, especially in a person that is young and athletic. Which of the statements below is correct in describing part of the function of the anterior Cruciate ligament?
A. The anterior cruciate ligament prevents excessive posterior roll of the femoral condyles during flexion of the femur at the knee joint
B. The anterior cruciate ligament prevents excessive anterior roll of the femoral condyles during flexion of the femur at the knee joint
C. The anterior cruciate ligament prevents excessive posterior roll of the femoral condyles during extension of the femur at the knee joint
D. The anterior cruciate ligament prevents excessive anterior roll of the femoral condyles during extension of the femur at the knee joint
The anterior cruciate ligament prevents excessive posterior roll of the femoral condyles during flexion of the femur at the knee joint
A therapist is evaluating a patient in the intensive care unit While performing a chart review, the therapist discovers that the patient was seriously injured to a fall from a 3-story building. The therapist determines from the physician’s evaluation that of the many injuries the patient has sustained, a rupture of two ligaments extends from the side of the dens to the medial side of the occipital condyle. Which of the following was injured?
A. Ligamentum nuchae
B. Tectorial membrane
C. Posterior atlanto-occipital ligament
D. Alar ligament
Alar ligament
A physical therapist is treating an 81-year-old man with Parkinson’s disease. The patient has been ambulation on a cane. He was referred to physical therapy because of a fall at home. The family reports a decrease in gait ability during the past several months. The therapist decides to begin gait training with a rolling walker. Which of the following is incorrect for the treatment of this patient?
A. Strengthening of the hip flexors, and stretching of the gluteals
B. Slow, rhythmical rocking techniques
C. Biofeedback during ambulation
D. Prolonged passive stretching of the gastrocnemius muscle group bilaterally.
Strengthening of the hip flexors, and stretching of the gluteals
A patient is an outpatient facility because of an injury sustained to the right knee joint. Only the structures within the synovial cavity were compromised during the injury. Knowing this information only, the therapist is not concerned with injury to which of the following structure?
A. Patellofemoral joint
B. Anterior cruciate ligament
C. Medial meniscus
D. Femoral condyles
Anterior cruciate ligament
A 14-year-old girl presents to an outpatient physical therapy clinic with complaints of anterior knee pain for 2 weeks. The patient notes no particular incident of onset. She indicates that pain increases when she attempts to ascend and descend stairs and with squatting to 130° of knee flexion. The evaluation show limited quadriceps strength on the involved side at 4/5 with manual muscle testing and normal hamstring strength. All meniscus and ligament tests are negative.
Given the above information, what is the most likely cause of the signs and symptoms?
A. Lateral glide of the patella
B. Medial tilt of the patella
C. Baker’s cyst
D. Anterior cruciate ligament tear
Lateral glide of the patella
Which of the following is the best treatment plan for the above patient?
A. Patellofemoral taping, open chain quadriceps strengthening at 90-45° of flexion, closed chain quadriceps strengthening at 45-0° of flexion
B. Patellofemoral taping, open chain quadriceps strengthening at 45-0°, closed chain quadriceps strengthening at 90-45° of flexion
C. Hamstring strengthening terminal knee extension exercises, and ice.
D. Band C
Patellofemoral taping, open chain quadriceps strengthening at 90-45° of flexion, closed chain quadriceps strengthening at 45-0° of flexion
A patient with decreased function of the gluteus minimus is referred to physical therapy for gait training. During the evaluation, the therapist places the patient in prone position and instructs the patient to extend the hip. Knowing that the gluteus minimus is extremely weak, which of the following is most likely to happen?
A. The patient will abduct the hip more than usual when attempting to perform hip extension
B. The patient will externally rotate the hip excessively when attempting to perform hip extension
C. The patient will excessively flex the knee when attempting to perform hip extension
D. The patient will not have difficulty performing straight hip extension
The patient will externally rotate the hip excessively when attempting to perform hip extension
A patient is placed in supine position with the knee in 90° of flexion. The foot is stabilized by the therapist’s body on the examination table. The therapist then wraps his fingers around the proximal tibia so that the thumbs are resting along the anteromedial and the anterolateral margins. The therapist then applies a force to pull the tibia forward? What special test is being performed?
A. Pivot shift
B. Lachman’s test
C. Anterior drawer
D. Posterior drawer
Anterior drawer
A therapist is evaluating a patient who complains of frequent foot, ankle and knee pain. The therapist asks the patient to assume a standing position with the knees slightly flexed. The therapist then demonstrates active bilateral foot pronation to the patient. When asked to perform this task, the patient has difficulty. Which of the following limitations is a possible cause of the patient’s difficulty in performing this task?
A. Restriction limiting plantar flexion and lateral rotation of the talus
B. Restriction limiting dorsiflexion and medial rotation of the talus
C. Restriction limiting eversion of the calcaneus and medial rotation of the talus
D. B and C are correct
Restriction limiting eversion of the calcaneus and medial rotation of the talus
Of the following, which is the earliest period after surgery that an 18-year-old boy who received an uncomplicated partial meniscectomy of the right knee can perform functional testing, such as a one-leg hop test, for distance?
A. 1 week after surgery
B. 2 weeks after surgery
C. 6 weeks after surgery
D. 12 weeks after surgery
6 weeks after surgery
A patient is being evaluated by a physical therapist because of bilateral knee pain. The therapist is attempting to rule out ankle or foot dysfunction as the source of the pain. Which of the following observations is not true in evaluating a patient without foot or ankle problems in the standing position?
A. The talus is situated somewhat medially to the midline of the foot
B. In quiet standing the muscles surrounding the ankle joint remain silent
C. The first and second metatarsal heads bear more weight than the fourth and fifth metatarsal heads
D. The talus transmits weight to the rest of the bones of the foot
In quiet standing the muscles surrounding the ankle joint remain silent
A physical therapist is evaluating a female distance runner who complains of intermittent medial ankle pain. In static standing, the therapist palpates excessive lateral deviation of the head of the talus. From this information, in what position is the subtalar joint during palpation?
A. Supination
B. Pronation
C. Neutral
D. Unable to determine from the information given
Supination
A patient presents to therapy with an ankle injury. The therapist has determined that the injury is at the junction of the distal tibia and fibula. Which of the following functions most in preventing excessive external rotation and posterior displacement of the fibula?
A. Anterior inferior tibiofibular ligament
B. Posterior inferior tibiofibular ligament
C. Interosseous membrane
D. None of the above
Anterior inferior tibiofibular ligament
A physical therapist is asked to evaluate a 37-year-old man with right side sciatica. The therapist performs a passive straight leg raise test of the right lower extremity with the knee and ankle in neutral position. In performing this test on a patient with an L5 disc protrusion, what is the lowest degree at which the therapist would expect to reproduce the patient’s symptoms?
A. At 0° of hip flexion
B. At 35° of hip flexion
C. At 70° of hip flexion
D. At 90° of hip flexion
At 35° of hip flexion
A patient is being treated in an outpatient facility after receiving a meniscus repair to the right knee
1 week ago. The patient has full passive extension of the involved knee but lacks 4° of full extension when performing a straight leg raise. The patient’s active flexion is 110° and passive flexion is 119. What is a common term used to describe the patient’s most significant range of motion deficit? What is a possible source of this problem?
A. Flexion contracture - quadriceps atrophy
B. Extension lag - joint effusion
C. Flexion lag - weak quadriceps
D. Extension contracture - tight hamstrings
Extension lag - joint effusion
A 17-year-old athlete has just received a posterior cruciate ligament reconstruction. The therapist is attempting to explain some of the characteristics of the posterior cruciate ligament. Which of the following is incorrect information?
A. The posterior cruciate ligament prevents posterior translation of the tibia on the femur.
B. Posterior bands of the posterior cruciate ligament are their tightest in full knee extension.
C. The posterior cruciate ligament is attached to the lateral meniscus and not to the medial meniscus
D. The posterior cruciate ligament helps with medial rotation of the tibia during full knee extension with open chain activities.
The posterior cruciate ligament helps with medial rotation of the tibia during full knee extension with open chain activities.
A physical therapist is evaluating a patient who complains of posterior ankle pain. The patient is positioned prone with the feet extended over the edge of the mat. The therapist squeezes the involved gastrocnemius over the middle third of the muscle belly. What test is the therapist performing? What indicates a positive test?
A. Thompson’s test - plantarflexion of the ankle
B. Homan’s test - plantarfiexion of the ankle
C. Thompson’s test - no ankle movement
D. Homan’s test - no ankle movement
Thompson’s test - no ankle movement
A patient who has suffered a recent stroke is being treated by a physical therapist. The patient exhibits increased extensor tone in the supine position along with an exaggerated symmetric tonIc labyrinthine reflex (STLR). What is the best position to initiate flexion movements of the lower extremity?
A. Prone position
B. Sidelying position
C. Supine position
D. A and B
A and B
A physical therapist is attempting to increase a patient’s functional mobility in a seated position. To treat the patient most effectively and efficiently, the following should be performed in what order?
(1) Weight shifting of the pelvis, (2) Isometric contractions of the lower extremity, (3) Trunk range of motion exercises, (4) Isotonic resistance to the quadriceps
A. 1,2,3,4
B. 2,3,1,4
C. 4,3,2,1
D. 3,2,1,4
3,2,1,4
A 14-year old girl place excessive valgus stress to the right elbow during a fall from a bicycle. Her forearm was in supination at the moment the valgus stress was applied. Which of the following is most likely involved in this type of injury?
A. Ulnar nerve
B. Extensor carpi radialis
C. Brachioradialis
D. Annular ligament
Ulnar nerve
Which tendon is most commonly involved with lateral epicondylitis?
A. Extensor carpi radialis longus
B. Extensor carpi radialis brevis
C. Brachioradialis
D. Extensor digitorum
Extensor carpi radialis brevis
A physical therapist is speaking to a group of avid tennis players. The groups asks how to prevent tennis elbow (lateral epicondylitis. Which of the following is incorrect information?
A. Primarily use the wrist and elbow extensors during a backhand stroke
B. Begin the backhand stroke in shoulder adduction and internal rotation
C. Use a racket that has a large grip
D. Use a light racket.
Primarily use the wrist and elbow extensors during a backhand stroke
Which of the following is not part of the triangular fibrocartilage complex of the wrist?
A. Dorsal radioulnar ligament
B. Ulnar collateral ligament
C. Radial collateral ligament.
D. Ulnar articular cartilage
Radial collateral ligament.
Which of the following is the correct method to test for interossei muscular tightness of the hand?
A. Passively flex the proximal interphalangeal (PIP) joints with the metacarpophalangeal (MCP) joints in extension, then passively flex the PIP joints with the MCP joints in flexion. Record the difference in PIP joint passive flexion.
B. Passively extend the PIP joints with the MCP joints in extension, then passively extend the PIP joints with the MCP joints in flexion. Record the difference in PIP joint passive flexion.
C. Passively flex the PIP joints with the MCP joints in extension, then passively extend the PIP joints with the MCP joints in flexion. Record the difference in PIP joint passive flexion.
D. Passively extend the PIP joints with the MCP joints in extension, then passively flex the PIP joints with the MCP joints in flexion. Record the difference in PIP joint passive flexion.
Passively flex the proximal interphalangeal (PIP) joints with the metacarpophalangeal (MCP) joints in extension, then passively flex the PIP joints with the MCP joints in flexion. Record the difference in PIP joint passive flexion
A therapist is beginning an evaluation of a 34-year-old woman with a diagnosis of carpal tunnel syndrome. Part of the evaluation consists of grip strength testing. To accurately test strength of the flexor digitorum profundus, where should the grip dynamometer’s adjustable handle be placed?
A. 1 inch from the dynamometer’s nonadjustable handle
B. 3 inches from the dynamometer’s nonadjustable handle
C. 1.5 inches from the dynamometer’s nonadjustable handle
D. All of the above are equally effective
3 inches from the dynamometer’s nonadjustable handle
A patient who has suffered a zone 2 rupture of the extensor tendon of the third digit presents to physical therapy. This patient had a surgical fixation of the avulsed tendon. During the period of immobilization, which of the following deformities is most likely to develop?
A. Boutonniére deformity
B. Claw hand
C. Swan neck deformity
D. Dupuytren’s contracture
Swan neck deformity
Which of the following muscle tendons most commonly sublux in patients who suffer from rheumatoid arthritis?
A. Flexor digitorum profundus
B. Extensor carpi ulnaris
C. Extensor carpi radialis longus
D. Flexor pollicis longus
Extensor carpi ulnaris
A physical therapist is fabricating a splint for a patient who received four metacarpophalangeal joint replacements. The surgical joint replacement was necessary because of severe rheumatoid arthritis, Which of the following is the correct placement of the metacarpophalangeal joints in the splint?
A. Full flexion and slight radial pull
B. Full flexion and slight ulnar pull
C. Full extension and slight radial pull
D. Full extension and slight ulnar pull
Full extension and slight radial pull
A patient presents to an outpatient clinic with an order to evaluate and treat the right forearm and wrist secondary to nerve compression. The patient has the following signs and symptoms: pain with manual muscle testing of pronation, decreased strength of the flexor pollicis longs and pronator quadratus, and pain with palpation of the pronator teres. What nerve is most likely compromised? What is the most likely area of compression?
A. Median nerve - carpal tunnel
B. Ulnar nerve - Guyon’s canal
C. Ulnar nerve - pronator quadratus
D. Median nerve - pronator teres
Median nerve - pronator teres
A therapist is ordered to fabricate a splint for a 2-month-old infant with a congenital hip dislocation.
In what position should the hip be placed while in the splint?
A. Flexion and adduction
B. Extension and adduction
C. Extension and abduction
D. Flexion and abduction
Flexion and abduction
A 30-year-old woman who had a full term infant 4 weeks ago presents to physical therapy with diastasis recti. The separation was measured by the physician and found to be 3 cm. Which of the following exercises is most appropriate to minimize the separation?
A. Sit-ups while using the upper extremities to bring the rectus abdominis to midline
B. Bridges while using the upper extremities to bring the rectus abdominis to midline
C. Dynamic lumbar stabilization exercises in quadruped position
D. Gentle head lifts in supine position while using the upper extremities to bring the rectus abdominis to midline.
Gentle head lifts in supine position while using the upper extremities to bring the rectus abdominis to midline.
A patient presents to outpatient physical therapy with tarsal tunnel syndrome. What nerve is involved? Where should the therapist concentrate treatment?
A. Superficial peroneal nerve - inferior to the medial malleolus
B. Posterior tibial nerve - inferior to the medial malleolus
C. Superficial peroneal nerve - inferior to the lateral malleolus
D. Posterior tibial nerve - inferior to the lateral malleolus.
Posterior tibial nerve - inferior to the medial malleolus
A physical therapist is discharging a 32-year-old man from outpatient physical therapy. The patient received therapy for a traumatic ankle injury that occurred several months prior. The surgery performed on the patient’s ankle required placement of plates and screws, which resulted in a permanent range of motion deficit of 10° of active and passive dorsiflexion. Strength in the ankle is 5/5 with manual muscle testing. Of the following, which is the highest functional outcome that the patient can expect?
A. Independent ambulation with no gait deviations
B. Ambulation with a cane with minimal gait deviations
C. Running with no gait deviations
D. Ascend or descend stairs with no gait deviations
Independent ambulation with no gait deviations
A physical therapist is performing passive range of motion on the shoulder of a 43-year-old woman who received rotator cuff repair 5 weeks ago. During passive range of motion, the therapist notes a capsular end feel at 95° of shoulder flexion What should the therapist do?
A. Continue with passive range of motion
B. Begin joint mobilization
C. Schedule the patient an appointment with the physician immediately
D. A and B
A and B
A physical therapist is treating a 40-year-old business executive who lives a sedentary lifestyle.
The patient tires quickly and complains of quadriceps fatigue and “burning” after 2 minutes on the stair stepper. The therapist explains to the patient that the “burning “ is probably due to lactic acid build-up in muscles. Which of the following statements is incorrect?
A. Lactic acid build-up is due to the aerobic system not keeping up with the energy demands of the muscles.
B. Lactic acid builds up is more quickly in an unconditioned person than in a conditioned person exercising at the same intensity level
C. A small amount of lactic acid is produced at low to moderate intensity levels of exercise
D. Only the anaerobic system is active during rest
Only the anaerobic system is active during rest
A physical therapist is attempting to explain the importance of slow stretching to an athlete training to compete in a marathon. The therapist explains that quick stretching often causes the muscle to
, which is a response initiated by the
which are located in the muscle fibers. Fill in
the blanks.
A. Relax - Golgi tendon organs
B. Contract - Golgi tendon organs
C. Relax - muscle spindles
D. Contract - muscle spindles
Contract - muscle spindles
In which of the following situations should the therapist be most concerned about the complications resulting from grade IV joint mobilization techniques?
A. A 37-year-old man with a Colles’ fracture suffered 10 weeks ago
B. A 23-year-old woman with a boxer’s fracture suffered 10 weeks ago
C. A 34-year-old man with a scaphoid fracture suffered 12 weeks ago
D. A 53-year-old man with a Bennett’s fracture suffered 12 weeks ago
A 34-year-old man with a scaphoid fracture suffered 12 weeks ago
A physical therapist is evaluating a 17-year-old distance runner with complaints of lateral knee pain
During evaluation, the therapist performs the following test The patient is placed in supine position with the hip flexed to 45 and the knee to 90. The therapist then places firm pressure over the lateral femoral epicondyle and extends the patient’s knee. Pain is felt by the patient at the point of palpation when her knee is 30 from full knee extension. The positive result of this test suggests which of the following structures as the source of pain?
A. Iliotibial band
B. Biceps femoris
C. Quadriceps
D. Lateral collateral ligament
Iliotibial band
When ambulating on uneven terrain, how should the subtalar joint be positioned to allow forefoot rotational compensation?
A. Pronation
B. Supination
C. Neutral position
D. The position of the subtalar joint does not influence forefoot compensation
Pronation
Which of the following is inappropriate exercise for a patient who received an anterior cruciate ligament reconstruction with a patella tendon autograft 2 weeks ago?
A. Lateral step-ups
B. Heel slides
C. Stationary bike
D. Pool walking
Lateral step-ups
A physical therapist is speaking to a group of receptionists about correct posture. Which of the following is incorrect information?
A. Position computer monitors at eye level
B. Position seats so that the feet are flat on the floor while sitting
C. Position keyboards so that wrists are approximately in 20° extension
D. Take frequent stretching breaks
Position keyboards so that wrists are approximately in 20° extension
A physical therapist is treating an automobile mechanic. The patient asks for tips on preventing upper extremity repetitive motion injuries. Which of the following is incorrest advice?
A. Use your entire hand rather than just the fingers when holding an object
B. Position tasks so that they are performed below shoulder height
C. Use tools with small straight handles when possible
D. When performing a forceful task, keep the materials slightly lower than the elbow
Use tools with small straight handles when possible
A physical therapist is treating a 17-year-old boy who suffered a traumatic brain injury. The patient has been in stage IV of Rancho Los Amigos Cognitive Functioning Scale for 1 week. Which of the following is arnappropriate treatment approach?
A. Start treatment at the same time each day
B. Teach wheelchair safety techniques
C. Change treatment if the patient show a decrease in interest
D. Give the patient many different exercises options
Teach wheelchair safety techniques
A 43-year-old man with right biceps brachi rupture presents to physical therapy after a surgical repair. According to the surgeon, the rupture was at the musculotendinous junction. Which of the following has most likely been compromised?
A. Meissner’s corpuscles
B. Merkel’s disks
C. Ruffini endings
D. Golgi tendon organs
Golgi tendon organs
A patient presents to physical therapy with a long-standing diagnosis of bilateral pes planus. The therapist has given the patient custom-fit orthotics. After using the orthotics for 1 week, the patient (complains of pain along the first metatarsal The therapist decides to use joint mobilization techniques to decrease the patient’s pain. In which direction should the therapist mobilize the first metatarsal?
A. Inferiorly
B. Superiorly
C. Laterally
D. A and C
Inferiorly
A physical therapist begins gait training for a patient with bilateral knee flexion contractures at 30® at a long-term care facility. The therapist knows that the patient will have a forward trunk lean during gait because.
A. The patient’s line of gravity is anterior to the hip
B. The patient’s line of gravity is anterior to the knee
C. The patient’s line of gravity is anterior to the ankle
D. A and C
A and C
A therapist is scheduled to evaluate a patient with a chronic condition of hammer toes. Where should the therapist expect to find callus formation?
A. The distal tips of the toes
B. The superior surface of the interphalangeal joints
C. The metatarsal heads
D. All of the above
All of the above
What motion takes place in the lumbar spine with right lower extremity single limb support during the gait cycle?
A. Left lateral flexion
B. Right lateral flexion
C. Extension
D. Flexion
Right lateral flexion
An outpatient physical therapist is gait training a patient recently discharged from the hospital. The inpatient therapist’s notes describe a decrease in left stride length due to pain with weight bearing on the right lower extremity. The outpatient therapist knows that the patient’s gait deviation is
A. An abnormally short distance from the left heel strike and the successive right heel strike
B. An abnormally short amount of time between the left heel strike and the successive right heel strike
C. An abnormally short amount of time in stance phase on the left lower extremity
D. An abnormally short distance between the left heel strike and the successive left heel strike
An abnormally short distance between the left heel strike and the successive left heel strike
In the terminal swing phase of gait, what muscles of the foot and ankle are active?
A. Extensor digitorum longus
B. Gastrocnemius
C. Tibialis posterior
D. Band C
Extensor digitorum longus
A physical therapist is beginning a gait evaluation. During heel strike to foot flat on the right lower extremity, which of the following does not normally occur?
A. The left side of the pelvis initiates movement in the direction of travel
B. The right femur medially rotates
C. The left side of the thorax initiates movement in the direction of travel
D. The right tibia medially rotates
The left side of the thorax initiates movement in the direction of travel
When the knee is at its maximal amount of flexion during the gait cycle, which of the following muscles are active concentrically?
A. Hamstrings
B. Gluteus maximus
C. Gastrocnemius
D. All of the above
Hamstrings
When comparing the gait cyce of young adults to the gait cycle of older adults, what would a therapist expect to find?
A. The younger population has a shorter step length
B. The younger population has a shorter stride length
C. The younger population has a shorter period of double support
D. The younger population has a decrease in speed of ambulation
The younger population has a shorter period of double support
A therapist is treating a patient with a venous insufficiency ulcer over the medial malleolus. The wound is moist and not infected. The involved lower extremity is swollen, and the patient reports no pain around the wound. The physician has ordered wound care 3 times a week. Which of the following is the best treatment?
A. Warm whirlpool
B. Unna boot dressing between therapy sessions
C. Intermittent compression pump
D. B and C
B and C
A 68-year-old man is being treated by a physical therapist after a right below knee amputation.
The patient is beginning ambulation with a preparatory prosthesis. In the early stance phase of the involved lower extremity, the therapist notes an increase in knee flexion. Which of the following are possible causes of this gait deviation?
A. The heel is too stiff.
B. The foot is set too far anterior in relation to the knee
C. The foot is set in too much plantarflexion
D. All of the above
The heel is too stiff.
