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A1 C1 III A patient sustained a fracture to the left proximal humerus which is now healed. Treatment is proceeding well except that with left shoulder flexion. The therapist notices the scapula protracts and elevates early and it continues to move excessively. Physical therapy intervention should em...

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A1 C1 III 1. A patient sustained a fracture to the left proximal humerus which is now healed. Treatment is proceeding well except that with left shoulder flexion. The therapist notices the scapula protracts and elevates early and it continues to move excessively. Physical therapy intervention should emphasize: A. glenohumeral mobilization and strengthening of scapular stabilizers to regain normal scapulohumeral movement. B. glenohumeral mobilization and strengthening of the rotator cuff muscles to regain muscle balance. C. scapulothoracic mobilization and strengthening of the pectoralis major and minor muscles to regain normal scapulohumeral rhythm. D. stretching of scapular stabilizers and strengthening of the pectoralis major and minor muscles to regain muscle balance. A2 C8 I 2. A 79 year-old ex-machinist demonstrates significant age-related hearing loss, presbycusis. When trying to communicate with this patient the physical therapist would NOT suspect: A. bilateral hearing loss at all frequencies. B. decreased language comprehension. C. poor auditory discrimination. D. unilateral hearing loss A3 C3 III 3. A therapist is supervising the exercise of cardiac rehabilitation outpatient class on a very hot day, with temperatures expected to be above 90 degrees F. The class is scheduled for 2 p.m. and the facility is not air-conditioned. The strategy that is unacceptable is to: A. change the time of the exercise class to early morning or evening. B. decrease the exercise intensity by slowing the pace of exercise. C. increase the warm-up period to equal the total aerobic interval in time. D. make the exercise intermittent by adding rest cycles. A4 C6 I 4. A patient has a transtibial amputation and has recently been fitted with a PTB socket. During initial prosthetic checkout, the physical therapist instructs the patient to walk several times in the parallel bars and then sit down and take the prosthesis off. Upon inspection of the skin the therapist would expect no redness in the area of the: A. anterior tibia and tibial crest. B. medial and lateral distal ends of the residual limb. C. medial tibial and fibular plateaus. D. patellar tendon and tibial tuberosity. A5 C4 II 5. A patient who is terminally ill with cancer is in tears, unable to cope with the changes in her life and current hospitalization. The therapist has a referral for gait training so the patient can be discharged to home under hospice care. The BEST approach is: A. ask the patient questions in order to obtain a detailed history. B. encourage denial so she can cope better with life’s challenges. C. ignore the tears and focus on therapy but in a compassionate manner. D. take time now to allow the patient to express her fears and frustrations. A6 C5 III 6. The examination reveals muscle spasm of the piriformis, which is compressing the sciatic nerve and producing pain in the posterior hip region. The pain has been worsening over the past three months. What is the most appropriate ultrasound setting for this case? A. 1 MHz continuous at 1.0 W/cm2. B. 1 MHz pulsed at 1.0 W/cm2. C. 3 MHz continuous at 1.0 W/cm2. D. 3 MHz pulsed at 1.0 W/cm2.

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A7 C2 II 7. A patient is recovering from a complete spinal cord injury, at the level of L2. The expected outcome in this case would MOST likely include: A. a spastic or reflex bladder. B. greater loss of arm function than leg function with early loss of pain and temperature sensation. C. loss of motor function and pain & temperature sensation below the level of the lesion with light touch, proprioception and position sense preserved. D. some recovery of function since damage is to peripheral nerve roots. A8 C7 III 8. A patient with left hemiplegia receives a new AFO. The therapist is overwhelmed with too many patients and asks the physical therapy student to take over. This is the student’s first affiliation (second day) and has never performed an orthotic checkout for a patient with an AFO. The supervising therapist will be in the same vicinity treating other patients. This task should be: A. delegated to another physical therapist. B. delegated to the student who could call out to the supervisor if problems arose. C. delegated to the physical therapist assistant who is working nearby. D. not be completed now and the patient sent back to his room. A9 C1 II 9. A patient has been diagnosed with acute synovitis of the temporomandibular joint. Early intervention might best focus on: A. instruction to eat a soft food diet and phonophoresis. B. application of an intraoral appliance and phonophoresis. C. joint mobilization and postural awareness. D. temporalis stretching and joint mobilization. A10 C1 III 10. During a cervical spine examination the therapist observes restricted left rotation of the C7-T1 spinal level. After stabilizing the thoracic spine, the therapist’s hand placement for mobilization to improve left rotation should be at the: A. posterior left C6 articular pillar. B. posterior left C7 articular pillar. C. posterior right C7 articular pillar. D. T1 spinous process. A11 C8 I 11. An appropriate fine motor behavior that should be established by 9 months of age would be the ability to: A. build a tower of 4 blocks. B. hold a cup by the handle while drinking. C. pick up a raisin with a fine pincer grasp. D. transfer objects from one hand to another. A12 C2 I 12. A patient with a 10-year history of Parkinson’s disease has been taking L-dopa for the last 5 years. The patient presents with deteriorating function and is no longer able to transfer or walk independently. During a physical therapy session, the therapist observes facial grimacing with twitching of the lips and tongue protrusion. The patient appears restless, with constant dancing, athetoid-like movements of his legs. The therapist’s BEST course of action is to: A. complete the treatment session, focusing specifically on examining the effects of rigidity. B. document observations and refer the patient back to the physician for evaluation of possible levodopa toxicity. C. examine for additional signs of chronic levodopa therapy such as dizziness and headache. D. talk to the spouse to see if the patient is taking any drugs with hallucinogenic effects such as Selegiline. A13 C7 III 13. A patient who is to undergo surgery for a chronic shoulder dislocation asks the therapist to explain the rehabilitation following a scheduled surgical reconstructive procedure. The therapist’s BEST response is to: A. explain how patients typically respond to the surgery and outline the progression of exercises. B. explain in detail about the surgical procedure. C. refer the patient to a physical therapy clinical specialist who is an expert of shoulder reconstructive rehabilitation. D. tell the patient to ask the surgeon for information about the procedure and appropriate rehabilitation.

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A14 C3 II 14. Which of the following is NOT an appropriate reason to terminate a maximum exercise tolerance test for a patient with pulmonary dysfunction? A. ECG monitoring reveals diagnostic ischemia. B. PaO2 decreases 20 mmHg. C. patient reaches age-predicted maximal heart rate. D. patient states he is maximally short of breath. A15 C6 III 15. A patient with a complete T10 paraplegia is receiving his initial ambulation training. He has received bilateral Craig-Scott knee-ankle-foot orthoses and is being trained with axillary crutches. Since a reciprocal gait pattern is problematic for him, the BEST initial gait pattern to teach him is: A. four-point. B. swing-through. C. swing-to. D. two-point. A16 C4 II 16. After mastectomy, a patient receiving home care, cannot accept the loss of her breast. She reports being weepy all the time with loss of sleep. She is constantly tired and has no energy to do anything. The BEST action the therapist can take is: A. contact her primary physician and request a psychological consult. B. have her spouse observe her closely for possible suicidal tendencies. C. tell her depression is common at first, but will resolve with time. D. tell the nurse case manager to monitor the patient closely. A17 C5 III 17. A college volleyball player complains of moderate pain resulting from a left hamstring strain four weeks ago. The focal point of pain and tightness is noted where a hematoma developed initially. The specific massage technique that would be MOST beneficial in this case is: A. friction. B. kneading. C. stroking. D. tapotement. A18 C8 II 18. A six year-old boy born with myelomeningocele at the L2 level is referred for physical therapy treatment at home. In determining the plan of care, it would NOT be appropriate to emphasize: A. gait training with a reciprocating gait orthosis. B. transfer training from floor to wheelchair. C. upper extremity strengthening with weights. D. vigorous range of motion of the lower extremities. A19 C1 I 19. During an examination of a patient who complains of back pain, the physical therapist notes pain with end range AROM into left hip flexion, abduction and external rotation. The origin of the pain is MOST likely the: A. capsule of the hip joint. B. left kidney. C. sacroiliac joint. D. sartorius muscle. A20 C7 II 20. A therapist wants to compare frequencies of carpal tunnel syndrome occurring in different groups of individuals: assembly line workers and computer programmers. The MOST appropriate statistical tool to use for analysis of the data is: A. chi square test. B. normal distribution curve. C. simple one-way ANOVA. D. t test.

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A21 C7 I 21. In a research study in which there is a skewed distribution with extreme scores on a balance measure that deviate from the performance of the total group, the MOST accurate representation of central tendency is: A. mean. B. median. C. mode. D. standard deviation. A22 C2 I 22. A factory worker injured the right arm in a factory press with damage to the ulnar nerve at the elbow. A diagnostic EMG was performed with evidence of spontaneous fibrillation potentials. In this case, the physical therapy plan of care should consider that: A. axonotmesis is occurring. B. denervation atrophy has occurred. C. reinnervation is complete. D. reinnervation is in process. A23 C6 III 23. A patient is recovering from a right CVA resulting in severe left hemiplegia and visuospatial deficits. Additionally, there is a large diabetic ulcer on the left foot with pitting edema. The MOST appropriate wheelchair prescription for this patient would be a: A. hemiplegic chair with elevating legrest on the left. B. lightweight active duty wheelchair with elevating legrests. C. one-arm drive chair with elevating legrest on the left. D. powered wheelchair with joystick and elevating legrests. A24 C3 I 24. A 14 year-old boy with advanced Duchenne muscular dystrophy is administered a pulmonary function test. The value that is UNLIKELY to show any deviation from normal is: A. FEV1. B. functional residual capacity. C. total lung capacity. D. vital capacity. A25 C6 III 25. A patient fractured the right midtibia in a skiing accident three months ago. After cast removal, a severe foot drop was noted. The patient desires to try electrical stimulation orthotic substitution. The physical therapist would set up the functional electrical stimulation to contract the appropriate muscles during: A. foot flat. B. push off. C. swing phase. D. toe off. A26 C4 II 26. A physical therapist has a small open wound on the back of the hand. The therapist is scheduled to treat a patient with HIV for management of a wound. The therapist should: A. continue with treatment as scheduled but wash hands thoroughly before and after. B. double glove and treat as scheduled. C. refuse to treat that patient. D. use sterile precautions with mask and gloves. A27 C1 II 27. A home care therapist is treating a patient who underwent a total hip replacement four weeks ago. The therapist notices that the patient arches his lumbar spine when lying supine. The patient states that this is uncomfortable and doesn’t remember having the problem before. The patient is most likely unable to maintain a comfortable supine position due to: A. poor abdominal strength. B. tight hamstrings muscles. C. tight iliopsoas muscle. D. tight piriformis muscle. '06 Sullivan A

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A28 C8 III 28. An elderly patient has been hospitalized for the past three days with pneumonia. The physician is being pressured to discharge her tomorrow. The patient lives with her sister in a first floor apartment. The physical therapist has determined her ambulation endurance to be only up to 15 feet, not enough to allow her to get from her bed to the bathroom (a distance of 20 feet). The therapist should recommend: A. a bedside commode and referral for home health services. B. a skilled nursing facility placement until her endurance increases. C. out patient physical therapy until her condition improves. D. postponing her discharge until she can walk 20 feet. A29 C2 III 29. A therapist examines a patient with a right CVA and determines the patient has a profound deficit of homonymous hemianopsia. The BEST initial strategy to assist the patient in compensating for this deficit is to: A. place items, eating utensils on the left side. B. provide constant reminders, printed notes on the left side, telling the patient to look to the left. C. rearrange the room so while in bed the left side is facing the doorway. D. teach the patient to turn the head to the affected left side. A30 C2 II 30. A patient with multiple sclerosis exhibits moderate fatigue during a 30-minute exercise session. When the patient returns for the next regularly scheduled session 2 days later, the patient reports that she went home after the last session and went right to bed. The patient was so exhausted she was unable to get out of bed until the late afternoon of the next day. The therapist’s BEST response is: A. switch the patient to a pool therapy program. B. treat the patient in a warm, relaxing environment. C. utilize a distributed practice schedule. D. utilize a massed practice schedule. A31 C7 III 31. A 72 year-old medically stable individual requires custodial care in the home. She is severely disabled with rheumatoid arthritis and is in a great deal of pain. She presents with significant deformities which limit her functional abilities and is dependent in all basic activities of daily living. A recent exacerbation of her disease has left her bed-bound for the past 2 weeks. Appropriate physical therapy services would be covered by: A. Medicaid. B. Medicare. C. Medigap policies. D. only by HMO or private insurance policies. A32 C4 II 32. A patient with a venous stasis ulcer near the left medial malleolus is referred for physical therapy. Skin changes consistent with stasis dermatitis are evident in the lower leg. Physical exam reveals patent femoral, popliteal, and pedal pulses. An enlarged and dilated greater saphenous vein is evident in the standing position. The MOST important physical therapy intervention to consider for this patient is: A. compression therapy with exercise. B. daily walking for 30-60 minutes. C. daily warm water baths and exercise. D. elastic wraps and daily exercises. A33 C6 I 33. A patient recovering from stroke is having difficulty bearing weight on the left leg. The patient is unable to advance the tibia forward and abbreviates the end of the stance phase on the left going directly into swing phase. The MOST likely cause of her problem is: A. spasticity of the anterior tibialis muscle. B. spasticity or contracture of the plantar flexors. C. weakness or contracture of hip extensors. D. weakness or contracture of the dorsiflexors.

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A34 C1 I 34. With traction injury to the anterior division of the brachial plexus the therapist would expect to see weakness of the elbow flexors, wrist flexors and forearm pronators. The therapist would also expect to find additional weakness in: A. forearm supination. B. lateral rotation of the shoulder. C. thumb abduction. D. wrist extension. A35 C8 III 35. A 95 year-old has recently been admitted to a skilled nursing facility following a fall-related injury (fractured hip with open reduction, internal fixation). Since she lived alone on the second floor, she was unable to return home. She is extremely agitated over her placement here and demonstrates early signs of dementia. She tells the therapist “leave me alone, I just want to get out of here!” An important approach to take while working with this client is to: A. be calm and supportive, and use only one or two level commands. B. minimize verbal communication and maximize guided movements. C. promise her anything to calm her down, as long as she gets up and walks. D. tell her clearly and firmly what she is going to do in therapy. A36 C8 I 36. A 72 year-old woman is being treated for depression following the death of her husband. She is currently taking antidepressant medication (tricyclics) and has a recent history of a fall. The therapist suspects the precipitating cause of the fall is her medication as it can cause: A. cardiac arrhythmias. B. dyspnea. C. hyperalertness. D. postural hypotension. A37 C3 I 37. A patient and his caregivers should understand the common side effects of the medication that he is taking. He has Class III heart disease and is continually in and out of congestive heart failure. He is taking digitalis (Digoxin) to improve his heart function. The therapist will know he and his caregivers understand the adverse side effects of this medication if they relate that they will contact the patient’s physician if he demonstrates: A. confusion and memory loss. B. involuntary movements and shaking. C. slowed heart rate. D. weakness and palpitations. A38 C7 III 38. The director of physical therapy from a large teaching hospital is asked to develop an operating budget for the upcoming fiscal year. The item that would NOT be included in an operating budget is: A. a treadmill purchase. B. equipment maintenance. C. housekeeping supplies. D. long distance telephone calls. A39 C4 I 39. A physical therapist is treating a patient with active hepatitis B infection. Transmission of the disease is best minimized if the therapist: A. has the patient wear a gown and mask during treatment. B. has the patient wear gloves to prevent direct contact with the therapist. C. washes hands before and after treatment. D. wears gloves during any direct contact with blood or body fluids.

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A40 C5 III 40. A patient complains of pain (7/10) and limited range of motion of the right shoulder as a result of chronic overuse. The therapist elects to use procaine hydrochloride iontophoresis as part of physical therapy intervention for this patient’s problems. To administer this substance, it would be appropriate to use: A. continuous biphasic current with the medication under the anode. B. continuous monophasic current with the medication under the anode. C. continuous monophasic current with the medication under the cathode. D. interrupted biphasic current with the medication under the cathode. A41 C1 II 41. A contraindication to initiating joint mobilization on a patient with chronic pulmonary disease may include: A. concurrent inhalation therapy. B. functional chest wall immobility. C. Long-term corticosteroid therapy. D. reflex muscle guarding. A42 C8 III 42. Long term care for institutionalized elderly who have reduced their financial resources to qualify for low-income status is typically funded by: A. Health Maintenance Organizations. B. Medicaid. C. Medicare. D. Social Security Administration. A43 C3 I 43. A computer programmer, with no significant past medical history, presents to the emergency room with complaints of fever, shaking chills and a worsening productive cough. Complaints of chest pain over the posterior base of the left thorax is made worse on inspiration. An anterior-posterior X-ray shows an infiltrate on the lower left thorax at the posterior base. This patient’s ch...