CH 3: Patient Care Management

Question 1

What includes the commonalities of providing a label for the recognition of specific signs and symptoms that correlate to an identifiable disease or disorder?

Answer 1

Diagnosis

Question 2

What involves the practice of differentiating similar signs and symptoms into a specific pattern that guides a practitioner’s choice of intervention?

Answer 2

Diagnosis

Question 3

What is the act of intervening, especially a deliberate entry into a situation or dispute to influence events or prevent undesirable consequences?

Answer 3

Intervention

Question 4

What is the process of carefully comparing and contrasting patient data points with the goal of appropriate exclusion and inclusion that terminates with the development of intervention strategies?

Answer 4

Differential diagnosis

Question 5

What is a dynamic process that may result in minor alterations or significant shifts and revisions in the patient POC?

Answer 5

Differential diagnosis

Question 6

What is within the scope of practice for the PT but not the PTA?

Answer 6

Diagnosis

Question 7

What is a unique body of knowledge that is provided only by qualified, trained, and credentialed PT and PTAs under direction and supervision of a PT?

Answer 7

Physical therapy

Question 8

What encompasses various aspects of acute, rehabilitative, and chronic phases of patient care?

Answer 8

Practice of physical therapy

Question 9

What focuses primarily on musculoskeletal, neuromuscular, cardiopulmonary, and integumentary systems?

Answer 9

Practice of physical therapy

Question 10

What is described as a comprehensive screening that includes specific tests and measures?

Answer 10

Examination

Question 11

What is the judgement about something based on an understanding of the situation?

Answer 11

Assessment

Question 12

What is the act of considering or examining something to judge its value, quality, importance, extent, or condition?

Answer 12

Evaluation

Question 13

What process occurs when the PT must synthesize the information obtained during the examination and begin to develop clinical decisions?

Answer 13

Evaluation

Question 14

What are the factors that the PT must account for during evaluation?

Answer 14

• Overall physical and mental health status
• Specific phase of healing (acute, subacute, chronic)
• Involvement of singular or multiple sites or systems
• Preexisting conditions or comorbidities

Question 15

What are the 5 elements of client management?

Answer 15

• Examination
• Evaluation
• Diagnosis
• Prognosis
• Intervention
• Outcomes

Question 16

What is both the process and end result of evaluation examination data, which the PT organizes into defined clusters, syndromes, or categories to help determine the prognosis (POC) and most appropriate intervention strategies?

Answer 16

Diagnois

Question 17

What is the determination of level of optimal improvement that may be attained through intervention and the amount of time required to reach that level?

Answer 17

Prognosis

Question 18

What specifies interventions to be used and their timing and frequency?

Answer 18

POC

Question 19

What is the dynamic process in which PT makes clinical judgements based on data gathered during the examination?

Answer 19

Evaluation

Question 20

What is the process that may identify possible problems that require consultation with or referral to another provider?

Answer 20

Evaluation/Examination

Question 21

What is the process of obtaining a history, performing a systems review, and selecting and administering tests and measures to gather data about the patient/client?

Answer 21

Examination

Question 22

What is a comprehensive screening and specific testing process that leads to a diagnostic classification?

Answer 22

Initial examination

Question 23

What is the results of patient/client management, which include the impact of PT interventions in the following domains: (pathology- disease, disorder, condition), impairments, functional limitations, disabilities, risk reduction/prevention, health, wellness, fitness, etc?

Answer 23

Outcomes

Question 24

What is the purposeful and skilled interaction of the PT with the patient/client and with other individuals involved in care of patient/client, using various PT procedures and techniques to produce changes in condition that are consistent with the diagnosis and prognosis?

Answer 24

Intervention

Question 25

What is the determination of the diagnosis?

Answer 25

End result of examination and evaluation

Question 26

What are examples of a medical diagnosis?

Answer 26

- Low back pain - Shoulder pain - Rotator cuff tear - Fracture - Cerebrovascular accident

Question 27

What is the problem with medical diagnostic labeling?

Answer 27

It is often nonspecific and provides no information related to a patient's overall functional status

Question 28

What diagnosis focuses on the influences of the disease or disorder on the patient's functional status at the system level and the interrelationship between the systems and the person as a whole?

Answer 28

Physical therapy diagnosis

Question 29

What requires a global understanding of the functions of all systems and how each system interacts with and influences the others?

Answer 29

Differential diagnosis

Question 30

What involves data collection, formulation of a solution, application of the intervention, and assessment of the outcome?

Answer 30

Problem solving

Question 31

What are the potential solutions for the end result of the diagnostic procedure?

Answer 31

- Specific evidence based interventions for specific identified problems - Short term interventions to reduce symptoms to allow reexamination that produces a more definite diagnosis - Referral to an appropriate health care provider or alternative sources

Question 32

What are the four systems most commonly addressed in PT?

Answer 32

- Musculoskeletal - Neuromuscular - Cardiovascular/pulmonary - Integumentary

Question 33

What are the six sections that cover each preferred practice pattern?

Answer 33

- Client diagnostic classification (inclusion and exclusion diagnostic criteria) - ICD codes (medical diagnostic codes that may relate to practice pattern) - examination descriptions - evaluation, diagnosis, prognosis - Intervention recommendations - Reexamination, outcome, discharge descriptions

Question 34

What involves the prediction of the outcome of physical therapy episode of care with the establishment of POC?

Answer 34

Prognosis

Question 35

What is initiated with the development of the patient-based goals that address the problems exposed during the examination and evaluation?

Answer 35

POC

Question 36

What are actions take by the PT or PTA under direction and supervision of the PT to facilitate improvement or resolution of the specified problems?

Answer 36

Interventions

Question 37

What must possess a working knowledge of the methods and procedures of the diagnostic process and how this process directs the chosen interventions?

Answer 37

PTA

Question 38

What role requires assessment skills that involve problem solving and clinical decision making that may result in appropriate immediate adaptations during a treatment session or collection of data that are reported to the primary PT resulting in the need for changes of the POC?

Answer 38

PTA

Question 39

What are the basic skills required to begin the practice of assessment?

Answer 39

- Observation - Listening - Manual proficiency (ROM, MMT, Anthropometric measurements, and motor and sensory screening) - Communication

Question 40

What is the ability to incorporate visually all activities and events in a given environment and filter the information to incorporate the correct data as they relate to the task of assessment?

Answer 40

Observation

Question 41

What skill requires the discipline of avoiding tunnel vision or developing a preconceived notion or idea of what one expects to see or thinks he/she sees?

Answer 41

Observation

Question 42

What requires a global viewpoint that can be isolated as needed to gather and direct the individual's decisions on what should be include or excluded?

Answer 42

Successful observation

Question 43

What is a dynamic endeavor that requires dedication and effort?

Answer 43

Listening

Question 44

What is more than recognizing noise and involves interpreting sounds carefully and accurately?

Answer 44

Listening

Question 45

What are active listening skills?

Answer 45

- Attentiveness (face patient, eye contact, open posture) - Duplicate or restate - Clarify - Perception - Summarize - Interested (responsiveness)

Question 46

What is the nucleus of effective, efficient, and quality patient care and includes verbal, nonverbal, and written exchanges?

Answer 46

Communication

Question 47

What are some defensible documentation elements?

Answer 47

- Limit abbreviations - Document legibly - Document clinical decision and problem solving process - Document interventions connected to impairment and functional limitation - Document interventions connected to goals stated in POC - Document complications of comorbidities and safety issues - Document nature and severity of illness or injury - Document valid and reliable tests and measures - Document standardized tests and measures - Document changes in client status - Document factors that modify frequency and intensity of intervention and progression of goals

Question 48

What are other assessment skills the PTA should have

Answer 48

- Locate and isolate specific tissues - Differentiate tissue types and determine if changes have occurred - Be aware of sensations encountered during palpation - Integrate information to formulate a judgement as to normality or abnormality

Question 49

What types of written communication should the PTA have?

Answer 49

- Ability to accurately document data from assessment - Vital for recording information used from one treatment session to the next - Critical means of communication between PTA and PT and other health team members