SuSig B

Question 1

A physical therapist is treating a child with spastic cerebral palsy who is 3 years old cognitively but at a 6-month-old gross developmental level. What is an appropriate treatment activity for this child?

a. Reaching for a multicolored object while in an unsupported standing position
b. Reaching for a multicolored object while in an unsupported, guarded sitting position
c. Visually tracking a black and white object held 9 inches from his/her face
d. Reaching for a black and white object while in the supine position

Answer 1

b. Reaching for a multicolored object while in an unsupported, guarded sitting position

Question 2

A patient with multiple sclerosis (MS) presents with dysmetria in both upper extremities. Which of the following interventions is the BEST choice to deal with this problem?

a. 3-1 weight cuffs to wrists during activities of daily living (ADL) training
b. Isokinetic training using low resistance and fast movement speeds
c. Pool exercises using water temperatures greater than 85°F
d. Proprioceptive neuromuscular facilitation (PNF) patterns using dynamic reversals with carefully graded resistance

Answer 2

d. Proprioceptive neuromuscular facilitation (PNF) patterns using dynamic reversals with carefully graded resistance

Question 3

A patient is receiving mobilizations to regain normal mid thoracic extension. After three sessions, the patient complains of localized pain that persists for greater than 24 hours. What is the therapist’s best option?

a. Change mobilizations to gentle, low-amplitude oscillations to reduce the joint and soft tissue irritation
b. Continue with current mobilizations, followed by a cold pack to the thoracic spine
c. Place the physical therapy on hold and resume in 1 week
d. Change to self-stretching activities, because the patient does not tolerate mobilization

Answer 3

a. Change mobilizations to gentle, low-amplitude oscillations to reduce the joint and soft tissue irritation

Question 4

A therapist wishes to use behavior modification techniques as part of a plan of care to help shape the behavioral responses of a patient recovering from traumatic brain injury (TBI). What intervention is the BEST to use?

a. Use frequent reinforcements for all desired behaviors
b. Encourage the staff to tell the patient which behaviors are correct and which are not
c. Reprimand the patient every time an undesirable behavior occurs
d. Allow the patient enough time for self-correction of the behavior

Answer 4

a. Use frequent reinforcements for all desired behaviors

Question 5

A patient recovering from cardiac transplantation for end-stage heart failure is referred for exercise training. The patient is receiving immunosuppressive drug therapy (cyclosporine and prednisone) What guidelines should the therapist follow when implementing an exercise program for this patient?

a. Require longer periods of warm-up and cool-down
b. Require short bouts of exercise
c. Eliminate all resistance training
d. Require a frequency of 2-3 times/week

Answer 5

a. Require longer periods of warm-up and cool-down

Question 6

Knee capsular tightness has limited a patient’s ability to attain full flexion. An INITIAL intervention a physical therapist can employ to restore joint motion should emphasize sustained mobilization in the loose-packed position. Which of the following is the BEST choice to use?

(Anterior/Posterior) glide and (External/Internal) rotation of the tibia

Answer 6

POSTERIOR glide and INTERNAL rotation of the tibia

Question 7

A patient presents with weakness and atrophy of the biceps brachii resulting from an open fracture of the humerus. The therapist reads a report of needle electromyography (EMG) of the biceps. What is the anticipated muscle response after the needle is inserted and prior to active contraction?

Polyphasic potentials
Interference patterns
Electrical silence
Fibrillation potentials

Answer 7

Electrical silence

Question 8

A new staff physical therapist on the oncology unit of a large medical center receives a referral for strengthening and ambulation for a woman with ovarian cancer. She is undergoing radiation therapy after surgical hysterectomy. Her current platelet count is 17,000. What intervention is indicated for this patient at this time?

a. Active range-of-motion (AROM) exercises and activities of daily living (ADLs) exercises
b. Aerobic exercise 3-5 days/week at 40-60%, one repetition maximum
c. Resistance training at 60%, one repetition maximum
d. Progressive stair climbing using a weighted waist belt

Answer 8

a. Active range-of-motion (AROM) exercises and activities of daily living (ADLs) exercises

Question 9

A patient complains of increased pain and tingling in both hands after sitting at a desk for longer than 1 hour. The diagnosis is thoracic outlet syndrome (TOS). Which treatment would be the MOST effective physical therapy intervention?

a. Cardiovascular training using cycle ergometry to reduce symptoms of TOS
b. Stretching program for the pectoralis minor and scalenes
c. Strengthening program for the scalenes and sternocleidomastoids
d. Desensitization by maintaining the should in abduction, extension, and external rotation with the head turned toward the ipsilateral shoulder

Answer 9

b. Stretching program for the pectoralis minor and scalenes

Question 10

A patient with diabetes is exercising. The patient reports feeling weak, dizzy, and somewhat nauseous. The therapist notices that the patient is profusely and is unsteady when standing. What is the therapist’s BEST immediate course of action?

a. Insist that the patient sit down until the orthostatic hypotension resolves
b. Have a nurse administer an insulin injection for developing hyperglycemia
c. Administer orange juice for developing hypoglycemia
d. Call for emergency services; the patient is having an insulin reaction

Answer 10

c. Administer orange juice for developing hypoglycemia

Question 11

A patient with post polio syndrome started attending a supervised outpatient exercise program. The patient failed to show up for follow-up sessions. The patient reported increased muscle pain and being too weak to get out of bed for the past 2 days. The patient is afraid to continue with the exercise class. What is the therapist’s BEST course of action regarding the patient’s exercise program?

a. Discharge the patient from the program because exercise is counterproductive in post polio syndrome
b. Reschedule exercise workouts for early morning when there is less fatigue
c. Decrease the intensity and duration, but maintain a frequency of 3 time/week
d. Decrease the frequency to once a week for an hour session, keeping the intensity moderate

Answer 11

c. Decrease the intensity and duration, but maintain a frequency of 3 time/week

Question 11

A therapist has elected to use continuous inductive coil short wave diathermy (SWD) as one of the interventions in managing hip pain. Use of other thermal or electrical modalities were either ineffective or contraindicated. Which patient would be a candidate for use of short wave diathermy?

a. A morbidly obese patient
b. A patient with Type 1 diabetes who uses an insulin pump
c. An 1 year-old boy with a slipped capital femoral epiphysis
d. A patient with ankylosing spondylitis on high doses of NSAIDS and DMARDS

Answer 11

d. A patient with ankylosing spondylitis on high doses of NSAIDS and DMARDS

Question 11

An elderly person has lost significant functional vision over the past 4 years and complains of blurred vision and difficulty reading. The patient frequently mistakes images directly in front of her, especially in bright light. When walking across a room, the patient is able to locate items in the environment using peripheral vision when items are located to both sides. Based on these findings, what is the visual condition this patient is MOST likely experiencing?

Glaucoma
Cataracts
Homonymous hemianopsia
Bitemporal hemianopsia

Answer 11

Cataracts

Question 12

A patient with asthma is taking a drug from the sympathomimetic group, albuterol (Ventolin). What is the MOST important effect of this medication?

a. Increases airway resistance and decreases secretion production
b. Reduces airway resistance by reducing bronchospasm
c. Increases heart rate (HR) and BP to enhance training effect during aerobic activity
d. Reduces bronchial constriction and high blood pressure (BP) that accompanies exercise

Answer 12

b. Reduces airway resistance by reducing bronchospasm

Question 12

A patient is recovering from open heart surgery (sternotomy and coronary artery bypass). The PT is supervising the patient’s outpatient exercise program at 8 weeks post surgery. What guideline should be followed regarding the use of moderate to heavy weights during resistance training?

a. Should include upper body exercises only
b. Is contraindicated during the first two months
c. Should be based on 60%-80%, one repetition maximum initially
d. Can be included if resistance training is once a week

Answer 12

b. Is contraindicated during the first two months

Question 13

A PT decides to exercise a patient with lower extremity lymphedema using aquatic therapy. Hydrostatic pressure exerted by the water can be expected to do which of the following?

a. Increase cardiovascular demands at rest and with exercise
b. Reduce effusion and assist venous return
c. Provide joint unloading and enhance ease of active movement
d. Increase resistance as speed of movement increases

Answer 13

b. Reduce effusion and assist venous return

Question 13

A therapist determines that a patient is walking with a backward trunk lean with full weight on the right leg. The patient also demonstrates great difficulty going up ramps. What is the BEST intervention to remediate this problem?

a. Strengthen hip extensors through bridging
b. Stretch hip abductors through side-lying positioning
c. Strengthen knee extensors with weights, using 80%, one repetition maximum
d. Stretch hip flexors through prone-lying positioning

Answer 13

a. Strengthen hip extensors through bridging

Question 14

A patient has developed a thick eschar secondary to a full-thickness burn. What is the antibacterial agent MOST effective for infection control for this type of burn?

Sulfamylon
Nitrofurazone
Panafil
Silver nitrate

Answer 14

Sulfamylon

Question 15

A patient incurred a right CVA 1 month ago and demonstrates moderate spasticity in the left upper extremity (predominantly increased flexor tone). The major problem at this time is a lack of voluntary movement control. There is minimal active movement, with 1⁄4 inch subluxation of the shoulder. What initial treatment activity is the BEST choice for this patient?

a. Sitting, left active shoulder protraction with extended elbow and shoulder flexed to 90°
b. Sitting, weight bearing on extended left upper extremity, weight shifting
c. Quadruped, rocking from side to side
d. PNF D2 flexion pattern, left upper extremity

Answer 15

b. Sitting, weight bearing on extended left upper extremity, weight shifting

Question 15

A patient presents with complaints of pain and difficulty with ADL that is consistent with carpal tunnel syndrome. What is the BEST test to identify the cause of symptoms in this patient?

Pronator teres syndrome test
Ulnar nerve tension test
Allen’s test
Phalen’s test

Answer 15

Phalen’s test

Question 16

A patient is referred to physical therapy after an antero-inferior dislocation of the right shoulder. What positive examination finding is expected as a result of this dislocation?

Weak rhomboids
Positive drop arm test
Positive Neer’s test
Weak deltoids

Answer 16

Weak deltoids

Question 16

During an examination, a patient demonstrates large-amplitude, sudden flailing motions of the arm and leg on one side of the body with primary involvement of axial and proximal joint muscles. What clinical term BEST describes the patient’s behaviors?

Chorea
Intention Tremor
Hemiballismus
Athetosis

Answer 16

Hemiballismus

Question 17

An older patient complains of pain in the right hip region. The therapist suspects hip osteoarthritis based on the patient’s subjective symptoms. What clinical test is the BEST choice to confirm this diagnosis?

Scouring test
Thomas Test
Craig’s test
Posterior impingement test

Answer 17

Scouring test

Question 17

PTRP KA NA THIS JUNE, 2024! 🫶🏽

Question 17

A therapist has been asked to give an in-service presentation to staff aides on safe guarding techniques in a nursing home. The patients are at risk for falls. How should the therapist BEST prepare for this talk?

a. Provide a questionnaire to a random sampling of participants 1 week before the scheduled presentation
b. Provide a questionnaire to all participants 2 weeks before the scheduled session
c. Survey the audience a day before the scheduled session
d. Survey the audience at the scheduled session

Answer 17

b. Provide a questionnaire to all participants 2 weeks before the scheduled session

Question 18

A patient with pain in the left lateral face and head is found to have limited active and passive mouth opening range of motion. However, passive lateral deviation is full to both sides. What is the likely reason for the limitation in mouth opening range of motion?

a. An anteriorly displaced disc with reduction in the left temporomandibular joint
b. Decreased flexibility in the muscles of mastication on the left
c. Capsular restriction of the left temporomandibular joint
d. An anteriorly displaced disc without reduction in the left temporomandibular joint

Answer 18

b. Decreased flexibility in the muscles of mastication on the left

Question 18

A therapist is treating a patient with left hemiplegia and profound visuospatial perceptual deficits. What is the BEST strategy to use initially to assist this patient in the relearning of motor tasks?

a. Simplify and restructure the environment and minimize distractions
b. Maximize use of demonstration and gesture
c. Minimize use of verbal cues
d. Encourage independent practice

Answer 18

a. Simplify and restructure the environment and minimize distractions

Question 18

A 2-week-old infant born at 27 weeks gestation with hyaline membrane disease is referred for a physical therapy consultation. Nursing reports that the child “desaturates to 84% with handling” and has minimal secretions at present. What is the therapist’s BEST course of action?

a. Provide suggestions to nursing for positioning for optimal motor development
b. Put the PT consult on hold because the child is too ill to tolerate exercise
c. Delegate to a physical therapy assistant (PTA) a maintenance program of manual techniques for secretion clearance.
d. Perform manual techniques for secretion clearance, 2-4 hours daily, to maintain airway patency.

Answer 18

a. Provide suggestions to nursing for positioning for optimal motor development

Question 18

A patient sustained a valgus stress to the left knee while skiing. The orthopedist found a positive McMurray’s test and a positive Lachman’s stress test. The patient has been referred to physical therapy for conservative management of this problem. What is the BEST intervention for the subacute phase of rehabilitation?

a. Open-chain exercises of the hip extensors and hamstrings to inhibit anterior translation of the femur on the tibia.
b. Closed-chain functional strengthening of the quadriceps femoris and hamstrings, emphasizing regaining terminal knee extension.
c. Closed-chain functional strengthening of the quadriceps femoris and hip abductors to promote regaining terminal knee extension.
d. Open-chain strengthening of the quadriceps femoris and hip adductors to inhibit anterior translation of the tibia on the femur

Answer 18

b. Closed-chain functional strengthening of the quadriceps femoris and hamstrings, emphasizing regaining terminal knee extension.

Question 18

A patient with TBI has a convulsive seizure during a therapy session. The patient has lost consciousness and presents with tonic-clonic convulsions of all extremities. What is the therapist’s BEST response?

a. Position in supine-lying with head supported with a pillow, and wait out the seizure
b. Wrap the limbs with a sheet to prevent self-harm, position in supine-lying and call for emergency assistance.
c. Position in side-lying, check for an open airway, and immediately call for emergency assistance
d. Initiate rescue breathing immediately and call for help to restrain the patient

Answer 18

c. Position in side-lying, check for an open airway, and immediately call for emergency assistance

Question 19

An adult with no significant past medical history presents to the emergency room with complaints of fever, shaking chills, and a worsening productive cough. The patient has chest pains over the posterior base of the left thorax, which are made worse on inspiration. What would be an expected physical finding for this patient?

Symmetrical breathing
Crackles over the left thorax
Increased chest excursion
Slowed respiratory rate

Answer 19

Crackles over the left thorax

Question 19

A team of researchers investigated the use of constraint-induced movement therapy on patients with chronic stroke (>1 year poststroke) using a multicentre randomized controlled trial (RCT). What are the specific characteristics of this type of research design?

a. A sample of convenience for the intervention group
b. Alternating experimental and control conditions for a subject
c. Random assignment to an experimental or control group
d. Random assignment to matched cohort groups

Answer 19

c. Random assignment to an experimental or control group

Question 19

A therapist wants to know whether neurodevelopmental treatment (NDT) handling techniques produce an improvement in independent rolling that lasts longer than 30 minutes. In this study, rolling is what type of variable?

Control variable
Independent variable
Dependent variable
Intervening variable

Answer 19

Dependent variable

Question 19

A patient is referred to physical therapy for functional gait difficulties. The patient is unable to take a normal step and drags the left foot. Examination reveals muscle weakness with fasciculations in the left lower leg. For what should the therapist examine?

Decreased tone and hyporeflexia
Muscle spasms and positive Babinski
Increased tone and hyperreflexia
Dyssynergia and timing deficits

Answer 19

Decreased tone and hyporeflexia

Question 19

An elderly patient with hyperthyroidism is referred to physical therapy following a period of prolonged bed rest. What should the therapist be alert for when monitoring exercise of this patient?

Decreased heart rate and blood pressure
Tachycardia and dyspnea
Muscle weakness and joint pain
Arrhythmias and bradycardia

Answer 19

Tachycardia and dyspnea

Question 20

A patient strained the lower back muscles 3 weeks ago, and now complains of pain (6/10). Upon examination, the therapist identifies bilateral muscle spasm from T10-L4. The therapist elects to apply interferential current to help reduce pain and spasm. What is the BEST electrode configuration in this case?

a. Four electrodes, with current flow perpendicular to the spinal column
b. Two electrodes, with current flow perpendicular to the spinal column
c. Four electrodes, with current flow diagonal to the spinal column
d. Two electrodes, with current flow parallel to the spinal column

Answer 20

c. Four electrodes, with current flow diagonal to the spinal column

Question 21

A patient presents to physical therapy with a primary complaint of low back pain and right lower extremity radicular symptoms extending distally to the calf of 2 weeks duration. Current pain intensity is rated as 2/10 with rest and 5/10 during lumbar extension movements. What is the strongest prognostic indicator that would affect the clinical outcome?

2/10 pain intensity with rest
Current symptom duration (2 weeks)
Lower extremity radicular symptoms
5/10 pain intensity during lumbar extension

Answer 21

Lower extremity radicular symptoms

Question 21

An elderly patient with diabetes and bilateral lower extremity amputation is to be discharged from an acute care hospital 2 weeks post surgery. The incisions on the residual limbs are not healed and continue to drain. The patient is unable to transfer because the venous graft sites in the upper extremities are painful and not fully healed. Endurance out-of-bed is limited. What is the BEST choice of discharge destination for this patient?

Skilled nursing facility
Custodial care facility
Home
Rehabilitation hospital

Answer 21

Skilled nursing facility

Question 21

A patient currently being seen for low back pain awoke one morning with drooping left facial muscles and excessive drooling. The patient was recovering from a cold and had experienced an earache in the left ear during the previous 2 days. The therapist suspects Bell’s palsy. What cranial nerve test can confirm this diagnosis?

a. Taste over the posterior tongue, and having the patient protrude the tongue
b. Taste over the anterior tongue, and having the patient raise the eyebrows and puff the cheeks
c. Corneal reflex and stretch reflexes of facial muscles
d. Trigger points for pain, especially over the temporomandibular joint (TMJ).

Answer 21

b. Taste over the anterior tongue, and having the patient raise the eyebrows and puff the cheeks

Question 22

An infant is independent in sitting, including all protective extension reactions, and can pull-to-stand through kneeling, cruise sideways, and stand alone. The infant still demonstrates plantar grasp in standing. What is this infant’s approximate chronological age?

6 months
5 months
8-9 months
10-15 months

Answer 22

8-9 months

Question 23

A retired bus driver has experienced an increasing frequency of low back pain over the past 10 years. The patient states that nonsteroidal anti-inflammatory drugs (NSAIDs) help to relieve the symptoms, but there is always a nagging-type pain, the patient reports significant stiffness in the morning that dissipates by noon after exercising and walking. Pain is exacerbated with frequent lifting and bending activities, as well as sitting for long periods. What should the physical therapy plan of care emphasize?

a. Modalities to reduce pain, postural re-education, and dynamic stabilization exercises.
b. Postural re-education, soft tissue mobilization, and dynamic stabilization.
c. Modalities to reduce pain, joint mobilization, and lumbar extension exercises.
d. Joint mobilization, soft tissue mobilization, and flexion exercises.

Answer 23

b. Postural re-education, soft tissue mobilization, and dynamic stabilization.

Question 24

A PTA is assigned to ambulate a patient with a 10-year history of Parkinson’s disease (PD). What should the PT instruct the PTA to watch for?

Wider steps and increased double support time
An abnormally wide base of support
Decreased trunk rotation with shorter steps
Unsteady, uneven gait with veering to one side

Answer 24

Decreased trunk rotation with shorter steps

Question 25

A therapist investigated the accuracy of pulse oximetry estimates during exercise. Correlational analysis measured the strength of the relationship between two types of ear probe-equipped pulse oximeters during heavy cycle exercise under hypoxic conditions. The investigator measured arterial oxyhemoglobin saturation (%H602) level to have a correlation of 0.89 at high saturation but only 0.68 at low saturation levels. How should the therapist interpret these results?

a. During heavy exercise, oxygen saturation levels should be interpreted cautiously
b. Both devices are highly accurate at all saturation levels
c. Accuracy of the measurements increases at higher saturation levels
d. Both devices are only moderately accurate

Answer 25

c. Accuracy of the measurements increases at higher saturation levels

Question 26

A patient with congestive heart failure (CHF) is on a regimen of diuretics (chlorothiazide). What are the potential adverse effects of this medication that the PT should be alert for?

Hyperkalemia and premature ventricular contractions (PVCs).
Myalgia and joint pains
Orthostatic hypotension and dizziness
Reflex tachycardia and unstable BP

Answer 26

Orthostatic hypotension and dizziness

Question 27

A patient is seen in physical therapy 2 days after a motor vehicle accident. The chief complaints are headaches, dizziness, neck pain with guarding, and a “sensation of a lump in the throat.” Plain film x-rays were read as negative. The therapist should refer this patient for what type of imaging?

Second series of plain film x-rays
T2 magnetic resonance imaging (MRI)
Computed tomography (CT) scan
Myelogram

Answer 27

Computed tomography (CT) scan

Question 27

A patient with a traumatic injury to the right hand had a flexor tendon repair to the fingers. When should physical therapy intervention being following this type of repair?

a. After the splint is removed in 4-6 weeks to allow ample healing time for the repaired tendon
b. After the splint is removed in 2-3 weeks to allow full AROM of all affected joints
c. Within a few days after surgery to allow for early initiation of strengthening exercises
d. Within a few days after surgery to preserve tendon gliding

Answer 27

d. Within a few days after surgery to preserve tendon gliding

Question 27

A female patient complains of intermittent pain in the right sacroiliac region. There was an insidious onset approximately 4 months ago. Pain has gradually worsened and is now fairly constant and does not vary much with activity or movement. Active motion assessment of the lumbar spine reveals no change in symptoms with movement. Sacroiliac provocation tests are negative. The patient is mildly tender over the right sacroiliac region. What is the MOST likely diagnosis for this patient?

Sacroiliac joint sprain
Multifidus muscle strain
Ovarian Cyst
Right L5/S1 facet joint arthrosis

Answer 27

Ovarian Cyst

Question 28

The therapist suspects that a patient recovering from a middle cerebral artery stroke is exhibiting a pure hemianopsia. What test should be used to confirm the hemianopsia?

a. Penlight held approximately 12 inches from the eyes and moved to the extremes of gaze right and left
b. Penlight held 6 inches from the eyes and moved inward toward the face
c. Visual confrontation test with a moving finger
d. Distance acuity chart placed on a well-lighted wall at patient’s eye level 20 feet away

Answer 28

c. Visual confrontation test with a moving finger

Question 29

An overweight adult patient complains of right anterior hip and knee pain while walking, especially when weight bearing on the right. Lumbar AROM is normal and pain free. Right hip AROM and PROM are limited compared to the left. Right knee AROM and PROM are full and pain free. There is no pain with resisted testing at the right hip or right knee. The scouring test reproduces the patient’s hip and knee symptoms. Hip joint distraction relieves these symptoms. Based on the above findings, what is the MOST likely diagnosis?

Trochanteric Bursitis
Patellofemoral syndrome
Piriformis Strain
Hip degenerative joint disease

Answer 29

Hip degenerative joint disease

Question 29

PTRP KA NA THIS JUNE, 2024! 🫶🏽

Question 30

An infant who was 39 weeks gestational age at birth and is now 3 weeks chronological age demonstrates colic. In this case, what is the BEST intervention the PT should teach the mother?

Stroking and tapping
Neutral warmth
Visual stimulation with a colored object
Fast vestibular stimulation

Answer 30

Neutral warmth

Question 30

A patient who is 5 weeks’ post myocardial infarction (MI) is participating in a cardiac rehabilitation program. The therapist is monitoring responses to increasing exercise intensity. The indicator that exercise should be immediately terminated is:

a. 1.5 mm of downs loping ST segment depression
b. Peak exercise HR > 140
c. Appearance of a PVC on the electrocardiogram (ECG)
d. Systolic BP > 140 mm Hg or diastolic BP > 80 mm Hg

Answer 30

a. 1.5 mm of downs loping ST segment depression

Question 30

A patient presents with a persistently downwardly rotated and adducted scapula during humeral elevation. The plan of care includes stretching and strengthening to improve range of motion. What muscles should be stretched and strengthened?

a. Stretching rhomboid muscles and strengthening serratus anterior muscle
b. Stretching pectoralis major and strengthening rhomboid muscles
c. Stretching pectoralis minor and strengthening trapezius muscles
d. Stretching serratus anterior and strengthening levator scapula and lower trapezius

Answer 30

a. Stretching rhomboid muscles and strengthening serratus anterior muscle

Question 30

A patient is recovering from stroke and, at 4 months, is ambulating with a straight cane for household distances. During outpatient physical therapy, the therapist has the patient practice walking with no assistive device. Recurvatum is observed that worsens with continued walking. What is the therapist’s BEST choice for intervention?

a. Give the patient a small-based quad cane (SBQC) to improve stability and have him/her practice AROM in supine
b. Exercise the quadriceps using isokinetic resistance at higher loads and increasing speeds
c. Practice isolated small-range quadriceps eccentric control work in standing and continue with the straight cane
d. Give the patient a KAFO to control hypertension and a hemi-walker.

Answer 30

c. Practice isolated small-range quadriceps eccentric control work in standing and continue with the straight cane

Question 30

Under HIPAA rules, to whom is it illegal to release protected health information (PHI) without a competent patient’s consent?

a. A State Agency responsible for investigating suspected abuse
b. The insurance company that is paying for the patient’s treatment
c. Another health care provider involved in the care of the patient
d. The patient’s spouse

Answer 30

d. The patient’s spouse

Question 30

During a test of upper extremity rapid alternating movement (RAM), the movements of the hands and elbows become irregular with wider excursions than expected. As speed is increased, the movements become more disorganized. These findings are indicative of:

Brainstem dysfunction
Lower motor neuron weakness
Cerebellar dysfunction
Upper motor neuron weakness

Answer 30

Cerebellar dysfunction

Question 30

With respect to a worker’s sitting posture, the greatest reduction in lumbar spine compression forces would be achieved by:

a. Eliminating armrests on the chair
b. Decreasing the chair backrest-seat angle to 85°
c. Increasing the chair backrest-seat angle to between 90° and 110°
d. Using a 2-inch gel seat cushion

Answer 30

c. Increasing the chair backrest-seat angle to between 90° and 110°

Question 31

A patient recovering from an incomplete spinal cord injury at the L3 level (ASIA scale D) ambulates with bilateral Lofstrand crutches. The patient reports great difficulty going down ramps with unsteady; wobbly knees. What is the BEST intervention to use with this patient?

a. Prolonged icing to reduce hamstring pain
b. Stretching using a posterior resting splint for tight plantar flexors
c. Progressive resistance training for the quadriceps
d. Biofeedback training to reduce knee extensor spasticity

Answer 31

c. Progressive resistance training for the quadriceps

Question 31

A baseball pitcher is referred to physical therapy with progressive posterior shoulder pain and weakness of the shoulder abductors and lateral rotators. The therapist notices muscle wasting superior and inferior to the scapular spine. The patient’s problem is MOST LIKELY attributable to damage involving the:

Spinal accessory nerve
Scalene muscles
Suprascapular Nerve
Long head of the biceps brachii

Answer 31

Suprascapular Nerve

Question 31

A physical therapist is treating a patient with diabetic peripheral neuropathy. The patient recently began taking Lyrica (pregabalin). During a monofilament exam of the feet the therapist notices circumferential marks bilaterally at the level of the malleoli after the socks are removed. The patient is complaining of increased difficulty ambulating long distances. In this situation, what is the therapist’s BEST course of action?

a. Contact the physician about possible development of congestive heart failure
b. Begin manual lymphatic drainage for secondary lymphedema
c. Complete the examination and instruct in proper skin care precautions
d. Educate the patient about the risks of foot ulceration

Answer 31

a. Contact the physician about possible development of congestive heart failure

Question 31

A patient is recovering from surgical resection of an acoustic neuroma and presents with symptoms of dizziness, vertigo, horizontal nystagmus, and postural instability. To address these problems, what should the physical therapy plan of care incorporate?

a. Repetition of movements and positions that provoke dizziness and vertigo
b. Hallpike’s exercises to improve speed in movement transitions
c. Strengthening exercises focusing on spinal extensors
d. Prolonged bed rest to allow vestibular recovery to occur

Answer 31

a. Repetition of movements and positions that provoke dizziness and vertigo

Question 32

An elderly patient presents with severe COPD, GOLD stage 4, shows which of the following physical examination findings would the therapist expect to find?

a. Kyphosis with an increased thoracic excursion
b. Barreled chest with a decreased thoracic excursion
c. Pectus excavatum with an increased thoracic excursion
d. Pectus carinatum with decreased thoracic excursion

Answer 32

b. Barreled chest with a decreased thoracic excursion

Question 33

A patient presents to the clinic with pain and decreased function of the right shoulder. A full tear of the right rotator cuff musculature is suspected. The special test that would provide the most valid and reliable information confirming this suspicion would be the:

Drop arm test
Yergason’s test
Neer’s impingement test
Clunk test

Answer 33

Drop arm test

Question 33

A patient presents with low back pain of insidious onset. Based on the history and subjective complaints, the patient appears to have a dysfunction of a lumbar facet joint. What clinical test should be utilized to confirm this diagnosis?

McKenzie’s side glide test
Stork standing test
Slump test
Lumbar quadrant test

Answer 33

Lumbar quadrant test

Question 34

A therapist is treating a patient with Brown-Sequard syndrome that resulted from a gunshot wound. The therapist’s examination should reveal:’

a. Sparing of tracts to sacral segments with preservation of perianal sensation and active toe flexion
b. Loss of motor function and pain and temperature sensation, with preservation of light touch and proprioception below the level of the lesion
c. Loss of motor function below the level of the lesion, primarily in the upper extremities
d. Ipsilateral loss of motor function, ipsilateral loss of light touch and proprioception, and contralateral loss of pain and temperature

Answer 34

d. Ipsilateral loss of motor function, ipsilateral loss of light touch and proprioception, and contralateral loss of pain and temperature

Question 34

A patient is recovering from stroke and presents with moderate impairments of the left upper and lower extremities. The PT’s goal today is to instruct the patient in a stand-pivot transfer to the more affected side so the patient can go home on a weekend pass. The spouse is attending today’s session and will be assisting the patient on the weekend. What are the BEST choices for teaching this task?

a. Practice the task first with the patient then with the caregiver
b. Demonstrate the task, then have the caregiver practice with the patient
c. Practice the task first with the caregiver, then with the patient
d. Demonstrate the task, and then practice with the patient

Answer 34

d. Demonstrate the task, and then practice with the patient

Question 35

When using a patellar tendon-bearing (PTB) prosthesis, a patient will experience excessive knee flexion in early stance if the:

a. Socket is aligned too far back or tilted posteriorly
b. Foot position is inset too much
c. Socket is aligned too far forward or tilted anteriorly
d. Foot position is outset too much

Answer 35

c. Socket is aligned too far forward or tilted anteriorly

Question 36

A patient presents with Bluish discoloration of the skin and nail beds of fingers and toes. Palms are also cold and moist. What is the MOST likely cause of these changes?

Carotenemia
Hypothyroidism
Cyanosis
Liver disease

Answer 36

Cyanosis

Question 36

A patient complains of persistent wrist pain after painting a house 3 weeks ago. The patient demonstrates signs and symptoms consistent with de Quervain’s tenosynovitis. An appropriate special test to confirm the diagnosis is:

Finkelstein’s test
Phalen’s test
Froment’s Sign
Craig’s test

Answer 36

Finkelstein’s test

Question 36

An outpatient physical therapist is examining a patient who underwent a total knee arthroplasty 2 weeks ago. The patient reports that the entire leg has started swelling in the past 2 days. On examination there is pitting edema throughout the lower leg and foot with tenderness throughout the mid calf. Girth measurements reveal a 3.5 cm increase in the size of the mid calf in the symptomatic leg. What recommendation should the physical therapist make to the patient?

a. Rest, ice, and elevate the affected lower extremity
b. Go home and monitor symptoms. Phone the physician if there is no improvement in 24 hours
c. Go immediately to the emergency department
d. Go to the physician’s office after the therapy session for further assessment

Answer 36

c. Go immediately to the emergency department

Question 37

An elderly patient with persistent balance difficulty and a history of recent falls (two in the past 3 months) is referred for physical therapy examination and evaluation. During the initial examination, what should the therapist examine first?

a. Level of dyspnea during functional transfers
b. Cardiovascular endurance during a 6-minute walking test
c. Sensory losses and sensory organization of balance
d. Spinal musculoskeletal changes secondary to degenerative joint disease (DJD)

Answer 37

c. Sensory losses and sensory organization of balance

Question 37

PTRP KA NA THIS JUNE, 2024! 🫶🏽

Question 38

To reduce an elderly individual’s chronic forward head posturing in standing and sitting the therapist should consider stretching exercises to:

Middle trapezius and rhomboid muscles
Rectus capitis anterior muscles
Longus capitis and longus colli muscles
Rectus capitis posterior minor and rectus capitis posterior major muscles

Answer 38

Rectus capitis posterior minor and rectus capitis posterior major muscles

Question 39

What are the major benefits of using the 6-Minute Walking Test as an outcome measure?

a. Accurately documents maximal exercise capacity
b. Provides good correlation with functional abilities
c. Allows determination of severity of lung disease
d. Provides determination of peak oxygen uptake

Answer 39

b. Provides good correlation with functional abilities

Question 39

A patient in chronic renal failure is being seen in physical therapy for deconditioning and decreased gait endurance. The therapist needs to schedule the patient’s sessions around dialysis, which is received three mornings a week. What guidelines should the therapist follow when taking the patient’s blood pressure?

a. Every minute during walking, using the non shunt arm
b. Pre-and post activities, using the non shunt arm
c. In sitting when activity has ceased, using the shunt arm
d. In the supine position, using the shunt arm

Answer 39

b. Pre-and post activities, using the non shunt arm

Question 40

During a postural screen for a patient complaining of low back pain, the therapist notices that the knees are in genu recurvatum. What are the common contributory problems for which the therapist should examine?

Ankle dorsiflexion and hip abduction
Forefoot varus and posterior pelvic tilt
Ankle plantarflexion and anterior pelvic tilt
Lateral tibial torsion and anterior pelvic tilt

Answer 40

Ankle plantarflexion and anterior pelvic tilt

Question 40

After treating a patient for trochanteric bursitis for 1 week, the patient has no resolution of pain and is complaining of problems with gait. After re-examination, the therapist finds weakness of the quadriceps femoris and altered sensation at the greater trochanter. What is the MOST likely cause of the problems?

L5 nerve root compression
Sacroiliac (SI) dysfunction
L4 nerve root compression
Degenerative joint disease (DJD) of the hip

Answer 40

L4 nerve root compression

Question 41

While providing sports coverage at a local high school, a physical therapist is asked to examine an athlete with a knee injury. Based on the mechanism of injury, the therapist suspects rupture of the ACL. What test should be performed immediately to identify a torn ACL?

McMurray’s test
Reverse Lachman’s stress test
Lachman stress test
Posterior sag test

Answer 41

Lachman stress test

Question 41

A patient with left hemiplegia is able to recognize his wife after she is with him for a while and talks to him, but is unable to recognize the faces of his children when they come to visit. The children are naturally very upset by their father’s behavior. The BEST explanation for his problem is:

Somatognosia
Anosognosia
Visual agnosia
ideational apraxia

Answer 41

Visual agnosia

Question 41

After a myocardial infarction (MI), a patient is a new admission to a phase 3 hospital-based cardiac rehabilitation program. During the initial exercise session, the patient’s ECG responses are continuously monitored via radio telemetry. The therapist notices three PVCs occurring in a run with no P wave. The therapist should:

a. Modify the exercise prescription by decreasing the intensity
b. Stop the exercise and notify the physician immediately
c. Continue the exercise session, but monitor closely
d. Have the patient sit down and rest for a few minutes before resuming exercise

Answer 41

b. Stop the exercise and notify the physician immediately

Question 42

A home care PT receives a referral to evaluate the fall risk potential of an elderly community-dweller with chronic coronary artery disease (CAD). The patient has fallen three times in the past 4 months, with no history of fall injury except for minor bruising. The patient is currently taking a number of medications. What is the drug that is MOST likely to contribute to dizziness and increased fall risk?

Colace
Albuterol
Nitroglycerin
Coumadin sodium

Answer 42

Nitroglycerin

Question 42

A patient who is currently being treated for low back pain arrives for therapy complaining of pain across the middle of the right chest and back. When the therapist inspects the skin, clustered vesicles are apparent in a linear arc. The surrounding skin is hypersensitive. What is the MOST likely diagnosis?

Herpes simplex infection
Psoriasis
Dermatitis
Herpes zoster infection

Answer 42

Herpes zoster infection

Question 43

A patient complains of foot pain when first arising that eases with ambulation. The therapist finds that symptoms can be reproduced in weight bearing and running on a treadmill. Examination reveals pes planus and pain with palpation at the distal aspect of the calcaneus. Early management would include:

Prescription for a customized orthosis
Strengthening of ankle dorsiflexors
Modalities to reduce pain
Use of a resting splint at night

Answer 43

Use of a resting splint at night

Question 43

A patient presents with weakness in the right lower leg 3 weeks after a motor vehicle accident. The patient complains of spontaneous twitching in the muscles of the lower leg. The therapist visually inspects both limbs and determines that muscle bulk is reduced on the involved right limb. Girth measurements confirm a 1-inch difference in the circumference of the right leg measured 4 inches below the patella. Deep tendon reflexes and tone are diminished. What is the MOST likely cause of the patient’s weakness?

Peripheral nerve injury
Pyramidal tract dysfunction in the medulla
Guillain-Barre syndrome
Brainstem dysfunction affecting extrapyramidal pathways

Answer 43

Peripheral nerve injury

Question 43

A patient with a T10 paraplegia (ASIA A) resulting from a spinal cord injury is ready to begin community wheelchair training. The therapist’s goal is to teach the patient how to do a wheelie in order to manage curbs. What is the BEST training strategy to instruct the patient in performing a wheelie?

a. Place a hand on the top of the hand rims to steady the chair while throwing the head and trunk forward.
b. Throw the head and trunk backward to rise up on the large wheels
c. Lean backward while moving the hands slowly backward on the rims
d. Grasp the hand rims posteriorly, and pull them forward abruptly and forcefully

Answer 43

d. Grasp the hand rims posteriorly, and pull them forward abruptly and forcefully

Question 44

A PT should be alert to recognize the signs and symptoms associated with the onset of aspiration pneumonia. Which patient diagnosis is the MOST susceptible to develop this form of pneumonia?

a. A circumferential burn of the thorax associated with significant pain
b. Severe scoliosis with compression of internal organs, including the lungs
c. Amyotrophic lateral sclerosis (ALS) with dysphagia and diminished gag reflex
d. A complete spinal cord lesion at T2 with diminished coughing ability and forced vital capacity (FVC)

Answer 44

c. Amyotrophic lateral sclerosis (ALS) with dysphagia and diminished gag reflex

Question 45

Independent community ambulation as the primary means of functional mobility is a realistic functional expectation for a patient with the highest level of complete spinal cord injury (ASIA A) at:

Low lumbar (L4-5)
Low thoracic (T9-10)
Midthoracic (T6-9)
High lumbar (T12-L1)

Answer 45

Low lumbar (L4-5)

Question 45

A patient demonstrates quadriceps weakness (4/5) and difficulty descending stairs. The BEST intervention to regain functional strength in the quadriceps is:

a. Progressive resistance exercises, 70% 1 repetition maximum, three sets of 10
b. Partial squats, progressing to lunges
c. Maximum isometric exercise, at 45° and 90° of knee extension
d. Isokinetic exercise, at 36°sec

Answer 45

b. Partial squats, progressing to lunges

Question 46

A patient presents with multiple fractures of both hands and wrists as a result of a mountain bike accident. Now, weeks later, the patient has limited wrist and finger motion and dry, scaly skin over the involved areas. What is the biophysical agent that would provide the GREATEST benefit?

Contact ultrasound (US)
Hot packs
Paraffin
Functional electrical stimulation

Answer 46

Paraffin

Question 46

An elderly patient demonstrates a history of recent falls (two in the past 2 months) and mild balance instability. The therapist’s referral is to examine the patient and recommend an assistive device as needed. Based on the patient’s history, it would be BEST to select a:

Folding reciprocal walker
Standard, fixed-frame walker
Front wheel rolling walker that folds
Hemi walker

Answer 46

Front wheel rolling walker that folds

Question 46

A patient with bacterial pneumonia has crackles and wheezes in the left lateral basal segment and decreased breath sounds throughout. The patient is on 4 L of oxygen by nasal cannula with a resulting arterial oxygen saturation (SaO2) of 90%. Respiratory rate is 28. What is the MOST BENEFICIAL intervention for this case?

a. Postural drainage, percussion, and shaking over the appropriate area on the left lateral thorax for secretion removal
b. Positioning in left side-lying to improve ventilation/perfusion ratios
c. Postural drainage, percussion, and shaking to the right basilar segments in order to keep the right lung healthy
d. Breathing exercise encouraging expansion of the right lateral basilar thorax, because the left side is not currently participating in gas exchange

Answer 46

a. Postural drainage, percussion, and shaking over the appropriate area on the left lateral thorax for secretion removal

Question 47

After surgery, a patient develops a stiff pelvis and limited pelvic/lower trunk mobility. The therapist elects to use sitting exercises on a therapy ball to correct these impairments. In order to improve lower abdominal control, what direction should the patient move the ball?

(Backward/Forward), producing (Anterior/Posterior) tilting of the pelvis

Answer 47

FORWARD, producing POSTERIOR tilting of the pelvis

Question 48

A therapist receives a referral to see an elderly patient in the intensive care unit (ICU) recovering from a severe case of pneumonia. The therapist recognizes that the disorientation is due to delirium rather than dementia because the:

a. Patient has hallucinations throughout the day
b. Patient demonstrates persistent personality changes
c. Symptoms are intermittent
d. Level of arousal is significantly depressed

Answer 48

c. Symptoms are intermittent

Question 48

An elderly adult patient presents with a history of and subjective complaints consistent with lumbar central spinal stenosis. The most appropriate clinical test used to differentiate spinal stenosis from intermittent vascular claudication would be:

Femoral nerve traction test
Bicycle (van Gelderens) test
Valsalva’s maneuver
Lumbar quadrant test

Answer 48

Bicycle (van Gelderens) test

Question 48

A comparison of the effects of exercise in water, on land, or combined on the rehabilitation outcome of patients with intra-articular anterior cruciate ligament reconstructions revealed that less joint effusion was noted after 8 weeks in the water group. An appropriate statistical test to compare the girth measurements of the three groups is:

Analysis of covariance
Spearman’s rho
Chi-square
ANOVA

Answer 48

ANOVA

Question 49

A patient has a recent history of strokes (two in the past 4 months) and demonstrates good return in the right lower extremity. The therapist is concentrating on improving balance and independence in gait. Unfortunately, speech recovery is lagging behind motor recovery. The patient demonstrates a severe fluent aphasia. What is the BEST strategy to use during physical therapy sessions?

a. Demonstrate and gesture to get the idea of the task across
b. Have the family present to help interpret during physical therapy sessions
c. Utilized verbal cues, emphasizing consistency and repetition
d. Consult with the speech pathologist to establish a communication board

Answer 49

a. Demonstrate and gesture to get the idea of the task across

Question 49

During a gait examination, a patient with a trans femoral prosthesis demonstrates terminal swing impact. Additional examination is needed as the therapist suspects the:

a. Prosthesis has too little tension in the extension aid
b. Hip flexors are weak
c. Prosthesis is externally rotated
d. Prosthesis has insufficient knee friction

Answer 49

d. Prosthesis has insufficient knee friction

Question 50

A patient with no significant past medical history who now presents with a bacterial pneumonia in the right anterior base would present with which of the following exam findings?

a. Decreased breath sounds throughout all lung fields, increased SaO2, febrile
b. Bronchial breath sounds at the right anterior base, increased SaO2, febrile
c. Crackles on inspiration only at right anterior base, decreased SaO2, and productive cough × 3 days
d. Wheezes on inspiration only throughout the right lung fields, decreased SaO2, dry cough × 1 day.

Answer 50

c. Crackles on inspiration only at right anterior base, decreased SaO2, and productive cough × 3 days

Question 50

A patient with type 2 diabetes is referred to physical therapy for exercise conditioning. What is a pathophysiologic cause of type 2 diabetes?

a. Metabolic syndrome
b. Impaired ability of the tissues to use insulin and insulin deficiency
c. Loss of beta-cell function and insulin deficiency
d. Pancreatic tumor

Answer 50

b. Impaired ability of the tissues to use insulin and insulin deficiency

Question 50

A patient with chronic obstructive pulmonary disease (COPD) reports to the fourth outpatient pulmonary rehabilitation session complaining of nausea, gastric upset, and feeling jittery. The patient reports no change in pulmonary symptoms. The PT records the following set of vital signs: temperature 98.6°F. HR 110 beats/min and irregular, BP 150/86, respiratory rate 20. Breath sounds show no change from baseline. The therapist checks the medical record and finds that the patient has no history of gastric disease. The patient is presently taking theophylline, albuterol sulfate (ventolin), and triamcinolone diacetate (Amcort). What action should the PT take?

a. Call the patient’s physician immediately and report signs of theophylline toxicity
b. Have the patient increase use of Ventolin to improve respiratory status
c. Have the patient stop use of Amcort until he/she schedules an appointment with the physician
d. Send the patient home and notify the physician of current symptoms

Answer 50

a. Call the patient’s physician immediately and report signs of theophylline toxicity

Question 51

Which intervention is BEST to improve left-sided neglect in a patient with left hemiplegia?

a. Hook-lying, holding, light resistance to both hip abductors
b. Rolling, supine to side-lying on right, using a PNF lift pattern
c. Sitting, with both arms extended, hands resting on support surface, active holding
d. Bridging with both arms positioned in extension at the sides

Answer 51

b. Rolling, supine to side-lying on right, using a PNF lift pattern

Question 51

A patient was burned over 40% of the body in an industrial accident and has full-thickness burns over the anterior trunk and neck and superficial partial-thickness burns over the shoulders. In order to stabilize this patient out of positions of common deformity, what orthotic device would be of GREATEST benefit?

a. Soft cervical collar with an intrinsic plus hand splint
b. A cervical thoracic lumbosacral orthosis (CTLSO) used during all upright activities
c. Plastic cervical orthosis and axillary splints utilizing an airplane position
d. Splints utilizing a flexed position for the shoulders and body jacket for the trunk

Answer 51

c. Plastic cervical orthosis and axillary splints utilizing an airplane position

Question 52

A patient with left knee degenerative joint disease (DJD) complains of left-sided knee pain of 2 months’ duration. The patient has been followed by outpatient physical therapy for 3 weeks and feels this condition is worsening. Pain has increased during weight-bearing activities, and the patient can no longer fully extend the left knee. Examination findings include increased swelling, decreased knee AROM into extension, and an antalgic gait. What action should the PT take?

a. Tell the patient to see an orthopedic surgeon for possible immediate surgical intervention
b. Immediately return the patient to the referring physician with documentation indicating that treatment was ineffective.
c. Continue physical therapy for another 2 weeks, because there is uncertainty whether the patient understands or is complying with the home exercise program
d. Continue therapy for another week to ensure that all interventions have been attempted, and then return the patient to the referring physician.

Answer 52

b. Immediately return the patient to the referring physician with documentation indicating that treatment was ineffective.

Question 53

The therapist tests a patient’s hearing by holding a vibrating tuning fork on the mastoid process and then in front of the ear. Comparison is made by asking the patient which is louder. What is the name of this test?

Weber’s test
Rinne’s test
Hallpike-Dix test
Caloric test

Answer 53

Rinne’s test

Question 53

The therapist is treating a 1-year-old child with Down syndrome at home and notices decreasing strength in the extremities, with neck pain and limited neck motion. Upper extremity deep tendon reflexes (DTRs) are 3+. These signs and symptoms are a hallmark of what diagnosis?

a. Lower motor neuron signs consistent with Down syndrome
b. Atlanto-axial subluxation with lemniscal impingement
c. Upper motor neuron signs consistent with Down syndrome
d. Atlanto-axial subluxation with spinal cord impingement

Answer 53

d. Atlanto-axial subluxation with spinal cord impingement

Question 54

Which of the following factors is likely to contribute to subluxation and shoulder pain in hemiplegia?

Spastic paralysis of the biceps
Traction using on a depressed, downwardly rotated scapula
PROM with normal scapulohumeral rhythm
Spastic retraction with elevation of scapula

Answer 54

Traction using on a depressed, downwardly rotated scapula

Question 54

PTRP KA NA THIS JUNE, 2024! 🫶🏽

Question 55

A postpartum patient with stress incontinence is referred for physical therapy. The therapist instructs the patient in pelvic floor exercises. What is the BEST choice for initial exercise?

a. Supine, squeeze the sphincters and hold for 10 seconds
b. Hook Lying, bridge and hold for 5 seconds
c. Sitting on toilet, stop and hold the flow of urine for 5 seconds during urination
d. Supine, squeeze the sphincters and hold for 3 seconds.

Answer 55

c. Sitting on toilet, stop and hold the flow of urine for 5 seconds during urination

Question 55

A patient presents with an acute sprain of the right ankle. According to the patient, this has occurred fairly frequently over the past 5 years. What clinical test should the therapist use to examine the integrity of the anterior talofibular ligament?

Anterior drawer test
Morton’s test
Talar tilt
Thompson’s Test

Answer 55

Anterior drawer test

Question 55

A patient with stroke demonstrates early recovery in the right upper extremity (RUE) with moderate spasticity in the biceps and finger flexors. Voluntary movement is evident in elbow flexors and shoulder abductors only (through 1⁄2 range). What is the BEST choices for initial exercise?

a. Functional activities emphasizing ADL using the less-affected UE
b. Facilitation of early movements in the flexor synergy pattern
c. Weight bearing on an extended RUE with wrist and fingers extended
d. Prolonged positioning of the RUE in a hemi sling.

Answer 55

c. Weight bearing on an extended RUE with wrist and fingers extended

Question 56

A physical therapist and a physician are at odds regarding ordering a power wheelchair for a 3-year-old child. What is the MOST important factor to consider for not recommending a power wheelchair for this child?

Age of the child
Child has quadriplegic cerebral palsy
Child is non-verbal
Child has poor head and fine motor control

Answer 56

Child has poor head and fine motor control

Question 57

A 10-year-old boy who play catcher on a baseball team complains of bilateral knee pain that is exacerbated with forceful quadriceps contraction. Examination reveals pain and swelling at the distal attachment of the patellar tendon. What is the BEST early intervention to use?

a. Decreased loading of the knee by the quadriceps femoris muscle
b. Strengthening exercises for the quadriceps femoris to prevent disuse atrophy
c. Casting followed by decreased loading of the knee
d. Ultrasound to decrease pain and inflammation

Answer 57

a. Decreased loading of the knee by the quadriceps femoris muscle

Question 57

A patient presents with a decubitus ulcer of 3 months’ duration on the lateral ankle. The ankle is swollen, red, and painful, with a moderate to high amount of wound drainage (exudate). What is the BEST choice of dressing for this wound?

Hydrogel dressings
Semipermeable film dressings
Calcium Alginate dressings
Gauze dressings

Answer 57

Calcium Alginate dressings

Question 57

An elderly resident of a community nursing home is diagnosed with Alzheimer’s type dementia. What patient behaviors should the therapist consider when formulating the plan of care?

a. Can reliably perform wheelchair transfer activities
b. Is more likely to remember current experiences than past ones
c. Will likely be resistant to activity training if unfamiliar activities are used
d. Can usually be trusted to be responsible for own daily care needs

Answer 57

c. Will likely be resistant to activity training if unfamiliar activities are used

Question 57

An ambulatory patient recovering from a left CVA is wearing a plastic AFO to stabilize the right foot. During gait analysis, the therapist observes lateral trunk bending toward the right as the patient bears weight on the right leg at midstance. What is the BEST intervention to correct this problem?

Strengthen hip flexors on the right side
Provide a lift on the shoe of the involved leg
Strengthen the hip abductors on the right side
Strengthen hamstrings on the right side

Answer 57

Strengthen the hip abductors on the right side

Question 58

A patient was diagnosed with a bulging disc at the right L5-S1 spinal level without nerve root compression. What is the impairment MOST likely to be documented?

A. Centralized gnawing pain with loss of postural control during lifting activities
B. Centralized gnawing pain with uncompensated gluteus medius gait
C. Radicular pain to the right great toe with a compensated gluteus medius gait
D. Radicular pain to the right great toe with difficulty sitting for long periods

Answer 58

A. Centralized gnawing pain with loss of postural control during lifting activities

Question 59

A patient recovering from traumatic brain injury (TBI) demonstrates impaired cognitive function (Rancho Cognitive Level VII). What training strategy should be the therapist’s focus?

a. Provide assistance as needed using guided movements during training
b. Provide a high degree of environmental structure to ensure correct performance
c. Involve the patient in decision-making and monitor for safety
d. Provide maximum supervision as needed to ensure successful performance and safety

Answer 59

c. Involve the patient in decision-making and monitor for safety

Question 60

What is the MOST appropriate intervention to correct for the problem of a forward festinating gait in a patient with Parkinson’s disease?

Use of a heel wedge
Use of a toe wedge
Increase stride length using floor markers
Increase cadence using a metronome

Answer 60

Use of a toe wedge

Question 60

A patient presents with difficulty with fast movement speeds and fatigue easily. The therapist decides on a strength training program that specifically focuses on improving fast- twitch muscle fiber function. What is the optimal exercise prescription to achieve this goal?

(High/Low)-intensity workloads for (Short/Long) periods of time

Answer 60

HIGH-intensity workloads for SHORT durations

Question 61

A cross-country runner presents with a complaint of pain in the proximal one-third of the right tibia with an insidious onset 4 weeks ago. The pain is present intermittently, and running exacerbates the symptoms. Ligamental testing and soft tissue examination of the knee and leg are unremarkable. Which imaging studies are recommended to be performed INITIALLY in order to help establish a diagnosis?

Radiograph and if positive, then MRI
CT scan and T2 MRI
Bone scan and if positive, MRI
Radiograph and if negative, a bone scan

Answer 61

Radiograph and if negative, a bone scan

Question 61

A patient with traumatic onset (motor vehicle accident) of neck pain presents with subjective complaints of frank upper cervical spine instability. Which test would safely assist in identifying the integrity of the C1-2 articulation?

Transverse Ligament Stress Test
Vertebral artery test
Maximum cervical compression test
Hautant’s test

Answer 61

Transverse Ligament Stress Test

Question 62

What is the MOST appropriate functional goal for a 5-year-old child with a high lumbar lesion (myelomeningocele, L2 level) and minimal cognitive involvement?

a. Household ambulation with KAFOs and rollator walker
b. Community ambulation with an RGO and Lofstrand crutches
c. Household ambulation with a reciprocating gait orthosis (RGO) and Lofstrand crutches
d. Community ambulation with HKAFOs and Lofstrand crutches

Answer 62

c. Household ambulation with a reciprocating gait orthosis (RGO) and Lofstrand crutches

Question 62

A patient with spinal cord injury is having difficulty learning how to transfer from mat to wheelchair. The patient just cannot seem to get the idea of how to coordinate this movement. In this case, what is the MOST effective use of feedback during early motor learning?

a. Focus on knowledge of performance and proprioceptive inputs
b. Focus on guided movement and proprioceptive inputs
c. Provide feedback only after a brief (5-sec) delay
d. Focus on knowledge of results and visual inputs

Answer 62

d. Focus on knowledge of results and visual inputs

Question 62

A retired patient is referred to a cardiac exercise group after a mild MI. From the intake questionnaire, the therapist learns the patient has type 1 insulin-dependent diabetes mellitus (IDDM), controlled with twice daily insulin injections. When initiating an exercise program, how should the therapist instruct the patient in order to minimize the risk of a hypoglycemic event?

a. Exercise daily for 40-50 minutes to achieve proper glucose control
b. Avoid exercise during periods of peak insulin activity
c. Monitor blood glucose levels carefully every week during the rehabilitation program
d. Decrease carbohydrate intake for 2 hours before the exercise session

Answer 62

b. Avoid exercise during periods of peak insulin activity

Question 63

A patient presents with pain and paresthesia over the first two metatarsal heads of her right foot. Pain is worse after prolonged periods of weight bearing. She typically wears shoes with 3-inch heels and pointed toes. What is the BEST intervention for this impairment?

a. Pad placed proximal to the metatarsal heads
b. Pad placed distal to the metatarsal heads
c. Scaphoid pad to support the medial longitudinal arch
d. Thomas heel to support the medial longitudinal arch

Answer 63

a. Pad placed proximal to the metatarsal heads

Question 63

The therapist is reading a recent report of arterial blood gas analysis with the following values:
* Fraction of inspired oxygen (Fi02) = 0.21
* Arterial oxygen pressure (Pa02) = 53 mm Hg
* Arterial carbon dioxide pressure (PaCO2) = 30 mm Hg
* pH = 7.48

Metabolic alkalosis
Respiratory alkalosis
Metabolic acidosis
Respiratory acidosis

Answer 63

Respiratory alkalosis

Question 64

A patient developed right throbbing shoulder pain after painting the kitchen. Passive and active glenohumeral motions increase pain. What is the suspected diagnosis and BEST initial intervention?

a. Stretching of the pectoralis minor muscle after acromioclavicular joint inflammation
b. Manual therapy techniques and biophysical agents to reduce pain as the result of subdeltoid bursitis
c. Rotator cuff strengthening exercises to allow ADL function after biceps tendinitis
d. Correction of muscle imbalances to allow healing of right shoulder supraspinatus tendinitis

Answer 64

b. Manual therapy techniques and biophysical agents to reduce pain as the result of subdeltoid bursitis

Question 64

A patient is being examined for impairments after a stroke. When tested for two-point discrimination on the right hand, the patient is unable to tell whether the therapist is touching with one or two points. The therapist determines that there is impaired function in the:

a. Spinotectal tract and somatosensory cortex
b. Lateral spinothalamic tract and somatosensory cortex
c. Dorsal column/lemniscal pathways and somatosensory cortex
d. Anterior spinothalamic tract and thalamus

Answer 64

c. Dorsal column/lemniscal pathways and somatosensory cortex

Question 64

A patient has a 5-year history of acquired immunodeficiency syndrome (AIDS). The caseworker reports a gradual increase in difficulty with walking. The patient rarely goes out anymore. A referral to PT is initiated. Examination findings reveal typical neuromuscular changes associated with AIDS. These deficits would likely include:

a. Widespread Sensory Loss Resulting In Sensory Ataxia
b. Motor ataxia and paresis with pronounced gait disturbances
c. Progressive rigidity and akinesia with severe balance disturbances
d. Paraplegia or tetraplegia

Answer 64

b. Motor ataxia and paresis with pronounced gait disturbances

Question 64

A patient is referred by an orthopedist with a diagnosis of impingement syndrome of the shoulder. The initial PT examination reveals signs and symptoms that are not consistent with this diagnosis and are more consistent with thoracic spine pain and dysfunction. The therapist treats the patient consistent with PT findings without communicating with the referring physician. Months later, the therapist is sued by the patient’s estate. The patient died of undiagnosed metastatic lung cancer. The therapist is:

a. Not responsible for diagnosing metastatic cancer, therefore cannot be held responsible for the patient’s death
b. Responsible for communicating PT examination results to the referring physician
c. Not responsible for the incorrect diagnosis because treatment was appropriate for the PT findings
d. Responsible for making the diagnosis of possible cancer consistent with the PT examination of the patient

Answer 64

b. Responsible for communicating PT examination results to the referring physician

Question 64

A PT is treating a 2-year-old child with Down syndrome who frequently uses a W sitting position. The main reason to discourage W sitting is that it may cause:

a. Hip subluxation and lateral knee stress
b. Femoral anteversion and medial knee stress
c. Abnormally low tone because of reflex activity
d. Developmental delay of normal sitting

Answer 64

b. Femoral anteversion and medial knee stress

Question 64

An elderly patient has a history of two myocardial infarctions (MIs) and one episode of recent congestive heart failure (CHF). The patient also has claudication pain in the right calf during an exercise tolerance test. An initial exercise prescription that BEST deals with these problems is walking:

a. Daily, using interval training for 10- to 15-minute periods.
b. Five times a week using continuous training for 60 minutes.
c. Three times a week using continuous training for 40-minute sessions.
d. Three times a week using interval training for 30-minute periods.

Answer 64

a. Daily, using interval training for 10- to 15-minute periods.

Question 65

A patient presents with signs and symptoms consistent with sacroiliac dysfunction. The cluster of special tests/ findings that has the highest diagnostic accuracy for sacroiliac dysfunction would be:

a. Thigh thrust test, Gillet’s test, stork test, and Patrick’s test.
b. Anterior superior iliac spine asymmetry, posterior iliac spine asymmetry, pubic symphysis pain with palpation, and sacral inferior lateral angle asymmetry.
c. Fortin finger test, torsion test, supine-to-sit test, and Gaenslen’s test.
d. SI gapping, sacroiliac compression, thigh thrust test (P4), sacral thrust, and Gaenslen’s test.

Answer 65

d. SI gapping, sacroiliac compression, thigh thrust test (P4), sacral thrust, and Gaenslen’s test.

Question 66

A patient demonstrates postpartum sacral pain. The patient complains that pain is increased with prolonged walking, ascending or descending stairs, and rising from sit-to- stand. The intervention that is MOST beneficial for this problem is:

a. Manual therapy techniques of the SI joint to provide relief of symptoms, and therapeutic exercise to restore normal function of the pelvic girdle.
b. Performing mobilization followed by cryotherapy to restore normal motion to the SI joint.
c. Cryotherapy and TENS to promote normal healing.
d. Increasing non-weight bearing with ambulation training and stabilization using a lumbosacral orthosis.

Answer 66

a. Manual therapy techniques of the SI joint to provide relief of symptoms, and therapeutic exercise to restore normal function of the pelvic girdle.

Question 67

A patient complains of right shoulder pain since falling onto the right shoulder 3 weeks ago. There was no dislocation and x-rays were negative. AROM is 35° of flexion and abduction with scapular elevation noted. Passive ROM is nearly full with mild pain and muscle guarding at the end of range. Resisted abduction is weak with pain noted in the anterior and lateral deltoid region. There is no atrophy. Based on the above findings, the physical therapist should MOST LIKELY suspect:

Rotator cuff tear
Axillary nerve palsy
Supraspinatus Tendinitis
Adhesive capsulitis

Answer 67

Rotator cuff tear

Question 68

A patient presents with neck pain, which is a result of a motor vehicle accident (hit from behind while the car was at rest). To determine the function of the deep cervical flexors, the physical therapist decides to perform a muscle function test utilizing the cranio-cervical flexion test. Findings of a normal test would be:

a. When palpating the anterior cervical musculature during the active chin tuck, the sternocleidomastoid muscle activates prior to the longus colli muscle.
b. During active chin tuck, the patient is able to hold the head 1 inch above the table for 30 seconds.
c. During active chin tuck, the patient is able to maintain the normal cervical lordosis for 10 seconds
d. During active chin tuck, the pressure in the stabilizer cuff increases to 22 and the patient can hold this position for 10 seconds.

Answer 68

d. During active chin tuck, the pressure in the stabilizer cuff increases to 22 and the patient can hold this position for 10 seconds.

Question 69

An elderly and frail older adult has low vision. The patient recently returned home from a 2-week hospitalization for stabilization of diabetes. The PT’s goal is to mobilize the patient and increase ambulation level and safety. The BEST intervention strategy for this patient is to:

a. Practice walking in areas of high illumination and low clutter.
b. Color-code stairs with pastel shades of blue and green to highlight steps.
c. Practice walking by having the patient look down at all times.
d. Keep window shades wide open to let in as much light as possible.

Answer 69

a. Practice walking in areas of high illumination and low clutter.

Question 70

The patient has a history of angina pectoris and limited physical activity. As the patient participates in the second exercise class, the PT suspects that angina is unstable and may be indicative of a pre-infarction state. The therapist determines this by the presence of:

a. Prolonged cessation of pain following the administration of nitroglycerin for angina
b. Angina that responds to rest and interval training but not to continuous training
c. Arrhythmias of increasing frequency, especially atrial arrhythmias.
d. Angina of increasing intensity that is unresponsive to the nitroglycerin or rest.

Answer 70

d. Angina of increasing intensity that is unresponsive to the nitroglycerin or rest.

Question 71

A patient with a left CVA exhibits right hemiparesis and strong and dominant hemiplegic synergies in the lower extremity. Which activity would be BEST to break up these synergies?

a. Foot tapping in a sitting position
b. Supine, PNF D2F with knee flexing and D2E with knee extending.
c. Supine-lying, hip extension with adduction
d. Bridging, pelvic elevation.

Answer 71

d. Bridging, pelvic elevation.

Question 72

An elderly and frail resident of a nursing home has developed a stage III pressure ulcer. The wound is open with necrosis of the subcutaneous tissue down to the fascia. This elderly patient when compared with a younger patient with the same type of ulcer can be expected to demonstrate:

a. Decreased vascular and immune responses resulting in impaired healing.
b. Increased vascular responses with significant erythema
c. Increased elasticity and eccrine sweating
d. Increased scarring with healing

Answer 72

a. Decreased vascular and immune responses resulting in impaired healing.

Question 73

An elderly patient has been hospitalized for 3 weeks after a surgical resection of carcinoma of the colon. The patient is very weak and is currently receiving physical therapy to improve functional ambulation. During the initial sessions, the patient complains of pain in the left shoulder that is aggravated by weight bearing when using the walker. The therapist decides to:

a. Ambulate the patient in the parallel bars considering age and diagnosis.
b. Apply pulsed US to decrease pain.
c. Notify the physician immediately
d. Apply heat in the form of a hot pack before ambulation

Answer 73

c. Notify the physician immediately

Question 73

Which measure of aerobic capacity is supported as a reliable and valid functional capacity measure with reported minimal detectable change scores in patients with heart failure?

6-Minute Walk Test.
Bruce protocol treadmill test.
Canadian Aerobic Fitness Step test.
Lower extremity ergometer test.

Answer 73

6-Minute Walk Test.

Question 73

The therapist is examining a patient recovering from stroke for the expected pattern of spastic hypertonia in the more involved upper extremity. The therapist expects to find abnormally increased resistance to PROM in:

a. Shoulder adductors, forearm pronators, and elbow extensors.
b. Shoulder retractors and abductors and flexors of the elbow, wrist, and hand.
c. Shoulder flexors and flexors of the elbow and hand.
d. Shoulder adductors; forearm pronators; and flexors of the elbow, wrist, and hand.

Answer 73

d. Shoulder adductors; forearm pronators; and flexors of the elbow, wrist, and hand.

Question 73

A patient diagnosed with left lateral epicondylitis has no resolution of symptoms after 2 weeks of treatment. The PT reexamines the patient and finds the left biceps reflex is 1+. The therapist should NEXT perform a complete examination of the:

Cervicothoracic region
Upper cervical region
Cervico-cranial region
Mid cervical region

Answer 73

Mid cervical region

Question 74

A child with spastic cerebral palsy is having difficulty releasing food from the hand to the mouth. Once the child has brought the foot to the mouth, it would be helpful for the caregiver to:

Slowly stroke the finger extensors in a proximal-to-distal direction
Apply a quick stretch to the finger flexors
Slowly stroke the finger flexors in a distal-to-proximal direction
Passively extend the fingers

Answer 74

Slowly stroke the finger extensors in a proximal-to-distal direction

Question 74

A patient sprained the left ankle 4 days ago. The patient complains of pain (4/10), and there is moderate swelling that is getting worse. At this time, which intervention would be BEST to use?

Cold/intermittent compression combination with the limb elevated
Cold whirlpool followed by massage
Contrast baths followed by limb elevation
Intermittent compression followed by elevation

Answer 74

Cold/intermittent compression combination with the limb elevated

Question 75

A patient underwent a right total hip replacement (THR) 4 months ago. The patient is now referred to physical therapy for gait evaluation. The patient demonstrates shortened stride length on the right.

Weakened quadriceps
Contracted hip flexors
Weakened hip flexors
Contracted hamstrings

Answer 75

Contracted hip flexors

Question 76

During the examination of the cervical spine of a client for C5 radiculopathy, small groupings of nevi are noted near the superior angle of the left scapula. The NEXT action the therapist should take is:

Perform a vertebral artery examination
Photograph the area in order to provide baseline documentation for the patient’s record.
Ask the patient about any history of moles and examine them closely.
Contact the physician immediately

Answer 76

Ask the patient about any history of moles and examine them closely.

Question 77

When lifting a constant load using either a stoop lift or a squat lift posture, the MOST significant contributing factor for increasing lumbar spine compression forces in addition to the weight of the load is:

a. Performing the lift with the lumbar spine in a kyphotic posture
b. Performing the lift with the lumbar spine in a neutral position rather than in a lordotic posture
c. The height of the load from the ground
d. The distance of the load from the base of the spine

Answer 77

d. The distance of the load from the base of the spine

Question 78

Nearly 2 months ago, a patient noticed left shoulder pain after walking the dog. This pain has progressively worsened. The patient now is unable to move the left upper extremity overhead while performing ADLs. An orthopedic surgeon diagnosed the problem as adhesive capsulitis. The MOST effective direction for glenohumeral mobilization for this patient would be:

a. Posteroinferior translator glides.
b. Anteroinferior translatory glides.
c. Anterosuperior translatory glides
d. Posterosuperior translator glides

Answer 78

a. Posteroinferior translator glides.

Question 79

An elderly patient is referred to physical therapy for an examination of functional mobility skills and safety in the home environment. The family reports that the patient is demonstrating increasing forgetfulness and some memory deficits. From the examination, the therapist would expect to find:

Impairments in short-term memory
Periods of fluctuating confusion
Periods of agitation and wandering, especially in the late afternoon
Significant impairments in long-term memory

Answer 79

Impairments in short-term memory

Question 80

A therapist is examining a patient with vestibular dysfunction. The patient is asked to assume a long sitting position with the head turned to the left side. The therapist then quickly moves the patient backward so that the head is extended over the end of the table approximately 30° below horizontal. This maneuver causes severe dizziness and vertigo. A repeat test with the head turned to the right produces no symptoms. What is the BEST way to document these results?

Positive left Hallpike-Dix test
Positive sharpened Romberg’s test
Positive right positional test
Positive positional test

Answer 80

Positive left Hallpike-Dix test

Question 81

A therapist is instructing a patient with a stroke in gait training. The therapist determines that learning is going well because the patient’s errors are decreasing and overall endurance is improving. The BEST strategy to promote continued motor learning at this point in the patient’s rehabilitation is to:

a. Have the patient practice walking in varying environments.
b. Intervene early whenever errors appear before bad habits become firmly entrenched
c. Provide continuous feedback after every walking trial
d. Have the patient continue to practice in the parallel bars until all errors are extinguished

Answer 81

a. Have the patient practice walking in varying environments

Question 82

A young child with newly diagnosed cystic fibrosis is being seen by a PT in the home. Which intervention should be considered for this patient?

a. Teach the child use of the acapella device in postural drainage positions to be performed once or twice a day
b. Teach the child autogenic drainage for secretion removal to be performed once or twice daily
c. Teach the parents secretion removal techniques to all segments of all lobes of both lungs once or twice a day
d. Teach the child active cycle of breathing technique (ACBT) to be done once or twice a day to clear retained secretions

Answer 82

c. Teach the parents secretion removal techniques to all segments of all lobes of both lungs once or twice a day

Question 83

A middle-aged woman is referred to a women’s clinic with problems of stress incontinence. She reports loss of control that began with coughing or laughing, but now reports problems even when she exercises (aerobics 3 times/wk). the BEST intervention for this patient is:

Kegel’s exercises several times a day
Behavioral modification techniques to reward proper voiding on schedule
Biofeedback 1 hour/wk to achieve appropriate sphincter control
Functional electrical stimulation 3 times/wk

Answer 83

Kegel’s exercises several times a day

Question 84

An elderly patient suffered a cerebral thrombosis 4 days ago and presents with the following symptoms: decreased pain and temperature sensation of the ipsilateral face, nystagmus, vertigo, nausea, dysphagia, ipsilateral Horner’s syndrome, and contralateral loss of pain and temperature sensation of the body. The MOST LIKELY site of the thrombosis is the:

Anterior cerebral artery
Posterior inferior cerebellar artery
Internal carotid artery
Posterior cerebral artery

Answer 84

Posterior inferior cerebellar artery

Question 85

A patient with a 2-inch stage I decubitus ulcer over the left lateral malleolus is referred for physical therapy. The therapist notes a greenish, pungent exudate at the wound site. The therapist decides to use electrical stimulation. The BEST choice of polarity and electrode placement is:

Cathode placed in the wound
Cathode placed proximal to wound
Anode placed in the wound
Anode placed proximal to wound

Answer 85

Cathode placed in the wound

Question 86

A patient arrives for outpatient cardiac rehab 10 weeks after a coronary artery bypass graft. The postoperative course was complicated by atrial fibrillation, which has been controlled with medications prescribed by a cardiologist. The patient’s resting vital signs are HR=90 in atrial fibrillation, BP= 116/74, RR=14, and SpO2 = 99% on room air. Is a symptom-limited exercise test appropriate for this patient at this time?

a. Yes, the patient is managed by a cardiologist and has no symptoms now
b. Yes, the heart rate is well controlled and the cardiologist is aware of the arrhythmia
c. No, the patient is tachycardic at rest and has an arrhythmia
d. No, a patient in atrial fibrillation should not complete an exercise test

Answer 86

b. Yes, the heart rate is well controlled and the cardiologist is aware of the arrhythmia

Question 87

A patient presents with a complete T10 paraplegia. An extensive neurological workup has failed to reveal specific cause for the paraplegia. The physician has determined a diagnosis of conversion disorder. During physical therapy, it would be BEST to:

a. Initiate ROM and strength training after the patient receives psychological counseling
b. Initiate functional training consistent with the level of injury
c. Use functional electrical stimulation as a means of demonstrating to the patient that the muscles are functional.
d. Discuss possible underlying cause for the paralysis with the patient in an empathetic manner

Answer 87

b. Initiate functional training consistent with the level of injury

Question 88

The director of a physical therapy department wants to fill a vacant PT position in the spinal cord injury program. Two resumes have been received. One candidate, a former employee, is a well-qualified and experienced 52-year-old female with a history of back pain which could impact her ability to do some heavy lifting at times. The other candidate is a newly licensed, very enthusiastic, 25-year-old male therapist for whom heavy lifting should not be a problem. In this case, what is the BEST hiring decision?

a. As long as age and back pain history were NOT discussed during the interview process with the female candidate, the male candidate would best meet the case load demands
b. Hire the male candidate but ensure that age and back pain history were discussed with the female candidate as the rationale for hiring someone else
c. Not have the female candidate partake in the interview process as issues with age and back pain would be justifiable grounds to rule her out based on the case load
d. Hire the more qualified female and provide aide assistance or lift equipment when heavy lifting is required.

Answer 88

d. Hire the more qualified female and provide aide assistance or lift equipment when heavy lifting is required.

Question 89

Which is an abnormal finding during an examination of a newborn infant?

Continuous tremulousness
Response decrement to repetitive stimuli
Dramatic skin color changes with change of state
Symmetry in ROM

Answer 89

Continuous tremulousness

Question 90

A patient with long-standing traumatic brain injury (TBI) comes into an outpatient clinic using a standing wheelchair. The patient demonstrates sacral sitting with a rounded, kyphotic upper back. The therapist suspects the cause of this posture is:

Decreased floor to seat height
Uneven weight distribution on the thighs and iIschial seat
Excessive leg length from seat to the foot plate
Excessive seat width

Answer 90

Excessive leg length from seat to the foot plate

Question 91

A patient presents with a large sacral decubitus ulcer that is purulent and draining. The therapist needs to take a representative sample of the infected material in order to obtain a laboratory culture. The method to culture this wound is to obtain samples from the:

a. Exudate In The Wound And The Surrounding Tissues
b. Dressing and exudate in the wound
c. Exudate in the wound
d. Dressing, exudate, and surrounding bed linen

Answer 91

c. Exudate in the wound

Question 91

A therapist is working in a major medical center and is new to the acute care setting. An orientation session for new employees concerns infection control. The therapist recognized that the most common infection transmitted to healthcare workers is:

Tuberculosis
Human immunodeficiency virus (HIV)
Hepatitis A
Hepatitis B

Answer 91

Hepatitis B

Question 91

A phase 2 outpatient cardiac rehabilitation program uses circuit training with different exercise stations for the 50-minute program. One station uses arm ergometry. For arm exercise as compared with leg exercise, at a given workload, the PT can expect:

Higher systolic and diastolic BP
Higher HR and systolic/diastolic BP
Higher HR and lower systolic BP
Reduced exercise capacity owing to higher stroke volumes

Answer 91

Higher HR and systolic/diastolic BP

Question 92

Before liver transplantation, a patient had a body mass index (BMI) of 17 and generalized muscle atrophy and completed the 6-minute walk with 65% of age-predicted distance. Surgery was 10 days ago, and the patient is able to complete bed mobility with an overhead trapeze, walk independently for short distances with a rolling walker, and complete deep breathing and lower extremity AROM exercises for two sets of 10 repetitions. The patient is being discharged home with family assistance today. Home care physical therapy is scheduled to begin in 1 week. The BEST choices for discharge home exercise program is:

a. Stationary cycling and lower extremity resistance exercises using a 5-1b weight cuff
b. Independent bed mobility exercises, elastic resistance extremity exercise, and partial sit-ups
c. Independent ambulation, elastic resistance lower extremity exercise, and active abdominal strengthening
d. Breathing exercises, ambulation with walker, and AROM lower extremity exercises.

Answer 92

d. Breathing exercises, ambulation with walker, and AROM lower extremity exercises.

Question 93

PTRP KA NA THIS JUNE, 2024! 🫶🏽

Question 94

A child with a developmental disability continues to be a no show for PT scheduled appointments. When the child does arrive to PT the family is usually late. It does not seem as though the home exercise program is being done and the child is regressing quickly. After the physical therapist discusses this with the parents they get angry and stop bringing the child for treatment. The BEST course of action in this situation would be to:

a. Report the family for neglect of the child
b. Contact your supervisor with information that you are discharging this child
c. Do nothing because it is the family’s choice whether to continue or not
d. Report the family for abuse of the child

Answer 94

a. Report the family for neglect of the child

Question 95

The most efficient intervention to regain biceps brachii strength if the muscle is chronically inflamed and has painful are of motion is:

Active concentric contractions through partial ROM
Active eccentric contractions in the pain-free range
Isokinetic exercises through the full ROM
Isometric exercises at the end range of movement only

Answer 95

Active eccentric contractions in the pain-free range

Question 95

During an ultrasound (US) treatment, the patient flinches and states that a strong ache was felt in the treatment area. To address this patient’s concern, it would be BEST to

Decrease the US frequency
Add more transmission medium
Decrease the US intensity
Increase the size of the treatment area

Answer 95

Decrease the US intensity

Question 96

A patient is referred for postoperative rehabilitation following a type I SLAP repair performed 1 week ago. The physical therapist should:

a. Focus on biceps brachii stretching and strengthening
b. Defer intervention during the maximum protection phase
c. Perform careful ROM of the shoulder internal rotators
d. Perform careful ROM of the shoulder external rotators

Answer 96

c. Perform careful ROM of the shoulder internal rotators

Question 97

A patient presents with a complaint of neck pain on the right. During the AROM examination, the physical therapist observes the following osteokinematic neck motions:
* full side-bending left,
* full rotation to the left,
* full forward flexion,
* limited and painful extension,
* limited and painful right side-bending, and
* limited and painful right rotation.

Based on this pattern, what is the arthrokinematic restriction?

Restriction with (upglide/downglide) of a facet on the (left/right)

Answer 97

Restriction with DOWNGLIDE of a facet on the RIGHT

Question 97

A patient with long-term postural changes exhibits an excessive forward head, and complains of pain and dizziness when looking upward. The MOST effective physical therapy intervention is:

a. Manual therapy techniques to provide pain relief and postural reeducation
b. Postural reeducation to reduce compression of the cervical sympathetic ganglia
c. Strengthening exercises to the posterior cervical musculature
d. Anterior cervical muscle stretching and postural reeducation to relieve vertebral artery compression

Answer 97

a. Manual therapy techniques to provide pain relief and postural reeducation

Question 97

A patient is recovering from deep-partial-thickness burns over the posterior thigh and calf that are now healed. The therapist’s examination reveals local tenderness with swelling and pain on movement in the hip area. While palpating the tissues, the therapist detects a mass. The therapist’s BEST course of action is to:

Use petrissage to work on this area of focal tenderness
Report these findings promptly to the physician
Continue with ROM exercise but proceed gently
Use RICE to quiet down the inflammatory

Answer 97

Report these findings promptly to the physician

Question 97

ECG changes that may occur with exercise in an individual with coronary artery disease (CAD) and prior myocardial infarction (MI) include:

a. Tachycardia at a relatively low intensity of exercise with ST segment depression
b. Bradycardia with ST segment elevation
c. Significant arrhythmias early on in exercise with a shortened QRS
d. Bradycardia with ST segment depression > 3 mm below baseline

Answer 97

a. Tachycardia at a relatively low intensity of exercise with ST segment depression

Question 98

PTRP KA NA THIS JUNE, 2024! 🫶🏽

Question 99

During the course of the physical therapy treatment in the ICU, a radial artery line gets pulled (comes out of the artery). What is the first action the PT should take?

a. Push the code button in the patient’s room, because this is a cardiac emergency
b. Elevate the arm above heart level to stop the bleeding
c. Place a BP cuff on the involved extremity and inflate the cuff until the bleeding stops
d. Reinsert the arterial catheter into the radial artery and check the monitor for an accurate tracing

Answer 99

c. Place a BP cuff on the involved extremity and inflate the cuff until the bleeding stops

Question 100

A therapist working in an outpatient clinic examines a patient referred for exercise conditioning. During the initial examination, the therapist finds unusual swelling and enlargement in the anterior neck with mild tenderness. The patient does not have any hoarseness or difficulty swallowing. What is the therapist’s BEST course of action?

Notify the referring physician
Document the findings in the medical record
Take girth measurements of the neck
Initiate the plan of care

Answer 100

Notify the referring physician

Question 101

A patient with a methicillin-resistant staphylococcus aureus (MRSA) infection has been discharged from an isolation setting with an open wound of the buttocks. The patient is now returning to physical therapy as an outpatient. The therapist should adhere to which precaution?

a. An open wound must be contained within a dressing
b. Direct contact with the patient should be avoided
c. Gloves are needed only with dressing changes
d. Treatment can be performed in the therapy gym if contact surfaces are covered

Answer 101

a. An open wound must be contained within a dressing

Question 102

After examining a patient who was referred to physical therapy for posterior thoracic pain, the therapist finds no musculoskeletal causes for the patient’s symptoms. What anatomical structure may refer to pain in this thoracic region?

Heart
Appendix
Gallbladder
Ovary

Answer 102

Gallbladder

Question 103

An elderly patient with a transfemoral amputation is being fitted with a temporary prosthesis containing a SACH (solid ankle cushion heel) prosthetic foot. Which of the following BEST characterizes the SACH foot?

a. Is an articulated foot with multiplanar motion
b. Allows full sagittal and frontal plane motion
c. Absorbs energy through a series of bumpers, permitting sagittal plane motion only.
d. Allows limited sagittal plane motion with a small amount of mediolateral motion

Answer 103

d. Allows limited sagittal plane motion with a small amount of mediolateral motion

Question 104

A physical therapist examines an adult patient that recently suffered a stroke that involved the right internal capsule. In addition to hemiparesis of the contralateral extremities, the patient also exhibits a facial palsy. Which facial muscles would MOST likely be affected?

a. All muscles on the left side of the face
b. All muscles on the right side of the face
c. Only muscles on the lower half of the right side of the face
d. Only muscles on the lower half of the left side of the face

Answer 104

d. Only muscles on the lower half of the left side of the face

Question 105

A patient in the ICU is referred to physical therapy and presents with significant shortness of breath. Notable on physical examination is a deviated trachea to the left. Which of the following processes would account for such a finding?

Right lung collapse
Left pleural effusion
Right hemothorax
Left pneumothorax

Answer 105

Right hemothorax

Question 106

A patient complains of pain (7/10) in the shoulder region secondary to acute subdeltoid bursitis. As part of the plan of care during the acute phase, the therapist elects to use conventional TENS. Which of the following BEST identifies the modulating properties of this biophysical device?

Stimulation of endorphins
Gate control mechanisms
Descending inhibition
Ascending inhibition

Answer 106

Gate control mechanisms

Question 107

A patient described a sudden onset of back pain while trying to lift a heavy barrel. The patient described this pain as constant, unremitting at an intensity of 10/10 over the past 3 days, and unresponsive to pain medications. The patient is unable to work but is able to drive to the clinic for treatment unaided. There is no history of other back-related symptoms in the past. Which of the following is the MOST likely causative factor?

Early degenerative osteoarthritis
Herniated lumbar disc
Neoplastic Disease
Secondary gain

Answer 107

Secondary gain

Question 108

After myocardial infarction (MI), a patient was placed on medications that included a beta-adrenergic blocking agent. When monitoring this patient’s response to exercise, what changes in HR are expected?

Increase proportionally to changes in diastolic BP
Be low at rest and rise very little with exercise
Increase proportionally to changes in systolic BP
Be low at rest and rise linearly as a function of increasing workload

Answer 108

Be low at rest and rise very little with exercise

Question 109

An individual presents with chronic TMJ dysfunction. There is limited lateral movement of the mandible to the right as a result of muscular tightness. Which of the following muscles should be the focus of inhibitory or soft tissue lengthening techniques?

Right temporalis muscle
Right geniohyoid muscle
Right medial pterygoid muscle
Right digastric muscle

Answer 109

Right medial pterygoid muscle

Question 110

After completing an examination of a patient with shoulder pain, the PT concludes that the cause is subscapularis tendinitis. Which clinical finding is supportive of this conclusion?

a. Tenderness at the greater tubercle of the humerus
b. Painful resisted shoulder adduction
c. Pain provoked with active glenohumeral external rotation
d. Pain provoked with passive glenohumeral external rotation

Answer 110

d. Pain provoked with passive glenohumeral external rotation

Question 111

A patient has a 20-year history of diabetes. Notable on the examination are the following vascular insufficiency and diminished sensation of both feet with poor healing of a superficial skin lesion. It is important that the patient understand the precautions and guidelines on foot care for people with diabetes. Which recommendation is CONTRAINDICATED to include in patient care instructions?

a. Inspect the skin daily for inflammation, swelling, redness, blister, or wounds
b. Wash the feet daily and hydrate with moisturizing lotion
c. Wear flexible shoes that allow adequate room and change shoes frequently
d. Use daily hot soaks and moisturize the skin

Answer 111

d. Use daily hot soaks and moisturize the skin

Question 112

A soccer player sustained a grade I inversion ankle sprain 2 weeks ago. What is the BEST intervention to use in the early subacute phase of rehabilitation?

Mobilization at the talocrural and subtalar joints
Closed-chain strengthening and proprioceptive exercises
Plyometric-based exercise program
Functional soccer-related drills

Answer 112

Closed-chain strengthening and proprioceptive exercises

Question 113

A patient is referred for outpatient care after a tendon transfer of the extensor carpi radialis longus. The muscle strength tests poor (2/5) in spite of previous intensive therapy. The therapist elects to apply biofeedback to assist in progressively increasing active motor recruitment. What are the BEST choices for the initial EMG protocol?

a. High-detection sensitivity with recording electrodes placed far apart.
b. Low-detection sensitivity with recording electrodes placed close together.
c. High-detection-detection sensitivity with recording electrodes placed close together.
d. Low-detection sensitivity with recording electrodes placed far apart.

Answer 113

c. High-detection-detection sensitivity with recording electrodes placed close together.

Question 114

A PT receives a home care referral from the nurse case manager. An elderly man has lost functional independence after the recent death of his wife. His past medical history includes stroke with minimal residual disability. Currently, he no longer goes out of his house and rarely even gets out of his chair anymore. During the initial session, the therapist determines that depression may be the cause of his increasing inactivity. What clinical signs and symptoms would lead the therapist to reach this determination?

Low scores on the Geriatric Depression Scale
Weight loss and social withdrawal
Complains of increasing dizziness and palpitations
Sleep apnea and weight gain

Answer 114

Weight loss and social withdrawal

Question 115

Exercise, electrical stimulation and biofeedback methodology are MOST OFTEN employed by physical therapists in the management of which type of incontinence?

Urge incontinence
Functional incontinence
Overflow incontinence
Stress incontinence

Answer 115

Stress incontinence

Question 116

A patient has been on bed rest for 4 days following complications after revascularization surgery involving a triple coronary artery bypass graft. During the first therapy session, the patient complains of tenderness and aching in the right calf. For what clinical signs should the therapist immediately examine?

Lowered body temperature
Bradycardia
Swelling in the calf or ankle
Homan’s sign

Answer 116

Swelling in the calf or ankle

Question 117

A patient is referred for physical therapy with jaw pain and dysfunction. The patient has experienced three episodes of jaw locking in an open position in the past week. What is the MOST likely cause of the patient’s jaw locking?

Entrapment of the retrodiscal lamina
Lateral pterygoid muscle spasm
Impingement of the temporomandibular ligament
Disc displacement

Answer 117

Disc displacement

Question 118

An elderly patient is referred to physical therapy after a fall and ORIF for a fracture of the right wrist. During the initial examination, the therapist observes that the patient’s skin and eyes have a yellowish hue. What is the therapist’s BEST course of action?

a. Send a copy of the examination results to the referring surgeon, emphasizing the skin hue
b. Treat the problem with whirlpool and massage and reevaluate skin color post treatment
c. Continue with the treatment; a yellowish hue is an expected finding 3-4 days post-ORIF
d. Document the findings and consult with the surgeon immediately after treatment

Answer 118

d. Document the findings and consult with the surgeon immediately after treatment

Question 119

An older adult received a cemented total hip replacement (THR) 2 days ago. What is the therapist’s initial priority?

a. AROM exercises and early ambulation using a walker, non-weight bearing
b. PROM exercises and gait training using crutches, weight bearing to tolerance
c. Proper technique for transferring to the toilet
d. Patient education regarding positions and movements to avoid

Answer 119

d. Patient education regarding positions and movements to avoid

Question 120

A patient with recent trauma presents with restricted movement of the right hand. There is decreased motion at the third right MCP joint. To differentiate as to whether this is joint restriction or some other type of tightness (not joint), which examination procedure should be employed?

Finkelstein’s test
Bunnel-Littler test
Tight retinacular test
Froment’s sign

Answer 120

Bunnel-Littler test

Question 121

A Patient with stage I primary lymphedema of the right lower extremity is referred for physical therapy. Examination reveals increased limb girth with skin folds/flaps evident. An important component of lymphedema management is manual lymphatic drainage. Which of the following describes a cardinal principle of manual lymphedema management?

a. Deep tissue friction massage for several minutes on fibrotic areas.
b. Decongesting the proximal portions of the limb first and working distally
c. Decongesting the trunk after the limb segments
d. Decongesting the distal portions of the limb first and working proximally

Answer 121

b. Decongesting the proximal portions of the limb first and working distally

Question 122

A patient with a 10-year history of multiple sclerosis (MS) demonstrates 3+ extensor tone in both lower extremities. The therapist needs to order a wheelchair. What is the BEST recommendation for this patient?

Standard wheelchair with elevating legrests
Tilt-in-space wheelchair with a pelvic belt
Standard wheelchair with a 30° reclining back
Electric wheelchair with toe loops

Answer 122

Tilt-in-space wheelchair with a pelvic belt