Question 1
A patient with a severe cerebellar lesion can sit independently but requires minimal assistance to
stand and moderate assistance to walk safely. The patient's goal is to transfer independently from a
wheelchair to a bed. Which transfer technique is MOST appropriate for this patient?
A) Standing-pivot
B) Manual-pivot
C) Mechanical-lift
D) Sliding board
Correct Answer: D) Sliding board
Rationale: Given the patient's inability to stand safely without assistance, a standing-pivot
transfer is contraindicated. A sliding board transfer allows the patient to move between
surfaces in a seated position, utilizing their upper body strength for independence while
maintaining safety. Manual-pivot and mechanical-lift transfers are dependent transfers and
would not meet the patient's goal of independence.
Question 2
A physical therapist is planning an intervention for a patient with a cerebellar lesion who has difficulty
with standing balance. Which intervention is MOST appropriate to address this specific deficit?
A) Approximation through the hips and shoulders with the patient standing.
B) Rhythmical stabilization exercises performed in a sitting position.
C) Resistive exercises for the antigravity muscles in a supine position.
D) Practicing standing with eyes open versus eyes closed.
Correct Answer: A) Approximation through the hips and shoulders with the patient standing.
Rationale: Approximation is a proprioceptive neuromuscular facilitation (PNF) technique that
involves applying compressive forces through the joints to promote stability and postural
control. Applying this technique in standing directly addresses the patient's primary deficit of
standing balance. Interventions in sitting would not be challenging enough, and patients with
cerebellar lesions typically do not rely on vision for balance (unlike those with vestibular or
somatosensory deficits).
Question 3
A physical therapist is using a monophasic electrical stimulation waveform with a ramp-up and ramp-
down feature. Which of the following is the MOST accurate rationale for selecting this waveform?
A) The ramp feature promotes more effective pain modulation via the gate control theory.
B) The gradual rise and fall of the amplitude enhances patient comfort during muscle contraction.
C) The change in frequency during the ramp promotes better motor unit recruitment.
D) The variability in pulse width during the ramp enhances motor unit recruitment.
Correct Answer: B) The gradual rise and fall of the amplitude enhances patient comfort during
muscle contraction.
Rationale: A ramp-up feature allows for a gradual increase in the current intensity, which
,causes a smoother and more comfortable onset of a muscle contraction. Similarly, a ramp-
down allows the contraction to subside gradually. This mimics a voluntary muscle
contraction more closely and is better tolerated by patients than a sudden, abrupt
stimulation.
Question 4
A physical therapist is selecting an electrotherapeutic modality for a patient with a 2-year history of
chronic low back pain. Which of the following is the MOST appropriate choice?
A) A portable stimulator delivering sensory-level stimulation (conventional TENS).
B) A clinic-based treatment delivering motor-level stimulation.
C) A clinic-based treatment delivering sensory-level stimulation.
D) A portable stimulator delivering motor-level stimulation (acupuncture-like TENS).
Correct Answer: D) A portable stimulator delivering motor-level stimulation (acupuncture-like
TENS).
Rationale: For chronic pain, motor-level stimulation (low-frequency, high-intensity TENS) is
often more effective as it is thought to provide a longer-lasting analgesia through the release
of endogenous opiates. A portable unit is preferable for a chronic condition, as it allows the
patient to manage their symptoms at home and throughout the day, rather than being limited
to clinic-based treatments.
Question 5
A physical therapist notes that a patient is taking 180 mg of codeine orally every 3 to 4 hours. Which
of the following side effects is this patient MOST likely to experience?
A) Urinary frequency
B) Hypertension
C) Constipation
D) Diaphoresis
Correct Answer: C) Constipation
Rationale: Opioid analgesics, including codeine, have a significant effect on the
gastrointestinal tract. They bind to mu-opioid receptors in the gut, which decreases
peristalsis and increases water absorption from the stool. This leads to constipation, which is
a very common and often dose-limiting side effect.
Question 6
A newly graduated physical therapist is initiating rehabilitation with a comatose patient. A relative
asks the therapist to find someone more experienced. Which response is MOST appropriate?
A) "Do you believe that I am not competent to help with the rehabilitation?"
B) "It sounds like you're concerned about the care your loved one will receive. Can you tell me more
about your concerns?"
C) "I passed my licensure examination, which indicates that I am fully competent to provide this
care."
,D) "Please allow me to work with this patient, and if you are still concerned afterward, we can
discuss it then."
Correct Answer: B) "It sounds like you're concerned about the care your loved one will receive.
Can you tell me more about your concerns?"
Rationale: This response uses the principles of active listening and empathy. It validates the
relative's feelings ("It sounds like you're concerned") and then uses an open-ended question
to invite dialogue. This approach is non-defensive and helps to build trust and rapport,
whereas the other options are either defensive or dismissive of the relative's concerns.
Question 7
While working in a clinic, a physical therapist observes a patient fall in the parking lot, sustaining a
severe forearm laceration. The therapist applies a pressure dressing, but blood is soaking through it.
What should the therapist do NEXT?
A) Elevate the limb above the level of the heart and continue to apply direct pressure.
B) Remove the saturated dressing and apply a new, tighter one.
C) Apply additional dressings on top of the first and apply pressure to the brachial artery.
D) Call 911 or arrange for immediate medical transportation.
Correct Answer: A) Elevate the limb above the level of the heart and continue to apply direct
pressure.
Rationale: The standard first aid for severe bleeding is direct pressure and elevation (if no
fracture is suspected). Since the initial dressing is soaked, the next immediate steps are to
continue applying pressure and to elevate the limb to use gravity to help reduce blood flow.
Removing the dressing could dislodge any clot that is forming. Applying a pressure point is a
later step if direct pressure and elevation fail.
Question 8
A patient reports a 2-week history of progressive weakness and tingling in their lower extremities.
The therapist suspects Guillain-Barré Syndrome. Which question is MOST appropriate to help
confirm this suspicion?
A) "Have you had a recent cold, flu, or infection?"
B) "Have you been in a car accident or had a fall recently?"
C) "Have you ever experienced these symptoms before?"
D) "How is this condition affecting your ability to work?"
Correct Answer: A) "Have you had a recent cold, flu, or infection?"
Rationale: Guillain-Barré Syndrome is an autoimmune disorder that is often triggered by a
preceding infection. Approximately two-thirds of patients report a respiratory or
gastrointestinal infection in the weeks prior to the onset of neurological symptoms. Asking
this question helps to establish a key piece of evidence that supports the suspected
diagnosis.
, Question 9
During an initial evaluation of a patient with acute right-sided congestive heart failure, which of the
following tests is MOST appropriate for the physical therapist to perform?
A) Sensory testing of the upper extremities.
B) Assessment for pitting edema in the lower extremities.
C) Resisted manual muscle testing of all extremities.
D) Deep tendon reflex testing of the lower extremities.
Correct Answer: B) Assessment for pitting edema in the lower extremities.
Rationale: Right-sided heart failure causes a backup of fluid into the systemic venous
circulation. This leads to the classic sign of dependent, pitting edema, particularly in the
ankles and lower legs. Assessing the presence and severity of this edema is a primary and
essential part of the examination for a patient with this diagnosis.
Question 10
A patient who had a closed reduction and cast for an ankle fracture one day ago reports new and
increasing foot pain. Which of the following examinations is MOST appropriate to perform
INITIALLY?
A) Gait examination
B) Transfer abilities
C) Capillary refill in the toes
D) Blood pressure examination
Correct Answer: C) Capillary refill in the toes
Rationale: Severe pain in a casted extremity is a major red flag for neurovascular
compromise, such as from swelling leading to compartment syndrome. The initial and most
critical assessment is to check the patient's circulatory status distal to the cast. Assessing
capillary refill in the toes is a quick and effective way to evaluate perfusion.
Question 11
A patient with muscular dystrophy, who was weaned from mechanical ventilation one day ago, is
unable to independently clear their secretions. Which intervention is MOST appropriate to assist this
patient?
A) Nasotracheal suctioning
B) Manual costophrenic assist (quad cough)
C) Supplemental oxygen
D) Inspiratory muscle training
Correct Answer: B) Manual costophrenic assist (quad cough)
Rationale: The patient's inability to clear secretions is due to weakness of the expiratory
muscles (abdominals). A manual costophrenic assist is a technique where the therapist
applies a firm, upward pressure to the abdomen, synchronized with the patient's cough
A patient with a severe cerebellar lesion can sit independently but requires minimal assistance to
stand and moderate assistance to walk safely. The patient's goal is to transfer independently from a
wheelchair to a bed. Which transfer technique is MOST appropriate for this patient?
A) Standing-pivot
B) Manual-pivot
C) Mechanical-lift
D) Sliding board
Correct Answer: D) Sliding board
Rationale: Given the patient's inability to stand safely without assistance, a standing-pivot
transfer is contraindicated. A sliding board transfer allows the patient to move between
surfaces in a seated position, utilizing their upper body strength for independence while
maintaining safety. Manual-pivot and mechanical-lift transfers are dependent transfers and
would not meet the patient's goal of independence.
Question 2
A physical therapist is planning an intervention for a patient with a cerebellar lesion who has difficulty
with standing balance. Which intervention is MOST appropriate to address this specific deficit?
A) Approximation through the hips and shoulders with the patient standing.
B) Rhythmical stabilization exercises performed in a sitting position.
C) Resistive exercises for the antigravity muscles in a supine position.
D) Practicing standing with eyes open versus eyes closed.
Correct Answer: A) Approximation through the hips and shoulders with the patient standing.
Rationale: Approximation is a proprioceptive neuromuscular facilitation (PNF) technique that
involves applying compressive forces through the joints to promote stability and postural
control. Applying this technique in standing directly addresses the patient's primary deficit of
standing balance. Interventions in sitting would not be challenging enough, and patients with
cerebellar lesions typically do not rely on vision for balance (unlike those with vestibular or
somatosensory deficits).
Question 3
A physical therapist is using a monophasic electrical stimulation waveform with a ramp-up and ramp-
down feature. Which of the following is the MOST accurate rationale for selecting this waveform?
A) The ramp feature promotes more effective pain modulation via the gate control theory.
B) The gradual rise and fall of the amplitude enhances patient comfort during muscle contraction.
C) The change in frequency during the ramp promotes better motor unit recruitment.
D) The variability in pulse width during the ramp enhances motor unit recruitment.
Correct Answer: B) The gradual rise and fall of the amplitude enhances patient comfort during
muscle contraction.
Rationale: A ramp-up feature allows for a gradual increase in the current intensity, which
,causes a smoother and more comfortable onset of a muscle contraction. Similarly, a ramp-
down allows the contraction to subside gradually. This mimics a voluntary muscle
contraction more closely and is better tolerated by patients than a sudden, abrupt
stimulation.
Question 4
A physical therapist is selecting an electrotherapeutic modality for a patient with a 2-year history of
chronic low back pain. Which of the following is the MOST appropriate choice?
A) A portable stimulator delivering sensory-level stimulation (conventional TENS).
B) A clinic-based treatment delivering motor-level stimulation.
C) A clinic-based treatment delivering sensory-level stimulation.
D) A portable stimulator delivering motor-level stimulation (acupuncture-like TENS).
Correct Answer: D) A portable stimulator delivering motor-level stimulation (acupuncture-like
TENS).
Rationale: For chronic pain, motor-level stimulation (low-frequency, high-intensity TENS) is
often more effective as it is thought to provide a longer-lasting analgesia through the release
of endogenous opiates. A portable unit is preferable for a chronic condition, as it allows the
patient to manage their symptoms at home and throughout the day, rather than being limited
to clinic-based treatments.
Question 5
A physical therapist notes that a patient is taking 180 mg of codeine orally every 3 to 4 hours. Which
of the following side effects is this patient MOST likely to experience?
A) Urinary frequency
B) Hypertension
C) Constipation
D) Diaphoresis
Correct Answer: C) Constipation
Rationale: Opioid analgesics, including codeine, have a significant effect on the
gastrointestinal tract. They bind to mu-opioid receptors in the gut, which decreases
peristalsis and increases water absorption from the stool. This leads to constipation, which is
a very common and often dose-limiting side effect.
Question 6
A newly graduated physical therapist is initiating rehabilitation with a comatose patient. A relative
asks the therapist to find someone more experienced. Which response is MOST appropriate?
A) "Do you believe that I am not competent to help with the rehabilitation?"
B) "It sounds like you're concerned about the care your loved one will receive. Can you tell me more
about your concerns?"
C) "I passed my licensure examination, which indicates that I am fully competent to provide this
care."
,D) "Please allow me to work with this patient, and if you are still concerned afterward, we can
discuss it then."
Correct Answer: B) "It sounds like you're concerned about the care your loved one will receive.
Can you tell me more about your concerns?"
Rationale: This response uses the principles of active listening and empathy. It validates the
relative's feelings ("It sounds like you're concerned") and then uses an open-ended question
to invite dialogue. This approach is non-defensive and helps to build trust and rapport,
whereas the other options are either defensive or dismissive of the relative's concerns.
Question 7
While working in a clinic, a physical therapist observes a patient fall in the parking lot, sustaining a
severe forearm laceration. The therapist applies a pressure dressing, but blood is soaking through it.
What should the therapist do NEXT?
A) Elevate the limb above the level of the heart and continue to apply direct pressure.
B) Remove the saturated dressing and apply a new, tighter one.
C) Apply additional dressings on top of the first and apply pressure to the brachial artery.
D) Call 911 or arrange for immediate medical transportation.
Correct Answer: A) Elevate the limb above the level of the heart and continue to apply direct
pressure.
Rationale: The standard first aid for severe bleeding is direct pressure and elevation (if no
fracture is suspected). Since the initial dressing is soaked, the next immediate steps are to
continue applying pressure and to elevate the limb to use gravity to help reduce blood flow.
Removing the dressing could dislodge any clot that is forming. Applying a pressure point is a
later step if direct pressure and elevation fail.
Question 8
A patient reports a 2-week history of progressive weakness and tingling in their lower extremities.
The therapist suspects Guillain-Barré Syndrome. Which question is MOST appropriate to help
confirm this suspicion?
A) "Have you had a recent cold, flu, or infection?"
B) "Have you been in a car accident or had a fall recently?"
C) "Have you ever experienced these symptoms before?"
D) "How is this condition affecting your ability to work?"
Correct Answer: A) "Have you had a recent cold, flu, or infection?"
Rationale: Guillain-Barré Syndrome is an autoimmune disorder that is often triggered by a
preceding infection. Approximately two-thirds of patients report a respiratory or
gastrointestinal infection in the weeks prior to the onset of neurological symptoms. Asking
this question helps to establish a key piece of evidence that supports the suspected
diagnosis.
, Question 9
During an initial evaluation of a patient with acute right-sided congestive heart failure, which of the
following tests is MOST appropriate for the physical therapist to perform?
A) Sensory testing of the upper extremities.
B) Assessment for pitting edema in the lower extremities.
C) Resisted manual muscle testing of all extremities.
D) Deep tendon reflex testing of the lower extremities.
Correct Answer: B) Assessment for pitting edema in the lower extremities.
Rationale: Right-sided heart failure causes a backup of fluid into the systemic venous
circulation. This leads to the classic sign of dependent, pitting edema, particularly in the
ankles and lower legs. Assessing the presence and severity of this edema is a primary and
essential part of the examination for a patient with this diagnosis.
Question 10
A patient who had a closed reduction and cast for an ankle fracture one day ago reports new and
increasing foot pain. Which of the following examinations is MOST appropriate to perform
INITIALLY?
A) Gait examination
B) Transfer abilities
C) Capillary refill in the toes
D) Blood pressure examination
Correct Answer: C) Capillary refill in the toes
Rationale: Severe pain in a casted extremity is a major red flag for neurovascular
compromise, such as from swelling leading to compartment syndrome. The initial and most
critical assessment is to check the patient's circulatory status distal to the cast. Assessing
capillary refill in the toes is a quick and effective way to evaluate perfusion.
Question 11
A patient with muscular dystrophy, who was weaned from mechanical ventilation one day ago, is
unable to independently clear their secretions. Which intervention is MOST appropriate to assist this
patient?
A) Nasotracheal suctioning
B) Manual costophrenic assist (quad cough)
C) Supplemental oxygen
D) Inspiratory muscle training
Correct Answer: B) Manual costophrenic assist (quad cough)
Rationale: The patient's inability to clear secretions is due to weakness of the expiratory
muscles (abdominals). A manual costophrenic assist is a technique where the therapist
applies a firm, upward pressure to the abdomen, synchronized with the patient's cough
