NPTE FF 18, 19, 20

Head to Toe milestone pneumonic

-Increments of 3months for 1st year, 6 months for 2nd year, 12 months for year 3/4. 3 - Keep Head upright 6 - sitting upright 9 - crawling on knees 12 - Walking on feet 18 - Running (at 18 we run away from home) 2 - Jumping (2 feet leave the ground) 3 - Ride TRIcycles 4 - Hop on 1 foot/on tiptoes (Yoga tree pose looks like #4)

Which of the following activities should be the PRIMARY emphasis of a PT treatment program for a child who has athetoid cerebral palsy with abnormal, involuntary movement? A. Facilitating co-contraction patterns and encouraging control in voluntary movement. B. Preservation of strength and muscle tone C. Facilitating use of primitive reflexes to perform fine motor skills. D. Prevention of contractures and determine the best method of mobility

A. Facilitating co-contraction patterns and encouraging control in voluntary movement. (Athetoid = involuntary movement that are slow and writhing)

A PT is treating a 65 year old to walk with a quadripod. He had severe arthritis of the R hip and was operated 2 months ago. What is the MOST appropriate way the PT should instruct the patient to use the the assistive device? A. Hold the cane in your L ha nd and move L hand and R leg together B. Hold cane in your R hand and move R hand and L leg together C. Hold cane in your L hand and move L hand and L leg together D. Hold cane in your R hand and move R hand and R leg together

A. Hold the cane in your L hand and move L hand and R leg together. 3-point gait is always for NWB or PWB

A PT aide was treating a patient who suffered from CVA patient and asked the patient to complete bridging exercises that were not in the original POC. During the bridging exercises, the patient suffered a back injury. Who will need to take the responsibility of the injury? A. Physical therapist B. Physical therapy assistant C. Physical therapy aide D. Physical therapy student

A. Physical Therapist (if question said PT assistant, not aide, then PT assistant would be responsible b/c they are also licensed)

A two year old child with down syndrome is being treated by a physical therapist. The child has moderate developmental delay and exhibits hypo tonicity. The MOST appropriate physical therapy treatment should include: A. Pushing a toy cart while standing B. Locomotion training using body weight support C. Rolling and somersault activities D. Rhythmic stabilization of postural extensors in sitting

A. Pushing a toy cart while standing (Pushing cart is best b/c function strength by using arms and is performed in standing)

A 45 year old female patient is recovering from a left fibular fracture and is restricted to partial (25%) weight bearing on the left side. What is the BEST assistive device? A. Cane on the left side B. 2 axillary crutches C. Cane on the right side D. Forearm crutch on the left

B. 2 axillary crutches (not ready for a cane until full weight bearing is allowed)

A PT is treating a child in an outpatient clinic. PT notices that the child is unable to transfer a toy from one hand to other hand. What age would be considered normal for a child to be able to transfer an object from one hand to another hand? A. 4 months B. 9 months C. 12 months D. 18 months

B. 9 months *rule of extremes*

A physical therapist is working with a patient who has tuberculosis. Which of the following options BEST describes the appropriate precautions and type of personal protective equipment that a physical therapist should wear? A. Contact precautions, N-95 respirator B. Airborne precautions, N-95 respirator C. Contact precautions, Gloves and Gown D. Airborne precautions, Glove and Gown

B. Airborne precautions, N-95 respirator Airborne precautions -> measles, varicella, tuberculosis

PT is treating a 6 year old child with autism in outpatient pediatric physical therapy. Which of the following is the MOST appropriate intervention? A. Tumbling on mat to promote core strength. B. Ball toss, hopping, and running with a partner with verbal cues for turn taking. C. Perform activities in a fast-paced environment with long explanations for sequencing. D. Performing standing dance routine in different rooms to improve generalizability of a skill.

B. Ball toss, hopping, and running with a partner with verbal cues for turn taking.

A 6 year old male child is referred to PT. The mother is concerned that child is using his hands to climb up their legs in order to stand up. Which of the following condition can the PT suspect? A. Cerebral palsy B. Muscular dystrophy C. Spinal bifida D. Down syndrome

B. Muscular Dystrophy + Gower's Sign = Muscular dystrophy

A patient presents complaints of loss of sensation over the deltoid, radial forearm, and hand. On elevation, there is weakness of shoulder and elbow muscles however, the intrinsic of the hand seems uninvolved. Which of the following is the MOST LIKELY diagnosis? A. Radial nerve palsy B. Erb's palsy C. Klumpke's palsy D. C6 radiculopathy

B. Erb's palsy Erb's and Klumpke's palsy and both brachial plexus lesions. E (C5-C6) comes before K (C8-T1) K for Klaw -> Klumpke's involved intrinsics of the hand

A PT is examining a 10 year old patient diagnosed as level 3 on gross motor classification of CP. According to the gross motor classification of CP, what is the most likely ambulation status of this patient? A. Patient will walk without restriction but will have limitation in more advanced gross motor skills. B. Patient will walk with assistive device with limitation in walking outdoors and in the community. C. Patient self mobility will be severely limited, even with the use of assistive technology. D. Patient will walk without assistive device with limitations in walking outdoors and in the community.

B. Patient will walk with assistive device with limitation in walking outdoors and in the community. Levels: 1 = without restrictions 2 = walk without assistive device 3 = walk with assistive device 4 = severely limited 5 = severely limited, even with assistive technology

a 21 year old volleyball player has limited ROM and pain on the right shoulder. The PT plans an intervention program but the patient refuses any treatment. Patient agrees that without intervention the symptoms might worsen. Which is thee MOST appropriate PT response? A. Call the coach of the team and report that the injury might affect the players performance. B. Respect the player's decision to not use physical therapy services. C. Start the treatment as the patient will most likely join in once she sees the benefits of the treatment. D. Refer the patient to another therapist who is a sports specialist.

B. Respect the player's decision to not use physical therapy services. (if pt was 14 years old, parent/guardian would make decision)

Documenting the care provided to the patient is essential and must be completed in a timely manner. Which of the following is NOT appropriate with respect to documentation? A. When a charting error is made, it must be clearly indicated that a change was made without deleting the original record. B. When charting error is made, use white-out material to correct the text. C. Mistakes must be crossed out with a single line through the error, and then both initialed and dated by the therapist. D. Medically approved symbols or abbreviations can be used for documentation.

B. When charting error is made, use white-out to correct the text.

A physical therapist is teaching a spinal cord injury patient to negotiate a 4 inch curb with a wheelchair. The MOST appropriate instruction that the therapist gives to the patient is: A. Hook the arms around push handle and descend backwards. B. Ascend backwards with large wheels first. C. Ascend in a wheelie position by lifting the front casters. D. Place the front casters down first during descent

C. Ascend in a wheelie position by lifting the front casters.

A newborn is examined at birth using the APGAR screening test. The following scores are reported at 5 min: heart rate(2), respiration (2), reflex irritability (1), muscle tone (2) and color (2). The PT should: A. Monitor the APGAR score again at 10 minutes B. Expect respiratory complications due to low score on respiration C. Expect good heart rate, good respiration, and normal reflex D. Expect neurological complications due to low score on reflex irritability

C. Expect good heart rate, good respiration, and normal reflex Score of: (out of 10) (7 or more, don't check again at 10min) 0 = bad 1 = ok 2= good

A 28 year old female patient with AKA present with a classic marked increase in lumbar lordosis posture. Prior to performing a hands on objective exam, the PT should anticipate which of the following based on her posture? A. Prosthetic limb is too long. B. High posterior prosthetic wall C. High anterior prosthetic wall D. The socket is in excessive abduction

C. High anterior prosthetic wall (High prosthetic wall is same as tight muscles. Therefore this would be tight hip flexors causing and anterior pelvic tilt)

A posterior approach was used for a case of revised total hip arthroplasty. Which of the following should NOT be included while educating the patient in order to prevent posterior dislocation? A. Transfer to the sound side from chair to bed B. When descending stairs, lead with the operated leg C. Keep the knees higher than the hips when sitting D. Avoid standing activities that involve rotating the body towards the operated extremity.

C. Keep the knees higher than the hips when sitting

A 34-year-old male has been diagnosed with as complete C5 spinal cord injury. Patient used a power chair to commute from the parking lot to the PT clinic. While performing a transfer, the MOST important consideration is to: A. Make sure he is using his shoulder extensors to support his upper body B. Make sure his legs are supported by PT aide C. Make sure his power chair is turned off D. Make sure to use the sliding board

C. Make sure his power chair is turned off

The PT is trying to provide the appropriate wheelchair measurements. Which of the following options provide the correct measurement for seat depth? A. Measure the length from posterior buttock to posterior aspect of popliteal fossa and add 2 inches to the measurement. B. Measure the total area of both the hips and add 2 inches to the measurement. C. Measure the total area from posterior buttock to posterior of popliteal fossa and subtract 2 inches from the measurement. D. Measure the trunk length and subtract it from lower leg length and add 2 inches to the measurement.

C. Measure the total area from posterior buttock to posterior of popliteal fossa and subtract 2 inches from the measurement. Width - add 2" Depth - subtract 2" *Rule of opposites* mostly likely answer will be A or C

A physical therapist is facilitating an in-service on BLS by educating on the Do's and Don'ts of adult high quality CPR. Which of the following SHOULD the rescuer do during the training? A. Include pauses in between compressions for greater than 10 seconds. B. Compress chest to depth of less than 2 cm C. Minimize pauses in between compressions D. Compress chest at a rate of 123/min

C. Minimize pause in between compressions B. correct is 5 cm D. correct is 100-120

The patient arrives to a PT clinic looking pale and is sweating profusely. His pulse is weak, and his breath is shallow and rapid. The PT suspects heat exhaustion. Which of the following is NOT an appropriate response? A. Offer the patient some water B. Offer ice pack for forehead and neck C. Offer the patient some salt tablets for electrolyte balance D. Ask the patient to remove any outer layer of clothing

C. Offer the patient some salt tablets for electrolyte balance (All other options will cool the patient down. Salt will cause the patient to be further dehydrated)

A patient is getting treated for pelvis pain and is accompanied by his wife to the PT session. While treating, the patient expressed dissatisfaction in his martial life and says he has regular suicidal thoughts. What would be BEST PT action? A. Ask the patient to seek an appointment with a mental health practitioner. B. Disagree with the patient and say positive things about living life. C. Refer the patient immediately to mental health practitioner and stay there until help arrives. D. Inform the patient's wife that this problem is outside the scope of physical therapy practice.

C. Refer the patient immediately to mental health practitioner and stay there until help arrives.

A 54 year old patient is admitted to the hospital for lung congestion. The patient's daughter who works in the same hospital as a respiratory therapist, visits him in the hospital. She want to look at her father's medical record. The PT should: A. Tell her to ask the consultant physician for permission. B. Tell her she cannot see the chart because she could misinterpret the information. C. Tell her that she must have the permission of her father before she can loo at the chart. D. Give her the chart and let her read it as she may have some insights.

C. Tell her that she must have the permission of her father before she can loo at the chart.

A 58-year-old patient is lifting a wine box using a stoop lift at a winery. Which of the following is the MOST significant factor in increasing compression forces on the spine in addition to the weight of the wine box? A. The width of the wine box B. Performing the lift with the lumbar spine in neutral position C. The distance of the wine box from the base of the spine D. The muscle strength of the lower extremities.

C. The distance of the wine box from the base of the spine

A 2 year old patient is being treated for gait training in outpatient physical therapy. The patient has calluses on the dorsal aspects of the toes and is unable to perform MTP extension. Which of the following is MOST likely true? A. The patient has a persistent ATNR B. The patient has an integrated STNR C. The patient has a persistent plantar grasp reflex D. The patient has an integrated plantar grasp reflex

C. the patient has a persistent plantar grasp reflex (ATNR - would have problems with rolling)

A PT examines a patient who complains of foot pain while running. The examination shows that the patient has excessive forefoot pronation. Which of the following would be the MOST appropriate orthotic insert? A. A lateral forefoot post under the fifth metatarsal head. B. A lateral rearfoot post under the calcaneus placing it in an everted position. C. A middle post just proximal to the third metatarsal head D. A medial post just proximal to the first metatarsal head

D. A medial post just proximal to the first metatarsal head

Occupational Safety and Health Administration (OSHA) is responsible for which of the following? A. Determining how much compensation the therapist should get yearly. B. Assuring minimum standards are met at the hospital to maintain accreditation and prevent negligence in patient care. C. Assuring minimum standards are met by the rehabilitation clinics to maintain accreditation and safety of patients. D. Ensuring adequate steps taken to prevent exposure to harmful radiation to employees at a X-ray center.

D. Ensuring adequate steps taken to prevent exposure to harmful radiation to employees at a X-ray center. (OSHA is for employers, not patient care)

A single 22 year old woman who is 3 months pregnant arrives at a therapist's private practice complaining of shoulder and leg pain. She has a black eye and some bruising at the wrists. The BEST course of action for the therapist is: A. Administer massage for bruising, TENS, and ice modalities for pain, as indicated by the examination findings. B. Direct the patient to the nearest ambulatory care center for physician evaluation. C. Refuse to examine the patient and send her to the nearest emergency room. D. Examine the patient, and if abuse is suspected, report the findings to the appropriate authorities.

D. Examine the patient, and if abuse is suspected, report the findings to the appropriate authorities.

A 6 months old child was referred to PT for right torticollis. The MOST effective method to stretch the muscle is by positioning the head and neck into: A. Flexion, left side-bending, and left rotation B. Extension, right side bending, and left rotation C. Flexion, right side bending, and left rotation D. Extension, left side bending, and right rotation

D. Extension, left side bending, and right rotation (Torticollis = function of SCM = Flexion, side bending, opposite rotation)

Which of the following combinations of orthotic and anatomical causes will MOST likely lead to the same gait deviation? A. Excessive height of medial upright of KAFO and glut maximus weakness B. Excessive height of lateral upright of KAFO and abduction contracture. C. Inadequate dorsiflexion stop and pes equinus deformity D. Inadequate dorsiflexion assist and weak hip flexors

D. Inadequate dorsiflexion assist and weak hip flexors Weak hip flexor = toe drag *orthotic and prosthetic principles are the same*

Integrated vs Persistent reflexes

Integrated: when the reflex disappears to allow for normal development Persistent: a reflex that has not integrated and indicative of central nervous (CNS) damage