DUTTON SET B (251-500) Flashcards
1
Q
On which bone is the tine of the vibrating tuning fork placed when administering the Rinne test?
A. Spinous process of C2
B. Mastoid process
C. Center of the forehead
D. Stapes
A
Answer: B
Rationale: The Rinne test is used to assess the integrity of the vestibulocochlea nerve (CN VIII) by comparing bone conduction hearing with air conduction hearing.
2
Q
Broca’s aphasia (expressive aphasia) is a common manifestation resulting from a CVA that affects which of the following arteries?
A. Basilar artery
B. Posterior cerebral artery
C. Middle cerebral arterv
D. Anterior cerebral artery
A
Answer: C
Rationale: Broca’s area receives its blood supply from the middle cerebralartery.
3
Q
What is the name given to the type of skin graft that uses cadaverskin?
A. Allograft
B. Autograft
C. Xenograft
D. Homograft
A
Answer: A
Rationale: An allograft is a graft between two genetically dissimilar individuals of the same species.
4
Q
You have been asked to present an in-service on three out of four published Journal articles that your director has given you. You make your choice by eliminating the research study with the poorest level of evidence grading. Of the following types of study, which has the poorest level of evidence grading?
A. Case report
B. Case study
C. Cohort study
D. Randomized controlled trial
A
Answer: A
Rationale: The case report has the poorest level of evidence grading. All those listed the randomized control trial has the highest.
5
Q
You are treating a patient in acute care hospital. The patient’s vital signs are being monitored prior to physical therapy.
Which of the following temperature values would be classified as normal?
A. 36°C
B. 37°C
C. 38°C
D. 39°C
A
Answer: B
Rationale: 37°C (98.6°F) is considered normal.
6
Q
You are examining a patient who is three days status post head injwry. You note that the patient is demonstrating decorticate posturing. This type of posturing is characterized by:
A. The upper extremities positioned in extension and the lower extremities positioned in flexion
B. The upper extremities positioned in flexion and the lower extremities positioned in flexion
C. The upper extremities positioned in extension and the lower extremities positioned in extension
D. The upper extremities positioned in flexion and the lower extremities positioned in extension
A
Answer: D
Rationale: Decorticate posturing is usually indicative of a lesion at or above the upper brainstorm. It is characterized by abnormal flexor responses in the upper extremities and extensor responses in the lower extremities.
7
Q
All of the following are considered part of the rotator cuff, except.
A. Infraspinatus
B. Teres major
C. Subscapularis
D. Supraspinatus
A
Answer: B
Rationale: The ters major is considered part of the rotator cuff. It is the teres minor that is part of the rotator cuff.
8
Q
You are treating a patient with C5 tetraplegia who begins to demonstrate signs and symptoms of autonomic dysreflexia.
Which of the following vital signs, if monitored, would validate the presence of this condition?
A. Pulse rate
B. Respiratory rate
C. Blood pressure
D. Body temperature
A
Answer: C
Rationale: In this medical emergency, blood pressure often rises dramatically.
9
Q
Which axis of movement is utilized with shoulder abduction?
A. Sagittal-horizontal
B. Frontal
C. longitudinal
D. Oblique
A
Answer: A
Rationale: Shoulder abduction typically occurs around a sagittal-horizontal axis.
10
Q
During pregnancy, the presence of the hormone relaxin can lead to abnormal joint hypermobility and pain, MOST frequently affecting the
A. Sacroiliac joints
B. Shoulder joints
C. Joints of the hands and feet
D. Temporomandibular joints
A
Answer: A
Rationale: The sacroiliac joint is the most affected due to its heavy reliance on ligamentous support.
11
Q
As part of the plan of care for a patient with low back pain, you elect to use conventional TENS. Theoretically, how does conventional TENS modulate the pain?
A. Spinal gating control
B. Descending inhibition
C. It takes the patient’s mind off the pain
D. stimulation of the endorphin system
A
Answer: A
Rationale: Spinal gating control occurs through stimulation of the large myelinated A alpha fibers, which inhibits transmission of the smaller pain transmitting unmyelinated C fibers, and myelinated A delta fibers.
12
Q
Which of the following statements is not a common physiologic change of aging?
A. Increase in resting and exercising blood pressure
B. Decrease in residual volume
C. Osteopenia
D. Maximal oxygen uptake decreases
A
Answer: B
Rationale: The residual volume does not decrease with aging–it doubles.
13
Q
What is the term used to describe the condition in which there is too much carbon dioxide in the systemic arteries, which is generally caused by hypoventilation, lung disease, diminished consciousness, or by rebreathing exhaled carbon dioxide.
A. Нурохета
B. Hypercapnia
С. Нуроха
D. Dyspnea
A
Answer: B
Rationale: Hypercapnia is the correct term.
14
Q
The following are true statements conceining pulmonary function tests, except:
A. FEV1 results are verv low in patients with asthma and emphvsema
B. FEV1/FVC % results are low in patients with asthma and emphysema
C. TLC results are low in patients with asthma and emphysema
D. FEV1FVC % results are high in patients with restrictive fibrosis
A
Answer: C
Rationale: TLC results are normal or high in patients with asthma and emphysema.
15
Q
Which of the following diagnostic imaging techniques would not be considered invasive?
A. arthrography
B. myelography
C. discography
D. computerized tomography
A
Answer: D
Rationale: All of the other procedures involve an injection of a substance.
16
Q
Which of the following treatment objectives would be the most likely to be reimbursed by a third party paver?
A. maintain strength of major muscle groups
B. prevent scar tissue and contractures
C. maintain range of motion
D. improve cardiovascular endurance
A
Answer: D
Rationale: Reimbursement is unlikely for objectives that just maintam status, or for prevention.
17
Q
You are attempting to auscultate over the aortic valve on a patient. The most appropriate area to auscultate is:
A. second right intercostal space at the right sternal border
B. second left intercostal space at the left sternal border
C. fourth left intercostal space along the lower left sternal border
D. fifth left intercostal space at the midclavicular line
A
Answer: A
Rationale: This is the correct location.
18
Q
The most consistent laboratory finding with a patient who has been diagnosed with chronic respiratory alkalosis is:
A. elevated arterial blood pH, low PaCO,
B. low arterial blood pH, elevated PaCOz
C. elevated arterial blood pH, elevated PaCO2
D. low arterial blood pH, low PaCO2
A
Answer: A
Rationale: This is the lab finding associated with chronic respiratory alkalosis.
19
Q
A patient recently diagnosed with a deep venous thrombophlebitis is placed on heparin. The primary side effect associated with heparin is:
A. hypotension
B. hypertension
C. excessive anticoagulation
D. Increased sweating
A
Answer: C
Rationale: Heparin is an anti-coagulant.
20
Q
What is the minimal blood glucose level that is considered too high for a diabetic patient to begin exercise?
A. 250 mg/dl
B. 400 mg/dI
C. 500 mg/dI
D. 600 mg/di
A
Answer: A
Rationale: A blood glucose level of 250 mg/dl is considered too high for exercise.
21
Q
A patient is sitting at a table and performing elbow flexion exercises using a dumbbell as resistance. This exercise demonstrates what class of lever?
A. First class
B. Second-class
C. Third class
D. Fourth class
A
Answer: C
Rationale: This is an example of a 3rd class lever.
22
Q
Which of the following tissues absorbs the least amount of an ultrasound beam at 1 MHz?
A. Blood
B. Muscle
C. Bone
D. Skin
A
Answer: A
Rationale: Absorption is based on tissue density. Blood transports thermal energy in and out of the tissue as blood flows.
23
Q
You are examining a patient with a history of congestive heat failure. You notice that the patient has some peripheral edema. Which of the following factors are pathenogenetic of this edema?
A. Increased blood supply to the various organs and tissues
B. Increased excretion of sodium by the kidneys
C. Decrease cardiac output
D. Decreased blood volume and elevated venous pressure
A
Answer: C
Rationale: As the cardiac output is decreased, blood supply and excretion of sodium decreases and blood volume increases with elevated venous pressure.
24
Q
You are presenting a departmental in-service on the lymphoid system. The lymphoid system is composed of all ofthe following except:
A. Bone marrow
B. thymus
C. Liver
D. Spleen
A
Answer: C
Rationale: The liver is not involved in the lymph system.
25
You are examining a patient with a history of congestive heart disease. In addition to the heart, which ofthe following organs is most seriously affected due to the decreased blood supply that ensues?
A. Lungs
B. Kidneys
C. Brain
D. Spleen
Answer: B
Rationale: This is due to the function of the kidneys in regard to normal body function.
26
You are examining a patient with diabetes insipidus. Which of the following is a true statement?
A. Diabetes insipidus is closely related to diabetes mellitus
B. Diabetes insipidus is associated with pituitarv disease
C. Diabetes insipidus results from insulin deficiency
D. Diabetes insipidus is a disorder of carbohydrate metabolism
Answer: B
Rationale: Diabetes insipidus is associated with the pituitary gland, while diabetes mellitus is associated with the pancreas
27
What structural change to the heart is associated with aortic stenosis?
A. Hypertrophy of the left ventricle
B. Hypertrophy of the right ventricle
C. Hypertrophy of the right aorta
D. Hypertrophy of the left aorta
Answer: A
Rationale: This is prominent in arterial hypertension and aortic valve disease, Right ventricle hypertrophy is associated with pulmonary hypertension.
28
You are examining a patient with a history of congestive heart disease with right ventricular hypertiophy. You would expect to find all of the following in this patient except:
A. Cvanosis
B. Ascites
C. Edema of the lower extremities
D. Dyspnea
Answer: D
Rationale: Shortness of breath is not included as part of the clinical picture in right ventricular hypertrophy.
29
You are presenting a departmental in-service about bronchiectasis. Which of the following are true statements?
A. It affects the lower lobes of the lungs more commonly than the upper lobes
B. It affects the right lung more frequently than the left
C. It is a chronic bronchitis condition
D. It is the result of emphysema
Answer: A
Rationale: Bronchiectasis usuallv affects the lower lobes because it is usuall associated with chronic bronchitis.
30
You are reviewing the medical records of the patient you're about to examine in the intensive care unit. According to the patient's chant the patient suffered an intracranial bleed due to trauma. Which of the following is the most common type of intracranial bleeding due to trauma?
A. Subdural hemorrhage
B. Subarachnoid hemorrhage
C. Intercranial bleed
D. Extracranial bleed
Answer: B
Rationale: This is due to the location of the subarachnoid arteries lying superficially in the subarachnoid space.
31
You are examining a patient with a diagnosis of chronic disease of the lungs. Of the following, which is the mostchronic disease of the lungs?
A. Pulmonary tuberculosis
B. Asthma
C. Emphysema
D. Bronchiectasis
Answer: C
Rationale: Emphysema is a disease that develops over a long period of time -- the other diseases can be acute in onset.
32
You are taking the history of a patient who reports that he becomes short of breath and wheezes when he runs, mows the lawn, or does other heavy work. Which of the following lung diseases do you suspect the patient has?
A. Bronchial asthma
B. Pulmonary emphysema
C. Chronic bronchitis
D. Acute bronchitis
Answer: B
Rationale: The patient is indicating that with any increased demand on his respiratory system, he experiences difficulty in breathing -- the classic symptoms of emphysema.
33
You are reviewing the medical chart of a patient diagnosed with metastasis of Hodgkin's disease. All of the following are sites of metastasis of Hodgkin's disease except:
A. Lymph nodes
B. Liver
C. Lungs
D. Spleen
Answer: C
Rationale: Hodgkin's disease does not spread from the lungs since it is a disease of the lymph system.
34
A patient has been referred to you with a diagnosis of cystic fibrosis. All of the following statements apply to cystic fibrosis except:
A. It is a familial disease, the defect transmitted as an autosomal recessive gene
B. It results in increased viscosity of the mucus of the glands of the trachea and bronchi onlv
C. It involves the pancreas
D. It may eventually involve the liver, resulting in cirhosis
Answer: B
Rationale: The mucus is not produced only by the glands of the trachea and bronchi, but also the pancreas.
35
A patient has arrived in your clinic with a diagnosis of emphysema. All of the following are physical signs associated with emphysema except:
A. Increased anterior -- posterior diameter of the chest
B. The patient uses the accessory muscles of respirations during breathing
C. The patient demonstrates an increased respiratory rate
D. There is decreased resonance to percussion over the lung fields
Answer: D
Rationale: With emphysema there is an increased resonance, not a decreased resonance.
36
You are examining a patient with advanced diabetes mellitus. Which of the following complications associated with diabetes mellitus is the most serious?
A. Renal disorders
B. Ocular complications
C. Peripheral neuritis
D. Acidosis
Answer: D
Rationale: Acidosis is life-threatening due to its effects on the body's electrolvtes.
37
You are examining a patient's EKG. The P-wave of an EKG corresponds to which of the following?
A. Mitral depolarization
B. Atrial depolarization
C. Mitral repolarization
D. Atrial repolarization
Answer: B
Rationale: The P-wave is the depolarization phase of the heartbeat and starts with the atrial valve.
38
Which wave of an EKG is generated by ventricular repolarization?
A. T-wave
B. Q-wave
C. S-wave
D. R-wave
Answer: A
Rationale: Only the ventricles have repolarization capabilities during the heartbeat.
39
You are examining a patient with a diagnosis of intermittent claudication. Which of the following diseases is suggestive of intermittent claudication in the lower extremities?
A. Buerger's disease
B. Ravnaud's disease
C. Pott's disease
D. Cardiac disease
Answer: A
Rationale: Of these, only Burger's disease deals with intermittent claudication of the lower extremities.
40
You are examining a patient in the late stages of rheumatoid arthritis. Which of the following clinical features characterizes this stage of the disease?
A. Muscular hypertrophy
B. Radial deviation of the fingers
C. Contractures of the soft tissues
D. Enlargement of Heberden's nodes
Answer: C
Rationale: Rheumatoid arthritis causes soft tissue damage, muscle weakness, and ulnar deviation of the fingers.
41
You are examining a patient with a history of cardiac arrhythmia. What is the most common form of cardiac arrhythmia?
A. Ventricular tachvcardia
B. Ventricular fibrillation
C. Ventricular premature beats
D. Ventricular ectopic beats
Answer: C
Rationale: This is the most common disturbance of cardiac rhythm and occurs before the ventricular beat of the heart.
42
You are examining a patient with acromegaly. Acromegaly is caused by a tumor of:
A. Adrenal cortex
B. Adrenal medulla
C. Posterior lobe of the pituitary gland
D. Anterior lobe of the pituitarv gland
Answer: D
Rationale: Acromegaly is caused by a tumor of the anterior lobe of the pituitary gland, a tumor in the posterior lobe causes dwarfism
43
You are educating a physical therapy student on the different types of hypertension. Which of the following statements applies to primary hypertension?
A. Not a hereditary disease
B. More common among people who exist on high sodium diets
C. More common among whites than blacks
D. More common with slender body types
Answer: D
Rationale: The most appropriate answer since the other 3 answers relate to secondary hypertension.
44
You are treating a patient with known diabetes mellitus who begins to present with diabetic acidosis. Which ofthe following signs/svmptoms are indicative of acidosis?
A. Fruity odor to the breath
B. Cvanotic lips and cheeks
C. Shallow breathing
D. Headache
Answer: A
Rationale: A fruity odor to the breath is indicative of acidosis.
45
You are freating an elderly debilitated patient confined to her bed in a nursing home. Which of the following conditions is this patient prone to?
A. Pneumothorax
B. Pulmonary congestion and edema
C. Hypostatic pneumonia and atelectasis
D. Muscle hypertrophy
Answer: C
Rationale: Both hypostatic pneumonia and atelectasis develop due to inactivity.
46
You are presenting an in-service about diseases of the muscle at a local community center. Which of the following muscle diseases has abnormal fatiguability of muscle as one of its main symptoms?
A. Myotonia cogenita
B. Myasthenia gravis
C. Guillain-Barré syndrome
D. Muscular dystrophy
Answer: B
Rationale: Of these diseases, myasthenia gravis is the only one in which muscles develop fatigue easily without much activity.
47
You are examining a patient who underwent abdominal surgery 24 hours prior. The patient demonstrates a positive Homan sign. This may indicate a potentially developing:
A. Thrombophlebitis
B. Cardiac arrest
C. Epileptic seizure
D. Constipation
Answer: A
Rationale: The Homan's sign may predict the presence of thrombophlebitis which in turn can lead to an embolism.
48
You are educating a physical therapy student about normal lab values. What is the normal pH of body fluids?
A. 7.8
B. 7.6
C. 7.5
D. 7.4
Answer: D
Rationale: The normal pH for body fluids is 7.4.
49
You are educating a physical therapy student about lung volumes. The maximum amount of air that can be contained in the lungs after a maximum inspiration is called:
A. Vital capacity
B. Residual volume
C. Total lung capacity
D. Inspiratory capacity
Answer: C
Rationale: Refers to the amount of air contained upon inspiration.
50
You are examining a patient who appears to be over suspicious, and demonstrates delusions of persecution. Which of the following describe this personality type?
A. Paranoid
B. Catatonic
C. Passive aggressive
D. Passive dependent
Answer: A
Rationale: The paranoid personality is based on deep-seated mistrust of other persons and persecutions by them.
51
You are examining a patient who appears to be demonstrating sensory disturbance as a conversion reaction. Which of the following findings would lead you to suspect this?
A. Stocking-like distribution of sensations over an extremitv
B. Dermatomal distribution of sensation changes
C. No specific line of demarcation of symptoms
D. Myotomal pattern of weakness
Answer: A
Rationale: This type of symptom distribution is often associated with conversion disorders.
52
You are examining a teenage girl who has been diagnosed with anorexia nervosa. Anorexia nervosa is a disorder that
causes:
A. Severe vomiting
B. Severe weight gain
C. Severe weight loss
D. Severe diarrhea
Answer: C
Rationale: This is a serious disorder that involves young women or girls who have an intense fear of becoming obese.
53
You are examining a patient with a history a stroke several weeks prior. The patient is unable to talk, to name common objects, or to formulate words because of the stroke. The medical term for this condition is
A. Apraxia
B. Aphasia
C. Apraxia
D. Agnosia
Answer: B
Rationale: This is the definition of aphasia.
54
You are examining a patient with a diagnosis of osteogenesis imperfecta (OI). Which of the following statementsdoes not apply to this condition?
A. OI is a rare congenital skeletal disease
B. The bones are extremely fragile and multiple fractures are common
C. The etiology of Ol is unknown
D. The bone fragility and the tendency for fractures is more severe following puberty
Answer: D
Rationale: After puberty, bone fragility becomes much less and tendency for fracture decreases.
55
While reading a patient's medical record, you see the term Heberden's nodes mentioned. Heberden's nodes are associated with:
A. Osteoarthritis
B. Rheumatoid arthritis
C. Gout
D. Ankylosing spondylitis
Answer: A
Rationale: These are bony enlargement of the distal interphalangeal joints, associated with osteoarthritis.
56
While reading a patient's medical record, you see that the patient has a diagnosis of pneumothorax. What is a pneumothorax?
A. A collection of gas in the pleural space resulting in collapse of the lung on the affectedside
B. A pigeon chest
C. Sternal apophysitis
D. Congenital curvature of the spine
Answer: A
Rationale: A pneumothorax refers to a collection of gas in the pleural space resulting in collapse of the lung on the affected side.
57
You are presenting a departmental in-service on the demyelinating diseases of the central nervous system (CNS). Which of the following is not a demyelinating disease of the CNS?
A. Multiple sclerosis
B. Shilder's disease
C. Alzheimer's
D. Niemann-Pick disease
Answer: C
Rationale: Alzheimer's disease affects the brain and does not involve the mvelin sheath of the nerve.
58
All of the following are characteristic of a lower motor neuron lesion except:
A. Spastic paralvsis below the level of lesion
B. Atrophy of muscles below the level of the lesion
C. Depressed reflexes below the level of lesion
D. Fasciculations
Answer: A
Rationale: Spastic paralysis is present in upper motor neuron lesions because it originates in the cerebral cortex.
59
You are about to examine a patient with a diagnosis of brain and spinal cord tumors. The most common tumor ofthe brain and spinal cord is:
A. The meningioma's
B. The neurilemmomas
C. Metastatic tumors
(D. The gliomas
Answer: D
Rationale: The origins of the other tumors are either in the meninges, nerves, or breast.
60
To help relax the muscles of the patient you're treating for low back pain, you decide to use a moist heat pack. What form of heat transmission occurs with a moist heat pack?
A. Radiation
B. Convection
C. Conduction
D. Evaporation
Answer: C
Rationale: The heat transfer is conduction.
61
Which of the following tissues show the best conductivity to an electrical current?
A. Skin
B. Tendon
C. Bone
D. Muscle
Answer: D
Rationale: Muscle is the only one that will respond to an electrical current.
62
You are explaining what affects ultrasound has on membrane permeability to physical therapy student. Ultrasound has the following effect on membrane permeability:
A. It produces no change
B. It alternates the permeability
C. It decreases the permeabilit
D. It increases the permeability
Answer: D
Rationale: Ultrasound increases the membrane's permeability.
63
You are reviewing a patient's lab values in the medical record. Which of the following would you consider to bean abnormal lab value in an adult male?
A. Arterial pH: 7.4
B. Low density lipoprotein (LDL): 190mg/dI
C. Triglycerides: 140mg/dl
D. High density lipoprotein (HDL): 60mg/di
Answer: B
Rationale: The lower your LDL cholesterol, the lower your risk of heart attack and stroke. Less than 100mg/ dl is optimal.
64
All of the following are functions of the skin except:
A. Secretion of oils that lubricate the skin
B. Vitamin A svnthesis
C. Insulation
D. Storage of nutrients
Answer: B
Rationale: The skin is involved in vitamin D synthesis.
65
All of the following are types of wound closures, except:
A. Primary closure
B. Secondary intention
C. Delayed primary closure
D. Delayed secondary intention
Answer: D
Rationale: Delayed secondary intention is not a type of closure.
66
All of the following are complications associated with electrical burns except:
A. Renal failure
B. Spinal cord damage
C. Cardiac arrythmias
D. Liver failure
Answer: D
Rationale: Liver failure is not a complication normally associated with electrical burns.
67
All of the following are considered to be the correct open-packed position of the joint, except:
A. Ulnohumeral: 70 degrees of flexion, 10 degrees of supination
B. Radiohumeral: 70 degrees of flexion, 35 degrees of supination
C. Glenohumeral: 55 degrees of abduction, 30 degrees of horizontal adduction
D. Distal radioulnar: 10 degrees of supination
Answer: B
Rationale: The open pack position for the radiohumeral joint is full elbow extension, full forearm supination.
68
You are recommending an adjustment to a patient's prosthesis in order to increase knee extension. How would you position the foot component in relation to the socket to accomplish this?
A. Anterior
B. Posterior
C. Medial
D. Lateral
Answer: A
Rationale: Placing the foot component anterior to the socket increases knee extension.
69
You are assessing a patient for gait who is using an above knee prosthesis. You notice that the prosthetic knee appears unstable as you determine that knee flexion is occurring prematurely. After you have ruled out the prothetic causes, which of the following patient causes could be at fault?
A. The amputee may have hip extensor weakness
B. The amputee may be using too much force
C. The amputee may have faulty walking habits
D. None of these would explain the problem
Answer: A
Rationale: Apparent prosthetic instability can be caused by hip extensor weakness (or a hip flexion contracture).
70
You are inspecting a patient's wound and notice there is an excessive accumulation of exudate and a white appearance to the skin. What term would vou use to describe this?
A. Hematoma
B. Maceration
C. Dessication
D. Seroma
Answer: B
Rationale: Maceration is the term used to describe softened tissues due to high fluid environment resulting in a moist and white appearance of skin.
71
You are assessing a patient's arm and shoulder strength. When assessing internal rotation at the shoulder, which of the following muscles would not be involved?
A. Pectoralis major
B. Infraspinatus
C. Latissimus dorsi
D. Subscapularis
Answer: B
Rationale: The infraspinatus is an external rotator of the shoulder.
72
You are performing a manual muscle test of a patient's hip. The patient reports pain with resisted hip externalrotation
Which of the following muscles are not involved with hip external rotation?
A. Sartorius
B. Pectineus
C. Quadratus femoris
D. Gluteus minimus
Answer: D
Rationale: The gluteus minimus is an internal rotator of the hip.
73
All of the following are examples of findings that would appear in the objective portion of a SOAP note, except
A. Pain of 5/10
B. MMT of 3+/5
C. AROM of shoulder flexion at 170 degrees
D. Circumferential measurement at mid thigh 18 inches
Answer: A
Rationale: Pain is a subiective measurement.
74
You are examining a patient who is referred to physical therapy following rotator cuff surgery. During your examination you observe decreased range of motion in the involved shoulder. Using the Guide to Physical Therapist Practice terminology, which of the following would best describe your finding?
A. Disability
B. Impairment
C. Functional limitation
D. Pathology
Answer: B
Rationale: An impairment is defined as a loss or abnormality of physiological, pvchological or anatomical structure or function.
75
You are examining the gait of a patient who was recently diagnosed with a mild stroke. During the examinationyou observe that the patient's left foot slaps the ground during the loading response, Weakness of which of the following muscles would you suspect?
A. Tibialis anterior
B. Tibialis posterior
C. Quadriceps
D. Gastrocnemius
Answer: A
Rationale: The tibialis anterior acts to dorsiflex the ankle joint. Weakness of this muscle can result in foot drop.
76
You are examining a patient's knee and observe the following findings: tenderness along the facets of the patella;
crepitus with knee flexion; an alteration in the Q-angle; pain with squatting. Which of the following would likely be your provisional diagnosis?
A. Patellotemoral syndrome
B. Osteoarthritis of the tibia femoral joint
C. Osgood-Schlatter's disease
D. Adaptive shortening of the iliotibial band
Answer: A
Rationale: These are the classic findings of a patellofemoral dysfunction.
77
You are treating a patient with a diagnosis of patellofemoral syndrome. All of the following should be included in your intervention, except:
A. Recommendation of proper footwear and/or orthotics
B. Patella taping
C. Restoration of muscle balance within the quadriceps group
D. All of these should be included
Answer: D
Rationale: All of these are considered to be beneficial in the treatment of patellofemoral syndrome.
78
You are assessing a patient straight leg raise following an anterior cruciate ligament reconstruction. You notice that the patient demonstrates a quadriceps extension lag during the straight leg raise. All of the following can produce a normal extension lag, except:
A. Muscle weakness
B. Pain inhibition
C. Patient apprehension
D. Knee stiffness
Answer: D
Rationale: Patients that demonstrate an extension lag have greater passive extension that active extension. Knee stiffness would not affect the results.
79
You are performing manual muscle testing to determine the strength of the scapular stabilizers. In order to properl assess the left middle trapezius, in which position should you position the patient?
A. Supine
B. Prone
C. Sitting
D. Right sidelying
Answer: B
Rationale: The patient should be positioned in prone, with the arm abducted to 90° and the forearm pronated.
80
You are examining a patient with a diagnosis of olecranon bursitis. Which clinical finding is usually not associatedwith olecranon bursitis?
A. Pain with palpation over the tip of the elbow
B. Pain with end range elbow flexion
C. Swelling over the posterior aspect of the elbow joint
D. Joint mobility limited in a capsular pattern
Answer: D
Rationale: Capture patterns of restriction are associated with arthritic changes to the joint and joint capsule.
81
You are taking goniometric measurements of a patient's knee following total knee arthroplasty. The patient involved knee the range of motion begins at 10° of flexion and ends at 95° of flexion. How would you record the patient's knee range of motion?
A. 0-95
B. 0-10-95
C. 10-0-95
D 10-95
Answer: D
Rationale: Because the patient's knee range of motion begins at 10° of flexion and ends at 95° of flexion, this would be the cOITect way to document.
82
You are assessing the ligamentous integrity of a patient's knee. You could use all of the following tests, except:
A. Abduction-valgus stress
B. Posterior drawer
C. Anterior drawer
D. Anderson medial-lateral grind
Answer: D
Rationale: The Anderson medial-lateral grind test used to detect meniscal lesions.
83
You are assessing the ligamentous integrity of a patient's ankle, specifically the deltoid ligaments. Which of the following special tests could you use?
A. Kleiger (external rotation) test
B. Anterior drawer
C. The clunk (cotton) test
D. Posterior drawer
Answer: A
Rationale: All of the other tests are designed to assess the lateral collateral ligaments.
84
You are working at a health fair where you are administeringthe Body Mass Index scale to a 45-year-old male patient.
Which of the following scores would be the most representative for this patient's sex and age?
A. 30.2 kg/m2
B. 28.4 kg/m2
C. 26.8 kg/m2
D. 24.6 kg/m2
Answer: C
Rationale: 26.8 kg/m? would be the most representative given the patient's sex and age.
85
You are examining a patient with a diagnosis of a stress fracture. The patient tells you that the fracture was confumed using an imaging study. Which of the following imaging studies would be the most appropriate to identify a stress fracture?
A. Radiograph
B. Bone scan
C. MRI
D. Doppler scan
Answer: B
Rationale: A bone scan identifies areas of bone that are hypervascular or that have an increased rate of bone uptake.
86
You are taking goniometric measurements of a patient's elbow and forearm. Which of the following values is most indicative of normal passive forearm supination?
A. 70 to 75°
B. 80 to 85°
C. 85 to 909
D. 90 to 95°
Answer: C
Rationale: Normal active range of motion for forearm supination is between 85 to 90°.
87
You are asked to document the extent of ataxia of a patient with cerebellar disease. Which of the following methods would be the most appropriate to use?
A. Finger to nose
B. Rinne's test
C. The ability of the patient to catch a ball
D. Manual muscle test
Answer: A
Rationale: The finger to nose test can be used to assess muscular coordination with active movements.
88
You are measuring a patient's lung volumes. Which lung volume are you assessing if you asked the patient to expire maximally after taking a maximal inspiration?
A. Total lung capacity
B. Vital capacity
C. expiratory reserve volume
D. inspiratory reserve volume
Answer: B
Rationale: Vital capacity is defined as the sum of inspiratory reserve volume, tidal volume, and expiratory reserve volume
89
You are taking goniometric measurements of the thumb. Where would you align the axis and the movable arm to measure carpometacarpal flexion?
A. Axis: Over the palmar aspect of the first carpometacarpal joint; movable arm: Ventral midline of the first metacarpal
B. Axis: Over the dorsal aspect of the first carpometacarpal joint; movable arm: Ventral midline of the first metacarpal
C. Axis: Over the lateral aspect of the radial styloid process; movable arm: Lateral midline of the first metacarpal
D. Axis: Over the medial aspect of the radial styloid process; movable arm: Lateral midline of the first metacarpal
Answer: A
Rationale: Carpometacarpal flexion occurs in a frontal plane around an anterior-posterior axis.
90
You are assessing foot and ankle alignment in a patient with a diagnosis of patellofemoral syndrome. You observe that the patient's foot and ankle appear to be pronated in standing. Which motions at the ankle combine to create pronation?
A. Abduction, dorsiflexion, eversion
B. Abduction, dorsiflexion, inversion
C. Abduction, plantarflexion, eversion
D. Adduction, plantarflexion, inversion
Answer: A
Rationale: Pronation of the foot consists of abduction all the forefoot, dorsiflexion of the subtalar and tarsal joints, and eversion of the heel.
91
You are about to assess the integrity of a patient's anterior cruciate ligament using the Lachman test. In order to perform the test in which position should the patient's knee be placed?
A. Complete extension
B. 10 to 20° of flexion
C. 20 to 30° of flexion
D. 30 to 40° of flexion
Answer: C
Rationale: The correct position is 20 to 30° of flexion.
92
You are using a 6 second electrocardiogram strip to determine a patient's heart rate. If you identify 10 QRS complexes in the strip, what would vou record the patient's heart rate as?
A. 70 bpm
B. 80 bpm
C. 90 bpm
D. 100 bpm
Correct Answer: D
Rationale: Using 6 second intervals, you should multiply the number of complexes identified by 10 to determine the patients heart rate.
93
You of palpating a patient's carpal bones. Which of the following carpal bones would not be found in the proximal row?
A. Capitate
B. Scaphoid
C. Lunate
D. Triquetrum
Answer: A
Rationale: The proximal row of carpal bones consists of the scaphoid, lunate, triquetrum, and pisiform.
94
You are assessing the strength of the foot and ankle muscles. Which of these muscles would be tested when resistances applied toward plantarflexion and eversion.
A. Tibialis anterior
B. Tibialis posterior
C. Fibularis (peroneus) longus
D. Fibularis (peroneus) brevis
Answer: A
Rationale: The tibialis anterior functions to dorsiflex the ankle joint and assists with inversion of the foot.
95
You are performing manual muscle testing (MIMT of a patient's shoulder. As the patient was unable to perform shoulder abduction in sitting, you position the patient in supine. In the supine position, the patient is able to complete full range of motion in the horizontal plane. What MMT grade would you give the patient for shoulder abduction?
A. Poor
B. Fair minus
C. Fair
D. Poor minus
Answer: A
Rationale: A poor grade is defined as the ability to move through complete range of motion in a gravity eliminated position
96
You are examining the strength of elbow flexion. All of the following are considered to contribute to elbow flexion, except:
A. Pronator teres
B. Flexor carpi radialis
C. Flexor carpi ulnaris
D. Flexor carpi radialis longus
Answer: D
Rationale: It is the extensor carpi radialis longs that contributes to elbow flexion
97
You are examining a female athlete in the standing position. You note that the patient's patella is located medially in relation to the ipsilateral hip and ankle. This condition is commonly referred to as
A. Genu valgum
B. Genu varus
C. Patella alta
D. Patella baja
Answer: A
Rationale: This is the correct term to describe the finding.
98
During your examination, all of the following circumstances would normally decrease body temperature in a healthy person, except:
A. Reaching the age of 65 years or older
B. Pregnancy
C. Exercising
D. Normal ovulation
Answer: A
Rationale: The geriatric population usually has a decreased body temperature due to poor diet, decreased cardiovascular status, and decreased metabolic rates.
99
Which of the following should a therapist evaluate first when performing a job site analysis?
A. Bathroom accessibility
B. Job description and duties
C. The frequency at which rest and lunch breaks occur
D. Handicap accessibility
Answer: B
Rationale: Before a jobsite analvsis can begin, the physical therapist must be familiar with the injuries or problems that have occured at the jobsite, and the employee's job description.
100
You are assessing the patient's ability to grasp objects.When you ask the patient to pick up a pen, the patient holds it between the pads of the thumb and the middle and index fingers. What type of grasp or prehension is the patient using?
A. Palmar prehension
B. Hook grasp
C. Lateral prehension
D. Normal prehension
Answer: A
Rationale: Palmar prehension is holding an object between the thumb pad and the middle and index finger.
101
You are examining a patient with a diagnosis of lateral epicondylitis. Which tendon is most commonly involved withthis condition?
A. Extensor digitorum
B. Ulnar carpi radialis
C. Extensor carpi radialis brevis
D. Extensor carpi radialis longus
Answer: C
Rationale: The extensor carpi radialis brevis is the most commonly involved.
102
You are examining a patient's wrist. Which of the following is not part of the triangular fibrocartilage complex of the wrist?
A. Ulnar articular cartilage
B. Radial collateral ligament
C. Ulnar collateral ligament
D. Dorsal radioulnar ligament
Answer: B
Rationale: The radial collateral ligament is not considered part of the trianglular fibrocartilage complex
103
During the gait cycle, which of the following muscles do not work eccentrically dwring midstance?
A. Posterior tibialis
B. Flexor hallucis longus
C. Flexor digitorum longus
D. Gastrocnemius
Answer: D
Rationale: The gastrocnemiusworks concentically at midstance.
104
All of the following would be found when comparing the gait cycle of young adults to the gait cycle of older adults, except:
A. The older population would have a longer period of double support
B. The older population would have a shorter step
C. The older population would have a shorter stride length
D. The older population would have an increase in the speed of ambulation
Answer: D
Rationale: The older population would have a decrease in the speed of ambulation.
105
A fifty-vear-old blind and deaf patient has been assigned to vou for evaluation. What should vour primary responsibility be for this patient?
A. Continuously update the patient on the social environment
B. Provide a secure environment for the patient
C. Communicate with your supervisor your concerns about the patient's deficits
D. Let others know about the patient's deficits
Answer: B
Rationale: Of the choices listed, this would be the most appropriate response.
106
355.A physical therapist is reviewing a patient's medication during an evaluation. Which of the following medication would be contraindicated if the patient were pregnant?
A. Coumadin
B. Celebrex
C. Catapress
D. Habitrol
Answer: A
Rationale: Coumadin is a blood-thinner and has been associated with birth defects and/or hemmorhage of the offspring.
107
356.A patient with a transfemoral amputation walks with the prosthetic leg abducted during the stance phase. The patient does not have hip abductor tightness and the residual limb fits into the socket correctly. The FIRST action the physical therapist should take is to:
A. Check the length of the prosthesis
B. initiate strengthening the hip adductors
C. instruct the patient to walk with shoiter steps
D. refer the patient to the prosthetist
Answer: A
Rationale: Given that the PT has checked for hip abductor tightness and correct fit of the prosthesis, the other common cause is a prosthesis that is too long.
108
Which of the following are the seronegative spondyloarthropathies?
A. Osteoarthritis
B. Ankylosing spondylitis
C. Psoriatic arthritis
D. Band C
Answer: D
Rationale: Both ankylosing spondylitis and psoriatic arthritis are considered to be seronegative spondyloarthropathies.
109
Which of the following pharmacologic agents are not used in the treatment of inflammatory conditions ofthe musculoskeletal system?
A. Nonsteroidal drugs
B. Blood pressure medications
C. Aspirin
D. Corticosteroids
Answer: B
Rationale: With the exception of the blood pressure medications, all of the other medications are anti-inflammatories.
110
Which of the following are not common musculoskeletal features of reactive arthritis?
A. Asymmetric joint stiffness of the lower extremities
B. Enthesopathy
C. urethritis/cervicitis
D. DIP deformity
Answer: D
Rationale: DIP deformity is more associated with rheumatoid arthritis
111
Which of the following are not common causes of infectious disease?
A. Fungi
B. Viruses
C. Prions
D. Protons
Answer: D
Rationale: The correct term here should beprotozoa.
112
Which of the following antigens is associated with ankylosing spondylitis (AS)?
A. HLA-B31
B. HLA-B27
C. HLA-B25
D. HLA-B19
Answer: B
Rationale: The HLA-B27 has a strong association with AS.
113
Which of the following is a tickborne inflammatory disorder?
A. Hepatitis C
B. Shingles
C. Lyme disease
D. Dengue fever
Answer: C
Rationale: Lyme disease is the only one of the choices associated with a tickborne disorder.
114
All of the following are considered to be findings associated with rheumatoid arthritis (RA), except?
A. Moming stiffness
B. Skin rash
C. Serum rheumatoid factor
D. Symmetric arthritis lasting 6 weeks
Answer: B
Rationale: Although associated with other rheumatic conditions, a skin rash is not associated with RA.
115
Infectious agents are now suspected in the origins of all of the following chronic diseases, except:
A. Scleroderma
B. Diabetes mellitus
C. Kawasaki disease
D. Parkinson's disease
Answer: D
Rationale: Infectious agents are associated with all of these conditions except Parkinson's disease
116
365.A patient presents at your clinic with an acute onset of pain, swelling, and limitation of motion of a joint with no history of trauma. Which of the following should be part of your differential diagnosis?
A. Infectious (septic) arthritis
B. Osteoarthritis
C. Crohn's disease
D. Rheumatoid arthritis
Answer: A
Rationale: Given the non-traumatic history, and the involvement of only one joint, an infectious joint condition should be considered. Gout would also be a consideration but is not listed as one of the choices.
117
Which of the following is not a true statement about tuberculosis (TB)?
A. It can develop after inhaling droplets sprayed into the air from a cough or sneeze by someone infected with TB
B. The risk of contracting TB increases with crowded or unsanitary living conditions and with poor nutrition.
C. Once the initial infection is contained, it will not reappear
D. The lungs are primarily involved, but the infection can spread to other organs
Answer: C
Rationale: TB mav lie dormant for vears and reappear after the initial infection is contained.
118
All of the following are common expressions of staphylococcal infections, except?
A. Skin, wound and soft tissue infections
B. Food poisoning
C. Infections related to prosthetic devices
D. Rheumatic fever
Answer: D
Rationale: Rheumatic heart disease can be the result of a streptococcal infection.
119
What is osteomyelitis?
A. An inflammation of bone
B. An infectious process of the bone and marrow
C. A bone tumor
D. A bony out growth
Answer: B
Rationale: This is the definition of osteomyelitis.
120
The majority of hematogenous osteomyelitis cases are caused by all of the following, except?
A. Poor dental hygiene
B. A pelvic inflammatory disease
C. A penetrating wound
D. A blood clot
Answer: D
Rationale: A blood clot does not cause osteomvelitis
121
Which of the following muscles is not innervated by the median nerve?
A. abductor pollicis brevis
B. flexor pollicis longus
C. medial heads of flexor digitorum profundus
D. pronator quadratus
Answer: C
Rationale: The medial heads of the flexor digitorum profundus are innervated by the ulnar nerve.
122
The nerve that innervates the first lumbrical muscle in the hand is the:
A. lateral cutaneous nerve of the hand
B. radial nerve
C. median nerve
D. anterior interosseus nerve
Answer: C
Rationale: The median nerve innervates the first (and second) lumbrical muscle in the hand.
123
After a nerve injwy, regeneration occurs proximally first and then progresses distally at a rate of about 1 mm per day.
Following a radial nerve injwy in the axilla, which muscle would be the last to recover?
A. long head of the triceps
B. extensor indicis
C. supinator
D. extensor digit minimi
Answer: B
Rationale: Of those listed, the extensor indicis is the most proximal muscle to the axilla
124
Contraindications to applying serial casting include all of the following, except:
A. Severe heterotopic ossification
B. Uncontrolled hypertension
C. Muscle rigidity
D. All are considered contraindications to serial casting
Answer: D
Rationale: All of those listed are considered contraindications to serial casting.
125
374.A bony mass is vaguely felt in the posterior midline of the neck about two finger breadths beneath the occipital protuberance. It is the:
A. inferior articular process of C 1
B. spinous process of the atlas
C. odontoid process
D. spinous process of the axis
Answer: D
Rationale: This is the location of the spinous process of the axis.
126
375.A patient complains of a buning sensation in the anterolateral aspect of the thigh. Dysfunction of which nerve could lead to these symptoms?
A. ilioinguinal
B. genitofemoral
C. lateral (femoral) cutaneous nerve of the thigh
D. obturator
Answer: C
Rationale: Dysfunction of this nerve leads to a condition called meralgia paresthetica.
127
The saphenous nerve supplies cutaneous sensation to the medial aspect of the leg. From which nerve does the saphenous nerve arise?
A. obturator
B. sciatic
C. femoral
D. it arises as a direct branch from the sacral plexus
Answer: C
Rationale: The saphenous nerve is one of the sensory branches of the femoral nerve.
128
377. patient presents with a sensor deficit in an area adjacent to the dorsal surfaces of the first and second toes. Which nerve might be involved?
A. deep branch of the fibular (peroneal) nerve
B. femoral
C. obturator
D. saphenous
Answer: A
Rationale: This is the area of sensory loss associated with the deep branch of the fibular (peroneal) nerve
129
Weakness of which of the following muscles can produce scapular winging?
A. long head of the triceps
B. seiTatus anterior
C. supraspinatus
D. Deltoid
Answer: B
Rationale: Weakness of the serratus anterior produces winging of the scapula.
130
The anterior interosseus branch of the median nerve innervates which muscles?
A. flexor pollicis longus
B. pronator teres
C. pronator quadratus
D. both A and C
Answer: D
Rationale: Both of these muscles are innervated by the anterior interosseous branch of the median nerve. The pronator teres is innervated by the median nerve.
131
The primary extensor of the metacarpophalangeal joints in the hand is the:
A. extensor digitorum communis
B. extensor carpi radialis longus
C. extensor carpi ulnaris
D. dorsal interossei muscles
Answer: A
Rationale: The primary function of the extensor digitorum communis is metacarpophalangeal function, but with full metacarpophalangeal extension or metacarpophalangeal extension blocked, the extensor digitorum communis can extend the interphalangeal joints.
132
381.A patient with Brown Sequard's syndrome is referred to physical therapy. This type of spinal cord injuy presents with:
A. Paralysis, loss of proprioception and vibration on the same side as the lesion
B. Loss of pain and temperature on the opposite side of the lesion
C. Paralysis, loss of pain and temperature on the same side as the lesion
D. Both A and B
Answer: D
Rationale: This is the classic presentation of Brown-Sequard's syndrome.
133
382.A sensor examination reveals light touch impairment to the anterolateral thigh. lateral calf, and sole the foot. When recording these findings what are the corresponding dermatomes respectively?
A. L2, L4, S3
B. LI, L3, L5
C. L2, L5, SI
D. L3, L5, S1
Answer: C
Rationale: This is the correct order for the corresponding dermatomes.
134
All of the following are developmental milestones with their appropriate ages, except:
A. Sit independently: 5-6 months
B. Walk: 12 months
C. Belly crawl: 3-4 months
D. Cruise: 11 months
Answer: C
Rationale: Belly crawling occurs at 7-8 months.
135
An injury to the posterior cord of the brachial plexus would most likely involve damage to which of the following nerve(s)?
A. Musculocutaneous
B. Axillarv
C. Radial
D. b and c
Answer: D
Rationale: The posterior cord serves both the radial and axillary nerves.
136
385.A 16 vear-old high school track athlete returns to physical therapy after seeing his physician. The physician informed the patient that magnetic resonance imaging (MRI) has shown a significant tear in the medial meniscus of the left knee. As you look back on your initial evaluation, which of the following special test would you expect to have been positive?
A. Lachman
B. Pivot shift
C. McMurrav
D. Apprehension
Answer: C
Rationale: Of the tests listed, the McMurray is the most specific for a meniscal injury.
137
386.A physical therapist observes that a patient's medial longitudinal arch is extremely depressed. What ligament helps to maintain the medial longitudinal arch?
A. Talonavicular
B. Anterior talofibular
C. Plantar calcaneonavicular
D. Posterior talofibular
Answer: C
Rationale: The plantar calcaneonavicular ligament helps to maintain the medial longitudinal arch of the foot and by providing support to the head of the talus bears the major portion of the body weight. It is the main part of the spring ligament complex
138
When palpating the wrist and hand, which metacarpal should articulate with the hamate?
A. First
B. Second
C. Third
D. Fourth
Answer: D
Rationale: The 4th metacarpal articulates with the hamate.
139
The O-angle is designed as a measurement to determine the amount of lateral force on the patella. What three bony landmarks are used to measure the O-angle?
A. Anterior superior iliac spme, superior border of the patella, tibial tubercle
B. Anterior superior iliac spine, midpoint of the patella, tibial tubercle
C. Anterior superior iliac spine, inferior border of the patella, midpoint of the patella tendon
D. Greater trochanter, midpoint of the patella, superior border of the patella tendon
Answer: B
Rationale: These are the correct landmarks to use when assessing the O=angle.
140
389.A patient presents with severe weakness of the deltoid muscle and wrist extensors. Where would you suspect the lesion to be located?
A. C6 Nerve root
B. C7 Nerve root
C. Middle trunk of the brachial plexus
D. Posterior cord of the brachial plexus
Answer: D
Rationale: The deltoid is served by the axillary nerve, while the wrist extensors are served by the radial nerve, both of which originate from the posterior cord of the brachial plexus.
141
390. patient was involved in a motorcycle accident and it is suspected that he mav have avulsed his C-5 nerve root at its origin. To test this impression, what is the best muscle to check electrophysiologically?
A. Supmator
B. Pronator teres
C. Rhomboids
D. Latissimus dorsi
Answer: C
Rationale: The rhomboids are served by the C4-5 level.
142
391. patient with a musculocutaneous nerve injury is still able to flex the elbow. The major muscle causing this elbow flexion is the?
A. Brachioradialis
B. Flexor carpi ulnaris
C. Pronator quadratus
D. Extensor carpi ulnaris
Answer: A
Rationale: Of those listed, the brachioradialis is the strongest elbow flexor and is not innervated by the musculocutaneous nerve.
143
392.A physical therapist is performing an evaluation on a patient that has fallen out of a truck and injued his right arm. The patient saw his physician 3 days ago when his arm began to go numb and become discolored? Upon the examination, the therapist notes a poor arterial pulse in the right arm. What should be the therapist's next step?
A. Notify the MD of the changes immediately
B. Begin a light exercise program as per the physician's orders
C. Apply electrical stimulation and ice to the right upper extremity
D. Perform further testing of the right arm
Answer: A
Rationale: In this situation, it is clear that the patient's condition has worsened quite dramatically
144
393.You are evaluating a 15-year-old female distance runner for foot pain of unknown etiology. As you palpate along the medial aspect of the foot and ankle you palpate the head of the first metatarsal bone and the metatarsophalangeal joint.
Immediately proximal to this you identify the first cuneiform. What large bony prominence would you expect to find next if you continue to move in and a proximal direction?
A. Talar head
B. Navicular
C. Medial malleolus
D. Cuboid
Answer: B
Rationale: The navicular would be the next bone to be palpated proximally.
145
394.A 36-year-old male who has been an insulin-dependent diabetic for five years is complaining that he is having difficulty to urinate. Which of the following would you most likely suspect?
A. Atherosclerosis
B. Diabetic nephropathy
C. Autonomic neuropathy
D. Somatic neuropathy
Answer: C
Rationale: Most commonly autonomic neuropathy is seen in persons with long-standing diabetes mellitus type I and II.
146
The patient is referred to physical therapy diagnosed with pes anserine bursitis. Which muscle does not contribute to the (pes anserme?
A. Sartorius
B. Semimembranosus
C. Semitendinosus
D. Gracilis
Answer: B
Rationale: The semimembranosus tendon does not contribute to the pes ansernus
147
Which special test is used to determine the integrity of the biceps tendon in the bicipital groove?
A. Yergason's test
B. Apley's compression test
C. Both A andB
D. Neither A or B
Answer: A
Rationale: Yergason's test is one of the special tests used to test for bicipital tendonitis.
148
397.A physical therapist forms passive range of motion to a C7 quadriplegic, The patient's bilateral straight leg raise is measured passively to be 90°. What should the physical therapist conclude about the patient's ability to perform activities of daily living?
A. The patient requires a straight leg raise of 110 to 120° in order to perform long sit and activities of daily living
B. The patient is at a functional range to perform a long sit and activities of daily living
C. The patient's range of motion is beyond the expected limit for a long sit and activities of daily living
D. The patient requires a straight leg raise of 150° in order to perform long sit and activities of daily living
Answer: A
Rationale: 110-120 degrees of straight leg raising is required to perform a long sit.
149
What diagnostic test can be used to identify a contracture of the iliotibial band (ITB)?
A. Thomas test
B. Trendelenburg test
C. Ober test
D. None of the above
Answer: C
Rationale: The Ober test is sued to assess ITB length.
150
399.A physical therapist is evaluating a 43 ear old female who has been diagnosed with a non-displaced fracture of the greater tuberosity of the humerus. The patient is unsure if she is supposed to keep her arm in the sling given to her by the physician. An appropriate course of action would be to:
A. Ask the patient to call her physician office, and in the meantime instruct the patient to wear the sling at all times
B. Instruct the patient not to use the sling because it will inhibit her range of motion
C. Use your best judgment based on how the referring physician usually treats humerus fractures
D. Contact the physician immediately and ask what instructions were given to the patient
Answer: A
Rationale: This would be the best course of action for the patient.
151
You are reviewing a patient's past medical history. The history indicates that the patient has been taking a medication which produces side effects similar to the clinical syndrome of Cushing's disease. Which of the following drugs could produce such a side effect?
A. Corticosteroids
B. Benzodiazepines
C. Tricyclic antidepressants
D. None of these drugs would produce those side effects
Answer: A
Rationale: The side effects from corticosteroids emulate from exogenous hypercotisolism, which is similar to the clinical syndrome of Cushing's disease.
152
You are taking the history of a 14-year-old girl who has a body mass index (BMI) of 18. The girl repots extreme difficulty with eating, induced vomiting and severe constipation. Which of the following would you most likely suspect?
A. Multiple sclerosis
BB. Anorexia nervosa
C. Bulimia
D. Systemic sclerosis
Answer: B
Rationale: The patient history highlights the classic signs and symptoms of anorexia nervosa.
153
You are considering the use of high-voltage galvanic therapy or high-voltage pulsed galvanic stimulation (HVPGS) on a patient. Which of the following conditions can benefit from this form of stimulation?
A. Wound management
B. Protective muscle spasm
C. Pain management
D. All are benefits of high-voltage galvanic therapy or high-voltage pulsed galvanic stimulation (HVPGS)
Answer: D
Rationale: All are benefits of high-voltage galvanic therapy or high-voltage pulsed galvanic stimulation (HVPGS).
154
The potential outcomes of pursed lip breathing exercises include?
A. Prolonging the expiratory phase
B. Slowing the respiratory rate
C. Increasing the excretion of carbon dioxide
D. All of the above
Answer: D
Rationale: All are considered to be potential outcomes of pursed lip breathing.
155
404.A home visit is performed for a patient who is four weeks status post total hip replacement. The patient is presently partial weight-bearing on the affected side. The patient resides alone. The minimum recommendations for this patient to increase safety in the bathroom are?
A. Tub bench. hand-held shower
B. Grab bars in the shower and next to the toilet
C. Hand rails for the toilet, tub bench, hand-held shower
D. The patient should not shower until their weight-bearing status increases
Answer: C
Rationale: This patient would likely require hand rails for the toilet, a tub bench, and a handheld shower.
156
405.You are about to examine a patient diagnosed with a left CA. All of the following secondary complications associated with a CVA should be assessed during your examination, except:
A. Contracture and deformity prevention
B. Decreased sensorimotor function
C. Spasticity
D. All of the above
Answer: D
Rationale: All are considered to be secondary complications associated with a CVA
157
406.You are assessing the strength of the long toe extensors on a patient with a spinal cord injury. Which nerve segment level primarily innervates this key muscle group?
A. L2
B. L3
C. LA
D L5
Answer: D
Rationale: The long toe extensors are served by L5-S1.
158
407.While assessing the posture of a patient, you note that the T2 spinous process in the thoracic region appears to be rotated to the left. Which bony landmark would you be using to make this approximation of the vertebral level?
A. Inferior angle of the scapula
B. Superior angle of the scapula
C. Spine of the scapula
D. Xiphoid process of the sternum
Answer: B
Rationale: The superior angle of the scapula is used for this approximation.
159
408.A patient with an above-knee prosthesis is swinging the prosthesis out to the side in an arc during the swing phase of the amputated limb. The most likelv cause of this is:
A. The prosthesis is too long
B. the prosthesis has an excessively low lateral wall
C. the knee unit is too loose
D. the prosthesis is not providing sufficient support
Answer: A
Rationale: This is one of the classic signs of a prosthesis that is too long.
160
When examining a patient with a new above- knee prosthesis, you notice that the heel on the involved foot moves laterally at toe-off. Which of the following is the most likely cause of this deviation?
A. The prosthesis is too long
B. Excessive internal rotation of the prosthetic knee
C. The prosthesis is too short
D. Excessive external rotation of the prosthetic knee
Answer: B
Rationale: Of those listed, this is the correct answer--none of the others would cause the foot to move laterally at toe-off.
161
You are evaluating an infant for normal reflexes. You deliberately temporarily lose grip of the infant, causing him tobe startled and begin to cry. Which of the following reflexes were you assessing?
A. Asymmetric tonic neck
B. Moro reflex
C. Landau reaction
D. Righting reaction
Answer: B
Rationale: This is the method by which to assess the Moro reflex.
162
You are setting long-term goals for an 18-year-old patient with C7 quadriplegia. Which of the following goalsrepresents the most reasonable and highest level of function that the patient should achieve?
A. Ambulation on level surfaces with knee-ankle-foot orthoses
B. Use of a power wheelchair
C. Independent bed mobility
D. Negotiation of uneven terrain with a manual wheelchair
Answer: D
Rationale: Of those listed, this would be the highest and most reasonable level of function for this patient.
163
While examining an infant you note a pronounced tuft of hair on the center of the spinal column in the lumbar area. Your examination reveals no loss in motor or sensory function. This patient most likely has what form of spinabifida?
A. Meningocele
B. Spina bifida occulta
C. Arnold Chiari
D. Meningomyelocele
Answer: B
Rationale: These are the clinical findings for spina bifida occulta.
164
You are evaluating a patient with a diagnosis of hip ligament sprain. Which of the following hip ligaments attachesto the anterior inferior iliac spine of the pelvis and the intertrochanteric line of the femur?
A. Ischiofemoral ligament
B. Iliofemoral ligament (Y ligament of Bigelow)
C. Pubofemoral ligament
D. Ligamentum teres
Answer: B
Rationale: This is the description of the iliofemoral ligament attachments. The iliofemoral ligament is considered to be the strongest of the hip ligaments.
165
414.A 72 year-old man presents with hot, red, and edematous skin over the shins of both lower extremities and a mild fever
The MOST likely cause of his symptoms is:
A. scleroderma
B. cellulitis
C. Tick bite
D. Psoriasis
Answer: B
Rationale: The inclusion of a fever in the findings would indicate some form of infection.
166
415.A 60-year-old wheelchair bound patient is being discharged home from your hospital. In preparation for discharge, you visit the home and find he has 3 standard height steps going into his home, requiring a ramp to be constructed for his wheelchair. The recommended length of his ramp should be:
A. 252 inches (21 feet).
B. 72 inches (6 feet).
C. 96 inches (8 feet).
D. 240 inches (20 feet).
Answer: A
Rationale: The accessibility requirements are 12 inches of length for each inch of vertical rise. The standard height of a step is 7 inches. Thus in this example of 3 steps there is a rise of 21 inches. This total is multiplied by 12.
167
You are examining a patient who sustained a left-sided injwy to her back while playing tennis. She was serving the ball when she felt an immediate sharp pain in her right low back. She reports that her low back is stiff in the moming but that her pain eases after taking a shower. Based on the above information, the structure MOST likely involved is:
A. Lumbar facet joint.
B. a spinal nerve root.
C. the transverse ligament
D. a lumbar disc.
Answer: A
Rationale: Based on the history and the absence of neurological symptoms, a facet joint would be the most likely cause.
168
Youread on an x-ray report that your patient has a problem with the pars interarticularis at the L5 level. A dysfunction of this part of the vertebra could possibly lead to:
A. Spondylolisthesis with possible anterior slippage of the vertebral body,
B. Spondylolysis
C. Spinal nerve root compression.
D. Disc herniation.
Answer: A
Rationale: Spondylylosis is a defect of the pars interarticularis of the spine, which lies between the superior and inferior articular facets of the vertebral arch.
169
418. You are examining a 65-year-old male who has a long history of lumbar pain and a diagnosis of degenerative joint disease (DJD) of his lumbar facet joints. During the exam, the patient complained of numbness, paresthesias and weakness of his bilateral lower extremities which increase with lumbar extension positions. However, he also reports he can ride a stationary bike for 30 minutes without any problems. What would be your provisional diagnosis for this patient?
A. spinal stenosis.
B. degenerative arthritis.
C. spondylolysis.
D. discal dysfunction.
Answer: A
Rationale: This is the classic history of a patient with spinal stenosis.
170
You are examining a college soccer player who sustained a hyperextension knee injury during a game the previous day.
The patient went to the emergency room of a local hospital and was diagnosed with "knee sprain. You decide to test the patient's anterior cruciate ligament of the involved knee. Which of the following tests would the best touse?
A. Lachman
B. McMuray
C. Ober
D. Ely
Answer: A
Rationale: The Lachman test is a special test designed to test the integrity of the ACL.
171
You are examining a tennis player who was refered to physical therapy with progressive posterior shoulder pain and weakness of the shoulder abductors and external (lateral) rotators. You notice muscle atrophy superior and inferior to the scapular spine. The patient's problem is MOST LIKELY attributable to damage involving the:
A. Median nerve
B. Suprascapular nerve.
C. Spinal accessory nerve.
D. Long thoracic nerve
Answer: B
Rationale: The suprascapular nerve innervates the supraspmatus and infraspinatus muscles, which are located superiorly and inferiorly to the scapular spine respectively.
172
During the gait assessment of a patient who is beginning ambulation training with a right above-knee prosthesis, you observe that the heel rises excessively during early swing. Possible causes for this are:
A. The prosthesis is too long
B. Too much tension in the extension aid.
C. Weakness of the hip extensors
D. Inadequate knee friction or too little tension in the extension aid.
Answer: D
Rationale: These are the two common reasons for excessive heel rising.
173
You are examining a 21 year-old man who suffered a gun shot wound and now exhibits Brown-Sequard syndrome. The classic signs and symptoms of this syndrome are:
A. Preservation of perianal sensation, normal lower extremity reflexes, and active toe flexion.
B. Ipsilateral weakness and loss of proprioception and vibration below the lesion level with contralateral loss of painand temperature sensation.
C. Loss of motor function and pain and temperature sensation below the level of the lesion on both sides of the body.
D. Loss of upper extremity function with preservation of lower extremitv function
Answer: B
Rationale: These are the classic signs and symptoms of the Brown-sequard syndrome.
174
You are performing a gait assessment on a patient using a patellar-tendon bearing prosthesis, and you observeexcessive knee flexion in early stance of the involved side. The most likely reason for this is:
A. The socket is aligned too far posteriorly.
B. The socket is aligned too far forward or tilted anteriorly.
C. The foot component is outset too much.
D. The foot component is inset too much.
Answer: B
Rationale: This is one of the common causes for excessive knee flexion in early stance.
175
Independent community ambulation as the primarv means of functional mobility is a realistic functional expectation fora patient with the highest level of spinal cord injury at:
A. T9-10
B. T12-L1
C. T6-T9
D. LA-L5
Answer: D
Rationale: This is the highest level of spinal cord injury that one could expect to achieve independent community ambulation as the primary means of functional mobility.
176
You are performing a gait assessment on a patient using a below-knee prosthesis who demonstrates an uneven heelrise on the prosthetic side. What is the most likely cause of this?
A. The hip extensors are weak.
B. Insufticient knee friction
C. The prosthesis is externally rotated.
D. the prosthesis is not providing sufficient support
Answer: B
Rationale: This is one of the common causes for an uneven heel rise.
177
You are ambulating a patient in their hospital room when she suddenly grabs vour arm and indicates that she feels faint.
The most appropriate immediate action is:
A. TIl the patient this is a normal reaction
B. ask the patient if she has ever previously fainted
C. loosen tight clothing and continue
D. assist the patient to a sitting position
Answer: D
Rationale: This would be the most appropriate first step to take.
178
You are taking a blood pressure measurement of a one-month-old infant. Which of the following measurements would be the most typical based on the infant's chronological age?
A. 55/40 mm Hg
B. 65/45 mm Hg
C. 85/60 mm Hg
D. 120/80 mm Hg
Answer: C
Rationale: These measurements would be appropriate based on the the infant's chronological age
179
As part of a work-site analysis, you examine the workstation of a computer operator. When seated at a video display terminal, how far should the screen be positioned from the patient?
A. 6 inches
B. 10 inches
C. 20 inches
D. 32 inches
Answer: C
Rationale: The screen should be positioned 20 inches from the patient.
180
You are examining a patient who is diagnosed with a C5 spinal nerve root compression? Which of the following would vou not expect to find during vour examination
A. muscle weakness of the elbow extensors and wrist flexors
B. decreased sensation in the deltoid area
C. muscle weakness of the deltoid and biceps muscles
D. diminished biceps and brachioradialis reflex
Answer: A
Rationale: The elbow extensors and wrist flexors are innervated by the C7-8 nerve root levels.
181
You are reading a patient's medical report concerning his gait. The previous therapist used Rancho Los Amigos terminology. Which pair of descriptive terms describes the same general point in the gaitcycle?
A. midstance to heel off and initial swing
B. heel strike and initial contact
C. foot flat to midstance and loading response
D. toe off and midswing
Answer: B
Rationale: These two descriptors describe the same general point in the gait cycle.
182
As part of a patient's shoulder examination, you position the patient in supine to take a goniometric measurement of internal rotation of the shoulder. Where should you position the fulcrum of the goniometer?
A. over the medial epicondyle of the humerus
B. perpendicular to the ceiling
C. along the midaxillary line
D. over the olecranon process
Answer: D
Rationale: The fulcrum of the goniometer should be placed over the olecranon process to assess internal rotation of the shoulder.
183
You are initiating a cranial nerve (CN examination on a patient. Which test would you use to test CN I?
A. the patient protrudes the tongue while you assess lateral deviation
B. the patient completes a vision examination
C. the patient performs a shoulder shrug against your resistance
D. the patient is asked to identify familiar odors with the eyes closed
Answer: D
Rationale: Cranial nerve I is responsible for the sense of smell.
184
Yoususpect the patient you are examining has an injury to the thoracodorsal nerve. Which of the following objective finding would lead you to suspect such an injury?
A. shoulder external rotation weakness
B. shoulder extension weakness
C. winging of the scapular
D. forward displacement of the lateral end of the clavicle
Answer: B
Rationale: The thoracodorsal nerve innervates the latissimus dorsi, the major extender of the shoulder
185
You are instructing a physical therapy student how to palpate the transverse process of C1. Which instructions describe the most appropriate method to palpate C1?
A. place your fingers at the base of the hairline and move laterally and inferiorly
B. place your fingers immediately inferior to the patient's earlobes until you identify a bony prominence
C. place your fingers in the space between the mastoid process and the angle of the mandible and move medially
D. place your fingers on the superior nuchal line and move laterally and superiorly
Answer: C
Rationale: This is the correct location of the C1 transverse process.
186
You are evaluating a patient in the intensive care unit. The patient demonstrates no eye opening, no verbal response, and no motor response, Using the Glasgow coma scale (GCS), how would you score this patient?
A. 0
B. 3.
C. 5
D. 7
Answer: B
Rationale: A GCS score of 3 is given to a patient who demonstrates no eye opening, no verbal response, and no motor response
187
You are measuring a 25-year-old man diagnosed with a C5 spinal cord injury for an appropriate wheelchair. What is the correct way to measure length of the footrests for the patient's permanent wheelchair?
A. From the patient's popliteal fossa to their heel and add 1 inch
B. From the patient's popliteal fossa to the medial malleolus and add 1 inch
C. From the patient's popliteal fossa to their heel and subtract 1 inch
D. From the patient's popliteal fossa to the medial malleolus and subtract 1 inch
Answer: C
Rationale: These are the correct landmarks to use when measuring the length of the footrests.
188
You are examining a patient who sustained a spinal cord injwy and who presents with the following findings: intact proprioception in bilateral lower extremities, with bilateral loss of motor function and sensitivity to painand temperature below the level of the lesion. Which of the following syndromes is this lesion most typical of?
A. Brown Sequard syndrome
B. Anterior cord syndrome
C. Posterior cord syndrome
D. Lateral cord syndrome
Answer: B
Rationale: This is the description of an anterior cord syndrome.
189
You are examining a 45-year-old man with the chief complaint of low back pain One of the findings in the exam is a positive Thomas test. What does a positive Thomas test indicate?
A. Adaptive shortening of the hip flexors and and rectus femoris
B. Adaptive shortening of the knee extensors
C. Weakness of the gluteus medius
D. Adaptive shortening of the heel cords
Answer: A
Rationale: A positive Thomas test indicates adaptive shoitening of the hip flexors and rectus femoris.
190
439.30-year-old woman presents to outpatient physical therapy, reporting that she is experiencing severe low back pain and parasthesia extending to the right foot following a lifting injury at work. The straight leg-raise test of the right lower extremity is positive. Based on these findings, which of the following would be your provisional diagnosis?
A. A lumbar disc herniation or protrusion
B. Piriformis syndrome
C. Sacroiliac joint dysfunction
D. Ligament sprain of the lumbar region
Answer: A
Rationale: Given the complaints of paresthesia and the positive straight leg raise, a lumbar disc protrusion would be the likeliest cause
191
440.You have been asked to estimate the percentage of a patient's body that has been burned. The patient is a 22-year-old man of normal size, who has received burns on the entire posterior surface of the head, the entire posterior portion of the left upper extremity, and the entire back. Using the rule of nines, what percentage of the patient's body is burned?
A. 27%
B. 18%
C. 9%
D. 4.5%
Answer: A
Rationale: Using the Rule of Nines for a normal adult, a burn covering the the entire posterior surface of the head (4.5%), the entire posterior portion of the left upper extremity (4.5%), and the entire back (18%) would total 27%.
192
441.A patient is referred to your department with a burn wound on the left hand. Upon examination, you find that the majority of the wound is anesthetic, but that there is significant eschar formation over the dorsum of the involved hand with moderate subcutaneous tissue damage. What is the most likely classification of this burn?
A. Full thickness
B. Partial thickness
C. First-degree
D. Second-degree
Answer: A
Rationale: With a full thickness burn, the majority of the wound is anesthetic, and there is significant eschar formation with moderate subcutaneous tissue damage.
193
You suspect adaptive shortening of a particular structure in an orthopedic patient. In order to test for this, youposition the patient is placed in the side lying positionwith the uninvolved leg closer to the table. Keeping the knee of the involved leg flexed at the knee, you extend and abduct the hip of the involved leg, and allow the proximal part of the involved leg to drop passively into adduction. Failure of the involved lower extremity to drop indicates an adaptive shortening of:
A. The hamstrings on the involved side
B. The hamstrings on the uninvolved side
C. The iliotibial band on the involved side
D. The rectus femoris on the involved side
Answer: C
Rationale: This is a description of the Ober test, a special test designed to detect adaptive shortening of the iliotibial band.
194
You are demonstrating developmental reflexes to a physical therapy student. Which reflex would be observed when passive flexion of the head of the infant results in the infant actively flexing the arms and actively extending the legs?
A. Symmetrical tonic neck
B. Landau's
C. Startle reflex
D. Crossed extension
Answer: A
Rationale: This is the correct description of the symmetrical tonic neck reflex.
195
You are examining a patient's wrist and want to determine the range of motion for radial deviation using a goniometer, The correct alignment of the goniometer should be as follows: the proximal arm is aligned with the forearm, and the distal arm is aligned with the third metacarpal. What structure should be used as the fulcrum point?
A. Scaphoid
B. Lunate
C. Pisiform
D. Capitate
Answer: D
Rationale: The capitate should be used as the fulcrum.
196
While reading the medical chartof an infant you are about to examine, you note that the patient has been diagnosed with tetralogy of Fallot. Which of the following findings are associated with this condition?
A. Ventricular septal defect, pulmonary valve stenosis, left ventricular hypertrophy, and transposition of the aorta to the right
B. Ventricular septal defect, pulmonary valve stenosis, right ventricular hypertrophy, and transposition of the aorta to the right
C. Atrial septal defect, pulmonary valve stenosis, right ventricular hypertrophy, and transposition of the aorta to the right side
D. Atrial septal defect, pulmonary valve stenosis, right ventricular hypertrophy, and transposition of the aorta to the left
Answer: B
Rationale: All are involved with tetralogy of Fallot -- it involves numerous developmental anomalies.
197
You are palpating a patient's foot. Which of the following articulate with the second cuneiform?
A. Cuboid
B. Navicular
C. Talus
D. Scaphoid
Answer: B
Rationale: The navicular articulates with the second cuneiform
198
You are performing auscultation of a patient's heart. Which of the following is true about the second sound during auscultation of the heart?
A. The second sound is of the closure of the aortic and pulmonic valves
B. The second sound is of the closure of the mitral and tricuspid valves
C. The second sound is of the opening of the mitral and tricuspid valves
D. The second sound is of the aortic and pulmonic valves
Answer: A
Rationale: The second sound during auscultation of the heart occurs with the closure of the aortic and pulmonic valves.
199
You are performing passive range of motion on a comatose patient in the intensive care unit. Although the patient is breathing independently, you notices that the patient is breathing with an increase in breathing rate and depth followed by brief pauses in breathing. What would be your best course of action?
A. Continue as normal as the patient is probably just dreaming
B. Notify the appropriate personnel that the patient is exhibiting paroxysmal nocturnal dysprea
C. Notify the appropriate personnel that the patient is exhibiting the Cheyne-Stokes type of breathing
D. Continue as normal and make a note in the patient's chart
Answer: C
Rationale: Cheyne-Stokes type of breathing is characterized by breathing with an increase in breathing rate and depth followed by brief pauses in breathing.
200
Your supervisor is watching you examine a patient in the intensive care unit who recentlv suffered a stroke. Your evaluation reveals contralateral hemiplegia (upper extremity involvement greater than lower extremities), homonymous hemianopsia, aphasia, and contralateral loss of sensation in the upper extremities. Your supervisor asks vou which of the cerebral arteries is the likely location of the lesion? Youreply:
(A. Middle cerebral arterv
B. Anterior cerebral artery
C. Posterior cerebral artery
D. Lateral cerebral artery
Answer: A
Rationale: The middle cerebral artery syndrome involves contralateral hemiplegia (upper extremity involvement greater than lower extremities), homonymous hemianopsia, aphasia, and contralateral loss of sensation in the upper extremities.
201
You are taking a patient history, in which the patient tells you he just recovered from a disease but he can't remember the name. When asked to describe his symptoms he tells you that he originally experienced tingling in the hands and feet approximately 3 months after a bout of the flu and that he then experienced progressive weakness to the point that he required a ventilator to breathe. He is now recovering rapidly and is expected to return to a normal functional level in 3 more months. Which of the following conditions did the patient most likely suffer?
A. Multiple sclerosis
B. Guillain-Barré svndrome
C. Tick bite
D. Amyotrophic lateral sclerosis (Lou Gehrig's disease)
Answer: B
Rationale: Based on the description, Guillain Barré syndrome is the most likely.
202
Which of the following is widely considered the most accurate body composition assessment?
A. Bathroom scales
B. Hydrostatic weighing
C. Skin calipers
D. Electrical impedance
Answer: B
Rationale: Of those listed, hydrostatic weighing is the most accurate body composition assessment.
203
Which of the following is the normal end-feel perceived by an examiner assessing elbow flexion?
A. Tissue stretch
B. Empty
C. Soft tissue approximation
D. Capsular
Answer: C
Rationale: Soft tissue approximation occurs as the end feel of elbow flexion--produced by the contact of two muscle bulks on either side of the flexing joint.
204
You are evaluating the range of motion of a patient's hip and you note that his limitations in range demonstrate anon-capsular pattern of restriction. Which of the following are possible causes for a non-capsular restriction of range of motion?
A. Ligamentous adhesion
B. Internal derangement of the joint
C. Extra-articular lesion
D. All of the above
Answer: D
Rationale: All of these are considered by Cyrax as examples of the causes for a non-capsular restriction.
205
You are examining a 12-year-old boy who complains of diffuse pain in the right hip, thigh, and knee joint. The physical exam reveals that the patient is slightly obese and his right lower extremitv abducts and externally rotates during hip lexion You also note the patient has significant atrophy in the right quadricep. Which of the following is the most likely source of the patient's signs and symptoms?
A. The patient's joints are hurting because he needs to lose some weight
B. Slipped capital femoral epiphysis (SCFE
C. Avascular necrosis of the hip
D. Lumbar disk herniation
Answer: B
Rationale: This is the classic description of SCFE.
206
You are examining a patient who suffered a dramatic brain injury as a result of a contrecoup insult. How does this type of insult differ from a coup injury?
A. The contrecoup injury occurs directly beneath the area of impact
B. The contrecoup injury occurs directly opposite the point of impact
C. The contrecoup injury is the result of a moving object that strikes the skull
D. The contrecoup injury is the result of a crush syndrome
Answer: B
Rationale: A coup is a stroke or blow; a contrecoup occurs opposite the site of impact.
207
456.A patient arrives at your clinic with a diagnosis of congenital cox valga deformity. This type of deformity refers to:
A. An increase in the angle of inclination between the neck of the femur and its shaft
B. An abnormality of the proximal end of the tibia
C. A decrease in the angle of inclination between the neck of the femur and itsshaft
D. An abnormality of the distal end of the tibia
Answer: A
Rationale: Coxa valga describes an increase in the angulation from the normal of 130°
208
You are examining a patient with a diagnosis of a shoulder dislocation. Which of the following structures is often injured in association with a shoulder dislocation?
A. Radial nerve
B. Radial arterv
C. Axillary nerve
D. Axillary artery
Answer: C
Rationale: The other structures are more distal than the shoulder.
209
You are examining a child with the following deformity of the foot: the foot inversion, forefoot adduction, and plantar flexion. The correct term for this deformity is:
A. Talipes equinovarus
B. Talipes calcaneovalgus
C. Talipes valgus
D. Talipes calcaneus
Answer: A
Rationale: This is the definition of an individual who walks on the toes.
210
You are about to examine a teenage boy who has been diagnosed with Erb-Duchenne paralysis. Which of the following muscles would vou expect to find weak?
A. Deltoid. and the internal rotators of the shoulder
B. Wrist flexors, and finger flexors
C. Wrist and elbow extensors
D. Biceps, brachialis, supinator, and brachioradialis
Answer: D
Rationale: Erb-Duchenne paralysis is another name for a paralysis that involves C5-6.
211
You are examining a patient who sustained a hand and wrist injwy a few weeks prior. You notice evidence of atrophy of the muscles of the thenar eminence. This would indicate an injury to which nerve?
A. Median
B. Unar
C. Radial
D. Musculocutaneous
Answer: A
Rationale: The median nerve innervates the thenar eminence.
212
You are examining a patient who has been diagnosed with a peripheral nerve injuy. The patient presents with the following findings: an inability to fully flex the index finger and middle finger, loss of thumb opposition, and loss of sensation in the lateral one half of the ring finger, the middle and index finger, and the thumb. Which nerve do you suspect is involved?
A. Musculocutaneous
B. Radial
C. Median
D. Ulnar
Answer: C
Rationale: The median nerve innervates the muscles that produce finger flexion, thumb opposition, and sensation to the ring finger.
213
You are evaluating the deep tendon reflexes of a soccer player who is complaining of back and leg pain. The patient has diminished knee jerk/patellar reflex. Which spinal nerve root is associated with the patellar reflex?
A. T12
B. L4
C. LI
D. T12
Answer: B
Rationale: The musculature of the knee is innervated by the L4 nerve root.
214
You are examining a patient with a history of joint disturbances involving arthritis and arthralgias which have been symmetrical and migratory when you notice an erythematous butterfly rash over the nose and molar area. What theumatoid diseases is associated with these findings?
A. Dermatomvositis
B. Progressive systemic scleroderma
C. Systemic lupus erythematosus
D. Juvenile rheumatoid arthritis
Answer: C
Rationale: This is the clinical picture of systemic lupus erythematosus.
215
464. You are examining a patient bedside who presents with left-sided weakness of the upper and lower extremity following a stroke. In which part of the brain was the lesion likely located?
A. Brainstem
B. Medulla
C. Cerebellum
D. Right cerebral hemisphere
Answer: D
Rationale: Each cerebral hemisphere is responsible for the function of the extremities on the opposite side of the body.
216
You are evaluating a patient who has difficulty swallowing. Which word would you use in your documentation to describe this difficult?
A. Dysphasia
B. Dysphagia
C. Dystonia
D. Dysmetria
Answer: B
Rationale: The definition of dysphagia is difficulty with swallowing. Dysphasia is an impairment of speech and verbal comprehension.
217
You are applying manual muscle testing to a patient's wrist and hand to help determine the extent of recovery from a median nerve lesion. Which of the following muscles is not supplied by the median nerve?
A. Flexor carpi radialis
B. Flexor digitorum superficialis
C. Flexor pollicus longus
D. Abductor pollicus longus
Answer: D
Rationale: The abductor pollicus longus is innervated by the posterior interosseous nerve.
218
You are observing a child for normal development. At which age should a child be able to roll from prone tosupine?
A. 0-3 months
B. 3-5 months
C. 4-6 months
D. 6-8 months
Answer: B
Rationale: A child should be able to roll from prone to supine at 3-5 months.
219
During your examintion of an infant, you note that when you resist movement of the right upper extremity of the infant, an involuntary movement of the left upper extremity occurs. What have you witnessed?
A. Landau reaction
B. Associated reaction
C. Overflow reaction
D. Contralateral reaction
Answer: B
Rationale: This is a description of the associated reaction.
220
You have just completed vour examination of a patient diagnosed with a spinal cord injuv. Your documentation states the following for motor control: Paralysis of trunk and both LE, but able to demonstrate shoulder control (deltoids) elbow flexion (biceps/elbow flexors) forearm supination (brachialis and brachioradialis), although lacks elbow extension and forearm pronation. Which spinal cord level injy are you describing?
A. C4
B. C5
C. C6
D. C7
Answer: B
Rationale: These impairments are involved with a C5 spinal cord lesion.
221
You are working in a Direct Access environment and are evaluating a 5-year-old girl with an elbow injury. According the mother, the injury was sustained when the mother suddenly pulled on the girls hand to prevent her running on to a busy street. The girl is holding the arm in a protected position and is refusing to let you move it. Which of the following is the most likely diagnosis?
A. Nursemaid's elbow
B. Radial head fracture
C. Child abuse
D. Muscle strain
Answer: A
Rationale: This history is often associated with nursemaid's elbow (a partial dislocation of the radial head).
222
When taking a history the patient describes his disease as involving a slowly progressive enlargement and deformity of multiple bones. Which bone pathology would you suspect?
A. Paget's disease
B. Osteogenesis imperfecta
C. Osteochondritis dissecans
D. Osteomalacia
Answer: A
Rationale: Paget's disease is described as a focal disorder of accelerated skeletal remodeling that may affect one or more bones
223
You are examining a pregnant female. All of the following are complications associated with pregnancy except:
A. Hypertension
B. Diastasis recti abdominis
C. Hyperemesis Gravidarum
D. Weight gain
Answer: D
Rationale: Weight gain is a normal finding with pregnancy.
224
You are examining a 70-year-old man with a diagnosis of sciatica. You are unable to reproduce the symptoms of radiculopathy with any test and deep tendon reflexes are normal. Upon further questioning, you learn that the pain increases with prolonged ambulation, but that it is relieved soon after resting in a seated position. What is the mostlikely diagnosis and how should vou proceed?
A. Intermittent claudication: call the physician and discuss your findings
B. Schmorl's node: refer the patient back to the physician
C. Sciatica: proceed with McKenzie protocol
D. Abdominal aortic aneurvsm: call for an ambulance immediatelv
Answer: A
Rationale: These are common findings with intermittent claudication.
225
You are examining a patient with a diagnosis of an ankle sprain. Which digament is most commonly involved in ankle sprains?
A. Anterior talofibular
B. Posterior talofibular
C. Anterior tibiotalar
D. Posterior tibiotalar
Answer: A
Rationale: The anterior talofibular ligament is the most commonly injured ankle ligament.
226
You are examining the ligaments of the knee. Which of the following statements below best describes the function of the anterior cruciate ligament?
A. It prevents excessive anterior translation of the tibia on the femur
B. It prevents valgus (contact) stress at the knee
C. It prevents excessive posterior translation of the tibia on the femur
D. It prevents varus (contact) stress at the knee
Answer: A
Rationale: The anterior cruciate ligament prevents excessive anterior translation of the tibia on the femur
227
You are examining a patient with a diagnosis cerebellar disease. Which of the following findings are not associatedwith cerebellar disease?
A. Intention tremor
B. dysdiadochokinesia
C. ataxia
D. resting tremor
Answer: D
Rationale: A resting tremor is more often associated with parkinson's disease.
228
You are examining a patient in a nursing home who is unable to ambulate. All of the following are important to assess in this patient if you are to help prevent a pressure ulcer except?
A. Activity level
B. Diabetes mellitus
C. Mental status
D. All are important to assess
Answer: D
Rationale: All 3 of these answers refer to areas that require consideration when assessing the risk for pressure ulcers.
229
You are assessing a patient with a pressure ulcer. The ulcer demonstrates a partial thickness skin loss that involves the epidermis and/or dermis. In addition, the ulcer is superficial and presents clinically as an abrasion, a blister, or shallow crater. Using the National Pressure Ulcer Advisory Panel (NPUAP) Pressure Ulcers Stages, how would you grade this ulcer?
A. Stage I
B. Stage II
C. Stage III
D. Stage IV
Answer: B
Rationale: The findings are indicative of a Stage II ulcer under the NPUAP classification.
230
You are examining a patient's wound. You observe that the exudate presents an opaque, yellow or tan color, with a thin. watery consistency. How would you classify this exudate for documentation purposes?
A. Sanguinous
B. Serous
C. Serosanguinous
D. Seropurulent
Answer: D
Rationale: This is the description of a seropurulent exudate.
231
You are helping a PT student to distinguish between the various ulcers based on appearance, An ulcer that demonstrates trophic changes, is pale on elevation and has a dusky rubor on dependency is likely to be:
A. A pressure ulcer
B. A venous ulcer
C. An arterial ulcer
D. A diabetic ulcer
Answer: C
Rationale: These findings describe an arterial ulcer.
232
You are about to examine a patient who according to the medical record suffered a middle cerebral artery stroke. Based on your knowledge of the various strokes and their manifestations, you expect this patient to present with:
A. contralateral hemiparesis and sensory deficits with greater involvement of leg than the arm
B. contralateral hemiparesis and sensory deficits with greater involvement in the arm than the leg
C. contralateral hemiparesis and sensory deficits equal in the arm and the leg
D. contralateral hemiparesis and aphasia
Answer: B
Rationale: These are the findings associated with a middle cerebral artery stroke.
233
You are examining a 23 month-old child and you observe that the child can sit independently, pull-to-stand andcruise sideways, but is unable to walk without support. You conclude that this child is exhibiting
A. normal gross motor development
B. advanced gross motor development
C. Is ahead in achieving developmental milestones
D. delay in achieving developmental milestones
Answer: D
Rationale:At 23 months, a child should be able to walk without support.
234
You are performing a cranial nerve test on a patient. The patient demonstrates motor impairments of the tongue with apsilateral wasting and deviation on protrusion. Which cranial nerve is involved?
A. XI
B. XII
C Х
D. IX
Answer: B
Rationale: Cranial nerve XII (Hypoglossal) is the motor nerve of the tongue, innervating the ipsilateral side of the tongue.
235
You are examining a patient who was referred to you with a diagnosis of impingement syndrome. During the examination you note rotatory winging of the scapula, and an inability to shrug the shoulder. Based on these findings, what would be your preliminary diagnosis?
A. Impingement syndrome
B. A lesion of CN XI
C. Poor scapular control
D. Overall deconditioning
Answer: B
Rationale: The spinal portion of the spinal accessory nerve (CN XI) supplies the sternocleidomastoid and the trapezius muscles.
236
You are performing a gait assessment on a patient diagnosed with a left CVA. You observe an increased circumduction of the right lower extremity. Which of the following is the most likely cause of this deviation?
A. weakness of the right quadriceps
B. increased spasticity of the right quadriceps
C. Weakness of the left dorsiflexors
D. Increased leg length on the left side
Answer: B
Rationale: An increase in spasticity in the right quadriceps would prevent the knee from flexing.
237
You are covering for an absentee colleague and are about to treat a pediatric patient with a diagnosis of cerebralpalsy
(CP). Youread in your colleague's progress notes that the following have been observed in the patient: periods of hypotonia followed by extensor spasticity in the lower extremities with little or no functional limitation of the upper extremities. Which CP classification best describes this patient?
A. Spastic hemiplegia
B. Spastic dyskinesia
C. Spastic diplegia
D. Spastic
Answer: C
Rationale: This is the CP classification that best describes this patient.
238
You have just completed your examination of a patient with a diagnosis of cystic fibrosis. Which of the following findings would vou not expect to find?
A. increased pulmonary secretions
B. History of frequent respiratory infections
C. Documented evidence of increased pancreatic secretions
D. reports of excessive weight gain
Answer: D
Rationale: Cystic fibrosis is characterized by weight loss.
239
You are examining a neonate and want to determine whether the patient is in pain. All of the following would indicate the patient may be in pain, except:
A. Decreased heart rate
B. Increased respirations
C. Skin flushing
D. Increased muscle tone
Answer: A
Rationale: Pain in a neonate manifest as an increase in heart rate.
240
You are examining a patient diagnosed with Alzheimer's disease (AD). Which of the following is not a true statement about Alzheimer's?
A. To date, no interventions have been shown to convincingly prevent AD or slow its progression
B. Therapeutic approaches to AD are based on developing theories of its pathogenesis and on the need to alleviate its cognitive and behavioral manifestations
C. Both physical and mental activities are recommended for patients with AD
D. All are true statements about AD
Answer: D
Rationale: All of these statements are true.
241
You are taking the history of a patient who is also a physician. The patient reports that he has been prescribed a beta adrenergic blocker, What impact might this drug have on your examination findings?
A. Beta adrenergic blockers slow down the heart rate and lower blood pressure
B. Beta adrenergic blockers increase the heart rate and raise blood pressure
C. Beta adrenergic blockers decrease the work of the left ventricle and lower blood pressure
D. Beta adrenergic blockers help prevent epileptic seizures
Answer: A
Rationale: The function of beta adrenergic blockers is to slow down the heart rate and lower blood pressure.
242
You decide to assess the joint glide involved with ankle dorsiflexion in a patient. Using your knowledge of the convex-concave rule, which of the following joint mobility techniques would be the most appropriate to perform?
A. Posterior glide of the talus on the mortise of the distal tibiofibular articulation
B. Anterior glide of the talus on the calcaneus
C. Posterior glide of the talus on the calcaneus
D. Anterior glide of the talus on the mortise of the distal tibiofibular articulation
Answer: A
Rationale: Ankle dorsiflexion involves a posterior glide of the convex talus on the concave ankle mortise.
243
You have just finished your examination and evaluation of a patient who is about to begin rehabilitating from a spinal cord injury. The patient's family ask you if the patient will ever be able to drive independently. What is the highest spinal cord injury level where this activity would be a realistic independent functional outcome?
A. C4
B. C6
C. TI
D. T3
Answer: B
Rationale: Of those listed, an injury at the C6 level would be the highest level that could achieve driving independently.
244
You are assessing ankle plantar flexor strength, All of the following muscles produce plantar flexion, except:
A. Fibularis brevis
B. Tibialis posterior
C. Popliteus
D. Soleus
Answer: C
Rationale: The popliteus serves to externally rotate the femur/internally rotate the tibia and assists with knee flexion.
245
You are measuring a patient for a wheelchair? When measuring back height, which method is most accurate?
A. measure from the seat of the chair to the base of the axilla and subtract twoinches
B. measure from the seat of the chair to the base of the axilla and subtract fourinches
C. measure from the seat of the chair to the acromion process and subtract twoinches
D. measure from the seat of the chair to the acromion process and subtract four inches
Answer: B
Rationale: Back height is measured from the seat of the chair to the base of the axilla and then 4 inches is subtracted.
246
You are performing positional assessment of the sacroiliac joint (SIJ. If the results of the prone examination revealed a deep sacral sulcus on the left, and a posterior inferior lateral angle (ILA) on the right when the patient moves into the prone on elbows position. What is the positional dysfunction?
A. Bilateral sacral extension dvs function
B. Bilateral sacral flexion dysfunction
C. Unilateral right extended sacrum
D. Unilateral left extended sacrum
Answer: C
Rationale: The sacrum should flex with spinal extension. A deep sacral sulcus on the left with a posterior ILA on the right indicates the left side is flexing normally but the right side is stuck in extension.
247
Which of the following are appropriate precautions to take when examining a patient who is diagnosed withactive tuberculosis?
A. Insuring that the patient is in a private, negative pressurized room
B. Washing your hands upon entering and leaving the patient'sroom.
C. Wearing a tight fitting mask while treating the patient.
D. All are appropriate precautions
Answer: D
Rationale: All are appropriate responses.
248
You are examining a patient who reports passing out after celebrating with his friends the previous Saturday night. The patient reported sleeping with his right upper limb hanging over the back of a kitchen chair and he awoke with wrist drop, a poor hand grip, and a weakness of his wrist. Which neural structure will be the focus of vour assessment?
A. Posterior cord of the brachial plexus
B. Median nerve
C. Ulnar nerve
D. Lateral cord of the brachial plexus
Answer: A
Rationale: The posterior cord gives off the axillary nerve at the lower border of the subscapularis muscle and continues along the inferior and posterior surface of the axillary artery as the radial nerve.
249
You are examining a patient diagnosed with COPD who suddenly develops dyspnea, anxiety, and becomes disoriented.
What is the likelv cause of this?
A. respiratory acidosis
B. respiratory alkalosis
C. Panic attack
D. orthostaic hypotension
Answer: A
Rationale: Of those listed, respiratory acidosis would be the most likely (Table 10-19).
250
You are examining the active range of motion of a patient's cervical spine. During cervical extension, the patient complains of dizziness and a loss of balance. Compromise to which structure could cause these complaints:
A. Internal carotid artery
B. Vertebral artery
C. Ligamentum flavum
D. BandC
Answer: D
Rationale: These symptoms can be caused by compromise to the vertebral artery and by buckling of the ligamentum flavum during cervical extension
