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83. C. A positive response to bouncing a patient 87. A. Allograft is the transfer of skin between the
several times on the soles of the feet but not same species. It could involve a cadaver skin. An
allowing his or her to bear weight is increased autograft is grafted skin from the same individual.
flexor tone in the lower extremities. A heterograft is s graft from an animal (e.g., a pig).
Z-plasty is a surgical revision of a scar or closure of
84. C. An incorrect or untrue statement regarding a
a wound using a Z-shape incision to reduce
cerebral palsy child be that the child the head into
contractures of the adjacent skin.
a normal position. Typically, a cerebral palsy child
cannot hold or bring the head into a normal 88. D. Slump test is utilizing to determine whether an
position. Such children cannot support themselves. impingement of the nerve root is sustained in the
Typically, they will demonstrate a scissors gait thoracic lumbar region. Compression test is
pattern. They will usually as either spastic, ataxic, utilized to test for neurological pathology in the
or athetoid. They may be passive or stiff and cervical spine at any level. Distraction test
cannot adjust the body position. determines the effectiveness of traction, which may
be used to alleviate pain. This is a complementary
85. C. A malingerer is one who pretends to be ill to
test to the compression test, as it is used to obtain
arouse sympathy or who Intentionally slows
the reverse effect. Ely’s test checks the L2 to L4
recuperation from a disorder to continue to receive
nerve root lever for impingement or for tightness
insurance benefits or other emotional, or social
of the rectus femoris.
benefits from the disorder. If the physical therapist
suspects the patient is a malingerer, he or she 89. D. A vertebrobasilar artery involvement will result in
should discuss the case in a teamwork approach loss of consciousness, as well as the patient being
and notify the physician. Negligence is failure to comatose or in a vegetative state. The patient will
do what another reasonable practitioner would have no ability to speak and may have either
have done under similar circumstances. A hemiplegia or quadriplegia.
hypochondriac is a person with a chronic,
90. D. Medication is not required to be listed in an
abnormal concern about his or her health.
initial evaluation according to the APTA Standards
Paranoid patient has a mental disorder
of Care.
characterized by an impaired sense of reality and
91. B. Maintaining joint mobility through exercise and
persistent delusions.
stretching, heat, and postural instruction is the best
86. D. Four-point gait pattern is a slow, stable gait treatment for a patient with Marie-Strumpell
pattern of left crutch, right crutch, and left leg. A disease (also named ankylosing spondylitis).
92. D. Deep pressure test is the least important when
testing a patient for peripheral vascular disease.
When testing a patient for peripheral vascular
disease, the following would all be appropriate:
rubor test, girth measurements, volumetric
measurement, reactive hyperemia, and ischemia
test.
99. C. A disorder characterized by the growth of 103. B. Gluteus medius, gluteus minimum, and tensor
cartilage in the epiphyses of the bones resulting in fasciae latae are all muscle of hip abduction and
the limbs remaining short and is transmitted as an their nerve innervation is the superior gluteal nerve.
autosomal dominant gene, is achondroplasia. Inferior gluteal nerve is innervation for gluteus
Osteogenesis imperfecta is a genetic disorder maximus. Psoas major, iliacus,
involving defective development of the connective and sartorius innervation from the femoral nerve
tissue. It is inherited as an autosomal dominant and the lumbar plexus. Gluteus medius, gluteus
trait and is characterized by abnormally brittle and minimus, and sartorius have innervation from the
fragile bones that are easily fractures with minimal superior gluteal nerve and femoral nerve. Gluteus
trauma. Fibrous dysplasia pertains to displacement medius, gracilis, and pectineus have innervation
of the osseous tissue within the affected bones. from the femoral nerve and superior and the
Bone tumor is any abnormal growth of tissue, superior gluteal nerve.
benign or malignant. 104. D. The femoral, obturator, and inferior gluteal
nerve are the correct answer, as the hip adductor
100. D. Fibrous dysplasia is not another name for
muscles consist of the pectineus, gracilis, adductor
thyrotoxicosis, as this pertains to an abnormal
longus, adductor brevis, and adductor magnus.
condition characterized by the fibrous
Their innervation includes the inferior gluteal nerve
displacement of the osseous tissue within the
for the gluteus nerve for the adductor brevis,
affected bones. Grave’s disease, as well as primary
adductor longus, adductor magnus, and gracilis.
and secondary hyperthyroidism, is also called
thyrotoxicosis. The condition of hyperthyroidism is
105. D. Evaporative coolants or spray not significant
lower tissue temperature below the surface.
Evaporative coolants cause a chemical reaction that
produces a cool felling on the outside surface of
the skin. Ice massage, cryopressure, and ice towels
all decrease swelling by decreasing tissue
temperature.
109. D. Saunder cervical traction device is 112. B. A patient with depression would appear
recommended for a patient with pessimistic, irritable, lack self-confidence, and have
temporomandibular joint dysfunction (TMJ). The a gloomy outlook on life. A psychopath is a person
Saunders cervical traction device does not contact who has an antisocial personality disorder. .
the jaw, thereby reducing further aggravation of Schizophrenia is any one of a large group of
the temporomandibular joints. Conventional psychotic disorder characterized by a gross
cervical traction methods utilize head halters that distortion of reality, disturbances of
fit under the chin anteriorly and on the occipital communication, withdrawal from social interaction,
bone posteriorly. Even when care is taken to and disorganized and fragmented thought,
minimize the force on the chin, there is sufficient perception, and emotional reaction.
force to cause an undesirable effect on the
113. C. Hypertonia is a condition characterized by
temporomandibular joints.
excessive tone in the limbs, which are to both
110. D. Intermittent mechanical traction is described as active and passive movement. Flaccidity is
intermittent traction when there is typically a hold characterized by week, soft, and flabby muscles
and rest period. Autotraction utilizes a special that lack normal muscle tone. Hypotonia is
traction bench made up of two sections that can characterized by less than adequate muscle
be individually angled and rotated. The patient contractions and a state of decreased motor
applies traction by pulling with his or her own neuron excitability. Rigidity is a condition of
arms. With gravity lumbar traction, the lower hardness, stiffness, or inflexibility.
border and the circumference of the rib cage are
114. C. At level C4, a patient is able only to direct
anchored through a specially made vest secured to
pressure-relief activities. At level C5, a patient is
the top of the bed. The patient is placed on a bed
independent in pressure relief. At level C8, a
that is titled vertically, putting the patient in a
patient is independent in pressure relief including
position in which the free weight of the legs and
wheelchair, and push-ups.
hips exerts a traction force on the lumbar spine by
gravity. With manual traction, the therapist grasps
115. A. The minimal level a patient can have to perform
the patient and manually applies a traction force
self-range of motion independently is C7. At C4
either for a few seconds or by a sudden quick
and C5, a patient can only direct range of motion.
thrust.
At C7 and C8, a patient is independent in range of
motion.
116. B. Sacral sparing occurs when the patient has
paralysis and loss of sensation except in the sacral
area. Cauda equina injury involves the lower end
of the spinal cord at the first lumbar vertebra and
the bundle of lumbar, sacral, and coccygeal nerve
roots that emerge from the spinal cord and
descend through the spinal canal of the sacrum
and coccyx. Central cord syndrome occurs when
there is damage to the central portion of the cord
and an incomplete lesion. Typically, greater deficits
are found in the upper extremities than the lower
extremities upon evaluation. Brown-Sequard
syndrome is a traumatic neurologic disorder
resulting from compression of one side of the
spinal cord, typically seen after a knife-type injury.
There is also an incomplete lesion, which typically
results in loss of motor function on the same side
as the lesion and loss of pain and temperature on
the opposite side.
120. A. A muscle grade of poor is defined as production 124. C. Inverse square law states that the intensity of
of movement only in a gravity-eliminated position. radiation from a light source varies inversely to the
A muscle grade of trace would be no movement square of the distance from the source. Clinical
but palpable twitching of the muscle contraction. application means the further the infrared light, for
A muscle grade of fair would be production of example, is moving from the patient, the greater
movement against gravity. A muscle grade of zero the decrease in intensity will be.
would be no palpable muscle contraction.
125. B. A patient in coma would show no voluntary
121. D. Testing bilaterally starting with the injured side movement be unresponsive to stimulus, have no
first is an incorrect method of performing manual reflexes, and exhibit a positive Babinski response.
muscle testing. When performing manual muscle The aftereffect of a cerebrovascular accident
testing, it is appropriate to test bilaterally starting depends on the location and extent of ischemia.
on the noninjured side and then comparing to the Paralysis, weak, speech defect, aphasia, and even
injured side. All other answers listed would be death may occur. Patients in a stupor would exhibit
important in performing manual muscle testing. a state of lethargy and unresponsiveness in which
The following considerations should be followed they seem unaware of their surroundings.
when performing manual muscle test; (1) test
126. A. A patient should only be seen once a week
bilaterally starting with the noninjured side; (2)
when receiving a third-degree erythemal dosage,
isolate the muscle you are testing, line up the
which can produce tissue damage.
origin and insertion; palpate the muscle testing for
Following is a chart of the appropriate treatment
contraction; (4) stabilize the proximal part – you
frequency for a patient:
must know proper hand position to isolate the
Suberythemal dosage Daily
muscle you are testing; (5) apply the correct
Second-degree erythemal dosage
amount of resistance for testing strength and, to
Two times a week
receive maximum cooperation from the patient,
Third-degree erythemal dosage Once a
inform him or her of the treatment you are
week
performing.
Fourth-degree erythemal dosage The correct body position should be arranged with
Once every 3 to 4 months the head and trunk level and the lower limbs
elevated. Lastly, oxygen, if available, should be
127. A. Standard deviation of the mean plus or minus
administered.
one is graded based on the score of 68% of the
students. 133. A. Strengthening for bed mobility for a C6
quadriplegic should emphasize major. The
128. D. In order to perform an ethical research study,
pectoralis major. The pectoralis major serve to flex,
prior to starting the research a patient sign the
adduct, and medially rotate the arm in the
informed consent document. Informing the patient
shoulder joint.
that he or she has the right to terminate the
experiment at any time, debriefing the patient 134. A. Given the information provided in this question,
following the experiment are necessary for a study the patient is most likely experiencing heat cramps.
to be ethical. However, an informed consent Heat cramps are caused by depletion of both water
document must be signed first. and salt because of heat exhaustion. They usually
occur after vigorous physical exertion in an
129. C. The most appropriate exercise for a patient in
extremely hot environment or under other
early stages of rehabilitation after a nonsurgical
conditions causing profuse sweating. Heat
operation would be closed-chain isokinetic exercise
syncope results in weakness, fatigue, and loss of
such as a stair machine.
motor tone. The patient typically will have blurred
vision and an elevated body temperature. Heat
130. D. The American red cross has recently
exhaustion results in fatigue, weakness,
recommended calling 911 (EMS) before instituting
incoordination, and elevated body temperature.
CPR, because if the adult has suffered cardiac
With heat hyperpyrexia, the patient becomes
arrest, he will need defibrillation immediately to
irrational, with muscle flaccidity and involuntary
increase his chance of survival.
limb movements as well as seizures.
131. B. The social worker should be contacted to start
135. A. When the stimulus is flexing the head, the
discharge planning in cooperation with the patient,
positive reaction will result in arm flexion and
family, and physical therapist. The physician has
extension. If the test stimulus had been extending
already given you the order for discharge so it is
the patient’s head, the positive response would
not necessary to contact him or her first. The
then have arm extension and leg positive response
home health agency can be contacted later
would then have arm extension and leg flexion.
through the social worker. The patient’s family will
also be contacted by the social worker in a team
136. C. Utilizing the Rule of Nines, an anterior arm is
approach. Therefore, the social worker would be
assigned a value of 4.5% and an anterior leg a
the correct person to contact first to get the ball
value of 9.0%. Therefore, the correct answer would
rolling.
be. 13.5%.
149. B. Pulmonary edema produce dull percussion 154. A. Bell’s palsy is a paralysis of the facial nerve
sound with wheezing and cracking upon resulting from trauma to the nerve, compression of
auscultation. Atelectasis will produce dull the nerve by a tumor, or possibly, an unknown
percussion sounds and decreased breath sounds infection. The typical treatment is electrical
with auscultation. Pneumonia will produce dull stimulation direct current to the motor points of
percussion sounds, decreased breath sounds, and the facial muscles.
sounds of a pleural lung. Pneumothorax will result
155. C. Teaching proper body mechanics is a
in hyperresonance, and increased breath sounds.
psychomotor areas that deal with motor skills.
150. A. When treating a patient 3 days postoperative, it
Educational contracts are usually divided into three
would be appropriate for the patient to have
areas. First is cognitive, which deals with the
monitored ambulation with no symptoms. Lower
information area; second is psychomotor, which
extremity ergometry x 15 or x 30 minutes, and
deals with the motor skills; and third is affective,
upper extremity ergometry x 15 minutes would be
which deals with feelings.
too aggressive to start on a patient 3 days cardiac
surgery.
156. B. An appropriate treatment program for a
pediatric patient with cystic fibrosis would include
151. B. Proprioception tests the patient’s ability to
both breathing exercises and postural drainage.
determine the direct position sense. Kinesthesia
This would be the most aggressive form of
tests the patient’s ability to determine movement
treatment for this patient that can be performed by
sensation. Graphesthesia test the ability of a
a licensed physical therapist.
patient to recognize letters and numbers written
on the patient’s skin. Barognosis is the ability to
157. B. A patient with a capsular pattern of the hip will
determine the weight of an object.
exhibit first a decreased range of motion in flexion,
then abduction, and then internal rotation.
152. D. Proper body mechanics for a post cesarean
patient would be to get up from a lying down
158. A. Observation of the patient’s posture while the
position by rolling over to the side, swinging the
body is in motion is an example of a dynamic
leg over the edge, and getting up slowly. When
balance coordination test. Having the patient
sitting, the patient should avoid soft chairs, as they
perform a finger-to-nose-finger test to evaluate
are hard to get up from and have poor back
the quality of movement, testing the patient’s
support. When standing, the patient should keep
ability to judge distance and speed of movement
the chin in and contract the abdominal muscles.
by drawing a circle, and evaluating the quality of
When bending over, the patient should keep a
movement control and speed with the patient
curve in the low back with one foot in front of the
pointing are examples of nonequilibrium
other.
coordination.
164. C. Cerebellar artery occlusion most likely results in 169. C. Schizophrenia is a psychotic disorder in which
coordination problems as well as ataxia. A middle the patient often has fragmented thoughts, bizarre
cerebral artery lesion would result in motor and ideas, and becomes withdrawn. Responses are
sensory aphasia, as well as hemiplegia. A posterior usually inappropriate and demonstrate serve mood
cerebral artery lesion would result in loss of shifts. Paranoid is a psychotic disorder in which the
superficial touch and deep sensation, as well as patient has delusions of persecution or grandiosity
contralateral hemiparesis. A vertebral artery lesion and is typically suspicious in all situations with all
would result in loss of consciousness or coma. people. The Depression is characterized by a
165. C. Huntington’s chorea is a hereditary condition feeling of sadness or helplessness. The patient
characterized by chronic, progressive chorea and typically has little drive for activity or achievement.
mental deterioration. No specific physical therapy Psychopathy is an antisocial personality disorder
treatment is required. In planning a treatment characterized by behavior patterns that lack moral
program for this patient, it would be appropriate to and ethical standards.
170. C. The low-pressure mercury vapor lamp, otherwise 176. C. Direct current is he only type of current that
known as cold mercury lamp, is utilized in could be utilized to stimulate a denervated muscle.
application against the skin to kill bacteria. The hot Direct current is necessary to get a response when
mercury lamp is high-pressure mercury vapor lamp stimulating a denervated muscle.
used for psoriasis skin. The ultraviolet lamp is used
177. C. In performing goniometric measurement of the
in the control of infectious air borne bacteria and
internal or external rotator of the shoulder, the
viruses, and in the treatment of psoriasis.
stationary arm should be parallel or perpendicular
171. B. Capsular end-feel is characterized by hard to the midline of the floor. The movable arm will
leather-like stoppage with slight give. This will then be longitudinally with the shaft of the ulna
occur in full normal range of motion. Bone-to- and the styloid process. The axis for measurement
bone end-feel is typically occurs when performing is over the olecranon process.
passive range of motion and the bone contracts
178. A. One gram of fat yields 9 calories. One gram of
another bone. Empty end-feel is defined by a lack
protein yields 4 calories. One gram of
of stoppage to the joint. Springy block end-feel is
carbohydrate yields 4 calories.
defined by rebound movement felt at the end-
179. B. In order for distraction of the bodies to occur
range of passive range of motion. Two other end-
under lumbar traction, the therapist must apply
feels include spasm end-feel and soft tissue
traction from 40% to 50% of the body’s weight.
approximation.
the lever between fulcrum and weight nerve, resulting in a distal tingling sensation on
percussion of a damaged nerve. The sign is often
192. B. Intolerance to treatment as indicated by low present in carpal tunnel syndrome and is produced
TcPCO2 values is an absolute contraindication to by tapping over the median nerve on the volar
vibration of a neonate. Persisted fatal circulation, aspect of the wrist.
198. A. A Chi-square is a statistical test for an
association between observed data and expected
data represented by frequencies. The test yields a
statement of the probability of the obtained
distribution having occurred by chance alone.