Scorebuilders Exam 1 UPDATED
QUESTIONS AND CORRECT ANSWERS
A 63-year-old female is referred to physical therapy with complaints of low back pain and
lower extremity paresthesia due to degenerative L5 spondylolisthesis. Which of the following
examination findings is MOST likely to be associated with the patient's diagnosis?
1.Decreased lumbar lordosis
2.Knee hyperextension
3.Hamstrings tightness
4.Decreased Achilles reflex - CORRECT ANSWER Some degree of hamstrings
tightness is typically associated with all grades of spondylolisthesis. This tightness may
contribute to nerve root irritation, limit straight leg raising and forward bending abilities, and
functionally alter gait and posture. Hamstrings tightness often causes an individual to walk
with short strides with the knees slightly bent. A waddling gait can also be observed since an
individual rotates the pelvis more to compensate for decreased hamstrings length. (Dutton
1333)
A physical therapist initiates gait training with a patient who is two days status post total knee
arthroplasty. During the activity, the therapist observes that the patient is experiencing foot
drop on her surgical limb. Damage to which of the following nerves is MOST likely
associated with with this finding?
1.Sural
2.Tibial
3.Peroneal
4.Saphenous - CORRECT ANSWER Because of their proximity to the surgical field
and the positioning required for surgery, several neurovascular structures are at risk for
sustaining damage during a total knee arthroplasty (TKA). Peroneal nerve palsy is the most
common neurological complication, while injuries to the superficial femoral and popliteal
vessels are among the vascular structures at greatest risk.
The peroneal nerve is derived from the sciatic nerve providing sensory and motor innervation
to the lower leg. Injury to the peroneal nerve typically manifests as weakness in the ankle
dorsiflexors (e.g., foot drop) and sensory deficits radiating from the fibular head to the
dorsum of the foot. (Dutton 95)
,A physical therapist reports the results obtained using the WeeFIM on a four-year-old child at
an interdisciplinary team meeting. What is this tool used to determine?
1.The optimal length of stay in an acute care facility
2.The amount of caregiver assistance required
3.The extent of gross motor delays present
4.The recommended programming to minimize disability - CORRECT ANSWER The
WeeFIM provides assessment through observation and subsequent rating in established motor
and cognitive categories. The higher the score, the greater the independence of the patient.
A physical therapist observes a patient completing a closed chain activity emphasizing knee
flexion. Which description is MOST consistent with the described therapeutic activity?
1.The femoral condyles roll backward and glide forward on the tibia
2.The femoral condyles roll forward and glide backward on the tibia
3.The tibia rolls and glides posteriorly on the femoral condyles
4.The tibia rolls and glides anteriorly on the femoral condyles - CORRECT
ANSWER Closed chain activities involve the body moving over a fixed distal segment.
Open chain activities involve the distal segment, usually the hand or foot, moving freely in
space. The proximal joint surface of the tibiofemoral joint is formed by the convex medial
and lateral condyles of the distal femur. The distal joint surface is formed by the concave
medial and lateral condyles of the proximal tibia.
During closed chain knee flexion the femoral condyles roll backward and glide forward on
the tibia. (Dutton 855)
A patient is referred to physical therapy after being diagnosed with entrapment of the
posterior interosseous nerve. Which finding would be MOST anticipated based on the
patient's diagnosis?
1.Weakness of the wrist extensors and finger extensors
2.Weakness of the wrist flexors and finger flexors
3.Weakness of the wrist flexors and ulnar deviators
4.Weakness of the finger abductors and thumb adductors - CORRECT ANSWER The
radial nerve divides into the superficial radial nerve and the posterior interosseous nerve at
the elbow. The posterior interosseous nerve is commonly entrapped in the proximal forearm
in the area of the supinator muscle.
,Weakness of the wrist extensors and finger extensors would be anticipated with entrapment of
the posterior interosseous nerve. Muscles innervated by the nerve contributing to the
described weakness would include extensor carpi radialis brevis, extensor carpi ulnaris, and
extensor digitorum communis.
A physical therapist works with a patient on abdominal strengthening. The therapist attempts
to have the patient complete a modified sit-up with their head and shoulders positioned on a
wedge while in supine. What is the MOST likely rationale associated with the use of the
wedge?
1.Weak rectus abdominis
2.Shortened hip flexors
3.Increased lordosis
4.Disk pathology - CORRECT ANSWER Failure to complete a sit-up due to weakness
of the rectus abdominis often requires a wedge placed behind the head and shoulders. As the
patient gradually becomes stronger, the size of the wedge can be diminished and ultimately
eliminated.
A patient with shortened hip flexors often performs a sit-up with pillows under the knees to
decrease the pull of the hip flexors on the spine and allow the patient to lie with the pelvis
and spine in neutral. Utilizing a wedge placed behind the head and shoulders would
unnecessarily minimize the difficulty of the sit-up.
3.Patients with increased lordosis typically perform sit-ups with the knees bent. The presence
of increased lordosis would not justify the use of a wedge placed behind the head and
shoulders.
4.Patients with disk pathology often have a highly variable clinical presentation. The
presented information does not provide adequate justification for the use of a wedge placed
behind the head and shoulders. Therapists often have patients with disk pathology avoid
straight leg sit-ups in order to avoid a significant increase in intradiskal pressure.
A physical therapist prepares to complete a selected manual muscle test on a patient with
rotator cuff tendonitis by placing the upper extremity in the recommended test position. The
therapist determines that the patient is unable to maintain the test position and slowly allows
the arm to sag. Which of the following muscle grades is MOST consistent with this scenario?
1.Good minus
2.Fair
3.Fair minus
, 4.Poor - CORRECT ANSWER A grade of fair minus is characterized by the patient
being unable to complete the full available range of motion against gravity, however, can
complete more than half of the range. If placed in the test position, the patient will have
insufficient strength to maintain the position.
1.A grade of good minus is characterized by the patient completing range of motion against
gravity with minimal-moderate resistance.
2.A grade of fair is characterized by the patient completing range of motion against gravity
without manual resistance.
4.A grade of poor is characterized by the patient completing range of motion with gravity-
eliminated.
A patient is evaluated in physical therapy after sustaining brain damage secondary to closed
head trauma. When performing a sensory examination, the therapist notes that the patient has
impaired stereognosis, two-point discrimination, and barognosis. Which type of sensations
are MOST representative of the patient's impairments?
1.Superficial sensations
2.Deep sensations
3.Combined cortical sensations
4.Cutaneous sensations - CORRECT ANSWER Combined cortical sensations include
stereognosis, tactile localization, two-point discrimination, double simultaneous stimulation,
graphesthesia, texture recognition, and barognosis.
1.Superficial sensations include pain, temperature, touch, and pressure.
2.Deep sensations include kinesthesia, proprioception, and vibration.
4.Cutaneous sensation is synonymous with superficial sensation.
A 65-year-old man attends physical therapy complaining of progressive shortness of breath
and lower leg swelling. During the examination the physical therapist identifies signs of
increased jugular venous pressure, an S3 gallop, and moderate lower extremity edema. On
auscultation of the patient's lungs, which of the following sounds would the therapist MOST
expect to hear?
1.Bilateral crackles
2.Pleural rub
QUESTIONS AND CORRECT ANSWERS
A 63-year-old female is referred to physical therapy with complaints of low back pain and
lower extremity paresthesia due to degenerative L5 spondylolisthesis. Which of the following
examination findings is MOST likely to be associated with the patient's diagnosis?
1.Decreased lumbar lordosis
2.Knee hyperextension
3.Hamstrings tightness
4.Decreased Achilles reflex - CORRECT ANSWER Some degree of hamstrings
tightness is typically associated with all grades of spondylolisthesis. This tightness may
contribute to nerve root irritation, limit straight leg raising and forward bending abilities, and
functionally alter gait and posture. Hamstrings tightness often causes an individual to walk
with short strides with the knees slightly bent. A waddling gait can also be observed since an
individual rotates the pelvis more to compensate for decreased hamstrings length. (Dutton
1333)
A physical therapist initiates gait training with a patient who is two days status post total knee
arthroplasty. During the activity, the therapist observes that the patient is experiencing foot
drop on her surgical limb. Damage to which of the following nerves is MOST likely
associated with with this finding?
1.Sural
2.Tibial
3.Peroneal
4.Saphenous - CORRECT ANSWER Because of their proximity to the surgical field
and the positioning required for surgery, several neurovascular structures are at risk for
sustaining damage during a total knee arthroplasty (TKA). Peroneal nerve palsy is the most
common neurological complication, while injuries to the superficial femoral and popliteal
vessels are among the vascular structures at greatest risk.
The peroneal nerve is derived from the sciatic nerve providing sensory and motor innervation
to the lower leg. Injury to the peroneal nerve typically manifests as weakness in the ankle
dorsiflexors (e.g., foot drop) and sensory deficits radiating from the fibular head to the
dorsum of the foot. (Dutton 95)
,A physical therapist reports the results obtained using the WeeFIM on a four-year-old child at
an interdisciplinary team meeting. What is this tool used to determine?
1.The optimal length of stay in an acute care facility
2.The amount of caregiver assistance required
3.The extent of gross motor delays present
4.The recommended programming to minimize disability - CORRECT ANSWER The
WeeFIM provides assessment through observation and subsequent rating in established motor
and cognitive categories. The higher the score, the greater the independence of the patient.
A physical therapist observes a patient completing a closed chain activity emphasizing knee
flexion. Which description is MOST consistent with the described therapeutic activity?
1.The femoral condyles roll backward and glide forward on the tibia
2.The femoral condyles roll forward and glide backward on the tibia
3.The tibia rolls and glides posteriorly on the femoral condyles
4.The tibia rolls and glides anteriorly on the femoral condyles - CORRECT
ANSWER Closed chain activities involve the body moving over a fixed distal segment.
Open chain activities involve the distal segment, usually the hand or foot, moving freely in
space. The proximal joint surface of the tibiofemoral joint is formed by the convex medial
and lateral condyles of the distal femur. The distal joint surface is formed by the concave
medial and lateral condyles of the proximal tibia.
During closed chain knee flexion the femoral condyles roll backward and glide forward on
the tibia. (Dutton 855)
A patient is referred to physical therapy after being diagnosed with entrapment of the
posterior interosseous nerve. Which finding would be MOST anticipated based on the
patient's diagnosis?
1.Weakness of the wrist extensors and finger extensors
2.Weakness of the wrist flexors and finger flexors
3.Weakness of the wrist flexors and ulnar deviators
4.Weakness of the finger abductors and thumb adductors - CORRECT ANSWER The
radial nerve divides into the superficial radial nerve and the posterior interosseous nerve at
the elbow. The posterior interosseous nerve is commonly entrapped in the proximal forearm
in the area of the supinator muscle.
,Weakness of the wrist extensors and finger extensors would be anticipated with entrapment of
the posterior interosseous nerve. Muscles innervated by the nerve contributing to the
described weakness would include extensor carpi radialis brevis, extensor carpi ulnaris, and
extensor digitorum communis.
A physical therapist works with a patient on abdominal strengthening. The therapist attempts
to have the patient complete a modified sit-up with their head and shoulders positioned on a
wedge while in supine. What is the MOST likely rationale associated with the use of the
wedge?
1.Weak rectus abdominis
2.Shortened hip flexors
3.Increased lordosis
4.Disk pathology - CORRECT ANSWER Failure to complete a sit-up due to weakness
of the rectus abdominis often requires a wedge placed behind the head and shoulders. As the
patient gradually becomes stronger, the size of the wedge can be diminished and ultimately
eliminated.
A patient with shortened hip flexors often performs a sit-up with pillows under the knees to
decrease the pull of the hip flexors on the spine and allow the patient to lie with the pelvis
and spine in neutral. Utilizing a wedge placed behind the head and shoulders would
unnecessarily minimize the difficulty of the sit-up.
3.Patients with increased lordosis typically perform sit-ups with the knees bent. The presence
of increased lordosis would not justify the use of a wedge placed behind the head and
shoulders.
4.Patients with disk pathology often have a highly variable clinical presentation. The
presented information does not provide adequate justification for the use of a wedge placed
behind the head and shoulders. Therapists often have patients with disk pathology avoid
straight leg sit-ups in order to avoid a significant increase in intradiskal pressure.
A physical therapist prepares to complete a selected manual muscle test on a patient with
rotator cuff tendonitis by placing the upper extremity in the recommended test position. The
therapist determines that the patient is unable to maintain the test position and slowly allows
the arm to sag. Which of the following muscle grades is MOST consistent with this scenario?
1.Good minus
2.Fair
3.Fair minus
, 4.Poor - CORRECT ANSWER A grade of fair minus is characterized by the patient
being unable to complete the full available range of motion against gravity, however, can
complete more than half of the range. If placed in the test position, the patient will have
insufficient strength to maintain the position.
1.A grade of good minus is characterized by the patient completing range of motion against
gravity with minimal-moderate resistance.
2.A grade of fair is characterized by the patient completing range of motion against gravity
without manual resistance.
4.A grade of poor is characterized by the patient completing range of motion with gravity-
eliminated.
A patient is evaluated in physical therapy after sustaining brain damage secondary to closed
head trauma. When performing a sensory examination, the therapist notes that the patient has
impaired stereognosis, two-point discrimination, and barognosis. Which type of sensations
are MOST representative of the patient's impairments?
1.Superficial sensations
2.Deep sensations
3.Combined cortical sensations
4.Cutaneous sensations - CORRECT ANSWER Combined cortical sensations include
stereognosis, tactile localization, two-point discrimination, double simultaneous stimulation,
graphesthesia, texture recognition, and barognosis.
1.Superficial sensations include pain, temperature, touch, and pressure.
2.Deep sensations include kinesthesia, proprioception, and vibration.
4.Cutaneous sensation is synonymous with superficial sensation.
A 65-year-old man attends physical therapy complaining of progressive shortness of breath
and lower leg swelling. During the examination the physical therapist identifies signs of
increased jugular venous pressure, an S3 gallop, and moderate lower extremity edema. On
auscultation of the patient's lungs, which of the following sounds would the therapist MOST
expect to hear?
1.Bilateral crackles
2.Pleural rub
