O'SULLIVAN NPTE PRACTICE QUESTIONS &
ANSWERS
Which motion at the glenohumeral joint has the greatest limitation if the diagnosis is
adhesive capsulitis? - Answers - External Rotation (Capsular pattern)
When considering the concave-convex rule, to which joints in the spine does the
concave rule apply - Answers - Every joint below the second cervical vertebra. Only the
atlanto-occipital joint is convex
Which special test when applied to the ankle/foot is BEST used to identify ligamentous
instability of the calcaneofibular ligament? - Answers - Talar Tilt
What are the major differences in diagnostic characteristics and pattern of joint
dysfunction between osteoarthritis and rheumatoid arthritis? - Answers - OA is first
manifested by changes in joint cartilage with eventual erosion to subchondral bone. All
joints are not equally affected. The DIPs, PIPs, the CMC of the thumb, cervical and
lumbar spine, hips, knees, and MTPs are the primary sites.
RA is an autoimmune disease that primarily affects the synovium. The synovium
proliferates, dissolves collagen, and extends over the joint cartilage. There is persistent
inflammation and systemic complaints such as morning stiffness, fever, and loss of
appetite. Joints are affected in a bilateral symmetrical pattern. All joints including the
spine and TMJ can be involved.
Based on Clinical Practice Guidelines for Knee Ligament Sprain, which intervention has
the strongest overall evidence for effectiveness? - Answers - Therapeutic exercise,
including NWB open-chain and WB closed-chain activities, is the most effective based
on evidence when dealing with patients with knee instability and movement coordination
impairments.
Other interventions, such as bracing, CPM, early intervention, etc., demonstrate
moderate to weak evidence based on available studies
Following a total hip replacement, in the acute phase, which positions should be
avoided in bed positioning and activities involving bed mobility - Answers - A wedge
should be used in positioning to prevent hip adduction. Hip flexion should not exceed 90
degrees. Adduction and internal rotation should be limited when moving in bed.
For an anteriorly displaced articular disc at the TMJ, what is the primary joint
mobilization technique? - Answers - If TMJ restriction is present, primary glide is inferior,
which gaps the joint, stretches the capsule, and allows relocation of the disc.
, Which cranial nerves may play any role in vision? What findings are normal or
abnormal? - Answers - CN II (optic) - Optic-visual acuity or visual fields, pupillary
constriction
CN III (Oculomotor) - Pupillary size, extraocular movement
CN IV (Trochlear) - Extraocular movement
CN V (Trigeminal) - Corneal reflex
CN VI (Abducens) - Extraocular movement
CN VII (Facial) - Ability to close eyes tightly (may be absent in Bell's palsy)
CN VIII (Vestibulocochlear) - Nystagmus (secondary to brain dysfunction)
Following a CVA, what are the major considerations when examining the patient for
perceptual deficits? - Answers - - Testing for visual field deficits such as homonymous
or bitemporal hemianopsia.
- Examine for body scheme or image such as unilateral neglect or somatoagnosia.
- Examine for spatial relations such as figure-ground, depth perception, vertical
disorientation, etc.
- Examine for agnosia such as the inability to recognize familiar objects with an impaired
sensory modality.
- Examine for apraxia such as dressing apraxia's, agraphia, etc.
When examining deep tendon reflexes, what is the score reported for an obligatory and
sustained response? - Answers - 0 = Absent reflex
1+ = Tone change but no movement
2+ = Visible movement of extremity
3+ = Exaggerated full movement of extremity
4+ = Obligatory and sustained movement lasting >30 sec
What are the characteristics in terms of communication, gait, tone, balance, and
respiratory function in a patient with late Parkinson's disease (Stage IV Hoehn and
Yahr) - Answers - Communication: Dysarthria, hypophonia, masklike face, small writing.
Gait: Poverty of movement, festinating gait possible
Tone: Cogwheel rigidity
Balance: Impaired postural reactions including trunk rigidity and lack of rotation
Respiratory function: Decreased chest expansion, decreased vital capacity
What are the initial physical therapy goals and interventions upon receiving a referral for
a patient recently diagnosed with a unilateral vestibular disorder? - Answers -
Implement safety measures first. Teach sensory substitution (visual, tactile) and
compensatory strategies and provide an ambulatory aid as indicated. Later on,
habituation training, eye and head exercises, and postural stability activities can be
implemented.
Following a MVA, a patient with a complete SCI at the C7 level has been admitted to a
rehab facility after a lengthy stay at an acute care hospital. What are the components of
the physical therapist's initial examination? - Answers - Vital signs, respiratory function,
ANSWERS
Which motion at the glenohumeral joint has the greatest limitation if the diagnosis is
adhesive capsulitis? - Answers - External Rotation (Capsular pattern)
When considering the concave-convex rule, to which joints in the spine does the
concave rule apply - Answers - Every joint below the second cervical vertebra. Only the
atlanto-occipital joint is convex
Which special test when applied to the ankle/foot is BEST used to identify ligamentous
instability of the calcaneofibular ligament? - Answers - Talar Tilt
What are the major differences in diagnostic characteristics and pattern of joint
dysfunction between osteoarthritis and rheumatoid arthritis? - Answers - OA is first
manifested by changes in joint cartilage with eventual erosion to subchondral bone. All
joints are not equally affected. The DIPs, PIPs, the CMC of the thumb, cervical and
lumbar spine, hips, knees, and MTPs are the primary sites.
RA is an autoimmune disease that primarily affects the synovium. The synovium
proliferates, dissolves collagen, and extends over the joint cartilage. There is persistent
inflammation and systemic complaints such as morning stiffness, fever, and loss of
appetite. Joints are affected in a bilateral symmetrical pattern. All joints including the
spine and TMJ can be involved.
Based on Clinical Practice Guidelines for Knee Ligament Sprain, which intervention has
the strongest overall evidence for effectiveness? - Answers - Therapeutic exercise,
including NWB open-chain and WB closed-chain activities, is the most effective based
on evidence when dealing with patients with knee instability and movement coordination
impairments.
Other interventions, such as bracing, CPM, early intervention, etc., demonstrate
moderate to weak evidence based on available studies
Following a total hip replacement, in the acute phase, which positions should be
avoided in bed positioning and activities involving bed mobility - Answers - A wedge
should be used in positioning to prevent hip adduction. Hip flexion should not exceed 90
degrees. Adduction and internal rotation should be limited when moving in bed.
For an anteriorly displaced articular disc at the TMJ, what is the primary joint
mobilization technique? - Answers - If TMJ restriction is present, primary glide is inferior,
which gaps the joint, stretches the capsule, and allows relocation of the disc.
, Which cranial nerves may play any role in vision? What findings are normal or
abnormal? - Answers - CN II (optic) - Optic-visual acuity or visual fields, pupillary
constriction
CN III (Oculomotor) - Pupillary size, extraocular movement
CN IV (Trochlear) - Extraocular movement
CN V (Trigeminal) - Corneal reflex
CN VI (Abducens) - Extraocular movement
CN VII (Facial) - Ability to close eyes tightly (may be absent in Bell's palsy)
CN VIII (Vestibulocochlear) - Nystagmus (secondary to brain dysfunction)
Following a CVA, what are the major considerations when examining the patient for
perceptual deficits? - Answers - - Testing for visual field deficits such as homonymous
or bitemporal hemianopsia.
- Examine for body scheme or image such as unilateral neglect or somatoagnosia.
- Examine for spatial relations such as figure-ground, depth perception, vertical
disorientation, etc.
- Examine for agnosia such as the inability to recognize familiar objects with an impaired
sensory modality.
- Examine for apraxia such as dressing apraxia's, agraphia, etc.
When examining deep tendon reflexes, what is the score reported for an obligatory and
sustained response? - Answers - 0 = Absent reflex
1+ = Tone change but no movement
2+ = Visible movement of extremity
3+ = Exaggerated full movement of extremity
4+ = Obligatory and sustained movement lasting >30 sec
What are the characteristics in terms of communication, gait, tone, balance, and
respiratory function in a patient with late Parkinson's disease (Stage IV Hoehn and
Yahr) - Answers - Communication: Dysarthria, hypophonia, masklike face, small writing.
Gait: Poverty of movement, festinating gait possible
Tone: Cogwheel rigidity
Balance: Impaired postural reactions including trunk rigidity and lack of rotation
Respiratory function: Decreased chest expansion, decreased vital capacity
What are the initial physical therapy goals and interventions upon receiving a referral for
a patient recently diagnosed with a unilateral vestibular disorder? - Answers -
Implement safety measures first. Teach sensory substitution (visual, tactile) and
compensatory strategies and provide an ambulatory aid as indicated. Later on,
habituation training, eye and head exercises, and postural stability activities can be
implemented.
Following a MVA, a patient with a complete SCI at the C7 level has been admitted to a
rehab facility after a lengthy stay at an acute care hospital. What are the components of
the physical therapist's initial examination? - Answers - Vital signs, respiratory function,
