Score builders PTA Exam One part B (2nd 50 questions)

A physical therapist assistant works with a patient post total knee arthroplasty who presents with increased knee flexion during the stance phase of gait. Which of the following interventions would BEST address this gait deviation? 1.Isometric quadriceps setting exercises in supine with the leg positioned in extension and the heel on a towel roll 2.Isometric quadriceps setting exercises in supine with a pillow under the knee 3.Active knee flexion exercises in sitting 4.Isometric gluteal setting exercises performed in supine

1.Isometric quadriceps setting exercises in supine with the leg positioned in extension and the heel on a towel roll. -quads are inhibited, so strengthening is important aspect of PT POC. this option promotes improved knee extension ROM through passive extension, strengthens knee extensors, and improves knee extension during gait.

A physical therapist assistant works with a four-month-old infant. During mat activities the infant suddenly becomes unconscious. Which of the following arteries is the MOST appropriate for the assistant to palpate to assess the infant's pulse? 1.Radial 2.Brachial 3.Popliteal 4.Carotid

2.Brachial artery = most appropriate artery for infant. easily palpated on medial aspect of mid-shaft of humerus and therefore provides PTA w/ timely and accurate method to assess patient's pulse *Radial and carotid most common for adult Radial pulse = volar side of radial styloid process of wrist (not easily palpated in infant) Carotid pulse = inferior angle of mandible, anterior SCM (infant has SMALL AND CHUBBY NECK, so too difficult to palpate carotid pulse) Popliteal artery pulse = popliteal space, femoral artery, then bifurcating anterior and posterior tibial arteries.

A physical therapist assistant suspects that a patient's chronic lower extremity swelling is due to lymphedema. Which of the following symptoms is the MOST consistent with the later stages of this condition? 1.Swelling that is relieved by elevation 2.Swelling proximal to the site of lymph dysfunction 3.Fibrotic changes of the dermis 4.Pitting edema

3.Fibrotic changes of the dermis -Fibrosis occurs in LATER stages = HARDENING of limbs which leads to increase size of limbs. 1. Swelling relived by elevation only works in EARLY STAGE 2. lymphedema = swelling adjacent and DISTAL to site of lymph dysfunction 4. Pitting edema = EARLY stages

A physical therapist assistant prepares to measure the blood pressure of a patient who has a history of cardiac disease. Which of the following values describes the MOST appropriate rate to release the pressure when obtaining the blood pressure measurement? 1.2-3 mm Hg per second 2.3-5 mm Hg per second 3.5-7 mm Hg per second 4.8-10 mm Hg per second

1.2-3 mm Hg per second Deflating cuff at 2-3 HG per second is recommended to identify normal Korotkoff sounds! rates faster than 2-3 Hg/sec increases measurement error!

A recent entry in the medical record indicates a patient exhibits dysdiadochokinesia. Based on the patient's documented deficit, which activity would be the MOST difficult for the patient? 1.Alternating supination and pronation of the forearms 2.Performing a standing squat 3.Catching a ball 4.Walking along a straight line

1.Alternating supination and pronation of the forearms -movemnt is slow and will lose range and rhythm quickly. dysdiadochokinesia = inability to perform rapid alternating movements. inappropriate timing of muscle firing and difficulty with cessation of ongoing movement. (CEREBELLAR region) 2. standing squat = concentric and eccentric muscle control of trunk and LE 3. catching ball = coordination 4. walking along straight line = cerebellar pathology, Ataxia.

A physical therapist assistant instructs a patient to close their eyes and hold out one hand. The assistant places a series of different weights in the patient's hand one at a time. The patient is then asked to identify the comparative weight of the objects. What sensory test has the assistant performed? 1.Barognosis 2.Graphesthesia 3.Recognition of texture 4.Stereognosis

1.Barognosis 2. graphesthesia = ability to verbally identify letters or numbers traced on palm of hand typically w/ fingertip or eraser of a pencil 3. recognition of texture = ability to differentiate different textures like cotton, wool or silk, Rough or smooth 4. Stereognosis = ability to identify object w/o sight. Coin, key or comb, and identify object by name

A patient who has a spinal cord injury develops a respiratory infection. Which of the following diagnoses would make the patient the MOST susceptible to respiratory problems? 1.Complete C4 tetraplegia 2.Cauda equina lesion 3.Brown-Sequard's syndrome 4.Posterior cord syndrome

1.Complete C4 tetraplegia - will have reduced ventilatory capacity due to muscle paralysis. Patient will exhibit limited ability to clear secretions. impaired chest mobility and alveolar hypoventilation. 2. Cauda Equina = injury BELOW L1. = flaccidity, areflexia, and impairment of bowel and bladder function 3. Brown sequard's = incomplete lesion by state = hemisection of SC. PARALYSIS and loss of vibratory and position sense on injured side, LOSS of pain and temp on opposite side. 4. Posterior cord syndrome = Loss of proprioception, 2-point discrimination, graphesthesia, and stereognosis.

A physical therapist assistant treats a patient post right CVA who exhibits "pusher syndrome." When observing the patient's posture in the sitting position, which of the following findings should the assistant MOST likely expect to detect? 1.Increased lean to the left along with increased weight bearing through the left buttocks 2.Increased lean to the right along with increased weight bearing through the right buttocks 3.Increased weight bearing through the right buttocks and the head rotated to the right; unresponsive to stimuli on the left 4.Unequal weight bearing and the head rotated to the left; unresponsive to stimuli on the right

1.Increased lean to the left along with increased weight bearing through the left buttocks PUSHER SYNDOME is RIGHT CVA (Left Hemiplegia) = Lateral lean to LEFT w/ increased WB on Left buttocks. (they have less WB through left side due to existing sensory and motor deficits)

A physical therapist assistant performs resisted isometric testing on a patient. The patient reports feeling pain during the test, however, strength is normal. Which of the following conclusions regarding this test is the MOST likely? 1.A severe lesion such as a fracture 2.A minor lesion of a muscle or tendon 3.A complete rupture of a muscle or tendon 4.Intermittent claudication may be present

2.A minor lesion of a muscle or tendon = tend to result in resistive movement that is classified as strong and painful 1. severe lesion such as fracture = WEAK AND PAINFUL with resistive movement 3. complete rupture of muscle or tendon = WEAK and PAINLESS 4. intermittent claudication = painful walking, occurs as result of insufficient blood supply and ischemia in active muscles. -STRENGTH NEGATIVELy impacted depending on severity of pain

A physical therapist assistant works with a patient who sustained a lesion to the long thoracic nerve. Which of the following objective findings should the assistant MOST expect as a result of this injury? 1.Decreased sensation on the lateral forearm 2.Atrophy of the deltoid muscle 3.Inability to elevate the arm overhead 4.Fair strength with shoulder extension

3.Inability to elevate the arm overhead = serratus anterior SP HMT SD SUR (works with traps) SAT 1. long thoracic n. = motor n. so no sensory disturbances, and decreased sensation to lateral forearm = musculocutaneous n. c5-6 2. deltoid muscle = axillary n. c5-6 4. serratus anterior does not do shoulder extension

A physical therapist assistant is treating a patient diagnosed with leukemia who is currently receiving chemotherapy. The patient has been referred to physical therapy to improve their functional mobility and endurance. Which activity would be the LEAST desirable to accomplish the stated goal? 1.Yoga 2.Bike riding 3.Jumping rope 4.Swimming

3.Jumping rope leukemia = risk for osteonecrosis which can occur at hips knees and ankles. High impact activities like this should be avoided Yoga and swimming = low impact Bike riding = endurance

A physical therapist assistant observes a patient utilize a suspensory strategy to regain their balance. Which active movement would be MOST characteristic of this postural strategy? 1.Trunk extension 2.Hip extension 3.Knee flexion 4.Ankle plantar flexion

3.Knee flexion Suspensory strategy is used TO LOWER COG during standing or ambulation in order to improve balance and stability. Ex) knee flexion, crouching, squatting.

A physical therapist assistant observes a patient complete a standing arm curl with a dumbbell using the starting and ending positions as shown in the image. Which of the following scenarios would produce the MOST power? (elbow flexion dumbbell curl) 1.Lifting a two pound dumbbell in two seconds 2.Lifting a two pound dumbbell in three seconds 3.Lifting a four pound dumbbell in one second 4.Lifting a four pound dumbbell in four seconds

3.Lifting a four pound dumbbell in one second -heaviest weight in shortest time = power power = work / time

A patient with HIV is being treated in physical therapy for general deconditioning. What is the associated condition MOST likely to increase the risk for opportunistic infection? 1.Neutropenia 2.Anemia 3.Polycythemia 4.Thrombocytopenia

1.Neutropenia -are a classification of WBC/leukocytes that digest various foreign materials and are referred to as first line of hematologic defense against invading pathogens. Neutropenia = neutrophil count BELOW normal reference values. Longer the neutropenia exists, the more likely the patient is to develop a significant infection. 2. Anemia = hemoglobin and hematocrit levels BELOW gender specific lab reference values. Anemic, change positions slowly, and allow full nights of sleep, NOT ABOUT INFECTION 3. Polycythemia = increase number of RBC in body. Increase blood viscosity and increased blood volume result in elevated BP. Increases risk of stroke or heart attack 4. Thrombocytopenia = platelet levels below normal lab values. BLEED and BRUISE EASILY avoid contact sports, sharp object, tight clothing

A patient who has complete C7 tetraplegia presents with a problem list that includes inability to complete an independent bed to wheelchair transfer, decreased passive lower extremity range of motion, tissue breakdown over the ischial tuberosities, and decreased upper extremity strength. Which of the following treatment activities should be given the HIGHEST priority? 1.Pressure relief activities 2.Transfer training using a sliding board 3.Self-range of motion activities 4.Upper extremity strengthening exercises

1.Pressure relief activities -this is highest priority for patient that has compromised sensation. patient can perform independent relief through weight shifting each 2 hour period to avoid further skin breakdown and infection. 2. Transfer training not highest priority, and weight shifting is precursor to slide board transfer 3. Self- ROM will be component of trx plan, but pressure relief is highest priority so patient can progress through rehab w/o skin breakdown 4. UE strengthening is component or tax plan, but failure to prevent tissue breakdown will place patient at considerable risk for serious medical complications

A patient who has shoulder pain of unknown etiology is referred by their physician for magnetic resonance imaging. Results of the test reveal a partial tear of the infraspinatus muscle. Which muscle group would be the MOST affected by this finding? 1.Shoulder lateral rotators 2.Shoulder medial rotators 3.Shoulder abductors 4.Shoulder adductors

1.Shoulder lateral rotators -Infraspinatus does ER SITS supraspinatus first 15-30 degrees infra ER teres minor ER Subscapularis IR 2. medial rotators = subs cap, teres minor, Lats, Anterior deltoid 3. Shoulder abduction = middle deltoid, supraspinatus (15-30) 4. Shoulder adduction = Pec Major, Lats, Teres Major

A patient uses a fixed support strategy to control backward sway when in a standing position. Which muscle would MOST likely be activated first in this scenario? 1.Tibialis anterior 2.Gastrocnemius 3.Hamstrings 4.Paraspinals

1.Tibialis anterior -first muscle activated w/ BACKWARD sway in standing, then quads, then abs (distal to proximal) gastroc first muscle activated w/ FORWARD sway, then hamstrings, then Paraspinals (distal to proximal

A physical therapist assistant documents gait training performed during a treatment session. Which descriptive term is only associated with the swing phase of the gait cycle? 1.Heel strike 2.Deceleration 3.Loading response 4.Midstance

2. Deceleration = traditional terminology that begins directly after mid-swing, as swing limb begins to extend (last 3 movements of gait) and end just prior to heel strike. -It is component of swing phase (Stance phase is 60% or first 4 steps and Midswing is 40% or last 3 steps)

A physical therapist assistant uses ultrasound to heat tissues at a depth of approximately four centimeters. Which parameter of ultrasound would MOST influence the depth of tissue heating? 1.Intensity 2.Frequency 3.Effective radiating area 4.Beam nonuniformity ratio

2. Frequency = DEPTH. most common frequency is 3 MHz superficial, 1 MHz is Deep 4 cm is significant amount of tissue depth and requires 1 MHz 1. Intensity = measure of rate where energy is being delivered per unit of area. (0.5 - 1.0 W/cm^2 = NON thermal 1.1 - 2.0 W/cm^2 = Thermal) Highest safe intensity = 8/BNR 3. ERA = portion of surface of transducer that produces sound wave. Area of 2 to 3 times transducer head = 5 minutes! 4. BNR = ratio of intensity of highest peak to average intensity of all peaks. DETERMINES SAFEST SPEED to move sound head to prevent tissue damage and increase patient comfort

A patient is treated using pulsed wave ultrasound at 1.2 W/cm2 for 7 minutes. The specific parameters of the pulsed wave are 2 msec on time and 8 msec off time for one pulse period. What duty cycle should the physical therapist assistant document? 1.10% 2.20% 3.25% 4.50%

2. pulsed wave 2msec ON and 8 sec OFF for one pulse period. Duty cycle = ON TIME / TOTAL TIME 2 / (2+8) = 2 / 10 = 1/5 =20%

A physical therapist assistant performs a gross range of motion screening and determines a patient has excessive medial rotation and limited lateral rotation of the hip. Which alignment of the hip would be the MOST consistent with the identified findings? 1.10 degrees of anteversion 2.18 degrees of anteversion 3.5 degrees of retroversion 4.8 degrees of retroversion

2.18 degrees of anteversion MEAN ANGLE of ANTERVERSION in adult is 8-15 degrees using Craig's test/ Prone Hip IR/ER ! (angle of torsion)

A physical therapist assistant performs ice massage on a patient who has infrapatellar tendonitis. The MOST appropriate treatment time for this procedure is typically how many minutes? 1.3-5 2.5-10 3.10-15 4.15-20

2.5-10 ICE MASAGE has intense cooling so 5-10 minutes is best

A physical therapist assistant records a patient's resting blood pressure as 115/75 mm Hg prior to initiating running activities on a treadmill. After five minutes of running at speeds ranging from 4.0-6.0 miles per hour, what diastolic blood pressure value would be MOST anticipated? 1.64 mm Hg 2.76 mm Hg 3.84 mm Hg 4.98 mm Hg

2.76 mm Hg ***Normal BP response to exercise is progressive increase in SYSTOLIC, And DIASTOLIC relatively UNCHANGED EX) post exercise, = 125/76

A patient with Alzheimer's disease is referred to physical therapy for instruction in an exercise program. Which of the following steps should the physical therapist assistant perform FIRST? 1.Provide verbal and written instructions 2.Frequently repeat multiple step directions 3.Assess the patient's cognitive status 4.Avoid using medical terminology

3.Assess the patient's cognitive status -PTA must determine patient's cognitive status prior to providing formal exercise instruction. this has significant impact on ability to interpret instructions, ability to perform exercises correctly, ability to recall elements of exc program.

A two-year-old who has T10 spina bifida receives physical therapy for gait training. Which of the following assistive devices should the physical therapist assistant use to teach a child how to maintain standing in the INITIAL stages of gait training? 1.Bilateral hip-knee-ankle-foot orthoses (HKAFO) and forearm crutches 2.Parapodium and the parallel bars 3.Bilateral knee-ankle-foot orthoses (KAFO) and the parallel bars 4.Bilateral ankle-foot orthoses (AFO) and the parallel bars

2.Parapodium and the parallel bars = a HKAFO WOTH THORACOLUMBAR ORTHOSIS that supports trunk and LE. LARGE BOS, used w/ or w/o AD. ideal for patient w/ T10 spina bifida to INIATE standing within // bars. 1. HKAFO requires swing-thru or reciprocal gait and requires high level of balance and energy expenditure, NOT APPROPRIATE for initial standing activities 3. and 4. T10 spina bifida would not use KAFO initially, and doesn't possess motor function to use BL AFO Spina bifida = a congenital defect of the spine in which part of the spinal cord and its meninges are exposed through a gap in the backbone. It often causes paralysis of the lower limbs, and sometimes mental handicap.

A physical therapist assistant works on wheelchair mobility with a patient who has right-sided hemiparesis. Which of the following wheelchair adaptations would be the MOST beneficial for the patient to ensure safety during stand pivot transfers? 1.Anti-tip tubes 2.Pull-to wheel lock with brake extensions 3.Elevating leg rests 4.Removable full-length armrests

2.Pull-to wheel lock with brake extensions -allows for closer access to surfaces during transfers. Brake extension on RIGHT help patients reach with UNINVOLVED side to LOCK W/C before transferring. without brake extension, patient is limited to lock brakes due to Right hemiparesis Anti-tip tubes attach to posteriorw/c to prevent tipping. This is if patient has absence of trunk control (ataxic or spastic). Elevating leg rests for patients who need support of LE. -prevent edema a may help in redistributing weight forces. Removable full-length armrests allow for squat pivot transfer, or sliding board transfer, NOT STAND-PIVOT transfer

A physical therapist assistant instructs a patient with a low back injury in a series of five pelvic stabilization exercises. The patient indicates that they understand the exercises, however, frequently become confused and are unable to perform them correctly. Which of the following actions is the MOST appropriate for the assistant to take? 1.Repeat the exercise instructions 2.Reduce the number of exercises in the series 3.Select a different treatment option 4.Conclude the patient is not a candidate for physical therapy

2.Reduce the number of exercises in the series - this simplifies the program. it is reasonable to hypothesize that number of exc may be primary reason for patient's difficulty. 1. repeat exc instructions is valuable but patient is "frequently confused" 3. not enough evidence to suggest patient is unable to learn exercises 4. therapist should attempt to alter learning environment or method before concluding patient is not fit for PT

A physical therapist assistant notices two prominent tendons visible on the posterior surface of the left knee while a patient completes a leg curl exercise. As shown in the image, the visible medial and lateral tendons are MOST likely associated with which of the following muscles? 1.Semimembranosus and semitendinosus 2.Semitendinosus and biceps femoris 3.Popliteus and semitendinosus 4.Semimembranosus and biceps femoris

2.Semitendinosus and biceps femoris = most visible posteriorly on medial and lateral side

A physical therapist assistant assesses a patient's home to ensure it is handicap accessible. When assessing the stairs, which characteristic would make stair navigation the MOST difficult? 1.Handrails that extend 12 inches past the stairs 2.Steps that are 8.5 inches high 3.Steps that are 12 inches deep 4.Stairs that are carpeted

2.Steps that are 8.5 inches high -steps should not be >7 inches high for people with disabilities (too difficult) 1. Hand rails should extend minimum of 12 inches past top and bottom of stairs for added safety. 3. Steps should have minimum depth of 11 inches to allow for adequate foot placement when navigating stairs 4. Carpeting improves traction!

A patient with a compensated rearfoot varus deformity prepares to utilize a set of rigid orthoses. Which recommendation would be the MOST appropriate when wearing the orthoses the first day? 1.No break-in period is necessary 2.Wear the orthoses for 1-2 hours 3.Wear the orthoses for 2-4 hours 4.Wear the orthoses for 6-8 hours

2.Wear the orthoses for 1-2 hours 1. rigid and semirigid orthoses both require break in period or may cause significant discomfort and potentially lead to more severe complications such as tissue breakdown 2. Rigid orthoses = 1-2 hours 3. Semirigid or temporary orthosisez = 2-4 hours 4. 6-8 hours is excessive for any orthoses. should be able to use for a full day before running. RIGID = Plastic or carbon fiber SEMI-RIGID = Layers of SOFT material , then rigid -FOR FLAT FOOT/PES CAVUS

A physical therapist assistant performs gait training with a patient outdoors to simulate the uneven terrain that the patient will encounter upon discharge. The assistant monitors the patient closely due to extreme heat and humidity. What is the PRIMARY mode of heat loss during exercise? 1.Conduction 2.Convection 3.Evaporation 4.Radiation

3. Evaporation = transfer of heat as a liquid absorbs energy and changes form to a vapor. 1. Conduction = gain or loss of heat as result of DIRECT heat b/w 2 materials at different temperatures. (warm hand touching handle of pot) 2. Convection = gain or loss of heat as result of AIR OR WATER MOVING in constant motion across body. (whirlpool or water being heated up on stone top, causing molecular motion) 4. radiation = direct transfer of heat for energy source of higher temperature to one of cooler temperature. (Infared lamp)

A physical therapist assistant identifies the presence of epibole in a pressure injury. With which pressure injury stage is this observation MOST visible? 1.Stage 1 2.Stage 2 3.Stage 3 4.Unstageable

3. Stage 3 = full thickness skin loss where adipose tissue is visible in ulcer. Granulation tissue and edible are often also present in stage 3 pressure injury. depth of tissue change varies by anatomical location and may include undermining and tunneling. 1. stage 1 = pressure injury by tact skin with localized area of non-blanch able erythema. 2. stage 2 = partial-thickness skin loss w/ exposed dermis. 4. unstageable pressure injury = full thickness skin and tissue loss where extent of tissue damage within pressure injury can't be determined cuz of slough or eschar. less obvious than stage 3

A physical therapist assistant uses functional electrical stimulation as part of a treatment regimen designed to improve quadriceps strength. Which of the following ratios for on:off time would result in the MOST rapid onset of muscle fatigue? 1.3:1 2.1:4 3.5:1 4.1:6

3.5:1 -5 seconds on, for every 1 second off time. This would promote rapid fatigue given LARGE ON time, SHORT OFF time. (longer contraction of 5 seconds and 1 second rest)

A patient post radial head fracture has developed an elbow flexion contracture. Which of the following interventions is considered a PASSIVE exercise technique to increase range of motion? 1.Contract-relax 2.Hold-relax 3.Maintained pressure 4.Rhythmic stabilization

3.Maintained pressure = effective passive technique that can be used to increase ROM by facilitating local muscle relaxation. -Maintained pressure over belly or tendon produces calming effect and breast relaxation of musculotendinous unit. Effects of pressure are immediate w/ little evidence of long term effects. 1. Contract relax = increase ROM. extremity reaches point of limitation, patient performs maximal contraction of ANTAGONISTIC muscle group. Therapists resists 8-10 seconds. Contract opposite muscle to lengthen agonist muscle Ex) elbow extend (therapist is resisting) to lengthen Bicep 2. Hold-relax = ISOMETRIC contraction to increase ROM, and then move into new range. Isometric Agonist (muscle you want to lengthen, then relaxing to lengthen and increase ROM) EX) therapist says "don't let me pull" for isometric contraction of bicep, to lengthen bicep 4. Rhythmic stabilization = increase ROM with coordinated isometric contractions ex) "don't let me move you" and moves patient into shld flex and ext alternating.

A physical therapist assistant notices a small area of skin irritation under the chin of a patient wearing a rigid cervical orthosis. The patient reports that the area is not painful, but it is becoming increasingly itchy. Which of the following actions is the MOST appropriate for the assistant to take? 1.Instruct the patient to apply 1% hydrocortisone cream to the area twice daily 2.Apply powder to the area and instruct the patient to avoid scratching 3.Provide the patient with a liner to use as a barrier between the skin and the orthosis 4.Discontinue use of the orthosis until the skin has become less irritated

3.Provide the patient with a liner to use as a barrier between the skin and the orthosis -liners made from lambs' wool are commonly utilized and prevent chafing and irritation to skin. easily donned and provides adequate barrie b/w skin and orthosis. 1. Hydrocortisone doesn't address primary cause of irritation 2. neither does powder 4. Discontinuing use of cervical orthosis would be undesirable

A patient with a spinal cord injury exercising on a treatment table in the supine position begins to experience signs and symptoms of autonomic dysreflexia, including a dramatic increase in blood pressure. Which of the following actions should be the MOST immediate to address the patient's blood pressure response? 1.Elevate the patient's legs 2.Call for assistance 3.Sit the patient upright 4.Check the urinary drainage system

3.Sit the patient upright -PTA should immediately position patient in sitting to address autonomic nervous system response and reduce patient's elevated BP. After patient positioned in sitting, urinary drainage system should be checked since a blocked catheter is common noxious stimulus that triggers sympathetic response. ***Autonomic dysreflexia is a serious medical problem that can happen if you've injured your spinal cord in your upper back. It makes your blood pressure dangerously high and, coupled with very low heartbeats, can lead to a stroke, seizure, or cardiac arrest. 1. elvating patient's legs = CONTRAINDICATED b/c it would further increase BP 2. Call for assistance is acceptable, but it's not most immediate option 4. checking drainage system should be done AFTER getting patient seated. (drainage system blockage of catheter, or full bladder, extreme temp change, and pressure ulcers are all causes of Autonomic dysreflexia)

A physical therapist assistant observes the standing posture of a patient from a lateral view. If the patient has normal postural alignment, which of the following anatomical reference points would be MOST appropriate for where the plumb line would fall? 1.Posterior to the lobe of the ear 2.Slightly anterior to the center of the hip joint 3.Slightly anterior to a midline through the knee 4.Slightly posterior to the lateral malleolus

3.Slightly anterior to a midline through the knee 1. through external auditory meatus 2. POSTERiOR to hip joint 4. POSTERIOR to lateral malleolus

A physical therapist assistant performs gait training using crutches on a patient post total hip arthroplasty. The patient has orders for partial weight bearing. Which of the following gait patterns would be the MOST appropriate for this patient? 1.Four-point 2.Two-point 3.Three-point 4.Swing-to

3.Three-point used when one limb is affected such as after joint arthroplasty. -crutches, affected, then unaffected LE 4 point gait (left crutch, RLE, right crutch, LLE) -NOT for PARTIAL WB, but FOR POOR BALANCE

A physical therapist assistant observes a patient's gait and identifies a lack of toe off (initial swing/toe coming off floor). Which finding in the patient's medical history would be MOST likely to contribute to this observation? 1.Vertigo 2.Lymphedema 3.Type 2 diabetes mellitus 4.Raynaud's phenomenon

3.Type 2 diabetes mellitus = chronic metabolic disease characterized by inappropriate cellular response to insulin. Can develop neuropathy affecting gait mechanics and motor control! 1. Vertigo = used to describe sense of movement and rotation of oneself or the surround environment. SENSATION OF SPINNING, can also present as linear motion or falling. Not toe off 2. Lymphedema = chronic incurable condition that is accumulation of protein=rich fluid in body. edema in body, yes gait deviations, but specifically causing toe off 4. Raynaud's phenomenon = changes in temp or pallor in digits when changes in environmental temp are experienced. gait deviations not common

A physical therapist assistant prepares a patient education program for a patient with chronic venous insufficiency. Which of the following instructions would be the LEAST appropriate to include in the patient education program? 1.Wear shoes that accommodate to the size and shape of your feet 2.Observe your skin daily for breakdown 3.Wear your compression stockings only at night 4.Keep your feet elevated as much as possible throughout the day

3.Wear your compression stockings only at night *stockings improve circulation preventing backward flow through veins of LE. RECOMMENDED to be applied in morning, where swelling is minimal, and LEFT ON during activity to promote blood flow. Chronic venous insufficiency = LE veins do not work properly and blood pools in LE leading to increase pressure in veins. can cause tissues in ankle and feet to ulcer 1. proper fitted shoes reduce risk of skin abrasions, ulcerations and wound infections 2. daily observation of skin is necessary for venous insufficency 4. elevating feet throughout day reduces pressure in LE (venous insufficiency = LE blood pooling) so this would improve blood flow!

A physical therapist assistant initiates an exercise program for a patient who has a lower extremity injury. Which of the following parameters is the single MOST important factor in an exercise program designed to increase muscular strength? 1.Recovery time between exercise sets 2.Number of repetitions per set 3.Duration of the exercise session 4.Intensity of the exercise

4. Intensity of the exercise Gains in STRENGTH are greatest when muscle is exercised against resistance at MAXIMAL INTENSITY.

A patient completing a resistive exercise program following an ankle injury reports to the physical therapist assistant that lifting weights often causes them to void small amounts of urine. Which of the following actions is the MOST appropriate for the assistant to take? 1.Refer the patient to a support group 2.Instruct the patient in pelvic floor muscle strengthening exercises 3.Discontinue resistive exercises as part of the established plan of care 4.Educate the patient about incontinence

4.Educate the patient about incontinence -patient may significantly benefit from formal education about incontinence. Action would provide patient w/ necessary info and make patient more likely to see a physician about this issue. Vast majority of patient w/ incontinence can be successfully treat w/ non-invasive measures such as pelvic floor exercises 1. use of support group yes, but at this time, education is most appropriate 2. inappropriate to begin pelvic floor exercises w/o referral from physician since cause is unknown 3. PTA should not discontinue RE, since it is necessary component of rehab following ankle injury. if RE is part of established POC, the not appropriate to change.

A patient sustains a chemical burn on the cubital area of the elbow. What position would be the MOST appropriate for splinting of the involved upper extremity? 1.Elbow flexion and forearm pronation 2.Elbow flexion and forearm supination 3.Elbow extension and forearm pronation 4.Elbow extension and forearm supination

4.Elbow extension and forearm supination when you get burned you get contractures so splinting in position of elbow extension and forearm supination LIMITS CONTRACTURES (stretching muscles) and maximize FUNCTIONAL use of UE. - we don't want elbow flexion contracture or with forearm pronation contracture. FUNCTIONAL = reaching / elbow extension and forearm supination

During a treatment session, a patient makes a culturally insensitive remark that the physical therapist assistant feels is offensive. Which of the following actions is the MOST appropriate for the assistant to take? 1.Document the incident in the medical record 2.Transfer the patient to another therapist's schedule 3.Recommend discharging the patient from physical therapy 4.Inform the patient that the remark was offensive and continue with treatment

4.Inform the patient that the remark was offensive and continue with treatment -PTA should provide immediate feedback to patient when an inappropriate behavior is witnessed. Culturally insensitive remark would not warrant interruption or cessation of existing plan of care. 1. Document for refusal of PT services, fall, or injury. 2. Patient should not be transferred to another therapist's schedule just b/c of insensitive remark 3. D/C only occurs when all attainable goals are met, or if patient makes decision to cease PT services.

A physical therapist assistant assesses the strength of selected lower extremity muscles on a patient post knee injury. The test pictured in the image would be MOST effective to examine the strength of which of the following muscles of the hip? (patient holding hip ER, ) 1.Abductors 2.Adductors 3.Medial rotators 4.Lateral rotators

4.Lateral rotators = ER, pulling medial side of patient's leg, to outward/ laterally 1. abduction = s/l, abduction pushing distal aspect of femur 2. adductors = s/l, adduction pushing distal aspect of femur 3. medial rotators = IR, pushing lateral side of patient's leg, to inward/medially

A physical therapist assistant performs an upper extremity manual muscle test on a patient. Assuming the patient has the ability to move the upper extremities against gravity, which of the following muscles should the assistant test with the patient in the prone position? 1.Pronator teres 2.Pectoralis major 3.Biceps brachii 4.Middle trapezius

4.Middle trapezius prone, 90 degrees shoulder abduction, ER and elbow extension Pronator teres Pec major Biceps brachii ALL test in supine

A physical therapist assistant repeats several clinical tests on a patient with a C6 nerve root injury. Which of the following clinical findings should the assistant LEAST expect with this type of injury? 1.Diminished sensation on the anterior arm and the index finger 2.Weakness in the biceps and supinator muscles 3.Diminished deep tendon reflex response of the brachioradialis 4.Paresthesias of the long and ring fingers

4.Paresthesias of the long and ring fingers = C7 nerve root, weakness of triceps and wrist flexors, and diminished triceps reflex

An older adult patient has difficulty communicating in physical therapy due to presbycusis. What intervention is the MOST appropriate to improve communication with the patient? 1.Speak with a louder voice 2.Speak in a higher tone 3.Speak with a lower voice 4.Speak in a lower tone

4.Speak in a lower tone = best. hair cells can receive this frequency are mostly preserved, therefore are capable of effectively transmitting the communication. PRESBYCUSIS = normal auditory acuity b/c of old age (Grandma is hard of hearing) -IS RELATED TO FREQEUNCY/ TONE 1. loud voice is not frequency 2. higher tone, hair cells in ear capable of receiving higher frequencies are compromised 3. low voice, background noise would diminish ability to transmit communication

A physical therapist assistant notes that a newborn has extremely limited dorsiflexion. Which positional foot deformity would be the MOST likely with this range of motion limitation? 1.Calcaneovalgus 2.Metatarsus adductus 3.Syndactyly 4.Talipes equinovarus

4.Talipes equinovarus = CLUB FOOT / ADDUCTION, HINDFOOT VARUS and PF (Inversion ankle sprain foot) 1. Calcaneovalgus = congenital positional deformity by forefoot being curved out laterally, hind foot valgus EXCESS DF 2. Metatarsus adductus = foot deformity of medially curved foot. (metatarsals go inward/adduct) 3. Syndactyly = WEBBED TOES AND FINGERS (2nd and 3rd toes)

A patient sustained a superficial wound that appears as a moderate abrasion on the anterior surface of their thigh approximately four inches above the superior pole of the patella. Which type of wound dressing would MOST likely be utilized? 1.Calcium alginate dressing 2.Hydrocolloid dressing 3.Hydrogel dressing 4.Transparent film dressing

4.Transparent film dressing - allows for frequent assessment of wound and offers some level of protection. 1. Calcium alginate for MOD - HEAVY exudate, not superficial wound 2. Hydrocolloid dressing for partial and full-thickness wounds, not superficial wound 3. Hydrogel dressing for superficial and partial -thickness