1. A physical therapist examines several distance and time parameters associated with gait.

Which finding would be

MOST anticipated when comparing walking in an 18-month-old to walking in an older child (i.e., 7 year old)?

1. an older child would exhibit decreased step length

2. an older child would exhibit decreased stride length
3. an older child would exhibit decreased cadence
4. an older child would exhibit decreased walking velocity

2. A physical therapist attempts to assess the balance of a 42-year-old female rehabilitating from a stroke. Which of
the following balance tests would require the GREATEST reliance on the vestibular system?

1. standing on a floor with the eyes closed

2. standing on a floor with the head tilted backward
3. standing on a foam surface with the eyes closed
4. standing on a foam surface with the head tilted backward

3. A physical therapist palpates a patient’s popliteal artery to monitor their lower extremity circulation. What is the
MOST likely reason the therapist used the popliteal artery?

1. the therapist suspects a blockage of the femoral artery

2. the therapist is trying to determine the patient’s ankle-brachial index
3. the popliteal artery is superficial in the popliteal fossa and easy to locate
4. the patient is taking beta-blockers

4. A physical therapist completes a systems review on a patient status post ankle arthrodesis. Which of the following
pieces of information would NOT be documented in the integumentary section of the systems review?

1. pliability of the scar

2. level of edema
3. continuity of skin color
4. skin integrity

5. A physical therapist reads in the medical record that a patient exhibits asthenia. Which test would be the MOST
useful to identify the presence of this condition?

1. manual resistance to assess muscle strength

2. marching in place
3. alternating finger to nose
4. placing feet on floor markers while walking

6. A note in the medical record indicates a patient is exhibiting signs and symptoms of rhabdomyolysis. Which of
the following would be the MOST relevant finding based on this condition?

1. decreased joint mobility

2. diminished muscle performance
3. increased pain
4. diminished coordination
7. A physical therapist treats a patient who has sustained a gunshot wound to the cervical spine causing an
incomplete lesion to the spinal cord. The therapist examines the patient and determines that they no longer can sense
pain signals on the right side of the body below the level of the lesion. Which part of the spinal cord was MOST
likely affected?

1. posterior spinal cord on the left

2. anterior spinal cord on the left
3. posterior spinal cord on the right
4. anterior spinal cord on the right

8. A physical therapist works with a patient with an obstructive lung condition characterized by permanent widening
and distortion of the medium-sized airways. The patient presents with cough, copious amounts of purulent sputum,
and recurrent pulmonary infections. The description is MOST characteristic of:

1. bronchiectasis
2. idiopathic pulmonary fibrosis
3. chronic bronchitis
4. emphysema

9. A physical therapist treats a patient with cerebellar pathology that exhibits dysdiadochokinesia.  Which finding
would be LEAST characteristic of this condition when attempting rapid supination and pronation of the forearms?

1. inability to maintain rhythm

2. failure to move through full range
3. rapid onset of fatigue
4. slowness of movement

10. A physical therapist employed in a rehabilitation hospital is saddened to learn that a patient she treated only
three months ago with amyotrophic lateral sclerosis recently died after a relatively short acute care hospitalization.
The MOST likely cause of death would be:   

1. meningitis
2. pneumonia
3. deep vein thrombosis
4. septic shock

11. A physical therapist treats a patient with a pulmonary artery catheter inserted through the subclavian vein. Which
range of motion exercise would MOST likely be restricted based on the presence of the catheter?

1. shoulder flexion
2. shoulder lateral rotation
3. shoulder abduction
4. shoulder extension
12. A physical therapist examines a patient with complaints of hip pain. The therapist places the patient in prone and
bends their knee to better evaluate the patient’s muscular flexibility. As the patient’s knee bends to end-range, they
hike their hip off of the table. This test would MOST likely be used to identify limited flexibility in the:

1. iliopsoas
2. vastus lateralis
3. rectus femoris
4. sartorius

13. A physical therapist plans to discharge a patient from a skilled nursing facility, but would first like to assess their
level of independence prior to returning home. If the therapist uses the Katz Index of Activities of Daily Living to
determine the level of independence, which activity would NOT be assessed?

1. using utensils for feeding

2. getting into and out of bed
3. controlling urination and bowel movements
4. combing hair

14. A physical therapist evaluates a patient who has had a cerebrovascular accident in a step-down neurological unit.
The patient asks the physical therapist for a glass of water prior to beginning the session. What is the MOST
appropriate physical therapist action?

1. provide the patient with a glass of water

2. check the patient’s medical record for oral intake orders
3. tell the patient they are not permitted to have water
4. call the patient’s physician

15. A physical therapist reads in the medical record that an epidural sensor was used for intracranial monitoring on a
patient with an acute head injury.  Which unit of measure would MOST likely be utilized with this type of
monitoring?

1. milligrams per deciliter 

2. millimeters of mercury
3. percent of oxygen saturation
4. pounds per square inch

16. A physical therapist instructs a patient in soft tissue mobilization using a foam roller as shown in the image. This
therapeutic technique may be MOST beneficial for a patient diagnosed with:

1. iliolumbar syndrome
2. iliotibial band syndrome
3. piriformis syndrome
4. trochanteric bursitis
17. A physical therapist treats a patient diagnosed with a right hemispheric stroke. During the session the therapist
instructs the patient to reach for an object with both hands. Which area of the brain is MOST responsible for
performing the motor portion of this movement?

1. the prefrontal cortex in the frontal lobe

2. the precentral gyrus in the frontal lobe
3. the postcentral gyrus in the parietal lobe
4. the cingulate gyrus in the limbic lobe

18. A physical therapist treats a 16-year-old male patient with an acute burn injury over his anterior chest. The
wound contains dry, leathery eschar and is insensate to touch. Given the wound characteristics, the PRIMARY goal
of the therapist’s treatment should be to:

1. provide an environment which promotes re-epithelialization

2. control infection to prepare the wound for surgical management
3. debride blisters to prepare the wound for primary healing
4. encourage the maintenance of a moist wound surface

19. A physical therapist examines differences in lung volumes based on gender. Which lung volume would the
therapist anticipate having the largest difference between males and females?

1. tidal volume
2. inspiratory reserve volume
3. expiratory reserve volume
4. residual volume

20. A physical therapist is treating a 45-year-old male who sustained a traumatic injury to his right shoulder while
playing basketball one week ago. The patient presents with pain, inflammation, and muscle spasm globally in the
shoulder. The MOST appropriate intervention is:

1. grade I and II joint mobilizations

2. bent over rows with a light handweight
3. doorway stretches for the pectoralis major
4. proprioceptive neuromuscular facilitation patterns without resistance

21. A physical therapist applies a transparent film dressing to a superficial wound on a patient’s lower leg. Which
therapeutic objective is LEAST likely based on the type of dressing?

1. permit autolytic debridement

2. prohibit entry of bacteria
3. absorb drainage in the wound bed
4. reduce friction over bony prominences

22. A physical therapist assesses the muscle activity of a patient ambulating on a level surface using
electromyography.  Which muscle would likely possess the MOST sustained activity throughout the swing phase of
gait?

1. tibialis anterior
2. gluteus medius
3. adductor longus
4. soleus

23. A physical therapist treats a patient that has experienced altered serum potassium levels during their current
hospitalization. The MOST relevant complication for a patient with abnormal potassium levels is: 

1. cardiac arrhythmias 
2. water retention
3. increased blood glucose level
4. increased oxygen saturation in the blood

24. A physical therapist works with a patient on ascending and descending a ramp in the physical therapy gym. The
patient is a 72-year-old female who recently fractured her left tibial plateau and, as a result, is using bilateral axillary
crutches. When descending the ramp, the therapist should stand:

1. in front of the patient toward the right side

2. in front of the patient toward the left side
3. behind the patient toward the right side
4. behind the patient toward the left side

25. A physician utilizes diagnostic imaging to show motion within a joint through x-ray. This type of imaging is
BEST termed:

1. computed tomography
2. fluoroscopy
3. discography
4. radionuclide scanning

26. A mother indicates that her four-year-old son was diagnosed with a disease during a newborn screening test
administered shortly after birth.  However, due to the early identification of the disease, the child's condition was
effectively treated without any residual impairments.  This type of scenario is MOST consistent with:

1. spina bifida
2. Down syndrome
3. phenylketonuria
4. Tay-Sachs disease

27. A physical therapist performs pulmonary function testing on an otherwise healthy 80-year-old male status post
humeral fracture. Which pulmonary value would the physical therapist expect to remain MOST stable over the
patient’s lifespan?

1. tidal volume
2. residual volume
3. forced vital capacity
4. inspiratory capacity
28. A patient diagnosed with amyotrophic lateral sclerosis is informed that most patients with this disease do not
survive more than 2-5 years from the time of diagnosis. Which of the following factors would MOST likely shorten
the patient’s lifespan?

1. the patient is 25 years old

2. the patient presents with bulbar onset
3. the patient has no complaints of dyspnea
4. the patient is taking riluzole

29. A physical therapist comes into the clinic in the morning and notices that the hot pack machine was unplugged
overnight. Which guideline would be the MOST appropriate after plugging in the hot pack unit?

1. wait to use a hot pack for a minimum of one hour

2. wait to use a hot pack until the following day
3. wait to use a hot pack until the water in the unit reaches 160 degrees Fahrenheit
4. wait to use a hot pack until the unit is formally inspected by a qualified individual

30. A therapist measures a patient’s blood pressure at the beginning of a therapy visit and notes that the resting
blood pressure is significantly lower than normal. The MOST logical explanation for this objective finding is:

1. the therapist used a blood pressure cuff that is too small

2. the patient exercised just prior to the therapy visit
3. the therapist took the measurement with the patient’s arm at their side while seated
4. the patient has been nauseous and vomiting over the past two days

31. A physical therapist assesses muscle activity in the trunk and pelvis of a patient referred to physical therapy with
low back pain. Which position would be the MOST appropriate to assess the transversus abdominis?

1. sidelying
2. supine with legs extended
3. supine with hips and knees flexed to 90 degrees
4. hooklying

32. A physical therapist treats a patient with epilepsy that was admitted to a rehabilitation unit five days after total
hip arthroplasty. Which setting would initially be MOST desirable when treating this patient?

1. therapeutic pool
2. physical therapy gym
3. hallway adjacent to the patient’s room
4. private treatment room

33. A physical therapist administers the slump test to a patient being treated in physical therapy with low back pain.
The patient notes pain in the posterior knee when the knee is extended and ankle is dorsiflexed. The therapist then
has the patient slump and flex their neck while plantar flexing the ankle. The patient indicates that this positional
change makes the pain disappear. What can the therapist conclude from this test?

1. the patient has tight musculature in the posterior leg

2. the patient is experiencing neural tension of the sciatic nerve
3. the patient has a lumbar disk herniation
4. the patient is likely malingering

34. A physical therapist measures the blood pressure of a patient sitting upright over the edge of a plinth.  Based on
the presented image, the greatest source of measurement error would likely be attributed to the position of the:

1. upper extremity
2. sphygmomanometer 
3. diaphragm of the stethoscope
4. inflation bulb

35. A physical therapist prepares to select a dressing for a patient with a lower extremity arterial insufficiency ulcer.
The wound measures two centimeters in diameter with a depth of one-half centimeter. Considering the typical
characteristics of an arterial insufficiency ulcer, which dressing would be the MOST desirable to maintain an
appropriate moisture balance in the wound bed?

1. hydrogel
2. transparent film
3. wet-to-dry gauze
4. calcium alginate

36. A physical therapist is treating a patient using neuromuscular electrical stimulation for muscle reeducation. The
therapist would like to increase the pulse characteristic called amplitude. Which control should be manipulated on
the stimulator?   

1. frequency
2. ramp time
3. intensity
4. phase duration

37. A physical therapist works with a 45-year-old male who was in good health prior to being diagnosed with
Guillain-Barre syndrome two weeks ago. The patient was referred to outpatient physical therapy after a seven-day
hospitalization. The patient did not experience respiratory involvement and had moderate weakness affecting all
joints of the lower extremities. What would be the MOST likely long-term outcome for the patient?   

1. independent at a wheelchair level in the home and community

2. independent at a wheelchair level in the community only
3. independent ambulation with an assistive device in the home and community
4. independent ambulation without an assistive device in the home and community
38. A physical therapist examines the foot and ankle alignment of a patient who is complaining of left ankle pain.
The therapist first assesses the patient’s alignment in prone after determining subtalar neutral. Based on the depicted
image in prone, which compensatory motion would MOST likely be observed during ambulation?

1. increased hip internal rotation

2. genu varum
3. excessive foot supination
4. forefoot varus

39. A physical therapist documents that the Neer impingement test is positive after a patient reports marked pain
during the testing procedure. The MOST likely source of the pain is compression of the:

1. greater tuberosity against the anterior acromion

2. greater tuberosity against the posterior acromion
3. lesser tuberosity against the anterior acromion
4. lesser tuberosity against the posterior acromion

40 A physical therapist places a patient in a semi-recumbent position to assess the magnitude of jugular vein
distention. Jugular vein distention would MOST likely indicate the presence of which condition?

1. peripheral arterial disease

2. congestive heart failure
3. coronary artery disease
4. aortic aneurysm

41. A physical therapist working in a neonatal intensive care unit reviews a patient’s medical record and observes
that the infant’s APGAR score was recorded as 7 and 9 for the first and fifth minutes, respectively. Which
observation would warrant a score of less than 2 in its respective category?

1. the infant is crying

2. the infant’s heart rate is 85 beats per minute
3. the infant is actively moving their arms and legs
4. the infant sneezes

42. A physical therapist uses therapeutic ultrasound for deep heating of the left piriformis muscle prior to soft tissue
mobilization and stretching. Which of the following would be the MOST appropriate treatment parameters?

1. 3 MHz, 1.0 W/cm2, 100% duty cycle, for 12 minutes

2. 1 MHz, 1.0 W/cm2, 100% duty cycle, for 12 minutes
3. 3 MHz, 1.5 W/cm2, 100% duty cycle, for 8 minutes
4. 1 MHz, 1.5 W/cm2, 100% duty cycle, for 8 minutes
43. A physical therapist works with a patient with left sided heart failure on endurance activities. The patient is using
a recumbent bicycle when they suddenly develop tachypnea and a cough that produces frothy sputum. What is the
MOST appropriate immediate action of the physical therapist?

1. call 911
2. offer the patient a rest break
3. take the patient’s vital signs
4. suggest the patient slow down the pace of the activity

44. A physical therapist works on balance reeducation activities with a patient diagnosed with diabetes and
peripheral neuropathy. Which of the following activities would be the MOST challenging for this patient?

1. activities in single-leg stance

2. reaching in and out of the base of support in standing
3. standing on foam with eyes closed
4. lateral weight shifting

45. A physical therapist receives a referral from a physician that states a patient has pes anserine tendinitis. Which of
the following muscles is MOST likely affected by this condition?

1. adductor longus
2. semimembranosus
3. biceps femoris
4. sartorius

46. A physical therapist assesses the vital signs of a newborn baby prior to the start of the therapy session. Which of
the following measurements would be considered abnormal for this patient?

1. body temperature of 99 degrees Fahrenheit

2. resting heart rate of 150 beats per minute
3. resting respiratory rate of 40 breaths per minute
4. resting blood pressure of 150/100 mm Hg

47. A physical therapist observes that a patient often exhibits toe drag during the swing phase of gait. Which
objective finding would be LEAST likely to contribute to this gait deviation?

1. flaccidity of the dorsiflexors

2. inadequate dorsiflexion range of motion
3. weakness of the dorsiflexors
4. spasticity of the dorsiflexors

48. A physical therapist treats a patient with stage II breast cancer who presents with neck and shoulder pain. Which
intervention would be inappropriate to incorporate into the plan of care?

1. ultrasound to the pectoralis major insertion

2. cold pack application to the shoulder
3. suboccipital release techniques
4. taping application to assist with postural awareness
49. A physical therapist treats a patient using grade III and IV oscillations. Which examination findings would
BEST support this type of intervention?

1. decreased active range of motion and decreased passive range of motion

2. decreased active range of motion and normal passive range of motion
3. normal active range of motion and decreased passive range of motion
4. decreased active range of motion and increased passive range of motion

50. A physical therapist administers ultrasound to a patient diagnosed with right patella tendinopathy.  Based on the
patient's medical diagnosis the MOST appropriate output frequency is:   

1. 1 W/cm2
2. 1 MHz
3. 3 W/cm2
4. 3 MHz

51. A physical therapist works with a patient referred to physical therapy with a diagnosis of Bell’s palsy. Which of
the following cranial nerves would be affected based on the diagnosis?

1. facial nerve
2. trigeminal nerve
3. oculomotor nerve
4. vagus nerve

52. A physical therapist plans to work with a patient on resistive exercises in a heated therapeutic pool. This type of
intervention would be MOST appropriate for a patient diagnosed with:

1. multiple sclerosis
2. psoriasis
3. hypothyroidism
4. Graves’ disease

53. A physical therapist positions a patient in supine on a mat table with their arms at their side and palms facing
upward. The therapist observes that in this position the patient’s lateral border of the spine of the right scapula is 1.5
inches above the surface of the mat table. This observation is MOST indicative of insufficient muscle length of the:

1. clavicular portion of the pectoralis major

2. sternal portion of the pectoralis major
3. pectoralis minor
4. latissimus dorsi

54. A physical therapist reviews the results of a recently completed isokinetic test on a 45-year-old construction
worker rehabilitating from an upper extremity injury. Which measure would serve as the BEST indicator of the
patient’s readiness to return to work?

1. maximum work repetition

2. peak torque
3. total work
4. work fatigue

55. A 30-year-old female is being treated in an ambulatory care setting by a physical therapist. The woman is in her
second trimester of pregnancy and reports pain in her right hand that often keeps her awake at night. She has
decreased sensation to the index and middle fingers using Semmes-Weinstein monofilaments. The MOST likely
explanation for the patient’s reported symptoms is:

1. capitate fracture
2. carpal tunnel syndrome
3. ulnar nerve entrapment
4. De Quervain’s syndrome

56. A physical therapist attempts to use a forearm strap to treat a patient with golfer’s elbow.  The forearm strap
would be MOST likely applied to the forearm immediately:

1. distal to the origin of the common extensor tendon at the lateral epicondyle
2. proximal to the origin of the common extensor tendon at the lateral epicondyle
3. distal to the origin of the flexor carpi radialis at the medial epicondyle
4. proximal to the origin of the flexor carpi radialis at the medial epicondyle

57. A physical therapist designs an exercise program for a patient with chronic obstructive pulmonary disease with
the goal of improving cardiovascular endurance and increasing the efficiency of breathing. Which scenario would be
MOST beneficial for the patient?

1. upper extremity ergometer five times per week at an intensity of 12 on a 6-20 RPE scale
2. stationary bicycle twice per week at an intensity of 7 on a 6-20 RPE scale
3. ambulation four times per week at an intensity of 12 on a 6-20 RPE scale
4. aquatic therapy program three times per week at an intensity of 15 on a 6-20 RPE scale

58. A female patient is contemplating genetic testing in order to rule out that she is a carrier of an autosomal
dominant inherited condition.  Which disease would be MOST relevant if the patient is in fact a carrier? 

1. Tay-Sachs disease
2. cystic fibrosis
3. Huntington’s disease
4. Duchenne muscular dystrophy

59. A physical therapist works with a patient rehabilitating from a femur fracture on functional activities in the gym.
During the session the patient becomes distracted and falls to the ground clutching the involved leg. Which action
would be the MOST appropriate following the incident?
1. enter the completed incident report in the medical record
2. report the relative guilt or innocence of involved parties
3. notify the risk manager or immediate supervisor about the incident
4. attempt to identify the cause of the incident

60. A physical therapist assesses a patient’s level of recovery after a recent stroke using the Fugl-Meyer Assessment.
Which of the following would NOT be included as part of the assessment?
1. biceps reflex testing
2. finger-to-nose coordination testing
3. assessment of seated balance
4. manual muscle test of the elbow extensors

61. Which of the following methods of drug administration results in the MOST rapid rate of drug absorption?

1. sublingual
2. oral
3. intravenous
4. intramuscular

62. A 78-year-old female falls to the ground while ambulating in an assisted living facility. The patient is found
lying supine with her right hip adducted and medially rotated. The patient reports severe hip pain with any active
movement. Upon examination, the greater trochanter is particularly prominent on the right side and the right limb
appears shorter than the left. The clinical presentation is MOST indicative of:   

1. femoral neck fracture

2. sacroiliac joint injury
3. posterior hip dislocation
4. anterior hip dislocation

63. A physical therapist works with a patient who has sustained a crush injury to the tibial nerve. Which gait
deviation would this patient MOST likely demonstrate?

1. shortened step length on the contralateral side

2. vaulting on the ipsilateral side
3. foot slap on the ipsilateral side during initial contact
4. toe drag on the ipsilateral side during swing phase

64. A physical therapist treats a patient with supraspinatus tendonitis using iontophoresis with acetic acid. Use of
this intervention is MOST likely intended to:

1. reduce inflammation
2. soften calcium deposits
3. facilitate tissue repair
4. reduce pain

65. physical therapist elects to utilize a wrist splint for a patient with a repetitive use disorder. The patient is
employed as a transcriptionist and spends up to eight hours a day on a computer. The therapist determines the
patient’s wrist and hand are acutely inflamed and the patient classifies her present pain as an 8 out of 10 on a visual
analogue scale. The MOST appropriate type of splint would be a:

1. serial splint
2. dynamic splint
3. functional splint
4. resting splint
66. A physical therapist examines a 36-year-old male recently referred to a rehabilitation hospital. During the
examination the therapist identifies abnormally low resistance to passive stretch and documents the findings as
hypotonia.  Which condition would be MOST likely to produce this type of objective finding?   

1. cerebellar disorder
2. traumatic brain injury
3. basal ganglia disorder
4. Huntington's disease

67. A physical therapist works with a 63-year-old patient with a patellar tendon bearing prosthesis and a SACH
foot.  The GREATEST expected limitation during gait would be:

1. inadequate suspension
2. excessive ankle motion
3. limited ankle motion
4. pylon alignment

68. A physical therapist performs a sensory assessment on a young female.  Based on the presented image, which
type of sensation is the therapist testing?

1. superficial
2. deep
3. proprioceptive
4. combined cortical

69. A physical therapist instructs a patient to perform a seated row exercise as shown using elastic tubing. Which
muscle would NOT be emphasized with this exercise?

1. biceps brachii
2. latissimus dorsi
3. posterior deltoid
4. rhomboids

70. A physical therapist attempts to educate a patient by using their hands to demonstrate facet movement in the
cervical spine. The therapist indicates that the upper facets move bilaterally up and forward on the lower facets. This
type of movement is characteristic of:
1. cervical flexion
2. cervical extension
3. cervical sidebending
4. cervical rotation

71. A physical therapist performs reflex testing on an infant with suspected developmental delay. The physical
therapist provides a noxious stimulus to the sole of the foot with the patient in supported sitting. This testing method
would be MOST useful to assess the:

1. crossed extension reflex

2. flexor withdrawal reflex
3. positive support reflex
4. protective extension reflex

72. A physical therapist discusses the care of a 56-year-old male patient with a metabolic bone disorder with the
patient’s physician.  The physician shows the therapist the patient’s x-ray, in which the affected bones are larger
than normal, yet less dense.  Which medical condition is MOST likely represented on the x-ray?

1. osteopenia
2. osteomalacia
3. Paget’s disease
4. rickets

73. A physical therapist reads in the medical record that a ten-year-old male sustained a type II Salter-Harris
fracture.  What type of fracture is MOST likely based on the classification scale indicated?

1. comminuted
2. epiphyseal
3. hairline
4. impaction

74. A physical therapist reads in the medical record that a physician ordered a maximal exercise test for a patient.
What is the primary rationale for utilizing a maximal exercise test instead of a submaximal exercise test?

1. assist in making a medical diagnosis

2. determine maximum oxygen consumption
3. assess the effectiveness of medical interventions
4. measure the effects of pharmacological agents

75. A physical therapist covering for a colleague on vacation reviews the medical record of a patient prior to
initiating treatment. A note in the medical record indicates that during the last session the patient received
iontophoresis with a dosage of 50 mA-min for 20 minutes. What current amplitude would have been used for the
described intervention?

1. 2.5 mA
2. 3.0 mA
3. 3.5 mA
4. 4.0 mA
76. A physical therapist performs a special test on a patient positioned in prone.  As part of the test, the therapist
observes spontaneous hip flexion as the knee is passively flexed.  This finding is commonly associated with:

1. Apley’s compression test

2. Craig’s test
3. Tripod sign
4. Ely’s test

77. A physical therapist works with a five-year-old female child with cystic fibrosis. The usual clinical presentation
of this condition involves impairments of the:

1. pulmonary and gastrointestinal systems

2. pulmonary and cardiovascular systems
3. pulmonary and urinary systems
4. pulmonary and integumentary systems

78. A physical therapist notices possible atrophy of the infraspinatus muscle while completing an examination on a
patient with shoulder pathology. This finding is MOST consistent with an injury to the:

1. axillary nerve
2. long thoracic nerve
3. spinal accessory nerve
4. suprascapular nerve

79. A physical therapist examines a patient who complains of pain and weakness in both hands.  The therapist
suspects that the patient has bilateral carpal tunnel syndrome.  Which of the following patients would be MOST
likely to have this condition?

1. a 65-year-old male with rheumatoid arthritis

2. a 45-year-old-female with diabetes
3. a 45-year-old male with history of ulnar nerve relocation surgery
4. a 75-year-old female with osteoporosis

80. A physical therapist works with a patient with nystagmus.  Pertinent patient information includes a cerebellar
lesion six months ago, mild vertigo, and nystagmus that persists even when performing visual fixation on an object. 
This form of nystagmus is BEST termed:

1. central nystagmus
2. peripheral nystagmus
3. positional nystagmus
4. spontaneous nystagmus

81. A physical therapist works in the therapy pool with a patient who is status post open reduction internal fixation
of the right tibia. The doctor has instructed the patient that he needs to remain less than 20% weight bearing while
ambulating. To what level would the patient have to submerge in the pool to satisfy the weight bearing restrictions?

1. the knees
2. the anterior superior iliac spines
3. the xiphoid process
4. C7 vertebra

82. A physical therapist works on paced breathing with a patient who has a restrictive lung disease. Which of the
following conditions is LEAST likely to be contributing to the patient’s dysfunction?

1. asthma
2. pulmonary edema
3. C6 spinal cord injury
4. ankylosing spondylitis

83. A physical therapist attempts to trial the use of an orthosis for a patient with a steppage gait. Which of the
following would be MOST appropriate for the therapist to utilize in the trial?

1. knee-ankle-foot orthosis (KAFO)

2. hip-knee-ankle-foot orthosis (HKAFO)
3. ankle-foot orthosis (AFO)
4. knee immobilizer

84. A physical therapist works with a patient with cerebellar pathology and wants to assess the patient’s level of
coordination. When observing the patient’s gait, which deviation would be MOST indicative of dysmetria?

1. inability to place feet on floor markers while ambulating

2. inability to alter speed while ambulating
3. inability to alter direction while ambulating
4. limited arm swing and trunk motion while ambulating

85. A physical therapist asks a patient to complete a visual analogue scale designed to assess pain intensity. The
scale consists of a 10 centimeter line with descriptive labels at each end. Which terminology would be the MOST
appropriate for the first label?

1. no pain
2. mild pain
3. weak pain
4. faint pain

86. A physical therapist reviews the medical record of a patient admitted to an acute care hospital with shortness of
breath. The patient’s chest x-ray reveals a pleural effusion. Which of the following pulmonary function tests is
MOST likely to be unaffected by this condition?

1. vital capacity
2. total lung capacity
3. FEV1/FVC
4. inspiratory capacity
87. A physical therapist contemplates using several different forms of practice to enhance learning during a
rehabilitation session for a patient with a mild traumatic brain injury.  Which type of practice would possess the
HIGHEST risk of potential injury for this patient?

1. distributed practice
2. massed practice
3. constant practice
4. variable practice

88. A physical therapist positions a patient as shown on a mat table in preparation for a manual muscle test.  This
position would be MOST appropriate for testing the:

1. latissimus dorsi
2. lower trapezius
3. pectoralis major
4. upper trapezius

89. A physical therapist concludes that a patient exhibits an extension lag after examining the patient’s range of
motion in short sitting. The physical therapist was able to extend the patient’s knee from 90 degrees of knee flexion
to 15 degrees of knee flexion passively. Which value would BEST represent the patient’s active knee range of
motion? 

1. 90 degrees of knee flexion to 5 degrees of knee hyperextension

2. 90 degrees of knee flexion to 10 degrees of knee flexion
3. 90 degrees of knee flexion to 15 degrees of knee flexion
4. 90 degree of knee flexion to 25 degrees of knee flexion

90. A patient with gouty arthritis of the knee experiences an acute exacerbation of their condition. Which of the
following interventions would be LEAST likely to control the patient’s acute symptoms?

1. modification of diet
2. injection of a corticosteroid
3. use of a knee immobilizer
4. administration of an anti-inflammatory medication

91. A physical therapist is treating an 82-year-old female that lives independently in a single story house.  The
therapist uses the Tinetti Performance Oriented Mobility Assessment as a screening tool to determine if the patient is
at an increased risk for falling.  This tool primarily assesses fall risk by examining:

1. static standing reach

2. gait and balance
3. activities in sitting and standing
4. timed mobility
92. A physical therapist has been asked to determine whether a ramp to enter a local shopping mall meets the
minimum accessibility standards required by law. The maximum grade for wheelchair ramps is BEST identified as:

1. for every inch of rise, there should be twelve inches of length

2. for every inch of rise, there should be nine inches of length
3. for every inch of rise, there should be six inches of length
4. for every inch of rise, there should be three inches of length

93. A patient is three weeks following transtibial amputation and is using a shrinker as part of the plan of care. The
primary purpose of the shrinker is to:

1. properly shape the limb 

2. maintain range of motion
3. provide intermittent compression
4. provide desensitization

94. A physical therapist attempts to assess a patient’s relative risk for developing coronary artery disease. Which
patient scenario would result in the patient being at the GREATEST risk?

1. a 51-year-old female with a sedentary lifestyle

2. a 53-year-old female with a high-density lipoprotein level of 60 mg/dl
3. a 48-year-old male with total serum cholesterol of 224 mg/dl
4. a 59-year-old male with a body mass index of 26 kg/m2

95. A physical therapist examines a 16-year-old soccer player who injured his knee while planting and pivoting. The
therapist suspects an anterior cruciate ligament (ACL) tear, but the Lachman test is negative. MRI later reveals that
the patient does have a complete tear of the ACL. What is the MOST likely reason that the Lachman test was
negative?

1. The patient could not flex the knee to 90 degrees to attain the test position.
2. The patient also has a posterior cruciate ligament tear.
3. The patient was experiencing protective spasm of the hamstrings.
4. The patient was experiencing protective spasm of the quadriceps.

96. A physical therapist works with an 18-year-old with Duchenne muscular dystrophy in a school setting.
Considering the typical progression of the disease, which of the following interventions is the MOST appropriate?

1. seating and positioning to maximize respiratory function

2. gait training with a reverse rolling walker
3. stand pivot transfer training
4. progressive resistive lower extremity exercises

97. During a recent physical therapy session, a patient's mother mentions that her son did not begin to exhibit any
symptoms associated with his current medical condition until the age of six.  This type of scenario is MOST likely
associated with:

1. phenylketonuria
2. spina bifida
3. Tay-Sachs disease
4. Wilson's disease

98. A physical therapist treats a patient who has experienced a lengthy hospitalization. Which cardiovascular system
change is LEAST likely with prolonged bed rest?

1. decreased stroke volume

2. decreased cardiac output
3. decreased maximal heart rate
4. decreased maximal oxygen consumption

98. A physical therapist’s therapeutic objectives include enhancing shoulder stability through the use of
approximation. Which neurodevelopmental position would be the MOST appropriate to accomplish the objective?

1. prone on elbows 
2. half kneeling
3. bridging 
4. sitting

99. A physical therapist observes a nurse insert an oropharyngeal airway in the mouth of an unconscious patient.
Which of the following would be LEAST likely to contribute to the decision to utilize the oral airway?

1. absent cough
2. excessive drooling
3. increased gag reflex
4. labored breathing

100. A child with spastic diplegia cerebral palsy has significantly shortened Achilles tendons bilaterally. Which
compensatory action would be MOST likely as the child attempts to achieve a foot flat position?

1. knee hyperextension
2. excessive knee flexion
3. excessive dorsiflexion
4. circumduction

101. A patient status post right transfemoral amputation receives a wheelchair specific for a patient that has a lower
extremity amputation. The MOST likely adaptation to a standard wheelchair is:

1. the seat is lowered two inches

2. the rear wheel axle is positioned two inches posterior
3. two handrims are placed on one drive wheel connected by a linkage bar
4. the seat back is positioned in a semi-reclining position of approximately 30 degrees

102. A patient diagnosed with multiple sclerosis works on transfer training in an inpatient rehabilitation setting. The
patient presents with ataxia, postural and intention tremors, hyptonia, and truncal weakness. Based on these
symptoms, the demyelinating lesions are MOST likely located within the:
1. corticospinal tract
2. cerebellar tracts
3. frontal lobe
4. spinothalamic tract

103. A physical therapist prepares to initiate an exercise program for a patient with end stage renal disease on
hemodialysis. Which statement is MOST accurate when designing the program?

1. monitor exercise intensity using maximal age-predicted heart rate

2. administer a formal exercise stress test prior to initiating exercise
3. exercise should occur four to six times per week at low intensities
4. progressively increase the duration of exercise to 60-90 minutes

104. A physical therapist works with an infant that was born prematurely and is demonstrating the absence of
several primitive reflexes. Which reflex would be the MOST important for allowing the baby to breastfeed?

1. palmar grasp reflex

2. Moro reflex
3. rooting reflex
4. symmetrical tonic neck reflex

105. A physical therapist working on a medical/surgical rotation returns from a morning inservice and finds a
number of items that require her attention. Which of the following items should be given the HIGHEST priority?

1. a patient requiring pre-operative instruction

2. an incomplete exercise flow sheet
3. an unfinished wheelchair order form
4. a written note from a staff dietician

106. A physical therapist works with a patient with a degenerative central nervous system disorder. The pathology
primarily consists of destruction of the motor neurons in the anterior horn cells of the spinal cord. The patient’s
MOST likely diagnosis is:

1. Parkinson’s disease
2. Huntington’s disease
3. amyotrophic lateral sclerosis
4. multiple sclerosis

107. A 65-year-old male who underwent a posterior approach left total hip arthroplasty prepares to return home.
Prior to discharge, the patient reviews safety recommendations with the physical therapist. Which of the following
activities involves the GREATEST risk for dislocation?

1. sleeping on the left side without lower extremity pillow support

2. standing to don pants during lower extremity dressing using a reacher
3. placing the left foot on a chair in order to tie a shoe
4. sitting reclined with the left foot placed over the right knee
108. A patient rehabilitating from a knee injury performs an open kinetic chain exercise. Which position of the knee
would result in the GREATEST amount of surface contact between the patella and the femur?

1. 0 degrees of knee flexion

2. 30 degrees of knee flexion
3. 60 degrees of knee flexion
4. 90 degrees of knee flexion

109. A physical therapist performs postural drainage on a 68-year-old male with bronchiectasis. The patient’s
medical history includes diabetes and hypertension, both of which are poorly controlled. Which lung segment would
MOST likely require the therapist to modify the standard treatment procedure?

1. apical segment of right upper lobe

2. posterior segment of left lower lobe
3. anterior segment of right upper lobe
4. superior segment of left lower lobe

110. A physical therapist treats an infant diagnosed with congenital torticollis.  The physician referral indicates that
the physical therapist should avoid passive stretching techniques.  Which comorbidity would MOST likely result in
this type of restriction?

1. Duchenne muscular dystrophy

2. Down syndrome
3. juvenile rheumatoid arthritis
4. cystic fibrosis

111. Following a cycling accident while on vacation, a 36-year-old man with no significant medical history
underwent surgical repair of an ankle fracture. On the flight home a few days later, the patient began to experience
significant chest pain and was transported to the emergency room immediately after landing. The MOST likely
cause of the patient’s emergent condition is:

1. pneumothorax
2. myocardial infarction
3. hemothorax
4. pulmonary embolism

112. A patient with thoracic outlet syndrome exhibits a positive Allen’s test. Which of the following interventions
would be the MOST beneficial for this patient?

1. postural re-education
2. strengthening of the pectoralis minor muscle
3. stretching of the rhomboids
4. iontophoresis

113. A physical therapist works with a patient who has a history of arterial insufficiency in the bilateral lower
extremities. Last year the patient sustained a severe injury to the right lower extremity and has since shown signs of
chronic venous insufficiency. Given the patient's past and current medical history, the MOST appropriate
intervention to effectively and safely reduce the patient's edema in the right lower extremity is:
1. ankle pumps in supine
2. retrograde massage with the leg elevated
3. use of intermittent pneumatic compression
4. ambulation on a treadmill

114. A patient that sustained significant burns to the right upper quadrant four months ago is referred to physical
therapy to be measured for new custom compression garments. To prevent hypertrophy and facilitate scar
remodeling, the garments should provide what level of compression?

1. 15 mm Hg
2. 25 mm Hg
3. 45 mm Hg
4. 55 mm Hg

115. A physical therapist works with a patient who has just undergone nerve conduction velocity testing. Assuming
that the patient does not have any neurological damage, which two factors would be MOST likely to affect the
outcome of the nerve conduction velocity testing?

1. gender and age

2. age and temperature of the limb
3. age and ethnicity
4. gender and temperature of the limb

116. A physical therapist determines that a patient’s elbow pain is primarily located in the medial elbow region.
Which diagnosis is MOST likely to exhibit this type of pain pattern?

1. biceps tendon rupture

2. chronic olecranon bursitis
3. ulnar nerve entrapment
4. radial tunnel syndrome

117. A physical therapist treats an infant with a number of sensorimotor impairments. The therapist observes that in
supine the patient exhibits excessive extensor tone which inhibits the ability of the flexors to contract. This finding
likely results from a loss of:

1. irradiation
2. reciprocal inhibition
3. successive induction
4. rhythmic initiation

118. A physical therapist participates in a blood pressure screening that examines pulse pressure. Which value is
MOST consistent with typical pulse pressure in a healthy adult population?

1. 30 mm Hg
2. 40 mm Hg
3. 80 mm Hg
4. 120 mm Hg
119. A physical therapist works with a patient one week status post arthroscopic repair of a large rotator cuff tear.
As part of the session, the therapist instructs the patient in a home exercise program. The patient’s program would
MOST likely include:

1. active shoulder range of motion, isometric shoulder exercise

2. active elbow and wrist range of motion, shoulder pendulum exercise
3. passive shoulder range of motion, resisted scapular stabilization exercise
4. passive shoulder range of motion, resisted internal and external shoulder rotation

120. A physical therapist performs cardiopulmonary resuscitation (CPR) at a rate of 15 compressions for every two
breaths. Which scenario would MOST warrant the use of this ratio?

1. one rescuer performing CPR on a 42-year-old female

2. one rescuer performing CPR on a 6-month-old male
3. two rescuers performing CPR on a 6-year-old female
4. two rescuers performing CPR on a 36-year-old male

121. A physical therapist discusses positioning with a 42-year-old female patient rehabilitating from a transfemoral
amputation. Based on the patient's postoperative status, which position would be the MOST appropriate to prevent a
contracture?

1. supine with a pillow between the legs

2. supine with a pillow on the outside of the affected leg
3. prone with a pillow between the legs
4. prone with a pillow on the outside of the affected leg

122. A physical therapist employed in an acute care hospital treats a patient with a chest tube.  The therapist notices
that in less than an hour there has been approximately 250 mL of drainage.  Which medical condition would be
LEAST likely associated with this scenario?

1. hemothorax
2. open chest surgery
3. pneumothorax
4. trauma

123. A physical therapist works on quadruped positioning with a patient following traumatic brain injury. Which of
the following would NOT be a benefit of this intervention?

1. decreased extensor tone at the knees

2. decreased extensor tone at the wrists
3. increased stability of the hips
4. decreased flexor tone at the elbows

124. A physical therapist applies a therapeutic modality prior to manually stretching a patient’s plantar fascia.
Which modality would be the MOST effective to improve the quality of the stretch?

1. pulsed ultrasound
2. moist heat
3. iontophoresis
4. ice massage

125. A physical therapist discusses anticipated physiologic changes associated with specific resistive programs
emphasizing strength and endurance. Which physiological adaptation is inherent to both types of programs?

1. increased muscle length

2. increased mitochondrial density and volume
3. increased muscle fiber hypertrophy
4. increased tensile strength of tendons, ligaments, and connective tissue

126. A physical therapist treats a patient with Raynaud’s disease. When experiencing an acute episode of this
condition, which symptom would the patient LEAST likely experience?

1. cyanosis of the digits

2. pain in the digits
3. clubbing of the digits
4. intense redness of the digits

127. A physical therapist works on ambulation with a patient rehabilitating from a CVA with right hemisphere
involvement. Based on the presented image, the therapist is attempting to:

1. decrease synergy in the upper extremity

2. increase weight bearing through the upper extremity
3. increase tone in the upper extremity
4. decrease subluxation of the upper extremity

128. A physical therapist teaches a patient to utilize the Valsalva maneuver. This type of instruction would be
MOST beneficial for:

1. flaccid bladder
2. congestive heart failure
3. herniated lumbar disk
4. peripheral vascular disease

129. A physical therapist instructs a patient to perform a wall stretch as shown in the presented image.  This type of
stretching technique would MOST likely benefit a patient diagnosed with:

1. brachial plexus injury

2. cervical spondylosis
3. thoracic outlet syndrome
4. congenital torticollis
130. A physical therapist identifies the presence of retained secretions in the lungs of a patient with pulmonary
disease via auscultation. Which intervention would be the MOST effective to teach the patient to clear the retained
secretions?

1. pursed lip breathing

2. active cycle of breathing
3. segmental breathing
4. inspiratory muscle training

131. A physical therapist attempts to obtain a general assessment of a patient’s cognitive status. The patient is a 62-
year-old female three days status post total hip arthroplasty. The MOST appropriate action is:

1. review the patient’s medical record

2. conduct a patient interview
3. conduct a physical examination
4. consult with family members

132. A physical therapist identifies the pisiform after palpating along the proximal row of carpals. Which carpal
bone articulates with the pisiform?

1. trapezium
2. trapezoid
3. lunate
4. triquetrum

133. A 53-year-old patient status post cerebrovascular accident is referred to physical therapy.  During the
examination the physical therapist determines that the patient is unable to sense sharp pain on the right side of the
body.  Which testing procedure would typically be used to obtain this information?

1. gently poking with a pin interspersed with light touches using the blunt end of the pin 
2. bilateral simultaneous touch
3. drawing a line (using a dull point) on the patient's skin
4. Semmes-Weinstein monofilament testing

134. A physical therapist completes a work site analysis for a patient with T3 paraplegia. The patient is employed in
the marketing department of an advertising agency and relies on a wheelchair for daily locomotion. Which of the
following is likely to be the MOST significant architectural barrier for the patient?

1. hardwood floors
2. an entrance ramp with one inch of vertical rise for every six inches of ramp length
3. one-quarter inch thresholds at each door
4. pedestal type sinks
135. A physical therapist administers a special test to a patient with a lower extremity injury. Which special test
would NOT be initiated with the patient in prone and the knee flexed to 90 degrees?

1. Apley’s test
2. Craig’s test
3. peroneal tendon dislocation test
4. Thompson test

136. A physical therapist treats a patient that presents with a chronic inflammatory disorder limited to the mucosa
and submucosa layers of the colon and rectum. A chart review reveals that the affected area is restricted to the colon
and presents as a continuous lesion with involvement of the inner lining progressing to the rectum. The patient
experiences chronic diarrhea and rectal bleeding. This is MOST indicative of:

1. Crohn’s disease
2. irritable bowel syndrome
3. ulcerative colitis
4. transmural inflammatory disease

137. A physical therapist classifies the gait of a patient with hemiplegia as equinus. Which finding is MOST likely
to promote this type of gait pattern?

1. excessive activity of the gastrocnemius

2. weakness of the tibialis posterior
3. excessive activity of the tibialis anterior
4. weakness of the flexor digitorum longus

138. A physical therapist works on improving the range of motion of a patient status post total hip arthroplasty using
a posterolateral approach. The patient is having difficulty reaching their feet to don and doff their shoes
independently. Which of the following motions should be emphasized to achieve improved independence with this
skill?

1. hip flexion
2. hip medial rotation
3. knee extension
4. hip lateral rotation

139. A patient discusses surgical options to treat coronary artery disease with their physical therapist including
percutaneous transluminal coronary angioplasty (PTCA). Which of the following statements about this procedure is
NOT accurate?

1. The catheter is inserted through a peripheral artery to gain access to the coronary arteries.
2. The procedure is indicated when there is complete occlusion of the lumen of a coronary artery.
3. The placement of an endoluminal stent may be performed in conjunction with the PTCA procedure.
4. Patients can be ambulatory within hours following the procedure.

140. A physical therapist begins to suspect that a patient may have compartment syndrome secondary to significant
lower leg swelling and a decreased dorsalis pedis pulse. If compartment syndrome is present, which nerve would
MOST likely be affected?
1. tibial nerve
2. sural nerve
3. deep peroneal nerve
4. superficial peroneal nerve

141. During a family meeting in an acute rehabilitation hospital a 26-year-old male with complete C7 tetraplegia
asks a variety of questions about self care and mobility expectations. With an uncomplicated recovery, the patient
can expect lower extremity dressing to be performed with what level of assist in bed?

1. dependent
2. minimal assist
3. modified independence
4. independent

142. A physical therapist instructs a patient in a series of progressive resistive exercises designed to increase lower
extremity strength. The exercises are performed at 60% of the patient’s one-repetition maximum. The MOST
important variable to consider when scheduling the patient’s next training session is the:

1. number of repetitions in each set

2. amount of weight in one repetition maximum
3. amount of time between the sessions
4. type of resistance training (e.g., weights, resistive bands)

143. A physical therapist observes the movement of the scapula during active flexion of the humerus. Which muscle
would be MOST likely to play an active role in protracting the scapula on the thorax during this movement?

1. upper trapezius
2. serratus anterior
3. rhomboids
4. middle trapezius

144. A physical therapist reviews the medical chart of a patient in an acute care hospital. The physician’s note states
that the patient was diagnosed with the Epstein-Barr virus approximately two weeks prior to the onset of progressive
distal to proximal muscle weakness. The patient’s MOST likely diagnosis is:

1. amyotrophic lateral sclerosis

2. Guillain-Barre syndrome
3. Lyme disease
4. post-herpetic neuralgia

145. A patient diagnosed with lateral epicondylitis is referred to physical therapy. Examination findings suggest that
the patient is acutely inflamed with pain limiting both strength and range of motion. Initial treatment should
emphasize:

1. restoration of full active range of motion

2. restoration of full muscle strength in pain limited areas
3. restoration of normal proprioceptive responses
4. restoration of pain free prior level of function
146. A physical therapist reads in the medical record that a patient with cardiovascular pathology is placed on a
diuretic. Which type of laboratory test would be the MOST essential to monitor based on the patient’s prescribed
medication?

1. cardiac biomarkers
2. prothrombin time
3. serum electrolytes
4. serum cholesterol

147. A physical therapist evaluates a four-year-old child who was referred to physical therapy by his classroom
teacher. The child has difficulty keeping up with his peers on the playground and climbing the playground
equipment. Upon reviewing his medical record, the therapist notes that the child’s blood tests revealed elevated
levels of creatine kinase (CK-MM). What other finding is the therapist MOST likely to identify?

1. impaired respiratory function

2. dystonia
3. Gowers’ sign
4. lower extremity muscle contractures

148. A physical therapist works with a 65-year-old male with a diagnosis of congestive heart failure and
hypertension. Which pharmacological agent would MOST likely be prescribed based on the patient’s medical
status?

1. diuretics
2. inhaled corticosteroids
3. mucolytics
4. bronchodilators

149. A physical therapist treats a patient with chronic low back pain presenting with a flat back posture. Which of
the following would NOT characterize this abnormal posture?

1. posterior pelvic tilt

2. weak rectus abdominis
3. elongated iliopsoas
4. tight hamstrings

150. A patient rehabilitating from a stroke involving the right hemisphere exhibits figure-ground discrimination
dysfunction. Which task would likely be the MOST difficult for the patient based on the reported perceptual deficit?

1. have the patient find his way in the hospital using written directions or a map
2. have the patient attempt to identify a familiar object when it is placed on its side
3. have the patient pick forks out of a drawer of disorganized silverware
4. have the patient point to left and right body parts after receiving verbal instructions

151. An 11-month-old male is able to grasp a raisin on a table with pad to pad opposition of the thumb and index
finger.  Which form of grasp does this BEST represent?

1. palmer grasp
2. scissors grasp
3. pincer grasp
4. superior pincer grasp

152. A physical therapist works in a hospital with a patient who has methicillin-resistant staphylococcus aureus
(MRSA). When treating the patient, which infection control procedures would be the MOST appropriate?

1. work in the therapy gym, therapist wears gown and gloves

2. work in the therapy gym, therapist wears gown, gloves, and mask
3. work in the patient’s room, therapist wears gown and gloves
4. work in the patient’s room, therapist wears gown, gloves, and mask

153. A physical therapist assesses a patient’s lumbar spine range of motion.  The therapist determines that active
extension exacerbates the patient’s symptoms and flexion tends to relieve the symptoms.  This type of clinical
presentation is MOST consistent with:

1. facet joint arthropathy

2. vascular claudication
3. piriformis syndrome
4. disk herniation

154. A physical therapist begins to notice an adverse reaction less than 10 minutes after applying a dressing to a
sacral pressure ulcer. The reaction includes a rash on the dorsum of the hands, swelling, abdominal cramps,
dizziness, and bronchospasm. The MOST likely explanation is:

1. irritant contact dermatitis

2. allergic contact dermatitis
3. latex allergy
4. urticaria

155. A patient lying in supine on a mat table is asked to perform bilateral shoulder flexion.  After observing the
patient perform the described action, the physical therapist concludes that the patient has adaptive shortening of the
latissimus dorsi.  Which observation during testing would BEST support the hypothesis?

1. increased lumbar lordosis

2. decreased lumbar lordosis
3. increased thoracic kyphosis
4. decreased thoracic kyphosis

156. A physical therapist treating a patient on hemodialysis attempts to measure the intensity of an exercise activity.
The MOST appropriate method to utilize is:

1. heart rate
2. blood pressure
3. respiratory rate
4. rating of perceived exertion
157. During a treatment session, a physical therapist notices that an eight-year-old patient is demonstrating the initial
signs of a seizure while lying on a treatment table. The MOST appropriate action for the therapist to take during the
seizure is to:

1. restrain the patient’s movements to decrease the chance of injury

2. administer cardiopulmonary resuscitation
3. keep the airway open by placing an object between the patient’s teeth
4. monitor the patient’s respiratory rate

158. A patient is referred to physical therapy after being diagnosed with acute unilateral vestibular hypofunction.
Which assessment result would the physical therapist MOST likely use to confirm the diagnosis?

1. abnormal vestibulo-ocular reflex

2. abnormal result with an audiogram
3. magnetic resonance imaging showing recent transient ischemic attack of the brainstem
4. presence of vertigo with the Dix-Hallpike maneuver

159. A physical therapist passively moves a patient’s forearm away from the abdomen while stabilizing the
humerus. This action would be MOST beneficial to stretch the:

1. subscapularis
2. posterior deltoid
3. infraspinatus
4. teres minor

160. A physical therapist uses a pan splint as an intervention to diminish spasticity in the wrist flexors. Diminished
spasticity in the wrist flexors would MOST likely occur with:

1. positioning the wrist in extension to decrease activity of the agonist

2. positioning the wrist in extension to increase activity of the agonist
3. positioning the wrist in flexion to decrease activity of the agonist
4. positioning the wrist in flexion to increase activity of the agonist

161. While greeting a patient in a waiting room, a physical therapist observes that another patient appears anxious,
diaphoretic, and dyspneic. When questioned, the gentleman reports a recent onset of substernal chest pain and
nausea that he attributes to severe indigestion. The therapist, however, is concerned that signs and symptoms may
instead be indicative of:

1. myocardial infarction
2. gastroesophageal reflux disease
3. spontaneous pneumothorax
4. pulmonary embolism
162. A patient recently diagnosed with multiple myeloma is treated in physical therapy. The MOST important
activities to incorporate into treatment should focus on:

1. decreasing fatigue and fall prevention

2. decreasing edema and mobility training
3. decreasing contractures and strengthening
4. decreasing pain and increasing range of motion

163. A physical therapist reviews the results of a patient’s electromyography test. The report notes the presence of
brief contractions of single muscle fibers at rest that are not visible through the skin. This description MOST likely
characterizes which abnormal potential?

1. fibrillation potentials
2. fasciculations
3. insertional activity
4. polyphasic potentials

164. A physical therapist assesses a patient’s home to ensure it is handicap accessible. When assessing the stairs,
which characteristic would make stair navigation the MOST difficult?

1. handrails that extend 12 inches past the stairs

2. steps that are 8.5 inches high
3. steps that are 12 inches deep
4. stairs that are carpeted

165. A patient with HIV is being treated in physical therapy for general deconditioning.  The associated condition
MOST likely to increase the risk for opportunistic infection is:  

1. neutropenia
2. anemia
3. leukocytosis
4. thrombocytopenia

166. A physical therapist works with a patient referred to physical therapy for lower extremity pain and difficulty
ambulating. The patient describes her pain as throbbing, tingling, and cold. These descriptors are MOST commonly
associated with:

1. bone pain
2. myofascial pain
3. neuropathic pain
4. vascular pain

167. A physical therapist performs training with the family of a patient who recently had a cerebrovascular accident.
The patient presents with a flexor synergy pattern. Which of the following positioning recommendations is MOST
appropriate for this patient?

1. place a squeezable ball in the palm of the involved hand

2. position the involved lower extremity with the foot resting against a footboard at the end of the bed
3. elevate the involved upper extremity with the shoulder externally rotated and the elbow extended
4. position the patient in sidelying to promote scapular retraction

168. Members of a health promotion task force design a program that annually will screen individuals in selected
retirement communities for osteoporosis. Which screening tool would be the MOST cost effective and reliable to
incorporate as part of the program?

1. physical activity survey

2. dietary analysis
3. measuring height
4. urinalysis screening

169. A physical therapist administers grade III and IV joint mobilizations to a patient with a capsular restriction of
the glenohumeral joint. After returning to therapy later in the week the patient indicates that they experienced mild
discomfort in the shoulder the evening after the last session, however, the discomfort had resolved by the next
morning. The MOST appropriate action is to:

1. administer active stretching activities

2. instruct the patient in passive stretching activities
3. continue with grade III and IV mobilizations
4. contact the referring physician

170. A physical therapist is treating a patient who recently received an Unna boot.  The MOST likely rationale for
this intervention is to:

1. provide compression and promote healing

2. provide protection and promote stability
3. provide absorption and promote oxygen exchange
4. provide stretch and promote range of motion

171. A physical therapist working with a three-year-old child diagnosed with an x-linked inherited disease notes that
the patient exhibits toe walking and pseudohypertrophy of the gastrocnemius muscle. The mother indicates that the
child has a tendency to fall frequently. This type of clinical presentation is MOST consistent with:

1. Down syndrome
2. Duchenne muscular dystrophy
3. spinal muscular atrophy
4. spina bifida

172. A physical therapist works with a patient in an intensive care unit. During the session the physical therapist
hears the low pressure alarm of a mechanical ventilator. This finding would MOST likely be caused by a:

1. change in patient position

2. pneumothorax
3. leak in the ventilator circuit
4. cough
173. A physical therapist examines the foot of a patient diagnosed with plantar fasciitis by performing the Windlass
test. What would be the expected response for this test given the patient’s diagnosis?

1. pain elicited at the base of the great toe

2. pain elicited at the medial calcaneal tubercle
3. flattening of the medial longitudinal arch
4. increased height of the medial longitudinal arch

174. A 21-year-old patient with diabetes in an acute care hospital seems irritable as she begins an exercise program
in the gym. When asked about her current state, the patient informs the therapist that she has a headache and feels
fatigued. The patient’s blood glucose level is measured at 60 mg/dL. The therapist should: 

1. discontinue the physical therapy session 

2. have an insulin injection administered
3. attempt to complete the exercise program and continue to monitor the patient
4. provide a carbohydrate snack such as orange juice

175. A 64-year-old female is referred to physical therapy following a left total hip arthroplasty. The physical
therapist notes that the patient demonstrates weakness in the left gluteus medius. Which gait abnormality is MOST
likely based on the presented information?

1. ipsilateral hip hiking

2. contralateral hip hiking
3. ipsilateral hip drop
4. contralateral hip drop

176. A physical therapist makes footwear recommendations to a patient that include wearing shoes that are wider
with a large toe box and a flat heel. This type of recommendation would be MOST beneficial for a patient
diagnosed with:

1. Morton’s neuroma
2. plantar fasciitis
3. peroneal tenosynovitis
4. tarsal tunnel syndrome

177. A patient in an acute care hospital makes a sexually charged statement during a treatment session that the
therapist finds to be offensive. The therapist expresses to the patient that the comment was inappropriate, however,
in response the patient gently laughs. The MOST appropriate action is to:

1. initiate a log detailing any potential future harassment

2. explain to the patient you are serious and want the behavior to stop
3. formally report the harassment to the human resource department
4. request that the patient is reassigned to another therapist
178. A physical therapist attends patient care rounds on an inpatient burn unit and learns that a patient has been
scheduled for a grafting procedure later that day. Which of the following wounds would be the BEST candidate for
the graft?

1. a deep partial-thickness wound that is infected

2. a large superficial partial-thickness wound that is infected
3. a deep partial-thickness wound that has healed 25% in 30 days
4. a large superficial partial-thickness wound that has healed 50% in 10 days

179. A physical therapist has a patient perform a core strengthening exercise using a therapeutic ball as shown in the
image. The therapist instructs the patient to alternately lift each foot from the floor (i.e., marching). After observing
the patient attempt the exercise the therapist determines that the activity is too difficult for the patient. Which
observation would BEST support the therapist’s conclusion?

1. The patient is unable to maintain the spine in a neutral position 

2. The patient is unable to lift each foot more than three inches off of the floor
3. The patient has increased difficulty lifting the right foot compared to the left
4. The patient experiences rapid fatigue when completing a set of 10 repetitions

180. A physical therapist assess a patient’s left hamstrings length by administering the 90-90 straight leg raising test.
The therapist begins the testing procedure by positioning the patient in supine with the hips and knees flexed to 90
degrees. The next step when performing this test is to:

1. instruct the patient to actively extend the left knee

2. instruct the patient to actively extend the left knee while flexing the left hip
3. passively extend the left knee until slight resistance is felt
4. passively extend the left knee while flexing the left hip until slight resistance is felt

181. A physical therapist enters the room of a patient diagnosed with tuberculosis. Which of the following
precautions would be MOST likely?

1. airborne precautions and a negative pressure room

2. airborne precautions and a positive pressure room
3. droplet precautions and a negative pressure room
4. contact precautions
182. A physical therapist assesses a patient’s shoulder passive range of motion and finds a significant limitation in
external rotation with the shoulder abducted to 100 degrees. The therapist classifies the end-feel as firm. Which
structure is MOST likely limiting the patient’s motion?

1. superior glenohumeral ligament

2. middle glenohumeral ligament
3. inferior glenohumeral ligament
4. coracohumeral ligament

183. A physical therapist attempts to facilitate upper extremity reaching in an eight-month-old infant positioned in
supine. The infant presents with a persistent tonic labyrinthine reflex. Which of the following positions would be the
MOST likely to eliminate the influence of this reflex while achieving the therapist’s objective?

1. supine with the upper trunk on a wedge and legs over a bolster
2. supine with the legs and trunk extended
3. prone with a pillow under the abdomen
4. prone with the legs and trunk extended

184. A physical therapist reviews the medical record of a patient that is currently on bed rest secondary to a deep
vein thrombosis. The risk factor that is MOST likely to be associated with the deep vein thrombosis would be:

1. varicose veins
2. prolonged liver disease
3. total hip arthroplasty
4. tobacco use

185. A physical therapist instructs a patient rehabilitating from a knee sprain to descend stairs using axillary
crutches. Assuming the patient is partial weight bearing on the left lower extremity, the MOST appropriate
sequence would be:

1. place the crutches and left foot down, then the right foot
2. place the crutches down, right foot, then the left foot
3. place the left foot down, right foot, then the crutches
4. place the right foot down, crutches, then the left foot

186. A patient status post left CVA works on strengthening the hip abductors and adductors while positioned in
supine on a mat. The physical therapist applies resistance to the left hip adductors and notices that the patient’s right
hip spontaneously moves into adduction. This finding is MOST indicative of:

1. limb synergy
2. Souques’ phenomenon
3. Raimiste’s phenomenon
4. homolateral synkinesis

187. A 29-year-old female who recently gave birth to twins is referred to physical therapy for treatment of low back
pain. During the session the therapist identifies a four-centimeter separation of the rectus abdominis. The therapist
instructs the patient to wrap a sheet around their abdomen while performing an exercise in hooklying. Which of the
following exercises would be the MOST appropriate?
1. lower trunk rotations
2. head lifts
3. abdominal curls
4. diagonal abdominal curls

188. A 67-year-old female was recently diagnosed with congestive heart failure. The patient has a lengthy past
medical history including renal insufficiency. Which symptom was MOST likely associated with the development
of congestive heart failure based on the patient’s past medical history?

1. left ventricular hypertrophy

2. fluid overload
3. pulmonary embolism
4. valvular stenosis

189. A physical therapist asks a patient with suspected facial nerve involvement to mimic several facial expressions. 
Which muscle would be emphasized if the patient wrinkles their forehead by raising their eyebrows?

1. frontalis
2. corrugator supercilii
3. mentalis
4. zygomaticus major

190. A physical therapist prepares to make discharge recommendations for an 80-year-old who is being discharged
from an acute care hospital after an admission for pneumonia. The patient is at their prior level of function,
demonstrating modified independence with all aspects of mobility and is walking household distances using a
rolling walker. The medical record indicates that the patient has previously fallen at home. Which of the following
discharge recommendations is the MOST appropriate?

1. home with home physical therapy services

2. skilled nursing facility
3. inpatient rehabilitation hospital
4. home with outpatient physical therapy services

191. A physical therapist instructs a patient in a traditional bench press exercise using free weights. Which
modification would be the MOST beneficial to limit the amount of stress placed on the anterior capsule of the
shoulder?

1. grasp the bar with a supinated grip with the hands slightly wider than shoulder width apart
2. ensure that the elbows are fully extended at the conclusion of the upward movement
3. ensure that the bar does not contact the chest during the downward movement
4. attempt to slightly raise the head off of the bench during the upward movement

192. A physical therapist works with a 78-year-old female who sustained a stroke involving the right hemisphere
three weeks ago. The patient demonstrates apparent balance deficits, displaying a left lateral lean when seated.
When the therapist manually attempts to correct the patient's posture, she leans further to the left. The MOST
appropriate method to have the patient achieve an upright posture is to:

1. have the patient work on trunk control by sitting on a therapy ball

2. have the patient perform activities in a tandem stance position
3. use visual and auditory cues to have the patient attend to their right side
4. use a mirror so the patient can see their body orientation

193. A physical therapist reviews a medical record of a patient with diabetes insipidus. This disorder is characterized
by:

1. excessive secretion of growth hormone by the anterior pituitary gland

2. hyperglycemia secondary to insulin deficiency
3. physiologic imbalance of water secondary to antidiuretic hormone deficiency
4. elevation of body metabolism due to excessive secretion of thyroid hormone

194. A patient is unable to perform thumb opposition.  Which type of grasp would NOT be affected by this deficit?

1. cylindrical
2. pad-to-pad prehension
3. hook grasp
4. spherical grasp

195. A physical therapist elects to use proprioceptive neuromuscular facilitation (PNF) techniques to help improve a
patient’s coordination with movement. Which of the following statements is MOST consistent with the PNF
treatment approach?

1. Extremity movement patterns should occur in the cardinal planes.

2. Extremity movement patterns are named for the movement that occurs at the distal joint.
3. PNF patterns consist of unilateral extremity movements only.
4. Rotation is an important component of the movement patterns.

196. A physical therapist has a patient attempt to perform a traditional push-up as part of an upper extremity
strengthening program. After observing the patient struggle to complete the push-up, the therapist decides to modify
the exercise. The MOST appropriate modification would be to:

1. perform the exercise with the knees on the ground

2. offer manual assistance through the pelvis and shoulders
3. decrease the planned number of repetitions
4. select an alternate strengthening exercise

197. A physical therapist works with a patient who complains of joint and muscle pain. The therapist reads in the
doctor’s note that the patient has a cardiovascular condition that results in damage to the heart valves. This
description is MOST consistent with:

1. pericarditis
2. coronary artery disease
3. endocarditis
4. congestive heart failure
198. A physical therapist hypothesizes that a child diagnosed with spina bifida may be exhibiting signs of shunt
malfunction.  Which signs and symptoms would BEST support the therapist’s hypothesis?

1. increased irritability and lethargy

2. decreased tone and deep tendon reflexes
3. shallow breathing and rapid pulse
4. skin redness and rash

199. A physical therapist works with a patient following total knee arthroplasty who presents with increased knee
flexion during the stance phase of gait. Which intervention would BEST address this gait deviation?

1. isometric quadriceps setting exercises in supine with the leg positioned in extension and the heel on a towel roll
2. isometric quadriceps setting exercises in supine with a pillow under the knee
3. active knee flexion exercises in sitting
4. isometric gluteal setting exercises performed in supine