qNum1= 1

&category1= CD

&domain1= D2
&reasoning1= R1

&q1= A patient sustained a fracture to the left proximal humerus which is now
healed. Treatment is proceeding well except that with left shoulder flexion the
therapist notices the scapula protracts and elevates early and it continues to
move excessively. Physical therapy intervention should emphasize:
&choice1a= stretching of scapular stabilizers and strengthening of the
pectoralis major and minor muscles to regain muscle balance.

&choice1b= scapulothoracic mobilization and strengthening of the pectoralis

major and minor muscles to regain normal scapulohumeral rhythm.
&choice1c= glenohumeral mobilization and strengthening of scapular stabilizers
to regain normal scapulohumeral movement.

&choice1d= glenohumeral mobilization, and strengthening of the rotator cuff

muscles to regain muscle balance.
&answer1= 3
&qNum2= 2

&category2= CD
&domain2= D5

&reasoning2= R1
&q2=Which of the following exercises would be most appropriate for a patient two
weeks post transurethral resection of the prostate (TURP) without complications?

&choice2a= Kegel exercises.

&choice2b= trunk stabilization.

&choice2c= hip and leg presses.

&choice2d= proprioception retraining.

&answer2= 1
&qNum3= 3
&category3= CC

&domain3= D1
&reasoning3= R5

&q3= A therapist is supervising the exercise of cardiac rehabilitation

outpatient class on a very hot day, with temperatures expected to be above 90
degrees F. The class is scheduled for 2 p.m. and the facility is not air
conditioned. The strategy that is unacceptable is to:
&choice3a= decrease the exercise intensity by slowing the pace of exercise.

&choice3b= increase the warm-up period to equal the total aerobic interval in
time.
&choice3c= change the time of the exercise class to early morning or evening.

&choice3d= make the exercise intermittent by adding rest cycles.

&answer3= 2
&qNum4= 4

&category4= CE
&domain4= D6

&reasoning4= R3
&q4= A patient has a transtibial amputation and has recently been fitted with a
PTB socket. During initial prosthetic checkout, the physical therapist instructs
the patient to walk several times in the parallel bars and then sit down and
take the prosthesis off. Upon inspection of the skin the therapist would expect
no redness in the area of the:

&choice4a= anterior tibia and tibial crest.

&choice4b= patellar tendon and tibial tuberosity.

&choice4c= medial tibial and fibular plateaus.

&choice4d= medial and lateral distal ends of the residual limb.

&answer4= 1
&qNum5= 5
&category5= CD

&domain5= D5
&reasoning5= R5

&q5= A patient who is terminally ill with cancer is in tears,unable to cope

with the changes in her life and current hospitalization. The therapist has a
referral for gait training so the patient can be discharged to home under
hospice care. The BEST approach is to:
&choice5a= ask the patient questions in order to obtain a detailed history.

&choice5b= ignore the tears and focus on therapy but in a compassionate manner.
&choice5c= encourage denial so she can cope better with life's challenges.

&choice5d= take time now to allow the patient to express her fears and
frustrations.
&answer5= 4
&qNum6= 6

&category6= CE
&domain6= D6

&reasoning6= R2
&q6= The examination reveals muscle spasm of the piriformis, which is
compressing the sciatic nerve and producing pain in the posterior hip region.
The pain has been worsening over the past three months. What is the most
appropriate ultrasound setting for this case?

&choice6a= 1 MHz pulsed at 1.0 W/cm2.

&choice6b= 3 MHz continuous at 1.0 W/cm2.

&choice6c= 3 MHz pulsed at 1.0 W/cm2.

&choice6d= 1 MHz continuous at 1.0 W/cm2.

&answer6= 4
&qNum7= 7
&category7= CA

&domain7= D3
&reasoning7= R3

&q7= A patient is recovering from a complete spinal cord injury, at the level
of L2. The expected outcome in this case would MOST likely include:
&choice7a= a spastic or reflex bladder.

&choice7b= some recovery of function since damage is to peripheral nerve roots.

&choice7c= loss of motor function and pain & temperature sensation below the
level of the lesion with light touch, proprioception and position sense
preserved.

&choice7d= greater loss of arm function than leg function with early loss of
pain and temperature sensation.
&answer7= 2
&qNum8= 8

&category8= CF
&domain8= D6

&reasoning8= R5
&q8= A patient with left hemiplegia receives a new AFO. The therapist is
overwhelmed with too many patients and asks the physical therapy student to take
over. This is the student's first affiliation (second day) and has never
performed an orthotic checkout for a patient with an AFO. The supervising
therapist will be in the same vicinity treating other patients. This task should
be:

&choice8a= delegated to the student who could call out to the supervisor if
problems arose.
&choice8b= delegated to another physical therapist.

&choice8c= delegated to the physical therapist assistant who is working nearby.

&choice8d= not be completed now and the patient sent back to his room.

&answer8= 2
&qNum9= 9
&category9= CD

&domain9= D2
&reasoning9= R4

&answer9= 3
&q9= A patient has been diagnosed with acute synovitis of the temporomandibular
joint. Early intervention might best focus on:

&choice9a= application of an intraoral appliance and phonophoresis.

&choice9b= joint mobilization and postural awareness.

&choice9c= instruction to eat a soft food diet and phonophoresis.

&choice9d= temporalis stretching and joint mobilization.
&qNum10= 10

&category10= CD
&domain10= D2

&reasoning10= R3
&answer10= 1

&q10= During a cervical spine examination the therapist observes restricted left
rotation of the C7-T1 spinal level. After stabilizing the thoracic spine, the
therapist's hand placement for mobilization to improve left rotation should be
at the:
&choice10a= posterior right C7 articular pillar.

&choice10b= posterior left C7 articular pillar.

&choice10c= T1 spinous process.

&choice10d= posterior left C6 articular pillar.

&qNum11= 11
&category11= CA

&domain11= D3
&reasoning11= R3

&answer11= 4
&q11= An appropriate fine motor behavior that should be established by 9 months
of age would be the ability to:

&choice11a= pick up a raisin with a fine pincer grasp.

&choice11b= build a tower of 4 blocks.

&choice11c= hold a cup by the handle while drinking.

&choice11d= transfer objects from one hand to another.
&qNum12= 12

&category12= CC
&domain12= D3

&reasoning12= R5
&answer12= 2

&q12= A patient with a 10 year history of Parkinson's disease has been taking L-
dopa for the last 5 years. The patient presents with deteriorating function and
is no longer able to transfer or walk independently. During a physical therapy
session, the therapist observes facial grimacing with twitching of the lips and
tongue protrusion. The patient appears restless, with constant dancing,
athetoid-like movements of his legs. The therapist's BEST course of action is
to:
&choice12a= complete the treatment session, focusing specifically on examining
the effects of rigidity.

&choice12b= document observations and refer the patient back to the physician
for evaluation of possible levodopa toxicity.
&choice12c= talk to the spouse to see if the patient is taking any drugs with
hallucinogenic effects such as selegiline.

&choice12d= examine for additional signs of chronic levodopa therapy such as

dizziness and headache.
&qNum13= 13
&category13= CF

&domain13= D6
&reasoning13= R3

&answer13= 3
&q13= A patient who is to undergo surgery for a chronic shoulder dislocation
asks the therapist to explain the rehabilitation following a scheduled surgical
reconstructive procedure. The therapist's BEST response is to:

&choice13a= explain in detail about the surgical procedure.

&choice13b= tell the patient to ask the surgeon for information about the
procedure and appropriate rehabilitation.

&choice13c= explain how patients typically respond to the surgery and outline
the progression of exercises.
&choice13d= refer the patient to a physical therapy clinical specialist who is
an expert of shoulder reconstructive rehabilitation.
&qNum14= 14

&category14= CB
&domain14= D1

&reasoning14= R2
&answer14= 4

&q14= Which of the following is NOT an appropriate reason to terminate a maximum

exercise tolerance test for a patient with pulmonary dysfunction?
&choice14a= ECG monitoring reveals diagnostic ischemia.

&choice14b= patient states he is maximally short of breath.

&choice14c= PaO2 decreases 20 mmHg.

&choice14d= patient reaches age-predicted maximal heart rate.

&qNum15= 15
&category15= CE

&domain15= D6
&reasoning15= R4

&answer15= 2
&q15= A patient with a complete T10 paraplegia is receiving his initial
ambulation training. He has received bilateral Craig-Scott knee-ankle-foot
orthoses and is being trained with axillary crutches. Since a reciprocal gait
pattern is problematic for him, the BEST initial gait pattern to teach him is:

&choice15a= four-point.
&choice15b= swing-to.

&choice15c= two-point.
&choice15d= swing-through.
&qNum16= 16

&category16= CC
&domain16= D5

&reasoning16= R5
&answer16= 1

&q16= After mastectomy, a patient receiving home care, cannot accept the loss of
her breast. She reports being weepy all the time with loss of sleep. She is
constantly tired and has no energy to do anything. The BEST action the therapist
can take is:
&choice16a= contact her primary physician and request a psychological consult.

&choice16b= tell the nurse case manager to monitor the patient closely.
&choice16c= tell her depression is common at first, but will resolve with time.

&choice16d= have her spouse observe her closely for possible suicidal
tendencies.
&qNum17= 17
&category17= CE

&domain17= D6
&reasoning17= R3

&answer17= 4
&q17= A college volleyball player complains of moderate pain resulting from a
left hamstring strain four weeks ago. The focal point of pain and tightness is
noted where a hematoma developed initially. The specific massage technique that
would be MOST beneficial in this case is:

&choice17a= stroking.
&choice17b= kneading.

&choice17c= tapotement.
&choice17d= friction.
&qNum18= 18

&category18= CC
&domain18= D5

&reasoning18= R4
&answer18= 3

&q18= The 58 year-old patient is ten days post-op left total knee arthroplasty
and has been seen by the home care physical therapist twice before since post-op
day five. The patient has been taking hydrocodone with ibuprofen for pain since
the surgery and is beginning to switch to non-prescription ibuprofen during the
daytime. The INR yesterday was within therapeutic levels. The patient has
progressed to stand-by assistance in ambulation using a standard walker and is
able to complete leg and knee exercises with assistance Today the patient is
complaining of back and groin pain of 7/10 when lying in bed or sitting. The
pain is 5/10 when standing. Which of the following screening questions is the
BESTfor the physical therapist to ask in consideration of these new symptoms? oy
born with myelomeningocele at the L2 level is referred for physical therapy
treatment at home. In determining the plan of care, it would NOT be appropriate
to emphasize:
&choice18a= When was your last pain medication?

&choice18b= Have you been screened for colon cancer?

&choice18c= When was your last bowel movement?

&choice18d= Do you have any pain or tenderness in your left calf?

&qNum19= 19
&category19= CC

&domain19= D2
&reasoning19= R3

&answer19= 2
&q19= During an examination of a patient who complains of back pain, the
physical therapist notes pain with end range AROM into left hip flexion,
abduction and external rotation. The origin of the pain is MOST likely the:

&choice19a= sartorius muscle.

&choice19b= sacroiliac joint.

&choice19c= left kidney.

&choice19d= capsule of the hip joint.
&qNum20= 20

&category20= CF
&domain20= D6

&reasoning20= R2
&answer20= 4

&q20= A therapist wants to compare frequencies of carpal tunnel syndrome

occurring in different groups of individuals: assembly line workers and computer
programmers. The MOST appropriate statistical tool to use for analysis of the
data is:
&choice20a= simple one-way ANOVA.

&choice20b= t test.
&choice20c= normal distribution curve.

&choice20d= chi square test.

&qNum21= 21
&category21= CF

&domain21= D6
&reasoning21= R2

&answer21= 3
&q21= In a research study in which there is a skewed distribution with extreme
scores on a balance measure that deviate from the performance of the total
group, the MOST accurate representation of central tendency is:

&choice21a= mean.
&choice21b= mode.

&choice21c= median.
&choice21d= standard deviation.
&qNum22= 22

&category22= CC
&domain22= D3

&reasoning22= R5
&answer22= 1

&q22= A factory worker injured the right arm in a factory press with damage to
the ulnar nerve at the elbow. A diagnostic EMG was performed with evidence of
spontaneous fibrillation potentials. In this case, the physical therapy plan of
care should consider that:
&choice22a= denervation atrophy has occurred.

&choice22b= reinnervation is complete.

&choice22c= axonotmesis is occurring.

&choice22d= reinnervation is in process.

&qNum23= 23
&category23= CE

&domain23= D6
&reasoning23= R3

&answer23= 1
&q23= A patient is recovering from a right CVA resulting in severe left
hemiplegia and visuospatial deficits. Additionally, there is a large diabetic
ulcer on the left foot with pitting edema. The MOST appropriate wheelchair
prescription for this patient would be a:

&choice23a= hemiplegic chair with elevating legrest on the left.

&choice23b= powered wheelchair with joystick and elevating legrests.

&choice23c= lightweight active duty wheelchair with elevating legrests.

&choice23d= one-arm drive chair with elevating legrest on the left.
&qNum24= 24

&category24= CC
&domain24= D1

&reasoning24= R4
&answer24= 3

&q24= A 14 year-old boy with advanced Duchenne muscular dystrophy is

administered a pulmonary function test. The value that is UNLIKELY to show any
deviation from normal is:
&choice24a= vital capacity.

&choice24b= FEV1.
&choice24c= functional residual capacity.

&choice24d= total lung capacity.

&qNum25= 25
&category25= CE

&domain25= D6
&reasoning25= R3

&answer25= 2
&q25= A patient fractured the right midtibia in a skiing accident three months
ago. After cast removal, a severe foot drop was noted. The patient desires to
try electrical stimulation orthotic substitution. The physical therapist would
set up the functional electrical stimulation to contract the appropriate muscles
during:

&choice25a= push off.

&choice25b= swing phase.

&choice25c= foot flat.

&choice25d= toe off.
&qNum26= 26

&category26= CF
&domain26= D6

&reasoning26= R5
&answer26= 4

&q26= A physical therapist has a small open wound on the back of the hand. The
therapist is scheduled to treat a patient with HIV for management of a wound.
The therapist should:
&choice26a= double glove and treat as scheduled.

&choice26b= use sterile precautions with mask and gloves.

&choice26c= continue with treatment as scheduled but wash hands thoroughly
before and after.

&choice26d= refuse to treat that patient.

&qNum27= 27
&category27= CB

&domain27= D2
&reasoning27= R5

&answer27= 2
&q27= As a therapist progresses through their examination it is becoming evident
that a current patient is anterior cruciate ligament (ACL) deficient in the
right knee. Which of the following tests would be unnecessary to perform in
order to determine if the ACL was ruptured?

&choice27a= Lachman's test.

&choice27b= anterior drawer test.

&choice27c= Slocum's test.

&choice27d= lateral pivot shift test.
&qNum28= 28

&category28= CF
&domain28= D6

&reasoning28= R5
&answer28= 3

&q28= An elderly patient has been hospitalized for the past three days with
pneumonia. The physician is being pressured to discharge her tomorrow. The
patient lives with her sister in a first floor apartment. The physical therapist
has determined her ambulation endurance to be only up to 15 feet, not enough to
allow her to get from her bed to the bathroom (a distance of 20 feet). The
therapist should recommend:
&choice28a= postponing her discharge until she can walk 20 feet.

&choice28b= a skilled nursing facility placement until her endurance increases.

&choice28c= a bedside commode, and referral for home health services.

&choice28d= outpatient physical therapy until her condition improves.

&qNum29= 29
&category29= CD

&domain29= D3
&reasoning29= R3

&answer29= 1
&q29= A therapist examines a patient with a right CVA and determines the patient
has a profound deficit of homonymous hemianopsia. The BEST initial strategy to
assist the patient in compensating for this deficit is to:

&choice29a= teach the patient to turn the head to the affected left side.
&choice29b= provide constant reminders, printed notes on the left side, telling
the patient to look to the left.

&choice29c= place items, eating utensils on the left side.

&choice29d= rearrange the room so while in bed the left side is facing the
doorway.
&qNum30= 30

&category30= CD
&domain30= D3

&reasoning30= R4
&answer30= 3

&q30= A patient with multiple sclerosis exhibits moderate fatigue during a 30

minute exercise session. When the patient returns for the next regularly
scheduled session 2 days later, the patient reports that she went home after the
last session and went right to bed. The patient was so exhausted she was unable
to get out of bed until the late afternoon of the next day. The therapist's BEST
strategy is to:
&choice30a= treat the patient in a warm, relaxing environment.

&choice30b= utilize a massed practice schedule.

&choice30c= utilize a distributed practice schedule.

&choice30d= switch the patient to a pool therapy program.

&qNum31= 31
&category31= CF

&domain31= D6
&reasoning31= R3

&answer31= 3
&q31= A 72 year-old medically stable individual requires custodial care in the
home. She is severely disabled with rheumatoid arthritis and is in a great deal
of pain. She presents with significant deformities which limit her functional
abilities and is dependent in all basic activities of daily living. A recent
exacerbation of her disease has left her bed-bound for the past 2 weeks.
Appropriate physical therapy services would be covered by:

&choice31a= Medigap policies.

&choice31b= Medicaid.

&choice31c= Medicare.
&choice31d= only by HMO or private insurance policies.
&qNum32= 32

&category32= CC
&domain32= D4

&reasoning32= R1
&answer32= 4

&q32= A patient with a venous stasis ulcer near the left medial malleolus is
referred for physical therapy. Skin changes consistent with stasis dermatitis
are evident in the lower leg. Physical exam reveals patent femoral, popliteal,
and pedal pulses. An enlarged and dilated greater saphenous vein is evident in
the standing position. The MOST important physical therapy intervention to
consider for this patient is:
&choice32a= daily walking for 30-60 minutes.

&choice32b= elastic wraps and daily exercises.

&choice32c= daily warm water baths and exercise.

&choice32d= compression therapy with exercise.

&qNum33= 33
&category33= CB

&domain33= D3
&reasoning33= R1

&answer33= 2
&q33= A patient recovering from stroke is having difficulty bearing weight on
the left leg. The patient is unable to advance the tibia forward and abbreviates
the end of the stance phase on the left going directly into swing phase. The
MOST likely cause of her problem is:

&choice33a= weakness or contracture of hip extensors.

&choice33b= spasticity or contracture of the plantar flexors.

&choice33c= spasticity of the anterior tibialis muscle.

&choice33d= weakness or contracture of the dorsiflexors.
&qNum34= 34

&category34= CA
&domain34= D2

&reasoning34= R3
&answer34= 3

&q34= With a traction injury to the anterior division of the brachial plexus the
therapist would expect to see weakness of the elbow flexors, wrist flexors and
forearm pronators. The therapist would also expect to find additional weakness
in:
&choice34a= wrist extension.

&choice34b= forearm supination.

&choice34c= thumb abduction.

&choice34d= lateral rotation of the shoulder.

&qNum35= 35
&category35= CA

&domain35= D4
&reasoning35= R5

&answer35= 2
&q35= A 95 year-old has recently been admitted to a skilled nursing facility
following a fall-related injury (fractured hip with open reduction, internal
fixation). Since she lived alone on the second floor, she was unable to return
home. She is extremely agitated over her placement here and demonstrates early
signs of dementia. She tells the therapist "leave me alone, I just want to get
out of here!" An important approach to take while working with this client is
to:

&choice35a= tell her clearly and firmly what she is going to do in therapy.
&choice35b= be calm and supportive, and use only one or two level commands.

&choice35c= minimize verbal communication and maximize guided movements.

&choice35d= promise her anything to calm her down, as long as she gets up and
walks.
&qNum36= 36

&category36= CA
&domain36= D5

&reasoning36= R3
&answer36= 4

&q36= A 72 year-old woman is being treated for depression following the death of
her husband. She is currently taking antidepressant medication (tricyclics) and
has a recent history of a fall. The therapist suspects the precipitating cause
of the fall is her medication as it can cause:
&choice36a= hyperalertness.

&choice36b= cardiac arrhythmias.

&choice36c= dyspnea.

&choice36d= postural hypotension.

&qNum37= 37
&category37= CA

&domain37= D1
&reasoning37= R5

&answer37= 4
&q37= A patient and his caregivers should understand the common side effects of
the medication that he is taking. He has Class III heart disease and is
continually in and out of congestive heart failure. He is taking digitalis
(Digoxin) to improve his heart function. The therapist will know he and his
caregivers understand the adverse side effects of this medication if they relate
that they will contact the patient's physician if he demonstrates:

&choice37a= confusion and memory loss.

&choice37b= slowed heart rate.

&choice37c= involuntary movements and shaking.

&choice37d= weakness and palpitations.
&qNum38= 38

&category38= CF
&domain38= D6

&reasoning38= R3
&answer38= 1

&q38= The director of physical therapy is asked to develop an operating budget

for the upcoming fiscal year. The item that would NOT be included in an
operating budget is:
&choice38a= a treadmill purchase.

&choice38b= clinic supplies such as therapy balls.

&choice38c= utility expenses.

&choice38d= lease of an off-site therapy pool.

&qNum39= 39
&category39= CF

&domain39= D6
&reasoning39= R4

&answer39= 3
&q39= A physical therapist is treating a patient with active hepatitis B
infection. Transmission of the disease is best minimized if the therapist:

&choice39a= washes hands before and after treatment.

&choice39b= has the patient wear a gown and mask during treatment.

&choice39c= wears gloves during any direct contact with blood or body fluids.
&choice39d= has the patient wear gloves to prevent direct contact with the
therapist.
&qNum40= 40

&category40= CE
&domain40= D6

&reasoning40= R2
&answer40= 2

&q40= A patient complains of pain (7/10) and limited range of motion of the
right shoulder as a result of chronic overuse. The therapist elects to use
procaine hydrochloride iontophoresis as part of physical therapy intervention
for this patient's problems. To administer this substance, it would be
appropriate to use:
&choice40a= continuous biphasic current with the medication under the anode.

&choice40b= continuous monophasic current with the medication under the anode.
&choice40c= continuous monophasic current with the medication under the cathode.

&choice40d= interrupted biphasic current with the medication under the cathode.
&qNum41= 41
&category41= CA

&domain41= D1
&reasoning41= R2

&answer41= 2
&q41= A contraindication to initiating joint mobilization on a patient with
chronic pulmonary disease may include:

&choice41a= reflex muscle guarding.

&choice41b= long term corticosteroid therapy.

&choice41c= concurrent inhalation therapy.

&choice41d= functional chest wall immobility.
&qNum42= 42

&category42= CF
&domain42= D6

&reasoning42= R3
&answer42= 3

&q42= Long term care for institutionalized elderly who have reduced their
financial resources to qualify for low-income status is typically funded by:
&choice42a= Medicare.

&choice42b= Health Maintenance Organizations.

&choice42c= Medicaid.

&choice42d= Social Security Administration.

&qNum43= 43
&category43= CC

&domain43= D1
&reasoning43= R3

&answer43= 4
&q43= A computer programmer, with no significant past medical history, presents
to the emergency room with complaints of fever, shaking chills and a worsening
productive cough. Complaints of chest pain over the posterior base of the left
thorax is made worse on inspiration. An anterior-posterior X-ray shows an
infiltrate on the lower left thorax at the posterior base. This patient's chest
pain is MOST likely caused by:

&choice43a= inflamed tracheobronchial tree.

&choice43b= angina.

&choice43c= trauma to the chest.

&choice43d= infected pleura.
&qNum44= 44

&category44= CF
&domain44= D6

&reasoning44= R5
&answer44= 1

&q44= Equipment safety is essential in all physical therapy clinics. Regularly

scheduling equipment maintenance programs to ensure that all equipment is
calibrated, lubricated, and adjusted according to manufacturer's guidelines is
an important element for patient and staff safety. The procedure that is not
part of routine equipment safety is:
&choice44a= training all staff to do "simple" repairs on all electrical
equipment if a breakdown should occur.

&choice44b= supervising new staff and students in the use of all newly purchased
equipment.
&choice44c= documenting all preventive maintenance and keeping this information
on file.

&choice44d= conducting educational sessions for staff regarding the indications

and contraindications for all equipment.
&qNum45= 45
&category45= CC

&domain45= D4
&reasoning45= R3

&answer45= 2
&q45= A 92 year-old patient presents with hot, red, and edematous skin over the
shins of both lower extremities. The patient also has a mild fever. The MOST
likely cause of the symptoms is:

&choice45a= dermatitis.
&choice45b= cellulitis.

&choice45c= herpes simplex infection.

&choice45d= scleroderma.
&qNum46= 46

&category46= CE
&domain46= D6

&reasoning46= R4
&answer46= 4

&q46= A 10 year-old presents with pain (4/10) and limited knee ROM (5-95
degrees) following surgical repair of the medial collateral ligament and
anterior cruciate ligaments. In this case, the modality which can be used with
PRECAUTION is:
&choice46a= premodulated interferential current.

&choice46b= continuous shortwave diathermy.

&choice46c= high rate transcutaneous electrical stimulation.

&choice46d= low dose ultrasound.

&qNum47= 47
&category47= CA

&domain47= D1
&reasoning47= R3

&answer47= 4
&q47= A weight lifter exhibits marked hypertrophy after embarking on a strength
training regime. Hypertrophy can be expected to occur following at least:

&choice47a= 1-2 weeks of training.

&choice47b= 3-4 weeks of training.

&choice47c= 2-3 weeks of training.

&choice47d= 6-8 weeks of training.
&qNum48= 48

&category48= CA
&domain48= D2

&reasoning48= R3
&answer48= 1

&q48= A diagnosis of bicipital tendinitis has been made following an evaluation

of a patient with shoulder pain. The BEST shoulder position to expose the tendon
of the long head of the biceps for application of phonophoresis would be:
&choice48a= external/lateral rotation and extension.

&choice48b= internal/medial rotation and abduction.

&choice48c= horizontal adduction.

&choice48d= abduction.
&qNum49= 49
&category49= CD

&domain49= D3
&reasoning49= R4

&answer49= 3
&q49= A patient is unable to bring her foot up on the next step during a
training session on stair climbing. The physical therapist's BEST course of
action to promote learning of this task is to have the patient:

&choice49a= practice marching in place in the parallel bars.

&choice49b= practice standing-up from half-kneeling.

&choice49c= step up onto a low step while in the parallel bars.

&choice49d= balance on the stairs while the therapist passively brings the foot
up.
&qNum50= 50

&category50= CA
&domain50= D4

&reasoning50= R3
&answer50= 4

&q50= A patient is transferred to a burn clinic with deep partial-thickness

burns over 30%25 of the body. Healing of this type of burn is characterized by:
&choice50a= blisters and minimal edema with spontaneous healing.

&choice50b= depressed skin area that heals with grafting and scarring.
&choice50c= moderate edema with spontaneous healing and minimal grafting.

&choice50d= marked edema with slow healing and extensive hypertrophic scarring.
&qNum51= 51
&category51= CE

&domain51= D6
&reasoning51= R2

&answer51= 3
&q51= A patient with a complete spinal cord injury at the T6 level is being
discharged home after a 2 month course of rehabilitation. In preparation for
discharge, the rehabilitation team visits the home and finds 3 standard height
steps going into his home. A ramp will have to be constructed for wheelchair
access. The recommended length of his ramp should be:

&choice51a= 60 inches (5 feet).

&choice51b= 192 inches (16 feet).

&choice51c= 252 inches (21 feet).

&choice51d= 120 inches (10 feet).
&qNum52= 52

&category52= CC
&domain52= D1

&reasoning52= R3
&answer52= 2

&q52= The one pulmonary change following a left pneumonectomy that is NOT
expected is:
&choice52a= decreased residual volume.

&choice52b= increased tidal volume.

&choice52c= deviated trachea toward the left.

&choice52d= decreased breath sounds on the left.

&qNum53= 53
&category53= CC

&domain53= D1
&reasoning53= R4

&answer53= 4
&q53= A patient with diagnosis of left-sided heart failure (CHF), Class II, is
referred for physical therapy. With exercise, this patient can be expected to
demonstrate:

&choice53a= severe, uncomfortable chest pain with shortness of breath.

&choice53b= weight gain with dependent edema.

&choice53c= anorexia, nausea with abdominal pain and distention.

&choice53d= dyspnea with fatigue and muscular weakness.
&qNum54= 54

&category54= CD
&domain54= D2

&reasoning54= R4
&answer54= 1

&q54= A physical therapist is instructing a student in proper positioning to

prevent the typical contractures in the patient with a transfemoral amputation.
The therapist stresses positioning the patient in:
&choice54a= prone lying with the residual limb in neutral rotation.

&choice54b= a wheelchair with a gel cushion and adductor roll.

&choice54c= supine-lying with the residual limb resting on a small pillow.

&choice54d= sidelying on the residual limb.

&qNum55= 55
&category55= CC

&domain55= D5
&reasoning55= R5

&answer55= 3
&q55= A physical therapist receives a referral to ambulate a patient who is
insulin dependent. In a review of her medical record, the therapist notices her
blood glucose level for that day is 310 mg/dL. The therapist's BEST course of
action is to:

&choice55a= refrain from ambulating the patient, reschedule for tomorrow before
other therapies.
&choice55b= ambulate the patient as planned but monitor closely for signs of
exertional intolerance.

&choice55c= postpone therapy and consult with the nurse as soon as possible.
&choice55d= talk to the nurse about walking the patient later on that day after
lunch.
&qNum56= 56

&category56= CC
&domain56= D3

&reasoning56= R5
&answer56= 4

&q56= A physical therapy plan of care for a newborn with Erb-Klumpke's Palsy
would NOT include:
&choice56a= partial immobilization of limb across abdomen.

&choice56b= gentle ROM after immobilization.

&choice56c= age appropriate movements of the upper extremity.

&choice56d= splinting the shoulder in abduction and internal rotation.

&qNum57= 57
&category57= CD

&domain57= D2
&reasoning57= R3

&answer57= 4
&q57= A six month-old child was referred to physical therapy for right
torticollis. The MOST effective method to stretch the muscle is by positioning
the head and neck into:

&choice57a= flexion, left side-bending, and left rotation.

&choice57b= extension, right side-bending, and left rotation.

&choice57c= flexion, right side-bending, and left rotation.

&choice57d= extension, left side-bending, and right rotation.
&qNum58= 58

&category58= CF
&domain58= D6

&reasoning58= R5
&answer58= 1

&q58= A student is on final internship following completion of academic

training. The student is overheard discussing a patient's history in the
elevator. When the therapist later points this out the student claims to be
unaware of any hospital policy regarding confidentiality. The therapist's BEST
analysis of this situation is that:
&choice58a= the student should be expected to value patient confidentiality.

&choice58b= compliance was not a realistic expectation since the student had
recently arrived at this facility.
&choice58c= now that the student is aware of confidentiality restrictions
compliance is expected.

&choice58d= since this is not strictly part of the professional code of ethics
the student should not be expected to demonstrate adherence to this concept.
&qNum59= 59
&category59= CF

&domain59= D6
&reasoning59= R2

&answer59= 3
&q59= A physical therapist is performing clinical research in which a specific
myofascial technique is applied to a patient with chronic back pain. She is
using a single case experimental design with an A-B-A-B format. Her research
hypothesis states that pain rating scores will decrease with the treatment
intervention. Acceptance of this hypothesis would be indicated if:

&choice59a= B is equal to A.
&choice59b= B is greater than A, at the 1.0 level.

&choice59c= B is less than A.

&choice59d= B is greater than A, at the .05 level.
&qNum60= 60

&category60= CD
&domain60= D3

&reasoning60= R4
&answer60= 2

&q60= A patient is recovering from stroke and demonstrates good recovery in his
lower extremity (out-of-synergy movement control). Timing deficits are apparent
during gait. Isokinetic training can be used to improve:
&choice60a= rate control at slow movement speeds.

&choice60b= rate control at varying movement speeds.

&choice60c= both reaction and movement times.

&choice60d= initiation of movement.

&qNum61= 61
&category61= CD

&domain61= D2
&reasoning61= R3

&answer61= 1
&q61= A 72 year-old patient with a transfemoral amputation is having difficulty
wrapping the residual limb. The therapist's BEST course of action is to:

&choice61a= use a shrinker.

&choice61b= redouble efforts to teach proper ace bandage wrapping.

&choice61c= apply a temporary prosthesis immediately.

&choice61d= consult with the vascular surgeon about the application of an Unna's
paste dressing.
&qNum62= 62

&category62= CD
&domain62= D1

&reasoning62= R3
&answer62= 4

&q62= A patient with peripheral vascular disease has been referred for
conditioning exercise. The patient demonstrates moderate claudication pain in
both legs following a 12 minute walking test. The MOST appropriate exercise
frequency and duration for this patient is:
&choice62a= 3 times/week, 30 minutes/session.

&choice62b= 3 times/week, 60 minutes/session.

&choice62c= 2 times/week, BID 20 minutes/session.

&choice62d= 5 times/week, BID 10 minutes/session.

&qNum63= 63
&category63= CC

&domain63= D2
&reasoning63= R5

&answer63= 3
&q63= The radiographic view shown in the diagram that demonstrates the observed
spinal defect is:

&choice63a= lateral.
&choice63b= frontal.

&choice63c= oblique.
&choice63d= posterolateral.
&qNum64= 64

&category64= CC
&domain64= D5

&reasoning64= R5
&answer64= 3

&q64= A physical therapist is working with a patient with metastatic breast

cancer who has been told that she has only months to live. She is quite angry
and disruptive during therapy. What is the MOST appropriate intervention for
this patient?
&choice64a= forbid all expressions of anger as she is only hurting herself.

&choice64b= provide honest, accurate information about her illness and rehab
plan of care.
&choice64c= allow the patient to express her anger while refocusing her on
effective coping strategies.

&choice64d= provide opportunities for the patient to question her impending

death but limit all expressions of anger.
&qNum65= 65
&category65= CC

&domain65= D2
&reasoning65= R4

&answer65= 2
&q65= A patient sustained a right-sided injury to her back while playing golf.
She was driving the ball when she felt an immediate sharp pain in her right low
back. She states that in the morning she is stiff and her pain eases after
taking a shower. Based on the above information, the source of the pain is MOST
likely:

&choice65a= nerve root compression.

&choice65b= facet joint impingement.

&choice65c= a stress fracture.

&choice65d= diminished blood supply to the spinal cord.
&qNum66= 66

&category66= CF
&domain66= D6

&reasoning66= R5
&answer66= 4

&q66= At 10 a.m. a physical therapist working on an inpatient spinal cord unit

is treating a patient with paraplegia. The therapist smells alcohol on the
patient's breath. The patient is having difficulty accomplishing a bed-to-chair
transfer that was previously done without assistance. In this case the therapist
should:
&choice66a= confront the patient and ask if he has been drinking.

&choice66b= document and report suspicions of alcoholism to the rehabilitation

team at the weekly meeting.
&choice66c= question the patient's family about any history of alcoholism.

&choice66d= document the findings and immediately inform the patient's physician
and nurse in charge.
&qNum67= 67
&category67= CD

&domain67= D3
&reasoning67= R4

&answer67= 3
&q67= A patient with right hemiparesis has difficulty clearing the more affected
foot during the swing phase of gait. An appropriate physical therapy
intervention for the right lower extremity might include:

&choice67a= sitting on a therapy ball, alternating lateral side steps and back
to neutral.
&choice67b= pushing backward while sitting on a rolling stool.

&choice67c= forward step-ups in standing using graduated height steps.

&choice67d= assumption of bridging.
&qNum68= 68

&category68= CE
&domain68= D6

&reasoning68= R3
&answer68= 1

&q68= A patient has a complete spinal cord injury at the level of L1. His
primary goal is to walk again. The physical therapist decides it would be MOST
appropriate to recommend that this patient use:
&choice68a= a reciprocating gait orthosis and walker.

&choice68b= a wheelchair, because ambulation is unrealistic.

&choice68c= bilateral KAFOs with thoracolumbosacral extension control.

&choice68d= bilateral AFOs and Lofstrand crutches.

&qNum69= 69
&category69= CC

&domain69= D1
&reasoning69= R5

&answer69= 2
&q69= A patient is four weeks post myocardial infarction. Resistive training
using weights to improve muscular strength and endurance is appropriate:

&choice69a= if exercise intensities are kept below 85%25 maximal voluntary

contraction.
&choice69b= if exercise capacity is greater than 5 METs with no anginal
symptoms/ST segment depression.

&choice69c= during all phases of rehabilitation if judicious monitoring of HR is

used.
&choice69d= only during post-acute phase 3 cardiac rehabilitation.
&qNum70= 70

&category70= CE
&domain70= D6

&reasoning70= R2
&answer70= 1

&q70= A patient diagnosed with lumbar spinal root impingement, due to narrowing
of the intervertebral foramen, has been referred to physical therapy for
mechanical traction. What is the lowest percentage of body weight that should be
considered for the initial traction force?
&choice70a= 25%25.

&choice70b= 15%25.
&choice70c= 55%25.

&choice70d= 85%25.
&qNum71= 71
&category71= CD

&domain71= D5
&reasoning71= R4

&answer71= 2
&q71= A fitness instructor who is 8 months pregnant was recently diagnosed with
placenta previa. The therapist's most important instructions to her are to:

&choice71a= continue proper breathing and discontinue pelvic floor exercises.

&choice71b= continue pelvic floor and discontinue any abdominal exercises.

&choice71c= continue with partial sit-ups and pelvic floor exercises.

&choice71d= continue with training in a therapeutic pool at waist-deep level.
&qNum72= 72

&category72= CA
&domain72= D2

&reasoning72= R1
&answer72= 3

&q72= It is important to note the status of the pars interarticularis on the X-

ray report. A problem with this part of the vertebra could possibly lead to:
&choice72a= spondylolysis with early degeneration of the vertebra.

&choice72b= spondylolysis resulting in early nerve root compression.

&choice72c= spondylolisthesis with possible slippage of the vertebral body.

&choice72d= spondylolisthesis with discal herniation.

&qNum73= 73
&category73= CD

&domain73= D3
&reasoning73= R3

&answer73= 2
&q73= The most appropriate physical therapy intervention to use during class for
a 9 year-old child with decreased sitting balance, but normal tone would be:

&choice73a= sitting on a therapy ball while performing desk-top activities.

&choice73b= sitting in an adaptive wheelchair with lateral supports and lap
tray.

&choice73c= standing on a static prone-stander with lap tray.

&choice73d= sitting in an appropriate height chair with with lateral postural
supports.
&qNum74= 74

&category74= CD
&domain74= D3

&reasoning74= R4
&answer74= 3

&q74= A patient with Parkinson's disease demonstrates a highly stereotyped gait

pattern characterized by impoverished movement. The intervention that would be
LEAST appropriate to use with this patient is:
&choice74a= standing, using body weight support from a harness.

&choice74b= sidestepping and cross stepping using light touch-down support of

hands.
&choice74c= gait training using a rolling walker.

&choice74d= rhythmic stepping using a motorized treadmill.

&qNum75= 75
&category75= CC

&domain75= D3
&reasoning75= R5

&answer75= 4
&q75= A patient is recovering from a right CVA. She tells the physical therapist
that she is thirsty and asks for a can of soda. When the therapist gives her the
can and instructs her to open it, she is unable to complete the task. Later
after the treatment session when she is alone, the therapist observes her
drinking from the can. The therapist suspects she may have a primary deficit in:

&choice75a= anosognosia.
&choice75b= ideational apraxia.

&choice75c= unilateral neglect.

&choice75d= ideomotor apraxia.
&qNum76= 76

&category76= CF
&domain76= D6

&reasoning76= R4
&answer76= 1

&q76= Peer review is an important professional activity. Recently, physical

therapists have been the focus of vigorous peer review due to increasing
financial pressure imposed by third party payers. An inappropriate use of peer
review is to determine whether care:
&choice76a= should be paid for by a third party payer.

&choice76b= was appropriate and required the skill of a physical therapist.

&choice76c= was cost effective.

&choice76d= was provided by the appropriate personnel.

&qNum77= 77
&category77= CB

&domain77= D1
&reasoning77= R3

&answer77= 2
&q77= A 62 year-old patient has chronic obstructive pulmonary disease. Pulmonary
test results include all of the following except increased:

&choice77a= total lung capacity.

&choice77b= FEV1/FVC ratio.

&choice77c= residual volume.

&choice77d= functional residual capacity.
&qNum78= 78

&category78= CE
&domain78= D6

&reasoning78= R3
&answer78= 1

&q78= A patient with a transfemoral amputation has been fitted with a prosthesis
that utilizes a quadrilateral socket. During prosthetic checkout the physical
therapist should examine pressure tolerance areas of the residual limb with the
device off. These include:
&choice78a= ischial tuberosity and lateral sides of residual limb.

&choice78b= adductor magnus and medial side of residual limb.

&choice78c= distolateral end of femur and ischial seat.

&choice78d= perineal area and medial side of the residual limb.

&qNum79= 79
&category79= CC

&domain79= D5
&reasoning79= R5

&answer79= 4
&q79= A patient recently diagnosed with fibromyalgia and chronic fatigue immune
system dysfunction demonstrates a loss of interest in all activities and
outlets. She is not eating well and is having problems sleeping. Recently she
has talked about suicide as her only hope. The therapist's BEST course of action
is to:

&choice79a= present a positive attitude and tell her she will feel better soon.
&choice79b= refer her to a fibromyalgia support group.

&choice79c= refer her to an occupational therapy intervention group.

&choice79d= immediately contact her primary physician.
&qNum80= 80

&category80= CD
&domain80= D2

&reasoning80= R3
&answer80= 3

&q80= A 77 year-old patient has been confined to bed for a period of 2 months
and now demonstrates limited ROM in both lower extremities. Range in hip flexion
is 5º to 115º and knee flexion is 10º to 120º. The MOST appropriate intervention
to improve flexibility and ready this patient for standing is:
&choice80a= manual passive stretching, 10 repetitions each joint, 2 times a day.

&choice80b= tilt table standing, 20 minutes, daily.

&choice80c= mechanical stretching using traction and 5 lb. weights, 2 hours,
twice daily.

&choice80d= hold-relax techniques followed by passive ROM, 10 repetitions, 2

times a day.
&qNum81= 81
&category81= CC

&domain81= D2
&reasoning81= R1

&answer81= 2
&q81= A retired carpenter has had long term lumbar pain and has been diagnosed
with degenerative joint disease (DJD) of his lumbar facet joints. He complains
of numbness, paresthesias and weakness of his bilateral lower extremities which
increase with extended positions or walking greater than 100 feet. His pain
persists for hours after assuming a resting position. He reports he can ride his
stationary bike for 30 minutes without any problems. Physical therapy
intervention should include:

&choice81a= increasing cardiovascular endurance as the result of degenerative

arthritis.
&choice81b= stretching and limiting extended spinal positions as the result of
spinal stenosis.

&choice81c= abdominal and back extension strengthening as the result of

spondylolysis.
&choice81d= traction and limitation of weight bearing positions as the result of
discal dysfunction.
&qNum82= 82

&category82= CF
&domain82= D6

&reasoning82= R5
&answer82= 1

&q82= A physical therapist is instructing a kindergarten teacher in a behavior

management program for a child with developmental disabilities who has been
mainstreamed into the regular classroom. The therapist requests that the teacher
encourage the child to maintain a head retracted sitting position in the class.
The strategy that would be MOST helpful in this situation is to:
&choice82a= have the teacher give a smile sticker when the child sits with head
retracted.

&choice82b= train the teacher in manual handling techniques to assist the child
in head retraction.
&choice82c= have the teacher issue a verbal reprimand whenever the child slumps
in the chair.

&choice82d= have the teacher encourage the classmates to tell the child to sit
up in the chair.
&qNum83= 83
&category83= CF

&domain83= D6
&reasoning83= R4

&answer83= 4
&q83= A physical therapist has recently attended a professional conference on
myofascial release. The therapist has been asked to share this information with
PT colleagues during an inservice session. The therapist's BEST initial activity
is to:

&choice83a= ask colleagues to select a suitable time and place for the physical
therapist's lecture.
&choice83b= provide a comprehensive packet of handouts in advance of the first
inservice session.

&choice83c= organize a PowerPoint presentation and prepare a handout.

&choice83d= survey colleagues about their current level of knowledge using a
brief questionnaire.
&qNum84= 84

&category84= CC
&domain84= D3

&reasoning84= R1
&answer84= 2

&q84= A patient who is 3 months post CVA is being treated in physical therapy
for adhesive capsulitis of the right shoulder, Today, the patient complains of
new symptoms including burning pain in the right upper extremity that is
increased by the dependent position along with lowered pain threshold and
heightened sensitivity to light touch. The right hand is mildly edematous and
the skin is dry and warm to touch. The intervention that should be AVOIDED in
this case is:
&choice84a= stress loading activities with weightbearing on the affected limb.

&choice84b= passive manipulation of the shoulder.

&choice84c= positional elevation, compression, and gentle massage.

&choice84d= active assistive ROM exercises of the shoulder.

&qNum85= 85
&category85= CA

&domain85= D3
&reasoning85= R4

&answer85= 4
&q85= To prepare a patient with an incomplete T12 paraplegia for ambulation with
crutches, the upper quadrant muscles that would be MOST important to strengthen
include the:

&choice85a= upper trapezius, rhomboids, and levator scapulae.

&choice85b= deltoid, triceps, and wrist flexors.

&choice85c= middle trapezius, latissimus dorsi, and triceps.

&choice85d= lower trapezius, latissimus dorsi, and triceps.
&qNum86= 86

&category86= CA
&domain86= D1

&reasoning86= R2
&answer86= 3

&q86= A patient is recovering at home from a myocardial infarction and

percutaneous transluminal coronary angioplasty. The physical therapist decides
to use pulse oximetry to monitor his responses to exercise and activity. An
acceptable oxygen saturation rate (SaO2) to maintain throughout the exercise
period is:
&choice86a= 82%25.

&choice86b= 75%25.
&choice86c= 92%25.

&choice86d= 85%25.
&qNum87= 87
&category87= CE

&domain87= D6
&reasoning87= R4

&answer87= 2
&q87= Following major surgery of the right hip, a patient ambulates with a
Trendelenburg gait. Examination of the right hip reveals abductor weakness and
ROM limitations in flexion and external rotation. As part of the intervention,
the therapist opts to include functional electrical stimulation to help improve
the gait pattern. Stimulation should be initiated for the:

&choice87a= right abductors during swing on the right.

&choice87b= rIght abductors during stance on the right.

&choice87c= left abductors during stance on the right.

&choice87d= left abductors during swing on the right.
&qNum88= 88

&category88= CA
&domain88= D2

&reasoning88= R3
&answer88= 4

&q88= A patient was referred to physical therapy complaining of loss of cervical

AROM. His X-rays showed DJD at the uncinate processes in the cervical spine. The
motion that would be MOST restricted would be:
&choice88a= flexion.

&choice88b= extension.
&choice88c= rotation.

&choice88d= side-bending.
&qNum89= 89
&category89= CC

&domain89= D2
&reasoning89= R4

&answer89= 1
&q89= An electrician is unable to pull wire overhead due to a painless inability
to reach past 80 degrees of right shoulder abduction. The 'empty can' test was
positive. Early subacute physical therapy intervention should focus on:

&choice89a= active assistive pulley exercises.

&choice89b= modalities to reduce pain and inflammation.

&choice89c= grade IV translatory glenohumeral mobilizations.

&choice89d= resistance exercises for the affected muscles.
&qNum90= 90

&category90= CF
&domain90= D6

&reasoning90= R2
&answer90= 3

&q90= Two therapists are asked to perform a test on the same group of patients
using the Functional Independence Measure (FIM). The results of both sets of
measurements reveal differences in therapists' scores but not in the repeat
measurements. This is indicative of a problem in:
&choice90a= concurrent validity.

&choice90b= intrarater reliability.

&choice90c= interrater reliability.

&choice90d= construct validity.

&qNum91= 91
&category91= CC

&domain91= D3
&reasoning91= R5

&answer91= 3
&q91= A patient is recovering from a complete spinal cord injury with C5
tetraplegia. The physical therapist is performing PROM exercises on the mat when
the patient complains of a sudden pounding headache and double vision. The
therapist notices he is sweating excessively, and determines his BP is 240/95.
The therapist's BESTcourse of action is to:

&choice91a= lie the patient down immediately, elevate his legs, then call for a
nurse.
&choice91b= place the patient in a supported sitting position and continue to
monitor BP before calling for help.

&choice91c= sit the patient up, check/empty catheter bag, and then call for
emergency medical assistance.
&choice91d= lie the patient down, open his shirt, and monitor his respiratory
rate closely.
&qNum92= 92

&category92= CE
&domain92= D6

&reasoning92= R4
&answer92= 4

&q92= A patient presents with a flatfoot deformity with abduction of the

forefoot in relation to the weight bearing line. The forefoot is inverted to the
varus position when inspected from the frontal plane. Corrections for this foot
deformity would NOT include a:
&choice92a= UCBL insert.

&choice92b= scaphoid pad.

&choice92c= Thomas heel.

&choice92d= metatarsal bar.

&qNum93= 93
&category93= CD

&domain93= D4
&reasoning93= R3

&answer93= 2
&q93= A 10-year old child with full thickness burns to both arms is developing
hypertrophic scars The BEST intervention to manage these scars is:

&choice93a= primary excision followed by autografts.

&choice93b= application of custom made pressure garments.

&choice93c= application of compression wraps.

&choice93d= application of occlusive dressings.
&qNum94= 94

&category94= CC
&domain94= D1

&reasoning94= R3
&answer94= 1

&q94= A patient with COPD has developed respiratory acidosis. The physical
therapist instructs a PT student participating in the care to monitor the
patient closely for:
&choice94a= disorientation.

&choice94b= tingling or numbness of the extremities.

&choice94c= dizziness or lightheadedness.

&choice94d= hyperreflexia.
&qNum95= 95
&category95= CD

&domain95= D2
&reasoning95= R4

&answer95= 4
&q95= A computer programmer who in her second trimester of pregnancy was
referred to physical therapy with complaints of tingling and loss of strength in
both of her hands. Her symptoms are exacerbated if she is required to use her
keyboard at work for longer than 20 minutes. The MOST appropriate physical
therapy intervention would include:

&choice95a= dexamethasone phonophoresis to the carpal tunnel.

&choice95b= ice packs to the carpal tunnel.

&choice95c= hydrocortisone iontophoresis to the volar surfaces of both wrists.

&choice95d= placing the wrists in resting splints.
&qNum96= 96

&category96= CE
&domain96= D6

&reasoning96= R3
&answer96= 2

&q96= A physical therapist is working in an elementary school system with a

child who demonstrates moderate to severe extensor spasticity and limited head
control. The MOST appropriate positioning device would be a:
&choice96a= wheelchair with adductor pommel.

&choice96b= wheelchair with a back wedge and head supports.

&choice96c= supine stander with abduction wedge.

&choice96d= prone stander with abduction wedge.

&qNum97= 97
&category97= CA

&domain97= D3
&reasoning97= R1

&answer97= 3
&q97= A physical therapist volunteered to teach a stroke education class on
positioning techniques for family members and caregivers. At the conclusion of
the class, caregivers will be expected to utilize the skills taught. The BEST
choice of teaching method is to utilize:

&choice97a= shoulder depressors and triceps, keeping the hands flexed to protect
tenodesis grasp.
&choice97b= pectoral muscles to stabilize elbows in extension and scapular
depressors to lift the trunk.

&choice97c= shoulder extensors, external rotators, and anterior deltoid to

position and lock the elbow.
&choice97d= serratus anterior to elevate the trunk with elbow extensors
stabilizing.
&qNum98= 98

&category98= CF
&domain98= D6

&reasoning98= R4
&answer98= 1

&q98= A physical therapist volunteered to teach a stroke education class on

positioning techniques for family members and caregivers. At the conclusion of
the class, caregivers will be expected to utilize the skills taught. The BEST
choice of teaching method is to utilize:
&choice98a= therapist demonstration, caregiver practice, and follow-up
individual discussion.

&choice98b= therapist demonstration with caregiver role-playing patient.

&choice98c= multimedia (PowerPoint and handouts) that accompany an oral
presentation.

&choice98d= question and answer addressing the specific individual concerns of

the caregivers
&qNum99= 99
&category99= CF

&domain99= D6
&reasoning99= R3

&answer99= 1
&q99= A patient with active tuberculosis is referred for physical therapy. Which
of the following is NOT an appropriate precaution?

&choice99a= have the patient wear a tight fitting mask while being treated in
his room.
&choice99b= wash hands upon entering and leaving the patient's room.

&choice99c= wear a tight fitting mask while treating the patient.

&choice99d= insure that the patient is in a private, negative pressurized room.
&qNum100= 100

&category100= CC
&domain100= D2

&reasoning100= R1
&answer100= 2

&q100= A twelve-year old has been referred to a physical therapy clinic for
treatment of patellar tendinitis. The examination reveals that she is unable to
hop on the affected lower extremity due to pain. The physical therapist decides
to refer her back to her pediatrician for an x-ray of her knee. The patient
returns for therapy with the x-ray shown in the figure. The therapist's initial
intervention should focus on:
&choice100a= aggressive plyometric exercises with focus on endurance
training.

&choice100b= Iontophoresis using dexamethasone and patient education

regarding avoidance of squatting and jumping activities.
&choice100c= fitting patient with crutches for non weight-bearing
ambulation and initiation of hydrocortisone phonophoresis.

&choice100d= patient education regarding avoiding falls onto her affected

knee and open chain knee extension exercises to improve quadriceps strength.
qNum101= 101
&category101= CA

&domain101= D4
&reasoning101= R3

&q101= A patient with a history of low back pain has been receiving
physical therapy for 12 weeks. The patient is employed as a loading dockworker.
He performs repetitive lifting and carrying of boxes weighing between 15 and 30
pounds. An appropriate engineering control to reduce the stresses of lifting and
carrying would be to:
&choice101a= use job rotation.

&choice101b= issue the employee a back support belt.

&choice101c= require the worker to attend a class in using correct body
mechanics while performing the job.

&choice101d= provide a two-wheel handcart for use in moving the boxes.

&answer101= 4
&qNum102= 102

&category102= CA
&domain102= D2

&reasoning102= R4
&q102= Common compensatory postures the therapist would expect for a
patient diagnosed with fixed severe forefoot varus are:

&choice102a= subtalar pronation and medial rotation of the tibia.

&choice102b= excessive ankle dorsiflexion and medial rotation of the femur.

&choice102c= excessive midtarsal supination and lateral rotation of the

tibia.
&choice102d= toeing-in and lateral rotation of the femur.

&answer102= 1
&qNum103= 103
&category103= CD

&domain103= D2
&reasoning103= R5

&q103= A patient has undergone surgery and subsequent immobilization to

stabilize the olecranon process. The patient now exhibits an elbow flexion
contracture. In this case, an absolute CONTRAINDICATION for joint mobilization
would be:
&choice103a= soft end-feel.

&choice103b= springy end-feel.

&choice103c= empty end-feel.

&choice103d= firm end-feel.

&answer103= 3
&qNum104= 104

&category104= CE
&domain104= D6

&reasoning104= R1
&answer104= 3

&q104= A physical therapist observes a physical therapist assistant

ambulating a patient for the first time after a left total hip replacement. The
patient is using crutches and is practicing on a level surface. The PTA should
guard the patient by standing slightly:
&choice104a= behind and to the intact side, one hand on the gait belt.

&choice104b= in front of the patient, walking backward, with one hand on

the gait belt and one hand on the shoulder.
&choice104c= behind and to the left side, one hand on the gait belt.

&choice104d= behind the patient with both hands on the gait belt.
&qNum105= 105
&category105= CE

&domain105= D6
&reasoning105= R5

&answer105= 1
&q105= A patient with left hemiplegia exhibits mild flexor pattern of
shoulder internal rotation with elbow and wrist flexion. Following initial
interventions, the therapist decides to use functional electrical stimulation to
help reach and grasp ability. The optimal stimulation pattern would be:

&choice105a= elbow and wrist extensors simultaneously.

&choice105b= elbow extensors followed by wrist extensors.

&choice105c= elbow extensors and finger flexors simultaneously.

&choice105d= elbow extensors followed by finger flexors.
&qNum106= 106

&category106= CD
&domain106= D2

&reasoning106= R3
&answer106= 4

&q106= A patient has lumbar spinal stenosis encroaching on the spinal cord.
The physical therapist should educate the patient to AVOID:
&choice106a= bicycling on hills

&choice106b= use of a rowing machine.

&choice106c= Tai Chi activities.

&choice106d= swimming using a crawl stroke.

&qNum107= 107
&category107= CE

&domain107= D6
&reasoning107= R1

&answer107= 2
&q107= A patient with post-polio syndrome is referred for outpatient
physical therapy with symptoms of myalgia and increasing fatigue. The patient
has been wearing a KAFO 10 years. When walking, the therapist observes the
patient rise up over the sound limb to advance the orthotic limb forward. The
BEST intervention is to provide:

&choice107a= a shoe lift on the orthotic side.

&choice107b= a shoe lift on the sound side.

&choice107c= an electric wheelchair with joystick.

&choice107d= a manual wheelchair with reclining back and elevating
legrests.
&qNum108= 108

&category108= CE
&domain108= D6

&reasoning108= R2
&answer108= 2

&q108= An athlete presents with pain (5/10) and muscle spasm of the left
upper trapezius as the result of a strain which occurred two weeks previously.
The therapist elects to use a combination of ultrasound and electrical
stimulation. The MOST appropriate treatment parameters would be:
&choice108a= continuous ultrasound with electrical stimulation at 50%25
duty cycle.

&choice108b= continuous ultrasound and electrical stimulation.

&choice108c= pulsed ultrasound with continuous electrical stimulation.

&choice108d= pulsed ultrasound with electrical stimulation at 50%25 duty

cycle.
&qNum109= 109
&category109= CB

&domain109= D4
&reasoning109= R4

&answer109= 1
&q109= During the initial examination of a client with an ulcer superior to
the medial malleolus the physical therapist notes hemosiderinosis and
liposclerosis. There are no signs of infection, there is minimal drainage,
granulation is present, and the wound bed is clean except for a small amount of
yellow fibrin deposits. The next action to take is:

&choice109a= perform an ankle-brachial index.

&choice109b= apply a four-layer bandaging system.

&choice109c= apply an Unna boot.

&choice109d= debride the wound with whirlpool irrigation.
&qNum110= 110

&category110= CC
&domain110= D2

&reasoning110= R1
&answer110= 4

&q110= An eleven-year-old was referred to physical therapy with complaints

of vague pain at his right hip and thigh which radiates to the knee. AROM is
restricted in abduction, flexion, and internal rotation. A gluteus medius gait
was observed with ambulation for 100 feet. Appropriate PT intervention would
include:
&choice110a= open-chain strengthening of his right hip abductors and
internal rotators for avascular necrosis of the hip.

&choice110b= hip joint mobilization to improve the restriction in motion as

the result of Legg-Calve-Perthe's disease.
&choice110c= orthoses to control lower extremity position as the result of
femoral anteversion.

&choice110d= closed-chain partial weight-bearing lower extremity exercises

for slipped capital femoral epiphysis.
&qNum111= 111
&category111= CF

&domain111= D6
&reasoning111= R2

&answer111= 3
&q111= A researcher states that he expects that there will be no
significant difference between 20 and 30 year-olds after a 12 week exercise
training program using exercise heart rates and myocardial oxygen consumption as
measures of performance. The kind of hypothesis that is being used in this study
is a (an):

&choice111a= experimental hypothesis.

&choice111b= research hypothesis.

&choice111c= null hypothesis.

&choice111d= directional hypothesis.
&qNum112= 112

&category112= CF
&domain112= D6

&reasoning112= R5
&answer112= 1

&q112= A physical therapist was treating a patient on the ward. The

patient in the next bed was uncomfortable and asked the therapist to reposition
one leg. The therapist placed the leg on 2 pillows as requested by the patient.
Unknown to the therapist, this patient had a femoral artery graft 2 days
previously. As a result, the graft became occluded and the patient was rushed to
surgery for a replacement. The patient claimed the therapist placed the leg too
high on the pillows causing the occlusion of the original graft and sued for
malpractice. The hospital administrator and legal team decided:
&choice112a= the therapist was functioning outside the common protocols of
the hospital, and therefore did not support the actions of the physical
therapist.

&choice112b= the physical therapist was functioning according to common

protocols of the institution and thus supported the actions of the therapist.
&choice112c= it was the patient's fault for requesting the position change
and therefore supported the action of the physical therapist.

&choice112d= to counter-sue, as the patient was responsible for requesting

the position change.
&qNum113= 113
&category113= CD

&domain113= D3
&reasoning113= R4

&answer113= 4
&q113= A patient has a 3 year history of multiple sclerosis. One of her
disabling symptoms is a persistent and severe diplopia which leaves her
frequently nauseated and immobile. An appropriate intervention strategy to
assist her in successfully participating in rehabilitation would be to:

&choice113a= give her special glasses which magnify images.

&choice113b= have her close her eyes and practice movements without visual
guidance.

&choice113c= give her a soft neck collar to limit head and neck movements.
&choice113d= patch one eye.
&qNum114= 114

&category114= CD
&domain114= D3

&reasoning114= R1
&answer114= 2

&q114= The MOST appropriate positioning strategy for a patient recovering

from acute stroke who is in bed and demonstrates a flaccid upper extremity is:
&choice114a= supine with the affected arm flexed with hand resting on
stomach.

&choice114b= sidelying on the sound side with the affected shoulder

protracted, and arm extended resting on a pillow.
&choice114c= supine with the affected elbow extended and arm positioned
close to the side of the trunk.

&choice114d= sidelying on the sound side with the affected upper extremity
flexed overhead.
&qNum115= 115
&category115= CC

&domain115= D4
&reasoning115= R3

&answer115= 2
&q115= A patient presents with a large plantar ulcer that will be debrided.
The foot is cold, pale, and painless. The condition that would most likely
result in this clinical presentation is:

&choice115a= chronic arterial insufficiency.

&choice115b= chronic venous insufficiency.

&choice115c= acute arterial insufficiency.

&choice115d= deep venous thrombosis.
&qNum116= 116

&category116= CE
&domain116= D6

&reasoning116= R2
&answer116= 3

&q116= A patient has been referred for physical therapy following a

fracture of the femur six months ago. The cast was removed, but the patient was
unable to volitionally contract the quadriceps. The therapist decides to apply
electrical stimulation to the quadriceps muscle. The MOST appropriate electrode
size and placement would consist of:
&choice116a= large electrodes, closely spaced.

&choice116b= small electrodes, closely spaced.

&choice116c= large electrodes, widely space.

&choice116d= small electrodes, widely spaced.

&qNum117= 117
&category117= CC

&domain117= D4
&reasoning117= R4

&answer117= 2
&q117= While setting a patient up for cervical traction, the physical
therapist notices a mole that is brown and black with diffuse edges on the
patient's neck. The therapist should:

&choice117a= discontinue treatment and refer the patient back to the

physician.
&choice117b= continue with the traction and report the findings to the
physician immediately.

&choice117c= continue the treatment; however, document the skin condition.

&choice117d= tell the patient to have the physician inspect the mole.
&qNum118= 118

&category118= CC
&domain118= D3

&reasoning118= R4
&answer118= 4

&q118= A patient suffered a severe traumatic brain injury and multiple

fractures following a motor vehicle accident. He is recovering in the intensive
care unit. The physical therapy referral requests PROM and positioning. On day 1
he is semi-alert and drifts in and out while the therapist is working with him.
On day 2 he is less alert and his status is changing. Signs and symptoms that
would require emergency consultation with a physician include:
&choice118a= developing irritability with increasing symptoms of
photophobia, disorientation and restlessness.

&choice118b= decreasing function of cranial nerves IV, VI, and VII.

&choice118c= positive Kernig's sign with developing nuchal rigidity.

&choice118d= decreasing consciousness with slowing of pulse and Cheyne-

Stokes respirations.
&qNum119= 119
&category119= CA

&domain119= D3
&reasoning119= R1

&answer119= 2
&q119= A physical therapist receives a referral for a patient with
neurapraxia involving the ulnar nerve secondary to an elbow fracture. Based on
knowledge of this condition, the therapist expects:

&choice119a= regeneration is likely in 6-8 months.

&choice119b= nerve dysfunction will be rapidly reversed, generally in 2-3
weeks.

&choice119c= regeneration is likely after 1-1½ years.

&choice119d= regeneration is unlikely because surgical approximation of the
nerve ends was not performed.
&qNum120= 120

&category120= CD
&domain120= D3

&reasoning120= R5
&answer120= 4

&q120= After three weeks of teaching a patient how to ambulate with

bilateral crutches and a touch down gait, the physical therapist determines the
most appropriate kind of feedback to give to the patient is:
&choice120a= immediate feedback given after each practice trial.

&choice120b= intermittent feedback given at scheduled intervals, every

other practice trial.
&choice120c= continuous feedback with ongoing verbal cuing during gait.

&choice120d= occasional feedback given when consistent errors appear.

&qNum121= 121
&category121= CC

&domain121= D5
&reasoning121= R4

&answer121= 4
&q121= A home health physical therapist is treating an elderly patient. On
this day he is confused with shortness of breath and generalized weakness. Given
his history of hypertension and hyperlipidemia, the therapist suspects:

&choice121a= his mental changes are indicative of early Alzheimer's

disease.
&choice121b= he may be experiencing unstable angina.

&choice121c= he forgot to take his hypertension medication.

&choice121d= he may be presenting with early signs of myocardial
infarction.
&qNum122= 122

&category122= CA
&domain122= D2

&reasoning122= R3
&answer122= 2

&q122= A baseball pitcher was seen by a physical therapist following

surgical repair of a SLAP lesion of his pitching arm. In follow up care, the
therapist needs to pay attention to the pitching motion. The phase of the
throwing motion that puts the greatest stress on the anterior labrum and capsule
is:
&choice122a= wind up.

&choice122b= cocking.
&choice122c= acceleration.

&choice122d= deceleration.
&qNum123= 123
&category123= CD

&domain123= D1
&reasoning123= R2

&answer123= 1
&q123= The recommended time duration for endotracheal suctioning is:

&choice123a= 10 to 15 seconds.
&choice123b= 1 to 5 seconds.

&choice123c= 5 to 10 seconds.
&choice123d= 15 to 20 seconds.
&qNum124= 124

&category124= CD
&domain124= D4

&reasoning124= R3
&answer124= 2

&q124= An 82 year-old frail adult is confined to bed in a nursing facility.

He has developed a small superficial wound over the sacral area. Since only
small amounts of necrotic tissue are present, the physician has decided to use
autolytic wound debridement. This is BEST achieved with:
&choice124a= wound irrigation using a syringe.

&choice124b= transparent film dressing.

&choice124c= wet-to-dry gauze dressing with antimicrobial ointment.

&choice124d= sharp debridement.

&qNum125= 125
&category125= CE

&domain125= D6
&reasoning125= R4

&answer125= 3
&q125= A patient was instructed to apply conventional (high rate) TENS to
the low back to modulate a chronic pain condition. The patient now states that
the TENS unit is no longer effective in reducing the pain in spite of increasing
the intensity to maximum. The therapist should now advise the patient to:

&choice125a= switch to low rate TENS.

&choice125b= increase the treatment frequency.

&choice125c= switch to modulation mode TENS.

&choice125d= decrease the pulse duration.
&qNum126= 126

&category126= CB
&domain126= D3

&reasoning126= R3
&answer126= 2

&q126= During initial standing a patient is pushing strongly backward

displacing the center-of-mass at or near the posterior limits of stability. The
most likely cause of this is:
&choice126a= weakness of the tibialis anterior/peroneals.

&choice126b= spasticity of the gastrocnemius-soleus.

&choice126c= contracture of the hamstrings.

&choice126d= contraction of the hip extensors.

&qNum127= 127
&category127= CE

&domain127= D6
&reasoning127= R2

&answer127= 1
&q127= A patient has been screened using a new test for the presence of a
gene (ALG-2) linked to Alzheimer's disease. The physician reports the patient
lacks the gene and should not be at increased risk to develop the disease. Some
years later the same patient develops Alzheimer's and a repeat test reveals the
presence of the gene. The results of the initial test can be interpreted as:

&choice127a= false negative test result.

&choice127b= high specificity error.

&choice127c= historically inconclusive test result.

&choice127d= high sensitivity error.
&qNum128= 128

&category128= CC
&domain128= D5

&reasoning128= R3
&answer128= 4

&q128= A 62 year-old lives at home with his wife and adult daughter. He has
recently been diagnosed with multi-infarct dementia and is recovering from a
fractured hip following a fall injury. In the initial interview with his wife,
the therapist would expect to find:
&choice128a= history of steady progression of loss of judgment and poor
safety awareness.

&choice128b= agitation and sundowning

&choice128c= perseveration on a thought or activity.

&choice128d= history of sudden onset of new cognitive problems and patchy

distribution of deficits.
&qNum129= 129
&category129= CC

&domain129= D2
&reasoning129= R1

&answer129= 1
&q129= A fourteen year-old girl complains of subpatellar pain after
participation in an aerobic exercise program for two weeks. The physical
therapist's examination shows a large Q angle, pain with palpation at the
inferior pole of the patella, and mild swelling at both knees. Physical therapy
intervention should promote:

&choice129a= vastus medialis muscle strengthening.

&choice129b= lateral patellar tracking.

&choice129c= vastus lateralis strengthening.

&choice129d= hamstring strengthening.
&qNum130= 130

&category130= CC
&domain130= D3

&reasoning130= R5
&answer130= 3

&q130= A physical therapist receives a referral from an acute care physical

therapist to treat a patient with right hemiparesis in the home. The referral
indicates that the patient demonstrates good recovery: both involved limbs are
categorized as stage 4 (Brunnstrom recovery stages). The patient is ambulatory
with a small-based quad cane. The activity that would be MOST appropriate for a
patient at this stage of recovery is:
&choice130a= supine, bending the hip and knee up to the chest with some hip
abduction.

&choice130b= sitting, marching in place (alternate hip flexion movements).

&choice130c= standing, picking the foot up behind and slowly lowering it.

&choice130d= standing, small range knee extension movements to gain

quadriceps control.
&qNum131= 131
&category131= CC

&domain131= D5
&reasoning131= R2

&answer131= 1
&q131= During a physical therapy session, a 67 year-old woman with low back
pain tells the therapist that she has had urinary incontinence for the last
year. It is particularly problematic when she has a cold and coughs a lot. She
has not told her physician about this problem because she is too embarrassed.
The therapist's BEST course of action is to:

&choice131a= examine the patient, document impairments and discuss findings

with the physician.
&choice131b= refer the patient back to the physician.

&choice131c= examine the patient, document impairments, then send her back
to her physician.
&choice131d= examine the patient and proceed with her back treatment.
&qNum132= 132

&category132= CA
&domain132= D3

&reasoning132= R2
&answer132= 4

&q132= During a sensory exam a patient complains of a dull, aching pain and
is not able to discriminate a stimulus as sharp or dull. Two-point
discrimination is absent. Based on these findings, the pathway that is intact is
the:
&choice132a= lateral spinothalamic tract.

&choice132b= dorsal columns/neospinothalamic systems.

&choice132c= fasciculus gracilis/medial lemniscus.

&choice132d= anterior spinothalamic tract.

&qNum133= 133
&category133= CD

&domain133= D1
&reasoning133= R4

&answer133= 2
&q133= A patient is five days post-MI and is referred for inpatient cardiac
rehabilitation. Appropriate criteria for determining the initial intensity of
exercise include:

&choice133a= systolic BP less than 240mmHg or diastolic BP less than 110 mg

Hg.
&choice133b= HR less than 120 beats/min and RPE less than 13.

&choice133c= HR resting + 30 beats/min and RPE less than 14.

&choice133d= greater than 1 mm ST-segment depression, horizontal or
downsloping.
&qNum134= 134

&category134= CE
&domain134= D6

&reasoning134= R3
&answer134= 4

&q134= A patient with bilateral short transfemoral (AK) amputations will

require a wheelchair for functional mobility in the home and community. An
appropriate prescription for the wheelchair includes:
&choice134a= placement of the drive wheels 2 inches anterior to the
vertical back supports.

&choice134b= lowering the seat height by 3 inches.

&choice134c= increasing the seat depth by 2 inches to accommodate the
length of the residual limbs.

&choice134d= placement of the drive wheels 2 inches posterior to the

vertical back supports.
&qNum135= 135
&category135= CF

&domain135= D6
&reasoning135= R2

&answer135= 1
&q135= A multicenter study was done on the reliability of passive wrist
flexion and extension goniometric measurements using volar/dorsal alignment,
ulnar alignment and radial alignment. Significant differences were revealed
between the three techniques. An appropriate level for determining significant
difference is a P value of:

&choice135a= P=0.05
&choice135b= P=0.015

&choice135c= P=0.5
&choice135d= P=0.1
&qNum136= 136

&category136= CD
&domain136= D2

&reasoning136= R1
&answer136= 2

&q136= In treating a patient with a diagnosis of right shoulder impingement

syndrome, the first priority of the physical therapist would be to:
&choice136a= implement a stretching program for the shoulder girdle
musculature.

&choice136b= instruct the patient in proper postural alignment.

&choice136c= achieve complete AROM in all shoulder motions.

&choice136d= modulate all pain.

&qNum137= 137
&category137= CC

&domain137= D5
&reasoning137= R1

&answer137= 1
&q137= An 80 year-old patient is being seen for balance instability and
frequent falls. She arrives for a therapy session complaining of pain and
tingling in the forehead, cheek, and jaw on the left side of the face. An
inspection of the trunk reveals the eruption of vesicles in the distribution of
the T2 dermatome. The therapist's best course of action is to:

&choice137a= refer the patient back to her physician immediately.

&choice137b= utilize warm water wraps to relieve the pain and continue with
balance training.

&choice137c= have the patient exercise in the pool to promote pain-free

movement.
&choice137d= have the patient keep a diary charting the course and
frequency of pain over the next week.
&qNum138= 138

&category138= CD
&domain138= D5

&reasoning138= R4
&answer138= 1

&q138= The patient's chief complaint relates to a recent compression

fracture at T8. The medical history includes a co-morbidity of gastric-
esophageal reflux disease (GERD), treated with antacids. Which of the following
is MOST important for the therapist to include in the plan of care?
&choice138a= schedule therapy sessions at least 90 minutes after eating.

&choice138b= assure that the patient eats a small snack before starting
exercise
&choice138c= include supine concentric abdominal strengthening exercises.

&choice138d= recommend an over-the-counter proton pump inhibitor (PPI)

medication.
&qNum139= 139
&category139= CE

&domain139= D6
&reasoning139= R2

&answer139= 4
&q139= A patient with spastic hemiplegia is referred to physical therapy
for ambulation training. The patient is having difficulty in rising to a
standing position as a result of cocontraction of the hamstrings and quadriceps.
The therapist elects to use biofeedback as an adjunct to help break up this
pattern. For knee extension, the biofeedback protocol should consist of:

&choice139a= high detection sensitivity with electrodes placed close

together.
&choice139b= low detection sensitivity with electrodes placed far apart.

&choice139c= high detection sensitivity with electrodes placed far apart.

&choice139d= low detection sensitivity with electrodes placed close
together.
&qNum140= 140

&category140= CD
&domain140= D4

&reasoning140= R5
&answer140= 3

&q140= A patient sustained a T10 spinal cord injury four years ago and is
now referred for an episode of outpatient physical therapy. During initial
examination the therapist observes redness over the ischial seat that persists
for 10 minutes when not sitting. The BEST intervention in this case would be to:
&choice140a= switch to a low density wheelchair foam cushion.

&choice140b= increase the wheelchair arm rest height which is adjustable.

&choice140c= re-emphasize the need for sitting push-ups performed every 10
minutes.

&choice140d= switch to a tilt-in-space wheelchair.

&qNum141= 141
&category141= CA

&domain141= D2
&reasoning141= R3

&answer141= 2
&q141= A 16 year-old female was sent to physical therapy with a diagnosis
of anterior knee pain. Positive findings include pes planus, lateral tibial
torsion and genu valgum. The position the femur will be in is excessive:

&choice141a= abduction.
&choice141b= medial rotation.

&choice141c= lateral rotation.

&choice141d= retroversion.
&qNum142= 142

&category142= CC
&domain142= D3

&reasoning142= R3
&answer142= 4

&q142= A patient is referred to physical therapy for vestibular

rehabilitation. The patient presents with spontaneous nystagmus that can be
suppressed with visual fixation, oscillopsia and loss of gaze stabilization,
lateropulsion, intense disequilibrium, and an ataxic wide-based gait. Based on
these findings, the therapist determines the patient is most likely exhibiting
signs and symptoms of:
&choice142a= benign paroxysmal positional vertigo.

&choice142b= acoustic neuroma.

&choice142c= Meniérè's disease.

&choice142d= acute unilateral vestibular dysfunction.

&qNum143= 143
&category143= CF

&domain143= D6
&reasoning143= R4

&answer143= 3
&q143= A physical therapist is working with a 10 year-old girl with
cerebral palsy. Part of the exercises in her plan of care involve using the
therapy ball. The choice of educational media that is BEST to use when
instructing her in use of this device is:

&choice143a= photos of other children using the therapy ball

&choice143b= an oral presentation describing the therapy ball positions.

&choice143c= a DVD of another child with cerebral palsy on a therapy ball.

&choice143d= printed handouts with stick figure drawings and instructions.
&qNum144= 144

&category144= CF
&domain144= D6

&reasoning144= R5
&answer144= 2

&q144= A sports physical therapist is working with a local high school

football team. During the game, a player is tackled violently by two opponents.
The therapist determines that the player is unresponsive. The immediate course
of action should be to:
&choice144a= ask for help to log roll the player on his back while
stabilizing his neck.

&choice144b= summon Emergency Medical Services.

&choice144c= open the airway by using the chin-lift method.

&choice144d= stabilize the neck and flip back the helmet face mask.
&qNum145= 145
&category145= CC

&domain145= D3
&reasoning145= R5

&answer145= 1
&q145= During a home visit, the mother of an 18 month-old child with
developmental delay and an atrio-ventricular shunt for hydrocephalus tells the
physical therapist that her daughter vomited several times, was irritable and is
now lethargic. The therapist's BEST course of action is to:

&choice145a= call for emergency transportation and notify the pediatrician

immediately.
&choice145b= give the child a cold bath to try and rouse her.

&choice145c= place the child in a sidelying position and monitor vital

signs.
&choice145d= have the mother give the child clear liquids since she
vomited.
&qNum146= 146

&category146= CD
&domain146= D5

&reasoning146= R4
&answer146= 4

&q146= A woman recently delivered twins. After delivery she developed a 4

centimeter diastasis recti abdominis. The BEST initial intervention for this
problem is to teach:
&choice146a= pelvic tilts and bilateral straight leg raising.

&choice146b= pelvic floor exercises and sit-ups.

&choice146c= gentle stretching of hamstrings and hip flexors.

&choice146d= protection and splinting of the abdominal musculature.

&qNum147= 147
&category147= CD

&domain147= D1
&reasoning147= R1

&answer147= 3
&q147= The optimal position for ventilation of a patient with a C5 complete
spinal cord injury is:

&choice147a= semi Fowler's.

&choice147b= sidelying, head of bed flat.

&choice147c= supine, head of bed flat.

&choice147d= sidelying, head of bed elevated 45 degrees.
&qNum148= 148

&category148= CF
&domain148= D6

&reasoning148= R5
&answer148= 3

&q148= A 16 year-old patient with osteosarcoma is being seen in physical

therapy for crutch training. Her parents have decided not to tell her about her
diagnosis. She is quite perceptive and asks the physical therapist directly if
she has cancer and about her future. The therapist's BEST course of action is
to:
&choice148a= discuss her condition, gently indicating her parent's fears
about not telling her the diagnosis.

&choice148b= change the subject and discuss the plans for that day's
treatment.
&choice148c= schedule a conference with the physician and family about her
questions.

&choice148d= tell the patient to speak directly with her physician.

&qNum149= 149
&category149= CC

&domain149= D3
&reasoning149= R3

&answer149= 2
&q149= A patient has a two year history of amyotrophic lateral sclerosis
and exhibits moderate functional deficits. The patient is still ambulatory with
bilateral canes but is limited in endurance. An important goal for the physical
therapy plan of care should be to prevent:

&choice149a= radicular pain and paresthesias.

&choice149b= overwork damage in weakened, denervated muscle.

&choice149c= further gait deterioration as a result of ataxia.

&choice149d= further functional loss as a result of myalgia.
&qNum150= 150

&category150= CE
&domain150= D6

&reasoning150= R2
&answer150= 2

&q150= A patient has extensive full thickness burns to the dorsum of the
hand and forearm. He is to be fitted with a resting splint to support his wrists
and hands in a functional position. An appropriately constructed splint
positions the wrist and hand in:
&choice150a= neutral wrist position with slight finger flexion and thumb
flexion.

&choice150b= slight wrist extension with fingers supported and thumb in

partial opposition and abduction.
&choice150c= slight wrist flexion with IP extension and thumb opposition.

&choice150d= neutral wrist position with IP extension and thumb flexion.

&qNum151= 151
&category151= CB

&domain151= D1
&reasoning151= R3

&answer151= 1
&q151= A patient is on the cardiac unit following admission for congestive
heart failure and a history of a myocardial infarction. The patient is currently
compensated due to pharmacologic management, is comfortable, alert and oriented
at rest with a normal heart rate and blood pressure. The telemetric
electrocardiograph depicts the rhythm in Figure 1. The physical therapist's
appropriate interpretation and action is:

&choice151a= ST segment depression, check medical record for baseline ECG.

&choice151b= normal sinus rhythm, continue to monitor during activity
progression.

&choice151c= ST segment depression, alert emergency medical personnel.

&choice151d= Ventricular tachycardia, alert emergency medical personnel.
&qNum152= 152

&category152= CC
&domain152= D1

&reasoning152= R4
&answer152= 4

&q152= The following set of PFTs demonstrate an FVC of 3.2, an FEV1 of 2.6,
and an FEV1/FVC ratio of 81.25%25. Which of the following Caucasian female
patients would these PFTs most likely represent?
&choice152a= 5'2 healthy 68 year-old with a s/p total knee replacement.

&choice152b= 5'4 28 year-old in a mild exacerbation of her asthma.

&choice152c= 4'8 10 year-old with cystic fibrosis.

&choice152d= 5'2 healthy 31 year-old with a casted tibia/fibula fracture.

&qNum153= 153
&category153= CD

&domain153= D3
&reasoning153= R4

&answer153= 3
&q153= An eighteen month-old child with Down syndrome and moderate
developmental delay is being treated at an Early Intervention Program. Daily
training activities that should be considered include:

&choice153a= stimulation to postural extensors in sitting using rhythmic

stabilization.
&choice153b= locomotor training using body weight support and a motorized
treadmill.

&choice153c= holding and weight shifting in sitting and standing using

tactile and verbal cueing.
&choice153d= rolling activities, initiating movement with stretch and
tracking resistance.
&qNum154= 154

&category154= CC
&domain154= D2

&reasoning154= R3
&answer154= 2

&q154= A patient has been referred to physical therapy for acute shoulder
pain after shoveling snow in a driveway for two hours. Positive findings include
pain and weakness with flexion of an extended upper extremity as well as
scapular winging with greater than 90 degrees of abduction. The patient's
problem is MOST LIKELY the result of:
&choice154a= supraspinatus tendinitis.

&choice154b= compression of the long thoracic nerve.

&choice154c= compression of the suprascapular nerve.

&choice154d= subdeltoid bursitis.

&qNum155= 155
&category155= CC

&domain155= D3
&reasoning155= R1

&answer155= 2
&q155= A patient with multiple sclerosis demonstrates strong bilateral
lower extremity extensor spasticity in the typical distribution of antigravity
muscles. This patient would be expected to demonstrate:

&choice155a= sitting with the pelvis laterally tilted with increased weight
bearing on ischial tuberosities.
&choice155b= sacral sitting with increased extension and adduction of lower
extremities.

&choice155c= sitting with both legs abducted and externally rotated.

&choice155d= skin breakdown on the ischial tuberosities and lateral
malleoli.
&qNum156= 156

&category156= CA
&domain156= D3

&reasoning156= R4
&answer156= 3

&q156= A patient with multiple sclerosis has been on Prednisolone for the
past 4 weeks. The medication is now being tapered off. This is the third time
this year she has received this treatment for an MS exacerbation. The physical
therapist recognizes this patient is likely to demonstrate:
&choice156a= weight gain and hyperkinetic behaviors.

&choice156b= hypoglycemia and nausea or vomiting.

&choice156c= muscle wasting, weakness and osteoporosis.

&choice156d= spontaneous fractures with prolonged healing or mal-union.

&qNum157= 157
&category157= CC

&domain157= D5
&reasoning157= R5

&answer157= 2
&q157= A 24 year-old pregnant woman who is 12 weeks pregnant asks a
therapist if it is safe to continue with her aerobic exercise. Currently she
jogs 3 miles, 3 times a week and has done so for the past 10 years. The
therapist's BEST answer is:

&choice157a= jogging is safe as long as the target HR does not exceed 140
beats/min.
&choice157b= jogging is safe at mild to moderate intensities while vigorous
exercise is contraindicated.

&choice157c= continue jogging only until the 5th month of pregnancy.

&choice157d= swimming is preferred over walking or jogging for all phases
of pregnancy.
&qNum158= 158

&category158= CD
&domain158= D2

&reasoning158= R1
&answer158= 4

&q158= A patient with a grade 2 quadriceps strain returns to physical

therapy after his first exercise session complaining of muscle soreness that
developed later in the evening and continued into the next day. He is unsure he
wants to continue with exercise. The therapist can minimize the possibility of
this happening again by using:
&choice158a= eccentric exercises, 1 set of 10, lifting body weight (sit-to-
stand).

&choice158b= eccentric exercises, 3 sets of 10, with gradually increasing

intensity.
&choice158c= concentric exercises, 3 sets of 10, at 80%25 of maximal
intensity.

&choice158d= concentric exercises, 3 sets of 10, with gradually increasing

intensity.
&qNum159= 159
&category159= CB

&domain159= D5
&reasoning159= R3

&answer159= 2
&q159= Upon examining a patient with vague hip pain which radiates to the
lateral knee, the physical therapist finds a negative FABERE test, negative
grind test, and a positive Noble compression test. The dysfunction is most
likely due to:

&choice159a= degenerative joint disease of the hip.

&choice159b= an iliotibial band friction disorder.

&choice159c= sacroiliac joint dysfunction.

&choice159d= irritation of the L5 spinal nerve root.
&qNum160= 160

&category160= CA
&domain160= D3

&reasoning160= R4
&answer160= 4

&q160= A patient suffered carbon monoxide poisoning from a work-related

factory accident. He is left with permanent damage to his nervous system,
affecting the basal ganglia. Exercise training for this patient will need to
address expected impairments of:
&choice160a= motor paralysis with the use of free weights to increase
strength.

&choice160b= muscular spasms and hyperreflexia with the use of ice wraps.
&choice160c= impaired sensory organization of balance with the use of
standing balance platform training.

&choice160d= motor planning with the use of guided and cued movement.
&qNum161= 161
&category161= CB

&domain161= D3
&reasoning161= R3

&answer161= 1
&q161= A patient presents with problems with swallowing. When the physical
therapist tests for phonation by having the patient say "AH" with the mouth
open, there is deviation of the uvula to one side. The therapist then tests for
function of the gag reflex and notices decreased response to stimulation. These
findings suggest involvement of the:

&choice161a= vagus nerve.

&choice161b= trigeminal nerve.

&choice161c= facial nerve.

&choice161d= hypoglossal nerve.
&qNum162= 162

&category162= CA
&domain162= D1

&reasoning162= R4
&answer162= 2

&q162= A patient with COPD is sitting in a bedside chair. The apices of the
lungs in this position compared with other areas of the lungs in this position
would demonstrate:
&choice162a= increased perfusion.

&choice162b= increased volume of air at resting end expiratory pressure

(REEP).
&choice162c= the lowest oxygenation and highest CO2 in blood exiting this
zone.

&choice162d= the highest changes in ventilation during the respiratory

cycle.
&qNum163= 163
&category163= CE

&domain163= D6
&reasoning163= R2

&answer163= 1
&q163= Checkout for a lower limb orthosis includes inspection of the
alignment of anatomic and orthotic joints. During a sagittal plane check-out the
physical therapist determines that the orthotic hip joint is malaligned. The
correct position is:

&choice163a= just anterior and superior to the greater trochanter.

&choice163b= 3 inches below the anterior superior iliac spine.

&choice163c= just posterior and inferior to the greater trochanter.

&choice163d= lateral to the greater trochanter.
&qNum164= 164

&category164= CF
&domain164= D6

&reasoning164= R5
&answer164= 4

&q164= A physical therapist assistant is supervising a patient's home

exercise program. The patient is 6 weeks post stroke. Part of the plan of care
includes "progressive gait training on level surfaces". The patient falls and
sustains a fractured hip. The fall occurred when the PTA took the patient on the
stairs for the first time. The responsible party in this case is:
&choice164a= the PT who is negligent for failing to provide adequate
supervision of the PTA.

&choice164b= neither the PT nor the PTA because patients who have sustained
a CVA are always at high risk for falls, and thus it is a regrettable occurrence
only.
&choice164c= both the PT and the PTA because the PT gave inadequate
supervision, and the PTA used poor judgment.

&choice164d= the PTA who is completely liable because the plan of care was
altered without communicating with the supervising PT.
&qNum165= 165
&category165= CD

&domain165= D2
&reasoning165= R4

&answer165= 4
&q165= As the result of blunt trauma to the quadriceps femoris muscle, a
patient experiences loss of knee function. Early PT interventions should stress:

&choice165a= aggressive soft tissue stretching to remove blood which has

accumulated in soft tissues.
&choice165b= aggressive open-chain strengthening of the quadriceps femoris
to regain normal lower extremity strength.

&choice165c= gentle PROM exercises in nonweightbearing to regain normal

knee motion.
&choice165d= gentle AROM exercises in weight bearing.
&qNum166= 166

&category166= CE
&domain166= D6

&reasoning166= R1
&answer166= 3

&q166= An important adjunct to physical therapy management of a child with

moderate spastic hemiplegia would be use of:
&choice166a= a posterior walker.

&choice166b= an anterior rollator walker.

&choice166c= a tone inhibiting ankle-foot orthosis (AFO).

&choice166d= a knee-ankle-foot orthosis (KAFO).

&qNum167= 167
&category167= CB

&domain167= D3
&reasoning167= R3

&answer167= 1
&q167= While evaluating the gait of a patient with right hemiplegia, the
physical therapist notes foot drop during midswing on the right. The MOST LIKELY
cause of this deviation is:

&choice167a= inadequate contraction of the ankle dorsiflexors.

&choice167b= excessive extensor synergy.

&choice167c= decreased proprioception of foot-ankle muscles.

&choice167d= excessive flexor synergy.
&qNum168= 168

&category168= CF
&domain168= D6

&reasoning168= R2
&answer168= 3

&q168= A patient's daughter wants to look at her father's medical record.

He has recently been admitted for an insidious onset of low back pain. The
physical therapist should:
&choice168a= give her the chart and let her read it.

&choice168b= tell her she cannot see the chart because she could
misinterpret the information.
&choice168c= tell her that she must have the permission of her father
before she can look at the chart.

&choice168d= tell her to ask the physician for permission.

&qNum169= 169
&category169= CE

&domain169= D6
&reasoning169= R4

&answer169= 2
&q169= Following a total knee replacement [TKR], continuous passive motion
[CPM] is initiated. One of the main objectives in using CPM in this case is to
facilitate:

&choice169a= active knee extension.

&choice169b= active knee flexion.

&choice169c= passive knee flexion.

&choice169d= passive knee extension.
&qNum170= 170

&category170= CE
&domain170= D6

&reasoning170= R5
&answer170= 3

&q170= The use of ultrasound in the area of a joint arthroplasty is

permissible even if the surrounding area contains:
&choice170a= plastic implants.

&choice170b= infected tissue

&choice170c= metal implants

&choice170d= neoplastic lesions.

&qNum171= 171
&category171= CB

&domain171= D3
&reasoning171= R3

&answer171= 1
&q171= A physical therapist observes genu recurvatum during ambulation in a
patient with hemiplegia. The patient has been using a posterior leaf spring
(PLS) orthosis since discharge from subacute rehab 4 weeks ago. The therapist
has previously administered Fugl-Meyer Assessment of Physical Performance and
determined the lower extremity score to be 22 (out of a possible 34) with strong
synergies in the lower extremity and no out-of-synergy movement. The most likely
cause of this deviation is:

&choice171a= extensor spasticity.

&choice171b= hip flexor weakness.

&choice171c= dorsiflexor spasticity.

&choice171d= hamstring weakness.
&qNum172= 172

&category172= CC
&domain172= D1

&reasoning172= R5
&answer172= 4

&q172= During a home visit a physical therapist is providing postural

drainage in the Trendelenburg position to a 15 year-old male with cystic
fibrosis. The patient suddenly complains of right-sided chest pain and shortness
of breath. On auscultation, there are no breath sounds on the right. The
therapist should:
&choice172a= continue treating as it is possibly a mucous plug.

&choice172b= reposition patient with the head of the bed flat as the
Trendelenburg position is causing shortness of breath.
&choice172c= place the right lung in a gravity dependent position to
improve perfusion.

&choice172d= call emergency medical services as it may be a pneumothorax.

&qNum173= 173
&category173= CF

&domain173= D6
&reasoning173= R3

&answer173= 3
&q173= A 65 year-old patient with multiple sclerosis is being treated at
home. The patient is bedridden for most of the day with only short periods up in
a bedside chair. Medicare is funding the patient's home care program which has
as its primary goals maintaining PROM and positioning to prevent deformity. The
role of the physical therapist is to provide:

&choice173a= a restorative exercise program aimed at improving upright

sitting control and improved functional independence.
&choice173b= a limited cardiovascular conditioning (sitting) program aimed
at improving respiratory capacity.

&choice173c= supervision of home health aides for completion of a daily

home exercise program.
&choice173d= PROM exercises 2 times a day with additional family
instruction to ensure weekend coverage.
&qNum174= 174

&category174= CD
&domain174= D3

&reasoning174= R4
&answer174= 4

&q174= A patient with an 8 year history of Parkinson's disease is referred

for physical therapy. During the initial examination, the patient demonstrates
significant rigidity, decreased PROM in both upper extremities in the typical
distribution, and frequent episodes of akinesia. The exercise intervention that
BEST deals with these problems would be:
&choice174a= quadruped position, upper extremity PNF D2 flexion and
extension.

&choice174b= resistance training, free weights for shoulder flexors at

80%25 of 1 repetition max.
&choice174c= modified plantigrade, isometric holding, stressing upper
extremity shoulder flexion.

&choice174d= PNF bilateral symmetrical upper extremity D2 flexion patterns,

rhythmic initiation.
&qNum175= 175
&category175= CF

&domain175= D6
&reasoning175= R5

&answer175= 2
&q175= A 72 year-old patient with diabetes is recovering from recent
surgery to graft a large decubitus ulcer over the heel of the left foot. The
physical therapist is concerned that loss of range at the ankle (-5° to neutral)
will limit ambulation and independent status. One afternoon the therapist is
very busy and requests that one of the physical therapy aides do the range of
motion exercises. The aide is new to the department but is willing to take this
challenge on if the therapist demonstrates the exercises. The therapist's BEST
course of action is to:

&choice175a= take 5 minutes to instruct the aide in ROM exercises.

&choice175b= perform the ROM exercises without delegating the task.

&choice175c= reschedule the patient for the next day.

&choice175d= defer the ROM exercises and have the aide ambulate the patient
in the parallel bars.
&qNum176= 176

&category176= CE
&domain176= D6

&reasoning176= R1
&answer176= 4

&q176= A 12 year-old child with moderate athetosis affecting the head,

trunk and upper extremities and extensor spasms of the lower extremities is
referred for mobility training. The MOST appropriate type of adaptive equipment
is:
&choice176a= a wheeled prone stander.

&choice176b= posterior rollator walker and reciprocating gait orthoses.

&choice176c= scooter board.

&choice176d= manual wheelchair with custom-contoured seating system.

&qNum177= 177
&category177= CC

&domain177= D2
&reasoning177= R4

&answer177= 1
&q177= The problems associated with ankylosing spondylitis in its early
stages can best be managed in physical therapy by:

&choice177a= postural education.

&choice177b= pain management.

&choice177c= joint mobilization.

&choice177d= stretching of scapular stabilizers.
&qNum178= 178

&category178= CC
&domain178= D3

&reasoning178= R2
&answer178= 2

&q178= A patient is referred for rehabilitation following a middle cerebral

artery stroke. Based on this diagnosis a physical therapist can expect the
patient will present with:
&choice178a= contralateral hemiplegia with thalamic sensory syndrome and
involuntary movements.

&choice178b= contralateral hemiparesis and sensory deficits, arm more

involved than the leg.
&choice178c= decreased pain and temperature to the face and ipsilateral
ataxia with contralateral pain and thermal loss of the body.

&choice178d= contralateral hemiparesis and sensory deficits, leg more

involved than the arm.
&qNum179= 179
&category179= CA

&domain179= D1
&reasoning179= R2

&answer179= 4
&q179= The cardiac rehabilitation team is conducting education classes for
a group of patients. The focus is on risk factor reduction and successful life
style modification. A participant asks the physical therapist to help him
interpret his cholesterol findings. His total cholesterol is 220mg/dL, his HDL
cholesterol is 24 mg/dL, and his LDL is 160 mg/dL. Analysis of these values
reveals:

&choice179a= the levels of HDL, LDL, and total cholesterol are all
abnormally high.
&choice179b= LDL and HDL cholesterol levels are within normal limits and
total cholesterol should be below 200 mg/dL.

&choice179c= the levels of HDL, LDL, and total cholesterol are all
abnormally low.
&choice179d= the levels of LDL and total cholesterol are abnormally high
and HDL abnormally low.
&qNum180= 180

&category180= CF
&domain180= D6

&reasoning180= R5
&answer180= 3

&q180= A physical therapist is treating a football player with an ACL

sprain. She is very fond of this patient and enjoys treating him. After a few
visits, the football player asks her out to dinner. The physical therapist's
response should be to:
&choice180a= thank him very much, and invite him for dinner at her
apartment with other guests.

&choice180b= transfer the patient care to one of her colleagues and then go
out to dinner with him.
&choice180c= thank him very much, but refuse his invitation while he is
receiving treatment as her patient.

&choice180d= thank him very much, and accept his offer for dinner.
&qNum181= 181
&category181= CB

&domain181= D2
&reasoning181= R3

&answer181= 1
&q181= A physical therapist is performing the maximal cervical quadrant
test to the right with a patient with right C5-6 facet syndrome. The patient
would, most likely complain of:

&choice181a= pain in the right cervical region.

&choice181b= tightness in the right upper trapezius.

&choice181c= radicular pain in both shoulders.

&choice181d= referred pain to the left midscapular region.
&qNum182= 182

&category182= CD
&domain182= D3

&reasoning182= R1
&answer182= 3

&q182= A 62 year-old woman developed polio at the age of 6 with significant

lower extremity paralysis. She wore bilateral long leg braces for a period of 2
years. She then recovered enough to stop using her braces but still required
bilateral Lofstrand crutches, then bilateral canes to ambulate. Recently she has
been complaining of new difficulties (she has had to start using her crutches
again). The physical therapist suspects post-polio syndrome. The BEST initial
intervention for this patient based on her current findings is:
&choice182a= initiate a lower extremity resistance training program
utilizing 80%25 one repetition max.

&choice182b= initiate a moderate conditioning program consisting of cycle

ergometry 3 times a week of 60 minutes at 75%25 maximal heart rate.
&choice182c= instruct in activity pacing and energy conservation
techniques.

&choice182d= implement an aquatic therapy program consisting of daily 1

hour aerobics.
&qNum183= 183
&category183= CA

&domain183= D2
&reasoning183= R3

&answer183= 2
&q183= A patient diagnosed with lumbar spondylosis without discal
herniation or bulging has a left L5 neural compression. The most likely
structure compressing the nerve root is the:

&choice183a= supraspinous ligament.

&choice183b= ligamentum flavum.

&choice183c= anterior longitudinal ligament.

&choice183d= posterior longitudinal ligament.
&qNum184= 184

&category184= CB
&domain184= D1

&reasoning184= R2
&answer184= 2

&q184= During an exercise tolerance test (ETT) a patient demonstrates poor

reaction to increasing exercise intensity. An absolute indication for
terminating this test is:
&choice184a= 1.5 mm of downsloping ST-segment depression.

&choice184b= onset of moderate to severe angina.

&choice184c= fatigue and shortness of breath.

&choice184d= supraventricular tachycardia.

&qNum185= 185
&category185= CC

&domain185= D4
&reasoning185= R3

&answer185= 4
&q185= While under the care of a babysitter, this child unfortunately sat
down in spilled pool chemicals and when their diaper was
later removed these chemical burns were present. The BEST choice to characterize
the burn depicted in the figure is:

&choice185a= partial-thickness skin involvement and scar formation.

&choice185b= skin involvement extending into fascia, muscle, or bone and
scar formation.

&choice185c= superficial skin involvement.

&choice185d= full-thickness skin involvement and scar formation.
&qNum186= 186

&category186= CE
&domain186= D6

&reasoning186= R2
&answer186= 1

&q186= A patient with a T4 spinal cord injury is being measured for a

wheelchair. In determining the correct seat height the physical therapist can
use as a measure:
&choice186a= clearance between the floor and the foot plate of at least 2
inches.

&choice186b= clearance between the floor and the foot plate of at least 4
inches.
&choice186c= the patient's leg length measurement plus four inches.

&choice186d= the distance from the bottom of the shoe to just under the
thigh at the popliteal fossa.
&qNum187= 187
&category187= CD

&domain187= D3
&reasoning187= R4

&answer187= 3
&q187= A 6 year-old boy has a diagnosis of Duchenne muscular dystrophy and
is still ambulatory. The MOST appropriate activity to include in his plan of
care would be:

&choice187a= progressive resistance strength training.

&choice187b= circuit training using resistance training and conditioning
exercises.

&choice187c= recreational physical activities such as swimming.

&choice187d= wheelchair sports.
&qNum188= 188

&category188= CF
&domain188= D6

&reasoning188= R5
&answer188= 3

&q188= A physical therapist works in a private outpatient clinic and sells

custom made orthotic shoe inserts at a reasonable price to patients. This
practice can be viewed as unethical if:
&choice188a= the therapist realizes all of the profits from the sale of the
inserts.

&choice188b= the patient's ability to pay is in doubt.

&choice188c= the need for the inserts is exaggerated.

&choice188d= the inserts are provided as part of pro bono services.

&qNum189= 189
&category189= CC

&domain189= D3
&reasoning189= R1

&answer189= 1
&q189= A patient with a CVA demonstrates a locked-in state characterized by
spastic quadriplegia and bulbar palsy. To facilitate communication with this
patient the physical therapist should instruct the family to:

&choice189a= encourage use of eye movements to signal letters.

&choice189b= give the patient a chance to mouth responses even though
vocalization is poor.

&choice189c= look closely at facial expression to detect signs of

communication.
&choice189d= use a communication board with minimal hand movements.
&qNum190= 190

&category190= CD
&domain190= D2

&reasoning190= R2
&answer190= 2

&q190= After performing an ergonomic examination of a computer programmer

and his workstation, the most appropriate recommendation for achieving ideal
wrist and elbow positioning would be to:
&choice190a= elevate the keyboard to increase wrist flexion.

&choice190b= maintain the keyboard in a position allowing a neutral wrist

position.
&choice190c= lower the keyboard to increase wrist extension.

&choice190d= add armrests.

&qNum191= 191
&category191= CA

&domain191= D1
&reasoning191= R3

&answer191= 1
&q191= A patient recovering from an extensive myocardial infarction is on
digitalis to improve cardiac contractility. He is a new participant in a Phase 2
outpatient cardiac rehabilitation program. He is being continuously monitored by
ECG via radio telemetry. On his ECG, the medication-induced changes that might
be expected are:

&choice191a= depressed ST segment with a flat T wave and shortened QT

interval.
&choice191b= elevated ST segment with T wave inversion.

&choice191c= widened QRS complex with a flattened P wave.

&choice191d= decreased heart rate with prolonged QRS and QT intervals.
&qNum192= 192

&category192= CD
&domain192= D1

&reasoning192= R1
&answer192= 4

&q192= A patient is being treated for secondary lymphedema of the right arm
as a result of a radical mastectomy and radiation therapy. The resulting edema
(Stage 1) can BEST be managed in physical therapy by:
&choice192a= isokinetics, extremity positioning in elevation, and massage.

&choice192b= AROM and extremity positioning in a functional arm/hand

position.
&choice192c= isometric exercises, extremity positioning in elevation and
compression bandaging.

&choice192d= intermittent pneumatic compression, extremity elevation and

massage.
&qNum193= 193
&category193= CF

&domain193= D6
&reasoning193= R5

&answer193= 2
&q193= A physical therapist has been treating a patient for chronic
subluxation of the patella in the outpatient clinic. The patient is now
scheduled for a lateral release and is worried about any complications of the
surgical procedure. The patient asks the therapist to describe any potential
complications. The therapist's BEST response is to:

&choice193a= refer the patient to a physical therapy colleague who

specializes in knee problems.
&choice193b= suggest that the patient speak with his surgeon.

&choice193c= explain how previous patients the therapist treated responded

to the surgery.
&choice193d= do an internet search and print out the information desired by
the patient.
&qNum194= 194

&category194= CD
&domain194= D2

&reasoning194= R4
&answer194= 3

&q194= A patient was referred for physical therapy following a right breast
lumpectomy with axillary lymph node dissection. Scapular control is poor when
upper extremity flexion or abduction is attempted. Early PT intervention should
focus on:
&choice194a= active assistive pulley exercises to assist rotator cuff
muscles as a result of damage to the suprascapular nerve.

&choice194b= rhomboid strengthening as a result of disuse of the scapular

stabilizers.
&choice194c= gravity assisted right upper extremity exercises to promote
scapular control following damage to the long thoracic nerve.

&choice194d= strengthening of the right deltoids to help stabilize the

shoulder to compensate for damage to the dorsal scapular nerve.
&qNum195= 195
&category195= CC

&domain195= D1
&reasoning195= R1

&answer195= 4
&q195= A post surgical patient is receiving a regimen of postural drainage
three times a day. The therapist assigned to the case could reduce the frequency
of treatment if the:

&choice195a= consistency of the sputum changes.

&choice195b= patient becomes febrile.

&choice195c= patient experiences decreased postoperative pain.

&choice195d= amount of productive secretions decreases.
&qNum196= 196

&category196= CC
&domain196= D5

&reasoning196= R3
&answer196= 2

&q196= A patient has a complaint of onset of unsteady gait. The past

medical history is unremarkable except for a kidney transplant 15 years ago.
Medications include oral steroids and immunosuppression agents for 15 years
without adverse effects. No history of cardiopulmonary problems, recent
illnesses, other significant medical problems are admitted to in the initial
interview. The patient was last seen 10 months ago by the primary care provider
and 18 months ago by the immunologist. Evaluation shows increased skin turgor
around the extremity joints, decreased proprioception (3/5 LE, 4+/5 UE),
flexibility and strength 4/5 LE, 4+/5 UE) with no difference contralaterally.
Berg Balance test was 40. Which of the following is the MOST important action
for the physical therapist to include in the plan of care?

&choice196a= progressive balance retraining beginning with center of

gravity control exercises.
&choice196b= referral for follow-up to both physicians.

&choice196c= progressive resistive strengthening exercises in a circuit

training program.
&choice196d= referral to yoga classes at local fitness center.
&qNum197= 197

&category197= CF
&domain197= D6

&reasoning197= R2
&answer197= 4

&q197= A physical therapist arrives at work one hour before the work day
commences and, begins moving treatment tables and rearranging the physical
therapy clinic without prior approval of the supervisor. This operation could
have been done during regular hours. The therapist sustained a low back injury
as a result of moving the equipment. Payment for the therapist's care relating
to this incident would be covered primarily by:
&choice197a= employee's health insurance.

&choice197b= the hospital's insurance company.

&choice197c= the therapist's own resources.

&choice197d= Workers' Compensation.

&qNum198= 198
&category198= CC

&domain198= D2
&reasoning198= R3

&answer198= 1
&q198= Patients diagnosed with Paget's disease typically have similar
symptomatology to spinal stenosis. The most important aspect of physical therapy
intervention emphasizes:

&choice198a= postural reeducation to prevent positions that increase

symptoms.
&choice198b= strengthening exercises for the abdominals and back muscles.

&choice198c= modalities to decrease pain.

&choice198d= lumbar extension exercises.
&qNum199= 199

&category199= CE
&domain199= D6

&reasoning199= R3
&answer199= 1

&q199= A patient with spastic left hemiplegia experiences severe genu

recurvatum during stance phase. The patient is using a double upright metal
ankle-foot orthosis. The cause of the problem might be attributed to:
&choice199a= the posterior stop setting the foot in too much
plantarflexion.

&choice199b= the posterior stop setting the foot in too much dorsiflexion.
&choice199c= the anterior stop setting the foot in too much plantar
flexion.

&choice199d= the anterior stop setting the foot in too much dorsiflexion.
&qNum200= 200
&category200= CC

&domain200= D1
&reasoning200= R1

&answer200= 3
&q200= A patient complains of difficulty walking. At rest, the skin in the
lower leg appears discolored. After walking for about two minutes the patient
complains of pain. A marked pallor is also evident in the skin over the lower
third of the extremity. The therapist suspects:

&choice200a= neurogenic claudication.

&choice200b= restless leg syndrome.

&choice200c= vascular claudication.

&choice200d= peripheral neuropathy.