Download 1 During pregnancy, which of the ff ex is CI

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1 During pregnancy, which of the ff ex is CI?
a. Curl-ups
b. Bridging
c. Double leg lifts
d. Deep breathing with forced expiration
2 A THR is determined for individuals entering a training program in order to:
a. regulate exercise intensity
b. estimate energy expenditure
c. control blood pressure at a specific heart rate
d. ensure that participants exercise at maximal capacity
3 For a child with DMD, the MOST appropriate PT goal is:
a. prevention of contractures and determination of the best method of mobility
b. preservation of strength and muscle tone
c. inhibition of abnormal muscle tone and facilitation of normal movement and postural reactions
d. facilitation of normal movement and improvement of strength
4 Outcomes of a prenatal exercise program would NOT include:
a. improved body mechanics
b. application of relaxation techniques
c. improved ligamentous flexibility
d. strengthened pelvic-floor musculature
5. A patient has limited ankle dorsiflexion following open reduction and internal fixation of the distal tibia.
Radiographs reveal that the fracture is well healed. Treatment with passive mobilization should include:
a. posterior glide of the talus on the tibia
b. lateral glide of the calcaneous on the tibia
c. posterior glide of the tibia on the talus
d. anterior glide of the talus on the tibia
6 A patient who has recently and successfully completed a 12-week program of Phase III cardiac
rehabilitation will MOST likely demonstrate a decrease in:
a. carbon dioxide elimination in maximal work
b. cardiac output in maximal work
c. stroke volume at a given level of submaximal work
d. heart rate at a given level of submaximal work
7 Redness on the inferior aspect of the patella upon removal of a patellar-tendon-bearing prosthesis
indicates that the residual limb:
a. is not far enough into the prosthesis, and fewer socks should be worn
b. is not far enough into the prosthesis, and additional socks should be worn
c. has slipped too far into the prosthesis, and fewer socks should be worn
d. has slipped too far into the prosthesis, and additional socks should be worn
8 A physical therapist is evaluating a patient with an acute lumbar disc protrusion and a right lateral shift
of the thoracic spine. Which of the following findings is the BEST indicator that the symptoms will respond
positively to physical therapy intervention?
a. The pain is referred only into the buttock and not the thigh
b. The patient prefers standing and walking to sitting
c. There is a decrease in lumbar lordosis
d. Repeated backward bending centralizes the pain
9 A physical therapist evaluates a patient who has lateral epicondylitis. The patient reports a subjective
pain rating of 8/10. The patient also reports pain and shows weakness with resisted wrist extension. The
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therapist decides to use ice massage as an intervention. The MOST appropriate length of time for the ice
massage is:
a. 10 minutes
b. until the area turns red, and the patient reports a burning sensation
c. until the patient reports that the area feels numb
d. no longer than 5 minutes
10 To conduct an experimental study on pain in postsurgical orthopedic patients, a physical therapist
randomly assigns patients into 2 groups. One group is treated with transcutaneous electrical nerve
stimulation, heat, and exercise; the second receives heat and exercise only. In this experimental design,
transcutaneous electrical nerve stimulation is the:
a. continuous variable
b. dependent variable
c. discrete variable
d. independent variable
11 It is important to perform cool-down exercises immediately following a general aerobic exercise
program PRIMARILY in order to prevent:
a. venous pooling
b. cardiac arrhythmia
c. decreased body temperature
d. muscle tightening
12 The intervention for a patient who has right sciatic pain caused by piriformis compression should NOT
include:
a. instruction in mild self-stretching in sitting with the right hip and knee flexed and pressure applied in the
medial direction to the distal thigh with the left upper extremity
b. contract-relax exercises to the hip external rotators performed with the patient sidelying on the left and
the right hip and knee positioned in 90° of flexion
c. active resistive strengthening exercises to the piriformis with the patient prone and the knee flexed
d. application of cold to the area of sciatic nerve irritability
13 A physical therapist is assigned the planning and implementation of physical therapy service for all
members of a community. The therapist’s FIRST step should be to:
a. develop a brochure for distribution to the community
b. organize a health fair to provide screening for the community
c. evaluate existing services and community resources
d. initiate contacts in the medical community to establish prescriptive relationships
14 A patient is referred to physical therapy reporting severe pain in the right hip and groin area, which
increases during walking. The patient reports tenderness when the therapist palpates the area over the
right greater trochanter. The MOST likely cause of the patient’s signs and symptoms is:
a. sacroiliac joint derangement
b. a hip fracture
c. a strain of the adductor longus muscle
d. hip bursitis
15 When working with neurological patients to ensure that physical therapy services are adequately
documented, it is MOST important to record changes in:
a. muscle tone
b. functional abilities
c. cognitive status
d. quality of movement
16 A patient has right hemiparesis resulting from a traumatic brain injury. When assessing motor control
in the right lower extremity with the patient standing, the physical therapist finds that the patient cannot
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extend the hip while flexing the knee or flex the hip while extending the knee. In which of the following
functional activities will this problem be MOST apparent?
a. Shifting weight while standing
b. Walking sideways
c. Walking backward
d. Moving from a sitting position to a standing position
17 (pic) A physical therapist examining wrist-joint play finds restriction in the direction indicated by the
arrow. To address the restriction, the therapist should include an intervention to increase which motion of
the index finger (2nd digit)?
a. Flexion
b. Extension
c. Abduction
d. Rotation
18 In which of the following conditions is a nerve conduction velocity test MOST appropriate?
a. Carpal tunnel syndrome
b. Cerebrovascular accident
c. Myotonia
d. Duchenne muscular dystrophy
19 A patient with leukemia has developed thrombocytopenia following a bone-marrow transplant. Which
of the following measures are indicative of the status of the thrombocytopenia?
a. T4 lymphocyte count
b. Red blood cell count
c. Platelet count
d. White blood cell count
20 For a patient with insulin-dependent diabetes who is completing a cardiovascular fitness program,
what change in diabetic management is MOST likely to be instituted as fitness increases?
a. Switching to oral rather than injected medication
b. Decreasing caloric intake for 2 to 3 hours following exercise sessions
c. Decreasing the amount of insulin taken daily
d. Increasing the amount of insulin taken daily
21 An elderly patient presents with a sacral pressure ulcer measuring 6 in x 6 in (15 cm x 15 cm). The
wound has moderate serous fluid drainage and is loosely covered with necrotic and fibrotic tissue,
although there are no indications of infection present. The BEST method of debridement is:
a. daily vigorous scrubbing of the wound
b. wet-to-dry dressings with normal saline 2 times/day
c. daily wet-to-dry dressings with 1:1 diluted povidone-iodine (Betadine).
d. whirlpool jet agitation 2 times/day
22 A patient has disuse atrophy of the anterior compartment muscles following cast removal after a
fracture of the tibia. The patient has Poor (2/5) strength in the ankle dorsiflexors. Electrical stimulation is
to be used to enhance dorsiflexor strength in conjunction with exercise. Initially, which of the following
waveform characteristics are MOST appropriate to stimulate the muscles?
a. Monophasic pulse with a frequency of 100 pps and an on/off cycle ratio of 3:1
b. Biphasic pulse with a frequency of 30 pps and an on/off cycle ratio of 1:5
c. Direct current waveform with an on/off ratio of 1:1
d. Interferential waveform with a beat frequency of 1 pps
23 A patient is referred to physical therapy with a 20° knee flexion contracture following arthroscopic knee
surgery 1 month ago. All of the following interventions are appropriate EXCEPT:
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a. stretching of the semimembranosus muscle.
b. strengthening of the vastus medialis
c. inferior gliding of the patella
d. mobility of the posterior capsule of the knee joint
24 During an evaluation, a patient lacks 10° of passive ankle dorsiflexion. The same degree of limitation
is present whether the knee is flexed or extended. The muscle MOST likely contributing to this restriction
is the:
a. gastrocnemius
b. tibialis anterior
c. plantaris
d. soleus
25 A patient sustained a severe brain stem injury 1 week ago and has demonstrated minimal change
since the incident. The patient’s cognitive status is MOST likely to include:
a. a decreased level of arousal
b. a decreased level of intelligence
c. an increased level of agitation
d. an increased level of impulsivity
26 To maximize continuity of patient care, the physical therapist should begin discharge planning when
the:
a. physician refers the patient for discharge
b. therapist makes the discharge evaluation of the patient
c. discharge planner requests information pertinent to the patient’s discharge status
d. therapist performs the initial evaluation of the patient
27 A manual muscle test of a patient who sustained a gunshot wound just superior to the elbow joint
reveals specific muscle weakness from a partial median nerve injury. The physical therapy intervention for
this patient should include strengthening activities for wrist flexion, forearm:
a. pronation, finger flexion, and thumb adduction
b. pronation, finger flexion, and thumb opposition
c. supination, finger abduction, and thumb opposition
d. supination, finger flexion, and thumb extension
28 A measurable objective for a community education program on proper exercise techniques would be
for participants to:
a. understand the importance of a sufficient warm-up period
b. list 5 stretching techniques that can be used when warming up
c. overcome lower extremity problems and adhere to a regular exercise program
d. appreciate the effects of increasing intensity of exercise on heart rate
29 During manual muscle testing of the hip flexors in the sitting position, a patient exhibits lateral
(external) rotation with abduction of the thigh as resistance is applied. The physical therapist should
suspect muscle substitution by the:
a. sartorius
b. tensor fascia latae
c. adductor longus
d. semimembranosus
30 A physical therapist is treating a patient who has lymphedema in the right lower extremity. The
therapist decides to use mechanical, intermittent pneumatic compression as an intervention, using a
sleeve that covers the foot, leg, and thigh. The therapist measures the patient’s blood pressure at 135/85
mm Hg. At the first treatment session, the MOST appropriate inflation pressure for the sleeve is:
a. 20 mmHg
b. 60 mmHg
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c. 100 mmHg
d. 140 mmHg
31 A physical therapist receives a telephone call from a woman who identifies herself as a friend of one of
the therapist’s patients. She wants to know how the patient is doing and if he will be able to go up and
down the stairs, because she wants to take him home for a weekend visit. Which of the following actions
is MOST appropriate for the therapist to take?
a. Discuss the patient’s program and functional status with the caller
b. Invite the caller to observe the patient’s next therapy session
c. Refuse to discuss the patient, unless the patient’s permission is obtained
d. Refer the caller to the patient’s social worker
32 The parents of a 1 month-old child with myelomeningocele report that the child has been increasingly
irritable and has changed sleeping patterns over the past 3 days. The child has also been vomiting.
Which of the following actions is MOST appropriate for the therapist to take?
a. Refer for immediate medical follow-up
b. Instruct the parents to monitor head circumference daily
c. Advise the parents to watch the child for worsening symptoms
d. Take head circumference measurements to compare at subsequent visits
33 A physical therapist is developing a gait training program for a patient following a total hip arthroplasty
of the right hip done via an anterolateral approach 2 weeks ago. The proper instructions and rationale for
crutch training utilizing 1 crutch include holding the crutch in the:
a. right hand to decrease activity in the right hip abductors
b. right hand to facilitate activity in the right hip abductors
c. left hand to decrease activity in the right hip abductors
d. left hand to facilitate activity in the right hip abductors
34 A right-handed woman is being examined by a physical therapist for right-sided weakness in her upper
and lower extremities. Her muscle tone is hypotonic and she is ataxic during walking. She has a history of
hypertension and alcoholism. Passive range of motion is normal with deep tendon reflexes showing
hyporeflexia. She has an intention tremor when she tries to pick up an object from a table and exhibits
difficulty in performing the finger to nose test. What is the location of the MOST probable area of the
lesion?
a. Right side, cervical spinal cord
b. Left side, cerebral hemisphere
c. Left side, substantia nigra
d. Right side, cerebellar hemisphere
35 A patient received a gunshot wound to the distal posterior thigh that resulted in complete severance of
the common fibular (peroneal) nerve. Which of the following exercises is necessary in the early
rehabilitation period to prevent contracture formation?
a. Active plantarflexion, inversion, and toe extension
b. Passive dorsiflexion, eversion, and toe extension
c. Active dorsiflexion, eversion, and toe flexion
d. Passive plantarflexion, eversion, and toe flexion
36 A patient with a mild closed head injury and bilateral femur fractures requires instruction in a lower
extremity exercise program. To plan the most effective teaching methods for this patient, what is MOST
critical to assess at the initial visit?
a. Comprehension of written, verbal, and demonstrated instructions
b. Short-term memory capacity
c. Auditory and visual status
d. Any personality changes compared to the patient’s premorbid status
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37 For a patient with a bilateral transfemoral amputation to maximize balance in a wheelchair, the rear
wheels should be positioned more:
a. laterally
b. posteriorly
c. anteriorly
d. inferiorly
38 On day 4 of physical therapy treatment, a patient who has had an open reduction and internal fixation
for a hip fracture develops a large ecchymosis over the unaffected hip. The patient has MOST likely
developed:
a. a hemangioma
b. a complication of anticoagulant therapy
c. a hematocele
d. deep vein thrombophlebitis
39 A patient who is exercising on a bicycle ergometer in the cardiac rehabilitation unit is being monitored
with electrocardiogram leads. During the exercise, the ST segment becomes depressed by 2 mm. If the
cardiologist has given no specific guidelines, the physical therapist should:
a. terminate the session immediately
b. reduce the resistance load
c. instruct the patient to slow down
d. direct the patient to continue as before
40 Prior to starting an exercise training program, a patient with cardiac problems who is receiving betablocking medication should receive an explanation of the:
a. greater benefits from cardiovascular exercise to be achieved at lower rather than at higher metabolic
levels
b. need to use measures other than heart rate to determine intensity of exercise
c. need for exercise training sessions to be more frequent but of shorter duration
d. need for longer warm-up periods and cool-down periods during exercise sessions
41 (pic) A physical therapist places electrodes on a patient to monitor surface electromyographic activity.
The electrode placement shown in the photograph is MOST appropriate to monitor which of the following
muscles?
a. Tensor fasciae latae
b. Sartorius
c. Rectus femoris
d. Gluteus minimus
42 A patient with chronic adhesive capsulitis of the shoulder is to be treated with joint mobilization to
increase joint range of motion. Which of the following is the MOST appropriate to increase shoulder
abduction?
a. Distraction with inferior glide
b. Anterior glide with internal rotation
c. Superior glide with approximation
d. Distraction with posterior glide
43 An 8 year-old child who has juvenile rheumatoid arthritis is developing bilateral knee flexion
contractures. Which of the following is LEAST appropriate?
a. Exercises to increase joint mobility
b. Ultrasound to the hamstring insertions to increase tissue extensibility
c. Progressive weight-bearing by walking in a therapeutic pool to increase endurance
d. Exercise to increase quadriceps strength
44 A physical therapist is screening a young adult patient for a possible right thoracic, left lumbar
structural scoliosis. The postural deviation commonly seen with this diagnosis is:
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a. spinous processes of thoracic spine rotated to the right
b. high left shoulder
c. posteriorly protruding scapula on the left
d. prominent right posterior rib cage
45 An exercise program for a patient with Parkinson’s disease would MOST likely include exercises to:
a. decrease movement of the upper extremities and trunk
b. increase trunk flexor strength
c. improve balance reactions and reciprocation
d. stretch the back extensor muscles
46 If a transtibial prosthesis has an excessively firm heel wedge, the patient is MOST likely to walk with:
a. excessive knee flexion in foot flat (loading response).
b. premature knee flexion in heel off (terminal stance).
c. insufficient knee flexion in foot flat (loading response).
d. excessive knee flexion in heel off (terminal stance).
47 A physical therapist is planning a patient education program for a group of patients with chronic low
back pain. To increase the likelihood that the patients will utilize the proper body mechanics at the work
site, the therapist should:
a. ask the patients to demonstrate use of proper body mechanics
b. provide a reference list of articles describing body mechanics
c. ask the patients to describe actions they do that increase their back pain
d. provide information on the frequency of low back injuries due to improper body mechanics
48 A patient presents with hemiparesis and demonstrates a foot drop during the swing phase of gait. It is
MOST appropriate to administer functional electrical stimulation to the tibialis anterior and the:
a. gastrocnemius
b. tibialis posterior
c. extensor digitorum longus
d. peroneus longus
49 A physical therapist is treating a patient with iontophoresis. If the current is set at 4 mA, the duration at
15 minutes, and the dexamethasone (Decadron) solution at 0.04%, with an electrode area of 4 cm 2, how
should the therapist record the current dosage in the patient’s chart?
a. 0.16 mA-mg
b. 16 mA/cm2
c. 0.60 mg/min
d. 60 mA-min
50 An elderly patient has a diabetic neuropathy. Upon examination, the patient shows marked
mediolateral instability of the left ankle while walking. The patient also has fluctuating edema and gloveand-stocking sensory loss in both of the lower extremities. The MOST appropriate orthotic aid is:
a. a double-upright metal ankle-foot orthosis
b. high-top shoes
c. a prefabricated plastic solid ankle-foot orthosis
d. a spiral ankle-foot orthosis
51 A 25 year-old patient with cystic fibrosis has been experiencing successful mobilization of thickened
secretions by standard percussion and postural drainage. During the current treatment session, the
patient coughs up sputum that has a small, brownish streak of blood. The physical therapist should:
a. percuss more vigorously in an attempt to clear out any other blood that is present in the airways
b. perform postural drainage in upright positions for this type of patient only
c. continue treatment with little modification, unless more blood is noted
d. stop the treatment and send the patient to the emergency room
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52 Which of the following should be recommended for a patient following a medial menisectomy, if the
physical therapy plan is to exercise the quadriceps femoris against accommodating resistance?
a. Knee bends through half of the range
b. Knee extension with a sandbag at the ankle
c. Knee extension on an isokinetic exercise device
d. Straight-leg raising with a sling suspension
53 A physical therapist is examining a patient who has difficulty making a fist. Results of the patient’s
muscle tests show the following: Flexors of the index, middle, ring, and little fingers (2 nd to 5th digits) at the
proximal interphalangeal joint are Normal (5/5). Flexors of the index finger (2 nd) and middle finger (3rd
digit) at the distal interphalangeal joint are Normal (5/5). Flexors of the ring finger (4th digit) and little finger
(5th digit) at the distal interphalangeal joint are Poor (2/5).These findings are consistent with a lesion of
the:
a. median nerve C8-T1
b. median nerve C5-C6
c. ulnar nerve C5-C6
d. ulnar nerve C8-T1
54 An elderly man who lives alone fell in his home, sustaining a hip fracture, which necessitated a total
hip arthroplasty. The patient was previously able to perform all activities of daily living independently. He
has been admitted to a skilled nursing facility for rehabilitation. The patient’s goal is to return home. His
family believes he should be admitted to a long-term care facility for his own safety once acute
rehabilitation is completed. The physical therapist’s MOST appropriate action is to:
a. advise the family that the patient should determine his own discharge environment
b. recommend a team conference with the patient and his family to discuss discharge plans
c. schedule a home visit to determine if home modifications are needed before discharge
d. implement a treatment plan with a long-term goal of discharge to home
55 During lower extremity exercise, a patient with incomplete C6 quadriparesis reports a new onset of
tingling and numbness in both hands. A manual muscle test reveals that overall strength has decreased
by 1 grade. In this situation, the MOST appropriate action for the physical therapist to take is to:
a. modify the exercise program to accommodate the change in strength
b. apply an ice massage prior to exercise
c. continue the lower extremity therapeutic exercise and use facilitation techniques to stimulate more
activity
d. discontinue all exercise and notify the physician immediately
56 A physical therapist is treating a patient with moderately well-controlled type 1 diabetes. One of the
goals is to help the patient regulate insulin dosage through exercise. In establishing an exercise program,
the therapist should be aware that regular exercise will generally:
a. lower blood glucose levels and decrease the amount of insulin required
b. lower blood glucose levels and increase the amount of insulin required
c. raise blood glucose levels and decrease the amount of insulin required
d. raise blood glucose levels and increase the amount of insulin required
57 A physical therapist recognizes that departmental patient education materials are written on a reading
level that is too difficult for some of the patients. The physical therapist can help the patients to better
understand the materials by:
a. including illustrations and a larger print
b. including illustrations and a simpler sentence structure
c. reducing the number of syllables and lengthening the sentences
d. using a large print format to present specific medical terminology
58 During inspiration, a patient demonstrates increased upper chest expansion with retraction of the
epigastric area. The physical therapist should suspect weakness of the:
a. scalene muscles
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b. diaphragm
c. rectus abdominus
d. intercostal muscles
59 A patient with low back pain has been undergoing treatment for 2 sessions. The patient tells the
physical therapist that today the pain is centralizing with the extension exercises, but is as intense as it
was at the first treatment session. The patient is frustrated by this reaction. The MOST appropriate
response of the therapist is to:
a. continue with the present program
b. eliminate the extension exercises
c. consult the patient’s physician about the situation
d. progress to trunk flexion exercises
60 An attorney calls the physical therapy department seeking information on the status of his client, a
patient who is undergoing rehabilitation following total knee surgery. The patient’s physical therapist
should:
a. refer the attorney to the patient’s insurance carrier
b. describe the patient’s current status
c. require written authorization from the patient to release information
d. obtain verbal permission from the patient to release information
61 Involving interdisciplinary team members in making decisions about continuity of patient care has all of
the following benefits EXCEPT:
a. promoting each individual’s commitment to, and responsibility for, the decisions that have been made
by the group
b. discouraging 1 or 2 team members from being in control and having all the authority
c. enabling decisions regarding quality of care to be made quickly
d. promoting quality of care by including several aspects of the patient’s care
62 A physical therapist examines a patient with multiple sclerosis who is in a period of exacerbation. The
patient is independent with bed mobility, can sit unassisted at the edge of the bed, and requires physical
assistance to stand with a walker. Which of the following activities of daily living is the MOST important for
the initial intervention session?
a. Wheelchair propulsion up a 10-ft (3-m) ramp
b. Wheelchair transfers
c. Walking with an assistive device
d. Tub transfers
63 While examining a patient who had a baby 3 days ago by vaginal delivery, the physical therapist
notices that the patient has a 2-cm diastasis of the rectus abdominis. To address this problem, the patient
should:
a. perform partial sit-ups supporting her abdominal muscles with her hands, while lifting her head in the
supine position
b. not perform exercises, until the diastasis heals spontaneously
c. perform sit-ups with the knees bent and arms behind the head
d. perform partial sit-ups with legs straight and arms in front
64 When evaluating wheelchair positioning of a child with cerebral palsy, the physical therapist should
FIRST examine the position of the child’s:
a. pelvis
b. lower extremities
c. head
d. spine
65 For a patient with a right-middle-lobe pneumonia, the proper bronchial drainage position is supine with
the body:
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a. one-quarter turned to the left and the foot of the bed raised 14 in (35.6 cm).
b. one-quarter turned to the right and the bed flat
c. three-quarters turned to the left and the head of the bed raised 14 in (35.6 cm).
d. three-quarters turned to the right and the foot of the bed raised 14 in (35.6 cm).
66 To avoid the appearance of increased motion, what movement MUST be prevented during
goniometric measurement of shoulder abduction?
a. Upward rotation of the scapula
b. Medial (internal) rotation of the shoulder
c. Lateral (external) rotation of the shoulder
d. Lateral flexion of the trunk to the opposite side
67 A patient who received an organ transplantation 4 years ago demonstrates progressive weakness and
is referred to physical therapy for strengthening exercises. In reviewing the medical history, the physical
therapist learns that the patient takes prednisone (Deltasone) and immunosuppressive drugs. Which of
the following does the therapist need to consider?
a. A patient who received an organ transplantation 4 years ago demonstrates progressive weakness and
is referred to physical therapy for strengthening exercises. In reviewing the medical history, the physical
therapist learns that the patient takes prednisone (Deltasone) and immunosuppressive drugs. Which of
the following does the therapist need to consider?
b. The patient may have limited range of motion from increased bone mass
c. The patient will need to be treated in an isolation room
d. Muscle strengthening may be limited in this patient
68 The results of a developmental screening of a 4 month-old infant indicate a possible right hip
dislocation. The presence of which of the following is the MOST consistent with this diagnosis?
a. Pelvic obliquity, apparent pain on movement of the right hip, and decreased hip abduction on the left
side
b. Asymmetrical gluteal folds, femoral telescoping, and limited hip abduction on the right side
c. Decreased active movement of the right hip, increased femoral neck retroversion, and atrophy of the
gluteus maximus on the right side
d. Hip flexion contracture on the right side, apparent leg-length discrepancy, and inability to tolerate
supported sitting
69 A 14 month-old child with brachial nerve palsy has motor and sensory loss in the right upper extremity
in the areas innervated by C5 and C6. Which of the following activities is MOST difficult for the child to
accomplish with the affected upper extremity?
a. Pushing a wagon
b. Carrying a teddy bear in the crook of the arm
c. Holding a raisin in the palm of the hand
d. Grasping a cup
70 A physical therapist is treating a patient who has been diagnosed with a nerve root impingement on
his right side due to a narrowing of the intervertebral foramen between L4 and L5. The therapist decides to
use mechanical, lumbar traction as an intervention. Which of the following positions, on a traction table, is
MOST appropriate to relieve pressure on the nerve root?
a. Supine with the hips and knees flexed
b. Supine with the hips and knees straight and laterally shifted to the right
c. Prone with the hips and knees straight
d. Sidelying on the right with a bolster between the table and patient
71 patient who is transported to the physical therapy department in a wheelchair reports severe, bilateral
lower extremity pain. A purple discoloration of both feet is observed. The pain is relieved when the
patient’s feet are raised just above the horizontal plane. These signs are MOST indicative of:
a. arterial insufficiency
b. intermittent claudication
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c. venous insufficiency
d. a psychosomatic episode
72 A patient who completes a Phase I (in-hospital) cardiac rehabilitation program should be expected to
achieve:
a. independence in self-monitored walking
b. increased aerobic capacity to physical activity
c. modification of risk factors
d. increased blood pressure at a given workload
73 A physical therapist has been working with a patient who has a spinal cord injury. To document that
the patient has been educated about skin care, the therapist should record that the patient:
a. is unable to tolerate more than 1 hour in a wheelchair
b. has good strength of the scapular depressors and elbow extensors
c. is able to state 3 causes of skin breakdown
d. is able to perform 10 push-ups in the wheelchair
74 A patient reports pain lateral to the coracoid process. When palpating the shoulder to assess the
possible cause of the pain, starting at the coracoid process and moving laterally, the physical therapist
should expect to find the following sequence of structures:
a. lesser tuberosity, biceps tendon, and greater tuberosity
b. greater tuberosity, biceps tendon, and lesser tuberosity
c. lesser tuberosity, coracobrachialis tendon, and greater tuberosity
d. greater tuberosity, coracobrachialis tendon, and lesser tuberosity
75 A factor that MUST be considered in designing an exercise program for a patient with angina pectoris
is that when the arms are exercised:
a. angina occurs at a lower heart rate than when exercising the lower extremities
b. heart rate and blood pressure rise more steeply in relation to workload than when exercising the lower
extremities
c. pulmonary ventilation increases less rapidly than when exercising the lower extremities
d. angina occurs at higher workloads than when exercising the lower extremities
76 A physical therapist is treating a patient for limitation of motion following knee surgery several weeks
ago. The patient’s passive knee extension is lacking 15° from full extension, and knee flexion is limited to
95°. Both movements have a capsular end-feel. Which of the following mobilization techniques is MOST
appropriate for increasing knee flexion?
a. Anterior glide of the tibia on the femur
b. Posterior glide of the tibia on the femur
c. Superior glide of the patella
d. Posterior glide of the femur on the tibia
77 When considering special tests for orthopedic assessment of a client, the validity of a test is important
because the:
a. results of the test can be standardized
b. test measures what it is supposed to measure
c. results of the test are reproducible
d. test can be accurately performed by someone else
78 A patient sustained a Colles’ fracture 8 weeks ago and has been in a cast since that time. Immediately
after cast removal, it is MOST appropriate for the physical therapy intervention for the wrist and hand to
include:
a. passive and active assistive range of motion exercises
b. progressive resistive exercises
c. grade-4 joint mobilization techniques
d. return to prefracture level of activity
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79 A patient with a traumatic brain injury is receiving outpatient physical therapy. The physical therapist
notices that the patient becomes agitated during therapy sessions. To which of the following professionals
should the patient be referred for assessment and diagnosis?
a. Occupational therapist
b. Neuropsychologist
c. Vocational counselor
d. Speech-language pathologist
80 During examination of the jaw-opening pattern of a patient with a temporomandibular joint problem,
the therapist notes early protrusion of the mandible. Which of the following mandibular movements MOST
likely causes the protrusion?
a. Condylar translation
b. Mandibular depression
c. Condylar rotation
d. Lateral glide
81 A child who has cerebral palsy has been receiving physical therapy 1 time/week for the past month.
During the fourth visit, the physical therapist instructs the parents in a daily exercise program for the child,
including stretching techniques. The BEST method to ensure correct implementation and carry-over of
the program is for the therapist to:
a. reassess the patient’s range of motion 1 month after instructing the parents
b. review the parents’ written notes on the child’s progress
c. demonstrate exercises for the parents and ask them to return for a program check in 1 week
d. ask the parents to demonstrate the exercises and to return for a program check in 1 week
82 Excessive upward rotation of the right scapula is noted when a patient attempts to perform shoulder
flexion. Which of the following exercises is MOST appropriate to help correct the excessive scapular
rotation?
a. Right scapular protraction against resistance with the right arm at 90° of flexion
b. Bilateral scapular elevation with the upper extremities at 180° of flexion
c. Wall push-ups with an isometric hold at end range with the elbows extended
d. Bilateral scapular adduction with the upper extremities medially (internally) rotated and adducted
across the back
83 (pic) A PT is measuring ankle range of motion in a patient. The measurement shown in photograph A
(sitting) is greater than that measurement shown in photograph B. The MOST likely cause of the
difference in measurement is:
a. Talocrural joint capsule restriction
b. Weakness of the ankle dorsiflexors
c. Tightness in the hamstrings
d. Tightness in the gastrocnemius
84 A patient with left hemiparesis is being discharged from a rehabilitation center. The physical therapist
has been unsuccessful in getting the family’s cooperation to instruct them in transfers, bed mobility, and
safety precautions. The MOST appropriate action for the PT to take is to:
a. educate the patient so she can tell others how to assist her
b. contact social services and arrange for a team and family meeting
c. refer the patient for home care and document the appropriate interventions
d. write a home program and give it to the family
85 A patient is being examined for medial epicondylitis. With this diagnosis, the physical therapist should
expect to MOST likely find pain over the:
a. origin of the flexor digitorum profundus with resisted finger flexion
b. origin of the pronator teres muscle with active pronation
c. medial epicondyle with passive wrist flexion
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d. insertion of the the triceps brachii with passive elbow extension
86 In treating a patient who has had recurrent anterior shoulder dislocation, the physical therapist should
AVOID which of the following extreme shoulder motions?
a. Adduction and lateral (external) rotation
b. Abduction and lateral (external) rotation
c. Hyperextension and medial (internal) rotation
d. Abduction and medial (internal) rotation
87 During the examination of a patient with carpal tunnel syndrome, the physical therapist is MOST likely
to find:
a. paresthesia of the medial palmar surface of the hand
b. weakness of finger extension of the lateral 3 digits
c. paresthesia of the lateral 3 digits
d. weakness in wrist flexion and ulnar deviation
88 A pt with GBS experiencing progressive paralysis is admitted to the intensive care unit. As a member
of the interdisciplinary team managing this patient’s care, the MOST appropriate physical therapy
intervention is for the physical therapist to:
a. alter the patient’s mechanical ventilation settings
b. develop the patient’s medication schedule
c. perform airway clearance techniques
d. discuss the patient’s medical prognosis with the family
89 A patient with complete C4 quadriplegia is working on a program to increase tolerance to the upright
position. While on the tilt table, the patient begins to have a pounding headache with flushing and profuse
sweating. The physical therapist should FIRST:
a. lower the tilt table to a flat position
b. remove the patient from the tilt table and return to room
c. check the patient’s catheter
d. check the patient’s blood pressure
90 A 6 year-old child with spastic diplegia is walking in the parallel bars. The child walks with increased
trunk and hip flexion. What is the MOST appropriate assistive device for this patient?
a. Standard walker
b. Forearm crutches
c. Posterior rolling walker
d. Bilateral quad canes
91 The physical therapist is teaching a patient with T 12 paraplegia to fall. The patient walks with bilateral
knee-ankle-foot orthoses and bilateral forearm cuff crutches using a swing-to gait. The MOST appropriate
method to use to prevent injury is to:
a. have the pt wear a helmet & practice on a soft padded surface
b. give the pt written instructions & illustrations on falling
c. demonstrate & guide the pt through the correct process of falling
d. demonstrate the correct method of falling
92 A PT is designing an exercise program for a healthy elderly individual. Which of the ff types of
exercises is MOST stressful to the cardiovascular system of this pt?
a. Upper-limb ergometry
b. Spinal range-of-motion exercise
c. Quadriceps setting exercise
d. Lower-limb diagonal proprioceptive neuromuscular facilitation patterns
93 A physical therapist is evaluating a patient for a wheelchair prescription. The patient, who lives alone
in a small apartment, has bilateral lower extremity weakness and is unable to stand to transfer. Trunk
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strength and upper extremity strength are normal and the patient can transfer independently with a sliding
board. The MOST appropriate prescription for this patient is a wheelchair with:
a. fixed, adjustable-height arm rests & detachable foot rests
b. removable arm rests and detachable swing-away leg rests
c. fixed arm rests and removable leg rests
d. desk-style removable arm rests & fixed, elevating leg rests
94 A patient who is on bed rest and who exhibits orthostatic hypotension upon standing will MOST likely
experience:
a. increased venous tone in the lower extremities
b. inadequate ventricular filling during diastole
c. dec hydrostatic pressure in the capillary beds
d. parasympathetic stimulation of the heart
95 Which of the following is the MOST appropriate intervention for a patient with juvenile rheumatoid
arthritis who is experiencing painful swelling of both knees?
a. Resistive exercises
b. Stretching to prevent contractures
c. Gentle, active exercises
d. Walking program
96 A patient who has left hemiparesis exhibits shoulder subluxation on the affected side. The patient has
a demand-type cardiac pacemaker. Which of the following interventions should be used ONLY with
extreme caution?
a. Manual resisted exercise on the nonaffected side
b. Active exercise on the affected upper extremity
c. FES to the affected side
d. Biofeedback to the affected side
97 A 5 year-old patient with a closed head injury is exhibiting behavior consistent with the
confused/agitated level of cognitive function. During physical therapy intervention, the patient becomes
combative. Which of the following techniques would be MOST effective in calming the patient?
a. Providing brief moving touch to the face and turning on the patient’s favorite musical tape
b. Maintaining touch to the shoulders and brightening the room by opening the curtains
c. Removing the patient from the current treatment environment and placing the patient in a quiet setting
d. Wrapping the patient in a blanket and rocking the patient rapidly
98 The MOST appropriate therapeutic exercise to stretch the neck muscles for a patient with an acute,
right-sided torticollis is:
a. right rotation and right lateral flexion
b. left rotation and right lateral flexion
c. left rotation and left lateral flexion
d. right rotation and left lateral flexion
99 (pic) A patient presents to physical therapy with low back and leg pain, with symptoms extending to
the bottom of the foot. During the physical therapy examination, the patient does not report leg pain in the
first test position (photograph #1), but reports a severe increase in symptoms in the second test position
(photograph #2). These findings support which of the following conclusions?
a. The pain is the result of a herniated disc
b. The patient may be displaying non-organic symptoms
c. The symptoms are the result of an inflamed sciatic nerve
d. The hamstrings are in a facilitated state of contraction
100 A patient who is re-learning the task of moving from sit to stand following traumatic brain injury is
frustrated because of repeated failed attempts. To facilitate the patient’s success, the physical therapist
should FIRST do which of the following?
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a. Permit the patient to rest until the next physical therapy session and re-attempt the activity
b. Encourage the patient to visualize success with the task, before resuming attempts
c. Provide incentive by holding a desired object for the patient to reach toward
d. Decrease the challenge of the task, so that the patient experiences success
101 The result of which of the following nerve tension tests is MOST likely to be positive for a waiter who
has hand pain when carrying trays overhead?
a. Ulnar
b. Median
c. Radial
d. Musculocutaneous
102 A patient reports dizziness and blurred vision when walking and turning the head to either the left or
the right. The patient has no problem when the head is kept still while walking. Which of the following
systems is MOST likely involved?
a. Visual
b. Vestibular
c. Somatosensory
d. Musculoskeletal
103 Which of the following questions is the MOST appropriate for a functional outcome measurement
tool?
a. “How high can you lift your arm?”
b. “How long have you had this pain?”
c. “How often do you walk with a limp?”
d. “How much does this leg bother you?”
104 A patient describes bilateral posterior lower leg aching that resolves with sitting and is exacerbated
by walking, especially down hills. What diagnosis is MOST likely responsible for this pain?
a. Lateral spinal stenosis
b. Central disc herniation
c. Bilateral piriformis syndrome
d. Neoplastic spinal lesion
105 A patient, who is a tennis player, has been receiving physical therapy intervention following an
anterior capsular reconstruction of the dominant shoulder. The physical therapist determines that the
patient is ready to begin dynamic stabilization exercises. Which of the following is an appropriate dynamic
stabilization exercise for this patient?
a. Hitting a tennis ball against a wall using a forehand stroke
b. Practicing slow forehand strokes with elastic tubing attached to the racquet grip
c. Maintaining a follow through position while the therapist provides rhythmic stabilization resistance
d. Performing push-ups against the wall with emphasis placed on scapular protraction
106 Which of the following ranges of motion is MOST important to obtain for an individual with a T 12
spinal cord injury to walk?
a. Neutral dorsiflexion
b. Full hip extension
c. Normal knee flexion
d. 110° straight-leg raise
107 The physical therapy intervention of a patient with dark skin pigmentation includes superficial heat.
After 5 minutes of this intervention, the physical therapist removes the heat and observes that the skin
over the region being treated is blotchy with both darker and lighter areas. What is the MOST appropriate
action for the physical therapist to take?
a. Discontinue superficial heat and initiate ultrasound
b. Continue with the use of superficial heat, as this is a normal response
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c. Discontinue superficial heat and initiate diathermy
d. Continue with the use of superficial heat, but add more towel layers
108 A 50 year-old patient had an uncomplicated open repair of a rotator cuff tear 2 weeks ago. The
patient asks the physical therapist when the shoulder will be normal again. Which of the following
expected outcome time frames MOST accurately addresses this patient’s question?
a. 3 wks to lift 5-lb (2.3-kg) objects
b. 3 wks to sleep on the involved side
c. 3 mos to lift the UE overhead to reach into a cabinet
d. 3 mos to play golf
109 A pt who had arthroscopic knee surgery 6 weeks ago currently has passive knee ROM of 25° to 125°
with pain at the end of the available range. Which of the following joint mobilization procedures is MOST
appropriate for this pt?
a. Large amplitude oscillations performed within the range of motion, moving the tibia anteriorly on the
femur
b. Small amplitude oscillations performed at the limit of the available motion and into tissue resistance,
moving the tibia posteriorly on the femur
c. Small amplitude oscillations performed at the limit of the available motion and into tissue resistance,
moving the tibia anteriorly on the femur
d. Large amplitude oscillations performed within the range of motion, moving the tibia posteriorly on the
femur
110 The work modification shown in the photo is MOST appropriate for a pt with which of the following
pathologies?
a. Central lumbar stenosis
b. Deep vein thrombosis
c. Thoracolumbar scoliosis
d. Lumbar disc bulge
111 A pt had knee surgery 4 weeks ago. Which of the ff descriptions represents the correct NMES
parameters to use for strengthening the quadriceps mm of this pt?
a. 1 to 4 pps, 100 microseconds
b. 1 to 4 pps, 350 microseconds
c. 40 to 50 pps, 350 microseconds
d. 100 pps, 100 microseconds
112 In order to manually assess a patient’s lower extremity circulation, a physical therapist should palpate
the patient’s peripheral pulse at which of the ff locations?
a. Dorsal foot, near the base of the 1st metatarsal
b. Lateral lower leg, just posterior to the fibular head
c. Lateral ankle, just inferior to the lateral malleolus
d. Plantar foot, just medial to the medial calcaneal tuberosity
113 A PT is evaluating a 70 yo female patient who reports the onset of midthoracic pain after working in a
garden for several hours. The presence of which of the ff Hx items should inc the PT’s suspicion of a
thoracic compression Fx in the pt?
a. Bowel and bladder dysfunction
b. Smoking and prolonged steroid use
c. Hypertension and diabetes
d. Emphysema and hormone replacement therapy
114 Which of the ff sleeping positions is LEAST appropriate for a physical therapist to recommend for a
patient with R glenohumeral joint ant/inf hypermobility & subacromial impingement?
a. Supine
b. Prone
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c. Right sidelying
d. Left sidelying
115 Which of the ff jts is indicated by the arrow in the radiograph?
a. Tibofibular
b. Subtalar
c. Talocrural
d. Midtarsal
116 Which of the ff positions is BEST to assess the length of a patient’s rectus femoris muscle?
a. Sidelying with tested hip in flexion
b. Supine with tested hip and knee in flexion
c. Prone with tested knee in flexion
d. Sidelying with tested hip in extension
117 A patient with an L4 - L5 posterolateral herniated nucleus pulposus is MOST likely to have sensory
deficits in which of the following locations?
a. Medial knee
b. Medial ankle
c. Plantar aspect of the foot
d. Dorsum of the great toe
118 Which of the following descriptions describes the correct physical examination technique to assess
tissue hydration in the hand?
a. Pinch and lift the skin and determine the time for the skin to return to normal
b. Push into the skin and determine the time for the skin to return to normal
c. Measure the surface temperature over the volar aspect of the wrist
d. Obtain volumetric measurements on each arm and compare displacement measures
119 A patient’s standing posture is characterized by a right thoracolumbar scoliosis. The scoliosis is not
present when the patient is sitting. Which of the following dysfunctions is MOST likely the cause of this
patient’s scoliosis?
a. Lumbar facet dysfunction
b. Unilaterally weak gluteus medius
c. Short iliopsoas muscle
d. Leg-length discrepancy
120 To obtain informed consent for an intervention, the physical therapist must disclose to the patient all
of the following EXCEPT the:
a. cost of the intervention
b. goals of the intervention
c. possible risks of the intervention
d. alternative interventions available
121 Which of the following statements is an appropriately written short-term goal?
a. In 2 weeks, the patient will increase walking distance from 50 ft to 100 ft (15 m to 30 m) with a wheeled
walker.
b. The patient will walk 100 ft (30 m) with a wheeled walker and minimal assistance in 3 weeks
c. In 4 weeks, the patient will walk with minimal assistance 100 ft (30 m) without loss of balance
d. The patient will increase walking distance from 50 ft to 100 ft (15 m to 30 m) with a wheeled walker
independently by discharge.
122 Which of the following pulmonary function tests measures the average total amount of air moved
during inspiration of normal breathing?
a. Vital capacity
b. Inspiratory capacity
c. Tidal volume
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d. Inspiratory reserve volume
123 A PT is evaluating a patient who had a R lower lobe resection due to lung cancer yesterday. During
auscultation of the patient’s lungs, the therapist notes decreased low-pitched crackles bilaterally. The
patient’s vital signs are: heart rate – 99 bpm; blood pressure - 115/75 mm Hg; and pulse oximetry - 92%
on 2 liters of oxygen while sitting at the edge of the bed. Which of the following actions should the
therapist take NEXT?
a. Begin walking for the patient on 4 liters of oxygen
b. Contact the physician
c. Perform active range of motion exercises with the patient at bedside
d. Initiate bronchopulmonary hygiene
124 A PT is treating a pt who sustained a complete SCI. The pt currently walks with bilateral KAFO & Fra
crutches. The pt asks the PT about how to correctly descend 1 step. Which of the ff actions is MOST
appropriate for the PT to take?
a. Instruct the pt to approach the step facing fw, lower the legs to the next step, & then place the crutches
on that step
b. Instruct the pt to approach the step facing fw, place the crutches on the lower step, & then lower the
legs to that step
c. Explain to the pt that descending stairs is not an appropriate goal at this time
d. Instruct the pt to approach the step facing fw, place one crutch on the lower step, lower the legs to that
step, & then place the other crutch on that step
125 A physical therapist is planning a 3-session educational series on physical therapy evaluation of the
low back for fourth year medical students. Which of following is MOST important to include in the first
session?
a. An overview of the material that will be covered in all 3 sessions
b. A pretest to determine the level of knowledge of the participants
c. Active participation of the students in a low back evaluation
d. A complete demonstration of a low back evaluation
126 A patient with which of the following diagnoses would MOST likely benefit from pursed-lip breathing
during exercise?
a. Peripheral vascular disease
b. Congestive heart failure
c. Emphysema
d. Sarcoidosis
127 A patient who had a complete spinal cord injury 1 week ago is referred to physical therapy for
transfer training. The examination by the physical therapist reveals that the patient has Good (4/5) upper
extremity strength, Zero (0/5) lower extremity strength, and fair sitting balance. Which of the following
transfers is most appropriate to utilize INITIALLY with this patient?
a. Standing-pivot
b. Sliding-board
c. Sitting-pivot
d. 2-man dependent
128 A patient comes to physical therapy with a wound on the plantar aspect of the heel. The patient
reports that the wound developed after stepping on a tack without realizing it. The wound is now round,
measures 0.75 in (2 cm) in diameter, and displays no signs of infection. Which of the following initial
interventions is MOST appropriate?
a. Bed rest
b. Custom molded shoe
c. Crutches with toe-touch weight-bearing
d. Total-contact casting
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129 A patient has pronounced weakness of the muscles of mastication on the left. A lesion in which of the
following cranial nerves is MOST likely the cause of this impairment in the patient?
a. Trochlear (IV
b. Trigeminal (V)
c. Facial (VII)
d. Hypoglossal (XII)
130 A physical therapist is working with a patient in phase II of a cardiac rehabilitation program. The
patient’s current medications include a beta blocker and antidepressants. Prior to the start of exercise, the
patient’s heart rate was 62 bpm, blood pressure - 110/75 mm Hg, and perceived rate of exertion - 6/20.
After 10 minutes of aerobic exercise, the patient’s heart rate is 68 bpm, blood pressure - 120/70 mm Hg,
and perceived rate of exertion - 14/20. Which of the following initial actions is MOST appropriate for the
physical therapist to take now?
a. Continue the exercise at a lower intensity
b. Continue the exercise at a higher intensity
c. Continue the exercise at the same intensity
d. Stop the exercise and contact the physician
131 A patient is receiving physical therapy for a large wound on the lower leg. Today, after 3 weeks of
treatment, the wound is free of necrotic tissue, but continues to have a copious amount of exudate. Which
of the following dressings is MOST appropriate for the wound?
a. Saline-saturated gauze
b. Semipermeable film
c. Gauze impregnated with zinc oxide
d. Hydrocolloid paste
132 An athlete sustained a severe inversion sprain of the right ankle while playing basketball. To provide
strapping support for the ankle, pressure and support should be applied over the tendons of the:
a. flexor digitorum longus and tibialis posterior
b. gastrocnemius and flexor hallucis longus
c. peroneus longus and peroneus brevis
d. tibialis anterior and tibialis posterior
133 A clean well-granulating Stage II pressure ulcer with minimal serous drainage is MOST appropriately
dressed with:
a. a nonadherent dressing
b. a packed dressing
c. topical medication only
d. dry-to-dry gauze
134 A patient had final approval and checkout of a permanent prosthesis 2 weeks ago. The patient now
reports to the physical therapist that the prosthesis is too heavy. The patient will benefit MOST from:
a. an evaluation of the socket fit by the prosthetist
b. a prescription from the physician for a lighter-weight prosthesis
c. re-evaluation of hip strength by the physical therapist
d. adding a fork strap attachment to the prosthesis
135 A researcher who studied the effects of exercise training on balance test scores measured preexercise and post-exercise. Both the exercise group and the control group were randomly selected from a
group of elderly adults residing in an assisted living facility. A t-test was used to compare the pre-test and
post-test results. The balance scores were significantly improved in the group that performed regular
exercises, but were unchanged in the control group. In deciding whether or not to incorporate these
results into practice, a physical therapist who works in an adult outpatient clinic should be MOST
concerned about which type of validity?
a. External
b. Internal
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c. Construct
d. Statistical conclusion
136 (pic) A patient is asked to grip a white card between the thumb (1st digit) and index finger (2nd digit)
with both hands. The physical therapist pulls on the card in the direction of the arrow shown. The starting
and ending result of the movement is shown in the photograph. The results indicate weakness in which of
the following muscles:
a. Flexor pollicis longus
b. Abductor pollicis brevis
c. Adductor pollicis
d. Extensor pollicis longus
137 A physical therapist is observing the gait of a patient with a transtibial prosthesis. The therapist
observes that at heel strike (initial contact) the patient’s knee is hyperextended. What is the MOST likely
cause of the patient’s gait deviation?
a. A heel cushion that is too soft
b. The socket is placed too far anterior to the foot
c. The prosthesis is too long
d. Inadequate suspension of the prosthesis
138 A patient presents to physical therapy with a 4-month history of low back pain. The patient has
previously received therapy from other health care practitioners for this same pain, without resolution.
During examination by the physical therapist, the patient reports a history of difficulty sleeping, concern
that the pain will never improve, and irritability. The physical therapist should refer this patient to a:
a. social worker
b. psychiatrist
c. nutritionist
d. physiatrist
139 A patient who is 8-mos pregnant has an abdominal diastasis recti with a separation of 1.5 in (4 cm).
Which of the ff ex would be the MOST appropriate initial exercise for abdominal strengthening in a supine
position?
a. Trunk curls
b. Hook-lying head lifts
c. Pelvic-tilt leg sliding
d. Bilateral leg lowering
140 A physical therapist is obtaining the history of a patient, during an initial evaluation. The patient
reveals a 5-year history of rheumatoid arthritis. The physical therapist should expect the patient to
describe pain associated with the rheumatoid arthritis as:
a. morning pain with stiffness that improves with activity
b. pain that is worse at the beginning of an activity
c. constant pain that lasts throughout the day
d. pain that increases throughout the day
141 A physical therapist is observing a patient from behind during bilateral shoulder abduction. The
therapist notes that the patient’s right scapula is more abducted than the left scapula at the end range of
movement. The MOST likely cause of the altered scapula position on the right is:
a. tightness of the rhomboid major and minor
b. weakness of the serratus anterior
c. restricted motion of the glenohumeral joint
d. weakness of the upper trapezius
142 A PT is evaluating a pt experiencing shoulder pain. The pt notices the shoulder pain when stocking
shelves that are overhead at work. The pain is not apparent when stocking shelves at waist or chest level.
The patient MOST likely has weakness in which of the ff muscles?
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PEAT SET 2
a. Pectoralis minor
b. Upper trapezius
c. Deltoid
d. Rhomboid major
143 A physical therapist is evaluating a patient with low back pain and associated symptoms. Which of
the following findings should cause the therapist to refer the patient back to the physician?
a. Good (4/5) strength of the hamstrings
b. Pain radiating down the back of the thigh into the calf
c. Positive straight-leg test at 60° of hip flexion
d. Saddle anesthesia around the perineum
144 A PT is planning to use EMG biofeedback to evaluate mm activity in a pt who had a CVA. The
therapist is monitoring activity in the patient’s triceps brachii muscle. Which method of electromyographic
biofeedback signal processing would give the BEST measure of the quantity of muscle activity during a
planned activity?
a. Integrated
b. Full-wave rectified
c. Amplified raw
d. Low-pass filtered
145 On the first day following a patient’s total knee arthroplasty, a physical therapist establishes the use
of a continuous passive motion device with a setting of 0° to 40° of motion. The MOST appropriate of the
following reasons to use the continuous passive motion device is to:
a. decrease length of the patient’s hospital stay
b. decrease prevalence of deep vein thrombosis in the patient
c. regain knee flexion in the patient
d. prevent knee flexion contracture in the patient
146 A patient presents with ptosis of the left eye, a lateral strabismus, and a dilated pupil on the left. The
patient also reports double vision. Upon examination, results of which of the following cranial nerve tests
is MOST likely to be abnormal?
a. Pupillary light reflex
b. Facial muscle strength
c. Jaw-jerk reflex
d. Pain sensation on the face
147 During steady rate exercise, the blood pressure in a normal person MOST typically responds with:
a. systolic pressure increase & no change in diastolic pressure
b. no change in systolic pressure & marked dec in diastolic pressure
c. systolic pressure decrease & diastolic pressure increase
d. no change in systolic pressure, until the end point of the exercise bout
148 A patient fell while rock climbing 2 days ago. The fall resulted in a fracture of the right ankle, requiring
an open reduction internal fixation. The patient also sustained a brachial plexus injury which resulted in
significant weakness in the muscles in the right C6-C7 myotome. The patient is to remain non-weightbearing on the right. Which of the following assistive devices is MOST appropriate for this patient?
a. Axillary crutches
b. Wheelchair
c. Standard walker
d. Forearm crutches
149 A PT is taking the Hx of a pt with LBP. Which of the ff questions is BEST for the therapist to ask, if
the therapist suspects the pain is caused by an inflammatory reaction?
a. “Is your pain constant or intermittent?”
b. “What activity bothers you the most?”
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c. “Is it difficult to stand up straight after you’ve been sitting?”
d. “Does your pain radiate down into the leg?”
150 Which of the following activities should be AVOIDED by a patient who has undergone a total hip
arthroplasty using a posterolateral approach 5 days ago?
a. Walking with a walker
b. Isometric gluteal setting exercises
c. Active hip abduction in supine
d. Crossing the legs while seated in a chair
151 A pt has a 2 week Hx of constant L, lower quadrant, abdominal pain that occasionally refers to the
low back, pelvis, & L LE. The pt also reports having a low grade fever & bloody, loose stools during the
last few days. Which of the ff conditions MOST likely explains the pt’s S & Sx?
a. Kidney stones
b. Diverticulitis
c. Gallstones
d. Appendicitis
152 During the gait evaluation of a patient, the physical therapist notices that the patient laterally bends
excessively towards the right side during midstance phase on the right. In order to muscle test the
suspected muscle for Normal strength (5/5) the patient should FIRST be positioned:
a. prone with the knee straight
b. supine with the knee bent
c. seated with the hip flexed to 110°
d. sidelying on the left side
153 During evaluation of a patient’s gait, the physical therapist observes that the patient leans forward
shortly after heel strike (initial contact). The patient’s forward bending is MOST likely a compensation for
weakness of which muscle(s)?
a. Quadriceps
b. Hamstrings
c. Gluteus maximus
d. Anterior tibialis
154 A patient reports pain and weakness when performing overhead activities and has difficulty flexing
the arm past 90°. The physical therapist finds the results of the patient’s impingement tests are positive
without a rotator cuff tear. Which of the following interventions should the therapist introduce FIRST in the
patient’s rehabilitation program?
a. Closed kinetic chain strengthening of the deltoid muscle
b. Active assistive shoulder range of motion
c. Stretching the shoulder external rotator muscles
d. Strengthening of the subscapularis and teres major muscles
155 A pt is being seen by a PT ff a mild MI. The goal is to increase the pt’s ex endurance for return to
work. The pt is otherwise healthy & is taking propanolol (Inderal) 1 time/day. The therapist is setting the pt
up on a daily home ex program utilizing a stationary bike & treadmill walking. The PT should teach the pt
to use which of the ff methods to monitor ex intensity during ex sessions at home?
a. Heart rate
b. Blood pressure
c. Perceived exertion
d. Respiration rate
156 Which of the ff stretching techniques is BEST for addressing an anteriorly tilting pelvis that is caused
by muscle shortness?
a. Prone lying with the knee bent
b. Supine with the knee bent and pulled toward the chest
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c. Quadruped sitting back on the heels with arms stretched forward
d. Lying on the back with hip flexed to 90° and knee straight
157 (pic) A PT is examining the hip ROM in a patient, as shown in the photo. PROM is applied to the pt’s
legs in the direction of the arrows. The photo shows the end points of the ROM. The MOST likely cause
of the hip dysfunction occurring in the pt is:
a. hypomobility of the hip IR on the L
b. weakness of the L hip IR
c. laxity of the L hip capsule
d. tightness of the hip ER on the L
158 A physical therapist is treating a patient who has shoulder pain radiating down into the elbow. The
therapist applies transcutaneous electrical nerve stimulation, which gives initial relief, but then the pain
returns. To prevent the nerve from accommodating to the stimulation, the therapist should FIRST:
a. decrease the intensity
b. increase the pulse width
c. switch to modulated mode
d. change the electrodes
159 A physical therapist is designing a rehabilitation program for a patient recently diagnosed with
ankylosing spondylitis. The physical therapist should anticipate that as the disease progresses, the
patient is MOST likely to require:
a. special precautions for osteoporosis
b. a wheelchair for community mobility
c. assisted ventilation
d. bilateral ankle-foot orthoses
160 A physical therapist is applying electrical stimulation to a patient with a neurapraxia. To minimize
accommodation, the physical therapist should:
a. decrease the size of the stimulating electrode
b. increase the pulse duration
c. utilize a rapid rate of rise
d. select a biphasic waveform
161 Sensory-level ES is MOST appropriate for a pt with which of the ff conditions? a. Chronic low back
pain of somatic origin
b. Acute ankle sprain with edema
c. Supraspinatus tendonitis
d. Active Raynaud’s syndrome
162 While working in a private practice clinic, a PT observes a patient fall in the parking lot outside the
office. The pt sustains a severe laceration to the Fra. The PT secures a pressure dressing to the wound
site, but notes that blood is soaking through the dressing & the bandage. Which of the ff actions should
the therapist perform NEXT?
a. Elevate the limb & apply pressure to the wound
b. Remove the dressing & bandage & start over with a tighter bandage
c. Apply additional dressings and bandages and apply pressure to the brachial artery
d. Call the pt’s physician & arrange transportation for medical care
163 A PT is using a stethoscope to auscultate a patient’s S1 and S2 heart sounds. Of the following
procedures, the MOST appropriate for the physical therapist to use is to apply the:
a. diaphragm of the head of the stethoscope firmly on the skin
b. bell of the head of the stethoscope firmly on the skin
c. diaphragm of the head of the stethoscope lightly on the skin
d. bell of the head of the stethoscope lightly on the skin
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PEAT SET 2
164 While performing transfer training from bed to chair with a pt who had a THA 2d ago, the ECG
monitor alarms & the PT that PVC’s have developed. What is the PT’s BEST action at this time?
a. Position the pt on a stable surface & DC PT for the day
b. Continue the transfer to the chair & monitor the pt’s SaO2
c. Continue the pt’s transfer to the chair & immediately notify the nurse about the PVC’s
d. Position the pt on a stable surface & determine the stability of the premature ventricular contractions
165 A pt with chest pain from MI will MOST likely exhibit:
a. increased pain upon chest-wall palpation
b. increased pain with deep breathing
c. relief with nitroglycerin (Nitrostat) ingestion
d. relief with antacid ingestion
166 Which of the following subjective reports from a patient with rheumatoid arthritis indicates the need
for further medical examination by a physician?
a. Morning pain in both lower extremities
b. Numbness in both lower extremities
c. Increased pain during activities of daily living
d. Inability to sleep at night
167 To acquire specific information about the visual status of a patient following an acute cerebrovascular
accident, the physical therapist should refer to what section in a physician’s admission note?
a. PERRLA
b. CBC
c. Cor
d. PMH
168 A patient with Parkinson’s disease demonstrates shortness of breath with activity. Which of the
following tests is MOST appropriate for the physical therapist to perform to help delineate a cause for the
patient’s shortness of breath?
a. Deep tendon reflex testing
b. Sensory examination
c. Muscle strength testing
d. Posture examination
169 During an initial evaluation, which of the following tests is MOST appropriate to perform with a patient
who has acute right-sided congestive heart failure?
a. Sensory testing of upper extremities
b. Pitting edema measurements in the lower extremities
c. Resisted manual muscle testing of all extremities
d. Reflex testing of lower extremities
170 A PT is working on progressive fxnl mobility with a pt who had a transverse colectomy 2d ago. The pt
has dev a low grade fever. What is the MOST appropriate exam for the PT to perform, prior to
continuation of the pt’s intervention?
a. Heart rate
b. Blood pressure
c. Respiratory rate
d. Auscultation
171 Upon auscultation, a PT hears crackles over the third intercostal space & R midclavicular line. To
MOST appropriately document this finding, what region of the lung should be identified by the therapist?
a. Anterior segment of the right upper lobe
b. Superior segment of the right middle lobe
c. Apical segment of the right upper lobe
d. Inferior segment of the right middle lobe
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PEAT SET 2
172 In addition to standard precautions, what other precaution should a physical therapist observe when
working with a patient infected with methicillin-resistant Staphylococcus aureus?
a. Airborne
b. Sterile
c. Droplet
d. Contact
173 A 50 yo pt with metabolic (insulin resistance) syndrome comes to PT to initiate a conditioning
program. Which of the ff initial ex prescriptions is MOST appropriate for this pt?
a. Intensity: HR 74-80bpm. Freq: 4-5d/wk. Duration: 30min. Mode: walking
b. Intensity: HR 105-115bpm. Freq: 2-3 d/wk. Duration: 20min. Mode: walking
c. Intensity: RPE 6-8 (6 to 20 scale). Freq: 4-5d/wk. Duration: 30min. Mode: stationary bike
d. Intensity: RPE 13-15 (6 to 20 scale). Freq: 2-3d/wk. Duration: 20min. Mode: stationary bike
174 A PT is performing sit-to-stand transfer training with a pt in a hospital room. The pt is currently
admitted for acute renal failure & has ECG monitoring in place. During the transfer training, the PT notes
new onset of 1 unsustained, unifocal PVC. Which of the ff actions is MOST appropriate for the therapist to
take at this time?
a. Discontinue transfer training and call the nurse immediately
b. Discontinue transfer training and switch to passive range of motion exercises
c. Allow the patient to rest and continue with transfer training, while monitoring the ECG
d. Allow the patient to rest & measure the pt’s BP
175 A patient had a split-thickness skin graft for a superficial partial-thickness burn injury to the upper
extremity. The surgeon has requested range of motion exercises for the patient. Currently, the patient is
able to actively move the upper extremity through one-third of range of motion for shoulder flexion. Based
on this finding, what is the MOST appropriate action for the physical therapist to take at this time?
a. Defer any range of motion exercises until the patient is able to participate more actively
b. Begin active assistive range-of-motion exercises
c. Begin bed mobility training to facilitate increased use of the upper extremity
d. Continue with active range-of-motion exercises
176 A patient with idiopathic pulmonary fibrosis completed a 6-minute walk test and demonstrates the
following results: Total Walking Distance - 1200 ft (366 m) in 6 minutes; Heart Rate - 82 to 110 bpm (pretest to post-test); Blood Pressure - 125/80 to 145/85 mm Hg (pre-test to post-test); Respiratory Rate - 18
to 40 (pre-test to post-test); Oxygen Saturation - 98% to 92% (pre-test to post-test); ECG-NSR throughout
test. Based on these results, the physical therapist should determine that this patient has impaired:
a. aerobic capacity and endurance associated with cardiovascular pump dysfunction
b. ventilation, respiration, and aerobic capacity associated with airway clearance dysfunction
c. ventilation, respiration, aerobic capacity and gas exchange associated with ventilatory pump
dysfunction
d. aerobic capacity and endurance associated with cardiovascular pump failure
177 A patient who is currently participating in an outpatient cardiac rehabilitation program asks the
physical therapist about intervention options for an apparent athlete’s foot fungal infection on both of the
patient’s feet. The patient has been using an over-the-counter analgesic ointment for 5 days, but the
condition does not seem to be improving. Which of the following actions is the correct response of the
physical therapist?
a. Refer the patient back to the cardiologist
b. Recommend an over-the-counter anti-fungal ointment
c. Tell the patient to continue using the ointment for another 5 days and then reassess
d. Instruct the patient to discuss the situation with a pharmacist
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PEAT SET 2
178 A PT is reviewing the medical record of a pt in the ICU. The pt was admitted the previous night
through the ER, ff a motorcycle accident resulting in a R femur Fx. The therapist notes a physician’s order
for a Doppler study of the left leg. The therapist should:
a. proceed with the evaluation and intervention without any changes
b. hold physical therapy, until results of the study are obtained and interpreted by the physician
c. proceed with the evaluation and limit intervention to transfer to a bedside chair
d. obtain clearance from the nurse to provide intervention for the patient
179 (pic) A PT is conducting a reflex text as shown in the photo. The starting & ending position of the test
is indicated by the arrow. The results of the test are MOST likely to indicate:
a. a peripheral nerve injury
b. a lesion of the anterior horn cells
c. a normal response
d. an injury to the spinal cord
180 A 3 mo-old infant presents to PT with poor midline head control. Upon evaluation, the PT notes facial
asymmetry & observes limitation of cervical Rot to the L & cervical lat flex to the R in the infant. A
radiology report indicates premature fusion of the infant’s cranial sutures. This infant has:
a. right congenital muscular torticollis
b. left congenital muscular torticollis
c. right cervical facet hypomobility
d. left cervical facet hypomobility
181 A PT evaluates a pt who has back pain & determines that the pt’s pes planus is contributing to this
pain. Which of the ff orthotic interventions is MOST appropriate for this pt?
a. Metatarsal pad
b. Solid ankle-foot orthosis
c. Hinged ankle-foot orthosis
d. Longitudinal arch support
182 During which of the ff scenarios are gloves required to comply with standard precautions?
a. During all pt care in the hospital setting
b. Performing ROM on a pt with AIDS
c. Massaging the neck of a pt with hepatitis C
d. Changing an infant’s diaper in the pediatric setting
183 A PT is educating a pt on the use of a HMP for home Tx. To prevent burns & still receive the benefits
of superficial heat, which of the ff heat application time frames is MOST appropriate for the therapist to
recommend to the pt?
a. 5 to 10 min
b. 20 to 30 min
c. 45 to 60 min
d. 61 to 90 min
184 A pt comes to PT via direct access for eval of insidious shoulder pain. Upon inspection, the PT notes
a yellowish color of the pt’s sclera & skin. The PT should refer this pt to a physician for probable primary
dysfunction of the:
a. liver
b. eye
c. duodenum
d. heart
185 A 22 yo pt is hospitalized awaiting a lung transplant due to cystic fibrosis. The pt’s MD is interested in
an objective measure of the pt’s preop endurance. Which of the ff tests is MOST appropriate for the PT to
administer to this pt?
a. VO2 max treadmill test
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PEAT SET 2
b. 2-step test
c. Submaximal exercise test on a cycle ergometer
d. 6-minute walk test
186 A physical therapist is preparing for gait training with a young, adult patient with paraplegia. Which of
the following gait training options is MOST appropriate for the patient’s first session?
a. Swing-through gait pattern with a walker
b. Swing-through gait pattern with forearm crutches
c. Swing-to gait pattern with axillary crutches
d. Swing-to gait pattern in the parallel bars
187 A patient with peripheral vascular disease presents to physical therapy for evaluation and
intervention. The patient used to walk for exercise, but can no longer walk to the mailbox at the end of the
driveway without experiencing leg pain. This patient will MOST likely also have:
a. relief of pain with the legs elevated
b. purple or brown pigmentation of the skin on the legs
c. relief of pain with the legs in the dependent position
d. a positive Homan’s sign
188 A patient comes to physical therapy for intervention for an ulcer on the right medial malleolus. Upon
inspection of the patient’s legs, the physical therapist notes normal skin temperature and brownish
pigmentation of the skin. The patient MOST likely also has:
a. edema
b. diminished pedal pulse
c. lower extremity pain with exercise
d. hypersensitivity to cold
189 The parent of a 4 year-old child who has myelomeningocele is interested in obtaining orthoses for the
child’s gait training. The child has an L1 neurological level lesion. Which of the following orthoses is the
MOST appropriate selection for the physical therapist to discuss with the parent?
a. Hip-knee-ankle-foot with locked hips
b. Reciprocating-gait
c. Knee-ankle-foot with a pelvic band
d. Ankle-foot
190 A patient who sustained a right cerebrovascular accident presents with a flaccid arm. During muscle
testing, the patient is able to shrug the left shoulder. The MOST accurate explanation for shoulder
movement is that the right cerebrovascular accident:
a. has affected the right shoulder and not the left shoulder
b. did not affect the vagus nerve (X), which innervates the upper trapezius muscle
c. did not affect spinal accessory nerve (XI), which innervates the upper trapezius muscle
d. has affected the left biceps and triceps muscles, but not the deltoid muscles
191 A physical therapist is evaluating the cranial nerves of a child who has a medulloblastoma. The
child’s right eye deviates medially. This child has impairment of which of the following cranial nerves?
a. Oculomotor (III)
b. Trochlear (IV)
c. Abducens (VI)
d. Vagus (X)
192 A physical therapist is examining a 9 month-old child who was born at 28 weeks gestational age.
Which of the following activities should this child be able to perform?
a. Walking independently
b. Standing independently
c. Creeping on hands and knees
d. Rolling supine to prone
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PEAT SET 2
193 A 90 year-old hospitalized patient was referred for physical therapy evaluation and intervention
following a C1 fracture secondary to a fall. The patient describes neck pain and left knee pain, but reports
no other postinjury changes in the extremities. The rehabilitation prognosis for this patient should
PRIMARILY be based on:
a. prior level of function
b. left-knee range of motion
c. use of a cervical collar
d. upper-extremity sensory integrity
194 A patient with a traumatic brain injury is being discharged to home following completion of inpatient
rehabilitation. Which of the following assessment tools would BEST assess the patient’s potential?
a. Glasgow Outcome Scale
b. Fugl-Meyer Assessment
c. Rancho Los Amigos Levels of Cognitive Functioning Scale
d. Sickness Impact Profile
195 A patient with COPD is starting to participate in a supervised exercise program. The MOST important
aspect to monitor during this exercise program is the:
a. cardiorespiratory endurance training
b. resistive exercise
c. active soft-tissue stretching
d. warm-up and cool-down intensity
196 During gait evaluation, a physical therapist notes that a patient demonstrates a shorter step length
with the right lower extremity. Which of the following problems is MOST likely the cause of this gait
dysfunction?
a. Right iliopsoas contracture
b. Painful left knee
c. Decreased ankle pronation on the right
d. Left gluteus medius weakness
197 A patient is receiving mechanical intermittent cervical traction with an on/off duty cycle of 20 sec/10
sec. The patient reports increased pain each time the traction unit cycles on, which then subsides over
the duration of the on time. Which of the following modifications to the duty cycle is MOST appropriate?
a. Increase the off time to 20 seconds
b. Increase the on time to 20 seconds
c. Decrease the off time to 5 seconds
d. Decrease the on time to 5 seconds
198 A patient, who had a C8 traumatic spinal cord injury 1 month ago, reports a severe, pounding
headache and restlessness while standing in the parallel bars. The patient’s vital signs indicate
hypertension and bradycardia. The MOST appropriate immediate response of the physical therapist is to:
a. instruct the patient in deep breathing techniques
b. apply a cervical cold pack
c. remove the abdominal gait belt
d. assess for catheter blockage
199 (pic) A physical therapist is testing the deep tendon reflex of a patient, as shown in the photograph.
The patient has a partial nerve injury to the tested nerve root. Which of the following reflex grades is the
therapist MOST likely to find in the patient?
a. 0
b. 1 +
c. 2 +
d. 3 +
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PEAT SET 2
200 During an initial physical therapy evaluation, a patient reports occasional breathlessness. Which of
the following patient reports indicates the PRIMARY need for a more thorough pulmonary examination by
the physical therapist?
a. There is paroxysmal nocturnal dyspnea
b. The symptoms are relieved by leaning forward
c. There has been a recent change in physical activities
d. The breathlessness is associated with lightheadedness
ANSWERS & RATIONALE
1. C During pregnancy and postpartum, the stretched abdominal muscles are unable to stabilize the lower
back as the legs are raised. Attempting to perform double leg lifts can overwork the abdominal muscles
and cause damage to spinal joints.
2. A Exercise intensity can be expressed as oxygen uptake during activity. Heart rate and oxygen uptake
have a relatively linear relationship. Therefore, utilizing a target heart rate will ensure that the appropriate
exercise intensity is being achieved. Estimation of energy expenditure requires measurement of oxygen
consumption that is then calculated into calories metabolized during the activity. Blood pressure cannot
be controlled at specific heart rates. Exercising at maximal capacity does not achieve aerobic training
benefits and is unsafe for the majority of patient populations.
3. A Goals of PT intervention for a child with Duchenne muscular dystrophy are to retard the development
of contracture and muscle weakness, which could lead to functional limitations, and thus, disability. The
physical therapist would also play a role in determining the appropriate use of assistive devices that could
help maintain the child’s mobility such as wheelchairs, walkers and orthoses. Muscle tone changes and
declines in strength cannot be prevented since they are results of the disease process.
4. C During pregnancy, the ligaments soften due to hormonal influences, and allow some degree of
separation between the joint surfaces. Additional stretching of the ligaments could result in joint instability
or injury, and would not be a goal of treatment. The remaining options are all appropriate interventions.
5. A The trochlea of the talus is convex. Therefore, during dorsiflexion of the ankle, the talus moves
posteriorly relative to the tibia. To facilitate the movement of dorsiflexion one would need to perform a
posterior glide of the talus on the tibia.
6. D Aerobic conditioning that occurs during the 12 weeks of cardiac rehabilitation will result in a decrease
in heart rate both at rest and with exercise. CO2 elimination and cardiac output would both increase with
maximal work. The stroke volume would increase during submaximal work.
7. D The residual limb is pistoning up and down because the socket diameter is too large or the
suspension system is inadequate, resulting in skin friction. The addition of more socks will enhance the fit.
8. D The fact that backward bending is centralizing the pain is an indicator that the nucleus of the disc is
being moved centrally, and the pressure is being taken off of the nerve root. Centralization of the pain is
also a good indicator for physical therapy intervention.
9. C Ice massage is usually applied to control pain, edema, or inflammation. In this case, the ice would be
used for pain relief and to reduce inflammation, if present. The dosage for ice massage is determined by
the patient’s response, and is usually applied until the patient experiences analgesia or reported
numbness over the area of the massage. Although 5 to 10 minutes may be a usual time for the response
to occur, the dosage depends on the patient’s response, not on an exact time. The patient will usually feel
the following, sequential sensations during the massage: cold, burning, aching and then finally numbness.
The desired effect is numbness, not aching. The skin may turn white; however, the desired effect is
numbness or pain reduction and not skin color.
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PEAT SET 2
10. D The independent variable can be thought of as the cause or treatment and the dependent variable
can be thought of as the effect or response. In this case the TENS is the treatment or independent
variable. Continuous and discrete variables are methods of quantifying variables.
11. A During aerobic exercise, there is vascular dilation that occurs in order to optimize blood flow and the
venous system relies on muscular pumping in order to return blood back to the heart. Without a cooldown period, there would be no muscular pumping and therefore blood would pool in the venous system.
Cardiac arrhythmia may occur as well, but is less likely in someone without cardiac disease. Cessation of
activity by itself would result in a gradual decrease in body temperature and specific exercises are not
necessary. Muscle tightening may occur as a result of metabolites accumulating in the circulatory system,
but this would occur as a result of the venous pooling.
12. C The piriformis muscle functions as an external rotator of the hip, and it is thought that a tight
piriformis muscle may compress the sciatic nerve causing pain. Passive internal rotation and resisted
external rotation may be painful. Intervention would call for stretching of the piriformis muscle, not
strengthening it. Modalities such as ice may also be helpful to decrease the inflammation.
13. C The most appropriate first step (pre-planning) would be to evaluate existing services within the
community and work out a budget for the project. Options 1 and 2, although important, are things that
would most likely be done after the practice is up and running. Option 4 may be done early on in the
planning process, but would follow Option 3.
14. D Signs and symptoms of hip bursitis include the following: severe pain over the bursa area, with pain
aggravated by active motion including activities such as walking. Signs and symptoms of a sacroiliac joint
derangement include pain directly over the region of the joint and in the low back, in addition to pain with
walking. Signs and symptoms of a hip fracture will include the following: severe pain in the groin area and
tenderness occurs in the area anterior to the femoral neck. An adductor longus muscle strain would not
cause tenderness over the greater trochanter.
15. B All documentation about PT services should readily translate the physical findings (impairments)
into functional abilities/limitations.
16. C Of the four options, backward walking is the only one that requires hip extension with concurrent
knee flexion and hip flexion with knee extension.
17. A The therapist is shown performing a volar glide which is the same joint motion used for finger
flexion. Limited motion in this direction indicates limited ability to perform finger flexion.
18. A NCV testing is most useful in the evaluation of peripheral nerve or lower motor neuron status.
Therefore, since carpal tunnel syndrome is the only one of the conditions that directly involves a
peripheral nerve; it would be the most appropriate choice. A cerebrovascular accident is an upper motor
neuron disorder. Both myotonia and Duchenne muscular dystrophy are primary muscle disorders.
19. C Thrombocytopenia is an acute or chronic decrease in the number of platelets in the circulation. The
T4 lymphocyte count is used to assess immune status in patients with HIV or AIDS. The red blood cell
count is utilized to assess for presence of anemia and the white blood cell count would be examined to
determine presence of infection or degree of immunosuppression.
20. C Exercise has been shown to increase sensitivity of the insulin receptors therefore leading to a
decrease in the amount required. Administration of medication is dictated by tolerance and efficacy of the
medication and would not necessarily be altered by exercise. In patients with moderate hyperglycemia,
exercise can lead to hypoglycemia for periods of 24 to 48 hours after exercise, therefore increasing
caloric intake, particularly carbohydrates, would be essential.
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PEAT SET 2
21. B Wet-to-dry dressings are indicated for necrotic tissue needing debridement. The moderate amount
of drainage would require more frequent (i.e., bid) dressing changes. Vigorous scrubbing of the wound
could damage friable tissue. Betadine can be cytotoxic. Whirlpool would not be effective in removing
necrotic tissue.
22. B The most efficient stimulus would be one that causes tetany in the muscle(s) without causing
fatigue. The biphasic waveform at 30 pps best fits this stimulus. The 100 pps stimulus rate may cause
fatigue, which would be undesirable. The interferential waveform at a frequency of 1 pps is too low and
the direct current would not be appropriate because it would not cause tetany. In addition an on/off cycle
of 1:5 would allow adequate recovery time for the muscles between successive contractions.
23. C A 20° knee flexion contracture means that the knee is unable to complete the last 20° of extension.
This limitation of motion can be caused by several factors including tightness of the hamstrings
(semimembranosus), restriction in the posterior capsule of the knee, and weakness of the quadriceps
femoris muscles (vastus medialis). Restriction of patellar movement may also be a factor, however the
proper glide technique to increase knee extension would be a superior (not inferior) glide of the patella.
24. D The soleus originates on the tibia and fibula and inserts onto the calcaneus, crossing only the ankle
joint. Therefore, it will have an effect on the ankle whether the knee is flexed or extended. The
gastrocnemius and plantaris both have origins on the femur and insert onto the calcaneus crossing both
the knee and ankle joints. Therefore, they will be placed on stretch with the knee extended and will
potentially limit ankle dorsiflexion to a greater extent with the knee extended. The tibialis anterior is a
dorsiflexor of the ankle and while weakness in this muscle may limit active dorsiflexion, it would not affect
passive dorsiflexion.
25. A A state of alertness to the internal and external environment must be maintained for motor or
mental activity to occur. The brain stem reticular activating system brings about this state of general
arousal. To proceed from a state of general arousal to one of "selective attention" requires the
communication of information to and from the cortex, the thalamus, and the limbic system and its
modulation over the brainstem and spinal pattern generators.
26. D The Standards of Practice for Physical Therapy state that the physical therapist is responsible for
establishing a plan of care for the patient based on the evaluation of the examination data and patient
needs. The plan of care includes plans for discharge. The implication is that the long-term goals for the
patient (discharge plans) are determined when the therapist first sees the patient. It is anticipated that
modifications of the plan of care is to be expected depending on the response of the patient to the
intervention.
27. B The median nerve innervates the following muscles in the forearm: (1) pronator teres and
quadratus, (2) flexor digitorum superficialis, (3) flexor digitorum profundus (index and middle fingers), (4)
thenar muscles (abductor pollicis brevis, opponens pollicis, flexor pollicis brevis). Therefore, a lesion of
the median nerve would affect those muscles and their accompanying actions: forearm pronation, finger
flexion and thumb opposition. Thumb adduction is accomplished by the adductor pollicis (ulnar nerve).
Finger abduction is performed by the dorsal interossei (ulnar nerve). Forearm supination is the action of
the supinator (radial nerve) and biceps brachii (musculocutaneous nerve).
28. B Objectives must be measurable and the specific behavior expected should be stated.
Understanding, overcoming, and appreciating elude tangible measurement, while listing five techniques is
an activity that can be documented and is therefore measurable.
29. A The sartorius flexes, externally rotates and abducts the hip joint. With resisted hip flexion, the
sartorius will be recruited to perform all three actions giving the observed substitution pattern. The tensor
fascia latae is a medial (internal) rotator and flexor of the hip, so substitution by it would involve medial
(internal) rotation and abduction. The adductor longus would adduct the hip. Substitution by the
semimembranosus would cause hip extension.
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PEAT SET 2
30. B The recommended dosage for mechanical, intermittent pneumatic compression pressure is
between 30 and 80 mm Hg, (higher for the lower extremities than upper extremities). It is also
recommended that the pressure be below the diastolic pressure. Pressures below 30 mm Hg are not
considered to be effective. Pressures above diastolic can be used with caution. For the first treatment, it
would be most appropriate to use a pressure which is considered effective, yet not so high as to cause
potential problems for the patient. If the patient responds positively to the intervention, a higher pressure
could be instituted.
31. C According to the Guide to Physical Therapist Practice, "Information relating to the physical
therapist/patient relationship is confidential and may not be communicated to a third party not involved in
that patient’s care without the prior written consent of the patient." Option 3 is the only one that fits these
criteria.
32. A Sixty percent of children with myelomeningocele develop hydrocephalus after surgical closure of
their lesion. Early warning signs of hydrocephalus include irritability; changes in sleep patterns, and
changes in appetite and weight. Eighty to ninety percent of children who acquire hydrocephalus will
require a cerebrospinal fluid shunt. These children require ongoing follow-up by a physician. Given the
seriousness of this child’s symptoms, the child should be immediately referred for medical follow-up.
33. C With an anterolateral approach, the gluteus medius is reflected or the trochanter is taken down.
Post operatively, these structures need time to heal and will not be healed only 2 weeks after surgery.
The abductors should not be aggressively strengthened with exercise.
34. D This patient’s signs and symptoms are reflective of a right sided cerebellar hemisphere lesion. That
is, cerebellar lesions commonly produce hypotonia, hyporeflexia, ataxia and an intention tremor.
Cerebellar lesions also produced ipsilateral signs and symptoms in the extremities. A right sided lesion of
the spinal cord (Brown-Sequard syndrome) would produce weakness with spasticity and hyperreflexia. A
left sided cerebral hemisphere lesion would present similar to a right sided cervical spinal cord lesion. A
lesion of the substantia nigra would produce signs and symptoms like as those seen with Parkinson’s
disease with rigidity and a resting tremor.
35. B The common peroneal nerve innervates the following muscles: peroneus longus and brevis, tibialis
anterior, extensor digitorum longus and brevis, peroneus tertius and extensor hallucis longus. Because of
the complete nerve severance, all of those muscles would be affected and would not be able to actively
contract until regeneration has taken place. Therefore, the patient would completely lose ankle
dorsiflexion, eversion, and toe extension. Those motions would have to be performed passively in order
to maintain range of motion. Option 2 is the only one that contains all of the correct actions.
36. A Option 1 is the best answer. In Option 2, if the patient does not initially understand the information,
then having short-term memory is irrelevant. For Option 3, hearing and vision are obviously important, but
the most critical component is comprehension. Option 4 is irrelevant to the scenario.
37. B The center of gravity of a person with bilateral above-knee amputations is more posterior than the
center of gravity of a person with their lower extremities intact. Setting the back wheels more posteriorly
will make the patient more stable in the chair. This adjustment prevents the wheelchair from tipping
backward.
38. B Anticoagulation therapy inhibits the synthesis and function of clotting factors and can lead to
bruising (ecchymosis) or more severely hemorrhage. A hemangioma is a benign liver tumor. Deep vein
thrombophlebitis would result in redness, swelling and warmth in the effected area and most commonly
occurs in the calf muscle, not the hip region. A hematocele is a blood cyst.
39. A An ST segment depression of greater than 1 mm is indicative of myocardial ischemia. Continuing
the exercise session could place the patient at serious risk for continued ischemia, which could ultimately
lead to myocardial infarction. Therefore, the best response for the therapist would be to stop the exercise
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PEAT SET 2
session immediately and inform the cardiologist of the patient’s response. All of the other options would
continue to place the patient at risk.
40. B The patient taking beta-blocking medication will experience a lower heart rate and blood pressure
response during exercise as compared to a patient who is not taking this medication. Since the heart rate
is lower than anticipated, using heart rate to monitor exercise intensity may not be as accurate. Another
measure, such as the Borg Scale (rating of perceived exertion) would be more beneficial. However, even
though heart rate and blood pressure would be lower, the patient actually achieves the same metabolic
levels during exercise and therefore altering the frequency or duration of exercise is unnecessary. The
time for warm-up and cool-down exercises does not need to be altered.
41. A The electrode placement in the photograph is the best placement for the tensor fascia latae. The
electrodes are placed over the muscle belly and lined up parallel to the muscle fibers. The satorius is
found more distal and medial and following the direction of the muscle fibers. The rectus femoris is found
more distal and central to the thigh. The gluteus medius is a deep muscle that is not monitored directly by
surface electromyography easily.
42. A Since most of the joint contracture/adhesion forms in the anterior-inferior portion of the capsule,
treatment to mobilize that portion of the capsule is of primary concern. Inferior glide would stretch the
inferior portion of the capsule.
43. B Options 1, 3, and 4 are acceptable interventions for this patient. The epiphyseal areas (growth
areas of bones) in children should not be exposed to ultrasound. The application of ultrasound over the
knee joint (hamstring insertion) could expose the epiphyseal areas to the ultrasound.
44. D Scoliosis deformities are named relative to the convexities of the curves, with the apex of the curve
defining the vertebral level. In a right thoracic, left lumbar structural scoliosis, there is a convex curve to
the right in the thoracic spine and a convex curve to the left in the lumbar spine. In the thoracic spine, the
body of the vertebrae rotates to the right (convex side) and the spinous processes rotate toward the left
(concave side). Along with this rotation, the ribs rotate posteriorly on the convex side causing the scapula
to become more prominent on the convex side and causing the shoulder to be elevated on the convex
side.
45. C Patients with Parkinson’s disease are characterized by rigidity, bradykinesia, tremor, lack of
associated movements, impaired balance reactions and a flexed posture (kyphosis). Therefore,
intervention should be directed toward full range of motion and correction of kyphotic posture through
back extensor strengthening exercises, balance exercises, and exercises that promote reciprocal
movement. Option 3 is the only one that includes appropriate exercises.
46. A Upon heel contact, the heel section compresses, partially absorbing the ground impact and thus
permitting a controlled plantarflexion. If the heel is too stiff, upon initial contact, the knee flexes too soon
and excessively on initial contact. An excessively firm heel wedge would not be a factor in late stance.
47. A Evaluation of the patient’s retention of the information presented in the program can be enhanced
by asking the patients questions about the program information, having the patients ask questions about
the program, having the patients demonstrate what they have learned and testing the patient about the
program material. Option 1 is the only one that utilizes one of these techniques. The other options do not
require active participation by the patients, and they do not address specific interventions.
48. C During the Sw phase of gait, the foot is DF to clear the floor. Muscles active during this phase of
gait are the TA’r, EHL, & the EDL. The gastrocnemius, TP’r & peroneus longus are active during St phase
of gait. Therefore, of the muscles listed, the EDL is the best choice. If only the TA’r was stimulated the
foot would go into Inv & DF, which could cause the pt to land on the lat side of the foot at IC causing them
injury. Addition of the EDL would bring the foot up into more DF & avoid excessive Inv.
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PEAT SET 2
49. D The current dosage for iontophoresis is calculated by multiplying the current (4 mA) by the duration
(15 minutes). In this case the calculation would yield a value of 60 mA-min. None of the other options use
the correct values.
50. A The double upright metal ankle foot orthosis (AFO) would provide the best support for the
mediolateral instability and would allow for changes in leg volume. The plastic, solid AFO would not
provide as much mediolateral support and because of its conformation to the leg it would not be advisable
for patients who are experiencing changes in leg volume due to the edema. High top shoes would not
provide enough support. The spiral AFO would not provide needed stability to the ankle and the design
would not be indicated when a patient has fluctuating edema in the leg.
51. C Hemoptysis or the coughing up of blood can be benign or severe and can be a common occurrence
in the cystic fibrosis population secondary to the pathophysiological processes in their pulmonary system.
In general, a small amount of hemoptysis that occurs occasionally or is non-persistent hemoptysis is
benign. The "brownish" color indicates either venous blood or old blood. In this situation, if the hemoptysis
does not persist, then it is appropriate to continue treatment without modification. If the blood was larger
in amount and fresher (denoted by a bright red color), then the treatment should be discontinued. The
presence of blood in the sputum should not warrant more vigorous chest percussion, until it is deemed
appropriate to continue with the session. Since this situation is a benign scenario, alteration of the
drainage position is not necessary, and there is no need to send the patient to the emergency room.
52. C Isokinetic exercise devices utilize accommodating resistance throughout the range of motion. The
other exercises are not forms of accommodating resistance.
53. D The weakness is in the flexors of the fourth and fifth digits at the distal interphalangeal joint (2/5).
The other fingers show normal strength (5/5). This weakness would indicate a problem with the flexor
digitorum profundus, since the distal joints are involved. The flexor digitorum profundus is innervated by
both the median and ulnar nerves. The flexor digitorum profundus muscles flexing the index and middle
fingers are innervated by the median nerve. The flexor digitorum profundus muscles flexing the ring and
little fingers are innervated by the ulnar nerve. Therefore, since the ring and little fingers are involved, the
lesion would have to be involving the ulnar nerve. The flexor digitorum profundus to the fourth and fifth
fingers is innervated by the ulnar nerve roots C8 and T1.
54. B The best answer would be for the therapist to recommend a team conference. That conference
would bring together members of the health care team as well as the patient and family members, to
arrive at joint decision as to the placement of this patient. The best time for such a meeting would be prior
to discharge, because after discharge it is difficult to arrange such meetings. Allowing the patient to
determine his own discharge environment may be fine if there are no safety concerns, however a
decision whether or not the patient is competent to make that decision must be made first. Scheduling a
home visit or the implementation of a treatment plan for home care would be premature until a decision
on placement has been made.
55. D Sudden tingling or the hands and weakness of muscle groups are alarming signs of cord
compression. The concern is that the spinal cord is sustaining further injury. The exercise may be
exacerbating or causing these signs. This is considered a medical emergency and the physician should
be immediately advised.
56. A In patients with moderate hyperglycemia, exercise can lead to hypoglycemia for periods of 24 to 48
hours after exercise. Exercise has been shown to increase sensitivity of the insulin receptors therefore
leading to a decrease in the amount of insulin required.
57. B A larger print will not simplify the meaning, nor will lengthening the sentences. Only Option 2, the
choice of illustrations and a simpler sentence structure, is correct.
58. B Normally, as the diaphragm descends with inspiration, it places increased pressure on the
abdominal contents with a resultant distension of the epigastric area. Weakness of the diaphragm would
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PEAT SET 2
decrease the distension and may result in a compensatory increase in upper chest expansion to improve
ventilation. The scalene muscles act to elevate or stabilize the clavicle during inspiration. The rectus
abdominus is a stabilizer during inspiration and assists with forced expiration. The intercostal muscles act
to stabilize the thoracic cage during ventilation.
59. A With an extension exercise program, centralization indicates that the patient is improving, even
though the pain may be just as intense as it was. Even though the patient may feel frustrated, he is
actually improving; and therefore the therapist should continue with the extension exercise program.
There is no need to call the physician at this point, since the centralization is perfectly normal. Although
trunk flexion may be used later in the intervention, it would not be indicated at this point because
extension is working.
60. C Information relating to the physical therapist/patient relationship is confidential and may not be
communicated to a third party not involved in that patient’s care without the prior written consent of the
patient. Option 3 is the only one that fits these criteria.
61. C Inclusion of all members of the health care team into decision-making is important for the patient
and provides for continuity of care for the patient. However, the team approach has some pitfalls such as
arranging meetings between team members, which may be a time consuming process. The team concept
would also assume that the team reaches a consensus that requires more time than relying on individual
decisions that can be made quickly. Therefore, Option 3 is the best answer to this question. The other
three options are advantages of the team concept.
62. B Physical therapy intervention should focus on helping the patient obtain maximal functional
independence. Wheelchair transfers are the means to enable the patient to be independently mobile and
will be a requirement before more difficult tasks are performed such as ascending a 10-foot ramp. The
patient is presumably too weak to walk at this point in time. Tub transfers are important, but the
wheelchair will be the best means to get the patient to the tub. Therefore, for the initial intervention
session wheelchair transfers would be the most important.
63. A Raising just the head activates only the recti muscles, and supporting the abdominal muscles with
the hands provides external support to the stretched abdominal muscles. This is the optimal position to
initiate abdominal strengthening following delivery for a patient with diastasis rectus abdominus. Doing no
exercise would not be appropriate. With no support of the abdominal muscles, Options 3 and 4 would be
too aggressive at this time.
64. A The assessment of posture in a wheelchair begins with the pelvis and its relationship to its adjacent
segments. The orientation and range of mobility of the pelvis in all three planes will in turn determine the
alignment and support needed at the trunk, head, and extremities.
65. A In order to place the right middle lobe in an optimal position to drain secretions, a patient would
need to be positioned as stated in Option 1. Another way this position may be stated is "left sidelying with
a quarter turn towards supine". The other positions do not optimally drain this lobe.
66. D During measurement of shoulder abduction, the spine should be kept straight. If the patient is
allowed to laterally flex the trunk it will give the appearance of increased shoulder abduction, but the
motion would be occurring in the spine and not in the shoulder. Upward rotation of the scapula and lateral
rotation of the shoulder would normally accompany the motion of shoulder abduction. Medial rotation of
the shoulder would decrease the available abduction.
67. D An adverse side effect of prolonged prednisone use, in this case for 4 years, is muscle
degeneration and therefore achieving increases in muscle strength may be limited. Since muscle
strengthening may be limited, then isokinetic exercise would not necessarily be more beneficial.
Prednisone may lead to a decrease in bone density, not an increase. Four years after transplantation, the
patient will have been out in the community and the need for an isolation room is unnecessary.
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68. B Physical findings of congenital hip dislocation include asymmetric skin folds of the buttocks and
adductor region; limitation of passive hip abduction; leg length inequality; and, telescoping of the flexed
and adducted thigh on the pelvis.
69. B The C5 and C6 myotomes include the biceps brachii, brachialis, brachioradialis, and deltoid
muscles. The elbow flexors and supinators (C5-6) are used to carry a teddy bear in the crook of the arm.
Pushing a wagon requires the use of the triceps (C7-8). Holding a raisin requires presence of wrist flexors
(C6-8). Grasping a cup requires finger, thumb and wrist muscles (C 6-8, T1).
70. A In order to open up the intervertebral foramen, it would be best to flex or at least flatten the lumbar
spine prior to applying the traction. Of the above options, positioning the patient supine with the hips and
knees flexed would be the best way to do this. Laterally bending the trunk to the left would also open up
the foramen, but this is not one of the options. Supine with hips and knees straight and then laterally
shifted to the right would tend to close down the intervertebral foramen. Prone would also close the
foramen. Sidelying with a bolster under the right lumber spine would also tend to close the foramen.
71. C With arterial insufficiency, elevation increases ischemia and therefore pain. Intermittent claudication
is a phenomenon associated with metabolic demands exceeding the capability of the vascular system to
supply adequate blood flow. Placing the limb in a dependent position increases swelling and therefore
possibly pain with venous insufficiency. An objective sign such as purple discoloration rules out a
psychosomatic episode.
72. A The primary physical therapy goal of Phase I cardiac rehabilitation is to achieve a safe and
independent level of activity that can be carried out at home. Increasing aerobic capacity cannot happen
until Phase III, when cardiac tissue has healed fully. Modification of risk factors is a life-long process and
will not be achieve during a short inpatient stay. Systolic blood pressure, when exercising, during the
inpatient stay should only rise approximately 20 mm Hg above resting.
73. C Option 3 is the only one stated clearly in educational terms. The other options are objectives based
on observations.
74. A Starting at the coracoid process and moving laterally, one would palpate the following structures:
(1) lesser tuberosity, (2) biceps tendon and (3) greater tuberosity. Any other order of structure palpation
would be incorrect.
75. B Heart rate and systolic blood pressure responses are higher for any given workload when
performed with the upper extremities as compared to the lower extremities. Angina is determined by a
certain myocardial workload that is represented by the product of heart rate and systolic blood pressure.
Therefore Option 1 cannot be a conclusive statement. Pulmonary ventilation has less definitive responses
than the cardiac responses but in general would be similar in that upper extremity exercise would cause a
greater ventilatory response than lower extremity exercise would. Since heart rate and blood pressure
would be higher at any given workload with upper extremity exercise, then angina would most likely occur
at a lower workload.
76. B During normal knee extension, the tibia moves posterior relative to the femur. Therefore, posterior
gliding of the tibia would promote knee flexion. Superior glide of the patella could be used to increase
knee extension. Posterior glide of the femur on the tibia would be used to increase knee extension.
77. B Option 2 is the definition of validity. Options 3 and 4 refer to reliability measures. Results can be
standardized even though they are not valid.
78. A The primary physical therapy goal at this time is to restore range of motion. Therefore, the most
appropriate intervention for that goal is passive and active assistive ROM exercises. Although gentle joint
mobilization techniques may be indicated, grade 4 techniques at this time would not be. Progressive
resistive exercises would come later in the plan of care. Although the long-term goal would be to return to
normal activities, the short-term goal would not.
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79. B Because the problem is a behavioral disorder, the most appropriate person to assess this patient
would be a neuropsychologist. The neuropsychologist is trained to assess intellectual, emotional and
coping functions of the patient as well as levels of depression and anxiety. They could also provide
consultation to the rehabilitation team members as to how to deal with the problem.
80. A The protrusion component involves the arthrokinematic movement of anterior condylar translation.
Mandibular depression (jaw opening) involves both condylar rotation and anterior translation. However,
this question is asking only about the protrusion component. Lateral glide involves anterior translation on
the contralateral side and spin on the ipsilateral side.
81. D The therapist should observe the parents performing the program as instructed to ensure correct
implementation. The parents should return in one week for another demonstration to determine if they
can correctly repeat the program as previously instructed.
82. D Excessive upward rotation of the scapula can result from weakness of the rhomboids and
latissimus dorsi (downward rotators). The scapular adduction with medial rotation and adduction of the
arm would require action by those muscles. Option 1 would help strengthen the serratus anterior, an
upward rotator of the scapula. Option 2 would activate the upper trapezius as well as the rhomboids and
since the upper trapezius is also an upward rotator of the scapula, this would not be the best exercise to
use. Option 3 would also help strengthen the serratus anterior, which would tend to aggravate the
problem.
83. D Capsular restriction would show up in both measurements. Dorsiflexor weakness would show up in
both measurements. Hamstring tightness would affect knee range of motion, not ankle range of motion. In
photograph A, there is more dorsiflexion present with the knee bent. In this position the gastrocnemius is
on slack across the knee joint, which allows greater range of dorsiflexion. In photograph B, the
gastrocnemius is stretched over the knee joint, so the ankle joint and tightness in the gastrocnemius
would restrict ankle dorsiflexion.
84. B Of the options above, a social worker (social services) would be the most appropriate person to
intervene in this case. The social worker is trained to help resolve family issues that arise and would be
the best person to lead a team of caregivers and family members in deciding the appropriate action in this
case. Educating the patient would only put more burden on them without guaranteeing results. A referral
for home care may be appropriate, but the social worker would be the best person to make such a
contact. Writing a home program for the family would not address the need to instruct family members in
person.
85. B The lesion is most likely a tendinitis involving a muscle or muscles that originate from the medial
epicondyle of the humerus (i.e., pronator teres, palmaris longus, flexor carpi radialis and ulnaris, and
flexor digitorum superficialis). Pain would be elicited with active contraction of the involved muscle (or
muscles) or when the muscle(s) is/are passively stretched. Resisted wrist flexion and pronation would
cause pain over the origin of the pronator teres. Options 1, 3 and 4 do not meet the criteria for eliciting
pain.
86. B The mechanism that creates an anterior dislocation of the shoulder is forced abduction and lateral
(external) rotation of the shoulder. This frequently results in a tear of the anterior portion of the capsule.
Abduction and external rotation may subject the patient to recurrent subluxations and/or dislocations, and
should therefore be avoided.
87. C In carpal tunnel syndrome there is pain and paresthesias in the median nerve distribution of the
hand, which includes the lateral three digits. There is weakness of the abductor pollicis brevis, but not of
the wrist flexors or finger extensors.
88. C The key phrase in this question is "interdisciplinary." Of all the options provided, only airway
clearance is within the scope of practice for physical therapists. Patients with Guillain-Barré syndrome
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PEAT SET 2
may experience respiratory muscle fatigue or paralysis and are susceptible to pulmonary infection.
Pulmonary hygiene is a critical role in their care.
89. C These are signs of autonomic dysreflexia. Among the most common cause is a distended or
irritated bladder. The FIRST step is to remove the noxious stimulus.
90. C The use of a posterior walker has been found to encourage a more upright posture during gait and
to promote better gait characteristics than does the use of an anterior walker. A standard walker, forearm
crutches and bilateral quad canes all emphasize trunk and hip flexion, which is already increased for this
child.
91. C If patients are skilled in falling, they are less likely to become injured during a fall. The patient
demonstrating or performing the task best verifies understanding of a skill. To accomplish this, the patient
should be given a demonstration of proper falling technique and then the patient should be allowed to
practice while being guided and guarded by the therapist. Without first demonstrating and then allowing
the patient to practice, the patient could be placed at risk for injury. Therefore, Options 1, 2, and 4 are not
adequate to ensure patient safety.
92. A Heart rate and systolic blood pressure responses are higher for any given workload when
performed with the upper extremities as compared to the lower extremities. Spinal motion does not create
much stress on the cardiovascular system. The quadriceps setting and diagonal patterns are performed
with the lower extremities and would produce less cardiovascular stress.
93. B In order to facilitate transfers utilizing a sliding board, the patient will need both removable arm rests
and detachable swing-away leg rests. Fixed arm rests make sliding board transfers extremely difficult and
unsafe. Any of the other options would not be optimal for this particular patient’s needs.
94. B Orthostatic hypotension from bed rest occurs as a result of decreased venous tone, which will lead
to a pooling of blood in the lower extremities upon standing. The pooling of blood in the lower extremities
will reduce the amount of blood returning to the heart decreasing ventricular filling and ultimately
decreasing cardiac output. This results in a drop in blood pressure with resultant dizziness. With pooling
of blood in the lower extremities, the hydrostatic pressure would increase. To compensate for the
decrease in cardiac output, the sympathetic system (not the parasympathetic) would stimulate the heart.
95. C All of the options, except for gentle, active exercises, are precautions or contraindications for this
patient.
96. C ES for patients with demand-type pacemakers is often listed as a contraindication. However, even
though it is often listed as a contraindication in textbooks, research studies apparently have not
substantiated the suspected risks. Nonetheless, it should only be applied with caution and close
supervision in these patients. Exercise, unless very strenuous, would be indicated in this patient.
Biofeedback introduces no electrical signals into the body and therefore would not be contraindicated.
97. C Sensory inputs such as intermittent music and touching the face, rocking the patient rapidly, and
brightening the room elicit arousal. When a child becomes agitated and confused, it is appropriate to
reduce the general amount of environmental stimulation. Decreasing auditory and visual activity in the
room may help the child focus.
98. D Isolated contraction of the right sternocleidomastoid muscle would cause the head to rotate to the
left and side bend (lateral flexion) to the right. To stretch the muscle, the opposite actions would be
performed on the patient by the therapist: rotation of the head to the right and lateral flexion to the left.
99. B Because sitting knee extension and the straight-leg raise culminate in essentially identical positions,
symptomatic responses to the 2 types of maneuvers should be similar. If the patient had a symptomatic
herniated disc, both positions would result in a similar symptom increase. Symptomatic responses to the
2 types of maneuvers should be similar. If the patient had an irritated sciatic nerve, both positions would
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PEAT SET 2
result in a similar symptom increase. If the patient had a facilitated hamstring, both positions would result
in a similar symptom response.
100. D It is most important for the patient to experience some form of success in order to provide
motivation. Stopping the session upon failure may further frustrate the patient. Visualization, although
useful, is a higher level task that should not be the first strategy used. Poor body mechanics and
stimulation of tone may occur if the patient reaches forward while moving from sit-to-stand. Necessary to
learning are motivation to try the unknown and, simultaneously, success in learning, to retain the learner’s
motivation.
101. A The overhead positioning of carrying food trays is similar to the end position of the ulnar nerve
tension test. The test for the ulnar nerve includes shoulder depression, abduction and external rotation,
elbow flexion, forearm pronation or supination, and wrist and finger extension. The median nerve tension
test employs elbow extension, but the position of the waiter is with elbow flexion. The radial nerve test is
low by the side, not reaching overhead. The musculocutaneous nerve does not innervate the hand.
102. B Since the patient does not have symptoms while looking straight ahead, the visual acuity
(peripheral visual system) does not appear to be at fault. When a patient complains of visual blurring with
head motion, the patient is experiencing oscillospsia. Oscillospsia is a visual instability with head
movement in which images appear to move or bounce. It is often due to decreased vestibulo-ocular
reflex. No information is given in the question which suggests that the patient is having difficulty with
somatosensory input or that indicates musculoskeletal deficits.
103. C Option 1 does not ask about function. It is an impairment-related question, not a function-related
question. Options 2 and 4 do not ask about function and even with improvement, neither would relate to
function. Option 3 is taken from the Short Musculoskeletal Function Assessment. It addresses function
and can be used again as an outcome question.
104. A Neurogenic claudication may be unilateral or bilateral. This scenario is bilateral. The diagnosis of
lateral spinal stenosis is supported because extension increases neurological signs and flexion decreases
neurological signs, regardless of weight-bearing factors. Walking down hills is worse for the patient,
because the extension of the lumbar spine is greater. Disc derangements tend to be worse with flexion
(sitting) and better with walking, and are rarely bilateral. Piriformis syndrome, although when present can
result in sciatic pain, is rarely bilateral. Also, walking uphill would probably be more difficult than downhill
for an irritated piriformis. Nothing in the question indicates neoplasm. The scenario seems to indicate a
musculoskeletal problem, since the pain changes with position.
105. A Dynamic stabilization exercises involve unconscious control and loading of the joint. They
introduce ballistic and impact exercises to the patient. Practicing the forehand stroke by hitting a ball
against a wall incorporates these principles. Practicing slow forehand strokes with elastic tubing attached
to the racquet grip will provide a functional exercise, but not a dynamic exercise as it would not introduce
ballistic movements, nor load the joint in the same way, as this motion is described as a slow movement
which limits its dynamic characteristics. Maintaining a follow through position while the therapist provides
rhythmic stabilization resistance is a hold position that’s isometric, not dynamic. There is no unconscious
or ballistic component. Performing push-ups against the wall with emphasis placed on scapular
protraction may be a good exercise, but it does not fit the criteria for being a dynamic stabilization
exercise. It does load the joint, but there is no unconscious or ballistic component.
106. B 10degrees of dorsiflexion is required for N walking. Full hip extension is required for walking for a
person with a T12 level injury. Normal knee flexion is not required for normal walking. While option 4 is
important for long-sitting and floor to wheelchair transfers, this is not required for gait.
107. D There is no reason to suspect that the modality must be changed. The first logical step is to
increase toweling. The patient’s response is not a normal response. An uneven blotchy red and white in
light skinned,or darker and lighter areas in darker skinned patients, could be a sign of overheating. Five
minutes after initiating heating, the physical therapist should remove the pack and check the patient’s skin
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PEAT SET 2
for any blotching-mottled erythema. The heat is too intense, so adding more towel layers is the most
appropriate action.
108. C 3 wks is too early to lift 5-lb (2.3-kg) objects. Three weeks is too early to sleep on the involved
side. Usually by 8 to 12 weeks, a patient who has had an uncomplicated open repair of a rotator cuff 2
weeks ago is able to actively elevate the arm to functional heights. Three months is too early to play golf.
109. C Option 1 describes a grade 2 oscillation, which is insufficient to gain range. Option 2 is incorrect
because it describes the opposite direction. Option 3 is incorrect, because a grade 4 mobilization (as
described) is needed to increase range of motion. Knee extension is the primary concern, requiring an
anterior glide of the tibia on the femur, but option 2 describes the opposite direction, and is therefore
incorrect.
110. D A patient with stenosis will do better in sitting, not standing. A patient with a deep vein thrombosis
will need to move, not be stationary. A scoliosis alone does not warrant a standing work station. The
photograph shows a standing desk/work station. Sitting increases intradiscal pressure, so standing is
often preferred to sitting.
111. C The pulse width of 100 makes it difficult to achieve a strong enough motor response. A 1 to 4 pps
frequency may lead to a twitch motor response, but not tetany, which is needed for strengthening. The
correct answer requires a frequency that will lead to tetany (something above about 30 Hz), and a long
enough pulse width to recruit motor fibers (usually something greater than 200 microseconds). Therefore,
of the options, 40 to 50 pps with a pulse width of 350 microseconds is the best. Option 4 describes the
typical parameter for conventional transcutaneous electrical nerve stimulation for acute pain
management. The pulse width of 100 makes it difficult to achieve a motor response and he higher
frequency of 100 pps leads to rapid fatigue.
112. A The therapist should palpate the dorsal pedal pulse, which is found on the dorsal aspect of the foot
near the base of the first metatarsal. The anatomical locations in options 2, 3, and 4 are not appropriate to
palpate the dorsal pedal pulse.
113. B Bowel and bladder dysfunction are related to spinal cord/upper motor neuron dysfunction.
Smoking and steroids can weaken bone and increase the likelihood for a compression fracture.
Hypertension and diabetes are not risk factors for a compression fracture. Although emphysema is a
pulmonary disease, by themselves, neither emphysema, nor hormone replacement therapy, increases
the likelihood of a compression fracture.
114. C Often the supine position is not tolerated with an anterior hypermobility, as the humeral head is
pushed anteriorly somewhat in this position. Prone is neither a good nor bad position, as far as this
scenario is concerned. It would be difficult for this patient to get the shoulder in a comfortable position
while lying prone. Right sidelying would be painful and could compromise circulation to the patient’s joint.
It could also stress the capsule with an underlying hypermobility. Of all the positions listed, left sidelying
would be most well tolerated by this patient.
115. C The joint indicated in the radiograph is the talocrural (ankle) joint.
116. C Option 1 does not mention the knee position and has the hip flexed, which shortens the rectus
femoris. Option 2 has the hip flexed, which shortens the rectus femoris. Prone with the knee in flexion
keeps the hip in neutral and does not allow the hip to flex. It describes the Ely test. Option 4 has the hip in
the correct position, but does not mention the knee position.
117. D The medial knee is the L3 dermatome. The medial ankle is L4 dermatome. The plantar foot is S1 or
S2. A posterolateral disc bulge at L4- L5 will most likely affect the L5 nerve root and the dermatome for the
L5 nerve root. The L5 dermatome includes the dorsal aspect of the great toe. The dorsal area of the great
toe is consistently included in the L5 dermatome.
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PEAT SET 2
118. A Tissue hydration is determined by pinching and lifting the skin and timing the return to normal.
Option 2 describes the measurement technique for pitting edema. Temperature is not directly related to
tissue hydration. Measurement of girth/size is not related to tissue hydration.
119. D A facet dysfunction would remain in sitting and in standing. It is unlikely that a postural problem
present in standing is due to muscular weakness. A weak gluteus medius would display more problems
during gait or movement. Although the iliopsoas is passively shortened in sitting, a short iliopsoas is not a
common cause to scoliosis, especially not thoracolumbar scoliosis. Short iliopsoas muscle is correct
because when the patient is sitting, leg length does not affect the spinal posture.
120. A Option 1 is not among the information that must be disclosed to a patient to obtain informed
consent. The goals of the intervention, the possible risks of the intervention, and any alternative
interventions available must be disclosed to the patient to obtain the patient’s informed consent.
121. B Option 1 does not specify the amount of assistance. Option 2 is a measurable, specific, and
objective goal. Option 3 does not specify the device the patient will be using. Option 4 is a goal which is to
be achieved by discharge, a LTG, not a STG.
122. C Vital capacity is measured from maximum inhalation to maximum exhalation. Inspiratory capacity
measures volume with maximal inhalation. Tidal volume measures total volume of air moved during either
inhalation or exhalation over a specific period of time (usually 1 minute) and then divided by the
ventilatory rate. Inspiratory reserve volume measures inspiratory volume beyond normal inspiration.
123. D Although walking usually helps to clear the lungs, the pulse oximetry is too low, although it might
be okay for someone with chronic obstructive pulmonary disease, to initiate until the patient’s lungs are
cleared first. The therapist should clear the lungs first, not contact the physician. If the therapist is
completely unsuccessful with clearing the lungs and the pulse oximetry remains low, then contacting the
physician may be appropriate. Range of motion exercises are important post-thoracotomy, but again, the
patient’s breathing should be addressed first. The crackles and low pulse oximetry indicate that the
patient needs better ventilation and secretion clearance, probably secondary to the recent surgery.
Bronchopulmonary hygiene, including postural drainage, percussion, vibration, suctioning, and incentive
spirometry, are beneficial in treating and preventing postoperative atelectasis.
124. A Regarding option 1, the legs need to be lowered first, then the crutches, otherwise the hips would
buckle when the patient leans forward to lower the crutches to the next step. Regarding option 2, lowering
the crutches first would cause the hips to buckle. When a patient is in knee-ankle-foot orthoses and has a
spinal cord injury, the patient does not have sufficient hip control, otherwise the patient would be in anklefoot orthoses. If the patient is able to walk in knee-ankle-foot orthoses, the patient should be able to learn
how to descend 1 step. Regarding option 4, having the crutches on separate steps would cause the
patient to be off balance and may cause the hips to unlock.
125. B An overview presented on the first day would imply that the therapist is not going to modify the
series to the students’ current knowledge level, which may be ascertained from the pretest. It is most
important for the physical therapist to know what level of knowledge the students have. Although active
participation is important for learning in every session, neither it, nor a complete demonstration of a low
back evaluation, is most important to include in the first session.
126. C Peripheral vascular disease is a vascular problem, not a pulmonary problem. Congestive heart
failure may lead to pulmonary problems, but not obstructive problems. Emphysema is an obstructive lung
disease for which pursed lip breathing helps. Sarcoidosis is a restrictive lung disease for which pursed lip
breathing does not help.
127. B A standing-pivot transfer is a dependent transfer that should be used when the patient can bear
some weight on the lower extremities. As a dependent transfer, it does not afford the patient the
opportunity to progress towards independence as the sliding-board transfer would. A sliding-board
transfer should be used when the patient has fair sitting balance, but does not have enough strength to
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PEAT SET 2
fully lift all weight off the buttocks. A sitting-pivot transfer requires the patient to have enough upper
extremity strength to fully lift the buttocks to clear the surfaces. It should be used as a progression from
the sliding-board transfer, so it is not most appropriate to use initially. A 2-man dependent transfer is a
dependent transfer that does not allow the patient to assist and is more than what is needed in this
situation.
128. D Although bed rest would decrease pressures on the foot and may allow healing, it would also lead
to deconditioning and other avoidable side effects. A custom molded shoe would not be sufficient as an
initial treatment option, as the wound is still open. Crutches with toe-touch weight-bearing would help to
decrease the pressure on the heal if the patient were able to appropriately follow instructions. However,
as the patient most likely cannot feel the foot, there is a high probability of noncompliance. Also, it would
not protect the foot from further injury as does the total-contact casting. Stepping on a tack without
realizing it indicates that this patient has a neuropathy. The best way to treat a neuropathic foot ulcer is
with total contact casting.
129. B The trochlear nerve (IV) innervates the superior oblique muscle in the eye. The trigeminal nerve
(V) innervates the masseter and temporalis, the major muscles of mastication. The facial nerve (VII)
innervates the muscles of facial expression, not the muscles of mastication. The hypoglossal nerve (XII)
innervates the tongue.
130. A Although the patient’s heart rate and blood pressure do not show abnormal changes, the
perceived rate of exertion of 14 corresponds to “somewhat hard” to “hard”. This is too high for phase II
cardiac rehabilitation, so the intensity should be decreased. The blunted response in the heart rate and
blood presure is due to the beta-blocker. Increasing intensity would mean working harder and would
increase the patient’s perceived rate of exertion. As the perceived rate of exertion is already too high, this
would be inappropriate. Because the perceived rate of exertion is too high, the same intensity should not
be maintained. Although the perceived rate of exertion is high, it can be controlled by decreasing exercise
intensity. It is presently unnecessary to contact the physician. If the patient abruptly stops exercise
without a cool down, an increased arrhythmia may result.
131. D Saline-saturated gauze is not advised to control copious amounts of drainage. Semipermeable
film cannot absorb copious amounts of exudate. Gauze impregnated with zinc oxide has not been shown
to be beneficial. Hydrocolloid paste is the only option given that is able to manage wounds with high
levels of exudate.
132. C With an inversion injury, the tendons of the peroneus longus and brevis can become strained.
Swelling with an inversion strain usually occurs over the anterolateral part of the ankle. Compression and
support is most beneficial by placing tape stirrups on the lateral side of the ankle, over the tendons of the
peroneus longus and brevis and pulling the ankle into slight eversion.
133. A A non-adherent dressing is best choice because any adherence of the dressing to the fragile
granulating tissue could cause additional trauma. This is a superficial wound, so there would be no need
to pack the wound. Since there is some drainage, a covering is preferential to topical medication only.
134. C A complaint of heaviness likely reflects weakness. The complaint is not the fit or comfort of the
prosthesis, so Option 1 is incorrect. The expense of obtaining a lighter prosthesis is not justified without
determining if the solution is strengthening of muscle groups, which control the prosthesis. A fork strap
attachment will assist with suspension, but will not reduce the weight of the prosthesis.
135. A Threats to external validity limit the generalizability of the results. Since the research participants
differ from the therapist’s patient population, applying the results on a different group of people would not
be appropriate due to external validity. Internal validity means that internal factors other than the
independent variables could be related to changes in the dependent variable(s). Construct validity is
challenged when constructs are poorly defined or an inconsistent use of constructs occurs. Statistical
conclusion validity is challenged with irregularities in the use of statistical tools or the use of incorrect
statistical tools.
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PEAT SET 2
136. C The action shown in the photograph is the Froment’s test. Both thumbs (1st digits) should stay
extended during the test. If the thumb (1st digit) is flexed, it is indicative of weakness of the adductor
pollicis with substitution by the flexor pollicis longus, which is usually due to a lesion of the ulnar nerve.
137. A A heel cushion that is too soft allows too rapid plantar flexion after heel strike (initial contact),
which causes the knee to go into extension and stay there longer than normal. A socket that is placed too
far anterior on the foot causes knee flexion, not extension. A prosthesis that is too long causes vaulting in
midstance. Inadequate suspension causes the socket to slip during midswing phase resulting in the toe of
the prosthesis catching on the floor.
138. B Neither a social worker nor a nutritionist can adequately treat the patient’s depression. A patient
exhibiting symptoms of chronic pain and depression warrants a referral to a psychiatrist or psychologist. A
physiatrist can address the patient’s chronic pain, but is not as well equipped as a psychiatrist to address
the patient’s depression.
139. B Trunk curls are contraindicated for a patient with diastasis recti. Supine hook-lying head lifts
emphasize the rectus abdominus muscle and are least likely to increase the separation of the diastasis
recti. Pelvic-tilt leg sliding is more advanced than head lifts. Bilateral leg-lowering is an advanced
abdominal strengthening exercise that causes excessive low back strain and should not be performed
during pregnancy.
140. A Chronic inflammatory disorders such as rheumatoid arthritis are often associated with morning
pain and stiffness that decreases throughout the day with activity. Pain that is worse at the beginning of
an activity implies acute inflammation. Constant pain suggests tumors or visceral pain. Pain that
increases throughout the day indicates increased congestion in a joint.
141. C Tightness of the rhomboid major and minor would promote downward rotation of the scapula.
Weakness of the serratus anterior would limit the upward rotation of the scapula. The most likely reason
for the increase in scapular motion is restriction of the glenohumeral joint. To fully abduct the shoulder,
the scapula and glenohumeral joint both have to contribute to the motion. If the glenohumeral joint is
restricted, the scapula has to increase its motion to accomplish the task. Weakness of the upper trapezius
would demonstrate a scapular lag in upward rotation.
142. B Weakness in the pectoralis minor would not cause restriction of the scapula, but would likely
cause scapular hypermobility. Weakness in the upper trapezius would dec upward rotation of the scapula
during shoulder flex & Ab. The more the shoulder is elevated, the more noticeable this would be. The
decreased scapular mvt would increase the predisposition towards impingement. Weakness in the deltoid
would cause the humerus to move downward, not upward, during shoulder elevation. Weakness in the
rhomboid major would not cause restriction of the scapula, but would likely cause scapular hypermobility.
143. D Options 1, 2, and 3 are typical with low back pain and none alone requires immediate referral.
Saddle anesthesia around the perineum is a sign of a cauda equine syndrome and usually requires
immediate treatment by someone other than a physical therapist.
144. A When using biofeedback there are several different options which may be used to analyze the
data. The best method for quantifying electromyographic biofeedback is to use an integrated form of the
data. This process provides a summation of the data over a period of time. Full-wave rectified
electromyographic biofeedback is performed prior to integration. Raw electromyographic biofeedback is
not quantified without applying integration. Low-pass filtering electromyographic biofeedback is used to
eliminate noise, but does not quantify the signal.
145. C There is no clear evidence that a continuous passive motion device reduces hospital stay or
prevents deep vein thrombosis. Evidence suggests that a continuous passive motion device can help to
regain knee flexion. If the knee is not placed in full extension outside the continuous passive motion
device unit, a knee flexion contracture may result.
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PEAT SET 2
146. A The CN involved is the oculomotor nerve. This n. innervates the med rectus, which if weak, would
cause a lat strabismus. The oculomotor n. is also responsible for mediating papillary constriction & a
lesion would cause papillary dilation. The ptosis is caused by loss of innervation to the levator palpabrae
superioris mm which elev the eyelid. The double vision would be caused from the inability to move the
eyeball normally since 4 of the 6 ocular mm are controlled by the oculomotor n. The oculomotor n. is also
important in mediating the pupillary light reflex. The facial n. innervates the mm of facial expression. The
trigeminal n. mediates the jaw-jerk reflex & pain sensation from the face.
147. A Steady rate exercise such as jogging or cycling causes a relatively rapid increase in systolic
pressure with diastolic pressure remaining the same or decreasing only slightly. Systolic pressure may
level off somewhat during the exercise, if it remains at the same intensity.
148. B The axillary crutches, standard walker, and forearm crutches all require adequate strength in the
elbow extensors and latissimus dorsi, especially due to the non-weight-bearing status of the patient. The
non-weight-bearing status on the right could indicate any of the options, however, because the patient
has weakness of the muscles in the C6-C7 dermatome, the patient would have difficulty using any
assistive device that requires use of the elbow extensors and latissimus dorsi muscles. Therefore, the
best option is the wheelchair since it provides mobility.
149. A All of the questions are important in Hx taking. However, constant pain is usually a hallmark of an
inflammatory reaction. Mechanical pain generally changes with positions or activities. “What bothers you
the most” is a good question to ask to find out what makes the pain better or worse & often helps
determine the best course of intervention. Difficulty standing up from a sitting position is usually indicative
of mechanical (disc) pain. Radiating pain could occur with mechanical or inflammatory disorders, so is not
as discriminating as “Is your pain constant or intermittent?”
150. D Patients can begin walking 1 or 2 days postoperation with some weight-bearing or touch down
depending on the surgical technique. They can also begin gluteal sets and active hip abduction from a
supine position within 5 days. The posterolateral approach for a total hip arthroplasty requires
postoperative precautions, which include no hip flexion beyond 80° or 90° and no hip adduction past the
midline.
151. B Kidney stones would most likely present with back pain and pelvic area pain and would not cause
bloody stools. Diverticulitis is associated with constant, left, lower quadrant pain and tenderness along
with bloody stools. The gall bladder is in the right upper quadrant. The appendix is in the right lower
quadrant.
152. D Prone with the knee straight would be used to test for a Poor (2/5) grade. Supine with knee bent is
used to isolate the gluteus maximus. Seated hip flexion is used to test the hip flexor muscle strength. The
most likely cause of laterally bending towards the stance limb is abductor weakness on the stance side.
The lateral bending helps compensate for weak abductors. The right abductors would be tested from a
left sidelying position for fair grade (3/5) and above which is the correct starting position.
153. A The quads are active shortly after HS/IC to prevent excessive knee bending during the loading
phase of initial stance. Weakness of the quadriceps causes the pt to compensate by leaning fw at HS/IC
& to use the body weight to help keep the knee ext. Weakness of the hams causes excessive knee
extension (recurvatum) prior to HS/IC. Weakness of the gluts maximus would be observed shortly after
HS/IC. However, the pt would lean bw to compensate. Weakness of the anterior tibialis causes a “foot
slap” just after heel strike (initial contact).
154. B Later in the course of the pt’s Tx, strengthening ex can be done, but first, the rotator cuff muscles,
& then later, the deltoid. Early strengthening of the deltoid would worsen the impingement. This patient
has an impingement syndrome. Generally, the first goal is to restore pain free range of motion. This can
be done actively, passively or with the use of active assistive devices such as cane exercises. The
external rotators should be strengthened, not stretched. External rotation would be emphasized which
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PEAT SET 2
would mean stretching the internal rotators. The subscapularis and teres major muscles are internal
rotators and should be stretched not strengthened. Strengthening them could potentially increase the
impingement symptoms.
155. C Normally, heart rate monitoring is the best method for monitoring exercise intensity. However,
since the heart rate is controlled, it should not be used. Blood pressure is a measure of intensity, but is
not practical in this case. The effect of the propanolol (Inderal), a beta blocking agent, is to control heart
rate and decrease the workload on the heart. Perceived exertion (Borg’s scale) is the preferred method to
monitor exercise intensity for a patient taking beta blocking agents. Respiration rate may not be an
accurate indicator of exercise intensity and cardiac workload.
156. A An anterior tilting pelvis is often caused by shortness in the hip flexors. The hip flexors can be
stretched with a number of exercises that emphasize hip extension. Prone lying with the knees bent
stretches both the iliopsoas and rectus femoris muscles. Supine with knees bent stretches the gluteus
maximus. Quadruped with arms extended stretches the latissimus dorsi and low back, but does not
address the iliopsoas, because the hips are fully flexed. Lying on the back with hip flexed and knee
extended should be used to stretch the hamstrings.
157. D Internal rotation of the left hip is limited. This could be caused by hypomobility of the left hip
capsule or tightness of the left external rotators, especially the piriformis. Hypomobility of the internal
rotators would cause limited external rotation.
158. C Decreasing the intensity reduces the effect. Increasing the pulse width increases the intensity of
stimulation, but does not prevent adaptation. Normal nerves adapt to constant stimulation. Since the
stimulation was effective initially, it may be assumed that the nerves were adapting to the stimulation. The
purpose of modulation mode on a transcutaneous electrical nerve stimulation device is to prevent the
adaptation. Therefore, this is the easiest and the most appropriate first action for the therapist to take.
Changing the electrodes may be an appropriate action, but is not the appropriate first action.
159. A Osteoporosis is a skeletal complication associated with longstanding ankylosing spondylitis.
Regarding requiring a wheelchair, the patient should still be able to walk even with advanced stages of
ankylosing spondylitis. While lung expansion is generally decreased, assisted ventilation would not be
required, because the muscles of respiration remain functional. Peripheral neuropathies are not
characteristic of ankylosing spondylitis.
160. C A dec in size of the electrode will intensify the current density & is not a measure to minimize
accommodation. An inc in the width of the stimulus inc the amt of time that the ES is applied, but should
not affect accommodation. A neurapraxia indicates that the mm is innervated. Too slow a rise time results
in changes in the tissue membrane known as accommodation, which gradually elevates the threshold
required for the nerve to fire. Therefore, the rise time must be rapid enough to avoid accommodation. A
biphasic waveform, also known as an alternating, bipolar, or faradic current, does not minimize
accommodation.
161. D Regarding chronic LBP of somatic origin, the pt has a chronic problem, so will most likely require
motor-level stimulation, because it provides a longer-lasting analgesia. There is no evidence to indicate
that sensory-level stimulation is effective in the treatment of edema. For edema reduction, rhythmic mm
contraction is preferred. Iontophoresis is more appropriate than sensory-level electrical stimulation for Tx
of a tendonitis, because it involves the delivery of anti-inflammatory meds. Raynaud’s syndrome is a
condition in which the smallest arteries that bring blood to the fingers or toes constrict when exposed to
cold or from an emotional upset. Sensory-level stimulation over nerve roots & trunks can increase
peripheral vasodilatation.
162. A Elevation and pressure is the correct next step in controlling bleeding. Removal of the dressing
and bandage would potentially irritate the wound and increase the hemorrhage. Elevation and pressure
should be applied first, before additional dressings, bandages, and pressure to the brachial artery. While
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PEAT SET 2
calling the patient’s physician to arrange transportation for medical care may be necessary, it does not
immediately control the bleeding.
163. A The diaphragm of the stethoscope is best for hearing higher-pitched sounds, such as S1 & S2. It is
placed firmly on the skin to ensure good contact. The bell of the head of the stethoscope is recommended
for S3 , because the pitch is deeper, & is placed lightly on the skin , because increased pressure can
cause the skin to act like a diaphragm preventing low-frequency sounds from being heard. Although the
diaphragm of the head of the stethoscope is correct, light placement on the skin would not ensure
adequate skin contact. Regarding option 4, this technique would not ensure adequate skin contact & the
bell of the head of the stethoscope is recommended for S3 because the pitch is deeper.
164. D Option 1 would apply only after the PT has done further analysis of the situation. Monitoring SaO2
is useful but not the most immediate thing to monitor. The PT should monitor the ECG & BP of the pt.
While notifying the nurse is something the PT should do, it should come after an IE of the stability of
PVC’s. Onset of PVC’s can be either benign or stable. <6 contractions/min is generally stable, while >6
contractions/min is considered less stable. A PT should be able to determine this stability. PVC’s are
entry level arrhythmias.
165. C Increased pain with chest-wall palpation is more indicative of a musculoskeletal origin of pain.
Increased pain with deep breathing is more indicative of a pulmonary origin of pain. Nitroglycerin
(Nitrostat) is a common vasodilator that is prescribed for pts who have angina. Ingestion of a vasodilator
will improve myocardial blood flow & help relieve ischemia & its manifestations. Relief of pain with antacid
ingestion is more indicative of referred pain from PUD.
166. B Morning pain is a typical finding in rheumatoid arthritis. Symmetrical numbness could be indicative
of myelopathy from either infectious or neoplastic causes. Increased pain during activities of daily living is
also a typical finding in rheumatoid arthritis. Inability to sleep at night alone is too vague of a report to
cause suspicion of more medical problems.
167. A PERRLA stands for pupils, equal, round and reactive to light and accommodation; and is where
physicians would document visual information. CBC stands for complete blood count and this section
should not contain information about vision. Cor stands for heart and should not contain information about
vision. PMH stands for past medical history and is not necessarily specific about visual information.
168. D Changes in reflexes would hinder balance & equilibrium, more so than ventilation. Changes in sen
are less pronounced in Parkinson’s as compared to motor changes. Depending on a pt’s level of tone,
mm strength is difficult to accurately examine in pts with Parkinson’s & also would be less likely to directly
contribute to SOB. With regard to posture exam, as bradykinesia & rigidity evolve in Parkinson’s disease,
concomitant kyphosis also develops. Thoracic kyphosis contributes to a restriction in ventilation &
subsequent shortness of breath.
169. B While sen testing is important in an initial exam, impaired sen is less likely to occur in CHF by itself
(as written in the question). R-sided CHF results in dep dema; measurements of pitting edema are
appropriate to determine the severity of CHF & aid the PT in Tx planning. MMT is also appropriate for an
initial exam. However, with acute CHF, resisted MMT is generally avoided until the CHF is more stable.
Reflex testing is also important in an initial exam, but again, since this pt only has CHF, then reflexes are
less likely to be impaired.
170. D Changes in heart rate, blood pressure, or respiratory rate can accompany fever but none will help
in delineating the cause of the fever. Common causes of immediate postoperative fevers are atelectasis
or pneumonia. Ausculation of the lungs would help the therapist in delineating this as a cause of the
fever.
171. A The surface anatomy of the third intercostal space, right midclavicular line corresponds to the
anterior segment of the right upper lobe. The surface anatomy of the third intercostal space, right
midclavicular line does not correspond to the right middle lobe, right upper lobe, or right middle lobe.
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PEAT SET 2
172. D Since methicillin-resistant staphylococcus aureus is spread by contact, wearing a face shield or
mask is not necessary. Sterile precautions or techniques are not necessary for the physical therapist to
use with methicillin-resistant staphylococcus aureus. The mode of transmission of methicillin-resistant
staphylococcus aureus is contact.
173. A Option 1’s exercise prescription is most ideal to begin an exercise program, because it satisfies
the criteria of increasing energy expenditure while promoting cardiovascular adaptations and weight loss.
The key feature in this prescription is the exercise intensity, as it is on the lower range of a target heart
rate range (50% of age-adjusted maximum) that would allow accommodation to this program. The
intensity in option 2’s prescription is too high (greater than 75% of the age adjusted maximum) to begin
with and could be detrimental to exercise adherence. The rate of perceived exertion level in option 3’s
prescription is too low and would not achieve sufficient energy expenditure and exercise adaptation. The
rate of perceived exertion level in this option 4’s prescription is too high and could be detrimental to
promoting exercise adherence.
174. C An unsustained unifocal premature ventricular contraction is a stable electrocardiograph change
associated with activity and therefore doesn’t need any modification of the current intervention. Since this
type of premature ventricular contraction is stable and there is no report of dizziness in the stem, then
taking blood pressure is not necessary at this time.
175. B Deferring any range of motion is not a practical choice, as contracture postoperatively will develop.
Since this patient cannot achieve full range of motion by himself, then active assistive range of motion is
indicated to prevent contracture postoperatively. While bed mobility training is a creative way to possibly
increase upper extremity range of motion, given the acuity of the patient’s surgical wound, the patient
would need more range of motion for this intervention to be more beneficial. Continuing with only active
range of motion would not facilitate adequate increases in range of motion and would not prevent
contractures.
176. C Based on the walk test results the heart rate and blood pressure have normal physiologic rise to
exercise and would not indicate cardiovascular pump dysfunction. While the walk test results do indicate
impaired ventilation and respiration, there is no indication of airway clearance issues in the question. In
general a patient with pulmonary fibrosis will have an impaired ventilatory pump. This is further evidenced
by the exaggerated respiratory rate response and desaturation in the 6-minute walk test results.
177. D The cardiologist is not the best referral, as this appears to be an integumentary problem unrelated
to the cardiac condition. A physical therapist should not recommend any over the counter medications, as
it is outside the scope of practice of a physical therapist. Any pharmaceutical education or advice , except
“as prescribed by your physician”, is outside the physical therapist’s scope of practice. A pharmacist is the
most appropriate heath care professional of those given to assist this patient.
178. B A complete physical therapy evaluation and treatment is contraindicated due to a possible deep
vein thrombosis. A physician’s order for a Doppler study indicates possible deep vein thrombosis, so the
physical therapy should not be conducted until the Dopler study is completed and the results analyzed by
the physician. Transfer from bed to chair contraindicated due to possible deep vein thrombosis. The
nurse alone should not be providing clearance, until the Doppler study has been completed and
interpreted.
179. D The therapist is testing for a positive Babinski’s sign. When the Babinski’s sign is positive, the toes
flare at the end of the test. The presence of a positive Babinski’s sign indicates an upper motor neuron
lesion such as a spinal cord injury. If the patient is normal, the toes will flex. The only upper motor neuron
lesion is injury to the spinal cord. Peripheral nerve injuries and lesions of the anterior horn cells are lower
motor neuron lesions.
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PEAT SET 2
180. A? The infant exhibits signs of torticollis affecting right sternocleidomastoid muscle. Torticollis is
named for the side of the limited lateral flexion. Asymmetry and premature closure of sutures
(plagiocephaly) is not typically seen with cervical facet hypomobility in infants.
181. D Neither a metatarsal pad, a solid ankle-foot orthosis, nor a hinged ankle-foot orthosis corrects a
longitudinal arch. The longitudinal arch support is the only orthotic given that will address pes planus.
182. D Gloves are only required in contact with blood or body fluids, not during patient care that does not
involve coming in contact with blood or body fluids. Gloves are required whenever changing an infant’s
diapers, since this involves coming into contact with body fluids.
183. B Five to 10 minutes is an insufficient amount of time for therapeutic heating effects. The ideal
amount of time for therapeutic heating effects with minimal risk of burns is 20 to 30 minutes. Forty-five to
60 minutes is to long a period of time, as there is an increased risk of burn. Sixty-one to 90 minutes is
also too long and has a significantly increased risk of burn.
184. A The patient is exhibiting jaundice consistent with liver or gallbladder disorder. Eye involvement
(sclera) is a symptom, not the primary disorder. There are no indications of duodenal involvement or
cardiac involvement in this patient.
185. D The patient is too ill for either the VO2 max treadmill test or the 2-step test. The submaximal
exercise test is not as sensitive or specific a test as the 6-minute walk test. The 6-minute walk test is
designed for acutely ill cardiopulmonary patients.
186. D Option 1 is an inappropriate assistive device for a young adult with paraplegia. Option 2 is the
ultimate goal of gait training, but too difficult for the patient’s first attempt. Option 3 is not the most efficient
gait aide for a patient with paraplegia. The first time session of gait training for a patient with paraplegia
should be in the parallel bars. A swing-to gait pattern would be the easiest for this patient to learn initially.
187. C Elevating the legs in the presence of arterial insufficiency decreases blood flow, which increases
pain. Purple or brown pigmentation of the skin on the legs is associated with venous insufficiency, not
arterial insufficiency. The patient has intermittent claudication caused by arterial insufficiency. Placing the
patient’s legs in the dependent position facilitates blood flow and reduces pain. Pain with exercise
indicative of intermittent claudication, not deep vein thrombosis associated with a positive Homan’s sign.
188. A Skin temperature, color, and presence of ulcer are consistent with chronic venous insufficiency.
Options 2 and 3 are characteristic of arterial insufficiency, not venous insufficiency. Option 4 is
characteristic of Raynaud’s, not venous insufficiency.
189. B Options 1, 3, and 4 would provide insufficient orthotic support for the child to walk. A child with L1
lesion can only walk with support of reciprocating gait orthoses or thoracic lumbar sacral orthosis.
190. C A right cerebrovascular accident affects the left shoulder, not the right shoulder. The upper
trapezius is controlled by spinal accessory nerve (XI ), not the vagus nerve (X). The spinal accessory
nerve (XI) (supplied by the corticobulbar tract) was apparently not affected by the stroke and accounts for
the patient’s ability to shrug a flaccid arm. The deltoid does not shrug the shoulder.
191. C The oculomotor nerve (III) controls the inferiomedial eye muscles. The trochlear nerve (IV)
controls inferiolateral eye movement. The abducens nerve (VI) controls lateral eye movement. Damage to
this nerve causes the eyeball to deviate medially due to weakness of the lateral rectus muscle. The vagus
nerve (X) does not control the eye muscles.
192. D Walking independently is not achieved until 12-months adjusted age. Standing independently is
not achieved until 11-to-12-months adjusted
age. Creeping on hands and knees is not achieved until 9-months adjusted age. As the child is only 6
months old (adjusted age) developmentally, the child should only be able to roll.
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PEAT SET 2
193. A Understanding a patient’s prior level of function is the most critical factor in a patient’s history to
determine a reasonable prognosis, as this establishes the baseline for recovery. Although knee range of
motion and upper-extremity sensory integrity are impairments that should be monitored, neither is more
critical than prior level of function as a determinant of prognosis. Although cervical collar is a potential
intervention, it is not more critical than prior level of function as a determinant of prognosis.
194. C The GOS is not as descriptive as the Rancho Los Amigos LOCF Scale & is used more often as a
categorization of TBI states for research purposes. The Fugl-Meyer Assessment should be used only with
pts who have had a stroke. The Rancho Los Amigos LOCF is a descriptive scale that outlines a
predictable sequence of cognitive & behavioral recovery in pts with TBI. The Sickness Impact Profile is
used to measure general health status & is self-administered; therefore, it would not be useful as a
prognostic D/C tool for a pt with TBI.
195. D Cardiorespiratory endurance training should occur ff the warm-up period & should be monitored;
however, the monitoring should have occurred prior to this time. Resistive ex’s occur ff the cool-down
period & therefore monitoring should have occurred prior to this time. There are minimal needs for
monitoring the active stretching. Cardiovascular complications during an ex session are most likely to
occur during warm-up & cool-down periods.
196. B R iliopsoas contracture may cause a shorter step length with the L LE, but the not the R LE. L
knee pain will cause the pt to spend less time in L-sided St as the pt will try to minimize the time spent in
St (WB on the knee) to minimize the pain. Therefore, the pt will take a shorter step with the R LE.
Decreased ankle pronation would not have an effect on R-sided step length. Gluteus medius weakness
would be seen as an increase in lateral pelvic tilt, not step length.
197. A When patients have severe symptoms, it is often useful to have increased on and off times to
reduce the movement caused by the cycling. Increasing the off time allows for longer recovery time prior
to re-initiating the traction and reduces the cycling. As the pain symptoms decrease, the relaxation time
can be decreased. Options 2, 3, and 4 do not allow for a longer off or recovery period.
198. D Neither deep breathing techniques, nor a cervical could pack, would be an effective response to
this emergency situation. Although the abdominal gait belt might be a contributing factor, it is not the most
likely primary cause. This patient scenario is indicative of autonomic dysreflexia, a pathological reflex. The
most common cause is bladder distention or urinary retention, which is likely to be caused by a urinary
catheter blockage.
199. B A grade of 0 indicates complete severance of the nerve. A partial nerve injury causes a diminished
reflex grade, which is graded as 1+. A 2+ grading is normal. A 3+ grade indicates an upper motor neuron
lesion, not a peripheral nerve injury.
200. B Paroxysmal nocturnal dyspnea is common in severe heart disease. Relieving the breathlessness
symptoms by a positional change is suggestive that the problem is pulmonary in origin. Occasional
breathlessness may be expected with a change in physical activities, but more history should be taken to
expand. Lightheadedness is more indicative of a cardiac problem.