2nd PEAT Part I

A patient reports a 2-day history of a hot, swollen, first metatarsophalangeal joint. This complaint is MOST common in:

1. osteoarthritis.

2. polymyositis.

3. gout.

4. rheumatoid arthritis.

3

A patient who sustained an avulsion of the right C5 and C6 spinal nerve roots will show functional loss of right:

1. distal thumb flexion.

2. ulnar wrist deviation.

3. elbow extension.

4. shoulder abduction.

4

After a kidney transplant, a patient develops a Stage 3 pressure injury over the sacrum and is referred to physical therapy for wound care. Which of the following is the MOST appropriate agent to use initially on this wound?

1. Povidone-iodine solution

2. Sterile normal saline

3. Silver sulfadiazine (Silvadene) cream

4. Zinc oxide cream

2

When providing patient education in cardiac rehabilitation, which of the following signs and symptoms of exertional intolerance should the physical therapist emphasize?

1. Anginal pain, insomnia, sudden weight gain, leg stiffness

2. Persistent dyspnea, dizziness, anginal pain, sudden weight gain

3. Persistent dyspnea, anginal pain, insomnia, weight loss

4. Anginal pain, confusion, leg numbness, weight loss

2

A patient with no history of trauma has nonradiating low back pain. Lumbar flexion does not reverse the lordosis and is pain-free; lumbar extension increases the symptom. Palpation reveals a step-off in the lower lumbar region. The MOST appropriate treatment for this patient would be:

1. abdominal strengthening.

2. sustained prone positioning on elbows.

3. exaggerated lumbar lordosis in sitting.

4. grade III posteroanterior glide to L5.

1

A patient positioned in prone has difficulty initiating hip extension with the knee bent. Which of the following muscles will MOST likely need strengthening?

1. Hamstrings

2. Gluteus maximus

3. Lumbar erector spinae

4. Gluteus medius

2

A patient presents with moderate pain in the elbow after a fall. The radiograph is negative for a fracture. Which of the following mobilizations is MOST appropriate for decreasing the pain?

1. Small-amplitude oscillations before the onset of tissue resistance

2. Small-amplitude oscillations into tissue resistance

3. Large-amplitude oscillations into tissue resistance

4. Large-amplitude oscillations at the end of tissue resistance

1

During the test in the photograph, the patient demonstrates hyperreflexia. What is the MOST likely cause of this finding?

1. A spinal cord tumor at L1

2. A herniated nucleus pulposus at L4

3. Femoral nerve impingement

4. A cauda equina lesion

1

A patient is referred to physical therapy for right shoulder pain. Which of the following findings suggests that physical therapy intervention may not be appropriate?

1. Pain that subsides with right sidelying

2. Tenderness to palpation at the origin of the biceps tendon

3. Trigger points at the right rib 2-3 intercostal space

4. Pain with resisted shoulder lateral (external) rotation

1

A patient with an incomplete C8 spinal cord injury reports of burning in the buttocks when sitting in a wheelchair. Which of the following problems with the patient's wheelchair would be MOST likely to contribute to the burning?

1. Footplates are too high.

2. Footplates are too low.

3. Seat is too narrow.

4. Seat is too deep.

1

A patient reports insidious onset of pain and paresthesia on the lateral aspect of the right forearm and hand. The symptoms are reproduced with neck extension. Which of the following is the MOST likely diagnosis?

1. C6 radiculopathy

2. Ulnar nerve entrapment

3. Radial nerve entrapment

4. C8 radiculopathy

1

A physical therapist is examining the posterior aspect of the heels of a patient who has darkly pigmented skin. Which of the following findings would indicate the presence of a Stage 1 pressure injury?

1. An intact area of the skin that is black and leathery

2. An intact area of the skin that is warm and purple

3. A shallow crater with a moist wound bed

4. An intact blister with a boggy feel

2

A 41-year-old patient sustained a grade II injury to the right medial collateral ligament of the elbow 3 weeks ago. A systems review reveals normal cardiopulmonary, integumentary, and neuromuscular status. Which of the following is MOST likely the status of the healing tissue?

1. Well organized and gaining in tensile strength

2. Well organized and capable of withstanding high tensile forces

3. Disorganized but able to withstand high tensile forces

4. Disorganized and unable to withstand high tensile forces

4

The patient in the photograph exhibits pronation of the feet. Pronation is associated with medial (internal), not lateral (external), rotation of the knee along with valgus stress. The person in the photograph is asked to perform a bilateral squat. Based on the rearfoot position, which of the following will MOST likely be observed?

1. Genu varum with tibial medial (internal) rotation

2. Genu varum with tibial lateral (external) rotation

3. Genu valgus with tibial medial (internal) rotation

4. Genu valgus with tibial lateral (external) rotation

3

While walking on a treadmill during Phase II cardiac rehabilitation following coronary artery bypass surgery, a patient reports the new onset of chest pain and dyspnea. The physical therapist should instruct the patient to:

1. continue walking while the therapist monitors the patient's vital signs.

2. continue walking at 50% slower speed while the therapist calls the physician.

3. cease walking while the therapist reassesses the patient's vital signs.

4. cease walking while the therapist activates the emergency medical system.

3

A home health physical therapist conducts an initial evaluation of a patient who sustained a tibial plateau fracture. The patient's status is non-weight-bearing, and the patient uses a walker. The patient lives alone, but has a neighbor who helps with meals. With which of the following aspects of the home environment should the therapist be MOST concerned?

1. Depth of the bathtub

2. Steps without a handrail

3. Width of the doorways

4. Height of the countertops

2

An 18-year-old patient who has osteogenesis imperfecta has been receiving physical therapy services through the school system. The patient is independent in transfers, wheelchair mobility with a motorized wheelchair, and self-care and has been utilizing public transportation. Which of the following courses of action is MOST appropriate in planning for the patient?

1. Continue physical therapy services with a modified goal to maintain independence with mobility.

2. Continue physical therapy services under the care of a physical therapist assistant.

3. Recommend that the patient participate in a support group.

4. Refer the patient to vocational services.

4

A patient who has severe bilateral hip and knee flexion contractures requires the assistance of two people for bed-to-chair transfers. The patient demonstrates normal dynamic sitting balance and Normal (5/5) upper body strength. The patient lives at home with one caregiver. The physical therapist's FIRST intervention should be to teach which of the following transfers?

1. Use of a mechanical lift operated by the caregiver

2. Sliding-board transfer performed by the patient with assistance from the caregiver

3. One-person lift transfer performed by the caregiver

4. One-person stand pivot transfer performed by the patient with assistance from the caregiver

2

A patient with normal urine control reports not being able to reach the toilet in time due to muscle weakness and joint pain. Which type of incontinence BEST describes the patient's condition?

1. Functional

2. Stress

3. Urge

4. Overflow

1

A physical therapist examines a right-handed patient who demonstrates a rounded upper back and protracted shoulders. The patient may be at INCREASED risk for developing which of the following conditions in the left upper extremity?

1. Thoracic outlet syndrome

2. Carpal tunnel syndrome

3. Paresthesia in an ulnar nerve distribution

4. Lateral epicondylalgia

1

During a symptom-limited graded exercise test, a patient exhibits the electrocardiogram pattern shown in the photograph. This pattern is indicative of which of the following phenomena?

1. ST segment elevation

2. Premature ventricular contractions

3. Acute first-degree atrioventricular block

4. Normal response to exercise

2

Which of the following blood pressure changes is an ABNORMAL response to increased exercise intensity and a reason to terminate exercise?

1. Decrease in diastolic blood pressure of 5 mm Hg

2. Increase in diastolic blood pressure of 5 mm Hg

3. Decrease in systolic blood pressure of 20 mm Hg

4. Increase in systolic blood pressure of 20 mm Hg

3

A patient reports constant bilateral posterior calf pain with itching. The examination reveals a body temperature of 98.8°F (37.1°C), normal temperature of the lower extremities, and tenderness to palpation and crusting of the skin in the affected areas. Which of the following conditions is MOST likely present?

1. Dermatitis

2. Cellulitis

3. Atrophie blanche

4. Superficial venous thrombosis

1

Which of the following options BEST describes the mode of action of angiotensin-converting enzyme (ACE) inhibitors?

1. Reduction of heart rate and increase in cardiac contractility

2. Reduction of heart rate and decrease in cardiac contractility

3. Reduction of peripheral vascular resistance and increase in venous capacitance

4. Reduction of peripheral vascular resistance and decrease in venous capacitance

3

A patient who has bicipital tendinopathy is MOST likely to experience pain with which of the following maneuvers?

1. Resisted shoulder flexion with the forearm supinated and the elbow flexed to 15°

2. Passive shoulder medial (internal) rotation and abduction with 90° of elbow flexion

3. Passive shoulder flexion greater than 90° with application of light pressure on the acromion

4. Resisted shoulder extension with the elbow extended and the shoulder abducted to 90° and medially (internally) rotated

1