'05 Sullivan C.

Practice Questions 1
C1 C3 1
1. A patient has developed congestive heart failure after experiencing his first myocardial infarction. The pulmonary
signs and symptoms you expect to find include:
A. cough productive of thick yellow secretions.
B. crackles and clubbing of the digits.
C. crackles and cough.
D. inspiratory wheezing and shortness of breath.
C2 C8 1
2. A newborn is examined at birth using the APGAR test. The APGAR does NOT include:
A. heart rate, blood pressure, respiratory rate.
B. heart rate, respiratory rate, color.
C. muscle tone, heart rate, reflex irritability.
D. reflexes, muscle tone, and color.
C3 C7 3
3. A physical therapist requested that a PTA perform ultrasound on the left shoulder of a patient. During the treatment
session, the patient experienced an electrical shock. The physical therapist would not be responsible for any injury
to the patient if this was the result of:
A. failure of the PTA to use a ground fault interrupter.
B. failure of the PTA to use sufficient ultrasound gel.
C. product liability.
D. the patient touching the ultrasound machine.
C4 C6 3
4. A 55 year-old individual with documented coronary artery disease but no history of myocardial infarction is
enrolled in an exercise class that utilizes circuit-interval training. The MOST appropriate spacing of work-rest
intervals to stress the aerobic system is:
A. 1:11/2
B. 1:6
C. 1:7
D. 1:10
C5 C1 3
5. The BEST INITIAL intervention to improve functional mobility in an individual with a stable humeral neck
fracture is:
A. active resistive ROM.
B. isometrics for all shoulder musculature.
C. modalities to decrease pain.
D. pendulum exercises.
C6 C1 3
6. A twenty-one year-old female dancer with unilateral spondylolysis at L4 is referred to you. She complains of
generalized low back pain when she stands longer than one hour. A postural screen shows excessive lumbar
lordosis, right hip abduction and internal/medial rotation. Interventions for the subacute phase should include:
A. stretching the abdominals and hip abductors; strengthening the multifidi.
B. stretching the gluteus medius and maximus; strengthening the abdominals.
C. stretching the iliopsoas and iliotibial (IT) band; strengthening the abdominals.
D. stretching the multifidi and right hip abductors; strengthening the hip abductors.
C7 C1 1
7. A patient has fixed forefoot varus malalignment. Possible compensatory motion(s) or posture(s) might include:
A. excessive midtarsal or subtalar pronation.
B. genu recurvatum.
C. hallux varus.
D. ipsilateral pelvic external rotation.
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2 Practice Questions
C8 C7 3
8. The purpose of ABC Physical Therapy Center is to deliver excellent health care services in a unique,
individualized and participative manner at a reasonable cost. The provision of services under these conditions
requires and encourages creative involvement of physicians, staff, patients and their agents in all aspects of the
care planning and delivery process. This is an example of a:
A. excessive midtarsal or subtalar pronation.
B. strategic plan.
C. values statement.
D. vision statement.
C9 C5 3
9. A 26 year-old presents with weakness of the knee resulting from an anterior cruciate ligament injury. Your
examination reveals moderate pain (5/10) and excessive translation of the tibia during active knee extension. You
determine functional electrical stimulation (FES) is an appropriate modality. Your protocol for strengthening the
quadriceps and improving stability of the knee should consist of stimulation of the:
A. hamstrings immediately before the quadriceps to produce cocontraction.
B. hamstrings only.
C. quadriceps immediately before the hamstrings to produce cocontraction.
D. quadriceps only.
C10 C2 1
10. You are reviewing a hospital record prior to examining a patient for the first time. The suspected diagnosis is
multiple sclerosis. On the neurologists note you find the following: DTR right quadriceps is 2+, left quadriceps is
3+. You will focus your examination of this patient based upon the determination that:
A. both sides are abnormal and indicative of hyporeflexia.
B. both sides are abnormal and indicative of upper motor neuron syndrome.
C. both sides are within normal range and not indicative of pathology.
D. there is a normal response on the right while the left is exaggerated and indicates spastic hypertonia.
C11 C3 1
11. A 72 year-old patient has an episode of syncope in the physical therapy clinic. You attempt to rule out orthostatic
hypotension as the cause of her fainting. This is BEST done by:
A. checking HR and BP at rest, and after 3 and 5 minutes of cycle ergometry exercise.
B. checking HR and BP in supine after 5 minutes rest, then repeating in semi-Fowler position.
C. checking resting BP and HR in sitting, then repeating measurements after standing for 1 minute.
D. palpating the carotid arteries and taking HR; using the supine position for BP measurements.
C12 C4 3
12. A patient with a grade III diabetic foot ulcer is referred for physical therapy. The wound is foul smelling with a
green exudate. You describe this type of drainage in the medical record as:
A. purulent.
B. sanguineous.
C. serosanguineous.
D. serous.
C13 C8 1
13. You receive a referral for evaluation of fall risk in a 82 year-old who lives alone and has had two recent falls. The
activity that represents the MOST common risk factor associated with falls in the elderly is:
A. climbing on a stepstool to reach overhead objects.
B. dressing while sitting on the edge of the bed.
C. turning and sitting down.
D. walking with a roller walker with hand brakes.
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C14 C6 1
14. You are performing a prosthetic checkout on a patient with a transfemoral amputation. The prosthesis has been
fitted with a quadrilateral socket. A checkout of the walls of the socket should reveal:
A. anterior and lateral walls are 212 to 3 inches higher than the posterior and medial walls to ensure proper
positioning on the ischial seat.
B. the height of the posterior wall is 2 inches less than all the other walls.
C. the medial wall is 21/2 inches higher than the posterior wall while the anterior and lateral walls are the same
height.
D. the posterior and lateral walls are 2 inches higher than the medial and anterior walls.
C15 C7 3
15. A two month-old child with bilateral hip dislocations is being discharged home from your acute pediatric facility.
You have developed a home exercise program and now need to instruct her parents. The MOST important item to
assess before instructing the parents is:
A. the financial reimbursement plan.
B. the home environment.
C. their degree of anxiety and attention.
D. their level of formal education.
C16 C7 3
16. The grip strength of a group of 50 to 60 year-olds was investigated. A mean score of 40, SD of 5, and range of 26-
57 were reported. The grip strength score for a given patient was determined to be 34. You can safely conclude that
in a normal distribution this patients score fell within:
A. 32%.
B. 68%.
C. 75%.
D. 95%.
C17 C3 1
17. Which of the following findings is NOT typically present with cystic fibrosis?
A. excessive weight gain due to decreased ability to exercise.
B. frequent respiratory infections caused by Staph and Pseudomonas.
C. increased pancreatic secretions which cause gastrointestinal obstruction.
D. increased pulmonary secretions which cause airway obstruction.
C18 C8 1
18. An infant demonstrates that the ATNR is NOT obligatory when he/she can:
A. turn the head and bring the hand to mouth on the same side.
B. turn the head to either side.
C. turn the head to one side and bring the opposite hand to mouth.
D. turn the head to one side and look at the extended arm on that side.
C19 C4 3
19. A 75 year-old patient is referred to physical therapy for back pain. Medical tests reveal he is at the end stage of
pancreatic cancer. The physician has told him he has cancer but has chosen not to inform the patient about the
prognosis. If the patient asks you what his prognosis is, your BEST response would be to:
A. ethically you must tell him the prognosis.
B. tell him everything should work out for the best.
C. tell him to ask the nurse.
D. tell him to discuss his concerns with the physician.
C20 C1 1
20. During surgery to remove an apical lung tumor, the long thoracic nerve was injured. The muscle that is weakened
(3+/5) and the best position to strengthen it is:
A. serratus anterior, standing, performing wall push-ups.
B. serratus anterior, supine using weights.
C. subscapularis, supine using a pulley.
D. upper trapezius, standing using hand weights.
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C21 C1 2
21. A physical therapist examination reveals: iliac crests high on the left; PSIS low and posterior on the left; ASIS high
and anterior on the left; standing flexion test shows that the left PSIS moves first and farthest superiorly; Gillets
test demonstrates the left PSIS moves inferiorly and laterally less than right; long sitting test shows the left
malleolus moves short to long; sitting flexion test is negative. In light of the above findings, your diagnosis is:
A. iliac inflare on the left.
B. left anterior rotated innominate.
C. left posterior rotated innominate.
D. left upslip.
C22 C7 3
22. The highest level of provider risk in reimbursement is related to:
A. the capitation payment method.
B. the cost-based payment method.
C. the fee-for-service payment method.
D. the per diem payment method.
C23 C5 3
23. A patient presents with partial and full thickness burns on the chest and neck region. You decide to apply TENS
prior to your debriding procedure to modulate pain. The type of TENS for optimal relief is:
A. acupuncture-like (low rate) TENS.
B. brief intense TENS.
C. conventional (high rate) TENS.
D. modulated TENS.
C24 C2 3
24. A patient recovering from traumatic brain injury demonstrates instability during feeding while sitting in a
wheelchair. You determine modification is necessary to ensure function. The FIRST body segment or segments
you would align is the:
A. head.
B. lower extremities.
C. pelvis.
D. trunk.
C25 C2 2
25. Your patient demonstrates beginning recovery Stage 4 movements following a left CVA. The PNF pattern that
represents the best choice to promote continued recovery of the right upper extremity through the use of out-of-
synergy movements is:
A. bilateral symmetrical D1 thrust and reverse thrust.
B. bilateral symmetrical D2F and D2E, elbows straight.
C. chop, reverse chop with right arm leading.
D. lift, reverse lift with right arm leading.
C26 C3 2
26. A 40 year-old individual has limited endurance as a result of a sedentary lifestyle. There is no history of
cardiorespiratory problems. Following an exercise tolerance test, which was negative, an appropriate INITIAL
exercise prescription for this individual would be:
A. 30 - 60% HRmax.
B. 40 - 60% HRmax.
C. 45 - 55% of VO2max.
D. 60 - 90% HRmax.
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C27 C3 2
27. Following a mild myocardial infarction, a 53 year-old patient is referred to physical therapy for exercise
conditioning. During an initial exercise session he reports chest pain, appears anxious, and wants to go back to his
room to rest. After a rest period, your BEST course of action is to:
A. contact his doctor immediately.
B. contact the charge nurse on his floor immediately.
C. let the physical therapist assistant monitor his vital signs and take him back to his room.
D. take him back to his room yourself and continue to monitor vital signs.
C28 C4 2
28. A 24 year-old patient with scleroderma is being treated with temperature biofeedback. You will know if this
intervention is successful if the:
A. blood pressure increases.
B. heart rate increases.
C. patient tells you she feels looser, more flexible.
D. skin blushes.
C29 C8 2
29. A patient has been referred to P.T. following a fall injury (fractured left hip with ORIF). Her medical history
reveals a diagnosis of early Alzheimers disease (Stage 1). At this stage of Alzheimers, the behaviors you would
NOT expect to find are:
A. memory loss with increasing disorientation of time and date.
B. poor judgment and safety awareness.
C. profound aphasia and global deterioration of mental functions.
D. restlessness and episodes of sundowning.
C30 C6 2
30. A patient recovering from stroke with minimal lower extremity weakness and spasticity is able to walk without an
assistive device. You observe that as he walks he hikes his pelvis on the affected side during the swing phase. Your
BEST intervention is:
A. active exercises: bridging.
B. active exercises: sitting and standing, marching in place.
C. manual pressure applied downward on the pelvis during swing.
D. passive mobilization and stretch to quadriceps.
C31 C7 3
31. You are instructing a 22 year-old patient with traumatic brain injury how to lock the brakes on his wheelchair. He
is right-handed and his right upper extremity is more affected than his left. To get the most rapid results, your
BEST training strategy in this case is to:
A. guide his right hand through the locking motions, then his left.
B. have him practice brake locking using both hands together.
C. have him practice locking the brakes first with his left UE, and then his right.
D. verbally talk him through the locking motions using both hands simultaneously.
C32 C7 3
32. A physical therapist wants to examine the effects of PNF using the technique of contract-relax on shoulder ROM.
A group of 10 patients with adhesive capsulitis were recruited. A matched group of patients were given straight
plane active-assisted exercise for the same length of time (3 times/week for 6 weeks). In this study the independent
variable is:
A. active-assisted exercise.
B. adhesive capsulitis.
C. PNF contract-relax technique.
D. ROM.
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C33 C3 1
33. Clinical findings in a patient with severe emphysema would NOT include:
A. clubbing.
B. cor pulmonale.
C. cyanosis.
D. decreased A-P to lateral chest ratio.
C34 C1 3
34. A patient is receiving physical therapy after an ACL repair. After 4 weeks of treatment the patient still complains
of pain and instability even though he reports he has been faithful with his home exercise program and wearing his
brace. The original referral was for 7 to 8 weeks of physical therapy. Your BEST course of action is to:
A. complete the full 8 weeks of treatment and carefully document his lack of improvement to ensure full
insurance coverage.
B. discontinue the treatment.
C. discontinue the treatment; discuss your findings and refer the patient back to his referring physician.
D. recommend to the patient that he get a second medical opinion.
C35 C1 2
35. During a postural screen for chronic shoulder pain in a recreational swimmer, you observe excessive
internal/medial rotation of the shoulders and winging of the scapula during overhead motion. The overall focus of
your intervention should be:
A. strengthening of middle and lower trapezius and stretching of pectoral muscles.
B. strengthening of pectoral muscles and stretching of upper trapezius.
C. strengthening of rhomboids and stretching of upper trapezius.
D. strengthening of upper trapezius and stretching of pectoral muscles.
C36 C7 3
36. When billing Medicare, Medicaid and many other third party payers, providers are required to use the appropriate:
A. Common Procedural Coding System of Center for Medicare & Medicaid Services (CMS).
B. CPT and Common Procedural Coding System procedure codes.
C. Current Procedural Terminology (CPT) procedure codes.
D. Resource Based Relative Value Scale (RBRVS).
C37 C1 2
37. The spinal defect shown in the diagram should be managed with avoidance of lumbar spinal:
A. extension.
B. flexion.
C. lateral flexion.
D. rotation.
C38 C2 2
38. A 32 year-old computer specialist is unable to work because of weakness and altered sensation in her dominant
right hand. She complains of pain and tingling of the thumb, index finger, long finger, and radial half of the ring
finger. You observe thenar weakness and atrophy. Strength, reflexes, and sensation are within normal limits
throughout the remainder of the right upper extremity. Her signs and symptoms are characteristic of:
A. carpal tunnel syndrome.
B. cervical root compression.
C. pronator teres syndrome.
D. ulnar nerve compression.
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C39 C2 2
39. A 34 year-old presents with symmetrical weakness that had affected the distal lower extremity muscles first but
now has ascended to include proximal, trunk and upper extremity muscles. The motor segments of the lower
cranial nerves are also showing deficits. He complains of abnormal sensations of tingling and burning of the
affected extremities. Consciousness, cognition, and communication are all normal. His signs and symptoms are
characteristic of:
A. amyotrophic lateral sclerosis.
B. Guillain-Barr syndrome.
C. multiple sclerosis.
D. post-polio syndrome.
C40 C3 3
40. A patient recovering from surgery for triple coronary artery bypass grafts is scheduled to begin a Phase III cardiac
rehabilitation program. During the resistance training portion of the circuit training protocol, you instruct her to
AVOID Valsalvas maneuver because:
A. a cholinergic or vagal response can occur.
B. heart rate and blood pressure are elevated.
C. slowing of pulse and increased venous pressure is expected.
D. the decreased return of blood to the heart can lead to pitting edema.
C41 C4 2
41. A patient experiences color changes in the skin during position changes of the foot. During elevation, pallor
develops. When the limb is then positioned in the seated hanging position, hyperemia develops. These changes are
indicative of:
A. arterial insufficiency.
B. chronic venous insufficiency.
C. deep vein thrombophlebitis.
D. lymphedema.
C42 C8 2
42. A 73 year-old is referred to physical therapy for an examination of balance. He has a recent history of falls (two in
the last 6 months). Based on your knowledge of balance changes in the elderly and scoring of standardized balance
measures, the test data that BEST indicates increased fall risk is:
A. a score on the Tinetti Performance Oriented Mobility Assessment (POMA) of 27.
B. A Timed Get Up & Go test result of 13 seconds.
C. Berg Balance score of 50.
D. Functional Reach of 7 inches.
C43 C6 3
43. A patient walks with a Trendelenburg gait. The MOST appropriate intervention to correct this problem is:
A. bridging, holding with Theraband around both thighs.
B. half kneeling, weight shifting onto the weak side (foot).
C. standing, stepping with the weaker limb, forward and backward.
D. supine, lateral leg slides.
C44 C3 2
44. A 72 year-old patient is walking on a treadmill in the physical therapy department while his vital signs are being
monitored. It is noted that his SaO2 drops from 97% to 95%. In this case, it would be BEST to:
A. not use supplemental O2.
B. place 2 liters of O2 by nasal cannula on the patient for the remainder of the exercise session.
C. place a 100% O2 face mask on the patient for the remainder of the exercise session.
D. place a 40% O2 face mask on the patient for the remainder of the exercise session.
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C45 C8 2
45. You are evaluating the needs of a 6 year-old child who is diagnosed with myelodysplasia at the T10 level. You
determine the most appropriate mobility device for this child to use in the school environment is a:
A. bilateral HKAFO.
B. bilateral KAFO.
C. lightweight wheelchair.
D. parapodium.
C46 C1 3
46. A patient has limited right rotation caused by left thoracic facet joint capsular tightness. The intervention that
would best facilitate improved right rotation in sitting is:
A. trunk extension with left rotation.
B. trunk extension with right rotation.
C. trunk flexion with left rotation.
D. trunk flexion with right rotation.
C47 C1 1
47. EMG activity in the lower extremities during erect standing is continuous in the :
A. anterior tibialis and peroneals.
B. posterior tibialis and intrinsic foot muscles.
C. quadriceps femoris and anterior tibialis.
D. soleus and gastrocnemius.
C48 C7 3
48. A patient had a fall while walking in the parallel bars. The incident report of the event should include:
A. the cause of the incident, the corrective actions taken, names of those involved.
B. the cause of the occurrence, the name of the injured and the date of the occurrence.
C. the name of those involved, witnesses, what occurred when it occurred, where it occurred only in event of an
injury.
D. the name of those involved, witnesses, what occurred, when it occurred, where it occurred.
C49 C5 3
49. Four days ago, your patient sustained a deep contusion of the right lateral thigh as a result of a blow on the leg by a
steel beam. Following several cryotherapy treatments, you choose to apply ultrasound. The US parameters of
choice are:
A. continuous US at 1 MHz.
B. continuous US at 3 MHz.
C. pulsed US at 1 MHz.
D. pulsed US at 3 MHz.
C50 C2 2
50. A 99 year-old woman was found unconscious at home. Two days later you examine her in the hospital. Your
findings include normal sensation and movement on the right side of the body with impaired sensation (touch,
pressure, proprioception) and paralysis on the left side of the body. The left side of her lower face and her trunk are
similarly impaired. The MOST LIKELY location of the lesion is the:
A. cerebral cortex: left parietal lobe.
B. cerebral cortex: right parietal lobe.
C. left side of the brainstem.
D. spinal cord.
C51 C2 1
51. The loss of sensory function in peripheral neuropathy is often among the first noticeable symptoms. If more than
one nerve is involved, the sensory loss typically appears as:
A. allodynia of the feet accompanied by pronounced dorsiflexor weakness.
B. bandlike dysesthesias and paresthesias in the hips and thighs.
C. paresthesias affecting primarily the proximal limb segments and trunk.
D. stocking and glove distribution.
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C52 C3 2
52. You are supervising a Phase II cardiac rehabilitation class of 10 patients. One of the patients, who is being
monitored with radiotelemetry, is having difficulty. You decide to terminate this patients exercise session and alter
his prescription to reduce the exercise intensity when you observe:
A. 1 mm ST-segment depression, upsloping.
B. a 20 AV heart block.
C. an increase in HR 20 BPM above resting.
D. an increase in systolic BP to 150 and diastolic BP to 90.
C53 C4 3
53. A 51 year-old patient presents with severe claudication which is evident when he walks distances greater than 200
feet. He also exhibits muscle fatigue and cramping of both calf muscles. Upon examination, you find his skin is
pale and shiny with some trophic nail changes. Your BEST choice for intervention is to:
A. avoid any exercise stress until he has been on calcium channel blockers for at least 2 weeks.
B. begin with an interval walking program, exercising only to the point of pain.
C. utilize a walking program of moderate intensity, instructing the patient that some pain is expected and to be
tolerated.
D. utilize nonweightbearing exercises such as cycle ergometry.
C54 C8 3
54. A 72 year-old is hospitalized with diabetes and a large stage II plantar ulcer located over his right heel. He has
been non-weightbearing for the past 2 weeks as a result of the ulcer. Based on your knowledge of this condition
the BEST intervention is:
A. clean and bandage with a dry sterile dressing; provide custom fitted, pressure relieving orthotic shoe insert.
B. clean and debride the wound in a whirlpool followed by a hydrogel dressing and pressure relief.
C. request a surgical consult; physical agents will not promote healing.
D. wash the foot and apply skin lubricants; a custom made shoe is indicated.
C55 C6 3
55. You are prescribing a wheelchair for a patient with left hemiplegia. The MOST appropriate feature to include in
this prescription:
A. are detachable arm rests
B. are elevating legrests.
C. is a 17 inch seat height.
D. is a 20 inch seat height.
C56 C6 3
56. A patient presents with decreased strength, 3/5, in the right quadriceps. During gait, you expect his greatest
difficulty will occur at:
A. heel off.
B. heel strike.
C. midstance.
D. terminal swing.
C57 C1 2
57. A patient who was casted for 3 weeks following a Grade III right ankle sprain has been referred to physical
therapy for mobility exercises. Examination shows a loss of 10 degrees of dorsiflexion. The patient will have the
MOST difficulty in:
A. ambulating barefoot.
B. ambulating over rough surfaces.
C. descending a ramp.
D. descending stairs.
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C58 C6 3
58. The torque output produced during isokinetic exercise involving the hamstrings in the sitting position is:
A. higher due to eccentric assistance of the quadriceps.
B. higher than the torque actually generated by the contracting hamstrings.
C. lower due to resistance of the quadriceps.
D. lower than the torque actually generated by the hamstrings.
C59 C1 3
59. A manual therapy technique utilized to correct a closing restriction of T5 on T6 is:
A. central P/A pressure at a 45 degree angle on the spinous process of T5 while stabilizing T6.
B. central P/A pressure at a 60 degree angle on the spinous process of T6 while stabilizing T5.
C. unilateral P/A pressure at a 45 degree angle on the right transverse process of T6 while stabilizing T5.
D. unilateral P/A pressure at a 60 degree angle on the left transverse process of T6 while stabilizing T5.
C60 C2 2
60. A patient presents with an acute onset of vertigo over night. Symptoms worsen with rapid change in head position.
If the head is held still, symptoms subside usually within 1 to 2 minutes. The MOST likely cause of this patients
problem is:
A. acoustic neuroma.
B. benign paroxysmal positional vertigo.
C. bilateral vestibular neuritis.
D. Mnires disease.
C61 C3 2
61. A patient with a significant history for coronary artery disease tells you he is currently taking atropine. Based on
your knowledge of the effects of this medication you expect:
A. bradycardia at rest and with exercise.
B. increased heart rate and contractility.
C. reduced blood pressure at rest and with exercise.
D. reduced myocardial ischemia and heart rate.
C62 C4 2
62. A 67 year-old patient recovering from stroke is on warfarin (Coumadin). During his rehabilitation, it would be
important to watch for:
A. cellulitis and xeroderma.
B. edema and dermatitis.
C. hematuria and ecchymosis.
D. palpitations and edema.
C63 C8 3
63. A 91 year-old patient has reduced vision as a result of bilateral cataracts. Which of the following is NOT an
appropriate intervention for this patient?
A. avoiding having him walk on shiny floor surfaces.
B. highlighting steps with pastels, blues and greens.
C. minimizing visual distractions in his immediate environment.
D. using high illumination for reading and ADLs.
C64 C6 2
64. A patient is having difficulty with stair climbing. He is able to position his foot on the step but is unable to transfer
the weight of his body up to the next stair level. The PRIMARY muscle that is responsible for elevating the body
is the:
A. gastrocnemius-soleus.
B. gluteus maximus.
C. quadriceps femoris.
D. tibialis anterior.
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C65 C4 2
65. A 72 year-old patient has been hospitalized, on complete bedrest, for 10 days. Your referral requests mobilization
out-of-bed and ambulation. The patient tells you that today his right calf is aching. If he gets up and moves around
he is sure he will feel better. Your examination reveals calf tenderness. You decide to:
A. ambulate the patient with elastic stockings.
B. begin with ankle pump exercises in bed.
C. begin with sitting the patient up over the edge of the bed for 5 minutes.
D. postpone ambulation and report your findings immediately.
C66 C8 1
66. A nine year-old boy with Duchennes muscular dystrophy is a new patient through homecare. You should BEGIN
your examination by:
A. asking the child and his parent/caretakers to describe the boys most serious physical problems from their
perspectives.
B. asking the parents to outline the childs developmental milestones.
C. performing a complete motor examination.
D. performing a functional examination using the weeFIM.
C67 C1 1
67. During an examination of an adolescent female who complains of anterior knee pain, you observe that the lower
extremity shows medial femoral torsion and toeing-in position of the feet. The lower extremity position may be
indicative of excessive hip:
A. anteversion.
B. lateral/external rotation.
C. medial/internal rotation.
D. retroversion.
C68 C1 3
68. A patient with osteoporosis and no fractures complains of increased mid and low back pain during breathing and
most other activities. The MOST appropriate interventions for this patient would include patient education and:
A. trunk extension and abdominal stabilization exercises.
B. trunk flexion and extension exercises.
C. trunk flexion, extension, and rotation exercises.
D. trunk rotation and abdominal stabilization exercises.
C69 C1 2
69. A single, 22 year-old female, who is 3 months pregnant, walks into your facility. She complains of shoulder and
leg pain. She has a black eye and some bruising at the wrists. The state in which you practice has direct access. An
appropriate course of action is:
A. administer massage for bruising, TENs and ice modalities for pain, as indicated by the examination findings.
B. direct the patient to the nearest Ambulatory Care Center for physician evaluation.
C. do a comprehensive examination and send her to the emergency room.
D. do a comprehensive examination, and if you suspect abuse report your findings to the appropriate authorities.
C70 C5 3
70. A 73 year-old patient presents with a stage III decubitus ulcer on the plantar surface of the right foot. After a series
of conservative interventions with limited success, the therapist chooses to apply electrical stimulation for tissue
repair. The electrical current BEST suited in this case is:
A. high volt monophasic pulsed current.
B. interferential current.
C. low volt biphasic pulsed current.
D. Russian current.
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C71 C5 3
71. A patient presents with pain radiating down the posterior hip and thigh as a result of a herniated disk in the lumbar
spine. You decide to apply mechanical traction. If the patient can tolerate it, the PREFERRED patient position is:
A. prone with no pillow.
B. prone with pillow under the abdomen.
C. supine with both knees flexed.
D. supine with one knee flexed.
C72 C2 3
72. A patient recovering from stroke demonstrates hemiparesis of his right upper extremity and moderate flexion and
extension synergies (flexion stronger than extension). Your goal is strengthen the shoulder muscles first,
specifically the deltoid. Your BEST choice is to promote:
A. abduction with elbow extension.
B. abduction with elbow flexion.
C. horizontal adduction with elbow extension.
D. horizontal adduction with elbow flexion.
C73 C2 2
73. A patient recovering from a middle cerebral artery stroke presents with gaze deviation of the eyes. In this type of
stroke the involved eye may deviate toward:
A. down and out.
B. the hemiplegic side.
C. the sound side.
D. up and in.
C74 C3 2
74. A 44 year-old patient is referred for physical therapy following an exercise tolerance test. His physician reports the
test was positive and had to be terminated at 7 minutes. Based on your knowledge of this procedure, you expect
the patient may have exhibited:
A. a hypertensive response, BPs of at least 170/95.
B. ECG changes from baseline (1 mm ST-segment elevation).
C. ECG changes from baseline (3 mm horizontal or downsloping, ST-segment depression).
D. increasing angina and dyspnea with progressive increases in the treadmill speed and grade.
C75 C1 2
75. A twenty-one year old college soccer player sustained a hyperextension knee injury when kicking the ball with his
other lower extremity. The patient was taken to the emergency room of a local hospital and was diagnosed with
knee sprain. He was sent to physical therapy the next day for aggressive rehabilitation. As part of the
examination to determine the type of treatment plan to implement, the therapist conducted the anterior drawer test.
The type of exercise that is contraindicated in the acute phase of treatment if a positive test is found includes:
A. agility training.
B. closed-chain terminal knee extension exercises.
C. open-chain terminal knee extension exercises.
D. short arc quad exercises.
C76 C4 3
76. A patient with a grade III diabetic ulcer is being treated with a calcium alginate wound dressing. This type of
dressing can be expected to:
A. absorb exudate and allow rapid moisture evaporation.
B. facilitate autolytic debridement.
C. prove impermeable to bacteria.
D. provide semirigid support for the limb.
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C77 C4 3
77. You receive a referral to treat a patient with cirrhosis and Hepatitis B. As a result of these diagnoses, you should:
A. ask the patient to refrain from touching you without gloves.
B. avoid all direct physical contact with the patient.
C. avoid direct exposure to blood and body fluids.
D. treat the patient as you would any other patient; no precautions are necessary.
C78 C6 2
78. A patient with a transtibial amputation is learning to walk using a PTB prosthesis. He is having difficulty
maintaining prosthetic stability from heel-strike to footflat. The muscle group that is MOST LIKELY weak are the:
A. back extensors.
B. hip flexors.
C. knee extensors.
D. knee flexors.
C79 C3 2
79. A patient with a history of coronary artery disease and recent myocardial infarction is exercising in the P.T. gym
while on an ECG telemetry monitor. You observe 5 consecutive PVCs on her ECG. Normal sinus rhythm then
returns. Your BEST course of action is to:
A. activate the emergency medical response team.
B. have the patient sit down, continue monitoring, and notify the physician.
C. stop the exercise and send her back to her room as soon as possible.
D. stop the exercise, have her rest, then resume at a lower intensity.
C80 C7 3
80. A 16 year-old patient recovering from traumatic brain injury is unable to bring her right foot up on the stair during
stair climbing training. The BEST training activity is to:
A. have her practice marching in place.
B. passively bring her foot up and place it on the 7 inch step.
C. practice stair climbing inside the parallel bars using a 3 inch step.
D. strengthen her hip flexors using an isokinetic training device before attempting stair climbing.
C81 C3 3
81. Which of the following interventions is NOT beneficial for a patient with a right lower lobe viral pneumonia:
A. ambulation activity, monitoring SaO2, HR, RR, and BP.
B. breathing exercises, encouraging right lateral costal expansion.
C. postural drainage, percussion, and shaking to the right lower lobe and other areas with abnormal auscultatory
findings.
D. teaching an independent exercise program to the patient.
C82 C4 2
82. A patient suffered a spinal cord injury with a complete injury (ASIA Level A) at T10. It is now three months post-
injury and she is refusing to participate in her functional training program because the major focus is wheelchair
independence. She is sure she is going to walk again. Your BEST approach is to:
A. discuss the harmful effects of denial and restrict all discussions to promoting wheelchair independence.
B. recognize the patients need for hope while outlining realistic short term goals to improve independence.
C. refer the patient for psychological counseling and discharge her from P.T.
D. send the patient home for a short time so she will recognize the need for wheelchair training.
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C83 C8 3
83. You are on a home visit, scheduled at lunchtime, visiting an 18 month-old child with moderate developmental
delay. You notice the child and mother are experiencing difficulties with feeding. The child is slumped down in the
highchair and is unsuccessfully attempting to use a raking grasp to lift cereal pieces to her mouth. Both the child
and mother are frustrated. Your FIRST intervention should be to:
A. position the child in a proper sitting position using postural supports.
B. recommend the mother feed the child baby food instead of cereal for a few more months.
C. recommend the mother return to breast feeding for a few more months.
D. work on desensitizing the gag reflex.
C84 C1 3
84. A 55 year-old woman was sent to physical therapy with a diagnosis of frozen shoulder. The MOST effective
mobilization technique for restricted shoulder abduction is:
A. inferior glide at 55 degrees of abduction.
B. inferior glide at 95 degrees of abduction.
C. lateral glide in neutral position.
D. posterior glide at 10 degrees of abduction.
C85 C1 2
85. A male patient presents with insidious onset of pain in the jaw that is referred to the head and neck regions. As best
as he can recall, it may be related to biting into something hard. Cervical ROM is limited in flexion by 20 degrees,
cervical lateral flexion limited to the left by 10 degrees. Mandibular depression is 10mm with deviation to the left,
protrusion is 4mm, and lateral deviation is 15mm to right and 6mm to left. Based on these findings the diagnosis
for this patient would be:
A. capsule-ligamentous pattern of TMJ on the left.
B. cervical spine and TMJ capsular restrictions on the left.
C. weak lateral pterygoids on the left.
D. weak lateral pterygoids on the right.
C86 C7 3
86. Your patient, a 35 year-old administrative assistant and mother of three is being treated for a Colles fracture. Her
husband wants to look at her medical record. As her physical therapist you should:
A. deny access to the chart unless written permission by his wife is granted.
B. give him the chart as he is a family member and has a right to view the information.
C. let him look at the chart with your supervision.
D. not let him look at the chart because he may misinterpret the documentation.
C87 C3 2
87. A patient with a recent history of rib fractures suddenly becomes short of breath during secretion removal
techniques. The patient looks panicked and complains of sharp pain in the left chest. A quick screen shows a
deviated trachea to the right among other signs and symptoms. The MOST LIKELY explanation for the above is:
A. angina.
B. mucous plugging of an airway.
C. pneumothorax.
D. pulmonary emboli.
C88 C5 3
88. Your patient presents with supraspinatus tendinitis. After the initial cryotherapy, you decide to apply ultrasound. To
effectively treat the supraspinatus tendon, you would place the shoulder joint in:
A. abduction and external rotation.
B. abduction and internal rotation.
C. neutral position and external rotation.
D. neutral position and internal rotation.
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C89 C2 3
89. A patient is 5 weeks poststroke and is demonstrating good recovery of her right upper extremity, characterized as
stage 4 recovery stage. Your BEST choice for a training activity is to have the patient:
A. bear weight on the extended right arm in sitting.
B. put on socks and shoes while in sitting.
C. reach forward to bear weight with the right arm extended against the wall.
D. reach overhead with right arm straight.
C90 C2 2
90. A patient is 2 days post left CVA and has just been moved from the intensive care unit to a stroke unit. When you
arrive to begin your examination, you find his speech slow and hesitant. He is limited to one and two-word
productions and his expressions are awkward and arduous. His writing skills parallel his speech difficulties.
However, he demonstrates good comprehension. His difficulties are consistent with:
A. Brocas aphasia.
B. dysarthria.
C. global aphasia.
D. Wernickes aphasia.
C91 C2 3
91. A 17 year-old patient recovering from traumatic brain injury is functioning at Stage IV on the Rancho Los Amigos
Levels of Cognitive Functioning Scale. During your initial examination she becomes agitated and tries to bite you.
Your BEST course of action is to:
A. engage in a calming activity and observe behaviors closely.
B. postpone the examination for one week and then try again.
C. postpone the examination until later in the day when she calms down.
D. restructure the formal examination so you can complete it in three very short sessions.
C92 C3 2
92. During an education session with patients and families, you are going over the major signs and symptoms
suggestive of myocardial infarction. You determine the outcomes of the class have been successful. The
participants can successfully identify major signs and symptoms. Which of the following is NOT an initial
presenting symptom of M.I.?
A. dizziness or syncope upon arising from bed.
B. pain or discomfort in the chest, neck, jaw, or arms.
C. palpitations or tachycardia.
D. unusual fatigue or shortness of breath, clammy skin.
C93 C3 2
93. A 32 year-old runner is examined in physical therapy for anterior pain in the right lower leg. Her resting heart rate
is found to be 46 bpm. The MOST LIKELY explanation for this is that:
A. a compensatory response to prolonged endurance activity is depressed heart rate with increased respiratory
rate.
B. a low heart rate is suggestive of a hypotensive disorder.
C. coronary pathology should be suspected with this abnormally low heart rate.
D. prolonged endurance training has resulted in a low heart rate.
C94 C4 2
94. A patient has been taking corticosteroids (hydrocortisone) for management of adrenocortical insufficiency. She is
referred to physical therapy for mobility training following a prolonged hospitalization. Potential adverse effects
that one can expect from prolonged use of this medication include:
A. confusion and depression.
B. decreased appetite and weight loss.
C. hypotension and myopathy.
D. muscle wasting and increased risk of fracture.
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C95 C4 3
95. A patient is referred for wound debridement using hydrotherapy. Upon examination, you find the wound is clean,
with healthy red granulation tissue and minimal drainage. Your BEST choice for wound management is to:
A. not use a whirlpool additive.
B. use high-pressure wound lavage while in the whirlpool.
C. use povidone-iodine as a whirlpool additive.
D. use sodium hypochlorite as a whirlpool additive.
C96 C6 3
96. Recently a 10 year-old patient has begun walking with supination of her foot. With her shoe off, you find a new
callus on the lateral side of the metatarsal head of the 5th toe. Your BEST choice for orthotic prescription is:
A. scaphoid pad.
B. Thomas heel.
C. viscoelastic shoe insert with forefoot lateral wedge.
D. viscoelastic shoe insert with forefoot medial wedge.
C97 C6 3
97. A 74 year-old patient is recovering from a right total hip replacement (posterolateral incision, cementless fixation).
The MOST appropriate type of bed-to-wheelchair transfer to teach is to have the patient:
A. increase forward flexion during standing-up.
B. transfer to the operated side.
C. transfer to the sound side.
D. use a transfer board.
C98 C6 3
98. A patient with paraplegia at the T10 level wants to participate in wheelchair basketball. He asks you what options
he should look for in a wheelchair. You tell him it would be important to include:
A. a folding frame.
B. a mid-scapular seat back.
C. a rigid frame.
D. hard-rubber tires.
C99 C8 3
99. You are treating a child with mild developmental delay secondary to moderate prematurity at birth who is just
learning to sit. The best choice for training activity is:
A. prone tilting reactions.
B. sideward protective extension in sitting.
C. standing tilting reactions.
D. supine tilting reactions.
C100 C3 2
100. A 80 year-old patient with emphysema with no history of cardiac disease performs a 12 minute exercise tolerance
test, covering 1,106 feet. His vital signs prior to exercise were: HR 104, BP 130/76, SaO2 92%. At peak exercise
his vital signs were: HR 137, BP 162/74, SaO2 92%. To calculate his exercise intensity parameters, the BEST
method would be to use:
A. 40 to 50% of Max METs.
B. 70 to 80% of HRmax.
C. 70 to 85% of age adjusted predicted HRmax.
D. Karvonens formula (HR reserve).
C101 C8 2
101. An expected outcome for a fifteen year-old boy with Duchennes muscular dystrophy is:
A. ambulation with a walker.
B. increase strength and range of motion of the lower extremities.
C. independent in ambulation.
D. independent in wheelchair mobility.
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C102 C1 1
102. When performing scoliosis screening in a school setting, the optimal age to screen for girls is:
A. 15-17.
B. 6-8.
C. 9-11.
D. 12-14.
C103 C1 3
103. A patient with a confirmed left C6 nerve root compression due to foraminal encroachment complains of pain in his
left thumb and index finger. The MOST effective cervical position to alleviate this radicular pain in weightbearing
is:
A. left sidebending.
B. lower cervical extension.
C. lower cervical flexion.
D. right rotation.
C104 C1 1
104. A patient is standing with excessive subtalar pronation. Possible correlated motions or postures are:
A. femoral external rotation, and pelvic external rotation.
B. femoral internal rotation, and pelvic external rotation.
C. tibial, femoral, and pelvic external rotation.
D. tibial, femoral, and pelvic internal rotation.
C105 C7 3
105. When performing a chart audit, you realize a date of service was documented inappropriately. You should:
A. do nothing.
B. put a single line through the incorrect date, initial it, document the correct date, and the date the correction
was made.
C. use white out and put the correct date of service in.
D. write over the date of service to correct it with ink.
C106 C5 3
106. You are applying high volt pulsed current to the vastus medialis to improve patellar tracking during knee
extension. Your patient complains that the current is uncomfortable. To make the current more tolerable to the
patient, yet maintain a good therapeutic effect, you should consider adjusting the:
A. current intensity.
B. current polarity.
C. pulse duration.
D. pulse rate.
C107 C2 2
107. A patient has a 10 year history of multiple sclerosis and presents with drooping of the right upper eyelid,
constriction of the pupil, and vasodilation with absence of sweating on the face and neck. These signs are
characteristic of:
A. Argyll Robertson pupil.
B. homonymous hemianopsia.
C. Horners syndrome.
D. nystagmus.
C108 C2 2
108. A patient presents with symptoms of uncoordinated eye movements and profound gait and trunk ataxia. He has
difficulty with postural orientation to vertical and tends to tip over even if his eyes are open. Examination of the
extremities reveals little change in tone or coordination. You suspect involvement of the:
A. basal ganglia.
B. premotor cortex.
C. spinocerebellum.
D. vestibulocerebellum.
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C109 C3 2
109. A 37 year-old patient experiences cramping, pain, and fatigue of the buttock after walking 400 feet. When he stops
exercising, the pain goes away immediately. You check his medical record and find no mention of this problem.
Your BEST course of action is to:
A. advise the patient he will have to curtail his walking until you do further tests.
B. prescribe an intermittent walking program with enough rests to eliminate the pain.
C. provide the patient with a home exercise program of spinal extension exercises.
D. report this finding to the physician as it might be indicative of peripheral vascular disease.
C110 C4 2
110. A 42 year-old patient has marked elevation of blood pressure. He complains of mild to severe midabdominal pain
that increases upon exertion. Palpation reveals a pulsing mass in the lower abdomen. You should:
A. discontinue treatment and notify his physician immediately.
B. do not treat; instruct the patient to see his physician as soon as possible.
C. instruct in relaxation exercises; postpone all other treatment.
D. provide warm hot packs to the abdomen to relieve the pain; do not exercise.
C111 C4 3
111. A patient with a small, purulent wound located on his left heel is referred for wound irrigation. It would be BEST
to:
A. irrigate the wound in the whirlpool using lukewarm water.
B. irrigate the wound with hydrogen peroxide while having the patient wear protective garments.
C. irrigate the wound with povidone-iodine while wearing protective eyewear, garment, and gloves.
D. protect the wound borders with protective shields to prevent pulsating lavage from damaging healthy tissue.
C112 C8 2
112. An 85 year-old female wheelchair dependent resident of a community nursing home has a diagnosis of organic
brain syndrome, Alzheimers type. In developing her plan of care, it is important to understand that she:
A. can usually be trusted to be responsible for her daily care needs.
B. can usually be trusted with transfers with appropriate positioning of the wheelchair.
C. is more likely to remember current experiences than past ones.
D. will likely be resistant to activity training if unfamiliar activities are used.
C113 C6 3
113. To increase the stride length of a patient with a right transfemoral amputation who uses a total contact prosthesis,
you should:
A. facilitate the gluteals.
B. provide anterior directed resistance to the right PSIS during swing.
C. provide posterior directed resistance to the left ASIS during swing.
D. provide posterior directed resistance to the right ASIS during stance.
C114 C6 3
114. A patient with a complete C7 spinal cord injury is having difficulty with pushups while in his wheelchair. The
MOST appropriate lead-up activity to enhance wheelchair pushups is:
A. prone-on-elbow pushups.
B. shoulder shrugs.
C. supine bench press using 50% one repetition max.
D. supine-on-elbows pushups.
C115 C7 3
115. You are concerned that a student you are supervising, who is on a final clinical rotation, is not exhibiting
appropriate behaviors. Specifically, he does not seem to be willing to listen to others or demonstrate tolerance and
sensitivity to patient needs. The MOST appropriate conclusion to reach from these behaviors is:
A. affective objectives dealing with attending are not being met.
B. he does not value respect for human dignity.
C. his problem is one of conceptualization and forming appropriate judgments.
D. his problem is one of failure to accept responsibility.
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C116 C7 3
116. A therapist wants to investigate the effectiveness of use of the therapeutic pool for decreasing pain in a group of
patients with fibromyalgia. Two groups of patients were recruited. One group was assigned to exercises and
walking in the pool 3 times/week for 6 months. The other group was assigned to a gym walking program for the
same amount of time. At the end of the study, outcomes were assessed using the McGill Pain Questionnaire and
the Health Status Questionnaire. In order to improve reliability, the lead investigator should:
A. have another therapist reassess after 6 months and compare to normalized scores.
B. have the same therapist reassess the patients after 6 months.
C. perform all the final assessments himself and compare to the initial assessments performed by a core group of
therapists.
D. utilize a core of 4 experienced therapists to randomly complete all the assessments.
C117 C3 2
117. Your patient is a 55 year-old individual who has many risk factors for coronary artery disease. He is interested in
beginning an exercise program to improve his cardiac health. The most accurate measure of exercise intensity to
monitor during his first exercise session is:
A. heart rate.
B. MET level.
C. rating of perceived exertion.
D. respiratory rate.
C118 C8 2
118. A mother brings her 8 week-old infant to be examined at Early Intervention because she noticed that the infant was
taking steps in supported standing at two weeks but was not able to do it now. You should:
A. explain that this is normal and that the stepping was a newborn reflex which has gone away.
B. recommend that a full developmental exam be performed by the Early Intervention team.
C. recommend that the mother bring the infant to a pediatric neurologist.
D. tell her she must have been mistaken.
C119 C1 1
119. A patient complains of pain with mouth opening that makes it difficult for her to eat foods that require chewing.
Mouth opening was found to be within normal limits of:
A. 15-24mm.
B. 25-34mm.
C. 35-49mm.
D. 50-65mm.
C120 C1 3
120. Correction of flexible forefoot varus with excessive subtalar pronation is accomplished by a customized orthosis
with:
A. lateral forefoot posting.
B. medial forefoot and rearfoot varus posting.
C. medial forefoot posting.
D. rearfoot varus posting.
C121 C1 2
121. Your patient, a 40 year-old female, presents with complaints of tingling and paresthesias in the median nerve
distribution of the right forearm and hand. The following tests were found negative bilaterally: Adson,
hyperabduction, costoclavicular, Phalens, and the ulnar nerve Tinel sign. Based on this information, the diagnosis
that has NOT been ruled out is:
B. pronator teres syndrome.
C. thoracic outlet syndrome.
D. ulnar nerve entrapment.
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C122 C7 3
122. A female patient scheduled for a 30-minute treatment session arrives 10 minutes late. The subsequent patients are
also scheduled for 30 minutes sessions and there is no break in your schedule to accommodate for the patients
tardiness. You should:
A. ask the patient if there is a more convenient time for her appointment so she can benefit from the complete 30-
minute session.
B. determine a better treatment time, treat the patient, and bill for the 20 minute session given.
C. have the office secretary send the patient home until her next scheduled appointment, with a request to be
punctual.
D. treat the patient and bill for 30 minutes of scheduled treatment time.
C123 C5 3
123. A patient has been referred to you s/p fracture of the femur six months ago. The cast was removed, but the patient
is unable to volitionally contract the quadriceps. You decide to apply electrical stimulation to stimulate the
strengthening of the quadriceps muscle. Your choice of electrode size and placement would consist of:
A. large electrodes, closely spaced.
B. large electrodes, widely spaced.
C. small electrodes, closely spaced.
D. small electrodes, widely spaced.
C124 C2 3
124. A 65 year-old patient is recovering from a right CVA. Due to a series of medical complications she is still
bedridden 6 days post stroke. You want to reduce the expected negative effects of developing spasticity. The BEST
choice of bed position for this patient is:
A. sidelying on the affected side, with the affected shoulder positioned directly underneath, the hip slightly
extended with knee flexed on a pillow.
B. sidelying on the sound side, affected arm and leg extended at the side, with a pillow between the knees.
C. supine, trunk in midline with small pillow under the scapula, arm extended on supporting pillow, and a small
towel roll under the knee.
D. supine, trunk in slight lateral flexion to the sound side with elbow flexed and supported on a pillow, leg
straight.
C125 C2 1
125. If the subjects vision is blocked either by having the subject close the eyes or by placing a barrier between the part
being tested and the subjects eyes, you can effectively examine:
A. conscious proprioception but not discriminative touch.
B. discriminative touch and fast pain but not proprioception.
C. somatosensory integrity.
D. vestibular/visual/somatosensory integration.
C126 C3 2
126. You are examining a patient in the coronary intensive care unit. On auscultation you hear an adventitious S3 heart
sound. This finding is indicative of:
A. aortic valve dysfunction.
B. congestive heart failure.
C. pericarditis.
D. pulmonary valve dysfunction.
C127 C3 2
127. You are advising a 67 year-old individual who wants to take part in a graduated conditioning program by joining
the Mall Walkers Club. Which of the following is LEAST appropriate when prescribing exercise for the healthy
elderly?
A. an initial conservative approach to reduce characteristic muscle fatigability.
B. focus on low intensity and increased duration of exercise to avoid injury.
C. intensity prescribed by HR reserve method and Ratings of Perceived Exertion.
D. intensity prescribed using maximal age-related HR.
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C128 C4 2
128. A 72 year-old patient recovering from stroke has been using a bilateral exerciser (UBE) to strengthen muscles in
his affected right upper extremity. He is now experiencing burning pain in his shoulder that worsens when his limb
is touched or moved. He also presents with paresthesias and pitting edema in the dorsum of the hand. ROM of the
wrist and fingers is painful and diminished. Your BEST course of action is to:
A. discontinue all treatment until pain disappears.
B. discontinue UBE exercise, splint the hand and wrist until pain and swelling disappear.
C. discontinue UBE exercise; provide massage and active assistive range of motion for the entire extremity.
D. switch to interval exercise and lower the resistance on the UBE.
C129 C8 2
129. A 74 year-old patient has had two recent falls coming home from Bingo after dark. Her outside steps are well lit.
Shes unsure why she has fallen but tells you both times she fell just as she came into her house, before she even
had a chance to put her purse down and turn on the inside lights. You suspect a problem with:
A. decreased corneal sensitivity.
B. decreased ocular scanning movements.
C. loss of accommodation and near vision.
D. poor light adaptation.
C130 C6 3
130. A patient presents with 2/5 muscle strength in both lower extremities and 3/5 strength in the upper extremities. The
MOST appropriate transfer to teach this patient to move from bed to wheelchair is:
A. dependent 1-man squat transfer.
B. sliding board.
C. stand pivot.
D. stand-by assist.
C131 C6 3
131. A patient with a spinal cord injury at the level of T1 is in the community phase of his mobility training. In order
for him to navigate a standard height curb with his wheelchair, you tell him to:
A. ascend backwards with the large wheels first.
B. descend backward with the trunk upright and arms hooked around the push handles.
C. lift the front casters and ascend in a wheelie position.
D. place the front casters down first during descent.
C132 C3 2
132. A patient with a long history of systemic steroid use for asthma control has a contraindication for percussion if
there is evidence of:
A. ankle edema from fluid retention.
B. BP > 140/90.
C. decreased bone density.
D. muscle wasting.
C133 C1 2
133. A female patient presents with a rapid onset of severe weakness of all small muscles of the hand, sharp pleuritic
pain in the shoulder and subscapular area, and a hoarse voice for the past three weeks. She is a hair stylist, has a
smoking history of 20 years, is not on any medications, and has not been ill. Her referral states examine and treat.
Based on the above information this patient is MOST LIKELY exhibiting symptoms of:
A. a Pancoast tumor.
B. carpal tunnel syndrome.
C. pronator teres syndrome.
D. thoracic outlet syndrome.
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C134 C1 2
134. An examination of a 30 year-old male patient reveals the following shoulder signs and symptoms: excessive
AROM and PROM; pain with activity, and on palpation; normal resisted isometric contractions; a positive
load/shift test; and negative X-ray findings. The MOST LIKELY diagnosis is:
A. atraumatic shoulder instability.
B. impingement.
C. rotator cuff lesion.
D. traumatic anterior shoulder dislocation.
C135 C5 3
135. You are applying cervical traction using a cervical harness. Your patient complains of pain in the
temporomandibular joint during the treatment. You should consider:
A. decreasing the treatment time.
B. discontinuing traction.
C. readjusting the harness and continuing with the treatment.
D. reducing the traction poundage and continuing with the treatment.
C136 C6 2
136. You are providing physical therapy for a 55 year-old female having a diagnosis of right shoulder rotator cuff
tendonitis. The findings of a worksite ergonomic assessment indicate that the worker is required to perform
repetitive reaching activities above shoulder height. The most appropriate worksite modification would be to:
A. allow the worker to take more frequent rest pauses.
B. provide the worker with a taller, sit-stand chair.
C. reposition the height of the shelf to below shoulder height.
D. require the worker to attend a cumulative trauma disorder educational class.
C137 C2 3
137. Your patient has been diagnosed with impingement syndrome of the shoulder. Following a course of modalities to
control pain and inflammation, progression is to an exercise program to restore normal function of the shoulder.
The BEST PNF diagonal pattern to improve function of the shoulder is:
A. D1 extension.
B. D1 flexion.
C. D2 extension.
D. D2 flexion.
C138 C6 2
138. A 38 year-old patient presents with pain of the right Achilles tendon as well as on the plantar aspect of the right
heel. Pain developed insidiously and has now lasted several months. On gait analysis you observe abnormal
supination throughout the stance phase of gait. Your BEST choice for orthotic intervention is a:
A. cushion heel with a rearfoot valgus post.
B. flexible shoe insert with forefoot varus post.
C. metatarsal pad.
D. UCBL insert.
C139 C3 2
139. A patient has a 10 year history of peripheral vascular disease. During auscultation of the popliteal artery you do
NOT expect to find:
A. 1+ pulses.
B. 2+ pulses.
C. a bruit.
D. absence of detectable blood flow.
C140 C4 2
140. The most common infection transmitted to healthcare workers is:
A. hepatitis A.
B. hepatitis B.
C. HIV.
D. tuberculosis.
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C141 C4 2
141. A patient presents with pain, joint swelling, positive serum rheumatoid factor, and increased erythrocyte
sedimentation rate. These findings are characteristic of:
A. fibromyalgia.
B. osteoarthritis.
C. rheumatoid arthritis.
D. systemic lupus erythematosus.
C142 C6 1
142. A patient with a transfemoral amputation and an above-knee prosthesis demonstrates knee instability while
standing. His knee buckles easily when he shifts his weight. You suspect the cause of his problem is a:
A. prosthetic knee set too far anterior to the TKA line.
B. prosthetic knee set too far posterior to the TKA line.
C. tight extension aid.
D. weak gluteus medius.
C143 C6 3
143. A 17 year-old individual with developmental disabilities is referred to your wheelchair clinic for a new wheelchair.
She presents with a severe kyphoscoliosis. You determine the BEST wheelchair modification to order is a:
A. contoured foam seat.
B. firm seat back with lateral posture supports and increased seat depth.
C. firm seat with lateral knee positioners.
D. sling seat with dense foam cushion.
C144 C6 3
144. A patient is referred for orthotic gait training after receiving a reciprocating gait orthosis. In order for this patient
to walk correctly, it is important to instruct her in the correct sequence. She should shift her weight:
A. onto her crutches and swing both legs through together to a position in front of her crutches.
B. onto her crutches and swing one leg, then the other forward.
C. onto her walker and one leg, tuck her pelvis by extending the upper trunk, and swing her other leg through.
D. onto her walker, extend the upper trunk, and swing both legs forward together to approach the walker.
C145 C7 3
145. A 42 year-old patient who is undergoing spinal cord rehabilitation is viewed as uncooperative by staff. He refuses
to complete the training activities you have outlined for him to promote independent functional mobility. A review
of his history reveals that previously he was the director of his own company, with a staff of 20. The MOST
appropriate strategy you can adopt is to:
A. carefully structure the activities and slow down the pace.
B. have him work with a supervisor since he works best with people in authority.
C. involve him in goal setting and have him participate in structuring the training session.
D. refer him to another therapist in the hopes that he will have better luck in engaging the patient.
C146 C7 3
146. A group of 10 patients is recruited into a study investigating the effects of relaxation training on blood pressure.
One group of patients is scheduled to participate in a cardiac rehabilitation program which includes relaxation
training 3 times a week for 12 weeks. The other group of patients is instructed to perform activities as usual. At the
conclusion of the study there was no significant difference between the groups; BP decreased significantly in both
groups. The investigator can reasonably conclude:
A. both groups had blood pressures initially so high that reductions should have been expected.
B. cardiac rehabilitation is not effective in reducing blood pressure.
C. the activities of the non-rehab group were not properly monitored and may account for these results.
D. the rehab group was not properly monitored.
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C147 C6 2
147. A patient is using a right KAFO. During orthotic checkout, you discover the height of the medial upright is
excessive. As she transfers weight to the orthotic leg during gait, you expect that this patient will demonstrate:
A. anterior trunk bending.
B. lateral lean toward the left.
C. lateral lean toward the right.
D. posterior trunk bending.
C148 C6 2
148. During gait, a patient with hemiparesis drags his toes during swing. Upon further examination, he has weak
dorsiflexors (able to lift the foot against gravity through 1/2 range) and a grade of 2 upon examining tone in his
plantar flexors using the Modified Ashworth Scale. An appropriate orthotic modification to correct this problem is:
A. a dorsiflexion assist.
B. a dorsiflexion stop.
C. a solid ankle AFO.
D. spiral AFO.
C149 C8 2
149. You are examining a 24 month-old child and you observe that the child can sit independently, creep in quadruped,
pull-to-stand, cruise sideways, but not walk without support. You conclude that this child is exhibiting:
A. advanced gross motor development.
B. delay in achieving developmental milestones.
C. normal gross motor development.
D. slow maturation that is within normal limits.
C150 C1 3
150. Therapist hand/finger placements for posterior to anterior (PA) mobilization techniques to improve down-
gliding/closure of the T7-8 facet joints should be located at the:
A. spinous process of T6.
B. spinous process of T8.
C. transverse processes of T7.
D. transverse processes of T8.
C151 C1 2
151. A 40 year-old female complains of waking up several times at night from severe pins and needles in both hands.
On awakening, her hands feel numb for half an hour, and she complains of clumsiness with fine hand movements.
Your examination revealed paresthesias confirmed to medial forearm and hypothenar region; reduced grip and
pinch strength; and normal tendon reflexes. Based on the above examination findings your diagnosis is:
B. pronator teres syndrome.
C. thoracic outlet syndrome.
D. ulnar nerve entrapment.
C152 C5 2
152. A 57 year-old auto mechanic has been referred to you with a diagnosis of degenerative joint disease affecting C2
and C3. The patient complains of pain and stiffness in the cervical region and transient dizziness with some
cervical motions. Your INITIAL examination procedure should be:
A. a manual muscle test.
B. a vertebral artery test.
C. Adsons maneuver.
D. Oppenheim test.
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C153 C5 2
153. A 45 year-old patient is referred to PT for mechanical compression. The patient has a history of recent DVT and
now presents with edema of the right lower extremity, which is very painful, and warm to the touch. You should:
A. apply intermittent compression with cold.
B. apply mechanical compression for 2 hours or more.
C. apply mechanical compression for less than 2 hours.
D. not apply mechanical compression and communicate with the referring physician.
C154 C2 1
154. To examine a patient with a suspected deficit in graphesthesia, you would ask the patient, with eyes shut, to
identify:
A. a series of letters traced on the hand.
B. different objects placed in the hand and manipulated.
C. different weighted, identically shaped cylinders placed in the hand.
D. the vibrations of a tuning fork when placed on a bony prominence.
C155 C2 3
155. A patient recovering from stroke is ambulatory without an assistive device. He demonstrates a consistent problem
with an elevated and retracted pelvis on the affected side. The BEST therapeutic exercise strategy is to manually
apply:
A. anterior directed pressure during swing.
B. downward compression during stance.
C. light resistance to forward pelvic rotation during swing.
D. resistance to posterior pelvic elevation during swing.
C156 C2 2
156. You suspect lower brainstem involvement in a patient with amyotrophic lateral sclerosis. You examine the patient
and find motor impairments of the tongue with ipsilateral wasting and deviation on protrusion. These findings
confirm involvement of cranial nerve:
A. IX.
B. X.
C. XI.
D. XII.
C157 C3 2
157. A patient is in the intensive care unit following myocardial infarction. Upon examination of the ECG tracings in
the medical record you observe the following changes: abnormal Q wave with ST elevation and T wave inversion
in leads II, III, and AVF. The probable location of the infarct is the:
A. anterior wall.
B. inferior wall.
C. lateral wall.
D. posterior wall.
C158 C4 1
158. A 22 year-old patient is hospitalized in the ICU with extensive trauma following a motor vehicle accident. A
review of her medical record reveals the following lab values: hematocrit 28%, hemoglobin 10 g/100ml, and
serum WBC 12,000/mm3. The MOST appropriate conclusion the therapist can reach is:
A. all values are abnormal.
B. hematocrit and hemoglobin values are abnormal; WBC is normal.
C. only hematocrit values are abnormal.
D. only serum WBC is abnormal.
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C159 C4 2
159. A patient with a transfemoral amputation is unable to wear his total contact prosthesis for the past 4 days.
Examination of the residual limb reveals erythema and edema extending over most of the lower anterior limb. He
tells you his limb is very itchy and painful after he scratches it. The MOST LIKELY cause of his symptoms is:
A. cellulitis.
B. dermatitis.
C. herpes zoster.
D. impetigo.
C160 C4 3
160. A patient is largely confined to bed and has a stage IV sacral pressure ulcer of three months duration. The BEST
choice of intervention is:
A. a two-inch, convoluted foam mattress.
B. gentle wound cleansing and wet-to-dry gauze dressings.
C. nutritional supplements and pressure relief with a flotation mattress.
D. surgical repair.
C161 C6 2
161. Following a hip fracture that is now healed, a patient presents with weak hip flexors (2/5). All other muscles are
within functional limits. During gait, you expect that she may walk with:
A. backward trunk lean.
B. circumduction.
C. excessive hip flexion.
D. forward trunk lean.
C162 C6 3
162. A 72 year-old patient with a left transfemoral amputation complains that his left foot is cramping and when he sits
it feels all twisted under him. Your BEST choice of intervention is:
A. appropriate bed positioning with the residual limb in extension.
B. hot packs and ultrasound to the residual limb.
C. icing and vigorous massage to the residual limb.
D. iontophoresis to the distal residual limb using hyaluronidase.
C163 C7 3
163. A researcher uses a group of volunteers (healthy, college students) to study the effects of Swiss ball exercises on
ankle ROM and balance scores. Twenty volunteers participated in the 20 minute ball exercise class 3 times a week
for 6 weeks. Measurements were taken at the beginning and end of the sessions. Significant differences were
found in both sets of scores and reported at the local PT meeting. Based on this research design, you conclude:
A. Swiss ball exercises are an effective intervention to improve ankle stability following chronic ankle sprain.
B. the Hawthorne effect may have influenced the outcomes of the study.
C. the reliability of the study was threatened with the introduction of systematic error of measurement.
D. the validity of the study was threatened with the introduction of sampling bias.
C164 C3 3
164. Your patient has a very large right-sided bacterial pneumonia. Her oxygen level is dangerously low. The body
position that would MOST LIKELY improve her PaO2 is:
A. left sidelying with the head of the bed in the flat position.
B. prone-lying with the head of the bed in the Trendelenburg position.
C. right sidelying with the head of the bed in the flat position.
D. supine-lying with the head of the bed in the Trendelenburg position.
C165 C1 1
165. An examination of a 46 year-old woman reveals drooping of the shoulder, rotatory winging of the scapula, an
inability to shrug the shoulder, and complaints of aching in the shoulder. Based on these findings, the cause of
these symptoms would MOST LIKELY be due to:
A. a lesion of CN XI.
B. a lesion of the long thoracic nerve.
C. muscle imbalance.
D. strain of the serratus anterior.
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C166 C5 3
166. A 66 year-old patient with spastic hemiplegia was referred to you for ambulation training. The patient is having
difficulty with standing-up from a seated position due to cocontraction of the quadriceps and hamstrings during the
knee and hip extension phase. You wish to use biofeedback beginning with simple knee extension exercise in the
seated position and progressing to sit-to-stand training. Initially, the biofeedback protocol should consist of:
A. high detection sensitivity with recording electrodes placed closely together.
B. high detection sensitivity with recording electrodes placed far apart.
C. low detection sensitivity with recording electrodes placed closely together.
D. low detection sensitivity with recording electrodes placed far apart.
C167 C2 2
167. Examination of a 57 year-old man with stroke reveals a loss of pain and temperature sensation on the left side of
the face along with loss of pain and temperature sensation on the right side of the body. All other sensations are
normal. You suspect a lesion in the:
A. left cerebral cortex or internal capsule.
B. left posterolateral medulla or pons.
C. midbrain.
D. right cerebral cortex or internal capsule.
C168 C2 2
168. A patient is taking the drug Baclofen to control spasticity following spinal cord injury. This medication can be
expected to decrease muscle tone and pain. Adverse reactions of concern to the physical therapist can include:
A. drowsiness and muscle weakness.
B. headache with visual auras.
C. hypertension and palpitations.
D. urinary retention and discomfort.
C169 C2 2
169. Symptoms of dysdiadochokinesia, dysmetria, and action tremor can be expected with a lesion located in the:
A. neocerebellum.
B. spinocerebellum.
C. vermis.
D. vestibulocerebellum.
C170 C3 2
170. The BEST gauge of exercise intensity in a healthy individual is:
A. blood pressure.
B. heart rate.
C. rating of perceived exertion.
D. respiratory rate.
C171 C4 3
171. A ten year-old boy with hemophilia fell and injured himself while skateboarding. He was admitted to your facility
and you see him that afternoon. Examination reveals a hemarthrosis in his left knee. The BEST initial intervention
for this patient is:
A. instruct in use of hot pack and nonweightbearing exercises.
B. instruct the patient in crutch use to assist in early return to ambulation.
C. prescribe a swimming program to maintain ROM and strength while his is nonweightbearing.
D. splint the limb and instruct in the use of ice, elevation and rest.
C172 C8 2
172. A 52 year-old male patient recovering from a fractured hip repaired with ORIF has recently been discharged home.
During a home visit, his wife tells you he woke up yesterday morning and told her he couldnt remember much.
Upon examination, you find some mild motor loss in his right hand and anomia. You affirm the presence of short-
term memory loss. Your BEST course of action is to:
A. advise the family to document and record any deficits they notice over the next week, then report back to you.
B. at present ignore these findings; they are expected following surgical anesthesia.
C. refer him back to his physician for a diagnostic workup; you suspect multi-infarct dementia.
D. refer him back to his physician for a diagnostic workup; you suspect presenile dementia, Alzheimers type.
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C173 C6 3
173. The primary benefit of residual limb wrapping following lower extremity amputation is to:
A. decrease adherent scar formation.
B. prevent contractures.
C. prevent lymphedema.
D. prevent phantom limb sensation.
C174 C6 3
174. A 61 year-old patient with a transtibial amputation has a short residual limb. The BEST choice for prosthetic
replacement is a:
A. supracondylar suspension.
B. supracondylar/suprapatellar suspension.
C. Symes suspension.
D. thigh corset.
C175 C6 1
175. A physical therapist assistant is ambulating a patient using a three-point crutch gait. The patient is unsteady and
fearful of falling. She does not appear to understand the correct gait sequence. Your BEST strategy is to:
A. discontinue the session and tell the PTA to try again tomorrow.
B. instruct the PTA to have the patient sit down and use mental rehearsal of the correct steps.
C. instruct the PTA to keep practicing until the patient achieves success.
D. intervene and teach the correct sequence yourself since the PTA is apparently unable to deal with this special
situation.
C176 C1 1
176. You have access to the x-rays from a patient you have been treating with a Grade 2 spondylolisthesis. The BEST
radiographic view to observe this bony anomaly is:
A. anteroposterior.
B. lateral.
C. oblique.
D. posteroanterior.
C177 C5 3
177. A 38 year-old athlete presents with pain and muscle spasm of the upper back (C7-T8) extending to the lateral
border of the scapula. This encompasses a 10 x 10 cm area on both sides of the spine. If your ultrasound unit only
has a 5 cm2 soundhead, you should treat:
A. both sides in five minutes.
B. both sides in ten minutes.
C. the area in two sections allotting five minutes for each section.
D. the area in two sections allotting two and a half minutes for each area.
C178 C5 2
178. A patient with chronic cervical pain is referred to your clinic. Past medical history reveals: appendectomy, 12 years
ago; chronic heart disease; demand-type pacemaker, 8 years ago; whiplash injury, 2 years ago. Presently the
patient complains of pain and muscle spasm in the cervical region. The modality that should not be considered in
the case is:
A. hot pack.
B. mechanical traction.
C. transcutaneous electrical stimulation.
D. ultrasound.
C179 C2 2
179. In posturography, patients who sway more or fall only under conditions with the eyes closed and platform moving
(condition 5) or with the visual surround moving and platform moving (condition 6) demonstrate:
A. problems with sensory selection.
B. somatosensory dependency.
C. vestibular deficiency.
D. visual dependency.
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C180 C2 2
180. A patient presented with severe, frequent seizures originating in the medial temporal lobes. Following bilateral
surgical removal of these areas, he is unable to remember any new information just prior to the surgery to the
present. He cannot recall text he read minutes ago and cannot remember people he has met repeatedly. These
outcomes are indicative of:
A. a primary deficit from the loss of the amygdala.
B. loss of integration of the temporal lobe with the basal ganglia and frontal cortex.
C. loss of procedural memory and integration with frontal cortex.
D. loss of the hippocampus and declarative memory function.
C181 C3 2
181. A patient recovering from a myocardial infarction has an exercise capacity of 6 METs. He is in the initial
conditioning phase of an outpatient cardiac rehabilitation program. Progression of his exercise is BEST done by:
A. decreasing frequency first.
B. increasing duration first.
C. increasing frequency first.
D. increasing intensity first.
C182 C3 2
182. While on a home visit, a 9 month-old infant becomes unresponsive. You tell the mother to call for emergency
medical services. Your IMMEDIATE next step is:
A. begin with chest compressions and alternate with rescue breaths at a ratio of 1:7.
B. check for pulse, if no pulse begin chest compressions at a rate of 100 compressions per minute.
C. check for pulse, if no pulse begin chest compressions at a rate of 80 compressions per minute.
D. tilt the infants head back and give 2 full breaths, covering both the mouth and nose with yours.
C183 C4 2
183. A patient in your exercise class develops muscle weakness and fatigue. Examination reveals leg cramps and
hyporeflexia. He also experiences frequent episodes of postural hypotension and dizziness. Abnormalities on his
ECG include a flat T wave, prolonged QT interval, and depressed ST segment. You suspect:
A. hyperkalemia
B. hypocalcemia
C. hypokalemia
D. hyponatremia
C184 C8 2
184. A 64 year-old patient with advanced coronary artery disease is receiving functional mobility training in a P.T.
clinic. While walking, she suffers an episode of syncope. Through history taking, you determine the MOST
LIKELY cause of her problem is:
A. heart failure.
B. hyperglycemia.
C. postprandial hypertension.
D. seizures.
C185 C6 3
185. The MOST appropriate position to guard a patient who is descending stairs for the first time using crutches and
non-weightbearing on the right is to:
A. stand behind and slightly to the right side.
B. stand behind and slightly to the right side.
C. stand in front and slightly to the left side.
D. stand in front and slightly to the right side.
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C186 C6 3
186. A patient with paraplegia at the T10 level is being discharged home. The rehab team is assisting the patients wife
in modifying the home to be barrier-free. A new first floor bedroom and bathroom wing are being built. The
builder asks you about the entrance. You recommend:
A. a ramp with a grade of 12% and a level landing at top of at least 50 by 50 inches.
B. a ramp with a slope of 1:12 with a level landing at the top of at least 60 by 60 inches.
C. door width of 36 inches with an outside door that opens out.
D. door widths of at least 40 inches with a handrail 34 inches high.
C187 C7 3
187. You have been assigned the job of instructing a new class of home health aides in how to perform safe transfers.
You plan a one day session that includes laboratory practice. Effective documentation of this session should
include:
A. learners progress, attainment of learning objectives, and level of satisfaction.
B. objectives, activities and modifications needed, and outcomes.
C. the activities used and the length of time it took for activities to be mastered.
D. the objectives and activities used.
C188 C3 2
188. A 43 year-old patient is recovering from a mild myocardial infarction and is referred for supervised exercise
training. While working out on a treadmill, he begins to develop ischemia. You will notice:
A. a PVC.
B. bradycardia.
C. ST segment depression on the ECG.
D. ST segment elevation on the ECG.
C189 C8 3
189. A 16 year-old boy with Duchennes muscular dystrophy has been confined to using a power wheelchair for the
past three years and is beginning to develop a 10 degree Cobb angle scoliosis. The BEST strategy to help slow this
spinal curvature at this time would be to:
A. alternate the side of the wheelchair power control.
B. emphasize spinal extension exercises.
C. emphasize spinal rotation exercises.
D. order a new wheelchair with a reclining seat back.
C190 C1 2
190. A 55 year-old male presents with a complaint of severe neck and shoulder pain of two days duration. He reports
that he fell asleep on the couch watching TV, and has been stiff and sore since. There is tenderness of the cervical
muscles on the right, with increased pain upon palpation. PROM is most limited in flexion, then sidebending left,
and then rotation left, and active extension. Sidebending right and rotation right is also painful. Based on these
examination findings, the patients diagnosis is:
A. cervical radiculopathy.
B. cervical strain.
C. facet syndrome.
D. herniated disc.
C191 C6 2
191. Your patient is a 36 year-old male mail sorter. He complains of numbness and tingling in his right hand in the
median nerve distribution. When you evaluate his work tasks, you note that he is required to key in the zip codes
of about 58 letters per minute. An appropriate administrative control to decrease his exposure would be to:
A. provide him with a height adjustable chair to position his wrists and hands in a neutral alignment.
B. provide the worker with a resting splint to support his wrist.
C. require the worker to attend a cumulative trauma disorder educational class.
D. use job rotation during the workday.
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C192 C5 3
192. A 31 year-old patient with a traumatic brain injury presents with hemiparesis of the left upper extremity. Your PT
examination reveals slight cutaneous and proprioceptive impairment, fair (3/5) strength of the shoulder muscles
and triceps and slight spasticity of the biceps. Voluntary control of the patients left arm has not progressed as
rapidly as you desire. You decide to use functional electrical stimulation and place the active electrode on the
triceps to facilitate active extension of the elbow. The timing sequence BEST to apply is:
A. 2-second ramp up, 10-second stimulation, no ramp down.
B. 2-second ramp up, 5-second stimulation, 2-second ramp down.
C. 5-second ramp up, 5-second stimulation, 5-second ramp down.
D. no ramp up, 10-second stimulation, 2-second ramp down.
C193 C2 2
193. Following a traumatic brain injury, a patient presents with significant difficulties in learning new skills. He is
wheelchair dependent and will need to learn how to transfer (a skill he has never done before). The BEST strategy
to enhance his motor learning is to:
A. provide bandwidth feedback using a random practice schedule.
B. provide consistent feedback using a blocked practice schedule.
C. provide summed feedback after every few trials using a serial practice schedule.
D. use only guided movement to ensure correct performance.
C194 C2 2
194. A patient recovering from a CVA presents with predominant involvement of the contralateral lower extremity and
lesser involvement of the contralateral upper extremity. He also demonstrates mild apraxia. These clinical
manifestations are characteristic of:
A. anterior cerebral artery syndrome.
B. basilar artery syndrome.
C. middle cerebral artery syndrome.
D. posterior cerebral artery syndrome.
C195 C3 1
195. A patient presents with significant intermittent claudication with onset after two minutes of walking. On further
examination, you expect to find:
A. bright red appearance of the extremity in both elevated and hanging positions.
B. elevation-induced pallor and dependent redness with the extremity in the hanging position.
C. grayish-white appearance of the extremity in both elevated and hanging positions.
D. little or no changes in color with changes in extremity position.
C196 C4 3
196. Following her cesarean section, a patient tells you that she is anxious to return to her premorbid level of physical
activity (working out at the gym 3 days a week and running 5 miles every other day). Your BEST advice is to tell
her to:
A. begin weightlifting after 4 weeks and running after 3 months.
B. begin weightlifting and running after 4 weeks.
C. begin with pelvic floor and gentle abdominal exercises for the first 4-6 weeks.
D. refrain from all exercise and running for at least 6 months.
C197 C8 2
197. A 67 year-old patient lives alone and is referred for home physical therapy services to improve functional mobility.
He refuses to get out of his chair. Upon examination, he appears irritable, with poor concentration and memory. He
tells you he has been sleeping poorly and has no energy or desire to do anything. He appears anorexic. The MOST
LIKELY explanation for his symptoms is:
A. alcohol abuse.
B. depression.
C. pseudodementia.
D. senile dementia.
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C198 C6 3
198. The rehab team is completing a home visit to recommend environmental modifications for a 72 year-old patient
who is scheduled to be discharged next week. He is wheelchair dependent. The bathroom has not been adapted.
Which of the following recommendations is NOT appropriate?
A. adding a tub seat and nonskid mat.
B. adding horizontal grab bars positioned at 45 inches.
C. raising the toilet seat to 18 inches.
D. taking the door off to widen the entrance to 32 inches.
C199 C6 2
199. During gait, the lateral pelvic tilt on the side of the swing leg, observed during frontal plane analysis, serves to:
A. control forward and backward rotations of the pelvis.
B. reduce knee flexion at mid stance.
C. reduce peak rise of the pelvis.
D. reduce physiological valgum at the knee.
C200 C1 2
200. A 40 year-old male experiences central thoracic pain while sitting which increases during the day. There are no
complaints in the night or morning. Lifting and carrying heavy objects increase the pain. Based on the above
information the MOST LIKELY diagnosis would be:
A. herniated nucleus pulposus of the spine.
B. spondylodiscitis.
C. thoracic postural syndrome.
D. traumatic compression fracture.
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1. crackles and cough

2. heart rate, blood pressure, respiratory rate.
3. product liability.
4. 1:11/2
5. pendulum exercises.
6. stretching the iliopsoas and iliotibial (IT) band; strengthening the abdominals.
7. excessive midtarsal or subtalar pronation.
8. excessive midtarsal or subtalar pronation.
9. hamstrings immediately before the quadriceps to produce cocontraction.
10. there is a normal response on the right while the left is exaggerated and indicates spastic hypertonia.
11. checking resting BP and HR in sitting, then repeating measurements after standing for 1 minute.
12. purulent.
13. turning and sitting down.
14. anterior and lateral walls are 212 to 3 inches higher than the posterior and medial walls to ensure proper
positioning on the ischial seat.
15. their degree of anxiety and attention.
16. 95%.
17. excessive weight gain due to decreased ability to exercise.
18. turn the head and bring the hand to mouth on the same side.
19. tell him to discuss his concerns with the physician.
20. serratus anterior, standing, performing wall push-ups.
21. left posterior rotated innominate.
22. the capitation payment method.
23. brief intense TENS.
24. pelvis.
25. chop, reverse chop with right arm leading.
26. 60 - 90% HRmax.
27. take him back to his room yourself and continue to monitor vital signs.
28. skin blushes.
29. profound aphasia and global deterioration of mental functions.
30. active exercises: sitting and standing, marching in place.
31. have him practice locking the brakes first with his left UE, and then his right.
32. PNF contract-relax technique.
33. decreased A-P to lateral chest ratio.
34. discontinue the treatment; discuss your findings and refer the patient back to his referring physician.
35. strengthening of middle and lower trapezius and stretching of pectoral muscles.
36. CPT and Common Procedural Coding System procedure codes.
37. extension.
38. carpal tunnel syndrome.
39. Guillain-Barr syndrome.
40. slowing of pulse and increased venous pressure is expected.
41. arterial insufficiency.
42. Functional Reach of 7 inches.
43. bridging, holding with Theraband around both thighs.
44. not use supplemental O2.
45. lightweight wheelchair.
46. trunk flexion with right rotation.
47. soleus and gastrocnemius.
48. the name of those involved, witnesses, what occurred, when it occurred, where it occurred.
49. pulsed US at 1 MHz.
50. cerebral cortex: right parietal lobe.
51. stocking and glove distribution.
52. a 20 AV heart block.
53. begin with an interval walking program, exercising only to the point of pain.
54. clean and debride the wound in a whirlpool followed by a hydrogel dressing and pressure relief.
55. is a 17 inch seat height.
56. heel strike.
57. descending stairs.
58. higher than the torque actually generated by the contracting hamstrings.
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59. central P/A pressure at a 60 degree angle on the spinous process of T6 while stabilizing T5.
60. benign paroxysmal positional vertigo.
61. increased heart rate and contractility.
62. hematuria and ecchymosis.
63. highlighting steps with pastels, blues and greens.
64. quadriceps femoris.
65. postpone ambulation and report your findings immediately.
66. asking the child and his parent/caretakers to describe the boys most serious physical problems from their
perspectives.
67. anteversion
68. trunk extension and abdominal stabilization exercises.
69. do a comprehensive examination, and if you suspect abuse report your findings to the appropriate authorities.
70. high volt monophasic pulsed current.
71. prone with no pillow.
72. abduction with elbow extension.
73. the sound side.
74. ECG changes from baseline (3 mm horizontal or downsloping, ST-segment depression).
75. agility training.
76. facilitate autolytic debridement.
77. avoid direct exposure to blood and body fluids.
78. knee extensors.
79. have the patient sit down, continue monitoring, and notify the physician.
80. practice stair climbing inside the parallel bars using a 3 inch step.
81. postural drainage, percussion, and shaking to the right lower lobe and other areas with abnormal auscultatory
findings.
82. recognize the patients need for hope while outlining realistic short term goals to improve independence.
83. position the child in a proper sitting position using postural supports.
84. inferior glide at 55 degrees of abduction.
85. capsule-ligamentous pattern of TMJ on the left.
86. deny access to the chart unless written permission by his wife is granted.
87. pneumothorax
88. abduction and internal rotation.
89. reach forward to bear weight with the right arm extended against the wall.
90. Brocas aphasia.
91. engage in a calming activity and observe behaviors closely.
92. dizziness or syncope upon arising from bed.
93. prolonged endurance training has resulted in a low heart rate.
94. muscle wasting and increased risk of fracture.
95. not use a whirlpool additive.
96. viscoelastic shoe insert with forefoot lateral wedge.
97. transfer to the sound side.
98. a rigid frame.
99. sideward protective extension in sitting.
100. Karvonens formula (HR reserve).
101. independent in wheelchair mobility.
102. 9-11.
103. lower cervical flexion.
104. tibial, femoral, and pelvic internal rotation.
105. put a single line through the incorrect date, initial it, document the correct date, and the date the correction was
made.
106. pulse duration.
107. Horners syndrome.
108. vestibulocerebellum
109. report this finding to the physician as it might be indicative of peripheral vascular disease.
110. discontinue treatment and notify his physician immediately.
111. irrigate the wound with povidone-iodine while wearing protective eyewear, garment, and gloves.
112. will likely be resistant to activity training if unfamiliar activities are used.
113. provide posterior directed resistance to the right ASIS during stance.
114. prone-on-elbow pushups.
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Practice Questions
109
115. affective objectives dealing with attending are not being met.
116. have the same therapist reassess the patients after 6 months.
117. heart rate.
118. explain that this is normal and that the stepping was a newborn reflex which has gone away.
119. 35-49mm.
120. medial forefoot and rearfoot varus posting.
121. pronator teres syndrome.
122. determine a better treatment time, treat the patient, and bill for the 20 minute session given.
123. large electrodes, widely spaced.
124. supine, trunk in midline with small pillow under the scapula, arm extended on supporting pillow, and a small
towel roll under the knee.
125. somatosensory integrity.
126. congestive heart failure.
127. intensity prescribed using maximal age-related HR.
128. discontinue UBE exercise; provide massage and active assistive range of motion for the entire extremity.
129. poor light adaptation.
130. sliding board.
131. lift the front casters and ascend in a wheelie position.
132. decreased bone density.
133. a Pancoast tumor.
134. atraumatic shoulder instability.
135. readjusting the harness and continuing with the treatment.
136. reposition the height of the shelf to below shoulder height.
137. D2 flexion.
138. cushion heel with a rearfoot valgus post.
139. 2+ pulses.
140. hepatitis B.
141. rheumatoid arthritis.
142. prosthetic knee set too far anterior to the TKA line.
143. contoured foam seat.
144. onto her walker and one leg, tuck her pelvis by extending the upper trunk, and swing her other leg through.
145. involve him in goal setting and have him participate in structuring the training session.
146. the activities of the non-rehab group were not properly monitored and may account for these results.
147. lateral lean toward the right.
148. a solid ankle AFO.
149. delay in achieving developmental milestones.
150. transverse processes of T8.
151. thoracic outlet syndrome.
152. a vertebral artery test.
153. not apply mechanical compression and communicate with the referring physician.
154. a series of letters traced on the hand.
155. light resistance to forward pelvic rotation during swing.
156. XII
157. inferior wall.
158. all values are abnormal.
159. dermatitis
160. surgical repair.
161. circumduction
162. icing and vigorous massage to the residual limb.
163. the validity of the study was threatened with the introduction of sampling bias.
164. left sidelying with the head of the bed in the flat position.
165. a lesion of CN XI.
166. low detection sensitivity with recording electrodes placed closely together.
167. left posterolateral medulla or pons.
168. drowsiness and muscle weakness.
169. neocerebellum
170. heart rate.
171. splint the limb and instruct in the use of ice, elevation and rest.
172. refer him back to his physician for a diagnostic workup; you suspect multi-infarct dementia.
373406390.doc
173. prevent lymphedema.

174. supracondylar/suprapatellar suspension.
175. instruct the PTA to have the patient sit down and use mental rehearsal of the correct steps.
176. lateral
177. the area in two sections allotting five minutes for each section.
178. transcutaneous electrical stimulation.
179. vestibular deficiency.
180. loss of the hippocampus and declarative memory function.
181. increasing duration first.
182. tilt the infants head back and give 2 full breaths, covering both the mouth and nose with yours.
183. hypokalemia
184. heart failure.
185. stand in front and slightly to the right side.
186. a ramp with a slope of 1:12 with a level landing at the top of at least 60 by 60 inches.
187. objectives, activities and modifications needed, and outcomes.
188. ST segment depression on the ECG.
189. alternate the side of the wheelchair power control.
190. facet syndrome.
191. use job rotation during the workday.
192. 5-second ramp up, 5-second stimulation, 5-second ramp down.
193. provide consistent feedback using a blocked practice schedule.
194. anterior cerebral artery syndrome.
195. elevation-induced pallor and dependent redness with the extremity in the hanging position.
196. begin with pelvic floor and gentle abdominal exercises for the first 4-6 weeks.
197. depression
198. adding horizontal grab bars positioned at 45 inches.
199. reduce peak rise of the pelvis.
200. thoracic postural syndrome.
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Practice Questions 1

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173. prevent lymphedema.

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