PTA NPTE Practice Exam 1

Question 1

A patient sustained a fractured to the left proximal humerus, which is now healed. The left scapula now protracts, elevates early, and moves excessively with shoulder flexion. Which of the following physical therapy interventions should be emphasized?

1. Stretching of scapular stabilizers and strengthening of the pectoralis major and minor
2. Scapulothoracic mobilization and strengthening of the pectoralis major and minor
3. Glenohumeral mobilization and strengthening of scapular stabilizer muscles
4. Glenohumeral mobilization, and strengthening of the rotator cuff muscles

Answer 1

3. Glenohumeral mobilization and strengthening of scapular stabilizer muscles.

Compensation for glenohumeral restrictions is often exhibited as excessive scapular movement. Therefore mobilization of the glenohumeral joint and strengthening of scapular stabilizers is needed to regain normal scapulohumeral motion.

Question 2

A physical therapist assistant is supervising the exercise of a cardiac rehabilitation outpatient class on very hot day, with temps above 90*. The class is scheduled for 2pm and the facility is not air conditioned. What is the best strategy?

1. Decrease the exercise intensity by slowing the pace of exercise
2. Increase the warm up period to equal the total aerobic interval in time
3. Continue with planned intensity for exercise class and encourage participants to drink more water
4. Shift to intermittent exercise but decrease the rest time

Answer 2

1. Decrease the exercise intensity by slowing the pace of exercise

Clinical decisions should focus on reducing the environmental costs of exercising (change the time of day to reduce heat stress) or reducing the overall metabolic costs of the activity (decrease the pace and add rest)

Question 3

A patient with transtibial amputation has recently been fitted with a patellar tendon bearing (PTB) socket. Following gait training, the patient removes the prosthesis. If the prosthesis is fitted correctly, which area should the PTA NOT expect to find skin redness?

1. Anterior tibia and tibial crest
2. Patellar tendon and tibial tuberosity
3. Medical tibial and fibular plateaus
4. Medical and lateral distal ends of the residual limb

Answer 3

1. Anterior tibia and tibial crest.

In a PTB socket, reliefs are provided for pressure sensitive areas; the anterior tibia, tibial crest, fibular head and peroneal nerve.

Question 4

The plan of care indicates ultrasound treatment for a muscle spasm of the piriformis. The piriformis is compressing the sciatic nerve and producing pain in the posterior hip. The pain has been worsening over the past 3 months. What is the MOST beneficial ultrasound setting for this case?

1. 3MHz continuous at 1.0w/cm.2
2. 3MHz pulsed at 1.0w/cm. 2
3. 1MHz pulsed at 1.0w/cm. 2
4. 1MHz continuous at 1.0w/cm. 2

Answer 4

4. 1MHz continuous at 1.0w/cm. 2

One MHz continuous ultrasound provides deep heating to a depth of 3-5 cm. This frequency attenuation (absorption) is less in superficial tissues. This allows more energy to be absorbed; thus more heat is produced in deeper tissue layers. Continuous ultrasound is applied to achieve thermal effects (for chronic pain) and pulsed ultrasound is used when nonthermal effects are desired (acute soft tissue injuries).

Question 5

A patient is recovering from a complete spinal cord injury at the level of L2. What is the expected outcome in this case?

1. A spastic or reflex bladder
2. Some recovery of function
3. Loss of motor function pain and temp sensation before the level of lesion
4. Greater loss of upper extremity function that of lower extremity function

Answer 5

2. Some recovery of function

A spinal cord lesion below L1 is a cauda equina lesion, thus a lower motor neurons injury to Peripheral roots and nerves. Because some regeneration is possible, some recovery in function can be expected.

Question 6

The PTA is scheduled to perform gait training with a patient recently fitted with an ankle foot orthosis but is running behind schedule. The PTA asks the PTA student on day 2 of his first affiliation to work with this patient although the student has never performed tissue inspection of an angle foot orthosis. Which of the following procedures is the most appropriate for the patient’s skin inspection?

1. Direct the student to perform
2. Request the supervising PT to perform
3. Request another PTA working in the area to perform
4. Send patient to their room and request the nurse to perform.

Answer 6

2. Request the supervising PT to perform

In this case, the PT is the most appropriate practitioner to perform the exam as he or she is familiar with the patient and knows the patients baseline skin condition.

PTAstudents should not perform advance tasks for the first time without instruction or direct supervision

Question 7

Patient has been diagnosed with acute synovitis of TMJ. Which intervention is MOST BENEFICIAL to help resolve early stage acute inflammation?

1. Application of an intraoral appliance and phonophoresis.
2. Joint mobilization and postural awareness
3. Instruction to eat soft food diet and phonophoresis
4. Temporalis stretching and joint mobilization

Answer 7

3. Instruction to eat soft food diet and phonophoresis

Phonophoresis and education regarding consumption of only soft foods could help resolve the acute inflammation and decrease stress demand on TMJ.

Phonophoresis is a treatment that uses ultrasound to help topical medications penetrate the skin.

Question 8

Which behavior represents a fine motor skills that should be established by 9 months of age?

1. Picking up a raisin with a fine pincer grasp
2. Building a tower of four blocks
3. Holding a cup by the handle while drinking
4. Transferring objects from one hand to the other

Answer 8

4. Transferring objects from one hand to the other

This is a task developmentally appropriate for a 8-9 month old. Check developmental guidelines of infants and fine motor skills, this is just a memorization of the developmental guidelines.

Question 9

A patient who is scheduled to undergo surgery for a chronic shoulder dislocation asks the PTA to explain the rehab following the reconstructive procedure. Which is the BEST approach?

1. Explain the surgical procedure in detail for the patient
2. Suggest the patient ask the surgeon for information about the procedure and appropriate rehab
3. Explain how the patients typically respond to the surgery and outline the progression of exercises
4. Refer the patient to a PT who is an expert on shoulder reconstructive rehab.

Answer 9

3. Explain how the patients typically respond to the surgery and outline the progression of exercises

PTA should assess the needs of patient and provide appropriate info based on the expected rehab process. PTA should be knowledgeable

Question 10

Which of the following processes will MOST accurately measure the circumference of a patients lower leg following a knee arthroplasty?

1. Begin at the area of the greatest edema, then every 2 inches proximal and 2 inches distal
2. Begin at the inferior angle of the greater trochanter of that extremity and continue distally until the inferior angle of the lateral malleolus.
3. Begin at the inferior angle of the lateral malleolus and in 2-4 inch increments proximally stopping proximal to the edematous area
4. Begin at the bend of the knee and proceeding distally every 2cm, stopping distal to the edematous area.

Answer 10

3. Begin at the inferior angle of the lateral malleolus and in 2-4 inch increments proximally stopping proximal to the edematous area

Circumferential measurement must be based from a bony landmarks that is reproducible for future measurements. The measurements should include areas immediately proximal and distal to the edematous area. Circumferential measurements are best taken with an anthropometric measuring tape that has a pressure gauge on one end to ensure consistent pressure on the tape during measurement.

Question 11

A patient with T10 Paraplegia has recently been fitted with bilateral knee ankle foot orthoses and is reviving initial ambulation raining with axillary crutches. The patient is unable to ambulate with a reciprocal gait pattern. Which of the following gait patterns is the BEST INITIAL choice to teach the patient?

1. 4 point
2. Swing To
3. 2 Point
4. Swing Through

Answer 11

2. Swing To

A swing to gait pattern is indicated for individuals with limited use of both lower extremities and trunk stability. It is slower and more stable that swing-through gait pattern’s.

Question 12

After mastectomy, a patient receiving home care cannot accept the loss of her breast. She reports being weepy all the time with loss of sleep, She is constantly tired and has no energy to do anything. Which of the following represents the BEST course of action for the physical therapist assistant treating this individual?

1. Contact the supervising physical therapist and suggest a psychological consult.
2. Report observations to the nurse case manager to monitor the patient closely.
3. Tell her depression is common at first but will not resolve with time.
4. Request that her spouse observe her closely for possible suicidal tendencies.

Answer 12

1. Contact the supervising physical therapist and suggest a psychological consult.

The patient is experiencing grief over her loss. Significant persistent symptoms are an indication for referral to a qualified professional (psychologist) to help her deal with her loss. Given that this depression is out of the scope of a physical therapy practice, a referral to an appropriate health professional is needed. The physical therapist needs to make that referral request to the physician.

Question 13

An individual with a body mass index (BMI) of 33 kg/m2 is referred to an outpatient exercise program. Which of the following risk factors should the physical therapist assistant recognize this patient is susceptible to?

1. Hyperthermia during exercise
2. Hypothermia during exercise
3. Rapid weight loss during the initial weeks
4. Increased anxiety and depression

Answer 13

1. Hyperthermia during exercise

A patient with a BMI of 33kg/m2 (BMI >30kg/m2) and is at increased risk for heat intolerance or hyperthermia during exercise (as well as orthopedic injury).

*know BMI disease/conditions

Question 14

In a research study resulting in a skewed distribution that includes extreme scores on a balance measure that deviate from the total group performance, which of the following measures MOST accurately represents the central tendency?

1. Mean
2. Median
3. Mode
4. Standard deviation

Answer 14

3. Mode

The median is the middle score of all the scores. The most accurate measure of performance in skewed distribution with extreme scores is the median.

Question 15

A patient is recovering from a night cerebrovascular accident) CVA_ resulting in severe left hemiplegia visuospatial deficits. Additionally there is a large diabetic ulcer on the left foot with pitting edema. What is the MOST appropriate wheelchair prescription for this patient?

1. Hemiplegic chair with elevating leg rest on the left
2. Powered wheelchair with joystick and elevating leg rests
3. Lightweight active duty wheelchair with elevating leg rests
4. One arm drive chair with elevating leg rest on the left

Answer 15

1. Hemiplegic chair with elevating leg rest on the left

A hemiplegic chair has a lower seat height (17 1/2 inches compared with the standard height of 19 1/2 inches) and is the best choice for this patient; the patient can propel the wheelchair by using both the sound upper and lower extremities.

Question 16

A patient fractured the right mid-tibia in a skiing accident 3 months ago. After cast removal, a severe foot drop was noted. The plan of care includes electrical stimulation orthotic substitution. During which phase of gait should the physical therapist assistant set up the functional electrical stimulation to contract the appropriate muscles?

1. Heel-Off (terminal stance)
2. Midswing (Midswing)
3. Foot flat (loading response).
4. Toe-Off preswing

Answer 16

2. Midswing (Midswing)

Foot drop is a swing phase deficit. Stimulation of the dorsiflexor muscles during the swing phase places the foot in a more neutral position and prevents the toes from contacting the ground and interfering with the gait pattern.

Question 17

A physical therapist assistant has weeping dermatitis on the back of the hand and is scheduled to treat a patient with HIV for management of a wound. Which represents the BEST course of action for the physical therapist assistant?

1. Double glove and treat as scheduled
2. Use sterile precautions with mask and gloves
3. Continue with treatment as scheduled but wash hands thoroughly before and after
4. Refrain from patient care but arrange for treatment by another practitioner

Answer 17

4. Refrain from patient care but arrange for treatment by another practitioner

Blood and Body Fluid Precautionary Guidelines from the Centers for Disease Control and prevention (CDC) state that a health care worker with exudative lesions or weeping dermatitis should refrain from all direct patient care and from handling patient care equipment until the condition resolves.

Question 18

The initial evaluation for a patient with a right cerebrovascular accident (CVA) identifies that the patient has a profound deficit of homonymous hemianopsia. Which of the following represents the BEST INITIAL strategy to assist the patient in compensating for this deficit?

1. Teach the patient to turn the head to the affected left side
2. Provide constant reminders, printed notes on the left side, telling the patient to look to the left
3. Place items, eating utensils on the patient’s left side
4. Rearrange the room so while the patient is in bed the left side is facing the doorway

Answer 18

1. Teach the patient to turn the head to the affected left side

A patient with homonymous hemianopsia need to be made aware of his or her deficit and instructed to turn the head to the affected left side (a compensatory training strategy).

Question 19

A patient with multiple sclerosis exhibits moderate fatigue during a 30 minute exercise session. When the patient returns for the next regularly scheduled session 2 days later, the patient reports going home after the last session and immediately going to bed. The patient was exhausted and unable to get out of bed until the late afternoon of the next day. Which of the following strategies is BEST for further treatment?

1. Treat the patient in a warm, relaxing environment.
2. Utilize a massed practice schedule
3. Utilize a distributed practice schedule
4. Switch the patient to a pool therapy program

Answer 19

3. Utilize a distributed practice schedule