Ot/Pt Haad Simulation 6

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Questions: 100 | Attempts: 983 | Updated: Mar 30, 2024

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. 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 Read morePASSING THIS ASSESSMENT EXAM WILL GIVE YOU A HIGH PROBABILITY OF PASSING

Questions and Answers

1.

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.
Correct Answer
C. 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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2.

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.
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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3.

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
Correct Answer
C. 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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4.

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.
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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5.

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.
Correct Answer
B. Encourage denial so she can cope better with her life’s challenges.
6.

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.
Correct Answer
C. 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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7.

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
Correct Answer
B. greater loss of arm function than leg function with early loss of pain & temperature sensation.

Explanation
The correct answer suggests that the patient is likely to experience a greater loss of arm function compared to leg function. Additionally, they are expected to have an early loss of pain and temperature sensation. This indicates that the injury is affecting the upper motor neurons, which control fine motor movements in the arms. The preservation of light touch, proprioception, and position sense suggests that the injury is not affecting the lower motor neurons or the sensory pathways. Therefore, the expected outcome is a greater loss of arm function with early loss of pain and temperature sensation.

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8.

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.
Correct Answer
C. be designated as a routine task and appropriate for the student who could call out to the supervisor if problems arose.

Explanation
The student should be able to perform the orthotic checkout for the patient with the AFO as it is considered a routine task. The supervisor will be in the same vicinity treating other patients, so the student can call out to the supervisor if any problems arise. This allows the student to gain valuable experience while still having the support and guidance of the supervisor nearby.

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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.
Correct Answer
B. instruction to eat a soft food diet and phonophoresis.

Explanation
Acute synovitis of the temporomandibular joint is inflammation of the joint that connects the jaw to the skull. To manage this condition, early intervention should focus on reducing the strain on the joint. Instructing the patient to eat a soft food diet helps to minimize the amount of force and stress placed on the joint during chewing. Phonophoresis, which is the use of ultrasound waves to deliver medication into the tissues, can help reduce inflammation and pain in the joint. Therefore, instruction to eat a soft food diet and phonophoresis is the most appropriate early intervention for a patient with acute synovitis of the temporomandibular joint.

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10.

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.
Correct Answer
C. 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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11.

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.
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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12.

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.
Correct Answer
A. Complete your evaluation focusing specifically on his main problems of rigidity and bradykinesia.

Explanation
The patient with a 10-year history of Parkinson's disease has been taking L-dopa for the last 5 years. The presenting symptoms of deteriorating function, inability to transfer or walk independently, facial grimacing with twitching of the lips and tongue protrusion, and athetoid-like movements of the legs indicate worsening rigidity and bradykinesia. Therefore, the best course of action is to complete a thorough evaluation focusing specifically on these main problems to assess the progression of the disease and adjust the treatment plan accordingly.

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13.

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
Correct Answer
C. refer the patient to a physical therapy clinical specialist who is an expert of shoulder reconstructive rehabilitation.

Explanation
The best response in this situation is to refer the patient to a physical therapy clinical specialist who is an expert in shoulder reconstructive rehabilitation. This is because the specialist will have the specific knowledge and expertise needed to explain the rehabilitation process following the surgical procedure. They will be able to provide detailed information about how patients typically respond to the surgery and outline the progression of exercises. Referring the patient to the specialist ensures that they receive accurate and tailored information for their specific condition and needs.

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14.

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.
Correct Answer
B. 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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15.

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.
Correct Answer
C. 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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16.

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.
Correct Answer
B. 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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17.

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.
  
  Tapotement.
Correct Answer
C. 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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18.

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.
Correct Answer
B. Transfer training from floor to wheelchair.

Explanation
It would not be appropriate to emphasize transfer training from floor to wheelchair because a six-year-old boy with myelomeningocele at the L2 level is likely to have limited lower extremity function and may not be able to independently transfer from the floor to a wheelchair. Therefore, it would be more appropriate to focus on other aspects of physical therapy such as gait training with a reciprocating gait orthosis, upper extremity strengthening with weights, and vigorous range of motion of the lower extremities.

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19.

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.
Correct Answer
A. Hamstring muscle.

Explanation
The patient's pain with end range AROM into hip flexion, abduction, and external/lateral rotation suggests that the hamstring muscle is the most likely structure causing the pain. The hamstring muscle is responsible for hip extension, knee flexion, and assists in hip rotation. When the hamstring muscle is stretched in these directions, it can cause pain in the back. The other options, including the hip joint, piriformis muscle, and SI joint, do not directly correlate with the specific movements mentioned in the question.

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20.

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.
Correct Answer
B. normal distribution curve.

Explanation
The most appropriate statistical tool to use for analyzing the frequencies of carpal tunnel syndrome occurring in different groups of individuals (assembly line workers and computer programmers) is the normal distribution curve. This is because the normal distribution curve can provide information about the distribution of data and compare the frequencies between the two groups. It can help determine if the occurrence of carpal tunnel syndrome differs significantly between the two groups and provide insights into the overall pattern of the data.

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21.

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 deviation
Correct Answer
A. mean.

Explanation
In a skewed distribution with extreme scores, the mean is the most accurate representation of central tendency because it takes into account all the scores in the data set. The mean is calculated by summing all the scores and dividing by the total number of scores. While the extreme scores may pull the mean towards one end of the distribution, it still provides a good measure of the average performance of the total group. The median and mode may be less accurate in this case because they are not as affected by extreme scores. Standard deviation, on the other hand, is a measure of variability and not central tendency.

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22.

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.
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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23.

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.
  
  A. one-arm drive chair.
- D.
  
  Powered wheelchair with joystick
Correct Answer
C. A. one-arm drive chair.

Explanation
The MOST appropriate wheelchair prescription for this patient would be a one-arm drive chair. This type of wheelchair allows the patient to propel themselves using only one arm, which is important in this case since the patient has severe right hemiplegia. The one-arm drive chair would provide the patient with the necessary mobility and independence while accommodating their physical limitations.

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24.

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.
  
  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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25.

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.
Correct Answer
C. 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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26.

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
Correct Answer
B. Double glove and treat as scheduled.

Explanation
The correct answer is to double glove and treat as scheduled. This is because HIV is not transmitted through casual contact or through intact skin. By double gloving, you provide an extra layer of protection against potential exposure to the patient's exudate. Washing your hands thoroughly before and after treatment is also important to maintain good hygiene and prevent the spread of any potential infections. Refusing to treat the patient is not necessary as long as appropriate precautions are taken. Using sterile precautions with a mask and gloves may be excessive for this situation since the risk of transmission is low.

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27.

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.
Correct Answer
B. Tight hamstrings muscles.

Explanation
The patient's inability to maintain a comfortable supine position is likely due to tight hamstrings muscles. Tight hamstrings can cause the patient to arch their lumbar spine in supine, leading to discomfort. The fact that the patient doesn't remember having this problem before suggests that it may be a new issue related to the surgery or recovery process. Poor abdominal strength, tight iliopsoas muscle, and tight piriformis muscle may also contribute to discomfort in supine position, but tight hamstrings muscles are the most likely cause based on the information provided.

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28.

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.
Correct Answer
C. 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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29.

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.
Correct Answer
C. 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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30.

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.
Correct Answer
B. ignore these behaviors and continue treating.

Explanation
The best response as a physical therapist when a patient with multiple sclerosis is agitated, irritated, and tired during treatment is to ignore these behaviors and continue treating. This is because these symptoms are common in multiple sclerosis and may not necessarily indicate a need to stop or modify treatment. By continuing with the treatment, the therapist can help the patient maintain their functional abilities and improve their overall condition.

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31.

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.
Correct Answer
C. Medigap policies.
32.

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.
Correct Answer
B. daily warm water baths to improve circulation.
33.

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
Correct Answer
A. Hip extensor weakness.

Explanation
The patient's inability to bear weight on the left leg and advance the tibia forward suggests a problem with the hip extensor muscles. Hip extensor weakness would result in difficulty in extending the hip and maintaining stability during weight-bearing activities, leading to compensatory strategies such as abbreviating the stance phase and going directly into the swing phase. This explanation is supported by the fact that the other options (spasticity of the anterior tibialis muscle, spasticity or contracture of the plantarflexors, weakness or contracture of the dorsiflexors) do not directly address the patient's inability to bear weight and advance the tibia forward.

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34.

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.
Correct Answer
A. forearm supination.

Explanation
With a traction injury to the anterior division of the brachial plexus, there is damage to the nerves that control the muscles responsible for forearm supination. This is because the anterior division of the brachial plexus innervates the muscles that perform forearm supination, such as the biceps brachii and supinator muscles. Therefore, weakness in forearm supination would be expected in this type of injury.

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35.

A 95 year-old has recently been admitted to your skilled nursing facility following a fall-related injury (fractured hip with open reduction, internal fixation). Since she lived alone on the second floor, she was unable to return home. She is extremely agitated over her placement here and demonstrates early signs of dementia. She tells you “leave me alone, I just want to get out of here!” An important approach to take while working with this client is to:
- A.
  
  Be calm and supportive, using only one or two level commands.
- B.
  
  Establish the rules: tell her exactly what she is to do while you are with her.
- C.
  
  Use gesture or sign language to communicate with her.
- D.
  
  Promise her anything as long as she gets up and walks for you.
Correct Answer
C. Use gesture or sign language to communicate with her.
36.

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
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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37.

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
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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38.

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.
Correct Answer
C. 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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39.

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.
Correct Answer
A. Avoid direct contact with any part of the patient.

Explanation
To minimize transmission of hepatitis B, it is best to avoid direct contact with any part of the patient. Hepatitis B is primarily transmitted through contact with infected blood or body fluids. By avoiding direct contact, the risk of coming into contact with these fluids is reduced. Wearing gloves if there is direct contact with blood or body fluids is also important, but it is not the best option for minimizing transmission as it does not address the issue of direct contact. Having the patient wear a gown and mask or wearing gloves to prevent the patient from touching you may provide some protection, but they are not as effective as avoiding direct contact altogether.

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40.

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.
Correct Answer
C. Continuous monophasic current with the medication under the cathode.

Explanation
In iontophoresis, a direct current is used to deliver medication through the skin. The medication is typically placed under either the anode (positive electrode) or the cathode (negative electrode). In this case, procaine hydrochloride iontophoresis is being used to relieve pain and limited range of motion in the wrestler's shoulder. To administer the medication, it would be appropriate to use continuous monophasic current with the medication under the cathode. This means that the medication should be placed under the negative electrode, and a continuous, unidirectional current should be applied.

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41.

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.
Correct Answer
B. Functional chest wall immobility.

Explanation
Functional chest wall immobility refers to the inability of the chest wall to move properly due to factors such as muscle weakness or stiffness. In patients with chronic pulmonary disease, their chest wall may already be compromised, leading to limited movement and decreased lung function. Initiating joint mobilization in such patients can further exacerbate their chest wall immobility and potentially worsen their respiratory condition. Therefore, functional chest wall immobility is a contraindication to initiating joint mobilization in patients with chronic pulmonary disease.

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42.

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.
Correct Answer
C. Medicare.

Explanation
Medicare is a federal health insurance program in the United States that primarily covers individuals who are 65 years or older. It also covers certain younger individuals with disabilities and those with end-stage renal disease. Medicare provides coverage for various healthcare services, including long-term care for institutionalized elderly individuals who have reduced financial resources. Medicaid, on the other hand, is a joint federal and state program that provides healthcare coverage for low-income individuals, including long-term care services. Therefore, the correct answer is Medicare, not Medicaid.

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43.

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.
Correct Answer
A. Angina.
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.
Correct Answer
C. Supervising new staff and students in the use of all newly purchased equipment.

Explanation
The correct answer is "supervising new staff and students in the use of all newly purchased equipment." This answer is incorrect because it is important to supervise new staff and students in the use of all newly purchased equipment to ensure their safety and proper usage. Supervision is necessary to prevent any accidents or misuse of the equipment. Therefore, this procedure should be followed to ensure safety in the clinic.

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45.

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.
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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46.

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.
Correct Answer
B. 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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47.

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 training.
Correct Answer
C. 3-4 weeks of training

Explanation
Hypertrophy is the process of muscle growth and is a response to strength training. It takes time for the muscles to adapt and grow in size. Therefore, it can be expected to occur after a certain period of consistent training. In this case, the correct answer is 3-4 weeks of training, indicating that it typically takes around a month of regular strength training for hypertrophy to start occurring.

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48.

A 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.
Correct Answer
C. Horizontal adduction.
49.

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.
Correct Answer
C. Practice standing-up from half-kneeling.

Explanation
The best course of action to promote active learning in this scenario is to have the patient practice standing-up from half-kneeling. This activity requires the patient to actively engage their muscles and coordinate movements to bring their foot up and stand up from a kneeling position. By practicing this movement, the patient will be able to improve their ability to bring their foot up on the next step during stair climbing. The other options mentioned, such as balancing on the stairs while the foot is passively brought up or practicing marching in place, do not specifically target the movement needed for stair climbing.

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50.

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.
Correct Answer
C. sit-to-stand and stand-to-sit activity training.

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Current Version
Mar 30, 2024

Quiz Edited by
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Aug 14, 2017

Quiz Created by
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Ot/Pt Haad Simulation 6

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:

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 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:

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 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 patient has been diagnosed with acute synovitis of the temporomandibular joint. Early intervention should focus on:

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:

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:

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

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:

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 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 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:

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 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:

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 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 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 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:

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:

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 with multiple sclerosis is agitated, irritated, and tired during treatment. Your BEST response as the P.T. is to:

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:

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:

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:

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:

You are treating a patient with active hepatitis B infection. Transmission of the disease is best minimized if you:

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 contraindication to initiating joint mobilization on a patient with chronic pulmonary disease may include:

Long term care for institutionalized elderly who have reduced their financial resources or qualify for low-income status is typically funded by:

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 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:

Hypertrophy is the muscular response to strength training. This can be expected to occur following at least:

A 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 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 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: