PTFE Practice Exam 2 Questions with 100% Correct Answers, Exams of Health sciences

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PTFE Practice Exam 2 Questions with 100%

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While working on the coronary care unit of a hospital, a physical therapist treats a patient who has undergone a coronary artery bypass graft (CABG) surgery. The patient's oxygen saturation level is observed to be 87% on 2 liters of oxygen (O2) via nasal cannula. The patient has decreased chest expansion and fast, shallow breaths. Upon auscultation, crackles are heard in the left lower lobe. The patient is also unable to perform a productive cough. The therapist decides to incorporate the active cycle breathing technique (ACBT). Which of the following is the FIRST step to facilitate the ACBT?

1. Breathing control
2. Chest expansion
3. Coughing
4. Huffing - Correct Answers 1 ACBT is as follows: Breathing control, 3 - 4 thoracic expansion exercises (inhalation with 3 second hold followed by a passive exhalation), return to breathing control. If secretions are ready to clear, the huff or forced exhalation will be performed. If not, return to thoracic expansions. A patient presents with complaints of heaviness and numbness into the ulnar side of the 4th and 5th digits, and the ulnar side of the left hand. Which nerve root segments can be concluded to be involved with these sensory test findings of decreased sensation?
5. C6 - 8
6. C6 - 8 and T
7. C7 - T
8. C8 and T1 - Correct Answers 4 If a patient presents with complaints of numbness on the ulnar half of the ring finger, the little finger, and the ulnar side of the hand, the therapist would be altered to carefully address ulnar nerve (C8 and T1) integrity during the sensory examination. Passive range of motion is an assessment of non-contractile function. Limitations in passive range of motion may be due to bone or joint abnormalities or shortening of soft tissue structures. Which of the following is not dependent upon for passive range osteokinematic motions?
9. Joint capsule extensibility
10. Ligament extensibility
11. Soft tissue extensibility
12. None of the above - Correct Answers 4

Passive range of osteokinematic motions depends on the integrity of joint surfaces and the extensibility of the joint capsule, ligaments, muscles, tendons, and soft tissue. A 30 - year-old male was diagnosed with osteosarcoma of the right distal femur. He is due to start chemotherapy to prevent the spread of the current tumor. He has been instructed to be non-weight bearing to reduce the risk of a pathological fracture. What would be the BEST assistive device for this patient?

1. Axillary crutches
2. Front wheel walker
3. Lofstrand crutches
4. Wheelchair - Correct Answers 2 The correct answer for this would be to issue a front-wheel walker. The axillary crutches would be an appropriate device once he has shown that he is able to maintain the weight- bearing restriction using a walker. In a one-on-one therapy session, an ambulatory patient appears agitated and restless. The patient is not responding to any verbal cues and refuses to perform any tasks. The patient keeps repeating "I just want to get up, get going, please." What is the BEST response in this situation?
5. Allow the patient to get up, walk with him/her and adapt your task to something you can do while walking
6. Discontinue the activity due to noncompliance
7. Explain the importance of the activity and insist they complete the task
8. Explain the task will only take 10 minutes and that if they'd only calm down and do the task, the activity would be over in 10 minutes - Correct Answers 1 When you have a patient that is agitated it is important to adapt and change the situation to defuse the agitation as much as possible. As this patient is agitated and ambulatory, it is vital to adapt the session to ensure an appropriate treatment. A patient presents with a Spinal Cord Injury (SCI) following a recent Motor Vehicle Accident (MVA). Upon initial evaluation, the patient displays contralateral loss of pain and temperature perception. In what spinal tracts are these impairment signs being suggestive of a lesion?
9. Anterolateral
10. Dorsal column
11. Medial lemniscus
12. Spinocerebellar - Correct Answers 1 Examination of sensory function also provides data that reflects the integrity of the spinal cord tracts that carry somatosensory information. For example, contralateral loss or impairment of pain and temperature perception is suggestive of lesions in the anterolateral

tracts. Deficits in discrimination sensations such as vibration and two-point discrimination suggest lesions of dorsal column. A 39 - year-old female presents to physical therapy with new complaints of cold hands and feet, and increased fatigue. Upon assessment, dependent edema is noted bilaterally. Which test is BEST initially to determine the physical therapist's next course of action?

1. Body temperature and lung auscultation for rales
2. Heart rate and blood pressure
3. Mini Mental State Examination (MMSE) and lung auscultation for rales
4. Turgor Test and Complete Blood Count - Correct Answers 1 This patient case is a classic differential diagnosis between hypothyroidism and congestive heart failure. Cold hands and feet, dependent edema, and fatigue are all characteristics of hypothyroidism and congestive heart failure. The differentiating factors are body temperature and lung auscultation. If the patients body temperature is NORMAL and rales are present upon lung auscultation, it is most likely heart failure. If body temperature is LOWER than normal, and no rales are auscultated, it is most likely hypothyroidism A physical therapist is assigned to assess a patient admitted with congestive heart failure exacerbation episode. During the initial evaluation, the pedal pulse is observed to be normal. While assessing edema, the skin near the ankle takes 10 seconds to return to a normal state after deep palpation pressure by the therapist. Which of the following grades would be the BEST measure to describe the extent of edema?
5. 1+
6. 2+
7. 3+
8. 4+ - Correct Answers 2 To determine pitting edema, the therapist applies deep pressure to the skin and observe how long it takes to return to normal. The scale is as follows: 1+ mild, barely perceptible 2 + within 15 sec 3+ within 15 - 30 sec 4+ last more than 30 sec A 12 - year-old female with cerebral palsy is being seen in therapy post botulinum toxin injections to treat her spasticity. What would be the LEAST appropriate intervention post- injection?
9. Grade 2 Maitland Glide
10. Passive Range of motion
11. Splinting
12. Strength training - Correct Answers 2 Grade 2 Maitland glides are large-amplitude out of resistance and this is used primarily to treat pain. All other options are used to increase ROM.

When educating a patient with right upper extremity lymphedema about proper care in daily activities, which of the following is NOT an appropriate statement for this patient's diagnosis?

1. Avoid any injuries to the skin
2. Avoid clothing that is too tight
3. Do not have blood pressure readings done on the right upper extremity
4. Embrace use of heat - Correct Answers 4 Use of any heat item, including hot showers, hot packs, saunas or hot tubs, or even sunburn should be avoided for any patient with lymphedema. A 78 year-old male is admitted to the hospital with bilateral swollen legs. He presents with redness, pain, and itching throughout the calf musculature of both lower extremities. The patient's white blood cells (WBC) count is 6,000 per mL and his temperature is 98.9 F (37. C). Which of the following conditions is MOST likely present?
5. Cellulitis
6. Dermatitis
7. Gout
8. Necrotizing fasciitis - Correct Answers 2 As dermatitis is an inflammation of the dermis, this will present with itching and redness without infection, and often, but not always, bilaterally. Cellulitis is often unilateral and the patient would have signs of infection including a fever. A 24 - year old female is being assessed by a physical therapist for right upper extremity bicep weakness and pain in the shoulder which radiates to the neck and face. Upon examination, the patient demonstrates tenderness to palpation at the axilla and a hypoactive deep tendon reflex of C5-6. Upon passive movement of the arm, the patient reports no change in symptom severity. Which of the following conditions is MOST likely to cause these signs and symptoms?
9. Brachial plexus lesion
10. Cervical myelopathy
11. Cervical radiculopathy
12. Clavicle fracture - Correct Answers 1 When treating a patient with a brachial plexus lesion, the pain is more localized to the shoulder with some radiation up to the neck and the face. There will also be a decrease in the deep tendon reflexes for the biceps tendon C5-6. The patient is displaying signs consistent with a urinary tract infection (UTI). With the presence of a fever of 102° F (39°C), immediate contact with the patient's physician is warranted and may indicate the need for hospitalization. While immediate action is required, this is not a life-or-death situation and calling 911 would not be warranted. A UTI can lead to the development of osteomyelitis or other infections elsewhere and requires immediate attention. Continuing the intervention or applying modalities will not solve the underlying issue and are not the best option when confronted with this situation.

1. Call 911 and initiate the emergency response system
2. Call the patient's primary physician and report the findings
3. Continue the physical therapy intervention, closely monitoring for symptoms of cardiac distress
4. Initiate modality treatment for the low back pain and apply ice with the patient in prone - Correct Answers 2 The patient is displaying signs consistent with a urinary tract infection (UTI). With the presence of a fever of 102° F (39°C), immediate contact with the patient's physician is warranted and may indicate the need for hospitalization. While immediate action is required, this is not a life-or-death situation and calling 911 would not be warranted. A UTI can lead to the development of osteomyelitis or other infections elsewhere and requires immediate attention. Continuing the intervention or applying modalities will not solve the underlying issue and are not the best option when confronted with this situation. A 46 - year old male reports to an outpatient physical therapy clinic for the chief complaint of neck pain. Upon examination, the therapist observes pain bilaterally in the C4- 5 dermatome distribution. The pain is increased with extension and relieved by flexion. The patient also reports that the pain reduces with rest. From this assessment, which of the following is the MOST likely cause of the symptoms?
5. Cervical disc herniation
6. Cervical spinal stenosis
7. Cervical spondylolisthesis
8. Cervical spondylosis - Correct Answers 2 Cervical spinal stenosis is a condition that often affects a large age group 11 - 70. Symptoms present both unilaterally and bilaterally. A key differentiating characteristic is that pain is relieved by rest. Which of the following conditions is LEAST likely to be associated with an inguinal hernia?
9. Lifting injury
10. Obesity
11. Pregnancy
12. Psoas abscess - Correct Answers 4 While symptoms of a psoas abscess and hernia can be similar, they are unrelated conditions. A psoas abscess occurs most frequently as a result of diverticulitis and inflammatory bowel disease. An inguinal hernia can occur as a result of congenital malformations, disturbances to the inguinal tissue, or from repetitive trauma/pressure. Obesity, lifting injuries, and pregnancy are all potential causes of inguinal hernias. A 15 year old male was playing basketball and had a clash of heads while jumping for a rebound. There was no loss of consciousness but he has transient confusion. His symptoms lasted for 20 minutes before they resolved. What would be the BEST description of this patient's level of concussion?
13. No Concussion
14. Grade 1 Mild concussion
15. Grade 2 Moderate concussion

4. Grade 3 Severe concussion - Correct Answers 3 Grade 1/mild - transient confusion; no loss of consciousness; symptoms and mental status abnormalities resolve in less than 15 mins. Grade 2/moderate transient confusion; no loss of consciousness; symptoms and mental state abnormalities last more than 15 mins. Grade 3/ severe loss of consciousness. A 74 year-old male is admitted to inpatient rehab status-post one day hospitalization for shortness of breath and fever. Upon meeting the patient, a productive cough is observed. When ambulating with the patient from the bed to a chair, reduced endurance and general fatigue is observed. After chart review, important aspects of past medical history is notable for the following: Chronic Bronchitis (over 1 year); History of smoking; and Hypertension. Based on the above information, what diagnosis may this patient have?
5. Asthma
6. Atelectasis
7. Chronic Obstructive Pulmonary Disease (COPD)
8. Pulmonary Fibrosis - Correct Answers 3 This patient is a classic case of COPD based on the above age, gender, past medical history and notable patient presentation/symptoms. Choices 2 and 4 describe restrictive lung diseases, which show opposite symptoms. Choice1 is an obstructive condition, but the presentation is different than COPD. While assessing a patient in the intensive care unit (ICU) who has sustained a traumatic brain injury (TBI) with damage to the medulla, the physical therapist observes an unpredictable, irregular breathing pattern of variable respiration depth, with alternating periods of apnea. This pattern of respiration is BEST described as:
9. Ataxic (Biots) Breathing
10. Cheyne Stokes Breathing
11. Obstructive Breathing
12. Sighing Respiration - Correct Answers 1 Ataxic breathing is characterized by unpredictable irregularity. Breaths may be shallow or deep and stop for short periods. Causes can include depression and brain damage, typically at the medullary level. Cheyne Stokes breathing is characterized by a gradual increase in depth of respirations followed by gradual decrease and then a period of apnea. Obstructive breathing is typically manifested as pursed-lip breathing. A 30 year old female waitress attends physical therapy with complaints of right hip and low back pain. She states her pain increases with prolonged periods of standing in place and walking. Upon gait assessment, the patient displays a left Trendelenburg sign. In which phase of gait would a Trendelenburg sign MOST likely be seen?
13. Initial contact
14. Loading response
15. Pre-swing
16. Terminal stance - Correct Answers 4 Initial contact represents the moment in time when the outstretched limb first hits the ground. During loading response, body weight is rapidly accepted onto the outstretched limb. Initial contact and loading response phases constitute initial double limb stance. Pre-

swing is the last phase of stance in the gait cycle where it is also considered as terminal double limb stance, or push off. During terminal stance, the heel rises from the ground, the leg achieves a "trailing limb" posture, and the trunk advances well in front of the reference foot. The combined phases of mid stance and terminal stance is single limb support, which is when one limb is in contact with the ground A 42 year old male sales-clerk attends physical therapy with complaints of left hip and low back pain. He states his pain increases with prolonged periods of standing in place and walking. Upon gait assessment, the patient displays a left Trendelenburg sign. Which condition is MOST likely consistent with a positive Trendelenburg sign?

1. Bursitis
2. Impingement
3. Labral tear
4. Tight adductors - Correct Answers 3 if the pelvis drops on the opposite side of the stance leg, it indicates a weak gluteus medius or an unstable hip on the stance side. Tearing to the hip labrum can lead to hip joint instability. Physical therapy is treating a 5 year old Hispanic male with a history of clubfoot. The goals of therapy have been to correct the deformity, regain mobility, and increase strength. What is the MOST appropriate foot position for the patient?
5. Plantigrade with a normal load bearing area
6. Slight Dorsiflexion
7. Slight Plantar Flexion
8. Varus foot angle - Correct Answers 1 The goal of the orthotic device and therapy will be to achieve as close to normal foot alignment for this patient. A clinician is assessing a patient for wound management. It has been determined that there are contraindications for wound debridement. Which of the following is NOT a contraindication for wound debridement?
9. Blisters
10. Electrical Burns
11. Granular tissue
12. Viable tissue - Correct Answers 1 NOT a contradiction, blisters are the only one A 65 year-old female has been admitted to the hospital for hyponatremia. She is currently receiving chemotherapy for a pancreatic mass. She has been dependent on a wheelchair for mobility and has only been able to transfer with a front-wheeled walker for the last 3 months. The physician has placed an order that the patient can go home today once she is cleared by a physical therapist. Her morning blood work is listed in the table shown. Which of the following actions would be MOST important to perform first? Hg=7.
13. Assess functional mobility for discharge to home
14. Hold therapy due to low Hemoglobin
15. Perform therapeutic exercise in bed

4. Recommend additional rehab stay prior to going home - Correct Answers 1 Although hemoglobin is below normal range, chemotherapy is a cause of this. According to the APTA guidelines Hb below 8 is not a contradiction to therapy but the patient is restricted to essential daily activities A 48 - year-old patient presents to physical therapy for acute back pain. The patient reports falling on his back 2 days ago while attempting to ride a skateboard. The patient reports that the pain is located primarily in the right costovertebral region. The patient also states that the pain is a constant dull ache that is unrelieved with position change or modalities. The patient's history is otherwise unremarkable. Which of the following signs would be LEAST likely to accompany this patient's pain?
5. Decreased urinary frequency
6. Generalized abdominal pain
7. Ipsilateral shoulder pain
8. Tenderness at the costovertebral angle - Correct Answers 1 This patient's history is consistent with trauma to the right kidney. Of the options presented, "decreased urinary frequency" is least likely to occur. While treating a patient with an above-knee amputee (AKA), the physical therapist notices the patient has a lateral lean away from the prosthetic side during swing phase of gait of the prosthesis. The therapist assists the patient to doff the prosthetic limb, check the fitting and re-don the prosthetic limb. This gait pattern continues. Which of the following issues is MOST likely to cause the gait deviation?
9. Prosthetic limb is too short
10. Prosthetic limb is too long
11. Prosthetic socket too deep
12. Weak gluteus medius on sound side - Correct Answers 2 If a patient has a lateral lean, the usual cause of this deviation is excessive length of the prosthetic limb. It could be the actual limb being too long or if could be that the residual limb is not getting far enough into the socket, thus a functionally longer leg. When performing research studies, several approaches can be used to improve an aspect of the tests, including the use of consistent guidelines for completing the tests, administration of the tests by trained skillful examiners, and subsequent retests performed by the same individual. These approaches are describing which measure of research?
13. Causality
14. Dependability
15. Reliability
16. Validity - Correct Answers 3 Reliability is an important parameter of any test or measure. Although limited published data is available related to reliability measures, several approaches can be used to improve this aspect of the test, including: 1) use of consistent guidelines for completing the tests; 2) administration of the tests by trained, skillful examiners; and 3) subsequent retests performed by the same individual. It should also be noted that the patient's understanding of the test procedure and the patient's abilities to communicate results further influence on the reliability of sensory tests.

Osteogenesis imperfecta's clinical presentation may include all of the following impairments except: - Correct Answers