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A patient with which of the following diagnoses would MOST likely benefit from
pursed-lip breathing during exercise?
1. Peripheral vascular disease
2. Congestive heart failure
3. Emphysema
4. Sarcoidosis ---------CORRECT ANSWER-----------------3
Peripheral vascular disease is a vascular problem, not a pulmonary problem.
Congestive heart failure may lead to pulmonary problems, but not obstructive
problems. Emphysema is an obstructive lung disease, for which pursed-lip
breathing may be beneficial. Sarcoidosis is a restrictive lung disease for which
pursed-lip breathing is not beneficial.
A patient has a history of neck pain that is aggravated by long periods of sitting
and becomes progressively worse by evening. Range of motion and strength of
the neck and shoulders are within normal limits. Sensation and reflexes are intact
in both upper extremities. The patient has a forward head and excessive thoracic
kyphosis. The MOST appropriate exercise program should focus on:
,1. stretching of the neck flexors and pectoral strengthening.
2. upper trapezius strengthening and pectoral stretching.
3. pectoral strengthening and rhomboid stretching.
4. rhomboid strengthening and axial neck retraction. ---------CORRECT ANSWER----
-------------3
The history suggests that prolonged improper positioning of the cervical spine
resulted in neck pain. A chronic forward head and kyphosis results in
hyperextension in the upper cervical spine and excessive flexion in the upper
thoracic spine. Further muscle length adaptation occurs with tight anterior
muscles and stretched posterior muscles. Treatment should include correction
of muscle weakness or imbalance. Rhomboid strengthening and axial neck
extension are the only options that are both correct.
A patient suspected of having hypoglycemia is MOST likely to show which of the
following signs?
1. Fruity smelling breath
2. Thirst, nausea, and vomiting
3. Dry, crusty mucous membranes
4. Difficulty speaking and concentrating ---------CORRECT ANSWER-----------------4
A common mental state manifestation of hypoglycemia is difficulty speaking
and concentrating, whereas in hyperglycemia there is outright confusion. The
other options are all signs of hyperglycemia and not signs of hypoglycemia.
,A patient is limited in shoulder abduction, as shown in the displayed radiograph.
Which of the following mobilization techniques is MOST likely to assist the patient
in achieving increased shoulder abduction?
1. Posterior glide
2. Anterior glide
3. Inferior glide
4. Superior glide ---------CORRECT ANSWER-----------------4
Neither posterior glide, anterior glide, nor superior glide, would improve
abduction. The radiograph shows limitation of glenohumeral motion causing the
reduction in shoulder abduction. Inferior glide assists with improving abduction.
Which of the following assignments is MOST appropriate for a physical therapist
to delegate to a volunteer?
1. Restocking treatment booths with linens, ultrasound gel, and massage lotion
2. Attending a patient who is on a tilt table while the therapist takes a phone call
3. Transporting a patient who reports dizziness back to the patient's room
4. Transferring a patient from the mat table to a wheelchair ---------CORRECT
ANSWER-----------------1
The restocking of treatment booths with supplies is the only option that does
not involve direct patient contact or care and thus is the MOST appropriate
activity to delegate to a volunteer. Although volunteers may at times be
, involved with patient care activities (i.e., transporting patients), the patients in
the situations described in options 2, 3, and 4 are at potential risk and would
require supervision by someone other than a volunteer.
A physical therapist is teaching a motor skill to a patient with chronic hemiplegia.
Which of the following teaching approaches should be MOST emphasized?
1. Habituation
2. Sensitization
3. Compensatory strategy
4. Recovery of normal movement ---------CORRECT ANSWER-----------------4
A patient with chronic hemiplegia is unlikely to recover normal function.
Compensatory strategies are used when there is a permanent loss of function
which prevents reacquiring normal movement patterns. Habituation is a
decrease in responsiveness that occurs as a result of repeated exposure to a
nonpainful stimulus. In the acute patient, the emphasis is on recovery of normal
function, but this patient has a chronic condition. Sensitization is an increased
responsiveness following a threatening or noxious stimulus.
A patient has low back and leg pain, with symptoms extending to the bottom of
the foot. During the physical therapy examination, the patient does not report leg
pain in the first test position (photograph #1) but reports a severe increase in
symptoms in the second test position (photograph #2). Which of the following
conclusions is MOST likely?