Flashcards in DPT 610: Concepts in Physical Therapy Deck (44)
You are working with a pt in the hospital and your plan for today's treatment is to help the pt from the bed to the bedside chair. As you transfer the pt you apply what you determine is 40% assistance to the gait belt in lifting the pt for the sit to stand transfer using a RW. What a level of assist does this pt require?
a. min assist
b. mod assist
c. max assist
While working with a pt in a skilled nursing facility (SNF) you are assisting the pt with a commode transfer. The pt is able to transfer from the bed to the commode using the bed rails and sequencing verbal cues from you. What level of assist does this pt require?
a. min assist
b. mod assist
c. max assist
While working with a pt in the hospital you are preparing to assist him with moving from the chair to the bed after a long afternoon sitting up visiting with family. It is important to properly prepare for any transfer. The MOST appropriate directions to give to your patient would be:
a. None, but rather to just begin the transfer and instruct as you go
b. Tell him that he will be moving from the chair to the bed and that he is to help as much as he can
c. that he will be moving from the bed to the chair
d. that he will be performing a bed to chair transfer and that he is to assist as much as he can
While working with a pt in the rehab hospital you have been asked to help transfer her from the bed to her wheelchair so she can be transferred to the radiology department for x-rays. This pt suffered a spinal cord injury a week ago and is just learning how to function with her new injury and requires a lot of assistance at this early stage in her recovery. Which level of standing pivot transfer would you most likely expect to use with this pt at this time in her recovery?
a. standing, assisted pivot
b. standing, dependent pivot
c. standing, independent pivot
d. standing, independent pivot
A patient fell and fractured her right tibia. The patient has been hospitalized for four weeks, due to surgical repair of the fracture and some minor complications, thus she is weak. The patient was referred to physical therapy for generalized strengthening with non-weight bearing status on the right LE. For exercise sessions, the patient must be transferred from a wheelchair to and from the high-low mat table. Which of the following transfers would be MOST appropriate for this patient?
a. standing, assisted pivot transfer
b. standing, independent pivot transfer
c. hydraulic or homer lift
d. sitting, dependent lift with two people
All of the following statements would be included in the Examination portion of a patient/client note EXCEPT:
a. Pt ankle present with significant edema with skin that is taught and waxy in appearance
b. Pt presents with decreased toe off during gait secondary to decreased dorsiflexion strength
c. Pt has constant pain in his left ankle with only minimal relief from ice and NSAIDS
d. Pt is currently unable to enjoy running, biking, and gardening
All of the following information would be included in the Subjective portion of a SOAP Note EXCEPT:
a. The patient’s daughter tells you the patient lives at home alone.
b. The patient tells you his gait is altered.
c. Pt presents antalgic gait ambulating with a RW.
d. The patient has a h/o of HTN, COPD, and CVA.
3) The following documentation would be included in what type and section of a documentation note?
“Pt presented with impaired gait, strength, and transfers. Pt is lethargic and oriented to only person and place.”
a. Patient/Client Note: History
b. Patient/Client Note: Systems Review
c. Patient/Client Note: Tests and Measures
d. SOAP Note: Objective
4) Which example of documentation eould you use that would BEST document the treatment that occurred in the following scenario?
You are working with a 59 year-old male patient that suffered a stroke 4 days ago and is hemipalegic in the right side. Your plan for today's treatment is to transfer the pt to his w/c so he can go out on the patio with his family. You transferred the pt supine to sitting EOB and he is only able to help by using his left UE to pull on the bedrail. You position the w/c at the correct angle to the bed so the pt transfers toward his left side. During the transfer you perform a traditional lift and move the pt from the EOB to the w/c in one swift, smooth motion. He is unable to assist due to his poor balance and weakness. You get him positioned in his w/c comfortably and complete your treatment for the day.
a. I performed dependent bed mobility for the patient to transfer from supine to sit. Next I provided max assistance for the to transfer using a standing assist pivot transfer to move from the bed to the wheelchair.
b. I helped the pt with bed mobility with max assist using one bedrail. Next I performed a standing dependent pivot transfer to move the patient from the bed to w/c.
c. Pt bed mobility max assist with use of bedrail. Standing dependent pivot transfer performed for bed to w/c transfer.
d. Pt bed mobility dependent with use of bed rail. Standing assisted pivot transfer with max assist performed for bed to w/c transfer.
5) You are working in an acute care setting and when you enter a pt's room you find a patient on the floor. You ask what happened and the patient states they were reaching for the phone and fell out of the chair. The patient is average size (5'8" 200 lbs) and does not have any additional injuries that would prevent you from transferring the patient back to the wheelchair. What transfer would be the most appropriate in this situation to assist the patient back to the wheelchair?
a. Two-person lift with you and another person of average size
b. One person left with only you and the patient helping as much as she can
c. Hoyer lift transfer
d. Three person lift with you and two other people of average size
When measuring seat depth, one should measure from the users posterior buttock, along the lateral thigh to the popliteal fold (space behind the knee). With this measurement, one should then:
a. Add 4 inches
b. Subtract 4 inches
c. Add 2 inches
d. Subtract 2 inches
A frail older adult is confined to bed in a nursing facility and has developed a small superficial wound over the sacral area. Because of the necrotic tissue present, the patient needs to be transferred to the therapy gym so a whirlpool can be applied to the wound. You are to assist the patient to transfer from bed to a wheelchair so he can be transported. what type of transfer would be MOST appropriate with this patient?
a. Hoyer lift transfer
b. Stand-pivot transfer with RW
c. 2-person lift transfer
d. Sliding board transfer
A patient with a complete spinal cord injury at T3 level is being discharged home. The patient will use an electric wheelchair for mobility. The rehabilitation team completes a home visit and finds that there are 3 full height steps (6 inches) into the house. A ramp must be constructed. The recommended length is:
a. 216 inches (18 feet)
b. 60 inches (5 feet)
c. 168 inches (14 feet)
d. 120 inches (12 feet)
You are planning to open your own outpatient PT clinic. You have contact at a near by orthopaedic office and have arranged to shadow one of the doctors every Tuesday morning from 8am-12 (noon) for 2 months. While shadowing with the doctor you plan to highlight many of your speciality certifications and the new advancements occurring within the PT profession. Which of the following accurately classifies “shadowing the doctor” and your plans to “highlight many of your specialty certifications and the advancements occurring within the PT profession?
a. Formal communication, secondary purpose of communication
b. Informal communication, primary purpose of communication
c. Formal communication, primary purpose of communication
d. Informal communication, secondary purpose of communication
True or False
The patient in the photo who is partial weight bearing on the left lower extremity is demonstrating the correct method for ascending stairs with crutches.
**Picture = going up stairs with crutches in both hands and the left extremity first
All of the following statements would be included in the examination portion of a patient/client note EXCEPT:
a. Pt presents with decreased heel strike during gait secondary to gastrocnemius
b. Pt has constant pain in her neck with only minimal relief from ice and NSAIDS
c. Pt is currently unable to enjoy knitting, baking, gambling
d. Pt knee presents with significant edema with skin that is taunt and waxy
Which of the following treatment methods is MOST INAPPROPRIATE when working with a young patient?
a. Using a game of Red Rover to help a 17 y/o boy work on UE strength
b. Identifying that missing recess at school may be causing a 10 year old to act poorly
c. Telling a 4 year old girl you are going to measure the ROM of her knee
d. Checking to see if your name badge is scratching an infant patient
What degree of elbow flexion is recommended with the use of parallel bars or axillary crutches?
The proper fit of the cuff forearm crutches are as follows
a. 5-6 inches to the ulnar styloid process (lateral wrist)
b. 1 – 1.5 inches proximal to the ulnar styloid process (lateral wrist)
c. 5-6 inches distal to the olecranon process (elbow)
d. 1 - 1.5 inches distal to the olecranon process (elbow)
Which of following statements are true regarding the importance of fit of a blood pressure cuff?
a. If the bladder in the BP cuff is to narrow in relation to the circumference of the patients arm, the reading will be erroneously low
b. If the bladder in the BP cuff is too narrow in relation to the circumference of the patients arm, the reading will be erroneously high
c. If the bladder is too wide, the reading will be erroneously high
d. If the bladder is too wide, the reading will be erroneously low
B and D
When your patient tells you she has stage IV metastatic bone cancer, your thought turn to overwhelming sadness and inability to think about anything other than the fact that her 3 year old child is likely to lose its mother. Which of the following best describes this feeling?
The purpose of cushions in wheelchairs, including custom made cushions are:
a. Increase comfort, increase support for pelvis, eliminate pressure
b. Eliminate need for weight shift, provide stable sacral position, add height to seated position
c. Increase support for pelvis, optimize body mechanics, eliminate need for weight shift, keep skin dry
d. Increase comfort, increase support for pelvis, distribute pressure
You have been working in the PT clinic for 7 years. Your supervisor approaches you about a new opportunity the hospital is wanting to offer. The hospital is looking into starting up a small rehab unit in the hospital, but cant determine if it would be a good investment. Your supervisor has asked you to serve as the PT representative for the hospitals brainstorming committee about adding a small rehab unit. This is an example of:
a. Lack of professional/interdisciplinary understanding
b. Territorial dispute
c. Role conflict
d. Role overload
You need to help an 82 y/o man with weakness in his R upper extremities transfer from bed to a wheelchair. He is mod assist for sit to stand, but has problems with his right knee buckling. He has not yet demonstrated a good understanding of using a hemi-walker. What kind of transfer would be most appropriate to use with this patient?
a. Hoyer lift transfer
b. Standing-pivot transfer
c. Squat-picot (swing-pivot) transfer
d. Slide board transfer
You have been working as a PT for 5 years. You constantly receive recognition for timely and efficient work from your supervisor. Your supervisor approaches you and says that she wants to streamline the process for issuing walkers to patients being discharged. She has determined that she would like you to be the go to person for this and plans to instruct all other therapists in the department and all the nurses to page you any time a walker is needed for a patient to discharge. This is an example of:
a. Role overload
b. Role conflict
c. Territorial disputes
d. Lack of interpersonal/interdisciplinary understanding
The most common method of transmission of pathogens is by __________. The habitual use of proper hand hygiene techniques is the single most effective way to protect the patient and the caregiver.
a. Moisture droplets
b. Contaminated linen or clothing
c. Direct contact
d. Air currents
Which gait patter describes the simultaneous, reciprocal forward placement of the AD and the patients opposite lower extremity.
a. 2 point
b. 3 point
c. 3-1 point
d. 4 point
A 45 y/o woman with a 1-day old postoperative abdominal incision needs to be transferred from a w/c to the bed. She has good upper extremity strength and is able to use a RW to assist her to perform a stand-pivot transfer from wheelchair to bed. As the therapist you have to give her multiple verbal cues for correct technique and provide 10% assistance. What level of assist would you document for this patients transfer?
c. Min assist
d. Max assist
A tilt in space w/c (entire wheelchair tilts) has been ordered for a patient with quadriplegia (paralysis of both UE LE) resulting from a spinal cord lesion at C4. This type of chair is ordered to:
a. Facilitate handgrip and propulsion
b. Improve the patients ability to transfer independently
c. Facilitate postural support by using gravity and provide pressure relief to the ischial tuberosities
d. Allow the patient to recline the seatback and this increase trunk and hip angle