1. A physical therapist compiles a table which identifies joint position at the hip, knee, ankle, andmetatarsophalangeal joints for each subunit of the stance phase of gait. Which of the following isnot accurate in describing normal joint position at the end of terminal stance?A. 15 degrees of hip hyperextensionB. 0 degrees of knee extensionC. 0 degrees of ankle dorsiflexionD. 10 degrees of metatarsophalangeal hyperextensionExplanation:Normal position of the lower extremity at the end of terminal stance is as follows: hip 10-20degrees of hyperextension; knee 0 degrees; ankle 0 degrees of dorsiflexion; metatarsophalangeal30 degrees of hyperextension. (Norkin and Levangie 460)2. A physical therapist instructs a patient diagnosed with C6 tetraplegia in functional activities.Which of the following activities would be least appropriate?A. independent raises for skin protectionB. manual wheelchair propulsionC. assisted to independent transfers with a sliding boardD. independent self range of motion of the lower extremitiesExplanation:A patient with C7 tetraplegia is the highest spinal injury level that will consistently attainindependence with self range of motion of the lower extremities. (Adkins 140)3. A group of graduate physical therapy students designs a study to determine the effect of noiselevel on the ability to perform a physical skill. In the student's study, noise is the:A. independent variableB. dependent variableC. criterion variableD. extraneous variableExplanation:The independent variable, often termed the experimental variable, is manipulated by theresearcher to determine the effect on the dependent variable. (Payton 11)4. A physical therapist uses paraffin as a means of superficial heat for a patient with a hand injury.When using the dip and wrap method, the most appropriate number of times to dip the handranges from:A. 1-3B. 3-6C. 6-9D. 9-12Explanation:A patient is usually required to immerse the hand in paraffin 6-10 times in order to form a solid waxglove around the fingers, wrist, and hand. (Michlovitz 120)5. A physical therapist interviews a patient recently involved in a motor vehicle accident. Thepatient sustained multiple lower extremity injuries as a result of the accident and appears to bevery depressed. In an attempt to encourage active dialogue the therapist asks open-endedquestions. Which of the following would not be considered an open-ended question?A. How does your knee feel today?B. What are your goals for physical therapy?C. Do you have trouble sleeping at night?D. Tell me about your present condition?Explanation:Open-ended questions allow patients to answer with a myriad of responses, while closed-endedquestions can often be answered with a yes or no response. (Goodman 25)6. A group of physical therapists employed in an acute care hospital is responsible for developingdepartmental guidelines for electrical equipment care and safety. What is the minimum requiredtesting interval for electrical equipment?A. 3 monthsB. 6 monthsC. 9 monthsD. 12 monthsExplanation:Electrical equipment should be inspected according to the specified intervals outlined by themanufacturer. Although often these intervals may be more frequent than every 12 months, it isunacceptable for any electrical equipment to be uninspected for more than a 12 month period.(Nelson 48)7. A physical therapist instructs a patient rehabilitating from a fractured right ankle to ascend a setof stairs equipped with handrails. The patient indicates that his job requires him to use the stairsfrequently and expresses concern that he will be unable to adequately navigate through traffic.The most appropriate location to stand when guarding the patient is:A. in front of the patient toward the involved sideB. in front of the patient toward the uninvolved sideC. behind the patient toward the involved sideD. behind the patient toward the uninvolved sideExplanation:When possible patients should be instructed to ascend stairs on the right side and descend on theleft side since the pattern coincides with the normal flow of traffic. As a result, the physicaltherapist should guard the patient on the left side when ascending the stairs and encourage thepatient to use the handrail with his/her right upper extremity. (Pierson 224)8. A patient rehabilitating from a lower extremity injury has been non-weight bearing for threeweeks. A recent physician entry in the medical record indicates the patient is cleared for weightbearing up to 25 pounds. The most appropriate device to use when instructing the patient on hernew weight bearing status is:A. an inclinometerB. a scaleC. an anthropometerD. a tape measureExplanation:A standard bathroom scale can effectively be used to educate patients on weight bearing status.(Minor 289)9. A patient is referred to physical therapy for instruction in an exercise program. Which of thefollowing conditions is not an absolute contraindication to exercise training?A. acute myocarditis

B. hypertrophic cardiomyopathyC. ventricular ectopyD. deep venous thrombosisExplanation:Ventricular ectopy is considered a relative contraindication to exercise testing, while the remainingoptions are absolute contraindications. (Mahler 42)10. A physical therapist observes a patient complete hip abduction and adduction exercises instanding. Which axis of movement is utilized with hip abduction and adduction?A. coronalB. verticalC. anterior-posteriorD. longitudinalExplanation:Abduction and adduction typically occur in a frontal plane around an anterior-posterior axis.(Norkin and Levangie 7)11. A physical therapy manager is informed by the Director of Rehabilitation that beginning nextweek the department must provide physical therapy services on Sunday. The manager isconcerned that the staff will not be receptive to the idea and as a result schedules a departmentalmeeting. The most immediate action to meet the staffing need is:A. ask for volunteers to work during the expanded timeB. develop a questionnaire to determine how other physical therapy departments meet theirstaffing needsC. appoint a committee to develop options to meet the staffing needsD. ask the Director of Rehabilitation to reconsider the need for the expanded coverageExplanation:A manager's role is to work with the staff to find acceptable solutions to existing problems. Byasking for volunteers the manager may solve the immediate staffing problem and thereforeprovide the necessary time to develop an appropriate long term solution. (Walter 131)12. A patient is treated using a pulsed wave ultrasound at 1.2 W/cm2 for seven minutes. Thespecific parameters of the pulsed wave is 2 msec on time and 8 msec off time for one pulseperiod. The duty cycle should be recorded as:A. 10 %B. 20 %C. 25 %D. 50 %Explanation:Duty cycle is defined as the ratio of the on time to the total time. Duty cycle = 2 msec / (2m sec +8 msec) = .20(100) = 20%. (Nelson 28)13. A physical therapist instructs a patient with a unilateral amputation to ascend and descendstairs. Which amputation level would you expect to have the most difficulty performing thedescribed task?A. transmetatarsalB. transtibialC. transfemoralD. SymesExplanation:A patient with a transfemoral amputation would have the greatest difficulty in ascending anddescending stairs. Due to the higher lever of the amputation and subsequent shorter lever armthe patient requires greater energy expenditure, balance, and coordination when using aprosthesis. (O'Sullivan 418)14. A physical therapist examines the output from a single lead electrocardiogram of a patient withatrioventricular heart block. The defining characteristic of first degree atrioventricular heart blockis:A. heightened T waveB. prolonged PR intervalC. bizarre QRS complexD. shortened ST segmentExplanation:Atrioventricular blocks are caused by an abnormal delay or failure of conduction through the AVnode or the atrioventricular bundle. Appearance of all waves on the electrocardiogram will benormal, however the PR interval will be prolonged. (Brannon 212)15. A physical therapist obtains a complete medical history prior to administering cryotherapy.Which condition would not be considered a contraindication to cryotherapy?A. Raynaud's phenomenonB. cryoglobinemiaC. cancerD. cold urticariaExplanation:Cryotherapy is not contraindicated for patient's with cancer. It is possible, however for cryotherapynot to be utilized with this patient population due to secondary complications such as diminishedsensation. (Michlovitz 101)16. A patient rehabilitating from a trimalleolar fracture is cleared for 20 pounds of weight bearing.During a scheduled therapy session, the patient admits he has not used crutches during the pastweek. The most appropriate physical therapist action is:A. instruct the patient to ask the physician to modify his weight bearing statusB. inform the patient of the potential consequence of placing too much weight on the involved legC. contact the patient's insurance providerD. discharge the patient from physical therapy due to noncomplianceExplanation:The most important factor is to promote patient compliance in order to avoid the complicationsassociated with premature weight bearing on a fracture. (Pierson 189)17. A 26 year old male rehabilitating from a fractured tibia sustained in a skiing accident is referredto physical therapy for instruction and fitting of an assistive device. The most appropriate numberof patient visits to accomplish the stated objective is:A. 1B. 3C. 5D. 7Explanation:

A 26 year old with a lower extremity injury without other associated injuries should have littledifficulty utilizing an assistive device following a single training session. (Pierson 188)18. A child with a unilateral hip disarticulation works on advanced gait training activities. Which ofthe following activities would be the most difficult for the patient?A. rising from a wheelchairB. ascending stairs with a handrailC. descending stairs with a handrailD. ascending a curbExplanation:A child with a hip disarticulation would have the greatest difficulty with ascending a curb duringprosthetic training since there are no external supports (rails) to assist with the activity. (O'Sullivan418)19. A patient with a C6 spinal cord injury is examined in physical therapy. Which objective findingwould be the strongest indication the spinal cord injury is not complete?A. intact sensation on the lateral portion of the shoulderB. absent triceps reflexC. diminished sensation over the hypothenar eminenceD. weakness of the biceps muscleExplanation:The dermatome that corresponds to the hypothenar eminence is at the C8 level. As a result, thefinding of diminished sensation (not absent) at a level below C6 may indicate the injury isincomplete. (Adkins 531)20. A physical therapist attempts to develop a research manuscript after completing a researchstudy. When drafting the manuscript the therapist reports the statistical findings of the researchstudy. In which section of the manuscript should this type of reporting occur?A. methodsB. resultsC. discussionD. conclusionExplanation:The results section includes the data and statistical analyses. The information may be presentedin a narrative, chart, or graph form. The interpretation of the data is not a component of the resultssection. (DePoy 284)21. A physical therapist reviews an entry in the medical record that indicates a 29 year old malehas normal dorsiflexion range of motion. Which measurement would be considered within normallimits?A. 0 degrees dorsiflexionB. 0-3 degrees dorsiflexionC. 0-8 degrees dorsiflexionD. 0-17 degrees dorsiflexionExplanation:According to the American Academy of Orthopedic Surgeons normal ankle dorsiflexion is 0-20degrees. (Norkin and White 222)22. A patient rehabilitating from a CVA exhibits a flexor synergy pattern in the upper extremity.The strongest component of the flexor synergy pattern is:A. shoulder lateral rotationB. forearm supinationC. elbow flexionD. scapular elevationExplanation:Elbow flexion is usually the first and the strongest component of the flexor synergy. (Brunnstrom10)23. A manager develops a policy on physical therapy utilization of continuing education resources.Which of the following would be the most appropriate action to enhance the quality of patientcare?A. offer continuing education resources to senior therapists in relation to their years of experienceB. divide the continuing education resources evenly among therapy staffC. establish a committee to review requests for continuing education resourcesD. prioritize requests for continuing education resources based on established patient carestandardsExplanation:Continuing education resources should be allocated in a manner that will provide the greatesttangible benefit for the current patient population. (Walter 128)24. A physical therapist familiarizes himself with potential sources of negligence in physicaltherapy. Which activity is most frequently cited as the basis for a malpractice claim?A. sexual misconductB. failure to follow physician's ordersC. failure to monitor the condition of the patientD. improper utilization of universal precautionsExplanation:Negligence results when a therapist provides care that falls below a standard established by law.Failure to monitor the condition of a patient is often the basis for health care malpractice claims.(Scott - Promoting Legal Awareness 32)25. A physical therapist examines the gait of a patient with a transtibial amputation. The patientexhibits delayed and limited knee flexion after heel strike on the prosthetic side. The most likelycause of the deviation is:A. foot positioned in plantar flexionB. heel wedge is too softC. socket positioned posteriorlyD. socket is too largeExplanation:If the heel wedge of a prosthesis is too soft it will not allow the prosthesis to advance as neededover the foot in order to create a flexion moment at the knee. ( Rothstein 831)26. A physical therapist examines a patient status post CVA. The patient has severe difficulty inverbal expression and mild difficulty in understanding complex syntax. This type of communicativedisorder is best termed:A. Broca's aphasiaB. conduction aphasiaC. global aphasia

D. Wernicke's aphasiaExplanation:Broca's aphasia usually occurs from a lesion to the left inferior frontal lobe. A patient with Broca'saphasia can understand what is said to them, however recovery of verbal output is slow andfragmented. (Rothstein 441)27. A patient with a hip flexion contracture exhibits inadequate hip extension during ambulationactivities. Which phase of gait would this type of deviation be identified:A. foot flat through heel offB. midstance through toe offC. heel strike through midstanceD. deceleration through midstanceExplanation:During the transition from midstance through toe off the hip should be positioned in 10-15 degreesof hip extension. A hip flexion contracture would be observed most easily during this stage of thestance phase. (Magee 570)28. A physical therapist reviews the medical record of a patient diagnosed with peripheral vasculardisease prior to initiating treatment. Which objective finding would most severely limit the patient'sability to participate in an exercise program?A. signs of resting claudicationB. decreased peripheral pulsesC. cool skinD. blood pressure: 165/90 mm HgExplanation:Peripheral vascular disease refers to a condition involving the arterial, venous, or lymphaticsystem that results in compromised circulation to the extremities. Resting claudication is typicallyconsidered a contraindication to active exercise in patients with peripheral vascular disease.(Kisner 631)29. A patient with limited elbow and forearm range of motion is referred to physical therapy. Whenmobilizing the humeroradial articulation, the treatment plane is considered to be:A. in the concave radial head, parallel to the long axis of the radiusB. in the concave radial head, perpendicular to the long axis of the radiusC. in the convex radial head, parallel to the long axis of the radiusD. in the convex radial head, perpendicular to the long axis of the radiusExplanation:The humeroradial joint consists of the convex capitulum articulating with the concave radial head.The resting position of the joint is full extension and supination. (Kisner 209)30. A physical therapist treats a patient diagnosed with spinal stenosis. As part of the treatmentprogram the patient lies prone on a treatment plinth with a hot pack draped over the lower back.The most effective method to monitor the patient while using the hot pack is:A. check on the patient at least every ten minutesB. supply the patient with a bell to ring if the hot pack becomes too hotC. instruct the patient to remove the hot pack if it becomes too hotD. select an alternate superficial heating modalityExplanation:A bell supplies the patient with a method to communicate with the therapist in a safe and efficientmanner without alarming other patients. (Michlovitz 116)31. A physical therapist asks a patient to complete a pain questionnaire. The questionnaireutilizes an ascending numeric scale ranging from 0 equaling no pain to 5 equaling excruciatingpain. This type of measurement scale is best described as:A. nominalB. ordinalC. intervalD. ratioExplanation:An ordinal measurement scale uses independent categories that have a qualitative relationshipregarding the order of ranking. (Payton 59)32. A patient with T10 paraplegia is discharged from a rehabilitation hospital following twelveweeks of intense rehabilitation. Which of the following pieces of equipment would be the mostessential to assist the patient with mobility?A. ambulation with Lofstrand crutchesB. ambulation with Lofstrand crutches and ankle-foot orthosesC. ambulation with Lofstrand crutches and knee-ankle-foot orthosesD. wheelchairExplanation:Patients with a lesion between T2 and T10 are not functional ambulators due to the extremeenergy demands and therefore utilize a wheelchair as their primary mode of mobility. (Adkins 200)33. A physical therapist assesses the mental status of a patient referred to physical therapyfollowing a motor vehicle accident. The therapist concludes that the patient can only be arousedby loud or painful stimulation. The most appropriate classification of the patient's mental status is:A. lethargicB. obtundedC. stuporousD. comatoseExplanation:A patient in a stupor will not respond to normal communication. (Magee 729)34. A physical therapist identifies the pisiform after palpating along the proximal row of carpals.Which carpal bone articulates with the pisiform?A. trapeziumB. trapezoidC. lunateD. triquetrumExplanation:The pisiform is located within the flexor carpi ulnaris tendon and lies immediately superior to thetriquetrum. (Hoppenfeld 71)35. A physical therapist examines a patient referred to physical therapy diagnosed with thoracicoutlet syndrome. The patient's past medical history is insignificant with the exception of adislocation of the sternoclavicular joint. Which of the following best describes the position of theclavicle as a result of the dislocation?A. lateral and inferior displacement

B. lateral and superior displacementC. medial and inferior displacementD. medial and superior displacementExplanation:Dislocation of the sternoclavicular joint is most often associated with a severe blow or fall on thefront of the shoulder which drives the outer end of the clavicle backward and the inner endforward. (Salter 594)36. A physical therapist measures a patient for a wheelchair. When measuring back height, whichmethod is most accurate:A. measure from the seat of the chair to the base of the axilla and subtract two inchesB. measure from the seat of the chair to the base of the axilla and subtract four inchesC. measure from the seat of the chair to the acromion process and subtract two inchesD. measure from the seat of the chair to the acromion process and subtract four inchesExplanation:A physical therapist should measure from the seat of the chair to the patient's axilla and subtractfour inches. This procedure will allow the back height to fall below the inferior angle of thescapula. Average back height in an adult size wheelchair is 16 to 16.5 inches. (Pierson 149)37. A patient diagnosed with infrapatellar tendonitis completes a series of functional activities.After completing the activities the physical therapist instructs the patient to use ice massage overthe anterior surface of the knee. The most appropriate treatment time is:A. 3 - 5 minutesB. 5 - 10 minutesC. 10 - 15 minutesD. 15 - 20 minutesExplanation:Ice massage serves as an effective method of cryotherapy over local areas such as tendons,bursae or muscle bellies. Due to the limited size of the treatment area, 5-10 minutes of icemassage is usually adequate. (Michlovitz 99)38. A patient sustains a deep partial thickness burn to the anterior surface of the right upperextremity and a superficial partial thickness burn to the anterior surface of the trunk. According tothe Rule of Nines, the patient has burns over:A. 18.5 percent of the bodyB. 22.5 percent of the bodyC. 27 percent of the bodyD. 36 percent of the bodyExplanation:The "Rule of Nines" is commonly utilized to assess the percentage of the body surface affected bya burn. Anterior surface of the right upper extremity = 4.5%, anterior surface of the trunk = 18%.(Rothstein 1119)39. A physical therapist reviews the medical record of a patient scheduled for debridement. Therecord indicates that the patient sustained a chemical burn eight days ago in an industrialaccident. The burn area was measured as 13 cm by 33 cm. This measurement most closelycorresponds to:A. 2 inches by 7 inchesB. 3 inches by 11 inchesC. 5 inches by 13 inchesD. 6 inches by 21 inchesExplanation:1 inch is equivalent to 2.54 centimeters, therefore 13 cm = 5.12 inches and 33 cm = 12.99 inches.(Thomas 345)40. A physical therapist examines a patient's scapulohumeral rhythm as the arm is activelyabducted to 30 degrees. Which description best summarizes the action of the scapula andclavicle during this movement?A. scapula 20 degrees rotation, clavicle 25-35 degrees elevationB. scapula 10 degrees rotation, clavicle 15-25 degrees elevationC. scapula minimal movement, clavicle 0-15 degrees elevationD. scapula 30 degrees rotation, clavicle 5 degrees elevationExplanation:The 2:1 ratio of humerus to scapula movement does not pertain to the initial phase of movement.(Magee 189)41. A physical therapist uses functional electrical stimulation as part of a treatment regimentdesigned to improve quadriceps strength. Which on:off time ratio would result in the most rapidonset of muscle fatigue?A. 3:1B. 1:4C. 5:1D. 1:6Explanation:Fatigue will vary directly with the ratio of on:off time. A ratio of 5:1 will therefore promote thegreatest amount of muscle fatigue. (Robinson 42)42. A national healthcare corporation agrees to provide physical therapy services for a group of25,000 autoworkers. The corporation is prepaid for services on a per member per month basis.This arrangement is best described as:A. credentialingB. fee for serviceC. accrualD. capitationExplanation:Capitation refers to a method of payment for services on a per member, per month basis. In thistype of system the provider receives payment whether or not services are utilized. (Sultz 256}43. A physical therapist enters a remote storage area to retrieve a piece of equipment andobserves flames and smoke throughout the room. The most appropriate immediate action is:A. attempt to extinguish the fireB. remove patients from the physical therapy areaC. announce the code for fire over the facility's public address systemD. attempt to contain the fire to the storage roomExplanation:A physical therapist will be much more efficient and effective in responding to an emergency withthe assistance of other trained professionals. The question provides little information on the

number of patients within the treatment area or the size of the health care facility, as a result themost appropriate response is to seek assistance by using the public address system. Althoughattempting to contain the fire through a specific action such as closing the door is very appropriate,other methods such as attempting to extinguish the fire could possibly further jeopardize the safetyof the therapist and patient. (Goold 1)44. A 55 year old male status post myocardial infarction is referred to physical therapy. Thepatient has a history of cardiac disease and is moderately obese. The patient's age predictedmaximal heart rate should be recorded as:A. 190B. 185C. 165D. 155Explanation:Age predicted maximal heart rate is determined by the formula 220 - patient's age (55) = 165.(Brannon 254)45. A physical therapist transports a patient in a wheelchair to the parallel bars in preparation forambulation activities. The patient is status post abdominal surgery and has not ambulated in overtwo weeks. The most appropriate action to facilitate ambulation is:A. assist the patient to standingB. monitor the patient's vital signsC. demonstrate ambulation in the parallel barsD. secure an additional staff member to offer assistanceExplanation:Demonstration is an essential component of any educational session particularly when instructinga patient in a new task. The parallel bars offer a secure and stable base for the patient to attemptambulation. (Minor 289)46. A physical therapist prepares to transfer a patient from a wheelchair to a treatment table. Thepatient can not stand independently, but is able to bear some weight through the lower extremities.The most appropriate transfer technique is:A. sliding board transferB. hydraulic liftC. dependent standing pivotD. two person liftExplanation:A dependent standing pivot transfer is used when a patient can bear some weight through thelower extremities, however can not transfer independently. (Minor 246)47. A risk management committee composed of various members of the rehabilitation team ischarged with identifying methods to prevent employee exposure to blood and body fluids. Themost appropriate initial action is:A. provide follow up to staff if exposed to blood and body fluidsB. provide free hepatitis B immunizations to staffC. develop an infection control policy that conforms to O.S.H.A. guidelinesD. educate staff about the policiesExplanation:All health care facilities must have a formal infection control policy that is consistent with O.S.H.A.requirements. (Pierson 314)48. A physical therapist uses a goniometer to measure range of motion at the thumb. Whenmeasuring carpometacarpal abduction, the fulcrum of the goniometer should be positioned:A. over the lateral aspect of the radial styloid processB. over the palmar aspect of the first carpometacarpal jointC. over the dorsal aspect of the first metacarpal jointD. over the dorsal midline of the proximal phalanxExplanation:Carpometacarpal abduction occurs in the sagittal plane around a medial-lateral axis. According tothe American Academy of Orthopedic Surgeons normal carpometacarpal abduction is 0-70degrees. (Norkin and White 108)49. A physical therapist examines a patient with a suspected injury to the thoracodorsal nerve.Which objective finding would be consistent with this injury?A. shoulder medial rotation weaknessB. shoulder extension weaknessC. paralysis of the rhomboidsD. forward displacement of the lateral end of the clavicleExplanation:The latissimus dorsi is innervated by the thoracodorsal nerve. Weakness in the muscle would beprimarily apparent through weakness during shoulder extension. (Kendall 279)50. A patient explains to her therapist that she was instructed to bear up to five pounds of weighton her involved extremity. This description best describes:A. non-weight bearingB. toe touch weight bearingC. partial weight bearingD. weight bearing as toleratedExplanation:Toe touch weight bearing permits the toes of the involved extremity to touch the ground forbalance, but not for weight bearing. Partial weight bearing permits the transfer of a small amountof weight through the involved extremity. (Pierson 298)51. A physical therapist completing a lower quarter screening examination attempts to palpate thetendon of the anterior tibialis. The most appropriate therapist action to facilitate palpation is:A. ask the patient to actively move the foot into dorsiflexion and eversionB. ask the patient to actively move the foot into dorsiflexion and inversionC. passively move the patient's foot into dorsiflexion and eversionD. passively move the patient's foot into dorsiflexion and inversionExplanation:The anterior tibialis acts to dorsiflex the ankle joint and assist in inversion of the foot. The muscleis innervated by the deep peroneal nerve. (Kendall 201)52. A physical therapist uses a TENS unit to generate sensory-level stimulation. Whichstimulation characteristic is not accurate when describing this technique?A. duration of treatment: 20 - 30 minutesB. amplitude: perceptible tinglingC. phase duration: 100 - 150 microseconds

D. frequency: 50 - 100 HzExplanation:Sensory-level stimulation is characterized by a relatively short phase duration of 2-50microseconds. (Robinson 285)53. A physical therapist works on transfer training with a patient and her family in preparation fordischarge. The patient can occasionally complete a wheelchair to bed transfer independently,however often requires assistance to initiate the transfer. The most appropriate classification ofthe patient's transfer status is:A. contact guard assistanceB. minimal assistanceC. moderate assistanceD. maximal assistanceExplanation:Since the patient requires assistance at times, the patient's transfer status is best described asminimal assistance. (Pierson 108)54. A physical therapist prepares to complete a series of manual lower extremity stretchingactivities on a patient with an adductor strain. The most appropriate therapist action prior toinitiating treatment is:A. ask another therapist to observe the treatment sessionB. utilize proper drapingC. position the patient in supineD. apply a superficial heating agentExplanation:Due to the location of the adductors, it is essential to adequately drape the patient prior to initiatingtreatment. (Pierson 40)55. A patient rehabilitating from a CVA requires an orthosis due to occasional dragging of the toeduring swing phase. The patient presents with weakness of the dorsiflexors and has goodmedial/lateral stability at the ankle. The most appropriate option for the patient is:A. solid ankle foot orthosisB. tone reducing foot orthosisC. posterior leaf spring orthosisD. custom articulating AFO with anterior trim linesExplanation:A posterior leaf spring orthosis is a type of ankle foot orthosis that provides a dorsiflexion assistduring swing phase. The trimline is posterior to the malleoli and does not provide any medial orlateral ankle support. (O'Sullivan 660)56. A physical therapist completes a standing flexion test to identify possible innominate distortionin a patient referred to physical therapy with chronic back pain. The most appropriate structure topalpate while completing the test is:A. spinous process of L5B. anterior superior iliac spinesC. posterior superior iliac spinesD. pubic tuberclesExplanation:The standing flexion test is designed to identify innominate distortion. The physical therapistshould palpate the inferior portion of the posterior superior iliac spine as the patient actively flexesthe spine. (Hertling 711)57. A physical therapist completes a respiratory assessment on a patient with T2 paraplegia. As acomponent of the assessment, the therapist measures the amount of chest excursion duringinspiration. The most appropriate patient position to conduct the measurement is:A. sittingB. supineC. proneD. sidelyingExplanation:The supine position creates support and resistance to the diaphragm. There is a direct correlationbetween the amount of chest expansion and intercostal strength. (Umphred 507)58. A physical therapist prescribes a wheelchair for a patient with bilateral lower extremityamputations. The most important feature of the amputee wheelchair should be:A. friction surface handrimsB. the drive wheels are set behind the vertical back supportsC. reclining back with elevating leg restsD. removable arm restsExplanation:A patient with bilateral lower extremity amputations requires offset rear wheels to accommodatefor the change in the center of gravity. An antitipping device is another method which will preventthe wheelchair and patient from falling backwards. (O'Sullivan 392)59. A physical therapist examines a 26 year old female whose subjective complaints includemorning stiffness of her hands and visible swelling. The patient indicates that the stiffness seemsto diminish with activity. This description best describes:A. carpal tunnel syndromeB. osteoporosisC. rheumatoid arthritisD. osteoarthritisExplanation:Rheumatoid arthritis is a chronic systemic disease characterized by inflammatory changes in jointsand related structures. Symptoms of rheumatoid arthritis include morning stiffness, limited rangeof motion, and pain with movement. The disease is 2-3 times more common in women than men.(Pauls 90)60. A 61 year old female diagnosed with chronic arterial disease is referred to physical therapy.Which of the following treatments would be the most appropriate based on the patient's diagnosis?A. Buerger-Allen exercisesB. Codman's exercisesC. segmental breathing exercisesD. Kegel exercisesExplanation:Buerger-Allen exercises are designed to promote collateral circulation. The exercises involve aseries of positional changes of the affected limb(s) in combination with active ankle dorsiflexionand plantar flexion. (Kisner 635)

61. A physical therapist reviews a patient's medical history before initiating soft tissue massage.Which condition would not be considered a contraindication for soft tissue massage?A. osteomyelitisB. tendonitisC. septic arthritisD. psoriasisExplanation:A variety of massage techniques are appropriate to incorporate into a treatment program for apatient with tendonitis. (De Domenico 68)62. A physical therapist prepares a patient recovering from a total hip replacement for dischargefrom the hospital. The patient is 65 years old and resides alone. Assuming an uncomplicatedrecovery, which of the following pieces of adaptive equipment would not be necessary for homeuse?A. long handled shoehornB. raised toilet seatC. sliding boardD. tub benchExplanation:A patient that is to be discharged home alone following total hip replacement surgery should beable to perform transfers without using a sliding board. (Minor 248)63. A patient with increased sympathetic output is examined in physical therapy. Which treatmenttechnique would not be beneficial in decreasing the level of sympathetic activity?A. connective tissue massageB. rotating the lower trunk in hooklyingC. slow reversal hold of the quadriceps and hamstringsD. gentle manual pressure to the abdomenExplanation:Slow reversal hold is a technique that is utilized to improve stability around a joint and control aparticular movement. Techniques that are used in order to decrease sympathetic activity includemassage, rocking, slow rolling, maintained pressure, and slow breathing. (Sullivan - ClinicalDecision Making 60)64. A physical therapist records the end-feel associated with forearm supination as firm in themedical record. Which of the following is not consistent with an end-feel categorized as firm?A. muscular stretchB. capsular stretchC. soft tissue approximationD. ligamentous stretchExplanation:Soft tissue approximation is associated with a soft end-feel. An example of a soft end-feel iscreated by contact between the soft tissue of the posterior leg and the posterior thigh during kneeflexion. (Norkin and White 9)65. A physical therapist attempts to identify the presence of clonus on a patient diagnosed with atraumatic brain injury. The most appropriate stimulus to identify clonus is:A. forcefully flex the toesB. rapidly dorsiflex the ankleC. squeeze the calfD. stroke the medial border of the footExplanation:Ankle clonus can be detected by sudden passive dorsiflexion of the ankle. Clonus is the rapidalternating muscle contraction and relaxation that occurs with damage to pyramidal pathways.(Berkow 1269)66. A 35 year old male diagnosed with ankylosing spondylitis is referred to physical therapy forinstruction in a home exercise program. Which general treatment objective would be the mostbeneficial for the patient?A. strengthening of the rectus abdominusB. strengthening of the internal and external obliquesC. strengthening of the quadratus lumborumD. strengthening of the back extensorsExplanation:Ankylosing spondylitis is a form of systemic rheumatic arthritis that results in inflammation of theaxial skeleton with subsequent back pain. The condition often is associated with an increase inthoracic kyphosis and loss of the lumbar curve. As a result, extension exercises are often animportant component of a comprehensive treatment plan. (Pauls 74)67. A 73 year old male patient receiving outpatient physical therapy begins to experience acuteangina. The patient indicates he uses nitroglycerin to combat angina. The most appropriate modeof administration is:A. oralB. buccalC. sublingualD. ointmentExplanation:Sublingual administration of nitroglycerin is most appropriate with an acute angina attack due tothe rapid absorption into the systemic circulation. (Ciccone 311)68. A physical therapist attempts to assess the motor component of the axillary nerve byconducting a resistive test. Which muscle would be the most appropriate to utilize?A. teres minorB. teres majorC. subscapularisD. supraspinatusExplanation:The teres minor and deltoid muscles are innervated by the axillary nerve. (Kendall 403)69. A physical therapist performs a dorsal glide to the distal radioulnar joint on a patient 12 weeksstatus post fracture. This technique is best used to increase:A. flexionB. extensionC. supinationD. pronationExplanation:The concave ulnar notch of the radius articulates with the convex head of the ulna to form the

distal radioulnar joint. A dorsal glide of the distal radius is used to increase supination. (Edmond66)70. A physical therapist prepares to conduct a manual muscle test of the hip flexors. Assuming agrade of poor, the most appropriate testing position is:A. proneB. sidelyingC. supineD. standingExplanation:A grade of poor indicates that the hip flexors can produce movement with gravity eliminated, butcan not function against gravity. As a result the recommended testing position is in sidelying.(Kendall 214)71. A physical therapist assesses the cough of a patient with a spinal cord injury. After completingthe assessment, the therapist classifies the cough as "functional." The most likely level of injurybased on cough function is:A. C5B. C7C. T4D. T10Explanation:A patient with a T10 spinal cord injury has normal vital capacities and a functional cough. Afunctional cough is characterized by strong expulsion of air and the ability to adequately movesecretions. (Adkins 82)72. A physical therapist applies a bandage to secure a dressing on the forearm. Which of thefollowing would indicate that the bandage was applied too loosely?A. the distal segment appears to be paleB. edema develops in the distal segmentC. the bandage changes position with active movementD. the patient complains of pain in the segment distal to the bandageExplanation:A bandage can be used for a variety of reasons including securing a dressing, maintaining abarrier between the dressing and the environment, or providing pressure to control swelling.(Pierson 307)73. A physical therapist measures elbow flexion while a patient grasps the handgrip of a walker instanding. The therapist records elbow flexion as 35 degrees. Which statement best describes theheight of the walker?A. the walker height is too low for the patientB. the walker height is too high for the patientC. the walker height is appropriate for the patientD. not enough information is given to assess walker heightExplanation:The walker should be positioned at a height that allows for 20-30 degrees of elbow flexion whenthe handgrip is grasped. (Minor 313)74. A patient with bilateral transtibial amputations works on ambulation activities prior to beingdischarged from a rehabilitation hospital. Which type of assistive device would be the mostappropriate to utilize during the training session?A. caneB. two canesC. two forearm crutchesD. walkerExplanation:Bilateral forearm crutches allow the patient to take adequate step length and exhibit a normal gaitpattern without unnecessarily jeopardizing patient safety. (O'Sullivan 417)75. A physical therapist continually makes errors when completing daily documentation. Which ofthe following statements would be the most appropriate advice to the therapist when an erroroccurs?A. use correction fluid as needed on your documentationB. place a single line through the error, write "error", date and initial itC. use pencil when completing your documentationD. use erasable ink when completing your documentationExplanation:The accepted method for correcting a mistake is to place a single line through the error, write"error", date and initial it. Other forms of correcting mistakes may be construed as negligence.(Kettenbach 10)76. A patient rehabilitating from a motor vehicle accident is referred to physical therapy for gaittraining. The patient sustained multiple injuries including a fractured tibia and a traction injury tothe brachial plexus. The patient is partial weight bearing and has good upper extremity strength.The most appropriate assistive device is:A. axillary crutchesB. Lofstrand crutchesC. walker with platform attachmentD. caneExplanation:Lofstrand crutches avoid transmitting pressure to the brachial plexus area and accommodate forthe weight bearing status of the involved lower extremity. (Pierson 194)77. A physical therapist asks a patient to complete a visual analog scale designed to assess painintensity. The scale consists of a 10 cm line with descriptive labels at each end. Whichterminology would be the most appropriate for the first label?A. no painB. mild painC. weak painD. faint painExplanation:The first label on a visual analog scale should always refer to no pain or the absence of pain. Thesecond label is most often termed most severe pain. (Magee 5)78. A physical therapist working on a medical-surgical rotation attends an inservice on HIVtransmission. Which general precaution would be the most effective to prevent the transmission ofHIV?A. use protective barriers when performing invasive procedures

B. consider all clients as potentially infectedC. wear gloves when touching blood or body fluidsD. frequently wash hands and skin surfacesExplanation:By considering all patients as potentially infected, therapists greatly reduce the transmission risk ofHIV. (Pierson 275)79. A physical therapy manager discusses the influence of laws and regulations on the practice ofphysical therapy. Which type of law would not be considered statutory?A. licensure lawsB. workers' compensation lawC. tort lawD. nondiscrimination lawExplanation:Statutory law is enacted by Congress and state legislatures. The Americans with Disabilities Actis an example of statutory law. Tort is a term that describes a private wrong and is usually doneby one person to another. (Scott - Professional Ethics 6)80. A patient is referred to physical therapy after sustaining a grade I acromioclavicular jointsprain. Common therapeutic management for this injury includes all of the following except:A. ice massageB. progressive active range of motionC. trapezius and deltoid strengtheningD. temporary immobilizationExplanation:A grade I acromioclavicular sprain often results in point tenderness and mild discomfort duringselected portions of shoulder range of motion. There is no deformity present with only mildstretching of the supporting ligaments. As a result immobilization would not typically be warranted.(Arnheim 564)81. A physical therapist assesses the pulse rate of a patient exercising on a treadmill. Thetherapist notes that the rhythm of the pulse is often irregular. The most appropriate action toensure an accurate measurement of pulse rate is:A. select a different pulse siteB. measure the pulse rate for 60 secondsC. use a different stethoscopeD. document the irregular pulse rate in the patient's medical recordExplanation:An irregular rhythm often requires a physical therapist to assess the pulse for 60 seconds.(Pierson 52)82. A physical therapist prepares to treat a patient with paraplegia on a floor mat. The patient hasfair upper extremity strength and trunk control. The most appropriate method to transfer thepatient from a wheelchair to the floor is:A. dependent standing pivotB. sliding board transferC. two person liftD. hydraulic liftExplanation:A two person lift is often used to transfer a patient with some trunk control between a wheelchairand the floor. One therapist controls the trunk and head, while the other manages the patient'slegs. The therapist controlling the trunk and the head verbalizes the commands and the patient ismoved as a unit. (Minor 242)83. A physical therapist participates in a community fitness program by conducting anthropometricmeasurements designed to determine percent body fat. Which site is not typically utilized whenmeasuring skinfolds?A. iliac crestB. subscapularC. tricepsD. lateral calfExplanation:The triceps and the subscapular skinfolds are the two most common sites utilized when measuringbody composition using a skinfold caliper. Other possible sites include the iliac crest, anteriorchest, just below and lateral to the umbilicus, and the anterior thigh. (Arnheim 107)84. A physical therapist prepares to treat a patient using ultraviolet light by determining thepatient's suberythemal dose. Which description best describes this measurement?A. time required for a severe sunburnB. time insufficient for perceptible reddening of the skinC. time required for mild reddening of the skinD. time necessary for an intense reaction causing edema, swelling and blister formationExplanation:Suberythemal dose is defined as a treatment time insufficient for perceptible reddening of the skin.Minimal erythemal dose is the time required for mild reddening of the skin, which appears withineight hours of treatment and disappears within 24 hours. (Michlovitz 270)85. A physical therapist employed in a rehabilitation hospital utilizes the services of a physicaltherapy aide. Which variable best determines the extent to which physical therapy aides areinvolved in patient care activities?A. the number of years of experienceB. the scope of formal trainingC. the discretion of the physical therapistD. the quantity of continuing education coursesExplanation:Physical therapy aides are non-licensed health care workers who are trained under the direction ofa physical therapist. The physical therapist of record is directly responsible for the actions of thephysical therapy aide. (Guide to Physical Therapist Practice 1-10)86. A physical therapist observes a patient in the physical therapy waiting room that appears to beexperiencing a heart attack. The most significant sign of a heart attack is:A. shortness of breathB. chest painC. sweatingD. nauseaExplanation:All of the presented options are signs of a heart attack, however chest pain is considered the most

significant. In addition to chest pain, patients may experience pain in the arm, neck, and shoulder.(Goold 94)87. A physical therapist prepares to treat a patient with cystic fibrosis using postural drainage. Themost appropriate patient position when treating the superior segments of the lower lobes is:A. sitting, leaning over a folded pillow at a 30 degree angleB. head down on left side, 1/4 turn backwardC. supine with two pillows under the kneesD. prone with two pillows under the hipsExplanation:To perform postural drainage to the superior segments of the lower lobes a physical therapistshould clap over the middle of the back at the tip of the scapula on either side of the spine with thepatient in prone and two pillows positioned under the hips. (Rothstein 535)88. A patient rehabilitating from a knee injury completes an isokinetic examination. The patientproduces 88 ft/lbs. of torque with the hamstrings at 120 degrees per second. Assuming normalquadriceps/hamstrings ratio, which of the following most accurately reflects the predictedquadriceps value?A. 67 ft/lbs.B. 109 ft/lbs.C. 136 ft/lbs.D. 183 ft/lbs.Explanation:The most commonly accepted ratio of quadriceps to hamstrings strength is 3:2. As the speed ofmovement increases above 200 degrees per second the ratio approaches 1:1. (Hamill 236)89. A physical therapist elects to treat a patient with a second degree ankle sprain using a contrastbath. Which temperatures would be the most appropriate when preparing the cool and warmwater?A. 9 degrees Celsius and 34 degrees CelsiusB. 14 degrees Celsius and 41 degrees CelsiusC. 19 degrees Celsius and 45 degrees CelsiusD. 23 degrees Celsius and 48 degrees CelsiusExplanation:The cooler water temperature should range from 10-18 degrees Celsius, while the warmer watertemperature is 38-44 degrees Celsius. (Michlovitz 161)90. A physical therapist uses a 3.0 MHz ultrasound beam at 1.5 W/cm2 to treat a patientdiagnosed with carpal tunnel syndrome. The majority of ultrasound energy will be absorbed withina depth of:A. 1 - 2 cmB. 2 - 3 cmC. 3 - 4 cmD. 4 - 5 cmExplanation:3.0 MHz frequency is used to treat tissues up to 1-2 cm from the skin surface, while 1.0 MHzfrequency is more appropriate for deeper structures. (Michlovitz 177)91. A physical therapist serves as an accessibility consultant for a local retail store. What is theminimum width required for a wheelchair dependent patient to safely traverse through a doorway?A. 28 inchesB. 30 inchesC. 32 inchesD. 34 inchesExplanation:According to the Americans with Disabilities Act the minimum doorway width is 32 inches. (Minor472)92. A physical therapist reviews the medical record of a 52 year old male status post myocardialinfarction. The patient is currently in the coronary care unit and is scheduled to begin cardiacrehabilitation tomorrow. Which potential complication of a myocardial infarction is the patient mostsusceptible to:A. heart failureB. arrhythmiasC. thrombus formationD. heart structural damageExplanation:Arrhythmias occur in approximately 90% of individuals following myocardial infarction. Each of thelisted options are possible complications following myocardial infarction, however they are not asprevalent as arrhythmias. (Brannon 102)93. A physical therapist discusses numerous aspects of a bladder management program with apatient diagnosed with a spinal cord injury. Which value is most reflective of the patient'srecommended daily fluid intake?A. 1000 - 2000 ccB. 3000 - 4000 ccC. 5000 - 6000 ccD. 7000 - 8000 ccExplanation:A patient that has sustained a spinal cord injury must intake between 3000-4000cc of fluid daily.This amount is required to avoid dehydration and prevent overdistention of the bladder.Scheduled catheterizations along with monitoring of fluid intake are required for a successfulbladder program. (Adkins 171)94. A physical therapist positions a patient in prone on a treatment plinth in preparation for a hotpack. When preparing the hot pack for the lower back, the therapist should utilize:A. 2 - 4 towel layersB. 4 - 6 towel layersC. 6 - 8 towel layersD. 8 - 10 towel layersExplanation:Six to eight towel layers placed between a hot pack and the treatment surface is generallyadequate to allow transmission of heat without jeopardizing patient safety. (Michlovitz 116)95. A physical therapist attempts to determine if a wheelchair is the appropriate size for a patientrecently admitted to a rehabilitation program. As part of the assessment, the therapist examinesthe distance from the front edge of the seat to the posterior aspect of the lower leg. If the seatdepth is appropriate, how much space should exist between these two landmarks?

A. 2 inchesB. 4 inchesC. 6 inchesD. 8 inchesExplanation:Two inches between the front edge of the seat and the posterior aspect of the lower legdemonstrates appropriate seat depth. Normal seat depth in an adult size wheelchair is 16 inches.(Pierson 95)96. A patient confined to a wheelchair arranges for a local contractor to build a ramp that will allowentry into the patient's house. What is the maximum recommended grade for the ramp?A. 6.2 %B. 8.3 %C. 9.5 %D. 10.4 %Explanation:According to the Americans with Disabilities Act the grade of a ramp should be no greater than8.3%. The information can also be expressed as for every inch of rise, there should be a minimumof 12 inches of run. (Minor 471)97. A physical therapist examines a 23 year old male diagnosed with a lower brachial plexus injurysustained four weeks ago. Which of the following mechanisms of injury is the most probablebased on the patient's diagnosis?A. high velocity motorcycle accidentB. excessive hyperabduction of the arm caused during a free fallC. a direct forceful blow to the anterior shoulder complexD. excessive traction and lateral flexion of the head and neck during the birthing processExplanation:Lower brachial plexus injuries can occur during the birthing process, however due to the patient'sage and acuity of the injury, the most likely mechanism of injury is through excessivehyperabduction of the upper extremity. Upper brachial plexus injuries can occur through highvelocity accidents where there is excessive separation of the neck and shoulder. (Saidoff 236)98. A 16 year old female accompanied by her mother receives exercise instructions. During thetreatment session the mother makes several comments to her daughter that appear to beextremely upsetting and result in the daughter losing concentration. The most appropriatephysical therapist action is:A. document the mother's comments in the medical recordB. ask the patient if her mother is verbally abusiveC. ask the mother to return to the waiting areaD. discontinue the treatment sessionExplanation:The physical therapist's primary concern should be to establish an environment that is conduciveto instructing the patient in an exercise program. Failure to address the negative interactionbetween the mother and daughter may limit the effectiveness of the session. (Purtillo - HealthProfessional 136)99. A physical therapist working on a medical/surgical rotation returns from a morning inserviceand finds a number of items that require her attention. Which of the following items should begiven the highest priority?A. a patient requiring preoperative instructionB. an incomplete exercise flow sheetC. an unfinished wheelchair order formD. a written note from a staff dieticianExplanation:The most important priority is to provide preoperative patient instruction. The other statedactivities are important, however can be deferred without immediate consequence. (Code ofEthics)100. A physical therapist explains to a patient each of the four distinct sensations he willexperience when using ice massage. Which sequence is most accurate?A. cold, aching, burning, analgesiaB. burning, analgesia, aching, coldC. analgesia, burning, aching, coldD. cold, burning, aching, analgesiaExplanation:Patients will typically experience cold, burning, aching, and finally analgesia during a 5-10 minutesession of ice massage. (Michlovitz 99)101. A case manager discusses placement options for a 78 year old female rehabilitating from atotal hip replacement. The patient has moderate dementia, however was living independentlyprior to surgery. The patient's spouse is deceased and she denies having any family or friends inthe area. The most appropriate location for continued therapy services is:A. extended care facilityB. outpatient private practiceC. home physical therapy servicesD. outpatient rehabilitation facilityExplanation:The patient's cognitive status combined with her postoperative condition make it unrealistic for thepatient to return to her home. An extended care facility would enable the patient to receivecontinued therapy services and at the same time provide a safe living environment. (Post StrokeRehabilitation 73)102. A male patient referred to physical therapy with low back pain attempts to complete anabdominal strengthening exercise. The patient is unable to complete a curl-up with his armsacross his chest. The most appropriate modification is:A. place the hands behind the headB. arch the back to lock the spineC. anteriorly rotate the pelvisD. place the arms at the sideExplanation:Placing the arms at the side of the body makes the exercise easier to perform and as a result is anacceptable modification. (Kisner 712)103. A physical therapist examines a patient rehabilitating from a middle cerebral artery stroke.Which condition is not typically associated with this type of stroke?A. urinary incontinence

B. contralateral hemiplegiaC. aphasiaD. homonymous hemianopsiaExplanation:Urinary incontinence is a clinical symptom that occurs with a vascular infarct to the anteriorcerebral artery. (Umphred 684)104. A patient sustains a deep laceration on the anterior surface of the forearm. The physicaltherapist attempts to stop the bleeding by direct pressure over the wound, but is unsuccessful.The most appropriate action is to:A. apply pressure to the brachial artery pressure pointB. apply pressure to the femoral artery pressure pointC. apply pressure to the radial artery pressure pointD. apply pressure to the ulnar artery pressure pointExplanation:The brachial artery can be compressed against the medial aspect of the humerus in an attempt tocontrol the bleeding. (Arnheim 193)105. A physical therapist discusses the importance of a well balanced diet with a patientdiagnosed with type II diabetes. The most appropriate action to emphasize the importance of dietis:A. provide a handout from the American Diabetes Association which outlines an appropriate dietB. ask other patients that have made dietary changes to speak to the patientC. arrange for a consultation with a dieticianD. provide copies of recent research articles which cite the benefit of a well balanced dietExplanation:Although many therapists possess a basic background in nutrition, a patient with type II (noninsulindependent) diabetes is an ideal candidate to refer to a dietician. (Tierney 1005)106. A patient of Iranian descent wearing a traditional turban is examined in physical therapy aftersustaining a whiplash type injury in a motor vehicle accident. The physical therapist would like thepatient to remove the turban, however is concerned that the patient may become insulted. Themost appropriate action is to:A. modify the examination in order to avoid removing the turbanB. explain to the patient the difficulty of conducting the examination with the turban onC. ask the patient if he would feel comfortable removing the turban during the examinationD. instruct the patient to remove the turbanExplanation:In order to conduct an appropriate examination of the cervical spine, a physical therapist shouldattempt to expose the entire cervical region. Asking the patient permission to remove the turbanprovides the patient with an opportunity to refuse the request. (Haggard 39)107. A physical therapist suspects a female patient recently referred to physical therapy may be avictim of domestic abuse. The most appropriate initial action is:A. provide the patient with a phone number to a domestic abuse centerB. report your suspicions to the local authoritiesC. ask the patient if she has experienced any form of domestic abuseD. document the domestic abuse in the medical recordExplanation:Physical therapists have a duty to identify and report suspected patient abuse to local authorities,however it is often advisable to seek confirming information from an adult prior to initiating formalaction. (Scott - Professional Ethics 162)108. A physical therapist administers a contrast bath to a patient rehabilitating from a lateral anklesprain. The therapist begins the first cycle by immersing the involved ankle in the warm water forthree minutes and then promptly moves the ankle into the cold water. How long should thetherapist leave the ankle in the cold water?A. 30 secondsB. 1 minuteC. 3 minutesD. 5 minutesExplanation:The ratio of heat to cold when using a contrast bath is most commonly expressed as 3:1 or 4:1.(Arnheim 320)109. A patient rehabilitating from a fractured acetabulum is referred to physical therapy forambulation activities. The patient has been on bed rest for three weeks and appears to besomewhat apprehensive about weight bearing. The most appropriate device to use when initiatingambulation activities is:A. parallel barsB. walkerC. axillary crutchesD. straight caneExplanation:The parallel bars provide the patient with the most stable environment to begin ambulationactivities. (Pierson 193)110. A twelve year old boy sitting in the physical therapy waiting area suddenly grasps his throatand appears to be in distress. The boy slowly stands, but is obviously unable to breathe. Thephysical therapist recognizing the signs of an airway obstruction should administer:A. abdominal thrustsB. chest thrustsC. back blowsD. back blows in combination with abdominal thrustsExplanation:An airway obstruction in a child or an adult is best treated by using subdiaphragmatic abdominalthrusts. (Arnheim 191)111. A physical therapist assesses a patient's upper extremity deep tendon reflexes as part of ascreening examination. The most appropriate location to elicit the brachioradialis reflex is the:A. radial tuberosityB. antecubital fossaC. biceps tendonD. styloid process of the radiusExplanation:The brachioradialis reflex is best elicited by using the flat end of the reflex hammer over the distalend of the radius. This reflex can be used to examine the integrity of the C6 nerve root. (Gross

207)112. A physical therapist working on an acute care floor reviews the medical record of a patientwith suspected renal involvement. Which laboratory test would be the most useful to assess thepatient's present renal function?A. platelet countB. hemoglobinC. blood urea nitrogenD. hematocritExplanation:Blood urea nitrogen is a common measure used to examine renal function. A rise in blood ureanitrogen levels can be indicative of an impairment in renal tubule excretion. (Goodman 276)113. A physical therapist attends an inservice on incomplete spinal cord injuries. As part of theinservice the speaker describes several frequently observed syndromes of neurologicalinvolvement. Which syndrome does not include an alteration in motor function?A. central cord syndromeB. anterior cord syndromeC. Brown-Sequard's syndromeD. posterior cord syndromeExplanation:Posterior cord syndrome results from an injury to the posterior column of the spinal cord. Thisinjury is rare and does not affect motor function, light touch, and pain. (Adkins 15)114. A physical therapist prepares to assist a patient with a sliding board transfer from awheelchair to a mat table. Which of the following would be the most appropriate initial instructionto the patient?A. place the sliding board under your buttocksB. move your buttocks toward the mat tableC. complete a series of push-upsD. secure the wheelchair brakesExplanation:Securing the wheelchair brakes is always the most appropriate action when preparing to perform atransfer from a wheelchair. (Minor 248)115. A physical therapist completes a respiratory assessment on a patient in an acute carehospital. The examination reveals decreased breath sounds and decreased fremitus. This findingis most indicative of:A. pleural effusionB. pulmonary edemaC. consolidationD. atelectasisExplanation:Decreased breath sounds and decreased fremitus are most likely caused by pleural effusion orpneumothorax. Pulmonary edema, consolidation, and atelectasis are often associated withdecreased breath sounds and increased fremitus. (Irwin 343)116. A patient with several motor and sensory abnormalities exhibits signs of autonomic nervoussystem dysfunction. Which of the following is not an indicator of increased sympatheticinvolvement?A. anxiety, distractibilityB. mottled, cold, shiny skinC. constriction of the pupilsD. rapid, shallow breathingExplanation:Dilation of pupils may be an indicator of increased sympathetic output. (Sullivan - ClinicalDecision Making 60)117. A patient diagnosed with Guillain-Barre syndrome works on weightshifting activities whilestanding in the parallel bars. The primary objective of this activity is to improve:A. mobilityB. stabilityC. controlled mobilityD. skillExplanation:Controlled mobility is the third stage of motor control where proximal segments move over a distalweight bearing part. Control should be attained first in a small range and gradually expanded aswarranted based on the patient response. (Sullivan - Integrated Approach 28)118. A physical therapist records the parameters of an electrical stimulation treatment in apatient's medical record. The standard unit of measure when recording AC frequency is:A. voltB. hertzC. coulombD. pulses per secondExplanation:Acceptable terminology for the frequency of alternating current is cycles per second or hertz.Pulses per second is utilized to describe the frequency of pulsed current. (Robinson 14)119. A physical therapist working in cardiac rehabilitation progresses a patient involved in a phaseII program through an established exercise protocol. The patient weighs 70 kg and hasprogressed without difficulty through the rehabilitation program. The protocol indicates the patientshould be performing activities requiring 3 - 4 METs. An example of an appropriate activity wouldbe:A. level walking at 1.5 mphB. jogging at 5 mphC. cycling at 10 mphD. walking on a treadmill at 3 mphExplanation:One metabolic equivalent is the amount of oxygen consumed at rest and is equal to approximately3.5 milliliters of oxygen per kilogram of body weight per minute. Other recreational activitiesrequiring 3-4 METs include cycling at 6 mph and golfing while pulling a bag cart. (Brannon 3)120. A physical therapist instructs a patient with a lower motor neuron disease to perform a swingto gait pattern. The most appropriate initial step when instructing the patient is:A. secure another staff member to assist with guardingB. demonstrate a swing to gait patternC. describe the various stages of weight bearing

D. provide a written handout describing the gait patternExplanation:Demonstration provides the opportunity for the patient to observe a specific action beingperformed correctly and as a result often enhances learning and decreases anxiety. (Minor 289)121. A physician provides a group of physical therapists with an overview of diagnostic imagingtechniques commonly used in clinical practice. Which imaging technique would not be consideredinvasive?A. arthrographyB. myelographyC. discographyD. computerized tomographyExplanation:Computerized tomography is an imaging technique that uses cross sectional images based on xrayattenuation. Computer enhancement allows the imaging to have significantly better contrastresolution when compared to conventional x-rays. (Magee 43)122. A physical therapist utilizes continuous ultrasound to supply thermal effects to a patientrehabilitating from a lower extremity injury. During the treatment session, the patient suddenlybecomes startled and reports feeling an electrical shock from the ultrasound machine. The mostappropriate therapist action is to:A. decrease the intensity of the ultrasoundB. modify the duty cycleC. discontinue ultrasound treatmentD. unplug the machine and label - defective, do not useExplanation:Any equipment that is potentially defective should be formally inspected prior to being used to treatpatients. (Nelson 48)123. A patient in a rehabilitation hospital begins to verbalize about the uselessness of life and thepossibility of committing suicide. The most appropriate physical therapist action is:A. suggest the patient be placed on a locked unitB. ask nursing to check on the patient every 15 minutesC. discuss the situation with the patient's case managerD. review the patient's past medical history for signs and symptoms of mental illnessExplanation:Suicide is a leading cause of death in an adult population. As a result, any formal or informalindication that a patient may be suicidal should be taken seriously. The case managercommunicates with all of the members of the rehabilitation team and is therefore the mostappropriate of the presented options. (Bailey - Mental Health 317)124. A physical therapy department embarks on a quality assurance program. Results from arandom sample of patient charts reveal that 40% of the charts do not include a dischargesummary. A logical next step to the quality assurance program would be:A. dismiss the findings because discharge summaries are not directly related to the quality ofpatient careB. discipline the staff members who did not complete the discharge summaries and continue tomonitor the situationC. dismiss the findings because a random sample does not provide accurate informationD. notify the staff that discharge summaries are to be completed on all patients and continue tomonitor the situationExplanation:Quality assurance refers to activities or programs designed to achieve a desired degree or gradeof care. Findings from quality assurance initiatives should be communicated directly to staff in amanner that is constructive, instead of punitive. (Walter 242)125. A physical therapist presents an inservice entitled "The Geriatric Patient and the Effect ofDrugs on Rehabilitation." As part of the inservice the therapist describes drug therapy for severaldifferent cardiovascular diseases. Which of the following is the most common type of medicationprescribed to patients with congestive heart failure?A. anticoagulantsB. vasodilatorsC. diureticsD. calcium channel blockersExplanation:Diuretics are commonly used to treat patients with congestive heart failure since the primarymechanism of action is to increase the formation and excretion of urine. (Ciccone 291)126. A physical therapist employed in a rehabilitation hospital examines a patient that exhibitsseveral signs and symptoms of anemia. Which question would be the most useful to gatheradditional information related to anemia?A. Does it hurt to take a deep breath?B. Do you experience heart palpitations or shortness of breath at rest or with mild exertion?C. Do you frequently experience dizziness, headaches or blurred vision?D. Are you susceptible to bruising?Explanation:Anemia refers to a condition in which there is reduced delivery of oxygen to the tissues due to areduction in the number of circulating red blood cells. Heart palpitations along with dyspnea areoften associated with this condition. (Goodman 195)127. A physical therapist completes a manual muscle test of the flexor digitorum brevis. In orderto accurately assess the strength of the muscle, the therapist should apply pressure against the:A. dorsal surface of the middle phalanx of the four toes in the direction of extensionB. plantar surface of the middle phalanx of the four toes in the direction of extensionC. dorsal surface of the distal phalanx of the four toes in the direction of extensionD. plantar surface of the distal phalanx of the four toes in the direction of extensionExplanation:The flexor digitorum brevis acts to flex the proximal interphalangeal joints, and assists in flexion ofthe metatarsophalangeal joints of the second through fifth digits. The muscle is innervated by thetibial nerve. (Kendall 193)128. A terminally ill patient completes a formal document that names his daughter as the individualto make health care decisions in the event that he is unable. This type of advanced directive istermed:A. living willB. directives to physiciansC. durable power of attorney

D. euthanasiaExplanation:Durable power of attorney for health care decisions is a legal document that delegates decisionmaking to a specified individual in the event another individual is found to be incompetent to makea decision. (Scott - Professional Ethics 150)129. A patient completes a home exercise program consisting of progressive resistive exercises ina sagittal plane. Which of the following exercises would be appropriate?A. shoulder abduction with a two pound dumbbellB. hip medial rotation with a one pound cuff weightC. elbow flexion with elastic tubingD. horizontal adduction with a wall pulleyExplanation:Flexion and extension occur in a sagittal plane around an anterior-posterior axis. (Norkin andLevangie 4)130. The medical record indicates a patient has been diagnosed with chronic respiratory alkalosis.The most consistent laboratory finding with this condition is:A. elevated arterial blood pH, low PaCO2B. low arterial blood pH, elevated PaCO2C. elevated arterial blood pH, elevated PaCO2D. low arterial blood pH, low PaCO2Explanation:Respiratory alkalosis is caused by alveolar hyperventilation. Signs and symptoms includedizziness, syncope, tingling, and numbness. (Rothstein 529)131. A physical therapist completes an examination on a self-referred patient. The patientcomplains of general fatigue, shortness of breath, and occasional dizziness. Results of a physicalexamination reveal localized lower extremity weakness and diminished balance. The mostappropriate action is to:A. implement a low level exercise programB. identify appropriate strengthening exercisesC. establish short and long term goalsD. refer the patient to a physicianExplanation:A self-referred patient that presents with multisystem involvement should be examined by aphysician prior to engaging in a formal physical therapy program. (Guide for ProfessionalConduct)132. A patient recently diagnosed with a deep venous thrombophlebitis is placed on Heparin. Theprimary side effect associated with Heparin is:A. hypotensionB. depressionC. excessive anticoagulationD. thrombocytopeniaExplanation:Heparin, the primary drug used to treat venous thrombosis, is administered parenterally. Themost common side effect of the drug is increased bleeding. (Ciccone 356)133. A 29 year old male diagnosed with ankylosing spondylitis reports progressive stiffening of thespine and associated pain for more than five years. The patient's most typical standing posturedemonstrates:A. posterior thoracic rib humpB. flattened lumbar curve, exaggerated thoracic curveC. excessive lumbar curve, flattened thoracic curveD. lateral curvature of the spine with fixed rotation of the vertebraeExplanation:Ankylosing spondylitis is a form of systemic rheumatic arthritis that is associated with an increasein thoracic kyphosis and loss of the lumbar curve. Ankylosing spondylitis occurs three times moreoften in males than females with a typical age of onset of 20-40 years. (Pauls 74)134. A physical therapist examines the residual limb of a patient following ambulation activitieswith a patellar tendon bearing prosthesis. The therapist identifies excessive redness over thepatella. The most likely cause is:A. settling due to limb shrinkageB. socket not properly alignedC. excessive withdrawal in sittingD. excessive number of residual limb socksExplanation:A patient would likely have reddening over the patella if the residual limb has shrunk and/or if thereis inadequate number ply of socks used. In both cases, the residual limb would sit lower in theprosthesis and the patella would hit the patellar tendon bearing surface. (O'Sullivan 390)135. A physical therapist prepares to complete an upper extremity manual muscle test by placingthe patient's arm in an antigravity test position. The patient is unable to maintain the test positionand slowly allows the arm to sag. The muscle grade should be recorded as:A. good minusB. fairC. fair minusD. trace plusExplanation:A fair minus muscle grade is associated with an inability to maintain the test position againstgravity. (Kendall 188)136. A physical therapist attempts to determine if a patient is a candidate for aquatic therapy.Which condition would not be considered a contraindication to aquatic therapy?A. infectious diseaseB. urinary tract infectionC. feverD. Raynaud's diseaseExplanation:Raynaud's disease is a peripheral vascular disorder characterized by abnormal vasoconstriction ofthe extremities upon exposure to cold or emotional distress. Although Raynaud's disease can beconsidered a contraindication for selected forms of cryotherapy, it is not contraindicated for aquatictherapy. (Michlovitz 102)137. A physical therapist examines a patient diagnosed with adhesive capsulitis. The examinationreveals the patient has significant capsular tightness in the anterior-inferior aspect. The most

likely resultant range of motion limitation is:A. adduction and medial rotationB. abduction and lateral rotationC. flexion and medial rotationD. extension and lateral rotationExplanation:Anterior capsular tightness at the glenohumeral joint may result in limited lateral rotation andextension, while inferior capsular tightness is associated with limited abduction. (Edmond 25)138. A patient is asked to complete a pain questionnaire. The patient selects words such ascramping, dull, and aching to describe the pain. What related structure is most consistent with thepain description?A. nerve rootB. muscleC. fractureD. sympathetic nerveExplanation:Muscle pain is often characterized as cramping, dull, and aching, while nerve root pain is moreoften termed sharp or shooting. Subjective pain descriptors can provide valuable informationrelated to a patient's condition. (Magee 6)139. A physical therapist examines a patient with suspected vascular compression in the shoulderregion. Which special test would be least beneficial to confirm the therapist's suspicions?A. Adson maneuverB. Halstead maneuverC. Froment's signD. Wright TestExplanation:Froment's sign is a special test where a patient attempts to grasp a piece of paper between thethumb and index finger. A positive test is indicated by flexion of the terminal phalanx of the thumbcaused by paralysis of the adductor pollicis longus. The test is used to assess the integrity of theulnar nerve. (Magee 308)140. A 29 year old female status post Colles' fracture is referred to physical therapy. The patienthas moderate edema in her fingers and the dorsum of her hand and complains of pain duringactive range of motion. The most appropriate method to quantify the patient's edema is:A. volumetric measurementsB. circumferential measurementsC. girth measurementsD. anthropometric measurementsExplanation:Volumetric measurements are often used to quantify the presence of edema in the wrist and hand.Comparison with the uninvolved extremity provides a baseline measure, however it is important tonote there may be a small difference between the dominant and nondominant hand. (Magee 311)141. A physical therapist prepares to treat a patient in respiratory isolation. What type ofprotective equipment would be necessary prior to entering the patient's room?A. glovesB. maskC. gloves and maskD. gloves, gown, and maskExplanation:Respiratory isolation requires individuals coming close to the patient to wear a mask, but does notrequire the use of a gown or gloves. Respiratory isolation is often indicated by placing a blue cardoutside of a patient's room. (Pierson 281)142. A physical therapist administers tapotement as part of a treatment plan for a patientdiagnosed with bronchiectasis. Which of the following massage strokes is not an example oftapotement?A. kneadingB. clappingC. hackingD. beatingExplanation:Kneading is a form of petrissage. (De Domenico 37)143. A physical therapist collects data as part of a research project that requires direct observationof children performing selected gross motor activities. The therapist is concerned about theinfluence of an observer on the children's performance. The most effective strategy to control forthis source of error is to:A. provide initial and refresher observer trainingB. increase observer awareness of the influence of his/her backgroundC. have an observer spend time with the children before direct observationD. ask the children to ignore the presence of the observerExplanation:Spending time with the children prior to direct observation will allow them to feel more at ease andas a result their performance may be more reflective of their current abilities. (Payton 104)144. A patient with severe low back pain is referred to physical therapy. The patient reportsinjuring his back two days ago while lifting his child out of a car seat. The patient has difficulty withactive movement and is currently unable to work. The most appropriate treatment intervention is:A. hot packs and ultrasoundB. lumbar stabilization exercisesC. high voltage galvanic stimulationD. bed mobility and postural awareness trainingExplanation:Bed mobility and postural training will assist the patient to successfully complete essential dailyactivities and may reduce stress on the spine. High voltage galvanic stimulation is an appropriatetreatment option, however it is unlikely to provide the same magnitude of benefit as the previouslydescribed option. (Kisner 496)145. A physical therapist preparing for phonophoresis treatment on a patient diagnosed withimpingement syndrome palpates the insertion of the supraspinatus. What bony landmark bestcorresponds to this site?A. lesser tubercle of the humerusB. greater tubercle of the humerusC. supraspinatus fossa of the scapula

D. deltoid tuberosity of the humerusExplanation:The supraspinatus originates on the supraspinatus fossa of the scapula and inserts on the greatertubercle of the humerus. The muscle is innervated by the suprascapular nerve. (Reese 57)146. A patient status post motor vehicle accident is referred to physical therapy. The patient hasmultiple injury sites including the hand, wrist, elbow, and knee. As part of the patient care plan,the physical therapist attempts to increase tissue temperature at each of the involved sites. Themost appropriate thermal agent is:A. diathermyB. ultrasoundC. hydrotherapyD. hot packsExplanation:Hydrotherapy is the most appropriate thermal agent due to the varied location and size of thetreatment area. (Cameron 174)147. A physical therapist presents an inservice on graded oscillation techniques. Which grades ofoscillation are the most appropriate for stretching maneuvers?A. I, IIB. I, IIIC. II, IIID. III, IVExplanation:Grade I and II oscillations are used primarily to treat joints limited by pain, while grade III and IVoscillations are used as stretching maneuvers. (Kisner 194)148. A physical therapist examines the breath sounds of a 55 year old male diagnosed withpulmonary disease. The therapist identifies rales during both inspiration and expiration. Thisfinding is most representative of:A. pleural effusionB. pulmonary fibrosisC. impaired secretion clearanceD. localized stenosisExplanation:Low pitched, nonrhythmical sounds occurring throughout the ventilatory cycle often are indicativeof fluid in the large airways due to impaired secretion clearance. (Irwin 339)149. A rehabilitation manager conducts an inservice on Medicare rules and regulations. Which ofthe following practice settings would not receive primary reimbursement through Medicare Part A?A. hospitalB. home health careC. outpatientD. skilled nursingExplanation:Outpatient physical therapy services are primarily reimbursed though Medicare Part B. MedicarePart A provides benefits for hospitals, outpatient diagnostic services, extended care facilities, andshort term care at home required by an illness for which the patient is hospitalized. (Sultz 220)150. A physical therapist reviews the medical record of a patient recently referred to physicaltherapy. The record indicates the patient has polycythemia. Which of the following laboratoryresults would be expected based on the patient's condition?A. increased hematocrit and hemoglobin levelsB. decreased hematocrit and hemoglobin levelsC. increased hematocrit and decreased hemoglobin levelsD. decreased hematocrit and increased hemoglobin levelsExplanation:Polycythemia is a condition characterized by an excessive number of erythrocytes and anincreased concentration of hemoglobin. (Goodman 199)151. A physical therapist instructs a patient's spouse to remove and reapply a bandage. Which ofthe following instructional methods would be the most appropriate to ensure the task is performedappropriately?A. have the patient instruct the spouse how to remove and reapply the bandageB. provide written instructions on how to remove and reapply the bandageC. instruct the spouse to remove and reapply the bandage and observe her performanceD. instruct the spouse to contact the physical therapy department if she has specific questions onhow to remove or reapply the bandageExplanation:The physical therapist should observe the removal and reapplication of the bandage in order todetermine if the spouse is capable of performing the task. Although this will not ensure the task isdone appropriately in the future, it will identify if the spouse needs remedial assistance. (Kisner12)152. A physical therapist completes a study which examines the effect of goniometer size on thereliability of passive shoulder joint measurements. The therapist concludes that goniometricmeasurements of passive shoulder range of motion can be highly reliable when taken by a singletherapist, regardless of the size of the goniometer. This study demonstrates the use of:A. intertester reliabilityB. intratester reliabilityC. internal validityD. external validityExplanation:Intratester reliability refers to the amount of agreement between repeated measurements of thesame joint position by the same therapist. (Norkin and White 41)153. A physical therapist employed in an acute care hospital examines a patient rehabilitating fromsurgery. Which of the following situations would most warrant immediate medical attention?A. diabetic patient demonstrating signs of confusion and lethargyB. systolic blood pressure elevation of 20 mm Hg during exerciseC. lack of significant clinical findings following an initial examinationD. discovery of significant past medical history unknown to the physicianExplanation:Signs of confusion and lethargy in a patient with diabetes can be indicative of a significantalteration in a patient's glycemic state. The condition if untreated can rapidly progress towards alife threatening situation. (Goodman 349)154. A patient with a peripheral nerve injury is examined in physical therapy. The patient's primary

symptoms result from an injury to the superficial peroneal nerve. The most likely area of sensoryalteration is:A. sole of the footB. plantar surface of the toesC. lateral aspect of the leg and dorsum of the footD. triangular area between the first and second toesExplanation:The superficial peroneal nerve innervates the peroneus longus and brevis. A peripheral nerveinjury affecting the superficial peroneal nerve often results in sensory alterations along the lateralaspect of the leg and dorsum of the foot. (Magee 642)155. A physical therapist reviews a physician examination which indicates diminished sensation inthe L3 dermatome. The most appropriate location to confirm the physician's findings is:A. dorsum of footB. anterior thighC. lateral thighD. lateral calfExplanation:The L3 dermatome corresponds to portions of the back, upper buttock, anterior thigh and knee,and the medial lower leg. (Magee 12)156. A 32 year old female complains of pain in her left wrist and forearm. The patient reports aninsidious onset of pain two weeks ago. Physical examination reveals weakness and pain withresisted thumb extension and abduction and point tenderness along the distal radius. The mostappropriate special test to gain additional insight into the patient's condition is:A. Froment's signB. Phalen's testC. Finkelstein testD. Bunnel-Littler testExplanation:The Finkelstein test is designed to identify the presence of de Quervain's tenosynovitis in thethumb. A positive test is indicated by pain over the abductor pollicis longus and the extensorpollicis brevis tendons at the wrist. (Magee 308)157. A physical therapist and a physical therapist assistant work as a team in an orthopedicprivate practice. Which activity would be inappropriate for the physical therapist assistant?A. application of a superficial modalityB. completing a discharge summaryC. leading a group exercise programD. performing an isokinetic testExplanation:Physical therapist assistants often complete documentation in the medical record, however thephysical therapist is responsible for establishing a discharge plan and documenting the dischargesummary. (Guide to Physical Therapist Practice 1-11)158. A physical therapist examines a patient diagnosed with calcific tendonitis. The therapistconcludes the patient's glenohumeral range of motion is limited in a capsular pattern. The mostcommon clinical presentation is:A. limitation in flexion, medial rotation, and abductionB. limitation in lateral rotation, abduction, and medial rotationC. limitation in flexion, adduction, and lateral rotationD. limitation in abduction, extension, and medial rotationExplanation:The capsular pattern in order of restriction for the glenohumeral joint is lateral rotation, abduction,and medial rotation. (Magee 22)159. A physical therapist prepares a patient with burns over 65 percent of the body forhydrotherapy. Due to the extent of the patient's burns, the therapist plans to use full-bodyimmersion. The most appropriate piece of equipment to satisfy the therapist's objective is:A. fluidotherapyB. highboy tankC. lowboy tankD. Hubbard tankExplanation:An average size Hubbard tank is eight feet long, six feet wide, and four feet deep. The tanks oftenhold over 400 gallons of water and are designed for full body immersion. (Cameron 201)160. A patient elevated on a tilt table to 60 degrees suddenly begins to demonstrate signs andsymptoms of orthostatic hypotension. The most appropriate physical therapist action is to:A. lower the tilt table 10 degrees and monitor the patient's vital signsB. lower the tilt table 20 degrees and monitor the patient's vital signsC. lower the tilt table 40 degrees and monitor the patient's vital signsD. lower the tilt table completely and monitor the patient's vital signsExplanation:The tilt table should be lowered to a horizontal position when a patient begins to demonstratesigns and symptoms of orthostatic hypotension. Signs and symptoms of this condition include a20 mm Hg or greater decrease in systolic blood pressure, dizziness, and nausea. (Pierson 328)161. A physical therapist examines a patient diagnosed with an anterior talofibular ligament sprain.The patient exhibits signs of inflammation in the ankle complex including heat, swelling, redness,and pain. This stage of inflammation and repair is best termed:A. acuteB. subacuteC. maturation and remodelingD. chronicExplanation:The acute phase, usually lasting 3-4 days, represents the initial reaction of body tissue to aninjury. Cellular injury results in changes in metabolism and the introduction of materials thatinitiate the inflammatory response. Signs of inflammation include redness, tenderness to touch,and increased temperature. (Arnheim 166)162. A physical therapist administers effleurage to the posterior neck and shoulder region of apatient with myofascial pain. Which therapeutic effect is most likely to occur when usingeffleurage?A. stimulation of muscle activity and deep circulationB. mobilization and removal of lung secretionsC. mobilization of muscle tissue

D. stimulation of superficial blood and lymph flowExplanation:Effleurage is defined as a slow, stroking movement performed with increasing pressure in thedirection of flow within the veins and lymph vessels. (De Domenico 35)163. A physical therapist attempts to obtain a history from a patient that has recently immigrated tothe United States. The patient does not speak English and seems to be intimidated by thehospital environment. The most appropriate action is to:A. ask the patient to communicate in writingB. ask another physical therapist to complete the examinationC. move the patient to a private treatment roomD. request an interpreterExplanation:In order to effectively communicate with a patient that does not speak English it is often essentialto utilize an interpreter. (Haggard 39)164. A physical therapist reviews the medical record of a patient diagnosed with de Quervain'sdisease. The record indicates the patient has extreme tenderness over the scaphoid. Whichcarpal bone is synonymous with the scaphoid?A. lunateB. capitateC. navicularD. trapeziumExplanation:The scaphoid and navicular are synonymous terms at the wrist. This bone is the largest carpalbone in the proximal row and is commonly fractured. (Hoppenfeld 164)165. A physical therapist educates a patient status post transfemoral amputation on theimportance of frequent skin checks. The most appropriate resource for the patient to utilize wheninspecting the posterior aspect of the residual limb is:A. hand mirrorB. video cameraC. nurseD. prosthetistExplanation:The use of a mirror during skin inspection of the residual limb will ensure that the patient canindependently see all areas that are not easily visible. (O'Sullivan 385)166. A patient status post stroke ambulates with a large base quad cane. The patient presentswith left neglect and diminished proprioception. The most appropriate method to ensure patientsafety is:A. provide continuous verbal cuesB. utilize visual cues and demonstrationC. offer manual assistance on the left sideD. offer manual assistance on the right sideExplanation:The physical therapist can offer manual contact and assistance with lower extremity placementwhile standing on the patient's affected side. This will also help to alert the patient as to theenvironment on the left. (Davies 147)167. A physical therapist completes a work site analysis for a patient with T3 paraplegia. Thepatient is employed in the marketing department of an advertising agency and relies on awheelchair for daily locomotion. Which of the following is likely to be the most significantarchitectural barrier for the patient?A. hardwood floorsB. an entrance ramp (six inches of ramp length for every one inch of step height)C. one quarter inch thresholds at each doorD. pedestal type sinksExplanation:An entrance ramp that has six inches of ramp length for each inch of vertical rise exceeds the 12:1inch minimum ratio identified in the Americans with Disabilities Act. (Minor 471)168. A pediatric patient throws frequent temper tantrums, usually contrived to gain attention. Thephysical therapist, recognizing the child's objective, refuses to acknowledge the action. This typeof behavior therapy is termed:A. aversive conditioningB. extinctionC. operant conditioningD. emotive imageryExplanation:By refusing to acknowledge the child's tantrums the physical therapist avoids reinforcing thebehavior. As a result the tantrums may decrease in frequency and eventually disappear.(Wortman 136)169. A physical therapist consults with a psychiatrist after examining a patient with a lengthyhistory of mental health issues. The psychiatrist describes the patient's current difficulty as shortlived,recurrent, unpredictable episodes of intense anxiety. This description best describes:A. psychosomatic disorderB. dissociative disorderC. panic disorderD. obsessive-compulsive disorderExplanation:Panic disorders may affect up to 3-5% of the population with a 2:1 prevalence in females. Thisdisorder may be associated with signs and symptoms such as dyspnea, tachycardia, dizziness,nausea, and feelings of impending doom. (Tierney 906)170. A physical therapist selects an assistive device for a patient rehabilitating from a recentillness. Which assistive device provides the least stability?A. Lofstrand crutchesB. walkerC. parallel barsD. axillary crutchesExplanation:Lofstrand crutches are wooden or metal crutches with a full or half cuff that fits over a patient'sforearms. Patients grasp the crutches using a handgrip that extends from the vertical axis of thecrutch. Lofstrand crutches allow for greater ease of movement than axillary crutches, but provideless stability. (Minor 296)

171. A 61 year old male referred to physical therapy complains of an excessive cough, sputumproduction, and shortness of breath. The patient indicates that he has been bothered by somecombination of these symptoms for over 10 years. The patient's present condition is mostindicative of:A. idiopathic hypoventilationB. chronic hypoxemiaC. Parkinson's diseaseD. chronic bronchitisExplanation:Chronic bronchitis is identified by the presence of a cough and pulmonary secretion expectorationfor at least 3 months, 2 years in a row. The disease is often associated with cigarette smoking.(Paz 131)172. A physical therapist reviews a physician's note on an 18 year old male diagnosed withimpingement syndrome. The note indicates standard radiographs were utilized as part of theexamination. Which finding would not be identifiable using a standard radiograph?A. chronic calcific tendonitisB. acromioclavicular arthritisC. partial thickness tear of the rotator cuffD. unfused acromial apophysisExplanation:Soft tissue structures such as muscles and tendons do not possess the density necessary to beseen on x-ray. (Magee 40)173. A physical therapist obtains a history of a self-referred patient to physical therapy. During thehistory the therapist identifies several subjective reports that suggest the possibility of cancer.Which finding is not typically associated with cancer?A. difficulty swallowingB. change in bowel or bladder habitsC. persistent coughD. change in visionExplanation:Seven early danger signs of cancer include change in bowel or bladder habits, a sore that doesnot heal, unusual bleeding or discharge, thickening or lump in breast or elsewhere, indigestion ordifficulty swallowing, obvious change in a wart or mole, and nagging cough or hoarseness.(Goodman 388)174. A patient appears to be somewhat anxious after learning her treatment will include soft tissuemassage. The most appropriate massage stroke to begin treatment is:A. effleurageB. kneadingC. petrissageD. tapotementExplanation:Effleurage is a massage stroke that is often utilized as a transitional stroke or as a means ofintroducing massage. (De Domenico 35)175. Physical therapists and physical therapist assistants work together in a variety of health caresettings. Which statement regarding the physical therapist assistant is not accurate?A. Physical therapist assistants can make entries in the patient medical record.B. Physical therapist assistants are licensed in all 50 states.C. Physical therapist assistants are affiliate members of the American Physical TherapyAssociation.D. Physical therapist assistants must work under direction and supervision of a physical therapist.Explanation:There are numerous states that do not license physical therapist assistants. (Pagliarulo 60)176. A patient two days status post arthrotomy of the knee completes a quadriceps settingexercise while lying supine on a mat table. During the exercise the patient begins to experiencesevere pain. The most appropriate physical therapist action is:A. have the patient perform the quadriceps set in sidelyingB. have the patient flex the knee prior to initiating the quadriceps setC. place a pillow under the ankleD. discontinue the exerciseExplanation:Severe pain in a patient rehabilitating from a surgical procedure is an acceptable reason toimmediately discontinue an exercise. (Kisner 59)177. A patient diagnosed with a cervical strain is examined in physical therapy. As part of theexamination, the physical therapist attempts to palpate the transverse process of C1. Whichinstructions describe the most appropriate method to palpate C1?A. place your fingers on the inion and move laterally and inferiorlyB. place your fingers immediately inferior to the patient's earlobes until you identify a bonyprominenceC. place your fingers in the space between the mastoid process and the angle of the mandible andmove mediallyD. place your fingers on the superior nuchal line and move laterally and inferiorlyExplanation:C1, commonly termed the atlas, has the broadest transverse process in the cervical spine and istherefore easily identifiable. (Hoppenfeld 107)178. A physical therapist enters a private treatment area and observes a patient collapsed on thefloor. The patient appears to be conscious, however seems to be in need of medical assistance.The most immediate therapist action is:A. check for unresponsivenessB. monitor airway, breathing, and circulationC. position the patientD. phone emergency medical servicesExplanation:The first step in performing a primary survey is to determine responsiveness. Although thequestion indicates "the patient appears to be conscious" it is still necessary to determine thepatient's level of responsiveness. (Goold 6)179. A physical therapist presents an inservice on ergonomics for administrative personnel. Aspart of the presentation the therapist discusses positioning when seated at a computer terminal.Which of the following recommendations would be most helpful?A. position your thighs parallel with the floor

B. position your knees one inch above your hipsC. position your knees two inches above your hipsD. position your knees one inch below your hipsExplanation:Other recommendations when seated at a computer terminal include: top of screen at eye level,minimum viewing distance 12 inches, height of work surface 23-28 inches, and width of worksurface 30 inches. (Hertfelder 138)180. A patient six weeks status post anterior dislocation of the glenohumeral joint is treated inphysical therapy. The patient's arm was immobilized for four weeks following the injury. Currentlythe patient has limited active range of motion in flexion, abduction, and lateral rotation. Which ofthe following treatment options would be least appropriate for the patient?A. D2 flexion proprioceptive neuromuscular facilitation muscle strengtheningB. strengthening of the scapular stabilizersC. posterior glenohumeral joint mobilizationD. use of single-channel electromyographic biofeedbackExplanation:A patient status post anterior dislocation of the glenohumeral joint should avoid abduction andlateral rotation. The D2 flexion proprioceptive neuromuscular facilitation technique should beavoided due to its emphasis on a pattern of shoulder flexion, abduction, and lateral rotation.(Sullivan-Integrated Approach 12)181. A physical therapist examines the posture of a 16 year old distance runner. The therapistidentifies excessive genu valgum. Which of the following would be the most probable associatedfinding?A. decreased Q angleB. excessive subtalar pronationC. posterior pelvic tiltD. ipsilateral pelvic medial rotationExplanation:Excessive subtalar pronation is a common finding in patients with genu valgum. This positionresults in patients bearing excessive weight on the inner side of the foot. (Magee 724)182. A physical therapist completes a functional leg length assessment as part of a lower quarterscreening examination. The therapist determines the right lower extremity is shorter than the leftlower extremity. Which of the following would be most indicative of functional shortening?A. lateral rotation of the right hipB. supination of the right footC. posterior rotation of the right innominateD. extension of the right kneeExplanation:Functional shortening refers to a shortening that is not a result of a structural change, but rather isassociated with a compensation for a positional change. Posterior rotation of the right innominateon the sacrum results in diminished leg length. (Magee 449)183. A physical therapist attends an inservice entitled "Principles of Exercise for the ObstetricPatient." During the session, the speaker identifies several conditions that are considered to resultin high risk pregnancies. Which of the following conditions would not be considered high risk?A. diastasis rectiB. incompetent cervixC. pre-eclampsiaD. multiple gestationExplanation:Diastasis recti refers to a separation of the two halves of the rectus abdominus muscle in themidline at the linea alba. This condition is often associated with pregnancy during the second andthird trimester, however is not considered to place a pregnancy at high risk. (Kisner 623)184. A 48 year old female rehabilitating from a fractured femur asks questions about her expectedfunctional level following rehabilitation. Assuming an uncomplicated recovery, the most accurateprediction of functional level would be based on the patient's:A. frequency of physical therapy visitsB. previous medical historyC. previous functional levelD. compliance with a home exercise programExplanation:A relatively young patient rehabilitating from a fractured femur should have a near completerecovery. As a result, the patient's previous functional level should serve as the best predictor ofher future functional level. (Hertling 104)185. A physical therapist utilizes neuromuscular electrical stimulation by attaching an electrodeover the motor point of the peroneus longus. The most appropriate location to attach the electrodeis:A. along the lateral border of the popliteal fossaB. on the anterolateral surface of the lower legC. proximal to the first metatarsophalangeal jointD. immediately inferior to the lateral malleolusExplanation:The peroneus longus originates on the head and upper two-thirds of the lateral surface of thefibula and inserts on the base of the first metatarsal and the lateral aspect of the medial cuneiform.The muscle acts to evert the foot at the subtalar joint and assists in plantar flexion at the ankle.(Robinson 161)186. A physical therapist attempts to assess the dynamic balance of an elderly patient. Whichassessment tool would be most helpful to test balance and gait?A. Functional Independence MeasureB. Tinetti ScaleC. Rankin ScaleD. Barthel IndexExplanation:The Tinetti scale measures balance and gait using a 2-3 point ordinal scale. (Shumway-Cook209)187. A physical therapist instructs a patient how to fall safely to the floor when using axillarycrutches. Which of the following should be the first to occur in the case of a forward fall?A. reach towards the floorB. turn your face towards one sideC. release the crutches

D. flex the trunk and headExplanation:A patient should release the crutches in an attempt to utilize the upper extremities to break theforward fall. (Pierson 249)188. A physical therapist attempts to strengthen the lumbricales on a patient with a low metatarsalarch. Which exercise would be the most appropriate?A. resisted extension of the metatarsophalangeal jointB. resisted flexion of the metatarsophalangeal jointC. resisted abduction of the metatarsophalangeal jointD. resisted adduction of the metatarsophalangeal jointExplanation:The lumbricales act to flex the metatarsophalangeal joints and assist in extending theinterphalangeal joints of the second through fifth digits. The lumbricales are innervated by thetibial nerve. (Kendall 196)189. A 46 year old male rehabilitating from a radial head fracture misses his third consecutivephysical therapy treatment session. The most appropriate physical therapist action is:A. contact the patient's insurance providerB. design a home exercise program for the patientC. schedule the patient with another physical therapistD. discharge the patient from physical therapyExplanation:A patient consistently missing scheduled appointments should be discharged from physicaltherapy unless there are extraordinary circumstances. (Kettenbach 169)190. A physical therapist examines a patient with burns over 30 percent of his body. The burnsrange from superficial to full-thickness. Which classification of burns would be the most painful?A. superficial burnB. superficial partial-thickness burnC. deep partial-thickness burnD. full thickness-burnExplanation:Superficial partial-thickness burns are characterized by damage to the epidermis and the upperpart of the dermis. Since the nerve endings are not damaged, superficial partial-thickness burnscan be extremely painful. (Rothstein 1115)191. A physical therapist completes a review of a patient's medical record prior to beginning aphysical examination. The record indicates the patient was recently placed on an antidepressantmedication. The most common side effect associated with antidepressants is:A. sedationB. dysarthriaC. seizuresD. blood pressure variabilityExplanation:Antidepressant medications can produce a broad range of side effects including sedation.Tricyclics are an example of a category of antidepressant medication that commonly results insedation. (Ciccone 86)192. A physical therapist instructs a patient rehabilitating from a lower back injury in a series of fivepelvic stabilization exercises. The patient indicates he understands the exercises, howeverfrequently becomes confused and is unable to perform them correctly. The most appropriatetherapist action is:A. repeat the exercise instructionsB. reduce the number of exercises in the seriesC. select a different treatment optionD. conclude the patient is not a candidate for physical therapyExplanation:A physical therapist should attempt to simplify the exercise session in order to reduce the patient'sconfusion. The most appropriate method to simplify the program is to reduce the number ofexercises. (Haggard 107)193. A patient with a lower back injury rings a call bell and informs the physical therapist that thehot pack is too intense. Assuming the patient has had the hot pack on for three minutes, the mostappropriate initial action is to:A. check the patient's skinB. add additional towel layersC. select another superficial heating agentD. document the incident in the medical recordExplanation:A physical therapist should always check the patient's skin prior to adjusting the number of towellayers utilized with a hot pack. (Michlovitz 116)194. A physical therapist designs an exercise program consisting of closed chain activities for apatient rehabilitating from a medial meniscus repair. An appropriate closed chain exercise toinclude in the rehabilitation program is:A. submaximal velocity spectrum isokinetic exerciseB. bilateral mini squats in standingC. short-arc terminal knee extensionD. prone leg curls with a two pound cuff weightExplanation:Closed chain activities require the distal segment to be in contact with the ground or some othersurface. (Arnheim 350)195. A patient with a spinal cord injury exercising on a treatment table begins to exhibit signs andsymptoms of autonomic dysreflexia. The most appropriate immediate action once autonomicdysreflexia has been confirmed is:A. monitor vital signsB. palpate for bladder distentionC. sit the patient uprightD. check urinary drainage systemExplanation:The most significant sign of autonomic dysreflexia is severe hypertension. As a result, it isnecessary to place the patient in a sitting or semirecumbent position in an attempt to reduce thehypertension. The therapist should then call for medical assistance and attempt to identify thenoxious stimulus causing the sympathetic response. (Pierson 335)196. A physical therapist observes a change in the muscle tone of an infant's extremities as a

result of head rotation. Which developmental reflex would facilitate this type of response?A. asymmetrical tonic neck reflexB. symmetrical tonic neck reflexC. symmetrical tonic labyrinthine reflexD. asymmetrical tonic labyrinthine reflexExplanation:The asymmetrical tonic neck reflex normally occurs in infants from birth to 6 months of age whenthe head is rotated to one side. This reflex causes extension of the extremities towards the side ofrotation. (Ratliffe 26)197. A physical therapist palpates medially along the spine of the scapula. Which spinous processis at the same level as the vertebral end of the spine?A. T2B. T3C. T4D. T5Explanation:The scapula in the resting position covers ribs two through seven, while the spine of the scapula isopposite the spinous process of T3. (Hoppenfeld 11)198. A physical therapist instructs an obstetric patient in an exercise designed to increase pelvicfloor awareness and strength. The exercise requires the patient to tighten the pelvic floor as ifattempting to stop urine flow. The patient is instructed to hold the isometric contraction for 5seconds and complete 10 repetitions. The most appropriate initial position for the exercise is:A. supineB. sittingC. tall kneelingD. standingExplanation:Kegel exercises are often utilized as part of a treatment program for the obstetric patient. Theexercises are designed to prevent or treat incontinence. Supine or sidelying is the easiest positionto begin the training session. (Kisner 615)199. An attorney contacts you by phone and requests specific information on a patient he claimsto represent. Questions asked include the extent of the patient's disability and his willingness toreturn to work. The most appropriate response is:A. answer the questions asked by the attorneyB. request that the attorney provide documented proof that he represents the patientC. tell the attorney not to bother you at workD. send the attorney a copy of the patient's medical recordsExplanation:A physical therapist should not release information to a third party without prior written consentfrom the patient or the patient's guardian. (Scott - Professional Ethics 86)200. A patient four weeks status post anterior cruciate ligament reconstruction questions aphysical therapist as to why he is still partial weight bearing. An acceptable rationale is:A. the patient does not have full active knee extensionB. the patient has good quadriceps strengthC. the patient has fair hamstrings strengthD. the patient has diminished superficial cutaneous sensationExplanation:A patient status post anterior cruciate ligament reconstruction surgery may continue to use anassistive device for weight bearing if he/she does not possess full active knee extension.Ambulation on a flexed knee can result in excessive irritation of the patellofemoral joint. (Kisner445)