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A therapist is instructing a physical therapy student in writing a SOAP note. The student has misplaced the following phrase: Patient reports a functional goal of returning to playing baseball in 5 weeks. Where should this phrase be placed in a SOAP note? A. Subjective B. Objective C. Assessment D. Plan

A. Any phrase stated by the patient that is relevant information goes into the subjective portion of the note.

CORF is an abbreviation for which of the following? A. Certified Owner of a Rehabilitation Facility B. Certified Outpatient Rehabilitation Facility C. Control Organization for Rehabilitation Facilities. D. Corporation for Organization of Rehabilitation Facilities.

B. A CORF is a classification of a type of outpatient facility.

A patient presents to a clinic with decreased tidal volume (TV). What is the most likely cause of this change in normal pulmonary function? A. Chronic pulmonary disease B. Restrictive lung dysfunction C. Both of the above D. None of the above

B. A decreased tidal volume is caused by a restrictive lung dysfunction. An increased tidal volume is caused by an obstructive lung dysfunction.

A therapist working at a hospital calls another therapist in an outpatient facility to provide a brief history of a patient who is scheduled to leave the hospital and receive outpatient therapy. The acute care therapist states that the patient received an injury to the somatic sensory association cortex in one hemisphere. From this information only, the outpatient therapist knows that the patient will most likely A. ignore someone talking to him or her on the involved side B. be unable to find one of his or her extremities. C. have no trouble putting on clothes. D. be unable to understand speech.

B. A deficit in this region of the brain usually results in the inability to locate an extremity. This patient would have trouble putting on clothes

Which of the following neural fibers are the largest and fastest? A. C fibers B. A fibers C. A and C are equal D. None of the above

B. A fibers are the largest in diameter and conduct faster than C fibers.

The therapist is evaluating a patient with left-side visual field deficits in both eyes. A lesion at what location may cause this defect? A. At the optic chiasm. B. At the right side optic tract. C. At the left side optic nerve D. At the right side optic nerve.

B. A lesion at choice A would cause bitemporal heteronymous hemianopsia. A lesion at choice C would cause left eye blindness, and a lesion at D would cause right eye blindness.

The following is a long-term goal for a patient with spinal cord injury: independence in performing a manual cough without applying pressure to the abdomen. This goal is the most challenging and obtainable for a patient with a complete lesion at which of the following spinal cord levels? A. C5 B. C7 C. T2 D. T10

B. A patient with a spinal cord injury at the C5 level would apply pressure to the abdomen to perform a cough. A patient with an injury in the T2 level and T10 level should be able to perform a cough independently, but this goal would be most challenging and obtainable for a patient an injury at the level of C7.

In order to determine if an exercise session should be terminated, the patient is asked to assess level of exertion using the Borg Rating of Perceived Exertion Scale (RPE). The patient rates the level of exertion as 9 on the 6-19 scale. A rating of 9 corresponds to which of the following? A. Very, very light B. Very light C. Somewhat hard D. Hard

B. A rating of 9 corresponds with "very light". A rating of 7 is "very, very light". A rating of 13 is "somewhat hard". A rating of 15 is "hard". A rating of 17 is "very hard". A rating of 19 is "very, very hard".

The therapist is ambulating a 42-year-old man who has just received an above knee prosthesis for the left leg. The therapist notices pistoning of the prosthesis as the patient ambulates. Which of the following is the most probable cause of this deviation? A. The socket is too small B. The socket is too large C. The foot bumper is too soft. D. The foot bumper is too hard.

B. A socket that is too large may cause the prosthetic limb to "drop" during ambulation.

A therapist is performing a chart review and discovers that lab results reveal that the patient has malignant cancer. When evaluating the patient, the therapist is asked by the patient, "Did my lab results come back and is the cancer malignant?" The appropriate response for the therapist is: A. To tell the patient the truth and contact the social worker to assist in consultation of the family. B. "It is inappropriate for me to comment on your diagnosis before the doctor has assessed the lab results and spoken to you first." C. "The results are positive for malignant cancer, but I do not have the training to determine your prognosis." D. To tell the patient the results are in, but physical therapists are not allowed to speak on this matter.

B. A therapist should never comment on such a serious prognosis before the physician has assessed the lab results and consulted with patient first.

A local plant asks a therapy team to perform a study of its workers. The study needs to determine the frequency of lung cancer in workers who insulate the inside area of an electrical oven appliance. Using company files, the therapy team studies all past employees with this job description. The employees were initially free of lung cancer, as determined by a routine physician's examination required by the plant. The team records from these files the frequency with which each one of the employees developed lung cancer. What type of study is the therapy team performing? A. Historical prospective B. Historical cohort C. Case control D. A & B

D. A and B are the same type of study. The records of the factory are used to determine the frequency of disease. In a case-control study the people are selected based on whether or not they have a disease, then the frequency of the possible cause of the disease in the past is studied.

When ordering a customized wheelchair for a patient, the therapist determines that the pelvic belt needs to be positioned so that it allows active anterior pelvic tilt. What is the best position for the pelvic belt in relation to the sitting surface? A. 30o B. 45o C. 60o D. 90o

D. A belt that angled at 90o with the sitting surface limits the patient's involuntary efforts to extend the trunk because of increased tone. This angle also allows the patient to actively tilt the pelvis anteriorly, which is a functional movement that does not need to be restricted.

The therapist is evaluating a patient with a diagnosis of cerebral palsy. The therapist notes that all of the extremities and the trunk are involved. Further assessment also reveals that the lower extremities are more involved than the upper extremities and that the right side is more involved than the left. This patient most likely has which classification of cerebral palsy? A. Spastic hemiplegia. B. Spastic triplegia. C. Spastic quadriplegia. D. Spastic diplegia.

D. A child with spastic diplegia most often presents with the lower extremities and trunk more involved than the upper extremities. Also one side is often more involved than the other side.

A therapist receives an order to evaluate a patient on the telemetry floor of a hospital. The therapist is informed at the nurses' station that an evaluation will not be necessary because the patient went into shock earlier that morning and died. The patient suffered a myocardial infarction earlier, resulting in damage to the left ventricle. Given the above information, what is the most likely type of shock? A. Vascular shock B. Anaphylactic shock C. Toxic shock D. Cardiogenic shock

D. A myocardial infarction that involves the left ventricle is likely to cause cardiogenic shock. Cardiogenic shock is a rapid decline in cardiac output. Vascular shock is widespread vasodilation. Toxic and anaphylactic shock occur when the body is exposed to a toxin or allergen, respectively.

According to the Joint Commission on Accreditation of Health Care Organizations (JCAHO), a sentinel event is A. A patient who is seriously injured at a facility. B. An employee who is seriously injured at a facility. C. A JCAHO surveyor who finds a major error in a facility's billing policies. D. A JCAHO surveyor who finds a major error in the structure of a facility (e.g., not enough handicap parking, not enough wheel chair ramps).

A. A patient seriously injured in a hospital or a hospital-owned facility is a sentinel event. Other choices might be JCAHO violations but only A is a sentinel event.

The most common type of stroke is ____________, and its primary precipitating factor is _____________. A. Atherothrombotic, atherosclerosis B. Atherothrombotic, hypertension C. Hemorrhage, atherosclerosis D. Hemorrhage, hypertension

A. Atherothrombotic strokes are caused by blood clots in the brain. Atherosclerosis leads to blood clots.

While reviewing a chart before performing postural drainage and percussion, the therapist finds that the patient has a platelet count of approximately 45,000. What is the appropriate course of action? A. Proceed with treatment B. Call the doctor and discuss the treatment plan. C. Immediately discharge the patient from physical therapy. D. Inform nursing of the relative contraindication and proceed with treatment.

A. A platelet count of 45,000 is low, but a count of approximately 20,000 is considered a contraindication for percussion treatment. Normal values are above 260,000.

What is the major concern of the physical therapist treating a patient with an acute deep partial thickness burn covering 27% of the total body? The patient was admitted to the intensive care burn unit 2 days ago. A. Range of motion B. Fluid retention C. Helping the family cope with the injured patient. D. Home modification on discharge.

A. A therapist's main responsibility with this patient is to maintain range of motion. Fluid retention is an important concern but for other medical staff. Choices C and D will be addressed later in the patient's course of therapy.

What is the most likely cause of anterior pelvic tilt during initial contact (heel strike)? A. Weak abdominals B. Tight hamstrings C. Weak abductors D. Back pain

A. Abdominal muscles attach to the lower border of the ribs and the superior surface of the pelvis. Strong abdominals prevent excessive anterior rotation of the pelvis during gait.

Which of the following is the most energy efficient and allows a T1 complete paraplegic the most functional mobility during locomotion? A. Manual wheelchair B. Electric wheelchair C. Bilateral knee ankle orthoses and crutches D. Bilateral ankle-foot orthoses and crutches

A. An electric wheelchair definitely uses less energy but does not require the physical effort needed by this patient to maintain functional mobility. Ambulation with a knee-ankle-foot orthosis is probably possible but requires much more energy than locomotion with a manual wheelchair. Ankle-foot orthoses alone do not provide enough support for the patient to attempt ambulation.

Which type of atrioventricular (AV) block is present, given the following information about the patient's rhythm strip: P waves are normal and have a QRS complex following P-R intervals that are longer than 0.2 seconds, and the heart rate is 82 beats per minute? A. First-degree AV block B. Second-degree AV block - type 1 C. Second-degree AV block - type 2 D. Third-degree AV block

A. This is a description of a first-degree atrioventricular block. The heart rate is usually between 60 and 100 beats/minute.

A supervisor in an outpatient facility is classified as a McGregor Theory X manager. Which of the following is the most appropriate characterization of the manager's beliefs? A. Work is natural for most people, workers will use their own self control to accomplish tasks, and workers will accept responsibility for their own actions. B. Workers have low drive, workers are concerned with their own job security, and employees do not like to work. C. Making decisions in the group is the best way to accomplish tasks, and encouraging a long term career for the employee is best. D. There are factors at work that satisfy or dissatisfy an employee.

A. Answer A is a description of McGregor Theory Y manager. Answer C is an example of William Ouchi's Theory Z. Answer D is part of the thought behind Herzberg's Two-Factor Theory.

A patient reports to therapy stating that his "sugar is too high" for exercise. What is the minimal blood glucose level that is considered too high for a diabetic patient to begin exercise? A. 300 mg/dl B. 400 mg/dl C. 300 g/dl D. 400 g/dl

A. A blood sugar value of 300 mg/dl is a contraindicated level for therapeutic exercise.

In the geriatric population, _________usually occurs after _______ is present. A. Spondylolisthesis, spondylolysis B. Spondylolysis, spondylolisthesis C. Spondyloschisis, spondylolysis D. Spondylolisthesis, spondyloschisis

A. A defect in the lamina of a vertebra usually occurs first. This defect is called spondylolysis. The vertebrae may then slip because of shear forces; this slip is called spondylolisthesis.

A patient's lawyer calls the therapist requesting his or her client's clinical records. The lawyer states that he or she needs the records to pay the patient's bill. What is the best course of action? A. Tell the lawyer either to have the patient request a copy of the records or to have the patient sign a medical release. B. Fax the needed chart to the lawyer. C. Mail a copy of the chart to the patient. D. Call the patient and tell him or her of the recent development.

A. A patient can obtain his or her medical records simply by signing a release form or requesting a copy. Charts and records should never be given or faxed to an attorney unless the patient has signed a release.

A physician prescribes isotonic exercises for the left biceps brachii. Which of the following exercises is in compliance with this order? A. Biceps curls with the patient actively and independently flexing the left elbow using a 5-pound dumbbell as resistance B. Rhythmic stabilization for the left elbow. C. Elbow flexion at 90o per second with speed controlled by a work stimulator. D. None of the above.

A. Choice A describes an isotonic exercise. Choice B is an isometric exercise. Choice C is an isokinetic exercise.

A patient presents to physical therapy with complaints of pain in the right hip due to osteoarthritis. Which of the following is not true about this type of arthritis? A. Causes pain usually symmetrically because it is a systemic condition. B. Not usually more painful in the morning. C. This type of arthritis commonly involves the distal interphalangeal joint. D. Mainly involves weight-bearing joints.

A. Choice A describes rheumatoid arthritis, a systemic condition. All of the other choices are signs and symptoms of osteoarthritis (OA). Sometimes OA can involve symmetrical joints, but it is not systemic.

The protocol for a cardiac patient states that the patient should not exceed 5 metabolic equivalents (METS) with any activity at this stage of recovery. Which of the following activities would be inappropriate for the patient? A. Cycling 11 miles per hour B. Walking 4 miles per hour. C. Driving a car. D. Weeding a garden.

A. Choice A is approximately 6-7 METs. Choice B is approximately 4-6 METs. Choice C is approximately 2 METs. Choice D is approximately 3-5 METs.

The therapist is crutch training a 26-year-old man who underwent right knee arthroscopy 10 hours ago. The patient's weight bearing status is toe-touch weight-bearing on the right lower extremity. If the patient is going up steps, which of the following is the correct sequence of verbal instructions? A. "Have someone stand below you while going up, bring the left leg up first, then the crutches and the right leg". B. "Have someone stand above you while going up, bring the left leg up first, then the crutches and the right leg". C. "Have someone stand below you while going up, bring the right leg up first, then the crutches and left leg". D. "Have someone stand above you while going up, bring the right leg up first, then the crutches and the right leg"

A. Choice A is the correct gait sequence for ascending stairs in the given scenario. A caregiver should stand below the patient because the patient is most likely to fall down the stairs. This same rule holds true for descending stairs.

After performing an evaluation, a therapist notes the following information: severe spasticity of plantar flexors in the involved lower extremity, complete loss of active dorsiflexion in the involved lower extremity, minimal spasticity between 0 o and 5 o of dorsiflexion, with increased spasticity when the ankle is taken into more than 5o of dorsiflexion. Which ankle-foot orthosis (AFO) is most likely contraindicated for the patient, an 87-year-old man who had a stroke 4 weeks ago? A. Dorsiflexion spring assist AFO B. Posterior leaf spring AFO C. Hinged AFO D. Spiral AFO

A. Choice A probably would activate increased tone because of the resistance to plantar flexion offered by the spring.

What lobe of the lungs is the therapist attempting to drain if the patient is in the following position? Resting on the left side rolled ¼ turn back, supported with pillows, and the foot of the bed raised 12-16 inches. A. Right middle lobe - lingular segment. B. Left upper lobe - lingular segment C. Right upper lobe - posterior segment D. Left upper lobe - posterior segment.

A. Choice B is drained by resting on the right ¼ turn to the back, and foot of the bed elevated 12-16 inches. Choices C and D are drained with patient in long sitting position or leaning forward over the pillow in sitting position.

Which of the following are tests for peripheral arterial involvement in a patient with complaints of calf musculature pain? A. Claudication time B. Homan's sign C. Percussion test D. None of the above

A. Claudication is a lack of blood flow. This test is performed by having a patient walk on a treadmill and recording how long the patient can walk before the onset of claudication. Homan's sign is a test performed to see whether a patient may have a deep vein thrombosis. The percussion test is designed to assess the integrity of the greater saphenous vein.

The therapist is ordered to evaluate a patient in the intensive care unit. The patient appears to be in a coma and is totally unresponsive to noxious, visual and auditory stimuli. What rating on the Rancho Los Amigos Cognitive Functioning Scale is most appropriate? A. I B. III C. IV D. VI

A. I- No response. II- Generalized response III - Localized responses IV - Confused agitated. V - Confused inappropriate. VI - confused appropriate. VII - Automatic appropriate. VIII - Purposeful and appropriate.

During the opening of a patient's mouth, a palpable and audible click is discovered in the left temporomandibular joint. The physician informs the therapist that the patient has anteriorly dislocated disk. This click most likely signifies: A. the condyle is sliding anterior to obtain normal relationship with the disk. B. the condyle is sliding posterior to obtain normal relationship with the disk. C. the condyle is sliding anterior and losing normal relationship with the disk D. the condyle is sliding posterior and losing normal relationship with the disk

A. In the case of reciprocal click, the initial click is created by the condyle slipping back into the correct position under the disk with opening of the mouth. In this disorder, the condyle is resting posterior to the disk before jaw opening. With closing the click is caused by the condyle slipping away from the disk.

A patient asks the therapist whether she should be concerned that her 4-month-old infant cannot roll from his back to his stomach. The most appropriate response to the parent is: A. "This is probably nothing to be concerned about because, although it varies, infants can usually perform this task by 10 months of age". B. "This is probably nothing to be concerned about because, although it varies, infants can usually perform this task by 5 months of age". C. "Your infant probably needs further evaluation by a specialist because, although it varies, infants can usually perform this task at 2 months of age". D. "Your infant probably needs further evaluation by a specialist because, although it varies, infants can usually perform this task at birth".

A. Infants accomplish this task between approximately 5 and 10 months of age. The response in choice A would prevent the parent from excessive unnecessary worry. Sources vary widely about the exact month when developmental milestones are reached, but A is the correct answer in this scenario.

What is the best way to first exercise the postural (or extensor) musculature when it is extremely weak to facilitate muscle control? A. Isometrically. B. Concentrically. C. Eccentrically. D. Is kinetically.

A. Isometric exercises in the shortest range of the extensor muscle are used to begin strengthening. In contract, weak flexor muscles should be strengthened in the middle-to-lengthened range, because they most often work near their end range.

A therapist has been treating a patient who received a rotator cuff surgical repair with sessions consisting only of passive range of motion (for an extended period). The patient has just returned from a follow-up doctor's visit with an additional order to continue with passive range of motion only. Which of the following is the best course of action for the therapist? A. Continue with passive range of motion as instructed, and call the physician to consult with him or her about the initiation of active range of motion. B. Begin active range of motion within the pain-free range, and continue passive range of motion. C. Continue passive range of motion, and do not question the physician's decision. D. Perform passive range of motion and any other exercise that is within the normal protocol for this diagnosis.

A. It is best to consult with a physician because of an extended amount of passive range of motion. A therapist should not deviate from a physician's order, but a telephone call to clarify the order is necessary when the therapist feels that another treatment plan is more appropriate.

A therapist decides to buy two ultrasound machines from a sales representative. The representative offers the therapist a free steak dinner at a local restaurant as a toke of appreciation. What is the best course of action for the therapist? A. Refuse the dinner gracefully B. Take his or her family out to eat. C. Offer to take the representative out to dinner. D. Take a local doctor out to dinner and discuss the benefits of using this type of ultrasound.

A. It is unethical to take gifts from anyone.

Which of the following is the next response of the leukocytes after emigration into the blood stream in the acute inflammatory stage? A. Margination B. Pavementing C. Adhesion D. Engulfment

A. Leukocytes respond to an injury by emigrating into the blood stream. The next stem of the leukocytes is margination, which is movement toward the inner surface of the vessels.

The therapist routinely places ice on the ankle of a patient with an acute ankle sprain. Ice application has many therapeutic benefits. Which of the following is the body's first response to application of ice? A. Vasoconstriction of local vessels B. Decreased nerve conduction velocity C. Decreased local sensitivity. D. All occur simultaneously.

A. Local vasoconstriction is the first response. Nerve conduction velocity decreases after approximately 5 minutes of ice application.

Which of the following is the most appropriate orthotic for a patient with excessive foot pronation during static standing? A. Scaphoid pad B. Metatarsal pad C. Metatarsal bar D. Rocker bar

A. Metatarsal pads, metatarsal bars, and rocker bars transfer weight onto the metatarsal shaft. A scaphoid pad is for patients with excessive pronation.

What portion of the adult knee meniscus is vascularized? A. Outer edges B. Inner edges C. The entire meniscus is vascular D. The entire meniscus is avascular

A. Only the edges of the adult meniscus are vascularized by the capillaries from the synovial membrane and joint capsule.

A therapist is examining a 3-year-old child who is positioned as follows: supine, hips flexed to 90 o , hips fully adducted, and knees flexed. The therapist passively abducts and raises the thigh, applying an anterior shear force to the hip joint. A click at 30 o of abduction is noted by the therapist. What orthopedic test is the therapist performing, and what is its significance? A. Ortolani's test - hip dislocation B. Apley's compression/distraction test - cartilage damage C. McMurray test - cartilage damage D. Piston test - hip dislocation.

A. Ortolani's test is used to detect a congenitally dislocated hip in an infant. Choices B and C are common meniscus damage tests for the knee. Choice D is performed by placing the infant in supine position with the hip at 90o of flexion and slight abduction and knee flexed to 90o. The examiner then moves the infant's hip anterior and posterior in an effort to detect abnormal joint mobility.

Which of the following acts forced all federally supported facilities to increase corridor width to minimum of 54 inches to accommodate wheelchairs? A. Americans with Disabilities Act B. National Healthcare and Resource Development Act C. Civil Rights Act D. Older Americans Act (title III)

A. The ADA allowed structural modifications of federal buildings and protection from discrimination based on disability.

A therapist is asked to estimate the percentage of a patient's body that has been burned. The patient is a 32-year-old man of normal size. Burns are located along the entire anterior surface of the face. The patient also burned the entire anterior portion of the right upper extremity in an attempt to guard himself from flames. Using the rule of nines, what percentage of the patient's body is burned? A. 9% B. 18% C. 4.5% D. 27%

A. The anterior surface of the face and the upper extremity are each considered 4.5% of the body, according to the rule of nines. The anterior trunk is 18%. Each anterior surface of the lower extremities is 9%. The posterior side is the same, respectively. The total groin area is 1%.

The therapist is treating a 52-year-old woman after right total hip replacement. The patient complains of being self-conscious about a limp. She carries a heavy briefcase to and from work every day. The therapist notes a Trendelenburg gait during ambulation on level surfaces. What advice can the therapist give the patient to minimize gait deviation? A. Carry the briefcase in the right hand B. Carry the briefcase in the left hand C. The patient should not carry a briefcase at all. D. It does not matter in which hand the briefcase is carried.

A. The briefcase should be carried in the right hand. Carrying the briefcase in the left hand would increase the amount of force that the right gluteus medius would have to exert to maintain a stable pelvis during gait.

A patient recently diagnosed with multiple sclerosis presents to a physical therapy clinic. The patient asks the therapist what she needs to avoid with this condition. Which of the following should the patient avoid? A. Hot tubs. B. Slightly increased intake of fluids. C. Application of ice packs. D. Strength training.

A. The danger in using a hot tub for a person with multiple sclerosis is that it may cause extreme fatigue. There is no need to avoid the other activities listed.

At what age does a human have the greatest amount of fluid in the intervertebral disc? A. 1 year B. 4 years C. 7 years D. 10 years

A. The intervertebral disc has the greatest amount of fluid at the time of birth. The fluid content decreases as a person ages.

At what point in the gait cycle is the center of gravity the lowest? A. Double support. B. Terminal swing. C. Deceleration. D. Midstance

A. The lowest point in the gait cycle occurs when both lower extremities are in contact with the ground (double support)

What ligament is most involved in sustaining the longitudinal arch of the foot? A. Plantar calcaneonavicular ligament B. Long plantar ligament C. Plantar calcaneocuboid ligament D. Anterior talofibular ligament

A. The plantar calcaneonavicular ligament originates on the sustentaculum tali of the calcaneus and inserts on the navicular. This ligament along with the long plantar ligament, plantar aponeurosis, and the short plantar ligament, gives support to the longitudinal arch of the foot. Choice A is the most important ligament.

A 17-year-old football player is referred to the outpatient physical therapy clinic with a diagnosis of a recent third-degree medial collateral ligament sprain of the knee. The patient wishes to return to playing football as soon as possible. Which of the below is the best protocol? A. Fit the patient with a brace that prevents him from actively moving the knee into the last available 20o of extension. Prescribe general lower extremity strengthening with the exception of sidelying hip adduction. B. Do not fit the patient with a brace. All lower extremity strengthening exercises are indicated. C. Fit the patient with a brace that prevents him from actively moving the knee into the last available 20o of extension. Avoid all open-chain strengthening for the lower extremity. D. Do not fit the patient with a brace. Prescribe general lower extremity strengthening with the exception of sidelying hip adduction.

A. The screw home mechanism that is present in the last few degrees of terminal knee extension stresses the MCL. Sidelying hip adduction also places the MCL in position of stretch.

Which of the following articulate with the second cuneiform? A. Navicular B. Talus C. First metatarsal D. Cuboid

A. The second cuneiform of the foot articulates with the first cuneiform, second metatarsal, third cuneiform and navicular.

A therapist receives an order to evaluate a 72-year-old woman who has suffered a recent stroke. The therapist needs to focus on pregait activities. Which of the proprioceptive neuromuscular facilitation (PNF) diagonals best encourages normal gait? A. D1 B. D2 C. PNF is contraindicated D. Pelvic PNF patterns only.

A. The therapist would use a PNF D1 diagonal to encourage the combined movements of hip flexion, adduction, and knee flexion. The diagonal also encourages the combined movements of hip adduction and extension. This is a combination of muscle activity most needed for gait.

Persuading a sedentary patient to become more active, the therapist explains the benefits of exercise. Which of the following is an inappropriate list of benefits? A. Increased efficiency of the myocardium to obtain oxygen, decreased high-density lipoprotein (HDL) and decreased cholesterol. B. Decreased low-density lipoprotein (LDL), decreased triglycerides, and decreased blood pressure. C. Increased efficiency of the myocardium to obtain oxygen, decreased cholesterol, and decreased LDL. D. Both B and C are inappropriate lists.

A. There are many benefits of exercise. Decreased HDL in answer A makes this an inappropriate list of the benefits of exercise. HDL is considered "good" cholesterol. Exercise decreases LDL and increases HDL in the bloodstream.

A patient presents with tachypnea, cor pulmonale, hypoxemia, rales on inspiration, and decreased diffusing capacity. What is the probable cause? A. Restrictive lung dysfunction B. Chronic obstructive pulmonary disease C. Neither of the above D. A and B

A. These signs are consistent with restrictive lung dysfunction.

The therapist is ambulating a patient with an above knee amputation. The new prosthesis causes the heel on the involved foot to move laterally at toe-off. Which of the following is the most likely cause of this deviation? A. Too much internal rotation of the prosthetic knee. B. Too much external rotation of the prosthetic knee. C. Too much outset of the prosthetic foot. D. None of the above would cause this deviation

A. This deviation is commonly referred to as a lateral heel whip. Excessive internal rotation of the prosthetic knee is one of the causes of this deviation. Excessive external rotation of the knee causes a medial heel whip.

Which of the following theories support the use of a transcutaneous electrical nerve stimulation (TENS) unit for sensory level pain control? A. Gate control theory B. Sensory interaction theory C. Central summation theory D. None of the above

A. This theory supports the use of a TENS unit for sensory level pain control. The activation of the larger fibers decreases the amount of sensory information traveling to the brain.

A 27-year-old woman is referred to a physical therapy clinic with a diagnosis of torticollis. The right sternocleidomastoid is involved. What is the most likely position of the patient's cervical spine? A. Right lateral cervical flexion and left cervical rotation B. Right cervical rotation and right lateral cervical flexion C. Left cervical rotation and left lateral cervical flexion D. Left lateral cervical flexion and right cervical rotation.

A. Torticollis involving the right sternocleidomastoid would cause right lateral cervical flexion and left cervical rotation.

A patient asks the therapist to explain the function of his medication verapamil (a calcium antagonist). Which of the following points should be conveyed in the therapist's explanation? A. Verapamil causes decreased contractility of the heart and vasodilation of the coronary arteries. B. Verapamil causes decreased contractility of the heart and vasoconstriction of the coronary arteries. C. Verapamil causes increased contractility of the heart and vasodilation of the coronary arteries. D. Verapamil causes increased contractility of the heart and vasoconstriction of the coronary arteries.

A. Verapamil reduces contractility of the heart and increases coronary artery dilation, resulting in decreased cardiac workload and increased blood flow to the heart muscle.

A physical therapy technician calls the therapist immediately to the other side of the outpatient clinic. The therapist discovers a 37-year-old female lying face down on the floor. Which of the following sequence of events is most appropriate for this situation? A. Have someone call 911, determine unresponsiveness, establish an airway, and assess breathing (look/listen/feel). B. Determine unresponsiveness, have someone call 911, establish an airway, and assess breathing (look/listen/feel) C. Have someone call 911, determine unresponsiveness, assess breathing (look/listen/feel). D. Determine unresponsiveness, have someone call 911, assess breathing (look/listen/feel), establish an airway.

B. According to the American Heart Association, a person is determined unresponsive before emergency medical service is activated.

The home health physical therapist arrives late at the home of a patient for a treatment session just as the occupational therapist has finished. The patient is angry because the sessions are so close together. The patient becomes verbally abusive toward the physical therapist. The most appropriate response to the patient is: A. "I'm sorry I'm late, but you must try to understand that I am extremely busy". B. "I know you are aggravated. It is inconvenient when someone does not show up when expected. Let's just do our best this session and I will make an effort to see that we do not have PT and OT scheduled so close together from now on". C. "You have to expect visits at any time of the day with home health". D. "The OT and I did not purposefully come so close together. I apologize, please let's now begin therapy".

B. Answer B is the most empathetic response. It also lets the patient know that the therapists will make an effort to prevent the problem from recurring.

While obtaining the history from a 62-year-old woman weighing 147 pounds, the therapist discovers that the patient has a history of rheumatoid arthritis. The order for outpatient physical therapy includes continuous traction due to a L2 disc protrusion. What is the best course of action for the therapist? A. Follow the order. B. Consult with the physician because rheumatoid arthritis is a contraindication. C. Apply intermittent traction instead of continuous traction. D. Use continuous traction with the weight setting at 110 pounds.

B. Answers A and C are incorrect because rheumatoid arthritis is a contraindication for continuous or intermittent traction. Answer D is incorrect for the above reason as well as the fact that a 110-pound setting is too great for a 147-pound patient.

The director of a physical therapy facility is in the process of conducting interviews for a staff physical therapist position that will open in a few weeks. Which of the following questions is inappropriate for the director to ask during the job interview? A. "What were some of your duties at your previous job?" B. "Do you have any children?" C. "What continuing education have you attended within the last year?" D. "How many years of experience do you have?"

B. Asking prospective employees how many children they have is inappropriate.

A physician notes a vertebral fracture in the X-ray of a patient involved in a car accident. The fractured vertebra has a bifid spinous process. Which of the following vertebrae is the most likely to be involved? A. Fourth lumbar vertebra B. Fifth cervical vertebra C. Twelfth thoracic vertebra D. First sacral vertebra.

B. Bifid spinous processes are found only in the cervical spine.

A football player presents to an outpatient clinic with complaints of pain in the right knee after an injury suffered the night before. The physician determines that the anterior cruciate ligament (ACL) is torn. Which of the following is most commonly associated with an injury causing damage to the ACL only? A. Varus blow to the knee with the foot planted and an audible pop B. Foot planted, medial tibial rotation, and an audible pop. C. Valgus blow to the knee with the foot planted and no audible pop. D. Foot planted, lateral tibial rotation, and no audible pop.

B. Choice B best describes the position that causes injury only to the ACL. In most cases an audible pop indicates a tear of the ACL. Varus or valgus blows to the knee injure the collateral ligaments and possibly the ACL.

The therapist is treating a track athlete who specializes in sprinting and wants to increase his or her speed on the track. To accomplish this goal, the plan of care should include activities to develop fast-twitch muscle fibers. Characteristics of this type of fiber include: A. Fatigues slowly, fiber colors appear red and used more in aerobic activity. B. Fatigues quickly, fiber colors appear white and used in anaerobic activity. C. Fatigues quickly, fiber colors appear white and used more in aerobic activity. D. Fatigues slowly, fiber colors appear white, and used more in anaerobic activity.

B. Choice B describes fast twitch muscle fibers. Choice A describes slow twitch fibers. Choices C and D are incorrect answers

Which of the following is observed by the therapist if a patient is correctly performing an anterior pelvic tilt in standing position? A. Hip extension and lumbar flexion. B. Hip flexion and lumbar extension. C. Hip flexion and lumbar flexion. D. Hip extension and lumbar extension.

B. Choice B is the correct answer. Choice A is a posterior pelvic tilt.

To treat effectively most patients with Parkinson's disease, the therapist should emphasize which proprioceptive neuromuscular facilitation (PNF) pattern for the upper extremities? A. D2 extension B. D2 flexion C. D1 extension D. D1 flexion

B. D2 flexion patterns support upper trunk extension, which is important for patients with Parkinson's disease who tend to develop excessive kyphosis.

A therapist instructed to provide electrical stimulation to a patient with a venous stasis ulcer on the right lower extremity. What is the correct type of electrical stimulation to promote wound healing? A. Biphasic pulsed current B. Direct current C. Interferential current D. Transcutaneous electrical stimulation

B. Direct current is shown to have the greatest benefit in wound healing. Monophasic pulse current has also been shown to have wound healing benefits.

Which of the following is least likely in a woman in the eighth month of pregnancy? A. Center of gravity anteriorly displaced B. Heart rate decreased with rest and increased with activity compared to heart rate prior to the pregnancy. C. Edema in bilateral lower extremities D. Blood pressure increased by 5% compared with blood pressure before pregnancy

B. During pregnancy a woman normally experiences an increase in resting heart rate and a decrease in heart during exercise. This change is compared with the heart rate of the particular woman before pregnancy. The other answers are true about pregnancy.

A patient who suffered a myocardial infarction is participating in an exercise test. The therapist notes ST segment depression of 1.7 mm on the patient's current rhythm strip. What is the most appropriate course of action? A. Stop the exercise session immediately and send the patient to the emergency room. B. Continue with the exercise session. C. Contact the patient's cardiologist about continuing exercise D. Stop the exercise session to take the patient's heart rate and blood pressure

B. Exercise testing should be terminated at 2 mm of ST depression.

Observing a patient in a standing position, the therapist notes that an angulation deformity of the right knee causes it to be located medially in relation to the left hip and foot. This condition is commonly referred to as: A. genu varum B. genu valgum C. pes cavus D. none of the above.

B. Genu valgum is a term used to describe a deformity of the knee causing an inward bowing of the legs. Genu varus is an outward bowing of the legs. Coxa valgum is a deformity at the hip in which the angle between the axis of the neck of the femur and the shaft of the femur is greater than 135o. In coxa varus this angle is less than 135o. Pes cavus is an increase in the arch of the foot. Pes planus is flat foot.

A therapist is mobilizing a patient's right shoulder. The movement taking place at the joint capsule is not completely to end range. It is a large amplitude movement from near the beginning of available range to near the end of available range. What grade of mobilization according to Maitland, is being performed? A. Grade I B. Grade II C. Grade III D. Grade IV

B. Grade I is a small oscillating movement at the beginning of range. Grade III is a large movement up to the end of available range. Grade IV is a small movement at the end of available range

A 35-year-old woman with a diagnosis of lumbar strain has a physician's prescription with a frequency and duration of 3 sessions/week for 6 weeks. The physical therapy evaluation reveals radiculopathy into the L5 dermatome of the right lower extremity, increased radiculopathy with lumbar flexion, decreased radiculopathy with lumbar extension, poor posture, and hamstring tightness bilaterally at 60o. What is the best course of treatment? A. Lumbar traction, hot packs, and ultrasound. B. McKenzie style lumbar extensions, a posture program, hamstring stretching, and a home exercise program. C. McKenzie style lumbar extensions, a posture program, hamstring stretching, home program, hot packs, and ultrasound. D. Lumbar traction, hot packs, ultrasound, and hamstring stretching.

B. Hot packs are no indicated because there is no mention of abnormal muscle tone. The entire lumbar area is too much surface area for ultrasound. An argument could be made for lumbar traction, but it is paired with heating modalities all of the answers.

A therapist is attempting to gain external rotation range of motion in a patient's right shoulder. The therapist decides to use contract-relax-contract antagonist. In what order should the following rotator cuff muscles contract to perform this movement successfully? A. Infraspinatus - teres minor B. Subscapularis - supraspinatus C. Teres minor - infraspinatus D. Supraspinatus - subscapularis

B. In performing contract-relax antagonist in this particular situation, the internal rotators are actively contracted first, the external rotators are contracted next in an effort to increase external range of motion. The agonists are the internal rotators (tight muscle group in this situation), and the antagonists are the external rotators. The infraspinatus, teres minor, and supraspinatus assist the external rotators. The subscapularis is an internal rotator. Other larger muscles also participate in rotation, but this question refers to the rotator cuff muscles.

A patient is referred to the therapist with a diagnosis of arthritis. What type of arthritis would the therapist expect if the patient present with the following signs and symptoms? (1) Bilateral wrists and knees are involved, (2) pain at rest and with motion, (3) prolonged morning stiffness, and (4) Crepitus. A. Osteoarthritis B. Rheumatoid arthritis C. Degenerative joint disease D. It is not possible to determine with the given information

B. Rheumatoid arthritis is a systemic condition commonly involving joints bilaterally. Crepitus can be associated with osteoarthritis or rheumatoid arthritis. but rheumatoid arthritis is the most likely in this case.

A patient presents to an outpatient clinic with complaints of shoulder pain. The therapist observes a painful arc between 70o and 120o of active abduction in the involved shoulder. This finding is most indicative of what shoulder pathology? A. Rotator cuff tear B. Acromioclavicular joint separation C. Impingement D. Labrum tear

B. The "painful arc" is most indicative of shoulder impingement. The soft tissues of the shoulder are pinched under the acromion process at approximately 60-120o of abduction. Pain throughout abduction active range of motion suggests acromioclavicular joint dysfunction.

The therapist is evaluating a 32-year-old woman for complaints of right hip pain. The patient has injured the strongest ligament of the hip. The therapist places the patient in the prone position on the plinth and passively extends the involved hip. The therapist notes an abnormal amount of increase in passive hip extension. Which of the following ligaments is damaged? A. Ischiofemoral ligament B. Iliofemoral ligament (Y ligament of Bigelow) C. Pubofemoral ligament D. Ligamentum teres

B. The Iliofemoral ligament is the strongest ligament in the hip that prevents extension. It is the ligament most likely to be compromised in this scenario.

What is the closed-packed position of the shoulder? A. Internal rotation and abduction B. External rotation and abduction C. Internal rotation and adduction D. External rotation and adduction

B. The area of contact between the humerus and the glenoid fossa is maximal in this position.

The therapist is evaluating a 36-year-old woman to fit her with the appropriate wheelchair. Recent injury caused C6 quadriplegia. What is the correct way to measure length of the footrests for the patient's permanent wheelchair? A. From the patient's popliteal fossa to the heel and add 1 inch B. From the patient's popliteal fossa to the heel and subtract 1 inch C. From the patient's popliteal fossa to the first metatarsal head and add 1 inch D. From the patient's popliteal fossa to the first metatarsal head and subtract 1 inch

B. The correct procedure is answer B. Subtracting 1 inch allows correct pressure distribution over the patient's buttocks and thighs.

A posterior lateral herniation of the lumbar disc between vertebrae L4 and L5 most likely results in damage to which nerve root? A. L4 B. L5 C. L4 and L5 D. L5 and S1

B. The fifth lumbar nerve root is impinged because it arises from the spinal column superior to the L4-L5 lumbar disc.

A patient presents to an outpatient facility with complaints of pain in the groin area (along the medial left thigh). With manual muscle testing of the involved lower extremity a therapist determines the following: hip flexion = 4+/5, hip extension = 4+/5, hip abduction = 4+/5, hip adduction = 2+/5, hip internal rotation = 2+/5, and hip external rotation = 2+/5. Which nerve on the involved side is most likely injured? A. Lateral cutaneous nerve of the upper thigh. B. Obturator nerve C. Femoral nerve. D. Ilioinguinal nerve.

B. The obturator nerve innervates the adductor brevis, adductor longus, adductor magnus, obturator externus, and gracilis muscles. Choice A has no motor function. Choice C innervates the sartorius, pectineus, iliacus, and quadriceps femoris. The ilioinguinal nerve innervates the obliquus internus abdominis and transversus abdominis.

The therapist is treating a patient in an outpatient facility for strengthening of bilateral lower extremities. During the initial assessment, the patient reveals that he has a form of cancer but is reluctant to offer any other information about his medical history. After 1 week of treatment, the therapist is informed by the physician that the patient has Kaposi's sarcoma and AIDS. Which of the following is the best course of action for the therapist? A. Cease treatment of the patient, and inform him than an outpatient facility is not the appropriate environment for a person with his particular medical condition. B. Continue treatment of the patient in the gym, avoiding close contact with other patients and taking appropriate universal precautions. C. Continue treatment of the patient in the gym as before, taking appropriate universal precaution. D. Cease treatment, but do not confront the patient with the knowledge of his HIV status.

B. The patient can be successfully treated by using universal precautions. The patient should be treated in a relatively isolated area because of his weakened immune system. The diagnosis of AIDS with Kaposi's sarcoma is an indication that the patient's immune system is weak. Gloves should be used if the patient's sarcomas are open; otherwise, hand washing before and after patient contact is appropriate.

The therapist is treating a patient with a T4 spinal cord injury when the patient suddenly complains of a severe headache. The therapist also notes that the patient's pupils are constricted and that the patient is sweating profusely. Which of the following is the best course of action for the therapist? A. Try to find a probable source of noxious stimulus and position the patient supine with feet elevated. B. Try to find a probable source of noxious stimulus and position the patient with upper trunk elevated and legs lowered. C. Try to find a probable source of noxious stimulus and place the patient in a sidelying position. D. Try to find a probable source of noxious stimulus and position the patient in prone position.

B. The patient is experiencing autonomic dysreflexia. The correct actions are to find the probable cause of the noxious stimulus and to lower the patient's blood pressure by inducing orthostatic hypotension. Patients with spinal cord injury above the level of T6 can experience this problem.

A 14-year-old girl with right thoracic scoliosis is referred to physical therapy. The therapist should expect which of the following findings? A. Left shoulder high, left scapula prominent, and right hip high B. Left shoulder low, right scapula prominent, and left hip high C. Right shoulder high, right scapula prominent, and right hip high D. Right shoulder low, right scapula prominent, and left hip high

B. The patient probably has a low left shoulder, prominent right scapula and high left hip.

The therapist is treating a male patient for a second-degree acromioclavicular sprain. The patient has just finished the doctor's prescription of 3 sessions/week for 4 weeks. The therapist is treating the patient with iontophoresis (driving dexamethasone), deltoid-strengthening exercises, pectoral strengthening exercises, and ice. The patient reports no decline in pain level since the initial evaluation. Which of the following is the best course of action for the therapist? A. Phone the doctor and request continued physical therapy. B. Tell the patient to go back to the doctor because he is not making appropriate progress. C. Discharge the patient because he will improve on his own. D. Take the problem to the supervisor of the facility.

B. The patient should have made adequate progress in this period with this protocol. Because of the lack of progress, the patient needs further evaluation by the physician.

A therapist is obtaining a subjective history from a new patient diagnosed with right-side hemiplegia. The therapist notes that the patient is able to understand spoken language but unable to speak well. Most of the patient's words are incomprehensible. The patient also has difficulty in naming simple objects. What type of aphasia does the patient most likely have? A. Anomic aphasia B. Broca's aphasia C. Crossed aphasia D. Wernicke's aphasia

B. The patient with damage of Broca's area is a right hemiplegic. Damage to this area causes difficulty with speaking and sometimes difficulty with writing. Usually damage to this area does not impair the ability to understand written or spoken language.

A patient at an outpatient facility experiences the onset of a grand mal seizure. Which of the following is the most appropriate course of action by the therapist? A. Assist patient to a lying position, move away close furniture, loosen tight clothes, and prop the patient's mouth open B. Assist patient to a lying position, move away close furniture, and loosen tight clothes C. Assist the patient to a seated position, move away close furniture, and loosen tight clothes. D. Assist the patient to a seated position, move away close furniture, loosen tight clothing, and prop the patient's mouth open.

B. The person should lie down to prevent head injury. Tight clothes are loosened to make sure that nothing is too constricting. Close furniture is move away for the patient's safety. Nothing should be placed in the patient's mouth because of the danger of obstructing the airway.

The therapist receives an order to treat a 42-year-old man admitted to the hospital 3 days ago with a stab would to the left lower thoracic spine. The patient is unable to move the left lower extremity and cannot feel pain or temperature differences in the right lower extremity. What is the most likely type of lesion? A. Anterior cord syndrome B. Brown-Sequard syndrome C. Central cord syndrome D. The patient is equally as likely to have anterior cord syndrome as he is to have Brown-Sequard syndrome.

B. The question describes a hemisection of the spinal cord, which is classified as a Brown-Sequard lesion. Anterior spinal cord injuries present with loss of motor function and insensitivity to pain and temperature bilaterally. Central cord injuries are characterized by loss of function in the upper extremities and normal function in the trunk and lower extremities.

A therapist is evaluating a patient in an intensive care unit. The therapist notes no eye opening, no verbal response, and no motor response. On the Glasgow coma scale, what is the patient's score? A. 0 B. 3 C. 5 D. 9

B. The responses of the patient represent the lowest possible score on the Glasgow Coma Scale. One point is given for each of the listed responses (or lack thereof).

While assessing the standing posture of a patient, the therapist notes that a spinous process in the thoracic region is shifted laterally. The therapist estimates that T2 is the involved vertebra because he or she notes that it is at the approximate level of the A. inferior angle of the scapula B. superior angle of the scapula C. spine of the scapula D. xiphoid process of the sternum

B. The superior angle of the scapula commonly rests at the same level as vertebra T2. The spine of the scapula is approximately at T3. The inferior angle of the scapula and xiphoid process represent T7.

A supervisor in a physical therapy clinic observes a new graduate performing incorrect exercises on a patient. The exercises are not life threatening but are incorrect. What is the best way to handle this situation? A. The supervisor should immediately tell the new therapist to stop exercising the patient and instruct the patient and therapist in the correct procedure. B. The supervisor should tactfully tell the new therapist to come into his or her office and discuss the situation in private C. The supervisor should put a note on the new therapist's desk to meet with him/her after work D. The supervisor should give the new therapist research articles about the correct options.

B. The supervisor can best handle this situation by discussing the exercise program away from the patient. Correcting the new graduate in front of the patient probably would decrease the confidence of the patient in the treatment and the therapist.

When reviewing a patient's chart, the therapist determines that the patient has a condition in which the cauda equina is in a fluid-filled sac protruding from the back. What form of spina bifida does the patient most likely have? A. Meningocele B. Meningomyelocele C. Spina bifida occulta D. None of the above

B. This form of spina bifida is associated with direct involvement with the cauda equina. The muscles that are innervated by the cauda equina usually present with flaccid paralysis.

During evaluation of a patient, the therapist observes significant posterior trunk lean at initial contact (heel strike). Which of the following is the most likely muscle that the therapist needs to focus on during the exercise session in order to minimize this gait deviation? A. Gluteus medius B. Gluteus maximus C. Quadriceps D. Hamstrings

B. This gait deviation is caused by the patient leaning back to decrease the flexion moment created at the hip at initial contact. The gluteus maximus is most responsible for counteracting this flexion moment.

A therapist is teaching a family to care for a family member at home. The patient is totally bed-bound. To prevent pressure ulcers most effectively, what should be the maximal amount of time between position changes? A. One hour B. Two hours C. Six hours D. Eight hours

B. To prevent pressure (decubitus) ulcers effectively, patients should be turned every 2 hours.

A local orthopedic doctor, who is a main referral source for an outpatient clinic, insists on an all open-chain exercise program for all patients who have undergone anterior cruciate ligament reconstruction. The therapist feels a closed-chain and open-chain program is the best course of therapy. What is the best course of action to convince the doctor? A. Call the physician's nurse and discuss with him or her the new treatment protocol. B. Schedule a face-to-face meeting with the doctor to discuss the correct treatment plan. C. Fax the doctor research supporting use of a combined open- and closed-chain program. D. Have one of the doctor's colleagues convince him that the new protocol is best.

B. With a disagreement about treatment, the therapist should speak with the physician directly.

The therapist has given a patient an ultraviolet treatment. The patient calls the therapist the next day with complaints of peeling and itching. These signs and symptoms resolve three days later (a total of 4 days after treatment). What dosage did the patient receive? A. Suberythemal dose B. Minimal erythemal dose. C. First-degree erythemal dose. D. Third-degree erythemal dose.

C. A Suberythemal dose of ultraviolet treatment is not enough to cause reddening of the skin. A minimal erythemal dose leads to slight itching and reddening. A third-degree erythema is a more severe reaction with blister and edema formation

A 42-year-old construction worker received a burst fracture in the cervical spine when struck by a falling crossbeam. Proprioception is intact in bilateral lower extremities. The patient has bilateral loss of motor function and sensitivity to pain and temperature below the level of the lesion. This type of lesion is most typical of which of the following syndromes? A. Central cord syndrome B. Brown Sequard syndrome C. Anterior cord syndrome D. Conus medullaris syndrome

C. A burst fracture causes damage to the spinal cord because bony fragments are pushed posteriorly into the spinal canal. This type of fracture is often accompanied with anterior cord syndrome.

A patient presents to an outpatient physical therapy clinic with a 140o kyphoscoliosis curve. What is the therapist's greatest concern? A. The patient's complaint of low back pain B. Gait deviation. C. Pulmonary status. D. Poor upright standing posture

C. A curve greater than 120o is often associated with restrictive lung dysfunction. The other factors listed are not life-threatening.

Which of the following duties cannot be legally performed by a physical therapist assistant? A. Confer with a doctor about a patient's status. B. Add 5 pounds to a patient's current exercise protocol. C. Allow a patient to increase in frequency from 2times/week to 3 times/week. D. Perform joint mobilization.

C. A physical therapist assistant (PTA) can do all of the listed options except the frequency or duration as prescribed by a therapist or physician. Choice B allows the PTA to work within the protocol established by the physical therapist.

A therapist is ordered to evaluate and treat a full-term infant. After reviewing the chart, the therapist discovers that at 1 minute after birth the infant exhibited the following symptoms: bluish color in the body and extremities, heart rate of 85 beats/minute, slow respirations, no response to reflex irritability, and some resistance of the extremities to movement. What was the infant's APGAR score at 1 minute after birth? A. 1 B. 2 C. 3 D. 4

C. A score of one is given for each of the following: some resistance of the extremities to movement, a heart rate less than 100 beats/minute, and slow respirations. A score of zero is given for bluish color in the body and extremities and no response to reflex irritability.

Which of the following is contraindicated to ultrasound at 1.5 watts/cm2 with a 1 MHz sound head? A. Over a recent fracture site. B. Over non-cemented metal implant. C. Over a recently surgically repaired tendon. D. Over the quadriceps muscle belly.

C. A therapist can use ultrasound with all of the other choices. Performing an ultrasound over a cemented metal implant is also a contraindication. However, with any ultrasound techniques, treatment should be stopped if the patient feels pain.

If the line of gravity is posterior to the hip joint in standing, on what does the body first rely to keep the trunk from moving into excessive lumbar extension? A. Iliopsoas muscle activity B. Abdominal muscle activity C. Anterior pelvic ligaments and the hip joint capsule. D. Posterior pelvic ligaments and the hip joint capsule.

C. In static standing the line of gravity is posterior to the hip joint. The body relies on the anterior pelvic ligaments and the hip joint capsule. The iliopsoas may be recruited at times, but anterior ligaments are used first to keep the trunk from extending in static stance.

A patient is positioned by the therapist with the cervical spine rotated to the right. The patient then extends the neck as the therapist externally rotates and extends the right upper extremity. The patient is ten instructed to hold a deep breath. The radial pulse is palpated in the right upper extremity by the therapist. What type of special test is this, and for what condition is it testing? A. Adson's maneuver - cervical disc herniation B. Lhermitte's sign - cervical disc herniation C. Adson's maneuver - thoracic outlet syndrome D. Lhermitte's sign - thoracic outlet syndrome

C. Adson's maneuver tests for thoracic outlet syndrome. Lhermitte's sign tests for dural irritation in the cervical spine.

A mother comes to a therapist concerned that her 4-month-old infant cannot sit up alone yet. Which of the following responses is the most appropriate for the therapist? A. "Your infant probably needs further evaluation by a specialist because, although it varies, infants can usually sit unsupported at 2 months of age". B. "Your infant probably needs further evaluation by a specialist because, although it varies, infants can usually sit unsupported at 3 months of age". C. "This is probably nothing to concerned about because, although it varies, most infants can sit unsupported at 8 months of age". D. "This is probably nothing to be concerned about because, although it varies, most infants can sit unsupported at 5 months of age".

C. Although sources vary widely, a child can sit unsupported usually between 4 and 8 months of age. Answers A and B are incorrect. Answer D would possibly cause the parent to worry prematurely.

A therapist is working in an outpatient rehabilitation facility. A female patient presents with an order for occupational therapy to evaluate and treat a diagnosis of carpal tunnel syndrome. The occupational therapist (OT) brings to the attention of the physical therapist (PT) that the patient's insurance will not reimburse for occupational therapy services. What is the best course of action? A. Allow the OT to treat the patient and the PT to sign off on his or her work. B. Tell the patient that she will have to pay out of pocket for OT services. C. Call the doctor's office and obtain an order for PT, then allow the PT to treat the patient. D. Tell the patient to return to her doctor to obtain a PT order.

C. Answer A is incorrect because the order is for occupational, not physical therapy, and under than order the patient has to be treated by an occupational therapist. Answer B is incorrect because it is unlikely that a patient will agree to paying out of pocket or be able to afford the expense of occupational therapy services. Answer D is incorrect because the problem can be solved by telephone without making the patient schedule another doctor's appointment. Answer C is correct because it would take about 5 minutes to obtain a verbal order, and therapy can begin right away.

Which of the following is not an acceptable long-term goal for a patient with a complete C7 spinal cord injury? A. Independence with dressing B. Driving an automobile. C. Balance a wheelchair for 30 seconds using a "wheelie". D. Independence with performing a manual cough.

C. Answer A is incorrect because the patient should be able to learn how to be independent with activities of daily living. Answer B is incorrect because the patient can learn to drive an automobile independently with the assist of hand control. Answer C is the correct answer because the patient may use momentum to negotiate a curb. Total balance of a wheelchair using a wheelie is an unrealistic goal.

The therapist receives a referral to evaluate a patient with a boutonniere deformity. With this injury, the involved finger usually presents in the position of A. Flexion of the proximal interphalangeal (PIP) joint and flexion of the distal interphalangeal (DIP) joint. B. Extension of the PIP joint and flexion of the DIP joint. C. Flexion of the PIP joint and extension of the DIP joint. D. Extension of the PIP joint and extension of the DIP joint.

C. Answer B describes a swan-neck deformity.

During the history a 74-year-old woman informs you that she is "taking a heart pill". The patient does not have her medication with her but states that the medication "slows down my heart rate". Which of the following is the most probable medication? A. Epinephrine B. Digitalis C. Quinidine D. Norepinephrine

C. Answers A, B and D increase heart rate. Quinidine is an antiarrhythmic drug.

The therapist is assessing a patient's strength in the right shoulder. The patient has 0o of active shoulder abduction in the standing position. In the supine position, the patient has 42o of active shoulder abduction and 175o pain-free passive shoulder abduction. What is the correct manual muscle testing grade for the patient's shoulder abduction? A. 3-/5 (fair -) B. 2+/5 (poor+) C. 2-/5 (poor-) D. 1/5 (trace)

C. Because the patient does not have 50% of normal range of motion in the gravity eliminated position, 2-/5 is the appropriate grade. Some therapists argue that this is an example of a 1+/5 grade. Sources used in preparation of this exam indicate that there is no grade of 1+/5 with manual muscle testing.

During the evaluation of an infant, the therapist observes that with passive flexion of the head the infant actively flexes the arms and actively extends the legs. Which of the following reflexes is being observed? A. Protective extension B. Optical righting C. Symmetrical tonic neck D. Labyrinthine head righting

C. Choice C describes the symmetric tonic neck reflex. With passive cervical extension an infant displays upper extremity extension and lower extremity flexion.

The therapist decides to use electrical stimulation to increase a patient's quadriceps strength. Which of the following is the best protocol? A. Electrodes placed over the superior/lateral quadriceps and the vastus medialis obliquus - stimulation on for 15 seconds, then off for 15 seconds B. Electrodes over the femoral nerve in the proximal quadriceps and the vastus medialis obliquus - stimulation on for 50 seconds, then off for 10 seconds C. Electrodes over the vastus medialis obliquus and superior/lateral quadriceps - stimulation frequency set between 50 - 80 hertz, pps D. Electrodes over the femoral nerve in the proximal quadriceps and the vastus medialis obliquus - stimulation frequency set between 50 - 80 hertz, pps

C. Correct electrode placement is over the motor points of the involved muscle. On-off cycle time is usually between 1:3 and 1:5. Fused tetany of a muscle usually occurs between 50-80 hertz or pps (sources vary).

Which of the following is used to treat a patient referred to physical therapy with a diagnosis of Dupuytren's contracture? A. Knee continuous passive motion (CPM) B. Work simulator set for squatting activities. C. Hand splint. D. A two-pound dumbbell

C. Dupuytren's contracture is a progressive thickening of the palmar aponeurosis of the hand. The progression is gradual, and the interphalangeal joints are pulled into flexion.

While observing the ambulation of a 57-year-old man with an arthritic right hip, the therapist observes a right lateral trunk lean. Why does the patient present with this gait deviation? A. To move weight toward the involved hip and increase joint compression force. B. To move weight toward the uninvolved hip and decrease joint compression force. C. To bring the line of gravity closer to the involved hip joint. D. To take the line of gravity away from the involved hip joint.

C. Leaning the trunk over the involved hip decreases joint reaction force and strain on the hip abductors. These factors together decrease pain in the involved hip.

Which of the following is a correct statement about Medicare? A. Medicare Part A is only for patients over 85 years old B. Medicare Part B is only for patients 65 - 84 years old. C. Medicare Part A is only for inpatient treatment. D. Medicare Part B is only for use in long-term facilities.

C. Medicare Part A is used for inpatient treatment and Part B for outpatient treatment. Medicare Part A or B can be used for home health treatment; part B being is when the patient does not have part A.

A patient living in a nursing home with Medicare Part A as the source of reimbursement is treated by physical therapy only. What is the required minimal frequency of physical therapy treatment? A. Once a week B. Three times a week C. Five times a week D. There is no required time frame.

C. Medicare requires that a patient living in a nursing home with Part A as the main source of reimbursement receive 5 days/week of skilled treatment. In this scenario, the physical therapist must see the patient 5 days/week because it is the only skilled service required by the patient.

Which of the following is the most important to assess first during an evaluation of a patient with a recent stroke? A. Sensory status B. Motor control C. Mental status. D. Ambulation potential

C. Mental status is the first item to assess. A therapist must first determine whether the patient is able to provide a reliable subjective history. It is also important to know whether the patient can follow a 1 or 2-step command beginning a formal evaluation. The other choices should be assessed later in the evaluation.

The therapist in an outpatient physical therapy clinic receives an order to obtain a shoe orthotic for a patient. After evaluating the patient, the therapist finds a stage I pressure ulcer on the first metatarsal head. Weight-bearing surfaces need to be transferred posteriorly. Which orthotic is the most appropriate for this patient? A. Scaphoid pad. B. Thomas heel. C. Metatarsal pad D. Cushion heel.

C. Metatarsal pads successfully transfer weight onto the metatarsal shafts of this patient. A Thomas heel and a scaphoid pad are for patients with excessive pronation. A cushion heel absorbs shock at contact.

A 32-year-old construction worker fell off a ladder. In his effort to prevent the fall, the worker reached for a beam with his right arm. This motion stretched the brachial plexus, resulting in decreased function in the right arm. Full function returned after 2 ½ weeks. What is the most likely type of injury? A. Axonotmesis B. Neurotmesis C. Neurapraxia D. None of the above

C. Neurapraxia is not associated with axon degeneration. It is associated instead with demyelination and complete recovery. With axonotmesis there is Wallerian degeneration below the site of the lesion. In neurotmesis the damage is so severe that full function may not be regained.

A teenager comes to an outpatient facility with complaints of pain at the tibial tubercle when playing basketball. The therapist notices that the tubercles are abnormally pronounced on bilateral knees. What condition does the patient most likely have? A. Jumper's knees. B. Anterior cruciate ligament sprain. C. Osgood-Schlatter disease. D. A & C

C. Osgood-Schlatter disease is severe tendinitis of the patellar tendon. It is characterized by pronounced tibial tubercles. The increased size of the tubercles is attributed to the patella tendon pulling away from its insertion. Jumper's knees (or normal patella tendinitis) does not necessarily present with tubercle enlargement.

On examination of a cross section of the spinal cord of a cadaver, the examiner notes plaques. The finding is most characteristic of what condition? A. Parkinson's disease B. Myasthenia gravis C. Multiple sclerosis. D. Dementia.

C. Parkinson's disease and dementia are disorders involving the brain. Myasthenia gravis is a problem with acetylcholine receptors at the neuromuscular junction.

A therapist is ordered by a physician to treat a patient with congestive heart failure in an outpatient cardiac rehabilitation facility. Which of the following signs and symptoms should the therapist not expect? A. Stenosis of the mitral valve B. Orthopnea C. Decreased preload of the right heart D. Pulmonary edema

C. Patients with congestive heart failure often develop an enlarged heart because of the burden of an increased preload and afterload.

A 20-year-old woman is referred to a therapist with a diagnosis of recurrent ankle sprains. The patient has a history of several inversion ankle sprains within the past year. No edema or redness is noted at this time. Which of the following is the best treatment plan? A. Gastrocnemius stretching, ankle strengthening, and ice. B. Rest, ice, compression, elevation and ankle strengthening. C. Ankle strengthening and a proprioception program. D. Rest, ice, compression, elevation and gastrocnemius stretching.

C. Patients with recurrent ankle sprains benefit from proprioceptive exercises. Choices B and D are not indicated because of the lack of acute signs and symptoms. Choice A is a good plan, but not the most correct because there is no mention of proprioception.

The therapist has just returned from an inservice offering new treatment techniques in wound care. The therapist would like to share the information with interested members of the hospital staff. What is the best way to share the information? A. Prepare a handout on the new treatment techniques and give it to the members of the hospital staff B. Schedule a mandatory inservice during lunch for the entire hospital staff that participate in some form of wound care C. Post bulletins in view of all hospital staff and send memos to the department heads inviting everyone to attend an inservice during lunch D. Call each department head and invite him or her and their staff to an inservice during lunch

C. Posting the inservice date on the bulletin board and sending a memo to the department heads is the most effective way to invite everyone interested. Scheduling during lunch often makes it easier for people to attend.

After arriving at the home of a home health patient, the primary nurse informs the therapist that she has activated emergency medical services. The nurse found the patient in what appears to be a diabetic coma. Which of the following is most likely not one of the patient's signs? A. Skin flush B. Rapid pulse C. Weak pulse D. High blood pressure

D. A person in a diabetic coma has low blood pressure.

A patient is positioned in the supine position. The involved left upper extremity is positioned by the therapist in 90o of shoulder flexion. The therapist applies resistance into shoulder flexion, then extension. No movement takes place. The therapist instructs the patient to "hold" when resistance is applied in both directions. Which of the following proprioceptive neuromuscular facilitation techniques is being used? A. Repeated contractions B. Hold-relax C. Rhythmic stabilization D. Contract-relax

C. Rhythmic stabilization involves a series of isometric contractions of the agonist, then antagonist.

The patient is referred by a physician to begin outpatient cardiac rehabilitation. Which of the following is not a contraindication to enter an outpatient program? A. Resting systolic blood pressure of 210 mmHg B. Third-degree atrioventricular block C. Resting ST displacement less than 1 mm. D. Acute fever

C. ST segment displacement greater than 3 mm is a contraindication. Resting systolic pressure above 200 mmHg is a contraindication.

A patient comes to the therapist because she has noted a pronounced tuft of hair on the center of her spinal column in the lumbar area. The therapist notes no loss in motor or sensory function. This patient most likely has what form of spina bifida? A. Meningocele B. Meningomyelocele C. Spina bifida occulta D. Syringomyelocele

C. Spina bifida occulta is a benign disorder. It presents with no decrease in function. There is no protrusion of the spinal cord or its associated structures, as in choices A and B.

A 3-month-old infant has a heart condition known as tetralogy of Fallot. This condition presents with which of the following signs? A. Atrial septal defect, pulmonary valve stenosis, aorta abnormally located to the right, and right ventricular hypertrophy. B. Atrial septal defect, pulmonary valve stenosis, aorta abnormally located to the left, and right ventricular hypertrophy C. Ventricular septal defect, pulmonary valve stenosis, aorta abnormally located to the right, and right ventricular hypertrophy. D. Ventricular septal defect, pulmonary valve stenosis, aorta abnormally located to the right, and left ventricular hypertrophy

C. Tetralogy of Fallot consists of these four abnormalities.

How often does the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) survey hospitals? A. Once per year B. Every 2 years C. Every 3 years D. Every 4 years

C. The Joint Commission surveys hospitals once every 3 years.

A therapist is treating an acute full-thickness burn on the entire right lower extremity of a 27-year-old man. What movements need to be stressed with splinting, positioning, and exercise to avoid contractures? A. Hip flexion, knee extension, and ankle dorsiflexion B. Hip extension, knee flexion, and ankle plantarflexion C. Hip extension, knee extension, and ankle dorsiflexion D. Hip flexion, knee extension, and ankle plantarflexion

C. The answer is correct because the most common deformity after a severe burn such as this is hip flexion, hip adduction, knee flexion, and ankle plantar flexion.

A patient is sitting over the edge of a table and performing active knee extension exercises using an ankle weight as resistance. This exercise demonstrates what class lever? A. First class B. Second class C. Third class D. Fourth class

C. The axis point is the knee joint. The effort arm is distal to the knee joint at the insertion of the patella tendon. The resistance is at the ankle. A class II level has the resistance arm in the middle, making a longer effort arm than resistance arm. The class I level has an axis in the middle.

A therapist assessing radial deviation range of motion at the wrist. The correct position of the goniometer should be as follows: the proximal arm aligned with the forearm and the distal arm aligned with the third metacarpal. What should be used as the axis point? A. Lunate B. Scaphoid C. Capitate D. Triquetrum

C. The capitate is the axis.

A patient has traumatically dislocated the tibia directly posteriorly during an automobile accident. Which of the following structures is the least likely to be injured? A. Tibial nerve B. Popliteal artery C. Common peroneal nerve D. Anterior cruciate ligament

C. The common peroneal nerve travels over the lateral knee. It is the least likely to be injured. The other structures are either within the knee or directly posterior.

A patient who has suffered a recent fracture of the right tibia and fibula has developed foot drop of the right foot during gait. Which nerve is causing this loss of motor function? A. Posterior tibial B. Superficial peroneal C. Deep peroneal D. Anterior tibial

C. The foot drop is caused by a lack of active dorsiflexion. The tibialis anterior is responsible for this motion and is innervated by the deep peroneal nerve.

A physical therapist should place the knee in which of the following positions to palpate the lateral collateral ligament (LCL)? A. Knee at 60o of flexion and the hip externally rotated. B. Knee at 20o of flexion and the hip at neutral. C. Knee at 90o of flexion and hip externally rotated. D. Knee at 0o and the hip at neutral.

C. The lateral collateral ligament of the knee is best palpated with the patient in the sitting position. The patient then places the foot of the involved lower extremity on the knee of the uninvolved lower extremity. This maneuver places the involved knee in 90o of flexion and hip in external rotation.

A therapist is evaluating the gait pattern of a patient and notes that the pelvis drops inferiorly on the right during the midswing phase of the right lower extremity. The patient also leans laterally to the left with the upper trunk during this phase. Which of the following is the most likely cause of this deviation? A. Weak right gluteus medius B. Weak right adductor longus C. Weak left gluteus medius D. Weak left adductor longus

C. The pelvis is dropping of the right side because the left gluteus medius is weak. The patient also may lean toward the left hip joint to move the center of gravity, making it easier to hold up the right side of the pelvis

Which of the following is the most vulnerable position for dislocation of the hip? A. 30o hip extension, 30o hip adduction, and minimal internal rotation B. 30o hip flexion, 30o hip adduction, and minimal external rotation C. 30o hip flexion, 30o hip abduction, and minimal external rotation. D. 30o hip extension, 30o hip abduction, and minimal external rotation.

C. This is the loose-packed position of the hip.

A therapist is scheduled to treat a patient with cerebral palsy who has been classified as a spastic quadriplegic. What type of orthopedic deformity should the therapist expect to see in a patient's feet? A. Talipes equinovalgus B. Talipes equinovarus C. Clubfeet D. B & C are correct

D. A person with spastic quadriplegia present with talipes equinovarus. This term is synonymous with clubfoot.

A physical therapist instructs a physical therapy assistant to teach a patient how to ascend and descend the front steps of her home. After first exercising the patient at her home, the assistant realizes that, because of her increased size and severe dynamic balance deficits, training on the step is unsafe at this time. The assistant contacts the therapist by telephone. Which of the following is the best course of action by the therapist? A. The therapist should instruct the assistant to attempt step training cautiously. B. The therapist should instruct the assistant to recruit the family members to assist with step training. C. The therapist should instruct the assistant to discontinue step training until both of them can be present D. The therapist should contact the physician and seek further instruction.

C. The physical therapist should tell the assistant to wait until they can both work together with the patient. The family is not qualified to help the assistant during the first attempt at ambulation in this situation.

A pitcher is exercising in a clinic with a sports cord mounted behind and above his head. The pitcher simulates pitching motion using the sports cord as resistance. Which proprioceptive neuromuscular facilitation (PNF) diagonal is the pitcher using to strengthen the muscles involved in pitching a baseball? A. D1 extension B. D1 flexion C. D2 extension D. D2 flexion.

C. The pitcher is moving into D2 extension with the throwing motion. He is strengthening the muscles involved in shoulder internal rotation, adduction, and forearm pronation.

A physical therapist receives an order to evaluate a home health patient. The primary nurse notes that the patient "may have suffered a stroke because she cannot move the right leg when she stands". The history that the therapist obtains from the patient and family members includes: (1) left total hip replacement 6 months ago, (2) inability to lift the right lower extremity off the floor in a standing position, (3) recent fall at home 2 nights ago, (4) left lower extremity strength with manual muscle testing in supine is 2+/5 overall, (5) complaints of pain with resisted movement of the left lower extremity, (6) right lower extremity strength is 4+/5 overall, (7) no pain with resisted movements with the right lower extremity, (8) no difference in bilateral upper extremity strength, (9) no decreased sensation, (10) no facial droop, (11) history of dementia but no decreased cognitive ability or speech level as compared with the prior level of function and (12) independence in ambulation with a standard walker before the recent fall. The therapist's recommendation to the nursing staff should be: A. The patient should receive physical therapy for strengthening exercises to the right lower extremity with standing exercises and gait training. B. The patient should receive a physician's evaluation for a possible stroke. C. The patient should receive a physician's evaluation for a possible left hip fracture. D. The patient should receive physical therapy for strengthening the left lower extremity and gait training.

C. The right lower extremity is still strong, and there is no facial droop or diminished sensation. Although these signs are not always present after a stroke, the other signs and symptoms such as a history of a recent fall and the past total hip replacement, should lead the therapist to choice C. The patient cannot lift the right lower extremity in the standing position because it increases weight bearing on the fractured left lower extremity. The left leg also shows a definite strength loss as graded with manual muscle testing.

A 13-year-old girl has fractured the left patella during a volleyball game. The physician determines that the superior pole is the location of the fracture. Which of the following should be avoided in early rehabilitation? A. Full knee extension B. 45 o of knee flexion C. 90 o of knee flexion D. 15 o of knee flexion

C. The superior pole is in most contact at approximately 90o of knee flexion.

A 52-year-old man with sciatica presents to outpatient physical therapy. The patient indicates that he is experiencing paresthesia extending to the left ankle and severe lumbar pain. Straight-leg-raise test is positive with the left lower extremity. Of the following, which if the most likely source of pain? A. A lumbar disc with a left posterior herniation or protrusion B. A lumbar disc with a right posterior herniation or protrusion C. Piriformis syndrome D. Sacroiliac joint dysfunction

C. The symptoms involving the left lower extremity are an indication that a disc is herniated or protruding onto a nerve root on the left side. A positive straight leg-raise test is also often an indication of a disc herniation or protrusion.

A 67-year-old woman presents to an outpatient facility with a diagnosis of right adhesive capsulitis. The therapist plans to focus mostly on gaining abduction range of motion. In which direction should the therapist mobilize the shoulder to gain abduction range of motion? A. Posteriorly B. Anteriorly C. Inferiorly D. Superiorly

C. The therapist must stretch the inferior portion of the capsule in an effort to gain abduction of the involved shoulder. This principle is supported by the convex-concave rule.

A 25-year-old woman has been referred to a physical therapist by an orthopedist because of low back pain. The therapist is performing an ultrasound at the L3 level of the posterior back when the patient suddenly informs the therapist that she is looking forward to having her third child. On further investigation, the therapist discovers that the patient is in the first trimester of pregnancy. Which of the following is the best course of action for the therapist? A. Change the settings of the ultrasound from continuous to pulsed. B. Continue with the continuous setting because first trimester pregnancy is not a contraindication. C. Cease treatment, notify the patient's orthopedic physician, and document the mistake. D. Send the patient to the gynecologist for an immediate sonogram.

C. The therapist should notify the referring physician. The mistake should be documented and the patient informed. The referring physician can determine the need for a consultation with him or her or an obstetrician.

A patient is scheduled to undergo extremely risky heart surgery. The patient seems really worried. During the treatment session, the patient and family look to the therapist for comfort. Which of the following is an appropriate response from the therapist to the patient? A. "Don't worry, everything will be okay." B. "Your physician is the best, and he will take care of you." C. "I know it must be upsetting to face such a difficult situation. Your family and friends are here to support you." D. "Try not to worry. Worrying increases your blood pressure and heart rate, which are two factors that need to be stabilized before surgery."

C. This answer is the most appropriate. The therapist cannot guarantee everything will be okay (answer A) or that the physician is the best (answer B). Answer D is too insensitive.

The therapist is performing an orthopedic test that involves: (1) placing the patient in a sidelying position, (2) placing the superior lower extremity in hip extension and hip abduction, (3) placing the knee of the superior lower extremity in 90o of flexion, and (4) allowing the superior lower extremity to drop into adduction. Failure of the superior lower extremity to drop indicates a tight: A. iliopsoas B. rectus femoris C. iliotibial band D. hamstring

C. This is called Ober's test, which screens for a tight iliotibial band.

A therapist receives an order to evaluate and treat a 76-year-old woman who was involved in a motor vehicle accident 2 days ago. The patient's vehicle was struck in the rear by another vehicle. The patient has normal sensation and strength in bilateral lower extremities but paralysis and loss of sensation in bilateral upper extremities. Bowel and bladder function are normal. The patient most likely has what type of spinal cord injury? A. Anterior cord syndrome. B. Brown-Sequard syndrome. C. Central cord syndrome. D. There is no evidence of an incomplete spinal cord lesion.

C. This scenario describes a central cord lesion. It is common in the geriatric population after cervical extension injuries (such as whiplash).

A 31-year-old man has loss of vision in one eye, staggering gait, numbness in bilateral upper extremities, and decreased bowel and bladder control. The episodes of the above symptoms have occurred every few weeks for the past 6 months. Each episode has been slightly worse than the first. What is the most likely condition? A. Parkinson's disease B. Guillain Barre syndrome C. Multiple sclerosis D. Amyotrophic lateral sclerosis

C. This set of signs and symptoms most likely points to multiple sclerosis.

During an evaluation, the therapist taps on the flexor retinaculum of the patient's wrist, which causes tingling in the thumb. What test is this? For what condition does it screen? A. Phalen's test - carpal tunnel B. Finkelstein test - de Quervain's disease C. Tinel's sign - de Quervain's disease D. Tinel's sign - carpal tunnel

D. A positive Tinel's sign screens for carpal tunnel syndrome when the tapping force is performed over the carpal tunnel itself. In Phalen's test, the therapist places the patient's wrists in maximal flexion and holds for 1 minute. The test is positive if there is paresthesia in the median nerve distribution. The Finkelstein test screens for de Quervain's disease by allowing the patient to make a fist with the thumb wrapped in the fingers. The test is positive if there is pain over the abductor pollicis longus and extensor pollicis brevis tendons.

The therapist observes a patient with the latter stages of Parkinson's disease during ambulation. Which of the following characteristics is the therapist most likely observing? A. Shuffling gait B. Increased step width C. Difficulty initiating the first steps D. A and C

D. A shuffling gait and difficulty with initiating gait are typical signs of Parkinson's disease.

A study of the local population was necessary to determine the need for a new fitness center in the area. The therapists performing the study divided the population by sex and selected a random sample from each group. This is an example of what type of random sample? A. Systematic random sample B. Random cluster sample C. Two-stage cluster sample D. Stratified random sample

D. A stratified random sample is taken by dividing the test population into two groups or strata (in this case, male and female) and taking a random sample from each group.

A patient is referred to physical therapy services for care of a burn wound on the left foot. The majority of the wound is anesthetic. There is significant eschar formation over the dorsum of the involved foot, and moderate subcutaneous tissue damage is present. What is the most likely classification of this burn? A. Electrical B. Superficial partial thickness C. Deep partial thickness D. Full thickness

D. A superficial partial thickness burn and a deep partial-thickness burn are not deep enough to involve the subcutaneous tissue. An electrical burn is complete destruction of the subcutaneous tissue. A full-thickness burn produces moderate subcutaneous tissue damage and little pain.

When should a physical therapist begin discharge planning for a patient admitted to a rehabilitation unit with a diagnosis of a recent stroke? A. At the first team meeting B. At the last team meeting C. Two weeks before discharge D. After the initial evaluation by the physical therapist.

D. After the therapist assesses the patient for the first time, he or she needs to begin discharge planning. This is true for an assessment of any patient, not just in the inpatient rehabilitation setting.

A patient presents to an outpatient physical therapy clinic with a severed ulnar nerve in the upper extremity. What muscle is still active and largely responsible for the obvious hyperextension at the metacarpophalangeal (MCP) joints of the involved hand? A. Dorsal interossei B. Volar interossei C. Extensor carpi radialis brevis D. Extensor digitorum

D. An ulnar nerve-compromised hand presents as a "claw" hand after a prolonged amount of time because of atrophy of the interossei. The extensor digitorum takes over and pulls the MCP in hyperextension.

The therapist is working in a nursing home. The company for which the therapist works requires that therapists be at least 75% efficient. The therapist realizes that he or she cannot effectively treat the patients in the given time frame. What is the best course of action? A. Work until the 75% limit is up and cease treatment. B. Work with the patients until the 75% limit is up and complete paperwork for the rest of the 8 hour working day. C. Quit the job and find a company that does not require the 75% limit. D. Go to the immediate supervisor in an attempt to alleviate the problem.

D. Answer A is incorrect because any way to solve this problem without denying needed therapy needs to be explored first. Answer B is incorrect because the therapist may be donating a considerable amount of time. This solution is not profitable for the therapist and is likely to cause an uncomfortable working atmosphere. Answer C is incorrect because the matter may be resolved without quitting. Answer D is correct because the immediate supervisor may be able to assist the therapist in coming to an agreement between the therapist and the company that employs them.

During a case conference, a respiratory therapist indicates that the patient has a low expiratory reserve volume. What does this mean? A. The volume of air remaining in the lungs after a full expiration is low. B. The volume of air in a breath during normal breathing is low. C. The volume of air forcefully expired after a forceful inspiration is low. D. The amount of air expired after a resting expiration is low.

D. Choice D describes an expiratory reserve volume. Choice A is residual volume, choice B is tidal volume, and choice C is vital capacity.

The therapist is working in an outpatient cardiac rehabilitation facility. A 50-year-old healthy man inquires about the correct exercise parameters for increasing aerobic efficiency. Which of the following is the most correct information to convey to this individual? A. Exercise at 50-85% of maximal volume of oxygen utilization (VO2) B. Exercise with heart rate between 111 and 153 beats/minute. C. Exercise at approximately 170 beats/minute. D. A and B are correct.

D. Choices A and B are correct exercise parameters for a healthy person. Choice B has the patient exercising at 65-90% of his age-adjusted maximal heart rate. Choice C is the patient's age-adjusted maximal heart rate.

The therapist is treating a patient who has suffered a recent stroke. There is a significant lack of dorsiflexion in the involved lower extremity and a significant amount of medial/lateral ankle instability. The therapist believes than an ankle foot orthosis (AFO) would be beneficial. Which of the following is an appropriate AFO? A. Solid AFO B. Posterior leaf spring AFO C. Hinged solid AFO D. A or C

D. Choices A and C provide the most medial/lateral ankle support. A posterior leaf spring ankle foot orthosis only provides assistance with dorsiflexion.

While ambulating a stroke patient (right side is the involved side), the therapist notes increased circumduction of the right lower extremity. Which of the following is an unlikely cause of this deviation? A. Increased spasticity of the right gastrocnemius. B. Increased spasticity of the right quadriceps. C. Weak hip flexors. D. Weak knee extensors.

D. Choices A, B, and C would increase the functional length of the right lower extremity and possibly cause a circumduction during gait. Choice D would not change the functional leg length.

The use of compression stockings on the feet and ankles is contraindicated in which patient population? A. Chronic venous disease B. Recent total knee replacement C. Burn patients D. Chronic arterial disease

D. Compression stockings (e.g., Jobst, TED hose) are used in patients with poor venous return. A patient with chronic arterial disease already has difficulty with getting blood to the lower extremities; there is no need to further inhibit the flow.

The therapist is treating a new patient with a diagnosis of lateral epicondylitis. The therapist decides to use iontophoresis driving dexamethasone. Dexamethasone is an _________ and is administered with the ______. A. Analgesic, anode. B. Analgesic, cathode C. Anti-inflammatory, anode D. Anti-inflammatory, cathode.

D. Dexamethasone is a common anti-inflammatory drug driven with the negative electrode. Lidocaine is a commonly used analgesic driven with the positive electrode.

A diabetic patient is exercising vigorously in an outpatient clinic. The patient informs the therapist that he or she received insulin immediately before the exercise session. If the patient goes into a hypoglycemic coma, which of the following is not a likely sign? A. Pallor B. Shallow respiration C. Bounding pulse D. Dry skin

D. Dry skin is a sign of a diabetic coma.

To decrease the risk of hypoglycemia in a patient with type I insulin-dependent diabetes, which of the following is inappropriate? A. Eat or drink a snack high in carbohydrates 30 minutes before exercises. B. Exercise muscles that have not had an insulin injection recently. C. A carbohydrate snack for each 30-45 minutes of exercise D. Exercise at the peak time of insulin effect

D. Exercising at the peak time of insulin effect causes hypoglycemia. Insulin causes the liver to decrease sugar production. The body needs increased levels of blood glucose during exercise.

A physician instructs the therapist to educate a patient about the risk factors of atherosclerosis. Which of the following is the most inappropriate list? A. Diabetes, male gender, and excessive alcohol B. Genetic predisposition, smoking, and sedentary lifestyle C. Stress and inadequate exercise D. Obesity, smoking and hypotension

D. Hypertension is a risk factor in atherosclerosis.

While evaluating a patient who has just received a new left below-knee prosthesis, the therapist notes that the toe of the prosthesis stays off the floor after heel strike. Which of the following is an unlikely cause of this deviation? A. The prosthetic foot is set too far anterior B. The prosthetic foot is set in too much dorsiflexion C. The heel wedge is too stiff. D. The prosthetic foot is outset too much.

D. If the foot is outset too much, it is likely to cause the prosthetic knee to bow inward during standing.

A therapist is treating a 35-year-old man diagnosed with lumbar disc degeneration in an outpatient clinic. Through conversation with the patient, the therapist learns that he is also being treated by a chiropractor for cervical dysfunction. What is the best course of action by the therapist? A. Continue with the current treatment plan and ignore the chiropractor's treatment. B. Ask the patient what the chiropractor is doing and try the same approach. C. Stop physical therapy at once and consult with the referring physician. D. Contact the chiropractor to coordinate his or her plan of care with the physical therapy plan of care.

D. In the ideal situation, the therapist should coordinate his or her plan of care with the chiropractor in case the problems are related

While observing a patient with posttraumatic brain injury (TBI), the therapist notes an increase in left ankle plantar flexion during loading response (heel strike to foot flat) of the involved lower extremity. With this particular patient, the left side is the involved side. Which of the following is not a likely cause of this deviation? A. Spasticity of the left gastrocnemius B. Hypotonicity of the left tibialis anterior. C. Leg length discrepancy. D. Left quadriceps hypertonicity.

D. Increased spasticity of the left gastrocnemius causes an increase in plantarflexion. Hypotonicity of the tibialis anterior causes a foot drop due to the inability to dorsiflex actively. Leg length discrepancy should be evaluated in the initial assessment. This is a possibility in any patient, regardless of the diagnosis. The least likely cause of this deficit is a hypertonic left quadriceps, which most likely would cause an increase in dorsiflexion on the involved side in an effort to decrease the functional leg length.

The supervisor of a rehabilitative facility insists on a weekly meeting to discuss drops in productivity. The supervisor is not concerned with the increased demand placed on the already overworked employees. According to the managerial grid, what is the best classification of this manager? A. 5.5 B. 9.9 C. 1.9 D. 9.1

D. Managers rates as 9,1 have high concern for productivity and low concern for employees. Manages classified as 5,5 have moderate concern for productivity and employees. Managers classified as 9,9 have a high concern for both. Managers rated as 1,9 have high concern for employees and little concern for productivity.

In developing the plan of care for a 28-year-old pregnant woman which of the following muscles should be the focus of the strengthening exercises to maintain a strong pelvic floor? A. Piriformis, obturator internus, and pubococcygeus B. Obturator internus, pubococcygeus and coccygeus C. Rectus abdominis, iliococcygeus, and piriformis D. Iliococcygeus, pubococcygeus, and coccygeus

D. One of the main reasons that pelvic floor exercises are beneficial for a pregnant woman is the extra weight of the viscera.

Which of the following actions places the greatest stress on the patellofemoral joint? A. When the foot first contacts the ground during the gait cycle. B. Exercising on a stair stepper machine. C. Running down a smooth decline of 30o D. Squats to 120o of knee flexion.

D. Patellofemoral joint reaction forces increase as the angle of knee flexion and quadriceps muscle activity increase. Choice D involves the greatest knee flexion angle and quadriceps activity

The therapist works in a cardiac rehabilitation setting. Which of the following types of exercises are most likely to be harmful to a 64-year-old man with a history of myocardial infarction? A. Concentric B. Eccentric C. Aerobic D. Isometric

D. Performing isometric exercises places too much load on the left ventricle of the heart for many cardiac patients.

Which of the following is an example of a policy in a physical therapy clinic? A. No shorts worn in the clinic B. The correct way to accept a telephone referral C. The clinic will open at 8:00 AM D. A and C

D. Policies can be viewed as the rules, and procedures are the ways in which the rules are carried out.

A physician orders stage II cardiac rehabilitation for a patient. The orders are to exercise the patient below 7 metabolic equivalents (METS). Which of the following is a contraindicated activity? A. Riding a stationary bike at approximately 5.5 mph B. Descending a flight of stairs independently C. Ironing D. Ambulate independently at 5-6 mph

D. Riding a stationary bike at 5.5 mph is approximately 3.5 METs. Descending a flight of stairs is approximately 4-5 METs. Ironing is approximately 3.5 METs. Ambulating 5-6 mph is approximately 8.6 METs.

A 32-year-old man is referred to physical therapy with the diagnosis of a recent complete anterior cruciate ligament tear. The patient and the physician have decided to avoid surgery as long as possible. The therapist provides the patient with a home exercise program and instructions about activities that will be limited secondary to this diagnosis. Which of the following is the best advice? A. There are no precautions. B. The patient should avoid all athletic activity for 1 year. C. The patient should avoid all athletic activity until there is a minimum of 20% difference in the bilateral quadriceps muscle as measure isokinetically. D. The patient should wear a brace and compete in only light athletic events.

D. The ACL-deficient patient has a significant rotatory instability. Bracing may prevent some of this instability. Sports that are especially difficult on the knees (e.g., skiing, competitive tennis) are contraindicated.

The therapist is performing an orthopedic test on a 25-year-lld man with the chief complaint of low back pain. The patient has a positive Thomas test. With this information, what might the therapist need to include in the treatment plan? A. Stretching of the hip abductors B. Stretching of the hip adductors C. Stretching of the hip extensors D. Stretching of the hip flexors

D. The Thomas test is a screen to determine whether the hip flexors are too tight.

An 87-year-old woman presents to an outpatient physical therapy clinic complaining of pain in the left sacroiliac joint. The examination reveals higher left anterior superior iliac spine (ASIS) than the right ASIS, shorter leg length on the left side (measured in supine position), and left side posterior superior iliac spine (PSIS) lower than the right PSIS. In what position should you place the patient to perform the correct sacroiliac mobilization of the left innominate? A. Right sidelying B. Supine C. Prone D. None of the above

D. The answer is none of the above because the sacroiliac joint of an 87-year-old woman is most often fused.

Which of the following is the best and first treatment for a wound with black eschar over 90% of the wound bed? A. Lidocaine B. Dexamethasone C. Silvadene D. Elase

D. The correct treatment involves debridement of the eschar over the wound. Elase is an enzymatic wound debridement. Lidocaine is an anesthetic. Dexamethasone is a steroid used mainly with iontophoresis. Silvadene is an antimicrobial used to prevent infection.

The therapist is asked to evaluate a baseball pitcher's rotator cuff isokinetically. Which isokinetic evaluation is most appropriate? A. 190o/second, 180o/second, and 240o/second B. 30o /second, 60o /second, and 90o /second C. 60o /second, 120o /second, and 180o /second D. 180o /second, 240o /second, and 360o /second

D. The fastest settings are appropriate for isokinetic testing. A pitcher's throwing motion is quite fast. It is better to evaluate with isokinetic speed as close as possible to the speed of the tested activity.

The therapist is treating a patient who recently received a below-knee amputation. The therapist notices in the patient's chart that a psychiatrist has stated that the patient is in the second stage of the grieving process. Which stage of the grieving process is this patient most likely exhibiting? A. Denial B. Acceptance C. Depression D. Anger

D. The five stages of grieving are (in order from first to last) denial, anger, bargaining, depression and acceptance.

An infant with Erb's palsy presents with the involved upper extremity in which of the following positions? A. Hand supinated and wrist extended B. Hand supinated and wrist flexed C. Hand pronated and wrist extended D. Hand pronated and wrist flexed

D. The involved upper extremity is in this position because of damage to the C5 and C6 spinal roots.

A tennis player receives a surgical repair of the annular ligament. Where should the therapist expect to note the most edema? A. Radial ulnar joint B. Olecranon bursa C. Ulnohumeral joint D. Lateral triangle

D. The lateral triangle (composed of the radial head, olecranon process, and lateral epicondyle) is the most likely of the choices to exhibit joint edema. Joint edema is common after a surgical procedure.

A therapist is testing key muscles on a patient who recently suffered a spinal cord injury. The current test assesses the strength of the long toe extensors. Which nerve segment primarily innervates this key muscle group? A. L2 B. L3 C. L4 D. L5

D. The long toe extensors represent the spinal cord segment L5. The iliopsoas represents L2. The quadriceps is innervated by L3 and the tibialis anterior is innervated by L4.

Which of the following is not an example of a synarthrodial joint in the body? A. Coronal suture B. The fibrous joint between the shaft of the tibia and fibula C. Symphysis pubis D. Metacarpophalangeal

D. The metacarpophalangeal joint is enclosed in a joint capsule and therefore is considered a diarthrodial joint.

A 42-year-old receptionist presents to an outpatient physical therapy clinic complaining of low back pain. The therapist decides that postural modification needs to be part of the treatment plan. What is the best position for the lower extremities while the patient is sitting? A. 90o of hip flexion, 90o of knee flexion, and 10o of dorsiflexion B. 60o of hip flexion, 90o of knee flexion, and 0o of dorsiflexion C. 110o of hip flexion, 80o of knee flexion, and 10o of dorsiflexion D. 90o of hip flexion, 90o of knee flexion, and 0o of dorsiflexion.

D. This position places the least amount of stress on the lumbar spine in the sitting position.

A therapist is instructing a patient in the use of a wrist-driven prehension orthotic. What must be done to achieve opening of the involved hand? A. Actively extend the wrist B. Passively flex the wrist C. Actively flex the wrist D. Passively flex the wrist

D. This type of orthotic uses tenodesis to achieve opening and closing of the hand. To close the hand, the patient actively extends the wrist. To open the hand, the patient passively flexes the wrist.

Which of the following tissues absorbs the least amount of an ultrasound beam at 1 MHz? A. Bone B. Skin C. Muscle D. Blood

D. Tissue with high collagen content absorbs more ultrasound. Bone absorbs the most ultrasound.

A therapist working in an outpatient physical therapy clinic evaluates a patient with a diagnosis of rotator cuff bursitis. The physician's order is to evaluate and treat. During the evaluation the following facts are revealed: Active shoulder flexion = 85o with pain; Passive shoulder flexion = 177 o ; Active shoulder abduction = 93 o with pain; Passive shoulder abduction = 181 o ; Active external rotation = 13 o ; Passive external rotation = 87 o ; Drop arm test = positive; Impingement test = negative; Biceps tendon subluxation test = negative; Sulcus sign = negative. Of the following, which is the best course of action? A. Treat the patient for 1 week with moist heat application, joint mobilization, and strengthening. then suggest to the patient that he or she return to the physician if there are no positive results. B. Treat the patient for 1 week with ultrasound, strengthening, and ice. Then suggest to the patient that he or she return to the physician if there are no positive results. C. Treat the patient for 1 week with a home exercise program, strengthening, passive range of motion by the therapist, and ice. Then suggest to the patient that he or she return to the physician if there are no positive results. D. Treat the patient for 1 week with strengthening, a home exercise program, and ice. Then suggest to the patient that he or she return to the physician if there are no positive results.

D. The patient most likely has a rotator cuff tear. Choices A and B are incorrect because there is no need for heating modalities. Choice C is wrong because the patient has full passive range of motion; thus there is no need for stretching provided by the therapist at this point.

A patient with a diagnosis of a rotator cuff tear has just begun active range of motion. The therapist is strengthening the rotator cuff muscles to increase joint stability and oppose the superior shear of the deltoid. Which of the rotator cuff muscles participate least in opposing the superior shear force of the deltoid? A. Infraspinatus B. Subscapularis C. Teres minor D. Supraspinatus

D. The subscapularis, teres minor, and infraspinatus muscles oppose the superior pull of the deltoid muscle. The supraspinatus does not oppose the pull of the deltoid but is important because (along with other cuff muscles), it provides a compression force to the glenohumeral joint.

In what position should the therapist place the upper extremity to palpate the supraspinatus tendon? A. Full abduction, full flexion and full external rotation B. Full abduction, full flexion and full internal rotation C. Full adduction, full external rotation, and full extension D. Full adduction, full internal rotation and full extension

D. The supraspinatus tendon is best palpated by placing the patient's involved upper extremity behind the back in full internal rotation.

The therapist's nephew, who is a prospect for a local minor league baseball team, wants an opinion about a set of exercises that he was given by a friend. What is the best way for the therapist to approach this situation? A. The therapist should tell the nephew to make an appointment at the outpatient clinic. B. The therapist should have the nephew fax the exercises to the clinic, then the therapist should mark through the incorrect ones. C. The therapist should have the nephew contact his doctor for an opinion. D. The therapist should meet with the nephew after hours and discuss the exercises.

D. The therapist should meet with the nephew on his or her own time and review the exercise.

A patient has been diagnosed with systemic lupus erythematosus. Which of the following is not a sign of this autoimmune disease? A. Increased photosensitivity B. Oral ulcers C. Butterfly rash D. Increased number of white blood cells

D. The white cell count in a patient with this diagnosis would decrease. Lupus affects mostly young women.

A 50-year-old man has a persistent cough, purulent sputum, abnormal dilation of bronchi, more frequent involvement of the left lower lobe than the right, hemoptysis, and reduced forced vital capacity. What is the most likely pulmonary dysfunction? A. Chronic bronchitis B. Emphysema C. Asthma D. Bronchiectasis

D. These are signs and symptoms of patient with bronchiectasis.

A 68-year-old man who suffered a stroke 4 weeks ago (involving the dominant hemisphere) presents with contralateral hemiparesis and sensory loss (greater in the lower extremity than in the upper extremity), mental confusion, and aphasia. What is the most likely location of the infarction? A. Middle cerebral artery B. Internal carotid artery C. Posterior cerebral artery D. Anterior cerebral artery

D. These signs and symptoms are consistent with an injury to the anterior cerebral artery.

A 35-year-old woman suffered brain injury in a motor vehicle accident and presents with the following symptoms: an intention tremor, nystagmus, hypotonia, and dysdiadochokinesia. What is the most likely location of the lesion? A. Basal ganglia B. Dorsal columns C. Frontal lobe D. Cerebellum

D. These signs and symptoms are most likely associated with damage to the cerebellum. Injuries to the basal ganglia can present with the following symptoms: rigidity, resting tremor, choreiform movements (jerky movements), and difficulty with initiating movement. Frontal lobe lesions lead to a change in mood or overall personality. The dorsal columns are involved in proprioception and awareness of movement.

In an attempt to establish a home exercise program the therapist gives a patient written exercises. After 1 week, the patient returns and has not performed any of the exercises. After further questioning, the therapist determines that the patient is illiterate. What is the best course of action? A. Go over the exercises in a one-on-one review session. B. Give the patient a picture of the exercises. C. Give a copy of the exercises to a literate family member D. All of the above.

D. This answer is correct because patients need a written home program with diagrams and instructions. One-on-one teaching is also necessary to ensure that the patient understands the program. Bringing in another family member is also definitely advisable to assist the patient with program at home.

A physician is preparing a patient for an upcoming procedure. The physician explains that the procedure will provide a detailed image that appears to be a slice of the brain. This image is obtained with a highly concentrated x-ray beam. What procedure is the patient scheduled to undergo? A. Angiogram B. Magnetic resonance imaging (MRI) C. Positron emission tomography (PET) D. Computed tomography (CT)

D. This is a description of a CT scan. A PET scan is performed by injecting a radioactive compound into the person being tested and then forming a picture of the brain with a computer that picks up the compound that reaches the brain tissue. An MRI picks up radiofrequency waves that are emitted by atomic particles displaced by radio waves in a magnetic field. An Angiogram uses a high contrast dye that reveals the vessels of the brain by x-ray.

The following is a long-term goal for a patient with spinal cord injury: independence in performing a manual cough without applying pressure to the abdomen. This goal is the most challenging and obtainable for a patient with a complete lesion at which of the following spinal cord levels? A. C5 B. C7 C. T2 D. T10

D. To assist a patient in developing a tenodesis grip, the therapist should allow the patient's finger flexors to tighten. This grip functions with active extension of the wrist, which allows flexion of the fingers because of shortened flexor tendons.

The therapist is treating a patient who received an above elbow amputation 2 years ago. The prosthesis has a split cable that controls the elbow and the terminal device. With this type of prosthesis, the patient must first lock the elbow to allow the cable to activate the terminal device. This is accomplished with what movements? A. Extending the humerus and elevating the scapula. B. Extending the humerus and retracting the scapula. C. Extending the humerus and protracting the scapula D. Extending the humerus and depressing the scapula.

D. To lock the elbow with this type of prosthesis, the patient must extend the humerus and depress the scapula.