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Question 1

Diagnosing medical conditions and diseases.

Is it in the scope or Physiotherapy or not?

Answer 1

No. Not in the PT scole of practice

Question 2

Prescribing or discussing the use of medication .

Is it in the scope or Physiotherapy or not?

Answer 2

No. Not in the PT scope of practice

Question 3

Individuals who have been delegated the activity by an individual who is authorized to perform them.

Can they perform the controlled acts or restricted activities?

Answer 3

Yes

Question 4

What are the 2 requirements to manage adverse outcomes related to controlled/ restricted acts?

Answer 4

Must know what to do if performing a controlled act results in a adverse outcome

Must have WRITTEN instructions that describe how to manage any reasonable foreseeable adverse outcome

Question 5

What are the 6 restricted activities?

Answer 5

Tracheal suctioning

Spinal manipulation

Acupuncture (including dry needling)

Treating a wound below the dermis

Assessing or rehabilitating pelvic musculature

Administering a substance by inhalation

Question 6

What are the controlled acts that can be delegated?

Answer 6

Tracheal suctioning

Treating a wound below the dermis

Adm a substance by inhalation

Question 7

What are the restricted activities that CANNOT be delegated?

Answer 7

Acupuncture
Communicating a diagnosis
Spinal manipulation
Internal assessment or rehabilitation of pelvic floor

Question 8

Can the PT perform iontophoresis?

Answer 8

PT can use meds prescribed by the physician when doing US

Question 9

Can the ptas conduct outcome measures like 6mwt, TUG, BERG balance?

Answer 9

Yes. But they can’t interpret the findings.

Ex: pta cannot document or say that based on the pts score he is at “high falls risk”

Also, if DURING the test there is an assessment or interpreting the test then the pta CANNOT perform it.

Question 10

Is sign a form and check the boxes considered “getting consent”?

Answer 10

No. It needs to be an INFORMED consent.

PT has also to CHART the conversation with the pt.

Question 11

Expressed consent can be… what forms?

Answer 11

Written
Verbal
Hand Gesture
Body language

Question 12

It is required to get consent prior to:

Answer 12

Assessing a pt

Treating a pt

Sharing health records or personal information regarding a pt to a third part

Question 13

The only exception for gettinga consent is….

Answer 13

An emergency. Pt needing CPR

Question 14

Is the a minimum agenfor giving consent?

Answer 14

No minimum age for giving consent

Question 15

Consent can only be given for each individual treatment? True or false?

Answer 15

False. Consent can be given for each individual treatment or for a multi faceted course of treatment.

Once u have consent for that specific tx. You do not need to obtain consent every time again.

Question 16

One health care provider can propose a plan or course of tx and get consent on behalf of all the others care providers involved in that plan.

True or false?

Answer 16

True
Ex: if u get consent for spinal mob and then another PT is seeing that pt. Then the physio does NOT need to get consent again

Question 17

Can you report an abuse to elderly ( at their house) without a consent?

Answer 17

No. You need to have consent to report it.

Question 18

Can you report an abuse to elderly ( in a ltc) without a consent?

Answer 18

Yes. Report is mandatory even when consent is DENIED.

Question 19

Can you report an abuse to child without a consent?

Answer 19

Report is mandatory.

Question 20

Can you report an elderly avise of mentally challenged without a consent?

Answer 20

Yes. It’s mandatory

Question 21

When can PTs use the title ‘Acupunturist’ ?

Answer 21

if they are registered with College of Traditional Chinese Medicine Practitioners. and Acupuncturist of Ontario Association.

Question 22

A new physiotherapy clinic is trying to attract new patients by offering a bundle package for their sessions which equates to a 15% savings over 10 sessions.

Which of the following is false regarding discounted prices for packaged/bundled services?

A: Discounted prices for packaged/bundled services must clearly state that there are still options to purchase single sessions.

B: The standard of care provided cannot be of lesser quality because of the packaged/bundled services.

C: When offering discounted prices for packaged/bundles services, refunds must be provided for any unused services.

D: Discounted prices for packaged/bundled services cannot exceed 10 sessions to avoid any conflicts of interest.

Answer 22

D. Discounted prices for packaged/bundled services cannot exceed 10 sessions to avoid any conflicts of interest. Best answer

• This is a false statement.

• There are no regulations regarding the number of sessions that can be included in a packaged/bundled.

Question 23

A new graduate physiotherapist has recently been hired by a private practice orthopedic clinic that employs several therapists that have a special interest in dizziness and vestibular conditions. The new graduate is hoping to receive vestibular mentoring at the clinic and plans to take some post graduate courses. The clinic owner has requested that the physiotherapist participate in an Instagram post to highlight their new position and requests that the physiotherapist mention that they now work at the best clinic in the Vancouver area. They would like the physiotherapist to also include that the clinic has over 99% success rate treating any and all vestibular related conditions.

Which of the following is the most ethical way for the physiotherapist to proceed?

A: Do as the owner requests and put up the Instagram story because the clinic is known to have a great reputation.

B: Refuse to post an Instagram story.

C: Agree to post an Instagram story but agree to only highlight their new position at the clinic.

D: Request to use Facebook instead to post about their new position and the clinic’s success rate as Instagram is not the best platform to use for advertisements.

Answer 23

C

This is the best answer as it helps to bring awareness and advertisement to the clinic without including any false or inaccurate statements.

• Using social media (Facebook, Instagram etc.) is a great marketing strategy for clinics and physiotherapists, but needs to be used in an ethical manner.

Question 24

A 35-year-old patient was working with their physiotherapist over the last 2 months to treat whiplash due to a motor vehicle accident. Upon discharge, the physiotherapist requests that the patient leave a Facebook and google review.

Question: Which of the following is true
regarding the use of reviews for advertisement purposes?

A: Physiotherapists cannot ask patients to leave reviews on any social media platform.

B: Physiotherapists can only ask patients to leave reviews on their professional website.

C: The use of reviews can only be used if they are given freely by patients without any prompting.

D: Physiotherapy clinics and/or the physiotherapists themselves can requests that patients leave a review.

Answer 24

D

• This is a true statement.

• Many organizations send out automatic emails to patients asking for reviews which means that the request for a review-toes not always come directly from the treating therapist.

Question 25

A physiotherapist is working with a patient who mentions that they can no longer afford their physiotherapy sessions. They have severe pain and benefit greatly from their weekly sessions. The patient is concerned that they will regress without ongoing treatment. The physiotherapist is in a difficult financial place and cannot afford to provide services at a discounted rate.

Question: How should the physiotherapist proceed?

A: Discuss alternative treatment options (e.g., working with a PTA or a home exercise program).

B: Offer a reduction in fee as the patient will benefit from ongoing physiotherapy sessions.

C: Ask a colleague if they are willing to continue to treat the patient for a discounted rate.

D: Advise the patient that physiotherapists cannot offer discounts on services as it can negatively affect the quality of care being delivered.

Answer 25

A: Discuss alternative treatment options (e.g., working with a PTA or a home exercise program).

Question 26

After a patient underwent a segmental resection surgery of rt lower lobe. She is experiencing hearing deficits along with mild agitation and irritation. You are scheduled to evaluate and treat this patient. Patients’ family is also present in the same room. Before initiating therapy what action will you take?

a) Request the entire family to wait outside the room.

b) Ask one person with whom the patient is comfortable to stay and then initiate therapy

C)Provide instruction and education to family on ambulation regarding patients status and prognosis

d) Conduct the exercise session with the patient in private room

Answer 26

B

Question 27

Therapist had a busy schedule today and two of the PTA’s working under him called out today due to snowstorm.
You are about to leave for the day in an hour and there are 4 patients who are not seen due to lack of enough staff., which of the following patient will you prioritize before you leave for home today?

a)A 75-year-old who underwent total hip replacement yesterday with history of DVT, and not on blood thinner.

b) A 32-year-old experiencing low back pain is currently managing pain with oxycodone.

C)A 54-year-old with emphysema is scheduled for discharge today.

d) A patient 3 days post-CABG is awaiting the commencement of cardiac rehabilitation.

Answer 27

A

Pos op day one always priority
D/c second

Always look whomis safe…3 days…not at risk

Question 28

In the context of a patient unable to follow ambulation instructions, which intervention aligns with best practice? There was not any problem during evaluation or education while the patient was at rest

a) Repeat the instructions using simplified language.

b) Get an interpreter and then start therapy.

c) Seek assistance from family members for instruction reinforcement.

d) Discontinue ambulation exercises for the session.

Answer 28

A

Question 29

During therapy, a patient with a below knee amputation becomes emotional and starts crying while recalling the incident that led to the amputation. Subsequently, she realizes her emotional outburst and now feels sorry for that. Which of the following would be least appropriate response from therapist here?

A)Express empathy and validate her emotions, encouraging open communication about the incident.

B)Provide a supportive environment, allowing her to express her feelings without judgment.

C)Offer tissues and assure her that her emotional response is understandable given the circumstances.

D)Ask her to reschedule therapy and start once she feels better to have best outcomes.

Answer 29

D

Question 30

Physical therapist is working in a home setting. He has noticed that patient fights with his wife verbally during a PT intervention in last few visits.

One day therapist noticed bruise on wife’s forearm. On questioning from therapist privately, wife admitted that she had an altercation with her husband last night, but everything is fine now. What will be the next step by therapist here?

a) Therapist is required to Report any incidents of abuse to State authorities.

b) Therapist must talk to patient and inform him about the consequences if he repeats the abuse.

c)Therapist must share the abuse helpline no with wife, if she decides to report the abuse in future.

d) Therapist must not indulge in their personnel matter.

Answer 30

C

Question 31

Physical therapist is working in a home setting. He has noticed that patient fights with his wife verbally during a PT intervention from last 1 week. One day therapist noticed bruise on wife’s forearm.

After being questioned by therapist privately, wife admitted that she had an altercation with her husband last night, but everything is fine now. In next visit, after 2 days therapist noticed that patient’s wife has bruise around left eye, small wound posterolateral to neck with a minor bleeding and a bruised great toe.

Later, therapist also heard her crying in a nearby room. What will be the next step by therapist here considering patient’s safety?

A) Therapist must call 911 and Report the incident to §tate

B) Therapist must talk to patient and explain him about the consequences of abuse.

C) Therapist must confront the patient and ask him to stay away from his wife.

D) Therapist must not indulge in their personnel matter.

Answer 31

A

Question 32

Therapist is treating an 84 yr old male in an outpatient physical therapy clinic for shoulder pain. After few sessions patient informed therapist that he is very upset with his daughter in law and grandson. They had many verbal arguments in last 1 month and in one incident his grandson even pushed him which led to his fall. What should be the next action by physical therapist?

A) Therapist must educate the patient about his rights and share the state’s helpline no to report abuse.

B) Therapist must report the incident to state as elderly abuse is part of mandatory reporting.

C) Therapist should avoid to indulge in their family matter as it may escalate the situation.

D) Therapist must call daughter in law and warn her to stop abusing the patient otherwise therapist will have to report the incident to state.

Answer 32

A

Question 33

• Therapist is treating a 92 yr. old bed ridden patient for transfer training in order to decrease assistance from caregivers in a long-term care home. During one of the session, patient was listless and did not want to do any of the exercises.

Later, patient reported that he is unhappy with his nursing aid because she does not change his diapers timely, makes him wait for lunch tray for prolong period and does not respond to call bells timely. Also, after the patient reported this incident to administrator of Nursing home, aid is verbally abusive in patients handling.

Patient is afraid of reporting it any further. What should be the next action by therapist here ?

A) Therapist must report the incident to state authorities

B) Therapist must document the incident without reporting it to state

C) Therapist must avoid getting indulged into Nursing matters

D) Therapist must confront the aid and warn her of consequences

Answer 33

A

Question 34

Patient has recently moved to a long-term care home. Patient reported that her elder son is using her pay cheque money for his personnel expenses too. Patient’s elder son is also her power of attorney. What could the next step here?

a) Report to patient’s nurse

b) Suggest patient to change her bank account address to her current location

c) Ask patient to discuss with son directly and express concern

d)Report to the long-term care director and request to remove son as power of attorney

Answer 34

A
It is a legal process to remove the poa. U cant ask that

Question 35

Patient is receiving physical therapy in an outpatient clinic status post Rt total knee replacement surgery from last 2 weeks. Patient has informed the therapist that he wants to do an alternate for bicycle exercises today as his pain increases after that exercise.

Therapist explained the importance of bicycle exercises to patient and made him do that before he finished therapy today. Which of the following ethical principles are being violated here by the therapist?

A) Beneficence
B) Autonomy
C) Non malfeasance
D) Justice

Answer 35

B

Question 36

Physiotherapist, with a specialization in Neurology has been approached by his uncle to receive therapy after his recent cerebrovascular accident.

Therapist’s uncle has visited all 4 clinics of his small town but none of the clinics have a Neurology specialist. What are the possible options therapist is having in this case ?

a) Therapist cannot treat his close relatives

b) Therapist can treat his uncle but for free

c) Therapist can give home exercises program and ask his uncle to do it by himself

D)Therapist can treat his uncle with proper referral from a doctor’s office at his regular fees

Answer 36

B

Question 37

• An 82yr old patient with recent Traumatic brain injury episode has been referred for physical therapy in a long-term care facility. Patient is very drowsy due to heavy medication dosage. Patient’s wife and 55 yr. old son is accompanying patient during the therapy examination.
From whom should a therapist take the consent to start Evaluation?

A. From patient himself
B. From Patient’s wife
C. From Patients son
D. From Patients doctor

Answer 37

B

Question 38

• Therapist has received a referral for an examination of an unconscious patient in Critical care unit whose vitals are unstable. Patient has no family members present to sign the consent form to start Examination. What should therapist do next ?

A) Wait for patient to get back in his senses or for his family members to come before doing examination
B) Consent is not needed
C) Hold therapy as it is not urgently needed
D) Take consent from social services before examining the patient

Answer 38

B

Question 39

• Patient has already signed the consent for treatment from therapist during the initial evaluation. Therapist is supervising a student and wants him to watch the treatment session to improve his clinical skills. Which of the following is an appropriate step here?

A. Patient has already signed the consent for physical therapy treatment,Another consent is not needed for student.

B. Student can later ask therapist about treatment session but cannot be present in the same room due to patient’s privacy

C. Students can observe the treatment session, but he will only need consent if he is wants to ask questions regarding patients’ diagnosis and treatment.

D. Student needs a consent from patient before observing the treatment session

Answer 39

D

Question 40

• Therapist is treating a 14 yr old child and takes consent from his parents because therapist believes that the child is not a mature minor. Before next visit child got an approval for his application to be considered as mature minor for all physiotherapy treatment by the consent and capacity board.
But therapist disagree with the decision of the consent board. What should a therapist do now?

A)Take consent from patient only.

B)Take consent from patient and his parents for your own safety.

C)Continue to take consent from parents as you don’t feel safe in taking consent from child.

D)Refer to another health care professional who has better experience in treating children’s below 18

Answer 40

A

Question 41

Physiotherapist has been treating a stroke patient from last 1 month but recently due to increased caseload, he has assigned the case to therapist assistant. Recently due to significant spike in Physiotherapist’s caseload, PTA has been gathering data on patient’s balance through Berg balance scale (BBS) and Timed up and go (TUG) test and reporting the findings to Physiotherapist. But patient is not happy, and complaint to college, stating that PTA is doing his assessment. What are the guidelines of PTA practice?

A)PTA cannot do evaluative tests such as BBS and TUG test

b) PTA can perform the BBS and TUG test on this patient.

c) PTA can only perform BBS and TUG in the presence of PT.

d) PT must perform the BBS and TUG test here.

Answer 41

B

PTAs can perform:

• Goniometry
• Berg balance test
• Timed Up and Go (TUG)
• Elderly Mobility Scale (EMS)
• Functional Reach
• 6 Minute Walk Test
• Ambulation Profile

• Muscle strength testing c.g.

Question 42

Patient had a total knee replacement done 2 weeks back. Physiotherapist after completing an evaluation and Plan of care development, assigned the case to PTA. Assistant is evaluating the range of motion weekly with goniometer and educating the progress and prognosis to patient based on goniometers readings. Patient was unhappy with poor improvement in knee range and complaint to college regarding unethical practice at clinic. Which of the following statement is correct here, considering the given case?

a) PTA cannot check range of motion as it has an evaluative component

b) PTA must not educate the patient based on the goniometric findings.

C)PT must not allow PTA to check ROM, as it has an evaluative component

d) PTA is working within standard guidelines of PTA practice.

Answer 42

B

Question 43

PT assistant is treating a patient with balance deficits and repetitive falls. PTA is making patient perform unilateral leg stance, Standing with eyes open and eyes closed on foam.

Patient is also happy with the progress and care received from PTA. Which of the following activities cannot be performed by PTA.

a)Performing the balance activities on foam in absence of PT

B)Explaining patient about how these exercises will improve patient’s proprioception and balance

C)Performing the outcome measure for balance testing such as functional reach test.

D)Documenting the scores of outcome measures in daily notes.

Answer 43

B

Question 44

Therapist is educating a newly hired PT assistant about his roles and responsibilities. PT assistant is going to treat a patient with frozen shoulder. Which of the following activities can be performed by a PT assistant ?

a) Assessment of Shoulder Range of Motion

b) Prioritizing the intervention based on patient’s needs. E.g. stretching.

C)Contributing to patient’s Plan of Care

D)Educating about importance of prolonged duration stretching

Answer 44

C

Question 45

Sunita is a physiotherapist who recently rostered to perform pelvic health care. This includes internal assessments of patients and rehabilitation of the pelvic musculature. Sunita is thinking about how they can protect their patients’ privacy while providing treatment.

Sunita is considering closing the door during the assessment and treatment sessions.
Should Sunita automatically close the door for these sessions to support patient privacy?

• A. Never
• в. Always
C. Under certain conditions

Answer 45

C

Sunita should only close the door under certain conditions and should not use a ‘one size fits all’ approach.
Physiotherapists should not automatically close the treatment room door. Instead, as part of the consent process, ask the patient if they would be more comfortable with the door open or closed or even partially open.

Question 46

Adrianna is a PT Resident who works in a busy outpatient clinic with three physiotherapist assistants (PTAs). Adrianna is newly rostered to perform acupuncture.
What are some things Adrianna should consider before performing acupuncture on patients?
Select all that apply:
A. Adrianna must have a written plan for managing adverse events.
B. Adrianna must not assign any part of agpuncture to the PTAs.

C. Adrianna must have the knowledge, skill and judgement to perform the treatment using acupuncture.
D. Adrianna must make sure their supervising physiotherapist is also rostered for acupuncture.

E. Adrianna must ensure that their liability insurance policy covers their use of acupuncture as a treatment.
F. Adrianna must only perform acupuncture with the supervising physiotherapist in the same room to oversee treatment.

Answer 46

Abcde

physiotherapists and PT Residents should contact their liability Insurers to confirm that they are covered to perform these activities.

Question 47

Han works for a private homecare company. During a busy morning of home visits, Han had a last-minute cancellation, and decided to take advantage of the time to get some charting done in a local coffee shop.
Later that day, Han was putting their patient files in their office cabinet. Han realized that they must have left two files at the coffee shop. Han went to the coffee shop as soon as it opened the next morning, but the files were gone.
Han is an agent of the Health Information Custodian (HIC) for the homecare company. What are Han’s responsibilities as an agent of the HIC?

A. Tell the Health Information Custodian (HIC) about the lost files right away.
B. Follow the protocol for a privacy breach as set out in the company’s privacy policy.

C. Contain the breach, if applicable (for example, make reasonable attempts to get the files back).
D. Contact the patients to tell them their files have been lost.
E. Han does not have to do anything because they are not the company’s Health Information Custodian.

Answer 47

A b c

Question 48

Mina is a physiotherapist who owns a physiotherapy clinic. Mina is updating the clinic’s fee schedule and would like to include the cost for copying a patient’s physiotherapy chart.

Is Mina allowed to charge a patient for photocopying their record?
A. Yes
B. No

Answer 48

The correct answer is A. Yes, physiotherapists can charge for photocopying a patient’s physiotherapy record.
The Information and Privacy Commissioner of Ontario (IPC) provides guidance about the copying and safe transfer of personal health information.

According to the IPC, it is reasonable to charge:
• A $30 processing fee for the first 20 pages, and
• 25 cents for every additional page.

Question 49

Michaela is a physiotherapist in a multidisciplinary clinic in Northern Ontario. Michaela was recently contacted by an insurance company looking into a claim from one of Michaela’s patients. The insurance company requested a list of the patient’s appointments and the services provided.
The insurance adjustor also provided a copy of the consent form signed by the patient allowing them to collect this information.
Howmuch can Michaela charge the insurance company for providing this information?

A. $25
в. $30
C. It depends on how many visits must be confirmed
D. Nothing
E. Any reasonable amount

Answer 49

The correct answer is D - nothing. A physiotherapist cannot charge an insurance company a fee to provide this information.

The Fees, Billing and Accounts Standard says that a physiotherapist must provide an itemized account for services or products if the patient or a payer (insurer) requests one. This itemized account must be free of charge.
It is not always necessary to request a copy of a patient’s signed consent form to share this information with the insurer.
Most patients will have already signed a consent form as a condition of receiving insurance benefits. If you or the patient are unsure if they have provided this type of consent, you can ask for confirmation from the insurer.

Question 50

Can a physiotherapist feature a patient on social media? If so, what are the legal and ethical responsibilities that a physiotherapist must consider?

A. Maybe. A physiotherapist can only post patient health information if the post is used for educational purposes. Any other use may be a privacy violation.

B. No. A physiotherapist can never use patient health information on social media. This is because it benefits the physiotherapist more than the patient.

C. Maybe he physiotherapist must ask the patient to sign a consent form, and the clinic must late insurance before personal health information is posted to social media.

D. Yes. But a physiotherapist is responsible for first communicating with a patient about the risks of sharing their personal health information online. The physiotherapist must get the patient’s consent.

E. Yes. Physiotherapists have the right to use social media to promote their services as long as the information they post on social media is true.

Answer 50

The correct answer is D. A physiotherapist who wants to post using patient health information must first communicate with a patient about the risks of sharing their personal health information online. The physiotherapist must get the patient’s consent.

Physiotherapists are responsible for any advertisement over which they have control. This includes social media. Getting the patient’s consent includes a discussion of the risks and benefits of posting the information online. The patient must also have an opportunity to ask questions.

Question 51

Which of the following patients would be inappropriate for a PT to transfer to a PTA?

a) A patient whom is a relative or person with whom the PTA has a close or intimate relationship.

b) A patient with severe cognitive decline

c) A patient that communicates that they do not need supervision during their exercises.

d) A patient with complex health history

Answer 51

Answer: A

PTAs are able to work with any patient type, as long as the task being assigned is within their scope.

The physiotherapist must carefully balance the risks of assigning and supervising care with the patient’s best interests and quality of care.

The supervising physiotherapist must ensure that the physiotherapist assistant has the knowledge, skill, and judgment to deliver safe and competent care. PTA questions are highly testable.

Question 52

A physiotherapist has been asked to assess a new patient on her ward. The patient is a 60 year-old woman of German descent who suffered a fractured distal radius as a result of a fall.
At the start of the interaction, the patient is having difficulty understanding what the therapist is saying. How should the therapist proceed?

a. Continue to discuss the purpose of the interaction but emphasize non-verbal communication.

b. Ask the nursing staff for an interpreter.

c. Speak slower and ensure there are no other noise distractions in the room

d. Assume implied consent and proceed with the physiotherapy assessment.

Answer 52

B

Question 53

A resident PT is working with a PTA in a clinic.

Q1Patient was billed for her PT sessions for low back pain by PTA. Next day the patient complained that she was billed incorrectly and was charged for the sessions she did not attend.
Who is responsible for the patient’s incorrect billing?

A) PTA herself is responsible
B) Resident PT is responsible
C) Supervising PT and resident PT are responsible
D) Clinic receptionist is responsible

Answer 53

C

Question 54

Your patient returned back after a week for a follow-up session and during treatment session. Again mentioned of ending his life so their pain is ended
forever. Based on your conversation previously you deem that patient needs help and patient has agreed to seek help. What will be your next step?

A. Call 911 and ask for help.
B. Send patient to their primary care physician
C. Discuss available options with patient and let them choose the option suits them best.
D. All of the above.

Answer 54

Correct Answer: Option C

Discuss available options with patient and let them choose the option suits them best.

Particularly in this case, the patient agreed to seek help so provide them with the resgurces. Offer hotline numbers, or offer to call together with the patient, prgvide rapid access service locations.

Question 55

During a recent session, you overhear the patient talking to the student about how he will not be taking anti- rejection drugs after their transplant as it goes against his belief system. You are very concerned. Without life long use of these medications, the surgery will be unsuccessful.
Which of the following is the correct way to handle this situation?

a. Refuse to treat the patient until they return to their specialist and discuss future treatment options.

b. Chart the patient’s comments and refer him back to his specialist. It is outside your scope of practice to discuss any further details with the patient.

c. Discuss with both the student and the patient the seriousness of these comments and encourage the patient to talk to his specialist about this decision.

d. Chart the patients comments and discuss with the patients the pros and cons of not taking medication, then refer the patient back to his specialist.

Answer 55

C

Question 56

The PTA is treating a patient in the Intensive care unit, senior supervisor PT is busy with admin duties. While positioning the patient from supine to side lying, patient’s IV line gets disturbed and bleeding starts from that site. Who is responsible for this incident?

A. Ptais only responsible for any incident happening during the session

B. Supervising PT is responsible for any kind of incident happening during session even if the session is conducted by PTA.

C. Both PT and pta are responsible for this incident.

D. None of the above

Answer 56

B

Question 57

A 78-year-old patient presents with post anesthetic atelectasis. They have a Sp02 of 85%, they are breathing shallow and rapidly and on auscultation have decreased breath sounds over the left lower lobe. They have post-surgical pain and have not been out of bed since their surgery 1 day ago. They have just returned from x-ray.

Question 1
The physiotherapist enters the room to dangle the patient for the first time. The patient is oriented to person, place and time. The patient’s wife is present and eager to see her husband exercise. The patient is very fatigued and refuses treatment. He does not want to move due to his pain. How should the physiotherapist proceed?

A) Gain consent from the patient’s wife.
B) Proceed with physiotherapy intervention as it is in the best interest of the patient.

C)Encourage the patient to participate and educate him that the pain will not be as bad as he thinks it will be.
D) Return later this afternoon once pain medications have been administered.

Answer 57

D

This is the best answer. It does not violate the patient’s right to decline treatment and provides an alterative option to ensure that the patient participates in therapy with more optimal pain management.

Question 58

A 78-year-old patient presents with post anesthetic atelectasis. They have a Sp02 of 85%, they are breathing shallow and rapidly and on auscultation have decreased breath sounds over the left lower lobe. They have post-surgical pain and have not been out of bed since their surgery 1 day ago. They have just returned from x-ray.

During your interaction, the patient disclosed that they previously smoked 1 pack of cigarettes a day. They are adamant that they no longer smoke and ask you several times to refrain from adding this information to their medical health history in their chart. How should the physiotherapist proceed?

A) Since this information is relevant to their current health issues, the physiotherapist must include it in their chart.

B)The physiotherapist should refrain from documenting this information in their chart to respect the patient’s wishes.

C)The physiotherapist should not include this in their chart, but should provide a verbal report to nursing staff so they can effectively treat the patient.

D)Without medical staff knowing this information, the patient is in imminent danger, and it is therefore a mandatory reporting situation.

Answer 58

B

Lockbox provisions are no longer valid in mandatory reporting scenarios, where you must disclose to prevent harm.
These scenarios can be broken into three categories:

1. If there is a clear risk to an identifiable person or group of persons.
   For example: A patient who claims they have already harmed someone or a group of people.
2. There is a risk of serious bodily harm or death.
   For example: A patient who has made threats against someone else - claiming they are going to harm someone or a group of people.
3. The danger is imminent.
   For example: A patient who has made threats of suicide and the physiotherapist is concerned that the threat is real and imminent.

Question 59

A physiotherapist works part time in private practice musculoskeletal clinic and as a school based PT. In the school, the physiotherapist is working with a 15 year old patient who has cystic fibrosis. Her condition is stable and she is awaiting a double lung transplant. She has a supportive family and lives with her mother, father, two siblings and aunt and uncle.
She is very private about her cystic fibrosis and very few students in the school know about her condition. She is very diligent about her lung hygiene and sticks to all guidelines but forth by her medical team.

The student uses a therapy vest at school everyday in a private room to avoid being teased. Her class is attending a field trip and she states she is not going because she fears other students will see her using her vest. How should the physiotherapist proceed?

A. Call a meeting with the school based team, including the student and her parents, to develop a disability awareness plan that educates her classmates, as well as a safety plan that monitors the student’s experience.

B. Educate the student’s classmates about their behavior towards the student. Let them know this is considered bullying and future action will result in consequences.

C. Support the student in her choice not to attend the field trip. Advocate for an education assistant to stay behind with her.

D. Meet with the child and mom and set up a time when they can experience the field trip together without the other students present.

Answer 59

A

This answer promotes education and inclusion.

B: does not promote inclusion, and advocating for an assistant to stay behind wouldn’t solve the problem. Is this within your scope? More of the teachèr’s