Bark's 2nd OA

PTA performing cervical traction on 170-pound male with degenerative disk disease of the cervical spine. Assuming the patient has not received traction previously, what is the MOST appropriate amount of traction force if the therapist's goal is to decrease compression on the nerve roots through joint distraction?

- 1. 8 pounds 2. 16 pounds 3. 24 pounds 4. 32 pounds 8-10 pounds is a good starting point to tell if the patients body responds well to traction.

A physical therapist assistant employed in an outpatient private practice works with a patient diagnosed with spondylolisthesis. Which of the following scenarios would be MOST consistent with the medical diagnosis?

- 1. A 13-year-old female gymnast with no significant medical history 2. A 17-year-old female tennis player with a 15 degree lateral curvature of the spine 3. A 28-year-old male machinist with a history of recurrent low back pain 4. A 67-year-old male with a previous diagnosis of ankylosing spondylitis Children ages 10-15 who are involved in activities such as gymnastics, weight lifting, volleyball, and pole vaulting are particularly susceptible to spondylolisthesis.

A physical therapist assistant has a patient perform active shoulder flexion in supine without using any weights. Which patient would LEAST benefit from this intervention?

- 1. A patient that is two weeks status post rotator cuff repair 2. A patient that has severe pain when performing standing shoulder flexion 3. A patient that has active cancer near the shoulder joint 4. A patient that is severely deconditioned

A physical therapist assistant reviews the medical record of a 77-year-old patient that was prescribed nonsteroidal anti-inflammatory medications (NSAIDs) for pain following arthroscopic surgery. Due to the toxicity concerns, which analgesic characteristic would be MOST desirable?

- 1. A short half-life 2. A long half-life 3. Minimal biotransformation 4. Limited clearance Half-life is defined as the amount of time required for fifty percent of the drug remaining in the body to be eliminated. In general, elderly patients do not metabolize medications as quickly as younger patients which creates higher plasma levels. As a result, the elderly are at a higher risk for toxicity or adverse effects. Medications with a short half-life reduce these risks.

A physical therapist assistant reviews the surgical report of a patient that sustained extensive burns in a fire. The report indicates that at the time of primary excision, cadaver skin was utilized to close the wound. What is this type of graft termed?

- 1. Allograft 2. Autograft 3. Heterograft 4. Xenograft An allograft is a temporary skin graft taken from another human, usually a cadaver, in order to cover a large burned area.

A six-year-old female is currently taking Neurontin for the treatment of seizures. Which item would be MOST affected by this pharmacological agent?

- 1. Coordination 2. Verbal comprehension 3. Strength 4. Flexibility

A physical therapist assistant treats a 12-year-old with spastic diplegia that recently underwent an iliopsoas tendon release. What is the MOST likely associated finding with this surgical procedure?

- 1. Crouched gait 2. Lower limb scissoring 3. Equinovarus deformity 4. Knee flexion contracture A crouched gait results from spasticity in the hip flexors and is associated with compensatory hip and knee flexion as well as lumbar hyperlordosis. The iliopsoas tendon is released from the lesser trochanter while maintaining its capsular attachments. This will effectively weaken the iliopsoas and decrease the crouching.

The medical record indicates that a patient being treated for a low back strain is taking Lasix for the management of heart failure. During ambulation activities, the patient complains of lightheadedness, fatigue, and weakness. The physical therapist assistant measures the patient's vital signs and identifies an irregular pulse. What is the MOST likely explanation?

- 1. Dehydration 2. Angina 3. Hypernatremia 4. Renal failure

A physical therapist assistant teaches a patient to utilize the Valsalva maneuver. Which medical condition would MOST benefit from this type of instruction?

- 1. Flaccid bladder 2. Congestive heart failure 3. Herniated lumbar disk 4. Peripheral vascular disease Flaccid bladder is a condition characterized by an inability of the detrusor muscles to contract when the bladder is full. The Valsalva maneuver causes an increase in intra-thoracic and intra-abdominal pressure and can be effectively used in these patients to assist with bladder emptying.

A physical therapist assistant asks a patient with suspected facial nerve involvement to mimic several facial expressions. Which muscle would be emphasized if the patient wrinkles their forehead by raising their eyebrows?

- 1. Frontalis 2. Corrugator supercilii 3. Mentalis 4. Zygomaticus major

A physical therapist assistant analyzes the gait of a child with spastic diplegia cerebral palsy in the school setting. Based on this diagnosis, which muscle group is MOST likely to be shortened?

- 1. Hip adductors 2. Knee extensors 3. Hip abductors 4. Ankle dorsiflexors During gait the combination of excessive hip flexion, adduction, and internal rotation produces a scissoring pattern. This type of gait deviation results primarily due to the presence of spasticity. Common management techniques of spasticity in this population include muscle lengthening or release of the musculature. Skeletal muscle relaxants are also used to control spasticity and can be given orally, intrathecally, or through injection at the motor point.

A physical therapist assistant treats a sixteen-year-old soccer player in an outpatient clinic. The patient presents with reports of diffuse lateral knee pain that increases with running and climbing stairs. Ober's test is positive. Which diagnosis is MOST likely based on the clinical presentation?

- 1. Iliotibial band syndrome 2. Prepatellar bursitis 3. Patellar tendonitis 4. Posterior cruciate ligament tear This patient is presenting with symptoms consistent with iliotibial band syndrome. This syndrome is a repetitive stress injury that is commonly observed in long-distance runners or anyone who participate in activities that require repetitive knee flexion and extension, such as soccer. It results from friction of the iliotibial band as it slides over the proximal lateral femoral condyle.

A patient lying in supine on a mat table is asked to perform bilateral shoulder flexion. After observing the patient perform the described action, the physical therapist assistant concludes that the patient has adaptive shortening of the latissimus dorsi. Which observation during testing would BEST support the hypothesis?

- 1. Increased lumbar lordosis 2. Decreased lumbar lordosis 3. Increased thoracic kyphosis 4. Decreased thoracic kyphosis

A physical therapist assistant treats a patient with lower extremity tightness. When the physical therapist assistant evaluates the length of the tensor fasciae latae, what is the MOST appropriate special test to perform?

- 1. Ober's test 2. Phelps' test 3. Ely's test 4. Thomas test The Ober's test is the correct test for this scenario and is performed with the patient positioned in sidelying with the lower leg flexed at the hip and the knee. The therapist moves the test leg into hip extension and abduction and then attempts to slowly lower the test leg. A positive test is indicated by an inability of the test leg to adduct and touch the table and may be indicative of a tensor fasciae latae contracture.

A physical therapist assistant instructs a patient in a series of core stabilization exercises using a ball. Assuming the patient is able to complete the exercise shown in the image without difficulty, which modification would be the MOST appropriate?

- 1. Place the ball under the soles of the feet and attempt to maintain the bridging position 2. Place the ball between the thighs and attempt to maintain the bridging position 3. Place the ball under the buttocks and attempt to maintain the bridging position 4. Place the ball between the shoulder blades and attempt to maintain the bridging position patient's feet are no longer in direct contact with the floor and the patient must instead utilize the ball as the point of contact.

A physical therapist assistant works with an 18-year-old with Duchenne muscular dystrophy in a school setting. Considering the typical progression of the disease, which of the following interventions is the MOST appropriate?

- 1. Seating and positioning to maximize respiratory function 2. Gait training with a reverse rolling walker 3. Stand pivot transfer training 4. Progressive resistive lower extremity exercises Over time children with Duchenne muscular dystrophy develop a restrictive pulmonary disorder that results in weakness and contracture of the respiratory muscles. These impairments lead to diminished ventilation and an inability to mobilize secretions which can cause pulmonary complications such as pneumonia and in severe cases, death. Scoliosis is also a common complication that contributes to ventilatory impairment and improper positioning. By the age of 18, it is likely that this patient is no longer ambulatory, making respiratory compromise more likely.

A physical therapist assistant treats a patient with a pulmonary artery catheter inserted through the subclavian vein. Which active range of motion exercise would MOST likely be restricted based on the presence of the catheter?

- 1. Shoulder flexion 2. Shoulder lateral rotation 3. Shoulder abduction 4. Shoulder extension Subclavian vein is under the clavical, and will be put under pressure from pec and deltoid if shoulder flexion happens. So it is avoided.

A physical therapist assistant attempts to facilitate upper extremity reaching in an eight-month-old infant positioned in supine. The infant presents with a persistent tonic labyrinthine reflex. Which of the following positions would be the MOST likely to eliminate the influence of this reflex while achieving the therapist's objective?

- 1. Supine with the upper trunk on a wedge and legs over a bolster 2. Supine with the legs and trunk extended 3. Prone with a pillow under the abdomen 4. Prone with the legs and trunk extended The trunk flexion and hip flexion achieved by positioning the child in supine with the upper trunk on a wedge and legs over a bolster counteracts the extensor tone elicited by the tonic labyrinthine reflex. This is the best position for the child to eliminate the influence of the reflex and facilitate upper extremity reaching.

Choosing a wheelchair for a 34-year-old patient with bilateral lower extremity amputations. What should be the MOST important feature of a wheelchair designed for the patient?

- 1. The drive wheels are set behind the vertical back supports 2. Friction surface handrims 3. Reclining back with elevating legrests 4. Removable armrests

A physical therapist assistant palpates a patient's popliteal artery to monitor their lower extremity circulation. What is the MOST likely reason the physical therapist assistant used the popliteal artery?

- 1. The therapist suspects a blockage of the femoral artery 2. The therapist is trying to determine the patient's ankle-brachial index 3. The popliteal artery is superficial in the popliteal fossa and easy to locate 4. The patient is taking beta-blockers

A physical therapist assistant is scheduled to administer a whirlpool treatment to a patient that is HIV positive. The physical therapist assistant is concerned about her ability to complete the treatment since she sustained a small paper cut on her fourth digit approximately three hours ago. What is the MOST appropriate action?

- 1. Treat the patient using appropriate medical asepsis 2. Refuse to treat the patient and document the rationale in the medical record 3. Ask the patient to reschedule their appointment 4. Select another appropriate treatment procedure

PTA is using a pan splint as an intervention to diminish spasticity in the wrist flexors. Which position of the wrist would be MOST desirable based on the established therapeutic goal?

- 1. Wrist in extension to decrease activity of the agonist 2. Wrist in extension to increase activity of the agonist 3. Wrist in flexion to decrease activity of the agonist 4. Wrist in flexion to increase activity of the agonist

A physical therapist assistant positions a patient in prone on a treatment plinth in preparation for a hot pack. When preparing the hot pack for the low back, what should the physical therapist assistant utilize?

1. 2-4 towel layers 2. 4-6 towel layers - 3. 6-8 towel layers 4. 8-10 towel layers Six to eight towel layers placed between a hot pack and the treatment surface is generally adequate to allow for the necessary transmission of heat without jeopardizing patient safety.

A physical therapist assistant works on balance reeducation activities with a patient diagnosed with diabetes and peripheral neuropathy. Which of the following activities would be the MOST challenging for this patient?

1. Activities in single-leg stance 2. Reaching in and out of the base of support in standing - 3. Standing on foam with eyes closed 4. Lateral weight shifting Standing on foam with eyes closed would be the most challenging activity for this patient. By having the patient stand on foam, the therapist increases stress on an already compromised somatosensory system. Closing the eyes further challenges the patient by eliminating the visual input that contributes to sense of position and body in space.

A physical therapist assistant reads in the medical record that a patient has pes anserine tendinitis. Which of the following muscles is MOST likely affected by this condition?

1. Adductor longus 2. Semimembranosus 3. Biceps femoris - 4. Sartorius The sartorius originates on the anterosuperior iliac spine of the pelvis and inserts on the anteromedial proximal tibia. It is one of the three tendons of the pes anserine, along with the gracilis and semitendinosus.

A physical therapist assistant enters the room of a patient diagnosed with tuberculosis. Which of the following precautions would be MOST likely?

1. Airborne precautions and a negative pressure room 2. Airborne precautions and a positive pressure room 3. Droplet precautions and a negative pressure room 4. Contact precautions Airborne precautions reduce the risk of airborne transmission of infectious agents through evaporated droplets in air or dust particles. A patient with this type of infection will be in a negative pressure room. A negative pressure room includes a ventilation system that generates negative pressure to allow air into the room, but prevents infected air from escaping. Anyone entering the room will wear respiratory protection. Tuberculosis is an example of an infection that is transmitted through an airborne mode.

A patient status post cardiac ablation is placed on Coumadin. What is the PRIMARY function of this medication?

1. Alter conduction patterns in the heart - 2. Prevent blood clot formation 3. Increase the excretion of water and sodium 4. Interfere with the metabolism of blood fats Coumadin is a commonly prescribed anticoagulant medication to prevent blood clot formation. For risk of deep vein thrombosis.

A patient confides in their physical therapist assistant that while taking a prescribed sedative they would often consume alcohol. What effect BEST describes the interaction of these two agents?

1. Antagonistic 2. Catalyst 3. Toxic - 4. Synergistic synergistic causes the effects to increase of both items. Antagonistic is opposite.

A physical therapist assistant performs a special test on a patient positioned in prone. As part of the test, the physical therapist assistant observes spontaneous hip flexion as the knee is passively flexed. Which special test is MOST likely to produce this type of finding?

1. Apley's compression test 2. Craig's test - 3. Ely's test 4. Tripod sign

A physical therapist assistant assesses the protective sensation of a patient using Semmes-Weinstein monofilaments. What is the MOST appropriate procedure when contacting the skin with the monofilament?

1. Ask the patient if they were able to detect monofilament contact - 2. Ask the patient to say "yes" when they sense contact with the monofilament 3. Ask the patient to move the contralateral ankle into dorsiflexion with monofilament contact 4. Ask the patient to qualify the difficulty level of perceiving the monofilament

A physical therapist assistant works on sit-to-stand transfers with a patient who has sustained a recent stroke. The physical therapist assistant elects to use techniques consistent with the neurodevelopmental treatment approach. According to the principles of this approach, what should the physical therapist assistant do?

1. Avoid using physical contacts so the patient can learn the movement pattern independently - 2. Focus on the relationship between sensory input and motor output 3. Focus more on positive signs (e.g., spasticity, hyperactive reflexes) than on negative signs (e.g., weakness, hypokinesia) 4. Focus on treating impairments rather than functional limitations NDT is based on an ongoing analysis of the patient's sensorimotor function. Treatment often focuses on the relationship between sensory input and motor output.

A physical therapist assistant instructs a patient to perform a seated row exercise as shown using elastic tubing. Which muscle would NOT be emphasized with this exercise?

1. Biceps brachii 2. Latissimus dorsi 3. Posterior deltoid 4. Rhomboids The biceps brachii originates on the coracoid process of the scapula and supraglenoid tubercle of the scapula and insert on the radial tuberosity and bicipital aponeurosis. The biceps brachii acts to flex the elbow and supinate the forearm. The muscle is not active during the seated row exercise and would be more active in exercises emphasizing elbow flexion and forearm supination.

A physical therapist assistant is treating a 53-year-old patient status post cerebrovascular accident. During the session the physical therapist assistant determines that the patient is unable to sense sharp pain on the right side of the body. Which testing procedure would typically be used to obtain this information?

1. Bilateral simultaneous touch 2. Drawing a line (using a dull point) on the patient's skin - 3. Gently poking with a pin interspersed with light touches using the blunt end of the pin 4. Semmes-Weinstein monofilament testing

A physical therapist assistant is treating a patient with right hemiplegia in standing balance activities. The physical therapist assistant works on reaching activities on level surfaces, on uneven surfaces, and by picking items up off the ground. Which type of practice is MOST consistent with the described interventions?

1. Blocked 2. Distributed 3. Constant - 4. Variable Variable practice refers to the practice of a given task under differing conditions. The described scenario best demonstrates variable practice since the patient is working on standing balance activities on level surfaces, on uneven surfaces, and when attempting to obtain items from the ground.

A physical therapist assistant assesses the vital signs of a newborn baby prior to the start of the therapy session. Which of the following measurements would be considered abnormal for this patient?

1. Body temperature of 99 degrees Fahrenheit 2. Resting heart rate of 150 beats per minute 3. Resting respiratory rate of 40 breaths per minute - 4. Resting blood pressure of 150/100 mm Hg

A physical therapist assistant elects to use cushion contact instead of traditional direct contact when administering ultrasound. Which medical condition would provide the MOST support for utilizing this method of ultrasound administration?

1. Carpal tunnel syndrome 2. Hamstrings strain - 3. Peroneal tenosynovitis 4. Rotator cuff tendonitis Peroneal tonosynovitis could use cushion contact rather then the others, because it is difficult to maintain consistent contact with the surface.

A physical therapist assistant treats a patient referred to an outpatient rehabilitation facility. During the session the physical therapist assistant identifies weakness, hypertonia, and hyperreflexia. What is the MOST likely diagnosis?

1. Carpal tunnel syndrome 2. Poliomyelitis 3. Bell's palsy - 4. Multiple sclerosis Multiple sclerosis is an upper motor neuron pathology that produces patches of demyelination of the myelin sheaths that surround nerves within the brain and spinal cord. This decreases the efficiency of nerve impulse transmission and symptoms will vary based on the location and the extent of demyelination. There is subsequent plaque development and eventual failure of impulse transmission.

A physical therapist assistant instructs a patient to perform a wall stretch as shown in the presented image. Which medical diagnosis would MOST warrant this type of intervention? (picture should be at a corner wall)

1. Cervical spondylosis 2. Congenital torticollis 3. Brachial plexus injury - 4. Thoracic outlet syndrome Thoracic outlet syndrome is compression of brachial plexus nerve truncks, subclavian vascular supply, and or axillary artery.

A physical therapist assistant administers phonophoresis to a patient rehabilitating from medial epicondylitis. Which action BEST explains the effectiveness of ultrasound in drug delivery?

1. Changes in systemic blood flow 2. Changes in pH of the skin - 3. Changes in permeability of the skin 4. Changes in temperature of the skin Ultrasound increases transdermal drug penetration by increasing the permeability of the stratum corneum through cavitation. The stratum corneum refers to the outer layer of the skin that functions as a protective barrier.

A physical therapist assistant positions a patient in supine on a mat table with their arms at their side and palms facing upward. The physical therapist assistant observes that in this position the patient's lateral border of the spine of the right scapula is 1.5 inches above the surface of the mat table. Insufficient length of which muscle would MOST likely be associated with this finding?

1. Clavicular portion of the pectoralis major 2. Sternal portion of the pectoralis major - 3. Pectoralis minor 4. Latissimus dorsi The pectoralis minor originates on the third to fifth ribs near the costal cartilages and inserts on the medial border and superior surface of the coracoid process. The relative tightness of the muscle is determined by the extent to which the shoulder is raised from the table and the amount of resistance felt to downward pressure on the shoulder.

A physical therapist assistant inspects a patient's wound during a dressing change. The physical therapist assistant identifies moderate amounts of purulent exudate throughout the wound surface and dressing. What would this type of exudate MOST likely be colored?

1. Clear - 2. Yellow 3. Pink 4. Red Purulent exudate presents as yellow or green in color with a thick, viscous consistency. Purulent exudate often signals wound infection and may be associated with a foul odor. Serous exudate is clear.

A patient diagnosed with multiple sclerosis works on transfer training in an inpatient rehabilitation setting. The patient presents with ataxia, postural and intention tremors, hyptonia, and truncal weakness. Based on these symptoms, where are the demyelinating lesions MOST likely located?

1. Corticospinal tract - 2. Cerebellar tracts 3. Frontal lobe 4. Spinothalamic tract

A note in the medical record indicates a patient is exhibiting signs and symptoms of rhabdomyolysis. Which of the following would be the MOST relevant finding based on this condition?

1. Decreased joint mobility - 2. Diminished muscle performance 3. Increased pain 4. Diminished coordination Diminished muscle performance is directly associated with rhabdomyolysis due to damage to muscle fibers

A physical therapist assistant notes that the output from a colostomy appears to be almost exclusively liquid. Which type of colostomy would MOST likely produce this type of output?

1. Descending colostomy - 2. Ascending colostomy 3. Sigmoid colostomy 4. Transverse colostomy The ascending colon, located on the right side of the abdomen, is the beginning portion of the large intestine. The ascending colon extends upward to a bend in the colon called the hepatic flexure. An ascending colostomy results in only a very short portion of the colon remaining active, and as a result, the output is primarily liquid containing many digestive enzymes.

A physical therapist assistant working with a three-year-old child diagnosed with an x-linked inherited disease notes that the patient exhibits toe walking and pseudohypertrophy of the gastrocnemius muscle. The mother indicates that the child has a tendency to fall frequently. What medical condition is MOST consistent with the described clinical presentation?

1. Down syndrome - 2. Duchenne muscular dystrophy 3. Spinal muscular atrophy 4. Spina bifida Duchenne muscular dystrophy is an x-linked inherited disorder which is characterized by muscle degeneration. The onset of the disease typically occurs between two and five years of age. Early symptoms include falling, difficulty getting up from the floor, toe walking, clumsiness, and an increase in the size of several muscle groups (i.e., pseudohypertrophy).

A physical therapist assistant treats an infant diagnosed with congenital torticollis. The physician referral indicates that the physical therapist assistant should avoid passive stretching techniques. Which comorbidity would MOST likely result in this type of restriction?

1. Duchenne muscular dystrophy - 2. Down syndrome 3. Juvenile rheumatoid arthritis 4. Cystic fibrosis

The measurement of blood pressure with an aneroid sphygmomanometer is said to have concurrent validity if the pressures measured by the sphygmomanometer are equal to the pressures measured at the same time by which of the following devices?

1. Electrocardiogram - 2. Pressure transducer inserted in the artery 3. Mercury sphygmomanometer 4. Pulse oximeter

A patient is unable to take in an adequate supply of nutrients by mouth due to the side effects of radiation therapy. As a result, the patient's physician orders the implementation of tube feeding. What type of tube is MOST commonly used for short-term feeding?

1. Endobronchial - 2. Nasogastric 3. Endotracheal 4. Tracheostomy A nasogastric tube is a plastic tube inserted through a nostril that extends into the stomach. The device is commonly used for liquid feeding, medication administration or to remove gas from the stomach. A gastric tube is inserted directly into the stomach for long-term feeding.

A physical therapist assistant works with a patient rehabilitating from a femur fracture on functional activities in the gym. During the session the patient becomes distracted and falls to the ground clutching the involved leg. Which action would be the MOST appropriate following the incident?

1. Enter the completed incident report in the medical record 2. Report the relative guilt or innocence of involved parties - 3. Notify the risk manager or immediate supervisor about the incident 4. Attempt to identify the cause of the incident

A physical therapist assistant elects to use proprioceptive neuromuscular facilitation (PNF) techniques to help improve a patient's coordination with movement. Which of the following statements is MOST consistent with the PNF treatment approach?

1. Extremity movement patterns should occur in the cardinal planes. 2. Extremity movement patterns are named for the movement that occurs at the distal joint. 3. PNF patterns consist of unilateral extremity movements only. - 4. Rotation is an important component of the movement patterns. PNF patterns are diagonal and spiral (i.e., rotational) in nature.

A patient presents with ape hand deformity secondary to a peripheral nerve injury. Which of the following findings would MOST likely be observed?

1. Fixed hyperextension of the metacarpophalangeal joints 2. Fixed flexion of the metacarpophalangeal joints - 3. Decreased strength with thumb opposition 4. Wasting of the hypothenar eminence Ape hand deformity is characterized by wasting of the thenar eminence, which results in weakness with thumb flexion and opposition. The patient's thumb may fall back in line with the other digits since the pull of the thumb extensors is stronger than the thumb flexors.

A physical therapist assistant completes a work site analysis for a patient with T3 paraplegia. The patient is employed in the marketing department of an advertising agency and relies on a wheelchair for daily locomotion. Which of the following is likely to be the MOST significant architectural barrier for the patient?

1. Hardwood floors - 2. An entrance ramp with one inch of vertical rise for every six inches of ramp length 3. One-quarter inch thresholds at each door 4. Pedestal type sinks

A physical therapist assistant works with a 78-year-old female who sustained a stroke involving the right hemisphere three weeks ago. The patient demonstrates apparent balance deficits, displaying a left lateral lean when seated. When the physical therapist assistant manually attempts to correct the patient's posture, she leans further to the left. What is the MOST appropriate method to have the patient achieve an upright posture?

1. Have the patient work on trunk control by sitting on a therapy ball 2. Have the patient perform activities in a tandem stance position 3. Use visual and auditory cues to have the patient attend to their right side - 4. Use a mirror so the patient can see their body orientation A patient with pusher syndrome has a misperception of their own body orientation in relation to gravity. Use of a mirror can be helpful for the patient to visually see their current body orientation and be able to correct accordingly. When correcting to an upright posture, the therapist should have the patient actively move into position instead of passively moving the patient.

A physical therapist assistant performs pull to sit with a two-month-old infant. Assuming normal development, what would the assistant expect to observe?

1. Head lag 2. Chin to chest 3. Physiological flexion 4. Plantar grasp When a two-month-old infant is in supine and is pulled to sit, a head lag is typically observed because the infant lacks sufficient strength of the neck muscles to overcome the force of gravity at this age. Postural control of the head normally emerges after the fourth month.

A physical therapist assistant employed in an acute care hospital treats a patient with a chest tube. The physical therapist assistant notices that in less than an hour there has been approximately 250 mL of drainage. Which medical condition would be LEAST likely associated with this scenario?

1. Hemothorax 2. Open chest surgery - 3. Pneumothorax 4. Trauma A pneumothorax refers to a collapse of the lung caused by a collection of air in the pleural space. Drainage from a pneumothorax is generally limited to small amounts of fluid caused by trauma associated with insertion of the chest tube.

A physical therapist assistant working in an acute care hospital arrives at a patient's room to work on transfers the day following their coronary bypass surgery. The patient appears lethargic and sedated and is unwilling to participate in the therapy session. The patient's behavior can MOST likely be explained by the administration of which medication?

1. Heparin 2. Nitroglycerin - 3. Oxycodone 4. Aspirin Oxycodone is an opioid analgesic that is commonly used in the treatment of moderate levels of pain. The primary side effects associated with opioid analgesics include sedation, drowsiness, respiratory depression, orthostatic hypotension, and gastrointestinal distress. The patient's level of sedation and lethargy may affect their ability to participate in a physical therapy session.

A patient's medical record indicates the presence of a significant electrolyte imbalance. Which condition would MOST commonly be associated with an increased risk of cardiac arrest if left untreated?

1. Hypercalcemia 2. Hypermagnesemia - 3. Hyperkalemia 4. Hypernatremia

A physical therapist assistant treats a 14-year-old child with a pulmonary condition. The physical therapist assistant teaches the patient various postural drainage positions. The child MOST likely has which medical condition?

1. Idiopathic pulmonary fibrosis 2. Pulmonary edema 3. Pneumonia - 4. Cystic fibrosis Cystic fibrosis is a multisystem disorder that affects the exocrine glands. This condition is primarily characterized by thick secretions that plug the airways of the lungs. Postural drainage is commonly used in patients with cystic fibrosis to help clear these retained secretions from the lungs.

A physical therapist assistant discusses anticipated physiologic changes associated with specific resistive programs emphasizing strength and endurance. Which physiological adaptation is inherent to both types of programs?

1. Increased muscle length 2. Increased mitochondrial density and volume 3. Increased muscle fiber hypertrophy - 4. Increased tensile strength of tendons, ligaments, and connective tissue Both strength and endurance training programs promote physiological adaptations of increased tensile strength of tendons, ligaments, and connective tissue. It is theorized that tendon and ligament tensile strength increases in response to resistance training in order to support the adaptive strength and size changes that occur in the muscles. Connective tissue will thicken to improve support to the enlarged fibers.

A physical therapist assistant treats a patient rehabilitating from a lower extremity injury with a cryotherapeutic agent. Which finding is MOST accurate when using this type of intervention?

1. Increased spasticity - 2. Increased pain threshold 3. Increased nerve conduction velocity 4. Increased metabolic rate Cryotherapy is most commonly used to decrease pain.

A physical therapist assistant works with a 45-year-old male who was in good health prior to being diagnosed with Guillain-Barre syndrome two weeks ago. The patient was referred to outpatient physical therapy after a seven-day hospitalization. The patient did not experience respiratory involvement and had moderate weakness affecting all joints of the lower extremities. What would be the MOST likely long-term outcome for the patient?

1. Independent at a wheelchair level in the home and community 2. Independent at a wheelchair level in the community only 3. Independent ambulation with an assistive device in the home and community - 4. Independent ambulation without an assistive device in the home and community Approximately 15-20% of patients will experience some long-term residual deficits after being diagnosed with Guillain-Barre syndrome. Because this patient has a relatively mild case of the condition, it is likely that he will experience a full recovery and not need an assistive device for ambulation.

A patient in an acute care hospital makes a sexually charged statement during a treatment session that the physical therapist assistant finds to be offensive. The physical therapist assistant expresses to the patient that the comment was inappropriate, however, in response the patient gently laughs. What is the MOST appropriate action?

1. Initiate a log detailing any potential future harassment - 2. Explain to the patient you are serious and want the behavior to stop 3. Formally report the harassment to the human resource department 4. Request that the patient is reassigned to another therapist Explaining that you are serious and want the behavior to stop builds upon the therapist's initial comment and reinforces the need to terminate the unacceptable behavior. If the patient does not change their behavior, the action establishes the groundwork for more formal action.

A physical therapist assistant interviews a patient diagnosed with osteoarthritis. Which statement would be MOST consistent with the typical clinical presentation of this disease?

1. Joint pain seemed to start symmetrically - 2. Morning stiffness lasts for less than one hour 3. Onset of symptoms was quite sudden 4. Frequent fatigue and general malaise

A physical therapist assistant performs electrical stimulation as part of the plan of care for a patient rehabilitating from a lower extremity injury. Which of the following recommendations would be LEAST effective to minimize electrode resistance?

1. Keep the sponge interface well moistened 2. Use small electrodes 3. Maintain even, firm contact with the skin 4. Remove hair from the skin Small electrodes increase electrode resistance, while large electrodes decrease electrode resistance.

A physical therapist assistant performs passive range of motion to a patient with severe congestive heart failure in the intensive care unit. The patient displays cycles of deep breathing followed by shallow breathing with periods of apparent apnea. Which breathing pattern is BEST described?

1. Kussmaul's 2. Eupnea 3. Orthopnea - 4. Cheyne-Stokes Cheyne-stokes is the increase and decrease of rate and depth of breathing

A patient is three weeks following transtibial amputation and is using a shrinker as part of the plan of care. What is the PRIMARY purpose of the shrinker?

1. Maintain range of motion 2. Provide intermittent compression - 3. Properly shape the limb 4. Provide desensitization The shrinker is a very effective form of soft dressing for reducing limb volume by applying constant pressure. The shrinker provides greater pressure distally which encourages the movement of edema and assists to properly shape the limb. The patient will require different size shrinkers as the limb decreases in size since the shrinker is measured specifically to the size of the limb.

A physical therapist assistant measures a patient for a straight cane prior to beginning ambulation activities. Which gross measurement method would provide the BEST estimate of cane length?

1. Measuring from the head of the fibula straight to the floor and multiplying by two 2. Measuring from the iliac crest straight to the floor - 3. Measuring from the greater trochanter straight to the floor 4. Dividing the patient's height by two and adding three inches The handgrip of a cane that is properly fit should be at the approximate level of the greater trochanter.

A patient in the intensive care unit rehabilitating from a serious infection is connected to a series of lines and tubes. Which lower extremity intravenous infusion site would be the MOST appropriate to administer an intravenous line?

1. Median cubital vein 2. Basilic vein - 3. Saphenous vein 4. Cephalic vein Saphenous vein is a superficial vein that extends from the foot to the saphenous opening. Also the only option in the LE.

A physical therapist assistant employed in a rehabilitation hospital is saddened to learn that a patient she treated only three months ago with amyotrophic lateral sclerosis recently died after a relatively short acute care hospitalization. What would be the MOST likely cause of death?

1. Meningitis - 2. Pneumonia 3. Deep vein thrombosis 4. Septic shock Pneumonia is an inflammatory condition of the lung that primarily affects the alveoli. The final stages of ALS are characterized by weakness of the respiratory muscles. This decrease in respiratory function can lead to infection of the lungs (i.e., pneumonia). Death usually occurs within 2-5 years from the onset of the disease.

A physical therapist assistant administers the rubor of dependency test to a patient with known peripheral arterial disease. With the patient in supine, the physical therapist assistant passively elevates the patient's leg 45 degrees and maintains the position for one minute. What is the MOST likely observation?

1. Mild blanching on the plantar aspect of the foot - 2. Dramatic blanching on the plantar aspect of the foot 3. Dark redness on the plantar aspect of the foot 4. Normal coloration on the plantar aspect of the foot

A physical therapist assistant reads in the medical record that an epidural sensor was used for intracranial monitoring on a patient with an acute head injury. Which unit of measure would MOST likely be utilized with this type of monitoring?

1. Milligrams per deciliter - 2. Millimeters of mercury 3. Percent of oxygen saturation 4. Pounds per square inch An intracranial pressure monitor reports a value using millimeters of mercury (mm Hg). Normal intracranial pressure is 4-15 mm Hg

A physical therapist assistant treats a patient with cardiac pathology. The patient explains that there are times that they wake up during the night with the feeling of suffocation which is only relieved by sitting upright or standing for approximately 20-30 minutes. What is the MOST likely cardiac condition associated with this occurrence?

1. Myocardial infarction - 2. Left-sided heart failure 3. Right-sided heart failure 4. Tetralogy of Fallot Left sided heart failure is a form of congestive heart failure, where the left ventrticle can no longer maintain a normal cardiac output. Left ventricle is overwhelmed, unless being in vertical positioning.

A patient without a cardiac history describes the sudden onset of substernal pain that has radiated to the subclavicular area over the last five hours. The patient indicates that the knifelike pain increases with inspiration and movement and decreases when seated and leaning forward. The physical therapist assistant identifies a pericardial friction rub through auscultation. What is the MOST likely diagnosis?

1. Myocardial infarction 2. Angina - 3. Pericarditis 4. Myocarditis Pericarditis is an inflammation of the pericardium of the heart.

A physical therapist assistant discusses the care of a 56-year-old male patient with a metabolic bone disorder with the patient's physician. The physician shows the physical therapist assistant the patient's x-ray, in which the affected bones are larger than normal, yet less dense. Which medical condition is MOST likely represented on the x-ray?

1. Osteopenia 2. Osteomalacia - 3. Paget's disease 4. Rickets Paget's disease is a condition characterized by inflammation of the bones that causes abnormal bone remodeling. Bone is resorbed and formed at an increased rate and in a disorganized fashion. This results in bones that are larger, less dense, more vascular, and more prone to fracture.

A physical therapist assistant works with a patient who exhibits neurogenic claudication. Which finding is MOST consistent with this condition?

1. Pain is exaggerated when walking on an incline 2. Pain occurs after walking a predictable distance - 3. Pain is relieved by resting in a sitting position 4. Pain seems to originate in the posterior calf Patients with neurogenic claudication often experience diminished pain when stooping, sitting or bending forward at the waist since the activities require the spine to be in a flexed position. As a result, activities such as climbing stairs, pushing a cart or cycling may be less problematic than anticipated. Activities requiring extension of the spine tend to exacerbate symptoms.

An 11-month-old male is able to grasp a raisin on a table with pad to pad opposition of the thumb and index finger. Which form of grasp does this BEST represent?

1. Palmar grasp 2. Scissors grasp - 3. Pincer grasp 4. Superior pincer grasp

A physical therapist assistant attempts to determine a patient's general willingness to use an affected body part. What objective information would be the MOST useful?

1. Passive movement 2. Sensory testing 3. Bony palpation - 4. Active movement Active movement requires the patient to perform unassisted voluntary range of motion. The activity provides the therapist with information on the patient's willingness to use the affected body part, available range of motion, strength, and coordination.

A patient rehabilitating from a left CVA ambulates with a quad cane. The physical therapist assistant notes right-sided early heel rise during midstance followed by excessive plantar flexion into terminal stance. The patient's passive plantar flexion range of motion is 0-45 degrees and dorsiflexion is 0-15. What is the MOST likely intervention based on the observation?

1. Passive range of motion activities 2. Active range of motion and mild resistive exercises 3. Standing static and dynamic balance activities - 4. Inhibition techniques Spasticity is an increased tension in a muscle when it is stretched secondary to neurological damage and often serves to interfere with functional activities. The patient likely presents with plantar flexor spasticity and would benefit from inhibitory techniques to decrease tonal influence and improve the fluidity of gait.

A physical therapist assistant places a patient in a semi-recumbent position to assess the magnitude of jugular vein distention. Jugular vein distention would MOST likely indicate the presence of which condition?

1. Peripheral arterial disease - 2. Congestive heart failure 3. Coronary artery disease 4. Aortic aneurysm Congestive heart failure is a condition characterized by an inability of the heart to effectively pump blood to meet the demands of the body. When the heart can no longer effectively pump blood to the body, fluid backs up into the lungs and venous system. A common sign of this type of fluid accumulation is distention of the jugular vein.

A physical therapist assistant administers a coupling agent to the forearm of a patient prior to performing an ultrasound treatment. What is the PRIMARY purpose of the coupling agent?

1. Promote patient comfort during the session - 2. Eliminate air between the transducer and the skin 3. Enhance the depth of tissue penetration 4. Minimize the likelihood of skin irritation Ultrasound waves do not travel effectively through air and therefore a medium must be used to transmit energy between the transducer and the target area. Eliminating the air allows the maximum amount of ultrasound energy to be absorbed.

The patient asks the physical therapist assistant for a glass of water prior to beginning the session, but has had a CVA accident. What is the MOST appropriate physical therapist assistant action?

1. Provide the patient with a glass of water 2. Check the patient's medical record for oral intake orders 3. Tell the patient they are not permitted to have water 4. Call the patient's physician

A physical therapist assistant works with a patient who is recovering from a T5 spinal cord injury. During the session the patient becomes extremely restless, begins to sweat, and complains of a severe headache. The physical therapist assistant measures the patient's blood pressure as 200/120 mm Hg. Based on the supplied information, what is the patient MOST likely experiencing?

1. Pulmonary embolism 2. Myocardial infarction 3. Spinal shock - 4. Autonomic dysreflexia Autonomic dysreflexia is a condition normally seen in patients with spinal cord injuries above T6 and is characterized by abnormal autonomic reflexes. Symptoms are triggered by a noxious stimulus below the level of the lesion and include hypertension, bradycardia, headache, profuse sweating, increased spasticity, and restlessness.

A patient is stretching the calf muscles using a wall stretch after running three miles on a treadmill. In this scenario, how is heat dissipated between the patient's hands and the wall?

1. Radiation - 2. Conduction 3. Convection 4. Evaporation Conduction is the transfer of heat from one object to another that requires direct contact between the two objects.

A physical therapist assistant treats a patient with supraspinatus tendonitis using iontophoresis with acetic acid. What is use of this intervention MOST likely intended to do?

1. Reduce inflammation - 2. Soften calcium deposits 3. Facilitate tissue repair 4. Reduce pain

A physical therapist assistant assesses the pulse rate of a patient exercising on a treadmill. The physical therapist assistant notes that the rhythm of the pulse is often irregular. What is the MOST appropriate action to ensure an accurate measurement of pulse rate?

1. Select a different pulse site - 2. Measure the pulse rate for 60 seconds 3. Use a different stethoscope 4. Document the irregular pulse rate in the patient's medical record The longer the duration of the measurement, the closer the obtained measure will be to the patient's actual pulse rate. Although 60 seconds may seem excessive to assess the pulse in a patient with a regular heart rhythm, it is often necessary in the presence of an irregular rhythm in order to ensure a valid measure of pulse rate.

A physical therapist assistant elects to utilize a wrist splint for a patient with a repetitive use disorder. The patient is employed as a transcriptionist and spends up to eight hours a day on a computer. The physical therapist assistant determines the patient's wrist and hand are acutely inflamed and the patient classifies her present pain as an 8 out of 10 on a visual analogue scale. What would be the MOST appropriate type of splint?

1. Serial splint 2. Dynamic splint 3. Functional splint - 4. Resting splint A resting splint is typically utilized to maintain a joint in an appropriate position during an acute exacerbation of symptoms allowing the joint to rest while limiting the risk of contracture development. A resting splint would be the most appropriate option given the patient's level of acuity and the intensity of the pain.

A physical therapist assistant works with a patient that sustained burns to the left axilla and shoulder. A splint would MOST likley be fabricated for the patient in order to avoid which of the following deformities?

1. Shoulder abduction contracture and webbing of the axillary folds - 2. Shoulder adduction contracture and webbing of the axillary folds 3. Shoulder flexion and medial rotation contracture 4. Thoracic kyphosis secondary to flexion forces

A physical therapist assistant examines a patient with an acute burn to the left shoulder and axilla area secondary to a spill of boiling water. What is the MOST appropriate splint for this patient?

1. Shoulder sling - 2. Airplane splint 3. C-bar splint 4. Hemi-arm sling An airplane splint is a type of complex splint that holds the arm in abduction with the elbow in approximately 90 degrees of flexion primarily protecting against a shoulder adduction contracture. Typically, this type of splint is used by patients with burns affecting the shoulder and axillary regions.

A physical therapist assistant assesses muscle activity in the trunk and pelvis of a patient referred to physical therapy with low back pain. Which position would be the MOST appropriate to assess the transversus abdominis?

1. Sidelying 2. Supine with legs extended 3. Supine with hips and knees flexed to 90 degrees - 4. Hooklying

A 25-year-old female patient sustained full-thickness burns to 50% of her body two years ago. Which statement BEST explains why the patient should avoid aerobic exercise in a hot environment?

1. Skin grafts cannot tolerate stretching while exercising in the heat 2. Exercising in the heat increases the risk of hypertrophic scarring - 3. Sweat glands are destroyed impairing temperature regulation in the heat 4. A hot environment stimulates nerve endings resulting in heightened pain

A physical therapist assistant observes a wound that is noticeably red, slightly shiny, and mildly moist. What is the physical therapist assistant MOST likely observing?

1. Slough - 2. Granulation tissue 3. Necrotic tissue 4. Exposed tendon Granulation tissue is characterized as pink or red, shiny, and moist.

A physical therapist assistant makes wheelchair recommendations for a patient referred to physical therapy after a six week hospital stay. The patient presents with bilateral venous insufficiency ulcers on the distal lower extremities. What would be the MOST desirable wheelchair component?

1. Standard bilateral legrests with heel loops - 2. Elevating bilateral legrests with calf pads 3. Ultralight wheelchair frame 4. Hemi wheelchair frame

Which of the following balance tests would require the GREATEST reliance on the vestibular system?

1. Standing on a floor with the eyes closed 2. Standing on a floor with the head tilted backward - 3. Standing on a foam surface with the eyes closed 4. Standing on a foam surface with the head tilted backward

A physical therapist assistant discusses positioning with a 42-year-old female patient rehabilitating from a transfemoral amputation. Based on the patient's postoperative status, which position would be the MOST appropriate to prevent a contracture?

1. Supine with a pillow between the legs 2. Supine with a pillow on the outside of the affected leg 3. Prone with a pillow between the legs - 4. Prone with a pillow on the outside of the affected leg Having the patient lie in a prone position with a pillow on the outside of the affected leg would be the most effective position to prevent a hip flexion and abduction contracture.

A physical therapist assistant works in the therapy pool with a patient who is status post open reduction internal fixation of the right tibia. The doctor has instructed the patient that he needs to remain less than 20% weight bearing while ambulating. To what level would the patient have to submerge in the pool to satisfy the weight bearing restrictions?

1. The knees 2. The anterior superior iliac spines 3. The xiphoid process - 4. C7 vertebra A patient submerged to the C7 vertebra would be approximately 10% weight bearing. This option most closely meets the weight bearing restrictions without exceeding them.

A physical therapist assistant decides to work on balance with a patient in the modified plantigrade position. Which of the following is a benefit of using this position during treatment?

1. The patient must rely on only the lower extremities for balance reactions 2. The position decreases extensor tone in the patient's wrists and elbows - 3. The position uses a wider base of support than does standing 4. The position increases flexion range of motion at the fingers The modified plantigrade posture involves the patient weight bearing through both the lower and upper extremities, therefore the patient's base of support would be larger than when the patient is in traditional standing.

A physical therapist assistant begins to suspect that a patient may have compartment syndrome secondary to significant lower leg swelling and a decreased dorsalis pedis pulse. If compartment syndrome is present, which nerve would MOST likely be affected?

1. Tibial nerve 2. Sural nerve - 3. Deep peroneal nerve 4. Superficial peroneal nerve The deep peroneal nerve is a branch of the common peroneal nerve, located in the anterior lower leg. Because of its location, this nerve is commonly affected with compartment syndrome. Compression of this nerve can result in a steppage gait due to difficulty performing dorsiflexion.

A physical therapist assistant plans to use a TENS device for a patient with chronic pain. Which of the following would be considered an absolute contraindication for use of this device?

1. Use on the periphery of an open wound - 2. Use over the muscles of the anterolateral neck 3. Use on a patient with premature ventricular contractions 4. Use in the presence of impaired sensation The muscles in the anterolateral neck surround an area known as the carotid sinus. The carotid sinus contains baroreceptors that are responsible for controlling blood pressure. Electrical stimulation to this area may cause a rapid fall in blood pressure and heart rate that may cause a patient to faint. Use of electrical stimulation in this area is contraindicated.

A physical therapist assistant treats a patient that has experienced altered serum potassium levels during their current hospitalization. What is the MOST relevant complication for a patient with abnormal potassium levels?

1. Water retention 2. Increased blood glucose level - 3. Cardiac arrhythmias 4. Increased oxygen saturation in the blood Diuretic agents act to increase the excretion of sodium and water from the body as urine. As a result, dehydration is often a persistent side effect. Symptoms associated with dehydration are commonly observed during physical activity and other forms of active exercise. Other side effects of diuretic agents include hypotension, electrolyte imbalance, polyuria, increased low-density lipoproteins, and arrhythmias. Therapists must recognize potential side effects of commonly used pharmacological agents in order to best manage patient intervention.

A physical therapist assistant works in a hospital with a patient who has methicillin-resistant staphylococcus aureus (MRSA). When treating the patient, which infection control procedures would be the MOST appropriate?

1. Work in the therapy gym, therapist wears gown and gloves 2. Work in the therapy gym, therapist wears gown, gloves, and mask - 3. Work in the patient's room, therapist wears gown and gloves 4. Work in the patient's room, therapist wears gown, gloves, and mask Contact precautions require staying in patients room