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A forty-eight year-old female sustained a fracture to her left shoulder. Treatment is proceeding well except that with left shoulder flexion you notice the scapula protract and elevate early and it continues to move excessively. Physical therapy intervention should emphasize:

A. glenohumeral mobilization and strengthening of scapular stabilizers to regain normal scapulohumeral movement.
B. glenohumeral mobilization, and strengthening of the rotator cuff muscles to regain muscle balance.
C. scapulothoracic mobilization and strengthening of the pectoralis major and minor muscles to regain normal scapulohumeral rhythm.
D. stretching of scapular stabilizers and strengthening of the pectoralis major and minor muscles to regain muscle balance.
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Terms in this set (100)
A forty-eight year-old female sustained a fracture to her left shoulder. Treatment is proceeding well except that with left shoulder flexion you notice the scapula protract and elevate early and it continues to move excessively. Physical therapy intervention should emphasize:

A. glenohumeral mobilization and strengthening of scapular stabilizers to regain normal scapulohumeral movement.
B. glenohumeral mobilization, and strengthening of the rotator cuff muscles to regain muscle balance.
C. scapulothoracic mobilization and strengthening of the pectoralis major and minor muscles to regain normal scapulohumeral rhythm.
D. stretching of scapular stabilizers and strengthening of the pectoralis major and minor muscles to regain muscle balance.
A. glenohumeral mobilization and strengthening of scapular stabilizers to regain normal scapulohumeral movement.
A 59 year-old ex-machinist demonstrates significant age-related hearing loss, presbycusis. When trying to communicate with this patient you would NOT suspect:
A. bilateral hearing loss, at all frequencies since he has had this problem for a number of years.
B. decreased language comprehension.
C. poor auditory discrimination.
D. unilateral hearing loss.
D. unilateral hearing loss.
You are supervising the exercise of cardiac rehabilitation outpatient class on a very hot day, with temperatures expected to be above 90 degrees F. Your class is scheduled for 2 p.m. and the facility is not air conditioned. The strategy that is unacceptable is to:

A. change the time of the exercise class to early morning or evening.
B. decrease the exercise intensity by slowing the pace of exercise.
C. increase the warm-up and cool-down periods to equal the total aerobic interval in time.
D. make the exercise intermittent by adding rest cycles.
C. increase the warm-up and cool-down periods to equal the total aerobic interval in time.
A patient has a transtibial amputation and has recently been fitted with a PTB socket. During your initial prosthetic checkout, you instruct the patient to walk several times in the parallel bars. You then have him sit down and take the prosthesis off. You inspect the skin. You would expect no redness in the area of the:
A. anterior tibia, tibial crest, and fibular head.
B. patellar tendon and tibial tuberosity.
C. medial tibial and fibular plateaus.
D. distal end of the residual limb.
A. anterior tibia, tibial crest, and fibular head.
A patient who is terminally ill with cancer is in tears, unable to cope with the changes in her life and with her current hospitalization. You have a referral for gait training so she can be discharged to home under hospice care. The BEST approach for you to take is:
A. ask the patient questions so you can gain a detailed history.
B. encourage denial so she can cope better with her life's challenges.
C. ignore her tears and focus on her therapy but in a compassionate manner. D. take time now to allow the patient to express her fears and frustrations.
D. take time now to allow the patient to express her fears and frustrations.
Your examination reveals muscle spasms of the deep hip rotators, which are compressing the sciatic nerve and producing pain in the posterior hip region. The MOST effective setting of ultrasound in this case is:
A. 1 MHz continuous at 1.0 W/cm2.
B. 1 MHz pulsed at 1.0 W/cm2.
C. 3 MHz continuous at 1.0 W/cm2.
D. 3 MHz pulsed at 1.0 W/cm2.
A. 1 MHz continuous at 1.0 W/cm2.
A 17 year-old patient is recovering from a complete spinal cord injury, at the level of L2. The expected outcome in this case would MOST likely include:
A. a spastic or reflex bladder.
B. greater loss of arm function than leg function with early loss of pain & temperature sensation.
C. loss of motor function, pain & temperature sensation below the level of the lesion with light touch, proprioception and position sense preserved.
D. some recovery of function since damage is to peripheral nerve roots.
D. some recovery of function since damage is to peripheral nerve roots.
A physical therapist is gait training a patient with left hemiplegia. The patient's new AFO arrives, but the therapist is overwhelmed with too many patients and asks the physical therapy student to take over. This is the student's first affiliation (second day) and she has never performed an orthotic checkout for a patient with an AFO. The supervising therapist will be in the same vicinity treating other patients. This task should: A. be considered an advanced task, but allowable for the student to perform as a good learning experience.
B. be designated as a more advanced task and more appropriately delegated to another physical therapist.
C. be designated as a routine task and appropriate for the student who could call out to the supervisor if problems arose.
D. not be completed now and the patient sent back to his room.
B. be designated as a more advanced task and more appropriately delegated to another physical therapist.
9. A patient has been diagnosed with acute synovitis of the temporomandibular joint. Early intervention should focus on: A. application of an intraoral appliance and phonophoresis.
B. instruction to eat a soft food diet and phonophoresis.
C. joint mobilization and postural awareness.
D. temporalis stretching and joint mobilization.
B. instruction to eat a soft food diet and phonophoresis.
During a cervical spine examination you observe restricted left rotation of the C7-T1 spinal level. After stabilizing the thoracic spine, your hand placement for mobilization to improve left rotation should be at the:
A. posterior left C6 articular pillar.
B. posterior left C7 articular pillar.
C. posterior right C7 articular pillar.
D. T1 spinous process.
B. posterior left C7 articular pillar.
An appropriate fine motor behavior that should be established by 9 months of age would be the ability to: A. build a tower of 4 blocks. B. hold a cup by the handle while drinking. C. pick up a raisin with a fine pincer grasp. D. transfer objects from one hand to another.D. transfer objects from one hand to another.A patient with a 10 year history of Parkinson's disease has been taking L-dopa for the last 5 years. He presents in your clinic with deteriorating function. He is not longer able to transfer or walk independently. During the oral interview, you observe facial grimacing with twitching of the lips and tongue protrusion. He appears restless, with constant dancing, athetoid-like movements of his legs. Your BEST course of action is to: A. complete your evaluation focusing specifically on his main problems of rigidity and bradykinesia. B. document your observations and refer him back to his physician for evaluation of possible dopamine toxicity. C. talk to his wife to see if he is taking any drugs with hallucinogenic effects. D. use isokinetic dynamometry to assess his inability to generate torque output during fast movements.B. document your observations and refer him back to his physician for evaluation of possible dopamine toxicity.A patient who is to undergo surgery for a chronic shoulder dislocation asks you to explain the rehabilitation following a surgical reconstructive procedure he is scheduled to undergo. Your BEST response is to: A. explain how patients typically respond to the surgery and outline the progression of exercises. B. explain in detail about the surgical procedure. C. refer the patient to a physical therapy clinical specialist who is an expert of shoulder reconstructive rehabilitation. D. tell the patient to ask his surgeon for this information.A. explain how patients typically respond to the surgery and outline the progression of exercises.Which of the following is NOT an appropriate reason to terminate a maximum exercise tolerance test for a patient with pulmonary dysfunction? A. ECG monitoring reveals diagnostic ischemia. B. PaO2 decreases 20 mmHg. C. patient reaches age-predicted maximal heart rate. D. patient states he is maximally short of breath.C. patient reaches age-predicted maximal heart rate.A patient with a complete T10 paraplegia is receiving his initial ambulation training. He has received bilateral Craig-Scott knee-ankle-foot orthoses and is being trained with axillary crutches. Since a reciprocal gait pattern is problematic for him, the BEST initial gait pattern to teach him is: A. four-point. B. swing-through. C. swing-to. D. two-point.C. swing-to.After mastectomy, a patient cannot accept the loss of her breast. She reports being weepy all the time with loss of sleep. She is constantly tired and has no energy to do anything. The BEST action you can take is: A. observe her closely for possible suicide. B. request her primary physician to refer her for psychological evaluation. C. tell her she's over-reacting, she has to get on with her therapy. D. tell the nurse case manager to monitor her behavior.B. request her primary physician to refer her for psychological evaluation.A 23 year-old college volleyball player complains of moderate pain resulting from a left hamstring strain four weeks ago. The focal point of pain and tightness is noted where a hematoma developed initially. The specific massage technique that would be MOST beneficial in this case is: A. friction. B. kneading. C. stroking. D. tapotementA. friction.A six year-old boy born with myelomeningocele at the L2 level is referred for physical therapy treatment at home. In determining the physical therapy plan of care, it would NOT be appropriate to emphasize: A. gait training with a reciprocating gait orthosis. B. transfer training from floor to wheelchair. C. upper extremity strengthening with weights. D. vigorous range of motion of the lower extremities.D. vigorous range of motion of the lower extremities.During your examination of a patient who complains of back pain you found pain with end range AROM into hip flexion, abduction and external/lateral rotation. The structure most likely causing the patient's pain is the: A. hamstring muscle. B. hip joint. C. piriformis muscle. D. SI joint.D. SI joint.A therapist wants to compare frequencies of carpal tunnel syndrome occurring in different groups of individuals: assembly line workers and computer programmers. The MOST appropriate statistical tool to use for analysis of the data is: A. chi square test. B. normal distribution curve. C. simple one-way ANOVA. D. t test.A. chi square test.In a research study in which there is a skewed distribution with extreme scores on a balance measure that deviate from the performance of the total group, the MOST accurate representation of central tendency is: A. mean. B. median. C. mode. D. standard deviationB. median.A 54 year-old factory worker injured his right arm in a factory press with damage to the ulnar nerve at the elbow. A diagnostic EMG was performed with evidence of spontaneous fibrillation potentials. In this case, the physical therapy plan of care should consider that: A. axonotmesis is occurring. B. denervation atrophy has occurred. C. reinnervation is complete. D. reinnervation is in process.B. denervation atrophy has occurred.A 67 year-old patient is recovering from a left CVA resulting in severe right hemiplegia. Additionally, he has a large diabetic ulcer on his left foot with pitting edema, requiring elevation of that extremity. The MOST appropriate wheelchair prescription for this patient would be a: A. hemiplegic chair. B. lightweight active duty wheelchair. C. one-arm drive chair. D. powered wheelchair with joystick.C. one-arm drive chair.A 14 year-old boy with advanced Duchenne muscular dystrophy is administered a pulmonary function test. The value that is UNLIKELY to show any deviation from normal is: A. FEV1. B. functional residual capacity. C. total lung capacity. D. vital capacity.B. functional residual capacity.A 29 year-old woman fractured her right midtibia in a skiing accident three months ago. After cast removal, a severe foot drop was noted. The patient desires to try electrical stimulation orthotic substitution. You would set up the functional electrical stimulation to contract the appropriate muscles during: A. foot flat. B. push off. C. swing phase. D. toe off.C. swing phase.You have a small area of dermatitis on the back of your hand with moderate exudate. You are scheduled to treat a patient with HIV for management of an open wound. You should: A. continue with treatment as scheduled but wash your hands thoroughly before and after. B. double glove and treat as scheduled. C. refuse to treat that patient. D. use sterile precautions with mask and gloves.C. refuse to treat that patient.You are a home therapist treating a patient who underwent a total hip replacement four weeks ago. You notice that the patient arches his lumbar spine in supine. He states that it is uncomfortable and doesn't remember having the problem before. The patient is unable to maintain a comfortable supine position due to: A. poor abdominal strength. B. tight hamstrings muscles. C. tight iliopsoas muscle. D. tight piriformis muscle.C. tight iliopsoas muscle.Your 102 year-old patient has been hospitalized for the past three days with an undisclosed ailment. After running numerous tests and finding nothing to explain her increasing weakness and fatigue, the physicians are being pressured to discharge her tomorrow. She lives alone in a first floor apartment. You have determined her ambulation endurance to be only up to 15 feet, not enough to allow her to get from her bed to the bathroom (a distance of 20 feet). You recommend: A. a live-in nurse (24 hour coverage) until her condition improves. B. a skilled nursing facility placement until her endurance increases. C. environmental changes, a bedside commode, and referral for home health services. D. postponing her discharge until she can complete the needed 20 feet.C. environmental changes, a bedside commode, and referral for home health services.You have determined a patient with a right CVA that you are currently treating has a profound deficit of homonymous hemianopsia. The BEST initial strategy to assist the patient in compensating for this deficit is to: A. make the patient aware of his deficit and teach him to turn his head to the affected left side. B. place items, eating utensils on his left side. C. provide constant reminders, printed notes on his left side, telling him to look to the left. D. rearrange his room so while in his bed his left side is facing the doorway.A. make the patient aware of his deficit and teach him to turn his head to the affected left side.A patient with multiple sclerosis is agitated, irritated, and tired during treatment. Your BEST response as the P.T. is to: A. begin pool therapy to promote relaxation. B. ignore these behaviors and continue treating. C. reduce the exercise intensity and provide relaxation strategies. D. treat the patient in a cool environment.C. reduce the exercise intensity and provide relaxation strategies.A 72 year-old medically stable individual requires custodial care in the home. She is severely disabled with rheumatoid arthritis and is in a great deal of pain. She presents with significant deformities which limit her functional abilities and is dependent in all basic activities of daily living. A recent exacerbation of her disease has left her bed-bound for the past 2 weeks. Appropriate physical therapy services would be covered by: A. Medicaid. B. Medicare. C. Medigap policies. D. only by HMO or private insurance policies.B. Medicare.A patient with a purulent venous insufficiency ulcer near the left medial malleolus is seen at home by a physical therapist. The MOST important goal/intervention for the therapist to try to achieve with this patient is: A. daily changes of elastic wraps to reduce fluid buildup. B. daily warm water baths to improve circulation. C. increase ambulation endurance to hasten wound healing D. instruct in proper dressing changes and wound care.D. instruct in proper dressing changes and wound care.Your patient is having difficulty bearing weight on the left leg. She is unable to advance the tibia forward and abbreviates the end of the stance phase on the left going directly into swing phase. The MOST likely cause of her problem is: A. hip extensor weakness. B. spasticity of the anterior tibialis muscle. C. spasticity or contracture of the plantarflexors. D. weakness or contracture of the dorsiflexors.C. spasticity or contracture of the plantarflexors.With a traction injury to the anterior division of the brachial plexus you would expect to see weakness of the elbow flexors, wrist flexors and forearm pronators. You would also expect to find additional weakness in: A. forearm supination. B. lateral rotation of the shoulder. C. thumb abduction. D. wrist extension.C. thumb abduction.A 72 year-old woman is being treated for depression following the death of her husband. She is currently taking antidepressant medication (tricyclics) and has a recent history of a fall. You suspect the precipitating cause of the fall can be attributed to side effects of her medication resulting in: A. cardiac arrhythmias B. dyspnea. C. hyperalertness. D. postural hypotension.D. postural hypotension.An 82 year-old patient and his caregivers should understand the common side effects of the medication that he is taking. He is continually in and out of congestive heart failure and has been taking digitalis (Digoxin) to improve his heart function. You will know he and his caregivers understand the adverse side effects of this medication if they tell you they will contact the patient's physician if he demonstrates: A. confusion and memory loss. B. involuntary movements and shaking. C. slowed heart rate. D. weakness and palpitations.D. weakness and palpitations.The Director of Physical Therapy from a large teaching hospital is asked to develop an operating budget for the upcoming fiscal year. The item that would NOT be included in an operating budget is: A. a treadmill purchase. B. equipment maintenance. C. housekeeping supplies. D. long distance telephone calls.A. a treadmill purchase.You are treating a patient with active hepatitis B infection. Transmission of the disease is best minimized if you: A. avoid direct contact with any part of the patient. B. have the patient wear a gown and mask every time your are in the room. C. have the patient wear gloves to prevent him from touching you. D. wear gloves if there is direct contact with blood or body fluids.D. wear gloves if there is direct contact with blood or body fluids.A wrestler complains of pain (7/10) and limited range of motion of the right shoulder as a result of chronic overuse. You elect to use procaine hydrochloride iontophoresis as part of your intervention for this patient's problems. To administer this substance, it would be appropriate to use: A. continuous biphasic current with the medication under the anode. B. continuous monophasic current with the medication under the anode. C. continuous monophasic current with the medication under the cathode. D. interrupted monophasic current with the medication under the cathode.B. continuous monophasic current with the medication under the anode.A contraindication to initiating joint mobilization on a patient with chronic pulmonary disease may include: A. concurrent inhalation therapy. B. functional chest wall immobility. C. long term corticosteroid therapy. D. reflex muscle guarding.C. long term corticosteroid therapy.Long term care for institutionalized elderly who have reduced their financial resources or qualify for low-income status is typically funded by: A. Health Maintenance Organizations. B. Medicaid. C. Medicare. D. Social Security Administration.B. Medicaid.A 45 year-old 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 pain over the posterior base of his left thorax which is made worse on inspiration. An anterior-posterior X-ray shows an infiltrate on the lower left thorax at the posterior base. This patient's chest pain is MOST likely caused by: A. angina. B. infected pleura. C. inflamed tracheobronchial tree. D. trauma to the chest.B. infected pleura.7 3 44. Equipment safety is essential in all physical therapy clinics. Regularly scheduling equipment maintenance programs to ensure that all equipment is calibrated, lubricated, and adjusted according to manufacturer's guidelines is an important element for patient and staff safety. All of the following procedures should be followed to ensure safety EXCEPT: A. conducting educational sessions for staff regarding the indications and contraindications for all equipment. B. documenting all preventive maintenance and keeping this information on file. C. supervising new staff and students in the use of all newly purchased equipment. D. training all staff to do simple repairs on all electrical equipment if a breakdown should occur.D. training all staff to do simple repairs on all electrical equipment if a breakdown should occur.A 92 year-old woman presents with hot, red, and edematous skin over the shins of both lower extremities. She also has a mild fever. The MOST likely cause of her symptoms is: A. cellulitis. B. dermatitis. C. herpes simplex infection. D. scleroderma.A. cellulitis.A 10 year-old presents with pain and limited ROM following surgical repair of the medial collateral ligament and anterior cruciate ligaments. The modality that would be CONTRAINDICATED in this case is: A. interferential current. B. shortwave diathermy. C. transcutaneous electrical stimulation. D. ultrasound.D. ultrasound.Hypertrophy is the muscular response to strength training. This can be expected to occur following at least: A. 1-2 weeks of training. B. 2-3 weeks of training. C. 3-4 weeks of training. D. 6-8 weeks of trainingD. 6-8 weeks of trainingA diagnosis of bicipital tendinitis has been made following an evaluation of a patient with shoulder pain. The BEST shoulder position to expose the tendon of the long head of the biceps for application of phonophoresis would be: A. abduction. B. external/lateral rotation and extension. C. horizontal adduction. D. internal/medial rotation and abduction.B. external/lateral rotation and extension.A patient is unable to bring her foot up on the next step during a training session on stair climbing. Your BEST course of action to promote active learning is to have the patient: A. balance on the stairs while you passively bring the foot up. B. practice marching in place in the parallel bars. C. practice standing-up from half-kneeling. D. step up onto a low step while in the parallel bars.D. step up onto a low step while in the parallel bars.A 76 year-old patient exhibits impaired balance. A diagnostic work-up has failed to reveal any specific etiology. An initial intervention for this patient would NOT include: A. limits of stability re-education including postural sway training. B. practice in maintenance of a wide base of support during gait and turns. C. sit-to-stand and stand-to-sit activity training. D. tandem walking and single limb stance.D. tandem walking and single limb stance.A 38 year-old patient with spinal cord injury is being discharged home after a 2 month course of rehabilitation. In preparation for discharge, you and your team visit the home and find he has 3 standard height steps going into his home. A ramp will have to be constructed for his wheelchair. The recommended length of his ramp should be: A. 120 inches (10 feet). B. 192 inches (16 feet). C. 252 inches (21 feet). D. 60 inches (5 feet).C. 252 inches (21 feet).A 38 year-old patient with spinal cord injury is being discharged home after a 2 month course of rehabilitation. In preparation for discharge, you and your team visit the home and find he has 3 standard height steps going into his home. A ramp will have to be constructed for his wheelchair. The recommended length of his ramp should be: A. 120 inches (10 feet). B. 192 inches (16 feet). C. 252 inches (21 feet). D. 60 inches (5 feet)C. 252 inches (21 feet).Following pneumonectomy, an expected change in a patient's status would NOT include: A. asymmetrical breathing. B. decreased breath sounds. C. deviated trachea. D. increased tidal volumeD. increased tidal volumeAn older person with diagnosis of congestive heart failure (CHF) should recognize the symptoms of exertional intolerance. You will know this client is properly informed if she can tell you these symptoms are: A. dizziness, visual blurring especially with turns and quick movements. B. overwhelming weakness with difficulty in standing up and walking. C. severe, uncomfortable chest pain with shortness of breath. D. shortness of breath at rest and with limited activity, and sudden weight gainD. shortness of breath at rest and with limited activity, and sudden weight gainYou are instructing a physical therapy student in proper positioning to prevent the typical contractures in the patient with a transtibial amputation. You stress: A. maximize out-of-bed time with sitting in a chair. B. position in prone lying and sitting with full knee extension. C. position in prone-lying with slight knee flexion. D. position in supine with a small pillow under the knee.C. position in prone-lying with slight knee flexion.You receive a referral to ambulate a patient who is insulin dependent. In a review of her medical record, you notice her blood glucose level for that day is 310 mg/dL. Your BEST course of action is to: A. ambulate the patient as planned but monitor closely. B. postpone therapy and coordinate with the nurse regarding insulin management and exercise. C. refrain from ambulating the patient, reschedule for tomorrow. D. talk to the nurse about seeing the patient later on that dayB. postpone therapy and coordinate with the nurse regarding insulin management and exercise.A physical therapy plan of care for a newborn with Erb-Klumpke Palsy would NOT include: A. age appropriate movements of the upper extremity. B. gentle ROM after immobilization. C. partial immobilization of limb across abdomen. D. splinting the shoulder in abduction and internal rotation.D. splinting the shoulder in abduction and internal rotation.A six month-old child was referred to physical therapy for right torticollis. The MOST effective method to stretch the muscle is by positioning the head and neck into: A. extension, left side-bending, and right rotation. B. extension, right side-bending, and left rotation. C. flexion, left side-bending, and left rotation. D. flexion, right side-bending, and left rotation.A. extension, left side-bending, and right rotation.A student you are supervising is on final affiliation following completion of academic training. He is overheard discussing a patient's history in the elevator. When you later point this out to the student, he tells you he was unaware of any hospital policy regarding confidentiality. Your BEST analysis of this situation is that: A. compliance was not a realistic expectation since he just arrived at this facility. B. he should be expected to value patient confidentiality. C. now that he is aware of confidentiality restrictions he should do better the next time. D. since this is not strictly part of the professional code of ethics you should not reasonably expect him to demonstrate adherence to this concept.B. he should be expected to value patient confidentiality.A therapist is performing clinical research in which a specific myofascial technique is applied to a patient with chronic back pain. She is using a single case experimental design with an A-B-A-B format. Her research hypothesis states that pain rating scores will decrease with the treatment intervention. Acceptance of this hypothesis would be indicated if: A. B is equal to A. B. B is greater than A, at the .05 level. C. B is greater than A, at the 1.0 level. D. B is less than AD. B is less than AIsokinetic training can best be used in the rehabilitation of patients with stroke during the late stages of recovery to: A. improve initiation of movement. B. improve rate control at faster movement speeds. C. improve rate control at slower movement speeds. D. increase strength of synergy components.B. improve rate control at faster movement speeds.A 72 year-old patient with a transfemoral amputation is unable to wrap his residual limb. Your BEST course of action is to: A. apply a temporary prosthesis immediately. B. consult with the vascular surgeon about the application of an Unna's paste dressing. C. redouble efforts to teach proper wrapping. D. use a shrinker.D. use a shrinker.A 75 year-old patient with peripheral vascular disease has been referred for conditioning exercise. He demonstrates moderate claudication pain in both legs following a 12 minute walking test. The MOST appropriate exercise frequency and duration for this patient is: A. 2 times/week, BID 20 minutes/session. B. 3 times/week, 30 minutes/session. C. 3 times/week, 60 minutes/session. D. 5 times/week, BID 10 minutes/session.D. 5 times/week, BID 10 minutes/session.The radiographic view shown in the diagram that demonstrates the observed spinal defect is: Twomey L, Taylor J (2000) Physical Therapy of the Low Back, 3rd ed. Philadelphia, Churchill Livingstone, Figure 7-1, page 204, with permission. A. frontal. B. lateral. C. oblique. D. posterolateral.C. oblique.A physical therapist is working with a patient with metastatic breast cancer who has been told that she has only months to live. She is quite angry and disruptive during therapy. What is the MOST appropriate intervention for this patient? A. allow the patient to express her anger while refocusing her on effective coping strategies. B. forbid all expressions of anger as she is only hurting herself. C. provide honest, accurate information about her illness and rehab plan of care. D. provide opportunities for the patient to question her impending death but limit all expressions of anger.A. allow the patient to express her anger while refocusing her on effective coping strategies.A forty year-old female cafeteria worker sustained a right-sided injury to her back while playing golf. She was driving the ball when she felt an immediate sharp pain in her right low back. She states that in the morning she is stiff and her pain eases after taking a shower. Based on the above information, the structure MOST likely involved is: A. a disc. B. a facet joint. C. a nerve root. D. the arterioles which supply circulation to the spinal cord.B. a facet joint.At 10 a.m. a physical therapist working on a spinal cord unit is treating a patient with paraplegia at the T3 level. The therapist smells alcohol on his breath and the patient is having difficulty accomplishing a bed-to-chair transfer that was previously done without assistance. In this case the physical therapist should: A. confront the patient and ask if he has been drinking. B. document and report suspicions of alcoholism to the rehabilitation team at the weekly meeting. C. document the findings and immediately inform the patient's physician about the situation. D. immediately inform the nurse in charge.C. document the findings and immediately inform the patient's physician about the situation.A patient with right hemiparesis has difficulty clearing the affected foot during the swing phase of gait. An appropriate physical therapy intervention for the right lower extremity might include: A. bridging. B. forward step-ups in standing using graduated height steps. C. pushing backward while sitting on a rolling stool. D. sitting on a Swiss ball, alternating lateral side steps and back to neutral.B. forward step-ups in standing using graduated height steps.A 19 year-old patient has a complete spinal cord injury at the level of L1. His primary goal is to walk again. You decide it would be MOST appropriate to recommend that this patient use: A. a reciprocating gait orthosis and walker. B. a wheelchair, because ambulation is unrealistic. C. bilateral AFOs and Lofstrand crutches. D. bilateral KAFOs with thoracolumbosacral extension control.A. a reciprocating gait orthosis and walker.A patient is four weeks post myocardial infarction. Resistive exercises using weights are: A. always contraindicated during acute and post-acute phases of cardiac rehabilitation due to expected elevations of BP. B. appropriate if intensities are kept below 40% maximal voluntary contraction. C. appropriate if intensities are kept below 85% maximal voluntary contraction. D. safe during all phases of rehabilitation if judicious monitoring of HR is used.B. appropriate if intensities are kept below 40% maximal voluntary contraction.A patient diagnosed with cervical radiculitis has been referred to you for mechanical traction. You are applying the traction using the cervical halter for 5 minutes at 20° neck flexion using 10 pounds. The patient complains of pain in the area of the TMJ. You should: A. change the angle of pull. B. decrease the traction poundage. C. decrease the treatment time. D. discontinue the treatment.A. change the angle of pull.On the first day following a cesarean delivery, the physical therapist's initial intervention would consist of teaching the new mother: A. ankle exercises to prevent thrombophlebitis. B. assisted ambulation. C. assisted breathing and coughing and pelvic floor exercises. D. partial sit-ups and pelvic floor exercises.C. assisted breathing and coughing and pelvic floor exercises.It is important to note the status of the pars interarticularis on the X-ray report. A problem with this part of the vertebra could possibly lead to: A. spondylolisthesis with discal herniation. B. spondylolisthesis with possible anterior slippage of the vertebral body. C. spondylolysis resulting in early nerve root compression. D. spondylolysis with early degeneration of the vertebra.B. spondylolisthesis with possible anterior slippage of the vertebral body.The most appropriate school physical therapy intervention to use during class for a child with decreased sitting balance, but normal tone would be to: A. adapt a desk and wheelchair to provide adequate sitting balance. B. use a prone-stander. C. use a sidelyer. D. use a therapeutic ball to promote sitting balanceA. adapt a desk and wheelchair to provide adequate sitting balance.A patient with Parkinson's disease demonstrates a highly stereotyped gait pattern characterized by impoverished movement. The intervention that would be LEAST appropriate to use with this patient is: A. a rolling walker to compensate for impaired balance. B. postural exercises to promote trunk and head extension in sitting and standing. C. range of motion exercises to reduce hip and knee flexion contractures. D. sidelying, upper and lower trunk rotation segmental patterns using the technique of rhythmic initiation.A. a rolling walker to compensate for impaired balance.Your patient is 72 and recovering from a right CVA. She tells you she is thirsty and asks you for a can of soda. When you give her the can and instruct her to open it, she is unable to complete the task. Later after the treatment session when she is alone you observe her drinking from the can. You suspect she may have a primary deficit in: A. anosognosia. B. ideational apraxia. C. ideomotor apraxia. D. unilateral neglect.C. ideomotor apraxia.Peer review is an important professional activity. Recently, physical therapists have been the focus of vigorous peer review due to increasing financial pressure imposed by third party payers. An inappropriate use of peer review is to determine whether care: A. should be paid for by a third party payer. B. was appropriate and required the skill of a physical therapist. C. was cost effective. D. was provided by the appropriate personnel.A. should be paid for by a third party payer.A 62 year-old patient has chronic obstructive pulmonary disease. The MOST likely pulmonary test result would be: A. decreased functional residual capacity. B. decreased residual volume. C. increased total lung capacity. D. increased vital capacity.C. increased total lung capacity.A patient with a transfemoral amputation is being fitted with a quadrilateral socket. Areas of pressure tolerance would be expected over the: A. distolateral end of femur and ischial seat. B. gluteals and adductor magnus. C. ischial tuberosity, gluteals, and lateral sides of residual limb. D. perineal area and medial side of femur.C. ischial tuberosity, gluteals, and lateral sides of residual limb.A patient recently diagnosed with fibromyalgia and chronic fatigue immune system dysfunction demonstrates a loss of interest in all activities and outlets. She is not eating well and is having problems sleeping. Recently she has talked about suicide as her only hope. Your BEST course of action is to: A. call her physician, saying that you cannot do anything for this patient until her psychological outlook is better. B. discuss her need for medications with her husband. C. immediately contact her primary physician. D. present a positive attitude and tell her she will feel better soon.C. immediately contact her primary physician.A 77 year-old patient has been confined to bed for a period of 2 months and now demonstrates limited ROM in both lower extremities. Range in hip flexion is 5º to 115º and knee flexion is 10º to 120º. The MOST appropriate intervention to improve flexibility and ready this patient for standing is: A. dynamic lower extremity splints, applied for 2 hours daily. B. hold-relax techniques followed by passive ROM 3 times a week. C. manual passive stretching, 5 repetitions each joint, 2 times a day. D. mechanical stretching using traction and 5 lb. weights, 2 hours, twice daily.D. mechanical stretching using traction and 5 lb. weights, 2 hours, twice daily.A seventy year-old male retired carpenter who has had long term lumbar pain with a previous diagnosis of degenerative joint disease (DJD) of his lumbar facet joints. He complains of numbness, paresthesias and weakness of his bilateral lower extremities which increase with extended positions or walking greater than 100 feet. His pain persists for hours after assuming a resting position. He reports he can ride his stationary bike for 30 minutes without any problems. Primary physical therapy intervention should include: A. abdominal and back extension strengthening as the result of spondylolysis. B. increasing cardiovascular endurance as the result of degenerative arthritis. C. stretching and limiting extended spinal positions as the result of spinal stenosis. D. traction and limitation of weight bearing positions as the result of discal dysfunction.C. stretching and limiting extended spinal positions as the result of spinal stenosis.A physical therapist is instructing a kindergarten teacher in a behavior management program for a child with developmental disabilities who has been mainstreamed into the regular classroom. The therapist requests that the teacher encourage the child to maintain a head retracted sitting position in the class. The strategy that would be MOST helpful in this situation is to: A. have the teacher encourage the classmates to tell the child to sit up in the chair. B. have the teacher give a smile sticker when the child sits with head retracted for five minutes. C. have the teacher issue a verbal reprimand when the child slumps in the chair. D. train the teacher in manual handling techniques to assist the child in head retraction.B. have the teacher give a smile sticker when the child sits with head retracted for five minutes.You have recently attended a professional conference on myofascial release. You wish to share this information with your colleagues during an inservice session. You BEST initial activity is to: A. ask your colleagues about their current level of knowledge using a brief questionnaire. B. determine the best sequence for the learning units within your presentation. C. provide a comprehensive packet of handouts when you begin the first inservice session. D. select a suitable time and place for your lecture.A. ask your colleagues about their current level of knowledge using a brief questionnaire.Following an episode of adhesive capsulitis of the right shoulder, a 52 year-old with a history of left CVA now exhibits reflex sympathetic dystrophy affecting the right upper extremity. The intervention that should be AVOIDED in this case is: A. graduated active exercises. B. massage to reduce edema. C. passive manipulation to the shoulder. D. passive ROM exercises.C. passive manipulation to the shoulder.To prepare a patient with an incomplete T12 paraplegia for ambulation with crutches, the upper quadrant muscles that would be MOST important to strengthen include the: A. deltoid, coracobrachialis, and brachialis. B. lower trapezius, latissimus dorsi, and triceps. C. middle trapezius, latissimus, dorsi and triceps. D. upper trapezius, rhomboids, and levator scapulae.B. lower trapezius, latissimus dorsi, and triceps.A 72 year-old is recovering at home from a myocardial infarction and percutaneous transluminal coronary angioplasty. As his home care physical therapist, you decide to use pulse oximetry to monitor his responses to exercise. An acceptable oxygen saturation rate (SaO2) to maintain throughout the exercise period is: A. 50%. B. 82%. C. 85%. D. 92%D. 92%A 42 year-old homemaker presents with acute lateral epicondylitis following participation in a local tennis tournament. Pain is 9/10. The MOST appropriate initial intervention for this problem is: A. cold intermittent compression three times per week. B. cold whirlpool daily until the pain subsides. C. fluidotherapy three times per week. D. ice massage B.I.D. until the pain subsides.D. ice massage B.I.D. until the pain subsides.A patient was referred to physical therapy complaining of loss of cervical AROM. His X-rays showed DJD at the uncinate processes in the cervical spine. The motion that would be MOST restricted would be: A. extension. B. flexion. C. rotation. D. side-bending.D. side-bending.A 55 year-old male electrician is unable to pull wire overhead due to a painless inability to reach past 80 degrees of right shoulder abduction. He has had numerous previous episodes of right shoulder pain over the last ten years which were diagnosed as shoulder tendinitis. Early subacute physical therapy intervention should focus on: A. active assistive pulley exercises. B. gentle grade III translatory glenohumeral mobilizations. C. modalities to reduce pain and inflammation. D. resistance exercises for the affected supraspinatus muscle.A. active assistive pulley exercises.Two therapists are asked to perform a test on the same group of patients using the Functional Independence Measure (FIM). The results of both sets of measurements reveal differences in therapists' scores but not in the repeat measurements. This is indicative of a problem in: A. concurrent validity. B. construct validity. C. interrater reliability. D. intrarater reliability.C. interrater reliability.Your patient is a 16 year-old recovering from a complete spinal cord injury with C5 quadriplegia. You are performing PROM exercises on the mat when he complains of a sudden pounding headache and double vision. You notice he is sweating excessively, and when you take his BP it is 240/95. Your BEST course of action is to: A. immediately contact the patient's physician. B. lie the patient down immediately, elevate his legs, then call for a nurse. C. place him in sitting position and continue to monitor BP. D. sit the patient up, check/empty catheter, and then call for emergency medical assistance.D. sit the patient up, check/empty catheter, and then call for emergency medical assistance.A 46 year-old patient presents with a flatfoot deformity with abduction of the forefoot in relation to the weight bearing line. The forefoot is inverted to the varus position when inspected from the frontal plane. Corrections for this foot deformity would NOT include a: A. metatarsal bar. B. scaphoid pad. C. Thomas heel. D. UCBL insert.A. metatarsal bar.A 10-year old with full thickness burns to both arms is developing hypertrophic scars The BEST intervention to manage these scars is: A. custom made pressure garments. B. occlusive dressings. C. primary excision followed by autografts. D. surgical resection (Z-plasty).A. custom made pressure garments.A patient with COPD has developed respiratory acidosis. You instruct the physical therapy student who is participating in her care to monitor the patient closely for: A. dizziness or syncope. B. dyspnea, anxiety, or disorientation. C. muscle twitching or tetany. D. tingling or numbness.B. dyspnea, anxiety, or disorientation.A 34 year-old female in her second trimester of pregnancy was sent to physical therapy with complaints of tingling and loss of strength in both of her hands. Her symptoms are exacerbated if she is required to use her keyboard at work for longer than 20 minutes. The MOST appropriate physical therapy intervention would include: A. dexamethasone phonophoresis to the carpal tunnel. B. hydrocortisone iontophoresis to the volar surfaces of both wrists. C. ice packs to the carpal tunnel. D. placing the wrists in resting splints.D. placing the wrists in resting splints.A child you are working with in the elementary school system has moderate to severe extensor spasticity and limited head control. The MOST appropriate positioning device would be a: A. prone stander with abduction wedge. B. supine stander with abduction wedge. C. wheelchair with a back wedge and head supports. D. wheelchair with adductor pommel.C. wheelchair with a back wedge and head supports.A patient with complete C6 quadriplegia should be instructed to initially transfer with a sliding board using: A. pectoral muscles to stabilize elbows, scapular depressors to lift trunk. B. serratus anterior to elevate trunk with shoulder extensors stabilizing. C. shoulder extensors, external rotators, and anterior deltoid to position and lock the elbow. D. triceps, keeping the hands flexed to protect tenodesis grasp.C. shoulder extensors, external rotators, and anterior deltoid to position and lock the elbow.You have volunteered to teach a stroke education class on positioning techniques for family members and caregivers. There will be 12 individuals attending this class, ranging in age from 42 to 82. Your BEST choice of teaching methods is to utilize: A. demonstration, practice, and follow-up discussion. B. lecture with some time for questions at the end of the 30 minute session. C. multimedia (slides and overheads) to accompany your oral presentation. D. one on one practice with adequate critiquing of performance.A. demonstration, practice, and follow-up discussion.A patient with active tuberculosis is referred for physical therapy. Which of the following is NOT an appropriate precaution? A. have the patient wear a tight fitting mask while being treated in his room. B. insure that the patient is in a private, negative pressurized room. C. wash hands upon entering and leaving the patient's room. D. wear a tight fitting mask while treating the patient.A. have the patient wear a tight fitting mask while being treated in his room.A twelve-year old female figure skater has been referred to your clinic for treatment for patellar tendinitis. The examination reveals that she is unable to hop on the affected lower extremity due to pain. You decide to refer her back to her pediatrician suggesting that the patient receive an x-ray of her knee. The patient returns for therapy with the x-ray shown in the figure. Your initial intervention should focus on: Magee D (2002). Orthopedic Physical Assessment, 4th ed. Philadelphia, W. B. Saunders, Figure 12-149, page 746, with permission. A. aggressive plyometric exercises with focus on endurance training. B. fitting patient with crutches for non weight-bearing ambulation and initiation of phonophoresis at 3mHz continuous wave using hydrocortisone. C. patient education regarding avoidance of squatting and jumping activities as well as initiation of iontophoresis using dexamethasone. D. patient education regarding avoiding falls onto her affected knee and open chain knee extension exercises to improve quadriceps strength.C. patient education regarding avoidance of squatting and jumping activities as well as initiation of iontophoresis using dexamethasone.