SUSIEG 2018 B Flashcards
A physical therapist is treating a child with spastic cerebral palsy who is 3 years old cognitively but at a 6-month-old gross developmental level. What is an appropriate treatment activity for this child?
A. Reaching for a multicolored object while in an unsupported standing position
B. Reaching for a multicolored object while in an unsupported, guarded sitting position
C. Visually tracking a black and white object held 9 inches from his/her face
D. Reaching for a black and white object while in the supine position
Correct Answer: B
The appropriate task would include the 6-month-old gross developmental level activity of working on unsupported sitting. A multicolored object is appropriate for a 3-year-old cognitive level.
A patient is receiving mobilizations to regain normal mid thoracic extension. After three sessions, the patient complains of localized pain that persists for greater that 24 hours. What is the therapist’s best option?
A. Change mobilizations to gentle, low -amplitude oscillations to reduce the joint and soft tissue irritation
B. Continue with current mobilizations, followed by a cold pack to the thoracic spine
C. Place the physical therapy on hold and resume in 1 week
D. Change to self-stretching activities, because the patient does not tolerate mobilization
Correct Answer: A
Changing to low-amplitude oscillations will promote a decrease in the pain and tissue irritation. If pain persists for more than 24 hours, the soft tissue and joint irritation may progress.
A therapist wishes to use behavior modification techniques as part of a plan of care to help shape the behavioural responses of a patient recovering from traumatic brain injury (TBI).
What intervention is the BEST to use?
A. Use frequent reinforcements for all desired behaviors
B. Encourage the staff to tell the patient which behaviors are correct and which are not
C. Reprimand the patient every time an undesirable behavior occurs
D. Allow the patient enough time for self-correction of the behavior
Correct Answer: A
Behavioral modification is best achieved through use of positive reinforcements for all desired behaviors.
A patient with multiple sclerosis (MS) presents with dysmetria in both upper extremities.
Which of the following interventions is the BEST choice to deal with this problem?
A. 3-Ib weight cuffs to wrists during activities of daily living (ADL) training
B. Isokinetic training using low resistance and fast movement speeds
C. Pool exercises using water temperatures greater than 85°F
D. Proprioceptive neuromuscular facilitation (PNF) patterns using dynamic reversals with carefully graded resistance
Correct Answer: D
Dysmetria is a coordination problem in which the patient is unable to judge the distance or range of movement (overshoots or undershoots a target). Adding manual resistance with PNF can assist the patient in slowing down the movement and achieving better control.
Knee capsular tightness has limited a patient’s ability to attain full flexion. An INITIAL intervention a physical therapist can employ to restore joint motion should emphasize sustained mobilization in the loose-packed position. Which of the following is the BEST choice to use?
A. Anterior glide and external rotation of the tibia
B. Posterior glide and external rotation of the tibia
C. Posterior glide and internal rotation of the tibia
D. Anterior glide and internal rotation of the tibia
Correct Answer: C
Posterior glide and internal rotation are accessory motions necessary to increase knee flexion. Initial treatment should not result in pain, soreness, or diminished range of motion.
A patient recovering from cardiac transplantation for end-stage heart failure is referred for exercise training. The patient is receiving immunosuppressive drug therapy (cyclosporine and prednisone). What guidelines should the therapist follow when implementing an exercise program for this patient?
A. Require longer periods of warm-up and cool-down
B. Require short bouts of exercise
C. Eliminate all resistance training
D. Require a frequency of 2-3 times/week
Correct Answer: A
A patient recovering from cardiac transplantation will require longer periods of warm-up and cool-down because physiological responses to exercise and recovery take longer.
A patient presents with weakness and atrophy of the biceps brachin resulting from an open fracture of the humerus. The therapist reads a report of needle electromyography (EMG) of the biceps. What is the anticipated muscle response after the needle is inserted and prior to active contraction?
A. Polyphasic potentials
B. Interference patterns
C. Electrical silence
D. Fibrillation potentials
Correct Answer: C
Inserting an EMG needle into a normal muscle cause a burst of electrical activity (insertional activity) after which the muscle produces no sound (electrical silence).
A new staff physical therapist (PT) on the oncology unit of a large medical center receives a referral for strengthening and ambulation for a woman with ovarian cancer. She is undergoing radiation therapy after surgical hysterectomy. Her current platelet count is 17,000. What intervention is indicated for this patient at this time?
A. Active range-of-motion (AROM) exercises and activities of daily living (ADLs)
exercises
B. Aerobic exercise 3-5 days/week at 40-60%, one repetition maximum
C. Resistance training at 60%, one repetition maximum
D. Progressive stair climbing using a weighted waist belt
Correct Answer: A
AROM and ADL exercises are beneficial and safe for this patient.
A patient complains of increased pain and tingling in both hands after sitting at a desk for longer than 1 hour. The diagnosis is thoracic outlet syndrome (TOS). Which treatment would be the MOST effective physical therapy intervention?
A. Cardiovascular training using cycle ergometry to reduce symptoms of TOS
B. Stretching program for the pectoralis minor and scalenes
C. Strengthening program for the scalenes and sternocleidomastoids
D. Desensitization by maintaining the should in abduction, extension, and external rotation with the head turned toward the ipsilateral shoulder
Correct Answer: B
TOS is described as compression to the neurovascular structures in the scalene triangle, the area defined by the anterior and middle scalenes between the clavicle and the first rib. The compression is a result of a shortened pectoralis minor and scalene muscle. Therefore, a stretching program to these muscles to gain space in the scalene triangle is appropriate.
A patient with diabetes is exercising. The patient reports feeling weak, dizzy, and somewhat nauseous. The therapist notices that the patient is profusely and is unsteady when standing.
What is the therapist’s BEST immediate course of action?
A. Insist that the patient sit down until the orthostatic hypotension resolves
B. Have a nurse administer an insulin injection for developing hyperglycemia
C. Administer orange juice for developing hypoglycaemia
D. Call for emergency services; the patient is having an insulin reaction
Correct Answer: C
Hypoglycaemia, or abnormally low blood glucose, results from too much insulin (insulin reaction). It requires accurate assessment of symptoms and prompt intervention. Have the patient sit down and give an oral sugar (e.g., orange juice).
A patient with postpolio syndrome started attending a supervised outpatient exercise program. The patient failed to show up for follow-up sessions. The patient reported increased muscle pain and being too weak to get out of bed for the past 2 days. The patient is afraid to continue with the exercise class. What is the therapist’s BEST course of action regarding the patient’s exercise program?
A. Discharge the patient from the program because exercise is counterproductive in postpolio syndrome
B. Reschedule exercise workouts for early morning when there is less fatigue
C. Decrease the intensity and duration, but maintain a frequency of 3 time/week
D. Decrease the frequency to once a week for an hour session, keeping the intensity moderate
Correct Answer: C
Clinical manifestations of postpolio syndrome include myalgias, new weakness as well as atrophy and excessive fatigue with minimal activity, Nonexhaustive exercise and general body conditioning are indicated. A change in the exercise prescription (intensity and duration) is warranted.
A therapist has elected to use continuous inductive coil short wave diathermy (SWD) as one of the interventions in managing hip pain. Use of other thermal or electrical modalities were either ineffective or contraindicated. Which patient would be a candidate for use of short wave diathermy?
A. A morbidly obese patient
B. A patient with Type 1 diabetes who uses an insulin pump
C. An 11 year-old boy with a slipped capital femoral epiphysis
D. A patient with ankylosing spondylitis on high doses of NSAIDS and DMARDS
Correct Answer: D
Ankylosing spondylitis is a form of arthritis that primarily affects the spine and other joints including the hip. Pain, stiffness, and inflammation can result. A physical therapy treatment plan can incorporate deep heating for muscle relaxation followed by stretching, posture management, and other exercises. Inductive SW D is preferred here as it penetrates more deeply than capacitive SWD. The use of the medications indicated will have no bearing on the application of SWD.
A patient is recovering from open heart surgery (sternotomy and coronary artery bypass).
The PT is supervising the patient’s outpatient exercise program at 8 weeks postsurgery.
What guideline should be followed regarding the use of moderate to heavy weights during resistance training?
A. Should include upper body exercises only
B. Is contraindicated during the first two months
C. Should be based on 60%-80%, one repetition maximum initially
D. Can be included if resistance training is once a week
Correct Answer: B
Resistive training after cardiothoracic surgery is restricted to 5 to 8 pounds for the first 5 to 8 weeks. Moderate to heavy resistance exercises are contraindicated.
14.A patient with asthma is taking a drug from the sympathomimetic group, albuterol (Ventolin). What is the MOST important effect of this medication?
A. Increases airway resistance and decreases secretion production
B. Reduces airway resistance by reducing bronchospasm
C. Increases heart rate (HR) and BP to enhance training effect during aerobic activity
D. Reduces bronchial constriction and high blood pressure (BP) that accompanies exercise
Correct Answer: B
Sympathomimetics are a class of drugs that mimics the effects of stimulation of body organs and structures by the sympathetic nervous system. Albuterol (Ventolin) has the primary action of reducing airway resistance by a decrease in bronchospasm.
A PT decides to exercise a patient with lower extremity lymphedema using aquatic therapy.
Hydrostatic pressure exerted by the water can be expected to do which of the following?
A. Increase cardiovascular demands at rest and with exercise
B. Reduce effusion and assist venous return
C. Provide joint unloading and enhance ease of active movement
D. Increase resistance as speed of movement increases
Correct Answer: B
The pressure exerted by water on an immersed object is equal on all surfaces (pascal’s law). As the depth of immersion increases, so does hydrostatic pressure. Increased pressure limits effusion, assists venous return, and can induce bradycardia.
16.A therapist determines that a patient is walking with a backward trunk lean with full weight on the right leg. The patient also demonstrates great difficulty going up ramps. What is the BEST intervention to remediate this problem?
A. Strengthen hip extensors through bridging
B. Stretch hip abductors through side-lying positioning
C. Strengthen knee extensors with weights, using 80%, one repetition maximum
D. Stretch hip flexors through prone-lying positioning
Correct Answer: A
Backward trunk lean (gluteus maximus gait) is the result of a weak gluteus maximus, It causes increased difficulty going up stairs or ramps. Functional-training exercises such as bridging are indicated.
17.A patient has developed a thick eschar secondary to a full-thickness burn. What is the antibacterial agent MOST effective for infection control for this type of burn?
A. Sulfamylon
B. Nitrofurazone
C. Panafil
D. Silver nitrate
Correct Answer: A
Sulfamylon penetrates through eschar and provides antibacterial control.
18.An elderly person has lost significant functional vision over the past 4 years and complains of blurred vision and difficulty reading. The patient frequently mistakes images directly in ront of her, especially in bright light. When walking across a room, the patient is able to locate items in the environment using peripheral vision when items are located to both sides.
Based on these findings, what is the visual condition this patient is MOST likely experiencing?
A. Glaucoma
B. Cataracts
C. Homonymous hemianopsia
D. Bitemporal hemianopsia
Correct Answer: B
Cataracts, which cause a clouding of the lens, result in a gradual loss of vision; central vision is lost first, then peripheral.
19.A patient presents with complaints of pain and difficulty with ADL that is consistent with carpal tunnel syndrome. What is the BEST test to identify the cause of symptoms in this patient?
A. Pronator teres syndrome test
B. Ulnar nerve tension test
C. Allen’s test
D. Phalen’s test
Correct Answer: D
Phalen’s test places stress on the compartment where the median nerve passes into the hand, so this test is typically positive for patients with carpal tunnel syndrome.
20.A patient incurred a right CVA 1 month ago and demonstrates moderate spasticity in the left upper extremity (predominantly increased flexor tone), The major problem at this time is a lack of voluntary movement control. There is minimal active movement, with ¼ inch subluxation of the shoulder. What initial treatment activity is the BEST choice for this patient?
A. Sitting, left active shoulder protraction with extended elbow and shoulder flexed to 90°
B. Sitting, weight bearing on extended left upper extremity, weight shifting
C. Quadruped, rocking from side to side
D. PNF D2 flexion pattern, left upper extremity
Correct Answer: B
Sitting, weight bearing, and rocking on an extended left upper extremity will help to decrease the flexor tone. It also provides joint compression (approximation) at the shoulder, which will help maintain shoulder position and stimulate stabilizing muscles.
21.An older patient complains of pain in the right hip region. The therapist suspects hip osteoarthritis based on the patient’s subjective symptoms. What clinical test is the BEST choice to confirm this diagnosis?
A. Scouring test
B. Thomas test
C. Craig’s test
D. Posterior impingement test
Correct Answer: A
A positive scouring test would be a consistent finding for a patient who has osteoarthrosis of the hip joint. It compresses the joint.
22.The therapist in the photograph is testing which muscle?
A. Upper trapezius
B. Middle deltoid
C. Supraspinatus
D. Anterior deltoid
Correct Answer: C
The muscle being tested is the supraspinatus. The empty-can position puts the supraspinatus muscle in its most effective position for contraction. Weakness may be a result of inflammation, neuropathy of the suprascapular nerve, or a tendon tear.
23.During an examination, a patient demonstrates large-amplitude, sudden flailing motions of the arm and leg on one side of the body with primary involvement of axial and proximal joint muscles. What clinical term BEST describes the patient’s behaviors?
A. Chorea
B. Intention tremor
C. Hemiballismus |
D. Athetosis
Correct Answer: C
Hemiballismus refers to sudden, jerky, forceful, and flailing involuntary movements on one side of the body (“Hemi” was a clue).
24.A patient is referred to physical therapy after an antero- inferior dislocation of the right shoulder. What positive examination finding is expected as a result of this dislocation?
A. Weak rhomboids
B. Positive drop arm test
C. Positive Neer’s test
D. Weak deltoids
Correct Answer: D
Because of the anatomical position of the axillary nerve, it can be damaged by an antero-inferior dislocation at the glenohumeral joint. This results in weak deltoids.
25.A team of researchers investigates the use of constraint induced movement therapy on patients with chronic stroke (>1 year poststroke) using a multicentre randomized controlled trial (RCT). What are the specific characteristics of this type of research design?
A. A sample of convenience for the intervention group
B. Alternating experimental and control conditions for a subject
C. Random assignment to an experimental or control group
D. Random assignment to matched cohort groups
Correct Answer: C
An RCT uses a randomization process to assign subjects to either an experimental group(s) or a control (comparison) group. Subjects in the experimental group receive the intervention and are then compared with subjects in the control group who do not receive the intervention. A large multicentre RCT study with large numbers of patients provides the highest level of scientific rigor and evidence.
26.A therapist has been asked to give an in-service presentation to staff aides on safe guarding techniques in a nursing home. The patients are at risk for falls. How should the therapist BEST prepare for this talk?
A. Provide a questionnaire to a random sampling of participants 1 week before the scheduled presentation
B. Provide a questionnaire to all participants 2 weeks before the scheduled session
C. Survey the audience a day before the scheduled session
D. Survey the audience at the scheduled session
Correct Answer: B
A questionnaire to all participants represents the best method of needs assessment in this situation.
27.A therapist is treating a patient with left hemiplegia and profound visuospatial perceptual deficits. What is the BEST strategy to use initially to assist this patient in the relearning of motor tasks?
A. Simplify and restructure the environment and minimize distractions
B. Maximize use of demonstration and gesture
C. Minimize use of verbal cues
D. Encourage independent practice
Correct Answer: A
Working in a closed environment in which clutter and distractions are minimized or eliminated is the best choice for this patient during initial training.
28.A 2-week-old infant born at 27 weeks gestation with hyaline membrane disease is referred for a physical therapy consult. Nursing reports that the child *desaturates to 84% with handling” and has minimal secretions at present. What is the therapist’s BEST course of action?
A. Provide suggestions to nursing for positioning for optimal motor development
B. Put the PT consult on hold because the child is too ill to tolerate exercise
C. Delegate to a physical therapy assistant (PTA) a maintenance program of manual techniques for secretion clearance.
D. Perform manual techniques for secretion clearance, 2-4 hours daily, to maintain airway patency.
Correct Answer: A
Excessive handling of a premature infant can cause oxygen desaturation. It is in the best Cinterests of the infant to limit the number of handlers. The PT’s role should be to assist nursing in developing positioning schedules, positions for feeding, infant stimulation activities, etc.
29.A patient sustained a valgus stress to the left knee while skiing. The orthopedist found a positive McMurray’s test and a positive Lachman’s stress test. The patient has been referred to physical therapy for conservative management of this problem. What is the BEST intervention for the subacute phase of rehabilitation?
A. Open-chain exercises of the hip extensors and hamstrings to inhibit anterior translation of the femur on the tibia.
B. Closed-chain functional strengthening of the quadriceps femoris and hamstrings, emphasizing regaining terminal knee extension.
C. Closed-chain functional strengthening of the quadriceps femoris and hip abductors to promote regaining terminal knee extension.
D. Open-chain strengthening of the quadriceps femoris and hip adductors to inhibit anterior translation of the tibia on the femur.
Correct Answer: B
The evaluation is suggestive of an unhappy triad injury. Closed-chain exercises are emphasized during the subacute phase to enhance functional control of the muscles surrounding the knee. Terminal extension must be achieved during this stage if normal function is to occur.
30.A patient with pain in the left lateral face and head is found to have limited active and passive mouth opening range of motion. However, passive lateral deviation is full to both sides. What is the likely reason for the limitation in mouth opening range of motion?
A. An anteriorly displaced disc with reduction in the left temporomandibular joint
B. Decreased flexibility in the muscles of mastication on the left
C. Capsular restriction of the left temporomandibular joint
D. An anteriorly displaced disc without reduction in the left temporomandibular joint
Correct Answer: B
Mouth opening requires lengthening of the muscles of mastication as the body of the mandible moves away from the upper palate. Lateral deviation does not require a significant lengthening in the muscles of mastication, as the primary motion of the mandible is a slight anterior translation of the mandibular condyle without increasing the distance between the body of the mandible and the upper palate.
31.A patient with TBI has a convulsive seizure during a therapy session. The patient has lost consciousness and presents with tonic-clonic convulsions of all extremities. What is the therapist’s BEST response?
A. Position in supine-lying with head supported with a pillow, and wait out the seizure
B. Wrap the limbs with a sheet to prevent self-harm, position in supine-lying and call for emergency assistance.
C. Position in side-lying, check for an open airway, and immediately call for emergency
assistance
D. Initiate rescue breathing immediately and call for help to restrain the patient
Correct Answer: C
This is an emergency situation. In order to prevent aspiration, turn the head to the side or position in side-lying. Check to see whether the airway is open, and then call for emergency assistance. Wait for tonic-clonic activity to subside before initiating artificial ventilation, if needed.
32.A therapist wants to know whether neurodevelopmental treatment (NDT) handling techniques produce an improvement in independent rolling that lasts longer than 30 minutes.
In this study, rolling is what type of variable?
A. Control variable
B. Independent variable
C. Dependent variable
D. Intervening variable
Correct Answer: C
The dependent variable is the change or difference in behavior (in this example, rolling) that results from the intervention.
33.An adult with no significant past medical history presents to the emergency room with complaints of fever, shaking chills, and a worsening productive cough. The patient has chest pains over the posterior base of the left thorax, which are made worse on inspiration. What would be an expected physical finding for this patient?
A. Symmetrical breathing
B. Crackles over the left thorax
C. Increased chest excursion
D. Slowed respiratory rate
Correct Answer: B
Crackles are a typical finding over the area correlating with an infiltrate.
34.A patient is referred to physical therapy for functional gait difficulties. The patient is unable to take a normal step and drags the left foot. Examination reveals muscle weakness with fasciculations in the left lower leg. For what should the therapist examine?
A. Decreased tone and hyporeflexia
B. Muscle spasms and positive Babinski
C. Increased tone and hyperreflexia
D. Dyssynergia and timing deficits
Correct Answer: A
Muscle weakness with fasciculations is symptomatic of a lower motor neuron (LMN) lesion. Other signs and symptoms of a LMN lesion include hypotonia or flaccidity, hyporeflexia, or absent reflexes and neurogenic atrophy.
35.An elderly patient with hyperthyroidism is referred to physical therapy following a period of prolonged bedrest. What should the therapist be alert for when monitoring exercise of this patient?
A. Decreased heart rate and blood pressure
B. Tachycardia and dyspnea
C. Muscle weakness and joint pain
D. Arrhythmias and bradycardia
Correct Answer: B
Hyperthyroidism is a hypermetabolic state and is associated with exercise intolerance and impaired cardiopulmonary function, Symptoms include dyspnea, fatigue, tachycardia, and arrhythmia. In older people there is increased risk of aggravating pre-existing heart disease (e.g., atrial fibrillation, angina, and myocardial infarction).
36.A patient strained the lower back muscles 3 weeks ago, and now complains of pain (6/10).
Upon examination, the therapist identifies bilateral muscle spasm from T10-L4. The therapist elects to apply interferential current to help reduce pain and spasm. What is the BEST electrode configuration in this case?
A. Four electrodes, with current flow perpendicular to the spinal column
B. Two electrodes, with current flow perpendicular to the spinal column
C. Four electrodes, with current flow diagonal to the spinal column
D. Two electrodes, with current flow parallel to the spinal column
Correct Answer: C
The crisscrossed electrode configuration allows: (1) a greater area to be treated and (2) current interference to occur between the frequencies of the two circuits because of the diagonal pattern.
37.An infant is independent in sitting, including all protective extension reactions, and can pull-to-stand through kneeling, cruise sideways, and stand alone. The infant still demonstrates plantar grasp in standing. What is this infant’s approximate chronological age?
A. 6 months
B. 5 months
C. 8-9 months
D. 10-15 months
Correct Answer: C
The 8 to 9-month-old will be able to pull-to-stand, stand alone, and cruise sideways, but because he/she is not yet walking, may still exhibit plantar grasp in the standing position,
38.A retired bus driver has experienced increasing frequency of low back pain over the past 10 years. The patient states that nonsteroidal anti-inflammatory drugs (NSAIDs) help to relive the symptoms, but there is always a nagging-type pain, the patient reports significant stiffness in the morning that dissipates by noon after exercising and walking, Pain is exacerbated with frequent lifting and bending activities, as well as sitting for long period.
What should the physical therapy plan of care emphasize?
A. Modalities to reduce pain, postural re-education, and dynamic stabilization exercises.
B. Postural re-education, soft tissue mobilization, and dynamic stabilization.
C. Modalities to reduce pain, joint mobilization, and lumbar extension exercises.
D. Joint mobilization, soft tissue mobilization, and flexion exercises.
Correct Answer: B
This is a long-term degenerative and postural dysfunction that is manageable with medication and proper physical activity. Therefore, the most effective use of treatment time should emphasize regaining normal postural alignment and functional ADLs.
39.A patient presents to physical therapy with a primary complaint of low back pain and right lower extremity radicular symptoms extending distally to the calf of 2 weeks duration.
Current pain intensity is rated as 2/10 with rest and 5/10 during lumbar extension movements. What is the strongest prognostic indicator that would affect the clinical outcome?
A. 2/10 pain intensity with rest
B. Current symptom duration (2 weeks)
C. Lower extremity radicular symptoms
D. 5/10 pain intensity during lumbar extension
Correct Answer: C
The presence of lower extremity radicular symptoms in patients experiencing low back pain is a strong negative prognostic indicator for achieving good clinical outcomes.
- An elderly patient with diabetes and bilateral lower extremity amputation is to be discharged from an acute care hospital 2 weeks postsurgery. The incisions on the residual limbs are not healed and continue to drain. The patient is unable to transfer because the venous graft sites in the upper extremities are painful and not fully healed. Endurance out-of-bed is limited.
What is the BEST choice of discharge destination for this patient?
A. Skilled nursing facility
B. Custodial care facility
C. Home
D. Rehabilitation hospital
Correct Answer: A
A skilled nursing facility is the best facility because the patient continues to require nursing care for the open wounds. Initiation of physical therapy when this patient is able is also available
41.A patient currently being seen for low back pain awoke one morning with drooping left facial muscles and excessive drooling. The patient was recovering from a cold and had experienced an earache in the left ear during the previous 2 days. The therapist suspects Bell’s palsy. What cranial nerve test can confirm this diagnosis?
A. Taste over the posterior tongue, and having the patient protrude the tongue
B. Taste over the anterior tongue, and having the patient raise the eyebrows and puff the cheeks
C. Corneal reflex and stretch reflexes of facial muscles
D. Trigger points for pain, especially over the temporomandibular joint (TMJ).
Correct Answer: B
Bell’s palsy is a lower motor neuron lesion affecting the branches off the facial nerve, CN VII. Examination of the motor function of the muscles of facial expression (i.e., raise eyebrows, show teeth, smile, close eyes tightly, puff cheeks) and taste over the anterior tongue will reveal deficits of CN VII function.
42.A PTA is assigned to ambulate a patient with a 10-year history of Parkinson’s disease (PD).
What should the PT instruct the PTA to watch for?
A. Wider steps and increased double support time
B. An abnormally wide base of support
C. Decreased trunk rotation with shorter steps
D. Unsteady, uneven gait with veering to one side
Correct Answer: C
Gait changes characteristic of PD include loss of arm swing and reciprocal trunk movement, shuffling gait with shorter steps, and festinating gait (an abnormal and involuntary increase in the speed of walking).
43.A patient with congestive heart failure (CHF) is on a regimen of diuretics (chlorotiazide).
What are the potential adverse effects of this medication that the PT should be alert for?
A. Hyperkalemia and premature ventricular contractions (PVCs).
B. Myalgia and joint pains
C. Orthostatic hypotension and dizziness
D. Reflex tachycardia and unstable BP
Correct Answer: C
Thiazide diuretics are used to manage mild to moderate hypertension. Adverse side effects include orthostatic hypotension and dizziness, along with drowsiness, lethargy and weakness.
These represent a safety risk during functional training and gait.
44.A patient with a traumatic injury to the right hand had a flexor tendon repair to the fingers
When should physical therapy intervention being following this type of repair?
A. After the splint is removed in 4-6 weeks to allow ample healing time for the repaired tendon
B. After the splint is removed in 2-3 weeks to allow full AROM of all affected joints
C. Within a few days after surgery to allow for early initiation of strengthening exercises
D. Within a few days after surgery to preserve tendon gliding
Correct Answer: D
Early passive and active assistive exercises promote collagen remodelling to allow free tendon gliding
45.A female patient complains of intermittent pain in the right sacroiliac region. There was an insidious onset approximately 4 months ago, Pain has gradually worsened and is now fairly constant and does not vary much with activity or movement. Active motion assessment of the lumbar spine reveals no change in symptoms with movement. Sacroiliac provocation tests are negative. The patient is mildly tender over the right sacroiliac region. What is the MOST likely diagnosis for this patient?
A. Sacroiliac joint sprain
B. Multifidus muscle strain
C. Ovarian cyst
D. Right L5/S1 facet joint arthrosis
Correct Answer: C
An ovarian cyst can refer pain to the sacroiliac region and is more likely to cause constant pain that dies not vary much with activity. Symptoms are not likely to be reproduced with a musculoskeletal examination.
- The therapist suspects that a patient recovering from a middle cerebral artery stroke is exhibiting a pure hemianopsia. What test should be used to confirm the hemianopsia?
A. Penlight held approximately 12 inches from the eyes and moved to the extremes of gaze right and left
B. Penlight held 6 inches from the eyes and moved inward toward the face
C. Visual confrontation test with a moving finger
D. Distance acuity chart placed on a well-lighted wall at patient’s eye level 20 feet away
Correct Answer: C
Visual field is examined using the confrontation test. The patient sits opposite the therapist and is instructed to maintain his/her gaze on the therapist’s nose. The therapist slowly brings a target (moving finger or pen) in the patient’s field of view alternately from the right or left sides. The patient indicates when and where he/she first sees the target.
47.An overweight adult patient complains of right anterior hip and knee pain while walking, especially when weight bearing on the right. Lumbar AROM is normal and pain free. Right hip AROM and PROM are limited compared to the left. Right knee AROM and PROM are full and pain free. There is no pain with resisted testing at the right hip or right knee. The scouring test reproduces the patient’s hip and knee symptoms. Hip joint distraction relieves these symptoms. Based on the above findings, what is the MOST likely diagnosis?
A. Trochanteric bursitis
B. Patellofemoral syndrome
C. Piriformis strain
D. Hip degenerative joint disease.
Correct Answer: D
Scouring test or compression at the hip joint reproduces the patient’s symptoms, suggesting a joint problem at the hip. The scouring test can also result in referred pain to the knee. Weight bearing that compressed the hip joint also reproduces the patient’s symptoms. Distraction of the hip joint surfaces relieves symptoms, suggesting hip DJD. The anterior knee region is a common pain referral site for the hip joint. In addition, the overweight condition supports the diagnosis of hip DJD due to excessive compressive forces over an extended period of time.
48.A therapist investigated the accuracy of pulse oximetry estimates during exercise.
Correlational analysis measured the strength of the relationship between two types of ear probe-equipped pulse oximeters during heavy cycle exercise under hypoxic conditions. The investigator found measured arterial oxyhemoglobin saturation (%H602) level to have a correlation of 0.89 at high saturation but only 0.68 at low saturation levels. How should the therapist interpret these results?
A. During heavy exercise, oxygen saturation levels should be interpreted cautiously
B. Both devices are highly accurate at all saturation levels
C. Accuracy of the measurements increases at higher saturation levels
D. Both devices are only moderately accurate
Correct Answer: C
The result of the study indicates that the correlation between the two types of oximiters was high when oxygen saturation levels were high (0.89), but only moderate (0.68) at low oxygen saturation levels.
49.A college soccer player sustained a hyperextension knee injury when kicking the ball. The patient was taken to the emergency room of a local hospital and was diagnosed with “knee sprain.” The player was sent to physical therapy the next day for rehabilitation. As part of the examination to determine the type of treatment plan to implement, the therapist conducted the test shown in the figure. Based on the test picture, the therapist is examining the integrity of which structure?
A. Iliotibial band
B. Posterior cruciate ligament
C. Anterior cruciate ligament
D. Medial meniscus
Correct Answer: C
The test shown in the figure is Lachman’s stress test to determine the integrity of the anterior cruciate ligament
50.A patient is seen in physical therapy 2 days after a motor vehicle accident. The chief complaints are headaches, dizziness, neck pain with guarding, and a “sensation of a lump in the throat.” Plain film x-rays were read as negative. The therapist should refer this patient for what type of imaging?
A. Second series of plain film x-rays
B. T2 magnetic resonance imaging (MRI)
C. Computed tomography (CT) scan
D. Myelogram
Correct Answer: C
The primary concern of the therapist is to rule out strong suspicions of an upper cervical spine fracture, CT scan is still preferred for assessing cortical bone, especially spinal fractures.
51.During a test of upper extremity rapid alternating movement (RAM), the movements of the hands and elbows become irregular with wider excursions than expected, As speed is increased, the movements become more disorganized. These findings are indicative of:
A. Brainstem dysfunction
B. Lower motor neuron weakness
C. Cerebellar dysfunction
D. Upper motor neuron weakness
Correct Answer: C
Cerebellar dysfunction is characterized by classic cerebellar movement disturbances of dyssynergia (in this case), dysmetria and dysdiadochokinesia. Movement decomposition is velocity dependent, with greater disturbances in movement control at higher speeds.
52.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
Correct Answer: A
The rhomboids are scapular downward rotators, scapular adductors, and scapular elevators.
Insufficient length of the rhomboids would limit upward scapular rotation, and stretching to restore proper length of these muscles would help to promote upward scapular rotation.
53.A patient is recovering from stroke and, at 4 months, is ambulating with a straight cane for household distances. During outpatient physical therapy, the therapist has the patient practice walking with no assistive device. Recurvatum is observed that worsens with continued walking. What is the therapist’s BEST choice for intervention?
A. Give the patient a small-based quad cane (SBQC) to improve stability and have him/her practice AROM in supine
B. Exercise the quadriceps using isokinetic resistance at higher loads and increasing speeds
C. Practice isolated small-range quadriceps eccentric control work in standing and continue with the straight cane
D. Give the patient a KAFO to control the hypertension and a hemi-walker.
Correct Answer: C
Eccentric quadriceps control work (closed-chain exercises) is indicated to reduce recurvatum.
The patient should continue with a straight cane until able to walk without the device and
recurvatum.
54.A patient recovering from an incomplete spinal cord injury at the L3 level (ASIA scale D) ambulates with bilateral Lofstrand crutches. The patient reports great difficulty going down ramps with unsteady; wobbly knees. What is the BEST intervention to use with this patient?
A. Prolonged icing to reduce hamstring pain
B. Stretching using a posterior resting splint for tight plantar flexors
C. Progressive resistance training for the quadriceps
D. Biofeedback training to reduce knee extensor spasticity
Correct Answer: C
A spinal cord injury at the level of L3 affects knee extensors. ASIA scale D means the injury is incomplete, with at least half of the key muscles below the neurological level having a muscle grade of 3 or more, A weak knee will wobble or buckle going down stairs or ramps. It is the result fo weak quadriceps or knee flexor contracture. Strengthening exercises using progressive resistance training for the quadriceps are indicated.
55.Under HIPAA rules, to whom is it illegal to release protected health information (PHI) without a competent patient’s consent?
A. A State Agency responsible for investigating suspected abuse
B. The insurance company that is paying for the patient’s treatment
C. Another health care provider involved in the care of the patient
D. The patient’s spouse
Correct Answer: D
A spouse does not have the legal right to the patient’s information without the patient’s consent
- With respect to a worker’s sitting posture, the greatest reduction in lumbar spine compression forces would be achieved by:
A. Eliminating armrests on the chair
B. Decreasing the chair backrest-seat angle to 85°
C. Increasing the chair backrest-seat angle to between 90° and 110°
D. Using a 2-inch gel seat cushion
Correct Answer: C
Maximal reduction of lumbar disc pressure can be achieved by increasing the angle between the seat pan and the chair backrest to between 90° and 110°, using armrests for support, or adding a lumbar support. Combining the effects of all three provides the best solution.
57.A baseball pitcher is referred to physical therapy with progressive posterior shoulder pain and weakness of the shoulder abductors and lateral rotators. The therapist notices muscle wasting superior and inferior to the scapular spine. The patient’s problem is MOST LIKELY attributable to damage involving the:
A. Spinal accessory nerve
B. Scalene muscles
C. Suprascapular nerve
D. Long head of the biceps brachii
Correct Answer: C
Microtrauma to the suprascapular nerve can occur with repetitive activities involving shoulder
“cocking” and follow-through resulting in inflammation and muscle weakness of the muscles supplied by the suprascapular nerve (the supraspinatus and infraspinatus).
58.An elderly patient presents with severe COPD, GOLD stage 4, shows which of the following physical examination findings would the therapist expect to find?
A. Kyphosis with an increased thoracic excursion
B. Barreled chest with a decreased thoracic excursion
C. Pectus excavatum with an increased thoracic excursion
D. Pectus carinatum with decreased thoracic excursion
Correct Answer: B
A patient with severe COPD (GOLD 4) will have lost much of the elastic recoil properties of the lung. The usual elastic properties of the lung tissue help to pull the thorax into the normal chest wall configuration of health. Without these elastic recoil properties the patient’s thorax will “barrel” in appearance, meaning it is larger and rounder than what you would normally expect. As the thorax has moved into an inspiratory position at rest, there is less movement available, so a decreased thoracic excursion would be expected.
59.A patient is recovering from surgical resection of an acoustic neuroma and presents with symptoms of dizziness, vertigo, horizontal nystagmus, and postural instability. To address these problems, what should the physical therapy plan of care incorporate?
A. Repetition of movements and positions that provoke dizziness and vertigo
B. Hallpike’s exercises to improve speed in movement transitions
C. Strengthening exercises focusing on spinal extensors
D. Prolonged bedrest to allow vestibular recovery to occur
Correct Answer: A
In patients with unilateral vestibular pathology, habituation training (use of positions and movements that evoke symptoms) will encourage the vestibular system to recalibrate, Good recovery can generally be expected with gradual progression of exercises.
60.A physical therapist is treating a patient with diabetic peripheral neuropathy. The patient recently began taking Lyrica (pregabalin). During a monofilament exam of the feet the therapist notices circumferential marks bilaterally at the level of the malleoli after the socks are removed. The patient is complaining of increased difficulty ambulating long distances. In this situation, what is the therapist’s BEST course of action?
A. Contact the physician about possible development of congestive heart failure
B. Begin manual lymphatic drainage for secondary lymphedema
C. Complete the examination and instruct in proper skin care precautions
D. Educate the patient about the risks of foot ulceration
Correct Answer: A
It is important to recognize serious side effects of commonly used medications and to institute contact with the physician as appropriate. Lyrica is used to help treat diabetic neuropathy.
Serious side effects include heart failure, greater difficulty walking long-distances, and ymphedema (marks from the sock).
61.A patient presents to the clinic with pain and decreased function of the right shoulder. A full tear of the right rotator cuff musculature is suspected. The special test that would provide the most valid and reliable information confirming this suspicion would be the:
A. Drop arm test
B. Yergason’s test
C. Neer’s impingement test
D. Clunk test
Correct Answer: A
The primary intent of the drop arm test is to assess if the rotator cuff is intact. If the rotator cuff is fully torn, the drop arm test will be positive, meaning that the arm will fall from a fully elevated position if it is unsupported. the empty-can test is also a test for the rotator cuff muscles but is more specific for the supraspinatus.
62.A patient who is 5 weeks’ post myocardial infarction (MI) is participating in a cardiac rehabilitation program. The therapist is monitoring responses to increasing exercise intensity. The indicator that exercise should be immediately terminated is:
A. 1.5 mm of downsloping ST segment depression
B. Peak exercise HR > 140
C. Appearance of a PVC on the electrocardiogram (ECG)
D. Systolic BP > 140 mm Hg or diastolic BP > 80 mm Hg
Correct Answer: A
The upper limit for exercise intensity prescribed for patients post-MI is based on signs and symptoms. Of the choices, only ST segment depression (>1.0 mm of horizontal or downsloping depression) is a significant finding, representative of myocardial ischemia.
63.An infant who was 39 weeks gestational age at birth and is now 3 weeks chronological age demonstrates colic. In this case, what is the BEST intervention the PT should teach the mother?
A. Stroking and tapping
B. Neutral warmth
C. Visual stimulation with a colored object
D. Fast vestibular stimulation
Correct Answer: B
Neutral warmth achieved through wrapping or bundling the infant is a calming stimulus.
64.A therapist is treating a patient with Brown-Sequard syndrome that resulted from a gunshot wound. The therapist’s examination should reveal:
A. Sparing of tracts to sacral segments with preservation of perianal sensation and active toe flexion
B. Loss of motor function and pain and temperature sensation, with preservation of light touch and proprioception below the level of the lesion
C. Loss of motor function below the level of the lesion, primarily in the upper extremities
D. Ipsilateral loss of motor function, ipsilateral loss of light touch and proprioception, and contralateral loss of pain and temperature
Correct Answer: D
Brown-Sequard syndrome is a hemisection of the spinal cord characterized by ipsilateral loss of dorsal columns with loss of touch, pressure, vibration and proprioception; ipsilateral loss of Corticospinal tracts with loss of motor function below level of lesion; contralateral loss of spinothalamic tract with loss of pain and temperature below level of lesion; at lesion level bilateral loss of pain and temperature.
65.A patient is recovering from stroke and presents with moderate impairments of the left upper and lower extremities. The PT’s goal today is to instruct the patient in a stand-pivot transfer to the more affected side so the patient can go home on a weekend pass. The spouse is attending today’s session and will be assisting the patient on the weekend. What is the BEST choices for teaching this task?
A. Practice the task first with the patient then with the caregiver
B. Demonstrate the task, then have the caregiver practice with the patient
C. Practice the task first with the caregiver, then with the patient
D. Demonstrate the task, and then practice with the patient
Correct Answer: D
To ensure optimal motor learning, first demonstrate the task at ideal performance speeds. This provides the patient with an appropriate reference of correction (cognitive map) of the task.
Then use guided practice with the patient to ensure safety and successful performance.
66.A patient presents with low back pain of insidious onset. Based on the history and subjective complaints, the patient appears to have a dysfunction of a lumbar facet joint. What clinical test should be utilized to confirm this diagnosis?
A. McKenzie’s side glide test
B. Stork standing test
C. Slump test
D. Lumbar quadrant test
Correct Answer: D
The motion of the lumbar quadrant test places the lumbar facet joint in its maximally closed and therefore most provocative position, so if positive it is typically indicative of a lumbar facet dysfunction.
- When using a patellar tendon-bearing (PTB) prosthesis, a patient will experience excessive knee flexion in early stance if the;
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
Correct Answer: C
In a PTB prosthesis, the socket is normally aligned in slight flexion to enhance loading on the patellar tendon, prevent genu recurvatum and resist the tendency of the amputated limb to slide too deeply into the socket. If it is aligned incorrectly (too far anterior or excessively flexed), it will result in excessive knee flexion.
68.A patient presents with Bluish discoloration of the skin and nail beds of fingers and toes.
Palms are also cold and moist. What is the MOST likely cause of these changes?
A. Carotenemia
B. Hypothyroidism
C. Cyanosis
D. Liver disease
Correct Answer: C
Bluish discoloration of the skin and nailbeds of fingers and toes, along with palms that are cold and moist, is indicative of cyanosis. It is caused by an excess of deoxygenated haemoglobin in the blood. It may be central (due to advanced lung disease, congenital heart disease, abnormal haemoglobin) or peripheral (decreased blood flow, venous obstruction).
69.An outpatient physical therapist is examining a patient who underwent a total knee arthroplasty 2 weeks ago. The patient reports that the entire leg has started swelling in the past 2 days. On examination there is pitting edema throughout the lower leg and foot with tenderness throughout the mid calf. Girth measurements reveal a 3.5 cm increase in the size of the mid calf in the symptomatic leg. What recommendation should the physical therapist make to the patient?
A. Rest, ice, and elevate the affected lower extremity
B. Go home and monitor symptoms. Phone the physician if there is no improvement in 24 hours
C. Go immediately to the emergency department
D. Go to the physician’s office after the therapy session for further assessment
Correct Answer: C
The patient scores a 3 on Well’s criteria for deep vein thrombosis, placing him/herin the high probability category. The most appropriate response for the physical therapist would be to send the patient to the emergency department for further assessment.
70.A patient complains of persistent wrist pain after painting a house 3 weeks ago. The patient demonstrates signs and symptoms consistent with de Quervain’s tenosynovitis. An appropriate special test to confirm the diagnosis is:
A. Finkelstein’s test
B. Phalen’s test
C. Froment’s sign
D. Craig’s test
Correct Answer: A
Finkelstein’s test is specific for reproducing the pain associated with de Quervain’s tenosynovitis of the abductor pollicis longus and extensor pollicis brevis.
71.As part of the chart review, the physical therapist views the patient’s most current chest film. Based on this film, what is the MOST likely examination finding?
A. Increased lateral costal expansion
B. Increased subcostal angle
C. Decreased inspiration: expiration (I:E) ratio
D. Decreased mediate percussion
Correct Answer: B
This film demonstrates a patient with hyperinflated lungs as evidenced by the flattened diaphragm, blunted costophrenic angle, and increased amount of air. This will cause the subcostal angle to increase significantly.
72.An elderly patient with persistent balance difficulty and a history of recent falls (two in the past 3 months) is referred for physical therapy examination and evaluation. During the initial examination, what should the therapist examine first?
A. Level of dyspnea during functional transfers
B. Cardiovascular endurance during a 6-minute walking test
C. Sensory losses and sensory organization of balance
D. Spinal musculoskeletal changes secondary to degenerative joint disease (DJD)
Correct Answer: C
A critical component of balance control is sensory input from somatosensory, visual and vestibular receptors, and overall sensory organization of inputs. Initial examination should address these elements before moving on to assess the motor components of balance (e.g., postural synergies). The Clinical Test for Sensory Integration in Balance (CTSIB) or modified CTSIB (Shumway-Cook, Horak) are appropriate instruments.
73.To reduce an elderly individual’s chronic forward head posturing in standing and sitting the therapist should consider stretching exercises to:
A. Middle trapezius and rhomboid muscles
B. Rectus capitis anterior muscles
C. Longus capitis and longs colli muscles
D. Rectus capitis posterior minor and rectus capitis posterior major muscles
Correct Answer: D
Forward head posturing or forward translation of the occiput in relation to the neck and trunk is associated with extension of the occipital axial joint and flexion of the lower and mid cervical spines. Chronic extension of the occipital axial joint will lead to shortening of the suboccipital extensor muscles (rectus capitis posterior major and minor), and localized stretching of these muscles would be indicated as part of a therapeutic intervention to reduce forward head posturing.
- What are the major benefits of using the 6-Minute Walking Test as an outcome measure?
A. Accurately documents maximal exercise capacity
B. Provides good correlation with functional abilities
C. Allows determination of severity of lung disease
D. Provides determination of peak oxygen uptake
Correct Answer: B
The 6-Minute Walk Test (6MWT) shows a good correlation with function, as the 6MWT is a submax test, and function is performed at a submax work level.
75.During a postural screen for a patient complaining of low back pain, the therapist notices that the knees are in genu recurvatum, What are the common contributory problems for which the therapist should examine?
A. Ankle dorsiflexion and hip abduction
B. Forefoot varus and posterior pelvic tilt
C. Ankle plantarflexion and anterior pelvic tilt
D. Lateral tibial torsion and anterior pelvic tilt
Correct Answer: C
A common contributory problem or correlated motion for genu recurvatum is ankle plantarflexion due to shortened gastrocnemius muscles. Alterations occurring up the kinetic chain include anterior pelvic tilt to maintain the center of gravity over the feet.
76.After treating a patient for trochanteric bursitis for 1 week, the patient has no resolution of pain and is complaining of problems with gait. After re-examination, the therapist finds weakness of the quadriceps femoris and altered sensation at the greater trochanter. What is the MOST likely cause of the problems?
A. L5 nerve root compression
B. Sacroiliac (SI) dysfunction
C. L4 nerve root compression
D. Degenerative joint disease (DJD) of the hip
Correct Answer: C
The positive findings are consistent with an L4 nerve root compression.
77.A patient in chronic renal failure is being seen in physical therapy for deconditioning and decreased gait endurance. The therapist needs to schedule the patient’s sessions around dialysis, which is received three mornings a week. What guidelines should the therapist follow when taking the patient’s blood pressure?
A. Every minute during walking, using the nonshunt arm
B. Pre-and postactivities, using the nonshunt arm
C. In sitting when activity has ceased, using the shunt arm
D. In the supine position, using the shunt arm
Correct Answer: B
A dialysis shunt would interfere with taking BP. Using the nonshunt arm. Pre- and postexercise measurements are appropriate.
78.A patient who is currently being treated for low back pain arrives for therapy complaining of pain across the middle of the right chest and back, When the therapist inspects the skin, clustered vesicles are apparent in a linear arc. The surrounding skin is hypersensitive. What is the MOST likely diagnosis?
A. Herpes simplex infection
B. Psoriasis
C. Dermatitis
D. Herpes zoster infection
Correct Answer: D
Herpes zoster is an acute infection caused by reactivation of the latent varicella-zoster virus (shingles). It is characterized by painful vesicular skin eruptions that follow the underlying route of a spinal (in this case) or cranial nerve. Additional symptoms include fever, gastrointestinal disturbances, malaise, and headache.
79.While providing sports coverage at a local high school, a physical therapist is asked to examine an athlete with a knee injury, Based on the mechanism of injury, the therapist suspects rupture of the ACL. What test should be performed immediately to identify a torn ACL?
A. McMurray’s test
B. Reverse Lachman’s stress test
C. Lachman stress test
D. Posterior sag test
Correct Answer: C
Lachman’s stress test is the primary clinical test utilized to identify if the anterior cruciate ligament is intact or ruptured.
- After a myocardial infarction (MI), a patient is a new admission to a phase 3 hospital-based
Cardiac rehabilitation program. During the initial exercise session, the patient’s ECG responses are continuously monitored via radio telemetry. The therapist notices three PVCs occurring in a run with no P wave. The therapist should:
A. Modify the exercise prescription by decreasing the intensity
B. Stop the exercise and notify the physician immediately
C. Continue the exercise session, but monitor closely
D. Have the patient sit down and rest for a few minutes before resuming exercise
Correct Answer: B
A run of three or more PVCs occurring sequentially is ventricular tachycardia. The rate is very rapid, resulting in seriously compromised cardiac output. This is potentially an emergency situation that can deteriorate rapidly into ventricular fibrillation (no cardiac output) and cardiac arrest.
- A patient with hemiplegia and a drop foot is referred for physical therapy gait training.
Examination reveals a pressure ulcer on the patient’s right heel (pictured). The ulcer has dry eschar without edema, erythema, fluctuance, or drainage. The patient is febrile. What is the BEST choices for intervention?
A. Sharp debridement
B. Refer for an arterial bypass graft
C. Use an AFO with heel pressure relief
D. Enzymatic debridement
Correct Answer: C
The AFO helps to prevent plantarflexion contractures, while the heel pressure relief prevents further damage to the heel and promotes healing.
- In reference to the figure, when lifting a constant load using either a stoop lift or a squat dift posture, the MOST significant contributing factor for increasing lumbar spine compression forces in addition to the weight of the load is:
A. Performing the lift with the lumbar spine in a kyphotic posture
B. Performing the lift with the lumbar spine in a neutral position rather than in a lordotic
posture
C. The height of the load from the ground
D. The distance of the load from the base of the spine
Correct Answer: D
Manual lifting biomechanical models have demonstrated high lumbar spine moments, especially when the load is not held close to the body.
Based on the pictured CT scan, this patient is LIKELY to manifest:
A. Ataxia
B. Nonfluent aphasia
C. Fluent aphasia
D. Left-sided unilateral neglect
Correct Answer: A
The arrow is pointing to a hemorrhage in the cerebellum. Damage to this area results in difficulty with movement, postural control, eye-movement disorders, and muscle tone, Ataxia is a common finding.
- A patient with idiopathic dilated cardiomyopathy is on the cardiac unit with telemetry ECG monitoring after a recent admission for decompensated heart failure, Figure 1 depicts this patient’s resting telemetric ECG recording, and Figure 2 depicts the patient’s exercise (ambulating 2.5 mph on a flat surface in the hallway) telemetric ECG recording. What is an accurate interpretation of the change between the two recordings?
A. Ventricular tachycardia, indicating abnormal response to increasing work demands and moderate risk.
B. Tachycardia, indicating normal response to increasing work demands and normal risk.
C. Bradycardia, indicating abnormal response to increasing work demands and high risk
D. Preventricular contractions, indicating abnormal response to increasing work demands and high risk.
Correct Answer: D
New onset of preventricular contractions (wide complex, lack of a PorT wave) indicates an abnormal response to increasing work demands and indicates high risk for cardiac patients based on American College response to increasing work demands and indicates high risk for cardiac patients based on American College of Physicians and American Association of Cardiovascular and Pulmonary Rehabilitation risk stratification.
