Flashcards in GILES AND SAUNDER Deck (81):
POST CORD INJURY WHAT IS NOT AFFECTED
3. latissimus dorsi
4. teres major
Improperly positioned bedrail has partially occluded the tubing of an IV line. The therapist’s most immediate response should be to _____?
1. contact nursing
2. contact the referring physician
3. reposition the bedrail
4. document the incident
A physical therapist designs
REPOSITION THE BEDRAIL
Client without cardiovascular pathology. The therapist calculates the client’s age predicted maximal heart rate as 175 beats per minute. Which of the following would be an acceptable target heart rate for the client during cardiovascular exercise?
1. 93 beats per minute
2. 122 beats per minute
3. 169 beats per minute
4. 195 beats per minute
122 BEATS PER MINUTE
175 x .70 = 122
1. While preparing a sterile field for wound debridement, a therapist accidentally places a nonsterile object on the sterile base. The most appropriate action is to _____?
1. remove the nonsterile object from the sterile base and continue with treatment
2. continue with treatment; however, be sure no other supplies come in contact with the nonsterile object
3. remove all of the items to be used from the sterile base and replace them with similar items that are sterile
4. discard the entire sterile field and establish a new sterile field
Discard the entire sterile field and establish a new sterile field
A client rehabilitating from a fractured right humerus is examined in physical therapy. The therapist determines goniometrically that the client can actively flex his right shoulder to 173 degrees. Which of the following entries would be the most appropriate to illustrate the therapist’s findings
1. right shoulder flexion range of motion 0-173 degrees
2. right shoulder range of motion is within normal limits
3. right shoulder flexion active range of motion to 173 degrees
4. right shoulder active range of motion to 173 degrees
right shoulder flexion active range of motion to 173 degree
A therapist works with a client placed in isolation. The therapist is required to wear a mask while treating the client, but is not required to wear gloves or a gown. This type of isolation could be termed ____?
1. strict isolation
2. contact isolation
3. respiratory isolation
4. blood/body fluid precautions
A 13ear-old female diagnosed with cerebral palsy is referred to physical therapy. The client exhibits slow, involuntary, continuous writhing movements of the upper and lower extremities. This type of motor disturbance best describes ____?
The Occupational Safety and Health Administration establishes regulations for health care facilities, which are designed to protect their employees. Which of the following regulations is not accurate?
1. Provide proper containers for the disposal of waste and sharp items.
2. Educate employees on the methods of transmission and the prevention of hepatitis B and HIV.
3. Require all employees to receive the hepatitis B vaccine.
4. Provide education and follow up care to employees who are exposed to communicable diseases.
3 - HEPA B VACCINE IS NOT REQUIRED
A client status post total hip replacement is referred to physical therapy for gait training. The client has not been weightbearing on the involved lower extremity since surgery and appears to be somewhat anxious. The most appropriate setting to begin ambulation activities is _____?
1. in the parallel bars
2. in the parallel bars with a rolling walker
3. in the physical therapy gym with a straight cane
4. in the physical therapy gym with a walker
A client involved in a motor vehicle accident sustains a Colles’ fracture and an intertrochanteric hip fracture. The client has been cleared for touch down weight bearing by her physician. Which assistive device would be the most appropriate for the client?
1. straight cane
2. axillary crutches
3. rolling walker
4. walker with a platform attachment
4. WALKER WITH PLATFORM ATTACHMENT
A therapist instructs a 55 year-old trauma victim with bilateral lower extremity paralysis to transfer from a wheelchair to a mat table. The client has normal upper extremity strength and has no other known medical problems. The most appropriate transfer technique is a ______?
1. dependent standing pivot
2. sliding board transfer
3. two person carry
4. hydraulic lift
sliding board transfer
A client with a confirmed posterior cruciate ligament tear is able to return to full dynamic activities following rehabilitation. Which of the following does not serve as a secondary restraint to the posterior cruciate ligament?
1. iliotibial band
3. lateral collateral ligament
4. medial collateral ligament
ITB - 2 restraint to ACL
A nine month old infant with cerebral palsy is unable to roll from prone to supine. This developmental activity typically occurs by _____?
1. 3 months
2. 5 months
3. 7 months
4. 9 months
A physical therapist working in a school system develops long term goals as part of an Individualized Educational Plan for a child with Down’s Syndrome. The most appropriate time frame for these goals is____?
1. one month
2. four months
3. six months
4. one year
A physical therapist administers ultrasound over a client’s anterior thigh. After one minute of treatment, the client reports feeling a slight burning sensation under the sound head. The therapist’s most appropriate action is to ___?
1. explain to the client that what she feels is not out of the ordinary when using ultrasound
2. temporarily discontinue treatment and examine the amount of coupling
3. discontinue treatment and contact the referring physician
4. continue with treatment utilizing the current parameters.
3. D/C AND EXAMINE AMT OF COUPLING
PD for a client positioned on a treatment table in prone with two pillows under her hips.
1. anterior basal segment of the lower lobes
2. lateral basal segment of the lower lobes
3. right middle lobe
superior segment of the lower lobes
4. superior segment of lower lobes
SUPERIOR SEGMENT OF LOWER LOBES
1. What event usually signifies the completion of a phase II program?
2. initiation of a high level aerobic exercise program
3. low level treadmill test
4. maximal treadmill test
maximal treadmill test
A client being treated in an outpatient orthopedic clinic begins to demonstrate signs and symptoms of stroke, including sudden weakness of the arm and leg, unexplained dizziness, and loss of vision. Recognizing the symptoms of a stroke the therapist begins to administer first aid. Which of the following would not be considered appropriate first aid management?
1. monitor the airway, breathing, and circulation
2. remove mucus from the mouth with a piece of cloth wrapped around a finger
3. position the client in supine and slightly elevate the legs.
4. immediately contact medical assistance
POSITION THE CLIENT IN SUPINE AND SLIGHTLY ELEVATE THE LEGS
Where is the major site for drug excretion?
1. gastrointestinal tract
Which physical property of water allows the client to move with greater ease?
2. specific gravity
3. specific heat
4. thermal conductivity
Which modality would have the greatest ability to elevate the temperature of fatty tissue to potentially dangerous levels?
2. hot packs
4. pulsed ultrasound
A therapist discusses the importance of proper nutrition with a client diagnosed with congestive heart failure. Which of the following substances would be most restricted in this client’s diet?
Which stage of bone healing is associated with the termination of external fixation?
1. hematoma formation
2. cellular proliferation
3. callus formation
4. clinical union
A client diagnosed with piriformis syndrome is referred to physical therapy for one visit for instruction in a home exercise program. After examining the client, the therapist feels the client’s rehabilitation potential is excellent, but is concerned that one visit will not be sufficient to meet the client’s needs. The most appropriate action is to ___?
1. schedule the client for treatment sessions, as warranted, based on the results of the initial examination
2. explain to the client that recent health care reforms have drastically reduced the frequency of physical therapy visits covered by third party payers
3. explain to the client that she can continue with physical therapy beyond the initial session, but will be liable for all expenses not covered by her insurance
4. contact the referring physician and request approval for additional physical therapy visits
CONTACT REFERRING PHYSICIAN FOR ADDITIONAL VISITS
A male client with limited shoulder range of motion explains that he has difficulty wiping himself after going to the bathroom. How much shoulder range of motion is required to successfully complete toileting activities?
1. 50 degrees horizontal abduction, 30 degrees abduction, 45 degrees medial rotation
2. 30 degrees horizontal abduction, 45 degrees adduction, 65 degrees medial rotation
3. 80 degrees horizontal abduction, 40 degrees abduction, 90 degrees medial rotation
4. 90 degrees horizontal adduction, 75 degrees abduction, 60 degrees medial rotation
80 DEGREES H ABD
40 DEG ABD
AND 90 DEG IR
A therapist completes lower extremity range of motion activities with a spinal cord injured client. While ranging the client, the therapist notices that the client’s urine is extremely dark and has a distinctive foul smelling odor. Which of the following is the most appropriate action?
1. verbally report the observation to the client’s physician
2. verbally report the observation to the client’s nurse
3. document and verbally report the observation to the client’s nurse
4. document and verbally report the observation to the director of rehabilitation
document and verbally report the observation to the client's nurse
An eight year-old female with a 25 degree scoliotic curve is fitted for a Milwaukee brace. The brace will likely be worn until ___?
1. the scoliotic curve does not increased within one year period
2. the client resumes all recreational and athletic activities
3. the client is pain free for six months
4. spinal growth ceases
Worn until spinal growth ceases
A physical therapist uses a S.O.A.P. formal for all his daily documentation. Which of the following would not be found in the assessment section of a S.O.A.P. note?
1. short and long term goals
2. discussion of a client’s progress in therapy
3. client’s equipment needs and equipment ordered
4. client’s rehabilitation potential
Client's equipment needs because it is seen in the plan
A rehabilitation manager designs a system to monitor the productivity of staff therapists. Which piece of data would be the least beneficial to accomplish the manager’s objective?
1. number of generated timed treatment units
2. results of client satisfaction survey data
3. total hours of direct client treatment time
4. number of regular payroll hours
RESULTS OF CLIENT SATISFACTION SURVEY DATA , quality is not used to measure productivity
A client with chronic shoulder instability is scheduled to have an open Bankart procedure. As part of the surgery, the subscapularis is removed and ten reattached to the anterior capsule. In order to protect the subscapularis postoperatively, which of the following shoulder motions initially should be most limited?
3. internal rotation
4. external rotation
A client is scheduled to undergo a transtibial amputation secondary to poor healing of an ulcer on his left foot. In addition, the client is two months status post right knee replacement due to osteoarthritis. Given the client’s past and current medical history, the physical therapist can expect which of the following tasks to be the most difficult for the client following his amputation?
1. rolling from supine to sidelying
2. moving from sitting to supine
3. moving from sitting to standing
4. ambulating in the parallel bars
MOVING FROM SITTING TO STANDING
A physical therapist conducts goniometric measurements on a client in supine. When measuring elbow flexion the therapist’s stabilizing force should be directed at the ____?
1. radioulnar joint
3. distal humerus
4. proximal humerus
A client who underwent a transtibial amputation one week ago complains of phantom sensation. Which of the following treatment options would be inappropriate?
1. tell the client to leave the residual limb exposed to the air at all times
2. discuss the option of a temporary prosthesis with the client’s physician
3. begin residual limb wrapping
4. teach the client to tap and massage the residual limb
TELL THE Pt. to LEAVE THE RESIDUAL LIMB EXPOSED TO THE AT ALL TIMES - would cause increased edema and misshapened residual limb
A therapist transports a client with multiple sclerosis to the gym for her treatment session. The client is wheelchair dependent and uses a urinary catheter. When transporting the client, the most appropriate location to secure the collection bag is_____?
1. in the client’s lap
2. on the lower abdomen
3. on the wheelchair armrest
4. on the wheelchair leg rest
ON THE W/C LEG REST
A physical therapist examines a client with multiple sclerosis. The client has poor to fair strength in her legs, good arm strength, and moderate truncal ataxia. The safest means for the client to ambulate in her home would be ___? this technique?
1. with a single point cane
2. with a walker
3. while holding onto furniture or walls
4. with axillary crutches
A therapist attempts to improve neck and upper back extension in an infant with developmental delay. When passively placed in prone prop, the infant quickly falls into the prone position. The therapist plans to position the child and then use toys and play objects to get the child to look up. Which position would be the most appropriate to meet the therapist’s treatment objective?
1. prone prop
2. prone over a gymnastic ball
3. prone over a wedge
prone over a wedge
A male therapist is treating a 16 year-old female for a low back strain. During the treatment session the client makes several sexually suggestive remarks. The therapist ignores the remarks, but the client reiterates them during the next treatment session. The most appropriate therapist action is to___?
1. continue to ignore the client’s remarks
2. explain to the client that her remarks are offensive
3. document the client’s behavior in the medical record
4. transfer the client to another therapist’s schedule
EXPLAIN TO THE CLIENT THAT HER REMARKS ARE OFFENSIVE
A physical therapist develops a series of long and short term goals for a client. Which of the following is not a necessary component of a properly written goal?
priority (AUDIENCE, DEGREE, BEHAVIOR AND CONDITION)
1. A physical therapist consults with an orthotist regarding the need for an ankle-foot orthosis for a stroke client. The client has difficulty moving from sitting to standing when wearing a prefabricated ankle-foot orthosis. The therapist indicates the client has poor strength at the ankle, intact sensation and does not have any edema or tonal influence. The most appropriate type of ankle-foot orthosis for the client would incorporate___?
1. an articulation at the ankle joint
2. tone reducing features
3. metal uprights
4. dorsiflexion assist spring
AN ARTICULATION AT THE ANKLE JOINT
A physical therapist establishes safe exercise intensity parameters for a phase I inpatient cardiac rehabilitation program. Which parameter would be the most appropriate for the phase I program?
1. a maximum heart rate increase of 20 beats per minute above resting
2. a maximum heart rate increase of 30 beats per minute above resting
3. a maximum heart rate increase of 40 beats per minute above resting
a maximum heart rate increase of 50 beats per minute above resting
A MAXIMUM HEART RATE INCREASE OF 20 BEATS
Premature ventricular contractions are the most commonly observed form of arrhythmias. Which of the following does not assist in precipitating PVCs?
1. Which of the following could result from a wheelchair with excessive seat depth?
1. decreased trunk stability
2. increased weightbearing on the ischial tuberosities
3. decreased balance
4. increased pressure in the popliteal area
INCREASED PRESSURE IN THE POPLITEAL AREA
A therapist assesses the functional strength of a client’s hip extensors while observing a client move from standing to sitting. What type of contraction occurs in the hip extensors during this activity?
Quality assurance program that examines the extent to which physical therapists conform to accepted professional practices. This type of quality assurance program is most concerned with ___?
The therapist documents the following clinical signs: pallor, cyanosis, and skin coolness. These clinical signs are most consistent with ___?
1. cor pulmonale
A pregnant client in her third trimester completes a series of exercises in supine. In order to prevent vena cava compression during the exercise session the therapist should ____?
1. place a folded towel under the right side of the client’s pelvis
2. place a folded towel under the left side of the client’s pelvis
3. complete the exercises in sidelying
4. elevate the client’s feet 12 inches
PLACE A TOWEL UNDER THE RIGHT SIDE OF THE CLIENT'S PELVIS
A physical therapist instructs the parents of a premature infant on proper positioning. The physical therapist should educate the parents to avoid ___ when placing their infant in supine?
1. lower extremity extension
2. slight neck flexion
3. hands towards midline
4. scapular protraction
A 45 year-old female with psoriasis is referred to physical therapy. The client has several lesions on the posterior portion of the thigh extending into the popliteal fossa. The most appropriate therapeutic modality to treat the client’s condition is ____?
2. moist heat
Which of the following terms is commonly used to express current?
A therapist instructs a client in breathing exercises to improve ventilation and oxygenation. The therapist’s treatment objective emphasizes the expansion of a selected area of the chest wall during inspiration. The most appropriate breathing exercise to achieve the desired outcome is ___?
1. deep breathing
2. diaphragmatic breathing
3. segmental breathing
4. abdominal breathing
A graded exercise test is performed on a client with pulmonary disease. During the test the therapist identifies that the client’s systolic blood pressure has decreased by 20 mmHg. The most appropriate action is to ____?
1. continue the graded exercise test
2. discontinue the graded exercise test
3. assess the client’s respiration rate
4. assess the client’s forced expiratory volume in one second
DISCONTINUE GRADED EXERCISE TEST
A 16 year old complete C5 spinal cord injured client is two weeks status post injury. The client presently tolerates only 30 degrees on the tilt table secondary to orthostatic hypotension. Which transfer would be the most appropriate to utilize when moving the client from bed to the tilt table?
1. hydraulic lift
2. sliding transfer with draw sheet
3. two person lift
4. dependent standing pivot transfer
SLIDING TRANSFER WITH DRAW SHEET
It is essential to maintain a sterile field once it has been established. Which of the following activities would not be in violation of a sterile field?
1. sneezing while standing in front of a sterile field
2. reaching across a sterile field
3. turning your back to the field
4. allowing a sterile object to touch another sterile object
ALLOWING A STERILE OBJECT TO TOUCH ANOTHER STERILE OBJECT
Residual limb wrapping is often a necessary component of a treatment program following lower extremity amputation. Which of the following is not characteristic of a properly applied bandage?
1. smooth and wrinkle free
2. emphasizes angular turns
3. provides pressure distally
4. encourages proximal joint flexion
ENCOURAGING PROXIMAL JT FLEXION CAN ENCOURAGE JT CONTRACTURES
A client rehabilitating from a radial head fracture is examined in physical therapy. During the examination, the therapist notes that the client appears to have an elbow flexion contracture. Which of the following would not act as an appropriate active exercise technique to increase range of motion?
3. maintained pressure
4. rhythmic stabilization
MAINTAINED PRESSURE (PASSIVE KASI)
1. Standard postural drainage positions for specific lung segments utilize a variety of client positions, including sitting, sidelying, supine, and prone. Postural drainage of the ___ typically is administered with the client in sitting?
1. anterior basal segments of the lower lobes
2. posterior segments of the upper lobes
3. posterior basal segments of the lower lobes
4. right middle lobe
POSTERIOR SEGMENT OF THE UPPER LOBE
1. A client recently admitted to the hospital with an acute illness is referred to physical therapy. During a scheduled treatment session the client asks what effect anemia will have on his ability to complete a formal exercise program. The most appropriate therapist response is?
1. you may feel as though your muscles are weak
2. you may experience frequent nausea
3. your aerobic capacity may be reduced
4. you may have a tendency to become fatigued
YOU MAY HAVE A TENDENCY TO BECOME FATIGUED
A client rehabilitating from injuries sustained in a motor vehicle accident is referred to physical therapy for gait training with an appropriate assistive device. The therapist attempts to instruct the client using axillary crutches, but feels the assistive device does not offer the client enough stability or support. Which of the following assistive devices would be the most appropriate for the client?
3. Lofstrand crutches
4. parallel bars
A therapist attempts to develop a problem list after examining a client with a transtibial amputation. Which of the following would be the most appropriate entry in the client problem list?
1. donning and doffing prosthesis required verbal cues
2. donning and doffing prosthesis requires verbal cues and minimal assist of 1
3. dependence with donning and doffing prosthesis
dependence when donning and doffing the prosthesis
The director of rehabilitation in an orthopedic private practice prepares a list of interview questions for applicants applying for a vacant position. Which of the following would be an acceptable interview question?
1. Are you in good health?
2. How much weight can you lift?
3. Have you held a position like this in the past?
Have you ever filed a workers’ compensation claim
HAVE YOU HELD A POSITION LIKE THIS IN THE PAST?
A 42 year-old female who is unable to satisfactorily control the retention and release of urine uses a catheter. Which type of urinary catheter would not be appropriate for the client?
1. indwelling urinary catheter
2. external urinary catheter
3. Foley catheter
4. suprapubic catheter
external urinary catheter (for penis)
A client ambulating with an IV in place should be instructed to grasp the IV pole at what level?
1. a level where the infusion site is above heart level
2. a level where the infusion site at heart level
3. a level where the infusion site is below heart level
4. a client with an IV in place should not participate in ambulation activities
A therapist monitors a 6 foot 3 inch
at heart level
A therapist monitors a 6 foot 3 inch, 275 pound, male’s blood pressure using the brachial artery. Which of the following is most important when selecting an appropriate size blood pressure cuff?
1. client age
2. percent body fat
4. extremity circumference
Accurate, clear and concise documentation is becoming increasingly important for all health care providers. Which of the following suggestions to improve documentation would not be useful?
1. avoid empty or open lines between entries in the medical record
2. make sure all entries in the medical record are typewritten
3. use abbreviations that have been standardized or accepted by a specific facility or the profession
4. co-sign the entries of other medical personnel when necessary according to state and facility requirements
it is not required to have medical records type written
THR ANTEROLATERAL APPROACH. Which of the following motions would be the most important to restrict during the initial phase of rehabilitation?
1. knee extension
2. knee flexion
3. hip external rotation
4. hip internal rotation
A therapist examines a client with post-polio syndrome. Given the client’s diagnosis, which of the following is the least important component of the examination?
4. functional mobility
SENSATION IS NOT AFFECTED IN POST POLIO SYNDROME
A therapist prepares to complete an assisted standing pivot transfer with a client that requires moderate assistance. In order to increase a client’s independence with the transfer, which of the following instructions would be the most appropriate?
1. I want you to help me perform the transfer.
2. Try to utilize your own strength to complete the transfer.
3. Only grab onto me if it is absolutely necessary.
4. Use the power in your legs to assist you during the transfer.
Try to utilize your own strength to complete the transfer
A therapist teaches a client positioned in supine to posteriorly rotate her pelvis. The client has full active and passive range of motion in the upper extremities, but is unable to achieve full shoulder flexion while maintaining the posterior pelvic tilt. Which of the following could best explain these findings?
1. capsular tightness
2. latissimus dorsi tightness
3. pectoralis minor tightness
4. quadratus lumborum tightness
LATISSIMUS DORSI TIGHTNESS
A clinical instructor asks a student to complete three selected joint mobilization techniques on a client diagnosed with adhesive capsulitis. Which learning domain is emphasized with the desired task?
* directed towards physical activity
Basic Fundamental Movements
Skilled movements and Non discursive communication
A client sustains a traction injury to the brachial plexus in a motor vehicle accident and has resultant C5 and C6 nerve root involvement. Which of the following muscles would be most affected by the injury?
1. flexor carpi ulnaris
2. levator scapulae
3. pectoralis minor
4. pectoralis major
A therapist orders a wheelchair for a client recently admitted to a rehabilitation hospital. How many inches above the chair seat is the armrest on a standard adult wheelchair?
1. 5 inches
2. 7 inches
3. 9 inches
4. 11 inches
A therapist designs a treatment program for a client with a traumatic head injury. The client currently is classified as confused agitated. Which of the following guidelines would be the least beneficial when developing the treatment program?
1. The therapist should emphasize previously learned skills and avoid teaching only new skills
2. The therapist should maintain a calm and focused affect.
3. The therapist should concentrate on one specific activity for each treatment session.
4. The therapist should schedule the client at the same time and same place each day.
The therapist should concentrate on one specific activity for each treatment session
*Short attention span - confused agit patients
A physical therapist designs a research study in which it is desirable to limit the risk when making a conclusion or inference from the study. Which of the following levels of significance would be the most appropriate for the study?
0.01 (1% risk for a type 1 error)
A therapist uses palpation to assess upper lobe expansion during quiet and deep breathing. Which of the following descriptions most accurately describes proper hand placement when palpating the upper lobe?
1. place the palms firmly against the chest wall and hook the fingers over the posterior axillary fold
2. place the palms of the hand firmly over the anterior aspect of the chest from the fourth rib cranially and hook the fingers around the trapezii
3. place the thumbs over the spine of the scapulae so that the fingers reach around the anterolateral aspects of the neck
4. extend the thumbs over the posterior midline of the back and hook the fingers around the anterior axillary fold
place the palms of the hand firmly over the anterior aspect of the chest from the fourth rib cranially and hook the fingers around the trapezius
A therapist presents an in-service entitled “Preventing Pressure Ulcers” to a group of physical therapy aides. As part of the in-service, the therapist identifies risk factors associated with the development of pressure ulcers. Which of the following would not be considered a significant risk factor?
1. nutritional deficiencies
3. psychological stress and depression
4. vocational dysfunction
A physical therapist examines a 42 year-old self-referred female. The client describes the onset of a variety of medical problems approximately one month ago. The client’s reported problems include right lower extremity weakness, decreased balance and blurred vision. The physical therapy examination confirms the client’s complaints, in addition to identifying decreased pinprick sensation and ankle clonus in the right lower extremity. The suspected diagnosis of this client is ___?
2. multiple sclerosis
4. Parkinson’s disease
A 78 year-old male, one month status post open reduction and internal fixation of an intertrochanteric fracture is referred to physical therapy. The client has pain with active movement and decreased hip range of motion. Which of the following modalities would be contraindicated for the client?
1. moist heat
2. pulsed ultrasound
4. shortwave diathermy
A physical therapist is treating a client with Parkinson’s disease. The client has trouble initiating movement and is unable to ambulate independently. The client reports that he has fallen on three separate occasions within the last two months while attempting to ambulate. Which assistive device would be the most appropriate for this client?
1. rolling walker
3. axillary crutches
4. small base quad cane