Neuromuscular and Nervous System 2010

1.Your patient with quadriplegia is exhibiting signs of autonomic dysreflexia. Your

supervisor tells you to that this is an emergency, you need to call the nurse immediately.
Which of the following are signs of this condition?

a) Severe pounding headache/ blurred vision

b) Diarrhea and vomiting
c) Increased heart rate
d) Decreased appetite

Rationale: Severe pounding headache and blurred vision could cause uncontrolled
high blood pressure. This is the most dangerous part of autonomic dysreflexia, if the
blood pressure goes high enough it could cause a stroke.

2.A male patient with a history of back injury complains of pain in legs. The patient wears
short leg braces. You read his chart and it states "lumbar plexus involvement", what area
of the spinal column is indicated?

a) L1- L2
b) L4 -L5 & S1
c) L5-S2
d) S1-S2

Rationale: The L1 -L2, move most leg muscles, which allows walking with short leg
braces, and involves the lumbar plexus spinal nerves , which supplies the
anterolateral abdominal wall, external genitals and part of the lower limbs.

3.Your patient is recovering from a motor vehicle accident. You assess the patient's
independence by evaluating how he performs his activities of daily living. He has good
upper arm strength which allows feeding, some dressing and propelling a wheel chair.
Which area of the spinal cord is affected?

a) C6- C7
b) T1- T3
c) T4- T9
d) T10- L1

Rationale: The patient has sustained trauma to the C5-C6 of the spinal column. The
affected area allows the patient to have some independence, which includes
personal care, and propelling the wheel chair .

4.Your patient states that someon stabbed him with a knife on his back. You perform
your assessement and you note that he has no ability to extend his leg over the
“anteromedial aspect “of his thigh. He also has a loss of sensation in his legs. Which is
the affected nerve ?

a) Lumbar nerve
b) Femoral nerve
c) Obturator nerve
d) Sciatic nerve
 Rationale: The largest nerve arising from the lumbar plexus is the femoral nerve and
usually related to stabbings or gun shot wounds.

5.A female-82-years old was referred for rehabilitation after fall at home injuring her
shoulder. The physician has diagnosed trauma to the “brachial nerve”. Which nerve
roots are affected?

a) C6-C8
b) C5-C6
c) C5-C7
d) C5-C8&T1

Rationale: The anterior ( ventral ) rami of spinal nerves form the brachial plexus
which extends inferiorly and laterally on either side of the last four cervical and first
thoracic vertebrae.

6.A female athlete sustained an injury to her arm. On your evaluation, you note
numbness, tingling and pain in the palm and fingers. There is also weakness in
pronation of the forearm and flexion of the proximal interphalangeal joints of the second
and third digits. Which nerve is affected?

a) Radial nerve
b) Median nerve
c) Ulna nerve
d) Long thoracic nerve

Rationale: The median nerve is located at the C5- T1. It innervates the flexors of
forearm (except flexor Carpi ulnaris); some muscles of the hand (lateral palm), and
the skin of lateral two thirds of palm of hand and fingers.

7.Your patient has burns on the dorsal surface of the arm. The wound area is mottled
red with a number of blisters. The physician informs the patient that healing should take
place in less than three weeks. This description is indicative of ?

a) superficial burn
b) superficial partial - thickness burn
c) deep partial - thickness burn
d) full -thickness burn

Rationale: A superficial partial thickness burn involves the epidermis and a portion
of the dermis. Healing would typically occur in approximately three weeks with little
or no scarring.

8.A patient is recovering from a complete spinal cord injury, at the level of L3. The
expected outcome would be :

a) greater loss of arm function than leg function

b) loss of motor function
c) a spastic bladder
d) some recovery of function
 Rationale: A spinal cord lesion below LI is a cauda equina lesion. It is an injury to
peripheral roots and nerves. Some regeneration can be expected. A spastic or reflex
bladder is associated with upper motor neuron injury. The other answers are
associated with anterior cord syndrome or central cord syndrome. Neuro: App

9.A patient is admitted with complete spinal cord transection. Which of the following
would best describe the diagnosis?
a) Entire severing of the spinal cord
b) Entire control of the arm and chest muscles
c) Entire control of trunk above the umbilicus
d) Entire control of leg muscles, which allows walking

Rationale: A spinal cord complete transection, identifies the entire severing of the
spinal cord. After transection , a patient will have permanent loss of sensations in
dermatones below the injury because ascending nerve impulses cannot propagate
past the transection to reach the brain.

10.A 22-year-old male waiting for scheduled therapy session in the gym suddenly begins
to scream. The patient sustained a traumatic brain injury in a motor vehicle accident and
is currently functioning at the confused appropriate stage . The Most appropriate
therapist action is:

a) Ask the patient if he needs assistance

b) Seek assistance from other health care professionals
c) Request that the patient is transported back to his room
d) Contact a physician and request that the patient’s medication dosage is
increased.

Rationale: A patient with a traumatic brain injury functioning at rancho los

amigos level v1 confused - appropriate typically demonstrates goal-directed
behavior and is able to follow simple commands fairly consistently. Since the
patient is no longer agitated, the verbal outburst would be considered an atypical
event and therefore warrants direct contact with the physical therapist.

11.A patient with Parkinson's disease exhibits the following symptoms: facial grimacing
with twitching of the lips, tongue protrusion, restless, with constant dancing and athetoid-
like movements of his legs. He states that he has been taking Levadopa for the past 7
years. What should you do?
a) ask the patient if he is taking any drugs with hallucinogenic effects
b) complete the treatment session
c) refer the patient back to the physician for levodopa toxicity
d) examine for additional signs of chronic levodopa therapy

Rationale:
Dyskinesias, gastrointestinal disturbances (nausea, vomiting) and mental
disturbances (restlessness, general over activity, anxiety or depression) are common
side effects of Levadopa. Nervous: evaluation
12.Brian is a 47 -years-old patient involved in motor vehicle accident. He sustained a
brain stem injury to the medulla oblongata. Which vital function will be affected by this
injury?
a) Blood pressure
b) Sight
c) Hearing
d) Moving

Rationale: The medulla oblongata controls autonomic functions, and relays nerve
signals to the brain and spinal cord. it is responsible for controlling several major
points and autonomic functions of the respiration, blood pressure, swallowing,
vomiting, defecation, reflexes.

13.A patient came to you with a profound deficit of homonymous hemi-anopsia. The
initial strategy to assist the patient in compensating for this deficit is to:
a) place items, eating utensils on the affected side
b) provide constant reminders, printed notes on the affected side
c) teach the patient to turn the head to the affected side
d) Bed on the affected side should be facing the doorway

Rationale: The patient should be instructed to turn the head to the affected left side.
Initial strategies include placing items or doorway on the unaffected side so the
patient can successfully interact with the environment. Later, as there is ability to
compensate, items can be moved to midline and finally to the affected left side.
Nervous The test taker must consider what the BEST INITIAL strategy is, which is
key to answering this analysis-type question. While all the choices are possibilities
and relevant, focusing on these key words helps one to arrive at the correct
conclusion that teaching the patient to turn his/her head is what needs to occur first.

14.John Walsh, 4 year-old boy, presents with progressive weakness and falling. The
physician diagnosed him to have Duchene Muscular Dystrophy. What do you expect to
find?
a) Disinterest in communicating or speaking
b) Disinterest in any form of learning
c) Disinterest in running, toe walking
d) Disinterest in any form of activities

Rationale: Duchene muscular dystrophy is a progressive disorder caused by the

absence of the gene required to produce the muscle proteins dystrophin and nebulin.

15.Your patient with Duchene Muscular dystrophy is scheduled for surgery. The physical
therapy student stated that he studied that most children with DMD die at the age of 25.
What is the main cause of the death for these patients?
a) Congestive heart disease
b) Peripheral vascular disease
c) Cardiopulmonary failure
d) Pneumonia
Rationale: Without dystrophin and nebulin, cell membranes weaken, myofibrils are
destroyed, and muscle contractibility is lost. Fat and connective tissue eventually
replace muscle, and death usually occurs from cardio pulmonary failure prior to age
25, usually in the teenage years.
16.Your patient (5 days old) with hydrocephalus is being admitted for a shunt insertion.
What are the problems associated with having a shunt inserted ?
a) Fixed staring
b) Muscle spasms
c) Involuntary movements
d) Retention of urine
Rationale: Modern shunts work very reliably and blockage and infection problems
have been minimized . However, shunts will block at some stage and require
replacement or revision in another operation. Increased head size , fixed staring,
irritability, vomiting, sleepiness or a bulging fontanelle ( soft spot in a baby’s skull )
are all signs of possible shunt problems in newborns.

17.Denise, a 38-year-old male, presents with facial weakness and twitching. She was
diagnosed with Bell's Palsy. What other signs do you expect?

a) Hearing
b) Facial rash
c) Paralysis
d) Difficulty swallowing

Rationale: Since the function of the facial nerve is so complex , many symptoms
may occur when the fibers of the facial nerve are disrupted. A disorder of the facial
nerve may result in twitching, weakness, or paralysis of the face, dryness of the eye
or mouth, or disturbance of taste

18.A CVA patient is unable to advance the tibia forward. He shortens the end of the
stance phase going directly into swing phase. The MOST likely cause of her problem is:
a) contracture of the plantar flexors
b) contracture of hip extensors
c) spasticity of dorsiflexors
d) weakness of the dorsiflexors

Rationale: Forward advancement of the tibia from midstance to heel-off is

controlled by eccentric contraction of the plantar flexors; from heel-off to toe-off
the plantar flexors contract concentrically. Either spasticity or contracture of the
plantar flexors would limit this forward progression. Neuro: Exam

19.Mr Carson, a 50-year-old below the knee amputatee, complains of pain on the
affected leg. His pain was classified as neuropathic pain. On your assessment, what do
you expect to find?
a) Altered sensation of affected area to pinprick
b) Swelling of affected leg
c) Altered sensation in the hip
d) Increased motor strength

Rationale: Neuropathic pain occurs in an area of abnormal or absent sensation due

to lesion in the central or peripheral nervous system. Nature of pain, burning,
shooting,, stabbing, jabbing, lancinating, altered sensation of affected area to pin
prick. Diminished motor sensation may be present.
20.A patient is prescribed an opioid analgesic for neuropathic pain associated with her
diagnosis of shingles. What are the known side effects of opioids ?
a) Fatigue
b) Urinary retention
c) Blurred vision
d) Insomnia

Rationale: Older people in particular may experience side effects from opioids. Side
effects can include, constipation, mental confusion, drowsiness, nausea and
vomitting.
21.The patient is unable to climb the stairs. How do you train the patient to perform this
task?
a) high marches
b) hip and knee flexion in supine and sitting
c) step on a 2 inch or 4 inch step ups
d) weight shifting between the parallel bars

Rationale: Task-specific practice of stepping using a low step represents the best
choice to ensure motor learning. Neuro: Intervention
22.Your patient complains of pain in an area of absent sensation due to lesion in the
central or peripheral system. What is the first line medication for this type of pain?
a) Meperidine
b) Morphine
c) Gabapentin
d) Pethidine

Rationale: Gabapentin is the first line medication for neuropathic pain. Starting with
100mg T.I.D; increasing to 200mg TID for the second day, and 300mg TID the third
day. This medication has very few side effects but expensive.

23.A 52-year-old female sustained an injury to the forehead due to motor vehicle
accident. The physician told you that she suffered a brain injury. Based on the location of
her injury, what do you expect?
a) loss of spontaneity in interacting with others
b) Increase in sleeping pattern
c) Inability to control bowel / bladder
d) loss of hearing

Rationale: A wide variety of symptoms can occur after brain injury. The nature of the
symptoms depends , in the large part, on where the brain has been injured. Loss of
simple movement of various body parts, inability to plan a sequence of complex
movements needed to complete multi-stepped tasks, such as making coffee, loss of
spontaneity in interacting with others can be found with these patients.

24.You are performing a manual muscle test on a patient. Your findings are-- paralysis
of the adductor muscles of the leg and loss of sensation over the medial aspect of the
thigh. Which nerve is affected with this presentation?
a) Femoral nerve
b) lumbar plexus nerve
c) Sacral plexus nerve
d) Obturator nerve
 Rationale: Obturator nerve injury, a common complication of child birth, results in
paralysis of the adductor muscles of the leg and loss of sensation over the medial
aspect of the thigh.

25.Jane 34 year old, with adductor muscle paralysis and loss of sensation over the
medial aspect of the thigh. What would be indicative of this neurological problem?
a) Back injury due to a fall
b) Congenital defect
c) Medical problem
d) Child birth

Rationale: Obturator nerve injury is a recognised complication of child birth.

26.What should be avoided in C5-C6 nerve palsy?

a) gentle ROM
b) partial immobilization
c) age specific exercises
d) abduction

Rationale: Erb's palsy is a paralysis of the upper limb that typically results from a
traction injury at birth causing a brachial plexus injury. Splinting the shoulder in
abduction leads to formation of abduction contractures and later hypermobility of the
shoulder.

27.Your patient with a lengthy history of cardiac problems, appears to be confused and
dizzy. She complains of inability to move one limb. You think that your patient is
suffering from:
a) Transient Ischemic Attack
b) Myocardial Infarction
c) Congestive Heart Failure
d) Low Blood Sugar

Rationale: A transient ischemic attack is an episode of temporary cerebral

dysfunction caused by impaired blood flow to the brain. Symptoms include dizziness,
weakness, numbness, or paralysis in a limb or in one side of the body, drooping of
one side of the face, headache , slurred speech, or difficulty understanding speech;
and a partial loss of vision or double vision.

28.Isokinetic training is used for patients with neuromuscular problems for:

a) rate control at fast movement speeds
b) rate control at slow movement speeds
c) rate control at varying movement speeds
d) does not improve rate control

Rationale: Patients with neuromuscular deficits are able to move at slow speeds but
as speed of movement increases, control decreases. An isokinetic device can be an
effective training modality to remediate this problem. Neuro: Intervention

29.Your patient presents with an involuntary and rhythmic movement or oscillation of the
eye. The physician diagnoses nystagmus. What other signs do you expect?
 a) Dilated pupils
b) Poor vision
c) Eyelid closing
d) Inflammation of the eye

Rationale: The eyes of an individual with nystagmus cannot remain still and oscillate
in some position of gaze. Those with nystagmus usually have decreased vision and
poor depth perception, although those born with nystagmus , may not realize their
vision is poor. Those acquired nystagmus may experience double vision or
oscillopsia, or that objects in their visual space appear to move. An acquired
nystagmus may be accompanied by other symptoms such as dizziness, difficulty
with balance, hearing loss or poor co-ordination, and numbness.

30.Your patient is diagnosed with congenital nystagmus. What would be the most
appropriate intervention for this diagnosis ?
a) Contact lenses
b) Glasses
c) Wearing an eye patch
d) No devices

Rationale: The treatment for nystagmus, once the etiology is determined and
treated, includes optical devices such as contact lenses and glasses, medication,
and help position the eye at its null point or to help the eyes converge.

31.A patient with complete C6 tetraplegia should be instructed to initially transfer with a
sliding board. Which muscles can the patient use?
a) shoulder extensors, external rotators, and anterior deltoid
b) shoulder depressors and triceps
c) pectoral muscles and scapular depressors
d) serratus anterior with elbow extensors

Rationale: The patient with complete C6 quadriplegia will lack triceps. He can be
taught to lock the elbow for push-up transfers byusing shoulder external rotators and
extensors to position the arm; the anterior deltoid locks the elbow by reverse actions.
Neuro: Application

32.You are performing an evaluation on a patient. Your findings are: pain and sensory
loss in the posterior thigh, lateral calf, and dorsal foot; Extension of the hallux is poor,
however the Achilles reflex is normal. Which spinal level is affected?
a) L4
b) L5
c) S1
d) S2

Rationale: L5 nerve root: dermatone -buttock posterior and lateral thigh , lateral
aspect of leg, dorsum of foot, medial half of sole, first , second, and third toes
myotome-extensor hallucis peroneals, gluteus medius, dorsiflexors, hamstrings
soleus, plantaris reflexes- medial hamstrings, posterior tibial.

33.Which muscles should be strengthened for an incomplete T12 paraplegia for

ambulation with crutches?
 a) middle trapezius, latissimus dorsi, and triceps.
b) deltoid, triceps, and wrist flexors.
c) upper trapezius, rhomboids, and levator scapulae
d) lower trapezius, latissimus dorsi, and triceps

Rationale: Shoulder depression and elbow extension strength is crucial for

successful crutch gait. Neuromuscular: Application

34.A physical therapist examines the forefoot position of a 36 year old male referred to
physical therapy with ankle pain of unknown etiology. The therapist determines that the
patient has a forefoot varus. What compensatory finding would the therapist most likely
find?
a) Subtalar eversion
b) Subtalar inversion
c) Talocrural dorsiflexion
d) Talocrural plantar flexion

Rationale: Subtalar eversion is a common compensatory finding in patients with

forefoot varus. This position of the rear foot allows the medial forefoot to come in
contact with the ground. This can lead to hypermobility in the foot and a loss of the
necessary rigid lever from midstance through toe off.

35.A 66 year old female, is referred to physical therapy with rheumatoid arthritis . During
the initial examination, the physical therapist notes that the fingers exhibit increased
flexion at the proximal interphalangeal joints and hyperextension at the
metacarpophalageal and distal interphalangeal joints. This deformity is most
representative of:
a) Boutonniere deformity
b) Mallet finger
c) Swan neck deformity
d) Ulnar drift

Rationale: Boutonniere deformity is most frequently encountered in patients with

rheumatoid arthritis or status post trauma. It is caused by damage to the central
tendinous slip of the extensor hood.

36.A patient diagnosed with piriformis syndrome is referred to physical therapy for one
visit for instruction in a home exercise program. After examining the patient, the physical
therapist feels the patients rehabilitation potential is excellent , but is concerned that one
visit will not be sufficient to meet the patient's needs . The appropriate action is to:
a) Schedule the patient for treatment sessions,as warranted by the results of the
examination
b) Explain to the patient that recent health care reforms have drastically reduced the
frequency of the physical therapy visits covered by third party payers
c) Explain to the patient that she can continue with physical therapy beyond the
initial session, but will be liable for all expenses not covered by her insurance.
d) Contact the referring physician and request approval for additional therapy
visits .

Rationale: It is an appropriate action to request additional physical therapy visits

from a referring physician
37.A male patient with limited shoulder range of motion, explains that he has difficulty
wiping himself after going to the bathroom. How much shoulder range of motion is
required to successfully complete toileting activities using a posterior approach ?
a) 50 degrees, horizontal abduction, 30 degrees abduction 45 degrees medial
rotation
b) 30 degrees horizontal abduction, 45 degrees adduction, 65 degrees medial
rotation.
c) 80 degrees horizontal, 40 degrees abduction, 70 degrees medial rotation
d) 90 degrees horizontal adduction, 75 degrees abduction, 60 degrees medial
rotation

Rationale: Full shoulder medial rotation is necessary to reach perineum using a

posterior approach.

38.A female patient recovering from ankle surgery has consistent difficulty with
functional activities that emphasize the frontal plane. Which of the following would be
most difficult for the patient?
a) Anterior lunge
b) six inch lateral step down
c) six inch posterior step up
d) eight inch posterior step down

Rationale: The frontal plane divides the body in to front and back halves.
Movements in the frontal plane occur as side to side movement such as abduction or
adduction. Rotary motion in the frontal plane occurs around an anterior posterior
axis.The most difficult movement for the patient would be a six inch lateral step
down.

39.A physical therapist, employed in an acute care hospital, conducts an initial interview
with a patient referred to physical therapy. During the interview, the therapist asks the
patient if he feels dependent on coffee, tea, or soft drinks. Which clinical scenario would
most appropriately warrant this type question ?
a) A 27 year old female status post arthroscopic medial menisectomy
b) A 42 year old male with premature ventricular contractions
c) A 37 year old female with restrictive pulmonary disease
d) A 57 year old male with respiratory alkalosis

Rationale: Premature ventricular contractions are premature beats arising form

ectopic foci in the ventricle. Premature ventricle contractions are the most common
form of arrthymia and may be precipitated by caffeine, anxiety, alcohol, and tobacco.

40.A patient with a lengthy history of substance abuse, is referred to physical therapy
after sustaining multiple injuries in a motor vehicle accident. Which of the following
controlled substances would not typically foster physical dependence?
a) Depressants
b) Hallucinogens
c) Narcotics
d) Stimulants
 Rationale: Hallucinogens may cause disturbance of senses , altered perception,
severe hallucinations, panic, and psychotic reactions. Physical dependence is not
characteristic of hallucinogens.

41.A physical therapist examines a patient diagnosed with post polio syndrome. Which
of the following areas is least likely to be affected based on the patient's diagnosis?
a) Strength
b) Sensation
c) Endurance
d) Functional mobility

Rationale: Post polio syndrome is a term used to describe symptoms that occur
years after the onset of poliomyelitis. The condition is believed to result as remaining
motor units become more dysfunctional- sensation is not typically affected by post-
polio syndrome.

42.During gait analysis, the physical therapist notes that the patient's gait has the
following characteristics; narrow base of support, short step length , and decreased trunk
rotation. This gait pattern is often observed in patients with a diagnosis of :
a) CVA
b) Parkinson’s disease
c) Post polio syndrome
d) Multiple sclerosis

Rationale: Patients with Parkinson’s disease often exhibit gait abnormalities due to
difficult initiating movement, rigidity, absence of equilibrium responses and
diminished associate reactions.

43.A patient who is 2 months post CVA complains of symptoms including burning pain in
the right upper extremity that is increased by the dependent position along with lowered
pain threshold and heightened sensitivity to light touch. The right hand is mildly
edematous and the skin is dry and warm to touch. Which stage of Complex Regional
Pain Syndrome is the patient in?
a) Stage III (atrophic stage)
b) Stage II (dystrophic stage)
c) Stage I (early) changes
d) None of the above

Rationale: This patient is demonstrating early signs of Complex Regional Pain

Syndrome (CRPS). Stage I (early) changes include those described in the question
and typically begin up to 10 days following injury. Stage II (dystrophic stage) and
Stage III (atrophic stage) changes typically develop later (3-6 months and 6-12
months) and are less responsive to treatment. In stage I CPRS all the treatments
listed can be used except passive manipulation which may aggravate
sympathetically maintained pain. Neuro: Exam

44.A patient complains of numbness, paresthesias and weakness of his bilateral lower
extremities which increase with extended positions or walking greater than 100 feet. His
pain persists for hours after assuming a resting position. Other activities does not affect
his pain. What do you think that patient has?
a) discal dysfunction
 b) spondylolysis
c) degenerative arthritis
d) Spinal Stenosis

Rationale: Spinal stenosis presents with bilateral dysesthesias and pain in extended
positions and/or during walking for distances greater than 100 feet. Physical therapy
intervention should emphasize stretching of tight structures and dynamic control of
the trunk to limit long-term extended spinal positions. Neuro: Differential Diagnosis

45.An 8 year-old child with decreased sitting balance, but normal tone would need:
a) standard chair with lateral supports
b) prone stander
c) Sitting on a therapy ball
d) adaptive wheelchair

Rationale: The goal of school physical therapy is to directly facilitate the educational
process. The adaptive wheelchair is the best choice for this child because it allows
the child to move around in the classroom while maintaining a stable position. Sitting
on a therapy ball is too advanced. The prone stander is restrictive and does not
promote sitting. Neuro : Intervention

46.A patient with a complete spinal cord injury with C5 tetraplegia complains of sudden
pounding headache and double vision. He is sweating excessively and his BP is 240/95.
All are interventions you should perform except for?
a) sit the patient up
b) lie the patient down
c) check/empty catheter bag
d) call for emergency medical assistance

Rationale: The patient is exhibiting autonomic dysreflexia. The therapist should first
sit the patient up and check for irritating or precipitating stimuli. The next step is to
call for emergency medical assistance. Placing the patient supine can aggravate the
situation. Neuro: eval

47.A patient demonstrates beginning recovery Stage 4 movements following a left CVA.
The PNF pattern that represents the BEST choice to promote continued recovery of the
right upper extremity through the use of out-of-synergy movements is:
a) chop, reverse chop with right arm leading.
b) bilateral symmetrical Dl thrust and reverse thrust.
c) lift, reverse lift with right arm leading.
d) bilateral symmetrical D2F and D2E, elbows straight.

Rationale: The appropriate task would include the six month gross developmental
level activity of working on unsupported sitting (standing and supine are not
appropriate choices). The use of a multicolored object is more appropriate than a
black and white object for a three year cognitive level.

48.What is contraindicated for a patient with Parkinson's who demonstrates festinating

gait?
a) side stepping
 b) rolling walker
c) stepping on treadmill
d) rhythmic stepping

Rationale: The patient with Parkinson's disease typically presents with postural
deficits of forward head and trunk with hip and knee flexion contractures. Gait is
narrow-based and shuffling. A festinating gait typically results from persistent forward
posturing of the body near the forward limits of stability. A rolling walker is
contraindicated because it would increase forward postural deformities and
festinating gait.

49.Your patient cannot perform a task upon command but can do the task when on their
own, for example, when you ask her to put on her socks, she cannot do it, but you
observe that she can do it on her own later in the day. This patient may have:
a) ideational apraxia
b) anosognosia
c) ideomotor apraxia
d) unilateral neglect

Rationale: With ideomotor apraxia, a patient cannot perform a task upon command
but can do the task when on their own. With ideational apraxia, a patient cannot
perform the task at all. Unilateral neglect might lead the patient to ignore the can
completely if positioned on her left side. Anosognosia is a more severe form of
neglect with lack of awareness and denial ofthe severity of one's paralysis. Neuro:
Eval

50.Your patient suffered a traction injury to the anterior division of the brachial plexus the
therapist would expect to see weakness of all the muscles listed below except for:
a) forearm pronators
b) thumb abductors
c) elbow flexors
d) wrist extensors

Rationale: The anterior divisions contribute to nerves that primarily serve flexors,
and the thumb