qNum1= 1

&category1= CC

&domain1= D1
&reasoning1= R4

&answer1= 2
&q1= A patient has developed congestive heart failure after experiencing his
first myocardial infarction. The pulmonary signs and symptoms the therapist
expect to find include:

&choice1a= inspiratory wheezing and shortness of breath.

&choice1b= crackles and cough.

&choice1c= cough productive of thick yellow secretions.

&choice1d= crackles and clubbing of the digits.
&qNum2= 2

&category2= CB
&domain2= D3

&reasoning2= R1
&answer2= 1

&q2= A newborn is 4 weeks premature and is examined at birth using the APGAR
test. Based on the following results, the neonatal therapist suspects
neurological complications are likely with an APGAR of:
&choice2a= 3 at 10 minutes.

&choice2b= 8 at 5 minutes.
&choice2c= 9 at 1 minute.

&choice2d= 8 at 1 minute.
&qNum3= 3
&category3= CF

&domain3= D6
&reasoning3= R5

&answer3= 4
&q3= A physical therapist requested that a PTA perform ultrasound on the left
shoulder of a patient. During the treatment session, the patient experienced an
electrical shock. The physical therapist would not be responsible for any injury
to the patient if this was the result of:

&choice3a= the patient touching the ultrasound machine.

&choice3b= failure of the PTA to use a ground fault interrupter.

&choice3c= failure of the PTA to use sufficient ultrasound gel.

&choice3d= faulty circuitry.
&qNum4= 4

&category4= CD
&domain4= D1

&reasoning4= R1
&answer4= 3

&q4= A patient with coronary artery disease received inpatient cardiac

rehabilitation following a mild myocardial infarction. The patient is now
enrolled in an outpatient exercise class that utilizes intermittent training.
The MOST appropriate initial spacing of exercise/rest intervals to safely stress
the aerobic system is:
&choice4a= 1:1

&choice4b= 5:1
&choice4c= 2:1

&choice4d= 10:1
&qNum5= 5
&category5= CC

&domain5= D2
&reasoning5= R4

&answer5= 3
&q5= The BEST INITIAL intervention to improve functional mobility in an
individual with a stable humeral neck fracture is:

&choice5a= active resistive ROM.

&choice5b= isometrics for all shoulder musculature.

&choice5c= pendulum exercises.

&choice5d= modalities to decrease pain.
&qNum6= 6

&category6= CD
&domain6= D2

&reasoning6= R3
&answer6= 2

&q6= A dancer with unilateral spondylolysis at L4 is referred for physical

therapy. She complains of generalized low back pain when she stands longer than
one hour. Interventions for the subacute phase should include strengthening
exercises for the:
&choice6a= abdominals working from neutral to full flexion.

&choice6b= multifidi working from full flexion back to neutral.

&choice6c= multifidi working from neutral to full extension.

&choice6d= abdominals working from full extension to full flexion.

&qNum7= 7
&category7= CB

&domain7= D2
&reasoning7= R4

&answer7= 2
&q7= A patient has fixed forefoot varus malalignment. Possible compensatory
motion(s) or posture(s) might include:

&choice7a= genu recurvatum.

&choice7b= excessive subtalar pronation.

&choice7c= ipsilateral pelvic external rotation.

&choice7d= hallux varus.
&qNum8= 8

&category8= CF
&domain8= D6

&reasoning8= R2
&answer8= 1

&q8= The purpose of ABC Physical Therapy Center is to deliver excellent health
care services in a unique, individualized and participative manner at a
reasonable cost. The provision of services under these conditions requires and
encourages creative involvement of physicians, staff, patients and their agents
in all aspects of the care planning and delivery process. This is an example of
a:
&choice8a= mission statement.

&choice8b= values statement.

&choice8c= vision statement.

&choice8d= strategic plan.

&qNum9= 9
&category9= CE

&domain9= D6
&reasoning9= R2

&answer9= 2
&q9= A patient presents with weakness of the knee (2/5) resulting from an
anterior cruciate ligament injury. The therapist's examination reveals moderate
pain (5/10) and excessive translation of the tibia during active knee extension.
The therapist determines functional electrical stimulation (FES) is an
appropriate intervention. The protocol for strengthening the quadriceps and
improving stability of the knee should consist of stimulation of the:

&choice9a= quadriceps but not the hamstrings.

&choice9b= hamstrings immediately before the quadriceps to produce
cocontraction.

&choice9c= hamstrings but not the quadriceps.

&choice9d= quadriceps immediately before the hamstrings to produce
cocontraction.
&qNum10= 10

&category10= CC
&domain10= D3

&reasoning10= R4
&answer10= 1

&q10= A therapist is reviewing a hospital record prior to examining a patient

for the first time. The suspected diagnosis is multiple sclerosis. On the
neurologist's note, the therapist finds the following: DTR right quadriceps is
2%2b, left quadriceps is 3%2b. The therapist concludes that:
&choice10a= the right DTR is normal while the left is exaggerated.

&choice10b= both DTRs are abnormal and indicative of upper motor neuron
syndrome.
&choice10c= the right DTR is exaggerated while the left is clearly abnormal.

&choice10d= both DTRs are abnormal and indicative of hyporeflexia.

&qNum11= 11
&category11= CB

&domain11= D2
&reasoning11= R4

&answer11= 4
&q11= A 72 year-old patient has an episode of syncope in the physical therapy
clinic. The therapist attempts to rule out orthostatic hypotension as the cause
of her fainting. This is BEST done by:

&choice11a= checking HR and BP in supine after 5 minutes rest, then repeating in

semi-Fowler position.
&choice11b= palpating the carotid arteries and taking HR; using the supine
position for BP measurements.

&choice11c= checking HR and BP at rest, and after 3 and 5 minutes of cycle

ergometry exercise.
&choice11d= checking resting BP and HR in sitting, then repeating measurements
after standing for 1 minute.
&qNum12= 12

&category12= CC
&domain12= D4

&reasoning12= R5
&answer12= 3

&q12= An inpatient with a grade III diabetic foot ulcer is referred for physical
therapy. Panafil has been applied to the necrotic tissue BID. The wound has no
foul smell; however, the therapist notes a green tinge on the dressing. In this
case, the therapist should:
&choice12a= document the finding and contact the physician immediately.

&choice12b= begin a trial of acetic acid to the wound.

&choice12c= document the finding and continue with treatment.

&choice12d= fit the patient with a total contact cast.

&qNum13= 13
&category13= CC

&domain13= D5
&reasoning13= R5

&answer13= 4
&q13= The therapist receives a referral to examine the fall risk in an 82 year-
old who lives alone and has had two recent falls. The activity that represents
the MOST common risk factor associated with falls in the elderly is:

&choice13a= climbing on a stepstool to reach overhead objects.

&choice13b= walking with a roller walker with hand brakes.

&choice13c= dressing while sitting on the edge of the bed.

&choice13d= turning around and sitting down in a chair.
&qNum14= 14

&category14= CE
&domain14= D6

&reasoning14= R3
&answer14= 1

&q14= A therapist is performing a prosthetic checkout on a patient with a

transfemoral amputation. The prosthesis has been fitted with a quadrilateral
socket. A checkout of the walls of the socket should reveal that the:
&choice14a= anterior and lateral walls are 2½ inches higher than the posterior
and medial walls.

&choice14b= posterior and lateral walls are 2 inches higher than the medial and
anterior walls.
&choice14c= height of the posterior wall is 2 inches less than all the other
walls.

&choice14d= medial wall is 2½ inches higher than the posterior wall while the
anterior and lateral walls are the same height.
&qNum15= 15
&category15= CB

&domain15= D3
&reasoning15= R4

&answer15= 2
&q15= A two month-old child with bilateral hip dislocations is being discharged
home from an acute pediatric facility. The therapist has developed a home
exercise program and now needs to instruct the parents. The MOST important item
for the therapist to assess before instructing the parents is:

&choice15a= the financial reimbursement plan.

&choice15b= their degree of anxiety and attention.

&choice15c= their level of formal education.

&choice15d= the home environment.
&qNum16= 16

&category16= CF
&domain16= D6

&reasoning16= R2
&answer16= 3

&q16= The grip strength of a group of 50 to 60 year-olds was investigated. A

mean score of 40, SD of 5, and range of 26-57 were reported. The grip strength
score for a given patient was determined to be 34. The therapist can safely
conclude that in a normal distribution this patient's score fell within:
&choice16a= 68%25.

&choice16b= 75%25.
&choice16c= 95%25.

&choice16d= 32%25.
&qNum17= 17
&category17= CC

&domain17= D1
&reasoning17= R4

&answer17= 1
&q17= Which of the following clinical manifestations is NOT typical of early
stage cystic fibrosis?

&choice17a= excessive appetite and weight gain.

&choice17b= increased pulmonary secretions with airway obstruction.

&choice17c= frequent recurrent respiratory infections.

&choice17d= salty skin and sweat.
&qNum18= 18

&category18= CA
&domain18= D3

&reasoning18= R3
&answer18= 4

&q18= An infant demonstrates that the ATNR is NOT obligatory when he/she can
turn the head:
&choice18a= to either side and open the hand.

&choice18b= to one side and look at the extended arm on that side.
&choice18c= to one side and bring the opposite hand to mouth.

&choice18d= and bring the hand to mouth on the same side.

&qNum19= 19
&category19= CC

&domain19= D5
&reasoning19= R5

&answer19= 1
&q19= A 75 year-old patient is referred to physical therapy for back pain.
Medical tests reveal he is at the end stage of pancreatic cancer. The physician
has told him he has cancer but has chosen not to inform the patient about the
prognosis. If the patient asks the therapist what his prognosis is, the
therapist's BEST response is to tell him:

&choice19a= to discuss his concerns with the physician.

&choice19b= to ask the nurse practitioner.

&choice19c= …"everything usually works out for the best."

&choice19d= the prognosis.
&qNum20= 20

&category20= CC
&domain20= D5

&reasoning20= R3
&answer20= 4

&q20= During surgery to remove an apical lung tumor, the long thoracic nerve was
injured. Muscle weakness is 3+/5. It would be best to implement exercises:
&choice20a= standing using hand weights.

&choice20b= supine using weights.

&choice20c= supine using a pulley.

&choice20d= standing while performing wall push-ups.

&qNum21= 21
&category21= CC

&domain21= D2
&reasoning21= R3

&answer21= 2
&q21= A physical therapist examination reveals: iliac crests high on the left;
PSIS low and posterior on the left; ASIS high and anterior on the left; standing
flexion test shows that the left PSIS moves first and farthest superiorly;
Gillet's test demonstrates the left PSIS moves inferiorly and laterally less
than right; long sitting test shows the left malleolus moves short to long;
sitting flexion test is negative. In light of the above findings, the
therapist's diagnosis is:

&choice21a= left anterior rotated innominate.

&choice21b= left posterior rotated innominate.

&choice21c= left upslip.

&choice21d= iliac inflare on the left.
&qNum22= 22

&category22= CF
&domain22= D6

&reasoning22= R2
&answer22= 3

&q22= The highest level of provider risk in reimbursement is related to:

&choice22a= the cost-based payment method.

&choice22b= the fee-for-service payment method.

&choice22c= the capitation payment method.

&choice22d= the per diem payment method.

&qNum23= 23
&category23= CE

&domain23= D6
&reasoning23= R2

&answer23= 4
&q23= A patient presents with partial and full thickness burns on the chest and
neck region. The therapist decides to apply TENS prior to debridement to
modulate pain. Which TENS mode should provide the BEST relief?

&choice23a= conventional (high rate) TENS.

&choice23b= acupuncture-like (low rate) TENS.

&choice23c= modulated TENS.

&choice23d= brief intense TENS.
&qNum24= 24

&category24= CD
&domain24= D3

&reasoning24= R1
&answer24= 1

&q24= A patient recovering from traumatic brain injury demonstrates instability

during feeding while sitting in a wheelchair. The therapist determines
modification is necessary to ensure optimal function. The FIRST body segment or
segments the therapist would align is the:
&choice24a= pelvis.

&choice24b= head.
&choice24c= lower extremities.

&choice24d= trunk.
&qNum25= 25
&category25= CD

&domain25= D3
&reasoning25= R4

&answer25= 1
&q25= A patient demonstrates beginning recovery Stage 4 movements following a
left CVA. The PNF pattern that represents the BEST choice to promote continued
recovery of the right upper extremity through the use of out-of-synergy
movements is:

&choice25a= chop, reverse chop with right arm leading.

&choice25b= bilateral symmetrical D1 thrust and reverse thrust.

&choice25c= lift, reverse lift with right arm leading.

&choice25d= bilateral symmetrical D2F and D2E, elbows straight.
&qNum26= 26

&category26= CC
&domain26= D1

&reasoning26= R3
&answer26= 2

&q26= A 50 year-old individual has limited endurance as a result of a sedentary

lifestyle. There is no history of cardiorespiratory problems. Following an
exercise tolerance test, which was negative, appropriate INITIAL exercise
prescription parameters for this individual would be:
&choice26a= 30 - 60%25 Hrmax

&choice26b= 60 - 90%25 Hrmax

&choice26c= 40 - 60%25 Hrmax

&choice26d= 45 - 55%25 of VO2max

&qNum27= 27
&category27= CC

&domain27= D1
&reasoning27= R5

&answer27= 1
&q27= A patient is admitted to a coronary care unit with a mild myocardial
infarction, After 2 days the patient is referred to physical therapy for
exercise conditioning. During an initial exercise session on the unit, he
reports chest pain, appears anxious, and wants to go back to bed to rest. The
therapist's BEST course of action is to terminate the exercise and:

&choice27a= have him sit down and continue to monitor his vital signs carefully.
&choice27b= monitor his vital signs and contact his doctor immediately.

&choice27c= assist the patient back to bed and contact the charge nurse on his
floor.
&choice27d= assign the physical therapist assistant to assist him back to his
bed and monitor his vital signs carefully.
&qNum28= 28

&category28= CC
&domain28= D4

&reasoning28= R1
&answer28= 4

&q28= A patient with a 10-year history of scleroderma is referred for physical

therapy to improve functional status and endurance. The patient was recently
treated with corticosteroids for a bout of myositis. Examination findings reveal
limited ROM and fibrotic soft tissue along with hypersesthesia. The BEST choice
for initial intervention is:
&choice28a= soft tissue mobilization and stretching.

&choice28b= closed chain and modified aerobic step exercises.

&choice28c= treadmill walking using body weight support at an intensity of 40%25
HRmax.

&choice28d= AROM exercises and walking in a therapeutic pool.

&qNum29= 29
&category29= CC

&domain29= D5
&reasoning29= R4

&answer29= 2
&q29= A patient is referred to physical therapy following a fall injury
(fractured left hip with ORIF). Medical history reveals a diagnosis of Stage I
Alzheimer's disease. At this stage, the behaviors the therapist would NOT expect
to find are:

&choice29a= anxiety and irritability.

&choice29b= language comprehension problems.

&choice29c= fragmented memory.

&choice29d= restlessness and sundowning.
&qNum30= 30

&category30= CD
&domain30= D3

&reasoning30= R1
&answer30= 3

&q30= A patient recovering from stroke with minimal lower extremity weakness and
spasticity is able to walk without an assistive device. The therapist observes
that as he walks he hikes his pelvis on the affected side during the swing
phase. The BEST initial intervention is:
&choice30a= partial wall squats using a small ball held between the knees.

&choice30b= standing, marching with manual pressure applied downward on the

pelvis.
&choice30c= marching while sitting on a therapy ball.

&choice30d= bridging exercises progressing to sit-to-stand training.

&qNum31= 31
&category31= CD

&domain31= D3
&reasoning31= R1

&answer31= 3
&q31= The therapist is instructing a patient with traumatic brain injury how to
lock the brakes on his wheelchair. He is right-handed and his right upper
extremity is more affected than his left. To obtain optimal results, the BEST
training strategy is to:

&choice31a= guide his right hand through the locking motions, then his left.
&choice31b= verbally talk him through the locking motions practicing with both
hands simultaneously.

&choice31c= have him practice locking the brakes first with his left hand, and
then his right.
&choice31d= have him practice brake locking using his left hand to assist his
right.
&qNum32= 32

&category32= CF
&domain32= D6

&reasoning32= R2
&answer32= 2

&q32= A physical therapist wants to examine the effects of PNF using the
technique of contract-relax on shoulder ROM. A group of 10 patients with
adhesive capsulitis were recruited. A matched group of patients were given
straight plane active-assisted exercise for the same length of time (3
times/week for 6 weeks). In this study the independent variable is:
&choice32a= active-assisted exercise.

&choice32b= PNF contract-relax technique.

&choice32c= ROM.

&choice32d= adhesive capsulitis.

&qNum33= 33
&category33= CC

&domain33= D1
&reasoning33= R4

&answer33= 4
&q33= A therapist is examining a patient with a 12-year history of emphysema.
The clinical finding the therapist would NOT expect to find is:

&choice33a= cor pulmonale.

&choice33b= clubbing.

&choice33c= cyanosis.
&choice33d= decreased A-P to lateral chest ratio.
&qNum34= 34

&category34= CF
&domain34= D6

&reasoning34= R5
&answer34= 1

&q34= A patient is receiving physical therapy following an ACL repair. After 4

weeks of treatment the patient still complains of pain and instability even
though he reports he has been faithful with his home exercise program and
wearing his orthosis. The original referral was for 7 to 8 weeks of physical
therapy. The therapist's BEST course of action is to:
&choice34a= discontinue the treatment; and discuss the situation with the
patient and his referring physician.

&choice34b= recommend to the patient that he get a second medical opinion as the
surgery seems unsuccessful.
&choice34c= complete the full 8 weeks of treatment and carefully document his
lack of improvement to ensure full insurance coverage.

&choice34d= re-examine the patient and implement a modified therapy program.

&qNum35= 35
&category35= CD

&domain35= D2
&reasoning35= R3

&answer35= 3
&q35= During a postural screen for chronic shoulder pain in a recreational
swimmer, the therapist observes excessive internal rotation of the shoulders and
winging of the scapula during overhead motion. Intervention should focus on:

&choice35a= strengthening of pectoral muscles and stretching of upper trapezius.

&choice35b= strengthening of upper trapezius and stretching of pectoral muscles.

&choice35c= strengthening middle and lower trapezius and stretching of pectoral

muscles.
&choice35d= strengthening of rhomboids and stretching of upper trapezius.
&qNum36= 36

&category36= CD
&domain36= D4

&reasoning36= R1
&answer36= 4

&q36= Re-examination of a patient with a dermal ulcer over the coccyx reveals a
wound exposing the deep fascia. There is no necrotic tissue, exudate is minimal,
and the borders of the ulcer are diffusely covered with granulation tissue.
Previous treatment has included daily whirlpool and wet-to-dry dressings with
normal saline. Based on the re-examination, intervention should consist of:
&choice36a= continuation of the same treatments.

&choice36b= whirlpool and hydrogel dressings.

&choice36c= calcium alginate dressings.

&choice36d= wound irrigation with pressures below 15 psi.

&qNum37= 37
&category37= CC

&domain37= D2
&reasoning37= R3

&answer37= 3
&q37= The spinal defect shown in the diagram should be managed with avoidance of
lumbar spinal:

&choice37a= flexion.
&choice37b= rotation.

&choice37c= extension.
&choice37d= lateral flexion.
&qNum38= 38

&category38= CC
&domain38= D3

&reasoning38= R3
&answer38= 4

&q38= A computer specialist is unable to work because of weakness and altered

sensation in her dominant right hand. She complains of pain and tingling of the
thumb, index finger, long finger, and radial half of the ring finger. The
therapist observes thenar weakness and atrophy. Strength, reflexes, and
sensation are within normal limits throughout the remainder of the right upper
extremity. Her signs and symptoms are characteristic of:
&choice38a= pronator teres syndrome.

&choice38b= cervical root compression.

&choice38c= ulnar nerve compression.

&choice38d= carpal tunnel syndrome.

&qNum39= 39
&category39= CC

&domain39= D3
&reasoning39= R3

&answer39= 2
&q39= A patient presents with rapidly progressive symmetrical weakness that
started in the distal lower extremity muscles but now has ascended to include
proximal trunk and upper extremity muscles. The motor segments of the lower
cranial nerves are also showing impairment. The patient complains of abnormal
sensations of tingling and burning of the affected extremities. Consciousness,
cognition, and communication are all normal. These signs and symptoms are
characteristic of:

&choice39a= post-polio syndrome.

&choice39b= Guillain-Barré syndrome.

&choice39c= multiple sclerosis.

&choice39d= amyotrophic lateral sclerosis.
&qNum40= 40

&category40= CA
&domain40= D1

&reasoning40= R5
&answer40= 2

&q40= A patient recovering from surgery for triple coronary artery bypass grafts
is scheduled to begin a Phase III cardiac rehabilitation program. During the
resistance training portion of the circuit training program, the therapist
instructs the patient to AVOID the Valsalva maneuver because:
&choice40a= heart rate and blood pressure are likely to be elevated.

&choice40b= slowing of pulse and increased venous pressure are possible.

&choice40c= a cholinergic or vagal response can occur.

&choice40d= the decreased return of blood to the heart can lead to pitting
edema.
&qNum41= 41
&category41= CC

&domain41= D1
&reasoning41= R4

&answer41= 3
&q41= A patient experiences color changes in the skin during position changes of
the foot. During elevation, pallor develops. When the limb is then positioned in
the seated hanging position, hyperemia develops. These changes are indicative
of:

&choice41a= chronic venous insufficiency.

&choice41b= lymphedema.

&choice41c= arterial insufficiency.

&choice41d= deep vein thrombophlebitis.
&qNum42= 42

&category42= CB
&domain42= D3

&reasoning42= R2
&answer42= 1

&q42= A 73 year-old is referred to physical therapy for an examination of

balance. He has a recent history of falls (two in the last 6 months). Based on
knowledge of balance changes in the elderly and scoring of standardized balance
measures, the test data that BEST indicates increased fall risk is:
&choice42a= Functional Reach of 7 inches.

&choice42b= Berg Balance score of 50.

&choice42c= Tinetti Performance Oriented Mobility Assessment (POMA) score of 27.

&choice42d= Timed Get Up %26 Go test result of 13 seconds.

&qNum43= 43
&category43= CC

&domain43= D5
&reasoning43= R4

&answer43= 2
&q43= In completing an examination of a patient complaining of pain in the lower
thoracic/upper lumbar area, the physical therapist should perform percussion of
the costovertebral angle on a patient with a medical history of:

&choice43a= post-kidney transplant.

&choice43b= recent motor vehicle accident.

&choice43c= post-kidney transplant.

&choice43d= compression fracture T8.
&qNum44= 44

&category44= CC
&domain44= D1

&reasoning44= R4
&answer44= 4

&q44= A 72 year-old patient is walking on a treadmill in the physical therapy

department while his vital signs are being monitored. It is noted that his SaO2
drops from 97%25 to 95%25. In this case, it would be BEST to:
&choice44a= place a 100%25 O2 face mask on the patient for the remainder of the
exercise session.

&choice44b= place a 40%25 O2 face mask on the patient for the remainder of the
exercise session.
&choice44c= place 2 liters of O2 by nasal cannula on the patient for the
remainder of the exercise session.

&choice44d= not use supplemental O2.

&qNum45= 45
&category45= CE

&domain45= D6
&reasoning45= R1

&answer45= 2
&q45= The therapist is evaluating the needs of a 6 year-old child who is
diagnosed with myelodysplasia at the T10 level. The therapist determines the
most appropriate mobility device for this child to use in the school environment
is a:

&choice45a= bilateral HKAFO.

&choice45b= lightweight wheelchair.

&choice45c= bilateral KAFO.

&choice45d= parapodium.
&qNum46= 46

&category46= CD
&domain46= D2

&reasoning46= R1
&answer46= 2

&q46= A patient has limited right rotation caused by left thoracic facet joint
capsular tightness. The intervention that would best facilitate improved right
rotation in sitting is:
&choice46a= trunk flexion with left rotation.

&choice46b= trunk flexion with right rotation.

&choice46c= trunk extension with right rotation.

&choice46d= trunk extension with left rotation.

&qNum47= 47
&category47= CA

&domain47= D2
&reasoning47= R3

&answer47= 4
&q47= EMG activity in the lower extremities during erect standing is continuous
in the:

&choice47a= anterior tibialis and peroneals.

&choice47b= posterior tibialis and intrinsic foot muscles.

&choice47c= quadriceps femoris and anterior tibialis.

&choice47d= soleus and gastrocnemius.
&qNum48= 48

&category48= CF
&domain48= D6

&reasoning48= R5
&answer48= 3

&q48= A patient falls while walking in the parallel bars. The therapist is
required to fill out an incident report of the event. Information in the report
should include the names of those involved and:
&choice48a= the date of the occurrence, a description of the event, and the
cause of the fall.

&choice48b= a description of the event, where the patient was injured and the
corrective actions to be taken.
&choice48c= what occurred, when and where it occurred, and witness statements.

&choice48d= witness reports and therapist's opinion as to the cause.

&qNum49= 49
&category49= CE

&domain49= D6
&reasoning49= R2

&answer49= 1
&q49= Four days ago, a patient sustained a deep contusion of the right lateral
thigh as a result of a blow on the leg by a steel beam. Following several
cryotherapy treatments, the therapist decides to apply ultrasound [US]. The
parameters that are most appropriate in this case are:

&choice49a= pulsed US at 1 MHz.

&choice49b= continuous US at 1 MHz.

&choice49c= continuous US at 3 MHz.

&choice49d= pulsed US at 3 MHz.
&qNum50= 50

&category50= CA
&domain50= D3

&reasoning50= R3
&answer50= 4

&q50= A 99 year-old woman was found unconscious at home. Two days later the
therapist examines her in the hospital. Findings include normal sensation and
movement on the right side of the body with impaired sensation (touch, pressure,
proprioception) and paralysis on the left side of the body. The left side of her
lower face and her trunk are similarly impaired. The MOST LIKELY location of the
lesion is the:
&choice50a= left side of brainstem.

&choice50b= left parietal lobe.

&choice50c= spinal cord.

&choice50d= right parietal lobe.

&qNum51= 51
&category51= CA

&domain51= D3
&reasoning51= R4

&answer51= 3
&q51= The loss of sensory function in peripheral neuropathy is often among the
first noticeable symptoms. If more than one nerve is involved, the sensory loss
typically appears as:

&choice51a= bandlike dysesthesias and paresthesias in the hips and thighs.

&choice51b= paresthesias affecting primarily the proximal limb segments and
trunk.

&choice51c= stocking and glove distribution of the lower and upper extremities.
&choice51d= allodynia of the feet accompanied by pronounced dorsiflexor
weakness.
&qNum52= 52

&category52= CB
&domain52= D1

&reasoning52= R3
&answer52= 3

&q52= The therapist is supervising a Phase II cardiac rehabilitation class of 10

patients. One of the patients, who is being monitored with radiotelemetry, is
having difficulty. The therapist decides to terminate the patient's exercise
session upon observing:
&choice52a= an increase in HR 20 BPM above resting.

&choice52b= an increase in systolic BP to 150 and diastolic BP to 90.

&choice52c= a 2° AV heart block.

&choice52d= 1 mm ST-segment depression, upsloping.

&qNum53= 53
&category53= CD

&domain53= D1
&reasoning53= R1

&answer53= 1
&q53= A patient presents with severe claudication which is evident when he walks
distances greater than 200 feet. He also exhibits muscle fatigue and cramping of
both calf muscles. Upon examination, the therapist finds his skin is pale and
shiny with some trophic nail changes. The BEST choice for intervention is to:

&choice53a= begin with an interval walking program, exercising only to the point
of pain.
&choice53b= avoid any exercise stress until he has been on calcium channel
blockers for at least 2 weeks.

&choice53c= utilize a walking program of moderate intensity, instructing the

patient that some pain is expected and to be tolerated.
&choice53d= utilize non-weightbearing exercises such as cycle ergometry.
&qNum54= 54

&category54= CD
&domain54= D4

&reasoning54= R4
&answer54= 3

&q54= A 72 year-old is hospitalized with diabetes and a large stage II plantar

ulcer located over his right heel. He has been non-weightbearing for the past 2
weeks as a result of the ulcer. The BEST intervention is:
&choice54a= clean and bandage with a sterile gauze dressing.

&choice54b= request a surgical consult as available wound dressings will not

promote healing.
&choice54c= clean and debride the wound, and apply a hydrogel dressing.

&choice54d= wash the foot and apply skin lubricants followed by a transparent
film dressing.
&qNum55= 55
&category55= CE

&domain55= D6
&reasoning55= R4

&answer55= 2
&q55= The therapist is prescribing a wheelchair for a patient with left
hemiplegia. The MOST appropriate feature to include in this prescription is:

&choice55a= detachable arm rests

&choice55b= a 17.5 inch seat height.

&choice55c= a 20 inch seat height.

&choice55d= elevating legrests.
&qNum56= 56

&category56= CF
&domain56= D6

&reasoning56= R2
&answer56= 4

&q56= A patient who is participating in a cardiac rehab program suddenly

collapses and falls to the floor. The physical therapist is the lone rescuer on
site. The therapist checks for a pulse and finds the patient unresponsive. The
therapist calls the emergency response number, and then opens the airway, checks
breathing. The patient is not breathing and has no pulse. The therapist should:
&choice56a= give 2 rescue breaths followed by 15 chest compressions, repeating
the cycle.

&choice56b= give chest compressions only at a rate of 100 per minute.

&choice56c= use the AED to shock the patient immediately; if unsuccessful then
initiate CPR.

&choice56d= give 2 rescue breaths followed by 30 chest compressions, repeating

the cycle.
&qNum57= 57
&category57= CC

&domain57= D2
&reasoning57= R1

&answer57= 2
&q57= A patient who was casted for 3 weeks following a Grade III right ankle
sprain has been referred to physical therapy for mobility exercises. Examination
shows a loss of 10 degrees of dorsiflexion. The patient will have the MOST
difficulty in:

&choice57a= ambulating barefoot.

&choice57b= descending stairs.

&choice57c= descending a ramp.

&choice57d= ambulating over rough surfaces.
&qNum58= 58

&category58= CA
&domain58= D2

&reasoning58= R2
&answer58= 3

&q58= The torque output produced in the sitting position during isokinetic
exercise involving the hamstrings is:
&choice58a= lower than the torque actually generated by the hamstrings.

&choice58b= higher due to eccentric assistance of the quadriceps.

&choice58c= higher than the torque actually generated by the contracting
hamstrings.

&choice58d= lower due to resistance of the quadriceps.

&qNum59= 59
&category59= CD

&domain59= D2
&reasoning59= R3

&answer59= 1
&q59= A manual therapy technique utilized to correct a closing restriction of T5
on T6 is:

&choice59a= central P/A pressure at a 60 degree angle on the spinous process of

T6 while stabilizing T5.
&choice59b= central P/A pressure at a 45 degree angle on the spinous process of
T5 while stabilizing T6.

&choice59c= unilateral P/A pressure at a 45 degree angle on the right transverse

process of T6 while stabilizing T5.
&choice59d= unilateral P/A pressure at a 60 degree angle on the left transverse
process of T6 while stabilizing T5.
&qNum60= 60

&category60= CC
&domain60= D3

&reasoning60= R3
&answer60= 1

&q60= A patient presents with an acute onset of vertigo over night. Symptoms
worsen with rapid change in head position. If the head is held still, symptoms
subside usually within 1 to 2 minutes. The MOST likely cause of this patient's
problem is:
&choice60a= benign paroxysmal positional vertigo.

&choice60b= bilateral vestibular neuritis.

&choice60c= Ménière's disease.

&choice60d= acoustic neuroma.

&qNum61= 61
&category61= CA

&domain61= D1
&reasoning61= R4

&answer61= 2
&q61= A patient with a significant history for coronary artery disease tells the
therapist he is currently taking atropine with careful monitoring. Based on
knowledge of the effects of this medication the therapist expects:

&choice61a= bradycardia at rest and with exercise.

&choice61b= increased heart rate and contractility at rest.

&choice61c= reduced blood pressure at rest and with exercise.

&choice61d= reduced myocardial ischemia and heart rate.
&qNum62= 62

&category62= CA
&domain62= D4

&reasoning62= R4
&answer62= 4

&q62= A 67 year-old patient recovering from stroke is on warfarin (Coumadin).

During his rehabilitation, it would be important to watch for:
&choice62a= edema and dermatitis.

&choice62b= palpitations and edema.

&choice62c= cellulitis and xeroderma.

&choice62d= hematuria and ecchymosis.

&qNum63= 63
&category63= CB

&domain63= D5
&reasoning63= R3

&answer63= 3
&q63= The physical therapist reviews the lab results of a patient admitted to
the acute care hospital yesterday: Hematocrit 45%25, Blood glucose 180 mg/dL and
cholesterol 180 mg/dL. Based on these lab results, the patient most likely has:

&choice63a= hyperlipidemia.
&choice63b= anemia.

&choice63c= diabetes mellitus.

&choice63d= polycythemia vera.
&qNum64= 64

&category64= CD
&domain64= D3

&reasoning64= R3
&answer64= 2

&q64= A patient recovering from a stroke is having difficulty with stair

climbing. During ascent, the patient is able to position the more involved foot
on the step above but is unable to transfer the weight up to the next stair
level. The BEST intervention to solve this problem is:
&choice64a= hooklying, bridging.

&choice64b= standing, partial wall squats.

&choice64c= plantigrade, knee flexion with hip extension.

&choice64d= standing, side steps.

&qNum65= 65
&category65= CC

&domain65= D1
&reasoning65= R5

&answer65= 2
&q65= A 72 year-old patient has been hospitalized, on complete bedrest, for 10
days. A physical therapy referral requests mobilization out-of-bed and
ambulation. The patient complains that today his right calf is aching. If he
gets up and moves around he is sure he will feel better. The therapist's
examination reveals calf tenderness with slight swelling and warmth. The
therapist decides to:

&choice65a= ambulate the patient with his support stockings on.

&choice65b= postpone ambulation and report the findings immediately.

&choice65c= begin with ankle pump exercises in bed and then ambulate.
&choice65d= use only AROM exercises with the patient sitting at the edge of the
bed.
&qNum66= 66

&category66= CB
&domain66= D3

&reasoning66= R1
&answer66= 3

&q66= A nine year-old boy with Duchenne's muscular dystrophy is referred for
homecare. The physical therapist should BEGIN the examination by:
&choice66a= performing a complete motor examination.

&choice66b= performing a functional examination using the weeFIM.

&choice66c= asking the child and his parents to describe the boy's most serious
functional limitations.

&choice66d= asking the parents to outline the boy's past rehabilitation

successes.
&qNum67= 67
&category67= CC

&domain67= D2
&reasoning67= R3

&answer67= 1
&q67= During an examination of an adolescent female who complains of anterior
knee pain, the therapist observes that the lower extremity shows medial femoral
torsion and toeing-in position of the feet. The lower extremity position may be
indicative of excessive hip:

&choice67a= anteversion.
&choice67b= medial/internal rotation.

&choice67c= retroversion.
&choice67d= lateral/external rotation.
&qNum68= 68

&category68= CD
&domain68= D2

&reasoning68= R4
&answer68= 1

&q68= A patient with osteoporosis and no fractures complains of increased mid

and low back pain during breathing and other functional activities. The MOST
appropriate interventions for this patient include patient education and:
&choice68a= trunk extension and abdominal stabilization exercises.

&choice68b= trunk rotation and abdominal stabilization exercises.

&choice68c= trunk flexion and extension exercises.

&choice68d= trunk flexion, and rotation exercises.

&qNum69= 69
&category69= CC

&domain69= D5
&reasoning69= R5

&answer69= 4
&q69= A single, 22 year-old woman, who is 3 months pregnant, arrives at a
therapist's private practice complaining of shoulder and leg pain. She has a
black eye and some bruising at the wrists. The state in which the therapist
practices has direct access. An appropriate course of action is:

&choice69a= administer massage for bruising, TENS and ice modalities for pain,
as indicated by the examination findings.
&choice69b= direct the patient to the nearest Ambulatory Care Center for
physician evaluation.

&choice69c= perform a comprehensive examination and send her to the emergency

room along with a copy of the findings.
&choice69d= do a comprehensive examination, and if the therapist suspects abuse
report the findings to the appropriate authorities.
&qNum70= 70

&category70= CE
&domain70= D6

&reasoning70= R2
&answer70= 2

&q70= A 73 year-old patient presents with a stage III decubitus ulcer on the
plantar surface of the right foot. After a series of conservative interventions
with limited success, the therapist chooses to apply electrical stimulation for
tissue repair. The electrical current BEST suited in this case is:
&choice70a= low volt biphasic pulsed current.

&choice70b= high volt monophasic pulsed current.

&choice70c= medium frequency burst current.

&choice70d= medium frequency beat current.

&qNum71= 71
&category71= CE

&domain71= D6
&reasoning71= R1

&answer71= 3
&q71= A patient presents with pain radiating down the posterior hip and thigh as
a result of a herniated disk in the lumbar spine. The therapist decides to apply
mechanical traction. If the patient can tolerate it, the PREFERRED patient
position is:

&choice71a= supine with one knee flexed.

&choice71b= supine with both knees flexed.

&choice71c= prone with no pillow.

&choice71d= prone with pillow under the abdomen.
&qNum72= 72

&category72= CD
&domain72= D3

&reasoning72= R4
&answer72= 4

&q72= A patient recovering from stroke demonstrates hemiparesis of his right

upper extremity and moderate flexion and extension synergies (flexion stronger
than extension). The therapist's goal is strengthen the shoulder muscles first,
specifically the deltoid. The BEST choice is to promote:
&choice72a= horizontal adduction with elbow extension.

&choice72b= horizontal adduction with elbow flexion.

&choice72c= abduction with elbow flexion.

&choice72d= abduction with elbow extension.

&qNum73= 73
&category73= CA

&domain73= D3
&reasoning73= R4

&answer73= 3
&q73= A patient recovering from a middle cerebral artery stroke presents with
gaze deviation of the eyes. In this type of stroke the involved eye may deviate
toward:

&choice73a= the hemiplegic side.

&choice73b= up and in.

&choice73c= the sound side.

&choice73d= down and out.
&qNum74= 74

&category74= CB
&domain74= D1

&reasoning74= R4
&answer74= 1

&q74= A patient is referred for physical therapy following an exercise tolerance

test. The physician reports the test was positive and had to be terminated at 7
minutes. Based on the therapist's knowledge of this procedure, the therapist
expects the patient may have exhibited:
&choice74a= ST segment depression from baseline of 3 mm horizontal or
downsloping depression.

&choice74b= a hypertensive response with a BP of at least 170/95.

&choice74c= increasing angina and dyspnea with progressive increases in the
treadmill speed and grade.

&choice74d= ECG changes from baseline of 1 mm ST-segment elevation.

&qNum75= 75
&category75= CC

&domain75= D2
&reasoning75= R3

&answer75= 2
&q75= A college soccer player sustained a hyperextension knee injury when
kicking the ball with his other lower extremity. The patient was taken to the
emergency room of a local hospital and was diagnosed with "knee sprain". He was
sent to physical therapy the next day for aggressive rehabilitation. As part of
the examination to determine the type of treatment plan to implement, the
therapist conducts the test shown in the figure. The type of exercise that is
indicated in the acute phase of treatment if a positive test is found includes:

&choice75a= agility exercises.

&choice75b= closed chain terminal knee extension exercises.

&choice75c= open-chain terminal knee extension exercises.

&choice75d= plyometric functional exercises.
&qNum76= 76

&category76= CD
&domain76= D4

&reasoning76= R2
&answer76= 2

&q76= A patient with a grade III diabetic ulcer is being treated with a calcium
alginate wound dressing. This type of dressing can be expected to:
&choice76a= absorb exudate and allow rapid moisture evaporation.

&choice76b= facilitate autolytic debridement and absorb exudate.

&choice76c= provide semirigid support for the limb while maintaining a sterile
field.

&choice76d= restrict bacteria from the wound while supporting the tissues.
&qNum77= 77
&category77= CF

&domain77= D6
&reasoning77= R2

&answer77= 3
&q77= The therapist receives a referral to treat a patient with a 5-year history
of cirrhosis and Hepatitis B. The therapist should:

&choice77a= use droplet transmission precautions.

&choice77b= use contact precautions.

&choice77c= avoid direct exposure to blood and body fluids.

&choice77d= ask the patient to wear gloves and avoid contact.
&qNum78= 78

&category78= CA
&domain78= D2

&reasoning78= R4
&answer78= 1

&q78= A patient with a transtibial amputation is learning to walk using a PTB

prosthesis. He is having difficulty maintaining prosthetic stability from heel-
strike to footflat. The muscles that are MOST LIKELY weak are the:
&choice78a= knee extensors.

&choice78b= back extensors.

&choice78c= hip flexors.

&choice78d= knee flexors.

&qNum79= 79
&category79= CC

&domain79= D1
&reasoning79= R5

&answer79= 3
&q79= A patient with a history of coronary artery disease and recent myocardial
infarction is exercising in an inpatient Cardiac Rehab Program. As the patient
is new, continuous ECG telemetry monitoring is being done. The therapist
observes the following. The BEST course of action is to:

&choice79a= have the patient sit down and sent back to the room after a brief
rest period.
&choice79b= activate the emergency medical response team.

&choice79c= have the patient sit down, continue monitoring, and notify the
physician immediately.
&choice79d= have the patient sit down, rest, then resume the exercise at a lower
intensity.
&qNum80= 80

&category80= CD
&domain80= D3

&reasoning80= R1
&answer80= 1

&q80= A patient recovering from traumatic brain injury is unable to bring the
right foot up on the step during stair climbing training. The BEST training
activity is to:
&choice80a= practice stair climbing inside the parallel bars using a 3 inch
step.

&choice80b= practice marching in place.

&choice80c= passively bring the foot up and place it on the 7 inch step.

&choice80d= strengthen the hip flexors using an isokinetic training device

before attempting stair climbing.
&qNum81= 81
&category81= CC

&domain81= D5
&reasoning81= R4

&answer81= 3
&q81= The physical therapist is completing general activity recommendations for
a group home of young adults with emotional and behavioral issues. All patients
are chemically controlled with either antipsychotic or antidepressant
medications. Full time supervision is available for any activity recommended.
Which precautions would be MOST appropriate for inclusion in the report?

&choice81a= promote rhythmic movement to soothing music to avoid agitation.

&choice81b= promote activities with sequential movements to improve memory.

&choice81c= avoid aerobic exercises outdoors when temperature is over 90º.

&choice81d= avoid games with throwing activities to prevent injuries.
&qNum82= 82

&category82= CC
&domain82= D5

&reasoning82= R5
&answer82= 1

&q82= A patient suffered a spinal cord injury with a complete injury (ASIA Level
A) at T10. It is now three months post-injury and she is refusing to participate
in her functional training program because the major focus is wheelchair
independence. She is sure she is going to walk again. The therapist's BEST
approach is to:
&choice82a= outline realistic short term goals to improve independence while
maintaining for the possibility of further recovery.

&choice82b= discuss the harmful effects of denial and restrict all discussions
to promoting wheelchair independence.
&choice82c= refer the patient for psychological counseling and discharge her
from P.T.

&choice82d= send the patient home for a short time so she will recognize the
need for wheelchair training.
&qNum83= 83
&category83= CC

&domain83= D3
&reasoning83= R1

&answer83= 4
&q83= The therapist is on a home visit, scheduled at lunchtime, visiting an 18
month-old child with moderate developmental delay. The therapist notices the
child and mother are experiencing difficulties with feeding. The child is
slumped down in the highchair and is unsuccessfully attempting to use a raking
grasp to lift cereal pieces to her mouth. Both the child and mother are
frustrated. The FIRST intervention should be to:

&choice83a= work on desensitizing the gag reflex.

&choice83b= recommend the mother return to breast feeding for a few more months.

&choice83c= recommend the mother feed the child baby food instead of cereal for
a few more months.
&choice83d= reposition the child in a proper sitting position using postural
supports.
&qNum84= 84

&category84= CD
&domain84= D2

&reasoning84= R3
&answer84= 2

&q84= A patient is sent to physical therapy with a diagnosis of "frozen

shoulder". The MOST effective mobilization technique for restricted shoulder
abduction is:
&choice84a= posterior glide at 10 degrees of abduction.

&choice84b= inferior glide at 55 degrees of abduction.

&choice84c= inferior glide at 95 degrees of abduction.

&choice84d= lateral glide in neutral position.

&qNum85= 85
&category85= CC

&domain85= D2
&reasoning85= R3

&answer85= 1
&q85= A patient presents with insidious onset of pain in the jaw that is
referred to the head and neck regions. As best as he can recall, it may be
related to biting into something hard. Cervical ROM is limited in flexion by 20
degrees, cervical lateral flexion limited to the left by 10 degrees. Mandibular
depression is 10mm with deviation to the left, protrusion is 4mm, and lateral
deviation is 15mm to right and 6mm to left. Based on these findings the
diagnosis for this patient would be:

&choice85a= capsule-ligamentous pattern of TMJ on the left.

&choice85b= weak lateral pterygoids on the left.

&choice85c= weak lateral pterygoids on the right.

&choice85d= cervical spine and TMJ capsular restrictions on the left.
&qNum86= 86

&category86= CF
&domain86= D6

&reasoning86= R5
&answer86= 4

&q86= A 35 year-old administrative assistant and mother of three is being

treated for a Colles' fracture. Her husband wants to look at her medical record.
The physical therapist should:
&choice86a= give him the chart as he is a spouse and has a right to view the
information.

&choice86b= not let him look at the chart because he may misinterpret the
documentation.
&choice86c= let him look at the chart and be available to answer any questions.

&choice86d= deny access to the chart unless written permission by his wife is
granted.
&qNum87= 87
&category87= CC

&domain87= D1
&reasoning87= R3

&answer87= 3
&q87= A patient with a recent history of rib fractures suddenly becomes short of
breath during secretion removal techniques. The patient looks panicked and
complains of sharp pain in the left chest. A quick screen shows a deviated
trachea to the right among other signs and symptoms. The MOST LIKELY explanation
for the above is:

&choice87a= angina.
&choice87b= pulmonary emboli.

&choice87c= pneumothorax.
&choice87d= mucous plugging of an airway.
&qNum88= 88

&category88= CA
&domain88= D2

&reasoning88= R1
&answer88= 2

&q88= A patient presents with supraspinatus tendinitis. After the initial

cryotherapy, the therapist decides to apply ultrasound. To effectively treat the
supraspinatus tendon, the therapist would place the shoulder joint in:
&choice88a= adduction.

&choice88b= slight abduction and internal rotation.

&choice88c= adduction and internal rotation.

&choice88d= adduction and external rotation.

&qNum89= 89
&category89= CD

&domain89= D3
&reasoning89= R4

&answer89= 4
&q89= A patient is 5 weeks post stroke and is demonstrating good recovery of her
right upper extremity, characterized as stage 4 recovery. The BEST choice for a
training activity is to have the patient:

&choice89a= reach overhead with right arm straight.

&choice89b= bear weight on the extended right arm in sitting.

&choice89c= put on socks and shoes while in sitting.

&choice89d= reach forward to bear weight with the right arm extended against the
wall.
&qNum90= 90

&category90= CC
&domain90= D3

&reasoning90= R3
&answer90= 4

&q90= A patient is 2 days post left CVA and has just been moved from the
intensive care unit to a stroke unit. When beginning the examination, the
therapist finds the patient's speech slow and hesitant. He is limited to one and
two-word productions and his expressions are awkward and arduous. However, he
demonstrates good comprehension. His difficulties are consistent with:
&choice90a= global aphasia.

&choice90b= dysarthria.
&choice90c= Wernicke's aphasia.

&choice90d= Broca's aphasia.

&qNum91= 91
&category91= CB

&domain91= D3
&reasoning91= R5

&answer91= 3
&q91= A patient recovering from traumatic brain injury is functioning at Stage
IV on the Rancho Los Amigos Levels of Cognitive Functioning Scale. During the
therapist's initial examination the patient becomes agitated and tries to bite
the therapist. The BEST course of action is to:

&choice91a= postpone the examination until later in the day when the patient
calms down.
&choice91b= postpone the examination for one week and then try again.

&choice91c= engage in a calming activity and document the behaviors.

&choice91d= restructure the formal examination so the therapist can complete it
in three very short sessions.
&qNum92= 92

&category92= CC
&domain92= D1

&reasoning92= R3
&answer92= 1

&q92= A therapist is working on a cardiac care unit in an acute care facility.

After exercising a patient recovering from a ventricular infarct, the therapist
notices fatigue and dyspnea after mild activity. Later that day, on a return
visit, the therapist notices the patient has a persistent spasmodic cough while
lying in bed. HR is rapid (140) and slight edema is evident in both ankles. The
patient appears anxious and agitated. The therapist suspects:
&choice92a= left ventricular failure.

&choice92b= right ventricular failure.

&choice92c= impending myocardial infarction.

&choice92d= developing pericarditis.

&qNum93= 93
&category93= CA

&domain93= D1
&reasoning93= R4

&answer93= 3
&q93= A marathon runner is examined in physical therapy for anterior pain in the
right lower leg. Her resting heart rate is found to be 46 bpm. The MOST LIKELY
explanation for this is that:

&choice93a= a low heart rate is suggestive of a hypotensive disorder.

&choice93b= a compensatory response to prolonged endurance activity is depressed
heart rate with decreased stroke volume.

&choice93c= prolonged endurance training has resulted in a low heart rate.

&choice93d= incipient coronary pathology is often characterized by an abnormally
low heart rate.
&qNum94= 94

&category94= CA
&domain94= D5

&reasoning94= R4
&answer94= 2

&q94= A patient has been taking corticosteroids (hydrocortisone) for management

of adrenocortical insufficiency. She is referred to physical therapy for
mobility training following a prolonged hospitalization. Potential adverse
effects that one can expect from prolonged use of this medication include:
&choice94a= confusion and depression.

&choice94b= atrophy and osteoporosis.

&choice94c= decreased appetite and weight loss.

&choice94d= hypotension and myopathy.

&qNum95= 95
&category95= CA

&domain95= D4
&reasoning95= R4

&answer95= 4
&q95= A therapist is treating a patient with deep partial-thickness burns over
35%25 of the body (chest and arms). Wound cultures reveal a bacterial count in
excess of 105 per gram of tissue on the anterior left arm. The therapist can
reasonably expect:

&choice95a= the risk of hypertrophic and keloid scars is low as there is no

viable tissue.
&choice95b= the burn area is pain free as all nerve endings in the dermal tissue
were destroyed.

&choice95c= with antibiotics, spontaneous healing can be expected.

&choice95d= the infected wound can convert the area to a full-thickness burn.
&qNum96= 96

&category96= CE
&domain96= D6

&reasoning96= R1
&answer96= 4

&q96= Recently, a 10 year-old patient has begun walking with supination of her
foot. With her shoe off, the therapist finds a new callus on the lateral side of
the metatarsal head of the 5th toe. The BEST choice for orthotic prescription
is:
&choice96a= viscoelastic shoe insert with forefoot medial wedge.

&choice96b= scaphoid pad.

&choice96c= Thomas heel.

&choice96d= viscoelastic shoe insert with forefoot lateral wedge.

&qNum97= 97
&category97= CD

&domain97= D2
&reasoning97= R2

&answer97= 3
&q97= A 74 year-old patient is recovering from a right total hip replacement
(posterolateral incision, cementless fixation). The MOST appropriate type of
bed-to-wheelchair transfer to teach is to have the patient use a:

&choice97a= stand-pivot transfer to the surgical side.

&choice97b= lateral slide transfer using a transfer board.

&choice97c= stand-pivot transfer to the sound side.

&choice97d= squat-pivot transfer to the surgical side.
&qNum98= 98

&category98= CE
&domain98= D6

&reasoning98= R1
&answer98= 1

&q98= A patient with paraplegia at the T10 level wants to participate in

wheelchair basketball. He asks the therapist what options he should look for in
a wheelchair. The therapist tells him it would be important to include:
&choice98a= a rigid frame.

&choice98b= hard-rubber tires.

&choice98c= a mid-scapular seat back.

&choice98d= a folding frame.

&qNum99= 99
&category99= CD

&domain99= D3
&reasoning99= R4

&answer99= 2
&q99= The therapist is treating a child with mild developmental delay secondary
to 7 weeks prematurity at birth. The child is now 8 months old and is just
learning to sit. The BEST choice for training activity is:

&choice99a= standing tilting reactions.

&choice99b= sideward protective extension in sitting.

&choice99c= prone tilting reactions.

&choice99d= supine tilting reactions.
&qNum100= 100

&category100= CC
&domain100= D1

&reasoning100= R1
&answer100= 1

&q100= A 80 year-old patient with emphysema and a history of hypertension

performs a 12 minute walking exercise tolerance test. He was able to walk 1,106
feet. His vital signs prior to exercise were: HR 104, BP 130/76, SaO2 93%25. At
peak exercise his vital signs were: HR 137, BP 162/74, SaO2 92%25. To calculate
his exercise intensity parameters, the BEST method to use is:
&choice100a= 40 to 85%25 HR reserve (Karvonen's formula).

&choice100b= 70 to 80%25 of HR max

&choice100c= 70 to 85%25 of age adjusted predicted HR max

&choice100d= 40 to 50%25 of Max METs.

&qNum101= 101
&category101= CD

&domain101= D5
&reasoning101= R4

&q101= The patient is complaining of heartburn and says previous PT

treatments have made it worse. Prior treatments have included supine and prone
exercises for trunk stabilization as well as sitting balance perturbation
exercises. The BEST response to address the patient's concerns would be to:
&choice101a= perform trunk stabilization exercises in a semi-Fowler's
position; no change in balance activities.

&choice101b= perform trunk stabilization exercises in a semi-Fowler's

position; reduce intensity of balance challenges.
&choice101c= perform trunk stabilization exercises in standing and
incorporate balance challenges.

&choice101d= assure the patient that the heartburn is not aggravated by

exercise and suggest taking antacids before physical therapy.
&answer101= 2
&qNum102= 102

&category102= CA
&domain102= D2

&reasoning102= R1
&q102= When performing scoliosis screening in a school setting, the optimal
age to screen for girls is:

&choice102a= 6-8.
&choice102b= 12-14.

&choice102c= 15-17.
&choice102d= 9-11.

&answer102= 4
&qNum103= 103
&category103= CA

&domain103= D3
&reasoning103= R4

&q103= A patient with a confirmed left C6 nerve root compression due to

foraminal encroachment complains of pain in his left thumb and index finger. The
MOST effective cervical position to alleviate this radicular pain in
weightbearing is:
&choice103a= lower cervical flexion.

&choice103b= left sidebending.

&choice103c= lower cervical extension.

&choice103d= right rotation.

&answer103= 1
&qNum104= 104

&category104= CA
&domain104= D2

&reasoning104= R3
&answer104= 2

&q104= A patient is standing with excessive subtalar pronation. Possible

correlated motions or postures are:
&choice104a= tibial and femoral external rotation, with pelvic external
rotation.

&choice104b= tibial, femoral, and pelvic internal rotation.

&choice104c= tibial, femoral, and pelvic external rotation.

&choice104d= tibial and femoral internal rotation with pelvic external

rotation.
&qNum105= 105
&category105= CF

&domain105= D6
&reasoning105= R5

&answer105= 3
&q105= When performing a chart audit, the therapist realizes a date of
service was documented inappropriately. The therapist should:

&choice105a= use "white out", initial; then add the correct date of
service.
&choice105b= write over the date with a different color ink, then make and
initial the correction.

&choice105c= put a single line through the incorrect date, initial, then
make and date the correction.
&choice105d= erase the incorrect date; then make and date the correction.
&qNum106= 106

&category106= CE
&domain106= D6

&reasoning106= R2
&answer106= 3

&q106= A therapist is applying high volt pulsed current to the vastus

medialis to improve patellar tracking during knee extension. The patient
complains that the current is uncomfortable. To make the current more tolerable
to the patient, yet maintain a good therapeutic effect, the therapist should
consider adjusting the:
&choice106a= pulse rate.

&choice106b= current intensity.

&choice106c= pulse duration.

&choice106d= current polarity.

&qNum107= 107
&category107= CC

&domain107= D3
&reasoning107= R3

&answer107= 4
&q107= A patient has a 10-year history of multiple sclerosis and presents
with drooping of the right upper eyelid, constriction of the pupil, and
vasodilation with absence of sweating on the face and neck. These signs are
characteristic of:

&choice107a= Argyll Robertson pupil.

&choice107b= homonymous hemianopsia.

&choice107c= nystagmus.
&choice107d= Horner's syndrome.
&qNum108= 108

&category108= CC
&domain108= D3

&reasoning108= R3
&answer108= 4

&q108= A patient presents with symptoms of uncoordinated eye movements and

profound gait and trunk ataxia. He has difficulty with postural orientation to
vertical and tends to tip over even if his eyes are open. Examination of the
extremities reveals little change in tone or coordination. The therapist
suspects involvement of the:
&choice108a= spinocerebellum.

&choice108b= basal ganglia.

&choice108c= premotor cortex.

&choice108d= vestibulocerebellum.
&qNum109= 109
&category109= CC

&domain109= D4
&reasoning109= R3

&answer109= 3
&q109= A patient with a 10-year history of diabetes complains of cramping,
pain, and fatigue of the right buttock after walking 400 feet or climbing
stairs. When he stops exercising, the pain goes away immediately. The skin of
the involved leg is cool and pale. The therapist checks his medical record and
finds no mention of this problem. The therapist suspects:

&choice109a= spinal root impingement.

&choice109b= peripheral nerve injury.

&choice109c= peripheral arterial disease.

&choice109d= Raynaud's phenomenon.
&qNum110= 110

&category110= CC
&domain110= D1

&reasoning110= R5
&answer110= 2

&q110= A patient with low back pain has marked elevation of blood pressure.
He complains of mild to severe midabdominal pain that increases upon exertion.
Palpation reveals a pulsing mass in the lower abdomen. The therapist should:
&choice110a= instruct in relaxation exercises as a pulsating mass is not
unusual with hypertension.

&choice110b= discontinue treatment and notify his physician immediately.

&choice110c= instruct the patient to contact his physician at the
conclusion of therapy.

&choice110d= provide hot packs to the abdomen to help relieve the muscle
spasm.
&qNum111= 111
&category111= CD

&domain111= D4
&reasoning111= R1

&answer111= 4
&q111= A patient with a 12-year history of diabetes and a small, purulent
tunneling wound located on the left heel is referred for wound lavage. The
therapist's BEST choice is to irrigate the wound using:

&choice111a= whirlpool with water temperature at 20°C.

&choice111b= hydrogen peroxide spray.

&choice111c= a syringe with Dakin's solution while the patient is in the

whirlpool.
&choice111d= whirlpool with povidone-iodine.
&qNum112= 112

&category112= CC
&domain112= D5

&reasoning112= R3
&answer112= 3

&q112= An 85 year-old wheelchair dependent resident of a community nursing

home has a diagnosis of organic brain syndrome, Alzheimer's type, Stage 2.
During the therapist's initial interview, the patient demonstrates limited
interaction, mild agitation, and keeps trying to wheel her chair down the hall.
As it is late in the day, the therapist decides to resume the examination the
next morning. The patient is most likely exhibiting:
&choice112a= frustration because of an inability to communicate.

&choice112b= disorientation to time and date.

&choice112c= sundowning behavior.

&choice112d= inattention as a result of short term memory loss.

&qNum113= 113
&category113= CD

&domain113= D2
&reasoning113= R4

&answer113= 1
&q113= To increase the stride length of a patient with a right transfemoral
amputation who uses a total contact prosthesis, the therapist should:

&choice113a= provide posterior directed resistance to the right ASIS during

stance.
&choice113b= facilitate the gluteals with tapping over the muscle belly.

&choice113c= provide posterior directed resistance to the left ASIS during

swing.
&choice113d= provide anterior directed resistance to the right PSIS during
swing.
&qNum114= 114

&category114= CD
&domain114= D3

&reasoning114= R1
&answer114= 2

&q114= A patient with a complete C7 spinal cord injury is having difficulty

with pushups while in his wheelchair. The MOST appropriate lead-up activity to
enhance wheelchair pushups is:
&choice114a= shoulder shrugs.

&choice114b= prone-on-elbow pushups.

&choice114c= supine bench press using 50%25 one repetition max.

&choice114d= supine-on-elbows pushups.

&qNum115= 115
&category115= CF

&domain115= D6
&reasoning115= R2

&answer115= 1
&q115= A therapist is concerned that a student PT, who is on a final
clinical rotation, is having difficulty interacting with the patients.
Specifically, the student does not seem to be willing to listen or demonstrate
tolerance and sensitivity to patient needs. The MOST appropriate conclusion the
therapist can reach is that affective objectives for the clinical education
experience are not being met. The primary deficit is:

&choice115a= Level 1.0 Receiving.

&choice115b= Level 3.0 Valuing.

&choice115c= Level 4.0 Organization.

&choice115d= Level 5.0 Adherence to a professional code of ethics.
&qNum116= 116

&category116= CF
&domain116= D6

&reasoning116= R2
&answer116= 1

&q116= A therapist wants to investigate the effectiveness of use of the

therapeutic pool for decreasing pain in a group of patients with fibromyalgia.
Two groups of patients were recruited. One group was assigned to exercises and
walking in the pool 3 times/week for 6 months. The other group was assigned to a
gym walking program for the same amount of time. At the end of the study,
outcomes were assessed using the McGill Pain Questionnaire and the Health Status
Questionnaire. In order to improve reliability, the lead investigator should:
&choice116a= have the same therapist reassess the patients after 6 months.

&choice116b= have another therapist reassess after 6 months and compare to

normalized scores.
&choice116c= utilize a core of 4 experienced therapists to randomly
complete all the assessments.

&choice116d= perform all the final assessments and compare to the initial
assessments performed by a core group of therapists.
&qNum117= 117
&category117= CB

&domain117= D1
&reasoning117= R1

&answer117= 4
&q117= An apparently healthy individual has many risk factors for coronary
artery disease. He is interested in improving his overall fitness and cardiac
health. Following an exercise tolerance test, which was asymptomatic, he is
referred for an exercise class. The most accurate measure of exercise intensity
to monitor during his first exercise session is:

&choice117a= rating of perceived exertion (RPE).

&choice117b= MET level.

&choice117c= respiratory rate.

&choice117d= heart rate.
&qNum118= 118

&category118= CA
&domain118= D3

&reasoning118= R5
&answer118= 2

&q118= A mother brings her 8 week-old infant to be examined at Early

Intervention because she noticed that the infant was taking steps in supported
standing at two weeks but was not able to do it now. The therapist should:
&choice118a= recommend that a full developmental exam be performed by the
Early Intervention team.

&choice118b= explain that this is normal and that the stepping was a
newborn reflex that has gone away.
&choice118c= recommend that the mother bring the infant to a pediatric
neurologist.

&choice118d= explain this was due to a stepping reflex that will re-emerge
again around 10 months.
&qNum119= 119
&category119= CA

&domain119= D2
&reasoning119= R3

&answer119= 3
&q119= A patient complains of pain with mouth opening that makes it
difficult for her to eat foods that require chewing. Examination revealed active
mouth opening to be within normal limits of:

&choice119a= 15-24mm.
&choice119b= 50-64mm.

&choice119c= 35-44mm.
&choice119d= 65-74mm
&qNum120= 120

&category120= CE
&domain120= D6

&reasoning120= R4
&answer120= 4

&q120= Correction of flexible forefoot varus with excessive subtalar

pronation is BEST accomplished by a customized orthosis with:
&choice120a= medial forefoot and rearfoot valgus posting.

&choice120b= lateral forefoot and rearfoot varus posting.

&choice120c= rearfoot varus posting only.

&choice120d= medial forefoot and rearfoot varus posting.

&qNum121= 121
&category121= CC

&domain121= D2
&reasoning121= R3

&answer121= 2
&q121= A patient presents with complaints of tingling and paresthesias in
the median nerve distribution of the right forearm and hand. The following tests
were found negative bilaterally: Adson, hyperabduction, costoclavicular,
Phalen's, and the ulnar nerve Tinel sign. Based on this information, the
diagnosis that has NOT been ruled out is:

&choice121a= thoracic outlet syndrome.

&choice121b= pronator teres syndrome.

&choice121c= carpal tunnel syndrome.

&choice121d= ulnar nerve entrapment.
&qNum122= 122

&category122= CF
&domain122= D6

&reasoning122= R5
&answer122= 1

&q122= A patient scheduled for a 30-minute treatment session arrives 10

minutes late. The subsequent patients are also scheduled for 30 minutes sessions
and there is no break in the therapist's schedule to accommodate for the
patient's tardiness. The therapist should:
&choice122a= treat the patient, and bill for the 20 minute session given.

&choice122b= send the patient home until the next scheduled appointment,
with a request to be punctual.
&choice122c= ask the patient if there is a more convenient time for the
appointment in order to complete a 30-minute session.

&choice122d= treat the patient and bill for 30 minutes of scheduled

treatment time.
&qNum123= 123
&category123= CE

&domain123= D6
&reasoning123= R2

&answer123= 4
&q123= A patient has been referred to the therapist s/p fracture of the
femur six months ago. The cast was removed, but the patient is unable to
volitionally contract the quadriceps. The therapist decides to apply electrical
stimulation to stimulate the strengthening of the quadriceps muscle. The BEST
choice of electrode size and placement is:

&choice123a= large electrodes, closely spaced.

&choice123b= small electrodes, closely spaced.

&choice123c= small electrodes, widely spaced.

&choice123d= large electrodes, widely spaced.
&qNum124= 124

&category124= CD
&domain124= D3

&reasoning124= R4
&answer124= 2

&q124= A 65 year-old patient is recovering from a right CVA. Due to a

series of medical complications she is still bedridden 6 days post-stroke. The
therapist wants to reduce the expected negative effects of developing
spasticity. The BEST choice of bed position for this patient is:
&choice124a= sidelying on the sound side, affected arm and leg extended at
the side, with a pillow between the knees.

&choice124b= supine, trunk in midline with small pillow under the scapula,
arm extended on supporting pillow, and a small towel roll under the knee.
&choice124c= supine, trunk in slight lateral flexion to the sound side with
elbow flexed and supported on a pillow, leg straight.

&choice124d= sidelying on the affected side, with the affected shoulder

positioned directly underneath, the hip slightly extended with knee flexed on a
pillow.
&qNum125= 125
&category125= CB

&domain125= D3
&reasoning125= R4

&answer125= 1
&q125= If the subject's vision is blocked either by having the subject
close the eyes or by placing a barrier between the part being tested and the
subject's eyes, the therapist can effectively examine:

&choice125a= somatosensory integrity.

&choice125b= vestibular/visual/somatosensory integration.

&choice125c= discriminative touch and fast pain but not proprioception.

&choice125d= conscious proprioception but not discriminative touch.
&qNum126= 126

&category126= CC
&domain126= D1

&reasoning126= R3
&answer126= 3

&q126= A therapist is examining a patient in the coronary intensive care

unit. On auscultation the therapist hears an adventitious S3 heart sound. This
finding is indicative of:
&choice126a= aortic valve dysfunction.

&choice126b= pulmonary valve dysfunction.

&choice126c= congestive heart failure.

&choice126d= pericarditis.
&qNum127= 127
&category127= CA

&domain127= D1
&reasoning127= R1

&answer127= 3
&q127= A therapist is asked to advise a healthy 67 year-old individual who
wants to take part in a graduated conditioning program by joining the "Mall
Walkers Club". The therapist's BEST approach to prescribing the intensity of
exercise for this individual is:

&choice127a= dyspnea scale.

&choice127b= 70-85%25 of maximal age-related HR.

&choice127c= HR reserve formula and Ratings of Perceived Exertion.

&choice127d= 4-8 MET level walking.
&qNum128= 128

&category128= CC
&domain128= D3

&reasoning128= R4
&answer128= 4

&q128= A 72 year-old patient recovering from stroke has been using a

bilateral exerciser (UBE) to strengthen muscles in his affected right upper
extremity. He is now experiencing burning pain in his shoulder that worsens when
his limb is touched or moved. He also presents with paresthesias and pitting
edema in the dorsum of the hand. ROM of the wrist and fingers is painful and
diminished. The therapist's BEST course of action is to:
&choice128a= discontinue exercise and use ice for pain relief.

&choice128b= switch to interval exercise and lower the resistance on the

UBE.
&choice128c= discontinue UBE exercise, splint the hand and wrist until pain
and swelling disappear.

&choice128d= discontinue UBE exercise; use massage and active assistive

ROM.
&qNum129= 129
&category129= CC

&domain129= D5
&reasoning129= R4

&answer129= 3
&q129= The physical therapist has just completed a chart review of a new
patient referred for general mobilization following a colon resection with
colostomy placement the prior day. At bedside the therapist observes an
intravenous line with clear fluid and a second intravenous line with blood
products, a urinary catheter, and oxygen cannula. All vital signs are stable.
Upon questioning, the patient is alert and oriented, reporting pain at 8/10. The
BEST plan to continue the examination is to:

&choice129a= assess range of motion of extremities.

&choice129b= assess trunk strength for bed mobility.

&choice129c= delay physical assessment.

&choice129d= assess pulmonary status for cough and deep breathing.
&qNum130= 130

&category130= CD
&domain130= D2

&reasoning130= R1
&answer130= 1

&q130= A patient presents with 2/5 muscle strength in both lower

extremities and 3/5 strength in the upper extremities. The MOST appropriate
transfer to teach this patient to move from bed to wheelchair is:
&choice130a= sliding board.

&choice130b= stand pivot.

&choice130c= dependent 1-person squat transfer.

&choice130d= stand-by assist.

&qNum131= 131
&category131= CD

&domain131= D3
&reasoning131= R5

&answer131= 3
&q131= A patient with a spinal cord injury at the level of T1 is in the
community phase of his mobility training. In order for him to navigate a
standard height curb with his wheelchair, the therapist tells him to:

&choice131a= descend backward with the trunk upright and arms hooked around
the push handles.
&choice131b= ascend backwards with the large wheels first.

&choice131c= lift the front casters and ascend in a wheelie position.

&choice131d= place the front casters down first during descent.
&qNum132= 132

&category132= CA
&domain132= D1

&reasoning132= R4
&answer132= 1

&q132= A patient with a long history of systemic steroid use for asthma
control has a contraindication for percussion if there is evidence of:
&choice132a= decreased bone density.

&choice132b= intercostals muscle wasting.

&choice132c= BP > 140/90.

&choice132d= barrel chest.

&qNum133= 133
&category133= CC

&domain133= D5
&reasoning133= R3

&answer133= 4
&q133= A patient presents with a rapid onset of severe weakness of all
small muscles of the hands, sharp pleuritic pain in the shoulder and subscapular
area, and a hoarse voice for the past three weeks. She is a hair stylist, has a
smoking history of 22 years, is not on any medications, and has not been ill.
Her referral states examine and treat. Based on the above information this
patient is MOST LIKELY exhibiting symptoms of:

&choice133a= a C5-6 bilateral foraminal stenosis.

&choice133b= thoracic outlet syndrome.

&choice133c= ascending Guillain-Barré syndrome.

&choice133d= a Pancoast tumor.
&qNum134= 134

&category134= CC
&domain134= D2

&reasoning134= R3
&answer134= 3

&q134= An examination of a patient reveals the following shoulder signs and

symptoms: excessive AROM and PROM; pain with activity, and on palpation; normal
resisted isometric contractions; a positive load/shift test; and negative X-ray
findings. The MOST LIKELY diagnosis is:
&choice134a= rotator cuff lesion.

&choice134b= impingement.
&choice134c= atraumatic shoulder instability.

&choice134d= traumatic anterior shoulder dislocation.

&qNum135= 135
&category135= CE

&domain135= D6
&reasoning135= R1

&answer135= 2
&q135= The therapist is applying cervical traction using a cervical
harness. The patient complains of pain in the temporomandibular joint during the
treatment. The therapist should consider:

&choice135a= reducing the traction poundage and continuing with the

treatment.
&choice135b= readjusting the harness and continuing with the treatment.

&choice135c= decreasing the treatment time.

&choice135d= discontinuing traction.
&qNum136= 136

&category136= CD
&domain136= D2

&reasoning136= R4
&answer136= 2

&q136= A therapist is treating a patient with a diagnosis of right shoulder

rotator cuff tendonitis. The findings of a worksite ergonomic assessment
indicate that the worker is required to perform repetitive reaching activities
above shoulder height. The most appropriate worksite modification would be to:
&choice136a= allow the worker to take more frequent rests to avoid overuse.

&choice136b= reposition the height of the shelf and items to below shoulder
height
&choice136c= provide the worker with a taller, sit-stand chair.

&choice136d= provide the worker with a standing desk for daily activities.
&qNum137= 137
&category137= CD

&domain137= D2
&reasoning137= R4

&answer137= 2
&q137= A patient has been diagnosed with impingement syndrome of the
shoulder. Following a course of modalities to control pain and inflammation,
progression is to an exercise program to restore normal function of the
shoulder. The BEST PNF diagonal pattern to improve function of the shoulder is:

&choice137a= D1 flexion.
&choice137b= D2 flexion.

&choice137c= D1 extension.
&choice137d= D2 extension.
&qNum138= 138

&category138= CE
&domain138= D6

&reasoning138= R4
&answer138= 1

&q138= A patient presents with pain of the right Achilles tendon as well as
on the plantar aspect of the right heel. Pain developed insidiously and has now
lasted several months. On gait analysis the therapist observes abnormal
supination throughout the stance phase of gait. The BEST choice for orthotic
intervention is a:
&choice138a= cushion heel with a rearfoot valgus post.

&choice138b= UCBL insert.

&choice138c= flexible shoe insert with forefoot varus post.

&choice138d= metatarsal pad.

&qNum139= 139
&category139= CB

&domain139= D1
&reasoning139= R4

&answer139= 4
&q139= A patient has a 10 year history of peripheral vascular disease
affecting the right lower extremity. During auscultation of the popliteal artery
the therapist would NOT expect to find:

&choice139a= a bruit.
&choice139b= absence of detectable blood flow.

&choice139c= 1%2b pulses.

&choice139d= 2%2b pulses.
&qNum140= 140

&category140= CA
&domain140= D5

&reasoning140= R2
&answer140= 3

&q140= A therapist is working in a major medical center and is new to the

acute care setting. An orientation session for new employees concerns infection
control. The therapist learns that the most common infection transmitted to
healthcare workers is:
&choice140a= hepatitis A.

&choice140b= HIV.
&choice140c= hepatitis B.

&choice140d= tuberculosis.
&qNum141= 141
&category141= CC

&domain141= D2
&reasoning141= R3

&answer141= 1
&q141= A patient presents with pain, joint swelling, subcutaneous olecranon
nodules, and increased erythrocyte sedimentation rate. These findings are
characteristic of:

&choice141a= rheumatoid arthritis.

&choice141b= fibromyalgia.

&choice141c= systemic lupus erythematosus.

&choice141d= osteoarthritis.
&qNum142= 142

&category142= CE
&domain142= D6

&reasoning142= R1
&answer142= 2

&q142= A patient with a transfemoral amputation and an above-knee

prosthesis demonstrates knee instability while standing. His knee buckles easily
when he shifts his weight. The therapist suspects the cause of his problem is a:
&choice142a= prosthetic knee set too far posterior to the TKA line.

&choice142b= prosthetic knee set too far anterior to the TKA line.
&choice142c= weak gluteus medius.

&choice142d= tight extension aid.

&qNum143= 143
&category143= CE

&domain143= D6
&reasoning143= R1

&answer143= 3
&q143= A 17 year-old individual with developmental disabilities is referred
to a wheelchair clinic for a new wheelchair. She presents with a severe
kyphoscoliosis. The therapist determines the BEST wheelchair modification to
order is a:

&choice143a= sling seat with dense foam cushion.

&choice143b= firm seat back with lateral posture supports and increased
seat depth.

&choice143c= contoured foam seat.

&choice143d= firm seat with lateral knee positioners.
&qNum144= 144

&category144= CD
&domain144= D2

&reasoning144= R2
&answer144= 2

&q144= A patient is referred for orthotic gait training after receiving a

reciprocating gait orthosis. In order for this patient to walk correctly, it is
important to instruct her in the correct sequence. She should shift her weight
onto her:
&choice144a= crutches and swing both legs through together to a position in
front of her crutches.

&choice144b= walker and one leg, tuck her pelvis by extending the upper
trunk, and swing her other leg through.
&choice144c= crutches and swing one leg, then the other forward.

&choice144d= walker, extend the upper trunk, and swing both legs forward
together to approach the walker.
&qNum145= 145
&category145= CF

&domain145= D6
&reasoning145= R5

&answer145= 4
&q145= A patient who is undergoing spinal cord rehabilitation is viewed as
uncooperative by staff. He refuses to complete the training activities outlined
for him to promote independent functional mobility. A review of his history
reveals that previously he was the director of his own company, with a staff of
20. The MOST appropriate strategy the therapist can adopt is to:

&choice145a= carefully structure the activities and slow down the pace of
training.
&choice145b= have him work with a supervisor since he works best with
people in authority.

&choice145c= refer him to another therapist who is male in the hopes that
he will have better luck in engaging the patient.
&choice145d= involve him in goal setting and have him participate in
structuring the training session.
&qNum146= 146

&category146= CF
&domain146= D6

&reasoning146= R4
&answer146= 1

&q146= A group of 10 patients is recruited into a study investigating the

effects of relaxation training on blood pressure. One group of patients is
scheduled to participate in a cardiac rehabilitation program which includes
relaxation training 3 times a week for 12 weeks. The other group of patients is
instructed to perform activities as usual. At the conclusion of the study there
was no significant difference between the groups; BP decreased significantly in
both groups. The investigator can reasonably conclude:
&choice146a= the activities of the non-rehab group were not properly
monitored and may account for these results.

&choice146b= cardiac rehabilitation is not effective in reducing blood

pressure.
&choice146c= both groups had blood pressures initially so high that
reductions should have been expected.

&choice146d= the rehab group was not properly monitored.

&qNum147= 147
&category147= CE

&domain147= D6
&reasoning147= R4

&answer147= 3
&q147= A patient is using a right KAFO. During orthotic checkout, the
therapist discovers the height of the medial upright is excessive. As she
transfers weight to the orthotic leg during gait, the therapist expects that
this patient will demonstrate:

&choice147a= posterior trunk bending.

&choice147b= lateral lean toward the left.

&choice147c= lateral lean toward the right.

&choice147d= anterior trunk bending.
&qNum148= 148

&category148= CE
&domain148= D6

&reasoning148= R5
&answer148= 3

&q148= During gait, a patient with hemiparesis drags his toes during swing.
Upon further examination, he has weak dorsiflexors (able to lift the foot
against gravity through 1/2 range) and a grade of 2 upon examining tone in his
plantar flexors using the Modified Ashworth Scale. An appropriate orthotic
modification to correct this problem is:
&choice148a= a dorsiflexion assist.

&choice148b= spiral AFO.

&choice148c= a solid ankle AFO.

&choice148d= a dorsiflexion stop.

&qNum149= 149
&category149= CC

&domain149= D3
&reasoning149= R3

&answer149= 2
&q149= A therapist is examining a 24 month-old child and observes that the
child can sit independently, creep in quadruped, pull-to-stand, cruise sideways,
but not walk without support. The therapist concludes that this child is
exhibiting:

&choice149a= normal cephalocaudal motor development.

&choice149b= delay in achieving developmental milestones.

&choice149c= normal gross motor development.

&choice149d= slow maturation that is within normal limits.
&qNum150= 150

&category150= CD
&domain150= D2

&reasoning150= R3
&answer150= 1

&q150= Therapist hand/finger placements for posterior to anterior (PA)

mobilization techniques to improve down-gliding/closure of the T7-8 facet joints
should be located at the:
&choice150a= transverse processes of T8.

&choice150b= spinous process of T8.

&choice150c= transverse processes of T7.

&choice150d= spinous process of T6.

&qNum151= 151
&category151= CC

&domain151= D2
&reasoning151= R3

&answer151= 1
&q151= A patient complains of waking up several times at night from severe
"pins and needles" in both hands. On awakening, her hands feel numb for half an
hour, and she complains of clumsiness with fine hand movements. The therapist's
examination revealed paresthesias in the medial forearm and hypothenar region;
reduced grip and pinch strength; and normal tendon reflexes. Based on the above
examination findings the MOST appropriate diagnosis is:

&choice151a= thoracic outlet syndrome.

&choice151b= ulnar nerve entrapment.

&choice151c= carpal tunnel syndrome.

&choice151d= pronator teres syndrome.
&qNum152= 152

&category152= CB
&domain152= D2

&reasoning152= R4
&answer152= 2

&q152= An auto mechanic is referred for physical therapy with a diagnosis

of degenerative joint disease affecting C2 and C3. The patient complains of pain
and stiffness in the cervical region and transient dizziness with some cervical
motions. The MOST appropriate INITIAL examination procedure is:
&choice152a= Lhermitte's test.

&choice152b= a vertebral artery test.

&choice152c= Oppenheim test.

&choice152d= Adson's maneuver.

&qNum153= 153
&category153= CC

&domain153= D3
&reasoning153= R3

&answer153= 1
&q153= A 22 year-old otherwise healthy patient is recovering from a
complete spinal cord injury at the level of L2. Functional expectations for this
patient include:

&choice153a= ambulation using bilateral AFOs and canes.

&choice153b= ambulation using bilateral KAFOs and a reciprocating walker.

&choice153c= ambulation using bilateral KAFOs, crutches and a swing-through

gait.
&choice153d= wheelchair locomotion using an active duty light weight chair.
&qNum154= 154

&category154= CB
&domain154= D3

&reasoning154= R2
&answer154= 3

&q154= To examine a patient with a suspected deficit in graphesthesia, the

therapist would ask the patient, with eyes shut, to identify:
&choice154a= different weighted, identically shaped cylinders placed in the
hand.

&choice154b= the vibrations of a tuning fork when placed on a bony

prominence.
&choice154c= a series of letters traced on the hand.

&choice154d= different objects placed in the hand and manipulated.

&qNum155= 155
&category155= CD

&domain155= D3
&reasoning155= R1

&answer155= 2
&q155= A patient recovering from stroke is ambulatory without an assistive
device. He demonstrates a consistent problem with an elevated and retracted
pelvis on the affected side. The BEST therapeutic exercise strategy is to
manually apply:

&choice155a= anterior directed pressure during swing.

&choice155b= light resistance to forward pelvic rotation during swing.

&choice155c= downward compression during stance.

&choice155d= light resistance to posterior pelvic elevation during swing.
&qNum156= 156

&category156= CA
&domain156= D3

&reasoning156= R3
&answer156= 2

&q156= A therapist suspects lower brainstem involvement in a patient with

amyotrophic lateral sclerosis. Examination findings reveal motor impairments of
the tongue with ipsilateral wasting and deviation on protrusion. These findings
confirm involvement of cranial nerve:
&choice156a= IX.

&choice156b= XII.
&choice156c= XI.

&choice156d= X.
&qNum157= 157
&category157= CC

&domain157= D1
&reasoning157= R3

&answer157= 1
&q157= A patient is in the intensive care unit following myocardial
infarction. Upon examination of the ECG tracings in the medical record the
therapist observes the following changes: ST elevation and T wave inversion in
leads II, III, and AVF. The probable location of the infarct is the:

&choice157a= inferior wall.

&choice157b= lateral wall.

&choice157c= posterior wall.

&choice157d= anterior wall.
&qNum158= 158

&category158= CA
&domain158= D5

&reasoning158= R2
&answer158= 4

&q158= A patient is hospitalized in the ICU with extensive trauma following

a motor vehicle accident. A review of her medical record reveals the following
lab values: hematocrit 28%25, hemoglobin 10g/100ml, and serum WBC 12,000/mm3.
The MOST appropriate conclusion the therapist can reach is:
&choice158a= hematocrit and hemoglobin values are abnormal; WBC is normal.

&choice158b= only hematocrit values are abnormal.

&choice158c= only serum WBC is abnormal.

&choice158d= all values are abnormal.

&qNum159= 159
&category159= CC

&domain159= D4
&reasoning159= R3

&answer159= 2
&q159= A patient with a transfemoral amputation is unable to wear his total
contact prosthesis for the past 4 days. Examination of the residual limb reveals
erythema and edema extending over most of the lower anterior limb. He tells the
therapist his limb is very itchy and painful after he scratches it. The MOST
LIKELY cause of his symptoms is:

&choice159a= cellulitis.
&choice159b= dermatitis.

&choice159c= impetigo.
&choice159d= herpes zoster.
&qNum160= 160

&category160= CC
&domain160= D4

&reasoning160= R1
&answer160= 3

&q160= A patient is largely confined to bed and has a stage IV sacral

pressure ulcer of three months duration. The BEST choice of intervention is:
&choice160a= a two-inch, convoluted foam mattress.

&choice160b= gentle wound cleansing and wet-to-dry gauze dressings.

&choice160c= surgical repair.

&choice160d= nutritional supplements and pressure relief with a flotation

mattress.
&qNum161= 161
&category161= CB

&domain161= D2
&reasoning161= R4

&answer161= 2
&q161= Following a hip fracture that is now healed, a patient presents with
weak hip flexors (2/5). All other muscles are within functional limits. During
gait, the therapist expects that the patient may walk with:

&choice161a= forward trunk lean.

&choice161b= a circumducted gait.

&choice161c= excessive hip flexion.

&choice161d= backward trunk lean.
&qNum162= 162

&category162= CC
&domain162= D2

&reasoning162= R4
&answer162= 4

&q162= A 72 year-old patient with a left transfemoral amputation complains

that his left foot is cramping and when he sits it feels all twisted under him.
The therapist's BEST choice of intervention is:
&choice162a= hot packs and continuous ultrasound to the residual limb.

&choice162b= iontophoresis to the distal residual limb using hyaluronidase.

&choice162c= appropriate bed positioning with the residual limb in
extension.

&choice162d= icing and massage to the residual limb.

&qNum163= 163
&category163= CF

&domain163= D6
&reasoning163= R4

&answer163= 2
&q163= A researcher uses a group of volunteers (healthy, college students)
to study the effects of therapy ball exercises on ankle ROM and balance scores.
Twenty volunteers participated in the 20 minute ball exercise class 3 times a
week for 6 weeks. Measurements were taken at the beginning and end of the
sessions. Significant differences were found in both sets of scores and reported
at the local PT meeting. Based on this research design, the therapist concludes:

&choice163a= therapy ball exercises are an effective intervention to

improve ankle stability following chronic ankle sprain.
&choice163b= the validity of the study was threatened with the introduction
of sampling bias.

&choice163c= the reliability of the study was threatened with the

introduction of systematic error of measurement.
&choice163d= the Hawthorne effect may have influenced the outcomes of the
study.
&qNum164= 164

&category164= CD
&domain164= D1

&reasoning164= R4
&answer164= 4

&q164= A patient has a very large right-sided bacterial pneumonia. Her

oxygen level is dangerously low. The body position that would MOST LIKELY
improve her PaO2 is:
&choice164a= right sidelying with the head of the bed in the flat position.

&choice164b= prone-lying with the head of the bed in the Trendelenburg

position.
&choice164c= supine-lying with the head of the bed in the Trendelenburg
position.

&choice164d= left sidelying with the head of the bed in the flat position.
&qNum165= 165
&category165= CC

&domain165= D2
&reasoning165= R3

&answer165= 3
&q165= An examination of a 46 year-old woman reveals drooping of the
shoulder, rotatory winging of the scapula, an inability to shrug the shoulder,
and complaints of aching in the shoulder. Based on these findings, the cause of
these symptoms would MOST LIKELY be due to:

&choice165a= muscle imbalance.

&choice165b= a lesion of the long thoracic nerve.

&choice165c= a lesion of the spinal accessory nerve.

&choice165d= strain of the serratus anterior.
&qNum166= 166

&category166= CE
&domain166= D6

&reasoning166= R1
&answer166= 2

&q166= A patient with spastic hemiplegia is referred to the therapist for

ambulation training. The patient is having difficulty with standing-up from a
seated position due to cocontraction of the quadriceps and hamstrings during the
knee and hip extension phase. The therapist wishes to use biofeedback beginning
with simple knee extension exercise in the seated position. The plan is to
progress to sit-to-stand training. The initial biofeedback protocol should
consist of:
&choice166a= high detection sensitivity with recording electrodes placed
closely together.

&choice166b= low detection sensitivity with recording electrodes placed

closely together.
&choice166c= low detection sensitivity with recording electrodes placed far
apart.

&choice166d= high detection sensitivity with recording electrodes placed

far apart.
&qNum167= 167
&category167= CA

&domain167= D3
&reasoning167= R3

&answer167= 3
&q167= Examination of a patient recovering from stroke reveals a loss of
pain and temperature sensation on the left side of the face along with loss of
pain and temperature sensation on the right side of the body. All other
sensations are normal. The therapist suspect a lesion in the:

&choice167a= midbrain.
&choice167b= right cerebral cortex or internal capsule.

&choice167c= left posterolateral medulla or pons.

&choice167d= left cerebral cortex or internal capsule.
&qNum168= 168

&category168= CA
&domain168= D3

&reasoning168= R2
&answer168= 2

&q168= A patient is taking the drug Baclofen to control spasticity

following spinal cord injury. This medication can be expected to decrease muscle
tone and pain. Adverse reactions of concern to the physical therapist can
include:
&choice168a= hypertension and palpitations.

&choice168b= drowsiness and muscle weakness.

&choice168c= headache with visual auras.

&choice168d= urinary retention and discomfort.

&qNum169= 169
&category169= CA

&domain169= D3
&reasoning169= R3

&answer169= 1
&q169= Symptoms of dysdiadochokinesia, dysmetria, and action tremor can be
expected with a lesion located in the:

&choice169a= neocerebellum.
&choice169b= spinocerebellum.

&choice169c= vermis.
&choice169d= vestibulocerebellum.
&qNum170= 170

&category170= CA
&domain170= D1

&reasoning170= R4
&answer170= 3

&q170= A patient is exercising in a Phase 3 outpatient cardiac

rehabilitation program that utilizes circuit training. One of the stations
utilizes weights. The patient lifts a 5 lb weight, holds it for 20 seconds and
then lowers it slowly. The therapist corrects the activity and tells the patient
to reduce the length of the static hold. The static exercise can be expected to
produce:
&choice170a= abnormal oxygen uptake.

&choice170b= lower heart rate and arterial blood pressure.

&choice170c= higher heart rate and arterial blood pressure.

&choice170d= reduced normal venous return to the heart and elevated blood
pressure.
&qNum171= 171
&category171= CC

&domain171= D5
&reasoning171= R1

&answer171= 4
&q171= A ten year-old boy with hemophilia fell and injured himself while
skateboarding. He was admitted to a pediatric acute care facility and a
therapist sees him that afternoon. Examination reveals a hemarthrosis in his
left knee. The BEST initial intervention for this patient is:

&choice171a= instruct the patient in crutch use to protect the joint and
assist in early return to walking.
&choice171b= a pool program to maintain ROM and strength while he is
nonweightbearing.

&choice171c= a hot pack for the knee, splint and instruction in

nonweightbearing exercises.
&choice171d= ice, elevation and a splint for the limb.
&qNum172= 172

&category172= CC
&domain172= D5

&reasoning172= R5
&answer172= 2

&q172= A 72 year-old male patient recovering from a fractured hip repaired

with ORIF has recently been discharged home. During a home visit, his wife tells
the therapist he woke up yesterday morning and told her he couldn't remember
much. Upon examination, the therapist finds some mild motor loss in his right
hand and anomia. The therapist affirms the presence of short-term memory loss.
The BEST course of action is to:
&choice172a= refer him to his physician as the therapist suspects
Alzheimer's dementia.

&choice172b= refer him to his physician as the therapist suspects a small

stroke.
&choice172c= advise the family to document and record any new problems they
notice over the next week, then report back to the therapist.

&choice172d= ignore the findings as they are expected following surgical

anesthesia.
&qNum173= 173
&category173= CC

&domain173= D5
&reasoning173= R5

&answer173= 3
&q173= A 16 year-old with a 4-year history of Type I diabetes is insulin
dependent. He wants to participate in cross country running. The physical
therapist working with the school team advises the athlete to measure his plasma
glucose concentrations before, and after running. In addition, the student
should:

&choice173a= consume a carbohydrate after practice to avoid hyperglycemia.

&choice173b= increase insulin dosage immediately before running.

&choice173c= consume a carbohydrate before or during practice to avoid

hypoglycemia.
&choice173d= avoid carbohydrate-rich snacks within 12 hours of a race
&qNum174= 174

&category174= CE
&domain174= D6

&reasoning174= R1
&answer174= 2

&q174= A 61 year-old patient with a transtibial amputation has a short

residual limb. The BEST choice for prosthetic replacement is a:
&choice174a= supracondylar suspension.

&choice174b= supracondylar/suprapatellar suspension.

&choice174c= thigh corset.

&choice174d= Syme's suspension.

&qNum175= 175
&category175= CF

&domain175= D6
&reasoning175= R5

&answer175= 1
&q175= A physical therapist assistant is ambulating a patient using a
three-point crutch gait. The patient is unsteady and fearful of falling. The
patient does not appear to understand the correct gait sequence. The supervising
therapist's BEST strategy is to:

&choice175a= instruct the PTA to have the patient sit down and utilize
mental practice of the task.
&choice175b= tell the PTA and patient to stop the ambulation and work on
dynamic balance activities instead.

&choice175c= instruct the PTA to use a distributed practice schedule to

ensure patient success.
&choice175d= intervene and teach the correct sequence since the PTA is
apparently unable to deal with this special situation.
&qNum176= 176

&category176= CB
&domain176= D2

&reasoning176= R3
&answer176= 2

&q176= The therapist is reviewing x-rays from a patient with a Grade 2

spondylolisthesis. The BEST radiographic view to observe this bony anomaly is:
&choice176a= posteroanterior.

&choice176b= lateral.
&choice176c= anteroposterior.

&choice176d= oblique.
&qNum177= 177
&category177= CE

&domain177= D6
&reasoning177= R1

&answer177= 4
&q177= An athlete presents with pain and muscle spasm of the upper back
(C7-T8) extending to the lateral border of the scapula. This encompasses a 10 x
10 cm area on both sides of the spine. If the ultrasound unit only has a 5 cm2
soundhead, the therapist should treat:

&choice177a= the entire area in five minutes.

&choice177b= the entire area in ten minutes.

&choice177c= each side allotting two and a half minutes for each section.
&choice177d= each side allotting five minutes for each section.
&qNum178= 178

&category178= CE
&domain178= D6

&reasoning178= R4
&answer178= 4

&q178= A patient with chronic cervical pain is referred to an outpatient

physical therapy clinic. Past medical history reveals: appendectomy, 12 years
ago; chronic heart disease; demand-type pacemaker, 8 years ago; whiplash injury,
2 years ago. Presently the patient complains of pain and muscle spasm in the
cervical region. The modality that should NOT be considered in the case is:
&choice178a= mechanical traction.

&choice178b= ultrasound.
&choice178c= hot pack.

&choice178d= transcutaneous electrical stimulation.

&qNum179= 179
&category179= CB

&domain179= D3
&reasoning179= R4

&answer179= 2
&q179= In posturography, patients who sway more or fall under conditions
with the eyes closed and platform moving (condition 5) or with the visual
surround moving and platform moving (condition 6) are likely to demonstrate:

&choice179a= problems with sensory selection.

&choice179b= vestibular deficiency.

&choice179c= somatosensory dependency.

&choice179d= visual dependency.
&qNum180= 180

&category180= CA
&domain180= D3

&reasoning180= R3
&answer180= 1

&q180= A patient presents with severe, frequent seizures originating in the

medial temporal lobes. Following bilateral surgical removal of these areas, he
is unable to remember any new information just prior to the surgery to the
present. He cannot recall text he read minutes ago and cannot remember people he
has met repeatedly. These outcomes are indicative of:
&choice180a= loss of the hippocampus and declarative memory function.

&choice180b= loss of procedural memory and integration with frontal cortex.

&choice180c= a primary deficit from the loss of the amygdala.

&choice180d= loss of integration of the temporal lobe with the basal

ganglia and frontal cortex.
&qNum181= 181
&category181= CC

&domain181= D5
&reasoning181= R1

&answer181= 4
&q181= A 14 year-old with a body mass index of 30kg/m2 and a history
limited participation in physical activities is referred for exercise training.
The nutritionist has prescribed a diet limiting his caloric intake. The BEST
initial exercise prescription is:

&choice181a= 3 weekly sessions of 50 minutes at 70-85%25 VO2max

&choice181b= 3 weekly, sessions of 30 minutes at 60-70%25 VO2max

&choice181c= 2 weekly, sessions of 60 minutes at 50%25 VO2max

&choice181d= 2 daily sessions of 30 minutes at 40–70%25 VO2max
&qNum182= 182

&category182= CF
&domain182= D6

&reasoning182= R2
&answer182= 1

&q182= While on a home visit, a 9 month-old infant becomes unresponsive.

The therapist tells the mother to call for emergency medical services. The
therapist's IMMEDIATE next step is to tilt the infant's head back and give 2
full breaths, while covering both the mouth and nose. Chest compressions should
then be given. The correct procedure for chest compressions for the infant is
to:
&choice182a= compress with one hand to a depth of 1/3 to 1/2 the depth of
the chest at a rate of 100/min.

&choice182b= compress lightly with 2 fingers to a depth of 1/2 to 1 inch at

a rate of 100/min.
&choice182c= compress lightly with 2 fingers to a depth of 2 inches at a
rate of 60/min.

&choice182d= compress with both hands to a depth of 1 inch at a rate of

60/min.
&qNum183= 183
&category183= CC

&domain183= D5
&reasoning183= R3

&answer183= 4
&q183= A patient in an exercise class develops muscle weakness and fatigue.
Examination reveals leg cramps and hyporeflexia. He also experiences frequent
episodes of postural hypotension and dizziness. Abnormalities on his ECG include
a flat T wave, prolonged QT interval, and depressed ST segment. The therapist
suspects:

&choice183a= hyperkalemia
&choice183b= hypocalcemia

&choice183c= hyponatremia
&choice183d= hypokalemia
&qNum184= 184

&category184= CC
&domain184= D5

&reasoning184= R3
&answer184= 2

&q184= A 64 year-old patient with advanced coronary artery disease and

diabetes is receiving functional mobility training in a P.T. clinic. While
walking after lunch, the patient experiences difficulty breathing, starts
hyperventilating, and suffers an episode of syncope. The MOST LIKELY cause of
this problem is:
&choice184a= postprandial hypertension.

&choice184b= coronary artery disease.

&choice184c= hyperglycemia.

&choice184d= seizures.
&qNum185= 185
&category185= CE

&domain185= D6
&reasoning185= R1

&answer185= 2
&q185= The MOST appropriate position to guard a patient who is descending
stairs for the first time using crutches and non-weightbearing on the right is
to:

&choice185a= stand behind and slightly to the right side.

&choice185b= stand in front and slightly to the right side.

&choice185c= stand in front and slightly to the left side.

&choice185d= stand behind and slightly to the right side.
&qNum186= 186

&category186= CE
&domain186= D6

&reasoning186= R2
&answer186= 1

&q186= A patient with paraplegia at the T10 level is being discharged home.
The rehab team is assisting the patient's wife in modifying the home to be
barrier-free. A new first floor bedroom and bathroom wing are being built. The
builder asks the therapist about the entrance. The therapist recommends:
&choice186a= a ramp with a slope of 1:12 with a level landing at the top of
at least 60 by 60 inches.

&choice186b= door widths of at least 40 inches with a handrail 34 inches

high.
&choice186c= door width of 36 inches with an outside door that opens out.

&choice186d= a ramp with a grade of 12%25 and a level landing at top of at

least 50 by 50 inches.
&qNum187= 187
&category187= CD

&domain187= D3
&reasoning187= R4

&answer187= 4
&q187= A patient has a 10 year history of Parkinson's disease and has been
on levodopa for the past 6 years. He has fallen 3 times in the past month
resulting in a Colles' fracture. The therapist decides to try postural
biofeedback training using a platform balance training device. The training
sequence should focus on:

&choice187a= decreasing the limits of stability and improving increasing

anterior weight displacement.
&choice187b= increasing the limits of stability and improving increasing
anterior weight displacement.

&choice187c= decreasing the limits of stability and improving increasing

posterior weight displacement.
&choice187d= increasing the limits of stability and improving center of
pressure alignment.
&qNum188= 188

&category188= CC
&domain188= D1

&reasoning188= R3
&answer188= 1

&q188= A patient is recovering from myocardial infarction and is referred

for supervised exercise training. While working out on a treadmill, the patient
begins to develop mild shortness of breath. Upon inspection of the ECG readout
the therapist determines the presence of:
&choice188a= sinus rhythm with upsloping ST segment depression.

&choice188b= sinus rhythm with SA blocks.

&choice188c= sinus rhythm with downsloping ST segment depression.

&choice188d= tachycardia with abnormal P waves.

&qNum189= 189
&category189= CC

&domain189= D2
&reasoning189= R1

&answer189= 2
&q189= A 16 year-old boy with Duchenne's muscular dystrophy has been
confined to using a power wheelchair for the past three years and is beginning
to develop a 10 degree Cobb angle scoliosis. The BEST strategy to help slow this
spinal curvature at this time would be to:

&choice189a= emphasize spinal rotation exercises.

&choice189b= alternate the side of the wheelchair power control.

&choice189c= emphasize spinal extension exercises.

&choice189d= order a new wheelchair with a reclining seat back.
&qNum190= 190

&category190= CC
&domain190= D2

&reasoning190= R3
&answer190= 2

&q190= A patient presents with a complaint of severe neck and shoulder pain
of two days duration. The patient reports falling asleep on the couch watching
TV, and has been stiff and sore since. There is tenderness of the cervical
muscles on the right, with increased pain upon palpation. PROM is most limited
in flexion, then sidebending left, and then rotation left, and active extension.
Sidebending right and rotation right is also painful. Based on these examination
findings, the patient's diagnosis is:
&choice190a= cervical radiculopathy.

&choice190b= facet syndrome.

&choice190c= cervical strain.

&choice190d= herniated disc.

&qNum191= 191
&category191= CC

&domain191= D2
&reasoning191= R2

&answer191= 3
&q191= A postal worker (mail sorter) complains of numbness and tingling in
his right hand in the median nerve distribution. When the therapist evaluates
his work tasks, the therapist notes that he is required to key in the zip codes
of about 58 letters per minute. An appropriate administrative control to
decrease his exposure would be to:

&choice191a= provide the worker with a resting splint to support his wrist.
&choice191b= provide him with a height adjustable chair to position his
wrists and hands in a neutral alignment.

&choice191c= use job rotation during the workday.

&choice191d= require the worker to attend a cumulative trauma disorder
educational class.
&qNum192= 192

&category192= CE
&domain192= D6

&reasoning192= R1
&answer192= 2

&q192= A patient with a traumatic brain injury presents with hemiparesis of

the left upper extremity. The examination reveals slight cutaneous and
proprioceptive impairment, fair (3/5) strength of the shoulder muscles and
triceps and slight spasticity of the biceps. Voluntary control of the patient's
left arm has not progressed since admission. The therapist decides to use
functional electrical stimulation and place the active electrode on the triceps
to facilitate active extension of the elbow. The timing sequence BEST to apply
is:
&choice192a= 2-second ramp up, 5-second stimulation, 2-second ramp down.

&choice192b= 5-second ramp up, 5-second stimulation, 5-second ramp down.

&choice192c= 2-second ramp up, 10-second stimulation, no ramp down.

&choice192d= no ramp up, 10-second stimulation, 2-second ramp down.

&qNum193= 193
&category193= CD

&domain193= D3
&reasoning193= R4

&answer193= 1
&q193= Following a traumatic brain injury, a patient presents with
significant difficulties in learning new skills. He is wheelchair dependent and
will need to learn how to transfer (a skill he has never done before). The BEST
strategy to enhance his motor learning is to:

&choice193a= provide consistent feedback using a blocked practice schedule.

&choice193b= use only guided movement to ensure correct performance.

&choice193c= provide summed feedback after every few trials using a serial
practice schedule.
&choice193d= provide bandwidth feedback using a random practice schedule.
&qNum194= 194

&category194= CC
&domain194= D3

&reasoning194= R3
&answer194= 2

&q194= A patient recovering from a CVA presents with predominant

involvement of the contralateral lower extremity and lesser involvement of the
contralateral upper extremity. The patient also demonstrates mild apraxia. These
clinical manifestations are characteristic of:
&choice194a= middle cerebral artery syndrome.

&choice194b= anterior cerebral artery syndrome.

&choice194c= posterior cerebral artery syndrome.

&choice194d= basilar artery syndrome.

&qNum195= 195
&category195= CC

&domain195= D1
&reasoning195= R4

&answer195= 4
&q195= A patient presents with significant intermittent claudication with
onset after two minutes of walking. On further examination, the therapist would
expect to find:

&choice195a= grayish-white appearance of the extremity in both gravity

dependent and independent positions.
&choice195b= little or no changes in color with changes in extremity
position.

&choice195c= bright red appearance of the extremity in both gravity

dependent and independent positions.
&choice195d= elevation-induced pallor and dependent redness with the
extremity in the gravity dependent position.
&qNum196= 196

&category196= CC
&domain196= D5

&reasoning196= R5
&answer196= 2

&q196= Following her cesarean section, a patient tells the therapist that
she is anxious to return to her pre-pregnancy level of physical activity
(working out at the gym 3 days a week and running 5 miles every other day). The
therapist's BEST advice is to tell her to resume activities with:
&choice196a= pelvic floor exercises and refrain from all other exercise and
running for at least 6-8 weeks.

&choice196b= pelvic floor and gentle abdominal exercises for the first 4-6
weeks.
&choice196c= abdominal crunches with return to running after 1 month.

&choice196d= a walking program progressing to running after 5 weeks.

&qNum197= 197
&category197= CC

&domain197= D5
&reasoning197= R3

&answer197= 1
&q197= A 77 year-old patient lives alone and is referred for home physical
therapy services to improve functional mobility. He refuses to get out of his
chair. Upon examination, he appears irritable, with poor concentration and
memory. He tells the therapist he has not been sleeping well and has no energy
or desire to do anything. He appears anorexic. The MOST LIKELY explanation for
his symptoms is:

&choice197a= depression.
&choice197b= hypothyroidism.

&choice197c= alcohol abuse.

&choice197d= pseudodementia.
&qNum198= 198

&category198= CE
&domain198= D6

&reasoning198= R4
&answer198= 3

&q198= The rehabilitation team is completing a home visit to recommend

environmental modifications for a 72 year-old patient who is scheduled to be
discharged next week. He is wheelchair dependent. The bathroom has not been
adapted. Which of the following recommendations is NOT appropriate?
&choice198a= adding a tub seat.

&choice198b= taking the door off to widen the entrance to 32 inches.

&choice198c= adding horizontal grab bars positioned at 45 inches.

&choice198d= raising the toilet seat to 18 inches.

&qNum199= 199
&category199= CB

&domain199= D2
&reasoning199= R4

&answer199= 2
&q199= During gait, the lateral pelvic tilt on the side of the swing leg,
observed during frontal plane analysis, serves to:

&choice199a= control forward and backward rotations of the pelvis.

&choice199b= reduce peak rise of the pelvis.

&choice199c= reduce physiological valgum at the knee.

&choice199d= reduce knee flexion at mid stance.
&qNum200= 200

&category200= CC
&domain200= D2

&reasoning200= R3
&answer200= 3

&q200= A patient experiences central thoracic pain while sitting which

increases during the day. There are no complaints in the night or morning.
Lifting and carrying heavy objects increase the pain. Based on the above
information the MOST LIKELY diagnosis would be:
&choice200a= herniated nucleus pulposus of the spine.

&choice200b= spondylodiscitis.
&choice200c= thoracic postural syndrome.

&choice200d= traumatic compression fracture.