Answers and Explanations Section 1 1 Dd. A patient must always provide informed consent for physical therapy evaluation andl treatment, Even when educated as to the risks and benefits, the patient has the right to refuse treatment. Continued treatment without consent is unethical (Gabard, page 58) Safety, Protection & Professional Roles D. It takes 25 lb of force to adequately elongate the cervical spine (Bebrens, page 102) ‘Therapeutic Modalities A When the output ofthe right side ofthe heart is great= er than thatof the letsie, blood and fluid accumulate inthe pulmonary veins, alveoli and tissue spaces. This condition often accompanies congestive heart flue. (rin, page 20) Cardiac, Vascular, & Pulmonary Systems: Differential Diagnosis & Pathology c Bone marrow suppression isa common side effect with chemotherapy and can put the patient at increased tisk for osteoporosis and fractures, Aerobie and resi tance exeicise may be beneficial at decreasing other symptoms associated with chemo, Local superficial modalities are allowed as needed, (Goodman/Pathology, page 253) ‘Multi-system: Differential Diagnosis & Pathology For Practice Test 1 5. B. ‘To maintain good posture with bending and lift: ing, the primary motion should occur in the lower extremities (ie, bend atthe knees). From the waist up, a neutral spine should be maintained. To prevent loss of balance, a wide base of support is necessary, (Saunders, page 154) Safety, Protection & Professional Roles 6G Venous insufficiency typically presents with hemosid. erin deposits that cause discoloration of the affected lower extremity. Pain typically worsens throughout the day. Skin may weep or remain dry A risk factor for venous ulcer is previous or current deep vein throm: bosis, (Baranoski, page 280) Integumentary System: Differential Diagnosis & Pathology 2D. An open-ended question does not have a limited choice of responses (i.e. yes or no) but allows for respondents to be expansive in their answers (Hicks, page 20) Research && Evidence Based Practice ac In pregnancy, weight-bearing does shift to the heels in an attempt to compensate forthe forward and upward shift of the center of gravity that occurs with anterior weight changes, (Stephenson, page 125) Multi-system: Differential Diagnosis & Pathology BA Subtalar neutral is the preferred position for aul: foot orthosis, (Nawocvensta, page 124) Equipment & Devices KAPLAN) 309Practice Tests WD. Muscles attaching to the pelvis can become tight and have trigger points that can cause urgency for urination. Soft-tissue mobilization, trigger-point release, and stretching can improve this. (Goodman/Pathology, page 707) Genitourinary: ‘Treatment Interventions LL. D. Informed consent must be given prior to initiation of treatment. For this informed consent to be legal, the patient must not be a minor (under age of 18), the patient must be able to communicate, and the patient must be able to understand how the informed con- sent is presented (language). Informed consent is not dependent on insurance, (Gabard, page 57) Safety, Protection & Professional Roles 2 Dd. Hydrocortisone is synthetically made cortisol and is primarily used for its ant However, the ability to suppress inflammatory response also delays healing and bone formation, It does not affect the ability of skeletal muscle to contract (Gooiman/Pathology, page 321) Metabolic & Endocrine: Foundational Sciences & Background aflammatory effects 13. D. Clinical signs and symptoms of a deep vein thrombosis can include tenderness, swelling, redness, and tight- ness in the calf. Sometimes the patient is asymptom atic, Regardless, if symptoms oceur soon after surgery itis crucial that the physician be notified. (Goodman/Pathology, page 458) Musculoskeletal System: Differential Diagnosis. & Pathology 4A, The use of a TENS unit for pain management provides analgesia while the unit is on and for up to 30 minutes after treatment (Preatice, page 103) ‘Therapeutic Modalities san waniaw) 15, 16. 7 1a, 19, 20, B. Upper-extremity D1 begins in elbow extension, shoul der extension, and shoulder abduction, The shoulder is also internally rotated and the wrist is pronated and ulnarly deviated, Itends with shoulder flexed, adduced and externally rotated; the elbow extended and supi- nated; wrist radially deviated; and hand fisted. D1 extension is the reverse of D1 flexion. (Voss, page 15) Nervous System: Treatment Interventions AL In the early stage of controlled motion and beginning exercise, activities to strengthen the quad and bip flexors ate appropriate, Exercise that stresses the ACI, such as short-are quads (SAQs) or deep squats; should be avoided (Kisner, page 375) Musculoskeletal System: Treatment Interventions AL Declarative knowledge is knowledge about objects or things, Procedural knowledge is knowledge about how to perform a task. (Christiansen, page 429) ‘Teaching & Learning c ‘There hasbeen no evidence that an MRI would haveany adverse affects on a patient if needed for diagnostics. (Magec/Scientific Differential Diagnosis & Pathology, page 574) Muli-systems Differential Diagnosis & Pathology A ‘The rotator cut assists with stabilization of the glenol- ‘metal oint by providing an inferior pull to counteract the superior pull or compression of the joint by the deltoid, (Norkin/Levangie, page 225) Musculoskeletal System: Foundational Sciences & Background . B. IFC is used primarily for pain management and should be sensory, not motor (as in choice D). The sensation should be strong and comfortable and may appear to lessen as the patient assimilates to the stimulation, (Prentice, page 103) ‘Therapeutic Modalities21, 22. 23. 25. 26, 27. A “To test for myotomel weakness, the isometsie contrac- tion must be maintained for at last five seconds to sce it weakness develops. (Magee, page 16) Musculoskeletal System: Evaluation c Sublingual nitroglycerin is the most common drug used to treat acute angina. (win, page 226) CCardise, Vascular, & Pulmonary Systems: Foundational Sciences & Background B. ‘An inferior subluxation isthe most common sublux- ation, Subluxation occurs due to severe weakness as the humeral head slips out of the glenoid fossa. The slenoid fossa is displaced due to muscular weakness, causing decreased shoulder stability (Umphned, page 771) ‘Nervous System: Evaluation a Acdelta fibers selay shoup, pricking pain s that are wel localized, C fibers relay dul, burning sen- sation that is more poorly localized. Both are afferent neurons that are peripheral fibers. (Bebrens, page 10) ‘Therapeutic Modalities ations © ‘The myocardium isthe cardiae muscular layer (rin, page 14) Cardiac, Vascular, Pulmonary Systems Foundational Sciences & Background D. A hydrocolloid is used for autolytic debridement, pro- ‘motion of moist wound environment, and protection ‘of the wound from contamination. (Brown, page 65) Integumentary System: Treatment Interventions A Blectrocardiography measures the electrical activity of the heart, Chrwin, page 178) ‘Cardiac, Vascular, & Pulmonary Systems; Differential Diagnosis & Pathology 29, 30, 31 32. 33. Answers and Explanations c Adhesive capsuitis is «common musculoskeletal pathology in patients with diabetes mellitus (DM), Type 1 DM is typically adult-onset and most com: mon in the obese population. Blurred vision and foot neuropathies are common symptoms associated with type Il DM. (Goodman/Pathology, page 345) Metabolic & Endocrine: Differential Diagnosis & Background B. Borg’s Rating of Perceived Exeition is used for its strong correlation of maximal oxygen uptake. (ewin, page 301) Cardiac, Vascular, & Pulmonary Systems: ‘Treatment Interventions A ‘The Oxford technique uses ten reps at full 10-RM, fen at 75 percent 10-RM, and ten at $0 percent 10-RM. (Kisner, page 89) ‘Musculoskeletal: Treatment Interventions D. Exercises can be modified to accommodate patients? individual balance or endurance deficits. Since this patient needs this support, the physical therapist should assess his safety and independence with the stepping task and assess his need for an assistive device (Frownfelter, page 284) Cardiac, Vascular, & Pulmonary Systems: Treatment Interventions B, Cranial nerve VI is the facial nerve, which supplies muscles of facial expression and eye closure. It also innervates tears, salvation, and taste, (Martin, page 20) Nervous System: Foundational Sciences & Background B Manual muscle testing that finds weak, painless muscle action can indicate either a full muscle tear or injury to the nerve, (Dutton, page 180) Masculoskeletel System: Differential Dia Pathology. cee34, 35. 36. 37. 38, 39, 392 aaa aaa aaa A Babinski sign is elicited by stroking the lateral partof the sole ofthe foot from the heel tothe ball and then across the ball. Normally, in a patient older than six months the normal response is toe flexion. In infants less than six months and im patients with corticospinal tract dys- fanetion, the big toe extends and the other toes spread. (Martin, page 18) Nervous System: Evaluation B Fever pein, erythema, and edema are signs of infection, Osteomyelitis is infection in the bone and most eom- ‘monly occurs inthe long bones where bone formation ‘cuits. Infections elsewhere in the body, as may occur witha dental procedure, can spread to the bone itself. (Goodian/Clinical Medicine, page 576) Musculoskeletal System: Differential Diagnosis. & Pathology B. ‘Myelomeningocele is the term used to describe spina bifida cystica in which the eyst contains spinal cord. ‘Meningocele is the term used to describe spina bifida cystica in which the cyst contains only cerebrospinal fluid and meninges. Anencephaly is the condition where the brain does not developage Eneephalocele is the condition where the brain projects from the skull (Martin, page 155) Nervous System: Diflerential Diagnosis & Pathology C ‘These rotator culf muscles are responsible for deceler- ating the arm as the ball is released dung @ throw. (Donatelli, page 242) Musculosleletal System: Treatment Interventions D, Ataxia is uncoordinated movement. Lack of move- ment is akinesia. Weakness of one side of the body is hemiplegia, Slow movement is bradykinesia, (Martin, page 285) Nervous System: Differential Diagnosis & Pathology Be Slough and eschar are necrotic tissue that should be Aebrided., Pink or red tissue is granulation tissue that signals wound healing, Macerated tissue is peri-wound tissue that is wet and delicate. (Brown, page 12) Integumentary System: Ticatment Interventions APLAN, 40. a, 42. 43, 44, 45, ‘The motions to maximally open the facet joints are flexion, contralateral side-bending, and ipsilateral rotation, (Behrens, page 106) Musculoskeletal System: Foundational Sciences & Background D. Class 3 complete neurotmesis isa clasfication that indicates complete severance of a peripheral nerve Regeneration is not possible without sumgical repai However, « patient should be able to gain funetion through physical therapy treatment using orthotics, stretching, and compensatory techniques. (Rothstein, page 295) Nervous System; Differential Diagnosis & Pathology © Econcentric exercise is specific to two-jint mute. In this cas, the biceps isthe two-joint muscle an xcs the bow. By moving the shoulder into an extended position, i lengthens the biceps to allow safe elbow flexion stengthening in a position that could pot tally be one of injory. I the shoulder were flexed the biceps would be shortened and not inthe appropriate functional position, (Mlagee/Sciemtfc Differential Diagnosis & Pathology, page 447) Musculosieletal System: Foundational Sciences & Background c In high environmental temperatuces, the body diates skin blood vessels and increases sweat production (Serup, page 34) Integumentary System: Foundational Sciences. & Background A Functional training involves repeated practice of fune- tional activities to improve these activities (Umphred, page 73) Nervous System: Treatment Intervent B Knee flexion contracture causes excessive knee flexion in the affected knee, (Lusardi, page 737) Equipment & DevicesAnswers and Explanations 46. De ‘The transverse humeral igament ofthe shoulder holds the biceps tendon in the bicipitel groove. The rupture of this ligament allows the biceps tendon to slip into and out of the geoove, sometinnes causing iritation of. the tendon, (Donatelli, page 56) Musculoskeletal Systems: Foundational Sciences & Background 47. ‘The transtheoretical model describes these six stages that persons progress and digress through when mak- ing a health behavior change. (Bastable, poge 176) ‘Teaching & Learning 48, D. Prostaglandin isa vasodilator, which allows an increase of bload flow to the area in need. (Magee(Scientific Differential Diagnosis & Pathology, page 10) ‘Multi-system: Foundational Sciences & Background. 1. ds “The Berg Balance Scale is one standardized measure that is used as an ontcomes measure. Proprioceptive neuromuscular fecilitation, neurodevelopmental {reatment, and craniosaeral therapy are all treatment techuiques. (Cole page 36) Research & Bvidence Based Practice 50. B, ‘An incident report should be filled out and addled to the patients chart. In some facilities the clinic supervi- sor of medical director also signs the incident report (Gabard, page 217) Safety, Protection & Professional Roles Section 2 SLA. Dring forwatd flexion, both facet joints open, In exten- sion, both facet joints close, In side-bending right, the right facet closes and the lft feet opens: in side-bending lef the left facet closes and the right Facet opens (Saunders, page 268) Musculoskeletal System: Differential Diagnosis & Pathology 52, 53. 54, 55. 37. Dd. Duchenne muscular dystrophy isan x-linked recessive genesonly males exhibit symptoms, Symptoms include profound and progressive weakness, especially of the shoulder and pelvis gitdle; cardiac ancl respiratory muscle weakness scoliosis; and contractures. (Umphred, page 399) Nervous System: Differential Diagnosis & Pathology A Volumetric water displacement iss general way 10 measure edema of @ hand or foot. IF the water placed was more, the volume of the foot was greater, thus indicating increased edema. (Bebrens, page 31) ‘Therapeutic Modalities A Rheumatoid arthritis (RA) isa systemicdisease. Nodules and inflammation associated. with RA can occur in tocations other than just synovial joints. Osteoarthritis affects primarily weight-bearing joints, COPD affects primarily the palmonary system, and fibromyalgin is a ruseuloskeletal system connectve-tisue cisorder (Goodman/Pathology, page 102) Malti-system: Differential Diagnosis & Pathology G ‘The temporal lobe contains the primary auditory cor- tex and Wernicke’savea (Martin, page 11) Nervous System: Foundations! Sciences & Background c Regular exercise is beneficial for this patient during times of symptoms and when no symptoms of pain are present. Benefits are twofold in that regular exer cise can help with the movement of bowels through the GI tract and relieve stress (a trigger for (BS). (Goodman/Pathology, page 652) Gastrointestinal: Foundational Sciences & Background A Motor leaming is needs to tech the patient which muscles need to contract to stop or stow the flow of urine. Once the paticnt i better able to isolate these mses, strengthening cn occur Strengthening ofthe pelvic floor sls can decrease the fequency of incontinent (Goodiman/Pathology, page 725) Genitowtinary: Foundational Sciences & Background KAPLAN) 325Practice Tests 58. 8B. Hyperthyroidism is characterized by unexplained ‘weight loss, intolerance to heat, tremor, poor balance and coordination, and changing moods. An overactive Uyroid may be enlarged (a goiter). Musculoskeletal presentation may include calcific tendonitis or inflain- mation of structures around a joint, {Goodman/Pathology, page 329) Metabolic & Endocrine: Differential Diagnosis & Pathology 59.6 Injury to the common peroneal nerve presents with inability to dorsiflex and evert the foot. Patients with this petipheral nerve injury present with foot drop during gait. Pain is usually not present. Rothstein, page 357) [Nervous System: Differential Diagnosis & Pathology 0, ‘The peroneal nerve is supplied by the SI nerve root and when injured, such as ina freeze mechanisin, ean ‘cause weakness ofthe ankle everters and numbness on the lateral side of the foot, (Eoppenfeld/Orthopaedtic, page 59) Musculoskeletal System: Differential Diagnosis. & Pathology 6 A. “Tenodesis isthe passive shortening of the finger flexors a the wrist extends, This passive motion can replace active grippage. Care should be taken to avoid finger flexor stretching while the wrist is extended! to main- tain some tension to achieve tenodesis graspage. (Umphred, page 498) [Nervous System: Treatment jterventions ak “To increase the intervertebral foramina space, 25° of flexion is optimal. Too much fexion or even smal amounts of extension ean decrease interforaminal space. (Behrens, page 103) ‘Therapeutic Modslitis sa Kaptan) 63. ot. 65, 66. 67, Dd. Duchenne muscular dystrophy is an x-linked reces- sive gene, Only males exhibit symptoms, Syinptoms include profound and progressive weataess (especially of the shoulder and pelvis girdles), cardiac and respi- zatory muscle weakness, scoliosis, and contractures, (Umphred, page 399) Nervous System: Differential Diagnosis & Pathology D. Glucocorticoids are used to decrease inflammation but can hinder healing and the body's ability to fight, infection by decreasing the inflammatory response, In all.ases, care must be taken with passive mobilizations and stretches so as not to injure the area while the inflammatory response is suppressed (Goodman/Pathology, page 95) Maulti-system: Foundational Sciences & Background B. Pain resulting from an injury causes the muscles to react by tightening or guarding to prevent further injury. This muscle guarding can then cause dysfinc- tion of the muscle and joint, thus causing more pain, It can be. citcle of one thing causing another (Behrens, page 4) ‘Therapeutic Modalities D. Buttock, posterior leg, and foot pain can be referred from auything innervated by the L3 nerve root. This includes the La facet as it articulates with the L5 facet, The L4 nerve root, however, supplies a dermatomat area over the front of the thigh. (Behrens, page 8) Musculoskeletal System: Differential Diggnosis & Pathology A Nominal level simply puts data in groups, Ordinal level allows data to be ranked. Interval level allows dati to be ranked and assumes equal intervals between the rankings. Ratio level has an absolute zero, (Hicks, page 34) Research & Evidence Based Practice8G ‘The glenohumeral (GH) joint itself contributes 120° of elevation motion for flexion and abduction. The remaining 60 motion for full range comes from rota~ tion of the scapulothoracic (ST) joint. This makes the ratio 2" of GH motion for every 1° of ST motion, (Norkin/Levangie, page 229) ‘Musculoskeletal System: Foundational Sciences & Background 0D. ‘The greatest risk factor for developing COPD is ciga- rette smoking. (Cerwin, page 147) Gardine, Vasculas, & Pulmonary Systems: Differential Diagnosis & Pathology 7. D, Gastrocnemins is considered primarily « movernent muscle, It crosses over two joints and is made of primatily type Ha muscle fibers. The remaining choices are all postural stabilizers and are considered endurance muscles. (Dutton, page 16) Musculoskeletal System: Foundational Sciences & Background mG Since the pain appears to be corning from an Ld nerve supply, it would be most appropriate to ultrasound the area over the LA nerve root, For the best thermal effects, an area no larger than tivee the size of the sound bead should be used. (Bebrens, page 74) ‘Therapeutic Modalities A Following anterior shoulder dislocation, the motions of abduction and external rotation away from neutral should be avoided. Internal rotation coupled with aulduction also moves the humeral head anterior to an ‘uncomfortable position, Cane-assistad shoulder flexion is the appropriate exercise fr this patient a this time. (Kisner, page 256) ‘Masculoskeletal Syste ‘Treatment Interventions B. 74, 75. 76. Answers and Explanations A Al goals should be specific, objective, and measurable Short-term goals are usually achieved in two to four ‘weeks and are purposeful in moving toward a tong- term goal. Long-term goals are also specifi, objec- tive, and measurable and should also be functional. ‘Choices B and D are not specific ancl objectively mea- surable, Choice C isan example of a long-term goal (Shans, page 129) Safety, Protection & Profesional Roles v. Normally, the diastolic blood pressure increases less than 10 mm Hg, remains the same, or decreases less than 10 mm Hg. rvin, page 87) Cardiac, Vasculat, & Pulmonary Systems: Foundational Sciences & Background D. Long, complicated surveys are lesslikelyto be returned. Follow-up for unreturned surveys is helpful. Spring and fall are better times of year to improve return of surveys. A well-written and informative cover letter can increase the rate of return, (Bork, page 200) Research & Evidence Based Practice c A respiratory rate above 20 breaths per minute is con- sidered to be tachypneic. A respiratory rate below ten breaths per minute is described as bradypneic. Apnea is the absence of breath, Eupnea is normal rate of breathing, (Irwin, page 288) Cardiac, Vascular, & Pulmonary Systems: Evaluation B Side-lying is more comfortable than prone in cases of severe low back prin, Gentle rotational mobilization can increase movement of the vertebral joints, thus decreasing pain and muscle spasm. (Saunders, page 258) Muscioskeletal System: Treatment Intervent anePractice Tests 78. 79. 80, 81. 82, 83, A Chest radiography isthe mest commonly used imaging technique in the assessment of patients’ hung disease, (win, page 211) Cardiac, Vascular, & Pultnonary Systems: Differential Diagnosis & Pathology D. ‘The hypoglossal nerve functions to move the tongue, (Martin, page 20) ‘Nervous System: Foundational Sciences & Background A Ics difficult to establish treatment goals that involve independent decision-making or action by the patient ‘when dementia is involved. The patient tends to for get the recommendations or may be unable to follow through with home programs. (Lewis, page 83) Multi-system: Differential Diagnosis & Pathology A IF & patient is unable to perform standardized tests and measurements, a therapist can use nonstandard ied! methods to record a baseline measurement. For example, if the patient has difficulty donning a shirt and cannot lift his left shoulder high enough to place the left arm in the shirt after the right arm, the thera pist can document this in the notes and document change with physical therapy treatment interventions, (Glickstein, page 164) Nervous System: Evaluation b, ‘With parsed-lip breathing, the patient inhales through the nose and then slowly exhales through pursed lps. (lewin, page 311) Careline, Vascular, & Pulmonary Systems: Treatment Interventions G Definitive diagnosis of diabetes mellitus includes hav: ing the classic signs and symptoms of diabetes and « nonfasting blood plasma glucose concentration >200 mg/dL. Fasting blood ghicose levels are diabetic if they ave >126 mgfdL. (GeodmanyPathology, page 351) Metabolic & Endocrine: Evaluation 386 Kartany 84, 85, 86, 87, 88, 89, A ‘Upper extremity flexion is described as scapular retrace tion; elevation; shoulder external rotation and abduc- tion; elbow, wrist, and finger flexion; and forearm supination, Lower extremity flexion is described as hip flexion, abduction, and external rotation; knee flexion ankle dorsiflexion and inversion; and toe extension. (Martin, page 287) Nervous System: Differential Diagnosis & Pathology B. Sudoriferous glands are sweat glands, The evaporation of sweat assists in thermoregulation. (Hanumadass, page 18) Integumentary System: Foundational Sciences & Background © ‘The brachioradialis reflex is specific for Os disc her niation with nerve root involvement. The biceps reflex tests C3 and triceps tests C7, (Hoppenfeld/Orthopedic, page 33) Musculoskeletal System: Evalwation D. ‘The ankle-brachial index is used to compate the blood pressure of the ankle with the blood pressure of the ‘arm and measures arterial perfusion of the leg. (Baranoski, page 291) Integumentary System Pathology Differential Diagnosis & A Hiold-relax isa specific PNE technique that can target range of motion. The antagonist is isometrically con- tracted in a shortened range, followed by a relaxation ‘and movement into 2 lengthened position of the ago- nist (Voss, page 304) [Nervous System: Treatment Interventions A Mechanical debridement may be painful for the patient Wetting the dry dressing before removing it defeats the purpose of debridement. Wet-to-dry dressings ate often used in conjunction with other treatments and other dabridement techniques. Wet-to-dry dressings are non- selective and can remove both necrotic and viable tissue, (Baranoski, page 119) tegumentary System: Treatment fnterventions90. on. 2, 93, 9, 95, 96, © A reclining-back wheelchair to achieve the 60° hip flexion restriction is needed, (Sussman, page 373) Equipment & Devices c Upper limb tension testing can identify neural involve- ‘ent in the arm or neck, Itcan be further specified by ulnar, median, o radial bias, (Magee/Orthopedic, page 165) Musculoskeletal System: Evaluation c For avery large and/or dependent transfer, a hydraulic lift isthe safest mode of transfer, (Pierson, page 88) Equipment & Devices B ‘This is classic Pavovian, or respondent, conditioning, A ‘neutral stimulus is added to a bebavior (music playing with sit-to-stand) and the musie becomes conditioned ssimalus tothe conditioned response (sl-o-stand) (Bastable, page 45) ‘Teaching & Learning A ‘The physical therapy assistant isthe only one licensed to instruct and perform exercises as part of physical therapy treatment, If any of the other choices were to supervise the exercise, it would not be considered a physical therapy service (Pagliarul, page $5) Safety, Protection & Professional Roles A Solid ankle-foot orthoses resist hyperextension of the kenee, (Edelstein, page 4) Equipment & Devices A ‘To stretch the hamstrings, the hip must be flexed with the knee extended as in a stinight leg raise, To stabi- lize the pelvis, the other leg can be stabilized in the extended position, Some may prefer the method of 90/90 to avoid back strain, but itis not truly meant ¢o stretch the hamsteings, (Kiser, page 137) Musculoskeletal System: Evaluation Answers and Explanations 7” D@ B Droplet naclet only travel approximately hice fet through the air before dissipating. Ifthe patient covers his mnouth while coughing, contamination should not be problem. (Duesteshous, page 14) Safty, Protection & Professional Roles 98 AL Explicit learning includes not enly procedural know edge but also knowledge only known to the learner, such as coordination and force generation. (Christiansen, page 430) ‘Teaching & Learning 99, Dd. Heart rate is the dependent variable, The dependent variable is the observed variable that is changed! due to ‘manipulation of the independent variable, (His, page 70) Research & Evidence Based Practice 100. 8 As part of the patient interview, the therapist may ask, “Are you in a safe relationship? If the patent indicates that he or she is not, the physical therapist should have information readily available for weatment interven- tions. f the patient denies any domestic abuse, the observation of unexplained contusions should be documented (Gabard, page 77) Safety, Protection & Professional Roles Section 3 101. D. nthe cervical spine, sde-bending and rotation occut in opposite directions. Therefore, to increase right rotation, left side-bending can also be improved with side glides toward the lef, (Dution, page 1087) ‘Musculoskeletal System: Treatment Interventions KAPLAN) 387Practice Tests 102. Segmental breathing exercises work by providing pressure to an area of lung on the chest wall and structing the patient to improve the expansion of that area, This treatment can be used in patients with atelectasis. (lewin, page 311) Cardine, Vasculat, & Pulmonary Systems: Treatment Interventions 103. D. ‘The cardinal signs of inflammation are erythema, ineveased tissue temperature, edema, loss of funetion, and pain, Low-grade fever isa systemic response and ccan indicate other pathology, including infection, (Behrens, page 6) ‘Therapeutic Modalities 104, A, ‘The Dix-Hallpite test indicates there is pathology of the left posterior canal, The appropriate treatment would be an Epley maneaver that stavts with the head to the left, (Umpheed, page 650) [Nervous System: Treatment Inte 105. A. ‘The best approach to teke when educating an obese patient on the benefits and need for exercise is the overall improved health viewpoint. Many patients who are obese do not have the motivation to exercise juat For weightloss or to become athletic. Is also pos- sible that some obese patients do not enjoy walking ot athletics, A broad list of health benefits is bes. (Goodman/Pathology, page 33) Multi-systemt: Differential Diagnosis & Pathology 106. A. ‘An inguinal hernia occurs when abdominal tissue ot ‘organs push through a weakened area of the abdominal ‘mtcle wall. There is pain with exertion that cases the abdominals to pinch on the herniated tissue, In this case, the weakened abdomen could be a result of the tackle, and the herniation may have occurred during his liking (Goodman/Pathology, page 658) Gastiointestinal: Differential Diagnosis & Pathology 398 KAPLAN) 107. B. Neglect is inattention to one side ofthe body. {Umphred, page 831) Nervous System: Differential Diagnosis & Pathology 108, A, Endometriosis can produce implants on the iliopsoas and pelvic floor muscles, causing pain with muse testing of each of those, The presence of cyclic pain clues you into the endometriosis (Goodman Clinical Med, page 561) Genitourinary: Differential Diagnosis & Pathology 109. A. ‘An assistive orthosis can pre-position the thumb to assist with grip and prehension. (Edelstein, page 125) Equipment & Devices 110. A, Lung cancer is most likely to metastasize to one ofthe long bones or humbar spine (Goodman/Clinical Med, page 575) Multi-system: Differentiat Diagnosis & Pathology ML A. Alternating isometrics, slow reversals, and agor reversals are all specific techniques used in proprio- ceptive neuromuscular facilitation, Also included ate contract-relax, hold-relax, hold-relax active movement, rhythmic initiation, shythmic rotation, shythmic stabi- lization, slow reversal hold, and slow reversals (Martin, page 255) Nervous System: Tieatment Interventions 112, A. Lidocaine is different from the other choices due 6 its local analgesic and anti-inflamamatory effects. (Michlovitz, page 117) ‘Therapeutic Modalities 113. D. 7 Random practice schedules involve scheduling tasks in random orders, (Christiansen, page 433) ‘Teaching & LearningSe _Answers and Explanations 4. C Interval level allows data to be ranked and assumes equal intervals between the rankings. Ratio level has an absolute zero. Nominal level simply puts data in groups. Ordinal level only allows data to be ranked. (Hicks, page 37) Research & Evidence Based Practice 15. G Secondary osteoporosis can present after prolonged use of certain medications. Heparin, Coumadin, sto- zoids, and aspivin are a few of these, Secondary osteo- porosis occurs as a result of some other modifiable isk factors. (Goodman/Pathology, page 872) ‘Metabolic & Endocrine: Treatment Interventions 6. B. ‘The lft facet joint is stuck in an open position or can- not close. In extension, the right transverse process closes as it should while the left facet remains open. ‘The right transverse process will be more posterior. (Saunders, page 268) Musculoskeletal System: Evaluation nA. jal and upward motion of the Tower ribs is the normal motion with inspiration. The flattening of the diaphragm that is commonly seen with chronic obstructive pulmonary disease results in equal and inward motion of the lower margin ofthe ribs. Crwin, page 297) Gariae, Vascular, & Pulmonary Systems: Evaluation 18. A, ‘The loss of fluid associated with the fht ean cause ‘an imbalance in the electrolytes within the body. Muscle weakness, cramping, and paresthesia are all resultant signs and symptoms of inadequate eleceo ‘yte availability. (Goodnian/Pathotogy, page 111) Mulisystemy: Differential Diagnosis & Pathology 19, D, Lying supine puts the leat amount of pressure on the disc; walking and standing both provide seconc-least and sitting puts the greatest presse on the disc (Saunders, page 125) ‘Musculoskeletal System: Theatment Interventions 120. ‘To elicit a motor response, the most appropriate electrode setup would be a smaller electrode over the motor point of the muscle and a larger eloctrode over the muscle belly. (Behrens, page 170) ‘Therapeutic Modalities DLA. ‘The APTA Guide for Professional Conduct guidelines say gifts and favors should not be accepted that affeet professional judgment. In this case, the patient is on hher last treatment session and is offering a small token of appreciation, I¢is correct to accept the gift soit will not appear unappreciated. (Gabard, page 152) Safety, Protection & Profe al Roles 122. Be Pressure from immobilization on the radial nerve can elicit symptoms similar to those of C7 nerve root immobilization. However, in this case, the aggravating factor isthe cast, not anything in the Inmbat spine. (Hoppenfeld/Orthopedic, page 14) Musculoskeletal system: Differential Diagnosis & Pathology 123. A. Kehr sign is pain in the teft shoulder referred from a lacerated or ruptured spleen, The symptoms of bloated ness andl weakness (most ikely due to a bleed) support the organ involvement, Immediate referral i indicated. (Goodman/Pathology, page 631) Gastrointestinal System: Differential Diagnosis. & Pathology 14, D. ‘Tidal volume is the volume of air inspited or expized during a normat breathing cycle. The volume of air that can be inspived after normal inspiration is the inspiratory reserve volume. The volume of air that can be expired after normal expiration is the expiratory reserve volume, The volume of air that remains in the Ings after maximal expiration is residual volume. (lrwin, page 44) Cardiac, Vascular & Pulmonary Systems; Foundational Sciences & Background KAPLAN) 399Practice Tests 125. D, A Trendelenburg gait indicates a gluteus medivs weak ness during stance. Hip abduction itself strengthens the hip in an abducted postion, which does not carry over as welt the function ofthe gluteus medias in an adducted position during got, Single-eg stance more closely simulates that function, (Magce/Pathology, page 455) ‘Masculosteletal System: Treatment Interventions 126. B, Pulmonary emphysema results from destruction of bronchioles, alveolar ducts, and septa that creates large airspaces that are unavailable for gas exchange. Cystic Fibrosis sa genetic disorder that affects lung secretions, Asthma is a hyperreactivity of smooth muscle of the bronchioles, Clewin, page 148) Careline, Vasculay, & Pulmonary Systems: Differential Diagnosis & Pathology 127. D. Exercise is known to decrease blood pressure, decrease resting heart rate, decrease the progression oF onset of osteoporosis, and increase walking endurance and walking speed. (Goodman/Ciinical Med, paye 443) Musculoskeletal System: Foundational Sciences & Background 128. D. Orthostatic hypotension is often seen after prolonged bed rest, ancl patients should be monitored for changes in vital signs and tolerance for activity when allowed to progress to more upright positions after bed vest (iewin, page 272) Cardiac, Vascular, & Pulmonary Systems: Tieatment Interventions 129. B, “The parietal lobe is the primary sensory cortex and. also plays a role in short-term memory. (Martin, page 11) Nervous System: Foundational Sciences & Bal ton KAPLAN) 130. D. The convex-concave rule states that if one joint surface is concave related to another, the slide isin the same direction as the motion of the bone, Ifthe joint surface is convex, the slide is in the opposite direction to the motion of the bone, (Dutton, page 81) Musculoskeletal System: Foundational Sciences & Background BL B, Homonymous hemianopia is the loss of vision of hall the visual field. Diplopia is double vision, Nystagmus presents as eyes moving rapidly horizontally or verti cally. Visual agnosia is the inability to recognize famil- far objects. (Martin, page 285) Nervous System: Evaluation 132. Cohorting is when patients with similar diagnoses ate grouped together to avoid infection to others when space or transport is needed. Patients with airborne precautions should remain isolated in single rooms. (Ducsterhaus, page 96) Safety, Protection & Professional Roles 133, G Physical therapists cannot diagnose medical condi tions but can diagnose nonmedical conditions sch as developmental delay, sensory integrative dysfunction, and postural dysfunction, (Farber, page 108) Nervous System: Evaluation 134. B, According to the Rule of Nines, the posterior trunk accounts for 18 percent and an entire arm accounts for 9 percent. The total surface area is 27 percent, (Hanumadass, page 8) Integumentary System: Evaluation 135. B. Plethysmography records volume changes in the limb and is used to asses the severity of venous insufficiency. (Baranoski, page 293) Integumentary System: Differential Diagnosis & Pathology SU eee eet eee te te eee ISA IEE)136. G With vertebral compression fractures itis essential to avoid flexion activities that will further compress the vertebral body, causing pain. The further into ext sion the motion is, the more uncomfortable it can be due to distraction stresses. The best position is neutral spine (Gaumders page 135) Masculoskeletal System: Treatment Interventions 137. Be ‘The posterior columns convey information on pro~ prioception, vibration, two-point discrimination, and deep touch. The spinothalamic tract conveys pain and temperature information, The corticospinal tract is the primary motor pathway. The tectospinal tract car- vies information on orientation of the head toward a sound or objec. (actin, page 16) [Nervous System: Foundational Sciences & Background. 138. 2 In this position the ulnar nerve isa its greatest ten- (agee!Oxthopedic, page 165) Musculosteletal System: Difforential Diagnosis. & Pathology 139, D. Leg exercises are important for patients with venous insufficiency to improve the muscle pump mecha- (Baranoskt, page 305) Integumentary System: ‘Treatment Interventions Wo. B, Neurodevelopmental treatment is based om facil tion of tormal postural control while inhibiting abnorinal posture and muscle tone. The therapist directs movements so that the patient ean experience ormal movement, Once tone is normalized, func- Uional activities and movements are added, (Stokes, page 320) [Nervous System: Treatment Interventions MLA, Phantom pain is pain in the amputated lina. (Carrol, page 37) Equipment & Devices —— Answers and Explanations 142. D. When reading research articles, the physical therapist should consider how the study will affect the manage- ment and care of her own patients (Helewa, page 81) Research & Evidence Based Practice 143. D. Increased intracranial pressure can be due to swelling of the brain itself, thereby pressing the brain against the skull and possibly resulting in herniation through ‘openings of the cranial cavity. Increased blood or fluid in the ventricles may alsa place increased pressure on the brain tissue, Increased intracranial pressure results ina poor prognosis. (Umphred, page 417) Nervous System: Differential Diagnosis & Pathology 144, D. ‘The benefits of exercise while undergoing chemother- apy are many, However, bone marrow suppression isa side effect of the chemotherapy drugs and is nor ised asa benefit of exercise during treatment, (Goodman/Pathology, page 259) Multi-system: Foundational Sciences & Background 145. B. Although all of these features may be desirable, the Foot exit feature is the most important for the patient's mobility (Wilbon, page 22) Equipment & Devices 146. A. Cognitive learning theorists do not rely on rewards Cognitive learning theory emphasizes an individuals perception, thought, memory, motivation, and past experience and how this relates to learning. (Bestable, page 50) ‘Teaching & Learning 47, B. Scapular depression is the movement used to per form a wheelchair push-up for pressure relief. Other techniques for pressure relief include a side lean or forward lean. For patients who cannot perform pres- sure reli independently, wheelchair positioning and special equipment may be needed to avoid skin break. down, (Umphred, page 510) ‘Nervous System: Treatment Interventions KAPLAN) 401Practice Tests 8, D. ‘The first step should be to perform a detailed litera- ture review, before completing a proposal, creating a hypothesis, or establishing control groups. (Curries, page 36) Research & Bvidence Based Practice 49. B. ‘The Ocenpational Safety and Health Ado (OSHA) establishes health and safety standards for the workplace. Workers are given the right to register a com plaint or refuse to work in unsafe conditions without risking consequences or retaliation from the employes. (Gabard, page 215) Safety, Protection & Professional Roles stration 150. B, All equipment used in the clinic should be checked regularly for proper function and calibration, For this type of maintenance, the biomedical department and the equipment mamnfacturer are the best options. (Behicens, page 69) Safety, Protection & Professional Roles Section 4 ASL. A Tee is considered @ conduction mechanism of energy exchange because heat is conducted from the body to the ice in an attempt to warm the cold ice. (Behrens, page 38) ‘Therapeutic Modalities 152, B. “Toe raises are meant to strengtlien the gastrocnemius soleus complex, The calf is a major stabilizer of the ankle from mid to late stance, and calf weakness can contribute to instability. (Braddom, page 108) ‘Musculoskeletal Systems: Treatment Interventions 153. A. Brandt-Darolf exerises are designed to habituate an abnormally functioning vestibular system, (Umphred, page 650) Nervous System: Treatment Interventions 402 KAPLAN 154, A. Localized erythema, edema, pain, and decreased ROM are all normal responses to tissue injury from the arthroplasty. Purulent or yellow discharge from the ‘wound would be more indicative of fever. (Goodman/Pathology, page 130) Masculoskeletal System: Treatment Interventions c A polmonary embolus most commonly forms fallow- ing the development of a deep vein thrombosis. (lrwin, page 166) Cardiac, Vascular, & Pulmonary Systems: Differential Diagnosis & Pathology c Of the four options given, walking on the treaduill offers the greatest chance of aggravating joint pain with the repetitive trauma from pounding on the joints, Aquatic therapy and cycling offer non-weight- bearing or partial weight-bearing aerobic exercise to save the joints. Resistive strength training can strengthen as well as offer “stress to the bones to pre- vent progression toward osteopenia, Joodmsn/Pathology, page 33) Multi-system: Differential Diagnosis & Pathology 57. B. Some gastric pathologies may refer to the lower tho- racic spine. If the patient is not responding properly to physical therapy treatment interventions, oF if there are other systemic complaints, « non-musculoskeleta pathology may be the culprit (Dutton, page 211) Gasteointestinal: Differentiat Diagnosis & Pathology c Pia mater is the innermost layer of the meninges; it adheres to the brain, (Martin, page 10) Nervous System: Foundational Sciences & Background D. Endometriosis can occur only in women who are in ‘the childbearing yeats. It is more prevalent in women who have not had children or are pregnant later in lite (Goodinan/Ciinical Med, page 559) Genitourinary: Differential Diagnosis & Pathology160. D. Resistance traning that is specific to the site of bone loss can help to improve bone density. Cycling and aquatic therapy are non-weight-bearing and do not stinnulate bone growth, (Goodman/Pathology, page 881) ‘Metabolic & Endocrine: Trestment Interventions 161, C. Volar glides of the radius on the humerus will increase elbow flexion. (Kisner, page 177) Mascaloskeletal System: Treatment Interventions 162. ©. ial and error allows the patient to experience normal and abnormal movement patterns and to be involved in evauntion, modification, and repetition of the movement pattern. The learner/patient is allowed (0 experience mistakes and then is an active pacticipant in solving problems. (Umphred, page 438) ‘Teaching & Learaing 16. D. ‘the recommendation is to work at 600 70 percent ofthe safe maximal heart rate. To determine the safe mnaximal heart rate, subtract the patient's age fom 220. this case, 220 ~ 32 = 188, 0 the safe maximal beat rate is 18 bpm; 60 percent of 188 = 113; and 70 percent of 188 = 131, Thus, 125 bpm falls into the target range. (Stephenson, page 129) Mult-system: Differential Diagnosis & Pathology 164, B, Concentric contractions require more motor units than the other choices to move against the same resis- tance. (Magee/Scientific Differential Diagnosis & Pathology, age 445) Musculoskeletal System: Founclational Sciences & Background Answers and Explanations 165. B, Heat application ean increase local blood flow to the treatment area, IF the treated atea is also an insulin injection sit, it can accelerate the absorption of insu- lin and cause hypoglycemia, Symptoms of bypogly cemia can inelude headache, decreased coordination, and lethargy, (Goodiman/Pathology, page 359) Metabolic & Endocrine: Treatment Interventions 166. B. uring active flexion ofthe knee the tibia moves pos- teriorly on a fixed femur in an open chain position, following the convex-concave rule. (isner, page 194) Musculoskeletal System: Treatment Interventions 167. Mottling is a sign of overheating of the tissues, so more towels should be added to prevent a burn injury Mottling does not mean heat can no longer be used (Behrens, page 25) ‘Therapeutic Modalities 168. A. “Type | diabetes is characterized by the fact that itis insulin-depenclent. [tis essentially not improved with exercise and requites medication for control of blood sugar, It is most often juvenile-onset. (Goodman/Pathology, page 344) Metabolic & Endocrine: Differential Diagnosis & Pathology 169. G. ‘The ulnar werve has sensory distribution to the pinky and ulpar half of the ring finger. The median nerve distributes to the midale finger. The radial nerve dis- tributes to the thumb and index fingers and the radial half of the middle finger. (Patton, page 40) Musculoskeletal System: Evaluation 170. B. Graves’ disease isa form of hyperthyroidism, ‘Musculoskeletal manifestations can include periar- thvitis with joint pain and stiffness, Calcifie tendonitis Iso occur, further limiting function. (Goodman/Pathology, page 329) Metabolic & Endocrine: Differential Diagnosis & Pathology KAPLAN) 403Practice Tests 171. B, Cardiac output equals the product of heart rate and stroke volume: CO = HR x SV.S0: CO = 60 bpm x0. L CO= 6 Limin ewin, page 30) Cardiac, Vascular, 8¢Pulmonary Systems: Foundational Sciences & Background 172. B, “The close-packed position of the shoulder is abduc- tion and external rotation, In a close-packed position, the ligaments of a joint are most tightened and are therefore at greatest risk of injury (Dutton, page 83) Musculoskeletal System: Foundational Sciences & Background 173, ‘Tricyclic antidepressants significantly increase heart rate during exercise. This may mean that although ssuch patients do not perceive the exercise as exerting, their heart rate must be monitored to avoid activity that pushes them over the desired increase. (Goodman/Pathology, page 57) ‘Mult-system: Foundational Sciences & Background. 174, Be ‘The ADA hhas assembled a list of necessary adjust ments to allow for the use of a wheelchair in the home and community setting. Doorways should be more than 32 inches wide and toilets should be 17-19 inches call In this ease, a handrail is not as good a choice asa ramp, and the 16-inch-high recliner is to0 Low for him to rise from. (Deusterhaus, page 483) Safety, Protection & Professional Roles 175, A. Elbow flexion is innervated by the C5 nesve root. (Martin, page 381) ‘Nervous System: Foundational Sciences & Background 176. Be Pulse oximetry measures arterial oxygen saturation. (rin, page 206) Cardiac, Vascular, & Pulmonary Systems: aon Kantan) 177. A. ‘The function of L2 myotome is hip flexion, with the dermatome affecting the anteromedial thigh above the knee, {(Magee/Orthopedic, page 552) Musculoskeletal System: Foundational Sciences & Background 178. B. "This patient is at risk of developing heart disease and ‘would benefit from physical therapy for prevention and risk reduction, The other patients presented here are beyond prevention; they have active cardixe or pulmonary disease Clewin, page 262) Cardiac, Vascular, & Pulmonary Systems: Treatment Interventions 179. B. Sinee the patient is spending les time on the pain- fal leg he is working to get the unaffected leg down for added support. The shortened stance time on the injured side will cusea shortened step Tength on the ‘opposite side. (fagee/Orthopedic, page 963) Musculosleletal System: Evaluation 180. D, ‘The Modified Ashworth Scale is used to grade spas- ticity. A grade of 3 indicates considerable increase in muscle tone, and passive range of motion is difficult. (Umphred, page 430) ‘Nervous System: Evaluation 181. A. Tnereased or increasing intracranial pressure is a contraindication to chest percussion. Presence of secretions eytic fibrosis, and mechanical ventilation ate all indications for postural drainage and manuat percussion, (Feosnfelte, page 333) Cardiac, Vaseulat, & Pulmonary Systems: ‘Treatment Interventions 182. A. Vital signs such as blood pressure, heart rate, and respiratory rate can be used to assess the autonomic nervous systern, (Farber, page 109) Nervous System: Evaluation183, 184. 188. 186. 187, 188, B. This position allows the heels of the feet and the elbows to be “on air” so as not to cause pressure areas that can become sore, (Deusterhaws, page 118) Safety, Protection & Professional Roles B. To address nmusele guarding and spasticity, the goal is to fatigue the muscle to facilitate muscle relaxation. Less rest time is necessary, since strength is not a goal, (Behrens, page 183) ‘Therapeutic Modalities A ‘The patient needs to anteriony shift the weight of the bodly to stan up. The pelvis should bein neutral, rota ed neither posteriorly nor anteriorly. The therapist may need to facilitate upward displacement of the pelvis (Bly, page 69) Nervous System: Treatment Interventions AL Increasing the amount of time that a patient spends in bed may cause impairment of respiratory function and status, putting im at risk of respiratory infections sand comptications. (lsvin, page 274) Integumentary System: Treatment Interventions D. Autonomic dysrellexia happens in spinal cord-injured patients whose injury is above the level of 16, A nox: ious stimolus results in eramatic rise in blood pres- sure due to sympathetic nervous system overflow. (Martin, page 386) Nervous System: Treatment tnterventions B Ankle-foot orthosis offers the support this patient needs without the extra support and bulkiness that he does not require, (Seymour, page 381) Equipment & Devices Answers and Explanations 199. C. ‘The subject is entitled to withdraw from the study at any time, The subject should give informed consent and should be made aware of any risks ofthe study. A control group that receives a placebo is appropriate for this study (Currier, page 73) Research & Evidence Based Practice 190, D. ‘Myelin increases the speed of nerve impulses. A patient with multiple sclerosis has multiple lesions or plaques of the central nervous system. (Umphired, page 595) ‘Nervous System: Differential Diagnosis & Pathology 191. B. A forearm cuff is used to teat lateral epicondylitis and to decrease stress on the forearm flexors, (Edelstein, page 134) Equipment & Devices 192. G Learning is specific. By the therapist's creating the ‘same conditions that the patient will encounter at hhome, the patient is able to learn specific techniques that apply to her home situation. (Christiansen, page 429) “Teaching & Learning 193. D. Passive range of motion is indicated for this patient, Quick movements during change of position, ‘Trondlenburg position, and chest percussions are all contraindicated. (Umphred, page 708) Nervous Systems: Treatment Interventions 194. A. ‘Constant feedback is feedback that is given aller every teal, (Christiansen, page 434) ‘Teaching & Learning 195. D. Standard deviation measures the average amount that 4 set of scores deviates from the mean. (Hicks, page $5) Research & Evidence Based Pr eeePractice Tests 196. ©. ‘A keloid scars raised and extends beyond the original | ‘wound boundaries, (Sussman, page 95) Tniegumnentary System: Evaluation 197. B. ‘Countercoup lesions are on the opposite side of the brain, not the impacted side, and are # result of deceleration, Coup lesions are damage tothe same side of the brain as the impact to the head. (Martin, page 31) Nervous System: Differential Diagnosis & Pathology 198. . Sharp debridement via tweezers is an example of selective debridement. Wel-to-dry clessings, whitl- pool and wound irrigation are examples of nonselec- five debridement and may result in removing viable tisoe a8 well asthe necrotic tissue (Baranoski, page 120) Totegumentary Systems Treatment Interventions 199, B. A positive correlation means that two variables increase ‘or decrease together. A negative correlation means that 1s one variable increases, the other variable decreases, Correlation, however, does not necessarily indicate that one variable causes the other, (licks, page 80) Research & Evidence Based Practice 200. A. If the knees and hips cannot be at 90° angles, this is the best position to maintain a neutral spine and avoid postural injury. (Saunders, page 372) Safety, Protection & Professional RolesPractice Tests 196. G. ‘A keloid scar is raised and extends beyond the original ‘wound boundaries. (Sussman, page 95) Integumentary System: valuation 197. B. Countercoup lesions are on the opposite side of the brain, not the impacted side, and are a result of deceleration, Coup lesions are damage tothe same side ‘of the brain asthe impact tothe head. (Mertin, page 31) Nervous System: Differential Diagnosis & Pathology 198. C, Sharp debridement via tweezers is an cxample of selective debridement. Wet-to-dry dressings, whitl- ool, and wound ierigation are examples of nonsclec- tive debridement and may result in removing viable tissue as well as the necrotic tissue. (Beranoski, page 120) Integumentary System: Treatment Interventions 199, B, A positivecorrelation means that two variables increase cor decrease together, A negative correlation means that as ome variable increases, the other vaviable decreases. Correlation, however, does not necessarily indicate that one variable causes the other. iicks, page 80) Research & Bividence Based Practice 200, A. If the knees and hips cannot be at 60° angles, this is intain a neutral spine and avoid postural injury. (Saunders, page 372) Safety, Protection & Professional Roles Section 5 201. D. Spondylolisthesis isthe forward slippage of one verte- bra on another. Spondylosis is when the two vertebrae are showing degenerative changes that appear anvil- like on X-ray. Spondylolyss is a defect in the pars (Dutton, page 1217) Musculoskeletal System: Foundational Sciences. & Background 406 KAPLAN 202. D. Bresence of a pacemaker is a contraindication to elec- tical stimolation in this area. Electrical stimulation is used to increase blood flow, decrease edema, ancl encourage wound contraction, ‘(Gussman, page 491) Integumentary System: Treatment Interventions 203. A. High-level exercise is contraindicated for patients diagnosed with pericarditis (lewin, page 10) Cardiac, Vascular, & Pulmonary Systems: Treatment Interventions 204. D. “Application of moist heat may actually inbibit muscle strength for the first 30 minutes after its use. It also decreases muscle endurance. It does aid in increasing tissue extensibility, decreasing pain, and decreasing ‘muscle spastn, (Behrens, page 42) ‘Therapeutic Modalities 205. B. Habituation exercises overstimulate the vestibular system to “reset” the system and decrease symptoms of dizziness. (Umphred, page 650) ‘Nervous System: Foundational Sciences & Background, 206. A. Metastatic cancer often shows up in the long bones ‘of lurabar vertebrae. Signs ane symptoms that do not add up and night pain should be red flags for referral to the physician. (Magee/Scientific Differential Diagnosis & Pathology, page 244) ‘Muli-system: Differential Diagnosis & Pathology 207. Be ‘Uncontrlled inflammation that remains in an injured joint can have detrimental effects on otherwise healthy tissue surrounding the injured area, It is the injury itself that causes laxity and imomobiliztion that causes ‘capsular tightness, and vasodilation i primary effet. ‘of the inflammatory response, (MageetScientific Differential Diagnosis & Pathology, age 41) ‘Musculoskeletal System: Treatment Interventions208. B. A healthy individual should be able to maintain non- ‘weight-bearing to go from sit to stand and then pivot, to the chair. No assistance should be necessary (Deusterhaus, page 245) Safety, Protection & Professional Roles, \ 209. A. ) Maceration is the softening of tissue by soaking Macerated tissue appears white and is thin and fragile. (Sussman, page 96) Imegumentary System: Evaluation 210. A, ‘The supine position allows the stomach to slide up in the abdominal cavity and push into the diaphragm, inriteting the symptoms, A wedge behind the patient can allow recumbent exercise without worsening. symptoms. (Goodnvan/Pathology, page 633) Gastrointestinal: Treatment Interventions a. Endocrine pathologies affect the glands of the body that secrete hormones, Depending on the typeof pathology, either too such oF too litle hormone may be excreted, causing a multiade of signs and symptoms, (Goodiman/ Pathology, page 324) Metabolic & Endocrine: Foundational Seiences & Background 212 Ae Resistive exercise can be done every other day for a basic strengthening with aerobic exercise on the off days to improve cardiovascular health, (Hall, page 80) Musculoskeletal Systems: Treatment Interventions 213. A Since the pulling motion is less strenuous on the back than ¢ push, most ofthe help should be pulling 9 that the one who assists with a push does not have much oad to move. (Duesterhaus, page 226) Safety, Protection & Professional Roles ppg re see ere TT _ Answers and Explanations 24. A. Bruiustiom has described synergy paterns seen inthe upper and lower exteemities, flexion, and extension. This patient demonstrates a classic upper-extremity flexion synergy. (Rothstein, page 466) Nervous System: Evaluation m5. A A lower frequency will elicit stronger contraction in this denervated msde, "The lower frequency may be more uncomfortable, (Robinson, page 178) “Therapeutic Modalities 216. D. ‘When tightened, the transverse abeominis, multfidus, and pelvie floor provide stability to the lumbar spine. ‘The rectus abcominis does not attach to the spine and does not provide the stabilization that the transverse abdominis does. (Magee/Scientific page 395) Musculoskeletal System: ‘eatment Interventions ifferential Diagnosis & Pathology, 217. G ‘The PTA has the knowledge and background to follow through with an exercise regimen as instructed and supervised by a physical therapist and is familiar with what to look for as adverse reactions to the exercise. (Gabard, page 250) Safety, Protection & Professional Roles 218. ©. If patient who was previously independent with mobility presents with limitations, fanetional training, js one technique to adlress this. Strength and endur- ance training can also help. (rwin, page 359) Cardiac, Vascular, & Pulmonary Systems: ‘Treatment Interventions 219. B Myelin increases the speed of nerve impulses and insulates the axons. (Martin, page 10) ‘Nervous System: Foundational Sciences & Background KAPLAN) amf Practice Tests 220. C, Based on the desired depth of penetration (superfi- cial), the 3 MElz frequency is most suitable. Based on the fact that che injury is still in the acute inflamma~ tory stage, nontherinal pulsed effects are most desir- able. (Bchrens, page 70) ‘Therapeutic Modalities 221 A. [As pregnancy progresses, the center of gravity moves anterior and superior. (Kisner, page 554) Malt-system: Differential Diagnosis & Pathology 22. Ie is the responsibility of the physical therapist to respect the patient’ wishes regarding a male or female therapist, There may be religions, ethnic, or other reo- sons forthe patients preference. (Gabard, page 92) Safety, Protection & Professional Roles 223. B. “The right lung has three lobes: upper, middle, and lower. The lft ng has two lobes: upper and lover. (irwin, page 41) Cardiac, Vascular, Pulmonary Systems: Foundational Sciences 8 Background 24. De Whirlpool is used for wounds with thick exudate, slough, and necrotic tissue. It should be discontinued ‘when the necrotic tissue is cleared, (Brown, page 29) Integumentary System: Treatment Interventions 225, D. Dysphagia is difficulty with swallowing. (Martin, page 285) ‘Nervous System: Differential Diagnosis & Pathology 26. B, ‘Motivation is key in this situation. Patient A has husband who is eager to help her. Patient B needs to do this movement by herself in order to go home independently. Motivation is necessary. (Umphred, page 17) “Teaching & Learning aoa Kantan) 27. C. ‘The shump test assesses neural tension of the lower extremity. (Magce/Orthopedic page 497) Musculoskeletal System: Evaluation 228. A. Plouraleffusionisthe condition ofan increased amount \ of fluid accupying the pleural space. Pnemothorax is condition of fice air leaked into the plearal space. ‘Aielectasis i the collapse of lung tissue. (lain, page 172) Cardiac, Vascular, & Pulmonary Systems: Differential Diagnosis & Pathology 209. C. Rancho Los Amigos Cognitive Functioning Seale is used to describe a patient's cognitive fametion. The ‘Modified Ashworth Scale is used to measure spastic- ity, The Glasgow Coma Scale is used to ratea patient’ level of avousal and cortical function. Brannstrom's stages of recovery identify the levels of a patient's recovery from hemiplegia, (dartn, page 358) Nervous System: Evaluation 230. A. A pancoast tumor is in the apex of the lung; when large enough, it can put pressure on surrounding structures, giving the described signs and symptoms, (Goodinan/Pathology, page 610) Malti-systems: Differential Diagnosis & Pathology 231. B, Iner-rater reliability is the degree to which there is agreement in measurement between raters. (Currie, page 167) Research & Evidence Based Practice 232, G Dysdiedochokinesia is defined as impaired ability to produce rapid alternating movements. Ataxia scefined as impaired muscular coordination. Bradykinesia is defined as a slowness of movement. Dysphagia is defined as impaired swallowing, (Uimphred, page 724) [Nervous System: Differential Diagnosis & Pathology233, B. ‘To predict maximal heart rate, subtract the patients age ftom 220; in this case, 220 — 72 = 148. Certain medications such as beta-blockers and sympatho- mimetics blunt or exaggerate the heart rate response and this formula cannot be used. Following a heart transplant, the heart is denervated and will have an. abnormal heart-rate response. (Clewin, page 84) Cardiae, Vascular, & Pulmonary Systems: Evaluation 234, D. Multidirectional weight-shifting with and without farm support can address dynamic sitting balance goals. Patients should be challenged to progress into higher levels of maintaining balance (Umphred, page 732) ‘Nervous System: Treatment Interventions 235. A. ‘The epidermis isthe outer layer of the skin, (Moffat, page 1) Integumentary System: Background Foundational Sciences & 236. D. ‘A patient with Alzheimer’s disease has memory and cognitive deficits. A caregiver should be educated on the exercise program in order to help the patient 10 correctly complete the exercises. (Glicksein, page 66) Nervous System: Treatment Interventions 237. B, ‘A band serves a more cosmetic function, An active terminal device is able to open and close without the use of the sound hand, (Carroll, page 143) Equipment & Devices 238, D. ‘Any indication of systemic signs such as fatigue or proximal muscle weakness (inability to sit up at her desk, and a heavy feeling while lifting her legs) should caution the physical therapist to look beyond the mus culoskeletal diagnosis, Lack of appropriate response to therapy treatment interventions should also indicate something more global. (Goodman/Pathology, page 324) Metabolic & Endocrine: Differential Diagnosis & Pathology 239. m0, 21. 202. m3. 4. 4s, psu en cn Answers aud Explanations B In this cas, either the right facet will not close or the left facet is stuck open. It will be the left transverse process that can be palpated in extension {Saunders, page 269) ‘Moscaloskeletal System: Evaluation G A four-point pattern uses alternate and reciprocal movement of the erutehes and the opposite lover extremity. (Gierson, page 110) Equipment & Devies c Generalization refers to leaning one skill and being. able to complete a closely related shill. (Christiansen, page 429) ‘Teaching & Learning B. Qualitative research avoids numbers and can help look at other people's views or opinions. (Hicks, page 7) Research & Evidence Based Practice B. ‘The capsular pattern of the shoulder is external rota tion > abduction > internal rotation. (Magee/Orthopedic, page 232) Musculoskeletal System: Foundational Sciences & Background G If the results are statistically significant, it is unlikely that the difference is due to chance. Also, the treat- ment may be clinically important ifthe change is large enough for therapists to change the way they treat patients. (Helewa, page 87) Research & Evidence Based Practice © ‘The deep peroneal nerve can become compressed by fluid accumulation in the anterior compartment, causing numbness, pain, and foot drop. (Magee/Orthopedic, page 900) Musculoskeletal System: Differential Diagnosis & Pathology KAPLAN) 409Practice Tests 246, A. Decreased potassium levels inhibit normal muscle fanetion by limiting the effectiveness of the sodi- tum-potassium pump needed for muscle contraction, Flectrolyte loss is common, with fulike symptoms of diarrhea and vomiting. (Goodman/Pathology, page 631) Molti-system: Foundational Sciences & Background 247. D, Proprioception is the ability to identify the position of, the body or a body part without looking, (Umphred, page 430) ‘Nervous System: Evaluation 248, © ‘Asking another therapist to measure the range of ‘motion without the second therapist knowing why creates a blind procedure. In a blind test, the examiner is not aware of the hypothesis. This can eliminate any possible bias on the part of the examine (Hicks, page 100) Research & Evidence Based Practice 249. D. ‘A person's locus of control can be external or internal. AA person with an external lacus of control believes that events are caused by fate and powerful others. ‘They tend to respond to directions from an expert (Davis, page 192) Teaching & Learning, 410 KAPLAN 250. B, The capsular pattern of the hip is restriction of flex- jon, abduction and medial rotation. These motion restrictions indicate capsular involvement. The order of restriction may vary. (Magee/Oxthopedlic, page 33) Musculoskeletal System Pathology Diagnosis &