MCQ 2.1

1. An eleven-month-old child with cerebral palsy attempts to maintain a quadruped position. Which reflex would interfere with this activity if it was NOT integrated? 1. Galant reflex 2. symmetrical tonic neck reflex 3. plantar grasp reflex 4. positive support reflex

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14. A physician orders an electrocardiogram for a patient diagnosed with congestive heart failure. The medical record indicates the patient is currently taking digitalis. What effect would you expect digitalis to have on the patient's ECG? 1. lengthened ventricular activation time 2. increased refractory period of AV node 3. lengthened QT interval 4. elevated ST segment

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15. A physical therapist completes an examination on a five-year-old boy diagnosed with Duchenne muscular dystrophy. The referral indicates that the boy was diagnosed with the disease less than one year ago. Assuming a normal progression, which of the following findings would be the first to occur? 1. distal muscle weakness 2. proximal muscle weakness 3. impaired respiratory function 4. inability to perform activities of daily living

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17. A physical therapist completes a developmental assessment on a five-month-old infant. If the therapist elects to examine the infant's palmar grasp reflex, which of the following stimuli is the most appropriate? 1. contact to the pall of the foot in upright standing 2. maintained pressure to the palm of the hand 3. noxious stimulus to the palm of the hand 4. sudden change in the position of the hand

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19. A physical therapist treats a nine-year-old child diagnosed with cystic fibrosis. As part of the treatment session the therapist attempts to improve the efficiency of the patient's breathing. The most appropriate technique to encourage full expansion at the base of the lungs is 1. manual percussion on the posterior portion of the ribs with the patient in prone 2. manual contacts with pressure on the lateral borders of the ribs with the patient in supine 3. manual vibration on the lateral portion of the ribs with the patient in sidelying 4. manual cues on the epigastric area with the patient in supine.

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24. A 42-year-old female status post abdominal surgery is unable to satisfactorily control the retention and release of urine. Which type of urinary catheter would NOT be appropriate for the patient? 1. indwelling urinary catheter 2. external urinary catheter 3. Foley catheter 4. suprapubic catheter

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33. A patient rehabilitating from a lower extremity injury is referred to physical therapy for hydrotherapy treatments. The physical therapist would like the patient to fully extend the involved lower extremity while in the hydrotherapy tank. Which type of whirlpool would not allow the patient to extend the involved lower extremity? 1. Hubbard tank 2. highboy tank 3. lowboy tank 4. walk tank

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34. A patient recovering in the hospital from a total knee replacement is examined by a physical therapist. Assuming an uncomplicated recovery, how much knee range of motion is anticipated prior to discharge? 1. 0-50 degrees 2. 0-90 degrees 3. 15-90 degrees 4. 15-105 degrees

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40. A physical therapist reviews the results of a pulmonary function test for a 58-year-old male patient recently admitted to the hospital. The therapist notes that the patient's total lung capacity is significantly increased when compared to established norms. Which medical condition would most likely produce this type of result? 1. chronic bronchitis 2. emphysema 3. spinal cord injury 4. pulmonary fibrosis

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44. A physical therapist treats a 36-year-old male status post knee surgery. The therapist performs goniometric measurements to quantify the extent of the patient's extension lag. Which of the following would not provide a plausible rationale for the extension lag? 1. muscle weakness 2. bony obstruction 3. inhibition by pain 4. patient apprehension

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45. A patient successfully completes ten anterior lunges. The physical therapist would like to modify the activity to maximally challenge the patient in the sagittal plane. Which of the following modifications would be the most appropriate? 1. anterior lunge with concurrent bilateral elbow flexion to 45 degrees with five pound weights 2. anterior lunge with concurrent bilateral shoulder flexion to 90 degrees with five pound weights 3. anterior lunge with concurrent unilateral shoulder flexion to 90 degrees with a five pound weight 4. anterior lunge with concurrent bilateral shoulder abduction to 45 degrees with five pound weights

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46. A physical therapist teaches a patient positioned in supine to posteriorly rotate her pelvis. The patient has full active and passive range of motion in the upper extremities, but is unable to achieve full shoulder flexion while maintaining the posterior pelvic tilt. Which of the following could best explain these findings? 1. capsular tightness 2. latissimus dorsi tightness 3. pectoralis minor tightness 4. quadratus lumborum tightness

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48. A physical therapist observes a burn on the dorsal surface of a patient's arm. The wound area is mottled red with a number of blisters. The therapist informs the patient that healing should take place in less than three weeks. This description is most indicative of a 1. superficial burn 2. superficial partial-thickness burn 3. deep partial-thickness burn 4. full-thickness burn

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49. A group of physical therapists develops a research project that examines the effect of increased abdominal muscle strength on forced vital capacity and forced expiratory volume. In order to conduct the study, the therapists are required to have the approval of the Hospital Institutional Review Board. The primary purpose of the committee is to 1. protect the hospital from unnecessary litigation 2. ensure that established patient care standards are not compromised 3. examine the design of the research project 4. assess the financial ramifications of the research project

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6. A physical therapist assesses the functional strength of a patient's hip extensors while observing the patient move from standing to sitting. What type of contraction occurs in the hip extensors during this activity? 1. concentric 2. eccentric 3. isometric 4. isotonic

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8. A patient with cardiopulmonary pathology is referred to physical therapy. The physical therapist documents the following clinical signs: pallor, cyanosis, and cool skin. These clinical signs are most consistent with: 1. cor pulmonale 2. anemia 3. atelectasis 4. diaphoresis

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11. A physical therapist receives a referral for a two-month-old infant diagnosed with osteogenesis imperfecta. After completing the examination, the therapist discusses the physical therapy plan of care with the infant's parents. The primary goal of therapy should be 1. improve muscle strength and diminish tone 2. facilitate protected weight bearing 3. promote safe handling and positioning 4. diminish pulmonary secretions

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13. Communication and perceptual problems are extremely common in patients with hemiplegia. Which clinical problem would be characteristic of a patient status post right CVA? 1. inability to recognize symbols and perform basic math problems 2. inability to plan and perform serial steps in activities 3. distorted awareness of self-image 4. diminished functional speech

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16. A physical therapist obtains an x-ray of a 14-year-old female recently referred to physical therapy following activity. The patient previously participated in competitive gymnastics, however, states her back was unable to tolerate the intensity of training. Based on the presented x-ray (Scottie dog decapitated) the therapist would expect the patient's medical diagnosis to be 1. spondylitis 2. spondylolysis 3. spondylolisthesis 4. spondyloptosis

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2. A physical therapist attempts to schedule a patient for an additional therapy session after completing the examination. The physician referral indicates the patient is to be seen two times a week. The therapist suggests several possible times to the patient, but the patient insists she can only come in Wednesday at 4:30. The therapist would like to accommodate the patient, but already has two patients scheduled at that time. The most appropriate action is to 1. schedule the patient on Wednesday at 4:30 2. attempt to move one of the patient's scheduled on Wednesday at 4:30 to a different time. 3. schedule the patient with another therapist on Wednesday at 4:30. 4. inform the referring physician the patient will only be seen once this week in therapy.

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23. A physical therapist develops a problem list after examining a patient with a transtibial amputation. Which of the following would be the most appropriate entry in the patient problem list? 1. donning and doffing prosthesis requires verbal cues 2. donning and doffing prosthesis requires verbal cures and minimal assist of one 3. dependence with donning and doffing prosthesis 4. independent donning and doffing prosthesis in one week

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26. A patient informs a physical therapist that he has to use the bathroom immediately after being transported outside the hospital to practice car transfers. The physical therapist's most appropriate response to meet the patient's physical need is to 1. ask the patient if it is an emergency 2. complete the transfer training as quickly as possible and allow the patient to use the bathroom 3. transport the patient back into the hospital to use the bathroom 4. instruct the patient that in the future he should use the bathroom before beginning physical therapy

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27. A physical therapist examines a patient four days status post total hip replacement. The patient's medical record indicates the surgeon utilized an anterolateral surgical approach. Which of the following motions would be the most important to restrict during the initial phase of rehabilitation? 1. knee extension 2. knee flexion 3. hip lateral rotation 4. hip medial rotation

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28. A patient informs a physical therapist how frustrated she feels after being examined by her physician. The patient explains that she becomes so nervous, she cannot ask any questions during scheduled office visits. The therapist's most appropriate response is to 1. offer to go with the patient to her next scheduled physician visit. 2. offer to call the physician and ask any relevant questions 3. suggest that the patient write down questions for the physician and bring them with her to the next scheduled visit. 4. tell the patient it is a very normal response to be nervous in the presence of a physician

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35. A physical therapist inspects a wound over the sacrum of a 58-year-old female. The therapist would most accurately classify the presented wound (picture of a wound with the muscle exposed) as: 1. stage I 2. stage II 3. stage III 4. stage IV

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36. A physical therapist observes a patient's breathing as part of a respiratory assessment. Which muscle of respiration is most active during forced expiration? 1. diaphragm 2. external intercostals 3. internal intercostals 4. upper trapezius

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37. A physical therapist performs a manual muscle test on a patient with unilateral upper extremity weakness. The patient is able to complete 75% of the available range of motion with gravity eliminated. The therapist should record the muscle grade as: 1. poor plus 2. poor 3. poor minus 4. trace plus

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38. A physical therapist measures a patient for a straight cane prior to beginning ambulation activities. Which gross measurement method would provide the best estimate of cane length? 1. measuring from the head of the fibula straight to the floor and multiplying by two 2. measuring from the iliac crest straight to the floor 3. measuring from the greater trochanter straight to the floor 4. dividing the patient's height by two and adding three inches

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39. A physical therapist recommends a wheelchair for a patient rehabilitating from a CVA with the goal of independent mobility. The left upper and lower extremities are flaccid and present with edema. There is normal strength on the right, however, the patient's trunk is hypotonic. The patient is cognitively intact. The most appropriate wheelchair for the patient is 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

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4. A physical therapist provides pre-operative instruction for a patient scheduled for anterior cruciate ligament reconstructive surgery. During the treatment session, the patient expresses to the therapist a sincere fear of dying during surgery. The therapist's most appropriate response would be 1. This surgery is done many times every day. 2. I have never had a patient die yet. 3. Surgery can be a very frightening thought.

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50. Members of a community health task force evaluate a proposal for a new adolescent screening program. Several members of the task force raise questions as to the validity of the screening instrument. Which measure of validity examines the instrument's ability to identify diseased persons by comparing the true positives? 1. adaptability 2. selectivity 3. sensitivity 4. specificity

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12. A physical therapist elects to utilize the Six-Minute Walk Test as a means of quantifying endurance for a patient rehabilitating from a lengthy illness. Which variable would be the most appropriate to measure when determining the patient's endurance level with this objective test? 1. perceived exertion 2. heart rate response 3. elapsed time 4. distance walked

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18. A physical therapist treats a 54-year-old male rehabilitating from a tibial plateau fracture. While completing a resistive exercise the patient indicates that lifting weights often causes him to void small amounts of urine. The most appropriate therapist action is 1. refer the patient to a support group 2. instruct the patient in pelvic floor muscle strengthening exercises 3. discontinue resistive exercises as part of the established plan of care 4. educate the patient about incontinence

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21. A patient recently admitted to the hospital with an acute illness is referred to physical therapy. During a scheduled treatment session the patient asks what effect anemia will have on his ability to complete a formal exercise program. The most appropriate therapist response is 1. you may feel as though your muscles are weak 2. you may experience frequent nausea 3. your aerobic capacity may be reduced 4. you may have a tendency to become fatigued

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25. A physical therapist monitors a 6 foot 3 inch, 275 pound, male's blood pressure using the brachial artery. Which of the following is most important when selecting an appropriate size blood pressure cuff for the patient? 1. patient age 2. percent body fat 3. somatotype 4. extremity circumference

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30. An athlete is forced to contemplate knee surgery after spraining the anterior cruciate ligament while playing soccer. Which situation would provide the most direct support for an anterior cruciate ligament reconstruction? 1. grade III ACL, and grade I PCL injury 2. grade III ACL sprain with a lateral meniscus tear 3. grade II ACL sprain with a medial meniscus tear 4. functional instability

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31. A physical therapist examines a patient that recently sustained a cervical hyperextension injury. Results of the examination reveal a loss of proprioception and two-point discrimination with intact motor function. This type of incomplete spinal cord injury is most appropriately termed 1. anterior cord syndrome 2. Brown-Sequard syndrome 3. central cord syndrome 4. posterior cord syndrome

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41. A physical therapist observes a patient's skin shortly after applying moist heat to the low back. The therapist identifies several signs of heat intolerance including uneven blotching and a surface rash. The most appropriate action is to 1. continue with the present treatment 2. select an alternate superficial heating agent 3. limit moist heat exposure to five minutes 4. discontinue the moist heat and document the findings

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42. A physical therapist works with a patient rehabilitating from a traumatic brain injury on a mat program. The program emphasizes various developmental positions to prepare the patient for ambulation activities. Which developmental position would be the most demanding? 1. hooklying 2. quadruped 3. kneeling 4. modified plantigrade

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47. A patient with paraplegia is interested in learning how to perform a wheelie to assist with community mobility. The patient is independent with basic wheelchair propulsion. When instructing the patient to perform a wheelie, the physical therapist first should teach the patient to 1. make small adjustments (forward and backward) after being placed in the wheelie position 2. move into the wheelie position 3. perform turns while holding the wheelie 4. statically hold the wheelie position after being placed in it by the therapist

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7. A patient referred to physical therapy with chronic low back pain has failed to make any progress toward meeting established goals in over three weeks of treatment. The physical therapist has employed a variety of treatment techniques, but has yet to observe any sign of subjective or objective improvement in the patient's condition. The most appropriate action would be to 1. transfer the patient to another therapist's schedule. 2. re-examine the patient and establish new goals 3. continue to modify the patient's treatment plan 4. alert the referring physician to the patient's status

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10. A pregnant patient in her third trimester completes a series of exercises in supine. In order to prevent vena cava compression during the exercise session, the therapist should 1. place a folded towel under the right side of the patient's pelvis 2. place a folded towel under the left side of the patient's pelvis 3. complete the exercises in sidelying 4. elevate the patient's feet 12 inches

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20. A physician discusses a patient's plan of care with a physical therapist. The patient is a 29year-old male that sustained deep partial-thickness burns to the anterior surface of his upper legs. The physician discusses the possibility of discontinuing use of the topical antibiotic silver sulfadiazine after identifying an irregularity in the patient's laboratory results. Which findings could be most related to the use of silver sulfadiazine? 1. leukopenia 2. peripheral edema 3. hypokalemia 4. altered pH balance

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22. When performing range of motion exercises with a patient who sustained a head injury, a physical therapist notes that the patient lacks full elbow extension and classifies the end-feel as hard. The most likely cause is 1. heterotopic ossification 2. spasticity of the biceps 3. anterior capsular tightness 4. triceps weakness

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29. A physical therapist observes an electrocardiogram of a patient on beta-blockers. Which of the following ECG changes could be facilitated by beta-blockers? 1. bradycardia 2. tachycardia 3. increased AV conduction time 4. ST segment sagging

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3. A physical therapist consults with an orthotist regarding the need for an ankle-foot orthosis for a patient status post CVA. The patient has difficulty moving from sitting to standing when wearing a prefabricated ankle-foot orthosis. The therapist indicates the patient has poor strength at the ankle, intact sensation, and does not have any edema or tonal influence. The most appropriate type of ankle-foot orthosis for the patient would incorporate: 1. an articulation at the ankle joint 2. tone reducing features 3. metal uprights 4. dorsiflexion assist spring

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32. A physical therapist employed in a long-term care setting attempts to identify a screening tool that examines a patient's ability to perform a variety of activities of daily living independently. The therapist would like to readminister the tool to assess patient progress. The most appropriate screening tool is the 1. Barthel index 2. Berg Balance Scale 3. Health Status Profile 4. Tinetti Performance Oriented Mobility Assessment

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4. You will be back to athletics before you know it. 5. A physical therapist using an electrical stimulation device attempts to quantify several characteristics of a monophasic waveform. When measuring phase charge, the standard unit of measure is the 1. coulomb 2. ampere 3. ohm 4. second

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43. A physical therapist prepares a patient status post CVA with global aphasia for discharge from a rehabilitation hospital. The patient will be returning home with her husband and daughter. The most appropriate form of education to facilitate safe discharge is to 1. perform hands-on training sessions with the patient and family members 2. videotape the patient performing transfers and ADL 3. provide written instructions on all ADLs and functional tasks 4. meet with family members to discuss the patient's present status and abilities

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9. A physical therapist employed by a home health care agency knocks on the door of a patient that has a scheduled therapy session. After waiting several minutes, the therapist concludes the patient is not at home. The most appropriate therapist action is 1. contact the patient and reschedule 2. notify the patient's insurance provider 3. notify the referring physician 4. discharge the patient from physical therapy

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