Other Systems

During an inpatient physical therapy treatment session with a patient in the intensive care unit (ICU), the patient’s chest tube becomes dislodged when rising to a sitting position. Which of the following actions is MOST appropriate for the clinician to perform first?

Place a gloved hand over the insertion site

A 55-year-old male patient presents to physical therapy initial evaluation without a physician referral. He reports he hasn’t been to his primary care for over 4 years. His chief complaint today is sciatica-like pain of insidious onset. He reports pain with weight bearing that is unrelieved by rest or position change, and unremitting at night. His past medical history is notable for prostate cancer. When questioned further, the patient admits to a recent weight loss of approximately 10% of his body weight in the last month but denies dieting or new active lifestyle change. Which of the following is MOST important to consider when developing this patient’s plan of care?

1. Consistent vital sign monitoring before, during, and after treatment

2. Ensure monitoring of patient’s weight throughout his length of stay

3. Minimize amount of weight bearing during treatment due to sciatic reproducing pain

4. Physical therapy intervention is not indicated currently; MD referral necessary

A 35-year-old female presents to physical therapy with chief complaints of urine loss when

laughing, coughing, and sneezing. The patient’s past medical history is notable for the

following: Type 1 diabetes, seasonal allergies, and childbirth in the last year. Which of the

following conditions is this patient MOST likely experiencing?

1. Functional incontinence

2. Overflow incontinence

4. Urge incontinence

3. Stress incontinence

While examining a 12-year-old patient with cerebral palsy, the child’s mother reports that the child has complained of moderate abdominal pain over the last 12 hours. The mother also reports that the patient has a low-grade fever, anorexia and has vomited several times earlier in the day. Which of the following tests will be LEAST useful to determine the source of the symptoms?

Lumbar quadrant test

A patient is receiving physical therapy treatment for hip pain. The patient has a history of Crohn’s Disease with chronic mild abdominal pain and an appendectomy 5 years ago. The patient reports an increase in pain located in the lower right quadrant of the abdomen over the past 2 weeks. The patient also describes an exacerbation of the pain when bringing the right hip into extension with the knee extended. Which of the following conditions is MOST likely present?

Psoas abscess

A patient with a history of an inguinal lymph node removal reports persistent pain in the inguinal area in addition to tachycardia, increased blood pressure, and abdominal distension that have worsened steadily over the past 3 days. What is the MOST likely cause of these signs and symptoms?

Hernia incarceration

A 56-year-old male complains of increased thirst which has been causing him to drink more water throughout the day. As a result, he also has to frequently urinate very large amounts of urine multiple times a day. Which of the following conditions is this patient MOST likely to be diagnosed with?

2. Diabetes mellitus

A 57-year-old female presents to physical therapy with complaints of pain in her mid-back and stomach, as well as generalized achiness in both arms. The patient states that she recently participated in weightlifting classes and has recently experienced an unusual amount of fatigue and difficulty sleeping. Which of the following should the clinician most likely suspect?

Myocardial ischemia

For a 66-year-old male with a diagnosis of gastroesophageal reflux disease, which of the following positions is MOST effective for decreasing symptoms?

Left sidelying

A patient presents to an outpatient clinic with a chief complaint of right upper abdominal quadrant and right scapular pain. The physical therapist discovers that the patient’s inspiration is inhibited by pain on local palpation to that region. Which pathology is the LEAST likely cause?

1. Appendicitis

2. Cholecystitis

3. Gallbladder inflammation

4. Pyelonephritis