1. A physical therapist performs the Thessaly test to a patient with a suspected meniscal tear. This testing procedure would require the therapist to: A. Passively medially rotate the patient’s tibia and extend the knee B. Cup the patient's heel and allow the knee to extend from a fully flexed position C. Grasp the patient’s hands in standing to promote balance D. Passively flex and extend the patient's knee while feeling for “popping” Correct Answer: C The Thessaly test for a meniscal tear oceurs in single leg stance by having a patient rotate the fermur on the tibia ‘medially and laterally three times. A positive testis indigafed by joint line discomfort, catching or locking in the knee. ‘A. The Mcmurray test is performed with the patient -d in supine. The therapist grasps the distal leg. with one hand and palpates the knee joint line 1. With the knee fully flexed, the therapist medially rotates the tibia and extends the repeats the same procedure while laterally. rotating the tibia. A positive test is indicated nounced crepitation felt over the joint line and may be indicative of a posterior meniscal ‘The bounce home test is performed with heel and maximally flexes the knee. The indicated by incomplete extension or 3 ‘The therapist grasp the patient's i whieh allows the patien while the i ‘A physician ordé extent of pathology B. Spontaneous potent C. Polyphasic potentials D. Occasional motor unit Correct Answer: A Electromyography is a test tha needle electrode is inserted th into the muscle. The electr size and shape of the wave about the ability of the nmsd A. Anomaly innervated 1 of needle insertion) resg fd be no action potential 's tended passively. A positive test is be indicative of a meniscal lesion. test to provide additional balance ively determine the muscle at rest? pntrolling the muscles. A inserted through the skin lope provides information Spontaneous electrical, ¢ fibrillations and positive shar een in an acutely denervated muscle, Fibnillation and positive sharp waves are the result of § ous discharge of a single muscle fiber. Polyphasie potentials are the electrical potentials from a denervated motor unit, motor unt thet exhibits five or more phases is referred to as polyphasic . Neuropraxia is likely when oecasional motor unit potentials occur duting minimal effort musele contractions two to thtee weeks after injury. A patient being treated in physical therapy experiences a syncopal event. A review of the patient's medical record indicates that the patient has had oth diarrhea and vomiting within the last 24 hours. The MOST likely cause associated with the syncopal event is: A. AnemiaB. Dehydration C. Orthostatic hypotension D. Premancy Correct Answer: B Syncope is a sudden and reversible loss of consciousness with an inability to maintain postural tone. The condition is due to a temporary reduction in blood flow which ereates a shortage of oxygen to the brain. There are a variety of potential causes of syncopal events including anemia, dehydration, orthostatic hypotension, and pregnancy. ‘A. Anemia refers to a low red blood cell count which, increased red blood cell destnuction or blood loss, cells delivering oxygen to the brain. Dehydration refers to a lack of sufficient fluid: diarrhea and vomiting can lead to dehydeatio diarrhea and vomiting within the last 24 ho . Orthostatic hypotension occurs due to a lo absent or severely reduced muscle tone. if blood pressure drops far enough, syng orthostatic hypotension including dei . Pregnancy can be associated with syn C. A benign gro D. A benign grow Correct Answer: A Osteosarcoma is diagnosed growth in adolescence. Osteosa part of treatment for other mal ‘A. Osteosarcoma is a maligna commonly diagnosed in th B. A malignancy, such as E (c.g., pelvis, scapula) as ¥ pelvis, and long bones o Osteochondroma is one is most commonly diag Although more commo} be caused by impaired red blood cell production, pia can cause syncope due to the lack fo red blood The loss of fluids from bodily processes such as \cope. The fact that the patient has experienced etion the most probable cause. ntrol of vasoconstriction in combination with al blood pressure cannot be maintained and of conditions can increase the risk of inferior vena cava by the enlarged ‘periods of rapid bone idiation treatment received as § of the body. tis most e proxintal humerus, ¢g., femur) and flat bones pst commonly in the spine, 3. A physical therapist treats a patient diagnosed with posterior tibial tendon dysfunction, When observing the posterior aspect of the patient's lower leg and ankle in standing, the MOST probable finding is: A. Forefoot adduction B. Hindfoot valgus C. Hypertrophy of the gastrocnemiusD. Swelling in the lateral ankle region Correct Answer: B Posterior tibial tendon dysfunction is the primary cause of medial ankle pain in middle-aged patients. This condition occurs due to the inability of the posterior tibial tendon to support the medial longitudinal arch, As a result, the patient tends to exhibit a flat foot and may fee! like the ankle tends to roll inward, A. The forefoot consists ofthe tarsometatarsal joints, metatarsophalangeal joints, and interphalangeal joint Posterior tibial tendon dysfunction is most often characterized by forefoot abduetion and hindfoot valgus. B. The hindfoot consists of the talus and the calcaneus sPosterior tibial tendon dysfimction is most often characterized by a valgus deformity of the hindfoogidue to a flattening of the medial longitudinal arch. Hypertrophy of the gastrocnemius would not be 9§§06iifed with posterior tibial tendon dysfunction, ‘Hypertrophy of the gastrocnemius may be cause -cted gait deviations such as toe walking or can also be observed in Duchenne muscular dystrophy. General swelling of the ankle ean be present ibial tendon dysfunction, however. The swelling is most often concentrated in the medial asp jue to the muscle descending posterior to the medial malleolus and inserting on the navis A physical therapist is informed that a ha Lisfiane injury afier returning froma physician visit. The patient was orig Jateral ankle sprain, however, retuned to the physician after falling to make "AST likely to be impacted with this Lisfrane injuries oc disruptions of the tarso hree cuneiforms and ‘heir articulations with the nly mistaken for sprains since the clinical pres detect upon x-ay. Undiagnosed Lisfiane injuries eration or even compartment syndrome. A. The caleanens is a ates with the cuboid and the talus. The calcaneus is con B. The cuboid is a lateral bo ‘with the calcaneus, lateral cuneiform, and fourth d could potentially be involved in Lisfiane in rd cuneiforms. The bone ‘The cuneiforms are part cuneiform bones, and guboid. The navicular is part of the midfoot and could Lisfranc injury. A physical therapist completes a sensory assessment on a 61 -yeat-old female diagnosed with multiple sclerosis. As part of the assessment the therapist examines stereognosis, vibration, and two point discrimination, What type of receptor is primarily responsible for generating the necessary information? A. Deep sensory receptors B. Mechanoreceptors C. Nociceptors D. Thermoreceptors Correct Answer: B‘Mechanoreceptors generate information related to discriminative sensations. The information is then mediated. ‘through the dorsal column-medial lemniscal system. Examples of mechanoreceptors include fiee nerve endings, ‘Merkel’s disks, Ruffini endings, hair follicle endings, Meissner’s corpuscles, and Pacinian corpuscles. A. Deep sensory receptos are sensory receptors that are located in the muscles, tendons, and joints. Musele and joint receptors are both classified as deep sensory receptors and include Golgi tendon organs, Pacinian corpuscles, umscle spindle, Ruffini endings, free nerve endings, and joint receptors. They evaluate position seuise, proprioception, muscle tone, and movement. Mechanorecepiors are sensory receptors that respond to mechanical deformation of the area surrounding a receptor. They ate responsible for sensations of tough, pressure, itch, tickle, vibration, and discriminative touch, Nociceptors are specialized peripheral free nerve ‘that are found throughout different tissues within the body that respond fo noxious stinmuli and perception of pain. A painful stimulus will ascend through the spinal cord via the lateral spinoth feral areas of the brain provide specific responses to the painfull stimulus. . Thermoreceptors are sensory receptors that in temperature. Stimulation of the cold or warm receptors will ascend through the § al spinothalamic tract. A physical therapist completes a devel nfant. At what age should an infant begin to sit with hand support for an exte A ‘months of age. The B. supine to sit, pul to st C. When an infant is 10-11 it support, transition from supine to sitting or quadrup prasp. When an infant is 12-15 m padruped, use a wide array of sitting positions, walk wit ‘mark paper with crayons. A patient rehabilitatin py. During the ‘examination the patient begins to complain of pain. The MOST immediate Biiysital therapist action is to: A. Notify the musingstaff to administer pain medication B. Contact the referring physician C. Discontinue the treatment session D. Ask the patient to deseribe the location and severity of the pain Correct Answer: D Congestive heart failure is characterized by the inability of the heart to maintain adequate cardiae ontput. Before the physical therapist can adequately respond to the patient's report of pain, itis essential to gather additional information.Administering pain medication is premature until more information is known about the pain. Once additional information is collected, the nursing staff will be able to make a more informed decision. Contacting the physician is premature until more information is known about the location and severity of the pain. This type of detailed information is necessary to provide the physician with a better sense of what the patient is currently experiencing. Discontinning the treatment session based on a subjective report of pain is a viable option particularly given the patient’s diagnosis, however, the physical therapist would need to gather additional information about the pain prior to making a definitive decision. Having the patient describe the location and severigof the pain is the most immediate action of the physical therapist should take, The information ean be col a timely manner and may be usefil to determine the relative seriousness of the patient's subjectit of pain. A patient demonstrates a significant loss of s 1g to grasp a cup. However, the patient has much less difficulty when holding onto a clinical scenario is consistend with pathology affective the: A. Median nerve B. Suprascapular nerve C. Musculocutaneous nerve D. Ulnar nerve Correct Answer: D, a direct role in grasping The musculocutaneous brachialis muscles, These nnscles do not play a dire The ulnar nerve controls ved primarily in power tips. The ulnar nerve inng have a small effeet on precision grips, though t whieh rely on the ulnar side of the hand. A patient presents with, Which of the following findings would MOST A. Decreased strengtl B. Fixed flexion of C. Fixed hyperextension of the metacarpophalangeal joints D. Wasting of the hypothenar eminence Correct Answer: A It is important for physical therapists to recognize impairments commonly associated with specifie wrist and hand deformities. Ape hand deformity is a hand deformity caused by median nerve palsy. The condition, also known as simian hand, is characterized by an individual being unable to move the thumb away from the rest of the hand.Ape hand deformity is characterized by wasting of the thenar eminence, which results in weakness with thumb flexion and opposition. The patient's thumb may fall back in line with the other digits since the pull of the thumb extensors is stronger than the thumb flexors. . Dupuytren’s contracture is a hand deformity that is caused by contracture of the palmar fascia. The shortening of the fascia results ina fixed flexion deformity of the metacarpophalangeal and proximal interphalangeal joints. . Claw finger deformity is a hand deformity that is caused by a loss of strength in the hand intrinsies (ofthen secondary to a nerve injury). The loss of intrinsic strength results in a fixed deformity with the ‘metacarpophalangeal joints in haperextension and glisinterphalangeal joints in flexion, Bishop's hand (or benediction hand) deformity is deformity that is caused by ulnar nerve pathology. This condition results in wasting of the hypot ence. A physical therapist reviews a research study, knee flexion range of motion two weeks following arthroscopic surgery. Assuming of motion is a normally distributed variable, what percentage of patients in the populati oniometric measurement value between the This type of procedure is| A. Ambythmias B. Bursitis C. Osteoarthritis D. Spasticity Correct Answer: C ‘Viscosupplementation is polysaccharide that restores the normal viscosity of the synovial fluid and helps to properties of synovial fluid within that joint. ‘A. Anarthythmia is a cardiac condition characterized by the cardiac cycle being irregular in either rate or rhythm, Arhythmias are typically treated with the use of antiarrhythmic agents (e.g, beta blockers, ealeiu channel blockers). B. Bursitis is a condition characterized by the inflammation of a bursa, commonly in the hip, knee, shoulder or elbow. Bursitis is typically treated conservatively with rest, ie, physical therapy, and anti-inflammatory drugs. In cases that do not respond to conservative treatment, a steroid injection may be necessary. ved viscosupplementation.C. Osteoarthritis is a condition characterized by the loss of articular cartilage within a joint secondary to mechanical stresses. Viscusupplementation is commonly used in the treatment of osteoarthritis as the improved lubrication within the joint cau help reduce joint stresses and reduce the progression of cartilaginous destruction. The benfits of viscosupplementation are relatively transient. D. Spasticty is a symptom characterized by resistance of a muscle to passive stretch and often oceurs secondary to damage to the central nervous system. Spasticity is often treated with the use of baclofen, a ‘medication which reduces the effeets of spasticity through muscle relaxation, ‘A patient recently visited a podiatrist and was told g@)purehase a heel lift for one of their shoes. Which condition would be LEAST likely to benefit fromfietige of the heel lift? ‘A. True leg length discrepancy B. Achilles tendonitis C. Achilles tendon repair D. Caleaneal bone spur Comect Answer: D A heel lift isa type of shoe orthosis that can of the shoe. It Is a wedge-shaped piece of saterial that places the ankle in slightly mo) fis can be used in the management of a variety of orthopedic conditions. A. A true leg length disrepaney oeeus a true leg length disc tendon, the patient lift would place the att . A calcaneal (or heel) bon a result of excess stress on the bone. Calcaueal spurs ¢: ‘would not be effective at n effective at lessening press A physical therapist colle a designed to identify individuals susceptible to he the MOST valuable to collect? A. Heat B. Weight C. Percent body fat D. Vital capacity Correct Answer: C A variety of factors ean inerease a patient's susceptibility to heat illness. Some of include age extremes (i.e, children, elderly), excessive muscle mass or obese individuals, previous history of heat illness, salt or water depletion, and acute or chronic illness. A. Height without additional information such as weight would provide little benefit to identify individuals susceptible to heat illness. B. Weight without additional information such as height would provide little benefit to identify individuals susceptible to heat illness.C. Patients with a higher percent body fat are more susceptible to heat illness since the larger the person is, the ‘more difficulty it will be to dissipate excess heat. In addition, research has revealed that overweight individuals may generate up to 18% greater heat production than underweight individuals. D. Vital capacity is defined as the maximal volume of air forcefully expired after a maximal inspiration, The pulmonary fiction test measure would not be useful in isolation to identify individuals susceptible to heat illness, A physical therapist employed in an acute care hospijal works with a patient on bed mobility activities. The therapist would like to incorporate a strengthening dleivity forthe hip extensors that will improve the patient's ability to independently reposition in ever, the patient does not have adequate strength to perform bridging. The MOST appropriate exerci : ‘A. Anterior pelvic tilts. B. Heelslides C. Straight leg raises D. Isometric gluteal sets Correct Answer: D Bridging occurs when a patient positioned The activity can be used to facilitate pelvig ng the hip extensors, A. An anterior pelvic tilt requires the ay ¢ pelvis to move anteriorly and inferiorly. Anterionpelyi i A straight leg rais rectus femoris is the An isometric gluteal s extensors. /. A patient with a transtibial, nutes of training, the patellar tendon bearing prosthesis i «don multiple areas of the residual limb, Which area A. Patellar tendon: B. Fibular shaft C. Gastrocnemius musel D. Distal anterior tibia Correct Answer: D Redness is a normal part of : : history and skin tolerance, various degrees components (¢-g., socks/liners) are designed the forces throughout the residual limb andMMgiorces on pressure tolerant areas, such as the patellar fendon. Bouy prominences are pressure intolerant and a Well-desinged socket will ‘mninimize pressure in these areas. ‘A. The patellar tendon is presse tolerant and redness in this area is not a concern as long as it resolves within 10-20 minutes after doffing. B. The fibular shaft is a pressure tolerant area and should have resolution of reduess within 20 minutes after doffing the prosthesis. C. The gastrocnemius muscle is pressure tolerant as it can spread the force of weight bearing across a large area,D. The distal anterior tibia is not a pressure tolerant area, as itis covered by a thin layer of skin and has little to no adipose tissue to distribute the transmitted forces. If redness is noted in this area, it is necessary to verity that socks and liners are being worn appropriately prior to contacting a prosthetist. 18. A physical therapist uses a self-care assessment to examine change over time in rehabilitation programs, The assessment uses a seven point scale to examine 18 items. The collected information is based on observations of patient performance. This type of assessment MOST closely deseribes the ‘A. Functional Independence Measure B. Functional Status Index C. Physical Self-Maintenance Scale D. Katz Index of Activities of Daily Living Correct Answer: A There are a variety of outcome measures which therapists should have general knowledge of th and measurement model, reliability, validity, x A. The Functional Independence Measure degree of disability experienced by an. 18 areas, which include self-care, sp cognitive activities. The FIM is co . A physival therapist worki positioning. The patient physical therapy. The pati appropriate patient positi A. Decrease the risk of B. Decrease the risk of C. Decrease the risk of, D. Decrease the risk of Correct Answer: D The reverse Trendelenburs plane in relation to the fe and activities of daily living. Physical used measures and consider the conceptual erpretability inherent to each measure. nultiple areas to determine the overall A seven-point scale is utilized to examine tion, communication, and social n disability status that oceur over time. care problems and continence, and tient on therapeutic ‘was only recently referred to /hypertensive, The MOST to a position in which the pat ‘A. The prone position w a difficult position in which to teach the patient the weight of the abdominal contents on the diaphragm makes it mote difficult for a weaknened diaphragm to contract. B. In supine, the weight of the abdominal contents on the diaphragm makes it more difficult for a weakened diaphragm to contract. Also, the supine position can reduce the functional residual volume of the lungs by as mmuch as fifly percent In the Trendelenburg position the patient's head is lower than their feet. The position is used to facilitate drainage fiom the lower lobes of the hangs and to increase blood pressure in hypotensive patients. The position would tend to increase the blood pressure of a patient that is already hypertensiveD. The reverse Trendelenburg position is recommended to reduce hypertension and facilitate movement of the diaphragm by using gravity to reduce the weight of the abdominal contents on the diaphragm. 20. A physical therapist works with a patient who is HIV positive and has been admitted to an acute care hospital for a course of intravenous antibioties. The patient's medical record states that he has had a persistent cough producing bloody sputum for four weeks and that airbome precautions should be observed. ‘The MOST likely rationale for this level of precaution is to: A. Decrease the risk of exposing the urmmunocompgomissed patient to pneumonia B. Decrease the risk of exposing the immunocomyi@ynised patient to active tuberculosis, C. Decrease the risk of staff and visitor exp eumonia D. Deerease the risk of staff and visitor exposus tuberculosis Correct Answer: D Standard precautions should be observed with, dlless of their reported medical history. Physical therapists must also be aware of additional prec; ‘be associated with more specific forms of infections. Airborne precautions typically ine! alory pathways (e.g., wearing a mask or face shield) in order to prevent the risk of air| infectious agents through evaporated droplets in air or dust particles containing in A. Although it is important to protect a pa intial sources of infection, airbome precautions are typically designated others. Penumonia is Airbome precaution hg an infection spread through airborne tra Ong patients who are HIV positive and the reported I the clinical presentation of the disease 21. A physical therapist de How long would it take the patient to complete 120 fi A. 30 seconds B. 60 seconds C. 120 seconds D. 240 seconds Correct Answer: C Cadence is defined as the humber of steps an individual will walk over a period and is expressed in steps per minute, The average adult cadence is 110-120 steps per minute, The cadeiiee corresponds to half strides per 60 seconds or full strides per 120 seconds. ‘A. A period of 30 seconds would allow a patient walking at a cadence of 120 steps per minute to complete 30 strides, B. A period of 60 seconds would allow a patient walking at a cadence of 120 steps per minute to complete 60 strides. C. A period of 120 seconds would be necessary to complete 120 strides since the patient ean currently complete 120 steps in 60 seconds. In 120 full strides or 240 half strides based on a cadence of 120 steps per minute.D. A period of 240 seconds would allow a patient walking at a cadence of 120 steps per minute to complete 240 strides. 22. A patient is referred to physical therapy with a diagnosis of temporomandibular joint pain, After completing the examination, the physical therapist suspects that the patient may actually be experiencing referred visceral pain. Which organ is MOST likely involved? A. Heatt B. Liver C. Diaphragm D. Pancreas: Correct Answer: A Referred pain pattems can be musculoskeletal or joint (TMI pain may be caused by pathology of organ, It is important that a physical therapist is musculoskeletal and visceral sources of pain. ‘A. Pathology of the heart can result in refer B. Pathology of the liver cau result in refeu C. Pathology of the diaphragm can result D. Pathology of the pancreas cau result Pressure uleers are areas 6 between a bony prominence development of pressure ulcer that cause immobility. A. A patient with diabetes uleet, not a pressure uleer: pressure uleers, This patient would be at African American), ge spinal cord injuries are 4 While the patient's age obstructive pulmonary While a patient status experience the same le due to her race. arthroplasty may be inamobile obility as a patient with a spinal cord inj rigin. While the presence of temporomandibular It could be referred pain from pathology of an yharacteristies to differentiate between neck, upper back or TMJ. dthoracic region or low back. der or lumbar spine. midthoracie region or low back. Risk factors for the vanced age, and conditions Fe likely be a neuropathic ith the risk factors for due to her race (ie., d injury). Patients with bping pressure ulcers er development, chronic patient's mobility. fier surgery, they will not wpatient is also at less risk 24. A physical therapist treats a patient wearing a shoe that incorporates a rocker bottom. This type of modification would be the MOST beneficial for a patient diagnosed with: A. Achilles tendonitis B. Hallux rigidus C. Plantar fasciitis D. Posterior tibial tendonitis Correct Answer: BA rocker bottom shoe has a thicker than normal sole with a rounded heel. This type of shoe serves to reduce the funetion or replace the lost function of a joint, relieve metatarsal pain, shorten the gait cycle, and assist with dorsiflexion. A. Achilles tendonitis is @ repetitive overuse disorder resulting in microscopic tears of collagen fibers on the surface or in the substance of the Achilles tendon. Management may include a heel lift which places the foot in a relatively plantar flexed position to reduce traction on the Achilles tendon and promote healing. A rocker bottom shoe would offer little clinical benefit to a patient diagnosed with Achilles tendonitis. Halhux rigidus refers to degenerative arthritis due toybone spurring that affects the first metatarsophalangeal joint. Patients with this condition often experience gain and stiffness with walking, standing or bending. A rocker bottom shoe could be potentially benefici lucing extension of the hallux during normal gait. This type of modification may assist the patient ience decreased pain and allow for an increased activity level. Plantar fasciitis refers to inflammation of the, it the proximal insertion on the medial tubercle of the caleaneus. Management may include | longitudinal arch taping or orthoties if the condition is caused by excessive pronatio joe would offer little clinical benelit to a patient diagnosed with plantar fasciitis. . Posterior tibial tendonitis occurs when tendo becomes inflamed or torn. The tendon functions to maintain the arch and support the foot when walking Management may include bracing and oithoties designed to support the archjand reduce pressure on the f&udon. A rocker bottom shoe would offer A. Trabectilar bone erosion. B. Femoral rerve paralysis C. Posterior capsule damage D. Hip abductor Weakness Correct Answer: C The specific surfical approach utilized for total hip arthrop! ded based on a variety of factors including patient activity level, eo-morbidities, life expect nee, aud surgeon familiarity. Physical therapists must have an awareness of ead structures impacted and the associated hip precautions. Surgieal procedures i arthroplasty include an anterolateral, direct lateral or posterolateral appro Trabecular bone is synonymous with eancel ie is typically found at the ‘end of long bones, proxirnal to joints, and écular bone erosion is not typically associated withlinstability follo such as osteoporosis. ‘A peripheral nerve injury fo the femoral nes rit is unlikely that it would directly result in hip instability. In addition, dam erve is less common with ‘a posterolateral surgical approach than with other surgical procedures il hip arthroplasty. Femoral nerve injuries eanalso occur with a displaced acetabular fracture, dislocation of the femur.hystectomy, and appendectomy. A total hip arthroplasty using a posterior surgical approach penetrates the posterior capsule. As a result, it is associated with a high post-surgical dislocation rate. To prevent posterior dislocation of the femoral head component, the patient should avoid excessive hip flexion greater than 90 degrees, hip adduction, and hip iedial rotation. The primary advantage of the posterolateral surgical approach is that the hip abductors remain intact. As a result, it would be unlikely that hip abduetors remain intact. As a result, it would be unlikely that hip abductor wealtness would be associated with instability following total hip arthroplasty using a posterolateral approach.26. A 68-year-old male is referred to physical therapy after being diagnosed with primary osteoarthritis. The associated articular changes are MOST likely attributed to: A. Age-related changes B. Trauma from previous injuries C. Congenital bony abnormalities D. Underlying inflammatory processes Correct Answer: A Osteoarthritis (OA) may be categorized as either primaijor secondary. Primary OA is associated with the absence of a specific etiology. Secondary OA is as swith the presence of a predisposing condition that accelerates the degenerative process. Secondary OA commonly diagnosed in younger populations. Primary OA is diagnosed when there is no clin ical history present to support the initiation of the condition. The idiopathic articular changes a ormal aging and typically occur in older populations. Previous trauma (e.g., motor vehicle accicl juries) resulting in changes to articular surfaces frequently contributes to early is that is based on a predisposing condition would be considered secondary OA. Bony abnormalities that are present fig for decades only to be identified when the onset of symptoms warrants diagnost rent abnormality may accelerate B. Decreased bloo C. Hypovolemia D. Constipation Correct Answer: A Physical therapist must be a yrmacological agents, ADH promotes water resorption b} extracellular uid, When ADH production decreases, tl ‘ions of diluted urine. Patients with diabetes insipid ADH administration can contraction of the vas¢ arteries which can result in angina or myocardial Decreased blood pres excessive excretion of urine. This is not a typical side effect of ADH administration. Hypovolemia is the dgoreased volume of cixculating blood and is a symptom of Biabetes insipidus. This is not typically a side effeet of ADH administration. Constipation is a symptom of diabetes insipidus. Diarrhea is a potential side effect of ADH administration secondary to stimulation of smooth muscle contraction of the gastrointestinal tract. 28. A physical therapist reviews a patient's medical record and identifies an entry that indicates the patient was recently prescribed an emetic agent. The PRIMARY purpose of this pharmacological agent is to: A. Promote defecation B. Induce vomitingC. Minimize gastrointestinal irritation D. Reduce diarrhea Correct Answer: B Phiysieal therapists must possess an awareness of commonly used pharmacological agents, their indications, and potential side effects. ‘A. Laxative agents are used to promote defecation. Side effects include nausea, abdominal discomfort, and dehydration. Examples of laxative agents include Citrucel and Metamucil. B. Emetie agents are used to induce vomiting usually afjer ingestion of a toxie substance. Side effects inetnde dehydration, electrolyte imbalance, and gastrointesfiial erosion with prolonged use. Examples of emetic agents include Apomorphine and Ipecac Antacid agents are used to minimize gastrointes| rion by chemically neutralizing gastric acid and increasing intragastricpH. Side effects include, d phenomenon and constipation or diarrhea depending on the specific agent. Examples of include Tumsand Milk of Magnesia. Antidiartheal agents are used to reduce diar include constipation and abdominal discomfort. Examples of antidiartheal age . A. 48-year-old female patient is referred, syndrome. As part of the session, the p ‘exercises that she was instructed to perform by her personal trainer. (OST problematic? Patellofemoral jormal contract and/or tracking b ically increases with increasing patello the activity performed is an open-chai A. This exercise is a close on, With elosed-chain activites, the patellofeme degrees of flexion. Exercise performed within this range This exercise is similar to snore knee flexion range of motion, However, the ra e acceptable range for avoiding an exacerbation In contrast to closed-chai ‘open-chain activities are their lowest at 90 degree: ee moves closer to full xion are not recommended. d in terminal knee s setting is a relatively groove. 30. A patient with a T3 spinal cord injury exercising on a treatment table in supine Begins to exhibit signs and symptoms of autonomic dysreflexia including a dramatic inerease in blood pressure. The MOST immediate action to address the patient's blood pressure response is to: A. Elevate the patient's legs B. Call for assistance C. Sit the patient upright D. Check the urinary drainage system Correct Answer: CAutonomic dysreflexia is caused by a noxious stimulus below the level of the lesion that triggers the autonomic ‘nervous system causing a sudden elevation in blood pressure. If untreated, this condition ean lead to convulsions, hemorrhage, and death. A. Elevation of the patient’s legs would be contraindicated since the position would serve to inetease the return of circulation and further increase blood pressure. B. Calling for assistance is an acceptable option given seriousness of autonomic dysreflexia, however, the action would not be the most immediate action to address the patient's blood response. C. The physical therapist should immediately position the patient in sitting to address the autonomic nervous system response and reduce the patient’s elevated iloiod pressure, After the patient has been positioned in sitting, the urinary drainage system should be cl juice a blocked catheter is a common noxious stimulus that triggers the sympathetic response. The common causes of autonomic dysretlexia \ded or full bladder, kink or blockage in the catheter, bladder infections, pressure ulcers, ature changes, tight clothing or an ingrown toenail. A physical therapist should check tl system immediately after moving the patient into a sitting position. 31. A patient rehabilitating fiom a traumat ince being placed on Phenobarbital. The PRIMARY purpose of the medication, A. Dectease agitation A ally diminished, however, the primar B. adult seizures. Side effects include sedation, C. There are many medication Baclofen, Diazepam, and Dantrolene sodium. D. Antianthythmic drugs are lockers, beta-blockers, drugs that prolong repola 32. A patient with a transtibi paptient exhibits an ‘extended knee throughot yropriate action to resolve the patient's difficulty A. Plantar flex the foo! B. Soften the heel we C. Move the foot ante D. Dorsiflex the foot, Correct Answer: D The prosthesis requires slight ankle dorsiflexion to allow for subsequent knee flexion during early stance. A prosthesis with excessive plantar flexion will promote full knee extension during early stance. ‘A. A prosthetic foot that is plantar flexed will present with an increased extension moment and impede sufficient knee flexion during early stance. The prosthesis must be set into neutral or slight dorsiflexion to allow for knee flexion during stance phase B. Softening the heel wedge of a transtibial prosthesis will create an increased extension moment and impede sufficient knee flexion during stance phase.C. Moving the foot of transtibial prosthesis anteriorly will create an increased extension moment and impede sufficient knee flexion during stance phase. D. A prosthetic foot that is set in slight dorsiflexion will present with an increased flexion moment and assist with knee flexion during stance and when advaneing the prosthesis. 33. A physical therapist examines a patient diagnosed with carpal tunnel syndrome. As part of the examination the therapist assesses end-feel. The therapist classifies the end-feel associated with wrist extension as firm. ‘The MOST logical explanation is: A. Tension in the dorsal radiocarpal ligament and, B. Contact between the ulna and the carpal bone; C. Contact between the radius and the carpal b D. Tension in the palmar radiocarpal ligamen Correct Answer: D End-feel is the type of resistance that is felt wl ing a joint through the end range of motion. Certain tissues and joints have a consistent bed as firm, hard or soft. Patholofy can be identified through noting the type of abno: ‘ticular joint. A. A firmend-feel with wrist Hexion can 1 dorsal radiocarpal ligament and the dorsal joint capsule. B. The ulna articulates with the radius g does not articulate with the carpal 34, A physical therapist exami As part of the examination the therapist elects to meas are used to measure the Q angle? ‘A. Anterior superior iliac B. Anterior superior ilia C. Anterior superior ilial D. Greater trochanter, Correct Answer: B The Q angle refers to the ay quadriceps muscles and p. The angle represents the angle of quadsiceps musele angle values are 13 degrees TO Wl 18 degrees for females. ‘An increased Q angle aboye 18 degrees may be associated with patellar trackul@dysfinction, subluxing patella, increased femoral anteversion or increased lateral tibial torsion. ‘A. The anterior superior iliae spine and tibial tubercle are landmarks used when measuring Q angle, however, the midpoint of the patella should be used as the axis instead of the superior border of the patella B. The most accurate measure of the angle of quadriceps muscle force (ie., Q angle) utilizes the origin and insertion of the quadriceps nnscle and the midpoint of the patella, C. The inferior border of the patella is located too far distally to use as the axis when measuring Q angle. The ‘midpoint ofthe patella tendon is relatively close to the axis and may be difficult to accurately locate ‘compared to a bony landmark such as the tibial tubercle.D. The greater trochanter is not associated with the origin of the quadriceps muscle and is located too far laterally to use as a landmark when measuring Q angle. 35. A physical therapist positions a patient as shown prior to testing for elonus, The ‘MOST appropriate action to complete the test is: A. Provide a quick stretch to the plantar flexors B. Provide a quick stretch to the dorsiflexors C. Provide a quick stretch to the plantar flexors whie extending the knee D. Provide a quick stretch to the dorsiflexors whilgl@ytending the knee Correct Answer: A Clomus refers to rhythmic oscillation of a body part, from a quick stretch. The test is ideally performed by providing a stretch to the plantar flexors with t ins in a relaxed position A. Clonus is evaluated by supporting the knee iy -d position, encouraging the patient to relax, and passively moving the foot. The therapis| stretch into dorsiflexion and observes any rhythmic oscillations between plantar flex ‘When assessing clonus, the therapist pro the plantar flexor mmscle group, not the dorsiflexor muscle group. 3) ‘When assessing clonus, the therapist ‘a quick streteh to the plantar flexor muscle group, however, the knee should be partially flexed rather tit extended in order fOksyccessfully place the gastrocnemius on slack and elicit the response ‘When assessing elonus, the therapist should provide quik st :naintain the knee in slight flexion, This optiox while extending the knee). A physical thevapist examines a patient with multi Which position would be the MOST appropriate when assessing i A. Abduction to 98 degrees with neutral rotation B. Abduction to 90 degrees with full external rotation CC. Flexion to 90 degrees with fill internal rotation D. Anmat the side in neuttalrotation Correct Answer: C There are several special tests that ean assess the eral joint. An examination for shoulder instability often involves an assess ior instabilities. The jerk test is one example of a special test that assesses inst A. Many of the special tests ffor shoulder instabi ‘90 degrees. Abduction to 90 degrees is more commonly used when testi E Additionally, these tests usually involve some depree of rotatio a ‘used to assess for anterior and posterior instability, respectively. Abduction to 90 degree with fill extemal rotation describes the P n testing for anterior shoulder instability. Oue example of this is the apprehension (crank) est, the therapist passively moves the patient’s shoulder into 90 degrees of abduction and then slowly ly rotates the shoulder. ‘The therapist assesses for pain or apprehension as they move the shoulder into mote external rotation, Flexion to 90 degrees with full internal rotation deseribes the position used when testing for posterior shoulder instability. These motions both move the humeral head posteriorly in the joint and place stress on the posterior capsule, During the jerk test, the patient is placed in this position and the therapist applies an axial load trough the elbow in a posterior direction. The therapist ean then horizontally adduct the shoulder to place further stress on the posterior capsule The arm at the side in neutral rotation describes the position used when testing for inferior shoulder instability. One example of this is the sulcus sign. In this test, the patient stands with their arm relaxed attheir side while the therapist pulls the arm inferiorly and looks for the presence of a suleus between the humeral head and acromion. 37. A physical therapist employed in a busy outpatient orthopedic clinic attempts to determine a schedule for calibration and maintenance of an ultrasound unit. The MOST important factor for the therapist to consider ‘when determining an appropriate schedule is: A. Beaini nomuniformity ration B. Frequency of use C. Cost associated with calibration and maintenai D. Availability of qualified personnel to inspect Correct Answer: B Electrical equipment must be calibrated and maint lified personnel on a regular schedule consistent -, once estabilished, can be modified based on ‘variables such as increased frequency of use or yerformance. ty of the highest peak to the average intensity of all peaks. The BNR is determined by. ‘operties of the piepiezoelectric transducer defetinining a calibration and maintenance sveral time a year, while a ‘The availability Of qualified personnel to inspect the Br in determining a calibration and mainfeniance schedule, [fappropriate p i the health care organization, there area Variety of external companies . A physical therapist positions a patient as shown complete paresis of the tight lower extremity. I perform a rapid straight leg raise with their Te would BEST dispute the patient’s elsim? A. The patient is unable (0 lift their left hee B. The patient experiences radiating pain int C. The patient exerts a downward force i D. The patient reports severe pain while per Correct Answer: C The hoover testis often employed as a gross test for malingering. pist places one hand underneath each calcaneus with the patient lying in supine. The patient is © perform a straight leg raise on the uninvolved extremity while the therapist simultaneously assesses I put on the involved side ‘A. The Hoover test relieson assessing the reaction of the contralateral limb rather tha the quality of the straight leg raise. B. The Hoover testis designed to provide insight on potential malingering rather than serving as a provocative test intended to create radiating pain or other signs ot symptoms. C. A rapid straight leg raise of the left (uninvolved) lower extremity should result in the patient exerting a downward force into the therapist's hand with the right (involved) heel. This action would be considered a normal response due fo the effort associated with performing the straight leg raise, therefore disputing the patient's claim of complete paresis of the right lower extremity. D. The Hoover test is not influenced by the presence or absence of pain.recorded as: A. 10% B. 20% C. 25% D. 50% Correct Answer: B Duty cycle is defined as the ratio of the on time to 20% or lower duty cycle, the heat produced a and as a result, there is no measurable net increase, ‘would typically be used for nonthermal effeets. A. A 10% duty cycle would result if the paramg time. Duty cyele= Imsec (Imisee * 9 msec) B. The question indicates that the parameten one pulse period. As a result, duty cycle C. This option may have been a common D. ST segment depression Correct Answer: B atrioventricular node, This is characterized as first, second cardiac impulse through the ¢ defining feature is a prolo ‘myocardial ischemia ‘The normal duration off the defining feature of, A bizarre QRS compl 39, A patient is treated using pulsed wave ultrasound at 1.2 Wem? for seven minutes. The specific parameters of the pulsed wave are 2 msec ou time and Sinsec off time for one pulse period. The duty cycle should be ime. When ultrasound is used in a pulsed mode with of the cycle is dispersed dnring the off time ure, Ultrasound using a 20% or lower duty cyele xi wave were 1 msee on time and 9 msec off ¢ 2 msec on time and 8 msec off time for ssec) = .20 (100) = 20% i incorrectly answered the question since aJculation would be as follows: 2 msec / is relatively benign. The monly associated with terval (> 0.20 seconds) is contraction (PVC) arising from an ectopic focus in the ventricle that occurs be! normal ventricular depolarization, ST segment depression is a classic sign of myocardial ischemia. 41. A patient diagnosed with ankylosing spondylitis exhibits a forward stooped posture. As part ofthe patient's care plan the physical therapist selects a numiber of active exercises that promote improved posture. Which proprioceptive neuromuscular facilitation pattern would be the MOST appropriate to achieve the therapist's objective? A. Dl extensionB. DI flexion C. D2 extension D. D2? flexion Correct Answer: D ‘A proprioceptive neuromuscular facilitation approach utilizes methods that promote or hasten the response of ‘the neuromuscular mechanism through stimulation of the proprioceptors. The two diagonal patterns are commonly referred to as D1 and D2 where “D” stands for diagonal and “1” and “2” refer to specific pattems of ‘movement. To improve the patient's standing posture thg therapist should use a pattern that requires the patient to move the arms upward and away from the body (d2,xion), ‘A. The command for D1 extension would be to openjyoiiijiand and push down and away from your boy. B. The command for D1 flexion would be to close. d and pull up and across your body. C. The command for D2 extension would be to and pull down and across your body. D. The command for D2 flexion would be to op nd pull up and away from your body. The pattern emphasizes shoulder flexion, abduet piation which would facilitate improved standing posture 42, A physical therapist completing a balang patient in standing prior to administering the Romberg test. When administer be MOST important for the therapist to br column lesion B al period. The test does not attempt to quantify the amo Sture, rather the amount of sway present during the te: The amount of sway pres Romberg testis positive or negative. A positive testis jo more than minimal sway with the eyes open, but pn A physical therapist re to initiating treatment. participate in an ambul ‘A. Signs of resting ck B. Decreased periphe C. Cool skin D. Blood pressure of 165/90 mm Hg Correct Answer: A Peripheral arterial disease refers to a condition involving the arterial system that results in compromised circulation to the extremities. Resting claudication is typically considered a contraindication to active exercise in patients with peripheral arterial disease.Claudication pain is a symptom of ischemia of the lower extremity muscles caused by peripheral arterial disease. Resting claudication pain is typically considered a contraindication to exercise with peripheral arterial disease and may be an indication that the disease process is more advanced. . Decreased peripheral pulses are a common sign associated with peripheral arterial disease, but would only severely limit ambulation if blood flow was markedly diminished or absent. Decreased peripheral pulses are a result of plaque buildup in the arteries which decreases blood flow and subsequently oxygen to the extremities. Cool skin may be a sign of peripheral arterial diseasg, but would only severely limit ambulation if blood flow was markedly diminished or absent. Cool skixigsuts from the diminished circulation, particularly in the extremities. A blood pressure of 165/90 mm Hg is common ercise and does not severely limit ambulation. |. A seven-year-old boy sitting in the phys suddenly grasps his throat and appears to be in distress, The boy slowly stands, b yeathe. The physical therapist recognizing the signs of an airway obstruction sho A. Abdominal th fon with abdominal ge) because of an increased risk of injury. abdominal thrusts are ine jug chest thrusts. Research has demonstrated that appro, ere not relieved by a single technique, As a result, the ‘ombinations of back blows, abdominal thrusts, and ei Rescue breathing is reco ple pulse, but is not breathing. This would not nce the priority should focus on clearing the airway. A finger sweep is recom obstructing the airway of ‘an unresponsive patient A patient reports signifi i. The therapist believes the discomfort is caused by periosteal pain fiom the ultrasound, Which sce (OST likely associated with the patient's subjective report of discomfort? A. Anultrasound unit with @ high beam nonuniformity ratio B. An ultrasound unit with a low beam nommiformity ratio C. A transducer with a large effective radiating area D. A transducer with a small effective radiating area Correct Answer: A Beam nonuniformity ratio (BNR) is the ratio between the spatial peak intensity and spatial average intensity. The higher the quality of the erystal, the lower the BNR. The BNR is derived from the intrinsic factors and quality of the piezoelectric crystalA high beam nonuniformity ratio produces a less uniform beam and therefore places the patient at greater risk for undesirable side effects such as periosteal pain or hot spots . A low beam nouniformity ratio produces a more uniform beam and therefore allows for greater patient comfort and safety. Large ultrasound transdncers have relatively large effective radiating areas. Effective radiating area (ERA) refers to the area ofthe transducer that transmits ultrasound energy. The ERA is more relevant when considering the size of the transducer to utilize and the duration of treatment. Sinall ultrasound transducers have small ERAS. ThaERA is always slightly smaller than the total size of the transducer head, A transducer with a small ERA walild be unlikely to produce the described discomfort without additional contributing variables. . A physical therapist participates in a oly composition as a function of aerobie exercise and diet. Wh st with the MOST. D. Skinfold i Correct Answer: Body composition is d OF fat and fat-free tissue. There are multiple ‘static weighing, skinfold measurements, pl impedance analysis. A ‘Common anthropometric u | BML, waist-to-hip ratio, and percentage of body fat. The nds to assess items such as ‘weight status and the risk f Bioelectrical impedance m to determine the resistance ‘or opposition to current ineiple that resistance 10 electrical current is inver ly. Limitations incinde the requisite hydration sta the established testing. protocol. Hydrostatic weighing n p water and measuring the amount of water that the criterion or gold standard for determini . Skinfold measuremen ‘through the 47. measurement of nine slaidardized sites. The theory associated with skinfold meastements is that the amount of subeutaneous fat is proportional to the total amount of body fat. Limitations of this method. include the availability of an experienced examiner as well as variance from the standards due to gender, age, and ethnicity. A physical therapist reviews the surgical report of a patient that sustained extensive bums in a fire. The report indicates that at the time of primary exeision, cadaver skin was utilized to close the wound, This type of graft is termed: A. AllograftB. Autograft C. Hetetograft D. Xenograft Correct Answer: A Cadaver skin is removed from donors shortly after their deaths, then processed and distributed by skin and tissue banks. Cadaver skin is offen used on patients with severe burns as a substitute until a graft of their own skin ean be applied. ‘A. Anallograft isa temporary skin graft taken from angjher human, usually a cadaver, in order to cover a large burned area. A homograft is synonymous with the snp allograft. B. Anautograft is a permanent skin graft taken for site on the patient's own body. C. A heterograft is a temporary skin graft taken fro sr species. D. A xenograft is synonymous with the term he 48. A patient classifies the intensity of 0-point) Rating of Perceived Exertion Seale. This classification BEST cot A. 40 percent of i ‘Borg’s Rating of of exercise once tl appropriate target level A. A rating of 16 is rela percent that is less than B. 60% ofthe heart rate range. C. 70% of the heart rate r D. A rating of 16 (very hard) heat rate range 49. A male patient rehabilita al therapy for gait analysis. ‘The physical therapist be; valking. The normal degree of toe-out at this speed i ‘A. 3 degrees B. 7 degrees C. 14 degrees D. 21 degrees Correct Answer: B The degree of toe-out is measured by determining the angle formed by each foot’s Tine of progression and a line intersecting the center of the heel and the second toe. A. A measurement of 3 degrees of toe-out may be associated with walking at a relatively fast rate of speed since the normal degree of toe-out decteases as the speed of walking increases. B. The degree of toe-out during fiee speed walking is approximately 7 degrees C. A measurement of 14 degrees is greater than normal and may be associated with a wiede range of orthopedic or neurologic abnormalities, A measurement of 21 degrees is excessive and may be associated with more severe orthopedic or neurologic abnormalities.50. A patient diagnosed with patellofemoral syndrome discusses his past medical history with a physical therapist. The patient reports having anterior ruciate ligament reconstruction surgery on his right knee two ‘years ago, however, the therapist is not able to identify a scar over the anterior surface of the right knee ‘Assuming the surgeon utilized an autograft for the reconstruction, whieh of the following would be the MOST likely graft site? A. Semitendinosus and semimembranosus B. Semitendinosus and gracilis C. Semimembranosus and gracilis D. Semitendinosus and biceps femoris Correct Answer: B Anterior cruciate ligament (ACL) reconstruction rg cruciate ligament. The graft is placed through with a fixation device. The most common grafty semitendinosus and gracilis. A. The semitendinosus and semimembrano: innervated by the tibial branch of the sc femoral and tibial tunnels and then anchored lar tendon or the tendons of the al hamstrings muscles. The muscles are emimembranosus is not used as a graft for ACL reconstruction. ‘The semitendivosis and gracilis te er as a graft for anterior cruciate erapist notes that the ehild SST address this postural C. Tliopsoas tendon lengti D. Lumbar laminectomy: Correct Answer: C ‘Muscle tendon lengthening or muscle contracture. This joint position. Children wha mscle shortening or contr ‘A. A hamstring tendon ley nscle, This procedure is used to reduce a knee Beion dering gait Lengthening of the addu he gracilis and iliopsoas in order to reduce hip subluxation in children with cerebral palsy. Lengthening of the adduetor musele group ccan result in rednction of a seissoring gait pattem. Contracture of the iliopsoas causes an excessive anterior pelvic till, which results in increased lordosis of the lumbar spine. Lengthening of the iliopsoas reduces the anterior pull on the pelvis and corrects the lordosis. A laminectomy is a surgical procedure that removes the lamina of a vertebra to relieve pressure on the spinal cord or nerves, The procedure is often performed in patients who have spinal stenosis. A laminectomy would not specifically address the muscular pull on the pelvis that is causing the excessive lordosis. palsy to correct a deformity and assists in correcting asticity which can lead to52. A physical therapist completes a series of resisted movements on a patient with a lower extremity injury. ‘The patient denies pain initially, but complains of increasing pain after performing a number of repetitions. This scenario is MOST consistent with: A. Complete rupture of a tendon B. Intermittent claudication C. Ligamentous laxity D. Emotional hypersensitivity Correct Answer: B Resisted movements attempt to identify the status of gOititile tissue (i.e., muscles, tendons, associated attachments) and the nervous tissue supplying the cg tissue. ‘A. Acomplete rupture ofa tendon is characterize cant muscle weakness. The onset of the weakness would be immediate. B. Intermittent claudication oceurs as a result g od supply and ischemia in active muscles, Symptoms most commonly include pain au to progressively worsen with increasing 4 Ligamentous laxity would not signific jpvements. Ligamentous laxity is more commonly associated with excessive . Entional hypersensitivity may re we with all forms of resistive D. Full extension,’ Correct Answer: B Physical therapists must be Bi "ints. A loose packed or resting position is commonly u ition is characterized by ‘minimal congruency between e most lax and the joint has the greatest capacity. ‘A. Placing the ulnohumeral ( tion for this joint, The close packed position should notes maximum tension of joint structures. Placing the ulnohumeral is the comect placement to obtain the open packed 3 assessing joint play of the ulnohumeral joint. Placing the unohumera grees flexion and 35 de® the correct placement to obtain the loose packed ‘proximal radioulnar joint. Thi be correct positioning for the ulnohumeral joint. . Placing the uluohumeral joint into full extension aud full supination is the conet¥ placement to obtain the loose packed position of the radiohumeral joint. This would not be correct positioning for the ulnohumerél joint 54, Members of @ community health task force evaluate a proposal for a new adolescent screening program, Several members of the task force raise questions as to the validity of the screening instrument. Which ‘measure of validity examines the instruments’s ability to identify diseased persons by comparing true positives? ‘A. AdaptabilityB. Selectivity C. Sensitivity D. Specificity Correct Answer: C The validity ofa diagnostic testis evaluated by its ability to accurately assess the presence or absence of the target condition. A diagnostic test can have four possible outcomes: true positive, true negative, false positive, and false negative. Adaptability is not a measure of the accuracy or valigity of a diagnostic or screening test. Selectivity is not a measure of the accuracy or validify of a diagnostic or screening test. Sensitivity is a measure of the validity of a screen based on the probability that the screening test will be positive in someone with the disease or dition (Le., true positive). Specificity is a measure of the validity of a s Jpased on the probability that the screening test will be negative in someone who does not ha or target condition (ie., true negative) . A physical therapist attempts to qua el by administering a maximal exercise test. What is the PRIMARY limitation A. Maximal exercise testing require point of volitional fitgue B. Maximal exercise, The decision to US availability of the ap for diagnosing corona oxygen uptake than a subt A. The primary limitation 6 volitional fatigue. Some sul Exercise intolerance before reaching their physiologica te of maximum oxygen uptake. Most standardized exercis three minute intervals before increasing to a hig i) come to a steady state heart rage for each workload bi Maximal exercise testin fers better sensitivity than submaximal exercise tes Most standard exercise intervals, however, this is not considered the pr . A physical therapist pu extremity bum, Whicl A. Presece of a skin graft B. Depth of bum injury C. Percentage of body surface affected D. Extent ofhypertiophie seating Correct Answer: B- Patients with burns often experience a number of sensory changes. These changes can include impaired sensation or increased sensitivity. Although many factors contribute to sensory alteration, the depth of the burn appears to be the best predictor.Skin grafts are typically used with full-thickness bums and although there is a predictable pattern of sensory alteration with fill-thickness burns, the absence of a skin graft would not be useful to predict sensory changes in less severe burns (ie, superficial and pattial-thickness). is possible to predict the relative extent of sensory alteration based on the depth of the bum, For example, 1 superficial partial-thickness bums characterized by extreme pain and significant sensitivity to temperature change, while a full-thickness bum is characterized by an absence of pain and ability to identify temperature change. The percentage of body surface affected provides information on the size or extent of the burn, but does not provide information on other important variables syleh as the depth or severity of the burn. Hypertrophic scarring refers to an overgrowth of etm} constituents that remain within the boundaries of the burn extends into the dermis. Hypertrophic scarring results in poor cosmesis and the deve! mtractures that may limit finetion, The presence yegarding the extent ofaltered sensation. . A physical therapist would like to ‘burn when using iontophoresis. Which ive? B. Decrease the space between the e C. Increase the current intensity D. Decrease the moi accumnlation of p is more likely to create tissue damage. Decreasing the space b ‘increases current density resulting in an increased 1 Increasing the current inten of the ions and inerease ion uptake. The result of this i electrochemical burn. Commercially produced el ve a sinall chamber covered bra semipermeable mem Jeetrode eliminates the need to soak a more traditional idherent. A physical therapist revi during a recent ultrasound treatment to 3 z, 6 minmtes. Assuming the objective of the ultr ease tissue temperatu would be the MOST critical for the therapi A. Time B. Duty cycle C. Frequency D. Intensity Correct Answer: B Physieal therapists must seleet specific parameters when using ultrasound based on the desired physiological effect. Failure to select the correct parameters will minimize the effectiveness of the session and could potentially jeopardize patient safety in extreme cases. ‘A. The duration of the ultrasound is an important parameter, however, it is typically determined based on the size of the area to be treated and not by the desired inerease in tissue temperature.Duty cycle is defined as the ratio of the on time to the total time. When ultrasound is used in a pulsed mode with a 20% or lower duty cyele, the heat produced ruing the on time of the cycle is dispersed during the off time and as a result there is no measurable net increase in temperature. To increase tissue temperature it would be necessary to significantly increase the duty cycle or use a continuous mode The frequency of ultrasound selected primarily determines the depth of penetration. A frequency setting of 1 MEZz is used for heating of deeper tissues (up to five centimeters). A frequency setting of 3 MHz produces a ‘more rapid heating with a depth of penertration of less than two centimeters, Intensity for continuous ultrasound is normaly set bafween 0.5 to 2.0 Wien for thermal effects. Pulsed ultrasound is normally set between 0.5 to 0.75 Wiedhtawith a 20% duty eycle for nonthermal effects A physical therapist attempts to assess the inte; -vestibulocochlear nerve by administering the Rinne test on a patient with a suspected upper mn lesion. After striking the tine of the tuning fork to begin vibration, which bony prominence s st utilize to position the stem of the tuning fork? A. Midline of the skull B. Occipital protuberance C. Inion D. Mastoid process Correct Answer: D The Rinne testis desi ing. A therapist uses a 60. A physical therapist prepay the upper arm of a patient with a deep partial-thiel rapist should utilize whieh, form of medical asepsis? A. Gloves B. Sterile gloves C. Sterile gloves, gown D. Sterile gloves, go Correct Answer: B Topical antibiotics are oft; terial count, provide a covering for the wound, .. and reduce evaporative loss. Si jibioties are applied directly to the affected ‘gloves should be wom, ‘A. Gloves offer protection to the physical therapist's hands to reduce the likelihood @f becoming infected with, inieroorganisins from a patient and reduee the risk of the patient receiving microorganisms fiom the physical therapist. Non-sterile gloves are typically used with intact skin. B. Topical antibiotics are applied ditectly to the bum and therefore require the use of sterile gloves. Failure to use sterile technique intcteases the probability of contamination. C. A gown is used to protect the physical therpaist’s clothing from being contaminated or soiled by a contaminant, The gown also reduces the probability of the physical therapist transmitting a microorganism from their clothing to the patient. The size and the location of the burn make it unnecessary to use a gown.D. A mask is designed to reduce the spread of microorganisms that are transmitted through the air. The mask protects the physical therapist from inhalation of particles or droplets that may contain pathogens and also reduces the transmission of pathogens from the physical therapist to the patient. The mask would not be necessary since there is minimal risk of microorganisms being transmitted through the air in the described scenario, 61. A physical therapist examines a patient with coordingtion deficits presenting with excessive involuntary and extraneous movements including hemiballismus, Tjiigclinical presentation is MOST consistent with damage tot A. Cerebellum B. Basal ganglia C. Frontal lobe D. Medulla oblongata Correct Answer: B Ballistic movements refer to large amplitude, yts affecting the proximal limb musculature, manifested in jerking, flinging movements g ‘usually results forma lesion in the subthalamic nucleus within the basal ga body ins involved, resulting in muscle tone. Damage hemiballisnms, 0 A frontal lobe lesio and goal-directed disttactible, and lack juds . The medulla oblongata is fo purpose is to control the body's vital functions by in 2 the processes of heart rate, swallowing, and respiratio gata, the body would cease to fimetion, A patient with Addison’ he MOST likely cause of this patient’s symptoms A. Decreased produetio| B. Hyperfimction of th C. Decreased absomptid hin the intestines D. Hyperfimetion of Correct Answer: A Addison's disease, also kuown as primary adrenal insufficiency, is characterized by bypo fmetion of the adrenal glands. The most common cause of adrenal insufficiency is an autoinamune process that causes destruction of the adrenal cortex. Signs and symptoms include dark pigmentation of the skin, hypotension, fatigue, hyperkalemia, gastrointestinal disturbances, weight loss, nausea, vomiting, arthralgias, and hypoglycemia. A. The adrenal glands are responsible for the production of cortisol and aldosterone. Decteased production of these hormones results in fatigue and weight loss. Addison’s disease can be treated by the administration of exogenous cortisolHyperfunction of the thyroid gland (ie., hyperthyroidism), as seen in conditions such as Graves’disease, can result in fatigue and weight loss through an elevation in the body's metabolism. However, this is not the mechanism by which Addison's disease occurs. Decreased absorption of nutrients within the intestines, as seen in conditions such as Crohn's disease, can result in weight loss through nutritional deficiencies. Though this is sometimes a secondary side effect of ‘Addison's disease, itis not the primary mechanism by which Addison’s disease occurs. . Hyperfunction of the adrenal gland (ie., Cushing's syndrome) results in increased secretion of cortisol, This condition is more likely to result in weight gain A physical therapist observes a patient complete dumbbell using the starting and ending positior scenario would produce the MOST power? A. A2 pound dumbbell lifted in two seco B. A2 pound dumbbell lifted in three seco C. A4 pound dumbbell lifted in one secoi D. A4 pound dumbbell lifted in four Correct Answer: C mh, Power is calculated as the amount of work by the fime need to perform the wrok. Work is defined as. the product of fore and distance, Fach of he presented options favo the same ensount of distance, therefore the relevant variables to considenifeitie weight ofthe dumbbell and A. A 2 pound dumbbell lifted in two seconds w. longer period of time, however, it would not shorter period of time (ie., one second). A. 2 pound dumbbell lifted in three seconds “Of fhe presented ‘options since the weight is relatively light (ie ste the repetition is relatively long (Le, three seconds) ‘A4 pound dumbbell ified in one second would p since the weight lifted is the heaviest ofthe presented options and the jlete the repetition (ie, one second) is the shortest. . Ad pound dumbbell lifted in four seconds would prod same amount of weight lifled over a shorter period of time ‘A physical therapist examines a patient with jrsal nerve, Which objective finding would be consistent with this injury? A. Shoulder medial rotation weakness B. Shoulder extension weakness C. Paralysis of the rhoniboids D. Paralysis of the diaphragm Correct Answer: B The thoracodorsal nerve (46, C7, C8) is a branch of the posterior cord o| the course of the subscapular artery along the posterior wall of the axilla to the A. The medial rotators ofthe shoulder include the subscapularis, teres major, pectoralis major, latissimus dorsi, and anterior deltoid. The latissinus dorsi would be affected by an injury to the thoracodorsal nerve, however, the presence of'a number of other muscles which act to medially rotate the humerus would be adequate to compensate for any impairment in the latissimus dorsi ‘The latissimus dotsi is innervated by the thoracodorsal nerve (C6, C7, C8). Weakness of the latissimus dorsi ‘would produce impaired strength during shoulder extension resistive testing despite the fact that several other muscles also function to extend the shoulder. These muscles include the posterior deltoid and teres ‘major. C. The thomboids are innervated by the dorsal scapular nerve (C4, C5).‘D. The diaphragm is innervated by the phrenic nerve (C3, C4, C5). 65. A physical therapist works with a patient using a fl pool. Which area of the patient's body would expe A. Shoulders B. Torso C. Hips D. Feet Correct Answer: D “Hydrostatic pressure refers to the pressure exe! pressure increases as the depth of immersion, ‘A. When positioned vertically, the shouldey flotation device, The hydrostatic press . When positioned vertically, the torsp procedure? A. Gluteus maximus B. Gluteus medius C. Piriformis D. Vastu lateralis Correct Answer: A The specific surgical approad ineluding patient activity le Physical therapists must la associated hip precautions. anterolateral, direct lateral A. Access to the hip using line with the nmscle fi potential post-operati ut instability. In order to prevent dislocation of the f@ ion device positioned vertically in the deep end of a -e the GREATEST amount of hydrostatic pressure? body immersed in the uid, Hydrostatic immersed since the patient is using a te negligible. 9s fully immersed. The hydrostatic uspbut less than the Sure since they a with this surgical on a variety of factors hice, and surgeon familiarity es impacted and the ihroplasty include an al head component, the patient should avoid excessive hip flexion greater than 90 degrees, hip adduction, and medial rotation. The gluteus medius muscle remains largely functional following total hip arthroplasty using a posterolateral surgical approach would be more likely to compromise the hip abduetors since a portion of the abductors are released fiom the greater trochanter and the hip is dislocated anteriorly The piriformis musele is released from its insertion on the greater trochanter during a total hip arthroplasty using a posterolateral surgical approach, however, it i later reattached, The muscle does not play a critical role in maintaining hip stability.D. The vastus lateralis remains largely functional following a total hip arthroplasty using a posterolateral surgical approach. The muscle is part of the quadriceps complex and is located on the anterolateral portion of the thigh. 67. A physical therapist completes an examination on a patient diagnosed with Parkinson's disease. Results of the examination include 4/5 strength in the lower exigemities, 10 degree flexion contracture at the hips, and exaggerated forward standing posture. The patient is difficulty initiating movement and requires manual assistance for gait on level surfaces. The MOS ate activity to incorporate into a home program is: ‘A. Prone lying B. Progressive relaxation exercises C. Lower extremity resistive exercises with. ‘D. Postural awareness exercises in standing Correct Answer: A to stretch the hip flexors in patients with ‘ove standing posture and enable the h some of the other options are ent based on the described clinical Strengthening is a patient’s strength in th immediate treatment pd . Postural awareness exercise ver, the relative benefit of the activity is limited without a hip flexibility, the patient would be able to exhibit i ‘The medical record indice consistent laboratory find A. Elevated arterial blod B. Low arterial blood pi D. Low arterial blood p Correct Answer: A Analysis of arterial blood ion, and oxygenation. ‘A. Elevated arterial blood pH and low PaCO> are consistent with respiratory al This condition can be caused by alveolar hyperventilation due to dizziness or syncope. B. Low arterial blood pH and elevated PaCO2 are consistent with respiratory acidosis. This condition can be caused by alveolar hypoventilation due to anxiety, confusion, and coma C. Elevated arterial blood pH and elevated PaCO> are consistent with a partially compensated metabolic alkalosis. Causes of metabolic alkalosis include bicarbonate ingestion, vomiting, diuretics, steroids, and adrenal diseaseD. Low arterial blood pH and low PaCO> are consistent with a partially compensated metabolic acidosis Causes of metabolic acidosis inclide metabolic diseases or disturbances such as diabetes, lactic acid, uremic acidosis, and chronic diarrhea. 69. A patient involved in a motor vehicle accident suslaimiia proximal fibula fracture. The fracture damaged the ‘motor component of the ommon peroneal nerve, orsiflexion and eversion are tested as 2/5. The MOST appropriate intervention to assist the pa A. Electrical stimulation B. Osthosis C. Exercise program D. Aquatic program Correct Answer: B There are a variety of interventions tha cau peripheral nerve injury. Physical therapjg the established goals f daily living orm activities of Anexercise program Re patient will need to perform selected moveui ature has been affected. Exercise will also be necess provide additional stability Despite the stated benefits, jude of benefit as the orthosis when performing activities An aquatic program allow; environment however, the intervention is unlikely t0 form activities of daily living. A physical therapist in prvation techniques. Which of the following techni ? pt to complete a selected activity without dyspn . Ventilator muscle traning Correct Answer: B Pacing is a technique that can allow patients to complete fictional activities without shortness of breath or dyspnea, A. Diaphragmatic breathing is a breathing technique that can decrease the work of breathing by lowering respiratory rate, increasing tidal volume, and decreasing the use of accessory muscles of respiration by facilitating use of the diaphragm. Diaphragmatic breathing can be used with pacing when necessary.Pacing is an integral component of energy-saving techniques used by patients who present with dyspnea during activity. Pacing refers to dividing an activity into component parts so that the patient does not exceed the limits of their breathing capacity throughout each portion of the task. For example, climbing upstairs is performed only on exhalation and by taking only one or two steps at a time. Pursed-lip breathing is a breathing technique performed by inhaling through the nose and exhaling through pursed lips. Patients with chronic obstructive pulmonary disease have been shown to benefit from pursed-lip breathing by decreasing respiratory rate, inereasing tidal volume, and decreasing the sense of dyspnea. ‘When used in isolation the technique would not be ag effective as pacing to assist the patient to complete the activity without dyspnea Ventilatory muscle training is accomplished by dd¥iee§ called inspiratory muscle trainers, which strengthen the inspiratory muscles by providing resistance ‘During an examination, a physical therapist \liscoloration of the patient's skin and sclera of the eye. This discoloration would be LEAST with: A. Cholecystitis B. Ulcerative colitis C. Pancreatitis D. Hepatitis Correct Answer: B- Pathology of the body's org isauschloskeletal injuries. low quadtant pai Ulcerative colit symptoms include: Jaundice is not a symptom typically sea Pancreatitis is am infla of the organ by its own enzymes, Signs and sympla a, fever, tachycardia ‘malaise, and jaundice Hepatitis is an acute or chuy py a virus, a chemical, a drug reaetion or alcohol abuse epatitis (e.g, viral, nonviral, chronic), however, jaundi A physical therapist cons following school-based ‘A. Maintaining upright B. Negotiating a crowd C. Opening and closin D. Writing their name Correct Answer: B Dyspraxia, or motor ineoordinetion, is associated with developing coordination disorders. Developmental coordination disorders are disorders in movement without a known medical diagnosis. Children with developmental coordination disorders often present with slow movement tintes, poor motor sequeneing, poor ‘motor iiemory, and perceptual problems. Leaming disabilities, sensory integration disorders, and attention deficit hyperactivity disorders are often associated with developmental coordination disorders. ‘A. Maintaining an upright sitting posture will not be the most difficult activity for this child since it isa static activity.‘A child with dyspraxia will have difficulty maintaining their balance in environments with changing surfaces and many obstacles, such as in a crowded hallway. To accommodate for this, a student may be allowed to leave class a few minutes early in order to trausition between classrooms in. less crowded. hallway. Opening and closing a locker is not the most difficult activity for this child since the activity is not as dynamic as traversing through a crowded hallway. . Poor written communication will be one of the first signs of developmental coordination disorders in school-aged children. Since this child is nine years of age, any issues with writing their name should have been identified and addressed previously. A physical therapist works with a nine-year-old, Down syndrome. The therapist determines that the patient has abnormalities in muscular tone ith the diagnosed condition. Which technique would be the MOST beneficial when treatin jpne abnormalities? A. Quick stretch B. Deep pressure . Prolonged icing D. Neutral warmth Correct Answer: A There are a variety of stimulation technig lp treat tone abnormalities (ie., hypertonicity versus hyposonis contraction while others septors and results tho already has low uuscular tone. This would not be a useful technique fo D. Neutral warmth helps acti bition of nmscular tone. This would not be a usefi 74. A physical therapist trea condyle, Which patient profile if MOST typical w ‘A. A42-year-old femalé B. A 64-year-old female C. A46-year-old male D. A 68-year-old male osis of the lateral femorab® Correct Answer: B Osteonecrosis of the fem ‘when a segment of the bone loses its blood Spl. Symptoms include sudden pain on the medial side of the knee, swelling, and sensitivity to touch. The medical condition is diagnosed based on a combination of symptoms and x-ray. The etiology is unknown, however, likely involves a combination of trauma and altered blood flow. A. Females are more likely than males to experience osteonecrosis of the femoral condyle. Pear incidence is greater at a more advanced age that 42 and the lateral femoral condyle is less likely to be involved than the medial femoral condyle Females are three time more likely than males to experience osteonecrosis of the femoral condyle with peak incidence occurring in women who are over 60 years of age. The medial femoral condyle is more likely tobe affected than the lateral femoral condyle due to increased weight bearing forces caused by the center of gravity being medial to the knee. C. Males are less likely than females to experience osteonecrosis of the femoral condyle and peak incidence is greater at amore advanced age than 46, The medial femoral condyle is mote likely to be affected than the lateral femoral condyle D. Males are less likely than females to experience osteonecrosis of the femoral condyle. The patient’s age ie. over 60) is consistent with peak incidence, however, the lateral femoral condyle is less likely to be involved than the medial femoral condyle. A physical therapist employed in a rehabilitation flogpital treats a patient status post traumatic brain injury. During the treatment session the therapist notice patient’s toes are discolored below a bivalved lower extremity east, The cast was applied ive hours ago in an attempt to reduce a plantar flexion contracture. The MOST appropriate 1 is to: A. Discontinue the use of the anterior portig B. Contact the staf nurse and request that C. Refer the patient to an orthoptist D. Remove the cast Correct Answer: D Discoloration of the patient's toes is ain band is kely impeding the patient's circulation. This objec further inspection it need to rely on ). A physical therapist treats a applying approximation ‘The patient exhibits signif reflex. The therapist is M A. Avoid a mass extenso C. Allow the patient pa D. Limit range of motia The positive support reflex al reflex that occurs with weight ih the ball of the foot. The response produces an i kc The use of trunk flesion with lower extremly weight bearing activities using the therapeutic ball asi the pateat fo avoid a ‘mass extensor pattem in standing. A therapeutic ball can be utilized for facilitation, inhibition, and range of motion. A. In this particular scenario, the patient uses the therapeutic ball to allow for supported trunk flexion when. standing. This avoids a mass extensor response aud allows for weight bearing and weight shifting through the lower extremities. B. The therapeutic ball can be used to promote active assistive range of motion, hiowever, the use of the therapeutic ball in this scenario is more related to supported standing with the trunk flexed to avoid a mass. extensor pattern,C. The therapeutic ball can be used for weight bearing through the upper extremities, however, the use of the therapeutic ball in this scenario is more related to supported standing with the trunk flexed to avoid a mass extensor pattern, D. The therapeutic ball may be used for increasing range of motion of a given joint, however, itis rarely used. to limit range of motion. Decreasing upper extremity range of motion would not be beneficial to limit the ‘mass extensor pattern. A physical therapist asks a patient who has been inegnsistent with his attendance in physical therapy, why he is having difficulty keeping scheduled appointmms. The patient responds that itis difficult to understand the scheduling card that lists the appojiitménts. The therapist’s MOST appropriate action would be to: ‘A. Contact the referring physician to discuss poor attendance in therapy B. Make sure the patient is given a schedulit onchision of each session. C. Write down the patient's appointments g ina manner that the patient can understand D. Discharge the patient from physical Correct Answer: C Inorder to determine ifthe patient's poor aif to difficulty understanding the scheduling card, the information uust be presented in . Contacting the referring pliysician y A patient shot steps to impro ‘A physical therapist esultant left hemiplegia for a colleague on vacatio patient exhibits “pusher syndrome.” When ex: ing findings would be MOST likely? A. Sitting with increased hrough the left buttocks B. Sitting with increased through the right buttocks C. Sitting with increased rotated to the right; unresponsive to stinn D. Sitting with unequal jsive to stimuli on the right Correct Answer: A Pusher syndrome is charact r legic side. Pusher syndrome commonly occu intervention for a patient that exhibits pusher syndto der the left lateral thigh, ‘weight shifting across midline, and facilitation techniques for trunk control A. A patient with right CWA (left hemiplegia) with pusher syndrome would typically exhibit a lateral lean to the left in sitting with increased weight bearing on the left buttocks. B. A patient with right CVA (left hemiplegia) without pusher syndrome would typically exhibit less weight bearing through the left side due to the existing sensory and motor deficits. Intervention would include ‘midline orientation, and weight shifting in sitting. A patient with right CVA (left hemiplegia) who demonstrates the inability to interpret stimuli on the left side of the body is exhibiting unilateral neglect. Neglect is most often associate with a lesion of the right frontal lobe of the brainD. A patient with right CBVA (left hemiplegia) would not typically rotate the head towards the affected (left) side, but rather away fom it secondary to negleet. The patient would be more responsive to stimuli on the right. 79. A physical therapist working in a school system develops long-term goals as part of an individualized Educational Plan for a child with Down syndrome. The MOST appropriate timeframe to attain these goals is: A. One month B. Four months C. Six months D. One year Correct Answer: D ‘An individualized Educational Plan (IEP) is de: hool-aged child that requires therapy services Long-term goals are based on a one-year plan. provided through federal legislation through the individuals with Disabilities Education Ect ‘A goal with a one month timeframe is deg 9 requires therapeutic intervention for an injury or condition that requites therap or condition that will steady progress and improve. This timeframe is not A four month timeframe may be an. reassess the child and quantify the actual progress toward jen amount of time to Federal legisl A two-year-old with itally, the preferred method to teach a child hi A. Bilateral hip-knee-a B. Parapodium and the C. Bilateral knee-ankle D. Bilateral ankle-foot or Correct Answer: B The parapodium provides vith standing activities for table assistive device to HKAFOs would require (s with forearm (lofstrand) crutches requires a hig priate for initial standing activities, ‘The parapodium is aH ith a thoracolumbar oxthosisthat supports € and lower extremities. It has a large base of support and is used with or without an assistive device. This Wonld be ideal for a patient with T10 spina bifida to initiate standing within the parallel bars. A patient with T10 spina bifida would not initially use KAFOs in the parallel bars when working on standing aetivities due to the deficits in strength and sensation below the T10 level. . A patient with T10 spina bifida would not possess the necessary motor function to use bilateral AFOs,81. A physical therapist works on weight shifting activities with a patient sitting over the edge ofa mat table with their feet positioned on the floor. The therapist facilitates an anterior weight shift through facilitation of the pelvis. What pattem of activity would be required for the patient to maintain an upright posture? A. Spinal extension resulting from concentric contraction of the spinal extensors B. Spinal flexion resulting from concentric contraction of the spinal flexors C. Spinal extension resulting from eccentric contraction of the spinal extensors D. Spinal flexion resulting from eecenttie contraction of the spinal flexors Correct Answer: A ‘Weight shifting is necessary to maintain upright positiging and perform fimctional siting activities. Certain tasks require the ability to stabilize and weight shift tifoug the trunk simultaneously (ie., upper versus lower trunk). When weakness of the trunk exists, weight trunk control activities are often included in the plan of care. A. When a patient initiates an anterior weight sh pelvis, spinal extension mst occur in order to ‘maintain an upright posture in sitting. Coneg of the spinal extensors is required to produce spinal extension. ‘When a patient initiates a posterior weigh is, spinal flexion must occur in order to ‘maintain an upright posture in sitting. Cy spinal flexors is required to produce spinal flexion. Spinal extension is necessary to mig following an anterior weight shift throngh the pelvis, jomof the spinal extensors. (ATP) produced A. Amino acids B. Carbohydrates C. Fats: D. Proteins Correct Answer: B Assuming adequate availabilit yy sources of energy production while proteins pro} e and facilitating numerous chemical processes. The perc ed by a mmber of variables including intensity and durati ‘A. Proteins consist of long é Jo the production of ATP is minimal during short-ten As exercise intensity mption), carbohydrates are responsible for the i .¢ of fats to carbohydrates as the primary fuel sor idation during exercise is a function of the rate offearbohydcate utilization and the availability of cwet ity acids. If activity lasts for a long period of tine (e.g., greater than one hour), fats play a greater rolein energy metabolism. At lower levels of exercise intensity, the majority of ATP production comes fiom fats. As exercise intensity increases, the biochemical processes for fat metabolism are too slow to meet the needs for faster production of ATP, and carbohydrate utilization increases. ). Proteins are used in ATP production as described in option 1, Protein ean be metabolized in more significant amounts during long duration activity or long-term starvation, 83. A physical therapist examines several pathological reflexes on a patient with a suspected upper motor neuron disease. Which stimulus would be the MOST appropriate when assessing Hoffiman’s reflex?‘A. Tapping the nail of the middle finger B. Stroking the inner thigh C. ‘Stroking the plantar aspect of the foot D. Rapidly dorsiflexing the foot Correct Answer: A Reflexes are often used for diagnosing and localizing nervous system disorders. Categories of reflexes include superficial, deep, visceral, and pathological ‘A. Hoftinan’s reflex is assessed by tapping or snappingglhe nail of the middle finger. An abnormal response consists of flexion of the first finger and thumb. B. The eremasteric reflex is assessed by stroking 1 n the area of the superior and medial thigh. The anticipated response is elevation of the testicle g side as the stimulus. C. The plantar reflex is assessed by stroking the Ig of the sole of the foot from the heel to the ball of the foot and medially to the base of the great jnnt end ofa reflex hammer. An abnormal response, also known as Babinski’s sign, co} n of the great toe and flexion of the toes. D. Clonus is assessed by supporting the knee position and providing a quick stretch into dorsiflexion. Clonus refers to rhythmic os ntar flexion and dorsiflexion, |. A physical therapist attempts to assess | level. Which deep tendon reflex would brovidethe therapist with te MOS Dist should attempt to assess the reflex by" fon slight stretch. ‘A. The lateral hamstring: B. The medial hamstrings 12 C. The patellar reflex is immer D. The Achilles reflex is inne 85. A patient receiving physicy pt he has felt nauseous since having his methotrexate cal therapist action is to: A. Exphin to the patient B. Ask the patient to sto Correct Answer: D Methotrexate is used as a d ‘ng agent in the treatment of shel itis. Adverse effects include nausea, gastrointestinal distress, hemomthage, cough, shortness of brea pwer extremity edema, ‘Nausea refers to the seusafion of unease and discomfort in the stomach with an wge8,vonuit. Although nausea is not a medical emergency, it is appropriate for the patient to inform the physician of any persistent side effects as soon as possible A. A physical therapist may inform a patient about common side effects of medication, however, the patient's acknowledgement of feeling nauseous after having their medication level altered would still require contact with the physician. A physical therapist is not able to ask a patient to discontinue the use of a prescribed medication. This aetion is the sole responsibility of the physician.C. A recommendation to make an appointment with the physician is appropriate, however, would not typically be timely as contacting the physician’s office. Given the patient's present status (ie., feeling nauseous), it is necessary to advocate for an immediate resolution to the problem. D. A patient should contact the physician’s office whenever they experience side effects that may be associated with prescribed medication. Direct contact with the physician is an immediate response which makes the physician aware of the patient's present status and allows them to potentially modify or discontinue tnedication, A physical therapist examines a patient diagnosed with cerebellar degeneration. Which of the following clinical findings is NOT typically associated with A. Athetosis B. Dysmetria C. Nystagmus: D. Dysdiadochokinesia Correct Answer: A Athetosis is a term used to describe slow, writ movements that may occur with damage to the basal ganglia A. Athetosis is characterized by extraneo p's, slowness of movement, and alteration in musele tone, AthetoX ¢” with a rotatory component evident, B i ately reach a target. The alternating movere . A physical therapist two weeks ago. The patien lateral thigh and denies any referred pain down the pos 0-10 scale, however, indicates that the pain is a “6” or a“ iT closely resembles: A. Sactoilltis, B. Tliolumbar syndrome C. Piriformis syndrome D. Trochanteric bursitis Correct Answer: D ical therapists should be by a given diagnosis after is typically tender to palpation directly over the sacroiliac joint. Tiiolumbar syndrome, also known as iliac crest pain syndrome, is caused by inflammation or a tear of the iliolumbar ligament. The condition often leads to referred pain in the pelvis or groin. The patient is often tender to palpation over the iliac crest and pain tends to be exacerbated with sidebending. Piriformis syndrome refers to a condition in which the piriformis musele irritates the seiatic nerve causing pain in the buttocks and referred pain along the course of the sciatic nerve. The primary patient complaint is buttock pain that is made worse by siting, stair climbing or squatting, Trochanteric bursitis refers to inflammation of the trochanteric bursa, which is a pad-like sac that protects the soft tissue structures that cross the posterior portion of the greater trochanter. The patient is oftenextremely sensitive to palpation over the bursa and may experience lateral thigh pain that is exacerbated by activity or periods of prolonged rest. 88. A physical therapist treats a patient with a suspected rupture of the patellar tendon, Which objective finding would be MOST indicative of this condition? A. Marked tendemess along the anterior surface of the knee joint B. Inability to actively extend the knee against gravity C. Limited ability to complete range of motion duego hemarthrosis, D. Resistive isometries are strong and painful for kilbe Correct Answer: B The patellar tendon originates on the patella and ins ‘tibial tuberosity. The structure is a flat ligament approximately 10 centimeters in length. A patellar, jure is often caused by an extremely strong force such as in a fall or during an explosive movemen A weakened tendon due to chronic tendonitis, chronic diseases that impact blood d use significantly increases the incidence of a patellar tendon rupture. ‘A. Marked tenderness along the anterior surf a possible finding with a patellar tendon rupture particularly in the acute phase. H ety of other medical conditions such as patellofemoral syndrome, prepatellar b iis that are likely to exhibit similar ). A patient experiences a p provide the BESt support £9 A. Hematoma formation B. Diminished pain C. Callus formation D. Remodeling Correct Answer: C Proximal humerus fractures adult females due to decreased bone density. Phy’ ng when selecting therapeutic activities. A. A hematoma occurs in healing and would the: Diminished pain often accom however, the finding by lself does not provide the necessary information to determine the patient's current stage of healing. Callus formation is one of the first indications that healing has ocurred. The presence of a callus identified through diagnostic imaging allows the patient to progress to active-assistive exercise . Remodeling is the final stage of bone healing where the fiacture has solidly united with woven bone, A patient would begin active-assisted exercise far earlier in the rehabilitation process,90. A physical therapist reviews the medical record ofa patient recently admitted to the intensive care unit. A note from the patient's physician indicates an order for arterial blood gas analysis six times daily. Which type of indwelling line would be used to collect the necessary samples? A, Intravenous line B. Arterial line C. Central venous line D. Pulmonary artery line Correct Answer: B Samples for blood gas analysis may be obtained from dierent regions of the vascular bed. Arterial samples are taken fiom either a needle puncture ot indwelling ea a peripheral artery. A. An intravenous line consists of a short catheter through the skin into a peripheral vein. Intravenous lines are used as a route to administer medicat B. Anarterial line consists of a catheter insert into an artery connected to pressure tubing, a transducer, and a monitor. The device can b ious direct blood pressure readings and to sample arterial blood for arterial blood ga: and brachial arteries are the most common sites for an arterial line. A central venous line consists of a cathe u into a large vein, usually the superior ‘venta cava or inferior vena cava, or to measure right arterial pressure. The catheter also may be used as a route f ion, blood sampling, and emergency placement ofa pacem ‘A physical thera objective finding B. Preservation of the C. Presence of a steppage D. Weakness of the quad Correct Answer: B The sciatic nerve derived fro , LS, $1, $2, and $3. The nerve divides into the tibial a teal fossa. The common fibular nerve divides into the fibula. A lesion of the seiati¢ Inability to actively dors injury ora sciatie nerve injury. Asa result, the 0 i ra atic nerve lesion. jury. Preservation of the pmmon fibular nerve could still be affected since this nerve is not responsible for the Achilles ref A steppage gait is characterized by lifting of the fet.and toes through exaggerated hip and knee flexion during swing phase. The gait pattem is associated with a common fibular nerve injury or a sciatic nerve injury due to the presence of dorsiflexor weakness. . Weakness of the quadriceps muscle would not typically be associated with a common fibular nerve injury or sciatic nerve injury. Weakness of the quadriceps muscle is more likely associated with involvement of the femoral nerve.92. A 16-year-old male patient sprained his thumb in a volleyball game five weeks ago and continues to have decreased range of motion with carpometacarpal abduction. What joint mobilization technique would the therapist use to increase carpometacarpal abxluction? ‘A. Medial glide of the first metacarpal on the trapezium, B. Lateral glide of the first metacarpal on the trapezium, C. Anterior glide of the first metacarpal on the trapezium D. Posterior glide of the first metacarpal on the trapezium Correct Answer: D The movements at the first carpometacarpal joint inclyd@\exiorvextension, abductiowadduction, and opposition. Flexion and extension occur in the front around an anterior-posterior axis. In this plane, the ‘metacarpal surface is concave and the trapezium st nvex. Abduetion and adduction occur in the sagittal plane around a medial-lateral axis, In this carpal surface is convex and the trapezium surface is concave. A. Since abduction occurs in an anterior-postet sagittal plane), a medial glide would not be used to increase this motion. A medial g swould be used to increase carpometacarpal flexion. Since abduction occurs in an antetior- ittal plane), a lateral glide would not be used to increase this motion, A lateral ‘be used to increase carpometacarpal extension. Ananterior glide direction to transplant. The patient's platelet cout appropriate? A. Log roll training and br B. Progressive resistive e C. Bicycling and lower es D. Patient education on fa Correct Answer: D Thrombocytopenia, or low pl clotting sequence to repair Normal platelet counts are 1 serious bleeding can occur. associated with a low platel Log roll training and ‘ses are more appropriate for a Performing a log roll during bed mobility allows for improved ¢ pain, Breathing exercises are also important since the patient’s breathing patt post-operatively secondary to pain, Progressive resistive exercises are allowed for patients with patient levels greater than 50,00 cells’mm’. The patient's present platelet level results in progressive resistive exercises being contraindicated. Infection conttol is important in patients with decteased white blood cells. Decteased white blood cells can be problematic following chemotherapy since they place the patient at risk for opportunistic infections. Bicycling is not recommended for patients with platelet levels below 50,000 cells/mm*. Based on the patient's diagnosis, muscle length is not expected to be significantly impaired, making this intervention less desirable.D. Thrombocytopenia places a patient at an increased risk of bleeding following injury. Fall prevention is an important aspect of patient education for patients with this disorder. Progressive ambulation to tolerance is typically allowed as an activity for patients with platelet levels greater than or equal to 20,000 cells/imm* 94. A physical therapist treats a six-year-old child with cerebral palsy classified at Level V using the Gross Motor Function Classification System. Recommendations from the physical therapist will MOST likely include: A. Orthoses and assistive devices for community ambulation B. Orthoses and assistive devices for household auulation C. Standing fame and orthoses and/or assistive dBvieks for household ambulation D. Standing frame and wheelchair for communif Correct Answer: D The functional abilities of children with cerebral fied using the Gross Motor Function Classification System (GMFCS). There ate five this classification system. Children at Level I are more functional and less severely involved svel V. Children at Level V are severely limited in their factional abilities, are unabld head and trunk positions, and possess minimal control of the upper and lower extu A. Community ambulation is not likely fg kl al Levels I and II would be more likely to effectively ambulate in the comm Ly. would be more likely however, ht si A standing fia ‘weight bearing thro {6 9 prolonged stretch to the hip flexors a for both home and community mobility. 95. A patient four weeks stat jons a physical therapist as to why he is still partial wei A. The patient does not B. The patient has good C. The patient has fair al cutaneous sensation The physician is responsit termining a patient's weight bearing status 1 surgery. Physical ‘therapists should possess anv understanding of relevant factors associated with the plestribed weight bearing status and understand what is necessary for the patient to progress to full weight bearing. ‘A. A patient status post anterior cruciate ligament reconstruction surgery may continue to use an assistive device for weight bearing if they do not possess full active knee extension. Ambulation on a flexed knee ean result in excessive itttation of the patellofemoral joint. B. The quadriceps control the amount of knee flexion during initial contact (loading response) and then extend the knee toward midstance. The quadriceps also control the amount of knee flexion during pre-swing (hee! off to toe off) and prevent excessive heel rise during initial swing. Good quadriceps strength would be adequate for full weight bearing on the involved lower extremity assuming the absence of other relevantclinical findings. A grade of good indicates that the patient completes range of motion against gravity with moderate resistance. ‘The hamstrings are responsible for controlling the forward swing of the leg during terminal swing. The hamstrings provide posterior support to the knee capsule when the knee is extended during stance. Fait hamstrings strength would be adequate for full weight bearing on the involved lower extremity assuming the absence of other relevant clinical findings. A grade of fair indicates that the patient completes range of inotion against gravity without manual resistance, Diminished superficial cutaneous sensation is common following surgery particularly in close proximity to an incision, The presence of diminished superficialjétganeous sensation would not influence a patient’s weight bearing status, 96. A physical therapist assesses several superficial s part of a neurological examination. Which ‘grading system is MOST appropriate when re ined results? A. Present, absent B. Ordinal scale fiom 0-4+ C. Hypoactive, normal, hyperactive D. Zeto, trace, poor, fair, good, normal Correct Answer: A Superficial reflexes ae involuntary muy ation of the skin usually by stroking or scratching. Exa flex, corneal reflex, abnormal respors Hypoactive, no tendon reflexes to sti |. Manual muscle testing grad ability to move a body seament through range with ally, manual muscle test grades include zero (0), ta 97. A physical therapist trea j the diagnosis, which of the following tests would MG A. Coordination testing B. Sensory testing C. Deep tendon reflex D. Endurance testing. Correct Answer: D ‘Myasthenia gravis is an ai i n and results in muscle ‘weakness aud fatigablity the condition is characterized by weakuess with repetitive'etivity that is restored quickly after a period of rest. Other neurologic findings typieally are normal in patients with myasthenia gravis. ‘A. A patient with myasthenia gravis does not typically demonstrate coordination deficits and therefore would not exhibit abnormal findings with coordination testing. A patient with a cerebellar disorder would be mote likely to exhibit abnormal findings with coordination testing. B. A patient with myasthenia gravis does not typically demonstrate sensory deficits and therefore would not exhibit abnormal findings with sensory testing. A patient with a spinal cord injury would be more likely to exhibit abnormal findings with sensory testing.‘A patient with myasthenia gravis does not typically demonstrate hyporeflexia or hyperteflexia and therefore would not exhibit abnormal findings with deep tendon reflex testing. A patient with a traumatic brain injury would be more likely to exhibit abnormal findings with deep tendon reflex testing. . Myastlienia gravis is a condition that is characterized by muscle weakness and significant muscle fatigability. A patient with myasthenia gravis could demonstrate normal strength with manual muscle testing since it only requires a single muscle contraction. However, the patient would demonstrate significant ‘weakness if required to perform repeated contractions. Endurance testing (e.g., treadmill testing, eyele exgometry) would likely be abnormal for this patien A patient rehabilitating from a CVA requires an gitfdSis due to occasional dragging of the toe during swing phase. The patient presents with weakness of th sors and has good mediaV/Iateral stability at the ankle, The MOST appropriate option for the A. Solid ankle-foot orthosis B. Tone reducing foot orthosis C. Posterior leaf spring orthosis D. Custom articulating ankle-foot ont Correct Answer: C A posterior leaf spring (PLS) orthosis is a swing phase. The trim line is posterior tg fon can occur during 6 its flexibility and therefore would be the m level of mediaVlateral stability. . A custom articulating ankle lly provides total contact and a significant amount of sta wechianics allowing the tibia to advance over the foot d level of stability offered by this type of AFO. jr to being diagnosed with hhysical therapy after a Wer extremities B. Loss of sensation throughout the extremities C. Respiratory impaism D. Bladder dysfunction Correct Answer: C Guillain-Barre syndrome is an acute polyneuropathy that primarily affects the peripheral nervous system. The condition often occurs following a relatively benign respiratory or gastrointestinal illness. Guillain-Barre syndrome is characterized by ascending weakness that begins distally in the lower extremities and progresses towards the trunk‘The primary symptom associated with Guillain-Barre syndrome is ascending weakness, which begins in the distal lower extremities and moves toward the trunk. Patients displaying this symptom are likely experiencing a normal progression of the condition. ‘Though not as common of a symptom as ascending weakness, sensory loss is also a relatively common symptom associated with Guillain-Barre syndrome. Sensory loss usually takes the form of loss of proprioception and areflexia. Loss of pain and temperature sensation are usually mild, Respiratory impairment is a symptom that ean be associated with Guillain-Barre syndrome and is seen in more severe cases of the condition. Patients that havg respiratory impairment and require mechanical ventilation are considered to have a poor prognosigi@mpared to those patients that do not require ‘meehianical ventilation. Other poor prognostic fagfons yclude advanced age, long hospital stays, and poor upper extremity musele strength. Bladder dysfunction is seen in the more severe ilain-Barre syndrome. Though this symptom is seen in severe eases, it would be less likely tg ; prognosis (Ic., mortality) than would respiratory impairment. 100. A physical therapist completes a fami patient rehabilitating fiom a spinal cord injury. During the training the patient ag ir functional ability following rehabilitation. The MOST appropriate, A. Enplain that itis difficult to pre reasonable for the-therapist fo provide the patient ‘motor and sensory infervation. ‘A. The statement, although aecurate, does not directly Y ical therapists should attempt to answer questions posed by patients in Ahenever possible. Physical therapists can share information with patients 1e rehabilitation. Physical therapists should be scope of practice. The director of rehabilitation is typically x py services provided by the various health care disciplines, The position frefore the director would not typically be well suited to respond to ques Referring the patient to the physiatrist, althor attractive option if the question posed by the patient was directly Atbr another similar topic that would fall under the scope of practice of the: 3 101. A physical therapist! performs an examination on a patient di thoracic outlet syndrome. During the examination, the therapist initial test as shown in the image, Which of the following would be considered a'P finding when performing the special test? A. Inability to maintain the test position for three minutes B. Subjective report of fatigue in the arms C. Absence of a radial pulse after one minute D. Failure of the hands to regain their normal color after 30 seconds Correct Answer: A Roos test is a commonly employed special test for patients with thoracic outlet syndrome. The test is performed ‘with the patient positioned in sitting or standing with the arms positioned in 90 degrees of abduction, lateral rotation, and elbow flexion. The patient is asked to open and close their hands for three minutes.‘A positive Roos test is indicated by an inability to maintain the test position, weakness of the arms, sensory Joss or ischemic pain ‘The act of opening and closing the hands for three minutes often produces a subjective report of fatigue in the arms. A subjective report of fatigue would also need to be accompanied by an inability to maintain the test position for three minutes to be considered a positive finding. The absence of a radial pulse after one minute is not considered a positive test when performing Roos test Unlike other tests for thoracie outlet syndrome (e.g., Adson’s test, Halstead maneuver), Roos test does not require the radial pulse to be assessed during the testing procedure. ‘The color of the hands is not typically examined duffing Roos test, Other special tests such as Allen’s test at the wrist or the eapillary refill test would be m to assess this type of change in appearance. 102. A physical therapist inspects a patient’s wh x identifies that the wheel axle is aligned further posterior than it typically would be in a sta This type of alignment would likely result in ‘A. Decreased rolling resistance B. Increased ability to perform a “wheelie C. Decreased turning radius D. Increased energy required for prop Correct Answer: D Posterior alignment of the wheel axle is. jateral amputations to inerease stability and compensate fr bh also.be utilized in a recliner elie.” Patients with spinal e0 a*wheelie” since this positio The posterior alig fir since the distance from the wheel. axle to 1 maneuverability of the wheelchair . The posterior alignment o} hured for propulsion which serves to decrease the ps 103. _A physical therapist axillary cruteh is modified ly reason for the modification? A. The patient has a rad B. The patient has a pro: C. The patient has imp D. The patient has a tr Correct Answer: A A platform attachment cal be added to axillary crutches, forearm crutches or # This modification is used for patients who are jmable to bear weight through their wrists and hands, who have deformities of the ‘wrists or fingers, who have an amputation distal to the elbow or who are unable to extend the elbow. A. A patient with a radial nerve injury would have significant weakness of the triceps muscle and be unable to extend the elbow. The platform modification would be necessary since the patient would be unable to produce elbow extension and would instead need to bear weight through the albow and forearm. B. A platform attachment would not be appropriate for a patient with a proximal humeral fracture. Whether the ‘weight bearing occurs through the patient’s hand or the patient's elbow and forearm, the fracture site would still be experiencing increased weight bearing forces.C. A patient with impaired balance and coordination would not likely be a good candidate for axillary crutches In the event a patient with impaired balance and coordination was determined to be an appropriate candidate for axillary crutches, the platform attachment would still not offer any additional compensation for the patient's described impairments. D. A transhumeral amputation occurs at the elvel of the mid-humerus, Without an elbow joint and forearm, the patient would have nothing to bear their weight through when using a platform attachment 104. A physical therapist works with patient on whe cerebrovascular accident with right-sided hemiparg would be MOST beneficial for the patient to e [chair mobility. The patient has a history of Which of the following wheelchair adaptations ety during stand pivot transfers? A. Anti-tip tubes B. Pull-to wheel lock with brake extensions C. Elevating leg rests D. Removable full-length armrests Correct Answer: B Performing transfer training with a patient wii of the physical therapy plan of care to u present following a left hemisphere cerebrg include weakness, paralysis of the right s apraxia, and right hemianopsis eee scular accident is an important component independence, Impairments that are affect a patient's ability to safely transfer ed processing, possible motor hemiparesis. Elevating leg rests are ind prevent dependent ede ‘most essential wheelehair Removable full-length a necessary for a stand pivot muty. Elevating leg rests can s, however, would not be the 105. A patient is limited ir but is not limited when the nee is flexed, The MOS: ‘A. The gastrocnemius B. The soleus is respo C. The popliteus is re: D. The gastrocnemi Correct Answer: A The gastrocnemius umiscle eousists of a medial and lateral head innervated by the originates on the proximal and posterior part of the medial condyle, adjacent part of the femur, and capsule of the knee joint. The lateral head originates on the lateral condyle, posterior surface of the femur, and capsule of the knee joint. The muscle inserts on the middle part of the posterior surface of the calcaneus. A. The gastrocnemius is a two-joint nmuscle that crosses both the knee and ankle joints. When the knee is flexed, the muscle is placed on slack which allows for normal ankle range of motion. A limitation in ankle range of motion when the knee is extended may indicate a restriction in the gastrocnemius and possibly the plantaris. both responsible for the limitatiB. The soleus is a one-joint muscle that plantar flexes the ankle joint and is innervated by the tibial nerve. The muscle’s length would not be influenced by the position of the knee. C. The popliteus muscle medially rotates the tibia on the femur and flexes the kuee joint in non-weight bearing, ‘The muscle acts to laterally rotate the femur on the tibia and flexes the knee joint in weight bearing. The popliteus muscle is also a one-joint muscle D. The gastrocnemius and soleus work together to plantar flex the ankle. The length of the gastrocnemius would be affected based on the position of the knee, however, the length of the soleus would not be affected. since itis one-joint muscle. 106, A physical therapist completes a coordinationjiggsesment on a 67-year-old patient with central nervous system involvement. After reviewing the result: sessment, the therapist concludes the clinical findings are indicative of cerebellar dysfunctig nding is NOT associated with cerebellar dysfunction? ‘A. Dysmetria B. Hypertonia Cc. Ataxia D. Nystagmus Correct Answer: B Cerebellar pathology is often characterizg pecifie motor impairments associated with cerebellar pathol, jdpnystagmus, tremor, and otonia causes ‘movement, and po hm, and timeing of responses. . Nystagmus refers to abud oscillation of the eyes. The speed of movement is 107. A physical therapist cl MOST likely be associate ‘A. Asthina B. Lung abscess C. Pulmonary edema D. Tuberculosis Correct Answer: B Sputum refers to matter exp he respiratory system 18 saliva, nmcus or foreign matter, The relative color ition of the sputum can provide val ption to health care sh-greenish in color and . Asthma is a chronic inflammatory disease of the airways, Sputum associated with asthma is most often described as mmicoid . A lung abscess refers to necrosis of pulmonary tissue and formation of cavities containing necrotic debris or fluid caused by infection. Sputum associated with a lung abscess is most often described as purulent Pulmonary edema refers to an abnormal accumulation of finid in the alveolar spaces of the lungs. Sputum associated with pulmonary edema is most often described as frothy.D. Tuberculosis refers to a highly contagious infectious disease spread via airbome transmission, Sputum associated with tuberculosis is often blood-tinged due to damage to the respiratory tract caused by excessive coughing. 108. A physical therapist participates in a research study to determine the effect of noise level on the ability to perform a physical skill. In the study, noise is the: A. Independent variable B. Dependent variable C. Criterion variable D. Extraneous variable Correct Answer: A The independent variable is also known as the predictor variable, Iti the condition, intervention or characteristic that will predict or in an experimental study. A. Noise level is the independent variable bec ‘ion or characteristic that the researcher will manipulate to see how it changes physical ‘The dependent variable is also known as ‘hich is the response or effect that is presumed to vary with the independent she dependent variable because itis presumed to vary depending on noise us variable is any Correct Answer: C A patient with @ complete C6 sf or reflex fimction below the C6 level. As a result, any ident e that the injury is not complete. A. The dermatome associate fefore sensation in this area would typically be intact B. The triceps reflex is asso would be absent ina complete spinal cord inj c. ‘a result, the finding of injury at this level 110. _A physical therapist reviews the medical record of a 77-year-old patient that was prescribed nonsteroidal antiinflammatory medications (NSAIDS) for pain following arthroscopic surgery. If toxicity is a eoncem, the physician would have likely prescribed an analgesic that possesses: A. Fashort half-life B. A long half-life C. Minimal biotransformation D. Limited clearance Correct Answer: A.‘When prescribing medication, the physician should be aware of a variety of factors including absorption, distribution, metabolism, excretion, and pharmacodynamics. A. Half life is defined as the amount of time required for fifty percent of the drug remaining in the body to be climinated in general, elderly patients do not metabolize medications as quickly as younger patients which creates higher plasma levels. As a result, the elderly are at a higher risk for toxicity or adverse effects, Medications with a short half-life reduce these risks. Half-life is typically the most relevant pharmacokinetic parameter that is considered with the prescription of medication. NSAIDs stich as Aleve have a long hall F has a short half-life (approximately two hours), Biottansformation refers to the series of chemicaljehatiges that take place within a drug following its administration, most often due to enzymatic acti ansformation typically converts the drug to an. occur with accumulation or prolonged fective in preventing drug toxicity as a iedication with a shorter half-life. . Clearance refers to the rate at which an a from the body. Clearance is dependent on the organ’s or tissue’s ability to extract the .d on the overalll perfusion of the organ. Ifa rug possessed limited clearance, there toxicity since it would take the drug longer to be eliminated fiom the systeu ‘which technique to Correct Answer: Superficial cutaneous, brief contraction of the mit A. Light touch sensation is 3 B. Passive joint range of motia ictile structures on range of inotion or tone (hypertonic; C. The plantar reflex (S1, $2) cited by stroking the lateral aspect of the foot from the il response is indicated by flexion of the great toe, w the great toe with fining of the four other toes (Bal upper motor neuron damage. Deep tendon reflexes ard ire elicited by tapping over a nmsele tendon. A ph S er after placing the tendon onsslight stretch. 112. A patient retums td an outpatient physical therapy clinic two hours afte ical therapy session complaining of increased back pain. The patient has been in physical therapy {oF three previous visits and has had litle difficulty with a program consisting of palliative modalities and pelvie stabilization exercises. The patient was referred to physical therapy after injuring his back two weeks ago. The MOST appropriate physical therapist action is: A. Contact the referring physician to discuss the patient's care plan B. Instruct the patient to discontinue the pelvic stabilization exercises and re-examine the patient at his next visit C. Refer the patient to the emergeney room of a local hospitalD. Instruct the patient to cancel existing physical therapy visits and schedule an appointment with the physician Correct Answer: B Physical therapist must carefully assess a patient's response to physical therapy interventions. The severity of ‘he patient’s signs and symptoms combined with the therapist's knowledge of their medical condition assists the ‘therapist to make an informed decision regarding an appropriate eourse of action, A. The patient's current complaints do not suggest the need for immediate consultation with the referring physician. ‘The physical therapist should have the patient discdiifinue any activities that increase their pain. The therapist can re-examine the patient at the enxt scliediiled visit and determine an appropriate course of action based on the findings. ‘The patient’s current complains are not severe, warrant referral to an emergency room. Physical therapists most often refer patients ‘ring physician due to a change in medical status or failure to make anticipated progress in pl Ujhe patient's recent increase in symptoms does not suggest that the patient is not a candida a ditions, which are experienced at a high rate in old ‘na definitive medical diagnosis. ‘A. Pseudogout is an inflam cium crystals in the articular and periarticular structures Jo diagnose this condition, Pseudogout most commot B. Goutisan inflammatory tion of wate crystals in the joint which causes hy st metatarsophalangeal joint Polymyalgia cheumatic primarily by older adults. pain is most commonly experienced in the pelv Systemic lupus erythen 1 autoimmune condition character78 ous organ and joint issues. Typically, a pai h systemic Inpus erythematosus exhibits a 0 butterfly rash and experiences joint pain ly affecting smaller joints. 114, A patient exhibits pain and sensory loss in the posterior thigh, Iteral calf, and dorsal foot. Extension of the hallux is poor, however, the Achilles reflex is normal. What spinal level would you expect to be involved? A 14 B. LS c SL D. S2Correct Answer: B Involvement of a specific spinal level often results in predictable impairments including diminished sensation, muscle weakness, impaired reflexes, and paresthesias. a. L4 nerve root: Dermatome- medial buttock, lateral thigh, medial leg, dorsum of foot, great toe Myotome-tibialis anterior, extensor halluces Reflexes- patellar b._LS nerve root: Dermatome- buttock, posterior and lateral thigliflateral aspect of leg, dorsum of foot, medial half of sole, first, second, and third toes. , hamstrings, plantar flexors ‘Dermatome — lateral and plantar aspect @ Myotome- hamstrings, peroneal, plant d. S2 nerve root: Dermatouse — buttock thigh, poster Myotome — hamstrings, plantar J Reflexes — AcI placebo control may be used in clinical conditions for which pose of the research is to determine if particular treatn pliged to inform the potential Jnuman subjects when the stud ‘A. Anon-treatment control gt treatments have been effective Positive results in animal| ‘group acceptable in research on humans, Federal regulations in th A d (IRB) review research proposals using human of the subjects are protected. However, re ontrol group acceptable Random assignment off that could affect the outcomes of the study, However, it does not mike the use of a non-treatimeW@pHiaol group acceptable. 116. A physical therapist treats a patient diagnosed with spinal stenosis. As part of the treatment program the patient lies prone on a treatment plinth with a hot pack draped over the low back. The MOST effective ‘method to monitor the patient while using the hot pack is: ‘A. Check on the patient at least everyten minutes B. Supply the patient with a bell toring if the hot pack becomes too hot C. Instruct the patient to remove the hot pack if it becomes too hot D. Select an altemative superficial heating modality Correct Answer: B‘A hot pack consists of a canvas or nylon covered pack filled with a hydrophilic silicate gel that provides a moist ‘heat. A hot pack must be stored in hot water between 158 to 167 degrees Fahrenheit (70 to 75 degrees Celsius). Application requires six to eight layers of towels around the hot pack. Given the potential for burns, formal measures must be adopted to ensure safe use throughout the treatment session. ‘A. Checking on a patient on a frequent basis is desirable, however, 10 minutes is not frequent enough particularly when considering that the duration of treatment with a hot pack may only be 15-20 minutes. B. Supplying the patient with a bell to ring ifthe hot pack becomes too intense provides a form of instant communication with the therapist. The use of a bell does not negate the need for the physical therapist to formally check on the patient frequently. Imay be challenging for the patient to indepen -move the hot pack based on the selected positioning. In addition, this option places the b ely on the patient to make a definitive decision on Whether or not fo contimie using the hot pack n should be made by the therapist with feedback from the patient. D. There is no need to discontinue a selected i absence of data to support this decision. Hot packs can be a safe and effective form of applied with the necessary precautions. 117. A patient employed ina machine syndrome. The patient indicates that diagnosis. Which of the followin ‘A. Electroencephalography is the recording ofthe electrical herlectrical activity is collected by examining the difference between the electrical potential of two electrodes placed at different locations on the scalp. Electroencephalographiy & ily, metabolic disorders, and cerebellar lesions. An evoked potential refers to electrical acti ofa stimulus. Signals can be recorded from the cerebral cortex, brain stem s. Evoked potentials ean be used to determine how quickly and complet mil can be used to assist with the diagnosis of several medical conditions: Nerve conduction velocity refers to the spee Ves down a peripheral nerve. ‘The measure is recorded in meters per secon @ used to diagnose conditions such as carpal funnel syndrome, > e syndrome. Electromyographty is the recording of the electrical activity of a muscle group at rest and during voluntary contraetion. Electromyography is performed by ins electrode percutaneously into a muscle or through the Use of surface electrodes. The test is common] J assess peripheral nerve injuries and to differentiate between various neuromuscular disorders. patient diagnosed with carpal tunnel syndrome. Based on the presented image, which value would be MOST anticipated assuming the patient has normal wrist range of motion? . A. 0-20 degrees B. 0-30 degtees C. 0-40 degrees 118. A physical therapist performs a goniometric measurement of the wrist ona CG