Board exam questions incorrect

A physical therapist prepares to complete an assisted standing pivot transfer with a patient who requires moderate assistance. In order to increase a patient's independence with the transfer, which of the following instructions would be the MOST appropriate? 1."I want you to help me perform the transfer." 2."Try to utilize your own strength to complete the transfer." 3."Only grab onto me if it is absolutely necessary." 4."Pretend you were home alone and needed to complete the transfer."

"Try to utilize your own strength to complete the transfer." explains the exact expectations of the patient during the transfer

A patient sustains a deep partial-thickness burn to the anterior surface of the right upper extremity and a superficial partial-thickness burn to the anterior surface of the trunk. According to the rule of nines, the patient has burns over what percentage of total body surface area? 1.13.5% 2.22.5% 3.27.0% 4.36.0%

22.5% *upper extremity is only 9% total, so 4.5% for only anterior side

A physical therapist elects to use mechanical lumbar traction for a patient with low back pain. The therapeutic goal of the treatment is to decrease the patient's muscle spasm. What percentage of the patient's body weight is the MOST appropriate force for the therapist to utilize? 1.10% 2.15% 3.25% 4.50%

25% *50% is required for mechanical separation of the lumbar spine but this amount of force would be excessive for diminishing muscle spasm

A physical therapist educates a patient on how to apply a transparent film dressing to a wound located on the anterior surface of their thigh. What is the MOST appropriate distance of the dressing's border from the edge of the wound when using this type of dressing? 1. 10 millimeters 2. 1 centimeter 3. 3 centimeters 4. 6 centimeters

3 cm (minimum border of one inch required to cover wound and ensure that adherent used isn't on the wound bed)

A physical therapist treats a patient receiving supplemental oxygen using a nasal cannula with a flow rate of three liters per minute. Which value BEST approximates the percentage of oxygen delivered to the patient? 1.25% 2.29% 3.33% 4.37%

33% 1 liter/min = 25% O2 2 liter/min = 29% O2 3 liters/min = 33% O2 4 liters/min = 37% O2

A physician orders compression garments for a patient who is ambulatory but has significant difficulty with lower extremity edema. How much pressure would typically be necessary to control lower extremity edema? 1.10 mm Hg 2.18 mm Hg 3.25 mm Hg 4.35 mm Hg

35 mmHg

A physical therapist treats a patient with several injuries impacting the upper extremity including mallet finger. The therapist notes that the affected finger is immobilized using a static splint. Which position of the finger would be the MOST essential when splinting? 1.5 degrees of flexion at the distal interphalangeal joint 2.5 degrees of flexion at the proximal interphalangeal joint 3.5 degrees of hyperextension at the distal interphalangeal joint 4.5 degrees of hyperextension at the proximal interphalangeal joint

5 degrees of hyperextension at the DIP joint *allows tendon to heal in optimal position without becoming excessively lengthened *mallet finger: DIP hyperflexion

A patient who has infrapatellar tendonitis completes a series of functional activities. After completing the activities, the physical therapist instructs the patient to use ice massage over the anterior surface of the knee. What is the MOST appropriate treatment time in minutes? 1.3-5 2.5-10 3.10-15 4.15-20

5-10 minutes *ice massage is only 5-10 minutes

Prior to initiating an ultrasound treatment a physical therapist formally measures the target area as 12 cm2. Based on the therapist's measurements, what is the MOST appropriate size of soundhead to utilize during the treatment? 1.1 cm2 2.3 cm2 3.5 cm2 4.8 cm2

5cm2 *ultrasound can be administered to an area 2-3x the size of the transducer face

A patient with prediabetes is seen by their primary care physician every three months to review the results of their diabetes tests. The patient recently had a series of tests to determine if their condition has progressed to diabetes mellitus. Which of the following criteria is typically considered a positive result for diabetes mellitus? 1.Oral glucose tolerance test of greater than 140 mg/dL 2.Oral glucose tolerance test of less than 140 mg/dL 3.A1c test of greater than 6.5% 4.A1c test of less than 6.5%

A1c test of greater than 6.5% *positive test for oral glucose is more than 200 mg/dl

A physical therapist works with a patient post CVA on a therapeutic exercise program. The therapist assists the patient in lateral weight shifting activities while positioned in prone on elbows on a mat table. Which of the following facilitation techniques would BEST allow the patient to improve dynamic stability with this activity? 1.Alternating isometrics 2.Approximation 3.Rhythmic initiation 4.Timing for emphasis

Approximation *approximation is designed to facilitate contraction and stability through joint compression; compression force is most often applied to joints through gravity acting on body weight, manual contacts, or weight belts

A physical therapist observes thenar atrophy when examining a patient's hand. In the absence of other relevant findings, this could BEST be explained by which of the following conditions? 1.C8 nerve root lesion 2.Paralysis of the interossei 3.Radial nerve lesion 4.Ulnar nerve lesion

C8 nerve root lesion - can cause the only finding of thenar atrophy *others cause additional findings

A physical therapist reviews the results of a patient's laboratory testing and notices the erythrocyte sedimentation rate was normal. Which medical condition would typically produce this finding? 1.Duchenne muscular dystrophy 2.Hodgkin's lymphoma 3.Systemic lupus erythematosus 4.Polymyalgia rheumatica

DMD

A physical therapist reviews a physician referral form that includes only the patient's name and the referring physician's signature. During the examination, the patient indicates that they had knee surgery two weeks ago, however, is unable to provide more specific details. The therapist attempts to call the physician's office, but is unable to reach anyone. Which of the following actions is the MOST appropriate for the therapist to take? 1.Initiate treatment based on the results of the examination 2.Initiate treatment based on an established protocol following knee surgery 3.Initiate treatment, however, avoid resistive exercises and high-level functional activities 4.Delay treatment until orders are received from the referring physician

Delay treatment until orders are received from the referring physician

A physical therapist attempts to identify a patient's risk factors for coronary artery disease as part of a health screening. The patient's heart rate is recorded as 78 beats per minute and blood pressure as 110/70 mm Hg. Laboratory values indicate a total cholesterol level of 170 mg/dL with high-density lipoproteins reported as 20 mg/dL and low-density lipoproteins as 110 mg/dL. Which of these values would be considered atypical? 1.Heart rate 2.Blood pressure 3.High-density lipoproteins (HDL) 4.Low-density lipoproteins (LDL)

HDL *LDL normal is below 100 or 100-129 (near optimal)

A physical therapist prepares to treat a patient with limited elbow and forearm range of motion. When mobilizing the humeroradial articulation, which of the following statements BEST represents the appropriate treatment plane? 1.In the concave radial head, parallel to the long axis of the radius 2.In the concave radial head, perpendicular to the long axis of the radius 3.In the convex radial head, parallel to the long axis of the radius 4.In the convex radial head, perpendicular to the long axis of the radius

In the concave radial head, perpendicular to the long axis of the radius

A physical therapist inspects a patient's wheelchair and identifies that the wheel axle is aligned further posterior than it typically would be in a standard wheelchair. This type of alignment would MOST likely result in which of the following outcomes? 1.Decreased rolling resistance 2.Increased ability to balance on the rear wheels 3.Decreased turning radius 4.Increased energy required for propulsion

Increased energy required for propulsion *axle moved anterior would lead to increased ability to balance on rear wheels and decreased turning radius

A physical therapist works with a six-year-old patient with hip pathology. Which condition would be the MOST likely based on the patient's age? 1.Apophysitis 2.Legg-Calve-Perthes disease 3.Rheumatoid arthritis 4.Slipped capital femoral epiphysis

Legg-Calve Perthes disease *degeneration of femoral head due to avascular necrosis with peak incidence between 5-7 years of age and more common in boys *SCFE is pre-adolescent age

A physical therapist recommends a wheelchair for a patient post CVA with the goal of independent mobility. The left upper and lower extremities are flaccid and present with edema. There is Normal (5/5) strength on the right, however, the patient's trunk is hypotonic. The patient is cognitively intact. Which of the following wheelchairs is the MOST appropriate for this patient? 1.Solid seat, solid back, elevating legrests, and anti-tippers 2.Sling seat, sling back, arm board, and elevating legrests 3.Light weight, solid seat, solid back, arm board, and elevating legrests 4.Light weight, solid seat, solid back, arm board, and standard footrests

Light weight, solid seat, solid back, arm board, and elevating legrests

. A patient is seen by a physical therapist after being diagnosed with patellofemoral pain syndrome. As part of the session, the patient describes a number of exercises that they were instructed to perform by their personal trainer. Which of the following exercises would be the MOST likely to exacerbate the patient's symptoms? 1.Terminal knee extension in standing 2.Mini-squats from 0-30 degrees of knee flexion 3.Long arc quads from 0-45 degrees of knee flexion 4.Quadriceps setting in terminal knee extension in supine

Long arc quads from 0-45 degrees of knee flexion patellofemoral joint forces greatest during: 0-90 degrees of open chain exercises 90+ degrees of closed chain (safe side is stay below 30/45 degrees)

A patient with chronic edema in the extremities is told that they have a form of primary lymphedema. Which of the following conditions is an example of primary lymphedema? 1.Filariasis 2.Mastectomy 3.Milroy's disease 4.Lymphadenitis

Milroy's disease *primary lymphedema occurs due to abnormal development of lymphatic system whereas secondary lymphedema is a result of some disease or injury to the lymphatic system *filariasis and mastectomy are secondary lymphedema *lymphadenitits is infection of lymph node but not lymphedema

when performing neural tension testing to the lower limb, which ankle position when combined with SLR will best bias the deep fibular nerve? 1. DF and eversion 2. DF and inversion 3. PF and eversion 4. PF and inversion

PF and inversion *tibial nerve = DF+EV *sural nerve =DF+INV

what would a therapist who is examining the breathing pattern of a patient with a complete (ASIA A) C5 SCI expect to observe? 1. asymmetric lateral costal expansion 2. increased subcostal angle to to air trapping from muscle weakness 3. no diaphragmatic motion since the diaphragm is below the level of the lesion 4. Rising of the abdomen due to no abdominal muscle tone on the abdominal viscera

Rising of the abdomen due to no abdominal muscle tone on the abdominal viscera - viscera displaced due to lack of external stability. *diaphragm is C3-5 *air trapping would be obstructive disorder and SCI muscle weakness is a restrictive disorder

A physical therapist completes a respiratory assessment on a patient with T2 paraplegia. As a component of the assessment, the therapist measures the amount of chest excursion during inspiration. Which position is the MOST appropriate for the therapist to place the patient in to conduct the measurement? 1.Sitting 2.Supine 3.Prone 4.Sidelying

Supine *supine creates support and resistance to the diaphragm; there is a direct correlation between amount of chest expansion and intercostal strength *sitting is more challenging position that can be progressed to after supine *prone is not recommended for spinal cord injury patients *measurement wouldn't work in sidelying since one side of thorax would be supported

PT examining patient who is complaining of pain in L shoulder region. Examination of shoulder elicits pain in last 30 degrees of shoulder abduction ROM. This finding matches what diagnosis? 1. calcific supraspinatus tendinitis 2. subacromial bursitis 3. AC sprain 4. thoracic outlet syndrome

acromioclavicular sprain - pain at extreme AROM *subacromial bursitis and supraspinatus tendon would be painful arc: 60-120

A physical therapist treats a patient with a peroneal tendon subluxation. To observe the subluxation, which of the following motions is the MOST appropriate to reproduce the subluxation? 1.Active ankle plantar flexion and inversion 2.Active ankle dorsiflexion and eversion 3.Passive ankle plantar flexion and inversion 4.Passive ankle dorsiflexion and eversion

active ankle DF and eversion *reproducing subluxation more successful with active motion; motion the muscle does will lead to subluxation (peroneus longus and brevis are strong everters)

Following reattachment of flexor tendons of the fingers, the patient is in a splint. One PT goals is to minimize adhesion formation. What should the PT teach the patient to perform after 72 hours post-surgery 1. passive extension and active flexion of IP joints 2. active extension and flexion of IP joints 3. active extension and passive flexion of IP joints 4. gentle passive extension and flexion of IP joints

active extension and passive flexion of IP joints *no active flexion should occur for first 3 weeks; no passive extension should occur until there is adequate strength of the repair *need to wait 48-72 hours to initiate any ROM

A patient presents to outpatient physical therapy with reports of shoulder pain. The patient has a history of chronic shoulder dislocations that she is able to self-reduce. The last occurrence was six months ago. Upon evaluation, the physical therapist notes excessive motion and pain at end range in all directions. What would be the MOST appropriate initial treatment technique for this patient? 1. alternating isometrics with arm at side 2. rhythmic stabilization in supine with arm at 90 degrees of flexion 3. light resistance exercise through full active range in all directions as tolerated 4. contract relax techniques

alternating isometrics with arm at side *Alternating isometrics are utilized to increase joint stability by strengthening the agonists and antagonists of a movement. Having the arm in neutral is the most stable position with which to start. *Though rhythmic stabilization is effective for improving joint stability, it is more advanced than alternating isometrics, especially with the humerus at 90 degrees of flexion. This may not be best for an initial treatment. *Strengthening through the full active range of motion is not indicated since the patient is hypermobile, and the patient should not complete resistance training into the painful end range.

capsular tightness has limited a patient's ability to fully extend the left knee. What joint mobilization technique should be used to restore joint motion? 1. anterior glide and ER of tibia 2. anterior glide and IR of tibia 3. posterior glide and ER of tibia 4. posterior glide and IR of tibia

anterior glide and ER of tibia *concave on convex = same roll and glide for tibia on femur

damage as a result of a salter-harris type IV supracondylar humeral epiphyseal fracture will most likely result in what consequence? 1. refracture at future time 2. nonunion 3. arrested growth 4. severing of the radial nerve

arrested growth *type IV goes through all 3 elements of bone *nonunion is not common in kids in general

A physical therapist examines the abdomen of a patient with suspected referred shoulder pain from the viscera. Which examination component should be assessed FIRST? 1.Superficial palpation 2.Deep palpation 3.Percussion 4.Auscultation

auscultation *order: auscultation -> palpation -> percussion if don't do auscultation first the sounds may be altered due to palpation/percussion movement

A physical therapist is treating a patient that has been prescribed levodopa. The patient has been taking the drug as directed for two weeks. Which physical therapy intervention would be MOST affected secondary to the potential negative side effects of the prescribed medication? 1.Balance activities 2.Strengthening activities 3.Range of motion activities 4.Endurance activities

balance activities *patients experience orthostatic hypotension and lightheadedness

A patient recently visited a podiatrist and was told to purchase a heel lift for one of their shoes. Which of the following conditions would be the LEAST likely to benefit from the use of a heel lift? 1.True leg length discrepancy 2.Achilles tendonitis 3.Achilles tendon repair 4.Calcaneal bone spur

calcaneal bone spur (requires a heel cushion instead of a heel lift *following achilles repair, will allow for initial reduced stress on tendon

Patient recovering from stroke walks with limited tibial advancement during stance on more affected lower extremity. Therapist examines the patient for a compensatory gait deviation, which is most likely 1. trendelenberg 2. circumduction 3. exaggerated flexion synergy 4. exaggerated extension synergy

circumduction

A patient has a stage IV pressure ulcer over the right greater trochanter. The wound bed is 75% granular and 25% slough. Which of the following dressings will most effectively reduce the slough? 1. wet to dry dressing 2. hydrofiber 3. collagenase 4. hydrogel

collagenase (enzymatic debrider that decreases amount of slough) *can't use wet to dry dressing because it would decrease the granulation tissue too *hydrofiber used to remove exudate *hydrogel used to moisten wound

A patient diagnosed with multiple sclerosis uses extensor tone to assist them to successfully complete a sit to stand transfer. Which pharmacological agent would MOST limit the patient's ability to complete the transfer? 1.Calcium carbonate 2.Dantrolene sodium 3.Levodopa 4.Secobarbital

dantrolene sodium (post-synaptic muscle relaxant: used to treat spasticity)

A physical therapist treating a four-year-old child with cerebral palsy decides to utilize sustained positioning through lower extremity casting. What is the PRIMARY goal of this intervention? 1.Increased standing tolerance 2.Increased core stability 3.Decreased hypertonicity 4.Decreased dependent edema

decreased hypertonicity *design of cast integrates pressure points to decrease tone and diminish influence of spasticity

A patient presents with ape hand deformity due to a peripheral nerve injury. Which of the following findings would MOST likely be noted during examination of the patient? 1.Decreased strength with thumb opposition 2.Fixed flexion of the metacarpophalangeal joints 3.Fixed hyperextension of the metacarpophalangeal joints 4.Wasting of the hypothenar eminence

decreased strength with thumb opposition

what is one of the first signs of right ventricular failure? 1. paroxysmal nocturnal dyspnea 2. exertional dyspnea 3. pulmonary edema 4. dependent edema

dependent edema *left ventricular failure would be pulmonary edema

Therapist is treating patient with TMJ disorder, Patient has history of jaw clicking upon opening and closing the mouth, but the noises are now gone. current complaint is inability to open mouth wide and difficulty performing functional jaw movements such as chewing and yawning. What is the most likely cause? 1. capsular fibrosis 2. TMJ subluxation 3. chronic TMJ osteoarthritis 4. disc displacement without reduction

disc displacement without reduction

patient has a BMI of 32 kg/m with excessive tissue mass in hip area. What accommodations are needed to make the wheelchair prescription for this patient? 1. move the small front casters closer to the drive wheels to increase stability 2. add friction rims to increase handgrip function 3. add antitipping device to prevent falls going up curbs 4. displace rear axle forward for more efficient arm push

displace rear axle forward for more efficient arm push -moving front casters closer would decrease stability -anti tippers and friction rims are for spinal cord patients

A physical therapist is performing gait training with a patient post transtibial amputation. After 15 minutes of training, the patellar tendon-bearing prosthesis is removed and the skin is inspected. Redness is noted on multiple areas of the residual limb. Which area of redness should be the GREATEST concern? 1.Patellar tendon 2.Fibular shaft 3.Gastrocnemius muscle 4.Distal anterior tibia

distal anterior tibia - only area that is not pressure tolerant (is pressure sensitive)

vertebral artery test is being performed (supine, head off table, extension, lateral flexion, and ipsilateral rotation) with position maintained for 30 seconds. Which of the following indicates a positive test? 1. sensory changes occur in face along with visual changes 2. dizziness or nystagmus occurs, indicating that the opposite side artery is being compressed 3. hearing difficulties and facial paralysis occur 4. dizziness or nystagmus occurs, indicating that the same side artery is being compressed

dizziness or nystagmus occurs, indicating that the OPPOSITE side artery is being compressed

during examination of a patient with degenerative osteoarthritic changes in the carpometacarpal joint of the right thumb, the PT notes a 20 degree loss of thumb palmar abduction. what translatory joint play motion is associated with thumb palmar abduction and should be examined? 1. dorsal translation of metacarpal on trapezium 2. palmar translation of metacarpal on trapezium 3. ulnar translation of metacarpal on trapezium 4. radial translation of metacarpal on trapezium

dorsal translation of metacarpal on trapezium *palmar abduction if convex on concave (dorsal roll required)

PT examining patient with history of TBI who just started taking oral baclofen to manage their spasticity. What is a common side effect? 1. drowsiness 2. dry mouth 3. liver toxicity 4. respiratory depression

drowsiness *dry mouth side effect of tizanidine (another spasticity medication) *liver toxicity is side effect of dantrolene sodium (another spasticity medication)

A patient diagnosed with ankylosing spondylitis reports progressive stiffening of the spine and associated pain for more than five years. Which of the following descriptions best represents the patient's MOST typical and anticipated standing posture? 1.Posterior thoracic rib hump 2.Flattened lumbar curve, exaggerated thoracic curve 3.Excessive lumbar curve, flattened thoracic curve 4.Lateral curvature of the spine with fixed rotation of the vertebrae

flattened lumbar curve with exaggerated thoracic curve

An individual presents to the clinic with a report of dull, achy pain along the low back and tingling into the right foot. The patient feels most comfortable in sitting position and has difficulty standing for long periods of time or lying in prone. Dermatomal testing reveals diminished sensation along the big toe on the right. The physical therapist notes fatiguing weakness along the extensor hallicus longus on the right. Repeated motion testing reveals improvement in all symptoms with repeated flexion, and an increase in low back pain with repeated extension. Which of the following medical diagnoses should the physical therapist MOST likely suspect? 1. central stenosis 2. herniated nucleus pulposus 3. foraminal stenosis 4. retrolisthesis

foraminal stenosis *herniated disc would improve with extension, while foraminal stenosis improves with flexion

A physical therapist examines the foot of a patient with lower extremity pain. After placing the foot in subtalar neutral, the therapist determines that the medial border of the foot along the first metatarsal is higher than the lateral border of the foot along the fifth metatarsal. This position would MOST appropriately be documented as which of the following malalignments? 1.Forefoot varus 2.Forefoot valgus 3.Rearfoot varus 4.Rearfoot valgus

forefoot varus

A physical therapist is treating a man with type 1 diabetes who is in cardiac rehabilitation. Prior to the session, the patient's serum glucose reading is 55 mg/dL. Which of the following is the MOST appropriate course of action? 1. ask patient when he last took insulin 2. instruct patient to begin exercise program 3. give patient 4 oz of juice 4. wait 5 min and then have patient recheck glucose level

give patient 4 ounces of juice *normal fasting glucose is 70mg/dl-100mg/dl; 55mg/dl needs carbohydrate before exercise to rise glucose level to above 100mg/dl

During gait analysis, PT notes patient is lurching backward during stance phase. What is the cause of this compensatory motion? 1. gluteus medius weakness 2. hip and knee flexion contractures 3. quad weakness 4. glute maximus weakness

gluteus maximus weakness -leaning backward during loading response inclines ground reaction force vector posteriorly which passes hip joint axis laterally and makes moment arm shorter, producing small hip flexor moment

A physical therapist treats a patient wearing a shoe that incorporates a rocker bottom. This type of modification would be the MOST beneficial for a patient diagnosed with which of the following conditions? 1.Achilles tendonitis 2.Hallux rigidus 3.Plantar fasciitis 4.Posterior tibial tendonitis

hallux rigidus rocker bottom shoes have thicker than normal sole with rounded heel which reduces the function or replaces the lost function of a joint, relives metatarsal pain, shortens gait cycle, or assists with dorsiflexion

A physical therapist makes footwear recommendations for a patient with foot pathology. The recommendations include a high and wide toe box, small to no heel, medial arch support, and a contoured posterior counter. This type of shoe prescription would be the MOST beneficial for a patient diagnosed with which of the following conditions? 1.Sesamoiditis 2.Hallux valgus 3.Pes cavus 4.Metatarsalgia

hallux valgus *need high and wide toe box to reduce friction and pressure on first MTP *need medial support to decrease pronation *need reduced heel height to decrease forefoot pressure *contoured posterior counter of shoe better controls subtalar joint

A physical therapist treats a patient diagnosed with posterior tibial tendon dysfunction. When observing the posterior aspect of the patient's lower leg and ankle in standing, which of the following findings is the MOST probable for the therapist to observe? 1.Forefoot adduction 2.Hindfoot valgus 3.Hypertrophy of the gastrocnemius 4.Swelling in the lateral ankle region

hindfoot valgus

patient with crush injury to foot appears to be developing CRPS. What are some early signs of condition? 1. worsening pain with edema and atrophic skin and nail changes 2. cool, dry, and cyanotic skin with thickened fascia and developing contracture 3. hyperalgesia, allodynia, and hyperpathia 4. muscle atrophy, osteoporosis, and developing anklyosis

hyperalgesia, allodynia, and hyperpathia *additional: edema, increased sweaty, thin and shiny skin *atrophic skin changes are later on (stage 2) and the other 2 answer choices are even later (stage 3)

A patient's medical chart indicates that a patient has a lesion in the posterior portion of the spinal cord. Which of the following impairments would MOST likely be observed? 1.Inability to determine joint position 2.Inability to distinguish between hot and cold 3.Inability to distinguish between sharp and dull 4.Inability to feel light touch

inability to determine joint position sense *proprioception damaged through dorsal column medial lemniscus pathway *sensation of feeling touch transmitted through anterolateral spinothalamic tract; if patient was asked to locate the touched area that would come through the dorsal column medial lemniscus pathway

A physical therapist reviews the results of recent laboratory testing before treating a patient. A note in the medical record indicates that the patient was dehydrated at the time the blood sample was taken. Which of the following findings would be the MOST likely based on the patient's hydration status? 1.Increased coagulation time 2.Decreased hematocrit level 3.Increased blood urea nitrogen level 4.Decreased hemoglobin level

increased blood urea nitrogen level *indicates dehydration, renal failure, or heart failure -increased coagulation time not impacted by hydration -hematocrit: increases when dehydrated -hemoglobin: increases with dehydration

therapist examining gait of patient with transfemoral prosthesis and patient circumducts the prosthetic limb during swing. the therapists needs to identify the cause of gait deviation - what is the most likely prosthetic cause 1. unstable knee unit 2. inadequate socket flexion 3. high medial wall or abducted hip joint 4. increased knee flexion resistance

increased knee flexion resistance *high medial wall or abducted hip joint = abducted gait not circumduction

what will a patient with significant right thoracic structural scoliosis demonstrate on examination? 1. decreased breath sounds on the right 2. decreased throracic rib elevation on the right 3. increased lateral costal expansion on the right 4. shortened internal and external intercostals on the right

increased lateral costal expansion on the right -allows for increased aeration and mobility on that side *right scoliosis = convex side on right (name based on side of convex curve) *ribs would elevate normally on right side *other answer options would be true if on left side - concave side will have shortened intercostals and decreased breath sounds

A physical therapist is evaluating a patient with left foot pain when walking. The patient has a history of arthritis. During examination of gait, the therapist finds excessive pronation during mid stance through terminal stance. This gait deviation is caused by which of the following? 1. pes cavus of foot 2. plantar flexed first ray 3. limited calcaneal eversion 4. insufficient ankle dorsiflexion (less than 10 degrees)

insufficient ankle dorsiflexion *all other options lead to excessive supination of the foot

A physical therapist treats a patient with a wound impacting the epidermis of the skin. Which structure would be the MOST affected based on the described wound? 1.Arrector pili muscles 2.Meissner's corpuscles 3.Melanocytes 4.Sebaceous glands

melanocytes

A patient with atrial fibrillation is taking a type II antiarrhythmic medication that reduces sympathetic nervous system input to the cardiac muscle. Which of the following medications is MOST likely being prescribed? 1. Diltiazem (Cardizem) 2. Ibutilide (Corvert) 3. Metroprolol (Lopressor) 4. Propafenone (Rythmol)

metroprolol (Lopressor) - betablockers are Class II *Class I = sodium channel blockers - Propafenone (Rythmol) *Class III: potassium channel blockers - Ibutilide (Corvert) *Class IV: calcium channel blockers - Diltiazem (Cardizem)

A physical therapist attempts to utilize a functional activity as a method to increase a patient's limited wrist passive range of motion due to shortened wrist flexors. Which position would be the MOST appropriate to utilize to achieve the stated objective? 1. Semi-Fowler's 2.Modified plantigrade 3.Ring sitting 4.Pivot prone

modified plantigrade

patient with chronic asthma has been admitted to hospital for acute exacerbation. What is the most important info the therapist needs in order to determine patient's prognosis with PT? 1. current medication list 2. previous history of disease 3. most recent chest xray 4. most recent pulmonary function test results

most recent pulmonary function test results -only option that shows patients current functional level

Strengthening of lateral pterygoid, anterior head of digastric muscle, and suprahyoid muscles would be most beneficial intervention to improve which of the following? 1. mouth closing 2. mouth opening 3. mouth protrusion 3. mouth retrusion

mouth opening

A patient is referred to physical therapy with a diagnosis of carpal tunnel syndrome. The patient is scheduled for a diagnostic test that may help to confirm the diagnosis. Which of the following electrodiagnostic tests would be the MOST appropriate? 1.Electroencephalography 2.Evoked potentials 3.Nerve conduction velocity 4.Electromyography

nerve condition velocity *measures the speed by which an action potential travels down a peripheral nerve and can be used to diagnose carpal tunnel, GBS, and peripheral neuropathy *evoked potential: electrical activity recorded after a stimulus to determine how quickly signals reach the brain (used to diagnose MS) *electromyography: recording of muscle electrical activity (diagnose nerve injuries and neuromuscular disorders)

Following an MVA, a patient with chest trauma developed atelectasis. which intervention is ineffective in immediate management of atelectasis? 1. pain reduction techniques 2. segmental breathing 3. incentive spirometry 4. paced breathing

paced breathing -patient needs technique to facilitate depth of breathing - paced breathing controls the rate of breathing and not the depth

The physical therapist is completing a physical examination in a patient with a suspected visceral disorder. The therapist uses sound to screen the abdomen to determine size, shape, and density of tissue. Which component of the physical exam of the abdomen is being completed? 1. auscultation 2. percussion 3. inspection 4. palpation

percussion *used to determine size, shape and density of tissue using sound and vibration *auscultation is for bowel sounds in abdomen (can't provide info on size, shape, or density)

A patient who has left hemiplegia post CVA is referred for orthotic examination. Significant results of manual muscle testing include: hip flexion 3+/5, hip extension 3/5, knee flexion 3+/5, knee extension 3+/5, ankle dorsiflexion 2/5, and ankle inversion and eversion 1/5. Sensation is intact and no abnormal tone is noted. Which of the following orthoses is the MOST appropriate for this patient? 1.Knee-ankle-foot orthosis with a locked knee 2.Plastic articulating ankle-foot orthosis 3.Metal upright ankle-foot orthosis locked in neutral 4.Prefabricated posterior leaf spring orthosis

plastic articulating AFO *metal AFO prescribed in patient has fluctuating one or a sensory deficit *posterior leaf spring would not give this patient enough stability *KAFO appropriate if patient had no voluntary knee control

A physical therapist completes a respiratory assessment on a patient in an acute care hospital. The examination reveals decreased breath sounds and decreased fremitus. This finding is MOST indicative of which of the following medical conditions? 1.Pleural effusion 2.Pulmonary edema 3.Consolidation 4.Atelectasis

pleural effusion *fremitus: vibration detected through chest wall *atelectesis, pulmonary edema, and consolidation all cause decreased breath sounds, but increased fremitus

During a balance assessment of a patient with left hemiplegia, it is noted that in sitting the patient requires minimal assistance to maintain the position and cannot accept any additional challenge. What grade should the physical therapist use to document this patient's sitting balance? 1.Normal 2.Good 3.Fair 4.Poor

poor: patient unable to maintain balance in sitting without external support

A patient post total hip arthroplasty using a posterolateral surgical approach experiences hip instability. Which finding would BEST explain the reason for the hip instability? 1.Trabecular bone erosion 2.Femoral nerve paralysis 3.Posterior capsule damage 4.Hip abductor weakness

posterior capsule damage *surgery penetrates the posterior capsule so there is an increased risk of disclocation (reason why no flexion, adduction, IR) *advantage of posterolateral surgical approach is that hip abductors remain intact

Following an athlete's baseball season, the individual presents to physical therapy with a report of stiffness when trying to fully extend the elbow. Examination of range of motion (ROM) reveals a limitation both actively and passively with elbow extension. Which joint mobility assessment should the physical therapist perform at the humeroradial joint to determine if hypomobility is limiting the ROM? 1. anterior glide at radial head 2. posterior glide at radial head 3. medial glide at radial head 4. lateral glide at radial head

posterior glide at radial head *same roll/glide (concave on convex)

TO prevent max compressive forces being placed on the patella, a therapist should minimize placing the patient in which position? 1. prone and flexing knee to 30 degrees 2. sitting position with knee flexed to 90 degrees 3. supine and flexing both hip and knee to 110 degrees 4. prone and flexing knee to 110 degrees with hip extended

prone and flexing knee to 110 degrees with hip extended -position will lengthen rectus femoris = increase compressive forces

therapist doing mechanical lumbar traction on patient with posterior herniated nucleus pulposus at L2-3. if tolerated by the patient, what is the best position for applying this treatment? 1. prone with no pillow 2. prone with pillow under hips and abdomen 3. supine with hips and knees flexed to 45 degrees 4. supine with hips and knees flexed to 90 degrees

prone with no pillow under hips or abdomen - allows for neutral/extended spine: need for seperation of vertebral bodies without causing excessive stress on posterior structures

what is an acceptable modified position to drain posterior basal segment of left lower lobe in patient with pulmonary congestion? 1. sidelying on right, with a pillow under the right hip and bed flat 2. prone with pillow under hips and the bed flat 3. sidelying on right with pillow between legs and foot of bed elevated 18 inches 4. prone with pillow under hips and head of head elevated 18 inches

prone with pillow under hips and the bed flat

A physical therapist prepares to treat a patient with cystic fibrosis using postural drainage. Which of the following patient positions is the MOST appropriate when treating the superior segments of the lower lobes? 1.Sitting, leaning back at a 30-40 degree angle 2.Head down on left side, 1/4 turn backward 3.Supine with two pillows under the knees 4.Prone with two pillows under the hips

prone with two pillows under hips

A physical therapist evaluates a client who suffered a complete spinal cord injury. The client can demonstrate full motion with moderate resistance in elbow flexion/extension, forearm pronation/supination, wrist flexion/extension, finger flexion/extension, and thumb flexion/extension/abduction. The highest level of manual wheelchair activities the client will be able to perform is to: 1. propel independently on all indoor and outdoor surfaces 2. propel independently on all indoor surfaces and level outdoor terrain 3. propel independently on all indoor surfaces and some to total assist on outdoor surfaces 4. propel independently to some assist indoors on non carpet, level surfaces; some to total outdoor assist

propel independently on all indoor surfaces and level outdoor terrain *this person has a C7-C8 injury *independent on all indoor and outdoor surfaces would be T1-9 injury

An elderly patient with hypothyroidism is recovering from a fall and is referred to PT to increase exercise tolerance and safety. Patient complains to therapist of significant muscle pain in both lower extremities. What additional MS effects should therapist examine for? 1. distal muscle weakness 2. proximal muscle weakness 3. Joint laxity 4. decreased DTR

proximal muscle weakness hypothyroidism can cause myalgia, proximal muscle weakness, stiffness, and prolonged deep tendon reflexes

A physical therapist inspects the static wrist and hand position of a patient who has advanced rheumatoid arthritis. Which positioning would MOST likely be observed based on the medical diagnosis? 1.Radial deviation of the radiocarpal joint and radial deviation of the fingers 2.Radial deviation of the radiocarpal joint and ulnar deviation of the fingers 3.Ulnar deviation of the radiocarpal joint and radial deviation of the fingers 4.Ulnar deviation of the radiocarpal joint and ulnar deviation of the fingers

radial deviation of radiocarpal joint and ulnar deviation of the fingers *radiocarpal joint has loss of joint space

A physical therapist reviews the medical record of a patient who has atrial flutter. Which characteristic of atrial flutter BEST differentiates this condition from atrial fibrillation? 1.The regularity of the atrial rhythm 2.The irregularity of the atrial rhythm 3.The rapid rate of atrial depolarization 4.The slow rate of atrial depolarization All C

regularity of atrial rhythm *heart beats fast but very regularly, in atrial fibrilation it is irregular

A 13-year-old patient diagnosed with juvenile rheumatoid arthritis experiences an acute exacerbation of their condition. The physical therapist recommends a custom splint in order to prevent a knee flexion contracture. Which type of splint is the MOST appropriate to support this goal? 1.Functional 2.Dynamic 3.Resting 4.Serial

resting (maintains joint in appropriate position during acute exacerbation of symptoms, allowing the joint to rest while limiting risk of contractures)

A physical therapist works on therapeutic positioning with a patient who has chronic pulmonary disease. The patient has significant weakness of the diaphragm and is hypertensive. Which of the following positions is the MOST appropriate to initiate treatment? 1.Prone 2.Supine 3.Trendelenburg 4.Reverse Trendelenburg

reverse trendelenberg (head higher than feet) *reduces weight of abdominal contents on diaphram and reduces hypertension

A physical therapist examines a patient who reports morning stiffness of their hands and visible swelling. The patient indicates that the stiffness seems to diminish with activity. This description would MOST likely be associated with which of the following conditions? 1.Carpal tunnel syndrome 2.Osteoporosis 3.Rheumatoid arthritis 4.Osteoarthritis

rheumatoid arthritis *patients with OA experience increase in pain and stiffness with activity

A physical therapist observes an infant exhibiting a high guard position when sitting. Which of the following muscles would be the MOST essential for the infant to maintain this position? 1.Pectoralis major 2.Rhomboids 3.Serratus anterior 4.Lower trapezius

rhomboids *adducting the scapula helps with maintaining upright posture *high guard position: arms near shoulder height with retraction of scapula

patient recovering from surgery to remove a cerebellar tumor presents with pronounced ataxia and problems with standing balance and postural stability. To help improve this situation, what would be best approach to incorporate in the intervention? 1. lower extremity splinting and light touch down hand support 2. rhythmic stabilization during holding in kneeling 3. perturbed balance activities while standing on carpet 4. stabilizing reversals during holding in sidelying

rhythmic stabilization during holding in kneeling *high kneeling position is good choice for beginning with person who has severe ataxia - COM lowered, posture upright, BOS increased, degrees of freedom reduced

which of these findings is characteristic of a boutonniere deformity of the finger 1. flexion of DIP joint 2. contracture of extensor digitorum tendon 3. rupture with volar slippage of lateral bands 4. hyperextension of PIP joint

rupture with volar slippage of lateral bands -extension of MCP and DIP, with PIP flexion (due to FDP tendon being unopposed)

A physical therapist reviews the medical record of a patient who recently had a "long" spinal fusion. Which medical condition would MOST likely require this type of surgical procedure? 1.Ankylosing spondylitis 2.Scoliosis 3.Spinal disk herniation 4.Spinal segment instability

scoliosis (long fusion with Harrington rod)

A patient with a T3 spinal cord injury exercising on a treatment table in the supine position begins to exhibit signs and symptoms of autonomic dysreflexia, including a dramatic increase in blood pressure. Which of the following actions should be the MOST immediate to address the patient's blood pressure response? 1.Elevate the patient's legs 2.Call for assistance 3.Sit the patient upright 4.Check the urinary drainage system

sit the patient upright should sit upright to reduce elevated BP then check the catheter

A physical therapist treats a patient with mechanical lumbar traction in the supine position with the hips and knees flexed and the lower legs resting on a stool. This position would be MOST appropriate to treat a patient diagnosed with which of the following conditions? 1.Spinal stenosis 2.Herniated disk 3.Osteoporosis 4.Spondylolisthesis

spinal stenosis *best treated in flexion since this maximizes opening of the intervertebral foramen *prone positioning would be best for disc herniation

A patient status post left total hip replacement complains of difficulty moving, swelling, and sensory changes in the left lower extremity. During palpation, the therapist notes skin fibrosis and skin pitting in various areas of the extremity. Skin mobility is decreased, and skin texture is brawny. The legs are of unequal size, with the left being significantly larger. When the limb is elevated, the edema does not dissipate. The dorsum of the second toe elicits a positive Stemmer sign. The therapist is correct in documenting that the patient is in which of the following stages of lymphedema? 1. stage 0 2. stage 1 3. stage 2 4. stage 3

stage 2 *edema present but doesn't dissipate with elevation (stage 1 dissipates with elevation), palpation positive for fibrosis and has pitting (stage 3 doesn't have pitting)

Patient who has been training for marathon for 3 weeks reports deep ache in right knee that has not improved with cold packs. Radiograph of right knee does not show a fracture. PT notes tenderness to palpation over tibial plateau. Upon examination, patient has full pain free AROM. Which of following conditions is most likely the cause of the pain? 1. bursitis 2. muscle strain 3. stress fracture 4. Tendonitis

stress fracture *common in distance runners with increased training; AROM doesn't reproduce pain but palpation over fracture sign can reveal tenderness; xrays don't always show stress fractures *not tendonitis because pain would be produced with ROM and cold modalities should relieve pain

PT is instructing family of a 9 year old boy with DMD. What should be the main focus of the plan of care for maintaining function in the lower extremities? 1. strengthening knee extensors and plantarflexors 2. strengthening the PF and stretching hip extensors 3. stretching hip flexors and PF 4. strengthening hip flexors and knee extensors

stretching hip flexors and plantarflexors -contractures of hips, knees, plantar flexors and IT band are common (main focus is to prevent this, as well as maintain ADLs, family education, and positioning) *strengthening may cause breakdown of muscle fibers and not be safe (although low rep AROM is safe)

Following a period of spinal shock, a patient with complete spinal cord injury at T5 is placed on a bladder training program coordinated by the nurse. A realistic ultimate outcome for this program would be independent voiding by using which of the following? 1. Crede manueuver 2. Valsalva maneuver 3. timed voiding program 4. suprapubic stroking or tapping

suprapubic stroking or tapping -reflexive bladder: can stimulate reflexive emptying with manual stimulation techniques *Crede maneuver, valsalva maneuver, and timed voiding programs are for a flaccid bladder (LMN impacted) due to not having reflex

A physical therapist plans to perform a sensory examination on a patient with a suspected neurological lesion. Which type of sensation should the therapist assess FIRST? 1.Vibration 2.Two-point discrimination 3.Temperature 4.Kinesthesia

temperature *order: superficial sensation -> deep sensations -> cortical sensations -two point discrimination is a cortical sensation -kinesthesia and vibration are deep sensations -temperature is the only superficial sensation

A physical therapist administers the Functional Reach Test to a patient who has a neurological disorder. What bony landmark would be the MOST appropriate for the therapist to utilize when measuring the distance the patient reached during each trial? 1.Distal tip of the third digit 2.Third metacarpal 3.Radial styloid process 4.Ulnar styloid process

third metacarpal *patient needs to make a first for the test, so that is why the third metacarpal is used, not the distal tip of the third digit

A patient sustained a grade II strain to the iliopsoas muscle. Which of the following phases of the gait cycle should the physical therapist expect to be the MOST impacted by this injury? 1.Toe off (pre-swing) and acceleration (initial swing) 2.Heel strike (initial contact) and acceleration (initial swing) 3.Foot flat (loading response) and deceleration (terminal swing) 4.Midstance and deceleration (terminal swing)

toe off (eccentric) and acceleration (concentric)

A physical therapist treats a patient with Parkinson's disease using whole-body vibration. Which symptom associated with Parkinson's disease would this intervention MOST influence? 1.Dysphagia 2.Tremor 3.Akinesia 4.Cognitive impairment

tremor *whole body vibration shown to decrease tremor and rigidity

Men are at risk for development of metabolic syndrome if they exhibit which of the following symptoms? 1. HDL lower than 45 mg/dL 2. waist size greater than 40 inches 3. triglyceride levels greater than 100mg/dL 4. fasting blood glucose less than 100mg/dL

waist size greater than 40 inches (abdominal obesity is criteria) *other criteria: triglycerides above 150mg/dL, HDL below 40, and fasting plasma glucose above 110

A patient who has a grade II lumbar spondylolisthesis experiences symptoms of neurogenic claudication. Which of the following exercises would MOST likely exacerbate the patient's symptoms? 1.Walking on a treadmill with zero incline 2.Cycling with varying resistance 3.Abdominal crunches on an exercise ball 4.Contraction of the multifidi in a flexed position

walking on a treadmill with zero incline *exacerbates symptoms due to extension of spine

An infant has been diagnosed with complete rupture of C8 and T1 resulting in Klumpkes paralysis. Which movement can be expected to be impaired? 1. shoulder elevation 2. wrist flexion 3. elbow extension 4. elbow supination

wrist flexion -Klumpke's effects the intrinsic hand muscles, flexors of the wrist, and forearm pronators