NPTE EXAM 1 QUESTIONS AND ANSWERS
#8 - Answers - Trapezius is in spasm, the electrodes should be closely placed and with
low sensitivity to minimize cross-talk. For spastic muscles we start with low sensitivity
and gradually increase it while with flaccid or weak muscles we start with high
sensitivity. Wide space electrodes recruits more muscle activity while closely spaced is
for specific muscle.
Lymphedema 10 - Answers - Short stretch bandages used in treatment of lymphedema.
Short stretch bandages are made of extensible elastic material that provides high
stability (support), low resting pressure, and high working pressure of the limb. The
effectiveness of high working pressure is maximized by muscle and joint activity to
pump the fluid proximally. Long stretch bandages have high resting pressure, hence not
used for lymphedema. The proximal components are drained before distal to prevent
clogging.
ITB - Answers - Activities on the level surface place minimal stress on ITB like sprinting,
tennis, squash whereas the uphill, downhill surfaces place more stress on the knee
joint. Also, cycle with excessive seat height increase the stress on ITB more than
sprinting.
Exercise stress test - Answers - PVCs are ectopic beats that originate in the ventricle,
PVCs that come from the same irritable site are termed unifocal PVCs. Single PVCs
does not compromise CO, if less than 7 per minute. Therefore, the patient can exercise
at lower intensity with EKG monitoring and consultation with physician is not required
here.
#14 - Answers - Genu varum results in tibial external rotation, leading to a forefoot
position of supination. All other conditions result in pronated foot position.
17 - Answers - An arch index of more than 0.30 indicates low arch or pes planus.
Providing longitudinal arch support will be most appropriate intervention. It can be
supplemented by foot intrinsic muscle strengthening exercises. A Heel lift (Option A) will
help in weight redistribution and increase plantarflexion. Post under 5th metatarsal head
(Option B) is useful for forefoot varus or supination. Transverse arch (Option D) runs
medio-lateral and is not accounted in arch index calculations.
22-digitalis toxicity - Answers - Signs of digoxin toxicity in patients with CHF : Nausea,
vomiting, headache, dizziness, confusion, abdominal pain, delirium, vision disturbance.
With Alzheimer's and dementia, patient will experience significant memory loss.
26 - Answers - Optic and oculomotor together are responsible for the pupillary reflex.
30 - Answers - Side effects of chemotherapy include anorexia, nausea, vomiting,
diarrhea, ulcers, hemorrhage, bone marrow suppression, anemia, leukemia,
,thrombocytopenia, fatigue, skin rashes, neuropathies, and phlebitis and hair loss.
Myopathy is not a side effect of chemotherapy.
31 - Answers - With excessive femoral retroversion, related posture is lateral tibial
torsion, subtalar supination. Compensatory posture is medial tibial torsion, subtalar
pronation.
33 - Answers - Dyspnea, shortness of breath, or cramping in the calf muscles are
common signs of respiratory distress. Mucus plugging, tube displacement, disruption or
disconnection of oxygen can cause respiratory distress in a tracheostomy patient.
respiratory alkalosis - Answers - A patient comes into an outpatient clinic with symptoms
of anxiety, hyperventilation, syncope, and cramping of the wrist. Upon PT evaluation,
the therapist finds increased respiratory rate and a decrease in blood pressure. Based
on the symptoms and findings, what condition does the patient present with and what is
the MOST appropriate treatment?
37 - Answers - The terms decorticate rigidity and decerebrate rigidity are often used to
denote abnormal posturing in patients with severe brain injury. Decorticate rigidity refers
to sustained contraction and posturing of the upper limbs in flexion and the lower limbs
in extension. Decerebrate rigidity (abnormal extensor response) refers to sustained
contraction and posturing of the trunk and limbs in a position of full extension.
A patient referred for vestibular rehab presents with oscillopsia, a loss of gaze
stabilization, and spontaneous nystagmus that can be suppressed with visual fixation.
Additional problems include disequilibrium and ataxic gait pattern with consistent
veering to the left. Based on these findings, the patient is MOST likely to have which
condition? - Answers - Symptoms of UVH - resting (spontaneous) nystagmus,
oscillopsia, dysequilibrium, postural instability. BPPV is a disorder arising from a
problem in the inner ear. Symptoms of BPPV include nystagmus, vertigo with change in
head position, and occasionally nausea with or without vomiting, and dysequilibrium.
Each episode of vertigo typically lasts less than one minute. Meniere's disease is a
recurrent and usually progressive vestibular disease. It is associated with tinnitus,
deafness, sensation of fullness in the ear and vertigo
39 - Answers - The patient has congestive heart failure so foot end elevation and
standard postural drainage positions are contraindicated. Vigorous percussion and
vibration is also not advisable. Turning, coughing and deep breathing every 1-2 hours is
the best prophylactic treatment.
A 13-year-old girl has been diagnosed with structural idiopathic scoliosis. The physical
therapist notices a left thoracic and right lumbar curvature of her spine. Which postural
deviation would be MOST expected in this patient? - Answers - In left thoracic scoliosis,
rotation of thoracic vertebra is towards the scoliotic side( left), spinous process deviate
towards the concave side (right), right shoulder is low, left shoulder is high and left
(scoliotic side) scapula is protruded.
, 44 - Answers - Irritable Bowel Syndrome is a functional disorder of motility in the small
and large intestines. Abdominal pain or discomfort is relieved by defecation and the pain
tends to disappear at night (while sleeping). The typical pain pattern consists of lower
left quadrant abdominal pain, constipation, and diarrhea. Symptoms seem to come and
go with no apparent cause and effect that can be identified by the affected individual. In
Crohn's disease pain is felt in lower right quadrant. Ulcerative colitis is the inflammation
and ulceration of the inner lining of the large intestine and rectum; it main symptoms are
diarrhea, rectal bleeding. Diverticulitis is the infection and inflammation that accompany
a microperforation of one of the diverticula. Option A,B,C are not relieved with rest.
45 - Answers - The location of the pain is determined by the site of the major arterial
occlusion The occlusion of iliac artery produces pain or discomfort in the buttock, hip,
thigh of the affected leg, diminished or absent femoral or distal pulses. Femoral and
popliteal artery occlusion produces pain in calf and foot. Tibial and common peroneal
artery occlusion produces pain in calf and feet (occasionally)
A 30-year-old male patient presents with left lower abdominal pain, bloody stools, and
flatulence. The "pinch-an-inch" test result is positive. Which condition is MOST related
to the symptoms described? - Answers - A 30-year-old male patient presents with left
lower abdominal pain, bloody stools, and flatulence. The "pinch-an-inch" test result is
positive. Which condition is MOST related to the symptoms described?
A patient presents to a clinic with complaints of dizziness and vertigo in certain
positions. On examination, the PT found that patient has his head slightly tilted to one
side, has conjugate eye torsion, and an abnormal weight shift in standing. These signs
are MOST consistent with what condition? - Answers - Unilateral vestibular
hypofunction is a term used when the balance system in the inner ear, the peripheral
vestibular system, is not working properly in one ear. The most common symptoms
include: Dizziness or vertigo, poor balance, especially with head turns, trouble walking,
especially outdoors, in dark rooms, or in crowded places, blurred vision, especially
when turning your head quickly. Nausea and vomiting in acute or severe cases. Otitis
media is infection of the middle ear causing fever and ear pain. Malingering is
fabricating a physical or a mental disorder for secondary gains. Ototoxicity is ear
poisoning caused by drugs, chemicals.
Diabetic low blood sugar Sx? - Answers - Hypoglycemia is the most common problem
for people with diabetes mellitus who exercise. Common symptoms associated with
hypoglycemia include shakiness, weakness, abnormal sweating, nervousness, anxiety,
tingling of the mouth and fingers, and hunger. Neuroglycopenic symptoms may include
headache, visual disturbances, mental dullness, confusion, amnesia, seizures, and
coma. Hypoglycemia can be treated in the conscious patient by immediate
administration of sugar, and immediate acting glucose sources like half cup of fruit juice
or sugared cola, 8 Oz of milk, two packets of sugar are sufficient to reverse the episode
of hypoglycemia.
#8 - Answers - Trapezius is in spasm, the electrodes should be closely placed and with
low sensitivity to minimize cross-talk. For spastic muscles we start with low sensitivity
and gradually increase it while with flaccid or weak muscles we start with high
sensitivity. Wide space electrodes recruits more muscle activity while closely spaced is
for specific muscle.
Lymphedema 10 - Answers - Short stretch bandages used in treatment of lymphedema.
Short stretch bandages are made of extensible elastic material that provides high
stability (support), low resting pressure, and high working pressure of the limb. The
effectiveness of high working pressure is maximized by muscle and joint activity to
pump the fluid proximally. Long stretch bandages have high resting pressure, hence not
used for lymphedema. The proximal components are drained before distal to prevent
clogging.
ITB - Answers - Activities on the level surface place minimal stress on ITB like sprinting,
tennis, squash whereas the uphill, downhill surfaces place more stress on the knee
joint. Also, cycle with excessive seat height increase the stress on ITB more than
sprinting.
Exercise stress test - Answers - PVCs are ectopic beats that originate in the ventricle,
PVCs that come from the same irritable site are termed unifocal PVCs. Single PVCs
does not compromise CO, if less than 7 per minute. Therefore, the patient can exercise
at lower intensity with EKG monitoring and consultation with physician is not required
here.
#14 - Answers - Genu varum results in tibial external rotation, leading to a forefoot
position of supination. All other conditions result in pronated foot position.
17 - Answers - An arch index of more than 0.30 indicates low arch or pes planus.
Providing longitudinal arch support will be most appropriate intervention. It can be
supplemented by foot intrinsic muscle strengthening exercises. A Heel lift (Option A) will
help in weight redistribution and increase plantarflexion. Post under 5th metatarsal head
(Option B) is useful for forefoot varus or supination. Transverse arch (Option D) runs
medio-lateral and is not accounted in arch index calculations.
22-digitalis toxicity - Answers - Signs of digoxin toxicity in patients with CHF : Nausea,
vomiting, headache, dizziness, confusion, abdominal pain, delirium, vision disturbance.
With Alzheimer's and dementia, patient will experience significant memory loss.
26 - Answers - Optic and oculomotor together are responsible for the pupillary reflex.
30 - Answers - Side effects of chemotherapy include anorexia, nausea, vomiting,
diarrhea, ulcers, hemorrhage, bone marrow suppression, anemia, leukemia,
,thrombocytopenia, fatigue, skin rashes, neuropathies, and phlebitis and hair loss.
Myopathy is not a side effect of chemotherapy.
31 - Answers - With excessive femoral retroversion, related posture is lateral tibial
torsion, subtalar supination. Compensatory posture is medial tibial torsion, subtalar
pronation.
33 - Answers - Dyspnea, shortness of breath, or cramping in the calf muscles are
common signs of respiratory distress. Mucus plugging, tube displacement, disruption or
disconnection of oxygen can cause respiratory distress in a tracheostomy patient.
respiratory alkalosis - Answers - A patient comes into an outpatient clinic with symptoms
of anxiety, hyperventilation, syncope, and cramping of the wrist. Upon PT evaluation,
the therapist finds increased respiratory rate and a decrease in blood pressure. Based
on the symptoms and findings, what condition does the patient present with and what is
the MOST appropriate treatment?
37 - Answers - The terms decorticate rigidity and decerebrate rigidity are often used to
denote abnormal posturing in patients with severe brain injury. Decorticate rigidity refers
to sustained contraction and posturing of the upper limbs in flexion and the lower limbs
in extension. Decerebrate rigidity (abnormal extensor response) refers to sustained
contraction and posturing of the trunk and limbs in a position of full extension.
A patient referred for vestibular rehab presents with oscillopsia, a loss of gaze
stabilization, and spontaneous nystagmus that can be suppressed with visual fixation.
Additional problems include disequilibrium and ataxic gait pattern with consistent
veering to the left. Based on these findings, the patient is MOST likely to have which
condition? - Answers - Symptoms of UVH - resting (spontaneous) nystagmus,
oscillopsia, dysequilibrium, postural instability. BPPV is a disorder arising from a
problem in the inner ear. Symptoms of BPPV include nystagmus, vertigo with change in
head position, and occasionally nausea with or without vomiting, and dysequilibrium.
Each episode of vertigo typically lasts less than one minute. Meniere's disease is a
recurrent and usually progressive vestibular disease. It is associated with tinnitus,
deafness, sensation of fullness in the ear and vertigo
39 - Answers - The patient has congestive heart failure so foot end elevation and
standard postural drainage positions are contraindicated. Vigorous percussion and
vibration is also not advisable. Turning, coughing and deep breathing every 1-2 hours is
the best prophylactic treatment.
A 13-year-old girl has been diagnosed with structural idiopathic scoliosis. The physical
therapist notices a left thoracic and right lumbar curvature of her spine. Which postural
deviation would be MOST expected in this patient? - Answers - In left thoracic scoliosis,
rotation of thoracic vertebra is towards the scoliotic side( left), spinous process deviate
towards the concave side (right), right shoulder is low, left shoulder is high and left
(scoliotic side) scapula is protruded.
, 44 - Answers - Irritable Bowel Syndrome is a functional disorder of motility in the small
and large intestines. Abdominal pain or discomfort is relieved by defecation and the pain
tends to disappear at night (while sleeping). The typical pain pattern consists of lower
left quadrant abdominal pain, constipation, and diarrhea. Symptoms seem to come and
go with no apparent cause and effect that can be identified by the affected individual. In
Crohn's disease pain is felt in lower right quadrant. Ulcerative colitis is the inflammation
and ulceration of the inner lining of the large intestine and rectum; it main symptoms are
diarrhea, rectal bleeding. Diverticulitis is the infection and inflammation that accompany
a microperforation of one of the diverticula. Option A,B,C are not relieved with rest.
45 - Answers - The location of the pain is determined by the site of the major arterial
occlusion The occlusion of iliac artery produces pain or discomfort in the buttock, hip,
thigh of the affected leg, diminished or absent femoral or distal pulses. Femoral and
popliteal artery occlusion produces pain in calf and foot. Tibial and common peroneal
artery occlusion produces pain in calf and feet (occasionally)
A 30-year-old male patient presents with left lower abdominal pain, bloody stools, and
flatulence. The "pinch-an-inch" test result is positive. Which condition is MOST related
to the symptoms described? - Answers - A 30-year-old male patient presents with left
lower abdominal pain, bloody stools, and flatulence. The "pinch-an-inch" test result is
positive. Which condition is MOST related to the symptoms described?
A patient presents to a clinic with complaints of dizziness and vertigo in certain
positions. On examination, the PT found that patient has his head slightly tilted to one
side, has conjugate eye torsion, and an abnormal weight shift in standing. These signs
are MOST consistent with what condition? - Answers - Unilateral vestibular
hypofunction is a term used when the balance system in the inner ear, the peripheral
vestibular system, is not working properly in one ear. The most common symptoms
include: Dizziness or vertigo, poor balance, especially with head turns, trouble walking,
especially outdoors, in dark rooms, or in crowded places, blurred vision, especially
when turning your head quickly. Nausea and vomiting in acute or severe cases. Otitis
media is infection of the middle ear causing fever and ear pain. Malingering is
fabricating a physical or a mental disorder for secondary gains. Ototoxicity is ear
poisoning caused by drugs, chemicals.
Diabetic low blood sugar Sx? - Answers - Hypoglycemia is the most common problem
for people with diabetes mellitus who exercise. Common symptoms associated with
hypoglycemia include shakiness, weakness, abnormal sweating, nervousness, anxiety,
tingling of the mouth and fingers, and hunger. Neuroglycopenic symptoms may include
headache, visual disturbances, mental dullness, confusion, amnesia, seizures, and
coma. Hypoglycemia can be treated in the conscious patient by immediate
administration of sugar, and immediate acting glucose sources like half cup of fruit juice
or sugared cola, 8 Oz of milk, two packets of sugar are sufficient to reverse the episode
of hypoglycemia.
