\'05 Sullivan B PDF

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B1 C8 2 A physical therapy plan of care for a child with spastic cerebral palsy who is three years-old chronologically and cognitively, but at a six month-old gross developmental level would include: A. reaching for a black and white object while in the supine position. B. reaching for a multicolore...

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B1 C8 2 1. A physical therapy plan of care for a child with spastic cerebral palsy who is three years-old chronologically and cognitively, but at a six month-old gross developmental level would include: A. reaching for a black and white object while in the supine position. B. reaching for a multicolored object while in an unsupported standing position. C. reaching for a multicolored object while in an unsupported, guarded sitting position. D. visually tracking a black and white object held nine inches from his face. B2 C1 2 2. A patient is receiving grade III mobilizations to regain normal midthoracic extension. After three sessions he complains of localized pain that persists for greater than 24 hours. Your treatment should: A. change to grade II mobilizations to reduce the joint and soft tissue irritation. B. change to grade IV mobilizations to stretch through the pain. C. change to self stretching activities because the patient does not tolerate mobilization. D. continue with grade III mobilizations followed by a cold pack to the thoracic spine. B3 C7 3 3. A therapist wishes to use behavior modification techniques as part of her treatment to help shape the behavioral responses of a 22 year-old patient recovering from traumatic brain injury. The BEST choice is to: A. allow the patient enough time for self correction of the behavior. B. encourage the staff to tell the patient which behaviors are correct and which are not. C. reprimand the patient every time an undesirable behavior occurs. D. use frequent reinforcements for all desired behaviors. B4 C2 3 4. Which is NOT a useful intervention for a patient with multiple sclerosis who presents with a primary deficit of dysmetria? A. isokinetic training using low resistance at fast movement speeds. B. PNF patterns using carefully graded resistance and slow reversals. C. pool therapy using moderate water temperatures. D. weight cuffs to distal extremities during functional training. B5 C6 3 5. A 16 year old patient suffered fractures of C4 and C5 following trauma received in a motor vehicle accident. Maximum stabilization of his cervical spine can BEST be achieved with: A. four-poster orthosis. B. halo orthosis. C. Milwaukee orthosis. D. soft collar. B6 C3 2 6. A patient had been on oxygen, but it was discontinued by physician order yesterday. During physical therapy, the patient becomes short of breath and requests supplemental oxygen. The patient’s SaO2 is measured at 90%. The decision that is NOT appropriate is: A. administer supplemental O2. B. allow the patient to rest. C. continue to monitor SaO2. D. encourage an efficient breathing pattern. B7 C2 1 7. A 26 year-old presents with weakness and atrophy of the biceps brachii resulting from an open fracture of the humerus. Your examination includes needle electromyography of the biceps. The muscle response you would anticipate after the needle was inserted and prior to asking the patient to contract the muscle is: A. electrical silence. B. fibrillation potentials. C. interference patterns. D. polyphasic potentials.

'05 Sullivan B.

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Practice Questions

B8 C4 2 8. You are a new staff member on the oncology unit of a large medical center. Your first referral is for strengthening and ambulation for a 42 year-old women with ovarian cancer. She is undergoing radiation therapy following a surgical hysterectomy. Her current platelet count is 17,000. The MOST appropriate treatment activity for this patient at this time is: A. passive ROM exercise. B. progressive stair climbing using weighted belts. C. resistance training at 30% one repetition max. D. resistance training at 50 % one repetition max. B9 C1 2 9. A forty-three year-old male office worker who is a long term smoker now with emphysema has been referred to physical therapy. He complains of increased pain and tingling in both hands after sitting at his desk for longer than one hour. The MOST effective physical therapy intervention is: A. mobilization of the first rib and stretching of middle trapezius muscle due to long term postural changes. B. strengthening of the upper trapezius and pectoralis major muscles for early thoracic outlet syndrome symptoms. C. stretching of scalenes and sternocleidomastoid muscles for early thoracic outlet syndrome symptoms. D. stretching of the pectoralis major and rhomboid muscles due to long term postural changes. B10 C8 2 10. A 68 year-old patient with diabetes is exercising in your P.T. clinic. He reports feeling weak, dizzy, and somewhat nauseous. You notice that he is sweating profusely and is unsteady on his feet. He then becomes confused about where he is. You determine his problems are most likely due to and your immediate course of action should be: A. an insulin reaction; you call for emergency services. B. fatigue; you insist that he rest until his symptoms resolve. C. hyperglycemia; you have a nurse administer an insulin injection. D. hypoglycemia; you immediately administer orange juice and notify his physician. B11 C2 2 11. A patient with postpolio syndrome has started attending an aerobic exercise program as an outpatient. When she does not show up for her scheduled session, you telephone to find out what is the matter. She tells you that she is very tired and has not been able to get out of bed for the last two days. Her muscles ache and she is afraid to continue with the exercise class. You decide to: A. discharge her from the program since exercise is counterproductive in postpolio syndrome. B. modify her exercise prescription to decrease the frequency to once a week for an hour session, keeping the intensity moderate. C. modify her exercise prescription to decrease the intensity and duration but maintain a frequency of 3 times/week. D. reschedule her workouts for early morning when she feels refreshed. B12 C7 3 12. You are the primary clinical instructor for a final affiliation physical therapy student. As you work with this student you become aware that she tends to process information all at once, not in an ordered step-by-step manner. Your best strategy to ensure adequate learning for this student is to: A. focus the student on learning important relationships and concepts. B. focus the student on objective information and interrelationships. C. provide real-life examples that link learning to her personal experiences. D. redirect her to process information in a step-by-step manner. B13 C7 2 13. A 69 year-old male falls and breaks his hip. He undergoes a total hip replacement at the local medical center. The physician orders physical therapy two days after surgery. The patient is covered by Medicare and is still a patient in an acute care facility. The appropriate frequency of treatment would be: A. as often as possible, for the first two weeks based on the therapist’s caseload. B. daily, following the initial examination. C. every other day. D. three to four times per day to facilitate early discharge.

'05 Sullivan B.

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B14 C3 1 14. A patient is taking a drug from the sympathomimetic group, Albuterol. Which is NOT an expected effect of this drug? A. bronchodilation. B. exercise-induced bronchospasm. C. hypertension D. tachycardia. B15 C5 2 15. A 48 year-old female patient is recovering from a total knee replacement. Following her surgery, you receive a referral to teach therapeutic exercises and a home program. The intervention not appropriate during the early postoperative phase is: A. ankle pumps. B. isotonic exercises using ankle weights. C. seated knee extension. D. straight leg raising. B16 C6 2 16. You determine that a patient is walking with a backward trunk lean as he takes full weight on his right leg. He also demonstrates great difficulty going up ramps. The BEST intervention to remediate his problem is to: A. strengthen hip extensors through bridging. B. strengthen knee extensors with weights, using 80% one repetition maximum. C. stretch hip abductors through sidelying positioning. D. stretch hip flexors through prone lying. B17 C4 2 17. If a patient has developed a thick eschar secondary to a full thickness burn, the antibacterial agent MOST effective for infection control is: A. silver nitrate. B. Sulfamylon. C. Travase. D. nitrofurazone. B18 C8 1 18. An 89 year-old has gradually lost much of his functional vision over the last 4 years. He complains his vision is “foggy” and he has difficulty reading. He mistakes images directly in front of him, especially in bright light. He does better walking across a room and is able to locate items in his environment with his peripheral vision when items are located to both sides. Based on his descriptions, you suspect he may be presenting with: A. cataracts. B. glaucoma. C. homonymous hemianopsia. D. tunnel vision secondary to overdoses of steroid medications. B19 C2 2 19. Following a traumatic brain injury, a 26 year-old woman is inconsistently oriented to time and place. She is unable to remember recent events and shows little or no carry-over for new learning. The PRIMARY goal of rehabilitation at this stage of recovery is to promote: A. an environmental and daily structure in which the patient is best able to process stimuli cognitively. B. functional independence in bed mobility and transfers. C. increased arousal and attention through the use of sensory stimulation techniques. D. independence in problem solving skills in variable environments.

'05 Sullivan B.

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B20 C2 2 20. A 65 year-old woman suffered a right CVA one month ago. She demonstrates moderate tone in her left upper extremity (predominantly flexor tone). Her major problem at this time is a lack of voluntary movement control and her left upper extremity shows minimal active movement with 1/4 inch subluxation of the shoulder. An appropriate initial activity would be: A. PNF D2 flexion pattern, left upper extremity. B. quadruped, rocking from side to side. C. sitting, left active shoulder protraction with extended arm. D. sitting, weight bearing on extended left arm, weight shifting. B21 C7 3 21. A therapist conducts a study of the effectiveness of hot and cold in treating patients with pain. He recruits 200 patients for each treatment group. The pain instrument he uses has a possible total score of 50, with 50 being the worst pain. His data analysis reveals that Group A (heat modalities) has a mean score of 33 with a standard deviation of 1.0 while Group B (cold modalities) had a mean of 35 with a standard deviation of 6.0. Based on this data the conclusion one should reach is: A. cold has a greater effect on pain relief than heat. B. heat has a greater effect on pain relief than cold. C. the spread of scores with cold treatment demonstrates variability is greater. D. the spread of scores with heat treatment demonstrates variability is greater. B22 C1 1 22. The therapist in the photograph is testing which muscle? A. anterior deltoid. B. middle deltoid. C. supraspinatus. D. upper trapezius. B23 C6 2 23. A patient presents with pain and instability of the left foot/ankle secondary to poliomyelitis with more recent development of progressive post-polio muscle atrophy. In this case, a plastic solid ankle-foot orthosis is an appropriate prescription in order to: A. control excessive amounts of knee flexion during swing. B. maintain dorsiflexion throughout swing. C. provide modest assistance to dorsiflexion while restricting plantar flexion. D. restrict all movement. B24 C1 1 24. A patient is referred to physical therapy following an anterior dislocation of the right shoulder. A possible positive examination finding as the result of this trauma would be: A. positive drop arm test. B. positive Neer test. C. weak deltoids. D. weak rhomboids. B25 C8 1 25. A 3 month-old infant is being examined at an early intervention program. The therapist is having difficulty flexing the right upper extremity to remove the infant’s clothing. This task is made more difficult if: A. the infant is turned into sidelying on the left. B. the infant sits up with support of the head in a neutral position. C. the infant’s head is turned to the left. D. the infant’s head is turned to the right.

'05 Sullivan B.

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B26 C7 3 26. You have been asked to give an inservice presentation to staff nurses on safe guarding techniques. In order to best prepare for this talk, you should: A. provide a questionnaire to a random sampling of participants one week before the scheduled presentation. B. provide a questionnaire to all participants two weeks before the scheduled session. C. survey your audience at the scheduled session. D. survey your audience just before the scheduled session. B27 C2 3 27. The patient with left hemiplegia would be least likely to respond in therapy if the motor learning strategies emphasized: A. encouragement of the patient to slow down. B. maximum use of demonstration and gesture. C. maximum use of verbal cues. D. simplification/restructuring of the environment including removal of all clutter. B28 C3 2 28. A two-week old infant born at 27 weeks gestation with hyaline membrane disease is referred for a physical therapy consult. Nursing reports that the child “desaturates to 84% with handling” and has minimal secretions at present. The physical therapist should: A. delegate to a physical therapist assistant for a maintenance program of manual techniques for secretion clearance. B. perform manual techniques for secretion clearance, 2 to 4 hours daily, to maintain airway patency. C. provide suggestions to nursing for positioning for optimal motor development. D. put the PT consult on hold as the child is too ill to tolerate exercise. B29 C1 2 29. A thirty-four year-old male sustained a valgus stress to his left knee while skiing. His orthopedist found a positive McMurray’s test, and a positive Lachman stress test. He has been sent to physical therapy for conservative management of his dysfunction. The sub-acute phase of physical therapy intervention should emphasize: A. closed-chain functional strengthening of the quadriceps femoris and hamstrings emphasizing regaining terminal knee extension. B. closed-chain functional strengthening of the quadriceps femoris and hip abductors to promote regaining terminal knee extension. C. open-chain exercises of the hip extensors and hamstrings to inhibit anterior translation of the femur on the tibia. D. open-chain strengthening of the quadriceps femoris and hip adductors to inhibit anterior translation of the tibia on the femur. B30 C8 1 30. The most enthusiastic visual tracking by a neonate would be elicited by: A. a black and white face, with a red nose, held approximately nine inches from the infant’s eyes, moved horizontally. B. a multicolored clown’s face, held 12 inches away and moved horizontally. C. a multicolored spinning top placed 15 inches from the infant’s eyes. D. a red ring on a string, held six inches away from the infant’s eyes and moved horizontally. B31 C2 2 31. A 14 year-old patient with traumatic brain injury has a convulsive seizure during a therapy session. She loses consciousness and presents with tonic-clonic convulsions of all extremities. Your BEST response is to: A. initiate CPR immediately and call for help to restrain her. B. position in sidelying, check to see if the airway is open, and immediately call for emergency assistance. C. position in supine with head supported with a pillow and wait out the seizure. D. use straps to secure her limbs so she can’t hurt herself.

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B32 C7 2 32. A therapist wants to know whether NDT handling techniques produces an improvement in independent rolling that lasts longer than 30 minutes. In this study rolling is the: A. control variable. B. dependent variable. C. independent variable. D. intervening variable. B33 C3 1 33. A 45 year-old computer programmer, with no significant past medical history, presents to the emergency room with complaints of fever, shaking chills and a worsening productive cough. He has chest pains over the posterior base of his left thorax which is made worse on inspiration. Which of the following is NOT an appropriate physical finding for this patient? A. asymmetrical breathing. B. crackles over the posterior aspect of his left thorax. C. limited chest excursion. D. slowed respiratory rate. B34 C6 2 34. A patient is demonstrating genu valgum during standing and walking This problem can be effectively controlled by prescribing a knee-ankle-foot orthosis with: A. anterior knee cap strap. B. posterior plastic shell. C. pretibial and suprapatellar anterior bands. D. quadrilateral brim. B35 C4 1 35. You are called in to consult on a nursing home patient who, following a severe stroke and congestive heart failure, is confined to bed and is immobile. During a skin inspection you note an area of erythema over her left sacrum which persists longer than 50% of time pressure was applied to it. You determine that this is MOST likely: A. an indurated decubitus ulcer with signs of maceration. B. poor circulation secondary to end stage congestive heart failure. C. Stage 1 ulcer formation. D. Stage 2 ulcer formation. B36 C5 3 36. Your patient strained the lower back muscles three weeks ago. The patient complains of pain (6/10) and you note bilateral muscle spasm from T11-L4. You elect to apply interferential current. The BEST electrode configuration to choose in this case would be: A. four electrodes with current flow diagonal to the spinal column. B. four electrodes with current flow perpendicular to the spinal column. C. two electrodes with current flow parallel to the spinal column. D. two electrodes with current flow perpendicular to the spinal column. B37 C8 1 37. An infant has just begun to pull-to-stand through kneeling, still demonstrates plantar grasp in standing, and is independent in sitting including all protective extension reactions. This infant’s chronological age is approximately: A. 5-6 months. B. 7-8 months. C. 9-10 months. D. 12-14 months.

'05 Sullivan B.

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B38 C1 2 38. A sixty-five year old male retired bus driver has an increasing frequency of low back pain over the last 10 years. He states that NSAIDs help to relieve his symptoms but there is always a nagging type pain. He reports significant stiffness in the morning which dissipates by noon after exercising and walking his dog. Pain is exacerbated with frequent lifting and bending activities as well as sitting for long periods. Physical therapy intervention should emphasize: A. joint mobilization, soft tissue mobilization, and flexion exercises. B. modalities to reduce pain, joint mobilization, and lumbar extension exercises. C. modalities to reduce pain, postural reeducation and dynamic stabilization exercises. D. postural reeducation, soft tissue mobilization, and dynamic stabilization. B39 C7 3 39. You are orienting a new physical therapy aide in transfer techniques. Your initial consideration should be to: A. ask about previous work and other experiences related to transferring individuals. B. determine specific goals for teaching the techniques. C. give a computer simulated instructional program before actual “hands on” training takes place. D. provide an organized series of talks dealing with patient safety during transfers. B40 C7 2 40. A 77 year-old patient with diabetes and bilateral lower extremity amputation is to be discharged from an acute care hospital two weeks post surgery. The incisions on his residual limbs are not healed and continue to drain. He is unable to transfer because the venous graft sites in his upper extremities are painful and not fully healed. The MOST appropriate discharge destination for this patient would be: A. custodial care facility. B. home. C. rehabilitation hospital. D. skilled nursing facility. B41 C2 1 41. A 54 year-old man awoke one morning with drooping left facial muscles and excessive drooling. He was recovering from a cold and had experienced an earache in his left ear during the previous 2 days. You suspect a Bell’s Palsy which can be confirmed by examining: A. corneal reflex and stretch refle...