Ot/Pt Haad Simulation 6

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1/100 Questions

A patient has been diagnosed with acute synovitis of the temporomandibular joint. Early intervention should focus on:
- Application of an intraoral appliance and phonophoresis.
- Instruction to eat a soft food diet and phonophoresis.
- Joint mobilization and postural awareness.
- Temporalis stretching and joint mobilization.

About This Quiz

. This is a Simulated Examination for Gulf Physical Therapy/ Occupational Therapy Examinations taken from Last Month's HAAD Feedbacks.
This examination contains 100 of the most UPDATED EXAMS from Abu Dhabi, KSA, and UAE.
Take this examination for 120 minutes.
You need to get 86% to pass the HAAD. 60% to pass MOH, DHA, or Prometrics.
Please text 0919-286-29-29 in the Philippines or visit our website www. Ptonline. Weebly. Com
THIS IS YOUR ASSESSMENT FOR ANY GULF Physical Therapy/ Occupational Therapy EXAMINATIONS INCLUDING HAAD, SAUDI PROMETRICS, DUBAI DHA, AND UAE MOH.
THE QUESTIONS HERE ARE TAKEN FROM THIS ACTUAL EXAMINATIONS, SO PASSING THIS ASSESSMENT EXAM WILL GIVE YOU A HIGH PROBABILITY OF PASSING

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2.

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:
- prone stander with abduction wedge.
- Supine stander with abduction wedge.
- wheelchair with a back wedge and head supports.
- wheelchair with adductor pommel.
Correct Answer

A. wheelchair with a back wedge and head supports.

Explanation

The child described in the question has moderate to severe extensor spasticity and limited head control. This means that the child has difficulty maintaining an upright position and controlling their head movements. A wheelchair with a back wedge and head supports would be the most appropriate positioning device in this case. The back wedge will provide support and help maintain an upright position, while the head supports will provide stability and control for the child's head. This combination of supports will help address the child's specific needs and promote proper positioning and comfort.

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3.

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:
- Cellulitis.
- Dermatitis
- Herpes simplex infection.
- Scleroderma.
Correct Answer

A. Cellulitis.

Explanation

The symptoms described, including hot, red, and edematous skin over the shins of both lower extremities, along with a mild fever, are consistent with cellulitis. Cellulitis is a bacterial skin infection that commonly affects the lower legs, causing inflammation and swelling. It is more common in older adults and individuals with compromised immune systems. Dermatitis, herpes simplex infection, and scleroderma do not typically present with the combination of symptoms described in the patient.

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4.

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:
- observe her closely for possible suicide.
- request her primary physician to refer her for psychological evaluation.
- tell her she’s over-reacting, she has to get on with her therapy.
- Tell the nurse case manager to monitor her behavior.
Correct Answer

A. request her primary physician to refer her for psychological evaluation.

Explanation

The best action to take in this situation is to request her primary physician to refer her for psychological evaluation. The patient is displaying symptoms of depression, such as being weepy, having loss of sleep, constant tiredness, and lack of energy. These symptoms, along with her difficulty accepting the loss of her breast, indicate a need for psychological support and evaluation. By referring her to a psychologist or psychiatrist, the patient can receive appropriate treatment and support for her emotional well-being.

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5.

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:
- ambulate the patient as planned but monitor closely.
- postpone therapy and coordinate with the nurse regarding insulin management and exercise.
- Refrain from ambulating the patient, reschedule for tomorrow.
- Talk to the nurse about seeing the patient later on that day.
Correct Answer

A. postpone therapy and coordinate with the nurse regarding insulin management and exercise.

Explanation

The best course of action is to postpone therapy and coordinate with the nurse regarding insulin management and exercise because a blood glucose level of 310 mg/dL indicates hyperglycemia, which can be dangerous for an insulin-dependent patient during physical activity. It is important to address the high blood glucose level and adjust the patient's insulin management before proceeding with ambulation to ensure their safety and well-being.

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6.

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:
- spondylolisthesis with discal herniation.
- spondylolisthesis with possible anterior slippage of the vertebral body.
- Spondylolysis resulting in early nerve root compression.
- Spondylolysis with early degeneration of the vertebra.
Correct Answer

A. spondylolisthesis with possible anterior slippage of the vertebral body.

Explanation

The status of the pars interarticularis on the X-ray report is important because it can indicate the possibility of spondylolisthesis with possible anterior slippage of the vertebral body. Spondylolisthesis refers to the forward displacement of one vertebra over another, and the pars interarticularis is a small bony segment that connects the upper and lower parts of the vertebra. If there is a problem with this part of the vertebra, such as a fracture or defect, it can weaken the connection and potentially lead to spondylolisthesis with anterior slippage.

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7.

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:
- Change the time of the exercise class to early morning or evening.
- Decrease the exercise intensity by slowing the pace of exercise.
- Increase the warm-up and cool-down periods to equal the total aerobic interval in time.
- Make the exercise intermittent by adding rest cycles
Correct Answer

A. Increase the warm-up and cool-down periods to equal the total aerobic interval in time.

Explanation

Increasing the warm-up and cool-down periods to equal the total aerobic interval in time is not an acceptable strategy because it does not address the issue of exercising in hot temperatures. While a longer warm-up and cool-down period may be beneficial for overall exercise safety, it does not mitigate the potential risks of exercising in high temperatures. The other options, such as changing the exercise time to cooler parts of the day, decreasing exercise intensity, or adding rest cycles, are all valid strategies to help manage the heat and reduce the risk of heat-related complications during the exercise class.

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8.

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:
- Should be paid for by a third party payer.
- Was appropriate and required the skill of a physical therapist.
- Was cost effective.
- was provided by the appropriate personnel.
Correct Answer

A. Was cost effective.

Explanation

The correct answer is "was cost effective." Peer review is a process where professionals in the same field evaluate and assess the quality, appropriateness, and effectiveness of care provided by their peers. In this context, physical therapists are being subjected to peer review due to financial pressure from third party payers. The focus of this review is to determine if the care provided by physical therapists is cost effective, meaning if it provides good value for the cost.

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9.

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 live-in nurse (24 hour coverage) until her condition improves.
- A skilled nursing facility placement until her endurance increases.
- Environmental changes, a bedside commode, and referral for home health services.
- Postponing her discharge until she can complete the needed 20 feet.
Correct Answer

A. Environmental changes, a bedside commode, and referral for home health services.

Explanation

The correct answer is to recommend environmental changes, a bedside commode, and referral for home health services. This option addresses the patient's limited ambulation endurance by making necessary modifications to her living environment, such as installing a bedside commode. Referring her for home health services ensures that she receives the necessary medical care and support while remaining in her own home. This option also takes into consideration the patient's current condition and aims to improve her quality of life without the need for a skilled nursing facility or postponing her discharge.

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10.

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:
- friction.
- kneading.
- Stroking
- Tapotement.
Correct Answer

A. Stroking

Explanation

Stroking would be the most beneficial massage technique in this case. Stroking involves long, gentle, and rhythmic movements over the affected area. This technique can help improve blood circulation, reduce muscle tension, and promote relaxation. Since the volleyball player has a left hamstring strain with a focal point of pain and tightness where a hematoma developed, stroking can help alleviate the pain, increase blood flow to the area, and promote healing.

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11.

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:
- Anosognosia.
- Ideational apraxia.
- Ideomotor apraxia.
- Unilateral neglect.
Correct Answer

A. Ideomotor apraxia.

Explanation

Ideomotor apraxia is a condition where individuals have difficulty performing purposeful motor actions or tasks despite having the understanding and knowledge of how to perform them. This disorder affects the ability to translate an idea or concept into a coordinated movement. In this case, the patient understands the task of drinking from the soda can but struggles with the motor execution of opening it, indicating ideomotor apraxia.

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12.

A patient with complete C6 quadriplegia should be instructed to initially transfer with a sliding board using:
- pectoral muscles to stabilize elbows, scapular depressors to lift trunk.
- Serratus anterior to elevate trunk with shoulder extensors stabilizing.
- Shoulder extensors, external rotators, and anterior deltoid to position and lock the elbow.
- Triceps, keeping the hands flexed to protect tenodesis grasp.
Correct Answer

A. Shoulder extensors, external rotators, and anterior deltoid to position and lock the elbow.

Explanation

The correct answer is shoulder extensors, external rotators, and anterior deltoid to position and lock the elbow. This is because these muscles are responsible for stabilizing and positioning the elbow joint during the transfer. The shoulder extensors help to extend the arm, the external rotators rotate the arm outward, and the anterior deltoid assists in flexing and stabilizing the shoulder joint. By using these muscles, the patient can safely transfer using a sliding board.

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13.

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:
- anterior tibia, tibial crest, and fibular head.
- Patellar tendon and tibial tuberosity.
- Medial tibial and fibular plateaus.
- Distal end of the residual limb.
Correct Answer

A. anterior tibia, tibial crest, and fibular head.

Explanation

During the initial prosthetic checkout, the patient is instructed to walk in the parallel bars. The PTB socket is designed to distribute the pressure evenly along the anterior tibia, tibial crest, and fibular head. Therefore, if the socket is properly fitted and aligned, there should be no redness or skin irritation in these areas.

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14.

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:
- Foot flat.
- Push off.
- swing phase.
- toe off.
Correct Answer

A. swing phase.

Explanation

The correct answer is "swing phase." During the swing phase of the gait cycle, the foot is lifted off the ground and swung forward. In a patient with foot drop, the muscles responsible for dorsiflexion (lifting the foot) are weak or paralyzed, leading to difficulty in clearing the foot during the swing phase. Functional electrical stimulation can be used to contract the appropriate muscles during the swing phase to help lift the foot and improve gait.

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15.

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:
- FEV1.
- Functional residual capacity.
- Total lung capacity.
- A. vital capacity.
Correct Answer

A. FEV1.

Explanation

FEV1, or forced expiratory volume in 1 second, is a measure of the amount of air a person can forcefully exhale in one second. In advanced Duchenne muscular dystrophy, the muscles involved in breathing become weak, leading to a decrease in lung function. Therefore, it is unlikely that FEV1, which measures the ability to forcefully exhale, would show any deviation from normal in this patient. The other measures, functional residual capacity, total lung capacity, and vital capacity, are all measures of lung volume and are more likely to show deviations from normal in a patient with advanced Duchenne muscular dystrophy.

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16.

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:
- Call her physician, saying that you cannot do anything for this patient until her psychological outlook is better.
- discuss her need for medications with her husband.
- Immediately contact her primary physician.
- present a positive attitude and tell her she will feel better soon.
Correct Answer

A. discuss her need for medications with her husband.

Explanation

The best course of action is to discuss her need for medications with her husband. This is because the patient is displaying symptoms of depression, such as loss of interest in activities, poor appetite, and sleep problems. Additionally, she has mentioned suicidal thoughts as her only hope. By involving her husband in the discussion about medications, it ensures that the patient has a support system and someone who can help monitor her mental health and ensure she is taking the necessary steps to receive appropriate treatment.

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17.

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:
- deltoid, coracobrachialis, and brachialis.
- Middle trapezius, latissimus, dorsi and triceps.
- Lower trapezius, latissimus dorsi, and triceps.
- Upper trapezius, rhomboids, and levator scapulae.
Correct Answer

A. Lower trapezius, latissimus dorsi, and triceps.

Explanation

To prepare a patient with an incomplete T12 paraplegia for ambulation with crutches, it is important to strengthen the muscles that provide stability and support to the upper body. The middle trapezius, latissimus dorsi, and triceps are all muscles that contribute to the movement and stability of the upper quadrant. Strengthening these muscles would help the patient maintain balance and control while using crutches for ambulation.

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18.

Which of the following is NOT an appropriate reason to terminate a maximum exercise tolerance test for a patient with pulmonary dysfunction?
- ECG monitoring reveals diagnostic ischemia.
- PaO2 decreases 20 mmHg.
- patient reaches age-predicted maximal heart rate.
- Patient states he is maximally short of breath.
Correct Answer

A. PaO2 decreases 20 mmHg.

Explanation

A decrease in PaO2 (partial pressure of oxygen in arterial blood) is a common response during exercise for patients with pulmonary dysfunction. It is not considered an appropriate reason to terminate a maximum exercise tolerance test because it is expected and does not pose an immediate threat to the patient's health. The other options, such as diagnostic ischemia, reaching age-predicted maximal heart rate, and being maximally short of breath, are all valid reasons to terminate the test as they indicate potential risks or limitations for the patient.

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19.

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:
- interferential current.
- Shortwave diathermy.
- Transcutaneous electrical stimulation.
- Ultrasound.
Correct Answer

A. Shortwave diathermy.

Explanation

Shortwave diathermy is contraindicated in this case because it produces heat deep within the tissues. Since the patient has recently undergone surgical repair of ligaments, the application of heat can potentially increase inflammation and delay the healing process. Therefore, shortwave diathermy should be avoided to prevent further pain and limited range of motion.

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20.

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:
- Compliance was not a realistic expectation since he just arrived at this facility.
- He should be expected to value patient confidentiality.
- Now that he is aware of confidentiality restrictions he should do better the next time.
- Since this is not strictly part of the professional code of ethics you should not reasonably expect him to demonstrate adherence to this concept.
Correct Answer

A. Now that he is aware of confidentiality restrictions he should do better the next time.

Explanation

The correct answer suggests that now that the student is aware of confidentiality restrictions, he should be expected to improve his behavior in the future. This implies that the student's lack of knowledge about the hospital policy was the reason for his inappropriate behavior. It also indicates that the student should be able to understand the importance of patient confidentiality and make an effort to adhere to it after being made aware of the policy.

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21.

On the first day following a cesarean delivery, the physical therapist’s initial intervention would consist of teaching the new mother:
- Ankle exercises to prevent thrombophlebitis.
- assisted ambulation.
- Assisted breathing and coughing and pelvic floor exercises.
- Partial sit-ups and pelvic floor exercises.
Correct Answer

A. Assisted breathing and coughing and pelvic floor exercises.

Explanation

After a cesarean delivery, the new mother may experience decreased lung capacity and difficulty breathing due to the surgery. Assisted breathing and coughing exercises can help improve lung function and prevent complications such as pneumonia. Additionally, pelvic floor exercises are important for strengthening the muscles that support the bladder, uterus, and bowels, which may have been weakened during pregnancy and delivery. Therefore, teaching the new mother assisted breathing and coughing exercises, as well as pelvic floor exercises, would be the appropriate initial intervention for a physical therapist.

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22.

The most appropriate school physical therapy intervention to use during class for a child with decreased sitting balance, but normal tone would be to:
- adapt a desk and wheelchair to provide adequate sitting balance.
- Use a prone-stander.
- Use a sidelyer.
- Use a therapeutic ball to promote sitting balance.
Correct Answer

A. Use a sidelyer.

Explanation

The most appropriate school physical therapy intervention to use during class for a child with decreased sitting balance, but normal tone would be to use a sidelyer. A sidelyer is a positioning device that allows the child to lie on their side, providing support and stability while still allowing them to engage in classroom activities. This intervention helps to maintain a proper sitting position and prevent the child from falling or losing balance. It is a suitable option for a child with decreased sitting balance as it provides the necessary support without restricting their movement or independence.

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23.

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:
- Change the angle of pull.
- Decrease the traction poundage.
- decrease the treatment time.
- Discontinue the treatment.
Correct Answer

A. decrease the treatment time.

Explanation

The patient's complaint of pain in the area of the TMJ suggests that the traction is causing discomfort or aggravating the condition. Decreasing the treatment time would reduce the duration of the traction and potentially alleviate the pain in the TMJ area. Changing the angle of pull or decreasing the traction poundage may not directly address the issue of TMJ pain. Discontinuing the treatment altogether may not be necessary if reducing the treatment time can provide relief.

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24.

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:
- ask your colleagues about their current level of knowledge using a brief questionnaire.
- Determine the best sequence for the learning units within your presentation.
- provide a comprehensive packet of handouts when you begin the first inservice session.
- select a suitable time and place for your lecture.
Correct Answer

A. provide a comprehensive packet of handouts when you begin the first inservice session.

Explanation

The best initial activity to share the information from the professional conference on myofascial release with colleagues during an inservice session is to provide a comprehensive packet of handouts when you begin the first inservice session. This allows colleagues to have all the necessary information and resources at hand to follow along and refer back to later. It also ensures that everyone starts with the same foundation of knowledge, regardless of their current level of understanding. Asking about their current level of knowledge or determining the best sequence for learning units can be done after providing the handouts. Selecting a suitable time and place for the lecture is important, but it is not the best initial activity for sharing the information.

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25.

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:
- posterior left C6 articular pillar.
- Posterior left C7 articular pillar.
- posterior right C7 articular pillar.
- T1 spinous process.
Correct Answer

A. posterior right C7 articular pillar.

Explanation

The correct answer is posterior right C7 articular pillar. During a cervical spine examination, restricted left rotation of the C7-T1 spinal level indicates a dysfunction in the right C7 articular pillar. To improve left rotation, mobilization should be performed at the posterior right C7 articular pillar. This will help to restore normal range of motion and alleviate the restriction.

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26.

An appropriate fine motor behavior that should be established by 9 months of age would be the ability to:
- build a tower of 4 blocks.
- hold a cup by the handle while drinking.
- pick up a raisin with a fine pincer grasp.
- Transfer objects from one hand to another.
Correct Answer

A. build a tower of 4 blocks.

Explanation

By 9 months of age, infants should have developed the fine motor skills necessary to build a tower of 4 blocks. This involves using their fingers and hands to grasp and manipulate the blocks, demonstrating coordination and control. Holding a cup by the handle while drinking requires gross motor skills, not fine motor skills. Picking up a raisin with a fine pincer grasp and transferring objects from one hand to another are also important fine motor skills, but building a tower of blocks is a more complex task that demonstrates a higher level of fine motor development.

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27.

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:
- Cardiac arrhythmias
- Dyspnea.
- hyperalertness.
- Postural hypotension
Correct Answer

A. Cardiac arrhythmias

Explanation

The correct answer is cardiac arrhythmias. Tricyclic antidepressant medications can have side effects on the cardiovascular system, including the potential to cause cardiac arrhythmias. This can increase the risk of falls, especially in older adults who may already have underlying cardiovascular issues. Dyspnea, hyperalertness, and postural hypotension are not typically associated with the side effects of tricyclic antidepressants.

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28.

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:
- graduated active exercises.
- Massage to reduce edema.
- Passive manipulation to the shoulder.
- Passive ROM exercises.
Correct Answer

A. Massage to reduce edema.

Explanation

Reflex sympathetic dystrophy (RSD) is a condition characterized by chronic pain, swelling, and changes in skin color and temperature. It is believed to be caused by dysfunction of the sympathetic nervous system. In this case, the patient has RSD affecting the right upper extremity following adhesive capsulitis (frozen shoulder) of the right shoulder and a history of left cerebrovascular accident (CVA). Massage to reduce edema should be avoided because it can potentially exacerbate the symptoms of RSD by increasing blood flow and aggravating the sympathetic dysfunction. Graduated active exercises, passive manipulation to the shoulder, and passive ROM exercises may be beneficial in improving range of motion and reducing stiffness in the affected shoulder.

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29.

1. 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:
- Metatarsal bar.
- Scaphoid pad.
- Thomas heel.
- UCBL insert.
Correct Answer

A. Thomas heel.

Explanation

A Thomas heel is not used for correcting a flatfoot deformity with abduction of the forefoot and inversion of the varus position. A Thomas heel is a wedge-shaped heel extension that is used to decrease tension on the Achilles tendon and calf muscles. It is typically used for conditions such as Achilles tendinitis or calf muscle strains. In this case, the deformity requires correction of the arch and alignment of the forefoot, which would be addressed with a metatarsal bar, scaphoid pad, or UCBL insert.

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30.

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:
- Dizziness or syncope
- dyspnea, anxiety, or disorientation.
- muscle twitching or tetany.
- Tingling or numbness.
Correct Answer

A. Dizziness or syncope

Explanation

Respiratory acidosis occurs when there is an excess of carbon dioxide in the blood due to inadequate ventilation. This can lead to a decrease in oxygen levels and an increase in carbon dioxide levels, causing symptoms such as dizziness or syncope (loss of consciousness). Monitoring for these symptoms is important as they indicate worsening respiratory acidosis and the need for immediate intervention to improve ventilation and oxygenation.

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31.

A patient with active tuberculosis is referred for physical therapy. Which of the following is NOT an appropriate precaution?
- have the patient wear a tight fitting mask while being treated in his room.
- insure that the patient is in a private, negative pressurized room.
- Wash hands upon entering and leaving the patient’s room.
- Wear a tight fitting mask while treating the patient.
Correct Answer

A. insure that the patient is in a private, negative pressurized room.

Explanation

The correct answer is "insure that the patient is in a private, negative pressurized room." This is not an appropriate precaution because a private, negative pressurized room is actually an appropriate precaution for a patient with active tuberculosis. It helps to prevent the spread of the disease to others by ensuring that any airborne particles are contained within the room. The other options, such as having the patient wear a tight fitting mask and washing hands, are appropriate precautions to prevent the transmission of tuberculosis.

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32.

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:
- active assistive pulley exercises.
- Gentle grade III translatory glenohumeral mobilizations.
- modalities to reduce pain and inflammation.
- Resistance exercises for the affected supraspinatus muscle.
Correct Answer

A. Gentle grade III translatory glenohumeral mobilizations.

Explanation

The correct answer is gentle grade III translatory glenohumeral mobilizations. This intervention is appropriate because the patient has a painless inability to reach past 80 degrees of right shoulder abduction, indicating a restriction in the glenohumeral joint. Gentle grade III translatory mobilizations can help improve joint mobility and increase the range of motion in the shoulder. This intervention is more suitable than active assistive pulley exercises, modalities to reduce pain and inflammation, or resistance exercises for the supraspinatus muscle, as these interventions do not specifically address the joint restriction.

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33.

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:
- 1 MHz continuous at 1.0 W/cm2.
- 1 MHz pulsed at 1.0 W/cm2.
- 3 MHz continuous at 1.0 W/cm2.
- 3 MHz pulsed at 1.0 W/cm2.
Correct Answer

A. 3 MHz continuous at 1.0 W/cm2.

Explanation

The deep hip rotators are causing muscle spasms that are compressing the sciatic nerve and causing pain in the posterior hip region. Ultrasound therapy can be used to treat this condition. In this case, the most effective setting of ultrasound would be 3 MHz continuous at 1.0 W/cm2. Continuous ultrasound at a higher frequency (3 MHz) is more effective in treating deep tissues, such as the deep hip rotators. The intensity of 1.0 W/cm2 ensures sufficient energy is delivered to the affected area for therapeutic benefits. Pulsed ultrasound or lower frequency ultrasound may not penetrate deep enough or provide enough energy to effectively treat the condition.

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34.

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:
- Four-point.
- Swing-through.
- swing-to.
- Two-point.
Correct Answer

A. swing-to.

Explanation

The BEST initial gait pattern to teach a patient with complete T10 paraplegia, who is receiving ambulation training with bilateral knee-ankle-foot orthoses and axillary crutches, is the swing-to gait pattern. This gait pattern involves advancing both crutches forward, followed by advancing both lower extremities forward simultaneously. It is suitable for patients who have difficulty achieving a reciprocal gait pattern due to their condition. The swing-to gait pattern allows for better stability and control during ambulation, making it the most appropriate choice for this patient.

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35.

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 treadmill purchase.
- Equipment maintenance.
- Housekeeping supplies.
- Long distance telephone calls.
Correct Answer

A. Housekeeping supplies.

Explanation

The operating budget for a hospital typically includes expenses related to the daily operations and functioning of the facility. This includes equipment maintenance to ensure that all medical equipment is in proper working condition, long distance telephone calls for communication purposes, and even a treadmill purchase if it is necessary for physical therapy services. However, housekeeping supplies, although important for maintaining cleanliness and hygiene, would generally be categorized under the facility's maintenance budget rather than the operating budget.

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36.

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:
- 120 inches (10 feet).
- 192 inches (16 feet).
- 252 inches (21 feet).
- 60 inches (5 feet).
Correct Answer

A. 252 inches (21 feet).

Explanation

The recommended length of the ramp should be 252 inches (21 feet). This is because the patient has 3 standard height steps going into his home, and the recommended slope for a wheelchair ramp is 1:12. This means that for every 1 inch of vertical rise, there should be 12 inches of ramp length. Since the steps are of standard height, which is usually around 7 inches, the ramp should have a length of 7 x 12 = 84 inches to cover the vertical rise. In addition, there should also be a flat landing at the top and bottom of the ramp, each measuring at least 60 inches (5 feet). Therefore, the total recommended length of the ramp is 84 + 60 + 60 = 204 inches (17 feet). However, it is generally recommended to add an additional 2 feet to the ramp length for ease of use, making the total length 252 inches (21 feet).

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37.

A 62 year-old patient has chronic obstructive pulmonary disease. The MOST likely pulmonary test result would be:
- Decreased functional residual capacity.
- Decreased residual volume.
- Increased total lung capacity.
- Increased vital capacity.
Correct Answer

A. Decreased functional residual capacity.

Explanation

Patients with chronic obstructive pulmonary disease (COPD) often have airway obstruction and increased air trapping, leading to decreased functional residual capacity (FRC). FRC is the volume of air remaining in the lungs after a normal exhalation and is decreased in COPD due to the inability to fully exhale. Decreased residual volume (RV) and increased total lung capacity (TLC) are not typically seen in COPD. Increased vital capacity (VC) may occur in COPD as a compensatory response to decreased FRC, but it is not the most likely result. Therefore, the most likely pulmonary test result in a 62 year-old patient with COPD would be decreased functional residual capacity.

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38.

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:
- Dynamic lower extremity splints, applied for 2 hours daily.
- Hold-relax techniques followed by passive ROM 3 times a week.
- Manual passive stretching, 5 repetitions each joint, 2 times a day.
- Mechanical stretching using traction and 5 lb. weights, 2 hours, twice daily.
Correct Answer

A. Manual passive stretching, 5 repetitions each joint, 2 times a day.

Explanation

The most appropriate intervention to improve flexibility and ready this patient for standing is manual passive stretching, 5 repetitions each joint, 2 times a day. This intervention involves the therapist gently moving the patient's joints through their full range of motion without the patient actively participating. Manual passive stretching helps to increase flexibility by elongating the muscles and connective tissues, improving joint mobility, and preventing contractures. This intervention is suitable for a patient who has limited range of motion in both lower extremities due to prolonged bed rest. Dynamic lower extremity splints, hold-relax techniques, and mechanical stretching using traction and weights are not as appropriate in this case.

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39.

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:
- Cold intermittent compression three times per week.
- Cold whirlpool daily until the pain subsides
- Fluidotherapy three times per week
- Ice massage B.I.D. until the pain subsides
Correct Answer

A. Cold whirlpool daily until the pain subsides

Explanation

The most appropriate initial intervention for acute lateral epicondylitis is cold whirlpool daily until the pain subsides. Cold therapy helps reduce inflammation and pain by constricting blood vessels and reducing blood flow to the affected area. Whirlpool therapy provides a combination of cold therapy and gentle massaging action, which can help alleviate pain and promote healing. Daily treatment with cold whirlpool is recommended to effectively manage the symptoms of acute lateral epicondylitis.

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40.

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:
- Axonotmesis is occurring.
- Denervation atrophy has occurred.
- Reinnervation is complete.
- Reinnervation is in process.
Correct Answer

A. Axonotmesis is occurring.

Explanation

Based on the information provided, the diagnostic EMG showing evidence of spontaneous fibrillation potentials indicates that there is damage to the ulnar nerve at the elbow. Axonotmesis refers to a nerve injury where the axons are damaged but the connective tissue surrounding the nerve remains intact. Spontaneous fibrillation potentials are characteristic of axonotmesis, indicating ongoing muscle fiber denervation and subsequent muscle wasting. Therefore, in this case, the physical therapy plan of care should consider that axonotmesis is occurring.

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41.

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:
- Make the patient aware of his deficit and teach him to turn his head to the affected left side.
- place items, eating utensils on his left side.
- provide constant reminders, printed notes on his left side, telling him to look to the left.
- rearrange his room so while in his bed his left side is facing the doorway.
Correct Answer

A. provide constant reminders, printed notes on his left side, telling him to look to the left.

Explanation

The best initial strategy to assist a patient with a profound deficit of homonymous hemianopsia is to provide constant reminders, printed notes on his left side, telling him to look to the left. This strategy helps the patient become aware of the deficit and encourages them to actively compensate for it by consciously directing their attention towards the affected side. Placing items or rearranging the room may provide some assistance, but constant reminders and visual cues are more effective in helping the patient develop compensatory strategies and improve their overall functioning.

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42.

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:
- extension.
- Flexion.
- rotation.
- Side-bending
Correct Answer

A. extension.

Explanation

The patient's X-rays showed DJD at the uncinate processes in the cervical spine. DJD, also known as degenerative joint disease, is a condition that causes the breakdown of cartilage in the joints. In the cervical spine, this can lead to the formation of bone spurs and narrowing of the joint space, limiting the range of motion. Extension refers to the backward bending of the neck, and since the uncinate processes are affected by DJD, this motion would be the most restricted for the patient.

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43.

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:
- Glenohumeral mobilization and strengthening of scapular stabilizers to regain normal scapulohumeral movement.
- Glenohumeral mobilization, and strengthening of the rotator cuff muscles to regain muscle balance
- Scapulothoracic mobilization and strengthening of the pectoralis major and minor muscles to regain normal scapulohumeral rhythm.
- Stretching of scapular stabilizers and strengthening of the pectoralis major and minor muscles to regain muscle balance.
Correct Answer

A. Scapulothoracic mobilization and strengthening of the pectoralis major and minor muscles to regain normal scapulohumeral rhythm.

Explanation

The correct answer is scapulothoracic mobilization and strengthening of the pectoralis major and minor muscles to regain normal scapulohumeral rhythm. This is because the patient is experiencing excessive movement of the scapula during shoulder flexion. Scapulothoracic mobilization can help restore normal movement of the scapula, while strengthening the pectoralis major and minor muscles can help improve scapulohumeral rhythm.

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44.

A 59 year-old ex-machinist demonstrates significant age-related hearing loss, presbycusis. When trying to communicate with this patient you would NOT suspect:
- Bilateral hearing loss, at all frequencies since he has had this problem for a number of years.
- Decreased language comprehension.
- Poor auditory discrimination
- unilateral hearing loss.
Correct Answer

A. Bilateral hearing loss, at all frequencies since he has had this problem for a number of years.

Explanation

The correct answer is bilateral hearing loss, at all frequencies since he has had this problem for a number of years. This is because presbycusis, which is age-related hearing loss, typically affects both ears and all frequencies. It is a gradual and progressive condition that occurs over time due to the natural aging process. Therefore, it would not be unexpected for a 59-year-old individual with presbycusis to have bilateral hearing loss at all frequencies.

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45.

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:
- confusion and memory loss.
- Involuntary movements and shaking.
- Slowed heart rate.
- Weakness and palpitations
Correct Answer

A. confusion and memory loss.

Explanation

The correct answer is "confusion and memory loss" because these are common side effects of digitalis (Digoxin) medication. Digitalis can affect the central nervous system and cause cognitive impairment, including confusion and memory loss. It is important for the patient and caregivers to be aware of these side effects and to contact the physician if they occur, as it may indicate a need for dosage adjustment or alternative treatment options. The other options listed, such as involuntary movements and shaking, slowed heart rate, and weakness and palpitations, are not typically associated with digitalis use.

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46.

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:
- Angina.
- Infected pleura.
- Inflamed tracheobronchial tree.
- trauma to the chest.
Correct Answer

A. Angina.
47.

A patient with a transfemoral amputation is being fitted with a quadrilateral socket. Areas of pressure tolerance would be expected over the:
- Distolateral end of femur and ischial seat.
- Gluteals and adductor magnus.
- Ischial tuberosity, gluteals, and lateral sides of residual limb.
- Perineal area and medial side of femur.
Correct Answer

A. Ischial tuberosity, gluteals, and lateral sides of residual limb.

Explanation

For a patient with a transfemoral amputation fitted with a quadrilateral socket, pressure tolerance is expected over the ischial tuberosity (sitting bone), the gluteal muscles, and the lateral sides of the residual limb. These areas are crucial for distributing pressure, providing comfort, stability, and support when using a prosthetic limb.

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48.

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:
- Immediately contact the patient’s physician.
- lie the patient down immediately, elevate his legs, then call for a nurse.
- Place him in sitting position and continue to monitor BP.
- sit the patient up, check/empty catheter, and then call for emergency medical assistance.
Correct Answer

A. Place him in sitting position and continue to monitor BP.

Explanation

Placing the patient in a sitting position and continuing to monitor their blood pressure is the best course of action in this scenario. The sudden onset of a pounding headache, double vision, excessive sweating, and a significantly elevated blood pressure may indicate autonomic dysreflexia, a potentially life-threatening condition that can occur in individuals with spinal cord injuries. Placing the patient in a sitting position helps to alleviate the increased blood pressure caused by autonomic dysreflexia. Continuing to monitor the blood pressure is important to ensure that it does not continue to rise to dangerous levels.

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49.

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:
- demonstration, practice, and follow-up discussion.
- Lecture with some time for questions at the end of the 30 minute session.
- Multimedia (slides and overheads) to accompany your oral presentation.
- One on one practice with adequate critiquing of performance.
Correct Answer

A. Multimedia (slides and overheads) to accompany your oral presentation.

Explanation

The best choice of teaching methods for a stroke education class with a diverse age range is to utilize multimedia (slides and overheads) to accompany the oral presentation. This method allows for visual aids to enhance understanding and engagement for all participants, regardless of their age. It also provides a structured format that can cater to different learning styles. The combination of oral presentation and visual aids ensures that the information is effectively communicated and retained by the attendees.

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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 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:

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:

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:

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:

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:

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 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 patient with complete C6 quadriplegia should be instructed to initially transfer with a sliding board using:

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:

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:

Which of the following is NOT an appropriate reason to terminate a maximum exercise tolerance test for a patient with pulmonary dysfunction?

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:

On the first day following a cesarean delivery, the physical therapist’s initial intervention would consist of teaching the new mother:

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 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:

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:

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:

An appropriate fine motor behavior that should be established by 9 months of age would be the ability to:

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:

1. 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 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 patient with active tuberculosis is referred for physical therapy. Which of the following is NOT an appropriate precaution?

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 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:

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 62 year-old patient has chronic obstructive pulmonary disease. The MOST likely pulmonary test result would be:

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 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:

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 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 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 59 year-old ex-machinist demonstrates significant age-related hearing loss, presbycusis. When trying to communicate with this patient you would NOT suspect:

A patient with a transfemoral amputation is being fitted with a quadrilateral socket. Areas of pressure tolerance would be expected over the:

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: