Exam 18 May 2017, questions PDF

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1. A patient has acute synovitis of the left temporomandibular joint. Mandibular depression is limited. You would also expect to find: A. right lateral excursion to be less than functional. B. left lateral excursion to be less than functional. C. protrusion to be functional. D. protrusion to be less...

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1. A patient has acute synovitis of the left temporomandibular joint. Mandibular depression is limited. You would also expect to find: A. right lateral excursion to be less than functional. B. left lateral excursion to be less than functional. C. protrusion to be functional. D. protrusion to be less than functional with deflection to the right. 2. With the patient sitting on a therapy ball, training and strengthening the lumbar extensors is best accomplished by A. rolling the ball in a circular pattern B. rolling the ball backward. C. pushing the pelvis backward. D. pushing the pelvis forward. 3. A full-time plumber with low back pain wishes to discontinue physical therapy and return to work. She is receiving worker's compensation benefits. The PT should not discontinue the patient from treatment if she has pain which precludes prolonged: A. standing. B. sitting. C. squatting. D. ambulation on uneven terrain. 4. A patient has loss of the last 15 degrees of elbow extension. To regain motion the PT should implement: A. dorsal glide at the radioulnar joint. B. volar glide of the radius on the humerus. C. dorsal glide of the radius on the humerus D. volar glide at the radioulnar joint 5. History reveals that a patient awoke from an afternoon nap and was very unsteady on her feet. She loses her balance to the right. There is horizontal nystagmus and loss of conjugate gaze on the right with impaired sensation of the contralateral face, limbs and trunk. These clinical manifestations are most suggestive of: A. anterior inferior cerebellar artery syndrome. B. superior cerebellar artery syndrome. C. lateral medullary syndrome. D. medial medullary syndrome 6. A patient has difficulty during the early swing phase of gait. She circumducts her leg to bring it through swing. A likely cause of this problem is: A. flexor withdrawal reflex B. hamstring spasticity C. knee pain with decreased ROM. D. dysmetria. 7. An investigator wants to study the effectiveness of a post-coronary rehabilitation program on both male and female patients. The variables in this study are: A. ordinal B. nominal C. interval D. ratio

8. The patient population that would most likely have decreased effectiveness in generating a cough are those with: A. longstanding Parkinson's disease. B. complete spinal lesions at T12 C. Down syndrome D. sickle cell anemia. 9. You receive a referral from an osteopath. In this situation A. You receive a referral from an osteopath. In this situation B. you need a referral from a non-osteopathic primary care physician. C. both the osteopathic and a primary care physician referral are required to begin the examination. D. you can proceed with the patient examination 10. The factor that would disallow the use of ultrasound in an 11 year-old boy with patellar tendinitis is: A. open epiphysis at the knee. B. sexual immaturity. C. potential for metagenesis D. ineffectiveness of ultrasound as a modality for those younger than 12 years of age. 11. A patient with a past medical history of recurrent pneumonia is referred to physical therapy with new symptoms of cough and sputum production. The examination technique that would provide the least important information in this case is: A. vital sign measurement B. auscultation. C. Sa02 measurement D. thoracic excursion. 12. You are to examine a two-year-old for fine and gross motor skills. The appropriate standardized test to use in this case is the: A. Peabody Developmental Motor Scales B. Alberta Infant Motor Scales. C. Denver Developmental Screening Test D. Pediatric Evaluation of Disability Inventory. 13. A 15 year-old boy with Duchenne muscular dystrophy will exhibit all of the following except: A. Gower's sign. B. hyperactive DTRs. C. increased lumbar lordosis. D. minimal ambulation capability. 14. During an adaptive seating clinic, you are asked to examine a child who is wheelchairbound. Your findings include asymmetrical shoulders and a forward, flexed head. Based on these findings, the next thing you would do is: A. check to see if the pelvis is symmetrical and supported. B. recommend an abduction wedge for the chair. C. recommend a high back with head supports for the chair. D. a scoliosis screening 15. A fee from a payer for each insured member per month regardless of number or duration of visits would be considered:

A. B. C. D.

capitation. case rate. fee-for-service. diagnostic related grouping.

16. A therapist that you supervise has been arriving 10-15 minutes late each day for the past week. The clinic hours are 8:00AM to 5:00 PM. This tardiness occurs on Monday of the following week. In this case you should: A. say nothing as the therapist usually stays until 5:20 each day. B. ask the therapist to meet with you during a schedule break. C. ask the therapist to meet with you immediately. D. discuss the issue with the therapist during lunch in the cafeteria. 17. You should inform a building contractor on the need for a resting platform on a wheelchair ramp every: A. 45 feet B. 12 feet C. 24 feet D. 30 feet 18. The balance test which specifically discriminates for vestibular dysfunction is the: A. Timed Up and Go Test B. Berg Balance Test. C. Clinical Test for Sensory Interaction in Balance. D. Multidirectional Reach Test. 19. Your preprosthetic examination of a patient with a transfemoral amputation reveals arching of the lumbar spine when in the supine position. It is most likely this is a result of: A. weak back extensors and weak hip flexors. B. tight back extensors and weak hip extensors. C. tight hip flexors and weak abdominals. D. tight hip extensors and weak abdominals. 20. A 22 year-old male suffered a traumatic above-knee amputation as a result of a collision with a train. In the patient's adjustment to this physical loss, he is experiencing a stage of grief. This period is often characterized by: A. hostility and anger towards family and caregivers. B. depression and exaggerated self-blame over what had occurred. C. denial of the loss and fantasizing that the extremity had been restored. D. regression into more dependent behaviors. 21. In a child diagnosed with spastic cerebral palsy, use of a prone stander would be appropriate if the child could do all of the following except for: A. active trunk flexion. B. active trunk extension. C. bear weight when standing or kneeling. D. have the use of the upper extremities for weightbearing or activities. 22. You examine a teenager in an outpatient brace clinic. A recent diagnosis of Charcot-MarieTooth disease has been confirmed. The adaptive device that would benefit this individual the most would be: A. a knee-ankle-foot orthosis with a drop ring lock.

B. a shoe fit with a Thomas heel and metatarsal bar. C. an ankle-foot orthosis with a varus correction strap. D. a Toronto hip abduction orthosis. 23. On the second day following surgery a patient begins to take a few steps at bedside. Suddenly, the patient present with hemoptysis. This is most likely the result of: A. pulmonary edema B. pulmonary embolus C. pleural effusion D. pleural empyema 24. When designing the hydrotherapy area in a private practice, the electrical components critical to include are: A. wall outlets with ground fault interrupters. B. three-slotted electrical outlets. C. surge protectors. D. rheostats. 25. You are examining an eight year-old girl with spastic diplegia. An indication that the asymmetrical tonic neck reflex is integrated would be if the child can: A. maintain gaze at both hands held in front. B. turn her head from side to side with no corresponding limb movement. C. ventroflex the neck while both shoulders flex. D. turn her head from side to side as the shoulders alternately extend. 26. To improve abduction and external rotation of the shoulder, the best diagonal PNF pattern to use is: A. D2 extension B. D1 flexion. C. D1 extension. D. D2 flexion. 27. A patient with peripheral vascular disease has an ulcer located on the medial malleolus. This is most likely indicative of: A. arterial insufficiency. B. a pressure ulcer. C. an indurated ulcer. D. venous insufficiency. 28. A therapist wants to determine the interrater reliability of force measurements using a modified sphygmomanometer. Three examiners evaluated isometric force of elbow and hip extensors. Intraclass correlation coefficients that would reflect a moderate degree of reliability in measuring both sets of muscles are: A. .75 (elbow) and .50 (hip). B. .87 (elbow) and .80 (hip) C. .48 (elbow) and .70 (hip). D. .70 (elbow) and .64 (hip). 29. When descending stairs, the type of contraction performed by the quadriceps femoris of the stance limb is: A. eccentric B. isometric

C. isotonic D. concentric 30. A women with a fixed deformity of minus ten degrees of plantar flexion would have the greatest difficulty: A. walking barefoot B. ascending a ramp C. walking with one inch heels D. walking down stairs 31. If a women developed a postnatal diastasis recti of less than two centimeters, all of the following exercises would be appropriate except for: A. head lifting with posterior pelvic tilting in the supine hooklying position. B. head lifting in the supine hooklying position. C. posterior pelvic tilting in the quadruped position. D. pelvic floor exercises. 32. To improve artistic performance, you should advise an opera singer to strengthen the: A. muscles of inspiration B. abdominal muscles C. oblique muscles D. muscles of expiration

33. You are a private practitioner and have been treating a 55 year-old construction worker for bicipital tendonitis. He now reports to you that he has been waking up almost every night with significant aches and pains in his low back. While at work, the back pain is constant and is not relieved by rest. As his therapist you should: A. seek approval to treat this patient for facet joint impingement using deep heat and mobilization techniques. B. ask the patient to touch his toes. If the motion is full and pain does not increase, refer him back to his primary care physician for further evaluation. C. ask the patient to touch his toes. If the motion is full and pain does not increase, inform his primary care physician that you believe that patient is showing signs of malingering. D. try to identify comfortable positions for the patient and instruct him in using safe and proper body mechanics on the job which should ease his discomfort. 34. Excessive femoral anteversion will result in standing posture characterized by: A. external rotation of the hip and toeing-out. B. external rotation of the hip and toeing-in. C. internal rotation of the hip and toeing-in. D. internal rotation of the hip and toeing-out. 35. When a patient with quadriplegia is positioned sidelying, the areas of the body that are least susceptible to pressure are the: A. medial malleoli B. lateral malleoli C. scapulae D. knees

36. A primary care physician refers a 38 year-old woman to you. This patient is having recent difficulty in properly positioning her cane, which she has used for many years. The most important aspect of the physical therapy examination is this patient's: A. proprioceptive sensation B. visual acuity C. tactile localization D. figure-ground discrimination 37. Risk factors for the development of coronary artery disease include: age, gender, family history, cigarette smoking, obesity, physical inactivity and blood lipid abnormalities. The distribution of lipoproteins associated with a lower risk of heart disease are: A. low levels of HDL and LDL. B. high levels of HDL and LDL. C. high level of HDL and low level of LDL. D. low level of HDL and high level of LDL. 38. Following trauma, extreme care must be taken in the management of myositis ossificans. The muscle most often affected is the: A. triceps B. biceps brachii C. quadriceps femoris D. brachialis 39. A classical sign indicative of congenital hip dysplasia in the newborn is: A. limited passive adduction B. limited external rotation C. excessive internal rotation D. limited passive abduction 40. A child with brain damage shows evidence of mental retardation, tactile defensiveness and proximal joint instability. Activities that the physical therapist can best utilize in this case include: A. repetitive brushing and joint traction B. firm pressure and joint approximation C. very light touch and weightbearing D. neutral warmth and rhythmic stabilization 41. Use of the pivot prone position in a child with severe cerebral palsy might help lead to the long-term goal accomplishment of: A. improvement of righting reflexes B. rolling from prone to supine C. functional crawling D. anteroposterior pelvic shifting 42. During a phonophoresis treatment of the shoulder, a patient reports to you that he is experiencing a deep aching pain. This situation is best remedied by: A. using a smaller sound head but doubling the exposure time. B. adding more coupling agent and moving the sound head more rapidly. C. reducing the power and moving the sound head over a large area. D. decreasing the frequency and moving the sound head more rapidly.

43. Following an ankle sprain, a therapist elects to use contrast baths. To help promote circulation in the subacute stage, the procedure should begin with: A. hot water at 102 degrees F for 4 minutes followed by cold water at 60 degrees for one minute and alternating for 20 minutes ending with hot immersion. B. cold water at 60 degrees F for one minute followed by hot water at 102 degrees F for 4 minutes and alternating for 20 minutes ending with cold immersion. C. cold water at 40 degrees F for 4 minutes followed by warm water at 96 degrees F for one minute and alternating for 30 minutes ending with cold immersion. D. warm water at 96 degrees F for one minute followed by cold water at 40 degrees F for 4 minutes and alternating for 30 minutes ending with warm immersion. 44. The device least likely you help deal with the specific disability that results from a lesion to the deep peroneal nerve is a: A. spring assist ankle-foot orthosis. B. plastic spiral ankle-foot orthosis. C. posterior leaf spring ankle-foot orthosis. D. metal ankle-foot orthosis with a posterior stop. 45. In ordering a wheelchair for someone with pronounced flexor spasticity, the components which ordinarily should not be included are: A. web heel loops. B. removable arm rests. C. detachable, swing-away foot rests. D. elevating leg rests. 46. An obstetrician refers a patient to you for prenatal exercises. During your examination, the patient says that she belongs to an HMO and her primary care physician had referred her to the obstetrician. Your physical therapy report should go first to the: A. primary care physician. B. HMO medical records department. C. patient. D. referring obstetrician. 47. During gait, a patient is observed using quadratus lumborum action to compensate for unilateral lower extremity extensor spasticity. In planning a gait training program, the physical therapist should consider applying: A. manual contact to limit upward pelvic motion during stance phase. B. manual contact to enhance upward pelvic motion during stance phase. C. manual contact to limit upward pelvic motion during swing phase. D. manual contact to enhance upward pelvic motion during swing phase. 48. Management of a patient in her third trimester of pregnancy may include all of the following activities with the exception of: A. positioning in left sidelying while exercising. B. bridging from the supine position. C. posterior pelvic tilting done while standing with the back against a wall. D. aerobic swimming programs. 49. In order to differentiate between pain originating in the sacroiliac joints as opposed to hip pathology, it would be best to employ the: A. Noble Compression Test. B. compression-distraction tests.

C. Fabere Test. D. straight leg test. 50. You are to treat a patient with a large posterolateral protrusion of a herniated nucleus pulposus. Examination reveals decreased sensation, radiating pain and 1+ Achilles DTR in the left lower extremity. Trunk flexion is limited to 45 degrees and pain increases with sitting of more than 15 minutes. Based on this symptomatology, it would be best if treatment stressed: A. Williams flexion exercises, posterior pelvic tilting and hamstring stretch. B. hip shifting to the right followed by prone and standing trunk extensions. C. posterior pelvic tilting, bridging, diagonal curl ups and gradual increase in sitting tolerance. D. prone and standing trunk extensions followed by hip shifting to the left. 51. The most important stimulus which will result in an increase in ventilation is: A. diminished arterial PCO2. B. diminished arterial PO2. C. increased arterial PCO2. D. the Hering-Breuer reflex.

52. The parents of an eight year-old girl with Down syndrome have asked for your advice about recreational activities for their daughter. You could recommend all of following except for: A. soccer B. ballet dancing C. softball D. horseback riding 53. As a result of a left cerebral vascular accident, an 83 year-old patient has right hemiplegia and severe global aphasia. As her therapist, you could use: A. visual representations or pictographs of what you wish to communicate. B. oral communication, since the patient is able to comprehend but is nonfluent in speech C. written communication. since the patient is unable to comprehend oral speech. D. oral communication that only requires simple yes or no responses. 54. A patient with chronic rheumatoid arthritis lacks self-esteem and seems uninterested during physical therapy treatment session. In this case: A. remind the patient that others with similar disorders have greater limitations. B. get the patient involved in making choices regarding day to day treatment options. C. keep the patient fully informed of the therapeutic outcomes you envision. use appropriate behavior D. modifications if there are any signs of depression or withdrawal. 55. You have evaluated a nine-month-old who cannot assume or maintain the quadruped position without assistance. The parents insist that the child has already begun to walk with assistance. You suspect that what the parents are describing is most likely the result of: A. spontaneous stepping. B. protective extension downward. C. the positive supporting reaction. D. the negative supporting reaction.

56. Following a CVA, a 75 year-old man is having motor control difficulty and is fearful when descending stairs. Early in the relearning process, effective strategies to be employed by a therapist to address these problems could include all of the following EXCEPT: A. mental practice of the task to help decrease fear. B. use of a more open environment in which to practice the skill. C. guided movement to help position the involved extremity on the proper step. D. provision of feedback which focuses on correct aspects of performance. 57. A 79 year-old female received a Colles' fracture as a result of a fall on an outstretched hand. Now six weeks later, the fracture is well healed and the cast has been removed. The patient was referred to physical therapy because radiographs revealed osteoporosis of the forearm and wrist and complaints of pain in the hand, which could be indicative of developing reflex sympathetic dystrophy. The best strategy the physical therapist could employ to deal with these problems is: A. use of TENS and progressive resistance exercises to strengthen the wrist extensors. B. progressive weightbearing stress loading of the forearm and wrist. C. use of friction massage and ultrasound at the fracture site. D. paraffin application followed by progressive squeezing and release of silly putty or a tennis ball. 58. You are treating a 16 year-old female athlete for patellofemoral malalignment syndrome. During competition, the orthosis that would be most helpful in aiding this situation is a: A. knee orthosis with an offset hinge joint. B. derotation brace. C. knee orthosis with a hinge joint. D. patellar stabilizing brace.

59. An athlete experiences a first degree strain of the right quadriceps muscle. Ice packs were applied for the first two days. At the end of this time, there was no indication of inflammation or reports of pain. However, there was decreased active and passive range of motion and the athlete reported tigh...