SuSig C

Question 1

After an uncomplicated acute myocardial infarction, under what circumstances should a patient be administered a graded exercise test (GXT) before hospital discharge?

a. Symptom-limited GXT at 10 days post-MI
b. Low level GXT at 4-6 days post-MI
c. GXT to 85% age predicted maximum HR 3-5 days post-MI
d. GXT to 75% age predicted maximum HR 4-6 days post-MI

Answer 1

b. Low level GXT at 4-6 days post-MI

Question 2

A newborn is examined at birth using the APGAR test. Which of the following APGAR results is a likely indicator of potential neurological complications?

a. 3 at 10 minutes
b. 9 at 1 minute
c. 8 at 1 minute
d. 8 at 5 minutes

Answer 2

a. 3 at 10 minutes

Question 3

A PT requested that a PT Assistant performed ultrasound to the shoulder of a patient. During the treatment session, the patient experienced an electrical shock. In which situation would the PT be responsible for any injury the patient might receive?

a. Faulty circuitry
b. The PTA failing to use a ground fault interrupter
c. The patient touching the US device during treatment
d. The PT having instructed the PTA to use a device that had malfunctioned on the previous day

Answer 3

d. The PT having instructed the PTA to use a device that had malfunctioned on the previous day

Question 4

A patient with coronary artery disease received inpatient cardiac rehabilitation after a mild myocardial infarction. The patient is now enrolled in an outpatient exercise class that utilizes intermittent fasting. What is the best initial spacing of exercise/rest intervals to safely stress the aerobic system?

a. 5:1
b. 1:1
c. 10:1
d 2:1

Answer 4

d 2:1

Question 5

What is the best initial intervention to improve functional mobility in an individual with a stable humeral neck fracture?

a. Isometrics for all shoulder musculature
b. Heat modalities
c. AROMEs
d. Pendulum exercises

Answer 5

d. Pendulum exercises

Question 6

A patient with U/L spondylolysis is preferred for PT. the patient complains of generalized lower back pain when standing longer than 1 hour. Which strengthening exercise is best for the subacute phase of this patient’s rehabilitation?

a. Multifidi working from neutral to full extension
b. Abdominals working from neutral to full flexion
c. Multifidi working from full flexion back to neutral
d. Abdominals working from full extension to full flexion

Answer 6

c. Multifidi working from full flexion back to neutral

Question 7

A patient has fixed forefoot varus malalignment. What possible compensatory motion or posture might occur?

a. Excessive subtalar pronation
b. I/L pelvic ER
c. Hallux varus
d. Genu recurvatum

Answer 7

b. I/L pelvic ER

Question 8

A patient presents with fingertips that are rounded and bulbous. The nail plate is more convex than normal. These changes are the likely result of which condition?

a. Psoriasis
b. Chronic hypoxia from heart disease
c. Inflammation of the proximal and lateral nail folds
d. Trauma to the nail bed

Answer 8

b. Chronic hypoxia from heart disease

Question 9

A patient has an episode of syncope in the physical therapy clinic. The therapist attempts to rule out OH as the cause of fainting. What Is the BEST test protocol to use?

a. Palpate the carotid arteries and take resting HR and BP in the supine position
b. Take resting HR and BP in supine, then in sitting, then in standing after 1 minute.
c. Take resting HR and BP in supine after 5 minutes, then in semi-Fowler position.
d. Take resting HR and BP in sitting and after 3 and 5 minutes of cycle ergometry exercise.

Answer 9

b. Take resting HR and BP in supine, then in sitting, then in standing after 1 minute.

Question 10

The PT is examining a patient for right neck pain and spasms. Several inflamed submandibular nodes are noted. The nodes are approximately 1.0 cm in size, tender, and erythematous. The patient has no known history of cancer or metabolic diseases. What is the first action the therapist should take?

a. Question the patient regarding the impact of neck pain and emotional distress
b. Question the patient regarding any dental or throat infections
c. Have another therapist confirm the findings before implementing treatment
d. Apply superficial heat and begin manual lymphatic drainage

Answer 10

b. Question the patient regarding any dental or throat infections

Question 11

A PT is reviewing a medical record prior to examining a patient for the first time. The suspected diagnosis is multiple sclerosis. On the neurologist’s notes, the therapist finds the following: (R) quadriceps is 2+, (L) quadriceps is 4+. What is the correct interpretation of these findings?

a. The (R) DTR is normal, the (L) is abnormal
b. Both DTRs are abnormal and indicative of hyporeflexia
c. The (R) DTR is exaggerated, the (L) is clearly abnormal
d. Both DTRs are abnormal and are indicative of UMN syndrome

Answer 11

a. The (R) DTR is normal, the (L) is abnormal

Question 12

An inpatient with a grade III diabetic foot ulcer is referred for physical therapy. Panafil has been applied to the necrotic tissue BID. The wound has no foul smell; however, the therapist notes a green tinge on the dressing. What is the BEST action for the therapist to take?

a. Fit the patient with a total contact cast.
b. Document the finding and contact the physician immediately.
c. Begin a trial of acetic acid to the wound.
d. Document the finding and continue with treatment.

Answer 12

d. Document the finding and continue with treatment.

Question 13

A PT receives a referral to examine the fall risk of an elderly patient with Parkinson’s disease who lives alone and has had two recent falls. Which activity is the MOST common reason for falls in the elderly?

a. Walking with a roller walker with hand brakes.
b. Climbing on a step stool to reach overhead objects
c. Turning around and sitting down in a chair.
d. Dressing while sitting on the edge of the bed.

Answer 13

c. Turning around and sitting down in a chair.

Question 14

A patient with Addison’s disease is referred for physical therapy following a hip fracture. Which of the following is a cardinal symptom of Addison’s disease?

a. Weight gain
b. Tremors
c. Asthenia
d. Diarrhea

Answer 14

c. Asthenia

Question 15

A 2-month-old child with bilateral hip dislocations is being discharged from an acute pediatric facility. The PT has developed a home exercise program and now needs to instruct the patients. What is the MOST important item for the therapist to assess before instructing the parents?

a. Their degree of anxiety and attention.
b. Their knowledge of the etiology of the hip dislocations.
c. The home environment.
d. The financial reimbursement plan.

Answer 15

a. Their degree of anxiety and attention.

Question 16

A PT receives a referral for a young child that had been swung around while being held from the wrists. The referral reads, “functional disuse following nursemaid’s elbow.” Which of the following commonly results from a forceful longitudinal pull of the forearm of a child?

a. Superior subluxation of the radial head from the annular ligament.
b. Inferior subluxation of the ulna from the annular ligament.
c. Superior subluxation of the ulna from the annular ligament
d. Inferior subluxation of the radial head from the annular ligament.

Answer 16

d. Inferior subluxation of the radial head from the annular ligament.

Question 17

Which of the following activities demonstrates an infant’s integration of the asymmetrical tonic neck reflex?

a. Turns head to one side and brings opposite hand to mouth.
b. Can turn head to either side with extended arms.
c. Turns head to one side and brings hand to mouth on the same side.
d. Turns head to one side and looks at the extended arm on that side.

Answer 17

c. Turns head to one side and brings hand to mouth on the same side.

Question 18

Which is typical early clinical manifestation of cystic fibrosis (CF)?

a. Increase in secretions of the endocrine system.
b. Frequent recurrent urinary tract infections.
c. Excessive appetite and weight loss.
d. Increased FEV1 (forced expiratory volume in 1 sec) during pulmonary function testing.

Answer 18

c. Excessive appetite and weight loss.

Question 19

A Physical therapy aide is cleaning a mat table with a new product supplied by the housekeeping department. The spray from the cleaning agent contacts the skin resulting in irritation, redness, and some swelling. The symptoms were minor and abated within 20 minutes. Later, the aide informed the physical therapy supervisor of this situation. What action should the supervisor take?

a. Initiate first aid by rinsing the affected area with a skin cleanser and applying cortisone cream for the inflammation.
b. Inform housekeeping to immediately cease using the cleaning agent.
c. Fill out an incident/occurrence report and have the aide examined by employee health or their own primary care physician.
d. Fill out an incident/occurrence report and review the Material Safety Data Sheet (MSDS) from Occupational Safety and Health Administration (OSHA) with the aide on how to properly handle the cleaning agent.

Answer 19

d. Fill out an incident/occurrence report and review the Material Safety Data Sheet (MSDS) from Occupational Safety and Health Administration (OSHA) with the aide on how to properly handle the cleaning agent.

Question 20

During surgery an apical lung tumor, the long thoracic nerve was injured. Muscle testing of the serratus anterior demonstrates its strength to be 3+/5. What is the BEST initial exercise for this patient?

a. Standing wall push-ups.
b. Standing arm overhead lifts using hand weights.
c. Supine arm overhead lifts using weights.
d. Sitting arm overhead lifts using a pulley

Answer 20

a. Standing wall push-ups.

Question 21

A PT examination reveals posterior superior iliac spine (PSIS) is low on the left; anterior superior iliac spine (ASIS) is high on the left; standing flexion test shows that the left PSIS moves first and farthest superiorly; Gillet’s test demonstrates that the left PSIS moves inferiorly and laterally less than right; long sitting test shows that the left malleolus moves short to long; and the sitting flexion test is negative. Based on these findings, what is the therapist’s diagnosis?

a. Left upslip
b. Iliac Inflare On The Left
c. Left posterior rotated innominate
d. Left anterior rotated innominate

Answer 21

c. Left posterior rotated innominate

Question 22

A patient recovering from a burn on the back of the hand is referred to physical therapy for mobilization exercises. The therapist observes a 14-cm irregular area that is thick and pink. How should the therapist document this finding?

a. Hypertrophic scarring
b. An excoriation
c. Atrophic scarring
d. A scale

Answer 22

a. Hypertrophic scarring

Question 23

A patient presents with partial-and full-thickness burns on the chest and neck regions. The therapist decides to apply transcutaneous electrical nerve stimulation (TENS) before debridement to modulate pain. Which TENS mode should provide the BEST relief?

a. Acupuncture-like (low-rate) TENS
b. Brief intense TENS
c. Modulated TENS
d. Conventional (high-rate) TENS

Answer 23

b. Brief intense TENS

Question 24

A patient recovering from traumatic brain injury (TBI) demonstrates difficulties in feeding resulting from an unstable posture while sitting. The therapist determines that modification is necessary to ensure optimal function. What is the first body segment or segments that the therapist should align?

a. Trunk
b. Pelvis
c. Head
d. Lower extremities

Answer 24

b. Pelvis

Question 25

A patient demonstrates some out-of-synergy movements in the right upper extremity indicative of stage 4 recovery after a left cerebrovascular accident ( CVA ) . Which proprioceptive neuromuscular facilitation (PNF) pattern represents the BEST choice to promote continued recovery of the right upper extremity?

a. Bilateral symmetrical D2F and D2E, elbows straight
b. Chop, reverse chop with right arm leading
c. Lift, reverse lift with right arm leading
d. Bilateral symmetrical D1 thrust and reverse thrust

Answer 25

b. Chop, reverse chop with right arm leading

Question 26

An elderly individual has limited endurance as a result of a sedentary lifestyle. There is no history of cardiorespiratory problems. An exercise tolerance test was negative for coronary heart disease. What is the BEST initial exercise prescription for this individual?

a. 40%-50% HRmax
b. 35%-50%ofVO2max
c. 60%-90% HRmax
d. 30%-50% HRmax

Answer 26

c. 60%-90% HRmax

Question 27

A patient is admitted to a coronary care unit with a mild myocardial infarction (MI). after 2 days, the patient is referred to physical therapy for inpatient cardiac rehabilitation. During an initial exercise session on the unit, the patient reports chest pain, appears anxious and wants to go back to bed to rest. What is the therapist’s BEST initial course of action?

a. Assist the patient back to bed and contact the charge nurse on the floor.
b. Sit the patient and monitor vital signs carefully during the rest period.
c. Assign the PTA to assist the patient back to bed and monitor vital signs carefully
d. Terminate the exercise and contact the attending physician immediately

Answer 27

b. Sit the patient and monitor vital signs carefully during the rest period.

Question 28

A patient with a 10-year history of scleroderma is referred for physical therapy to improve functional status and endurance. The patient was recently treated with corticosteroids for a bout of myositis. Examination findings reveal limited ROM and fibrotic soft tissue along with hyperesthesia. What is the BEST choice for initial intervention?

a. Treadmill walking using body weight support at an intensity of 40% HR max
b. Active range of motion (AROM) exercises and walking in a therapeutic pool
c. Closed-chain and modified aerobic step exercises
d. Soft tissue mobilization and stretching

Answer 28

b. Active range of motion (AROM) exercises and walking in a therapeutic pool

Question 29

A patient is referred to physical therapy after a fall injury (fractured left hip with operative reduction, internal fixation [ORIF]). Medical history reveals a diagnosis of mild Alzheimer’s type dementia (AD). Given this stage of AD, which change should not be evident in this patient?

a. Profound communication deficits
b. Memory loss
c. Anxiety and irritability
d. Difficulty concentrating

Answer 29

a. Profound communication deficits

Question 30

A patient recovering from stroke with minimal lower extremity weakness and spasticity is able to walk without an assistive device. The therapist observes that as the patient walks there is noticeable hip hiking on the more affected side during swing phase. What is the BEST initial intervention?

a. Bridging Exercise Progression To Sit-to-stand training.
b. Marching while sitting on a therapy ball.
c. Standing and marching with manual pressure applied downward on the pelvis
d. Partial wall squats using a small ball held between the knees.

Answer 30

b. Marching while sitting on a therapy ball.

Question 31

In neural tension testing, what position will BEST bias the tibial nerve?

a. Straight leg raise with plantarflexion and eversion
b. Straight leg raise with dorsiflexion and inversion
c. Straight leg raise with plantarflexion and inversion
d. Straight leg raise with dorsiflexion and eversion

Answer 31

d. Straight leg raise with dorsiflexion and eversion

Question 32

The therapist is instructing a patient with traumatic brain injury (TBI) how to lock the brakes on a wheelchair. The patient is right-handed, and the right upper extremity is more affected than the left. What is the BEST motor learning strategy to use with this patient?

a. Have the patient practice brake locking using the left hand to assist the right.
b. Guide the patient’s right hand through the locking motions, then the left.
c. Verbally talk the patient through the locking motions, practicing with both hands simultaneously.
d. Have the patient practice locking the brakes first with the left hand and then with the right.

Answer 32

d. Have the patient practice locking the brakes first with the left hand and then with the right.

Question 33

A therapist is examining a patient with chronic obstructive pulmonary disease (COPD) GOLD stage III. What would be a clinical finding that the therapist would expect for this patient?

a. Decreased anteroposterior to lateral chest ratio.
b. Muscle wasting.
c. Use of supplemental oxygen.
d. Weight gain.

Answer 33

b. Muscle wasting.

Question 34

What muscle length test for the tensor fascia lata is recommended in a patient with decreased
muscle length of the rectus femoris?

a. Modified Ober test (knee extended).
b. FAIR (flexion, adduction, internal rotation) test.
c. Ober test (knee flexed).
d. Ely’s test.

Answer 34

a. Modified Ober test (knee extended).

Question 35

During a postural screen for chronic shoulder pain, the therapist observes excessive internal rotation of the shoulders and winging of the scapula during overhead motion. What is the BEST choice for exercise intervention?

a. Strengthening of rhomboids and stretching of upper trapezius.
b. Strengthening of pectoral muscles and stretching of upper trapezius.
c. Strengthening of upper trapezius and stretching of pectoral muscles.
d. Strengthening of middle and lower trapezius and stretching of pectoral muscles

Answer 35

d. Strengthening of middle and lower trapezius and stretching of pectoral muscles

Question 36

Examination of a patient with a dermal ulcer over the coccyx reveals a wound exposing the deep fascia. There is no necrotic tissue, exudate is minimal, and the borders of the ulcer are diffusely covered with granulation tissue. Previous treatment has included wet-to-dry dressings with normal saline. What is the BEST choice for intervention?

a. Hydrogel dressings and whirlpool immersion
b. Continuation of the same treatment
c. Wound irrigation with pressures below 15 psi
d. Calcium alginate dressings

Answer 36

c. Wound irrigation with pressures below 15 psi

Question 37

A patient presents with rapidly progressive symmetrical weakness that started in the distal lower extremity muscles but now has ascended to include proximal trunk and upper extremity muscles. The motor segments of the lower cranial nerves are also showing impairment. The patient complains of abnormal sensations of tingling and burning of the affected extremities. Consciousness, cognition, and communication are all normal. These signs and symptoms are characteristic of what diagnosis?

a. Multiple sclerosis
b. Guillain-Barre syndrome
c. Amyotrophic lateral sclerosis
d. Post Polio syndrome.

Answer 37

b. Guillain-Barre syndrome

Question 38

PTRP KA NA THIS SEASON! 🫶🏽

Question 39

A computer specialist is unable to work because of weakness and altered sensation in the dominant right hand. The patient complains of pain and tingling of the thumb, index finger, long finger, and radial half of the ring finger. The therapist observes thenar weakness and
atrophy. Strength, reflexes, and sensation are within normal limits throughout the remainder of the right upper extremity. These signs and symptoms are characteristic of what diagnosis?

a. Ulnar nerve compression
b. Carpal tunnel syndrome
c. Pronator teres syndrome
d. Cervical root compression

Answer 39

b. Carpal tunnel syndrome

Question 40

A patient recovering from surgery for triple coronary artery bypass grafts is scheduled to begin a phase III cardiac rehabilitation program. During the resistance training portion of the circuit training program, the therapist instructs the patient to avoid the Valsalva maneuver. What are the expected adverse effects of the Valsalva maneuver?

a. Slowing of pulse and increased venous pressure are possible.
b. The decreased return of blood to the heart can lead to pitting edema.
c. Heart rate (HR) and blood pressure are likely to be elevated.
d. A cholinergic or vagal response can occur.

Answer 40

a. Slowing of pulse and increased venous pressure are possible.

Question 41

A patient experiences color changes in the skin during position changes of the foot. During evaluation, pallor develops. When the limb is then positioned in the seated hanging position,
hyperemia develops. What do these changes indicate?

a. Lymphedema
b. Arterial insufficiency
c. Deep vein thrombophlebitis
d. Chronic venous insufficiency

Answer 41

b. Arterial insufficiency

Question 42

During an examination, a patient complains of right upper quadrant pain and tenderness. The PT percusses over the costal margin at the point where the lateral border of the rectus muscle intersects with the costal margin. The patient complains of acute pain and stops inspiratory effort. What does this patient’s response indicate?

a. Hernia
b. Acute cholecystitis
c. Irritation of the psoas muscle by an inflamed appendex
d. Peritoneal inflammation

Answer 42

b. Acute cholecystitis

Question 43

The therapist is evaluating the needs of a young child who is diagnosed with myelodysplasia at the T10 level. What is the therapist’s BEST choice of mobility device for this child to use in the school environment?

a. Bilateral knee-ankle-foot orthosis (KAFO)
b. Parapodium
c. Bilateral hip-knee-ankle-foot orthosis (HKAFO)
d. Lightweight wheelchair

Answer 43

d. Lightweight wheelchair

Question 44

An elderly and frail adult is referred to physical therapy for an examination of balance. The patient has a recent history of falls (two in the last 6 months). Based on knowledge of balance changes in the elderly and scoring of standardized balance measures, which of the following test results BEST indicates increased fall risk?

a. Tinetti Performance Oriented Mobility Assessment (POMA) score of 27
b. Functional Reach of inches
c. Timed Get UP & GO (GUG) test result of 13 seconds.
d. Berg Balance score of 50

Answer 44

b. Functional Reach of inches

Question 45

A 72-year-old patient is walking on a treadmill in the physical therapy department while vital signs and pulse oximetry are being monitored. It is noted that the patient’s arterial oxygen saturation (SpOz) drops from 95% to 92%. What is the therapist’s BEST response to this change?

a. Place a 40% O2 face mask on the patient for the remainder of the exercise session.
b. Not use supplemental O2
c. Place 2L of O2 by nasal cannula on the patient for the remainder of the exercise session
d. Place a 100% O2 face mask on the patient for the remainder of the exercise session.

Answer 45

d. Place a 100% O2 face mask on the patient for the remainder of the exercise session.

Question 46

A patient has limited right rotation caused by left thoracic facet joint capsular tightness at T6-7, what arthrokinematic glide would MOST effectively improve right rotation in sitting?

a. Superior and anterior glide on the right T7 transverse process.
b. Superior and anterior glide on the left T7 transverse process.
c. Superior and anterior glide on the right T6 transverse process.
d. Superior and anterior glide on the left T6 transverse process.

Answer 46

d. Superior and anterior glide on the left T6 transverse process.

Question 47

Which muscles provide fairly continuous activity during quiet standing when measured by EMG?

a. Quadriceps femoris and anterior tibialis
b. Posterior tibialis and intrinsic foot muscles
c. Anterior tibialis and peroneals
d. Soleus and gastrocnemius

Answer 47

d. Soleus and gastrocnemius

Question 48

A patient falls while walking in the parallel bars. The therapist is required to fill out an incident report of the event. In addition to the names of those involved, what information is required in an incident report?

a. A description of the event, where the patient was injured, and the corrective actions to be taken.
b. Witness reports and therapist’s opinion as to the cause
c. What occurred, when and where it occurred, and witness statements.
d. The cause of this fall and cross-references to others who have fallen in the parallel bars

Answer 48

d. The cause of this fall and cross-references to others who have fallen in the parallel bars

Question 49

A therapist is beginning manual lymphatic drainage for a patient recently diagnosed with secondary lymphedema in the left upper extremity following a radical mastectomy. What is the BEST choice for initial bandaging of the limb?

a. Long-stretch compression wrap (Ace wrap).
b. Custom-made low-elastic garment
c. Gauze wrap
d. Short-stretch compression wrap (comprilan®)

Answer 49

d. Short-stretch compression wrap (comprilan®)

Question 50

The PT is supervising a phase II cardiac rehabilitation class of 10 patients. One of the patients, who is being monitored with radiotelemetry, is having difficulty. Which change would be a criterion for terminating this exercise session?

a. An increase in systolic BP to 150 and diastolic BP to 90
b. 1-mm ST segment depression,up sloping.
c. A second-degree atrioventricular (AV) heart block
d. An increase in HR 20 beats/minute above resting

Answer 50

c. A second-degree atrioventricular (AV) heart block

Question 51

An elderly individual was found unconscious at home and was hospitalized with a diagnosis of cerebrovascular accident (CVA). Examination by the PT reveals normal sensation and movement on the right side of the body with impaired sensation (touch, pressure, proprioception) and paralysis on the left side of the body. The left side of the lower face and trunk are similarly impaired. What is the MOST likely location of the CVA?

a. Left parietal lobe
b. Right parietal lobe
c. Left side of brain stem
d. Spinal cord

Answer 51

b. Right parietal lobe

Question 52

The loss of sensory function in peripheral neuropathy is often among the first noticeable symptoms. With large fiber damage, what is the typical pattern of sensory loss?

a. Allodynia of the feet accompanied by pronounced dorsiflexor weakness
b. Band-like dysesthesias and paresthesias in the hips and thighs
c. Paresthesias affecting primarily the proximal limb segments and trunk
d. Stocking and glove loss of light touch and position sense

Answer 52

d. Stocking and glove loss of light touch and position sense

Question 53

A patient presents with severe claudication that is evident when walking distances greater than 200 feet. The patient also exhibits muscle fatigue and cramping of both calf muscles. Upon examination, the PT finds the skin is pale and shiny with some trophic nail changes. What is the BEST choice for this patient’s initial exercise program?

a. Avoid any exercise stress until the patient has been on calcium channel blockers for at least 2 weeks.
b. Begin with an interval walking program, exercising just to the point of pain.
c. Utilize non-weight-bearing exercises such as cycle ergometry.
d. Utilize a walking program of moderate intensity, instructing the patient that some pain is expected and to be tolerated.

Answer 53

b. Begin with an interval walking program, exercising just to the point of pain.

Question 54

A patient is hospitalized with diabetes and a large stage I plantar ulcer located over the right heel. The patient has been non-weight bearing for the past 2 weeks as a result of the ulcer. What is the BEST choice for this patient’s initial intervention?

a. Wash the foot and apply skin lubricants followed by a transparent film dressing.
b. Clean and bandage with a sterile gauze dressing.
c. Refer the patient for a surgical consult
d. Clean and debride the wound and apply a hydrogel dressing.

Answer 54

d. Clean and debride the wound and apply a hydrogel dressing.

Question 55

A PT is prescribing a wheelchair for a patient with left hemiplegia who is of average height (5 feet 7 inches). Which of the following is the BEST choice to improve the patient’s function?

a. Desk armrests
b. A 20-inch seat height
c. A 17.5-inch seat height
d. Elevating leg rests

Answer 55

c. A 17.5-inch seat height

Question 56

A patient who is participating in a cardiac rehabilitation program suddenly collapses and falls to the floor. The PT is the lone rescuer on site. The therapist checks for a response and finds the patient unresponsive. After activating the emergency response system (phone 911), what is the BEST action for the therapist to take?

a. Use the automated external defibrillator (AED) to shock the patient after 3 minutes of cardiopulmonary resuscitation (CPR)
b. Begin CPR and attach and use the AED as soon as possible
c. Give 100 chest compressions per minute.
d. Give two rescue breaths followed by 15 chest compressions, repeating the cycle for at least 2 minutes

Answer 56

b. Begin CPR and attach and use the AED as soon as possible

Question 57

A patient who was caster for 3 weeks after a grade III right ankle sprain has been referred to physical therapy for mobility exercises. Examination shows a loss of 10° of dorsiflexion. Which activity will be the MOST difficult for the patient?

a. Ambulating over rough surfaces
b. Descending stairs
c. Ambulating barefoot
d. Descending a ramp

Answer 57

b. Descending stairs

Question 58

What is the torque output produced in the sitting position during isokinetic exercise involving the hamstring muscle?

a. Higher than the torque actually generated by the contracting hamstrings.
b. Lower because of resistance of the quadriceps.
c. Higher because of eccentric assistance of the quadriceps.
d. Lower than the torque actually generated by the hamstrings

Answer 58

a. Higher than the torque actually generated by the contracting hamstrings.

Question 59

A patient presents with an acute onset of vertigo overnight. Symptoms worsen with rapid change in head position. If the head is held still, symptoms subside usually within 30-60 seconds. What is the MOST likely cause of these symptoms?

a. Meniere’s disease
b. Benign paroxysmal positional vertigo (BPPV)
c. Bilateral vestibular neuritis
d. Acoustic neuroma

Answer 59

b. Benign paroxysmal positional vertigo (BPPV)

Question 60

Which is the BEST choice of manual therapy technique to correct a closing restriction of T5 on T6?

a. Unilateral posteroanterior (PA) pressure at a 60° angle on the left transverse process of T6 while stabilizing T5.
b. Central PA pressure at a 60° angle on the spinous process of T6 while stabilizing T5
c. Unilateral PA pressure at a 45° angle on the right transverse process of T6 while stabilizing T5
d. Central PA pressure at a 45° angle on the spinous process of T5 while stabilizing T6

Answer 60

b. Central PA pressure at a 60° angle on the spinous process of T6 while stabilizing T5

Question 61

A patient with a significant history of coronary artery disease is currently taking atropine. Based on knowledge of this medication, what are the expected effects?

a. Increased HR and contractility at rest.
b. Increased myocardial ischemia.
c. Palpitations at rest and with exercise.
d. Orthostatic hypotension

Answer 61

a. Increased HR and contractility at rest.

Question 62

A patient recovering from a stroke is taking warfarin (Coumadin). What potential adverse reactions are associated with this medication?

a. Hematuria and ecchymosis
b. Palpitations and edema
c. Edema and dermatitis
d. Cellulitis and xeroderma

Answer 62

a. Hematuria and ecchymosis

Question 63

The PT reviewed the laboratory results of a patient admitted to the acute care hospital yesterday: Hematocrit 45%, fasting blood glucose 180 mg/dL, and cholesterol 180 mg/dL. Based on these laboratory results, what condition is MOST likely?

a. Polycythemia vera
b. Hyperglycemia of diabetes
c. Anemia
d. Hyperlipidemia

Answer 63

b. Hyperglycemia of diabetes

Question 64

An elderly patient has been hospitalized and on complete bed rest for 10 days. A physical therapy referral requests mobilization out of bed and ambulation. The patient complains of aching in the right calf. The therapist’s examination reveals calf tenderness with slight swelling and warmth. What is the BEST course of action for the therapist?

a. Begin with ankle pump exercises in bed and then ambulate.
b. Postpone ambulation and report the findings immediately.
c. Ambulate the patient with support stockings on.
d. Use only AROM exercises with the patient sitting at the edge of the bed.

Answer 64

b. Postpone ambulation and report the findings immediately.

Question 65

A patient recovering from a stroke is having difficulty with stair climbing. During ascent, the patient is able to position the more involved foot on the step above but is unable to transfer the weight up to the next stair level. What is the BEST exercise intervention to remediate this problem?

a. Bridging, holding.
b. Standing, side steps.
c. Standing, partial wall squats
d. Plantigrade, knee flexion with hip extension

Answer 65

c. Standing, partial wall squats

Question 66

A patient with osteoporosis and no fractures complains of increased middle and lower back pain during breathing and other functional activities. What is the MOST beneficial exercise intervention for this patient?

a. Trunk flexion and rotation exercises
b. Trunk flexion and extension exercises
c. Trunk extension and abdominal stabilization exercises
d. Trunk rotation and abdominal stabilization exercises.

Answer 66

c. Trunk extension and abdominal stabilization exercises

Question 67

A 9-year-old boy with Duchenne’s muscular dystrophy is referred for home care. How should the therapist begin the examination?

a. Ask the parents to outline the boy’s past rehabilitation successes.
b. Ask the child and his parents to describe the boy’s most serious functional limitations
c. Perform a complete motor examination
d. Perform a functional examination using the weeFIM

Answer 67

b. Ask the child and his parents to describe the boy’s most serious functional limitations

Question 68

During an examination of an adolescent female who complains of anterior knee pain, the PT observes that the lower extremity shows medial femoral torsion and toeing-in position of the feet. What pathology of the hip is commonly associate with medial femoral torsion and toeing-in?

a. Retroversion
b. Anteversion
c. Medial/internal rotation
d. Lateral/external rotation

Answer 68

b. Anteversion

Question 69

A single 22-year-old woman who is 3 months pregnant arrives at a therapist’s private practice complaining of shoulder and leg pain. She has a black eye and some bruising at the wrists. The state in which the therapist practices has direct access. What is the BEST course o f action for the therapist?

a. Examine the patient, and if abuse is suspected, report the findings to the appropriate authorities
b. Administer massage for bruising, TENS, and ice modalities for pain, as indicated by the examination findings
c. Direct the patient to the nearest ambulatory care center for physician evaluation
d. Refuse to examine the patient and send her to the nearest emergency room

Answer 69

a. Examine the patient, and if abuse is suspected, report the findings to the appropriate authorities

Question 70

A patient presents with pain radiating down the posterior hip and thigh as a result of a herniated disc in the lumbar spine. The therapist decides to apply mechanical traction. If the patient can tolerate it, what is the preferred patient position?

a. Supine with one knee flexed
b. Prone with pillow under the abdomen
c. Supine with both knees flexed
d. Prone with no pillow

Answer 70

d. Prone with no pillow

Question 71

A patient recovering from stroke demonstrates hemiparesis of the right upper extremity with moderate flexion and extension synergies (flexion stronger than extension). The therapist’s goal is to strengthen the shoulder muscles first to promote elevation of the arm. What is the BEST exercise intervention to achieve this goal?

a. Shoulder abduction with elbow flexion
b. Shoulder flexion with elbow extension
c. Shoulder horizontal adduction with elbow extension
d. Shoulder horizontal adduction with elbow flexion

Answer 71

b. Shoulder flexion with elbow extension

Question 72

An elderly patient presents with stage III decubitus ulcer on the plantar surface of the right foot. After a series of conservative interventions with limited success, the therapist chooses to apply electrical stimulation for tissue repair. What is the BEST electrical current to administer in this case?

a. Medium-frequency burst current
b. High-volt monophasic pulsed current
c. Medium-frequency beat current.
d. Low-volt biphasic pulsed current

Answer 72

b. High-volt monophasic pulsed current

Question 73

A physical therapist shines a light into a patient’s eye and observes the pupil of the eye. Constriction of the pupil results. Which cranial nerve is being tested?

a. Abducens
b. Trochlear
c. Optic
d. Oculomotor

Answer 73

d. Oculomotor

Question 74

A patient is referred for physical therapy after a graded exercise test (GXT). The physician reports the test was positive and had to be terminated at 7 minutes. Which of the following criteria is an absolute indication for terminating exercise testing?

a. Mild angina and dyspnea with progressive increases in the treadmill speed and grade
b. A hypertensive response with blood pressure of at least 170/95.
c. ST segment depression from baseline of 3-mm horizontal or downsloping depression.
d. ECG changes from baseline of 1-mm ST segment elevation.

Answer 74

c. ST segment depression from baseline of 3-mm horizontal or downsloping depression.

Question 75

A college soccer player sustained a hyperextension knee injury when kicking the ball with the other lower extremity. The patient was taken to the emergency room of a local hospital and was diagnosed with “knee sprain.” The patient was sent to physical therapy the next day for rehabilitation. As part of the examination, the therapist conducts the test. Based on a positive test, what type of exercise intervention is indicated during the acute phase o f treatment?

a. Open-chain terminal knee extension exercises.
b. Closed-chain terminal knee extension exercises.
c. Plyometric functional exercises.
d. Agility exercises

Answer 75

b. Closed-chain terminal knee extension exercises.

Question 76

A patient with a grade III diabetic ulcer is being treated with a calcium alginate wound dressing. What are the primary indications for this type of wound dressing?

a. Provide semirigid support for the limb while maintaining a sterile field.
b. Facilitate autolytic debridement and absorb exudate.
c. Absorb exudate and allow rapid moisture evaporation.
d. Restrict bacteria from the wound while supporting the tissues.

Answer 76

b. Facilitate autolytic debridement and absorb exudate.

Question 77

The PT receives a referral to treat a hospitalized patient with adhesive capsulitis. The patient is recovering from a recent hepatitis B infection. What precautions should the therapist observe?

a. Use of droplet transmission precautions
b. Use Contact Precautions
c. Ask the patient to wear gloves and avoid contact
d. Wear personal protection equipment (PPE) when transporting the patient to therapy.

Answer 77

b. Use Contact Precautions

Question 78

A patient recovering from traumatic brain injury (TBI) is unable to bring the right foot up on the step during stair climbing training. What is the BEST choice to promote independent stair climbing for this patient?

a. Practice Marching In Place
b. Strengthen the hip flexors using an isokinetic training device before attempting stair climbing
c. Passively bring the foot up and place it on the 7-inch step
d. Practice stair climbing inside the parallel bars using a 3-inch step.

Answer 78

d. Practice stair climbing inside the parallel bars using a 3-inch step.

Question 79

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Question 80

The PT is completing general activity recommendations for a group home of young adults with emotional and behavioral issues. All patients are chemically controlled with either antipsychotic or antidepressant medications. Full-time supervision is available for any activity recommended. Which exercise precautions would be important for the therapist to include?

a. Avoid games with throwing activities to prevent injuries
b. Promote rhythmic movement to soothing music to avoid agitation
c. Promote activities with sequential movements to improve memory
d. Avoid aerobic exercise outdoors when temperature is over 90°F

Answer 80

d. Avoid aerobic exercise outdoors when temperature is over 90°F

Question 81

A patient with a transtibial amputation is learning to walk using a patellar tendon-bearing (PTB) prosthesis and is having difficulty maintaining knee stability from heel strike to foot-flat. Which muscles are MOST likely weak?

a. Hip flexors
b. Back extensors
c. Knee extensors
d. Knee flexors

Answer 81

c. Knee extensors

Question 82

Following an initial functional examination using the Functional Independence Measure (FIM), a patient is found to require minimal contact assistance in transferring from sit-to-stand and bed-to-wheelchair. Which of the following accurately documents these results?

a. FIM level 4; completes activity with 75% or more of the effort
b. FIM level 6; completes activity with extra time
c. FIM level 5; completes activity with cueing
d. FIM level 3; completes activity with 50% or more but less than 75% of the effort.

Answer 82

a. FIM level 4; completes activity with 75% or more of the effort

Question 83

The therapist is on a home visit, scheduled at lunchtime, visiting an 18-month-old child with moderate developmental delay. The therapist notices that the child and mother are experiencing difficulties with feeding. The child is slumped down in the highchair and is unsuccessfully attempting to use a raking grasp to lift cereal pieces to the mouth. Both the child and the mother are frustrated. Which intervention should the therapist work on FIRST?

a. Recommended that the mother return to breastfeeding for a few more months
b. Work on desensitizing the gag reflex
c. Recommended that the mother feed the child baby food instead of cereal for a few more months
d. Reposition the child in a proper sitting position using postural supports.

Answer 83

d. Reposition the child in a proper sitting position using postural supports.

Question 84

A patient is referred to physical therapy with a diagnosis of “frozen shoulder.” Which of the following is the BEST choice of technique to mobilize the shoulder?

a. Lateral glide in neutral position
b. Inferior glide at 55° of abduction
c. Posterior glide at 10° of abduction
d. Inferior glide at 95° of abduction

Answer 84

b. Inferior glide at 55° of abduction

Question 85

A patient presents with an insidious onset of pain in the jaw that is referred to the head and neck regions. As best as the patient can recall, it may be related to biting into something hard. Cervical ROM is limited in flexion by 20°, cervical lateral flexion limited to the left by 10°. Mandibular depression is 10 mm with deviation to the left, protrusion is 4 mm, and lateral deviation is 15 mm to the right and 6 mm to the left. What is the MOST likely diagnosis given this patient’s symptoms?

a. Weak lateral pterygoids on the right
b. Weak lateral pterygoids on the left
c. Capsule-ligamentous pattern of temporomandibular joint (TMJ on the left.)
d. Cervical spine and TMJ capsular restrictions on the left.

Answer 85

c. Capsule-ligamentous pattern of temporomandibular joint (TMJ on the left.)

Question 86

A patient has been referred to physical therapy with a diagnosis of cervicogenic headaches. During the initial examination, the therapist notes clinical findings of a droopy eyelid, constricted pupil (a pinpoint pupil), and lack of sweating on the same side of the face. What is the MOST likely diagnosis based on this group of symptoms?

a. Horner’s syndrome
b. Bell’s palsy
c. Trigeminal neuralgia
d. Myasthenia gravis

Answer 86

a. Horner’s syndrome

Question 87

A patient with a recent history of rib fractures suddenly becomes short of breath during a bout of coughing. The patient looks panicked and complains of sharp pain in the left chest. A quick screen shows a deviated trachea to the right, among other signs and symptoms. What is the MOST likely diagnosis based on these symptoms?

a. Pulmonary emboli
b. Pneumothorax
c. Angina
d. Mucous plugging of an airway

Answer 87

b. Pneumothorax

Question 88

A patient presents with supraspinatus tendinitis. After the initial cryotherapy, the therapist decides to apply ultrasound (US). In what position should the therapist place the shoulder joint in order to effectively treat the supraspinatus tendon?

a. Adduction and external rotation
b. Slight abduction and internal rotation
c. Adduction and internal rotation
d. Slight abduction and external rotation

Answer 88

b. Slight abduction and internal rotation

Question 89

A patient is referred for postmastectomy rehabilitation. During the initial examination, the therapist observes an irregular area of skin on the patient’s shoulder about 7mm in diameter. The patient reports that there has always been a mole there but is more prominent lately and that the color has changed, now ranging from black to red to blue. How should the therapist document this finding?

a. Papule
b. Wheal
c. Atypical dysplastic nevus
d. Benign nevus

Answer 89

c. Atypical dysplastic nevus

Question 90

A patient is 2 days, post-left CVA and has just been moved from the intensive care unit to a stroke unit. When beginning the examination, the therapist finds the patient’s speech slow and hesitant. The patient is limited to one- and two-word productions, and expressions are awkward and arduous. However, the patient demonstrates good comprehension. What type of speech disorder is this patient exhibiting?

a. Fluent aphasia
b. Global aphasia
c. Nonfluent aphasia
d. Dysarthria

Answer 90

c. Nonfluent aphasia

Question 91

A patient recovering from traumatic brain injury (TBI) is functioning at level IV on the Rancho Los Amigos Levels ofCognitive Functioning Scale (LOCF). During the therapist’s initial examination, the patient becomes agitated and tries to bite the therapist. What is the therapist’s BEST course of action?

a. Postpone the examination for 1 week and then try again
b. Restructure the formal examination so the therapist can complete ti in three very short sessions.
c. Document the behaviors and engage in a calming activity.
d. Postpone the examination until later in the day when the patient calms down

Answer 91

c. Document the behaviors and engage in a calming activity.

Question 92

A therapist is working on a cardiac care unit in an acute care facility. After exercising a patient recovering from a ventricular infarct, the therapist notices fatigue and dyspnea after mild activity. Later that day, on a return visit, the therapist notices the patient has a persistent spasmodic cough while lying in bed, heart rate is rapid (140), and slight edema is evident in both ankles. The patient appears anxious and agitated. What are these signs and symptoms characteristic of?

a. Developing pericarditis
b. Right ventricular failure
c. Impeding MI
d. Left ventricular failure

Answer 92

d. Left ventricular failure

Question 93

A patient with anterior knee pain has increased adduction and internal rotation at the hip when performing a squat. Which muscle are MOST likely weak, causing this compensatory movement?

a. Knee flexors and extensors
b. Hip adductors and internal rotators
c. Hip and knee flexors
d. Hip abductors and external rotators

Answer 93

d. Hip abductors and external rotators

Question 94

A patient has been taking corticosteroids (hydrocortisone) for management of adrenocortical insufficiency and is referred to physical therapy for mobility training after a prolonged hospitalization. What are the potential adverse effects from prolonged use of this medication?

a. Hypotension and myopathy
b. Decreased appetite and weight loss
c. Atrophy and osteoporosis
d. Confusion and depression

Answer 94

c. Atrophy and osteoporosis

Question 95

A PT is treating a patient with deep partial-thickness burns over 35% of the body (chest and arms). Wound cultures reveal a bacterial count in excess of 105/g of tissue on the anterior left arm. What are the reasonable expectations for this type of burn wound?

a. With antibiotics, spontaneous healing can be expected.
b. The risk of hypertrophic and keloid scars is low because there is no viable tissue
c. The burn area is pain free because all nerve endings in the dermal tissue were destroyed
d. The infected wound can convert the area to a full-thickness burn

Answer 95

d. The infected wound can convert the area to a full-thickness burn

Question 96

Recently, a 10-year-old patient has begun walking with supination of the right foot. With the shoe off, the therapist finds a new callus on the lateral side of the metatarsal head of the fifth toe. Which of the following is the BEST choice for orthotic prescription for this patient?

a. Thomas Heel
b. Viscoelastic shoe insert with a forefoot medial wedge
c. Viscoelastic shoe insert with forefoot lateral wedge
d. Scaphoid pad.

Answer 96

c. Viscoelastic shoe insert with forefoot lateral wedge

Question 97

A patient is recovering from a right total hip replacement (posterolateral incision, cementless fixation). During initial healing, what is the MOST appropriate type of bed-to- wheelchair transfer to teach this patient?

a. Squat-pivot transfer to the surgical side
b. Lateral slide transfer to the surgical side using a transfer board
c. Stand-pivot transfer to the sound side
d. Stand-pivot transfer to the surgical side

Answer 97

c. Stand-pivot transfer to the sound side

Question 98

The therapist is treating a child with mild developmental delay secondary to 7 weeks prematurity at birth. The child is now 8 months old and is just learning to sit. Which is the BEST choice for a training activity?

a. Sideward protective extension in sitting.
b. Supine tilting reactions
c. Standing Tilting Reactions
d. Prone tilting reactions

Answer 98

a. Sideward protective extension in sitting.

Question 99

During an initial interview and history, a patient with a right CVA seems unconcerned about obvious paralysis of the left arm and leg. When the therapist asks the patient to describe what happened, the patient says “I must have slept wrong and my arm and leg fell asleep.” The patient further tells the therapist, “My family put me in this place so they could go on vacation.” Which type of perceptual disorder BEST characterizes the patient’s responses?

a. Anosognosia
b. Prosopagnosia
c. Spatial relations disorder
d. Somatoagnosia

Answer 99

a. Anosognosia

Question 100

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Question 101

A patient with complete spinal cord injury at the level of T1 is on a bowel program. Which of the following is the MOST effective bowel training program for this patient?

a. Diet and medications to manage a flaccid bowel
b. Digital stimulation of intact defecation reflexes
c. Manual removal of stool from the rectum
d. Medications such as laxative for passive elimination

Answer 101

d. Medications such as laxative for passive elimination

Question 102

When performing scoliosis screening in a school setting, what is the optimal age for girls to be screened?

a. 12-14
b. 6-8
c. 9-11
d. 15-17

Answer 102

c. 9-11

Question 103

A patient with a confirmed left C6 nerve root compression due to foraminal encroachment complains of pain in the left thumb and index finger. What is the MOST effective cervical motion to alleviate this patient’s pain?

a. Lower cervical flexion
b. Right rotation
c. Lower cervical extension
d. Left side bending

Answer 103

a. Lower cervical flexion

Question 104

A patient is standing with excessive subtalar pronation. Which of the following indicates the obligatory motions that accompany this condition?

a. Tibial, femoral, and pelvic external rotation
b. Tibial and femoral internal rotation with pelvic external rotation
c. Tibial and femoral external rotation with pelvic internal rotation
d. Tibial, femoral, and pelvic internal rotation

Answer 104

a. Tibial, femoral, and pelvic external rotation

Question 105

Which of the following conditions associated with pelvic floor muscle dysfunction may actually worsen when treated with Kegel exercises?

a. Interstitial cystitis
b. Stress incontinence
c. Pelvic Organ Prolapse
d. Chronic constipation

Answer 105

a. Interstitial cystitis

Question 106

Which of the following gastrointestinal sources of pain can refer to the shoulder?

a. Esophageal pain
b. Colon or appendix pain
c. Spleen or diaphragmatic pain
d .Gallbladder pain

Answer 106

c. Spleen or diaphragmatic pain

Question 107

A therapist is applying a symmetrical biphasic pulsed current to the vastus medialis to improve patellar tracking during knee extension. The patient complains that the current is uncomfortable. To make the current more tolerable to the patient, yet maintain a good therapeutic effect, what should the therapist adjust?

a. Current polarity
b. Pulse duration
c. Current intensity
d. Pulse rate

Answer 107

b. Pulse duration

Question 108

A patient presents with symptoms of uncoordinated eye movements, profound gait and trunk ataxia, and difficulty with postural orientation to vertical. Balance deficits are pronounced in standing with eyes open and eyes closed. Examination of the extremities reveals little change in tone or coordination. What is the likely CNS location of the patient’s dysfunction?

a. Premotor cortex
b. Vestibulocerebellum
c. Spinocerebellum
d. Basal ganglia

Answer 108

b. Vestibulocerebellum

Question 109

A patient with a 10-year history of diabetes complains of cramping, pain, and fatigue to the right buttock after walking 400 feet or climbing stairs. When the patient stops exercising, the pain goes away immediately. The skin of the involved leg is cool and pale. The therapist checks the record and finds no mention of this problem. Given this patient’s symptoms, what is the likely diagnosis?

a. Peripheral nerve injury
b. Spinal nerve root impingement
c. Raynaud’s phenomenon
d. Peripheral arterial disease (PAD)

Answer 109

d. Peripheral arterial disease (PAD)

Question 110

A patient with lower back pain has marked elevation of BP and complains of mild to severe mid-abdominal pain that increases upon exertion. Palpation reveals a pulsating mass in the lower abdomen. What is the therapist’s BEST course of action?

a. Discontinue treatment and notify the patient’s physician immediately
b. Provide hot packs to the abdomen to help relieve the muscle spasm
c. Instruct the patient to contract his/her physician at the conclusion of therapy
d. Instruct in relaxation exercises because a pulsating mass is not unusual with hypertension

Answer 110

a. Discontinue treatment and notify the patient’s physician immediately

Question 111

A patient presents for the initial examination with an acute and painful shoulder impingement. During the examination, the PT finds significantly increased muscle guarding around the shoulder girdle with difficulty in accurately assessing joint mobility. Which manual therapy technique is the BEST option to use to assist in performing a proper assessment?

a. Maitland grade III posterior glide to the glenohumeral joint
b. Maitland grade I oscillation to the glenohumeral joint
c. Maitland grade III inferior glide to the glenohumeral joint
d. Maitland grade IV inferior glide to the glenohumeral joint

Answer 111

b. Maitland grade I oscillation to the glenohumeral joint

Question 112

A frail, elderly wheelchair-dependent resident of a community nursing home has a diagnosis of organic brain syndrome, moderate Alzheimer’s type dementia. During the therapist’s interview, the patient demonstrates limited interaction and mild agitation and keeps trying to wheel the chair down the hall. Because it is late in the day, the therapist decides to resume the examination the next morning. How should the therapist document this in the medical record?

a. Disorientation to time and date
b. Inattention as a result of short-term memory loss
c. Frustration because of an inability to communicate
d. Sundowning behavior

Answer 112

d. Sundowning behavior

Question 113

A patient with a right trans femoral amputation is undergoing prosthetic training. What is the BEST technique to use to improve the patient’s shortened step length on the right?

a. Provide anterior-directed resistance to the right PSIS during swing
b. Provide posterior-directed resistance to the left ASIS during swing
c. Provide posterior-directed resistance to the right ASIS during stance
d. Facilitate the glutes with tapping over the muscle belly.

Answer 113

c. Provide posterior-directed resistance to the right ASIS during stance

Question 114

An elderly, frail resident of an extended care facility has intractable constipation. During a scheduled visit from the PT, the patient complains of abdominal pain and tenderness. Where may this patient experience referred pain?

a. Buttock, thigh, and posterior leg
b. Anterior hip, groin, or thigh region
c. Low back and front of the thigh to the knee
d. Medial thigh and leg

Answer 114

b. Anterior hip, groin, or thigh region

Question 115

An adult patient is diagnosed with thoracic outlet syndrome. The patient presents with guarding in the upper trapezius and scalene muscles. Given this situation, which technique would be the MOST effective way to decrease the muscle guarding and provide pain relief?

a. Maitland grade V manipulation of the C6-C7 joint
b. Maitland grade I mobilization of the atlanto-axial joint
c. Maitland grade III mobilization of the C6-C7 joint
d. Maitland grade V manipulation of the first rib

Answer 115

d. Maitland grade V manipulation of the first rib

Question 116

A patient presents with decreased motion at the occipitoatlantal joint (OA). The PT wants to use the principles of coupled motions that occur in that area of the spine during manual therapy techniques. In order to improve OA mobility, when the occiput is side bent to the right, how should the therapist mobilize C1?

a. Into rotation to the left
b. Into rotation to the right
c. Back into extension
d. Forward into flexion

Answer 116

a. Into rotation to the left

Question 117

An apparently healthy individual has several risk factors for coronary artery disease. The client is interested in improving overall fitness and cardiac health. After a graded exercise test, which was asymptomatic, the client is referred for an exercise class. Which is the BEST measure of exercise intensity in a newly tested and exercising individual?

a. Heart rate (HR)
b. Rating of perceived exertion (RPE)
c. MET level
d. Respiratory rate

Answer 117

a. Heart rate (HR)

Question 118

A mother brings her 8-week-old infant to be examined at early intervention clinic because she noticed that the infant was taking steps in supported standing at 2 weeks but is not able to do it now. What should the therapist do given the infant’s symptoms and behaviors?

a. Recommend that the mother bring the infant to a pediatric neurologist
b. Explain that this was abnormal and it is a good sign that it has disappeared.
c. Recommend that a full developmental examination be performed by the early intervention team
d. Explain that this is normal and that this early automatic walking is a newborn response

Answer 118

d. Explain that this is normal and that this early automatic walking is a newborn response

Question 119

A patient complains of pain with mouth opening that makes it difficult to eat foods that require chewing, Which of the following provides the normal limits of mouth opening that should guide the therapist’s examination?

a. 15-24 mm
b. 35-50mm
c. 51-65 mm
d. 66-74 mm

Answer 119

b. 35-50mm

Question 120

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Question 121

A patient presents with complaints of tingling and paresthesias in the median nerve distribution of the right forearm and hand. The following tests were found negative bilaterally: Adson’s hyperabduction, costoclavicular, Phalen’s, and the ulnar nerve Tinel’s sign. Based on this information, what Is the likely diagnosis?

a. Ulnar nerve entrapment
b. Pronator teres syndrome
c. Thoracic outlet syndrome (TOS)
d. Carpal tunnel syndrome

Answer 121

b. Pronator teres syndrome

Question 122

A young adult patient is referred to outpatient physical therapy for an insidious onset of thoracic spine stiffness and mild pain. The patient reports a great deal of difficulty moving the mid-back region in the morning and states that thus has become progressively worse over the past 6 months. The neurological exam is negative. Based on these symptoms, what is the likely diagnosis?

a. Pneumothorax
b. Thoracic compression fracture
c. Ankylosing spondylitis
d. Lyme disease

Answer 122

c. Ankylosing spondylitis

Question 123

An adolescent felt a “clunk” in the lumbar spine 2 weeks ago while lifting weights. There was immediate right lumbar pain and spasm. Posteroanterior 1 mm anterior to L5 on the lateral views. Which of the following imaging techniques would give the PT the best information regarding a diagnosis and formulating a plan of care for this individual?

a. Posteroanterior computed tomography (CT) scan
b. Posteroanterior TI magnetic resonance imaging (MRI)
c. Bilateral oblique radiographs
d. Right oblique radiograph

Answer 123

c. Bilateral oblique radiographs

Question 124

A young patient presents with primary lymphedema of the right lower extremity. What is the BEST choice for initial exercise?

a. Treadmill walking
b. Treadmill jogging
c. Exercising on a stair climbing machine
d. Step aerobics

Answer 124

a. Treadmill walking

Question 125

An elderly patient is recovering from a right CVA and demonstrates strong spasticity in the left upper extremity. The therapist wants to reduce the expected negative effects of spasticity in the left upper extremity while the patient is working on sitting control. What is the BEST position for the upper extremity?

a. Left elbow flexed with arm resting on supporting pillow, positioned on the patient’s lap
b. Affected upper extremity extended and internally rotated with the hand at the side
c. Left shoulder abducted and externally rotated with elbow extended and weight supported on the palm of the hand
d. Left shoulder adduction and internal rotation with arm extended and hand resting on the thigh

Answer 125

c. Left shoulder abducted and externally rotated with elbow extended and weight supported on the palm of the hand

Question 126

During an initial examination, the therapist occludes vision by having the patient close the eyes. What can the therapist effectively examine?

a. Discriminative touch and fast pain but not proprioception
b. Vestibular/ visual / somatosensory integration
c. Conscious proprioception but not discriminative touch
d. Somatosensory integrity

Answer 126

d. Somatosensory integrity

Question 127

A 28-year-old professional mountain bike rider presents to cardiac rehabilitation after suffering a myocardial infarction 8 weeks ago. Which graded exercise test would be MOST beneficial in order to assess aerobic capacity in this patient in order to create an aerobic conditioning program?

a. Bruce protocol
b. Step test
c. Lower extremity ergometer
d. 6-minute walk test

Answer 127

c. Lower extremity ergometer

Question 128

A patient with trigeminal nerve neuralgia (CN V) is referred to the physical therapist. What are the expected examination findings?

a. Sudden severe pains in the ophthalmic division of CN V
b. Paroxysmal and severe pain originating from the mandibular or maxillary divisions of CNV
c. Unilateral sensory loss of the ophthalmic division of CN V
d. Bilateral sensory loss of CN V in all three divisions

Answer 128

b. Paroxysmal and severe pain originating from the mandibular or maxillary divisions of CNV

Question 129

A patient with hypothyroidism and poor drug compliance is referred to physical therapy following a fall. What symptoms might be evident during exercise based on this diagnosis?

a. Paresthesias of the lower limbs
b. Elevated cardiac output
c. Sinus tachycardia and arrhythmias
d. Myalgia and weakness

Answer 129

d. Myalgia and weakness

Question 130

A group of researchers utilized meta-analysis to identify the evidence for aerobic fitness exercises in the management of fibromyalgia. Thirteen randomized controlled trials (RCTs) and three controlled clinical trials (cohort studies and case control studies) were selected. What is the main difference between the two types of trials?

a. Duration of the studies
b. Use of multiple centers versus single center trials
c. Length of the studies
d. Use of randomization of subjects

Answer 130

d. Use of randomization of subjects

Question 131

A patient with a complete spinal cord injury at the level of TI (ASIA A) is in the community phase of mobility training. In order for the patient to navigate a 4-inch-height curb with the wheelchair, what should the therapist tell the patient to do?

a. Ascend backward with the large wheels first
b. Descend backward with the trunk upright and arms hooked around the push handles
c. Lift the front casters and ascend in a wheelie position
d. Place the front casters down first during descent

Answer 131

c. Lift the front casters and ascend in a wheelie position

Question 132

A patient with a long history of systemic steroid use for asthma control is hospitalized with pneumonia. Which of the following is a contraindication to percussion?

a. Barrel chest
b. BP > 140/90
c. Intercostal muscle wasting
d. Decreased bone density

Answer 132

d. Decreased bone density

Question 133

A patient with possible ligamentous injury of the knee presents with excessive tibial external rotation. Which ligament is MOST LIKELY to be injured?

a. Posterior cruciate
b. Medial patello-femoral
c. Anterior cruciate
d. Medial collateral

Answer 133

d. Medial collateral

Question 134

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Question 135

A patient suffered a meniscus injury and underwent recent meniscal repair surgery. What is the earliest the patient will be allowed to weight bear after surgery?

a. At the end of postsurgical week 1
b. Immediately
c. At the end of postsurgical week 3
d. At the end of postsurgical week 2

Answer 135

c. At the end of postsurgical week 3

Question 136

A therapist is treating a patient with a diagnosis of right shoulder rotator cuff tendinitis. The findings of a work site ergonomic assessment indicate that the worker is required to perform repetitive reaching activities above shoulder height. Which of the following is the MOST beneficial work site modification?

a. Reposition the height of the shelf and items to below shoulder height
b. Provide the worker with a taller, sit-stand chair
c. Allow the worker to take more frequent rests to avoid overuse
d. Provide the worker with a standing desk for daily activities

Answer 136

a. Reposition the height of the shelf and items to below shoulder height

Question 137

The patient has a fifth rib that is “stuck” in the position of maximal inspiration. Which technique is BEST to improve the rib mobility and assist it in returning to its resting position?

a. Maitland grade IV mobilization of the head of the rib at the costovertebral joint in the superior direction
b. Maitland grade II mobilization of the head of the rib at the costovertebral joint in the superior direction
c. Maitland grade IV mobilization of the head of the rib at the costovertebral joint in the inferior direction
d. Maitland grade I mobilization of the head of the rib at the costovertebral joint in the inferior direction

Answer 137

a. Maitland grade IV mobilization of the head of the rib at the costovertebral joint in the superior direction

Question 138

A patient with a fibular fracture complains of weakness in the ® LE following cash removal. Examination reveals measurable loss of muscle bulk (2-inch girth difference between the right and left legs). The therapist suspects neurogenic atrophy and next examines tone. Which finding is consistent with this diagnosis?

a. Normal tone
b. Hypotonia
c. Dystonia
d. Hypertonia

Answer 138

b. Hypotonia

Question 139

A teenager presents to the clinic with vague left hip and groin pain that worsens with weight bearing. The PT’s examination reveals limited and painful hip internal rotation, antalgic gait, and a weak gluteus medius. Based upon this clinical presensation, what is the MOST likely diagnosis?

a. Gluteus medius muscle strain
b. Oligoarticular juvenile rheumatoid arthritis (JRA)
c. Slipped capital femoral epiphysis (SCFE)
d. Legg-Calve-Perthes-disease

Answer 139

c. Slipped capital femoral epiphysis (SCFE)

Question 140

A patient has a 10-year history of peripheral vascular disease (PVD) affecting the right lower extremity. During auscultation of the popliteal artery, what would the therapist expect to find?

a. A positive Homan’s sign
b. Intense pain and cramping
c. Abruit
d. 4+ pulses

Answer 140

c. Abruit

Question 141

When performing the Thomas test, the patient’s thigh does not touch the table, indicating limited hip extension. The amount of limited hip extension does not change when the ipsilateral knee is extended. What is the range-limiting muscle?

a. Rectus femoris
b. Tensor fascia lata
c. Biceps femoris
d. Iliopsoas

Answer 141

d, Iliopsoas

Question 142

A patient with a transfemoral amputation and an above-knee prosthesis demonstrates knee instability while standing. The patient’s knee buckles easily when performing weight shifts. What is the MOST likely cause of the problem?

a. Weak gluteus medius
b. Prosthetic knee set too far anterior to the TKA line
c. Tight extension aid
d. Prosthetic knee set too far posterior to the trochanter-knee-ankle (TKA) line

Answer 142

b. Prosthetic knee set too far anterior to the TKA line

Question 143

An older adult at risk for falls has undergone a structured home-based exercise program that consisted of standing balance training and strengthening exercises. Which measure is the BEST choice to document improvements?

a. Timed Up & Go Test
b. Berg Balance Test
c. 6-Minute Walk Test
d. Performance-Oriented Mobility Assessment (Tinetti)

Answer 143

b. Berg Balance Test

Question 144

A middle-aged patient complains of “throbbing pain” in the lumbar region with activities upon exertion, such as walking up a flight of steps or playing tennis. The patient expresses no complains of pain with bending, twisting, sitting, standing, or walking any distance. Active movements of the lumbar spine are full and pain free. Provocation testing is negative. Neurological signs are unremarkable. There is no significant tenderness to palpation. What is the MOST likely diagnosis for this patient?

a. Lumbar disc herniation
b. Aortic aneurysm
c. Quadratus lumborum muscle strain
d. Sacroiliac joint sprain.

Answer 144

b. Aortic aneurysm

Question 145

A patient who is undergoing spinal cord rehabilitation is viewed as uncooperative by staff. The patient refuses to complete the training activities outlined to promote independent functional mobility. A review of history reveals that previously the patient was the director of a company with a staff of 20. What is the MOST appropriate action the therapist can take?

a. Have the patient work with a supervisor who is a person in authority
b. Refer the patient to a support group before resuming rehabilitation
c. Involve the patient in goal setting and structuring the training session
d. Carefully structure the activities and slow down the pace of training

Answer 145

c. Involve the patient in goal setting and structuring the training session

Question 146

A group of 10 patients is recruited into a study investigating the effects of relaxation training on blood pressure (BP). One group of patients is scheduled to participate in a supervised cardiac rehabilitation program that includes relaxation training three times a week for 12 weeks. The other group of patients is instructed to perform activities as usual. At the conclusion of the study, there was no significant difference between the groups; BP decreased significantly in both groups. What is the MOST accurate interpretation of this study?

a. The rehabilitation group was not properly monitored
b. Both groups had BPs initially so high that reductions should have been expected
c. The activities of the non rehabilitation group were not properly monitored and may account for these results.
d. Cardiac rehabilitation is not effective in reducing BP

Answer 146

c. The activities of the non rehabilitation group were not properly monitored and may account for these results.

Question 147

A therapist is examining a patient newly diagnosed with multiple sclerosis. The patient experiences an intense shock-like pain throughout the body when the neck is passively flexed. What is the correct term for the therapist to use in order to document these findings?

a. Lhermitte’s sign
b. Dysesthesias
c. Paresthesias
d. Uthoff’s sign

Answer 147

a. Lhermitte’s sign

Question 148

Which cluster of examination findings would indicate that a patient is in decompensated heart failure?

a. S4 heart sound, wheezes on lung auscultation, decreased jugular vein distension
b. S4 heart sound, crackles on lung auscultation, increased jugular vein distension
c. S2 Heart sound, crackles on lung auscultation, decreased jugular vein distension
d. S2 heart sound, wheezes on lung auscultation, increased jugular vein distension

Answer 148

b. S4 heart sound, crackles on lung auscultation, increased jugular vein distension

Question 149

A physical therapist is observing a child who is typically developing and has just begun to walk within the last month. Which of the following is expected in a child just learning to walk?

a. Neutral hip position
b. Bilateral hip adduction
c. Genu valgum
d. External rotation of the hips

Answer 149

d. External rotation of the hips

Question 150

Where should a therapist’s hand/fingers be located for posteroanterior mobilization to improve down-gliding/closure of the T7-8 facet joints?

a. Spinous process of T6
b. Transverse processes of T8
c. Spinous process of T8
d. Transverse processes of T7

Answer 150

b. Transverse processes of T8

Question 151

A patient complains of waking up several times at night from severe “pins and needles” in the right hand. On awakening, the hand feels numb for half an hour and fine hand movements are impaired. The therapist’s examination reveals sensory loss and paresthesias in the thumb, index, middle, and lateral half of the ring finger, and reduced grip and pinch strength. Some thenar atrophy is present. Based on these examination findings, what is the MOST appropriate diagnosis?

a. Pronator teres syndrome
b. Ulnar nerve entrapment
c. Thoracic outlet syndrome
d. Carpal tunnel syndrome

Answer 151

d. Carpal tunnel syndrome

Question 152

A patient is referred for physical therapy with a diagnosis of degenerative joint disease (DJD) affecting C2 and C3. The patient complains of pain and stiffness in the cervical region and transient dizziness with some cervical motions. What is the BEST initial examination procedure?

a. Vertebral artery test
b. Adson’s maneuver
c. Lhermitte’s test
d. Oppenheim’s test

Answer 152

a. Vertebral artery test

Question 153

A young, otherwise healthy, adult is recovering from a complete spinal cord injury (ASIA A) at the level of L4. What are the functional expectations for this individual?

a. Ambulation using bilateral AFOs and cane
b. Ambulation using bilateral KAFOs, crutches, and a swing-through gait
c. Ambulation using reciprocating gait orthoses and a reciprocating walker
d. Ambulation using bilateral KAFOs and a reciprocating walker

Answer 153

a. Ambulation using bilateral AFOs and cane

Question 154

To examine a patient with a suspected deficit in graphesthesia, what should the therapist ask the patient to identify with eyes closed?

a. Different objects placed in the hand and manipulated
b. The vibrations of a tuning fork when placed on a bony prominence
c. A series of letters traced on the hand
d. Differently weighted, identically shaped cylinders placed in the hand

Answer 154

c. A series of letters traced on the hand

Question 155

A patient recovering from stroke is ambulatory without an assistive device and demonstrates a consistent problem with an elevated and retracted pelvis on the affected side. Which manual therapeutic exercise procedure is the BEST choice to remediate this problem?

a. Provide downward compression during stance
b. Utilize light resistance to posterior pelvic elevation during swing
c. Provide anterior-directed pressure during swing
d. Utilize light resistance to forward pelvic rotation during swing

Answer 155

d. Utilize light resistance to forward pelvic rotation during swing

Question 156

A therapist suspects lower brain stem involvement in a patient with amyotrophic lateral sclerosis (ALS). Examination findings reveal motor impairments of the tongue with ipsilateral wasting and deviation on protrusion. These findings confirm the involvement of which cranial nerve?

a. Hypoglossal
b. Glossopharyngeal
c. Vagus
d. Spinal accessory

Answer 156

a. Hypoglossal

Question 157

A baseball pitcher report insidious onset of symptoms characteristic of impingement, including catching and popping in the throwing arm. Examination reveals that glenohumeral passive internal rotation is painful and limited to 30°. External rotation is less symptomatic and has 130° of passive range. What is the BEST initial course of action for the therapist?

a. Recommend an MRI
b. Mobilize the glenohumeral joint to increase internal rotation ROM
c. Begin elastic resistance exercises for impingement
d. Recommend an anteroposterior radiograph

Answer 157

a. Recommend an MRI

Question 158

A woman is hospitalized in the intensive care unit with multiple closed and open fractures after a motor vehicle accident. A review of her medical record reveals the following laboratory values: haematocrit 28%, hemoglobin 10 g/ 100 mL and serum white blood cell (WBC) count 12,000/mm°. What is the MOST accurate interpretation of these findings?

a. Only serum WBC is abnormal
b. Only hematocrit values are abnormal
c. Haematocrit and hemoglobin values are abnormal; WBC is normal
d. All values are abnormal

Answer 158

d. All values are abnormal

Question 159

A patient with a transfemoral amputation is unable to wear a total contact prosthesis for the past 4 days. Examination of the residual limb reveals erythema and edema extending over most of the lower anterior limb. The patient tells the therapist that the limb is very itchy and painful. What is the MOST likely cause of these symptoms?

a. Impetigo
b. Herpes Zoster
c. Cellulitis
d. Dermatitis

Answer 159

d. Dermatitis

Question 160

A PT is treating a patient who lacks wrist extension. The cause of the impingement is a problem at the radiocarpal joint with a lack of arthrokinematic motion necessary for proper wrist extension. What direction should the proximal aspect of the scaphoid/lunate glide?

a. In a dorsal direction relative to the radius
b. Radially
c. Ulnarly
d. In a palmar direction relative to the radius

Answer 160

d. In a palmar direction relative to the radius

Question 161

Following a hip fracture that is now healed, a patient presents with weak hip flexors (2/5). All other muscles are within functional limits. Based on these findings, what should the therapist expect the patient may display during gait?

a. Backward trunk lean
b. Forward trunk lean
c. A circumducted gait
d. Excessive hip flexion

Answer 161

c. A circumducted gait

Question 162

An elderly patient with a left trans femoral amputation complains that when sitting, the left foot feels cramped and twisted. What is the therapist’s BEST choice of intervention?

a. Appropriate bed positioning with the residual limb in extension
b. Iontophoresis to the distal residual limb using hyaluronidase
c. Hot packs and continuous US to the residual limb
d. Icing and massage to the residual limb

Answer 162

d. Icing and massage to the residual limb

Question 163

A researcher uses a group of volunteers (healthy college students) to study the effects of therapy ball exercises on ankle ROM and balance scores. Twenty volunteers participated in the 20-minute ball exercise class three times a week for 6 weeks. Measurements were taken at the beginning and end of the sessions. Significant differences were found in both sets of scores and reported at the local physical therapy meeting. What is the MOST accurate interpretation of this study and its results?

a. The reliability of the study was threatened with the introduction of systematic error of measurement
b. The Hawthorne effect may have influenced outcomes the study
c. The validity of the study was threatened with the introduction of sampling bias
d. Therapy ball exercises are an effective intervention to improve ankle stability after chronic ankle sprain

Answer 163

d. Therapy ball exercises are an effective intervention to improve ankle stability after chronic ankle sprain

Question 164

A patient has a very large right-sided bacterial pneumonia. Oxygen level is dangerously low. Which of the following body positions is the MOST likely to improve this patient’s arterial oxygen pressure (Pa02)?

a. Prone-lying with the head of the bed in the trendelenburg position
b. Right side-lying with the head of the bed in the flat position
c. Left side-lying with the head of the bed in the flat position
d. Supine-lying with head of the bed in the trendelenburg position

Answer 164

c. Left side-lying with the head of the bed in the flat position

Question 165

An examination of a patient reveals drooping of the shoulder, rotary winging of the scapula, an inability to shrug the shoulder, and complaints of aching in the shoulder. Based on these findings, what is the MOST likely cause of these symptoms?

a. Strains of the serratus anterior
b. A lesion of the spinal accessory nerve
c. A lesion of the long thoracic nerve
d. Muscle imbalance

Answer 165

b. A lesion of the spinal accessory nerve

Question 166

A patient with spastic hemiplegia is referred to the therapist for ambulation training. The patient is having difficulty with standing up from a seated position as the result of co- contraction of the quadriceps and hamstrings during the knee and hip extension phase. The therapist wishes to use biofeedback beginning with simple knee extension exercise in the seated position. The plan is to progress to sit-to-stand training. What is the proper initial biofeedback protocol?

a. Low-detection sensitivity with recording electrodes placed far apart
b. High-detection sensitivity with recording electrodes placed closely together
c. Low-detection sensitivity with recording electrodes placed closely together
d. High-detection sensitivity with recording electrodes placed far apart

Answer 166

c. Low-detection sensitivity with recording electrodes placed closely together

Question 167

Examination of a patient recovering from stroke reveals a loss of pain and temperature sensation on the left side of the face along with loss of pain and temperature sensation on the right side of the body. All other sensations are normal. What is the likely location of the lesion?

a. Right cerebral cortex or internal capsule
b. Midbrain
c. Left cerebral cortex or internal capsule
d. Left posterolateral medulla

Answer 167

d. Left posterolateral medulla

Question 168

A patient is taking the drug baclofen to control spasticity after a complete spinal cord injury at T10. This medication can be expected to decrease muscle tone and pain. What are the possible adverse effects of taking baclofen?

a. Urinary retention and discomfort
b. Drowsiness and muscle weakness
c. Hypertension and palpitations
d. Headache with visual auras

Answer 168

b. Drowsiness and muscle weakness

Question 169

A teen-aged female distance runner presents a history of stress fractures and general leg pain. Her parents think it may be due to overtraining. Based on this subjective information, what should the physical therapist question the patient about next?

a. Recent growth spurts
b. Menses and eating habits
c. Type of running shoe
d. Participation in other sports

Answer 169

b. Menses and eating habits

Question 170

A patient is exercising in a phase 3 outpatient cardiac rehabilitation program that utilizes circuit training. One of the stations utilizes weights. The patient lifts a 5-Lb weight, holds it for 20 seconds, and then lowers it slowly. The therapist correct the activity and tells the patient to reduce the length of the static hold. Which of the following BEST describes the expected effects of isometric exercise?

a. Reduced normal venous return to the heart and elevated BP
b. Abnormal oxygen uptake
c. Lower heart rate (HR) and arterial blood pressure (BP)
d. Higher HR and arterial BP

Answer 170

d. Higher HR and arterial BP

Question 171

A patient complains of pain in the right lower aspect of the lateral rib cage. The chief complaint is intense pain, which also occurs at night. The pain lasts for approximately 15 minutes and then subsides. There was no mechanism of injury and no pain with activity during the day. Active and passive motion of the thoracic spine and costal cage is normal and pain free. Mild tenderness is present inferior to the right lateral rib cage. What is the MOST likely diagnosis for this patient?

a. Intercostal muscle strain
b. Costochondritis
c. Systemic disease
d. Abdominal muscle strain

Answer 171

c. Systemic disease

Question 172

An elderly male patient recovering from a fractured hip repaired with ORIF has recently been discharged home. During a home visit, his wife tells the therapist that he woke up yesterday morning and told her he couldn’t remember much. Upon examination, the therapist finds some mild motor loss in his right hand and anomia. The therapist affirms the presence of short-term memory loss. What is the therapist’s BEST course of action?

a. Advise the family to document and record any new problems that they notice over the next week and then report back to the therapist.
b. Ignore the findings because they are expected after surgical anesthesia
c. Refer him to his physician immediately because the therapist suspects a stroke.
d. Refer him to physician because the therapist suspects Alzheimer’s type dementia

Answer 172

c. Refer him to his physician immediately because the therapist suspects a stroke.

Question 173

An adolescent with a 4-year history of type 2 diabetes is insulin dependent and wants to participate in cross-country running. The PT working with the school team advises the athlete to measure plasma glucose concentrations before and after running. What additional advice should the therapist give this student athlete?

a. Increase insulin dosage immediately before running
b. Consume a carbohydrate before or during practice to avoid hypoglycemia
c. Avoid carbohydrate-rich snacks within 12 hours of a race
d. Consume a carbohydrate after practice to avoid hyperglycemia

Answer 173

b. Consume a carbohydrate before or during practice to avoid hypoglycemia

Question 174

A male patient is referred to outpatient physical therapy for lower back pain. During the patient interview, he describes a recent increased difficulty with urinating that does not affect his lower back pain symptoms. Neurological screening examination is normal and Murphy’s sign is negative. Based on this clinical scenario, what may this patient’s low back pain be associated with?

a. Lower Urinary tract
b. First lumbar nerve root
c. Kidney
d. Sacro-iliac joint

Answer 174

a. Lower Urinary tract

Question 175

A PTA is ambulating a patient with a stroke using a walker. The patient is unsteady and fearful of falling. The patient does not appear to understand the correct gait sequence. What is the supervising PT’s BEST course of action?

a. Intervene and teach the correct sequence because the PTA is apparently unable to deal with this special situation
b. Instruct the PTA to have the patient sit down and utilize mental practice of the task
c. Tell the PTA and patient to stop the ambulation and work on dynamic balance activities instead
d. Instruct the PTA to use a distributed practice schedule to ensure patient success.

Answer 175

b. Instruct the PTA to have the patient sit down and utilize mental practice of the task

Question 176

A therapist is reviewing x-rays from a patient with a trimalleolar fracture. What are the BEST radiographic views to visualize this bony fracture?

a. Oblique and lateral
b. Anteroposterior and lateral
c. Posteroanterior and lateral
d. Lateral and coronal

Answer 176

b. Anteroposterior and lateral

Question 177

A patient presents with pain and muscle spasm of the upper back (C7-T8) extending to the lateral border of the scapula. This encompasses a 10 × 10-cm area on both sides of the spine. If the US unit only has a 5 cm2 sound head, how should the therapist treat the upper back area?

a. Each side, allotting 5 minutes for each section
b. The entire area in 5 minutes
c. The entire area in 10 minutes
d. Each side, allotting 2.5 minutes for each section

Answer 177

a. Each side, allotting 5 minutes for each section

Question 178

PTRP KA NA THIS SEASON! 🫶🏽

Question 179

A therapist is examining a patient’s balance using posturography testing with the Clinical Test for Sensory Integration in Balance (CTSIB. The patient’s sway increases with loss of balance under conditions with the eyes closed and platform moving (condition 5). During condition 6, with both the visual surround and platform moving, loss of balance is more immediate. Which of the following BEST identifies the source of the patient’s problems?

a. Vestibular deficiency
b. Visual dependency
c. Problems with sensory selection
d. Somatosensory dependency

Answer 179

c. Problems with sensory selection

Question 180

A patient presents with severe, frequent seizures originating in the medial temporal lobes. After bilateral surgical removal of these areas, the patient is unable to remember any new information from just prior to the surgery to the present. The patient cannot recall test read minutes ago or remember people previously met. How should this surgical outcome be characterized?

a. Loss of integration of the temporal lobe with the basal ganglia and frontal cortex
b. Loss of procedural memory and integration with frontal cortex
c. Loss of the hippocampus and declarative memory function
d. A primary deficit from the loss of the amygdala

Answer 180

c. Loss of the hippocampus and declarative memory function

Question 181

A 14-year-old with a body mass index of 3 kg/m2 and a history of limited participation in physical activities is referred for exercise training. The nutritionist has prescribed a diet limiting his caloric intake. What Is the BEST initial exercise prescription for this patient?

a. Three weekly sessions of 60 minutes at 50% VO2max
b. Three weekly sessions of 50 minutes at 75%-85% VO2max
c. Three weekly sessions of 30 minutes at 65%-70% VO2max
d. Two daily sessions of 30 minutes at 45%-70% VO2max

Answer 181

d. Two daily sessions of 30 minutes at 45%-70% VO2max

Question 182

A patient is admitted to a hospital after a fall. A review of the patient’ medical chart reveals a blood pressure (BP) of 160/85, a triglyceride level of 160 mg/dL, and a fasting blood glucose level of 115 mg/dL. Weight is 310 Ib. Examination of the patient reveals a rotund man with a 54-inch waistline. Which diagnosis is consistent with this patient’s signs and symptoms?

a. Type 1 diabetes
b. Cushing’s syndrome
c. Metabolic Syndrome
d. Chronic heart disease

Answer 182

c. Metabolic Syndrome

Question 183

A patient in an exercise class develops muscle weakness and fatigue. Examination reveals leg cramps and hyporeflexia. The patient also experiences frequent episodes of postural hypotension and dizziness. Abnormalities on the ECG include a flat T wave, prolonged QT interval, and depressed ST segment. Which electrolyte imbalance is consistent with this patient’s signs and symptoms?

a. Hypocalcemia
b. Hyperkalemia
c. Hypokalemia
d. Hyponatremia

Answer 183

c. Hypokalemia

Question 184

A patient has experienced swelling in both lower legs (below the knees) since the age of 16 (10-year history). The referring diagnosis is bilateral lymphedema. Which test should the therapist include in the initial examination?

a. Ankle-brachial index (ABI)
b. Systolic blood pressure before and after exercise
c. Homan’s sign
d. Rubor of Dependency test

Answer 184

a. Ankle-brachial index (ABI)

Question 185

A patient is referred to a woman’s health specialist PT with a diagnosis of pelvic and uterine prolapse. Which of the following interventions is the BEST choice for this patient?

a. External stabilization with a support belt
b. Gentle abdominal exercises with incisional support
c. Protective splinting of abdominal musculature
d. Kegel’s exercises

Answer 185

d. Kegel’s exercises

Question 186

A therapist is working with a patient recovering from traumatic brain injury, Rancho Los Amigos Levels of Cognitive Functioning (LOCF), level IV. This is the patient’s first time in the physical therapy gym. While the therapist attempts to work with the patient on sitting control, the patient becomes agitated and combative. Which strategy is the BEST choice in the situation?

a. Remove the patient to a quiet environment and provide support and calming stimuli
b. Give the patient a 5-minutes test and resume the training activity
c. Return the patient to his/her room and try the training activity later in the day
d. Enlist the help of a PTA to support the patient while slowly instructing the patient again

Answer 186

c. Return the patient to his/her room and try the training activity later in the day

Question 187

A patient has a 10-year history of Parkinson’s disease and has been on levodopa (carbidopa) for the past 6 years. The patient has fallen three times in the past month, resulting in a Colles fracture. The therapist decides to try postural biofeedback training using a platform balance training device. Which of the following is the BEST choice for a training protocol?

a. Increase the limits of stability and improve anterior weight displacement
b. Decrease the limits of stability and anterior weight displacement
c. Increase the limits of stability and improve center of pressure alignment
d. Decrease the limits of stability and improve posterior weight displacement

Answer 187

c. Increase the limits of stability and improve center of pressure alignment

Question 188

A patient is recovering from MI and is referred for supervised exercise training. While working out on a treadmill, the patient begins to develop mild shortness of breath. Continuous telemetry monitoring reveals the following ECG rhythm. What is the correct interpretation of this rhythm?

a. Tachycardia with abnormal P waves
b. Sinus rhythm with upsloping ST segment depression
c. Sinus rhythm with sinoatrial blocks
d. Sinus rhythm with downsloping ST segment depression

Answer 188

b. Sinus rhythm with upsloping ST segment depression

Question 189

A female patient complains of right lumbosacral pain after giving natural childbirth to her first child 2 months ago. Pain has subsided somewhat, but remains high enough that she has to sit after walking more than 2 blocks. Pain is noted in the right lumbosacral region, buttock, and groin and is aggravated with weight bearing on the right. Active flexion, extension, and
side bending reproduces the patient’s symptoms. Hamstrings are slightly tight on the right, but no neural tension is noted. Neurological findings (reflexes, sensation, and motor) are unremarkable. S1 provocation tests are positive. What is the MOST likely diagnosis for this patient?

a. Lumbar disc protrusion at L5/S1
b. Sacroiliac sprain
c. Quadratus lumborum strain
d. Piriformis syndrome

Answer 189

b. Sacroiliac sprain

Question 190

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?

a. Cervical strain
b. Herniated disc
c. Cervical radiculopathy
d. Facet syndrome

Answer 190

d. Facet syndrome

Question 191

A postal worker (mail sorter) complains of numbness and tingling in the right hand. Examination reveals a median nerve distribution. When the therapist evaluates the patient’s work tasks, the therapist notes that the patient is required to key in the zip codes of about 58 letters per minute. Which of the following is the BEST choice of administrative control to reduce this patient’s problem?

a. Require the worker to attend a cumulative trauma disorder educational class
b. Provide the worker with a resting splint to support the wrist
c. Provide a height adjustable chair to position the wrists and hands in a neutral alignment
d. Use job rotation during the workday

Answer 191

d. Use job rotation during the workday

Question 192

A patient with a traumatic brain injury presents with hemiparesis. The examination reveals slight cutaneous and proprioceptive impairment, fair (3/5) strength of the shoulder muscles and triceps, and slight spasticity of the biceps. Voluntary control of the patient’s left arm has not progressed since admission. The therapist decides to use functional electrical stimulation (FES), placing the active electrode on the triceps to facilitate active extension of the elbow. Which of the following is the BEST choice of timing sequence for FES in this case?

a. No ramp up, 10-second stimulation, 2-second ramp down
b. 2-second ramp up, 10-second stimulation, no ramp down
c. 2-second ramp up, 5-second stimulation, 2-second ramp down
d. 5-second ramp up, 5-second stimulation, 5-second ramp down

Answer 192

d. 5-second ramp up, 5-second stimulation, 5-second ramp down

Question 193

After a traumatic brain injury, a patient presents with significant difficulties in learning how to use a wheelchair. Memory for new learning is present but limited (Rancho Los Amigos Levels of Cognitive Functioning, level VII. The patient is wheelchair dependent and needs to learn how to transfer from the wheelchair to the mat (a skill never done before. Which of the following is the BEST strategy to enhance this patient’s motor learning?

a. Use only guided movement to ensure correct performance
b. Provide bandwidth feedback using a random practice schedule
c. Provide consistent feedback using a blocked practice schedule
d. Provide summed feedback after every few trials using a serial practice schedule

Answer 193

c. Provide consistent feedback using a blocked practice schedule

Question 194

A patient recovering from stroke presents with predominant involvement of the contralateral lower extremity and lesser involvement of the contralateral upper extremity. These clinical manifestations are characteristic of which cerebral syndrome?

a. Basilar artery syndrome
b. Anterior cerebral artery syndrome
c. Posterior cerebral artery syndrome
d. Middle cerebral artery syndrome

Answer 194

b. Anterior cerebral artery syndrome

Question 195

A patient presents with significant intermittent claudication with onset after 2 minutes of walking. Which of the following are likely findings for this patient, given the patient’s symptoms in response to walking?

a. Persistent local redness of the extremity in both gravity-dependent and independent positions
b. Elevation-induced pallor and dependent redness with the extremity in the gravity- dependent position
c. Little or no changes in color with changes in extremity position
d. A brownish color just above the ankle in both gravity-dependent and independent positions.

Answer 195

b. Elevation-induced pallor and dependent redness with the extremity in the gravity-dependent position

Question 196

After a recent cesarean, a patient tells the therapist that she is anxious to return to her pre pregnancy level of physical activity (working out at the gym three days/wk and running 5 miles every other day). What is the BEST choice of activities for this patient at this time?

a. Pelvic floor and gentle abdominal exercises for the first 4-6 weeks
b. A walking program progressing to running after 4 weeks
c. Pelvic floor exercises and refrain from all other exercise and running for at least 12 weeks
d. Abdominal crunches with return to running after 5 weeks

Answer 196

a. Pelvic floor and gentle abdominal exercises for the first 4-6 weeks

Question 197

A 26-year-old who was diagnosed with schizophrenia, disorganized type, at the age of 2 is referred for gait training after a compound fracture of the tibia. The therapist suspects the patient has recently experienced an exacerbation of schizophrenia. Which behaviors support this conclusion?

a. Poor ability to perform multi step tasks requiring abstract problem-solving
b. Sleep disturbances and flashbacks
c. Increased fear of going out in public
d. Frequent verbalizations of pervasive feelings of low-self-esteem

Answer 197

a. Poor ability to perform multi step tasks requiring abstract problem-solving

Question 198

The rehabilitation team is completing a home visit to recommend environmental modifications for a patient who is scheduled to be discharged next week. The patient is wheelchair dependent. The home has not been adapted. Which of the following recommendations is correct?

a. Widening the door entrance to 28 inches
b. Adding horizontal grab bars in the bathroom positioned at 34 inches
c. Raising the toilet seat to 25 inches
d. Installing an entry-way ramp with a running slope of 1:10

Answer 198

b. Adding horizontal grab bars in the bathroom positioned at 34 inches

Question 199

During an examination of gait, the therapist observes lateral pelvic tilt on the side of the swing leg during frontal plane analysis. What is the purpose of the lateral pelvic tilt on the side of the swing leg during gait?

a. Reduce physiological valgum at the knee
b. Reduce knee flexion at mid-stance
c. Control forward and backward rotations of the pelvis
d. Reduce peak rise of the pelvis

Answer 199

d. Reduce peak rise of the pelvis

Question 200

A group of researchers investigated the effect of tai chi on perceived health status in older, frail adults. The subjects were 269 women who were older than 70 years of age and recruited from five independent senior living facilities. Participants took part in a 48-week single-blind RCT. Perceived health status was measured by five pre-trained testers using the Sickness Impact Profile (SIP) the researchers found significant perceived health benefits. Which of the following is an accurate conclusion regarding the design of this study?

a. Generalizability to a larger population of elderly women
b. Errors in reliability due to the number of testers
c. Errors in validity due to the selection of the outcome measure
d. Limited findings on the effects of tai chi exercise in the frail elderly

Answer 200

a. Generalizability to a larger population of elderly women