Medical-Surgical Physical Therapy
Exam Questions
Course Introduction
Medical-Surgical Physical Therapy is a comprehensive course that focuses on the evaluation, management, and rehabilitation of patients undergoing medical or surgical treatment for a variety of conditions. Emphasizing the role of the physical therapist within interdisciplinary healthcare teams, this course covers key topics such as patient assessment, pre- and post-operative care, rehabilitation protocols for common medical and surgical disorders, and strategies to optimize functional outcomes. Students will develop practical skills in designing individualized treatment plans, facilitating patient recovery, and addressing complications related to mobility, cardiopulmonary function, wound healing, and pain management in acute care and outpatient settings.
Recommended Textbook
Essentials of Cardiopulmonary Physical Therapy 4th Edition by Ellen Hillegass
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22 Chapters
681 Verified Questions
681 Flashcards
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Page 2
Chapter 1: Anatomy of the Cardiovascular and Pulmonary Systems
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30 Verified Questions
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Sample Questions
Q1) Regurgitation or insufficiency of the mitral valve causes blood to accumulate in which of the following heart chambers?
A)Right ventricle
B)Left ventricle
C)Right atrium
D)Left atrium
Answer: D
Q2) Which of the following upper respiratory structures provide humidification?
A)Nasopharynx
B)Pharynx
C)Larynx
D)Nasal cavity
Answer: D
Q3) Irritation of the phrenic nerve supplied pleura results in which of the following pain referral patterns?
A)Thoracic wall
B)Abdominal wall
C)Mediasternal region
D)Lower neck and shoulder
Answer: D
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Chapter 2: Physiology of the Cardiovascular and Pulmonary Systems
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Sample Questions
Q1) Compliance is BEST explained by which of the following statements.
A)The tendency of a structure to return to its initial size after being distended
B)The pressure that acts to collapse the alveolus and increase the pressure of air within the structure
C)The tendency of a force that exists to collapse or recoil the structure while inflated
D)The pressure that allows changes in lung volume to parallel changes in thoracic excursion during breathing
Answer: C
Q2) Which of the following statements is MOST correct about surfactant?
A)Diminishes the overall surface tension of the alveoli to keep air in smaller alveoli.
B)Pulmonary surfactant is composed of a single class of molecules.
C)Compression of the surfactant molecules decreases their density.
D)Surfactant develops early in fetal life.
Answer: A
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Chapter 3: Ischemic Cardiovascular Conditions and Other Vascular Pathologies
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Sample Questions
Q1) Which of the following layers of the coronary arteries is selectively permeable to low-density lipoprotein (LDL)leading to the possible development of myocardial ischemia?
A)Adventitia
B)Media
C)Intima
D)None of the above
Answer: C
Q2) Which of the following risk factors is considered nonmodifiable?
A)Cigarette smoking
B)High blood pressure
C)Increased age
D)Physical inactivity
Answer: C
Q3) The accumulation of lipids by monocytes between endothelial cells is termed:
A)foam cells.
B)fibrous cap.
C)thrombus.
D)Sclerosis.
Answer: A
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Chapter 4: Cardiac Muscle Dysfunction and Failure
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33 Verified Questions
33 Flashcards
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Sample Questions
Q1) A breathing pattern characterized by waxing and waning depths of respiration with recurring periods of apnea is termed which of the following?
A)Paroxysmal nocturnal dyspnea
B)Tachypnea
C)Cheyne-Stokes respiration
D)Orthopnea
Q2) In normal cardiac neurohumoral function,beta -adrenergic receptors facilitate which of the following physiological changes?
A)Increases heart rate and myocardial force of contraction.
B)Promotes vasodilation of capillary beds.
C)Activates the inhibitory G protein and inhibits adenylate cyclase.
D)Transmits stimulatory (Gs)or inhibitory (G1)signals to the catalytic unit.
Q3) Which of the following pathological conditions may lead to congestive heart failure (CHF)?
A)Hypertension
B)Renal insufficiency
C)Pulmonary embolism
D)All of the above
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Chapter 5: Restrictive Lung Dysfunction
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Sample Questions
Q1) The distribution of inspired air and pulmonary blood flow becomes less homogeneous with increasing age.This age-related change contributes MOST to which of the following clinical manifestations?
A)Left shift of lung compliance curve
B)Sleep ventilation is altered
C)Decreased maximal ventilatory effort
D)Reduced diffusing capacity
Q2) Ventilation-perfusion mismatching in restrictive lung disease leads to which of the following classic signs?
A)Tachypnea
B)Hypoxemia
C)Low lung volume
D)Pulmonary hypertension
Q3) Hallmark symptoms of restrictive lung disease include dyspnea,an emaciated appearance,and which of the following?
A)Chest wall pain
B)Wet,productive cough
C)Dry,nonproductive cough
D)Fatigue
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Chapter 6: Chronic Obstructive Pulmonary Diseases
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Sample Questions
Q1) Bronchiectasis characterized by bronchi that are distorted and bulging is more specifically termed which of the following types of bronchiectasis?
A)Varicoid bronchiectasis
B)Cylindrical bronchiectasis
C)Saccular bronchiectasis
D)Atypical bronchiectasis
Q2) Chronic obstructive pulmonary diseases (COPD)are diseases of the airways that produce obstruction to expiratory airflow.Which of the following problems relates to COPD?
A)Inflammation of mucosal lining of airways
B)Retained secretions
C)Bronchial constriction related to spasm of the smooth muscle
D)All of the above
Q3) Which of the following pathological changes results in lung recoil reduction in a patient with chronic inflammation secondary to inhalation of cigarette smoke?
A)Narrowing of small airways
B)Increased numbers of inflammatory cells
C)Reduction in airway remodeling
D)Loss of alveolar attachments (tethers)
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Page 8
Chapter 7: Cardiopulmonary Implications of Specific Diseases
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Sample Questions
Q1) The MOST common cardiovascular problem in patients with human immunodeficiency virus (HIV)is which of the following?
A)Pericardial effusion
B)Biventricular hypertrophy
C)Hypertension
D)Cardiac arrhythmias
Q2) Which of the following pathological conditions is MOST likely to occur secondary to obesity-related chronic daytime alveolar hypoventilation (PaCO ³45 mm Hg,PaO <70 mm Hg)?
A)Respiratory alkalosis
B)Hypercapnia
C)Metabolic acidosis
D)Anemia
Q3) Research evidence supports which of the following interventions as being the MOST likely have the greater short- and long-term weight loss among obese and overweight adults?
A)Moderate-intensity activity
B)Diet modifications
C)Moderate-intensity activity plus diet modifications
D)Behavior modifications
Page 9
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Chapter 8: Cardiovascular Diagnostic Tests and Procedures
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Sample Questions
Q1) Which of the following target international normalized ratio (INR)values for anticoagulative therapy is MOST appropriate for patients with prosthetic heart valves?
A)1.8 (1.5-2.0)
B)2.5 (2.0-3.0)
C)3 (2.5-3.5)
D)3.5 (3.0-4.0)
Q2) Which of the following imaging modalities is often the diagnostic tool of choice over the PET imaging for measuring myocardial perfusion?
A)Computed tomography
B)Single-photon emission computed tomography (SPECT)
C)Electron beam compute tomography
D)Magnetic resonance imaging
Q3) An elevated international normalized ratio (INR)should alert the therapist to consider which of the following?
A)Avoid having the patient walk a long distance due to low endurance.
B)Avoid out-of-bed physical activity due to low oxygen-carrying capacity.
C)Be cautious about moving the patient from supine to stand quickly.
D)Be cautious about bumping extremities with all movements.
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Chapter 9: Electrocardiography
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Sample Questions
Q1) The rhythm strip reveals the following findings:all P waves are upright,normal in appearance,and exist before every QRS complex,the P-R interval is between 0.12 and 0.20 second,the QRS complexes are identical and are between 0.04 and 0.10 second,the R-R interval is regular,and the HR is >100 bpm.These findings BEST describe which of the following?
A)Sinus bradycardia
B)Sinus tachycardia
C)Normal sinus rhythm
D)Atrial arrhythmia
Q2) The presence of a significant Q wave (one-third the size of the QRS complex)on an ECG indicates which of the following?
A)Acute infarction
B)Ischemia
C)Digitalis toxicity
D)Previous infarction
Q3) Repolarization of the ventricular is BEST described as which of the following?
A)T wave on ECG
B)Return of potassium ions into the cell
C)Movement of sodium ions out of the cell
D)All of the above
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Chapter 10: Pulmonary Diagnostic Tests and Procedures
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Sample Questions
Q1) Forced vital capacity (FVC)is defined BEST by which of the following statements?
A)The volume of air exhaled over the middle half of the maximum flow
B)The average expiratory flow during the early phase of exhalation
C)The maximum volume of gas the person can exhale forcefully and quickly
D)The maximum flow that occurs at any point in time during exhalation
Q2) Which of the following partial pressure of CO values is a primary indication for ventilator failure?
A)Partial pressure CO = 35
B)Partial pressure CO = 40
C)Partial pressure CO = 45
D)Partial pressure CO = 55
Q3) A patient has the following arterial blood gas values:pH = 7.48,PaCO = 42,PaO = 70,and HCO - = 30.Which of the following statements is the MOST accurate interpretation?
A)Uncompensated metabolic alkalosis
B)Uncompensated respiratory alkalosis
C)Partially compensated metabolic alkalosis
D)Partially compensated respiratory alkalosis
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Page 12
Chapter 11: Cardiovascular and Thoracic Interventions
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Sample Questions
Q1) Which of the following blood glucose level ranges is associated with an increased operative morbidity and mortality in women undergoing a coronary artery bypass graft?
A)<90 mg/dL
B)90 to 100 mg/dL
C)100 to 150 mg/dL
D)>150 mg/dL
Q2) Which of the following advantages of video-assisted thoracoscopic surgery over a thoracotomy is MOST related to recovery in the activities domain within the International Classification of Functioning (ICF)model?
A)Reduced hospital length of stay
B)Improved pulmonary functioning
C)Early patient mobilization and recovery
D)Less pain postoperatively
Q3) Common risk factors for thoracic aortic aneurysms include which of the following factors?
A)Hypertension
B)Hypercholesteremia
C)Prior tobacco use
D)All of the above
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Chapter 12: Thoracic Organ Transplantation: Heart, Heart
Lung, and Lung
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Sample Questions
Q1) Which of the following patient characteristics indicates end-stage cardiopulmonary disease?
A)Marked decrease in cardiopulmonary function.
B)Require multiple medications and/or oxygen to complete daily activities.
C)Unable to work full-time.
D)All of the above.
Q2) Which of the following treatment actions should be employed by the physical therapist when monitoring the patient during an exercise session who is postoperative heterotopic heart transplant candidate?
A)Monitor heart rate more frequently before,during,and after exercise.
B)Encourage the patient to perform a longer warm-up and cool-down during the session.
C)Make sure the patient does not exercise greater than low intensity during the session.
D)Use a pulse oximeter to monitor the patient's response to activity during the session.
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Chapter 13: Monitoring and Life Support Equipment
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Sample Questions
Q1) Patients with intra-aortic balloon pump can tolerate early activity such as mobilization out of bed and ambulation.
A)True
B)False
Q2) Low central venous pressure (CVP)indicates which of the following clinical abnormalities?
A)Fluid overload
B)Right ventricular failure
C)Dehydration
D)Tricuspid insufficiency
Q3) The continuous positive airway pressure (CPAP)ventilation system is the treatment of choice for which of the following pulmonary abnormalities?
A)Obstructive sleep apnea
B)Chronic ventilator failure
C)Acute respiratory failure
D)Pulmonary edema
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15
Chapter 14: Cardiovascular Medications
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Sample Questions
Q1) Which of the following physiological changes is considered a negative effect of a prescribed nonselective beta-blocker to decrease myocardial oxygen demand?
A)Enhancing bronchospasm
B)Decreasing heart rate
C)Decreasing heart contractility
D)Decreasing blood pressure
Q2) Bipyridines inhibitors (positive inotrope medications)increase myocardial contractility by which of the following mechanisms?
A)Increase intracellular calcium influx by inhibition of cyclic nucleotide phosphodiesterase.
B)Inhibiting the sodium-potassium pump (Na+-K+ pump).
C)Stimulate Beta adrenoceptors of the myocardium.
D)Stimulate Beta myocardial receptors.
Q3) Which of the following tissue types has an affinity for MOSTLY extracellular calcium?
A)Striated muscle
B)Smooth muscle
C)Myocardium
D)Coronary veins
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16
Chapter 15: Pulmonary Medications
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Sample Questions
Q1) Medications that stimulate the cholinergic receptors are referred to as which of the following?
A)Sympathomimetics
B)Sympatholytics
C)Muscarinic agonists
D)Parasympatholytics
Q2) Administration of which of the following sympathomimetic agent would MOST likely produce a quick response and be more specific to the respiratory system?
A)Epinephrine (adrenaline)
B)Ephedrine
C)Short-acting Beta adrenergic agonists (SABAs)
D)Long-acting Beta adrenergic agonists (LABAs)
Q3) Chronotropic is defined as which of the following?
A)Enhanced heart rate
B)Enhanced myocardial contractility
C)Lowered heart rate
D)Diminished systemic vascular resistance
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Chapter 16: Examination and Assessment Procedures
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Sample Questions
Q1) When a physical therapist determines the impact of a condition on function at the level of the system and the patient subsequently classifying the patient within a specific practice pattern or cluster of the dysfunctions identified,this is BEST described by which of the following elements of patient management?
A)Examination
B)Evaluation
C)Diagnosis
D)Prognosis
Q2) Auscultation at the lower left sternal border,approximately the fourth to fifth intercostal spaces,describes the area where which of the following heart sounds is heard?
A)Aortic area
B)Pulmonary area
C)Tricuspid area
D)Mitral area
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18
Chapter 17: Interventions for Acute Cardiopulmonary Conditions
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Sample Questions
Q1) A patient with pulmonary infection and excessive secretions in multiple segments is able to tolerate only one or two postural drainage (PD)positions in one session.Which of the following modifications to treatment should the physical therapist implement to increase the effectiveness of this pulmonary intervention?
A)The clinician should vary the postural drainage positions in subsequent sessions in order to drain all affected lung segments.
B)Coordinate postural drainage with turning schedules for skin protection.
C)Ask the nursing staff to assist with some postural drainage positions during bathing.
D)All of the above.
Q2) Which of the following conditions is LEAST likely to be a precaution for percussion and vibration airway clearance technique?
A)Osteoporosis
B)Rib fractures
C)Recent head trauma
D)Recent pacemaker placement
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Chapter 18: Interventions and Prevention Measures for
Individuals With Cardiovascular Disease, or Risk of Disease
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Q1) Which of the following are considered precautions with regard to safety in the cardiac rehabilitation?
A)Avoid exercise within 1 to 2 hours after meals.
B)Avoid isometric exercise and breath holding during exercise.
C)Add warm-up and extended cool-down periods.
D)All of the above should be precautions.
Q2) Patients with low functional capacity are generally not good candidates for cardiac rehabilitation due to failure to make reasonable progress.
A)True
B)False
Q3) Which of the following reasons provides the BEST rationale for never abruptly ending an exercise session at training intensity without a cool-down phase?
A)May result in reduced blood flow return to the myocardium leading to irritation.
B)May result in a higher risk of falling.
C)May result in muscular soreness in the lower extremities.
D)May result in high blood pressure for an extended period after exercise.
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Page 20
Chapter 19: Pulmonary Rehabilitation
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Sample Questions
Q1) Which of the following outcomes is MOST associated with improvement in clinical symptoms?
A)Timed activities of daily living tests
B)Questionnaire to measure impact of dyspnea
C)Evaluation of a patient diary
D)Evaluation of a behavioral survey
Q2) A pulmonary patient who is unable to tolerate an extended session of moderate- to high-intensity aerobic endurance training is able to MOST likely improve exercise endurance using which of the following alternative methods of training?
A)Interval training,alternating periods of high and low intensity (or rest)
B)Lower intensity training (<40% of maximal work rate)for 10 minutes,daily
C)Participating in daily activities of living
D)Use of transcutaneous electrical nerve stimulation (TENS)on lower extremities
Q3) Which of the following changes in a conditioning program would be considered a method of progressing functional training with a pulmonary patient?
A)Keeping the repetitions the same and lower the weight
B)Encouraging the patient to work at a higher level within a given time
C)Encouraging longer rest periods between bouts of exercise
D)Encouraging the use of an assistive device when ambulating
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Page 21
Chapter 20: Pediatric Cardiopulmonary Physical Therapy
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Sample Questions
Q1) Which of the following interventions would be the BEST choice for a pediatric patient to strengthen upper extremities?
A)Free weights
B)Weighted ball toss
C)Wheelbarrow walking
D)Wall pulley system
Q2) The failure of increasing oxygen level after birth signaling a decrease in production of prostaglandin E1 results in which of the following acyanotic lesions?
A)Atrial septal defect
B)Patent ductus arteriosus
C)Ventricular septal defect
D)Coarctation of the aorta
Q3) The Trendelenburg position for postural draining and subsequent airway clearance is recommended for all ages.
A)True
B)False
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22
Chapter 21: The Lymphatic System
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Q1) Which of the following pathological conditions is associated with mechanical insufficiency or low-output (volume)insufficiency?
A)Congestive heart failure
B)Hypoproteinemia
C)Lymphedema
D)Chronic venous insufficiency
Q2) Which of the following steps of manual lymph drainage should be FIRST?
A)Patient should be lying down and affected extremity elevated.
B)Determine how strokes should be applied.
C)Treat the appropriate central areas and uninvolved lymph nodes.
D)Teach the patient appropriate manual techniques.
Q3) Besides cancer,which of the following conditions is the MOST significant risk factor for the development of lymphedema?
A)Smoking
B)Type 2 diabetes
C)Obesity
D)Increasing age
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Chapter 22: Outcome Measures:a Guide for the Evidence
Based Practice of Cardiopulmonary Physical Therapy
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Q1) Which of the following changes is a reflection of management decision making enhanced by outcome data?
A)Redistribution of program resources to improve care delivery
B)Hiring new practitioners
C)Maintaining existing protocols
D)All of the above
Q2) Which of the following instruments would be MOST appropriate to screen and measure outcomes in patients with peripheral arterial disease across a variety of settings?
A)The Kansas City Cardiomyopathy Questionnaire
B)The Chronic Respiratory Disease Questionnaire
C)The Walking Impairment Questionnaire
D)The Seattle Angina Questionnaire
Q3) The more specific the tool is to the population,the less sensitive the tool will be toward change.
A)True
B)False
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Page 24