PT EVAL EXAM 1

Question 1

The type of pain questionnaire that utilizes an ascending numeric scale ranging from 0 which corresponds to no
pain to 10 corresponding to excruciating pain is best defined as what type of measurement scale?
A. Nominal
B. Ordinal
C. Interval
D. Ratio

Answer 1

B. Ordinal

Question 2

You are examining a neonate and want to determine whether the patient is in pain. All of the following would indicate that the patient may be in pain except:
A. Increased heart rate
B. Increased respiration
C. Skin flushing
Increased muscle tone
D. NOTA

Answer 2

D. NOTA

Question 3

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 3

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

Question 4

A PT prepares to write a SOAP note after performing gait training activities with a patient status post total hip arthroplasty. The statement "I'm getting a little dizzy. I better sit down" should be included in the section labeled:
A. Subjective
B. Objective
C. Assessment
D. Plan

Answer 4

A. Subjective

Question 5

During the examination of the cervical spine of a client for C5 radiculopathy, small groupings of nevi are noted near the superior angle of the scapula. The NEXT action the therapist should take is:
A. Perform a vertebral artery examination
B. Photograph the area in order to provide baseline documentation for the patient’s record.
C. Ask the patient about any history of moles and examine them closely
D. Contact the physician immediately

Answer 5

C. Ask the patient about any history of moles and examine them closely

Question 6

Which of the following methods is BEST for a PT to use to determine the impact of pain on the lifestyle and daily function of a patient with chronic pain?
A. Observe the patient during simulations of usual tasks and note any signs of pain
B. Have the patient rate changes in pain on a 0-10 scale during exercise in physical therapy
C. Administer a standardized disability questionnaire
D. Have trained observers watch the patient perform activities at home

Answer 6

C. Administer a standardized disability questionnaire

Question 7

A PT often makes errors when completing daily documentation. Which of the following statements would be the most appropriate advice to the therapist when an error?
A. Use correction fluid as needed on your documentation
B. Place a single line through the error, write “error”, date and initials
C. Place a single line through the error, write “error”, initials, signature and date
D. Use pencil when completing your documentation

Answer 7

B. Place a single line through the error, write “error”, date and initials

Question 8

Categorizing items as Subjective, except:
A. Response to treatment
B. Other clinical tests
C. Employment status
D. Functional status / activity level
E. None of these

Answer 8

E. None of these

Question 9

A type of interviewing technique that assist in fostering effective, accurate communication between the patient and the physical therapist
A. Open ended Questions
B. Close-ended questions
C. Paraphrasing technique
D. Funnel technique

Answer 9

C. Paraphrasing technique

Question 10

A type of interviewing technique that can establish an effective forum for trust between the patient and physical therapist.
A. Open ended Questions
B. Paraphrasing technique
C. Funnel technique
D. Close-ended questions

Answer 10

C. Funnel technique

Question 11

Interviewing tools are employed to identify solutions, to quantify symptoms, and to demonstrate the effectiveness of treatment. There is no single interviewing tool that can be considered to be the best under all circumstances.
A. Both statements are true
B. Both statements are false
C. The first statement is true, the second statement is false
D. The first statement is false, the second statement is true

Answer 11

D. The first statement is false, the second statement is true

Question 12

Generally agreed that 80% of the information needed to clarify the cause of symptoms is contained within the subjective examination. The information obtained from the interview guides the physical therapist in either referring the patient to a physician or in treating the patient in a clinic.
A. Both statements are true
B. Both statements are false
C. The first statement is true, the second statement is false
D. The first statement is false, the second statement is true

Answer 12

A. Both statements are true

Question 13

State the 2 Importance of Assessing Subjective information:

Answer 13

1. To plan how to evaluate the Objective portion of the examination to determine what tests and measures to use
2. To justify or explain certain goals that are set with the patient

Question 14

List 3 disadvantages of close ended questions.

Answer 14

1. Tend to be more impersonal and may set an impersonal tone for the relationship between the patient and the physical therapist.
2. Limited by the restrictive nature of the information received so that the patient may only respond to the category in question and may omit vital, but seemingly unrelated, information.
3. May elicit false-positive or false-negative responses that develop from the patient’s attempt to please the healthcare provider or to comply with what the patient believes is the correct response or expectation.

Question 15

Give at least 3 importance of the Identifying Data/Demographics.

Answer 15

1. Certain diseases have a specific demographic characteristic
2. It gives an idea on the kind of approach a PT would make when interviewing and examining a patient
3. It helps in anticipating social problems
4. It facilitates conduct of epidemiologic researches, as well as follow-up researches

Question 16

Based on the image below, look for patterns/clinical syndromes. Identify the most probable syndrome. The priority then becomes “Does this patient belong in my clinic?”
A. C8 radiculopathy
B. Thoracic outlet syndrome
C. Cardiac
D. Cervical and thoracic spine from C2-T8
E. Glenohumeral joint, AC joint, SC joint
F. First rib, costovertebral joints and costosternal joints T1-T8
G. Muscles: Trapezius, rhomboids, rotator cuff, levator, erector spinae
H. Ulnar nerve at the elbow

Answer 16

C. Cardiac

Question 17

Based on your answer of the previous question, the following are included in your detailed specific system screening except:
A. Dyspnea
B. Palpitations
C. Pain/sweats
D. Syncope
E. Peripheral edema
F. Cough
G. NOTA
H. AOTA

Answer 17

G. NOTA

Question 18

A 26 y.o. male presented with the complaint of left shoulder pain which occurred only when he carried kayaks overhead from his workshop to the end of the pier (30 yards). He denied history of or risk factors for CVD. Vigorous examination of the neck and shoulder failed to reproduce his symptoms or identify any comparable impairments. The patient was referred back to MD. What else should have been examined?
A. Take vital signs
B. Put him on the treadmill with a weight held overhead and have him walk. Monitor symptoms and vital signs. A positive response to this form of testing would have made a stronger argument to the MD indicating further testing
C. Both treadmill test and VS
D. None. No further screening is necessary.

Answer 18

C. Both treadmill test and VS

Question 19

A 63 y.o. male presented with complaints of left neck pain radiating along the trap to the left shoulder. He denies pain below the point of the shoulder or numbness and tingling. He is overweight, inactive, and a smoker. Review of the medical record indicates he has hypertension (controlled by medication) and hypercholesterolemia that is not controlled. One week ago he was admitted to the ER with symptoms of perioral anesthesia and slurred speech thought to be related to a TIA. He was held overnight for medical work up, and started on ASA. Patient states he was given, “clean bill of health”. What must be examined?
A. Take vital signs: BP and HR
B. Cranial nerve examination and full neurological examination of the upper and lower extremities looking for evidence of long tract signs before provocative tests
C. Examine movements to 1st onset of pain and then slowly to end of range, constantly monitoring symptoms. Stop with reproduction
D. Maintain the awareness of assessing for VBI with all movements looking for symptoms, nystagmus and slurring of speck.
E. Remain vigilant and alert to any change in the patient’s symptoms or sign throughout the examination and treatment process
F. AOTA
G. NOTA

Answer 19

F. AOTA

Question 20

It is often necessary to limit the vigor or amount of the examination. The strategy here is to move just until the symptoms first increase (if there is pain at rest) or until the symptoms are just reproduced. STOP immediately, and return to the start positions and assess the symptoms and the amount of increase.
A. True
B. False

Answer 20

A. True

Question 21

Where latency has been reported, you must wait longer between tests and reassess the potential accumulation of symptoms. The nature of the problem relates to pathology and specific considerations which must be made.
A. True
B. False

Answer 21

A. True

Question 22

Limiting the vigor or amount of the examination is appropriate when:
A. The nature of the problem warrants caution.
B. The possibility of latency is present.
C. The symptoms are severe. The symptoms are irritable. The condition is unstable.
D. Co-existing musculoskeletal or medical problems may be adversely affected by the testing.
E. Minor upper cervical instability is present in a patient presenting with neck pain & instability.
F. Significant psychosocial issues such as fear avoidance or previous adverse reaction to treatment are present.
G. AOTA
H. NOTA

Answer 22

G. AOTA

Question 23

At certain times the order or sequence of testing should be considered. The following statements are true, except:
A. The examination of movement begins from a broad perspective and becomes more focused and specific in an attempt to localize the problem and to reproduce the pain the patient is seeking treatment for.
B. The examination always begins gently and gradually increases in vigor.
C. For each movement, the range of motion, the quality of motion both through the range and at the limit (end feel) and the nature of the factor limiting motion: pain, resistance, and muscle spasm must be taken into consideration.
D. AOTA
E. NOTA

Answer 23

E. NOTA

Question 24

A patient presents with a history of neck trauma and complaints of HA, intermittent dizziness, blurring of vision and intermittent difficulty walking. You are concerned with the possibility of VBI or upper cervical instability. What is the most effective order of testing to ensure patient safety and to mitigate the risk of symptom aggravation? The following statements are correct, except:
A. These tests should be performed first before any provocative testing occurs. One may look at AROM to the onset of symptoms only, prior to testing.
B. Upper cervical instability testing (all tests must be done): Tectorial membrane, Transverse ligament, Alar ligament, Fractured dens
C. VBI testing begins with AROM and continues throughout the remainder of the examination.
D. Therapist must be positioned to observe the patient’s eyes during VBI testing, looking for signs of nystagmus,
E. In addition to the pain response to movement, the therapist should keep the patient answering questions, observing for slurred speech.
F. The vigor of the VBI testing can be continued with overpressure, combined movements or specific testing such as the pre-manipulative position
G. Where the patient is at risk, consideration should be given to stopping the tests once the comparable sign has been reproduced. If patient is at high risk, we may look for comparable signs in appropriate structures rather than continue with end range VBI testing.
H. Neurological testing is required.
I. Full cranial nerve examination
Reflex testing in the upper and lower extremities looking for evidence of hyperreflexia
J. Sensory testing for any reported areas of numbness and tingling.
K. Tests for long tract signs: Hoffman’s, Babinski and Clonus
L. AOTA
M. NOTA

Answer 24

M. NOTA

Question 25

A patient presents with right shoulder pain and numbness in the thumb and index finger of the right hand that limits the ability to move the hand behind the head where a single movement produces a sharp and stabbing pain 8/10 that takes 15 minutes to subside. What is the most effective order of testing to ensure patient safety and to mitigate the risk of symptom aggravation? The following statements are false, except:
A. The volume of testing and the vigor of testing should be limited for both the cervical spine and the shoulder.
B. The neurological examination should be done first with awareness that test positions may require modifications, e.g. Test abduction at 45 degrees rather than 90 to limit potential exacerbation of shoulder or tension sign.
C. Movements should be conducted to the position of the 1st onset of pain, the onset of symptoms.
D. In this case the hypothesis of radiculopathy with a tension sign also warrants further caution as provocation can cause a delayed or latent response, and the exacerbation typically requires time to settle.
E. Move slowly from test to test allowing time to assess for the presence of latency.
F. Select the test movements from the aggravating factors reported by the patient, and in this case save the worst aggravating factor for last.
G. AOTA
H. NOTA

Answer 25

G. AOTA

Question 26

The patient presents with a pattern consistent with lumbar derangement with peripheralization in flexion and centralization in extension. The condition is both severe and irritable. There is a positive SLR and weakness in the L5 dermatome. The nature of the pathology warrants caution and the condition is severe and irritable. From the subjective examination, we know that flexion peripheralizes symptoms and extension centralizes symptoms. What is the most effective order of testing to ensure patient safety and to mitigate the risk of symptom aggravation?
A. Evaluation of derangement requires repeated movements and in this case we will only use repeated extension: in standing if tolerated, but we will be quick to move to unloaded position in prone if not tolerated.
B. If tolerance to prone is not good, the patient may need to be positioned prone on pillows.
C. Neurological examination is performed in sitting or hook lying if sitting is poorly tolerated.
D. Sitting: Knee extension to the first onset of pain as an approximation of SLR for use as a comparable finding.
E. If the neurological examination had to be done in hook lying, assess SLR to 1st onset of pain in supine.
F. One movement to the 1st onset of pain into flexion to establish a baseline: noting range, quality of motions and symptom reproduction.
G. One movement of extension to 1st onset of pain
H. Repeated extension in standing (EIS): Expecting centralization and gradual increase in ROM of EIS. If this does not occur plan to move quickly to prone position
I. AOTA
J. NOTA

Answer 26

I. AOTA

Question 27

The patient presents with signs and symptoms of adverse neural tension in the upper extremity. The decisions on what to test and how to test will depend entirely on:
A. The suspected nature of the condition. Acute or developing radiculopathy should be respected and where condition is severe and irritable testing may be delayed to a later date because he test will be aggravating to sensitive structures.
B. Severity and irritability
C. Both
D. Neither

Answer 27

C. Both

Question 28

The patient presents with signs and symptoms of adverse neural tension in the upper extremity. What is the most effective order of testing to ensure patient safety and to mitigate the risk of symptom aggravation? The following statements are true, except:
A. Neurological examination will generally be indicated and should be done first.
B. The individual components of the test can be examined first before combining as part of the test.
C. Standard straight plane movement should be performed before pre-tensioning of distal components is introduced.
D. SLR is completed before the introduction of additional components: Neck flexion, addition of dorsiflexion, plantar flexion, hip adduction and IR.
E. Slump test is is done as the first test because of it is convenient to address it as one moves through the progression of standing ,sitting, side-lying, supine and prone..
F. For ULTT, testing of the end range movement of each of the components is paramount: wrist extension, elbow extension, shoulder abduction and shoulder ER.
G. AOTA
H. NOTA

Answer 28

E. Slump test is is done as the first test because of it is convenient to address it as one moves through the progression of standing ,sitting, side-lying, supine and prone..

Question 29

The decision to reproduce symptoms may be based on the same criteria as described in the previous questions. Where the symptoms are severe or irritable, the patient may be moved to the point where pain is first reproduced (P1) and just beyond to determine the behavior of pain with movement. Further testing or reproduction of the symptoms may not be desirable for the following reasons:
A. The patient must be treated in the first session and the primary goal of treatment for such patients (severe and irritable) will be relief of symptoms.
B. A comparable sign (replication of the pt.’s C/C) is easy to find.
C. Further information may be obtained during treatment or on subsequent visits as the patient improves.
D. AOTA
E. NOTA

Answer 29

D. AOTA

Question 30

Sudden and progressive onset of acute C7 radiculopathy with C7 distribution of symptoms, weakness of the triceps and wrist flexors 3+/5, diminished triceps reflex 1+ c.f. 2+ on the contralateral sign which is judged to be severe, irritable and not stable (worsening). It would be sufficient to examine the following, except:
A. 1-2 Active movements to the onset of point where pain is first reproduced.
B. Dorsal glide: This is commonly a peripheralizing maneuver which may be used in treatment.
C. Rotation toward the affected side.
D. Palpation in supine looking for joint and soft tissue changes at C6C7 greater on the left than the right
E. Traction at C6C7 to attempt to relieve.
F. AOTA
G. NOTA

Answer 30

B. Dorsal glide: This is commonly a peripheralizing maneuver which may be used in treatment.

Question 31

Right lateral calf pain from the fibular head to midcalf, described as burning which comes on only with 4-6 hours of sitting or standing and walking. Examination of multiple potential sources of the pain would be required, including:
A. Lumbar spine, hip
B. Knee, superior tibiofibular joint
C. Adverse neural tension (likely to include Slump test)
D. All except adverse neural tension tests
E. AOTA
F. NOTA

Answer 31

E. AOTA

Question 32

An appropriate structure is considered to be any relevant structure under the area of symptoms or which can refer into the area of symptoms. If the pt. complains of medial knee pain, the following locations or structures must be examined, except:
A. Local structures of the knee
B. Medial collateral ligament
C. Pes anserine
D. Medial compartment of the knee
E. Referred pain from the hip
F. Referred pain from the lumbar spine
G. AOTA
H. NOTA

Answer 32

H. NOTA

Question 33

When symptoms are not severe or not irritable and the condition is stable, the examination need not be limited, and the patient may move to the limit of their range with the inclusion of a progression of forces.
A. True
B. False

Answer 33

A. True

Question 34

Goals of the objective examination include the following, except:
A. Reproduce the symptoms the patient is complaining of.
B. Find comparable signs (abnormalities of movement or function) in appropriate structures.
C. Determine the nature and extent of any abnormalities of movement or function
D. Determine physical factors which may have predisposed the patient to the onset of the disorder or which may increase the likelihood of recurrence.
E. To prove that a structure implicated by the working hypothesis is not involved
F. To rule out contraindications to examination or treatment.
G. AOTA
H. NOTA

Answer 34

H. NOTA

Question 35

The following are strategies to reduce and monitor risk, except:
A. Take vital signs: BP and HR at each treatment session
B. Cranial nerve examination and full neurological examination of the upper and lower extremities looking for evidence of long tract signs before any provocative tests.
C. Establish a baseline for comparison if symptoms should emerge during testing or the course of treatment.
D. Examine movements to the point where pain is 1st reproduced first and then slowly move to the end of range (EOR), constantly monitoring symptoms.
E. Stop provocative testing with reproduction of symptoms.
F. Advocate for sustained end range positions or sustained combined movement testing
G. Maintain the awareness of assessing for VBI with all movements looking for symptoms, nystagmus and slurring of speech, etc.
H. AOTA
I. NOTA

Answer 35

F. Advocate for sustained end range positions or sustained combined movement testing