PEAT 1

1. In splinting or immobilization, the functional position of the hand includes A. Reduction in sensation
wrist: B. Decrease elasticity of the skin
A. extension, phalangeal flexion, and thumb abduction C. Decrease epidermal proliferation
B. extension, phalangeal extension and thumb abduction D. Change in pigmentation
C. extension, phalangeal flexion and thumb adduction
D. flexion, phalangeal flexion and thumb adduction 8. Which of the following techniques is MOST effective in teaching an IDDM
patient about foot care?
2. During pregnancy, which of the following is contraindicated? A. Reassure the patient that no infection will occur if the directions are
A. curl-ups followed, then demonstrate procedure
B. bridging B. Tell patient how foot care is performed, then watch patient’s
C. double leg lifts performance
D. deep breathing with forced expiration C. Watch patient perform foot inspection and caution him that amputation
results from unattended skin problems
3. A target heart rate is determined for individual entering a training program in D. Have the patient demonstrate a foot inspection, then give feedback on
order to: patient’s performance
A. regulate exercise intensity
B. estimate energy expenditure 9. For a child with Duchenne muscular dystrophy, the MOST appropriate
C. control blood pressure and specific heart rate rehabilitation goal would be:
D. ensure participants exercise at maximal capacity A. prevention of contractures and determine method of mobility
B. preservation of strength and muscle tone
4. A herniated nucleus pulposus at the L3-L4 disc produces which of the C. inhibition of abnormal tone and facilitation of normal movement and
following clinical findings? position reaction
A. Numbness in the back of the calf and dorsiflexor weakness D. facilitation of normal movement and improvement of strength
B. Numbness in the anteromedial thigh and knee and quadriceps weakness
C. Numbness and weakness in the thigh, legs, feet and/or perineum 10. A patient with complete long thoracic nerve injury would have difficulty in:
D. Numbness in the back of the calf and atrophy of gastrocnemius and A. putting hand in the back pocket.
soleus B. bending toward the involved side.
C. taking a deep breath.
5. The intervention for a patient with limitation of shoulder flexion and medial D. reaching forward above head.
rotation includes mobilization. Which glide is the most appropriate for
mobilizing this shoulder to specifically increase the restricted motion? 11. Outcomes of prenatal exercise program would not include:
A. Posterior A. improved body mechanics
B. Anterior B. application of relaxation technique
C. Medial C. improve ligament flexibility
D. Lateral D. strengthen pelvic floor musculature

6. Which of the following techniques is MOST appropriate for a patient with 12. Utilization review and peer review are activities that are part of a
low postural tone? comprehensive:
A. Slow regular rocking while sitting on the treatment bolster A. policy and procedure manual
B. Continuous pressure to the skin overlying the back muscle B. quality improvement program
C. Low frequency vibration to the back muscle C. audit cycle
D. Joint approximation applied through the shoulder to the trunk D. performance evaluation

13. Which of the following is the BEST documentation exercise of a goal?

7. Which skin change associated with aging has the GREATEST effect on A. The therapist will reduce patient’s hip flexion contracture to neutral
wound healing? B. The patient will ambulate 75 feet independently in 3 weeks
 PEAT 1
C. The therapist will reduce patient’s pain from 7/10 to 3/10 C. has slipped too far into the prosthesis and fewer socks should be worn
D. The patient will understand how to increase ADL in 4 weeks D. has slipped too far into the prosthesis and additional socks should be
worn
14. Patient has a limited ankle dorsiflexion following ORIF of distal tibia.
Radiographs reveal that the fracture is well healed. Treatment with passive 20. A therapist is evaluating a patient with an acute lumbar disc protrusion and a
mobilization should include: right lateral shift of the thoracic spine. Which of the following findings
A. posterior glide of talus on tibia would be the BEST indicator that the symptoms will respond positively to
B. lateral glide of calcaneus on tibia. the PT intervention?
C. posterior glide of tibia on talus A. The pain is referred only to the buttock and not the thigh.
D. anterior glide of talus on tibia. B. The patient prefers standing and walking than sitting.
C. There is a decrease in lumbar lordosis.
15. A patient who recently and successfully completed a 12 week program of D. Repeated backward bending centralizes the pain.
phase III cardiac rehabilitation will MOST likely demonstrate a decrease in:
A. CO2 elimination in maximal work 21. A therapist evaluates a patient who has lateral epicondylitis. the patient
B. cardiac output in maximal work reports a subjective pain of 8/10. The patient also reports pain and shows
C. stroke volume at a given level of submaximal work weakness with resisted wrist extension. The therapist decides to use ice
D. heart rate at a given level of submaximal work massage as an intervention. The MOST appropriate length of time for the
ice massage is:
16. The demographic information on the subject in a research study list a mean A. ten minutes
age of 32 and median of 35. The difference between the median and mean B. until the area turns red and patient reports burning sensation
indicates: C. until the patient reports that the area is numb
A. the value of standard deviation score D. no longer than five minutes
B. the value of the Z score
C. that the distribution is skewed 22. Following spinal joint mobilization procedure, a patient calls the therapist
D. that the two measures should be average and reports a minor dull ache in the treated area of the back that lasted for 2
to 3 hours. Based on this symptom, the therapist should:
17. Rocking in quadruped position could be included in physical therapy A. consider a possible neurological lesion in the area
intervention for a 40 year old patient to increase ROM at the: B. refer the patient back to the physician
A. hip joint, 1 month post total hip replacement C. inform the patient that the response is common
B. distal radioulnar joint, 2 weeks post fracture of the distal radius D. add strengthening exercises to the home program.
C. glenohumeral joint, 2 months post rotator cuff tear
D. hip joint, 1 week post subcapital fracture of the femoral neck 23. In order to conduct an experimental study on pain in postsurgical orthopedic
patients, a therapist randomly assigns patients into two groups. One group is
18. A therapist is treating a young athlete with gastrocnemius muscle strength of treated with TENS, heat and exercises; the second receives heat and
fair plus (3+/5). In the prone position, which of the following exercises is exercises only. In this experimental design, TENS is the:
the MOST appropriate to maximize strengthening? A. continuous variable
A. Resistive exercises with the knee bent. B. dependent variable
B. Resistive exercises with the knee straight. C. discrete variable
C. Active exercises with the knee bent D. independent variable
D. Active exercises with the knee straight.
24. A 90-year-old patient with chronic congestive heart failure has been non-
19. Redness on the inferior aspect of the patella upon removal of a patellar ambulatory and a nursing home resident in the past year. The patient was
tendon bearing prosthesis indicates that the residual limb: recently admitted to the hospital following an episode of dehydration.
A. is not far enough into the prosthesis and fewer socks should be worn Which of the following plans for prophylactic respiratory care is MOST
B. is not far enough into the prosthesis and additional socks should be appropriate?
worn A. Turning, coughing and deep breathing every 1 to 2 waking hours.
 PEAT 1
B. Vigorous percussion and vibration 4 times a day D. initiate contacts in the medical community to establish prescriptive
C. Gentle vibration, with the foot of the bed elevated once a day. relationships.
D. Segmental postural drainage using standard positions throughout the
day. 30. To prevent contractures in a patient with an above-knee amputation
(transfemoral), emphasis should be placed on designing a positioning
25. Which diagnostic procedure is LEAST likely to confirm suspected disc program that maintains ROM in hip:
herniation in a patient with low back pain? A. flexion and abduction
A. MRI scan B. extension and adduction
B. CAT scan C. adduction and lateral rotation
C. Radiograph D. flexion and medial rotation.
D. Myelogram
31. After a long-term history of bilateral lower extremity vascular insufficiency,
26. To help the students apply newly learned skill to clinical practice, the MOST an otherwise healthy patient had a right above-knee amputation. For this
effective action for the clinical instructor to take is to: patient, which of the following is the MOST important factor in establishing
A. point our possible patient situations and discuss how the skill would long-term goals for functional walking?
apply to them. A. Status of the wound at the amputation site.
B. have the students research reference materials and compile a list of the B. ROM of the right hip.
steps required in the acquisition of the skill C. Condition of the left lower extremity
C. prepare a list of indications and contraindications for the skill. D. Ability to maintain upright posture.
D. have the students provide examples of patient situations where the skill
would be appropriately applied. 32. A patient is referred to physical therapy complaining of severe pain in the
right hip and groin area, which increases during walking. The patient
27. It is important to perform cool down exercises immediately following a complains of tenderness when the therapist palpates the area over the right
general aerobic program PRIMARILY in order to prevent: greater trochanter. The MOST likely cause of the patient’s signs and
A. venous pooling symptoms is:
B. cardiac arrhythmia A. sacroiliac joint derangement
C. decrease body temperature B. a hip fracture
D. muscle tightening C. a strain of the adductor longus muscle
D. hip bursitis
28. The intervention for a patient who has right sciatic pain caused by piriformis
compression would NOT include: 33. A therapist is conducting a 12-minute walk test with a patient who has
A. instruction in mild self-stretching in sitting with the right hip and knee COPD and uses 2 L/min of O2 by nasal cannula. The patient’s resting O2
flexed and pressure applied in the medial direction to the distal thigh saturation is 91 % and the resting heart rate is 110 bpm. The O 2 flow should
with the left arm. be increased if the:
B. contract-relax exercise to the hip external rotators performed with the A. patient’s CO2 level starts to increase
patient sidelying and the right hip and knee positioned in 90 degrees of B. patient starts to complain of shortness of breath.
flexion. C. patient’s O2 saturation falls below 87%.
C. active resistive strengthening exercise to the piriformis with the patient D. patient’s heart rate is greater than 150 bpm.
prone and the knee flexed 34. When working with a neurological patient to ensure that physical therapy
D. application of cold to the area of sciatic nerve irritability services are adequately documented, it is MOST important to record changes
in:
29. A therapist is assigned in the planning and implementation of services for all A. muscle tone
members of the community. The therapist’s FIRST step would be to: B. functional abilities
A. develop a brochure for distribution to the community. C. cognitive status
B. organize a health fair to provide screening for the community. D. quality of movement
C. evaluate existing services and community resources.
 PEAT 1
35. A patient has right hemiparesis resulting from TBI. When assessing motor 40. A patient with leukemia has developed thrombocytopenia following a bone
control in the right lower extremity with the patient standing, the therapist marrow transplant. Which of the following measures are indicative of the
finds that the patient cannot extend the hip while flexing the knee or flex the status of the thrombocytopenia?
hip while extending the knee. In which of the following functional activities A. T4 lymphocyte count
will this problem be MOST apparent? B. Red blood cell count.
A. Shifting weight while standing. C. Platelet count
B. Walking sideways. D. White blood cell count
C. Walking backward.
D. Moving from sitting position to standing position. 41. During a postural examination, the therapist notes that the patient’s patella
both point inward when viewed from the front of the patient. The MOST
36. A patient was injured in a motor vehicle accident two days ago, resulting in likely cause of this problem is excessive:
quadriplegia at C6 level. When providing PROM to the UE, which of the A. femoral anteversion
following is MOST critical in order to optimize long-term hand function? B. weakness of the vastus medialis
A. Passive wrist and finger extension exercise to gain maximum stretch of C. genu varum
the finger flexors D. medial tibial torsion
B. Passive wrist and finger flexion exercise to gain maximum stretch of
the finger extensors. 42. A therapist is evaluating a patient who has a vascular lesion in the brainstem
C. Holding the wrist in flexion when passively extending the fingers. affecting the oculomotor nerve. During the cranial nerve examination,
D. Holding the wrist in extension when passively extending the fingers. which of the following would be the MOST significant sign?
A. Inability to close the eyelid
37. An athlete sustained a severe inversion sprain of the right ankle while B. Medial strabismus
playing basketball. To provide strapping support for the ankle, pressure and C. Ptosis of the eyelid
support should be applied over the tendons of the: D. Constricted pupil
A. flexor digitorum longus and tibialis posterior
B. gastrocnemius and flexor hallucis longus 43. For a patient with IDDM who is completing a cardiovascular fitness
C. peroneus longus and brevis program, what change in diabetic management is MOST likely to be
D. tibialis anterior and tibialis posterior. instituted as fitness increase?
A. Switching to oral rather than injected medication.
38. In which of the following conditions would a nerve conduction velocity test B. Decreasing caloric intake for 2 to 3 hours following the exercise
be MOST important? sessions.
A. Carpal tunnel syndrome C. Decreasing the amount of insulin taken daily.
B. Cerebrovascular accident D. Increasing the amount of insulin taken daily.
C. Myotonia
D. Duchenne Muscular Dystrophy

44. An elderly patient presents with a sacral pressure ulcer measuring 6 in. x 6
in. The wound has moderate serous fluid drainage and is loosely covered
39. When training a patient to increase muscle activity with the use of EMG with necrotic and fibrotic tissue, although there are no indications of
biofeedback, the therapist should adjust the unit so that sensitivity: infection present. The BEST method of debridement would be:
A. starts at low and increases as the patient shows an increase in muscle A. daily vigorous scrubbing of the wound.
activity B. wet-to-dry dressings with normal saline 2 times a day.
B. starts high and decreases as the patient shows an increase in muscle C. daily wet-to-dry dressings with 1:1 dilute povidone-iodine (Betadine)
activity D. whirlpool jet agitation 2 times a day.
C. remains at approximately mid-range during the entire treatment period.
D. is not set, since this is not necessary for this form of biofeedback. 45. A patient is referred to physical therapy for treatment of tenosynovitis. The
patient complains of “pins and needles” sensation on the palmar surface of
 PEAT 1
the first three fingers. The therapist’s examination reveals a positive Tinel’s B. Attending a patient who is on a tilt table while the therapist takes a
sign at the wrist and good (4/5) grade thumb opposition. Based on these phone call.
findings, the therapist should suspect: C. Transporting a patient who complains of dizziness back to his room.
A. median nerve compression at the wrist D. Transferring a patient from the mat to a wheelchair.
B. ulnar nerve compression distal to the elbow
C. tenosynovitis of abductor pollicis longus 51. A patient sustained a severe brain stem injury one week ago and has
D. thoracic outlet syndrome demonstrated minimal change since the incident. The patient’s cognitive
status is MOST likely to include:
46. A patient has disuse atrophy of the anterior compartment muscle following A. a decrease level of arousal
cast removal after a fracture of the tibia. The patient has poor (2/5) strength B. a decrease level of intelligence
in the ankle dorsiflexors. Electrical stimulation is to be used to enhance C. an increase level of agitation
dorsiflexor strength in conjunction with exercise. Initially, which of the D. an increase level of impulsivity
following waveform characteristics is MOST appropriate to stimulate the
muscles? 52. The hospital administrator asks members of the rehabilitation department to
A. Monophasic pulse with a frequency of 110 pps and on/off cycle ration develop a comprehensive program to help reduce the risk of low back
of 3:1 injuries. Which of the following would be the FIRST step necessary to
B. Biphasic pulse with a frequency of 30 pps and on/off cycle ratio 1:5. develop the program?
C. Direct current waveform with an on/off ratio of 1:1 A. Include all employees in a lumbar extension exercise class
D. Interferential waveform with a beat frequency of 1 pps. B. Design a program that meets each department’s functional needs
C. Perform an ergonomic analysis on each workstation
47. A patient is referred to physical therapy with a 20-degree knee flexion D. Provide pamphlets on proper body mechanics
contracture following arthroscopic knee surgery a month ago. All of the
following interventions are appropriate EXCEPT: 53. To maximize continuity of patient care, the PT should begin discharge
A. stretching of the semimembranosus muscle planning when the:
B. strengthening of vastus medialis. A. physician refers the patient for discharge
C. inferior gliding of the patella. B. therapist makes the discharge review of the patient
D. mobility of the posterior capsule of the knee joint. C. discharge planner requests information pertinent to the patient’s
discharge status
48. A patient with a complete SCI is sitting in a wheelchair on a custom made D. therapist performs initial review of the patient
cushion. Pressure relief activities should be performed:
A. when the patient shows signs of pressure sores
B. every 15 to 20 minutes
C. every 1 to 2 hours 54. The PT is positioning a patient for postural drainage. In order to BEST drain
D. if the patient does not have an appropriate cushion. the posterior segment of both lower lobes, the patient should be placed in
49. During a review, a patient lacks 10 degrees of passive ankle dorsiflexion. which of the following positions?
The same degree of limitation is present whether the knee is flexed of A. Prone, head down at 45 degree angle
extended. The muscle MOST likely contributing to this restriction is the: B. Supine, flat surface
A. gastrocnemius C. Side lying, head elevated 30 degree angle
B. tibialis anterior D. Sitting, leaning forward
C. plantaris
D. soleus 55. A MMT of a patient sustained a gunshot wound just superior to the elbow
joint reveals specific muscle weakness from a partial median nerve injury.
50. Which of the following assignments is MOST appropriate for the physical The PT intervention for this patient would MOST likely include
therapist to delegate to a volunteer? strengthening activities for wrist flexion and forearm:
A. Restocking treatment booths with linens, US gel, massage lotion. A. pronation, finger flexion, thumb adduction
B. pronation, finger flexion, thumb opposition
 PEAT 1
C. supination, finger abduction, thumb opposition
D. supination, finger abduction, thumb extension 61. During MMT of the hip flexors in the sitting position, a patient exhibits
lateral rotation and abduction of the thigh as resistance is applied. The PT
56. A patient who has a piriformis syndrome is referred to TP for review and should suspect substitution by:
intervention. The patient’s history includes THR on the right side 2 years A. sartorius
ago. Because of the THR, which of the following should only be used with B. tensor fascia latae
precaution? C. adductor longus
A. TENS D. semimembranosus
B. Continuous us
C. Hot packs 62. A PT is treating a patient who has lymphedema in the right LE. The
D. Massage to the right hip therapist decides to use mechanical, intermittent pneumatic compression as
an intervention, using a sleeve that covers the foot, leg and thigh. The
57. A patient presents with adhesive capsulitis of the shoulder joint. The ROM therapist measures BP at 135/85 mm Hg. At first treatment session, the
examination reveals restricted external rotation and abduction of the MOST appropriate inflation pressure for the sleeve is:
shoulder. The FIRST mobilization procedure that should be done for this A. 20 mm Hg
patient is: B. 60 mm Hag
A. posterior glide C. 100 mm Hg
B. distraction D. 140 mm Hg
C. anterior glide
D. external rotation 63. A patient is entering a cardiac rehabilitation program. The PT should FIRST
ask the patient to:
58. A patient sustained a severe TBI 3 months ago. During the exam of passive A. describe the correct aspect of exercise demonstrated by the therapist
ROM, the therapist notices decrease passive knee extension and moderate B. list problems associated with nutritional habits
hamstring spasticity. Palpation reveals a firm mass on the lateral aspect of C. identify the harmful effects of smoking with regards to cardiac disease
the joint. The therapist should refer the patient to a physician for a review of D. describe the type of angina that the patient experience
probable:
A. osteogenic sarcoma
B. patellar fracture
C. osteomyelitis
D. heterotopic ossification 64. A PT receives a telephone call from a woman who identifies herself as a
friend of one of the therapist’s patients. She wants to know how the patient is
59. A patient complains of anterolateral shoulder pain with insidious onset. doing and if he will be able to go up and down the stairs, because she wants
Examination shows full passive ROM, pain on passive lateral rotation and to take him home for a weekend visit. What should the therapist do?
pain on resistive internal rotation. These signs are consistent with a A. Discuss the patient’s program and functional status with the caller
diagnosis of: B. Invite the caller to observe the patient’s next therapy session
A. bicipital tendonitis C. Refuse to discuss the patient’s status unless the patient’s permission is
B. supraspinatus tendonitis obtained
C. subscapularis tendonitis D. Refer the caller to the patient’s social worker
D. infraspinatus tendonitis
65. The parents of a 1-month old child with myelomeningocele report that the
60. A measurable objective for a community education program exercise child has been increasingly irritable and has changed sleeping patterns over
techniques would be for participants to: the past three days. The child has also been vomiting. Which of the
A. understand the importance of sufficient warm-up period following is the MOST appropriate action for the therapist to take?
B. list five stretching techniques that can be used when warming up A. Refer to immediate medical follow-up
C. overcome LE problems and adhere to a regular exercise program B. Instruct the parents to monitor head circumference daily
D. appreciate the effects of increasing intensity of exercise on heart rate C. Advise the parents to watch the child for worsening symptoms
 PEAT 1
D. Take the head circumference measurements to compare to subsequent with DTR show hyporefexia. She has an intention tremor when she tries to
visits pick up an object from a table, and exhibits difficulty performing the finger
to nose test. Where is the MOST probable area of the lesion?
66. A therapist is setting up a home program of ES for a patient who has Bell’s A. Right side, cervical spinal cord
palsy. Which of the following muscles should be stimulated as part of the B. Left side, cerebral hemisphere
home program? C. Left side, substantia nigra
A. Sternocleidomastoid D. Right side, cerebellar hemisphere
B. Masseter
C. Temporalis 72. A patient sustained a gunshot wound to the distal posterior thigh that resulted
D. Frontalis in complete severance of the common peroneal nerve. Which of the
following exercise is necessary in the early rehabilitation period to prevent
67. A patient is lying supine with his hips and knees extended and hands behind contracture formation?
his head. The patient is able to raise his head, shoulder and thorax from the A. Active plantarflexion, inversion and toe extension
treatment table, but is unable to come to a complete long-sitting position. B. Passive dorsiflexion, eversion and toe extension
The PT should target which muscle for strengthening program? C. Active dorsiflexion, eversion and toe flexion
A. Iliopsoas D. Passive plantarflexion, eversion and toe flexion
B. External abdominal oblique
C. Quadratus lumborum 73. A patient with mild closed head injury and bilateral femur fracture requires
D. Upper rectus abdominis instructions in a LE exercise program. In order to plan the most effective
teaching methods for this patient, what would be the MOST critical to assess
68. A 14-month old child with spastic diplegia is up on his tiptoes with his toes at the initial visit?
curled when held in supported standing. This position is characteristic of a: A. Comprehension of written, verbal and demonstrated instructions
A. proprioceptive placing reaction B. Short tem memory capacity
B. moro reflex C. Hearing and vision
C. plantar grasp reflex D. Any personality changes compared to the patient’s premorbid status
D. traction response
74. A patient with right above-knee prosthesis will be able to maintain the knee
69. A therapist is developing a gait training program for a patient following a in extension while weight bearing if the center of gravity of the body is
THA of the right hip. The proper instructions and rationale for crutch shifted so that the gravitational line falls:
training utilizing one crutch include holding the crutch in: A. posterior to the axis of the right knee joint
A. right hand to decrease activity in the right hip abductors B. lateral to the axis of the right knee joint
B. right hand to facilitate action in the right hip abductors C. anterior to the axis of the right knee joint
C. left hand to decrease action in the right hip abductors D. medial to the axis of the right knee joint
D. left hand to facilitate action in the right hip abductors
75. In order for a patient with bilateral BKA to maximize balance in a
70. Following trauma at C5 spinal cord level, a patient was admitted to the wheelchair, the rear wheels should be positioned more:
hospital. 24 hours later, the patient shows no reflexes, sensation, or A. laterally
voluntary motor activity below the level of injury. These findings indicate: B. posteriorly
A. the presence of spasticity C. anteriorly
B. decerebrate rigidity D. inferiorly
C. spinal shock
D. a lower motor neuron lesion 76. An initial PT evaluation performed on an elderly patient who is 1 day post
total hip arthroplasty (non-cemented) using a posterolateral approach. The
71. A right handed woman is being examined by the PT for right sided weakness patient has no complicating medical history and was active and independent
in her UE and LE. The muscle tone is hypotonic and she is ataxic during preoperatively. Which of the following activities is NOT an appropriate goal
walking. She has a history of hypertension and alcoholism. Passive ROM for the first week of therapy?
 PEAT 1
A. Active-assistive positioning of the left hip to 60 degrees of flexion C. Relate the therapist’s experiences with other patients
B. Active left hip abduction in right sidelying D. Encourage the patient’s statement of feelings
C. Independent bed mobility with use of a trapeze
D. Walking with moderate assistance with a standard walker to 25 feet 82. Prior to starting an exercise training program, a patient with cardiac
(7.6 meters) problems who is receiving beta blocking medication should receive an
explanation of the:
77. A patient with frequent tension headaches has been referred to physical A. greater benefits from cardiovascular exercise to be achieved at lower
therapy for instruction in a program of progressive relaxation exercises. rather than at higher metabolic level
Which of the following is MOST essential in a program of progressive B. need to use measures other than heart rate to determine intensity of
relaxation to reduce muscle tension? exercise
A. Release of tension by suggestion and persuasion C. need for exercise training sessions to be more frequent but of shorter
B. Passive exercise in quiet surrounding to relieve tension duration
C. General massage using deep stroking and kneading of tense muscle D. need for longer warm-up periods and cool-down periods during an
D. Recognition of the sensation of tension and release exercise session

78. On the fourth day of PT treatment, a patient who has had an ORIF for a hip 83. A clean, well granulating stage II pressure ulcer with minimal serous
fracture develops a large ecchymosis over the unaffected hip. The patient drainage is MOST appropriately dressed with:
has MOST likely developed: A. a non-adherent dressing
A. a hemangioma B. a packed dressing
B. a complication of anticoagulant therapy C. topical medication only
C. a hematocele D. dry-to-dry gauze
D. deep vein thrombophlebitis

84. A PT examines a patient who complains of foot pain while jogging. The
79. A patient who is exercising on a bicycle ergometer in the cardiac examination sows that the patient has excessive foot pronation and forefoot
rehabilitation unit is being monitored with electrocardiogram leads. During varus. The therapist decides to try a temporary orthotics insert in the
the exercise, the ST segment becomes depressed by 2 mm. If the patient’s running shoe. Which of the following would be the MOST
cardiologist has given no specific guidelines, the PT should: appropriate orthotics insert?
A. terminate the session immediately A. A lateral forefoot post under the fifth metatarsal head
B. reduce the resistance load B. A lateral rearfoot post under the calcaneus placing it in everted position
C. instruct the patient to slow down C. A wedge placed under the instep of the medial foot just beneath the
D. direct the patient to continue as before head of the talus
D. A medial post just proximal to the first metatarsal head
80. A patient slips, falls and cuts her arm in the clinic. The cut is bleeding and
the patient is alert and well oriented. In performing first aid for the patient, 85. A patient with chronic adhesive capsulitis of the shoulder is to be treated
the FIRST action that the PT should take is to: with joint mobilization to increase joint range of motion. Which of the
A. don a pair of gloves following would be the MOST appropriate to increase shoulder abduction?
B. clean the cut with an antiseptic A. Distraction with inferior glide
C. check the patient’s BP B. Anterior glide with internal rotation
D. cover the cut with sterile dressing C. Superior glide with approximation
D. Distraction with posterior glide
81. A PT is working with patient who is aware that he is terminally ill. What is
the MOST appropriate intervention when the patient wants to talk about his 86. An 8-year-old child who has juvenile rheumatoid arthritis is developing
prognosis? bilateral knee flexion contractures. Which of the following would be the
A. Discourage discussion of death or dying LEAST appropriate action?
B. Refer the patient for pastoral counseling A. Exercises to increase joint mobility
 PEAT 1
B. Ultrasound to the hamstring insertions to increase tissue extensibility 92. If a BK prosthesis has an excessively firm heel wedge, the patient is MOST
C. Progressive weight bearing by walking in a therapeutic pool to increase likely to walk with:
endurance A. excessive knee flexion in early stance
D. Exercise to increase quadriceps strength B. premature knee flexion in late stance
87. Although knee motion occurs primarily in one plane, tibial rotation is C. insufficient knee flexion in early stance
possible when the knee is positioned in 90 degrees or more of flexion D. excessive knee flexion in late stance
because in this position the:
A. condyles of the femur glide posteriorly on the condyles of the tibia 93. A patient who has COPD is being treated with a regimen that includes
B. hamstrings act as rotating force pursed lip breathing exercise. The PRIMARY purpose of the pursed lip
C. patella deviates inferiorly breathing is to:
D. tension on the ligaments is decreased A. help prevent collapse of pulmonary airways during exhalation thereby
reducing air trapping
88. A PT is screening a young adult patient for a possible right thoracic, left B. decrease the removal of CO2 during ventilation
lumbar structural scoliosis. The postural deviation commonly seen with this C. increase the residual volume of respiration so that more O2 is available
diagnosis would be: for body metabolism
A. spinous processes of the thoracic spine rotated to the right D. stimulate further mobilization of mucous secretions to higher air
B. high left shoulder passages where they can be expectorated
C. posteriorly protruding scapula to the right
D. prominent right posterior rib cage

94. A patient with a diagnosis of cervical radiculopathy reports numbness of the

89. A postural correction program for a patient with forward head, kyphosis, and right little finger. The therapist would MOST likely find a diminished DTR
increased lumbar lordosis would include all of the following EXCEPT: in the:
A. strengthening of the scapular protractors A. biceps brachii
B. strengthening the thoracic erector spinae muscles B. deltoid
C. lengthening the short suboccipital muscles C. triceps brachii
D. lengthening the lumbar erector spinae muscles D. brachioradialis

90. A patient in the eighth month of pregnancy presents with numbness and 95. A therapist is planning a patient education program for a group of patients
tingling of the left hand except the fifth digit. She demonstrates edema of with chronic LBP. To increase the likelihood that the patients will utilize the
the hand and fingers, a positive Tinel’s sign at the wrist, and a good (4/5) proper body mechanics at the work site, the therapist should:
muscle test grade of the wrist and finger flexors. The MOST appropriate A. ask patients to demonstrate the use of proper body mechanics
intervention would be: B. provide a reference list of articles describing body mechanics
A. a wrist splint to position the wrist in full extension C. ask patients to describe actions they do that increase their back pain
B. a hot pack followed by tendon gliding exercises D. provide information on the frequency of low back injuries due to
C. resistive exercises for the wrist and finger flexors improper body mechanics
D. frequent rest and elevation of the left upper extremity
96. A patient presents with hemiparesis and demonstrate a foot drop during
91. An exercise program for a patient with Parkinson’s disease would MOST swing phase of gait. It would be MOST appropriate to administer FES to the
likely include exercise to: tibialis anterior and the:
A. decrease movement of the upper extremities and trunk A. gastrocnemius
B. increase trunk flexor strength B. tibialis posterior
C. improve balance reactions and reciprocation C. extensor digitorum longus
D. stretch back extensor muscle D. peroneus longus
 PEAT 1
97. A PT is treating a patient with iontophoresis. If the current is set at 4 mA, 102. A patient with chronic venous insufficiency of the LE would MOST likely
the duration at 15 minutes, and the dexamethasone solution at 0.4%, with an exhibit:
electrode area of 4 cm2, how would the therapist record the current dosage? A. normal superficial veins, no edema, ulceration and patches of gangrene
A. 0.16 mA.mg around the toes
B. 16 mA/cm2 B. dilation of superficial veins, edema, stasis ulceration
C. 0.60 mg/min C. no edema, cold, hairless LE, faint dorsalis pedis pulse
D. 60 mA.min D. dilation of superficial veins, edema made worse during sitting or leg
elevation
98. An elderly patient has diabetic neuropathy. Upon examination he shows
marked mediolateral instability of the left ankle while walking. The patient 103. Following removal of a long leg cast, a patient has limited knee flexion. The
also has fluctuating edema and glove-and-stocking sensory loss in both legs. MOST appropriate direction of patellar mobilization would be:
The MOST appropriate orthotics aid would be: A. distal
A. a double-upright ankle foot orthosis B. lateral
B. hip to toe shoes C. proximal
C. a prefabricated plastic, solid ankle-foot orthosis D. medial
D. a spiral ankle foot orthosis

104. Which lower extremity PNF pattern is MOST appropriate for a patient who
needs strengthening of the tibialis posterior?
99. A 25-year-old patient with cystic fibrosis has been experiencing successful A. Hip extension, abduction and medial rotation with ankle plantarflexion
mobilization of thickened secretions by standard percussion and postural and eversion
drainage. During the current treatment session, the patient coughs up B. Hip flexion, adduction and lateral rotation with ankle dorsiflexion and
sputum that has small, brownish streak of blood. The PT should: inversion
A. percuss more vigorously in an attempt to clear out any other blood that C. Hip extension, adduction and lateral rotation with ankle plantarflexion
is present in the airways and inversion
B. perform postural drainage in upright positions for this type of patient D. Hip flexion, abduction and medial rotation with ankle dorsiflexion and
only eversion
C. continue treatment with little modification unless more blood is noted
D. stop the treatment and send the patient to the emergency room 105. A patient is referred to PT with a diagnosis of low back pain. Radiographic
studies, including MRI, have rules out the presence of disc pathology. The
100. Which of the following should be recommended for a patient following a patient complains of continuous back pain that radiates towards the thorax
medial meniscectomy if the PT plans to exercise the quadriceps femoris and anteriorly into the abdominal region. The therapist should consider
against accommodating resistance? which of the following areas as a potential source of discomfort?
A. Knee bends through half of the range A. Dura mater
B. Knee extension with sandbag in the ankle B. Diaphragm
C. Knee extension on an isokinetic exercise device C. Kidney
D. Straight leg raising with a sling suspension D. Urinary bladder

101. In a suction socket prosthesis, the primary function of the valve in the lower 106. An adult patient who was involved in a motor vehicle accident has sustained
and medial part of the socket is to permit air to: multiple traumas, including fractured ribs on the right side. The patient is
A. remain during the stance phase of gait unconscious, intubated and on a mechanical ventilator in the ICU. Chest
B. remain during the swing phase of gait radiographs show the development of an infiltrate in the lower lobe during
C. escape during the swing phase of gait the past two days. Rales and ronchi are heard over the right lower lung
D. escape during the stance phase of gait fields. Which chest program is MOST appropriate?
 PEAT 1
A. Manual hyperventilation and suctioning while positioned on the left B. apply an ice massage prior to exercise
side C. continue LE therapeutic exercise and use facilitation techniques to
B. Positioning supine for suctioning, followed by manual hyperventilation stimulate more activity
while positioned on the left side D. discontinue all exercises and notify the physician
C. Suctioning, percussion and vibration while positioned on the right side
D. Positioning on the left side for deep breathing exercises only 111. In early management of a patient with partial peripheral nerve injury, the
goal of the PT intervention will MOST likely be to prevent:
107. A patient who has RA comes to PT with signs of muscle atrophy, A. nerve degeneration
ecchymosis, puffy cheeks and a diagnosis of osteoporosis. This patient is B. spasticity and increase muscle tone
MOST likely receiving a high dosage of: C. muscle atrophy
A. penicillin D. contractures and adhesions
B. prednisone
C. aspirin
D. gold salts

112. A PT is developing an educational program for individuals with LE

peripheral neuropathies due to diabetes. Which of the following is the
108. A PT is examining a patient who has difficulty making a fist. The muscle MOST important information for the PT to recommend for the prevention of
test show the following: flexors of the 2 nd to 5th digits at the PIP are normal injury to the foot?
(5/5); flexors of the 2nd and 3rd digits at the DIP are normal (5/5); flexors of A. Orthosis to support the extremity
the 4th and 5th digits at the DIP are poor (2/5). These findings are consistent B. Use of proper footwear
with a lesion of the C. Moisturizing the skin to prevent dryness
A. median nerve C8-T1 D. Exercise parameter
B. median nerve C5-C6
C. ulnar nerve C5-C6 113. Elevating a patient’s LE for less than 1 minute produces a noticeable pallor
D. ulnar nerve C8-T1 of the foot, followed by delayed reactive hyperemia in a dependent position.
These signs are indicative of:
109. An elderly man who lives alone fell in his home, sustaining a hip fracture, A. an intact circulatory system
which necessitated a THR. The patient was previously able to perform all B. arterial insufficiency
ADLs independently. He has been admitted to a skilled nursing facility for C. venous insufficiency
rehabilitation. The patient’s goal is to return home. His family believes he D. acute arterial occlusion
should be admitted to a long-term care facility for his own safety once acute
rehabilitation is completed. The therapist’s MOST appropriate action is to: 114. While ascending stairs, an elderly patient leans forward with increased hip
A. advise the family that the patient should determine his own discharge flexion. Which of the following muscles are being used to the BEST
environment advantage with this forward posture?
B. recommend a team conference with the patient and his family to A. Rectus femoris
discuss discharge plans B. Tensor fascia lata
C. schedule a home visit to determine if home modifications are needed C. Gluteus maximus
before discharge D. Lumbar paraspinal
D. implement a treatment plan with a long term goal of discharge to home
115. A therapist is treating a patient with moderately well controlled type I
110. During LE exercise, a patient with incomplete C6 quadriparesis reports a diabetes. One of the goals is to help regulate her insulin dosage through
new onset of tingling and numbness in both hands. MMT reveals that therapeutic exercise. In establishing an exercise program, the therapist
overall strength has decreased by one grade. In this situation, the therapist’s should be aware that regular exercise will generally:
MOST appropriate course of action is: A. lower blood glucose levels and decrease amount of insulin required
A. modify the exercise program to accommodate change in strength B. lower blood glucose levels and increase amount of insulin required
 PEAT 1
C. raise blood glucose levels and decrease amount of insulin required unable to take any resistance applied by the therapist. During the subsequent
D. raise blood glucose levels and increase amount of insulin required. gait examination, the therapist would MOST likely expect the patient to
display which of the following?
116. A PT recognizes that departmental education materials are written on a A. Normal gait, with no deviations
reading level that is too difficult for some of the patients. The PT can help B. Increased right hip flexion during swing phase
the patients better understand the materials by: C. Throwing the trunk backward, on the right side, shortly after the initial
A. including illustrations and a larger print contact
B. including illustrations and a simpler sentence structure D. Lateral bending toward the right side during midstance
C. reducing the number of syllables and lengthening the sentences.
D. using a larger print format to present specific medical terminology
121. A patient is referred for PT with a diagnosis of chondromalacia patella. The
PT decides to include quads setting and SLR as part of the home exercise
program because:
117. An inpatient PT department has only one PT and one PTA on duty due to A. the vastus medialis muscle is primarily responsible for terminal knee
staff illness. A patient with which of the following is MOST appropriate for extension
the therapist to delegate to the assistant? B. quads setting and SLR help improve patellar tracking
A. Ataxia, who is undergoing a trial to determine an appropriate assistive C. Patellofemoral compression forces are increased when the knee is
device extended
B. Hemiparesis, whose initial review has not been completed D. the vastus medialis muscle is preferentially activated during SLR.
C. Multiple sclerosis, so is receiving gait training with a rolling walker
D. Alzheimer’s disease, who is easily agitated during the initial gait 122. A patient with low back pain has been undergoing treatment for two
training sessions. The patient tells the therapist that today the pain is centralizing
with the extension exercises, but is intense as it was at the first treatment
118. During inspiration, a patient demonstrates increased upper chest expansion session. The patient is frustrated by this reaction. The therapist’s most
with retraction of the epigastric area. The PT should suspect weakness of appropriate response would be:
the: A. continue with the present program
A. scalene muscle B. eliminate the extension exercises
B. diaphragm C. consult the patient’s physician about the situation
C. rectus abdominis D. progress to trunk flexion exercises
D. intercostal muscles
123. Which of the following statements does NOT document patient outcome?
119. The brother of a patient who was recently discharged from the hospital’s A. The patient propelled his wheelchair independently after 4 weeks
outpatient PT department telephones on the patient’s behalf to request a copy B. The patient demonstrated independent performance of home program
of the patient’s medical record. The therapist should explain to the patient’s after 2 weeks
brother that the medical record is the property of the: C. The patient walks 100 feet with minimal assistance after one week
A. patient’s family and can be released to the bother upon request D. The patient attended PT sessions 3x a week for 2 weeks
B. patient’s insurer now and that the request for a copy must be made in
writing to the insurer 124. Which of the following is the MOST likely cause of reduced vital capacity in
C. hospital and the patient can be released only with written authorization a patient who has quadriplegia at C5-C6 level?
from the patient A. Decreased anterolateral chest expansion resulting from paralysis of the
D. hospital and can be released only with written authorization from the external intercostals
patient’s physician B. Inability of the patient to generate a negative intrapleural pressure
secondary to a denervated diaphragm
120. A PT is examining a patient for a possible LE weakness. PROM is within C. A relatively high resting position of the diaphragm resulting from
normal limits. The patient is seated. When the patient tries to dorsiflex and paralysis of abdominal muscles
invert his right foot, he is unable to move it through the full ROM and is
 PEAT 1
D. Reduced rib cage elevation due to paralysis of the anterior scalene and 130. When examining a patient who had a baby 3 days ago by vaginal delivery,
sternocleidomastoid muscles the physical therapist notices that the patient has a 2-cm. diastasis of the
rectus abdominis. To address this problem, the patient should:
125. An attorney calls the PT department seeking information on the status of his A. perform partial sit-ups, supporting her abdominal muscles with her
client, a patient who is undergoing rehabilitation following total knee hands while lifting her head in the supine position
surgery. The patient’s physical therapist should: B. not perform exercises until the diastasis heals spontaneously
A. refer the attorney to the patient’s insurance carrier C. perform sit-ups with knees bent and arms behind the head
B. describe the patient’s current status D. perform partial sit-ups with the legs straight and arms in front
C. require written authorization from the patient to release information
D. obtain verbal permission from the patient to release information
126. Involving interdisciplinary team members in making decisions about 131. To minimize skin irritation during functional electrical nerve stimulation, the
continuity of patient care has all of the following benefits EXCEPT: physical therapist should use:
A. promoting each individual’s commitment to, and responsibility for, the A. lower intensity, larger inter-electrode distance and larger electrodes
decisions that have been made by the group B. lower intensity, larger inter-electrode distance and smaller electrodes
B. discouraging one or two members from being in control and having all C. higher intensity, smaller inter-electrode distance and smaller electrodes
the authority D. lower intensity, smaller inter-electrode distance and larger electrodes
C. enabling decisions regarding quality of care to be made quickly
D. promoting quality of care by including several aspects of the patient’s 132. A patient is doing active and resistive exercises on a mat table in the physical
care therapy department. After 15 minutes, the patient becomes short of breath,
begins coughing and expectorates pink, frothy sputum. At this point, the
127. Instruction in energy conservation and joint protection should be provided to physical therapist should first stop the treatment, then:
the patient with rheumatoid arthritis because: A. assess vital signs, let the patient rest a few minutes with the feet
A. the joints may be predisposed to damage by overuse elevated, and ten resume with a less vigorous program
B. fatigue often masks joint pain B. sit the patient up, assess vital signs and call a nurse or physician for
C. phagocytes remove more pannus in resting joint further instructions
D. activity of the antigen-antibody complex is diminished with rest C. lay the patient supine, transfer the patient to stretcher and return the
patient to the nursing unit
128. In which of the following is independence the MOST realistic long-term D. lay the patient down flat, call for assistance and begin cardiopulmonary
goal for a patient with a complete spinal cord lesion at C8? resuscitation
A. Effective cough technique
B. Rolling from side to side 133. When evaluating a wheelchair positioning of a child with cerebral palsy, the
C. Transfer from bed to wheelchair therapist should FIRST examine the position of the child’s:
D. Ambulation with forearm crutches A. pelvis
B. legs
129. A physical therapist examines a patient with multiple sclerosis who is in the C. head
period of exacerbation. The patient is independent with bed mobility, can sit D. spine
unassisted at the edge of the bed, and requires physical assistance to stand
with a walker. Which of the following ADL activities is the MOST 134. A patient who sustained a mild CVA 3 weeks ago is being prepared by the
important for the initial intervention? physical therapist for discharge to home and an adult day program. To
A. Wheelchair propulsion up a 10 foot ramp facilitate the discharge plan, the MOST appropriate health professional for
B. Wheelchair transfers the therapist to consult with is the:
C. Walking with an assistive device A. skilled nursing coordinator
D. Tub transfers B. occupational therapist
C. medical social worker
D. primary physician
 PEAT 1
135. For a patient with a right middle lobe pneumonia, the proper bronchial B. Asymmetrical gluteal folds, femoral telescoping and limited hip
drainage position is supine with the body: abduction on the right side
A. one-quarter turned to the left and foot of the bed raised 14 inches C. Decreased active movement of the right hip, increased femoral neck
B. one-quarter turned to the right and bed flat retroversion, and atrophy of the gluteus maximus on the right side
C. three-quarters turned to the left and head of the bed raised 14 inches D. Hip flexion contracture on the right side, apparent leg length
D. three-quarters turned to the right and foot of the bed raised 14 inches discrepancy, and inability to tolerate supported sitting

141. A 14-month old child with brachial nerve palsy has motor and sensory loss
136. To avoid the appearance of increased motion, which movement must be in the right upper extremity in the areas innervated by C5 & C6. Which of
prevented during goniometric measurement of shoulder abduction? the following activities is MOST difficult to accomplish with the affected
A. Upward rotation of the scapula upper extremity?
B. Medial rotation of the shoulder A. Pushing a wagon
C. Lateral rotation of the shoulder B. Carrying a teddy bear in the crook of the arm
D. Lateral flexion of the trunk to the opposite side C. Holding a raisin in the palm of the hand
D. Grasping a cup
137. A patient who receive organ transplantation 4 years ago demonstrates
progressive weakness and is referred to physical therapy for strengthening 142. A therapist is treating a patient who has been diagnosed with a nerve root
exercises. In reviewing the medical history, the therapist learns that the impingement on his right side due to narrowing of the intervertebral foramen
patient takes prednisone and immunosuppressive drugs. Which of the between L4 & L5. The therapist decides to use mechanical, lumbar traction
following would the therapist MOST likely need to consider? an intervention. Which of the following positions, on a traction table, would
A. Isokinetic strengthening will be preferable for this patient be the MOST appropriate to relieve pressure on the nerve root?
B. The patient may have limited ROM from increased bone mass A. Supine, hips & knees flexed
C. The patient will need to be treated in an isolation room B. Supine, with hips and knees straight and laterally shifted to the right
D. Muscle strengthening may be limited in this patient C. Prone, hips and knees straight
D. Sidelying on the right with a bolster between the table and the patient
138. A therapist examines a high school athlete in the training room. After
removing the adhesive strapping from the athlete’s ankle, the therapist 143. A prone standing board has been recommended for a 5-year old child with
discovers that the athlete has developed an open weepy rash on the instep of severe hypotonia. The PRIMARY purpose for the use of a prone stander is
the foot. The therapist should FIRST: to:
A. apply moist heat to the foot A. promote weight bearing
B. send the patient to the hospital emergency room B. reinforce an exaggerated positive support reflex
C. use more pre-wrap with the next joint taping C. prevent hip dislocation
D. refer the patient to the team physician D. increase hip and knee ROM

139. A patient who sustained a left below-knee amputation 3 weeks ago is being 144. A patient who is transported to the physical therapy department in a
evaluated for possible ambulation with prosthesis. Which of the following wheelchair complains of severe, bilateral lower extremity pain. A purple
factors is MOST relevant? discoloration of both feet is observed. The pain is relieved when the
A. Size of the right residual limb scar patient’s feet are raised just above the horizontal plane. These signs are
B. Length of the right residual limb MOST indicative of:
C. Proficiency in previous prosthetic use A. arterial insufficiency
D. Severity of phantom pain B. intermittent claudication
140. The results of a developmental screening of a 4-month old infant indicate a C. venous insufficiency
possible right hip dislocation. The presence of which of the following are D. a psychosomatic episode
the MOST consistent with this diagnosis?
A. Pelvic obliquity, apparent pain on movement of the right hip, and 145. A patient who completes a Phase I cardiac rehabilitation program should be
decreased hip abduction on the left side expected to achieve:
 PEAT 1
A. independence in self-monitored walking D. splinting of the right arm in full elbow extension
B. increased aerobic capacity to physical activity
C. modification of risk factors
D. increased blood pressure at a given workload 151. A therapist wishes to study the effect of cold compression on PROM in a
group of 10 patients. The plan is to apply this compress to the hamstring
146. A therapist has been working with a patient who has a spinal cord injury. To muscles once a day for 5 days. Which of the following experimental designs
document that the patient has been educated about skin care, the therapist is the MOST appropriate for this type of study?
should record that the patient: A. For both the experimental and control groups, gather data from the
A. is unable to tolerate more than 1 hour in a wheelchair patient record
B. has good strength of the scapular depressors and elbow extensors B. For both the experimental and control groups, measure ROM of both
C. is able to state 3 causes of skin breakdown groups on day 5
D. is able to perform 10 push-ups in the wheelchair C. For both the experimental and control groups, measure ROM on days 1
and 5
147. A patient has difficulty palpating the carotid pulse during exercise. The D. For the experimental groups, measure ROM everyday. For the control
patient should be instructed in alternate methods of self-monitoring, because group, measure ROM on days 1 and 5.
repeated palpation is likely to result in:
A. increasing the heart rate 152. During an examination of elbow strength using MMT, the patient supinates
B. decreasing the heart rate the forearm when attempting elbow flexion. Which of the following muscles
C. an irregular heart rhythm is MOST likely doing the major part of the work?
D. increasing systolic BP A. Biceps brachii
B. Brachialis
148. A patient complains of pain lateral to the coracoid process. When palpating C. Supinator
the shoulder to assess the possible cause of the pain, starting at the coracoid D. Brachioradialis
process and moving laterally, the therapist would expect to find the
following sequence of structures: 153. A therapist is treating a patient for limitation of motion following knee
A. lesser tuberosity, biceps tendon, greater tuberosity surgery several weeks ago. The patient’s passive knee extension is lacking
B. greater tuberosity, biceps tendon, lesser tuberosity 15 degrees from full extension, and knee flexion is limited to 95 degrees.
C. lesser tuberosity, coracobrachialis tendon, greater tuberosity Both movements have capsular end feel. Which of the following
D. greater tuberosity, coracobrachialis tendon, lesser tuberosity mobilization techniques is the MOST appropriate for increasing knee
flexion?
149. A factor that MUST be considered in designing an exercise program for a A. Anterior glide of the tibia on the femur
patient with angina pectoris is that when the arms are exercised: B. Posterior glide of the tibia on the femur
A. angina occurs at a lower heart rate than when exercising the legs C. Superior glide of the patella
B. heart rate and BP rise more steeply in relation to workload than when D. Posterior glide of the femur on the tibia
exercising the legs
C. pulmonary ventilation increases less rapidly than when exercising the 154. A patient has pain, swelling and tenderness in the medial border of the hand.
legs The patient also shows changes in the color and temperature of the skin,
D. angina occurs at higher workloads than when exercising the legs hyperhidrosis and progressive joint stiffness in the wrist and hand. The
MOST likely cause of the patient’s signs and symptoms is:
150. A patient spilled boiling water on the right arm when reaching for a pan on A. cervical disc disease
the stove. The forearm, elbow and lower half of the upper arm appear B. raynaud’s phenomenon
blistered and red, with some subcutaneous swelling and pain on touch. To C. reflex sympathetic dystrophy
facilitate optimal function, the therapist should PRIMARILY emphasize: D. carpal tunnel syndrome
A. ROM exercises to the right hand, wrist and elbow
B. application of compression dressings
C. sterile whirlpool to the right upper extremity
 PEAT 1
160. When treating a patient with ankylosing spondylitis, the muscle requiring the
155. When considering a special test for orthopedic assessment of a client, the MOST emphasis for strengthening exercises are the:
validity of the test is important because the: A. pectorals
A. results of the test can be standardized B. hip flexors
B. test measures what it is supposed to measure C. back extensors
C. results of the test are reproducible D. abdominals
D. test can be accurately performed by someone else
161. A 3-month old child has motor and sensory loss in the right upper extremity
156. A patient sustained a Colle’s fracture 8 weeks ago and has been in a cast in the areas innervated by the C5 and C6 spinal nerves. The cause of this
since that time. Immediately after cast removal, the physical therapy birth injury MOST likely is:
intervention for the wrist and hand should MOST appropriately include: A. hemiplegia
A. passive and active assistive ROM exercises B. Erb-Duchenne paralysis
B. progressive resistive exercises C. Spinal Cord Injury
C. grade 4 mobilization techniques D. Klumpke’s paralysis
D. return to pre-fracture level of activity
162. During examination of the jaw opening pattern of the patient with TMJ
157. A patient with TBI is receiving outpatient physical therapy. The therapist problem, the therapist notes early protrusion of the mandible. Which of the
notices that the patient becomes agitated during therapy sessions. To which following mandibular movements MOST likely caused the protrusion?
of the following professionals should the patient be referred for assessment A. Condylar translation
and diagnosis? B. Mandibular depression
A. Occupational therapist C. Condylar rotation
B. Neuropsychologist D. Lateral glide
C. Vocation counselor
D. Speech-language pathologist 163. A patient with multiple sclerosis is referred for physical therapy at home.
Before going home, the patient requires training in bathing, dressing and
158. While a patient is walking in the parallel bars, the therapist observes that the eating. Adaptive devices maybe needed to accomplish this. The therapist
pelvis drops down on the side opposite the stance extremity. This gait should recommend that the patient be seen by:
deviation is an indication of weakness of the hip: A. a social worker
A. abductors of the swing extremity B. an orthotist
B. adductors of the swing extremity C. an occupational therapist
C. abductors of the stance extremity D. a home health nurse
D. adductors of the stance extremity
164. A child who has cerebral palsy has been receiving physical therapy once a
159. A client on a weight loss program has been walking 3 days a week for 15 week for the past month. During the 4 th visit, the therapist instructs the
minutes for the past 3 weeks. To progress the exercise program, which of parents in a daily exercise program for the child, including stretching
the following will MOST likely accomplish the weight loss goal? techniques. The BEST method to ensure correct implementation and carry
A. Maintain the current walking speed and increase the duration to 30 over of the program is for the therapist to:
minutes A. reassess the patient’s ROM one month after instructing the parents
B. Increase the walking speed and keep the duration to 15 minutes B. review the parent’s written notes on the child’s progress
C. Walk 4 days a week and decrease the duration to 10 minutes. C. demonstrate the exercises for the parents and ask them to return for a
D. Changing from walking 3 days to jogging 1 day a week for 20 minutes program check in one week
D. ask the parents to demonstrate the exercises and to return for a program
check in one week

165. An otherwise healthy inpatient is referred to physical therapy following total

hip arthroplasty. The patient reports persistent low energy levels. What
 PEAT 1
medical record information will prove the GREATEST clarification of the A. educate the patient so she can tell others how to assist her
complaint? B. contact social services and arrange for a team and family meeting
A. CO2 value C. refer the patient for home care and document appropriate interventions
B. Hematocrit value D. write a home program and give it to the family
C. Creatinine level
D. Blood urea nitrogen (BUN) level 170. A patient has a history of neck pain that is aggravated by long periods of
sitting. The pain becomes progressively worse by evening. ROM and
166. Excessive upward rotation of the right scapula is noted when the patient strength of the neck and shoulder are within normal limits. Sensation and
attempts to perform shoulder flexion. Which of the following exercises is reflexes are intact in both UE. The patient has a forward head and excessive
MOST appropriate to help correct the excessive scapular rotation? thoracic kyphosis. The MOST appropriate exercise program would include:
A. Right scapular protraction against resistance with the right arm at 90 A. stretching of the neck flexors and pectoral strengthening
degrees of flexion B. upper traps strengthening and pectoral stretching
B. Bilateral scapular elevation with the upper extremity at 180 degrees of C. pectoral strengthening and rhomboid stretching
flexion D. rhomboid strengthening and axial neck extension
C. Wall push-ups with an isometric hold at the end range with the elbows
extended 171. A patient is being examined for medial epicondylitis. With this diagnosis,
D. Bilateral scapular adduction with the arms medially rotated and the therapist would MOST likely expect to find pain over the:
adducted across the back A. origin of flexor digitorum profundus with resisted finger flexion
B. origin of pronator teres muscle with active pronation
167. A patient with Parkinson’s disease has just been admitted to the C. medial epicondyle with passive wrist flexion
rehabilitation unit. The patient is dependent in all transfers and requires D. insertion of the triceps brachii with passive elbow extension
moderate assistance of one person to walk 30 feet with standard walker. In
order to facilitate good carry over for activities, instruction of the family in 172. In treating a patient who has had recurrent anterior shoulder dislocation, the
transfers should occur: therapist should AVOID which of the following extreme shoulder motions?
A. during a home visit after the patient is discharged A. adduction and external rotation
B. just prior to discharging the patient B. abduction and external rotation
C. early in the rehabilitation program C. hyperextension and internal rotation
D. when the family feels ready to take the patient home D. abduction and internal rotation

168. A patient had final approval and checkout of a permanent prosthesis 2 weeks 173. During the examination of a patient with carpal tunnel syndrome, the
ago. The patient now complains to the therapist that the prosthesis is too therapist will MOST likely find:
heavy. The patient will benefit MOST from: A. paresthesia of the medial palmar surface of the hand
A. an evaluation of socket fit by the prosthetist B. weakness of finger extension of the lateral three digits
B. a prescription from the physician for lighter weight prosthesis C. paresthesia of the lateral three digits
C. reevaluation of hip strength by the therapist D. weakness in wrist flexion and ulnar deviation
D. adding a fork strap attachment to the prosthesis

174. Upon removal of a wet-to-dry dressing from a draining wound, the therapist
observes that the skin immediately surrounding the wound is macerated.
169. A patient with left hemiparesis is being discharged from the rehabilitation What should the therapist recommend for future wound care?
center. The therapist has been unsuccessful in getting the family’s A. Continue using current dressing type
cooperation to instruct them in transfers, bed mobility, and safety B. Make the dressing more absorbent
precautions. The MOST appropriate action for the therapist to take is to: C. Leave the dressing on longer between dressing changes
 PEAT 1
D. Change to a pressure type dressing C. A hydraulic lift from her wheelchair to the mat
D. Full, standing pivot transfer to her right side
175. A patient’s severe knee sprain resulted from medial rotation of the femur on
the tibia with simultaneous application of a valgus force while the foot was 179. A patient with complete C4 quadriplegia is working on a program to increase
placed on the ground. Which structures are MOST likely to be involved? tolerance to the upright position. While on the tilt table, the patient begins to
A. Medial collateral ligament, medial meniscus and anterior cruciate complain of a pounding headache, with flushing and profuse sweating. The
ligament therapist should FIRST:
B. Medial collateral ligament, lateral collateral ligament and posterior A. lower the tilt table to a flat position
cruciate ligament B. remove the patient from tilt table and return to room
C. Lateral collateral ligament, medial meniscus and anterior cruciate C. check the patient’s catheter
ligament D. check the patient’s BP
D. Medial collateral ligament, lateral meniscus and posterior cruciate
ligament 180. In physical therapy program planning for geriatric patients, an important
age-related change that should be taken into consideration is:
176. A patient with Guillain-Barre syndrome experiencing progressive paralysis A. the inability to learn new motor tasks
is admitted to the ICU. As a member of the interdisciplinary team managing B. decrease pain sensation
this patient’s care, the MOST appropriate physical therapy intervention C. decrease motivation
would be to: D. the inability to select alternative movement strategies
A. alter the patient’s mechanical ventilation settings
B. develop patient’s medication schedule 181. To achieve maximum reaction of lymphedema following a mastectomy in
C. perform airway clearance techniques the upper extremity by means of a massage, it is MOST important that:
D. discuss the patient’s medical prognosis with the family A. local heat be applied before the massage
B. the upper arm be massaged before the forearm
177. A patient is performing a phase I cardiac rehabilitation exercise session. The C. the hand be massaged before the forearm
therapist should terminate low level activity in which of the following value D. the massage strokes occur in a centrifugal direction
changes from resting level?
A. The diastolic BP increases to 120 mmHg 182. A 6-year-old child with spastic diplegia is walking in the parallel bars. The
B. The respiratory rate increases to 20 breaths per minute child walks with increased trunk and hip flexion. What would be the MOST
C. The systolic BP increases by 20 mmHg appropriate assistive device?
D. The heart rate increases by 20 beats per minute A. Standard walker
B. Forearm crutches
C. Posterior rolling walker
D. Bilateral quad canes

183. A physical therapist is teaching a patient with T12 paraplegia to fall. The
patient walks with bilateral KAFO and bilateral forearm crutches using
178. A therapist is preparing to teach a patient who has Guillain-Barre syndrome swing to gait. The MOST appropriate method to use to prevent injury would
to transfer from wheelchair to a mat table. The patient weighs 150 lbs., she be to:
has poor (2/5) grade in both of her lower extremities and fair (4/5) grade in A. have the patient wear a helmet and practice on a soft padded surface
her left upper extremity; her right upper extremity has normal (5/5) strength. B. give the patient written instructions and illustrations on falling
Which of the following would be the MOST appropriate assisted transfer for C. demonstrate and guide the patient through the correct process of falling
the initial session of this patient? D. demonstrate the correct method of falling
A. Two person lift on her right side
B. Sliding board transfer to her right side
 PEAT 1
184. A patient with a diagnosis of complete SCI at C4-C5 demonstrates a weak
cough mechanism. Which of the following techniques would MOST 189. A patient is undergoing a treadmill stress test. The appearance of abnormally
effectively augment coughing? wide, irregularly spaced QRS complexes on the ECG represents:
A. Manual pushing against the upper abdomen A. ventricular depolarization
B. Positioning the patient in prone B. premature ventricular contractions
C. Pursed-lip breathing C. atrial fibrillation
D. Interrupting the expiratory air stream D. atrial repolarization

185. A patient is referred for recommendation regarding purchase of a wheelchair. 190. A patient who is on bed rest exhibits orthostatic hypotension upon standing
The measurements of the patient while sitting are 16 inches across the widest will MOST likely experience:
point of the hips and 18 inches from the rear of the buttocks to the popliteal A. increase venous tone in the lower extremity
crease. Which of the following wheelchair dimensions are BEST suited for B. inadequate ventricular filling during diastole
this patient’s needs? C. decrease hydrostatic pressure in the capillary beds
A. Seat width and seat depth of 18 inches D. parasympathetic stimulation of the heart
B. Seat width of 18 inches and seat depth of 16 inches
C. Seat width and seat depth of 16 inches 191. Treatment of a patient with hemophilia who has a subacute hemarthrosis of
D. Seat width of 16 inches and seat depth of 18 inches the knee will initially include:
A. active assistive ROM exercise to the knee
186. A physical therapist is designing an exercise program for a healthy, elderly B. instruction of the patient for weight bearing to tolerance
individual. Which of the following types of exercise is MOST stressful to C. gentle resistive ROM exercise to the knee
the cardiovascular system? D. continuous immobilization of the knee in an extension splint
A. Upper limb ergometry
B. Spinal ROM exercise 192. Which of the following is the MOST appropriate intervention for a patient
C. Quadriceps setting exercise with juvenile rheumatoid arthritis who is experiencing painful swelling of
D. Lower limb diagonal PNF patterns both knees?
A. Resistive exercises
187. Which of the following techniques is MOST important prior to discharge for B. Stretching to prevent contractures
a patient who has had myocardial infarction? C. Gentle active exercises
A. Ascend a flight of stairs before discharge D. Walking program
B. Perform prescribed exercises without angina
C. Return to normal daily activity level
D. Take a radial pulse reliably before discharge

193. Which of the following is the MOST appropriate home program for a patient
with chronic lateral epicondylitis?
188. A therapist is evaluating a patient for a wheelchair prescription. The patient, A. Using a forearm cuff to increase loading on the extensor tendons
who lives alone in a small apartment, has bilateral lower extremity weakness B. Performing exercises for wrist strength and stretching
and is unable to stand to transfer. Trunk strength and upper extremity C. Administering iontophoresis with dexamethasone and xylocaine
strength are normal and the patient can transfer independently with a sliding D. Doing friction massage of the brachioradialis tendon
board. The MOST appropriate prescription for this patient is a wheelchair
with: 194. A therapist who works in a home health agency is treating a patient with
A. fixed, adjustable-height arm rests and detachable foot rests diabetes mellitus. The patient tells the therapist that he is no longer taking
B. removable arm rests and detachable swing-away leg rests his insulin. The therapist’s FIRST course of action should be to:
C. fixed arm rests and removable leg rests A. instruct the patient in proper technique for injecting insulin
D. desk-style removable arm rests and fixed elevating leg rests B. contact the patient’s home health nurse
 PEAT 1
C. tell the patient’s family to report this information to the physician B. Daily tetracycline use
D. have the patient perform a urine glucose test while the therapist is in C. Penicillin allergy
the home D. Long-standing calcium supplement use

195. Which of the following methods is appropriate for handling a 1-year-old 200. Which of the following instructions is MOST appropriate for teaching a
child with cerebral palsy who exhibits strong extensor tone in the trunk and patient with C6 quadriplegia to transfer from a wheelchair to a mat?
extremities? A. “Keep your fingers extended, to give a broader base of support”
A. Carrying the child in a sitting position B. “Rotate your head and shoulders in the same direction to the desired
B. Carrying the child over one’s shoulder hip motion”
C. Keeping contact with the back of the child’s head C. “Rotate your head and shoulders in the direction opposite to the desired
D. Picking the child up under the arms motion”
D. “Keep both hands next to your knees to lock your elbows”
196. A patient with left hemiparesis exhibits shoulder subluxation on the affected
side. The patient has a demand-type cardiac pacemaker. Which of the
following interventions should be used only with extreme caution?
A. Manual resistive exercise on the non-affected side
B. Active exercise on the affected upper extremity
C. Functional electrical stimulation to the affected side
D. Biofeedback to the affected side

197. A 5-year-old patient with a closed head injury is exhibiting behavior

consistent with the confused agitated level of cognitive function. During
physical therapy intervention, the patient becomes combative. Which of the
following techniques would be MOST effective in calming the patient?
A. Providing brief moving touch to the face and turning on the patient’s
favorite musical tape
B. Maintaining touch to the shoulders and brightening the room by
opening curtains
C. Removing the patient from the current treatment environment and
placing the patient in a quiet setting
D. Wrapping the patient in a blanket and rocking the patient rapidly

198. The MOST appropriate therapeutic exercise to stretch the neck muscles for
the patient with an acute right sided torticollis is:
A. right rotation and right lateral flexion
B. left rotation and right lateral flexion
C. left rotation and left lateral flexion
D. right rotation and left lateral flexion

199. A therapist evaluates a 65-year-old patient with psoriasis for treatment with
ultraviolet radiation. The patient’s history includes the following: total hip
arthroplasty 1 year ago; penicillin allergy: calcium supplements since
menopause; daily tetracycline use for the past 2 weeks for a urinary tract
infection. Which of these factors should alert the therapist to use extra
caution when applying ultraviolet light?
A. Arthroplasty with a metal implant
 PEAT 1
1. A. The functional position of the wrist and hand describes the position effectively perform proper foot care. Options B & C do not include
from which the optimal function is most likely to occur. This position is feedback that informs the patient about their performance.
described as a) slight wrist extension, b) slight ulnar deviation, c) fingers
flexed at the MCP, PIP & DIP joints and d) thumb slightly abducted. 9. A. Goals of PT intervention for a child with DMD are to retard the
development of contracture and muscle weakness, which could lead to
2. C. During pregnancy and postpartum period, the stretched abdominal functional limitations and thus disability. The PT would also play a role in
muscles are unable to stabilize the lower back, as the legs are raised. determining the appropriate use of assistive devices that could help
Attempting to perform double leg lifts can overwork the abdominal muscle maintain the child’s mobility such as wheelchairs, walkers and orthoses.
and cause damage to the spinal joints. Muscle tone changes and decline in strength cannot be prevented since they
are results of the disease process.
3. A. Exercise intensity can be expressed as O 2 uptake during activity. HR
and O2 uptake have a relatively lower linear relationship. Therefore, 10. D. The long thoracic nerve innervates the serratus anterior muscle.
utilizing a target HR will ensure that the appropriate exercise intensity is Reaching forward above the head (shoulder flexion) would require the
being achieved. Estimation of energy expenditure requires measurement of action of serratus anterior, and long thoracic nerve injury would affect the
O2 consumption that is then calculated into calories metabolized during the motion. The serratus anterior muscle also works in conjunction with the
activity. BP cannot be controlled at specific HR. Exercising at maximal upper and lower trapezius muscle to upwardly rotate the scapula (abduct)
capacity does not achieve aerobic training benefits and is unsafe for the during shoulder flexion. Putting the hand in the back pocket would require
majority of patient population. scapular adduction. Side bending and deep breathing would not require
scapular motion.
4. B. Pressure on the L3 L4 root causes numbness in the anteromedial thigh
and knee and quads weakness. Numbness in the back of the calf and 11. C. During pregnancy, the ligaments soften due to hormonal influences and
dorsiflexor weakness is indicative of L4, L5 and S1 nerve root involvement. allow some degree of separation between joint surfaces. Additional
Numbness and weakness in the thighs, legs and feet and perineum is stretching of the ligaments would result in joint instability or injury, and
indicative of L2 through S1 nerve root involvement. Numbness in the back would not be a goal of treatment. The remaining options are all appropriate
of the calf and atrophy of gastrocsoleus is indicative of the S1 nerve root interventions.
involvement.
12. B. According to the Standards of PT Practice, there should be a written
5. A. The most appropriate mobilization technique for increasing both plan of continuous improvement of quality of care. This includes ongoing
shoulder flexion and medial rotation would be posterior (dorsal) glide. review and evaluation of the PT services provided. Utilization and peer
Lateral glide may be used as a general joint distraction technique. Medial review are two types of review processes.
glide would not be appropriate to increase flexion and medial rotation.
Anterior glide is used to increase extension and lateral rotation. 13. B. A goal should include the following elements: a) Audience; who will
exhibit the skill, b) Behavior; what the person will do, c) Condition; under
6. D. Options A, B & C are techniques used to decrease postural tone, which what circumstances (the position, the equipment that must be available for
is not indicated for this patient. Option D is the most appropriate technique the patient to perform the behavior), d) Degree; how well will the behavior
for improving low postural tone. be done, e) Time span; set an anticipated specific time span in which the
goal will be achieved, and f) Measurable; the outcome must be measurable.
7. C. Wounds heal via a complex process involving re-epithelialization. With Option B meets all the criteria while the other responses do not.
advanced aging, the rate of epidermal proliferation decreases.
14. A. The trochlea of the talus is convex. Therefore, during dorsiflexion of
8. D. Learning the process of foot care is a psychomotor skill and effective the ankle, the talus moves posteriorly relative to the tibia. To facilitate
strategies to teach psychomotor skills include repeat demonstration by the movement of dorsiflexion, one would need to perform a posterior glide of
patient of the skill followed by feedback from the therapist to highlight the talus on the tibia.
what was performed correctly and what areas need improvement.
Reassurance about prevention of infection with proper foot care would 15. D. Aerobic conditioning that occurs during the 12 weeks of cardiac rehab
primarily be a cognitive skill and does not ensure that the patient can will result in a decrease HR both at rest and with exercise. CO 2 elimination
 PEAT 1
and cardiac output would both increase with maximal work. The stroke aching. The skin may turn white, however, the desired effect is numbness
volume would increase during submaximal work. or pain reduction and not skin color.

16. C. A normally distributed sample has a median and mean that are equal in 22. C. Joint mobilization procedures may cause some soreness. The therapist
value. In that type of distribution, the median and mean would be at the should inform the patient of this response to treatment. The patient should
halfway point. One half of the scores (50%) would be distributed above the re-evaluate the patient and could alter the treatment by waiting an extra day
median and one half below. If the median and mean are not of equal value, before the next treatment or by decreasing the dosage. There would not be
the distribution is skewed. If the median is of a higher value than the mean, a need to refer to the physician. The additional exercises would not alter the
the distribution is to the left, if lower, it is skewed to the right. The standard response and there would be no indication of neurological involvement with
deviation is a measure of variability of the mean. The z score is a standard the reported symptom.
score with a mean of zero and a standard deviation of 1. Averaging the two
measures would not be appropriate or meaningful. 23. D. The independent variable can be thought of as the cause or treatment
and the dependent variable can be thought of as the effect or response. In
17. C. Increasing hip flexion is usually contraindicated for THA at 1 month. this case, the TENS is the treatment or independent variable. Continuous
The quadruped position would not be allowed for a patient at 2 weeks post and discrete variables are methods of quantifying variables.
distal radius fracture. There are no precautions for the patient 2 months
following a rotator cuff tear as the motions in quadruped rocking would be 24. A. A patient who is bed bound and immobile will be prone to developing
synonymous with the glenohumeral motions that need to be increased and atelectasis (partial collapse of lung tissue); which can lead to pneumonia.
are achieved in a closed chain position. Frequent position changes with deep breathing and coughing will help
prevent development of atelectasis. Given that this patient is elderly and
18. B. With a muscle grade of fair plus, the patient should not need active does not have diagnosis of secretion retention, vigorous percussion and
assistive exercise. Resistive exercise against gravity would be most vibration is not indicated. Vibration with the head down or standard
appropriate to strengthen this muscle. Since the gastrocnemius in a postural drainage positions will not be tolerated in this elderly patient with
shortened position and lesser its ability to produce tension. Therefore, chronic CHF.
exercising with knee straight put the gastrocnemius on a stretch, increasing 25. C. Radiographs are in orthopedics to detect bony abnormalities. Soft tissue
its ability to produce tension. defects such as disc herniations would not show up on the radiograph. MRI
scans are used to assess degenerative diseases, infarction, tumor,
19. D. The residual limb is pistoning up and down because the socket diameter hemorrhage and congenital anomalies. Myelography is used to assess bone
is too large or the suspension system is inadequate, resulting in skin friction. displacement, disc herniation, cord compression or tumor. Computed
The addition of more socks will enhance fit. tomography (CAT scan) is used to assess the density, displacement of
abnormality of the ventricular system and gray and white matter.
20. D. The fact that backward bending is centralizing the pain is an indicator
that the nucleus of the disc is being moved centrally and the pressure is 26. D. Behavioral objective should be learner centered, outcome oriented,
being taken off the nerve root. Centralization of the pain is also a good specific, and measurable. Option D is the only one that is learner (student)
indicator for PT intervention. oriented and specific to a situation. Options A & C require action by the
clinical instructor, not the student. Option C, which may be a step in the
21. C. Ice massage is usually applied to control pain, edema and inflammation. process is not as learner centered or outcome centered as option D.
In this case, the ice would be used for pain relief and to reduce
inflammation, if present. The dosage for ice massage is determined by the 27. A. During aerobic exercise, there is vascular dilation that occurs in order to
patient’s response, and usually applied until the patient experiences optimize blood flow and the venous system relies on muscular pumping in
analgesia or reported numbness over the area of massage. Although 5 to 10 order to return blood back to the heart. Without a cool-down period, there
minutes may be a usual time for the response to occur, the dosage depends would be no muscular pumping and therefore blood would pool in the
on the patient’s response, not the exact time. The patient will usually feel venous system. Cardiac arrhythmia may occur as well, but is less likely in
the following sequential sensations during the massage: cold, burning, someone without cardiac disease. Cessation of activity by itself would
aching and then finally numbness. The desired effect is numbness, not result in gradual decrease in body temperature and specific exercises are not
necessary. Muscle tightening may occur as a result of metabolites
 PEAT 1
accumulating in the circulatory system, but this would occur as a result of 34. B. All documentation about physical therapy services should readily
the venous pooling. translate the physical findings (impairment) into functional
abilities/limitations.
28. C. The piriformis muscle functions as an external rotator of the hip and it is
thought that the tight piriformis muscle may compress the sciatic nerve 35. C. Of the four options, backward walking is the only one that requires hip
causing pain. Passive internal rotation and resisted external rotation may be extension with concurrent knee flexion and hip flexion with knee extension.
painful. Intervention would call for stretching of the piriformis muscle, not
strengthening it. Modalities such as ice may also be helpful to decrease the 36. C. This patient needs to have functional benefits of tenodesis by allowing
inflammation. the finger flexors to shorten with the wrist extended; therefore, PROM of
the finger flexors should be performed with the wrist in non-functional
29. C. The most appropriate first step (pre-planning) would be to evaluate position of flexion. People with C6-C7 quadriplegia use the tenodesis
existing services within the community and work out a budget for the grasp. This allows the fingers to flex with wrist extension and to open with
project. Options A & B, although important, are things that would most wrist flexion.
likely be done after the practice is up and running. Option D may be done 37. C. With an inversion injury, the tendons of peroneus longus and brevis can
early on in the planning process, but would follow option C. become strained. Swelling with an inversion strain usually occurs over the
anterolateral part of the ankle. Compression and support is most beneficial
30. B. Following an above knee amputation (transfemoral), the residual limb by placing tape stirrups on the lateral side of the ankle, over the tendons of
has tendency to develop contractures in the hip flexors and abductors. the peroneus longus and brevis and pulling the ankle into slight eversion.
Therefore, it is particularly important that the patient be positioned so as to
maintain full ROM in hip extension and adduction. 38. A. Nerve conduction velocity testing is most useful in the evaluation of
peripheral nerve or lower motor neuron status. Therefore, since carpal
31. C. The left limb must function as the main support limb. Any treatment tunnel syndrome is the only one of the conditions that directly involves a
strategy for ambulation must ensure that the remaining limb is optimally peripheral nerve, it would be the most appropriate choice. A
functioning and that the limb is healthy. While the other factors are cerebrovascular accident is an upper motor neuron disorder. Both myotonia
relevant, the integrity of the remaining limb is the greatest concern for this and Duchenne muscular dystrophy are primary muscle disorders.
patient establishing long term functional goals.
39. B. Increasing the sensitivity makes the biofeedback unit more sensitive to
32. D. Signs and symptoms of hip bursitis include the following: severe pain electrical potentials from muscles. As the sensitivity is decreased, it takes
over the bursa area, with pain aggravated by active motion including more electrical activity to trigger the biofeedback unit (i.e. provide an audio
activities such as walking. Signs and symptoms of a sacroiliac joint visual cue to the patient). For use in muscle re-education, the unit should be
derangement include pain directly over the region of the joint and in the low most sensitive during the initial treatment so that the patient is able to
back, in addition to pain with walking. Signs and symptoms of hip fracture recruit enough motor units to trigger the unit. As the patient is able to
will include the following: severe pain in the groin area and tenderness recruit more motor units, the sensitivity is decreased which would require
occurs in the area anterior to the femoral neck. An adductor longus muscle the patient to activate more motor units.
strain would not cause tenderness over the greater trochanter.
33. C. A fall in oxygen saturation below 87% is equivalent to a partial pressure 40. C. Thrombocytopenia is an acute or chronic disease in the number of
of 55 mmHg of oxygen in the blood, which is considered to be moderately platelets in the circulation. The T4 lymphocyte count is used to assess
hypoxemic (low O2 levels). This situation would require increased oxygen immune status in patients with HIV or AIDS. The red blood cell count is
levels in order to be rectified. A rise in carbon dioxide level would not be utilized to assess for presence of anemia and the white blood cell count
alleviated by increased oxygen levels. Complaints of shortness of breath would be examined to determine presence of infection or degree of
can come from a variety of causes and would not necessarily be alleviated immunosuppression.
by increased oxygen levels. An increased heart rate to 150 bpm may be a
normal response to this activity and would not necessarily require increased 41. A. The most common cause of inwardly pointing or “squinting patellae” is
oxygen levels. excessive femoral anteversion. Although there is normally 8-15 degrees of
femoral anteversion, an excessive amount leads to squinting patellae and
 PEAT 1
toeing in. The other options would all have a tendency to cause the patella 47. C. A 20 degrees knee flexion contracture means that the knee is unable to
to point outward during standing. complete the last 20 degrees of extension. This limitation of motion can be
caused by several factors including tightness of the hamstrings
42. C. The oculomotor nerve innervates the levator palpebrae superioris (semimembranosus), restriction in the posterior capsule of the knee, and
muscle that elevates the upper eyelid and the pupillary constrictor muscle. weakness in the quadriceps femoris muscle (vastus medialis). Restriction
Therefore, a lesion of the oculomotor nerve would make it difficult, if not of patellar movement may also be a factor, however the proper glide
impossible for the patient to fully raise the lid (open the eye) and would technique to increase knee extension would be a superior (not inferior) glide
cause a condition termed ptosis. In addition, the eye may not react to light of the patella.
and therefore may not show pupillary constriction when light is directed
into the eye. Inability to fully close the eye would be seen with a lesion of 48. B. A patient with thoracic spinal cord level injury is able to perform
the facial nerve (Bell’s palsy). Medial strabismus would be caused by independent pressure relief strategies and should be complete every 15 to
damage to the abducens nerve, innervating the lateral rectus causing a 20 minutes.
medial strabismus.
43. C. Exercise has been shown to increase sensitivity of insulin receptors 49. D. The soleus originates on the tibia and fibula and inserts onto the
therefore leading to a decrease in the amount required. Administration of calcaneus, crossing only the ankle joint. Therefore, it will have an effect on
medication is dictated by tolerance and efficacy of the medication and the ankle whether the knee is flexed or extended.
would not necessarily be altered by exercise. In patients with moderate
hyperglycemia, exercise can lead to hypoglycemia for periods of 24 - 48 50. A. The restocking of treatment booths with supplies is the only option
hours after exercise, therefore increasing caloric intake, particularly which does not involve direct patient contact or care, and thus is the MOST
carbohydrates, would be essential. appropriate activity to delegate to a volunteer. Although volunteers may at
times be involved with patient care activities (i.e., transporting patients), the
44. B. Wet-to-dry dressings are indicated for necrotic tissue needing patients in the above situations pose a potential risk and would require
debridement. The moderate amount of drainage would require more supervision by someone other than a volunteer.
frequent (i.e., BID) dressing changes. Vigorous scrubbing of the wound
could damage friable tissue. Betadine can be cytotoxic. Whirlpool would 51. A. A state of alertness to the internal and external environment must be
not be effective in removing necrotic tissue maintained for a motor or mental activity to occur. The brainstem reticular
activating system brings about the state of general arousal. To proceed from
45. A. The median nerve supplies sensory innervation to the palmar surface of a state of general arousal to one of “selective attention” requires the
the thumb, index and middle fingers. A positive Tinel’s sign (eliciting a communication of information to and from the cortex, the thalamus, and the
paresthesia while tapping over the carpal tunnel at the wrist) and weakness limbic system and its modulation over the brainstem and spinal pattern
of the opponens pollicis muscle are indicative of carpal tunnel syndrome. generators.
Ulnar nerve compression would cause sensory and motor changes in the
little and ring fingers, not the thumb. Tenosynovitis of the abductor pollicis 52. C. The first step in preparing any education experience is to determine
longus muscle would most likely reveal a positive Finklestein’s test what the needs of the audience are. Since prevention of low back injury is
(stretching of the abductor muscle) with pain over the dorsum of the hand. the ultimate goal, assessment of the employee’s workstations is an
Thoracic outlet syndrome would most likely reveal with special tests that important first step in planning the education program. Simply instructing
cause alteration of radial pulse. all employees in lumbar extension exercises is inappropriate without a
thorough evaluation of their physical needs. Option B cannot be done
46. B. The most efficient stimulus would be one that causes tetany in the unless an assessment of the functional needs has be performed. Providing
muscle without causing fatigue. The biphasic waveform at 30 pps best fit pamphlets are useful teaching adjunct but would not be the first step to
this stimulus. The 100 pps stimulus rate may cause fatigue, which would be prevent low back pain effectively in this population.
undesirable. The interferential waveform at the frequency of 1 pps is too
low and the direct current would not be appropriate because it would not 53. D. The Standards of Practice of Physical Therapy state that the physical
cause tetany. In addition, an on/off cycle of 1:5 would allow adequate therapist is responsible for establishing a plan of care for the patient based
recovery time for the muscles between successive contractions. on the evaluation of the examination data and patient needs. The plan of
care includes plans for discharge. The implication is that the long-term
 PEAT 1
goals for the patient (discharge plans) are determined when the therapist 60. B. Objectives must be measurable and the specific behavior expected
first sees the patient. It is anticipated that modifications of the plan of care should be stated. Understanding, overcoming, and appreciating elude
is to be expected depending on the response of the patient to the tangible measurement, while listing five techniques is an activity that can be
intervention. documented and is therefore measurable.

54. A. The best position for the patient, to drain the posterior segment of both 61. A. The sartorius flexes, externally rotates and abducts the hip joint. With
lower lobes would be prone lying with the head down and lower extremities resisted hip flexion, the sartorius will be recruited to perform all three
and hips elevated about 45 degrees. actions giving the observed substitution pattern. The tensor fascia latae is a
medial (internal) rotator flexor of the hip, so substitution by it would
55. B. The median nerve innervates the following muscles in the forearm: (1) involve medial (internal) rotation and abduction. The adductor longus
pronator teres and quadratus, (2) flexor digitorum superficialis, (3) flexor would adduct the hip. Substitution by the semimembranosus would cause
digitorum profundus (index and middle fingers), three (3) thenar muscles hip extension.
(abductor pollicis brevis, opponens pollicis, flexor pollicis brevis).
Therefore, a lesion of the median nerve would affect those muscles and 62. B. The recommended dosage for mechanical, intermittent pneumatic
their accompanying actions: forearm pronation, finger flexion and thumb compression pressure is between 30 and 80 mmHg (higher for the LE than
opposition. Thumb adduction is accomplished by the adductor pollicis UE). It is also recommended that the pressure be below the diastolic
(ulnar nerve). Finger abduction is performed by the dorsal interossei (ulnar pressure. Pressures below 30 mmHg are not considered to be effective.
nerve). Forearm supination is the action of the supinator (radial nerve) and Pressures above diastolic can be used with caution. For the first treatment,
biceps brachii (musculocutaneous nerve). it would be most appropriate to use a pressure that is considered effective,
yet not so high as to cause a potential problem for the patient. If the patient
56. B. The only one of the above interventions that requires precaution because responds positively to the intervention, the higher pressure could be
of total hip replacement is continuous ultrasound. However, that does not instituted.
mean that ultrasound is contraindicated for this patient. TENS may be used
over metal implants. Hot packs and massage would not affect the total hip 63. D. In order to best intervene with a patient who has had cardiac
prosthesis. dysfunction, a full examination and evaluation is necessary to properly form
a treatment plan. An important aspect of the examination is ascertaining the
57. B. For this patient, the first mobilization procedure would be distraction of type of angina that the patient experience so that the therapist will know
the glenohumeral joint. The distraction separates the joint surfaces and is how to prevent angina with exercise or recognize if it does occur during the
used as a test of joint play. The distraction can also help increase joint play. treatment session. The other options provided are all outcomes that would
Distraction may also be used in conjunction with the other mobilization occur after the patient has completed a cardiac rehabilitation program.
techniques listed. Later, mobilization techniques would most likely include
anterior glide. 64. C. According to the Guide to PT Practice, “Information relating to
58. D. Heterotopic ossification occurs in 10% to 20% of patients with therapist/patient relationship is confidential and may not be communicated
traumatic brain injury. The abnormal bone formation occurs in the soft to a third party not involved in that patient’s care without the prior written
tissue surrounding major joints. Patients with spasticity are at increased consent of the patient”. Option C is the only one that fits these criteria.
risk. Loss of ROM is characteristic for this problem. Osteogenic sarcoma
is less likely. A patellar fracture would not present as a lateral mass. 65. A. Sixty percent (60 %) of children with myelomeningocele develop
hydrocephalus after surgical closure of their lesion. Early warning signs of
59. C. Pain with resisted medial (internal) rotation and pain with passive lateral hydrocephalus include: irritability, changes in sleep patterns, and changes
(external) rotation is indicative of subscapularis tendonitis. Bicipital in appetite and weight. 80 – 90 % of children who acquire hydrocephalus
tendonitis is suspected if resisted supination is painful when the patient’s will require a cerebrospinal fluid shunt. These children require ongoing
arm is at the side and the elbow is flexed to 90 degrees. Painful resisted follow-up by a physician. Given the seriousness of this child’s symptoms,
abduction and resisted lateral (external) rotation is indicative of the child should immediately be referred for medical follow-up.
supraspinatus tendonitis. Pain on resisted lateral (external) rotation is
indicative of infraspinatus tendonitis. 66. D. Bell’s palsy involves the facial nerve. The frontalis is the only muscle
listed that is innervated by the facial nerve. The sternocleidomastoid is
 PEAT 1
innervated by the spinal accessory nerve, and the masseter and temporalis maintain ROM. Option B is the only one that contains all of the correct
are innervated by the trigeminal nerve. actions.

67. A. The abdominal muscles are active during sit-ups (with knees extended) 73. A. Option A is the best answer. In option B, if the patient does not initially
up until the spine is completely flexed (head, shoulders, thorax lifted from understand the information, then having short-term memory is irrelevant.
surface). In order to come to a long-sitting position however, the hips must For option C, hearing and vision are obviously important but the most
be flexed and the abdominals cannot perform this action because they do critical component is comprehension.
not cross the hip joint. Therefore, the hip flexors (iliopsoas among others)
would have to complete this motion. The inability to achieve a long-sitting 74. C. Static alignment for knee stability is established by positioning of the
position would suggest weakness in the iliopsoas muscle. knee so that lateral reference line falls anterior to the knee joint.

68. C. The plantar grasp reflex is characterized by curling of the toes when the 75. B. The center of gravity of a person with bilateral above-knee amputation
child is held supported in standing. The reflex is normal up to 9 months of is more posterior that the center of gravity of a person with their LE intact.
age. Delayed integration of this reflex can result in delayed, independent Setting the back wheels more posteriorly will make the patient more stable
ambulation. in the chair. This adjustment prevents the wheelchair from tipping
backward.
69. C. Placing a crutch in the left hand reduces the magnitude of the right hip
abductor force needed to prevent the pelvis from dropping on the left side 76. B. Although protocols depend on the surgeon and the approach, it is
during the stance phase on the right. Pushing down on the crutch of the generally recommended that anti-gravity hip abduction exercises not begin
right limb reduces the amount of right hip abductor force needed, which is until 5 to 6 weeks post-surgery. Patients are taught to avoid excessive hip
turn reduces the compression force on the right hip joint. This effect is flexion, usually beyond 80 degrees. Bed mobility and ambulation would be
desirable in patients who have hip abductor weakness or hip pain. started 1 to 2 days post-operatively.
70. C. Spinal shock occurs as a reaction to spinal cord injury and is
characterized by an absence of all reflex activity below the level of the 77. D. Posterior muscle tension is implicated in the development of tension
lesion. Depending on the extent of the lesion, the patient may lose all or headaches. Positive imagery is recommended as a self-treatment technique,
some of their sensation and motor activity below the level of the lesion. but the awareness of tension and the appreciation of its absence are
Spasticity is associated with hyperreflexia and increased muscle tone. fundamental. Massage and passive exercise may be relaxing, but the
Spasticity would be expected to develop following the spinal shock stage. patient must be aware of the sensations of tension to prolong the benefit.
Decerebrate rigidity involves sustained contraction of the UE and LE in
extension. With a lower motor neuron lesion, the loss of sensation and 78. B. Anticoagulation therapy inhibits the synthesis and function of clotting
motor activity would be confined to a much smaller region (depending on factors and can lead to bruising (ecchymosis) or more severely, hemorrhage.
the exact lesion) and would not affect all levels below the lesion. A hemangioma is a benign liver tumor, deep vein thrombosis would result
in redness, swelling and warmth in the affected area and most commonly
71. D. The patient’s signs and symptoms are reflective of a right-sided occurs in the calf muscle, not the hip region. A hematocele is a blood cyst.
cerebellar hemisphere lesion. That is, cerebellar lesions commonly produce
hypotonia, hyporeflexia, ataxia and an intention tremor. Cerebellar lesions 79. A. An ST segment depression of greater than 1 mm is indicative of
also produce ipsilateral manifestations in the extremities. myocardial ischemia. Continuing the exercise session could place the
patient at serious risk for continued ischemia, which could ultimately lead
72. B. The common peroneal nerve innervates the following muscles: to myocardial infarction. Therefore, the best response for the therapist
peroneus longus and brevis, tibialis anterior, extensor digitorum longus and would be to stop the exercise session immediately and inform the
brevis, peroneus tertius and extensor hallucis longus. Because of the cardiologist of the patient’s response. All the other options would continue
complete severance, all of those muscles would be affected and would not to place the patient at risk.
be able to actively contract until regeneration has taken place. Therefore,
the patient would completely lose ankle dorsiflexion, eversion and toe 80. A. Infection control requires that the wound not be contaminated further,
extension. Those motions have to be performed passively in order to and that the health care workers protect themselves from disease by
avoiding contact with body fluids. In this case, the patient does not appear
 PEAT 1
to be in life threatening danger, and so the wound should be attended to. 86. B. Options A, C and D are acceptable interventions for this patient. The
Therefore, checking the patient’s blood pressure would not be the first ting epiphyseal areas (growth areas of bones) in children should not be exposed
to do. Once the gloves are donned, cleaning the wound and covering it with to ultrasound. The application of ultrasound over the knee joint (hamstring
a sterile dressing would be appropriate. insertion) could expose the epiphyseal areas to the ultrasound.

81. D. Patients should be encouraged to express their feelings. Comparisons to 87. D. When the knee is extended, the medial and lateral collateral ligaments
other patients who are dying in an effort to assure the patient is not alone, are taut. During knee flexion, the ligaments slacken. Therefore, there is
takes away from this patient’s feelings. Denial of death would not be good very little tibial rotation when the knee is extended (close packed position)
for the patient, since he must ultimately cope with the inevitable. Pastoral and approximately 40 degrees of axial rotation with the knee flexed.
counseling would be an option, but the therapist should be ready to listen to Although the femoral condyles may glide posteriorly (depending on the
the patient, encourage statement of feelings and avoid denial. direction of rotation) on the tibia and the hamstrings may rotate the tibia,
the reason the motion is available is due to laxity in the collateral ligaments.
82. B. The patient taking beta-blocking medication will experience a lower Other ligaments such as the cruciates and the joint capsule may add to the
heart rate and blood pressure response during exercise as compared to a stability in the close packed position.
patient who is not taking this medication. Since the heart rate is lower than
anticipated, using heart rate to monitor exercise intensity may not be as 88. D. Scoliosis deformities are named relative to the convexities of the curves,
accurate. Another measure, such as the Borg Scale (rating of perceived with the apex of the curve defining the vertebral level. In the right thoracic,
exertion) would be more beneficial. However, even though heart rate and left lumbar scoliosis, there is a convex curve to the right the thoracic spine
blood pressure would be lower, the patient actually achieves the same and a convex curve to the left in the lumbar spine. In the thoracic spine, the
metabolic levels during exercise and therefore altering the frequency or body of the vertebrae rotates to the right (convex side) and the spinous
duration of exercise is unnecessary. The time for warm-up and cool-down process rotate toward the left (concave side). Along with this transition, the
exercises is not to be altered. ribs rotate posteriorly on the convex side causing the scapula to become
more prominent on the convex side and causing the shoulder to be elevated
83. A. A non-adherent dressing is best choice because any adherence of the on the convex side.
dressing to the fragile granulating tissue could cause additional trauma.
This is superficial wound, so there would be no need to pack the wound. 89. A. With this particular posture, the patient’s scapula would be in a
Since there is some drainage, a covering is preferential to topical protracted (abducted) position, therefore the scapular protractors are already
medication only. overactive and would require stretching, not strengthening. The kyphosis
suggests that the thoracic erector spinae muscles are weak and need
84. D. Pronation of the foot can be caused by a variety of factors including strengthening. The lumbar lordosis indicates shortened lumbar erector
calcaneal eversion and forefoot varus. Correction of the pronation by an spinae muscles. Forward head posture suggests that the cervical spine is
orthosis could include a medial post (wedge) placed just proximal to the flexed and the occiput is extended, therefore stretching of suboccipital
metatarsal heads or a medial post under the calcaneus. The approach muscles would be indicated. A TEST-TAKING HINT. Although EXCEPT
involves bringing the ground up to meet the foot. A post under the fifth questions are rarely used on the NPTE, be alert for this type of question and
metatarsal head would accentuate the problem, as would a rearfoot post read the responses so that you select the unrelated response.
placing the calcaneus in an everted position. If the patient has excessive 90. D. Compression on the median nerve (carpal tunnel syndrome) is
forefoot varus, a wedge may be placed in the instep in addition to the occurring, most likely as a result of swelling associated with the individual
medial wedge proximal to the metatarsal heads to distribute the load, being in the eighth month of pregnancy. In this case, rest and elevation
however, a wedge in the instep by itself would not be the best intervention. would do the most to decrease the edema and relieve the symptoms. The
wrist should not be positioned in full extension. Initial conservative
85. A. Since most of the joint contracture/adhesion forms in the anterior- treatment sometimes includes cock-up splinting to hold the wrist in neutral
inferior portion of the capsule, treatment to mobilize that portion of the to 10 degrees of extension, but not full extension. Although tendon-gliding
capsule is of primary concern. Inferior glide would stretch the inferior exercises may be used, heat would not be indicated since it may increase the
portion of the capsule. edema. Resistive exercises for the wrist and fingers may aggravate the
compression in the carpal tunnel.
 PEAT 1
91. C. Patients with Parkinson’s disease are characterized by rigidity, 97. D. The current dosage for iontophoresis is calculated by multiplying the
bradykinesia, tremor, lack of associated movements, impaired balance current (4 mA) by the duration (15 minutes). In this case, the calculation
reactions and a flexed posture (kyphosis). Therefore intervention should be would yield a value of 60 mA.min. None of the other options use the
directed toward full ROM and correction of kyphotic posture through back correct value.
extensor strengthening exercises, balance exercise, and exercises that
promote reciprocal movement. Option C is the only one that includes 98. A. The double-upright metal ankle foot orthosis would provide the best
appropriate exercises. support for mediolateral instability and would allow for changes in leg
volume. The plastic solid AFO would not provide as much mediolateral
92. A. Upon heel contact, the heel section compresses partially absorbing the support and because of its conformation of the leg, it would not be
ground impact and thus permitting a controlled plantarflexion. If the heel is advisable for patients who are experiencing changes in leg volume due to
too stiff, upon initial contact, the knee flexes too soon and excessively. An edema. High top shoes would not provide enough support. The spiral AFO
excessively firm heel wedge would not be a factor in late stance. would not provide needed stability to the ankle and the design would not be
indicated with a patient has fluctuating edema.
93. A. A patient with COPD has premature collapse of the airways upon
exhalation, which leads to air trapping and ultimately poor gas exchange. 99. C. Hemoptysis or the coughing up of blood can be benign or severe and
Breathing out through pursed-lips slows the airflow and creates a can be a common occurrence in the cystic fibrosis population secondary to
backpressure, which helps to prevent the airways from collapsing while the pathophysiological processes in their pulmonary system. In general, a
exhaling. By exhaling more fully through pursed-lips, more carbon dioxide small amount of hemoptysis that occurs occasionally or a non-persistent
is removed. By preventing airway collapse and air trapping in the lungs, hemoptysis is benign. The brownish color indicates either venous blood or
the residual volume is actually decreased. Pursed-lipped breathing helps old blood. In this situation, if the hemoptysis does not persist, then it is
with ventilation, but does not necessarily assist with secretion mobilization. appropriate to continue treatment without modification. If the blood was
larger in amount and fresher (denoted by a bright red color), then the
94. C. The dermatome providing sensation to the little finger is innervated by treatment should be discontinued. The presence of blood in the sputum
the C8 nerve root. The triceps brachii is the only one of the muscles listed should not warrant more vigorous chest percussion, until it is deemed
that is also innervated by the C8 nerve root. The biceps brachii, deltoid, and appropriate to continue with the session. Since this situation is a benign
brachioradialis are innervated by the C5, C6 and sometimes C7 nerve roots. scenario, alteration of drainage position is not necessary, and there is no
95. A. Evaluation of the patient’s retention of information presented in the need to send the patient to the emergency room.
program can be enhanced by asking the patients questions about the
program information, having the patient ask questions about the program, 100. C. Isokinetic exercise device utilize accommodating resistance throughout
having the patients demonstrate what they have learned and testing the the range of motion. The other exercises are not forms of accommodating
patient about the program material. Option A is the only one that utilizes resistance.
one of these techniques. The other options do not require active
participation by the patients; they do not address specific interventions. 101. D. Air is released during the stance phase of gait, which results in a
negative pressure inside the socket to provide a suction suspension during
96. C. During the swing phase of gait, the foot is dorsiflexed to clear the foot. swing phase.
Muscles active during this phase of gait are the tibialis anterior, extensor 102. B. With venous insufficiency, the limbs would be edematous, the
hallucis longus and extensor digitorum longus. The gastrocnemius, tibialis superficial veins would be dilated and if not corrected ulceration could
posterior and peroneus longus are active during the stance phase of gait. develop. Options A and C are ruled out because they indicate no edema.
Therefore, of the muscles listed, the extensor digitorum longus is the best Option D is not correct because the condition is relieved by sitting or leg
choice. If only the tibialis anterior was stimulated, the foot would go into elevation.
inversion and dorsiflexion, which could cause the patient to land on the
lateral side of the foot at initial contact causing them injury. Addition of the 103. A. In order to improve knee flexion, the therapist needs to address patellar
extensor digitorum longus would bring the foot up into more dorsiflexion tightness. During flexion at the knee, the posterior motion of the tibia
and avoid excessive inversion. causes the ligamentum patellae to pull the patella distally and posteriorly.
Patellar mobilization in the distal direction would assist with increasing
knee flexion.
 PEAT 1
decision as to the placement of this patient. The best time for such meeting
104. C. The tibialis posterior plantarflexes and inverts the foot. This pattern would be prior to discharge, because after discharge, it is difficult to arrange
requires the specific action of that muscle. The other patterns do not. such meetings. Allowing the patient to determine his own discharge
environment may be fine if there is no safety concern, however a decision
105. C. Pain that is experienced in the thoracic spine can be caused by a variety whether or not the patient is competent to make the decision must be made
of pathologic conditions. Low back pain can be either mechanical or non- first. Scheduling a home visit or the implementation of a treatment plan for
mechanical in nature. Pathology in the kidney may refer pain to the lumbar home care would be premature until a decision on placement has been
spine (ipsilateral flank), or upper abdomen. Pathology in the urinary made.
bladder refers to the subpubic or thoracolumbar region. The diaphragm is 110. D. Sudden tingling of the hands and weakness of muscle groups are
innervated by C3, C4 and C5 with the pain normally confused to the C4 alarming signs of cord compression. The concern is that the spinal cord
dermatome. The negative MRI has ruled out possible involvement of the sustaining further injury. The exercise may be exacerbating or causing
dura mater. these signs. This is considered a medical emergency and the physician
should be immediately advised.
106. A. In order to optimally clear the congestion that has developed in the right
lower lobe, the patient would need to be positioned on the left side to allow 111. D. The primary physical therapy goal in this case would be joint protection
gravity to help drain the secretions to the proximal airways. This patient is and prevention of contractures and adhesions, usually through splinting.
also unconscious and intubated so in addition to drainage, manual There is no evidence to suggest that physical therapy can prevent nerve
hyperinflation is necessary to provide increased ventilation which would degeneration and muscle atrophy, as they are the normal effects of a
help mobilize secretions followed by suctioning to clear out secretions. peripheral lesion. Spasticity would not be present in lower motor neuron
Suctioning first then hyperventilating while in left sidelying less effective injury.
than the order suggested in option A. Positioning on the right side would
not drain the right lower lobe, and also since the patient is lying on the right 112. B. While all of the above would help prevent injury to a diabetic foot, the
side, the only place to percuss and vibrate would be on the left side, which most important information to provide is about proper footwear. Ensuring
has no pathology. Finally, positioning on the left side with deep breathing properly fitting footwear would alleviate risk of skin breakdown as well as
will no be effective in mobilizing secretions, especially since the patient is providing appropriate cushioning to the articular cartilage of the foot joints
unconscious and unable to actively perform breathing exercises that are prone to injury from repetitive trauma and compression. Orthoses
may not be necessary for all patients. Despite moisturizing the skin, if there
107. B. Prednisone is a glucocorticoid that exhibits these side effects. The is improper protection, skin breakdown can still occur. Exercising within
primary side effect of penicillin is an allergic reaction such as skin rashes appropriate parameters will not be beneficial if the patient’s footwear is not
and difficulty breathing. The primary side effect of aspirin is gastritis. The supportive or properly fitting.
primary side effect of gold therapy is diarrhea, irritation of oral mucosa and
skin rashes. 113. B. An intact circulatory system can sustain adequate blood flow to an
elevated limb. A limb with arterial insufficiency may not be able to sustain
108. D. The weakness in the flexors of the 4th and 5th digits at the DIP joint (2/5). adequate blood flow against gravity. The vasodilatation, caused by local
The other fingers show normal strength (5/5). This weakness would mechanisms, occurs in response to ischemia. An acute arterial occlusion
indicate a problem with the flexor digitorum profundus, since the distal creates pallor, but because blood flow is blocked, the reactive hyperemia is
joints are involved. The FDP is innervated by both median and ulnar impaired.
nerves. The median nerve innervates the FDP muscles flexing the index
and middle fingers. The ulnar nerve innervates the FDP muscles flexing the 114. C. The gluteus maximus is a hip extensor that is more active during
ring and little fingers. Therefore, since the ring and little fingers are resisted motions or when the hip is in flexion, especially in functional
involved, the lesion would have to be involving the ulnar nerve. The FDP activities such as stair climbing. In this case, the patient flexes the hip
to the 4th and 5th fingers is innervated by the ulnar nerve roots C8 and T1. placing the gluteus maximus in stretch increasing its ability to produce
tension. Therefore, the patient is leaning forward to maximize the ability of
109. B. The best answer would be for the therapist to recommend a team the gluteus maximus to extend the hip during the stair climbing activity.
conference. That conference would bring together members of the health The other muscles listed would not benefit as much from the increased hip
care team as well as the patient and family members, to arrive at joint flexion.
 PEAT 1
Throwing the trunk backward after initial contact may be due to weakness
115. A. In patients with moderate hyperglycemia, exercise can lead to of hip extensors (gluteus maximus).
hypoglycemia for periods of 24 to 48 hours after exercise. Exercise has
been shown to increase sensitivity of the insulin receptors therefore leading 121. B. The patient’s symptoms would be aggravated by exercises that cause
to a decrease in the amount of insulin required. increases in patellofemoral joint reaction force. One of the goals of
treatment would be to promote proper patellar tracking. Isometric exercises
116. B. A larger print will not simplify the meaning, nor will lengthening the such as quadriceps setting and SLR are most often used for strengthening
sentences. Only option B, the choice and illustrations and a simpler with a diagnosis of chondromalacia patella because they produce smaller
sentence structure is correct. patellofemoral joint reaction forces than some other forms of quadriceps
exercises, and thus are less painful. The vastus medialis is one of the
117. C. A physical therapist would be required to perform the initial evaluation, muscles active during quads setting. This muscle tends to pull the patella
plan of care, re-evaluations, modifications to the plan of care and discharge medially during contraction and thus acts as a dynamic medial stabilizer,
plan for the patient. The patient who is stable and on an existing program which promotes proper patellar tracking. The vastus medialis is not
would be most appropriate patient to be delegated to the assistant. preferentially recruited during a straight leg raising, nor it is the only muscle
Therefore, the patient who has multiple sclerosis who is on an established responsible for terminal knee extension. Patellofemoral compression forces
gait training program would be the most appropriate. The other three are generally less during SLR than when doing extension exercises with the
patients are receiving their initial treatments. knee bent.
122. A. With an extension exercise program, centralization indicate that the
118. B. Normally, as the diaphragm descends with inspiration, it places patient is improving, even through the pain may be just as intense as it was.
increased pressure on the abdominal contents with a resultant distension of Even though the patient may feel frustrated, he is actually improving, and
the epigastric area. Weakness of the diaphragm would decrease the therefore the therapist should continue with the extension exercise program.
distension and may result in a compensatory increase in upper chest There is no need to call the physician at this point, since the centralization is
expansion to improve ventilation. The scalene muscles act to elevate or perfectly normal. Although trunk flexion may be used later in the
stabilize the clavicle during inspiration. The rectus abdominis is a stabilizer intervention, it would not be indicated at this point because extension is
during inspiration and assists with forced expiration. The intercostal working.
muscles act to stabilize the thoracic cage during ventilation.
123. D. An outcome measure documents a desired performance or change in the
119. C. The medical record is owned by the hospital subject to the patient’s patient’s condition over time. This may include a description of the
interest in the information it contains. Unless restricted by state or federal patient’s function before, during and after intervention. Option D does not
law or regulation, a hospital shall furnish to a patient, or a patient’s indicate a change or function, but is focused on attendance.
representative parts of the hospital record upon request in writing by the 124. A. The rib cage would not be able to expand normally during inspiration
patient or their representative. Option C is the only correct answer in this due to weakness of the intercostal muscles, which are innervated by
case, since it specifies that the patient must authorize the release of thoracic nerve segments. With a spinal cord lesion at the C5-C6 level, the
information. diaphragm would still receive innervation from the phrenic nerve (C4). The
anterior scalene (C4-C6) would be partially innervated and the
120. B. The anterior tibialis shows poor (2/5) grade strength during the sternocleidomastoid (C2-C3) would be fully innervated. The abdominal
examination. Because this muscle is active during swing phase of gait and muscles would not be innervated since they receive their innervation from
shortly after initial contact, one would expect to see gait deviation showing thoracic nerve segments. Paralysis of the abdominal muscles would cause
up at those times. Specifically, the anterior tibialis maintains dorsiflexion of the diaphragm to assume a low resting position.
the foot during swing phase and controls plantarflexion after initial contact.
During swing phase, weakness of the anterior tibialis would cause the 125. C. “Information relating the therapist-patient relationship is confidential
patient to increase the amount of hip and knee flexion to prevent toe drag. and may not be communicated to a third party not involved in that patient’s
With weak hip abduction, this patient would be expected to have excessive care without the prior written consent of the patient”. Option C is the only
pelvic rotation. To compensate, the patient would laterally bend toward the one that fits these criteria.
weak (right) side during midstance to help prevent the excessive hip drop.
 PEAT 1
126. C. Inclusion of all members of the health care team into decision-making is stimulation, increasing the inter-electrode distance and the use of larger
important for the patient and provides for continuity of care for the patient. electrodes.
However, the team approach has some pitfalls such as arranging meetings
between team members, which may be a time consuming process. The 132. B. The presence of Dyspnea and the pink, frothy sputum would suggest the
team concept would also assume that the team reaches a consensus that presence of CHF and resultant pulmonary edema. CHF can occur from
require more time than relying on individual decisions that can be made poor cardiac muscle function as a result of myocardial infarction.
quickly. Therefore, option C is the best answer to the question. The other Pulmonary edema occurs from the backflow of blood from the heart into the
three options are advantages of the team concept. pulmonary vessels, increasing pulmonary capillary pressure. The increase
in pulmonary capillary pressure increases fluid movement into the alveoli,
127. A. Rheumatoid arthritis is a chronic inflammatory disease that affects many which are normally dry. These leads to the presence of pink, frothy sputum
body systems including the joint space. Destruction and subluxation of that can be expectorated along the shortness of breath (dyspnea). Positions
joints can occur over time secondary to the inflammation that occurs in the that increase blood flow to the heart, such as lying flat, will increase the
synovium. Fatigue is a common symptom that accompanies RA. signs and symptoms. Therefore, the patient should be positioned with the
Therefore, the patient must get enough rest to avoid excessive fatigue and to head up or as in this problem; the patient should be placed in a sitting
protect the joints from overuse damage. Therefore, education on energy position to help alleviate the symptoms. Laying the patient down flat,
conservation and joint protection is essential to minimize joint deformity. supine or with the legs elevated would exacerbate the patient’s problems.
However, the patient must realize that some activity is good for them to
prevent contractures and maintain strength and endurance. Fatigue and 133. A. The assessment of posture in a wheelchair begins with the pelvis and its
joint pain can and often do co-exist in patients with RA. The pannus in the relationship to its adjacent segments. The orientation and range of mobility
joints is actually increased with rest. Rest does not appear to change the of the pelvis in all three planes will in turn determine the alignment and
activity of the antigen-antibody complex. support needed at the trunk, head and extremities.

128. C. This patient would have functional use of the triceps and finger flexors 134. C. Medical social services deal with home situations, financial supports
and would therefore, be independent for all wheelchair transfers to all and acts, as a resource director on behalf of the patient. Social services
surfaces. Coughing would not be limited and would not be a goal. Rolling would be the most appropriate choice to help arrange and coordinate
would be easily achievable as a short-term goal. Ambulation with forearm rehabilitative services for this patient while they are at home. Although
crutches would not be a reasonable expectation for this patient. nurses, occupational therapists, physical therapists and physicians may all
be involved with direct patient care, they would not be the most appropriate
129. B. Physical therapy intervention should focus on helping the patient obtain for this level of discharge planning.
maximal functional independence. Wheelchair transfers are the means to
enable the patient to be independently mobile and will be a requirement 135. A. In order to place the right middle lobe in an optimal position to drain
before more difficult tasks are performed such as ascending a 10-foot ramp. secretions, a patient would need to be positioned as stated in option A.
The patient is presumably too weak to walk at this point in time. Tub Another way this position may be stated is “left sidelying with quarter turn
transfer is important, but the wheelchair will be the best means to get the towards supine”. The other positions do not optimally drain this lobe.
patient to the tub. Therefore, for the initial intervention session, wheelchair
transfers would be the most important. 136. D. During measurement of shoulder abduction, the spine should be kept
straight. If the patient is allowed to laterally flex the trunk, it will give the
130. A. Raising just the head activates only the recti muscles, and supporting the appearance of increased shoulder abduction, but the motion would be
abdominal muscle with the hands provides external support to the stretched occurring the spine and not in the shoulder. Upward rotation of the scapula
abdominal muscles. This is the optimal position to initiate strengthening and lateral rotation of the shoulder would normally accompany the motion
following delivery for a patient with diastasis rectus abdominis. Doing of shoulder abduction. Medial rotation of the shoulder would decrease the
exercise would not be appropriate. With no support of the abdominal available abduction.
muscles, option C and D would be too aggressive at this time.
137. D. An adverse side effect of prolonged prednisone use, in this case for 4
131. A. Several things can be done to decrease the current density and the years, is muscle degeneration and therefore achieving increases in muscle
possibility of skin irritation. These include decreasing the intensity of the strength may be limited. Since muscle strengthening may be limited, then
 PEAT 1
isokinetic exercise would not necessarily be more beneficial. Prednisone 144. C. With arterial insufficiency, elevation increases ischemia and therefore
may lead to a decrease in bone density, not an increase. Four years after pain. Intermittent claudication is a phenomenon associated with metabolic
transplantation, the patient will have been out in the community and the demands exceeding the capability of the vascular system to supply adequate
need for an isolation room is unnecessary. blood flow. Placing the limb in a dependent position increases swelling and
138. D. The open weeping rash may be infected. Skin infections are easily therefore possibly pain with venous insufficiency. An objective sign such
spread in training from environment, and if not attended to correctly may as purple discoloration rules out a psychosomatic episode.
infect more people. If an infection were suspected, the precise diagnosis
would be made by means of a culture. There the most appropriate action 145. A. The primary physical therapy goal of phase I cardiac rehabilitation is to
would be to refer the patient to the team physician. Moist heat increases the achieve a safe and independent level of activity that can be carried out at
infection by increasing blood flow. An emergency room visit would not be home. Increasing aerobic capacity cannot happen until phase III, when
indicated at this time. Occluding the wound with more pre-wrap creates an cardiac tissue has healed fully. Modification of risk factors is a life-long
environment ideal for infection. process and will not be achieved during a short in-patient stay. Systolic BP,
when exercising, during the in-patient stay should only rise approximately
139. C. The previously amputated left limb must function as the main support 20 mmHg above resting.
limb. Any treatment strategy for ambulation must ensure that the left limb
is functioning optimally. While the other factors are relevant, the previous 146. C. Option C is the only one stated clearly in education terms. The other
ability of the patient to ambulate is the greatest concern. options are objectives based on observation.

140. B. Physical findings of congenital hip dislocation include asymmetric skin 147. B. Pressure receptor (baroreceptors) are present in the carotid sinus and
folds of the buttocks and adductor region; limitation of passive hip these receptors respond to changes in BP. An increase in blood pressure
abduction; leg length inequality; and telescoping of the flexed and adducted that is sensed by these receptors will stimulate the parasympathetic system
thigh on the pelvis. to decrease the rate and force of contraction of the heart in order to help
lower the pressure. Repeated palpation in the carotid sinus area may
141. B. The C5 and C6 myotomes include the biceps brachii, brachialis, stimulate an increase in BP and cause this reaction. Therefore increased
brachioradialis and deltoid muscles. The elbow flexors and supinators (C5- heart rate and blood pressure are incorrect. Irregular heart rhythms
C6) are used to carry a teddy bear in the crook of the arm. Pushing a wagon generally result from electrolyte imbalance and/or ischemia to the
requires the use of the triceps (C7-C8). Holding a raisin requires the conduction system of the heart.
presence of wrist flexors (C6-C8). Grasping a cup requires finger, thumb
and wrist muscles (C6-C8, T1). 148. A. Starting at the coracoid process and moving laterally, one would palpate
the following structures: (1) lesser tuberosity, (2) biceps tendon and (3)
142. A. In order to open up the intervertebral foramen, it would be best to flex greater tuberosity. Any other order of structure palpation would be
or at least flatten the lumbar spine prior to applying the traction. Of the incorrect.
above options, positioning the patient supine with the hips and knees flexed
would be the best way to do this. Laterally bending the trunk to the left 149. B. Heart rate and systolic blood pressure responses are higher for any given
would also open up the foramen, but this is not one of the options. Supine workload when performed with the upper extremity as compared to the
with hips and knees straight and then laterally shifted to the right would lower extremity. Angina is determined by a certain myocardial workload
tend to close down the intervertebral foramen. Prone would also close the that is represented by the product of heart rate and systolic blood pressure.
foramen. Sidelying with bolster under the right lumbar spine also tends to Therefore option A cannot be a conclusive statement. Pulmonary
close the foramen. ventilation has less definitive responses but in general would be similar in
that upper extremity exercise would cause a greater ventilatory response
143. A. Prone standers are used frequently for children who cannot achieve or than lower extremity exercise would. Since heart rate and blood pressure
maintain upright standing. The benefits from the physiologic changes would be higher at any given workload with upper extremity exercise, then
associated with weight bearing and from the social and perceptual angina would most likely occur at a lower workload.
opportunity to see the environment from an upright position.
150. A. The patient will be reluctant to move the limb because it is painful.
ROM is essential to regain and maintain a functional ROM. In this case,
 PEAT 1
the physical therapist’s primary goal is to restore function with ROM 157. B. Because the problem is a behavioral disorder, the most appropriate
exercises. Compression dressings, whirlpool and splinting are all person to assess this patient would be a Neuropsychologist. The
acceptable aspects of care that help in restoration of ROM. However, Neuropsychologist is trained to assess intellectual, emotional and coping
functional ROM would be the primary goal. functions of the patient as well as levels of depression and anxiety. They
151. C. The most appropriate design would be a two-group pretest-posttest. could also provide consultation to the rehabilitation team members as to
Both groups are measured at the same time, but only the experimental how to deal with the problem.
group receives treatment. Gathering information from patient records may
not provide the same accuracy as if the researcher had performed all the 158. C. The abductors are particularly active during the midstance phase (single
measurements directly. Measuring ROM only on day 5 would not account limb support) of gait to prevent the contralateral pelvis from excessive
for any pretest differences between groups. lateral tilting. Weakness of the hip abductors, particularly the gluteus
medius, causes the hip to drop down on the side opposite the weakness. For
152. A. The biceps brachii is both an elbow flexor and supinator, and it is most example, weakness in the right gluteus medius would show up during
effective as a supinator with the elbow flexed to about 90 degrees stance phase on the right by excessive downward movement (lateral tilt) of
(approximately the muscle resting position). The brachialis does not cause the left pelvis. The hip adductors are active during terminal stance and
supination (only flexion). The supinator does not flex the elbow. The through midswing and would not play a role in controlling the lateral
brachioradialis would move the forearm to midposition rather than fully rotation of the pelvis. The hip abductors show little activity during swing
supinating it. Therefore, when the elbow both flexes and supinates, the phase.
biceps brachii would be the most likely muscle causing this action.
159. A. The optimal exercise duration for achieving weight loss with a walking
153. B. During normal knee extension, the tibia moves posterior relative to the program is 40 to 60 minutes of continuous aerobic activity. Therefore once
femur. Therefore, posterior gliding of the tibia would promote knee flexion. a patient is safely tolerating 15 minutes, the best progression is to increase
Superior glide of the patella could be used to increase knee extension. the duration while maintaining the same intensity or walking speed.
Posterior glide of the femur on the tibia would be used to increase knee Increasing walking speed should only be performed once the patient can
extension. consistently tolerate 20 to 30 minutes of exercise. Decreasing the duration
while increasing the frequency of exercise would not accomplish the goal of
154. C. All of these manifestations are indicative of reflex sympathetic 40 to 60 minutes of continuous exercise. A patient who has been walking
dystrophy syndrome. Cervical disc disease does not produce swelling in the for only 15 minutes 3 times/week would not be ready to begin jogging and
hand, color and temperature changes or hyperhidrosis. Raynaud’s jogging one time per week would be too low of an exercise frequency in
phenomenon results in pain, pallor and coolness, but no hyperhidrosis. general to achieve by training benefit.
Although carpal tunnel syndrome can also show sympathetic nervous
system abnormalities, compression of the median nerve would refer 160. C. Trunk ROM exercises and strengthening to minimize thoracic kyphosis
symptoms to the lateral border of the hand (thumb area). With carpal tunnel are essential. Persons with ankylosing spondylitis tend to assume flexed
syndrome, the patient may also display thenar muscle weakness. postures. Disproportionately strong pectorals, hip flexors, or abdominals
could worsen the kyphosis.
155. B. Option B is the definition of validity. Options C and D for reliability
measures. Results can be standardized even though they are not valid. 161. B. A brachial plexus injury that affects the C5 and C6 nerve roots is termed
Erb-Duchenne paralysis. A lesion affecting the C8 and T1 roots is termed
156. A. The primary physical therapy goal at this time is to restore ROM. Klumpke’s paralysis. Hemiplegia and spinal cord injury would be caused
Therefore, the most appropriate intervention for that goal is passive and by trauma to the CNS and would not normally affect just the C5 and C6
active assistive ROM exercises. Although gentle joint mobilization nerve roots.
techniques may be indicated, grade 4 techniques at this time would not be
appropriate. Progressive resistive exercises would come later in the plan of 162. A. The protrusion component involves the arthrokinematic movement of
care. Although the long-term goal would be to return to normal activities, anterior condylar translation. Mandibular depression (jaw opening)
the short-term goal would not. involves both condylar rotation and anterior translation. However, this
question is asking only about the protrusion component. Lateral glide
 PEAT 1
involves anterior translation on the contralateral side and spin on the trained to help resolve family issues that arise and would be the best person
ipsilateral side. to lead a team of caregivers and family members in deciding the appropriate
action in this case. Educating the patient would only put more burden on
163. C. The occupational therapist would be the most appropriate member of the them without guaranteeing results. A referral for home care may be
health care team to teach the patient the needed self-care skills. The appropriate, but the social worker would be the best person to make such
occupational therapist would also be able to provide the patient with contact. Writing a home program for the family would not address the need
information regarding modifications to the home environment that would to instruct family members in person.
increase the patient’s independence. The occupational therapist could teach
the patient how to use adaptive devices and help with the fabrication of 170. D. The history suggests that prolonged improper positioning of the cervical
splints or self-care aides. spine resulted in neck pain. A chronic forward head and kyphosis results in
164. D. The therapist should observe the parents performing the program as hyperextension in the upper cervical spine and excessive flexion in the
instructed to ensure correct implementation. The parents should return in upper thoracic spine. Further muscle length adaptation occurs with tight
one week for another demonstration to determine if they can correctly anterior muscles and stretched posterior muscles. Treatment should include
repeat the program as previously instructed. correction of muscle weakness or imbalance. Rhomboid strengthening and
axial neck extension are the only options that are both correct.
165. B. The hematocrit value provides the percentage of red blood cells in
plasma. A decrease in the number of red blood cells (anemia) would lead to 171. B. The lesion is most likely a tendonitis involving a muscle or muscles that
a decreased oxygen carrying capacity in the blood and therefore less oxygen originate from the medial epicondyle of the humerus (i.e., pronator teres,
to the tissues would lead to fatigue. The carbon dioxide value would be palmaris longus, flexor carpi radialis and ulnaris, and flexor digitorum
examined to assess a patient’s respiratory status while creatinine and BUN superficialis). Pain would be elicited with active contraction of the
levels are examined in relation to kidney function. involved muscle (or muscles) or when the muscle/s is/are passively
stretched. Resisted wrist flexion and pronation would cause pain over the
166. D. Excessive upward rotation of the scapula can result from weakness of origin of the pronator teres. Options A, C and D do not meet the criteria for
the rhomboids and latissimus dorsi (downward rotators). The scapular eliciting pain.
adduction with medial rotation and adduction of the arm would require
action by those muscles. Option A would help strengthen the serratus 172. B. The mechanism that creates an anterior dislocation of the shoulder is
anterior, an upward rotator of the scapula. Option B would activate the forced abduction and lateral (external) rotation of the shoulder. This
upper trapezius as well as the rhomboids and since the upper trapezius is frequently results in a tear of the anterior portion of the capsule. Abduction
also an upward rotator the scapula, this would not be the best exercise to and external rotation may subject the patient to recurrent subluxations
use. Option C also helps strengthen the serratus anterior, which would tend and/or dislocations and should therefore by avoided.
to aggravate the problem.
173. C. In carpal tunnel syndrome there is pain and paresthesias in the median
167. C. The family should be involved in all stages of planning and treatment. nerve distribution of the hand, which includes the lateral three digits. There
Family involvement can shorten the rehabilitation process and patient’s is weakness of the abductor pollicis brevis, but not of the wrist flexors or
return to the community. It is important to have the family involved early in finger extensors.
the rehabilitation process rather than wait until the patient is ready to be
discharged. 174. B. Macerated tissue results from excessive moisture. A more absorbent
dressing would soak up the excessive moisture and prevent maceration.
168. C. A complaint of heaviness likely reflects weakness. The complaint is not
the fit or comfort of the prosthesis. So option A is incorrect. The expense 175. A. A combination of valgus, flexion and external rotation forces applied to
of obtaining a lighter prosthesis is not justified without determining if the the knee while the foot is planted on the ground results in damage to the
solution is strengthening of the muscle groups, which controls the anterior cruciate ligament, medial collateral ligament and medial meniscus.
prosthesis. A fork strap attachment will assist with suspension, but will not
reduce the weight of the prosthesis. 176. C. The key phrase in the question is “interdisciplinary”. Of all the options
169. B. Of the options above, a social worker (social services) would be the provided, only airway clearance is within the scope of practice for physical
most appropriate person to intervene in this case. The social worker is therapists. Patients with Guillain-Barre syndrome may experience
 PEAT 1
respiratory muscle fatigue or paralysis and are susceptible to pulmonary Without first demonstration and then allowing the patient to practice, the
infection. Pulmonary hygiene is a critical role in their care. patient could be place at risk for injury. Therefore, options A, B & D are
not adequate to ensure patient safety.
177. A. During phase I (in-patient) cardiac rehabilitation, vital sign parameters
with activity that warrant termination are: diastolic blood pressure of 110 184. A. In order to cough effectively, the abdominal muscles must contract to
mmHg or greater, systolic blood pressure above 210 mmHg or an increase expel air forcefully. This patient does not have this ability; therefore
greater than 20 mmHg from resting and a heart rate that increases beyond manual force against the abdomen would mimic the action of the abdominal
20 beats per minute above resting. The normal resting respiratory rate can muscles. The prone position would not assist the cough mechanism in this
range between 12 to 20 breaths per minute in adults, so an increase to 20 patient. Both pursed-lipped breathing and interrupting the expiratory air
breaths per minute with low-level activity would not be a reason to stream would decrease the force of exhalation and decrease cough
terminate the activity. effectiveness.

178. B. Because this patient has significant weakness in both lower extremities, 185. B. The seat width should be slightly wider than the width of the widest
a standing pivot transfer would not be safe. However, since the patient does body part and depth should come to within 1 inch of the popliteal fossa.
have fair to normal upper extremity strength, and is not totally dependent, a
hydraulic lift or two person lift would not be appropriate because it would 186. A. Heart rate and systolic blood pressure responses are higher for any given
not be enhancing the patient’s functional skills. The most appropriate workload when performed with the UE as compared to the LE. Spinal
transfer method would be for the patient to use a sliding board transfer to motion does not create much stress on the cardiovascular system. The
her strongest right side. quadriceps setting and diagonal patterns are performed with the LE and
would produce less cardiovascular stress.
179. C. These are signs of autonomic dysreflexia. Among the most common
cause is a distended or irritated bladder. The FIRST step is to remove the 187. D. There is normal, linear relationship between heart rate and exercise
noxious stimulus. intensity in patients who are not on beta blocker medication or who are on
non-rate responsive pacemakers. Therefore, teaching patients to take their
180. B. Neurological changes that are age-related include decreased pain and pulse reliably before discharge is important learning objective to ensure
vibratory sensation. The other changes listed do not normally occur with safety with exercise upon discharge. Ascending a flight of stairs before
aging in the absence of pathology. discharge is only appropriate if the patient needs to negotiate stairs at home,
but not as important as pulse monitoring. Performing exercises without
181. B. Massaging the upper arm before the forearm helps reduce the proximal angina can be achieved by monitoring HR with exercise; therefore, taking a
resistance of lymphatic flow, which will optimize the flow of fluid or edema pulse is necessary. Returning to normal daily activity immediately after a
from the distal areas. This has been referred to as the “uncorking effect”. myocardial infarction is an unreasonable objective, as it will take 6 to 8
Local heat would cause vasodilation and may increase edema. Massaging weeks for the myocardium to heal; therefore, activity levels will need to be
the forearm would not allow the “uncorking effect” to occur. The massage tempered in order to protect the heart while it is healing.
strokes should be from distal to proximal (centripetal) direction.
188. B. In order to facilitate transfers utilizing a sliding board, the patient will
182. C. The use of posterior walker has been found to encourage a more upright need both removable arm rests and detachable swing-away leg rests. Fixed
posture during gait and to promote better gait characteristics than does the arm rests make sliding board transfers extremely difficult and unsafe. Any
use of an anterior walker. A standard walker, forearm crutches and bilateral other options would not be optimal for this particular patient’s needs.
quad canes all emphasize trunk and hip flexion, which is already increased
for this child. 189. B. The QRS complex represents ventricular contraction. Atrial contraction
is represented by the P wave. When an area of the ventricle becomes
183. C. If patients are skilled in falling, they are less likely to become injured irritable and develops an ectopic foci, the ventricle will depolarize
during a fall. The patient demonstrating or performing the task best prematurely before the normal conduction sequence (e.g., prior to SA node
understanding of a skill. To accomplish this, the patient should be given a firing in the atria) and presents a wide, irregularly shaped QRS complex. In
demonstration of proper falling technique and then the patient should be normal ventricular depolarization, the QRS would be narrow and regularly
allowed to practice while being guided and guarded by the therapist. spaced and atrial fibrillation would appear as the P wave changes. Atrial
 PEAT 1
repolarization occurs within the QRS complex and is not normally visible 196. C. Electrical stimulation for patients with demand-type pacemakers is often
on EKG. listed as contraindication. However, even though it is often listed as
contraindication in textbooks, research studies apparently have not
190. B. Orthostatic hypotension from bed rest occurs as a result of decreased substantiated the suspected risks. Nonetheless, it should only be applied
venous tone, which will lead to a pooling of blood in the LE upon standing. with caution and close supervision in these patients. Exercise, unless very
The pooling of blood in the LE will reduce the amount of blood returning to strenuous, would be indicated in this patient. Biofeedback introduces no
the heart decreasing ventricular filling and ultimately decreasing cardiac electrical signals into the body and therefore would not be contraindicated.
output. This results in drop in BP with resultant dizziness. With pooling of
blood in the LE, the hydrostatic pressure would increase. To compensate 197. C. Sensory inputs such as intermittent music and touching the face, rocking
for the decrease in cardiac output, the sympathetic system (not the the patient rapidly and brightening the room elicit arousal. When a child
parasympathetic) would stimulate the heart. becomes agitated and confused, it is appropriate to reduce the general
amount of environment stimulation. Decreasing auditory and visual activity
191. A. The stage of hemarthrosis will mean that there is still some bleeding into in the room may help the child focus.
the joint space, but not as extensively, therefore the patient will benefit from 198. D. Isolated contraction of the right sternocleidomastoid muscle would
ROM exercise to prevent contracture. The patient may need active-assist, cause the head to rotate the left and side bend (lateral flexion) to the right.
as there may still be pain or edema in the joint that prevents independent To stretch the muscle, the opposite actions would be performed on the
performance of ROM. The mechanical trauma of weight bearing to patient by the therapist; rotation of the head to the right and lateral flexion
tolerance at this stage may impinge and damage the pathologic synovium to the left.
within the joint. Resistive ROM is more appropriate when pain and
swelling have subsided and no bleeding is occurring. Continuous 199. B. Caution should be used in patients who are taking tetracycline, because
immobilization in the extended position will promote contracture in the drug will enhance the effects of ultraviolet radiation. Ultraviolet is not
edematous knee. contraindicated in these patients, however the dosage of the ultraviolet
would probably have to be adjusted to some lower level. The penicillin
192. C. All of the options, except for gentle, active exercises, are precautions or allergy, calcium supplements and metal implants would not be affected by
contraindications for this patient. the ultraviolet light. It should be noted that although UV radiation therapy
is not common in today’s practice of physical therapy, therapists should
193. B. Lateral epicondylitis is caused by overuse of wrist extensors that nonetheless be aware of the precautions; and be able to advise patients who
originate on the lateral epicondyle of the humerus, especially the ECRB. If may be using UV radiation at home.
the lateral epicondylitis is at a chronic stage, conditioning of the extensor
muscles and sustained grip activities will be most effective in long-term 200. C. The position described creates the necessary force to move the lower
management. A forearm cuff is thought the muscle loading. Iontophoresis body in this transfer given the level of SCI. Finger extension against
would not be appropriate for a home program. Friction massage of the resistance would be difficult for a patient with C6 quadriplegia. The
brachioradialis would not be appropriate since the ECRB muscle is usually patient’s hands would be kept near the thigh or hips with one hand on the
the one affected. mat and one on the wheelchair.

194. B. Contacting the patient’s home nurse is the appropriate first course of
action because of the possible safety risk associated with the patient not
taking their insulin. Injections and glucose testing would go beyond the
scope of practice of physical therapy. Placing the responsibility on the
family would not be appropriate because of the gravity of the situation.

195. A. The sitting position promotes visual attending, use of the UE and social
interaction. A child who exhibits extensor posturing should be carried in a
symmetric position that does not allow axial hyperextension and keeps the
hips and knees flexed.
PEAT 1