2nd PEAT Part II

A 4-year-old child who has an L1 myelomeningocele has developed scoliosis over the past 2 years. The curve currently measures 25°. Which of the following recommendations is MOST appropriate for scoliosis management?

1. Continue to monitor the scoliosis, with no intervention at this time.

2. Begin a home program of stretching exercises for trunk rotators.

3. Refer to an orthopedic surgeon for evaluation for spinal fusion.

4. Fit the child with a thoracolumbosacral orthosis.

4

Which of the following strategies for transfer training is MOST likely to be successful for a patient who has apraxia?

1. Give frequent and detailed verbal commands.

2. Provide the patient with written instructions.

3. Teach one component of the transfer at a time.

4. Have the patient practice transfers in a variety of settings and contexts.

3

A patient sustained a T10 complete spinal cord injury. Which of the following wheelchair-to-bed transfer techniques is MOST appropriate for the patient?

1. Sit pivot

2. Sliding board

3. Standing pivot

4. Mechanical lift

1

Which of the following activities would be MOST appropriate to practice to assist a 20-year-old patient who has Duchenne muscular dystrophy in maintaining independence?

1. Stair training using both handrails

2. Gait training using a rolling walker

3. Transfer training using a slide board

4. Power wheelchair training over various surfaces

4

Which of the following functions is MOST likely to be impaired in a patient who has a pontine infarct?

1. Jaw movement

2. Eyelid elevation

3. Tongue movement

4. Pharyngeal swallowing

1

A patient's left eye is adducted at rest. During examination of extraocular eye movements, the patient is unable to move the left eye laterally. These findings MOST likely result from a lesion of which of the following nerves?

1. Oculomotor (CN III)

2. Trochlear (CN IV)

3. Trigeminal (CN V)

4. Abducent (CN VI)

4

If the test shown in the photograph has positive findings, which of the following muscles is MOST likely affected?

1. Adductor pollicis

2. Pronator quadratus

3. Flexor pollicis longus

4. Abductor pollicis longus

1

Which of the following findings BEST describes an injury in the acute stage?

1. Collagen fibers reorient in response to stresses placed on connective tissue.

2. Collagen formation and granulation tissue development occurs at an increased rate.

3. During range of motion testing, the patient experiences pain synchronous with tissue resistance.

4. During range of motion testing, the patient experiences pain with movement and before tissue resistance.

4

Which of the following skeletal conditions is NORMAL in a newborn infant?

1. Pes cavus

2. Genu varum

3. Genu valgum

4. Talipes equinovarus

2

Which of the following conditions is a CONTRAINDICATION for mechanical traction of the cervical spine?

1. Muscle spasm

2. Rheumatoid arthritis

3. Hypomobility of the spine

4. Decreased upper extremity sensation

2

A patient is unable to reach behind the low back during activities of daily living. Muscle performance testing is pain-free, normal, and symmetrical. What is the MOST likely problem contributing to this functional impairment?

1. Subscapularis disorder

2. Pectoralis minor stiffness

3. Posterior capsular stiffness

4. Acromioclavicular joint arthrosis

3

Iontophoresis should be used with precaution for a patient who has which of the following conditions?

1. Peripheral neuropathy

2. Raynaud disease

3. Degenerative joint disease

4. Chronic edema

1

Which of the following interventions is MOST appropriate for an individual who has multiple sclerosis?

1. Submaximal exercise performed in the morning

2. Swimming exercises performed in a heated indoor pool

3. Resistance exercise alternating each day between upper and lower body workouts

4. Maximal exercise to the point of fatigue with several days of rest between training sessions

1

A patient reports low back pain that radiates down one leg below the knee. The patient also reports numbness and tingling in the location shown on the photograph. Which of the following examination findings is MOST likely?

1. Diminished knee reflex

2. Diminished ankle reflex

3. Weakness of the gastrocnemius

4. Weakness of the extensor hallucis longus

4

A patient who has emphysema reports a weight gain of 20 lb (9 kg) over the past month. There is 3+ pitting edema in both distal lower extremities. Which of the following tests is MOST important to identify the likely underlying condition?

1. Heart rate

2. Capillary refill

3. Heart auscultation

4. Ankle-brachial index

3

A physical therapist is working with a patient who had a total knee arthroplasty 2 days ago. The patient's resting electrocardiogram is shown in strip A. While gait training, the patient's electrocardiogram changes, as shown in strip B. Based on this finding, what is the BEST action for the therapist to take at this time?

1. Stop gait training and notify the nurse.

2. Continue gait training, because the heart rate is less than 100 bpm.

3. Stop gait training and allow the patient to sit down and rest.

4. Continue gait training, but allow the patient standing rest breaks.

1

A patient reports dizziness and frequent falls. Upon examination, the patient demonstrates constant vertical pendular nystagmus, abnormal smooth pursuit, and abnormal saccadic eye movements. The patient's symptoms are MOST likely caused by which of the following conditions?

1. Vertebrobasilar insufficiency

2. Central vestibular system lesion

3. Peripheral vestibular system lesion

4. Posterior semicircular canalithiasis

2

Which of the following lower extremity proprioceptive neuromuscular facilitation patterns is MOST appropriate to strengthen a patient's weak tibialis posterior?

1. Hip extension, abduction, and medial (internal) rotation, with ankle plantar flexion and eversion

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

3. Hip extension, adduction, and lateral (external) rotation, with ankle plantar flexion and inversion

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

3

When evaluating wheelchair positioning of a child with cerebral palsy, the position of which of the following body parts should be examined FIRST?

1. Pelvis

2. Lower extremities

3. Head

4. Spine

1

Which of the following home programs is MOST appropriate for a patient who has chronic lateral epicondylalgia?

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

2. Performing exercises for wrist strength and stretching

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

4. Doing friction massage of the brachioradialis tendon

2

A home health patient who recently had a three-vessel coronary artery bypass graft describes experiencing bilateral lower extremity swelling, leg pain, and shortness of breath, especially when lying down. The patient MOST likely has which of the following diagnoses?

1. Deep vein thrombosis

2. Myocardial infarction

3. Pulmonary embolism

4. Heart failure

4

During examination of a patient, a physical therapist notes bradycardia. The patient reports constipation and cold intolerance. Which of the following conditions is the MOST likely cause of the sign and symptoms?

1. Hypothyroidism

2. Hyperthyroidism

3. Hyperparathyroidism

4. Hypoparathyroidism

1

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:

1. sartorius.

2. tensor fasciae latae.

3. adductor longus.

4. semimembranosus.

1

A patient with evidence of nerve root involvement at the L4-L5 level would MOST likely have which of the following signs and symptoms?

1. Weak knee flexors, diminished Achilles tendon reflex, and paresthesia at the lateral aspect of the lower extremity

2. Weak foot intrinsics, diminished patellar tendon reflex, and paresthesia at the medial aspect of the knee

3. Weak ankle dorsiflexors, diminished patellar tendon reflex, and paresthesia at the medial calf and ankle

4. Weak ankle plantar flexors, diminished Achilles tendon reflex, and paresthesia at the lateral border of the foot

3

A physical therapist performs heart auscultation as part of a patient's cardiac systems review. The therapist hears a sound represented by "A" in the illustration. This sound is BEST described as a:

1. systolic murmur not considered to be normal.

2. normal heart sound occurring during systole.

3. diastolic murmur not considered to be normal.

4. normal heart sound occurring during diastole.

1