Fortinberry - Chapter 3 (PT Apps)

Question 1

The most serious complication of lower extremity thrombophlebitis is

Cerebral infarction
Pulmonary infarction
Myocardial infarction
Kidney infection

Answer 1

Pulmonary infarction

Question 2

Which of the following are tests for peripheral arterial involvement in a patient with complaints of calf musculature?

Claudication time
Homan’s sign
Percussion test
Hoffa’s sign

Answer 2

Claudication time

Question 3

A physician instructs the therapist to educate a patient about the risk factors of atherosclerosis. Which of the following is the most inappropriate list?

a.Diabetes, male gender, and excessive alcohol
b. Genetic predisposition, smoking, and sedentary lifestyle
c. Stress and inadequate exercise
d. Obesity, smoking, and hypotension

Answer 3

d. Obesity, smoking, and hypotension

Question 4

A therapist is ordered by a physician to treat a patient with congestive heart failure in an outpatient cardiac rehabilitation facility. Which of the following signs and symptoms should the therapist not expect?

Stenosis of the mitral valve
Orthopnea
Decreased preload of the right heart
Pulmonary edema

Answer 4

Decreased preload of the right heart

Question 5

At a team meeting, the respiratory therapist informs the rest of the team that the patient, just admitted to the subacute floor, experiences breathing difficulty in the acute care department. The respiratory therapist describes the breathing problem as a pause before exhaling after a full inspiration. Which of the following is the therapist describing?

Apnea
Orthopnea
Eupnea
Apneusis

Answer 5

Apneusis

Question 6

A therapist is performing chest physiotherapy on a patient who is coughing up a significant amount of sputum. The therapist later describes the quality of the sputum in his notes as mucoid. This description tells other personnel which of the following?

The sputum is thick
The sputum has a foul odor
The sputum is clear or white in color
The patient has possible bronchopulmonary infection

Answer 6

The sputum is clear or white in color

Question 7

A therapist is sent to provide passive range of motion to a patient in the intensive care unit. The chart reveals that the patient is suffering from pulmonary edema. The charge nurse informs the therapist that the patient is coughing a thin, white sputum, with a pink tint. Which of the following terms best describe this sputum?

Purulent
Frothy
Mucopurulent
Rusty

Answer 7

Frothy

Question 8

Strengthening exercises for persons with hemophilia should

a. Begin as soon as joint bleed is recognized
b. Never include isokinetic exercises
c. Be increased using high repetition, low load PREs
d. Only occur in joints that demonstrate muscle weakness

Answer 8

Be increased using high repetition, low load PREs

Question 9

A patient with cryoglobulinemia presents to outpatient physical therapy with complaints of lumbar pain. Which of the following should the physical therapist avoid during intervention for this diagnosis?

Most heat packs
Weight-bearing exercises
Muscle energy techniques
Cold pack application

Answer 9

Cold pack application

Question 10

A physical therapist is assessing the endurance of a 12-year-old female with cystic fibrosis. Which objective screening tool would be most appropriate to quantify the patient’s endurance?

Six-minute walk test
Tinetti Performance-Oriented Mobility Assessment
VOMax Test
Romberg test

Answer 10

Six-minute walk test

Question 11

A physical therapist is performing an examination for an infant that has recently been diagnosed with a congenital her defect. Which of the following clinical signs would not likely be present?

Bradycardia
Poor weight gain
Decreased respiratory rate
Lower extremity swelling

Answer 11

Bradycardia

Question 12

Besides the anterolateral abdominal muscles, which muscles assists in forced expiration, coughing, sneezing, vomiting, urinating, defecating, and fixation of the trunk during strong movements of the upper limb?

Piriformis
Pelvic diaphragm
Trapezius
Gluteus maximus

Answer 12

Pelvic diaphragm

Question 13

Which muscle does not flex the knee and extend the hip?

Semitendinosus
Hamstring portion of the adductor magnus
Long head of the biceps femoris
Semimembranosus

Answer 13

Hamstring portion of the adductor magnus

Question 14

History taking revealed that a patient experiences pain after horseback riding or skating. The pain is located over the anteromedial thigh and is aggravated by resisted abduction. What is the most likely preliminary diagnosis?

Piriformis syndrome
Trochanteric bursitis
Adductor longus strain/tendonitis/tendinosis
Avascular necrosis

Answer 14

Adductor longus strain/tendonitis/tendinosis

Question 15

A patient has dull posterior hip pain radiating down the leg. He say that he has a limp and that his pain is aggravated by turning his leg outside or with deep pressure near the middle of the right buttock. What is the most likely preliminary diagnosis?

Piriformis syndrome
Trochanteric bursitis
Adductor longus strain/tendonitis/tendinosis
Avascular necrosis

Answer 15

Piriformis syndrome

Question 16

What is the best imaging modality for detecting the changes in the articular cartilage seen with chondromalacia patella?

Plain film radiography
Bone scan
Magnetic resonance imaging
Computed tomography

Answer 16

Magnetic resonance imaging

Question 17

Which of the following imaging modalities does not give a radiation dose to the patient?

MRI
CT
Mammography
Bone scan

Answer 17

MRI

Question 18

A therapist is examining a 3-year-old child who is positioned as follows: supine, hips flexed to 90 degrees, hips fully adducted, and knees flexed. The therapist passively abducts and raises the thigh, applying an anterior shear force to the hip joint. A click at 30 degrees of abduction is noted by the therapist. What orthopedic test is the therapist performing, and what is its significance?

a. Ortolani’s test, hip dislocation
b. Apley’s compression/distraction test, cartilage damage
c. McMurray test, cartilage damage
d. Piston test, hip dislocation

Answer 18

a. Ortolani’s test, hip dislocation

Question 19

A teenager comes to an outpatient facility with complaints of pain at the tibial tubercle when playing basketball. The therapist notches that the tubercles are abnormally pronounced on bilateral knees. What condition does the patient most likely have?

Jumper’s knees
ACL sprain
Osgood-Schlatter disease
Sever’s disease

Answer 19

Osgood-Schlatter disease

Question 20

Which of the following is used to treat a patient referred to physical therapy with a diagnosis of Dupuytren’s contracture?

Knee continuous passive motion
Work simulator set for squatting activities
Hand splint
A 2-pound dumbbell

Answer 20

Hand splint

Question 21

A 17-year-old football player is referred to the outpatient physical therapy clinic with a diagnosis of a recent third-degree medial collateral sprain of the knee. The patient wishes to return to playing football as soon as possible. Which protocol is the best?

a. Fit the patient with a brace that prevents him from actively moving the knee into the last available 20 degrees of extension. Prescribe general lower extremity strengthening with the exception of side-lying hip adduction
b. Do not fit the patient with a brace that prevents him from actively moving the knee into the last available 20 degrees of extension. Avoid all open-chain strengthening for the lower extremity
c. Fit the patient with a brace that prevents him from actively moving the knee into the last available 20 degrees of extension. Avoid all open-chain strengthening for the LE
d. Do not fit the patient with a brace. Prescribe general lower extremity strengthening with the exception of side-lying hip adduction

Answer 21

a. Fit the patient with a brace that prevents him from actively moving the knee into the last available 20 degrees of extension. Prescribe general lower extremity strengthening with the exception of side-lying hip adduction

Question 22

During an examination, the therapist taps on the flexor retinaculum of the patient’s wrist, which causes tingling in the thumb. What test is this? For what condition does it screen?

Phalen’s test, carpal tunnel
Finkelstein test, De Quervain’s disease
Tinel’s sign, De Quervain’s disease
Tinel’s sign, carpal tunnel

Answer 22

Tinel’s sign, carpal tunnel

Question 23

A physical therapist is treating a patient with balance deficits. During treatment, the physical therapist notes that large-amplitude changes in the center of mass cause the patient to lose balance. The patient, however, can accurately compensate for small changes nearly every time a change is introduced. What muscles most likely need to be strengthened to help alleviate this dysfunction?

Tibialis anterior, gastrocnemius
Peroneus longus/brevis, tibialis posterior
Rectus abdominis, erector spinae
Iliopsoas, gluteus maximus

Answer 23

Iliopsoas, gluteus maximus

Question 24

The physical therapist is reading the physician’s interpretation of an x-ray that was taken of the left humerus of a 7-year-old patient. The physician notes in the report the presence of an incomplete fracture on the convex side of the humerus. Which type of fracture is the physician describing?

Comminuted
Avulsion
Greenstick
Segmental

Answer 24

Greenstick

Question 25

A physical therapist is beginning an examination of a 5-year-old boy. The mother indicates that she pulled the child from a seated position by grasping the wrists. The child then experienced immediate pain at the right elbow. The physician’s orders are for right elbow range of motion and strengthening. Which of the following is the most likely diagnosis?

Radial head fracture
Nursemaid’s elbow
Erb’s palsy
Ulnar coronoid process fracture

Answer 25

Nursemaid’s elbow

Question 26

A child presents to physical therapy with a diagnosis of right Sever’s disease. What joint should be the focus of the therapist’s examination?

Right knee joint
Right hip joint
Right wrist joint
Right ankle joint

Answer 26

Right ankle joint

Question 27

A 31-year-old boy presents to outpatient physical therapy with complaints of diffused pain in the right hip, thigh, and knee joint. The patient was involved in a motor vehicle accident 3 weeks ago. He is also obese and has significant atrophy in the right quadricep. The right lower extremity is held by the patient in the position of flexion, abduction, and lateral rotation. Which of the following is most likely the source of the patient’s signs and symptoms?

Greater trochanteric bursitis
Avascular necrosis
Slipped femoral capital epiphysis
Septic arthritis

Answer 27

Slipped femoral capital epiphysis

Question 28

Which tendon is most commonly involved with lateral epicondylitis?

Extensor carpi radialis longus
Extensor carpi radialis brevis
Brachioradialis
Extensor digitorum

Answer 28

Extensor carpi radialis brevis

Question 29

A high-school athlete is considering whether to have an ACL reconstruction. The therapist explains the importance of this ligament, especially in a person that is young and athletic. Which of the statements is correct in describing part of the function of the ACL?

The ACL prevents excessive (anterior/posterior) roll of the femoral condyles during (flexion/extension) of the femur at the knee joint

Answer 29

The ACL prevents excessive POSTERIOR roll of the femoral condyles during FLEXION of the femur at the knee joint

Question 30

A patient who has suffered a zone 2 rupture of the extensor tendon of the third digit presents to physical therapy. This patient had a surgical fixation of the avulsed tendon. During the period of immobilization, which of the following deformities is most likely to develop?

Boutonniere deformity
Claw hand
Swan neck deformity
Dupuytrne’s contracture

Answer 30

Swan neck deformity

Question 31

Which of the following muscle tendons most commonly sublux in patients who suffer from rheumatoid arthritis?

Flexor digitorum profundus
Extensor carpi radialis
Extensor carpi radialis longus
Flexor pollicis longus

Answer 31

Extensor carpi radialis

Question 32

A therapist is scheduled to examine a patient with a chronic condition of hammer toes. Where should the therapist not expect to find callus formation?

a. The distal tips of the toes
b. The superior surface of the interphalangeal joints
c. The metatarsal heads
d. The inferior surface of the interphalangeal joints

Answer 32

The inferior surface of the interphalangeal joints

Question 33

Each of these factors influences the probability of scoliosis curve progression in the skeletally immature patient except

Magnitude
Gender
Race
Age

Answer 33

Race

Question 34

The child with clubfoot will have

A larger than normal calcaneus
Forefoot valgus
Significant tibial shortening
Fixed equinus

Answer 34

Fixed equinus

Question 35

Differential diagnosis in the infant born with severe calcaneovalgus includes

Congenital vertical talus
Metatarsus adductus
Accessory navicular
Tarsal coalition

Answer 35

Congenital vertical talus

Question 36

All of the following may be part of the clinical picture of a child in the first 48 hours after onset of osteomyelitis except

Radiographs are positive for signs of infection and avascular necrosis
Needle aspiration may or may not be produce pus
The child does not appear sick and has no fever
High fever and refusal to walk

Answer 36

Radiographs are positive for signs of infection and avascular necrosis

Question 37

In a child, the most common site of transient synovitis, slipped epiphysis and septic arthritis is the

Shoulder
Hip
Knee
Ankle

Answer 37

Hip

Question 38

All of the following are common in children who have slipped capital femoral epiphysis except

Knee pain
Obesity
No history of trauma
Negative findings on a frog lateral radiograph

Answer 38

Negative findings on a frog lateral radiograph

Question 39

Which of the following conditions are not implicated in overuse injuries in youth?

Training errors
Musculotendinous imbalances
Anatomic malalignment of the lower extremity
Constant practice of turf (grass)

Answer 39

Constant practice of turf (grass)

Question 40

The signs and symptoms of juvenile rheumatoid arthritis include all of the following except

Swollen joints
Neurologic impairments
Stiffness
Muscle weakness

Answer 40

Neurologic impairments

Question 41

Fourteen weeks after surgical repair of the rotator cuff, a patient presents with significant deltoid weakness. ROM is within normal limits and equal bilaterally. Internal and external rotation strength is equal bilaterally; flexion and abduction strength is significantly reduced. What is the most likely cause of this dysfunction?

a. Poor compliance with a home exercise program
b. Tightness of the inferior shoulder capsule
c. Surgical damage to the musculocutaneous nerve
d. Surgical damage to the axillary nerve

Answer 41

d. Surgical damage to the axillary nerve

Question 42

Which of the following is an absolute contraindication to initiation of an outpatient cardiac rehabilitation program?

Obesity
Patient currently on dialysis 3 days a week because of renal failure
Asthma
Third -degree heart block

Answer 42

Third -degree heart block

Question 43

A patient has recently undergone an acromioplasty. What is the most important goal in early rehabilitation?

Regaining muscle strength
Return to activities of daily living (ADLs)
Endurance and functional progression
Return of normal ROM

Answer 43

Return of normal ROM

Question 44

A 72-year-old female comes into the clinic complaining of a new onset of sudden severe right temporal headache and pain with chewing. The likely cause of her headache is

Migraine
Subarachnoid hemorrhage
Temporal arteritis
Cervicogenic headache

Answer 44

Temporal arteritis

Question 45

A 15-year-old patient complains of acute jaw pain. The patient opens to 23 mm active and passive deflection to the right. Right lateral deviation is 8 mm, left lateral deviation is 3 mm. Palpation is negative for crepitus. What type of disorder do these symptoms indicate?

a. Right temporomandibular anterior disc displacement with reduction
b. Right temporomandibular anterior disc displacement without reduction
c. Trismus
d. Left temporomandibular anterior disc displacement with reduction

Answer 45

b. Right temporomandibular anterior disc displacement without reduction

Question 46

A 28-year-old male complains of pain in his right jaw and his bite not touching on the right side after biting into beef jerky 5 days ago. What is the probable disorder?

a. Right acute anterior disc displacement without reduction
b. Right acute anterior disc displacement with reduction
c. Right acute osteoarthritis
d. Right acute capsulitis

Answer 46

d. Right acute capsulitis

Question 47

A physical therapist is completing a manual muscle testing (MMT) examination of a patient with right lateral hip pain. The standing alignment reveals anterior pelvic tilt and associated hip flexion. During the MMT of the right posterior gluteus medius, which substitution is likely to occur?

a. Increase in hip flexion angle to substitute with the TFL
b. Increase in lateral rotation to substitute with the TFL
c. Forward rotation of the pelvis to substitute with the gluteus minimus
d. Knee flexion to substitute with the lateral hamstrings

Answer 47

a. Increase in hip flexion angle to substitute with the TFL

Question 48

Osgood-Schaltter’s disease is primarily

An inflammatory process
An injury to epiphyseal cartilage
An injury in adolescent females
Caused by tight calf muscles

Answer 48

An injury to epiphyseal cartilage

Question 49

A swollen knee immediately following trauma indicates

Blood in the joint
Blood or synovial fluid accumulation
Possible gout
Underlying arthritic degeneration

Answer 49

Blood in the joint

Question 50

The ulnar collateral ligament of the elbow is injured during which phase of the baseball pitch?

Early cocking phase
Late cocking phase
Acceleration phase
Deceleration phase

Answer 50

Acceleration phase

Question 51

Swimmer’s shoulder

Occurs in all swimmers
Is a rotator cuff tear
Is worse with backstrokers
Is an impingement syndrome

Answer 51

Is an impingement syndrome

Question 52

Anterior “black line” tibia stress fracture

Is a failure in compression
Heals predictability with rest and splinting
Requires bone stimulation to heal
May require intramedullary rodding to heal

Answer 52

May require intramedullary rodding to heal

Question 53

During MMT of knee flexion strength, the physical therapist wishes to differentiate between medial and lateral hamstrings. To test medial hamstrings, the therapist positions the patient in hip

a. External rotation to test semimembranosus and biceps femoris
b. Internal rotation to test semimembranosus and semitendinosus
c. External rotation to test semimembranosus and semitendinosus
d. Internal rotation to test biceps femoris

Answer 53

c. External rotation to test semimembranosus and semitendinosus

Question 54

A patient is involved in a near-end motor vehicle accident and now complains of neck pain, muscle spasm, and decreased cervical ROM. after performing your subjective examination, the next thing you would most appropriately do is

Ligamentous testing
Muscle testing
Active ROM testing
Passive motion testing

Answer 54

Active ROM testing

Question 55

The piano key sign is a test used to assess the

Glenoid labrum
Long head of the biceps
AC joint
Anterior shoulder stability

Answer 55

AC joint

Question 56

Your patient is a 16-year-old male who injured his left knee playing football. There was an onset of immediate swelling, a locking sensation, and restricted ROM. You hypothesize the most likely structure involved is

A collateral ligament
A tear of the retinaculum
A meniscus injury
The cruciate ligament

Answer 56

A meniscus injury

Question 57

You suspect that your patient has a torn rotator cuff. Which three tests would best confirm this diagnosis?

a. The lift off test, the anterior apprehension test, and Speed’s test
b. The drop arm test, crank test, load and shift test
c. The belly press test, drop arm test, and lift off test
d. Internal rotation lag sign, drop arm test, crank test

Answer 57

c. The belly press test, drop arm test, and lift off test

Question 58

A cause of a noncapsular pattern might be which of the following?

Arthrosis in the knee
Hemarthrosis of the shoulder
Septic arthritis in the knee
Loose body in the shoulder

Answer 58

Loose body in the shoulder

Question 59

In the single leg stance, when the C/L hip drops because of weakness, it is considered

A compensated hip varus
An uncompensated Trendelenburg
A compensated Trendelenburg
An uncompensated hip varus

Answer 59

An uncompensated Trendelenburg

Question 60

Your patient has sustained a fracture of the coronoid process. Which of the following is most true about these fractures?

a. It is most commonly an isolated fracture
b. It is more often accompanied by avulsion of the biceps
c. Fractures of the coronoid process account for better than of elbow fractures
d. Fractures of the coronoid process are usually accompanied by a radial head fracture

Answer 60

d. Fractures of the coronoid process are usually accompanied by a radial head fracture

Question 61

You find that a patient has a leg length discrepancy. Upon review of the radiographs, you notice that the angle of the neck of the femur to the femoral shaft is less than 120 degrees. You have determined that the apparent leg length difference is due to

A pelvic obliquity
A coxa varum
A coxa valga
An acetabular tropism

Answer 61

A coxa varum

Question 62

Your patient presents with pain and tenderness over the distal radial forearm and pain with resistive thumb extension after using a screwdriver repeatedly for several days. Based on this history, the most likely diagnosis is

Scaphoid instability
Gout in the thumb
De Quervain’s syndrome
Radial carpal syndrome

Answer 62

De Quervain’s syndrome

Question 63

A patient reports to physical therapy with a referral from his primary care physician that reads and suspects partial biceps tear, evaluate and treat. The patient sustained the injury 2 days ago during soccer practice. Which of the following objective findings would be most consistent with the patient’s condition during the physical examination?

Pain with passive shoulder abduction
Pain with resisted shoulder extension
Pain with resisted forearm supination
Pain with forearm extension

Answer 63

Pain with resisted forearm supination

Question 64

During ambulation, a physical therapist notices that the patient is exhibiting genu recurvatum during the stance phase of the gait cycle. Of the choices, the most likely cause for the observed gait deviation is

A tight gluteus maximus
Tight hip flexors
A tight gastroc-soleus complex
Tight ankle dorsiflexors

Answer 64

A tight gastroc-soleus complex

Question 65

A physical therapist is examining passive range of motion in a patient reporting hip pain. When measuring with a goniometer, the patient had 0 to 60 degrees of passive hip internal rotation. This finding is

Normal
Indicative of hypomobility
Indicative of hypermobility
Indicative of a capsular pattern

Answer 65

Indicative of hypomobility

Question 66

A physical therapist is performing a manual muscle test on a patient with reported lower extremity weakness. When examining the patient’s ability to plantarflex the foot in a prone position, suspicion arises that the patient is using the tibialis posterior as a substitute for significant gastroc-soleus weakness. The therapist’s hypothesis is based on the following observation

a. The foot moves into eversion and plantar flexion
b. The foot moves into inversion and plantar flexion
c. The forefoot moves into plantar flexion
d. The toes flex as the foot plantar flexes

Answer 66

b. The foot moves into inversion and plantar flexion

Question 67

Your patient is a 21-year-old male who reports to you with complaints of low back pain and stiffness. This has been ongoing for the past several months. He has been experiencing difficulties breathing and has noticed a difficulty with cervical flexion. The stiffness is most prevalent in the morning. He has noticed a low grade fever over the past several weeks. What pathology is most likely the source of the patient’s symptoms?

Ankylosing spondylitis
Rheumatoid arthritis
Systemic lupus erythematosus
Myasthenia gravis

Answer 67

Ankylosing spondylitis

Question 68

A 16-year-old male basketball player complains of pain in lower back and notes that the pain increases after landing from a jump. After a supine-to-sit test, the therapist notes that the right lower extremity appears longer in supine and shorter in sitting. What is the most likely cause of this problem?

Posterior rotation of the right innominate
Anterior rotation of the left innominate
Anterior rotation of the right innominate
Inflare of the right innominate

Answer 68

Anterior rotation of the right innominate

Question 69

A patient with an upper motor neuron spinal cord lesion at C6 began receiving occupational therapy 2 weeks after the injury. During the third week, the therapist noticed an increase in spasticity. The therapist should

a. Conclude that symptoms are typical after spinal shock
b. Conclude that the patient maybe is in respiratory distress
c. Suspect that a contracture is developing
d. Look for signs of autonomic dysreflexia

Answer 69

a. Conclude that symptoms are typical after spinal shock

Question 70

At the caudal level of the medulla, what percentage of the fibers of the corticospinal tract cross at the pyramidal decussation?

90-100
80-90
70-80
60-70

Answer 70

80-90

Question 71

This descending tract, the __ originates in the superior colliculus and is involved with the orientation toward a stimulus in the environment by reflex turning of the head.

Rubrospinal
Reticulospinal
Tectospinal
Vestibulospinal

Answer 71

Tectospinal

Question 72

Which is the least likely cause of dementia in the elderly?

Stroke
Alzheimer’s disease
Depression
CVA

Answer 72

Depression

Question 73

A 41-year-old woman presents with a sudden onset of numbness and drooping of the left side of her face and pain directly behind her left ear. Further questioning and a general assessment of the patient revealed asymmetrical facial expression lateralizing to the right side, mild slurring of speech, dysgeusia, hyperacusis, and difficulty drinking noted as the “Dribbling” of a beverage. She was recently diagnosed with a viral upper respiratory infection 3 days ago and treatment consisted of rest and fluids. Ms. Ryan denies a traumatic episode, headache, vertigo, lightheadedness, tinnitus, use or oral contraceptives, and smoking of cigarettes. What is the most likely diagnosis?

GBS
Bell’s palsy
Lyme disease
Stroke

Answer 73

Bell’s palsy

Question 74

SKIP QUESTION FOR THE SAKE OF NUMBERING

Question 75

A patient recently diagnosed with multiple sclerosis presents to a physical therapy clinic. The patient asks the therapist what she needs to avoid with this condition. Which of the following should the patient avoid?

Hot tubs
Slightly increased intake of fluids
Application of ice packs
Strength training

Answer 75

Hot tubs

Question 76

The therapist is examining a patient with a diagnosis of cerebral palsy. The therapist notes that all of the extremities and the trunk are involved. Further assessment also reveals that the lower extremities are more involved than upper extremities and that the right side is more involved than the left. This patient most likely has which classification of cerebral palsy?

Spastic hemiplegia
Spastic triplegia
Spastic quadriplegia
Spastic diplegia

Answer 76

Spastic diplegia

Question 77

The therapist receives an order to treat a 42-year-old man admitted to the hospital 3 days ago with a stab wound to the left lower thoracic spine. The patient is unable to move the left lower extremity and cannot feel pain or temperature differences in the right lower extremity. What is the most likely lesion?

a. The patient most likely has an anterior cord syndrome
b. The patient most likely has a Brown-Sequard syndrome
c. The patient most likely has a central cord syndrome
d. The patient is equally as likely to have anterior cord syndrome as he is to have Brown-Sequard syndrome

Answer 77

b. The patient most likely has a Brown-Sequard syndrome

Question 78

The therapist receives a referral to examine a patient with a boutonniere deformity. With this injury, the involved finger usually presents in the position of

a. Flexion of the proximal interphalangeal (PIP) joint and flexion of the distal interphalangeal joint
b. Extension of the PIP joint and flexion of the DIP joint
c. Flexion of the PIP joint and extension of the DIP joint
d. Extension of the PIP joint and extension of the DIP joint

Answer 78

c. Flexion of the PIP joint and extension of the DIP joint

Question 79

A therapist receives an order to examine and treat a 76-year-old woman who was involved in a motor vehicle accident 2 days ago. The patient’s vehicle was struck in the rear by another vehicle. The patient has normal sensation and strength in bilateral lower extremities but paralysis and loss of sensation in bilateral upper extremities. Bowel and bladder functions are normal. The patient most likely has what type of spinal cord injury?

a. The patient most likely has an anterior cord syndrome
b. The patient most likely has a Brown-Sequard syndrome
c. The patient most likely has a central cord syndrome
d. There is no evidence of an incomplete spinal cord lesion

Answer 79

c. The patient most likely has a central cord syndrome

Question 80

A 31-year-old man has loss of vision in one eye, staggering gait, numbness in bilateral upper extremities, and decreased bowel and bladder control. The episodes of these symptoms have occurred every few weeks for the past 6 months. Each episode has been slightly worse than the last. What is the most likely condition?

Parkinson’s disease
Guillain-Barre syndrome
Multiple sclerosis
Amyotrophic lateral sclerosis

Answer 80

Multiple sclerosis

Question 81

A 35-year-old woman suffered brain injury in a motor vehicle accident and presents with an intention tremor, nystagmus, hypotonia, and dysdiadochokinesia. What is the most likely location of the lesion?

Basal ganglia
Dorsal columns
Frontal lobe
Cerebellum

Answer 81

Cerebellum

Question 82

A 42-year-old construction worker received a burst fracture in the cervical spine when struck by a falling cross-beam. Proprioception is intact in bilateral lower extremities. The patient has bilateral loss of motor function and sensitivity to pain temperature below the level of the lesion. This type of lesion is most typical of which of the following syndromes?

Central cord syndrome
Brown-Sequard syndrome
Anterior cord syndrome
Conus medullaris syndrome

Answer 82

Anterior cord syndrome

Question 83

A 52-year-old man with sciatica presents to outpatient physical therapy. The patient indicates that he is experiencing paresthesia extending to the left ankle and severe lumbar pain. Straight leg raise test is positive with the left lower extremity. Of the following, which is the most likely source of pain?

a. A lumbar disc with a left posterior herniation or protrusion
b. A lumbar disc with a right posterior herniation or protrusion
c. Piriformis syndrome
d. Sacroiliac joint dysfunction

Answer 83

a. A lumbar disc with a left posterior herniation or protrusion

Question 84

A patient who has suffered a recent fracture of the right tibia and fibula has developed foot drop of the right foot during gait. Which nerve is causing this loss of motor function?

Posterior tibial
Superficial peroneal
Deep peroneal
Anterior tibial

Answer 84

Deep peroneal

Question 85

An infant with Erb’s palsy presents with the involved upper extremity in which of the following positions?

Hand supination and wrist extended
Hand supinated and wrist extended
Hand pronation and wrist extended
Hand pronation and wrist flexed

Answer 85

Hand pronation and wrist flexed

Question 86

When reviewing a patient’s chart, the therapist determines that the patient has a condition in which another cauda equina is in a fluid-filled sac protruding from the back. What form of spina bifida does the patient most likely have?

Menigocele
Meningomyelocele
Spina bifida oculta
Lipoma

Answer 86

Meningomyelocele

Question 87

A physician is preparing a patient for an upcoming procedure. The physician explains that the procedure will provide a detailed image that appears to be a slice of the brain. This image is obtained with a high concentrated x-ray beam. What procedure is the patient scheduled to undergo?

Angiogram
MRI
PET
CT

Answer 87

CT

Question 88

A 32-year-old construction worker fell off a ladder. In his effort to prevent fall, the worker reached for a beam with his right arm. This motion stretched the brachial plexus resulting in decreased function in the right arm. Full function returned after 2 1/2 weeks. What is the most likely type of injury?

Axonotmesis
Neurotmesis
Neuropraxia
Nerve root avulsion

Answer 88

Neuropraxia

Question 89

A therapist is assessing a patient in an attempt to discover the source of the pain. She positions the patient’s cervical spine in different directions in an attempt to elicit the patient’s symptoms. In one such direction, the patient’ reports return of symptoms, including pain located at the right posterior scapular region, which extends down the posterior side of the right upper extremity to the ends of the fingers, and tingling in the second, third, and fourth digits. She also has noticeable weakness in the right triceps? Which nerve root is most likely involved?

Fourth cervical root
Fifth cervical root
Sixth cervical root
Seventh cervical root

Answer 89

Seventh cervical root

Question 90

A patient presents to an outpatient clinic with an order to examine and treat the right forearm and wrist secondary to nerve compression. The patient has the following signs and symptoms: pain with manual muscle testing of pronation, decreased strength of the flexor pollicis longus and pronator quadratus, and pain with palpation of the pronator teres. What nerve is most likely compromised? What is the most likely area of compression?

Median nerve, carpal tunnel
Ulnar nerve, Guyon’s canal
Ulnar nerve, pronator quadratus
Median nerve, pronator teres

Answer 90

Median nerve, pronator teres

Question 91

A 14-year-old girl paced excessive valgus stress to the right elbow during a fall from a bicycle. Her forearm was in supination at the moment the valgus stress was applied. Which of the following is not likely involved in this type of injury?

Ulnar nerve
Extensor carpi radialis
Brachioradialis
Annular ligament

Answer 91

Ulnar nerve

Question 92

The best predictors of ambulation in young children with cerebral palsy is

Absence of primitive reflexes at 3 months
Absence of tonic neck reflexes
Independent sitting by 24 months of age
Independent standing by 1 year of age

Answer 92

Independent sitting by 24 months of age

Question 93

Which complication of spinal cord injury is more likely to occur in children and teenagers than in adults?

Hypercalcemia
Autonomic dysreflexia
Spasticity
Deep venous thrombosis

Answer 93

Hypercalcemia

Question 94

Which orthopedic complication is not probable in a child with tetraplegia spinal cord injury?

Shoulder subluxation
Scoliosis
Heterotopic ossification
Hip dislocation

Answer 94

Shoulder subluxation

Question 95

All of of the following are clinical signs of heterotopic ossification except

Pressure sores
Pain
Decreased range of motion
Joint swelling

Answer 95

Pressure sores

Question 96

The most common clinical signs of a cerebellar brain tumor may include all of the following except

Hypotonia
Ataxia
Vomiting
Low back pain

Answer 96

Low back pain

Question 97

Areas that a physical therapist can address with a child with an acquired brain injury in terms of long-term health and well-being include all of the following except

Neurologic sequelae
Growth disturbance
Obesity
Arthritis

Answer 97

Growth disturbance

Question 98

Research indicates there is a significant correlation between functional restrictions in children with juvenile rheumatoid arthritis and

The number of tender joints
Elbow flexion contractures of 10-20 degrees
Loss of motion in the hips or shoulders
Low back pain

Answer 98

Elbow flexion contractures of 10-20 degrees

Question 99

Based on recent studies in children with traumatic brain injury, you would expect to see recovery slow down after __ in a child with a severe injury

6 months
1 year
3 years
5 years

Answer 99

1 year

Question 100

What is necessary for an infant to have mastered before sitting independently on propped upper extremities can be achieved?

a. Rolling prone to supine and supine to prone
b. Translation of grasped objects from hand to hand
c. Extending the head neck in prone, and controlling
d. Crawling and creeping

Answer 100

c. Extending the head neck in prone, and controlling

Question 101

During examination of a patient with neck pain and left arm pain, the therapist is suspicious of a C6 nerve root irritation. Which of the findings will help confirm that condition?

a. Weakness in the shoulder abduction of left arm
b. Decreased triceps reflex on left compared to right
c. Decreased biceps reflex on left compared to right
d. Increased tone in left biceps

Answer 101

c. Decreased biceps reflex on left compared to right

Question 102

A 55-year-old man with type I diabetes mellitus reports double visions. On examination of his extraocular movements, he has limited adduction, elevation, and depression of his right eye. The pupils are equal and reactive. The patient most likely has a lesion of the following right side cranial nerve

Abducens nerve VI
Trochlear nerve IV
Oculomotor nerve III
Optic nerve II

Answer 102

Oculomotor nerve III

Question 103

An overweight patient presents with right lower thoracic and right shoulder pain. She noted that the pain began after eating fried chicken at a fast food restaurant. You suspect it is a visceral pain coming from the

Gallbladder
Pancreas
Liver
Heart

Answer 103

Gallbladder

Question 104

Your patient has an involvement of the 5th lumbar nerve root on the left secondary to a lumbar disc protrusion. Which of the following is true?

a. The ankle jerk is diminished or absent
b. The patient has fatigable weakness in the calf
c. Sensation was diminished between the first and second toe
d. Sensation was diminished on the plantar surface of the foot

Answer 104

c. Sensation was diminished between the first and second toe

Question 105

Your patient is a 65-year-old male who complains of pain radiating down both legs with static and dynamic standing, but with relief while sitting. In the absence of any serious disease, he most likely has a

Herniated disc
Lateral stenosis
Central stenosis
Schmorl’s node defect

Answer 105

Central stenosis

Question 106

The classification of a nerve injury that would produce pain muscle wasting, complete motor and sympathetic function loss with a recovery time of months, with sensation restored before motor function best describes

Neuropraxia
Axonotmesis
Neurotmesis
Axonorpaxia

Answer 106

Axonotmesis

Question 107

While performing an upper quarter screen, a physical therapist suspects neurologic system involvement. In examining the integrity of the C8 dermatome, the therapist, the should check sensation along the

Thumb and index finger
Ulnar border of the hand
Middle three fingers
Radial border of the hand

Answer 107

Radial border of the hand

Question 108

A patient has been referred to physical therapy for acute shoulder pain after shoveling snow in a driveaway for 2 hours. Positive findings include pain and weakness with flexion of an extended upper extremity as well as scapular winging with greater than 90 degrees of abduction. The patient’s problem is most likely the result of

Supraspinatus tendinitis
Compression of the long thoracic nerve
Compression of the suprascapular nerve
Subdeltoid bursitis

Answer 108

Compression of the long thoracic nerve

Question 109

A physical therapist is conducting a physical examination with a patient diagnosed with an ASIA. A spinal injury at the level of C6. During manual manual muscle testing of the upper extremity, the patient should have function in all of the following muscles except the

Biceps
Triceps
Deltoid
Diaphragm

Answer 109

Triceps

Question 110

A physical therapist is treating an 18-year-old male who had an ASIA T1 SCI 6 months ago. Given the level and completeness of the lesion, what would be his expected functional capability for transfers?

a. Dependent with all mat mobility
b. Dependent with wheelchair to mat transfers
c. Independent with wheelchair to mat transfers
d. Independent with floor to wheelchair transfers

Answer 110

c. Independent with wheelchair to mat transfers

Question 111

A physical therapist completes a developmental assessment and identifies that the infant is unable to roll from supine to side. Which of the following reflexes could interfere with the action of rolling?

Asymmetric tonic neck reflex
Moro reflex
Landau reflex
Symmetric tonic neck reflex

Answer 111

Asymmetric tonic neck reflex

Question 112

An inpatient physical therapist is performing an examination of an 8-year-old female that sustained a traumatic brain injury because of a motor vehicle accident. Which of the following standardized instruments would be most appropriate to measure the child’s level of consciousness?

MRI
MAS
GCS
Barthel Scale

Answer 112

GCS

Question 113

You are performing an examination on a 36-month-old male who is able to ascend stairs with a step to pattern, jump off of a step and run with decreased coordination. The patient is unable to maintain a single limb stance. What do you determine from this observation?

a. The patient is demonstrating age-appropriate skills
b. The patient is demonstrating skills at approximately the 10-to-12 month level
c. The patient is demonstrating skills at approximately the 18-to-20 month level
d. The patient is demonstrating skills at approximately the 30-to-32 month level

Answer 113

a. The patient is demonstrating age-appropriate skills

Question 114

Recovery of the upper arm after a brachial plexus injury can occur for up to

2 years
1 year
6 months
9 months

Answer 114

2 years

Question 115

What is the major concern of the physical therapist treating a patient with an acute deep partial-thickness burn covering 27 of the total body? The patient was admitted to the intensive care burn unit 2 days ago.

ROM
Fluid retention
Helping the family cope with the injured patient
Home modifications on discharge

Answer 115

ROM

Question 116

A therapist is examining a wound in a patient with the following signs: the right foot has a toe that is gangrenous, the skin on the dorsum of the foot is shiny in appearance, and no calluses are present. The patient has what type of ulcer?

Venous insufficiency ulcer
Arterial insufficiency ulcer
Decubitus ulcer
Trophic ulcer

Answer 116

Arterial insufficiency ulcer

Question 117

A 21-year-old female has sustained a traumatic brain injury and is demonstrating significant neurologic impairments. The physical therapist notices on examination a blister with surrounding erythema on the patient’s sacrum. The physical therapist should document the patient having which of the following?

Stage I pressure ulcer
Stage II pressure ulcer
Stage III pressure ulcer
Stage IV pressure ulcer

Answer 117

Stage II pressure ulcer

Question 118

A diabetic patient is exercising vigorously in an outpatient clinic. The patient informs the therapist that he or she received insulin immediately before the exercise session. Of the following symptoms, which is an unlikely sign of hypoglycemic coma?

Pallor
Shallow respiration
Bounding pulse
Dry skin

Answer 118

Dry skin

Question 119

After arriving at the home of a home health patient, the primary nurse informs the therapist that she has activated emergency medical services. The nurse found the patient in what appears to be a diabetic coma. Which of the following is most likely not one of the patient’s signs?

Skin flush
Rapid pulse
Weak pulse
High blood pressure

Answer 119

High blood pressure

Question 120

A 5-year-old male diagnosed with medulloblastoma is currently receiving chemotherapy. The physical therapist is preparing to treat this patient in an inpatient hospital setting. What lab value must the therapist consider before initiating treatment?

WBC
Glucose
HDL/LDL
Platelets

Answer 120

Platelets

Question 121

Differentiation of the sources of pain is critical to the accurate diagnosis and appropriate treatment of patient conditions. Which of the following would not describe pain or symptoms from a visceral source?

a. It can be produced by the heart and internal organs
b. The symptoms tend to be well-localized
c. Hypersensitivity to touch or pressure often accompanies disease
d. Generally associated signs and symptoms are present

Answer 121

b. The symptoms tend to be well-localized

Question 122

A patient with fibromyalgia has performance deficits in ADLs, including lack of a daily routine because of a loss of energy and motivation to engage in daily occupations, depression and anxiety, and difficulty managing home and instrumental activities of daily living (IADL) because of fatigue and pain. Based on these performance deficits, the initial focus of treatment should be

a. Completing IADL tasks independently
b. Establishing a new daily routine that can be done within the patient’s tolerance
c. Referring to a support group to address depression and anxiety
d. Energy conservation and activities for pain management

Answer 122

d. Energy conservation and activities for pain management

Question 123

Which of the following is least likely in a woman in the eighth month of pregnancy?

a. COG anteriorly displaced
b. Heart rate decreased with rest and increased with activity (compared to heart rate before pregnancy)
c. Edema in bilateral lower extremities
d. Blood pressure increased by 5 (compared with blood pressure before pregnancy)

Answer 123

b. Heart rate decreased with rest and increased with activity (compared to heart rate before pregnancy)

Question 124

A physical therapist is speaking to a group of pregnant women about maintaining fitness level during pregnancy. Which of the following statements contain incorrect information?

a. Perform regular exercise routines at least three times per week
b. Perform daily at least 15 minutes of abdominal exercises in supine position
c. Increase caloric intake by 300 kcal per day
d. Exercise decreases constipation during pregnancy

Answer 124

b. Perform daily at least 15 minutes of abdominal exercises in supine position

Question 125

A 30-year-old woman who had a full-term infant presents to physical therapy with diastasis recti. The separation was measured by the physician and found to be 3cm. Which of the following exercises is most appropriate to minimize the separation?

a. Sit-ups while using the UE to bring the rectus abdominis to midline
b. Bridges while using the UE to bring the rectus abdominis to midline
c. Dynamic lumbar stabilization exercises in quadruped position
d. Gentle head tilts in supine position while using the UE to ring the rectus abdominis to midline

Answer 125

d. Gentle head tilts in supine position while using the UE to ring the rectus abdominis to midline

Question 126

Proper supportive positioning of an infant with osteogenesis imperfecta is important for all of the following reasons except

a. Keeping extremities immobilized to prevent fractures
b. Protection during fracturing
c. Minimizing joint malalignment and deformities
d. Promotion of muscle strengthening

Answer 126

a. Keeping extremities immobilized to prevent fractures

Question 127

A gross motor program for a school-aged child with osteogenesis imperfecta should not include

Muscle strengthening
Aerobic conditioning
Protected ambulation
Keeping extremities immobilized to prevent fractures

Answer 127

Keeping extremities immobilized to prevent fractures

Question 128

In a child who has sustained a submersion injury, the physical therapist needs to be aware of neurologic and __ system changes before initiating treatment.

Integumentary
Orthopedic
Cardiopulmonary
Renal

Answer 128

Cardiopulmonary

Question 129

Which of the following is the only appropriate exercise in the third trimester of pregnancy?

a. One-legged balance activities
b. Quadruped (crawling position) with hip extension
c. Bilateral SLR
d. Bridging

Answer 129

Bridging

Question 130

Elderly patients often present with atypical signs and symptoms. Which of the following best explains the atypical presentation of symptoms in the elderly?

a. The number of potential risk factors for disease may be greater
b. They fail to make connections between their signs and symptoms
c. The onset of new disease often presents in the most vulnerable systems
d. They utilize home remedies that alter their signs and symptoms

Answer 130

b. They fail to make connections between their signs and symptoms

Question 131

A patient in the sixth month of pregnancy is in a physical therapy clinic for examination secondary to lumbar pain. Which of the following is incorrect advice to give to this patient?

a. Sleep on the left with a pillow between the knees
b. Sleep on the right with a pillow between the knees
c. Sleep supine with a pillow under the knees
d. Sit with a lumbar support at all times

Answer 131

c. Sleep supine with a pillow under the knees

Question 132

In a direct access state, a physical therapist is examining a patient with joint pain complaints. The patient has had no diagnostic work-up before arrival at the clinic. Which finding would raise suspicion of RA rather than just osteoarthritic complaints?

a. Morning stiffness that resolves within 10-15 minutes after getting up
b. Development of joint pain in more than one joint with onset between 20-40 years of age
c. Unilateral joint pain in hip or knee
d. Absence of associated such as fatigue, weight loss, or malaise

Answer 132

b. Development of joint pain in more than one joint with onset between 20-40 years of age

Question 133

Which descriptors make you suspicious of a neuropathic pain source?

Aching, sore, dull
Dreadful, cruel, punishing
Burning, shooting, pricking
Throbbing, pulsing, pounding

Answer 133

Burning, shooting, pricking

Question 134

A patient is difficult to arouse and falls asleep without constant stimulation from the therapist. Even when the patient has difficulty interacting with the physical therapist. What would be the best description of the patient’s level of arousal?

Stupor
Lethargic
Obtunded
Alert

Answer 134

Obtunded

Question 135

Individuals with impaired vestibular system function are most likely to experience a loss of balance on the foam and dome test, or the Clinical Test of Sensory Integration and Balance (CTSIB), when information from the is/are altered during testing.

Spinal reticular system
Visual system
Somatosensory system
Somatosensory and visual systems

Answer 135

Somatosensory and visual systems

Question 136

A physical therapist is testing a patient with a diagnosis of vestibular impairment. Which of the following is most likely to be true?

a. The vestibulo-ocular reflex (VOR) is normal so you can rule out BPPV
b. The VOR is delayed so you suspect a unilateral hypofunction
c. The dynamic visual acuity test shows a two-line loss so you suspect a unilateral hypofunction
d. The dynamic visual acuity test shows a four-line loss so you suspect a posterior canal BPPV

Answer 136

b. The VOR is delayed so you suspect a unilateral hypofunction

Question 137

Your patient is a 45-year-old female with complaints of right shoulder pain and paresthesias running down her right arm. No specific dermatome. Symptoms have been increasing in the past 3 months and now are continuous in nature. She has a history of smoking but quit 3 years ago. Her shoulder pain increases at night, as to her arm symptoms. She reports that in recent months, she has been feeling tired more frequently and has been losing weight. What pathology is most likely the source of the patient’s symptoms?

Cancer
Rotator cuff tear
Cervical radiculopathy
Thoracic outlet syndrome

Answer 137

Cancer

Question 138

An 18-year-old male was involved in a motorcycle accident and has sustained a TBI. The patient is starting to squeeze the therapist’s hand upon command, beginning to recognize his mother, and withdraws to pain. The patient is at what stage of RLA Levels of Cognitive Functioning?

II - generalized response
III - localized response
IV - confused-agitated
V - confused-inappropriate, non-agitated

Answer 138

III - localized response

Question 139

You will be performing an examination on a 20-week-old female and will be completing the Peabody Developmental Motor Scale to determine the severity of developmental delay. In order to accurately score the patient, you must determine if the patient is premature. During your examination, you learn that the patient was born at 3 weeks’ gestation. What is the patient’s corrected/adjusted age?

a. No adjustment is needed for this patient
b. The patient’s corrected/adjusted age 10 weeks
c. The patient’s corrected/adjusted age 12 weeks
d. The patient’s corrected/adjusted age 14 weeks

Answer 139

c. The patient’s corrected/adjusted age 12 weeks

Question 140

A patient requires examination 4 months following treatment for breast cancer and mastectomy. She is complaining of chest, arm, and shoulder pain with overhead activities. Which of the following is most likely the source of her pain?

Torn rotator cuff
Adhesive capsulitis
Cervical pathology
Recurrence of the breast cancer

Answer 140

Adhesive capsulitis

Question 141

You observe that your patient walks with the spine in extension (increased lumbar lordosis). This could be due to all of the following except

Tight semitendinosus
Tight rectus femoris
Tight psoas major
Weak gluteus maximus

Answer 141

Tight semitendinosus

Question 142

During normal gait, in single limb stance,

a. The center of mass is at its highest point
b. Potential energy is at a low point
c. Kinetic energy is at its highest point
d. The magnitude of the ground reaction force is always greater than body weight

Answer 142

a. The center of mass is at its highest point

Question 143

Which of the following is false regarding osteoarthritis?

a. The initial biochemical changes include loss of proteoglycan and loosening of the collagen matrix
b. In severe cases, ulnar deviation of the MCP joints is observed
c. Later changes include cartilage thinning and joint space narrowing
d. In severe cases, total joint replacements are a realistic treatment option

Answer 143

b. In severe cases, ulnar deviation of the MCP joints is observed

Question 144

Mrs. Brown is a patient in the acute rehabilitation unit. She is sleepy, but easily roused when you enter the room. She knows her name but thinks she is at home. She is unable to give the year. She tries to get out of bed when you approach, and does not seem to realize she has weakness on the left side. Briefly describe Mrs. Brown’s arousal, orientation, and cognition.

Alert, oriented x2, confused
Obtunded, oriented x1, confused
Lethargic, oriented x1, confused
Sleepy, oriented x3, confused

Answer 144

Lethargic, oriented x1, confused

Question 145

Which of the following statements is true relative to differentiation of dementia from depression in older adults?

a. Memory loss associated with dementia is often noticed by the patient
b. Disorientation is general associated with dementia but not depression
c. Difficulty concentrating is more common with dementia
d. Writing, speaking, and motor impairments are more common with depression

Answer 145

b. Disorientation is general associated with dementia but not depression

Question 146

A physical therapist is performing ultrasound over the lumbar paraspinals of a patient. Which of the following conditions would cause the therapist to use a lower intensity and shorter dosage of treatment?

Diabetes
Hypertension
Hypothyroidism
Parkinson’s disease

Answer 146

Diabetes

Question 147

Which of the following circumstances would normally decrease body temperature in a healthy person?

Exercising on a treadmill
Pregnancy
Normal ovulation
Reaching age of 65 years or older

Answer 147

Reaching age of 65 years or older

Question 148

A patient has been diagnosed with SLE. Which of the following is not a sign of this autoimmune disease?

Increased photosensitivity
Oral ulcers
Butterfly rash
Increased number of WBC

Answer 148

Increased number of WBC

Question 149

A physical therapist receives an order to evaluate a home health patient. The primary nurse states that the patient “may have suffered a stroke because she cannot move the right leg when she stands.” the history that the therapist obtains from the patient and family members includes:
* (1) left THR 6 months ago,
* (2) inability to lift the right LE off of the floor in a standing position,
* (3) recent fall at home 2 nights ago,
* (4) left LE strength with MMT in supine is 2⁄5 overall,
* (5) complaints of pain with resisted movement of the lower extremity,
* (6) right LE strength is 4⁄5 overall,
* (7) no pain with resisted movement with the right LE,
* (8) no difference in bilateral UE strength,
* (9) no decrease in sensation,
* (10) no facial droop,
* (11) history of dementia but no decreased cognitive ability or speech level as compared with prior level of function, and
* (12) independence in ambulation with a standard walker before the recent all.

What should the therapist’s recommendation to the nursing stagg be?

a. The patient should receive physical therapy for strengthening exercises to the right LE with standing exercises and gait training
b. The patient should receive a physician’s evaluation for a possible stroke
c. The patient should receive a physician’s evaluation for a possible left hip fracture
d. The patient should receive physical therapy for strengthening the left LE and gait training

Answer 149

c. The patient should receive a physician’s evaluation for a possible left hip fracture

Question 150

Your patient complaints of loss of urine as soon as she has the urge to urinate. She also complains of deep pressure (NOT PAIN) in her lower pelvis area with prolonged standing. What kind of incontinence do these patients’ symptoms most likely mimic?

Stress
Urge
Mixed
Functional

Answer 150

Urge

Question 151

Which of the following statements about lymph node palpation is true?

a. Normal lymph nodes are generally not visible or easily palpable
b. A non-tender, immovable lymph node is not significant
c. Only tender lymph nodes are important in differential diagnosis
d. Lymph node palpation will confirm an infection

Answer 151

a. Normal lymph nodes are generally not visible or easily palpable

Question 152

A physical therapist is discussing appropriate exercise parameters for a patient with type II diabetes. Which statement reflects inappropriate advice to the patient?

a. Do not begin exercise if blood glucose is above 100 mg/dL
b. Be sure to stay adequately hydrated
c. Avoid insulin injections in the active extremities within 1 hour before exercise
d. Exercise at moderate intensity and use RPE to help determine response to exercise

Answer 152

a. Do not begin exercise if blood glucose is above 100 mg/dL

Question 153

A 65-year-old man presents to physical therapy with complaints of pain due to compression fractures of the C2 and C3 vertebrae. The patient has an unusually large cranium. He describes this condition by staging “much of my bone tissue is continually decreasing, then reforming”. The patient also indicates that the condition has caused limb deformity. Which of the following cases does he have?

Paget’s disease
Achondroplastic dwarfism
Osteogenesis imperfecta
Osteopetrosis

Answer 153

Paget’s disease

Question 154

Improved survival rates for cancer increase the likelihood that a physical therapist will be treating patients with a past medical history of cancer treatment. Which statement does not accurately describe the presentation of potential side effects of cancer treatment?

a. Increased risk of infections and bleeding due to bone marrow suppression
b. Debilitating fatigue that may persist in spite of rest
c. Demineralization and bone necrosis that increases risk of pathologic fractures
d. Symptoms that are easily distinguishable from cancer recurrence

Answer 154

d. Symptoms that are easily distinguishable from cancer recurrence

Question 155

A therapist is treating a new patient in an outpatient facility. The patient has recently been diagnosed with type-I insulin-dependent diabetes mellitus. The patient asks the therapist the differences between type-I insulin-dependent DM and type-II non-insulin-dependent DM. Which of the following statements is true?

a. There is usually some insulin present in the blood in type 1 and non in type 2
b. Ketoacidosis is a symptoms of type 2
c. The diagnosis with type 1 is usually younger than the age of diagnosis with type 2
d. Both conditions can be managed with a strict diet only without taking insulin

Answer 155

c. The diagnosis with type 1 is usually younger than the age of diagnosis with type 2

Question 156

A physical therapist is assessing the skin integrity over the ischial tuberosities of a 17-year-old female with spastic cerebral palsy after being transferred out of child’s wheelchair. The therapist notes that the wound extends to the bone. The therapist would stage this pressure sore as

Stage I
Stage II
Stage III
Stage IV

Answer 156

Stage IV

Question 157

The most common hand deformity following burn injury in children is

Hyper-extension of fifth MCP
Radial deviation of wrist
Boutonniere deformity
Palmar contracture

Answer 157

Palmar contracture

Question 158

A patient is referred to physical therapy services for care of a burn wound on the left foot. The majority of the wound is anesthetic. There is significant eschar formation over the dorsum of the involved foot, and moderate subcutaneous tissue damage is present. What is the most likely classification of this burn?

Electrical
Superficial partial thickness
Deep partial thickness
Full thickness

Answer 158

Full thickness

Question 159

A 12-year-old female with cerebral palsy is admitted to the hospital for a Baclofen test does to determine if she is a candidate for a Baclofen pump. One hour post-injection, the physical therapist assesses the tone in the lower extremities. There is marked increase in muscle tone through most of the ROM, but it is easily moved. What level is the ankle on the MAS?

1
0
4
2

Answer 159

2

Question 160

A physical therapist completes a developmental assessment and notes the child is able to crawl forward, pull to stand at furniture, and sits without hand support for extended periods of time. The most appropriate chronologic age of this child is

4-5 months
6-7 months
8-9 months
11 months

Answer 160

8-9 months

Question 161

When performing resistive testing to determine the integrity of the C5 myotome, the physical therapist should examine which of the following movements?

Wrist radial deviation
Elbow extension
Thumb extension
Elbow flexion

Answer 161

Elbow flexion

Question 162

Your patient was in a car accident and now has a herniated nucleus pulposus at vertebral level C5-C6. She reports difficulty removing her shirt overhead. With nerve root injury at the level of C5-C6, what part of the motion will most likely be problematic for you patient and why?

a. Grasping the shirt due to weakness of all finger flexors
b. Internally rotating the shoulder due to weakness of teres minor
c. Shoulder flexion due to weakness of deltoid
d. Cervical flexion to remove shirt due to weakness of deep neck flexors

Answer 162

c. Shoulder flexion due to weakness of deltoid

Question 163

When should sport-specific drills begin for the athlete following surgical repair of the anterior shoulder capsule?

a. When the involved upper extremity has 30 strength of the uninvolved upper extremity
b. When the involved upper extremity has 50 strength of the uninvolved upper extremity
c. When the uninvolved upper extremity has 75 strength of the uninvolved upper extremity
d. When the involved upper extremity as 100 strength of the uninvolved upper extremity

Answer 163

c. When the uninvolved upper extremity has 75 strength of the uninvolved upper extremity

Question 164

Recovery from spinal cord injury occurring over several years is most likely with which syndrome

Brown-Sequard
Anterior cord
Posterior cord
Cauda equina

Answer 164

Cauda equina

Question 165

A 29-year-old woman who is 8 months pregnant presents to an outpatient clinic with complaints of “pain and tingling” over the lateral thigh. She also indicates no traumatic injury. The symptoms increase after she has been sitting for 30 minutes or longer, and the overall intensity of the symptoms has been increasing over the patient 2 weeks. The therapist notes that repeated active lumbar flexion does not increase pain, and the patient’s lumbar range of motion is normal for a pregnant woman. There is also no motor weakness in the hip or pelvis, and the sacroiliac joint is not abnormally rotated. What is the most probable diagnosis?

L3 disc dysfunction
Spondylolisthesis
L4 disc dysfunction
Meralgia paresthetica

Answer 165

Meralgia paresthetica

Question 166

A patient informs his therapist that his problem began 3 months after the flu. The patient originally experienced tingling in the hands and feet. He also reports progressive weakness to the point that he required a ventilator to breathe. He is now recovering rapidly and is expected to return to a normal functional level in 3 more months. From which of the following conditions is the patient most likely suffering?

Parkinson’s disease
Guillain-Barre syndrome
Multiple sclerosis
Amyotrophic lateral sclerosis

Answer 166

Guillain-Barre syndrome

Question 167

A therapist is examining a patient in the intensive care unit. The therapist notices that the patient is moving his hands and fingers in slow, writhing motions. Which of the following terms best describes this type of movement?

Lead-pipe rigidity
Ballisms
Chorea
Athetosis

Answer 167

Athetosis

Question 168

A thrapist is scheduled to treat a patient with cerebral palsy who has been classified as a spastic quadriplegia. What type of orthopedic deformity should the therapist expect to see in the patient’s feet?

Talipes equinovalgus
Talipes equinovarus
Hindfoot valgus
Abnormally large calcaneus

Answer 168

Abnormally large calcaneus

Question 169

Postinfectious ascending paralysis and radiculoneuropathy are characteristics of what condition?

GBS
Myasthenia Gravis
ALS
MS

Answer 169

GBS

Question 170

A physical therapist is treating a patient who has bilaterally “weak” knee and hip extensors. The patient is most likely to have the greatest difficulty performing which of the following functional activities?

Transferring from a wheelchair to a mat
Rolling from supine to side-lying
Transferring from sitting to supine
Transferring from sitting to standing

Answer 170

Transferring from sitting to standing

Question 171

Your patient has been diagnosed as having pronator syndrome. You have determined that the structure involved is the lacertus fibrosis. The maneuver that would verify this is

Elbow flexion of 120 to 135 degrees
Resisted forearm supination
Resisted forearm pronation
Resisted long finger flexion

Answer 171

Resisted forearm supination

Question 172

Your patient presents with a non-contact injury from a quick stop. He reports an audible “pop” at the time of injury. He complains of pain on either side of his patella. He now complains of difficulty with cutting and pivoting when running. The patient did not have immediate swelling or joint line tenderness. The structure most likely involved is the

Medial meniscus
MCL
PCL
ACL

Answer 172

ACL

Question 173

A 45-year-old male electrician presents with a gradual onset of left shoulder pain. He notes it is most prominent with overhead activities and throwing. The position that hurts his shoulder the most is 90 degrees of flexion with internal rotation. This most likely indicates

A SLAP lesion
Anterior instability of the shoulder
Impingement syndrome
Posterior instability of the shoulder

Answer 173

Impingement syndrome

Question 174

Ankle pain anteriorly

Is usually a bone bruise
Is usually osteochondritis dissecans
Is usually ligament pain following sprain
Is usually soft tissue impingement

Answer 174

Is usually soft tissue impingement

Question 175

The most likely cause for a baseball pitcher to injure the throwing arm is

Throwing side-arm
High pitch counts
Throwing curve balls
“Dead arm” syndrome

Answer 175

Throwing curve balls

Question 176

What are signs and symptoms of an acute TMJ anterior displaced disc without reduction?

a. Clicking and pain in the TMJ
b. Absence of clicking and opening limited to 26-30 mm, lateral movements limited to contralateral side, deflection to the same wide with protrusion
c. Crepitation and limitation to 26 mm
d. Absence of clicking and opening is limited to 26-30 mm, lateral movements limited to I/L side, deflection to same side with protrusion

Answer 176

b. Absence of clicking and opening limited to 26-30 mm, lateral movements limited to contralateral side, deflection to the same wide with protrusion

Question 177

What is the temporomandibular reciprocal click?

a. Clicking that occurs during the end of opening
b. Clicking that occurs during the beginning of opening
c. Clicking that occurs during the middle of opening
d. Clicking that occurs during opening and closing

Answer 177

d. Clicking that occurs during opening and closing

Question 178

A patient cannot open the jaw greater than 15 mm interincisal with active and passive opening. Lateral jaw movements are 8 mm bilaterally and protrusion is 6 mm. What type of disorder do these symptoms indicate?

Anterior disc displacement with reduction
Anterior disc displacement without reduction
Trismus
Capsulitis

Answer 178

Capsulitis

Question 179

A 39-year-old patient presents with complaints of pain and point tenderness slightly anterior to the TMJ. the tissue that likely is causing the pain is the

Temporalis tendon
Masseter
Maxillary sinus
Parotid gland

Answer 179

Masseter

Question 180

What clinical examination technique will establish whether an infant’s hip is dislocated but reducible?

Barlow’s test
Ortolani’s maneuver
Hoffman test
Galeazzi test

Answer 180

Ortolani’s maneuver

Question 181

A patient presents to physical therapy with complaints of pain in the right hip due to osteoarthritis. Which of the following is not true about this type or arthritis?

a. Osteoarthritis causes pain that is usually symmetric because it is a systemic condition
b. Osteoarthritis is not usually more painful in the morning
c. Osteoarthritis commonly involves the distal interphalangeal joint
d. Osteoarthritis mainly involves weight-bearing joints

Answer 181

a. Osteoarthritis causes pain that is usually symmetric because it is a systemic condition

Question 182

A patient presents with tachypnea, cor pulmonale, hypoxemia, rales on inspiration, and decreased diffusing capacity. What is the probable cause?

Restrictive lung dysfunction
COPD
Asthma
Emphysema

Answer 182

Restrictive lung dysfunction

Question 183

A patient presents to a clinic with decreased tidal volume (TV). What is the most likely cause of this change in normal pulmonary function?

COPD
Restrictive lung dysfunction
Emphysema
Asthma

Answer 183

Restrictive lung dysfunction

Question 184

A 50-year-old man has a persistent cough, purulent sputum, abnormal dilation of bronchi, more frequent involvement of the lower lobe than the right, hemoptysis, and reduced forced vital capacity. What is the most likely pulmonary dysfunction?

Chronic bronchitis
Emphysema
Asthma
Bronchiectasis

Answer 184

Bronchiectasis