PT APPLICATION ENHANCEMENT PROGRAM

Question 1

You are to perform a postural evaluation of a patient from the POSTERIOR view. Specifically determining alignment for the head, scapula, and back, which of the following is the normal alignment?

a. Head forward, scapula flat, shoulder neutral
b. Head neutral, scapula flat, shoulder neutral
c. Head neutral, scapula neutral, plumbline straight through thoracic and lumbar spine
d. Head neutral, scapula level, plumbline straight through cervical spine

Answer 1

c. Head neutral, scapula neutral, plumbline straight through thoracic and lumbar spine

Question 2

You are treating a patient on the field who has the following clinical features: demonstrates weakness, fatigue, and loss of motor tone, with blurred vision and elevated body temperature. Which of the following heat disorders is this patient most likely experiencing?

a. Heat cramps
b. Heat syncope
c. Heat exhaustion
d. Heat hyperpyrexia

Answer 2

c. Heat exhaustion

**Heat Cramps - depletion of H2O and salt; vigorous activity in heat

**Heat Syncope - fainting episode secondary to dehydrating

**Heat Hyperpyrexia - flaccidity, involuntary movement, seizures

Question 3

You are planning the treatment program for a patient who is referred to physical therapy with Huntington’s chorea. This is a hereditary disease that is characterized by irregular movements and tremors. In planning this patient’s treatment program, which of the following could a licensed physical therapist perform?

a. Advise the physician to prescribe medication to slow down the disease

b. Advise the patient that there is no treatment; therefore, you are sorry but you cannot help him

c. Call the family and suggest family education regarding the disease, also contact the social worker

d. Utilize postural exercises and balance activities

A. I and II are correct
B. II and IV are correct
C. III and IV are correct
D. Only III is correct

Answer 3

D. Only III is correct

Question 4

You are assisting in planning the diet of a runner for a prolonged low-intensity running event. You are determining the number of calories required in the conversion process for energy. The number of calories required is different for protein, carbohydrates, and fats. How many calories are there in one gram of protein?

a. 1
b. 2.25
c. 3
d. 4

Answer 4

d. 4

**1 g of protein = 4 calories

Question 5

You are a physical therapist providing athletic coverage to a high school basketball game. One of the players is injured and begins hemorrhaging. You notice that there is a very rapid flow of bright red blood, which escapes in a rhythmical pattern spurting with each heartbeat. It was not easy for you to control the bleeding. Which of the following is the type of hemorrhaging that this patient is most likely experiencing

a. Arterial hemorrhage
b. Venous hemorrhage
c. Capillary hemorrhage
d. Internal hemorrhage

Answer 5

a. Arterial hemorrhage

**Capillary hemorrhage - easy to control
**Internal hemorrhage - (+) bruising

Question 6

A physical therapist completes a series of pulmonary function tests on a patient diagnosed with emphysema. Which pulmonary function tests could be used to calculate the patient’s functional residual capacity?

a. Expiratory reserve volume and residual volume
b. Total lung capacity and expiratory reserve volume
c. Vital capacity and inspiratory capacity
d. Residual volume and inspiratory reserve volume

Answer 6

a. Expiratory reserve volume and residual volume

Question 7

A 67-year-old male with long-standing cardiac pathology is referred to physical therapy. The medical record indicated the patient is taking Nitrostat. The primary function of nitrates is:

a. To strengthen the heart’s pumping force
b. To produce a general vasodilation of vascular structures
c. To increase the excretion of sodium and water
d. To decrease electrical conduction

Answer 7

b. To produce a general vasodilation of vascular structures

Question 8

A physical therapist assesses a patient’s pulse by palpating at the wrist between the flexor digitorum superficialis and the flexor carpi ulnaris tendons. This site is used to assess the:

a. Radial artery
b. Ulnar artery
c. Brachial artery
d. Carotid artery

Answer 8

b. Ulnar artery

Question 9

A nurse notifies a therapist that a patient has been placed on hold. The nurse indicates the patient has been diagnosed with respiratory acidosis. Which of the following is not a typical symptom of this condition?

a. Dyspnea
b. Restlessness
c. Anxiety
d. Vomiting

Answer 9

d. Vomiting

Question 10

A physical therapist reviews the surface anatomy of the hand in preparation for a patient status post wrist arthrodesis. Which bony structure does not articulate with the lunate?

a. Trapezium
b. Radius
c. Capitate
d. Scaphoid

Answer 10

a. Trapezium

**Capitate - largest carpal bone; 1st to ossify
**Scaphoid - “Navicular”; MC fractured

Question 11

A physical therapist performs palpation as part of a respiratory assessment with the patient in standing. Which structure would be the most appropriate to assess with the therapist’s position behind the patient?

a. Mediastinum
b. Upper lobes
c. Right middle lobe
d. Lower lobes

Answer 11

d. Lower lobes

Question 12

A physical therapist attempts to prevent alveolar collapse in a patient following thoracic surgery. Which breathing technique would be the most beneficial to achieve the established goal?

a. Diaphragmatic breathing
b. Pursed-lip breathing
c. Incentive respiratory spirometry
d. Segmental breathing

Answer 12

c. Incentive respiratory spirometry

Question 13

A physical therapist performs segmental breathing exercises with a patient following atelectasis. Which manual contract would be the most appropriate to emphasize lingula expansion?

a. Place the hands on the left side of the chest below the axilla

b. Place the hands below the clavicle on the anterior chest wall

c. Place the hands over the posterior aspect of the lower ribs

d. Place the hands on the right side of the chest below the axilla

Answer 13

a. Place the hands on the left side of the chest below the axilla

Question 14

A physician orders a series of pulmonary function tests for a patient with pectus excavatum. Which test result is not typical for a patient with this condition?

a. Forced vital capacity is decreased
b. Vital capacity is decreased
c. Forced expiratory volume/forced vital capacity ratio is decreased
d. Total lung capacity is decreased

Answer 14

c. Forced expiratory volume/forced vital capacity ratio is decreased

**Increased
**FEV1/FVC ration: V/Q ration = increased
**CRPD = increased
**COPD = decreased

Question 15

A physical therapist performs rescue breathing on a patient who collapsed in the physical therapy gym. Which of the following is not accurate when performing rescue breathing on an adult?

a. Maintain open airway with head-tilt/chin-lift
b. Give one breath every five seconds
c. Pinc nose shut
d. Continue for 30 seconds; approximately six breaths

Answer 15

d. Continue for 30 seconds; approximately six breaths

**60 seconds every 5 seconds rescue breathing

Question 16

A patient positioned in standing completes shoulder medial and lateral rotation exercises using a piece of elastic tubing. Which plane of the body is utilized in this activity?

a. Coronal
b. Frontal
c. Sagittal
d. Transverse

Answer 16

d. Transverse

Question 17

A physical therapist completes a lower quarter screening examination on a patient diagnosed with trochanteric bursitis. Assuming a normal end-feel, which of the following classifications would be most consistent with hip extension?

a. Soft
b. Firm
c. Hard
d. Empty

Answer 17

b. Firm

Question 18

A patient is referred to physical therapy after sustaining a lower extremity injury. The physical therapist examines the patient and identifies several postural abnormalities
including genu varum. Which of the following motions or postures is not often correlated with genu varum?

a. Lateral patellar subluxation
b. Excessive hip abduction
c. Ipsilateral hip lateral rotation
d. Medial tibial torsion

Answer 18

a. Lateral patellar subluxation (Genu Valgum)

Question 19

A physical therapist uses vibration in conjunction with percussion as part of a postural drainage program. When should vibration occur?

a. During expiration
b. During inspiration
c. After a maximal expiration
d. Before a maximal inspiration

Answer 19

a. During expiration

**Percussion - performed both during inspiration and expiration

Question 20

A physical therapist performs a variety of special tests on a patient with a suspected anterior cruciate ligament injury. Which special test is not indicative of a one-plane anterior instability ligamentous test?

a. Lachman test
b. Drawer test
c. Active drawer test
d. Loose test

Answer 20

d. Loose test (Antero-lateral rotatory instability)

Question 21

A physical therapist utilizes a manual assisted cough technique on a patient with a mid thoracic spinal cord injury. When completing this technique with the patient in supine, the most appropriate location for the patient’s hand placement is:

a. Diaphragm
b. Epigastric area
c. Xiphoid process
d. Umbilicus

Answer 21

b. Epigastric area

Question 22

A physical therapist completes a dorsal glide of the humeroradial articulation with a patient in supine. When performing this mobilization technique, the therapist should stabilize the:

a. Distal humerus from the lateralside of the patient’s arm

b. Distal humerus from the medial side of the patient’s arm

c. Proximal humerus from the lateral side of the patient’s arm

d. Proximal humerus from the medial side of the patient’s arm

Answer 22

c. Proximal humerus from the lateral side of the patient’s arm

Question 23

A 21-year-old female is examined in physical therapy after sustaining a grade1 ankle sprain 2 days ago in a marching band competition. The patient’s description of the mechanism of injury is consistent with inversion and plantarflexion. Which of the following ligaments would most likely be affected?

a. Anterior talofibular ligament
b. Calcaneofibular ligament
c. Tibiofibular ligament
d. Deltoid ligament

Answer 23

a. Anterior talofibular ligament

Question 24

A patient with a longstanding history of cardiopulmonary disease is scheduled to have a portion of a lung removed. This procedure is best termed as:

a. Pneumectomy
b. Lobectomy
c. Lumpectomy
d. Pleurectomy

Answer 24

a. Pneumectomy

**Lobectomy - lobe removal
**Lumpectomy - CA from a breast
**Pleurectomy - pleural removal

Question 25

A physical therapist performs a manual muscle test on a patient’s shoulder lateral rotators. Which muscle would not be involved in this specific test/

a. Teres minor
b. Infraspinatus
c. Supraspinatus
d. Teres major

Answer 25

d. Teres major (ExAddIR)

Question 26

A patient with suspected scaphoid fracture is referred to physical therapy. Which clinical sign is most indicative of a scaphoid fracture?

a. Localized edema along the dorsum of the hand
b. Crepitus with active range of motion
c. Localized bony tenderness in the anatomic snuff box
d. Pain with resisted wrist extension

Answer 26

c. Localized bony tenderness in the anatomic snuff box

Question 27

A patient with a 40 degree limitation in the right shoulder flexion and a 35 degree limitation in lateral rotation is unable to perform a number of activities of daily living. Which activity would be the most difficult for the patient using the right upper extremity?

a. Tucking in shirt
b. Combing hair
c. Eating
d. Washing the left shoulder

Answer 27

b. Combing hair

Question 28

A physician examines a 36-year-old male with shoulder pain. As part of the examination, the physician orders x-rays. Which medical condition could be confirmed using this type of diagnostic imaging?

a. Bicipital tendonitis
b. Calcific tendonitis
c. Supraspinatus impingement
d. Subacromial bursitis

Answer 28

b. Calcific tendonitis

**Increased Ca2+ deposit

Question 29

A patient placed on bed rest is examined in physical therapy. Which effect would not typically be associated with extended bed rest?

a. A decrease in physical work capacity
b. An increase in lung volume and vital capacity
c. An increase in the heart rate response to activity
d. A negative nitrogen and calcium balance

Answer 29

b. An increase in lung volume and vital capacity

**Decreased lung volume and vital capacity

Question 30

A physical therapist obtains a gross measurement of hamstrings length by passively extending the lower extremity of a patient in short sitting. The most common substitution to exaggerate hamstring length is:

a. Weight shift to the contralateralside
b. Anterior rotation of the pelvis
c. Poster rotation of the pelvis
d. Hike the contralateral hip

Answer 30

c. Poster rotation of the pelvis

Question 31

A patient presents with a persistently downwardly rotated and adducted scapula during humeral elevation. The plan of care includes stretching and strengthening to improve range of motion. What muscles should be stretched and strengthened?

a. Stretching rhomboid muscles and strengthening serratus anterior muscle

b. Stretching pectoralis major and strengthening rhomboid muscles

c. Stretching pectoralis minor and strengthening trapezius muscles

d. Stretching serratus anterior and strengthening levator scapula and lower trapezius

Answer 31

a. Stretching rhomboid muscles and strengthening serratus anterior muscle

Question 32

When using a transtibial total surface bearing prosthesis, a patient experiences excessive knee flexion in early stance. What is the MOST likely cause of this problem?

a. Socket is aligned too far back or tilted posteriorly
b. Foot position is inset too much
c. Socket is aligned too far forward or tilted anteriorly
d. Foot position is outset too much

Answer 32

c. Socket is aligned too far forward or tilted anteriorly

Question 33

A patient complains of foot pain when first arising that eases with ambulation. The therapist finds that symptoms can be reproduced in weight bearing and running on a treadmill. Examination reveals pes planus and pain with palpation at the distal aspect of the calcaneus. What is the BEST choice for early intervention?

a. Prescription for a customized orthosis
b. Strengthening of ankle dorsiflexors
c. Modalities to reduce pain
d. Use of a resting splint at night

Answer 33

d. Use of a resting splint at night

Question 34

A patient with a transfemoral amputation and an above knee prosthesis demonstrates forward trunk leaning during the stance phase of gait with a rolling walker. What is the MOST LIKELY cause of this gait deviation?

a. Prosthesis is too long
b. Walker is set too high
c. Weak gluteus maximus
d. Unstable knee unit

Answer 34

d. Unstable knee unit

**Prosthesis is too long - vaulting/circumduction

**Walker is set too high - flexed elbow c trunk erect

**Weak gluteus maximus - lumbar and trunk extension

Question 35

Which intervention is BEST to improve left sided neglect in a patient with left hemiplegia?

a. Hook-lying, holding, light resistance to both hip abductors

b. Rolling, supine to side-lying on right, using a PNF lift pattern

c. Sitting, with both arms extended, hands resting on support surface, active holding

d. Bridging with both arms positioned in extension at the sides

Answer 35

b. Rolling, supine to side-lying on right, using a PNF lift pattern

Question 36

What is the MOST appropriate intervention to correct for the problem of a forward festinating gait in a patient with Parkinson’s disease?

a. Use of a heel wedge
b. Use of a toe wedge
c. Increase stride length using floor markers
d. Increase cadence using a metronome

Answer 36

b. Use of a toe wedge

Question 37

The therapist is reading a recent report of arterial blood gas analysis with the following values:

Fraction of inspired oxygen (FiO2) = 0.21
Arterial oxygen pressure (PaO2) = 53 mm Hg
Arterial carbon dioxide pressure (PaCO2) = 30 mm Hg
pH = 7.48

a. Metabolic alkalosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Respiratory acidosis

Answer 37

b. Respiratory alkalosis

**pH = 7.35-7.45
**CO2 = 35-45 mmHg
**HCO3 = 22-26

Question 38

A retired administrative assistant with a history of chronic neck pain secondary to whiplash associated disorder (WAD) is referred to physical therapy. The patient denies experiencing any radiating pain to the upper extremities and is neurologically intact on examination. Which intervention should be emphasized in the physical therapy plan of care?

a. Wearing a cervical collar
b. Thoracic manipulation
c. C1-2 self-sustained natural apophyseal glide (SNAG)
d. Submaximal deep neck flexor endurance training

Answer 38

d. Submaximal deep neck flexor endurance training

Question 39

A physical therapist treating a patient with rheumatoid arthritis identifies the presence of hallux valgus. The patient complains of pain and tenderness in the area of the great
toe. The MOST beneficial action to address this condition is:

a. recommend a shoe with a wide toe box
b. improve alignment of the great toe by using a metatarsal bar
c. increase flexion range of motion of the great toe
d. use a heel cup to redistribute forces

Answer 39

a. recommend a shoe with a wide toe box

Question 40

A physical therapist works with a patient who experiences hyperfunction of the parathyroid glands secondary to a tumor. This condition would MOST likely contribute to the development of:

a. cardiac arrhythmias
b. osteopenia
c. muscle spasms
d. obesity

Answer 40

b. osteopenia

**Increased Ca2+ in the bloodstream

Question 41

What is the best position for a patient with disc herniation lateral to the Left L4 nerve root?

A. Trunk flexion and lateral bending to the left

B. Trunk extension and lateral bending to the right

C. Trunk flexion and lateral bending to the right

D. Trunk extension and lateral bending to the left

Answer 41

B. Trunk extension and lateral bending to the right

Question 42

A physical therapist works with an eight-year old child who walks with an equinus gait pattern. Which of the following interventions would be the MOST appropriate to address the muscle shortening associated with this gait pattern?

a. side stepping
b. backward stepping
c. activities in single leg stance
d. toe walking

Answer 42

b. backward stepping

Question 43

A 13-year-old female diagnosed with CP is referred to physical therapy. The client exhibits slow, involuntary, continuous writhing movement of UE and LE. This type of motor disturbance best describes?

a. Spasticity
b. Ataxia
c. Hypotonia
d. Athetosis

Answer 43

d. Athetosis

Question 44

A 19-year-old woman is referred to a psychiatrist by her internist after she admits to him that she recurrently pulls hair from her eyebrows to the point that she has scarring and there is little or no eyebrow hair left. She states that her natural eyebrows are “bushy” and “repulsive” and that she “looks like a caveman.” A photograph of the woman before she began pulling her eyebrow hair shows a normal-looking teenager. What is the most appropriate diagnosis?

a. Trichotillomania
b. Body dysmorphic disorder
c. Delusional disorder,somatic type
d. Normal age-appropriate appearance concerns
e. Obsessive-compulsive disorder

Answer 44

a. Trichotillomania

Question 45

The most common site of hair pulling is:

a. Head
b. Eyebrows
c. Pubic area
d. Armpit

Answer 45

a. Head

Question 46

A 25-year-old man is referred to a psychiatrist by his primary care doctor after mentioning to the doctor that he routinely spends a lot of time pulling out facial hair with tweezers, even after carefully shaving. On evaluation, he admits to frequent pulling of his facial hair, consuming significant amount of time; he explains that he becomes anxious when looking at himself because his moustache, hairline, and side burns are asymmetrical. He
pulls out hairs in an effort to make them more symmetrical, but is rarely satisfied with the results. He finds this very upsetting but cannot resist the urge to try and “fix” his facial hair. What is the most appropriate diagnosis?

a. Trichotillomania
b. Body dysmorphic disorder
c. Delusional disorder,somatic type
d. Normal age-appropriate appearance concerns
e. Obsessive-compulsive disorder

Answer 46

a. Trichotillomania

Question 47

During evaluation of range of motion, the PT observed that the patient was able to do full knee extension and able to do knee flexion up to 70 degrees. Which of the following is TRUE based on this information?

a. The patient would have difficulty in maintaining standing

b. The patient would have difficulty ascending 1 flight of stair

c. The patient would have difficulty walking in normal terrain

d. All of these

Answer 47

b. The patient would have difficulty ascending 1 flight of stair

Question 48

A therapist instructs a client to ascent stairs using axillary crutches. Which of the following statements most accurately reflects proper guarding technique?

a. The therapist is positioned posterior and lateral on the affected side behind the client

b. The therapist is positioned anterior and lateral on the affected side in front of the client

c. The therapist is positioned posterior and lateral on the non-affected side behind the client

d. The therapist is positioned anterior and lateral on the non-affected side in behind the client

Answer 48

a. The therapist is positioned posterior and lateral on the affected side behind the client

Question 49

An 18-year-old female soccer player, with a Q angle in excess of 30 degrees, exhibits patella-femoral tracking problems. While playing soccer, it would be best if she wore a:

a. Patellar stabilizing brace with lateral buttress

b. Patellar stabilizing brace with medial buttress

c. Neoprene sleeve with a patellar cutout

d. Derotation brace

Answer 49

a. Patellar stabilizing brace with lateral buttress

Question 50

A patient in the physical therapy gym suddenly grasps his throat and begins to cough. The physical therapist, recognizing the signs of an airway obstruction should:

A. Attempt to ventilate
B. Administer abdominal thrusts
C. Perform a quick finger sweep of the mouth
D. Continue to observe the patient but do not interfere

Answer 50

D. Continue to observe the patient but do not interfere