1.
A patient sustained a deep partial thickness burn to the left forearm. A reduction in the cellular and protein constituents of hypertrophic scarring can be accomplished through
Correct Answer
A. Pressure garments
Explanation
Pressure garments can help reduce the cellular and protein constituents of hypertrophic scarring. These garments apply constant pressure to the affected area, which can help flatten and soften the scar tissue. The pressure helps to improve blood flow and oxygenation to the area, promoting healing and reducing the formation of excessive scar tissue. Additionally, pressure garments can also help to protect the area from further injury or damage, allowing the skin to heal properly. Therefore, the use of pressure garments is an effective method to reduce hypertrophic scarring in burn patients.
2.
A therapist identifies a bluish discoloration of the skin and nail beds of a 55 year-old male referred to physical therapy for pulmonary rehabilitation. What does this objective finding indicate?
Correct Answer
D. Hypoxemia
Explanation
The bluish discoloration of the skin and nail beds, known as cyanosis, is a clinical sign of hypoxemia. Hypoxemia refers to low levels of oxygen in the blood, which can be caused by various respiratory or cardiovascular conditions. In this case, the 55-year-old male being referred to physical therapy for pulmonary rehabilitation may have an underlying respiratory condition that is leading to inadequate oxygenation. This objective finding suggests that the patient may require further medical evaluation and intervention to address the hypoxemia.
3.
A therapist employed in a large medical center reviews the chart of a 63 year-old male referred to physical therapy for pulmonary rehabilitation. The chart indicates the patient has smoked 1-2 packs of cigarettes a day since the age of 25. The admitting physician also documented that the patient’s thorax appeared to be enlarged with flaring of the costal margins and widening of the costochondral angle. What pulmonary disease does the chart most accurately describe?
Correct Answer
D. EmpHysema
Explanation
The chart most accurately describes emphysema. Emphysema is a type of chronic obstructive pulmonary disease (COPD) characterized by the destruction of the alveoli in the lungs. Smoking is a major risk factor for developing emphysema, and the patient's history of smoking 1-2 packs of cigarettes a day since the age of 25 is consistent with this. The enlarged thorax with flaring of the costal margins and widening of the costochondral angle are physical findings commonly associated with emphysema.
4.
A physical therapist positions a patient’s hip in the loose packed position. This position for the hip is
Correct Answer
A. 30o hip flexion, 30o abduction, 5o lateral rotation
Explanation
The correct answer is 30o hip flexion, 30o abduction, 5o lateral rotation. This position is considered the loose packed position for the hip joint. In the loose packed position, the joint surfaces are not under maximum tension, allowing for more mobility and less stress on the joint. This specific position allows for a combination of flexion, abduction, and lateral rotation, which helps to optimize joint movement and reduce discomfort for the patient.
5.
A therapist attempts to obtain information on the ability of noncontractile tissue to allow motion at a specific joint. What selective tissue tension test would provide the therapist with the most valuable information?
Correct Answer
C. Passive range of motion
Explanation
Passive range of motion would provide the therapist with the most valuable information in this scenario. Passive range of motion involves the therapist moving the joint through its full range of motion without the patient's active involvement. By performing this test, the therapist can assess the ability of noncontractile tissues (such as ligaments, joint capsules, and fascia) to allow motion at the specific joint. This can help the therapist determine if there are any restrictions or limitations in the joint's mobility, which can guide the treatment plan and interventions.
6.
A patient reports to her physician complaining of increasing discomfort with activities of daily living. The physician orders x-rays which reveal evidence of osteoporosis with mild subchondral bone destruction. The physician refers the patient to physical therapy for instruction in a home exercise program. The physical therapy evaluation identifies the following general findings.1. absence of specific joint deformity2. limitation in joint mobility3. adjacent muscle atrophy What stage of rheumatoid arthritis best describes this patient’s condition?
Correct Answer
B. Moderate
Explanation
The patient's condition is best described as moderate rheumatoid arthritis based on the given information. The presence of osteoporosis and mild subchondral bone destruction suggests some degree of joint damage. The absence of specific joint deformity indicates that the disease has not progressed to a severe stage. The limitation in joint mobility and adjacent muscle atrophy further support a moderate stage of rheumatoid arthritis.
7.
Physical therapy aides are commonly employed in a variety of physical therapy clinics. Which statement does not accurately describe the American Physical Therapy Association’s prerequisites needed to be employed as a physical therapy aide?
Correct Answer
D. The individual must have successfully completed a formalized program which meets the criteria established by the American pHysical Therapy Association
Explanation
The statement that does not accurately describe the American Physical Therapy Association's prerequisites is "The individual must have successfully completed a formalized program which meets the criteria established by the American Physical Therapy Association." This is because physical therapy aides do not typically require formalized education or training programs. Instead, they usually receive on-the-job training or may have a high school diploma or equivalent.
8.
Limitations of movement at a specific joint often occur in predictable patterns. When a limitation at a given joint falls into a predictable pattern it is often termed capsular. Which of the following patterns is considered to be a capsular pattern of the glenohumeral joint?
Correct Answer
B. Greatest limitation in external rotation, followed by abduction
Explanation
A capsular pattern refers to a specific pattern of limitations in movement at a joint. In the case of the glenohumeral joint, the capsular pattern is characterized by the greatest limitation in external rotation, followed by abduction. This means that when there is a limitation in movement at the glenohumeral joint, external rotation will be the most restricted motion, followed by abduction. This pattern is commonly observed in conditions such as adhesive capsulitis (frozen shoulder), where the joint capsule becomes thickened and tight, leading to these specific movement limitations.
9.
The reliability of goniometric measurements taken by different therapists is measured by interrater reliability. Which joint motion would you expect to have the poorest interrater reliability?
Correct Answer
A. Ankle eversion
Explanation
Ankle eversion would be expected to have the poorest interrater reliability. This is because ankle eversion involves a complex motion that can be difficult to accurately measure and assess. Different therapists may have different techniques or interpretations when measuring ankle eversion, leading to inconsistencies in the measurements taken. In contrast, elbow flexion, knee flexion, and shoulder external rotation are relatively simpler motions that are easier to measure consistently, resulting in higher interrater reliability for these joint motions.
10.
There are a variety of systems used to record goniometric measurements. Using the 0 to 180 system the anatomical position is used for the starting position for all movements EXCEPT
Correct Answer
B. Forearm pronation and supination
Explanation
The correct answer is forearm pronation and supination. In the 0 to 180 system, the anatomical position is used as the starting position for all movements except for forearm pronation and supination. Ankle inversion and eversion, shoulder flexion and extension, and wrist flexion and extension all start from the anatomical position. However, forearm pronation and supination start from a neutral position with the palm facing downwards or upwards, respectively.
11.
A physician instructs a therapist to begin gait training with a patient three days status post cemented total hip replacement. Assuming the patient has not had any significant problems postoperatively, which weight bearing status would be the most probable?
Correct Answer
B. Partial weight bearing
Explanation
After a total hip replacement, it is common for patients to start with partial weight bearing. This means that the patient is allowed to put some weight on the operated leg, but not the full body weight. This is done to protect the healing hip joint and prevent any complications. As the patient progresses and shows no significant problems, they may gradually increase their weight bearing status. Therefore, partial weight bearing is the most probable weight bearing status for a patient three days post cemented total hip replacement.
12.
A physical therapist performs a manual muscle test on a patient with bilateral upper extremity weakness. The therapist should test the patient’s scapular adductors with the patient positioned in
Correct Answer
A. Prone
Explanation
In order to test the patient's scapular adductors, the therapist should position the patient in the prone position. This position allows for a better assessment of the scapular adductors as it isolates the muscles and provides a stable base for testing. It also allows the therapist to observe any compensatory movements or weaknesses that may be present.
13.
A therapist palpates proximally along the second metacarpal. Which carpal bone does not articulate with the second metacarpal?
Correct Answer
B. Hamate
Explanation
The therapist is palpating the second metacarpal, which is one of the bones in the hand. The question is asking which carpal bone does not articulate or connect with the second metacarpal. The correct answer is the hamate. This means that the hamate bone does not directly connect with the second metacarpal bone.
14.
Assuming normal development which of the following activities should a child first accomplish?
Correct Answer
C. Turning from side to supine
Explanation
A child should first be able to turn from side to supine. This means that they are able to move from lying on their side to lying on their back. This is typically one of the earliest motor skills that infants develop, usually around 3-4 months of age. Rolling from prone to supine and rolling from supine to prone usually come later in development, around 5-6 months of age. Turning supine to side is also a later skill, typically seen around 6-7 months of age.
15.
A therapist employed in a nursing home routinely treats patients in excess of 70 years of age. The therapist has noted several consistent postural changes in her patients. Which of the following does not accurately describe the postural changes associated with aging?
Correct Answer
C. Increase in flexion at the atlanto-occipital joint
Explanation
As individuals age, there are several postural changes that occur. One of these changes is the shortening of the trunk flexor muscles, which can lead to a stooped posture. Another change is the lengthening of the trunk extensor muscles, which can result in a decreased ability to maintain an upright posture. Additionally, there is an increase in flexion of the cervical spine, causing a forward head posture. However, the statement that does not accurately describe the postural changes associated with aging is the increase in flexion at the atlanto-occipital joint. This joint allows for nodding movements of the head, and it does not typically experience an increase in flexion with aging.
16.
A therapist orders a wheelchair for a C7 quadriplegic. What type of wheelchair would be the most appropriate for the patient?
Correct Answer
D. Manual wheelchair with standard handrims
Explanation
A C7 quadriplegic refers to an individual with a spinal cord injury at the C7 level, which typically results in some loss of function in the upper and lower extremities. A manual wheelchair would be suitable for this patient as it allows them to have control and independence in their mobility. Standard handrims are appropriate as they provide a basic grip for propulsion. Electric wheelchairs may not be necessary if the patient has sufficient upper body strength and coordination. Handrim projections or friction surface handrims may not be necessary unless the patient requires additional support or assistance in propelling the wheelchair.
17.
A patient is instructed by the nursing staff to increase their dietary consumption of food sources that are rich in vitamin A. Which of the following food groups would be the most appropriate to meet this goal?
Correct Answer
B. Fish liver oils, butter, yellow vegetables
Explanation
Fish liver oils, butter, and yellow vegetables are the most appropriate food sources to increase dietary consumption of vitamin A. Fish liver oils, such as cod liver oil, are one of the richest sources of vitamin A. Butter is also a good source of vitamin A. Yellow vegetables, such as carrots and sweet potatoes, are rich in beta-carotene, which the body converts into vitamin A. Therefore, consuming these food groups would help the patient meet their goal of increasing their vitamin A intake.
18.
A therapist reviews a patient’s medical chart to determine when they were last medicated. The chart indicates the patient received medication at 2300 hours. Assuming it is now 8:00 a.m., how long ago did the patient receive their medication?
Correct Answer
B. 9 hours
Explanation
Based on the information given, the patient received medication at 2300 hours. Assuming it is now 8:00 a.m., we need to calculate the time difference between 2300 hours and 8:00 a.m. To do this, we subtract 8 hours (from 8:00 a.m. to 00:00 hours) from 23 hours, which gives us 15 hours. Therefore, the patient received their medication 15 hours ago, which corresponds to the answer choice of 9 hours.
19.
A patient rehabilitating from a fractured ankle is referred to physical therapy for gait training. The patient is in a short leg cast and is not permitted to bear weight through the involved lower extremity. What gait pattern is the most appropriate for the patient?
Correct Answer
A. Two point gait using axillary crutches
Explanation
The most appropriate gait pattern for a patient rehabilitating from a fractured ankle who is not permitted to bear weight through the involved lower extremity is the two point gait using axillary crutches. This gait pattern involves advancing both crutches and the affected leg together, followed by advancing the unaffected leg. This allows for partial weight-bearing and provides stability and support while walking. The other options, such as three point swing through using Lofstrand crutches or a walker, or four point alternating gait using axillary crutches, may not be suitable for a patient who cannot bear weight on the affected leg.
20.
During an evaluation a male patient tells their therapist they are 160 centimeters tall and weigh 120 kilograms. The patient’s weight would most accurately be classified as
Correct Answer
D. Grossly obese
Explanation
Based on the information provided, the patient's weight of 120 kilograms is extremely high for a height of 160 centimeters. The term "grossly obese" is used to describe individuals who have a significantly higher body weight than what is considered healthy or normal. Therefore, the patient's weight would most accurately be classified as grossly obese.
21.
A therapist attempts to auscultate over the aortic valve. Which of the following areas is the most appropriate to isolate the desired valve?
Correct Answer
B. Second right intercostal space at the right sternal border
Explanation
The aortic valve is best auscultated at the second right intercostal space at the right sternal border. This location corresponds to the area where the aortic valve can be heard most clearly. The other options are not accurate for auscultating the aortic valve.
22.
A therapist presents the results of a research project entitle ”Effects of an Aerobic Exercise Program on Heart Rate and Blood Pressure”. The independent variable in the therapist’s study is
Correct Answer
A. Exercise program
Explanation
In this research project, the therapist is studying the effects of an aerobic exercise program on heart rate and blood pressure. The independent variable is the exercise program because it is the variable that the therapist is manipulating or controlling. The therapist will be implementing and controlling the exercise program, while measuring its effects on heart rate and blood pressure, which are the dependent variables.
23.
A therapist completes a pulmonary function test on a patient admitted to the hospital three days ago. Assuming normal values, the patient’s residual volume should be approximately ____ percent of the patient’s total lung capacity?
Correct Answer
B. 25
Explanation
The patient's residual volume should be approximately 25% of their total lung capacity. Residual volume refers to the amount of air that remains in the lungs after a person exhales as much as possible. This volume is necessary to keep the lungs inflated and prevent collapse. Normal values indicate that the residual volume should be around 25% of the total lung capacity, which is the maximum amount of air the lungs can hold.
24.
A therapist positions a patient for bronchial drainage to the anterior segments of the upper lobes. The most appropriate patient position is
Correct Answer
A. Supine with a pillow under their knees
Explanation
The most appropriate patient position for bronchial drainage to the anterior segments of the upper lobes is supine with a pillow under their knees. This position helps to promote drainage by allowing the patient's chest to expand fully and facilitating the movement of mucus towards the larger airways. Placing a pillow under the knees also helps to reduce strain on the lower back and improve overall comfort for the patient. Elevating the head or foot of the bed would not specifically target the anterior segments of the upper lobes, and being in a prone position would not be ideal for drainage in this case.
25.
A therapist attempts to estimate the energy expenditure in calories for a cardiac patient performing a selected number of activities. Assuming the therapist has a metabolic equivalent value for each of the activities of daily living, what other variables are necessary to obtain an estimate of the patient’s energy expenditure?
Correct Answer
B. Patient’s weight and oxygen consumption
Explanation
To estimate the energy expenditure of a cardiac patient, the therapist needs to consider the patient's weight and oxygen consumption. Weight is an important variable as it affects the amount of energy required for physical activities. Oxygen consumption is also crucial as it reflects the metabolic rate and energy expenditure during exercise. By combining these two variables, the therapist can obtain a more accurate estimate of the patient's energy expenditure.
26.
An acute myocardial infarction can often be diagnosed by analyzing the characteristic pattern and duration of selected enzymes in the blood. Which of the following enzymes is not commonly elevated following an acute myocardial infarction?
Correct Answer
D. Alkaline pHospHatase
Explanation
An acute myocardial infarction (heart attack) can be diagnosed by analyzing the levels of certain enzymes in the blood. Aspartate aminotransferase (AST), creatine phosphokinase (CPK), and lactate dehydrogenase (LDH) are commonly elevated following a heart attack, as they are released into the bloodstream when heart muscle cells are damaged. However, alkaline phosphatase is not commonly elevated in this condition. Alkaline phosphatase is an enzyme found in many tissues throughout the body, including the liver, bones, and intestines, but it is not specific to heart muscle damage.
27.
A patient is placed on a 12 lead EKG following a suspected myocardial infarction. What EKG finding is the best indicator of an acute myocardial infarction?
Correct Answer
A. ST segment elevation
Explanation
ST segment elevation is the best indicator of an acute myocardial infarction. The ST segment represents the time between ventricular depolarization and repolarization. In a normal EKG, the ST segment is usually isoelectric or slightly elevated. However, in the case of an acute myocardial infarction, there is significant ST segment elevation, indicating myocardial injury. This finding is commonly seen in the early stages of an acute myocardial infarction and can help diagnose and guide treatment for the patient.
28.
A physical therapy department attempts to develop a clinical education program. Which of the following criteria is the most essential to develop a successful clinical education program?
Correct Answer
B. The clinical staff should have a strong desire to participate in the education of future therapists.
Explanation
The most essential criteria for developing a successful clinical education program is the clinical staff's strong desire to participate in the education of future therapists. This is important because the staff's enthusiasm and willingness to teach and mentor students will greatly enhance the learning experience for the students. When the clinical staff is actively engaged and invested in the education of future therapists, they are more likely to provide high-quality instruction and guidance, which ultimately contributes to the success of the program.
29.
A therapist often works with a variety of patients with known or suspected communicable diseases or infections. Depending on the type of disease or infection, these patients may be placed in isolation. What type of isolation would require a therapist to wear a gown?
Correct Answer
D. Strict
Explanation
A therapist would need to wear a gown in strict isolation. Strict isolation is used for patients with highly contagious diseases that can be easily transmitted through direct contact or through the air. Wearing a gown helps to prevent the therapist from coming into direct contact with the patient's bodily fluids or respiratory secretions, reducing the risk of transmission.
30.
A patient is referred to physical therapy for gait training following an extended illness. The patient has poor balance but is able to move their legs alternately. Which of the following gait patterns would be the most appropriate?
Correct Answer
C. Four point
Explanation
The most appropriate gait pattern for a patient with poor balance but able to move their legs alternately would be the four point gait pattern. In this pattern, the patient uses a walker or crutches and moves one leg forward followed by the opposite arm, and then repeats with the other leg and arm. This gait pattern provides maximum stability and support, allowing the patient to maintain balance while walking.
31.
A patient is admitted to the hospital after suffering a myocardial infarction. Assuming an uncomplicated medical course, how long would a patient typically stay in the hospital?
Correct Answer
B. 7-10 days
Explanation
After suffering a myocardial infarction, a patient typically stays in the hospital for 7-10 days assuming an uncomplicated medical course. This duration allows for monitoring, further evaluation, and necessary treatment to ensure the patient's recovery and stability. It provides enough time for medical professionals to assess the patient's condition, manage any complications, and provide appropriate care before considering their discharge.
32.
A therapist outlines a walking program for a patient rehabilitating from a prolong illness. Which of the following recommendations would not be beneficial to the patient?
Correct Answer
D. When walking up or down steep hills lean backward slightly and lengthen your stride
Explanation
When walking up or down steep hills, leaning backward slightly and lengthening your stride would not be beneficial to the patient. This posture and stride length may put unnecessary strain on the patient's muscles and joints, increasing the risk of injury. It is recommended to maintain an upright posture and take shorter, controlled steps when walking on steep hills to ensure stability and reduce the risk of falls.
33.
A therapist designs a general fitness program for a senior citizen group. Which of the following guidelines is not accurate?
Correct Answer
C. Exercise should be performed daily for at least 30 minutes
Explanation
The guideline that is not accurate is "exercise should be performed daily for at least 30 minutes." This is not accurate because for senior citizens, it is recommended to engage in moderate-intensity aerobic activity for at least 150 minutes per week or vigorous-intensity aerobic activity for at least 75 minutes per week. It is not necessary to exercise daily for 30 minutes, as it is important to allow for rest and recovery days.
34.
Patients often progress through a predictable series of stages after being diagnosed with a terminal illness. According to Elizabeth Kubler Ross’ Stages of Dying, what is the stage patients will first experience?
Correct Answer
C. Denial and isolation
Explanation
According to Elizabeth Kubler Ross' Stages of Dying, the stage that patients will first experience after being diagnosed with a terminal illness is denial and isolation. This stage is characterized by the patient's refusal to accept the reality of their diagnosis and their tendency to isolate themselves from others. It is a defense mechanism that helps them cope with the overwhelming emotions and fear associated with their illness.
35.
A patient indicates they are currently taking medication to control high blood pressure. Which of the following classifications of drugs would be helpful in the treatment of hypertension?
Correct Answer
A. Diuretics
Explanation
Diuretics would be helpful in the treatment of hypertension because they help reduce blood pressure by promoting the excretion of excess salt and water from the body. This helps to decrease the volume of blood circulating in the blood vessels, which in turn reduces the pressure on the vessel walls. Diuretics are commonly prescribed for patients with high blood pressure to help manage and control their condition.
36.
A therapist monitors the blood pressure of a 28 year-old male during increasing levels of physical exertion. Assuming a normal physiologic response, which of the following best describes the patient’s blood pressure response to exercise?
Correct Answer
D. Systolic pressure increases, diastolic pressure remains the same
Explanation
During physical exertion, the body requires more oxygen and nutrients, leading to an increase in heart rate and cardiac output. This increased demand causes the systolic pressure (the pressure in the arteries when the heart contracts) to increase. However, the resistance in the blood vessels also increases, which can cause the diastolic pressure (the pressure in the arteries when the heart is at rest) to remain the same or even decrease slightly. Therefore, the correct answer is that the systolic pressure increases, while the diastolic pressure remains the same.
37.
A patient rehabilitating from a myocardial infarction completes the following activities1. walking to a chair and sitting for 30-60 minutes three times a day2. walking in the hall three times a day3. walking up and down one flight of stairsThe patient’s cardiac rehabilitation program can best be described as phase
Correct Answer
A. I
Explanation
The patient's cardiac rehabilitation program can best be described as Phase I. Phase I of cardiac rehabilitation typically focuses on early mobilization and increasing activity levels after a myocardial infarction. The activities mentioned, such as walking to a chair, walking in the hall, and walking up and down stairs, are common exercises in Phase I. This phase aims to gradually increase the patient's exercise tolerance and improve their overall cardiovascular fitness.
38.
A therapist palpates the proximal row of carpals on a patient diagnosed with carpal tunnel syndrome. Which of the following bones does not articulate with the proximal row of carpals?
Correct Answer
D. Ulna
Explanation
The ulna does not articulate with the proximal row of carpals. The proximal row of carpals consists of the scaphoid, lunate, triquetrum, and pisiform bones. The ulna is one of the two bones in the forearm, along with the radius, and it articulates with the radius and various bones in the wrist and hand, but not with the proximal row of carpals.
39.
A therapist performs goniometric measurements at the carpometacarpal joint. If the therapist elects to measure carpometacarpal abduction, the stationary arm of the goniometer should be aligned with the
Correct Answer
A. Lateral midline of the second metacarpal
Explanation
When measuring carpometacarpal abduction, the therapist should align the stationary arm of the goniometer with the lateral midline of the second metacarpal. This is because the carpometacarpal joint is located between the first metacarpal and the second metacarpal bones. By aligning the goniometer with the lateral midline of the second metacarpal, the therapist ensures an accurate measurement of the abduction movement at this joint.
40.
A patient with degenerative joint disease is referred to physical therapy with right shoulder pain. During the initial evaluation, the therapist identifies significant muscle guarding and spasm throughout the right shoulder musculature. If the therapist elects to treat the patient using ultrasound, which patient position would be the most appropriate?
Correct Answer
D. A position where the patient is as comfortable and as relaxed as possible
Explanation
The therapist should choose a position where the patient is as comfortable and relaxed as possible when treating a patient with degenerative joint disease and right shoulder pain using ultrasound. This is because significant muscle guarding and spasm have been identified in the right shoulder musculature. By ensuring that the patient is in a comfortable and relaxed position, it can help to reduce muscle tension and promote relaxation, allowing for a more effective ultrasound treatment.
41.
A therapist views a videotape which compares and contrasts the normal gait of young children and adults. Which of the following statements is not accurate when comparing the gait of these two groups?
Correct Answer
B. Children walk with an increased single leg support time
Explanation
The given answer is not accurate because children actually walk with a decreased single leg support time compared to adults.
42.
The recent evolution in the American health care system has had a variety of effects on many traditional health care delivery centers, particularly the hospital. Which of the following has not resulted from the evolution in health care?
Correct Answer
C. A decrease in external competition for consumer business
Explanation
The recent evolution in the American health care system has resulted in a variety of effects on traditional health care delivery centers, particularly hospitals. However, one effect that has not resulted from this evolution is a decrease in external competition for consumer business. This means that despite the changes in the health care system, there has not been a decrease in the number of competitors vying for consumer business in the healthcare industry.
43.
A physician completes a physical examination on a sixteen year-old male who injure his knee while playing in a soccer contest yesterday. The physician’s preliminary diagnosis is a grade II anterior cruciate ligament injury with probable meniscal involvement. Which of the following diagnostic tools would be the most appropriate in the immediate medical management of the patient?
Correct Answer
D. X-rays
Explanation
X-rays would be the most appropriate diagnostic tool in the immediate medical management of the patient. X-rays can help assess the bones and detect any fractures or dislocations. In this case, the physician suspects a grade II anterior cruciate ligament injury with probable meniscal involvement, which primarily involves soft tissues rather than bones. Therefore, x-rays would be useful in ruling out any bone-related injuries and providing initial information about the extent of the injury. However, for a more detailed evaluation of soft tissues like ligaments and menisci, magnetic resonance imaging (MRI) would be a more appropriate diagnostic tool.
44.
A fifteen year-old male is referred to a local orthopedic surgeon after injuring his knee in a football game. The most appropriate first step in the orthopedic surgeon’s care of this patient would be to
Correct Answer
A. Complete a pHysical examination
Explanation
The most appropriate first step in the orthopedic surgeon's care of this patient would be to complete a physical examination. This is because a physical examination would allow the surgeon to assess the extent of the injury, identify any signs of swelling or deformity, and evaluate the stability of the knee joint. It would also help the surgeon determine the need for further diagnostic tests such as x-rays or an MRI. Immobilizing the injured knee or aspirating the knee may be necessary depending on the findings of the physical examination, but these interventions should only be considered after a thorough assessment of the patient's condition.
45.
Performance appraisals are often conducted on a regular basis to assess an employee’s performance in relation to the performance expectations. Which of the following statements describing a performance appraisal is not accurate?
Correct Answer
A. Employees should be aware of the performance standards after they are evaluated
Explanation
The statement "Employees should be aware of the performance standards after they are evaluated" is not accurate. In reality, employees should be aware of the performance standards before they are evaluated, as this allows them to understand what is expected of them and work towards meeting those expectations.
46.
A therapist completes an upper extremity goniometric evaluation on a patient with right lateral epicondylitis. The therapist concludes the patient can actively hyperextend the elbow 10 degrees and move the elbow to 145 degrees of flexion. The patient’s active right elbow range of motion should be recorded as
Correct Answer
B. –10-0-145
Explanation
The correct answer is –10-0-145. The negative sign before the 10 indicates that the patient has a deficit in elbow hyperextension, meaning they cannot fully extend their elbow. The 0 indicates that there is no deficit in elbow flexion, as the patient can fully flex their elbow to 145 degrees. Therefore, the correct recording of the patient's active right elbow range of motion is –10-0-145.
47.
A therapist performs goniometric measurements on a 38 year-old female rehabilitating from an acromioplasty. The therapist attempts to stabilize the scapula while measuring glenohumeral abduction. Failure to stabilize the scapula will lead to
Correct Answer
C. Upward rotation and elevation of the scapula
Explanation
Failure to stabilize the scapula while measuring glenohumeral abduction will lead to upward rotation and elevation of the scapula. This means that the scapula will move upwards and rotate in an upward direction. Stabilizing the scapula is important during this measurement because it ensures that the movement is isolated to the glenohumeral joint and not influenced by the scapula. Failure to stabilize the scapula can result in compensatory movements of the scapula, leading to incorrect measurement and potentially affecting the rehabilitation process.
48.
A therapist measures a patient’s shoulder internal rotation with the patient positioned in supine with the glenohumeral joint in 90 degrees of abduction and the elbow in 90 degrees of flexion. The therapist records the patient’s shoulder internal rotation as 0-70 degrees and classifies the end-feel firm. Which portion of the joint capsule is primarily responsible for the firm end-feel?
Correct Answer
B. Posterior joint capsule
Explanation
The therapist measures the patient's shoulder internal rotation with the glenohumeral joint in 90 degrees of abduction and the elbow in 90 degrees of flexion. The recorded range of motion is 0-70 degrees, indicating that the patient has limited internal rotation. The firm end-feel suggests that there is resistance and tension in the joint capsule. The posterior joint capsule is primarily responsible for limiting internal rotation in the shoulder, so it is the most likely source of the firm end-feel.
49.
A patient with chronic arterial insufficiency may demonstrate which of the following signs?
Correct Answer
C. Gangrene
Explanation
Chronic arterial insufficiency refers to a condition where there is a decrease in blood flow to the extremities due to narrowing or blockage of the arteries. Gangrene is a severe complication of this condition and occurs when there is a lack of oxygen and nutrients reaching the tissues, leading to tissue death. Therefore, the presence of gangrene is a sign of chronic arterial insufficiency. Edema, brown skin pigment, and warm skin temperature are not typically associated with this condition.
50.
A physician suspects a stress fracture in a sixteen year-old distance runner after completing a physical examination. X-rays of the lower leg were taken, however, they failed to demonstrate any conclusive findings. Assuming the physician’s preliminary diagnosis is correct, which of the following diagnostic tests would be the most appropriate to identify the stress fracture?
Correct Answer
A. Bone scan
Explanation
A bone scan would be the most appropriate diagnostic test to identify a stress fracture in this case. X-rays may not show conclusive findings for stress fractures, especially in the early stages. A bone scan uses a small amount of radioactive material to highlight areas of increased bone activity, which can help detect stress fractures. Magnetic resonance imaging (MRI) can also be used to diagnose stress fractures, but it may not be as sensitive as a bone scan. Telethermography and ultrasound scans are not commonly used for diagnosing stress fractures.