Fortinberry - Chapter 5 (PT Apps)

Question 1

Which of the following is a contraindication to ultrasound at 1.5 watts/cm with a 1 MHz sound head?

Over a recent fracture site
Over uncemented metal implant
Over a recently surgically repaired tendon
Over quadriceps muscle belly

Answer 1

Over a recently surgically repaired tendon

Question 2

While obtaining history from a 62-year-old woman weighing 147 pounds, the therapist discovers that the patient has a history of RA. The order for outpatient physical therapy includes continuous traction due to an L2 disc protrusion. What is the best course of action for the therapist?

a. Follow the order
b. Consult with the physician because RA is a contraindication
c. Apply intermittent traction instead of continuous traction
d. Use continuous traction with the weight setting at 110 pounds

Answer 2

b. Consult with the physician because RA is a contraindication

Question 3

A 25-year-old woman has been referred to a physical therapist by an orthopedist because of low back pain. The therapist is performing an ultrasound at the L3 level of the posterior back when the patient suddenly informs the therapist that she is looking forward to having her third child. On further investigation, the therapist discovers that the patient is in the first trimester of the pregnancy. Which of the following is the best course of action for the therapist?

a. Change the settings of the ultrasound from continuous to pulsed
b. Continue with the continuous setting because first-trimester pregnancy is not a contraindication
c. Cease treatment, notify the patient’s orthopedic physician, and document the mistake
d. Send the patient to the gynecologist for an immediate sonogram

Answer 3

c. Cease treatment, notify the patient’s orthopedic physician, and document the mistake

Question 4

The therapist routinely places ice on the ankle of a patient with an acute ankle sprain. Ice application has many therapeutic benefits. Which of the following is the body’s first response to application of ice?

Vasoconstriction of local blood vessels
Decreased nerve conduction velocity
Decreased local sensitivity
Complaints of pain

Answer 4

Vasoconstriction of local blood vessels

Question 5

Which of the following theories support the use of a TENS unit for sensory level pain control?

Gate control theory
Sensory interaction theory
Central summation theory
Sensory integration theory

Answer 5

Gate control theory

Question 6

Which of the following tissues absorbs the least amount of an ultrasound beam at 1MHz?

Bone
Skin
Muscle
Blood

Answer 6

Blood

Question 7

The therapist decides to use ES to increase a patient’s quadriceps strength. Which of the following is the best protocol?

a. Electrodes placed over the superior/lateral quadriceps and the vastus medialis obliquus; stimulation on for 15 seconds, then off for 15 seconds
b. Electrodes over the femoral vein in the proximal quadriceps and the vastus medialis obliquus; stimulation on for 50 seconds, then off for 10 seconds
c. Electrodes over the vastus medialis obliquus and superior/lateral quadriceps; stimulation frequency set between 50 and 80 Hz, pps
d. Electrodes over the femoral nerve in the proximal quadriceps and the vastus medialis obliquus; stimulation frequency set between 50 and 80 Hz pps

Answer 7

c. Electrodes over the vastus medialis obliquus and superior/lateral quadriceps; stimulation frequency set between 50 and 80 Hz, pps

Question 8

A therapist should consider using a form of treatment other than moist heat application on the posterior lumbar region of all of the following patient except

a. Patient with a history of hemophilia
b. Patient with a history of malignant cancer under the site of heat application
c. Patient with a history of Raynaud’s phenomenon
d. Patient with a history of including many years of steroid therapy

Answer 8

c. Patient with a history of Raynaud’s phenomenon

Question 9

A 50-year-old woman has been receiving treatment in the hospital for increased edema in the right UE. The therapist has treated the patient for the past 3 weeks with an intermittent compression pump equipped with a multi-compartment compression sleeve. The patient’s average blood pressure is 135/80 mmHg. The daily sessions are 3 hours in duration. The pump is set at 50 mmHg, 40mmHg, and 30 mmHg (distal to proximal) for 30 seconds, on and off for 15 seconds. The therapist decides to change the parameters. Of the following changes, which is the most likely to increase the efficiency of treatment?

a. Place the patient in a seated position with the right UE in a dependent position versus supine and elevated
b. Increase the maximal pressure from 50 mmHg to 60 mmHg
c. Change the on/off time to 15 seconds on and 45 seconds off
d. Equalize the sleeve compartments versus having greater pressure distally

Answer 9

b. Increase the maximal pressure from 50 mmHg to 60 mmHg

Question 10

A therapist chose to work with her patient using fluidotherapy rather than paraffin wax. The patient has a lack of ROM and also needs to decrease hypersensitivity. There are no open wounds on the hand to be treated. Which of the following would not be an advantage of using fluidotherapy versus paraffin wax in the above scenario?

a. The therapist can assist ROM manually while the patient has his hand in the fluidotherapy and not while in the paraffin wax
b. The fluidotherapy can be used to assist in desensitization by adjusting air intensity
c. The fluidotherapy can be provided at the same time as dynamic splinting, and this cannot be done while in paraffin wax
d. The fingers can be bound, to assist gaining finger flexion, with tape while in fluidotherapy and not in paraffin wax

Answer 10

d. The fingers can be bound, to assist gaining finger flexion, with tape while in fluidotherapy and not in paraffin wax

Question 11

A therapist is treating a 35-year-old man who has suffered loss of motor control in the right LE due to peripheral neuropathy. The therapist applies biofeedback electrodes to the right quadricep in an effort to increase control and strength of this muscle group. The biofeedback can help achieve this goal in all of the following ways except

a. Providing visual input for the patient to know how hard he is contracting the right quadricep
b. Assisting the patient in recruitment of more motor units in the right quadricep
c. Providing a measure of torque in the right quadricep
d. Providing the therapist input on the patient’s ability and effort in contracting the right quadricep

Answer 11

c. Providing a measure of torque in the right quadricep

Question 12

A patient is receiving electrical stimulation for muscle strengthening of the left quadricep. One electrode from one lead wire, 4 x 4 inches in size, is placed on the anterior proximal portion of the left quadricep. Each of the two other electrodes from one lead wire are 2 x 2 inches in size. One of the electrodes is placed on the inferior medial side of the left quadricep and one on the inferior lateral side of the left quadricep. This is an example of what type of electrode configuration?

Monopolar
Bipolar
Tripolar
Quadripolar

Answer 12

Bipolar

Question 13

In comparing the use of cold pack and hot pack treatments, which of the following statements is false?

a. Cold packs penetrate more deeply than hot packs
b. Cold increases the viscosity of fluid and heat decreases the viscosity of fluid
c. Cold decreases spasm by decreasing sensitivity to muscle spindles and heat decreases spasm by decreasing nerve conduction velocity
d. Cold decreases the rate of oxygen uptake, and heat increases the rate of oxygen uptake

Answer 13

c. Cold decreases spasm by decreasing sensitivity to muscle spindles and heat decreases spasm by decreasing nerve conduction velocity

Question 14

A patient is being treated with iontophoresis, diving dexamethasone, for inflammation around the lateral epicondyle of the left elbow. The therapist is careful when setting the parameters and with cleaning the site of electrode application to prevent a possible blister. This possibility is not as strong with some other forms of electrical stimulation, but with iontophoresis using a form of __, precautions must be taken to ensure that the patient does not receive mild burns or blisters during the treatment session.

Alternating current
Direct current
Pulsed current
TENS

Answer 14

Direct current

Question 15

A 63-year-old woman presents to physical therapy with a diagnosis of herpes zoster. The physician informs the PT that the L5 dorsal root is involved and that the TENS unit should be used to help control the pain. Where should the TENS unit electrodes be placed?

Posterior thigh
Lateral hip/greater trochanter area
Anterior thigh
Anterolateral tibia

Answer 15

Anterolateral tibia

Question 16

A physician has ordered ES to a 43-year-old male with complaints of SCM spasms. What is the appropriate course of action by the PT?

a. Begin intervention with low frequency, high phase duration ES
b. ES in this area is a contraindication. Contact physician to discuss alternative interventions
c. Begin intervention with high frequency, low phase duration ES
d. Use ultrasound only and do not contact the physician

Answer 16

b. ES in this area is a contraindication. Contact physician to discuss alternative interventions

Question 17

The PT has decided to use FES in order to help an SCI patient ambulate. What is the lowest SCI level that FES would be considered?

T3-T4
T8-T9
T11-T12
L3-L4

Answer 17

T11-T12

Question 18

A PT is using a cold pack to decrease inflammation after a therapeutic exercise session. Which of the following areas needs to be monitored most closely during the ice pack application?

Lateral knee
Lumbar area
Quadriceps area
AC joint

Answer 18

Lateral knee

Question 19

In which of the following patient conditions would it be safe to apply spinal traction to help decompress a spinal nerve root?

Acute RA
DJD
Osteoporosis
Spinal tumor

Answer 19

DJD

Question 20

Which of the following best describes the patient’s position when administering positional traction?

a. Hanging upside down on an inversion table (or with inversion boots)
b. Hanging by the hands (right side up) from an overhead bar
c. Side-lying with a pillow placed under one side of the lumbar spine
d. Sitting with head in a halter that is attached to an over-the-door traction

Answer 20

c. Side-lying with a pillow placed under one side of the lumbar spine

Question 21

You plan to administer lumbar traction to a patient who has back pain and nerve root impingement. You determine from your history that this patient has no contraindications to the use of traction. What other piece of information do you need to obtain from this patient in order to determine the appropriate intensity for your traction treatment?

Age
Body weight
Medications currently taken
Pain rating

Answer 21

Body weight

Question 22

Before a lumbar traction treatment, your patient tells you that his pain is localized in his low back and right buttock. Your examination indicates a medium-sized herniated disk. The day after the traction treatment, he tells you that his back pain has diminished, but he now has deep aching and numbness down the posterior aspect of his right LE. In addition, you are no longer able to elicit his Achilles tendon reflex. Based on these responses, you should

a. Increase the intensity of the traction during the next treatment session
b. Reduce the intensity of the traction during the next treatment session
c. Swing from a static to an intermittent mode of traction application
d. Discontinue the traction treatments

Answer 22

d. Discontinue the traction treatments

Question 23

You administer cervical traction to a patient in your clinic to help stretch the tight soft tissues along the posterior aspect of her neck. She responds well to the initial treatment so you arrange for her to lease a home cervical traction unit to continue this treatment on a daily basis. In what position would you instruct her to place the traction unit to produce the optimal effect?

a. At a downward angle that pulls her neck into slight extension
b. At an upward angle that slightly flexes her neck
c. At an upward angle that fully flexes her neck
d. Lying flat with no angle (no extension or flexion)

Answer 23

b. At an upward angle that slightly flexes her neck

Question 24

When the goal of a lumbar traction is to cause distraction of the vertebrae, the magnitude is to cause distraction of the vertebrae, the magnitude of the traction force should approximate what percent of the patient’s body weight?

10%
25%
50%
75%

Answer 24

50%

Question 25

Which of the following is not a physiologic benefit associated with the use of CPM?

a. Prevents muscle atrophy by stimulating a normal concentric contraction
b. Prevents adhesions by orienting collagen fibers as they heal
c. Reduced edema by facilitating the movement of fluid in and out of the joint
d. Reduced pain via the stimulation of joint mechanoreceptors

Answer 25

a. Prevents muscle atrophy by stimulating a normal concentric contraction

Question 26

A patient with venous insufficiency in his lower extremities is referred for instruction on the use of a pneumatic compression pump at home. What inflation pressure and the treatment time will you use to initiate this compression treatment?

a. Continuous pressure equal to the patient’s diastolic BP for 20-30 minutes
b. Continuous pressure between 30 and 50 mmHg for 20-30 minute
c. Intermittent pressure no higher than 30 mmHg for one hour
d. Intermittent pressure between 40 and 80 mmHg for 2 hours

Answer 26

d. Intermittent pressure between 40 and 80 mmHg for 2 hours

Question 27

Which of the following conditions would contraindicate the use of an intermittent pneumatic compression pump?

Congestive heart failure
Lymphedema
Recent joint arthroplasty
Venous stasis ulcers

Answer 27

Congestive heart failure

Question 28

You are treating a patient with acute bicipital tendinitis, so your goal is to reduce inflammation. Two of your treatment choices are iontophoresis and phonophoresis. Which of the following comparative statements regarding these two modalities are true?

a. Both procedures can be performed at home by the patient
b. Both procedures require medications to be suspended in a solution
c. Iontophoresis can deliver medication to deeper tissues than phonophoresis
d. Iontophoresis is more likely to cause skin irritation than phonophoresis

Answer 28

a. Both procedures can be performed at home by the patient

Question 29

If you are using dexamethasone to an inflamed tissue, which of the following would be the most appropriate treatment parameters?

a. Active electrode; intensity = 1.5 mAmps; treatment time = 30 minutes
b. Active electrode; intensity = 2 mAmps; treatment time = 20 minutes
c. Active electrode; intensity = 4 mAmps; treatment time = 10 minutes
d. Active electrode; intensity = 8 mAmps; treatment time = 5 minutes

Answer 29

b. Active electrode; intensity = 2 mAmps; treatment time = 20 minutes

Question 30

If you want ions into the tissue, as in the application of iontophoresis, what type of electrical current will you need to use?

Continuous biphasic
Continuous monophasic
Pulsed biphasic
Pulsed monophasic

Answer 30

Continuous monophasic

Question 31

You have a patient with a diabetic ulcer that has not responded well to conventional treatment, so you think he might be a good candidate for ES. Which type of ES would most likely facilitate wound healing?

a. High-volt using a pulsed monophasic waveform
b. Interferential (medium frequency)
c. Iontophoresis using a continuous monophasic waveform
d. TENS using a pulsed biphasic waveform

Answer 31

a. High-volt using a pulsed monophasic waveform

Question 32

You are treating a patient who is recovering from a muscle strain and you want to help increase the blood flow to that muscle as well as enhance its extensibility. Which thermal agent is most likely to produce these effects in muscle tissue?

Hot pack
Infrared radiation
Pulsed ultrasound
SWD

Answer 32

SWD

Question 33

You decide to use sensory-level (i.e., conventional) TENS to provide some relief for incisional pain in your patient who recently underwent knee surgery. The physiological mechanism by which this form of TENS is thought to provide is known as __ inhibition.

Autogenic
Descending
Presynaptic
Reciprocal

Answer 33

Presynaptic

Question 34

You want to use NMES to facilitate AROMs in a patient who is recovering from a fractured wrist. The patient has bony union but is limited by soft tissue tightness in her wrist flexors and extensors because of her immobilization. Which of the following stimulation parameters would you recommend?

a. Reciprocal stimulation mode using a frequency of 40 Hz and high enough intensity to elicit a full muscle contraction
b. Reciprocal stimulation mode using a frequency of 2 Hz and high enough intensity to elicit an observable muscle twitch
c. Synchronous stimulation mode suing a frequency of 100 Hz with high enough intensity to elicit a comfortable sensory response
d. Synchronous stimulation mode using a frequency of Hz with intensity as high as the patient can tolerate

Answer 34

a. Reciprocal stimulation mode using a frequency of 40 Hz and high enough intensity to elicit a full muscle contraction

Question 35

You have a patient with subacute RA in her hands who also has a history of Raynaud’s disease. Which of the following modalities would be contraindicated for this patient?

Cold pack
Fluidotherapy
Paraffin wax bath
UV light

Answer 35

Cold pack

Question 36

You plan to administer a combination of US and ES to a patient who is experiencing muscle spasm in her upper trapezius and posterior neck muscles following a recent whiplash injury. To perform this type of treatment, what type of electrode setup would you use?

a. Bipolar technique using a dispersive pad that equal to the size of the soundhead
b. Monopolar technique using a dispersive pad that is much larger than the soundhead
c. Monopolar technique using a dispersive pad that is much smaller than the soundhead
d. Quadripolar technique using 2 soundheads and 2 equal-sized dispersive pads

Answer 36

b. Monopolar technique using a dispersive pad that is much larger than the soundhead

Question 37

You are treating a 12-year old patient with Osgood Schlatter disease and want to apply a modality treatment over his tibial tuberosity to help relieve his pain. Which of the following should you probably avoid using in a patient his age?

Ice massage
Iontophoresis
TENS
Ultrasound

Answer 37

Ultrasound

Question 38

You have an older patient with balance problems who you think would benefit from walking in a therapeutic pool. However, this patient also has some LE edema associated with venous insufficiency. What effect might the pool therapy have on her edema?

a. The hydrostatic pressure exerted by the water should reduce her edema
b. The relaxing effect of the water is likely to slow her circulation and diminish her edema
c. Her edema will probably worsen because therapeutic pools are usually heated to at least 100 degrees F
d. It should have no effect on her edema because walking in water is not that strenuous

Answer 38

a. The hydrostatic pressure exerted by the water should reduce her edema

Question 39

You are treating a patient who is recovering from Guillain Barre syndrome and is still experiencing considerable weakness and fatigue in her LE muscles. You want to use some ES to help facilitate the strength of her muscle contractions. What type of duty cycle would be most appropriate for a patient like this?

10 seconds on, 50 seconds off
10 seconds on, 15 seconds off
15 seconds on, 15 seconds off
15 seconds on, 5 seconds off

Answer 39

10 seconds on, 50 seconds off

Question 40

You have placed equal-sized electrodes over the dorsal aspect of a patient’s proximal and distal forearm in order to stimulate his wrist and finger extensor muscles. However, when you first turn the electrical stimulator on, the response you are getting is finger flexion, rather than extension. How would you correct this problem to get the desired motor response?

a. Increase the pulse duration to maximize the intensity
b. Move the electrodes closer together over the muscle belly
c. Switch from a biphasic current to a monophasic current
d. Use a smaller electrode over the distal forearm

Answer 40

b. Move the electrodes closer together over the muscle belly

Question 41

You are using ES to facilitate the contraction of a muscle that is recovering from a PNI. Because the patient only shows signs of partial innervation at this time, any electrical stimulation treatment will require the use of a stimulator that can produce a

a. High amplitude and long pulse duration
b. High duration (i.e., 5000 Hz)
c. Monophasic waveform of positive polarity
d. Very low intensity in the microamperage range

Answer 41

a. High amplitude and long pulse duration

Question 42

You are treating a patient with adhesive capsulitis of the glenohumeral joint. You decide to administer some ultrasound in order to increase the extensibility of the patient’s joint capsule before you begin joint mobilization procedures. Which ultrasound parameters are most likely to produce the desired results in this particular tissue?

1 MHz continuous ultrasound
1 MHz pulsed ultrasound
3 MHz continuous ultrasound
3 MHz pulsed ultrasound

Answer 42

1 MHz continuous ultrasound

Question 43

Which of the following patient conditions would contraindicate the use of most thermal, mechanical, and electrical modalities?

Diabetic neuropathy
Hypertension
Metastatic cancer
Urinary incontinence

Answer 43

Metastatic cancer

Question 44

Which of the following patients would not be an appropriate candidate for EMG biofeedback training?

a. Individual with tension headaches
b. Older adult with Alzheimer’s dementia
c. Post-stroke patient who needs balance training
d. Quadriplegic patient who has had a recent tendon transfer

Answer 44

b. Older adult with Alzheimer’s dementia

Question 45

Which of the following physiologic changes would not be associated with the application of superficial heat?

Decreased interstitial fluid
Decreased pain perception
Increased extensibility of collagen tissue
Increased metabolic activity

Answer 45

Decreased interstitial fluid

Question 46

You are preparing to apply cryotherapy to a patient who has never had it before. In your history, which question would help you determine whether your patient might be hypersensitive to cold?

a. Do your fingers ever go numb when exposed to cold, damp weather?
b. Have you ever had an allergic response to a cold stimulus (i.e., itchy rash or hives)?
c. Have you ever been frostbitten?
d. How often do you wear gloves when you are outside in cold weather?

Answer 46

b. Have you ever had an allergic response to a cold stimulus (i.e., itchy rash or hives)?

Question 47

If you apply a cold pack or ice massage over a patient’s biceps muscle for 5-10 minutes before a session of resistive exercise, what change would you expect to see in that muscle?

An immediate increase in isometric strength
And immediate decrease in muscle tone and tendon reflex
Elimination of any exercise-induced muscle soreness
Faster recruitment of type II muscle fibers

Answer 47

An immediate increase in isometric strength

Question 48

Heat modalities are generally contraindicated in the presence of an infectious lesion because they may

a. Increase circulation, which can spread the organism to other parts of the body
b. Increase the rate of cellular mitosis and cause the organism to mutate
c. Mask the pain associated with the lesion, which may cause further tissue damage
d. Reduce the effectiveness of the body’s immune system

Answer 48

a. Increase circulation, which can spread the organism to other parts of the body

Question 49

In most cases, it is considered safe to apply US over or near

Cemented and plastic implants
Metal screws, plates, implants
A pacemaker
Reproductive organs

Answer 49

Cemented and plastic implants

Question 50

In examining an ultrasound machine, you note that it operates at a frequency of 1MHz and has a Beam Non-Uniformity Ratio (BNR) of 8:1. Which of the following statements regarding this machine is true?

Most energy will be absorbed in (superficial/deep) tissues, and it may produce (even/uneven) heating

Answer 50

Most energy will be absorbed in DEEP tissues, and it may produce UNEVEN heating

Question 51

The most common clinical use of phonophoresis is to

a. Apply an anti-inflammatory medication to a localized musculoskeletal tissue
b. Deliver antibiotics to an infected wound
c. Provide a mechanical stimulus to accelerate repair in bone and cartilage
d. Slow the conduction velocity of sensory nerves to relieve pain

Answer 51

a. Apply an anti-inflammatory medication to a localized musculoskeletal tissue

Question 52

You are administering US to a localized area around a patient’s patellar tendon when she begins to complain of intense pain over her tibial tuberosity. What is the most likely cause of this response?

a. You are using ineffective or insufficient amount of coupling mechanism
b. There is a very low attenuation of US in bony tissue
c. You are using a US unit with a high BNR and/ore are moving it too slowly
d. The crystal soundhead has been damaged

Answer 52

c. You are using a US unit with a high BNR and/ore are moving it too slowly

Question 53

A patient with diabetes is admitted for care of a venous stasis ulcer on the medial aspect of his ankle. You decide to include pulsed ultrasound as part of your treatment plan to take advantage of its non-thermal effects on wound healing. Which of the following is an example of a non-thermal effect produced by ultrasound?

a. Decrease cell membrane permeability which reduces edema
b. Decreased histamine release and macrophage activity
c. Destruction of surface bacteria and stimulation of antibodies in the wound bed
d. Increased intracellular calcium and protein synthesis

Answer 53

d. Increased intracellular calcium and protein synthesis

Question 54

You plan to give a SWD treatment to a 42-year-old female patient who has low back pain. Which of the following questions would not be necessary or appropriate to ask this patient before giving her this treatment?

a. Are you currently menstruating?
b. Could you possibly be pregnant?
c. Do you know if you have a urinary infection or a pelvic tumor?
d. Do you take birth control pills?

Answer 54

d. Do you take birth control pills?

Question 55

A college student injures his ankle in an intramural volleyball game. X-ray reveals no evidence of fracture, so he is referred to PT for treatment of an acute ankle sprain. Which of the following modalities would be the most appropriate to apply at this time?

Air-activated heat wrap
Cold compression cuff
Fluidotherapy
SWD

Answer 55

Cold compression cuff

Question 56

You receive a referral to treat a decubitus ulcer over a patient’s sacrum. Following hydrotherapy to clean and debride the ulcer, you decide to irradiate the wound with UV light. Before administering a UV treatment, you need to ask your patient if he/she

Has a cardiac pacemaker
Has any food allergies
Has ever been severely sunburned
Is currently taking any medications that cause sensitivity to sunlight

Answer 56

Is currently taking any medications that cause sensitivity to sunlight

Question 57

The intensity of an infrared or UV lamp is greatest when the lamp is

a. Positioned closer to the patient at a 45 degree angle
b. Positioned closer to the patient at a 90 degree angle (perpendicular to skin)
c. Positioned further from the patient at a 90 degree angle (perpendicular to skin)
d. Radiating the skin through a sheet or thin towel

Answer 57

b. Positioned closer to the patient at a 90 degree angle (perpendicular to skin)

Question 58

How does low-powered (“cold”) laser light differ from other types of phototherapy?

a. Laser light has greater divergence from its source
b. Laser light is monochromatic (i.e., one wavelength)
c. Light waves from lasers are transmitted in an asynchronous, non-coherent manner
d. Laser light is classified as a form of ionizing radiation

Answer 58

b. Laser light is monochromatic (i.e., one wavelength)

Question 59

A young woman is referred to you with severe muscle spasms in her back that began shortly after she started working as a ticket agent at the local airport. You think that some deep heat will really help calm down her spasm. When you ask about her past history of back problems, she tells you that she had scoliosis as a child but underwent a surgical fusion (with metal rods) to stop the progression of the curve. She thinks her limited spinal mobility may be what triggered her spasm. Based on this history and her current symptoms, which thermal modality would you select?

a. Diathermy because it selectively heats muscle tissue the best
b. Ultrasound because diathermy is contraindicated in this patient
c. Hot packs because both diathermy and ultrasound are contraindicated
d. NOTA because heat will only make her muscle spasm worse

Answer 59

b. Ultrasound because diathermy is contraindicated in this patient

Question 60

Why must a patient’s skin be cleaned and debrided before applying electrodes?

To avoid contaminating your electrodes
To determine whether his or her sensation is intact
To help decrease skin resistance
To reduce current density at the electrode-tissue interface

Answer 60

To help decrease skin resistance

Question 61

PTRP KA NA THIS JUNE 2024! 🫶🏽

Question 62

For which of the following patient conditions would electrotherapy be an inappropriate treatment modality?

An infected wound
Prior history of seizures
Muscle spasticity
Urinary incontinence

Answer 62

Prior history of seizures

Question 63

A high-frequency sinusoidal (i.e., biphasic) waveform that is typically delivered in burst of approximately 50 per second and used for muscle strengthening is usually referred to as

High-volt galvanic stimulation
Interferential current
Microcurrent
Russian current

Answer 63

Russian current

Question 64

Why do most NMES protocols recommend frequency settings between 30 and 50 pulses per second?

a. Frequencies lower than this range cannot produce a muscle contraction
b. Higher frequencies usually stimulate the nocireceptors and make the patient uncomfortable
c. It produces a smooth, tetanic muscle contraction without excessive fatigue
d. Most muscle stimulators cannot produce above or below this range

Answer 64

c. It produces a smooth, tetanic muscle contraction without excessive fatigue

Question 65

In which of the following situations would it be appropriate to use a low frequency (i.e., 1-5 Hz) to simulate a muscle?

a. When the muscle is only partially innervated and very weak
b. When stimulating the intrinsic muscles of the hand or foot
c. When you are trying to relax a muscle that is in spasm
d. When you are trying to stretch a joint contracture

Answer 65

a. When the muscle is only partially innervated and very weak

Question 66

When using NMES, when would you want to use a long rise/ramp time (i.e., 2-3 seconds)?

a. When stimulating a completely denervated muscle
b. When stimulating a hypotonic (i.e., flaccid) muscle
c. When stimulating a hypertonic (i.e., spastic) muscle
d. When stimulating the antagonist of a hypertonic (i.e., spastic) muscle

Answer 66

d. When stimulating the antagonist of a hypertonic (i.e., spastic) muscle

Question 67

Which muscles would you stimulate if you were using NMES to help correct a subluxed GH joint in a patient who has had a stroke?

a. Anterior and posterior deltoids
b. Rhomboids and serratus anterior
c. Supraspinatus and latissimus dorsi/teres major
d. Supraspinatus and posterior deltoid

Answer 67

d. Supraspinatus and posterior deltoid

Question 68

The concept of current dosage in iontophoresis refers to the

a. Current amplitude (intensity) multiplied by treatment time
b. Current density as determined by the size of the delivery electrode
c. Current polarity in relation to the medication’s polarity
d. Difference between the phase charge and the treatment time

Answer 68

a. Current amplitude (intensity) multiplied by treatment time

Question 69

If you are using ES to limit edema formation in an acutely injured joint, the amplitude should be adjusted to produce a

Mild muscle contraction (tapping)
Strong muscle contraction (beating)
Sensory response only
Subsensory response

Answer 69

Sensory response only

Question 70

Why is a modulated current recommended when using conventional TENS for pain control?

a. It provides combined effects of sensory and motor level TENS
b. It helps prevent sensory adaptation/habituation
c. It reduces the placebo effect of TENS
d. It selectively activates A-beta fibers

Answer 70

b. It helps prevent sensory adaptation/habituation

Question 71

Nerves cannot achieve a continuous state of excitation due to

Threshold
Depolarization period
Repolarization period
Refractory period

Answer 71

Refractory period

Question 72

When utilizing ES, what is the pulse frequency range for tetany?

25-50 pps
0-10 pps
10-20 pps
75-100 pps

Answer 72

25-50 pps

Question 73

What is the duty cycle for an electrical stimulation program with 6 seconds on time and 18 seconds off time?

25%
15%
33%
50%

Answer 73

25%

Question 74

When stimulating the wrist extensors, the best current type/electrode configuration is

Symmetric biphasic/monopolar
Symmetric biphasic/bipolar
Asymmetric biphasic/monopolar
Asymmetric biphasic/bipolar

Answer 74

Asymmetric biphasic/monopolar

Question 75

When utilizing ES, the key element of pulsed current is

A period of electrical silence
The duration of the current
The frequency of the current
The amplitude of the current

Answer 75

A period of electrical silence

Question 76

A 29-year-old woman fractured her right mid-tibia in a skiing accident 3 months ago. After cast removal, a severe foot drop was noted. The patient wants to try ES orthotic substitution. You would set up the FES to contract the appropriate muscles during

Toe off
Push off
Foot flat
Swing phase

Answer 76

Swing phase

Question 77

A patient has been referred to you following a fracture of the femur six months ago. The cast was removed, but the patient was unable to volitionally contract the quadriceps. You decide to apply ES to the quadriceps muscle. Your choice of electrode placement and ES duty cycle (on/off) would consist of

Large electrodes, closely spaced (10:10)
Large electrodes, widely spaced (10:30)
Small electrodes, closely spaced (10:30)
Small electrodes, widely spaced (10:10)

Answer 77

Large electrodes, widely spaced (10:30)

Question 78

A 31-year-old patient complains of patellar tendonitis as a result of a mountain climbing accident 3 weeks ago. The patient complains of pain with resisted knee extension, stair climbing, and sit-to-stand movements. You choose to apply iontophoresis using a pain medication with a positive charge. The correct type, polarity, and active electrode placement is

a. Monophasic current with anode placed on the tendon
b. Monophasic current with the cathode placed on the tendon
c. Biphasic current with the cathode placed proximal on the tendon
d. Low-volt, continuous current with the anode placed distal on the tendon

Answer 78

a. Monophasic current with anode placed on the tendon

Question 79

A 28-year-old actor/singer is complaining of TMJ pain. He also complains of headaches and neck tightness. He has been under a lot of stress lately and has noticed an increase in the frequency and magnitude of symptoms. His doctor suggested, and you concur that biofeedback might help him relax the neck and shoulder muscles and therefore decrease his symptoms. Initially, the EMG biofeedback protocol should consist of

a. High detection sensitivity with recording electrodes placed far apart
b. Low detection sensitivity with recording electrodes placed closely together
c. Low detection sensitivity with recording electrodes placed far apart
d. High detection sensitivity with recording electrodes placed closely together

Answer 79

b. Low detection sensitivity with recording electrodes placed closely together

Question 80

A 26-year-old presents with weakness of the knee resulting from an ACL injury. Your examination reveals moderate pain (5/10) and excessive translation of the tibia during knee extension. You determine functional stability of the knee should consist of stimulation of the

a. Hamstrings immediately before the quadriceps to produce co-contraction
b. Quadriceps only
c. Hamstrings only
d. Quadriceps immediately before the hamstrings to produce co-contraction

Answer 80

a. Hamstrings immediately before the quadriceps to produce co-contraction

Question 81

A patient presents with partial- and full-thickness burns on the chest and neck region. You are applying TENS during your debriding procedure to modulate pain. Your TENS treatment of choice would be

Modulated TENS
Conventional (high-rate) TENS
Acupuncture-like (low-rate) TENS
Brief intense TENS

Answer 81

Brief intense TENS

Question 82

A 73-year-old patient presents with a stage III decubitus ulcer on the plantar surface of the right foot. After a series of conservative treatments with limited success, the therapist chooses to apply ES for the tissue repair. The electrical current best suited in this case is

Russian current
Asymmetric biphasic pulsed current
Symmetric biphasic pulsed current
Interferential current

Answer 82

Asymmetric biphasic pulsed current

Question 83

You are applying pulsed current to the quadriceps to improve patellar tracking during knee extension. Your patient complains that the current is uncomfortable. To make the current more tolerable to the patient, yet maintain a good therapeutic effect, you should consider adjusting the

Current intensity
Pulse rate
Pulse duration
Current polarity

Answer 83

Current intensity

Question 84

Your patient has moderate spasticity of the biceps brachii on the left as a result of a stroke. You choose to use electrical stimulation to temporarily decrease the effects of hypertonicity in order to work on ADL activities. Your objective in applying the current is to

Fatigue the I/L biceps brachii
Stimulate the C/L biceps brachii
Stimulate the I/L triceps
Stimulate the C/L triceps

Answer 84

Stimulate the I/L triceps

Question 85

A 66-year-old patient with spastic hemiplegia was referred to you for ambulation training. The patient is having difficulty with standing up from a seated position due to co-contraction of the quadriceps and hamstrings during the knee and hip extension phase. You choose EMG biofeedback to assist you in progressively decreasing the motor activity of the hamstrings. You wish to use biofeedback beginning with simple knee extension exercise and progressing to sit-to-stand training. Initially, the biofeedback protocol should consist of

a. Low detection sensitivity with recording electrodes placed far apart
b. High detection sensitivity with recording electrodes placed closely together
c. Low detection sensitivity with recording electrodes placed closely together
d. High detection sensitivity with recording electrodes placed far apart

Answer 85

c. Low detection sensitivity with recording electrodes placed closely together

Question 86

A PT is providing intervention for an 11-year-old boy diagnosed with Server’s disease. All are appropriate therapeutic interventions for this patient except

Gastrocnemius/soleus stretches
Tibialis anterior strengthening
US
Ice

Answer 86

US

Question 87

The PT makes recommendations to a patient after hip replacement surgery for positioning in a wheelchair. Which set of instructions would adhere to safety precautions?

a. Keep the legs abducted with abductor pillow and affected leg in neutral
b. Keep the legs together by using an adductor strap to prevent ER of the legs
c. Sit in a regular wheelchair with the feet supported on a foot rest
d. Sit in regular wheelchair with the affected leg in full extension

Answer 87

a. Keep the legs abducted with abductor pillow and affected leg in neutral

Question 88

The therapist is ambulating a patient with an above-knee amputation. The new prosthesis causes the heel on the involved foot to move laterally at toe-off. Which of the following is the most likely cause of this deviation?

a. Too much IR of the prosthetic knee
b. Too much ER of the prosthetic knee
c. Too much outset of prosthetic foot
d. The prosthetic foot is set in excessive dorsiflexion

Answer 88

a. Too much IR of the prosthetic knee

Question 89

The therapist in an outpatient physical therapy clinic receives an order to obtain a shoe orthotic for a patient. After examining the patient, the therapist finds a stage I pressure ulcer on the first metatarsal head. Weight-bearing surfaces need to be transferred posteriorly. Which orthotic is the most appropriate for this patient?

Scaphoid pad
Thomas heel
Metatarsal pad
Cushion heel

Answer 89

Metatarsal pad

Question 90

When ordering a customized wheelchair for a patient, the therapist determines that the pelvic belt needs to be positioned so that it allows active anterior pelvic tilt. What is the best position for the pelvic belt in relation to the sitting surface?

30 degrees
45 degrees
60 degrees
90 degrees

Answer 90

90 degrees

Question 91

The therapist is treating a patient who has suffered a recent stroke. There is a significant lack of dorsiflexion in the involved LE and a significant amount of medial/lateral ankle instability. The therapist believes that an AFO would be beneficial. Which of the following is an inappropriate AFO?

Solid AFO
Posterior leaf spring AFO
Hinged solid AFO
Electrical stimulation-aided AFO

Answer 91

Posterior leaf spring AFO

Question 92

The use of compression stockings on the feet and ankles is contraindicated in which patient population?

Chronic venous disease
Recent total knee replacement
Burn patients
Chronic arterial disease

Answer 92

Chronic arterial disease

Question 93

The therapist is examining a 36-year-old woman to fit her appropriate wheelchair. Recent injury caused C6 quadriplegia. What is the correct way to measure the patient’s permanent wheelchair?

a. From the patient’s popliteal fossa to the heel and add 1 inch
b. From the patient’s popliteal fossa to the heel and subtract 1 inch
c. From the patient’s popliteal fossa to the first metatarsal head and add 1 inch
d. From the patient’s popliteal fossa to the first metatarsal and subtract 1 inch

Answer 93

b. From the patient’s popliteal fossa to the heel and subtract 1 inch

Question 94

The therapist is ambulating a 42-year-old man who has just received an above-knee prosthesis for the left leg. The therapist notices the pistoning of the prosthesis as the patient ambulates. Which of the following is the most probable cause of this deviation?

The socket is too small
The socket is too large
The foot bumper is too soft
The foot bumper is too hard

Answer 94

The socket is too large

Question 95

While examining a patient who has just received a new left below-knee prosthesis, the therapist notes that the toe of the prosthesis stays off the floor after heel strike. Which of the following is an unlikely cause of this deviation?

The prosthetic foot is set too far anterior
The prosthetic foot is set in too much dorsiflexion
The heel wedge is too stiff
The prosthetic foot is outset too much

Answer 95

The prosthetic foot is outset too much

Question 96

Which of the following is the most appropriate orthotic for a patient with excessive foot pronation during static standing?

Scaphoid pad
Metatarsal pad
Metatarsal bar
Rocker bar

Answer 96

Scaphoid pad

Question 97

A therapist is instructing a patient in the use of a wrist-driven prehension orthosis. What must be done to achieve opening of the involved hand?

Actively extend the wrist
Passively extend the wrist
Actively flex the wrist
Passively flex the wrist

Answer 97

Passively flex the wrist

Question 98

The therapist is treating a patient who received an above-elbow amputation 2 years ago. The prosthesis has a split cable that controls the elbow and the terminal device. With this type of prosthesis, the patient must first lock the elbow to allow the cable to activate the terminal device. This is accomplished with what movements?

a. Extending the humerus and elevating the scapula
b. Extending the humerus and retracting the scapula
c. Extending the humerus and protracting the scapula
d. Extending the humerus and depressing the scapula

Answer 98

d. Extending the humerus and depressing the scapula

Question 99

A 30-year-old man is referred to physical therapy after a recent motor vehicle accident that resulted in total loss of motor control of both legs. Trunk and bilateral UE control allows independent sitting at bedside. The patient is to be discharged from the hospital and will return to home a few hours after the physical therapy session. The therapist notices, from the history in the chart, that the patient lives alone and has little or no outside support from family members. The patient also suffers from severe obesity. The therapist decides to practice a transfer from bed to the wheelchair. Which assistive device should the therapist use for this transfer attempt?

Hoyer lift (pneumatic lift)
Sliding board
Geriatric hair (using a slide sheet transfer)
Trapeze bar

Answer 99

Sliding board

Question 100

The physical therapist has just given the patient a custom wheelchair. The patient has a long standing history of hamstring contractures resulting in fixation of the knees into 60 degrees of flexion. The patient is also prone to develop decubitus ulcers. Which of the following is incorrect advice to give the family and patient?

Keep the patient’s buttocks clean and dry
Make sure that the wheelchair cushion is always in the wheelchair seat
Keep the leg rests of the wheelchair fully elevated
Never transfer using a sliding board from one surface to the another

Answer 100

Keep the leg rests of the wheelchair fully elevated

Question 101

PTRP KA NA THIS JUNE, 2024! 🫶🏽

Question 102

A physical therapist is ordered to provide gait training for an 18-year-old girl who received a partial medial meniscectomy of the right knee one day earlier. The patient was independent in ambulation without an assistive device before surgery and has no cognitive deficits. The patient’s weight-bearing status is currently partial weight-bearing on the involved lower extremity. Which of the following is the most appropriate assistive device and gait pattern?

a. Crutches, three-point gait pattern
b. Standard walker, three-point gait pattern
c. Standard walker, four-point gait pattern
d. Crutches, swing-to gait pattern

Answer 102

a. Crutches, three-point gait pattern

Question 103

A physical therapist is ordered to provide gait training to a 78-year-old man who received a right cemented total knee replacement 24 hours earlier. The patient also had a traumatic amputation of the left UE 3 inches above the elbow 40 years ago. If the patient lives at home alone, which of the following is an appropriate assistive device?

Rolling walker
Standard walker
Hemi-walker
Wheelchair for 2 weeks

Answer 103

Hemi-walker

Question 104

Which of the following statements about below-knee amputations is false?

a. Gel socket inserts should be left in the prosthesis overnight
b. The therapist should puncture any blisters that appear on the stump
c. Areas of skin irritation on the stump can be covered with a dressing, then a nylon sock, before donning the prosthesis
d. When not in use, the prosthesis should be laid on the floor

Answer 104

b. The therapist should puncture any blisters that appear on the stump

Question 105

A therapist is assisting a patient with pre-gait activities who has been fitted with a hip disarticulation prosthesis. To ambulate with the most correct gait pattern, what must be mastered first?

Forward weight shift on to the prosthesis
Swing-through of the prosthesis
Maintain stability while in single-limb support on the prosthesis
Posterior pelvic tilt to advance the prosthesis

Answer 105

Posterior pelvic tilt to advance the prosthesis

Question 106

A 68-year-old man is being treated by a physical therapist after a right below-knee amputation. The patient is beginning ambulation with a preparatory prosthesis. In the early stance phase, the therapist notes an increase in knee flexion. Which of the following are possible causes of this gait deviation?

The heel is too stiff
The foot is set too far anterior in relation to the knee
The foot is set in too much plantar flexion
The heel is too soft

Answer 106

The heel is too stiff

Question 107

Orthotic intervention is usually recommended at __ degrees for a child with idiopathic scoliosis.

15
25
40
60

Answer 107

25

Question 108

An advantage for use of an externally-powered UE prosthetic device over a body-powered prosthetic device is

Cost
Ease of use
Improved fit
Weight

Answer 108

Cost

Question 109

A patient begins ambulation with axillary crutches for the first time. The gait required will be non-weight bearing for the right foot. What is the best advice to give them in regard to crutch placement during static standing?

a. Stand with the crutches and weight-bearing foot in a parallel line
b. Stand with both crutches under the right arm
c. Stand with both crutches under the left arm
d. Stand with both crutches approximately 4 inches to the front and side of the shoulders

Answer 109

d. Stand with both crutches approximately 4 inches to the front and side of the shoulder

Question 110

Of the walkers listed, which is the least stable?

Folding walker
Reciprocal walker
Rolling walker
Non-folding standard walker

Answer 110

Reciprocal walker

Question 111

The physical therapist is providing intervention for a patient with a recent stroke. Gait training with a new AFO will begin today. What is the most important aspect of the fit of the AFO?

The ankle should be flexed to 90 degrees
The top AFO should be 4 inches below the knee joint
Any complaints of pain or discomfort are important to AFO fit
The bottom AFO should stop at the metatarsal heads

Answer 111

Any complaints of pain or discomfort are important to AFO fit

Question 112

Which of the following is the most important factor when considering using restraints on a patient?

Comfort of application
Consent to apply restraints from family/patient
Current knowledge of staff in securing restraints
Mental status of patient

Answer 112

Consent to apply restraints from family/patient

Question 113

A physician orders gait training for a 16-year-old male with recent open reduction internal fixation of the left femur. The patient is non-weight bearing on the affected leg. Which of the following assistive devices is most appropriate for this patient?

Forearm crutches
Front-wheel walker
Axillary crutches
Quad cane

Answer 113

Axillary crutches

Question 114

Which of the following modalities produces its thermal effects via evaporation?

Hot pack
Ice massage
Paraffin wax
Vapocoolant spray

Answer 114

Vapocoolant spray

Question 115

When you apply cryotherapy to a patient, you can expect it to __ the patient’s sensory and motor nerve conduction velocity.

Decreased
Increase
Initially increase, then decrease
Not change

Answer 115

Decreased

Question 116

You are treating an athlete who strained his hamstring muscle. Which of the following modalities would be contraindicated if this patient had a cardiac pacemaker?

Ice massage
Hydrotherapy
SWD
Ultrasound

Answer 116

SWD

Question 117

Use of FES in patients with longstanding SCI does not improve

Aerobic capacity
Muscle strength
Osteopenia
Muscle mass

Answer 117

Osteopenia

Question 118

A patient with chronic back pain is referred to physical therapy for application of a TENS unit. The parameters chosen by the therapist are set to provide a noxious stimulus described as an acupuncture-type of stimulus. Which of the following lists of parameters produces this type of stimulation?

a. Low intensity, duration of 60 sec, and a frequency of 50 Hz
b. High intensity, duration of 150 sec, and a frequency of 100 Hz
c. Low intensity, duration of 150 sec, and a frequency of 100 Hz
d. High intensity, duration of 150 sec, and a frequency of 2 Hz

Answer 118

d. High intensity, duration of 150 sec, and a frequency of 2 Hz

Question 119

A physical therapist who is pregnant has been studying the use of TENS during labor and birth to decrease pain perception. Which of the following is the most effective technique in this situation?

a. Place the electrodes over the upper abdominals during the first stages of labor and over the lower abdominals during the later stages
b. Place the electrodes over the paraspinals at the L5 and S1 level throughout labor and delivery
c. Place the electrodes in a V pattern above the pubic region during labor and delivery
d. Place electrodes over the paraspinals at the L1 and S1 level initially during labor, and over the pubic region during the latter stages

Answer 119

d. Place electrodes over the paraspinals at the L1 and S1 level initially during labor, and over the pubic region during the latter stages

Question 120

A physician has ordered a specific type of ES that utilizes a frequency of 2500 Hz with a base frequency at 50 Hz to achieve fused tetany. What type of ES has the physician ordered?

Iontophoresis
TENS
Intermittent flow con
Russian stimulation

Answer 120

Russian stimulation