IER 1

Release of confidential information from a medical record without the patient's consent is illegal if it involves

A. the patient's employer.

B. another therapist involved in peer review.

C. the patient's insurance company.

D. a social worker.

A

You are evaluating an athlete who is complaining of pain in the left shoulder region. Your assessment of the shoulder elicits pain in the last 30 degrees of shoulder abduction range of motion. this finding is most congruent with

A. calcific supraspinatus tendinitis.

B. subacromial bursitis.

C. acromioclavicular sprain.

D. thoracic outlet syndrome.

C

Following a cerebrovascular accident involving the dominant right hemisphere, a patient exhibiting unilateral neglect would generally not

A. eat food only from the right side of the plate.

B. bump a one-arm driven wheelchair into things on the left side.

C. ignore or deny the existence of the left-sided limbs.

D. shave or put make-up only on the left side of the face

D

A patient with spastic left hemiplegia experiences recurvatum during stance phase. If the patient is using an anklefoot orthosis, the cause of the problem might be attributed to

A. not enough limitation by the posterior stop.

B. not enough limitation by the anterior stop.

C. too much limitation by the posterior stop.

D. too much limitation by the anterior stop.

A

Students in clinical settings are held to the standard of practice that is equivalent to

A. a licensed physical therapist.

B. that of a foreign-educated physical therapist.

C. physical therapist assistants.

D. physical therapy aides.

A

To help decrease shear when transferring a patient with a spinal cord injury from bed to chair, it would be best to use

A. a draw sheet.

B. skin lubricant on involved skin surfaces.

C. an air mattress.

D. a sheepskin pad

A

Teaching pursed-lip breathing as part of the treatment regimen would be most appropriate for a patient with

A. circumferential thoracic burns.

B. asbestosis.

C. radiation pneumonitis.

D. emphysema.

D

If a patient with above-knee prosthesis has a prosthetic foot with a plantarflexion bumper that is too hard, during ambulation, the

A. prosthesis would rotate internally at heel strike.

B. prosthetic foot would remain dorsiflexed during the gait cycle.

C. prosthetic foot would remain plantarflexed during the gait cycle.

D. prosthetic knee would not flex sufficiently during stance

B

Prior to performing manual traction in the cervical region, one should perform a test for vertebral artery insufficiency in order to ascertain the adequacy of blood supply to the

A. vertebrae.

B. upper extremities.

C. spinal canal.

D. brain stem

D

A snowmobile left the trail and struck a tree. The driver's left knee was fully flexed and the tibia impacted with the inside front of the snowmobile. This mechanism of injury would most likely result in a

A. dislocated patella.

B. sprained or ruptured posterior cruciate ligament.

C. sprained or ruptured anterior cruciate ligament.

D. rupture of the popliteal artery

B

A patient with a transtibial amputation of 2 months duration complains to you of an intense burning pain that seems to emanate from his heel. This phantom pain mirrored preoperative pain which was the result of previous damage to the

A. dorsalis pedis artery.

B. popliteal artery.

C. peroneal nerve.

D. tibial nerve.

D

Following the reduction of development dysplasia of the hip in an infant, the physical therapist should instruct the parents to maintain that hip in a stable position of

A. flexion and adduction.

B. flexion and abduction.

C. extension and adduction.

D. extension and abduction

C

The quality assurance committee has found that 72 % of the inpatients receiving physical therapy showed no improvement in function. To discover the cause of this high rate, it would be best if the committee check

A. the source of referrals.

B. patient diagnoses.

C. appropriateness and consistency of the physical therapy service.

D. age of the patients.

D

To prepare a patient with a cauda equina lesion for ambulation with crutches, the upper quadrant muscles that would be most important to strengthen would be the

A. upper trapezius, rhomboids and levator scapulae.

B. deltoid, coracobrachialis, and brachialis.

C. middle trapezius, serratus anterior, and triceps.

D. lower trapezius, latissimus dorsi and pectoralis major.

D

When examining the upper quarter of a 52 year-old female patient, the therapist detects a small lump in the axilla. There is no mention of this lump in the medical record. The next thing the therapist should do is

A. tell the patient she may have cancer and to call her physician immediately.

B. stop the examination and refer the patient back to her physician.

C. complete the examination and document the lump.

D. complete the examination, document the lump and refer the patient to her physician.

C

You have been treating a 61 year-old woman over a period of four months for adhesive capsulitis, which has resulted in a "frozen shoulder". Her recovery has been good, however, she still complains that she cannot reach the upper shelves in her kitchen cupboards and closets. To help her achieve his goal, joint mobilization should focus on

A. inferior glide.

B. posterior glide.

C. anterior glide.

D. grade II oscillations

B

Which activity would not help to break up lower extremity synergy combinations in a patient with hemiplegia?

A. Balance training in a kneeling position.

B. Backward leg lifts with the knee extended on the affected side.

C. Bridging in the hooklying position.

D. Rolling from a hooklying position

C

A new student physical therapist and her supervising therapist are overwhelmed by a sudden increase in the number of new patients attending a group exercise class. In this situation it would be best to

A. cancel the class and reschedule the new patients for individual evaluations.

B. allow the student to conduct the class while the supervisor evaluates the new patients.

C. allow the student to assist, in an appropriate way, with the management of the class.

D. assign the student to a less busy therapist while the supervisor concentrates on managing the class.

D

In managing the residual limb of a 72 year-old patient with a transfemoral amputation, the most important factor to consider is

A. contracture of hip musculature.

B. residual limb shape.

C. muscle atrophy.

D. residual limb healing

B

A 54 year-old male, with a long history of cigarette smoking, has been admitted to the hospital and presents with signs of infection, tachycardia, abnormal breath sounds in both lower lobes and dullness to percussion. The physical therapist's major concern and focus with this patient is

A. getting the patient to quit smoking.

B. breathing reeducation to increase efficiency of ventilation.

C. airway clearance and secretion removal.

D. graded inspiratory muscle training.

C

A patient with adhesive capsulitis of the glenohumeral joint should demonstrate the greatest limitation of motion when performing shoulder

A. flexion.

B. abduction.

C. medial rotation.

D. lateral rotation.

D

During a treatment session in a rehabilitation hospital a patient asks the physical therapist assistant to let him see the physical therapy progress notes in his medical record. The physical therapist assistant should

A. refuse to let the patient see the record.

B. allow the patient to see the notes.

C. get the permission of the physical therapist supervisor before giving the patient the chart.

D. contact the patient's physician and explain the situation.

B

If a chest tube gets dislodged during physical therapy treatment and the therapist fails to cover the defect, the patient could develop:

A. pulmonary embolism

B. pulmonary edema

C. pneumothorax

D. aspiration pneumonia

C

Following a motor vehicle accident, a patient with chest trauma developed atelectasis. To help in the immediate management of atelectasis, it would not be appropriate to implement:

A. pain reduction techniques

B. segmental breathing

C. incentive spirometry

D. paced breathing

D

Following a reattachment of the flexor tendons of the fingers, one physical therapy goal is to minimize adhesion formation. A few days after surgery, with the patient in a splint, the physical therapist should teach the patient to perform:

A. passive extension and active flexion of the interphalangeal joints

B. active extension and flexion of the interphalangeal joints

C. active extension and passive flexion of the interphalangeal joints

D. gentle passive extension and flexion of the interphalangeal joints

C

The most functional way to teach an individual with a T4 complete paraplegia to transfer from wheelchair to mat is by using a:

A. stand pivot technique

B. squat pivot technique

C. sliding board

D. back-out technique

B

Your plan of care includes use of iontophoresis in the management of calcific bursitis of the shoulder. To administer this treatment using the acetate ion, the current characteristics and polarity should be:

A. monophasic twin peaked pulses using the positive pole

B. monophasic twin peaked pulses using the negative pole

C. continuous monophasic using the positive pole

D. continuous monophasic using the negative pole

D

If a therapist is planning to establish a new private physical therapy practice, it is best to first:

A. do a community needs assessment

B. outline a budget to determine how much of a business loan is required

C. seek an ideal location or building site for the practice

D. circulate a brochure informing physicians and other practitioners of this new service

A

A friend of yours is an avid tennis player. She telephones and asks you to help her reduce the possibility of developing tennis elbow. As a physical therapist, the best way to respond to your friend is to:

A. describe exercises and proper tennis techniques during the phone conversation

B. in your spare time, watch her play tennis and, after analysis, offer specific suggestions as to how to minimize the risk of developing tennis elbow

C. invite her to your clinic for an evaluation and instruction in appropriate exercises and stretches if indicated

D. send her an illustrated pamphlet dealing with tennis elbow prevention and treatment including other suggested reading

B

Following a mastectomy, a sixty=three year=old female developed massive edema of the arm on the involved side. A compression garment was ordered to help the situation. To help decrease the edema, this garment must exert enough pressure to:

A. decrease the osmotic pressure of the capillaries.

B. increase the capillary permeability

C. exceed the internal tissue hydrostatic pressure

D. equal the fluid outflow from the capillaries

C

A family is caring for a child with a diagnosis of spina bifida. The physical therapist should write the home program assuming a familial education reading level at the:

A. 2 nd - 3 rd grade

B. 5 th - 6 th grade

C. 8 th - 9 th grade

D. 11th - 12th grade

B

During a cold winter day, an outpatient slipped and fell on the ice at the entrance to your outpatient clinic. Before beginning the rehabilitation for a knee injury, the patient says he feels a bit sore, but he can proceed with the treatment. As his physical therapist you should:

A. cancel the treatment for the day

B. start the treatment after noting the incident in the patient's record

C. briefly re-examine the patient prior to any treatment

D. have the patient call his physician to get clearance for physical therapy treatment

C

Twenty-four hours following a major thermal burn, a patient experiences syncope while the physical therapist works on positioning as part of edema management. The syncope is most likely a result of

A. orthostatic hypotension

B. extreme pain

C. intravascular hypovolemia

D. massive infection

C

If you are treating a patient with active infectious Hepatitis B, transmission of the disease is best minimized if you take precautions to avoid:

A. direct contact with the patient's blood or blood-contaminated equipment

B. direct contact with any part of the patient

C. droplet spread of the organisms by coughing

D. direct contact with patient's hands

A

You are working in a school setting as a physical therapist. A supervisor asks you to organize a scoliosis screening program. It would be best to asses:

A. 2 nd or 3rd graders

B. 6 th or 7th graders

C. high school freshmen or sophomores

D. high school juniors or seniors

B

A candidate for admission to a physical therapist assistant program was ranked at +1.0 standard deviations above the mean among all applicants. Interpretation of the class rank, using a normal curve would indicate that this candidate's position is:

A. as good or better than 84% of the other candidates

B. lower than 34% of the other candidates

C. within the top 6% of all candidates

D. within the top 14% of all candidates

A

Use of continuous ultrasound at 1.5 Watts/cm2 will result in:

A. no change in nerve conduction velocity

B. increase in motor nerve conduction velocity and decrease in sensory nerve conduction velocity

C. decrease in motor nerve conduction velocity and increase in sensory nerve conduction velocity

D. increase in both motor and sensory nerve conduction velocity

D

Your spinal cord injury unit within a rehabilitation hospital is preparing for accreditation visits. Accreditation would fall principally under the jurisdiction of the:

A. Joint Commission on Accreditation of Healthcare Organizations and Occupational Safety & Health Administration

B. Commission on Accreditation of Rehabilitation Facilities and Occupational Safety & Health Administration

C. Commission on Accreditation of Rehabilitation facilities and the US Department of Health and Human Services

D. Joint Commission on Accreditation of Healthcare Organizations and Commission on Accreditation of Rehabilitation Facilities

D

It is most likely than when treating a patient with Lyme Disease of more than one year's duration, the physical therapy focus will be on management of arthritic changes primarily affecting the:

A. small joints of the hands and feet

B. large joints of the body; especially the knee

C. axial joints, especially the lumbosacral spine

D. axial joints, especially the cervical and thoracic spine

B

As a physical therapist working with a variety of special needs students in a high school setting, the long term goal that should take the highest priority in the plan of care is that the students should be:

A. independent in taking off and putting on outerwear at the start and finish of the school day

B. able to independently change from classroom to classroom in the allotted time period

C. independent in the purchasing and consumption of lunch in the school cafeteria

D. independent in getting on and off the school bus

B

Just after birth, you observe a full-term infant in the neonatal intensive care unit. In the supine position, the shoulders are abducted and externally rotated, elbows and fingers are flexed, hips are abducted and externally rotated and knees are flexed. This posturing would seem to indicate that the:

A. upper extremity tone is abnormal

B. lower extremity tone is abnormal

C. tone is abnormal in both upper and lower extremities

D. tone is normal in both upper and lower extremities

D

A patient has a fused right knee and placement of an Intramedullary rod in the right femur. In this case, ascending stairs with crutches would best be accomplished by instructing the patient to:

A. face forward, advance the lower left extremity first followed by hiking and circumducting the right lower extremity

B. face forward, advance the right lower extremity first by hiking and circumducting followed by placement of the left lower extremity

C. face backwards to the stairs and advance the right lower extremity first by hiking and circumducting followed by hiking of the left lower extremity

D. face sideward, grasp the banister and advance the right lower extremity first by hiking and abducting followed by placement of the left lower extremity onto the stair below the right lower extremity.

A

While ambulating a patient in the parallel bars, the patient suddenly falls and suffers a severe laceration in the area of the lateral distal right thigh. To help control bleeding you should apply pressure directly over the wound and:

A. behind the knee at the popliteal fossa

B. at the femoral triangle

C. at the antecubital fossa

D. at midthigh, directly over the profunda femoris artery

B

While gait training a patient following a cerebral vascular accident, you observe the knee on the affected side going into recurvatum during stance phase. The most likely cause of this deviation can be attributed to:

A. severe spasticity of the hamstrings or weakness of the gastrocnemius-soleus.

B. weakness or severe spasticity of the quadriceps

C. weakness of the gastrocnemius-soleus or spasticity of the pretibial muscles

D. weakness of both the gastrocnemius-soleus and pretibial muscles

B

You are organizing a group exercise session in a therapeutic pool. Use of the pool would be contraindicated for a group member who has:

A. an indwelling catheter

B. paraparesis and is on a regular bowel program

C. unstable blood pressure

D. an open skin lesion, even if it is covered by waterproof dressing

C

A child with spastic diplegia is now independent in using a walker. Additional goals desired by the physical therapist include increasing the child's energy-efficiency and velocity while ambulating. In this case, the selection of walker that is most likely to help improve these factors is:

A. a standard anterior walker with no wheels

B. an anterior rollator walker with two wheels

C. a posterior rollator walker with two wheels

D. a posterior rollator walker with four wheels

D

The major purpose of having an incident or occurrence report system in a health care facility is for the purpose of:

A. satisfying legal and regulatory authorities

B. satisfying the facility's insurance carrier mandate

C. corporate accountability

D. risk management

D

. Following a myocardial infarction, a patient was placed on medications, which included a beta-adrenergic blocking agent. When monitoring this patient's responses to exercise, you would expect that this drug will cause:

A. heart rate to be low at rest and rise very little with exercise

B. heart rate to be low at rest and rise continuously to expected levels as exercise intensity increases

C. systolic blood pressure to be low at rest and not rise with exercise

D. systolic blood pressure to be within normal limits at rest and progressively fall as exercise intensity increases

A

A neonate's APGAR score at one minute after birth is 8 and four minutes later is 9. You would expect that this baby would probably:

A. have a heart rate of less than 100 beats per minute with slow and irregular respirations and not require resuscitation

B. require extensive resuscitation efforts including intubation

C. require some resuscitation and administration of supplemental oxygen

D. have a heart rate of greater than 100 beats per minute, good respiration and require resuscitation

D

Immediately contact appropriate authorities if you:

A. suspect a patient had been driving under the influence of alcohol

B. suspect a patient has been abusing cocaine

C. notice illegal drug paraphernalia on a table next to a patient during a home visit.

D. believe a patient might be a victim of battered child syndrome

D

You are involved in the management of a young adult who is comatose (Glasgow Coma Scale 3) and is in a nursing home for custodial care. One day, you notice that the patient is beginning to demonstrate decerebrate posturing. You recommend that this patient:

A. be rehospitalized in an acute care facility for reevaluation and intense physical therapy

B. be transferred to a rehabilitation hospital for more intense physical therapy

C. be transferred home with evaluation and treatment by a home health team

D. remain in the nursing home since there is not functional change of status

D

A physical therapy note states: "A patient ambulates independently with crutches on level surfaces and on stairs. The patient lacks endurance to walk up more than one floor at a time; however, this should increase with practice. The patient says he lives on the fourth floor and there is no elevator. Will work to increase endurance prior to discharge." In the SOAP format, the "A" of the note is:

A. will work to increase endurance

B. endurance should increase with practice

C. patient lives on the fourth floor with no elevator

D. patient ambulates independently with crutches

B

To prevent contracture in a newly admitted 8 year-old with anterior neck burns, it would be best to position the neck in:

A. hyperflexion

B. slight flexion

C. neutral

D. extension

D

You are treating a 54 year-old woman for degenerative arthritis of the left knee. Her medical record indicates that she is on estrogen replacement therapy. In this case, you should consider that this patient might be more susceptible to:

A. coronary artery disease

B. osteoporosis

C. clinical depression

D. weight gain

D

You are instructing a new mother to perform range of motion and stretching on her newborn who has a clubfoot. You would advise her to carefully stretch in the direction of:

A. plantarflexion and inversion

B. plantarflexion and eversion

C. dorsiflexion and inversion

D. dorsiflexion and eversion

D

The normal end-feel associated with full elbow extension can be classified as:

A. empty

B. capsular

C. springy block

D. bone-on-bone

D

If a patient had normal quadriceps strength; but, unilateral weakness (3/5) of the hamstring muscles, during swing phase you might observe:

A. excessive compensatory hip extension on the sound side

B. decreased hip flexion followed by increased knee flexion on the weak side

C. excessive hip extension followed by abrupt knee extension on the weak side

D. excessive hip flexion followed by abrupt knee extension on the weak side

D

Following cast immobilization for a now healed supracondylar fracture of the humerus, a patient's elbow lacks mobility. To increase elbow range of motion, joint mobilization in the maximum loose-packed position should be performed at:

A. full extension

B. 90 degrees of flexion

C. 70 degrees of flexion

D. 30 degrees of flexion

C

A patient with quadriplegia at the C6 level should be instructed to transfer using a sliding board with her:

A. forearms pronated, wrists and fingers extended

B. forearms pronated, wrists extended and fingers flexed

C. forearms pronated, wrists and fingers flexed

D. forearms supinated, wrists and fingers extended

B

Upon removing a dressing covering a decubitus ulcer, you observe copious amounts of a foul-smelling yellow/green discharge. You should note in this patient's medical record that:

A. there is likelihood of a Staphylococcus aureus infection

B. there is likelihood of a Pseudomonas aeruginosa infection

C. the would was purulent

D. there was serosanguinous discharge

C

A patient wishes to improve her aerobic fitness. She currently jogs four days a week for 30 minutes at 70% of her age-predicted maximum heart rate. The recommendation that would not result in improved aerobic fitness is:

A. increasing the distance covered in the same 30 minutes

B. increasing the jogging time to 45 minutes while keeping at 70% of the age-predicted heart rate

C. changing to interval training with maximum burst of running for 15 seconds, followed by a 30 second rest. Complete 4 sets per day, 4 days per week.

D. changing to interval training for 4 days per week by doing 90 seconds of comfortable running followed by 90 seconds of rest for a period of 30 minutes

C

A gymnast comes to physical therapy. Her chief complaint is nagging, localized pain in the left lower leg, which is present at night and increases during activity. This complaint is most characteristic of:

A. bone tumor

B. anterior compartment syndrome

C. shin splints

D. stress fracture

D

Four days following open heart surgery, a patient is being treated in the physical therapy department. He complains of some chest discomfort during treatment and wishes to return to his room. You should:

A. call his physician immediately

B. complete the treatment and have an aide transport him back to his room as some discomfort is expected

C. call the nurse and check to see if the discomfort is to be expected

D. immediately transport the patient back to his room yourself and inform nursing services of the patient's complaint

D

A patient who is to undergo surgery for a chronic shoulder dislocation asks you to explain the advantages and disadvantages of the various surgical reconstructive procedures used to alleviate the problem. Your best response is to:

A. give the patient as much information about the procedures as you currently know

B. explain how patients you have treated responded to the surgery

C. tell the patient to ask the surgeon for this information since this precise information is outside the scope of physical therapy practice

D. refer the patient to another therapist in the department who is an expert on shoulder reconstructive rehabilitation

C

A patient's peripheral skin color progresses from blue to white to red. This would be most characteristic of:

A. chronic venous insufficiency

B. acute venous insufficiency

C. acute arterial insufficiency

D. vasomotor disorders

D

You see a patient who had a CVA two weeks ago. The patient has motor and sensory impairments primarily in the opposite lower extremity. There is some confusion and perseveration. Based on these findings, the vascular problem can be characterized as:

A. transient ischemic attack

B. internal carotid syndrome

C. anterior cerebral artery syndrome

D. middle cerebral artery syndrome

C

A hospital administrator asks for your help in dealing with a significant increase in back injuries suffered by nurses and nurse's aides as a result of lifting patients. The most efficient and effective way to address this situation is by:

A. observing each nurse and nurse's aide as they lift patients and provide immediate feedback about correct lifting

B. providing a series of inservice experiences to all appropriate nursing personnel which covers lifting and other 'back-saving' techniques

C. sending everyone on the nursing service a comprehensive booklet that teaches 'back-saving' techniques in a step-by-step fashion.

D. reviewing proper techniques with nursing supervisors and have them evaluate all personnel under their supervision.

B

In the management of systemic lupus erythematosus, the intervention that would not be appropriate would be the use of:

A. nonsteroidal anti-inflammatory agents to control arthralgia

B. resting splints to decrease joint pain and prevent deformity

C. ultraviolet irradiation to help decrease the skin lesions and rash often associated with the disorder

D. endurance training to compensate for cardiopulmonary dysfunction that is often present with the disorder

C

A patient with degenerative joint disease of the right hip complains of pain in the anterior hip and groin, which is aggravated by weightbearing. There is decreased range of motion and capsular mobility. Right gluteus medius weakness is evident during ambulation and there is decreased tolerance of functional activities including transfers and lower extremity dressing. In this case, a capsular pattern of joint motion should be evident by restriction of hip:

A. flexion, abduction and internal rotation

B. flexion, adduction and internal rotation

C. extension, abduction and external rotation

D. flexion, abduction and external rotation

A

Confirmation of a diagnosis of spondylolisthesis can be made when viewing an oblique radiograph of the spine. The tell-tale finding is:

A. posterior displacement of L5 over S1

B. bamboo appearance of the spine

C. compression of the vertebral bodies of L5 and A1

D. bilateral pars interarticularis defects

D

A physical therapist and physical therapist assistant are conducting a cardiac rehabilitation session for twenty patients. The therapist is suddenly called out of the room. The physical therapist assistant should:

A. terminate the exercises and have the patients monitor their pulses until the therapist returns

B. have the patients continue with the same exercise until the therapist returns

C. have the patients switch to a less intense exercise until the therapist returns

D. continue with the outlined exercise progression for that session

D

When fitting a patient for adjustable axillary crutches, the measurement technique that would not be appropriate to use is:

A. placing the patient supine and measuring from the anterior axillary fold to the bottom of the foot and adding 2 inches

B. placing the patient supine and measuring from the anterior axillary fold to a point 6 inches lateral to the foot

C. subtracting 16 inches from the height of the patient

D. placing the patient in standing with shoes on, and the crutches placed 6 inches lateral to the foot

D

A therapist wishes to study the progress of her patients with paraplegia who are discharged from a rehabilitation setting. Starting with the patient's discharge, and once a month for three years, the therapist will measure their joint range of motion of both hips and knees. Accurate analysis of this time series study is heavily dependent upon:

A. random sampling

B. interrater reliability

C. intrarater reliability

D. predictive validity of the measurements

C

A boutonniere deformity of the finger would not consist of

A. hyperextension of the proximal interphalangeal joint

B. overstretch of the extensor digitorum communis tendon

C. volar slippage of the lateral bands

D. hyperextension of the distal interphalangeal joint

A

You are evaluating a patient with chronic obstructive pulmonary disease. You would not expect to find:

A. the presence of hypercapnia

B. increased total lung capacity

C. increased vital capacity

D. abnormal ventilation/perfusion ratio

C

When using a patellar-tendon-bearing prosthesis, a patient will experience excessive knee flexion in early stance if the:

A. socket is aligned too far anteriorly

B. socket is aligned too far posteriorly

C. foot is outset excessively

D. foot is inset excessively

A

A patient exhibiting flexible pes valgus would most benefit from a combination of shoe modifications consisting of a:

A. rocker bar, scaphoid pad and lateral sole wedge

B. reverse Thomas heel, metatarsal bar and medial sole wedge

C. Thomas heel, medial sole wedge and scaphoid pad

D. rocker bar, metatarsal pad and Thomas heel

C

An inpatient currently in an acute care facility is having her Medicare Part A benefits come to an end. Medicare Part B will cover all except:

A. inpatient room and board in a rehabilitation hospital

B. inpatient therapy services in a rehabilitation hospital

C. outpatient therapy services in an acute care facility

D. outpatient therapy services in a private therapy practice

A

You receive a referral from an osteopath to treat a patient for lower back pain. When giving feedback regarding the patient's progress in physical therapy you should contact the:

A. patient's primary care physician

B. osteopath

C. primary care physician and the osteopath

D. patient's general practitioner and osteopath

B

Following a hard tackle, a football quarterback exhibits signs of fractured ribs and a pneumothorax. In this case, upon auscultation over the injured area, you would expect:

A. soft, rustling sounds on inhalation

B. decreased or no breath sounds

C. crackles on inhalation

D. wheezes on exhalation

B

A 12 year-old girl with cystic fibrosis has been readmitted to the hospital in acute respiratory failure as a result of an infection. Physical therapy, in the form of bronchial hygiene should:

A. not be administered since it is contraindicated in acute respiratory failure

B. be administered two times a day to the patient's tolerance

C. be administered vigorously three times a day

D. be administered vigorously once every two hours at least six times a day

D

While ambulating a patient in the parallel bars, you lose control and the patient falls hitting her head on the bar. The patient lies motionless on the floor between the bars bleeding heavily form a scalp laceration. The first thing you should do is:

A. put thick gauze over and apply manual pressure to the scalp wound

B. check for responsiveness.

C. call Emergency Medical Services

D. immediately determine the patient's heart rate and blood pressure

B

You are treating an outpatient three times per week. The physician's referral indicated a diagnosis of acute subdeltoid bursitis. Initial evaluation reveals active shoulder abduction is painful (8/10) and limited to 75O . After Two weeks, pain is 5/10 and abduction is 95O . At the end of week three, pain is 6/10 and abduction is 88o . In this case, you should:

A. modify the treatment and continue three times per week

B. modify the treatment and increase to five times per week

C. contact the physician and seek guidance since this patient is not progressing

D. discontinue treating this patient since it is unethical to treat a patient who is not benefiting from treatment

A

During pregnancy, the presence of the hormone relaxin can lead to abnormal movement and pain which most frequently affect the:

A. glenohumeral joints

B. hip joints

C. lumbosacral joints

D. sacroiliac joints

D

A patient with angina pectoris has been instructed to use sublingual nitroglycerin in case of anginal attack. This medication will help to ease the situation primarily by:

A. lowering blood pressure

B. decreasing resistance in the peripheral vasculature

C. increasing venous return

D. increasing cardiac afterload, thus decreasing the work of the heart

B

An 8 year-old with severe spasticity in the lower extremities is to receive a new wheelchair. The patient is average in height and weight for his age. Funding restrictions limit the selection to only the standard wheelchair dimensions as supplied by the manufacturers. As the physical therapist you should recommend the selection of a:

A. narrow adult chair which allows for growth since funds for future new chairs will be scarce

B. junior chair with standard seat depth of 16 inches and seat width of 16 inches

C. child chair (sometimes known as a junior-13) with a standard seat depth of 13 inches and a seat width of 16 inches

D. tiny tot chair with a standard seat depth of 11.5 inches and a seat width of 12 inches

C

An occupation which requires a great deal of kneeling will be impacted the most if the diagnosis is:

A. Osgood-Schlatter Disease

B. plica syndrome

C. acute prepatellar bursitis

D. iliotibial band friction syndrome

C

Three days following a cerebral vascular accident, a patient is supine in bed. It would be best to position the upper extremity so that the:

A. scapula is protracted and upwardly rotated and the shoulder is abducted and externally rotated

B. scapula is protracted and upwardly rotated and the shoulder is abducted and internally rotated

C. scapula is retracted and downwardly rotated and the shoulder is adducted and internally rotated

D. scapula is retracted and downwardly rotated and the shoulder is abducted and externally rotated

A

An acceptable modified position to drain the posterior basal segment of the left lower lobe is to position the patient:

A. sidelying on the right, with a pillow under the right hip and the bed flat.

B. prone, with a pillow under the hips and the bed flat

C. sidelying on the right, with a pillow between the legs and foot of the bed elevated 18 inches

D. prone, with a pillow under the hips and the bed elevated 18 inches

B

When the ankle is forcibly inverted and plantarflexed, the ligament that is most frequently disrupted is the:

A. deltoid

B. anterior talofibular

C. posterior talofibular

D. calcaneofibular

B

A therapist cut her finger with a kitchen knife and on the same morning was scheduled to do open wound care on a patient who has HIV. In this case she should:

A. not treat the patient

B. bandage her cut with an occlusive dressing and don gloves normally

C. treat using normal standard precautions

D. double glove

A

A physical therapist notes in the medical record that a patient she is treating is receiving a new medication. The therapist is unfamiliar with this medication. To determine its purpose it would be best if the therapist first:

A. called the patient's physician

B. asked the nurse in charge of the patient

C. called the pharmacist

D. asked the patient during the treatment session

B

You are performing a physical examination of a patient in a custodial care facility, which includes observation of a lesion on the left heel (see image below). Based on the characteristics of the wound, you would classify it as a:

A. stage I lesion

B. stage II lesion

C. stage III lesion

D. stage IV lesion

C

The clinical status of a truck driver with a posterior herniated nucleus pulposus has improved if:

A. peripheral pain increases only when lumbar extension is attempted

B. peripheral pain occurs only with straight leg raising

C. pain centralizes with passive hyperextension of the spine

D. there is flattening of the lumbar lordosis

C

You are working with a patient with ALS who has a tendency to aspirate foods. You should advise the caregiver that:

A. hyperextension of the neck makes swallowing easier

B. warmer solid food aspirates more readily than cooled solid food

C. solid foods aspirate more readily than liquid foods such as soup

D. liquid foods, such as soup, aspirate more readily than solid food

D

When instructing the family of a 9 year-old boy with Duchenne muscular dystrophy, the main emphasis in the lower extremities should be placed on:

A. strengthening the knee extensors and plantarflexors

B. strengthening the plantarflexors and stretching the hip extensors

C. stretching the hip flexors and plantarflexors

D. strengthening the hip flexors and knee extensors

C

An 18 year-old female soccer player, with a Q angle in excess of 30 degrees, exhibits patello-femoral tracking problems. While playing soccer, it would be best if she wore a:

A. patellar stabilizing brace with a lateral buttress

B. patellar stabilizing brace with a medial buttress

C. neoprene sleeve with a patellar cutout

D. derotation brace

A

A 69 year-old man with diabetes mellitus has had a Stage III decubitus ulcer over the right ischial tuberosity for the past five months. The ulcer is infected with Staphylococcus aureus and necrotic tissue covers much of the wound. The physical agent that would be the least helpful and not usually recommended to treat this problem would be:

A. low voltage, constant microamperage direct current

B. high voltage monophasic pulsed current

C. whirlpool

D. moist hot packs

D

In treating a 5 year-old with spastic diplegia, as part of the program, relaxation might be accomplished by:

A. use of rhythmic stabilization

B. slow rocking

C. inhibition of parasympathetic fibers

D. facilitation of sympathetic fibers

B

Capsular tightness has limited your patient's ability to fully extend her left knee. Treatment to restore joint motion should emphasize:

A. anterior glide and external rotation of the tibia

B. anterior glide and internal rotation of the tibia

C. posterior glide and external rotation of the tibia

D. posterior glide and internal rotation of the tibia

A