Pqg4 Part 4 Of 4

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A physical therapist assistant is providing patient coverage for a physical therapist who is on vacation. The physical therapist assistant should be allowed to perform all of the following EXCEPT
- Supervise exercise activities
- Modify treatment plan
- Gait training activities
- Write daily progress notes

About This Quiz

PQG4 Part 4 of 4 explores key concepts in physical therapy. It covers thoracodynia, joint receptor sensitivity, effects of nerve injuries, exercise types, joint mobility, and muscle insufficiency. Essential for students and professionals aiming to enhance diagnostic and therapeutic skills in physical therapy.

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2.

A physical therapist is treating a patient with unilateral lower extremity weakness. As the patient performs hip flexion in supine, the therapist helps the patient complete the full range of motion. This would best be described as
- Active exercise
- Passive exercise
- Resistive exercise
- Active-assistive exercise
Correct Answer

A. Active-assistive exercise

Explanation

The therapist is helping the patient complete the full range of motion while the patient performs hip flexion in supine position. This indicates that the patient is actively participating in the exercise, but requires assistance from the therapist to complete the movement. Therefore, the best description for this scenario is active-assistive exercise.

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3.

A patient is treated for a brachial plexus injury sustained in a stabbing. The patient presents with winging of the scapula. Which nerve is commonly involved with this condition?
- Long thoracic
- Musculocutaneous
- Subscapular
- Ulnar
Correct Answer

A. Long thoracic

Explanation

The long thoracic nerve is commonly involved with winging of the scapula. This condition occurs when the nerve is damaged or compressed, leading to weakness or paralysis of the muscles that stabilize the scapula. In the case of a brachial plexus injury sustained in a stabbing, it is possible for the long thoracic nerve to be affected, resulting in winging of the scapula.

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4.

An effective supervisor should adhere to all of the following guidelines EXCEPT
- Create a climate of involvement for all staff
- Delegate responsibility with commensurate authority
- Use intuition in the selection of new employees, rather than selection techniques and interviews
- Maintain open channels of communication for all levels of staff
Correct Answer

A. Use intuition in the selection of new employees, rather than selection techniques and interviews

Explanation

An effective supervisor should adhere to all of the given guidelines except using intuition in the selection of new employees, rather than selection techniques and interviews. This is because using intuition alone may lead to biased or subjective decision-making in the hiring process. It is important for supervisors to rely on objective selection techniques and interviews to ensure fairness and find the most qualified candidates for the job.

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5.

A patient diagnosed with Parkinson’s disease has difficulty initiating movement. What proprioceptive neuromuscular technique would be most appropriate to treat this problem?
- Contract-relax
- Rhythmic initiation
- Rhythmic stabilization
- Slow reversal
Correct Answer

A. Rhythmic initiation

Explanation

Rhythmic initiation would be the most appropriate proprioceptive neuromuscular technique to treat a patient with difficulty initiating movement in Parkinson's disease. This technique involves the therapist guiding the patient through passive range of motion exercises, gradually increasing the patient's active participation. By starting with passive movements and gradually transitioning to active movements, rhythmic initiation helps to improve the patient's ability to initiate voluntary movements and overcome the difficulties caused by Parkinson's disease.

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6.

A manual muscle test is repeated by three therapists who obtain the same grade each time. This activity demonstrates
- Intrarater reliability
- Interrater reliability
- Intrarater validity
- Interrater validity
Correct Answer

A. Interrater reliability

Explanation

The fact that three therapists obtain the same grade each time they repeat the manual muscle test suggests that there is consistency and agreement among the therapists. This demonstrates interrater reliability, which refers to the consistency of measurements or observations made by different raters or observers. In this case, the therapists are able to obtain the same grade consistently, indicating that their ratings are reliable and consistent with each other.

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7.

A physical therapist evaluates a patient with a suspected acutely torn medial meniscus. Which symptom is not commonly associated with a medial meniscus tear?
- Tenderness along the medial joint line
- Moderate to severe pain
- Joint locking
- Hamstring atrophy
Correct Answer

A. Hamstring atrophy

Explanation

Hamstring atrophy is not commonly associated with a medial meniscus tear. A tear in the medial meniscus usually causes symptoms such as tenderness along the medial joint line, moderate to severe pain, and joint locking. However, hamstring atrophy refers to the wasting or loss of muscle mass in the hamstring muscles, and it is not typically seen in cases of a medial meniscus tear.

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8.

A therapist performs a muscle screening test on a 16 year-old male. The therapist positions the patient in supine with his hips and knees flexed and the soles of his feet in contact with the table. The therapist instructs the patient to raise his hips from the table. The therapist uses these instructions to assess the patient’s
- Hip abductors
- Hip adductors
- Hip extensors
- Hip flexors
Correct Answer

A. Hip extensors

Explanation

The therapist positions the patient in supine with his hips and knees flexed and the soles of his feet in contact with the table. The therapist instructs the patient to raise his hips from the table. This test is used to assess the strength and function of the hip extensors, which are the muscles responsible for lifting the hips up from a supine position.

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9.

A patient diagnosed with multiple sclerosis is instructed in cane walking using two canes. Which gait pattern is most appropriate using two canes?
- Swing to
- Swing through
- Three point gait
- Four point gait
Correct Answer

A. Four point gait

Explanation

The four point gait is the most appropriate gait pattern when using two canes for a patient diagnosed with multiple sclerosis. In the four point gait, the patient moves one cane forward, followed by the opposite leg, then moves the other cane forward, followed by the opposite leg. This pattern provides the patient with the most stability and support while walking, helping to improve balance and prevent falls.

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10.

A physical therapist performs a test to measure the strength of a patient’s lower abdominal muscles. The most appropriate technique to evaluate this is
- Partial sit up
- Full sit up with rotation
- Single leg raise
- Double leg raise
Correct Answer

A. Double leg raise

Explanation

The double leg raise is the most appropriate technique to evaluate the strength of a patient's lower abdominal muscles. This exercise specifically targets the lower abdominal muscles by requiring the patient to lift both legs off the ground while lying on their back. This movement engages the entire core, including the lower abdominal muscles, and provides a more accurate assessment of their strength compared to other exercises such as partial sit-ups or single leg raises. Additionally, the double leg raise allows for greater resistance and challenge, making it a more effective test for measuring lower abdominal muscle strength.

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11.

A physical therapist is treating a patient with a dorsal scapular nerve injury. Which muscles would you expect to be most affected by this condition?
- Serratus anterior, pectoralis minor
- Levator scapulae, rhomboids
- Latissimus dorsi, teres major
- Supraspinatus, infraspinatus
Correct Answer

A. Levator scapulae, rhomboids

Explanation

A dorsal scapular nerve injury would most likely affect the levator scapulae and rhomboid muscles. The levator scapulae muscle helps elevate the scapula (shoulder blade), while the rhomboid muscles retract the scapula towards the spine. Damage to the dorsal scapular nerve can result in weakness or paralysis of these muscles, leading to difficulty in elevating and retracting the scapula properly. This can cause pain, limited range of motion, and postural abnormalities in the affected individual.

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12.

The long term goal of a CVA patient is to return to driving. The primary deficit that the patient must learn to compensate for is
- Hemianopsia
- Expressive aphasia
- Agraphia
- Dysarthria
Correct Answer

A. Hemianopsia

Explanation

The correct answer is hemianopsia. Hemianopsia is a visual deficit where a person loses half of their visual field in both eyes. This can make driving difficult as the person may not be able to see objects or people on one side of the road. To compensate for this deficit, the patient must learn to scan their environment more thoroughly and use techniques such as head turning to ensure they are aware of their surroundings while driving.

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13.

A female distance runner complains of recurrent friction blisters whenever she increases the intensity of her training regimen. Appropriate physical therapy care of friction blisters include all of the following EXCEPT
- Pad the blister with a pressure pad
- Use of skin tougheners with astringents
- Soak regularly in ice water after activity
- Cut a large incision along the periphery of the blister with a sterile instrument
Correct Answer

A. Cut a large incision along the periphery of the blister with a sterile instrument

Explanation

Cutting a large incision along the periphery of the blister with a sterile instrument is not an appropriate physical therapy care for friction blisters. This can increase the risk of infection and delay the healing process. The other options mentioned, such as padding the blister with a pressure pad, using skin tougheners with astringents, and soaking regularly in ice water after activity, are all appropriate methods to manage friction blisters.

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14.

A forearm laceration causes damage to the median nerve. Which muscle not innervated by the medial nerve can flex the wrist?
- Flexor carpi radialis
- Flexor carpi ulnaris
- Flexor digitorum superficialis
- Palmaris longus
Correct Answer

A. Flexor carpi ulnaris

Explanation

The correct answer is flexor carpi ulnaris. The question asks for a muscle that can flex the wrist but is not innervated by the median nerve. The median nerve is responsible for innervating the flexor carpi radialis, flexor digitorum superficialis, and palmaris longus muscles. Therefore, the flexor carpi ulnaris is the only option left that fits the criteria.

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15.

A group of physical therapy students gathers data on the public’s perception of physical therapy. The students use a questionnaire of closed end questions which is randomly distributed to individuals throughout the country. All of the following are advantages of using closed end questions EXCEPT
- Quicker and relatively inexpensive to analyze
- Helps to ensure that answers are given in a frame of reference relevant to the research
- Forces the respondent to choose an answer even if the choice that corresponds to that of the respondent is not listed
- Makes the meaning of the question clearer
Correct Answer

A. Forces the respondent to choose an answer even if the choice that corresponds to that of the respondent is not listed

Explanation

Closed end questions do not force the respondent to choose an answer if the choice that corresponds to their response is not listed. Instead, closed end questions provide a set of predetermined answer options for the respondent to choose from. This helps to ensure that answers are given in a frame of reference relevant to the research, makes the meaning of the question clearer, and allows for quicker and relatively inexpensive analysis of the data.

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16.

A clinical instructor notices that his senior student is unmotivated and occasionally noncompliant with the facility’s policies and procedures. The therapist’s immediate response to assist the student would be to
- Ask the student to discuss the problems in a formal setting with the director of the department
- Meet formally with the student to discuss the situation
- Contact the student’s school and discuss the student’s difficulty with the academic coordinator of clinical education
- Give the student a short term deadline to improve his level of motivation
Correct Answer

A. Meet formally with the student to discuss the situation

Explanation

The correct answer is to meet formally with the student to discuss the situation. This option allows the clinical instructor to directly address the student's lack of motivation and noncompliance. By meeting with the student, the instructor can understand the underlying issues and provide guidance and support to help improve the student's performance. This approach promotes open communication and collaboration between the instructor and student, fostering a better learning environment.

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17.

A therapist tests a small area of skin for hypersensitivity prior to using a cold immersion bath. The patient begins to demonstrate evidence of cold insensitivity within 60 seconds after cold application. The most appropriate response is to
- Limit cold exposure to ten minutes or less
- Select an alternative cryotherapeutic agent
- Continue with the cold immersion bath
- Discontinue cold treatment and document your findings
Correct Answer

A. Discontinue cold treatment and document your findings

Explanation

The correct answer is to discontinue cold treatment and document your findings. If the patient demonstrates evidence of cold insensitivity within 60 seconds after cold application, it indicates that they may have a condition that makes them unable to tolerate cold immersion. Continuing with the cold immersion bath could potentially harm the patient. Therefore, it is important to discontinue the treatment and document the findings to ensure proper care and avoid any further complications.

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18.

A physical therapist positions a patient in prone to measure passive knee flexion. Range of motion may be limited in this position due to
- Active insufficiency of the knee extensors
- Active insufficiency of the knee flexors
- Passive insufficiency of the knee extensors
- Passive insufficiency of the knee flexors
Correct Answer

A. Passive insufficiency of the knee extensors

Explanation

Passive insufficiency of the knee extensors refers to the inability of the knee extensor muscles to fully lengthen or stretch when the knee is in a flexed position. In the prone position, with the patient lying face down, the knee is flexed, which puts the knee extensor muscles in a shortened position. This can limit the range of motion during passive knee flexion measurement because the knee extensors cannot fully lengthen to allow for a greater range of motion. Therefore, the correct answer is passive insufficiency of the knee extensors.

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19.

Physical therapy intervention for a child with chronic asthma include all of the following EXCEPT
- Parental education in drainage positioning and manual techniques
- Education in relaxation techniques
- Education in decreasing diaphragmatic breathing and increasing accessory muscle use
- Education in the use of nasal breathing
Correct Answer

A. Education in decreasing diaphragmatic breathing and increasing accessory muscle use

Explanation

Physical therapy intervention for a child with chronic asthma typically includes parental education in drainage positioning and manual techniques to help clear mucus from the airways, education in relaxation techniques to reduce stress and anxiety which can trigger asthma symptoms, and education in the use of nasal breathing to promote better airflow. However, education in decreasing diaphragmatic breathing and increasing accessory muscle use is not typically included in physical therapy for asthma as it may exacerbate symptoms and make breathing more difficult. This answer option does not align with the usual goals and strategies of physical therapy for asthma.

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20.

A physical therapist uses proprioceptive neuromuscular facilitation to increase muscular strength. The therapist instructs the patient to actively perform a pattern of hip extension, abduction and internal rotation. The pattern emphasizes strengthening of the
- Psoas major and minor, iliacus
- Tensor fasciae latae, biceps femoris
- Gluteus maximus, medius and minimus
- Gluteus maximus, piriformis, adductor magnus
Correct Answer

A. Gluteus maximus, medius and minimus

Explanation

The correct answer is gluteus maximus, medius, and minimus. Proprioceptive neuromuscular facilitation (PNF) is a technique used by physical therapists to increase muscular strength. In this case, the therapist instructs the patient to actively perform a pattern of hip extension, abduction, and internal rotation. These movements specifically target the gluteus maximus, medius, and minimus muscles, which are important for hip stability and overall lower body strength. Strengthening these muscles can help improve posture, balance, and functional movement.

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21.

Which clinical observation is not usually characteristic with a rupture of the rotator cuff?
- The typical patient is less than 40 years old
- The patient is often unable to move the arm actively without pain
- Scapulohumeral rhythm is altered
- Night pain is a common patient complaint
Correct Answer

A. The typical patient is less than 40 years old

Explanation

The typical patient being less than 40 years old is not usually characteristic of a rupture of the rotator cuff. Rotator cuff tears are more common in individuals over the age of 40, particularly in those who engage in repetitive overhead activities or have a history of shoulder trauma. Therefore, a patient being younger than 40 would be atypical for this condition.

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22.

Which of the following fractures involving the cranium is the least likely to produce a brain injury?
- Depressed
- Linear
- Compound
- Comminuted
Correct Answer

A. Linear

Explanation

A linear fracture involves a single line of break in the cranial bone, without any displacement or depression. This type of fracture is considered the least likely to produce a brain injury because it does not involve any displacement or compression of the brain tissue. Linear fractures are usually stable and do not cause significant damage to the brain, making them less likely to result in brain injury compared to other types of fractures such as depressed, compound, or comminuted fractures.

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23.

Studies using intradiscal pressures in the lumbar spine have given physical therapists valuable information on the importance of body position. Which body position would you expect to place the most pressure on the lumbar spine?
- Standing in the anatomical position
- Standing with a 45 degrees of hip flexion
- Sitting in a chair
- Sitting in a chair with reduced lumbar lordosis
Correct Answer

A. Sitting in a chair with reduced lumbar lordosis

Explanation

Sitting in a chair with reduced lumbar lordosis would place the most pressure on the lumbar spine. Lumbar lordosis refers to the natural inward curve of the lower spine. When this curve is reduced or flattened, it increases the load on the intervertebral discs, leading to higher intradiscal pressures. Therefore, sitting in a chair with reduced lumbar lordosis would result in increased pressure on the lumbar spine compared to the other positions mentioned.

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24.

Therapists often have an extremely busy schedule and must therefore make the most of the scheduled time they have with each patient. Which of the following would not improve the quality of time a therapist spends with a patient?
- Sit down when talking to the patient
- Call attention to how busy you are but let the patient know you enjoy the time you spend with them
- Remove the patient from hospital traffic or busy areas where distractions may occur
- Look the patient in the eye during conversation
Correct Answer

A. Call attention to how busy you are but let the patient know you enjoy the time you spend with them

Explanation

Calling attention to how busy the therapist is may create a sense of rush and stress during the session, which can negatively impact the quality of time spent with the patient. It is important for therapists to create a calm and comfortable environment for the patient, and focusing on their own busyness may distract from this goal. However, letting the patient know that the therapist enjoys the time spent with them can help build rapport and trust, enhancing the quality of the therapeutic relationship.

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25.

A physician orders an immediate postoperative prosthesis for a patient with a below knee amputation. All of the following are benefits of the rigid dressing EXCEPT
- It limits the development of edema
- It allows for early ambulation with the pylon/foot attachment
- It is custom made to each individual residual limb
- It allows for daily wound inspection and dressing changes
Correct Answer

A. It allows for daily wound inspection and dressing changes

Explanation

The rigid dressing is custom made to each individual residual limb, limits the development of edema, and allows for early ambulation with the pylon/foot attachment. However, it does not allow for daily wound inspection and dressing changes.

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26.

Reflex sympathetic dystrophy syndrome can be a painful and debilitating problem. All of the following techniques are commonly used to treat reflex sympathetic dystrophy syndrome EXCEPT
- Active and passive range of motion exercises in a warm whirlpool
- Topical stimulation using a towel or soft cloth
- Transcutaneous electrical nerve stimulation
- Resistive exercises
Correct Answer

A. Resistive exercises

Explanation

Resistive exercises are not commonly used to treat reflex sympathetic dystrophy syndrome. Reflex sympathetic dystrophy syndrome is a condition characterized by chronic pain and inflammation in the affected area. The other three techniques mentioned - active and passive range of motion exercises in a warm whirlpool, topical stimulation using a towel or soft cloth, and transcutaneous electrical nerve stimulation - are commonly used to alleviate pain and improve mobility in patients with this condition. However, resistive exercises, which involve using weights or resistance bands to strengthen muscles, may exacerbate the pain and inflammation associated with reflex sympathetic dystrophy syndrome.

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27.

Treating a patient diagnosed with reflex sympathetic dystrophy can be at times frustrating for a physical therapist. The most important ingredient of productive treatment is
- The selection of appropriate therapeutic modalities
- The selection of appropriate range of motion exercises
- The use of transcutaneous electrical nerve stimulation
- The attitude of the rehabilitation team
Correct Answer

A. The attitude of the rehabilitation team

Explanation

The attitude of the rehabilitation team is the most important ingredient of productive treatment for a patient diagnosed with reflex sympathetic dystrophy. This suggests that the way the team approaches and interacts with the patient plays a crucial role in their overall treatment and recovery. A positive and supportive attitude from the rehabilitation team can greatly impact the patient's motivation, compliance, and overall progress. Conversely, a negative or dismissive attitude can hinder the patient's willingness to participate in therapy and may negatively affect their outcomes. Therefore, the attitude of the rehabilitation team is vital in providing effective treatment for this condition.

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28.

A physical therapist is treating a CVA patient with apraxia. All of the following techniques are commonly used to treat apraxia EXCEPT
- The therapist should speak slowly and directly to the patient
- Multiple step commands should be used for activities of daily living
- A new task should be broken down into smaller components
- Repetition of tasks may be necessary
Correct Answer

A. Multiple step commands should be used for activities of daily living

Explanation

Apraxia is a motor planning disorder that affects a person's ability to perform purposeful movements. To treat apraxia, a physical therapist would typically use techniques such as speaking slowly and directly to the patient, breaking down new tasks into smaller components, and repeating tasks as necessary. However, using multiple step commands for activities of daily living may be challenging for a patient with apraxia, as they have difficulty planning and coordinating complex movements. Therefore, this technique would not be commonly used to treat apraxia.

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29.

A physical therapist evaluates a patient status post medial meniscectomy. The patient reports a chronic history of medial knee pain. Static posture assessment reveals significant genu valgum bilaterally. Causes of genu valgum include all of the following EXCEPT
- Tightness of the iliotibial band and lateral knee joint structures
- Lengthened medial knee joint structures
- Femoral retroversion
- Foot pronation
Correct Answer

A. Femoral retroversion

Explanation

Genu valgum is a condition where the knees are positioned inwards, causing the legs to appear bowed. It is commonly caused by tightness of the iliotibial band and lateral knee joint structures, lengthened medial knee joint structures, and foot pronation. However, femoral retroversion is not a cause of genu valgum. Femoral retroversion refers to a backward rotation of the femur bone in relation to the hip joint, which can affect the alignment of the hip and leg, but it is not directly related to the positioning of the knees.

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30.

A physical therapist instructs a patient to move from sitting to quadruped to tall kneeling. By moving through the developmental sequence a patient gains ____ control during movement and ___ during balance activities.
- Isometric, isotonic
- Isotonic, isometric
- Isometric, isokinetic
- Isokinetic, isotonic
Correct Answer

A. Isotonic, isometric

Explanation

Moving through the developmental sequence from sitting to quadruped to tall kneeling allows a patient to gain isotonic control during movement. This means that the patient is able to control and generate force throughout the entire range of motion. Additionally, the patient gains isometric control during balance activities, which means they are able to maintain stability and control without any joint movement.

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31.

All of the following are true statements regarding associated reactions EXCEPT
- A stimulus is needed to produce an associated reaction
- Associated reactions are volitional
- The Raimiste’s phenomenon is an example of an associated reaction
- Associated reactions tend to occur in predictable patterns
Correct Answer

A. Associated reactions are volitional

Explanation

Associated reactions are involuntary, meaning they are not under conscious control. This is in contrast to volitional actions, which are intentional and can be controlled by the individual. Therefore, the statement "associated reactions are volitional" is not true.

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32.

A physical therapist is evaluating a right hemiplegic four days status post CVA. All of the following would be appropriate short term goals EXCEPT
- Improve trunk control and sitting balance
- Initiate self care activities
- Promote awareness and use of the hemiplegic side
- Perform lower extremity exercises without assistance
Correct Answer

A. Perform lower extremity exercises without assistance

Explanation

The correct answer is "perform lower extremity exercises without assistance." This would not be an appropriate short-term goal for a right hemiplegic patient four days post CVA. The patient is likely to have significant weakness and limited mobility on the affected side, so it would be more appropriate to focus on goals that address trunk control, sitting balance, and promoting awareness and use of the hemiplegic side. Initiating self-care activities would also be important for the patient's overall independence and recovery.

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33.

Experimental evidence exists that immobilization following surgery can facilitate faster healing with a better end result. Which statement regarding immobilization is not true?
- The position of a limb during immobilization affects the end result
- Prolonged immobilization can be detrimental to certain body parts
- Immobilization can lead to abnormal cross-linking of collagen fibers and an increase in tissue elasticity
- Immobilization does not always produce a good result when applied indiscriminately
Correct Answer

A. Immobilization can lead to abnormal cross-linking of collagen fibers and an increase in tissue elasticity

Explanation

The given statement is not true because immobilization does not lead to abnormal cross-linking of collagen fibers and an increase in tissue elasticity. Immobilization can actually cause collagen fibers to become weaker and less elastic. This can result in decreased range of motion and increased stiffness in the immobilized area.

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34.

A physical therapist might select a metal upright ankle foot orthosis instead of a plastic ankle foot orthosis if the patient exhibits
- Mild sensory loss
- Severe fluctuating edema
- Cosmetic concerns
- Mediolateral ankle instability
Correct Answer

A. Severe fluctuating edema

Explanation

A physical therapist might select a metal upright ankle foot orthosis instead of a plastic ankle foot orthosis if the patient exhibits severe fluctuating edema. This is because a metal upright ankle foot orthosis provides more support and stability to the ankle and foot, which is necessary for patients with severe fluctuating edema. The metal construction helps to prevent excessive swelling and provides better control of the edema. Plastic ankle foot orthosis may not provide enough support and may not be able to accommodate the fluctuating edema effectively.

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35.

Which therapeutic modality would be contraindicated in a pediatric patient with juvenile rheumatoid arthritis?
- Superficial heat
- Ultrasound
- Transcutaneous electrical nerve stimulation
- Ice
Correct Answer

A. Ultrasound

Explanation

Ultrasound would be contraindicated in a pediatric patient with juvenile rheumatoid arthritis because it generates heat and can potentially increase inflammation and pain in the affected joints. Inflammation is a key feature of juvenile rheumatoid arthritis, and applying heat through ultrasound can exacerbate this inflammation, leading to further discomfort and potentially worsening the condition. Therefore, ultrasound should be avoided in this population to prevent any adverse effects.

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36.

While discussing a patient’s progress with the referring physician, the physician asks if the patient has demonstrate any signs of thoracodynia. Thoracodynia can be described as
- Hypoventilation
- Inadequate chest expansion
- Diaphragmatic spasm
- Chest pain
Correct Answer

A. Chest pain

Explanation

Thoracodynia refers to chest pain. This term is used to describe pain or discomfort in the chest area. It is a symptom that can be caused by various conditions such as heart problems, lung diseases, musculoskeletal issues, or even anxiety. When discussing a patient's progress, the referring physician might be interested in knowing if the patient has experienced any chest pain as it can be indicative of certain underlying conditions.

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37.

Which type of joint receptor would a therapist expect to be most sensitive to high frequency vibration, acceleration and high velocity changes in joint position?
- Free nerve endings
- Golgi-Mazzoni corpuscles
- Pacinian corpuscles
- Ruffini endings
Correct Answer

A. Pacinian corpuscles

Explanation

Pacinian corpuscles are specialized nerve endings that are highly sensitive to high frequency vibration, acceleration, and high velocity changes in joint position. These receptors are found in the skin and connective tissues surrounding joints. When there is a rapid change in joint position or movement, Pacinian corpuscles detect the mechanical stimuli and send signals to the brain, allowing us to perceive and respond to these changes. This sensitivity makes Pacinian corpuscles the most likely type of joint receptor to be sensitive to high frequency vibration, acceleration, and high velocity changes in joint position.

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38.

A physical therapist often utilizes therapeutic massage as part of a patient’s treatment program. Which of the following statements describing massage is correct?
- The therapist should avoid prolonged massage in painful areas
- Massage will not provide relaxation and decrease stress
- Massage prior to mobilization is contraindicated
- The therapist should use deep massage aggressively with acute conditions
Correct Answer

A. The therapist should avoid prolonged massage in painful areas

Explanation

Prolonged massage in painful areas can potentially worsen the pain and cause further discomfort to the patient. It is important for the therapist to be cautious and avoid applying excessive pressure or prolonged massage in areas that are already painful or sensitive.

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39.

A physical therapist is treating a four month-old infant. During mat activities the infant suddenly becomes unconscious. The most appropriate location to check the infant’s pulse is the
- Femoral artery
- Brachial artery
- Popliteal artery
- Carotid artery
Correct Answer

A. Brachial artery

Explanation

The brachial artery is the most appropriate location to check the infant's pulse because it is easily accessible and is commonly used for pulse assessment in infants. It is located in the upper arm, near the elbow, and can be easily palpated. Checking the pulse in this location allows for quick assessment of the infant's circulation and can help determine if there is a problem with blood flow or oxygenation.

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40.

A CVA patient with a flaccid upper extremity lies supine in bed. The patient’s physical therapist discourages her from lying supine for long periods of time because
- The position can cause shoulder-hand syndrome
- The position increases an inferior subluxation
- The position increases and reinforces increased tone in the scapula and shoulder
- The position increases tone in the pectoralis
Correct Answer

A. The position increases and reinforces increased tone in the scapula and shoulder

Explanation

Lying supine for long periods of time can lead to increased tone in the scapula and shoulder muscles in a CVA patient with a flaccid upper extremity. This is because the position does not provide adequate movement and stimulation to these muscles, causing them to become stiff and tense. By discouraging the patient from lying supine, the physical therapist aims to prevent the reinforcement of this increased tone and promote better muscle function and mobility.

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41.

A physical therapist observes a patient during gait training. The patient has normal strength and equal leg length. As the patient passes midstance he slightly vaults and has early toe off. The most likely cause of this deviation is
- Patient has excessive forefoot pronation
- Patient has limited hamstring length
- Patient has limited plantarflexion
- Patient has limited dorsiflexion
Correct Answer

A. Patient has limited dorsiflexion

Explanation

The most likely cause of the patient's deviation is limited dorsiflexion. Limited dorsiflexion refers to a restricted range of motion in which the patient is unable to adequately flex their foot upward. This can lead to compensatory movements during gait, such as vaulting and early toe off, as the patient tries to compensate for the lack of dorsiflexion.

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42.

A physical therapist performs deep transverse friction massage to the supraspinatus tendon. The most appropriate position to administer this technique would be with the patient
- Sitting with the upper arm in a neutral to slightly extended position with the lower arm supported
- Sitting with the upper arm extended and externally rotated
- Supine with the upper arm fully flexed
- Supine with the upper arm abducted to 45 degrees and the lower arm supported
Correct Answer

A. Sitting with the upper arm in a neutral to slightly extended position with the lower arm supported

Explanation

The most appropriate position to administer deep transverse friction massage to the supraspinatus tendon is with the patient sitting with the upper arm in a neutral to slightly extended position with the lower arm supported. This position allows for better access to the supraspinatus tendon and ensures that the patient is comfortable during the procedure. Sitting also helps to relax the shoulder muscles, making it easier for the therapist to perform the massage effectively.

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43.

To assess joint play movement a therapist places the joint in the loose packed or resting position. Which statement describing this position is not accurate?
- The loose packed position is the position of a joint in its range of motion where the joint is under the least amount of stress.
- The loose packed position is equivalent to the anatomic resting position for each joint
- The loose packed position allows the movement of spin, slide and roll in a joint.
- The loose packed position is one of minimal congruency between the articular surface and joint capsule
Correct Answer

A. The loose packed position is equivalent to the anatomic resting position for each joint

Explanation

The loose packed position is not equivalent to the anatomic resting position for each joint.

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44.

A therapist observes the gait of a 55 year-old male diagnosed with peripheral vascular disease. The therapist identifies an increase in the base of support during stance phase and circumduction of the right lower extremity during swing phase. Possible causes include all of the following EXCEPT
- Decrease in active dorsiflexion
- Increase in active hip flexion
- Weakness in the adductor muscles
- General lack of coordination and balance
Correct Answer

A. Increase in active hip flexion

Explanation

The therapist observes an increase in the base of support during stance phase and circumduction of the right lower extremity during swing phase. These observations suggest that the individual is compensating for a lack of active dorsiflexion, which is the ability to lift the foot upwards towards the shin. This compensatory movement pattern helps to clear the foot during the swing phase. Weakness in the adductor muscles could also contribute to the observed gait abnormalities. A general lack of coordination and balance could also affect gait, but it is not specifically related to the observed findings. Therefore, the possible cause that is not related to the observed gait abnormalities is an increase in active hip flexion.

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45.

While reviewing the results of a goniometric evaluation, a physical therapist notes that active horizontal adduction was recorded at 80 degrees. This recording should be considered
- Hypermobile
- Hypomobile
- Within normal limits
- Not enough information is given to make an accurate assessment
Correct Answer

A. Hypermobile

Explanation

Based on the information provided, a physical therapist notes that active horizontal adduction was recorded at 80 degrees. In a goniometric evaluation, horizontal adduction refers to the movement of bringing the arm across the body towards the midline. A normal range of motion for horizontal adduction is typically around 0-45 degrees. Therefore, a recording of 80 degrees indicates an excessive range of motion, suggesting hypermobility.

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46.

A physical therapist evaluates a patient diagnosed with patellofemoral syndrome. The therapist identifies significant genu recurvatum bilaterally. Which of the following is not usually associated with genu recurvatum?
- Tightness of the quadriceps
- Tight popliteus and hamstring muscles at the knee
- Increased compression forces anteriorly
- Tightness of the gastrocnemius and soleus
Correct Answer

A. Tight popliteus and hamstring muscles at the knee

Explanation

Tight popliteus and hamstring muscles at the knee are usually associated with genu recurvatum.

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47.

Using proper techniques for goniometry ensures reliability, validity and objectivity. Which of the following is considered appropriate technique when conducting goniometric measurements?
- Place the movable arm of the goniometer parallel to the longitudinal axis of the midline of the fixed segment in line with the designated bony landmark
- Align the goniometer and take readings at the middle and at the completion of each movement
- Perform the motion passively two or three times to eliminate substitutions and tightness due to inactivity
- Stabilize the distal body segment
Correct Answer

A. Perform the motion passively two or three times to eliminate substitutions and tightness due to inactivity

Explanation

Performing the motion passively two or three times helps to eliminate substitutions and tightness due to inactivity. This technique ensures that the measurements are accurate and reliable by allowing the joint to move freely without any compensatory movements or restrictions caused by muscle tightness. By repeating the motion, any initial resistance or stiffness in the joint can be overcome, providing a more accurate measurement of the joint's range of motion.

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48.

According to the Standards of Ethical Conduct for Physical Therapist Assistants as written by the American Physical Therapy Association, all of the following are correct EXCEPT
- Physical therapist assistants shall work under the supervision and direction of a physical therapist or senior physical therapist assistant.
- Physical therapist assistants may not initiate or alter a treatment program without prior evaluation by and approval of the supervising physical therapist
- Physical therapist assistants may not interpret data beyond the scope of their physical therapist assistant education
- Physical therapist assistants shall refer inquiries regarding patient prognosis to a supervising physical therapist
Correct Answer

A. Physical therapist assistants shall work under the supervision and direction of a physical therapist or senior physical therapist assistant.

Explanation

According to the Standards of Ethical Conduct for Physical Therapist Assistants, physical therapist assistants are indeed required to work under the supervision and direction of a physical therapist or senior physical therapist assistant. Therefore, this statement is correct and not an exception. The other statements mentioned in the question are also correct as per the standards.

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49.

Health Maintenance Organizations continue to grow in popularity throughout the United States. Health Maintenance Organizations are most likely to restrict physical therapy coverage based on
- Duration of individual treatment sessions
- Period of delivery
- Number of visits
- Frequency of visits
Correct Answer

A. Period of delivery

Explanation

Health Maintenance Organizations (HMOs) are a popular choice for healthcare in the United States. These organizations are likely to restrict coverage for physical therapy based on the period of delivery. This means that they may limit the coverage to a specific time frame or duration. The HMOs may have certain guidelines or restrictions on how long an individual can receive physical therapy treatment. This could be based on the overall period of delivery for the treatment, ensuring that it does not extend beyond a certain timeframe.

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Pqg4 Part 4 Of 4

A physical therapist assistant is providing patient coverage for a physical therapist who is on vacation. The physical therapist assistant should be allowed to perform all of the following EXCEPT

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A physical therapist performs deep transverse friction massage to the supraspinatus tendon. The most appropriate position to administer this technique would be with the patient

To assess joint play movement a therapist places the joint in the loose packed or resting position. Which statement describing this position is not accurate?

A therapist observes the gait of a 55 year-old male diagnosed with peripheral vascular disease. The therapist identifies an increase in the base of support during stance phase and circumduction of the right lower extremity during swing phase. Possible causes include all of the following EXCEPT

While reviewing the results of a goniometric evaluation, a physical therapist notes that active horizontal adduction was recorded at 80 degrees. This recording should be considered

A physical therapist evaluates a patient diagnosed with patellofemoral syndrome. The therapist identifies significant genu recurvatum bilaterally. Which of the following is not usually associated with genu recurvatum?

Using proper techniques for goniometry ensures reliability, validity and objectivity. Which of the following is considered appropriate technique when conducting goniometric measurements?

According to the Standards of Ethical Conduct for Physical Therapist Assistants as written by the American Physical Therapy Association, all of the following are correct EXCEPT

Health Maintenance Organizations continue to grow in popularity throughout the United States. Health Maintenance Organizations are most likely to restrict physical therapy coverage based on

A physical therapist instructs a patient to move from sitting to quadruped to tall kneeling. By moving through the developmental sequence a patient gains __ control during movement and _ during balance activities.