210 PT 2

In considering wheelchair casters, which of the following choices is MOST appropriate when the primary concern is chair stability?

8-in. casters

During assisted bed mobility activities, the pelvic and shoulder girdles are considered _____________________________________.

Points of control

During a floor-to-wheelchair transfer, why are the casters positioned forward?

To make the chair less likely to tip forward

Which instruction is MOST appropriate for negotiating stairs for a patient who has a sprained left ankle and is weight bearing as tolerated (WBAT)?

"Place the right foot on the step above, followed by the cane and the left leg simultaneously."

Your patient recently underwent a second right total hip arthroplasty (posterior approach) because of repeated dislocation following the first procedure. Which of the following instructions is MOST appropriate during initial gait training with this patient?

"Turn toward your left side."

A 39-year-old patient with paraplegia needs to transfer from the bed to a wheelchair positioned to the patient's left. Which of the following instructions is MOST appropriate to give the patient to facilitate the movement?

"Turn your face to the right as I assist you in moving to the chair."

When instructing a cognitively intact patient on the proper technique to transfer in and out of a wheelchair at home, which of the following instructions is MOST appropriate to provide the patient?

"You can transfer from the wheelchair to the bed with the armrest closest to the bed moved out of the way."

A physical therapist assistant is testing the deep tendon reflexes of a patient's patellar tendon. The patient has not been able to produce a voluntary contraction the the affected quadriceps. The therapist strikes the patellar tendon with a hammer and gets no response. The PTA then instructs the patient to undergo the Jendrassik maneuver and strikes the tendon again and still gets no response.

0

For the optimal push angle, wheelchair seat alignment should allow how much elbow flexion when the hand is at the apex of the wheel?

100 to 120 degrees

A 39-year-old man who had knee surgery 4 weeks ago is ready to begin aerobic conditioning activities. What is the estimated maximum heart rate for this patient?

181 beats per minute

A 51-year-old patient who had a myocardial infarction 5 weeks ago is ready to begin outpatient cardiac rehabilitation. If the patient's resting heart rate is 78 beats per minute, which of the following values should be used as a target heart rate for conditioning activities for this patient?

98 beats per minute

Which of the following SOAP note sections is not matched with its intended definition?

A - Assistant

What accommodation is made to ensure safety as patients are learning to perform transfers between the chair and floor?

A cushioned surface is used to make the maneuver more comfortable.

An abnormal hypotonic deep tendon reflex is MOST likely caused by which of the following pathologies?

A lesion associated with the PNS

Which of the following factors is key to preserving dynamic trunk stability?

A neutral pelvis

Which of the following patients is MOST likely to use anteroposterior seated transfer?

A patient with a bilateral transfemoral amputation

An independent backward lift transfer from the floor into a wheelchair requires which of the following?

Adequate patient shoulder strength and range of motion

Which of the following lateral transfer devices is MOST appropriate for use with patients with integumentary problems?

Air-assisted devices

Which of the following is a reason for documenting a physical therapy session?

All of the above.

Which of these patients is NOT likely to be the victim of abuse?

Any of these people could be the victim of abuse.

When working with a 79-year-old woman following a surgical repair of a right hip fracture, which technique would be MOST appropriate to use to assist her in scooting to the head of the bed if she is non-weight bearing?

Ask her to bend her left leg only and bridge, using her arms to assist.

When working with a patient, who identifies as a woman, in an inpatient rehabilitation center, the clinician discovers that the patient only has dresses to wear while in the open gym. Which of the following is the MOST appropriate item for the clinician to tell the nurse who is getting the patient dressed for therapy?

Ask the nursing staff to help the patient put on one of her dresses, and plan to drape her in the gym.

A 73-year-old patient is 2 days status post total hip replacement (posterior appropriate). He has been lethargic during his hospitalization but needs to transfer to the wheelchair for transport. Which of the following would be MOST appropriate to determine a patient's understanding of a transfer technique?

Ask the patient to repeat the steps back to before beginning the transfer.

When assisting a patient during a high transfer such as from chair to plinth, which of the following represent the best contact points for guarding the patient?

At the shoulder and pelvic girdles

When assisting a patient who requires moderate to maximum assistance into a long-sitting position in the bed, which of the following is the BEST position for the clinician to assume?

Beside and slightly behind the patient, facing in the same direction as the patient

Weight-bearing in modified plantigrade is shared by __________________________.

Both feet and both hands

Venous insufficiency

Brown/purple

May be due to aging, liver issues, pregnancy

Brown/yellow

A physical therapist assistant (PTA) is performing at deep tendon reflex (DTR) test to a patient with a lesion in the lateral corticospinal tract. Which DTR response would the PTA expect to see?

Clonus of the foot

When transferring a patient from the edge of the bed to a wheelchair using a stand-pivot transfer, which of the following positions is MOST appropriate for the caregiver?

Close to the patient with feet spread apart and staggered with hips and knees bent

A skin assessment includes which of the following? Choose all that apply.

Color, Temperature, Texture, Presence of healed skin, scars etc

A clinician was out sick with a cold last week and still has an intermittent cough. Which of the following is acceptable practice for the clinician while walking through the hospital between patient treatment sessions?

Coughing into one's sleeve or elbow if a tissue isn't available

Use of a sling seat in a wheelchair tends to result in all of the following EXCEPT:________________.

Decreased thoracic kyphosis

What would be the BEST way to drape a patient with bilateral hamstring pain when performing soft tissue work?

Drape a sheet over both legs and expose one leg at a time, securing the sheet so that it does not move.

Which of the following statements is true regarding how CoM affects patients' movement?

Each body part, such as a leg or an arm, has its own CoM.

May indicate inflammation, infection, cellulitis, or beginning stages of skin break down.

Erythema

Which of the following is the BEST instruction for a sit-to-stand transfer with a walker for a patient who is limited to 30 lb weight-bearing on the right lower extremity?

Extend the right knee and keep the foot in front of the body while rising to a standing position.

Which of the following tasks would be considered "gait training" instead of "ambulating" a patient who recently had a CVA?

Facilitating advancement of the patient's hemiparetic leg during treadmill training

Bare feet are a good alternative to slippery bedroom slippers for transfers.

False

The most effective way to grip a drawsheet is with a pincher grip.

False

Which of the following wheelchair frames is MOST appropriate when the primary concern is shock absorption when traveling over rough or uneven surfaces?

Folding-frame wheelchair

When assisting a patient to sitting, one hand is placed over the humeral head of the shoulder that is against the bed. Which of the following is the BEST rationale for this hand placement?

Force applied at the humeral head allows for an effective line of force.

Which of the following is the BEST way for a wheelchair user to negotiate very steep slopes?

Go up the slope using a zigzagging path.

Which of the following factors is a requirement for performing independent seated lateral transfers without a transfer board?

Good trunk control

When performing a transfer, which of the following is the BEST way to prevent a patient with a partial weight-bearing restriction from putting too much weight on the affected leg?

Have the patient extend the knee of the involved lower extremity.

Cannot be used when non-weight-bearing status on one extremity is required

Hemi-Walker

Which of the following positions is MOST appropriate for a patient who sustained a spinal cord injury and is unable to move below the level of the umbilicus?

In a three-quarters supine position with pillows behind the head and between the legs

A 65-year-old woman who underwent abdominal surgery yesterday and has poor strength in her bilateral lower extremities needs to transfer from the bed to the bedside commode. Which of the following positions would be the safest to assume for this transfer?

In front of the patient, with both of her legs blocked by your legs

Which of the following is the initial position for a turnaround technique to transfer from the floor to a wheelchair?

In quadruped position facing the chair

While performing the Skin Turgor Test, if the skin takes longer than 3 seconds to return to normal, what would be indicated?

Indicates that the patient is moderately to severely dehydrated

Which of the following is true regarding a properly positioned armrest on a wheelchair?

It can decrease the weight on the buttocks.

Which of the following represents the BEST safety instruction for a patient who is learning to manage a sideways fall in a wheelchair?

Laterally flex the head away from the ground and tuck the arms close to the chest.

Upon completion of a total body lift with a sling to transfer a patient to a bedside chair, what is the BEST way to manage the sling at the end of the transfer when planning to return the patient to bed in 1 hour?

Leave the sling under the patient, making sure to eliminate any wrinkles in the sling.

When transferring a supine patient using a lateral transfer device, which of the following maneuvers should always be avoided?

Lifting a patient with the device

When testing for integumentary tolerance to pressure during positioning, observing which of the following responses to a skin-blanching test would indicate healthy tissue?

Light skin that turns white immediately and then becomes pink within a few seconds

Another way to describe forearm crutches

Lofstrand or Canadian

Which of the following is the BEST technique for performing supine to sit for a patient who underwent a left total hip arthroplasty using a posterolateral approach?

Long-sitting with transitioning to sitting on the side of the bed

Which of the following is the best way for a patient with no lower extremity functional strength to begin a transition from the floor to a chair?

Long-sitting, facing away from the chair

May indicate prolonged exposure to moisture which is a risk factor for skin breakdown and infection

Maceration

Which of the following is the KEY element of log-rolling?

Maintaining a neutral spine throughout the task

While assessing girth measurements you should:

Measure at determined intervals from the reference point, Measure bilaterally for comparison, Use boney landmarks as a reference point

Light Touch

Mechanoreceptors in the Ventral (Anterior) Spinothalamic Tract

Which of the following is an example of an internal force commonly used when assisting patients with movement?

Muscular tension

May indicate gangrene

Necrotic

Pain perception

Nociceptors in the Lateral Spinothalmaic Tract

In which section of a SOAP note would you document a patient's blood pressure reading?

O

Which of the following is a component of a two-person patient lift from the wheelchair to the floor?

One clinician stands behind the patient, straddling the chair's drive wheel.

To minimize repositioning, where should a patient, who is about to lie down, sit on the edge of the bed?

One-third of the way down from the head of the bed

Which of the following statements is true regarding hand grip adjustment for an assistive device?

Optimal hand grip height should be confirmed during functional use of the assistive device.

What are hallmark signs of infection? Select ALL that apply.

Pain Erythema

May indicate anemia, shock, hemorrhage, nervousness

Pallor

Provides the greatest amount of stability for the patient in a standing position

Parallel Bars

While performing bed mobility with your 89 year old patient who recently had a left posterior THA, the student physical therapist (SPTA) noticed she was having some difficulty propping up on her elbows. The SPTA then assists her by placing their hand on her back to push her up. With the your assistance she was able to perform 75% of the task on her own. How could this be documented in the SOAP note?

Patient required MinA during bed mobility to prop on elbows

Which of the following statements regarding bed mobility activities is true?

Patients' movements are best controlled by applying forces centrally.

Which of the following supine positions would be MOST appropriate to prevent a contracture commonly associated with increased muscle tone following a stroke with left hemiparesis?

Place a pillow under the patient's left shoulder blade to promote scapular protraction.

A patient with lower-extremity paralysis has been working on transferring from the floor into his wheelchair and is experiencing difficulty secondary to upper extremity weakness. What can be done to make the transfer easier?

Place a stool in front of the wheelchair for the patient to move onto first.

Assuming a patient has adequate strength and range of motion, which of the following instructions should be provided for the MOST efficient forward propulsion using both hands?

Place both arms behind you (at approximately the 10 o'clock position on the pushrims).

Which of the following is the recommended method of standing up from a seated position with two axillary crutches?

Place both crutches on one side, grasp both hand grips with one hand, and push down on the hand grip and chair armrest to stand.

Which of the following is true regarding spinal alignment of the seated patient?

Poor alignment can lead to increased mechanical loading and pain.

Which of the following would be MOST effective in promoting stability during patient-care activities?

Position the LoG near the center of the BoS.

When assisting a patient with wheelchair fitting, which of the following is the FIRST goal in achieving postural stability?

Positioning the pelvis correctly

Which of the following considerations is appropriate when repositioning a patient upward in bed?

Positioning yourself beside the bed in a semilunge stance

Which of the following force-couple applications is LESS than optimal for patients to use when preparing to transition from sitting to standing?

Pushing the upper trunk into the back of the chair while sliding the pelvis forward

Which of the following assessment sites typically yields a temperature reading closest to a patient's core temperature?

Rectum

Which of the following legrests would be MOST appropriate for a sedentary and deconditioned 63-year-old man with a history of cancer who lives alone?

Removable swing-away leg rests

Your patient is a 43-year-old woman with multiple sclerosis who needs a wheelchair for occasional use, especially for locomotion over long distances. Her husband will push her during such trips. He will also put the chair in the car trunk for transportation. Which of the following is likely to be the most appropriate type of legrest for this patient?

Removable swing-away legrests

After treating a patient with contact precautions, what should be done after the treatment?

Remove the gloves by pulling one off with a gloved hand, and then slide the fingers of the exposed hand inside the other glove to remove it.

When working with a 64-year-old man who had a stroke resulting in right upper-extremity weakness, which of the following positions is BEST to decrease the patient's risk for developing edema in the right hand?

Right hand on a pillow, elevated higher than the heart, while the patient is supine

Which of the following measures for wheelchair fitting is best taken with the patient in the supine position?

Seat depth

In both squat-pivot and stand-pivot transfers, which of the following is the FIRSTtask that must be accomplished?

Shifting the patient's center of mass (CoM) forward over the pivot point

When working with a patient with severe thoracic kyphosis who fell and has a bruised right hip, which of the following positions would be BEST for inspecting the skin on her back?

Sidelying on her left side

When positioning the feet for a pivot transfer, which position is MOST appropriate for the inner foot?

Slightly forward to prevent obstruction

An 80-year-old patient who has sustained a right middle cerebral artery stroke with left-sided weakness needs to transfer from the bed to the wheelchair for the first time. Which of the following transfers would be MOST appropriate for this patient?

Squat-pivot transfer to the right side

Which of the following assistive devices can be used for a patient who is non-weight-bearing on one side because of a femoral fracture?

Standard "pick up" walker

Which of the following positions creates the greatest risk of injury to the clinician during a lateral supine transfer requiring the assistance of two or more people?

Standing beside the patient and leaning forward as the patient is moved laterally

A 60-year-old patient who has recently undergone total right knee arthroplasty is seated on a plinth with both feet resting on a stepstool. How should the patient be instructed to step down off the stepstool and onto the floor?

Step down first with the right foot.

Information provided by the patient to the SPTA as it relates to their status or functioning should be documented in which section of a SOAP note?

Subjective

Which section of the SOAP note would you document the patient's pain rating that they stated they had prior to treatment?

Subjective

When working with a 23-year-old man who has complete paralysis from a spinal cord injury, which of the following should be the PRIMARY factor to consider when making recommendations to the family about bed-to-wheelchair transfers?

The amount of help the patient requires for the transfer

Which of the following is involved in the setup for a sit-to-stand lift transfer?

The anterior aspects of the patient's lower legs are placed in contact with the leg pads.

Which of the following BEST describes center of mass (CoM)?

The balance point of an object

Your patient is a 15-year-old patient who has just had knee surgery following a volleyball injury, and you are fitting the patient with axillary crutches. Which of the following is the greatest risk for the patient if the axillary crutches are too tall?

The crutches will cause pressure in the axilla, potentially damaging nerves and vessels.

Your patient is a 15-year-old patient who is recovering from knee surgery following a volleyball injury, and you are fitting the patient with axillary crutches. Which of the following is the GREATEST risk for a patient if axillary crutches are too tall?

The crutches will cause pressure in the axilla, potentially damaging nerves and vessels.

Which of the following actions is MOST likely to result in the inability to detect Korotkoff sounds accurately during blood pressure assessment?

The cuff is not inflated enough.

To understand the fundamental principles of movement, it is MOST important to know which of the following?

The direction of force application

Which of the following can be used to estimate the appropriate length of axillary crutches while the patient is seated?

The distance between the fingertips of the patient's arm held out to the side and the elbow of the opposite abducted arm

Which of the following statements regarding bridging is true?

The ending position is one of nearly full hip extension.

Which of the following BEST describes an articulating legrest?

The footplate extends a few inches as the legrest is elevated.

When working with a 14-year-old girl who was in a motor vehicle accident and is now comatose in the intensive care unit (ICU), which of the following would be MOST appropriate to tell the family regarding appropriate positioning?

The inability to move independently makes her more vulnerable to skin breakdown.

A patient has right hip pain from osteoarthritis that is exacerbated with walking. Which hand would be MOST appropriate for the patient to use in handling a single-point cane?

The left hand

When transitioning from supine to sitting through sidelying, what is the advantage of moving both legs off the edge of the bed together?

The legs provide a counterweight to the upper body.

Which of the following is MOST strongly related to injuries sustained when assisting patients?

The number of repetitions of the task completed by the person

Which of the following patient situations would MOST likely indicate the need for a mechanical lift transfer?

The patient requires a level 3 transfer that does not involve a teaching component.

Which of the following strategies is MOST important to consider when teaching a patient to get up from the floor if a fall were to occur at home?

The patient's strength and range of motion

Which of the following is true of a sit-to-stand lift?

The sling for the sit-to-stand lift supports only the upper body.

Which of the following statements regarding seated transfer board use is true?

The transfer board can be used between surfaces of slightly different height.

Temperature

Thermoreceptors Lateral Spinothalamic Tract

Which of the following is true of rollator walkers?

They allow patients to walk with less energy expenditure than standard walkers.

When patients demonstrate generalized weakness, which of the following characteristics is commonly observed during their attempts at functional mobility?

They use flexion to replace extension.

A 19-year-old patient with paraplegia is preparing for discharge home from a rehabilitation unit. The patient does not understand why the clinician is teaching her to transfer from the wheelchair to the floor and back. Which of the following is the BEST explanation to give her?

This transfer is important for functional independence.

What is the MOST likely cause for a patient to develop atrophy while on a ventilator in the intensive care unit (ICU)?

Too little load applied to the tissues

A 48-year-old patient who fractured her pelvis has been using a sit-to-stand lift to transfer between the bed and the chair during therapy sessions. Which of the following would be the BEST option when beginning to work on standing tolerance with the patient?

Transfer her to standing in the sit-to-stand lift and work on standing tolerance in the device.

Proprioception and Kinesthesia are consider to be a deep sensation and travel through the dorsal column of the spine.

True

Which of the following is recommended to minimize risk of injury during a fall with crutches?

Turn the head to one side.

When considering the use of restraints, which of the following is true?

Using a device that the patient is able to release reduces the level of restrictiveness of a restraint.

Which of the following is MOST commonly experienced by a patient whose examination or intervention requires the removal of clothing?

Vulnerability

For a patient with right-leg weakness who is ascending a curb using a walker, which of the following sequences is MOST appropriate?

Walker, left foot, right foot

When determining which mobility procedures to use in patient care, what is the FIRST question that should be considered?

What am I trying to accomplish with the maneuver?

When is it MOST likely that a stepstool will be required for transfers between chairs and plinths?

When the table surface is above the patient's gluteal folds

Which of the following responses is consistent with culturally related concerns more common within Asian populations?

Women are uncomfortable with having their legs exposed during treatment.