Practice Questions 1

1. Release of confidential information from a medical record without the patient’s consent is illegal if it involves
A. the patient’s employer.
B. another therapist involved in peer review.
C. the patient’s insurance company.
D. a social worker.

2. You are evaluating an athlete who is complaining of pain in the left shoulder region. Your assessment of the
shoulder elicits pain in the last 30 degrees of shoulder abduction range of motion. this finding is most
congruent with
A. calcific supraspinatus tendinitis.
B. subacromial bursitis.
C. acromioclavicular sprain.
D. thoracic outlet syndrome.

3. Following a cerebrovascular accident involving the dominant right hemisphere, a patient exhibiting
unilateral neglect would generally not
A. eat food only from the right side of the plate.
B. bump a one-arm driven wheelchair into things on the left side.
C. ignore or deny the existence of the left-sided limbs.
D. shave or put make-up only on the left side of the face.

4. A patient with spastic left hemiplegia experiences recurvatum during stance phase. If the patient is using an ankle-
foot orthosis, the cause of the problem might be attributed to
A. not enough limitation by the posterior stop.
B. not enough limitation by the anterior stop.
C. too much limitation by the posterior stop.
D. too much limitation by the anterior stop.

5. Students in clinical settings are held to the standard of practice that is equivalent to
A. a licensed physical therapist.
B. that of a foreign-educated physical therapist.
C. physical therapist assistants.
D. physical therapy aides.

6. To help decrease shear when transferring a patient with a spinal cord injury from bed to chair, it would be best
to use
A. a draw sheet.
B. skin lubricant on involved skin surfaces.
C. an air mattress.
D. a sheepskin pad.

7. Teaching pursed-lip breathing as part of the treatment regimen would be most appropriate for a patient with
A. circumferential thoracic burns.
B. asbestosis.
C. radiation pneumonitis.
D. emphysema.

8. If a patient with above-knee prosthesis has a prosthetic foot with a plantarflexion bumper that is too hard,
during ambulation, the
A. prosthesis would rotate internally at heel strike.
B. prosthetic foot would remain dorsiflexed during the gait cycle.
C. prosthetic foot would remain plantarflexed during the gait cycle.
D. prosthetic knee would not flex sufficiently during stance.

IER-
 2 Practice

9. Prior to performing manual traction in the cervical region, one should perform a test for vertebral
artery insufficiency in order to ascertain the adequacy of blood supply to the
A. vertebrae.
B. upper extremities.
C. spinal canal.
D. brain stem.

10. A snowmobile left the trail and struck a tree. The driver’s left knee was fully flexed and the tibia impacted
with the inside front of the snowmobile. This mechanism of injury would most likely result in a
A. dislocated patella.
B. sprained or ruptured posterior cruciate ligament.
C. sprained or ruptured anterior cruciate ligament.
D. rupture of the popliteal artery.

11. A patient with a transtibial amputation of 2 months duration complains to you of an intense burning pain that
seems to emanate from his heel. This phantom pain mirrored preoperative pain which was the result of
previous damage to the
A. dorsalis pedis artery.
B. popliteal artery.
C. peroneal nerve.
D. tibial nerve.

12. Following the reduction of development dysplasia of the hip in an infant, the physical therapist should instruct
the parents to maintain that hip in a stable position of
A. flexion and adduction.
B. flexion and abduction.
C. extension and adduction.
D. extension and abduction.

13. The quality assurance committee has found that 72 % of the inpatients receiving physical therapy showed
no improvement in function. To discover the cause of this high rate, it would be best if the committee check
A. the source of referrals.
B. patient diagnoses.
C. appropriateness and consistency of the physical therapy service.
D. age of the patients.

14. To prepare a patient with a cauda equina lesion for ambulation with crutches, the upper quadrant muscles
that would be most important to strengthen would be the
A. upper trapezius, rhomboids and levator scapulae.
B. deltoid, coracobrachialis, and brachialis.
C. middle trapezius, serratus anterior, and triceps.
D. lower trapezius, latissimus dorsi and pectoralis major.

15. When examining the upper quarter of a 52 year-old female patient, the therapist detects a small lump in the
axilla. There is no mention of this lump in the medical record. The next thing the therapist should do is
A. tell the patient she may have cancer and to call her physician immediately.
B. stop the examination and refer the patient back to her physician.
C. complete the examination and document the lump.
D. complete the examination, document the lump and refer the patient to her physician.

16. You have been treating a 61 year-old woman over a period of four months for adhesive capsulitis, which has
resulted in a “frozen shoulder”. Her recovery has been good, however, she still complains that she cannot
reach the upper shelves in her kitchen cupboards and closets. To help her achieve his goal, joint mobilization
should focus on
A. inferior glide.
B. posterior glide.
C. anterior glide.
D. grade II oscillations.

IER-
 Practice 3

17. Which activity would not help to break up lower extremity synergy combinations in a patient with hemiplegia?
A. Balance training in a kneeling position.
B. Backward leg lifts with the knee extended on the affected side.
C. Bridging in the hooklying position.
D. Rolling from a hooklying position.

18. A new student physical therapist and her supervising therapist are overwhelmed by a sudden increase in
the number of new patients attending a group exercise class. In this situation it would be best to
A. cancel the class and reschedule the new patients for individual evaluations.
B. allow the student to conduct the class while the supervisor evaluates the new patients.
C. allow the student to assist, in an appropriate way, with the management of the class.
D. assign the student to a less busy therapist while the supervisor concentrates on managing the class.

19. In managing the residual limb of a 72 year-old patient with a transfemoral amputation, the most important factor
to consider is
A. contracture of hip musculature.
B. residual limb shape.
C. muscle atrophy.
D. residual limb healing.

20. A 54 year-old male, with a long history of cigarette smoking, has been admitted to the hospital and presents
with signs of infection, tachycardia, abnormal breath sounds in both lower lobes and dullness to percussion. The
physical therapist’s major concern and focus with this patient is
A. getting the patient to quit smoking.
B. breathing reeducation to increase efficiency of ventilation.
C. airway clearance and secretion removal.
D. graded inspiratory muscle training.

21. A patient with adhesive capsulitis of the glenohumeral joint should demonstrate the greatest limitation of motion
when performing shoulder
A. flexion.
B. abduction.
C. medial rotation.
D. lateral rotation.

22. During a treatment session in a rehabilitation hospital a patient asks the physical therapist assistant to let him
see the physical therapy progress notes in his medical record. The physical therapist assistant should
A. refuse to let the patient see the record.
B. allow the patient to see the notes.
C. get the permission of the physical therapist supervisor before giving the patient the chart.
D. contact the patient’s physician and explain the situation.

23. If a chest tube gets dislodged during physical therapy treatment and the therapist fails to cover the defect,
the patient could develop:
A. pulmonary embolism
B. pulmonary edema
C. pneumothorax
D. aspiration pneumonia

24. Following a motor vehicle accident, a patient with chest trauma developed atelectasis. To help in the
immediate management of atelectasis, it would not be appropriate to implement:
A. pain reduction techniques
B. segmental breathing
C. incentive spirometry
D. paced breathing

IER-
 4 Practice

25. Following a reattachment of the flexor tendons of the fingers, one physical therapy goal is to minimize adhesion
formation. A few days after surgery, with the patient in a splint, the physical therapist should teach the patient
to perform:
A. passive extension and active flexion of the interphalangeal joints
B. active extension and flexion of the interphalangeal joints
C. active extension and passive flexion of the interphalangeal joints
D. gentle passive extension and flexion of the interphalangeal joints

26. The most functional way to teach an individual with a T4 complete paraplegia to transfer from wheelchair to
mat is by using a:
A. stand pivot technique
B. squat pivot technique
C. sliding board
D. back-out technique

27. Your plan of care includes use of iontophoresis in the management of calcific bursitis of the shoulder.
To administer this treatment using the acetate ion, the current characteristics and polarity should be:
A. monophasic twin peaked pulses using the positive pole
B. monophasic twin peaked pulses using the negative pole
C. continuous monophasic using the positive pole
D. continuous monophasic using the negative pole

28. If a therapist is planning to establish a new private physical therapy practice, it is best to first:
A. do a community needs assessment
B. outline a budget to determine how much of a business loan is required
C. seek an ideal location or building site for the practice
D. circulate a brochure informing physicians and other practitioners of this new service.

29. A friend of yours is an avid tennis player. She telephones and asks you to help her reduce the possibility
of developing tennis elbow. As a physical therapist, the best way to respond to your friend is to:
A. describe exercises and proper tennis techniques during the phone conversation
B. in your spare time, watch her play tennis and, after analysis, offer specific suggestions as to how to
minimize the risk of developing tennis elbow
C. invite her to your clinic for an evaluation and instruction in appropriate exercises and stretches if indicated
D. send her an illustrated pamphlet dealing with tennis elbow prevention and treatment including other
suggested readings

30. Following a mastectomy, a sixty=three year=old female developed massive edema of the arm on the involved
side. A compression garment was ordered to help the situation. To help decrease the edema, this garment must
exert enough pressure to:
A. decrease the osmotic pressure of the capillaries.
B. increase the capillary permeability
C. exceed the internal tissue hydrostatic pressure
D. equal the fluid outflow from the capillaries

31. A family is caring for a child with a diagnosis of spina bifida. The physical therapist should write the
home program assuming a familial education reading level at the:
A. 2nd – 3rd grade
B. 5th – 6th grade
C. 8th – 9th grade
D. 11th – 12th grade

32. During a cold winter day, an outpatient slipped and fell on the ice at the entrance to your outpatient clinic.
Before beginning the rehabilitation for a knee injury, the patient says he feels a bit sore, but he can proceed with
the treatment. As his physical therapist you should:
A. cancel the treatment for the day
B. start the treatment after noting the incident in the patient’s record
C. briefly re-examine the patient prior to any treatment
D. have the patient call his physician to get clearance for physical therapy treatment

IER-
 Practice 5

33. Twenty-four hours following a major thermal burn, a patient experiences syncope while the physical
therapist works on positioning as part of edema management. The syncope is most likely a result of
A. orthostatic hypotension
B. extreme pain
C. intravascular hypovolemia
D. massive infection

34. If you are treating a patient with active infectious Hepatitis B, transmission of the disease is best minimized if
you take precautions to avoid:
A. direct contact with the patient’s blood or blood-contaminated equipment
B. direct contact with any part of the patient
C. droplet spread of the organisms by coughing
D. direct contact with patient’s hands

35. You are working in a school setting as a physical therapist. A supervisor asks you to organize a
scoliosis screening program. It would be best to asses:
A. 2nd or 3rd graders
B. 6th or 7th graders
C. high school freshmen or sophomores
D. high school juniors or seniors

36. A candidate for admission to a physical therapist assistant program was ranked at +1.0 standard deviations
above the mean among all applicants. Interpretation of the class rank, using a normal curve would indicate that
this candidate’s position is:
A. as good or better than 84% of the other candidates
B. lower than 34% of the other candidates
C. within the top 6% of all candidates
D. within the top 14% of all candidates

37. Use of continuous ultrasound at 1.5 Watts/cm2 will result in:

A. no change in nerve conduction velocity
B. increase in motor nerve conduction velocity and decrease in sensory nerve conduction velocity
C. decrease in motor nerve conduction velocity and increase in sensory nerve conduction velocity
D. increase in both motor and sensory nerve conduction velocity

38. Your spinal cord injury unit within a rehabilitation hospital is preparing for accreditation visits.
Accreditation would fall principally under the jurisdiction of the:
A. Joint Commission on Accreditation of Healthcare Organizations and Occupational Safety &
Health Administration
B. Commission on Accreditation of Rehabilitation Facilities and Occupational Safety & Health Administration
C. Commission on Accreditation of Rehabilitation facilities and the US Department of Health and
Human Services
D. Joint Commission on Accreditation of Healthcare Organizations and Commission on Accreditation
of Rehabilitation Facilities

39. It is most likely than when treating a patient with Lyme Disease of more than one year’s duration, the
physical therapy focus will be on management of arthritic changes primarily affecting the:
A. small joints of the hands and feet
B. large joints of the body; especially the knee
C. axial joints, especially the lumbosacral spine
D. axial joints, especially the cervical and thoracic spine

40. As a physical therapist working with a variety of special needs students in a high school setting, the long term
goal that should take the highest priority in the plan of care is that the students should be:
A. independent in taking off and putting on outerwear at the start and finish of the school day
B. able to independently change from classroom to classroom in the allotted time period
C. independent in the purchasing and consumption of lunch in the school cafeteria
D. independent in getting on and off the school bus

IER-
 6 Practice

41. Just after birth, you observe a full-term infant in the neonatal intensive care unit. In the supine position, the
shoulders are abducted and externally rotated, elbows and fingers are flexed, hips are abducted and
externally rotated and knees are flexed. This posturing would seem to indicate that the:
A. upper extremity tone is abnormal
B. lower extremity tone is abnormal
C. tone is abnormal in both upper and lower extremities
D. tone is normal in both upper and lower extremities

42. A patient has a fused right knee and placement of an Intramedullary rod in the right femur. In this case,
ascending stairs with crutches would best be accomplished by instructing the patient to:
A. face forward, advance the lower left extremity first followed by hiking and circumducting the right
lower extremity
B. face forward, advance the right lower extremity first by hiking and circumducting followed by placement
of the left lower extremity
C. face backwards to the stairs and advance the right lower extremity first by hiking and circumducting
followed by hiking of the left lower extremity
D. face sideward, grasp the banister and advance the right lower extremity first by hiking and abducting
followed by placement of the left lower extremity onto the stair below the right lower extremity.

43. While ambulating a patient in the parallel bars, the patient suddenly falls and suffers a severe laceration in the
area of the lateral distal right thigh. To help control bleeding you should apply pressure directly over the wound
and:
A. behind the knee at the popliteal fossa
B. at the femoral triangle
C. at the antecubital fossa
D. at midthigh, directly over the profunda femoris artery

44. While gait training a patient following a cerebral vascular accident, you observe the knee on the affected side
going into recurvatum during stance phase. The most likely cause of this deviation can be attributed to:
A. severe spasticity of the hamstrings or weakness of the gastrocnemius-soleus.
B. weakness or severe spasticity of the quadriceps
C. weakness of the gastrocnemius-soleus or spasticity of the pretibial muscles
D. weakness of both the gastrocnemius-soleus and pretibial muscles

45. You are organizing a group exercise session in a therapeutic pool. Use of the pool would be contraindicated for a
group member who has:
A. an indwelling catheter
B. paraparesis and is on a regular bowel program
C. unstable blood pressure
D. an open skin lesion, even if it is covered by waterproof dressing

46. A child with spastic diplegia is now independent in using a walker. Additional goals desired by the physical
therapist include increasing the child’s energy-efficiency and velocity while ambulating. In this case, the selection
of walker that is most likely to help improve these factors is:
A. a standard anterior walker with no wheels
B. an anterior rollator walker with two wheels
C. a posterior rollator walker with two wheels
D. a posterior rollator walker with four wheels

47. The major purpose of having an incident or occurrence report system in a health care facility is for the purpose of:
A. satisfying legal and regulatory authorities
B. satisfying the facility’s insurance carrier mandate
C. corporate accountability
D. risk management

IER-
 Practice 7

48. Following a myocardial infarction, a patient was placed on medications, which included a beta-adrenergic
blocking agent. When monitoring this patient’s responses to exercise, you would expect that this drug will
cause:
A. heart rate to be low at rest and rise very little with exercise
B. heart rate to be low at rest and rise continuously to expected levels as exercise intensity increases
C. systolic blood pressure to be low at rest and not rise with exercise
D. systolic blood pressure to be within normal limits at rest and progressively fall as exercise intensity increases

49. A neonate’s APGAR score at one minute after birth is 8 and four minutes later is 9. You would expect that this
baby would probably:
A. have a heart rate of less than 100 beats per minute with slow and irregular respirations and not
require resuscitation
B. require extensive resuscitation efforts including intubation
C. require some resuscitation and administration of supplemental oxygen
D. have a heart rate of greater than 100 beats per minute, good respiration and require resuscitation

50. Immediately contact appropriate authorities if you:

A. suspect a patient had been driving under the influence of alcohol
B. suspect a patient has been abusing cocaine
C. notice illegal drug paraphernalia on a table next to a patient during a home visit.
D. believe a patient might be a victim of battered child syndrome

51. You are involved in the management of a young adult who is comatose (Glasgow Coma Scale 3) and is in a
nursing home for custodial care. One day, you notice that the patient is beginning to demonstrate
decerebrate posturing. You recommend that this patient:
A. be rehospitalized in an acute care facility for reevaluation and intense physical therapy
B. be transferred to a rehabilitation hospital for more intense physical therapy
C. be transferred home with evaluation and treatment by a home health team
D. remain in the nursing home since there is not functional change of status

52. A physical therapy note states: “A patient ambulates independently with crutches on level surfaces and on stairs.
The patient lacks endurance to walk up more than one floor at a time; however, this should increase with
practice. The patient says he lives on the fourth floor and there is no elevator. Will work to increase endurance
prior to discharge.” In the SOAP format, the “A” of the note is:
A. will work to increase endurance
B. endurance should increase with practice
C. patient lives on the fourth floor with no elevator
D. patient ambulates independently with crutches

53. To prevent contracture in a newly admitted 8 year-old with anterior neck burns, it would be best to position
the neck in:
A. hyperflexion
B. slight flexion
C. neutral
D. extension

54. You are treating a 54 year-old woman for degenerative arthritis of the left knee. Her medical record indicates
that she is on estrogen replacement therapy. In this case, you should consider that this patient might be more
susceptible to:
A. coronary artery disease
B. osteoporosis
C. clinical depression
D. weight gain

55. You are instructing a new mother to perform range of motion and stretching on her newborn who has a
clubfoot. You would advise her to carefully stretch in the direction of:
A. plantarflexion and inversion
B. plantarflexion and eversion
C. dorsiflexion and inversion
D. dorsiflexion and eversion

IER-
 8 Practice

56. The normal end-feel associated with full elbow extension can be classified as:
A. empty
B. capsular
C. springy block
D. bone-on-bone

57. If a patient had normal quadriceps strength; but, unilateral weakness (3/5) of the hamstring muscles, during
swing phase you might observe:
A. excessive compensatory hip extension on the sound side
B. decreased hip flexion followed by increased knee flexion on the weak side
C. excessive hip extension followed by abrupt knee extension on the weak side
D. excessive hip flexion followed by abrupt knee extension on the weak side

58. Following cast immobilization for a now healed supracondylar fracture of the humerus, a patient’s elbow lacks
mobility. To increase elbow range of motion, joint mobilization in the maximum loose-packed position should be
performed at:
A. full extension
B. 90 degrees of flexion
C. 70 degrees of flexion
D. 30 degrees of flexion

59. A patient with quadriplegia at the C6 level should be instructed to transfer using a sliding board with her:
A. forearms pronated, wrists and fingers extended
B. forearms pronated, wrists extended and fingers flexed
C. forearms pronated, wrists and fingers flexed
D. forearms supinated, wrists and fingers extended

60. Upon removing a dressing covering a decubitus ulcer, you observe copious amounts of a foul-smelling
yellow/green discharge. You should note in this patient’s medical record that:
A. there is likelihood of a Staphylococcus aureus infection
B. there is likelihood of a Pseudomonas aeruginosa infection
C. the would was purulent
D. there was serosanguinous discharge

61. A patient wishes to improve her aerobic fitness. She currently jogs four days a week for 30 minutes at 70% of
her age-predicted maximum heart rate. The recommendation that would not result in improved aerobic fitness is:
A. increasing the distance covered in the same 30 minutes
B. increasing the jogging time to 45 minutes while keeping at 70% of the age-predicted heart rate
C. changing to interval training with maximum burst of running for 15 seconds, followed by a 30 second rest.
Complete 4 sets per day, 4 days per week.
D. changing to interval training for 4 days per week by doing 90 seconds of comfortable running followed by
90 seconds of rest for a period of 30 minutes

62. A gymnast comes to physical therapy. Her chief complaint is nagging, localized pain in the left lower leg,
which is present at night and increases during activity. This complaint is most characteristic of:
A. bone tumor
B. anterior compartment syndrome
C. shin splints
D. stress fracture

63. Four days following open heart surgery, a patient is being treated in the physical therapy department.
He complains of some chest discomfort during treatment and wishes to return to his room. You should:
A. call his physician immediately
B. complete the treatment and have an aide transport him back to his room as some discomfort is expected
C. call the nurse and check to see if the discomfort is to be expected
D. immediately transport the patient back to his room yourself and inform nursing services of the
patient’s complaint

IER-
 Practice 9

64. A patient who is to undergo surgery for a chronic shoulder dislocation asks you to explain the advantages and
disadvantages of the various surgical reconstructive procedures used to alleviate the problem. Your best
response is to:
A. give the patient as much information about the procedures as you currently know
B. explain how patients you have treated responded to the surgery
C. tell the patient to ask the surgeon for this information since this precise information is outside the scope
of physical therapy practice
D. refer the patient to another therapist in the department who is an expert on shoulder
reconstructive rehabilitation

65. A patient’s peripheral skin color progresses from blue to white to red. This would be most characteristic of:
A. chronic venous insufficiency
B. acute venous insufficiency
C. acute arterial insufficiency
D. vasomotor disorders

66. You see a patient who had a CVA two weeks ago. The patient has motor and sensory impairments primarily in
the opposite lower extremity. There is some confusion and perseveration. Based on these findings, the vascular
problem can be characterized as:
A. transient ischemic attack
B. internal carotid syndrome
C. anterior cerebral artery syndrome
D. middle cerebral artery syndrome

67. A hospital administrator asks for your help in dealing with a significant increase in back injuries suffered
by nurses and nurse’s aides as a result of lifting patients. The most efficient and effective way to address
this situation is by:
A. observing each nurse and nurse’s aide as they lift patients and provide immediate feedback about correct
lifting
B. providing a series of inservice experiences to all appropriate nursing personnel which covers lifting and
other ‘back-saving’ techniques
C. sending everyone on the nursing service a comprehensive booklet that teaches ‘back-saving’ techniques in
a step-by-step fashion.
D. reviewing proper techniques with nursing supervisors and have them evaluate all personnel under
their supervision.

68. In the management of systemic lupus erythematosus, the intervention that would not be appropriate would be
the use of:
A. nonsteroidal anti-inflammatory agents to control arthralgia
B. resting splints to decrease joint pain and prevent deformity
C. ultraviolet irradiation to help decrease the skin lesions and rash often associated with the disorder
D. endurance training to compensate for cardiopulmonary dysfunction that is often present with the disorder

69. A patient with degenerative joint disease of the right hip complains of pain in the anterior hip and groin, which is
aggravated by weightbearing. There is decreased range of motion and capsular mobility. Right gluteus medius
weakness is evident during ambulation and there is decreased tolerance of functional activities including
transfers and lower extremity dressing. In this case, a capsular pattern of joint motion should be evident by
restriction of hip:
A. flexion, abduction and internal rotation
B. flexion, adduction and internal rotation
C. extension, abduction and external rotation
D. flexion, abduction and external rotation

70. Confirmation of a diagnosis of spondylolisthesis can be made when viewing an oblique radiograph of the
spine. The tell-tale finding is:
A. posterior displacement of L5 over S1
B. bamboo appearance of the spine
C. compression of the vertebral bodies of L5 and A1
D. bilateral pars interarticularis defects

IER-
 1 Practice

71. A physical therapist and physical therapist assistant are conducting a cardiac rehabilitation session for
twenty patients. The therapist is suddenly called out of the room. The physical therapist assistant should:
A. terminate the exercises and have the patients monitor their pulses until the therapist returns
B. have the patients continue with the same exercise until the therapist returns
C. have the patients switch to a less intense exercise until the therapist returns
D. continue with the outlined exercise progression for that session

72. When fitting a patient for adjustable axillary crutches, the measurement technique that would not be appropriate
to use is:
A. placing the patient supine and measuring from the anterior axillary fold to the bottom of the foot and adding 2
inches
B. placing the patient supine and measuring from the anterior axillary fold to a point 6 inches lateral to the foot
C. subtracting 16 inches from the height of the patient
D. placing the patient in standing with shoes on, and the crutches placed 6 inches lateral to the foot

73. A therapist wishes to study the progress of her patients with paraplegia who are discharged from a
rehabilitation setting. Starting with the patient’s discharge, and once a month for three years, the therapist will
measure their joint range of motion of both hips and knees. Accurate analysis of this time series study is
heavily dependent upon:
A. random sampling
B. interrater reliability
C. intrarater reliability
D. predictive validity of the measurements

74. A boutonniere deformity of the finger would not consist of

A. hyperextension of the proximal interphalangeal joint
B. overstretch of the extensor digitorum communis tendon
C. volar slippage of the lateral bands
D. hyperextension of the distal interphalangeal joint

75. You are evaluating a patient with chronic obstructive pulmonary disease. You would not expect to find:
A. the presence of hypercapnia
B. increased total lung capacity
C. increased vital capacity
D. abnormal ventilation/perfusion ratio

76. When using a patellar-tendon-bearing prosthesis, a patient will experience excessive knee flexion in early stance
if the:
A. socket is aligned too far anteriorly
B. socket is aligned too far posteriorly
C. foot is outset excessively
D. foot is inset excessively

77. A patient exhibiting flexible pes valgus would most benefit from a combination of shoe modifications
consisting of a:
A. rocker bar, scaphoid pad and lateral sole wedge
B. reverse Thomas heel, metatarsal bar and medial sole wedge
C. Thomas heel, medial sole wedge and scaphoid pad
D. rocker bar, metatarsal pad and Thomas heel

78. An inpatient currently in an acute care facility is having her Medicare Part A benefits come to an end.
Medicare Part B will cover all except:
A. inpatient room and board in a rehabilitation hospital
B. inpatient therapy services in a rehabilitation hospital
C. outpatient therapy services in an acute care facility
D. outpatient therapy services in a private therapy practice

IER-
 Practice 1

79. You receive a referral from an osteopath to treat a patient for lower back pain. When giving feedback
regarding the patient’s progress in physical therapy you should contact the:
A. patient’s primary care physician
B. osteopath
C. primary care physician and the osteopath
D. patient’s general practitioner and osteopath

80. Following a hard tackle, a football quarterback exhibits signs of fractured ribs and a pneumothorax. In this
case, upon auscultation over the injured area, you would expect:
A. soft, rustling sounds on inhalation
B. decreased or no breath sounds
C. crackles on inhalation
D. wheezes on exhalation

81. A 12 year-old girl with cystic fibrosis has been readmitted to the hospital in acute respiratory failure as a result
of an infection. Physical therapy, in the form of bronchial hygiene should:
A. not be administered since it is contraindicated in acute respiratory failure
B. be administered two times a day to the patient’s tolerance
C. be administered vigorously three times a day
D. be administered vigorously once every two hours at least six times a day

82. While ambulating a patient in the parallel bars, you lose control and the patient falls hitting her head on the bar.
The patient lies motionless on the floor between the bars bleeding heavily form a scalp laceration. The first
thing you should do is:
A. put thick gauze over and apply manual pressure to the scalp wound
B. check for responsiveness.
C. call Emergency Medical Services
D. immediately determine the patient’s heart rate and blood pressure

83. You are treating an outpatient three times per week. The physician’s referral indicated a diagnosis of acute
subdeltoid bursitis. Initial evaluation reveals active shoulder abduction is painful (8/10) and limited to 75O. After
Two weeks, pain is 5/10 and abduction is 95O. At the end of week three, pain is 6/10 and abduction is 88o. In this
case, you should:
A. modify the treatment and continue three times per week
B. modify the treatment and increase to five times per week
C. contact the physician and seek guidance since this patient is not progressing
D. discontinue treating this patient since it is unethical to treat a patient who is not benefiting from treatment

84. During pregnancy, the presence of the hormone relaxin can lead to abnormal movement and pain which
most frequently affect the:
A. glenohumeral joints
B. hip joints
C. lumbosacral joints
D. sacroiliac joints

85. A patient with angina pectoris has been instructed to use sublingual nitroglycerin in case of anginal attack. This
medication will help to ease the situation primarily by:
A. lowering blood pressure
B. decreasing resistance in the peripheral vasculature
C. increasing venous return
D. increasing cardiac afterload, thus decreasing the work of the heart

IER-
 1 Practice

86. An 8 year-old with severe spasticity in the lower extremities is to receive a new wheelchair. The patient is
average in height and weight for his age. Funding restrictions limit the selection to only the standard wheelchair
dimensions as supplied by the manufacturers. As the physical therapist you should recommend the selection of a:
A. narrow adult chair which allows for growth since funds for future new chairs will be scarce
B. junior chair with standard seat depth of 16 inches and seat width of 16 inches
C. child chair (sometimes known as a junior-13) with a standard seat depth of 13 inches and a seat width of
16 inches
D. tiny tot chair with a standard seat depth of 11.5 inches and a seat width of 12 inches

87. An occupation which requires a great deal of kneeling will be impacted the most if the diagnosis is:
A. Osgood-Schlatter Disease
B. plica syndrome
C. acute prepatellar bursitis
D. iliotibial band friction syndrome

88. Three days following a cerebral vascular accident, a patient is supine in bed. It would be best to position the
upper extremity so that the:
A. scapula is protracted and upwardly rotated and the shoulder is abducted and externally rotated
B. scapula is protracted and upwardly rotated and the shoulder is abducted and internally rotated
C. scapula is retracted and downwardly rotated and the shoulder is adducted and internally rotated
D. scapula is retracted and downwardly rotated and the shoulder is abducted and externally rotated

89. An acceptable modified position to drain the posterior basal segment of the left lower lobe is to position
the patient:
A. sidelying on the right, with a pillow under the right hip and the bed flat.
B. prone, with a pillow under the hips and the bed flat
C. sidelying on the right, with a pillow between the legs and foot of the bed elevated 18 inches
D. prone, with a pillow under the hips and the bed elevated 18 inches

90. When the ankle is forcibly inverted and plantarflexed, the ligament that is most frequently disrupted is the:
A. deltoid
B. anterior talofibular
C. posterior talofibular
D. calcaneofibular

91. A therapist cut her finger with a kitchen knife and on the same morning was scheduled to do open wound care on
a patient who has HIV. In this case she should:
A. not treat the patient
B. bandage her cut with an occlusive dressing and don gloves normally
C. treat using normal standard precautions
D. double glove

92. A physical therapist notes in the medical record that a patient she is treating is receiving a new medication.
The therapist is unfamiliar with this medication. To determine its purpose it would be best if the therapist first:
A. called the patient’s physician
B. asked the nurse in charge of the patient
C. called the pharmacist
D. asked the patient during the treatment session

93. You are performing a physical examination of a patient in a custodial care facility, which includes observation of
a lesion on the left heel (see image below). Based on the characteristics of the wound, you would classify it as a:
A. stage I lesion
B. stage II lesion
C. stage III lesion
D. stage IV lesion

IER-
 Practice 1

94. The clinical status of a truck driver with a posterior herniated nucleus pulposus has improved if:
A. peripheral pain increases only when lumbar extension is attempted
B. peripheral pain occurs only with straight leg raising
C. pain centralizes with passive hyperextension of the spine
D. there is flattening of the lumbar lordosis

95. You are working with a patient with ALS who has a tendency to aspirate foods. You should advise the
caregiver that:
A. hyperextension of the neck makes swallowing easier
B. warmer solid food aspirates more readily than cooled solid food
C. solid foods aspirate more readily than liquid foods such as soup
D. liquid foods, such as soup, aspirate more readily than solid food

96. When instructing the family of a 9 year-old boy with Duchenne muscular dystrophy, the main emphasis in
the lower extremities should be placed on:
A. strengthening the knee extensors and plantarflexors
B. strengthening the plantarflexors and stretching the hip extensors
C. stretching the hip flexors and plantarflexors
D. strengthening the hip flexors and knee extensors

97. An 18 year-old female soccer player, with a Q angle in excess of 30 degrees, exhibits patello-femoral tracking
problems. While playing soccer, it would be best if she wore a:
A. patellar stabilizing brace with a lateral buttress
B. patellar stabilizing brace with a medial buttress
C. neoprene sleeve with a patellar cutout
D. derotation brace

98. A 69 year-old man with diabetes mellitus has had a Stage III decubitus ulcer over the right ischial tuberosity
for the past five months. The ulcer is infected with Staphylococcus aureus and necrotic tissue covers much of
the wound. The physical agent that would be the least helpful and not usually recommended to treat this
problem would be:
A. low voltage, constant microamperage direct current
B. high voltage monophasic pulsed current
C. whirlpool
D. moist hot packs

99. In treating a 5 year-old with spastic diplegia, as part of the program, relaxation might be accomplished by:
A. use of rhythmic stabilization
B. slow rocking
C. inhibition of parasympathetic fibers
D. facilitation of sympathetic fibers

100. Capsular tightness has limited your patient’s ability to fully extend her left knee. Treatment to restore joint
motion should emphasize:
A. anterior glide and external rotation of the tibia
B. anterior glide and internal rotation of the tibia
C. posterior glide and external rotation of the tibia
D. posterior glide and internal rotation of the tibia

101. While administering a phonophoresis treatment to a patient with subdeltoid bursitis, the patient informs you
that she is HIV positive. This information was not part of the patient’s record. It would be best to:
A. discontinue the treatment since phonophoresis may be harmful in this case.
B. discuss this patient at the next staff meeting
C. continue treating the patient as usual
D. refer this patient back to the orthopedic physician who is apparently unaware of her HIV status

IER-
 1 Practice

102. The results of isokinetic dynamometry indicate that a patient can generate a peak torque of 120 with her
right quadriceps muscle and only 80 with her right hamstring musculature. This situation indicates that:
A. quadriceps torque generation is excessive
B. hamstring torque generation is insufficient
C. both quadriceps and hamstring torque generation is excessive
D. torque generation is proportionally correct

103. When using ultrasound in treating chronic bursitis of the hip, the most benefit might occur if the
ultrasound frequency and dosage were:
A. 1 MHz and 1.5 Watts/cm2
B. 1 MHz and 0.5 Watts/cm2
C. 3 MHz and 1.5 Watts/cm2
D. 3 MHz and 0.5 Watts/cm2

104. A patient presents with a red, beefy granulating wound. The dressing that would be inappropriate to apply is:
A. occlusive
B. wet-to-wet
C. hydrophilic
D. wet-to-dry

105. When performing underwater ultrasound, the most important safety factor is that the:
A. part being treated is not immersed in a metal tank
B. transducer head keeps moving
C. ultrasound apparatus is connected to a ground fault interruption circuit
D. piezoelectric crystal is not cracked

106. When recommending a wheelchair for a patient with a lesion at T11 resulting in paraplegia, the modification
least needed by a patient with this disability would be:
A. swing away foot rests
B. high seat back
C. pneumatic tires
D. caster locks

107. Damage as a result of Salter-Harris type IV supracondylar humeral epiphyseal fracture in a young athlete will
most likely result in:
A. refracture at a future time
B. nonunion
C. arrested growth
D. severing of the radial nerve

108. If the patient is placed in a supine position with the head flat, postural drainage is optimal for the
A. apical segments of the upper lobes
B. posterior segments of the upper lobes
C. anterior segments of the upper lobes
D. lingular segments of the left upper lobes

109. A weightlifter with hypertrophy of the scalene muscles complains of pain and paresthesia in the right upper
extremity when lifting the weight overhead. It is most likely that this is a manifestation of:
A. thoracic outlet syndrome
B. vertebral artery obstruction
C. cervical radiculitis
D. reflex sympathetic dystrophy

110. A patient is immersed up to the neck in a therapeutic pool. While exercising this patient, the therapist should
take into consideration the physiological effects of immersion which result in significantly:
A. increased forced vital capacity
B. increased expiratory reserve volume
C. increased work of breathing
D. decreased pulmonary blood flow

IER-
 Practice 1

111. When using TENS to help modulate pain, one electrode is placed on the posteromedial thigh and another on
the posterolateral calf. The dermatome involved in this case would be:
A. L2
B. L4
C. S2
D. S1

112. A patient with chronic asthma has been admitted to the hospital for an acute exacerbation of the disorder.
The most important thing for the physical therapist to check when seeing this patient for the first time is:
A. current medications the patient is taking
B. previous history of the disease relative to the patient’s current status
C. interpretation of the most recent chest x-ray
D. pulmonary function test results

113. You have assessed the deep tendon reflexes of a patient recently diagnosed with amyotrophic lateral
sclerosis. The results are 2+ left and 3+ right. Your interpretation is that the reflexes are:
A. diminished on the left and normal on the right
B. normal on the left and exaggerated on the right
C. exaggerated, but within normal limits on both sides
D. exaggerated on both sides

114. A five foot tall, 37 year-old word processing technician complains of lumbar discomfort after a full day at
her computer work station. To help the situation, you would not recommend that she try:
A. use of a lumbar roll
B. use of an elevated foot rest
C. moving her chair further away from the keyboard and screen
D. taking frequent short walks during the day

115. While crossing the finish line of a 100 meter race an athlete lunged and fell on her dorsiflexed wrist. She
immediately complained of pain and tenderness over the radial aspect of the wrist in the area of the
anatomical snuffbox. You suspect a possible fracture of the:
A. lunate
B. capitate
C. scaphoid
D. hook of the hamate

116. A patient with Parkinson’s disease is in a skilled nursing facility and has been seen regularly by a physical
therapist. The patient has been taking levodopa three times a day for several years to help control rigidity
and bradykinesia. Lately, the therapist has noticed the patient exhibiting dyskinesias during the usual
treatment sessions. In this case, the therapist should:
A. move the treatment time closer to the time the patient takes the initial levodopa dose for the day
B. move the treatment time to the afternoon following the administration of the second levodopa dose for
that day
C. consult with the nursing service about the deterioration of the patient’s condition
D. talk with the patient’s physician about the need for a possible change in levodopa dosage

117. You are working with a 12 month-old with a developmental level of 3 months. Appropriate intervention at
this time would incorporate:
A. pivot prone positioning
B. rolling from prone to supine
C. rolling from supine to prone
D. training in unsupported sitting

118. A patient with Parkinson’s disease is hospitalized. He is ambulatory but requires close supervision to
prevent falls. The physical therapist’s intervention should:
A. request that the patient remain hospitalized in order to work on balance perturbation until he is safe
B. request a prescription for a wheelchair since this would be the safest method of locomotion
C. train caregivers in contact guarding prior to discharge home
D. include the timed Up and Go test

IER-
 1 Practice

119. The most important stimulus which will result in an increase in ventilation is:
A. diminished arterial PO2
B. diminished arterial PCO2
C. increased arterial PCO2
D. the Hering-Breuer reflex

120. To exercise the middle deltoid during a home health visit, you apply a cuff weight to the wrist and instruct the
patient in glenohumeral abduction. Since the patient is unable to complete the exercise, you move the weight
to the elbow. This change in position may allow the patient to complete the motion because it:
A. reduces the force arm, thereby increasing the mechanical advantage of the lever
B. reduces the resistance arm, thereby decreasing the mechanical advantage of the lever
C. reduces the force arm, thereby decreasing the mechanical advantage of the lever
D. reduces the resistance arm, thereby increasing the mechanical advantage of the lever

121. On the first day following a cesarean delivery, the physical therapist’s primary treatment responsibilities
would consist of teaching the new mother:
A. gentle partial sit ups and pelvic tilting
B. breathing, coughing and pelvic floor exercises
C. assisted ambulation
D. active calf and ankle exercises to prevent venous stasis

122. A patient using an ankle-foot orthosis demonstrates excessive stride width during stance phase. To try and
correct the problem, an appropriate strategy would be to:
A. correct the foot outset
B. correct the foot inset
C. lower the height of the medial upright
D. have the patient try a walking aid such as a cane

123. You are performing sensory tests on a patient diagnosed with C6 nerve root impingement. Testing
should concentrate on the:
A. 3rd, 4th and 5th fingers
B. ulnar border of the hand
C. thumb and index fingers
D. medial forearm

124. A physical therapist is treating an 80 year-old female at home. The patient is in the very early stages of
amyotrophic lateral sclerosis. The patient lacks endurance to independently ambulate to and from the bathroom;
however, she refuses to use a bedpan. This has caused added difficulties and stress for family members caring
for her at home. In this situation, the therapist should:
A. begin immediate ambulation endurance training with distance to and from the bathroom as the primary goal.
B. recommend that the patient be transferred to a skilled nursing facility until she has sufficient endurance to
get to and from the bathroom
C. recommend for immediate delivery of a commode chair to deal with the situation
D. try behavior modification to convince the patient to try and use the bedpan until trained sufficiently to get
to and from the bathroom.

125. The muscles that can function as synergists when acting on the scapula are the:
A. rhomboids and trapezius
B. rhomboids and serratus anterior
C. serratus anterior and levator scapulae
D. teres major and infraspinatus

126. You are working with a patient who exhibits a fluent aphasia. This form of aphasia is usually characterized by:
A. normal auditory comprehension
B. very slow speech
C. impaired reading and writing
D. impaired articulation

IER-
 Practice 1

127. A 23 year-old male with an incomplete spinal cord lesion at the T12 level asks you questions about his
potential sexual capabilities. An accurate response to him, would indicate that erectile capability is:
A. more likely in complete lower motor neuron lesions than in incomplete upper motor neuron lesions
B. more likely in incomplete lower motor neuron lesions than in incomplete upper motor neuron lesions
C. most likely in incomplete upper motor neuron lesions as compared to complete upper and lower motor
neuron lesions or incomplete lower motor neuron lesions
D. unlikely except in cauda equina lesions

128. If an arterial line dislodges while treating a patient, the first thing to do is:
A. call the nurse
B. clamp the line
C. apply direct pressure to the site
D. elevate the limb

129. A supervising therapist should check the capital budget of the physical therapy department in order to determine
if there are sufficient funds to:
A. purchase a new computerized isokinetic dynamometer
B. recommend a 5% salary increase for staff physical therapists
C. double the towels ordered for patients and physical therapy staff who use the therapeutic pool
D. send a therapist to a week-long neurodevelopmental seminar in another state

130. A hospital volunteer is assigned to help out in the physical therapy department. Under normal circumstances
it would be inappropriate for the volunteer to:
A. change linen or clean whirlpools following patient treatments
B. transport patients to and from the department
C. help patients transfer from their wheelchairs to the treatment tables
D. schedule the times for department in-service education

131. The left phrenic nerve of a patient was accidentally severed during thoracic surgery. The physical therapist
should work on facilitating and strengthening all of the following muscles to provide substitute function with the
exception of the:
A. sternocleidomastoid
B. external intercostals
C. scalenes
D. external obliques

132. As a result of a cerebellar lesion, a patient presents with incoordination and problems with balance and
posture. To help improve this situation it would be best if the therapeutic program incorporated:
A. lower extremity splinting to improve stability and isokinetic exercises at moderate to fast speeds to
emphasize reciprocal movement
B. weight cuffs to increase proprioceptive feedback and use of rhythmic stabilization and slow reversals-hold
techniques to facilitate stability
C. Frenkel’s exercises to help with incoordination and PNF activities emphasizing traction of the proximal joints.
D. perturbed balance using a gymnastic ball and PNF patter using D1 diagonals which promote
proximal mobility with distal stability

133. A 65 year-old male with diabetes recently underwent a transtibial amputation. When instructing others
in wrapping the residual limb to minimize edema and provide proper shape, it is important to stress that:
A. greatest pressure should be provided distally
B. greatest pressure should be provided proximally
C. pressure should be evenly distributed
D. an overlapping, circular, wrinkle-free pattern should be used

IER-
 1 Practice

134. You are performing clinical research in which a specific myofascial technique is applied to a patient with
chronic neck pain. A single case study, time-series design using A-B-A-B format is to be followed. A more in-
depth follow up study would not be justified if:
A. A equals B
B. A is greater than B
C. B is greater than A
D. B is less than A

135. Six weeks following the conclusion of the football season, you examine a player whose chief complaint is
right thigh pain and decreased knee range of motion. Roentgenographic imaging of the area is shown below.
Intervention for this individual should be based on the diagnosis of:
A. femoral stress fracture
B. neoplasm
C. quadriceps hematoma
D. myositis ossificans

136. An energetic and independent-minded 78 year-old woman had a stroke a number of years ago and ambulates
with the aid of a walker. She lives in a community housing project and has many close friends. Recently, she fell
and fractured her hip and now four months later is having some difficulty ambulating safely when she leaves her
apartment. As her home therapist, your first course of action is to:
A. recommend that the patient be readmitted to a rehabilitation hospital until she can ambulate safely
B. have the patient use a wheelchair outside of her apartment
C. teach her friends to accompany and properly guard her when she is ambulating outside
D. implement a home program of balance training and lower extremity strengthening

137. A 62 year-old recreational athlete has spinal stenosis affecting the lumbar region. To minimize
symptomatology, the therapist should recommend that this individual not:
A. play tennis
B. ride a bicycle
C. perform curl ups
D. use a rowing machine

138. A physician requests that you perform hydrocortisone iontophoresis over the left shoulder of a patient
with tendonitis. You discover that the patient has a pacemaker. In this case:
A. perform the treatment since there is no contraindication as long as nothing is done directly over
the pacemaker.
B. refer the patient to another physical therapist who has greater expertise in using iontophoresis
C. begin to examine and evaluate the patient and consult with the physician about alternate forms of
therapy; however, do not perform the iontophoresis treatment
D. ethically you must refuse to administer iontophoresis and have the patient return immediately to the physician.

139. A patient, trying to cope with his disability, is going through a stage of anger. Anger would not be expressed
using the mechanism of:
A. denial
B. projection
C. noncompliance with treatment
D. displacement

140. During gait analysis, you note that a patient is lurching backward during stance phase as a result of
gluteus maximus weakness. This compensatory motion prevents:
A. circumduction with external rotation of the involved extremity
B. lateral trunk lean over the involved stance extremity
C. knee instability with possible buckling
D. excessive hip flexion and anterior pelvic tilt

IER-
 Practice 1

141. In patients with cardiovascular disease who receive either nitrates, diuretics, digitalis or calcium antagonists,
the side effects that may commonly occur with administration of any of these medications are:
A. hypotension and dizziness
B. arrhythmia and unstable blood pressure
C. gastrointestinal upset and extreme fatigue
D. hypotension and decreased electrolytes

142. A 3 year-old child with myelomeningocele has had a ventriculoperitoneal shunt put in place. During physical
therapy treatment, the child becomes agitated and irritable, then drowsy and listless. In this situation, the therapist
should:
A. immediately place firm pressure over the fontanel
B. administer emergency oxygen
C. place the child in a head-down position
D. call for emergency medical services

143. A therapist wishes to use operant conditioning as part of her treatment to help “shape” the behavior of
children with problems associated with cerebral palsy. Operant conditioning would not involve:
A. rewarding the child with a prize for a correct response or attitude
B. verbally reinforcing correct responses and pointing out and explaining incorrect behaviors
C. using words of praise or a pat on the back to strengthen desired responses
D. ignoring or not reacting to incorrect behaviors or attitudes

144. An 83 year-old man with peripheral vascular disease and diabetic retinopathy is having some difficulty with
balance when ambulating in his home. As his home physical therapist, the first priority you should consider is
to:
A. begin gait training with a cane to ensure safety
B. ensure that colors on flat surfaces in the home are the same and that raised surfaces, such as steps, have
a sharp color contrast
C. begin balance and ambulation practice on any soft or uneven surfaces in the home to help compensate
for decreased sensory feedback
D. recommend that night-lights be immediately placed in strategic areas throughout the house and that they
remain lit continuously

145. When having an individual perform interval training to stress the aerobic system, a work interval of three
minutes is employed. It would be best if the rest interval equals:
A. one minute
B. three minutes
C. six minutes
D. nine minutes

146. You are monitoring the blood pressure of a healthy, 27 year-old athlete as she is exercising on a treadmill. The
workload, in terms of speed and incline, is steadily increasing during the exercise period. You would expect
her blood pressure response demonstrate a:
A. very gradual or blunted rise in systolic pressure and a slight decrease in diastolic pressure
B. slight drop in systolic pressure and either a slight increase or decrease in diastolic pressure
C. steady increase in systolic pressure accompanied by a steady increase in diastolic pressure
D. steady increase in systolic pressure and either a slight increase or decrease in diastolic pressure

147. You are evaluating a patient with a temporomandibular disorder. The patient had a history of jaw clicking on
opening and closing the mouth, but the noises are now gone. The current major complaint is inability to open the
mouth wide and difficulty performing functional jaw movements such as chewing and yawning. You suspect
that the most likely cause is:
A. capsular fibrosis
B. TMJ subluxation
C. chronic TMJ osteoarthritis
D. disc displacement without reduction

IER-
 2 Practice

148. A physical therapist, working in a school system, wishes to examine a child with a complex medical history.
The therapist should first contact the:
A. parents
B. teacher
C. student
D. physician

149. You have just completed a course on manual therapy for the temporomandibular joint. Two days after the
course you receive a referral that implies the use of TMJ mobilization. You should:
A. treat the patient using joint mobilization
B. refer the patient to another therapist skilled in TMJ mobilization
C. refer the patient back to the physician
D. treat the patient; however, do not use joint mobilization

150. You are working with a child with Down syndrome whose major problem is severe Hypotonicity. In order to help
activate the postural muscles, it would be best to try:
A. slow repetitive rocking movements with the child seated on a large gymnastic ball
B. prone positioning on a large gymnastic ball with the head tipped down
C. slow stroking applied over the paravertebral muscles
D. rhythmic vestibular stimulation first using passive and then progressing to active rolling movements

151. Following a CVA, a 75 year-old man is having motor control difficulty and is fearful when descending
stairs. Early in the relearning process, a strategy one would not employ is:
A. mental practice of the task to help decrease fear
B. use of a more open environment in which to practice the skill
C. guided movement to help position the involved extremity on the proper step
D. provision of feedback which focuses on correct aspects of performance

152. A therapist investigates the normative values for isometric force obtained with hand-held dynamometers. This
type of research can be categorized as:
A. historical
B. descriptive
C. experimental
D. quasi-experimental using a sample of convenience

153. Patients with Parkinson’s disease who have been receiving levodopa for prolonged periods of time will most
likely exhibit:
A. elevated blood pressure
B. a sense of euphoria
C. cogwheel rigidity
D. dyskinesia

154. A 92 year-old resident of a custodial care nursing home is wheelchair bound and has limited cognitive
functioning. An advance directive proscribes any active rehabilitation. Assigning a student physical therapist to
implement a program of active resistive upper extremity exercises with this patient is:
A. inappropriate since limited cognition requires the skills of the supervising therapist to implement the program
B. appropriate if the student is only on final affiliation
C. appropriate if extreme care is taken to prevent injury or overfatigue of the patient
D. inappropriate under any circumstance

155. An external shoe modification that would be appropriate for a patient exhibiting flexible subtalar valgus
deformity is:
A. cushion heel
B. lateral sole wedge
C. medial sole wedge
D. medial heel wedge

IER-
 Practice 2

156. Early Intervention Programs are usually required to use a developmental test, which is standardized and
comprehensive. The best choice for a physical therapist to use for motor development testing would be
the:
A. APGAR test
B. Denver Developmental Screening Test (Denver II)
C. Peabody Developmental Motor Scales
D. Brazelton Neonatal Behavioral Assessment Scales

157. A home health physical therapist makes a list a list of equipment the patient will need to function in a
home environment. For a home bound patient, Medicare will not reimburse for a;
A. hospital bed
B. wheelchair
C. commode
D. home traction unit

158. A 13 year-old girl has a structure right thoracic idiopathic scoliosis. The clinical features you would expect to
find include:
A. a high right shoulder, a prominent right scapula and a left hip that protrudes
B. a high left shoulder, a prominent left scapula and a right hip that protrudes
C. a high right shoulder, a prominent left scapula and a right hip that protrudes
D. a high left shoulder, a prominent right scapula and a left hip that protrudes

159. You note in the medical record that a newly admitted patient, with a diagnosis of right cerebrovascular accident,
is demonstrating anosognosia. When examining this patient you would expect to find:
A. left-sided neglect
B. inability to follow your directions to move a body part even if that part was capable of moving
C. inability to recognize familiar objects by touch alone
D. inability to recognize familiar object visually

160. A 45 year-old male with a long history of cigarette smoking walks in to your private physical therapy clinic
complaining of right upper thoracic pain with tingling into the fourth and fifth digits of the right hand. He has
not seen his primary care physician in over a year. As a physical therapist your responsibility is to:
A. provide treatment for excessive scalene and other accessory breathing muscle hypertrophy secondary
to COPD
B. determine the origin of the dysfunction and refer the patient to his physician if you suspect a tumor as
a possible cause of the symptoms
C. begin treatment for thoracic outlet syndrome and discuss with the patient the importance of smoking cessation
D. provide appropriate treatment for pain and weakness secondary to nerve root impingement

161. A patient has sustained a trimalleolar fracture on the right and a fracture of the left distal radius. For partial weight
bearing it is best if the therapist has the patient use:
A. axillary crutches
B. forearm crutches
C. platform crutches
D. Lofstrand crutches

162. When using whirlpool at 99o-101oF in the care of an indurated ulcer, the treatment will not be of significant benefit
in:
A. loosening of any necrotic tissue within the wound
B. softening of wound debris
C. soaking off of adherent dressings
D. increasing circulation to the wound borders to facilitate healing

IER-
 2 Practice

163. Following a skiing accident, a 14 year-old boy is in a skilled nursing facility with a traumatic brain injury. He
is classified as Glasgow Coma 4. Family members visit him on a daily basis. In this situation it would be best if
passive range of motion exercises are:
A. taught to family members in order for them to participate in the care of the boy
B. not done since the patient is able to follow motor commands
C. performed only by physical therapists or physical therapist assistants to minimize the possibilities
of pathological fractures
D. taught to all the registered nurses who might care for the boy

164. After gait training a patient with a new below-knee prosthesis, you notice redness along the patellar tendon
and medial tibial flare. This would indicate:
A. the socket is too small and the residual limb is not seated properly.
B. the socket is too large and pistoning is occurring
C. improper weight distribution during stance
D. pressure tolerant weightbearing during stance

165. While evaluating a 2 year-old child with mild cerebral palsy, the therapist is encouraged because the normal
developmental milestones for a child of this age have been achieved. This was demonstrated by the child’s
ability to:
A. hop on one foot
B. stand on tiptoes
C. ascend stairs reciprocally
D. begin to self-feed

166. You see a patient in the intensive care unit with multiple trauma and severe traumatic brain injury. A chest tube
is in place and it exits from the right thorax. The patient is in need of bronchial hygiene. In this case:
A. postural drainage can be performed using the Trendelenburg position
B. percussion and shaking can be done only in the right sidelying position
C. percussion and shaking can be done carefully in the area surrounding the chest tube
D. postural drainage is permissible; however, percussion and shaking can be done only when the chest tube
is removed

167. To prevent maximal compressive forces being placed on the patella, a therapist should minimize placing
the patient:
A. prone and flexing the knee to 30 degrees
B. in a sitting position with the knee flexed to 90 degrees
C. supine and flexing both the hip and knee to 110 degrees
D. prone and flexing the knee to 110 with the hip extended

168. To promote upright posture and higher walking speeds in a child with spastic diplegia the ambulatory aid that
is most beneficial is:
A. a reciprocating gait orthosis
B. an anterior rollator walker
C. a posterior rollator walker
D. a parapodium

169. Following an exercise session in a Phase 3 cardiac rehabilitation program, in which some patient may
experience angina pectoris, the therapist employs a gradual and prolonged cool down period primarily to
prevent:
A. exertional dyspnea
B. tachycardia
C. venous pooling
D. hypertension

170. In a hospital situation, OSHA has no jurisdiction regarding:

A. proper grounding of electrical equipment
B. vaccination of the staff against Hepatitis B
C. biohazard disposal
D. workplace access for handicapped employees

IER-
 Practice 2

171. As a result of diminished movement associated with Parkinson’s disease, a physical therapist might
employ rhythmic initiation primarily to help improve:
A. trunk stability and proximal tone
B. trunk rotation
C. upper extremity function
D. active and passive range of motion

172. You wish to mobilize a patient’s shoulder using an inferior glide technique. It would be best to use this
technique be propositioning the patient’s arm in:
A. 95 degrees of abduction with lateral rotation
B. 125 degrees of abduction and internal rotation
C. 55 degrees of abduction and neutral rotation
D. 95 degrees of shoulder flexion and neutral rotation

173. You are evaluating a 48 year-old tennis player with a lower extremity problem. You would use the Thompson
test to assess for:
A. anterolateral rotational instability of the knee
B. iliopsoas tightness
C. rectus femoris tightness
D. Achilles tendon rupture

174. You are treating a terminally ill patient with AIDS at home. Your major psychological focus or
consideration when managing this patient would be to:
A. discontinue treatment of the patient if the patient/therapist relationship becomes overly dependent.
B. reassure the patient and address any feeling of loneliness, abandonment or isolation that the patient
expresses to you
C. keep the friends and relatives of the patient up to date on the patient’s state of mind
D. discontinue any activities that may cause the patient discomfort in order to keep anxiety levels low

175. A patient with a transverse spinal cord injury has total lack of hip flexion, abduction and knee extension. This
functional picture is consistent with a designation of a complete spinal cord lesion at the level of
A. T12/L1
B. L2/L3
C. L3/L4
D. L4/L5

176. If TENS is used to help control pain following caesarean section, it would be best to place the electrodes:
A. over the lumbar paravertebral muscles
B. over the sacrum
C. at the acupuncture point just distal to the focus of the pain
D. over the lateral aspects of the incision

177. Cryotherapy should be avoided with patients exhibiting:

A. myofascial pain syndrome
B. severe spasticity
C. degenerative joint disease
D. vasospasm

178. A therapist wants to know whether joint mobilization is an effective treatment tool in reducing joint pain
in patients with degenerative joint disease. In designing a clinical research study, joint mobilization is the:
A. control variable
B. intervening variable
C. independent variable
D. dependent variable

IER-
 2 Practice

179. A patient with mild congestive heart failure is attending an out-patient cardiac rehabilitation program. This patient
is on a regiment of medications, which include digitalis. The therapist should contact the physician immediately if
digitalis toxicity is suspected. One adverse side effect to look for would be:
A. decreased resting pulse rate
B. skin rash
C. unexplained muscle spasm
D. confusion

180. As a result of a gait analysis, a therapist has determined that the patient ambulates with excessive foot
pronation. This deviation would not occur as a result of:
A. compensated forefoot varus
B. internal tibial rotation
C. a weak tibialis posterior
D. excessive ankle dorsiflexion

181. Following grafting of the lower extremities for burns, a patient is now ready to initiate ambulation. However,
when standing in the upright position, the patient cannot tolerate the pain. To assist the patient in preparing
for standing, it would be best if the therapist utilized:
A. parallel bars
B. tilt table
C. a rolling walker
D. pool therapy

182. Following surgery for multiple trauma, a patient is placed on Percodan to help manage the pain. In your
treatment of this patient, it would be best if you:
A. schedule the patient before the Percodan is administered
B. schedule the patient when the Percodan reaches its peak effect
C. modify the treatment depending upon the analgesic effect of the Percodan
D. schedule the patient only during the withdrawal phase from Percodan

183. Following serious trauma, a patient is casted as a result of multiple bilateral wrist and hand fractures. It would
be best if physical therapy intervention begins:
A. as early as possible to maintain or regain strength and range of motion in nonimmobilized joints of the
upper extremities
B. as soon as the casts are removed to regain strength of the wrists and hands
C. about two weeks after the casts are removed so as not to damage vulnerable soft tissue
D. after six weeks of immobilization to ensure that bone healing is almost complete

184. One of the most common early signs of right ventricular failure is:
A. paroxysmal nocturnal dyspnea
B. exertional dyspnea
C. pulmonary edema
D. dependent edema

185. Your patient with flaccid hemiplegia exhibits pain in the shoulder region secondary to glenohumeral
subluxation. Using electrical stimulation as orthotic substitution, it would be best to place the electrodes over
the:
A. supraspinatus and upper trapezius
B. supraspinatus and posterior deltoid
C. anterior and posterior deltoid
D. anterior, middle and posterior deltoid

186. You are treating an 87 year-old woman at bedside following hospitalization for a femoral fracture. After three
days as an inpatient she has developed pneumonia. You should be alert to the fact that a typical early symptom
of pneumonia in the elderly which often is not seen in a younger population would include:
A. high fever
B. more productive cough
C. altered mental state and confusion
D. greater elevation of the white blood cell count

IER-
 Practice 2

187. Increasing the frequency of ultrasound in order to treat an ankle sprain will result in:
A. increased attenuation
B. decreased tissue temperature
C. decreased intensity
D. increased intensity

188. A patient has osteophyte formation affecting the atlanto-axial joint with resultant cervical nerve root irritation.
If the physical therapist elects to use gentle static manual traction to help deal with this problem, it would be best
if the neck was positioned in:
A. 10-15 degrees of hyperextension
B. neutral or 0 degrees of flexion
C. 20 degrees of flexion
D. 30 degrees of flexion

189. A patient with restrictive lung disease secondary to circumferential thoracic burns demonstrates decreased ability
to expand the lower rib cage and push the abdominal wall anteriorly. In this case, the therapist should consider
the use of facilitation techniques to enhance the function of the:
A. rectus abdominis
B. anterior scalenes
C. internal intercostals
D. diaphragm

190. A physical therapist assistant has been accused of intentional sexual misconduct involving a patient under his
care. The individual who bears the most responsibility in this situation is the:
A. physician who referred the patient
B. institution
C. supervising physical therapist
D. physical therapy assistant

191. A realistic functional outcome for a patient with a complete lesion at the C8 neurological level is independence in:
A. transfers using a sliding board
B. using a manual wheelchair with rim projections
C. all self-care and personal hygiene
D. driving an automobile without hand controls

192. An institution or organization would not be in compliance with the Americans with Disabilities Act of 1990 if:
A. an elevator was not installed to allow a nonambulatory employee access to the upper floors of a
publishing company
B. an employee with multiple sclerosis could not be accommodated in a small business with a payroll of
eight people
C. a blind patrol was denied access to a night club for “safety reasons”
D. a handicapped accessible restaurant did not provide assistance for a disable patron to get from his car to
the restaurant entrance

193. As a result of a pituitary tumor affecting the optic chiasm, a patient exhibits a visual field deficit, which
has inhibited performance in many daily activities. The expected deficit would be:
A. homonymous hemianopsia
B. blindness in one eye
C. circumferential blindness
D. bitemporal hemianopsia

194. A patient has limited motion in supination and calcaneal inversion at the subtalar joint. Using manual techniques,
the accessory motion of the calcaneus that needs to be emphasized in order to increase the motions that are
limited would be:
A. anterior glide
B. posterior glide
C. medial glide
D. lateral glide

IER-
 2 Practice

195. A patient has a complete spinal cord lesion at the C5 level. It is important for this patient to generate a
functional cough in order to avoid potential respiratory problems. In this case, effective coughing:
A. should be facilitated by use of phrenic nerve stimulator
B. should be facilitated by use of glossopharyngeal breathing
C. can be elicited with manual abdominal pressure provided with the assistance of a caregiver
D. can elicited with manual abdominal pressure provided independently by the patient

196. A patient with a crush injury to the foot developed reflex sympathetic dystrophy. Now, two months into the
RSD, the clinical presentation you would expect is:
A. edema and osteoporosis with decreased sweating and nail growth
B. a cool, dry extremity with the beginning of ankylosis
C. causalgia with vasomotor reflex spasm resulting in warm, dry skin with increased nail growth
D. pain on motion with trophic skin changes and osteoporosis

197. A patient with long-standing diabetes mellitus is showing early signs of polyneuropathy. The most
useful information as to whether demyelinization has taken place will be provided by:
A. nerve conduction velocity
B. electromyography
C. reaction of degeneration testing
D. motor point stimulation

198. During weightbearing, a soft tissue contracture resulting in supination of the forefoot will be compensated for by:
A. pronation of the forefoot
B. pronation of the rearfoot
C. supination of the rearfoot
D. pronation of the forefoot and rearfoot

199. During a cardiac rehabilitation exercise session involving patients who experienced myocardial infarctions 4 – 6
weeks ago, the most significant abnormal response requiring the immediate attention of the physical therapist is
a sharp:
A. decrease in systolic blood pressure
B. decrease in diastolic blood pressure
C. increase in diastolic pressure
D. increase in heart rate

200. A patient with paraplegia at the T8 level sustained his injury four years ago. He is seen by the physical therapist
at a routine outpatient clinic visit. The patient has recently purchased a new high-density foam wheelchair
cushion. The skin over the ischial tuberosities and sacral region is in perfect shape. The patient asks about the
need for pressure relief in the wheelchair considering the new cushion. The therapist should advise the patient to:
A. discontinue pressure relief as long as visual inspection reveals no skin breakdown
B. do a push-up in the chair at least once every 15 to 20 minutes
C. do a push-up in the chair at least once every 30 to 45 minutes
D. perform pressure relief once an hour since weight distribution is greatly improved.

IER-
 Answ 2

1. A 41. D 81. D 121.B 161.C

2. C 42. A 82. B 122.D 162.D
3. D 43. B 83. A 123.C 163.A
4. A 44. B 84. D 124.C 164.D
5. A 45. C 85. B 125.A 165.C
6. A 46. D 86. C 126.C 166.C
7. D 47. D 87. C 127.C 167.D
8. B 48. A 88. A 128.C 168.C
9. D 49. D 89. B 129.A 169.C
10. B 50. D 90. B 130.B 170.D
11. D 51. D 91. A 131.D 171.B
12. C 52. B 92. B 132.B 172.C
13. D 53. D 93. C 133.A 173.D
14. D 54. D 94. C 134.A 174.B
15. C 55. D 95. D 135.D 175.A
16. B 56. D 96. C 136.C 176.D
17. C 57. D 97. A 137.A 177.D
18. D 58. C 98. D 138.C 178.C
19. B 59. B 99. B 139.A 179.D
20. C 60. C 100.A 140.D 180.D
21. D 61. C 101.C 141.A 181.B
22. B 62. D 102.D 142.D 182.B
23. C 63. D 103.A 143.B 183.A
24. D 64. C 104.D 144.D 184.D
25. C 65. D 105.C 145.B 185.B
26. B 66. C 106.B 146.D 186.C
27. D 67. B 107.C 147.D 187.A
28. A 68. C 108.C 148.D 188.B
29. B 69. A 109.A 149.A 189.D
30. C 70. D 110.C 150.B 190.D
31. B 71. D 111.C 151.B 191.C
32. C 72. D 112.D 152.B 192.C
33. C 73. C 113.B 153.D 193.D
34. A 74. A 114.C 154.D 194.D
35. B 75. C 115.C 155.D 195.C
36. A 76. A 116.D 156.C 196.C
37. D 77. C 117.A 157.D 197.A
38. D 78. A 118.C 158.A 198.B
39. B 79. B 119.C 159.A 199.A
40. B 80. B 120.D 160.B 200.B

IER-