Fortinberry - Chapter 1 Flashcards

Clinical Application of Foundational Sciences

1
Q

The sinoatrial node is located in what chamber of the heart?

Left atrium
Right atrium
Left ventricle
Right ventricle

A

Right atrium

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2
Q

Where in the tissues does nutrient exchange take place?

Capillaries
Interstitial spaces
Arterioles
Venules

A

Interstitial spaces

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3
Q

During which phase of the cardiac cycle is ventricular volume the lowest?

Atrial systole
Isometric ventricular contraction
At the end of rapid ventricular ejection
Isometric ventricular relaxation

A

Isometric ventricular relaxation

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4
Q

The heart contains a variety of different types of muscle fibers, each with a frequency of spontaneous contraction. Which of the following has the shortest period (high frequency) of spontaneous contraction?

Purkinje fibers
SA node
AV node
Myocardium

A

SA node

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5
Q

Stimulation of CN X will cause which of the following effects?

Atrial fibrillation
Sinus bradycardia
Cardiac rigor
Ventricular fibrillation

A

Sinus bradycardia

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6
Q

The volume of air moved going from full forced expiration to full forced inspiration is known as:

Inspiratory capacity
Vital capacity
Total lung capacity
Inspiratory reserve volume

A

Vital capacity

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7
Q

During periods of intense physical activity, many physiologic adaptations occur, especially in the circulatory system. Which of the following occurs during increased physical exertion?

a. Increased ventricular filling, secondary to increased venomotor tone
b. Decreased cardiac output
c. Decreased stroke volume
d. Increased cardiac cycle time

A

Increased ventricular filling, secondary to increased venomotor tone

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8
Q

Which of the following is indicative of left heart failure?

Pitting edema
Neck vein distention
Orthopnea
Ascites

A

Orthopnea

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9
Q

A patient asks the therapist to explain the function of his medication verapamil (a calcium antagonist). Which of the following points should be conveyed in the therapist’s explanation?

Verapamil causes (increased/decreased) contractility of the heart and (vasoconstriction/vasodilation) of the coronary arteries

A

Verapamil causes DECREASED contractility of the heart and vasoCONSTRICTION of the coronary arteries

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10
Q

The protocol for a cardiac patient states that the patient should not exceed 5 metabolic equivalents (METs) with any activity at this stage of recovery. Which of the following activities would be inappropriate for the patient?

Cycling 11 mph
Walking 4 mph
Driving a car
Weeding a garden

A

Cycling 11 mph

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11
Q

During the opening of a patient’s mouth, a palpable and audible click is discovered in the left TMJ. The physician informs the therapist that the patient has an anteriorly dislocated disk. This click mostly likely signifies that

The condyle is sliding (anteriorly/posteriorly) to (obtain/lose) normal relationship with the disk

A

The condyle is sliding ANTERIORLY to OBTAIN normal relationship with the disk

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12
Q

In what position should the therapist place the upper extremity to palpate the supraspinatus tendon?

Full (ABD/ADD), full (flexion/extension), and full (ER/IR)

A

Full ADD, full EXTENSION, and full IR

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13
Q

A 13-year-old girl fractured the left patella during a volleyball game. The physician determines that the superior pole is the location of the fracture. Which of the following should be avoided in early rehabilitation?

Full knee extension
45 degrees of knee flexion
90 degrees of knee flexion
15 degrees of knee flexion

A

90 degrees of knee flexion

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14
Q

During a conference with the physical therapist, a respiratory therapist indicates that the patient has a low expiratory volume. What does this mean?

a. The volume of air remaining in the lungs after a full expiration is low
b. The volume of air in a breath during normal breathing is low
c. The volume of air forcefully expired after a forceful inspiration is low
d. The amount of air expired after a resting expiration is low

A

d. The amount of air expired after a resting expiration is low

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15
Q

During an evaluation, a 74-year-old woman informs you that she is “taking her heart pill”. The patient does not have her medication with her but states that the medication “slows down my heart rate”. Which of the following is the most probable medication?

Epinephrine
Digitalis
Quidine
Norepinephrine

A

Quidine

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16
Q

A patient is referred to physical therapy with a secondary diagnosis of hypertension. The physician has ordered relaxation training. The therapist first chooses to instruct the patient in the technique of diaphragmatic breathing. Which of the following choices is the correct set of instructions?

Slow breathing rate to (8-12 or 12-16) breaths per minute, (increase/decrease) movement of the abdominal region , and (increase/decrease) movement in the upper chest

A

Slow breathing rate to 8-12 breaths per minute, INCREASE movement of the abdominal region, and DECREASE movement in the upper chest

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17
Q

Which of the following statements about cardiovascular response to exercise in trained and/or sedentary patients is false?

a. If exercise intensities are equal, the sedentary patient’s heart rate will increase faster than the trained patient’s heart rate
b. Cardiovascular response to increased workload will increase at the same rate for sedentary patients as it will for trained patients
c. Trained patients will have a longer stroke volume during exercise
d. The sedentary patient will reach anaerobic threshold faster than the trained patient if workloads are equal

A

b. Cardiovascular response to increased workload will increase at the same rate for sedentary patients as it will for trained patients

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18
Q

A therapist is asked to examine a patient in the intensive care unit. The patient is comatose but breathing independently. During the assessment of range of motion in the right upper extremity, the therapist notices that the patient is breathing unusually. The pattern is an increase in breathing rate and depth followed by brief pauses in breathing. The therapist should notify the appropriate personnel that the patient is exhibiting which of the following patterns?

Biot’s respiration
Cheyne-Strokes respiration
Kussmaul’s respiration
Paroxysmal nocturnal dyspnea

A

Cheyne-Strokes respiration

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19
Q

Which of the following statements is not a common physiologic change of aging?

a. Blood pressure taken at rest and during exercise increases
b. Maximal oxygen uptake decreases
c. Residual volume decreases
d. Bone mass decreases

A

c. Residual volume decreases

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20
Q

A patient with cardiac arrhythmia is referred to physical therapy services for cardiac rehabilitation. The therapist is aware that the heart receives nerve impulses that begin in the sinoatrial node of the heart then proceed to the

a. Atrioventricular node, then to the Purkinje fibers, and then to the bundle branches
b. Purkinje fibers, then to the bundle branches, and then to the atrioventricular node
c. Atrioventricular node, then to the bundle fibers, and then to the Purkinje fibers
d. Bundle branches, then to the atrioventricular node, and then to the Purkinje fibers

A

c. Atrioventricular node, then to the bundle fibers, and then to the Purkinje fibers

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21
Q

A 65-year-old man is scheduled to begin a wellness program. He has no cardiovascular disease, major systemic illness, or musculoskeletal abnormality. However, he is deconditioned because of an extremely sedentary lifestyle. Resting heart rate is 90 beats/minute, and resting blood pressure is 145/92 mmHg. Which of the choices describes the most significant intensity, frequency, and duration at which the patient should begin exercise?

a. 75 Vo2max; 30 min/day; 3 days/wk
b. 40 Vo2 max; 30 min/day; 5 days/wk
c. 40 Vo2 max; 10 minutes twice daily; 5 days/wk
d. 75 Vo2 max; 10 minutes twice daily; 3 days/wk

A

c. 40 Vo2 max; 10 minutes twice daily; 5 days/wk

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22
Q

A 17-year-old athlete has just received a posterior cruciate ligament reconstruction. The therapist is attempting to explain some of the characteristics of the posterior cruciate ligament. Which of the following is incorrect information?

a. The PCL prevents posterior translation of the tibia on the femur
b. Posterior bands of the PCL are their tightest in full knee extension
c. The posterior cruciate ligament is attached to the lateral meniscus and not to the medial meniscus
d. The PCL helps with the medial rotation of the tibia during full knee extension with open-chain activities

A

d. The PCL helps with the medial rotation of the tibia during full knee extension with open-chain activities

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23
Q

A patient starting to use antihypertensive medications must be observed when getting up or leaving a warm therapeutic pool in order to avoid an episode of

Bradycardia
Orthostatic hypotension
Dysrhythmias
Skeletal muscle weakness

A

Orthostatic hypotension

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24
Q

A patient whose exercise-induced heart rate is less than the heart rate was before exercise is most likely starting therapy with

Anticholinergic drugs
Alpha blockers
Beta blockers
Antianginals

A

Beta blockers

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25
Q

A patient inhales a beta agonist to relieve his asthma. After its use, you may notice

An increase in heart rate
A few moments of incoordination
Flushing with red face
A decrease in blood pressure

A

An increase in heart rate

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26
Q

A patient is using a statin drug. Which of the following drug-induced signs or symptoms should be reported to the treating physician?

Muscle pain
Irregular heart beat
Persistent diarrhea
Intermittent confusion

A

Muscle pain

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27
Q

Statin drugs lower cholesterol by

Preventing cholesterol absorption
Binding to cholesterol in the intestines
Inhibiting HMG-CoA reductase
Inhibiting lipoprotein lipase

A

Inhibiting HMG-CoA reductase

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28
Q

A patient is being treated with an antiarrhythmic drug. The drug might cause all of the following adverse reactions except

Dizziness and fainting
Stevens Johnson syndrome
Irregular heart beats
Joint and muscle pain

A

Joint and muscle pain

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29
Q

An asthmatic patient is to be exercised in a rather cool environment. It is recommended that the patient use the inhaler

About 1 hour before exercise
About 20 minutes before exercise
Just at the beginning of exercise
At the first onset of breathing problems during exercise

A

About 20 minutes before exercise

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30
Q

A patient using beta blocker is exercise and might experience all of the following except

Some breathing difficulties
Muscle cramps and pain
A smaller than expected increase in heart rate
Some drowsiness

A

Muscle cramps and pain

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31
Q

A beta blocker reduces blood pressure by all of the following actions except

A reduction in cardiac output
A reduction in central sympathetic outflow
Inhibition of renin release
A reduction in peripheral resistance

A

A reduction in peripheral resistance

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32
Q

A patient on calcium channel blocker therapy might complain during therapy sessions about all of the following except

Lightheadedness and dizziness
Muscle pain and joint stiffness
Tremors
Edema

A

Tremors

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33
Q

A patient under the influence of local anesthetic therapy might experience all of the following except

Some sensory impairment
Increased blood pressure
Tremors
Motor deficits

A

Increased blood pressure

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34
Q

A patient with angina pectoris experiences some pain during exercise therapy and uses three tables of sublingual nitroglycerin, but the pain does not subside. You should

a. Ask the patient to stretch out quietly and breathe deeply
b. Tell the patient to continue the medication until the pain stops
c. Call 911 since this could signal a true heart attack
d. Administer two tablets of non-narcotic analgesic to help reduce the pain

A

c. Call 911 since this could signal a true heart attack

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35
Q

Your patient is a 48-year-old male who reports to physical therapy with complaints of left shoulder and neck pain. Symptoms began insidiously 3 weeks ago and have been increasing in frequency and duration since that time. He notices the symptoms with lifting heavy objects and shoveling dirt for a garden that he is building. Walking fast elicits symptoms. Symptoms abate after several minutes of rest. He is in relatively good health with the exception of high blood pressure and shortness of breath. What system is most likely affected?

Cardiovascular
Pulmonary
Musculoskeletal
Hepatic

A

Cardiovascular

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36
Q

Your patient is a 38-year-old male who is a patient that you have been treating for left shoulder pain. He was in motor vehicle accident since you last treated him 2 days ago. He was the driver and was rear-ended. He hit his left side on the door handle and has been having sharp pain in his ribs. X-rays the day of the accident revealed fractured ribs (ribs 6 and 7 on the left). He has been having difficulty breathing and has been very short of breath. Sharp pain is noted on the left with breathing and coughing. He has also noticed some blood in his sputum. What system is most likely the source of the patient’s symptoms?

Musculoskeletal
Pulmonary
Cardiovascular
Hepatic

A

Pulmonary

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37
Q

Aspirin and clopidogrel (Plavix) fall into which class of antithrombotics?

Thrombolytics
Platelet aggregator inhibitors
Anticoagulants
Fibrinolytics

A

Platelet aggregator inhibitors

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38
Q

Which of the following drug should angina patients always carry with/on them in case of an angina attack?

Nitroglycerin patch
An ACE inhibitor
Digoxin
Sublingual nitroglycerin

A

Sublingual nitroglycerin

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39
Q

The part of the respiratory system that is most affected by asthma is/are the

Bronchioles
Trachea
Nasal cavity
Bronchi

A

Bronchioles

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40
Q

Some of the classes of drugs used to treat angina include

Nitrates
HMG-CoA reductase inhibitors
Alpha-blockers
Diuretics

A

Nitrates

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41
Q

Beta-blockers that are useful in the treatment of hypertension

a. Work by competitively inhibiting beta-receptors, thereby decreasing heart rate
b. Are always selective for beta1-receptors
c. Do not cause bronchoconstriction in patients with asthma
d. Should not be combined with any other type of antihypertensives

A

a. Work by competitively inhibiting beta-receptors, thereby decreasing heart rate

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42
Q

Which of the following medications should be used to treat an acute asthma attack?

An oral steroid such as prednisone
A long-acting beta-agonist such as salmeterol
An inhaled steroid such as fluticasone
A short-acting beta-agonist such as albuterol

A

A short-acting beta-agonist such as albuterol

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43
Q

In children with osteogenesis imperfecta, fractures heal

Within the normal healing time
More quickly than normal
More slowly than normal
Only with assistance of medication

A

Within the normal healing time

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44
Q

Components of lower extremity alignment that contribute to toe in include

Femoral retroversion
Femoral anteversion
Calcaneovalgus feet
External tibial torsion

A

Femoral anteversion

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45
Q

Osteochondritis dissecans occurs most commonly in the

Capitellum
Humeral medial condyle
Medial femoral condyle
Lateral femoral condyle

A

Medial femoral condyle

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46
Q

The joint most frequently involved in pauciarticular juvenile rheumatoid arthritis is the

Cervical spine
Lumbar spine
Knee
Wrist

A

Knee

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47
Q

The most common onset type of juvenile rheumatoid arthritis is

Systematic
Juvenile ankylosing arthritis
Polyarticular
Pauciarticular

A

Pauciarticular

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48
Q

Considering an injury to the MCL of the knee, when does the inflammatory phase of healing begin?

First days after injury
2-3 weeks after injury
4-6 weeks after injury
6-8 weeks after injury

A

First days after injury

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49
Q

Which of the following types of exercise is most likely to intensify delayed onset of muscle weakness (DOMS)?

a. Concentric exercise is most likely to intensify DOMS
b. Eccentric exercise is most likely to intensify DOMS
c. Isometric exercise is most likely to intensify DOMS
d. DOMS will remain constant no matter the type of exercise

A

b. Eccentric exercise is most likely to intensify DOMS

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50
Q

Which of the following is the correct order of stages of bone healing after fracture?

a. Inflammatory phase, hard callus phase, soft callus phase, remodeling phase
b. Inflammatory phase, soft callus phase, hard callus phase, remodeling phase
c. Remodeling phase, soft callus phase, hard callus phase, inflammatory phase
d. Remodeling phase, hard callus phase, soft callus phase, inflammatory phase

A

b. Inflammatory phase, soft callus phase, hard callus phase, remodeling phase

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51
Q

Which type of connective tissue includes the superficial sheath of the body tissue under the skin, muscle, and nerve hearts, and the framework of internal organs?

Dense regular connective tissue
Dense irregular connective tissue
Loose irregular connective tissue
Loose regular connective tissue

A

Loose irregular connective tissue

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52
Q

Which patient population is most likely to have osteophyte formation that leads to rotator cuff damage?

16-year-old baseball player
34-year-old factory worker
45-year-old tennis player
75-year-old sedentary individual

A

75-year-old sedentary individual

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53
Q

You are seeing a patient who just received a steroid injection into a joint. You should

Treat the patient vigorously
Treat the patient gently
Not touch this joint at all
Postpone the session for at least 1 week

A

Treat the patient gently

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54
Q

A patient with osteoporosis might be treated with all of the following drugs except

Bisphosphonates
Calcitonin
Calcium with Vitamin D
Thyroid hormones

A

Thyroid hormones

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55
Q

A patient has been told to use Advil for rheumatoid arthritis. You notice that the patient uses acetaminophen because a friend uses it, and it is cheaper. You can tell the patient that acetaminophen

a. Can be used since it is the same as Advil
b. Is different from Advil but has the same therapeutic action
c. Is actually more effective than Advil
d. Does not work in rheumatoid arthritis

A

d. Does not work in rheumatoid arthritis

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56
Q

Skeletal muscle relaxants

a. May interfere with walking patients who use their spasticity to control balance
b. Selectively paralyze certain muscle groups
c. Should be stopped quickly after long-term use when problems have been resolved
d. Have never been proven effective

A

a. May interfere with walking patients who use their spasticity to control balance

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57
Q

While doing a worksite assessment in the hospital business office, a physical therapist found several employees complaining of neck and shoulder pain. It was determined that making a simple change in the set-up of the computer stations could reduce symptoms. The change to the computer monitor that would MOST affect neck and shoulder discomfort is

a. Lowering the monitor to the desk surface
b. Moving the computer monitor closer to the employee’s face
c. Tilting the monitor forward
d. Putting a non-glare screen on the face

A

b. Moving the computer monitor closer to the employee’s face

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58
Q

The cuboid bone is located just posterior to the

Base of the first metatarsal
Head of the first metatarsal
Medial cuneiform bone
Tuberosity of the fifth metatarsal

A

Tuberosity of the fifth metatarsal

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59
Q

The MCP joints are classified as what type of joint?

Plane
Hinge
Condyloid
Saddle

A

Condyloid

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60
Q

Which muscle would move the abducted (90 degree) arm anteriorly?

Sternocostal head of the pectoralis major
Clavicular head of the pectoralis major
Inferior fibers of the serratus anterior
Pectorais minor

A

Clavicular head of the pectoralis major

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61
Q

Which one of the following structures does NOT pass through the foramen magnum of the occipital bone?

Spinal cord
Meninges
Cranial Nerve XII
Vertebral artery

A

Cranial Nerve XII

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62
Q

Contraction of which muscle produces extension of the head?

Spinalis cervicis
Longus capitis
Longus colli
SCM

A

Spinalis cervicis

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63
Q

The nucleus pulposus is thickest in which region of the spine?

Lumbar spine
Inferior half of the thoracic spine
Superior half of the thoracic spine
Cervical spine

A

Lumbar spine

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64
Q

The speed of muscle contraction is a function of which of the following factors?

Resting length of the muscle fiber
Cross-sectional diameter of the muscle
Creatine phosphate of the muscle
Glycolytic capacity of the muscle

A

Resting length of the muscle fiber

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65
Q

Which of the following describes the proper normal anatomy of the proximal carpal row from lateral to medial?

a. Capitate, lunate, triquetrum, pisiform
b. Lunate, triquetrum, capitate, hamate
c. Scaphoid, lunate, triquetrum, pisiform
d. Scaphoid, hamate, lunate, capitate

A

c. Scaphoid, lunate, triquetrum, pisiform

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66
Q

A therapist is testing key muscles on a patient who recently suffered a spinal cord injury. The current test assesses the strength of the long toe extensors. Which nerve segment primarily innervates this key muscle group?

L2
L3
L4
L5

A

L5

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67
Q

A physician notes a vertebral fracture in the x-ray of a patient involved in a car accident. The fractured vertebra has a bifid spinous process. Which of the following is the most likely to be involved?

L4 vertebra
C5 vertebra
T12 vertebra
S1 vertebra

A

C5 vertebra

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68
Q

If the line of gravity is posterior to the hip joint in standing, on what does the body first rely to keep the trunk from moving into excessive lumbar extension?

Iliopsosas muscle activity
Abdominal muscle activity
Anterior pelvic ligaments and the hip joint muscle
Posterior pelvic ligaments and the joint capsule

A

Anterior pelvic ligaments and the hip joint muscle

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69
Q

What is the closed-packed position of the shoulder?

IR and abduction
ER and abduction
IR and adduction
ER and adduction

A

ER and abduction

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70
Q

A patient with a diagnosis of a rotator cuff tear has just begun active range of motion. The therapist is strengthening the rotator cuff muscles to increase joint stability and oppose the superior shear of the deltoid. Which of the rotator cuff muscles participate least in opposing the superior sheer force of the deltoid?

Infraspinatus
Subscapularis
Teres minor
Supraspinatus

A

Supraspinatus

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71
Q

What portion of the adult knee meniscus is vascularized?

The outer edges are vascularized
The inner edges are vascularized
The entire meniscus is vascular
The entire meniscus is avascular

A

The outer edges are vascularized

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72
Q

At what age does a human have the greatest amount of fluid in the IV disc?

1 year
4 years
7 years
10 years

A

1 year

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73
Q

Which of the following is not an example of a synarthrodial joint in the body?

a. Coronal suture
b. The fibrous joint between the shaft of tibia and fibula
c. Symphysis pubis
d. MCP

A

d. MCP

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74
Q

A football player presents to an outpatient clinic with complaints of pain in the right knee after an injury suffered the night before. The physician determines that the ACL is torn. Which of the following is most commonly associated with an injury causing damage to the ACL only?

a. Varus blow to the knee with the foot planted and an audible pop
b. Foot planted, medial tibial rotation, and an audible pop
c. Valgus blow to the knee with thew foot planted and non audible pop
d. Foot planted, lateral tibial rotation, and no audible pop

A

b. Foot planted, medial tibial rotation, and an audible pop

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75
Q

A 27-year-old woman is transferred to a physical therapy clinic with a diagnosis of torticollis. The right SCM is involved. What is the most likely position of the patient’s cervical spine?

a. Right lateral cervical flexion and left cervical rotation
b. Right cervical rotation and right lateral cervical flexion
c. Left cervical rotation and left lateral cervical flexion
d. Left lateral cervical flexion and right cervical rotation

A

a. Right lateral cervical flexion and left cervical rotation

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76
Q

Observing a patient in a standing position, the therapist notes that an angulation deformity of the right knee causes it to be located medially in relation to the left hip and left foot. This condition is commonly referred to as

Genu varum
Genu valgum
Pes cavus
None of the above

A

Genu valgum

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77
Q

Which of the following is the most vulnerable position for dislocation of the hip?

a. 30 degrees hip extension, 30 degrees hip adduction, and minimal internal rotation
b. 30 degrees hip flexion, 30 degrees hip adduction, and minimal external rotation
c. 30 degrees hip flexion, 30 degrees hip abduction, and minimal external rotation
d. 30 degrees hip extension, 30 degrees hip abduction, and minimal external rotation

A

c. 30 degrees hip flexion, 30 degrees hip abduction, and minimal external rotation

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78
Q

Which of the following articulates with the second cuneiform?

Navicular
Talus
First metatarsal
Cuboid

A

Navicular

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79
Q

The terms below refer to properties of water that make hydrotherapy valuable to a variety of patient populations. Match the following terms with the statement that best relates to each term.
1. Viscosity
2. Buoyancy
3. Relative density
4. Hydrostatic pressure

I. This property can assist in the prevention of blood pooling in the lower extremities of a patient in the pool above waist level
II. The property makes it harder to walk underwater
III. A person with a higher amount of body fat can float more easily than a lean person because of his property
IV. This property makes it easier to move a body part to the surface of the water and harder to move a part away from the surface

a. 1-II, 2-III, 3-IV, 4-I
b. 1-II, 2-IV, 3-III, 4-I
c. 1-III, 2-II, 3-I, 4-IV
d. 1-I, 2-III, 3-II, 4-IV

A

b. 1-II, 2-IV, 3-III, 4-I

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80
Q

A physician ordered a splint for a patient who should keep the thumb of the hand involved in abduction. A new graduate is treating the patient and is confused about the difference between thumb flexion, extension, abduction, and adduction. Which of the following lists is correct?

a. Extension is performed in a plane parallel to the palm of the hand, and abduction is performed in a plane perpendicular to the palm of the hand
b. Flexion is performed in a plane perpendicular to the palm of the hand, and adduction is performed in a plane parallel to the palm of the hand
c. Extension is performed in a plane perpendicular to the palm of the hand, and adduction is performed in a plane parallel to the palm of the hand
d. In referring to the positions of the thumb, flexion and adduction are used synonymously, and extension and abduction are used synonymously

A

a. Extension is performed in a plane parallel to the palm of the hand, and abduction is performed in a plane perpendicular to the palm of the hand

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81
Q

A physical therapist receives an order from the physician to treat a patient using iontophoresis. The order indicates that the purpose of the treatment is to attempt to dissolve a calcium deposit in the area of the Achilles tendon. When preparing the patient for treatment, the therapist connects the medicated electrode to the negative pole. Which of the following medications is the therapist most likely preparing to administer?

Dexamethasone
Magnesium sulfate
Hydrocortisone
Acetic acid

A

Acetic acid

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82
Q

A therapist is assisting a patient in gaining lateral stability of the knee joint. The therapist is using strengthening exercises to strengthen muscle groups that will increase active restraint of the lateral side of the joint. Which of the following offers the least amount of active lateral restraint?

Gastrocnemius
Poplitues
Biceps femoris
Iliotibial band

A

Gastrocnemius

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83
Q

A patient is in an outpatient facility because of an injury sustained to the right knee joint. Only the structures within the synovial cavity were compromised during the injury. Knowing this information only, the therapist is not concerned with injury to which of the following structures?

Patellofemoral joint
ACL
Medial meniscus
Femoral condyles

A

ACL

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84
Q

A patient is being examined by a physical therapist because of bilateral knee pain. The therapist is attempting to rule out ankle or foot dysfunction as the source of pain. Which of the following observations is not true in examining a patient without foot or ankle problems in the standing position?

a. The talus is situated somewhat medially to the midline of the foot
b. In quiet standing, the muscles surrounding the ankle joint remain silent
c. The first and second metatarsal heads bear more weight than the fourth and fifth metatarsal heads
d. The talus transmits weight to the rest of the bones of the foot

A

b. In quiet standing, the muscles surrounding the ankle joint remain silent

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85
Q

A physical therapist is examining a female distance runner who complains of intermittent medial ankle pain. In static standing, the therapist palpates excessive lateral deviation of the head of talus. From this information, in what position is the subtalar joint during palpation?

Supination
Pronation
Neutral
Unable to determine from the information given

A

Supination

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86
Q

Which of the following is not part of the triangular fibrocartilage complex of the wrist?

Dorsal radioulnar ligament
Ulnar collateral ligament
Radial collateral ligament
Ulnar articular cartilage

A

Radial collateral ligament

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87
Q

A physical therapist is attempting to explain the importance of slow stretching to an athlete training in a marathon. The therapist explains that quick stretching often causes the muscles to __, which is a response initiated by the __, which are located in the muscle fibers.

a. Relax, Golgi tendon organs
b. Contract, Golgi tendon organs
c. Relax, muscle spindles
d. Contract, muscle spindles

A

d. Contract, muscle spindles

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88
Q

What is the normal low-end range for interincisal opening with a TMD patient?

50 mm
30 mm
40 mm
60 mm

A

40 mm

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89
Q

What is dental trismus?

Capsulitis of the TMJ
Osteoarthritis of the TMJ
Muscle spasms of the TMJ
Trigger point of the TMJ

A

Muscle spasms of the TMJ

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90
Q

Temporomandibular anterior disc displacement without reduction occurs between the

a. Disc and lower joint compartment
b. Disc and the eminentia articularis
c. Disc and the lateral pterygoid
d. Disc and the upper joint compartment

A

d. Disc and the upper joint compartment

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91
Q

What are the signs and symptoms of a temporomandibular anterior displaced disc with reduction?

Crepitation with loss of opening
Clicking with opening
No clicking with loss of opening
Temporomandibular joint tenderness and loss of opening

A

Clicking with opening

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92
Q

What is the normal TMJ arthrokinematics for lateral movements?

Bilateral translation
Bilateral rotation
C/L rotation and I/L translation
I/L rotation and C/L translation

A

I/L rotation and C/L translation

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93
Q

What is the normal TMJ arthrokinematics for protrusion?

Bilateral anterior translation
Bilateral posterior translation
I/L rotation with C/L translation
Bilateral rotation

A

Bilateral anterior translation

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94
Q

What is the normal TMJ arthrokinematics for wide opening?

a. Bilateral translation
b. Combination of rotation occurs first 26 mm then anterior translation
c. Combination of anterior translation occurs first 26 mm then anterior rotation
d. Bilateral rotation

A

b. Combination of rotation occurs first 26 mm then anterior translation

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95
Q

Positioning of a patient in right side-lying can create pressure on the

Right ischial tuberosity
Left greater trochanter
Right lateral malleolus
Occiput

A

Right lateral malleolus

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96
Q

Ideal postural alignment is influenced by appropriate muscle balance. What combinations of muscle imbalance would likely contribute to increased anterior pelvic tilt?

a. Short hamstrings and elongated hip flexors
b. Strong anterior abdominals and strong hip flexors
c. Short hip flexors and lengthened anterior abdominals
d. Strong anterior abdominals and strong hip extensors

A

c. Short hip flexors and lengthened anterior abdominals

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97
Q

A patient presents with anterior knee pain. Which of the following cannot be the source of pat pain?

Synovium
Capsule
Patella cartilage
Patella bone

A

Patella cartilage

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98
Q

ACL tears do not heal as well as MCL tears because

The ACL is under greater tension
Synovial fluid inhibits ACL healing
The MCL is broad and flat allowing better healing
There is more motion in the ACL

A

Synovial fluid inhibits ACL healing

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99
Q

Patellofemoral joint reactive forces are highest with

Running
Straight leg raises
Prolonged sitting
Plyometrics

A

Plyometrics

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100
Q

Rotator cuff

Is rare under the age of 40
Is usually painful
Progresses from the bursal side towards the articular side
Requires surgical repair

A

Is rare under the age of 40

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101
Q

Foot drop following total hip arthroplasty most likely indicates

Stroke
Disc herniation
Sciatic laceration
Traction neuropraxia

A

Traction neuropraxia

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102
Q

Sever’s apophysitis

Frequently occurs with Achilles tendinitis
Is a result of leg length inequality
Is not an inflammatory condition
Responds to ultrasound treatment

A

Frequently occurs with Achilles tendinitis

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103
Q

Pes planus

Is a painful condition
Is common in patients with hyperlaxity
Requires orthotics treatment
Results in anterior knee pain if not corrected

A

Is common in patients with hyperlaxity

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104
Q

A patient was referred to physical therapy after removal of a long arm cast extending to the forearm. She lacks full passive elbow extension. What may be causing this problem?

Active insufficiency of the biceps
Tightness in posterior humeroulnar joint capsule
Passive insufficiency of the pronator teres
Passive insufficiency of the triceps

A

Passive insufficiency of the pronator teres

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105
Q

A 10 degrees hip flexion contracture produces __ torque at the hip that increases muscle demand on the __.

Extension, quadriceps
Flexion, biceps femoris
Abduction, adductor magnus
Flexion, iliopsoas

A

Flexion, biceps femoris

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106
Q

The physical therapist is analyzing a patient’s gait with descending stairs. During the left single limb stance, the patient demonstrates a right pelvic drop with left trunk lean. The physical therapy hypothesis is

a. Weak right gluteus medius with left trunk lean to move center of mass towards stronger side
b. Weak left gluteus medius with left trunk lean to move center of mass towards weaker side
c. Weak left quadratus lumborum producing left trunk lean
d. Weak right gluteus medius with left trunk lean to move center of mass towards stronger side

A

b. Weak left gluteus medius with left trunk lean to move center of mass towards weaker side

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107
Q

Left lateral trunk flexion is primarily limited by

a. The thoracic spine because of sagittal facet alignment
b. The rib cage because of multiple attachments
c. The lumbar spine because of horizontal plane facet orientation
d. The left quadratus lumborum

A

b. The rib cage because of multiple attachments

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108
Q

What is true about the hip joint?

a. The hip joint’s closed pack position is extension with full external rotation
b. The hip joint’s loose pack position is 30 degrees abduction, 70 degrees of flexion, with lateral rotation
c. With its capsular pattern of restriction, medial rotation is most restricted in the hip joint
d. With its capsular pattern of restriction, flexion is most restricted in the hip joint

A

d. With its capsular pattern of restriction, flexion is most restricted in the hip joint

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109
Q

A physical therapist is conducting a screen for visual field deficits by having the client look straight ahead and presenting a stimulus at the margins of the person’s visual fields. The examination technique checks cranial nerve(s) __ function

II
II, IV, VI
V
VIII

A

II

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110
Q

The next patient on your schedule is a 69-year-old Asian woman with a diagnosis of “T8 fracture”. What condition are you most concerned with for this patient?

Neck pain
Myopathy
Dizziness
Osteoporosis

A

Osteoporosis

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111
Q

Which of the following are not appropriate interventions for a patient with osteoporosis and a T8 compression fracture?

Balance exercises
Postural exercises
Proprioceptive training
Ultrasound

A

Proprioceptive training

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112
Q

A patient is suffering from chronic back pain as a result of a recent automobile accident. He is currently taking an opioid medication for relief of this pain. Which of the following medications is an opioid?

Ibuprofen
Aspirin
Codeine
Acetaminophen

A

Codeine

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113
Q

An athlete has been complaining of muscle spasm. Her physician decided to treat her with a medication called cyclobenzaprine, which is a muscle relaxant. She is unfamiliar with his medication and asks you if you can tell her anything about it. Which of the following is a correct statement?

a. There is no such medications as muscle relaxants
b. Muscle relaxants are the same thing as anti-inflammatory medications
c. Drowsiness, blurred vision, and dry mouth are some of the side effects of muscle relaxants
d. You cannot overdose on muscle relaxants

A

c. Drowsiness, blurred vision, and dry mouth are some of the side effects of muscle relaxants

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114
Q

All NSAIDs inhibit __ in some manner or another.

Bradykinin
Cyclooxygenase (COX)
Prostaglandins
Lipoxygenase

A

Cyclooxygenase (COX)

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115
Q

Which NSAID has been used because of its lower incidence of GI complications?

Naproxen
Aspirin
Ketoprofen
Celecoxib

A

Celecoxib

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116
Q

Your patient had a laceration anterior to the medial malleolus that required stitches. He is now in your office complaining of pain along the medial border of the foot. Which nerve is most likely involved?

Sural nerve
Deep fibular
Tibial nerve
Saphenous nerve

A

Saphenous nerve

117
Q

Which named peripheral nerve is responsible for pain sensation from the pericardium, mediastinal pleura, diaphragmatic pleura, and diaphragmatic peritoneum?

Vagus nerve
Phrenic nerve
Greater thoracic splanchnic nerve
Tenth intercostal nerve

A

Phrenic nerve

118
Q

The neural canal is smallest and circular in shape in the __ region of the vertebral canal.

Cervical
Thoracic
Lumbar
Sacral

A

Thoracic

119
Q

Ascending tracts in the white matter of the spinal cord carry __ information.

Sensory
Motor
Both sensory and motor
Autonomic

A

Sensory

120
Q

Which of the following does NOT contain parasympathetic fibers?

Oculomotor
Facial
Trigeminal
Vagus

A

Trigeminal

121
Q

A number of significant clinical conditions involve abnormalities of neurotransmitter release or reception at the myoneural junction. The neurotransmitter associated with the motor end plate is

Norepinephrine
Dopamine
Acetylcholine
Myasthenia gravis

A

Acetylcholine

122
Q

Which is an inhibitory neurotransmitter in the central nervous system?

GABA
Epinephrine
Glutamate
Norepinephrine

A

GABA

123
Q

On examination of a cross-section of the spinal cord of a cadaver, the examiner notes plaques. The finding is most characteristic of

Parkinson’s disease
Myasthenia gravis
Multiple sclerosis
Dementia

A

Multiple sclerosis

124
Q

The therapist is ordered to evaluate a patient in the intensive care unit. The patient appears to be in a coma and is totally unresponsive to noxious, visual, and auditory stimuli. What rating on the Ranchos Los Amigos Cognitive Functioning Scale is most appropriate?

I
II
IV
VIV

A

I

125
Q

Which of the following is not an acceptable long-term goal for a patient with a complete C7 spinal cord injury?

a. Independence with dressing
b. Driving an automobile
c. Balance a wheelchair for 30 seconds using a “wheelie”
d. Independence with performing a manual cough

A

c. Balance a wheelchair for 30 seconds using a “wheelie”

126
Q

Which of the following neural fibers are the largest and fastest?

C fibers
A beta fibers
A delta fibers
B fibers

A

A beta fibers

127
Q

A posterolateral herniation of the lumbar disc between vertebrae L4 and L5 most likely results in damage to which nerve root?

L4
L5
L4 and L5
L5 and S1

A

L5

128
Q

A therapist is examining a patient in the intensive care unit. The therapist notes no eye opening, no verbal response, and no motor response. On the Glasgow coma scale. What is the patient’s score?

0
3
5
9

A

3

129
Q

A patient asks the therapist whether she should be concerned that her 4-month-old infant cannot roll from his back to this stomach. The most appropriate response to the parent is:

a. “This is probably nothing to be concerned about because, although it varies, infants can usually perform this task by 10 moths of age.”
b. “This is probably nothing to be concerned about because, although it varies, infants can usually perform this task by 5 months of age”.
c. “Your infant probably needs further examination by a specialist because, although it varies, infants can usually perform ths task at 2 months of age.”
d. “Your infant probably needs further examination by a specialist because, although it varies, infants can usually perform this task at birth.”

A

a. “This is probably nothing to be concerned about because, although it varies, infants can usually perform this task by 10 moths of age.”

130
Q

A patient traumatically dislocated the tibia directly posteriorly during an automobile accident. Which of the following structures is the least likely to be injured?

Tibial nerve
Popliteal artery
Common peroneal nerve
Anterior cruciate ligament

A

Common peroneal nerve

131
Q

A patient is referred to physical therapy with complaints of sensation loss over the area of the radius of the right upper extremity, extending from the elbow joint distally to the wrist. Therapy sessions are focused on assisting the patient in regaining normal sensation. Which of the following nerves is responsible for sensation in this region?

a. Medial antebrachial cutaneous
b. Lateral antebrachial cutaneous
c. Musculocutaneous
d. Both B and C

A

d. Both B and C

132
Q

While examining a patient who suffered a complete spinal cord lesion, the therapist notes the following strength grades with manual testing: wrist extensors = ⅗, elbow extensors = ⅖, and intrinsic muscles of the hand = 0/5. What is the highest possible level of this lesion?

C3
C4
C5
C7

A

C7

133
Q

A physical therapist must have a clear understanding of normal development of the human body to treat effectively and efficiently. Which of the following principles of treatment is incorrect?

a. Early motor activity is influenced primarily by reflexes
b. Motor control develops from proximal to distal and from head to toe
c. Increasing motor ability is independent of motor learning
d. Early motor activity is influenced by spontaneous activity

A

c. Increasing motor ability is independent of motor learning

134
Q

During the examination of an infant, the therapist observes that with passive flexion of the head, the infant actively flexes the arms and actively extends the LEs. Which of the following reflexes is observed?

Protective extension
Optical righting
Symmetrical tonic neck
Labyrinthine head righting

A

Symmetrical tonic neck

135
Q

Which of the following statements about development motor control is incorrect?

a. Isotonic control develops before isometric control
b. Gross motor control develops before fine motor control
c. Eccentric movement develops before concentric movement
d. Trunk control develops before distal extremity control

A

a. Isotonic control develops before isometric control

136
Q

Which of the following statements is true in comparing infants with Down Syndrome to infants with no known abnormalities?

a. Motor milestones are reached at the same time with both groups
b. Postural reactions are developed in the same time with both groups
c. Postural reactions and motor milestones are developed slower in patients who have Down Syndrome, but with the same association as with normal infants
d. Postural reactions man motor milestones are not developed with the same association with patients who have Down Syndrome as with normal infants

A

c. Postural reactions and motor milestones are developed slower in patients who have Down Syndrome, but with the same association as with normal infants

137
Q

The spastic type of cerebral palsy usually results from involvement of the

Corpus callosum
Basal ganglia
Motor cortex
Cerebellum

A

Motor cortex

138
Q

A complete rupture of a cord of the brachial plexus is best described using the term

Neurotmesis
Neuropraxia
Axonotmesis
Axonopraxia

A

Neurotmesis

139
Q

Which of the following statements is true regarding myelodysplasia?

a. Myelodysplasia is defined as defective development limited to the anterior horn cells of the spinal cord
b. Embryologically, myelodysplastic lesions can be related to either abnormal nervous system neurulation or canalization
c. Myelodysplasia is often associated with genetic abnormalities; however, there is no association with teratogens
d. Myelodysplasia refers to defects in the lower spinal cord only

A

b. Embryologically, myelodysplastic lesions can be related to either abnormal nervous system neurulation or canalization

140
Q

Which of the following statements is true progressive neurologic dysfunction?

a. Progressive neurologic dysfunction is common during periods of rapid growth but does not occur once skeletal maturity is reached
b. Deterioration of gait pattern is one of the last symptoms to be detected
c. Symptoms include loss of sensation and/or strength, pain along a dermatome or incision, spasticity onset or worsens, and changes in bowel or bladder sphincter control
d. Development of scoliosis will always be rapid

A

c. Symptoms include loss of sensation and/or strength, pain along a dermatome or incision, spasticity onset or worsens, and changes in bowel or bladder sphincter control

141
Q

Fine synergistic control of neck flexors and extensors in the upright position typically appears in the

Second month
Third month
Fourth month
Fifth month

A

Second month

142
Q

Ballistic movements of arms and legs are characterized by

Reciprocal activation of antagonist muscles
Coactivation of antagonist muscles
Need for proprioceptive feedback during movement
Visual guidance during movement

A

Reciprocal activation of antagonist muscles

143
Q

In typically developing children, successful head turning in a prone position with an erect is characterized by

a. Hip extension, medial rotation, and abduction
b. Cervical spine extension and rotation with weight bearing on the upper abdomen
c. Shoulder flexion and abduction with weight bearing of elbows
d. Caudal weight shift and load on lateral thighs and lower abdomen

A

d. Caudal weight shift and load on lateral thighs and lower abdomen

144
Q

Development in children with cerebral palsy is characterized by

a. Failure to develop reciprocal patterns of muscle activation
b. The appearance of fidgety movements as defined by Precthl and colleagues at about 9 weeks of age
c. The appearance of chorea at about 6 months of age
d. Failure to develop binocularity of vision

A

a. Failure to develop reciprocal patterns of muscle activation

145
Q

Circling arm movements, finger spreading, and a poor repertoire of general movements are characteristic of

Down syndrome
Muscular atrophy
Spastic cerebral palsy
Dyskinetic cerebral palsy

A

Dyskinetic cerebral palsy

146
Q

The movement repertoire of the human newborn includes

a. Projection of the arm toward stationary objects, kicking, an mouth-to-hand behaviors
b. Projection of the arm toward stationary objects, reaching with grasping, and neonatal stepping behaviors
c. Projection of the arm toward moving objects, reaching and grasping, and light-avoidance behaviors
d. Projection of the arm toward moving objects, mouth-to-hand, and kicking behaviors

A

d. Projection of the arm toward moving objects, mouth-to-hand, and kicking behaviors

147
Q

Once a new motor skill is obtained, further development entails

a. Performance with morse use of sensory feedback
b. Constricting the degrees of freedom used when performing the skill
c. Perfecting postural control and transitions between postures
d. Developing a single way of performing the skill

A

c. Perfecting postural control and transitions between postures

148
Q

Which is the strongest predictor of skill in walking for children with typical development?

Age
Duration of time since walking began
Weight
Extent of walking practice

A

Extent of walking practice

149
Q

It is typical of a 3-year-old child to

Manage buttoning well
Alternate feet when ascending stairs
Be unafraid of falling
Show no dysmetria during block stacking

A

Alternate feet when ascending stairs

150
Q

A patient with Parkinson’s disease on levodopa/carbidopa therapy might experience during therapy all of the following except

The “off” phase
Dizziness
Involuntary movements
Marked bradycardia

A

Marked bradycardia

151
Q

A patient whose seizures are controlled with an anticonvulsant should be treated in a room or an area that

a. Is devoid of bright, flickering lights and repetitive, loud noises
b. Has no electronic equipment near the patient
c. Is warm and somewhat humid
d. Is not frequented by may people

A

a. Is devoid of bright, flickering lights and repetitive, loud noises

152
Q

You might want to inform a patient on lithium therapy to contact the physician or call the physician directly if this patient shows

Ataxia and fine tremor
Increased blood pressure and dyspnea
Excessive salivation and tearing
Constipation and trouble voiding

A

Ataxia and fine tremor

153
Q

Your patient is on antipsychotic drug therapy. During your therapy sessions, you might notice a number of movement abnormalities. The most severe one is

Tardive dyskinesia
Tremor
Akathisia
Dystonia

A

Tardive dyskinisea

154
Q

Which of the following adverse reactions experienced during antiviral drug treatment might be encountered most frequently during therapy?

Elevated blood pressure
Aggressive and inappropriate behavior
Neuralgia and myopathies
Sedation and incoordination

A

Neuralgia and myopathies

155
Q

Which of the following adverse reactions might be encountered during therapy sessions by a patient receiving anxiolytic drugs?

Psychomotor impairment
Erratic heart rates
Frequent interruptions due to diarrhea
Excessive sweating

A

Psychomotor impairment

156
Q

A patient starting cholinergic agonist therapy for myasthenia gravis might have to interrupt the therapy session repeatedly because of

Abdominal cramps and diarrhea
Intermittent tachycardia
Joint stiffness and muscle cramps
Extremely dry mouth

A

Abdominal cramps and diarrhea

157
Q

Among other reasons, mental activity and motor control is the result of excitatory and inhibitory neurotransmitter actions in the CNS. the most important inhibitory neurotransmitter is

Glutamate
GABA
Norepinephrine
Acetylcholine

A

GABA

158
Q

A patient has a tumor in the parietal lobe. The physical therapist anticipates problems with

Muscle strength
Perception of spatial relationships
Sensation and motor function
Vision

A

Perception of visual relationships

159
Q

What are the components of upper motor neuron syndrome?

Fasciculations, spasticity, hyperreflexia
Spasticity, rigidity, hyporeflexia
Spasticity, positive Babibski sign, rigidity
Spasticity, hyperreflexia, positive Babinski sign

A

Spasticity, hyperreflexia, positive Babinski sign

160
Q

After completing a developmental assessment on a seven month old, which of the following reflexes would not be integrated?

Galant reflex
Moro reflex
Landau reflex
Symmetrical tonic neck reflex

A

Landau reflex

161
Q

Nerve regeneration occurs at a pace of __ per month

5 mm
1 inch
1 cm
2.5 inches

A

1 inch

162
Q

A physical therapist working in an early intervention program is providing intervention to an infant diagnosed with Erb’s palsy. This condition most often involves what nerve roots?

C2-C3
C3-C4
C5-C6
C8-T1

A

C5-C6

163
Q

A patient with an Erb’s palsy will have paralysis of all the following muscles except the

Flexor carpi ulnaris
Rhomboids
Brachialis
Teres minor

A

Flexor carpi ulnaris

164
Q

The physical therapist is beginning the examination of a patient in an outpatient cardiac rehabilitation facility. A chart review shows that this patient has active atrial fibrillation with a controlled ventricular rate. What is the most appropriate intervention for this patient?

Low intensity exercise
High intensity exercise
High intensity lower extremity exercise
Low intensity lower extremity exercise

A

Low intensity exercise

165
Q

Which of the following is incorrect advice to give to a patient with a diagnosis of congestive heart failure who complains of shortness of breath and “smothering” while attempting to sleep?

a. Sleep with the head on 2 to 3 pillows
b. Sleep without any pillows
c. Sleep in a recliner during exacerbations
d. During exacerbations, come to a standing position for a short-term relief

A

b. Sleep without any pillows

166
Q

A physical therapist is treating a patient with significant burns over the limbs and upper trunk. Which of the following statements is false about some changes initially experienced after the burn?

a. This patient initially experienced an increase in the number of white blood cells
b. This patient initially experiences an increase in the number of red blood cells
c. This patient initially experienced an increase in the number of free fatty acids
d. This patient initially a decrease in fibrinogen

A

b. This patient initially experiences an increase in the number of red blood cells

167
Q

The most common cause of burn injury in infants is

a. Accidental flame burn from a smoking adult
b. Car accidents with immolation
c. Scald injury, either intentional or accidental by neglect
d. House fires, in which all family members are injured

A

c. Scald injury, either intentional or accidental by neglect

168
Q

What are the four stages, in time order, of wound healing after surgery?

a. Coagulation, inflammatory phase, granulation phase, and scar formation and maturation
b. Inflammatory phase, coagulation, scar formation and maturation,and granulation phase
c. Scar formation and maturation, granulation phase, coagulation phase, and inflammatory phase
d. Inflammatory phase, granulation phase, coagulation, and scar formation and maturation

A

a. Coagulation, inflammatory phase, granulation phase, and scar formation and maturation

169
Q

A patient is taking tetracyclines for an infection. You have to be most careful to

a. Not expose the patient to excessive light or UV therapy
b. Only exercise this patient moderately
c. Avoid using the warm therapeutic pool
d. Have the patient get up very slowly from a lying position

A

a. Not expose the patient to excessive light or UV therapy

170
Q

A patient with lymphedema following breast CA and reconstruction requires examination. She is presenting with heaviness, itching, aching, and redness in her left upper extremity. Your next course of action is to

Take girth measurements of the arm
Begin lymph drainage massage
Take her temperature
Send her back to physician

A

Send her back to physician

171
Q

Which of the following is responsible for the constant renewal of epidermal cells?

Stratum germinativum
Stratum granulosum
Stratum lucidum
Stratum corneum

A

Stratum germinativum

172
Q

The right adrenal gland is in contact with the

Spleen
Inferior vena cava
Pancreas
Stomach

A

Inferior vena cava

173
Q

Releasing hormones that regulate the anterior lobe of the pituitary gland are synthesized in the

Hypothalamus
Cerebral cortex
Thalamus
Basal ganglia

A

Hypothalamus

174
Q

Erythropoietin is a hormone required for the production of red blood cells. It is produced primarily in the

Kidney
Lung
Marrow
Pancreas

A

Kidney

175
Q

Which abdominal organs does the thoracic cage protect?

a. Spleen, liver, adrenal gland, upper portion of kidneys, and stomach
b. Pancreas, liver, and vermiform appendix
c. Gallbladder, urinary bladder, liver, and uterus
d. Spleen, pancreas, adrenal gland, and ovaries

A

a. Spleen, liver, adrenal gland, upper portion of kidneys, and stomach

176
Q

Which of the following muscles of the pharynx is supplied by the glossopharyngeal nerve (CN IX)?

Palatopharyngeus
Stylopharyngeus
Superior constrictor
Middle constrictor

A

Stylopharyngeus

177
Q

In abdominal examination, the spleen lies in which of the following quadrants?

Upper left
Upper right
Lower left
Lower right

A

Upper left

178
Q

The majority of disaccharide hydrolysis occurs due to the action of which enzymes?

Enzymes from pancreatic juice
Enzymes in the brush border of the small intestine
Enzymes found in the saliva
Enzymes in the gastric mucosa

A

Enzymes in the brush border of the small intestine

179
Q

The therapist in an outpatient physical therapy clinic receives an order to obtain a how orthotic for a patient. After examining the patient, the therapist finds a stage I pressure ulcer on the first metatarsal head. Weight-bearing surfaces need to be transferred posteriorly. Which orthotic is the most appropriate for this patient?

Scaphoid pad
Thomas heel
Metatarsal pad
Cushion heel

A

Metatarsal pad

180
Q

While obtaining the history, the therapist learns that the patient was recently hospitalized for malfunction of the anterior pituitary gland. Based on this information alone, the therapist knows that there may be problems with the patient’s ability to produce which of the following hormones?

a. Adrenocorticotropic hormone, thyroid-stimulating hormone, growth hormone, follicle-stimulating hormone, luteinizing hormone
b. Insulin and glucagon
c. Epinephrine and norepinephrine
d. Cortisol, androgens, and aldosterone

A

a. Adrenocorticotropic hormone, thyroid-stimulating hormone, growth hormone, follicle-stimulating hormone, luteinizing hormone

181
Q

A patient is using medication for a thyroid condition. Which of the following could be the result of overdosing with the drug and should be mentioned to the physician?

a. Tachycardia and restlessness when using propylthiouracil
b. Tachycardia when using a T4 medication
c. Weight loss when using propylthiouracil
d. Bradycardia when using a T4 medication

A

b. Tachycardia when using a T4 medication

182
Q

A patient using insulin injections before a therapy session must receive special care like

a. Not massaging the injection site
b. Recommending the use of glucosamine to increase insulin’s effects
c. Having insulin injected into leg muscles before exercise
d. All of the above

A

a. Not massaging the injection site

183
Q

A patient with type 2 diabetes using metformin asks about the use of herbal medications and OTC drugs to be used with his medication. You answer that

a. Some herbal preparations have been shown beneficial
b. OTC cimetidine can be taken freely without concern
c. Minerals and chromium might help drug actions
d. The antacid Tums can be taken but not in excess

A

d. The antacid Tums can be taken but not in excess

184
Q

Which of the following symptoms are most likely to raise suspicion of liver disease?

a. Fever, melena, urinary frequency
b. Left shoulder pain, pallor, coffee ground emesis
c. Jaundice, ascites, asterixis
d. Left upper quadrant pain, nausea, diaphoresis

A

c. Jaundice, ascites, asterixis

185
Q

Which of the following statements about immune disorders is true?

a. The progression of the disease will not change the clinical presentation of signs and symptoms
b. Early diagnosis is not likely to alter the course of the disease
c. Direct access will increase the likelihood that a physical therapist might be the first provider to identify potential autoimmune disorders
d. The risk factors for immune disorders are clearly understood and will assist in differential diagnosis

A

c. Direct access will increase the likelihood that a physical therapist might be the first provider to identify potential autoimmune disorders

186
Q

An 8-year-old female is admitted to the hospital with hepatosplenomegaly; low grade fever; and swollen and stiff ankle, knee, hip, elbow, and wrist joints. What is the most likely diagnosis?

Systemic onset juvenile rheumatoid arthritis (JRA)
Polyarticular RA
Pauciarticular RA
Oligoarticular RA

A

Polyarticular RA

187
Q

Lymphedema is

a. Pathologic accumulation of white-blood-cell-filled fluid
b. Accumulation of lymphocytes in the blood and tissues
c. Pathologic accumulation of protein-rich fluid in the tissue
d. Leakage of RBCs into the surrounding tissue

A

c. Pathologic accumulation of protein-rich fluid in the tissue

188
Q

The hormones FSH, progesterone, and estrogen do what during the onset of menopause?

Increase
Decrease
Stay the same
Cause CVAs

A

Decrease

189
Q

According to the literature, development of bone mass peaks in __ and begins to decrease in __.

Early thirties, late forties
Mid-teens, late thirties
Mid-twenties, mid-forties
Late twenties, late thirties

A

Late twenties, late thirties

190
Q

Primary lymphedema occurs in __ patients who __ had surgery.

Older, have
Younger, have
Younger, have not
Older, have not

A

Younger, have not

191
Q

A 14-year-old baseball player has type 1 diabetes and uses an insulin pump. His teammates want to know more about this condition. You inform them that all the following statements concerning insulin are true except

a. It facilitates glucose transport out of the cell and into the blood
b. It is secreted from B cells in pancreas
c. It decreases blood glucose levels
d. It may be present in decreased levels in those with type 2 diabetes mellitus

A

a. It facilitates glucose transport out of the cell and into the blood

192
Q

A patient who uses a magnesium-containing antacid at high doses for long periods might experience

Contripation
Diarrhea
Headaches
Muscle cramps

A

Diarrhea

193
Q

A patient on opioid pain medications might experience all of the following except

Seeing poorly in the dark
Some respiratory depression
Motor incoordination
Severe diarrhea

A

Severe diarrhea

194
Q

Your patient is a 35-year-old female who has been having severe low back pain for the past day. She has no mechanism of injury, but the pain that is located on the left side is greater than that on the right. Her only position of ease is in the left fetal position. Her pain has increased in the last day and now is at a constant level that waxes and wanes. She has a mild temperature and has been feeling weak and lethargic since the pain began. She has been experiencing nausea, vomiting, and diarrhea for the past day. What system is most likely the source of the patient’s symptoms?

Gastrointestinal
Urogenital
Musculoskeletal
Cardiovascular

A

Gastrointestinal

195
Q

Your patient is a 63-year-old male who presents to you in physical therapy with complaints of right shoulder and abdominal pain. He is having difficulty sleeping and has noticed bilateral tingling in his lateral three fingers. He has been feeling nauseated and has been vomiting lately. He is having muscle tremors and has noticed a dark color in his urine. He noticed a yellowing of his eyes. What is the system most likely sourcing the patient’s symptoms?

Endocrine
Urogenital
Hepatic
Gastrointestinal

A

Hepatic

196
Q

A patient recently informed you that he was diagnosed with a duodenal ulcer and prescribed a proton pump inhibitor. Which of the following is a type of proton pump inhibitor?

Ranitidine
Metoclopramide
Omeprazole
Famotidine

A

Omeprazole

197
Q

Adrenergic receptors

a. Are subdivided into four major categories
b. Include the muscarinic and nicotinic receptors
c. Include alpha and beta receptors
d. When blocked, can cause dry mouth, decreased salivation, blurry vision, and constipation

A

c. Include alpha and beta receptors

198
Q

Which of the following is an absolute contraindication to initiation of an outpatient cardiac rehabilitation program?

a. Obesity
b. Patient currently on dialysis 3 days a week because of renal failure
c. Asthma
d. Third-degree heart block

A

d. Third-degree heart block

199
Q

Fourteen weeks after surgical repair of the rotator cuff, a patient presents with significant deltoid weakness. Range of motion is within normal limits and equal bilaterally, internal and external rotation strength is equal bilaterally; flexion and abduction strength is significantly reduced. What is the most likely cause of this dysfunction?

a. Poor compliance with a home exercise program
b. Tightness of the inferior shoulder capsule
c. Surgical damage to the musculocutaneous nerve
d. Surgical damage to the axillary nerve

A

d. Surgical damage to the axillary nerve

200
Q

A patient has recently undergone an acromioplasty. What is the most important goal in early rehabilitation?

Regaining muscle strength
Return to ADLs
Endurance and functional progression
Return to normal ROM

A

Return to normal ROM

201
Q

Inhibition of the internal urethral sphincter allows the body to

Micturate
Defecate
Hold the urine until later
Ejaculate

A

Micturate

202
Q

Which of the following hormones stimulate ovulation in the female?

Follicle-stimulating hormone
Growth hormone
Prolactin
Luteinizing hormone

A

Luteinizing hormone

203
Q

Whiplash injury from a rear-end collision would tear the

PLL
ALL
Ligamentum nuchae
Ligamentum flavum

A

ALL

204
Q

A physical therapist should place the knee in which of the following positions to palpate the LCL?

a. Knee at 60 degrees of flexion and the hip externally rotated
b. Knee at 20 degrees of flexion and the hip at neutral
c. Knee at 90 degrees of flexion and the hip externally rotated
d. Knee at 0 degrees and the hip at neutral

A

c. Knee at 90 degrees of flexion and the hip externally rotated

205
Q

A patient on contraceptive medication and smoking must be warned that smoking increases the risk of

Thromboembolism
Liver cancer
Internal hemorrhaging
Ovarian cancer

A

Thromboembolism

206
Q

A patient on combination contraceptive medication might experience all of the following except

Depressive episodes
Weight gain
Swelling of feet
Joint or muscle pain

A

Joint or muscle pain

207
Q

You notice that a patient looks anemic and when you ask, she tells you that she is self-medicating with iron since she always loses a lot of blood during menstruation. You should respond that she should see a physician since

a. OTC iron is not effective for anemia
b. The dose recommended on OTC preparations is much too low
c. There are different anemias some of which do not respond to iron
d. Iron alone is not effective but needs additional prescription drugs

A

c. There are different anemias some of which do not respond to iron

208
Q

Your patient is a 33-year-old female who reports to physical therapy with complaints of left low back pain. She has been feeling cramping and has had sweats on and off for the past 3 days. Her symptoms are severe at times, but appear to be coming in waves. She is unable to find a position of comfort. No motion seems to increase the symptoms. She seems to feel an increase in symptoms shortly after drinking water. What system is most likely the source of the patient’s symptoms?

Urogenital
Gastrointestinal
Hepatic
Musculoskeletal

A

Urogenital

209
Q

Your patient is a 65-year-old male who reports to you with pain in his right big toe. Symptoms have been off and on for 3 years. He is having difficulty walking, and his great toe is hot and swollen. He has been having right mid back pain. He has previously been diagnosed with kidney stones and irritable bowel syndrome. What system is most likely the source of the patient’s symptoms?

Renal
Musculoskeletal
Gastrointestinal
Cancer

A

Renal

209
Q

A patient requires examination 1 year after a hysterectomy. There is no hormone replacement therapy at this time. She complains of having pain with intercourse and some vaginal burning. What condition does she most likely have?

Atrophic vaginitis
Vulvodynia
Asexually transmitted disease
Complications from the surgery

A

Atrophic vaginitis

210
Q

An 80-year-old female complains of daily urinary accidents. She says that when she gets the urge to urinate, she simply cannot get to the bathroom in time. She has had a total hip replacement (6 months ago), has had a long history of getting up in the middle of the night to urinate, and has 3 children and 5 grandchildren with whom she enjoys spending time. What ”type” of incontinence would this patient most closely match?

Urge
Stress
Functional
Mixed

A

Functional

211
Q

A therapist receives an order to examine a patient on the telemetry floor of a hospital. The therapist is informed at the nurses’ station that an evaluation will not be necessary because the patient went into shock earlier that morning and died. The patient suffered a myocardial infarction, resulting in damage to the left ventricle. Given information, what is the most likely type of shock?

Vascular
Anaphylactic
Toxic
Cardiogenic

A

Cardiogenic

212
Q
A
213
Q

Which of the following is false for the child versus the adult?

a. Children have less tolerance for exercise in the heat
b. Children have similar nutritional requirements
c. Children need more hydration in all situations
d. Children should follow the same weight-training routines

A

b. Children have similar nutritional requirements

214
Q

A sports pre-participation examination for prepubescent children is not designed to

a. Determine the general health of the athlete and detect conditions that place the participant at additional risk and to identify relative or absolute medical contraindications to participation
b. Identify sports that may be played safely and to educate the athlete
c. Assess maturity and overall fitness
d. Assess the eye-hand coordination of the athlete

A

d. Assess the eye-hand coordination of the athlete

215
Q

A patient informs the physical therapist that he self-medicates with over the counter (OTC) drugs and has been so for some time and it seems to be doing well. The physical therapist should inform the patient that

a. This is okay since OTC drugs contain such low drug concentrations they do not cause serious adverse reactions
b. OTC drugs should not be used for more than 2 weeks without a physician’s consent
c. OTC drug use does not have to be mentioned to a physician since they are not prescription drugs
d. This is a waste of money since OTC drugs have been found to be generally ineffective

A

b. OTC drugs should not be used for more than 2 weeks without a physician’s consent

216
Q

Which of the following are common signs and symptoms seen by a patient using OTC diphenhydramine?

a. Poor coordination and fatigue
b. Increased blood pressure and irregular heart beat
c. Excessive sweating and cold extremities
d. Weight gain and ankle edema

A

a. Poor coordination and fatigue

217
Q

A patient asks if they can use OTC niacin to lower high cholesterol and lipid levels since this has been recommended by friends. How should the physical therapist answer?

a. Yes, it is okay if the friends feel fine
b. No, because niacin is not effective in lowering cholesterol and lipid levels
c. Yes, a try can do no harm since it is offered OTC
d. No, because the use of niacin requires periodic lab tests to check liver functions

A

d. No, because the use of niacin requires periodic lab tests to check liver functions

218
Q

A patient using diuretics during strenuous exercise might experience all of the following except

Easy bruising
Dehydration
Muscle cramping
Dyspnea

A

Easy bruising

219
Q

A patient on cancer chemotherapeutic drugs might experience all of the following adverse reactions except

Easy bruising and bleeding
Fatigue and anemia
Constipation with fecal impact
Jaundice and hepatotoxicity

A

Constipation with fecal impact

220
Q

A patient on long-term corticosteroids during therapy might show all of the following except

Depressed mood
Orthostatic hypotension
Anemia
Muscle loss

A

Orthostatic hypotension

220
Q

A patient on cancer chemotherapy must be careful not to use other drugs including OTC drugs. In particular, you must warn the patient not to use

NSAIDs
Psyllium
Hypnotics
Anxiolytics

A

NSAIDs

221
Q

A geriatric patient using OTC cimetidine might experience all of the following except

Confusion
Orthostatic hypotension
Dizziness
Sedation

A

Orthostatic hypotension

221
Q

An individual consumes one glass of wine (100 mL, 10% alcohol). Most of the alcohol has been metabolized and eliminated after about

15 min
1 hr
2 hr
4 hr

A

1 hr

222
Q

A patient is on long-term NSAIDs therapy. These drugs reduce inflammatory processes by

a. Inhibiting the enzyme lipoxygenase
b. Reducing the formation of prostaglandins
c. Inhibiting formation of inflammatory white blood cells
d. Stimulating the enzymes COX I and II

A

b. Reducing the formation of prostaglandins

223
Q

A patient with severe sleep problems and using sedative/hypnotic drugs should

a. Preferably be seen in the morning
b. Preferably be seen in the afternoon
c. Be advised not to take the medication 2 days before therapy
d. Be advised that the addition of St. John’s wort might help the medications

A

b. Preferably be seen in the afternoon

224
Q

The patient has a dysfunction of the tenth rib; however, he complains of nausea and fullness. This is an example of

a. Viscero-viscero reflex
b. Viscero-somatic reflex
c. Somatic-viscero reflex
d. Somatic-somatic reflex

A

c. Somatic-viscero reflex

225
Q

Knowledge of pharmacology is important to differential diagnosis because

a. Management of the physical therapy patient cannot be enhanced by medications
b. Medication side effects can contribute to the signs and symptoms that patients present with
c. Physical therapists may need to alter the patient’s medications to improve disease control
d. Medications do not provide any additional risk to patient health status

A

b. Medication side effects can contribute to the signs and symptoms that patients present with

226
Q

A patient cannot find his dentures when they are on his crowded bedside table. His visual acuity tests at 20/20 with the Snellen eye chart. The physical therapist suspects problems with

Figure ground discrimination
Body-y scheme awareness
Agraphia
Vertical orientation

A

Figure ground discrimination

226
Q

You will be performing an examination on a patient diagnosed with Down’s syndrome. Which are the correct phenotypic features in Down’s syndrome?

a. Leukemia, hypotonia, joint hypomobility
b. Developmental delay, simian crease, hypertonia
c. Large cerebellum and brainstem, atlantoaxial instability, leukemia
d. Developmental delay, leukemia, atlantoaxial instability

A

d. Developmental delay, leukemia, atlantoaxial instability

227
Q

A patient who is 3 months pregnant asks for advice on activities. Which of the activities would you recommend?

Rock climbing
Soccer
Nothing, she’s pregnant
Hiking

A

Hiking

228
Q

Which is not a reason for the common postural changes seen during pregnancy?

Ligament laxity
Posterior shift in COG
Increase breast size
Enlarging uterus

A

Posterior shift in COG

229
Q

In a patient who has a uterine or bladder prolapse, which of the following findings do you expect?

a. Decreased pelvic floor tone and strength, elongated pelvic floor muscles
b. Increased pelvic floor tone and good pelvic floor strength
c. Decreased pelvic floor tone and good pelvic floor strength
d. Increased pelvic floor tone and poor pelvic floor strength

A

a. Decreased pelvic floor tone and strength, elongated pelvic floor muscles

229
Q

Which of the following comprise the diagnostic criteria for “female athlete triad” syndrome?

a. Dieting, dizziness, and weakness
b. Drop in blood pressure, fatigue, and disordered eating
c. Stress fracture, fatigue, cold hands and feet
d. Disordered eating, osteoporosis, amenorrhea

A

d. Disordered eating, osteoporosis, amenorrhea

230
Q

Which of the following will not be compressed with an enlarged uterus (pregnancy)?

Bladder
Vulvar veins
Breasts
Inferior vena cava

A

Breasts

231
Q

Which of the following is not a strong predictor of persistent low back pain after pregnancy?

Low BMI
High BMI
Early onset of pain during pregnancy
Hypermobility of the spine

A

Low BMI

232
Q

Which of the following antibiotics is classified as a beta-lactam?

Penicillin
Levofloxacin
Azithromycin
Tetracycline

A

Penicillin

233
Q

An athlete is being treated for sinusitis with Augmentin (amoxicillin; clavulanic acid). He mentions that he is allergic to penicillin. He’s been taking Augmentin for 2 days now, but his symptoms are not improving, and he’s starting to get red, itchy rashes on other parts of his body. What do you tell him?

a. Even though he’s allergic to penicillin, he should not be allergic to Augmentin ad he should keep taking it
b. Sinusitis is usually a viral infection, so the Augmentin should work and should keep taking it
c. He is probably developing an allergic reaction to Augmentin and should stop taking it and call his doctor
d. He is experiencing a normal side effect of the medication

A

c. He is probably developing an allergic reaction to Augmentin and should stop taking it and call his doctor

233
Q

Nasal decongestants used in the treatment of colds and allergies

a. Bind to alpha-1 receptors to cause vasoconstriction
b. Include pseudoephedrine, which is administered a a nasal spray
c. Cause adverse effects such as drowsiness, lethargy, and dry mouth
d. Can cause rebound congestion when taken orally

A

a. Bind to alpha-1 receptors to cause vasoconstriction

234
Q

Excretion (or elimination) of a drug

a. Is a removal of the rug from the body
b. Occurs only via the kidney
c. Is how the body breaks down medications
d. Begins only after a toxic amount has accumulated in the body

A

a. Is a removal of the rug from the body

235
Q

Which drug works by competitively inhibiting the enzyme HMG-CoA reductase to reduce cholesterol levels?

Gemfibrozil (Lopid)
Niacin (vitamin B12)
Atorvastatin (Lipitor)
Ezetimide (Zetia)

A

Atorvastatin (Lipitor)

236
Q

Excessive femoral anteversion in children may result in all of the following except

a. Toeing in during gait
b. Increased hip internal rotation range of motion
c. Increased hip external rotation range of motion
d. Decreased hip external rotation range of motion

A

c. Increased hip external rotation range of motion

236
Q

Your patient has a lesion of the left superior gluteal nerve. When your patient is in left unilateral stance, you may observe the

a. Right ASIS is higher than the left ASIS
b. Right ASIS is anterior to the left ASIS
c. Trunk side bending to the left
d. Lumbar spine is side bent to the right

A

c. Trunk side bending to the left

237
Q

Standing on the left leg and flexing your right hip up requires you to use all the following muscle except the

Right lumbar rotators
Left gluteus minimus
Right quadratus lumborum
Left gluteus medius

A

Right lumbar rotators

238
Q

A smaller than normal angle of inclination at the hip is called

Anteversion
Retroversion
Coxa vara
Coxa valga

A

Coxa vara

238
Q

Hip extension may be limited by all of the following tissues except

Iliofemoral ligament
Iliopsoas muscle
Ischiofemoral ligament
Gluteus minimus posterior fibers

A

Gluteus minimus posterior fibers

239
Q

An angle of 170 degrees to 175 degrees in front of the frontal plane taken on the lateral side of the knee is considered

Excess genu valgum
Excess genu varum
Normal
Coxa vara

A

Normal

240
Q

The pes anserine insertion is palpable at the ____, and includes the tendons of the ____.

a. Medial tibia; semimembranosus, semitendinosus, and gracilis
b. Lateral tibia; biceps femoris, semitendinosus, and iliotibial band
c. Medial tibia; sartorius, gracilis, and semitendinosus
d. Medial femur; biceps femoris, semitendinosus, and iliotibial band

A

c. Medial tibia; sartorius, gracilis, and semitendinosus

241
Q

As the knee extends and the patella moves superiorly in the trochlear groove, the sulcus angle (increases/decreases), making the patellofemoral joint (more/less) stable.

A

As the knee extends and the patella moves superiorly in the trochlear groove, the sulcus angle INCREASES, making the patellofemoral joint LESS stable.

242
Q

Anterior glenohumeral dislocations are often accompanied by

A stretched subscapularis
A Hill-Sachs lesion
A fracture of the greater tubercle
Rotator cuff full-thickness tears

A

A Hill-Sachs lesion

242
Q

A drug has 60 bioavailability when given orally at the recommended dosage. What does this mean?

a. 60 of the dose is excreted
b. 60 of the drug is available and active in the bloodstream
c. 40 will be bound to plasma proteins and active in the serum
d. 40 of the drug is available and active in the bloodstream

A

b. 60 of the drug is available and active in the bloodstream

242
Q

The glenoid faces somewhat

a. Lateral-inferior-posteriorly
b. Lateral-superior-anteriorly
c. Medial-superior-anteriorly
d. Medial-inferior-posteriorly

A

b. Lateral-superior-anteriorly

243
Q

Two drugs, an agonist and a competitive antagonist, are given to a patient. The agonist drug exists at four times the serum concentration of the antagonist. Assuming no other variables are present, what will be the resulting drug effect?

No effect
Increased agonist effect
Agonist effect
Antagonist effect

A

Agonist effect

243
Q

During normal scapulohumeral rhythm, the

a. Scapula upwardly rotates 60 degrees and the humeral abducts 120 degrees
b. Scapula upwardly rotates 2 degrees for every 1 degree of humeral abduction
c. Scapula abducts 60 degrees and upwardly rotates 120 degrees
d. Scapula upwardly rotates 120 degrees and the humeral abducts 60 degrees

A

a. Scapula upwardly rotates 60 degrees and the humeral abducts 120 degrees

244
Q

Which of the following is false regarding biomechanics of persons with patellofemoral pain?

a. Weakness of the hip abductors, external rotators, and extensors is frequently present
b. Excessive hp internal rotation and/or hip adduction is frequently present
c. Patella alta increases patellar instability
d. Increased trochlear groove depth increases patellar instability

A

d. Increased trochlear groove depth increases patellar instability

244
Q

The half-life of diazepam (valium) is approximately 12 hours. If a 70-kg patient took 10 mg at 8AM, what amount of drug would be present in his body the next day at 8AM during his scheduled appointment with you?

5 mg
2.5 mg
1.25 mg
0.625 mg

A

2.5 mg

244
Q

Aspirin, an acetylsalicylic acid, inhibits platelet aggregation like all NSAIDs, but is the drug of choice for thromboprophylaxis because

a. It has predictable irreversible mechanism of action
b. It has predictable reversible mechanism of action
c. It has a longer half-life than other NSAID agents
d. It has no COX II effect

A

a. It has predictable irreversible mechanism of action

245
Q

In first-order kinetics

a. A constant percentage of the drug is lost/metabolized per unit time
b. A variable percentage of the drug is metabolized per unit time
c. A constant amount (m) is metabolized per unit time
d. A constant first-pass effect is produced

A

a. A constant percentage of the drug is lost/metabolized per unit time

246
Q

Medications within the benzodiazepine class of drugs have multiple indications and uses for physical therapy patients. Which of the following is not an indication for use of benzodiazepines?

Alcohol withdrawal
Relief on anxiety
Sleep aid
Analgesia

A

Analgesia

247
Q

Which of the following benzodiazepine medications is properly indicated for relief of anxiety?

Xanax
Valium
Dalmane
Klonopin

A

Xanax

248
Q

Angiotensin-converting enzyme (ACE) inhibitors are prone to producing a common, irritating side effect that may necessitate change to another drug agent. What is that side effect?

Dry hacking cough
Peripheral edema
Visual color alteration of blue and green
Atrial fibrillation

A

Dry hacking cough

249
Q

Which of the following benzodiazepines is contraindicated in the elderly because of an extremely long half-life?

Alprazolam
Lorazepam
Temazepam
Flurazepam

A

Flurazepam

250
Q

Skeletal muscle relaxant agents fall into two main categories. Which of the following choices are those categories?

Beta-1 and beta-2
COX-1 and COX-2
Prostaglandin and prostacyclin agonists
Centrally and peripherally acting

A

Centrally and peripherally acting

251
Q

Which of the following benzodiazepine medications is most properly indicated for outpatient-based treatment of convulsive disorders?

Xanax
Valium
Dalmane
Klonopin

A

Klonopin

252
Q

A key side effect of Flexeril, Soma, Robaxin, and Norflex and other centrally acting skeletal muscle relaxants of note to therapists is

Sedation
Drug-induced spasticity in spinal cord patients
Paralysis
Rhabdomyolysis

A

Sedation

253
Q

A Tylenol with codeine #3 table (TC3) contains how much codeine?

60 mg
30 mg
15 mg
7.5 mg

A

30 mg

253
Q

In what way is Flexeril (cyclobenzaprine) somewhat unique among muscle relaxants that affect the central nervous system?

a. Flexeril has more peripheral effect
b. Flexeril shapes pharmacologic characteristics with the tricyclic antidepressant drugs
c. Flexeril is a GABA-agonist similar to barbiturates
d. Flexeril acts at the acetylcholine (Ach) receptors, producing neuromuscular blockade

A

b. Flexeril shapes pharmacologic characteristics with the tricyclic antidepressant drugs

254
Q

Opium, derived from the poppy flower, contains two natural main opiates. What are they?

Codeine and demerol
Heroin and codeine
Hydrocodone and hydrocodone
Codeine and morphine

A

Codeine and morphine

254
Q

The primary side effect, common among almost all oral hypoglycemic agents, of particular note during active physical therapy is

Hypoglycemia
CNS depression
Nephrolithiasis
Increased deep tendon reflex

A

Hypoglycemia

254
Q

Side effects of note among patients taking Baclofen include

Drowsiness and memory impairment
Weight gain
Weight loss
Beta-1 suppression of maximum heart rate

A

Drowsiness and memory impairment

255
Q

Talwin and Stadol are examples of which opiate analgesic class?

Antagonist
Agonist-Antagonist
Competitive Agonist
Agonist

A

Agonist-Antagonist

255
Q

Which of the paired drug interactions between an opiate and second drug agent is incorrect?

a. Alcohol-increased respiratory depression
b. Tricyclic antidepressants-increased constipation
c. Cigarette smoking-decreased opiate analgesic effect
d. Diuretic agents-hypertensive crisis

A

d. Diuretic agents-hypertensive crisis

256
Q

Which of the following is the only skeletal muscle relaxant that acts on the peripheral nervous system?

Diazepam (Valium)
Baclofen (Lioresol)
Orphenadrine (Norgesic)
Dantrolene (Dantrium)

A

Dantrolene (Dantrium)

257
Q

Demerol (Meperidine) is combined with Vistaril (hydroxyzine HCl, an antihistamine), producing an enhanced analgesic effect of demerol. This allows increased dosage and potential deleterious effects. This is an example of what drug interaction?

Additive
Reversible antagonism
Potentiation
Antagonism

A

Potentiation

258
Q

COX-II specific agents are not indicated only for patients with

a. History of GI or renal disorders
b. Patients with hypersensitivity to aspirin
c. Patients in need of postoperative thromboprophylaxis
d. Patients hypersensitive to acetaminophen

A

a. History of GI or renal disorders

259
Q

The chief difference between acetaminophen and the NSAIDs is that acetaminophen has no __ or __ effect.

a. Analgesic; antithrombotic
b. Antipyretic; antithrombotic
c. Anti-inflammatory; antithrombotic
d. Antipyretic; anti-inflammatory

A

c. Anti-inflammatory; antithrombotic

260
Q

Your patient is unlikely to be compliant with a short half-life NSAID, so you select a long-acting agent. Which of these NSAID agents has the longest half-life?

Aspirin
Feldene
Naproxyn
Daypro

A

Daypro

260
Q

An example of the most common first-line diuretic used in the treatment of hypertension would be

Hydrochlorothiazide
Lasix
Spironolactone
ACTH

A

Hydrochlorothiazide

260
Q

Your 31-year-old male patient presents with his third episode of extreme pain at the first MTP joint on the right foot. Clinical examination and laboratory results indicate gouty arthritis as the diagnosis. Which drug is least appropriate for acute care?

Colchicines
Indomethacin
Probenecid
Ibuprofen

A

Probenecid

261
Q

Side effects of physical therapy concern with use of angiotensin-converting enzyme (ACE) inhibitor agents include all of the following except

Headache
Dizziness
Postural hypotension
Potassium depletion

A

Potassium depletion

262
Q

Furosemide, 40 mg twice a day, is prescribed for your congestive heart failure (CHF) patient who is also taking Lanoxin. What is your chief monitoring concern?

Hypervolemia
Hypokalemia
Hypercalcemia
Hyperkalemia

A

Hypokalemia

263
Q

Of what significance is the Edinger-Westphal response to you in monitoring your patient prescribed an opiate analgesic?

a. The Edinger-Westphal response suggests opiate overdose
b. The Edinger-Westphal response suggests opiate antagonist effect
c. The Edinger-Westphal response correlates with concurrent Dantrium
d. The Edinger-Westphal response indicates the patient is receiving insufficient dosage for analgesic effect of the opiates

A

a. The Edinger-Westphal response suggests opiate overdose

264
Q

The angiotensin-receptor blockers (ARB agents) act by what mechanism of action?

a. Antagonize Na+ ion receptors
b. Angiotensin-receptor antagonism
c. Angiotensin-converting enzyme antagonism
d. Dilation of vascular smooth muscle

A

b. Angiotensin-receptor antagonism

265
Q

The main advantage of aldactone over thiazide is that aldactone is/causes

Potassium sparing
Less hypotension
Less hypertension
Receptor site specificity of alpha-1 receptors

A

Potassium sparing

266
Q

The biguanide group of oral hypoglycemic agents includes metformin. Metformin has what characteristic of note to physical therapists?

No hypoglycemic effect
Interferes with carbohydrate absorption
Delays carbohydrate absorption
Will not cause nausea

A

No hypoglycemic effect

267
Q

What is true of thiazolidinediones?

a. Thiazolidinediones will not cause hypoglycemia
b. Thiazolidinediones’ effect is independent of insulin production
c. Thiazolidinediones decrease insulin receptor activity
d. Thiazolidinediones decrease lipids

A

c. Thiazolidinediones decrease insulin receptor activity

268
Q

Side effects of progestin include all of the following except

Weight gain
Edema
Manic episodes
Possible mild androgenic effects

A

Possible mild androgenic effects

269
Q

What side effect is shared by all benzodiazepines?

Muscle weakness
Hypertension
Sedation
Cross-sensitivity with penicillin-derived antibiotics

A

Sedation

270
Q

The NSIADs impede COX-2 activity. COX-2 produces inflammatory prostaglandins via biosynthesis of what substance?

Serotonin
Substance P
Arachidonic acid
Gamma butyric acid

A

Arachidonic acid