A patient who has severe kidney disease participates in a strengthening and conditioning program.
Which of the following interventions would be CONTRAINDICATED for the patient?
1.Isometric exercises
2.Resistance training
3.Aerobic conditioning
4.Aquatic therapy - Answers 4.Aquatic therapy
Although aquatic therapy may be beneficial for patients who have mild to moderate renal failure
(Goodman, p. 977), it is contraindicated for anyone who has severe kidney disease due to the
patient's inability to adjust to fluid loss during immersion
Which of the following examination techniques is CONTRAINDICATED 1 week following ulnar
collateral ligament reconstruction at the elbow?
1.Shoulder lateral (external) rotation range of motion
2.Wrist extension range of motion
3.Grip strength testing
4.Scapular mobility - Answers 1.Shoulder lateral (external) rotation range of motion
Shoulder lateral (external) rotation creates valgus stresses at the elbow. This should be avoided
because valgus forces stress the ulnar collateral ligament.
A patient who has a 5° plantar flexion contracture is MOST likely to demonstrate which of the
following gait deviations?
1.Foot slap
2.Early heel rise
3.Knee buckling during midstance
4.Contralateral pelvic drop - Answers 2.Early heel rise
A plantar flexion contracture will not allow the patient's trunk to progress from behind the ankle to in
front of the ankle as normally occurs in midstance
A 70-year-old patient in a skilled nursing facility is noted to be confused and disoriented. The patient
did not exhibit these symptoms a day earlier. Which of the following conditions is the MOST likely
cause of these symptoms?
1.Myocardial infarction
2.Irritable bowel syndrome
3.Emphysema
4.Urinary tract infection - Answers 4.Urinary tract infection
4. A change in mental status, such as confusion and disorientation, is a potential symptom of a urinary
tract infection
A patient's posterior superior iliac spines are at the same height as the anterior superior iliac spines.
Which of the following tests would be MOST appropriate for further investigation of this finding?
1.Measurement of leg length
2.Muscle length testing of the hip flexors
3.Muscle length testing of the hamstring muscles
4.Measurement of lumbar flexion range of motion - Answers 3.Muscle length testing of the
hamstring muscles
The normal pelvic angle is 30°. The posterior superior iliac spines should be slightly higher than the
anterior superior iliac spines (pp. 1036-1039). A decreased pelvic angle indicates a posterior pelvic tilt,
which is associated with decreased hamstring muscle length
A physical therapist is assessing a patient's orientation to gravity while the patient is in a prone
stander. The therapist should be aware that the orientation to gravity:
1.affects the perception of sensation.
2.is a measure of function.
3.determines the degree of ROM available.
4.influences muscle tone throughout the trunk and extremities. - Answers 4.influences muscle tone
throughout the trunk and extremities.
, Position relative to gravity affects tone because of the way muscles activate to support posture.
Prone/upright increases extensor tone while supine increases flexor tone.
An adult patient has burns over the anterior and posterior surfaces of the left lower extremity.
According to the rule of nines, what percentage of the total body surface area is MOST likely
involved?
1.9%
2.18%
3.24%
4.36% - Answers 1. Using the rule of nines, the total body surface area would be approximately 18%,
not 9%.
2. Using the rule of nines, the total body surface area would be approximately 18%.
3. Using the rule of nines, the total body surface area would be approximately 18%, not 24%.
4. Using the rule of nines, the total body surface area would be approximately 18%, not 36%.
A patient who has a boggy end-feel with passive knee extension MOST likely has which of the
following conditions?
1.Arthritis
2.Hemarthrosis
3.Meniscal displacement
4.Patellofemoral syndrome - Answers 2.Hemarthrosis
A boggy end-feel is produced by fluid or blood in the joint.
A patient who had a lumbar spinal fusion 2 days ago has developed increased secretions in the left
lower lobe. Which of the following postural drainage strategies is MOST effective for clearing the
secretions?
1.Left sidelying with the head lower than the feet
2.Left sidelying with the head lower than the feet, with percussion
3.Right sidelying with the head lower than the feet
4.Right sidelying with the head lower than the feet, with percussion - Answers 3.Right sidelying with
the head lower than the feet
The postural drainage position for the left lower lobe is right sidelying with the head lower than the
feet
A patient has limited cervical mobility, headaches, and pain with cervical rotation, extension, and
lateral side bending. The patient also reports numbness in the right hand and walks with a wide base
of support. Which of the following conditions is MOST likely present?
1.Cervical myelopathy
2.Cervical radiculopathy
3.Brachial plexus injury
4.Transient ischemic attack - Answers 1.Cervical myelopathy
Cervical myelopathy is an injury to the spinal cord that would present with upper motor neuron
symptoms, including ataxic gait with a wide base of support, as well as headaches. Symptoms would
also not follow a straight nerve root dermatome/myotome pattern.
A patient has limited movements throughout the arc of forearm supination and pronation due to
moderate to severe pain. Which of the following manual therapy techniques to the proximal
radioulnar joint is MOST appropriate to perform initially?
1.With the patient positioned in 5° of supination and 90° of elbow flexion, perform small-amplitude
mobilizations at the beginning of the available range of motion.
2.With the patient positioned in 10° of supination and 70° of elbow flexion, perform large-amplitude
mobilizations at the end of the range of motion.
3.With the patient positioned in 35° of supination and 70° of elbow flexion, perform large-amplitude
mobilizations in the middle of the range of motion.
4.With the patient positioned in full supination and full elbow extension, perform small-amplitude
mobilizations at the end of the range of motion. - Answers 3.With the patient positioned in 35° of
supination and 70° of elbow flexion, perform large-amplitude mobilizations in the middle of the range
of motion.