SULLIVAN-SIEGELMAN BOOK REVIEW RETENTION
On initial examination,
EXAM
1. A patient presents with fingertips that are rounded
and bulbous. The nail plate is more convex than
normal. These changes are the likely result of
which condition?
a. Trauma to the nail bed.
b. Psoriasis.
c. Chronic hypoxia from heart disease.
d. Inflammation of the proximal and lateral nail
folds.
2. A patient complains of right shoulder pain since
falling onto the right shoulder 3 weeks ago. There
was no dislocation and x-rays were negative.
AROM is 35o of flexion and abduction with
scapular elevation noted. Passive ROM is nearly
full, with mild pain and muscle guarding at the end
of range. Resisted abduction is weak with pain
noted in the anterior and lateral deltoid region.
There is no atrophy. Based on the above findings,
the physical therapist should MOST LIKELY
suspect:
a. Adhesive capsulitis
b. Axillary nerve palsy
c. Supraspinatus tendinitis
d. Rotator cuff tear
3. A child with spastic diplegia is becoming
independent in using a walker. Additional goals
desired by the physical therapist include
improving posture and increasing the child’s
energy efficiency and velocity while ambulating. In
this case, which walker is most likely to help
improve these goals?
a. A posterior rollator walker with four wheels
b. A posterior rollator walker with two wheels
c. A standard anterior walker with no wheels
d. An anterior rollator walker with two wheels
4. A patient with an 8-year history of Parkinson’s
disease is referred for physical therapy. During
the initial examination, the patient demonstrates
significant rigidity, decreased PROM in both upper
extremities in the typical distribution and frequent
episodes of akinesia. The exercise intervention
that BEST deals with these problems is:
a. Modified plantigrade, isometric holding,
stressing upper extremity shoulder flexion
b. Resistance training, free weights for shoulder
flexors at 80% of one repetition maximum
c. Sitting, PNF bilateral symmetrical upper
extremity D2 flexion patterns, rhythmic
initiation
d. Quadruped position, upper extremity
proprioceptive neuromuscular facilitation
(PNF) D2 flexion and extension
5. A patient complains of difficulty walking. At rest,
the skin in the lower leg appears discolored, after
walking for about 2 minutes, the patient complains
of pain in the leg. A marked pallor is also evident
in the skin over the lower third of the extremity.
The PT suspects:
a. Restless leg syndrome
b. Vascular claudication
c. Peripheral neuropathy
d. Neurogenic claudication
6. A young adult who is comatose (Glasgow Coma
Scale score of 3) is transferred to a long-term care
facility for custodial care.
the therapist determines the patient is
demonstrating decerebrate posturing. Which limb
or body position is indicative of this?
a. The upper extremities in flexion and the lower
extremities in extension
b. Extreme hyperextension of the neck and
spine with both lower extremities flexed and
the heels touching the buttocks
c. All four limbs in extension
d. All four limbs in flexion
7. A patient is receiving mobilizations to regain
normal mid thoracic extension. After three
sessions, the patient complains of localized pain
that persists for greater that 24 hours. What is the
therapist’s best option?
a. Change mobilizations to gentle, low-amplitude
oscillations to reduce the joint and soft tissue
irritation
b. Continue with current mobilizations, followed
by a cold pack to the thoracic spine
c. Place the physical therapy on hold and
resume in 1 week
d. Change to self-stretching activities because
the patient does not tolerate mobilization
8. A patient recovering from stroke with minimal
lower extremity weakness and spasticity can walk
without an assistive device. The therapist
observes that as the patient walks there is
noticeable hip hiking on the more affected side
during swing phase. What is the BEST initial
intervention?
a. Bridging exercises progressing to sit-to-stand
training.
b. Marching while sitting on a therapy ball.
c. Standing and marching with manual pressure
applied downward on the pelvis
d. Partial wall squats using a small ball held
between the knees.
9. A soccer player with a Q angle more than 30
degrees exhibits abnormal patellofemoral
tracking. While playing soccer, what is the MOST
often used device to address this problem?
a. Derotation brace
b. Patellar stabilizing brace with a medial
buttress
c. Neoprene sleeve with a patellar cutout
d. Patellar stabilizing brace with a lateral
buttress
10. A therapist is treating a patient with left
hemiplegia and profound visuospatial perceptual
deficits. What is the BEST strategy to use initially
to assist this patient in the relearning of motor
tasks?
a. Simplify and restructure the environment and
minimize distractions
b. Maximize use of demonstration and gesture
c. Minimize use of verbal cues
d. Encourage independent practice
11. During which phases of the gait cycle would a PT
expect to observe an everted posture o the
calcaneus?
a. Terminal stance (heel-off) to pre-swing (toe-
off)
 b. From midstance through heel-off (toe-off)
c. From initial contact (heel strike) through
loading response (foot flat)
d. Initial swing (acceleration) through midswing
12. An elderly individual was found unconscious at
home and was hospitalized with a diagnosis of
cerebrovascular accident (CVA). Examination by
the PT reveals normal sensation and movement
on the right side of the body with impaired
sensation (touch, pressure, proprioception) and
paralysis on the left side of the body. The left side
of the lower face and trunk are similarly impaired.
What is the MOST likely location of the CVA?
a. Left parietal lobe
b. Right parietal lobe
c. Left side of brain stem
d. Spinal cord
13. An overweight adult patient complains of right
anterior hip and knee pain while walking,
especially when weight bearing on the right.
Lumbar AROM is normal and pain free. Right hip
AROM and PROM are limited compared to the left.
Right knee AROM and PROM are full and pain
free. There is no pain with resisted testing at the
right hip or right knee. The scouring test
reproduces the patient’s hip and knee symptoms.
Hip joint distraction relieves these symptoms.
Based on the above findings, what is the MOST
likely diagnosis?
a. Trochanteric bursitis
b. Patellofemoral syndrome
c. Piriformis strain
d. Hip degenerative joint disease.
14. What is the BEST evidence to determine orthotic
intervention to prevent inversion ankle sprains?
a. Systematic reviews of randomized controlled
trials
b. Meta-analyses of cohort studies
c. Meta-analyses of multiple case studies
d. Randomized double-blind controlled trials
15. A therapist is examining a patient with superficial
partial thickness burns over 20% of the trunk. The
correct identification of this burn type by surface
appearance characteristics includes:
a. A wet surface with broken blisters
b. A dry surface with no blisters
c. Intact blisters and a moist, weeping surface if
blisters are removed
d. Parchment-like, leathery, and dry surface
16. A patient who was caster for 3 weeks after a grade
III right ankle sprain has been referred to physical
therapy for mobility exercises. Examination shows
a loss of 10o of dorsiflexion. Which activity will be
the MOST difficult for the patient?
a. Ambulating over rough surfaces
b. Descending stairs
c. Ambulating barefoot
d. Descending a ramp
17. A patient with stage II primary lymphedema of the
right lower extremity is referred for physical
therapy. Examination reveals increased limb girth
with skin folds/flaps evident. An important
component of lymphedema management is
manual lymphatic drainage. Which of the
following describes a cardinal principle of manual
lymphedema management?
a. Deep tissue friction massage for several
minutes on fibrotic areas.
b. Decongesting the proximal portions of the
limb first and working distally
c. Decongesting the trunk after the limb
segments
d. Decongesting the distal portions of the limb
first and working proximally
18. When performing neutral tension testing to the
lower limb, which ankle position when combined
with a straight leg raise will BEST bias the
peroneal (fibular) nerve?
a. Dorsiflexion and eversion
b. Dorsiflexion and inversion
c. Plantarflexion and eversion
d. Plantarflexion and inversion
19. A contraindication to initiating extremity joint
mobilization on a patient with chronic pulmonary
disease may include:
a. Long-term corticosteroid therapy
b. Functional chest wall immobility
c. Concurrent inhalation therapy
d. Reflex muscle guarding
20. What common compensatory postures would a PT
expect a for a patient diagnosed with fixed severe
forefoot varus?
a. Excessive midtarsal supination and lateral
rotation of the tibia
b. Toeing-in and lateral rotation of the femur
c. Excessive ankle dorsiflexion and medial
rotation of the femur
d. Subtalar pronation and medial rotation of the
tibia
21. During a finger-to-nose test, a patient
demonstrates hesitancy in getting started and is
then unable to control the movement. The finger
slams into the side of the face, missing the nose
completely. How should the therapist document
this finding?
a. Dysmetria
b. Dysdiadochokinesia
c. Dyssynergia
d. Intention tremor
22. A therapist wishes to use behavior modification
techniques as part of a plan of care to help shape
the behavioral responses of a patient recovering
from traumatic brain injury (TBI). What
intervention is the BEST to use?
a. Use frequent reinforcements for all desired
behaviors
b. Encourage the staff to tell the patient which
behaviors are correct, and which are not
c. Reprimand the patient every time an
undesirable behavior occurs
d. Allow the patient enough time for self-
correction of the behavior
23. When performing scoliosis screening in a school
setting, what is the optimal age for girls to be
screened?
a. 11-13
b. 6-8
c. 9-11
d. 15-17
24. During gait analysis, a therapist notes that a
patient is lurching backward during stance phase.
What is the cause of this compensatory motion?
a. Gluteus medius weakness
 b. Hip and knee flexion contractures
c. Quadriceps weakness
d. Gluteus maximus weakness
25. A PT decides to exercise a patient with lower
extremity lymphedema using aquatic therapy.
Hydrostatic pressure exerted by the water can be
expected to do which of the following?
a. Increase cardiovascular demands at rest and
with exercise
b. Reduce effusion and assist venous return
c. Provide joint unloading and enhance ease of
active movement
d. Increase resistance as speed of movement
increases
26. A patient with a 10-year history of diabetes
complains of cramping, pain, and fatigue to the
right buttock after walking 400 feet or climbing
stairs. When the patient stops exercising, the pain
goes away immediately. The skin of the involved
leg is cool and pale. The therapist checks the
record and finds no mention of this problem.
Given this patient’s symptoms, what is the likely
diagnosis?
a. Peripheral nerve injury
b. Spinal nerve root impingement
c. Raynaud’s phenomenon
d. Peripheral arterial disease (PAD)
27. A patient sustained a trimallolar ankle fracture on
the right and a fracture of the left distal radius. For
partial weight bearing, it is BEST if the therapist
has the patient use which device?
a. Axillary crutches
b. Forearm crutches
c. Platform crutches
d. Lofstrand crutches
28. During an examination, a patient demonstrates
large-amplitude, sudden flailing motions of the
arm and leg on one side of the body with primary
involvement of axial and proximal joint muscles.
What clinical term BEST describes the patient’s
behaviors?
a. Athetosis
b. Chorea
c. Hemiballismus
d. Intention tremor
29. A 28-year-old professional mountain bike rider
presents to cardiac rehabilitation after suffering a
myocardial infarction 8 weeks ago. Which graded
exercise test would be MOST beneficial to assess
aerobic capacity in this patient to create an
aerobic conditioning program?
a. Bruce protocol
b. Step test
c. Lower extremity ergometry
d. 6-minute walk test
30. A patient recovering from stroke is having
difficulty bearing weight on the left leg. The
patient is unable to advance the tibia forward and
abbreviates the end of the stance phase on the left
going directly into swing phase. The MOST likely
cause of the patient’s problem is:
a. Weakness or contracture of the hip extensors
b. Spasticity or contracture of the plantarflexors
c. Spasticity of the anterior tibialis muscles
d. Weakness or contracture of the dorsiflexors
31. What is the expected hemodynamic response for
a patient on a beta-adrenergic blocking agent
during exercise?
a. Heart rate to be low at rest and rise minimally
with exercise
b. Heart rate to be low at rest and rise
continuously to expected levels as exercise
intensity increases
c. Systolic blood pressure to be low at rest and
not rise with exercise
d. Systolic blood pressure to be within normal
limits at rest and progressively fall as
exercise intensity increases.
32. During a test of upper extremity rapid alternating
movement (RAM), the movements of the hands
and elbows become irregular with wider
excursions than expected. As speed is increased,
the movements become more disorganized. These
findings are indicative of:
a. Brainstem dysfunction
b. Lower motor neuron weakness
c. Cerebellar dysfunction
d. Upper motor neuron weakness
33. A therapist suspects lower brain stem
involvement in a patient with amyotrophic lateral
sclerosis (ALS). Examination findings reveal
motor impairments of the tongue with ipsilateral
wasting and deviation on protrusion. These
findings confirm involvement of which cranial
nerve?
a. Hypoglossal
b. Glossopharyngeal
c. Vagus
d. Spinal accessory
34. A patient who is recovering from a right CVA
reports being thirsty and asks for a can of soda.
The PT gives the patient the soda with
instructions to open the can. The patient is unable
to complete the task. Later, after the treatment
session, when the patient is alone, the therapist
observes the patient drinking from the can, having
opened the can on his own. The therapist
suspects the patient may have a primary deficit in:
a. Unilateral neglect
b. Anosognosia
c. Ideational apraxia
d. Ideomotor apraxia
35. A patient complains of persistent wrist pain after
painting a house 3 weeks ago. The patient
demonstrates signs and symptoms consistent
with de Quervain’s tenosynovitis. An appropriate
special test to confirm the diagnosis is:
a. Finkelstein’s test
b. Phalen’s test
c. Froment’s sign
d. Craig’s test
36. A patient has normal quadriceps strength but
unilateral weakness (3/5) of the hamstring
muscles on the right. What might the therapist
observe during swing phase of gait?
a. Decreased hip flexion followed by increased
knee flexion on the weak side
b. Excessive compensatory hip extension on the
sound side
c. Excessive hip extension followed by abrupt
knee extension on the weak side
d. Excessive hip flexion followed by abrupt knee
extension on the weak side
37. Which of the following activities demonstrates an
infant’s integration of the asymmetrical tonic neck
reflex?
a. Can turn head to either side with extended
arms.
b. Turns head to one side and brings opposite
hand to mouth.
c. Turns head to one side and looks at the
extended arm on that side.
d. Turns head to one side and brings hand to
mouth on the same side.
38. A patient with diagnosis of left-sided CHF, class II
is referred for physical therapy. During exercise,
this patient can be expected to demonstrate:
a. Weight gain with dependent edema
b. Dyspnea with fatigue and muscular weakness
c. Severe, uncomfortable chest pain with
shortness of breath
d. Anorexia, nausea with abdominal pain and
distention
39. Confirmation of a diagnosis of spondylolisthesis
can be made when viewing an oblique radiograph
of the spine. What is the relevant diagnostic
finding?
a. Posterior displacement of L5 over S1
b. Bamboo appearance of the spine
c. Compression of the vertebral bodies of L5
and S1
d. Bilateral pars interarticularis defects
40. A patient demonstrates quadriceps weakness
(4/5) and difficulty descending stairs. The BEST
intervention to regain functional strength in the
quadriceps is:
a. Progressive resistance exercises, 70% 1
repetition maximum, three sets of 10
b. Partial squats, progressing to lunges
c. Maximum isometric exercise, at 45° and 90° of
knee extension
d. Isokinetic exercise, at 36°/sec
41. A patient recovering from traumatic brain injury
(TBI) is unable to bring the right foot up on the
step during stair climbing training. What is the
BEST choice to promote independent stair
climbing for this patient?
a. Practice marching in place
b. Strengthen the hip flexors using an isokinetic
training device before attempting stair
climbing
c. Passively bring the foot up and place it on the
7-inch step
d. Practice stair climbing inside the parallel bars
using a 3-inch step.
42. A PT has decided to refer a 2-year-old child to a
neurologist after the initial evaluation. The PT has
concluded that the child may be autistic. The
MOST PERTINENT factor to include in the referral
is that the child is:
a. Delayed in gross motor skills
b. Quiet and did not want to separate from the
mother
c. Defensive when touched
d. Responsive to most but not at all commands
43. While ambulating a patient in the parallel bars, a
therapist loses control and the patient falls, hitting
his or her head on the bar. The patient lies
motionless on the floor between the bars bleeding
heavily from a scalp laceration. What is the first
thing the therapist should do?
a. Apply a thick gauze and manual pressure to
the scalp wound
b. Immediately determine the patient’s heart rate
and blood pressure
c. Check for responsiveness
d. Call emergency medical services
44. During a gait examination, a patient with a
transfemoral prosthesis demonstrates terminal
swing impact. Additional examination is needed
as the therapist suspects the:
a. Prosthesis has too little tension in the
extension aid
b. Hip flexors are weak
c. Prosthesis is externally rotated
d. Prosthesis has insufficient knee friction
45. A patient presents for the initial examination with
an acute and painful shoulder impingement.
During the examination, the PT finds significantly
increased muscle guarding around the shoulder
girdle with difficulty in accurately assessing joint
mobility. Which manual therapy technique is the
BEST option to use to assist in performing a
proper assessment?
a. Maitland grade III posterior glide to the
glenohumeral joint
b. Maitland grade II oscillation to the
glenohumeral joint
c. Maitland grade III inferior glide to the
glenohumeral joint
d. Maitland grade IV inferior glide to the
glenohumeral joint
46. Upon examining a patient with vague hip pain that
radiates to the lateral knee, the PT finds a negative
FABERE test, a negative grind test, and a positive
Noble compression test. The dysfunction is MOST
likely due to:
a. Iliotibial band friction disorder
b. Degenerative joint disease of the hip
c. Sacroiliac joint dysfunction
d. Irritation of the L5 spinal nerve root
47. A patient with diabetes mellitus has had a stage III
decubitus ulcer over the right ischial tuberosity
for the past 5 months. The ulcer is infected with
staphylococcus aureus, and necrotic tissue
covers much of the wound. What therapeutic
modality is CONTRAINDICATED in this situation?
a. Low-voltage, constant micro amperage direct
current
b. High-voltage monophasic pulsed current
c. Alternating/biphasic current
d. Moist hot packs
48. A patient recovering from traumatic brain injury
(TBI) demonstrates impaired cognitive function
(Rancho Cognitive Level VII). What training
strategy should be the therapist’s focus.
a. Provide assistance as needed using guided
movements during training
b. Involve the patient in decision-making and
monitor for safety
c. Provide a high degree of environmental
structure to ensure correct performance
d. Provide maximum supervision as needed to
ensure successful performance and safety
49. A woman is hospitalized in the intensive care unit
with multiple closed and open fractures after a
motor vehicle accident. A review of her medical
 record reveals the following laboratory values:
haematocrit 28%, haemoglobin 10g/ 100 mL and
serum white blood cell (WBC) count 12,000/mm3.
What is the MOST accurate interpretation of these
findings?
a. All values are abnormal
b. Haematocrit and haemoglobin values are
abnormal; WBC is normal
c. Only serum WBC is abnormal
d. Only haematocrit values are abnormal
50. A patient was referred for physical therapy after a
right breast lumpectomy with axillary lymph node
dissection. Scapular control is poor when upper
extremity flexion or abduction is attempted. Early
PT intervention should focus on:
a. Gravity-assisted right upper extremity
exercises to promote scapular control
following damage to the long thoracic nerve
b. Strengthening of the right deltoids to help
stabilize the shoulder, which compensates for
damage to the dorsal scapular nerve
c. Active assistive pulley exercises to assist
rotator cuff muscles following damage to the
suprascapular nerve
d. Strengthening of the right rhomboid to
promote normal function of the scapula as a
result of damage to the dorsal scapular nerve
51. A physical therapist examined the deep tendon
reflexes of a patient recently diagnosed with
amyotrophic lateral sclerosis (ALS). The results
are 2+ left and 4+ right. What is the correct
interpretation of these findings regarding the
reflexes?
a. Abnormal on the left and normal on the right
b. Normal on the left and brisker, possibly
abnormal on the right
c. Depressed, low normal on the left and normal
on the right
d. Normal on the left and abnormal on the right
52. Nearly 2 months ago, a patient noticed left
shoulder pain after walking the dog. This pain has
progressively worsened. The patient now is
unable to move the left upper extremity overhead
while performing ADLs. An orthopedic surgeon
diagnosed the problem as adhesive capsulitis.
The MOST effective direction for glenohumeral
mobilization for this patient would be:
a. Anteroinferior translatory glides.
b. Posteroinferior translatory glides.
c. Anterosuperior translatory glides
d. Posterosuperior translatory glides
53. After completing an examination of a patient with
shoulder pain, the PT concludes that the cause is
subscapularis tendinitis. Which clinical finding is
supportive of this conclusion?
a. Tenderness at the greater tubercle of the
humerus
b. Painful resisted shoulder adduction
c. Pain provoked with active glenohumeral
external rotation
d. Pain provoked with passive glenohumeral
external rotation
54. A patient presents with rapidly progressive
symmetrical weakness that started in the distal
lower extremity muscles but now has ascended to
include proximal trunk and upper extremity
muscles. The motor segments of the lower cranial
nerves are also showing impairment. The patient
complains of abnormal sensations of tingling and
burning of the affected extremities.
Consciousness, cognition, and communication
are all normal. These signs and symptoms are
characteristic of what diagnosis?
a. Multiple sclerosis
b. Guillain-Barre syndrome
c. Amyotrohic lateral sclerosis
d. Postpolio syndrome.
55. A patient is 2 days, post-left CVA and has just
been moved from the intensive care unit to a
stroke unit. When beginning the examination, the
therapist finds the patient’s speech slow and
hesitant. The patient is limited to one- and two-
word productions, and expressions are awkward
and arduous. However, the patient demonstrates
good comprehension. What type of speech
disorder is this patient exhibiting?
a. Dysarthria
b. Fluent aphasia
c. Global aphasia
d. Nonfluent aphasia
56. A therapist wishes to determine the fall risk of an
elderly person in a long-term care facility. Which
test of static balance would be most difficult for
this person to perform?
a. Standing unsupported with feet together, eyes
open
b. Standing unsupported with one foot in front,
tandem position, eyes closed
c. Standing unsupported with eyes closed
d. Standing unsupported on one leg, eyes open
57. A PT is performing clinical research in which a
specific myofascial technique is applied to a
patient with chronic back pain. She is using a
single case experimental design with an A-B-A-B
format. Her research hypothesis states that pain-
rating scores will decrease with the treatment
intervention. Acceptance of this hypothesis would
be indicated if:
a. B is less than A
b. B is greater than A at 1.0 level
c. B is greater than A at the 0.05 level
d. B is equal to A
58. A weightlifter exhibits marked hypertrophy after
embarking on a strength training regime.
Hypertrophy can be expected to occur following at
least:
a. 1-2 weeks
b. 2-3 weeks
c. 3-4 weeks
d. 6-8 weeks
59. A patient has a C5, ASIA A spinal cord injury. An
effective coughing technique for this patient is
which of the following?
a. Should be facilitated by use of a phrenic
nerve stimulator
b. Should be facilitated by use of
glossopharyngeal breathing
c. Can be elicited with manual abdominal
pressure provided with the assistance of a
caregiver
d. Can be elicited with manual abdominal
pressure provided independently by the
patient
60. A patient with multiple sclerosis (MS) presents
with dysmetria in both upper extremities. Which of
the following interventions is the BEST choice to
deal with this problem?
a. 3-lb weight cuffs to wrists during activities of
daily living (ADL) training
b. Isokinetic training using low resistance and
fast movement speeds
c. Pool exercises using water temperatures
greater than 85°F
d. Proprioceptive neuromuscular facilitation
(PNF) patterns using dynamic reversals with
carefully graded resistance
61. During an initial interview and history, a patient
with a right CVA seems unconcerned about
obvious paralysis of the left arm and leg. When
the therapist asks the patient to describe what
happened, the patient says “I must have slept
wrong and my arm and leg fell asleep.” The
patient further tells the therapist, “My family put
me in this place so they could go on vacation.”
Which type of perceptual disorder BEST
characterizes the patient’s responses?
a. Anosognosia
b. Prosopagnosia
c. Spatial relations disorder
d. Somatoagnosia
62. An elderly patient is being examined by the PT.
The PT notes an irregular, dark-pigmented ulcer
over the medial malleolus. The patient states this
is not painful. The MOST likely diagnosis is:
a. Arterial ulcer
b. Venous ulcer
c. Diabetic ulcer
d. Arterial insufficiency
63. Upon removing the dressing covering a decubitus
ulcer located on the heel of an elderly patient, the
physical therapist observes copious amounts of a
foul-smelling, yellow-green discharge. How
should the therapist document this finding in the
patient’s medical record?
a. There is likelihood of a staphylococcus
aureus infection
b. Wound exudate is purulent
c. Maceration of the wound is evident
d. Wound exudate is serosanguinous
64. A therapist has elected to use continuous
inductive coil short-wave diathermy (SWD) as one
of the interventions in managing hip pain. Use of
other thermal or electrical modalities were either
ineffective or contraindicated. Which patient
would be a candidate for use of short-wave
diathermy?
a. A morbidly obese patient
b. A patient with Type 1 diabetes who uses an
insulin pump
c. An 11-year-old boy with a slipped capital
femoral epiphysis
d. A patient with ankylosing spondylitis on high
doses of NSAIDS and DMARDS
65. A teen-aged female distance runner presents a
history of stress fractures and general leg pain.
Her parents think it may be due to overtraining.
Based on this subjective information, what should
the physical therapist question the patient about
next?
a. Participation in other sports
b. Type of running shoe
c. Recent growth spurts
d. Menses and eating habits
66. A patient suffered carbon monoxide poisoning
from a work-related factory accident and is left
with permanent damage to the basal ganglia.
Intervention for this patient will need to address
expected impairments of:
a. Impaired sensory organization of balance with
the use of standing balance platform training
b. Muscular spasms and hyperreflexia with the
use of ice
c. Motor planning with the use of guided and
cued movement
d. Motor paralysis with the use of free weights to
increase strength
67. Which activity would help break up obligatory
lower extremity synergy patterns in a patient with
hemiplegia?
a. High kneeling position, ball throwing
b. Standing, alternate marching in place with hip
and knee flexion and hip abduction
c. Sitting, alternate toe tapping
d. Sitting, foot slides under the seat
68. A patient is referred to physical therapy after an
anteroinferior dislocation of the right shoulder.
What positive examination finding is expected as
a result of this diagnosis?
a. Weak rhomboids
b. Positive drop arm test
c. Positive Neer’s test
d. Weak deltoids
69. A newborn is examined at birth using the APGAR
test. Which of the following APGAR results is a
likely indicator of potential neurological
complications?
a. 9 at 1 minute.
b. 8 at 5 minutes
c. 3 at 10 minutes
d. 8 at 1 minute.
70. A patient is receiving immunosuppressants
(cyclosporine) following renal transplantation.
Referral to physical therapy is for mobility training
using crutches. Initial examination reveals
paresthesias in both lower extremities, with
peripheral weakness in both hands and feet. The
PT determines that the patient is MOST likely
experiencing:
a. Myopathy
b. Leukopenia
c. Quadriparesis
d. Peripheral neuropathy
71. A snowmobile left the trail and struck a tree. The
driver’s left knee was flexed approximately 90
degrees and the tibia impacted with the inside
front of the snowmobile. What would this
mechanism of injury MOST LIKELY result in?
a. Dislocated patella
b. Sprained or ruptured posterior cruciate
ligament (PCL)
c. Sprained or ruptured anterior cruciate
ligament (ACL)
d. Rupture of the popliteal artery
72. A patient with pain in the left lateral face and head
is found to have limited active and passive mouth
opening range of motion. However, passive lateral
 deviation is full to both sides. What is the likely
reason for the limitation in mouth opening range
of motion?
a. An anteriorly displaced disc with reduction in
the left temporomandibular joint
b. Decreased flexibility in the muscles of
mastication on the left
c. Capsular restriction of the left
temporomandibular joint
d. An anteriorly displaced disc without reduction
in the left temporomandibular joint
73. A patient presents with partial-and full-thickness
burns on the chest and neck regions. The
therapist decides to apply transcutaneous
electrical nerve stimulation (TENS) before
debridement to modulate pain. Which TENS mode
should provide the BEST relief?
a. Conventional (high-rate) TENS
b. Acupuncture-like (low-rate) TENS
c. Brief intense TENS
d. Modulated TENS
74. A patient is recovering from a complete SCI (ASIA
A) with C5 tetraplegia. The PT is performing PROM
exercises on the mat when the patient complains
of a sudden, pounding headache and double
vision. The therapist notices that the patient is
sweating excessively, and determines BP at
240/95. The therapist’s BEST course of action is
to:
a. Lay the patient down immediately, elevate the
legs and then call for a nurse
b. Place the patient in a supported sitting
position and continue to monitor BP before
calling for help
c. Lay the patient down, open the shirt and
monitor respiratory rate closely
d. Sit the patient up, check and empty the
catheter bag and then call for emergency
medical assistance.
75. The physical therapist is instructing a new mother
to perform range of motion and stretching for her
newborn who has a clubfoot. In what directions
should the therapist advise her to carefully
stretch?
a. Plantarflexion and inversion
b. Plantarflexion and eversion
c. Dorsiflexion and inversion
d. Dorsiflexion and eversion
76. A therapist wants to know whether
neurodevelopmental treatment (NDT) handling
techniques produce an improvement in
independent rolling that lasts longer than 30
minutes. In this study, rolling is what type of
variable?
a. Control variable
b. Independent variable
c. Dependent variable
d. Intervening variable
77. A patient recovering from traumatic brain injury
(TBI) demonstrates difficulties in feeding resulting
from an unstable posture while sitting. The
therapist determines that modification is
necessary to ensure optimal function. What is the
first body segment or segments that the therapist
should align?
a. Trunk
b. Pelvis
c. Head
d. Lower extremities
78. To prepare a patient with a complete T12
paraplegia (ASIA A) for ambulation with crutches,
what upper quadrant muscles would be MOST
important to strengthen?
a. Lower trapezius, latissimus dorsi, and triceps
b. Middle trapezius, latissimus dorsi, and triceps
c. Upper trapezius, rhomboids, and levator
scapulae
d. Deltoid, triceps, and wrist flexors
79. Which of these findings is characteristic of a
boutonniere deformity of the finger?
a. Flexion of the distal interphalangeal joint
b. Contracture of the extensor digitorum
communis tendon
c. Rupture of central slip with volar slippage of
the lateral bands
d. Hyperextension of the proximal
interphalangeal joint
80. A patient is recovering from stroke and, at 4
months, is ambulating with a straight cane for
household distances. During outpatient physical
therapy, the therapist has the patient practice
walking with no assistive device. Recurvatum is
observed that worsens with continued walking.
What is the therapist’s BEST choice for
intervention?
a. Exercise the quadriceps using isokinetic
resistance at higher loads and increasing
speeds
b. Give the patient a small-based quad cane
(SBQC) to improve stability and have him/her
practice AROM in supine
c. Give the patient a KAFO to control the
hyperextension and a hemi-walker.
d. Practice isolated small-range quadriceps
eccentric control work in standing and
continue with the straight cane
81. An elderly patient has been hospitalized and on
complete bed rest for 10 days. A physical therapy
referral requests mobilization out of bed and
ambulation. The patient complains of aching in
the right calf. The therapist’s examination reveals
calf tenderness with slight swelling and warmth.
What is the BEST course of action for the
therapist?
a. Begin with ankle pump exercises in bed and
then ambulate.
b. Postpone ambulation and report the findings
immediately.
c. Ambulate the patient with support stockings
on.
d. Use only AROM exercises with the patient
sitting at the edge of the bed.
82. A patient is referred to physical therapy for
vestibular rehabilitation. The patient presents with
spontaneous nystagmus that can be suppressed
with visual fixation, oscillopsia, and loss of gaze
stabilization. Additional postural findings include
intense disequilibrium, and an ataxic wide-based
gait with consistent veering to the left. Based on
these findings, the PT determines that the patient
is MOST likely exhibiting signs and symptoms of:
a. Meniere’s disease
b. Acoustic neuroma
c. Benign paroxysmal positional vertigo
d. Acute unilateral vestibular dysfunction

83. What is an acceptable modified position to drain
the posterior basal segment of the left lower lobe
in a patient with pulmonary congestion?
a. Side-lying on the right, with a pillow under the
right hip and the bed flat
b. Prone, with a pillow under the hips and the
bed flat
c. Side-lying on the right, with a pillow between
the legs and the foot of the bed elevated 18
inches
d. Prone, with a pillow under the hips and the
bed elevated 18 inches
84. A therapist is treating a patient with Brown-
Sequard syndrome that resulted from a gunshot
wound. The therapist’s examination should reveal:
a. Sparing of tracts to sacral segments with
preservation of perianal sensation and active
toe flexion
b. Loss of motor function and pain and
temperature sensation, with preservation of
light touch and proprioception below the level
of the lesion
c. Loss of motor function below the level of the
lesion, primarily in the upper extremities
d. Ipsilateral loss of motor function, ipsilateral
loss of light touch and proprioception, and
contralateral loss of pain and temperature
85. A male patient is referred to outpatient physical
therapy for lower back pain. During the patient
interview, he describes a recent increased
difficulty with urinating that does not affect his
lower back pain symptoms. Neurological
screening examination is normal and Murphy’s
sign is negative. Based on this clinical scenario,
what may this patient’s low back pain be
associated with?
a. Lower urinary tract
b. First lumbar nerve root
c. Kidney
d. Sacro-iliac joint
86. An appropriate fine motor behavior that should be
established by 9 months of age is the ability to:
a. Build a tower of blocks
b. Pick up a raisin with a fine pincer grasp
c. Transfer objects from one hand to another
d. Hold a cup by the handle while drinking
87. A therapist is instructing the family of a 9-year-old
boy with Duchenne’s muscular dystrophy (MD).
What should be the main focus of the plan of care
for maintaining function in the lower extremities?
a. Strengthening the knee extensors and plantar
flexors
b. Strengthening the plantar flexors and
stretching the hip extensors
c. Stretching the hip flexors and plantar flexors
d. Strengthening the hip flexors and knee
extensors
88. When using a patellar tendon-bearing (PTB)
prosthesis, a patient will experience excessive
knee flexion in early stance if the:
a. Socket is aligned too far back or tilted
posteriorly
b. Foot position is inset too much
c. Socket is aligned too far forward or tilted
anteriorly
d. Foot position is outset too much
89. To examine a patient with a suspected deficit in
graphesthesia, what should the therapist ask the
patient to identify with eyes closed?
a. Different objects placed in the hand and
manipulated
b. The vibrations of a tuning fork when placed
on a bony prominence
c. A series of letters traced on the hand
d. Differently weighted, identically shaped
cylinders placed in the hand
90. An elderly and frail individual is receiving physical
therapy in the home environment to improve
general strengthening and mobility. The patient
has a 4-year history of taking nonsteroidal anti-
inflammatory drugs (NSAIDs) such as aspirin for
joint pain, and recently began taking a calcium
channel blocker (verapamil). The PT examines the
patient for possible adverse reactions/side effects
that could include:
a. Increased sweating, fatigue, chest pan
b. Stomach pain, bruising, confusion
c. Weight increase, hyperglycemia, hypotension
d. Paresthesias, incoordination, bradycardia
91. A therapist is treating a child with spastic diplegia.
What intervention can be used to promote
relaxation?
a. Rhythmic stabilization
b. Slow rocking on a therapy ball
c. Spinning in a hammock
d. Rolling and spinning on a scooter board
92. An elderly patient with persistent balance
difficulty and a history of recent falls (two in the
past 3 months) is referred for physical therapy
examination and evaluation. During the initial
examination, what should the therapist examine
first?
a. Level of dyspnea during functional transfers
b. Cardiovascular endurance during a 6-minute
walking test
c. Sensory losses and sensory organization of
balance
d. Spinal musculoskeletal changes secondary to
degenerative joint disease (DJD)
93. A young, otherwise healthy, adult is recovering
from a complete spinal cord injury (ASIA A) at the
level of L4. What are the functional expectations
for this individual?
a. Ambulation using bilateral AFOs and canes
b. Ambulation using bilateral KAFOs, crutches,
and a swing-through gait
c. Ambulation using reciprocating gait orthoses
and a reciprocating walker
d. Ambulation using bilateral KAFOs and a
reciprocating walker
94. A 14-year-old girl complains of subpatellar pain
after participation in an aerobic exercise program
for 2 weeks. The PT’s examination shows a large
Q-angle, pain with palpation at the inferior pole of
the patella and mild swelling at both knees. The
BEST intervention for this situation is:
a. Hamstring strengthening
b. Vastus medialis muscle strengthening
c. Vastus lateralis muscle strengthening
d. Taping to increase lateral patellar tracking
95. Following a cerebrovascular accident involving
the right hemisphere, a male patient is exhibiting
unilateral neglect. What might he do as a result?
 a. Eat food only from the left side of a plate
b. Bump his wheelchair into things on the right
side
c. Ignore or deny the existence of the right
upper extremity
d. Shave only on the right side of the face

96. A patient complains of foot pain when first arising

that eases with ambulation. The therapist finds
that symptoms can be reproduced in weight
bearing and running on a treadmill. Examination
reveals pes planus and pain with palpation at the
distal aspect of the calcaneus. Early management
would include:
a. Prescription for a customized orthosis
b. Strengthening of ankle dorsiflexors
c. Modalities to reduce pain
d. Use of a resting splint at night

97. When performing the Thomas test, the patient’s

thigh does not touch the table, indicating limited
hip extension. The amount of limited hip
extension does not change when the ipsilateral
knee is extended. What is the range-limiting
muscle?
a. Rectus femoris
b. Tensor fascia lata
c. Biceps femoris
d. Iliopsoas

98. In treating a patient with a diagnosis of right

shoulder impingement syndrome, the FIRST
intervention the PT should consider is to:
a. Instruct the patient in proper postural
alignment
b. Complete AROM in all shoulder motions
c. Implement a stretching program for the
shoulder girdle muscle
d. Modulate all pain

99. The therapist is treating a 1-year-old child with

Down syndrome at home and notices decreasing
strength in the extremities, with neck pain and
limited neck motion. Upper extremity deep tendon
reflexes (DTRs) are 3+. These signs and
symptoms are a hallmark of what diagnosis?
a. Lower motor neuron signs consistent with
Down syndrome
b. Atlanto-axial subluxation with lemniscal
impingement
c. Upper motor neuron signs consistent with
Down syndrome
d. Atlanto-axial subluxation with spinal cord
impingement

100.A PT is prescribing a wheelchair for a patient with

left hemiplegia who is of average height (5 feet 7
inches). Which of the following is the BEST choice
to improve the patient’s function?
a. A 17.5-inch seat height
b. Elevating leg rests.
c. Desk armrests
d. A 20-inch seat height