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Ier Pe B
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1. When performing an audit of patients rehabilitated in your physical therapy department following total hip
replacements, it is necessary to:
A. review all therapist’s progress notes regarding daily progress of the patients
B. evaluate each therapist’s performance using peer review.
C. compare the progress of patients who have had hip replacements with others who have not had prosthetic
replacement.
D. evaluate the effectiveness of treatments for the patients in your facility as compared with other facilities.
2. You are evaluating an athlete who is complaining of pain in the left shoulder region. Your assessment of the
shoulder elicits pain in the last 30 degrees of shoulder abduction range of motion. This finding is most congruent
with
A. calcific supraspinatus tendinitis
B. subacromial bursitis
C. acromioclavicular sprain
D. thoracic outlet syndrome
3. Following a cerebrovascular accident on the dominant right hemisphere, a patient exhibiting unilateral neglect
might do the following with the exception of
A. eating food only from the right side of the plate
B. bumping a one-arm drive wheelchair into things on the left side.
C. ignoring or denying existence of the left-sided limbs
D. shaving or putting makeup only on the left side of the face
4. A patient with spastic left hemiplegia experiences recurvatum during stance phase. If the patient is using an ankle-
foot orthosis, the cause of the problem might be attributed to
A. not enough limitation by the posterior stop
B. not enough limitation by the anterior stop
C. too much limitation by the posterior stop
D. too much limitation by the anterior stop
5. You receive referrals from a dentist to treat temporomandibular dysfunction. However, the dentist refers these
patients many months after the initial diagnosis when the problems are much worse. As the therapist it would be
best to
A. send the dentist articles, written by other dentists, which point out the benefits of early physical therapy
treatment
B. give feedback to the patients that earlier treatment would have resulted in a better outcome
C. try to meet with the dentist and explain the need for earlier physical therapy intervention
D. not treat these patients as it exposes you to a greater risk of liability for negligence even though the dentist
was at fault
6. If a patient has developed a dry, thick, leathery eschar secondary to a full thickness burn, removal or softening of
the eschar might be enhanced by application of
A. silver sulfadiazine
B. nitrofurazone
C. silver nitrate
D. travase
7. A patient under considerable emotional stress suffers from chronic pain and muscle spasm. The therapist decides to
use a relaxation protocol as part of the treatment program. All of the following would be part of the protocol to
help reduce stress with the exception of
A. controlled diaphragmatic breathing
B. immersion in a hydrotherapy spa at body temperature
C. progressive tensing and relaxation of muscle groups
D. use of visual imagery and mental focus
8. If a patient with above-knee prosthesis has a prosthetic foot with a plantarflexion bumper that is too hard, during
ambulation the:
A. prosthesis would rotate internally at heel strike
B. prosthetic foot would remain dorsiflexed during the gait cycle
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2 Practice
9. In evaluating a gait pattern of a 21 year-old male, you note that the patient is demonstrating a Trendelenburg gait.
This gait pattern would be most consistent with a history of
A. traumatic arthritis of the hip or Legg-Calvé-Perthes disease
B. traumatic arthritis of the hip or piriformis syndrome
C. Legg-Calvé-Perthes disease or trochanteric bursitis
D. development hip dysplasia or slipped capital femoral epiphysis
10. A snowmobile left the trail and struck a tree. The driver’s left knee was fully flexed and the tibia impacted with the
inside front of the snowmobile. This mechanism of injury would most likely result in a
A. dislocated patella.
B. sprained or ruptured posterior cruciate ligament.
C. sprained or ruptured anterior cruciate ligament.
D. rupture of the popliteal artery.
11. When ordering a wheelchair for a patient with bilateral transfemoral amputations, stability will be improved if:
A. the wheels are set wider apart
B. eight inch diameter casters are specified
C. the wheels are set in a more posterior direction on the frame
D. a heavy duty frame and narrow adult seat are selected
12. Following knee injuries, subjects in a study were treated with proprioceptive neuromuscular facilitation techniques
or isokinetic exercise for the first two weeks of physical therapy to help increase strength. The independent
variable in this study is:
A. injury to the knee
B. type of exercise
C. proprioceptive neuromuscular facilitation
D. muscle strength
13. To prepare a patient with a cauda equina lesion for ambulation with crutches, the upper quadrant muscles that
would be the most important to strengthen would be the
A. upper trapezius, rhomboids and levator scapulae
B. deltoid, coracobrachialis and brachialis
C. middle trapezius, serratus anterior and triceps
D. lower trapezius, latissimus dorsi and pectoralis major
14. A female patient is confused and upset when the physical and occupational therapists gave her different advice on
how to perform self range of motion. When the patient asks the physical therapist what to do, it would be best if
the therapist:
A. tells the patient to perform range of motion the way the physical therapist instructed her until any differences
can be worked out with the occupational therapist
B. tells the patient that there is no need to worry, differences are expected
C. tells the patient that a meeting with the occupational therapist will occur as soon as possible to discuss the
differences and that the outcome of the meeting will be explained to her immediately.
D. eases the patient’s concern by telling her that the physical therapist and occupational therapist supervisors will
immediately review and correct any discrepancies in her range of motion program.
15. During a soccer game, a 17 year-old player was kicked in the shin. Later in the day, the athlete’s mother phones
you and describes her son’s leg as badly swollen and warm to the touch. His foot tingles and he cannot dorsiflex
his toes. As a friend as well as a physical therapist, you should advise your neighbor to
A. put ice on the shin and elevate the leg and improvement should occur when the swelling goes down.
B. put ice on the shin and elevate the leg but have her son come to your physical therapy clinic the next day to be
evaluated
C. put ice on the shin, elevate the leg, use an elastic wrap to control swelling and have her son see a physician in
three days if symptoms do not improve
D. take her son to an emergency room or see a physician immediately
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Practice 3
16. All of the following activities might help to break up lower extremity synergy combinations in a patient with
hemiplegia with the exception of
A. balance training in a kneeling position
B. backward leg lifts with the knee extended on the affected side
C. bridging in the hooklying position
D. rolling from a hooklying position
17. A new student physical therapist and her supervising therapist are overwhelmed by a sudden increase in the number
of new patients attending a group exercise class. In this situation it would be best to
A. cancel the class and reschedule the new patients for individual evaluations.
B. allow the student to conduct the class while the supervisor evaluates the new patients.
C. allow the student to assist, in an appropriate way, with the management of the class.
D. assign the student to a less busy therapist while the supervisor concentrates on managing the class.
18. Your patient has chronic alcoholism with associated peripheral polyneuropathy. A goal in the physical therapy
plan of care should point out the need to prevent
A. muscle atrophy
B. radicular pain and paresthesia
C. gait deterioration as a result of ataxia
D. loss of passive movement and contracture formation
19. Following the reduction of developmental dysplasia of the hip in an infant, the physical therapist should instruct the
parents to maintain that hip in a stable position of
A. flexion and adduction
B. flexion and abduction
C. extension and adduction
D. extension and abduction
20. A 54 year-old male, with a long history of cigarette smoking, has been admitted to the hospital and presents with
signs of infection, tachycardia, abnormal breath sounds in both lower lobes and dullness to percussion. The
physical therapist’s major concern and focus with this patient is:
A. getting the patient to quit smoking
B. breathing reeducation to increase efficiency of ventilation
C. airway clearance and secretion removal
D. graded inspiratory muscle training
21. A patient with adhesive capsulitis of the glenohumeral joint should demonstrate the greatest limitation of motion
when performing shoulder:
A. flexion
B. abduction
C. medial rotation
D. lateral rotation
22. If the results of a nerve conduction velocity test on the peroneal nerve of a three-year-old were within normal
limits, you would expect the values to be:
A. the same as those of a teenager
B. faster than those of a teenager
C. slower than those of a 35 year-old
D. faster than those of a 65 year-old
23. A 12 year-old boy with a history of Factor VIII hemophilia is currently in a subacute stage following a bleeding
episode. His left knee experienced hemarthrosis. The most appropriate physical therapy management for the
hemarthrosis would consist of:
A. rest, ice, elevation and continuous splinting in a functional position.
B. progressive resistance exercises, range of motion exercises, use of a knee splint when not exercising and safe
recreational activities to tolerance
C. cryotherapy, isokinetic exercise and manual stretching to gain range of motion
D. aquatic therapy, splinting at night and manual resistance exercises
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4 Practice
24. Following a motor vehicle accident, a patient with multiple chest trauma developed atelectasis. To help in the
immediate management of the atelectasis, all of the following physical therapy procedures would be appropriate
except for
A. pain reduction techniques
B. segmental breathing
C. incentive spirometry
D. paced breathing
25. Following a reattachment of the flexor tendons of the fingers, one physical therapy goal is to minimize adhesion
formation. A few days after surgery, with the patient in a splint, the physical therapist should emphasize that the
patient perform:
A. passive extension and active flexion of the interphalangeal joints
B. active extension and flexion of the interphalangeal joints
C. active and extension and passive flexion of the interphalangeal joints
D. gentle passive extension and flexion of the interphalangeal joints
26. A patient was admitted to the rehabilitation unit of a large teaching hospital with a diagnosis of paraplegia with a
complete lesion at T10. Planning for this patient’s discharge from the unit begins:
A. after approximately one month of treatment as long as there are no complications
B. once the plan of care has been established following the initial evaluation
C. about two weeks before the patient is to be discharged to home or another setting
D. after reassessment of the patient and analysis of the effectiveness of the treatment plan.
27. Your plan of care includes use of iontophoresis in the management of calcific bursitis of the shoulder. To
administer this treatment using the acetate ion, the current characteristics and polarity should be
A. monophasic twin peaked pulses using the positive pole
B. monophasic twin peaked pulses using the negative pole
C. continuous monophasic using the positive pole
D. continuous monophasic using the negative pole
28. If a therapist is planning to establish a new private physical therapy practice, it is best to first
A. do a community needs assessment
B. outline a budget to determine how much of a business loan is required
C. seek an ideal location or building site for the practice
D. circulate a brochure informing physicians and other practitioners of this new service.
29. A friend of yours is an avid tennis player. She telephones and asks you to help her reduce the possibility of
developing tennis elbow. As a physical therapist, the best way to respond to your friend is to:
A. describe exercises and proper tennis techniques during the phone conversation
B. in your spare time, watch her play tennis and, after analysis, offer specific suggestions as to how to minimize
the risk of developing tennis elbow
C. invite her to your clinic for an evaluation and instruction in appropriate exercises and stretches if indicated
D. send her an illustrated pamphlet dealing with tennis elbow prevention and treatment including other suggested
readings
30. Following a mastectomy, a sixty-three year-old female developed massive edema of the arm on the involved side.
A compression garment was ordered to help the situation. To help decrease the edema, this garment must exert
enough pressure to:
A. decrease the osmotic pressure of the capillaries.
B. increase the capillary permeability
C. exceed the internal tissue hydrostatic pressure
D. equal the fluid outflow from the capillaries
31. A family is caring for a child with a diagnosis of spina bifida. The physical therapist should write the home
program assuming an educational reading level at the:
A. 2nd – 3rd grade
B. 5th – 6th grade
C. 8th – 9th grade
D. 11th – 12th grade
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Practice 5
32. During a cold winter day, an outpatient slipped and fell on the ice at the entrance to your outpatient clinic. Before
beginning the rehabilitation for a knee injury, the patient says he feels a bit sore, but he can proceed with the
treatment. As his physical therapist you should:
A. cancel the treatment for the day
B. start the treatment after noting the incident in the patient’s record
C. briefly reevaluate the patient prior to any treatment
D. have the patient call his physician to get clearance for physical therapy treatment
33. Twenty-four hours following a major thermal burn, a patient experiences syncope while the physical therapist
works on positioning as part of edema management. The syncope is most likely a result of
A. orthostatic hypotension
B. extreme pain
C. intravascular hypovolemia
D. massive infection
34. If you are treating a patient with active infectious Hepatitis B, transmission of the disease is best minimized if you
take universal precautions to avoid:
A. direct contact with the patient’s blood or blood-contaminated equipment
B. direct contact with any part of the patient
C. droplet spread of the organisms by coughing
D. direct contact with patient’s hands
35. You are working in a school setting as a physical therapist. A supervisor asks you to organize a scoliosis screening
program. It would be best to asses:
A. 2nd or 3rd graders
B. 6th or 7th graders
C. high school freshmen or sophomores
D. high school juniors or seniors
36. A candidate for admission to a physical therapist assistant program was ranked at +1.0 standard deviations above
the mean among all applicants. Interpretation of the class rank, using a normal curve would indicate that this
candidate’s position is:
A. as good or better than 84% of the other candidates
B. lower than 34% of the other candidates
C. within the top 6% of all candidates
D. within the top 14% of all candidates
37. You are working with a distance runner with a history of bronchial asthma. To minimize the onset of an attack, the
least important factor to counsel the runner about would be the
A. air pollution index
B. wind chill factor
C. pollen count
D. wind direction
38. Your spinal cord injury unit within a rehabilitation hospital is preparing for accreditation visits. Accreditation
would fall principally under the jurisdiction of the:
A. Joint Commission on Accreditation of Healthcare Organizations and Occupational Safety & Health
Administration
B. Commission on Accreditation of Rehabilitation Facilities and Occupational Safety & Health Administration
C. Commission on Accreditation of Rehabilitation facilities and Healthcare Financing Administration
D. Joint Commission on Accreditation of Healthcare Organizations and Commission on Accreditation of
Rehabilitation Facilities
39. It is most likely than when treating a patient with Lyme Disease of more than one year’s duration, the physical
therapy focus will be on management of arthritic changes primarily affecting the:
A. small joints of the hands and feet
B. large joints of the body; especially the knee
C. axial joints, especially the lumbosacral spine
D. axial joints, especially the cervical and thoracic spine
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6 Practice
40. As a physical therapist working with a variety of special needs students in a high school setting, the long term goal
that should take the highest priority in the plan of care is that the students should be:
A. independent in taking off and putting on outerwear at the start and finish of the school day
B. able to independently change from classroom to classroom in the allotted time period
C. independent in the purchasing and consumption of lunch in the school cafeteria
D. independent in getting on and off the school bus
41. Just after birth, you observe a full-term infant in the neonatal intensive care unit. In the supine position, the
shoulders are abducted and externally rotated, elbows and fingers are flexed, hips are abducted and externally
rotated and knees are flexed. This posturing would seem to indicate that the:
A. upper extremity tone is abnormal
B. lower extremity tone is abnormal
C. tone is abnormal in both upper and lower extremities
D. tone is normal in both upper and lower extremities
42. A patient has a fused right knee and placement of an Intramedullary rod in the right femur. In this case, ascending
stairs with crutches would best be accomplished by instructing the patient to:
A. face forward, advance the lower left extremity first followed by hiking and circumducting the right lower
extremity
B. face forward, advance the right lower extremity first by hiking and circumducting followed by placement of
the left lower extremity
C. face backwards to the stairs and advance the right lower extremity first by hiking and circumducting followed
by hiking of the left lower extremity
D. face sideward, grasp the banister and advance the right lower extremity first by hiking and abducting followed
by placement of the left lower extremity onto the stair below the right lower extremity.
43. While ambulating a patient in the parallel bars, the patient suddenly falls and suffers a severe laceration in the area
of the lateral distal right thigh. To help control bleeding you should apply pressure directly over the wound and:
A. behind the knee at the popliteal fossa
B. at the femoral triangle
C. at the antecubital fossa
D. at midthigh, directly over the profunda femoris artery
44. While gait training a patient following a cerebral vascular accident, you observe the knee on the affected side going
into recurvatum during stance phase. The most likely cause of this deviation can be attributed to:
A. severe spasticity of the hamstrings or weakness of the gastrocnemius-soleus.
B. weakness or severe spasticity of the quadriceps
C. weakness of the gastrocnemius-soleus or spasticity of the pretibial muscles
D. weakness of both the gastrocnemius-soleus and pretibial muscles
45. You are organizing a group exercise session in a therapeutic pool. Use of the pool would be contraindicated for a
group member who has:
A. an indwelling catheter
B. paraparesis and is on a regular bowel program
C. unstable blood pressure
D. an open skin lesion, even if it is covered by waterproof dressing
46. A child with spastic diplegia is now independent in using a walker. Additional goals desired by the physical
therapist include increasing the child’s energy-efficiency and velocity while ambulating. In this case, the selection
of walker that is most likely to help improve these factors is:
A. a standard anterior walker with no wheels
B. an anterior rollator walker with two wheels
C. a posterior rollator walker with two wheels
D. a posterior rollator walker with four wheels
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Practice 7
47. Following an open reduction hip fracture repair, a 77 year-old patient is transferred from an acute care hospital to a
skilled nursing facility. To be eligible for physical therapy care that is reimbursable by Medicare in this new
facility, all of the following criteria must be met with the exception of:
A. provision of therapy at least five days per week
B. provision of care on an inpatient basis
C. therapy goals that are directed at improvement of the patient’s functional status and ability to perform
activities of daily living.
D. therapy goals that are directed at prevention of any deterioration in the patient’s current functional status.
48. Following a myocardial infarction, a patient was placed on medications, which included a beta-adrenergic blocking
agent. When monitoring this patient’s responses to exercise, you would expect that this drug will cause:
A. heart rate to be low at rest and rise very little with exercise
B. heart rate to be low at rest and rise continuously to expected levels as exercise intensity increases
C. systolic blood pressure to be low at rest and not rise with exercise
D. systolic blood pressure to be within normal limits at rest and progressively fall as exercise intensity increases
49. A neonate’s APGAR score at one minute after birth is 8 and four minutes later is 9. You would expect that this
baby would probably:
A. have a heart rate of less than 100 beats per minute with slow and irregular respirations and not require
resuscitation
B. require extensive resuscitation efforts including intubation
C. require some resuscitation and administration of supplemental oxygen
D. have a heart rate of greater than 100 beats per minute, good respiration and not require resuscitation
50. To prevent degenerative joint disease of the knee from progressing to more advanced and debilitating stages, the
physical therapist could incorporate all of the following into a plan of care with the exception of:
A. arranging for a shoe lift if there were uneven leg lengths
B. immobilizing the knee with an orthotic device to help minimize inflammation
C. counseling the client on weight loss if obesity was a factor.
D. joint mobilization to help restore restricted motion.
51. You are involved in the management of a young adult who is comatose (Glasgow Coma Scale 3) and is in a nursing
home for custodial care. One day, you notice that the patient is beginning to demonstrate decerebrate posturing.
You recommend that this patient:
A. be rehospitalized in an acute care facility for reevaluation and intense physical therapy
B. be transferred to a rehabilitation hospital for more intense physical therapy
C. be transferred home with evaluation and treatment by a home health team
D. remain in the nursing home since there is not functional change of status
52. A physical therapy note states: “A patient ambulates independently with crutches on level surfaces and on stairs.
The patient lacks endurance to walk up more than one floor at a time; however, this should increase with practice.
The patient says he lives on the fourth floor and there is no elevator. Will work to increase endurance prior to
discharge.” In the SOAP format, the “A” of the note is:
A. will work to increase endurance
B. endurance should increase with practice
C. patient lives on the fourth floor with no elevator
D. patient ambulates independently with crutches
53. Following a full thickness burn to 40% of the body, a blood chemistry value unlikely to be seen is
A. a sharp increase in albumin
B. an initial rise in white blood cell count
C. increased levels of serum creatinine and blood urea nitrogen
D. increased blood viscosity
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8 Practice
54. You are treating a 54 year-old woman for degenerative arthritis of the left knee. Her medical record indicates that
she is on estrogen replacement therapy. In this case, you should consider that this patient might be more
susceptible to:
A. coronary artery disease
B. osteoporosis
C. clinical depression
D. weight gain
55. You are instructing a new mother to perform range of motion and stretching on her newborn who has a clubfoot.
You would advise her to carefully stretch in the direction of:
A. plantarflexion and inversion
B. plantarflexion and eversion
C. dorsiflexion and inversion
D. dorsiflexion and eversion
56. In degenerative joint disease, Heberden’s nodes are most frequently noted in the:
A. distal interphalangeal joints of the fingers
B. both distal and proximal interphalangeal joints of the fingers
C. distal interphalangeal joints of the fingers and toes
D. distal and proximal interphalangeal joints of the fingers and toes
57. If a patient had normal quadriceps strength; but, unilateral weakness (3/5) of the hamstring muscles, during swing
phase you might observe:
A. excessive compensatory hip extension on the sound side
B. decreased hip flexion followed by increased knee flexion on the weak side
C. excessive hip extension followed by abrupt knee extension on the weak side
D. excessive hip flexion followed by abrupt knee extension on the weak side
58. Following cast immobilization for a now healed supracondylar fracture of the humerus, a patient’s elbow lacks
mobility. To increase elbow range of motion, joint mobilization in the maximum loose-packed position should be
performed at:
A. full extension
B. 90 degrees of flexion
C. 70 degrees of flexion
D. 30 degrees of flexion
59. A patient with quadriplegia at the C6 level should be instructed to transfer using a sliding board with her:
A. forearms pronated, wrists and fingers extended
B. forearms pronated, wrists extended and fingers flexed
C. forearms pronated, wrists and fingers flexed
D. forearms supinated, wrists and fingers extended
60. Upon removing a dressing covering a decubitus ulcer, you observe copious amounts of a foul-smelling
yellow/green discharge. You should note in this patient’s medical record that:
A. there is likelihood of a Staphylococcus aureus infection
B. there is likelihood of a Pseudomonas aeruginosa infection
C. the would was purulent
D. there was serosanguinous discharge
61. A patient wishes to improve her aerobic fitness. She currently jogs four days a week for 30 minutes at 70% of her
age-predicted maximum heart rate. All of the following recommendations may improve her aerobic fitness except
A. increasing the distance covered in the same 30 minutes
B. increasing the jogging time to 45 minutes while keeping at 70% of the age-predicted heart rate
C. changing to interval training with maximum burst of running for 15 seconds, followed by a 30 second rest.
Complete 4 sets per day, 4 days per week.
D. changing to interval training for 4 days per week by doing 90 seconds of comfortable running followed by 90
seconds of rest for a period of 30 minutes
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Practice 9
62. Following an acutely sprained ankle, a patient who exhibits urticaria or wheals when placed in an ice bath is
exhibiting signs of
A. Raynaud’s phenomenon
B. anaphylactic shock
C. reactive hyperemia
D. histamine release from cold hypersensitivity
63. Four days following open heart surgery, a patient is being treated in the physical therapy department. He
complains of some chest discomfort during treatment and wishes to return to his room. You should:
A. call his physician immediately
B. complete the treatment and have an aide transport him back to his room as some discomfort is expected
C. call the nurse and check to see if the discomfort is to be expected
D. immediately transport the patient back to his room yourself and inform nursing services of the patient’s
complaint
64. A patient who is to undergo surgery for a chronic shoulder dislocation asks you to explain the advantages and
disadvantages of the various surgical reconstructive procedures used to alleviate the problem. Your best response
is to:
A. give the patient as much information about the procedures as you currently know
B. explain how patients you have treated responded to the surgery
C. tell the patient to ask the surgeon for this information since this precise information is outside the scope of
physical therapy practice
D. refer the patient to another therapist in the department who is an expert on shoulder reconstructive
rehabilitation
65. A patient’s peripheral skin color progresses from blue to white to red. This would be most characteristic of:
A. chronic venous insufficiency
B. acute venous insufficiency
C. acute arterial insufficiency
D. vasomotor disorders
66. During the early, acute stage of traumatic brain injury rehabilitation, the primary goal is
A. reduction of spasticity and improvement of posture, coordination and balance to hasten transfer training and
ambulation
B. the functional independence of the patient based on attention span, motivation and motor control
C. use of calming stimuli such as gentle rocking or stroking to reduce excessive sympathetic responses and
promote homeostasis.
D. provision of an environment and daily structure in which the patient is best able to process stimuli cognitively.
67. A hospital administrator asks for your help in dealing with a significant increase in back injuries suffered by nurses
and nurse’s aides as a result of lifting patients. The most efficient and effective way to address this situation is by:
A. observing each nurse and nurse’s aide as they lift patients and provide immediate feedback about correct
lifting
B. providing a series of inservice experiences to all appropriate nursing personnel which covers lifting and other
‘back-saving’ techniques
C. sending everyone on the nursing service a comprehensive booklet that teaches ‘back-saving’ techniques in a
step-by-step fashion.
D. reviewing proper techniques with nursing supervisors and have them evaluate all personnel under their
supervision.
68. In the management of systemic lupus erythematosus, all of these treatments might be of help with the exception of
A. nonsteroidal anti-inflammatory agents to control arthralgia
B. resting splints to decrease joint pain and prevent deformity
C. ultraviolet irradiation to help decrease the skin lesions and rash often associated with the disorder
D. endurance training to compensate for cardiopulmonary dysfunction that is often present with the disorder
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1 Practice
69. A patient with degenerative joint disease of the right hip complains of pain in the anterior hip and groin, which is
aggravated by weightbearing. There is decreased range of motion and capsular mobility. Right gluteus medius
weakness is evident during ambulation and there is decreased tolerance of functional activities including transfers
and lower extremity dressing. In this case, a capsular pattern of joint motion should be evident by restriction of
hip:
A. flexion, abduction and internal rotation
B. flexion, adduction and internal rotation
C. extension, abduction and external rotation
D. flexion, abduction and external rotation
70. In the above case, to strengthen the gluteus medius and help decrease the hip pain, as part of the plan of care, the
best strategy would be inclusion of:
A. open kinematic chain exercises with gradually increasing resistance and Grade III and IV oscillating
mobilization
B. open kinematic chain exercises with gradually increasing resistance and Grade I and II oscillating
mobilization.
C. closed kinematic chain exercises with controlled loads to stimulate functional pelvic demands and Grade III
and IV oscillating mobilization
D. closed kinematic chain exercises with controlled loads to stimulate functional pelvic demands and Grade I and
II oscillating mobilization
71. A physical therapist and physical therapist assistant are conducting a cardiac rehabilitation session for twenty
patients. The therapist is suddenly called out of the room. The physical therapist assistant should:
A. terminate the exercises and have the patients monitor their pulses until the therapist returns
B. have the patients continue with the same exercise until the therapist returns
C. have the patients switch to a less intense exercise until the therapist returns
D. continue with the outlined exercise progression for that session
72. All of the following are possible means of fitting a patient for adjustable axillary crutches with the exception of:
A. placing the patient supine and measuring from the anterior axillary fold to the bottom of the foot and adding 2
inches
B. placing the patient supine and measuring from the anterior axillary fold to a point 6 inches lateral to the foot
C. subtracting 16 inches from the height of the patient
D. placing the patient in standing with shoes on, and the crutches placed 6 inches lateral to the foot
73. A therapist wishes to study the progress of her patients with paraplegia who are discharged from a rehabilitation
setting. Starting with the patient’s discharge, and once a month for three years, the therapist will measure their joint
range of motion of both hips and knees. Accurate analysis of this time series study is heavily dependent upon:
A. random sampling
B. interrater reliability
C. intrarater reliability
D. predictive validity of the measurements
74. A boutonniere deformity of the finger may be characterized by all of the following except
A. hyperextension of the proximal interphalangeal joint
B. overstretch of the extensor digitorum communis tendon
C. volar slippage of the lateral bands
D. hyperextension of the distal interphalangeal joint
75. You are evaluating a patient with chronic obstructive pulmonary disease. You would not expect to find:
A. the presence of hypercapnia
B. increased total lung capacity
C. increased vital capacity
D. abnormal ventilation/perfusion ratio
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Practice 1
76. When using a patellar-tendon-bearing prosthesis, a patient will experience excessive knee flexion in early stance if
the:
A. socket is aligned too far anteriorly
B. socket is aligned too far posteriorly
C. foot is outset excessively
D. foot is inset excessively
77. A patient exhibiting flexible pes valgus would most benefit from a combination of shoe modifications consisting of
A. rocker bar, scaphoid pad and lateral sole wedge
B. reverse Thomas heel, metatarsal bar and medial sole wedge
C. Thomas heel, medial sole wedge and scaphoid pad
D. rocker bar, metatarsal pad and Thomas heel
78. An inpatient currently in an acute care facility is having her Medicare Part A benefits come to an end. Medicare
Part B will cover all except:
A. inpatient room and board in a rehabilitation hospital
B. inpatient therapy services in a rehabilitation hospital
C. outpatient therapy services in an acute care facility
D. outpatient therapy services in a private therapy practice
79. You receive a referral from an osteopath to treat a patient for lower back pain. When giving feedback regarding the
patient’s progress in physical therapy you should contact the:
A. patient’s primary care physician
B. osteopath
C. primary care physician and the osteopath
D. patient’s general practitioner and osteopath
80. Following a mitral valve replacement, a patient is now ready to begin Phase II cardiac rehabilitation. It would be
best if:
A. both upper and lower extremity aerobic activities are begun at the start of Phase II
B. lower extremity aerobic activities are begun immediately and upper extremity aerobic activities should not be
started until approximately four weeks after beginning Phase II
C. lower extremity and upper extremity resistance training is implemented approximately four weeks after
surgery.
D. upper extremity training is not included in Phase II rehabilitation as it is too stressful to the heart.
81. A 12 year-old girl with cystic fibrosis has been readmitted to the hospital in acute respiratory failure as a result of
an infection. Physical therapy, in the form of bronchial hygiene should:
A. not be administered since it is contraindicated in acute respiratory failure
B. be administered two times a day to the patient’s tolerance
C. be administered vigorously three times a day
D. be administered vigorously once every two hours at least six times a day
82. While ambulating a patient in the parallel bars, you lose control and the patient falls hitting her head on the bar.
The patient lies motionless on the floor between the bars bleeding heavily form a scalp laceration. The first thing
you should do is:
A. put thick gauze over and apply manual pressure to the scalp wound
B. check for responsiveness.
C. call Emergency Medical Services
D. immediately determine the patient’s heart rate and blood pressure
83. You are treating an outpatient three times per week. The physician’s referral indicated a diagnosis of acute
subdeltoid bursitis. Initial evaluation reveals active shoulder abduction is painful (8/10) and limited to 75 O. After
Two weeks, pain is 5/10 and abduction is 95 O. At the end of week three, pain is 6/10 and abduction is 88 o. In this
case, you should:
A. modify the treatment and continue three times per week
B. modify the treatment and increase to five times per week
C. contact the physician and seek guidance since this patient is not progressing
D. discontinue treating this patient since it is unethical to treat a patient who is not benefiting from treatment
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1 Practice
84. During pregnancy, the presence of the hormone relaxin can lead to abnormal movement and pain which most
frequently affect the:
A. glenohumeral joints
B. hip joints
C. lumbosacral joints
D. sacroiliac joints
85. A patient with angina pectoris has been instructed to use sublingual nitroglycerin in case of anginal attack. This
medication will help to ease the situation primarily by:
A. lowering blood pressure
B. decreasing resistance in the peripheral vasculature
C. increasing venous return
D. increasing cardiac afterload, thus decreasing the work of the heart
86. An 8 year-old with severe spasticity in the lower extremities is to receive a new wheelchair. The patient is average
in height and weight for his age. Funding restrictions limit the selection to only the standard wheelchair
dimensions as supplied by the manufacturers. As the physical therapist you should recommend the selection of a:
A. narrow adult chair which allows for growth since funds for future new chairs will be scarce
B. junior chair with standard seat depth of 16 inches and seat width of 16 inches
C. child chair (sometimes known as a junior-13) with a standard seat depth of 13 inches and a seat width of 16
inches
D. tiny tot chair with a standard seat depth of 11.5 inches and a seat width of 12 inches
87. Components of a rehabilitation program to decrease patellofemoral dysfunction may include the following except
A. stretching the iliotibial band
B. taping to improve patellar tracking.
C. enhancing control of the vastus lateralis by using high repetition, low resistance therapeutic exercise
D. facilitating isolated activity of the vastus medialis with biofeedback training.
88. Three days following a cerebral vascular accident, a patient is supine in bed. It would be best to position the upper
extremity so that the:
A. scapula is protracted and upwardly rotated and the shoulder is abducted and externally rotated
B. scapula is protracted and upwardly rotated and the shoulder is abducted and internally rotated
C. scapula is retracted and downwardly rotated and the shoulder is adducted and internally rotated
D. scapula is retracted and downwardly rotated and the shoulder is abducted and externally rotated
89. An acceptable modified position to drain the posterior basal segment of the left lower lobe is to position the patient:
A. sidelying on the right, with a pillow under the right hip and the bed flat.
B. prone, with a pillow under the hips and the bed flat
C. sidelying on the right, with a pillow between the legs and foot of the bed elevated 18 inches
D. prone, with a pillow under the hips and the bed elevated 18 inches
90. When using adhesive tape to help manage an inversion ankle sprain, the best way to prevent the formation of
blisters over the area of the Achilles tendon is to
A. prepare the entire ankle with tape adherent and underwrap before applying the adhesive tape.
B. use a lubricated pad over the sensitive area before applying the tape
C. tape the ankle with the foot relaxed into plantarflexion to avoid friction over the Achilles tendon
D. tape the ankle using only lateral stirrups and an open basket weave technique.
91. A patient with renal dysfunction and subsequent peripheral neuropathy is seen by a physical therapist. The patient
undergoes hemodialysis three days per week and is seen by the therapist on nondialysis days. The therapist’s goals
are to increase this patient’s strength, function and endurance. In this case, all of the following guidelines should
be followed except for:
A. checking the patient’s hematocrit at each treatment session since chronic anemia is associated with patients
undergoing dialysis
B. avoiding strenuous activities if the patient is taking heparin.
C. never taking blood pressure in the arm with the arteriovenous anastomosis
D. never exercising or applying resistance to the arm with the arteriovenous anastomosis as this may dislodge the
shunt
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Practice 1
92. A physical therapist notes in the medical record that a patient she is treating is receiving a new medication. The
therapist is unfamiliar with this medication. To determine its purpose it would be best if the therapist first:
A. called the patient’s physician
B. asked the nurse in charge of the patient
C. called the pharmacist
D. asked the patient during the treatment session
93. As a sport physical therapist employed by a preparatory school, you observe one of the baseball players being
struck on the side of the head with a bat during practice. Your immediate assessment reveals that the player is
stunned, dizzy and a little disoriented. There is no loss of consciousness. The player seems to be fully recovered
when you check him before he leaves for home. Later that evening, the player’s parents call you on the telephone
and tell you that their son has a severe headache, is somewhat agitated, and has vomited. You advise the parents:
A. that these are normal symptoms following a concussion and to observe him for any worsening of symptoms.
B. that you will drive to their house as soon as possible to reevaluate the athlete.
C. to make an appointment with a neurologist to deal with post concussion syndrome.
D. to take their son to an emergency room or see a physician immediately.
94. The clinical status of a truck driver with a posterior herniated nucleus pulposus has improved if:
A. peripheral pain increases only when lumbar extension is attempted
B. peripheral pain occurs only with straight leg raising
C. pain centralizes with passive hyperextension of the spine
D. there is flattening of the lumbar lordosis
95. A physical therapist assistant is performing passive range of motion exercises on a patient with traumatic brain
injury who is comatose. The patient exhibits Cheyne-Stokes respiration. During the treatment, the patient takes
some shallow breaths and then becomes apneic. The PTA should
A. call emergency services
B. stop the treatment and contact the physical therapy supervisor
C. continue with the treatment
D. begin cardiopulmonary resuscitation
96. When instructing the family of a nine-year-old boy with Duchenne muscular dystrophy, the major emphasis in the
lower extremities should be to
A. strengthen the knee extensors and plantarflexors
B. strengthen the plantarflexors and stretch the hip extensors
C. stretch the hip flexors and plantarflexors
D. strengthen the hip flexors and knee extensors
97. An 18 year-old female soccer player, with a Q angle in excess of 30 degrees, exhibits patello-femoral tracking
problems. While playing soccer, it would be best if she wore a:
A. patellar stabilizing brace with a lateral buttress
B. patellar stabilizing brace with a medial buttress
C. neoprene sleeve with a patellar cutout
D. derotation brace
98. A 69 year-old man with diabetes mellitus has had a Stage III decubitus ulcer over the right ischial tuberosity for the
past five months. The ulcer is infected with Staphylococcus aureus and necrotic tissue covers much of the wound.
The physical agent that would be the least helpful and not usually recommended to treat this problem would be:
A. low voltage, constant microamperage direct current
B. high voltage monophasic pulsed current
C. ultraviolet irradiation
D. moist hot packs
99. In treating a 5 year-old with spastic diplegia, as part of the program, relaxation might be accomplished by:
A. use of rhythmic stabilization
B. slow rocking
C. inhibition of parasympathetic fibers
D. facilitation of sympathetic fibers
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1 Practice
100. Capsular tightness has limited your patient’s ability to fully extend her left knee. Treatment to restore joint motion
should emphasize:
A. anterior glide and external rotation of the tibia
B. anterior glide and internal rotation of the tibia
C. posterior glide and external rotation of the tibia
D. posterior glide and internal rotation of the tibia
101. While administering a phonophoresis treatment to a patient with subdeltoid bursitis, the patient informs you that
she is HIV positive. This information was not part of the patient’s record. It would be best to:
A. discontinue the treatment since phonophoresis may be harmful in this case.
B. discuss this patient at the next staff meeting
C. continue treating the patient as usual
D. refer this patient back to the orthopedic physician who is apparently unaware of her HIV status
102. The results of isokinetic dynamometry indicate that a patient can generate a peak torque of 120 with her right
quadriceps muscle and only 80 with her right hamstring musculature. This situation indicates that:
A. quadriceps torque generation is excessive
B. hamstring torque generation is insufficient
C. both quadriceps and hamstring torque generation is excessive
D. torque generation is proportionally correct
103. When using ultrasound in treating chronic bursitis of the hip, the most benefit might occur if the ultrasound
frequency and dosage were:
A. 1 MHz and 1.5 Watts/cm2
B. 1 MHz and 0.5 Watts/cm2
C. 3 MHz and 1.5 Watts/cm2
D. 3 MHz and 0.5 Watts/cm2
104. A physical therapist, who is HIV+ is assigned to change the dressings of a patient with Stage III decubitus ulcers
over the sacrum and ischial tuberosities. In this case, the therapist:
A. should perform the procedure using gloves
B. should perform the procedure but double glove
C. should perform the procedure, but double glove and use a mask
D. should not perform the dressing change.
105. When performing underwater ultrasound, the most important safety factor is that the:
A. part being treated is not immersed in a metal tank
B. transducer head keeps moving
C. ultrasound apparatus is connected to a ground fault interruption circuit
D. piezoelectric crystal is not cracked
106. When recommending a wheelchair for a patient with a lesion at T11 resulting in paraplegia, the modification least
needed by a patient with this disability would be:
A. swing away foot rests
B. high seat back
C. pneumatic tires
D. caster locks
107. A 16-year-old male limps into your outpatient sports physical therapy department claiming to have twisted his
ankle during a basketball game. In this case it would be best to
A. evaluate, but not treat, the patient without permission
B. evaluate and treat the ankle if practice without referral is permitted
C. tell the athlete you need written permission from his parents to evaluate and treat the problem providing
practice without referral is permitted.
D. get permission via telephone from the patient’s primary care physician to evaluate and treat the problem.
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Practice 1
108. In a patient with severe bronchiectasis, your initial evaluation of the patient should stress
A. review of pulmonary function tests, notation of chest wall deformities, assessment of cough and of any
limitations in performing self-care.
B. review of chest x-ray and of arterial blood gas results, assessment of diaphragmatic breathing and lateral
costal expansion and a quick screen of muscle strength.
C. assessment of the color, consistency and amount of sputum, assessment of cough and auscultation of the
lungs.
D. review of pulmonary function and arterial blood gas tests, check for chest deformities and assessment of
diaphragmatic breathing and lateral costal expansion.
109. A patient with diabetes has developed atherosclerosis of the lower extremities. For this condition, a home program
of care might consist of all of the following elements except
A. a controlled walking regiment aimed at enhancing circulation
B. support stockings to decrease edema
C. reflex heating to improve circulation
D. daily foot inspection and use of clean, white socks
110. While figure skating, a 13 year-old girl with a long history of asthma occasionally experiences dyspnea, wheezing
and anxiety. As her physical therapist, you recommend that during these periods of distress it would be best if she
stops skating and concentrates on
A. taking slow shallow breaths while seated in a “lean forward” position
B. performing relaxation exercises
C. controlling her breathing rate by inhaling evenly and exhaling slowly for a long time.
D. slowing her breathing rate with long inhalations and exhaling slowly with short breaths.
111. While treating a patient with an infrared lamp you change the lamp position from 30 inches to 15 inches above the
body part being treated. At this new distance the patient will receive
A. twice as much radiant energy
B. half as much radiant energy
C. four times as much radiant energy
D. no change in radiant energy since the lamp’s wattage remains the same
112. A patient with chronic asthma has been admitted to the hospital for an acute exacerbation of the disorder. The most
important thing for the physical therapist to check when seeing this patient for the first time is:
A. current medications the patient is taking
B. previous history of the disease relative to the patient’s current status
C. interpretation of the most recent chest x-ray
D. pulmonary function test results
113. You have assessed the deep tendon reflexes of a patient recently diagnosed with amyotrophic lateral sclerosis. The
results are 2+ left and 3+ right. Your interpretation is that the reflexes are:
A. diminished on the left and normal on the right
B. normal on the left and exaggerated on the right
C. exaggerated, but within normal limits on both sides
D. exaggerated on both sides
114. A five foot tall, 37 year-old word processing technician complains of lumbar discomfort after a full day at her
computer work station. To help the situation, you could recommend that she try all of the following except
A. use of a lumbar roll
B. use of an elevated foot rest
C. moving her chair further away from the keyboard and screen
D. taking frequent short walks during the day
115. A four year-old girl is seen in your clinic following a grade I sprain of her calcaneofibular ligament. She has a
history of recurrent ankle sprains. Physical therapy management in this situation should stress:
A. a comprehensive program of proprioceptive balance activities
B. intensive heel cord stretching
C. use of a plastic spiral ankle orthosis
D. intensive strengthening of the pretibial musculature.
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1 Practice
116. A patient with Parkinson’s disease is in a skilled nursing facility and has been seen regularly by a physical
therapist. The patient has been taking levodopa three times a day for several years to help control rigidity and
bradykinesia. Lately, the therapist has noticed the patient exhibiting dyskinesias during the usual treatment
sessions. In this case, the therapist should:
A. move the treatment time closer to the time the patient takes the initial levodopa dose for the day
B. move the treatment time to the afternoon following the administration of the second levodopa dose for that
day
C. consult with the nursing service about the deterioration of the patient’s condition
D. talk with the patient’s physician about the need for a possible change in levodopa dosage
117. In the neonate, the most serious developmental problem would result from lack of the:
A. optical righting response
B. rooting response
C. Moro reaction
D. asymmetrical tonic neck reflex
118. You are treating a child with spastic hemiplegia. He is supine on the mat table and you have place two pillows
under his neck for comfort. He is having difficulty actively flexing his involved hip which is most likely a result of
the influence of the:
A. asymmetrical and symmetrical tonic neck reflexes
B. symmetrical tonic neck reflex and crossed extension reflex
C. symmetrical tonic neck reflex and tonic labyrinthine reflex
D. asymmetrical tonic neck reflex and protective extension reflex
119. The most important stimulus which will result in an increase in ventilation is:
A. diminished arterial PO2
B. diminished arterial PCO2
C. increased arterial PCO2
D. the Hering-Breuer reflex
120. To exercise the middle deltoid during a home health visit, you apply a cuff weight to the wrist and instruct the
patient in glenohumeral abduction. Since the patient is unable to complete the exercise, you move the weight to the
elbow. This change in position may allow the patient to complete the motion because it:
A. reduces the force arm, thereby increasing the mechanical advantage of the lever
B. reduces the resistance arm, thereby decreasing the mechanical advantage of the lever
C. reduces the force arm, thereby decreasing the mechanical advantage of the lever
D. reduces the resistance arm, thereby increasing the mechanical advantage of the lever
121. On the first day following a cesarean delivery, the physical therapist’s primary treatment responsibilities would
consist of teaching the new mother:
A. gentle partial sit ups and pelvic tilting
B. breathing, coughing and pelvic floor exercises
C. assisted ambulation
D. active calf and ankle exercises to prevent venous stasis
122. A patient using an ankle-foot orthosis demonstrates excessive stride width during stance phase. To try and correct
the problem, an appropriate strategy would be to:
A. correct the foot outset
B. correct the foot inset
C. lower the height of the medial upright
D. have the patient try a walking aid such as a cane
123. You are treating a patient with a history of patellofemoral pain. To strengthen the quadriceps muscle on the
involved side while minimizing joint reaction forces, it would be best to have the patient perform:
A. open chain strengthening from 90-60 degrees and closed chain from 0-30 degrees
B. open chain strengthening from 30-0 degrees and closed chain from 60-90 degrees
C. quad sets at 0 degrees and open chain strengthening from 30-0 degrees
D. quad sets at 0 degrees and open chain strengthening from 60-90 degrees.
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Practice 1
124. A physical therapist is treating an 80 year-old female at home. The patient is in the very early stages of
amyotrophic lateral sclerosis. The patient lacks endurance to independently ambulate to and from the bathroom;
however, she refuses to use a bedpan. This has caused added difficulties and stress for family members caring for
her at home. In this situation, the therapist should:
A. begin immediate ambulation endurance training with distance to and from the bathroom as the primary goal.
B. recommend that the patient be transferred to a skilled nursing facility until she has sufficient endurance to get
to and from the bathroom
C. recommend for immediate delivery of a commode chair to deal with the situation
D. try behavior modification to convince the patient to try and use the bedpan until trained sufficiently to get to
and from the bathroom.
125. You are instructing a sedentary group of senior citizens at a local community center. Exercises that would be the
least beneficial to include in this class would be active:
A. stretching of the pectoral muscles
B. neck extension
C. hip flexion
D. hip extension
126. As a physical therapist, you are managing the rehabilitation of a patient with right hemiplegia and Broca’s aphasia.
Communication with the patient has made the rehabilitation process difficult. In this case, it would be best if:
A. you respond to the patient in writing
B. the patient responds to you in writing.
C. you phrase oral communication such that the patient only has to respond to you with simple yes or no answers
D. you use nonverbal communication or symbolic gestures as the primary form of communication with the
patient.
127. A 23 year-old male with an incomplete spinal cord lesion at the T12 level asks you questions about his potential
sexual capabilities. An accurate response to him, would indicate that erectile capability is:
A. more likely in complete lower motor neuron lesions than in incomplete upper motor neuron lesions
B. more likely in incomplete lower motor neuron lesions than in incomplete upper motor neuron lesions
C. most likely in incomplete upper motor neuron lesions as compared to complete upper and lower motor neuron
lesions or incomplete lower motor neuron lesions
D. unlikely except in cauda equina lesions
128. A woman in the second trimester of pregnancy frequently complains of low back pain. All of the following
interventions may be appropriate to help alleviate the pain with the exception of:
A. deep heating modalities applied once a day to ease muscle spasm
B. arching the back (cat exercise) done in the hands and knees position to increase flexibility
C. cold packs applied for 10 minutes at a time frequently throughout the day to ease muscle spasm
D. a sacroiliac support belt to improve posture
129. A supervising therapist should check the capital budget of the physical therapy department in order to determine if
there are sufficient funds to:
A. purchase a new computerized isokinetic dynamometer
B. recommend a 5% salary increase for staff physical therapists
C. double the towels ordered for patients and physical therapy staff who use the therapeutic pool
D. send a therapist to a week-long neurodevelopmental seminar in another state
130. A hospital volunteer is assigned to help out in the physical therapy department. Under normal circumstances it
would be inappropriate for the volunteer to:
A. change linen or clean whirlpools following patient treatments
B. transport patients to and from the department
C. help patients transfer from their wheelchairs to the treatment tables
D. schedule the times for department in-service education
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1 Practice
131. The left phrenic nerve of a patient was accidentally severed during thoracic surgery. The physical therapist should
work on facilitating and strengthening all of the following muscles to provide substitute function with the exception
of the:
A. sternocleidomastoid
B. external intercostals
C. scalenes
D. external obliques
132. As a result of a cerebellar lesion, a patient presents with incoordination and problems with balance and posture. To
help improve this situation it would be best if the therapeutic program incorporated:
A. lower extremity splinting to improve stability and isokinetic exercises at moderate to fast speeds to emphasize
reciprocal movement
B. weight cuffs to increase proprioceptive feedback and use of rhythmic stabilization and slow reversals-hold
techniques to facilitate stability
C. Frenkel’s exercises to help with incoordination and PNF activities emphasizing traction of the proximal joints.
D. perturbed balance using a gymnastic ball and PNF patter using D1 diagonals which promote proximal
mobility with distal stability
133. A 65 year-old male with diabetes recently underwent a transtibial amputation. When instructing others in wrapping
the residual limb to minimize edema and provide proper shape, it is important to stress that:
A. greatest pressure should be provided distally
B. greatest pressure should be provided proximally
C. pressure should be evenly distributed
D. an overlapping, circular, wrinkle-free pattern should be used
134. You are performing clinical research in which a specific myofascial technique is applied to a patient with chronic
neck pain. A single case study, time-series design using A-B-A-B format is to be followed. A more in-depth
follow up study would not be justified if:
A. A equals B
B. A is greater than B
C. B is greater than A
D. B is less than A
135. Avascular necrosis would least likely be a major complicating factor in the rehabilitation of a patient with:
A. Legg-Calvé Perthes’ disease
B. a tibial fracture
C. degenerative joint disease of the cervical spine
D. a carpal scaphoid fracture
136. An energetic and independent-minded 78 year-old woman had a stroke a number of years ago and ambulates with
the aid of a walker. She lives in a community housing project and has many close friends. Recently, she fell and
fractured her hip and now four months later is having some difficulty ambulating safely when she leaves her
apartment. As her home therapist, your first course of action is to:
A. recommend that the patient be readmitted to a rehabilitation hospital until she can ambulate safely
B. have the patient use a wheelchair outside of her apartment
C. teach her friends to accompany and properly guard her when she is ambulating outside
D. implement a home program of balance training and lower extremity strengthening
137. A patient with Osgood-Schlatter disease will experience the most difficulty and pain while:
A. playing basketball or volleyball
B. sitting for prolonged periods of time
C. walking down stairs.
D. lifting heavy weights.
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Practice 1
138. A physician requests that you perform hydrocortisone iontophoresis over the left shoulder of a patient with
tendonitis. You discover that the patient has a pacemaker. In this case:
A. perform the treatment since there is no contraindication as long as nothing is done directly over the
pacemaker.
B. refer the patient to another physical therapist who has greater expertise in using iontophoresis
C. begin to examine and evaluate the patient and consult with the physician about alternate forms of therapy;
however, do not perform the iontophoresis treatment
D. ethically you must refuse to administer iontophoresis and have the patient return immediately to the physician.
139. A patient, trying to cope with his disability, is going through a stage of anger. Anger would not be expressed using
the mechanism of:
A. denial
B. projection
C. noncompliance with treatment
D. displacement
140. While evaluating the gait of a patient with left hemiplegia, you note toe drag during midswing on the left. The least
likely cause of this deviation would be:
A. inadequate concentric activity of the ankle dorsiflexors
B. excessive extensor synergy
C. knee and ankle joint pain
D. decreased proprioception
141. In patients with cardiovascular disease who receive either nitrates, diuretics, digitalis or calcium antagonists, the
side effects that may commonly occur with administration of any of these medications are:
A. hypotension and dizziness
B. arrhythmia and unstable blood pressure
C. gastrointestinal upset and extreme fatigue
D. hypotension and decreased electrolytes
142. A 3 year-old child with myelomeningocele has had a ventriculoperitoneal shunt put in place. During physical
therapy treatment, the child becomes agitated and irritable, then drowsy and listless. In this situation, the therapist
should:
A. immediately place firm pressure over the fontanel
B. administer emergency oxygen
C. place the child in a head-down position
D. call for emergency medical services
143. A therapist wishes to use operant conditioning as part of her treatment to help “shape” the behavior of children with
problems associated with cerebral palsy. Operant conditioning would not involve:
A. rewarding the child with a prize for a correct response or attitude
B. verbally reinforcing correct responses and pointing out and explaining incorrect behaviors
C. using words of praise or a pat on the back to strengthen desired responses
D. ignoring or not reacting to incorrect behaviors or attitudes
144. An 83 year-old man with peripheral vascular disease and diabetic retinopathy is having some difficulty with
balance when ambulating in his home. As his home physical therapist, the first priority you should consider is to:
A. begin gait training with a cane to ensure safety
B. ensure that colors on flat surfaces in the home are the same and that raised surfaces, such as steps, have a
sharp color contrast
C. begin balance and ambulation practice on any soft or uneven surfaces in the home to help compensate for
decreased sensory feedback
D. recommend that night-lights be immediately placed in strategic areas throughout the house and that they
remain lit continuously
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2 Practice
145. A 77 year-old female has a compression fracture at T12 secondary to severe osteoporosis. The patient is active and
alert though in some pain. To help prevent further risk of compression fractures, elements of your therapeutic
program could include recommending:
A. active flexion to strengthen abdominals and use of a semi-rigid lumbosacral brace
B. active flexion to strengthen abdominals and use of a dorsal-lumbar corset
C. active strengthening of back extensors and use of a dorsal-lumbar corset
D. active strengthening of back extensors and use of a lumbosacral corset
146. You are monitoring the blood pressure of a healthy, 27 year-old athlete as she is exercising on a treadmill. The
workload, in terms of speed and incline, is steadily increasing during the exercise period. You would expect her
blood pressure response demonstrate a:
A. very gradual or blunted rise in systolic pressure and a slight decrease in diastolic pressure
B. slight drop in systolic pressure and either a slight increase or decrease in diastolic pressure
C. steady increase in systolic pressure accompanied by a steady increase in diastolic pressure
D. steady increase in systolic pressure and either a slight increase or decrease in diastolic pressure
147. You are evaluating a patient with a temporomandibular disorder. The patient had a history of jaw clicking on
opening and closing the mouth, but the noises are now gone. The current major complaint is inability to open the
mouth wide and difficulty performing functional jaw movements such as chewing and yawning. You suspect that
the most likely cause is:
A. capsular fibrosis
B. TMJ subluxation
C. chronic TMJ osteoarthritis
D. disc displacement without reduction
148. When preparing an in-service lecture, to determine the group needs it would be best to:
A. talk with a representative sample of the group a few days before the lecture
B. give everyone a pretest on the material about one week before the lecture
C. ask a representative sample of the group to complete a questionnaire two weeks or more before the lecture.
D. ask the entire group to complete a questionnaire two weeks or more before the lecture.
149. You have just completed a course on manual therapy for the temporomandibular joint. Two days after the course
you receive a referral that implies the use of TMJ mobilization. You should:
A. treat the patient using joint mobilization
B. refer the patient to another therapist skilled in TMJ mobilization
C. refer the patient back to the physician
D. treat the patient; however, do not use joint mobilization
150. You are working with a child with Down syndrome whose major problem is severe Hypotonicity. In order to help
activate the postural muscles, it would be best to try:
A. slow repetitive rocking movements with the child seated on a large gymnastic ball
B. prone positioning on a large gymnastic ball with the head tipped down
C. slow stroking applied over the paravertebral muscles
D. rhythmic vestibular stimulation first using passive and then progressing to active rolling movements
151. Following a CVA, a 75 year-old man is having motor control difficulty and is fearful when descending stairs.
Early in the relearning process, a strategy one would not employ is:
A. mental practice of the task to help decrease fear
B. use of a more open environment in which to practice the skill
C. guided movement to help position the involved extremity on the proper step
D. provision of feedback which focuses on correct aspects of performance
152. A therapist investigates the normative values for isometric force obtained with hand-held dynamometers. This type
of research can be categorized as:
A. historical
B. descriptive
C. experimental
D. quasi-experimental using a sample of convenience
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Practice 2
153. You are to evaluate and treat an 87 year-old patient. It states in the chart that the patient has hyponatremia. When
evaluating this patient, it is probable that you will encounter:
A. muscle weakness and restlessness
B. muscle cramping
C. hypotonia and pain on motion
D. pitting edema
154. A 72 year-old woman has a clinical diagnosis of osteoporosis with moderate to severe bone loss. She is sedentary
and smokes a pack of cigarettes per day. All of these would be appropriate treatment recommendations with the
exception of
A. advice to stop smoking immediately
B. advice to take up to 50 mg of calcium per day
C. postural exercises to correct kyphosis and forward head
D. increased weightbearing to include a daily walking program.
155. Following a stroke, a patient is being fitted for a limited motion, bilateral upright ankle-foot orthosis. An
appropriate shoe to use with this orthosis is one with a:
A. Blucher opening
B. Balmoral opening
C. cushion heel
D. rocker bottom
156. Early Intervention Programs are usually required to use a developmental test, which is standardized and
comprehensive. The best choice for a physical therapist to use for motor development testing would be the:
A. APGAR test
B. Denver Developmental Screening Test (Denver II)
C. Peabody Developmental Motor Scales
D. Brazelton Neonatal Behavioral Assessment Scales
157. A home health physical therapist makes a list a list of equipment the patient will need to function in a home
environment. For a home bound patient, Medicare will not reimburse for a;
A. hospital bed
B. wheelchair
C. commode
D. home traction unit
158. A 13 year-old girl has a structure right thoracic idiopathic scoliosis. The clinical features you would expect to find
include:
A. a high right shoulder, a prominent right scapula and a left hip that protrudes
B. a high left shoulder, a prominent left scapula and a right hip that protrudes
C. a high right shoulder, a prominent left scapula and a right hip that protrudes
D. a high left shoulder, a prominent right scapula and a left hip that protrudes
159. You note in the medical record that a newly admitted patient, with a diagnosis of right cerebrovascular accident, is
demonstrating anosognosia. When examining this patient you would expect to find:
A. left-sided neglect
B. inability to follow your directions to move a body part even if that part was capable of moving
C. inability to recognize familiar objects by touch alone
D. inability to recognize familiar object visually
160. A 45 year-old male with a long history of cigarette smoking walks in to your private physical therapy clinic
complaining of right upper thoracic pain with tingling into the fourth and fifth digits of the right hand. He has not
seen his primary care physician in over a year. As a physical therapist your responsibility is to:
A. provide treatment for excessive scalene and other accessory breathing muscle hypertrophy secondary to
COPD
B. determine the origin of the dysfunction and refer the patient to his physician if you suspect a tumor as a
possible cause of the symptoms
C. begin treatment for thoracic outlet syndrome and discuss with the patient the importance of smoking cessation
D. provide appropriate treatment for pain and weakness secondary to nerve root impingement
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2 Practice
161. In assessing a patient for a wheelchair, the measurement that will have no influence on the amount of pressure to be
placed on the ischial tuberosities is the seat:
A. depth
B. height
C. back height
D. tilt
162. When using whirlpool at 99o-101oF in the care of an indurated ulcer, the treatment will not be of significant benefit
in:
A. loosening of any necrotic tissue within the wound
B. softening of wound debris
C. soaking off of adherent dressings
D. increasing circulation to the wound borders to facilitate healing
163. Following a skiing accident, a 14 year-old boy is in a skilled nursing facility with a traumatic brain injury. He is
classified as Glasgow Coma 4. Family members visit him on a daily basis. In this situation it would be best if
passive range of motion exercises are:
A. taught to family members in order for them to participate in the care of the boy
B. not done since the patient is able to follow motor commands
C. performed only by physical therapists or physical therapist assistants to minimize the possibilities of
pathological fractures
D. taught to all the registered nurses who might care for the boy
164. After gait training a patient with a new below-knee prosthesis, you notice redness along the patellar tendon and
medial tibial flare. This would indicate:
A. the socket is too small and the residual limb is not seated properly.
B. the socket is too large and pistoning is occurring
C. improper weight distribution during stance
D. pressure tolerant weightbearing during stance
165. While evaluating a 2 year-old child with mild cerebral palsy, the therapist is encouraged because the normal
developmental milestones for a child of this age have been achieved. This was demonstrated by the child’s ability
to
A. hop on one foot
B. stand on tiptoes
C. ascend stairs reciprocally
D. begin to self-feed
166. You see a patient in the intensive care unit with multiple trauma and severe traumatic brain injury. A chest tube is
in place and it exits from the right thorax. The patient is in need of bronchial hygiene. In this case:
A. postural drainage can be performed using the Trendelenburg position
B. percussion and shaking can be done only in the right sidelying position
C. percussion and shaking can be done carefully in the area surrounding the chest tube
D. postural drainage is permissible; however, percussion and shaking can be done only when the chest tube is
removed
167. To prevent maximal compressive forces being placed on the patella, a therapist should minimize placing the
patient:
A. prone and flexing the knee to 30 degrees
B. in a sitting position with the knee flexed to 90 degrees
C. supine and flexing both the hip and knee to 110 degrees
D. prone and flexing the knee to 110 with the hip extended
168. A 3-year-old child with lumbar level myelomeningocele is using a parapodium. This device may be useful for all
of the following except
A. prevention of musculoskeletal deformity and strengthening bone
B. enhancement of social emotional development and body image
C. improvement of circulation and bladder function
D. achievement of a slow, safe reciprocal gait pattern
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Practice 2
169. Following an exercise session in a Phase 3 cardiac rehabilitation program, in which some patient may experience
angina pectoris, the therapist employs a gradual and prolonged cool down period primarily to prevent:
A. exertional dyspnea
B. tachycardia
C. venous pooling
D. hypertension
170. OSHA guidelines would cover all of the following situations in a hospital environment except for
A. proper grounding of electrical equipment
B. vaccination of the staff against Hepatitis B
C. biohazard disposal
D. workplace access for handicapped employees
171. As a result of diminished movement associated with Parkinson’s disease, a physical therapist might employ
rhythmic initiation primarily to help improve:
A. trunk stability and proximal tone
B. trunk rotation
C. upper extremity function
D. active and passive range of motion
172. You wish to mobilize a patient’s shoulder using an inferior glide technique. It would be best to use this technique
be propositioning the patient’s arm in:
A. 95 degrees of abduction with lateral rotation
B. 125 degrees of abduction and internal rotation
C. 55 degrees of abduction and neutral rotation
D. 95 degrees of shoulder flexion and neutral rotation
173. You are evaluating a 48 year-old tennis player with a lower extremity problem. You would use the Thompson test
to assess for:
A. anterolateral rotational instability of the knee
B. iliopsoas tightness
C. rectus femoris tightness
D. Achilles tendon rupture
174. You are treating a terminally ill patient with AIDS at home. Your major psychological focus or consideration
when managing this patient would be to:
A. discontinue treatment of the patient if the patient/therapist relationship becomes overly dependent.
B. reassure the patient and address any feeling of loneliness, abandonment or isolation that the patient expresses
to you
C. keep the friends and relatives of the patient up to date on the patient’s state of mind
D. discontinue any activities that may cause the patient discomfort in order to keep anxiety levels low
175. A patient with a transverse spinal cord injury has total lack of hip flexion, abduction and knee extension. This
functional picture is consistent with a designation of a complete spinal cord lesion at the level of
A. T12/L1
B. L2/L3
C. L3/L4
D. L4/L5
176. If TENS is used to help control pain following caesarean section, it would be best to place the electrodes:
A. over the lumbar paravertebral muscles
B. over the sacrum
C. at the acupuncture point just distal to the focus of the pain
D. over the lateral aspects of the incision
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2 Practice
177. You are treating an outpatient for low back pain which radiates down the posterior left lower extremity. After one
month of treatment, the frustrated patient complains to you that the pain is getting much worse. You should
respond to the patient by:
A. changing the overall treatment approach and adding the use of TENS to help with pain management.
B. increasing the frequency of treatment to five times per week as opposed to three times per week
C. stopping all physical therapy treatment and consulting with the patient’s physician.
D. continuing the treatment for another two weeks and then reassess the situation.
178. A therapist wants to know whether joint mobilization is an effective treatment tool in reducing joint pain in patients
with degenerative joint disease. In designing a clinical research study, joint mobilization is the:
A. control variable
B. intervening variable
C. independent variable
D. dependent variable
179. A resting pulse rate of 40-60 beats per minute could be considered normal in all but:
A. marathon runners
B. patients taking digitalis
C. elderly individuals with arteriosclerotic heart disease
D. children under five years of age
180. As a result of a gait analysis, a therapist has determined that the patient ambulates with excessive foot pronation.
This deviation would not occur as a result of:
A. compensated forefoot varus
B. internal tibial rotation
C. a weak tibialis posterior
D. excessive ankle dorsiflexion
181. The parents of an eight year-old child with Down Syndrome ask your advice about appropriate recreational
activities for their son. All of the following would be reasonable to recommend with the exception of
A. mountain biking on fairly level trails
B. non-contact martial arts
C. gymnastics including tumbling
D. kayaking or canoeing
182. Following surgery for multiple trauma, a patient is placed on Percodan to help manage the pain. In your treatment
of this patient, it would be best if you:
A. schedule the patient before the Percodan is administered
B. schedule the patient when the Percodan reaches its peak effect
C. modify the treatment depending upon the analgesic effect of the Percodan
D. schedule the patient only during the withdrawal phase from Percodan
183. Following serious trauma, a patient is casted as a result of multiple bilateral wrist and hand fractures. It would be
best if physical therapy intervention begins:
A. as early as possible to maintain or regain strength and range of motion in nonimmobilized joints of the upper
extremities
B. as soon as the casts are removed to regain strength of the wrists and hands
C. about two weeks after the casts are removed so as not to damage vulnerable soft tissue
D. after six weeks of immobilization to ensure that bone healing is almost complete
184. A 12-year-old boy with advanced Duchenne muscular dystrophy is being seen by a physical therapist as a result of
a chief complaint of shortness of breath while in his wheelchair. He is limited to 45 minutes in the wheelchair. To
improve this patient’s ventilatory ability and increase wheelchair time, the therapist should primarily consider
A. proper bed positioning to improve ventilation/perfusion abnormalities prior to wheelchair use.
B. secretion removal techniques since mucous plugging is causing the shortness ob breath
C. assisted coughing while in the wheelchair to remove secretions that are resulting shortness of breath.
D. provision of a solid wheelchair seat and appropriate postural modifications, while sitting, to allow for the best
ventilation possible.
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Practice 2
185. Your patient with flaccid hemiplegia exhibits pain in the shoulder region secondary to glenohumeral subluxation.
Using electrical stimulation as orthotic substitution, it would be best to place the electrodes over the:
A. supraspinatus and upper trapezius
B. supraspinatus and posterior deltoid
C. anterior and posterior deltoid
D. anterior, middle and posterior deltoid
186. You are treating an 87 year-old woman at bedside following hospitalization for a femoral fracture. After three days
as an inpatient she has developed pneumonia. You should be alert to the fact that a typical early symptom of
pneumonia in the elderly which often is not seen in a younger population would include:
A. high fever
B. more productive cough
C. altered mental state and confusion
D. greater elevation of the white blood cell count
187. After applying a hot pack to a patient you observe hyperemia in the treatment area after a few minutes. As the
therapist you should:
A. remove the hot pack immediately and assess for a burn.
B. keep the hot pack in place as this is indicative of heat dissipation secondary to vasodilation.
C. elevate the part to minimize edema formation.
D. remove the hot pack immediately as the patient is having a potentially dangerous histamine reaction.
188. A patient has osteophyte formation affecting the atlanto-axial joint with resultant cervical nerve root irritation. If
the physical therapist elects to use gentle static manual traction to help deal with this problem, it would be best if
the neck was positioned in:
A. 10-15 degrees of hyperextension
B. neutral or 0 degrees of flexion
C. 20 degrees of flexion
D. 30 degrees of flexion
189. A patient with restrictive lung disease secondary to circumferential thoracic burns demonstrates decreased ability to
expand the lower rib cage and push the abdominal wall anteriorly. In this case, the therapist should consider the
use of facilitation techniques to enhance the function of the:
A. rectus abdominis
B. anterior scalenes
C. internal intercostals
D. diaphragm
190. Following a double blind study to determine the effectiveness of a new arthritis medication, the data analyzed
should clearly consider the effects of:
A. epidemiology
B. the measures of central tendency
C. the null hypothesis
D. the placebo
191. A realistic functional outcome for a patient with a complete lesion at the C8 neurological level is independence in:
A. transfers using a sliding board
B. using a manual wheelchair with rim projections
C. all self-care and personal hygiene
D. driving an automobile without hand controls
192. An institution or organization would not be in compliance with the Americans with Disabilities Act of 1990 if:
A. an elevator was not installed to allow a nonambulatory employee access to the upper floors of a publishing
company
B. an employee with multiple sclerosis could not be accommodated in a small business with a payroll of 8 people
C. a blind patrol was denied access to a night club for “safety reasons”
D. a handicapped accessible restaurant did not provide assistance for a disable patron to get from his car to the
restaurant entrance
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2 Practice
193. In order to teach mobility skills to a patient with Alzheimer’s disease, all of the following would be appropriate
except for
A. minimizing use of multistep commands
B. redirecting the patient to another task if the patient becomes frustrated from lack of success
C. constant varying and use of innovative treatment approaches to keep the patient motivated.
D. use of a quiet room with low lighting levels if the patient becomes agitated during a treatment session.
194. A patient has limited motion in supination and calcaneal inversion at the subtalar joint. Using manual techniques,
the accessory motion of the calcaneus that needs to be emphasized in order to increase the motions that are limited
would be:
A. anterior glide
B. posterior glide
C. medial glide
D. lateral glide
195. A patient has a complete spinal cord lesion at the C5 level. It is important for this patient to generate a functional
cough in order to avoid potential respiratory problems. In this case, effective coughing:
A. should be facilitated by use of phrenic nerve stimulator
B. should be facilitated by use of glossopharyngeal breathing
C. can be elicited with manual abdominal pressure provided with the assistance of a caregiver
D. can elicited with manual abdominal pressure provided independently by the patient
196. A patient with a crush injury to the foot developed reflex sympathetic dystrophy. Now, two months into the RSD,
the clinical presentation you would expect is:
A. edema and osteoporosis with decreased sweating and nail growth
B. a cool, dry extremity with the beginning of ankylosis
C. causalgia with vasomotor reflex spasm resulting in warm, dry skin with increased nail growth
D. pain on motion with trophic skin changes and osteoporosis
197. Following traumatic brain injury, a child is in a coma (Glasgow Coma Scale, Level 7) and is exhibiting rigidity.
The physical therapy plan of care might include all of the following except
A. teaching all caregivers proper positioning for the child
B. serial casting
C. passive range of motion
D. goal directed movements
198. During weightbearing, a soft tissue contracture resulting in supination of the forefoot will be compensated for by:
A. pronation of the forefoot
B. pronation of the rearfoot
C. supination of the rearfoot
D. pronation of the forefoot and rearfoot
199. During a cardiac rehabilitation exercise session involving patients who experienced myocardial infarctions 4 – 6
weeks ago, the most significant abnormal response requiring the immediate attention of the physical therapist is a
sharp:
A. decrease in systolic blood pressure
B. decrease in diastolic blood pressure
C. increase in diastolic pressure
D. increase in heart rate
200. A patient with paraplegia at the T8 level sustained his injury four years ago. He is seen by the physical therapist at
a routine outpatient clinic visit. The patient has recently purchased a new high-density foam wheelchair cushion.
The skin over the ischial tuberosities and sacral region is in perfect shape. The patient asks about the need for
pressure relief in the wheelchair considering the new cushion. The therapist should advise the patient to:
A. discontinue pressure relief as long as visual inspection reveals no skin breakdown
B. do a push-up in the chair at least once every 15 to 20 minutes
C. do a push-up in the chair at least once every 30 to 45 minutes
D. perform pressure relief once an hour since weight distribution is greatly improved.
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Answ 2
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