PEAT Missed Questions

Question 1

A patient’s skin distal to the mid-calf is darker than the skin proximal to the mid-calf. Which of the following examination techniques would MOST efficiently screen for the expected dysfunction?

1. Capillary refill time
2. Venous filling time
3. Dorsalis pedis pulse
4. Sensory filament testing

Answer 1

2. Venous filling time

The patient presents with hemosiderin staining, which is a sign of venous insufficiency (Fruth, p. 192). A venous filling time test can indicate that a patient has venous insufficiency if the venous filling time is less than 15 seconds (Fruth, p. 195; O’Sullivan). If the test result is positive for venous insufficiency, further testing can be recommended for verification and examination of the extent of the condition.

Question 2

A family physician refers a patient to physical therapy for treatment of chronic low back pain. The patient is currently receiving treatment from a massage therapist for the same problem. Which of the following actions is MOST appropriate for the physical therapist?

1. Ask the patient to discontinue the massage therapy.
2. Treat the patient on days the patient is not seen by the massage therapist.
3. Gain permission from the patient to contact the massage therapist to discuss the plan of care.
4. Discontinue the patient’s physical therapy.

Answer 2

3. Gain permission from the patient to contact the massage therapist to discuss the plan of care.
4. Obtaining the patient’s permission to contact the massage therapist allows communication between healthcare providers and provides the most appropriate treatment for the patient.

Question 3

Which of the following therapeutic activities is the MOST appropriate for an infant who has a C5–C6 brachial plexus injury?

1. Open-hand batting of an object with finger extension and abduction
2. Reaching with shoulder medial (internal) rotation and forearm pronation
3. Reaching with shoulder lateral (external) rotation and forearm supination
4. Grasping an object with thumb (1st digit) adduction and metacarpophalangeal joint flexion

Answer 3

3. Reaching with shoulder lateral (external) rotation and forearm supination
4. A C5–C6 brachial plexus injury (also known as Erb palsy) will result in weakness of the shoulder abductors, flexors, and rotators as well as the forearm supinators. Therefore, activities encouraging these motions should be emphasized during physical therapy.

Question 4

Which of the following arthrokinematic motions occurs during open-chain knee flexion?

1. The tibia rolls posteriorly.
2. The tibia glides anteriorly.
3. The femur rolls anteriorly.
4. The femur glides posteriorly.

Answer 4

1. The tibia rolls posteriorly.
2. During open-chain knee flexion, the femur is stationary. According to the concave-convex rule of arthrokinematics, when the concave surface of the tibia is flexing on the convex surface of a fixed femur, the tibia both rolls and glides posteriorly on the relatively fixed femoral condyles.

Question 5

A patient has Fair (3/5) quadriceps strength, intact sensation in the lower extremity, and 0/10 pain. Which of the following electrical stimulation parameters would be MOST appropriate for the patient?

1. Frequency of 35 pps, duration of 50 microseconds
2. Frequency of 35 pps, duration of 150 microseconds
3. Frequency of 50 pps, duration of 250 microseconds
4. Frequency of 150 pps, duration of 50 microseconds

Answer 5

3. Frequency of 50 pps, duration of 250 microseconds
4. For a large muscle group with intact innervation, the most effective parameters for promoting increased muscle strength are a frequency of 35-80 pps and a pulse duration of 200-350 microseconds (p. 246).

Question 6

During an examination, a physical therapist observes that a patient has difficulty concentrating, refuses to participate in certain examination procedures, and appears reactive and fearful to touch. Which of the following strategies would be MOST appropriate during screening of the patient?

1. Ask direct questions about substance abuse.
2. Ask indirect questions about substance abuse.
3. Ask direct questions about violence or abuse.
4. Ask indirect questions about violence and abuse.

Answer 6

3. Ask direct questions about violence or abuse.
4. Asking direct questions about violence during routine social screening and safety questions is recommended. The therapist may suspect violence or abuse if a patient has injuries to the head and trunk (areas usually out of sight), lacerations, fractures, contusions, and/or black eyes. Burns, knife wounds, and joint injuries are also common. Victims of violence and abuse may appear excessively reactive and fearful of touch. Patients may use vague descriptions of pain and mechanism of injury, and even appear evasive. Patients may confide in health care providers that they feel isolated or alone. (p. 43)

Question 7

Which of the following objective findings is MOST likely to be present in a patient who has Parkinson disease at Hoehn and Yahr Stage 4?

1. Atrial fibrillation
2. Erratic respiration
3. Increased chest excursion
4. Paroxysmal atrial tachycardia

Answer 7

2. Erratic respiration
3. Erratic breathing is associated with Parkinson disease due to dyskinetic movement patterns of the muscles of respiration.

Question 8

A patient sustained an injury to the cerebellar cortex. Which of the following functions would MOST likely be diminished?

1. Initiation of movement
2. Upper extremity strength
3. Upper extremity sensation
4. Rapid alternating arm movements

Answer 8

4. Rapid alternating arm movements
5. Rapid alternating arm movements test for dysdiadochokinesia, the term used to indicate impaired ability to perform these movements. Patients who have cerebellar lesions would be most likely to experience this impairment. (p. 194)

Question 9

When conducting a 10-meter walk test, appropriate procedure includes which of the following elements?

1. The patient is permitted to use an assistive device.
2. The patient is instructed to walk with feet heel-to-toe.
3. The patient begins the assessment in a seated position.
4. The patient walks until reaching a marker, then turns around.

Answer 9

1. The patient is permitted to use an assistive device.

1. Assistive devices are permitted and should be used for safety if the patient usually uses one.

Question 10

A patient’s examination reveals weakness with scapular upward rotation and protraction. Which of the following nerves is MOST likely affected?

1. Axillary
2. Subscapular
3. Suprascapular
4. Long thoracic

Answer 10

4. Long thoracic
5. The long thoracic nerve innervates the serratus anterior, which is responsible for upward rotation and protraction of the scapula (p. 591).

Question 11

In the acute care setting, a patient who has which of the following conditions is MOST likely to receive physical therapy intervention?

1. Dissecting aortic aneurysm
2. Decompensated chronic heart failure
3. Third-degree heart block with a rate of 56 bpm
4. Chronic atrial fibrillation with a rate of 96 bpm

Answer 11

4. Chronic atrial fibrillation with a rate of 96 bpm
5. Atrial fibrillation alone is not an absolute indication that the patient is unstable and that treatment should be withheld. New, onset atrial fibrillation with a rapid ventricular rate (greater than 100 bpm) is an indication that physical therapy services should be withheld.

Question 12

A patient has a negative result on a stress test for the medial collateral ligament. A radiograph shows the coronoid process is inferior to the trochlea. The patient MOST likely has which of the following injuries?

1. Varus displacement
2. Valgus displacement
3. Anterior displacement
4. Posterolateral displacement

Answer 12

4. Posterolateral displacement
5. Displacing the coronoid process inferior to the trochlea requires the ulna to be displaced posterolateral to the humerus.

Question 13

Which of the following mobilizations to the temporomandibular joint would MOST likely improve a limitation in mouth opening?

1. Distraction with anterior glide
2. Distraction with posterior glide
3. Compression with anterior glide
4. Compression with posterior glide

Answer 13

1. Distraction with anterior glide
2. Distraction with anterior glide to the temporomandibular joint is best for improving a patient’s ability to achieve greater opening of the mouth.

Question 14

A patient who has sacroiliac joint dysfunction will MOST likely experience pain during which of the following activities?

1. Sitting
2. Lying in prone position
3. Walking
4. Lying in supine position

Answer 14

3. Walking
4. Patients who have sacroiliac dysfunction often report pain that is aggravated by prolonged standing, asymmetrical weight-bearing, or stair climbing; pain can also stem from running, long strides, or extreme postures (Frontera). The following findings are likely to be present with a sacroiliac joint dysfunction: pain with walking, ascending or descending stairs; hopping or standing on the involved leg; pain with transitional movements such as rising to standing position from a sitting position or getting in and out of a car; and/or pain that is worsened with long periods of sitting or standing if lumbar lordosis is not maintained (Dutton, pp. 1539-1540). Unbalanced muscle function in the lumbar/pelvic/hip region during walking is most likely to cause pain in someone with sacroiliac joint dysfunction.

Question 15

A physical therapist would be required to wear a surgical face mask when working on transfer training with a patient who has which of the following conditions?

1. Rubeola
2. Tuberculosis
3. Varicella zoster
4. Bacterial pneumonia

Answer 15

4. Bacterial pneumonia
5. Droplet precautions, including wearing a face mask, should be used when working with patients who have bacterial pneumonia.

Question 16

A patient has a recent diagnosis of lymphedema. The patient has soft, pitting edema that does not resolve with elevation and increases with standing and activity. Which of the following forms of compression is BEST for the intensive treatment phase?

1. Long-stretch bandages
2. Short-stretch bandages
3. Circular knit compression garment
4. Flat knit compression garment

Answer 16

2. Short-stretch bandages
3. This patient has a new diagnosis of stage 2 lymphedema (Hillegass, p. 660), which is an indication for phase 1 of treatment for lymphedema wherein bandages are the key component of compression. Short-stretch bandages are the bandages of choice for treating lymphedema because they are latex free and they stretch approximately 60% more than their original length; these bandages also provide a high resting pressure and can lead to compression of the more superficial lymphatic and venous vessels (Hillegass, p. 664).

Question 17

Which of the following interventions would be the BEST choice to remove wound exudate and loose debris from a sacral wound that exhibits tunneling?

1. Sharp debridement
2. Wet-to-dry dressings
3. Pulsatile lavage with suction
4. Acetic acid wound cleanser

Answer 17

3. Pulsatile lavage with suction
4. Pulsatile lavage with suction combines wound irrigation with suction and removes the irrigation fluid, wound exudate, and loose debris. It has been found to be advantageous over other interventions since it uses less water and requires less staff support, less cleanup, and less treatment time. It has been shown to increase healing time by rapid removal of contaminants, and it can be used to treat tunneling wounds using special cannula tips. (p. 551)

Question 18

A patient has pitting edema that is worse in the evenings and improves with elevation of the affected limb. Which of the following stages of lymphedema is MOST likely present?

1. Stage 0
2. Stage 1
3. Stage 2
4. Stage 3

Answer 18

2. Stage 1
3. Stage 1 lymphedema includes pitting edema, reversible with elevation, and edema that is increased with activity, heat, and humidity and is better in the morning.

Question 19

A patient who has multiple sclerosis reports increasing problems related to urinary incontinence. The patient experiences constant leaking of small amounts of urine and has a sensation of the bladder not being fully emptied after voiding. The patient MOST likely has which of the following conditions?

1. Overflow incontinence caused by an underactive detrusor muscle
2. Stress incontinence caused by anxiety about the disease
3. Urge incontinence caused by detrusor muscle spasms
4. Functional incontinence due to mobility changes

Answer 19

1. Overflow incontinence caused by an underactive detrusor muscle
2. The symptoms fit the description for overflow incontinence. In patients who have multiple sclerosis, overflow incontinence is usually the result of a hypotonic or underactive detrusor muscle. (p. 1302)

Question 20

A physical therapist is educating a patient on the use of a moist hot pack for home treatment. For the patient to prevent burns and still receive the benefits of superficial heat, which of the following heat application time frames is MOST appropriate?

1. 5-10 minutes
2. 20-30 minutes
3. 45-60 minutes
4. 70-90 minutes

Answer 20

2. 20-30 minutes

2. The ideal amount of time for therapeutic heating effects varies from 15-30 minutes.

Question 21

A patient reports long-standing pain and paresthesia along the anterior aspect of the elbow, medial forearm, and palmar (volar) aspect of the first through third phalanges. Pain is aggravated by pressure applied just distal to the cubital crease and concurrent resistance to elbow flexion, wrist flexion, and forearm rotation with the palm down. The Tinel sign is negative. The patient MOST likely has which of the following conditions?

1. Radial tunnel syndrome
2. Pronator teres syndrome
3. Cubital tunnel syndrome
4. Anterior interosseous nerve syndrome

Answer 21

2. Pronator teres syndrome
3. These signs and symptoms are consistent with median nerve entrapment at the level of the pronator teres muscle (p. 742).