MCQ 7

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1) A physical therapist working on an acute care floor treats an 18-year-old patient, two weeks
status post cardiac surgery. The patient is using a treadmill to increase her aerobic endurance.
The therapist continually monitors her heart rate, blood pressure, and oxygen saturation
during the session. Which of the following would be an indication for the therapist to
terminate the exercise session?
1. heart rate increases to 20 beats per minute above the resting heart rate
2. oxygen saturation drops to 95% from a resting level of 98%
3. diastolic blood pressure decreases by 15 mm Hg from the resting level
4. systolic blood pressure increases to 15 mm Hg above the resting level
2) A physical therapist is treating a patient using neuromuscular electrical stimulation for muscle
reeducation. The therapist would like to increase the pulse characteristic called amplitude.
Which control should be manipulated on the stimulator?
1. frequency
2. rate
3. intensity
4. phase duration
3) A physical therapist performs a gait analysis on a patient rehabilitating from a stroke with left
hemisphere involvement. As part of the examination the therapist observes that initial contact
phase on the right is performed with foot flat and during right swing phase the patient has a
tendency to hike the right hip in order to avoid stubbing his toes during midswing. The MOST
likely causes of these gait deviations are
1. spastic dorsiflexors/everters and weak gluteus medius
2. tight hamstrings and weak plantar flexors
3. spastic plantar flexors and weak dorsiflexors/everters
4. spastic adductors and tight dorsiflexors/everters
4) A physical therapist receives a new referral to examine a 22-year-old patient with cystic
fibrosis. The patient was admitted to the hospital after experiencing an acute pulmonary
exacerbation. Prior to beginning the session the therapist attempts to identify any potential
contraindications to chest physical therapy. Which of the following would NOT be a
contraindication to percussion?
1. recent pneumothorax
2. hemoptysis occurring 12 hours ago
3. chest tube inserted into the right lateral lower lobe
4. platelet count of 15,000/mm3
5) A physical therapist working in the neonatal intensive care unit reads the history of a new
patient, an infant born prematurely at 28-weeks gestation. The infant's APGAR scores for 1, 5,
and 10 minutes are 1, 1, and 3 respectively. APGAR scores measure:
1. heart rate, respiratory effort, muscle tone, reflex irritability, and color
2. heart rate, respiratory effort, crying, muscle tone, and body weight
3. appearance, heart rate, respiratory effort, eye opening, reflex irritability
4. heart rate, crying, eye opening, body weight, and grasp reflex
6) A physical therapist employed in an acute care hospital works with a 42-year-old female who
sustained a stroke two days ago. The patient is from Mexico and has only recently moved to
the United States. She does not speak any English, but her eight-year-old son is with her and
he speaks fairly fluent English. When communicating with the patient, the MOST appropriate
therapist action is:
1. simplify the questions to require only yes or no responses
2. ask the patient's son to interpret for you
3. use gestures to help in the communication process
4. seek the help of the hospital medical interpreter

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7) A physical therapist attempts to assess the blood pressure of a 49-year-old male participating
in a cardiac rehabilitation program. Which pharmacological agent would act to decrease the
patient's blood pressure?
1. ACE inhibitors
2. anticoagulants
3. digitalis
4. antihistamines
8) A patient with cardiac pathology experiences chest pain during a treatment session. The
patient is able to relieve the pain by taking two nitroglycerin tablets. Which cardiac condition
is MOST consistent with this type of chest pain?
1. angina pectoris
2. mitral valve prolapse
3. myocardial infarction
4. pericarditis
9) A physical therapist attempts to identify several strategies to improve the left neglect of a
patient rehabilitating from a stroke. Which of the following would be the LEAST useful to
accomplish the therapist's objective?
1. have the patient dress in front of a mirror
2. have the patient's husband sit on her right side while she is eating dinner
3. have the patient perform self-retrograde massage on her left hand
4. have the television in the patient's room placed slightly to the left of her field of vision
while she is lying in bed
10) A physical therapist reviews an electrocardiogram obtained from a patient exercising on a
treadmill. The therapist should interpret the rhythm as:

1. nodal or junctional arrhythmias


2. premature ventricular contractions
3. cardiomyopathy
4. ventricular tachycardia
11) A 32-year-old female presents with decreased joint play of the glenohumeral joint that is
limiting her glenohumeral medial rotation. The MOST appropriate mobilization technique to
improve the patient's medial rotation is:
1. caudal glide
2. posterior glide
3. anterior glide
4. long axis distraction
12) A physical therapist treats a 16-year-old football player rehabilitating from a right anterior cruciate
ligament reconstruction using a patellar tendon graft. The patient is three weeks status post surgery and
has experienced an unremarkable recovery. After completing an exercise session the therapist places an
ice pack over the patient's knee. After several minutes the patient complains of numbness and tingling
extending down his right leg below the level of the knee. The MOST appropriate therapist action is:
1. leave the ice pack on; the tingling is normal and the patient needs the ice pack
2. call the patient's primary care provider since the patient may have a herniated disk
3. remove the ice pack immediately and apply a hot pack
4. remove the ice pack

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13) A 16-year-old female athlete is seen in physical therapy with a complaint of pain and soreness
in her elbow. When applying ultrasound for vigorous heating to the extensor carpi radialis
brevis the therapist should direct the ultrasound energy to the:
1. anterior aspect of the elbow
2. medial aspect of the elbow
3. lateral aspect of the elbow
4. posterior aspect of the elbow
14) A 74-year-old female is referred to physical therapy with a diagnosis of osteoporosis. The
medical chart indicates that the patient sustained a vertebral fracture at T11, which according
to recent diagnostic imaging is now sufficiently healed. Assuming the patient has been cleared
for an exercise program, which of the following exercises would be contraindicated?
1. prone back extension
2. abdominal curls
3. knee extension with resistance
4. step-ups
15) A 29-year-old female who recently gave birth to twins is referred to physical therapy for
evaluation and treatment of low back pain. During the examination the therapist performs a
test for diastasis recti and identifies a four centimeter separation of the rectus abdominis.
Which of the following is the MOST appropriate intervention?
1. abdominal curl-ups bringing the trunk to 30 degrees of flexion
2. pelvic floor exercises
3. lift the head off of the floor while bracing the abdominal area with crossed hands
4. diagonal abdominal curls
16) A patient who uses a transfemoral prosthesis is observed to have a circumducted gait
deviation during swing phase on the involved side. The MOST likely cause is:
1. the prosthesis is too short
2. tightness of the involved gluteus medius muscle
3. excessive friction of the prosthetic knee
4. lateral rotation of the socket on the residual limb
17) A physical therapist attending a team conference discusses possible long-term outcomes for a
patient with C4 tetraplegia. All of the following would be appropriate long-term outcomes for
the patient EXCEPT
1. independent locomotion using a power wheelchair with an upper extremity operated
joystick
2. modified independent pressure relief with power wheelchair
3. self-direct attendant to perform proper bed positioning
4. typing on a computer keyboard with mouthstick
18) A physical therapist providing coverage for a colleague on vacation reads a coverage form that
states "apply ice massage to the left pes anserinus area after exercise." The ice massage would
be applied to which of the following areas?
1. superior lateral aspect of the tibia
2. superior aspect of the fibula
3. inferior medial aspect of the femur
4. superior medial aspect of the tibia
19) An 82-year-old female is referred to physical therapy for treatment of hand pain and weakness.
Visual inspection reveals extension of the metacarpophalangeal joints and distal interphalangeal
joints with flexion of the proximal interphalangeal joints of the patient's index and middle fingers.
Which of the following BEST describes this type of deformity?
1. Boutonniere deformity
2. trigger finger
3. garden spade deformity
4. swan neck deformity

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20) A physical therapist is asked to provide an educational session on the topic of osteoarthritis. As
part of the session the physical therapist lists common symptoms associated with this
condition. Which list would be the MOST accurate?
1. morning stiffness, pain at rest, increased pain with weather changes
2. sleep disturbances, Heberden's nodules, low grade fever
3. subcutaneous nodules, bilateral involvement, weakness
4. increased incidence of Raynaud's disease, progressive joint deformity
21) A physical therapist treats a 13-year-old female diagnosed with idiopathic scoliosis. The
patient exhibits a right thoracic curve that measures 30 degrees and a left lumbar curve
measuring 15 degrees. The MOST likely form of medical management is:
1. spinal orthosis and a home exercise program
2. bone growth generators and postural awareness exercises
3. electrical stimulation and a home exercise program
4. surgery and post-operative physical therapy intervention
22) A physical therapist administers pulsed ultrasound to a patient diagnosed with rotator cuff
tendonitis. Which statement about pulsed ultrasound is MOST accurate when comparing
pulsed to continuous mode?
1. the peak intensity of output for pulsed ultrasound is reduced
2. the average intensity of output over time for pulsed ultrasound is increased
3. the average intensity of output over time for pulsed ultrasound is reduced
4. the peak intensity of output for pulsed ultrasound is increased
23) A 55-year-old female is referred to physical therapy after being diagnosed with adhesive
capsulitis. The patient's range of motion restriction is consistent with a capsular pattern at the
shoulder. Which motion would typically be MOST limited?
1. lateral rotation
2. medial rotation
3. flexion
4. adduction
24) A 19-year-old female is referred to physical therapy after sustaining a knee injury. The range of
motion on the patient's uninvolved knee is documented as 7-0-140 degrees. Which statement
BEST summarizes the patient's knee range of motion compared to normal values?
1. decreased knee extension, increased knee flexion
2. decreased knee extension, normal knee flexion
3. increased knee extension, increased knee flexion
4. increased knee extension, normal knee flexion
25) A physical therapist examines a patient diagnosed with an anterior talofibular ligament sprain.
The patient exhibits signs of inflammation in the ankle complex including heat, swelling,
redness, and pain. This phase of inflammation and repair is BEST termed:
1. inflammatory phase
2. proliferative phase
3. maturation phase
4. chronic phase
26) A physical therapist employed in an outpatient physical therapy clinic treats a patient with
Parkinson's disease. During the session the patient mentions that his physician recently
prescribed levodopa. Which symptom of Parkinson's disease would be the MOST likely to
diminish in severity based on the prescribed pharmacological agent?
1. bradykinesia
2. sensory disturbances
3. postural abnormalities
4. resting tremors

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27) A physical therapist attempts to assess the Babinski reflex as part of an examination. To
effectively elicit the Babinski reflex, the therapist should
1. stroke the lateral aspect of the foot beneath the lateral malleolus
2. stroke the anteromedial tibial surface
3. stroke the lateral aspect of the sole of the foot
4. firmly squeeze the calf
28) A 26-year-old female runner diagnosed with iliotibial band syndrome complains of pain along
her right knee when she runs on a banked track or when she runs distances greater than three
miles. Which of the following would be the MOST appropriate intervention?
1. initiate a lower extremity flexibility program
2. implement short-arc knee extension exercises
3. perform cycling for 20 minutes at 80 revolutions per minute or greater
4. wear a neoprene sleeve over the knee during all running activities
29) The hallway Six-Minute Walk Test is considered the gold standard test for measuring
functional exercise capacity. If the therapist searches the literature to identify the
appropriateness of the treadmill version of the Six-Minute Walk Test compared to the hallway
Six-Minute Walk Test, the therapist is exploring:
1. test-retest reliability
2. generalizability
3. concurrent validity
4. sensitivity
30) A physical therapist treats a patient rehabilitating from knee surgery. The therapist is able to
fully extend the patient's knee passively, however, actively the patient can only extend the
knee as shown. The MOST probable explanation for the limitation in active range of motion is:

1. tightness of the hamstrings muscle


2. inhibition of the quadriceps due to pain
3. bony obstruction
4. degenerative joint changes
31) A physical therapist works with a 68-year-old male that was diagnosed with Guillain-Barre
syndrome two weeks ago. The patient did not require ventilatory support and his strength has
gradually improved in the past week. Which two signs would be MOST consistent with the
patient's medical diagnosis?
1. loss of bowel function and impaired sensation in bilateral fingers
2. asymmetrical weakness and slowed nerve conduction velocity
3. rapidly ascending symmetrical weakness and slowed nerve conduction velocity
4. clonus in bilateral ankles and bilateral distal sensory loss

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32) A 42-year-old patient rehabilitating from a lower extremity injury reports to outpatient
physical therapy complaining of soreness in his legs. During the previous session the patient
completed lower extremity eccentric strengthening exercises with five pound weights. The
MOST appropriate therapist action is to:
1. explain to the patient that this is a result of delayed onset muscle soreness and
decrease the amount and intensity of the strength training
2. explain to the patient that this is to be expected and he needs to keep working hard in
order to gain additional strength
3. increase the intensity of the strength training in order to build up the patient's muscle
strength
4. stop using weights for strengthening and increase the intensity of closed chain
functional exercises
33) A physical therapist examines a patient's position sense by passively moving the patient's
fourth digit up and down with their eyes closed. The patient is then required to inform the
therapist how the digit was positioned (i.e., up or down). Assuming the patient does not have
any position sense, what is the probability that the patient could answer the therapist's
questions correctly on two consecutive trials?
1. 0.2
2. 0.25
3. 0.5
4. 0.75
34) A physical therapist observes a patient's breathing pattern prior to initiating an exercise
session. The therapist concludes the rate and rhythm are within normal limits. This type of
breathing is BEST termed:
1. apnea
2. dyspnea
3. eupnea
4. orthopnea
35) A physical therapist employed in an acute care hospital would like to alter a patient's
medication schedule in order to have the patient be more responsive during physical therapy
sessions. The MOST appropriate medical professional to communicate this information to is
the:
1. administrator
2. physician
3. nurse
4. case manager
36) A physical therapist prepares to use neuromuscular electrical stimulation with a 13-year-old
female rehabilitating from a motor vehicle accident. Which treatment objective would require
the largest disparity between on and off time?
1. facilitate motor learning
2. increase muscle strength
3. reduce spasticity
4. increase range of motion
37) A physical therapist treats a 46-year-old female with venous insufficiency. As part of the plan of
care the therapist intends to order a custom fit compression garment to help control the patient's
lower extremity edema. The MOST appropriate action when fitting the patient for the compression
garment is:
1. perform pneumatic compression treatment before the scheduled fitting session
2. complete all measurements with the patient in standing
3. instruct the patient to avoid drinking fluids 24 hours before the scheduled fitting session
4. perform pneumatic compression treatment immediately after the scheduled fitting session

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38) A physical therapist employed in an inpatient rehabilitation facility treats a patient with
paraplegia. The therapist notes that the patient's muscle tone is significantly higher in the
lower extremities today, as compared to yesterday. The therapist should:
1. use warm blankets and stretching to decrease the patient's tone
2. discuss this change with the medical staff and suggest a urine culture
3. suggest initiation of antispasticity medication
4. inform the patient that this is a normal consequence of spinal cord injury
39) A 60-year-old male suddenly becomes ill during a meeting and is taken to the emergency
room. The patient is later diagnosed with a CVA involving a portion of the left middle cerebral
artery. Which impairments would be expected based on the patient's medical diagnosis?
1. impaired right upper extremity motor function, impaired speech, and impaired right
upper extremity sensation
2. impaired right lower extremity motor function, impaired speech, and impaired spatial
awareness
3. impaired left upper extremity motor function, impaired left upper extremity sensation,
and impaired spatial awareness
4. impaired left lower extremity motor function, impaired speech, and impaired spatial
awareness
40) A physical therapist completes a series of tests to examine selected aspects of the
neuromuscular system. Which test would MOST likely be performed with the patient's eyes
open?
1. two-point discrimination
2. stereognosis
3. dysdiadochokinesia
4. kinesthesia
41) A physical therapist employed in a rehabilitation hospital is saddened to learn that a patient
she treated only three months ago with amyotrophic lateral sclerosis recently died after a
relatively short acute care hospitalization. The MOST likely cause of death would be:
1. septic shock
2. respiratory muscle paralysis
3. deep vein thrombosis
4. infection
42) A physical therapist instructs a patient in an assisted cough technique using splinting. Which
patient would be MOST in need of this specific intervention?
1. a 46-year-old male status post abdominal surgery
2. a 67-year-old male rehabilitating from a stroke
3. a 52-year-old female on bed rest
4. a 59-year-old female on bed rest following deep venous thrombosis
43) A physical therapist instructs a patient to perform three sets of biceps curls using a piece of
light grade elastic tubing. If the therapist's primary objective is to improve the patient's muscle
endurance, the MOST appropriate number of repetitions in each set would be:
1. 5
2. 10
3. 30
4. 75
44) A physical therapist attempts to improve the kinesthetic awareness of a patient rehabilitating from a
neurological disorder. The MOST appropriate treatment strategy to accomplish the therapist's objective
is:
1. ambulation in front of a mirror with verbal cueing
2. ambulation with manual facilitation and demonstration
3. demonstration with verbal instructions
4. demonstration with written instructions

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45) A physical therapist receives orders to perform chest physical therapy with a 10-year-old child
secondary to the presence of retained secretions in the lungs. The child's MOST likely medical
diagnosis is:
1. cerebral palsy
2. cystic fibrosis
3. Down syndrome
4. spina bifida
46) A physical therapist attempts to assess the integrity of the olfactory nerve by asking a patient
to identify a familiar object by smell. Which testing procedure would be the MOST
appropriate?
1. assess both nostrils simultaneously with the patient's eyes open
2. assess one nostril at a time with the patient's eyes open
3. assess both nostrils simultaneously with the patient's eyes closed
4. assess one nostril at a time with the patient's eyes closed
47) A physician and physical therapist discuss the plan of care for a patient with a full-thickness
wound on the sacrum. During the course of the conversation the physician discusses the
benefits of using an occlusive dressing on the wound. What type of dressing would BEST meet
this criteria?
1. hydrocolloids
2. semipermeable film
3. alginates
4. impregnated gauze
48) A patient who sustained a burn three days ago after coming in contact with hot liquid is
referred to physical therapy. Presently, the burn is dry, leathery and blanches with direct
pressure. The patient reports mild pain and reduced sensation around the affected area. The
MOST likely burn classification is:
1. superficial burn
2. superficial partial-thickness burn
3. deep partial-thickness burn
4. full-thickness burn
49) A physical therapist works on transfer training with a patient and her family in preparation for
discharge. The patient can occasionally complete a wheelchair to bed transfer independently,
however, often requires assistance to initiate the transfer. The MOST appropriate classification
of the patient's transfer status is:
1. contact guard assistance
2. minimal assistance
3. moderate assistance
4. maximal assistance
50) A patient status post medial meniscus repair is referred to physical therapy. Which of the
following would be the responsibility of the physician post-operatively?
1. specify the parameters for superficial modality application
2. specify the frequency and duration of range of motion exercises
3. determine weight bearing status
4. select an appropriate resistive exercise program
51) A 19-year-old white male with Duchenne muscular dystrophy arrives at his first physical
therapy session. Which of the following would the therapist MOST likely address as a
component of the physical therapy session?
1. therapeutic exercise program to include treadmill training
2. weight training
3. gait training with knee-ankle-foot orthoses
4. power wheelchair mobility

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52) Computer tomography reveals that a patient admitted to the hospital two days ago sustained
a stroke involving the left middle cerebral artery. Based on the identified area of involvement
the patient would MOST likely demonstrate the following signs and symptoms EXCEPT:
1. apraxia
2. aphasia
3. right hemiparesis
4. neglect
53) A physical therapist designing a research project sets the level of significance at .05, however
after consulting with other clinicians the therapist concludes it is imperative to reduce the
chances of a type I error. The MOST appropriate modification to the level of significance is
1. 1.0
2. 0.5
3. 0.05
4. 0.01
54) A physical therapist working in an acute care hospital reviews the physical therapy
examination of a patient admitted 24 hours ago. The examination indicates that the patient's
hip flexor strength was graded as poor. This grade would be MOST appropriately described as:
1. the patient can move against gravity, but can only complete half of the full range of
motion
2. the patient can move against gravity and complete the full range of motion
3. the patient is able to move in a gravity-eliminated position, but can only complete half
of the full range of motion
4. the patient is able to move in a gravity-eliminated position and complete the full range
of motion
55) A physical therapist volunteers at a community basketball tournament. During the contest a
25-year-old male becomes very short of breath due to exercise-induced asthma. Which advice
would be the MOST appropriate based on the patient's medical condition?
1. use pursed-lip breathing to slow his breathing rate when he becomes short of breath
2. use an incentive spirometer to increase the strength of his respiratory muscles
3. encourage the patient to avoid playing basketball because of exercise-induced asthma
4. use an inspiratory muscle trainer before exercise to prevent dyspnea
56) A physical therapist designs a research study that examines patients' attitudes toward
managed care. The therapist collects data by analyzing patient responses to a questionnaire
that utilizes a Likert scale. This level of measurement is BEST termed:
1. nominal
2. ordinal
3. interval
4. ratio
57) A physical therapist instructs a patient rehabilitating from knee surgery in several positioning
strategies to decrease the likelihood of developing a knee flexion contracture. Which of the
following would be the MOST desirable position?
1. supine with a pillow under the knee
2. prone with a pillow under the hip
3. supine with a pillow under the calf and ankle
4. prone with a pillow under the distal tibia
58) While performing the Six-Minute Walk Test a patient begins to show symptoms associated
with hypoxemia. To confirm this, the physical therapist should assess:
1. heart rate and blood pressure
2. PaO2 with an oxygen analyzer
3. PaCO2 with a pulse oximeter
4. SaO2 with a pulse oximeter

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59) A physical therapist would like to assist a 64-year-old male with a history of chronic bronchitis
to increase his ability to walk on level surfaces, climb stairs, and perform activities of daily
living. The goals include completing the stated activities with only minimal dyspnea. The MOST
appropriate exercises to teach the patient to accomplish the stated goals are:
1. pursed-lip breathing and paced breathing
2. pursed-lip breathing and incentive spirometry
3. pursed-lip breathing and segmental breathing
4. paced breathing and active cycle of breathing
60) A physical therapist is in the process of assisting a patient to move from supine to sitting when
suddenly the patient reports that he is experiencing a pounding headache and blurred vision.
The patient appears slightly flush and is perspiring. The patient was admitted to the
rehabilitation hospital after a lengthy hospitalization secondary to a T2 spinal cord injury. The
MOST appropriate therapist action is:
1. lay the patient back down on the mat
2. sit the patient up on the edge of the mat
3. tell the patient it is a normal response following spinal cord injury
4. elevate the patient's lower extremities
61) A physical therapist administers ultrasound to a patient diagnosed with right patella
tendinopathy. Based on the patient's medical diagnosis the MOST appropriate output
frequency is:
1. 1 W/cm2
2. 1 MHz
3. 3 W/cm2
4. 3 MHz
62) A 63-year-old woman was admitted to the hospital with a stage III ulcer over her right lateral
malleolus. The physician orders whirlpool daily with debridement and wet to wet dressings.
The therapist prepares the sterile field prior to the patient's arrival for the whirlpool, but is
unexpectedly required to assist another patient in the physical therapy gym. Upon returning to
the whirlpool area the therapist should
1. check the field for signs of contamination
2. replace items on the periphery of the sterile field
3. discard the current sterile field and establish a new sterile field
4. proceed with the whirlpool since the sterile field was set up properly prior to the
interruption
63) A physician suspects a patient diagnosed with pulmonary disease is suffering from
hypercapnia. Which laboratory test would be MOST appropriate to confirm the physician's
suspicions?
1. pulmonary function tests
2. arterial blood gas analysis
3. pulmonary exercise stress test
4. bronchoscopy
64) A physical therapist working in an outpatient physical therapy department receives a referral
to see a 10-year-old girl with excessive femoral anteversion. Upon assessing the patient's
lower extremity range of motion, which of the following would the therapist MOST likely
identify?
1. increased hip lateral rotation
2. increased hip medial rotation
3. increased hip flexion and increased hip medial rotation
4. increased hip extension and increased hip lateral rotation

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65) A physical therapist performs chest physical therapy on a 17-year-old male diagnosed with
cystic fibrosis. After administering percussion and vibration to the posterior lower lobes, the
patient begins to cough. In the process, the patient expectorates sputum tinged with bright
red blood into a cup. What should the therapist's next course of action be?
1. call a code
2. continue chest physical therapy
3. allow the patient to rest for 10 minutes and then continue chest physical therapy
4. stop chest physical therapy and contact the patient's physician
66) A physical therapist attempts to identify a subjective means of monitoring exercise intensity
for patients participating in a cardiac rehabilitation program. The MOST appropriate method
to utilize is
1. pulmonary function tests
2. perceived exertion scale
3. target heart rate range
4. metabolic equivalents
67) A physical therapist reads a patient coverage form that indicates "ultrasound to the deep hip
rotators of the right posterior hip for tissue heating." The MOST appropriate parameters to
meet the identified objective are:
1. 1 MHz continuous ultrasound at 1.5 W/cm2
2. 1 MHz pulsed ultrasound at .8 W/cm2
3. 3 MHz continuous ultrasound at 1.0 W/cm2
4. 3 MHz continuous ultrasound at 2.0 W/cm2
68) A physical therapist treats a patient with urinary stress incontinence. The patient presents with
complaints of involuntary urine leakage with activities such as coughing, laughing or
participating in active exercise. What is the MOST appropriate intervention for the patient?
1. pelvic floor muscle exercises
2. instructing the patient to void at predetermined intervals
3. education regarding foods and beverages which might stimulate the detrusor muscle to
contract
4. electrical stimulation to the detrusor muscle
69) A physical therapist works with a 78-year-old female who sustained a stroke three weeks ago.
The patient presents with left-sided paresis and impaired balance. When sitting, the patient
leans to her left with the right arm abducted and the elbow extended. When the therapist
attempts to correct the patient's posture by providing manual assistance, the patient resists
and pushes to her left with her unaffected upper and lower extremities. The MOST
appropriate intervention to address this patient's balance deficit is:
1. sitting on a therapeutic ball
2. sitting using alternating isometrics with manual contacts at the upper trunk with resistance in a
medial-lateral direction
3. sitting using a full-length mirror to provide visual cues as to the patient's body orientation
4. sitting using slow reversals with manual contacts at the upper trunk in an anterior-posterior
direction
70) A 56-year-old female reports a gradual onset of right shoulder pain approximately two months ago. The
patient has been on nonsteroidal anti-inflammatory medication and states that the medication has not
helped. The patient reports weakness that allows her to lift her arm only to "shoulder level." An
examination reveals 15 degrees of lateral rotation and 50 degrees of medial rotation. Shoulder girdle
elevation is noted during abduction and flexion of the right upper extremity to compensate for the loss
of motion. Which diagnosis is MOST consistent with the presented information?
1. rotator cuff tear
2. adhesive capsulitis
3. atraumatic instability
4. bicipital tendonitis

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71) A 21-year-old male was playing rugby when he sustained an injury to his left elbow during a
fall. The patient states that his arm was outstretched to break the fall when another player fell
into his elbow. He presents with marked edema along the medial aspect of the elbow and a 15
degree carrying angle. Which of the following structures would MOST likely be involved?
1. annular ligament
2. ulnar collateral ligament
3. radial collateral ligament
4. biceps brachii
72) A 32-year-old male is referred to physical therapy for treatment of left lateral knee pain. The
patient states that he has been training for a marathon for the last three months and that the
pain began approximately four weeks ago after increasing his running mileage. An examination
reveals normal lower extremity strength, a positive Ober test (knee extended), and moderate
abduction during the modified Thomas test on the left. The patient's clinical presentation is
MOST consistent with:
1. greater trochanteric bursitis
2. iliotibial band syndrome
3. chondromalacia patella
4. tibial plateau fracture
73) A physical therapist utilizes a hold-relax active contraction technique in order to increase left
ankle dorsiflexion range of motion. This technique uses
1. autogenic inhibition
2. autogenic facilitation
3. successive induction
4. irradiation
74) A physical therapist attends an inservice on health promotion and patient adherence. Which of
the following techniques would be MOST beneficial to improve patient adherence for health
promotion activities?
1. ask the patients about their goals and encourage them to adhere to the plan of care
2. pick appropriate goals for patients and provide explanations as to why these goals are
important
3. ask the patients what they would like to do, what activities they are willing to perform,
and what the physical therapist can do to assist with these goals
4. give the patients appropriate education materials to read and answer any questions
they may have
75) A physical therapy manager informs the staff physical therapists that as part of their annual
performance appraisal all physical therapists will be required to demonstrate evidence of
primary, secondary, and tertiary prevention activities. The MOST appropriate recipient of
tertiary prevention activities would be
1. a 21-year-old male diagnosed with C5 tetraplegia
2. a 32-year-old male with a family history of cardiac disease
3. a 43-year-old female medical assistant with a repetitive use disorder
4. a 14-year-old female who is approximately 50 pounds overweight
76) A physical therapist demonstrates various types of lifting techniques for a patient participating
in a work hardening program. When using a power lift technique the therapist should
incorporate
1. a partial squat using a neutral pelvic tilt in order to maintain lumbar lordosis
2. a squat or stoop using a posterior pelvic tilt to flatten the low back
3. a stance using just one leg, similar to a golfer who is picking up a golf ball
4. a stance with trunk flexion while maintaining straight legs

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77) An 86-year-old female is restricted to partial weight bearing on the left lower extremity after a
total hip replacement. The patient's upper extremity strength is 3+/5 and she resides alone.
Which assistive device would be MOST appropriate for the patient?
1. Lofstrand crutches
2. axillary crutches
3. large base quad cane
4. walker
78) A physical therapist examines a 62-year-old female diagnosed with peripheral vascular disease.
The patient has intermittent claudication and frequently complains of feeling tired. The
therapist's PRIMARY treatment objective is:
1. increase collateral circulation
2. increase lower extremity strength
3. increase mobility
4. increase range of motion
79) A physical therapist instructs a patient status post abdominal surgery how to use an incentive
spirometer in order to prevent the occurrence of pulmonary complications. The MINIMUM
frequency for the patient to use the incentive spirometer is:
1. once each ten minutes
2. once every two hours
3. twice per day
4. once per day
80) A nurse NOTifies a physical therapist that a patient has been placed on hold. The nurse
indicates the patient has been diagnosed with respiratory acidosis. Which of the following is
NOT a typical symptom of this condition?
1. dyspnea
2. restlessness
3. anxiety
4. vomiting
81) A physical therapist assesses a patient's pulse by palpating at the wrist between the flexor
digitorum superficialis and the flexor carpi ulnaris tendons. This site is used to assess the:
1. radial artery
2. ulnar artery
3. brachial artery
4. carotid artery
82) A patient with a hip flexion contracture exhibits inadequate hip extension while ambulating.
During which phase of gait would this type of deviation be identified?
1. foot flat through heel off
2. midstance through toe off
3. heel strike through midstance
4. deceleration through midstance
83) A physical therapist completes manual muscle testing using the ASIA standards on a patient
status post spinal cord injury. What key muscle should the therapist test in order to determine
whether or not the patient has motor innervation at the C6 spinal level?
1. extensor carpi radialus longus
2. triceps
3. biceps
4. abductor digiti minimi

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84) A physical therapist contemplates wheelchair seating options for a patient rehabilitating from
a C6 spinal cord injury. Which of the following would be considered a benefit of a rigid manual
wheelchair compared to a folding wheelchair?
1. provides better shock absorption when propelling on uneven surfaces
2. more energy efficient
3. easier for a caregiver to place in a car
4. easier to remove the armrests for transfers
85) A physical therapist examines a patient recently referred to physical therapy with congenital
muscular torticollis. During the examination the therapist notes extremely limited muscle
length in the right sternocleidomastoid muscle. The MOST likely clinical presentation based on
the examination is:
1. lateral flexion of the neck to the right and rotation to the left
2. lateral flexion of the neck to the left and rotation to the right
3. lateral flexion of the neck to the right and rotation to the right
4. lateral flexion of the neck to the left and rotation to the left
86) A patient rehabilitating from deep partial-thickness burns to their right upper extremity is
evaluated for a pressure garment. How long should the patient expect to wear the device?
1. one month
2. three months
3. six months
4. one year
87) A patient rehabilitating from a burn to their right wrist and hand is fit for a splint that will
attempt to regain lost range of motion by offering a sustained force using rubber bands. This
type of splint is BEST classified as a:
1. corrective splint
2. dynamic splint
3. functional splint
4. resting splint
88) A physical therapist reviews the medical record of a patient rehabilitating from a CVA that
involves the left hemisphere. Diagnostic imaging revealed that the stroke involved the middle
cerebral artery. The MOST likely clinical finding based on the patient's diagnosis is:
1. aphasia
2. visual agnosia
3. perseveration
4. dysmetria
89) A physical therapist attempts to gain information on the L4-L5 spinal level by assessing the
tibialis posterior reflex. The therapist administers the reflex by striking the muscle's tendon
with a reflex hammer immediately posterior to the medial malleolus. The anticipated response
would be:
1. dorsiflexion and inversion
2. plantar flexion and eversion
3. dorsiflexion and eversion
4. plantar flexion and inversion
90) A physical therapist asks a patient several questions prior to administering cervical mechanical
traction. During the questioning the patient indicates he is wearing dentures. The MOST
appropriate therapist action is to:
1. initiate traction using normal treatment parameters with the dentures in place
2. initiate traction using normal treatment parameters after removing the dentures
3. initiate traction using fifty percent of the normal recommended force with the dentures
in place
4. avoid using traction since the intervention is contraindicated for the patient

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91) A physical therapist employed in an acute care hospital works with a patient on bed mobility
activities. The therapist would like to incorporate a strengthening activity for the hip extensors
that will improve the patient's ability to independently reposition in bed, however, the patient
does not have adequate strength to perform bridging. The MOST appropriate exercise activity
is:
1. anterior pelvic tilts
2. heel slides
3. straight leg raises
4. isometric gluteal sets
92) A physical therapist administers Phalen's test to a patient diagnosed with a repetitive use
injury of the right wrist and hand. As part of the testing procedure the therapist asks the
patient to push his wrists together while moving them into a fully flexed position. How long
would be the MOST appropriate time period to maintain the described position?
1. 10 seconds
2. 30 seconds
3. 1 minute
4. 3 minutes
93) A physical therapist prepares to initiate an exercise program with a patient three weeks status
post anterior glenohumeral dislocation. The patient has no prior past medical history of
shoulder instability and has been immobilized in a sling for three weeks. Which type of
strengthening exercise should the therapist INITIALLY include in the program?
1. eccentric
2. concentric
3. isometric
4. isotonic
94) A physical therapist performs a series of tests on a patient diagnosed with a grade III posterior
cruciate ligament sprain. After completing the tests the therapist documents in the medical
record that the posterior sag test was positive. The description MOST consistent with this
finding is:
1. static positioning reveals a posterior position of the tibia in relation to the femur
2. static positioning reveals an anterior position of the tibia in relation to the femur
3. manual resistance to the tibia in a posterior direction reveals excessive posterior
translation
4. manual resistance to the tibia in an anterior direction reveals excessive posterior
translation
95) A physical therapist palpates a patient's radial artery while slowly inflating a blood pressure
cuff. The therapist determines that the sphygmomanometer reads 100 mg Hg at the point
where the therapist can no longer identify the radial pulse. This value would be MOST
representative of the patient's:
1. estimated systolic blood pressure value
2. estimated diastolic blood pressure value
3. actual systolic blood pressure value
4. actual diastolic blood pressure value
96) A physical therapist in an outpatient cardiac rehabilitation program is instructing a patient in proper
technique for weight lifting. What should the therapist recommend to help the patient avoid the
Valsalva maneuver during weight lifting?
1. inhale during the lifting (concentric phase) and exhale during the lowering (eccentric phase)
2. exhale during the lifting (concentric phase) and inhale during the lowering (eccentric phase)
3. inhale during both the lifting (concentric phase) and lowering (eccentric phase)
4. exhale during both the lifting (concentric phase) and lowering (eccentric phase)

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97) A physical therapist questions if a patient possesses adequate knee flexion range of motion in
order to ambulate on level surfaces without utilizing compensatory strategies. Which value
represents the MINIMUM amount of knee flexion required to perform this activity?
1. 0.30
2. 0.45
3. 0.60
4. 0.90
98) A physical therapist performs gait training with a patient rehabilitating from a traumatic
amputation of the first metatarsophalangeal joint. The PRIMARY objective finding associated
with this type of injury would be
1. excessive trunk extension
2. decreased push-off with the involved lower extremity
3. excessive hip hiking
4. decreased stride length
99) A physical therapist secures several cotton balls to use during a sensory assessment of a
patient diagnosed with multiple sclerosis. The cotton balls would be MOST useful when
assessing
1. superficial pain
2. two-point discrimination
3. stereognosis
4. light touch
100) A 23-year-old female diagnosed with C6 quadriplegia attends outpatient physical therapy.
While waiting for her appointment, the patient overhears the therapist tell the secretary that
she can see the next patient as soon as she finishes treating her "quad." Which of the
following is the BEST reason for the therapist to avoid this type of language?
1. it is politically incorrect
2. it might offend the patient
3. it reinforces emotional detachment by shifting the focus away from the person and
onto the disability
4. it perpetuates stigma and bias toward people with disabilities
101) A physical therapist works with a nine-year-old boy diagnosed with a medulloblastoma. The
patient has significant difficulty with balance and walking. The MOST appropriate INITIAL
intervention would be
1. standing with weight shifting in a medial-lateral direction using slow reversals
2. static sitting balance using alternating isometrics with resistance in an anterior-
posterior direction
3. kicking a soccer ball back and forth with the therapist
4. modified plantigrade position using rhythmic stabilization with resistance at the pelvis
102) A physical therapist works with a patient who has impaired motor control and function of his
upper extremity secondary to a stroke. The patient complains of 7/10 pain in his shoulder
when he attempts to move it and 4/10 pain at rest. The patient has decreased passive range of
motion at the shoulder and exhibits a two finger subluxation in the affected shoulder. Which
of the following would be a contraindication for using functional electrical stimulation with
this patient?
1. pacemaker
2. impaired sensation
3. impaired cognition
4. skin hypersensitivity

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103) A patient placed on bed rest is examined in physical therapy. Which effect would NOT typically
be associated with extended bed rest?
1. a decrease in physical work capacity
2. an increase in lung volume and vital capacity
3. an increase in the heart rate response to activity
4. a negative nitrogen and calcium balance
104) A physical therapist discusses general guidelines for prevention of pressure ulcers with a
patient during a whirlpool session. The patient has diabetes and has been admitted to the
hospital due to a pressure ulcer over the patient's sacrum. Which statement would be
considered the BEST advice?
1. massage over areas with bony prominences for adequate circulation
2. reposition while in bed every 3-4 hours
3. use a "doughnut-type" ring when sitting for long periods of time
4. eat a balanced diet that is high in protein, vitamins, and minerals
105) A physical therapist performs a developmental assessment on a four-month-old infant. During
the assessment the therapist carefully drops the infant backward from a sitting position. In
response, the infant extends and abducts her arms and cries, then quickly flexes and adducts
her arms across her chest. The therapist has just observed a
1. startle reflex
2. seizure
3. labyrinthine reflex
4. Moro reflex
106) A physical therapist is planning a research study to measure patient satisfaction with physical
therapy services. The therapist develops a satisfaction questionnaire that will be mailed to
patients. How will the patients indicate their consent to participate in this research study?
1. returning a signed consent form with the completed survey to the therapist
2. returning the completed survey to the therapist
3. phoning the therapist
4. writing a letter to the therapist
107) A physical therapist reads the following entry in the medical record of a patient rehabilitating
from a spinal cord injury. "Biceps and deltoid strength intact; independent transfers from
wheelchair to bed with a sliding board may be possible." The MOST likely level of spinal injury
is
1. C4
2. C6
3. C8
4. T2
108) A 27-year-old female who recently gave birth is referred to physical therapy. The patient
complains of pain in the right buttock that radiates along the lateral and posterior portion of
the leg and the dorsal and plantar surface of the foot. In order to assess the tightness of the
piriformis muscle, the therapist positions the patient in sidelying with the painful side in the
upperMOST position. The MOST appropriate method of performing the piriformis test is:
1. flexion of the hip to 30 degrees with the knee flexed; apply an upward abduction pull
on the knee
2. flexion of the hip to 30 degrees with the knee flexed; apply a downward adduction push
on the knee
3. flexion of the hip to 60 degrees with the knee flexed; apply a downward adduction push
on the knee
4. flexion of the hip to 60 degrees with the knee flexed; apply an upward abduction pull
on the knee

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109) A physical therapist and a physiatrist discuss potential respiratory complications secondary to
a spinal cord injury. Which patient would have the GREATEST incidence of respiratory
complications?
1. a 47-year-old male with C3 tetraplegia
2. a 32-year-old male with C7 tetraplegia
3. a 52-year-old female with anterior cord syndrome
4. a 37-year-old female with T10 paraplegia
110) A physical therapist provides a patient with a handout describing a selected exercise to be
incorporated as part of a home exercise program. The therapist instructs the patient to pull his
arms and elbows back while keeping his arms close to his sides and maintain the position for
20 seconds. Based on the provided illustration the therapist's PRIMARY objective would be to

(1)

2. stretch the gastrocnemius and soleus


3. stretch the tibialis posterior
4. strengthen the gastrocnemius and soleus
5. strengthen the rhomboids and latissimus dorsi
111) While teaching a 42-year-old female patient diaphragmatic breathing the therapist notices
that during inspiration the patient's upper chest expands more than her abdomen. The MOST
appropriate feedback for the patient is
1. inhale through the nose and exhale through pursed lips
2. the upper chest should move the most
3. the upper chest should move the least
4. the breathing pattern is correct
112) A physical therapist assistant works with a 36-year-old female three weeks status post medial
meniscectomy. The established plan of care includes progressive strengthening of the involved
lower extremity. While observing the patient complete a unilateral leg press exercise the
physical therapist assistant concludes the amount of weight used on the exercise does not
sufficiently challenge the patient. The MOST appropriate physical therapist assistant action is
to:
1. increase the amount of weight
2. increase the number of repetitions
3. contact the supervising physical therapist to approve the modification
4. request new orders from the referring physician
113) In physical therapy, negligence is best described as a violation of the required standard of care
in a community. The required legal standard of care is based on:
1. entry-level knowledge and skill
2. minimally acceptable practice for all practitioners
3. expert medical opinion
4. advanced degree level clinical skill

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114) A physical therapist treats a 38-year-old female that is diagnosed with adhesive capsulitis. The
patient states that her life is very stressful and she is having difficulty focusing on her shoulder
rehabilitation. As a result, the therapist integrates stress management activities into the plan
of care. The positive effects of stress management activities occur
1. secondary to the placebo effect
2. secondary to the individual's desire to relax
3. from the various activities the patient performs that stimulate the sympathetic nervous
system and triggers the relaxation response
4. from the various activities the patient performs that enhance the parasympathetic
nervous system and trigger the relaxation response
115) A physical therapist employed in a rehabilitation hospital works with a patient recently
diagnosed with Guillain-Barre syndrome. During the physical therapy session, the patient
expresses concern regarding his future. Specifically, he states that his "life is ruined" and that
"he knows he'll never be able to walk again." The therapist should
1. tell the patient to discuss this with the doctor
2. inform the patient, "Keep your chin up because you're going to be just fine
3. inform the patient "Although life is very difficult right now, the vast majority of patients
with Guillain-Barre syndrome typically recover to near or full function
4. ignore the patient's statement, but suggest a referral to a psychologist
116) A patient is referred to physical therapy after sustaining a grade I acromioclavicular joint
sprain. Common therapeutic management for this injury includes all of the following EXCEPT:
1. ice massage
2. progressive active range of motion
3. trapezius and deltoid strengthening
4. temporary immobilization
117) A physical therapist presents an inservice entitled "The Geriatric Patient and the Effect of
Drugs on Rehabilitation." As part of the inservice the therapist describes drug therapy for
several different cardiovascular diseases. Which of the following is the MOST common type of
medication prescribed to patients with congestive heart failure?
1. anticoagulants
2. vasodilators
3. diuretics
4. calcium channel blockers
118) A patient completes a home exercise program consisting of progressive resistive exercises in a
sagittal plane. Which of the following exercises would be appropriate?
1. shoulder abduction with a two pound dumbbell
2. hip medial rotation with a one pound cuff weight
3. elbow flexion with elastic tubing
4. horizontal adduction with a wall pulley
119) A physical therapist discusses the status of a patient rehabilitating from surgery with a
physician. During the discussion the physician cautions the therapist to be alert for any signs or
symptoms of pulmonary embolism. Which scenario is MOST associated with this medical
condition?
1. depleted body electrolytes
2. excessive systemic insulin
3. bladder distension
4. thrombus formation

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120) A physical therapist incorporates manual vibration as part of a plan of care for a patient with
chronic obstructive pulmonary disease. The MOST appropriate time to administer the
technique is after a:
1. normal inspiration
2. deep inspiration
3. normal expiration
4. deep expiration
121) A 66-year-old male rehabilitating from a shoulder injury uses an upper body ergometer as part
of a rehabilitation program. The physical therapist would like the patient to use the ergometer
at 40 revolutions per minute for 12 minutes. The patient maintains an active lifestyle despite
the implantation of a fixed rate pacemaker six years ago. The MOST appropriate method to
monitor the intensity of exercise during the session is:
1. heart rate
2. blood pressure
3. respiration rate
4. rating of perceived exertion
122) A physical therapist traces letters on a patient's right palm using the tip of a pen cover. This
testing procedure would MOST likely assess the:
1. right temporal lobe
2. left parietal lobe
3. left temporal lobe
4. right parietal lobe
123) A physical therapist measures a patient for a wheelchair. Assuming a full grown adult of
average size and build, which of the following wheelchair dimensions would be the MOST
appropriate?
1. seat width 14 inches, seat depth 12 inches
2. seat width 16 inches, seat depth 14 inches
3. seat width 18 inches, seat depth 16 inches
4. seat width 20 inches, seat depth 18 inches
124) A physical therapist prepares to assess the strength of the supinator muscle by placing the
patient's upper extremity in the position shown. The PRIMARY benefit of testing the muscle in
this position is

(a)

2. places the triceps in a lengthened position


3. places the biceps in a shortened position
4. requires more applied resistance to maximally test the muscle
5. reduces the influence of gravity during the testing
6.

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125) A physical therapist performs upper extremity passive range of motion exercises on a patient with an
I.V. connected to the dorsum of his right hand. During the treatment session the therapist notices a
small amount of blood that has backed up in the intravenous line. The therapist's MOST IMMEDIATE
response should be to:
1. turn off the intravenous system
2. remove the intravenous line
3. reposition the peripheral intravenous line
4. contact the primary physician
126) A physical therapist attempts to identify the presence of clonus on a patient diagnosed with a
traumatic brain injury. The MOST appropriate stimulus to identify clonus is:
1. forcefully flex the toes
2. rapidly dorsiflex the ankle
3. squeeze the calf
4. stroke the medial border of the foot
127) A physical therapist attempts to quantify a patient's vital capacity with a spirometer. Assuming the
patient is rehabilitating from a complete C6 spinal cord injury, the therapist should anticipate that the
patient's vital capacity is approximately:
1. 100% of normal
2. 50% of normal
3. 20% of normal
4. 10% of normal
128) A physical therapist reads in the medical record that a patient's ankle-brachial index revealed the
presence of arterial insufficiency. Assuming the patient's ankle pressure was recorded as ll0 mm Hg, the
MOST likely brachial pressure would be
1. 80 mm Hg
2. 105 mm Hg
3. 125 mm Hg
4. 160 mm Hg
129) A physical therapist uses therapeutic ultrasound for deep heating of the left piriformis muscle prior to
soft tissue mobilization and stretching. Which of the following would be the MOST appropriate
treatment parameters?
2
1. 3 MHz, 1.0 W/cm , 100% duty cycle, for 12 minutes
2
2. 1 MHz, 1.0 W/cm , 100% duty cycle, for 12 minutes
2
3. 3 MHz, 1.5 W/cm , 100% duty cycle, for 8 minutes
2
4. 1 MHz, 1.5 W/cm , 100% duty cycle, for 8 minutes
130) A physical therapist examines a patient in the intensive care unit after being diagnosed with an
anoxic brain injury. The patient's current status is MOST consistent with:

(1)

2. severe flaccidity
3. decorticate rigidity
4. decerebrate rigidity
5. choreathetosis

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131) A physical therapist works with a patient diagnosed with anterior interosseous syndrome.
While examining the patient, what activity would the therapist expect to be the MOST difficult
for the patient to perform?
1. wrist ulnar deviation with the thumb tucked inside a closed fist
2. pinching together the tips of the index finger and thumb
3. opposition
4. resisted wrist extension with the elbow flexed to 90 degrees
132) A physical therapist monitoring a patient's blood pressure during an exercise test suddenly
terminates the exercise session. Which objective finding would BEST support the therapist's
decision to terminate the session?
1. A systolic blood pressure recording of 200 mm Hg
2. A recorded increase in systolic blood pressure of 40 mm Hg
3. A diastolic blood pressure recording of 115 mm Hg
4. A recorded increase in diastolic blood pressure of 5 mm Hg
133) A physical therapist draws a horizontal line on an examination form in preparation to
administer a visual analog pain scale. Which of the following distances is the MOST
appropriate for the length of the horizontal line?
1. 1 centimeter
2. 10 centimeters
3. 10 inches
4. 1 meter
134) A physical therapist works with a patient rehabilitating from a radial head fracture. The patient
has had significant difficulty regaining her range of motion following her injury. Which
description MOST accurately describes the normal arthrokinematics at the humeroradial joint?
1. convex radius moving on a concave humerus
2. convex humerus moving on a concave radius and ulna
3. concave humerus moving on a convex radius and ulna
4. concave radius moving on a convex humerus
135) A physical therapist reviews a patient's medical chart and identifies an entry that indicates the
patient's white blood cell count was significantly elevated. This finding is MOST often
associated with:
1. anemia
2. thrombosis
3. infection
4. polycythemia
136) A physical therapist prepares to transfer a 42-year-old female rehabilitating from a prolonged
illness. The patient cannot stand due to significant weakness in all extremities, but can bear
some weight through the trunk and lower extremities. The MOST appropriate transfer to
utilize is:
1. two-person lift
2. dependent squat pivot transfer
3. sliding board transfer
4. stand step transfer
137) A physical therapist describes the goal for managing a patient's wound as "protect the wound
and maintain a moist environment." Which wound description is MOST consistent with the
stated goal?
1. pink granulation tissue
2. moist yellow slough
3. black, thick eschar
4. black, loosely adhered eschar

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138) A physical therapist treats a 21-year-old male that sustained a burn to his entire right upper
extremity. The anticipated deformity at the elbow would be:
1. flexion and supination
2. flexion and pronation
3. extension and supination
4. extension and pronation
139) A physical therapist treats a 22-year-old male athlete rehabilitating from shoulder surgery. As
part of the patient's treatment plan the therapist utilizes a proprioceptive neuromuscular
facilitation pattern that incorporates shoulder flexion, abduction, and lateral rotation. This
description is MOST consistent with:
1. D1 flexion
2. D1 extension
3. D2 flexion
4. D2 extension
140) A physical therapist performs an inhibitory sensory stimulation technique on a patient
rehabilitating from a CVA. Which technique would be the MOST consistent with the described
intervention?
1. approximation
2. light touch
3. prolonged stretch
4. tapping
141) A physical therapist attempts to gather information on the integrity of a cranial nerve by
assessing the patient's field of vision. This technique would be MOST useful when assessing
cranial nerve:
1. I
2. II
3. VIII
4. X
142) A physical therapist plans to treat a patient diagnosed with a lower leg injury using superficial
heat. While preparing a hot pack for treatment the therapist notes that the water in the
hydrocollator unit is 180 degrees Fahrenheit. The MOST appropriate therapist action is:
1. continue with treatment as planned
2. avoid using the hot packs
3. add more towels since the water temperature is too hot
4. use fewer towels since the temperature is not hot enough
143) A patient performs an incline bench press exercise, as pictured, immediately after completing
a traditional bench press exercise. What muscle is emphasized when using the incline bench?

(a)

2. posterior deltoid
3. upper fibers of the pectoralis major
4. lower fibers of the pectoralis major
5. upper trapezius

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144) A physical therapist works with a patient diagnosed with a basal ganglia disorder. The therapist
hypothesizes that the patient is exhibiting signs of hypertonia. The MOST appropriate finding
to support the hypothesis is
1. abnormally high resistance to passive stretch
2. abnormally high resistance to active stretch
3. abnormally high resistance to active and passive stretch
4. abnormally high resistance to active muscle contraction
145) A physical therapist conducting a literature search on a given medical diagnosis identifies that
the condition affects men twice as much as women. The condition MOST consistent with this
finding is
1. amyotrophic lateral sclerosis
2. cerebrovascular accident
3. Guillain-Barre syndrome
4. Parkinson's disease
146) The National Health Survey reports that women's heights are normally distributed with a
mean of 65 inches and a standard deviation of 2.5 inches. What percent of women are
between 62.5 inches and 67.5 inches tall?
1. approximately 34%
2. approximately 68%
3. approximately 95%
4. approximately 99%
147) A physical therapist completes daily documentation using a S.O.A.P. NOTe format. Which entry
would NOT typically belong in the subjective section?
1. denies pain with cough or sneeze
2. hip hiking reproduces knee pain
3. states history of chronic obstructive pulmonary disease since 1990
4. patient goal: return home without assistance
148) A physical therapist attempts to identify the MOST appropriate intervention activities for a
wound that is classified as "yellow" using the Red-Yellow-Black system. This would MOST likely
entail:
1. debridement
2. debridement, absorb exudate
3. remove slough, absorb exudate
4. maintain moisture, wound protection
149) A physical therapist mobilizes a patient's glenohumeral joint in an attempt to decrease the
patient's present pain level. The therapist administers large amplitude oscillations at the
beginning of the range of motion. This technique BEST describes:
1. grade I
2. grade II
3. grade III
4. grade IV
150) A physical therapist notices that a patient being treated following an arthroscopic knee
procedure has a stage I ulcer on the left forearm. The patient reports mild pain and the skin
appears to be completely intact. The MOST predictable clinical presentation based on the
stage of the ulcer is:
1. blister
2. nonblachable erythema
3. partial disruption of the dermis
4. abrasion

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151) A 10-year-old boy with left hip and knee pain and an altered gait pattern is examined in
physical therapy. Examination reveals limited left hip abduction and medial rotation, weak
gluteus medius, and weak medial rotators. The therapist observes that the patient walks with
an antalgic gait, taking weight off his left hip as soon as possible. Based on the presented
information, the clinical presentation is MOST consistent with
1. Legg-Calve-Perthe's disease
2. slipped capital femoral epiphysis
3. impingement of the L5 nerve
4. fracture of the femoral neck
152) A physical therapist reviews contraindications to electrotherapy prior to initiating treatment.
Which of the following would be considered an absolute contraindication?
1. use over the carotid sinus
2. use across the spinal column
3. use over a healing fracture
4. use on an adolescent patient
153) A physical therapist completes several lower extremity muscle length tests on an athlete with
persistent hip pain. Which of the following findings would BEST represent a positive test for
tightness of the right iliopsoas?
1. in supine with the left hip flexed to the chest, the patient demonstrates diminished
lumbar lordosis
2. in supine with the left hip flexed to the chest, the patient demonstrates increased
lumbar lordosis
3. in supine with the right hip flexed to the chest, the patient demonstrates diminished
lumbar lordosis
4. in supine with the right hip flexed to the chest, the patient demonstrates increased
lumbar lordosis
154) A physical therapist designs an aquatic program for a patient diagnosed with multiple sclerosis.
The physical therapist should recommend that the patient
1. exercise at the end of a work day, in the late afternoon or early evening
2. perform the exercises in a pool with cool water
3. reduce muscle tension and stiffness by ending the session in the hot tub for ten
minutes
4. exercise daily on weekdays and twice daily on weekends
155) A 31-year-old female in her seventh month of pregnancy is referred to physical therapy with
complaints of numbness and tingling in the thumb, index, middle, and lateral half of the ring
finger. The patient works as an administrative assistant and spends MOST of the day using a
keyboard to type manuscripts. Which of the following is the MOST appropriate physical
therapy intervention?
1. iontophoresis with dexamethasone
2. placement of the wrist in a static splint
3. advice to take a 15 minute break every hour
4. advice to use an ice pack three to four times per day

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156) A 66-year-old female is referred to physical therapy to be fitted for compression stockings due
to a venous stasis ulcer. This patient has smoked two packs of cigarettes per day for over 40
years. The patient states that she has pain in both lower legs that usually improves when she is
in a dependent position. During the examination, the therapist determines that the patient has
an ankle-brachial index (ABI) of .6. Which of the following would be the MOST appropriate
action?
1. fit the patient with compression stockings and educate the patient on a progressive
wearing schedule
2. relate findings to her physician and inform the physician that stockings are
contraindicated with pain
3. relate findings to her physician and inform the physician that stockings are
contraindicated based on the patient's ABI value
4. contact emergency medical services
157) A physical therapist performs an examination on a patient with a history of imbalance and
falls. Which of the following tests would provide the MOST comprehensive analysis of the
patient's balance and offer specific information regarding the risk of falls?
1. Functional Reach Test
2. providing perturbations to the patient while in standing
3. Berg Balance Scale
4. assessing the amount of sway with eyes open and eyes closed while standing
158) A physical therapist is interested in estimating the risk of patients developing decubitus ulcers
during the period of hospitalization after sustaining a spinal cord injury. The statistic that BEST
estimates this risk is the:
1. coefficient of determination
2. intraclass correlation coefficient
3. incidence rate
4. coefficient of variation
159) A physical therapist attempts to establish short-term goals to facilitate the achievement of an
established long-term goal. The MOST important criterion when determining short-term goals
is:
1. the goal is process-oriented
2. the goal describes only one outcome
3. the goal is specific
4. the goal is observable and measurable
160) During a physical therapy examination a female patient with rheumatoid arthritis indicates
that she has significant difficulty opening jars, writing, and dressing. According to the Nagi
Model the described difficulties are MOST representative of a/an
1. pathology
2. impairment
3. functional limitation
4. diability
161) The director of physical therapy is interested in knowing the different medical diagnoses of
patients referred for physical therapy in the hospital. What statistic should the therapist use to
report the MOST frequently referred medical diagnosis?
1. mean
2. median
3. mode
4. weighted mean

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162) A patient with a spinal cord injury presents with decreased upper and lower extremity
strength and sensation. The therapist notes that strength is greater in the lower extremities
compared to the upper extremities. The clinical presentation is MOST consistent with
1. Brown Sequard's syndrome
2. anterior cord syndrome
3. posterior cord syndrome
4. central cord syndrome
163) A patient has accumulated mucous secretions in the anterior basal segments of the left and
right lower lobes of the lungs. During auscultation a physical therapist would expect to hear
1. vesicular sounds
2. percussion sounds
3. fremitus
4. crackles
164) A physical therapist assesses a child's fine motor prehension by asking the child to pick up a
small bead from a table using her index and thumb. This type of activity is MOST
representative of:
1. three-point chuck grasp
2. pincer grasp
3. hook grasp
4. digital palmar prehension grasp
165) A physical therapist inspects the skin of a patient during an iontophoresis treatment using
dexamethasone and concludes the patient is having an adverse skin reaction. The MOST
appropriate therapist action is
1. discontinue the intervention
2. decrease the duration of the treatment session
3. decrease the current intensity
4. select an alternate therapeutic ion
166) A physical therapist works with a patient rehabilitating from a stroke on transitioning from
sitting to standing. Which stage of motor control would be MOST representative of this
specific activity?
1. mobility
2. stability
3. controlled mobility
4. skill
167) A physical therapist prepares to measure the amount of femoral anteversion present in a
patient referred to physical therapy. Which patient would the therapist expect to exhibit the
GREATEST amount of anteversion?
1. 42-year-old female status post anterior cruciate ligament reconstruction surgery
2. 32-year-old male with trochanteric bursitis
3. 11-year-old female with patella femoral syndrome
4. 23-year-old male with anterior compartment syndrome
168) A patient rehabilitating from a compression fracture in the thoracic spine is referred to
physical therapy. When first meeting the patient the therapist notes that the patient is
wearing a Jewett hyperextension orthosis. The force system used in this type of orthosis is
BEST described as
1. two-point pressure system
2. three-point pressure system
3. four-point pressure system
4. five-point pressure system

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169) A physical therapist attempts to select a non-equilibrium test of coordination for a patient
with a cerebellar disorder. Which of the following tests would be the MOST appropriate?
1. Romberg test
2. finger to nose
3. walking
4. marching in place
170) A physical therapist uses functional electrical stimulation to treat a patient with a shoulder
subluxation due to a stroke. When setting up the unit the electrodes should be placed
1. over the middle deltoid and supraspinatus
2. over the posterior deltoid and supraspinatus
3. over the posterior deltoid and the teres minor
4. over the serratus anterior and pectoralis major
171) A physical therapist reviews the medical record of a patient diagnosed with a lower motor
neuron disorder. Which finding would be LEAST likely based on the presented information?
1. diminished deep tendon reflexes
2. clonus
3. hypotonia
4. fasciculations
172) A physical therapist returns to the physical therapy gym after a meeting and finds a patient
sitting on the floor near a treadmill. The patient exhibits many of the signs and symptoms of
shock including restlessness, pale skin, and a rapid, weak pulse. The MOST appropriate
position for the patient is termed
1. Fowler
2. semi-Fowler
3. modified Trendelenburg
4. reverse Trendelenburg
173) A physical therapist works with a 68-year-old male who was in good health prior to being
diagnosed with Guillain-Barre syndrome two weeks ago. The patient was referred to
outpatient physical therapy after a ten day hospitalization. The patient did not experience
respiratory involvement and had moderate weakness affecting all joints of the lower
extremities. What would be the MOST likely long-term outcome for the patient?
1. independent at a wheelchair level in the community; minimal residual loss of function
and movement
2. minimal assistance at a wheelchair level in the home; significant residual loss of
function and movement
3. independent ambulation in the home; minimal residual loss of function and movement
4. independent ambulation in the community; minimal residual loss of function and
movement
174) An entry in the medical record from the emergency room indicates that a patient status post
C6 spinal cord injury presented with flaccid lower extremities and an absent bulbocavernosus
reflex on admission. These findings are a result of which of the following?
1. lower motor neuron injury
2. upper motor neuron injury
3. spinal shock
4. damage to the myelin sheath

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175) A physical therapist evaluates the level of consciousness of a patient in the medical intensive
care unit. The patient does not seem to be aware of the therapist's presence and only
responds when being awakened by loud talking or physical contact. The MOST accurate
description of the patient's level of consciousness is
1. alert
2. lethargic
3. stuporous
4. comatose
176) A physical therapist identifies significant weakness in the muscles of the face and proximal
limbs of a 48-year-old female. Based on the patient's diagnosis, the therapist concludes the
cause of the weakness is neurogenic, specifically related to the neuromuscular junction. The
MOST likely patient diagnosis is
1. amyotrophic lateral sclerosis
2. poliomyelitis
3. spinal muscular atrophy
4. myasthenia gravis
177) An athlete who has completed a three month upper extremity strengthening program
expresses some degree of frustration since she does not feel the activity has translated to
improved performance on the volleyball court. The principle MOST likely to explain the
patient's observation is
1. overload
2. specificity
3. fatigue
4. neuromuscular efficiency
178) A physical therapist employed in an acute care hospital works with a patient diagnosed with
congestive heart failure. While discussing the planned treatment with the patient the therapist
identifies several findings consistent with the medical diagnosis. Which finding would be the
MOST likely?
1. decreased accessory muscle use during respiration
2. muscle fasciculations and atrophy
3. productive cough and decreased respiratory rate
4. peripheral edema and dyspnea
179) A physical therapist attempts to assess the balance of a 42-year-old female rehabilitating from
a stroke. In order to gain specific insight toward the vestibular component of balance the
therapist would need to utilize activities that alter
1. head position
2. tactile feedback
3. vision
4. kinesthetic awareness
180) A physical therapist performs a valgus stress test to a patient two days status post grade I
medial collateral ligament sprain. The MOST likely outcome of the testing is
1. pain with no discernable laxity when compared to the contralateral limb
2. pain with discernable laxity when compared to the contralateral limb
3. no pain with discernable laxity when compared to the contralateral limb
4. no pain with no discernable laxity when compared to the contralateral limb

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181) A physical therapist implements a series of extension activities with a patient rehabilitating
from a disk protrusion. During the session the therapist notes that the patient is able to
tolerate lying in prone on a firm surface. To progress the patient the therapist should instruct
the patient to
1. perform a prone press-up
2. position himself in prone on elbows
3. begin bridging activities in supine
4. perform extension exercises in standing
182) A physical therapist performs a lower extremity range of motion screening on a morbidly
obese patient rehabilitating from thoracic surgery. The MOST likely end-feel classification
associated with the patient's knee flexion range of motion would be
1. soft
2. firm
3. hard
4. empty
183) A physical therapist prepares to measure a patient's passive elbow flexion range of motion.
Which of the following steps would be the FIRST to occur when performing the goniometric
assessment?
1. palpate bony anatomical landmarks
2. align the goniometer
3. read and record the range of motion
4. stabilize the distal joint segment
184) A physical therapist states that a patient demonstrates a festinating gait pattern. This type of
gait pattern is MOST often associated with
1. cerebral palsy
2. Parkinson's disease
3. spina bifida
4. myasthenia gravis
185) A physical therapist notes that a patient who recently had a nasogastric tube inserted has
experienced a number of complications due to the device. The MOST common complication is:
1. air embolus
2. increased blood pressure
3. dehydration
4. increased gag reflex
186) A physical therapist lightly strokes the corner of an infant's mouth as part of a reflex
assessment. This type of stimulus is associated with the:
1. startle reflex
2. Moro reflex
3. rooting reflex
4. Galant reflex
187) A physical therapist prepares to elicit a patient's biceps reflex by positioning his thumb directly
over the biceps tendon. Assuming a normal response, what action is MOST likely after striking
the thumb with the reflex hammer?
1. elbow extension
2. elbow flexion
3. elbow extension and marked forearm pronation
4. elbow flexion and marked forearm supination

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188) A physical therapist recognizes the need to obtain informed consent prior to administering a
specific intervention. The patient is an adult who does not meet the necessary criteria to make
an informed decision. In this instance the MOST appropriate source to grant consent would be
a/an:
1. legal guardian
2. attorney
3. referring physician
4. insurance provider
189) A physical therapist reads in an existing patient's medical record that a patient will be seen in
physical therapy two times a week for an additional three weeks. Using a S.O.A.P. note format,
this information would appear in the
1. subjective section
2. objective section
3. assessment section
4. plan section
190) A patient explains to a physical therapist that she is scheduled to have a feeding device
inserted into her stomach through an incision in the abdomen. This type of device is MOST
likely a:
1. Swan-Ganz catheter
2. gastric tube
3. nasogastric tube
4. Hickman line
191) A physical therapist prepares to administer iontophoresis using lidocaine on a 36-year-old
male patient diagnosed with patellar tendonitis. Based on the identified pharmacological
agent, the MOST likely treatment objective is to reduce:
1. spasticity
2. pain
3. calcium deposits
4. scar tissue
192) A physical therapist is studying the relationship between the distance walked during a 6-
minute walk test and heart rate at the end of the walk in individuals recovering from
myocardial infarction. Examination of the data indicates that shorter distances are associated
with lower heart rates and longer distances are associated with higher heart rates. The
relationship described by the data is a
1. statistically significant correlation
2. clinically important correlation
3. negative correlation
4. positive correlation
193) A physical therapist administers mechanical cervical traction to a patient diagnosed with nerve root
impingement. The therapist initiates continuous traction with 10 pounds of force with the patient
positioned in supine. Shortly after beginning the session the patient experiences a dramatic
peripheralization of symptoms. The MOST appropriate therapist action is
1. continue with traction using the specified parameters
2. attempt traction in an alternate position
3. decrease the amount of force and utilize intermittent traction
4. discontinue traction
194) A physical therapist receives an order to utilize a hydrocolloid dressing on a patient with a full-thickness
wound. What is the MOST significant potential limitation with this type of dressing?
1. larger dressings are difficult to apply
2. requires use of a secondary dressing
3. limited use with highly exudating wounds
4. traumatize periwound skin upon removal

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195) A physical therapist assesses the standing balance of a patient receiving outpatient physical
therapy services. During the assessment the therapist provides a small perturbation to the
patient causing the patient's body to mildly sway forward. Assuming the movement is within
the patient's limits of stability, what muscle would likely be the FIRST to be activated?
1. gastrocnemius
2. tibialis anterior
3. hip flexors
4. quadriceps
196) A physical therapist uses a goniometer to measure range of motion at the thumb. When
measuring carpometacarpal abduction, the fulcrum of the goniometer should be positioned
1. over the lateral aspect of the radial styloid process
2. over the palmar aspect of the first carpometacarpal joint
3. over the dorsal aspect of the first metacarpal joint
4. over the dorsal midline of the proximal phalanx
197) A physical therapist assesses the cough of a patient with a spinal cord injury. After completing
the assessment, the therapist classifies the cough as "functional." The MOST likely level of
injury based on cough function is:
1. C5
2. C7
3. T4
4. T10
198) A 19-year-old patient who is in her 28th week of pregnancy is referred to physical therapy with
a diagnosis of carpal tunnel syndrome. As part of the examination, the therapist notes that the
patient's blood pressure is 140/90 mm Hg. The patient states that four days ago her blood
pressure was measured as 125/75 mm Hg. She also mentions that she has gained five pounds
in the last two days and yesterday had a bad headache and noticed that her hands and feet
were "puffy." What is the MOST appropriate therapist action?
1. call the patient's physician immediately
2. continue with the examination and advise the patient to call her physician if the weight
gain continues
3. continue with physical therapy since the blood pressure reading is within normal limits
for a pregnant woman
4. advise the patient to elevate her legs when she gets home
199) A physical therapist works with a 52-year-old female with T6 paraplegia resulting from a motor
vehicle accident one month ago. The patient's past medical history is unremarkable. She has
been referred to a wheelchair clinic to obtain a wheelchair prescription prior to discharge. The
aspects of the wheelchair prescription that will directly affect the patient's comfort and
maintenance of posture include:
1. seat surface, back surface, pelvic belt, upper extremity supports, and foot supports
2. seat surface, back surface, pelvic belt, and foot supports
3. seat surface, back surface, and upper extremity supports
4. seat surface and back surface
200) A six-month-old male infant demonstrates a Landau response when held prone in his father's
arms. This response is due to
1. the influence of the asymmetrical tonic neck reflex
2. the combined effects of the optical, tonic labyrinthine, and body righting reflexes
3. the combined effects of the Galant and equilibrium reflexes
4. the influence of the positive support reflex

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1. Answer: 3. Cardiac, Vascular, and Pulmonary Systems Interventions.


Physical therapists must closely monitor a patient's vital signs following
cardiac surgery. Normally systolic pressure would increase with active exercise, while
diastolic pressure would remain relatively stable. As a result, the 15 mm Hg decrease in the
patient's diastolic pressure would warrant terminating the exercise session. Failure to act in
this manner could expose the patient to an unnecessary health risk. (Hillegass p. 665)
2. Answer: 3 Non-Systems Equipment & Devices; Therapeutic Modalities
Amplitude refers to the magnitude of the current delivered. Amplitude is
synonymous with words such as current intensity or voltage. (Prentice - Therapeutic
Modalities p. 55)
3. Answer: 3 Other Systems Foundations for Evaluation, Differential Diagnosis, and Prognosis
A left hemisphere stroke will result in right-sided involvement that may
include a combination of paresis and spasticity. A combination of an increase in tone of the
plantar flexors and weakness of the dorsiflexors will cause a "foot flat" effect during initial
stance and make it more difficult for the patient to clear the limb during swing phase.
(Sullivan p. 136)
4. Answer: 3 Cardiac, Vascular, and Pulmonary Systems Interventions
An untreated pneumothorax, hemoptysis occurring less than 24 hours
ago, and a platelet count of less than 20,000/mm3 are all contraindications to percussion. A
chest tube, although something to be aware of, is not a contraindication. A therapist can
easily provide percussion to areas around the chest tube, avoiding any tender areas near the
tube's insertion. (Hillegass p. 649)
5. Answer: 1 Neuromuscular and Nervous System Examination
APGAR scores measure an infant's heart rate, respiratory effort, muscle
tone, reflex irritability, and color. Scores can range from 0-10 and are usually recorded at 1,
5, and 10 minutes of life. (Rothstein p. 692)
6. Answer: 4 Non-Systems Safety & Professional Roles, Teaching/Learning, Research.
If the patient is unable to speak the English language then the facility is responsible for
providing an interpreter to ensure that the patient understands the therapeutic intervention
and informed consent elements regarding care. The patient's son may be helpful during the
session, however, the boy's age and the patient's present medical status necessitate more
formal action. (Scott - Legal Aspects p. 118)
7. Answer: 1 Cardiac, Vascular, and Pulmonary Systems Clinical Application of Foundational
Sciences ACE inhibitors tend to decrease blood pressure by vasodilating the
peripheral vasculature, specifically by inhibiting the enzyme that converts angiotensin I to
angiotensin II. The other stated options do not directly impact blood pressure. (Ciccone p.
308)
8. Answer: 1 Cardiac, Vascular, and Pulmonary Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
Angina pectoris is a condition where a patient experiences chest pain and tightness due to
myocardial ischemia. Nitroglycerin acts to decrease myocardial demand by producing a
general vasodilation throughout the body. (Ciccone p. 329)
9. Answer: 2 Neuromuscular and Nervous Systems Interventions
If the patient's husband sits on her right side while the patient is eating, then the patient
could avoid attending to her left side throughout the dinner hour. For the best therapeutic
results, the patient should have to attend at times towards the left side of the midline.
(O'Sullivan p. 534)
10. Answer: 4 Cardiac, Vascular, and Pulmonary Systems Examination
Ventricular tachycardia is characterized by absent P waves; three or more consecutive
premature ventricular contractions; wide and bizarre QRS complexes; and a rapid ventricular
rate. (Hillegass p. 409)

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11. Answer: 2 Musculoskeletal System Interventions


Shoulder medial rotation involves a convex humerus moving on a concave glenoid. As a
result, a posterior glide of the humerus on the glenoid is required in order to address the
limitation in motion. (Kisner p. 231)
12. Answer: 4 Non-Systems Equipment & Devices, Therapeutic Modalities
Applying cold directly over a superficial main branch of a nerve, such as the peroneal nerve
at the lateral knee, may cause a nerve conduction block. When applying cryotherapy to such
an area, the therapist should monitor for signs of changes in nerve conduction such as
numbness or tingling. The therapist should discontinue use if these types of signs and
symptoms are identified. (Cameron p. 137)
13. Answer: 3 Non-Systems Equipment & Devices, Therapeutic Modalities
The extensor carpi radialis brevis originates from the common extensor tendon from the
lateral epicondyle of the humerus. As a result, the most appropriate area to direct
ultrasound energy is the lateral aspect of the elbow. (Kendall p. 260)
14. Answer: 2 Others Systems Interventions.
Trunk flexion exercises should be avoided if the patient has suffered a vertebral fracture.
The physical therapist should be sure to clear the vertebral artery prior to prescribing neck
exercises for a patient with osteoporosis. (Pauls p. 657)
15. Answer: 3 Other Systems Interventions.
Due to the size of the separation (four centimeters) the head lift exercise would be the only
appropriate abdominal exercise. When the size of the separation is less than two
centimeters more provocative exercises can be attempted. (Kisner p. 695)
16. Answer: 3 Musculoskeletal System Foundations for Evaluation, Differential Diagnosis, and
Prognosis. Excessive friction of the prosthetic knee will result in increased difficulty with
flexing the knee during swing phase. The patient may resort to circumducting the knee
during swing. Tightness of the involved gluteus medius muscle would result in an abducted
gait pattern, not a circumducted pattern. (Seymour p. 231)
17. Answer: 1 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis.
A patient with C4 tetraplegia would be able to achieve independent propulsion using a
power wheelchair with the head, mouth, chin, breath or sip-puff controls; but not with an
upper extremity controlled-joystick. (O'Sullivan p. 897)
18. Answer: 4 Musculoskeletal System Clinical Application of Foundational Sciences.
The pes anserinus bursa is located at the insertion point of the
semitendinosus, sartorius, and gracilis muscles. This area is located at the superior medial
aspect of the tibia. (Gross p. 343)
19. Answer: 4 Musculoskeletal System Clinical Application of Foundational Sciences, Differential
Diagnosis, and Prognosis.
A Boutonnière deformity is characterized by extension of the
metacarpophalangeal joints and distal interphalangeal joints with flexion of the proximal
interphalangeal joints. This deformity is due to a rupture of the central tendinous slip and is
commonly seen with rheumatoid arthritis or trauma. (Magee p. 364)
20. Answer: 1 Musculoskeletal System Foundations for Evaluation, Differential Diagnosis, and
Prognosis Osteoarthritis is characterized by pain that occurs due to excessive stress and
activity of the involved joints. Patients often experience morning stiffness, limited range of
motion, and may develop Heberden's and Bouchard's nodes. Advanced osteoarthritis will
present with pain at rest and during the night, impaired position sense, and progressive
muscle weakness due to inactivity. (Kisner p. 302)
21. Answer:1 Musculoskeletal System Foundations for Evaluation, Differnetial Diagnosis, and
Prognosis Spinal curves that measure between 20 and 40 degrees and remain flexible
are best treated with a spinal orthosis and exercise. Based on the patient's age and size of

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the scoliotic curve, the patient would be a good candidate for a spinal orthosis and a home
exercise program. (Campbell p. 267)
22. Answer: 3 Non-Systems Equipment & Devices, Therapeutic Modalities
Pulsed ultrasound requires periodic interruption of ultrasound energy. The result is a
decrease in the average intensity of output over time without a decrease in the peak
intensity. The percentage of time that ultrasound is being generated over one pulse period is
referred to as the duty cycle. Duty cycle is calculated by dividing the on time by the total
time (on + off time). (Prentice-Therapeutic Modalities p. 371)
23. Answer: 1 Musculoskeletal System Foundations for Evaluation, Differential Diagnosis, and
Prognosis Lateral rotation is typically the most restricted motion when there is
capsular tightness of the shoulder. Other restricted motions in a capsular pattern at the
glenohumeral joint include abduction and medial rotation. (Magee p. 208)
24. Answer: 4 Musculoskeletal System Examination
The patient has 7 degrees of hyperextension which is greater than normal, while 140
degrees of flexion is within normal limits (135-140 degrees). (Clarkson p. 316)
25. Answer: 1 Musculoskeletal System Clinical Application of Foundational Sciences
The inflammatory phase, usually lasting six days, represents the initial reaction of
body tissue to an injury. Cellular injury results in changes in metabolism and the introduction
of materials that initiate the inflammatory response. Signs of inflammation include redness,
tenderness to touch, and increased temperature. (Anderson p. 107)
26. Answer: 1 Neuromuscular and Nervous Systems Clinical Application of Foundational Sciences
Levodopa can dramatically improve bradykinesia and rigidity in patients
with Parkinson's disease. Approximately 80% of patients taking levodopa experience various
forms of dyskinesia including tremors, dystonia, and ballismus. (Ciccone p. 127)
27. Answer: 3 Neuromuscular and Nercous Systems Examination
A positive Babinski reflex is normal in infants up to six months of age. The reflex is elicited by
stimulating the lateral aspect of the sole of the foot. If the great toe extends in a person
older than six months of age, it may indicate the presence of an upper motor neuron lesion.
(Paz p. 297)
28. Answer: 1 Musculoskeletal System Interventions
The iliotibial band drops posteriorly behind the lateral femoral condyle
with knee flexion and then snaps forward under the epicondyle during extension. Improving
the flexibility of the hip abductors, hip flexors, and lateral thigh muscles can be helpful when
treating this condition. (Anderson p. 457)
29. Answer: 3 Non-Systems Safety & Professional Roles, Teaching/Leaning, Research
The concurrent validity of a new test can be studied when the
measurement to be validated and the criterion measure, or gold standard measurement, are
taken at relatively the same time, so that they both reflect the same behavior. (Portney p.
85)
30. Answer: 2 Musculoskeletal System Examination
An extension lag refers to an inability to actively extend the knee through the available full
passive range of motion. The difference between the available passive extension and the
amount of active extension is used to determine the amount of the extension lag. This
condition can be caused by joint effusion, pain or quadriceps inhibition. (Kisner p. 550)
31. Answer: 3 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
Guillain-Barre, also known as acute inflammatory demyelinating polyradiculoneuropathy, is
the most common form of polyneuropathy that affects the myelin sheaths of the peripheral
nerves. In addition to the ascending symmetrical weakness that occurs, a patient may also
experience paralysis, respiratory failure, absence of deep tendon reflexes, and the inability
to speak or swallow. (Umphred p. 387)

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32. Answer: 1 Musculoskeletal System Interventions


Eccentric strength training is linked to a delayed soreness phenomenon where a patient may
feel muscle soreness 24 to 48 hours after the actual exercise session. Moderate exercise
should continue during the soreness period to assist the patient with adaptation and
restoration of muscle function. (Hall p. 82)
33. Answer: 2 Non-Systems Safety & Professional Roles, Teaching/Learning, Research
The probability of answering a single trial correctly without position
sense would be one half or 50% since there are only two possible responses (up or down).
To answer two consecutive trials correctly it would be necessary to square the denominator
resulting in an one quarter probability of answering correctly. (DeMyer p. 476)
34. Answer: 3 Cardiac, Vascular, and Pulmonary Systems Clinical Application of Foundational
Sciences Eupnea is a term that describes a normal breathing pattern. The prefix "eu" is
defined as good, well or normal. (Anderson p. 635)
35. Answer: 3 Non-Systems Safety & Professional Roles, Teaching/Learning, Research
Nurses are the medical professionals typically responsible for administering
medication within the hospital. As a result, in order to modify an existing schedule, the
therapist would need to communicate directly with a member of the nursing staff. (Curtis p.
114)
36. Answer: 2 Non-Systems Equipment & Devices, Therapeutic Modalities
Neuromuscular electrical stimulation for strengthening requires significant periods of rest
between muscle contractions. Failure to allow for adequate rest (off time) will lead to rapid
muscle fatigue and a significant reduction in force with successive muscle contractions.
(Long p. 188)
37. Answer: 1 Non-Systems Equipment & Devices, Therapeutic Modalities
Treatment with pneumatic compression prior to the scheduled fitting session will reduce the
patient's lower extremity edema and therefore provide a better estimate of the necessary
size for the custom fit compression garment. Failure to limit existing edema will limit the
effectiveness of the compression garment. (O'Sullivan p. 596)
38. Answer: 2 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
Although spasticity is a common consequence of spinal cord injury, the sudden and dramatic
onset of the patient's spasticity suggests that there may be another cause. Bladder
infections are a common cause of increased muscle tone in patients with spinal cord injuries.
Typically, bladder infections can be detected through a urine culture and managed with
medication. (Goodman - Pathology p. 1090)
39. Answer: 1 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
The neurons regulating conscious sensation and movement of the upper body are located in
the lateral cerebral cortex and therefore would be affected by a CVA involving the middle
cerebral artery. Language impairment is common in CVAs that involve the left hemisphere,
while spatial awareness is more affected with a lesion in the right hemisphere. (Goodman -
Pathology p. 476)
40. Answer: 3 Neuromuscular and Nervous Systems Examination
Dysdiadochokinesia refers to an inability to perform rapidly alternating movements and is
often associated with a cerebellar disorder. Testing for the presence of dysdiadochokinesia
does not rely on visual sense, therefore it is not necessary for the examiner to remove visual
input. (Lundy-Ekman p. 237)
41. Answer: 2 Neuromuscular and Nervous System Foundations for Evaluation, Differential
Diagnosis, and Prognosis Amyotrophic lateral sclerosis is a rapidly progressing neurological
disease with an average course of two to five years with only 20-30% of patients surviving

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longer than five years. Death usually occurs from respiratory failure. (Physical Therapist's
Clinical Companion p. 207)
42. Answer: 1 Other Systems Interventions
Patients status post surgery are often instructed how to splint their incision during coughing.
Splinting is usually performed during the expiratory phase of the cough by applying pressure
with a blanket roll or pillow directly over the incision. Appropriate splinting technique and
assisted coughing can be used to promote secretion clearance post surgery. (Hillegass p.
652)
43. Answer: 3 Musculoskeletal System Interventions
Training programs designed to improve muscle endurance require a
significant number of repetitions against a submaximal load. Although no definitive
parameters have been established, most sources recommend three to five sets consisting of
15-50 repetitions. Training programs designed to improve muscle strength often are
described as two to three sets of 6-12 repetitions. (Kisner p. 75)
44. Answer: 1 Neuromuscular and Nervous Systems Interventions
Ambulating in front of a mirror with verbal cueing is an effective strategy to improve
kinesthetic awareness. Observing activity through a mirror serves as a valuable source of
intrinsic feedback especially for postural activities. This type of intervention strategy should
not be used, however, with patients that present with visual-spatial or severe perceptual
deficits. (O'Sullivan p. 545)
45. Answer: 2 Cardiac, Vascular, and Pulmonary Systems
Cystic fibrosis is an inherited disease that affects the ion transport of the exocrine glands
resulting in impairment of the hepatic, digestive, respiratory, and reproductive systems. This
disease causes the exocrine glands to overproduce thick mucus (that causes subsequent
obstruction), normal secretions, and sodium and chloride. Chest physical therapy should be
performed several times per day and includes bronchial drainage, percussion, vibration,
ventilatory muscle training, and assisted coughing techniques. (Goodman - Pathology p. 591)
46. Answer: 4 Neuromuscular and Nervous Systems Examination
Cranial nerve I refers to the olfactory nerve which is a sensory nerve responsible for the
sense of smell. To test the integrity of the nerve, the patient is positioned in sitting with the
eyes closed or blindfolded. The therapist places an item with a familiar odor under one of
the patient's nostrils and the patient is asked to identify the odor. A positive test may be
indicated by an inability to identify familiar odors. (Bickley p. 567)
47. Answer: 1 Integumentary Systems Interventions
Occlusion refers to the ability of a dressing to transmit moisture, vapor, and gases from the
wound bed to the atmosphere. Dressings that are occlusive promote healing by maintaining
moisture, retaining growth factors and enzymes, and allow autolytic debridement. A truly
occlusive substance such as latex would be completely impermeable to moisture, vapor, and
gases. (Sussman p. 262)
48. Answer: 3 Integumentary System Examination
A deep partial-thickness burn involves the entire epidermis and a significant portion of the
dermis. The burn may appear as a mixed red or waxy white color with broken blisters. Pain is
associated with the burn, although it is usually not as intense as with a superficial partial-
thickness burn. Healing may occur with hypertrophic scars and keloids. (Rothstein p. 1115)
49. Answer: 2 Other Systems Examination
Since the patient requires assistance at times, the patient's transfer status is best described
as minimal assistance. (Pierson p. 108)
50. Answer: 3 Non-Systems Safety & Professional Roles, Teaching/Learning, Research
Physicians routinely specify the weight bearing status for their
patients following surgical procedures such as a meniscus repair. (Goodman-Differential
Diagnosis p.6)

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51. Answer: 4 Other Systems Interventions


As an adolescent with Duchenne's muscular dystrophy reaches adulthood, he becomes
progressively more dependent for all mobility needs. A typical 19-year-old with Duchenne's
muscular dystrophy will require assistance with most activities of daily living as well as
require a specialized power wheelchair. Gait training with knee-ankle-foot orthoses may be
appropriate in a younger child, as well as therapeutic exercise programs. Weight training is
typically not performed due to the negative effects of overworking muscles in patient's with
Duchenne's muscular dystrophy. (Campbell p. 351)
52. Answer: 4 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
Neglect (or inattention) is often a characteristic finding after stroke where a patient will not
attend to the affected side. Neglect is more often observed with right hemisphere damage.
(Umphred p. 840)
53. Answer: 4 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
A type I error decribes the probability of mistakenly rejecting the null
hypothesis when it is true. A significance level of .01 would result in a 1.0% chance of making
a type I error. (Triola p. 350)
54. Answer: 4 Musculoskeletal System Examination
A grade of poor is given to a muscle that can complete the full range of
motion in a gravity-eliminated position. Sidelying would be considered a gravity-eliminated
position for the hip flexors. A manual muscle test grade of "poor" is synonymous with 2/5.
(Kendall p. 187)
55. Answer: 1 Cardiac, Vascular, and Pulmonary Systems Interventions
Pursed-lip breathing is a technique that can be used effectively to reduce respiratory rate. By
prolonging the expiratory phase through pursed lips, the patient secondarily reduces
respiratory rate. (Frownfelter p. 410)
56. Answer: 2 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
A Likert scale most commonly requires respondents to rate
agreement with items on a five or seven point scale. Categories may include items such as
strongly agree, agree, neutral, disagree, and strongly disagree. Since the categories have a
qualitative relationship regarding the order of rankings, this type of scale is best described as
ordinal. (DePoy p. 197)
57. Answer: 3 Musculoskeletal System Interventions
In order to limit the likelihood of a knee flexion contracture the patient
should be positioned in supine with a pillow under the calf and ankle. By placing the lower
extremity in this position it allows the knee to remain in extension. (Pierson p. 87)
58. Answer: 4 Cardiac, Vascular, and Pulmonary Systems Examination
Hypoxemia is defined as insufficient oxygenation of arterial blood. Hypoxemia can be
assessed clinically by measuring the oxygen saturation of hemoglobin (SaO2) with a pulse
oximeter. (Hillegass p. 665)
59. Answer: 1 Other Systems Interventions
The benefits of pursed-lip breathing are decreased frequency of respiration, increased tidal
volume, and improved control of breathing. Paced breathing using pursed-lip breathing
during activity will help diminish the use of the Valsalva maneuver. (Hillegass p. 736)
60. Answer: 2 Neuromuscular and Nervous Systems Interventions
The information appears to indicate the presence of autonomic dysreflexia. This condition is
a dangerous complication following spinal cord injury and can normally occur in a patient
with injury at or above the T6 level. The increase in blood pressure is most often facilitated
by noxious stimuli such as a kink in a catheter line. The patient should assume a sitting
position due to the elevation in blood pressure and the catheter or other areas of suspected
stimuli should be inspected. (Tan p. 551)

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61. Answer: 4 Non-Systems Safety & Professional Roles; Teaching/Learning; Research


Since the patella tendon is a superficial structure, 3 MHz is the most
appropriate frequency. Intensity (W/cm2) is expressed as the power per unit area of the
soundhead. Depth of ultrasound penetration is determined by frequency (MHz) and not
intensity (W/cm2). (Cameron p. 189)
62. Answer: 3 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
An unattended sterile field must be discarded and a new sterile field
established due to the potential risk of contamination. (Pierson p. 293)
63. Answer: 2 Cardiac, Vascular, and Pulmonary Systems Foundations for Evaluation,
Differential Diagnosis, and Prognosis
Imbalances in arterial blood gas will occur as a result of chronic obstructive pulmonary
disease. Hypoventilation causes a subsequent increase in PaCO2 and a decrease in PaO2.
(Brannon p. 116)
64. Answer: 2 Musculoskeletal System Foundations for Evaluation, Differential Diagnosis, and
Prognosis Femoral anteversion refers to the femoral head assuming an anteriorly directed
position within the acetabulum. The anterior position of the femoral head within the
acetabulum usually results in increased hip medial rotation and decreased hip lateral
rotation. The patient may have a tendency to walk with a "toe-in" type gait. (Campbell p.
400)
65. Answer: 4 Cardiac, Vascular, and Pulmonary Systems Interventions
Hemoptysis (coughing up blood) is a contraindication to chest physical therapy. Applying
percussion can make the bleeding worse. The therapist should stop chest physical therapy
and contact the physician. Usually it is safe to resume chest physical therapy when the
patient has not hemoptysized within the past 24 hours. (Hillegass p. 651)
66. Answer: 2 Cardiac, Vascular, and Pulmonary Systems Examination
A perceived exertion scale is a type of subjective measure that classifies the intensity of
exercise using specific numeric or verbal descriptors. The remaining options are objective
measures. (Brannon p. 316)
67. Answer: 1 Non-Systems Equipment & Devices; Therapeutic Modalities
An intensity of 1.5-2.0 W/cm2 is typically sufficient to increase tissue temperature using
ultrasound with a frequency of 1 MHz. Research indicates that ultrasound with a frequency
of 1 MHz can penetrate soft tissues up to five centimeters, while ultrasound using a
frequency of 3 MHz can penetrate up to two centimeters. As a result, the deep hip rotators
would require ultrasound with a frequency of 1 MHz. (Cameron p. 208)
68. Answer: 1 Other Systems Interventions
Pelvic floor exercises are the most appropriate option to strengthen muscles and alleviate
stress incontinence. Voiding at predetermined intervals is an effective treatment for urge
incontinence. (Pauls p. 644)
69. Answer: 3 Neuromuscular and Nervous Systems Interventions
The patient is described as having ipsilateral pushing or "Pusher's syndrome." The patient
will have a strong tendency to lean toward the affected side and they will be unable to right
themselves. This problem is seen more with left hemiplegia and is best treated through
visual feedback and verbal cues to assist the patient to make corrections with posture.
(O'Sullivan p. 535)
70. Answer: 2 Musculoskeletal System Foundations for Evaluation, Differential Diagnosis, and
Prognosis Age, clinical history of insidious onset, and range of motion restrictions in
a capsular pattern are key indicators associated with adhesive capsulitis of the shoulder.
(Magee p. 210)
71. Answer: 2 Musculoskeletal System Clinical Application of Foundational Sciences
When a patient is in the anatomic position the normal carrying angle for a
male is between 5 and 10 degrees. The angle is created by the long axis of the humerus and

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the long axis of the ulna. Any angle in excess of 10 degrees is considered cubitus valgus. The
ulnar collateral ligament is the primary restraint to excessive cubitus valgus force. (Magee p.
324)
72. Answer: 2 Musculoskeletal System Foundations for Evaluation, Differential Diagnosis, and
Prognosis The lateral location of the knee pain and positive Ober test are indicative
of iliotibial band tightness. When abduction occurs during the modified Thomas test, it often
indicates tightness of the tensor fasciae latae and iliotibial band syndrome. (Magee p. 632)
73. Answer: 1 Neuromuscular and Nervous Systems Interventions
Hold-relax utilizes isometric contractions of antagonist muscles in order to gain range of
motion on one side of the joint. Resistance applied to antagonist muscles can produce
autogenic inhibition to the tight antagonistic muscles. This is followed by an active
contraction of the agonist muscle, which causes reciprocal inhibition of the tight antagonist.
The therapist would have the patient dorsiflex to the point of limitation followed by an
isometric contraction of all antagonistic muscles. After 7-10 seconds of holding the
contraction, relaxation should occur followed by active movement into the newly gained
range of motion. This should be repeated until there is no further gain in motion. (O'Sullivan
p. 404)
74. Answer: 3 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
Evidence indicates that in order to improve adherence, physical therapists
must provide patient-centered care that meets the patient's perceived needs, goals, and
acceptable modes of interventions. (Shepard p. 362)
75. Answer: 1 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
Tertiary prevention is defined as efforts to decrease the degree of disability
and promote rehabilitation and restoration of function in patients with chronic and
irreversible disorders. C5 tetraplegia would be considered a chronic and irreversible
condition and would therefore be appropriate for targeted tertiary prevention activities.
(Guide to Physical Therapist Practice p. 24)
76. Answer: 1 Musculoskeletal System Interventions
The power squat utilizes a partial squat maintaining neutral lordosis of
the spine and vertical positioning of the trunk. (Pierson p. 71)
77. Answer: 4 Non-Systems Equipment & Devices; Therapeutic Modalities
A walker would be the most appropriate assistive device for the patient since it is
appropriate for her present weight bearing status and her upper extremity strength. Either
type of crutch will require more strength than the patient exhibits and the large base quad
cane will not allow for partial weight bearing status. (Pierson p. 217)
78. Answer: 1 Cardiac, Vascular, and Pulmonary Systems
Intermittent claudication is caused by ischemia that usually occurs in the calf and feet due to
an imbalance between oxygen supply and demand. An increase in collateral circulation can
occur with regular exercise and will allow for improved perfusion of blood to the tissues.
This improves cardiac output efficiency, oxygen to the muscles, and decreases the symptoms
of claudication. (Hillegass p. 303)
79. Answer: 2 Other Systems Interventions
Incentive spirometry is designed to provide patients with visual or auditory feedback during
deep inspiratory breathing. The device is used to prevent atelectasis in patients status post
abdominal or thoracic surgery. Patients should use the spirometer minimally once every two
hours, however, often use the device with greater frequency. (Frownfelter p. 755)
80. Answer: 4 Cardiac, Vascular, and Pulmonary Systems Foundations for Evaluation,
Differential Diagnosis, and Prognosis
Respiratory acidosis is a condition resulting from ventilatory impairment and subsequent
retention of carbon dioxide. Respiratory acidosis can result from pathologies that decrease
the efficiency of the respiratory system such as neoplasm, chronic obstructive pulmonary

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disease, and pneumonia. Signs and symptoms of respirtaory acidosis include anxiety,
restlessness, dyspnea, headache, and confusion. (Goodman - Differential Diagnosis p. 149)
81. Answer: 2 Cardiac, Vascular, and Pulmonary Systems Clinical Application of Foundational
Sciences The pulse of the ulnar artery can be
palpated proximal to the pisiform bone on the anterior aspect of the ulna, immediately prior
to the artery crossing the wrist. (Hoppenfeld p. 80)
82. Answer: 2 Musculoskeletal System Examination
During the transition from midstance through toe off the hip should be
positioned in 10-15 degrees of hip extension. A hip flexion contracture would be observed
most easily during this stage of the stance phase. (Magee p. 681)
83. Answer: 1 Other Systems Examination
Wrist extensors such as the extensor carpi radialus longus are often used to determine the
integrity of the C6 spinal level. ASIA standards state that the wrist extensors are tested to
determine the integrity of the C6 spinal level. (Umphred p. 4)
84. Answer: 2 Non-Systems Equipment & Devices; Therapeutic Modalities
Even though a rigid frame is typically more cumbersome and heavier, it is usually more
energy efficient. This is due to the chair's ability to be aligned more precisely (i.e., fewer
moving parts resulting in less energy loss) allowing for less rolling resistance during use. The
therapist would have to weigh all factors, however, before choosing this style since the
patient's strength is significantly compromised due to the level of injury. (Tan p. 300)
85. Answer: 1 Musculoskeletal System Foundations for Evaluation, Differential Diagnosis, and
Prognosis Congenital muscular torticollis presents with unilateral shortening of the
sternocleidomastoid muscle characterized by lateral flexion of the neck towards the
shortened muscle and rotation of the head and neck to the opposite side. The exact etiology
is unknown; conservative management consists of stretching and strengthening exercises as
well as handling and positioning techniques. (Tecklin p. 393)
86. Answer: 4 Integumentary System Interventions
Elastic support should be worn between 23-24 hours each day for approximately 12-18
months in order to prevent hypertrophic scarring. A physical therapist must take
circumferential measurements every 1.5 inches throughout the affected area in order to
ensure the proper fit of the custom pressure garment. Garments must be relatively tight in
order to supply the constant pressure necessary to eliminate hypertrophic scarring of the
burn site. (O'Sullivan p. 864)
87. Answer: 2 Non-Systems Equipment & Devices; Therapeutic Modalities
A dynamic splint is a type of orthosis that provides a method to control the direction and
amount of motion within affected joints usually through rubber bands, wires or springs. It is
most often used as an intervention to restore range of motion deficits. A corrective splint
can also be used to restore range of motion, but would not typically employ an externally
applied force like the dynamic splint. (Rothstein p. 762)
88. Answer: 1 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
A CVA to the middle cerebral artery will typically present with aphasia, homonymous
hemianopsia, motor hemiplegia, unilateral neglect and/or apraxia. Specific impairments are
based upon the effected hemisphere (dominant versus non-dominant) and specific
structures of the brain involved in the infarct. (Umphred p. 745)
89. Answer: 4 Neuromuscular and Nervous Systems Examination
The tibialis posterior reflex is a deep tendon reflex that examines the integrity of the L4-L5
spinal level. A normal response elicits plantar flexion and ankle inversion. A decreased
response could indicate lower motor neuron pathology where a heightened response may
indicate upper motor neuron pathology, electrolyte imbalance or metabolic impairments.
(Paz p. 296)

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90. Answer: 1 Non-Systems Equipment & Devices; Therapeutic Modalities


Patients wearing dentures should keep their dentures in place during traction since dentures
help maintain alignment of the temporomandibular joints. The therapist may elect to utilize
an occipital halter to provide additional support. (Cameron p. 317)
91. Answer: 4 Musculoskeletal System Interventions
Bridging occurs when a patient in hooklying lifts their buttocks and low back
from a fixed surface. This activity can be used to facilitate pelvic motion and to strengthen
the hip extensors. Isometric gluteal sets are an appropriate precursor to bridging since the
activity incorporates isometric strengthening of the hip extensors. (Kisner p. 80)
92. Answer: 3 Neuromuscular and Nervous Systems Examination
The patient should be asked to maintain the described position for one minute. A positive
test is identified by paresthesias in the thumb, index finger, middle finger, and the lateral
half of the ring finger. This finding often indicates median nerve compression and the
presence of carpal tunnel syndrome. (Rothstein p. 159)
93. Answer: 3 Musculoskeletal System Interventions
Isometric exercise does not involve a change in muscle length and is
therefore considered less aggressive than many other forms of exercise. Isometric exercise
at the shoulder often includes a progression that begins with the arm at the side and then
advances to more challenging degrees of flexion or abduction. The exercises must be
performed without placing the shoulder at significant risk for dislocation. (Kisner p. 80)
94. Answer: 1 Musculoskeletal System Examination
The posterior sag test is performed with the patient positioned in supine
with the knee flexed to 90 degrees and the hip flexed to 45 degrees. A positive test is
indicated by the tibia sagging back on the femur and may be indicative of a posterior
cruciate ligament injury. (Magee p. 704)
95. Answer: 1 Cardiac, Vascular, and Pulmonary Systems Examination
The estimate of systolic blood pressure occurs when the artery is fully occluded and the
therapist can no longer detect a pulse. Once the estimate of the systolic blood pressure is
obtained the blood pressure cuff is inflated an additional 15-20 mm Hg above the obtained
value. The therapist then releases the pressure gradually at a rate of 2-3 mm Hg per second
in order to obtain the actual systolic and diastolic blood pressure values. (Pierson p. 58)
96. Answer: 2 Cardiac, Vascular, and Pulmonary Systems Interventions
Avoiding the Valsalva maneuver (i.e., contraction of the muscles of the abdomen, chest wall,
and diaphragm in a forced expiratory effort against a closed glottis) is particularly important
in patients with a history of heart disease and hypertension. The abrupt increase in blood
pressure associated with this maneuver may be dangerous in these patients. To avoid the
Valsalva maneuver, it is recommended to exhale during the more strenuous phase of the lift
and inhale during the less strenuous phase of the lift. For example, exhale while performing
the flexion phase of a biceps curl and inhale while lowering the weight. (American College of
Sports Medicine p. 158)
97. Answer: 3 Musculoskeletal System Clinical Application of Foundational Sciences
Approximately 60 degrees of knee flexion is required at the end of initial
swing. Less than 60 degrees of knee flexion would result in one or more substitutions or
compensations. (Levangie p. 448)
98. Answer: 2 Musculoskeletal System Foundations for Evaluation, Differential Diagnosis, and
Prognosis A transphalangeal amputation, also known as a toe disarticulation, is
performed at the metatarsophalangeal joint. This type of amputation of the great toe affects
push-off especially during fast walking or running. Shoe fillers and other shoe modifications
may assist to decrease impairments during gait. (Seymour p. 28)

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99. Answer: 4 Neuromuscular and Nervous Systems Examination


Sensory testing for light touch is performed by applying a piece of cotton to selected
dermatomes and asking the patient when the sensation is perceived. (Hertling p. 85)
100. Answer: 3 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
Failure to use "people-first" language reinforces emotional detachment and
places the emphasis on the patient's disability rather than her abilities. Acknowledging the
patient and their individuality is part of the therapeutic process. It is recommended that the
therapist use empowering language as opposed to diminishing language when speaking
about patients. (Drench p. 7)
101. Answer 4 Other Systems Interventions
Initial treatment would focus on postural control and strengthening in positions such as
plantigrade where all extremities are weight bearing. The patient should have a reasonable
ability to maintain balance in this position. The position would allow the therapist to
effectively administer rhythmic stabilization as an intervention to promote enhanced
stability. (Sullivan p. 67)
102. Answer: 1 Non-Systems Equipment & Devices; Therapeutic Modalities
Electrical stimulation is contraindicated for patients with cardiac pacemakers since it has
been found to interfere with pacemaker activity. It may lead to arrhythmias that include
asystole or ventricular fibrillation. (Robinson p. 145)
103. Answer: 2 Other Systems Clinical Application of Foundational Sciences
Effects associated with extended bed rest include a measurable decrease in strength,
cardiovascular function, total blood volume, orthostatic tolerance, exercise tolerance, and
bone mineral density. (Kisner p. 152)
104. Answer: 4 Integumentary System Interventions
Eating a well balanced diet that is high in protein, vitamins, and minerals can accelerate the
healing process and protect the skin from further breakdown. Repositioning in bed should
occur at least every 2 hours. Massage should be avoided over any bony prominence,
however may occur in the surrounding area. Doughnut rings are contraindicated for people
at risk for breakdown because the ring itself places extra pressure on the areas of contact.
(Anderson p. 1318)
105. Answer: 4 Neuromuscular and Nervous Systems Examination
The Moro reflex occurs in response to a sudden change in position of the head in relation to
the trunk, as when an infant is dropped backward from a sitting position. The infant will
extend and abduct her extremities, with hands opening, and then flex and adduct her arms
across her chest. The onset of the Moro reflex is 28 weeks of gestation. The Moro reflex is
typically integrated at approximately 5-6 months. (Rothstein p. 688)
106. Answer: 2 Cardiac, Vascular, and Pulmonary Systems Interventions
Even though interviews or surveys do not require physical interaction between the subjects
and researcher, the studies must go through a formal review and approval by an institutional
review board (IRB). Researchers must demonstrate that participation will not put the
subjects at risk for psychological harm and guarantee the confidentiality of the information.
A cover letter should explain the purpose of the study, how the patient was selected,
reassurance that the survey will be anonymous, suggest how long it will take to complete,
provide a deadline for returning the survey, etc. Consent is implied by returning the
completed survey or questionnaire. A separate consent form is not needed. (Portney p. 291)
107. Answer: 2 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
A patient with a complete C6 spinal cord lesion will have the following muscles innervated:
biceps, deltoids, extensor carpi radialis, infraspinatus, latissimus dorsi, pectoralis major
(clavicular portion), pronator teres, serratus anterior, teres minor. The muscles collectively

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allow for independent bed mobility and in many cases independent transfers. (O'Sullivan p.
898)
108. Answer: 3 Other Systems Examination
To test the piriformis muscle, the hip should be flexed to approximately 60 degrees with the
knee flexed. If the muscle is tight, pain will occur when a downward pressure is applied to
adduct the lower extremity. (Magee p. 634)
109. Answer: 1 Other Systems Foundations for Evaluation, Differential Diagnosis, and Prognosis
A patient with C3 tetraplegia would have paralysis of the muscles of
inspiration and would generally require artificial ventilation. As a result, the patient would
be extremely susceptible to respiratory complications. (Goodman-Pathology p. 1091)
110. Answer: 1 Musculoskeletal System Interventions
A stretch that requires pulling the arms and elbows back while
maintaining the leg in an extended position serves to stretch the gastrocnemius and soleus.
Strengthening would not be possible since the ankle is passive during the described activity.
(Kisner p. 210)
111. Answer: 3 Cardiac, Vascular, and Pulmonary Systems Interventions
The diaphragm and intercostals are the normal muscles of quiet inspiration. When
evaluating a patient's breathing pattern, the use of accessory muscles during quiet breathing
should be noted and the patient instructed in relaxation of the accessory muscles to
decrease the work of breathing. (Frownfelter p. 392)
112. Answer: 1 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
A physical therapist assistant can modify the
parameters of an existing intervention within the established plan of care. Increasing the
amount of weight on a resistive exercise would therefore be an appropriate action for the
physical therapist assistant. (Guide to Physical Therapist Practice p. 42)
113. Answer: 2 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
The legal standard of care for a community is based on minimally
acceptable practice for all practitioners, regardless of degree level or number of years in
practice. (Scott - Health Care Malpractice p. 26)
114. Answer: 4 Other Systems Interventions
The relaxation response is mediated via the autonomic nervous system in response to
various stimuli including meditation. Stress management activities reduce the effects of the
sympathetic nervous system and enhance the effects of the parasympathetic system.
(Drench p. 133)
115. Answer: 3 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
This response not only addresses the patient's concern about his future, but also
acknowledges the patient's fear. Additionally, the information provided regarding outcome
is realistic and will likely provide the patient with hope. Although a psychology consult may
be warranted, the therapist should provide the patient with some information regarding
outcome. (Umphred p. 394)
116. Answer: 4 Musculoskeletal System Interventions
A grade I acromioclavicular sprain often results in point tenderness and
mild discomfort during selected portions of shoulder range of motion. There is no deformity
present with only mild stretching of the supporting ligaments. As a result immobilization
would not typically be warranted. (Arnheim p. 564)
117. Answer: 3 Cardiac, Vascular, and Pulmonary Systems Clinical Application of Foundational
Sciences Diuretics are commonly used to treat patients
with congestive heart failure since the primary mechanism of action is to increase the
formation and excretion of urine. (Ciccone p. 366)

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118. Answer: 3 Musculoskeletal System Interventions


Flexion and extension occur in a sagittal plane around a medial-lateral axis.
(Levangie p. 4)
119. Answer: 4 Cardiac, Vascular, and Pulmonary Systems Foundations for Evaluation,
Differential Diagnosis, and Prognosis
A pulmonary embolism results from a blood clot or thrombus that travels from a systemic
vein through the right side of the heart into the pulmonary circulation. The blood clot or
thrombus eventually lodges in the pulmonary artery or one of its branches. (Hillegass p. 218)
120. Answer: 2 Cardiac, Vascular, and Pulmonary Systems Interventions
Vibration is an airway clearance technique used in conjunction with postural drainage. The
technique should be performed while the patient exhales following a deep inspiration.
Vibration often causes the patient to produce a more effective cough. (Hillegass p. 651)
121. Answer: 4 Other Systems Examination
Rating of perceived exertion provides a subjective measure of exercise intensity. Selected
levels of perceived exertion using Borg's ten point scale: 0 - nothing, 3 - moderate, 5 - strong,
7 - very strong, 10 - very, very strong. Heart rate would not be an appropriate method to
monitor exercise intensity due to the fixed rate pacemaker. Blood pressure and respiration
rate are often monitored during exercise, however do not provide a measure of exercise
intensity. (Brannon p. 319)
122. Answer: 2 Neuromuscular and Nervous Systems Examination
Lesions in the parietal lobe typically result in contralateral loss of selective discriminative
sensation such as agraphesthesia, astereognosis, and two-point discrimination. (DeMyer p.
512)
123. Answer: 3 Non-Systems Equipment & Devices; Therapeutic Modalities
An average adult size wheelchair has the following dimensions: Seat width = 18 inches, seat
depth = 16 inches, back height = 16-16.5 inches, armrest length = 9 inches above the chair
seat, seat height/leg length = 19.5-20.5 inches. (Pierson p. 168)
124. Answer: 2 Musculoskeletal System Examination
The primary action of the supinator muscle is to supinate the forearm. The muscle is
innervated by the radial nerve (C5, C6, C7). The modified supinator test (shown above) is
designed to place the biceps in a shortened position and as a result can often be useful as a
tool for differential diagnosis. (Kendall p. 265)
125. Answer: 3 Other Systems Foundations for Evaluation, Differential Diagnosis, and Prognosis
A small amount of blood backed up in an I.V. line is not
an abnormal occurrence. By repositioning the peripheral I.V. line normal flow can often be
re-established. (Pierson p. 287)
126. Answer: 2 Neuromuscular and Nervous Systems Examination
Ankle clonus can be detected by sudden passive dorsiflexion of the ankle. Clonus is the rapid
alternating muscle contraction and relaxation that occurs with damage to pyramidal
pathways. (Berkow p. 1269)
127. Answer: 3 Other Systems Examination
The approximate percentage of normal vital capacity for patients with spinal cord injuries
from C3-C6 is approximately 20-30%. A spirometer consists of a ball in a container of water
that is displaced when a patient inhales and exhales into a tube that is connected to the
spirometer device. The movement is electrically recorded and converted to a value based on
the patient's age and size. A patient with a C6 spinal cord injury would lack abdominal,
intercostal, and trunk musculature. This along with poor posture contributes to impaired
overall ventilatory capacity. Vital capacity can be used as a baseline measurement in the
overall degree of respiratory weakness. (O'Sullivan p. 893)
128. Answer: 4 Cardiac, Vascular, and Pulmonary Systems Examination
The ankle-brachial index (ABI) is determined by dividing the systolic pressure of the lower

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extremity by the systolic pressure of the upper extremity. As a result, a relative increase in
the systolic pressure of the lower extremity would tend to produce a larger ABI value. A
patient with arterial insufficiency would have an ABI significantly below 1.0. An upper
extremity pressure of 160 mm Hg would result in an ABI value of .68. (Meyers p. 210)
129. Answer: 4 Non-Systems Equipment & Devices; Therapeutic Modalities
Deep heating of the piriformis would necessitate using a frequency of 1 MHz. A treatment
area twice the size of the ultrasound's effective radiating area can be effectively covered in
5-10 minutes, therefore 8 minutes would be sufficient to adequately heat the target area.
(Cameron p. 211)
130. Answer: 3 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
Decerebrate rigidity is characterized by rigid extension of the neck, trunk and all four
extremities as well as medial rotation and adduction of the limbs. (Lundy-Ekman p. 197)
131. Answer: 2 Neuromuscular and Nervous Systems Interventions
Anterior interosseous syndrome is characterized by weakness of the flexor pollicis longus,
pronator quadratus, and flexor digitorum profundus. Patients are often unable to pinch tip
to tip or flex the distal interphalangeal joints of the index finger and thumb. (Rothstein p.
251)
132. Answer: 3 Cardiac, Vascular, and Pulmonary Systems Interventions
There are multiple criteria for termination of an exercise session. An excessive increase in
blood pressure (a systolic pressure >220 mm Hg or a diastolic pressure > 110 mm Hg)
requires cessation of the session. Other causes include a drop in heart rate > 10 beats per
minute with no change in workload, light headedness, dyspnea, onset of angina, ST
displacement of 3 mm from the resting value, and/or multifocal PVCs. (American College of
Sports Medicine p. 127)
133. Answer: 2 Other Systems Examination
A visual analog scale is a one-dimensional scale that routinely consists of a 10 centimeter
line with anchors on either end indicating "no pain" and "worst pain possible." The patient is
asked to place a strike mark along the line to identify their current level of pain. The visual
analog scale is easy to use, produces immediate information, and can also reassess the
patient's pain level during treatment or on a regularly established timeframe. This scale may
not be reliable with children under eight years of age or with a person that is cognitively
impaired. (Tan p. 611)
134. Answer: 4 Musculoskeletal System Clinical Application of Foundational Sciences
The humeroradial joint consists of the convex capitulum of the humerus
articulating with the concave radial head of the radius. The resting position of the joint is full
extension and supination. The therapist may use distraction, dorsal and/or volar glides to
increase range of motion depending on the patient's identified restriction. (Kisner p. 236)
135. Answer: 3 Other Systems Foundations for Evaluation, Differential Diagnosis, and Prognosis
White blood cell count refers to the number of
white blood cells per milliliter of blood. White blood cell count is commonly used to identify
the presence of infection, allergens, bone marrow integrity or the degree of
immunosuppression. An increase in white blood cell count can also occur after hemorrhage,
surgery, coronary occlusion or malignant growth. (Pierson p. 285)
136. Answer: 2 Musculoskeletal System Interventions
The dependent squat pivot transfer is used to transfer a patient who cannot stand
independently, but can bear some weight through the trunk and lower extremities. (Pierson
p. 140)
137. Answer: 1 Integumentary System Interventions
Granulation tissue refers to pink, fleshy projections that form during the healing process.
This type of tissue consists of a large number of capillaries surrounded by fibrous collagen.

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Since the granulation tissue is associated with normal healing the treatment goal would be
to protect the wound and maintain a moist environment. (Sussman p. 37)
138. Answer: 2 Integumentary System Foundations for Evaluation, Differential Diagnosis, and
Prognosis 0 Patients with burns impacting the elbow are extremely
susceptible to elbow flexion and forearm pronation deformities. As a result, physical therapy
management often includes improving elbow extension and forearm supination range of
motion. (O'Sullivan p. 861)
139. Answer: 3 Neuromuscular and Nervous Systems Interventions
The D2 flexion pattern begins with the arm in extension, adduction, and medial rotation. The
patient moves the entire arm into flexion, abduction and lateral rotation. The patient may
increase the difficulty of this exercise by incorporating resistance using tubing, weights,
theraband or manual resistance. (Kisner p. 382)
140. Answer: 3 Neuromuscular and Nervous Systems Interventions
Examples of inhibitory sensory stimulation techniques include prolonged stretch, deep
pressure, and warmth. Examples of facilitory techniques include quick stretch, tapping, and
approximation. (O'Sullivan p. 405)
141. Answer: 2 Neuromuscular and Nervous Systems Examination
Cranial nerve II (optic) is often assessed by positioning a patient in standing a selected
distance from a chart or diagram. The therapist asks the patient to identify objects or read
selected items from the chart or diagram. A positive test may be indicated by an inability to
identify objects at a reasonable distance. (O'Sullivan p. 189)
142. Answer: 2 Non-Systems Equipment & Devices; Therapeutic Modalities
The temperature range for the hydrocollator unit should be 158-167 degrees Fahrenheit.
180 degrees Fahrenheit is too hot and places the patient at risk for being burned. (Cameron
p. 168)
143. Answer: 2 Musculoskeletal System Interventions
An incline bench press places the patient's torso on an incline with the head positioned
higher than the buttocks. This modification of the traditional bench press emphasizes the
upper fibers (clavicular portion) of the pectoralis major. The upper fibers of the pectoralis
major are innervated by the lateral pectoral nerve. (Kendall p. 276)
144. Answer: 1 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
Abnormally high resistance to passive stretch is characteristic of hypertonia (increased
muscle tone). Muscle tone refers to the amount of tension in resting muscle and therefore
can only be accurately assessed using passive range of motion. (Lundy-Ekman p. 195)
145. Answer: 1 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
Amyotrophic lateral sclerosis is a progressive syndrome marked by muscular weakness and
atrophy with spasticity and hyperreflexia due to degeneration of the motor neurons of the
spinal cord, medulla, and cortex. The disease is commonly referred to as Lou Gehrig's
disease and is far more common in men than women. (Physical Therapist's Clinical
Companion p. 207)
146. Answer: 2 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
The normal distribution is a particular type of frequency distribution.
The normal curve is smooth, symmetrical, and bell-shaped with most of the scores in the
middle of the scale (near the mean) and progressively fewer at the extremes. Because of
these standard properties, it is possible to determine the areas under the curve represented
by the standard deviation. It is known that approximately 34% (34.13%) of the area under
the normal curve is bounded by the mean and 1 standard deviation above or below the
mean. Thus, approximately 68% of heights (68.26%) will be within ± 1standard deviation
from the mean. Because 62.5 inches and 67.5 inches represent the heights within ±

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1standard deviation from 65 inches, approximately 68% is the correct answer. (Portney p.
381)
147. Answer: 2 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
The subjective section of a S.O.A.P. note typically contains information
received from the patient that is relative to their condition. The statement "hip hiking
reproduces pain" may be a more appropriate entry in the objective section of the note.
(Kettenbach p. 31)
148. Answer: 3 Integumentary System Interventions
A wound classified as "yellow" is indicative of slough. As a result the slough should be
removed and the exudate absorbed. "Red" is indicative of granulation tissue and "black" is
indicative of eschar. (Sussman p 148)
149. Answer: 2 Musculoskeletal System Interventions
Grade II oscillations are large amplitude oscillations performed at the beginning of the range
of motion. This type of mobilization can be used to reduce pain by stimulating
mechanoreceptors and to maintain available range of motion. (Kisner p. 224)
150. Answer: 2 Integumentary System Foundations for Evaluation, Differential Diagnosis, and
Prognosis A stage I ulcer is often characterized by nonblanchable erythema of
intact skin. A stage II ulcer is characterized by complete loss of the epidermis and a portion
of the dermis and may present as a blister or abrasion. (Sussman p. 88)
151. Answer: 1 Musculoskeletal System Foundations for Evaluation, Differential Diagnosis, and
Prognosis Clinical symptoms of Legg-Calve-Perthe's disease may include hip pain,
limitations of hip abduction and medial rotation, referred knee pain, and an antalgic gait.
Legg-Calve-Perthe's disease most often occurs in boys between the ages of 3 and 11. The
diagnosis is confirmed through radiographic imaging. (Salter p. 346)
152. Answer: 1 Non-Systems Equipment & Devices; Therapeutic Modalities
Placement of electrodes over the carotid sinus is an absolute contraindication for
electrotherapy since the current may interfere with the regulation of blood pressure and
cardiac contractility. (Cameron p. 237)
153. Answer: 2 Musculoskeletal System Examination
The iliopsoas is a primary hip flexor and its length can be assessed using the Thomas test. A
positive test for tightness of the right iliopsoas would result in the right leg failing to remain
flat on the testing surface or an increase in lumbar lordosis with the left leg flexed to the
chest. (Kendall p. 33)
154. Answer: 2 Neuromuscular and Nervous Systems Interventions
Since overheating can result in a temporary increase in the symptoms of multiple sclerosis,
exercise in a cool water pool is recommended. (Umphred p. 613)
155. Answer: 2 Other Systems Interventions
The most effective intervention would provide the patient with relief from her current
symptoms. Static splints are the best treatment option to provide long-term relief. The
patient's symptoms are consistent with carpal tunnel syndrome which is common in patients
during the late stages of pregnancy due to pregnancy induced physiologic changes. (Pauls p.
676)
156. Answer: 3 Other Systems Foundations for Evaluation, Differential Diagnosis, and Prognosis
The presence of arterial insufficiency, as indicated
by the ABI value (less than .7), precludes the use of compression stockings in patients with
venous insufficiency ulcers. (Sussman p. 242)
157. Answer: 3 Other Systems Foundations for Evaluation, Differential Diagnosis, and Prognosis
The presence of arterial insufficiency, as indicated by the ABI value (less
than .7), precludes the use of compression stockings in patients with venous insufficiency
ulcers. (Sussman p. 242)

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158. Answer: 3 Non-Systems Safety & Professional Roles; Teaching/Learning; Research


Incidence quantifies the number of new cases of a condition in the
population during a specified time, and therefore, is an estimate of the risk of developing
the condition during that time. However, because the length of each patient's
hospitalization will be different, the incidence rate is calculated. When the length of the
follow-up period is not uniform, as in the example, the incidence rate is calculated as the
number of new cases of a disorder or condition divided by the total time of observation for
all individuals in the population during the study time frame (total person-time). Incidence
rate allows for inclusion of all patients who developed decubitus ulcers in the hospital,
regardless of how long each patient was hospitalized. The distractors are all statistics used
for different purposes than estimating risk. The coefficient of determination (r2) is the
square of the correlation coefficient (r) and is calculated in regression analyses. It refers to
the percent of the total variance in the dependent variable Y that can be explained by the
variable X. Therefore, it indicates the accuracy of predicting Y based on X. The intraclass
correlation coefficient is an index of reliability that reflects both degree of correspondence
(correlation) and agreement (differences) among scores. The coefficient of variation (CV) is a
measure of variability used to describe data on the interval or ratio scale. CV is the ratio of
the standard deviation to the mean, expressed as a percentage. (Portney p. 322)
159. Answer: 4 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
If a behavioral objective or short-term goal lacks the ability to observe a
behavior or action, it cannot be measured. If a therapist cannot measure the goal or
objective, the therapist cannot conclude whether or not the goal or objective has been
achieved. Goals that use verbs such as "feel", "know" or "understand" cannot be observed
or measured. Action verbs should always be used to insure well-written objectives. (Shepard
p. 233)
160. Answer: 3 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
Functional limitations are limitations or restrictions in a person's ability to
perform a physical action due to an impairment. (Guide to Physical Therapist Practice p. 22)

161. Answer: 3 Non-Systems Safety & Professional Roles; Teaching/Learning; Research


The mode is the score or value that occurs most frequently in a
distribution of scores. Type of medical diagnosis is a variable on the nominal level of
measurement. For data on the nominal scale, only the mode is meaningful. The nominal
level of measurement applies to data that consist of names, labels or categories only. It is
not possible to obtain a mean, weighted mean or median for data at the nominal level.
(Portney p. 372)
162. Answer: 4 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
Central cord syndrome is an incomplete lesion that usually results from compression and
damage to the central portion of the spinal cord. The somatotopic organization of the tracts
is such that the medial or inner portion of the tracts represent the cervical nerves. Thus, the
patient can be expected to have more difficulty performing tasks that require use of the
upper extremities. Motor deficits are also greater when compared to sensory deficits with
this syndrome. (Paz p. 311)
163. Answer: 4 Cardiac, Vascular, and Pulmonary Systems Examination
Crackles are discontinuous, abnormal lung sounds more commonly heard during inspiration.
Crackles can result from the movement of secretions during inspiration and expiration or
with the reopening of a closed airway. (Hillegass p. 627)
164. Answer: 2 Musculoskeletal System Clinical Application of Foundational Sciences
The pincer grasp occurs when picking up an object between the thumb and midventral

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surface of the index finger. With this type of grasp the thumb's proximal joint is extended,
while the distal joint is slightly flexed and opposed to the index finger. (Magee p. 337)
165. Answer: 1 Non-Systems Equipment & Devices; Therapeutic Modalities
Sensitivity reactions to ions are relatively rare, but can be extremely serious. As a result, the
therapist should discontinue treatment and document the relevant findings. The patient's
skin should be inspected before, during, and after treatment with iontophoresis. (Prentice-
Therapeutic Modalities p. 75)
166. Answer: 3 Neuromuscular and Nervous Systems Interventions
Controlled mobility is the third stage of motor control and is defined as movement or weight
shifting in weight bearing postures or expressed slightly differently where proximal
segments move over a distal weight bearing part. Rotation is emphasized around the
longitudinal axis during movement and control should be attained first within a small range
and gradually expanded as warranted based on the patient's response. (Sullivan p. 77)
167. Answer: 3 Musculoskeletal System Clinical Application of Foundational Sciences
Anteversion of the hip is measured by the angle made by the femoral neck
with the femoral condyles. Anteversion is typically greatest at birth (30 degrees) and
gradually decreases (8-15 degrees) by the time an individual becomes an adult. As a result
an 11-year-old female would be the most likely to have the greatest amount of anteversion.
(Magee p. 621)
168. Answer: 2 Non-Systems Equipment & Devices; Therapeutic Modalities
The Jewett orthosis provides three points of pressure that facilitate a hyperextended
posture. Posterior forces are directed through the sternal and suprapubic pads while the
anterior force is directed through the thoracolumbar pad. (Seymour p. 438)
169. Answer: 2 Neuromuscular and Nervous Systems Examination
There are two types of coordination testing, equilibrium and non-equilibrium. Equilibrium
testing measures the static and dynamic components of posture when the patient is upright.
The Romberg, single leg stance, tandem stance, walking, walking - heel to toe, and marching
in place are all equilibrium tests. Non-equilibrium testing measures the static and dynamic
components of posture when the body is not in an upright posture. These tests include
finger to nose, pronation/supination, and heel to knee. (O'Sullivan p. 164)
170. Answer: 2 Non-Systems Equipment & Devices; Therapeutic Modalities
Functional electrical stimulation can be utilized with patients status post stroke that have
minimal to no active movement in the upper extremity and subluxation in the shoulder joint.
Positioning the electrodes over the posterior deltoid and the supraspinatus will assist with
the realignment of the joint. (O'Sullivan p. 562)
171. Answer: 2 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
Upper motor neuron lesions are characterized by hyperactive deep tendon reflexes, clonus,
hypertonia, and mild disuse atrophy. Lower motor neuron lesions are characterized by
fasciculations, hypoactive deep tendon reflexes, and hypotonia. (DeMyer p. 333)
172. Answer: 3 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
Management of shock commonly includes elevating the legs to promote
increased circulation to the vital organs. The modified Trendelenburg position is
characterized by raising the lower extremities without lowering the head and is therefore
consistent with the positional management of shock. (Anderson p. 1575)
173. Answer: 4 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
Guillain-Barre usually peaks at its greatest point of severity between one and two weeks
from onset. If the patient was discharged home by day ten and peaked with only moderate
involvement of the lower extremities without the need for ventilatory support; they are

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likely to have a significant recovery with only residual to no permanent loss of function.
(Umphred p. 387)
174. Answer: 3 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
Spinal shock is a period of areflexia that occurs immediately after a spinal cord injury. This
phenomenon is not fully understood, but is believed to occur from the unexpected
disconnection between the spinal cord and higher centers of the brain. If the
bulbocavernosus reflex resumes without accompanying motor or sensory return, it is likely
that the injury to the cord is a complete lesion. (O'Sullivan p. 877)
175. Answer: 3 Neuromuscular and Nervous Systems Examination
The ascending reticular activating system within the brainstem acts on the cortex to control
the state of consciousness and wakefulness of a person. The levels are defined as
consciousness, lethargy, obtundity, stupor, coma, vegetative and persistent vegetative
states. Stuporous describes a state of semiconsciousness with minimal to no voluntary
motor responses; often requiring arousal by strong stimuli such as a pinch or loud noise.
(Lundy-Ekman p. 345)
176. Answer: 4 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
Myasthenia gravis is a pathological process of the neuromuscular junction and although
etiology is unknown, in most cases it is considered an autoimmune disease process.
Weakness and significant fatigue occurs, most often in the ocular and facial muscles. EMG
testing often initially appears to be normal and then will progressively decrease in amplitude
with each repetition. Myasthenia gravis may be remitting, static or progressive in its course.
(Langford p. 328)
177. Answer: 2 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
The law of specificity states that the
specific nature of a training load produces its own specific responses and adaptations. In
other words, specific resistive activities require very unique patterns of joint and muscle
coordination. Whenever possible exercises incorporated in a training program should mimic
the anticipated function. (Kisner p. 61)
178. Answer: 4 Cardiac, Vascular, and Pulmonary Systems Foundations for Evaluation,
Differential Diagnosis, and Prognosis
Congestive heart failure is characterized by an inability of the heart to adequately deliver
oxygenated blood to tissue. Specifically, the heart cannot eject a sufficient stroke volume
during ventricular systole. Signs and symptoms of congestive heart failure include peripheral
edema, dyspnea, tachypnea, orthopnea, cyanotic extremities, and weight gain due to fluid
retention. (Hillegass p. 106)
179. Answer: 1 Neuromuscular and Nervous Systems Examination
The vestibular system reports information to the brain regarding the position and movement
of the head with respect to gravity and inertia. The vestibular system maintains clear vision
during head motion and generates postural reflexes to assist with balance. Testing of the
vestibular system often includes perturbations that require the body to make automatic
adjustments that restore normal alignment. (Goodman-Pathology p. 1137)
180. Answer: 1 Musculoskeletal System Examination
The medial collateral ligament (MCL) connects the medial epicondyle of
the femur to the medial tibia and as a result resists medially directed force at the knee. The
MCL is the primary stabilizer of the medial side of the knee against valgus force. A grade I
MCL sprain is characterized by mild pain and swelling with little to no disruption of the
ligament. Valgus stress testing will likely be painful given the acuity of the injury, however,
rarely reveals detectable instability. (Hertling p. 349)

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181. Answer: 2 Musculoskeletal System Interventions


The traditional progression of extension activities is from lowest to
highest level is: lie in prone on a firm surface, prone on elbows, prone press-up, extension
exercises in standing. (Prentice - Techniques p. 649)
182. Answer: 1 Musculoskeletal System Clinical Application of Foundational Sciences
End-feel is the type of resistance that is felt when passively moving a
joint through the end range of motion. The patient's body type makes it probable that the
recorded end-feel would be soft due to contact between the soft tissue of the posterior leg
and the posterior thigh during knee flexion. (Norkin p. 8)
183. Answer: 1 Musculoskeletal System Examination
In order to align a goniometer properly it is necessary to first
palpate the appropriate bony anatomical landmarks. Stabilization is a necessary component
of conducting goniometric measurements, however, it is the proximal segment that must be
stabilized and not the distal segment. (Norkin p. 35)
184. Answer: 2 Neuromuscular and Nervous Systems Foundations for Evaluation, Differential
Diagnosis, and Prognosis
Patients with Parkinson's disease often exhibit a festinating gait. This type of gait pattern is
characterized by a patient walking on their toes as though they are being pushed. It starts
slowly, increases, and may continue until the patient grasps an object in order to stop.
(Umphred p. 675)
185. Answer: 4 Other Systems Foundations for Evaluation, Differential Diagnosis, and Prognosis
A nasogastric tube is a plastic tube inserted through a nostril and
extending into the stomach. The device is commonly used for liquid feeding, medication
administration or to remove gas from the stomach. Common complications include an
increased gag reflex and sore throat. (Pierson p. 286)
186. Answer: 3 Neuromuscular and Nervous Systems Examination
The rooting reflex is a primitive reflex that is normally present from 28 weeks of gestation
through three months of age. Stroking the corner of an infant's mouth or simply touching
the cheek often stimulates the reflex. This reflex assists the mother when feeding. (Ratliffe p.
26)
187. Answer: 2 Neuromuscular and Nervous Systems Examination
The biceps reflex (C5-C6) can be assessed by striking the therapist's thumb with a reflex
hammer after it has been positioned over the patient's biceps tendon. A normal response
(2+) would result in slight contraction of the biceps muscle causing a small amount of elbow
flexion. The biceps muscle functions to supinate the forearm, however, the amount of force
generated by the spontaneous contraction would not be adequate to produce marked
supination. (O'Sullivan p. 185)
188. Answer: 1 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
A therapist must obtain informed consent from a legal guardian as the
surrogate decision maker when an adult patient is not competent or when the patient is a
minor. (Scott - Foundations p. 188)
189. Answer: 4 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
The plan section of a S.O.A.P. note typically includes the frequency and
expected duration of physical therapy services. (Quinn p. 124)
190. Answer: 2 Other Systems Foundations for Evaluation, Differential Diagnosis, and Prognosis
A gastric tube is a plastic tube that inserts through the abdomen,
directly into the stomach. Possible uses of the device include removing fluid or gas from the
stomach and gastrointestinal tract, feeding, and obtaining gastric specimens. (Pierson p.
286)

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191. Answer: 2 Non-Systems Equipment & Devices; Therapeutic Modalities


Lidocaine is a local anesthetic that can be utilized with iontophoresis. The primary treatment
objective when utilizing lidocaine is to decrease pain and inflammation. (Cameron p. 236)
192. Answer: 4 Non-Systems Safety & Professional Roles; Teaching/Learning; Research
The concept of correlation is used to describe how pairs of variables (x,y)
go together. A number of different correlation coefficients may be calculated to describe the
strength and direction of a relationship between two variables. Common coefficients include
the Pearson product-moment correlation coefficient (r), used when both X and Y are
continuous variables with normal distributions on the interval or ratio scales, and the
Spearman rank correlation coefficient (rS), used when X and Y are variables on the ordinal
scale. A positive correlation occurs when values of one variable (X) increase in proportion to
values of the second variable (Y). This is the condition described in the question. A negative
correlation describes the relationship between two variables that vary inversely with each
other. That is, larger values of X are associated with lower values of Y. Although the
correlation coefficient can be evaluated for statistical significance, to determine if the
observed value could have occurred by chance, this requires knowing its magnitude, which is
not reported, and a table of critical values for the particular coefficient. There is no
meaningful way to evaluate the clinical importance of the correlation. (Portney p. 491)
193. Answer: 4 Non-Systems Equipment & Devices; Therapeutic Modalities
Peripheralization of spinal symptoms is considered to be a contraindication of spinal
traction. This finding is often associated with impaired nerve function and increased
compression caused by the traction force. Given these symptoms, continuing with traction
would likely result in an aggravation of the patient's already compromised condition.
(Cameron p. 314)
194. Answer: 4 Integumentary System Interventions
Hydrocolloids absorb exudates by swelling into a gel-like mass over time. The dressings
consist of gel forming polymers such as gelatin, pectin, and carboxymethylcellulose with a
strong film or adhesive backing. Due to the strong film or adhesive backing, hydocolloids
often damage fragile periwound skin upon removal. (Sussman p. 261)
195. Answer: 1 Neuromuscular and Nervous Systems Clinical Application of Foundational
Sciences The gastrocnemius would be the first muscle to be activated with
forward sway followed by the hamstrings and then the paraspinals. Since the perturbation is
within the patient's limit of stability the ankle strategy in isolation would likely be sufficient
without employing a hip strategy or stepping strategy. (O'Sullivan p. 194)
196. Answer: 1 Musculoskeletal System Examination
Carpometacarpal abduction occurs in the sagittal plane around a medial-lateral axis.
According to the American Academy of Orthopedic Surgeons normal carpometacarpal
abduction is 0-70 degrees. (Norkin p. 164)
197. Answer: 4 Other Systems Foundations for Evaluation, Differential Diagnosis, and Prognosis
A functional cough is characterized by strong expulsion of air with the
ability to adequately move secretions. A patient with T10 paraplegia has normal vital
capacities and a functional cough secondary to full innervation of the primary muscles of
respiration including the diaphragm, internal intercostals, and external intercostals.
(O'Sullivan p. 878)
198. Answer: 1 Other Systems Foundations for Evaluation, Differential Diagnosis, and Prognosis
The patient's signs and symptoms are consistent with pre-eclampsia. As a
result, it is necessary to consult with the patient's physician as soon as possible. (Kisner p.
703)
199. Answer: 1 Non-Systems Equipment & Devices; Therapeutic Modalities
The seat, back, pelvic belt, upper extremity supports, and foot supports are all important
parts of the postural support system. Increased contact between the user and the support

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surfaces increases comfort and control and decreases pressure over bony prominences. The
upper extremity supports should facilitate upright posture and proper handrim positioning.
The foot supports will directly influence pelvic position, which has a significant influence on
alignment of the spine and lower extremities. (O'Sullivan p. 1066)
200. Answer: 2 Neuromuscular and Nervous Systems Examination
The Landau response is the result of the combined effects of the optical, tonic labyrinthine,
and body righting reflexes which are all considered head righting reactions. The Landau
response does not emerge until an infant is four to six months of age. (Shumway-Cook p.
196)

MCQ-7

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