Sara's questions

Question 1

A physical therapist has a pt in a supine position with his legs resting on the table. The therapist passively flexes one hip with the leg extended until the pt complains of shooting pain. Then the leg is slowly lowered until the pain subsides, and the therapist dorsiflexes the foot. The therapist is conducting this test in order to identify dysfunction of the neurologic tissues supplying the lower extremity. Which special lumbar test is the physical therapist performing?

• McKenzie’s side glide test
• Babinski test
• Lasegue’s test
• Valsalva’s maneuver test

Answer 1

Lasegue’s test

Explanation: Lasegue’s test is a special lumbra test that is performed with the pt in a supine position and is used ti identify if the pt’s neurological structures that supply his lower limbs are functioning correctly. If the physical therapist is able to reproduce the pt’s pathological neurological symptoms while his/her foot is dorsiflexed, then the test is deemed positive.

Valsalva’s maneuver test is used to identify space-occupying lesions. Teh Babinski test is used to identify upper motor neuron lesions. McKenzie’s side glide test is used to differentiate between neurological dysfunction and scoliotic curvature that causes the trunk to have abnormal curvature.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 1, pg 37. Print

Question 2

You are working in an intensive care pulmonary unit and want to perform bronchial drainage on a pt with pneumonia. IN order to correctly perform bronchial drainage, you must know the anatomy of the lungs. In regards to the anatomical structure of the lungs, which of the following statements is true?

• The right lung is divided into three lobes
• The lobes of the right lung contain eight segments
• The left lung is divided into three lobes
• The lobes of the left lung contain ten segments

Answer 2

The right lung is divided into three lobes

Explanation: It is true that the right lung is divided into three lobes. These three lobes use oblique and horizontal fissure lines to make the division.

The lobes of the right lung contain ten segments, not eight. The left lung is divided into two lobes, not three. The lobes of the left lung contain eight segments, not ten.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 4, pg 224. Print.

Question 3

If a pt hs weak peroneals or spastic invertors, it could cause which of the following during the swing phase of gait?

• Foot drop
• Foot flat
• Inverted foot
• Equinovarus

Answer 3

Inverted foot

Explanation: Weak peroneals or spastic invertors can cause inverted foot. An abnormal synergistic pattern could also cause an inverted foot.

Equinovarus can be caused by a developmental abnormality or spasticity of the gastrocnemius-soleus. Foot drop can be caused by spastic plantar flexors or impaired/delayed contraction of the dorsiflexors. Foot flat can be caused by limited range of motion or weak dorsiflexors.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 11, pg 406. Print.

Question 4

The stance phase and the swing phase are the two phases that make up the gait cycle. Which of the following is the action that happens at the end of the stance phase and initiates the swing phase?

• Mid swing
• Toe off
• Heel strike
• Mid-stance

Answer 4

Toe off

Explanation: Toe off is the action that happens at the beginning of the swing phase. The first portion of the swing phase is created by acceleration from the toe off, which marks the last portion of the stance phase and the first portion of the swing phase. The swing phase only utilizes single limb support.

The actions of the swing phase occur in the following order: toe off, mid swing, and heel strike. Mid-stance is an action that falls in the middle of the stance phase.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 11, pg 404. Print.

Picture is from explanation on app

Question 5

The S1 heart sound is recognized as a “lub” sound. The S1 heart sound is heard when which of the following occurs?

• When the aortic and pulmonary valves close
• During ventricular filling
• When the mitral and tricuspid valves close
• During ventricular filling and atrial contraction

Answer 5

When the mitral and tricuspid valves close

Explanation: It is normal to hear the S1 “lub” heart sound when the mitral and tricuspid valves close. The S1 heart sound signifies the beginning of the systole.

It is normal to hear the S2 heart sound when the aortic and pulmonary valves close. The S3 and S4 heart sounds are considered abnormal. The S3 heart sound is heard during ventricular filling. The S4 heart sound is heard during ventricular filling and atrial contraction.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National PHysical Therapy Examination Review and Study Guide. Ch 3, pg 195. Print.

picture from explanation on the app

Question 6

The ductal system of the male reproductive system includes ejaculatory ducts, epididymides, and vas deferens. The ductal system is responsible for which of the following?

• Storage and transportation of sperm
• Production of male sex hormones and spermatozoa
• Preparation of sperm for ejaculation
• Elimination of semen and urine

Answer 6

Storage and transportation of sperm

Explanation: The male reproductive system’s ductal system is responsible for the storage and transportation of sperm. It is comprised of the epididymides, vas deferens, and ejaculatory ducts.

The testes help make up the male reproductive system and are responsible for the production of male sex hormones and spermatozoa. The male reproductive system accessory glands are responsible for the preparation of sperm for ejaculation. The urethra helps make up the male reproductive system and is responsible for the elimination of semen and urine.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 3, pg 195. Print.

Question 7

A cervical traction unit is a mechanical spinal traction device that applies a distraction force to one’s spine in order to separate articular surfaces between elongated spinal structures and vertebral bodies. Which of the following is not a goal associated with the use of a cervical traction unit?

• Reduce chronic edema
• Reduce muscle spasms
• Reduce joint stiffness
• Reduce nerve root impingement

Answer 7

Reduce chronic edema

Explanation: An intermittent mechanical compression device is used to reduce chronic edema, not cervical traction unit.

A cervical traction unit is used in order to reduce nerve root impingement, joint stiffness, and muscle spasms. A cervical traction unit is used for pts who have degenerative discs, disc protrusions, joint disease, or joint pain.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 10, pg 386. Print.

Question 8

In order to identify bicipital tendonosis, Carrie used Speed’s test to reproduce the patient’s symptoms in the tendon of biceps long head. In order to perform this shoulder test, Carrie most likely placed the pt in which of the following positions?

• Sitting with shoulder passively abducted to 120 degrees
• Supine position with the shoulder fully abducted
• Sitting position with the shoulder passively internally rotated and then fully abducted
• Standing position with the upper limb fully extended and the forearm supinated

Answer 8

Standing position with the upper limb fully extended and the forearm supinated

Explanation: The Speed’s test is performed by placing the patient in a standing or sitting position with his/her upper limb fully extended and the forearm supinated. The Speed’s test could also be performed by placing the pt’s shoulder in a 90-degree flexion position and pushing the upper limb into extension. The speed’s test will help identify bicipital tendonosis or bicipital tendonopathy.

The Neer’s impingement test is performed by placing the pt in a sitting position with the shoulder passively internally rotated and then fully abducted. The drop arm test is performed by placing the pt in a sitting position with shoulder passively abducted to 120 degrees. The Clunk test is performed by placing the pt in a supine position with the shoulder fully abducted.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 1, pg 30. Print.

Question 9

You are working with a geriatric woman in a sub-acute rehabilitation setting. She presents with functional urinary incontinence. Functional urinary incontinence occurs when urine leakage is associated with the unwillingness or inability to use the toilet. Which of the following correctly identifies a cause of functional urinary incontinence?

• Alzheimer’s disease
• Hypersensitive bladder
• Obesity
• Prostate enlargement

Answer 9

Alzheimer’s disease

Explanation: Alzheimer’s disease is cause associated with functional urinary incontinence. Other causes associated with functional urinary incontinence includes depression, environmental barriers, stroke, and impaired physical functioning.

Obesity is a cause associated with stress urinary incontinence. Hypersensitive bladder is a cause associated with urge urinary incontinence. Prostate enlargement is a cause associated with overflow urinary incontinence.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 6, pg 296. Print.

Question 10

The thoracic springing test is a special thoracic test that is used to evaluate the mobility of the intervertebral joint in a pt’s thoracic spine. All except which of the following is a positive finding when performing the thoracic springing test?

• Numbness
• Pain
• Restricted movement
• Excessive movement

Answer 10

Numbness

Explanation: Numbness is not a positive finding that is associated with the performance of the thoracic springing test. The test is meant to evaluate the intervertebral joint mobility in the thoracic spine.

The thoracic springing test is deemed positive when pain, excessive movement, or restricted movement is present. This test is performed by placing the pt in a prone position and applying posterior glides, posterior springs, anterior glides, or anterior springs to the transverse processes of the thoracic vertebra.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 1, pg 37. Print.

Question 11

In reviewing the medical chart, you learn the patient has serous drainage from his surgical wound. If a patient’s wound drainage type is noted as serous, the wound draining is best described as which of the following.

• None of these
• Contains blood
• Thin, clear and watery
• Thick and gray, green, or yellow

Answer 11

Thin, clear and watery

Explanation: Serous drainage is plasma that’s thin, clear and watery. It’s normal to experience a small amount of this type of exudate during the inflammatory wound healing stages. However, excessive serous drainage may be a sign that the patient has high bioburden, which is the number of unsterilized bacteria living on the surface of the wound.

Purulent wound drainage is characterized by milky drainage. It’s generally gray, green or yellow and is most commonly thick in consistency though some purulent exudate can be thin. This may be a sign that the wound has an infection - the fluid becomes off-color and thick because pathogenic microorganisms and dying bacteria in addition to inflammatory and white cells are invading the affected area.

Sanguineous drainage is fresh blood that is prevalent among deep wounds of full and partial thickness. During the inflammatory stage, a small amount of this bloody leakage is natural. But when this type of exudate occurs during other wound healing stages, it may be an indicator that the wound bed has undergone trauma, such as during dressing changes, which can hinder healing.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 5, pg 258. Print.

Question 12

A 6-year-old patient presents with recurrent episodes of seizure-like activity and the healthcare team is attempting to determine a medical diagnosis. Which of the following diagnostic procedures provides structural brain disease information in regards to the presence of seizures?

• Lumbar puncture
• Electromyography
• Positron emission tomography
• Electroencephalography

Answer 12

Electroencephalography

An electroencephalography provides structural brain disease information in regards to the presence of seizures. This procedure is conducted by recording the patient’s ongoing electrical brain activity, which appears as waves.

A lumbar puncture is utilized for the measurement of intracranial pressure and spinal fluid dynamics. An electromyography is utilized for diagnosing primary muscles disease. The positron emission tomography can be used for physiological mapping and brain metabolism analysis.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 2, pg 145. Print.

Question 13

Peptic ulcer disease is a stomach disorder caused by ulcerative lesions on the upper gastrointestinal tract. If an individual suffers from peptic ulcer disease, he/she may experience which of the following?

• Lower back pain
• Burning, cramping abdominal pain
• Lower right quadrant pain
• Lower left quadrant pain

Answer 13

Burning, cramping abdominal pain

Explanation: Peptic ulcer disease may cause an individual to experience burning and cramping abdominal pain that is aggravated by the absence of food in the stomach.

Appendicitis may cause an individual to experience lower right quadrant pain. Diverticular disease may cause an individual to experience lower left quadrant pain. Inflammatory bowel disease may cause an individual to experience lower back pain.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 6, pg 286. Print.

Question 14

The physical therapist is performing gait analysis of a 75-year-old woman. She is able to consistently achieve appropriate heel strike. In regards to the gait cycle, which of the following is active during the heel strike in order to control a varying amount of knee flexion for shock absorption?

• Extensor digitorum longus
• Anterior tibialis
• Knee extensors
• Extensor hallucis longus

Answer 14

Knee extensors

Explanation: Knee extensors are active during the heel strike in order to control a varying amount of knee flexion for shock absorption. The heel strike occurs at the beginning of the stance phase and at the end of the sween phase.

The anterior tibialis, extensor hallucis longus, and extensor digitorum longus are ankle dorsiflexors that are active between the heel strike and foot flat in order to decelerate the foot.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 11, pg 404. Print.

Question 15

You are treating a patient s/p left TKA, but he is displaying symptoms of bradykinesia and rigidity in his right limb. You refer him to a neurologist for work up and he returns with a neurologic diagnosis. What is his diagnosis most likely to be?

• Parkinson’s disease
• Cerebrovascular accident
• Multiple sclerosis
• Myasthenia gravis

Answer 15

Parkinson’s disease

Explanation: Parkinson’s disease is a degenerative neurologic disorder that is characterized by degeneration of dopaminergic substantia nigra neurons and primarily affects older adults. Classic symptoms include rigidity, bradykinesia, postural reflexes and resting tremors.

Multiple sclerosis is described as a chronic, progressive, demyelinating disease of the central nervous system. It primarily affects younger adults and is characterized by demyelinating lesions (plaques) that impair neural transmission and cause rapid nerve fatigue.

A cerebrovascular accident (CVA) is a sudden, focal neurological deficit that results from ischemic or hemorrhagic lesions in the brain.

Myasthenia gravis is a degenerative neuromuscular junction disorder with progressive muscular weakness and fatigue upon exertion.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 2, pg 153. Print.

Question 16

An individual’s parasympathetic nervous system is known to do all except which of the following?

• Relaxes urinary bladder
• Dilates blood vessels in the gut
• Stimulate digestion
• Slows heart rate

Answer 16

Relaxes urinary bladder

Explanation: The parasympathetic nervous system does not relax the urinary bladder. The parasympathetic nervous system stimulates the urinary bladder to contract.

The parasympathetic nervous system is known to dilate blood vessels in the gut, stimulate digestion, and slow the heart rate. The parasympathetic nervous system is also known to stimulate tearing, constrict pupils, and constrict airways. The parasympathetic nervous system is responsible for body function in the rest-and-digest stage, in non-stressful situations.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 2, pg 133. Print.

Question 17

A cerebral angiography is a diagnostic procedure that x-rays the patient’s skull after injecting dye into which of the following?

• Vertebral arteries only
• Lateral ventricles
• Spinal subarachnoid space
• Carotid and/or vertebral arteries

Answer 17

Carotid and/or vertebral arteries

Explanation: A cerebral angiography is a diagnostic procedure that x-rays the pt’s skull after injecting dye into the carotid and/or vertebral arteries. This invasive procedure may cause an anaphylactic reaction to the dye, meningeal irritation, vasospasm, or hemorrhage.

During a ventriculography, dye is injected into the lateral ventricles. During a myelography, dye is injected into the spinal subarachnoid space.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 2, pg 144. Print.

Question 18

If during a physical therapy intervention for bronchial drainage the physical therapist claps over the patient’s lower ribs near the spine on either side, the secretion most likely needs to be removed from which of the following areas?

• Posterior basal segments of the lower lobes
• Right middle lobe
• Posterior segments of the upper lobes
• Anterior segments of the upper lobes

Answer 18

Posterior basal segments of the lower lobes

Explanation: A physical therapist can assist secretion drainage in the posterior basal segments of the lower lobes by clapping over the pt’s lower ribs near the spine on either sied.

A physical therapist can assist secretion drainage in the posterior segments of the upper lobes by standing behind the pt and clapping over both sides of the upper back. A physical therapist can assist secretion drainage in the anterior segments of the upper lobes by clapping between the clavicle and nipple area. A physical therapist can assist secretion drainage in the right middle lobe by clapping over the right nipple area.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 4, pg 237. Print.

Question 19

The normal urine magnesium serum level is 1.8 to 2.4 mg/dL. If an individual’s magnesium serum level is greater than 2.4 mg/dL, hypermagnesemia occurs. Which of the following is a cause associated with hypermagnesemia?

• Hemodialysis
• Renal failure
• Hepatic cirrhosis
• Severe burns

Answer 19

Renal failure

Explanation: Renal failure is a cause associated with hypermagnesemia. Other causes associated with hypomagnesemia include diabetic acidosis, Addison’s disease, and hypothyroidism. Signs of hypermagnesemia include weakness, drowsiness, confusion and hypotension.

Hemodialysis, hepatic cirrhosis, and severe burns are causes associated with hypomagnesemia, or a deficiency in magnesium.

Reference: O’Sullivan, Susan. (2015). Therapyed’s National Physical Therapy Examination Review and Study Guide. Ch 6, pg 294. Print.