DUTTON SET A (1-250) Flashcards

1
Q

A patient is referred to physical therapy with a diagnosis of pes anserinus bursitis. The physical therapist selects ultrasound as part of the intervention. The ultrasound should be applied to the area:
A. proximal to the lateral femoral condyle
B. proximal to the medial femoral condle
C. distal to the medial tibial condyle
D. distal to the lateral tibial condvle

A

Correct Answer: C
Rationale: This is the area where the tendons of the pes anserinus insert.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which of the following is the best exercise to correct a Trendelenburg gait pattern?
A. Bridging with Straight Leg Raise
B. Bridging
C. Bridging with resisted abduction
D. Wall squats

A

Correct Answer: C
Rationale: This exercise is designed to strengthen the gluteus medius, weakness of which causes the Trendelenberg gait pattern.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The physical therapy intervention for a patient with Parkinson’s disease includes therapeutic exercise. The desired response to exercise for this patient is:
A. Increased isotonic and isometric strength
B. Improved initiation of movement and reciprocal motion
C. improved range of motion and joint stability
D. increased proximal and distal stability

A

Correct Answer: B
Rationale: Dysfunctions related to Parkinson’s disease include problems with initiation of movement and reciprocal motion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

An elderly female patient with poor vision is being prepared for discharge after a 3 week hospitalization. Thebest intervention strategy for this patient to increase her ambulation level and safety is to
A. instruct the patient to keep curtains and window shades closed to avoid glare.
B. Recommend that the patient change the color of her walls to bright vellow.
C. practice walking in areas of high illumination and strong color contrasts
D. teach the patient to walk while not looking at her feet at all times.

A

Coirect Answer: C
Rationale: It is important to prepare the patient for difficult situations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which of the following is a contraindication to a 1-MHz ultrasound at 1.5 watts/cm??
A. Over an injured tendon
B. Over an injured muscle belly
C. Over a non-cemented metal implant
D. Over an inflamed bursa

A

Correct Answer: C
Rationale: The use of ultrasound over metal components is contraindicated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

You are instructed to provide electrical stimulation to a 58 year old patient with a venous stasis ulcer on the right lower extremity. What is the most suitable type of electrical stimulation to promote wound healing?
A. Transcutaneous electrical stimulation
B. Direct current
C. Iontophoresis
D. Biphasic pulsed curent

A

CoITect Answer: B
Rationale: The use of direct crent is the preferred form of electrical stimulation for wound healing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

After an above knee amputation, a patient cannot accept the loss of her leg. She reports being constantly tired, weepy, and has no energy to do anything. She also reports dificulty with sleeping. The BEST action you can take is:
A. tell the patient’s husband to monitor her behavior
B. request her primary physician to refer her for a psychological evaluation.
C. tell the patient to stop over-reacting, and to get on with her therapy.
D. observe her closely for possible suicide

A

Answer: B
Rationale: This patient is demonstrating obvious signs of depression and the physician should be notified.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A physical therapy plan of care for a newborn with Erb palsy would include all of the following, EXCEPT:
A. splinting the shoulder in abduction and external rotation, and forearm supination.
B. facilitate awareness of the involved upper extremity.
C. gentle ROM following the immobilization to prevent contractures
D. partial immobilization of limb across upper abdomen for 1-2 weeks

A

Answer: A
Rationale: Erb palsyis associated with a lack of shoulder motion – the affected arm is held adducted, pronated, and internally rotated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A patient is referred to physical therapy for stretching of the right sternocleidomastoid muscle. The MOST effective method to stretch the muscle is by positioning the head and neck into:
A. extension, left side-bending, and right rotation.
B. flexion, left side-bending, and left rotation.
C. extension, right side-bending, and left rotation.
D. flexion, right side-bending, and left rotation.

A

Answer: A
Rationale: The right sternocleidomastoid muscleproducers flexion right side bending and left rotation - - it should therefore be stretched in the opposite directions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

A patient with an above-knee amputation is having great difficulty wrapping his residual limb. Your BEST course of action is to:
A. use a shrinker.
B. Spend more time teaching the patient proper wrapping.
C. Apply a temporary prosthesis
D. Consider recommending the application of an Unna’s paste dressing.

A

Answer: A
Rationale: Shrinkers provide a degree of independence with those individuals who are not able to properly wrap the residual limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

You are applying mechanical cervical traction to patient diagnosed with cervical radiculitis using a cervical halter.
During the traction, the patient complains of pain in the area of the TMJ. Youshould:
A. discontinue the treatment
B. Replace the halter with a sliding device to take pressure off the IM
C. decrease the traction poundage
D. Increase the treatment time

A

Answer: B
Rationale: The sliding device applies no pressure to the TMJ.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A 12-year old girl has sustained full thickness burns to both arms and is now beginning to develop hypertrophic scars.
The most appropriate intervention to manage these scars is:
A. ace wrapping the affected areas
B. surgical resection
C. excision followed by autografts.
D. custom made pressure garments.

A

Answer: D
Rationale: Although expensive, these garments apply an even pressure and help prevent scarring.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

You have been consulted about a child in the elementary school system who has moderate extensor spasticity andlimited head control. The MOST appropriate positioning device would be a
A. Supine stander
B. wheelchair with a back wedge and head supports.
C. HKAFOs
D. Prone stander

A

Answer: B
Rationale: All of the other alternatives do not address the child’s limited head control or the spasticity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

A patient has lumbar spinal stenosis encroaching on the spinal cord. Which of the following activities should you instruct the patient to avoid?
A. rowing.
B. bicycling.
C. Tai Chi.
D. All of these activities can be performed

A

Answer: D
Rationale: All of these activities would be appropriate provided that the patient is able to avoid spinal extension.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The best course of action for a patient with symptoms of an early stage of ankylosing spondylitis include:
A. Strengthening the anterior chest muscles, and stretching of scapular stabilizers.
B. spinal extension and rib expansion exercises, and education about the maintenance of proper posture to prevent deformity.
C. Pain management, abdominal strengthening, and referral to a psychologist.
D. Cardiovascular conditioning, and weight bearing exercises

A

Answer: B
Rationale: Ankylosing spondylitis results in a gradual loss of spinal extension, and rib expansion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

You are about to perform an ice massage for an acutely sprained knee, This is the first time the patient has had anice massage. In order to repare the patient, you should tell the patient he/she will experience:
A. Intense cold, then burning, and then aching, followed bynumbness.
B. aching, then numbness, and then burning, followed by intense cold.
C. burning, then intense cold, and then aching, followed bynumbness.
D. numbness, then aching, and then intense cold, followed by burning.

A

Answer: A
Rationale: The typical sequence experienced by the patient when ice is applied is cold, then burning, then aching, and then numbness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which of the following is not a benefit of a post-operative rigid dressing?
A. limits the development of post-operative edema
B. allows for earlier ambulation
C. allows for earlier fitting of a prosthesis
D. allows for daily wound inspection and dressing changes

A

Answer: D
Rationale: As their name suggests, rigid dressings do not allow for wound inspections or for dressing changes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

You are setting up a patient on electrical stimulation for the puposes of muscle re-education. The most appropriate on: off time ratio 1S:
A.5:1
B. 15:1
C. 1:5
D. 1:15

A

Answer: C
Rationale: This is the correct on:off time ratio used with muscle reeducation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

A patient with suspected nerve root impingement has been referred to you for a trial of mechanical lumbar traction. The patient is a 170 pound male. The most appropriate amount of force to initiate the session is:
A. 20 lbs.
B. 35 lbs.
C. 60 Ibs.
D. 85 Ibs.

A

Answer: B
Rationale: 25-50 lbs is the recommended initial weight for lumbar traction. 50% of the body weight is required for vertebral separation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

You are preparing to perform joint mobilizations on a patient’s proximal radioulnar joint. How would you positionthe joint to place it in the loose packed position?
A. 10 degrees flexion, 10 degrees pronation
B. 20 degrees flexion, 45 degrees supination
C. 45 degrees flexion, 20 degrees supination
D. 70 degrees flexion, 35 degrees supination

A

Answer: D
Rationale: This is the loose pack position for the proximal radioulnar joint.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

You begin treating a patient status post total shoulder reconstruction is examined in physical therapy. The referring physician insists on a very specific post-operative protocol. If you decide to deviate from the established protocol, the most appropriate action is for you to:
A. read the patient’s operating report
B. complete a thorough examination
C. carefully document an modification
D. contact the referring physician

A

Answer: D
Rationale: Whenever an intervention deviates from a physician’s order, the physician must be first consulted.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

You are examining a patient following a total knee replacement. The patient asks you about the benefits of a continuous passive motion (CPM) machine. All of the following are reported benefits from a CPM, except:
A. increase in vascular dynamics
B. prevention of muscle atrophy
C. increases in range of motion
D. decrease in pain

A

Answer: B
Rationale: Because the CM only provides passive range of motion, there are no strengthening benefits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which of the following cryotherapeutic agents provides the greatest magnitude of tissue cooling?
A. frozen gel packs
B. ice massage
C. fluori-methane spray
D. cold water bath

A

Answer: B
Rationale: Of the modalities listed, ice massage provides the greatest magnitude of tissue cooling.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

A patient has been referred to your department for paraffin treatments for a chonic hand injury. When using the dip and wrap method, the most appropriate number of times to dip the hand would be:
A. 1-3
B. 2-4
C. 4-6
D. 6-10

A

Answer: D
Rationale: 6-10 dips are recommended using the dip and wrap method.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

A 35-year-old wheelchair bound patient is being discharged home from your hospital. In preparation for discharge, you visit the home and find he will require a ramp that will allow entry into the patient’s house. What is the maximum recommended grade for the ramp?
A. 6.2 %
B. 8.3%
C.9.5 %
D. 10.4%

A

Answer: B
Rationale: According to ADA, the grade of a ramp should be no greater than 8.3%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

You are preparing to stretch the glenohumeral capsule of a patient. Which grades of oscillation are the mostappropriate for stretching maneuvers?
A. I. II
B. I. III
C. II. III
D. III. IV

A

Answer: D
Rationale: Under the Maitland system, grades III and IV impart a stretch.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

You are mobilizing a patient’s left shoulder using a large-amplitude movement occuring from near the beginning of available range to near the end of available range. What grade mobilization, according to Maitland, is being performed?
A. Grade I
B. Grade II
C. Grade III
D. Grade IV

A

Answer: B
Rationale: Under the Maitland system, a grades II mobilization occurs from near the beginning of available range to near the end of available range.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

A local primary care physician is looking to refer patients with incontinence to your department. Knowing that this is an area of specialty, the physician asks if you know which muscles need to be the focus of the strengthening program to maintain a strong pelvic floor. Which of the following muscles would be included in your reply?
A. Gemellus inferior, obturator internus, and pubococcygeus
B. Obturator internus, pubococcygeus, and coccygeus
C. Rectus abdominis, iliococcygeus, and internal oblique
D. Iliococcygeus, pubococcygeus, and coccygeus

A

Answer: D
Rationale: Of those lited the Iliococcygeus, pubococcygeus, and coccygeus are all pelvic floor muscles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

A patient is referred to physical therapy with a history of temporomandibular joint pain and difficulty closing her mouth against minimal resistance. Which of the following muscles would not be a target for strengthening to help close the mouth?
A. Lateral ptergoid
B. Masseter
C. Medial ptervgoid
D. Temporalis

A

Answer: A
Rationale: The lateral ptergoid opens the mouth.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

You are about to perform a postural drainage technique on a patient using percussions. Which of the following is notan indication for postural drainage with percussion?
A. To loosen and mobilize secretions
B. To utilize the shape and direction of the lung segments in order to help with drainage
C. To safely apply forces over bony prominences such as the scapula, spinous processes, and clavicles
D. To help clear airways in conditions such as cystic fibrosis

A

Answer: C
Rationale: Percussion techniques should not be performed over bony prommences such as the scapula, spinous processes, and clavicles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

You are providing patient education to a 78-year-old man who received a cemented right total hip arthroplasty (THA)24 hours ago. You noted from the operating report that the surgeon used a posterolateral incision. Which precaution would you not stress to the patient?
A. Avoid hip flexion beyond 90 degrees
B. Avoid hip adduction past midline
C. Avoid any hip abduction
D. Avoid hip internal rotation bevond neutral when hip is flexed

A

Answer: C
Rationale: Hip abduction should not be avoided completely.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

One of your goals of treatment is to increase the knee flexion range of motion of a patient. You decide to use the proprioceptive neuromuscular facilitation (PNF) technique of hold-relax to help reach your goals. To whichmuscle group would you apply the hold-relax?
A. Hamstrings
B. Quadriceps
C. Hip flexors
D. Anterior tibialis

A

Proposed Answer and Ratio: B
Quadriceps, since the hamstrings serve as the agonist muscle of knee flexion. The quads act as antagonist to the movement, therefore should be the one limiting knee flexion. Hold- relax targets the antagonist muscle through the principle of autogenic inhibition. Contract-relax works the same way as hold-relax by principle of autogenic inhibition, but involves isotonic contraction by rotation of the range-limiting antagonist muscle instead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

You are teaching a patient how to use a cane to assist with ambulation. The cane is usually used:
A. Opposite the involved side
B. On the involved side
C. Only during the stance phase
D. As needed

A

Answer: A
Rationale: Placing the cane on the opposite side to the involved allows the forces to be better dissipated and allows the user to shift their weight off the involved side during the stance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

A 70 year-old patient has a pressue ulcer on the medial malleolus of his ankle. Upon inspection, you notice that the ankle is swollen, red, and painful with a moderate to high amount of exudate. Of the following dressings, which would be the BEST for this wound?
A. Gauze
B. Hydrogel
C. Semi-permeable
D. calcium alginate dressing

A

Answer: D
Rationale: Calcium alginate dressings are better suited to wounds with a moderate to high amount of exudate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

You are treating a patient admitted to the intensive care burn unit 48 hours ago with an acute deep partial-thickness burn covering 25% of the total body. As the treating physical therapist, what should be your major concern for this patient?
A. Fluid balance
B. Comforting the family
C. Initiating range of motion
D. Nutritional status

A

Answer: C
Rationale: All of the other alternatives, while being of some concern to the PT, are not a major concern as they are the responsibility of other services.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

While playing soccer approximately two months ago, your patient had an inversion sprain of the calcaneo fibular and anterior talofibular ligaments of the right ankle. The ankle is still painful, and very limited in motion. You decide to use ultrasound. The ultrasound treatment parameters should consist of
A. continuous US at 3 MHz.)
B. continuous US at 1 MHz.
C. pulsed US at 1 MHz
D. pulsed US at 3 MHz

A

Answer: A
Rationale: Based on the symptoms, the 3 Mhz would be a better choice as it is less invasive/ more superficial.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

You patient is recovering from a right CVA. During gait analysis you observe lateral trunk bending toward the left during midstance on the left leg. Of the following, what would you do to help correct this deviation?
A. strengthen the hip abductors on the right side
B. strengthen the hip abductors on the left side
C. Strengthen the hip extensors on the right side
D. Strengthen the hip extensors on the left side

A

Answer: B
Rationale: The lateral trunk bending to the left is a compensatory motion for a weak gluteus muscle on the same side.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

You are treating a patient whose chief complaint is difficultly with ballistic movements and who fatigues easily. The optimal exercise prescription for this patient is:
A. low intensity workloads for short durations to help develop slow twitch fibers.
B. high intensity workloads for long durations to help develop fast and slow twitch fibers.
C. high intensity workloads for short durations to help develop fast twitch fibers.
D. low intensity workloads for long durations to help develop slow twitch fibers.

A

Answer: C
Rationale: Ballistic movements involve fast-twitch fibers, which in turn are strengthened using high intensity exercises.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Your patient is recovering from an Achilles tendon strain and is planning to train for a marathon. Her history indicates that she has Tvpe I (IDDM diabetes, controlled with twice daily insulin injections. In order to minimize the risk of a hypoglycemic event during exercise, you should advise the patient to:
A. avoid exercise if her blood glucose is above 300 or below 100
B. decrease her carbohydrate intake for 8 hours before her training sessions
C. exercise daily for 40-50 minutes to achieve proper glucose control
D. Carry on as normal

A

Answer: A
Rationale: While exercises has many benefits for patients with diabetes, it is important to avoid exercising when the levels are indicating hypoglycemia (100) or hyperglycemia (300).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

A patient is having difficulty learning how to coordinate herself for a transfer from bed to chair. Which of the following types of feedback would provide the best help?
A. Emphasize guided movements
B. Emphasize knowledge of results and visual inputs
C. Emphasize knowledge of performance and proprioceptive inputs
D. Encourage her by telling her that practice makes perfect

A

Answer: B
Rationale: Knowledge of results can contribute to the development of motor skills, while visual input is key for developing coordination skills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Your patient presents with left shoulder pain after painting her dining room ceiling two days before. You determine that she has acute subdeltoid bursitis and therefore decide that the best intervention initially is to:
A. Use modalities to reduce pain and inflammation and instruct the patient in pendulum exercises
B. Initiate rotator cuff strengthening exercises
C. Begin correction of muscle imbalances
D. Order a TENs unit for the patient

A

Answer: A
Rationale: The first priority with this patient is to control the pain and inflammation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

As a home health physicial therapist, you have been asked to treat a teenage girl with a diagnosis of cystic fibrosis.
Which of the following interventions would NOT be appropriate for this patient?
A. inspiratory muscle training
B. secretion removal techniques
C. exercises and activities designed to increase endurance
D. breathing techniques designed to decrease inspiratory volumes

A

Answer: D
Rationale: All would be appropriate except that the goal would be to increase inspiratory volumes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

You are treating a woman who was referred to your clinic with a diagnosis of stress incontinence and who reports loss of control with coughing or laughing. Which of the following interventions would be best for this patient?
A. functional electrical stimulation three times a week
B. behavioral modification techniques
C. Instruction on Kegel exercises to be performed several times a day
D. using a biofeedback unit one hour a week

A

Answer: C
Rationale: Stress incontinence involving loss of control during valsalva type activities responds well to a strengthening program to address weakness of the pelvic floor muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Youhave been consulted to treat a patient with a 4 cm stage III decubitus ulcer over the right heel You note a green/yellow, pungent exudate at the wound site and opt to use electrical stimulation. Your choice of polarity and electrode placement would be:
A. The cathode is placed in the wound
B. The anode is placed in the wound
C. The cathode is placed proximal to the wound
D. The cathode is placed proximal to the wound

A

Answer: A
Rationale: This is the correct choice of polarity–cathode (negative pole), which is used to stimulate production of granulation tissue or to promote antimicrobial or anti-inflammatory effects, and the correct placement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

You are designing an exercise program for cardiac rehabilitation. All of the following activities would be considered to be within the 3-6 MET levels except:
A. Walking at a moderate or brisk pace of 3 to 4.5 mph on a level surface inside or outside
B. Roller skating or in-line skating at a leisurely pace
C. Water aerobics
D. Mountain climbing, rock climbing, rapelling

A

answer: D
mountain climbing, rock climbing, rapelling activities are vigorous activities that require more than 6 METS (more than 7 kcal/min)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

You are monitoring a cardiac patient during an exercise session. All of the following would be expected to occur physiologically with this patient at a given workload, except:
A. both HR and svstolic/diastolic BP will increase
B. HR will be higher while systolic BP will be lower
C. Systolic and diastolic BP will both increase
D. The patient will tire the longer the exercise duration

A

Answer: A
Rationale: As with HR, a linear increase in systolic pressure is expected with increasing levels of work.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

You are treating a patient who has a complete spinal cord injury at the level of C6. As part of your intervention you decide to instruct the family in exercises to maintain the patient’s passive range of motion. What should you instruct the family to do?
A. Focus on ranging only those muscles that assist with specific functional needs
B. Maintain the normal ROM of all of the patient’s muscles
C. Emphaize flexibilty of the low back extensors and hamstrings while maintaining normal ROM in the other areas
D. Avoid range of motion to certain areas to promote stability, e.g. shoulders

A

Answer: A
Rationale: It is important to only range those joints where flexibility is needed and to allow other joints to become more stable.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

While performing an ultrasound treatment on a patient’s lateral epicondyle using an intensity of 1.5 Wem?, the patient reports an increase in symptoms in the treatment area. Based on this feedback, what be the most appropriate action?
A. Change the ultrasound frequency
B. Add more transmission gel and continue
C. Decrease the ultrasound intensity
D. Increase the size of the treatment area

A

Answer: C
Rationale: Of those listed, decreasing the ultrasound intensity is the only option that addresses the issue while not changing the purpose of the treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

You are monitoring the exercise of a patient with a diagnosis of myocardial ischemia and coronary artery disease. This patient’s ECG changes would be expected to include
A. bradycardia with ST segment depression
B. significant arrhythmias early on in exercise with a shortened QRS segment
C. tachcardia at a relatively low intensity of exercise and ST segment depression
D. tachycardia early on in exercise with ST segment elevation

A

Answer: C
Rationale: Tachycardia occurs as the diseased heart works harder to pump blood. The ST segment connects the QRS complex and the T wave and can be depressed in ischemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

During your examination of an athlete, you noticed that the patient could not fully dorsiflex his right ankle while the right knee was positioned in full extension. When ankle dorsiflexion is tested with the knee flexed, the range of motion remains the same. Your evaluation and subsequent focus of treatment should be on which structure?
A. adaptive shortening of the right hamstrings
B. adaptive shortening of the right gastrocnemius
C. adaptive shortening of the right soleus
D. adaptive shortening of the right hip flexors

A

Answer: C
Rationale: Because the gastrocnemius is a two joint muscle, its effect on ankle dorsiflexion is altered with the introduction of knee flexion, whereas the length of the soles muscle is not altered.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

You are treating a 16-year-old basketball player who sustained a Grade II inversion ankle sprain 16 days ago. Interventions for this phase of rehabilitation (early subacute) should include:
A. Rest, Ice, Compression, Elevation (RICE and crutch training
B. lower extremity functional strengthening specific to soccer
C. open-chain lower extremity exercises and contrast baths
D. the fitting of an orthosis, closed-chain lower extremity strengthening, cardiovascular, and proprioceptive exercises

A

Answer: D
Rationale: Given the stage of healing, the patient should be moving toward a functional progression while still protecting the injury site.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Youare instructing a patient diagnosed with lymphedema on how to self-administer intermittent compression to the right lower extremity at home. Your recommended treatment time for home administration would be:
A. Up to 8 hours/day
B. Up to 1 hour/day
C. Up to 3 hours/day
D. Up to 4 hours/day

A

Answer:A
Rationale: The recommended time for the application of intermittent compression is up to eight hours per day.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

In an effort to help control pain during a debriding procedure on a patient, you decide to apply TENS during the procedure using the brief intense mode. What on the parameters you should set in terms of frequency and pulse width?
A. Frequency: 1-4 Hz; pulse width: 250+ us
B. Frequency: 80 Hz; pulse width: 150 us
C. Frequency: 10 Hz; pulse width: 150 lIs
D. Frequency: 10 Hz; pulse width: 200-500 us

A

Answer: A
Rationale: These are the correct parameters for the brief intense mode.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

You have been treating a 16-year-old soccer player following an ACL repair. After 4 weeks of treatment the patient still complains of pain and instability even though he reports he reports being compliant with his home exercise program and wearing his brace. The original referral was for 7 to 8 weeks of physical therapy. Your next step should beto:
A. discuss your findings and refer the patient back to his referring physician
B. complete the full 8 weeks of treatment and document the patient’s lack of improvement
C. Discharge the patient
D. Continue treating the patient and give him more time to improve

A

Answer: A
Rationale: The patient is making no progress despite indicating being compliant with the program. It would therefore be prudent to contact the physician and discuss your findings.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

During your examination of a patient with chronic shoulder pain, you observe excessive winging of the scapuladuring overhead motion. The overall focus of your intervention should be:
A. strengthening the rotator cuff muscles
B. strengthening of the rhomboids and middle trapezius
C. strengthening of middle and lower trapezius and the serratus anterior
D. Stretching the middle and upper trapezius muscles

A

Answer: C
Rationale: Winging of the scapula is indicative of a weak serratus anterior, and the middle and lower trapezius.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

While examining a patient you notice color changes in the skin during position changes of the foot. Specifically, pallor develops during elevation of the leg and hyperemia develops when the limb is then positioned in the dependent position.
Based on your findings, you decide to treat this patient for:
A. chronic venous insufficiency
B. arterial insufficiency
C. Ravnaud’s phenomena
D. Buerger’s disease

A

Answer: B
Rationale: Pallor developing with leg elevation which is then replaced with hyperemia when the leg is placed in the dependent position (rubor of dependency) is diagnostic for arterial insufficiency.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

One of your findings during the gait assessment of a patient is that he ambulates with a Trendelenburg gait. The best intervention to correct this problem is:
A. Strengthening the quadratus lumborum
B. Core strengthening program
C. Strengthening the gluteus maximus
D. Strengthening the gluteus medius

A

Answer: D
Rationale: The Trendelenburg sign is associated with weakness of the gluteus medius.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

You are treating a patient who has limited right trunk rotation in sitting, which you have determined to be caused by left thoracic facet joint capsular tightness. Following a specific joint mobilization to the affected thoracic facet joint, you educate the patient in the following exercise to reinforce your mobilization and improve right rotation in sitting
A. Lumbar extension combined with right trunk rotation
B. Lumbar flexion combined with right trunk rotation
C. Lumbar flexion combined with left trunk rotation
D. Lumbar extension combined with left trunk rotation

A

Answer: B
Rationale: The combined motion of lumber flexion and right trunk rotation stretches the left thoracic facet joints more than any of the other movements.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

You are treating a patient with a closing restriction at the right joint of C5 on C6. Which of the following describes the most specific technique vou could use?
A. Position the patient’s head and neck in neutral, apply central P/A pressure on the spinous process ofC5
B. Position the patient’s head and neck in flexion, and left rotation and apply central P/A pressure on the spinous process of C5
C. Position the patient’s head and neck in extension and right rotation, and apply P/A pressure on the facet joint of C6 in the direction of the plane of the C5-6 joint
D. Position the patient’s head and neck in extension and left rotation, and apply P/A pressure on the facet joint of C6 in the direction of the plane of the C5-6 joint

A

Answer: C
Rationale: Position the patient’s head and neck in the combined position of extension and right rotation places the closing restriction on the right side at its end range, thereby facilitating the mobilization technique.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

You are treating a patient for generalized weakness following a prolonged period on bedrest. The patient is able to ambulate well on the level, but is having difficulty with ascending stairs. Although he is able to position his foot on the step, he is unable to climb the stairs without pulling hard on the railing. Which of the following muscles will need to be strengthened to help this patient climb the stairs?
A. Hip and knee extensors
B. Biceps and triceps of both upper extremities
C. Hip extensors and core muscles
D. Hip and knee flexors

A

Answer: A
Rationale: Hip and knee extension strength is necessary for ascending stairs, which involves the patient’s ability to straighten the knee and then extend the hip.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

You are treating a patient with a transtibial amputation fitted with a PTB prosthesis who is leaming to walk. During your gait analysis you notice that this patient is having difficulty maintaining prosthetic stability during the phase from heel-strike to footflat. Based on these findings which muscle group will you decide to strengthen?
A. Trunk extensors
B. Knee extensors
C. Knee flexors
D. Hip flexors

A

Answer: B
Rationale: The knee extensors are involved during the phrase from heel strike to foot flat.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

You are treating a patient diagnosed with adhesive capsulitis of the shoulder. You decide to use joint mobilizations as part of your intervention plan. Which of the following mobilization techniques would be the most effective to use to help restore shoulder abduction?
A. Posterior glide at 90 degrees of abduction
B. Inferior glide at 30 degrees of abduction
C. General distraction technique
D. Inferior glide at 55 degrees of abduction

A

Answer: D
Rationale: Shoulder abduction involves an inferior glide of the humerus on the glenoid and the joint is placed in its loose packed position.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Your examination of a patient reporting right buttock and right posterior thigh pain reveals muscle spasms of theright piriformis muscle. You decide to use ultrasound to the right piriformis to help reduce the spasm. Which would be the most effective ultrasound setting in this case?
A. 3 MHz continuous at 1.5 W/cm2
B. 1 MHz continuous at 1.0 W/cm2
C. 1 MHz pulsed at 1.0 W/cm2
D. 3 MHz pulsed at 1.0 W/cm2

A

Answer: B
Rationale: Greater penetration is achieved with 1 MHz versus 3 MHz and with continuous versus pulsed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

You are treating a patient who has been diagnosed with acute synovitis of the right temporomandibular (TMJ joint. You early intervention should focus on:
A. gentle mobilizations to the right TMJ and patient education on posture, a soft food diet, and the application of ice athome
B. ROM exercises and grade Ill joint mobilizations to the TMJ
C. the issuing of a TENS unit to help control pain
D. application of an intraoral appliance

A

Answer: A
Rationale: The patient is in the acute stage of healing, therefore the focus should be on controlling the pain and inflammation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

You are treating a patient with complex regional pain syndrome (CRPS) of the right upper extremity. Which of the following interventions should be avoided with this patient?
A. Passive range of motion of the right upper extremity
B. Gradual exercising of the right upper extremity
C. Ice or heat applications
D. Jomt protection techniques

A

Answer: C
Rationale: Ice or heat applications should be avoided in most cases because they can cause over stimulation of nerve endings resulting in increased discomfort.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

You are trying to teach a 15-year-old patient to use crutches and non-weightbearing on the right, but the patient ishaving difficulty due to weakness of the upper quadrant muscles. Which of the following muscles would be the most important to strengthen?
A. deltoid, biceps, and brachialis
B. lower trapezius, latissimus dorsi, and triceps
C. upper trapezius, rhomboids and serratus anterior
D. deltoid, upper trapezius and levator scapulae

A

Answer: B
Rationale: All of these muscles are involved when using crutches.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Your patient has atrophy of the quadriceps of his right lower extremity due to a long-standing knee injuy. You decide to use electrical stimulation to increase the patient’s quadriceps strength. Which of the following electrode placement and stimulation protocol should vou use?
A. Small electrodes, widely spaced; 10 secs on 10 secs off.
B. Small electrodes, closely spaced; 10 secs on, 30 secs off.
C. Large electrodes, closely spaced; 10 secs on, 30 secs off.
D. Large electrodes, widely spaced: 10 secs on, 30 secs off.

A

Answer: D
Rationale: Larger electrodes widely spaced allow for deeper penetration. The 10 seconds on, 30 seconds off ratio is appropriate for muscle strengthening.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

A patient is referred to you for a course of iontophoresis for Achilles tendonitis. The patient arrives with the pain medication to be applied, which has a positive charge. The correct current type, polarity and active electrode placement IS:
A. Low volt continuous current with the anode placed distal on the tendon.
B. Monophasic current with the cathode placed on the tendon.
C. Low level current with the anode placed on the tendon.
D. Biphasic current with the cathode placed proximal on the tendon.

A

Answer: C
Rationale: Like poles repel, therefore the positive pole (anode) should be used for any medication with a positive charge.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

You are treating a patient who has a diagnosis of lumbar spinal stenosis. As part of the patient’s education, you should recommend the following sleeping position
A. Sleep on your stomach
B. Sleep on your back
C. Sleep on your side with a pillow between your bent knees
D. The sleeping position shouldn’t be an issue

A

Answer: C
Rationale: Sleeping on the side with the knees bent places the lumbar spine in flexion which helps widen the intervertebral foramen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

You are about to discharge a patient with a C7 spinal cord injwy. Which of the following would be challenging but obtainable goals for this patient?
A. Independent w/ all ADLs; may need adaptive aids for bowel care
B. Independent pressure relief
C. May have limited walking with bracing
D. Independent slide board transfer

A

Answer: A
Rationale: A patient with a C7 spinal cord injury should be able to achieve independence with all activities of daily living, but may need adaptive aids for bowel care.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

To design an intervention for a patient with poor motor control of the lower extremities you must consider the correct sequence for the 4 stages of control, which are:
A. Mobility, controlled mobility, stability, skill
B. Mobility, stability, controlled mobility, skill
C. Stability, controlled stability, mobility, skill
D. Skill, controlled stability, controlled mobility

A

Answer: B
Rationale: This sequence is based on Rood’s concept of levels of control throughout activities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

When considering to use high-voltage or direct crent, all of the following are true statements abouthigh-voltage, except
A. It can be used to stimulate peripheral nerves
B. It is in effective in stimulating the denervated tissues
C. It is an effective current for iontophoresis
D. It effects superficial and deep tissues

A

Answer: C
Rationale: High voltage current is not effective for use with iontophoresis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

You are setting up a patient for a specific type of electrical stimulation where the intensity is produced in a burst mode that has a 50 percent duty cycle, with a pulse width range of 50-200 us, and an interburst interval of 10 ms. What type of electrical stimulation are vou planning to use?
A. TENS
B. Russian
C. Hi-volt
D. FES

A

Answer: B
Rationale: These are the parameters for Russian stimulation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

You are planning to use the acupuncture mode of a transcutaneous electrical nerve stimulation unit to help controla patient’s low back pain. Which of the following parameters on the unit produce this type ofstimulation?
A. Low intensity, duration of 50 sec, and a frequency of 60 Hz
B. High intensity, duration of 150 sec, and a frequency of 2Hz
C. Low intensity, duration of 120 sec, and a frequency of 80 Hz
D. High intensity, duration of 120 sec, and a frequency of 100Hz

A

Answer: B
Rationale: These are the parameters for the acupuncture mode of a TENS unit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

A patient has been referred to your facility for aquatic therapy. Which of the following information derived from the patient would be considered a contraindication to aquatic therapy?
A. chronic pain
B. cerebral palsy
C. multiple sclerosis
D. urinary tract infection

A

Answer: D
Rationale: A urinary tract infection would be a contraindication for aquatic therapy due to the likelihood of contamination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

A patient you are treating requires an ambulation device to help with gait. Which of the following assistive devices provides the least stability?
A. Lofstrand crutches
B. walker
C. wheel walker
D. axillary crutches

A

Answer: A
Rationale: Of the assistive devices listed, Lofstrand crutches offer the least amount of stability.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

While treating a patient with a T4 spinal cord injw, the patient begins to exhibit signs and symptoms of autonomic dysreflexia while exercising in the supine position. What would be the best course of immediate action?
A. Check the patient’s catheter for blockage
B. Sit the patient up
C. elevate the patient’s legs
D. Monitor the patient’s blood pressure

A

Answer: B
Rationale: Autonomic dysreflexia produces a sympathetic response resulting in a rise in blood pressure. Sitting may cause a pooling of blood in the lower extremities thereby lowering blood pressure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Which of the following initial goals would be the least important for a patient who is being treated for extensive full thickness burns
A. A reduction in the risk of infection and complications
B. A reduction in the risk of secondarv impairments
C. Enhancement of wound and soft tissue healing
D. Achievement of good to normal strength

A

Answer: D
Rationale: Compared to the other goals, the achievement of good to normal strength is not a priority.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

You are designing an ulcer prevention program for a patient who spends a lot of time in the seated position. Which ofthe following bony prominences would not be the major focus of vour intervention?
A. Vertebral spinous processes
B. Ischial tuberosities
C. Spines of the scapulae
D. Sacrum

A

Answer: D
Rationale: The sacrum is the most vulnerable bony prominence for skin breakdown while in a supine position.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

You are assiting a patient with bed to chair transfers. In order to complete the task you have to provide the patient with 50% assist. How would you document this level of assist?
A. Minimal assist
B. Moderate assist
C. Contact guard
D. Maximal assist

A

Answer: B
Rationale: This is the definition of a moderate assist.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

All of the following are considerations when treating a patient with a transfemoral amputation, except.
A. Balance and stability
B. Difficulty rising from a seated position
C. Prosthetic comfort while sitting
D. prevent hip flexion, adduction and internal rotation contractures

A

Answer: D
Rationale: It is important to prevent hip flexion, abduction and external rotation contractures.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

You have been asked to help design a newlocal business so that it meets ADA requirements. According to the ADA what are the requirments for doorway dimensions?
A. Minimum width of 32 inches, maximum depth of 24 inches
B. Minimum width of 20 inches, maximum depth of 36 inches
C. Minimum width of 36 inches, maximum depth of 28 inches
D. Minimum width of 34 inches, maximum depth of 30 inches

A

Answer: A
Rationale: These are the ADA requirements for doorway dimensions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

You have just finished treating a patient with a small, purulent wound located on her right malleolus using whirlpool irrigation. Disinfection of the whirlpool can best be achieved with:
A. Sterile water
B. Povidone-iodine
C. Epsom salts
D. Bleach

A

Answer: B
Rationale: Povidone-iodineis a water-soluble chemical that works through disruption of the pathogen cell walls.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

A patient, who has a family history of coronary artery disease, is referred to you to begin an exercise program to improve her cardiac health. Which of the following would be the most accurate measure of exercise intensity to monitor during the first exercise session?
A. MET levels
B. Blood pressure
C. Heart rate
D. Rating of perceived exertion (RPE)

A

Answer: C
Rationale: Of the measures listed, the monitoring of heart rate would be the most important in this patient.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

A concerned mother brings her 2 month-old infant to be examined at Early Intervention because she has noticed that, although the infant had been taking steps in supported standing at two weeks, the infant appears unable to do the same now. You should:
A. Refer the mother and her infant to a pediatric neurologist.
B. Express your concerns and perform a full developmental exam
C. explain that this is normal and that she should not be concerned
D. Recommend a CT scan of the infant’s brain

A

Answer: C
Rationale: This is a normal developmental finding so the parent should be reassured.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

You are progressing a patient through an exercise program to restore normal function of the shoulder. The best PNE diagonal pattern to improve function of the shoulder is:
A. D1 flexion
B. D2 flexion
C. D1 extension
D. D2 extension

A

Answer: B
Rationale: D2 flexion involves shoulder flexion-abduction-external rotation – all key movements of the shoulder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

You are instructing a patient on how to use a reciprocating gait orthosis (RGO) with a walker. What is the correct sequence?
A. She should shift her weight onto her walker and one leg, extend the upper trunk, and swing her other leg through
B. She should shift her weight onto her walker, extend the upper trunk, and swing both legs forward together to approach the walker
C. She should shift her weight onto one leg, and swing her other leg through while leaning on the walker
D. You should not be teaching a patient to use a reciprocating gait orthosis with awalker

A

Answer: A
Rationale: As its name suggests, the RGO is designed to permit a reciprocal gait when accompanied with a weight shift.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

You are treating a patient with a diagnosis of TMI dysfunction The patient is unaware when she is clenching her jaw during periods of stress. You decide to use biofeedback to help teach the patient when she is clenching her teeth. Initially, the biofeedback protocol should consist of:
A. low detection sensitivity with recording electrodes placed closelytogether.
B. high detection sensitivity with recording electrodes placed closely together.
C. low detection sensitivity with recording electrodes placed far apart.
D. high detection sensitivity with recording electrodes placed far apart.

A

Answer: A
Rationale: The electrodes are placed closely together and the sensitivity of the biofeedback unit is set at a low sensitivity setting and adjusted so that the patient can perform the repetitions at a ratio of two thirds of the maximal muscle contraction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

You are treating a 25-year-old female athlete with a diagnosis of patellofemoral syndrome. As part of the patient’s intervention you decide to use both open and closed kinetic chain exercises. Which of the following exercises places the most stress on the patellofemoral joint?
A. Closed kinetic chain exercises involving 90 degrees of knee flexion
B. Open kinetic chain exercises performed between 25 and 90 degrees of knee flexion
C. Open kinetic chain exercises performed between 120 and 90 degrees of knee flexion
D. Closed kinetic chain exercises involving greater than 120 degrees of knee flexion

A

Answer: D
Rationale: Closed kinetic chain exercises involving greater than 120° of knee flexion place a very significant amount of force through the patellofemoral joint.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

All of the following are complications that the physical therapist must take into consideration when designingan intervention plan for a patient with a diagnosis of spina bifida, except:
A. Neurogenic bowel and bladder
B. Myelodysplasia
C. Arnold-Chiari deformitv
D. All are associated complications of spina bifida

A

Answer: D
Rationale: All are associated complications.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

All of the following would be appropriate goals when treating a patient diagnosed with Down syndrome, except:
A. Mininizing gross motor delay
B. Encouraging oral motor function
C. Management of obesity through exercise
D. Management of hypertonia

A

Answer: D
Rationale: Patients diagnosed with Down syndrome have difficulties with hypotonia, not hypertonia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

All of the following would be appropriate interventions for a patient diagnosed with muscular dystrophy, except:
A. Customized wheelchair to help maintain alignment of the spine and pelvis
B. Adaptive devices, such as a wheelchair table to maximize upper extremity mobility
C. Strengthening of the shoulder depressors and biceps to help with transfers
D. Brace prescription, such as ankle-foot orthoses and knee-ankle-foot orthoses, to prolong the period of ambulation and delav wheelchair dependency

A

Answer: C
Rationale: Should include strengthening of triceps, not biceps, to help with transfers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

All of the following are appropriate goals when prescribing strengthening exercises for a patient diagnosed with juvenile rheumatoid arthritis, except:
A. avoiding muscle substitutions
B. Minimizing atrophy
C. Minimizing deformity
D. Minimizing stability

A

Answer: D
Rationale: Strengthening exercises in this patient population are designed to decrease instability.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

All of the following are appropriate goals when prescribing exercises for a patient diagnosed with spinal muscular atrophy (SMA), except.
A. Prevent contractures
B. Prevent deformity
C. Decrease spasticity
D. Prevent secondary complications such as scoliosis

A

Answer: C
Rationale: SMA is a disease involving degeneration of the anterior horn cells of the spinal cord, and will therefore not manifest with spasticity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

All of the following are absolute contraindications for exercise in the adult population, except.
A. Severe coronary artery disease with unstable angina pectoris
B. Uncontrolled hypertension
C. Acute thrombophlebitis
D. Patients older than 85 years old

A

Answer: D
Rationale: Increasing age is not a contraindication for exercise.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

All of the following would be considered good advice to give to a patient diagnosed with hypertension, except
A. Lose weight if overweight
B. Maintain adequate intake of dietary potassium
C. Stop smoking
D. Reduce sodium intake to no more than 200 mmol/d

A

Answer: D
Rationale: Recommendation is no more than 100 mmol/d for sodium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

When designing an intervention plan for a patient diagnosed with a CVA, all of the following are primary impairments associated with stroke, except:
A. Visual changes, including neglect and visual field deficits
B. Changes in emotional status
C. Pain
D. All are primary impairments associated with stroke

A

Answer: D
Rationale: These are all primary impaiments associated with the stroke.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

You are teaching a 20-year-old patient diagnosed with L3 paraplegia how to ambulate using an adaptive device. What type of equipment would be the most appropriate for this patient?
A. bilateral hip-knee-ankle-foot orthoses and crutches
B. bilateral knee-ankle-foot orthoses and crutches
C. bilateral ankle-foot orthoses and crutches
D. You should not be teaching a patient with L3 paraplegia to ambulate

A

Answer: B
Rationale: Bilateral knee and ankle foot orthoses and crutches would be appropriate for this level of spinal cord injury.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

You are treating a patient who is recovering from a fracture of the surgical neck of the humerus, resulting in atrophy of the deltoid muscle. Which nerve was likely damaged by the fracture?
A. Axillary nerve
B. Musculocutaneous nerve
C. Dorsal scapular nerve
D. Long thoracic nerve

A

Answer: A
Rationale: The accessor nerve is commonly injured with a fracture of the surgical neck of the humerus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

You are treating a patient who sustained an injury to the area of the wrist known as the anatomical snuff-box. Whichof the following structures do not pass through the snuff-box?
A. Extensor pollicis longus
B. Abductor pollicis brevis
C. Extensor pollicis brevis
D. Abductor pollicis longus

A

Answer: B
Rationale: The abductor pollicis brevis does not pass through the anatomical snuff-box.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

You are stretching the pectoralis minor muscle of a patient diagnosed with thoracic outlet syndrome. All of the following are correct statements about the pectoralis minor, except:
A. It is supplied by the medial pectoral nerve only
B. It inserts into the middle third of the clavicle
C. It arises from ribs 3 through 5
D. It is a small somewhat triangular muscle

A

Answer: B
Rationale: The pectoralis minor inserts into the medial border and superior surface of the coracoid process of the scapula.

102
Q

You are designing a strengthening program for a patient with weak hip muscles. Each of the following muscles can produce movement of the hip, except.
A. Rectus femoris
B. Obturator internus
C. Quadratus femoris
D. Vastus medialis

A

Answer: D
Rationale: The vastus medialis does not cross the hip joint.

103
Q

You are applying massage to a muscle within the femoral triangle. Which of the following muscles is not found in the femoral triangle?
A. Adductor magnus
B. Adductor longus
C. Pectineus
D. Sartorius

A

Answer: A
Rationale: The adductor magnus is not found within the femoral triangle,

104
Q

You are part of a rehab team that is to recommend environmental modifications to a 76 year-old patient’s bathroom at his home. The patient, who is wheelchair dependent, is scheduled to be discharged next week. All of the following would be appropriate recommendations, except:
A. Bathroom sink not greater than 40 inches from floor to bottom of miror or paper dispenser
B. Grab bars bv the toilet should be 1¼-1½ in diameter
C. Minimum width of doorwav to be 32 inches
D. Horizontal grab bars to be positioned at 40 inches from floor level

A

Answer: D
Rationale: horizontal grab bars in tub should be positioned at 33-36 inches from floor level.

105
Q

You are teaching a patient who fractured his right tibia how to use crutches using a four-point gait pattern. Which ofthe following describes this pattern?
A. (L) crutch, (R) foot, (R) crutch, (I) foot
B. (R) crutch. (L) foot. (L) crutch. (R) foot
C. (L) crutch, (R) foot, (L) foot, (R) crutch
D. (L) crutch, (L) foot, (R) crutch, (R) foot

A

Answer: B
Rationale: With the 4-point gait pattern the crutch is moved with the opposite leg.

106
Q

You are instructing a patient that is partial weight bearing on the left lower extremity to ascend stairs using axillary
Crutches. Your first instruction should be:
A. place your left leg on the first step
B. place your left leg and right crutch on the first step
C. place your right leg on the first step
D. place your right leg and left crutch on the first step

A

Answer: C
Rationale: Remember the adage: Up with the good, down with the bad–when going up the stairs lead with the good (uninvolved) leg, when going down the stairs lead with the bad (involved) leg.

107
Q

You are asked by a colleague who must take an important phone call to continue postural drainage activities on a patient.
When you enter the room, the patient is positioned in sidelying. Which of the following lung segments is most likely being treated based on the patient’s position?
A. posterior basal segment of the lower lobes
B. apical segment of the upper lobes
C. lateral basal segment of the lower lobes
D. anterior segment of the upper lobes

A

Answer: C
Rationale: This is the position best suited to treat the basal segment of the lower lobes.

108
Q

You have been asked to provide an assistive device to a 90-year-old female who lives alone and is partial weight bearing on the right lower extremity. Her upper extremity strength is 3+/5. Which assistive device would you recommend for this patient?
A. Lofstrand crutches
B. axillary crutches
C. large base quad cane
D. walker

A

Answer: D
Rationale: A walker would be the safest assistive device for this patient as it provides the widest base of support.

109
Q

You have been asked to provide a recommendation for a wheelchair for a patient with C4 tetraplegia. Which wheelchair would be the most appropriate for the patient?
A. manual wheelchair with friction surface handrims
B. manual wheelchair with handrim projections
C. power wheelchair with sip-and-puff controls
D. power wheelchair with joystick controls

A

Answer: C
Rationale: A patient with a diagnosis of C4 tetraplegia would not be able to independently operate a manual wheelchair or joystick controls.

110
Q

You are treating a 60-year-old male diagnosed with Parkinson’s disease. Due to the effects of the disease, the patient is unable to perform basic activities of daily living without assistance from family members. Your most appropriate treatment objective IS:
A. improve upper and lower extremity strength
B. improve respiratory capacity
C. improve initiation of movement
D. improve upper and lower extremity range of motion

A

Answer: C
Rationale: While the other alternatives are reasonable objectives, improving initiation of movement is more specific to Parkinson’s disease.

111
Q

You are treating a patient who is rehabilitating from a spinal cord injwy. The patient’s feet often become dislodged from the wheelchair footrests due to significant lower extremity spasticity. The most appropriate modification to address this problem would be to attach:
A. fixed leg rests and foot plates
B. elevating footrests
C. heel loops and/or toe loops
D. detachable swing-away leg rests

A

Answer: C
Rationale: Of the options listed, attaching heel loops and /or toe loops would best address the spasticity issue.

112
Q

You are applying a manual assisted cough technique on a supine patient with a I 6-7 spinal cord injwy. Which of the following is the most appropriate location for yuor hand placement?
A. diaphragm
B. upper abdomen area
C. xiphoid process
D. umbilicus region

A

Answer: B
Rationale: The clinician should place both hands flat against patient’s upper abdomen directly below the xiphoid process.
With each cough the clinician applies manual pressure inwardly and superiorly.

113
Q

An extremelv obese patient has a diabetic ulcer on his right foot. Although the ulcer is in a chronic state of tissue inflammation, it is is not infected. The patient is unable to ambulate without applying pressure to the region. Which of the following interventions would be the most beneficial for this patient?
A. Whirlpool 10 minutes followed by sharps debridement
B. Fit the patient with an orthotic to offload pressures on the involved region
C. Review the role of glucose levels and impact on tissue healing with the patient
D. Prescribe axillary crutches for the patient and instruct them on NWB gait using the crutches

A

Answer: C
Rationale: The focus of your intervention should be to use patient education to prevent the ulcer worsening. Given the patient’s extreme obesity, ambulation would not be a priority at this time.

114
Q

Upon examination of a patient, you detect a restricted right joint facet at the T8 level. Following a joint mobilization to the involved joint, which of the following movements would be the best movement to teach the patient to stretch the joint?
A. Trunk rotation to the left and trunk extension
B. Trunk rotation to the left and trunk flexion
C. Trunk rotation to the right and trunk extension
D. Trunk rotation to the right and trunk flexion

A

Answer: B
Rationale: The combination of trunk rotation to the left and trunk flexion will stretch the right joint facet.

115
Q

Your patient, who has a history of severe chronic obstructive pulmonary disease (COPD), is getting discharged to home.
The patient’s family are very concerned about the patient’s ability to breath easily once they are discharged. Which of the following would be the best instruction for this patient?
A. Deep breathing exercises combined with postural stabilization training and education about body mechanics
B. Encourage the patient to cough regularly and deeply to clear airway passages
C. Encourage the patient to cough
D. None of the above would be appropriate

A

Answer: A
Rationale: Deep breathing exercises combined with postural stabilization training and education about body mechanics would be the most appropriate intervention from this list.

116
Q

A patient presents with dysfunction of the medial longitudinal arch due to depression of the subtalar joint. The appropriate shoe insert for this patient is:
A. scaphoid pad
B. Heel lift
C. pad over the transverse arch.
D. Thomas heel

A

Answer: A
Rationale: The scaphoid pad is designed to prevent depression of the subtalar joint by posting the sustentaculum tali and the navicular tuberosity

117
Q

You are working with a child with Down Syndrome who frequently uses a W sitting position. The main reason to discourage sitting in this manner is that it may:
A. cause femoral anteversion and knee strain
B. delay the development of normal sitting
C. increase abnormally low tone
D. increase abnormally high tone

A

Answer: A
Rationale: The W sit position fixes the hip in ananteverted position while simultaneously placing strain on the ligaments of the knee.

118
Q

Which of the following end-feels is always an absolute CONTRAINDICATION for joint mobilization?
A. empty end-feel.
B. soft end-feel.
C. springy end-feel.
D. firm end-feel.

A

Answer: A
Rationale: An empty end feel highlights that the patient is unable to tolerate further motion due to severe pain.

119
Q

All of the following are indications for mechanical traction, except
A. Spinal nerve root impingement
B. Hypomobility of spinal joints
C. Joint instability
D. Muscle spasm or guarding

A

Answer: C
Rationale: Traction should not be performed in the presence of joint instability,

120
Q

You are designing an aerobic exercise program for a healthy 64 year old using the age-adjusted target heatrange method. Which of the following heat rates would be the most appropriate for this patient?
A. 160 bpm
B. 150 bpm
C. 140 bpm
D. 130 bpm

A

Answer: D
Rationale: The patient’s max heart rate is calculated at 220-64=156. The appropriate range would be 60-90% of 156 –93.6 to 140.4.

121
Q

You are progressing a patient with a diagnosis of traumatic brain injury through a developmental sequence while performing dynamic activities. The patient is currently performing activities in the quadruped position. Which of the following would be the next posture to attain in the developmental sequence?
A. prone on elbows
B. Tall kneeling
C. Standing
D. Long sitting

A

Answer: B
Rationale: Tall kneeling follows the quadruped position in the developmental sequence.

122
Q

You are designing a program to improve coordination for patient with a history of cerebellar disease. Which of the following exercises would be the best to include?
A. McKenzie
B. Frenkel’s
C. Borg’s
D. Rhythmic stabilization

A

Answer: B
Rationale: Frenkel’s exercises are designed to improve coordination.

123
Q

You are treating a hemiplegic patient status post traumatic brain injury. You are trying to promote elbow extension in the patient using the asymmetrical tonic neck reflex. Which of the following actions would best facilitate elbow extension?
A. Have the patient turn the head to the involved side
B. Have the patient turn the head to the uninvolved side
C. Have the patient flex the neck
D. Have the patient extend the neck

A

Answer: A
Rationale: The asymmetrical tonic neck reflex may produce extension of the involved upper extremity by turning the patient’s head toward the involved side.

124
Q

You are instructing a patient how to rise from a chair so that they can begin ambulation using a walker. Which of the following instructions should vou give the patient?
A. While holding the walker with one hand push up on the chair with the other hand
B. Push up on the chair with both hands and reach for the walker once you are standing
C. Place both hands on the walker and pull yourself into the standing position
D. Push up on the chair using both hands and reach for the walker while rising

A

Answer: B
Rationale: It is important that the patient does not reach for the walker until they are standing to prevent the walker from tipping over.

125
Q

Which of the following breathing techniques decreases the patient’s respiratory rate, prolongs the expiratory phase, and increases the excretion of carbon dioxide?
A. Pursed lip breathing
B. Diaphragmatic breathing
C. Stacking breaths
D. Segmental breathing

A

Answer: B
Rationale: Diaphragmatic breathing is designed to decrease the patient’s respiratory rate, prolongs the expiratory phase, and increases the excretion of carbon dioxide

126
Q

You are explaining Ohm’s law to a physical therapy student. As the curent flow is directly proportional to the voltage and inversely proportional to the resistance, all of the following are true, except:
A. When resistance decreases, current increases
B. When voltage increases, current increases
C. When voltage is 0, current is O
D. When voltage increases, curent decreases

A

Answer: D
Rationale: When voltage decreases, current decreases.

127
Q

You are instructing a patient about precautions following a total hip replacement involving an anterolateral surgical approach. Which of the following motions should the patient avoid during the initial phase ofrehabilitation?
A. Hip external rotation
B. Hip internal rotation
C. Hip flexion
D. All of these motions would be safe to perform

A

Answer: A
Rationale: Failure to avoid external rotation of the hip can result in hip dislocation or subluxation following and anterolateral approach.

128
Q

You are treating a patient with right hemiplegia. You give the patient a comb and ask him to comb his head. Instead the patient uses the comb to brush his teeth. How would you document this finding?
A. Ideomotor apraxia
B. Ideational apraxia
C. Dyspraxia
D. Aphasia

A

Answer: B
Rationale: Ideational apraxia involves eITors in concepts and sequencing of tasks.

129
Q

You are treating a patient who has suffered a CVA eight weeks ago. The patient is demonstrating Isolated joint movements that are performed with coordination. According to Brunstrom, which stage of recovery is the patient in?
A. Three
B. Fou
C. Five
D. Six

A

Correct Answer: D
Rationale: Isolated joint movements are performed with coordination in stage six.

130
Q

You are treating a patient who demonstrates a 5° limitation in knee extension. You decide to use a jointmobilization technique to regain the last 5° of extension. Which of the following mobilization techniques would be indicated?
A. Anterior glide of the tibia on the femur
B. Posterior glide of the tibia on the femur
C. Inferior glide of the patella
D. Superior glide of the patella

A

Answer: A
Rationale: Although a superior glide of the patella is involved in knee extension, there is little engagement of the patella during the last 5° of extension. Therefore the best answer is anterior glide of the concave tibia on the convex femur.

131
Q

You are treating a patient with a diagnosis of pulmonary disease. Which of the following breathing techniques would help the patient perfom ADLs without dyspnea
A. Paced breathing
B. Diaphragmatic breathing
C. Stacking breaths
D. Segmental breathing

A

Answer: A
Rationale: Paced breathing uses a combination of pursed-lip breathing and diaphragmatie breathing performed at the normal
1:2 ratio of inspiration to expiration during functional activities.

132
Q

You are treating a patient with a diagnosis of an avulsion fracture of the ischial tuberosity. Which of the following would be the most likely mechanism of injuv?
A. Forceful extension of the hip with the knee extended
B. Forceful flexion of the hip with the knee extended
C. Forceful extension of the hip with the knee flexed
D. Forceful flexion of the hip with the knee flexed

A

Answer: B
Rationale: Forceful flexion of the hip with the knee extendedplaces significant forces through the hamstrings, which can result in an avulsion fracture.

133
Q

You are treating a patient diagnosed with multiple sclerosis. All of the following would be included in vour design for the intervention, except.
A. Scheduling late morning sessions
B. Aggressive stretching
C. Energy conservation and stress management techniques
D. High intensity exercise

A

Answer: D
Rationale: Fatigue is a common component associated with multiple sclerosis therefore the exercise should be at a moderate level and not high-intensity.

134
Q

You are designing a strengthening program for a patient recovering from an anterior shoulder dislocation. Which of the following muscle groups should be emphasized?
A. Shoulder adductors and internal rotators
B. Shoulder abductors and external rotators
C. Shoulder adductors and external rotators
D. Shoulder abductors and internal rotators

A

Answer: A
Rationale: The shoulder adductors and internal rotators provide support for the anterior joint capsule.

135
Q

You are cUrently treating a patient who recently underwent an above knee amputation, According to the psychiatrist report, the patient is in the third stage of the grieving process. Which stage of the grieving process is the patient most likely exhibiting?
A. Bargaining
B. Anger
C. Depression
D. Acceptance

A

Answer: A
Rationale: The five stages of grieving are (in order from first to last) denial, anger, bargaining, depression, and acceptance.

136
Q

You are treating a patient who traumatically dislocated the tibia directly posteriorly. Which of the following structures is the least likely to be injured?
A. Tibial nerve
B. Common fibularis (peroneal) nerve
C. Anterior cruciate ligament
D. Popliteal artery

A

Answer: B
Rationale: The common fibularis (peroneal) nerve travels over the lateral aspect of the knee and is therefore the least likely to be injured.

137
Q

You are treating a patient who recently suffered a stroke and has been diagnosed with right sided homonymous hemianopsia. Which of the following statements is true about placement of objects in the early rehabilitation period?
A. The objects should be placed on the left side of the patient
B. The object should be placed on the right side of the patient
C. The object should be placed on both sides of the patient
D. The object should be placed slightly to the right of the patient

A

Answer: A
Rationale: Initially, the objects should be placed on the left side of the patient As perception improves, the objects should be moved into the area of the deficit.

138
Q

You are treating a patient who underwent a left total knee replacement five weeks ago, Range of motion measurements for the left knee are 85° actively and 95° passively for flexion, and -12° of full passive extension and -18° of full active extension, Which of the following should you address first?
A. The lack of passive left knee extension
B. The lack of active left knee extension
C. The lack of passive left knee extension
D. The lack of passive left knee flexion

A

Answer: C
Rationale: You should address the lack of passive left knee extension first because the patient has to achieve passive knee extension before she can gain full active knee extension.

139
Q

You are treating a patient who requires a whirlpool treatmen. Because the patient is severely immobile, you need to set up a portable whirlpool unit in the patient’s room. Which is the most important factor you must consider before this patient is placed in the whirlpool?
A. Make sure the whirlpool unit is plugged into a ground fault circuit interruption outlet
B. Check to make sure the water temperature is below 100°F
C. Obtain the appropriate assistance to perform the transfer
D. Check to make sure the patient is stabilized properly in the chair

A

Answer: A
Rationale: A ground fault interruption circuit protects the patient from a potentially life-threatening situation.

140
Q

You have been asked to tape an athlete’s ankle prophylactically before a basketball game to prevent ankle sprain. In what position should the ankle be slightly positioned in before taping to provide the most protection?
A. Inversion, plantarflexion, adduction
B. Eversion, dorsiflexion, abduction
C. Eversion, plantarflexion, adduction
D. Inversion, dorsiflexion, abduction

A

Answer: B
Rationale: This position limits inversion, plantarflexion, and adduction.

141
Q

You have been asked to fabricate a splint for a one-month-old infant with congenital hip dislocation. In what position should the hip be replaced while in the splint?
A. Flexion and abduction
B. Flexion and adduction
C. Extension and adduction
D. Extension and abduction

A

Answer: A
Rationale: This is the most stable position.

142
Q

You have decided to use a whirlpool treatment to decrease spasticity of a muscle in conjunction with passive exercise.
Which of the following whirlpool temperatures would be the most appropriate to help achieve this?
A. Warm: 96-99 deg F (35.5-37 deg C)
B. Cool: 67-80 deg F (19-27 deg C)
C. Cold: 55-67deg F (13-19 deg C)
D. Very cold: 32-55 deg F (0-13 deg C)

A

Answer: A
Rationale: The most appropriate temperature would be waim.

143
Q

All of the following are true statements about learning and teaching, except:
A. Learning refers to the ways people acquire, process, store and apply new information
B. To identify realistic goals, instructors must be skilled in assessing a patient’s readiness or a patient’s progress toward goals
C. Motivation plays a critical role in leaning
D. Incentives, including privileges and receiving praise from the educator should be used sparingly

A

Answer: D
Rationale: Incentives, including privileges and receiving praise from the educator motivate learning.

144
Q

All of the following are true statements about motivation, except
A. Interesting visual aids, such as booklets, posters, or practice equipment, motivate learners
B. Internal motivation is longer lasting and more self-directive than is external motivation
C. Success is more predictably motivating than is failure
D. All are true statements about motivation

A

Answer: D
Rationale: All are true statements.

145
Q

All of the following are true statements about Maslow’s hierarchy of needs, except.
A. It is based on the concept that there is a hierarchy of biogenic and psychogenic needs that humans must progressthrough
B. The higher needs in this hierarchy only come into focus once all the needs that are lower down in the pyramid are mainly or entirely satisfied
C. Growth forces create upward movement in the hierarchy, whereas regressive forces push prepotent needs further down the hierarchy
D. Maslow’s hierarchy is often depicted as a pyramid consisting of three levels, with the lower levels refered to as being needs.

A

Answer: D
Rationale: Maslow’s hierarchy is depicted as a pyramid consisting of five levels with the lower levels being referred to as (deficiency needs.

146
Q

All of the following are considered to be one of Bloom’s domains of educational activities, except:
A. Cognitive
B. Affective
C. Psychomotor
D. Mental

A

Answer: D
Rationale: All are considered to be one of Bloom’s domains of educational activities, except Mental

147
Q

Which of the following statements is not true about the analytical/objective leaner?
A. He/she processes information in a step-by-step order
B. he/she is able to use facts and easily understand the relationships between them
C. he/she perceives information in an abstract, conceptual manner
D. He/she processes information all at once

A

Answer: D
Rationale: The intuitive/global leaner processes information all at once, and not in an ordered sequence,

148
Q

All of the following factors can be used to improve compliance with learning and participation, except
A. Involving the patient in the intervention planning and goal setting
B. Promoting perceived benefits
C. Promoting high expectations regarding final outcome
D. Having the patient work through the pain to increase tolerance levels

A

Answer: D
Rationale: The PT should strive to keep the exercises pain-free or with a low level of pain.

149
Q

You are presenting at a local community center where you are educating the public about physical therapy. Which of the following statements about physical therapy is incorrect?
A. Physical therapists are the only professionals who provide physical therapy
B. Physical therapists are professionallyeducated at the college or university level and are required to be licensed in the state (or states) m which they practice
C. Graduates from 1960 to the present have successfully completed professional physical therapist education programs accredited by the APTA
D. Physical therapists practice in a broad range of impatient, outpatient, and community-based settings

A

Answer: C
Rationale: Graduates from 1960 to the present have successfully completed professional physical therapist education programs accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE)

150
Q

Which program is designed to provide services to seniors and the disabled whose needs would otherwise require them to live in a nursing home?
A. Home Health Agency (HHA) program
B. The Medicaid Waiver for the Elderly and Disabled (ED Waiver) program
C. The ADA program
D. None of these programs

A

Answer: B
Rationale: The Medicaid Waiver for the Elderly and Disabled (ED Waiver) program is designed to provide services to seniors and the disabled whose needs would otherwise require them to live in a nursing home.

151
Q

All of the following are considered to be the focus of a home health physical therapist except:
A. Securing scatter rugs
B. Assessing the need for a raised toilet seat
C. Building outside ramps
D. Addressing equipment needs

A

Answer: C
Rationale: A home physical therapist makes recommendations about outside ramps but is not responsible for building them.

152
Q

All of the following are true statements about the Early Intervention Program (EIP), except:
A. It was created by Congress in 1986 under the Individuals with Disabilities Education Act (IDEA
B. To be eligible for services, children must be under 3 years of age and have a confirmed disability or established developmental delav
C. Confirmed disability or established developmental delays can include physical, cognitive, communication, social-emotional, and or adaptive impairments
D. All are true statements

A

Answer: D
Rationale: All are true statements.

153
Q

All of the following are true statements about correct clinical documentation, except:
A. All documents must be legible and should be written in black or blue ink, typed and or transcribed
B. Empty lines should not be left between one entry and another, nor should empty lines be left within a single entry
C. Correction fluid/tape or similar products can be used to correct text in the medical records
D. Any mistake should be crossed out with a single line through the error, initialed, and dated by the clinician

A

Answer: C
Rationale: Correction fluid/tape or similar products should never be used to correct text in the medical records.

154
Q

You have been asked to prepare a departmental budget that must include expenditures for the purchase of expensive equipment (i.e., over $300-500) with a life span of 3-5 years, repair needs, plans for purchasing buildings, and themeans to finance each over lengthy time periods. What type of budget is this?
A. Operating
B. Capital
C. Zero-based
D. Contingency

A

Answer: B
Rationale: This type of budget is a capital budget.

155
Q

You have been asked to give a presentation on hamstring injwy prevention for a group of high school athletes. Which of the following would be your most important consideration?
A. Typing up an outline
B. Using a PowerPoint presentation
C. Injecting humor into your presentation
D. Assessing the needs of your target audience

A

Answer: D
Rationale: It is always critical to assess the needs of your target audience prior to designing a presentation.

156
Q

You have been treating a patient who was placed on non weight-bearing status following surgery to his right knee, Within the first couple of sessions, it became clear to you that the patient was being noncompliant with the weight-bearing status. Of the following, which would be your most appropriate action?
A. Contact the orthopedic surgeon
B. Inform a familv member
C. Emphasize to the patient the importance of maintaining the non-weight-bearing status and the consequences of ignoring those restrictions
D. Refuse to treat the patient until he becomes compliant

A

Answer: A
Rationale: Addressing the issue with the patient may improve compliance, However, if the patient continues to ignore the restrictions, you should contact the orthopedic surgeon

157
Q

You are treating a patient with a diagnosis of status post shoulder dislocation. During the examination, the patient asks when she can stop wearing the sling. Your appropriate course of action would be to:
A. Tell the patient that you will be able to make that determination following your examination
B. Contact the patient’s physician to determine what instructions were given to the patient
C. Make a determination based on how the referring physician usually treats these conditions
D. Tell the patient she can stop wearing the sling once her arm feels comfortable

A

Answer: B
Rationale: The patient’s physician is responsible for determining when the sling can be discontinued.

158
Q

You have been asked to prepare a presentation on lifting techniques for a group of steelworkers. To maximizeleaming during the presentation, which of the following media should you include?
A. Instruction. handouts
B. Instruction, statistics, handouts
C. Instruction, demonstration
D. Instruction, handouts, demonstration

A

Answer: D
Rationale: By providing instruction, handouts, and demonstrations you are providing verbal, written, and visual information.

159
Q

Yourphysical therapy aide approaches you after checking the water temperature of the hot pack machine. Which of the following temperatures would not cause vou concern?
A. 70°C
B. 71°C
C. 120°F
D. 200°F

A

Answer: B
Rationale: Hot packs should be stored in water that is approximately 71°C or 160°F.

160
Q

The ratio of cardiac compression to breaths during two-man cardiopulmonary resuscitation is:
A. 30 to 2
B. 10 to 1
C. 15 to 1
D. 15 to 2

A

Answer: D
Rationale: This is the correct ratio of cardiac compression to breaths during two-man cardiopulmonary resuscitation according to the new American Heart Association recommendations. A ratio of 15:1 was previously recommended.

161
Q

161.A patient at risk for complex health and social problems, requiring multiple services including discharge planning, targeting, assessment, care planning, service implementation, monitoring and reassessment, as well as monitoring adequacy, quality and appropriateness, requires the services of a
to facilitate these activities:
A. Physical therapist
B. Occupational therapist
C. Physician
D. Case manager/coordinator

A

Answer: D
Rationale: It is the case manager’s/coordinator’s role to work with patients and/or families to obtain and monitor health, financial and social services. In addition, the case manager/coordinator provides assessments and develops and implements care planning.

162
Q

162.Based on a health fair screening, with the permission of the parent, a PT observes there is an obvious spinal curvature in a 13 year old female. It is the PT’s responsibility to:
A. Diagnose scoliosis
B. Suggest to the parent the child might have scoliosis
C. Refer the child for physical therapy services

A

Answer: D
Rationale: This is the most appropriate answer. It is not the role of the PT to make a diagnosis or to suggest a diagnosis to a parent. Referring a child for physical therapy services before referring the child to a primary care physician would also be inappropriate

163
Q

163.A claim is denied by a third party payer citing duplication of rehabilitation services. All of the following may account for this denial except:
A. There may have been duplicate CPT codes used between services without documentation of clear delineation of the goals
B. There may not have been adequate coordination of service delivery between disciplines
C. There was clear and accurate coding from the facility delivering the care
D. There were different codes for services but overlap in documentation

A

Answer: C
Rationale: Claims are rarely denied when clear and accurate coding is provided by a facility. All of the other responses infer some form of overlap or duplication of services.

164
Q

164.During a PT/client interview, a patient is relating his problems in narrative, and the PT demonstrates third person voice.
Third person voice:
A. Is the best choice because it appropriately distances the professional from the narrative
B. Is not the best choice because it appropriately distance the professional from the narrative
C. Should be replaced by first person voice so the pt can communicate sympathy during the narrative
D. Should be replaced by second person voice so the pt is restating the narrative while expressing empathy

A

Answer: A
Rationale: The third person voice provides appropriate distancing with expression of an appropriate level of interest, to effectively obtain necessary information from an interview

165
Q

165.A patient’s family complains a department that there has been a problem with miscommunication between the therapist and patient. A common for this is most likely:
A. Discomfort or uneasiness
B. Educational differences
C. Language
D. Political leanings

A

Answer: C
Rationale: Language differences are one of the most frequent reasons for miscommunication. As therapists lea how to communicate appropriately with lay individuals, educational differences should not be a problem. Discussions regarding political leaning should be avoided, and if a patient is uncomfortable or uneasy, these feelings do not usually lead to miscommunication.

166
Q

Each discipline is required to document in the medical record section identified for that discipline. This type of documentation record facilitates communication between different healthcare professionals and is called:
A. Integrated
B. Source Oriented
C. Problem oriented
D. Narrative

A

Answer: B
Rationale: Source oriented documents are divided by service or discipline. Integrated records combine all services into consecutive running entries. Problem oriented records were developed by Dr. Weed decades ago, and identified sets of problems that individual disciplines documented if they played a role in the management of that problem. The SOAP note commonly used in PT documentation today, is a hold over from the problem oriented record. Narrative is a format for health information entries that uses paragraph formatting.

167
Q

167.A team meeting to discuss a patient’s care and progress includes the physician, case manager, PT, OT, and nurse with the team sharing information and setting goals in order to prevent duplication of services. This is an example of which type of approach:
A. Interdisciplinary
B. Transdisciplinary
C. Multidisciplinary
D. Mixed disciplinary

A

Answer: A
Rationale: Interdisciplinarv (involving two or more academic disciplines that are considered distinct) is the correct answer.
Transdisciplinary approaches involve collaboration, consensus building, regular and open communication, and expanding roles across discipline boundaries. Multidisciplinary refers to the combining of several disciplines at once

168
Q

168.In the absence of or in between team meetings, the best way to communicate patient progress with other members of the healthcare team is through:
A. The patient’s physician
B. Documentation in the medical record
C. Seeking out individual team members for oral reports
D. Individual phone calls or email to team

A

Answer: B
Rationale: Documenting in a medical record is the most efficient method of communicating a patient’s progress to the other members of the healthcare team. All of the other responses convey information to individual members of the healthcare team and will require further dissemination.

169
Q

169.A facility emplovs a culturally diverse physical therapy staff. An Asian patient demonstrates hostile behavior toward a aucasian PT and demands to be changed to an Asian PT, insisting that the Asian PT is smarter. This is an example of
A. Ethnocentrism
B. Cultural bias
C. Prejudice
D. Discrimination

A

Answer: A
Rationale: Although all of the responses could be considered somewhat correct, ethnocentrism (the belief that one’s culture is superior to all others) is the correct answer

170
Q

In an acute care setting, the best time to enter the PT “Plan of Care (POC)” in the medical record is:
A. At the PT’s convenience so it can be thorough and clear to the other member of the healthcare team
B. By the next PT/patient session so any other PT could assume care in the absence of the evaluating PT
C. Immediately after completing the initial examination and evaluation to ensure timely communication offindings
D. By the end of the first day of the initial examination and evaluation regardless of when the session was conducted

A

Answer: C
Rationale: The entire healthcare team involved in a patient’s care uses the medical record and therefore entries must be made in a timely fashion.

171
Q

In order to affect the best therapeutic outcomes, at the outset of care, the best action a therapist should take is:
A. Determine goals based on examination findings
B. Provide primarily evidenced based interventions
C. Involve the patient in goal setting
D. Implementing interventions that generally work for them

A

Answer: C
Rationale: Whenever possible, the patient should always be involved in goal setting.

172
Q

172.A PT is observed with an older adult, attempting to transition the patient from sit to stand in order to initiate gait training.
The best method to accomplish this is:
A. Part to whole approach
B. Instruction to “stand up?
C. Independent discovery by patient
D. Lifting the patient to stand

A

Answer: B
Rationale: Automatic or routine activities, are performed as “whole” activities. Breaking an activity down into parts, can be confusing to the client, as automatic activities are completed in parts. If the client has any processing deficits, theyrespond to simple, single step instructions for which there is motor memory.

173
Q

173.A patient has limited respiratory reserve and motor control deficits following major trauma and hospitalization. The third party payer has approved a 7 day rehab stay during which the patient needs to achieve an appropriate functional level to return home. The best intervention training strategy and patient instruction includes emphasizing
(A. Therapeutic activities including repetitive appropriate functional tasks
B. Therapeutic activities including incremental activities of daily living
C. Therapeutic exercise focusing on increasing resistance
D. Therapeutic exercise focusing on aerobic capacity

A

Answer: A
Rationale: Repetition of functional tasks needed by an individual for return to home, incorporate strengthening and aerobic capacity while focusing on client needs. From a third party payer perspective, especially for Medicare, emphasis on function is encouraged and presents as relevant for the patient.

174
Q

Your patient is being treated for a humeral fracture. Her husband wants to look at her medical record. As her physical therapist vou should:
A. Give him the husband the chart as he has a right to view the information as a family member
B. Deny the husband access to the chart unless written permission is granted by his wife
C. Let the husband look at the chart with your supervision
D. Not let the husband view the chart in case he may misinterpret the information within the chart

A

Answer: B
Rationale: Based on privacy guidelines, the husband cannot have access to his wife’s chart unless the wife issues permission.

175
Q

You have been asked to instruct a new group of nurse aides in how to perform a safe transfer. You plan a session that includes some demonstration and practice. Effective documentation of this session should include:
A. The lesson objectives and the activities used
B. The lesson objectives, the activities and modifications needed, and the outcomes of the session
C. The length of time it took for the group to learn the activities
D. The ability of the group to leam new skills and their level of satisfaction

A

Answer: B
Rationale: This would be the most appropriate answer to include the objectives, activities, modifications, and the outcomes.

176
Q

You are performing an ultrasound at the L3 level of the lumbar spine for low back pain on a female patient whenthe patient suddenly informs you that she is looking forward to having her second child. On further investigation, you discover that the patient is in the first trimester of pregnancy. Which of the following is your best course of action?
A. Modifiy the ultrasound settings and continue with the treatment
B. Cease treatment, notify the patient’s orthopedic phsician, and document the mistake
C. Continue as before
D. Send the patient to the gynecologist for an immediate sonogram

A

answer: B

177
Q

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 is unlikely to increase the safety of the patient andtherapist?
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. Not using the unit in an area where there are puddles

A

answer: C

178
Q

178.A patient is referred to physical therapy with the diagnosis of a recent complete tear of the anterior cruciate ligament.
The patient and the physician have agreed to avoid surgery for as long as possible and the therapist has been asked to provide the patient with a home exercise program and instructions about activities based on this decision and diagnosis.
Which of the following is the best advice?
A. The patient should not worry and should continue to perform any activity until his knee gives out again.
B. The patient should not perform any athletic activity involving his knee again.
C. The patient should wear a brace and compete in only light athletic events
D. The patient should work hard at strengthening his hamstrings, but should wait until the ratio of his hamstring quadriceps measured isokinetically is equal before returning to athletic activities

A

Answer: C
Rationale: This is the best course of action. The brace will provide some protection and the light activity level is a good starting point prior to further progression.

179
Q

You read a clinical study investigating the relationship between ratings of perceived exertion (RE) and type of exercise: upper extremity (UE) isokinetics versus lower extremity (LE) isokinetics. The study reports a correlation of 0.40 with the UE isokinetics and a correlation of 0.85 with the LE isokinetics. From these findings, you could determine:
A. leg isokinetic exercises are highly correlated with RPE while arm isokinetic exercises are only moderately correlated.
B. both UE and LE isokinetic exercises are only moderatelv correlated with RPE.
C. both UE and LE isokinetic exercises are highly correlated with RPE.
D. The common variance of both types of testing is only .45.

A

Answer: A
Rationale: This is the correct answer based on the correlation values.

180
Q

You are interviewing a physical therapist for a job vacancy. As the interviewer, you should AVOID discussing:
A. Your company’s health insurance, continuing education, and vacation benefits
B. work hours associated with the position.
C. Parking arrangements for employees
D. the applicant’s marital status

A

Answer: D
Rationale: During an interview, you cannot enquire as to an applicant’s marital status.

181
Q

181.A male physical therapist is examining a female of Arabic descent. During the examination, the patient does not make eye contact with the therapist. The most appropriate action is to:
A. ask the patient if she would prefer a female therapist
B. continue with the examination
C. Discontinue the examination
D. Ask the patient to pay attention

A

Answer: B
Rationale: This would not be an appropriate reason to alter or discontinue the examination.

182
Q

182.A therapist is observed incorporating motor learning principles while emphasizing direct teaching of task specific activities. The therapist is employing the following strategy:
A. Fading feedback
B. Knowledge of results
C. Neurodevelopmental facilitation
D. Neuromotor task training

A

Answer: D
Rationale: Neuromotor task training encourages a patient to explore the environment and to solve specific movement problems, through therapist selected tasks. It is based on motor control and motor leaming principles.

183
Q

.For communication purposes, the following describes the most appropriate position for the therapist and client/patient:
A. If the client/patient is sitting, the therapist should be standing
B. If the client/patient is sitting, the therapist should be sitting
C. If the client/patient is standing, the therapist should be sitting
D. If the client/patient is supine, the therapist should be supine

A

Answer: B
Rationale: From a patient/therapist interaction perspective, the patient and therapist should be as close to eye level as possible. This prevents the patient from assuming awkward postures such as neck extension and promotes eye contact which facilitates communication in western culture.

184
Q

184.A therapist is focusing on intrinsic feedback for motor leaming. The expectation for learning is based on:
A. Verbal instructions from the therapist
B. Tactile cues or tactile guidance
C. Somatosensory information from the limbs
D. Verbal description of the task from the patient

A

Answer: C
Rationale: Intrinsic refers to the client’s internal feedback and sensory systems. This type of feedback has been found to be effective as a motor learning strategy.

185
Q

185.A PT will be screening falling risk of community dwellers at a local senior citizen center health fair. 15 minutes, in a limited space, are planned for each participant. The documented results of which of the following tests and measures will most clearly communicate to the participants and other healthcare providers the participant’s fall risk status in the total allotted time?
A. Functional Reach test; Barthel Index; Six Minutes Walk test
B. Timed Get-Up-and - Go test; Functional Reach test
C. Get-Up-and -Go, SF 36, FIM
D. OASIS; BERG balance; Functional Reach test

A

Answer: B
Rationale: The Timed Get Up and Go test and Functional Reach are reliable and valid for the geriatric population. They take only minutes, and can easily be administered in most settings. As the outcomes are numeric and there are established norms, clients can take the information to the appropriate healthcare professional for follow up care. The Barthel Index is an ADL oriented questionnaire, the Six Minutes Walk Test screens for aerobic capacity and distance that can be accomplished over six minutes, the SF 36 is a quality of life instrument, not fall risk, the FIM is used for inpatient rehabilitation outcomes, the OASIS is a questionnaire used in home health, and the BERG Balance, although it does assess fall risk, can take up to 15 minutes to administer by itself.

186
Q

In a completed documentation utilization review audit, the following entry is identified in the plan of care in on a completed patient initial examination and evaluation, Patient will demonstrate competence with home instructions by verbalizing and demonstrating them to the therapist. Relative to this statement and its placement, the statement is an example of:
A. An intervention and therefore should be in the intervention section
B. An intervention and belongs in the long term goal or outcomes section
C. A goal or outcome and therefore belongs in the intervention section
D. Agoal or outcome and therefore belongs in the goal or outcomes section

A

Answer: D
Rationale: The statement is an example of a goal/outcome as it does not describe how’ and therefore belongs in the goal outcome section.

187
Q

In 4 weeks, increase LLE quadriceps strength from 3-/5 to 4/5 in order to facilitate stability in weight bearing during stance phase of gait and prevent loss of balance, is an example of a patient goal that is:
A. poorly written as it does not include functional elements
B. poorly written as it does not state that it is the patient’s goal
C. well written as it contains the impairment based goal and functional goal
D. well written as it emphasized the impaiment based goal

A

Answer: C
Rationale: This is the correct response as the written goal is objective and contains an impairment based and functional goal.

188
Q

The relationship between PT/HCPCS coding and ID 9 coding in PT documentation is that:
A. ICD 9 procedural coding must match the PT/HCPCS diagnostic coding for reimbursement and determinationof appropriateness of procedures
B. ICD 9 diagnostic coding must be disease specific in order to determine CPT/HCPCS coding
C. CPT/HCPCS procedural coding must match the ICD 9 diagnostic coding to determine appropriateness ofprocedures
D. CPT/HCPCS diagnostic coding is critical in determining the correct ICD 9 coding to ensure appropriateness of procedures

A

Answer: C
Rationale: The Current Procedural Terminology (CPT) codes (developed, maintained and copyrighted by the AMA) and the Healthcare Common Procedure Coding System (HCPCS) numbers (codes used by the Centers for Medicare and Medicaid Services) provide a uniform language that accurately describes medical, surgical, and diagnostic services. The ICD-9 (International Classification of Diseases, 9th Revision) coding system is used to code signs, symptoms, injuries, diseases, and conditions (not procedures). The critical relationship between an ICD-9 code and a CPT/HCPCS code is that the diagnosis supports the medical necessity of the procedure.

189
Q

189.A traveling PT has moved from one Medicare region, Region I, to Medicare Region V for an outpatient assignment.
Because the regions are both Medicare, relative to documentation and reimbursement for PT services the following best describes the PT’s responsibilities: The documentation content requirements:
A. Are the same. but the services reimbursed mav be different
B. Are the same, but the services reimbursed are determined by the regional intermediary
C. Varies by region, but the services reimbursed are the same
D. Varies by region, but the services reimbursed are determined by the regional intermediary

A

Answer: B
Rationale: Although the documentation content requirements do not change from Medicare region to region, the regional intermediary determines the reimbursement from Medicare.

190
Q

.Authentication of medical record entries is verified by:
A. External audit
B. Internal audit
C. Health information management
D. Written or electronic signature

A

Answer: D
Rationale: The authentication of a medical record entry is verified by a written or electronic signature

191
Q

191.A PT intervention session was denied by the payer. During the resulting internal audit, which of the following was most likely identified as the reason for the denial?
A. Patient self report of progress in the S section matched all goals
B. Information in the O section was obiective and measurable
C. The assessment component clearly identified patient progress
D. The plan component identified areas of treatment focus

A

Answer: A
Rationale: Once a patient self reports that all of their PT goals have been met by description of their activities, they no longer qualify for skilled PT services. B - D are all appropriate for the designated SOAP note sections

192
Q

All the following are examples of non CPT verbiage except:
A. Transfer training
B. Bed mobility training
C. Total assist lift x 2 bed to stretcher
D. Therapeutic activities

A

Answer: D
Rationale: The American Medical Association CT verbiage matches the CP numbered codes categories for interventions.
Therapeutic activities is the only category listed that corresponds to a CPT code. The other activities listed are interventions or descriptions that would be documented under the CPT codes for therapeutic activities.

193
Q

During a focused review by a Medicare intermediary, one of the primary long term goals for an outpatient was to return to golf. Based on Medicare principles, this goal is considered?
A. Acceptable as it is functional, is patient centered and should be reimbursable
B. Acceptable as it is leisure oriented, is patient centered and should be reimbursable
C. Unacceptable as it is leisure oriented although it is patient centered and non-reimbursable
D. Unacceptable as it is an incremental activity of daily living andnon-reimbursable

A

Answer: C
Rationale: Medicare does not consider leisure activities appropriate justification for skilled PT services. This information is consistent with published CMS guidelines.

194
Q

Assessment tools or instruments should be used for baseline documentation during patient’s examination and evaluation.
Some of the advantages and disadvantages of using assessment tools are:
A. Provide objective data and systematic approach to data collection; improve reliability, but documented scores can not be compared over time
B. Provide objective data and systematic approach to data collection, improve reliability, but may not capture or document the abilities because of a ceiling effect
C. Provide subjective data and systematic approach to data collection; improve reliability, but documented scores can not be compared over time because of a ceiling effect
D. Provide subjective data and systematic approach to data collection; adds flexibility, but documented scores can not be compared over time

A

Answer: B
Rationale: The use of standardized assessment tools, especially those are both reliable and valid, facilitate justification of skilled PT services, and provide baselines and outcome information to show patient progress as they can be compared over time. However, there may be components of certain tools that are not sensitive enough to capture deficits or changes.

195
Q

195.A patient is difficult to arouse from a somnolent state, is frequently confused when awake, and repeated stimulation is required to keep the patient awake. The correct term to document this state of arousal is:
A. Coma
B. Stupor
C. Obtunded
D. Lethargic

A

Answer: C
Rationale: The statement defines an obtunded state.

196
Q

Based on a Medicare medical record audit, the auditor has determined that the record does not contain goals directed toward essential functions. This means that the following element was not included in the documented goals:
A. What the patient has to do for self care to function
B. What the patient wants to do relative to function
C. What the therapist wants the patient to do
D. What the patient’s leisure activities are

A

Answer: D
Rationale: Medicare does not consider leisure activities appropriate justification for skilled PT services. This information is consistent with published CMS guidelines.

197
Q
  1. The following practice variable enhances long-term retention and learning of a new task:
    A. Blocked practice
    B. Guided leaming
    C. Part to whole learning
    D. Random practice
A

Answer: D
Rationale: Under conditions where the environment is dynamic and the individual is required to adapt to variations in the surroundings, random practice schedules are superior to the other types of practice sessions for learning and retention of a new task.

198
Q

198.A Spanish speaking patient with involved family is receiving PT from an English speaking PT. They are able to communicate during treatment sessions by gesturing, demonstration and tactile cueing. The patient and her Spanish speaking family require home instruction. The best course of action is:
A. Demonstration with patient and family, having them demonstrate, reinforced by pictures
B. Giving the patient and family the standard English home instructions withpictures
C. Giving the patient and family a Spanish translated version of the home instructions
D. Demonstration to the patient and trusting the patient to communicate with family

A

Answer: A
Rationale: Given the fact that the patient and family are able to communicate during treatment sessions by gesturing, demonstration and tactile cueing, the same method

199
Q

Consideration for a PT in directing the type of patient/client instruction may include all of the following except:
A. Potential learning barriers
B. Support systems
C. Transitioning across settings in a continuum of care
D. No benefit from PT is possible

A

Answer: D
Rationale: All would be considerations except in the case where no benefit from PT is possible.

200
Q

200.A 38 yo patient is actively participating in his PT, but has not been adherent to home exercise instruction. Which of the following would not be a justification for this behavior? Provision of:
A. 4 pages of pictures and descriptions including 20 exercises to be done daily, multiple reps
B. Exercises that could easily be incorporated into the patient’s daily routine
C. Unclear understanding of the instructions
D. Increased pain and excessive fatigue after completion

A

Answer: B
Rationale: All of the responses would be a justification for non-compliance except in the case where the patient’s exercises could easilv be incorporated into his daily routine.

201
Q

201.All of the following are examples of objective documented assessments except:
(A. Tolerated treatment well without an complaints
B. Demonstrated improved aerobic capacity by stabilization of pulse during exercise
C. Increased gait distance by 50 feet with a continuous 3 point pattern with rollator
D. Able to increase resistance from 3 # to 8# over course of week for LE exercise

A

Answer: A
Rationale: This is a subjective assessment, whereas all of the others are objective.

202
Q

202.A patient with Parkinson’s disease is in the control group of a clinical study testing the effectiveness of a new medication. The patient reports that the medication makes her feel much better and allows her to move easier. Her responses are MOST likely due to:
A. sampling bias
B. Huntington effect.
C. placebo effect.
D. the medication is working

A

Answer: C
Rationale: The placebo (Latin for I shall please) effect is the measurable, observable, or felt improvement in health or behavior not attributable to a medication or treatment that has been administered.

203
Q

203.Each of the following includes a principle of the code of ethics of the American Physical Therapy Association, except:
A. maintain high standards when providing therapy
B. provide services for the length of time ordered
C. Respect the rights of patients
D. accept fair monetary compensation for services

A

Answer: B
Rationale: According to the The Guide for Professional Conduct, a physical therapist shall determine when a patient/client will no longer benefit trom physical therapy services.

204
Q

204.A valid informed consent for research purposes should include all of the following elements EXCEPT:
A. a statement ensuring the subject’s commitment to participate for the duration of the stud.
B. a clear explanation of the purpose and procedures to be used
C. all potential risks
D. all potential benefits of participation

A

Answer: A
Rationale: An informed consent does not include a statement ensuring the subject’s commitment to participate for the duration of the study.

205
Q

All of the following criteria would designate a patient as homebound and allow for home physical therapy services tobe approved by Medicare with the EXCEPTION of:
A. An inability to safely leave home unattended.
B. dependency on others for all transportation needs.
C. ambulation for shot distances causes dyspnea
D. the patient leaves the home three times a week to receive dialysis

A

Answer: B
Rationale: All are criteria that would designate a patient as homebound and allow for home physical therapy services to be approved by Medicare, except dependency on other for transportation.

206
Q

As a newly promoted department manager, you are asked to develop an operating budget for the upcoming fiscal year
All of the following items would be included, EXCEPT:
A. Staffing costs
B. Housekeeping supplies
C. Equipment maintenance
D. All should be included

A

Answer: D
Rationale: All are considered part of the operating budget.

207
Q

Long term care for institutionalized elderly who qualify for low-income status is tvpically funded by:
A. Social Securitv Administration
B. Health Maintenance Organizations
C. Medicaid
D. Medicare part B

A

Answer: C
Rationale: Reimbursement of this type is one of the functions of Medicaid.

208
Q

PT documentation entry for a Medicare beneficiary: 2/19/08 Jones, JohnS: Patient complained of increased pain, to
9/10 in left shoulder subsequent to bowling 3 games yesterday. O: Electrical stimulation, ultrasound, soft tissue mobilization and therapeutic exercise to left shoulder. A: Pain increased from 4/10 2 days ago to 9/10 after bowling.
Therefore, therapeutic exercise was reduced to passive stretching today.P: Continue the treatment as indicated in the POC. Patti Smith, DPT, 1234
A. all the elements of a skilled SOAP note, it will be reimbursed
B. the elements of a SOAP note but the S is related to a leisure activity and the extremity being treated, it will likely not be paid and all future reimbursement is questionable
C. intervention terminology that matches CPT language and indicates the extremity treated, it will be reimbursed
D. data documented by a DPT and a license number it is likely to be reimbursed

A

Answer: B
Rationale: The ‘S’ part of the SOAP note should be used to describe the consequence of the injury in terms of a restriction or loss of ADL function, not a leisure restriction, in order to obtain reimbursement.

209
Q

Regarding the physical therapist’s signature Patti Smith, DPT, 1234, the following statement is most appropriate based on the APTA recommendations and legal principles: As the therapist graduated with a DPT degree, it is:
A. The APTA recommended signature and therefore correct
B. An educational designation and should, if at all, follow the designation of ‘PT”
C. the highest entry level degree so it supersedes any other physical therapy designation
D. Acceptable because the therapist’s license number is included

A

Answer: B
Rationale: The APTA recommends the use of ‘PT’ after the clinician’s name DPT is an educational designation.

210
Q

All of the folowing would be important to determine from a peer review examining the care reived in relationto reimbursement levels imposed by third party payers, except:
A. the care was provided by the appropriate personnel.
B. the care was cost effective.
C. the care was appropriate and required the skill of a physical therapist.
D. the care should be paid for by a third partypayer.

A

Answer: D
Rationale: Whether the care should be paid for by a third party payer would not be the focus of a peer review. The peer review is conducted to determine the processes behind such systems as quality assurance and risk management.

211
Q

You and another therapist perform a test on the same group of children using the Pediatric Evaluation of Disability Inventory (PEDI). The results of both sets of measurements reveal differences in your scores compared to the other therapist, but not in the repeat measurements. This is indicative of a problem in:
A. construct validity.
B. intrarater reliability.
C. concurent validity.
D. interrater rehabilitv.

A

Answer: D
Rationale: Reliability may be measured as repeatability between measurements performed by the same examiner (intrarater reliability), or between measurements by different examiners (interrater reliability).

212
Q

You have been asked by a colleague to ambulate a patient for the first time after a right total hip replacement. The patient is using crutches and he is wearing a gait belt. How should you guard the patient?
A. standing slightly behind and to the right side, and with one hand on the gait belt.
B. Standing behind and to the intact side, one hand on the gait belt.
C. In front of the patient, walking backward, with one hand on the gait belt and one hand on the shoulder.
D. Keep out of the patient’s way by standing behind him, while keeping bothhands on the gait belt.

A

Answer: A
Rationale: This is the safest position to adopt for the patient.

213
Q

You decide to perform a study looking at the effects of an 8 week exercise training program using exercise heart rates as a measures of performance on a group of 30 ear olds and a group of 40 year olds. Your hypothesis states that there will be no significant difference between the 2 groups after the training program. The kind of hypothesis that is being used in this study is a (an):
A. null hypothesis.
B. alternative hvpothesis.
C. experimental hypothesis.
D. research hypothesis.

A

Answer: A
Rationale: A null hypothesis is a statistical hypothesis that states that there is no difference between a parameter and a specific value, or that there is no difference between two parameters. In statistical hypothesis testing, the null hypothesis is initially believed to be true, and the researcher sees if the data provide enough evidence to abandon the belief in favor of the alternative hypothesis.

214
Q

Your patient, who has a history of epilepsy has a convulsive seizure during a therapy session, losing consciousness and presenting with tonic-clonic convulsions of all his extremities. Your BEST response is to;
A. Check to see if the airway is open, prevent aspiration, and instruct someone to immediately call for emergency assistance
B. Go and get help
C. Restrain the patient’s limbs
D. Place a damp face towel in the patient’s mouth so he doesn’t bite histiongue.

A

Answer: A
Rationale: During these events the PT must establish an airway and prevent aspiration, then remain with the patient and protect the patient from injury until help arrives.

215
Q

You decide to perform a study to determine whether contract-relax techniques produce an improvement in muscle length of the hamstrings that lasts longer than 30 minutes. In this study muscle length of the hamstrings is the:
A. dependent variable.
B. independent variable.
C. uncontrolled variable.
D. controlled variable.

A

Answer:A
Rationale: The dependent variable is the variable that is measured by the researcher.

216
Q

Nursing homes that receive Medicare reimbursement are required by law to provide rehabilitation services foreligible residents based on:
A. Determination by a physical therapist that the care is both skilled and necessary.
B. A referal from a physician.
C. The patient’s diagnosis related group (DRG.
D. Every patient’s needs as determined bythe patient’s family

A

Answer: A
Rationale: Although Medicare reimbursement does require a referral from a physician, that alone is not sufficient–Medicare reimburses only physical therapy care that is considered to be skilled and necessary.

217
Q

217.A comparison of the effects of ultrasound, electrical stimulation, or both on the rehabilitation outcome of patients with lateral epicondylitis revealed that less ROM was noted after 6 weeks in the ultrasound group. An appropriate statistical test to compare the ROM measurements of the three groups 1s:
A. Analysis of variance.
B. Chi square.
C. Spearman rho.
D. Analysis of covariance.

A

Answer: A
Rationale: When it is necessary to test the hypothesis concerning the means of three or more populations, the technique is called analysis of variance (ANOVA). ANOVA is a useful tool that helps the user to identify sources of variability from one or more potential sources, sometimes referred to as “treatments” or “factors.”

218
Q

You are designing a research study that will examine the effect of contrast baths on edema following an ankle sprain
The most appropriate method to collect data is:
A. anthropometric measurements
B. circumferential measurements
C. goniometric measurements
D. volumetric measurements

A

Answer: D
Rationale: Volumetric measurements provide the most accurate data as compared to the other suggestions.

219
Q

You are performing an accessibility analysis at a local business. In order to meet minimum accessibility standards, the bathroom sink should have a knee clearance height of at least:
A. 23 inches
B. 29 inches
C. 35 inches
D. 39 inches

A

Answer: B
Rationale: 29 inches is the required height according to ADA regulations.

220
Q

You are attempting to examine the relationship between scores on the Harris Infant Neuromotor Test and another measurement whose validity is known. This type of example best describes:
A. face validity
B. predictive validity
C. concurrent validity
D. content validity

A

Answer: C
Rationale: Concurrent validity is the degree to which the measurement being validated agrees with an established measurement standard.

221
Q

You have devised a research study to determine the effect of visual acuity on the ability to perform a physical skill. In the study, visual acuity is the:
A. independent variable
B. dependent variable
C. criterion variable
D. extraneous variable

A

Answer: A
Rationale: Independent variables are controlled or fixed in order to observe their effect on dependent variables. For example, a treatment or program or cause.

222
Q

The type of pain questionnaire that utilizes an ascending numeric scale ranging from 0 equaling no pain to 10 equaling excruciating pain is best described as what type of measurement scale?
A. nominal
B. ordinal
C. interval
D. ratio

A

Answer: B
Rationale: An Ordinal scale classifies data into categories that can be ranked, although precise differences between the ranks do not exist, e.g., letter grades (A, B, C, etc.), body builds (small, medium, large).

223
Q

You are scheduled to treat a patient requiring droplet precautions. What type of protective equipment would be necessary to don prior to entering the patient’s room?
A. gloves
B. mask
C. gloves and mask
D. gloves, gown, and mask

A

Answer: B
Rationale: In addition to Standard Precautions, Droplet Precautions are used for patients known or suspected to be infected with serious illness microorganisms transmitted by large particle droplets. A gown is worn to protect skin and prevent soiling of clothing during procedures and patient care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, and excretions.

224
Q

Which of the following duties cannot be legally performed by a physical therapist assistant?
A. Add 3 pounds to a patient’s current exercise protocol
B. Instruct a patient to increase in frequency from 2 times/week to 3 times/week
C. Perform an ultrasound
D. Confer with a doctor about a patient’s status

A

Answer: B
Rationale: All of the other responses are out of the scope of a PTA.

225
Q

CORF is an abbreviation for which of the following?
A. Corporately Owned Rehabilitation Facility
B. Certified Organization of Rehabilitation Facilities
C. Certified Outpatient Rehabilitation Facility
D. Controlled Organization for Rehabilitation Facilities

A

Answer: C
Rationale: CORF is the abbreviation for Certified Outpatient Rehabilitation Facilitv.

226
Q

226.A patient living in a nursing home who has Medicare part A as the source of reimbursement is treated by physical therapy only. What is the required minimal frequency of physical therapy treatment?
A. Three times a week
B. Five times a week
C. Seven times a week
D. There is no standard set frequency

A

Answer: B
Rationale: The required minimal frequency under Medicare Part A is five times a week.

227
Q

How often does the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) survey hospitals?
A. Every year
B. Every 2 years
C. Every 3 years
D. Every 4 years

A

Answer: C
Rationale: The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) survey hospitals every 3 years.

228
Q

228.A patient is scheduled to undergo a liver transplant and is understandably concerned. During your treatment session, the patient and family appear to be looking to you for comfort. Which of the following is an appropriate response from you to the patient?
A. Your surgeon knows what she is doing, and she will take care of you.
B. I realize you are facing a challenging situation, and that you must be concerned, but your family and friends are here to support you
C. Don’t worry, everything will be fine.
D. Hundreds of patients have had this procedure and done just fine

A

Answer: B
Rationale: This is the best response as it demonstaites empathy and support.

229
Q

How often does the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) require that all electrical equipment in hospitals be inspected?
A. Ever 12 months
B. Every 2 years
C. Every 3 years
D. Every 4 years

A

Answer: A
Rationale: The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requires that all electrical equipment in hospitals be inspected every year.

230
Q

You have just been told you are to receive a promotion to team leader. All of the following are examples of effective leadership except:
A. Early conflict resolution
B. Encouragement of creativity and innovation
C. The provision of little control or feedback
D. Providing subordinates an opportunity for growth

A

Answer: C
Rationale: An effective leader must provide control and feedback.

231
Q

While treating a patient in the ICU, you accidentally pull out the patient’s catheter. Which of the following problems can occur if a catheter becomes disconnected or accidentally removed?
A. Hemorrhage
B. Air emboli
C. Catheter contamination
D. All of the above

A

Answer: D
Rationale: All are problems that can occur it a catheter becomes disconnected or accidentally removed.

232
Q

You are working in an outpatient clinic and your supervisor tells you never to charge less than 6 charges per visit for all of your patients. You should:
A. Schedule a time to speak to your supervisor about the fact that this policy is in conflict with the Code of Ethics.
B. Ignore your supervisor’s instructions and continue to charge your patients in a manner you feel is appropriate
C. Resign from the clinic and report the supervisor to the state’s licensing board.
D. Carry out the supervisor’s instructions

A

Answer: A
Rationale: This would be the most appropriate response.

233
Q

You are about to examine a patient in his room who was admitted to the hospital the day before with severe low back pain of unknown etiology Upon reviewing the patient’s chart, you note that tests carried out earlier that day reveal he is at the end stage of pancreatic cancer when you begin your examination, it is clear that the patient does not know he has cancer. If the patient asks you what his prognosis is, your BEST response would be to;
A. Tell him to ask the nurse
B. Tell him to ask his physician
C. Tell him that everything will be fine
D. Avoid answering the question

A

Answer: B
Rationale: This would be the most appropriate response.

234
Q

Your patient had a fall while getting off the treadmill. With the exception of a slight cut and some bruising the patient was OK. The incident report of the event should include:
A. The name of those involved, any witnesses, and what, when and where the incident occurred
B. The cause of the incident, the corrective actions taken, and the names of the staff involved.
C. The witnesses and where it occurred
D. This does not qualify for an incident report as the patient was not seriously hurt

A

Answer: A
Rationale: The incident report must include information about the name of those involved, any witnesses, and what, when and where the incident occred.

235
Q

As the Director of a department you have noticed a recent spate of accidents in your department involving the exercise equipment. All of the following would be appropriate courses of action, except:
A. Scheduling regular (at least annually) equipment inspections
B. Reminding staff about the importance of adhering to policies and procedures addressing the maintenance ofexercise equipment
C. Safety training for staff in the use and care of the equipment
D. All of the above would be appropriate steps to take

A

Answer: D
Rationale: All of these would be appropriate.

236
Q

You have been asked to develop an incontinence program in the local community. The correct sequence of steps to take include:
A. Needs assessment, program evaluation, program planning, program implementation
B. Needs assessment, program planning, program implementation, program evaluation
C. Program planning, needs assessment, program implementation, programevaluation
D. Program planning, needs assessment, program evaluation, program implementation

A

Answer: B
Rationale: This would be the correct sequence.

237
Q

237.A local sales rep offers to take you out for dinner because you are using his products throughout your clinic. What should be your response?
A. Politelv decline the offer
B. Ask if the sales rep would also take the rest of the staff to dinner
C. Accept the invitation, it’s the least the sales rep could do
D. Ask the sales rep if there are any other items you should place in your clinic

A

Answer: A
Rationale: This would be the most appropriate response according to the The Guide for Professional Conduct.

238
Q

All of the following are recognized gait deviations resulting from disease, except:
A. Tabetic
B. Festinating
C. Waddling
D. Strutting

A

Answer: D
Rationale: Strutting is not a recognized gait deviation resulting from disease.

239
Q

All of the following are examples of autosomal recessive diseases except:
A. Muscular dystrophy
B. Cystic fibrosis
C. Sickle cell anemia
D. Leukemia

A

Answer: D
Rationale: Leukemia is not inherited. Autosomal recessive inheritance means that the gene is located on one of the autosomes (chromosome pairs 1 through 22). This means that males and females are equally affected.

240
Q

All of the following are examples of medical terminology seen in the NICU, except
A. ROP-Retinopathy of prematurity
B. AGA-Appropriate for gestational age
C. PDA-Patent ductus arteriosus
D. All are examples of medical terminology seen in the NICU

A

Answer: D
Rationale: All are examples of medical terminology seen in the NICU.

241
Q

All of the following are considered to be functions of a healthy liver, except:
A. Breakdown ofbile
B. Detoxification of numerous drugs and hormones
C. Carbohydrate, protein, and fat metabolism
D. Synthesis of clotting factors, and plasma proteins

A

Answer: A
Rationale: The liver functions in the formation of bile.

242
Q
  1. All of the following are signs and symptoms of vitamin D deficiency except:
    A. Osteomalacia
    B. Muscular tetanv
    C. Keratomalacia
    D. Spontaneous fractures
A

Answer: C
Rationale: Keratomalacia is caused by a vitamin A deficiency.

243
Q

All of the following are examples of anthropometric measurements, except
A. Height
B. Weight
C. Pain
D. Waist circumference

A

Answer: C
Rationale: Anthropometrics are measurable physiological characteristics.

244
Q

Which of the following structures provide anterolateral stability to the knee?
A. Anterior cruciate ligament, lateral collateral ligament, and iliotibial band
B. Posterior cruciate ligament, medial collateral ligament, and biceps femoris tendon
C. Anterior cruciate ligament, medial collateral ligament, and gastrocnemius
D. Posterior cruciate ligament, lateral collateral ligament, and lateral meniscus

A

Answer: A
Rationale: The anterior cruciate ligament, lateral collateral ligament, and iliotibial band provide anterolateral stability to the knee.

245
Q

Which of the following types of current has the lowest total average current?
A. Interferential
B. Low volt
C. High volt
D. Russian

A

Answer: C
Rationale: High volt current uses an extremelv short pulse duration with a monophasic waveform.

246
Q

All of the following are signs and symptoms of an impending heart attack, except:
A. Shortness of breath
B. Sweating and nausea
C. Chest and jaw pain
D. All are considered signs and svmptoms of an impending heart attack

A

Answer: D
Rationale: All of these signs and symptoms have a strong correlation with an impending heart attack.

247
Q

Supine hypotension (also known as inferior vena cava syndrome may develop in the supine position, especially after the first trimester. All of the following signs and symptoms of supine hypotension, except
A. Bradycardia
B. Tachveardia
C. Shortness of breath
D. Headache

A

Answer: B
Rationale: All of signs and symptoms of supine hypotension except tachycardia.

248
Q

You are reading a patient’s electrocardiogram. The patient is diagnosed with congestive heart failure and has been prescribed digitalis. Which of the following effects would vou expect the medication to have on the patient’s ECG?
A. Irregular or absent P waves
B. Lengthened QRS interval
C. Elevated ST segment
D. Increased refractory period of the AVnode

A

Answer: D
Rationale: Digitalis has the primary effect of strengthening the force of contractions by increasing the amount of calcium supplied to the heart muscle, thereby increasing the refractory period of the A V node.

249
Q

You are reading a patient’s electrocardiogram. All of the following are associated with abnormalities in the ORS complex, except:
A. bundle branch block (when wide)
B. ventricular origin of tachycardia
C. ventricular hypertrophy or other ventricular abnormalities
D. atrial problems

A

Answer: D
Rationale: The shape of the P waves may indicate atrial problems.

250
Q

Which of the following lung pathologies results in an increase in the patient’s total lung capacity when compared to established norms?
A. Emphysema
B. Asthma
C. Atelectasis
D. Pulmonary fibrosis

A

Answer: A
Rationale: Emphysema is characterized by a chest wall that becomes fixed in a hyperinflated position