2 Part IV

Question 1

Crackles and low pulse oximetry measure indicate that the patient needs better ventilation and secretion clearance due to the recent surgery. Bronchopulmonary hygiene, include:

Answer 1

postural drainage, percussion, vibration, suctioning, and incentive spirometry, are beneficial in treating and preventing postoperative atelectasis.

Question 2

An abnormal lymph node can range in feeling from

Answer 2

firm to hard, be mobile or nonmobile, and be tender or nontender

Question 3

Which nervous system complication would indicate the poorest prognosis for a patient with (AIDS)?

Answer 3

multifocal leukoencephalopathy is the most serious, and death occurs in a few months after it is diagnosed.

Question 4

Patients who have lacunar strokes demonstrate improved

Answer 4

motor recovery as compared to patients who have hemispheric lesions

Question 5

A patient who has atrophy of the hypothenar eminence of the hand will most likely have the GREATEST difficulty performing which of the following tasks?

Answer 5

Pulling a piece of paper between the pads of the thumb (1st digit) and the index finger (2nd digit) - ulner nerve innervates adductor pollicis.

Question 6

When treating a patient who has ankylosing spondylitis, which of the following muscles require the MOST emphasis in strengthening exercises?

Answer 6

Back extensors - Trunk ROM exercises & strengthening back extensors to minimize thoracic kyphosis are essential. Persons with ankylosing spondylitis tend to assume flexed postures.

Question 7

If PT suspects the low back pain is caused by an inflammatory reaction, which question is BEST to ask?

Answer 7

Is your pain constant or intermittent? Constant pain is systemic and mechanical pain generally changes with positions or activities

Question 8

Excessive upward rotation of the rt scapula is noted when a pt attempts to perform shoulder flexion. Which exercise is MOST appropriate to help correct the excessive scapular rotation?

Answer 8

results from weakness of the rhomboids and latissimus dorsi (downward rotators). The scapular adduction with medial (internal) rotation and adduction of the arm would require action by those muscles

Question 9

Chronic use of corticosteroids can lead to

Answer 9

calcium loss and osteoporosis. Manipulation should not be applied to areas of the body directly affected by osteoporosis due to risk of fracture

Question 10

characteristics of venous insufficiency

Answer 10

Edema, brownish discoloration (hemosiderin deposits), and skin contraction in the ankle region

Question 11

Age-related trophic changes include

Answer 11

decreased flexibility due to a decrease in collagen, increased wrinkles and dryness, and decreased turgor

Question 12

Trophic changes that can occur with arterial disease

Answer 12

absence of hair and shiny, pale skin

Question 13

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

Answer 13

plantar grasp reflex - curling of the toes when a child is held supported in standing position. The reflex is normal up to 9 months of age. Delayed integration of this reflex can result in delayed independent ambulation.

Question 14

The Moro reflex is exhibited by

Answer 14

upper extremity movement in response to passive positioning of the neck

Question 15

The ankle-brachial index is

Answer 15

the highest ankle systolic pressure divided by the highest brachial systolic pressure.

Question 16

Bell Palsy S&S

Answer 16

facial nerve (CN VII) - sudden onset of weakness of the facial muscles on the right side is unable to wrinkle the forehead, smile, pucker the lips, or wrinkle the nose, absence of tearing, corneal reflex is absent, dryness of the mouth, and pinprick and temperature sensation are normal on both sides of the face

Question 17

increase the likelihood of a compression fracture

Answer 17

Smoking and prolonged steroid use

Question 18

Decreased perineal reflexes are associated with

Answer 18

cauda equina syndrome

Question 19

When a patient makes a fist, the head of the third metacarpal is level with the second and fourth metacarpals. This is

Answer 19

This observation describes the Murphy sign, which indicates lunate dislocation

Question 20

prone instability test

Answer 20

has a positive result when a pt who has pain upon prone segmental palpation of the lumbar spine demonstrates a reduction of tenderness when asked to stabilize the upper body and lift the legs off the ground.implies that the tenderness initially encountered in prone position can be reduced upon activation of the segmental stabilizers of the spine. Determines whether pain can be addressed mainly through lumbar spine stabilization techniques.

Question 21

Basal cell carcinomas usually occur on

Answer 21

hair-bearing areas exposed to the sun, such as the face, neck, head, ears, or hands. They grow slowly to 1-2 cm after years of growth.

Question 22

Malignant melanoma can appear

Answer 22

anywhere in the body. It is usually asymmetric, has irregular borders, its colors can be black, brown, red, or white. It is larger than a pencil eraser, and it evolves in shape

Question 23

early symptom of human immunodeficiency virus (HIV) infection

Answer 23

Fatigue. Easy bruising and poor wound healing are found at more advanced stages of the disease

Question 24

Gout is the most common form of inflammatory arthritis in men older than 40 years of age. The onset is

Answer 24

usually sudden, often during the night or early morning. Classic findings are warmth, swelling, and severe pain in the first metatarsophalangeal joint. May or may not have fever

Question 25

localized response level (level III) of the Rancho Los Amigos levels

Answer 25

defined as a pt having a localized response and reacting specifically but inconsistently to stimuli. Responses are delayed and directly related to the type of stimulus present.

Question 26

Generalized response (level II) is defined as

Answer 26

generalized response where a patient reacts non-purposefully to stimuli

Question 27

Confused-agitated response (level IV)

Answer 27

the state where a patient is at a heightened state of activity

Question 28

Confused-inappropriate response (level V)

Answer 28

occurs when the patient is able to respond to simple commands fairly consistently

Question 29

Pt is receiving PT intervention for RA, which is in remission. Which intervention is MOST appropriate?

Answer 29

Strengthening exercises for weak muscles bc/ pt in remission

Question 30

PT observes a pt from behind during bilateral shoulder abduction and notes that the patient’s rt scapula is more abducted than the lt scapula at the end range of movement. Which condition is the MOST likely cause of the altered scapula position on the right?

Answer 30

restriction of the glenohumeral joint - If the glenohumeral joint is restricted, the scapula has to increase its motion to accomplish the task.

Question 31

The presence of dyspnea and the pink, frothy sputum would suggest the presence of

Answer 31

heart failure and resultant pulmonary edema. The pt should be positioned with the head up or should be placed in a sitting position to help alleviate the symptoms

Question 32

pt’s feet erythematous, swollen, and significantly warmer to the touch than the contralateral foot. Denies any pain or trauma. Hx of diabetes, peripheral vascular disease, and chronic heart failure.

Answer 32

Charcot foot

Question 33

For a patient with a bilateral transfemoral amputation to maximize balance in a wheelchair, the rear wheels should be positioned more

Answer 33

posteriorly - The center of gravity of a person with bilateral transfemoral amputations is more posterior than the center of gravity of a person with lower extremities intact.

Question 34

For slight perturbations, most individuals use

Answer 34

an ankle strategy. For larger perturbations, individuals utilize hip and knee muscles to recover the balance. If strong, then use step strategy

Question 35

The therapist accidentally knocks over the collection reservoir from a chest tube. The therapist should return the reservoir to the upright position and

Answer 35

Hanging the collection reservoir from the side of the bed or securing it to the floor are recommended - keep drainage level below heart level