Questions with Answers)
A physical therapist examines a patient three days following shoulder surgery. The patient
complains of general malaise and reports a slightly elevated body temperature during the last
twenty-four hours. Physical examination reveals an edematous shoulder that is warm to the
touch. A small amount of yellow fluid is observed seeping from the incision. The MOST
appropriate therapist action is:
1) Send the patient to the emergency room
2) Communicate the information to the referring physician
3) Document the findings in the medical record
4) Ask the patient to make an appointment with the referring physician - ANS ✔✔2)
Communicate the information with the referring physician
What factors increase with an acute burn? - ANS ✔✔Increased oxygen consumption, minute
ventilation, and core temperature
What factors decrease with an acute burn? - ANS ✔✔Intravascular, interstitial, and intracellular
fluids
Is hyponatremia or hypernatremia more common with an acute burn? - ANS ✔✔Hyponatremia
usually occurs within the first 36 hours secondary to extracellular changes from the increased
cellular permeability.
What type of treatment is given for patients who sustain burns that are over 20% of the total
body surface? - ANS ✔✔Fluid and electrolyte replacement is a component of immediate
medical management in order to control the hypermetabolic cycle that results from the burn.
,What happens to cardiac output with patients with burns? - ANS ✔✔Can have a decrease in CO
due to increase in blood viscosity, decrease in intravascular fluid, and increase in peripheral
resistance
What do patients that have sustained extensive burns require in regards to temperature? - ANS
✔✔Warmer ambient temperature in order to reduce their metabolic rates
A patient sustains a deep partial-thickness burn to the anterior surface of the right upper
extremity and a superficial partial-thickness burn to the anterior surface of the trunk. According
to the "rule of nines," the patient has burns over:
1) 13.5 percent of the body
2) 22.5 percent of the body
3) 27.0 percent of the body
4) 36.0 percent of the body - ANS ✔✔2) 22.5 percent of the body
Rule of Nines (adult) - ANS ✔✔9% per arm
9% for head
18% each leg
18% anterior trunk
18% posterior trunk
Graves Disease - ANS ✔✔Autoimmune disease in which certain antibodies produced by the
immune system stimulate the thyroid gland causing it to become overactive
What are the symptoms of graves disease? - ANS ✔✔Consistent with hyperthyroidism - mild
enlargement of the thyroid gland (goiter), heat intolerance, nervousness, tremor, palpitations
,A physician discusses a patient's plan of care with a physical therapist. The patient is a 29-year-
old male that sustained deep partial-thickness burns to the anterior surface of his lower
extremities. The physician discusses the possibility of discontinuing use of the topical antibiotic
silver sulfadiazine after identifying an irregularity in the patient's laboratory results. Which
finding could be MOST related to the use of silver sulfadiazine?
1) leukopenia
2) peripheral edema
3) hypokalemia
4) altered pH balance - ANS ✔✔1) leukopenia
What are precautions when using the topical agent silver sulfadiazine? - ANS ✔✔Decrease in
the number of white blood cells, GI distress, and allergic reactions
What are causes of hypokalemia? - ANS ✔✔Vomiting, diarrhea, burns, uncontrolled diabetes,
diuretic therapy, steroid therapy
Normal serum calcemia - ANS ✔✔8.4-10.2 mg/dl
Symptoms of hypercalcemia - ANS ✔✔Constipation, pain, nausea, and vomiting
Normal serum potassium - ANS ✔✔3.5-5.0 mEq/L
Symptoms of hyperkalemia - ANS ✔✔Respiratory paralysis, cardiac arrest (>8.5 mEq/L), sx
typically related to abnormalities in muscular or cardiac function
Normal serum magnesium - ANS ✔✔1.5 - 2.0 mEq/L
, Symptoms of hypermagnesium - ANS ✔✔Hypotension and respiratory depression (often caused
by renal failure)
Normal serum sodium - ANS ✔✔135-145 mEq/L
Symptoms of hypernatremia - ANS ✔✔Caused by impaired thirst or restricted access to water
and can be facilitated by pathologic conditions with increased fluid loss. Primary symptom of
the condition is thirst
A physical therapist treats a patient with a colostomy that is capable of producing solid stool on
a fairly regular schedule. Which type of colostomy would be MOST consistent with this
description?
1) ascending colostomy
2) descending colostomy
3) sigmoid colostomy
4) transverse colostomy - ANS ✔✔3) sigmoid colostomy
A physical therapist receives a referral for a 48-year-old female diagnosed with lung cancer. The
patient reports smoking three packs of cigarettes a day for the last 25 years. Assuming the
patient was diagnosed with cancer two months ago, which of the following pieces of data would
provide the therapist with the MOST valuable information when establishing the plan of care
and the associated goals?
1) premorbid lifestyle
2) staging of cancer
3) past medical history
4) motivation level - ANS ✔✔2) staging of cancer