Sullivan Siegelman 2015

A

A patient has undergone surgery and subsequent immobilization to stabilize the olecranon process. The patient now exhibits an elbow flexion contracture. In this case, an absolute CONTRAINDICATION for joint mobilization would be:

A. Empty end-feel

B. Soft end-feel

C. Springy end-feel

D. Firm end-feel

C

A PT instructing a student in proper positioning to prevent the typical contractures in a patient with a transfemoral amputation. The therapist stresses positioning the patient in:

A. Side-lying on the residual limb

B. A wheelchair with gel cushion and adductor roll

C. Prone-lying with the residual limb in neutral rotation

D. Supine-lying with the residual limb resting on acsmall pillow

A

In treating a patient with a diagnosis of right shoulder impingement syndrome, the FIRST intervention the PT should consider is to:

A. Instruct the patient in proper postural alignment

B. Complete AROM in all shoulder motions

C. Implement a stretching program for the shoulder girdle musculature

D. Modulate all pain

A

A patient with Parkinson's disease (PD) demonstrates a highly stereotyped gait pattern characterized by impoverished movement and a festinating gait. The intervention that would be the MOST beneficial to use with this patient is :

A. Locomotor training using a motorized treadmill and body weight support harness

B. Braiding with light touch-down support of hands

C. Standing and reaching with a body weight support harness

D. Locomotor training using a rolling walker

D

A patient is experiencing sensory changes secondary to left CVA. Upon testing, the patient is unable to detect pinprick or temperature in the right hand, leading to disuse and increased safety risk. These changes are BEST documented as "Patient is experiencing"

A. Allodynia

B. Abarognosis

C. Anesthesia

D. Analgesia

B

A 14 year old girl complains of subpatellar pain after participation in an aerobic exercise program for 2 weeks. The PT's examination shows a large Q angle, pain with palpation at the inferior pole of the patella and mild swelling at both knees. The BEST intervention for this situation is:

A. Hamstring strengthening

B. Vastus medialis (VM) muscle strengthening

C. Vastus lateralis (VL) strengthening

D. Taping to increase lateral patellar tracking

D

A patient is referred to a physical therapist with a diagnosis of Bell's palsy. Which cluster of examination findings below would the physical therapist expect to find?

A. Decreased sensation to the forehead, cheek and jaw; absence of a gag reflex; and deviation of the tongue to one side

B. Ptosis, weakness in the temporalis and masseter muscles and deviation of th etongue to one side

C. Ptosis, decreased abduction of the eye and excessive tearing

D. Decreased closuremof one eye, drooping of the mouth, and inability to raise the eyebrow

D

The cardiac rehabilitation team is conducting education classes for a group of patients. The focus is on risk factor reduction and successful lifestyle modification. A participant asks the PT to help interpret cholesterol findings. Total cholesterol is 220 mg/dL, high-density lipoprotein (HDL) cholesterol is 24 mg/dL and low-density lipoprotein (LDL) is 160 mg/dL. Analysis of these values reveals:

A. The levels of HDL, LDL and total cholesterol are all abnormally low

B. LDL and HDL cholesterol levels are within normal limits, and total cholesterol should be below 200 mg/dL

C. The levels of HDL, LDL and total cholesterol are all abnormally high

D. The levels of LDL and total cholesterol are abnormally high, and HdL is abnormally low

B

An elderly patient is being treated for depression following the death of her husband. She is currently taking a tricyclic antidepressant medication (amitriptyline) and has a recent history of a fall. The PT suspects the precipitating cause of the fall is the medication because ot can cause:

A. Hyperalertness

B. Postural hypotension

C. Dyspnea

D. Hypertension

A

As the result of blunt trauma to the quadriceps femoris muscle, a patient experiences loss of knee function. The BEST choice for early physical therapy intervention is:

A. Gentle AROM exercises in weight bearing

B. Aggressive soft tissue stretching to remove blood that has accumulated in soft tissues

C. Aggressive open-chain sttrengthening of the quadriceps femoris to regain normal lower extremity strength

D. Gentle PROM exercises in non-weight bearing to regain knee motion

C

A patient with active tuberculosis (TB) is referred for physical therapy. The patient has been hospitalized and on appropriate antituberculin drugs for 3 weeks. During treatment, what precautions should the therapist observe?

A. The patient must be treated in a private,cnegative-pressured room

B. The therapist must wear personal protective equipment at all times

C. The patient can be treated in the PT gym, without prescriptions

D. The patient must wear a tight-fitting mask at all times

B

With a traction injury to the anterior division of the brachial plexus, the PT would expect to see weakness of the elbow flexors, wrist flexors, and forearm pronators. The therapist would also expect to find additional weakness in:

A. Wrist extension

B. Thumb abduction

C. Forearm supination

D. Lateral rotation of the shoulder

A

A patient complains of right buttock pain after slipping. The right hip has been forced into internal rotation. Lumbar active motion testing is full and pain free. Neurological findings are unremarkable. S1 provocation testing is unremarkable. Passive hip internal rotation is limited with pain and pulling noted in the right buttock region. Resisted external rotation produces pain in the same region. Based on these finding, the MOST LIKELY diagnosis would be:

A. Piriformis strain

B. Quadratus lumborum strain

C. Lumbar disc herniation at L5/S1

D. Sacroiliac sprain/strain

C

A patient with MS demonstrates strong bilateral lower extremity extensor spasticity in the typical distribution of antigravity muscles. This patient would be expected to demonstrate:

A. Skin breakdown on the ischial tuberosities and lateral malleoli

B. Sitting with both hips abducted and externally rotated

C. Sacral sitting with increased extension and adduction of lower extremities

D. Sitting with the pelvis laterally tilted and both lower extremities in windswept position

D

A computer-programmer with no significant past emdical history presents to the emergency room with complains of fever, shaking chills , and a worsening productive cough. Complaints of chest pain over the posterior base of the left thorax at the posterior base. This patient's chest pain is MOST LIKELY caused by:

A. Inflamed tracheobronchial tree

B. Angina

C. Trauma to the chest

D. Infected pleura

A

The posture of a patient's forefoot is an inverted position relative to the rearfoot while in subtalar neutral. What is the therapist's BEST choice to document this finding?

A. Forefoot varus

B. Medial column equinus

C. Metatarsus abductus

D. Forefoot valgus

B

During a sensory examination, a patientcomplains of a dull, aching pain and is not able to discriminate a stimulus as sharp or dull. Two-point discrimination is absent. Based on these findings, the pathway that is intact is the :

A. Dorsal columns/neospinothalamic tracts

B. Anterior spinothalamic tract

C. Fasciculus gracilis/ medial lemniscus

D. Lateral spinothalamic tract

B

A patient is hospitalized in an intensive care unit following a traumatic SCI resulting in C3 tetraplegia (ASIA A). The patient is receiving endotracheal suctioning, following development of significant pulmonary congestion. The recommended time duration for endotracheal suctioning is:

A. 1-5 seconds

B. 10-15 seconds

C. 5-10 seconds

D. 15-20 seconds

D

A patient present swith pronounced muscle weakness and wasting in the lower extremities, hypertension and a moon-shaped face with truncal obesity. The therapist recognizes these symptoms as characterisitic of:

A. Hypoparsthyroidism

B. Type 2 diabetes

C. Addison's disease

D. Cushing's syndrome

D

During which phases of the gait cycle would a physicaltherapist expect to observe an everted posture of the calcaneus?

A. Terminal stance (heel-off) to preswing(toe-off)

B. Initial swing (acceleration) through midswing

C. From midstance through heel-off(toe-off)

D. From initial contact(heel strike) through loading response (foot flat)

D

A patient with roght hemiparesis has difficulty clearing the more affected foot during the swing phase of gait. An appropriate physical therapy intervention for the right lower extremity might include:

A. Pushing backward while sitting on a rolling stool

B. Sitting on a therapy ball, alternating lateral side steps and back to neutral

C. Assumption of bridging

D. Forward step-ups in standing, using graduated height steps

B

A researcher reviewed current literature related to moderate exercise for maintaining independence without accelerating disease progression in persons with amyotrophic lateral sclerosis (ALS). The search yielded nine studies: two clinical case reports, two cohort studies, three single randomized controlled trials (RCTs) and two multicenter RCTs. According to levels of evidence, which studies provide the BEST evidence for support of exercise in persons with ALS?

A. Case series without controls

B. Multicenter RCTs

C. Single-center RCTs

D. Cohort/comparison studies

C

A sports PT working with a local high school football team. During the game, a player is tackled violently and incurs a blow to the head. The therapist determines that the player is. unresponsive with normal respirations. The IMMEDIATE course of action should be to:

A. Stabilize the neck, and flip back the helmet face mask

B. Use the chin-lift method to improve the airway

C. Summon Emergency Medical Services

D. Ask for help to log roll the player onto his back, while stabilizing his neck

B

During a finger to nose test, a patient demonstrates hesitancy in getting started and is then unable to control the. movement. The moving finger slams into the side of the face and misses the nise completely. The therapist documents these findings as moderate impairment in:

A. Dyssynergia

B. Dysmetri

C. Response orientation

D. Dysdiadochokinesia

A

A patient with complete tetraplegia (ASIA A) should be instructed to initially transfer worh a sliding board using:

A. Shoulder extensors, external rotatorsm and anterior deltoid to position and lock the elbow.

B. Serratus anterior to elevate the trunk with elbow extensors stabilizing

C. Pectoral muscles to stabilize the elbows in extension and scapular depressors to lift the trunk

D. Shoulder depressors and triceps, keeping thr hands flexed to protect tenodesis grasp

B

A PT has been treating a patient for chronic subluxation of the patella in the outpatient clinic. The patient is now scheduled for a lateral release and is worried about any complications of the surgical procedure. The patient asks the therapist to describe any potential complications. The therapist's BEST response is to:

A. Refer the patient to a physical therapy colleague who specializes in knee problems

B. Suggest that the patient speak with the surgeon

C. Do an internet search and print out the information desired by the patient

D. Explain how previous patients that the therapist treated responded to the surgery

D

A patient is unable to perform overhead activities because of a painless inability to reach past 80 degrees of right shoulder abduction. The "empty can" test was positive. Early subacute physical therapy intervention should focus on:

A. Resistance exercises for the affected muscles

B. Modalities to reduce pain and inflammation

C. Superior translatory mobilizations to increase glenohumeral arthrokinematic motion

D. Active assistive pulley exercises

C

The physical therapist is reviewing the medical history of a new patient being seen for balance deficits and general deconditioning. Prior to admission, the chief finding by the physician, 3 days ago, was a positive fecal blood test. Which laboratory value would confirm that the patient is safe for balance retraining activities?

A. Erythrocyte sedimentation rate (ESR) 7mm/1 hr

B. Leukocyte count 7000

C. Hematocrit 42%

D. Platelet count 70,000

D

A middle-aged patient is recovering from surgical repair of an inguinal hernia and is experincing persistent discomfort in the groin area. Patient education should focus on:

A. Avoiding sitting too long in any one position

B. Avoiding straining or turning in bed

C. Closed-mouth breathing during any lifting

D. Proper lifting techniques and precautions against heavy lifting

C

A computer programmer in her second trimester pregnancy was referred to physical therapy with complaints of tingling and loss of strength in both of her hands. Her symptoms are exacerbated if she is required to use her keyboard at work for longer than 20 minutes. The MOST beneficial physical therapy intervention is :

A. Ice packs to the carpal tunnel

B. Hydrocortisone iontophoresis to the volar surfaces of both wrists

C. Placing the wrists in resting splints

D. Dexamethasone phonophoresis to the carpal tunnel

C

A physical therapist has decided to refer a 2 year old child to a neurologist after the initial evaluation. The therapist has concluded that the child may be autistic. The MOST PERTINENT factor to include in the referral is that the child is:

A. Delayed in gross motor skills

B. Quiet and did not want to separate from the mother

C. Defensive when touched

D. Responsive to most but not all commands

A

A patient was instructed to apply conventional (high-rate) transcutaneous electrical nerve stimulation (TENS) to the low back to modulate a chronic pain comdition. The patient now states that the TENS unit is no longer effective in reducing the. pain in spite of increasing the intensity to maximum. The PT should now advise the patient to:

A. Switch to modulation-mode TENS

B. Increase the treatment frequency

C. Decrease the pulse duration

D. Switch to low-rate TENS

A

After performing an ergonomic examination of a computer programmer and workstation, the most appropriate recommendation for achieving ideal wrist and elbow positioning would be to:

A. Maintain the keyboard in a position that allows a neutral wrist position

B. Add armrests

C. Elevate the keyboard to increase wrist flexion

D. Lower the keyboard to increase wrist extension

B

An elderly patient receiving outpatient physical therapy as a result of a stroke (cerebrovascular accident) presents with left hemiparesis. The patient requires moderate assistance for ADL and transfers. The patient lives with and is cared for by a single adult daughter. The patient arrives for a physical therapy session and the therapist notes multiple bruises on the patient's face and arms. When asked about the bruises, the patient hesitates and says she does not know. Later int he session, the patient reports that her daughter is under a great deal of stress. In this case, what should the PT do?

A. Document and treat the bruises as necessary and assess whether the bruises are resolved at the next visit.

B. Contact the appropriate jurisdiction and file a report for suspected abuse/neglect

C. Call the police and have the daughter arrested for elder abuse

D. Counsel the daughter on how to handle stress and advise her to hire a personal care attendant to help care for her mother and prevent falls

B

Following major surgery of the right hip, a patient ambulated with a Trendelenburg gait. Examination of the right hip reveals abductor weakness (gluteus medius 3/5) and ROM limitations in flexion and external rotation. As part of the intervention, the PT opts to include functional electrical stimulation to help improve the gait pattern. Stimulation should be initiated for the:

A. Left abductors during stance on the right

B. Right abductors during stance on the right

C. Left abductors during swing phase on the right

D. Right abductors during swing on the right

D

An 18 month old child with Down syndrome and moderate developmental delay is being treated at an early intervention program. Daily training activities that should be considered include

A. Locomotor training using body weight support and a motorized treadmill

B. Stimulation to postural extensors in sitting using rhythmic stabilization

C. Rolling activities, initiating movement with stretch and tracking resistance

D. Holding and weight shifting in sitting using tactile and verbal cueing

A

A high school wrestler has been taking anabolic-androgenic steroids for the past 6 months to build muscle and improve performance. The PT working with the team suspects illegal drug use and examines the athlete for:

A. Rapid weight gain, marked muscular hypertrophy and mood swings

B. Rapid weight loss with disproportionate muscular enlargement

C. Changes in personality, including passivity and anxiety

D. Hypotension, edema, and rapid muscular enlargement

B

While driving the ball during a golf match, a patient felt an immediate sharp pain in the lower back. The following morning, the patient reported stiffness, with easing of pain after taking a shower. Based on this information, the source of the pain is MOST LIKELY

A. Diminished blood supply to the spinal cord

B. Facet joint impingement

C. A stress fracture

D. Nerve root compression

A

A PT is performing the maximal cervical quadrant test to the right with a patient with C5-C6 facet syndrome.vThe patient would most likely complain of:

A. Pain in the right cervical region

B. Referred pain to the left midscapular region

C. Radicular pain into the right upper limb

D. Tightness in the right upper trapezius

B

A 62 year old patient has chronic obstructive pulmonary disease(COPD). Which of these pulmonary test results will NOT be increased when compared with those of a 62 year old healthy individual?

A. Functional residual capacity

B. FEV1/FVC (forced vital capacity) ratio

C. Total lung capacity

D. Residual volume

B

A patient with a grade 2 quadriceps strain returns to physical therapy after the first exercise session, complaining of muscle soreness that developed later in the evening and continued into the next day. The patient is unsure whether to continue with the exercise. The therapist can minimize the possibility of this happening again by using:

A. Eccentric exercises, 3 sets of 10, with gradually increasing intensity

B. Concentric exercises, 3 sets of 10, with gradually increasing intensity

C. Eccentric exercises, 1 set of 10, lifting body weight (sit-to-stand)

D. Concentric exercises, 3 sets of 10, at 80% of maximal intensity

A

A patient with multiple sclerosis (MS) exhibits moderate fatigue during a 30-minute exercise session. When the patient return for the next regularly scheduled session 2 days later, the patient reports going right to bed after the last session. Exhaustion was so severe, the patient was unable to get out of bed until late afternoon of the next day. The PT's BEST strategy is to:

A. Utilize a distributed practice schedule

B. Utilize a massed practice schedule

C. Treat the patient in a warm, relaxing environment

D. Switch the patient to exercising in a warm pool

C

A patient has lumbar spinal stenosis encroaching on the spinal cord. The PT should educate the patient to avoid:

A. Use of rowing machine

B. Bicycling using a recumbent cycle ergometer

C. Swimming using a crawl stroke

D. Tai chi activities

A

A PT is performing clinical research in which a specific myofascial technique is applied to a patient with chronic back pain. She is using a single-case experimental design with an A-B-A-B format. Her research hypothesis states that pain-rating scores will decrease with the treatment intervention. Acceptance of this hypothesis would be indicated if:

A. B is less than A

B. B is greater than A at the 1.0 level

C. B is greater than A at the 0.05 level

D. B is equal to A

D

An individual with a body mass index (BMI) of 33 kg/m2 is referred to an outpatient exercise program. The PT in charge of the program recognizes this patient is at increased risk for:

A. Increased anxiety and depression

B. Hypothermia during exercise

C. Rapid weight loss during the initial weeks

D. Hyperthermia during exercise

B

A patient with a recent modified radical mastectomy for breast cancer is referred to physical therapy. The therapist recognizes that an important predictor for lymphedema after treatment for breast cancer is:

A. A diet low in sodium

B. Obesity

C. Mild strength loss in the affected extremity

D. Use of diuretics

B

An elderly patient has been confined to bed for 2 months, and now demonstrates limited ROM in both lower extremities. Range in hip flexion is 5-115 degrees, and knee flexion is 10-120 degrees. The MOST beneficial intervention to improve flexibility and ready this patient for standing is:

A. Hold-relax techniques followed by passive range of motion (PROM), 10 repetitions, two times per day

B. Mechanical stretching using traction and 5 lb weights, 2 hours, two times per day

C. Manual passive stretching, 10 repetitions each joint, two times per day

D. Tilt-table standing, 20 minutes, daily

A

During a home visit, a PT is providing postural drainage in the Trendelenburg position to an adolescent with cystic fibrosis. The patient suddenly complains of right-sided chest pain and shortness of breath. On auscultation, there are no breath sounds on the right. The therapist should:

A. Call Emergency Medical Services because it may be a pneumothorax

B. Continue treating as it is possibly a mucous plug

C. Reposition patient with the head of the bed flat because the Trendelenburg position is causing shortness of breath

D. Place the right lung in a gravity-dependent position to improve perfusion

B

A patient is 5 days postmyocardial infarction and is referred for inpatient cardiac rahabilitation. Appropriate criteria for determining the initial intensity of exercise include:

A. > 1 mm ST segment depression, horizontal or downsloping

B. HR < 120 bpm and rate of perceived exertion (RPE) < 13

C. Systolic BP < 240 mmHg or diatolic BP <110 mmHg

D. HR resting plus 30 bpm and RPE < 14

B

A PT examines a patient with a right CVA and determines that the patient has a profound deficit of homonymous hemianopsia. The BEST INITIAL strategy to assist the patient in compensating for this deficit is to:

A. Provide constant reminders, printed notes no the left side, telling the patient to look to the left

B. Teach the patient to turn the head to the affected left side

C. Place items such as eating utensils on the left side

D. Rearrange the room so that while the patient is in bed, the left side is facing the doorway

B

A patient with a 10-year history of Parkinson's disease (PD) has been taking (Sinemet) for the last 5 years. The patient presents with deteriorating function and is no longer able to walk independently due to constant and uncontrolled involuntary movements. During the examination, the PT observes that the patient is restless, with constant dancing, hyperkinetic movements of his legs. The therapist's BEST course of action is to:

A. Complete the treatment session, focusing specifically on documenting the effects of rigidity

B. Document the observations and refer the patient back to the physician for possible medication adjustment

C. Examine for additional signs of chronic levodopa therapy, such as dizziness and headache

D. Talk to the spouse to see if the patient is taking any drugs with hallucinogenic effects, such as selegiline

C

A patient with stasis dermatitis secondary to venous insufficiency is being examined by the physical therapist. Visual inspection of the skin can be expected to reveal:

A. Extensive erosions with serous exudate

B. Pruritus, erythema and edema

C. Hemosiderin staining

D. Plaques with scales

A

A 24 year old woman who is 12 weeks' pregnant asks a PT if it is safe to continue with her aerobic exercise. Currently she jogs 3 miles, three times a week, and has done so for the past 10 years. The therapist's BEST answer is:

A. Jogging is safe at mild to moderate intensities, whereas vigorous exercise is contraindicated

B. Jogging is safe as long as the target HR does not exceed 140 beats/min.

C. Continue jogging only until the fifth month of pregnancy

D. Swimming is preferred over walking or jogging for all phases of pregnancy

B

A patient is able to stand feet together, unassisted, with eyes open. When asked to close the eyes, the patient immediately loses balance and has to take a step and grab onto the table to keep from falling. The therapist documents this finding as:

A. Ataxic posture

B. Positive Romberg Test

C. Negative Romberg Test

D. Positive Dizziness Handicap inventory

C

A patient is referred for rehabilitation after a middle cerebral artery stroke. Based on this diagnosis, a Pt can expect that the patient will present with:

A. Contralateral hemiparesis and sensory deficits, with the leg more involved than the arm

B. Contralateral hemiplegia with central poststroke pain and involuntary movements

C. Contralateral hemiparesis and sensory deficits, with the arm more involved than the leg

D. Decreased pain and temperature to the face and ipsilateral ataxia, with contralateral pain and thermal loss of the body

A

A patient complains of pain (7/10) and limited range of motion (ROM) of the right shoulder as a result of chronic overuse. The PT elects to use procaine hydrochloride iontophoresis as part of the intervention for this patient's problems. To administer this substance, it would be appropriate to use:

A. Continuous monophasic current, with the medication under the anode

B. Continuous biphasic current, with the medication under the anode

C. Interrupted biphasic current, with the medication under the cathode

D. Continuous monophasic current, with the medication under the cathode

A

A patient fractured the right mid tibia in a skiing accident 3 months ago. After cast removal, a severe foot drop was noted. The patient wants to try electrical stimulation orthotic substitution. the PT would set up the functional electrical stimulation to contract the appropriate muscles during:

A. Mid swing

B. late stance at push-off

B. late stance at push-off

C. Early stance at foot-flat

D. Late stance at toe-off

C

A patient who is terminally ill with cancer is in tears, unable to cope with the changes in life and current hospitalization. The PT has a referral for gait training so that the patient can be discharged to home under hospice care. The BEST approach is to:

A. Encourage denial so the patient can cope better with life's challenges

B. Ask the patient questions in order to obtain a detailed history

C. Take them now to allow the patient to express fears and frustrations

D. Ignore the tears and focus on therapy, but in a compassionate manner

B

A patient with multiple sclerosis (MS) has been on prednisolone for the past 4 weeks. The medication is now being tapered off. This is the third time this year that the patient has received this treatment for an MS exacerbation. The PT recognizes that possible adverse effects of this medication are:

A. Weight gain and hyperkinetic behaviors

B. Muscle wasting, weakness and osteoporosis

C. Spontaneous fractures with prolonged healing or malunion

D. Hypoglycemia and nausea and vomiting

D

A patient is 4 weeks post-myocardial infarction (MI). Resistive training using weights to improve muscular strength and endurance is appropriate:

A . only during post-acute phase 3 cardiac rehabilitation

B. During all phases of rehabilitation, if judicious monitoring of heart rate is used

C. If exercise intensities are kept below 85% maximal voluntary contraction

D. If exercise capacity is greater than 5 metabolic equivalents (METs) with no anginal symptoms/ST segment depression

C

To test for maximal passive tibiofemoral internal or external rotation the knee should be placed in:

A. 45 degrees of knee flexion

B. 60 degrees of knee flexion

C. 90 degrees of knee flexion

D. 30 degrees of knee flexion

D

An adolescent female is referred to physical therapy with a diagnosis of anterior knee pain. Positive findings include pes planus, lateral tibial torsion, and genu valgum. The position that the femur will be in is excessive:

A. Retroversion

B. Lateral rotation

C. Abduction

D. Medial rotation

B

A therapist is examining a patient with superficial partial-thickness burns over 20% of the trunk. The correct identification of this burn type by surface appearance characteristics includes:

A. A dry surface with no blisters

B. Intact blisters and a moist, weeping surface if blisters are removed

C. A wet surface with broken blisters

D. Parchment-like, leathery and dry surface

C

A 10 year old presents with pain (4/10) and limited knee ROM (5-95) following surgical repair of the medial collateral ligament and ACLs. In this case, the modality that can be used with PRECAUTION is:

A. Premodulated interferential current

B. Continuous shortwave diathermy

C. Low dose ultrasound (US)

D. High-rate transcutaneous electrical stimulation

B

A CONTRAINDICATION to initiating extremity joint mobilization on a patient with chronic pulmonary disease may include:

A. Reflex muscle guarding

B. Long-term corticosteroid therapy

C. Concurrent inhalation therapy

D. Functional chest wall immobility

A

Manual glide of the talus posteriorly within the ankle joint mortise can be used as a technique to increase:

A. Tibotalar dorsiflexion motion

B. Talocalcaneal supination

C. Talocalacaneal pronation

D. Distal tibiofibular joint extensibility

C

A patient with spastic hemiplegia is referred to physical therapy for ambulation training. The patient is having difficulty in rising to a standing position due to cocontraction of the hamstrings and quadriceps. The therapist elects to use biofeedback as an adjunct to help break up this pattern. For knee extension, the biofeedback protocol should consist of:

A. High-detection sensitivity, with electrodes placed far apart

B. High-detection sensitivity, with electrodes placed close together

C. Low-detection sensitivity, with electrodes placed close together

D. Low-detection sensitivity, with electrodes placed far apart

D

A baseball pitcher was seen by a PT following surgical repair of a SLAP (superior labral, anterior posterior) lesion of his pitching arm. In follow-up care, the therapist needs to pay attention to the pitching motion. The phase of the throwing motion that puts the greatest stress on the anterior labrum and capsule is:

A. Wind-up

B. Acceleration

C. Deceleration

D. Cocking

B

A frail, elderly patient has recently been admitted to a skilled nursing facility following a fall-related injury (fractured hip with open reduction, internal fixation). The patient lived alone on the second floor and was unable to return home. The patient is extremely agitated over being in a nursing facility and demonstrates early signs of dementia, exclaiming to the PT, "Leave me alone, I just want to get out of here !" An important approach to take while working with this patient is to:

A. Firmly state what the patient is expected to perform

B. Be calm and supportive, and use only one or two-level commands

C. Minimize verbal communication and maximize guided movements

D. Promise anything to calm the patient down, as long as some walking occurs

D

Upon examining a patient with vague hip pain that radiates to the lateral knee, the PT finds a negative FABERE test, a negative grind test and a positive Noble's compression test. The dysfunction is MOST LIKELY due to:

A. DJD of the hip

B. SI joint dysfunction

C. Irritation of the L5 spinal nerve root

D. An iliotibial band friction disorder

C

What common compensatory postures would a PT expect for a patient diagnosed with fixed severe forefoot varus?

A. Toeing-in and lateral rotation of the femur

B. Excessive midtarsal supination and lateral rotation of the tibia

C. Subtalar pronation and medial rotation of the tibia

D. Excessive ankle dorsiflexion and medial rotation of the femur

D

A weight lifter exhibits marked hypertrophy after embarking on a strength training regime. Hypertrophy can be expected to occur following at least:

A. 3-4 weeks of training

B. 1-2 weeks of training

C. 2-3 weeks of training

D. 6-8 weeks of training

D

A patient with a diagnosis of chronic prostatitis is referred for physical therapy. As part of a multidisciplinary treatment program, the therapist considers performing manual therapy compression techniques applied to tender, tight pelvic floor muscles. Which of the following muscles should the therapist target in this case?

A. Piriformis, gluteus medius, and pubococcygeus

B. Pubococcygeus, gluteus medius, and obturator internus

C. Obturator internus, gluteus medius, and piriformis

D. Obturator internus, pubococcygeus, and piriformis

C

An elderly patient is being examined by the PT. The therapist notes an irregular, dark-pigmented ulcer over the medial malleolus. The patient states this is not painful. The MOST LIKELY diagnosis is:

A. Arterial ulcer

B. Diabetic ulcer

C. Venous ulcer

D. Arterial insufficiency

A

A patient with COPD is sitting in a bedside chair. The apices of the lungs in this position compared with other areas of the lungs in this position would demonstrate:

A. Increased volume of air at REEP

B. The highest changes in ventilation during the respiratory cycle

C. Increased perfusion

D. The lowest oxygenation and highest carbon dioxide content in blood exiting this zone

A

An elderly patient is referred to physical therapy following a recent compression fracture at T8. The medical history includes osteoporosis and gastroesophageal reflux disease (GERD). The patient is currently taking antacids. Which of the following is MOST important for the therapist to consider in the POC?

A. Schedule therapy sessions at least 90 minutes after eating

B. Recommended an over-the-counter proton pump inhibitor (PPI) medication

C. Include sit-ups in supine to strengthen abdominals

D. Ensure that the patient eats a small snack before starting exercise

A

In a patient demonstrating early lift-off during the preswing phase of gait, the mobility of which joints of the ankle and foot are important for assessing the ability to maintain forward progression of the foot?

A. Talocrural and first metatarsophalangeal joints

B. Talocrural and talonavicular joints

C. Subtalar and talonavicular joints

D. Subtalar and first metatarsophalangeal joints

C

An elderly patient with a transfemoral amputation is having difficulty wrapping the residual limb. The PT's BEST course of action is to:

A. Apply a temporary prosthesis immediately

B. Consult with the vascular surgeon about the application of an Unna's paste dressing

C. Use a shrinker

D. Redouble efforts to teach proper Ace bandage wrapping

B

A patient is being treated for secondary lymphedema of the right arm as a result of a radical mastectomy and radiation therapy. The resulting edema (stage 1) can BEST be managed in physical therapy by:

A. Isometric exercises, extremity positioning in elevation, and compression bandaging

B. Intermittent pneumatic compression, extremity elevation, and massage

C. AROM and extremity positioning in a functional arm/hand position

D. Isokinetics, extremity positioning in elevation, and massage

A

A patient has a 2 year history of ALS and exhibits moderate functional deficits. The patient is still ambulatory with bilateral canes, but is limited in endurance. An important goal for the physical therapy POC should be to prevent:

A. Overwork damage in weakened, denervated muscle

B. Further gait deterioration as a result of ataxia

C. Further functional loss as a result of myalgia

D. Radicular pain and paresthesias

D

A therapist decides to use the Dynamic Gait Index (DGI) to examine a patient's gait. The DGI evaluates and documents a patient's ability to:

A. Maintain consistency of gait in a structured environment

B. Safely navigate the home environment

C. Safely navigate the community environment

D. Modify gait in response to changing task demands

C

During initial standing, a patient with chronic stroke is pushing strongly backward, displacing the center of mass at or near the posterior limits of stability. The MOST LIKELY cause of this is :

A. Contraction of the hip extensors

B. Spasticity of the tibialis anterior

C. Spasticity of the gastrocnemius-soleus

D. Contracture of the hamstrings

B

A patient presents with decreased ankle dorsiflexion range of motion following repair of the Achilles tendon that is now well healed. Which joint, in addition to the talocrural joint, should be assessed as a likely contribution to the restricted range?

A. Subtalar joint

B. Tibiofibular joint

C. Cuboid-navicular joint

D. Calacaneo-cuboid joint

C

An elderly and frail individual is receiving physical therapy in the home environment to improve general strengthening and mobility. the patient has 4 year history of taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin for joint pain, and recently began taking a calcium channel blocker (verapamil). The PT examines the patient for possivble adverse reactions/side effects that could include:

A. Increased sweating, fatigue, chest pain

B. Weight increase, hyperglycemia, hypotension

C. Stomach pain, bruising, confusion

D. Paresthesia, incoordination, bradycardia

A

A PTA becomes aware that her supervising therapist is having a consensual sexual relationship with a current male outpatient under the supervisor's care. What is the BEST course of action for the PTA?

A. Report any concerns to the human resources department

B. Immediately report the situation to the state licensing board

C. Approach the supervising therapist emphasizing her concerns about this behavior

D. Do nothing as the behavior is consensual and not occurring on the hospital premises

D

A patient presents with a large plantar ulcer that will be debrided. The foot is cold, pale and edematous. The patient complains of dull aching, especially when the leg is in the dependent position. The condition that would most likely result in this clinical presentation is:

A. Acute arterial insufficiency

B. DVT

C. Chronic arterial insufficiency

D. Chronic venous insufficiency

C

it is most important for the physical therapist to educate a client who recently had a radical lymph node dissection secondary to prostate cancer to:

A. Use a home compression pump with pressures > 80 mmHg

B. Routinely perform circumferential measurements of both lower extremities

C. Closely monitor any changes in the fitting of their socks or shoes

D. Use alkaline soaps and cleansers on the skin

A

Five days after an aortic valve replacement, a patient is diagnosed with a deep vein thrombosis (DVT). The patient was immediately started on an anticoagulant. What is the therapist's BEST initial treatment option?

A. Early ambulation while wearing compression stockings

B. Supine exercises as the patient will be kept on bed rest for a week

C. Delay exercise as it is contraindicated at this time

D. ADLs while sitting on the edge of the bed

B

Researchers examined the benefits of strength training on functional performance in older adults. The data analysis involved a meta-analysis. This refers to:

A. Pooling of data of all available studies to yield a larger sample

B. Pooling of data of RCTs to yield a larger sample

C. A mechanism to critically evaluate studies

D. Data analysis performed by the Cochraine Collaborations

D

A factory worker injured the right arm in a factory press with damage to the ulnar nerve at the elbow. A diagnostic electromyogram (EMG) was performed 3 weeks after the injury, with evidence of spontaneous fibrillation potentials. in this case, the PT recognizes that:

A. Reinnervation is in process

B. Reinnervation is complete

C. Neurapraxia has occurred

D. Denervation has occurred

B

A young adult develops patellofemoral pain syndrome (PFPS) after starting a new exercise class. Which combination of static and dynamic postural alignment tests and measures would be of GREATEST benefit in identifying potential abnormal patellofemoral joint biomechanics?

A. Patellar baja and hop test

B. Q-angle and step-down test

C. Patella alta and heel raise

D. Genu recurvatum and single leg stance

D

A 16 year old patient with osteosarcoma is being sen in physical therapy for crutch training. The parents have decided not to tell their child about the diagnosis. The patient is quite perceptive, and asks the PT directly if it is cancer. The therapist's BEST course of action is to:

A. Tell the patient to speak directly with the physician

B. Discuss the cancer with the patient, gently acknowledging the parents' fears

C. Change the subject and discuss the plans for that day's treatment

D. Schedule a conference with the physician and family about these questions

A

A 6 year old boy has a diagnosis of Duchenne's muscular dystrophy, with more than a third of lower extremity muscles graded less than 3/5. The child is still ambulatory with assistive devices for short distances. The MOST appropriate activity to include in his POC would be:

A. Recreational physical activities such as swimming

B. 30 minutes of circuit training using resistance training and conditioning exercises

C. Wheelchair sports

D. Progressive resistance strength training at 80% maximum vital capacity

C

A patient who is 3 months' post-CVA is being treated in physical therapy for adhesive capsulitis of the right shoulder. Today, the patient complains of new symptoms, including constant burning pain in the right upper extremity that is increased by the dependent position and touch. The right hand is mildly edematous and stiff. in this case, the intervention that is CONTRAINDICATED is:

A. Positional elevation, compression and gentle massage to reduce edema

B. Stress loading using active compression during upper extremity weight bearing activities

C. Passive manipulation and ROM of the shoulder

D. AROM exercises of the limb withing a pain-free range to regain motion

C

An appropriate fine motor behavior that should be established by 9 months of age is the ability to:

A. Build a tower of four blocks

B. Pick up a raisin with a fine pincer grasp

C. Transfer objects from one hand to another

D. Hold a cup by the handle while drinking

B

An 11 year old was referred to physical therapy with complaints of vague pain at the right hip and thigh that radiated to the knee. AROM is restricted in abduction, flexion and internal rotation. A gluteus medius gait was observed with ambulation for 100 feet. The BEST choice for PT intervention is:

A. Orthoses to control lower extremity position as the result of femoral anteversion

B. Closed-chain partial weight bearing lower extremity exercises for slipped capital femoral epiphysis

C. Open-chain strengthening of the right hip abductors and internal rotators for avascular necrosis of the hip

D. Hip joint mobilization to improve the restriction in motion as the result of Legg-Calve Perthes disease

D

A middle-aged adult is running a marathon race and collapses well short of the finish line. Ambient temperature is 92 degrees Fahrenheit and body temperature is measured at 101 degrees Fahrenheit. This individual has a rapid pulse and rapid respirations. Skin feels warm and dry. When questioned by the PT who is helping monitor the runners, the individual is confused. The therapist recognizes that these findings are consistent with:

A. Hypervolemic shock

B. Septic shock

C. Anaphylactic shock

D. Hypovolemic shock

A

A patient is able to walk independently with an assistive device in the hall outside the PT gym. When asked to walk across the hospital lobby and through a revolving door, the patient slows down considerably and stops by the revolving door, unable to proceed. The therapist determines:

A. Open skills and externally paced skills are impaired while closed skills are intact

B. Co-incident timing is impaired while open and closed skills are intact

C. Serial skills are intact while continuous skills are impaired

D. Both open and closed skills are impaired

A

A patient with a T4 spinal cord injury (SCI) is being measured for a wheelchair. In determining the correct seat height, the PT can use as a measure:

A. Clearance between the floor and the foot plate of at least 2 inches

B. The patient's leg length measurement plus 4 inches

C. Clearance between the floor and the foot plate of at least 4 inches

D. The distance from the bottom of the shoe to just under the thigh at the popliteal fossa

C

A patient suffered carbon monoxide poisoning from a work-related factory accident and is left with permanent damage to the basal ganglia. Intervention for this patient will need to address expected impairments of:

A> Impaired sensory organization of balance with the use of standing balance platform training

B. Muscular spasms and hyperreflexia with the use of ice wraps

C. Motor planning with the use of guided and cued movement

D. motor paralysis with the use of free weights to increase strength