1..The therapist is treating a patient in an outpatient facility for strengthening of bilateral lower extremities.

During
the initial assessment, the patient reveals that he has a form of cancer but is reluctant to offer any other information
about his medical history. After 1 week of treatment, the therapist is informed by the physician that the patient has
Kaposi's sarcoma and AIDS. Which of the following is the best course of action for the therapist?

A. Cease treatment of the patient, and inform him than an outpatient facility is not the appropriate environment for
a person with his particular medical condition.

B. Continue treatment of the patient in the gym, avoiding close contact with other patients and taking appropriate
universal precautions.

C. Continue treatment of the patient in the gym as before, taking appropriate universal precaution.

D. Cease treatment, but do not confront the patient with the knowledge of his HIV status.

*Answer:

B. The patient can be successfully treated by using universal precautions. The patient should be treated in a
relatively isolated area because of his weakened immune system. The diagnosis of AIDS with Kaposi's sarcoma is an
indication that the patient's immune system is weak. Gloves should be used if the patient's sarcomas are open;
otherwise, hand washing before and after patient contact is appropriate.

2..A physician notes a vertebral fracture in the X-ray of a patient involved in a car accident. The fractured vertebra
has a bifid spinous process. Which of the following vertebrae is the most likely to be involved?

A. Fourth lumbar vertebra

B. Fifth cervical vertebra

C. Twelfth thoracic vertebra

D. First sacral vertebra.

*Answer:

B. Bifid spinous processes are found only in the cervical spine.

3..According to the Joint Commission on Accreditation of Health Care Organizations (JCAHO), a sentinel event is

A. A patient who is seriously injured at a facility.

B. An employee who is seriously injured at a facility.

C. A JCAHO surveyor who finds a major error in a facility's billing policies.

D. A JCAHO surveyor who finds a major error in the structure of a facility (e.g., not enough handicap parking, not
enough wheel chair ramps).

*Answer:

A. A patient seriously injured in a hospital or a hospital-owned facility is a sentinel event. Other choices might be
JCAHO violations but only A is a sentinel event.
4..The therapist is treating a male patient for a second-degree acromioclavicular sprain. The patient has just finished
the doctor's prescription of 3 sessions/week for 4 weeks. The therapist is treating the patient with iontophoresis
(driving dexamethasone), deltoid-strengthening exercises, pectoral strengthening exercises, and ice. The patient
reports no decline in pain level since the initial evaluation. Which of the following is the best course of action for the
therapist?

A. Phone the doctor and request continued physical therapy.

B. Tell the patient to go back to the doctor because he is not making appropriate progress.

C. Discharge the patient because he will improve on his own.

D. Take the problem to the supervisor of the facility.

*Answer:

B. The patient should have made adequate progress in this period with this protocol. Because of the lack of progress,
the patient needs further evaluation by the physician.

5..The protocol for a cardiac patient states that the patient should not exceed 5 metabolic equivalents (METS) with
any activity at this stage of recovery. Which of the following activities would be inappropriate for the patient?

A. Cycling 11 miles per hour

B. Walking 4 miles per hour.

C. Driving a car.

D. Weeding a garden.

*Answer:

A. Choice A is approximately 6-7 METs. Choice B is approximately 4-6 METs. Choice C is approximately 2 METs.
Choice D is approximately 3-5 METs.

6..Which of the following is a correct statement about Medicare?

A. Medicare Part A is only for patients over 85 years old

B. Medicare Part B is only for patients 65 - 84 years old.

C. Medicare Part A is only for inpatient treatment.

D. Medicare Part B is only for use in long-term facilities.

*Answer:

C. Medicare Part A is used for inpatient treatment and Part B for outpatient treatment. Medicare Part A or B can be
used for home health treatment; part B being is when the patient does not have part A.
7..A mother comes to a therapist concerned that her 4-month-old infant cannot sit up alone yet. Which of the
following responses is the most appropriate for the therapist?

A. "Your infant probably needs further evaluation by a specialist because, although it varies, infants can usually sit
unsupported at 2 months of age".

B. "Your infant probably needs further evaluation by a specialist because, although it varies, infants can usually sit
unsupported at 3 months of age".

C. "This is probably nothing to concerned about because, although it varies, most infants can sit unsupported at 8
months of age".

D. "This is probably nothing to be concerned about because, although it varies, most infants can sit unsupported at 5
months of age".

*Answer:

C. Although sources vary widely, a child can sit unsupported usually between 4 and 8 months of age. Answers A and
B are incorrect. Answer D would possibly cause the parent to worry prematurely.

8..A therapist decides to buy two ultrasound machines from a sales representative. The representative offers the
therapist a free steak dinner at a local restaurant as a toke of appreciation. What is the best course of action for the
therapist?

A. Refuse the dinner gracefully

B. Take his or her family out to eat.

C. Offer to take the representative out to dinner.

D. Take a local doctor out to dinner and discuss the benefits of using this type of ultrasound.

*Answer:

A. It is unethical to take gifts from anyone.

9..While observing a patient with posttraumatic brain injury (TBI), the therapist notes an increase in left ankle
plantar flexion during loading response (heel strike to foot flat) of the involved lower extremity. With this particular
patient, the left side is the involved side. Which of the following is not a likely cause of this deviation?

A. Spasticity of the left gastrocnemius

B. Hypotonicity of the left tibialis anterior.

C. Leg length discrepancy.

D. Left quadriceps hypertonicity.

D. Increased spasticity of the left gastrocnemius causes an increase in plantarflexion. Hypotonicity of the tibialis
anterior causes a foot drop due to the inability to dorsiflex actively. Leg length discrepancy should be evaluated in
the initial assessment. This is a possibility in any patient, regardless of the diagnosis. The least likely cause of this
deficit is a hypertonic left quadriceps, which most likely would cause an increase in dorsiflexion on the involved side
in an effort to decrease the functional leg length.

10..A therapist working in an outpatient physical therapy clinic evaluates a patient with a diagnosis of rotator cuff
bursitis. The physician's order is to evaluate and treat. During the evaluation the following facts are revealed: Active
shoulder flexion = 85o with pain; Passive shoulder flexion = 177 o ; Active shoulder abduction = 93 o with pain;
Passive shoulder abduction = 181 o ; Active external rotation = 13 o ; Passive external rotation = 87 o ; Drop arm test
= positive; Impingement test = negative; Biceps tendon subluxation test = negative; Sulcus sign = negative. Of the
following, which is the best course of action?

A. Treat the patient for 1 week with moist heat application, joint mobilization, and strengthening. then suggest to
the patient that he or she return to the physician if there are no positive results.

B. Treat the patient for 1 week with ultrasound, strengthening, and ice. Then suggest to the patient that he or she
return to the physician if there are no positive results.

C. Treat the patient for 1 week with a home exercise program, strengthening, passive range of motion by the
therapist, and ice. Then suggest to the patient that he or she return to the physician if there are no positive results.

D. Treat the patient for 1 week with strengthening, a home exercise program, and ice. Then suggest to the patient
that he or she return to the physician if there are no positive results.

*Answer:

D. The patient most likely has a rotator cuff tear. Choices A and B are incorrect because there is no need for heating
modalities. Choice C is wrong because the patient has full passive range of motion; thus there is no need for
stretching provided by the therapist at this point.

11..A local plant asks a therapy team to perform a study of its workers. The study needs to determine the frequency
of lung cancer in workers who insulate the inside area of an electrical oven appliance. Using company files, the
therapy team studies all past employees with this job description. The employees were initially free of lung cancer,
as determined by a routine physician's examination required by the plant. The team records from these files the
frequency with which each one of the employees developed lung cancer. What type of study is the therapy team
performing?

A. Historical prospective

B. Historical cohort

C. Case control

D. A & B

*Answer:
D. A and B are the same type of study. The records of the factory are used to determine the frequency of disease. In
a case-control study the people are selected based on whether or not they have a disease, then the frequency of the
possible cause of the disease in the past is studied.

12ّ ..CORF is an abbreviation for which of the following?

A. Certified Owner of a Rehabilitation Facility

B. Certified Outpatient Rehabilitation Facility

C. Control Organization for Rehabilitation Facilities.

D. Corporation for Organization of Rehabilitation Facilities.

*Answer:

B. A CORF is a classification of a type of outpatient facility

13..A patient presents to an outpatient facility with complaints of pain in the groin area (along the medial left thigh).
With manual muscle testing of the involved lower extremity a therapist determines the following: hip flexion = 4+/5,
hip extension = 4+/5, hip abduction = 4+/5, hip adduction = 2+/5, hip internal rotation = 2+/5, and hip external
rotation = 2+/5. Which nerve on the involved side is most likely injured?

A. Lateral cutaneous nerve of the upper thigh.

B. Obturator nerve

C. Femoral nerve.

D. Ilioinguinal nerve.

*Answer:

B. The obturator nerve innervates the adductor brevis, adductor longus, adductor magnus, obturator externus, and
gracilis muscles. Choice A has no motor function. Choice C innervates the sartorius, pectineus, iliacus, and quadriceps
femoris. The ilioinguinal nerve innervates the obliquus internus abdominis and transversus abdominis.

14..A patient at an outpatient facility experiences the onset of a grand mal seizure. Which of the following is the
most appropriate course of action by the therapist?

A. Assist patient to a lying position, move away close furniture, loosen tight clothes, and prop the patient's mouth
open

B. Assist patient to a lying position, move away close furniture, and loosen tight clothes

C. Assist the patient to a seated position, move away close furniture, and loosen tight clothes.
D. Assist the patient to a seated position, move away close furniture, loosen tight clothing, and prop the patient's
mouth open.

*Answer:

B. The person should lie down to prevent head injury. Tight clothes are loosened to make sure that nothing is too
constricting. Close furniture is move away for the patient's safety. Nothing should be placed in the patient's mouth
because of the dang

15..The therapist is crutch training a 26-year-old man who underwent right knee arthroscopy 10 hours ago. The
patient's weight bearing status is toe-touch weight-bearing on the right lower extremity. If the patient is going up
steps, which of the following is the correct sequence of verbal instructions?

A. "Have someone stand below you while going up, bring the left leg up first, then the crutches and the right leg".

B. "Have someone stand above you while going up, bring the left leg up first, then the crutches and the right leg".

C. "Have someone stand below you while going up, bring the right leg up first, then the crutches and left leg".

D. "Have someone stand above you while going up, bring the right leg up first, then the crutches and the right leg"

*Answer:

A. Choice A is the correct gait sequence for ascending stairs in the given scenario. A caregiver should stand below the
patient because the patient is most likely to fall down the stairs. This same rule holds true for descending stairs.

16ّ ..A 35-year-old woman with a diagnosis of lumbar strain has a physician's prescription with a frequency and
duration of 3 sessions/week for 6 weeks. The physical therapy evaluation reveals radiculopathy into the L5
dermatome of the right lower extremity, increased radiculopathy with lumbar flexion, decreased radiculopathy with
lumbar extension, poor posture, and hamstring tightness bilaterally at 60o. What is the best course of treatment?

A. Lumbar traction, hot packs, and ultrasound.

B. McKenzie style lumbar extensions, a posture program, hamstring stretching, and a home exercise program.

C. McKenzie style lumbar extensions, a posture program, hamstring stretching, home program, hot packs, and
ultrasound.

D. Lumbar traction, hot packs, ultrasound, and hamstring stretching.

*Answer:

B. Hot packs are no indicated because there is no mention of abnormal muscle tone. The entire lumbar area is too
much surface area for ultrasound. An argument could be made for lumbar traction, but it is paired with heating
modalities all of the answers.

17..A patient living in a nursing home with Medicare Part A as the source of reimbursement is treated by physical
therapy only. What is the required minimal frequency of physical therapy treatment?
A. Once a week

B. Three times a week

C. Five times a week

D. There is no required time frame.

*Answer:

C. Medicare requires that a patient living in a nursing home with Part A as the main source of reimbursement receive
5 days/week of skilled treatment. In this scenario, the physical therapist must see the patient 5 days/week because it
is the only skilled service required by the patient.

18..A therapist is working in an outpatient rehabilitation facility. A female patient presents with an order for
occupational therapy to evaluate and treat a diagnosis of carpal tunnel syndrome. The occupational therapist (OT)
brings to the attention of the physical therapist (PT) that the patient's insurance will not reimburse for occupational
therapy services. What is the best course of action?

A. Allow the OT to treat the patient and the PT to sign off on his or her work.

B. Tell the patient that she will have to pay out of pocket for OT services.

C. Call the doctor's office and obtain an order for PT, then allow the PT to treat the patient.

D. Tell the patient to return to her doctor to obtain a PT order.

*Answer:

C. Answer A is incorrect because the order is for occupational, not physical therapy, and under than order the
patient has to be treated by an occupational therapist. Answer B is incorrect because it is unlikely that a patient will
agree to paying out of pocket or be able to afford the expense of occupational therapy services. Answer D is
incorrect because the problem can be solved by telephone without making the patient schedule another doctor's
appointment. Answer C is correct because it would take about 5 minutes to obtain a verbal order, and therapy can
begin right away.

19..How often does the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) survey hospitals?

A. Once per year

B. Every 2 years

C. Every 3 years

D. Every 4 years

*Answer:

C. The Joint Commission surveys hospitals once every 3 years.

A. C5

B. C7

C. T2

D. T10

*Answer:

B. A patient with a spinal cord injury at the C5 level would apply pressure to the abdomen to perform a cough. A
patient with an injury in the T2 level and T10 level should be able to perform a cough independently, but this goal
would be most challenging and obtainable for a patient an injury at the level of C7.

21..When ordering a customized wheelchair for a patient, the therapist determines that the pelvic belt needs to be
positioned so that it allows active anterior pelvic tilt. What is the best position for the pelvic belt in relation to the
sitting surface?

A. 30o

B. 45o

C. 60o

D. 90o

*Answer:

D. A belt that angled at 90o with the sitting surface limits the patient's involuntary efforts to extend the trunk
because of increased tone. This angle also allows the patient to actively tilt the pelvis anteriorly, which is a functional
movement that does not need to be restricted.

22..When should a physical therapist begin discharge planning for a patient admitted to a rehabilitation unit with a
diagnosis of a recent stroke?

A. At the first team meeting

B. At the last team meeting

C. Two weeks before discharge

D. After the initial evaluation by the physical therapist.

*Answer:
D. After the therapist assesses the patient for the first time, he or she needs to begin discharge planning. This is true
for an assessment of any patient, not just in the inpatient rehabilitation setting.

23..Which of the following is an example of a policy in a physical therapy clinic?

A. No shorts worn in the clinic

B. The correct way to accept a telephone referral

C. The clinic will open at 8:00 AM

D. A and C

*Answer:

D. Policies can be viewed as the rules, and procedures are the ways in which the rules are carried out.

24..The therapist is asked to evaluate a baseball pitcher's rotator cuff isokinetically. Which isokinetic evaluation is
most appropriate?

A. 190o/second, 180o/second, and 240o/second

B. 30o /second, 60o /second, and 90o /second

C. 60o /second, 120o /second, and 180o /second

D. 180o /second, 240o /second, and 360o /second

*Answer:

D. The fastest settings are appropriate for isokinetic testing. A pitcher's throwing motion is quite fast. It is better to
evaluate with isokinetic speed as close as possible to the speed of the tested activity.

25..A patient presents to a clinic with decreased tidal volume (TV). What is the most likely cause of this change in
normal pulmonary function?

A. Chronic pulmonary disease

B. Restrictive lung dysfunction

C. Both of the above

D. None of the above

*Answer:

B. A decreased tidal volume is caused by a restrictive lung dysfunction. An increased tidal volume is caused by an
obstructive lung dysfunction.
26.ّ In order to determine if an exercise session should be terminated, the patient is asked to assess level of exertion
using the Borg Rating of Perceived Exertion Scale (RPE). The patient rates the level of exertion as 9 on the 6-19 scale.
A rating of 9 corresponds to which of the following?

A. Very, very light

B. Very light

C. Somewhat hard

D. Hard

*Answer:

B. A rating of 9 corresponds with "very light". A rating of 7 is "very, very light". A rating of 13 is "somewhat hard". A
rating of 15 is "hard". A rating of 17 is "very hard". A rating of 19 is "very, very hard".

27ّ ..The therapist is treating a new patient with a diagnosis of lateral epicondylitis. The therapist decides to use
iontophoresis driving dexamethasone. Dexamethasone is an ___ and is administered with the __.

A. Analgesic, anode.

B. Analgesic, cathode

C. Anti-inflammatory, anode

D. Anti-inflammatory, cathode.

*Answer:

D. Dexamethasone is a common anti-inflammatory drug driven with the negative electrode. Lidocaine is a commonly
used analgesic driven with the positive electrode.

28..During the opening of a patient's mouth, a palpable and audible click is discovered in the left temporomandibular
joint. The physician informs the therapist that the patient has anteriorly dislocated disk. This click most likely
signifies:

A. the condyle is sliding anterior to obtain normal relationship with the disk.

B. the condyle is sliding posterior to obtain normal relationship with the disk.

C. the condyle is sliding anterior and losing normal relationship with the disk

D. the condyle is sliding posterior and losing normal relationship with the disk

*Answer:
A. In the case of reciprocal click, the initial click is created by the condyle slipping back into the correct position
under the disk with opening of the mouth. In this disorder, the condyle is resting posterior to the disk before jaw
opening. With closing the click is caused by the condyle slipping away from the disk.

29..In what position should the therapist place the upper extremity to palpate the supraspinatus tendon?

A. Full abduction, full flexion and full external rotation

B. Full abduction, full flexion and full internal rotation

C. Full adduction, full external rotation, and full extension

D. Full adduction, full internal rotation and full extension

*Answer:

D. The supraspinatus tendon is best palpated by placing the patient's involved upper extremity behind the back in
full internal rotation.

30ّ ..A posterior lateral herniation of the lumbar disc between vertebrae L4 and L5 most likely results in damage to
which nerve root?

A. L4

B. L5

C. L4 and L5

D. L5 and S1

*Answer:

B. The fifth lumbar nerve root is impinged because it arises from the spinal column superior to the L4-L5 lumbar disc.

31..Which of the following is the best and first treatment for a wound with black eschar over 90% of the wound bed?

A. Lidocaine

B. Dexamethasone

C. Silvadene

D. Elase

*Answer:
D. The correct treatment involves debridement of the eschar over the wound. Elase is an enzymatic wound
debridement. Lidocaine is an anesthetic. Dexamethasone is a steroid used mainly with iontophoresis. Silvadene is an
antimicrobial used to prevent infection.

32..After performing an evaluation, a therapist notes the following information: severe spasticity of plantar flexors in
the involved lower extremity, complete loss of active dorsiflexion in the involved lower extremity, minimal spasticity
between 0 o and 5 o of dorsiflexion, with increased spasticity when the ankle is taken into more than 5o of
dorsiflexion. Which ankle-foot orthosis (AFO) is most likely contraindicated for the patient, an 87-year-old man who
had a stroke 4 weeks ago?

A. Dorsiflexion spring assist AFO

B. Posterior leaf spring AFO

C. Hinged AFO

D. Spiral AFO

*Answer:

A. Choice A probably would activate increased tone because of the resistance to plantar flexion offered by the
spring.

33..In the geriatric population, ____usually occurs after ____ is present.

A. Spondylolisthesis, spondylolysis

B. Spondylolysis, spondylolisthesis

C. Spondyloschisis, spondylolysis

D. Spondylolisthesis, spondyloschisis

*Answer:

A. A defect in the lamina of a vertebra usually occurs first. This defect is called spondylolysis. The vertebrae may then
slip because of shear forces; this slip is called spondylolisthesis.

34..A football player presents to an outpatient clinic with complaints of pain in the right knee after an injury suffered
the night before. The physician determines that the anterior cruciate ligament (ACL) is torn. Which of the following is
most commonly associated with an injury causing damage to the ACL only?

A. Varus blow to the knee with the foot planted and an audible pop

B. Foot planted, medial tibial rotation, and an audible pop.

C. Valgus blow to the knee with the foot planted and no audible pop.
D. Foot planted, lateral tibial rotation, and no audible pop.

*Answer:

B. Choice B best describes the position that causes injury only to the ACL. In most cases an audible pop indicates a
tear of the ACL. Varus or valgus blows to the knee injure the collateral ligaments and possibly the ACL.

35..A patient presents to an outpatient clinic with complaints of shoulder pain. The therapist observes a painful arc
between 70o and 120o of active abduction in the involved shoulder. This finding is most indicative of what shoulder
pathology?

A. Rotator cuff tear

B. Acromioclavicular joint separation

C. Impingement

D. Labrum tear

*Answer:

B. The "painful arc" is most indicative of shoulder impingement. The soft tissues of the shoulder are pinched under
the acromion process at approximately 60-120o of abduction. Pain throughout abduction active range of motion
suggests acromioclavicular joint dysfunction.

36..While reviewing a chart before performing postural drainage and percussion, the therapist finds that the patient
has a platelet count of approximately 45,000. What is the appropriate course of action?

A. Proceed with treatment

B. Call the doctor and discuss the treatment plan.

C. Immediately discharge the patient from physical therapy.

D. Inform nursing of the relative contraindication and proceed with treatment.

*Answer:

A. A platelet count of 45,000 is low, but a count of approximately 20,000 is considered a contraindication for
percussion treatment. Normal values are above 260,000.

37..A physician orders stage II cardiac rehabilitation for a patient. The orders are to exercise the patient below 7
metabolic equivalents (METS). Which of the following is a contraindicated activity?

A. Riding a stationary bike at approximately 5.5 mph

B. Descending a flight of stairs independently

D. Ambulate independently at 5-6 mph

*Answer:

D. Riding a stationary bike at 5.5 mph is approximately 3.5 METs. Descending a flight of stairs is approximately 4-5
METs. Ironing is approximately 3.5 METs. Ambulating 5-6 mph is approximately 8.6 METs.

38..The therapist is evaluating a 36-year-old woman to fit her with the appropriate wheelchair. Recent injury caused
C6 quadriplegia. What is the correct way to measure length of the footrests for the patient's permanent wheelchair?

A. From the patient's popliteal fossa to the heel and add 1 inch

B. From the patient's popliteal fossa to the heel and subtract 1 inch

C. From the patient's popliteal fossa to the first metatarsal head and add 1 inch

D. From the patient's popliteal fossa to the first metatarsal head and subtract 1 inch

*Answer:

B. The correct procedure is answer B. Subtracting 1 inch allows correct pressure distribution over the patient's
buttocks and thighs.

39..Which of the following is least likely in a woman in the eighth month of pregnancy?

A. Center of gravity anteriorly displaced

B. Heart rate decreased with rest and increased with activity compared to heart rate prior to the pregnancy.

C. Edema in bilateral lower extremities

D. Blood pressure increased by 5% compared with blood pressure before pregnancy

*Answer:

B. During pregnancy a woman normally experiences an increase in resting heart rate and a decrease in heart during
exercise. This change is compared with the heart rate of the particular woman before pregnancy. The other answers
are true about pregnancy.

40..In developing the plan of care for a 28-year-old pregnant woman which of the following muscles should be the
focus of the strengthening exercises to maintain a strong pelvic floor?

A. Piriformis, obturator internus, and pubococcygeus

C. Rectus abdominis, iliococcygeus, and piriformis

D. Iliococcygeus, pubococcygeus, and coccygeus

*Answer:

D. One of the main reasons that pelvic floor exercises are beneficial for a pregnant woman is the extra weight of the
viscera.

41..The following is a long-term goal for a patient with spinal cord injury: independence in performing a manual
cough without applying pressure to the abdomen. This goal is the most challenging and obtainable for a patient with
a complete lesion at which of the following spinal cord levels?

A. C5

B. C7

C. T2

D. T10

*Answer:

D. To assist a patient in developing a tenodesis grip, the therapist should allow the patient's finger flexors to tighten.
This grip functions with active extension of the wrist, which allows flexion of the fingers because of shortened flexor
tendons.

42..A 52-year-old man with sciatica presents to outpatient physical therapy. The patient indicates that he is
experiencing paresthesia extending to the left ankle and severe lumbar pain. Straight-leg-raise test is positive with
the left lower extremity. Of the following, which if the most likely source of pain?

A. A lumbar disc with a left posterior herniation or protrusion

B. A lumbar disc with a right posterior herniation or protrusion

C. Piriformis syndrome

D. Sacroiliac joint dysfunction

*Answer:

A.The symptoms involving the left lower extremity are an indication that a disc is herniated or protruding onto a
nerve root on the left side. A positive straight leg-raise test is also often an indication of a disc herniation or
protrusion.

43..A patient is positioned by the therapist with the cervical spine rotated to the right. The patient then extends the
neck as the therapist externally rotates and extends the right upper extremity. The patient is ten instructed to hold a
deep breath. The radial pulse is palpated in the right upper extremity by the therapist. What type of special test is
this, and for what condition is it testing?

A. Adson's maneuver - cervical disc herniation

B. Lhermitte's sign - cervical disc herniation

C. Adson's maneuver - thoracic outlet syndrome

D. Lhermitte's sign - thoracic outlet syndrome

*Answer:

C. Adson's maneuver tests for thoracic outlet syndrome. Lhermitte's sign tests for dural irritation in the cervical
spine.

44..A patient is sitting over the edge of a table and performing active knee extension exercises using an ankle weight
as resistance. This exercise demonstrates what class lever?

A. First class

B. Second class

C. Third class

D. Fourth class

*Answer:

C. The axis point is the knee joint. The effort arm is distal to the knee joint at the insertion of the patella tendon. The
resistance is at the ankle. A class II level has the resistance arm in the middle, making a longer effort arm than
resistance arm. The class I level has an axis in the middle

45..A physical therapy technician calls the therapist immediately to the other side of the outpatient clinic. The
therapist discovers a 37-year-old female lying face down on the floor. Which of the following sequence of events is
most appropriate for this situation?

A. Have someone call 911, determine unresponsiveness, establish an airway, and assess breathing (look/listen/feel).

B. Determine unresponsiveness, have someone call 911, establish an airway, and assess breathing (look/listen/feel)

C. Have someone call 911, determine unresponsiveness, assess breathing (look/listen/feel).

D. Determine unresponsiveness, have someone call 911, assess breathing (look/listen/feel), establish an airway.

*Answer:

B. According to the American Heart Association, a person is determined unresponsive before emergency medical
service is activated.
46..The therapist is performing an orthopedic test that involves: (1) placing the patient in a sidelying position, (2)
placing the superior lower extremity in hip extension and hip abduction, (3) placing the knee of the superior lower
extremity in 90o of flexion, and (4) allowing the superior lower extremity to drop into adduction. Failure of the
superior lower extremity to drop indicates a tight:

A. iliopsoas

B. rectus femoris

C. iliotibial band

D. hamstring

*Answer:

C. This is called Ober's test, which screens for a tight iliotibial band.

47..A patient is positioned in the supine position. The involved left upper extremity is positioned by the therapist in
90o of shoulder flexion. The therapist applies resistance into shoulder flexion, then extension. No movement takes
place. The therapist instructs the patient to "hold" when resistance is applied in both directions. Which of the
following proprioceptive neuromuscular facilitation techniques is being used?

A. Repeated contractions

B. Hold-relax

C. Rhythmic stabilization

D. Contract-relax

*Answer:

C. Rhythmic stabilization involves a series of isometric contractions of the agonist, then antagonist.

48..During the evaluation of an infant, the therapist observes that with passive flexion of the head the infant actively
flexes the arms and actively extends the legs. Which of the following reflexes is being observed?

A. Protective extension

B. Optical righting

C. Symmetrical tonic neck

D. Labyrinthine head righting

*Answer:
C. Choice C describes the symmetric tonic neck reflex. With passive cervical extension an infant displays upper
extremity extension and lower extremity flexion.

49..A patient asks the therapist whether she should be concerned that her 4-month-old infant cannot roll from his
back to his stomach. The most appropriate response to the parent is:

A. "This is probably nothing to be concerned about because, although it varies, infants can usually perform this task
by 10 months of age".

B. "This is probably nothing to be concerned about because, although it varies, infants can usually perform this task
by 5 months of age".

C. "Your infant probably needs further evaluation by a specialist because, although it varies, infants can usually
perform this task at 2 months of age".

D. "Your infant probably needs further evaluation by a specialist because, although it varies, infants can usually
perform this task at birth".

*Answer:

A. Infants accomplish this task between approximately 5 and 10 months of age.

50..A physical therapist receives an order to evaluate a home health patient. The primary nurse notes that the
patient "may have suffered a stroke because she cannot move the right leg when she stands". The history that the
therapist obtains from the patient and family members includes: (1) left total hip replacement 6 months ago, (2)
inability to lift the right lower extremity off the floor in a standing position, (3) recent fall at home 2 nights ago, (4)
left lower extremity strength with manual muscle testing in supine is 2+/5 overall, (5) complaints of pain with
resisted movement of the left lower extremity, (6) right lower extremity strength is 4+/5 overall, (7) no pain with
resisted movements with the right lower extremity, (8) no difference in bilateral upper extremity strength, (9) no
decreased sensation, (10) no facial droop, (11) history of dementia but no decreased cognitive ability or speech level
as compared with the prior level of function and (12) independence in ambulation with a standard walker before the
recent fall. The therapist's recommendation to the nursing staff should be:

A. The patient should receive physical therapy for strengthening exercises to the right lower extremity with standing
exercises and gait training.

B. The patient should receive a physician's evaluation for a possible stroke.

C. The patient should receive a physician's evaluation for a possible left hip fracture.

D. The patient should receive physical therapy for strengthening the left lower extremity and gait training.

*Answer:

C. The right lower extremity is still strong, and there is no facial droop or diminished sensation. Although these signs
are not always present after a stroke, the other signs and symptoms such as a history of a recent fall and the past
total hip replacement, should lead the therapist to choice C. The patient cannot lift the right lower extremity in the
standing position because it increases weight bearing on the fractured left lower extremity. The left leg also shows a
definite strength loss as graded with manual muscle testing.
51..A diabetic patient is exercising vigorously in an outpatient clinic. The patient informs the therapist that he or she
received insulin immediately before the exercise session. If the patient goes into a hypoglycemic coma, which of the
following is not a likely sign?

A. Pallor

B. Shallow respiration

C. Bounding pulse

D. Dry skin

*Answer:

D. Dry skin is a sign of a diabetic coma.

52..A patient has been diagnosed with systemic lupus erythematosus. Which of the following is not a sign of this
autoimmune disease?

A. Increased photosensitivity

B. Oral ulcers

C. Butterfly rash

D. Increased number of white blood cells

*Answer:

D. The white cell count in a patient with this diagnosis would decrease. Lupus affects mostly young women

53..A study of the local population was necessary to determine the need for a new fitness center in the area. The
therapists performing the study divided the population by sex and selected a random sample from each group. This
is an example of what type of random sample?

A. Systematic random sample

B. Random cluster sample

C. Two-stage cluster sample

D. Stratified random sample

*Answer:

D. A stratified random sample is taken by dividing the test population into two groups or strata (in this case, male
and female) and taking a random sample from each group.
54..A physical therapist instructs a physical therapy assistant to teach a patient how to ascend and descend the front
steps of her home. After first exercising the patient at her home, the assistant realizes that, because of her increased
size and severe dynamic balance deficits, training on the step is unsafe at this time. The assistant contacts the
therapist by telephone. Which of the following is the best course of action by the therapist?

A. The therapist should instruct the assistant to attempt step training cautiously.

B. The therapist should instruct the assistant to recruit the family members to assist with step training.

C. The therapist should instruct the assistant to discontinue step training until both of them can be present

D. The therapist should contact the physician and seek further instruction.

*Answer:

C. The physical therapist should tell the assistant to wait until they can both work together with the patient. The
family is not qualified to help the assistant during the first attempt at ambulation in this situation.

55..When reviewing a patient's chart, the therapist determines that the patient has a condition in which the cauda
equina is in a fluid-filled sac protruding from the back. What form of spina bifida does the patient most likely have?

A. Meningocele

B. Meningomyelocele

C. Spina bifida occulta

D. None of the above

*Answer:

B. This form of spina bifida is associated with direct involvement with the cauda equina. The muscles that are
innervated by the cauda equina usually present with flaccid paralysis.

56..During the history a 74-year-old woman informs you that she is "taking a heart pill". The patient does not have
her medication with her but states that the medication "slows down my heart rate". Which of the following is the
most probable medication?

A. Epinephrine

B. Digitalis

C. Quinidine

D. Norepinephrine

*Answer:
C. Answers A, B and D increase heart rate. Quinidine is an antiarrhythmic drug.

57..A therapist receives an order to evaluate a patient on the telemetry floor of a hospital. The therapist is informed
at the nurses' station that an evaluation will not be necessary because the patient went into shock earlier that
morning and died. The patient suffered a myocardial infarction earlier, resulting in damage to the left ventricle.
Given the above information, what is the most likely type of shock?

A. Vascular shock

B. Anaphylactic shock

C. Toxic shock

D. Cardiogenic shock

*Answer:

D. A myocardial infarction that involves the left ventricle is likely to cause cardiogenic shock. Cardiogenic shock is a
rapid decline in cardiac output. Vascular shock is widespread vasodilation. Toxic and anaphylactic shock occur when
the body is exposed to a toxin or allergen, respectively.

58..Which of the following acts forced all federally supported facilities to increase corridor width to minimum of 54
inches to accommodate wheelchairs?

A. Americans with Disabilities Act

B. National Healthcare and Resource Development Act

C. Civil Rights Act

D. Older Americans Act (title III)

*Answer:

A. The ADA allowed structural modifications of federal buildings and protection from discrimination based on
disability.

59..A supervisor in an outpatient facility is classified as a McGregor Theory X manager. Which of the following is the
most appropriate characterization of the manager's beliefs?

A. Work is natural for most people, workers will use their own self control to accomplish tasks, and workers will
accept responsibility for their own actions.

B. Workers have low drive, workers are concerned with their own job security, and employees do not like to work.

C. Making decisions in the group is the best way to accomplish tasks, and encouraging a long term career for the
employee is best.

D. There are factors at work that satisfy or dissatisfy an employee.

A. Answer A is a description of McGregor Theory Y manager. Answer C is an example of William Ouchi's Theory Z.
Answer D is part of the thought behind Herzberg's Two-Factor Theory.

60..A 3-month-old infant has a heart condition known as tetralogy of Fallot. This condition presents with which of
the following signs?

A. Atrial septal defect, pulmonary valve stenosis, aorta abnormally located to the right, and right ventricular
hypertrophy.

B. Atrial septal defect, pulmonary valve stenosis, aorta abnormally located to the left, and right ventricular
hypertrophy

C. Ventricular septal defect, pulmonary valve stenosis, aorta abnormally located to the right, and right ventricular
hypertrophy.

D. Ventricular septal defect, pulmonary valve stenosis, aorta abnormally located to the right, and left ventricular
hypertrophy

*Answer:

C. Tetralogy of Fallot consists of these four abnormalities.

61..Which of the following is the most vulnerable position for dislocation of the hip?

A. 30o hip extension, 30o hip adduction, and minimal internal rotation

B. 30o hip flexion, 30o hip adduction, and minimal external rotation

C. 30o hip flexion, 30o hip abduction, and minimal external rotation.

D. 30o hip extension, 30o hip abduction, and minimal external rotation.

*Answer:

C. This is the loose-packed position of the hip.

62..After arriving at the home of a home health patient, the primary nurse informs the therapist that she has
activated emergency medical services. The nurse found the patient in what appears to be a diabetic coma. Which of
the following is most likely not one of the patient's signs?

A. Skin flush

B. Rapid pulse

C. Weak pulse
D. High blood pressure

*Answer:

D. A person in a diabetic coma has low blood pressure.

63..A patient who suffered a myocardial infarction is participating in an exercise test. The therapist notes ST segment
depression of 1.7 mm on the patient's current rhythm strip. What is the most appropriate course of action?

A. Stop the exercise session immediately and send the patient to the emergency room.

B. Continue with the exercise session.

C. Contact the patient's cardiologist about continuing exercise

D. Stop the exercise session to take the patient's heart rate and blood pressure

*Answer:

B. Exercise testing should be terminated at 2 mm of ST depression.

64..Which type of atrioventricular (AV) block is present, given the following information about the patient's rhythm
strip: P waves are normal and have a QRS complex following P-R intervals that are longer than 0.2 seconds, and the
heart rate is 82 beats per minute?

A. First-degree AV block

B. Second-degree AV block - type 1

C. Second-degree AV block - type 2

D. Third-degree AV block

*Answer:

A. This is a description of a first-degree atrioventricular block. The heart rate is usually between 60 and 100
beats/minute.

65..The therapist is treating a patient who received an above elbow amputation 2 years ago. The prosthesis has a
split cable that controls the elbow and the terminal device. With this type of prosthesis, the patient must first lock
the elbow to allow the cable to activate the terminal device. This is accomplished with what movements?

A. Extending the humerus and elevating the scapula.

B. Extending the humerus and retracting the scapula.

C. Extending the humerus and protracting the scapula

*Answer:

D. To lock the elbow with this type of prosthesis, the patient must extend the humerus and depress the scapula.

66ّ ..A therapist is ordered to evaluate and treat a full-term infant. After reviewing the chart, the therapist discovers
that at 1 minute after birth the infant exhibited the following symptoms: bluish color in the body and extremities,
heart rate of 85 beats/minute, slow respirations, no response to reflex irritability, and some resistance of the
extremities to movement. What was the infant's APGAR score at 1 minute after birth?

A. 1

B. 2

C. 3

D. 4

*Answer:

C. A score of one is given for each of the following: some resistance of the extremities to movement, a heart rate less
than 100 beats/minute, and slow respirations. A score of zero is given for bluish color in the body and extremities
and no response to reflex irritability.

67..A therapist is attempting to gain external rotation range of motion in a patient's right shoulder. The therapist
decides to use contract-relax-contract antagonist. In what order should the following rotator cuff muscles contract
to perform this movement successfully?

A. Infraspinatus - teres minor

B. Subscapularis - supraspinatus

C. Teres minor - infraspinatus

D. Supraspinatus - subscapularis

*Answer:

B. In performing contract-relax antagonist in this particular situation, the internal rotators are actively contracted
first, the external rotators are contracted next in an effort to increase external range of motion. The agonists are the
internal rotators (tight muscle group in this situation), and the antagonists are the external rotators. The
infraspinatus, teres minor, and supraspinatus assist the external rotators. The subscapularis is an internal rotator.
Other larger muscles also participate in rotation, but this question refers to the rotator cuff muscles.

68..Which of the following is the next response of the leukocytes after emigration into the blood stream in the acute
inflammatory stage?
A. Margination

B. Pavementing

C. Adhesion

D. Engulfment

*Answer:

A. Leukocytes respond to an injury by emigrating into the blood stream. The next stem of the leukocytes is
margination, which is movement toward the inner surface of the vessels.

69..The therapist is treating a patient who recently received a below-knee amputation. The therapist notices in the
patient's chart that a psychiatrist has stated that the patient is in the second stage of the grieving process. Which
stage of the grieving process is this patient most likely exhibiting?

A. Denial

B. Acceptance

C. Depression

D. Anger

*Answer:

D. The five stages of grieving are (in order from first to last) denial, anger, bargaining, depression and acceptance.

70..A patient has traumatically dislocated the tibia directly posteriorly during an automobile accident. Which of the
following structures is the least likely to be injured?

A. Tibial nerve

B. Popliteal artery

C. Common peroneal nerve

D. Anterior cruciate ligament

*Answer:

C. The common peroneal nerve travels over the lateral knee. It is the least likely to be injured. The other structures
are either within the knee

،71..A 32-year-old man is referred to physical therapy with the diagnosis of a recent complete anterior cruciate
ligament tear. The patient and the physician have decided to avoid surgery as long as possible. The therapist
provides the patient with a home exercise program and instructions about activities that will be limited secondary to
this diagnosis. Which of the following is the best advice?

A. There are no precautions.

B. The patient should avoid all athletic activity for 1 year.

C. The patient should avoid all athletic activity until there is a minimum of 20% difference in the bilateral quadriceps
muscle as measure isokinetically.

D. The patient should wear a brace and compete in only light athletic events.

*Answer:

D. The ACL-deficient patient has a significant rotatory instability. Bracing may prevent some of this instability. Sports
that are especially difficult on the knees (e.g., skiing, competitive tennis) are contraindicated.

72..A therapist instructed to provide electrical stimulation to a patient with a venous stasis ulcer on the right lower
extremity. What is the correct type of electrical stimulation to promote wound healing?

A. Biphasic pulsed current

B. Direct current

C. Interferential current

D. Transcutaneous electrical stimulation

*Answer:

B. Direct current is shown to have the greatest benefit in wound healing. Monophasic pulse current has also been
shown to have wound healing benefits.

73..The supervisor of a rehabilitative facility insists on a weekly meeting to discuss drops in productivity. The
supervisor is not concerned with the increased demand placed on the already overworked employees. According to
the managerial grid, what is the best classification of this manager?

A. 5.5

B. 9.9

C. 1.9

D. 9.1

*Answer:
D. Managers rates as 9,1 have high concern for productivity and low concern for employees. Manages classified as
5,5 have moderate concern for productivity and employees. Managers classified as 9,9 have a high concern for both.
Managers rated as 1,9 have high concern for employees and little concern for productivity.

74..The therapist is evaluating a 32-year-old woman for complaints of right hip pain. The patient has injured the
strongest ligament of the hip. The therapist places the patient in the prone position on the plinth and passively
extends the involved hip. The therapist notes an abnormal amount of increase in passive hip extension. Which of the
following ligaments is damaged?

A. Ischiofemoral ligament

B. Iliofemoral ligament (Y ligament of Bigelow)

C. Pubofemoral ligament

D. Ligamentum teres

*Answer:

B. The Iliofemoral ligament is the strongest ligament in the hip that prevents extension. It is the ligament most likely
to be compromised in this scenario.

75..While obtaining the history from a 62-year-old woman weighing 147 pounds, the therapist discovers that the
patient has a history of rheumatoid arthritis. The order for outpatient physical therapy includes continuous traction
due to a L2 disc protrusion. What is the best course of action for the therapist?

A. Follow the order.

B. Consult with the physician because rheumatoid arthritis is a contraindication.

C. Apply intermittent traction instead of continuous traction.

D. Use continuous traction with the weight setting at 110 pounds.

*Answer:

B. Answers A and C are incorrect because rheumatoid arthritis is a contraindication for continuous or intermittent
traction. Answer D is .incorrect for the above reason as well as the fact that a 110-pound setting is too great for a
147-pound patient..

، 76..Which of the following actions places the greatest stress on the patellofemoral joint?

A. When the foot first contacts the ground during the gait cycle.

B. Exercising on a stair stepper machine.

C. Running down a smooth decline of 30o

D. Squats to 120o of knee flexion.

D. Patellofemoral joint reaction forces increase as the angle of knee flexion and quadriceps muscle activity increase.
Choice D involves the greatest knee flexion angle and quadriceps activity

77..A therapist working at a hospital calls another therapist in an outpatient facility to provide a brief history of a
patient who is scheduled to leave the hospital and receive outpatient therapy. The acute care therapist states that
the patient received an injury to the somatic sensory association cortex in one hemisphere. From this information
only, the outpatient therapist knows that the patient will most likely

A. ignore someone talking to him or her on the involved side

B. be unable to find one of his or her extremities.

C. have no trouble putting on clothes.

D. be unable to understand speech.

*Answer:

B. A deficit in this region of the brain usually results in the inability to locate an extremity. This patient would have
trouble putting on clothes.

78..A therapist is treating a 35-year-old man diagnosed with lumbar disc degeneration in an outpatient clinic.
Through conversation with the patient, the therapist learns that he is also being treated by a chiropractor for cervical
dysfunction. What is the best course of action by the therapist?

A. Continue with the current treatment plan and ignore the chiropractor's treatment.

B. Ask the patient what the chiropractor is doing and try the same approach.

C. Stop physical therapy at once and consult with the referring physician.

D. Contact the chiropractor to coordinate his or her plan of care with the physical therapy plan of care.

*Answer:

D. In the ideal situation, the therapist should coordinate his or her plan of care with the chiropractor in case the
problems are related

79..The therapist has given a patient an ultraviolet treatment. The patient calls the therapist the next day with
complaints of peeling and itching. These signs and symptoms resolve three days later (a total of 4 days after
treatment). What dosage did the patient receive?

A. Suberythemal dose

B. Minimal erythemal dose.

D. Third-degree erythemal dose.

*Answer:

C. A Suberythemal dose of ultraviolet treatment is not enough to cause reddening of the skin. A minimal erythemal
dose leads to slight itching and reddening. A third-degree erythema is a more severe reaction with blister and edema
formation

80..Which of the following duties cannot be legally performed by a physical therapist assistant?

A. Confer with a doctor about a patient's status.

B. Add 5 pounds to a patient's current exercise protocol.

C. Allow a patient to increase in frequency from 2times/week to 3 times/week.

D. Perform joint mobilization.

*Answer:

C. A physical therapist assistant (PTA) can do all of the listed options except the frequency or duration as prescribed
by a therapist or physician. Choice B allows the PTA to work within the protocol established by the physical therapist.

81..What lobe of the lungs is the therapist attempting to drain if the patient is in the following position? Resting on
the left side rolled ¼ turn back, supported with pillows, and the foot of the bed raised 12-16 inches.

A. Right middle lobe - lingular segment.

B. Left upper lobe - lingular segment

C. Right upper lobe - posterior segment

D. Left upper lobe - posterior segment.

*Answer:

A. Choice B is drained by resting on the right ¼ turn to the back, and foot of the bed elevated 12-16 inches. Choices C
and D are drained with patient in long sitting position or leaning forward over the pillow in sitting position.

82..A therapist has been treating a patient who received a rotator cuff surgical repair with sessions consisting only of
passive range of motion (for an extended period). The patient has just returned from a follow-up doctor's visit with
an additional order to continue with passive range of motion only. Which of the following is the best course of action
for the therapist?
A. Continue with passive range of motion as instructed, and call the physician to consult with him or her about the
initiation of active range of motion.

B. Begin active range of motion within the pain-free range, and continue passive range of motion.

C. Continue passive range of motion, and do not question the physician's decision.

D. Perform passive range of motion and any other exercise that is within the normal protocol for this diagnosis.

*Answer;

A. It is best to consult with a physician because of an extended amount of passive range of motion. A therapist
should not deviate from a physician's order, but a telephone call to clarify the order is necessary when the therapist
feels that another treatment plan is more appropriate.

83..A 25-year-old woman has been referred to a physical therapist by an orthopedist because of low back pain. The
therapist is performing an ultrasound at the L3 level of the posterior back when the patient suddenly informs the
therapist that she is looking forward to having her third child. On further investigation, the therapist discovers that
the patient is in the first trimester of pregnancy. Which of the following is the best course of action for the therapist?

A. Change the settings of the ultrasound from continuous to pulsed.

B. Continue with the continuous setting because first trimester pregnancy is not a contraindication.

C. Cease treatment, notify the patient's orthopedic physician, and document the mistake.

D. Send the patient to the gynecologist for an immediate sonogram.

*Answer:

C. The therapist should notify the referring physician. The mistake should be documented and the patient informed.
The referring physician can determine the need for a consultation with him or her or an obstetrician.

84..A 20-year-old woman is referred to a therapist with a diagnosis of recurrent ankle sprains. The patient has a
history of several inversion ankle sprains within the past year. No edema or redness is noted at this time. Which of
the following is the best treatment plan?

A. Gastrocnemius stretching, ankle strengthening, and ice.

B. Rest, ice, compression, elevation and ankle strengthening.

C. Ankle strengthening and a proprioception program.

D. Rest, ice, compression, elevation and gastrocnemius stretching.

*Answer:

C. Patients with recurrent ankle sprains benefit from proprioceptive exercises. Choices B and D are not indicated
because of the lack of acute signs and symptoms. Choice A is a good plan, but not the most correct because there is
no mention of proprioception.