Practice Questions 1

1. A physical therapist prepares a presentation on proper body mechanics for a group of 100 autoworkers. Which of
the following media would be most effective to maximize learning during the presentation?
A. lecture, handouts
B. lecture, charts, statistics
C. lecture, handouts, demonstration
D. lecture, statistics

2. A physical therapist attempts to have a patient status post CVA reach for a cone by moving her trunk away from
midline. The most appropriate type of manual contact to assist the patient with this movement is
A. firm, deep touch
B. light, intermittent touch
C. maintained touch
D. no manual contact

3. A patient two weeks status post transtibial amputation is instructed by his physician to remain at rest for two days
after contracting bronchitis. The most appropriate position for the patient in bed is
A. supine with a pillow under the patient’s knees
B. supine with a pillow under the patient’s thigh and knee
C. supine with the legs extended
D. sidelying in the fetal position

4. A student physical therapist is treating a 65 year-old mildly obese patient. The patient is status post total hip
replacement and is cleared for 25 pounds of weight bearing through the involved lower extremity. Appropriate
assistive devices for gait training would include all of the following EXCEPT
A. parallel bars
B. walker
C. axillary crutches
D. straight cane

5. A therapist tests a small area of skin for hypersensitivity prior to using a cold immersion bath. The patient begins
to demonstrate evidence of cold intolerance within 60 seconds after cold application. The most appropriate
response is to
A. limit cold exposure to ten minutes or less
B. select an alternative cryotherapeutic agent
C. continue with the cold immersion bath
D. discontinue cold application and document your findings

6. A physical therapist would NOT expect a seven month-old infant to have completed which of the following
developmental milestones?
A. hold head erect when sitting
B. crawl forward
C. sit unsupported
D. roll from supine to prone

7. A 21 year-old male suffers a primary dislocation of the right shoulder playing football. The athlete is referred to
physical therapy after three weeks of immobilization. A physical therapist might elect to begin treatment with all
of the following EXCEPT
A. isometric shoulder exercises
B. passive range of motion exercises
C. active-assistive range of motion exercises
D. high speed isokinetic exercises

8. A patient with a C3 spinal cord injury is positioned in supine. Which area is most susceptible to pressure in this
position?
A. greater trochanter
B. anterior iliac crest
C. medial malleolus
D. sacrum

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9. Muscles that flex or extend in the sagittal plane against gravity are tested in the ____ plane for gravity eliminated
testing?
A. coronal
B. frontal
C. sagittal
D. transverse

10. An administrative assistant seeks advice from a physical therapist on proper positioning at a video display
terminal. The therapist would be correct in telling the patient all of the following EXCEPT
A. the top of the video display screen should be slightly above the operator’s eye level
B. the operator’s arms should be perpendicular to the floor
C. the operator’s chair should be adjusted to keep the body in an upright position
D. the operator’s feet should be flat on the floor or elevated on an appropriate foot rest

11. A therapist determines the maximum load a patient can squat ten times is 240 lbs. The patient’s ten repetition
maximum should be recorded as
A. 10 lbs.
B. 24 lbs.
C. 120 lbs.
D. 240 lbs.

12. A patient demonstrates mild dizziness during vertebral artery testing. The therapist should pay particular attention
when treating the patient to avoid positioning the neck in
A. extension and extremes of rotation
B. flexion and extremes of rotation
C. flexion and sidebending
D. extension and sidebending

13. A patient lies supine with one knee over the edge of a treatment table and the other held against his chest. The
therapist notes that the knee over the edge of the treatment table is flexed to 45 degrees. A probable cause of this
position of the knee includes tightness of the
A. iliopsoas
B. rectus femoris
C. tensor fascia latae
D. vastus medialis

14. According to the Standards of Practice for Physical Therapy as published by the American Physical Therapy
Association, who is responsible for the physical therapist’s individual professional development and continued
competence?
A. the individual physical therapist
B. the physical therapist’s employer
C. the state chapter of the American Physical Therapy Association
D. the American Physical Therapy Association

15. Tissues of high collagen content are affected to a greater extent by ultrasound energy. Which tissue would you
expect to absorb the most ultrasound energy?
A. bone
B. muscle
C. tendon
D. skin

16. Biophysical effects of ultrasound include thermal and nonthermal effects. The amount of heat absorbed using
ultrasound is least dependent upon
A. the intensity
B. the duration of exposure
C. the choice of coupling agent
D. the size of the area sonated

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17. A complete medical history can provide valuable information about a disorder, its prognosis, and the appropriate
treatment. Which statement is NOT accurate when obtaining a medical history?
A. The examiner should ask one question at a time and should receive an answer before proceeding with the next
question
B. The questions should be easy for the patient to understand and should not be leading
C. The examiner should encourage the patient to discuss irrelevant information since it will foster the patient-
therapist relationship
D. The history should be taken in an orderly sequence

18. An effective manager should adhere to all of the following guidelines EXCEPT
A. maintain a mutual commitment to goals
B. provide staff with the opportunity to develop professionally
C. allow participation in decision making
D. delegate undesirable tasks to subordinates

19. A physical therapist observes a patient ambulating in the clinic. The therapist notes that the patient’s pelvis drops
on the left during left swing phase. This deviation is usually caused by weakness of the
A. left gluteus medius
B. right gluteus medius
C. left gluteus minimus
D. right gluteus minimus

20. A therapist examines a patient diagnosed with cerebellar degeneration. Which of the following clinical findings is
not typically associated with this condition?
A. athetosis
B. dysmetria
C. nystagmus
D. dysdiadochokinesia

21. A physical therapist examines the reflex status of a patient. The therapist should use which technique to assess the
patient’s superficial reflexes?
A. brushing the skin with a light feathery object
B. percussing a muscle over the musculotendinous junction
C. stroking the skin with a non-cutting but pointed object
D. tapping a tendon or bony prominence

22. Patients with cervical rib syndrome can experience tingling and numbness throughout the upper extremity when
carrying heavy objects at their side. Which structures are commonly affected by the cervical rib?
A. common carotid artery and inferior trunk of the brachial plexus
B. common carotid artery and superior trunk of the brachial plexus
C. subclavian artery and inferior trunk of the brachial plexus
D. subclavian artery and superior trunk of the brachial plexus

23. A patient with a diagnosis of CVA presents with significant balance and coordination deficits. The patient has
good upper and lower extremity strength, however ambulates with an ataxic gait pattern. Upon reviewing the
patient’s chart, you are not surprised to find that the area of the brain affected by the CVA is the
A. cerebellum
B. cerebrum – left hemisphere
C. frontal lobe
D. Broca’s area

24. A patient status post CVA exercises in supine. As the therapist resists adduction of the unaffected leg, the affected
leg begins to adduct. This should be documented as
A. Souque’s phenomenon
B. overextension phenomenon
C. Schunkel reflex
D. Raimiste’s phenomenon

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25. A physical therapist is employed at a physician owned physical therapy clinic that charges for treatment by the
modality. One of the physicians, who is an owner of the practice, requests that all of his patients receive a
minimum of heat, ultrasound, and electrical stimulation during each treatment session. The therapist feels that the
majority of patients receive little clinical benefit from the proposed treatment regimen. The most appropriate
immediate response would be to
A. ignore the physician’s request and treat each patient as you feel is indicated
B. discuss with the physician the rationale for requesting modalities on each patient
C. report the physician’s conduct to the American Medical Association
D. inform the physician he is abusing the health care system

26. A therapist completes a developmental assessment on an infant. At what age should an infant begin to sit
unsupported for an extended period of time?
A. 6-7 months
B. 8-9 months
C. 10-11 months
D. 12 months

27. A physical therapist is required to train a 71 year-old patient to ascend and descend a flight of stairs. The patient
presents with a fractured left tibia and is weight bearing as tolerated. There is moderate weakness in the involved
lower extremity secondary to the fracture. The most appropriate instructions are
A. “One step at a time, right foot first to ascend and to descend the stairs”
B. “One step at a time, right foot first to ascend the stairs and left foot first to descend the stairs”
C. “Step over step slowly”
D. “One step at a time, left foot first to ascend and to descend the stairs”

28. A therapist designs an exercise program for a woman that is pregnant. The physician referral identifies diastasis
recti as a secondary diagnosis. Diastasis recti is
A. an incision made at the opening of a vagina to increase the diameter
B. when the embryo develops in the fallopian tube
C. a separation of the rectus abdominis muscle
D. when the placental pulls away from the uterine wall

29. A patient presents with orthostatic hypotension. The most appropriate treatment technique to assist the patient
with standing is
A. standing in parallel bars for increasing time intervals
B. using a standing table
C. standing in a pool
D. tilt table with progressive vertical positioning

30. A therapist can obtain valuable information during an examination by using special orthopedic tests. Which of the
following tests is not performed with the patient in supine?
A. anterior drawer test
B. Apley’s compression test
C. McMurray test
D. patella apprehension test

31. A therapist examines a healthy 12 month-old baby. Which activity does not initially develop between the 9th and
12th month?
A. pincer grasp
B. walking
C. transfers objects from one hand to the other
D. stands up with high guard

32. A therapist records the blood pressure of a two year-old child in the medical record. Assuming normal values, the
most typical blood pressure reading is
A. 80 systolic, 35 diastolic
B. 85 systolic, 60 diastolic
C. 105 systolic, 65 diastolic
D. 120 systolic, 80 diastolic

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33. During an examination of a patient with a traumatic brain injury a therapist notes the patient mumbling phrases
which are non-purposeful in nature. As the physical therapist initiates passive range of motion to the patient’s
lower extremities, the patient attempts to strike the therapist in the head. According to the Ranchos Los Amigos
levels of cognitive functioning, this patient would be best described at level
A. II
B. III
C. IV
D. V

34. A therapist identifies excessive femoral neck anteversion during an examination of a patient diagnosed with
trochanteric bursitis. This structural finding commonly results in
A. an increase in hip lateral rotation
B. an increase in hip medial rotation
C. an increase in hip extension
D. an increase in hip flexion

35. A 63 year-old female referred to physical therapy for gait training suddenly loses her balance and falls to the floor.
After rushing to the scene, it becomes obvious that the patient is unconscious. Which of the following would be
the most appropriate immediate response?
A. secure and maintain an airway
B. file an incident report
C. observe and record vital signs
D. attempt to define the specific cause for the loss of consciousness

36. A therapist examines a patient placed in respiratory isolation. Which of the following diseases would require
respiratory isolation?
A. diphtheria
B. pharyngitis
C. pertussis
D. hepatitis

37. A physical therapist working on a team with a physical therapist assistant would be incorrect in asking an assistant
to perform which of the following tasks?
A. modify treatment plan or goals
B. apply and measure assistive or adaptive devices
C. identify changes in treatment outcome
D. administer therapeutic modalities

38. The most common mechanism for an anterior talofibular ligament sprain is
A. inversion and dorsiflexion
B. inversion and plantarflexion
C. inversion
D. pronation, eversion, and dorsiflexion

39. A therapist examines a patient with L1 paraplegia for a wheelchair. A wheelchair designed for this patient should
include
A. reclining frame
B. elevating leg rests
C. handrims with 12 vertical projections
D. removable armrests

40. A patient is referred to physical therapy diagnosed with right hip trochanteric bursitis. Which clinical finding is
usually NOT associated with trochanteric bursitis?
A. resisted abduction reproduces symptoms
B. full hip active range of motion
C. positive Ober test
D. joint play motions are limited in a capsular pattern

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41. A patient status post large rotator cuff repair surgery is referred to physical therapy. Which of the following
motions would you initially expect to be the most restricted?
A. extension
B. abduction
C. medial rotation
D. lateral rotation

42. A patient is found to have limited knee extension. Which of the following mobilization techniques would be
indicated?
A. lateral glide of the patella
B. caudal glide of the patella
C. posterior glide of the tibia
D. anterior glide of the tibia

43. If the axillary nerve was severed, what muscle could laterally rotate the humerus?
A. teres major
B. subscapularis
C. infraspinatus
D. teres minor

44. Exercise causes a significant increase in the body’s cardiac output. During mild to moderate exercise what
redistribution of the available cardiac output would you expect?
A. an increase in cerebral and coronary blood flow
B. a decrease in cerebral and active skeletal muscle blood flow
C. an increase in coronary and active skeletal muscle blood flow
D. a decrease in cerebral and coronary blood flow

45. A physical therapist performs passive range of motion to a patient with C7 tetraplegia. The patient’s bilateral
straight leg raise is measured passively to 90 degrees. What should the physical therapist conclude about the
patient’s ability to perform activities of daily living?
A. The patient requires a straight leg raise of 110-120 degrees in order to perform long sit and activities of daily
living
B. The patient is at a functional range to perform long sit and activities of daily living
C. The patient’s range of motion is beyond the expected limit for long sit and activities of daily living.
D. The patient requires a straight leg raise of 150 degrees in order to perform long sit and activities of daily living

46. Typically drugs are administered through enteral administration. Which of the following is an example of enteral
administration?
A. inhalation
B. injection
C. topical
D. oral

47. An increasing number of states offer consumers the ability to enter the health care system by going directly to a
physical therapist. Which statement describing the effects of direct access is accurate?
A. Physical therapists’ malpractice rates have sharply risen as a result of direct access.
B. Insurance carriers may deny claims without a physician’s signature in states with direct access.
C. Physical therapy has been overutilized in states with direct access.
D. Physicians are being alienated by physical therapists in states with direct access.

48. A patient is positioned in supine with the hips flexed to 90 degrees and knees extended. As the patient slowly
lowers her extended legs toward the horizontal, there is an increase in lordosis of the low back. This finding is
indicative of weakness of the
A. hip flexors
B. back extensors
C. hip extensors
D. abdominals

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49. What functional position should the metacarpophalangeal joint be placed in when designing a splint?
A. complete extension
B. 30-40 degrees of flexion
C. 60-70 degrees of flexion
D. 80-90 degrees of flexion

50. A patient with a transfemoral amputation ambulates with an abducted gait pattern on the prosthetic side. All of the
following may cause this gait deviation EXCEPT
A. high medial wall
B. inadequate suspension
C. abduction contracture
D. prosthesis is too short

51. A patient with C4 tetraplegia requires a custom wheelchair upon discharge from the hospital. The patient’s
diaphragm is partially innervated. The most appropriate recommendation for proper seating is
A. light weight manual wheelchair, upright frame, seat and back cushions
B. folding reclining wheelchair, power chin control, seat and back cushions
C. non-folding reclining wheelchair, power tongue control, underslung tray for ventilator
D. upright power wheelchair, joystick hand control, seat cushion

52. A therapist examines a patient with a C6 spinal cord injury. Which muscle would not be innervated based on the
patient’s level of injury?
A. biceps
B. deltoids
C. triceps
D. diaphragm

53. At what level is it realistic for a patient with a spinal cord injury to functionally ambulate?
A. C7
B. T1
C. T6
D. L1

54. Progress notes allow members of all health services to know what the patient is accomplishing in each given area.
Which statement regarding physical therapy progress notes is NOT accurate?
A. Observations and recordings should be the result of tangible tests and measurements
B. The progress note must contain patient identification, the date, and the signature of the therapist
C. Progress notes can include diagrams, graphs, and flow sheets
D. Progress notes should be written by physical therapists and not by other care providers such as physical
therapist assistants.

55. The primary area of the residual limb used for weight bearing in a transtibial prosthesis is the
A. patella tendon
B. distal end of the residual limb
C. lateral tibial condyle
D. fibular head

56. A patient one week status post left total hip replacement is diagnosed with an acute deep vein thrombosis in the
left calf. The physical therapist’s role in the care of a deep vein thrombosis is
A. continued gait training with an assistive device and partial weight bearing
B. progressive resistive exercises for bilateral lower extremities
C. patient is on bed rest with no active therapy to the left leg
D. postural drainage and diaphragmatic breathing

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57. Health maintenance organizations differ from typical fee for service insurance providers in a variety of ways.
Which of the following does NOT accurately describe health maintenance organizations?
A. Members are limited to receiving services from specific providers
B. Payment to providers is often on a capitated or prospective basis
C. Health maintenance organizations provide services for a monthly fee which varies based on the amount of
services utilized by each member
D. Health maintenance organizations are responsible for the provision and accessibility of care

58. A patient with right hemiplegia is observed during gait training. The patient performs side stepping towards the
hemiplegic side. The physical therapist may expect the patient to compensate for weakened abductors by
A. hip hiking the unaffected side
B. lateral trunk flexion towards the hemiplegic side
C. lateral trunk flexion towards the unaffected side
D. hip extension of the hemiplegic side

59. A patient in a pulmonary rehabilitation program is positioned in supine with a pillow under the knees. The
therapist claps between the clavicle and nipple on each side. The technique is utilized for postural drainage of the
A. anterior segments of the upper lobes
B. anterior basal segments of the lower lobes
C. superior segments of the lower lobes
D. superior segments of the lower lobes
E. postural basal segments of the lower lobes

60. A fifteen year-old male is referred to local orthopedic surgeon after injuring his knee in a football game. The most
appropriate initial step in the surgeon’s care of the patient is to
A. complete a physical examination
B. immobilize the injured knee
C. aspirate the knee
D. order x-rays

61. A recreational tennis player is diagnosed with lateral epicondylitis. All of the following are considered appropriate
forms of treatment for acute lateral epicondylitis EXCEPT
A. modification of tennis grip and string tension
B. phonophoresis
C. curvilinear brace applied just below the bend in the elbow
D. progressive resistive exercises emphasizing the wrist extensors

62. The open basketweave taping technique is commonly used as a form of treatment for an acute ankle sprain.
Which of the following does NOT accurately describe the benefits of the open basketweave taping technique?
A. allows freedom of movement in dorsiflexion
B. allows freedom of movement in plantarflexion
C. provides room for additional edema
D. promotes proximal joint stability

63. A patient with an ankle-foot orthosis demonstrates genu recurvatum during the stance phase of gait. Which action
would be the most appropriate action to decrease the recurvatum?
A. increase the plantarflexion stop
B. increase the dorsiflexion stop
C. allow full range of motion of the ankle
D. ankle joint position does not affected recurvatum

64. A patient with a full-thickness burn receives a skin graft. Immediately after the procedure the graft site requires
A. temporary immobilization
B. long term immobilization of one month
C. active-assistive range of motion
D. aggressive passive range of motion

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65. A therapist identifies that a child is unable to roll from prone to supine. Which reflex could MOST interfere with
the child’s ability to roll?
A. asymmetrical tonic neck reflex
B. Moro reflex
C. Galant reflex
D. symmetrical tonic neck reflex

66. A therapist develops a plan of care of a patient with hemiplegia. What is the primary purpose of using a sling in
the management of a subluxed shoulder?
A. correct the cause of the subluxation
B. decrease muscle spasticity
C. facilitate movement patterns
D. to hold the upper extremity in proper alignment

67. A therapist reviews a laboratory report for a 41 year-old male diagnosed with chronic obstructive pulmonary
disease. Which of the following would be considered a normal hemoglobin value?
A. 10 gm/dL
B. 15 gm/dL
C. 20 gm/dL
D. 25 gm/dL

68. A therapist places a patient’s knee in the resting position. This position is BEST described as
A. 5 degrees flexion
B. 15 degrees flexion
C. 25 degrees flexion
D. complete extension

69. A patient with a history of rheumatoid arthritis is referred to physical therapy diagnosed with acute glenohumeral
joint pain. Which treatment technique would be INAPPROPRIATE for the patient?
A. passive range of motion in a pain-free range
B. grade III and IV mobilization
C. periodic immobilization in a sling
D. gentle joint oscillation techniques

70. A patient diagnosed with an incomplete spinal cord lesion that presents with muscle paralysis on the ipsilateral
side of the lesion and a loss of pain, temperature, and sensitivity on the contralateral side of the lesion describes
A. Steinert’s disease
B. central cord syndrome
C. anterior spinal artery syndrome
D. Brown-Sequard syndrome

71. A therapist applies a hot pack to the lumbar region of a patient rehabilitating from a lumbar laminectomy. Which
mode of heat transmission is utilized with hot packs?
A. conduction
B. convection
C. evaporation
D. radiation

72. The physical therapist’s initial priority for an acute burn patient is
A. functional examination of bed mobility and transfers
B. correct positioning of burned and unaffected body parts
C. cognitive screening to determine the patient’s level of understanding
D. diversional therapy to assess the patient’s level of pain

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73. A therapist performs a manual muscle test of the peroneus tertius on a patient diagnosed with anterior
compartment syndrome. When providing resistance to the peroneus tertius, the therapist should direct pressure
towards
A. dorsiflexion and eversion
B. dorsiflexion and inversion
C. plantarflexion and eversion
D. plantarflexion and inversion

74. The tendon of the ____ muscle is commonly compressed against the bottom of the acromion process in a patient
diagnosed with impingement syndrome.
A. supraspinatus
B. infraspinatus
C. teres minor
D. subscapularis

75. Bed positioning is important for patients status post amputation. The prone position or prone lying is
recommended for thirty minutes several times a day. This position is of particular importance for
A. transfemoral amputation
B. transtibial amputation
C. Syme’s amputation
D. hip disarticulation

76. A physical therapist observes excessive knee flexion from heel strike to midstance while observing a patient with a
transfemoral amputation during gait training. A possible cause for this deviation is
A. the foot is set in neutral
B. the socket is set posterior in relation to the foot
C. the prosthesis is too short
D. the socket is aligned in excessive flexion

77. A therapist attempts to improve a patient’s lower extremity strength. Which proprioceptive neuromuscular
facilitation technique would be most appropriate to achieve the therapist’s goals?
A. contract-relax
B. repeated contraction
C. rhythmic stabilization
D. hold-relax

78. A physical therapist observes a patient with a transfemoral amputation during gait training. The therapist
identifies marked lateral rotation of the prosthesis at heel strike. Which of the following would not be a
contributing factor to the patient’s gait deviation?
A. weak hip medial rotators
B. inadequate suspension
C. excessive toe-out built into the prosthesis
D. prosthesis is too short

79. A woman’s pulmonary and cardiovascular systems are altered physiologically during pregnancy. Which of the
following would a physical therapist expect to observe when examining a pregnant woman?
A. decreased oxygen reserve and decreased stroke volume
B. increased oxygen reserve and increased stroke volume
C. decreased oxygen reserve and increased cardiac output
D. decreased stroke volume and decreased cardiac output

80. The most common type of contracture in a patient with a transfemoral amputation is
A. hip flexion
B. hip extension
C. hip adduction
D. knee flexion

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81. A physical therapist is concerned with a patient’s lateral knee discomfort. The therapist attempts to determine if a
contracture of the fasciae latae or iliotibial band could be contributing to the patient’s symptoms. Which special
test might help to identify a restriction in this area?
A. Ober
B. Thomas
C. Apley’s compression
D. Thompson

82. A patient completing an exercise program starts to demonstrate signs of an insulin reaction including dizziness,
vision difficulties, and a change in the level of consciousness. The most appropriate response for a conscious
victim would include
A. give the patient sugar, candy or juice
B. monitor airway, breathing and circulation
C. treat the patient for shock
D. continue to supervise the patient, however do not intervene

83. A physical therapist performs a manual muscle test on a patient’s shoulder medial rotators. Which muscle would
not be involved in this test?
A. pectoralis major
B. subscapularis
C. teres major
D. teres minor

84. A therapist can use a variety of pulse sites to examine the general condition of the heart and the circulatory system.
Which of the following pulse sites is NOT found on the lower extremity?
A. brachial
B. dorsalis pedis
C. femoral
D. popliteal

85. An example of a heating agent which can cause temperature elevation in tissues to depths of three centimeters or
more includes
A. paraffin
B. moist heating packs
C. whirlpool
D. ultrasound

86. A therapist attempts to determine if a patient has muscular weakness in the gastrocnemius or soleus by observing
the patient’s gait. Which objective finding would NOT be consistent with weakness in this area?
A. inability to dorsiflex the ankle during midswing phase
B. inability to perform a calf raise against resistance
C. inability to walk on toes
D. decreased toe off

87. A physical therapist instructs a patient diagnosed with rotator cuff tendonitis in transverse plane resistive
exercises. Which motions would be appropriate based on this given information?
A. abduction and adduction
B. flexion and extension
C. medial and lateral rotation
D. pronation and supination

88. A patient is limited in passive ankle dorsiflexion when the knee is extended, but is not limited when the knee is
flexed. The MOST logical explanation is
A. the gastrocnemius is responsible for the limitation
B. the soleus is responsible for the limitation
C. the popliteus is responsible for the limitation
D. the gastrocnemius and soleus are both responsible for the limitation

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89. Which assistive device allows for a two-point, three-point, and four-point gait pattern?
A. straight cane
B. walker
C. quad cane
D. axillary crutches

90. A patient with a C6 spinal cord injury relies on tenodesis to assist with functional activities. Which condition will
reduce the benefits of tenodesis?
A. lengthening of the long finger flexors
B. excessive hamstrings length
C. insufficient hamstrings length
D. transferring with the fingers flexed

91. A physical therapist palpates the muscle bellies of the wrist extensors. The therapist follows the muscles
proximally to their common origin. The bony landmark is termed the
A. lateral epicondyle
B. medial epicondyle
C. radial head
D. olecranon

92. A patient sustains a deep laceration on the right anterior thigh after stumbling and falling into a modality cart. The
therapist’s MOST immediate response should be to
A. apply direct pressure over the wound
B. apply heat
C. apply ice
D. fill out an incident report

93. When measuring hip abduction the stationary arm of the goniometer should be positioned
A. between the anterior superior iliac spine
B. parallel to the anterior aspect of the femur
C. along the midline of the tibia
D. along a line from the crest of the ilium, femur and greater trochanter

94. A therapist is treated in physical therapy after injuring his hamstrings. The medical chart describes the injury as an
avulsion fracture of the ischial tuberosity. This injury usually results from
A. forceful extension of the hip with an extended knee
B. forceful extension of the hip with a flexed knee
C. forceful flexion of the hip with an extended knee
D. forceful flexion of the hip with a flexed knee

95. A physical therapist reviews the initial examination of a patient diagnosed with a cerebellar CVA. The therapist
might expect the patient’s primary impairment to be
A. visual field cuts
B. gait disturbances
C. impaired speech
D. impaired comprehension skills

96. A therapist hypothesizes that a patient’s persistent shoulder pain is caused by an injury to a specific upper
extremity muscle. What selective tissue tension assessment would provide the therapist with the most useful
information to test the hypothesis?
A. active range of motion
B. active-assistive range of motion
C. passive range of motion
D. resisted isometrics

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97. A woman in her third trimester of pregnancy is referred to physical therapy with acute low back pain. During a
postural examination the therapist identifies several significant findings. Which of the following postural findings
is NOT commonly associated with pregnancy?
A. decrease in cervical lordosis
B. increase in lumbar lordosis
C. hyperextension of the knees
D. protraction of the shoulder girdle

98. A therapist completes an upper extremity goniometric examination. The therapist records right elbow range of
motion as 15-0-150 degrees. The total available range of motion for this patient is
A. 1350
B. 4500
C. 1650
D. 1800

99. A therapist classifies a patient’s end-feel as soft after completing a specific passive movement. Which of the
following joint motions would typically produce a soft end-feel?
A. hip flexion with the knee extended
B. knee flexion
C. elbow extension
D. forearm supination

100. A group of therapists conducts a research study which examines the effect of functional knee bracing on speed and
agility. As part of the study the therapist determine measures of central tendency for each measured test. Which
of the following would not be considered a measure of central tendency?
A. median
B. mode
C. mean
D. range

101. A male therapist prepares to treat a female patient using a soft tissue massage technique. The therapist would like
to ensure that the patient does not misinterpret the purpose of the treatment technique. The MOST appropriate
action is to
A. transfer the patient to another therapist’s schedule
B. request a female staff member to be present during treatment
C. select another less invasive technique
D. discharge the patient from physical therapy

102. A therapist attempts to gain information on the ligamentous integrity of the knee. Which of the following special
tests would not provide the therapist with the desired information?
A. anterior drawer test
B. apprehension test
C. Lachman test
D. pivot shift test

103. A therapist completes an examination on a young girl with spastic cerebral palsy. The therapist determines that
the girl has involvement in all four extremities as well as the head, neck and trunk. What type of cerebral palsy
classification BEST describes the girl’s condition?
A. spastic diplegia
B. spastic hemiplegia
C. spastic tetraplegia
D. spastic triplegia

104. A therapist modifies a wheelchair to allow the rear wheels to be moved backwards by approximately two inches.
This type of modification would be most beneficial to a patient with
A. bilateral lower extremity amputation
B. flaccid hemiplegia
C. paraplegia
D. tetraplegia

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105. A therapist positions a patient in the Trendelenburg position in preparation for postural drainage. Which of the
following is NOT a relative precaution for the use of the Trendelenburg position?
A. nausea
B. obesity
C. pulmonary edema
D. secretion retention

106. Health care cost containment efforts have created incentives for inpatient care providers and hospitals to control
the cost and utilization of inpatient service. Which of the following has not resulted as a product of cost
containment efforts?
A. a decrease in the average length of inpatient hospitalization
B. an increase in the utilization of home care and skilled long term care
C. a decreased use of routine diagnostic testing during inpatient hospitalization
D. a decreased use of outpatient diagnostic testing and treatment

107. A therapist designs an exercise program to increase muscle strength and endurance in a patient rehabilitating from
knee surgery. Which type of pharmacological agent would have an antagonistic effect on the desired objective?
A. non narcotic analgesics
B. nonsteroidal anti-inflammatory medications
C. peripheral vasodilators
D. skeletal muscle relaxants

108. Pharmacologic agents can be an important component of a treatment program designed to treat rheumatoid
arthritis. Which of the following is NOT commonly used to treat rheumatoid arthritis?
A. calcium channel blockers
B. compounds containing elemental gold
C. glucocorticoids
D. nonsteroidal anti-inflammatory medications

109. A physical therapist participates in a community based screening program designed to identify individuals with
osteoporosis. Which group would have the highest risk for developing osteoporosis?
A. white females over the age of 60
B. black females over the age of 60
C. white females over the age of 40
D. black females over the age of 40

110. A therapist instructs a 62 year-old female rehabilitating from an ankle sprain in the use of a straight cane. The
patient is confused as to why it is necessary to use the cane in the left hand since it is her right ankle that is injured.
The most appropriate explanation would be
A. using the cane in the left hand will increase your base of support
B. using the cane in the left hand will improve your coordination and balance
C. using the cane in the left hand will reduce the pressure over your injured ankle
D. using the cane in the left hand will allow more weight bearing on your injured ankle and will therefore
accelerate your rehabilitation time

111. The sensory system can be divided into protective and discriminative sensations. Which of the following is NOT
considered to be a protective sensation?
A. light touch
B. pain
C. proprioception
D. temperature

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112. A therapist completes a series of special tests designed to examine the ligamentous integrity of a patient’s knee.
After completing the tests, the therapist is unsure if the laxity is normal for the patient or if is indicative of a
ligamentous injury. The most appropriate step to gather more information is to
A. attempt to quantify the millimeters of laxity and compare the values with established norms
B. contact the physician and suggest a referral for magnetic resonance imaging
C. directly compare the laxity in the involved knee to the laxity in the uninvolved knee
D. attempt to identify other special tests which can offer more information on the ligamentous integrity of the
knee

113. A therapist visits a former patient diagnosed with pneumonic plague in the hospital. The patient is in strict
isolation, but the therapist has been granted permission to visit if there is no body contact. What protective
measures are necessary when entering the room of a patient in strict isolation?
A. mask
B. mask, gown
C. gloves, gown
D. mask, gown, gloves

114. A physical therapy department plans to study to examine rehabilitation outcomes in patients who have undergone
anterior cruciate ligament reconstruction. The study will include a sample of patients from 26 orthopedic surgeons
in the local region. If the therapists compile a list of all eligible patients and select every third patient to
participate in the study, what type of sampling was used?
A. simple random sampling
B. stratified sampling
C. systematic sampling
D. cluster sampling

115. A therapist performs a talar tilt test on a 22 year-old female rehabilitating from an inversion ankle sprain. Which
ligament does the talar tilt test examine?
A. anterior tibiofibular
B. calcaneofibular
C. deltoid
D. posterior tibiofibular

116. A therapist attempts to palpate the lunate by moving his finger immediately distal to Lister’s tubercle. Which
wrist motion will allow the therapist to facilitate palpation of the lunate?
A. extension
B. flexion
C. radial deviation
D. ulnar deviation

117. Which category-specific isolation precaution would be the most appropriate for a patient diagnosed with acquired
immunodeficiency syndrome?
A. blood/body fluid isolation
B. contact isolation
C. respiratory isolation
D. strict isolation

118. The clinical instructor and the center coordinator of clinical education both play an integral role in a clinical
education program. Which of the following responsibilities is typically completed by the clinical instructor?
A. perform administrative functions between the academic program and the clinical center
B. serve as a representative of the clinical center to the academic programs
C. coordinate the assignments and activities of students at the clinical center
D. perform formative and summative evaluations of the student’s performance

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119. A therapist conducts a study, which measures knee flexion range of motion two weeks following arthroscopic
surgery. Assuming a normal distribution, what percentage of patients participating in the study would you expect
to achieve a goniometric measurement value greater than one standard deviation below the mean?
A. 49%
B. 64%
C. 68%
D. 84%

120. A therapist positions a patient in prone with two pillows under the hips in preparation for bronchial drainage. If
the therapist’s goal is to perform bronchial drainage to the superior segments of the lower lobes, which area should
the therapist’s force be directed?
A. between the clavicle and nipple on each side
B. over the area between the clavicle and top of the scapula on each side of the spine
C. over the lower ribs on each side
D. over the middle of the back at the tip of the scapula on each side of the spine

121. Secretion removal techniques are often a necessary component of a pulmonary rehabilitation program. Which
pulmonary disease is usually associated with a change in the composition of secretions?
A. asthma
B. bronchiectasis
C. chronic bronchitis
D. cystic fibrosis

122. Certain types of drugs such as nitroglycerin can be metabolized and destroyed by the liver. What route of
administration would best allow nitroglycerin to reach the systemic circulation?
A. oral
B. rectal
C. nasal
D. sublingual

123. Acetaminophen is a commonly encountered drug seen frequently in patients requiring physical therapy. What is
the primary benefit of acetaminophen compared to aspirin and other nonsteroidal anti-inflammatory medications?
A. increased analgesic effects
B. increased antipyretic effects
C. decreased upper gastrointestinal tract irritation
D. decreased irritation of the oral mucosa

124. A patient with suspected cardiac dysfunction is placed on a continuous ambulatory ECG monitor. Which of the
following is the name commonly used for this type of monitoring?
A. hemodynamic
B. Holter
C. phonocardiography
D. pulmonic

125. A therapist performs a respiratory assessment on a patient with restrictive lung disease. If the therapist records the
respiration rate as 22 breaths per minute, which term is most appropriate to classify the patient’s respiration rate?
A. eupnea
B. tachypnea
C. bradypnea
D. hyperpnea

126. Dysrhythmias can result in varying degrees of abnormal hemodynamics. Which of the following dysrhythmias
would have the most significant effect on hemodynamics?
A. sinus rhythm with first degree AV block
B. sinus rhythm with premature atrial contractions
C. sinus rhythm with short episodes of paroxysmal supraventricular tachycardia
D. ventricular tachycardia

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127. A therapist uses ultrasound to elevate the tissue temperature at the insertion of the supraspinatus. What would be
the most appropriate patient position for the ultrasound application?
A. patient in supine with the arm abducted and externally rotated
B. patient in supine with the arm adducted and medially rotated
C. patient in supine with the arm abducted and medially rotated
D. patient in supine with the arm adducted and externally rotated

128. After administration, many drugs are stored at specific locations in the body. What is the primary site for drug
storage in the body?
A. adipose tissue
B. bone
C. muscle
D. organs

129. A therapist treats a 15 year-old female of Spanish descent. The patient speaks only a few words of English and
has significant difficulty understanding the therapist’s instructions. The most appropriate therapist action is to
A. speak strongly and directly to the patient
B. encourage frequent feedback from the patient
C. utilize an interpreter
D. emphasize nonverbal communication

130. What is the first functional task that should be taught to a patient with a T2 spinal cord injury?
A. rolling
B. self range of motion
C. ambulation with long leg braces
D. bed to wheelchair transfer

131. A therapist examines a patient referred to physical therapy with thoracic outlet syndrome. Which of the following
special tests would not assist the therapist to confirm the physician’s diagnosis?
A. Adson’s maneuver
B. Allen test
C. Halstead maneuver
D. Speed’s maneuver

132. A patient rehabilitating from knee surgery is examined in physical therapy. The patient’s involved knee range of
motion begins at 15 degrees of flexion and ends at 90 degrees of flexion. The total available range of motion for
this patient is
A. 60o
B. 75o
C. 90o
D. 105o

133. A patient is able to actively hyperextend the right knee 5 degrees. Assuming the patient’s total knee range of
motion is 65 degrees, which of the following recordings would be the most representative of the patient’s actual
range of motion?
A. 5-0-60
B. 5-0-65
C. 5-60
D. 5-65

134. Documentation can be an extremely important factor in malpractice litigation. Which of the following statements
does NOT reflex appropriate documentation procedures?
A. The complete signature and title of the document’s writer should appear at the end of the document
B. Valid objective measurements and terms should be used
C. The date and in some cases, the time of an observation, treatment, or other action should be included
D. Corrections made in records after the notification of a claim should be made by placing a single line through
the incorrect entry

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135. A physical therapy problem list is often developed following an initial examination. The problem list can be a
useful tool for therapists to develop an effective and organized treatment plan. The physical therapy problem list
should be recorded in the _____ section of a SOAP note.
A. subjective
B. objective
C. assessment
D. plan

136. A therapist palpates the body structures of the wrist and hand. Which of the following structures would not be
identified in the distal row of carpals?
A. capitate
B. hamate
C. triquetrium
D. trapezoid

137. A therapist examines an electrocardiogram of a patient during exercise. What change in the electrocardiogram
would be indicative of myocardial ischemia?
A. P wave changes
B. PR interval changes
C. QRS changes
D. ST segment changes

138. Proper technique is essential to obtain accurate results when performing a manual muscle test. Which of the
following manual muscle testing instructions is NOT accurate?
A. have the patient perform the movement actively
B. stabilize proximal to the joint
C. check the passive range of motion of the joint being moved
D. apply pressure at the proximal end of the moving part

139. A physical therapist prepares a patient for ambulation. The patient has been in the hospital for six weeks with
pneumonia and has only recently had enough strength to begin ambulation training. Which of the following
treatment activities would be the last to occur?
A. development of standing balance
B. development of sitting balance
C. training in a specific gait pattern
D. training in weight shifting in a standing position

140. A therapist develops a list of behavioral objectives for a new employee working in hydrotherapy. Which of the
following is NOT considered to be a behavioral objective?
A. The therapist will perform wound debridement to remove necrotic material
B. The therapist will identify two commonly used antibacterial agents
C. The therapist will apply sterile dressings to an open wound
D. The therapist will understand the stages of tissue inflammation and repair

141. A therapist examines a patient bedside, when suddenly the patient’s IV becomes disconnected. The therapist’s
most appropriate response would be to
A. reconnect the IV
B. contact the primary physician
C. contact nursing
D. continue with your present treatment

142. A physician orders the nursing staff to administer digitalis to a patient diagnosed with congestive heart failure.
The physician’s primary goal using this medication is to
A. increase cardiac pumping ability
B. increase cellular metabolism
C. regulate fluid and electrolyte levels
D. regulate glucose metabolism

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143. A therapist identifies a bluish discoloration of the skin and nail beds of a 55 year-old male referred to physical
therapy for pulmonary rehabilitation. What does this objective finding indicate?
A. hyperoxemia
B. hyperoxia
C. hypokalemia
D. hypoxemia

144. A therapist employed in a large medical center reviews the chart of a 63 year-old male referred to physical therapy
for pulmonary rehabilitation. The chart indicates the patient has smoked 1-2 packs of cigarettes a day since the
age of 25. The admitting physician documented that the patient’s thorax was enlarged with flaring of the costal
margins and widening of the costochondral angle. Which pulmonary disease does the chart most accurately
describe?
A. asthma
B. bronchiectasis
C. chronic bronchitis
D. emphysema

145. A physical therapist positions a patient’s hip in the resting position. This position for the hip is
A. 30o of hip flexion, 30o of abduction, and 5o of lateral rotation
B. 60o of hip flexion, 30o of abduction, and 15o of lateral rotation
C. 90o of hip flexion, 15o of abduction, and 5o of lateral rotation
D. 120o of hip flexion, 15o of abduction, and 15o of lateral rotation

146. A therapist instructs a patient diagnosed with rotator cuff tendonitis in a home exercise program. The most
important consideration when designing a home exercise program is to
A. focus the program on the individual needs of the patient
B. limit the length of the program to 10 minutes
C. provide written instructions that detail the frequency and duration of each exercise
D. limit the amount of equipment required to complete the program

147. A therapist examines a patient with limited range of motion at the glenohumeral joint. Which of the following is
considered a capsular pattern of the glenohumeral joint?
A. greatest limitation in flexion, followed by medial rotation
B. greatest limitation in lateral rotation, followed by abduction
C. greatest limitation in medial rotation, followed by abduction
D. greatest limitation in extension and lateral rotation

148. A therapist is scheduled to treat a patient with meningitis in respiratory isolation. What precautions are necessary
when treating the patient?
A. mask
B. mask, gown
C. gloves, gown
D. mask, gloves, gown

149. There are a variety of systems used to record goniometric measurement. Using the 0 to 180 system the anatomical
position is used as the starting position for all movements EXCEPT
A. ankle inversion and eversion
B. forearm pronation and supination
C. shoulder flexion and extension
D. wrist flexion and extension

150. A patient rehabilitating from a spinal cord injury works on self-range of motion activities in sitting. Suddenly, the
patient begins to demonstrate signs and symptoms of autonomic dysreflexia. The most appropriate therapist action
is to
A. keep the patient in sitting, monitor blood pressure, and check the bowel and bladder for impairment
B. lie the patient flat, monitor blood pressure, and check the bowel and bladder for impairment
C. lie the patient flat, monitor blood pressure, and give the patient fluids
D. keep the patient sitting, monitor blood pressure, wait for medical assistance

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151. A physical therapist performs a manual muscle test on a patient with bilateral upper extremity weakness. The
therapist should test the patient’s scapular adductors with the patient positioned in
A. prone
B. sidelying
C. standing
D. supine

152. A therapist palpates proximally along the second metacarpal. Which carpal bone does NOT articulate with the
second metacarpal?
A. capitate
B. hamate
C. trapezoid
D. trapezium

153. Assuming normal development which of the following activities should a child first accomplish?
A. rolling from prone to supine
B. rolling from supine to prone
C. turning from side to supine
D. turning from supine to side

154. A therapist employed in a nursing home routinely treats patients in excess of 70 years of age. The therapist has
noted several consistent postural changes in her patients. Which of the following does NOT accurately describe
the postural changes associated with aging?
A. forward head
B. rounded shoulders
C. increased hip extension
D. increased knee flexion

155. A therapist orders a wheelchair for a patient with C5 tetraplegia. Which type of wheelchair would be the MOST
appropriate for this patient?
A. electric wheelchair
B. manual wheelchair with handrim projections
C. manual wheelchair with friction surface handrims
D. manual wheelchair with standard handrims

156. A patient is instructed by the nursing staff to increase dietary consumption of food sources that are rich in vitamin
A. Which of the following food groups would be the most appropriate to meet this goal?
A. green leaves, nuts, seafood
B. fish liver oils, butter, yellow vegetables
C. milk, cheese, liver
D. vegetable oil, wheat germ, dried yeast

157. A therapist reviews a patient’s medical chart to determine when they were last medicated. The chart indicates the
patient received medication at 2300 hours. Assuming it is now 8:00 AM, how long ago did the patient receive the
medication?
A. 5 hours
B. 9 hours
C. 15 hours
D. 18 hours

158. A patient rehabilitating from a fractured ankle is referred to physical therapy for gait training. The patient is in a
short leg cast and is not permitted to bear weight through the involved lower extremity. What gait pattern is the
most appropriate for the patient?
A. three point gait using axillary crutches
B. three point swing through using Lofstrand crutches
C. three point swing through using a walker
D. four point alternating gait using axillary crutches

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159. A therapist attempts to auscultate over the aortic valve. Which of the following areas is the most appropriate to
isolate the desired valve?
A. second left intercostal space at the sternal border
B. second right intercostal space at the right sternal border
C. fourth left intercostal space along the lower left sternal border
D. fifth left intercostal space at the midclavicular line

160. A therapist presents the results of a research project entitle ”Effects of an Aerobic Exercise Program on Heart Rate
and Blood Pressure”. The independent variable in the therapist’s study is
A. exercise program
B. exercise program and heart rate
C. exercise program and blood pressure
D. heart rate and blood pressure

161. A therapist completes a pulmonary function test on a patient admitted to the hospital three days ago. Assuming
normal values, the patient’s residual volume should be approximately ____ percent of the patient’s total lung
capacity?
A. 10
B. 25
C. 35
D. 50

162. A therapist positions a patient for bronchial drainage to the anterior segments of the upper lobes. The most
appropriate patient position is
A. supine with a pillow under their knees
B. supine with the head of the bed elevated 16 inches
C. supine with the foot of the bed elevated 16 inches
D. prone with the head of the bed elevated 12 inches

163. A therapist attempts to estimate the energy expenditure in calories for a cardiac patient performing a selected
number of activities. Assuming the therapist has a metabolic equivalent value for each of the activities of daily
living, what other variables are necessary to obtain an estimate of the patient’s energy expenditure?
A. patient’s height and weight
B. patient’s weight and oxygen consumption
C. patient’s stroke volume and heart rate
D. patient’s residual volume and heart rate

164. An acute myocardial infarction can often be diagnosed by analyzing the characteristic pattern and duration of
selected enzymes in the blood. Which of the following enzymes is not commonly elevated following an acute
myocardial infarction?
A. aspartate aminotransferase
B. creatine phosphokinase
C. lactate dehydrogenase
D. alkaline phosphatase

165. A patient is placed on a 12 lead EKG following a suspected myocardial infarction. What EKG finding is the best
indicator of an acute myocardial infarction?
A. ST segment elevation
B. QRS complex elevation
C. P wave elevation
D. T wave elevation

166. A physical therapy department attempts to develop a clinical education program. Which of the following criteria
is the most essential to develop a successful clinical education program?
A. The clinical facility’s philosophy and objectives for patient care should be identical with those of the
affiliating physical therapy education program
B. The clinical staff should have a strong desire to participate in the education of future therapists.
C. The clinical staff should develop a specific plan to meet the objectives of individual students.
D. The clinical facility should have a variety of learning experiences available during the clinical practicum

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167. A therapist often works with a variety of patients with known or suspected communicable diseases or infections.
Depending on the type of disease or infection, these patients may be placed in isolation. What type of isolation
would require a therapist to wear a gown?
A. AFB
B. contact
C. respiratory
D. strict

168. A patient is referred to physical therapy for gait training following an extended illness. The patient has poor
balance, but is able to move her legs alternately. Which of the following gait patterns would be the most stable?
A. two-point
B. three-point
C. four-point
D. swing-through

169. A patient is admitted to a phase I cardiac rehabilitation program after sustaining a myocardial infarction.
Assuming an uncomplicated medical course, how long would a patient typically stay in a phase I program?
A. 3-5 days
B. 7-12 days
C. 16-20 days
D. 24-30 days

170. A therapist outlines a walking program for a patient rehabilitating from a prolonged illness. Which of the
following recommendations would NOT be beneficial to the patient?
A. wear comfortable, loose fitting clothing appropriate for the present temperature and weather
B. walk at a rate designed to bring the heart to target levels
C. walk continuously; frequent stops interfere with aerobic training
D. when walking up steep hills lean backward slightly and lengthen your stride

171. A therapist designs a general fitness program for a senior citizen group. Which of the following guidelines is NOT
accurate?
A. allow participants the opportunity to reduce the intensity of exercise
B. exercise intensity should be at a level which will provide a training effect
C. exercise should be performed daily for at least 30 minutes
D. exercise activities should include a warm-up and cool-down period

172. Patients often progress through a predictable series of stages after being diagnosed with a terminal illness.
According to Elizabeth Kubler Ross’ Stages of Dying, what is the stage the patients will first experience?
A. acceptance
B. anger
C. denial and isolation
D. depression

173. A patient indicates that she is currently taking medication to control high blood pressure. Which of the following
classifications of drugs would be helpful in the treatment of hypertension?
A. diuretics
B. narcotics
C. nonsteroidal anti-inflammatory
D. stimulants

174. A therapist monitors the blood pressure of a 28 year-old male during increasing levels of physical exertion.
Assuming a normal physiologic response, which of the following BEST describes the patient’s blood pressure
response to exercise?
A. systolic pressure decreases, diastolic pressure increases
B. systolic pressure remains the same, diastolic pressure decreases
C. systolic pressure and diastolic pressure remain the same
D. systolic pressure increases, diastolic pressure remains the same

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175. A therapist palpates the proximal row of carpals on a patient diagnosed with carpal tunnel syndrome. Which of
the following bones does NOT articulate with the proximal row of carpals?
A. hamate
B. radius
C. trapezium
D. ulna

176. A therapist performs goniometric measurements at the carpometacarpal joint. If the therapist elects to measure
carpometacarpal abduction, the stationary arm of the goniometer should be aligned with the
A. lateral midline of the second metacarpal
B. lateral midline of the first metacarpal
C. palmar midline of the radius
D. palmar midline of the first metacarpal

177. A patient with degenerative joint disease is referred to physical therapy with right shoulder pain. During the initial
examination the therapist identifies significant muscle guarding and spasm throughout the right shoulder. If the
therapist elects to treat the patient using ultrasound, which patient position would be the most appropriate?
A. supine with the upper extremity slightly flexed and adducted
B. supine with the arm resting against the abdomen
C. supine with the glenohumeral joint in the resting position
D. a position where the patient is comfortable and relaxed

178. A therapist views a videotape, which compares and contrasts the normal gait of toddlers and adults. Which of the
following statements is NOT accurate when comparing the gait of these two groups?
A. toddlers walk with a wider base of support
B. toddlers walk with an increased single leg support time
C. toddlers walk with a higher cadence
D. toddlers walk with a shorter step length

179. A physician completes a physical examination on a sixteen year-old male who injured his knee while playing in a
soccer contest yesterday. The physician’s preliminary diagnosis is a grade II anterior cruciate ligament injury with
probable meniscal involvement. Which of the following diagnostic tools would be the most appropriate in the
immediate medical management of the patient?
A. bone scan
B. computerized tomography
C. magnetic resonance imaging
D. x-rays

180. Performance appraisals are often conducted on a regular basis to assess an employee’s performance in relation to
the performance expectations. Which of the following statements describing a performance appraisal is NOT
accurate?
A. Employees should be aware of the performance standards after they are examined.
B. A mechanism should be in place which employees can use to dispute or comment on appraisal outcomes.
C. A manager’s appraisal decisions should be audited by the organization
D. Performance discrepancies should be clearly documented on appraisal forms.

181. A therapist performs goniometric measurements on a 38 year-old female rehabilitating from an acromioplasty.
The therapist attempts to stabilize the scapula while measuring glenohumeral abduction. Failure to stabilize the
scapula will lead to
A. downward rotation and elevation of the scapula
B. downward rotation and depression of the scapula
C. upward rotation and elevation of the scapula
D. upward rotation and depression of the scapula

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182. A therapist measures a patient’s shoulder medial rotation with the patient positioned in supine with the
glenohumeral joint in 90 degrees of abduction and the elbow in 90 degrees of flexion. The therapist records the
patient’s shoulder medial rotation as 0-70 degrees and classifies the end-feel as firm. Which portion of the joint
capsule is primarily responsible for the firm end-feel?
A. anterior joint capsule
B. posterior joint capsule
C. inferior joint capsule
D. superior joint capsule

183. A patient with chronic arterial insufficiency may demonstrate which of the following signs?
A. edema
B. brown skin pigment
C. gangrene
D. warm skin temperature

184. A physician suspects a stress fracture in a sixteen year-old distance runner after completing a physical
examination. Assuming the physician’s preliminary diagnosis is correct, which of the following diagnostic tests
would be the most appropriate to identify the stress fracture?
A. bone scan
B. magnetic resonance imaging
C. telethermography
D. ultrasound scan

185. A therapist develops a physical therapy problem list after completing an initial examination on a patient diagnosed
with right shoulder impingement. Which of the following entries would not typically belong in the physical
therapy problem list?
A. decreased active right shoulder lateral rotation
B. decreased strength of the right upper trapezius and middle deltoid
C. increased pain with right shoulder active movement
D. increased stress secondary to financial problems

186. While discussing a patient’s progress with a referring physician, the physician asks if the patient has demonstrated
any signs of thoracodynia. Thoracodynia can best be described as
A. hypoventilation
B. inadequate chest expansion
C. diaphragmatic spasm
D. chest pain

187. Which type of joint receptor would a therapist expect to be most sensitive to high frequency vibration, deep
pressure, and velocity changes in joint position?
A. free nerve endings
B. Golgi-Mazzoni corpuscles
C. Pacinian corpuscles
D. Ruffini endings

188. A physical therapist examines a patient with a dorsal scapular nerve injury. Which muscles would you expect to
be MOST affected by this condition?
A. serratus anterior, pectoralis minor
B. levator scapulae, rhomboids
C. latissimus dorsi, teres major
D. supraspinatus, infraspinatus

189. A physical therapist examines a patient with unilateral lower extremity weakness. As the patient performs hip
flexion in supine, the therapist helps the patient complete the full range of motion. This would BEST be described
A. active exercise
B. passive exercise
C. resistive exercise
D. active-assistive exercise

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190. A physical therapist positions a patient in prone to measure passive knee flexion. Range of motion may be limited
in this position due to
A. active insufficiency of the knee extensors
B. active insufficiency of the knee flexors
C. passive insufficiency of the knee extensors
D. passive insufficiency of the knee flexors

191. A physical therapist assistant provides patient coverage for a physical therapist on vacation. The physical therapist
assistant should be allowed to perform all of the following EXCEPT
A. supervise exercise activities
B. modify plan of care
C. gait training activities
D. write daily progress notes

192. A physical therapist examines a four month-old infant. During mat activities the infant suddenly becomes
unconscious. The most appropriate location to check the infant’s pulse is the
A. radial artery
B. brachial artery
C. popliteal artery
D. carotid artery

193. A patient diagnosed with Parkinson’s disease has difficulty initiating movement. What proprioceptive
neuromuscular facilitation technique would be MOST appropriate to treat this problem?
A. contract-relax
B. rhythmic initiation
C. rhythmic stabilization
D. slow reversal

194. A physical therapist instructs a patient to move form sitting through quadruped to tall kneeling. By moving
through the development sequence a patient gains ___ control during movement and ___ during static positioning.
A. isometric, isotonic
B. isotonic, isometric
C. isometric, isokinetic
D. isokinetic, isotonic

195. The long term goal of a patient status post CVA is to walk to work. Which of the following conditions would
serve as the largest obstacle to the patient achieving the goal?
A. homonymous hemianopsia
B. expressive aphasia
C. agraphia
D. dysarthria

196. A physical therapist observes a patient during gait training. The patient has normal strength and equal leg length.
As the patient passes midstance he slightly vaults and has early toe off. The most likely cause of this deviation is
A. patient has excessive forefoot pronation
B. patient has limited hamstrings length
C. patient has limited plantarflexion
D. patient has limited dorsiflexion

197. A physical therapist examines a patient with right hemiplegia four days status post CVA. All of the following
would be appropriate short term goals EXCEPT
A. improve sitting balance
B. initiate activities of daily living with assistance
C. demonstrate awareness of the hemiplegic side through positioning
D. perform lower extremity exercises without assistance

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198. Which clinical observation is NOT usually characteristic with a rotator cuff tear?
A. the patient is less than 40 years old
B. the patient is often unable to move the arm actively without pain
C. scapulohumeral rhythm is altered
D. night pain is a common patient complaint

199. A patient status post CVA with abnormal tone on the right side lies supine in bed. The patient’s physical therapist
discourages her from lying supine for long periods of time because
A. the position can cause shoulder-hand syndrome
B. the position increases an inferior subluxation
C. the position encourages tonic neck and labyrinthine reflexes
D. the position increases tone in the pectoralis

200. A physical therapist might select a metal upright ankle-foot orthosis instead of a plastic ankle-foot orthosis if the
patient exhibits
A. mild sensory loss
B. significant fluctuating edema
C. cosmetic concerns
D. mediolateral ankle instability

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 Answers 27

1. C. Lecture, handouts, and demonstration provide the broadest range of media for the presentation. A broad range
of media allows for individuals with diverse learning styles to benefit from the presentation.

2. B. A therapist should attempt to facilitate movement of the patient’s trunk and extremities using intermittent light
touch. Intermittent light touch allows the patient to initiate movement and progress through the full range of
movement with assistance as necessary.

3. C. It is extremely important for a patient with a transtibial amputation to keep the knee in an extended position in
order to avoid a knee flexion contracture.

4. D. A straight cane can be used to compensate for balance deficits and to promote stability, however does not
allow for various degrees of weight bearing.

5. D. Signs of cold intolerance include pain, cyanosis, wheals, mottling, increased pulse rate, and a significant drop
in blood pressure. A therapist should immediately stop the application of cold when any sign of cold intolerance is
observed.

6. B. A child that is seven months old is not usually able to crawl in a forward direction. The seventh month old
normally explores quadruped position with weight shifting and rocking. Dissociation of the lower extremities
occurs in the eighth or ninth month

7. D. High speed isokinetic exercises are considered extremely aggressive and would not be appropriate for a patient
three weeks status post shoulder dislocation

8. D. The area of the sacrum, which lies between the two innominate bones, is the most susceptible to skin
breakdown with prolonged positioning in supine.

9. D. A transverse plane, sometimes referred to as the horizontal plane, is used for gravity eliminated testing of
muscles that produce flexion or extension in a sagittal plane.

10. A. The top of the video display screen should be at or just below the operator’s eye level in an appropriately
designed workstation

11. D. The ten repetition maximum is equal to the maximum load a patient can lift ten times. The ten repetition
maximum is used to determine the amount of weight used during each set of an exercise session using the
DeLorme technique.

12. A. Positioning the neck in extension and extremes of rotation places the vertebral artery in a compromised
position. Extension, sidebending, and rotation are components of the vertebral artery test.

13. B. The supplied description is the classic method of testing the length of the rectus femoris. Tightness of the
rectus femoris is noted by failure to maintain a position of 90 degrees of knee flexion in the test leg.

14. A. Physical therapists have an obligation for their own professional development and continue competence.
Opportunities for development include courses, in-services, mentoring, peer review, and physical therapy
literature.

15. A. Bone absorbs the most ultrasound energy due to its high collagen content.

16. C. A number of factors play a significant role in determining the amount of heat absorbed using ultrasound,
however the choice of coupling agent has a relatively small impact when compared to the other present options.

17. C. Encouraging a patient to discuss irrelevant information typically results in inefficient use of available time.

18. D. An effective manager should not delegate tasks based on desirability, instead tasks should be delegated to the
most qualified individual.

19. B. A drop in the pelvis on the left during right stance phase is often indicative of right gluteus medius weakness.
This type of deviation is termed a Trendelenburg gait pattern.

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20. A. Athetosis is a term used to describe slow, writhing, and involuntary movements that may occur with damage to
the basal ganglia.

21. C. Superficial reflexes are tested with some form of noxious stimuli. An example of this is the method of testing
for the Babinski reflex.

22. C. A cervical rib that arises from the seventh cervical vertebra often compresses the inferior trunk of the brachial
plexus and the subclavian artery. Adson’s test may be useful in confirming the diagnosis of cervical rib syndrome.
Additional findings include weakness and atrophy of intrinsic hand muscles and sensory alterations in the hand
and forearm.

23. A. The cerebellum is the area of the brain that is associated with balance and coordination. Damage to the
cerebellum often yields balance deficits and ataxia.

24. D. Raimiste’s phenomenon is an associated reaction that is considered a form of overflow or irradiation.

25. B. The Guide for Professional Conduct states that physical therapists seek remuneration for their services that is
deserved and reasonable. Despite the fact the present information indicates the physician may be inappropriate
with his/her referrals, the most appropriate immediate response should be to discuss the situation directly with the
physician.

26. A. Infants develop the stability necessary to sit independently for extended periods of time in the sixth to seventh
month.

27. B. The uninvolved extremity leads when ascending stairs and the involved extremity leads when descending.

28. C. Diastasis recti is the separation of the abdominals at the linea alba. Etiology is unknown and it does not
typically cause discomfort. There are several specific exercises that can be used to reduce the diastasis recti.

29. D. A patient with orthostatic hypotension would benefit from using the tilt table in order to slowly progress
toward a standing position. Vital signs should be monitored during treatment.

30. B. Apley’s test is designed to detect the presence of a meniscal injury. The test is performed with the patient in a
prone position with the knees flexed to 90 degrees.

31. C. Transferring objects from one hand to another is an activity that usually occurs in infants between six and
seven months of age.

32. B. Normal blood pressure for a two year-old ranges from 80-90 mmHg systolic and 55-65 mmHg diastolic.

33. C. A patient classified as level IV, confused-agitated is likely to exhibit non-purposeful speech, poor attention,
diminished recall, and irritable behavior.

34. B. Patients with an anteverted hip typically present with excessive medial rotation and limited lateral rotation.
The mean angle of anteversion in an adult is 8-15 degrees.

35. A. Securing and maintaining an airway is a necessary and immediate step when performing basic life support.

36. C. Pertussis or whooping cough is an acute bacterial infection of the tracheobronchial tree. Pertussis often
requires respiratory isolation since the disease is transmitted through airborne particles.

37. A. Modification of an established treatment plan or the associated goals is the responsibility of the physical
therapist.

38. B. The anterior talofibular ligament runs from the anterior portion of the lateral malleolus to the lateral aspect of
the talar neck. The ligament is placed under stress with inversion and plantarflexion. The anterior talofibular,
calcaneofibular, and posterior talofibular ligament make up the lateral collateral ligaments of the ankle complex.

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39. D. Patients with paraplegia often utilize wheelchairs equipped with removable armrests. Removable armrests
allow for better access in an out of the wheelchair.

40. D. Capsular patterns of restriction result from loss of mobility of the entire joint capsule. In trochanteric bursitis
passive and active range of motion are typically preserved, although there is often pain at end range with selected
motions such as abduction.

41. D. Postoperative care of a rotator cuff repair often includes immobilization in abduction and medial rotation using
an abduction splint. Lateral rotation is often restricted during the initial stages of rehabilitation since the position
tends to place the repaired structures on stretch.

42. D. Anterior glide of the tibia on the femur is indicated to increase knee extension.

43. C. The infraspinatus is a lateral rotator of the shoulder and is innervated by the suprascapular nerve.

44. C. Mild to moderate exercise causes a significant increase in blood flow to active muscle and the coronary
system. Cardiac output can increase by up to five times the normal rate during strenuous exercise.

45. A. A patient with C7 tetraplegia will not be able to independently perform activities of daily living secondary to
inadequate hamstrings length. A patient requires between 110-120 degrees of straight leg raise in order to reach
forward and don clothing.

46. D. A drug that enters the body through the alimentary canal is defined as enteral administration. Taking
medication orally is the primary means of enteral administration.

47. B. Direct access permits consumers to enter the health care system through a physical therapist without a
physician referral. Numerous insurance carrier continue to deny physical therapy claims without physician
referral, despite direct access legislation.

48. D. The supplied description is a standard method to assess the strength of the lower abdominal muscles. Failure
to maintain the low back flat on the treatment table as the legs are lowered is indicative of muscle weakness.

49. C. Splinting is a common treatment technique following a burn to maintain range of motion and prevent edema.
Optimal positioning of the hand in a splint is 10-15 degrees of wrist extension, 60-70 degrees of
metacarpophalangeal joint flexion, and full extension of the proximal and distal interphalangeal joints.

50. D. A short prosthesis would have more than adequate clearance to advance the limb during swing phase without
abducting

51. B. A patient with C4 tetraplegia is appropriate for a reclining wheelchair with chin controls since the neck
muscles are innervated. Back and seat cushions are necessary due to paralysis and inability to perform pressure
relief.

52. C. The triceps muscle is innervated by the radial nerve (C7-C8)

53. D. Functional ambulation is not realistic until the L1 level. The L1 level has innervation of the hip flexors and
adductors and proprioception at the hip joint. The patient will require bilateral knee-ankle-foot orthoses in order to
ambulate.

54. D. Physical therapist assistants routinely complete progress notes in the medical record. Specific types of
documentation such as an initial examination or a discharge summary are the responsibility of the physical
therapist.

55. A. A transtibial prosthesis is constructed with a total contact socket. This allows for maximal distribution of
weight with the primary area of weight bearing through the patella tendon.

56. C. Pulmonary embolism is the primary complication of a deep vein thrombosis, as a result physical therapy
intervention is not indicated.

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57. C. Health maintenance organizations offer health coverage to participants in exchange for a fixed, prepaid
premium.

58. C. A patient with right hemiplegia can compensate for weak hip abductors while side stepping towards the right
by leaning towards the left. This action unweights the right lower extremity and utilizes momentum along with the
abductor muscles to perform sidestepping

59. A. The supplied description is the classic position for the anterior segments of the upper lobes.

60. A. It is essential to complete a physical examination prior to initiating diagnostic imaging or any other form of
direct intervention.

61. D. Lateral epicondylitis refers to inflammation of the lateral epicondyle of the humerus and the surrounding
tissues. The condition primarily involves the extensor carpi radialis brevis, although may also involve extensor
carpi radialis longus and extensor digitorum. Progressive resistive exercises of the wrist extensor muscles are not
indicated in the acute stage of rehabilitation.

62. D. An open basketweave taping technique provides room for edema while allowing ankle motion in the sagittal
plane. The technique is often utilized immediately after an acute ankle sprain in combination with cryotherapy
and elevation.

63. A. A patient that presents with genu recurvatum while ambulating would benefit from increasing the
plantarflexion stop of the ankle-foot orthosis. This would serve to prevent plantarflexion after heel strike and
subsequently inhibit full extension of the knee during midstance.

64. A. Temporary immobilization is necessary following a skin graft in order to prevent movement that may disrupt
the graft.

65. A. Asymmetrical tonic neck reflex interferes with rolling due to the tonal influence of flexion to one side of the
body and concurrent extension to the other.

66. D. The primary use of a sling in the treatment of hemiplegia is to hold the humerus and scapula in proper
alignment during functional activities. Prolonged use of a sling can increase the incidence of contracture and
flexor synergy in the upper extremity.

67. B. Normal hemoglobin values for a male range from 14-18 gm/dL.

68. C. The resting position of the tibiofemoral joint is 25 degrees of flexion. The close packed position is full
extension and lateral rotation of the tibia.

69. B. Grade III and IV mobilization techniques are utilized primarily for stretching. Since patients with rheumatoid
arthritis often present with inflammation, any joint mobilization technique must be utilized with great caution.
Grade I and II mobilization techniques are often used to treat painful joints.

70. D. Brown Sequard syndrome is a spinal cord injury due to a partial or full hemisection of the cord. The syndrome
is frequently observed in stab wound victims.

71. A. Hot packs transfer heat to the body through conduction. Direct contact of the higher temperature hot packs
result in heat being transferred to the cooler skin.

72. B. A physical therapist should give immediate attention to proper positioning in order to prevent secondary
complications such as contracture and scarring.

73. D. The peroneus tertius acts to dorsiflex the ankle joint and evert the foot. As a result, resistance should be
applied against the lateral side of the dorsal surface of the foot in the direction of plantarflexion and inversion.
The deep peroneal nerve innervates the peroneus tertius.

74. A. Impingement syndromes is a generic term that describes a condition where the subacromial space is
compromised. Common offenders include the supraspinatus, subacromial bursa, and biceps tendon.

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75. A. Prone lying is an important positioning technique that stretches the hip flexors. Prone lying is essential to
prevent hip flexion contractures in patients with transfemoral amputations.

76. D. When the socket of a transtibial prosthesis is aligned in excessive flexion it may cause exaggerated knee
flexion during stance phase resulting in instability.

77. B. Repeated contractions is a technique that focuses on movement on one side of the joint. The technique is
facilitated by quick stretch and utilizes an isotonic contraction. Providing resistance at the point of weakness can
enhance repeated contractions.

78. D. A prosthesis with insufficient length would not be responsible for excessive lateral rotation of the prosthesis
upon heel strike. The deviation may be caused by weak hip medial rotators, poor suspension of the prosthesis, or
excessive toe-out of the prosthesis.

79. C. Cardiac output increases 30-60% and oxygen consumption increases 15-20% during pregnancy.

80. A. Patients with transfemoral amputations are particularly susceptible to hip flexion contractures. Prolonged
sitting in combination with a flexed posture can lead to the development of the contracture.

81. A. A positive Ober test is indicative of a contracture of the iliotibial band or tensor fasciae latae.

82. A. An insulin reaction is often associated with hypoglycemia or low blood sugar. Treatment for hypoglycemia
includes the administration of food or drink containing sugar.

83. D. The teres minor acts to laterally rotate the shoulder and stabilize the humeral head during shoulder movement.
The axillary nerve innervates the teres minor.

84. A. The pulse of the brachial artery can be felt directly medial to the biceps tendon. The brachial pulse is
commonly used when assessing blood pressure.

85. D. Ultrasound can elevate tissue temperature to depths of 3 cm. Paraffin, moist heating packs. and whirlpool
elevate tissue temperature to depths of approximately 1 cm.

86. A. The soleus acts to plantarflex the ankle joint, while the gastrocnemius plantarflexes the ankle and assists in
flexing the knee. An inability to dorsiflex the ankle during midswing may be indicative of weakness of the tibialis
anterior.

87. C. Shoulder medial and lateral rotation occur in a transverse plane around a longitudinal axis.

88. A. By flexing the knee, the two joint gastrocnemius muscle is placed on slack. Since active ankle dorsiflexion is
normal when the knee is flexed and is limited when the knee is extended, the gastrocnemius is likely responsible
for the limitation.

89. D. Two-point and four-point gait patterns require bilateral ambulation aids, while a three-point gait pattern
requires bilateral ambulation aids or a walker.

90. A. A patient with C6 tetraplegia relies on grasp through tenodesis. The grasp occurs through tension of the finger
flexors when the wrist is extended. Tenodesis cannot occur if the finger flexors are stretched or lengthened.

91. A. The lateral epicondyle serves as the common origin for the wrist extensors. The wrist extensors include
extensor carpi radialis longus, extensor carpi radialis brevis, and extensor digitorum.

92. A. Direct pressure is an appropriate first aid technique to control bleeding from a laceration.

93. A. The stationary arm of the goniometer should be positioned along a line extending from one anterior superior
iliac spine to the other.

94. C. The medial and lateral hamstrings originate on the ischial tuberosity. Forceful hip flexion and knee extension
places significant stress on the ischial tuberosity and can result in an avulsion fracture.

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95. B. A patient status post cerebellar CVA often presents with an ataxic gait pattern.

96. D. Resisted isometrics are strong, static isometric contractions that are performed in a neutral position. Resistive
isometrics are designed to assess the integrity of a selected muscle or group of muscles.

97. A. Pregnancy does not have a significant effect on cervical lordosis.

98. C

99. B

100. D

101. B

102. B

103. C

104. A

105. D

106. D

107. D

108. A

109. A

110. C. Using the cane in the left hand will allow the patient to shift her center of gravity away from the involved
lower extremity and therefore reduce the pressure on the injured ankle.

111. C. Proprioception is a discriminative sensation that includes both position sense and kinesthesia. Protective
sensations include light touch, pain, temperature, and pressure.

112. C. Performing ligamentous testing on an uninvolved joint provides a therapist with a valuable baseline that can
then be compared to the involved joint.

113. D. Strict isolation always requires the use of a mask, gown, and gloves.

114. C. A systematic sample is often used in place of a random sample when a population can be accurately listed or is
finite. Members of the sample are automatically selected once the first subject has been chosen.

115. B. The talar tilt test can be used to identify the presence of a calcaneofibular ligament sprain.

116. B. The lunate lies in the proximal row immediately distal to the Lister’s tubercle and proximal to the capitate.
Wrist flexion acts to facilitate palpation of the lunate.

117. A. Blood and body fluid precautions are often used for patients with AIDS and Hepatitis B.

118. D. The clinical instructor is the individual responsible for supervising and evaluating student performance in the
clinical setting. The center coordinator of clinical education is responsible for coordinating the student program at
a given facility and is the primary liaison with the academic institution.

119. D. In a normal distribution a known percentage of the population falls between specific standard deviation units.
In the supplied example 50% of the population will fall above the mean and 34% of the population will fall
between the mean and one standard deviation below the mean. Therefore, 50% + 34% = 84% of the population.

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120. D. The supplied description accurately describes the position and technique associated with bronchial drainage to
the superior segments of the lower lobes.

121. D. Cystic fibrosis is an inherited disease affecting the exocrine glands. The disease is characterized by
hypertrophy of goblet cells resulting in excessive airway secretions.

122. D. Sublingual administration of nitroglycerin provides rapid absorption into the blood stream. This route also
allows the medication to bypass the liver where it could be metabolized prior to reaching its destination.

123. C. Acetaminophen appears to have equal analgesic properties compared to aspirin or nonsteroidal anti-
inflammatory medications, but does not produce gastrointestinal irritation.

124. B. A Holter monitor is a portable unit that records electrocardiograph recordings during activities of daily living.

125. B. Tachypnea refers to a respiratory rate of greater than 20 breaths per minute.

126. D. Ventricular tachycardia is defined as three consecutive ventricular complexes with a rate of 150-200 beats per
minute. Sustained ventricular tachycardia can be life threatening due to inadequate cardiac output.

127. C. Shoulder abduction and medial rotation exposes the supraspinatus tendon from under the acromion process.

128. A. The primary site for drug storage within the body is adipose tissue. Drugs that are fat soluble and are store
within adipose tissue can remain there for long periods of time due to diminished blood flow and reduced
metabolic rate.

129. C. The patient’s inability to communicate using the English language necessitates the use of an interpreter.

130. C. Rolling is a basic skill that allows for bed mobility as well as pressure relief.

131. D. Speed’s maneuver is designed to assess the biceps tendon. A positive test may be indicative of bicipital
tendonitis.

132. B. Total available knee range of motion can be determined by the following: 90o – 15o = 75o.

133. A. If the total available knee range of motion is 65 degrees and the patient has 5 degrees of hyperextension, the
patient must have 60 degrees of knee flexion. Therefore the patient’s range of motion should be recorded as
5 - 0 - 60 degrees of right knee active range of motion.

134. D. Therapists should not alter entries in the medical record after the notification of a claim. Intentional alteration
of a record is termed spoliation.

135. C. The assessment section of a SOAP note includes the problem list, short-term goals, and long-term goals. The
assessment section allows a therapist to express his/her professional judgment on a variety of issues related to
patient care.

136. C. The distal row of carpal bones consists of the trapezium, trapezoid, capitate, and hamate.

137. D. ST segment depression of greater than 1 mm is indicative of ischemia and is often used to confirm the
diagnosis of coronary artery disease.

138. D. When conducting a manual muscle test, a therapist should attempt to apply pressure using a long lever arm.
Although there are a few exceptions to this rule, a long lever arm offers a therapist with a better opportunity to
assess strength with limited physical exertion.

139. C. Training the patient in a specific gait pattern is one of the final components of an ambulation program.
Development of standing balance and weight shifting are prerequisite activities that should be addressed prior to
ambulation.

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140. D. Behavioral objectives must include a behavior that can be seen or heard. The verb “understand” does not
satisfactorily meet this criterion.

141. C. A therapist should notify nursing immediately and avoid any attempt to reconnect the IV.

142. A. Digitalis is utilized in the treatment of congestive heart failure. Digitalis works directly on electrolytes to
improve the force and contractility of the heart.

143. D. Hypoxemia refers to an abnormal deficiency of oxygen in arterial blood.

144. D. Emphysema is an obstructive pulmonary disease characterized by overinflation and destructive changes in
alveolar walls. Although closely related to other obstructive pulmonary diseases, the presence of a barrel chest is
most characteristic of emphysema.

145. A. The hip is a ball and socket joint whose resting position is described as 30 degrees of hip flexion, 30 degrees of
abduction and slight lateral rotation.

146. A. In order to provide maximum benefit a home exercise program must be designed to meet the individual needs
of each patient.

147. B. A capsular pattern of restriction at the glenohumeral joint typically presents with the greatest limitation in
lateral rotation followed by abduction and medial rotation.

148. A. Masks are indicated by individuals coming in close proximity to patients in respiratory isolation. Examples of
conditions that may require respiratory isolation include meningitis, pertussis, and pneumonia.

149. B. When measuring forearm pronation and supination a position of midway between supination and pronation is
utilized as the starting position.

150. A. The most immediate response in treating autonomic dysreflexia is to support the patient in a sitting position in
an attempt to lower blood pressure. The patient’s bowel and bladder should be assessed and vital signs should be
monitored.

151. A. Scapular adductors including the rhomboids, middle trapezius, and the lower trapezius are tested with the
patient in the prone position.

152. B. The hamate is in the distal row of carpal bones on the ulnar side.

153. C. At approximately one month of age an infant placed in sidelying is able to roll from a sidelying position to
supine through the use of extension.

154. C. Increased hip flexion is a postural change associated with aging.

155. B. The appropriate wheelchair for a patient with C5 tetraplegia is a manual chair with handrim projections. The
projections should be angled at 30 degrees during the training period to assist with propulsion.

156. B. Vitamin A is a fat-soluble vitamin essential for functions such as bone growth, maintenance of body linings,
and vision. Vitamin A is found in animal products such as butter, milk, liver, egg yolks, and in dark green, deep
orange, and yellow vegetables.

157. B. Military time operates on the premise that 2400 hours is equivalent to 12:00 AM and 1200 hours is equivalent
to 12:00 PM. 8:00 AM or 0800 is nine hours after 11:00 PM or 2300 hours.

158. A. A three-point gait pattern with axillary crutches allows the patient to move in an efficient manner while
maintaining the prescribed non-weight bearing status.

159. B. The aortic valve is located at the junction of the left ventricle and the ascending aorta. The aortic valve
prevents regurgitation at the entrance of the aorta to the heart.

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160. A. Independent variables are the conditions or characteristics that are manipulated to determine the effect on the
dependent variable. In the supplied example, the exercise program is the independent variable.

161. B. Residual volume is defined as the amount of gas in the lungs at the end of maximal expiration. Normal
residual volume for a male is approximately 1,500 ml, while total lung capacity is 6000 ml. Total lung capacity is
equal to the sum of tidal volume, inspiratory reserve volume, expiratory reserve volume and residual volume.

162. A. To perform bronchial drainage to the anterior segments of the upper lobes the therapist should clap between
the clavicle and nipple on each side with the patient positioned in supine.

163. B. Energy expenditure expressed in the form of calories can be estimated using weight and oxygen consumption.

164. D. Selected enzymes are released into the blood in a predictable fashion following myocardial infarction. These
enzymes can be used to confirm the diagnosis of acute myocardial infarction. The most common enzymes
analyzed after myocardial infarction include aspartate aminotransferase, creatine phosphokinase, and lactate
dehydrogenase.

165. A. ST segment elevation is a common finding observed on an electrocardiogram following myocardial infarction.
ST segment elevation is caused by premature cell repolarization.

166. B. The primary requirement for developing a clinical education program is the desire to play a role in the
education of physical therapists. This requirement is a prerequisite before exploring any other criteria associated
with clinical education.

167. D. Strict isolation always requires the use of a gown, mask, and gloves.

168. C. A four-point gait pattern is often prescribed for patients requiring significant stability. The gait pattern
requires low energy expenditure, but is very slow.

169. A. Patients status post myocardial infarction are typically referred to cardiac rehabilitation as soon as they are
medically stable. Length of stay in phase I program has decreased dramatically in the past few years and currently
averages 3-5 days.

170. D. When walking up hills it is advisable to shorten stride length and lean slightly forward to accommodate for the
slope.

171. C. Exercise seven days a week for at least 30 minutes may be considered excessive for a general fitness program,
particularly for a geriatric population. Positive effects of exercise can be achieved with diminished frequency.

172. C. Patients typically move through predictable series of stages when experiencing dying. According to Elizabeth
Kubler Ross these stages include denial and isolation, anger, bargaining, depression, and acceptance.

173. A. Diuretics act to lower blood pressure by decreasing fluid levels in the vascular system, primarily through the
excretion of urine.

174. D. Systolic pressure gradually increases as exercise intensity increases, however diastolic pressure remains
relatively stable.

175. D. The proximal row of carpals articulate with the radius at the radiocarpal joint and with the distal row of carpals
at the midcarpal joints. The ulna does not form an articulation with the proximal row of carpals.

176. A. The stationary arm of the goniometer should be aligned with the lateral midline of the second metacarpal using
the center of the second metacarpophalangeal joint for reference.

177. D. Failure to place a patient with muscle guarding and spasm in a comfortable position will only serve to
exacerbate the patient’s current condition.

178. B. When compared to the gait of an adult, toddlers tend to exhibit a wider base of support, decreased single leg
support time, shorter step length, slower velocity, and higher cadence.

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179. D. Immediate medical management should focus on identifying potential complications such as a fracture. X-rays
are a cost effective diagnostic tool commonly utilized with orthopedic injuries.

180. A. Performance standards must be communicated openly to all employees on an ongoing basis. Introducing
performance standards to an employee at a performance appraisal is unacceptable.

181. C. Failure to stabilize the scapula when measuring glenohumeral abduction will result in upward rotation and
elevation of the scapula. When measuring shoulder complex abduction the thorax should be stabilized to prevent
lateral flexion of the trunk.

182. B. The humeral head slides posteriorly on the glenoid fossa during shoulder complex medial rotation and as a
result places pressure on the posterior capsule.

183. C. Chronic arterial insufficiency typically results from narrowing, fibrosis, or occlusion of arteries. Signs and
symptoms include blanching of the skin, decreased hair growth distal to the insufficiency, decreased skin
temperature, dryness of the skin, and gangrene.

184. A. A bone scan is a diagnostic test that utilizes radioactive isotopes to identify areas of bone that are
hypervascular or have an increased rate of bone mineral turnover. Bone scans can demonstrate bone disease or
stress fractures with as little as 4-7% bone loss.

185. D. The problem list typically provides a summary of the patient’s physical therapy problems and forms the
foundation for short and long-term goals. As a result the entry “increased stress secondary to financial problems”
is not an appropriate entry in the problem list.

186. D. Thoracodynia refers to pain in the thorax or chest.

187. C. Pacinian corpuscles are encapsulated sensory nerve endings found in subcutaneous tissue. The receptors are
stimulated by deep pressure, quick stretch to tissue, and vibration.

188. B. The dorsal scapular nerve innervates the levator scapulae and rhomboids. The levator scapulae function to
elevate the scapula while the rhomboids adduct the scapula.

189. D. Active-assistive exercise is performed when the patient is able to produce some active movement, however
relies on assistance from an external force.

190. C. Passive insufficiency occurs when a two joint muscle is stretched across two joints at the same time.

191. B. A physical therapist assistant can modify a selected intervention procedure within an established plan of care
when necessary, however should not modify the actual plan of care.

192. B. An infant’s pulse is often assessed at the brachial artery, while the radial artery is utilized for an older child.

193. B. Rhythmic initiation is indicated when a patient has difficulty initiating movement. Rolling is usually one of the
first tasks performed using this technique. Rhythmic initiation begins with passive range of motion and progresses
to resisted movement as the patient acquires the skill.

194. B. Using the developmental sequence allows for treatment to focus on isometric control at each static position and
isotonic control when moving from one position to the next.

195. A. A patient with homonymous hemianopsia has a visual field loss to the lateral half of the visual field in one eye
and to the medial half of the visual field in the other eye. The patient may be able to compensate for this deficit by
constantly scanning the environment to avoid danger when walking.

196. D. A patient with limited dorsiflexion may present with a vault or bounce through mid to late stance. Ten to
twenty degrees of dorsiflexion is required for late stance through toe off.

197. D. A patient that sustained a CVA four days ago with resultant hemiplegia would not be expected to perform
lower extremity exercises without assistance.

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198. A. Rotator cuff tears typically occur in adults over the age of 40 as a result of repetitive microtears to the rotator
cuff or long head of the biceps.

199. C. A patient status post CVA should avoid prolonged supine positioning in bed. A supine position encourage
abnormal reflexes including asymmetrical tonic neck reflex, symmetrical tonic neck reflex, and labyrinthine
reflexes.

200. B. A metal upright ankle-foot orthosis is able to accommodate fluctuating edema because the stirrups do not have
total contact with the patient’s lower extremity. The plastic ankle-foot orthosis is molded for total contact with the
lower extremity.

Giles B4.doc