PTA practice exam 1
A physical therapist assistant works with a patient recovering from surgery on gait activities on a level surface. Which value represents the MAXIMUM amount of knee flexion required to complete the described activity?
0-60 degrees
If the patient's blood pressure is already established, the therapist can use the known systolic measurement as the baseline value. The blood pressure cuff should then be inflated to _______ mm Hg above the baseline value
15-25
A patient requires ___ degrees of ankle plantar flexion with gait on a level surface.
20
max heart rate formula
220-age
A physical therapist assistant contemplates the necessary amount of force to overcome friction when performing mechanical lumbar traction using a non-split traction table. What percentage of a patient's body weight would be MOST representative of this value?
25%
A bathroom sink should have a minimum of ___ inches of clearance (height) under the sink to accommodate a wheelchair.
29 inches
A patient requires ____ degrees of hip flexion with gait on a level surface
30
for a patient to safely propel a wheelchair through the doorway, The minimum width required for a doorway is ___ inches.
32 inches
A ramp should have a minimum width of ____ inches in order for a patient to ascend and descend the ramp using a wheelchair.
36 inches
A physical therapist assistant prepares to measure the amount of femoral anteversion present in a patient referred to physical therapy. Which patient would the physical therapist assistant expect to exhibit the GREATEST amount of anteversion?
A 9-year-old female with patellofemoral syndrome
A patient attending her third physical therapy session transitions from a hospital bed to standing in preparation for ambulation activities. Which blood pressure response would BEST support the physical therapist assistant's decision to return the patient to a recumbent position?
A decrease in systolic blood pressure greater than 20 mm Hg after moving from a supine position to a sitting or standing position or a decrease in diastolic blood pressure greater than 10 mm Hg is typically indicative of orthostatic hypotension
A 52-year-old female is referred to physical therapy with right shoulder pathology. The patient reports a gradual onset of pain beginning six months ago with a progressive loss of range of motion and strength, most notably in lateral rotation and abduction. The patient reports an inability to perform a number of activities of daily living including any tasks requiring the arm to be lifted overhead. Which medical condition is MOST consistent with this scenario?
Adhesive capsulitis
A physical therapist assistant attempts to assess the patency of a patient's airway who appears to be in distress. Which emergent condition would be MOST likely to make this type of assessment essential?
Allergic reaction
A patient recently admitted to an acute care hospital is referred to physical therapy. A physical therapist assistant documents the following clinical signs: pallor, cyanosis, and cool skin. These clinical signs are MOST consistent with which of the following conditions?
Anemia
A 22-year-old female is referred to physical therapy after sustaining a severe ankle sprain. The patient reports that while playing basketball she landed on the "outside" of her ankle and it immediately became quite swollen. During the anterior drawer test the lateral aspect of the calcaneus translates a greater amount than the medial aspect resulting in medial rotation of the talus. What is the structure MOST likely involved?
Anterior talofibular ligament
A physical therapist assistant reviews the medical record of a patient post myocardial infarction. The patient is currently in the coronary care unit and is scheduled to begin cardiac rehabilitation tomorrow. Which of the following complications is MOST common following a myocardial infarction?
Arrhythmias
are caused by abnormalities in cardiac impulse generation, conduction, or both and occur in 90% of individuals who have experienced a myocardial infarction.
Arrhythmias
A physical therapist assistant works with a patient who is rehabilitating from a T2 spinal cord injury. During the session the patient begins to demonstrate signs and symptoms consistent with autonomic dysreflexia. What would be the MOST immediate course of action?
Assess for obstruction of the urinary catheter line or any irritating stimuli
is characterized by cyclical, spasmodic alternation of muscular contraction and relaxation in response to a sustained stretch of a spastic muscle. This sign is characteristic of upper motor neuron disorders.
Clonus
A physical therapist assistant documents that the Neer impingement test is positive after a patient reports marked pain during the testing procedure. What is the PRIMARY source of pain when performing this test?
Compression of the greater tuberosity against the anterior acromion
is a condition characterized by malalignment of the femoral head within the acetabulum. The condition develops during the last trimester in utero and is often treated with the use of a harness, bracing, splinting or traction. The malalignment does not resolve with skeletal maturity, although it can be effectively treated through conservative or surgical methods.
Congenital hip dysplasia
is right-sided heart failure arising from disease of the lungs. Signs of right ventricular failure are elevated central venous pressure with distention of the neck veins. Ascites (accumulation of fluid in the peritoneal cavity) and peripheral edema of the feet and ankles are common. Individuals with heart failure often experience fatigue and exercise intolerance.
Cor pulmonale
A physical therapist assistant works on positioning with a 78-year-old female in a skilled nursing facility. Which physiologic change would contribute to an increased incidence of skin breakdown in this population?
Decreased subcutaneous adipose tissue
A physical therapist assistant works with a seven year old child diagnosed with spina bifida. The physical therapist assistant has noticed that over the last two months the child has become less participatory with physical therapy and has experienced more frequent behavioral issues. What is the MOST appropriate strategy to promote long-term improvement in the patient's level of participation?
Develop a reward system for the child based on their level of participation
refers to profuse perspiration and is often associated with shock or other emergent medical conditions.
Diaphoresis
A physical therapist assistant works with a 65-year-old male with a diagnosis of congestive heart failure and hypertension. Which pharmacological agent would MOST likely be prescribed based on the patient's medical status?
Diuretics
A physical therapist assistant demonstrates an anterior step down from a four inch platform for a patient rehabilitating from knee surgery. What type of muscle contraction is produced by the quadriceps of the stance leg during this activity?
Eccentric
A physical therapist assistant employed by a home health agency discusses the established plan of care with the patient. The patient indicates that he understands what the physical therapist assistant is recommending, but insists he is not interested in performing active exercise as part of the program. What would be the MOST appropriate physical therapist assistant response?
Explain to the patient why active exercise is a critical component of the plan of care
A physical therapist assistant monitors a 6 foot 3 inch, 275 pound male's blood pressure using the brachial artery. Which of the following is MOST important when selecting an appropriate size blood pressure cuff for the patient?
Extremity circumference
A physical therapist assistant prepares to complete a selected manual muscle test on a patient with rotator cuff tendonitis by placing the upper extremity in the recommended test position. The physical therapist assistant determines that the patient is unable to maintain the test position and slowly allows the arm to sag. Which of the following muscle grades is MOST consistent with this scenario?
Fair minus
are random, spontaneous twitches in a muscle group which may be visible through the skin. They are characteristic of lower motor neuron disorders.
Fasciculations
A physical therapist assistant is treating an 82-year-old female that lives independently in a single story house. The therapist uses the Tinetti Performance Oriented Mobility Assessment as a screening tool to determine if the patient is at an increased risk for falling. What is the PRIMARY method this tool uses to assess fall risk?
Gait and balance
is a syndrome that reflects an inability of the heart to maintain a cardiac output sufficient to meet the oxygen and nutritional needs of the tissues.
Heart failure
A physical therapist assistant monitors the aerobic response of a patient ambulating in an acute care hospital following coronary artery bypass graft surgery. Which condition would MOST likely result post-operatively if the patient's hemoglobin level was low?
Hypoxia
are used to limit the inflammatory response of the respiratory tract.
Inhaled corticosteroids
refers to the extent of agreement of the scores recorded by two or more individuals, addresses the consistency of the implementation of a rating system.
Intertester reliability
A patient uses a self-administered assessment tool as a method to record daily progress. What type of reliability would be the MOST essential using this tool?
Intratester
refers to the extent to which scores on the tool obtained by the same tester are consistent.
Intratester reliability
A 55-year-old female is referred to physical therapy after being diagnosed with adhesive capsulitis. The patient's range of motion restriction is consistent with a capsular pattern at the shoulder. Which motion would typically be MOST limited?
Lateral rotation
is characterized by degeneration of the femoral head due to a disturbance in the blood supply (i.e., avascular necrosis). This type of structural condition does not resolve with skeletal maturity.
Legg-Calve-Perthes disease
A physical therapist assistant discusses fitness parameters with a 30-year-old patient who is five months pregnant. Assuming the patient has not experienced any complications from her pregnancy, which of the following would be the MOST appropriate exercise program for the patient?
Mild to moderate walking program performed three times per week
Which heart valves are closed during ventricular systole to prevent blood from flowing back into the atria?
Mitral and tricuspid valves
During a family meeting in an acute rehabilitation hospital a 26-year-old male with complete C7 tetraplegia asks a variety of questions about self care and mobility expectations. With an uncomplicated recovery, the patient can expect lower extremity dressing to be performed with what level of assist in bed?
Modified independence
are used to improve the expectoration of bronchopulmonary secretions in patients with chronic bronchopulmonary diseases.
Mucolytics
A physical therapist assistant educates a patient about their medical condition during a physical therapy session. During the discussion, the physical therapist assistant mentions that most patients experience resolution of symptoms when they stop growing. Which medical condition is MOST consistent with this scenario?
Osgood-Schlatter disease
is a self-limiting condition that results from repetitive traction on the tibial tuberosity apophysis. Symptoms include point tenderness over the patella tendon at the insertion on the tibial tubercle, antalgic gait, and pain.
Osgood-Schlatter disease
A 52-year-old female who was involved in a motor vehicle accident three days ago is referred to physical therapy with a cervical strain. The physical therapist assistant attempts to quantify the patient's available range of motion in the cervical spine. When measuring flexion and extension of the cervical spine, where should the axis of the goniometer be aligned?
Over the external auditory meatus
A physical therapist assistant treats a 29-year-old male who sustained a superficial partial-thickness burn to the anterior portion of his left forearm and wrist. Based on the classification of the burn, what is the MOST likely outcome?
Painful burns that present with thickened blisters that heal in less than three weeks
is a general term describing pain or discomfort in the anterior knee. Adolescents are at increased risk for developing patellofemoral syndrome, although reaching skeletal maturity does not necessarily lead to the resolution of symptoms.
Patellofemoral syndrome
A physical therapist assistant assesses the lower extremity muscle length of a 26-year-old male with low back pain. Which of the following describes the MOST appropriate method to test the length of the patient's left iliopsoas?
Patient lying in supine with the right hip flexed to the chest and the left leg extended
refers to the consistency between results of two tests constructed in the same way from the same content domain.
Reliability of parallel forms
A physical therapist assistant participates in a research study that measures patient satisfaction with physical therapy services. The physical therapist assistant uses a satisfaction questionnaire that will be mailed to patients. How will patients indicate their consent to participate in this research study?
Returning the completed survey to the therapist
A physical therapist assistant inspects the prosthesis of a 68-year-old male with a right transfemoral amputation. The physical therapist assistant identifies that the patient's prosthetic knee often buckles at heel strike and concludes that this issue should be addressed with a strengthening program. What is the PRIMARY muscle group to target?
Right hip extensors
A physical therapist assistant works with a 75-year-old female that presents with residual periodic loss of balance secondary to a recent stroke. The patient has minor residual strength deficits in her affected upper and lower extremities and will need an assistive device for ambulation. Based on the patient's present status what would be the MOST appropriate assistive device?
Rolling walker
A physical therapist assistant implements a home exercise program for a patient rehabilitating from a lower extremity injury. Which step would be the MOST appropriate to maximize patient compliance?
Select exercises consistent with the patient's rehabilitation goals
A female patient expresses to a physical therapist assistant that she has difficulty shrugging her shoulders and turning her head due to a nerve injury. Based on the patient's comment, which cranial nerve is MOST likely affected?
Spinal accessory
A physical therapist assistant discusses positioning issues with the nursing staff prior to a scheduled treatment session. What bony prominence would be particularly susceptible to breakdown with the patient positioned in the supine position?
Spinous processes
is a tool designed to assess a patient's risk for falling. There are fourteen tasks, each scored on an ordinal scale from 0-4. These tasks include static activities, transitional movements, and dynamic activities in sitting and standing positions. The maximum score is a 56 with a score less than 45 indicating an increased risk for falling. This tool can be used as a one-time examination or as an ongoing tool to monitor a patient who may be at risk for falls.
The Berg Balance scale
single task screening tool used to assess standing balance and risk of falling. A person is required to stand upright with a static base of support. A yardstick is positioned to measure the forward distance that a patient can reach without moving the feet. Three trials are performed and averaged together. A patient that falls below the age appropriate range for functional reach has an increased risk for falling.
The Functional Reach test
is a functional performance screening tool used to assess a person's level of mobility and balance. The person initially sits in a supported chair with a firm surface, transfers to a standing position, and walks approximately 10 feet. The patient must then turn around without external support, walk back towards the chair, and return to a sitting position. The patient is scored based on amount of postural sway, excessive movements, reaching for support, side stepping or other signs of loss of balance. Patients who are independent can complete the multi-task process in 10 seconds or less. Patients that require 30 seconds or more are at a high risk for a fall.
The Timed Get Up and Go test
A physical therapist assistant treats a patient recently admitted to an acute care hospital after being diagnosed with Guillain-Barre syndrome. Which of the following MOST accurately represents the condition's typical prognosis?
The majority of patients will experience a full recovery
A physical therapist assistant works with a patient on abdominal strengthening. The physical therapist assistant attempts to have the patient complete a modified sit-up with their head and shoulders positioned on a wedge while in supine. What is the MOST likely rationale associated with the use of the wedge?
Weak rectus abdominis
A physical therapist assistant reviews the medical record of a 46-year-old female diagnosed with myasthenia gravis. A recent physician entry indicates that the patient is currently taking immunosuppressive medication. Which laboratory test should be the MOST frequently monitored based on the patient's medication?
White blood cell count
is the sensory system associated with hearing. The auditory system is highly involved in vestibular functions and as a result, anything that disrupts auditory information can also affect vestibular functioning.
auditory system
work to relieve bronchospasm in patients with obstructive pulmonary disease by relaxing the smooth muscle of the bronchi or bronchioles.
bronchodilators
occurs when the muscle shortens while developing tension.
concentric contraction
are indicated for heart failure and hypertension with the goal of reducing preload and vascular volume.
diuretics
A physical therapist assistant works with a patient on vertical positioning using a tilt table. During the session, the patient suddenly begins to demonstrate signs of intolerance to being upright. Which symptoms would be anticipated?
dizziness, nausea, syncope
are generated when a muscle lengthens while controlling movement against resistance.
eccentric contractions
A physical therapist assistant assesses a patient's passive shoulder range of motion. After moving the patient's arm into approximately 80 degrees of shoulder flexion the patient indicates he is experiencing a great deal of pain and requests that the physical therapist assistant avoid moving his arm any further. How should the end-feel associated with shoulder flexion be labeled?
empty
results when pain prevents reaching the end range of motion. Resistance is not felt, although protective muscle splinting or muscle spasm may be detected.
empty end feel
this grade is characterized by the patient completing range of motion against gravity without manual resistance.
fair
this grade is characterized by the patient being unable to complete the full available range of motion against gravity, however, can complete more than half of the range. If placed in the test position, the patient will have insufficient strength to maintain the position.
fair minus
results when there is tension in the way the joint feels with a slight give, comparable to pulling a rubber band or a piece of leather
firm end feel
this grade is characterized by the patient completing range of motion against gravity with minimal-moderate resistance.
good minus
results in an unyielding sensation most often caused by bone to bone contact
hard or bony end feel
measures the percentage of red blood cells in a volume of blood. may be decreased with anemia, nutritional deficiency, and leukemia. may be increased with dehydration, polycythemia, and burns.
hematocrit
is the iron containing pigment in red blood cells that functions to carry oxygen in the blood. Low _________ may indicate anemia or blood loss; elevated _____________ suggests polycythemia or dehydration.
hemoglobin
is characteristic of lower motor neuron disorders.
hypotonia
occurs when tension develops, but there is no change in the length of the muscle.
isometric contraction
Diminished deep tendon reflexes (i.e., hyporeflexia) are characteristic of
lower motor neuron disorders.
acts to adduct the scapula. The muscle is more likely to be active in arm extension or puling activities which require scapula retraction and is innervated by the accessory nerve.
middle trapezius
refers to the consistency of results across items within a test. The reliability of the instrument is evaluated by estimating how well the different items within the test, which are supposed to reflect the same construct, do yield similar results.
nternal consistency reliability
may be susceptible to skin breakdown in the prone position, but not in the supine position.
patella, anterior superior illiac spine, anterior shoulder
A physical therapist assistant performs a developmental screening on an eight-month old infant. Assuming normal development, which reflex would potentially hinder the child's ability to ambulate?
plantar grasp reflex
are small blood cells that are necessary for clotting. If the ___________ level is high, it indicates increased risk of thrombosis and if the level is low, it indicates increased risk of bruising and bleeding.
platelets
this grade is characterized by the patient completing range of motion with gravity-eliminated.
poor
act to adduct and downwardly rotate the scapula, The muscle is more likely to be active in arm extension or puling activities which require scapula retraction and are innervated by the dorsal scapular nerve.
rhomboids
A physical therapist assistant observes the movement of the scapula during active flexion of the humerus. Which muscle would be MOST likely to play an active role in protracting the scapula on the thorax during this movement?
serratus anterior
acts to protract and upwardly rotate the scapula on the thorax during active flexion of the humerus and is innervated by the long thoracic nerve.
serratus anterior
results in a yielding compression that halts further movement.
soft end feel
provides information about the relative orientation and movement of the body in relation to a supporting surface.
somatosensory system
When measuring cervical lateral flexion, the axis of the goniometer is aligned over the
spinous process of the C7 vertebra
nvolves partial-thickness tissue loss of the dermis and presents as a shallow open ulcer with a red or pink wound bed.
stage II pressure ulcer
refers to a temporary loss of consciousness (i.e., fainting) due to generalized cerebral ischemia.
syncope
acts to assist with scapula elevation. The muscle is more likely to be active in upwardly rotating the scapula and is innervated by the accessory nerve.
upper trapezius
A physical therapist assistant works with a patient who complains of occasional difficulty maintaining her balance when walking and frequent episodes of vertigo. A disorder of which system is the MOST likely cause of the patient's difficulty?
vestibular system
reports information to the brain regarding the position and movement of the head with respect to gravity and inertia. Abnormalities of the vestibular system result in dizziness and impaired balance.
vestibular system
allows individuals to perceive movement and detect the relative orientation of the body in space.
visual system