A patient is receiving grade III mobilizations to regain normal midthoracic extension. After three sessions the patient complains of localized pain that persists for greater than 24 hours. The therapist's treatment would:

85. A therapist wishes to use behavior modification techniques as part of a plan of care to help shape the behavioral responses of a patient recovering from traumatic brain injury. The BEST form of intervention is to:

Which is NOT a useful intervention for a patient with multiple sclerosis who presents with a primary deficit of dysmetria?

A patient suffered fractures of C4 and C5 following trauma received in a motor vehicle accident. Maximum stabilization of his cervical spine can BEST be achieved with a:

A patient had been on oxygen, but it was discontinued by physician order yesterday. During physical therapy, the patient becomes short of breath and requests supplemental oxygen. The patient's SaO2 is measured at 90%25. The decision that is NOT appropriate is:

A patient presents with weakness and atrophy of the biceps brachii resulting from an open fracture of the humerus. The therapist's examination includes needle electromyography of the biceps. The muscle response anticipated after the needle is inserted and prior to asking the patient to contract the muscle is:

A new staff physical therapist on the oncology unit of a large medical center receives a referral for strengthening and ambulation for a woman with ovarian cancer. She is undergoing radiation therapy following a surgical hysterectomy. Her current platelet count is 17,000. The MOST appropriate treatment activity for this patient at this time is:

A patient with diabetes is exercising. The patient reports feeling weak, dizzy, and somewhat nauseous. The therapist notices that the patient is sweating profusely and is unsteady when standing. The therapist's immediate course of action would be to:

A patient with postpolio syndrome has started attending an aerobic exercise program as an outpatient. When she does not show up for her scheduled session, the therapist telephones to find out what is wrong. She says that she is very tired and has not been able to get out of bed for the last two days. Her muscles ache and she is afraid to continue with the exercise class. The therapist's BEST course of action regarding exercise is to:

A physical therapy student is on a final clinical rotation. The supervising physical therapist becomes aware that the student tends to process information all at once, not in an ordered step-by-step manner. The therapist's best strategy to ensure adequate learning for this student is to:

A 69 year-old falls and breaks his hip. He undergoes a total hip replacement at the local medical center. The physician orders physical therapy two days after surgery. The patient is covered by Medicare and is still in an acute care facility. The appropriate frequency of treatment would be:

A patient is taking a drug from the sympathomimetic group, albuterol (Proventil). What is the MOST important effect of this medication?

A physical therapist decides to exercise a patient with fibromyalgia using aquatic therapy. The patient is moderately deconditioned from months of inactivity and has a history of a mild myocardial infarction 4 years ago. Hydrostatic pressure exerted by the water can be expected to:

A therapist determines a patient is walking with a backward trunk lean as he takes full weight on his right leg. He also demonstrates great difficulty going up ramps. The BEST intervention to remediate his problem is to:

If a patient has developed a thick eschar secondary to a full thickness burn, the antibacterial agent MOST effective for infection control is:

An 89 year-old has gradually lost much of his functional vision over the last 4 years. He complains his vision is "foggy" and he has difficulty reading. He mistakes images directly in front of him, especially in bright light. He does better walking across a room and is able to locate items in his environment with his peripheral vision when items are located to both sides. Based on his descriptions, the therapist suspect he may be presenting with:

Following a traumatic brain injury, a patient is inconsistently oriented to time and place. She is unable to remember recent events and shows little or no carry-over for new learning. The PRIMARY goal of rehabilitation at this stage of recovery is to promote:

A patient incurred a right CVA one month ago. She demonstrates moderate tone in her left upper extremity (predominantly flexor tone). Her major problem at this time is a lack of voluntary movement control and her left upper extremity shows minimal active movement with 1⁄4 inch subluxation of the shoulder. An appropriate initial activity would be:

A therapist conducts a study of the effectiveness of hot and cold in treating patients with pain. He recruits 200 patients for each treatment group. The pain instrument he uses has a possible total score of 50, with 50 being the worst pain. His data analysis reveals that Group A (heat modalities) has a mean score of 33 with a standard deviation of 1.0 while Group B (cold modalities) had a mean of 35 with a standard deviation of 6.0. Based on this data the conclusion one should reach is:

Based on this data the conclusion one should reach is:

The therapist in the photograph is testing which muscle?

A patient presents with pain and instability of the left foot/ankle secondary to poliomyelitis with more recent development of progressive post-polio muscle atrophy. In this case, a plastic solid ankle-foot orthosis is an appropriate prescription in order to:

A patient is referred to physical therapy following an anterior dislocation of the right shoulder. A possible positive examination finding as the result of this trauma would be:

A 3 month-old infant is being examined at an early intervention program. The therapist is having difficulty flexing the right upper extremity to remove the infant's clothing. This task is made more difficult if:

A therapist has been asked to give an inservice presentation to staff nurses on safe guarding techniques. In order to best prepare for this talk, the therapist should:

The patient with left hemiplegia would be least likely to respond in therapy if the motor learning strategies emphasized:

A two-week old infant born at 27 weeks gestation with hyaline membrane disease is referred for a physical therapy consult. Nursing reports that the child "desaturates to 84%25 with handling" and has minimal secretions at present. The physical therapist should:

A patient sustained a valgus stress to his left knee while skiing. His orthopedist found a positive McMurray's test, and a positive Lachman's stress test. He has been sent to physical therapy for conservative management of his dysfunction. The sub-acute phase of physical therapy intervention should emphasize:

The most enthusiastic visual tracking by a neonate would be elicited by:

A 14 year-old patient with traumatic brain injury has a convulsive seizure during a therapy session. The patient lost consciousness and presents with tonic-clonic convulsions of all extremities. The therapist's BEST response is to:

A therapist wants to know whether NDT handling techniques produces an improvement in independent rolling that lasts longer than 30 minutes. In this study rolling is the:

A computer programmer, with no significant past medical history, presents to the emergency room with complaints of fever, shaking chills and a worsening productive cough. He has chest pains over the posterior base of his left thorax which is made worse on inspiration. Which of the following is NOT an appropriate physical finding for this patient?

A patient is demonstrating genu valgum during standing and walking. This problem can be effectively controlled by prescribing a knee-ankle-foot orthosis with:

A 62 year-old patient is confined to bed following a severe stroke. She has 25 year history of diabetes and diabetic neuropathy in both lower extremities. During an examination of sensory and integumentary integrity, the therapist identifies an ischemic necrosis on the lateral side of the right foot in the region of the fifth metatarsal head. Hypoesthesia is found in both feet and she is not able to sense a 5.07 Semmes-Weinstein monofilament in the right forefoot. The therapist's interpretation is that:

A patient strained his lower back muscles three weeks ago and now complains of pain (6/10). Upon examination, the therapist identifies bilateral muscle spasm from T10-L4. The therapist elects to apply interferential current to help reduce pain and spasm. The MOST APPROPRIATE electrode configuration to choose in this case would be:

An infant has just begun to pull-to-stand through kneeling, still demonstrates plantar grasp in standing, and is independent in sitting including all protective extension reactions. This infant's chronological age is approximately:

A sixty-five year old male retired bus driver has an increasing frequency of low back pain over the last 10 years. He states that NSAIDs help to relieve his symptoms but there is always a nagging type pain. He reports significant stiffness in the morning which dissipates by noon after exercising and walking his dog. Pain is exacerbated with frequent lifting and bending activities as well as sitting for long periods. Physical therapy intervention should emphasize:

A therapist is orienting a new physical therapy aide in transfer techniques. Initial consideration would be to:

An elderly patient with diabetes and bilateral lower extremity amputation is to be discharged from an acute care hospital two weeks post surgery. The incisions on his residual limbs are not healed and continue to drain. He is unable to transfer because the venous graft sites in his upper extremities are painful and not fully healed. His endurance out-of-bed is limited. The MOST appropriate discharge destination for this patient would be:

A patient currently being seen for low back pain awoke one morning with drooping left facial muscles and excessive drooling. He was recovering from a cold and had experienced an earache in his left ear during the previous 2 days. The therapist suspects a Bell's Palsy which can be confirmed by examining:

A physical therapist assistant is assigned to ambulate a 72 year-old patient with Parkinson's disease. The therapist instructs the PTA to watch for:

A patient with congestive heart failure is on a regimen of diuretics and calcium channel blockers. The potential side-effects of these medications that the physical therapist should be alert for include:

A patient with a traumatic injury to her right hand had a flexor tendon repair to the fingers. Physical therapy intervention following this type of repair would begin:

An 89 year-old community dwelling elder fell in her home and suffered multiple fractures of her right arm including Colles' fracture of her right wrist, and humeral fracture of her right shoulder. She is hospitalized for open reduction, internal fixation of her right radius. Which is NOT an expected finding with this patient?

The therapist suspects a patient recovering from a middle cerebral artery stroke is exhibiting a pure hemianopsia. This can be examined using a:

A patient is recovering from a left tibial amputation and complains of numbness and tingling affecting his dorsal foot and big toe. This is driving him crazy because he knows the limb is gone. The therapist suspects the source of his discomfort is most likely pressure from residual limb wrapping affecting the:

A therapist investigated the accuracy of pulse oximeter estimates during exercise. Correlational analysis measured the strength of the relationship between two types of ear-probe-equipped pulse oximeters during heavy cycle exercise under hypoxic conditions. The investigator found measured arterial oxyhemoglobin saturation (%25HbO2) levels to have a correlation of .89 at high saturation but only .68 at low saturation levels. The results of this study suggest:

A college soccer player sustained a hyperextension knee injury when kicking the ball. The patient was taken to the emergency room of a local hospital and was diagnosed with "knee sprain". He was sent to physical therapy the next day for aggressive rehabilitation. As part of the examination to determine the type of treatment plan to implement, the therapist conducted the test shown in the figure. Based on the test picture, the therapist is examining the integrity of the:

A patient is seen in physical therapy 2 days post motor vehicle accident. The chief complaints are headaches, dizziness, neck pain with guarding, and a "sensation of a lump in the throat". Plain film x-rays were read as negative. The therapist should refer this patient for a:

A patient with an acutely sprained ankle will be treated by immersion into an ice water bath. The therapist should tell the patient to expect in order:

A 94 year-old patient with cancer is admitted to a local hospital. She is given an Advanced Care Medical Directive to review and sign. Guidelines for this document include specifying the rights of the individual patient to:

A patient is recovering from stroke. At 4 months he is ambulating with a straight cane for household distances. In the clinic, when his cane is taken away and he practices ambulating with no assistive device, recurvatum is observed that worsens with continued walking. The therapist's BEST strategy is to:

A patient recovering from an incomplete spinal cord injury at the L3 level (ASIA Scale D) ambulates with bilateral Loftstrand crutches. He remarks that he has great difficulty going down ramps and reports his knees wobble and are unsteady. An appropriate intervention for this problem would be:

It is illegal to release patient information without obtaining the patient's consent to:

With respect to the worker's sitting postures in the Figure, the greatest reduction in lumbar spine compression forces would be achieved by:

A baseball pitcher has been sent to physical therapy with progressive posterior shoulder pain and weakness of the shoulder abductors and lateral rotators. The therapist notices muscle wasting superior and inferior to the scapular spine. The patient's problem is MOST LIKELY attributable to damage involving the:

Nursing homes that receive Medicare reimbursement for eligible residents are required by law to provide for rehabilitation services including physical therapy based on:

A patient is recovering from surgical resection of an acoustic neuroma. She presents with symptoms of dizziness, vertigo, horizontal nystagmus, and postural instability. To address these problems, her physical therapy plan of care should incorporate:

A patient is beginning her ambulation training with a right above-knee prosthesis. The therapist notices that during early swing the heel rises excessively. A possible cause is:

A therapist is providing home care for a 93 year-old patient. Upon arrival, the therapist notices that the patient is confused and skin color and turgor are poor. The patient reports of an intestinal bug for the last few days with frequent vomiting and diarrhea. The therapist's BEST course of action is to:

A patient who is 5 weeks post-myocardial infarction is participating in a cardiac rehabilitation program. The therapist is monitoring responses to increasing exercise intensity. The indicator that exercise should be immediately terminated is:

An infant who was 33 weeks gestational age at birth and is now 3 weeks chronological age demonstrates colic. In this case, the BEST intervention the physical therapist could teach the mother is:

64.        A therapist is treating a patient with Brown-Sequard syndrome that resulted from a gun shot wound. The therapist’s examination should reveal:

65.       A patient is recovering from stroke and presents with moderate impairments of the left upper and lower extremities. The therapist’s goal today is to instruct him in a stand-pivot transfer to his affected side so he can go home on a weekend pass. His wife is attending today’s session and will be assisting him on the weekend. The BEST choice for teaching this task is to:

66.        A 78 year-old currently in an acute care facility is recovering from fractures of the spine and hip. His Medicare Part A benefits have come to an end and he is soon to be discharged. Medicare Part B will NOT cover:

67. 67.When using a patellar-tendon bearing prosthesis, a patient will experience excessive knee flexion in early stance if the:

1.        A chronic smoker developed carcinoma of the lung. Following a right pneumonectomy, post-operative physical therapy intervention should include:

69.        A physical therapist has to order a wheelchair for a patient with a T9-10 spinal cord injury who wishes to engage in sports activities. The wheelchair WILL NOT need:

70.        A patient complains of persistent wrist pain after painting her house three weeks ago. The patient demonstrates signs and symptoms consistent with deQuervain’s tenosynovitis. An appropriate special test which can be used to confirm the diagnosis is:

71.        An adaptive wheelchair for a child with moderate spastic quadriplegic cerebral palsy would include:

72.        A 73 year-old with persistent balance difficulty and a history of recent falls (2 in the last 3 months) is referred for physical therapy examination and evaluation. During the initial session it is crucial to examine:

73.        A patient with adhesive capsulitis of the shoulder sustains a fracture of the shoulder during treatment provided by the PTA. The fracture occurred while the PTA was mobilizing the shoulder joint, which was part of the plan of care established by the PT. After the incident, the PTA told the PT that she was not familiar with the mobilization techniques to the shoulder. Responsibility in this case falls on:

A.       the PT who is solely responsible for assessing the competence of the PTA under their supervision.

B.       the PTA who is responsible for informing their supervising PT whenever they are unfamiliar or uncomfortable with any treatment procedure.

C.       both the PT and the PTA are responsible for establishing effective communication regarding the skills and competencies of the PTA.

D.       neither the PT nor the PTA are responsible for the fracture, it is an accepted risk associated with joint mobilization.

1.       A patient is referred for physical therapy with a diagnosis of second degree ankle sprain. The therapist is busy writing a discharge summary when the patient with the ankle sprain arrives for his scheduled appointment. The physical therapist assistant on staff knows the patient as he had treated the patient previously for a similar injury. The physical therapist should:

75.        During a postural screen for a patient complaining of low back pain the therapist notices that the knees are in genu recurvatum. Possible contributory postures would include:

.

76.       A patient with a 10 year history of multiple sclerosis demonstrates 3+ extensor tone in both lower extremities. The therapist needs to order a wheelchair. It would be BEST to recommend a/an:

A.       standard wheelchair with a 30 degree reclining back.

B.       tilt-in-space wheelchair with a pelvic belt.

C.       electric wheelchair with toe loops.

D.       standard wheelchair with elevating leg rests.

77.        A patient with Stage II primary lymphedema of the right lower extremity is referred for physical therapy. Examination reveals increased limb girth with skin folds/flaps evident. An important component of lymphedema management is manual lymphatic drainage.

78.        A patient is referred by an orthopedist with a diagnosis of impingement syndrome of the shoulder. The initial PT examination reveals signs and symptoms that are not consistent with this diagnosis and are more consistent with thoracic spine pain and dysfunction. The therapist treats the patient consistent with PT findings without communicating with the referring physician. Months later the therapist is sued by the patient’s estate. The patient died of undiagnosed metastatic lung cancer. The therapist is:

A.       not legally licensed to diagnose metastatic cancer, therefore cannot be held responsible for the patient’s death.

B.       responsible for making the diagnosis of possible cancer consistent with the PT examination of the patient.

C.       responsible for communicating findings to the referring physician when the findings are inconsistent with a referring physician’s diagnosis.

 not responsible for the incorrect diagnosis because treatment was appropriate for the PT findings

79.        A 75 year-old inpatient received a cemented total hip replacement two days ago. The physical therapy plan of care should have as its number one priority:

A

80.        A 62 year-old patient is referred to physical therapy after a fall and ORIF for a fracture of her right wrist. During the initial examination, the therapist observes that her skin and eyes have a yellowish hue. The therapist’s BEST course of action is to:

81.        A patient referred for TMJ dysfunction states that she has had three episodes of her jaw locking in an open position. The MOST LIKELY cause of her problems is:

82.        A patient has been on bedrest for two days following revascularization surgery involving a triple coronary artery bypass graft. During his therapy session the therapist notices increased tenderness in the patient’s calf. The therapist should immediately examine for:

83.       A 40 year-old has been laid off his construction job for the last two years. He has a wife who is a homemaker and seven small children. They are currently on welfare. While raking leaves he has a stroke and is admitted to the hospital. In this case, the third party payer that would provide assistance is:

84.  A therapist receives a home care referral from the nurse case manager. An 82 year-old has lost functional independence after the recent death of his wife. His past medical history includes stroke with minimal residual disability. Currently he no longer goes out of his house and rarely even gets out of his chair anymore. During the initial session the therapist determines that depression may be the cause of his increasing inactivity based on the presence of:

85. A patient is referred for outpatient care following a tendon transfer of the extensor carpi radialis longus. The muscle strength tests poor (2/5) in spite of previous intensive therapy. The therapist elects to apply biofeedback to assist in progressively increasing active motor recruitment. Initially, the EMG biofeedback protocol should consist of:

86.        A nineteen year-old male soccer player sustained a Grade II inversion ankle sprain two weeks ago. Intervention in the early subacute phase of rehabilitation would most likely include:

87.        After completing an examination of a patient with shoulder pain, the physical therapist concludes that the cause is subscapularis tendinitis. This clinical finding supportive of this conclusion is:

88.        A patient has a 20 year history of diabetes. Changes include vascular insufficiency and diminished sensation of both feet with poor healing of a superficial skin lesion. It is important that he understand the precautions and guidelines on foot care for people with diabetes. Which of the following is NOT appropriate for a therapist to stress?

89.        A therapist is working in an outpatient clinic that has provider contracts with many types of insurance plans. A large percentage of the clinic’s patients have insurance coverage that has a contract that pays a flat rate of reimbursement per episode of care. The supervisor tells the therapist never to treat these patients for more than five visits. The therapist should:

90.        Following myocardial infarction, a patient was placed on medications which included a beta-adrenergic blocking agent. When monitoring this patient’s response to exercise, the therapist expects this drug will cause heart rate to:

91        A patient with a methicillin-resistant staphylococcal infection (MRSA) has been discharged from an isolation setting as an inpatient and is now returning to physical therapy as an outpatient. The precaution that needs to be adhered to is that:

92.        A patient suffers a CVA resulting in right hemisphere damage. This patient will MOST LIKELY exhibit:

A

93.        Following myocardial infarction, a patient was placed on medications which included a beta-adrenergic blocking agent. When monitoring this patient’s response to exercise, the therapist expects this drug will cause heart rate to:

94.        A construction worker describes a sudden onset of back pain while trying to lift a heavy barrel with another worker. He describes his pain as constant, unremitting at an intensity of 10/10 over the last three days. He is unable to work, but can drive himself to the clinic for treatment. Medication has not influenced his symptoms. He states he has never had any other back-related symptoms in the past. MOST LIKELY involved in his symptomatology is:

95.  A patient complains of pain (7/10) in the shoulder region secondary to acute subdeltoid bursitis. As part of the plan of care during the acute phase, the therapist elects to use conventional TENS which will modulate the pain primarily through:

96.        A 10 month-old (corrected age) infant born at 23 weeks gestational age suffered Grade III intraventricular hemorrhage prenatally and was on a ventilator for 2 months after birth. During a physical therapy examination, increased resistance to passive movement is noted in all extremities, but most markedly in the lower extremities. The infant will probably be diagnosed with:

97.        A 79 year-old patient is referred to physical therapy for an examination of his functional mobility skills and safety in the home environment. The family reports the patient is demonstrating increasing forgetfulness and some memory deficits. From the examination, the therapist would expect to find:

98.        A patient with a left CVA has left him hemiparetic on the right side. In his current stage of recovery, he demonstrates strong and dominant hemiplegic synergies in the leg. Which activity would NOT be helpful to break up these synergies?

99.        A therapist has completed a study investigating the relationship between ratings of perceived exertion (RPE) and type of testing modality: arm ergometry versus leg ergometry.The therapist finds a correlation 0.59 with the arm testing while the correlation is 0.79 with the leg testing. Interpretation of these results is that:

A.       both arm and leg ergometry are only moderately correlated with RPE.

B.       both arm and leg ergometry are highly correlated with RPE.

C.       the common variance of both types of testing is only 22%25.

D.       leg ergometry is highly correlated with RPE while arm ergometry is only moderately correlated.

100.        Your examination of the pressure ulcer pictured on the patient’s heel reveals dry eschar without edema, erythema, fluctuance or drainage. The patient is afebrile. The BEST recommendation regarding intervention for this ulcer is: