Questions and Answers

 1. A forty-eight year-old female sustained a fracture to her left shoulder. Treatment is

proceeding well except that with left shoulder flexion you notice the scapula protract and
elevate early and it continues to move excessively. Physical therapy intervention should
emphasize:
o A. Glenohumeral mobilization and strengthening of scapular stabilizers to regain
normal scapulohumeral movement.
o B. Glenohumeral mobilization, and strengthening of the rotator cuff muscles to
regain muscle balance
o C. Scapulothoracic mobilization and strengthening of the pectoralis major and
minor muscles to regain normal scapulohumeral rhythm.
o D. Stretching of scapular stabilizers and strengthening of the pectoralis major and
minor muscles to regain muscle balance.

 2. A 59 year-old ex-machinist demonstrates significant age-related hearing loss,

presbycusis. When trying to communicate with this patient you would NOT suspect:
o A. Bilateral hearing loss, at all frequencies since he has had this problem for a
number of years.
o B. Decreased language comprehension.
o C. Poor auditory discrimination
o D. unilateral hearing loss.

 3. You are supervising the exercise of cardiac rehabilitation outpatient class on a very hot
day, with temperatures expected to be above 90 degrees F. Your class is scheduled for 2
p.m. and the facility is not air conditioned. The strategy that is unacceptable is to:
o A. Change the time of the exercise class to early morning or evening.
o B. Decrease the exercise intensity by slowing the pace of exercise.
o C. Increase the warm-up and cool-down periods to equal the total aerobic interval
in time.
o D. Make the exercise intermittent by adding rest cycles

 4. A patient has a transtibial amputation and has recently been fitted with a PTB socket.
During your initial prosthetic checkout, you instruct the patient to walk several times in
the parallel bars. You then have him sit down and take the prosthesis off. You inspect the
skin. You would expect no redness in the area of the:
o A. anterior tibia, tibial crest, and fibular head.
o B. Patellar tendon and tibial tuberosity.
o C. Medial tibial and fibular plateaus.
o D. Distal end of the residual limb.
 5. A patient who is terminally ill with cancer is in tears, unable to cope with the changes
in her life and with her current hospitalization. You have a referral for gait training so she
can be discharged to home under hospice care. The BEST approach for you to take is:
o A. ask the patient questions so you can gain a detailed history.
o B. Encourage denial so she can cope better with her life’s challenges.
o C. Ignore her tears and focus on her therapy but in a compassionate manner.
o D. take time now to allow the patient to express her fears and frustrations.

 6. Your examination reveals muscle spasms of the deep hip rotators, which are
compressing the sciatic nerve and producing pain in the posterior hip region. The MOST
effective setting of ultrasound in this case is:
o A. 1 MHz continuous at 1.0 W/cm2.
o B. 1 MHz pulsed at 1.0 W/cm2.
o C. 3 MHz continuous at 1.0 W/cm2.
o D. 3 MHz pulsed at 1.0 W/cm2.

 7. A 17 year-old patient is recovering from a complete spinal cord injury, at the level of
L2. The expected outcome in this case would MOST likely include:
o A. A spastic or reflex bladder.
o B. greater loss of arm function than leg function with early loss of pain &
temperature sensation.
o C. Loss of motor function, pain & temperature sensation below the level of the
lesion with light touch, proprioception and position sense preserved.
o D. Some recovery of function since damage is to peripheral nerve roots

 8. A physical therapist is gait training a patient with left hemiplegia. The patient’s new
AFO arrives, but the therapist is overwhelmed with too many patients and asks the
physical therapy student to take over. This is the student’s first affiliation (second day)
and she has never performed an orthotic checkout for a patient with an AFO. The
supervising therapist will be in the same vicinity treating other patients. This task should:
o A. Be considered an advanced task, but allowable for the student to perform as a
good learning experience.
o B. be designated as a more advanced task and more appropriately delegated to
another physical therapist.
o C. be designated as a routine task and appropriate for the student who could call
out to the supervisor if problems arose.
o D. not be completed now and the patient sent back to his room.
 9. A patient has been diagnosed with acute synovitis of the temporomandibular joint.
Early intervention should focus on:
o A. application of an intraoral appliance and phonophoresis.
o B. instruction to eat a soft food diet and phonophoresis.
o C. Joint mobilization and postural awareness.
o D. temporalis stretching and joint mobilization.

 10. During a cervical spine examination you observe restricted left rotation of the C7-T1
spinal level. After stabilizing the thoracic spine, your hand placement for mobilization to
improve left rotation should be at the:
o A. posterior left C6 articular pillar.
o B. Posterior left C7 articular pillar.
o C. posterior right C7 articular pillar.
o D. T1 spinous process.

 11. An appropriate fine motor behavior that should be established by 9 months of age
would be the ability to:
o A. build a tower of 4 blocks.
o B. hold a cup by the handle while drinking.
o C. pick up a raisin with a fine pincer grasp.
o D. Transfer objects from one hand to another.

 12. A patient with a 10 year history of Parkinson’s disease has been taking L-dopa for the
last 5 years. He presents in your clinic with deteriorating function. He is not longer able
to transfer or walk independently. During the oral interview, you observe facial
grimacing with twitching of the lips and tongue protrusion. He appears restless, with
constant dancing, athetoid-like movements of his legs. Your BEST course of action is to:
o A. Complete your evaluation focusing specifically on his main problems of
rigidity and bradykinesia.
o B. Document your observations and refer him back to his physician for evaluation
of possible dopamine toxicity.
o C. Talk to his wife to see if he is taking any drugs with hallucinogenic effects.
o D. Use isokinetic dynamometry to assess his inability to generate torque output
during fast movements.
 13. A patient who is to undergo surgery for a chronic shoulder dislocation asks you to
explain the rehabilitation following a surgical reconstructive procedure he is scheduled to
undergo. Your BEST response is to:
o A. explain how patients typically respond to the surgery and outline the
progression of exercises.
o B. explain in detail about the surgical procedure.
o C. refer the patient to a physical therapy clinical specialist who is an expert of
shoulder reconstructive rehabilitation.
o D. Tell the patient to ask his surgeon for this information

 14. Which of the following is NOT an appropriate reason to terminate a maximum

exercise tolerance test for a patient with pulmonary dysfunction?
o A. ECG monitoring reveals diagnostic ischemia.
o B. PaO2 decreases 20 mmHg.
o C. patient reaches age-predicted maximal heart rate.
o D. Patient states he is maximally short of breath.

 15. A patient with a complete T10 paraplegia is receiving his initial ambulation training.
He has received bilateral Craig-Scott knee-ankle-foot orthoses and is being trained with
axillary crutches. Since a reciprocal gait pattern is problematic for him, the BEST initial
gait pattern to teach him is:
o A. Four-point.
o B. Swing-through.
o C. swing-to.
o D. Two-point.

 16. After mastectomy, a patient cannot accept the loss of her breast. She reports being
weepy all the time with loss of sleep. She is constantly tired and has no energy to do
anything. The BEST action you can take is:
o A. observe her closely for possible suicide.
o B. request her primary physician to refer her for psychological evaluation.
o C. tell her she’s over-reacting, she has to get on with her therapy.
o D. Tell the nurse case manager to monitor her behavior.
 17. A 23 year-old college volleyball player complains of moderate pain resulting from a
left hamstring strain four weeks ago. The focal point of pain and tightness is noted where
a hematoma developed initially. The specific massage technique that would be MOST
beneficial in this case is:
o A. friction.
o B. kneading.
o C. Stroking
o D. Tapotement.

 18. A six year-old boy born with myelomeningocele at the L2 level is referred for
physical therapy treatment at home. In determining the physical therapy plan of care, it
would NOT be appropriate to emphasize:
o A. Gait training with a reciprocating gait orthosis.
o B. Transfer training from floor to wheelchair.
o C. upper extremity strengthening with weights.
o D. vigorous range of motion of the lower extremities.

 19. During your examination of a patient who complains of back pain you found pain
with end range AROM into hip flexion, abduction and external/lateral rotation. The
structure most likely causing the patient’s pain is the:
o A. Hamstring muscle.
o B. Hip joint.
o C. piriformis muscle.
o D. SI joint.

 20. A therapist wants to compare frequencies of carpal tunnel syndrome occurring in

different groups of individuals: assembly line workers and computer programmers. The
MOST appropriate statistical tool to use for analysis of the data is:
o A. chi square test.
o B. normal distribution curve.
o C. Simple one-way ANOVA.
o D. t test.
 21. In a research study in which there is a skewed distribution with extreme scores on a
balance measure that deviate from the performance of the total group, the MOST accurate
representation of central tendency is:
o A. mean.
o B. Median.
o C. Mode.
o D. Standard deviation

 22. A 54 year-old factory worker injured his right arm in a factory press with damage to
the ulnar nerve at the elbow. A diagnostic EMG was performed with evidence of
spontaneous fibrillation potentials. In this case, the physical therapy plan of care should
consider that:
o A. Axonotmesis is occurring.
o B. Denervation atrophy has occurred.
o C. Reinnervation is complete.
o D. Reinnervation is in process.

 23. A 67 year-old patient is recovering from a left CVA resulting in severe right
hemiplegia. Additionally, he has a large diabetic ulcer on his left foot with pitting edema,
requiring elevation of that extremity. The MOST appropriate wheelchair prescription for
this patient would be a:
o A. hemiplegic chair.
o B. Lightweight active duty wheelchair.
o C. A. one-arm drive chair.
o D. Powered wheelchair with joystick

 24. A 14 year-old boy with advanced Duchenne muscular dystrophy is administered a

pulmonary function test. The value that is UNLIKELY to show any deviation from
normal is:
o A. FEV1.
o B. Functional residual capacity.
o C. Total lung capacity.
o D. A. vital capacity.
 25. A 29 year-old woman fractured her right midtibia in a skiing accident three months
ago. After cast removal, a severe foot drop was noted. The patient desires to try electrical
stimulation orthotic substitution. You would set up the functional electrical stimulation to
contract the appropriate muscles during:
o A. Foot flat.
o B. Push off.
o C. swing phase.
o D. toe off.

 26. You have a small area of dermatitis on the back of your hand with moderate exudate.
You are scheduled to treat a patient with HIV for management of an open wound. You
should:
o A. Continue with treatment as scheduled but wash your hands thoroughly before
and after.
o B. Double glove and treat as scheduled.
o C. Refuse to treat that patient.
o D. Use sterile precautions with mask and gloves

 27. You are a home therapist treating a patient who underwent a total hip replacement
four weeks ago. You notice that the patient arches his lumbar spine in supine. He states
that it is uncomfortable and doesn’t remember having the problem before. The patient is
unable to maintain a comfortable supine position due to:
o A. Poor abdominal strength.
o B. Tight hamstrings muscles.
o C. Tight iliopsoas muscle.
o D. Tight piriformis muscle.

 28. Your 102 year-old patient has been hospitalized for the past three days with an
undisclosed ailment. After running numerous tests and finding nothing to explain her
increasing weakness and fatigue, the physicians are being pressured to discharge her
tomorrow. She lives alone in a first floor apartment. You have determined her ambulation
endurance to be only up to 15 feet, not enough to allow her to get from her bed to the
bathroom (a distance of 20 feet). You recommend:
o A. a live-in nurse (24 hour coverage) until her condition improves.
o B. A skilled nursing facility placement until her endurance increases.
o C. Environmental changes, a bedside commode, and referral for home health
services.
o D. Postponing her discharge until she can complete the needed 20 feet.
 29. You have determined a patient with a right CVA that you are currently treating has a
profound deficit of homonymous hemianopsia. The BEST initial strategy to assist the
patient in compensating for this deficit is to:
o A. Make the patient aware of his deficit and teach him to turn his head to the
affected left side.
o B. place items, eating utensils on his left side.
o C. provide constant reminders, printed notes on his left side, telling him to look to
the left.
o D. rearrange his room so while in his bed his left side is facing the doorway.

 30. A patient with multiple sclerosis is agitated, irritated, and tired during treatment. Your
BEST response as the P.T. is to:
o A. treats the patient in a warm relaxing environment.
o B. Utilized a massed practice schedule
o C. Utilized a distributed practice schedule
o D. Switch the patient to a pool therapy program

 31. A 72 year-old medically stable individual requires custodial care in the home. She is
severely disabled with rheumatoid arthritis and is in a great deal of pain. She presents
with significant deformities which limit her functional abilities and is dependent in all
basic activities of daily living. A recent exacerbation of her disease has left her bed-
bound for the past 2 weeks. Appropriate physical therapy services would be covered by:
o A. Medicaid.
o B. Medicare.
o C. Medigap policies.
o D. Only by HMO or private insurance policies.

 32. A patient with a purulent venous insufficiency ulcer near the left medial malleolus is
seen at home by a physical therapist. The MOST important goal/intervention for the
therapist to try to achieve with this patient is:
o A. elastic wraps and daily exercise.
o B. daily warm water baths and exercise
o C. daily walking for 30-60 minutes
o D. compression therapy with exercises.
 33. Your patient is having difficulty bearing weight on the left leg. She is unable to
advance the tibia forward and abbreviates the end of the stance phase on the left going
directly into swing phase. The MOST likely cause of her problem is:
o A. weakness or contracture of Hip extensor weakness.
o B. Spasticity of the anterior tibialis muscle.
o C. spasticity or contracture of the plantarflexors.
o D. Weakness or contracture of the dorsiflexors

 34. With a traction injury to the anterior division of the brachial plexus you would expect
to see weakness of the elbow flexors, wrist flexors and forearm pronators. You would
also expect to find additional weakness in:
o A. forearm supination.
o B. lateral rotation of the shoulder.
o C. thumb abduction.
o D. wrist extension.

 35. A 95 year-old has recently been admitted to your skilled nursing facility following a
fall-related injury (fractured hip with open reduction, internal fixation). Since she lived
alone on the second floor, she was unable to return home. She is extremely agitated over
her placement here and demonstrates early signs of dementia. She tells you “leave me
alone, I just want to get out of here!” An important approach to take while working with
this client is to:
o A. Be calm and supportive, using only one or two level commands.
o B. Establish the rules: tell her exactly what she is to do while you are with her.
o C. Use gesture or sign language to communicate with her.
o D. Promise her anything as long as she gets up and walks for you.

 36. A 72 year-old woman is being treated for depression following the death of her
husband. She is currently taking antidepressant medication (tricyclics) and has a recent
history of a fall. You suspect the precipitating cause of the fall can be attributed to side
effects of her medication resulting in:
o A. Cardiac arrhythmias
o B. Dyspnea.
o C. hyperalertness.
o D. Postural hypotension
 37. An 82 year-old patient and his caregivers should understand the common side effects
of the medication that he is taking. He is continually in and out of congestive heart failure
and has been taking digitalis (Digoxin) to improve his heart function. You will know he
and his caregivers understand the adverse side effects of this medication if they tell you
they will contact the patient’s physician if he demonstrates:
o A. confusion and memory loss.
o B. Involuntary movements and shaking.
o C. Slowed heart rate.
o D. Weakness and palpitations

 38. The Director of Physical Therapy from a large teaching hospital is asked to develop
an operating budget for the upcoming fiscal year. The item that would NOT be included
in an operating budget is:
o A. A treadmill purchase.
o B. Utility expenses.
o C. clinic supplies such as therapy balls
o D. Lease of an off-site therapy pool

 39. You are treating a patient with active hepatitis B infection. Transmission of the
disease is best minimized if you:
o A. Avoid direct contact with any part of the patient.
o B. Have the patient wear a gown and mask every time your are in the room.
o C. have the patient wear gloves to prevent him from touching you.
o D. Wear gloves if there is direct contact with blood or body fluids.

 40. A wrestler complains of pain (7/10) and limited range of motion of the right shoulder
as a result of chronic overuse. You elect to use procaine hydrochloride iontophoresis as
part of your intervention for this patient’s problems. To administer this substance, it
would be appropriate to use:
o A. continuous biphasic current with the medication under the anode.
o B. continuous monophasic current with the medication under the anode.
o C. Continuous monophasic current with the medication under the cathode.
o D. interrupted monophasic current with the medication under the cathode.
 41. A contraindication to initiating joint mobilization on a patient with chronic
pulmonary disease may include:
o A. Concurrent inhalation therapy.
o B. Functional chest wall immobility.
o C. Long term corticosteroid therapy.
o D. Reflex muscle guarding.

 42. Long term care for institutionalized elderly who have reduced their financial
resources or qualify for low-income status is typically funded by:
o A. Health Maintenance Organizations.
o B. Medicaid.
o C. Medicare.
o D. Social Security Administration.

 43. A 45 year-old computer programmer, with no significant past medical history,

presents to the emergency room with complaints of fever, shaking chills and a worsening
productive cough. He has chest pain over the posterior base of his left thorax which is
made worse on inspiration. An anterior-posterior X-ray shows an infiltrate on the lower
left thorax at the posterior base. This patient’s chest pain is MOST likely caused by:
o A. Angina.
o B. Infected pleura.
o C. Inflamed tracheobronchial tree.
o D. trauma to the chest.

 44. Equipment safety is essential in all physical therapy clinics. Regularly scheduling
equipment maintenance programs to ensure that all equipment is calibrated, lubricated,
and adjusted according to manufacturer’s guidelines is an important element for patient
and staff safety. All of the following procedures should be followed to ensure safety
EXCEPT:
o A. Conducting educational sessions for staff regarding the indications and
contraindications for all equipment.
o B. Documenting all preventive maintenance and keeping this information on file.
o C. Supervising new staff and students in the use of all newly purchased
equipment.
o D. training all staff to do simple repairs on all electrical equipment if a breakdown
should occur.
 45. A 92 year-old woman presents with hot, red, and edematous skin over the shins of
both lower extremities. She also has a mild fever. The MOST likely cause of her
symptoms is:
o A. Cellulitis.
o B. Dermatitis
o C. Herpes simplex infection.
o D. Scleroderma.

 46. A 10 year-old presents with pain (4/10) and limited knee ROM (5/95degree)
following surgical repair of the medial collateral ligament and anterior cruciate ligaments.
In this case, The modality which can be used with precaution is:
o A. premodulated interferential current.
o B. continuous shortwave diathermy.
o C. high rate transcutaneous electrical stimulation.
o D. low dose Ultrasound.

 47. a weight lifter exhibits marked hypertrophy after embarking on a strength training
regime. Hypertrophy can be expected to occur following at least:
o A. 1-2 weeks of training.
o B. 2-3 weeks of training
o C. 3-4 weeks of training
o D. 6-8 weeks of training.

 48. A diagnosis of bicipital tendinitis has been made following an evaluation of a patient
with shoulder pain. The BEST shoulder position to expose the tendon of the long head of
the biceps for application of phonophoresis would be:
o A. Abduction.
o B. external/lateral rotation and extension.
o C. Horizontal adduction.
o D. internal/medial rotation and abduction

 49. A patient is unable to bring her foot up on the next step during a training session on
stair climbing. Your BEST course of action to promote active learning is to have the
patient:
o A. Balance on the stairs while the therapist passively brings the foot up.
o B. practice marching in place in the parallel bars.
o C. Practice standing-up from half-kneeling.
o D. Step up onto a low step while in the parallel bars.
 50. A 76 year-old patient exhibits impaired balance. A diagnostic work-up has failed to
reveal any specific etiology. An initial intervention for this patient would NOT include:
o A. limits of stability re-education including postural sway training.
o B. practice in maintenance of a wide base of support during gait and turns.
o C. sit-to-stand and stand-to-sit activity training.
o D. Tandem walking and single limb stance.

 51. A 38 year-old patient with complete spinal cord injury at T6 level is being discharged
home after a 2 month course of rehabilitation. In preparation for discharge, the
rehabilitation team visits the home and fined 3 standard height steps going into his home.
A ramp will have to be constructed for his wheelchair. The recommended length of his
ramp should be:
o A. 120 inches (10 feet).
o B. 192 inches (16 feet).
o C. 252 inches (21 feet).
o D. 60 inches (5 feet).

 52. The one pulmonary change following left pneumonectomy that is NOT expected is:
o A. decreased residual volume
o B. Decreased breath sounds on the left.
o C. Deviated trachea toward the left.
o D. increased tidal volume.

 53. An older person with diagnosis of congestive heart failure (CHF) should recognize
the symptoms of exertional intolerance. You will know this client is properly informed if
she can tell you these symptoms are:
o A. dizziness, visual blurring especially with turns and quick movements.
o B. Overwhelming weakness with difficulty in standing up and walking.
o C. Severe, uncomfortable chest pain with shortness of breath.
o D. Shortness of breath at rest and with limited activity, and sudden weight gain

 54. A physical therapist is instructing a student in proper positioning to prevent the

typical contractures in the patient with a transfemoral amputation. The therapist stresses
positioning the patient in:
o A. Prone lying with the residual limb in neutral rotation.
o B. A wheelchair with gel cushion and adductor roll
o C. supine-lying with the residual limb resting on a small pillow
o D. sidelying on the residual limb.
 55. A physical therapist receives a referral to ambulate a patient who is insulin dependent.
In a review of her medical record, you notice her blood glucose level for that day is 310
mg/dL. The therapist BEST course of action is to:
o A. ambulate the patient as planned but monitor closely for signs of exertional
intolerance.
o B. postpones therapy and consults with the nurse as soon as possible.
o C. Refrain from ambulating the patient, reschedule for tomorrow before other
therapist.
o D. Talk to the nurse about walking the patient later on that day after.

 56. A physical therapy plan of care for a newborn with Erb-Klumpke Palsy would NOT
include:
o A. Age appropriate movements of the upper extremity.
o B. Gentle ROM after immobilization.
o C. Partial immobilization of limb across abdomen.
o D. Splinting the shoulder in abduction and internal rotation.

 57. A six month-old child was referred to physical therapy for right torticollis. The
MOST effective method to stretch the muscle is by positioning the head and neck into:
o A. extension, left side-bending, and right rotation.
o B. extension, right side-bending, and left rotation.
o C. flexion, left side-bending, and left rotation.
o D. Flexion, right side-bending, and left rotation.

 58. A student you are supervising is on final affiliation following completion of academic
training. He is overheard discussing a patient’s history in the elevator. When you later
point this out to the student, he tells you he was unaware of any hospital policy regarding
confidentiality. Your BEST analysis of this situation is that:
o A. Compliance was not a realistic expectation since the student just had recently
arrived at this facility.
o B. The student should be expected to value patient confidentiality.
o C. Now that the student is aware of confidentiality restrictions, compliance is
expected.
o D. Since this is not strictly part of the professional code of ethics, the student
should not be expected to demonstrate adherence to this concept.
 59. A therapist is performing clinical research in which a specific myofascial technique is
applied to a patient with chronic back pain. She is using a single case experimental design
with an A-B-A-B format. Her research hypothesis states that pain rating scores will
decrease with the treatment intervention. Acceptance of this hypothesis would be
indicated if:
o A. B is equal to A.
o B. B is greater than A, at the .05 level.
o C. B is greater than A, at the 1.0 level.
o D. B is less than A.

 60. A patient is recovering from stroke and demonstrates good recovery in his lower
extremity (out-of-synergy movement control). Timing deficits are apparent during gait.
Isokinetic training can be used to improve:
o A. initiation of movement.
o B. rate control at varying movement speeds.
o C. rate control at slow movement speeds.
o D. both reaction and movement times.

 61. A 72 year-old patient with a transfemoral amputation is having difficulty wrapping

the residual limb. The therapist’s BEST course of action is to:
o A. apply a temporary prosthesis immediately.
o B. Consult with the vascular surgeon about the application of an Unna’s paste
dressing.
o C. Redouble efforts to teach proper ace bandage wrapping.
o D. use a shrinker.

 62. A 75 year-old patient with peripheral vascular disease has been referred for
conditioning exercise. The patient demonstrates moderate claudication pain in both legs
following a 12 minute walking test. The MOST appropriate exercise frequency and
duration for this patient is:
o A. 2 times/week, BID 20 minutes/session.
o B. 3 times/week, 30 minutes/session.
o C. 3 times/week, 60 minutes/session.
o D. 5 times/week, BID 10 minutes/session.
 63. The radiographic view shown in the diagram that demonstrates the observed spinal
defect is (Twomey L, Taylor J (2000) Physical Therapy of the Low Back, 3rd ed.
Philadelphia, Churchill Livingstone, Figure 7-1, page 204, with permission):
o A. Frontal.
o B. Lateral.
o C. Oblique.
o D. posterolateral.

 64. A physical therapist is working with a patient with metastatic breast cancer who has
been told that she has only months to live. She is quite angry and disruptive during
therapy. What is the MOST appropriate intervention for this patient?
o A. allows the patient to express her anger while refocusing her on effective coping
strategies.
o B. forbids all expressions of anger as she is only hurting herself.
o C. Provide honest, accurate information about her illness and rehab plan of care.
o D. provides opportunities for the patient to question her impending death but limit
all expressions of anger.

 65. A forty year-old female cafeteria worker sustained a right-sided injury to her back
while playing golf. She was driving the ball when she felt an immediate sharp pain in her
right low back. She states that in the morning she is stiff and her pain eases after taking a
shower. Based on the above information, the structure MOST likely involved is:
o A. A stress fracture.
o B. A facet joint impingement.
o C. A nerve root compression.
o D. Diminished blood supply to the spinal cord.

 66. At 10 a.m. a physical therapist working on a spinal cord unit is treating a patient with
paraplegia at the T3 level. The therapist smells alcohol on his breath and the patient is
having difficulty accomplishing a bed-to-chair transfer that was previously done without
assistance. In this case the physical therapist should:
o A. confronts the patient and asks if he has been drinking.
o B. Document and report suspicions of alcoholism to the rehabilitation team at the
weekly meeting.
o C. Document the findings and immediately inform the patient’s physician about
the situation.
o D. Question the patient’s family about any history of alcoholism.
 67. A patient with right hemiparesis has difficulty clearing the affected foot during the
swing phase of gait. An appropriate physical therapy intervention for the right lower
extremity might include:
o A. Assumption of bridging.
o B. forward step-ups in standing using graduated height steps.
o C. pushing backward while sitting on a rolling stool.
o D. Sitting on a Swiss ball, alternating lateral side steps and back to neutral.

 68. A 19 year-old patient has a complete spinal cord injury at the level of L1. His primary
goal is to walk again. You decide it would be MOST appropriate to recommend that this
patient use:
o A. A reciprocating gait orthosis and walker.
o B. A wheelchair, because ambulation is unrealistic.
o C. Bilateral AFOs and Lofstrand crutches.
o D. Bilateral KAFOs with thoracolumbosacral extension control.

 69. A patient is four weeks post myocardial infarction. Resistive training using weights to
improve muscular strength and endurance is appropriate:
o If exercise intensities are kept below 85% maximal voluntary contraction.
o If exercise capacity is greater than 5 METs with no angina symptoms/ ST
segment depression.
o During all phase of rehabilitation if judicious monitoring of HR is used.
o Only during post-acute phase 3 cardiac rehabilitation.

 70. A patient diagnosed with cervical radiculitis has been referred to you for mechanical
traction. You are applying the traction using the cervical halter for 5 minutes at 20° neck
flexion using 10 pounds. The patient complains of pain in the area of the TMJ. You
should:
o A. Change the angle of pull.
o B. Decrease the traction poundage.
o C. decrease the treatment time.
o D. Discontinue the treatment.

 71. On the first day following a cesarean delivery, the physical therapist’s initial
intervention would consist of teaching the new mother:
o A. Ankle exercises to prevent thrombophlebitis.
o B. assisted ambulation.
o C. Assisted breathing and coughing and pelvic floor exercises.
o D. Partial sit-ups and pelvic floor exercises.
 72. It is important to note the status of the pars interarticularis on the X-ray report. A
problem with this part of the vertebra could possibly lead to:
o A. spondylolisthesis with discal herniation.
o B. spondylolisthesis with possible slippage of the vertebral body.
o C. Spondylolysis resulting in early nerve root compression.
o D. Spondylolysis with early degeneration of the vertebra.

 73. The most appropriate school physical therapy intervention to use during class for a 9
year old child with decreased sitting balance, but normal tone would be to:
o A. sitting in adaptive wheelchair with lateral supports and lap tray.
o B. Standing on a static prone-stander with lap tray.
o C. sitting in appropriate height chair with lateral postural supports.
o D. Sitting on a therapeutic ball while performing desk-top activities.

 74. A patient with Parkinson’s disease demonstrates a highly stereotyped gait pattern
characterized by impoverished movement. The intervention that would be LEAST
appropriate to use with this patient is:
o Standing, using body weight support from a harness
o Sidestepping and cross stepping using touch-down support of hands.
o Gait training using a rolling walker.
o Rhythmic stepping using a motorized treadmill.

 75. A patient is recovering from a right CVA. She tells the therapist that she is thirsty and
asks you for a can of soda. When the therapist gives her the can and instructs her to open
it, she is unable to complete the task. Later after the treatment session when she is alone
the therapist observes her drinking from the can. The therapist suspect she may have a
primary deficit in:
o A. anosognosia.
o B. Ideational apraxia.
o C. Ideomotor apraxia.
o D. Unilateral neglect.
 76. Peer review is an important professional activity. Recently, physical therapists have
been the focus of vigorous peer review due to increasing financial pressure imposed by
third party payers. An inappropriate use of peer review is to determine whether care:
o A. Should be paid for by a third party payer.
o B. Was appropriate and required the skill of a physical therapist.
o C. Was cost effective.
o D. was provided by the appropriate personnel.

 77. A 62 year-old patient has chronic obstructive pulmonary disease. Pulmonary test
results include all of the following except increased:
o A. Functional residual capacity.
o B. Residual volume.
o C. Total lung capacity.
o D. FEV1/FVC ratio.

 78. A patient with a transfemoral amputation is being fitted with a prosthesis that utilizes
a quadrilateral socket. During prosthetic checkout the physical therapist should examine
pressure tolerance areas of the residual limb with the device off. These include:
o A. Distolateral end of femur and ischial seat.
o B. adductor magnus and medial side of residual limb.
o C. ischial tuberosity and lateral sides of residual limb.
o D. perineal area and medial side of the residual limb.

 79. A patient recently diagnosed with fibromyalgia and chronic fatigue immune system
dysfunction demonstrates a loss of interest in all activities and outlets. She is not eating
well and is having problems sleeping. Recently she has talked about suicide as her only
hope. Your BEST course of action is to:
o A. Refer her to a fibromyalgia support group.
o B. Refer her to an occupational therapy intervention group.
o C. Immediately contact her primary physician.
o D. Present a positive attitude and tell her she will feel better soon.
 80. A 77 year-old patient has been confined to bed for a period of 2 months and now
demonstrates limited ROM in both lower extremities. Range in hip flexion is 5º to 115º
and knee flexion is 10º to 120º. The MOST appropriate intervention to improve
flexibility and ready this patient for standing is:
o A. Tilt table standing, 20 minutes, daily.
o B. Hold-relax techniques followed by passive ROM, 10 repetition,2 times a day.
o C. Manual passive stretching, 10 repetitions each joint, 2 times a day.
o D. Mechanical stretching using traction and 5 lb. weights, 2 hours, twice daily.

 81. A retired carpenter who has had long term lumbar pain with a previous diagnosis of
degenerative joint disease (DJD) of his lumbar facet joints. He complains of numbness,
paresthesias and weakness of his bilateral lower extremities which increase with extended
positions or walking greater than 100 feet. His pain persists for hours after assuming a
resting position. He reports he can ride his stationary bike for 30 minutes without any
problems. Primary physical therapy intervention should include:
o A. abdominal and back extension strengthening as the result of spondylolysis.
o B. Increasing cardiovascular endurance as the result of degenerative arthritis.
o C. Stretching and limiting extended spinal positions as the result of spinal
stenosis.
o D. Traction and limitation of weight bearing positions as the result of discal
dysfunction.

 82. A physical therapist is instructing a kindergarten teacher in a behavior management

program for a child with developmental disabilities who has been mainstreamed into the
regular classroom. The therapist requests that the teacher encourage the child to maintain
a head retracted sitting position in the class. The strategy that would be MOST helpful in
this situation is to:
o A. Have the teacher encourage the classmates to tell the child to sit up in the
chair.
o B. Have the teacher give a smile sticker when the child sits with head retracted for
five minutes.
o C. Have the teacher issue a verbal reprimand when the child slumps in the chair.
o D. Train the teacher in manual handling techniques to assist the child in head
retraction.
 83. A physical therapist has recently attended a professional conference on myofascial
release. The therapist has been asked to share this information with PT colleagues during
an inservice session. The therapist’s BEST initial activity is to:
o A. Ask colleagues to select a suitable time and place for the physical therapist’s
lecture.
o B. Survey colleagues about their current level of knowledge using a brief
questionnaire.
o C. Provide a comprehensive packet of handouts in advance of the first inservice
session.
o D. Ask colleagues to select a suitable time and place for the physical therapist’s
lecture.
o Organize a powerpoint presentation and prepare a handout.

 84. A patient who is 3 months post CVA is being treated in physical therapy for adhesive
capsulitis of the right shoulder, Today, the patient complains of new symptoms including
burning pain in the right upper extremity that is increased by the dependent position
along with lowered pain threshold and heightened sensitivity to light touch. The right
hand is mildly edematous and the skin is dry and warm to touch. The intervention that
should be AVOIDED in this case:
o A. Stress loading activities with weight bearing in the affected limb.
o B. Passive manipulation of the shoulder.
o C. Positional elevation, compression, and gentle massage.
o D. Active assistive ROM exercises of the shoulder

 85. To prepare a patient with an incomplete T12 paraplegia for ambulation with crutches,
the upper quadrant muscles that would be MOST important to strengthen include the:
o A. deltoid, triceps, and wrist flexors.
o B. lower trapezius, latissimus dorsi, and triceps.
o C. Middle trapezius, latissimus, dorsi and triceps.
o D. Upper trapezius, rhomboids, and levator scapulae.

 86. A 72 year-old is recovering at home from a myocardial infarction and percutaneous

transluminal coronary angioplasty. The physical therapist, decide to use pulse oximetry to
monitor his responses to exercise and activity. An acceptable oxygen saturation rate
(SaO2) to maintain throughout the exercise period is:
o A. 82%.
o B. 75%.
o C. 92%.
o D. 85%.
 87. A 42 year-old homemaker presents with acute lateral epicondylitis following
participation in a local tennis tournament. Pain is 9/10. The MOST appropriate initial
intervention for this problem is:
o A. Cold intermittent compression three times per week.
o B. Cold whirlpool daily until the pain subsides
o C. Fluidotherapy three times per week
o D. Ice massage B.I.D. until the pain subsides

 88. A patient was referred to physical therapy complaining of loss of cervical AROM.
His X-rays showed DJD at the uncinate processes in the cervical spine. The motion that
would be MOST restricted would be:
o A. extension.
o B. Flexion.
o C. rotation.
o D. Side-bending

 89. An electrician is unable to pull wire overhead due to a painless inability to reach past
80 degrees of right shoulder abduction. The empty can test was positive. Early subacute
physical therapy intervention should focus on:
o A. active assistive pulley exercises.
o B. Gentle grade IV translatory glenohumeral mobilizations.
o C. modalities to reduce pain and inflammation.
o D. Resistance exercises for the affected muscles.

 90. Two therapists are asked to perform a test on the same group of patients using the
Functional Independence Measure (FIM). The results of both sets of measurements reveal
differences in therapists’ scores but not in the repeat measurements. This is indicative of
a problem in:
o A. Concurrent validity.
o B. Construct validity.
o C. Interrater reliability.
o D. intrarater reliability.
 91. A patient is recovering from a complete spinal cord injury with C5 tetraplegia. The
physical therapist is performing PROM exercises on the mat when he complains of a
sudden pounding headache and double vision. The therapist notice he is sweating
excessively, and determines his BP is 240/95. PT’s BEST course of action is to:
o A. lie the patient down, open his shirt, and monitor his respiratory rate closely.
o B. lie the patient down immediately, elevate his legs, then call for a nurse.
o C. Place the patient in supported sitting position and continues to monitor BP
before calling help.
o D. sit the patient up, check/empty catheter bag, and then call for emergency
medical assistance.

 92. A 46 year-old patient presents with a flatfoot deformity with abduction of the forefoot
in relation to the weight bearing line. The forefoot is inverted to the varus position when
inspected from the frontal plane. Corrections for this foot deformity would NOT include
a:
o A. Metatarsal bar.
o B. Scaphoid pad.
o C. Thomas heel.
o D. UCBL insert.

 93. A 10-year old with full thickness burns to both arms is developing hypertrophic scars
The BEST intervention to manage these scars is:
o A. Application of Custom made pressure garments.
o B. Application of Occlusive dressings.
o C. A. primary excision followed by autografts.
o D. Application of compression wraps

 94. A patient with COPD has developed respiratory acidosis. You instruct the physical
therapy student who is participating in her care to monitor the patient closely for:
o A. Dizziness or lightheadedness
o B. disorientation.
o C. Hyperreflexia
o D. Tingling or numbness of the extremities.
 95. A 34 year-old female in her second trimester of pregnancy was sent to physical
therapy with complaints of tingling and loss of strength in both of her hands. Her
symptoms are exacerbated if she is required to use her keyboard at work for longer than
20 minutes. The MOST appropriate physical therapy intervention would include:
o A. Dexamethasone phonophoresis to the carpal tunnel.
o B. Hydrocortisone iontophoresis to the volar surfaces of both wrists.
o C. ice packs to the carpal tunnel.
o D. Placing the wrists in resting splints.

 96. A child you are working with in the elementary school system has moderate to severe
extensor spasticity and limited head control. The MOST appropriate positioning device
would be a:
o A. prone stander with abduction wedge.
o B. Supine stander with abduction wedge.
o C. wheelchair with a back wedge and head supports.
o D. wheelchair with adductor pommel.

 97. A patient with complete C6 quadriplegia should be instructed to initially transfer with
a sliding board using:
o A. pectoral muscles to stabilize elbows, scapular depressors to lift trunk.
o B. Serratus anterior to elevate trunk with shoulder extensors stabilizing.
o C. Shoulder extensors, external rotators, and anterior deltoid to position and lock
the elbow.
o D. Shoulder depressor and Triceps, keeping the hands flexed to protect tenodesis
grasp.

 98. You have volunteered to teach a stroke education class on positioning techniques for
family members and caregivers. There will be 12 individuals attending this class, ranging
in age from 42 to 82. Your BEST choice of teaching methods is to utilize:
o A. therapist demonstration, caregiver practice, and follow-up individual
discussion.
o B. question and answers addressing the specific individual concerns of the
caregiver.
o C. Multimedia (powerpoint slides and handouts) to accompany an oral
presentation.
o D. therapist demonstration with caregiver role-playing patients.
 99. A patient with active tuberculosis is referred for physical therapy. Which of the
following is NOT an appropriate precaution?
o A. have the patient wear a tight fitting mask while being treated in his room.
o B. insure that the patient is in a private, negative pressurized room.
o C. Wash hands upon entering and leaving the patient’s room.
o D. Wear a tight fitting mask while treating the patient.

 100. A twelve-year old female figure skater has been referred to your clinic for treatment
for patellar tendinitis. The examination reveals that she is unable to hop on the affected
lower extremity due to pain. You decide to refer her back to her pediatrician suggesting
that the patient receive an x-ray of her knee. The patient returns for therapy with the x-ray
shown in the figure. Your initial intervention should focus on: Magee D (2002).
Orthopedic Physical Assessment, 4th ed. Philadelphia, W. B. Saunders, Figure 12-149,
page 746, with permission.
o A. Aggressive plyometric exercises with focus on endurance training.
o B. fitting patient with crutches for non-weight-bearing ambulation and initiation
of using hydrocortisone phonophoresis.
o C. iontophoresis using dexamethasone and patient education regarding avoidance
of squatting and jumping.
o D. Patient education regarding avoiding falls onto her affected knee and open
chain knee extension exercises to improve quadriceps strength.
Questions and Answers

 1. A 40 year-old male with a history of low back pain has been receiving physical therapy
for 12 weeks. The patient is employed as a loading dockworker. He performs repetitive
lifting and carrying of boxes weighing between 15 and 30 pounds. An appropriate
engineering control to reduce the stresses of lifting and carrying would be to:
o A. issue the employee a back support belt.
o B. Provide a two-wheel handcart for use in moving the boxes.
o C. Require the worker to attend a class in using correct body mechanics while
performing the job.
o D. Use job rotation.

 2. Common compensatory postures you would expect for a patient diagnosed with fixed
severe forefoot varus are:
o A. Excessive ankle dorsiflexion and medial rotation of the femur.
o B. excessive midtarsal supination and lateral rotation of the tibia.
o C. Subtalar pronation and medial rotation of the tibia.
o D. Toeing-in and lateral rotation of the femur.

 3. A patient has undergone surgery and subsequent immobilization to stabilize the

olecranon process. The patient now exhibits an elbow flexion contracture. In this case, an
absolute CONTRAINDICATION for joint mobilization would be:
o A. empty end-feel.
o B. Firm end-feel.
o C. soft end-feel.
o D. Springy end-feel.

 4. A physical therapist observes a physical therapist assistant ambulate a patient for the
first time after a left total hip replacement. The patient is using crutches and is practicing
on a level surface. The PTA should guard the patient by standing slightly:
o A. Behind and to the intact side, one hand on the gait belt.
o B. behind and to the left side, one hand on the gait belt.
o C. Behind the patient with both hands on the gait belt.
o D. in front of the patient, walking backward, with one hand on the gait belt and
one hand on the shoulder.
 5. A 13 year-old severed the median nerve three days ago when his hand went through a
glass window. To determine the motor function of the nerve you perform a chronaxie
test. At this time you would expect the chronaxie of the nerve to be:
o A. Absent.
o B. Decreased.
o C. Increased.
o D. unaffected.

 6. A patient has lumbar spinal stenosis encroaching on the spinal cord. The physical
therapist should educate the patient to AVOID:
o A. bicycling on hills.
o B. Use of Rowing machine.
o C. swimming using a crawl stroke.
o D. Tai Chi activities.

 7. A patient with post-polio syndrome presents in your clinic with symptoms of myalgia
and increasing fatigue. He is wearing a KAFO which he has had for 10 years. When
walking, you observe that he rises up over the sound limb to advance the orthotic limb
forward. Your BEST intervention is to provide:
o A. a manual wheelchair with reclining back and elevating legrests.
o B. A shoe lift on the orthotic side.
o C. a shoe lift on the sound side.
o D. an electric wheelchair with joystick.

 8. Your patient has moderate spasticity of the biceps brachii on the left as a result of a
CVA. You choose to use electrical stimulation to temporarily decrease the effects of
hypertonicity in order to work on ADL activities. Your objective in applying the current
is to:
o A. fatigue the ipsilateral biceps brachii.
o B. Stimulate the contralateral biceps brachii.
o C. Stimulate the contralateral triceps.
o D. Stimulate the ipsilateral triceps.

 9. You are working with a four year-old child who has myelodysplasia at the L5 level. At
this level the most appropriate orthosis to recommend for ambulation would be a (an):
o A. Ankle-foot orthosis.
o B. Knee-ankle-foot orthosis.
o C. parapodium.
o D. Reciprocating gait orthosis.
 10. An eleven-year-old male was referred to physical therapy with complaints of vague
pain at his right hip and thigh which radiates to his knee. His AROM is restricted in
abduction, flexion, and internal rotation. A gluteus medius gait was observed with
ambulation for 100 feet. Appropriate PT intervention would include:
o A. closed-chain partial weight-bearing lower extremity exercises for slipped
capital femoral epiphysis.
o B. Hip joint mobilization to improve the restriction in motion as the result of
Legg-Calvé Perthe’s disease
o C. Open-chain strengthening of his right hip abductors and internal rotators for
avascular necrosis of the hip
o D. Orthoses to control lower extremity position as the result of femoral
anteversion.

 11. A researcher states that he expects that there will be no significant difference between
20 and 30 year-olds after a 12 week exercise training program using exercise heart rates
and myocardial oxygen consumption as measures of performance. The kind of hypothesis
that is being used in this study is a (an):
o A. directional hypothesis.
o B. experimental hypothesis.
o C. null hypothesis.
o D. Research hypothesis

 12. A physical therapist was treating a patient and the patient in the next bed was
uncomfortable and asked the therapist to move his leg. The therapist placed the leg on 2
pillows as requested by the patient. Unknown to the therapist this patient had a femoral
artery graft 2 days previously. As a result the graft became occluded and the patient was
rushed to surgery for a replacement. The patient claimed the therapist placed his leg too
high on the pillows causing the occlusion of the original graft and sued for malpractice.
The hospital administrator decided:
o A. It was the patient’s fault for requesting the position change and therefore
supported the action of the physical therapist.
o B. That the physical therapist was functioning according to common protocols of
the institution and thus supported the actions of the therapist.
o C. That the therapist was functioning outside the common protocols of the
hospital, and therefore did not support the actions of the physical therapist.
o D. to counter-sue the patient because he was responsible for requesting the
position change.
 13. A 26 year-old female has a 3 year history of multiple sclerosis. One of her disabling
symptoms is a persistent and severe diplopia which leaves her frequently nauseated and
immobile. An appropriate intervention strategy to assist her in successfully participating
in rehabilitation would be to:
o A. Give her a soft neck collar to limit head and neck movements.
o B. Give her special glasses which magnify images.
o C. have her close her eyes and practice movements without visual guidance.
o D. patch one eye.

 14. The MOST appropriate positioning strategy for a patient recovering from acute stroke
who is in bed and demonstrates a flaccid upper extremity is:
o A. sidelying on the sound side with the affected upper extremity flexed overhead.
o B. Sidelying on the sound side with the affected shoulder protracted, and arm
extended resting on a pillow.
o C. Supine with the affected arm flexed with hand resting on stomach.
o D. Supine with the affected elbow extended and arm positioned close to the side
of the trunk.

 15. A patient presents with a large plantar ulcer that will be debrided in the whirlpool.
The foot is cold, pale, and painless. The condition that would most likely result in this
clinical presentation is:
o A. Acute arterial insufficiency.
o B. chronic arterial insufficiency.
o C. Chronic venous insufficiency.
o D. Deep venous thrombosis.

 16. A patient has been referred to you following a fracture of the femur six months ago.
The cast was removed, but the patient was unable to volitionally contract the quadriceps.
You decide to apply electrical stimulation to the quadriceps muscle. Your choice of
electrode placement and electrical stimulation duty cycle (on:off ratio) would consist of:
o A. large electrodes, closely spaced; 10:30.
o B. large electrodes, widely spaced; 10:30.
o C. small electrodes, closely spaced; 10:30.
o D. Small electrodes, widely spaced; 10:10.
 17. While setting a patient up for cervical traction, the therapist notice a mole that is
brown and black with diffuse edges on the patient’s neck. The therapist should:
o A. Discontinue treatment and refer the patient back to the physician
o B. Continue with the traction and report the findings to the physician
immediately.
o C. Continue the treatment; however; document the skin condition.
o D. Tells the patient to have the physician inspect the mole.

 18. A 15 year-old male suffered traumatic brain injury and multiple fractures following a
motor vehicle accident. He is recovering in the intensive care unit. The physical therapist
referral requests PROM and positioning. On day 1 he is semi-alert and drifts in and out
while the therapist is working with him. On day 2 he is less alert and his status is
changing. Signs and symptoms that would require emergency consultation with a
physician include:
o A. decreasing consciousness with slowing of pulse and Cheyne-Stokes
respirations.
o B. Decreasing function of cranial nerves IV, VI, and VII.
o C. Developing irritability with increasing symptoms of photophobia,
disorientation and restlessness.
o D. Positive Kernig’s sign with developing nuchal rigidity.

 19. A physical therapist receives a referral for a 42 year-old patient who has a
neurapraxia involving the ulnar nerve secondary to an elbow fracture. Based on your
knowledge of this condition, you expect that:
o A. regeneration is unlikely because surgical approximation of the nerve ends was
not performed.
o B. Nerve dysfunction will be rapidly reversed, generally in 2-3 weeks.
o C. Regeneration is likely after 1-1(1/2) years.
o D. regeneration is likely in 6-8 months.

 20. After three weeks of teaching a patient how to ambulate with bilateral crutches and a
touch down gait, the therapist determine the most appropriate kind of feedback to give to
the patient is:
o A. Continuous feedback in ongoing verbal cuing during gait.
o B. immediate feedback given after each practice trials.
o C. intermittent feedback given at scheduled intervals, every other practice trial.
o D. Occasional feedback given when consistent errors appear.
 21. A home health physical therapist is treating an elderly. On this day, he is confused
with shortness of breath and generalized weakness. given his history of hypertension and
hyperlipidemia, the therapist suspect:
o A. He forgot to take his hypertension medication.
o B. he may be experiencing unstable angina.
o C. he may be presenting with early signs of myocardial infarction.
o D. his mental changes are indicative of early Alzheimer’s disease.

 22. Physical therapy intervention for a sixty-five year-old male patient with a recent
diagnosis of supraspinatus tendinitis with possible impingement syndrome of the right
shoulder should emphasize:
o A. Joint mobilization, use of ice, and rotator cuff strengthening.
o B. Modalities to reduce inflammation, active assistive range of motion exercises
using pulleys, and postural realignment.
o C. Reducing stresses to abnormal tissues by placing the right upper extremity in a
sling, use of ice, and rotator cuff strengthening.
o D. rest to reduce pain, iontophoresis, and strengthening of the rotator cuff
muscles.

 23. The recommended time duration for endotracheal suctioning is:

o A. 1 to 5 seconds.
o B. 10 to 15 seconds.
o C. 15 to 20 seconds.
o D. 5 to 10 seconds.

 24. An 82 year-old frail older adult is confined to bed in a nursing facility. He has
developed a small superficial wound over the sacral area. Since only small amounts of
necrotic tissue are present, the physician has decided to use autolytic wound debridement.
This is BEST achieved with:
o A. wound irrigations using a syringe.
o B. Sharp debridement.
o C. transparent film dressing.
o D. Wet-to-dry gauze dressing with antimicrobial ointment.
 25. A patient was instructed to apply conventional (high rate) TENS to the low back to
modulate a chronic pain condition. The patient now states that the TENS unit is no longer
effective in reducing the pain in spite of increasing the intensity to maximum. The patient
should now advise the patient to:
o A. Decrease the pulse duration.
o B. Increase the treatment frequency.
o C. Switch to low rate TENS.
o D. switch to modulation mode TENS.

 26. During initial standing a patient is pushing backward displacing the center-of-mass at
or near the posterior limits of stability. The most likely cause of this is contraction of the:
o A. spasticity of Gastrocnemius-soleus.
o B. contracture of Hamstrings.
o C. contracture of Hip extensors
o D. weakness of tibialis anterior/peroneals.

 27. A patient has been screened using a new test for the presence of a gene (ALG-2)
linked to Alzheimer’s disease. His physician reports he lacks the gene and should not be
at increased risk to develop the disease. Some years later he develops Alzheimer’s and a
repeat test reveals the presence of the gene. The results of the initial test can be
interpreted as:
o A. False negative test result.
o B. Historically inconclusive test result.
o C. High sensitivity error.
o D. High specificity error.

 28. A 62 year-old lives at home with his wife and adult daughter. He has recently been
diagnosed with multi-infarct dementia and is recovering from a fractured hip following a
fall injury. In initial interview with his wife, therapist would expect to find:
o A. Agitation and sundowning.
o B. History of steady progression of loss of judgment and poor safety awareness.
o C. History of sudden onset of new cognitive problems and patchy distribution of
deficits.
o D. Perseveration on a thought or activity.
 29. A fourteen-year-old girl complains of subpatellar pain after participation in an aerobic
exercise program for two weeks. Your examination shows a large Q angle, pain with
palpation at the inferior pole of the patella, and mild swelling at both knees. Physical
therapy intervention should promote:
o A. Hamstring strengthening.
o B. lateral patellar tracking.
o C. vastus lateralis strengthening.
o D. Vastus medialis muscle strengthening.

 30. The therapist receives a referral from an acute care physical therapist to treat a patient
with right hemiparesis in the home. The referral indicates that the patient demonstrates
good recovery: both involved limbs are categorized as stage 4 (Brunnstrom recovery
stages). He is ambulatory with an small-based quad cane. The activity that would be
MOST appropriate for a patient at this stage of recovery is:
o A. Sitting, marching in place (alternate hip flexion movements).
o B. Standing, picking the foot up behind and slowly lowering it.
o C. standing, small range knee extension to gain quadriceps control
o D. supine, bending the hip and knee up to the chest with some hip abduction.

 31. During a physical therapy session for low back pain, a 67 year-old patient tells you
that she has had urinary incontinence for the last year. It is particularly problematic when
she has a cold and coughs a lot. She has not told her doctor about this problem because
she is too embarrassed. Your BEST course of action is to:
o A. Examine the patient and proceed with her back treatment.
o B. Examine the patient, document impairments and discuss findings with the
doctor.
o C. examine the patient, document impairments, then send her back to her doctor.
o D. Refer the patient back to her doctor.

 32. During a sensory exam you determine that a patient complains of a dull, aching pain
but is not able to discriminate a stimulus as sharp or dull. Two-point discrimination is
absent. Based on these findings, the pathway that is intact is the:
o A. anterior spinothalamic tract.
o B. dorsal columns/neospinothalamic systems.
o C. fasciculus gracilis/medial lemniscus.
o D. Lateral spinothalamic tract.
 33. A patient is five days post-MI and is receiving inpatient cardiac rehabilitation.
Appropriate criteria for determining the initial intensity of exercise include:.
o A. Systolic BP less that 240 mmhg or Diastolic BP less than 110 mg.
o B. HR less than 120 beats/min and RPE less than 13.
o C. HR resting + 30 beats/min and PRE less than 14.
o D. greater than 1mm ST segment depression, horizontal or downsloping.

 34. A 73 year-old man has bilateral short transfemoral (AK) amputations and will require
a wheelchair for functional mobility in the home and community. An appropriate
prescription for his wheelchair includes:
o A. Increasing the seat depth by 2 inches to accommodate the length of the residual
limbs.
o B. Lowering the seat height by 3 inches.
o C. Placement of the drive wheels 2 inches anterior to the vertical back supports.
o D. Placement of the drive wheels 2 inches posterior to the vertical back supports.

 35. A multicenter study was done on the reliability of passive wrist flexion and extension
goniometric measurements using volar/dorsal alignment, ulnar alignment and radial
alignment. Significant differences were revealed between the three techniques. An
appropriate level for determining significant difference is a P value of:
o A. P=0.015
o B. P=0.05
o C. P=0.1
o D. P=0.5

 36. In treating a patient with a diagnosis of right shoulder impingement syndrome, the
therapist should not allow the patient to perform assisted repetitive overhead exercises
without FIRST:
o A. Modulate all pain.
o B. Active complete AROM in all the shoulder motion.
o C. instructs the patient in proper postural alignment.
o D. Implement a stretching program for the shoulder girdle muscles.
 37. An older person with a diagnosis of degenerative joint disease should understand his
disease, its progression, and its management. You will know your patient education has
been effective if he can tell you:
o A. Aerobic conditioning is not appropriate when pain is present and medications
must be used.
o B. Joint protection strategies are important but cannot reduce the expected loss of
function.
o C. Loss of ROM and immobility are expected and irreversible.
o D. Pain and stiffness are worse in the early morning and should decrease with
moderate activity.

 38. A 34 year-old patient is recently admitted to your facility with a diagnosis of

Guillain-Barré syndrome. In your initial examination, you expect to find:
o A. asymmetrical weakness with hyperreflexia, bulbar palsy.
o B. Glossopharyngeal and vagal paralysis with hyperactive jaw and snout reflexes.
o C. Sensory loss (stocking and glove distribution) with minor loss of motor
function.
o D. Symmetrical distribution of weakness, ascending with possible involvement of
lower cranial nerves.

 39. A 31 year-old patient presents with patellar tendinitis as a result of a mountain

climbing accident three weeks ago. The patient complains of pain on resisted knee
extension, stair climbing, and sit-to-standing movements. You choose to apply
iontophoresis using a pain medication with a positive charge. The correct current type,
polarity and active electrode placement is:
o A. Biphasic current with the cathode placed proximal on the tendon.
o B. low volt continuous current with the anode placed distal on the tendon.
o C. monophasic current with the anode placed on the tendon.
o D. monophasic current with the cathode placed on the tendon.

 40. A 52 year-old patient sustained a T10 spinal cord injury four years ago. During initial
examination you observe redness over the ischial seat that persists for 10 minutes when
not sitting. The BEST intervention in this case would be to:
o A. switch to a low density wheelchair foam cushion.
o B. re-emphasize the need for sitting push-ups performed every 10 minutes.
o C. Increase the wheelchair arm rest height which is adjustable.
o D. switch to a tilt-in-space wheelchair.
 41. A 16 year-old adolescent female was sent to physical therapy with a diagnosis of
anterior knee pain. Positive findings include pes planus, lateral tibial torsion and genu
valgum. The position the femur will be in is excessive:
o A. Abduction.
o B. Lateral rotation.
o C. medial rotation.
o D. retroversion.

 42. A 24 year-old patient in a coma recovering from traumatic brain injury is receiving
PROM exercises. The family is confused because the occupational therapist has told
them to do range of motion exercises in a different way than the physical therapist had
instructed. As the physical therapist it would be BEST to deal with this situation by
telling the family:
o A. the PT and OT supervisors will review and correct any discrepancies in the
exercise program.
o B. There is no need for them to worry and note the problem in the patient’s
record.
o C. to exercise the way you instructed until any differences can be worked out with
the occupational therapist.
o D. You will meet with the occupational therapist to discuss the exercise
approaches and you will let them know the outcome of the meeting as soon as
possible.

 43. A physical therapist is working with a 10 year-old girl with cerebral palsy. Part of the
exercises in her plan of care involve using the Swiss ball. The choice of educational
media that is BEST to use when instructing her in use of this device is:
o A. a oral presentation describing the Swiss ball positions.
o B. Photos of other children using the Swiss ball.
o C. A DVD of another child with cerebral palsy on a Swiss ball.
o D. printed handouts with stick figure drawings and instructions.

 44. A sport physical therapist is working with a local high school football game. During
the game, a player is tackled violently by two opponents. The therapist determine that the
player is unresponsive. the immediate course of action should be to:
o A. ask for help to log roll the player on his back while stabilizing his neck.
o B. Open the airway by using the chin-lift method.
o C. Stabilize the neck and flip back the helmet face mask.
o D. Summon emergency medical services.
 45. During a home visit, the mother of an 18 month-old child with developmental delay
and an atrio-ventricular shunt for hydrocephalus tells you that her daughter vomited
several times, was irritable and is now lethargic. Your BEST course of action is to:
o A. Call for emergency transportation and notify the pediatrician immediately.
o B. Give the child a cold bath to try and rouse her.
o C. have the mother give the child clear liquids since she vomited.
o D. Place the child in a sidelying position and monitor vital signs.

 46. A 24 year-old woman recently delivered twins on the obstetrical service of your
hospital. After delivery she has developed a 4 centimeter diastasis recti abdominis. The
BEST initial intervention for this problem is to teach:
o A. Gentle stretching of hamstrings and hip flexors
o B. pelvic floor exercises and sit-ups.
o C. Pelvic tilts and bilateral straight leg raising.
o D. Protection and splinting of the abdominal musculature

 47. The optimal position for ventilation of a patient with a C5 complete spinal cord injury
is:
o A. Semi Fowler’s
o B. Sidelying, head of bed elevated 45 degrees
o C. Sidelying, head of bed flat
o D. Supine, head of bed flat

 48. A 16 year-old patient with osteosarcoma is being seen in physical therapy for crutch
training. Her parents have decided not to tell her about her diagnosis. She is quite
perceptive and asks you directly if she has cancer and about her future. Your BEST
course of action is to:
o A. Change the subject and discuss the plans for that day’s treatment.
o B. Discuss her condition gently indicating her parent’s fears about not telling her
the diagnosis.
o C. schedule a conference with the doctor and family about her condition and your
discussions with the patient.
o D. tell the patient to speak directly with her doctor.
 49. Your patient has a 2 year history of amyotrophic lateral sclerosis and exhibit
moderate functional deficits. The patient is still ambulatory with bilateral canes but is
limited in his endurance. An important goal for the physical therapy plan of care should
be to prevent:
o A. Further gait deterioration as a result of ataxia.
o B. Further functional loss as a result of Myalgia.
o C. Overwork damage in weakened, denervated muscle.
o D. Radicular pain and paresthesias.

 50. A 28 year-old patient has extensive full thickness burns to the dorsum of the hand and
forearm. He is to be fitted with a resting splint to support his wrists and hands in a
functional position. An appropriately constructed splint positions the wrist and hand in:
o A. neutral wrist position with IP extension and thumb flexion.
o B. Neutral wrist position with slight finger flexion and thumb flexion.
o C. slight wrist extension with fingers supported and thumb in partial opposition
and abduction.
o D. Slight wrist flexion with IP extension and thumb opposition.

 51. Your patient is 82 years-old with a long history of congestive heart failure. You are
alert to the signs of left-sided heart failure associated with activity. The MOST important
indicators include:
o A. bilateral ankle swelling within 2-3 hours post exercise.
o B. complaints of fatigue with increasing dyspnea and cough.
o C. Nausea and anorexia.
o D. Sudden weight gain within 24 hours following exercise.

 52. A patient using an incentive spirometer complains of feeling lightheaded. Your

instructions to the patient should be to:
o A. lie down while using the spirometer.
o B. Take a deeper breath on the following attempt.
o C. take a rest period and only use the device 10 times per hour.
o D. Try to use the spirometer more frequently to get used to it.
 53. An eighteen month-old child with Down Syndrome and moderate developmental
delay is being treated at an Early Intervention Program. Daily training activities that
should be considered include:
o A. Stimulation to postural extensors in sitting using rhythmic stabilization
o B. Locomotor training using body weight support and motorized treadmill
o C. holding and weight shifting in sitting and standing using tactile and verbal
cueing.
o D. Rolling activities , initiating movement with stretch and tracking resistance.

 54. A patient has been referred to you for acute shoulder pain after shoveling snow in a
driveway for two hours. Positive findings include pain and weakness with flexion of an
extended upper extremity as well as scapular winging with greater than 90 degrees of
abduction. The patient’s problem is MOST LIKELY the result of:
o A. Compression of the long thoracic nerve.
o B. compression of the suprascapular nerve.
o C. Subdeltoid bursitis.
o D. supraspinatus tendinitis.

 55. A patient with multiple sclerosis demonstrates strong bilateral lower extremity
extensor spasticity in the typical distribution of antigravity muscles. You would expect
this patient to demonstrate:
o A. sacral sitting with increased extension and adduction of lower extremities.
o B. Sitting with both legs abducted and externally rotated.
o C. Sitting with the pelvis laterally tilted, with increased weight bearing on ischial
tuberosities.
o D. skin breakdown on the ischial tuberosities and lateral malleoli.

 56. A 58 year-old woman with osteopenia has been on Premarin for the past 4 years.
Based on your knowledge of estrogen replacement therapy, you recognize this patient is
more susceptible to:
o A. fractures.
o B. Osteoporosis.
o C. Peripheral edema.
o D. Vasomotor symptoms (hot flashes).
 57. A 24 year-old pregnant woman who is 12 weeks pregnant asks you if it is safe to
continue with her aerobic exercise. Currently she jogs 3 miles, 3 times a week and has
done so for the past 10 years. Your BEST answer is:
o A. Continue jogging only until the 5th month of pregnancy.
o B. jogging is safe at mild to moderate intensities while vigorous exercise is
contraindicated.
o C. swimming is preferred over walking or jogging for all phases of pregnancy.
o D. jogging is safe as long as target HR does not exceed 140 beats/min.

 58. A patient with grade 2 quadriceps strain returns to physical therapy after his first
exercise session complaining of muscle soreness that developed later in the evening and
continued into the next day. He is unsure he wants to continue with exercises. The
therapist can minimize the possibility of this happening again by using :
o A. Concentric exercises, 3 sets of 10, at 80% of maximal intensity.
o B. Concentric exercises, 3 sets of 10, with gradually increasing intensity.
o C. Eccentric exercises, 1 set of 10, lifting body weight (sit-to-stand).
o D. Eccentric exercises, 3 sets of 10, with gradually increasing intensity.

 59. Upon examining a patient with vague hip pain which radiates to the lateral knee, you
have found a negative FABERE test, negative grind test, and a positive Noble
compression test. The dysfunction is most likely due to:
o A. A possible fracture of the femoral neck.
o B. An iliotibial band friction disorder.
o C. Degenerative joint disease of the hip.
o D. Sacroiliac joint dysfunction.

 60. A 22 year-old male suffered carbon monoxide poisoning from a work-related factory
accident. He is left with permanent damage to his nervous system, affecting the basal
ganglia. You logically expect his symptoms to include:
o A. impaired sensory organization of balance with the use of standing balance
platform training.
o B. Motor paralysis with the use of free weights to increase strength.
o C. Muscular spasms and hyperreflexia with the use of ice wraps.
o D. motor planning with the use of guided and cued movements.
 61. A patient presents with problems with swallowing. When you test for phonation by
having the patient say “AH” with his mouth open, you notice there is deviation of the
uvula to one side. You then test for function of the gag reflex and notice loss of response
to stimulation. These findings suggest involvement of the:
o A. Facial nerve.
o B. hypoglossal nerve.
o C. trigeminal nerve.
o D. vagus nerve.

 62. A patient with COPD is sitting in a bedside chair. The apices of the lungs in this
position compared with other areas of the lungs in this position would demonstrate:
o A. Increased perfusion.
o B. Increased volume of air at resting end expiratory pressure (REEP).
o C. The highest changes in ventilation during the respiratory cycle.
o D. the lowest oxygenation and highest CO2 in blood exiting this zone.

 63. Checkout for a lower limb orthosis includes inspection of the alignment of anatomic
and orthotic joints. During a sagittal plane check-out you determine that the orthotic hip
joint is malaligned. The correct position is:
o A. 3 inches below the anterior superior iliac spine.
o B. Just anterior and superior to the greater trochanter.
o C. Just posterior and inferior to the greater trochanter.
o D. lateral to the greater trochanter.

 64. A physical therapist assistant you supervise treated a patient in the home care setting.
The patient is status post CVA. Part of the plan of care includes “progressive gait training
on level surfaces”. The patient falls and sustains a fractured hip during a visit done by the
PTA. The fall occurred when the PTA took the patient on the stairs for the first time. The
responsible party in this case is:
o A. Both the PT and the PTA because the PT gave inadequate supervision, and the
PTA used poor judgment.
o B. Neither the PT nor the PTA because patients who have sustained a CVA are
always at high risk for falling, and thus it is a regrettable occurrence only.
o C. the PT who is negligent for failing to provide adequate supervision of the PTA.
o D. The PTA who is completely liable because the plan of care was altered without
communicating with the supervising PT.
 65. As the result of blunt trauma to the quadriceps femoris muscle, a patient experiences
loss of knee function. Early PT interventions should stress:
o A. Aggressive open-chain strengthening of the quadriceps femoris to regain
normal lower extremity strength.
o B. Aggressive soft tissue stretching to remove blood which has accumulated in
soft tissues.
o C. Gentle AROM exercises in weight bearing.
o D. Gentle PROM exercises in nonweightbearing to regain normal knee motion.

 66. An important adjunct to physical therapy management of a child with moderate

spastic hemiplegia would be use of:
o A. a Knee Ankle Foot Orthosis (KAFO)
o B. A posterior walker.
o C. A tone inhibiting ankle-foot orthosis (AFO).
o D. an anterior rollator walker.

 67. While evaluating the gait of a patient with right hemiplegia, you note foot drop during
midswing on the right. The MOST LIKELY cause of this deviation is:
o A. Decreased proprioception.
o B. Excessive extensor synergy.
o C. Excessive flexor synergy.
o D. inadequate contraction of the ankle dorsiflexors.

 68. A patient’s daughter wants to look at her father’s medical record. He has recently
been admitted for an insidious onset of low back pain. You, as the physical therapist,
should:
o A. Give her the chart and let her read it.
o B. Tell her she cannot see the chart because she could misinterpret the
information.
o C. Tell her that she must have the permission of her father before she can look at
the chart.
o D. Tell her to ask the physician for permission
 69. A 48 year-old female has had a total knee replacement. Following surgery, you place
her on a regimen of continuous passive motion. One of the main objectives in using
CPM in this case is to facilitate:
o A. Active knee extension.
o B. Active knee flexion.
o C. Active knee flexion.
o D. passive knee flexion.

 70. A 37 year-old male developed acute bicipital tendinitis two days after water skiing.
He is unable to work as a result of the pain he rates as 8/10. He is referred to physical
therapy for iontophoresis treatment to help relieve the pain. For the first two weeks this
patient should optimally be seen:
o A. Five times per week
o B. Once a week.
o C. three times per week.
o D. Two times per week

 71. PT observe genu recurvatum during ambulation in a patient with hemiplegia. The
patient has been using a posterior leaf spring (PLS) orthosis since discharge from
subacute rehab 4 weeks ago. PT has previously administered Fugl-Meyer assessment pf
physical performance and determined the lower extremity score to be 22 (out of possible
34) with strong synergies in the lower extremity and no out-of-synergy movement. The
most likely cause of this deviation is:
o A. Extensor spasticity.
o B. Hip flexion weakness.
o C. dorsiflexor spasticity.
o D. Hamstring weakness.

 72. During a home visit you are providing postural drainage in the Trendelenburg
position to a 15 year-old male with cystic fibrosis. The patient suddenly complains of
right-sided chest pain and shortness of breath. On auscultation, there are no breath sounds
on the right. The physical therapist should:
o A. Call emergency medical technicians as it may be a pneumothorax.
o B. Continue treating as it is possibly a mucous plug.
o C. Place the right lung in a gravity dependent position to improve perfusion.
o D. Reposition patient in the head of bed flat position as Trendelenburg is causing
shortness of breath.
 73. A 65 year-old patient with multiple sclerosis is being treated at home. The patient is
bedridden for most of the day with only short periods up in a bedside chair. Medicare is
funding the patient’s home care program which has as its primary goals maintaining
PROM and positioning to prevent deformity. Your role as the physical therapist is to
provide:
o A. a limited cardiovascular conditioning (sitting) program aimed at improving
respiratory capacity.
o B. a restorative exercise program aimed at improving upright sitting control and
improved functional independence.
o C. PROM exercises 2 times a day with additional family instruction to ensure
weekend coverage.
o D. Supervision of home health aides for completion of a daily home exercise
program.

 74. Your patient is a 72 year-old man with an 8 year history of Parkinson’s disease. He
demonstrates significant rigidity, decreased PROM in both upper extremities in the
typical distribution, and frequent episodes of akinesia. The exercise that BEST deals with
these problems would be:
o A. modified plantigrade, isometric holding, stressing upper extremity shoulder
flexion.
o B. PNF bilateral symmetrical upper extremity D2 flexion patterns, rhythmic
initiation.
o C. Quadruped position, upper extremity PNF D2 flexion and extension.
o D. Resistance training, free weights for shoulder flexors at 80% of 1 repetition
max.

 75. A 72 year-old patient with diabetes is recovering from recent surgery to graft a large
decubitus ulcer over the heel of her left foot. You are concerned that her loss of range at
the ankle (-5° to neutral) will limit her ambulation and independent status. One afternoon
you are very busy and request that one of the physical therapy aides do her range of
motion exercises. The aide is new to your department but tells you she is willing to take
this challenge on if you show her how to do it. Your BEST course of action is to:
o A. modify the treatment session to eliminate the ROM exercises and have the aide
walk the patient in the parallel bars.
o B. Perform the ROM exercises without delegating the task.
o C. Reschedule the patient for the next day.
o D. Take 5 minutes to instruct the aide in ROM exercises.
 76. A 12 year old child with moderate athetosis affecting the head, trunk, and upper
extremities and extensor spasm of the lower extremities is referred for mobility training.
The MOST appropriate type of adaptive equipment is:
o A. Posterior rollator walker and reciprocating gait orthoses.
o B. Scooter board.
o C. A wheeled prone stander.
o D. A manual wheelchair with custom-contoured seating system.

 77. The problems associated with ankylosing spondylitis in its early stages can best be
managed in physical therapy by:
o A. postural education.
o B. stretching of scapular stabilizers.
o C. Pain management
o D. joint mobilization

 78. A 72 year-old male was referred for rehabilitation following a middle cerebral artery
stroke. Based on this diagnosis you suspect he will present with:
o A. Decreased pain and temperature to the face and ipsilateral ataxia with
contralateral pain and thermal loss of the body.
o B. Contralateral hemiparesis and sensory deficits, arm more involved than the leg.
o C. Contralateral hemiparesis and sensory deficits, leg more involved than arm.
o D. Contralateral hemiplegia with thalamic sensory syndrome and involuntary
movements.

 79. The cardiac rehabilitation team is conducting education classes for a group of
patients. The focus is on risk factor reduction and successful life style modification. A
participant asks the physical therapist to help him interpret his cholesterol findings. His
total cholesterol is 220 mg/dL, his HDL cholesterol findings are 24 mg/dL, and his LDL
is 160 mg/dL. Analysis of these values reveal:
o A. the level of HDL, LDL, and total cholesterol are all abnormally high.
o B. LDL and HDL cholesterol levels are within normal limits and total cholesterol
should be below 200 mg /dL.
o C. the level of HDL, LDL, and total cholesterol are abnormally low.
o D. the level of LDL and total cholesterol are abnormally high and HDL
abnormally low.
 80. An attractive physical therapist is treating a young and handsome football player with
an ACL sprain. She is very fond of this patient and enjoys treating him. After a few visits,
the football player asks her out to dinner. The physical therapist’s response should be to:
o A. Thank him very much, and accept his offer for dinner.
o B. Thank him very much, and invite him for dinner at her apartment with other
guests.
o C. Thank him very much, but refuse his invitation while he is receiving treatment.
o D. Transfer the patient care to one of her colleagues and then go out to dinner
with him.

 81. After running one mile, an athlete complains of deep cramping at the anterior aspects
of the legs which does not ease and prevents continued running. Management of this
problem should include:
o A. orthotic fabrication to enable continued running on all surfaces
o B. referral to a physician to evaluate anterior compartment pressures during
activity.
o C. Referral to a physician to rule out spinal stenosis.
o D. Stretching of the tibialis anterior muscles to help resolve shin splints.

 82. A 62 year-old woman developed polio at the age of 6 with significant lower extremity
paralysis. She wore bilateral long leg braces for a period of 2 years. She then recovered
enough to stop using her braces but still required bilateral Lofstrand crutches, then
bilateral canes to ambulate. Recently she has been complaining of new difficulties (she
has had to start using her crutches again). You suspect post-polio syndrome. The BEST
goal/intervention for this patient based on her current findings is to:
o A. implement an aquatic therapy program consisting of daily 1 hour aerobics.
o B. initiate a lower extremity resistance training program utilizing 80% one
repetition max.
o C. instruct in activity pacing and energy conservation techniques.
o D. initiate a moderate conditioning program consisting of cycle ergometry 3 times
a week of 60 minutes at 75% maximal heart rate.

 83. A patient diagnosed with lumbar spondylosis without discal herniation or bulging has
a left L5 neural compression. The most likely structure compressing the nerve root is:
o A. anterior longitudinal ligament.
o B. Ligamentum flavum.
o C. posterior longitudinal ligament.
o D. Supraspinous ligament.
 84. During an exercise tolerance test (ETT) a patient demonstrates poor reaction to
increasing exercise intensity. According to the American College of Sports Medicine, an
absolute indication for terminating this test is:
o A. 1.5 mm of downsloping ST-segment depression.
o B. Fatigue and shortness of breath.
o C. Onset of moderate to severe angina.
o D. Supraventricular tachycardia.

 85. A patient with T10 paraplegia is receiving daily ROM exercises. On this day you
notice swelling, pain, local warmth and erythema in the thigh near the hip joint with some
limitation in motion. Your BEST course of action is:
o A. Apply ice before his ROM exercises to ease his pain and discomfort and
inflammation.
o B. Document the findings in his record and double his daily sessions of ROM
exercises.
o C. instruct his aides to be more vigorous in positioning and ROM exercises.
o D. Notify the physician immediately, you suspect heterotopic ossifications may be
developing.

 86. A patient with a T4 spinal cord injury is being measured for a wheelchair. In
determining the correct seat height you can use as a measure:
o A. Clearance between the floor and the foot plate of at least 2 inches.
o B. Clearance between the floor and the foot plate of at least 4 inches.
o C. The distance from the bottom of the shoe to just under the thigh at the popliteal
fossa.
o D. The patient’s leg length measurement plus four inches.

 87. A 6 year-old boy has a diagnosis of Duchenne muscular dystrophy and is still
ambulatory. The MOST appropriate activity to include in his plan of care would be:
o A. Circuit training using resistance training and conditioning exercise.
o B. Progressive resistance strength training.
o C. Recreational physical activities such as swimming.
o D. Wheelchair sports.
 88. A 72-year old patient is receiving outpatient physical therapy at your private clinic.
The clinic is an approved Medicare outpatient provider. Your patient is concerned that
she will not be able to pay for her continuing care and worries that her Medicare benefits
will run out soon. You tell her:
o A. Coverage is limited only for hospital-based outpatient PT services.
o B. Currently there is no limit to her Medicare coverage for outpatient PT services.
o C. there is currently a limit of $1000.00 for coverage of outpatient PT services.
o D. there is currently a limit of $1590.00 for coverage of outpatient PT services.

 89. Your patient is a 42 year-old woman who suffered a stroke and demonstrates a
locked-in state characterized by spastic quadriplegia and bulbar palsy. To facilitate
communication with this patient you should instruct the family to:
o A. give her a chance to mouth her responses even though she can’t vocalize well.
o B. look closely at her facial expression to detect signs communication.
o C. Use a communication board with minimal hand movements.
o D. Encourage use of eye movements to signal letters.

 90. After performing an ergonomic examination of a worker and workstation the most
appropriate recommendation for achieving ideal wrist and elbow positioning would be to:
o A. Add armrests.
o B. Elevate the keyboard to increase wrist flexion.
o C. lower the keyboard to increase wrist extension.
o D. maintain the keyboard in a position allowing a neutral wrist position.

 91. A 43 year-old patient with a post myocardial infarction is on digitalis to improve

cardiac contractility. He is a new participant in your Phase 2 outpatient cardiac
rehabilitation program. He is being continuously monitored by ECG via radio telemetry.
On his ECG, the medication induced changes that could be expected are:
o A. Decreased heart rate with prolonged QRS and QT intervals.
o B. Depressed ST segment with a flat T wave and shortened QT interval.
o C. elevated ST segment with T wave inversion.
o D. widened QRS complex with a flattened P wave.
 92. Your patient has lymphatic disease of the right arm secondary to radical mastectomy
and radiation. The resulting edema can BEST be managed in physical therapy by:
o A. AROM and extremity positioning in a functional arm/hand position.
o B. intermittent pneumatic compression, extremity elevation, and massage.
o C. isokinetic and extremity positioning in elevation, and massage.
o D. isometric exercises and extremity positioning in elevation, and compression
bandaging.

 93. You have been treating a patient for chronic subluxation of the patella in the
outpatient clinic. He is now scheduled for a lateral release and is worried about any
complications of the surgical procedure. He asks you to describe any potential
complications. Your BEST response is to:
o A. Do a search on the internet and get back to the patient with the desired
information.
o B. Explain how patients you have treated responded to the surgery.
o C. refer the patient to a physical therapy colleague who specializes in knee
problems.
o D. Suggest that the patient speak with his surgeon.

 94. A 46 year-old female was referred for physical therapy following a right breast
lumpectomy with axillary lymph node dissection. Scapular control is poor when upper
extremity flexion or abduction is attempted. PT intervention should focus on:
o A. Active assistive pulley exercises to assist rotator cuff muscles as a result of
damage to the suprascapular nerve.
o B. Gravity assisted right upper extremity exercises to promote scapular control
following damage to the long thoracic nerve.
o C. rhomboid strengthening as a result of disuse of the scapular stabilizers.
o D. Strengthening of the right deltoids to help stabilize the shoulder to compensate
for damage to the dorsal scapular nerve.

 95. A post surgical patient is receiving a regimen of postural drainage three times a day.
You could reduce the frequency of treatment if the:
o A. Amount of productive secretions decreases.
o B. consistency of the sputum changes.
o C. patient becomes febrile.
o D. Patient experiences decreased postoperative pain.
 96. The distinguishing feature of Mèniére’s disease which sets it apart from other
peripheral conditions affecting the vestibular system is:
o A. chronic, episodic bouts of dysfunction.
o B. postural instability.
o C. Significant dysfunction with severe attacks of vertigo and nausea.
o D. time-limited, usually lasting only 24-48 hours.

 97. A physical therapist arriving at work one hour before she was due to start work,
began moving treatment tables and rearranging the physical therapy clinic. This operation
could have been done during regular hours. The therapist sustained a low back injury as a
result of moving the equipment. Payment for the therapist’s care relating to this incident
would be covered primarily by:
o A. Employee’s health insurance.
o B. The hospital’s insurance company.
o C. The therapist’s own resources.
o D. Workers’ Compensation.

 98. Patients diagnosed with Paget’s disease typically have similar symptomatology to
spinal stenosis. The most important aspect of physical therapy intervention emphasizes:
o A. Lumbar extension exercises.
o B. Modalities to decrease pain.
o C. postural reeducation to prevent positions that increase symptoms.
o D. Strengthening exercises for the abdominals and back muscles.

 99. A patient with spastic left hemiplegia experiences severe genu recurvatum during
stance phase. If the patient is using an ankle-foot orthosis, the cause of the problem might
be attributed to:
o A. The anterior stop setting the foot in too much dorsiflexion.
o B. The anterior stop setting the foot in too much plantar flexion.
o C. the posterior stop setting the foot in too much dorsiflexion.
o D. the posterior stop setting the foot in too much plantarflexion.

 100. A patient has arterial peripheral vascular disease with symptoms of intermittent
claudication in both lower extremities. Which of the following is NOT an appropriate
guideline for exercise training?
o A. Daily walking through pain in order to attain predetermined distances.
o B. Daily walking, 2 to 3 times a day.
o C. Interval training protocol with frequent rests.
o D. stopping exercise and resting once the pain threshold is reached.
Additional questions in my exam:

 Following major surgery of the right hip, a patient ambulates with a Trendelenburg gait.
Examination of the right hip reveals abductor weakness and ROM limitations in flexion
and external rotation. As a part of the intervention, the therapist opts to include functional
electrical stimulation to help improve the gait pattern. Stimulation should be initiated for
the :
o A. Right abductors during swing on the right
o B. Right abductors during stance on the right
o C. Left abductors during stance on the right
o D. Left abductors during swing on the right

 Ober test check the integrity of which muscle?

o Tensor Fasciae Latae (TFL) and Iliotibial band (ITB)

 Navicular drop test check the integrity of which muscle?

o Medial longitudinal arch (to assess the height of the navicular bone).

 As a therapist progresses through their examination it is becoming evident that a current

patient is anterior cruciate ligament (ACL) deficient in the right knee. Which of the
following tests would be unnecessary to perform in order to determine if ACL was
ruptured?
o A. Lachman’s test.
o B. Anterior drawer test
o C. slocum’s test.
o D. Lateral pivot shift test.

 Which of the following is not considered knee joint stabilizer?

o A. Anterior cruciate ligament.
o B. quadriceps muscle
o C. popliteus muscle.
o D. semitendinosus

(The dynamic stabilisers of the knee are all the muscles and their aponeuroses including:
– quadriceps femoris and extensor retinaculum, pes anserinus, popliteus, biceps femoris, semi-
membranosis. The ligaments which all act as static stabilisers include the medial collateral
ligament, the lateral collateral ligament, the ACL, PCL, the oblique popliteal and arcuate
ligament)