PEAT 2 EXAM
D.
There is a normal, linear relationship between heart rate and exercise intensity
in patients who are not on beta blocker medication or who are on non-rate
responsive pacemakers. Therefore, teaching patients to take their pulse reliably
before discharge is an important learning objective to ensure safety with
exercise upon discharge. Ascending a flight of stairs before discharge is only
appropriate if the patient needs to negotiate stairs at home, but not as important
as pulse monitoring. Performing exercises without angina can be achieved by
monitoring heart rate with exercise; therefore, taking a pulse is necessary.
Returning to normal daily activity immediately after an MI is an unreasonable
objective as it will take 6 to 8 weeks for the myocardium to heal; therefore,
activity levels will need to be tempered in order to protect the heart while it is
healing. - ANSWERS-1. Which of the following objectives is MOST important
prior to discharge, for a patient who has had a myocardial infarction?
A. Ascend a flight of stairs before discharge
B. Perform prescribed exercises without angina
C. Return to normal daily activity level.
D. Take a radial pulse reliably before discharge
B.
The QRS complex represents ventricular contraction. Atrial contraction is
represented by the 'p' wave. When an area of the ventricle becomes irritable and
develops an ectopic foci, the ventricle will depolarize prematurely before the
normal conduction sequence (e.g., prior to SA node firing in the atria) and
presents as a wide, irregularly spaced QRS complex. In normal ventricular
,depolarization, the QRS would be narrow and regularly spaced and atrial
fibrillation would appear as the 'p' wave changes. Atrial repolarization occurs
within the QRS complex and is not normally visible on EKG. - ANSWERS-1. A
patient is undergoing a treadmill stress test. The appearance of abnormally wide,
irregularly spaced QRS complexes on the electrocardiogram represents:
A. ventricular depolarization
B. premature ventricular contractions
C. atrial fibrillation.
D. atrial repolarization
A.
This stage of hemarthrosis will mean that there is still some bleeding into the
joint space, but not as extensively, therefore the patient will benefit from range
of motion exercise to prevent contracture. The patient may need active-assist, as
there may still be pain or edema in the joint that prevents independent
performance of range of motion. The mechanical trauma of weight bearing to
tolerance at this stage may impinge and damaged the pathologic synovium
within the joint. Resistive range of motion is more appropriate when pain and
swelling have subsided and no bleeding is occurring. Continuous
immobilization in the extended position will promote contracture in the
edematous knee - ANSWERS-1. Treatment of a patient with hemophilia who
has a subacute hemarthrosis of the knee should INITIALLY include:
A. active assistive range-of-motion exercise to the knee.
B. instruction of the patient for weight bearing to tolerance
C. gentle resistive range-of-motion exercise to the knee
D. continuous immobilization of the knee in an extension splint.
,B.
Lateral epicondylitis is caused by overuse of the wrist extensors that originate
on the lateral epicondyle of the humerus, especially the extensor carpi radialis
brevis. If the lateral epicondylitis is at a chronic stage, conditioning of the
extensor muscles and sustained grip activities will be most effective in long
term management. A forearm cuff is thought to decrease the muscle loading.
Iontophoresis would not be appropriate for a home program. Friction massage
of the brachioradialis would not be appropriate since the extensor carpi radialis
brevis muscle is usually the one affected. - ANSWERS-1. Which of the
following home programs is MOST appropriate for a patient with chronic lateral
epicondylitis?
A. Using a forearm cuff to increase loading on the extensor tendons
B. Performing exercises for wrist strength and stretching
C. Administering iontophoresis with dexamethasone (Decadron) and lidocaine
(Xylocaine)
D. Doing friction massage of the brachioradialis tendon
B.
Contacting the patient's home health nurse is the appropriate first course of
action because of the possible safety risk associated with the patient not taking
their insulin. Injections and glucose testing would go beyond the scope of
practice for physical therapy. Placing the responsibility on the family would not
be appropriate because of the gravity of the situation. - ANSWERS-1. A
physical therapist who works in a home health agency is treating a patient with
diabetes mellitus. The patient tells the therapist that he is no longer taking his
insulin. The physical therapist's FIRST course of action should be to:
A. instruct the patient in the proper technique for injection of insulin
, B. contact the patient's home health nurse.
C. tell the patient's family to report this information to the physician.
D. have the patient perform a urine glucose test while the therapist is in the
home.
A.
The sitting position promotes visual attending, use of the upper extremities, and
social interaction. A child who exhibits extensor posturing should be carried in a
symmetric position that does not allow axial hyperextension and keeps the hips
and knees flexed. - ANSWERS-1. Which of the following methods is
appropriate for handling a 1 year-old child with cerebral palsy who exhibits
strong extensor tone in the trunk and extremities?
A. Carrying the child in a sitting position
B. Carrying the child over one's shoulder
C. Keeping contact with the back of the child's head
D. Picking the child up under the upper extremities
B.
Caution should be used in patients who are taking tetracycline, because the drug
will enhance the effects of the ultraviolet radiation. Ultraviolet is not
contraindicated in these patients, however the dosage of the ultraviolet would
probably have to be adjusted to some lower level. The penicillin allergy,
calcium supplements and metal implants would not be affected by the
ultraviolet light. It should be noted that although ultraviolet radiation therapy is
not common in today's practice of physical therapy, therapists should
nonetheless be aware of the precautions; and be able to advise patients who may
be using ultraviolet radiation at home. - ANSWERS-1. A physical therapist
evaluates a 65 year-old patient with psoriasis for treatment with ultraviolet
D.
There is a normal, linear relationship between heart rate and exercise intensity
in patients who are not on beta blocker medication or who are on non-rate
responsive pacemakers. Therefore, teaching patients to take their pulse reliably
before discharge is an important learning objective to ensure safety with
exercise upon discharge. Ascending a flight of stairs before discharge is only
appropriate if the patient needs to negotiate stairs at home, but not as important
as pulse monitoring. Performing exercises without angina can be achieved by
monitoring heart rate with exercise; therefore, taking a pulse is necessary.
Returning to normal daily activity immediately after an MI is an unreasonable
objective as it will take 6 to 8 weeks for the myocardium to heal; therefore,
activity levels will need to be tempered in order to protect the heart while it is
healing. - ANSWERS-1. Which of the following objectives is MOST important
prior to discharge, for a patient who has had a myocardial infarction?
A. Ascend a flight of stairs before discharge
B. Perform prescribed exercises without angina
C. Return to normal daily activity level.
D. Take a radial pulse reliably before discharge
B.
The QRS complex represents ventricular contraction. Atrial contraction is
represented by the 'p' wave. When an area of the ventricle becomes irritable and
develops an ectopic foci, the ventricle will depolarize prematurely before the
normal conduction sequence (e.g., prior to SA node firing in the atria) and
presents as a wide, irregularly spaced QRS complex. In normal ventricular
,depolarization, the QRS would be narrow and regularly spaced and atrial
fibrillation would appear as the 'p' wave changes. Atrial repolarization occurs
within the QRS complex and is not normally visible on EKG. - ANSWERS-1. A
patient is undergoing a treadmill stress test. The appearance of abnormally wide,
irregularly spaced QRS complexes on the electrocardiogram represents:
A. ventricular depolarization
B. premature ventricular contractions
C. atrial fibrillation.
D. atrial repolarization
A.
This stage of hemarthrosis will mean that there is still some bleeding into the
joint space, but not as extensively, therefore the patient will benefit from range
of motion exercise to prevent contracture. The patient may need active-assist, as
there may still be pain or edema in the joint that prevents independent
performance of range of motion. The mechanical trauma of weight bearing to
tolerance at this stage may impinge and damaged the pathologic synovium
within the joint. Resistive range of motion is more appropriate when pain and
swelling have subsided and no bleeding is occurring. Continuous
immobilization in the extended position will promote contracture in the
edematous knee - ANSWERS-1. Treatment of a patient with hemophilia who
has a subacute hemarthrosis of the knee should INITIALLY include:
A. active assistive range-of-motion exercise to the knee.
B. instruction of the patient for weight bearing to tolerance
C. gentle resistive range-of-motion exercise to the knee
D. continuous immobilization of the knee in an extension splint.
,B.
Lateral epicondylitis is caused by overuse of the wrist extensors that originate
on the lateral epicondyle of the humerus, especially the extensor carpi radialis
brevis. If the lateral epicondylitis is at a chronic stage, conditioning of the
extensor muscles and sustained grip activities will be most effective in long
term management. A forearm cuff is thought to decrease the muscle loading.
Iontophoresis would not be appropriate for a home program. Friction massage
of the brachioradialis would not be appropriate since the extensor carpi radialis
brevis muscle is usually the one affected. - ANSWERS-1. Which of the
following home programs is MOST appropriate for a patient with chronic lateral
epicondylitis?
A. Using a forearm cuff to increase loading on the extensor tendons
B. Performing exercises for wrist strength and stretching
C. Administering iontophoresis with dexamethasone (Decadron) and lidocaine
(Xylocaine)
D. Doing friction massage of the brachioradialis tendon
B.
Contacting the patient's home health nurse is the appropriate first course of
action because of the possible safety risk associated with the patient not taking
their insulin. Injections and glucose testing would go beyond the scope of
practice for physical therapy. Placing the responsibility on the family would not
be appropriate because of the gravity of the situation. - ANSWERS-1. A
physical therapist who works in a home health agency is treating a patient with
diabetes mellitus. The patient tells the therapist that he is no longer taking his
insulin. The physical therapist's FIRST course of action should be to:
A. instruct the patient in the proper technique for injection of insulin
, B. contact the patient's home health nurse.
C. tell the patient's family to report this information to the physician.
D. have the patient perform a urine glucose test while the therapist is in the
home.
A.
The sitting position promotes visual attending, use of the upper extremities, and
social interaction. A child who exhibits extensor posturing should be carried in a
symmetric position that does not allow axial hyperextension and keeps the hips
and knees flexed. - ANSWERS-1. Which of the following methods is
appropriate for handling a 1 year-old child with cerebral palsy who exhibits
strong extensor tone in the trunk and extremities?
A. Carrying the child in a sitting position
B. Carrying the child over one's shoulder
C. Keeping contact with the back of the child's head
D. Picking the child up under the upper extremities
B.
Caution should be used in patients who are taking tetracycline, because the drug
will enhance the effects of the ultraviolet radiation. Ultraviolet is not
contraindicated in these patients, however the dosage of the ultraviolet would
probably have to be adjusted to some lower level. The penicillin allergy,
calcium supplements and metal implants would not be affected by the
ultraviolet light. It should be noted that although ultraviolet radiation therapy is
not common in today's practice of physical therapy, therapists should
nonetheless be aware of the precautions; and be able to advise patients who may
be using ultraviolet radiation at home. - ANSWERS-1. A physical therapist
evaluates a 65 year-old patient with psoriasis for treatment with ultraviolet
