SuSig A Flashcards
An elderly patient with hypothyroidism is recovering from a fall and is referred to physical therapy to increase tolerance and safety. The patient complains to the therapist of significant muscle pain in both lower extremities. What additional musculoskeletal effects should the therapist examine for?
Distal muscle weakness
Proximal muscle weakness
Joint laxity
Decreased deep tendon reflexes
Proximal muscle weakness
A child experiences a superficial partial-thickness burn from a scalding pot of water affecting 26% of the thorax and neck. On what should the therapist’s INITIAL plan of care focus?
a. Return to preborn function and activities
b. Pain management
c. Infection management
d. Chest wall mobility and prevention of scar contracture
d. Chest wall mobility and prevention of scar contracture
A patient is referred to a woman’s health clinic with moderate to severe uterine prolapse. What symptoms should the therapist examine for?
a. Absent perineal sensation
b. Bowel leakage
c. Low back pain and perineal discomfort aggravated by prolonged standing
d. Low back pain and perineal discomfort aggravated by lying down
c. Low back pain and perineal discomfort aggravated by prolonged standing
A patient with coronary artery disease has been doing regular aerobic exercise on a treadmill. If the patient fails to comply in taking beta-blocker medication and continues to exercise, what potential rebound effect result?
a. Increase in blood pressure and decrease in heart rate during exercise
b. Decrease in blood pressure and heart rate during exercise
c. Increase in blood pressure and heart rate during exercise
d. Decrease in blood pressure and increase in heart rate during exercise
c. Increase in blood pressure and heart rate during exercise
A patient has persistent midfoot pain with weight bearing. The injury occurred during a soccer match when an opposing player stepped on the patient’s right foot when it was planted and cutting to the left. Patient locates the pain where laces are tied. Upon examination there is splaying of the first metatarsal and increased pain when passively stressing the foot with plantarflexion and rotation. What injury should the therapist suspect the patient has sustained?
Lisfranc injury
Turf toe
Calcaneocuboid joint subluxation
Hallux rigidus
Lisfranc injury
A patient is referred to physical therapy with a 10-year history rheumatoid arthritis (RA). What are possible extra-articular complications?
Disc degeneration
Psoriatic skin and nail changes
Vasculitis
Conjunctivitis and iritis
Vasculitis
A physical therapist is instructing an elderly patient how to perform bed mobility following total hip replacement. The therapist should carefully consider the effects of aging that relate to skin. What is one such effect?
Increased perception of pain
Impaired sensory integrity
Increased skin elasticity
Increased inflammatory responsiveness
Impaired sensory integrity
What would a therapist who is examining the breathing pattern of a patient with a complete (ASIA A) C5 spinal cord injury expect to observe?
a. Asymmetric lateral costal expansion due to ASIA A injury
b. An increased subcostal angle due to air trapping from muscle weakness
c. No diaphragmatic motion since the diaphragm is below the level of the lesion
d. Rising of the abdomen due to no abdominal muscle tone on the abdominal viscera
d. Rising of the abdomen due to no abdominal muscle tone on the abdominal viscera
Men are at high risk for development of metabolic syndrome if they exhibit which of the following symptoms?
An HDL level lower than 45 mg/dL
A waist size greater than 40 inches
Triglyceride levels greater than 100 mg/dL
Fasting blood glucose less than 100 mg/dL
A waist size greater than 40 inches
During an examination, the limitations of ultrasound imaging include which of the following?
a. Inability to clearly see cartilage in infants
b. Disruption of cardiac pacemakers
c. Difficulty penetrating bone and therefore visualizing internal structure of bones
d. Inability to give a clear picture of tendons and therefore diagnose tendon tears
c. Difficulty penetrating bone and therefore visualizing internal structure of bones
A patient with a BMI of 37 is referred to physical therapy for exercise conditioning. What are additional clinical manifestations associated with the BMI that this patient might exhibit?
Hyperpnea and hyperpituitarism
Hypertension and hyperinsulinism
Hormone-related cancer
Hyperlipoproteinemia and hypotension
Hypertension and hyperinsulinism
To prepare a patient with a cauda equina lesion for ambulation with crutches, what upper quadrant muscles would be the most important to strengthen?
Upper trapezius, rhomboids, levator scapulae
Deltoid, coracobrachialis, brachialis
Middle trapezius, serratus anterior, and triceps
Lower trapezius, latissimus dorsi, and pectoralis major
Lower trapezius, latissimus dorsi, and pectoralis major
What will a patient with a significant right thoracic structural scoliosis demonstrate on examination?
Decreased breath sounds on the right
Decreased thoracic rib elevation on the right
Increased lateral costal expansion on the right
Shortened internal and external intercostals on the right
Increased lateral costal expansion on the right
A therapist has been treating a patient over a period of 4 months for decreased shoulder elevation and a loss of external rotation. Recovery has been good; however, the patient still complains of being unable to reach the upper shelves of kitchen cabinets and closets. To help the patient achieve this goal, what should be the focus of manual therapy?
Superior glide
Inferior glide
Anterior glide
Grade II oscillations
Anterior glide
Which activity would help break up obligatory lower extremity synergy patterns in a patient with hemiplegia?
a. High kneeling position, ball throwing
b. Standing, alternate marching in place with hip and knee flexion and hip abduction
c. Sitting, alternate toe tapping
d. Sitting, foot slides under the seat
a. High kneeling position, ball throwing
A patient recovering from stroke reports lack of feeling in the more-affected hand. Light touch testing reveals lack of ability to tell when the stimulus is being applied (only 1 correct response out of 10 tests). What additional sensory tests should the therapist perform?
Test for pain and temperature
Test for two-point discrimination
Test for two-point discrimination
Test for barognosis
Test for pain and temperature
In managing the residual limb of an elderly patient with a transfemoral amputation, what is the MOST IMPORTANT factor the therapist should consider?
Contracture of hip musculature
Residual limb shape
Muscle atrophy
Residual limb healing
Residual limb healing
A chest tube gets dislodged during physical therapy treatment. If the therapist fails to cover the defect, what could the patient develop?
Pulmonary embolism
Pulmonary edema
Pneumothorax
Aspiration pneumonia
Pneumothorax
A patient with a long history of cigarette smoking has been admitted to the hospital and presents with tachycardia, signs of lung infection, abnormal breath sounds in both lower lobes, and dullness to percussion. What should the therapist’s initial intervention focus on with this patient?
Getting the patient to quit smoking
Breathing reeducation to increase efficiency of ventilation
Airway clearance and secretion removal
Graded inspiratory muscle training
Airway clearance and secretion removal
A patient has adhesive capsulitis of the glenohumeral joint. What is the expected greatest limitation of motion when performing shoulder ROM?
Flexion
Abduction
Medial rotation
Lateral rotation
Lateral rotation
During a home visit an adult patient asks the physical therapist assistant to see the physical therapy progress notes in the medical record. What should the PTA do?
Refuse to let the patient see the record
Allow the patient to see the notes
Let the patient see the notes only with the permission of the physical therapist
Contact the patient’s physician and explain the situation
Allow the patient to see the notes
Following a motor vehicle accident, a patient with chest trauma developed atelectasis. What is the LEAST appropriate intervention to help with the immediate management of atelectasis?
Pain reduction techniques
Segmental breathing
Incentive spirometry
Paced breathing
Paced breathing
Following reattachment of the flexor tendons of the fingers, the patient is in a splint. One physical therapy goal is to minimize adhesion formation. What should the physical therapist teach the patient after 72 hours post-surgery?
a. Passive extension and active flexion of the interphalangeal joints
b. Active extension and flexion of the interphalangeal system
c. Active extension and passive flexion of the interphalangeal joints
d. Gentle passive extension and flexion of the interphalangeal joints
c. Active extension and passive flexion of the interphalangeal joints
A patient with a transtibial amputation of 2 months’ duration complains of an intense burning pain that seems to emanate from the heel. The phantom pain mirrors the patient’s preoperative pain. What is the most likely previous source of this pain?
Dorsalis pedis artery obstruction
Popliteal artery obstruction
Damage to the superficial peroneal (fibular) nerve
Damage to the tibial nerve
Damage to the tibial nerve
A patient’s plan of care includes use of iontophoresis for the management of calcific bursitis of the shoulder. To administer this treatment using the acetate ion, what current characteristics and polarity should be used?
Monophasic twin-peaked pulses using the positive pole
Monophasic twin-peaked pulses using the negative pole
Direct current using the positive pole
Direct current using the negative pole
Direct current using the negative pole
A snowmobile left the trail and struck a tree. The driver’s left knee was flexed approximately 90 degrees and the tibia impacted with the inside front of the snowmobile. What would this mechanism of injury MOST LIKELY result in?
Dislocated patella
Sprained or ruptured PCL
Sprained or ruptured ACL
Rupture of the popliteal artery
Sprained or ruptured PCL
The interview with an 18 year-old female cross-country runner elicits a history of stiffness and diffuse ache in her right knee that is aggravated by prolonged sitting. Going down stairs is also painful. Based on this information, what is the LIKELY diagnosis that should serve as a focus for the physical examination?
Iliotibial band friction syndrome
Osgood-Schlatter disease
Meniscal tear
Patellofemoral syndrome
Patellofemoral syndrome
Following mastectomy with axillary lymph node dissection, a patient developed 4+ edema in the ipsilateral arm. A compression garment was ordered. What is the primary reason this garment decreases edema?
It decreases the osmotic pressure of the capillaries
It increases the capillary permeability
It exceeds the internal tissue hydrostatic pressure
It equals the fluid outflow from the capillaries
It exceeds the internal tissue hydrostatic pressure
A patient presents with a chronic restriction of the temporomandibular joint (TMJ). The physical therapist observes the situation during mouth-opening range of motion (ROM) assessment. What is the BEST intervention if the patient has a classic TMJ unilateral capsular restriction?
(Left/Right) TMJ, (superior/inferior) glide manipulation
RIGHT TMJ, INFERIOR glide manipulation
A patient in the late stages of Parkinson’s disease exhibits episodes of akinesia while walking. What should the therapist examine?
Primary involvement of the head and trunk
Associated dyskinesias
Primary involvement of the hips and knees
Triggers that precipitate the freezing episodes
Triggers that precipitate the freezing episodes
A patient is referred to physical therapy for balance and gait training following two falls in the home in the past month. The therapist notes in the medical record that the patient has adrenal insufficiency. What are the metabolic abnormalities associated with adrenal insufficiency?
Hypokalemia
Hyponatremia
Hyperglycemia
Alkalosis
Hyponatremia
Idiopathic scoliosis is suspected in a 12-year-old girl. During the physical examination, what is the standard screening test for this condition?
Long-sitting, forward bend test
Standing, Adam’s forward bend test
Sitting, rotation test to the right and left
Standing, backward extension test
Standing, Adam’s forward bend test
A patient had anterior cruciate ligament (ACL) reconstructive surgery 2 weeks ago. During the initial examination, the physical therapist noticed marked edema around the knee and calf. Knee passive range of motion was limited from -5 degrees extension to 90 degrees of flexion. Hip PROM was within normal limits. Ankle dorsiflexion was limited to 0 degrees because of pulling pain in the calf. Marked tenderness to superficial palpation to anterior knee and posterior calf and increased temperature were also noted. The patient is experiencing calf pain and discomfort when standing during partial weight-bearing ambulation. Upon completion of the examination, what is the BEST intervention at this time?
a. Isometrics and PROM for the knee
b. Massage to knee and calf to help alleviate the expected post surgical edema
c. Ice and interferential current to alleviate edema and facilitate movement
d. Immediate referral to the surgeon
d. Immediate referral to the surgeon
During observation of bilateral active straight leg raising in a supine position, the patient demonstrates progressively increasing lumbar lordosis during lowering of the limbs with each successive lift. What is the MOST LIKELY cause of the observed excessive lordosis during the bilateral straight leg activity?
a. Muscle imbalance between the rectus femoris and the Sartorius muscles
b. Weakness of both quadratus lumborum muscles
c. Fatigue weakness of the rectus abdominis and oblique muscle group
d. Excessive elastic shortening of the ipsilateral hamstring muscle group
c. Fatigue weakness of the rectus abdominis and oblique muscle group
The therapist is treating a patient with chronic Lyme disease of more than 1 year’s duration. What joints are likely to demonstrate more arithmetic changes and therefore should be the focus of physical therapy interventions?
Small joints of the hands and feet
Large joints, especially the knee
Axial joints especially the lumbosacral spine
Axial joints, especially the cervical and thoracic spine
Large joints, especially the knee
What is pain and tenderness with palpation over McBurney’s point associated with?
Acute appendicitis
Hiatal hernia
Acute cholecystitis
GERD
Acute appendicitis
With the patient supine, the vertebral artery test is performed by passively moving the head and neck into extension and side flexion, then rotation to the same side and holding for 30 seconds. Which of the following indicates a positive test?
a. Sensory changes occur in the face along with visual changes
b. Dizziness or nystagmus occurs, indicating that the opposite side artery is being compressed
c. Hearing difficulties and facial paralysis occur
d. Dizziness or nystagmus occurs, indicating that the same side artery is being compressed
b. Dizziness or nystagmus occurs, indicating that the opposite side artery is being compressed
A neonate’s APGAR score at 1 minute after birth is 8; at 5 minutes it is 9. Based on this score and expected heart rate, what can the therapist conclude about this infant?
a. The infant would have a heart rate of less than 100 beats per minute with slow and irregular respirations and not require resuscitation
b. The infant would require extensive resuscitation efforts including intubation
c. The infant would require some resuscitation and administration of supplemental oxygen
d. The infant would have a heart rate of greater than 100 beats per minutes with good respiration and not require resuscitation
d. The infant would have a heart rate of greater than 100 beats per minutes with good respiration and not require resuscitation
A child with spastic diplegia is becoming independent in using a walker. Additional goals desired by the physical therapist include improving posture and increasing the child’s energy efficiency and velocity while ambulating. In this case, which walker is most likely to help improve these goals?
A standard anterior walker with no wheels
An anterior rollator walker with two wheels
A posterior rollator walker with two wheels
A posterior rollator walker with four wheels
A posterior rollator walker with four wheels
To prevent contractures in a newly admitted patient with anterior neck burns, it would be best to position the neck in which of the following?
Hyperflexion
Slight flexion
Neutral
Slight extension
Slight extension
A young adult who is comatose (GCS score of 3) is transferred to a long-term care facility for custodial care. On initial examination, the therapist determines the patient is demonstrating decerebrate posturing. Which limb or body position is indicative of this?
a. The upper extremities in flexion and the lower extremities in extension
b. Extreme hyperextension of the neck and spine with both lower extremities flexed and the heels touching the buttocks
c. All four limbs in extension
d. All for limbs in flexion
c. All four limbs in extension
A therapist wishes to examine the balance of an elderly patient with a history of falls. The Berg Balance Test is selected. Which area is NOT examined using this test?
Sit-to-stand transitions
Functional reach in standing
Turning while walking
Tandem standing
Turning while walking
The physical therapist is instructing a new mother to perform a range of motion and stretching for her newborn who has a clubfoot. In what directions should the therapist advise her to carefully stretch?
Plantarflexion and inversion
Plantarflexion and eversion
Dorsiflexion and inversion
Dorsiflexion and eversion
Dorsiflexion and eversion
A patient has normal quadriceps strength but unilateral weakness (3/5) of the hamstring muscles on the right. What might the therapist observe during the swing phase of gait?
a. Excessive compensatory hip extension on the sound side
b. Decreased hip flexion followed by increased knee flexion on the weak side
c. Excessive hip extension followed by abrupt knee extension on the weak side
d. Excessive hip flexion following by abrupt knee extension on the weak side
d. Excessive hip flexion following by abrupt knee extension on the weak side
A competitive gymnast is examined by the physical therapist. The chief complaint is nagging, localized pain in the anterior left lower leg that is consistently present at night and increases during activity with swelling. What are these complaints MOST characteristic of?
Bone tumor
Anterior compartment syndrome
Shin splints
Stress fracture
Stress fracture
A patient with a complete tetraplegia (ASIA A) at the C6 level is initially instructed to transfer using a transfer board. With shoulders externally rotated, how should the remaining upper extremity (UE) joints be positioned?
a. Forearms pronated with wrist and fingers extended
b. Forearms supinated with wrist extended and fingers flexed
c. Forearms pronated pronated with wrists and fingers flexed
d. Forearms supinated with wrists and fingers extended
b. Forearms supinated with wrist extended and fingers flexed
During examination of the right shoulder of a teenager with anterior shoulder pain, the physical therapist notices an excessive amount of scapular abduction during both shoulder flexion and abduction. Full range of glenohumeral (GH) motion is achieved at the ends flexion and abduction. The axillary border of the scapula protrudes laterally beyond the thorax much more on the right as compared to the left. Which muscle(s) would be associated with excessive lengthening during the movements of shoulder flexion and abduction?
Serratus anterior
Rhomboids
Teres major
Levator scapular
Rhomboids
A group of institutionalized elderly was examined for balance instability and fall risk using a standardized test, the Performance-Oriented Mobility Assessment (POMA). The test-retest reliability of total test (POMA-T) and the subtests, balance subtest (POMA-B) and gait subtest (POMA-G) varied between 0.77 and 0.86 the interrater reliability values ranged from 0.80 to 0.93. What is the therapist’s correct interpretation of these findings?
a. Overall, the test demonstrated moderate reliability
b. The test demonstrated moderate reliability for test-retest and good reliability for integrated comparisons
c. The test demonstrated poor reliability for test-retest and moderate reliability for interrater comparisons
d. Overall, the test demonstrated good reliability
d. Overall, the test demonstrated good reliability
A patient presents with hemosiderin changes and increased lower extremity edema. What diagnosis are these changes consistent with?
Chronic venous insufficiency
Acute venous insufficiency
Acute arterial insufficiency
Chronic arterial insufficiency
Chronic venous insufficiency
A patient experienced a cerebrovascular accident (right CVA) 2 weeks ago. The patient has motor and sensory impairments primarily in the lower extremity; the left upper extremity shows only mild impairment. There is some confusion and perseveration. Based on these findings, what type of stroke syndrome does this patient present with?
Posterior cerebral stroke
Internal carotid syndrome
Anterior cerebral artery syndrome
Middle cerebral artery syndrome
Anterior cerebral artery syndrome
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A therapist is planning to use percussion and shaking for assisting airway clearance with a patient diagnosed with chronic obstructive pulmonary disease (COPD). What major precaution might curtail selection of this form of intervention?
a. A platelet count of 30,000
b. Dyspnea when in the Trendelenburg position
c. SaO2 range of 88% to 94% on room air
d. Functional Independence Measure (FIM score of 4)
a. A platelet count of 30,000
A physical therapist and physical therapy assistant are conducting a cardiac rehabilitation session for 20 patients. The therapist is suddenly called out of the room. The physical therapist assistant should do which of the following?
a. Terminate the exercises and have the patients monitor their pulses until the therapist returns
b. Have the patients continue with the same exercise until the therapist returns
c. Have the patients switch to a less intense exercise until the therapist returns
d. Continue with the outlined exercise progression for that session
d. Continue with the outlined exercise progression for that session
A physical therapist is examining a patient who has a recent history of falls while ambulating on level surfaces. Interaction with the patient indicates that cognition is unaffected. Which test should be performed next once it has been established that cognition is not impaired?
Static balancing tests
Locomotor tests
Sensory testing
Dynamic balance tests
Sensory testing
A patient with chronic asthma has been admitted to the hospital for an acute exacerbation. What is the MOST important information the therapist needs in order to determine the patient’s prognosis with physical therapy?
A current medication list
A previous history of the disease
The most recent chest x-ray results
The most recent pulmonary function test results
The most recent pulmonary function test result
A therapist is examining the gait of a patient with a transfemoral prosthesis. The patient circumducts the prosthetic limb during swing. The therapist needs to identify the cause of the gait deviation. What is the MOST likely prosthetic cause?
Unstable knee unit
Inadequate socket flexion
Sharp or high medial wall or abducted hip joint
Inadequate suspension or loose socket
Inadequate suspension or loose socket
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An elderly patient with degenerative joint disease is seen by a physical therapist 3 days following a total knee replacement. Which of these findings would be an indication for the therapist to contact the surgeon?
a. Patient is noncompliant when learning to transfer properly
b. Patient cannot ambulate at least 50 feet with a standard walker
c. Patient fails to recognize the therapist on the third consecutive postoperative visit
d. Patient complains of soreness at the incision site
c. Patient fails to recognize the therapist on the third consecutive postoperative visit
The primary contribution of a physical therapist member of a facility emergency/disaster preparedness committee in formulating a disaster plan is describing the role of the physical therapists in providing which of the following?
a. Triage and basic life support during the disaster
b. Evaluation of soft tissue injuries and rendering appropriate care
c. Unique preparedness concerns needed for people with disabilities or special needs
d. Emotional distress management of victims or patients during crisis situations
c. Unique preparedness concerns needed for people with disabilities or special needs
While ambulating a patient in the parallel bars, a therapist loses control and the patient falls, hitting his or her head on the bar. The patient lies motionless on the floor between the bars bleeding heavily from a scalp laceration. What is the first thing the therapist should do?
Apply a thick gauze and manual pressure to the scalp wound
Check for responsiveness
Call emergency medical services
Immediately determine the patient’s heart rate and blood pressure
Check for responsiveness
During pregnancy, the presence of the hormone relaxin can lead to abnormal movement and pain. Which joints are typically affected?
Glenohumeral joints
Hip joints
Lumbosacral joints
Sacroiliac joints
Sacroiliac joints
A patient with angina pectoris has been instructed to use sublingual nitroglycerin in case of an acute angina attack. What are the primary effects of this medication?
Vasoconstriction of peripheral vessels
Vasodilation of the coronary vessels
Increasing myocardial oxygen consumption
Increasing left ventricular end-diastolic pressure
Vasodilation of the coronary vessels
A patient has a body mass index (BMI) of 32 kg/m2 with excessive tissue mass in the hip area. What accommodations are needed for the wheelchair prescription for this patient?
a. Move the small front casters closer to the drive wheels to increase stability
b. Add friction rims to increase hand grip function
c. Add an anti tipping device to prevent falls going up curbs
d. Displace the rear axle forward for more efficient arm push
d. Displace the rear axle forward for more efficient arm push
Following a cerebral vascular accident (CVA), a patient is hospitalized. The therapist determines that a positioning schedule should be implemented. While in supine, what is the BEST position for the patient’s affected upper extremity?
a. Shoulder protracted and slightly abducted with external rotation, elbow extension, wrist neutral, and fingers extended
b. Shoulder protracted and slightly abducted with internal rotation, elbow flexion, wrist neutral and fingers extended
c. Shoulder retracted and adducted with internal rotation and elbow, wrist, and fingers flexed
d. Shoulder retracted and abducted with external rotation, elbow extension, wrist neutral and fingers flexed
a. Shoulder protracted and slightly abducted with external rotation, elbow extension, wrist neutral, and fingers extended
What is an acceptable modified position to drain the posterior basal segment of the left lower lobe in a patient with pulmonary congestion?
a. Side-lying on the right, with a pillow under the right hip and the bed flat
b. Prone, with a pillow under the hips and the bed flat
c. Side-lying on the right, with a pillow between the legs and the foot of the bed elevated 18 inches
d. Prone, with a pillow under the hips and the bed elevated 18 inches
b. Prone, with a pillow under the hips and the bed flat
When the ankle is forcibly inverted and plantar flexed, which ligament is MOST FREQUENTLY sprained?
Deltoid
Anterior talofibular
Posterior talofibular
Calcaneofibular
Anterior talofibular
Following a period of spinal shock, a patient with a complete spinal cord injury (ASIA A) at the T5 level is placed on a bladder training program coordinated by the nurse. A realistic ultimate outcome for this program would be independent voiding by using which of the following?
The Crede maneuver
The Valsalva maneuver
A timed voiding program
Suprapubic stroking or tapping
Suprapubic stroking or tapping
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A therapist is instructing the family of a 9-year-old boy with Duchenne’s muscular dystrophy (MD). What should be the main focus of the plan of care for maintaining function in the lower extremities?
a. Strengthening the knee extensors and plantar flexors
b. Strengthening the plantarflexors and stretching the hip extensors
c. Stretching the hip flexors and plantarflexors
d. Strengthening the hip flexors and knee extensors
c. Stretching the hip flexors and plantarflexors
A patient with diabetes mellitus has had a stage III decubitus ulcer over the right ischial tuberosity for the past 5 months. The ulcer is infected with staphylococcus aureus, and necrotic tissue covers much of the wound. What therapeutic modality is CONTRAINDICATED in this situation?
Low-voltage, constant microamperage direct current
High-voltage monophasic pulsed current
Alternating/biphasic current
Moist hot packs
Moist hot packs
A therapist is treating a child with spastic diplegia. What intervention can be used to promote relaxation?
Rhythmic stabilization
Slow rocking on a therapy ball
Spinning in a hammock
Rolling and spinning on a scooter board
Slow rocking on a therapy ball
Capsular tightness has limited a patient’s ability to fully extend the left knee. What joint mobilization technique should be used to restore joint motion?
Anterior glide and external rotation of the tibia
Anterior glide and internal rotation of the tibia
Posterior glide and external rotation of the tibia
Posterior glide and internal rotation of the tibia
Anterior glide and external rotation of the tibia
When using continuous ultrasound in treating the hip of an obese patient, the greatest benefit might occur if the ultrasound frequency and dosage are set at which parameters?
a. 1 MHz and 1.5 watts/cm2
b. 1 MHz and 0.5 watts/cm2
c. 3 MHz and 1.5 watts/cm2
d. 3 MHz and 0.5 watts/cm2
a. 1 MHz and 1.5 watts/cm2
Following a CVA involving the right hemisphere, a male patient is exhibiting unilateral neglect. What might he do as a result?
a. Eat food only from the left side of a plate
b. Bump his wheelchair into things on the right side
c. Ignore or deny the existence of the right UE
d. Shave only the right side of the face
d. Shave only the right side of the face
What is the best way to monitor the intensity of exercise for a patient limited mostly by claudication?
a. Assessing ankle-brachial index (ABI) during exercise
b. Maintaining the heart rate (HR) between 60-70% of age-predicted HRMax during exercise
c. Sustaining pain levels of at least 2 out of 4 on the claudication scale during exercise
d. Upholding RPE levels of 11 to 13 out of 20 during exercise
c. Sustaining pain levels of at least 2 out of 4 on the claudication scale during exercise
What intervention best illustrates selective stretching when working with a patient with an SCI (C6 complete)?
a. Longer finger flexors are fully ranged into extension with wrist extension
b. Hamstrings are fully ranged to 110 degrees in supine
c. Low back extensors are fully ranged in long-sitting
d. Hamstrings are full ranged in long sitting
b. Hamstrings are fully ranged to 110 degrees in supine
A physical therapist examined the depep tendon reflexes of a patient recently diagnosed with amyotrophic lateral (ALS). The results are 2+ left and 4+ right. What is the correct interpretation of these findings regardinng the reflexes?
a. Abnormal on the left and normal on the right
b. Normal on the left and brisker, possibly abnromal on the right
c. Depressed, low normal on the left and normal on the right
d. Normal on the left and abnormal on the right
d. Normal on the left and abnormal on the right
Severe epigastric and abdominal pain that radiates to the middle back and may worsen when lying is MOST characteristic of which condition?
a. Small intestine obstruction
b. Irritable bowel syndrome
c. Appendicitis
d. Acute pancreatitis
d. Acute pancreatitis
A patient is referred to physical therapy with a diagnosis of congestive heart failure. During the initial session, the physical therapist examines the skin for suspected changes. What appearance can be expected?
a. Pale, washed-out color
b. Yellowish discoloration
c. Slightly bluish, slate-colored discoloration
d. Cherry-red discoloration
c. Slightly bluish, slate-colored discoloration
On the third day following a cesarean delivery, what should a physical therapist’s interventions include?
a. Gentle partial sit-ups and head lifts
b. Breathing, coughing, and pelvic floor exercises
c. Low-intensity aerobic conditioning
d. Pelvic tilts on all fours
b. Breathing, coughing, and pelvic floor exercises
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When performing neutral tension testing to the lower limb, which ankle position when combined with a straight leg raise will BEST bias the peroneal (fibular) nerve?
a. Dorsiflexion and eversion
b. Dorsiflexion and inversion
c. Plantarflexion and eversion
d. Plantarflexion and inversion
d. Plantarflexion and inversion
A patient recovering from surgery to remove a cerebellar tumor presents with pronounced ataxia and problems with standing balance and postural stability. To help improve this situation, what would be BEST approach to incorporate in the intervention?
a. Lower extremity splinting and light touch-down hand support
b. Rhythmic stabilization during holding in kneeling
c. Perturbed balance activities while standing on carpet
d. Stabilizing reversal during holding in side-lying
b. Rhythmic stabilization during holding in kneeling
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A physician requests that a physical therapist perform hydrocortisone iontophoresis over the left shoulder of a patient with tendonitis. The therapist discovers that the patient has a pacemaker. In this case, what should the therapist do?
a. Perform the treatment since there is no contraindication
b. Refer the patient to another physical therapist who has greater expertise in using iontophoresis for patients with pacemakers
c. Consult with the physician about alternative forms of therapy; do not perform the iontophoresis treatment
d. Administer the iontophoresis but only on the top of the shoulder not near the chest wall
c. Consult with the physician about alternative forms of therapy; do not perform the iontophoresis treatment
During gait analysis, a therapist notes that a patient is lurching backward during stance phase. What is the cause of this compensatory motion?
a. Gluteus medius weakness
b. Hip and knee flexion contractures
c. Quadriceps weakness
d. Gluteus maximus weakness
d. Gluteus maximus weakness
A 3-year old child with Arnold-Chiari malformation has a ventriculoperitoneal shunt in place. During physical therapy treatment, the child becomes agitated and irritable, then drowsy and listless. What should the therapist do in this situation?
a. Immediately place firm pressure over the fontal
b. Administer emergency oxygen
c. Place the child in a head-down position
d. Call for emergency medical services
d. Call for emergency medical services
An elderly patient with diabetic peripheral neuropathy and retinopathy is having difficulty with balance when ambulating at home. The patient has fallen three times in the last month. What is the first priority of the home physical therapist’s plan of care?
a. Gait training with a cane to ensure safety
b. Color-coding raised surfaces, such as steps, with a sharp color contrast
c. Ambulation practice on changing floor to carpet surfaces in the home
d. Installing nightlights in strategic areas throughout the house and keeping lit continuously
a. Gait training with a cane to ensure safety
What is the minimum recommended work interval duration for a non deconditioned adult performing aerobic interval training?
a. 5 minutes
b. 10 minutes
c. 20 minutes
d. 30 minutes
b. 10 minutes
A therapist is monitoring the blood pressure of a healthy athlete exercising on a treadmill. The speed and incline steadily increase during the exercise period. The therapist would expect the blood pressure response to demonstrate which of the following?
a. Blunted rise in systolic pressure and a slight decrease in diastolic pressure
b. Slight drop in systolic pressure and either a slight increase or decrease in diastolic pressure
c. Steady increase in systolic pressure accompanied by a steady increase pressure
d. Steady increase in systolic pressure and either a slight increase or decrease in diastolic pressure
d. Steady increase in systolic pressure and either a slight increase or decrease in diastolic pressure
A therapist is examining a patient with a temporomandibular disorder. The patient had a history of jaw clicking upon opening and closing the mouth, but the noises are now gone. The current major complain is inability to open the mouth wide and difficulty performing functional jaw movements such as chewing and yawning. What is the most likely cause of this current impairment?
a. Capsular fibrosis
b. Temporomandibular joint (TMJ) subluxation
c. Chronic TMJ osteoarthritis
d. Disc displacement without reduction
d. Disc displacement without reduction
A patient recovering from a total hip arthroplasty is seen by the physical therapist for early mobilization out of bed. While sitting on the edge of the bed, the patient experiences rapid onset of dyspnea, sudden chest pain, and cyanosis. What action should the therapist take?
a. Return the patient to supine and monitor vital signs for the 5 minutes
b. Stabilize the patient and contact medical services immediately
c. Allow the patient to rest for a few minutes and continue with the therapy session
d. Return the patient to supine and reschedule the therapy session for later in the afternoon
b. Stabilize the patient and contact medical services immediately
A patient with traumatic brain injury exhibits strong spasticity in both lower extremities (limbs are held rigid in extension). Using the Modified Ashworth Scale, the therapist gives this response: which of the following grades?
a. 1+
b. 2
c. 3
d. 4
d. 4
When working with a child with Down syndrome and severe hypotonicity, how would it be best to activate the postural extensor muscles during early intervention?
a. Slow repetitive rocking movements with the child seated on a large gymnastic ball
b. Prone positioning on a large gymnastic ball with the child looking up
c. Quadruped, opposite arm and leg lifts
d. Standing, weight shifts in modified plantigrade
b. Prone positioning on a large gymnastic ball with the child looking up
A patient recovering from a stroke demonstrates dyspraxia. On what should physical therapy intervention optimally focus?
a. Re-education of weak muscles using isokinetics before activity practice
b. Compensatory training strategies with maximum use of environmental cues
c. Task-specific practice of familiar activities progressing from parts to whole
d. Maximum use of manual facilitation of movements and new tasks
c. Task-specific practice of familiar activities progressing from parts to whole
A patient presents with a limitation of wrist flexion. The joint manipulation technique that would BEST improve the patient’s range of motion is which of the following Grade IV descriptions?
a. Posterior to anterior glide of the proximal carpal row on distal radius and ulna
b. Posterior to anterior glide of the lunate on capitates
c. Anterior to posterior glide of the proximal carpal row on distal radius and ulna
d. Anterior to posterior glide of lunate on capitates
c. Anterior to posterior glide of the proximal carpal row on distal radius and ulna
A therapist wishes to determine the fall risk of an elderly person in a long-term care facility. Which test of static balance would be most difficult for this person to perform?
a. Standing unsupported with feet together, eyes open
b. Standing unsupported with one foot in front, tandem position, eyes closed
c. Standing unsupported with eyes closed
d. Standing unsupported on one leg, eyes open
b. Standing unsupported with one foot in front, tandem position, eyes closed
A patient with insulin-dependent diabetes is participating in an aerobic exercise class. The therapist recognized that important dietary recommendations to prevent delayed hypoglycemia after exercise include intake of which of the following?
a. Fruit juice or candy
b. Crackers or bread
c. Steak or chicken
d. Salad or cooked vegetables
b. Crackers or bread
A physical therapist is examining a patient who is complaining of pain in the left shoulder region. The examination of the shoulder elicits pain in the last 30 degrees of shoulder abduction range of motion. This finding is most congruent with which diagnosis?
a. Calcific supraspinatus tendinitis
b. Subacromial bursitis
c. Acromioclavicular (AC) sprain
d. Thoracic outlet syndrome
c. Acromioclavicular (AC) sprain
Early intervention program are usually required to use a standardized and comprehensive developmental test. What is the BEST test for use by a physical therapist?
a. Functional Independence Measure for Children (WeeFIM)
b. Denver Developmental Screening Test (Denver II)
c. Peabody Developmental Motor Scales
d. Movement Assessment of Infants (MAI)
c. Peabody Developmental Motor Scales
A patient presents with an acquired flatfoot deformity. The therapist recognizes that this can result from injury to muscle tendon. Which structure should be examined?
Anterior tibialis tendon
Posterior tibial tendon
Fibularis longus tendon
Achilles tendon
Posterior tibial tendon
A 13-year-old girl has a structural right thoracic idiopathic scoliosis. The clinical features a physical therapist would expect to find include which of the following?
A high (right/left) shoulder, a prominent (right/left) scapula, and a (right/left) hip that protrudes
A high RIGHT shoulder, a prominent RIGHT scapula, and a LEFT hip that protrudes
A patient with complete C7 spinal cord injury is receiving physical therapy in an inpatient rehabilitation setting to maintain joint mobility. What intervention is likely to produce the GREATEST risk of heterotopic ossification (HO)?
a. Prolonged positioning with resting splints
b. Forceful passive range of motion (PROM), especially if spasticity is present
c. Prolonged stretching using tilt table standing
d. Joint mobilization with PROM
b. Forceful passive range of motion (PROM), especially if spasticity is present
A patient sustained a tri-malleolar ankle fracture on the right and a fracture of the left distal radius. For partial weight bearing, it is BEST if the therapist has the patient use which device?
Axillary crutches
Forearm crutches
Platform crutches
Lofstrand crutches
Platform crutches
Ten weeks after shoulder surgery, a patient develops capsular stiffness that is limiting glenohumeral internal rotation. The physical therapist chooses joint manipulation followed by a supportive exercise to correct this impairment. What is the BEST intervention?
a. Anterior glide of the humerus and functional internal rotation stretch with arm up the back
b. Anterior glide of the humerus and partial push-ups
c. Posterior glide of the humerus and horizontal adduction stretch with arm across chest
d. Posterior glide of the humerus and standing scapular retractions
c. Posterior glide of the humerus and horizontal adduction stretch with arm across chest
A teenager is admitted to a skilled nursing facility with a severe traumatic brain injury and marked spasticity. Cognitive function is documented at Rancho Los Amigos Levels of Cognitive Functioning Scale level IV. Family members visit on a daily basis. In this situation, it would be BEST if passive range of motion (PROM) exercises are which of the following?
a. Taught to family members in order for them to participate in the care for the patient
b. Performed only by the physical therapist since the patient is unable to follow verbal commands
c. Performed only by the physical therapist (PT) or physical therapist assistant (PTA) to minimize the possibility of pathological fractures
d. Taught to all registered nurses (RNs) who might participate in the care for the patient
a. Taught to family members in order for them
After gait training with a transtibial prosthesis, a therapist notices redness along the patellar tendon and medial tibial flare. What would this indicate?
a. The socket is too small and residual limb is not seated properly
b. The socket is too large and pistoning is occurring
c. There is improper weight distribution during stance
d. Pressure-tolerant weight bearing is occurring
d. Pressure-tolerant weight bearing is occurring
During examination of a 2-year-old child with mild cerebral palsy, the therapist is encouraged because the normal developmental milestones for a child of this age have been achieved. This was demonstrated by the child’s ability to perform which of the following activities?
Hop on one foot
Stand on tiptoes
Go upstairs foot-over-foot
Jump with two feet
Go upstairs foot-over-foot
A therapist sees a patient in the ICU with multiple trauma and severe traumatic brain injury. A chest tube is in place and it exits from the right thorax. The patient is in need of airway clearance. What action should be taken in this case?
a. Percussion and shaking are contraindicated due to TBI
b. Percussion and shaking can be done only in the right side-lying position
c. Percussion and shaking can be done in the area surrounding the chest tube
d. Percussion and shaking can be done only when the chest tube is removed
c. Percussion and shaking can be done in the area surrounding the chest tube
To prevent maximal compressive forces being placed on the patella, a therapist should minimize placing the patient in which position?
a. Prone and flexing the knee to 30 degrees
b. In a sitting position with the knee flexed to 90 degrees
c. Supine and flexing both the hip and knee to 110 degrees
d. Prone and flexing the knee to 110 degrees with the hip extended
d. Prone and flexing the knee to 110 degrees with the hip extended
Following an exercise session for a patient with heart failure in a phase 3 cardiac rehabilitation program, what is prevented if the therapist employs a gradual and prolonged cool-down period?
Exertional dyspnea
Tachycardia
Venous pooling
Hypertension
Venous pooling
As a result of diminished movement associated with rigidity in Parkinson’s Disease, a physical therapist might employ rhythmic initiation primarily to help improve which of the following?
Trunk stability and proximal tone
Trunk rotation
UE function
Active and passive ROM
Trunk rotation
What is the Thomspon test used to examine?
Anterolateral rotatory instability of the knee
Iliopsoas tightness
Rectus femoris tightness
Achilles tendon rupture
Achilles tendon rupture
A physical therapist is substituting for an ill colleague and is unable to access the previous PT’s notes in the medical record. In this case, what should the therapist do?
a. Ask the patient what treatment had been administered in the last session
b. Attempt to reach the ill therapist by phone before commencing the session
c. See if the other coworkers can figure out how to access the information in the medical record
d. Briefly examine the patient and intervene properly
d. Briefly examine the patient and intervene properly
An elderly female patient is being evaluated for recurrent thoracic back pain. During the history, the patient reveals a smoking habit, and she drinks four to six cups of coffee a day. Activity level is low, consisting of daily trips to the local coffee shop to socialize with friends. Body weight and height are below normal. Medical history includes Grave’s disease. The therapist decides to consult the primary physician for further workup. What is the suspected problem?
Osteoporosis
Osteoarthritis
Gout
Spinal stenosis
Osteoporosis
A human bite injury resulted in laceration of the extensor tendons over the MCP joints. Following surgical repair, the patient was placed in a dorsal dynamic extension splint. Therapy is initiated in the first 24-48 hours, with the therapist instructing the patient to move in which way?
a. Actively extend the wrist and passively flex the MCP joints
b. Actively extend the wrist and MCP joints
c. Passively extend the wrist and MCP joints
d. Passively extend the wrist and actively flex the MCP joints
d. Passively extend the wrist and actively flex the MCP joints
A patient with flaccid hemiplegia exhibits pain in the shoulder region secondary to inferior glenohumeral subluxation. Using ES as orthotic substitution, where would it be best to palace the electrodes?
Posterior deltoid
Supraspinatus
Middle deltoid
Anterior, middle, and posterior deltoid
Supraspinatus
An ectomorphic adolescent patient presents at a physical therapy service with a 6-month history of pain in both hands. Subjective complaints consist of pain that is worse in the morning but gradually improves throughout the day and overall fatigue. The only significant objective data from examination was mild edema and pain at end ranges of motion. What should the physical therapist do next in order to try to establish a diagnosis?
Administer the Functional Independence Measure (FIM)
Examine for clubbing at the DIP
Examine for Dupuytren’s contracture
Refer the patient to a physician
Refer the patient to a physician
A patient with restrictive lung disease secondary to circumferential thoracic burns demonstrates decreased ability to expand the lower rib cage and push the abdominal wall anteriorly. The therapist should consider the use of facilitation techniques to enhance the function of which of the following?
Rectus abdominis
Anterior scalenes
Internal intercostals
Diaphragm
Diaphragm
A patient with post-polio syndrome (PPS) is referred to physical therapy for exercise and training. The patient reports recent general fatigue and weakness along the muscle and joint pain. What is the best initial intervention?
a. Treadmill training at 2 mph and a 10 degree slope, 3 days/week for 30 minutes
b. Cycle ergometry at peak heart rate, 3 days/week for 40 minutes
c. Therapeutic aquatics, 3 days/week for 20 minutes
d. Strength training at 70% 1RM, 2 days/week
c. Therapeutic aquatics, 3 days/week for 20 minutes
An elderly patient with a 5 year history of Parkinson’s Disease demonstrates freezing of gait (FOG) episodes while ambulating. What is the best choice of intervention to improve gait and FOG?
a. Part-to-whole training in sequencing of required gait elements
b. Walking using lightly resisted progression with elastic bands to facilitate forward progression
c. Body weight support and treadmill training (BWSTT), 40% unweighting, 3% incline, at 2.7 mph
d. Locomotor training using a personal listening device with 80-100 beats/minute
d. Locomotor training using a personal listening device with 80-100 beats/minute
A patient has a C5 ASIA SCI. An effective coughing technique for this patient is which of the following?
a. Should be facilitated by use of a phrenic nerve stimulator
b. Should be facilitated by used of glossopharyngeal breathing
c. Can be elicited with manual abdominal pressure provided with the assistance of a caregiver
d. Can be elicited with manual abdominal pressure provided independently by the patient
c. Can be elicited with manual abdominal pressure provided with the assistance of a caregiver
During cardiac rehabilitation exercise sessions involving the patients who experienced myocardial infarctions 6-8 weeks ago, what is the most significant abnormal response requiring the immediate attention of the physical therapist?
Decrease in systolic BP
Decrease in diastolic BP
Increase in diastolic BP
Increase in heart rate
Decrease in systolic BP
A patient with TB paraplegia sustained 4 years ago is seen by a physical therapist at a routine outpatient clinic visit. The skin over the ischial tuberosities and sacral region is in perfect shape. The patient asks about the further need for pressure relief in the wheelchair, considering a new gel cushion is being used. What should the therapist advise the patient to do?
a. Discontinue pressure relief as long as the gel cushion is used and visual inspection continues to reveal no skin breakdown
b. Continue to perform push-ups in the chair at least once every 15-20 minutes
c. Continue to perform push-ups in the chair at least once every 30-45 minutes
d. Continue to perform push-ups in the chair once an hour
b. Continue to perform push-ups in the chair at least once every 15-20 minutes
During weight bearing, a soft-tissue contracture resulting in supination of the forefoot will be compensated for by which of the following?
Pronation of the forefoot
Pronation of the rearfoot
Supination of the rearfoot
Pronation of the forefoot and rearfoot
Pronation of the rearfoot
A patient with long-standing DM is showing early signs of polyneuropathy. What is the most useful test to determine whether demyelination has taken place?
Nerve conduction velocity (NCV) testing
Electromyography (EMG)
Transcutaneous Electrical Nerve Stimulation (TENS)
Motor point stimulation
Nerve conduction velocity (NCV) testing
A patient with a crash injury to the foot appears to be developing Complex Regional Pain Syndrome (CPRS). What are some early signs of this clinical condition the therapist expects to see?
a. Worsening pain with edema and atrophic skin and nail changes
b. Cold, dry, and cyanotic skin with thickened fascia and developing contracture
c. Hyperalgesia, allodynia, and hyperpathia
d. Muscle atrophy, osteoporosis, and developing ankylosis
c. Hyperalgesia, allodynia, and hyperpathia
A patient has limited motion in supination and calcaneal inversion at the subtalar joint. Using manual techniques, what is the accessory motion of the calcaneus that needs to be emphasized in order to increase the motions that are limited?
Anterior glide
Posterior glide
Medial glide
Lateral glide
Lateral glide
A patient recovering from stroke walks behind limited tibial advancement during stance on the more affected LE. The therapist next examines the patient for a compensatory gait deviation. What is the most likely deviation?
Trendelenburg
Circumduction
Exaggerated flexion synergy
Exaggerated extension synergy
Circumduction
A patient presents with a complaint of severe neck and shoulder pain of 2 days’ duration. The patient reports falling asleep on the couch watching TV and has been stiff and sore since. There is tenderness of the cervical muscles on the right, with increased pain upon palpation. Passive ROM is most limited in flexion, then side-bending left, and then rotation left and active extension. Side-bending right and rotation right are also painful. What is the MOST likely diagnosis for this patient?
Cervical strain
Herniated disc
Cervical radiculopathy
Facet syndrome
Facet syndrome
A patient has osteophyte formation affecting the atlantoaxial joint with resultant cervical nerve root irritation. If the physical therapist elects to use gentle, static manual traction to help deal with this problem, what neck position would be best?
10-15 degrees of hyperextension
Neutral to zero degrees of flexion
20 degrees of flexion
30 degrees of flexion
Neutral to zero degrees of flexion
A therapist has decided to use mechanical lumbar traction on a patient with posterior herniated nucleus pulposus at L2-L3. If tolerated by the patient, what is the best positioning for this treatment?
a. Prone, with no pillow under the hips or abdomen
b. Prone, with a pillow under the hips and abdomen
c. Supine, with the hips and knees flexed to 45 degrees
d. Supine, with hips and knees flexed to 90 degrees
a. Prone, with no pillow under the hips or abdomen
What is one of the most common early signs of right ventricular failure?
Paroxysmal nocturnal edema
Exertional dyspnea
Pulmonary edema
Dependent edema
Dependent edema
Following a serious trauma, a patient is casted as a result of multiple bilateral wrist and hand fractures. When would be the best for physical therapy intervention to begin?
a. As early as possible to maintain or regain strength and ROM in non-immobilized joints of the UE
b. As soon as the casts are removed so as not to damage vulnerable soft tissue
c. After 6 weeks of immobilization to ensure that bone healing is almost complete
d. Hyponatremia
a. As early as possible to maintain or regain strength and ROM in non-immobilized joints of the UE
The patient has venous insufficiency in the right LE resulting in fluid accumulation at the ankle. Which intervention would be most effective at reducing the edema?
Crushed ice pack
Intermittent compression pump
Pulsed ultrasound
Contrast bath
Intermittent compression pump
A patient ambulates with excessive foot pronation. What will the therapist’s examination likely reveal?
Varus position of the heel
Forefoot valgus
Plantar fasciitis
Valgus position of the heel
Valgus position of the heel
The physical therapist receives a referral to evaluate and treat a 6-month-old infant with right congenital muscular torticollis. On initial examination, the therapist would expect the head to be in which position?
a. Tilted towards the non-involved side, with the chin rotated towards the same side
b. Tilted towards the involved side, with the chin rotated towards the opposite side
c. Limited in ROM in lateral flexion toward the involved side
d. Limited in ROM in neck flexion and extension
b. Tilted towards the involved side, with the chin rotated towards the opposite side
A physical therapist receives a referral to examine and treat an elderly patient in the early stage of ALS. A confounding factor is the patient’s mild Alzheimer’s type dementia (AD). A significant factor in the patient’s management at this time will most likely be which impairment?
Memory impairment
Maintaining airway clearance
Limited mobility
Limited ADLs
Memory impairment
A patient with a transverse SCI has total lack of hip flexion, abduction, and knee extension. This functional loss is consistent with a designation of a complete spinal cord lesion at which level?
L1
L3
L4
L5
L1
A physical therapist is treating a terminally ill patient with AIDS at home. What would be a major psychological focus or consideration when managing this patient?
a. Discontinue treatment if the patient/therapist relationship becomes overly dependent
b. Encourage expression of feelings and memories
c. Keep the patient’s friends and relative up to date on the patient’s treatment and state of mind
d. Discontinue any activities that may cause the patient discomfort in order to keep anxiety levels low
b. Encourage expression of feelings and memories
A physical therapist wishes to mobilize a patient’s shoulder using an inferior glide technique. It would be best to initially use this technique by prepositioning the patient’s arm in which position?
95 degrees of abduction with lateral rotation
125 degrees of abduction with internal rotation
35 degrees of abduction and neutral rotation
95 degrees of shoulder flexion and neutral rotation
35 degrees of abduction and neutral rotation
A therapist wishes to examine the effects of fatigue on physical, cognitive, and functional performance in a patient with a 7-year history of multiple sclerosis (MS). What is the BEST instrument to use?
Functional Independence Measure (FIM)
Walking Ability Questionnaire (WAQ)
Outcome and Assessment Information Set (OASIS)
Modified fatigue impact scale (MFIS)
Modified fatigue impact scale (MFIS)
To promote upright posture and higher walking speeds in a child with spastic diplegia, which ambulatory aid is most beneficial?
A reciprocating gait orthosis
An anterior rollator walker
A posterior rollator walker
A parapodium
A posterior rollator walker
A patient complains of vascular changes in the hands usually experienced whenever it is cold. The therapist suspects Raynaud’s disease. Which examination findings are consistent with this diagnosis?
Hypersensitivity to tactile stimuli
Loss of proprioception of the affected fingers
Loss of two-point discrimination in the affected hands
Temporary pallor and cyanosis of the digits
Temporary pallor and cyanosis of the digits
A patient with a 6-year history of Parkinson’s disease (PD) has experienced two recent bouts of pneumonia and limited functional mobility in the home. The therapist’s plan of care focuses on improving respiratory function and postural control. What is the BEST choice for intervention to address these issues at this time?
a. Supine, UE PNF lift and reverse lift patterns using rhythmic initiation
b. Quadruped, alternate arm and leg raises
c. Sitting, bilateral symmetrical UE PNF D2 flexion patterns using rhythmic initiation
d. Standing, bilateral symmetrical UE PNF D2 flexion patterns using dynamic reversals
c. Sitting, bilateral symmetrical UE PNF D2 flexion patterns using rhythmic initiation
What are some common adverse effects that patients taking nitrates, diuretics, beta-blockers, or calcium antagonists might experience?
a. Hypotension and dizziness
b. Arrhythmia and unstable blood pressure
c. Extreme fatigue and arrhythmias
d. Hypotension and decreased electrolytes
a. Hypotension and dizziness
Normotensive overweight and obese adolescents are performing isometrics and weightlifting as part of an exercise program. What is an important factor for the physical therapist to consider?
a. This type of exercise will decrease lean body mass and assist in weight loss
b. Blood pressure will fall if participants continuously hold their breath at the beginning of these exercises
c. This type of exercise will not affect cardiovascular conditioning
d. Blood pressure will rise during exercise and fall below resting levels after exercises ceases
d. Blood pressure will rise during exercise and fall below resting levels after exercises ceases
What is the primary reason a patient with advanced chronic obstructive pulmonary disease (COPD) has improved/increased aerobic capacity with bilateral upper extremity support during activity training?
a. It facilitates reverse action latissimus dorsi function to maximize ventilation
b. Holding on increases the resistance or workload
c. It increases sensory input and decreases balance work
d. It improves scalene recruitment to improve expiration
a. It facilitates reverse action latissimus dorsi function to maximize ventilation
During a finger-to-nose test, a patient demonstrates hesitancy in getting started and is then unable to control the movement. The finger slams into the side of the face, missing the nose completely. How should the therapist document this finding?
a. Dysmetria
b. Dysdiadochokinesia
c. Dyssynergia
d. Intention tremor
a. Dysmetria
A patient has worsening lateral knee pain that is exacerbated with running. Based on the history and symptoms, the therapist suspects iliotibial band friction syndrome. Which special test is performed that would help confirm this diagnosis?
a. Stutter test
b. Thessaly test
c. Ely’s test
d. Noble compression test
d. Noble compression test
A patient with diabetes recently underwent a transtibial amputation. When instructing others in wrapping the residual limb to minimize edema and provide proper shape, it is important to stress which of the following?
a. The greatest pressure should be provided distally
b. The greatest pressure should be provided proximally
c. The pressure should be evenly distributed
d. An overlapping, circular, wrinkle-free pattern should be used
a. The greatest pressure should be provided distally
The left phrenic nerve of a patient was accidentally severed during thoracic surgery. Which muscles should the physical therapist strengthen in order to provide substitute function?
a. Transversus abdominis
b. Scalenes
c. Internal obliques
d. External obliques
b. Scalenes
An elderly male patient is not able to participate in rehabilitation. He is lethargic, complains of nausea and painful urination, and seems to be feverish. The therapist should inform his primary care physician if which of the following is suspected?
a. Bladder cancer
b. Benign prostatic hyperplasia
c. Urinary tract infection
d. Renal calculi
c. Urinary tract infection
What is the most effective form of diagnostic imaging for patients with multiple sclerosis (MS) to help determine level of disease activity?
a. Positron emission tomography (PET)
b. Magnetic resonance imaging (MRI)
c. Computed tomography (CT)
d. Transcranial sonography
b. Magnetic resonance imaging (MRI)
Three months following a left cerebrovascular stroke and a 4-week stay of inpatient rehabilitation, a patient is receiving home care physical therapy. The patient’s movements in the right extremities show good recovery (out-of-synergy). Functional level is a 6 on the Functional Independence Measure (FIM). At this juncture, what should be the focus of motor learning strategies?
a. Use of mental practice to improve performance
b. Breaking down complex tasks into component parts
c. Use of serial practice order of related skills
d. Consistency of performance in variable environments
d. Consistency of performance in variable environments
A physical therapist is working with a patient who exhibits fluent aphasia. What is a typical characteristic of this form of aphasia?
a. Impaired auditory comprehension
b. Slow, hesitant speech
c. Good comprehension
d. Impaired articulation
a. Impaired auditory comprehension
A physical therapist is treating an elderly patient in the very early stages of amyotrophic lateral sclerosis (ALS). The patient lacks endurance to independently ambulate to and from the bathroom; however, she refuses to use a bed pan. This has caused added difficulties and stress for family members caring for her at home. What should the therapist do in this situation?
a. Initiate ambulation endurance training with distance to and from the bathroom as the primary goal
b. Recommend that the patient be transferred to a skilled nursing facility until she has sufficient endurance to get to and from the bathroom
c. Recommend use of a commode chair for the bedroom
d. Recommend use of a wheelchair and toilet grab rails
c. Recommend use of a commode chair for the bedroom
A physical therapist is performing sensory tests on a patient diagnosed with C6 nerve root impingement. Where should the testing concentrate?
a. Second, third, and fourth fingers, palmar surface
b. Ulnar border of the hand (fifth finger)
c. Palmar surface of the thumb and distal, radial forearm
d. Medial (ulnar) forearm
c. Palmar surface of the thumb and distal, radial forearm
A patient with post-traumatic brain injury (Rancho Los Amigos Levels of Cognitive Functioning Scale level III) has evidence of retained secretions on auscultation and chest films. What is the BEST mode of airway clearance for this patient?
a. Active cycle of breathing
b. Autogenic drainage
c. Use of FLUTTER device
d. Use of the Vest Airway Clearance System
d. Use of the Vest Airway Clearance System
A patient with a 10-year history of discoid lupus erythematosus presents with multiple discoid skin lesions that are raised and red and contain scaling plaques with central atrophy on the lower extremities. Topical corticosteroid creams are being used. What should be the focus of therapist’s initial plan of care?
a. Range of motion (ROM) exercises and prevention
b. Lightweight splints to provide joint protection
c. Aerobic training using a treadmill
d. Resistive training using at 60% to 80%, one-repetition maximum
a. Range of motion (ROM) exercises and prevention
A patient with a 7-year history of Parkinson’s disease is hospitalized. The patient is ambulatory but requires close supervision to prevent falls. What should be the focus of the physical therapist’s plan of care?
a. Manual balance perturbation training
b. Transfer and wheelchair training
c. Caregiver training for contact guarding during level walking and stairs
d. Locomotor training using a rolling walker
c. Caregiver training for contact guarding during level walking and stairs
A physical therapist is working with a patient recovering from traumatic brain injury (Rancho Los Amigos Levels of Cognitive Functioning Scale level VII). The best test to determine if this patient demonstrates progression to open skills is to have the patient walk in which environment?
a. In the hallway
b. Across the busy hospital lobby
c. In the patient’s room
d. In the patient’s home
b. Across the busy hospital lobby
A patient presents with an insidious onset of low back pain that started 10 days ago. Examination reveals an Oswestry Disability Index score of 40%, a Fear Avoidance Belief Questionnaire for Physical Activity score of 16, hypomobility at L4-5 with posteroanterior (PA) glide, and pain that radiates into the right buttock. Lumbar active range of motion (AROM) is painful at 50% of expected range in all directions. Hip passive range of motion (PROM) is within normal limits. Abdominal strength is fair. Based on this data, what is the BEST intervention for the patient?
a. Abdominal stabilization
b. Manipulation
c. Positional distraction
d. Transcutaneous electrical nerve stimulation (TENS) and ice
d. Transcutaneous electrical nerve stimulation (TENS) and ice
What is the BEST evidence to determine orthotic intervention to prevent inversion ankle?
a. Meta-analyses of cohort studies
b. Systematic reviews of randomized controlled trials
c. Meta-analyses of multiple case studies
d. Randomized double-blind controlled trials
b. Systematic reviews of randomized controlled trials
Strengthening of the lateral pterygoid, anterior head of the digastric muscle, anterior head of the digastric muscle, and suprahyoid muscles would be the MOST BENEFICIAL intervention to improve which of the following?
a. Mouth closing
b. Mouth opening
c. Mouth protrusion
d. Mouth retrusion
b. Mouth opening
A patient is immersed up to the neck in a therapeutic pool. While exercising this patient, the therapist should take into consideration the physiological effect of immersion. Which significant result might occur?
a. Increased forced vital capacity
b. Increased expiratory reserve volume
c. Increased work of breathing
d. Decreased pulmonary blood flow
c. Increased work of breathing
A weightlifter with hypertrophy of the scalene muscles complains of pain and paresthesia in the right UE when lifting weight overhead. What is the most likely cause?
a. Thoracic outlet syndrome
b. Vertebral artery obstruction
c. Cervical radiculopathy
d. CRPS Type I
a. Thoracic outlet syndrome
Damage as a result of Salter-Harris type IV supracondylar humeral epiphyseal fracture in a young athlete will most likely result in what consequence?
a. Refracture at at future time
b. Non-union
c. Arrested growth
d. Severing of the radial nerve
c. Arrested growth
During examination of a patient with degenerative osteoarthritic changes in the CMC joint of the right thumb, the physical therapist notes a 20-degree loss of thumb palmar abduction. What translatory joint play motion (based on traditional concave-convex rules of motion) is associated with thumb palmar abduction and should be examined?
a. Dorsal translation of the MCP on the trapezium
b. Palmar translation of the MCP on the trapezium
c. Ulnar translation of the MCP on the trapezium
d. Radial translation of the MCP on the trapezium
a. Dorsal translation of the MCP on the trapezium
A patient presents with a stage III pressure ulcer with a moist, necrotic wound. A hydrocolloid dressing (DuoDERM) is being used. During the dressing change, the therapist detects a strong odor, and the wound drainage has a yellow color. What is the therapist’s best course of action?
a. Reapply a new gauze dressing instead of hydrocolloid and report findings to the physician
b. Speak to the nurse about changing to a hydrogel dressing
c. Leave the dressing off the wound and report the findings immediately to the physician
d. Re-apply a new DuoDERM dressing and record the findings in the chart
d. Re-apply a new DuoDERM dressing and record the findings in the chart
The results of isokinetic dynamometry at 180 degrees per second indicate that a male patient can generate a peak torque of 120 ft lbs with the right quadriceps muscle and only 80 ft lbs with the right hamstring musculature. What situation is being described?
a. Quadriceps torque generation is excessive
b. Hamstring torque generation is insufficient
c. Both quadriceps and hamstring torque generation is excessive
d. Torque generation is proportionally correct
d. Torque generation is proportionally correct
A group of 37 adolescent girls ages 12-13 were recruited into a study on developmental changes in bone density. Bone mineral density (BMD) was measured on admission into the study and every 4 months thereafter for a period of 3 years. The investigators concluded that BMD peaked at the age of 14, with a standard deviation of 7 months. What is the category of this research?
a. RCT
b. Case control study
c. Between-subject study
d. Prospective cohort study
d. Prospective cohort study
A soccer player with a Q angle in excess of 30 degrees exhibits abnormal patellofemoral tracking. While playing soccer, what is the MOST often used device to address this problem?
Patellar stabilizing brace with a lateral buttress
Patellar stabilizing brace with a medial buttress
Neoprene sleeve with a patellar cutout
Derotation brace
Patellar stabilizing brace with a lateral buttress
PTRP KA NA THIS SEASON! 🫶🏽
How would the clinical status of a patient with a posterior herniated nucleus pulposus be determined if there is improvement?
a. Peripheral pain increases only when lumbar extension is attempted
b. Peripheral pain occurs only with straight leg raising
c. Pain centralizes with passive hyperextension of the spine
d. There is flattening of the lumbar lordosis
c. Pain centralizes with passive hyperextension of the spine
A patient complains of excessive upper and lower extremity muscle aching, cramping, and right upper quadrant pain when exercising. The patient has a history of chronic alcoholism and was placed on atorvastatin (a statin drug) 2 months ago. The therapist should refer the patient to the primary care physician for which reason?
For an exercise test to determine the right intensity for exercise
To rule out cirrhosis of the liver
To rule out liver and muscle dysfunction from statin
To rule out gallstones that may be obstructing the bile duct
To rule out liver and muscle dysfunction from statin
A patient diagnosed with benign paroxysmal positional vertigo (BPPV). What intervention should the plan of care for this patient emphasize?
a. Gaze stability exercises using horizontal head rotation (X1 viewing)
b. Canalith repositioning treatment
c. Postural stability exercises in sitting using a therapy ball
d. Habituation exercises using provocative positions and movements
b. Canalith repositioning treatment
A therapist is examining a patient with an ulcer in the lower leg/ankle and suspects it is an arterial rather than a venous ulcer. One of the factors the therapist uses to determine this is based on the location of the ulcer. What is the typical location of an arterial ulcer?
Medial malleolus
Posterior tibial area
Lateral malleolus
Medial distal tibia
Lateral malleolus
A patient with cystic fibrosis (CF) has been admitted to the hospital in acute respiratory failure as a result of an infection. What is the BEST choice for use of airway clearance techniques?
a. Should not be administered since it is contraindicated in acute respiratory failure
b. Should be administered two times a day to the patient’s tolerance
c. Should be administered according to the patient’s current home regimen
d. Should be administered vigorously once every 2 hours
d. Should be administered vigorously once every 2 hours
Following a hard tackle, a football player exhibits signs of fractured ribs and a pneumothorax. When auscultating during inhalation over the injured area, what would the physical therapist expect to hear?
Soft, rustling sounds on inhalation
Decreased or no breath sounds crackles
Crackles
Wheezes
Decreased or no breath sounds crackles
Which of these findings is characteristic of a Boutonniere deformity of the finger?
Flexion of the distal interphalangeal joint
Contracture of the extensor digitorum communis tendon
Rupture with volar slippage of the lateral bands
Hyperextension of the proximal interphalangeal joint
Rupture with volar slippage of the lateral bands
A therapist wishes to study the progress of patients with paraplegia who are discharged from a rehabilitation setting. Starting with the patient’s discharge and once a month for 3 years, the therapist will measure their joint range of motion of both hips and knees. Accurate analysis of this time series study is heavily dependent upon which of the following?
Random sampling
Interrater reliability
Intrarater reliability
Predictive validity of the measurement
Intrarater reliability
Confirmation of a diagnosis of spondylolisthesis can be made when viewing an oblique radiograph of the spine. What is the relevant diagnostic finding?
Posterior displacement of L5 over S1
Bamboo appearance of the spine
Compression of the vertebral bodies of L5 and S1
Bilateral pars interarticularis defects
Bilateral pars interarticularis defects
A patient with degenerative joint disease of the right hip complains of pain in the anterior hip and groin, which is aggravated by weight bearing. There is decreased range of motion and capsular restrictions. Right gluteus medius weakness is evident during ambulation, and there is decreased tolerance of functional activities including transfers and lower extremity dressing. In this case, a capsular pattern of joint motion should be evident by which of the following?
Hip flexion, abduction, and internal rotation
Hip flexion, adduction, and internal rotation
Hip extension, abduction, and external rotation
Hip flexion, abduction and external rotation
Hip flexion, abduction, and internal rotation
Upon removing the dressing covering a decubitus ulcer located on the heel of an elderly patient, the physical therapist observes copious amounts of a foul-smelling, yellow-green discharge. How should the therapist document this finding in the patient’s medical record?
There is likelihood of a staphylococcus aureus infection
Maceration of the wound is evident
Wound exudate is purulent
Wound exudate is serosanguinous
Wound exudate is purulent
Four days following open-heart surgery, a patient is ambulating with a physical therapist in the hallway. The patient complains of some chest discomfort during the activity and wishes to return to his or her room. What should the therapist do?
a. Sit the patient down and call the physician immediately
b. Complete the treatment and have an aide transport the patient to the room as some discomfort is expected
c. Call the nurse and check to see if the discomfort is ongoing
d. Sit the patient down, take vital signs, and inform nursing services of the patient’s complaint
d. Sit the patient down, take vital signs, and inform nursing services of the patient’s complaint
Following cast immobilization for a now healed supracondylar fracture of the humerus, a patient’s elbow lacks mobility. To increase elbow range of motion, joint mobilization in the maximum loose-packed position should be performed at what position?
Full extension
90 degrees of flexion
70 degrees of flexion
30 degrees of flexion
70 degrees of flexion
Pursed lip breathing as part of the treatment regimen would be MOST appropriate for a patient with which condition?
Circumferential thoracic burns
Asbestosis
Rib fracture
Emphysema
Emphysema
While gait training a patient following a stroke, the therapist observes the knee on the hemiparetic side going into recurvatum during stance phase. What is the MOST LIKELY cause of this deviation?
a. Severe spasticity of the hamstrings or weakness of the gastrocnemius-soleus
b. Weakness or severe spasticity of the quadriceps
c. Weakness of the gastrocnemius-soleus or spasticity of the pretibial muscles
d. Weakness of both the gastrocnemius-soleus and pretibial muscles
b. Weakness or severe spasticity of the quadriceps
A patient suddenly falls and lands on a piece of equipment on the floor. A severe laceration with spurting blood is noted in the area of the lateral distal right thigh. To help control bleeding, where should the physical therapist apply pressure in addition to directly over the wound?
Behind the knee at the popliteal fossa
At the femoral triangle
At the antecubital fossa
At mid-thigh, directly over the profunda femoris artery
At the femoral triangle
A patient is recovering from a mild stroke with trunk weakness and postural instability, The patient complains of severe heartburn. What is the BEST choice to maximize stroke recovery and improve trunk stabilization while minimizing heartburn?
a. Perform trunk stabilization exercises with the patient in the semi-Fowler position
b. Begin with bridging exercise progressing to sitting holding
c. Perform resisted holding in sitting using rhythmic stabilization
d. Take antacids before physical therapy
c. Perform resisted holding in sitting using rhythmic stabilization
PTRP KA NA THIS SEASON! 🫶🏽
What is the expected hemodynamic response for a patient on a beta-adrenergic blocking agent during exercise?
a. Heart rate to be low at rest and rise minimally with exercise
b. Heart rate to be low at rest and rise continuously to expected levels as exercise intensity increases
c. Systolic blood pressure to be low at rest and not rise with exercise
d. Systolic blood pressure to be within normal limits at rest and progressively fall as exercise intensity increases
a. Heart rate to be low at rest and rise minimally with exercise
A patient with type 1 diabetes mellitus has generalized osteoporosis. What is the BEST exercise to include in this patient’s plan of care?
a. Bilateral quadriceps presses against resistance in sitting
b. Aquatic exercises
c. Running on a treadmill
d. Partial squats in standing
d. Partial squats in standing
A physical therapist observes a full-term infant in the neonatal intensive care unit (NICU) just after birth. In the supine position, the shoulders are abducted and externally rotated, elbow and fingers are flexed, hips are abducted and externally rotated, and knees are flexed. What would this posturing be an indication of?
a. Upper extremity tone is abnormal
b. Lower extremity tone is abnormal
c. Tone is abnormal in both upper and lower extremities
d. Tone is normal in both upper and lower extremities
d. Tone is normal in both upper and lower extremities
During auscultation of the heart, the therapist hears S1 and S2 heart sounds. During early diastole, the therapist also hears a low frequency sound of turbulence. What suspected abnormal sound should the therapist record this as?
S4 sound
S3 sound
Heart murmur
Pericardial friction rub
S3 sound
Use of continuous ultrasound at 1.5 watts/cm2 can increase which of the following?
Local metabolic rate
Rate of muscle hypertrophy
Stiffness of collagen tissue
The resolution of acute inflammation
Local metabolic rate
A physical therapist is treating a patient with active infectious hepatitis B. In addition to wearing a protective gown when in the patient’s room, what precautions should be taken to avoid transmission of the disease?
a. Avoid direct contact with the patient’s blood or blood-contaminated equipment by wearing gloves
b. Avoid direct contact with any part of the patient
c. Have the patient wear a mask to minimize droplet spread of the organisms from coughing
d. Provide tissues and no-touch receptacles for disposal of tissue
a. Avoid direct contact with the patient’s blood or blood-contaminated equipment by wearing gloves
Three months ago a patient experienced a traumatic injury to the hand that resulted in surgical tendon repair and fracture stabilization. The therapist is planning a treatment program to address tightness of the lumbricals. What exercises would be BEST in order to increase range of motion of the hand?
Both MCP and IP joints are moved into flexion
Both MCP and IP joints are moved into extension
MCP joints extended and the IP joints flexed
MCP joints flexed and the IP joints extended
MCP joints extended and the IP joints flexed
When visually examining active abduction of the arm to 150 degrees, what is the normal composition of the motion a therapist would expect?
a. 150 degrees of the glenohumeral joint and 0 degrees of scapulothoracic motion
b. 110 degrees of the glenohumeral motion and 40 degrees of scapulothoracic motion
c. 75 degrees of the glenohumeral motion and 75 degrees of scapulothoracic motion
d. 100 degrees of the glenohumeral motion and 50 degrees of scapulothoracic motion
d. 100 degrees of the glenohumeral motion and 50 degrees of scapulothoracic motion
