NPTE Practice Questions with 100% correct answers 2024

If a magnetic resonance image (MRI) correctly identifies 95% of patients as positive for anterior cruciate ligament tears, then the MRI is a)Sensitive b)Specific c)Significant d)Stable - ANSWER-A. Sensitive This is the correct answer. A test that is sensitive will correctly identify the true positives. With high sensitivity, a test that is negative will likely mean that you can rule OUT the condition because positives are so reliable. A 20 year old male soccer player presents with a Grade II right lateral ankle sprain upon evaluation. What are the characteristics of a Grade II ankle sprain? a)Partial tear of the lateral ligament complex with mild joint instability, moderate intra-capsular swelling and tenderness, and some loss of ROM and joint function b)Complete rupture of the anterior talofibular ligament, calcaneofibular ligament, and capsule with mechanical joint instability; severe intra/extra-capsular swelling, ecchymosis, tenderness and inability to weight-bear. c)Stretch of the lateral ligament complex with no macroscopic tear or joint instability, little swelling or tenderness d)Partial tear of the syndesmosis, creating generalized swelling and tenderness throughout the ankle joint complex; inability to bear weight, severe ecchymosis, and mortise widening. - ANSWER-a) Partial tear of the lateral ligament complex with mild joint instability, moderate intra-capsular swelling and tenderness, and some loss of ROM and joint function This is the correct answer. This describes a Grade II lateral ankle sprain. An 11 year old male presents to the physical therapy clinic with signs of hypertonicity related to cerebral palsy. The boy has significant shortening of the left sternocleidomastoid muscle, creating a severe torticollis to the right. This has led to a pressure ulcer forming on his right ear from contact with the wheelchair headrest. The MOST appropriate course of action is to: a) Begin a course of active-assisted range of motion exercises, focusing on the upper extremities and creating a home program to improve shoulder active range of motion. b) Inform the patient's family that the child should not be in a wheelchair to prevent the formation of any more pressure ulcers and decrease pain associated with torticollis. c)Inform the primary care provider of the child and request him/her to order an oral prescription of Baclofen because the child has developed a tolerance for the current dosage. d)Begin a course of pass - ANSWER-d) Begin a course of passive range of motion stretches, focusing on the neck, and instruct the patient's family on proper positioning and wheelchair adjustments to decrease the likelihood of future ulcers. This is the MOST correct answer. It is straightforward in describing a course of action that focuses on treating the hypertonic neck muscles, but also addresses positioning and family/patient education A patient with a stroke affecting the right middle cerebral artery has difficulty walking, especially over uneven surfaces. Which of the following describes the MOST appropriate initial treatment to improve the patient's ability to walk over uneven surfaces? a)Place a single point cane in the patient's left hand and train him to use a step-to gait pattern. b)Place a single point cane in the patient's right hand and train him to use a step-to gait pattern. c)Fit the patient with a 4-wheeled walker and instruct him to use a 4-point gait pattern. d)Fit the patient with axillary crutches and instruct him to use a 4-point gait pattern. - ANSWER-b)Place a single point cane in the patient's right hand and train him to use a step-to gait pattern. This is the correct answer. The question indicates that the patient has difficulty with uneven surfaces, implying that even surfaces are not as difficult. Thus using a SPC with a swing-to gait pattern would be the most correct initial treatment. A physical therapist evaluating a 66 year old female who has a history of severe head trauma following a motor vehicle accident. The patient has difficulty with rapid alternating movements while performing neurologic testing. The BEST term to describe this specific impairment is: a)Ataxia b)Dysmetria c)Dysarthria d)Dysdiadocokinesia - ANSWER-d)Dysdiadocokinesia This is the correct answer. By definition, dysdiadochokinesia is an impairment specifically involving rapid alternating movements, such as pronating and supinating one's hands quickly A 79 year old female presents to outpatient rehabilitation services 6 weeks following a CVA with right hemiplegia. She complains of right shoulder pain working on functional upper extremity movements and has severe shoulder pain when practicing bed mobility activities such as rolling and scooting. On examination, it is observed that the humeral head is inferiorly displaced. Which of the following would be the MOST appropriate for her condition? a)Transcutaneous Electrical Nerve Stimulation (TENS) b)Functional Electrical Stimulation (FES) c)Short Wave Diathermy (SWD) d)Interferential Current (IFC) Stimulation - ANSWER-b)Functional Electrical Stimulation (FES) FES is the correct answer. Using FES to help elevate her shoulder will treat the displacement and ideally eliminate the source of pain. A 30 year old male presents to outpatient rehabilitation with numbness and tingling on the 4th and 5th fingers of the left hand consistent with nerve entrapment symptoms. Upon further examination, it is noted that the patient has normal sensation on the dorsum of the hand on the ulnar side. Where is the MOST likely source of nerve entrapment? a) Guyon's Canal b) Carpal Tunnel c) Cubital Tunnel d) 1st Rib - ANSWER-a)Guyon's Canal Guyon's Canal is the correct answer. The ulnar nerve provides the sensory innervation for the 4th and 5th digits, narrowing the answer to either the Cubital Tunnel or Guyon's Canal. The ulnar nerve has a dorsal cutaneous branch that innervates the dorsum of the hand. Because dorsal sensation is intact, the nerve must be trapped at Guyon's Canal. A 45 year old male presents to the burn unit with partial thickness burns over the entire right arm, left arm, front of head, and front of chest. Approximately what percentage of his body is burned? a) 31.5% b) 36% c) 40.5% d) 45% - ANSWER-c)40.5% This questions requires knowledge of the rule of nines: entire right arm = 9%, entire left arm = 9%, front of head = 4.5%, front of chest = 18%. Total = 40.5%, correct answer is 3. A patient presents to the inpatient rehabilitation unit who has suffered a vertebro-basilar CVA and has difficulty adducting and depressing his eyes. Which cranial nerve is the MOST likely cause of this impairment? a) CN I b) CN II c) CN III d) CN IV - ANSWER-d)CN IV Cranial nerve testing for ocular movements is performed using the "H" pattern to assess tracking movements. Difficulty adducting and depressing the eye is indicative of Trochlear nerve involvement (CN IV). A 59 year old male patient is being evaluated for left shoulder pain. The patient reports that his shoulder pain is closely associated with activity, including stress at work. The patient reports that at worst, the pain radiates into his neck, and he feels shortness of breath which subsides with rest. What would the MOST appropriate intervention be? a) Begin passive range of motion exercises within the pain free range of motion. b) Postpone treatment and refer the patient to his physician for further evaluation. c) Apply modalities to the shoulder and instruct the patient on activity modification. d) Begin the patient with rotator cuff exercises within the pain reduced range of motion and instruct patient on activity modification. - ANSWER-b)Postpone treatment and refer the patient to his physician for further evaluation. This is the most appropriate initial action. The patient is having signs of cardiac distress that would be worsened with activity. A 35 year old patient with a complete T5 spinal cord injury is working on supine to sit transfers on the mat table when he suddenly appears flushed and complains of his heart pounding. Upon examination, his blood pressure is 180/100 and he has a pounding headache. The most appropriate INITIAL course of action is: a) Lay the patient supine and notify the patient's physician. b) Sit the patient up and notify the patient's physician. c) Allow the patient to rest longer between sets of activity. d) Initiate core strengthening exercises to maintain intraabdominal pressure. - ANSWER-c) Allow the patient to rest longer between sets of activity. This is the correct answer. By sitting the patient up, you decrease the blood pressure in the head and mitigate the effects of the dysreflexia. During an examination of cranial nerve integrity a Physical Therapist asks their patient to say "ah" and examines the patient's soft palate. The therapist notices that the soft palette elevates asymmetrically. Which of the following is the most likely cause of this abnormality? a. Trigeminal nerve injury b. Unilateral Hypoglossal nerve injury c. Unilateral Vagus nerve injury d. A spinal nerve injury - ANSWER-c. Unilateral Vagus nerve injury The vagus nerve is responsible for elevation of the soft palate. A bilateral injury would result in no palate elevation, whereas a unilateral vagus nerve injury would result in asymmetrical elevation. A physical therapist is currently evaluating a 58 y/o male patient who experienced an obstruction of the right middle cerebral artery which resulted in an ischemic cerebrovascular accident 2 months ago. The astute physical therapist decides to perform a Performance-Oriented Mobility Assessment in order to assess functional balance and gait. The patient scores a 17 which places him at what risk for falls? a. High b. low c. moderate d. The POMA test does not assess fall risk - ANSWER-a. High who score <19 on the Performance Oriented Mobility Assessment (otherwise known as Tinetti test) are at a high risk for falls. Patients who core at 19-24 are at a moderate risk. A physical therapist performs an evaluation of a 76 y/o male patient with recent Right CVA. It is determined during the evaluation that the patient is experiencing left hemiparesis and sensory loss with greater LLE involvement than LUE. Which of the following vascular structures is most likely involved? a. Middle cerebral artery b. Anterior cerebral artery c. Posterior cerebral artery d. Basilar artery - ANSWER-b. Anterior cerebral artery Occlusions of the ACA typically produce contralateral hemiparesis and sensory loss with greater LLE involvement than LUE. The LE>UE involvement is the key differentiator between an ACA occlusion and an MCA occlusion, which displays UE involvement> LE involvement. You are treating a patient who is currently displaying a stage IV Rancho Los Amigos functional level. During the exam the patient becomes aggressive after 5 minutes of treatment and begins to swing his upper extremity towards the therapist. The patient has displayed these behaviors more often recently and does not appear to be in danger of harming himself. Which of the following is the BEST method for continuing treatment? a. Reschedule the treatment for the following week when the patients outbursts have diminished b. Break your treatment into three 15 minute sessions throughout the day c. Document this behavior and request that your facility assign another therapist to the case d. Document the behavior and perform treatment that you deem to be safe and calming in nature. - ANSWER-d. Document the behavior and perform treatment that you deem to be safe and calming in nature. This is the appropriate response to the described scenario. If for some reason you were unable to identify a safe treatment, you may consider other alternatives, however this does not appear to be the case in this example. After entering a patient's room, you observe that the patient is having difficulty answering your questions. His speech appears to be slow and the patient is having difficulty forming his words. When asked if he is able to sit up on the edge of the bed the patient immediately attempts to transfer to a sitting position. This leads you to suspect which of the following? a. Facial nerve injury b. Wernicke's aphasia c. Broca's aphasia d. Basal nuclei involvement - ANSWER-c. Broca's aphasia The scenario above describes a patient who has difficult speaking, but is able to interpret verbal speech. This is typical with confluent aphasia, otherwise known as Broca's aphasia. Which neurological syndrome results in scattered demyelinating lesions throughout the CNS and is described as having a variable course of symptoms and fluctuating periods of severity? a. Guillan-barre b. post-polio syndrome c. Multiple sclerosis d. amyotrophic lateral sclerosis - ANSWER-c. Multiple sclerosis Answer#3: Correct. Multiple Sclerosis is characterized by scattered demyelinating lesions throughout the CNS and fluctuating symptom severity that can be characterized as one of 4 MS symptom pattern types. You are treating a patient s/p CVA who is having difficulty ascending the steps into his home. He is able to place his right foot on the step above, but is unable to transfer his body weight entirely to his RLE due to LE weakness. Which of the following would be the most appropriate exercise to improve the patient's stair climbing ability? a. LAQ's b. Partial wall squats c. Bridging exercises d. Straight leg raises - ANSWER-b. Partial wall squats All of these exercise will likely strengthen the muscle groups involved in stair climbing. However, partial wall squats most closely mimic the activity. This exercise will not only strengthen the involved muscle groups but provide the sensory feedback that is needed during a CVA recovery. You are treating a patient s/p severe infection and subsequent gentamicin antibiotic course. This patient was referred to you by her neurologist and presents to your clinic with complaints of a spinning sensation when she turns her head. Which of the following would be most appropriate? a. Refer the patient immediately to her PCP b. Perform a head thrust test c. Assess the patient's cranial nerve integrity d. Perform a TUG test - ANSWER-b. Perform a head thrust test The scenario described suggests vestibular system involvement, likely unilateral vestibular hypofunction or BPPV. The patient's neurologist is aware of these symptoms and treatment of these conditions is within the PT scope of practice. The head thrust test is the only item listed that will assess the performance of the patient's vestibular system. Which of the following gait abnormalities is most consistent with Parkinson's Disease? a. generalized lack of extension, and abnormal involuntary increases in gait speed b. increased trunk extension and step length c. excessively wide BOS d. contralateral hip drop associated with gluteus medius weakness - ANSWER-a. generalized lack of extension, and abnormal involuntary increases in gait speed Patient's with Parkinson's Syndrome typically display a lack of extension and festinating gait. Festinating gait is described as an involuntary increase in gait speed. Ipsilateral weakness and loss of vibration/proprioception sense below the lesion is indicative of which spinal cord syndrome? a. Anterior cord syndrome b. Brown-Sequard syndrome c. Central cord syndrome d. Cuada equina - ANSWER-b. Brown-Sequard syndrome This question very clearly describes a Brown-Sequard syndrome (hemisection of the spinal cord). A therapist is currently treating a 47 y/o type 1 diabetic patient in an outpatient physical therapy clinic. During treatment, the therapist begins to observe irritability, slurred speech, and profuse sweating. The therapist suggests that the patient check their blood glucose levels, which reveals a blood glucose reading of 60 mg/dl. What is the most appropriate course of action for the therapist to take FIRST? a. Call 911 immediately b. Call the patient's physician immediately c. Provide some fruit juice for the patient if available. d. Ask that the patient administer their prescribed insulin - ANSWER-c. Provide some fruit juice for the patient if available. This question asks us to prioritize our response during a patient's hypoglycemic reaction. While we may need to notify the patient's physician and call 911 if symptoms worsen, the most immediate course of action should be to provide the patient with some type of hyperglycemic agent. If the patient is unable to take this agent then 911 should be called immediately. It is always a good idea to inform responders that your patient is a diabetic and experiencing low blood sugar so that they can plan accordingly. Remember, insulin actually lowers a patient's glucose levels and therefore would make this While evaluating a patient who is experience right flank pain, an outpatient therapist observe pain that does not appear to be provoked through soft tissue palpation. The astute physical therapist places her fingertips on the patient's right rectus abdominus just below the rib cage and applies pressure. While applying pressure the therapist asks the patient to take a deep breath. This procedure reproduces the patient's pain. What is the most appropriate course of action? a. Inform the patient that their gallbladder may have burst and advise them to go the the emergency department immediately. b. Ask the patient to set an appointment with their physician as soon as possible. d. Perform rectus abdomens soft tissue mobilization and stretching. e. Document a positive murphy's sign for gallbladder and continue to treat the underlying musculoskeletal pathology. - ANSWER-b. Ask the patient to set an appointment with their physician as soon as possible. The above scenario describes a positive murphy's sign for the gallbladder with a typical gallbladder pain referral pattern. The patient should see their physician as soon as possible and the therapist should notify the physician of her findings. Which of the following exercises would be most appropriate for a patient in the early weeks of the third trimester of pregnancy with weak abdominal and gluteal muscles. a. Traditional sit-ups b. Bridging exercises c. Side-lying clamshell exercises d. Straight Leg Raises - ANSWER-c. Side-lying clamshell exercises During the later stages of pregnancy, patients should avoid the supine position for extended periods due to the weight placed on the inferior vena cava. Side-lying clamshell exercises will strengthen the gluteal muscles while also avoiding the supine position. While performing a routine treatment, the patient mentions that their urine has recently began to smell foul.The astute therapist decide to measure the patients temperature and records a reading of 100 degrees fahrenheit. Which of the following is the patient likely experiencing? a. Early onset of CKD b. Stage II renal failure c. Normal symptoms of hemodialysis d. Urinary tract infection - ANSWER-d. Urinary tract infection Foul smelling urine and elevated temperature are classic symptoms of a urinary tract infection. McBurney's point for the appendix is located: a. at the intersection of the right mid-clavicular line and 6th intercostal space b. equidistant between the right ASIS and umbilicus c. equidistant between the left ASIS and umbilicus d. directly below the xiphoid process - ANSWER-b. equidistant between the right ASIS and umbilicus McBurney's point is located over the appendix at a point on the surface of the skin halfway between the right ASIS and umbilicus. Palpation of this point can be used as a pain provocation test to identify appendicitis. Under normal conditions, hematocrit composes approximately what percentage of whole blood? a. 55% b. 45% c. 35% d. 65% - ANSWER-b. 45% Whole Blood Composition Plasma: 55% Hematocrit: 45% Platelets and WBC's: less than 1% In the absence of a musculoskeletal disorder, which of the following could refer pain to the shoulder? a. Liver b. Diaphragm c. Pericardium d. Any of the above could refer pain to the shoulder - ANSWER-d. Any of the above could refer pain to the shoulder All three structures listed are capable of referring pain to the shoulder. See page 224 of the NPTE review and study guide by O'Sullivan/Siegelman for additional information. During a skin examination, a therapist notes a mole on the patients right cheek. Which of the following most clearly indicates a possible Melanoma? a. Symmetry of shape b. Diameter of 4mm c. 2mm elevation above skin surface d. A regular well circumscribed border - ANSWER-c. 2mm elevation above skin surface Make sure you know the ABCDEF's of melanoma lesions: Asymmetry of shape, Border irregularity, Color Variation, Diameter larger than 6mm, Elevation greater than 1 mm, Friable (flaky). All of the above indicate a possible malignant melanoma. Therefore, elevation of greater than 2mm would be a concern. Decreased glucose tolerance; Edema; Muscular atrophy; Round "moon" face and Obesity. The sings and symptoms listed above best describe which endocrine system pathology? a. Addison's disease b. Cushing's syndrome c. Secondary adrenal insufficiency d. Hyperthyroidism - ANSWER-b. Cushing's syndrome All of the listed symptoms are characteristic of Cushing's syndrome, especially "moon" face. Cushing's syndrome results from overproduction of the adrenocortical hormone cortisol A patient is performing a Phase I (inpatient) cardiac rehabilitation exercise session. The physical therapist should terminate low-level activity if which of the following changes occurs? a. The diastolic blood pressure increases to 120 mm Hg. b. The respiratory rate increases to 20 breaths per minute. c. The systolic blood pressure increases by 20 mm Hg. d. The heart rate increases by 20 bpm. - ANSWER-a. The diastolic blood pressure increases to 120 mm Hg. During Phase I (inpatient) cardiac rehabilitation, vital sign parameters with activity that warrant termination are: diastolic blood pressure of 110 mm Hg or greater, systolic blood pressure above 210 mm Hg or anincrease greater than 20 mm Hg from resting, and a heart rate that increases beyond 20 bpm above resting. The normal resting respiratory rate can range from 12 to 20 breaths per minute in adults, so an increase to 20 breaths per minute with low-level activity would not be a reason to terminate the activity. A patient is being evaluated for possible carpal tunnel syndrome, and a nerve conduction velocity test is performed.Which of the following findings would MOST strongly support the diagnosis? a. Decreased latency at the elbow. b. Decreased latency at the carpal tunnel. c. Increased latency at the carpal tunnel. d. Increased latency at the forearm. - ANSWER-c. Increased latency at the carpal tunnel. Nerve conduction above and below the local nerve compression is usually normal. Latency is typically increased, not decreased, across the carpal tunnel compression site. Nerve conduction above and below the local nerve compression is usually normal. When examining a patient with a history of alcohol abuse, a physical therapist notes that the patient demonstrates fine resting tremors and hyperactive reflexes. The patient reports frequent right upper quadrant pain. Which of the following additional signs is MOST likely? a. Jaundice b. Hyperhidrosis c. Hypotension d. Nocturnal cough - ANSWER-a. Jaundice With a history of alcohol abuse and the presence of fine resting tremors and right upper quadrant pain, thepatient is presenting a history and signs and symptoms consistent with liver disease. Jaundice is a skin change associated with disease of the hepatic system. Hyperhidrosis can be present with endocrine disorders but is not associated with liver disease. Hypotension is not listed as a sign of liver disorders. A nocturnal cough can be associated with rheumatic fever, but is not characteristic of liver disease Which of the following examination findings would be expected in a patient who also had sustained ankle clonus? a. An upgoing great toe when the sole of the foot is stroked b. Weakness of ankle plantar flexors with one-repetition strength testing c. Absence of sensation to sharp/dull testing over the posterior lower leg d. Hyporeflexia when deep tendon reflexes are elicited in the lower leg - ANSWER-a. An upgoing great toe when the sole of the foot is stroked Sustained ankle clonus indicates a central nervous system dysfunction, as does the presence of a Babinskisign (that is, an upgoing great toe with stroking of the plantar foot). The other options are associated with lower motor neuron problems. Which of the following sensory testing locations corresponds to the C7 nerve root? a. Volar aspect of the little finger (5th digit) b. Dorsal aspect of the middle finger (3rd digit) c. Lateral aspect of the upper arm d. Medial aspect of the upper arm - ANSWER-b. Dorsal aspect of the middle finger (3rd digit) The C7 nerve root supplies sensation in the dorsal middle finger. A 3-month-old infant has poor midline head control. During evaluation, the physical therapist notes facial asymmetry and observes that the infant has limitation of cervical rotation to the left and cervical lateral flexion to the right. A radiology report indicates premature fusion of the infant's cranial sutures. The infant MOST likely has: a. right congenital muscular torticollis. b. left congenital muscular torticollis. c. right cervical facet hypomobility. d. left cervical facet hypomobility. - ANSWER-a. right congenital muscular torticollis. The infant exhibits signs of torticollis affecting the right sternocleidomastoid muscle. Torticollis is namedfor the side of the limited lateral flexion. Asymmetry and premature closure of sutures (plagiocephaly) are not typically seen with cervical facet hypomobility in infants. A patient had a split-thickness skin graft for a partial-thickness burn injury to the upper extremity. The surgeon has requested range-of-motion exercises for the patient. Currently, the patient is able to actively move the upper extremity through one-third of the range of motion for shoulder flexion. Based on this finding, what is the MOST appropriate action for the physical therapist to take at this time? a. Defer any range-of-motion exercises until the patient is able to participate more actively. b. Begin active assistive range-of-motion exercises. c. Begin bed mobility training to facilitate increased use of the upper extremity d. Continue with active range-of-motion exercises. - ANSWER-b. Begin active assistive range-of-motion exercises. Deferring any range-of-motion exercises is not a practical choice, as contracture will develop postoperatively. Because this patient cannot achieve full range of motion by himself, active assistive range of motion is indicated to prevent contracture postoperatively. Although bed mobility training is a creative way to possibly increase upper extremity range of motion, given the acuity of the patient's surgical wound, the patient would need more range of motion for this intervention to be more beneficial. Continuing with only active range of motion would not facilitate adequate increases in range of motion and would not prevent contractures Which of the following modalities BEST addresses the cause of calcific tendinitis in the bicipital tendon? a. Sensory level interferential current at 80 Hz to 100 Hz b. Iontophoresis with acetic acid at 60 mA/minute c. High-volt pulsed electrical stimulation at 200 pps d. Diathermy with a parallel treatment set - up - ANSWER-B. Iontophoresis with acetic acid at 60 mA/minute Sensory level interferential current at 80 to 100 Hz does not address the problem itself but may address any related pain. Iontophoresis with acetic acid can address the cause of calcific tendinitis, not just the symptoms. High-volt pulsed electrical stimulation at 200 pps does not address the problem itself but may address any related pain. Diathermy with a parallel treatment set-up is not the best choice, as deep heat will not address the pathology. A physical therapist is treating a pediatric patient with cerebral palsy. The patient is seen in standing with a toe-in posture. Which of the following postural strategies most accurately correlates with the observed foot position? a. Metatarsus abductus, internal tibial torsion, increased femoral retroversion b. Metatarsus adductus, internal tibial torsion, increased femoral anteversion c. Metatarsal adductus, external tibial torsion, increased femoral retroversion d. Metatarsal abductus, external tibial torsion, increased femoral anteversion - ANSWER-b. Metatarsus adductus, internal tibial torsion, increased femoral anteversion Rationale- The position of toe-in would correlate with metatarsus adductus (forefoot adducted), internal tibial torsion (position of pronation), and increased femoral anteversion. A 33-year-old female patient present with chronic TMJ dysfunction. Which of the following muscles should be lengthened to help restore limited lateral movement of the mandible to the right because of muscular tightness? a. Right lateral pterygoid muscle b. Left medial pterygoid muscle c. Right massester muscle d. Left temporalis muscle - ANSWER-a. Right lateral pterygoid muscle Rationale- Unilateral contraction of the medial pterygoid (Option B) and lateral pteryoid (Option A) muscle produces a contralateral excursion of the mandible. Temporalis (Option D) and Masseter (Option C) also act when assistance is required to cause ipsilateral excursion of the mandible. So, unilateral contraction of right lateral muscle causes deviation of mandible to left and its tightness will limit movement to right. Thus, lengthening of this muscle will help to restore the movement of mandible towards right side, making A as the correct answer. A 26-year-old male presents to the PT clinic with a history of neurotmesis of superficial peroneal nerve. Which foot deformity and cutaneous sensation loss can be expected in this patient? a. Calcaneovalgus deformity; loss of sensation over the dorsum of foot. b. Equinovarus deformity; loss of sensation over lateral plantar aspect of foot. c. Calcaneovarus deformity; loss of sensation in the web space between big toe and second toe. d. Equinovarus deformity; loss of sensation over the dorsum of the foot. - ANSWER-d. Equinovarus deformity; loss of sensation over the dorsum of the foot. Equinovarus deformity; loss of sensation over the dorsum of the foot. Rationale- Superficial peroneal nerve innervates evertors of foot. If evertors are weak, the foot is pulled into inversion and plantar flexion, resulting in a equinovarus deformity (Option B and D). Superficial peroneal nerve has cutaneous supply over dorsum of foot and anterolateral aspect of leg which makes D as the correct answer. The web space between big toe and 2nd toe which is by the deep peroneal nerve which innervate dorsiflexors (Option C). A 34-year-old female patient comes to an outpatient clinic for evaluation. The patient reports feeling a "pop" in the posterior leg and pain in the posterior lower leg, with no loss of functional strength. Which of the following is MOST likely diagnosis? a. Partial rupture of the achilles tendon b. Complete tear of anterior cruciate ligament c. Complete rupture of the plantaris tendon d. Partial tear of the medial meniscus - ANSWER-c. Complete rupture of the plantaris tendon Complete rupture of the plantaris tendon. The key words are 'no loss of functional strength'. Rupture of the plantaris is felt as pop. Plantaris does not contribute much force production during functional mobility. Partial rupture at the Achilles tendon (Option A) will result in the functional loss of movement. Complete rupture of ACL (Option B ) will lead to instability of the knee. Partial tear of the medial meniscus (Option D) will result in a pop but during testing of the knee motion. A 60 year old male has a Right supranuclear lesion of the facial nerve. What do you expect to find during the examination? a. The patients right eye droops down and the patient is unable to frown. b. The patients has no sensation on the right side of the face. c. The patients mouth droops on the left side and deviates to right when asked to smile. d. The patients is unable to keep the left eye closed when the therapist forces it open. - ANSWER-c. The patients mouth droops on the left side and deviates to right when asked to smile. A supra nuclear lesion or UMN facial nerve affection causes a contralateral palsy of the lower half of the face. The upper half is spared. Here., the left lower half of face is affected in this patient with lips drooping on left or affected side and deviation of the mouth to right or unaffected side when asked to smile. The upper face is unaffected so frowning or closing eyelids wont be a problem A patients with an imbalance of parathyroid function shows prolonged QT wave in his EKG. On performing an examination, which of the following sign is most likely to be positive? a. Bakodys sign (Bakodys sign is seen in cervical radiculopathy.) b. Trosseaus sign c. Kernigs sign (Kernig's sign is seen in meningitis) d. Murphys sign (Murphy's sign is positive in acute cholecystitis) - ANSWER-b. Trosseaus sign The patient has parathyroid disorder with prolonged QT which indicates hypocalcemia . Trousseaus sign is seen in hypocalcemia. It is elicited by inflation of a blood pressure cuff above systolic bp for more than 3 minutes. .It is positive when this causes flexion of the wrist and metacarpal phalangeal joints, extension of the interphalangeal joints and adduction of the thumb (carpal spasm). It's a tetany like response . A 70 year old patient presents with a long history of type 2 diabetes has developed an ulcer on the left . The ulcer is a Wagners scale 3 . Which is a BEST description of the extent of ulcer? a. A deep ulcer extending to ligaments, joint capsule but without infection. b. A deep infected ulcer with presence of abscesses. c. A full thickness ulcer involving epidermis and dermis but not extending through fascia. d. Ulcer with the presence of gangrene localized to portion of forefoot - ANSWER-b. A deep infected ulcer with presence of abscesses. A Wagner scale 3 ulcer is deep involving all of the layers of skin extending to ligaments and capsule , it shows infection and can have presence of abscesses but are not gangrenous. A therapist is considering using iontophoresis in a an athlete with tinea pedis on his left foot. Which of the following agent is the MOST suitable for use with this condition? a. Zinc oxide b. Copper sulfate c. Dexamethasone d. Potassium iodide - ANSWER-b. Copper sulfate Tinea pedis is a fungal infection. Copper sulfate is the agent of choice used in iontophoresis for fungal infections. A 40 year old obese male is being educated on the risk factors for developing a metabolic syndrome . Which of the following is NOT a factor influencing the development of this syndrome? a. Systolic BP of 150mmof ng b. Fasting blood glucose of 90mg/dl c. Waist circumference of 50inches d. HDL of 25 mg/dl - ANSWER-b. Fasting blood glucose of 90mg/dl Fasting blood glucose of greater than 90mg/dl is not a risk factor for metabolic syndrome. Risk factors are : fasting glucose of greater than 100mg/dl. A 30 year old male athlete complains of knee pain post training going on past few weeks . He reports of stiffness and locking of joint on movement. On examintaiin there is swelling around the knee joint and Wilson's test is positive. What is most likely the diagnosis for this presentation? a. Osteitis deformans. b. Osteochondritis Dessicans c. Osteomalacia. d. Osteomyelitis. - ANSWER-b. Osteochondritis Dessicans Osteochondritis dessicans is a condition which is charachterised by osteochondral separation with loose bodies in the joint space, which cause knee pain, stiffness and locking on movement. Wilson's test is a special test for this condition in which internal rotation of tibia at 90 degree of knee flexion produces pain . A 50 male patient with secondary-degree heart block (Mobitz type I Wenckebach) presents his ECG report to the physical therapist. What would a physical therapist expect to find on his EKG? A. An increase in PR interval lengths with no dropped beats B. No relationship between P waves and QRS complexes C. Normal PR intervals in all the beats preceding a dropped beat D. A gradual increase in PR interval length in all the beats preceding a dropped beat - ANSWER-D. A gradual increase in PR interval length in all the beats preceding a dropped beat A. is a first degree heart block, B. is a third degree heart block, C. is a second degree heart block Mobitz Type II During a cardiac rehabilitation session, PT notices after 5 minutes that the ECG strip is displaying a PR interval of 0.28. The QRS segment is slightly widened. When PT asks the patient, he says he is fine and can keep on going. Which of the following would be indicative of your findings? A. 1st AV block B. 2nd AV block C. 3rd AV block D. 2nd AV block, Mobitz I - ANSWER-Correct answer is A since a 1st degree AV block a PR interval of more than 0.20 but still shows not abnormality in the QRS segment. A physical therapist was observing 65 year old male patient participating in cardiac rehabilitation. The patient suddenly feels discomfort and dizziness, ECG strip is showing 3-4 ectopic beats in groups. What should be the therapist's first responsibility? A) Call 911 B) Start CPR C) Continue exercises D) Assist the patient to be in comfortable position - ANSWER-D) Assist the patient to be in comfortable position First responsibility is to confirm patient's safety, then call 911 or start CPR. While in the acute care setting, PT reads an ECG strip of a 52-year-old patient. ECG strip displays a widened QRS segment, flattened P wave, and a peaked T wave. Which of the following would be indicated by your findings? A) Hypokalemia B) Hypercalemia C) Hyperkalemia D) Hypocalemia - ANSWER-C) Hyperkalemia Hyperkalemia is indicated in the ECG as described above. Hypokalemia presents with a flattened T wave and a U wave. Hypercalemia presents with a widened QRS segment and shortened QT interval. Hypocalemia presents with a prolonged QT interval. A PT is having a 45-year-old male with a BMI of 23, exercise on a treadmill with a non- complex medical history. Vitals are monitored throughout the session. It is determined that resting HR was 65 BPM, during the exercise it was 155 BPM and 5 minutes after the exercise had ended the HR returned to 65 BPM. The patient then asks his therapist how his twin brother might respond to the same exercise program he just completed. The patient states they are the same age and height, but the brother weighs 50 more pounds and has a BMI of 32. What is the most accurate response to exercise the unfit twin brother would have for HR 5 minutes after the exercise had ended? A) Resting HR was 90 BPM, during the exercise it was 170 BPM and 5 minutes after the exercise had ended the HR returned to 90 BPM B) Resting HR was 45 BPM, during the exercise it was 155 BPM and 5 minutes after the exercise had ended the HR returned to 65 BPM C) - ANSWER-C) Resting HR was 75 BPM, during the exercise it was 165 BPM and 5 minutes after the exercise had ended the HR returned to 100 BPM First, the unfit person begins to exercise with a higher resting heart rate. Once the unfit person begins exercising, the heart rate will rise quicker to a total heart rate higher than that of the fit person. The unhealthy person's heart rate will then take longer to slow down than the average person, balancing out to a higher resting heart rate once again. Patient underwent incident of myocardial infarction 5 weeks ago. PT has to give strength training to patient. Which is the MOST appropriate protocol that can be given to a post MI patient at 5 weeks? A) PT should wait 2 more weeks for strength training B)Start using 5 lb free weights or dumbells with UE and LE training C) Use 5-10 lb for UE and10-15 lb for LE D) 1-3 LB with light weights and elastic bands - ANSWER-D- use 1-3lbs with light weights and elastic bands. ( After 5 weeks Post MI begin with light weight 1-3lb and elastic bands for 12-15 reps ) A 30 years old male goes to Colorado for the ski season. He's never been to that state before and learns that the city where he'll be staying is over 8000 feet above sea level. What are the INITIAL cardiovascular responses during the his first few days in Colorado? A) Temporarily slightly increased BP, increased Cardiac Output with tachycardia and no significant changes in SV. B) Decreased BP, decreased Cardiac Output with bradycardia and increased SV. C) Increased BP, decreased Cardiac Output with bradycardia and increased SV. D) Decreased BP, increased Cardiac Output with tachycardia and increased SV. - ANSWER-A) Temporarily slightly increased BP, increased Cardiac Output with tachycardia and no significant changes in SV. The initial cardiovascular response to altitude is characterized by an increase in cardiac output with tachycardia, no change in stroke volume, whereas blood pressure may be slightly increased. While a physical therapist is designing exercise for a patient who is on Beta Blockers, which of the following statement is NOT correct: A) Decrease HR with exercise B) Decreasing Preload C) Increasing stroke volume D) Increasing Afterload - ANSWER-C) Increasing stroke volume Beta Blockers blunt HR and decrease stroke volume. A 58-year-old male patient comes to the outpatient clinic for Phase II cardiac rehabilitation. On the initial evaluation, patient mentions that he was taking propanol, metformin and vitamin supplements. The therapist wants the patient to use the stationary bike, and make sure he maintains 60-70% of the maximum heart rate. What is the BEST way to measure the patient's exertion level? A) Heart rate monitor B) Radial pulse C) Rate of Perceived Exertion Scale D) Systolic Blood Pressure - ANSWER-Correct Answer: C. Propanol is a beta blocker that would decrease the heart rate of the patient, so the HR monitor/pulse wouldn't give an accurate measurement. The rating of perceived exertion scale is considered to be an acceptable method for determining exercise intensity because it correlates well with: A. heart rate B. respiratory rate C. systolic blood pressure D. diastolic blood pressure - ANSWER-Correct answer is A. Heart rate divided by RPE is Borg Scale A 62 years old male patient came to outpatient clinic. He wants to start aerobic exercise. Which of the following is MOST appropriate value suggesting aerobic exercise intensity? A. Exercise at 4-5 MET B. Exercise with heart rate between 106 to 145 beats/min C. Exercise at 158 beats/min D. Exercise at 85% to 95% of VO2max. - ANSWER-B. Exercise with heart rate between 106 to 145 beats/min Karvonen Formula: THRR=(HRmax-HRrest)(0.40and 0.85)+HRrest C is max HR. Here resting HR is not given , so we use 60-85% of max HR Which is closest to option B A patient is pregnant in her third-trimester and she would like advice on resting positioning from her PT. What is the most effective position for her to rest in at night? A) Supine B) Side-lying Right C) Supine at a 20 degree angle D) Side-lying Left - ANSWER-D) Side-lying Left Lying on right side will cause compression of internal organs as well as the aorta thereby reducing CO A patient presents with intermittent laudication after walking for 5 minutes. Upon examination the patient has a 0.78 ABI score. What does a score of 0.78 ABI indicate? A. Severe arterial disease B. Normal- no arterial disease C. Mild arterial disease D. Moderate arterial disease - ANSWER-Answer: C Normal- 1.19-0.95 Mild- 0.94-0.75 Moderate- 0.74-.50 Severe- <0.50 A patient with arterial insufficiency is starting a walking program using treadmill. The patient complains of moderate pain and reaches a 2 on the claudication scale. What is the NEXT step the therapist should take? A. Continue walking pain is expected and a normal response B. Stop exercise, sit patient down, continue walking when pain subsides C. Continue exercising but slow treadmill speed to 1.0 mph D. Stop walking patient isn't tolerating it well, use arm cycle ergometery instead - ANSWER-B. Stop exercise, sit patient down, continue walking when pain subsides Walking programs are used for patients with claudication, which is common in patients with arterial insufficiency. Walking programs should include intensity should be where patient reports 1 on claudication scale within 3-5 minutes, stopping if they reach a 2 (until pain subsides), total of 20-60 minutes intervals if necessary, 3-5 days per week. Therapist should record time of pain onset and duration A patient arrives to therapy and the physical therapist notices that he patient has edema. When testing for the edema, PT notices that there is a deep indentation that returns to normal in 25 seconds. What stage of pitting edema does this patient have? A) 4+ B) 2+ C) 3- D) 3+ - ANSWER-D) 3+ 3+- severe depression , takes 15-30 secs to rebound , 1⁄2-1 inch pitting While a patient is doing exercises in cardiac rehabilitation center, a physical therapist is supervising the patient's vital signs. The physical therapist decides that the patient should STOP doing exercise immediately if: A) Increase systolic blood pressure up to 180 mmHG. B) Drop in Systolic Blood pressure > 10 mmHg C) First degree AV block D) Glucose level of 200 mg/d - ANSWER-B) Drop in Systolic Blood pressure > 10 mmHg Drop in SBP is an absolute contraindication to terminate ex. A 50 yr old male patient visited cardiac rehabilitation center referred by cardiologist with diagnosis of right ventricular failure. Which of the following is INCORRECT regarding right ventricular failure? A. S3 heart sound B. Increased pulmonary artery pressure with peripheral edema C. Increased pulmonary artery pressure and pulmonary edema with dyspnea on exertion D. Venous hypertension and stasis - ANSWER-Correct Answer: C A,B,D are related to Right heart failure C is related to left heart failure The definition of atherosclerosis is characterized by the thickening of the blood vessel walls from focal accumulation of all of the following except: A) Lipids B) Platelets C) Monocytes D) Sodium and Potassium - ANSWER-D) Sodium and Potassium Which of the following factors is NOT considered to be a primary risk factor for atherosclerosis? A. High Blood Pressure B. Increased Lipids C. Cigarette smoking D. Sedentary lifestyle - ANSWER-D. Sedentary lifestyle High blood pressure, cigarette smoking, and hyperlipidemia are direct or primary risk factors for atherosclerosis A PT is conducting a 6MWT with a 50 y.o. male patient with quad cane and hypertension to determine his exercise capacity. Which of the following is the least important in giving out the test: A. The patient could walk as far as he can in a normal walking pace B. Standardized encouragement is provided periodically by the PT C. The patient could use his quad cane during the test D. The time stops when the patient stops and rest - ANSWER-D. The time stops when the patient stops and rest In the 6MWT, options A, B and C are all part of the protocol. In this test the distance covered walking at a comfortable pace for 6 minutes is determined. The time doesn't stop. 55 year old, female patient 5 weeks post MI, clinically stable walks in the outpatient cardiac rehab department, after a period of aerobic conditioning. The goal of treatment is to strengthen the lower extremity musculature. At present, she is at 9 METS. What will be the best measure to monitor the responses for the resistive exercise? A) BP,HR, VO2 max B) Maximum oxygen consumption C) Heart rate reserve D) Rate Pressure Product. - ANSWER-The correct answer is -D Rate pressure product as it incorporates BP also which is a safer measure to use. A physical therapist is evaluating a patient who has a history of CAD. Currently, at rest, the patient presents with a BP of 135/75 and HR of 85. Also, noted was a RR of 19 and Sp02 of 95%. After 15 minutes of light exercise the physical therapist noted that the BP was 145/74, HR 86, RR 23, and Sp02 92% respectively. Which medication would MOST influence these post exercise values? A) Nitrostat B) Propanolol C) Lasix D) Lidocaine - ANSWER-Correct answer B. Noted was HR that only increased secondary to the side effects of beta-blockers that include bradycardia. Lidocaine is for AF (hypotension). Lasix is an antidiuretic used to treat edema (dehydration). And, nitrostat is for angina (OH). A 25 year old female with supraventricular tachycardia has an exacerbation of her symptoms due to anxiety related to exams. She asked her cardiologist for an alternate to the beta- blockers due to unfavourable side effects. The most appropriate intervention by her cardiologist would be: A. Calcium channel blockers B. Anti anxiety medication to relieve her exam induced stress C. Teach her valsalva maneuver D. Increase the dose of beta blockers - ANSWER-Correct answer C: Carotid massage and valsalva maneuver are effective methods of reducing the heart rate if done correctly. These two methods are easy to do and do not have any undesirable side effects. A - Beta blockers are the best drugs for SVT hence changing to another category of drugs is not effective/desirable B- Anti anxiety drugs are mostly sedative and are not the appropriate choice as the patient has to study for her exams and needs to be alert. D- Beta blockers have various side effects like depression, fatigue, weight gain, mild headaches, dizziness, restless etc. Since her main concern is the side effects of beta blockers, increasing the dosage will not be an appropriate intervention. A 63 year old female patient has undergone surgery and has been on bed rest since 4 days. Therapist visits the patient to prepare her for ambulation. While getting the patient up from bed to standing which of the following BP responses will have therapist take an action of returning the patient back to bed? A) Decrease in SBP of 10mm Hg and increase in DBP of 3 mm Hg B) Increase in SBP OF 17mm Hg and increase in DBP of 5 mm Hg C) Increase in SBP of 15 mmHg and decrease in DBP of 7mm Hg D) Decrease in SBP of 18 mmHg and decrease in DBP of 11 mm Hg - ANSWER-D) Decrease in SBP of 18 mmHg and decrease in DBP of 11 mm Hg What is the best way to monitor the intensity of exercise for a patient limited mostly by claudication? A )Assessing ankle-brachial index (ABI) during exercise B) Maintaining heart rate (HR) between 60% and 70% of age-predicted HR max during exercise. C) Sustaining pain levels of at least 2 out of 4 on the claudication scale during exercise. D) Upholding rate of perceived exertion (RPE) levels of 11 to 13 out of 20 during exercise. - ANSWER-C) Sustaining pain levels of at least 2 out of 4 on the claudication scale during exercise. In a Cardiac Rehab Clinic a patient is exercising, Monitoring Physical therapist notes that Patient has Ventricular Quadrigeminy. What should be the initial or the first response of a PT. A) Its an emergency, call 911. B) Call the Physician immediately. C) Ask the patient to keep exercising. D) Check the Heart Rate of the patient. - ANSWER-Correct answer is D in this case, as a PT we should check the heart rate first, if its below normal we should stop the exercise and if the heart rate is normal we should only continue with a low intensity exercise. A 10 year old child presents with burns to the trunk, anterior left arm, anterior left leg, and genitals. What percentage of the child's body is suffering from burns, based on the Lund Browder chart? A. 29% B. 30% C. 31.5% D. 32.5% - ANSWER-Correct answer is B. 18%TRUNK 4.5%LEFT anterior ARM 6.5% Left ant leg 1% genitals =30% Which of the following compression garment pressure is contraindicated in patients with Lymphedema? A. 12 MM HG B. 25 MM HG C. 30 MM HG D. 50 MM HG - ANSWER-Ans is D Pressure higher than 45 mm hg causes lymphatic collapse. What acute change in arterial oxygenation will a person who resides close to sea level experience immediately after ascending to an altitude of 5,000 ft above sea level or higher? A. Arterial oxygenation is reduced due to reduced oxygen concentration in the air. B. Arterial oxygenation is reduced due to reduced air pressure. C. Arterial oxygenation is reduced due to increase air pressure. D. Arterial oxygenation is increased due to increased air pressure. - ANSWER-B. Arterial oxygenation is reduced due to reduced air pressure. A physical therapist is trying to determine which special test to use for an examination and is researching the statistical values of each. What is the MOST important statistical attribute a special test must have to effectively limit Type I errors? 1. Sensitivity 2. Specificity 3. Positive likelihood ratio 4. Negative likelihood ratio - ANSWER-2. Specificity High specificity effectively limits type I errors (False Positives). High specificity indicates that if the test is positive, you can effectively rule IN the condition with very few false positives. A physical therapist is evaluating a 50 year old patient with a generally swollen right leg. The patient does not report any trauma to the leg and describes the swelling as increasing gradually over the last 12 months. The swelling is non-pitting, primarily below the knee. The leg is not red or hot, and the patient indicates that his leg just feels "heavy." What is the MOST likely origin of the swelling? 1. Systemic infection 2. Chronic inflammation 3. Congestive heart failure 4. Lymphedema - ANSWER-4. Lymphedema (This condition is typically associated with a "heaviness" that appears gradually and usually involves non-pitting edema.) A physical therapist is evaluating a patient with pain that radiates throughout his lower extremities. The patient has significant foot drop while ambulating and complains of numbness and tingling extending from the great toe up to the knee along the anterior leg. What is the MOST likely pathology underlying these symptoms? 1. Sciatic nerve entrapment 2. Deep peroneal nerve inflammation 3. Tibial nerve entrapment 4. L5 nerve root entrapment - ANSWER-4. L5 nerve root entrapment This is the correct answer. Tibialis anterior weakness and sensory loss along the anterior leg below the knee are the most common signs of L5 nerve root entrapment. A patient has right leg pain and displays redness and swelling throughout the foot and ankle distal to the knee that has developed over the last 3 days. The patient reports no trauma and complains of a deep ache in the calf musculature. What is the MOST appropriate initial treatment? 1. Refer to physician to further examination.. 2. Elevate the lower extremity and apply an ice modality. 3. Instruct the patient on range of motion exercises and begin a home exercise program. 4. Perform instrument assisted manual soft tissue mobilization to decrease the swelling. - ANSWER-1. Refer to physician to further examination.. (Symptoms of a DVT include redness and swelling combined with a deep ache. Suspected DVT's should be ruled out before beginning treatment.) A patient with cystic fibrosis is receiving postural drainage and percussion for the right lung's middle lobe. What is the MOST appropriate patient position? 1. Supine on a wedge with the left shoulder elevated on pillows with the head lower than the pelvis. 2. Supine on a wedge with the right shoulder elevated on pillows with the head lower than the pelvis. 3. Prone with the right shoulder elevated on pillows and the head on the same plane as the pelvis. 4. Prone with the left shoulder elevated on pillows and the head on the same plane as the pelvis. - ANSWER-2. Supine on a wedge with the right shoulder elevated on pillows with the head lower than the pelvis. This is the correct position and is most appropriate for the right middle lobe. A patient is being evaluated by a physical therapist for a diabetic ulcer that penetrates the subcutaneous tissue, extending into the subcutaneous fat and fascia but without any gangrene or osteomyelitis present. The physical therapist wishes to document the severity of the ulcer. What is the MOST appropriate objective measure of the wound? 1. Measure the depth and shape of the ulcer and classify it as a Grade 2 ulcer on the Wagner Ulcer Grade Classification System. 2. Measure the depth and shape of the ulcer and classify it as a Grade 3 ulcer on the Wagner Ulcer Grade Classification System. 3. Measure the depth and shape of the ulcer and classify it as a Grade 4 ulcer on the Wagner Ulcer Grade Classification System. 4. Measure the depth and shape of the ulcer and classify it as a Grade 5 ulcer on the Wagner Ulcer Grade Classification System. - ANSWER-1. Measure the depth and shape of the ulcer and classify it as a Grade 2 ulcer on the Wagner Ulcer Grade Classification System. As a physical therapist, you should always document depth and shape of the ulcer. Grade 2 on the Wagner Scale is defined as a deep ulcer penetrating into the subcutaneous tissue, but without gangrene. The Wagner scale is commonly used to classify diabetic ulceration. A physical therapist is evaluating a patient with ulceration on the lower extremity. The leg is apparently swollen and red upon examination. Which of the following grouping of symptoms is MOST consistent with this type of ulceration? 1. Ulceration is on the lateral leg, pulseless, cool, and painful. 2. Ulceration is medial leg, shows permanent blanching, and is painless. 3. Ulceration is upon bony prominences, shows non-blanchable redness at the perimeter of the wound, and has a pink appearance. 4. Ulceration is upon the bony prominence, began as a small scrape or blister several months ago, with a concomitant diagnosis of diabetic neuropathy. - ANSWER-2. Ulceration is medial leg, shows permanent blanching, and is painless. This is the correct answer. Venous insufficiency ulcers are typically less painful than arterial ulcers. A physical therapist is performing a treadmill exercise stress test using the Bruce protocol. During stage 3 of the test, the P wave increases in height and the S-T segment begins to become significantly upsloping. What is the MOST appropriate course of action? 1. Stop the test and refer patient to a physician. 2. Lower the stage back to stage 2 and monitor for improved electrocardiographic indicators. 3. Continue with the test without any modification, monitoring for symptoms of cardiac distress. 4. Discontinue the test, and monitor the patient's vital signs for 10 minutes. - ANSWER-3. Continue with the test without any modification, monitoring for symptoms of cardiac distress. This is the correct answer. Both of these signs are normal responses to the stress test. A patient is receiving cardiac rehab and has a heart rate of 110 during moderate intensity exercise. The patient reports a 16 on the Borg RPE scale. Which class of heart medications is MOST likely present? 1. Beta Blockers 2. Angiotensin-Converting Enzyme (ACE) Inhibitors 3. Calcium Channel Blockers 4. Angiotensin II Receptor Blockers - ANSWER-1) Beta Blockers Explanation: Beta blockers work on the beta-adrenergic receptors to decrease sympathetic responses to stress, primarily the heart rate. The Borg Scale should represent Heart Rate divided by 10. Thus there is a disparity in heart rate and exertion, indicating a blunted heart rate. A 12 year old male athlete is being evaluated by a physical therapist. The patient reports pain with running and has a sharp pain over the patellar tendon, particularly on the tibial tubercle. Which of the following disorders is MOST likely present? 1. Legg-Calvé-Perthes' disease 2. Chondromalacia patellae 3. Osgood-Schlatter disease 4. Pes anserine bursitis - ANSWER-3. Osgood-Schlatter disease (characterized by a painful bump over the tibial tubercle and pain with sporting activities. This is most common in young children who are very active in sports, particularly males.) A patient is recovering from a broken tibia and has just been instructed to discontinue use of a walking boot. The patient demonstrates excessive pronation and complains of pain and instability in the ankle while ambulating. Which of the following is the MOST appropriate treatment? 1. Begin a single leg standing program and advance to eccentric calf strengthening as tolerated. 2. Begin with open-chain exercises and progress to closed-chain strengthening of the ankle as tolerated. 3. Begin with closed-chain exercises and progress to open-chain strengthening of the ankle as tolerated. 4. Begin a strengthening program involving primarily ankle evertors, progressing as tolerated. - ANSWER-2. Begin with open-chain exercises and progress to closed-chain strengthening of the ankle as tolerated. (Progressive strengthening of the ankle will be the MOST appropriate treatment) A patient reports pain around the anterior aspect of the calcaneus extending toward the 2nd metatarsal head. The patient has the most pain when first standing up after waking which gradually lessens throughout the day. The patient has recently begun a walking program. Which of the following disorders is MOST likely present? 1. Medial deviation of the 1st metatarsal 2. Metatarsalgia 3. Tarsal tunnel syndrome 4. Plantar fasciitis - ANSWER-4. Plantar fasciitis (Typically associated with pain at the anterior portion of the calcaneus and increased symptoms with the first steps of the day that gradually decreases. ) A physical therapist is evaluating a patient with back pain. The patient reports having pain that has increased steadily over the last 2 months and is constant and unremitting. The pain radiates into both lower extremities. The patient also feels marked weakness throughout the right lower extremity. What is the MOST appropriate initial treatment? 1. Discontinue treatment and refer patient to primary care physician for further testing. 2. Begin a program of core strengthening, focusing on transversus abdominis training and progressing toward a long term stabilization program. 3. Instruct the patient in appropriate lower extremity exercises to improve leg strength, focusing on the right leg. 4. Initiate piriformis stretching as tolerated and instruct the patient in self mobilization techniques to improve mobility throughout the lumbar spine. - ANSWER-1. Discontinue treatment and refer patient to primary care physician for further testing. This is the correct answer. Constant pain without any relation to position is a key indicator of spinal cancer. After working for several hours as a mechanic, a patient describes sharp elbow pain over the origin point of the common extensor tendon of the wrist extensors. The pain is alleviated with rest. Which of the following disorders is MOST likely present? 1. Medial epicondylitis 2. Lateral epicondylitis 3. Anconeus tendonitis 4. Olecranon bursitis - ANSWER-2. Lateral epicondylitis (Pain is typically over the extensor tendons, especially on the insertion point of the lateral epicondyle. Repetitive motions involving mechanic work are also among common causes of lateral epicondylitis (tennis elbow).) A patient presents with rheumatoid arthritis and finger pain. The 2nd digit has a flexed metacarpophalangeal joint, hyperextended proximal interphalangeal joint, and a flexed distal interphalangeal joint. Which of the following is the MOST accurate description of the position? 1. Swan neck deformity 2. Boutonniere deformity 3. Mallet finger deformity 4. De Quervain syndrome - ANSWER-1. Swan neck deformity A physical therapist examines a patient and determines that the patient has a positive Active Compression test (O'Brien's Test). Which of the following pathologies is MOST implicated? 1. Rotator cuff tear 2. Biceps tendonitis 3. Superior labral tear 4. Acromioclavicular joint sprain - ANSWER-3. Superior labral tear (The O'Brien's test is indicative of SLAP tears.) While examining a patient's lumbar x-ray films, a physical therapist notices that the L5 vertebra is displaced anteriorly on sacrum by approximately 50% of the vertebral body. How will this MOST affect physical therapy if the patient is being treated fo