PEAT 2 (Questions 1 - 100)

A

A physical therapist examining wrist-joint play finds restriction in the direction indicated by the arrow (downward). (The forearm in midposition with the ulnar side resting on the table and the hand at the edge of the table, palm facing you.) The therapist should suspect a decrease in which joint motion?

A. Radial deviation

B. Ulnar deviation

C. Flexion

D. Extension

A

The intervention for a patient with limitation of shoulder flexion and medial (internal) rotation includes mobilization. What glide is MOST appropriate for mobilizing this shoulder to specifically increase the restricted motions?

A. Posterior

B. Anterior

C. Medial

D. Lateral

D

Which of the following techniques is MOST appropriate for a patient with low postural tone?

A. Slow regular rocking while sitting on a treatment bolster

B. Continuous pressure to the skin overlying the back muscles

C. Low-frequency vibration to the back muscles

D. Joint approximation applied through the shoulders to the trunk

C

What skin change associated with aging has the GREATEST effect on wound healing?

A. Reduction in sensation

B. Decreased elasticity of the skin

C. Decreased epidermal proliferation

D. Change in pigmentation

D

Which of the following techniques is MOST effective in teaching a patient with insulin-dependent diabetes about foot care?

A. Reassure the patient that no infections will occur if the directions are followed, then

demonstrate procedures.

B. Tell the patient how foot care is performed, then watch the patient's performance.

C. Watch the patient perform a foot inspection and caution him that amputations result from

untended skin problems.

D. Have the patient demonstrate a foot inspection, then give feedback on the patient's

performance

B

Utilization review and peer review are activities that are a part of a comprehensive:

A. policy and procedure manual.

B. quality improvement program.

C. audit cycle.

D. performance evaluation

C

The demographic information of the participants in a research study lists a mean age of 32 and median age of 35. The difference between the median and mean indicates:

A. the value of the standard deviation score.

B. the value of the Z-score.

C. that the distribution is skewed.

D. that the 2 measures should be averaged.

B

A physical therapist is treating a young athlete with gastrocnemius muscle strength of Fair plus (3+/5). In the prone position, which of the following exercises is MOST appropriate to maximize strengthening?

A. Resistive exercises with the knee bent

B. Resistive exercises with the knee straight

C. Active assistive exercises with the knee bent

D. Active assistive exercises with the knee straight

C

Following spinal joint mobilization procedures, a patient calls the therapist and reports a minor dull ache in the treated area of the back that lasted for 2 to 3 hours. Based on this symptom, the therapist should:

A. consider a possible neurological lesion in the area.

B. refer the patient back to the physician.

C. inform the patient that this response is common.

D. add strengthening exercises to the home program.

A

A 90 year-old patient with chronic congestive heart failure has been non-ambulatory and a nursing home resident for the past year. The patient was recently admitted to the hospital following an episode of dehydration. Which of the following plans for prophylactic respiratory care is MOST appropriate?

A. Turning, coughing, and deep breathing every 1 to 2 waking hours

B. Vigorous percussion and vibration 4 times/day

C. Gentle vibration with the foot of the bed elevated 1 time/day

D. Segmental postural drainage using standard positions throughout the day

D

To help students apply a newly learned skill to clinical practice, the MOST effective action for the clinical instructor to take is to:

A. point out possible patient situations and discuss how the skill would apply to them.

B. have the students research reference materials and compile a list of the steps required to

acquire the skill.

C. prepare a list of indications and contraindications for the skill.

D. have the students provide examples of patient situations where the skill would be

appropriately applied.

B

To prevent contractures in a patient with a transfemoral amputation, emphasis should be placed on designing a positioning program that maintains range of motion in hip:

A. flexion and abduction.

B. extension and adduction.

C. adduction and lateral (external) rotation.

D. flexion and medial (internal) rotation.

C

After a long-term history of bilateral lower extremity vascular insufficiency, an otherwise healthy patient had a right transfemoral amputation. For this patient, which of the following factors is MOST important in establishing long-term goals for functional walking?

A. Status of the wound at the amputation site

B. Range of motion of the right hip

C. Condition of the left lower extremity

D. Ability to maintain upright posture

C

A physical therapist is conducting a 12-minute walk test with a patient who has chronic obstructive pulmonary disease and uses 2 L/min of oxygen by nasal cannula. The patient's resting oxygen saturation is 91% and resting heart rate, 110 bpm. The oxygen flow should be increased if the:

A. patient's carbon dioxide level starts to increase.

B. patient starts to report shortness of breath.

C. patient's oxygen saturation falls below 87%.

D. patient's heart rate is greater than 150 bpm.

B

When training a patient to increase muscle activity with the use of electromyographic biofeedback, the physical therapist should adjust the unit so that sensitivity:

A. starts low and increases as the patient shows an increase in muscle activity.

B. starts high and decreases as the patient shows an increase in muscle activity.

C. remains at approximately midrange during the entire treatment period.

D. is not set, since this is not necessary for this form of biofeedback.

A

During a posture examination, the physical therapist notes that both of the patient's patella point inward when viewed from the front of the patient. The MOST likely cause of this problem is excessive:

A. femoral anteversion.

B. weakness of the vastus medialis.

C. genu varum.

D. medial tibial torsion.

C

A physical therapist is evaluating a patient who has a vascular lesion in the brainstem affecting the oculomotor nerve (III). During the cranial nerve examination, which of the following signs would be the MOST significant?

A. Inability to close the eyelid

B. Medial strabismus

C. Ptosis of the eyelid

D. Constricted pupil

A

A patient is referred to physical therapy for treatment of tenosynovitis. The patient reports a "pins and needles" sensation on the palmar surface of the thumb (1st digit), index (2nd digit), and middle (3rd digit) fingers. The physical therapist's examination reveals a positive Tinel's sign at the wrist and Good (4/5) grade opposition of the thumb (1st digit). Based on these findings, the therapist should suspect:

A. median nerve compression at the wrist.

B. ulnar nerve compression distal to the elbow.

C. tenosynovitis of the abductor pollicis longus.

D. thoracic outlet syndrome.

B

A patient with a complete thoracic spinal cord injury is sitting in a wheelchair on a custom made cushion. Pressure relief activities should be performed:

A. when the patient shows signs of pressure sores.

B. every 15 to 20 minutes.

C. every 1 to 2 hours.

D. if the patient does not have an appropriate cushion.

B

A therapist is measuring passive knee range of motion in a patient. The measurements obtained are shown in photographs A and B. (A - more knee flexion with hip flexed; B - less knee flexion with the hip extended). The MOST likely cause of the difference in knee range of motion is:

A. knee joint capsule restriction.

B. tightness in the rectus femoris.

C. weakness of the hamstrings.

D. tightness in the vastus medialis

C

The hospital administrator asks members of the rehabilitation department to develop a comprehensive program to help reduce the risk of low back injuries. Which of the following steps is the FIRST step necessary to develop this program?

A. Include all employees in a lumbar extension exercise class.

B. Design a program that meets each department's functional needs.

C. Perform an ergonomic analysis on each workstation.

D. Provide pamphlets on proper body mechanics.

A

The physical therapist is positioning a patient for postural drainage. To BEST drain the posterior segment of both lower lobes, the patient should be placed in which of the following positions?

A. Prone, head down at a 45° angle

B. Supine, flat surface

C. Sidelying, head elevated at a 30° angle

D. Sitting, leaning forward

B

A patient who has a right piriformis syndrome is referred to physical therapy for evaluation and intervention. The patient's history includes a total hip arthroplasty on the right side 2 years ago. Because of the total hip arthroplasty, which of the following interventions require added precautions for this patient?

A. Transcutaneous electrical nerve stimulation

B. Continuous ultrasound

C. Hot packs

D. Massage to the right hip

B

A patient presents with adhesive capsulitis of the shoulder joint. The range of motion examination reveals restricted lateral (external) rotation and abduction of the shoulder. The FIRST mobilization procedure that should be done for this patient is:

A. posterior glide.

B. distraction

C. anterior glide

D. lateral (external) rotation

D

A patient sustained a severe, traumatic brain injury 3 months ago. During the examination of passive range of motion, the physical therapist notices decreased passive knee extension and moderate hamstring spasticity. Palpation of the knee reveals a firm mass on the lateral aspect of the joint. The therapist should refer the patient to a physician for an evaluation of probable:

A. osteogenic sarcoma

B. patellar fracture

C. osteomyelitis

D. heterotopic ossification

C

A patient reports anterolateral shoulder pain with an insidious onset. Examination shows full passive range of motion pain on passive lateral (external) rotation and pain on resistive medial (internal) rotation. These signs are consistent with a diagnosis of:

A. bicipital tendonitis

B. supraspinatus tendonitis

C. subscapularis tendonitis

D. infraspinatus tendonitis

A

During manual muscle testing of the hip flexors in the sitting position, a patient exhibits lateral (external) rotation with abduction of the thigh as resistance is applied. The physical therapist should suspect muscle substitution by the:

A. sartorius

B. tensor fascia latae

C. adductor longus

D. semimembranosus

D

A patient is entering a cardiac rehabilitation program. The physical therapist should FIRST ask the patient to:

A. describe the correct aspects of exercise demonstrated by the therapist.

B. list problems associated with poor nutritional habits.

C. identify the harmful effects of smoking with regards to cardiac disease.

D. describe the type of angina that the patient experiences.

D

A physical therapist is setting up a home program of electrical stimulation for a patient who has Bell's palsy. Which of the following muscles should be stimulated as part of the home program?

A. Sternocleidomastoid

B. Masseter

C. Temporalis

D. Frontalis

A

A patient is lying supine with hips and knees extended and hands behind the head. The patient is able to raise the head, shoulders, and thorax from the treatment table, but is unable to come to a complete long-sitting position. What muscle should the physical therapist target for a strengthening program?

A. Iliopsoas

B. External abdominal oblique

C. Quadratus lumborum

D. Upper rectus abdominis

C

A 14 month-old child with spastic diplegia is up on the tiptoes with the toes curled when held in supported standing. This position is characteristic of a:

A. proprioceptive placing reaction.

B. moro reflex

C. plantar grasp reflex

D. traction response

C

Following trauma at the C5 spinal cord level, a patient was admitted to the hospital. Twenty-four hours later, the patient shows no reflexes, sensation, or voluntary motor activity below the level of injury. These findings indicate:

A. the presence of spasticity

B. decerebrate rigidity

C. spinal shock

D. a lower motor neuron lesion

C

A patient with a right transfemoral prosthesis will be able to maintain the knee in extension while weight bearing if the center of gravity of the body is shifted so that the gravitational line falls:

A. posterior to the axis of the right knee joint.

B. lateral to the axis of the right knee joint.

C. anterior to the axis of the right knee joint.

D. medial to the axis of the right knee joint.

B

An initial physical therapy evaluation is performed on an elderly patient who is 1 day post total left hip arthroplasty (non-cemented) using a posterior-lateral approach. The patient has no complicating medical history and was active and independent preoperatively. Which of the following activities is NOT an appropriate goal for the first week of therapy?

A. Active-assistive positioning of the left hip to 60° of flexion

B. Active, left hip abduction in right sidelying

C. Independent bed mobility with use of a trapeze

D. Walking with moderate assistance with a standard walker to 25 ft (7.6 m)

D

A patient with frequent tension headaches has been referred to physical therapy for instruction in a program of progressive relaxation exercises. Which of the following is MOST essential in a program of progressive relaxation to reduce muscle tension?

A. Release of tension by suggestion and persuasion

B. Passive exercise in quiet surroundings to relieve tension

C. General massage using deep stroking and kneading of tense muscles

D. Recognition of the sensations of tension and release

A

A patient slips, falls, and cuts her arm in the clinic. The cut is bleeding and the patient is alert and well oriented. In performing first aid for the patient, the FIRST action that the physical therapist should take is to:

A. don a pair of gloves.

B. clean the cut with an antiseptic.

C. check the patient's blood pressure.

D. cover the cut with a sterile dressing.

D

A physical therapist is working with a patient who is aware of being terminally ill. What is the MOST appropriate intervention when the patient wants to talk about the prognosis?

A. Discourage discussion of death or dying.

B. Refer the patient for pastoral counseling.

C. Relate the therapist's experiences with other patients.

D. Encourage the patient's expression of feelings.

D

A physical therapist examines a patient who reports foot pain while jogging. The examination shows that the patient has excessive foot pronation and forefoot varus. The therapist decides to try a temporary orthotic insert in the patient's running shoe. Which of the following is the MOST appropriate orthotic insert?

A. A lateral forefoot post under the 5th metatarsal head

B. A lateral rearfoot post under the calcaneus placed in an everted position

C. A wedge placed under the instep of the medial foot just beneath the head of the talus

D. A medial post just proximal to the 1st metatarsal head

D

Although knee motion occurs primarily in 1 plane, tibial rotation is possible when the knee is positioned in 90° or more of flexion because in this position the:

A. condyles of the femur glide posteriorly on the condyles of the tibia.

B. hamstrings act as a rotating force.

C. patella deviates inferiorly.

D. tension on the ligaments is decreased.

A

A postural correction program for a patient with forward head, kyphosis, and increased lumbar lordosis should include all of the following EXCEPT:

A. strengthening the scapular protractors.

B. strengthening the thoracic erector spinae muscles.

C. lengthening the short suboccipital muscles.

D. lengthening the lumbar erector spinae muscles.

D

A patient in the eighth month of pregnancy presents with numbness and tingling of the left hand, except for the little finger (5th digit). She demonstrates edema of the hand and fingers, a positive Tinel's sign at the wrist, and a Good (4/5) muscle test grade of the wrist and finger flexors. The MOST appropriate intervention is:

A. a wrist splint to position the wrist in full extension.

B. a hot pack followed by tendon gliding exercises.

C. resistive exercises for the wrist and finger flexors.

D. frequent rest and elevation of the left upper extremity.

A

A patient who has chronic obstructive pulmonary disease is being treated with a regimen that includes pursed-lipped breathing exercises. The PRIMARY purpose of the pursed-lipped breathing is to:

A. help prevent the collapse of pulmonary airways during exhalation thereby reducing air

trapping.

B. decrease the removal of carbon dioxide during ventilation.

C. increase the residual volume of respiration so that more oxygen is available for body

metabolism.

D. stimulate further mobilization of mucous secretions to higher air passages where they can be

expectorated

C

A patient with a diagnosis of cervical radiculopathy reports numbness of the right little finger (5th digit). The physical therapist will MOST likely find a diminished tendon reflex in the:

A. biceps brachii

B. deltoid

C. triceps brachii

D. brachioradialis

D

In a suction-socket prosthesis, the PRIMARY function of the valve in the lower and medial part of the socket is to permit air to:

A. remain during the stance phase of gait.

B. remain during the swing phase of gait.

C. escape during the swing phase of gait.

D. escape during the stance phase of gait.

B

A patient with chronic venous insufficiency of the lower extremities is MOST likely to exhibit:

A. normal superficial veins, no edema, ulceration, and patches of gangrene around the toes.

B. dilation of superficial veins, edema, and stasis ulceration.

C. no edema, cold, hairless extremities, and faint dorsalis pedis pulse.

D. dilation of superficial veins and edema made worse during sitting or elevation of the lower extremities.

A

Following removal of a long-leg cast, a patient has limited knee flexion. The MOST appropriate direction of patellar mobilization is:

A. distal

B. lateral

C. proximal

D. medial

C

Which lower extremity proprioceptive neuromuscular facilitation pattern is MOST appropriate for a patient who needs strengthening of the tibialis posterior?

A. Hip extension, abduction, and medial (internal) rotation, with ankle plantarflexion and

eversion

B. Hip flexion, adduction, and lateral (external) rotation, with ankle dorsiflexion and inversion

C. Hip extension, adduction, and lateral (external) rotation, with ankle plantarflexion and

inversion

D. Hip flexion, abduction, and medial (internal) rotation, with ankle dorsiflexion and eversion

C

A patient is referred to physical therapy with a diagnosis of low back pain. Radiographic studies, including magnetic resonance imaging, have ruled out the presence of disc pathology. The patient reports continuous back pain that radiates upward toward the thorax and anteriorly into the abdominal region. The physical therapist should consider which of the following areas as a potential source of the discomfort?

A. dura mater

B. diaphragm

C. kidney

D. urinary bladder

A

An adult patient who was involved in a motor vehicle accident has sustained multiple traumas, including fractured ribs on the right side. The patient is unconscious, intubated, and on a mechanical ventilator in the intensive care unit. Chest radiographs show the development of an infiltrate in the right lower lobe during the past 2 days. Rales and rhonchi are heard over the right lower lung fields. Which of the following chest physical therapy programs is MOST appropriate?

A. Manual hyperventilation and suctioning while positioned on the left side

B. Positioning supine for suctioning, followed by manual hyperventilation while positioned on

the left side

C. Suctioning, percussion, and vibration while positioned on the right side

D. Positioning on the left side for deep breathing exercises only

B

A physical therapist reads an article on a muscle physiology study. The results of the study are shown in the graph (length-tension curve). The therapist can BEST use the results of the study to explain the underlying rationale for which of the following interventions?

A. The use of prolonged passive stretching to lengthen shortened connective tissue

B. The use of plyometrics to enhance muscle power

C. The use of closed chain versus open chain exercises to enhance co-contraction of muscles

D. The use of hold-relax techniques for muscle stretching

D

In the early management of a patient with a partial peripheral nerve injury, the goal of the physical therapy intervention will MOST likely be to prevent:

A. nerve degeneration

B. spasticity and increased muscle tone

C. muscle atrophy

D. contractures and adhesions

B

A physical therapist is developing an educational program for individuals with lower extremity peripheral neuropathies due to diabetes. Which of the following information is MOST important for the physical therapist to recommend for the prevention of injury to the feet?

A. Orthoses to support the extremity

B. Use of proper footwear

C. Moisturizing the skin to prevent dryness

D. Exercise parameters

B

Elevating a patient's lower extremity for less than 1 minute produces a noticeable pallor of the foot, followed by delayed reactive hyperemia in a dependent position. These signs are indicative of:

A. an intact circulatory system

B. arterial insufficiency

C. venous insufficiency

D. acute arterial occlusion

C

While ascending stairs, an elderly patient leans forward with increased hip flexion. Which of the following muscles are being used to the best advantage with this forward posture?

A. rectus femoris

B. tensor fascia latae

C. gluteus maximus

D. erector spinae

C

An inpatient physical therapy department has only 1 physical therapist and 1 physical therapist assistant on duty, due to staff illness. A patient with which of the following conditions and circumstances is MOST appropriate for the therapist to delegate to the assistant?

A. Ataxia, who is undergoing a trial to determine an appropriate assistive device

B. Hemiparesis, whose initial evaluation has not been completed

C. Multiple sclerosis, who is receiving gait training with a rolling walker

D. Alzheimer's disease, who is easily agitated during the initial gait training

C

The brother of a patient who was recently discharged from the hospital's outpatient physical therapy department telephones on the patient's behalf to request a copy of the patient's medical record. The physical therapist should explain to the patient's brother that the medical record is the property of the:

A. patient's family and can be released to the brother upon written request.

B. patient's insurer now and that the request for a copy must be made in writing to the insurer.

C. hospital and the patient and can be released only with written authorization from the patient.

D. hospital and can be released only with written authorization from the patient's physician.

B

A physical therapist is examining a patient for possible lower extremity weakness. Passive range of motion is within normal limits. The patient is seated. When the patient tries to dorsiflex and invert the right foot, the patient is unable to move it through the full range of motion and is unable to take any resistance applied by the therapist. During the subsequent gait examination, the therapist should expect the patient to display which of the following?

A. Normal gait with no deviations

B. Increased right hip flexion during midswing phase

C. Throwing the trunk backward on the right side shortly after heel strike (initial contact)

D. Laterally bending towards the right side during midstance

B

A patient is referred to physical therapy with a diagnosis of chondromalacia patella. The physical therapist should decide to include quadriceps setting and straight-leg raises as part of the home exercise program, because:

A. the vastus medialis muscle is primarily responsible for terminal knee extension.

B. quadriceps setting and straight-leg raises help improve patellar tracking.

C. patello-femoral compression forces are increased when the knee is extended.

D. the vastus medialis muscle is preferentially activated during a straight-leg raise.

C

Which of the following statements does NOT document patient outcome?

A. The patient propelled his wheelchair independently after 4 weeks.

B. The patient demonstrated independent performance of home program after 2 weeks.

C. The patient walked 100 ft (30.5 m) with minimal assistance after 1 week.

D. The patient attended physical therapy sessions 3 times/week for 2 week.

A

Which of the following is the MOST likely cause of a reduced vital capacity in a patient who has quadriplegia at the C5-C6 level?

A. Decreased anterolateral chest expansion resulting from paralysis of the external intercostal

muscles

B. Inability of the patient to generate a negative intrapleural pressure secondary to a denervated

diaphragm

C. A relatively high resting position of the diaphragm resulting from paralysis of the abdominal

muscles

D. Reduced rib-cage elevation due to paralysis of the anterior scalene and sternocleidomastoid

muscles

A

Instruction in energy conservation and joint protection should be provided to a patient with rheumatoid arthritis, because:

A. the joints may be predisposed to damage by overuse.

B. fatigue often masks joint pain.

C. phagocytes remove more pannus in a resting joint.

D. activity of the antigen-antibody complex is diminished with rest.

C

In which of the following is independence the MOST realistic long-term goal for a patient with a complete spinal cord lesion at C8?

A. Effective cough technique

B. Rolling from side to side

C. Transfer from bed to wheelchair

D. Walking with forearm crutches

A

To minimize skin irritation during functional electrical nerve stimulation, the physical therapist should use:

A. lower intensity, larger interelectrode distance, and larger electrodes.

B. lower intensity, larger interelectrode distance, and smaller electrodes.

C. higher intensity, smaller interelectrode distance, and smaller electrodes.

D. lower intensity, smaller interelectrode distance, and larger electrodes.

B

A patient is doing active and resistive exercises on a mat table in the physical therapy department. After 15 minutes, the patient becomes short of breath, begins coughing, and expectorates pink, frothy sputum. At this point, the physical therapist should first stop the treatment, then NEXT:

A. assess vital signs, let the patient rest a few minutes with the feet elevated, and then resume

with a less vigorous program.

B. sit the patient up, assess vital signs, and call a nurse or physician for further instructions.

C. lay the patient supine, transfer the patient to a stretcher, and return the patient to the nursing

unit.

D. lay the patient down flat, call for assistance, and begin cardiopulmonary resuscitation.

C

A patient who sustained a mild cerebrovascular accident 3 weeks ago is being prepared by the physical therapist for discharge to home and an adult day program. To facilitate the discharge plan, the MOST appropriate health professional for the therapist to consult with is the:

A. skilled nursing coordinator.

B. occupational therapist.

C. medical social worker.

D. primary physician.

D

A physical therapist examines a high school athlete in the training room. After removing the adhesive strapping from the athlete's ankle, the therapist discovers that the athlete has developed an open weepy rash on the instep of the foot. The therapist should FIRST:

A. apply moist heat to the foot.

B. send the patient to a hospital emergency room.

C. use more pre-wrap with the next joint taping.

D. refer the patient to the team physician.

C

A patient who sustained a left transtibial amputation 2 years ago and a right transtibial amputation 3 weeks ago is being evaluated for possible walking with prosthesis. Which of the following factors is MOST relevant?

A. Size of the right residual limb scar

B. Length of the right residual limb

C. Proficiency in previous prosthetic use

D. Severity of phantom pain

A

A prone standing board has been recommended for a 5 year-old child with severe hypotonia. The PRIMARY purpose for the use of a prone stander is to:

A. promote weight bearing.

B. reinforce an exaggerated positive support reflex.

C. prevent hip dislocation.

D. increase hip and knee range of motion.

B

A patient has difficulty palpating the carotid pulse during exercise. The patient should be instructed in alternate methods of self-monitoring, because repeated palpation is likely to result in:

A. increasing the heart rate.

B. decreasing the heart rate.

C. an irregular heart rhythm.

D. increasing systolic blood pressure.

A

A patient spilled boiling water on the right arm when reaching for a pan on the stove. The forearm, elbow, and lower half of the upper arm appear blistered and red, with some subcutaneous swelling and pain on touch. To facilitate optimal function, the physical therapist should PRIMARILY emphasize:

A. range of motion exercises to the right hand, wrist, and elbow.

B. application of compression dressings.

C. sterile whirlpool to the right upper extremity.

D. splinting of the right upper extremity in full elbow extension.

C

A physical therapist plans to study the effect of cold compresses on passive range of motion in a group of 10 patients. The plan is to apply these compresses to the hamstring muscles 1 time/day for 5 days. Which of the following experimental designs is MOST appropriate for this type of study?

A. For both the experimental and control groups, gather data from patient records.

B. For both the experimental and control groups, measure range of motion of both groups on

day 5.

C. For both the experimental and control groups, measure range of motion on days 1 and 5.

D. For the experimental group, measure range of motion every day. For the control group,

measure range of motion on days 1 and 5.

A

During an examination of elbow strength using MMT, the patient supinates the forearm when attempting elbow flexion. Which of the following muscles is MOST likely doing the major part of the work?

A. Biceps brachii

B. Brachialis

C. Supinator

D. Brachioradialis

C

A patient has pain, swelling, and tenderness over the medial border of the hand. The patient also shows changes in the color and temperature of the skin, hyperhidrosis, and progressive joint stiffness in the wrist and hand. The MOST likely cause of the patient's signs and symptoms is:

A. cervical disc disease.

B. Raynaud's phenomenon.

C. Complex Regional Pain Syndrome

D. carpal tunnel syndrome.

C

While a patient is walking in the parallel bars, the physical therapist observes that the pelvis drops down on the side opposite the stance extremity. This gait deviation is an indication of weakness of the hip:

A. abductors of the swing extremity

B. adductors of the swing extremity.

C. abductors of the stance extremity.

D. adductors of the stance extremity.

B

Which of the following structures is indicated by the arrow in the radiograph?

A. Intertubercular groove

B. Greater tubercle

C. Lesser tubercle

D. Coracoid process

C

When treating a patient who has ankylosing spondylitis, the muscles requiring the MOST

emphasis for strengthening exercises are the:

A. pectorals.

B. hip flexors.

C. back extensors

D. abdominals.

B

A 3 month-old child has motor and sensory loss in the right upper extremity in the areas innervated by the C5 and C6 spinal nerves. The cause of this birth injury MOST likely is:

A. hemiparesis

B. Erb-Duchenne paralysis.

C. spinal cord injury.

D. Klumpke's paralysis

C

A patient with multiple sclerosis is referred for physical therapy at home. Before going home, the patient requires training in bathing, dressing, and eating. Adaptive devices may be needed to accomplish this. The physical therapist should recommend that the patient be seen by:

A. a social worker

B. an orthotist.

C. an occupational therapist.

D. a home health nurse.

C

A patient with Parkinson's disease has just been admitted to the rehabilitation unit. The patient is dependent in all transfers and requires moderate assistance of 1 person to walk 30 ft (9.1 m) with a standard walker. To facilitate good carry-over for activities, instruction of the family in transfers should occur:

A. during a home visit after the patient is discharged

B. just prior to discharging the patient

C. early in the rehabilitation program

D. when the family feels ready to take the patient home.

C

A patient had final approval and checkout of a permanent prosthesis 2 weeks ago. The patient now reports to the physical therapist that the prosthesis is too heavy. The patient will benefit MOST from:

A. an evaluation of the socket fit by the prosthetist.

B. a prescription from the physician for a lighter-weight prosthesis

C. re-evaluation of hip strength by the physical therapist

D. adding a fork strap attachment to the prosthesis

D

A patient has a history of neck pain that is aggravated by long periods of sitting. The pain becomes progressively worse by evening. Range of motion and strength of the neck and shoulders are within normal limits. Sensation and reflexes are intact in both upper extremities. The patient has a forward head and excessive thoracic kyphosis. The MOST appropriate exercise program includes:

A. stretching of the neck flexors and pectoral strengthening

B. upper trapezius strengthening and pectoral stretching.

C. pectoral strengthening and rhomboid stretching

D. rhomboid strengthening and axial neck extension

B

Upon removal of a wet-to-dry dressing from a draining wound, a physical therapist observes that the skin immediately surrounding a patient's wound is macerated. What should the therapist recommend for future wound care?

A. Continue using the current dressing type

B. Make the dressing more absorbent.

C. Leave the dressing on longer between dressing changes

D. Change to a pressure-type dressing

A

A patient is performing a Phase I (inpatient) cardiac rehabilitation exercise session. The physical therapist should terminate low-level activity if which of the following values changes from resting level?

A. The diastolic blood pressure increases to 120 mm Hg.

B. The respiratory rate increases to 20 breaths per minute.

C. The systolic blood pressure increases by 20 mm Hg.

D. The heart rate increases by 20 bpm.

B

A therapist is preparing to teach a patient who has Guillain-Barre syndrome to transfer from wheelchair to a mat table. The patient weighs 150 lbs., she has poor (2/5) grade in both of her lower extremities and fair (4/5) grade in her left upper extremity; her right upper extremity has normal (5/5) strength. Which of the following would be the MOST appropriate assisted transfer for the initial session of this patient?

A. 2-person lift to the right side

B. Sliding-board transfer to the right side

C. A hydraulic lift from the wheelchair to the mat

D. Full standing-pivot transfer to the right side

B

In physical therapy program planning for geriatric patients, an important age-related change that should be taken into consideration is:

A. the inability to learn new motor tasks.

B. decreased pain sensation

C. decreased motivation.

D. the inability to select alternative movement strategies

B

To achieve maximum reduction of lymphedema following a mastectomy in the upper extremity by means of massage, it is MOST important that:

A. local heat be applied before the massage

B. the upper arm be massaged before the forearm

C. the hand be massaged before the forearm.

D. the massage strokes occur in a centrifugal direction

A

A patient with a diagnosis of complete spinal cord lesion at C4-C5 demonstrates a weak, cough mechanism. Which of the following techniques would MOST effectively augment the patient's coughing?

A. Manual pushing against the upper abdomen

B. Positioning the patient in prone

C. Pursed-lipped breathing

D. Interrupting the expiratory air stream

B

A patient is referred for recommendation regarding purchase of a wheelchair. The measurements of the patient while sitting are 16 in (40.6 cm) across the widest point of the hips and 18 in (45.7 cm) from the rear of the buttocks to the popliteal crease. Which of the following wheelchair dimensions are BEST suited for this patient's needs?

A. Seat width and seat depth of 18 in (45.7 cm)

B. Seat width of 18 in (45.7 cm) and seat depth of 16 in (40.6 cm)

C. Seat width and seat depth of 16 in (40.6 cm) Seat width and seat depth of 16 in (40.6 cm)

D. Seat width of 16 in (40.6 cm) and seat depth of 18 in (45.7 cm)

D

Which of the following objectives is MOST important prior to discharge, for a patient who has had a myocardial infarction?

A. Ascend a flight of stairs before discharge

B. Perform prescribed exercises without angina

C. Return to normal daily activity level.

D. Take a radial pulse reliably before discharge

B

A patient is undergoing a treadmill stress test. The appearance of abnormally wide, irregularly spaced QRS complexes on the electrocardiogram represents:

A. ventricular depolarization

B. premature ventricular contractions

C. atrial fibrillation.

D. atrial repolarization

A

Treatment of a patient with hemophilia who has a subacute hemarthrosis of the knee should INITIALLY include:

A. active assistive range-of-motion exercise to the knee.

B. instruction of the patient for weight bearing to tolerance

C. gentle resistive range-of-motion exercise to the knee

D. continuous immobilization of the knee in an extension splint.

B

Which of the following home programs is MOST appropriate for a patient with chronic lateral epicondylitis?

A. Using a forearm cuff to increase loading on the extensor tendons

B. Performing exercises for wrist strength and stretching

C. Administering iontophoresis with dexamethasone (Decadron) and lidocaine (Xylocaine)

D. Doing friction massage of the brachioradialis tendon

B

A physical therapist who works in a home health agency is treating a patient with diabetes mellitus. The patient tells the therapist that he is no longer taking his insulin. The physical therapist's FIRST course of action should be to:

A. instruct the patient in the proper technique for injection of insulin

B. contact the patient's home health nurse.

C. tell the patient's family to report this information to the physician.

D. have the patient perform a urine glucose test while the therapist is in the home.

A

Which of the following methods is appropriate for handling a 1 year-old child with cerebral palsy who exhibits strong extensor tone in the trunk and extremities?

A. Carrying the child in a sitting position

B. Carrying the child over one's shoulder

C. Keeping contact with the back of the child's head

D. Picking the child up under the upper extremities

B

A physical therapist evaluates a 65 year-old patient with psoriasis for treatment with ultraviolet radiation. The patient's history includes the following: total hip arthroplasty 1 year ago; penicillin allergy; calcium supplements since menopause; and daily tetracycline (Achromycin) use for the past 2 weeks for a urinary tract infection. Which of these factors should alert the therapist to use extra caution when applying ultraviolet light?

A. Arthroplasty with a metal implant

B. Daily tetracycline (Achromycin) use

C. Penicillin allergy

D. Long-standing calcium supplement use

C

Which of the following instructions is MOST appropriate for teaching a patient with C6 quadriplegia to transfer from a wheelchair to a mat?

A. Keep your fingers extended to give a broader base of support

B. Rotate your head and shoulders in the same direction as the desired hip motion.

C. Rotate your head and shoulders in the direction opposite to the desired hip motion.

D. Keep both hands next to your knees to lock your elbows.

C

Upon abduction and internal rotation of the shoulder with forearm pronated and wrist ulnarly deviated, a patient complains of poorly localized pain over the radial aspect of the proximal forearm with tingling sensation over the lateral dorsum of the hand. The patient most likely has:

A. Cubital tunnel syndrome

B. Pronator teres syndrome

C. Radial tunnel syndrome

D. Anterior interosseous syndrome

A

A patient comes to physical therapy with generalized body pain. Which of the following criteria would BEST provide the physical therapist with discriminating information to distinguish between the presence of fibromyalgia and the presence of any other painful conditions in the patient?

A. The existence of specific tender points

B. Loss of sleep over the past 3 months

C. A poor response to stretching exercises

D. Visual disturbances and loss of balance

D

A patient, who recently had an ankle injury, reports pain in the front of the ankle while walking. This pain is reproduced when, with the patient in sitting, the physical therapist grasps the patient's heel and with the foot remaining in neutral introduces a lateral (external) rotation force to the lower extremity. The pain is not reproduced with inversion or eversion tests to the ankle. The patient MOST likely has which of the following injuries?

A. Syndesmosis sprain

B. Calcaneocuboid sprain C. 5th metatarsal fracture

D. Tibial stress fracture

C

The joint indicated by the arrow (subacromial joint) contains what soft tissue structure?

A. Glenoid labrum

B. Middle deltoid muscle

C. Biceps brachii tendon

D. Pectoralis minor muscle