Latest Version: 6.0

Question: 1

The PTA is working with a patient shortly after a transtibial amputation, and is instructing the patient in ambulation while using a prosthesis. The patient presents with a medial thrust at midstance. What is the MOST likely cause of this gait deviation?

A. Socket is tilted anteriorly

B. Foot is outset too much

C. Dorsiflexion bumper is too soft

D. Socket is set too far forward

Explanation:

Answer: B

When working with a patient post transtibial amputation, the PTA may discover a number of common gait deviations. If the foot is outset too much, the patient may display a medial thrust at midstance. If the socket is set too far forward or tilted anteriorly, the patient may exhibit excessive knee flexion during stance. If the dorsiflexion bumper is too soft, the patient may exhibit drop off or premature knee flexion in stance.

Question: 2

What is NOT a common sign or symptom of hyperglycemia?

A. Excessive hunger

B. Dry mouth

C. Weakness

D. Deep, rapid respiration

Explanation:

Answer: A

Excessive hunger is a sign of hypoglycemia (low blood sugar), not hyperglycemia. Hyperglycemia occurs when glucose is > 300 mg/dL and has a gradual onset over days. Patients in a hyperglycemic state often exhibit decreased appetite, nausea or vomiting, and abdominal tenderness.

Additional signs of hyperglycemia include weakness, increased thirst, dry mouth, frequent but scant urination, dulled senses, deep and rapid respirations, rapid and weak pulse, fruity odor to the breath, and hyperglycemic coma. Immediate medical treatment is needed for hyperglycemia.

Question: 3

Which of the following options is NOT a precaution for local immersion in a whirlpool (hydrotherapy)?

A. Disorientation

B. Impaired cognition

C. Multiple sclerosis

D. Recent skin graft

Explanation:

Answer: C

Multiple sclerosis is a precaution for full-body and not for local immersion in a whirlpool (hydrotherapy). Impaired cognition, disorientation/confusion, recent skin grafts, decreased temperature sensation, and a deconditioned state are all precautions for local immersion in a whirlpool.

Question: 4

Fill in the blank: When using an ultrasound, excessively high temperatures may produce a strong ache caused by overheating ________ .

A. ligaments

B. muscle fibers

C. subdermal tissue

D. periosteal tissue

Explanation:

Answer: D

The patient may experience periosteal pain as a result of excessively high temperatures over a directed surface area of treatment. The clinician should reduce the intensity of the ultrasound or increase the surface area of the treatment if the patient experiences periosteal pain.

Question: 5

Which of the following options is the LEAST LIKELY reason to apply Electrical Stimulation (ES)?

A. Impaired sensation

B. Spasticity

C. Edema

D. Soft-tissue repair

Explanation:

Answer: A

Areas of impaired sensation are a precaution, not an indication, for Electrical Stimulation (ES).

ES may be used to treat edema, but excessive edema is a precaution for this treatment. ES may also be used for soft-tissue repair and to reduce spasticity.

Question: 6

Which type of research study is an experimental design in which participants are randomly assigned to either an experimental or control group to receive different interventions or a placebo?

A. Random sampling

B. Case-control study

C. Double-blind study

D. Randomized control trial

Explanation:

Answer: D

A randomized control trial is an experimental study in which participants are randomly assigned to either an experimental or control group, receiving either the variable intervention or placebo. In a double-blind study, neither the subject(s) nor the investigator(s) are aware of the subject(s) group assignment. In a random sampling, all individuals in a population have an equal chance of being chosen for a study. A case study is a type of descriptive research in which only one patient is studied in depth, and a retrospective report is written about the case.

Question: 7

Which of the following options should result in a soft end-feel?

A. Wrist flexion on a patient with fibrotic forearm extensors

B. Knee flexion

C. Shoulder abduction on a patient with a torn rotator cuff

D. Knee extension

Explanation:

Answer: B

A soft end-feel (due to soft tissue approximation) occurs when two soft tissues meet and restrict any further movement. In knee flexion, the hamstring approximates with the gastrocnemius and prevents any further motion at the knee.

Knee extension would typically have a firm end-feel, which indicates capsular and ligamentous stretching. If the patient has fibrotic forearm extensors, wrist flexion would likely result in a firm endfeel with decreased elasticity. If the patient has a torn rotator cuff and the clinician is assessing the end feel for shoulder abduction, they would likely notice an empty end-feel. This occurs when the clinician is unable to bring the joint through the full range due to guarding by the patient, and is typically due to pain.

Question: 8

A patient s/p CVA presents with left-sided sensory and motor loss to her lower extremity with no involvement in her upper extremity. She has confusion and slow, delayed movement. Additionally, she has behavioral changes and confusion. Which CVA syndrome is likely?

A. Anterior cerebral artery syndrome

B. Vertebrobasilar artery syndrome

C. Posterior cerebral artery syndrome

D. Middle cerebral artery syndrome

Explanation:

Answer: A

The anterior cerebral artery supplies the medial part of the frontal and parietal lobe, basal ganglia, and corpus callosum. Patients with anterior cerebral artery syndrome have contralateral sensory and motor loss with legs more affected than upper extremities. They have mental impairment, urinary incontinence, apraxia, slow delayed movement, and behavioral changes.

The middle cerebral artery supplies the lateral cerebral hemispheres, including the frontal, temporal and parietal lobes. Patients with middle cerebral artery syndrome have contralateral sensory motor loss with the face and upper extremities affected more than lower extremities. Additionally, they can have perceptual deficits, homonymous hemianopsia, Broca's and Wernicke's aphasia, and global aphasia.

The posterior cerebral artery supplies the occipital lobe, medial and inferior temporal lobe, thalamus, and midbrain. With posterior cerebral artery syndrome, the patient can experience contralateral sensory and motor loss, homonymous hemianopsia, visual agnosia, oculomotor nerve palsy, involuntary movement, Pusher syndrome, and thalamic pain syndrome.

Patients with vertebrobasilar artery syndrome have a wide variety of symptoms that can be on the same side or opposite side of the infarct. There is cranial nerve involvement (diplopia, dysphagia, dysarthria, deafness, and vertigo) as well as ataxia. They may have Wallenberg's syndrome (deficits in visual disturbances, balance, and gait deficits) or locked-in syndrome (the patient is awake and aware but unable to speak or control any muscles beyond the eyes).

Question: 9

The PTA is evaluating a patient for potential neurological dysfunction. Of the following options, which special test is the clinician LEAST likely to use?

A. Gaenslen's test

B. Slump test

C. Lasegue's test

D. Crossed straight leg raise

Explanation:

Answer: A

Gaenslen's test is used to identify Sacroiliac Joint (SIJ) dysfunction, not neurological dysfunction. This test is performed with the patient side-lying at the edge of the table while holding their bottom leg in maximal hip and knee flexion. Standing behind the patient, the clinician passively extends the hip of the uppermost limb. A positive finding is pain in the SIJ.

The crossed leg test identifies a herniated nucleus pulposis or neural tension/radiculopathy. The slump test and Lasegue's test (also called the straight leg raise test) identify dysfunction of the neurological structures supplying the lower limb.

Question: 10

What is the resting position of the knee?

A. 25 degrees flexion

B. 45 degrees flexion

C. 30 degrees flexion

D. 90 degrees flexion

Explanation:

Answer: A

The resting position of the knee is 25 degrees flexion. The close-packed position of the knee (bony structures) is 90 degrees flexion, slight abduction, and slight external rotation. The resting position of the hip is 30 degrees flexion, 30 degrees abduction, and slight lateral rotation.