Practice Exam Questions

A patient who has a traumatic brain injury and is awake, confused, and agitated would MOST benefit from which of the following intervention strategies?

B A (TBI) patient who is described as awake, confused, and agitated is an RLA level IV patient with poor memory, decreased attention span, and is easily distracted. Therefore, relying on highly familiar skills and tasks is the most correct answer as the patient does not have the capacity for integrating new environmental or learning changes. Range of motion and positioning is a level 1-111.

A nerve root injury with weakness in elevation of the hip and extension of the knee A S1 B L5 C L1 D L3

D L3 serves the femoral nerve which includes the hip flexors and knee extensors in the proximal thigh. L1 is primarily hip flexors only, LS and below would have included muscles from the sacral portion of the L-S plexus in the posterior thigh and lower leg.

A patient who has type 2 diabetes mellitus and has been on a regular exercise program is eager to begin their program today. The patient reports their blood glucose level this morning is 130 mg/dl. What is the BEST action for the physical therapist assistant to take? A l Have the patient warm up and perform light stretches. B Have the patient eat a small snack before beginning C Inform the patient they are not safe to exercise and reschedule. D No exercise, instruct the patient to consult with their physician

A 100 to 300mg/dl. You're good to go. For most people, this is a safe pre-exercise blood sugar range. A patient should always warm up and stretch before exercising to reduce sudden cardiovascular overload and reduction of muscular injury.

A patient who has type 2 diabetes mellitus and has been on a regular exercise program is eager to begin their program today. The patient reports their blood glucose level this morning is 130 mg/dl. What is the BEST action for the physical therapist assistant to take? A Have the patient warm up and perform light stretches. B Have the patient eat a small snack before beginning c Inform the patient they are not safe to exercise and reschedule. D No exercise, instruct the patient to consult with their physician

A 100 to 300mg/dl. You're good to go. For most people, this is a safe pre-exercise blood sugar range. A patient should always warm up and stretch before exercising to reduce sudden cardiovascular overload and reduction of muscular injury.

A physical therapist assistant is working on a patient with a Spinal cord injury (SCI) at T6 to cough efficiently. Which of the following techniques is the MOST appropriate to instruct this patient onperforming? A Abdominal thrusts B Huffing C Manual or mechanical percussion D Postural drainage

A A patient with SCI above T10 will have difficulty with expiration due to a loss of abdominal muscle control to force expiration (cough). Abdominal thrusts can be used with SCI patients who do not have abdominal control to assist coughing. Huffing is a technique used to keep the airway open longer by taking a breath in and holding it then actively exhaling. Breathing in and holding it enables air to get behind the mucus and separates it from the lung wall so it can be coughed out. Postural drainage is the positioning of a patient with an involved lung segment such that gravity has a maximal effect of facilitating the drainage. Manual or mechanical percussion helps loosen thick secretions.

A 35-year-old construction worker is having numbness and tingling in their ring and little finger. What dermatome is most likely affected? A C8 B T1 C C6 D C7

A Dermatomal mapping illustrates that the C8 distribution includes the ring and little finger on the medial aspect of the wrist and hand. C6 thumb and index finger, C7 middle finger, and T1 medial aspect of the elbow.

Which of the following is an ABNORMAL response to vigorous aerobic exercise in a healthy adult with normal vital signs at rest? A An increase in diastolic pressure B Systolic blood pressure increases to 170 mm Hg. C Respiratory rate increases to 40 breaths/minute. D Arterial oxygen saturation decreases from 99% to 95%.

A Diastolic BP (resting phase) remains nearly constant during exercise. An increase in diastolic pressure which can indicate coronary artery disease. Muscles during vigorous exercise demand more blood flow during exercise causing a rise in the pumping pressure (systolic) phase of blood pressure. Oxygen saturation (02 sat) ranges between 99=95% during exercise. During vigorous exercise respiration rate can range from 40-60 breaths/ min

A physical therapist assistant is working with a patient for lymphedema management in a congested extremity. What is the MOST appropriate way for the assistant to proceed? A Decongest the involved trunk quadrant before decongesting the involved extremity B Decongest the distal extremity segments before progressing to the proximal segments. C Decongest distal portions of the involved extremity before decongesting the corresponding trunk quadrant. D Decongest proximal extremity segments before decongesting the involved trunk quadrant.

A Lymphatic drainage starts centrally and proximally with treatments starting in the trunk on the same side of the congested extremity where functional and healthy lymph nodes are treated first, making it possible for the fluid to move out of the affected area, or "decongest" the region {proximal to distal).

Which of the following systolic blood pressure responses should be expected during the warm-up phase of an aerobic exercise program? A Gradual increase in systolic pressure B Rapid increase in systolic pressure C Rapid decrease in systolic pressure d Gradual decrease in systolic pressure

A Question feedback Gradual increase is found in the warm-up phase, and gradual

A patient has a wound on the sole of the foot. When the dressing is removed, the area around the wound appears white and wrinkled. This appearance is BEST described by using which of the following terms? a Maceration b Hyperkeratosis c Eschar d Necrotic

A Question feedback Maceration is skin that looks soggy, feels soft, or appears whiter than usual. There may be a white ring around the wound in wounds that are too moist. Necrotic tissue gives a dark brown or black appearance to your skin area. Eschar is characterized by dark, crusty tissue at either the bottom or the top of a wound. Ecchymosis is discoloration of the skin resulting from bleeding underneath turning the skin a dark purple color

A physical therapist assistant is selected as part of an interdisciplinary team to create a fall prevention program.Which step is the MOST important in initiating this program? A Identify the intended population B Obtain physician approval C Identify valid and reliable outcome measures D Assign roles for each team member

A Question feedback This is a concept; the intended target population must be identified beforeother steps areconsidered.Sincethisisaprevention program andnotaplanof care physician approval isnot required. The other answers arelater steps in evidenced based practice

A physical therapist assistant is working with a patient in an inpatient setting for initial exercise and general conditioning following a triple bypass surgery. The patient is complaining of pain in the chest when coughing. The MOST effective instruction to address patient's complaint is? A Hold a pillow into the chest when coughing B Raise arms overhead when coughing C Hold onto the sides of the chair when coughing D Take shallow breath to avoid coughing

A Question feedback The patients' complaints are consistent with thesurgical procedure and will benefit from holding a pillow into the chest for a splining effect to reduce the sudden onset of pain when coughing.

A patient presenting with rigidity and reduced mobility from Parkinson's would respond BEST to which PNF A Rhythmic Initiation B Repeated contraction C Contract-relax D Rhythmic stabilization

A Rhythmic initiation is a common technique in PNF used for improving physical performance through a goal-oriented range the rhythmic motion reduces tone to improve mobility using a progression of 1) initial passive, 2) active-assistive, and 3) active movement through the agonist pattern. Rhythmic stabilization is a technique used to improve the dynamic stability of a joint. Contract-relax is a stretching techniques and repeated contractions is a strengthening technique.

A physical therapist assistant sees a patient who slid forward and is sitting with a posterior pelvic tilt while in a wheelchair. What is the BEST action to address this problem? A Direct the patient to scoot back. B Add a seat cushion. C Raise the footrest. D Increase the seat-to-back angle

A Scooting back in the chair would immediately reduce the posterior pelvic tilt and sacral pressure directing weight to the ischial tuberosities.

A physical therapist assistant is working with a 15-year old female who is a competing in springboard diving for her high school team. She reports that she is unable to tolerate springing off from the board due to pain in her back after overextending her back on her previous dive landing. Based on this information the MOST likely cause of the condition is? A Spondylolysis B Spondylosis C Ankylosing Spondylitis D Spondylolisthesis

A Spondylolysis A spinal disorder in which a bone (vertebra) incurs a stress fracture at the pars interarticularis,risk factors include sports that put hyperextension stress on the bones in the lower back. Ankylosing spondylitis is an inflammatory disease that,over time, can cause some of the bones in the spine (vertebrae) to fuse. Spondylosis is an umbrella term for different forms of age-related degeneration of the spine. Spondylolisthesis is where one of the bones in your spine, known as a vertebra, slips out of position from fracture through the pars interarticularis of the lumbar vertebrae

A physical therapist assistant prepares an intervention for a patient with weak activation of the vastus medial is muscle following knee surgery. What is the BEST treatment to address this? A Surface electromyography biofeedback B 4 pad interferential electrical stimulation C2 pad pulsed high volt galvanic electrical stimulation D TENS unit in burst mode

A Surface electromyography biofeedback is used to detect muscle fiber activity and could be used to improve muscle activation. lnterferential electrical stimulation is used for deep pain, TENS for short duration pain relief, and pulsed galvanic stim for wound healing or edema reduction, dependent on the polarity.

A physical therapist assistant prepares to treat a patient with ultrasound for deep heat prior to stretching for piriformis syndrome. Which of the following ultrasound parameters are MOST appropriate to treat this patient? A 1 MHZ frequency with a 5 cm sound head B 1 MHZ frequency with a 2 cm sound head C 3 MHZ frequency with a 5 cm sound head D 3 MHZ frequency with a 2 cm sound head

A The application of ultrasound in this deep location with require a 1 MHz level frequency and the larger sound head to provide effective coverage to the treatment area. Examples; 1cm. TMJ, 2cm for peripheral small areas (tennis elbow), and 5cm for larger areas such as the hip and low back.

A 32-year-old male patient reports he is having pain in the right shoulder limiting motion when reaching to adjust his rearview mirror while driving. What condition is MOST likely to cause this? A Rotator cuff impingement B Scapular winging C Tear of the external rotators D Thoracic outlet syndrome

A The motion of reaching up with the thumb down (Internal shoulder rotation) producing pain is similar to the positioning for the Neer impingement test. Scapular winging and rotator cuff tears would produce weakness but not pain. Thoracic outlet syndrome would cause a broader collection of neurological symptoms.

A physical therapist assistant is working with a patient diagnosed with rotor cuff impingement. What is the tendon MOST frequently associated with this condition? A Supraspinatus B Biceps brachii long head C Subscapularis D Infraspinatus

A The supraspinatus tendon is the tendon on the superior aspect of the shoulder that becomes compressed under the coracoacromial arch and bony acromion. The infraspinatus is an external rotator and the subscapularis an internal rotator, these muscles are more prone to tear injuries; the long head of the biceps is not part of the rotator cuff.

A physical therapist assistant prepares for an intervention to a patient with pain and muscle guarding following a low back sprain. What is the BEST treatment to address this? A 2 pad Russian muscle electrical stimulation B TENS unit in burst mode C 4 pad interferential electrical stimulation D Surface electromyography biofeedback

A lnterferential electrical stimulation is used for deep pain and would be the most effective treatment for this condition. Neuromuscular electrical stimulation using Russian stimulation has a carrier frequency of 2,S00HZ. This higher frequency allows for a deeper, stronger, yet comfortable penetration to the muscle to address weakness. Surface electromyography biofeedback is used to detect muscle fiber activity and could be used to improve muscle activity. TENS is used for superficial pain relief with the patient often using this at home for pain management in between therapy visits.

Which of the following skin conditions may have been associated with a past episode of chicken pox? A Herpes zoster B Psoriasis C Stasis dermatitis D Eczema

A Herpes zoster (shingles) is an acute, cutaneous viral infection. Shingles causes a painful rash that may appear as a stripe of blisters on the trunk of the body. Anyone who's had chickenpox may develop shingles. Psoriasis can progress to psoriatic arthritis with joint pain, stiffness and swelling in about 30% on those affected with the condition. Stasis dermatitis happens when there's a problem with your veins, a common inflammatory skin disease that occurs on the lower extremities, symptoms are itching, scaling, and hyperpigmentation. Eczema is also called dermatitis. Most types cause dry, itchy skin and rashes on the face, inside the elbows and behind the knees, and on the hands and feet.

A 45-year-old male patient with an injury from a slip and fall resulting in a small fracture of the medial malleolus is referred for an assistive device to help with mobility and energy conservation. Which is the MOST appropriate device to consider for this individual? A Knee scooter B Cast boot and a cane C Standard axillary crutches D Front wheeled walker

A The tibia is a weight bearing bone and any fracture will require a prolonged period of NWB (8-12 weeks). Knee scooters have been shown to offer the greatest mobility and the least energy expenditure for a prolonged NWB period. A cane and front wheeled walker would include wt. bearing and standard crutches require more energy with use of UE muscles.

A patient with an ankle brachia! index of .80 is examined in supine prior to exercise. What is the MOST likely presentation to be observed in the distal lower extremities? A Hyperemia B Pitting edema C Pallor D Cellulitis

An ABI of less than 1.0 is abnormal and indicates peripheral artery disease (PAD). This will manifest as a decrease of blood flow in the gravity neutral (supine) position leading to a pale appearance of the distal lower extremities.

A physical therapist assistant is using resistive bands to strengthen the UE of a patient with a C5 radiculopathy. What 2 muscle groups would MOST likely be weak in this patient? A Latissimus and Serratus anterior B Deltoid and Biceps C Upper trapezius and Levator scapulae D Rhomboids and Triceps

B Myotome testing of the C5 nerve root level. The primary muscles tested for C5 are the Deltoids and the Biceps, weakness of only would indicate a nerve lesion not a nerve root. Upper traps are Cr.Nerve XI, Triceps are C7, the Latissimus innervation begins at C6

A patient who has a traumatic brain injury and is awake, confused, and agitated would MOST benefit from which of the following intervention strategies? A Introducing new skills and challenges frequently B Relying on highly familiar skills C Focusing on positioning and range of motion D Introducing auditory and visual stimulation

B

A physical therapist assistant observes a patient with a transfemoral amputation who prefers to sleep in their recliner rather than lying supine in a bed. The assistant informs the patient this position will MOST likely develop? A sacral pressure injury B Hip Flexion contracture C A knee flexion contracture D Tight hamstrings

B A reclined position will keep their hip in a prolonged flexed posture. Knee flexion contracture and tight hamstrings are below knee considerations, and sacral pressure injury is not a immediate concern following amputation.

A 75-year-old patient presents with a normal TV, decreased ERV and a significantly increased RV. Which of the following pathologies is MOST likely to present this way clinically? A Hemothorax B COPD C Pneumonia D Pulmonary fibrosis

B Analysis of lung volumes for conditions. Decreased ERV and increased RV indicate an obstructive condition, COPD is the umbrella term for these conditions. All other choices are restrictive conditions

Which of the following shoulder motions is CONTRAINDICATED for strengthening the shoulder of a patient who has had an anterior shoulder dislocation? A Extension, adduction, and internal rotation B Extension, abduction, and external rotation C Flexion, abduction, and internal rotation D Flexion, adduction, and external rotation

B Approximately. 95% of all dislocations at the shoulder are anterior, the (FOOSH) mechanism of extension, abduction, and external rotation is the combination of motions that result in an anterior dislocation and these motions should be avoided during exercise

For patients who have chronic obstructive pulmonary disease, a forward-bent posture produces which of the following physiological effects to help relieve dyspnea? A Decreased intra-abdominal pressure B Increased effectiveness of the muscles of expiration C Slowed respiratory rate D Improved length-tension relationship of the diaphragm

B Bending forward will produce increased intra-abdominal pressure by activation of the abdominal trunk flexor muscles. A COPD patient has difficulty with forced expiration. Improved length tension relationship of the diaphragm assists with inspiration; this is accomplished with extension of the thoracic spine. The other answers do not relate to expiration.

A patient in the spinal cord rehab unit is referred for transfer training, he can push off the mat and lift and shift using his arms but cannot stand. What is the patient's LIKELY cord level of injury? A C5 B C7 C T12 D L1

B C7 level = triceps, latissimus, finger extensors and flexor carpi radialis is preserved. The latissimus and triceps are required for pushing up and shifting the body weight but no innervation of the trunk or LE exists for standing. C5 would not include these muscles and the ability to push up, T12 and L1 would include postural muscles for standing but would require complete stabilization of the lower extremities to stand weight bearing through the upper extremities in a standing frame or parallel bars.

During goniometric measurement in sitting position, a patient who is limited in medial (internal) rotation of the right hip will give the appearance of increased range of motion due to which of the following compensatory movements? A Elevation of the buttock on the left side BElevation of the buttock on the right side C Inversion of right foot and extension of the right knee D Eversion of the right foot and flexion of the right knee

B Elevation on the R side would shift weight to the L side causing the appearance of more motion.

A physical therapist assistant prepares a patient for the application of a TENS treatment for extended pain relief. What is the BEST method to address this? A Medium rate B Low rate C High rate D Pulse mode

B Low-rate TENS stimulates the body to release endogenous opioids (endorphins) creating longer pain relief of up to 4 hours. High-rate or conventional TENS work on the Gate theory for quick relief. Medium rate is not a setting for pain relief and is used in NMES. All electrical stim is delivered in pulses.

A physical therapist assistant is developing an exercise program for a patient who has upper extremity lymphedema. Which of the following exercises should the patient perform INITIALLY? A Wrist circumduction B Shoulder circumduction C Forearm pronation/supination D Elbow flexion/extension

B Lymphatic drainage exercises proceed proximal to distal to drain the affected areas, before compression warps move fluids distal to proximal.

A physical therapist assistant monitors the blood pressure of a patient on a treadmill during the cool down phase of exercise in a stage 2 Cardiac rehab program. Which of the following is MOST likely to occur as a normal response to exercise? A Rise in systolic and a drop in diastolic blood pressure. B Drop in systolic and minimal diastolic blood pressure. C Rise in systolic and rise in diastolic blood pressure. D Drop in systolic and a rise in diastolic blood pressure.

B Muscle blood flow demand during the cool down phase of exercise decreases reducing the pumping pressure (systolic) phase of blood pressure while the resting phase remains nearly constant

A physical therapist assistant is working with a child who has Down's syndrome and hypotonicity. The plan of care includes activities to gain extensor tone. The MOST effective early intervention to activate postural extensor tone is? A Rhythmic rocking activities seated on a gymnastic ball B Prone positioned on a mat reaching for bright colored balls C Supine bridging exercises D Weight shifting while standing in modified plantigrade.

B Postural hypotonia of the trunk extensors correlates to poor stability. Early interventions that keep the child's attention while looking up in a safe and stable position promotes the use of neck and upper trunk extensors. Weight shifting in modified plantigrade and supine bridging exercises are not appropriate for pediatrics at 18 months. Rhythmic rocking would decrease tone.

A physical therapist assistant is monitoring a patient who experiences a sudden drop in blood pressure. To return to resting blood pressure which of the following reflexive responses are MOST likely to occur. A Vascular dilation and a decrease in cardiac output B Tachycardia and vascular constriction C Decreased cardiac contractility and respiratory rate D Bradycardia and vascular constriction

B Question feedback When blood pressure drops, baroreceptors fire and trigger sympathetic stimulation of the heart producing a rise in heart rate, cardiac output, and sympathetic stimulation of the peripheral arterioles resulting in constriction. Decreased cardiac contractility, bradycardia, and vascular dilation would all maintain the lowered blood pressure.

During sensory exam a physical therapist positions a patient's extremity and asks the patient to place the opposite extremity in the identical position. The physical therapist assistant should recognize that the therapist is testing for: A Vibration B Position Sense C Movement sense. D Tactile localization.

B Recreating an identical position with the opposite extremity is position sense (proprioception). Movement sense is the ability to tell the movement of a digit when the therapist moves it up or down when the patient's eyes are closed. Vibration is tested with a tuning fork. Tactile localization is asking when the patient is being touched and identifying the area when eyes are closed.

Automated external defibrillators are used when a person collapses from cardiac arrest and is unresponsive. Which of the following conditions will the device identify for application of a shock? A Atrial fibrillation B Ventricular fibrillation C Atrioventricular block D Pre-ventricular contraction

B The AED can detect ventricular problems of tachycardia and fibrillation in which a shock may restore normal rhythm.

A physical therapist assistant and physical therapist are discussing a discharge plan for a patient in an acute rehab facility. The patient lives alone and wishes to return to her home. She is independent in transfers and mobility on level surfaces but lives on the third floor of an apartment complex without elevators. Which of the following is the MOST appropriate test to administer for this patient? A Lower extremity cycle ergometer test B Queen's college step test C Treadmill stress test D 6-minute walk test

B The Queen's college step test (QCT) is a submaximal exercise test that is used to measure cardiorespiratory fitness. This is performed by stepping up and down for 3 minutes with a metronome timed beat. Maximal oxygen consumption (V02max) values can be achieved with a lower extremity cycle ergometry allowing for safety and adaptability for those with balance difficulties and weakness in weight bearing. The Maximal oxygen consumption (V02max) is best achieved with a treadmill due to the activation of more muscle mass during weight bearing but lack adaptability for individuals with balance and weight bearing issues. The 6 Minute Walk Test is a sub-maximal exercise test used to assess aerobic capacity and endurance.

A patient in a spinal cord rehab unit is independent in wheelchair propulsion but has only 2+/5 quadriceps strength. He is determined to be able to independently ambulate with crutches and KAFO braces in his home. What is the MOST likely level of spinal cord injury? A S2 B T10 C L5 D L2

B The quadriceps are innervated by the femoral nerve from the lumbar plexus L2-L4. An L2 level would only produce a less than 3/5 level of quad strength. Lower cord levels would have full knee function and the higher level would have no innervation for the quadriceps.

A patient has medial ankle pain, a pronated foot with a calcaneal valgus deformity, has pain with passive ankle eversion and weakness of the great toe flexors. The patient MOST likely has which of the following conditions? A Common fibular, {peroneal) nerve injury B Tarsal tunnel syndrome C Deltoid ligament strain D Tibial is anterior tendonitis

B The tarsal tunnel is located just inferior to the medial malleolus. Over pronation would put increased repetitive stress on this area with irritation producing pain and irritation of the flexor hallucis longus that runs through the tunnel. The common fibular nerve is in the upper lateral leg near the fibular head. Deltoid ligament strain would not affect the flexor hallucis longus, and tibial is anterior tendonitis would not affect toe flexion.

A physical therapist assistant reviews a plan of care for deep tissue healing the provides increased vasodilation, increased metabolism, and decreased pain. Which of the following modalities is MOST appropriate to treat this patient? A Hot pack B Short wave diathermy C Cold pack D Interferential electrical stimulation

B Thermal effects are required for increased vasodilation, increased metabolism, and decreased pain; Short wave diathermy (SWD) can reach the deeper tissues. Hot pack is a superficial heat, cold pack have the opposite circulatory and metabolic effects. interferential electrical stimulation which is used for deep pain.

A patient displays a second degree burn on the left thigh from spilled hot coffee, what is the MOST appropriate dressing to apply? A Foam B Transparent film C Alginates D Hydrogel

B Transparent dressings allow the transfer of moisture while offering a securement layer as well as visualization of the wound. In general foam dressings are meant for partial- or fullthickness wounds. Wounds which benefit from the use of foams dressings include leg ulcers. Hydrogel dressings lend moisture to a wound which can help breakdown dry and dead (necrotic) tissue. Alginate dressings are highly absorbent and can hold as much as 20 times its weight in moisture. It is especially useful in wicking moisture out of deep tunneling areas of a wound.

A geriatric patient with Rheumatoid arthritis having Swan neck deformities of the digits on the right hand. This can be identified MOST accurately by this joint position. A MCP hyperextension B PIP hyperextension C PIP flexion D DIP extension

B A Swan-neck deformity is flexion of the base of the finger (MCP}, hyperextension of the middle joint (PlP), and flexion of the outermost joint (DIP).

A The pain symptoms have begun to centralize B The pain symptoms have begun to peripheralize C Back pain increased when body weight force applied. D No change is symptoms following the first treatment

B Peripheralization indicates the condition is being made worse by compressing the nerve root. Centralization indicates decompression of the disc. No change in an initial treatment is not unusual, and body weight force is never used in lumbar traction; a maximum for of 50% body can be utilized.

A patient has an aching, cramping sensation in the posterior lower legs bilaterally that occurs during walking and is relieved by rest. The patient's feet are pale and cool to the touch. The popliteal and pedal pulses are absent. Strength and range of motion in the lower leg are within normal limits. The MOST likely cause of this patient's pain is: A Deep vein thrombosis B Arterial Insufficiency C Chronic lymphedema D Tightness in the gastrocnemius

B Absence of distal LE pulses with calf pain elicited with activity and relieved by rest are signs of intermittent claudication from arterial insufficiency. All other answers are not related to arterial issues.

You are treating a female patient who recently has undergone radical mastectomy with axillary lymph node removal. Which of the following would be an early indication of lymphedema development on the surgical side? A Numbness above the elbow B Decreased flexibility in the digits C Surgical site swelling D Increased blood pressure

B Radical mastectomy with removal of axillary lymph nodes will impair lymph return form the UE. The Distal portion of the extremity will be the first area to show fluid collection. Digit inflexibility would be an early sign of this fluid accumulation. Surgical site site swelling is common in any surgical procedure and is not lymph related. Numbness is a neurological sign not associated with lymphedema;. Increased blood pressure traditionally is not associated with post-operative lymphedema.

What muscle does not contribute to shoulder extension with a patient positioned in prone for M M T of the shoulder? A Teres major B Anterior deltoid C Posterior deltoid D Latissimus dorsi

B The anterior deltoid is a shoulder flexor an antagonist to shoulder extension and does not contribute to any position. The remaining muscles all contribute to shoulder extension with the Latissimus dorsi being the prime mover.

A complete spinal cord injury at which spinal level allows wrist extensors, pec major, and teres major muscles to allow a patient to use a sliding board with assistance? A C5 B C6 C C7 D C8

B C6 The spinal cord level that introduces wrist extension is C6, the pec and the teres major are innervated by CS. Picking C6 will give one the ability to use wrist extension as well as have the above spinal levels

What special test is MOST likely used in assessing a patient with a suspected shoulder dislocation?

D The apprehension is used for anterior glenohumeral instability from a shoulder dislocation, the empty can test is used for rotator cuff tear, the O'Brien's test is used to assess for SLAP lesion, and the Hawkins/Kennedy for shoulder impingement.

A patient is being instructed for initial gait training following aright posterior approach total hip replacement. When reaching the end of a hall, and instructing your patient to turn around. What are the MOST appropriate lower extremityturning instructions? A Turn the the left leading with the right. B Turn to the right leading with your left foot C Turn to the right leading with the right foot D Turn either direction using both feet with a twisting X motion.

C

A patient is seen in an out-patient therapy clinic 1 week after undergoing a partial meniscectomy. What type of exercises would be MOST appropriate for improving mobility? A Ankle pumps B Isometric quadriceps contractions C Stationary bicycle D 4 position straight leg raises

C A partial meniscectomy is removal of the damaged tissue and does not involve any structural repair. Progression to low resistance non weight bearing cycling will improve knee ROM and mobility following the acute phase of recovery.

Which of the following objective findings would MOST likely limit a patient with peripheral artery disease to participate in a treadmill exercise program? A Cool skin on palpation B 02 saturation of 94 at rest C Signs of resting claudication D Numbness and tingling in the wrist and hands

C A red flag is a patient with resting claudication, they will not be able to tolerate any walking activity. Low 02 sat may benefit from treadmill ex but need close monitoring, cool skin is not a red flag sign. Numbness in the UE is a neurologic sign and will not affect LE treadmill activity.

A physical therapist assistant is performing a sit to stand wheelchair transfer with a patient who is taking an ACE inhibitor. What response to this is MOST likely to be observed? A Increased pain with exertion B A rise in resting heart rate C A drop in blood pressure D Profuse sweating

C Angiotensin-converting enzyme (ACE) inhibitors are medications that help relax the veins and arteries to lower blood pressure which may cause blood pressure to drop suddenly when standing (orthostatic hypotension)

A patient having received a cemented posterior approach total hip replacement is MOST likely to have this postoperative weight bearing restriction A Non weight bearing (NWB) B Touch down weight bearing (TDWB) C Weight bearing as tolerated (WBAT) D Partial weight bearing (PWB)

C Bone cement allows a surgeon to affix prosthetic joint components to a bone that is slightly porous from osteoporosis, typically an acrylic polymer called polymethylmethacrylate (PMMA) is used. The bone cement dries within 10 minutes of application and the implant is fixed in place when the patient leaves the operating room allowing the patient to be weight bearing as tolerated. All other answers are weight bearing restrictions that may apply to a non-cemented

A physical therapist assistant in an outpatient clinic is performing wrist stretching exercise on a patient recovering from a Catie's fracture 6 weeks ago. Comorbidities include type 11 diabetes and ERSD (end stage renal disease). During the treatment the patient begins scratching at their forearm and becomes dizzy. The MOST likely explanation for this is: A The stretching activities are too aggressive B The patient is experiencing low blood sugar C The patient is experiencing side effects from dialysis D The patient is having an autonomic reaction to pain

C End-stage renal disease (ESRD) is the last stage of kidney failure when treatment is essential to preserve body functions and is treated by dialysis; common side effects are itching and Low blood pressure (hypotension). A drop in blood pressure can lead to dizziness and is a common side effect of hemodialysis. Low blood sugar signs include shakiness, anxiety, and sweating. An autonomic reaction to pain would include sweating and increased heart rate. There is no mention of pain in the question for aggressive stretching.

A patient with a T2 spinal cord injury is referred for rehabilitation. Shortly after the session begins, the physical therapist assistant notices that the patient is beginning to perspire heavily and is developing a flushed appearance. The pulse slows and the patient reports a severe headache. What is the MOST likely cause of this reaction? A Myocardial infarction B Acute respiratory distress C Autonomic dysreflexia D Adverse medication reaction

C In autonomic dysreflexia, patients will experience hypertension, sweating, bradycardia and erythema (flushed appearance) and may suffer from headaches. It is more common in people with spinal cord injuries that involve the thoracic nerves of the spine or above (T 6 or above). All others do not have this specific collection of symptom presentation.

What bone disease affects the medial femoral condyle and the humeral capitellum? A Osteoporosis B Osteomyelitis C Osteochondritis Dissecans D Osteomalacia

C Osteochondritis Dissecans occurs predominately in children with softened and fibrillated cartilage that most often occurs in the knee and elbow. Osteomyelitis inflammation of bone or bone marrow, usually due to infection. Osteomalacia is softening of the bones, typically through a deficiency of vitamin Dor calcium. Osteoporosis means porous bone. It is a disease that weakens bones making them brittle and susceptible to fracture.

A physical therapist assistant is working with a 67-year-old male patient in a home setting. The plan of care indicates gait training due poor endurance following a recent fall. The patient lives alone, is obese, with complaints of shortness of breath, trouble urinating, and constant swelling in both legs. What is the MOST likely reason for the patient's condition? A Early stages of Parkinson's B Cirrhosis of the liver C Kidney Failure D Prediabetes

C Question feedback Kidney failure signs include shortness of breath, decreased urine output, fluid retention in the lower extremities, fatigue, and irregular heartbeat. Prediabetes symptoms include fatigue, increased thirst, increased urination, and blurred vision. Diabetes can lead to peripheral neuropathy in a stocking type distribution of the distal lower extremities bilaterally. Parkinson's symptoms include tremors, slow movements, rigid muscles, impaired posture, and impaired balance leading to increased risk of falls. Cirrhosis of the liver is often associated with chronic alcoholism which leads to unsteady gait. Cirrhosis symptoms include weight loss, excessive bruising and yellowing of the skin and eyes (jaundiced).

A physical therapist assistant is assisting a patient with a recent left hemisphere CVA. The MOST likely manifestation in this patient is A Difficulty with drawing B Impaired spatial body recognition C Difficulty understanding verbal commands D Impaired decision making

C Speech centers are predominately located in the left hemisphere. Wernicke's area is the receptive area for processing speech. All other answers reflect right hemisphere damage.

A physical therapist assistant prepares an intervention for a patient presenting with trochanteric bursitis and applies a 10% cortisone cream to the area. What is the BEST method of drug delivery? A 2 pad pulsed galvanic electrical stimulation using a negative dispersive electrode. B Hot pack with 6 to 8 towel layers placed over the area C Pulsed ultrasound,using a 1 MHz setting D 4 pad interferential electrical stimulation

C The application a 10% hydrocortisone cream is used in phonophoresis a 1 MHz heat allows deeper penetration to the bursa and the pulsed setting will allow for a more effective stationary technique. There would be no tissue absorption of the cream using hot packs or lnterferential electrical stimulation which is used for deep pain and pulsed galvanic stim for wound healing or edema reduction dependent on the polarity.

A physical therapist assistant is working with a patient who has right thoracic structural scoliosis. What is the MOST likely finding on this patient? A Decreased lateral costal expansion on the right B Increased lateral costal expansion on the left C Decreased breath sounds on the left D Increased breath sounds on the left

C The convexity of the curve is in the right thoracic region allowing increased expansion, breath sounds, and lung function with decreased expansion, breath sounds, and lung function on the left (concave side).

A physical therapist assistant positions a patient to isolate the origin of the hamstrings for stretching to improve hip flexion. The most effective STARTING position to accomplish this is? A The patient positioned in sitting with the knee flexed B The patient positioned in prone with the knee extended C The patient positioned in supine with the hip and knee extended D The patient positioned in sitting with the knee flexed

C The hamstring is a 2 joint muscle (hip extensor, knee flexor). To isolate the origin at the hip the knee would be extended at the distal insertion site first then the hip flexed to focus the stretch at the origin from the hip. To isolate the insertional area at the knee the hip would be flexed first followed by extension of the knee at its distal insertional site. The supine position offers reduced stress to the low back versus the sitting posture.

A 58-year-old female in an inpatient therapy gym is ambulating with an assistant. They suddenly clutch the assistant's arm stating they feel faint. What is the MOST appropriate immediate action the assistant should take? A Support the patient and call for ammonia capsules B Activate the inpatient emergency code system C Assist the patient to a sitting position D Support the patient and call for a wheelchair

C The most appropriate action is to ensure the patients safety and prevent a possible fall by lowering the patient to a sitting position. All other answers do not immediately resolve the fall risk.

Which of the following muscles are MOST active during initial contact (heel strike) of the gait cycle? A lliopsoas and gluteus maxi mus B Gluteus maximus and hamstrings C Quadriceps and tibialis anterior D Gluteus medius and gastrocnemius

C The quadriceps and tibialis anterior are eccentrically contracting to control the impact loading moment to stabilize the knee and lower the ankle into plantar flexion. The gluteus medius is active during mid stance to keep the pelvis level, the gastrocnemius is active in pre-swing to push us forward, the iliopsoas is active in hip flexion during the swing phase along with the hamstrings for knee flexion. The gluteus maximus is most active in the terminal stance phase of gait.

A nerve injury with inability to oppose the thumb and fingers as well as cause abduction of the 1st carpometacarpal joint? A Posterior interosseus nerve B Radial nerve C Median nerve D Ulnar nerve

C The thenar muscles abductor pollicis, opponens pollicis, and flexor pollicis brevis position the thumb (1st digit) and are innervated by the median nerve.

A physical therapist assistant is working with a client diagnosed with benign paroxysmal positional vertigo (BPPV). Which semicircular canal is MOST likely affected? A Horizontal B Posterior C Anterior D Lateral

C The three semicircular canals of the bony labyrinth are designated according to their position: superior, horizontal, and posterior. The Posterior canal is the most likely affected between 85-90% of the time?

patient is being instructed for initial gait training following a right posterior approach total hip replacement. When reaching the end of a hall, and instructing your patient to turn around. What are the MOST appropriate lower extremity turning instructions? A Turn the the left leading with the right. B Turn to the right leading with your left foot C Turn to the right leading with the right foot D Turn either direction using both feet with a twisting motion.

C Using the same side foot as the turning direction will always create external rotation of the LE and prevent adduction and crossing midline of the surgical side for the total hip patient. All other answers involve crossing midline and internal rotation (THA precautions)

A patient has the appearance of a skin breakdown of the medial aspect of the left lower leg. The skin of the lower leg appears dark and has a bumpy texture. The popliteal and pedal pulses are present. The MOST likely cause of this patient's condition is: A Stage 2 lymphedema B Deep-vein thrombosis. C Lower extremity venous insufficiency D Chronic arterial occlusion.

C Venous (insufficiency) stasis presents as a darker (hemosiderin, coffee colored staining) discoloration with possible ulcerations on the medial side of the leg and bumpy appearance to the skin. Chronic arterial occlusion is characterized by intermittent claudication of the lower extremities where cramping and burning sensations occur in the calf (posterior lower leg) and subside with rest. A deep vein thrombosis (DVT) is a clot in the venous system more common in one lower extremity that would have pain at rest that increases with walking with the leg appearing bright red, swollen, shiny and hot. Stage 2 Lymphedema appears as swollen with no pitting edema often with hardening and thickening of the skin surface.

A high school basketball player is 2 months status-post a grade II lateral ankle sprain. To prepare this athlete to return to sport, which of the following interventions is the MOST appropriate to deter long term chronic instability? A High speed walking on a treadmill at 5% incline B Progressive increase of eversion strengthening exercises C Closed chain balance and proprioceptive balance activities in a single leg stance D Functional Electrical stimulation to the ankle dorsiflexors

C balance and proprioception are associated with a decreased risk of lower limb injury when returning to sports.

According to Brunnstrom's stages of recovery for CVA, at WHICH stage can a limb move out of a synergy pattern? A Stage II B Stage VI C Stage V D Stage IV

C stage 1: no volitional movement initiated stage 2: appearance of basic limb synergies and beginning of spasticity stage 3: the synergies are performed voluntary; spasticity increases and peaks stage 4: spasticity begins to decrease movement patterns are not dictated solely by limb synergies stage 5: further decrease in spasticity is noted with independence from limb synergies stage 6 isolated join movement are performed with coordination stage 7: normal motor function is restored

Which of the following interventions is MOST appropriate for a patient with weakness from a CS radiculopathy? A Cuff weight exercise performed in D2 Extension B Resistive band exercise in D1 Extension , C Submaximal exercise performed in D1 Flexion D Isotonic exercises performed in D2 Flexion

C Infers you know the muscles affected by a C5 radiculopathy (Deltoids and Biceps) and can choose the pattern of PNF (D1 Flexion) that would include all muscles, the exercise types are distractors.

You are treating a patient diagnosed with tuberculosis. What the most important precautions when treating this patient. A Wash before and after treating the patient. B You should wear gown, gloves, and a medical mask. C A negative pressures room and wear a N95 mask D You should be wearing gloves, gown, goggles, and a N95 mask

C To prevent the spread of airborne nuclei expelled by a patient with TB disease an N95 mask is worn to protect the provider and negative pressure in the room so that air should flow from corridors (cleaner areas) into isolation rooms (less clean areas) to prevent the spread of contaminants throughout the facility.

A patient in an assisted living center scores a 34 on the Berg Balance Scale. This score indicates what about the patient? A The patient is at no risk of falling B The patient has impaired proprioception. C The patient will need verbal cueing D The patient has impaired balance and at an increased risk of falling

D The Berg scale was developed to measure balance among older people with impairment in balance function; scoring identifies those in a range 0-20 high risk; 21-40 as having a medium risk; 41-56 low risk.

A physical therapist assistant prepares a patient for the application of a TENS treatment for acute neck pain resulting from a MVA. What condition is a CONTRAINDICATION for this treatment? A History of coronary bypass B Type 11 diabetes C Recent total shoulder replacement D Implanted pacemaker

D TENS is an electrical current that could interfere with the electrical signals generated by the pacemaker. The Other Conditions would not cause any adverse interactions

What muscle is innervated by the Axillary Nerve? Response A Teres Major B Latissimus Dorsi C Coracobrachialis D Teres Minor

D The Axillary nerve innervates the deltoids and the teres minor in the proximal region of the UE. Coracobrachialis is the musculocutaneous nerve, Latissimus Dorsi is the thoracodorsal nerve, and the Teres Major is the subscapular nerve.

When performing a goniometric measurement for hip rotation with the patient in sitting what structure must be stabilized to isolate hip rotation? A The distal femoral condyles B The tibial condyles C The mid line of the femur D The pelvic region

D For hip rotation the pelvis must be stabilized for accurate measures. Limitations in rotational motion may cause the patient to shift their pelvis to compensate for deficits.

What is the desired splinting position for a patient with a rotator cuff repair of the supraspinatus tendon? A Shoulder in neutral rotation. B Shoulder internally rotated. C Shoulder external rotation. D Shoulder abducted

D Level 1 Synthesis; A repaired tendon is placed in a mildly shortened position to heal after a repair to reduce tension across the repair site. The shoulder placed in an abducted position will put the supraspinatus in a shortened position

Which lower extremity special test is used to indicate tightness of the rectus femoris when the hip of tested limb flexes toward the testing surface when the knee is flexed? A Ober's Test B Lachman Test C Thomas Test D Ely's Test

D Level 2 Analysis; The Ely's test is performed in prone with the hip flexing toward the table a positive finding. The Thomas test for the Rectus is performed in supine with a positive finding of the knee extending as the hip is passively lowered to the table with the knee flexed to 90 degrees.

What Rancho Los Amigo description would be correct for a patient who has had a closed-head traumatic brain injury, exhibiting non-purposeful and uncooperative behavior, verbalizations that are not appropriate for the environment, and lacks short-term and long-term recall? A Confused-appropriate. B Confused-agitated. C Automatic-appropriate D Confused-inappropriate

D Level V behavior is bizarre and non-purposeful relative to the immediate environment. is unable to cooperate directly with treatment. verbalizations are frequently incoherent and/or inappropriate to the environment. Automatic-appropriate Level VI I Confused-appropriate Level VI Confused-agitated. Level IV

A patient with shoulder R O M restriction due to pain and not tissue tightness is MOST appropriate for these grades of oscillation techniques. A Grades II, III B Grades III, IV C Grades IV, V D Grades I, II

D Lower grades (I+ 11) are used to reduce pain and irritability. Higher grades (111+ IV) are used to stretch the joint capsule and passive tissues to increase movement. Grade V i s a quick thrust manipulation

A patient who underwent a triple bypass 1 month ago is receiving instructions in the home from a physical therapist assistant on effective inspiration. What is the BEST method to help to improve the patient's efficiency with inspiration? A Placing a pillow over the incision area and squeezing B Instruct the patient to practice holding their breath. C Leaning forward in a sitting position D Placing the Pt hand directly on the top of their head

D Placing the hands directly on top of the head will promote increased stretching and elevation of the rib cage making inspiration more effective. Leaning forward in the sitting position will promote improved abdominal compression to make coughing more efficient. Having a patient hold their breath will promote Valsalva which is a risk of increased cardiac stress. Placing a pillow over the incisional area and squeezing will result in effective splinting of the region stabilizing it during a cough reducing pain and improving comfort.

The photograph demonstrates a condition MOST likely following which type of injury? A Clavicle fracture B Rotator cuff tear C Shoulder dislocation D Shoulder separation

D Question feedback The right acromial clavicular articulation has been disrupted resulting in a separation of the distal clavicle superior to the shoulder complex.

A patient who is exhibiting personality changes, perception of speech, and difficulty with long term memory MOST likely to have a lesion in the. A Frontal lobe B Parietal lobe C Cerebellum D Temporal lobe

D Symptoms of the temporal lobe are more subtle. While behavioral changes are manifested in the frontal lobe, personality changes are manifested in the temporal lobe. In speech the left side lesion produces problems of speech perception with difficulty in discriminating speech and the temporal order of sounds impaired while the right side perceives the rhythm of speech. The temporal lobe is where connections to long term memories are linked.

A physical therapist assistant is preparing to transfer a patient in a long-term rehabilitation setting who is complaining of right hip pain and observes a reddened area over their greater trochanter which does not change color when pressured. What is the MOST likely cause of the patient's pain? A 1st degree burn B Cellulitis C Trochanteric bursitis D Stage 1 pressure injury

D The skin may be painful, but it has no breaks or tears. The skin appears reddened and does not blanch or lose color briefly when you press your finger on it then remove it. Trochanteric bursitis is inflammation of the bursa (fluid-filled sac near a joint) at the part of the hip called the greater trochanter causing pain on the outside of the hip that's worse with activities such as standing, walking, or running. A 1st degree burn involves the epidermis, or the outer layer of the skin. It can be red, painful and exhibits blanching (turns white with pressure). It is like a non-blistering sunburn. Cellulitis is inflammation of subcutaneous connective tissue; the affected skin appears swollen and red and may be hot.

A nerve injury with inability to make a tight fist and results in a flexed wrist posture is the? A Median nerve B Ulnar Nerve C Anterior interosseus nerve D Radial Nerve

D The radial nerve is responsible for wrist extension which in required for positioning the hand to utilize the digit flexors effectively to make a fist. Damage to the radial nerve results in a condition known as wrist drop.

A 45-year-old female patient being treated for tennis elbow reports intermittent aching and stiffness in both hands and feeling fatigued unrelated to any activity. What is the MOST likely cause of these symptoms? A Carpal tunnel syndrome B Complex regional pain syndrome C Gout D Rheumatoid arthritis

D. Rheumatoid arthritis is a systemic auto immune disease and affects joint linings, causing painful swelling typically involving several joints. It is often noticed first in the smaller joint of the hands. Onset is more prevalent in women between 40-60 years old. Primary Gout is a genetic disorder that affect males with their first attack occurring between the ages of 30-40. The first attack presents with excruciating pain and inflammation of one or more joints commonly in the metatarsal phalangeal joint of the 1st (great toe). Carpal tunnel is a nerve compression of the median nerve at the wrist rarely affecting both hands simultaneously and complex regional pain syndrome is an autonomic disorder that affect a reginal area with weakness, pain, trophic hair, skin, and nail changes.

A physical therapist assistant prepares a patient for the application of a LASER treatment. What is the BEST method to address this treatment safely?

LASER is a high intensity single stream beam of light at a specific wavelength and can cause damage to the eyes. Both the patient and therapist are required to wear googles and additionally provided in a private room, so the light beam does not stray to any who are not wearing protective eyewear.

PRACTICE EXAM 3

PRACTICE EXAM 3

A physical therapist assistant reviews the plan of care for a patient with MS for aquatic therapy due to declining mobility. Which of the following Fahrenheit temperature levels is MOST appropriate for this patient? A 88-92 B 84-88° C 80-84° D 76-80°

The National MS society recommends a pool temperature of 80- 84° due reduce muscle spasm and deter early fatigue. Aquatic therapy pools for all condition ranges from 80-92° but temperatures above 84 should be avoided for the MS patient. Temperatures 79 and under will lower core body temperature.

A patient reports a 2-week history of left upper abdominal quadrant pain, left shoulder and flank pain as a result of a motor vehicle accident. The patient also reports being fatigued and has difficulty taking a deep breath. Which of the following conditions would the physical therapist assistant suspect is MOST likely for these symptoms? A Fibromyalgia B Urinary tract infection C Referred pain from spleen Complex regional pain syndrome D Complex regional pain syndrome

The main symptom of a ruptured spleen is severe pain in the abdomen, especially on the left side. The pain may also be referred to the left shoulder and can make breathing painful. Fatigue comes from the damaged spleen which filters lymph and WBC's. Complex region pain syndrome is a adverse sympathetic reaction affecting a region of an extremity. UTI presents with low back pain. Fibromyalgia has pain in all 4 quadrants of the body.

A physical therapist assistant instructs the parents of a child with cystic fibrosis in postural drainage positioning. Which of the following positions is MOST appropriate for the upper lobe posterior segments? A Sitting on a chair, leaning forward over a folded pillow B Sitting in a recliner, leaning slightly backward C Prone lying on a bed with two pillows under the pelvis D Lying supine on a bed with pillows under the knees

a Postural drainage uses gravity to help drain lung segments toward the larger main bronchial tree. The upper lobe posterior (apical) segments are drained sitting in a chair leaning forward over a folded pillow. The superior (upper segments) of the lower lobe will drain best with a pillow under the pelvis in prone. Anterior segments of the upper lobe (apical) are drained lying supine on a bed with pillows under the knees. The upper lobe anterior (apical) segments are drained sitting in a recliner, leaning slightly backwards.

A physical therapist assistant is implementing knee extension exercises for a patient who developed weakness after receiving an intramuscular injection in the upper thigh. What nerve was likely compromised? A Obturator nerves B Femoral Nerve C Superior Gluteal nerve D Sciatic nerve

• Femoral nerve= Quads • Superior Gluteal nerve= Hip abductors • Obturator nerve= Hip adductors • Sciatic nerve= Hamstrings