704 final

What is the BMI definition of overweight?

BMI > 25

You are preparing to treat a post-surgical patient who has an IV, a urinary catheter, and a post surgical drain in place. The most appropriate transmission based precaution is: Airborne Contact Plus Standard Droplet

Droplet

Which of the following represents the best safety instruction for a patient who is learning to manage a sideways fall in a wheelchair? Extend the arm toward the floor in the direction of the fall. Flex the elbows to allow the arm muscles to absorb some of the impact. Laterally flex the head away from the ground and tuck the arms close to the chest. Tuck the chin toward the chest to protect the head.

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

Stage 1 Pressure Injury:

Non-blanchable erythema of intact skin

A typical response protocol to a fire in an inpatient facility includes (select correct order of response): Remove occupants from immediate danger Close doors to contain and confine the fire Extinguish a small fire and / or evacuate the building or vicinity Activate the alarm

R, A, C, E

During which of the following situations would the wearing of gloves be most appropriate? You are cleaning the therapy treatment area at the end of the day in your inpatient rehabilitation unit. You are opening packages of clean linens to place in the covered linen storage shelves. You are educating the patient's family on fall risks. You have an open wound on your forearm where your kitten scratched you.

You are cleaning the therapy treatment area at the end of the day in your inpatient rehabilitation unit.

Name at least 1 factor besides an individual's behavior (not diet or exercise) that can be a contributing factor or a risk factor for obesity.

genetics

Dizziness, dysphoria, lightheadedness, blurred or dimmed vision symptoms of what condition?

orthostatic hypotension

LE in swing phase is advanced only to the level of the ADs (type of swing or step pattern)

step-to pattern

Canes are typically used on which side? Involved Left Uninvolved Right

Univolved

What is the BMI definition of obesity?

BMI > 30

Your patient is a 56-year-old who just had a left total hip arthroplasty (THA - posterior surgical approach) secondary to severe osteoarthritis. You are going to assist her to a sitting position for the first time after surgery. Which of the following is the best technique to use? Rolling her to the right side and transitioning her to sitting on the side of the bed Passively bringing her to sitting on the side of the bed using the drawsheet Rolling her to the left side and transitioning her to sitting on the side of the bed Long-sitting with transitioning to sitting on the side of the bed

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

A pt requires 50% or more assistance to complete a transfer activity. This is best documented as: Independent Minimal assistance Maximal assistance Moderate assistance

Moderate assistance

Both assistive devices are advanced together, followed by a single weight-bearing extremity. (type of gait)

Modified 3-point

One assistive device is advanced, followed by a single weight-bearing extremity. (type of gait)

Modified Four-point pattern

Shortness of breath •Rapid heart rate •Decreased level of O2 saturation symptoms of what condition?

Respiratory distress

Select the correct order of response for an active shooter response. Hide Run Fight

Run, Hide, Fight

You should always report a patient fall. T/F

T

Which of the following is the best definition of center of mass (CoM)? The balance point of an object The direction of movement when weight is added The point directly behind the gravity pull The push or pull that modifies movement

The balance point of an object

A standard walker without wheels is able to allow for NWB status of one LE. T/F

True

Healthcare Associated Infections are best reduced through strict adherence to: aseptic technique hand hygiene use of Personal Protective Equipment for every patient contact patient isolation

hand hygiene

Prolonged bedrest (immobility) can potentially impact the cardiovascular system in all of the following ways EXCEPT: increased cardiac output (CO) resting HR (heart rated) increased increased orthostatic hypotension DVT (deep vein thrombosis)

increased cardiac output (CO)

For an exercise program for a patient with a below knee (transtibial) amputation, the physical therapist should emphasize stretching and positioning to PREVENT which type of common contracture? knee extension contracture knee flexion contracture hip abduction contracture hip adduction contracture

knee flexion contracture

select the assistive device (gait) progression from most supportive to least supportive. single point cane, quad cane, walker parallel bars, walker, quad cane crutches, walker, cane walker, quad cane, forearm crutches

parallel bars, walker, quad cane

List one goal of appropriate draping.

protection of vulnerable sites.

A 22-year-old man with complete paralysis of his lower trunk and lower extremities due to a complete spinal cord injury is referred to PT for transfer training. He is currently using a wheelchair. He has good upper body strength and spatial awareness. He is cognitively intact and is medically stable. His goal is to return to living in a college dorm. What is the most appropriate type of transfer training for this patient? stand pivot transfer totally dependent transfer sliding board transfer squat pivot transfer

sliding board transfer

When positioning the feet for a pivot transfer, the inner foot (of the patient) is positioned: separated from, but in line with, the outer foot for maximum stability. slightly back to allow maximum liftoff. slightly forward to prevent obstruction. in close contact with the outer foot to create an increased BoS.

slightly forward to prevent obstruction

A patient is performing a stand pivot transfer and requires 25% assistance from the PT. The correct documentation of this transfer would be: stand pivot transfer with moderate assistance stand pivot transfer with minimal assistance stand pivot transfer with standby assist stand pivot transfer with maximal assistance

stand pivot transfer with minimal assistance

LE in swing phase is advanced beyond level of ADs (type of swing or step pattern)

step-through pattern

A patient is able to walk to the bathroom using a walker without physical assistance but requires additional time and supervision for safety awareness. The documented level of assistance would be accurately depicted as: minimal assistance contact guarding supervision max assist

supervision

A reciprocal gait is one in which: increased stance time on one leg is matched by decreased stance time on the opposite leg. forward ambulation occurs in a continuous manner. the amount of time spent in swing phase is equal to the amount of time spent in stance phase. the opposite arm and leg move forward at the same time.

the opposite arm and leg move forward at the same time.

To correctly fit the height of a cane, the cane handle should come approximately: to the level of the patient's ASIS. to the level of the patient's ulnar styloid process. to the level of the patient's umbilicus. to the level of the patient's fingertips.

to the level of the patient's ulnar styloid process.

Which type of transfer equipment is most appropriate for a floor to bed totally dependent transfer? sit-to-stand mechanical lift total body lift (i.e. Hoyer) slide board transfer manual 2-person lift

total body lift (ex. Hoyer)

Your patient that uses a wheelchair full-time is experiencing pain caused by pressure in the perineal area and recently got a donut pillow to sit on to relieve the pressure. You respond with concern because:

A donut pillow can worsen the condition because all the pressure from the upper body is transferred to the circular perimeter around the sacrum.

Which of the following assistive devices requires the most energy to advance? A single-point cane A knee walker A standard "pick up" walker A rolling walker

A standard "pick up" walker

You are a therapist working in home health care. Your new patient is a 75-year-old woman who fell and broke her hip. She is home after a brief rehabilitation stay. Which of the following vital signs would be the most important to include in your initial assessment? Blood pressure Lung sounds Pedal pulses Weight

Blood pressure

A physical therapist initiates mobility activities with an 83-year-old man who has had surgical stabilization of a right hip fracture due to a fall in his home. Considering that the patient has a fall history and seems confused and disoriented during the session, the therapist decides that the patient should not be left in a bedside chair without restraint. The therapist should: Consult with other members of the health care team (such as doctor or nurse) to determine the most appropriate measures or restraint use before leaving the patient unsupervised in the chair. Discontinue all future PT interventions since patient is not be safe in bedside chair. Leave the patient in the bedside chair with the call light and tv remote. Strap the gait belt around the patient and chair to ensure patient safety. Use a second belt if needed.

Consult with other members of the health care team (such as doctor or nurse) to determine the most appropriate measures or restraint use before leaving the patient unsupervised in the chair.

When using crutches, which order should generally be followed? Crutches Involved LE Uninvolved LE

Crutches Involved LE Uninvolved LE

Which of the following is true regarding personal protective equipment (PPE)? Airborne precautions require that the clinician wear a respirator when working with the patient. Long-sleeved lab coats have been shown to be effective barriers to infection transmission. The order of doffing is not important, as long as all items are disposed of properly. When full PPE has been worn, gloves are usually the last item removed.

Airborne precautions require that the clinician wear a respirator when working with the patient.

You are mobilizing a patient in an acute care setting from the bed to the bedside chair. This is the patient's first time OOB (out of bed). You notice O2 saturation drop to 95% and an increase in respiration rate as you assist the patient into a seated position at EOB. The best choice of action is: Call nursing to initiate a rapid response Terminate activity and have the patient lay back down. Do not mobilize to bedside chair Initiate CPR and call for help Allow the patient rest sitting at EOB, cue patient to take normal breaths, and continue to monitor vitals

Allow the patient rest sitting at EOB, cue patient to take normal breaths, and continue to monitor vitals

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? Rigid footplate only Removable swing-away legrests Fixed legrests Elevating legrests

Removable swing-away legrests

hoose the exercise that would be the most advanced for someone post knee replacement (TKA): SLR (straight leg raise) SAQ (short arc quad) Ham sets (isometric) Quad set (isometric)

SLR (straight leg raise)

What is the best hand placement for the patient during a transfer to the left when a transfer board (slide board) is used? Left hand around the far end of the board for leverage Left hand close to the hips, directly under the axilla Left hand through the opening in the board for leverage Left hand open far out enough on the board to allow the hips to move left

Left hand open far out enough on the board to allow the hips to move left

A patient was admitted to the hospital 3 days ago with complaints of left LE edema and pain. Lab tests and venous scanning revealed a left lower leg DVT. The patient started anticoagulation therapy on Day 2 of admission. It is Day 3 post admission and a PT consult has been ordered. Based on the condition of the patient, which level of activity is most appropriate? Refer to slides 49 and 50. Light intensity exercise and ambulation with PT. Leg compression only, no exercise or mobility. Bed level AROM exercise. No out of bed (OOB) activity. No exercise or OOB (out of bed) activity until a Doppler ultrasound shows evidence that the DVT is resolved.

Light intensity exercise and ambulation with PT.

Your patient does not have functional strength in either of his lower extremities. Which of the following is the best way for this patient to begin a transition from the floor to a chair? Half-kneeling, facing away from the chair Half-kneeling, facing the chair Long-sitting, facing away from the chair Kneeling facing away from the chair

Long sitting, facing away from the chair

Which of the following patterns allow for PWB status? Modified Three-point gait Modified Two-point gait Modified One-point gait Modified Four-point gait

Modified Three-point gait

Your patient with lower-extremity (LE) paralysis has been working on transferring from the floor into his wheelchair. He is having difficulty with the task, primarily because his arms are not yet very strong. What can you do to make the transfer easier for him? Turn the wheelchair casters backward Place a stool in front of the wheelchair for him to move onto first Have him move into a quadruped position first Tip the chair forward to make it easier to reach Response Feedback:

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

Which of the following is the recommended method of standing up from a seated position with two axillary crutches? With a crutch on each side, grasp the armrest and crutch hand grip in one hand and push to standing. Lay both crutches down against the chair, stand by pushing down on the armrests of the chair, and then reach for the 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. Place one crutch on either side of the chair and push down on the hand grips.

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.

When assisting a patient with wheelchair fitting, which of the following is the first goal in achieving postural stability? Positioning the head correctly Positioning the trunk correctly Positioning the pelvis correctly Positioning the feet correctly

Positioning the pelvis correctly

Your patient has recently undergone total right knee arthroplasty and is seated on a plinth with both feet resting on a stepstool. How should you instruct your patient to step down off the stepstool and onto the floor? It does not matter which foot steps down first. Step down first with the left foot. Step down with both feet simultaneously. Step down first with the right foot.

Step down first with the right foot

Both crutches advance simultaneously followed by simultaneous advancement of LEs beyond the level of ADs. (type of step or swing pattern)

Swing-through

Both crutches advance simultaneously followed by simultaneous advancement of LEs to level of ADs. (type of step or swing pattern)

Swing-to

Which of the following is involved in the setup/prep for a sit-to-stand mechanical lift transfer? The patient's knees are positioned in approximately 45° flexion. The patient places both hands in his or her lap to avoid injury during the lift. The anterior aspects of the patient's lower legs are placed in contact with the leg pads. The lower seam of the sling is placed at the patient's gluteal fold.

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

Which of the following can be used to estimate the appropriate length of axillary crutches while the patient is seated? Patient's shoulder height in sitting 50% of the patient's known height The distance between the fingertips of the patient's arm held out to the side and the elbow of the opposite abducted arm The patient's known height minus 6 inches

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

Bridging is an important component of many bed mobility activities. Which of the following statements regarding bridging is true? The ending position is one of nearly full hip extension. The maneuver is best performed with the patient in the prone position. The patient is instructed to use the head and neck to assist. The pelvis remains in an anterior tilt throughout the maneuver.

The ending position is one of nearly full hip extension

Which of the following best describes a two-point gait? Both assistive devices are advanced together, followed by a single weight-bearing extremity. The right leg and right assistive device are advanced simultaneously, followed by the simultaneous advancement of the left leg and left assistive device. The leg and opposite assistive device are advanced simultaneously, followed by the other leg and opposite device. One assistive device is advanced, followed by a single weight-bearing extremity.

The leg and opposite assistive device are advanced simultaneously, followed by the other leg and opposite device.

Which of the following is true of a sit-to-stand mechanical lift? The sling for the sit-to-stand lift is typically applied with the patient in a supine position. The sling for the sit-to-stand lift supports the torso/upper body. The sling for the sit-to-stand lift supports only the lower body. The sit-to-stand lift equipment does not include a foot plate.

The sling for the sit-to-stand lift supports the torso/upper body

Which of the following patterns allow for NWB status? One-point gait Four-point gait Three-point gait Two-point gait

Three-point gait

During a floor-to-wheelchair transfer, the casters are positioned forward. Why is this done? To keep the chair from rolling during the transfer To make the chair less likely to tip backward To make the chair less likely to tip forward To position the casters out of the way for the transfer

To make the chair less likely to tip forward

A patient's feet should stay within the "box" of the walker. T/F

True

Axillary crutches allow for complete unloading of one LE (NWB status). T/F

True

Patients using positioning devices must still be frequently repositioned and monitored. (T/F)

True

Rolling walkers are less stable than standard walkers. T/F

True

When performing a transfer using a transfer board (slide board), where should you position the board? Under the coccyx Under the ischial tuberosity Under the lower third of the low back Under the lower third of the thigh

Under the ischial tuberosity

The primary reason we are interested in biomechanics as rehab therapists is that: We need to be able to explain moment and lever arms to our patients. We need to know how to move twice our own body weight safely. We need to be able to apply biomechanical principles to assist patients safely and efficiently. Understanding biomechanics will ensure that we do not sustain common injuries affecting the lower back.

We need to be able to apply biomechanical principles to assist patients safely and efficiently.

When performing patient care with a person suspected of or positive for COVID-19, you should use which PPE? Gloves Gown Surgical/ear loop mask Eye protection/face shield All of the above

all the above

Upon entering a patient's room when your hands are unsoiled, the appropriate infection control measure is to: vigorously wash hands with soap and water apply alcohol-based hand sanitizer apply gloves do no further hand hygiene but be prepared to wash hands in case of exposure to blood or body fluid

apply alcohol-based hand sanitizer

List 2 ways to prevent a pressure injury that is discussed in Chapter 7 of "Mobility in Context

-cushioning between hard surfaces -increase surface area to decrease pressure on patient's body

When performing patient care with a person with a person NOT suspected of COVID-19 or screening patients, you should use which PPE? (could be more than one) Surgical/ear loop mask Eye protection/face shield Gloves Gown

-surgical mask -eye protection/face shield

You are treating a patient whose job requires him to transfer 5lb boxes at a rate of 5/min from a waist-high conveyor belt to a pallet on the floor. The boxes contain fragile items and can be stacked only 2 high. What suggestions or instructions could you give him or the employer to help perform the task safely and effectively?

-Keep boxes close to Center of Gravity -Avoid narrow base of support

If exposed to a blood borne pathogen, the best order of action is to:

1. provide immediate care to exposure site 2. report the exposure to supervisor/instructor 3. notify occupational health immediately to ensure that patient labs can be drawn

You are working in an outpatient rehabilitation setting. Your patient is a 39-year-old man who had knee surgery 4 weeks ago and is ready to begin aerobic conditioning activities. Which of the following represents this patient's estimated maximum heart rate? 165 beats per minute 181 beats per minute 197 beats per minute 216 beats per minute

181 beats per minute (220-age=bpm)

The maximum time in a sustained position for a patient who is unable to independently reposition in a hospital bed is: 1 hour 90 minutes 2 hours 30 minutes

2 hours

The leg and opposite assistive device are advanced simultaneously, followed by the other leg and opposite device. (type of gait)

2 point gait

Generally, when fitting an assistive device such as a cane or crutch, the elbow should be positioned in about: 20-30 degrees of resting elbow extension. 0-10 degrees of resting elbow flexion. 40-50 degrees of resting elbow flexion. 20-30 degrees of resting elbow flexion.

20-30 degrees of resting elbow flexion.

Bilateral device advances first, followed by single non-weight bearing extremity. (type of gait)

3-point gait

Brown et al in 2009 found that a general medical patient, independent prior to hospitalization, spent how much time (%) in bed vs. (%) walking?

83, 3

All of the following are true of proper body mechanics EXCEPT: Position yourself close to the object to be moved to use short lever arms. Position your COG (center of gravity) close to the object's COG. As long as 2 or more persons are assisting, a mechanical lift is not necessary Roll, push, or pull an object rather than lift it.

As long as 2 or more persons are assisting, a mechanical lift is not necessary

"Face is red, raise the head." (type of condition)

Autonomic Dysreflexia

•Throbbing headache •Sweating •Flushed face •High blood pressure •Bradycardia •Anxiety symptoms of what condition?

Autonomic dysreflexia

In the International Classification of Function (ICF) model, the home environment would be considered an aspect of which of the following? Disorder/Disease Body Structure/Function Activity Environmental factors

Environmental factors

A DVT only occurs in the deep veins of the lower leg. T/F

F

Active ROM exercises that increase pain during and after causing persisting pain are contraindicated. T/F

F

Only occupational therapists are qualified to do a home assessment. T/F

F

PROM exercise tends to yield slightly less range of motion than AROM activity. T/F

F

To accurately assess capsular and ligamentous flexibility of two-joint muscles, it is necessary to lengthen the muscles simultaneously over both of the joints involved. T/F

F

Which of the following methods is able to deliever the highest % of supplemental oxygen O2? Face Mask Nasal Cannula N95 Respirator Venturi Mask

Face Mask

According to a 2008 meta-analysis, obesity in critically ill patients is linked to excess rate of death. (t/f)

False

Stage 4 Pressure Injury

Full thickness skin and tissue loss

Stage 3 Pressure Injury:

Full thickness skin loss

Which of the following is the best way for a wheelchair user to negotiate very steep slopes (not curbs)? Tip the chair into a wheelie position and go up the slope forward. Have someone pull the chair up the slope backward. Tip the chair into a wheelie position and go up the slope backward. Go up the slope using a zigzagging path.

Go up the slope using a zigzagging path.

Your patient is a 78-year-old woman who has had shoulder surgery. She is leaving rehabilitation at the end of the week. She lives alone and has a history of falls, and you need to teach her how to get up from the floor if she should fall at home. Which of the following is most important to consider when determining which strategy to teach her? Her strength and range of motion Whether her home is one or two stories Her blood pressure If she wears a personal medical emergency response unit

Her strength and range of motion

A patient in the acute care setting is being monitored with an arterial line in the femoral artery. As the PT is working with the patient in the bed, the line becomes dislodged. What is the next best action by the PT? Disconnect the line and continue with PT session. Reinsert the line and continue with PT session. Hold pressure in the area of the arterial line insertion and alert for nurse/emergency help immediately. Initiate CPR and call for help.

Hold pressure in the area of the arterial line insertion and alert for nurse/emergency help immediately.

Confusion •Visual disturbance •Tremor •Anxiety •Sweating symptoms of what condition?

Hypoglycemia

ISBAR is a communication handout strategy. What does ISBAR stand for?

Identify Situation Background Assessment Recommend Correct Answer:

Which of the following is the most important or key element of log-rolling? Knee flexion in preparation for movement Reaching across the patient's body to pull them into sidelying position Pushing the patient with your underside arm to sitting from sidelying Maintaining a neutral spine throughout the task

Maintaining a neutral spine throughout the task

What is the typical progression of range of motion activities? (place in correct order) AnswersSelected Answer1. PROM RROM AROM AAROM

PROM, AAROM, AROM, RROM

Stage 2 Pressure Injury:

Partial thickness skin loss with exposed dermis

Provide an example of positioning that could lead to a contracture AND an example of how this could be prevented

Patients that lie with the head of the bed elevated. Positioning head in same frontal plane as shoulders

Morbidity refers to disease states, while mortality refers to death. A 2019 systematic review and meta-analysis revealed that critically ill children with obesity have higher risk of: (in the form of length of hospital stay) morbidity mortality both mortality and morbidity

both mortality and morbidity