PRACTICE EXAM A

1. A patient sustained a fracture to the left proximal humerus which is now healed. Treatment is proceeding well except that with left
shoulder flexion. The therapist notices the scapula protracts and elevates early and it continues to move excessively. Physical therapy
intervention should emphasize:
a. stretching of scapular stabilizers and strengthening of the pectoralis major and minor muscles to regain muscle balance.
b. scapulothoracic mobilization and strengthening of the pectoralis major and minor muscles to regain normal scapulohumeral
rhythm.
c. glenohumeral mobilization and strengthening of scapular stabilizers to regain normal scapulohumeral movement.
d. glenohumeral mobilization, and strengthening of the rotator cuff muscles to regain muscle balance.
2. A 79 year-old ex-machinist demonstrates significant age-related hearing loss, presbycusis. When trying to communicate with this patient
the physical therapist would NOT suspect:
a. unilateral hearing loss.
b. poor auditory discrimination.
c. bilateral hearing loss at all frequencies.
d. decreased language comprehension.
3. A therapist is supervising the exercise of cardiac rehabilitation outpatient class on a very hot day, with temperatures expected to be
above 90 degrees F. The class is scheduled for 2 p.m. and the facility is not air conditioned. The strategy that is unacceptable is to:
a. decrease the exercise intensity by slowing the pace of exercise.
b. increase the warm-up period to equal the total aerobic interval in time.
c. change the time of the exercise class to early morning or evening.
d. make the exercise intermittent by adding rest cycles.
4. A patient has a transtibial amputation and has recently been fitted with a PTB socket. During initial prosthetic checkout, the physical
therapist instructs the patient to walk several times in the parallel bars and then sit down and take the prosthesis off. Upon inspection of
the skin the therapist would expect no redness in the area of the:
a. anterior tibia and tibial crest.
b. patellar tendon and tibial tuberosity.
c. medial tibial and fibular plateaus.
d. medial and lateral distal ends of the residual limb.
5. A patient who is terminally ill with cancer is in tears, unable to cope with the changes in her life and current hospitalization. The therapist
has a referral for gait training so the patient can be discharged to home under hospice care. The BEST approach is to:
a. ask the patient questions in order to obtain a detailed history.
b. ignore the tears and focus on therapy but in a compassionate manner.
c. encourage denial so she can cope better with life's challenges.
d. take time now to allow the patient to express her fears and frustrations.
6. The examination reveals muscle spasm of the piriformis, which is compressing the sciatic nerve and producing pain in the posterior hip
region. The pain has been worsening over the past three months. What is the most appropriate ultrasound setting for this case?
a. 1 MHz pulsed at 1.0 W/cm2.
b. 3 MHz continuous at 1.0 W/cm2.
c. 3 MHz pulsed at 1.0 W/cm2.
d. 1 MHz continuous at 1.0 W/cm2.
7. A patient is recovering from a complete spinal cord injury, at the level of L2. The expected outcome in this case would MOST likely
include:
a. a spastic or reflex bladder.
b. some recovery of function since damage is to peripheral nerve roots.
c. loss of motor function and pain
d. greater loss of arm function than leg function with early loss of pain and temperature sensation.
8. A patient with left hemiplegia receives a new AFO. The therapist is overwhelmed with too many patients and asks the physical therapy
student to take over. This is the student's first affiliation (second day) and has never performed an orthotic checkout for a patient with an
AFO. The supervising therapist will be in the same vicinity treating other patients. This task should be:
a. delegated to the student who could call out to the supervisor if problems arose.
b. delegated to another physical therapist.
c. delegated to the physical therapist assistant who is working nearby.
d. not be completed now and the patient sent back to his room.
9. A patient has been diagnosed with acute synovitis of the temporomandibular joint. Early intervention might best focus on:
a. application of an intraoral appliance and phonophoresis.
b. joint mobilization and postural awareness.
c. instruction to eat a soft food diet and phonophoresis.
d. temporalis stretching and joint mobilization.
10. During a cervical spine examination the therapist observes restricted left rotation of the C7-T1 spinal level. After stabilizing the thoracic
spine, the therapist's hand placement for mobilization to improve left rotation should be at the:
 a. posterior right C7 articular pillar.
b. posterior left C7 articular pillar.
c. T1 spinous process.
d. posterior left C6 articular pillar.
11. An appropriate fine motor behavior that should be established by 9 months of age would be the ability to:
a. pick up a raisin with a fine pincer grasp.
b. build a tower of 4 blocks.
c. hold a cup by the handle while drinking.
d. transfer objects from one hand to another.
12. A patient with a 10 year history of Parkinson's disease has been taking L-dopa for the last 5 years. The patient presents with deteriorating
function and is no longer able to transfer or walk independently. During a physical therapy session, the therapist observes facial
grimacing with twitching of the lips and tongue protrusion. The patient appears restless, with constant dancing, athetoid-like movements
of his legs. The therapist's BEST course of action is to:
a. complete the treatment session, focusing specifically on examining the effects of rigidity.
b. document observations and refer the patient back to the physician for evaluation of possible levodopa toxicity.
c. talk to the spouse to see if the patient is taking any drugs with hallucinogenic effects such as selegiline.
d. examine for additional signs of chronic levodopa therapy such as dizziness and headache.
13. A patient who is to undergo surgery for a chronic shoulder dislocation asks the therapist to explain the rehabilitation following a
scheduled surgical reconstructive procedure. The therapist's BEST response is to:
a. explain in detail about the surgical procedure.
b. tell the patient to ask the surgeon for information about the procedure and appropriate rehabilitation.
c. explain how patients typically respond to the surgery and outline the progression of exercises.
d. refer the patient to a physical therapy clinical specialist who is an expert of shoulder reconstructive rehabilitation.
14. Which of the following is NOT an appropriate reason to terminate a maximum exercise tolerance test for a patient with pulmonary
dysfunction?
a. ECG monitoring reveals diagnostic ischemia.
b. patient states he is maximally short of breath.
c. PaO2 decreases 20 mmHg.
d. patient reaches age-predicted maximal heart rate.
15. A patient with a complete T10 paraplegia is receiving his initial ambulation training. He has received bilateral Craig-Scott knee-ankle-foot
orthoses and is being trained with axillary crutches. Since a reciprocal gait pattern is problematic for him, the BEST initial gait pattern to
teach him is:
a. four-point.
b. swing-to.
c. two-point.
d. swing-through.
16. After mastectomy, a patient receiving home care, cannot accept the loss of her breast. She reports being weepy all the time with loss of
sleep. She is constantly tired and has no energy to do anything. The BEST action the therapist can take is:
a. contact her primary physician and request a psychological consult.
b. tell the nurse case manager to monitor the patient closely.
c. tell her depression is common at first, but will resolve with time.
d. have her spouse observe her closely for possible suicidal tendencies.
17. A college volleyball player complains of moderate pain resulting from a left hamstring strain four weeks ago. The focal point of pain and
tightness is noted where a hematoma developed initially. The specific massage technique that would be MOST beneficial in this case is:
a. stroking.
b. kneading.
c. tapotement.
d. friction.
18. A six year-old boy born with myelomeningocele at the L2 level is referred for physical therapy treatment at home. In determining the plan
of care, it would NOT be appropriate to emphasize:
a. upper extremity strengthening with weights.
b. gait training with a reciprocating gait orthosis.
c. vigorous range of motion of the lower extremities.
d. transfer training from floor to wheelchair.
19. During an examination of a patient who complains of back pain, the physical therapist notes pain with end range AROM into left hip
flexion, abduction and external rotation. The origin of the pain is MOST likely the:
a. sartorius muscle.
b. sacroiliac joint.
c. left kidney.
d. capsule of the hip joint.
20. A therapist wants to compare frequencies of carpal tunnel syndrome occurring in different groups of individuals: assembly line workers
and computer programmers. The MOST appropriate statistical tool to use for analysis of the data is:
a. simple one-way ANOVA.
b. t test.
c. normal distribution curve.
d. chi square test.
21. In a research study in which there is a skewed distribution with extreme scores on a balance measure that deviate from the performance
of the total group, the MOST accurate representation of central tendency is:
a. mean.
b. mode.
c. median.
d. standard deviation.
22. A factory worker injured the right arm in a factory press with damage to the ulnar nerve at the elbow. A diagnostic EMG was performed
with evidence of spontaneous fibrillation potentials. In this case, the physical therapy plan of care should consider that:
a. denervation atrophy has occurred.
b. reinnervation is complete.
c. axonotmesis is occurring.
d. reinnervation is in process.
23. A patient is recovering from a right CVA resulting in severe left hemiplegia and visuospatial deficits. Additionally, there is a large diabetic
ulcer on the left foot with pitting edema. The MOST appropriate wheelchair prescription for this patient would be a:
a. hemiplegic chair with elevating legrest on the left.
b. powered wheelchair with joystick and elevating legrests.
c. lightweight active duty wheelchair with elevating legrests.
d. one-arm drive chair with elevating legrest on the left.
24. A 14 year-old boy with advanced Duchenne muscular dystrophy is administered a pulmonary function test. The value that is UNLIKELY to
show any deviation from normal is:
a. vital capacity.
b. FEV1.
c. functional residual capacity.
d. total lung capacity.
25. A patient fractured the right midtibia in a skiing accident three months ago. After cast removal, a severe foot drop was noted. The patient
desires to try electrical stimulation orthotic substitution. The physical therapist would set up the functional electrical stimulation to
contract the appropriate muscles during:
a. push off.
b. swing phase.
c. foot flat.
d. toe off.
26. A physical therapist has a small open wound on the back of the hand. The therapist is scheduled to treat a patient with HIV for
management of a wound. The therapist should:
a. double glove and treat as scheduled.
b. use sterile precautions with mask and gloves.
c. continue with treatment as scheduled but wash hands thoroughly before and after.
d. refuse to treat that patient.
27. A home care therapist is treating a patient who underwent a total hip replacement four weeks ago. The therapist notices that the patient
arches his lumbar spine when lying supine. The patient states that this is uncomfortable and doesn't remember having the problem
before. The patient is most likely unable to maintain a comfortable supine position due to:
a. tight hamstrings muscles.
b. tight iliopsoas muscle.
c. poor abdominal strength.
d. tight piriformis muscle.
28. An elderly patient has been hospitalized for the past three days with pneumonia. The physician is being pressured to discharge her
tomorrow. The patient lives with her sister in a first floor apartment. The physical therapist has determined her ambulation endurance to
be only up to 15 feet, not enough to allow her to get from her bed to the bathroom (a distance of 20 feet). The therapist should
recommend:
a. postponing her discharge until she can walk 20 feet.
b. a skilled nursing facility placement until her endurance increases.
c. a bedside commode, and referral for home health services.
d. outpatient physical therapy until her condition improves.
29. A therapist examines a patient with a right CVA and determines the patient has a profound deficit of homonymous hemianopsia. The
BEST initial strategy to assist the patient in compensating for this deficit is to:
 a. teach the patient to turn the head to the affected left side.
b. provide constant reminders, printed notes on the left side, telling the patient to look to the left.
c. place items, eating utensils on the left side.
d. rearrange the room so while in bed the left side is facing the doorway.
30. A patient with multiple sclerosis exhibits moderate fatigue during a 30 minute exercise session. When the patient returns for the next
regularly scheduled session 2 days later, the patient reports that she went home after the last session and went right to bed. The patient
was so exhausted she was unable to get out of bed until the late afternoon of the next day. The therapist's BEST strategy is to:
a. treat the patient in a warm, relaxing environment.
b. utilize a massed practice schedule.
c. utilize a distributed practice schedule.
d. utilize a distributed practice schedule.
31. A 72 year-old medically stable individual requires custodial care in the home. She is severely disabled with rheumatoid arthritis and is in a
great deal of pain. She presents with significant deformities which limit her functional abilities and is dependent in all basic activities of
daily living. A recent exacerbation of her disease has left her bed-bound for the past 2 weeks. Appropriate physical therapy services
would be covered by:
a. Medigap policies.
b. Medicaid.
c. Medicare.
d. only by HMO or private insurance policies.
32. A patient with a venous stasis ulcer near the left medial malleolus is referred for physical therapy. Skin changes consistent with stasis
dermatitis are evident in the lower leg. Physical exam reveals patent femoral, popliteal, and pedal pulses. An enlarged and dilated greater
saphenous vein is evident in the standing position. The MOST important physical therapy intervention to consider for this patient is:
a. daily walking for 30-60 minutes.
b. elastic wraps and daily exercises.
c. elastic wraps and daily exercises.
d. compression therapy with exercise.
33. The test taker must evaluate each treatment approach and determine which one will, most likely, result in improvement of the venous
stasis ulcer. One must understand the nature of stasis ulcers and how they respond or do not respond to each of the treatment
approaches. In this type of question, knowledge plus clinical judgment is used to arrive at the correct answer.
a. weakness or contracture of hip extensors.
b. spasticity or contracture of the plantar flexors.
c. spasticity of the anterior tibialis muscle.
d. weakness or contracture of the dorsiflexors.
34. With a traction injury to the anterior division of the brachial plexus the therapist would expect to see weakness of the elbow flexors, wrist
flexors and forearm pronators. The therapist would also expect to find additional weakness in:
a. wrist extension.
b. forearm supination.
c. thumb abduction.
d. lateral rotation of the shoulder.
35. A 95 year-old has recently been admitted to a skilled nursing facility following a fall-related injury (fractured hip with open reduction,
internal fixation). Since she lived alone on the second floor, she was unable to return home. She is extremely agitated over her placement
here and demonstrates early signs of dementia. She tells the therapist “leave me alone, I just want to get out of here!” An important
approach to take while working with this client is to:
a. tell her clearly and firmly what she is going to do in therapy.
b. be calm and supportive, and use only one- or two-level commands.
c. minimize verbal communication and maximize guided movements.
d. promise her anything to calm her down, as long as she gets up and walks.
36. A 72 year-old woman is being treated for depression following the death of her husband. She is currently taking antidepressant
medication (tricyclics) and has a recent history of a fall. The therapist suspects the precipitating cause of the fall is her medication as it
can cause:
a. hyperalertness.
b. cardiac arrhythmias.
c. dyspnea.
d. postural hypotension.
37. A patient and his caregivers should understand the common side effects of the medication that he is taking. He has Class III heart disease
and is continually in and out of congestive heart failure. He is taking digitalis (Digoxin) to improve his heart function. The therapist will
know he and his caregivers understand the adverse side effects of this medication if they relate that they will contact the patient's
physician if he demonstrates:
a. confusion and memory loss.
b. slowed heart rate.
 c. lnvoluntary movements and shaking.
d. weakness and palpitations.
38. The director of physical therapy from a large teaching hospital is asked to develop an operating budget for the upcoming fiscal year. The
item that would NOT be included in an operating budget is:
a. a treadmill purchase.
b. housekeeping supplies.
c. long distance telephone calls.
d. equipment maintenance.
39. A physical therapist is treating a patient with active hepatitis B infection. Transmission of the disease is best minimized if the therapist:
a. washes hands before and after treatment.
b. has the patient wear a gown and mask during treatment.
c. wears gloves during any direct contact with blood or body fluids.
d. has the patient wear gloves to prevent direct contact with the therapist.
40. A patient complains of pain (7/10) and limited range of motion of the right shoulder as a result of chronic overuse. The therapist elects to
use procaine hydrochloride iontophoresis as part of physical therapy intervention for this patient's problems. To administer this
substance, it would be appropriate to use:
a. continuous biphasic current with the medication under the anode.
b. continuous monophasic current with the medication under the anode.
c. continuous monophasic current with the medication under the cathode.
d. interrupted biphasic current with the medication under the cathode.
41. A contraindication to initiating joint mobilization on a patient with chronic pulmonary disease may include:
a. reflex muscle guarding.
b. long term corticosteroid therapy.
c. concurrent inhalation therapy.
d. functional chest wall immobility.
42. Long term care for institutionalized elderly who have reduced their financial resources to qualify for low-income status is typically funded
by:
a. Medicare.
b. Health Maintenance Organizations.
c. Medicaid.
d. Social Security Administration.
43. A computer programmer, with no significant past medical history, presents to the emergency room with complaints of fever, shaking
chills and a worsening productive cough. Complaints of chest pain over the posterior base of the left thorax is made worse on inspiration.
An anterior-posterior X-ray shows an infiltrate on the lower left thorax at the posterior base. This patient's chest pain is MOST likely
caused by:
a. inflamed tracheobronchial tree.
b. angina.
c. trauma to the chest.
d. infected pleura.
44. Equipment safety is essential in all physical therapy clinics. Regularly scheduling equipment maintenance programs to ensure that all
equipment is calibrated, lubricated, and adjusted according to manufacturer's guidelines is an important element for patient and staff
safety. The procedure that is not part of routine equipment safety is:
a. training all staff to do “simple” repairs on all electrical equipment if a breakdown should occur.
b. supervising new staff and students in the use of all newly purchased equipment.
c. documenting all preventive maintenance and keeping this information on file.
d. conducting educational sessions for staff regarding the indications and contraindications for all equipment.
45. A 92 year-old patient presents with hot, red, and edematous skin over the shins of both lower extremities. The patient also has a mild
fever. The MOST likely cause of the symptoms is:
a. dermatitis.
b. cellulitis.
c. herpes simplex infection.
d. scleroderma.
46. A 10 year-old presents with pain (4/10) and limited knee ROM (5-95 degrees) following surgical repair of the medial collateral ligament
and anterior cruciate ligaments. In this case, the modality which can be used with PRECAUTION is:
a. premodulated interferential current.
b. continuous shortwave diathermy.
c. high rate transcutaneous electrical stimulation.
d. low dose ultrasound.
47. A weight lifter exhibits marked hypertrophy after embarking on a strength training regime. Hypertrophy can be expected to occur
following at least:
 a. 1-2 weeks of training.
b. 3-4 weeks of training.
c. 2-3 weeks of training.
d. 6-8 weeks of training.
48. A diagnosis of bicipital tendinitis has been made following an evaluation of a patient with shoulder pain. The BEST shoulder position to
expose the tendon of the long head of the biceps for application of phonophoresis would be:
a. external/lateral rotation and extension.
b. internal/medial rotation and abduction.
c. horizontal adduction.
d. abduction.
49. A patient is unable to bring her foot up on the next step during a training session on stair climbing. The physical therapist's BEST course of
action to promote learning of this task is to have the patient:
a. practice marching in place in the parallel bars.
b. practice standing-up from half-kneeling.
c. step up onto a low step while in the parallel bars.
d. balance on the stairs while the therapist passively brings the foot up.
50. A 76 year-old patient exhibits impaired balance. A diagnostic work-up has failed to reveal any specific etiology. An initial intervention for
this patient would NOT include:
a. limits of stability re-education including postural sway training.
b. sit-to-stand and stand-to-sit activity training.
c. practice in maintenance of a wide base of support during turning.
d. tandem walking and single limb stance.
51. A patient with a complete spinal cord injury at the T6 level is being discharged home after a 2 month course of rehabilitation. In
preparation for discharge, the rehabilitation team visits the home and finds 3 standard height steps going into his home. A ramp will have
to be constructed for wheelchair access. The recommended length of his ramp should be:
a. 60 inches (5 feet).
b. 192 inches (16 feet).
c. 252 inches (21 feet).
d. 120 inches (10 feet).
52. Chronic pulmonary changes following a left pneumonectomy would include all of the following except:
a. decreased residual volume.
b. increased tidal volume.
c. deviated trachea toward the left.
d. decreased breath sounds on the left.
53. A patient with diagnosis of left-sided heart failure (CHF), Class II, is referred for physical therapy. With exercise, this patient can be
expected to demonstrate:
a. severe, uncomfortable chest pain with shortness of breath.
b. weight gain with dependent edema.
c. anorexia, nausea with abdominal pain and distention.
d. dyspnea with fatigue and muscular weakness.
54. A physical therapist is instructing a student in proper positioning to prevent the typical contractures in the patient with a transfemoral
amputation. The therapist stresses positioning the patient in:
a. prone lying with the residual limb in neutral rotation.
b. a wheelchair with a gel cushion and adductor roll.
c. supine-lying with the residual limb resting on a small pillow.
d. sidelying on the residual limb.
55. A physical therapist receives a referral to ambulate a patient who is insulin dependent. In a review of her medical record, the therapist
notices her blood glucose level for that day is 310 mg/dL. The therapist's BEST course of action is to:
a. refrain from ambulating the patient, reschedule for tomorrow before other therapies.
b. ambulate the patient as planned but monitor closely for signs of exertional intolerance.
c. postpone therapy and consult with the nurse as soon as possible.
d. talk to the nurse about walking the patient later on that day after lunch.
56. A physical therapy plan of care for a newborn with Erb-Klumpke's Palsy would NOT include:
a. partial immobilization of limb across abdomen.
b. gentle ROM after immobilization.
c. age appropriate movements of the upper extremity.
d. splinting the shoulder in abduction and internal rotation.
57. A six month-old child was referred to physical therapy for right torticollis. The MOST effective method to stretch the muscle is by
positioning the head and neck into:
a. flexion, left side-bending, and left rotation.
 b. extension, right side-bending, and left rotation.
c. flexion, right side-bending, and left rotation.
d. extension, left side-bending, and right rotation.
58. A student is on final internship following completion of academic training. The student is overheard discussing a patient's history in the
elevator. When the therapist later points this out the student claims to be unaware of any hospital policy regarding confidentiality. The
therapist's BEST analysis of this situation is that:
a. the student should be expected to value patient confidentiality.
b. compliance was not a realistic expectation since the student had recently arrived at this facility.
c. now that the student is aware of confidentiality restrictions compliance is expected.
d. since this is not strictly part of the professional code of ethics the student should not be expected to demonstrate adherence to
this concept.
59. A physical therapist is performing clinical research in which a specific myofascial technique is applied to a patient with chronic back pain.
She is using a single case experimental design with an A-B-A-B format. Her research hypothesis states that pain rating scores will decrease
with the treatment intervention. Acceptance of this hypothesis would be indicated if:
a. B is equal to A.
b. B is greater than A, at the 1.0 level.
c. B is less than A.
d. B is greater than A, at the .05 level.
60. A patient is recovering from stroke and demonstrates good recovery in his lower extremity (out-of-synergy movement control). Timing
deficits are apparent during gait. Isokinetic training can be used to improve:
a. rate control at slow movement speeds.
b. rate control at varying movement speeds.
c. both reaction and movement times.
d. initiation of movement.
61. A 72 year-old patient with a transfemoral amputation is having difficulty wrapping the residual limb. The therapist's BEST course of action
is to:
a. use a shrinker.
b. redouble efforts to teach proper ace bandage wrapping.
c. apply a temporary prosthesis immediately.
d. consult with the vascular surgeon about the application of an Unna's paste dressing.
62. A patient with peripheral vascular disease has been referred for conditioning exercise. The patient demonstrates moderate claudication
pain in both legs following a 12 minute walking test. The MOST appropriate exercise frequency and duration for this patient is:
a. 3 times/week, 30 minutes/session.
b. 3 times/week, 60 minutes/session.
c. 2 times/week, BID 20 minutes/session.
d. 5 times/week, BID 10 minutes/session.
63. The radiographic view shown in the diagram that demonstrates the observed spinal defect is:
a. lateral.
b. Frontal
c. Oblique
d. Posterolateral
64. A physical therapist is working with a patient with metastatic breast cancer who has been told that she has only months to live. She is
quite angry and disruptive during therapy. What is the MOST appropriate intervention for this patient?
a. forbid all expressions of anger as she is only hurting herself.
b. provide honest, accurate information about her illness and rehab plan of care.
c. allow the patient to express her anger while refocusing her on effective coping strategies.
d. provide opportunities for the patient to question her impending death but limit all expressions of anger.
65. A patient sustained a right-sided injury to her back while playing golf. She was driving the ball when she felt an immediate sharp pain in
her right low back. She states that in the morning she is stiff and her pain eases after taking a shower. Based on the above information,
the source of the pain is MOST likely:
a. nerve root compression.
b. facet joint impingement.
c. a stress fracture.
d. diminished blood supply to the spinal cord.
66. At 10 a.m. a physical therapist working on an inpatient spinal cord unit is treating a patient with paraplegia. The therapist smells alcohol
on the patient's breath. The patient is having difficulty accomplishing a bed-to-chair transfer that was previously done without assistance.
In this case the therapist should:
a. confront the patient and ask if he has been drinking.
b. document and report suspicions of alcoholism to the rehabilitation team at the weekly meeting.
c. immediately inform the nurse in charge who can then speak with the patient.
 d. document the findings and immediately inform the patient's physician about the situation.
67. A patient with right hemiparesis has difficulty clearing the more affected foot during the swing phase of gait. An appropriate physical
therapy intervention for the right lower extremity might include:
a. sitting on a therapy ball, alternating lateral side steps and back to neutral.
b. pushing backward while sitting on a rolling stool.
c. forward step-ups in standing using graduated height steps.
d. assumption of bridging.
68. A patient has a complete spinal cord injury at the level of L1. His primary goal is to walk again. The physical therapist decides it would be
MOST appropriate to recommend that this patient use:
a. a reciprocating gait orthosis and walker.
b. a wheelchair, because ambulation is unrealistic.
c. bilateral KAFOs with thoracolumbosacral extension control.
d. bilateral AFOs and Lofstrand crutches.
69. A patient is four weeks post myocardial infarction. Resistive training using weights to improve muscular strength and endurance is
appropriate:
a. if exercise intensities are kept below 85% maximal voluntary contraction.
b. if exercise capacity is greater than 5 METs with no anginal symptoms/ST segment depression.
c. during all phases of rehabilitation if judicious monitoring of HR is used.
d. only during post-acute phase 3 cardiac rehabilitation.
70. A patient diagnosed with lumbar spinal root impingement, due to narrowing of the intervertebral foramen, has been referred to physical
therapy for mechanical traction. What is the lowest percentage of body weight that should be considered for the initial traction force?
a. 25%.
b. 15%.
c. 55%.
d. 85%.
71. A fitness instructor who is 8 months pregnant was recently diagnosed with placenta previa. The therapist's most important instructions to
her are to:
a. continue proper breathing and discontinue pelvic floor exercises.
b. continue pelvic floor and discontinue any abdominal exercises.
c. continue with partial sit-ups and pelvic floor exercises.
d. continue with training in a therapeutic pool at waist-deep level.
72. It is important to note the status of the pars interarticularis on the X-ray report. A problem with this part of the vertebra could possibly
lead to:
a. spondylolysis with early degeneration of the vertebra.
b. spondylolysis resulting in early nerve root compression.
c. spondylolisthesis with possible slippage of the vertebral body.
d. spondylolisthesis with discal herniation.
73. The most appropriate physical therapy intervention to use during class for a 9 year-old child with decreased sitting balance, but normal
tone would be:
a. sitting on a therapy ball while performing desk-top activities.
b. sitting in an adaptive wheelchair with lateral supports and lap tray.
c. standing on a static prone-stander with lap tray.
d. sitting in an appropriate height chair with with lateral postural supports.
74. A patient with Parkinson's disease demonstrates a highly stereotyped gait pattern characterized by impoverished movement. The
intervention that would be LEAST appropriate to use with this patient is:
a. standing, using body weight support from a harness.
b. sidestepping and cross stepping using light touch-down support of hands.
c. gait training using a rolling walker.
d. rhythmic stepping using a motorized treadmill.
75. A patient is recovering from a right CVA. She tells the physical therapist that she is thirsty and asks for a can of soda. When the therapist
gives her the can and instructs her to open it, she is unable to complete the task. Later after the treatment session when she is alone, the
therapist observes her drinking from the can. The therapist suspects she may have a primary deficit in:
a. anosognosia.
b. ideational apraxia.
c. unilateral neglect.
d. ideomotor apraxia.
76. Peer review is an important professional activity. Recently, physical therapists have been the focus of vigorous peer review due to
increasing financial pressure imposed by third party payers. An inappropriate use of peer review is to determine whether care:
a. should be paid for by a third party payer.
b. was appropriate and required the skill of a physical therapist.
 c. was appropriate and required the skill of a physical therapist.
d. was provided by the appropriate personnel.
77. A 62 year-old patient has chronic obstructive pulmonary disease. Pulmonary test results include aldistolateral end of femur and ischial
seat.l of the following except increased:
a. total lung capacity.
b. FEV1/FVC ratio.
c. residual volume.
d. functional residual capacity.
78. A patient with a transfemoral amputation has been fitted with a prosthesis that utilizes a quadrilateral socket. During prosthetic checkout
the physical therapist should examine pressure tolerance areas of the residual limb with the device off. These include:
a. ischial tuberosity and lateral sides of residual limb.
b. adductor magnus and medial side of residual limb.
c. distolateral end of femur and ischial seat.
d. perineal area and medial side of the residual limb.
79. A patient recently diagnosed with fibromyalgia and chronic fatigue immune system dysfunction demonstrates a loss of interest in all
activities and outlets. She is not eating well and is having problems sleeping. Recently she has talked about suicide as her only hope. The
therapist's BEST course of action is to:
a. present a positive attitude and tell her she will feel better soon.
b. refer her to a fibromyalgia support group.
c. refer her to an occupational therapy intervention group.
d. immediately contact her primary physician.
80. A 77 year-old patient has been confined to bed for a period of 2 months and now demonstrates limited ROM in both lower extremities.
Range in hip flexion is 5º to 115º and knee flexion is 10º to 120º. The MOST appropriate intervention to improve flexibility and ready this
patient for standing is:
a. manual passive stretching, 10 repetitions each joint, 2 times a day.
b. tilt table standing, 20 minutes, daily.
c. mechanical stretching using traction and 5 lb. weights, 2 hours, twice daily.
d. hold-relax techniques followed by passive ROM, 10 repetitions, 2 times a day.
81. A retired carpenter has had long term lumbar pain and has been diagnosed with degenerative joint disease (DJD) of his lumbar facet
joints. He complains of numbness, paresthesias and weakness of his bilateral lower extremities which increase with extended positions or
walking greater than 100 feet. His pain persists for hours after assuming a resting position. He reports he can ride his stationary bike for
30 minutes without any problems. Physical therapy intervention should include:
a. increasing cardiovascular endurance as the result of degenerative arthritis.
b. stretching and limiting extended spinal positions as the result of spinal stenosis.
c. abdominal and back extension strengthening as the result of spondylolysis.
d. traction and limitation of weight bearing positions as the result of discal dysfunction.
82. A physical therapist is instructing a kindergarten teacher in a behavior management program for a child with developmental disabilities
who has been mainstreamed into the regular classroom. The therapist requests that the teacher encourage the child to maintain a head
retracted sitting position in the class. The strategy that would be MOST helpful in this situation is to:
a. have the teacher give a smile sticker when the child sits with head retracted for two minutes.
b. train the teacher in manual handling techniques to assist the child in head retraction.
c. have the teacher issue a verbal reprimand whenever the child slumps in the chair.
d. have the teacher encourage the classmates to tell the child to sit up in the chair.
83. A physical therapist has recently attended a professional conference on myofascial release. The therapist has been asked to share this
information with PT colleagues during an inservice session. The therapist's BEST initial activity is to:
a. ask colleagues to select a suitable time and place for the physical therapist's lecture.
b. provide a comprehensive packet of handouts in advance of the first inservice session.
c. organize a PowerPoint presentation and prepare a handout.
d. survey colleagues about their current level of knowledge using a brief questionnaire.
84. A patient who is 3 months post CVA is being treated in physical therapy for adhesive capsulitis of the right shoulder, Today, the patient
complains of new symptoms including burning pain in the right upper extremity that is increased by the dependent position along with
lowered pain threshold and heightened sensitivity to light touch. The right hand is mildly edematous and the skin is dry and warm to
touch. The intervention that should be AVOIDED in this case is:
a. stress loading activities with weightbearing on the affected limb.
b. passive manipulation of the shoulder.
c. positional elevation, compression, and gentle massage.
d. active assistive ROM exercises of the shoulder.
85. To prepare a patient with an incomplete T12 paraplegia for ambulation with crutches, the upper quadrant muscles that would be MOST
important to strengthen include the:
a. upper trapezius, rhomboids, and levator scapulae.
 b. deltoid, triceps, and wrist flexors.
c. middle trapezius, latissimus dorsi, and triceps.
d. lower trapezius, latissimus dorsi, and triceps.
86. A patient is recovering at home from a myocardial infarction and percutaneous transluminal coronary angioplasty. The physical therapist
decides to use pulse oximetry to monitor his responses to exercise and activity. An acceptable oxygen saturation rate (SaO2) to maintain
throughout the exercise period is:
a. 82%.
b. 75%.
c. 92%
d. 85%
87. Following major surgery of the right hip, a patient ambulates with a Trendelenburg gait. Examination of the right hip reveals abductor
weakness and ROM limitations in flexion and external rotation. As part of the intervention, the therapist opts to include functional
electrical stimulation to help improve the gait pattern. Stimulation should be initiated for the:
a. right abductors during swing on the right.
b. rIght abductors during stance on the right.
c. left abductors during stance on the right.
d. left abductors during swing on the right.
88. A patient was referred to physical therapy complaining of loss of cervical AROM. His X-rays showed DJD at the uncinate processes in the
cervical spine. The motion that would be MOST restricted would be:
a. flexion.
b. extension.
c. rotation.
d. side-bending.
89. An electrician is unable to pull wire overhead due to a painless inability to reach past 80 degrees of right shoulder abduction. The ‘empty
can' test was positive. Early subacute physical therapy intervention should focus on:
a. active assistive pulley exercises.
b. modalities to reduce pain and inflammation.
c. grade IV translatory glenohumeral mobilizations.
d. resistance exercises for the affected muscles.
90. Two therapists are asked to perform a test on the same group of patients using the Functional Independence Measure (FIM). The results
of both sets of measurements reveal differences in therapists' scores but not in the repeat measurements. This is indicative of a problem
in:
a. concurrent validity.
b. intrarater reliability.
c. interrater reliability.
d. construct validity.
91. A patient is recovering from a complete spinal cord injury with C5 tetraplegia. The physical therapist is performing PROM exercises on the
mat when the patient complains of a sudden pounding headache and double vision. The therapist notices he is sweating excessively, and
determines his BP is 240/95. The therapist's BEST course of action is to:
a. lie the patient down immediately, elevate his legs, then call for a nurse.
b. place the patient in a supported sitting position and continue to monitor BP before calling for help.
c. sit the patient up, check/empty catheter bag, and then call for emergency medical assistance.
d. lie the patient down, open his shirt, and monitor his respiratory rate closely.
92. A patient presents with a flatfoot deformity with abduction of the forefoot in relation to the weight bearing line. The forefoot is inverted
to the varus position when inspected from the frontal plane. Corrections for this foot deformity would NOT include a:
a. UCBL insert.
b. scaphoid pad.
c. thomas heel.
d. metatarsal bar.
93. A 10-year old child with full thickness burns to both arms is developing hypertrophic scars The BEST intervention to manage these scars
is:
a. primary excision followed by autografts.
b. application of custom made pressure garments.
c. application of compression wraps.
d. application of occlusive dressings.
94. A patient with COPD has developed respiratory acidosis. The physical therapist instructs a PT student participating in the care to monitor
the patient closely for:
a. disorientation.
b. tingling or numbness of the extremities.
c. dizziness or lightheadedness.
 d. hyperreflexia.
95. A computer programmer who in her second trimester of pregnancy was referred to physical therapy with complaints of tingling and loss
of strength in both of her hands. Her symptoms are exacerbated if she is required to use her keyboard at work for longer than 20
minutes. The MOST appropriate physical therapy intervention would include:
a. dexamethasone phonophoresis to the carpal tunnel.
b. ice packs to the carpal tunnel.
c. hydrocortisone iontophoresis to the volar surfaces of both wrists.
d. placing the wrists in resting splints.
96. A physical therapist is working in an elementary school system with a child who demonstrates moderate to severe extensor spasticity and
limited head control. The MOST appropriate positioning device would be a:
a. wheelchair with adductor pommel.
b. wheelchair with a back wedge and head supports.
c. supine stander with abduction wedge.
d. prone stander with abduction wedge.
97. A patient with complete C6 tetraplegia should be instructed to initially transfer with a sliding board using:
a. shoulder depressors and triceps, keeping the hands flexed to protect tenodesis grasp.
b. pectoral muscles to stabilize elbows in extension and scapular depressors to lift the trunk.
c. shoulder extensors, external rotators, and anterior deltoid to position and lock the elbow.
d. serratus anterior to elevate the trunk with elbow extensors stabilizing.
98. A physical therapist volunteered to teach a stroke education class on positioning techniques for family members and caregivers. There
will be 12 individuals attending this class, ranging in age from 42 to 82. The therapist's BEST choice of teaching methods is to utilize:
a. demonstration, practice, and follow-up discussion.
b. rotating through the class for one-on-one practice with adequate knowledge of results.
c. multimedia (PowerPoint and handouts) that accompany an oral presentation.
d. lecture about the principles and contraindications of positioning with some time for questions at the end.
99. A patient with active tuberculosis is referred for physical therapy. Which of the following is NOT an appropriate precaution?
a. have the patient wear a tight fitting mask while being treated in his room.
b. wash hands upon entering and leaving the patient's room.
c. wear a tight fitting mask while treating the patient.
d. insure that the patient is in a private, negative pressurized room.
100. A twelve-year old has been referred to a physical therapy clinic for treatment of patellar tendinitis. The examination reveals that she is
unable to hop on the affected lower extremity due to pain. The physical therapist decides to refer her back to her pediatrician for an x-ray
of her knee. The patient returns for therapy with the x-ray shown in the figure. The therapist's initial intervention should focus on:
a. aggressive plyometric exercises with focus on endurance training.
b. Iontophoresis using dexamethasone and patient education regarding avoidance of squatting and
jumping activities.
c. fitting patient with crutches for non weight-bearing ambulation and initiation of hydrocortisone
phonophoresis.
d. patient education regarding avoiding falls onto her affected knee and open chain knee extension
exercises to improve quadriceps strength
101. A patient with a history of low back pain has been receiving physical therapy for 12 weeks. The patient is
employed as a loading dockworker. He performs repetitive lifting and carrying of boxes weighing between 15 and 30 pounds. An
appropriate engineering control to reduce the stresses of lifting and carrying would be to:
a. use job rotation.
b. issue the employee a back support belt.
c. require the worker to attend a class in using correct body mechanics while performing the job.
d. provide a two-wheel handcart for use in moving the boxes.
102. Common compensatory postures the therapist would expect for a patient diagnosed with fixed severe forefoot varus are:
a. subtalar pronation and medial rotation of the tibia.
b. excessive ankle dorsiflexion and medial rotation of the femur.
c. excessive midtarsal supination and lateral rotation of the tibia.
d. toeing-in and lateral rotation of the femur.
103. A patient has undergone surgery and subsequent immobilization to stabilize the olecranon process. The patient now exhibits an elbow
flexion contracture. In this case, an absolute CONTRAINDICATION for joint mobilization would be:
a. soft end-feel.
b. springy end-feel.
c. empty end-feel.
d. firm end-feel.
104. A physical therapist observes a physical therapist assistant ambulating a patient for the first time after a left total hip replacement. The
patient is using crutches and is practicing on a level surface. The PTA should guard the patient by standing slightly:
 a. behind and to the intact side, one hand on the gait belt.
b. in front of the patient, walking backward, with one hand on the gait belt and one hand on the shoulder.
c. behind and to the left side, one hand on the gait belt.
d. behind the patient with both hands on the gait belt.
105. A patient with left hemiplegia exhibits mild flexor pattern of shoulder internal rotation with elbow and wrist flexion. Following initial
interventions, the therapist decides to use functional electrical stimulation to help reach and grasp ability. The optimal stimulation
pattern would be:
a. elbow and wrist extensors simultaneously.
b. elbow extensors followed by wrist extensors.
c. elbow extensors and finger flexors simultaneously.
d. elbow extensors followed by finger flexors.
106. A patient has lumbar spinal stenosis encroaching on the spinal cord. The physical therapist should educate the patient to AVOID:
a. bicycling on hills
b. use of a rowing machine.
c. Tai Chi activities.
d. swimming using a crawl stroke.
107. A patient with post-polio syndrome is referred for outpatient physical therapy with symptoms of myalgia and increasing fatigue. The
patient has been wearing a KAFO 10 years. When walking, the therapist observes the patient rise up over the sound limb to advance the
orthotic limb forward. The BEST intervention is to provide:
a. a shoe lift on the orthotic side.
b. a shoe lift on the sound side.
c. an electric wheelchair with joystick.
d. a manual wheelchair with reclining back and elevating legrests.
108. An athlete presents with pain (5/10) and muscle spasm of the left upper trapezius as the result of a strain which occurred two weeks
previously. The therapist elects to use a combination of ultrasound and electrical stimulation. The MOST appropriate treatment
parameters would be:
a. continuous ultrasound with electrical stimulation at 50% duty cycle.
b. continuous ultrasound and electrical stimulation.
c. pulsed ultrasound with continuous electrical stimulation.
d. pulsed ultrasound with electrical stimulation at 50% duty cycle.
109. A pediatric physical therapist is working with a four year-old child who has myelodysplasia at the L5 level. At this level the most
appropriate orthosis to recommend for ambulation would be a (an):
a. ankle-foot orthosis.
b. reciprocating gait orthosis.
c. parapodium.
d. knee-ankle-foot orthosis.
110. An eleven-year-old was referred to physical therapy with complaints of vague pain at his right hip and thigh which radiates to the knee.
AROM is restricted in abduction, flexion, and internal rotation. A gluteus medius gait was observed with ambulation for 100 feet.
Appropriate PT intervention would include:
a. open-chain strengthening of his right hip abductors and internal rotators for avascular necrosis of the hip.
b. hip joint mobilization to improve the restriction in motion as the result of Legg-Calvé Perthe's disease.
c. orthoses to control lower extremity position as the result of femoral anteversion.
d. closed-chain partial weight-bearing lower extremity exercises for slipped capital femoral epiphysis.
111. A researcher states that he expects that there will be no significant difference between 20 and 30 year-olds after a 12 week exercise
training program using exercise heart rates and myocardial oxygen consumption as measures of performance. The kind of hypothesis that
is being used in this study is a (an):
a. experimental hypothesis.
b. research hypothesis.
c. null hypothesis.
d. directional hypothesis.
112. A physical therapist was treating a patient on the ward. The patient in the next bed was uncomfortable and asked the therapist to
reposition one leg. The therapist placed the leg on 2 pillows as requested by the patient. Unknown to the therapist, this patient had a
femoral artery graft 2 days previously. As a result, the graft became occluded and the patient was rushed to surgery for a replacement.
The patient claimed the therapist placed the leg too high on the pillows causing the occlusion of the original graft and sued for
malpractice. The hospital administrator and legal team decided:
a. the therapist was functioning outside the common protocols of the hospital, and therefore did not support the actions of the
physical therapist.
b. the physical therapist was functioning according to common protocols of the institution and thus supported the actions of the
therapist.
c. it was the patient's fault for requesting the position change and therefore supported the action of the physical therapist.
 d. to counter-sue, as the patient was responsible for requesting the position change.
113. A patient has a 3 year history of multiple sclerosis. One of her disabling symptoms is a persistent and severe diplopia which leaves her
frequently nauseated and immobile. An appropriate intervention strategy to assist her in successfully participating in rehabilitation would
be to:
a. give her special glasses which magnify images.
b. have her close her eyes and practice movements without visual guidance.
c. give her a soft neck collar to limit head and neck movements.
d. patch one eye.
114. The MOST appropriate positioning strategy for a patient recovering from acute stroke who is in bed and demonstrates a flaccid upper
extremity is:
a. supine with the affected arm flexed with hand resting on stomach.
b. sidelying on the sound side with the affected shoulder protracted, and arm extended resting on a pillow.
c. supine with the affected elbow extended and arm positioned close to the side of the trunk.
d. sidelying on the sound side with the affected upper extremity flexed overhead.
115. A patient presents with a large plantar ulcer that will be debrided. The foot is cold, pale, and painless. The condition that would most
likely result in this clinical presentation is:
a. chronic arterial insufficiency.
b. chronic venous insufficiency.
c. acute arterial insufficiency.
d. deep venous thrombosis.
116. A patient has been referred for physical therapy following a fracture of the femur six months ago. The cast was removed, but the patient
was unable to volitionally contract the quadriceps. The therapist decides to apply electrical stimulation to the quadriceps muscle. The
MOST appropriate electrode size and placement would consist of:
a. large electrodes, closely spaced.
b. small electrodes, closely spaced.
c. large electrodes, widely space.
d. small electrodes, widely spaced.
117. While setting a patient up for cervical traction, the physical therapist notices a mole that is brown and black with diffuse edges on the
patient's neck. The therapist should:
a. discontinue treatment and refer the patient back to the physician.
b. continue with the traction and report the findings to the physician immediately.
c. continue the treatment; however, document the skin condition.
d. tell the patient to have the physician inspect the mole.
118. A patient suffered a severe traumatic brain injury and multiple fractures following a motor vehicle accident. He is recovering in the
intensive care unit. The physical therapy referral requests PROM and positioning. On day 1 he is semi-alert and drifts in and out while the
therapist is working with him. On day 2 he is less alert and his status is changing. Signs and symptoms that would require emergency
consultation with a physician include:
a. developing irritability with increasing symptoms of photophobia, disorientation and restlessness.
b. decreasing function of cranial nerves IV, VI, and VII.
c. positive Kernig's sign with developing nuchal rigidity.
d. decreasing consciousness with slowing of pulse and Cheyne-Stokes respirations.
119. A physical therapist receives a referral for a patient with neurapraxia involving the ulnar nerve secondary to an elbow fracture. Based on
knowledge of this condition, the therapist expects:
a. regeneration is likely in 6-8 months.
b. nerve dysfunction will be rapidly reversed, generally in 2-3 weeks.
c. regeneration is likely after 1-1½ years.
d. regeneration is unlikely because surgical approximation of the nerve ends was not performed.
120. After three weeks of teaching a patient how to ambulate with bilateral crutches and a touch down gait, the physical therapist determines
the most appropriate kind of feedback to give to the patient is:
a. immediate feedback given after each practice trial.
b. intermittent feedback given at scheduled intervals, every other practice trial.
c. continuous feedback with ongoing verbal cuing during gait.
d. occasional feedback given when consistent errors appear.
121. A home health physical therapist is treating an elderly patient. On this day he is confused with shortness of breath and generalized
weakness. Given his history of hypertension and hyperlipidemia, the therapist suspects:
a. his mental changes are indicative of early Alzheimer's disease.
b. he may be experiencing unstable angina.
c. he forgot to take his hypertension medication.
d. he may be presenting with early signs of myocardial infarction.
122. A baseball pitcher was seen by a physical therapist following surgical repair of a SLAP lesion of his pitching arm. In follow up care, the
therapist needs to pay attention to the pitching motion. The phase of the throwing motion that puts the greatest stress on the anterior
labrum and capsule is:
a. wind up.
b. cocking.
c. acceleration.
d. deceleration.
123. The recommended time duration for endotracheal suctioning is:
a. 10 to 15 seconds.
b. 1 to 5 seconds.
c. 5 to 10 seconds.
d. 15 to 20 seconds.
124. An 82 year-old frail adult is confined to bed in a nursing facility. He has developed a small superficial wound over the sacral area. Since
only small amounts of necrotic tissue are present, the physician has decided to use autolytic wound debridement. This is BEST achieved
with:
a. wound irrigation using a syringe.
b. transparent film dressing.
c. wet-to-dry gauze dressing with antimicrobial ointment.
d. sharp debridement.
125. A patient was instructed to apply conventional (high rate) TENS to the low back to modulate a chronic pain condition. The patient now
states that the TENS unit is no longer effective in reducing the pain in spite of increasing the intensity to maximum. The therapist should
now advise the patient to:
a. switch to low rate TENS.
b. increase the treatment frequency.
c. switch to modulation mode TENS.
d. decrease the pulse duration.
126. During initial standing a patient is pushing strongly backward displacing the center-of-mass at or near the posterior limits of stability. The
most likely cause of this is:
a. weakness of the tibialis anterior/peroneals.
b. spasticity of the gastrocnemius-soleus.
c. contracture of the hamstrings.
d. contraction of the hip extensors.
127. A patient has been screened using a new test for the presence of a gene (ALG-2) linked to Alzheimer's disease. His physician reports he
lacks the gene and should not be at increased risk to develop the disease. Some years later he develops Alzheimer's and a repeat test
reveals the presence of the gene. The results of the initial test can be interpreted as:
a. false negative.
b. high specificity.
c. false positive.
d. high sensitivity.
128. A 62 year-old lives at home with his wife and adult daughter. He has recently been diagnosed with multi-infarct dementia and is
recovering from a fractured hip following a fall injury. In the initial interview with his wife the therapist would expect to find:
a. history of steady progression of loss of judgment and poor safety awareness.
b. agitation and sundowning
c. perseveration on a thought or activity.
d. history of sudden onset of new cognitive problems and patchy distribution of deficits.
129. A fourteen-year-old girl complains of subpatellar pain after participation in an aerobic exercise program for two weeks. The physical
therapist's examination shows a large Q angle, pain with palpation at the inferior pole of the patella, and mild swelling at both knees.
Physical therapy intervention should promote:
a. vastus medialis muscle strengthening.
b. lateral patellar tracking.
c. vastus lateralis strengthening.
d. hamstring strengthening.
130. A physical therapist receives a referral from an acute care physical therapist to treat a patient with right hemiparesis in the home. The
referral indicates that the patient demonstrates good recovery: both involved limbs are categorized as stage 4 (Brunnstrom recovery
stages). The patient is ambulatory with a small-based quad cane. The activity that would be MOST appropriate for a patient at this stage
of recovery is:
a. supine, bending the hip and knee up to the chest with some hip abduction.
b. sitting, marching in place (alternate hip flexion movements).
c. standing, picking the foot up behind and slowly lowering it.
d. standing, picking the foot up behind and slowly lowering it.
131. During a physical therapy session, a 67 year-old woman with low back pain tells the therapist that she has had urinary incontinence for
the last year. It is particularly problematic when she has a cold and coughs a lot. She has not told her physician about this problem
because she is too embarrassed. The therapist's BEST course of action is to:
a. examine the patient, document impairments and discuss findings with the physician.
b. refer the patient back to the physician.
c. examine the patient, document impairments, then send her back to her physician.
d. examine the patient and proceed with her back treatment.
132. During a sensory exam a patient complains of a dull, aching pain and is not able to discriminate a stimulus as sharp or dull. Two-point
discrimination is absent. Based on these findings, the pathway that is intact is the:
a. lateral spinothalamic tract.
b. dorsal columns/neospinothalamic systems.
c. fasciculus gracilis/medial lemniscus.
d. anterior spinothalamic tract.
133. A patient is five days post-MI and is referred for inpatient cardiac rehabilitation. Appropriate criteria for determining the initial intensity
of exercise include:
a. systolic BP less than 240mmHg or diastolic BP less than 110 mg Hg.
b. HR less than 120 beats/min and RPE less than 13.
c. HR less than 120 beats/min and RPE less than 13.
d. greater than 1 mm ST-segment depression, horizontal or downsloping.
134. A patient with bilateral short transfemoral (AK) amputations will require a wheelchair for functional mobility in the home and community.
An appropriate prescription for the wheelchair includes:
a. placement of the drive wheels 2 inches anterior to the vertical back supports.
b. lowering the seat height by 3 inches.
c. increasing the seat depth by 2 inches to accommodate the length of the residual limbs.
d. placement of the drive wheels 2 inches posterior to the vertical back supports.
135. A multicenter study was done on the reliability of passive wrist flexion and extension goniometric measurements using volar/dorsal
alignment, ulnar alignment and radial alignment. Significant differences were revealed between the three techniques. An appropriate
level for determining significant difference is a P value of:
a. P=0.05
b. P=0.015
c. P=0.5
d. P=0.1
136. In treating a patient with a diagnosis of right shoulder impingement syndrome, the first priority of the physical therapist would be to:
a. implement a stretching program for the shoulder girdle musculature.
b. instruct the patient in proper postural alignment.
c. achieve complete AROM in all shoulder motions.
d. modulate all pain.
137. An 80 year-old patient is being seen for balance instability and frequent falls. She arrives for a therapy session complaining of pain and
tingling in the forehead, cheek, and jaw on the left side of the face. An inspection of the trunk reveals the eruption of vesicles in the
distribution of the T2 dermatome. The therapist's best course of action is to:
a. refer the patient back to her physician immediately.
b. utilize warm water wraps to relieve the pain and continue with balance training.
c. have the patient exercise in the pool to promote pain-free movement.
d. have the patient keep a diary charting the course and frequency of pain over the next week.
138. A patient is recently admitted to a hospital with a diagnosis of Guillain-Barré syndrome. In the initial examination, the physical therapist
should expect:
a. symmetrical distribution of weakness, ascending with possible involvement of lower cranial nerves.
b. asymmetrical weakness with hyperreflexia, bulbar palsy.
c. glossopharyngeal and vagal paralysis with hyperactive jaw and snout reflexes.
d. sensory loss (stocking and glove distribution) with minor loss of motor function.
139. A patient with spastic hemiplegia is referred to physical therapy for ambulation training. The patient is having difficulty in rising to a
standing position as a result of cocontraction of the hamstrings and quadriceps. The therapist elects to use biofeedback as an adjunct to
help break up this pattern. For knee extension, the biofeedback protocol should consist of:
a. high detection sensitivity with electrodes placed close together.
b. low detection sensitivity with electrodes placed far apart.
c. high detection sensitivity with electrodes placed far apart.
d. low detection sensitivity with electrodes placed close together.
140. A patient sustained a T10 spinal cord injury four years ago and is now referred for an episode of outpatient physical therapy. During initial
examination the therapist observes redness over the ischial seat that persists for 10 minutes when not sitting. The BEST intervention in
this case would be to:
 a. switch to a low density wheelchair foam cushion.
b. increase the wheelchair arm rest height which is adjustable.
c. re-emphasize the need for sitting push-ups performed every 10 minutes.
d. switch to a tilt-in-space wheelchair.
141. A 16 year-old female was sent to physical therapy with a diagnosis of anterior knee pain. Positive findings include pes planus, lateral tibial
torsion and genu valgum. The position the femur will be in is excessive:
a. abduction.
b. medial rotation.
c. lateral rotation.
d. retroversion.
142. A patient is referred to physical therapy for vestibular rehabilitation. The patient presents with spontaneous nystagmus that can be
suppressed with visual fixation, oscillopsia and loss of gaze stabilization, lateropulsion, intense disequilibrium, and an ataxic wide-based
gait. Based on these findings, the therapist determines the patient is most likely exhibiting signs and symptoms of:
a. benign paroxysmal positional vertigo.
b. acoustic neuroma.
c. Meniérè's disease.
d. acute unilateral vestibular dysfunction.
143. A physical therapist is working with a 10 year-old girl with cerebral palsy. Part of the exercises in her plan of care involve using the
therapy ball. The choice of educational media that is BEST to use when instructing her in use of this device is:
a. a PowerPoint presentation of exercises using the therapy ball.
b. a oral presentation describing the therapy ball positions.
c. a videotape or DVD of another child with cerebral palsy on a therapy ball.
d. printed handouts with stick figure drawings and instructions.
144. A sports physical therapist is working with a local high school football team. During the game, a player is tackled violently by two
opponents. The therapist determines that the player is unresponsive. The immediate course of action should be to:
a. ask for help to log roll the player on his back while stabilizing his neck.
b. summon Emergency Medical Services.
c. open the airway by using the chin-lift method.
d. stabilize the neck and flip back the helmet face mask.
145. During a home visit, the mother of an 18 month-old child with developmental delay and an atrio-ventricular shunt for hydrocephalus tells
the physical therapist that her daughter vomited several times, was irritable and is now lethargic. The therapist's BEST course of action is
to:
a. call for emergency transportation and notify the pediatrician immediately.
b. give the child a cold bath to try and rouse her.
c. place the child in a sidelying position and monitor vital signs.
d. have the mother give the child clear liquids since she vomited.
146. A woman recently delivered twins. After delivery she developed a 4 centimeter diastasis recti abdominis. The BEST initial intervention for
this problem is to teach:
a. pelvic tilts and bilateral straight leg raising.
b. pelvic floor exercises and sit-ups.
c. gentle stretching of hamstrings and hip flexors.
d. protection and splinting of the abdominal musculature.
147. The optimal position for ventilation of a patient with a C5 complete spinal cord injury is:
a. semi Fowler's.
b. sidelying, head of bed flat.
c. supine, head of bed flat.
d. sidelying, head of bed elevated 45 degrees.
148. A 16 year-old patient with osteosarcoma is being seen in physical therapy for crutch training. Her parents have decided not to tell her
about her diagnosis. She is quite perceptive and asks the physical therapist directly if she has cancer and about her future. The therapist's
BEST course of action is to:
a. discuss her condition, gently indicating her parent's fears about not telling her the diagnosis.
b. change the subject and discuss the plans for that day's treatment.
c. schedule a conference with the physician and family about her questions.
d. tell the patient to speak directly with her physician.
149. A patient has a two year history of amyotrophic lateral sclerosis and exhibits moderate functional deficits. The patient is still ambulatory
with bilateral canes but is limited in endurance. An important goal for the physical therapy plan of care should be to prevent:
a. radicular pain and paresthesias.
b. overwork damage in weakened, denervated muscle.
c. further gait deterioration as a result of ataxia.
d. further functional loss as a result of myalgia.
150. A patient has extensive full thickness burns to the dorsum of the hand and forearm. He is to be fitted with a resting splint to support his
wrists and hands in a functional position. An appropriately constructed splint positions the wrist and hand in:
a. neutral wrist position with slight finger flexion and thumb flexion.
b. slight wrist extension with fingers supported and thumb in partial opposition and abduction.
c. slight wrist flexion with IP extension and thumb opposition.
d. neutral wrist position with IP extension and thumb flexion.
151. An 82 year-old patient has a 10-year history of heart disease. He presents with severely impaired aerobic capacity (less than 4 METS),
abnormal heart rate and pulmonary responses to increased oxygen demand, severely limited ADL, and hypertensive blood pressure to
increased oxygen demand. The preferred practice pattern that describes the generally accepted elements of patient/client management
by physical therapists is:
a. 6D: Impaired Aerobic Capacity/Endurance Associated with Cardiovascular Pump Dysfunction or Failure.
b. 6C: Impaired Ventilation, Respiration/Gas Exchange, and Aerobic Capacity/Endurance Associated with Airway Clearance
Dysfunction.
c. 6B: Impaired Aerobic Capacity/Endurance Associated with Deconditioning.
d. 6A: Primary Prevention/Risk Reduction for Cardiovascular/Pulmonary Disorders.
152. The following set of PFTs demonstrate an FVC of 3.2, an FEV1 of 2.6, and an FEV1/FVC ratio of 81.25%. Which of the following Caucasian
female patients would these PFTs most likely represent?
a. 5'2 healthy 68 year-old with a s/p total knee replacement.
b. 5'4 28 year-old in a mild exacerbation of her asthma.
c. 4'8 10 year-old with cystic fibrosis.
d. 5'2 healthy 31 year-old with a casted tibia/fibula fracture.
153. An eighteen month-old child with Down Syndrome and moderate developmental delay is being treated at an Early Intervention Program.
Daily training activities that should be considered include:
a. stimulation to postural extensors in sitting using rhythmic stabilization.
b. locomotor training using body weight support and a motorized treadmill.
c. holding and weight shifting in sitting and standing using tactile and verbal cueing.
d. rolling activities, initiating movement with stretch and tracking resistance.
154. A patient has been referred to physical therapy for acute shoulder pain after shoveling snow in a driveway for two hours. Positive findings
include pain and weakness with flexion of an extended upper extremity as well as scapular winging with greater than 90 degrees of
abduction. The patient's problem is MOST LIKELY the result of:
a. supraspinatus tendinitis.
b. compression of the long thoracic nerve.
c. compression of the suprascapular nerve.
d. subdeltoid bursitis.
155. A patient with multiple sclerosis demonstrates strong bilateral lower extremity extensor spasticity in the typical distribution of antigravity
muscles. This patient would be expected to demonstrate:
a. sitting with the pelvis laterally tilted with increased weight bearing on ischial tuberosities.
b. sacral sitting with increased extension and adduction of lower extremities.
c. sitting with both legs abducted and externally rotated.
d. skin breakdown on the ischial tuberosities and lateral malleoli.
156. A patient with multiple sclerosis has been on Prednisolone for the past 4 weeks. The medication is now being tapered off. This is the third
time this year she has received this treatment for an MS exacerbation. The physical therapist recognizes this patient is likely to
demonstrate:
a. weight gain and hyperkinetic behaviors.
b. hypoglycemia and nausea or vomiting.
c. muscle wasting, weakness and osteoporosis.
d. spontaneous fractures with prolonged healing or mal-union.
157. A 24 year-old pregnant woman who is 12 weeks pregnant asks a therapist if it is safe to continue with her aerobic exercise. Currently she
jogs 3 miles, 3 times a week and has done so for the past 10 years. The therapist's BEST answer is:
a. jogging is safe as long as the target HR does not exceed 140 beats/min.
b. jogging is safe at mild to moderate intensities while vigorous exercise is contraindicated.
c. continue jogging only until the 5th month of pregnancy.
d. swimming is preferred over walking or jogging for all phases of pregnancy.
158. A patient returns to physical therapy after his first exercise session complaining of muscle soreness that developed later in the evening
and continued into the next day. He is unsure he wants to continue with exercise. The therapist can minimize the possibility of this
happening again by using:
a. eccentric exercises, 1 set of 10, lifting body weight (sit-to-stand).
b. eccentric exercises, 3 sets of 10, with gradually increasing intensity.
c. concentric exercises, 3 sets of 10, at 80% of maximal intensity.
d. concentric exercises, 3 sets of 10, with gradually increasing intensity.
159. Upon examining a patient with vague hip pain which radiates to the lateral knee, the physical therapist finds a negative FABERE test,
negative grind test, and a positive Noble compression test. The dysfunction is most likely due to:
a. degenerative joint disease of the hip.
b. an iliotibial band friction disorder.
c. sacroiliac joint dysfunction.
d. sacroiliac joint dysfunction.
160. A patient suffered carbon monoxide poisoning from a work-related factory accident. He is left with permanent damage to his nervous
system, affecting the basal ganglia. Exercise training for this patient will need to address expected impairments of:
a. motor paralysis with the use of free weights to increase strength.
b. muscular spasms and hyperreflexia with the use of ice wraps.
c. impaired sensory organization of balance with the use of standing balance platform training.
d. motor planning with the use of guided and cued movement.
161. A patient presents with problems with swallowing. When the physical therapist tests for phonation by having the patient say “AH” with
the mouth open, there is deviation of the uvula to one side. The therapist then tests for function of the gag reflex and notices decreased
response to stimulation. These findings suggest involvement of the:
a. Vagus nerve.
b. Trigeminal nerve.
c. Facial nerve.
d. Hypoglossal nerve.
162. A patient with COPD is sitting in a bedside chair. The apices of the lungs in this position compared with other areas of the lungs in this
position would demonstrate:
a. increased perfusion.
b. increased volume of air at resting end expiratory pressure (REEP).
c. the lowest oxygenation and highest CO2 in blood exiting this zone.
d. the highest changes in ventilation during the respiratory cycle.
163. Checkout for a lower limb orthosis includes inspection of the alignment of anatomic and orthotic joints. During a sagittal plane check-out
the physical therapist determines that the orthotic hip joint is malaligned. The correct position is:
a. just anterior and superior to the greater trochanter.
b. 3 inches below the anterior superior iliac spine.
c. just posterior and inferior to the greater trochanter.
d. lateral to the greater trochanter.
164. A physical therapist assistant is supervising a patient's home exercise program. The patient is 6 weeks post stroke. Part of the plan of
care includes “progressive gait training on level surfaces”. The patient falls and sustains a fractured hip. The fall occurred when the PTA
took the patient on the stairs for the first time. The responsible party in this case is:
a. the PT who is negligent for failing to provide adequate supervision of the PTA.
b. neither the PT nor the PTA because patients who have sustained a CVA are always at high risk for falls, and thus it is a
regrettable occurrence only.
c. both the PT and the PTA because the PT gave inadequate supervision, and the PTA used poor judgment.
d. the PTA who is completely liable because the plan of care was altered without communicating with the supervising PT.
165. As the result of blunt trauma to the quadriceps femoris muscle, a patient experiences loss of knee function. Early PT interventions should
stress:
a. aggressive soft tissue stretching to remove blood which has accumulated in soft tissues.
b. aggressive open-chain strengthening of the quadriceps femoris to regain normal lower extremity strength.
c. gentle PROM exercises in nonweightbearing to regain normal knee motion.
d. gentle AROM exercises in weight bearing.
166. An important adjunct to physical therapy management of a child with moderate spastic hemiplegia would be use of:
a. a posterior walker.
b. an anterior rollator walker.
c. a tone inhibiting ankle-foot orthosis (AFO).
d. a knee-ankle-foot orthosis (KAFO).
167. While evaluating the gait of a patient with right hemiplegia, the physical therapist notes foot drop during midswing on the right. The
MOST LIKELY cause of this deviation is:
a. inadequate contraction of the ankle dorsiflexors.
b. excessive extensor synergy.
c. decreased proprioception of foot-ankle muscles.
d. excessive flexor synergy.
168. A patient's daughter wants to look at her father's medical record. He has recently been admitted for an insidious onset of low back pain.
The physical therapist, should:
a. give her the chart and let her read it.
b. tell her she cannot see the chart because she could misinterpret the information.
 c. tell her that she must have the permission of her father before she can look at the chart.
d. tell her to ask the physician for permission.
169. Following a total knee replacement [TKR], continuous passive motion [CPM] is initiated. One of the main objectives in using CPM in this
case is to facilitate:
a. active knee extension.
b. active knee flexion.
c. passive knee flexion.
d. passive knee extension.
170. The use of ultrasound in the area of a joint arthroplasty is permissible even if the surrounding area contains:
a. plastic implants.
b. infected tissue
c. metal implants
d. neoplastic lesions.
171. A physical therapist observes genu recurvatum during ambulation in a patient with hemiplegia. The patient has been using a posterior
leaf spring (PLS) orthosis since discharge from subacute rehab 4 weeks ago. The therapist has previously administered Fugl-Meyer
Assessment of Physical Performance and determined the lower extremity score to be 22 (out of a possible 34) with strong synergies in
the lower extremity and no out-of-synergy movement. The most likely cause of this deviation is:
a. extensor spasticity.
b. hip flexor weakness.
c. dorsiflexor spasticity.
d. hamstring weakness.
172. During a home visit a physical therapist is providing postural drainage in the Trendelenburg position to a 15 year-old male with cystic
fibrosis. The patient suddenly complains of right-sided chest pain and shortness of breath. On auscultation, there are no breath sounds
on the right. The therapist should:
a. continue treating as it is possibly a mucous plug.
b. reposition patient with the head of the bed flat as the Trendelenburg position is causing shortness of breath.
c. place the right lung in a gravity dependent position to improve perfusion.
d. call emergency medical services as it may be a pneumothorax.
173. A 65 year-old patient with multiple sclerosis is being treated at home. The patient is bedridden for most of the day with only short
periods up in a bedside chair. Medicare is funding the patient's home care program which has as its primary goals maintaining PROM and
positioning to prevent deformity. The role of the physical therapist is to provide:
a. a restorative exercise program aimed at improving upright sitting control and improved functional independence.
b. a limited cardiovascular conditioning (sitting) program aimed at improving respiratory capacity.
c. supervision of home health aides for completion of a daily home exercise program.
d. PROM exercises 2 times a day with additional family instruction to ensure weekend coverage.
174. A patient with an 8 year history of Parkinson's disease is referred for physical therapy. During the initial examination, the patient
demonstrates significant rigidity, decreased PROM in both upper extremities in the typical distribution, and frequent episodes of akinesia.
The exercise intervention that BEST deals with these problems would be:
a. quadruped position, upper extremity PNF D2 flexion and extension.
b. resistance training, free weights for shoulder flexors at 80% of 1 repetition max.
c. modified plantigrade, isometric holding, stressing upper extremity shoulder flexion.
d. PNF bilateral symmetrical upper extremity D2 flexion patterns, rhythmic initiation.
175. A 72 year-old patient with diabetes is recovering from recent surgery to graft a large decubitus ulcer over the heel of the left foot. The
physical therapist is concerned that loss of range at the ankle (-5° to neutral) will limit ambulation and independent status. One afternoon
the therapist is very busy and requests that one of the physical therapy aides do the range of motion exercises. The aide is new to the
department but is willing to take this challenge on if the therapist demonstrates the exercises. The therapist's BEST course of action is to:
a. take 5 minutes to instruct the aide in ROM exercises.
b. perform the ROM exercises without delegating the task.
c. reschedule the patient for the next day.
d. defer the ROM exercises and have the aide ambulate the patient in the parallel bars.
176. A 12 year-old child with moderate athetosis affecting the head, trunk and upper extremities and extensor spasms of the lower extremities
is referred for mobility training. The MOST appropriate type of adaptive equipment is:
a. a wheeled prone stander.
b. posterior rollator walker and reciprocating gait orthoses.
c. scooter board.
d. manual wheelchair with custom-contoured seating system.
177. The problems associated with ankylosing spondylitis in its early stages can best be managed in physical therapy by:
a. postural education.
b. pain management.
c. joint mobilization.
 d. stretching of scapular stabilizers.
178. A patient is referred for rehabilitation following a middle cerebral artery stroke. Based on this diagnosis a physical therapist can expect
the patient will present with:
a. contralateral hemiplegia with thalamic sensory syndrome and involuntary movements.
b. contralateral hemiparesis and sensory deficits, arm more involved than the leg.
c. decreased pain and temperature to the face and ipsilateral ataxia with contralateral pain and thermal loss of the body.
d. contralateral hemiparesis and sensory deficits, leg more involved than the arm.
179. The cardiac rehabilitation team is conducting education classes for a group of patients. The focus is on risk factor reduction and successful
life style modification. A participant asks the physical therapist to help him interpret his cholesterol findings. His total cholesterol is
220mg/dL, his HDL cholesterol is 24 mg/dL, and his LDL is 160 mg/dL. Analysis of these values reveals:
a. the levels of HDL, LDL, and total cholesterol are all abnormally high.
b. LDL and HDL cholesterol levels are within normal limits and total cholesterol should be below 200 mg/dL.
c. the levels of HDL, LDL, and total cholesterol are all abnormally low.
d. the levels of LDL and total cholesterol are abnormally high and HDL abnormally low.
180. A physical therapist is treating a football player with an ACL sprain. She is very fond of this patient and enjoys treating him. After a few
visits, the football player asks her out to dinner. The physical therapist's response should be to:
a. thank him very much, and invite him for dinner at her apartment with other guests.
b. transfer the patient care to one of her colleagues and then go out to dinner with him.
c. thank him very much, but refuse his invitation while he is receiving treatment as her patient.
d. thank him very much, and accept his offer for dinner.
181. A physical therapist is performing the maximal cervical quadrant test to the right with a patient with right C5-6 facet syndrome. The
patient would, most likely complain of:
a. pain in the right cervical region.
b. tightness in the right upper trapezius.
c. radicular pain in both shoulders.
d. referred pain to the left midscapular region.
182. A 62 year-old woman developed polio at the age of 6 with significant lower extremity paralysis. She wore bilateral long leg braces for a
period of 2 years. She then recovered enough to stop using her braces but still required bilateral Lofstrand crutches, then bilateral canes
to ambulate. Recently she has been complaining of new difficulties (she has had to start using her crutches again). The physical therapist
suspects post-polio syndrome. The BEST initial intervention for this patient based on her current findings is:
a. initiate a lower extremity resistance training program utilizing 80% one repetition max.
b. initiate a moderate conditioning program consisting of cycle ergometry 3 times a week of 60 minutes at 75% maximal heart
rate.
c. instruct in activity pacing and energy conservation techniques.
d. implement an aquatic therapy program consisting of daily 1 hour aerobics.
183. A patient diagnosed with lumbar spondylosis without discal herniation or bulging has a left L5 neural compression. The most likely
structure compressing the nerve root is the:
a. supraspinous ligament.
b. ligamentum flavum.
c. anterior longitudinal ligament.
d. posterior longitudinal ligament.
184. During an exercise tolerance test (ETT) a patient demonstrates poor reaction to increasing exercise intensity. An absolute indication for
terminating this test is:
a. 1.5 mm of downsloping ST-segment depression.
b. onset of moderate to severe angina.
c. fatigue and shortness of breath.
d. supraventricular tachycardia.
185. A patient with T10 paraplegia is receiving daily ROM exercises. On this day the physical therapist notices erythema, swelling, and pain in
the thigh near the hip joint with some limitation in motion. The therapist's BEST course of action is to:
a. document the findings in the record and continue the daily ROM exercises.
b. instruct the nursing staff to be more careful about positioning and when performing PROM.
c. apply ice to ease the pain and then continue with ROM exercises.
d. notify the physician immediately.
186. A patient with a T4 spinal cord injury is being measured for a wheelchair. In determining the correct seat height the physical therapist can
use as a measure:
a. clearance between the floor and the foot plate of at least 2 inches.
b. clearance between the floor and the foot plate of at least 4 inches.
c. the patient's leg length measurement plus four inches.
d. the distance from the bottom of the shoe to just under the thigh at the popliteal fossa.
187. A 6 year-old boy has a diagnosis of Duchenne muscular dystrophy and is still ambulatory. The MOST appropriate activity to include in his
plan of care would be:
a. progressive resistance strength training.
b. circuit training using resistance training and conditioning exercises.
c. recreational physical activities such as swimming.
d. wheelchair sports.
188. A physical therapist works in a private outpatient clinic and sells custom made orthotic shoe inserts at a reasonable price to patients. This
practice can be viewed as unethical if:
a. the therapist realizes all of the profits from the sale of the inserts.
b. the patient's ability to pay is in doubt.
c. the need for the inserts is exaggerated.
d. the inserts are provided as part of pro bono services.
189. A patient with a CVA demonstrates a locked-in state characterized by spastic quadriplegia and bulbar palsy. To facilitate communication
with this patient the physical therapist should instruct the family to:
a. encourage use of eye movements to signal letters.
b. give the patient a chance to mouth responses even though vocalization is poor.
c. look closely at facial expression to detect signs of communication.
d. use a communication board with minimal hand movements.
190. After performing an ergonomic examination of a computer programmer and his workstation, the most appropriate recommendation for
achieving ideal wrist and elbow positioning would be to:
a. elevate the keyboard to increase wrist flexion.
b. maintain the keyboard in a position allowing a neutral wrist position.
c. lower the keyboard to increase wrist extension.
d. add armrests.
191. A patient recovering from an extensive myocardial infarction is on digitalis to improve cardiac contractility. He is a new participant in a
Phase 2 outpatient cardiac rehabilitation program. He is being continuously monitored by ECG via radio telemetry. On his ECG, the
medication-induced changes that might be expected are:
a. depressed ST segment with a flat T wave and shortened QT interval.
b. elevated ST segment with T wave inversion.
c. widened QRS complex with a flattened P wave.
d. decreased heart rate with prolonged QRS and QT intervals.
192. A patient is being treated for secondary lymphedema of the right arm as a result of a radical mastectomy and radiation therapy. The
resulting edema (Stage 1) can BEST be managed in physical therapy by:
a. isokinetics, extremity positioning in elevation, and massage.
b. AROM and extremity positioning in a functional arm/hand position.
c. isometric exercises, extremity positioning in elevation and compression bandaging.
d. intermittent pneumatic compression, extremity elevation and massage.
193. A physical therapist has been treating a patient for chronic subluxation of the patella in the outpatient clinic. The patient is now
scheduled for a lateral release and is worried about any complications of the surgical procedure. The patient asks the therapist to
describe any potential complications. The therapist's BEST response is to:
a. refer the patient to a physical therapy colleague who specializes in knee problems.
b. suggest that the patient speak with his surgeon.
c. explain how previous patients the therapist treated responded to the surgery.
d. do an internet search and print out the information desired by the patient.
194. A patient was referred for physical therapy following a right breast lumpectomy with axillary lymph node dissection. Scapular control is
poor when upper extremity flexion or abduction is attempted. Early PT intervention should focus on:
a. active assistive pulley exercises to assist rotator cuff muscles as a result of damage to the suprascapular nerve.
b. rhomboid strengthening as a result of disuse of the scapular stabilizers.
c. gravity assisted right upper extremity exercises to promote scapular control following damage to the long thoracic nerve.
d. strengthening of the right deltoids to help stabilize the shoulder to compensate for damage to the dorsal scapular nerve.
195. A post surgical patient is receiving a regimen of postural drainage three times a day. The therapist assigned to the case could reduce the
frequency of treatment if the:
a. consistency of the sputum changes.
b. patient becomes febrile.
c. patient experiences decreased postoperative pain.
d. amount of productive secretions decreases.
196. The patient with vertigo of central origin demonstrates significant impairments of functional status and activity level. The physical
therapy plan of care should emphasize:
a. gaze stability training during head movements.
b. fall prevention strategies with compensatory training.
 c. habituation training to decrease sensitivity to motion.
d. a daily walking program in both home and community environments.
197. A physical therapist arrives at work one hour before the work day commences and, begins moving treatment tables and rearranging the
physical therapy clinic. This operation could have been done during regular hours. The therapist sustained a low back injury as a result of
moving the equipment. Payment for the therapist's care relating to this incident would be covered primarily by:
a. employee's health insurance.
b. the hospital's insurance company.
c. the therapist's own resources.
d. Workers' Compensation.
198. Patients diagnosed with Paget's disease typically have similar symptomatology to spinal stenosis. The most important aspect of physical
therapy intervention emphasizes:
a. postural reeducation to prevent positions that increase symptoms.
b. strengthening exercises for the abdominals and back muscles.
c. modalities to decrease pain.
d. lumbar extension exercises.
199. A patient with spastic left hemiplegia experiences severe genu recurvatum during stance phase. The patient is using a double upright
metal ankle-foot orthosis. The cause of the problem might be attributed to:
a. the posterior stop setting the foot in too much plantarflexion.
b. the posterior stop setting the foot in too much dorsiflexion.
c. the anterior stop setting the foot in too much plantar flexion.
d. the anterior stop setting the foot in too much dorsiflexion.
200. A patient complains of difficulty walking. At rest, the skin in the lower leg appears discolored. After walking for about two minutes the
patient complains of pain. A marked pallor is also evident in the skin over the lower third of the extremity. The therapist suspects:
a. neurogenic claudication.
b. restless leg syndrome.
c. vascular claudication.
d. peripheral neuropathy.