Physical Therapy Assessment and Intervention Final
Exam
Course Introduction
This course provides a comprehensive overview of the principles and techniques used in the assessment and intervention of patients in physical therapy practice. Students will learn to conduct systematic evaluations, including taking patient history, performing physical examinations, and utilizing appropriate measurement tools to identify functional limitations and impairments. The course covers various intervention strategies tailored to different patient populations and conditions, focusing on evidence-based practice. Emphasis is placed on developing critical thinking and clinical reasoning skills, documenting findings, and formulating effective treatment plans to promote movement, reduce pain, and restore physical function.
Recommended Textbook
Therapeutic Exercise Foundations and Techniques 6th Edition by Carolyn Kisner
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25 Chapters
448 Verified Questions
448 Flashcards
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Chapter 1: Therapeutic Exercise: Foundational Concepts
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Sample Questions
Q1) Due to supraspinatus impingement syndrome,Mrs.J is unable to fully lift her arm overhead without pain.You plan to design an exercise program consisting of both discrete and serial tasks.You do not want to include continuous tasks at this time.Which of the following should not be included?
A) ROM exercises using a cloth to wipe down the wall
B) Active reaching exercises to place small objects in a cabinet
C) Active Assisted stretching by lifting a cane overhead in supine
D) Warming up on the UE ergometer (UE cycling)
Answer: D
Q2) As a therapist,one way you can be relatively confident that motor learning has taken place is when your patient demonstrates which of the following?
A) Consecutive repetitions of a task without error during the treatment session
B) Decreased need for manual guidance during the treatment sessions
C) The ability to perform a slight variation of the task in a new context during the treatment session
D) Increased speed demonstrated when carrying out the task
Answer: C
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Chapter 2: Prevention, health, and Wellness
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10 Flashcards
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Sample Questions
Q1) An individual who perceives a threat of contracting a disease follows specific health recommendations to prevent or reduce the risk of contracting the disease.These behaviors are aligned with what behavioral change theory or model?
A) Social cognitive theory
B) Health belief model
C) Transtheoretical model
D) Risk assessment theory
Answer: B
Q2) Which of the following best describes the target audience for a program of physical activity designed for primary prevention of childhood obesity?
A) A group of morbidly obese children who have been diagnosed with type 2 diabetes
B) A group of mildly obese children who are identified as being "at risk" for type 2 diabetes
C) A group of mildly obese children
D) A group of sedentary children whose weight is within normal limits
Answer: D
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Chapter 3: Range of Motion
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Sample Questions
Q1) Optimal duration per day on a CPM for maximal patient compliance and most gained range of motion is:
A) 2-4 hours.
B) 4-8 hours.
C) 8-12 hours.
D) 18-22 hours.
Answer: B
Q2) You've been doing AROM for the left hip abductors and you wish to progress your patient to work this muscle group against gravity.Which of the following positions would you place him in?
A) Supine
B) Prone
C) Left side-lying
D) Right side-lying
Answer: D
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5
Chapter 4: Stretching for Impaired Mobility
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Sample Questions
Q1) The type of stretching technique that utilizes a high-speed,high-intensity,and short-duration stretch force is called a:
A) Ballistic stretch.
B) Static stretch.
C) Cyclic stretch.
D) Mechanical stretch.
Q2) You are asked to do "selective stretching" with a patient with a spinal cord injury.Which of the following best describes the concept of this particular technique?
A) The duration and frequency of the treatment sessions are limited to 5 minutes once a day as a precaution.
B) Active and passive stretching techniques are alternated so that the muscle spindle will regenerate.
C) You allow tightness of specific muscles to remain in order to optimize function.
D) PNF patterns are used to encourage reflexive responses.
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Chapter 5: Peripheral Joint Mobilizationmanipulation
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Sample Questions
Q1) Your patient has a painful right wrist from typing a very large report.You find that she has full active and passive ROM and normal strength.Of the following mobilization techniques,which is most appropriate for managing this patient's signs and symptoms?
A) Anterior-posterior grade II oscillations
B) Sustained grade III distractions
C) Sustained grade III glides
D) Joint mobilization using these grades of sustained or oscillation techniques is not appropriate for this patient at this time.
Q2) Which of the following joint-mobilization procedures matches the desired goal?
A) Posterior glide of the tibia on femur-increase knee extension
B) Lateral glide of the calcaneus on talus-increase subtalar inversion
C) Dorsal glide of the navicular on talus-increase foot supination
D) Caudal glide patella-increase knee extension
Q3) To increase abduction of the thumb,stabilize the trapezium and:
A) Radially glide the base of the first metacarpal.
B) Ulnarly glide the base of the first metacarpal.
C) Dorsally glide the base of the first metacarpal.
D) Volarly glide the base of the first metacarpal.
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7
Chapter 6: Resistance Exercise for Impaired Muscle
Performance
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Sample Questions
Q1) If a patient,who is in a prone-lying position with a cuff weight around his ankle,flexes his knee from a fully extended (0S1U1P1\(\circ\)S1S1P0)position to a fully flexed (150S1U1P1\(\circ\)S1S1P0)position,what type(s)of contraction will occur in which muscle group(s)?
A) The knee flexors contract concentrically through the full ROM.
B) The knee flexors contract concentrically from 0S1U1P1\(\circ\)S1S1P0 to 90S1U1P1\(\circ\)S1S1P0,and the knee extensors contract eccentrically from 90S1U1P1\(\circ\)S1S1P0 to 150S1U1P1\(\circ\)S1S1P0 of flexion.
C) The knee flexors contract eccentrically from 0S1U1P1\(\circ\)S1S1P0 to 90S1U1P1\(\circ\)S1S1P0,and the knee extensors contract concentrically from 90S1U1P1\(\circ\)S1S1P0 to 150S1U1P1\(\circ\)S1S1P0 of flexion.
D) The knee flexors contract eccentrically throughout the full ROM.
Q2) It has been shown that after performing resistance exercise to the point of exhaustion,recovery from exercise (recovery from fatigue)occurs most efficiently if:
A) The fatigued muscle rests completely during recovery.
B) Cold is applied to the fatigued muscle.
C) The patient performs low-intensity,active exercise using the fatigued muscle.
D) The muscle is passively stretched during recovery.
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Chapter 7: Principles of Aerobic Exercise
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Sample Questions
Q1) Principles of stress testing include each of the following except:
A) The workload initially used in the test is low compared to an individual's anticipated aerobic threshold.
B) To increase the workload during treadmill testing,the speed and/or incline are increased.
C) Each successive workload level is maintained for no more than 1 minute.
D) Testing is terminated at the onset of symptoms,or definable abnormalities are noted on the electrocardiogram (ECG).
Q2) Your patient is a sedentary 52-year-old man who smokes a pack of cigarettes a day and has a family history of cardiovascular disease.The most appropriate method of determining his cardiovascular fitness is:
A) Distance run in 12 minutes.
B) Heart rate following 6 minutes of fast walking.
C) Sample expired air during multistage treadmill testing.
D) Time required to run 1.5 miles.
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9
Chapter 8: Exercise for Impaired Balance
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Sample Questions
Q1) While testing a patient's balance,you have the patient perform a series of activities,starting with those that require a low level of balance control and progressing to more difficult tasks.Of the following,the task that requires the greatest amount of balance control is:
A) Catching and throwing a ball while sitting.
B) Raising the opposite arm and leg while in the quadruped position.
C) Walking with one foot placed in front of the other.
D) While standing,balancing on one leg for 10 seconds.
Q2) To prevent falls and maximize safety while lifting heavy objects from the floor,an elderly patient is instructed to:
A) Bend at the knees as far as possible,keeping the back straight and placing the load between the legs.
B) Keep the knees straight,bend at the hips,keep the back straight,and pick up the load quickly.
C) Bend at the knees partially while keeping her back straight and pick up the load slowly.
D) Bend the knees partially and rotate and laterally bend the back to lift the load to one side of the hips.
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Chapter 9: Aquatic Exercise
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Sample Questions
Q1) In an aquatic environment,manual resistance exercises of the extremities typically involve which type of muscle contractions?
A) Eccentric,closed-chain (distal segment fixed)
B) Concentric,closed-chain (distal segment fixed)
C) Isometric
D) Concentric,open-chain (distal segment moving)
Q2) The ability of the body to regulate temperature must be considered with the prescription of aquatic therapy for both the healthy and the rehabilitating patient.All of the following are true of temperature regulation except:
A) The body is not as efficient at dissipating heat in the water as it is on land.
B) Patients are unable to maintain adequate core warmth at water temperatures below 25°C.
C) The ambient air temperature should be equal to the water temperature to avoid overheating or chilling while in the pool area.
D) Water temperatures above 37°C cause increased cardiac demand both at rest and while exercising,especially with prolonged time or deep immersion.
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11
Chapter 10: Soft Tissue Injury,repair,and Management
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Sample Questions
Q1) Your patient reports having had a sudden onset of severe pain in the left posterior thigh yesterday while sprinting.Today he is unable to fully extend his left knee while walking because of pain.Which of the following interventions are most appropriate today?
A) Passive knee flexion/extension with the hip flexed to 90°
B) Passive knee flexion/extension with the hip positioned in 0°<sup> </sup>extension
C) Active knee flexion but no passive or active extension
D) Submaximal resisted knee flexion in the prone-lying position
Q2) Which of the following terms refers to the degeneration of a tendon due to repetitive microtrauma?
A) Tendinitis
B) Tenosynovitis
C) Tenovaginitis
D) Tendinosis
Q3) Muscle guarding is best treated by:
A) Applying modalities and then massaging the muscle.
B) Identifying and treating the cause of the guarding.
C) Gentle muscle-setting exercises with the muscle in a shortened position.
D) Massaging the muscle.
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Page 12
Chapter 11: Joint,connective Tissue,and Bone Disorders and Management
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Sample Questions
Q1) Which of the following interventions would be appropriate for myofascial pain syndrome but not for fibromyalgia,based on the etiology of the two conditions?
A) Providing education with a focus on activity modification
B) Eliminating trigger points with techniques such as muscle elongation with contract-relax procedures and spray and stretch techniques
C) Reducing postural stresses and improving posture
D) Treating muscular pain with low-intensity strengthening and aerobic exercise
Q2) A patient with a diagnosis of osteoporosis wishes to participate in a fitness program at her local community center.All of the following describe precautions that she should adhere to during exercise except:
A) Avoid high-impact,repetitive exercises,such as jumping and bouncing.
B) Avoid high-velocity movements of the spine and extremities.
C) Avoid strength training with free weights or on weight machines regardless of the intensity of exercise.
D) Avoid end-range resisted movements of the spine combining flexion and rotation.
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Page 13
Chapter 12: Surgical Interventions and Postoperative Management
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Sample Questions
Q1) There are several types of grafts that can be used to reconstruct a torn knee or ankle ligament.Of the following,which is the best description of an allograft?
A) Graft made of synthetic material
B) Patient's own tissue harvested from the identical ligament on the contralateral (noninvolved)extremity
C) Patient's own tissue harvested from one of many possible donor sites
D) Tissue graft from a cadaver
Q2) Each of the following is a relative or absolute contraindication for use of total joint replacement arthroplasty except:
A) Severe loss of bone stock.
B) Active systemic infection or infection in the joint.
C) Significant paralysis of the muscles surrounding the joint.
D) Significant joint deformity.
Q3) Which of the following surgical procedures is also considered to be a diagnostic tool?
A) Arthrotomy
B) Capsulorrhaphy
C) Arthroscopy
D) Osteotomy
Page 14
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Chapter 13: Peripheral Nerve Disorders and Management
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Sample Questions
Q1) The pain associated with CRPS type I (reflex sympathetic dystrophy)characteristically is:
A) Entirely psychogenic and responsive to antidepressants.
B) Intermittent and related to body and head position.
C) Out of proportion to the report of history of injury or precipitating event.
D) Always responsive to modalities,primarily cold and electrical stimulation.
Q2) Nonoperative management of carpal tunnel syndrome emphasizes:
A) Vigorous stretching to gain mobility of the structures in the carpal tunnel.
B) Activity modification and joint,nerve,and tendon mobilization.
C) Strengthening exercises,especially to the muscles of the thenar eminence.
D) Immobilization.
Q3) Dominant signs of complex regional pain syndrome type I (reflex sympathetic dystrophy)that should alert you to the potential of this condition developing are:
A) Pain,osteoporosis,swelling,and paresthesias.
B) Pain,swelling,stiffness,and discoloration of the hand.
C) Pain,muscle atrophy,stiffness,and brittle nails.
D) Recent injury;pain;and red,hot,swollen tissue.
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Chapter 14: The Spine: Structure, function, and Posture
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Sample Questions
Q1) To teach a patient how to manage painful symptoms related to poor posture,which of the following is most important?
A) Awareness of the relationship between the faulty posture and pain
B) Stretching program
C) Strengthening program
D) High-repetition,low-resistance exercise program
Q2) Your patient has a forward head posture.On testing (supine-lying),she cannot isolate capital flexion to lift her head when you ask her to flex her neck.Passively you can move the head about 5S1U1P1\(\circ\)S1S1P0 into capital flexion and then feel tissue resistance.Based on these supine tests,what muscles are tight and what muscles are weak?
A) Tight suboccipital muscles and weak longus capitis and longus colli muscles
B) Tight erector spinae and weak sternocleidomastoid muscles
C) Tight splenius capitis and splenius cervicis muscles and weak multifidus muscles
D) Tight erector spinae and weak suprahyoid and infrahyoid muscles
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16
Chapter 15: The Spine: Management Guidelines
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Sample Questions
Q1) All of these are reasons to assess the thoracic spine during evaluation of patients who present with cervical spine dysfunction except:
A) The thoracic spine becomes unstable with pain and soft tissue dysfunction in the cervical spine.
B) The thoracic spine is prone to hypomobility.
C) There are common muscle attachments between the cervical and thoracic areas.
D) Joint manipulation performed along with high-velocity thrust of the thoracic spine often improves outcomes in patients with cervical complaints.
Q2) A serious complication of rheumatoid arthritis in the spine is:
A) Subluxation due to ligamentous necrosis.
B) Joint effusion.
C) Synovial hypertrophy.
D) Pain.
Q3) Which of the following is contraindicated for a patient who has undergone L4/L5 laminectomy?
A) Extension exercises of the trunk
B) Joint manipulation at the thoracolumbar junction
C) Flexion exercises of the trunk
D) Strengthening of the transverse abdominals
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Page 17
Chapter 16: The Spine: Exercise and Manipulation
Interventions
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Sample Questions
Q1) Your patient is recovering from a back injury that occurred 3 weeks ago.You decide it is time to place him on a progressive walking program and integrate it with the other fundamental stabilization interventions in order to:
A) Improve control of the spine while performing a basic functional activity and to improve cardiopulmonary endurance.
B) Strengthen the legs while improving cardiopulmonary function.
C) Improve cardiopulmonary function and his sense of well-being.
D) Develop muscular endurance along with general lower extremity strengthening.
Q2) All of the following may be indications for using stretching or mobility exercises in acute spinal conditions except:
A) When there is an accompanying postural impairment that prevents an alignment that would relieve symptoms.
B) When there is decreased mobility in the extremities that restrict postural alignment.
C) When an inflamed tissue is the cause of restriction.
D) When fluid stasis prevents movement.
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Chapter 17: The Shoulder and Shoulder Girdle
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Sample Questions
Q1) Your patient exhibits a forward head posture and excessive thoracic kyphosis.Considering the muscles that typically are weak with this faulty posture,which of the following muscles of the shoulder girdle are most important to strengthen using the exercise program you are developing for this patient?
A) Pectoralis minor and levator scapulae
B) Serratus anterior and levator scapulae
C) Upper and lower trapezius and serratus anterior
D) Upper and lower trapezius and pectoralis minor
Q2) According to Neer's classification of rotator cuff disease,which of the following stages is seen most often in patients 25 to 39 years of age and characterized by tendonitis or bursitis but not a rotator cuff tendon rupture?
A) Stage I
B) Stage II
C) Stage III
D) Stage IV
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Chapter 18: The Elbow and Forearm Complex
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Sample Questions
Q1) When a period of continuous immobilization of the elbow is required after trauma or surgery,the elbow often is positioned in only a moderate amount of flexion (20S1U1P1\(\circ\)S1S1P0 to 30S1U1P1\(\circ\)S1S1P0)rather than 90S1U1P1\(\circ\)S1S1P0 of flexion.This position is selected to:
A) Decrease the risk of ulnar neuropathy from compression of the ulnar nerve in the cubital tunnel.
B) Decrease the risk of radial neuropathy from compression of the radial nerve in the cubital tunnel.
C) Decrease the risk of median nerve neuropathy from compression in the cubital tunnel.
D) Decrease the risk of overstretching the lateral collateral ligament complex of the elbow that could cause posterior translation of the radial head.
Q2) Current research shows that the "survival rate" for total elbow arthroplasty (TEA)is:
A) 30% over a 10-year period.
B) Greater for patients with RA than for those with traumatic arthritis or OA.
C) Highly correlated with the type of implant (prosthesis).
D) 82% over a 5.5-year period.
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Chapter 19: The Wrist and Hand
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Sample Questions
Q1) Each of the following descriptions of the flexor zones of the hand and forearm is correct except:
A) Zone I is where the FDS tendon inserts;if the tendon avulses,the patient will be unable to flex the DIP joint.
B) Zone II,known as "no-man's land," is where the extrinsic flexor (FDS and FDP)tendons lie in close proximity;range-limiting adhesions that prevent tendon gliding are likely to develop in this area after injury and repair.
C) Zone III is in the palm of the hand;injury in this area can damage the lumbricales and interfere with MCP flexion.
D) Zone IV includes the carpal tunnel;extrinsic flexor tendons (FDS,FDP,and FPL)can adhere in the tunnel following inflammation.
Q2) Prerequisites for successful PIP arthroplasty include all of the following except:
A) Adequate bone stock.
B) No history of chronic synovitis.
C) Intact neurovascular system.
D) Functioning flexor/extensor mechanism.
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21
Chapter 20: The Hip
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Sample Questions
Q1) If a patient stands in a fencer's posture but with the back leg externally rotated and then lunges forward,this self-stretching maneuver primarily stretches which muscle groups of the back leg?
A) Hip abductors and external rotators
B) Hip flexors
C) Hip extensors
D) Hip adductors and internal rotators
Q2) The term "hybrid" total hip arthroplasty refers to a(n):
A) Hip replacement with a cemented femoral component and a noncemented acetabular component.
B) Total hip replacement that is all metal.
C) Alternate term for bipolar hemiarthroplasty of the hip.
D) Alternate term for minimally invasive arthroplasty.
Q3) The clinical prediction rule for the diagnosis of osteoarthritis of the hip developed by Sutlive and colleagues includes consideration of all of the following variables except:
A) Self-reported squatting aggravates symptoms.
B) Walking more than 1 block causes groin and anterior thigh pain.
C) Passive internal rotation is less than or equal to 25°.
D) Scour test with adduction causes lateral hip or groin pain.
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Page 22
Chapter 21: The Knee
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Q1) Each of the following is an expected outcome of conservative management of osteoarthritis of the knees except:
A) Maintaining functional range of motion and strength.
B) Relieving pain.
C) Regenerating worn articular cartilage.
D) Preventing deformity.
Q2) The "minimally invasive knee arthroplasty" is a more recent surgical approach for performing TKA.When the surgeon chooses this approach,it is because:
A) It is easier to perform and therefore is the choice of the less-experienced surgeon.
B) The incidence of intraoperative complications is lower.
C) It is an arthroscopic procedure,so the rehabilitation is shorter.
D) It is less disruptive to the soft tissue,with increased rate of post-op recovery and less post-op pain.
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Chapter 22: The Ankle and Foot
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Q1) Each of the following is true about surgical repair/reconstruction of the lateral ligament complex of the ankle and postoperative management except:
A) The most common procedure is a direct repair and imbrication of the torn ligaments through an open surgical approach.
B) After reconstruction of the lateral ligaments that includes a tendon autograft and tendon transposition (often the peroneus brevis tendon)to reinforce the lateral aspect of the ankle,there may be some permanent loss of full ankle inversion postoperatively.
C) The ankle is immobilized in plantarflexion and slight eversion for 4 to 6 weeks postoperatively;therefore the patient must remain non-weight-bearing on the operated lower extremity during the period of immobilization to prevent rupture of the repair site.
D) It is usually permissible to remove the ankle immobilizer by about 4 to 6 weeks postoperatively to begin active range of motion exercises of the ankle.
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24
Chapter 23: Advanced Functional Training
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Q1) Which of the following describes a proper progression of positions to increase balance and postural stability?
A) Standing to tall kneeling
B) Unilateral stance to tandem stance
C) Half-kneeling to sitting without foot support
D) Reaching activities in bilateral stance to unilateral stance
Q2) Examples of plyometric activities for the upper extremities could include any of the following except:
A) Seated push-ups.
B) Clap push-ups.
C) Catching and throwing a weighted ball.
D) Dribbling a ball against the wall.
Q3) Plyometric training drills are an example of an intervention to develop primarily which of the following?
A) Coordination
B) Power
C) Balance
D) Endurance
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25
Chapter 24: Womens Health: Obstetrics and Pelvic Floor
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Q1) During pregnancy,each of the following changes in the respiratory system occurs except:
A) Increased respiratory rate.
B) Increased O<sub>2</sub> consumption and increased work of breathing.
C) Relatively unchanged or slightly decreased total lung capacity.
D) State of hyperventilation throughout pregnancy.
Q2) Each of the following is a normal change during pregnancy except:
A) Increased secretion of insulin.
B) Decreased ligamentous stability.
C) Decreased resting heart rate.
D) Increased thyroid activity.
Q3) During pregnancy,in which direction does the center of gravity of the body move?
A) Superior and posterior
B) Superior and anterior
C) Inferior and posterior
D) Inferior and anterior
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Chapter 25: Management of Lymphatic Disorders
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Q1) Axillary web syndrome is a relatively common condition that develops after treatment for breast cancer and is recognized by which of the following signs and symptoms?
A) A feeling of heaviness in the upper extremity during active flexion and adduction,indicating the initial sign of lymphedema.
B) Muscle guarding and tenderness of the cervical muscles with fibrosis of the sternocleidomastoid muscle limiting range of motion of the neck.
C) Cording of the lymphatic vessels from the axilla to the antecubital space and/or forearm restricting shoulder mobility.
D) Weakness of the serratus anterior after lymph node dissection resulting from surgical damage to the long thoracic nerve.
Q2) Signs and symptoms of chronic venous insufficiency can include any of the following except:
A) Venous distention in the affected limb.
B) Dependent peripheral edema.
C) Brownish pigmentation of the affected limb.
D) Severe pain with the limb in an elevated position.
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