Practice Questions 1

1. A physical therapist instructs a client rehabilitating D. the respiration rate decreases as the
from a tibial plateau fracture to ascend a curb using intensity of the exercise plateaus
axillary crutches. The client is partial weightbearing RATIO: 4. As the intensity of exercise plateaus, a client
and uses a three point gait pattern when ambulating. will accommodate to the level of exercise and his/her
When ascending a curb the therapist should instruct respiration rate will tend to decrease.
the client to lead with the __________?
A. uninvolved lower extremity 6. A physical therapist reviews the results of a
B. involved lower extremity pulmonary function test. Assuming normal values,
C. axillary crutches which of the following measurements would you
D. right axillary crutch and right lower extremity expect to be the greatest?
RATIO: 1. When ascending a curb a client should lead A. vital capacity
with uninvolved lower extremity in order to avoid placing B. tidal volume
unnecessary force on the involved extremity. C. residual volume
D. inspiratory reserve volume
2. A physical therapist attempts to transfer a RATIO: 1. Vital capacity is defined as the amount of air
moderately obese client from a wheelchair to a bed. that can be exhaled following a maximal inspiratory effort.
The therapist is concerned about the size of the Vital capacity varies directly with height and indirectly
client, but is unable to secure another staff member with age.
to assist with the transfer. Which type of transfer
would allow the therapist to move the client with the 7. A client involved in a motor vehicle accident
greatest ease? sustains an injury to the posterior cord of the
A. dependent standing pivot brachial plexus. Which muscle would not be
B. hydraulic lift affected by the injury?
C. sliding board A. infraspinatus
D. assisted standing pivot B. subscapularis
RATIO: 2. A hydraulic lift can be a safe and efficient C. latissimus dorsi
mode to transfer large or dependent clients with little D. teres major
physical exertion RATIO: 1. The infraspinatus muscle is innervated by the
suprascapular nerve (C4, C5, C6) which extends from the
3. A therapist conducts a goniometric assessment of a superior trunk of the brachial plexus.
client’s upper extremities. Which of the following
values is most indicative of normal passive 8. While treating a client bedside, a therapist notices
glenohumeral abduction? that an improperly positioned bedrail has partially
A. 80 degrees occluded the tubing of an IV line. The therapist’s
B. 120 degrees most immediate response should be to _____?
C. 155 degrees A. contact nursing
D. 180 degrees B. contact the referring physician
RATIO: 2. Passive shoulder complex flexion is C. reposition the bedrail
approximately 180 degrees; however glenohumeral D. document the incident
abduction is 120 degrees with approximately 60 degrees of RATIO: 3. Repositioning the bedrail is an immediate and
motion occurring at the scapulothoracic joint. appropriate response that is within the therapist’s scope of
practice.
4. A physical therapist designs a therapeutic exercise
program for a client with sway-back. The most 9. A physical therapist designs a training program for a
appropriate exercise is______? client without cardiovascular pathology. The
A. lower abdominal strengthening therapist calculates the client’s age predicted
B. hip flexor strengthening maximal heart rate as 175 beats per minute. Which
C. anterior pelvic tilts of the following would be an acceptable target heart
D. lower back strengthening rate for the client during cardiovascular exercise?
RATIO: 1. Swayback is synonymous with excessive A. 93 beats per minute
lordosis. Individuals with weakness of the abdominal B. 122 beats per minute
muscles often present with an anterior pelvic tilt and thus C. 169 beats per minute
a lordotic posture. D. 195 beats per minute
RATIO: 2. An acceptable target heart rate during
cardiovascular exercise is between .6 - .8 of the age
predicted maximal heart rate.
5. A physical therapist monitors a client’s respiration
rate during exercise. Which of the following would 10. While preparing a sterile field for wound
be considered a normal response? debridement, a therapist accidentally places a
A. the respiration rate declines during exercise nonsterile object on the sterile base. The most
before the intensity of exercise declines appropriate action is to _____?
B. the respiration rate does not increase during A. remove the nonsterile object from the sterile
exercise base and continue with treatment
C. the rhythm of the respiration pattern becomes B. continue with treatment; however, be sure no
irregular during exercise other supplies come in contact with the
nonsterile object

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 2 Practice Questions

C. remove all of the items to be used from the C. using repetition

sterile base and replace them with similar D. demonstrating
items that are sterile RATIO: 2. Wernicke’s aphasia refers to an inability to
D. discard the entire sterile field and establish comprehend written or spoken words. As a result of this
a new sterile field condition it is inappropriate to provide detailed
RATIO: 4. Once a nonsterile object is placed within a instructions.
sterile field, the entire sterile field should be considered
nonsterile. 15. A physician refers a client rehabilitating from a
fractured femur to physical therapy for gait training.
11. A client rehabilitating from a fractured right Which of the following would not be the
humerus is examined in physical therapy. The responsibility of the physical therapist?
therapist determines goniometrically that the client A. assessing balance
can actively flex his right shoulder to 173 degrees. B. determining weightbearing status
Which of the following entries would be the most C. selecting an assistive device
appropriate to illustrate the therapist’s findings D. assessing endurance
A. right shoulder flexion range of motion 0-173 RATIO: 2. Determining weightbearing status is the
degrees responsibility of the referring physician.
B. right shoulder range of motion is within
normal limits 16. The Occupational Safety and Health Administration
C. right shoulder flexion active range of establishes regulations for health care facilities,
motion to 173 degrees which are designed to protect their employees.
D. right shoulder active range of motion to 173 Which of the following regulations is not accurate?
degrees A. Provide proper containers for the disposal of
RATIO: 3. Although the client can flex his right shoulder waste and sharp items.
to 173 degrees, this does not indicate the starting position B. Educate employees on the methods of
was equal to 0. Documentation must specify whether the transmission and the prevention of hepatitis B
range of motion was active or passive. and HIV.
C. Require all employees to receive the
12. A therapist works with a client placed in isolation. hepatitis B vaccine.
The therapist is required to wear a mask while D. Provide education and follow up care to
treating the client, but is not required to wear gloves employees who are exposed to communicable
or a gown. This type of isolation could be termed diseases.
____? RATIO: 3. Although it is strongly recommended that
A. strict isolation health care employees receive the hepatitis B vaccine, it is
B. contact isolation not mandated by OSHA
C. respiratory isolation
D. blood/body fluid precautions 17. A client status post total hip replacement is referred
RATIO: 3. Protective asepsis for respiratory isolation to physical therapy for gait training. The client has
includes a mask. Examples of conditions that may require not been weightbearing on the involved lower
respiratory isolation include measles, mumps, and extremity since surgery and appears to be somewhat
pertussis. anxious. The most appropriate setting to begin
ambulation activities is _____?
A. in the parallel bars
13. A 13ear-old female diagnosed with cerebral palsy is B. in the parallel bars with a rolling walker
referred to physical therapy. The client exhibits C. in the physical therapy gym with a straight
slow, involuntary, continuous writhing movements cane
of the upper and lower extremities. This type of D. in the physical therapy gym with a walker
motor disturbance best describes ____? RATIO: 1. The parallel bars provide the most stable
A. spasticity setting for the client to begin ambulation activities.
B. ataxia
C. hypotonia 18. A client involved in a motor vehicle accident
D. athetosis sustains a Colles’ fracture and an intertrochanteric
RATIO: 4. Athetosis refers to involuntary movements hip fracture. The client has been cleared for touch
characterized as slow, irregular and twisting. This type of down weight bearing by her physician. Which
motor disturbance makes it extremely difficult to maintain assistive device would be the most appropriate for
a static body position. the client?
A. straight cane
B. axillary crutches
14. A client, who is status post stroke and demonstrates C. rolling walker
Wernicke’s aphasia, is learning how to perform a sit D. walker with a platform attachment
to stand transfer. To enhance the client’s ability to RATIO: 4. A walker with a platform attachment will
learn the transfer, the physical therapist should provide the stability the client requires while avoiding
avoid _____ when instructing the client? significant pressure on both of the fracture sites.
A. using a mirror for visual feedback
B. providing detailed instructions
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 Practice Questions 3
19. A therapist instructs a 55 year-old trauma victim 24. A physical therapist working in a school system
with bilateral lower extremity paralysis to transfer develops long term goals as part of an
from a wheelchair to a mat table. The client has Individualized Educational Plan for a child with
normal upper extremity strength and has no other Down’s Syndrome. The most appropriate time
known medical problems. The most appropriate frame for these goals is____?
transfer technique is a ______? A. one month
A. dependent standing pivot B. four months
B. sliding board transfer C. six months
C. two person carry D. one year
D. hydraulic lift RATIO: 4. An Individualized Education Plan articulates
RATIO: 2. A sliding board transfer is possible based on the goals and objectives of special education services for a
the client’s upper extremity strength. The transfer will given school aged child. The plan is for a one year period.
allow the client to maintain a high level of independence.
25. A physical therapist administers ultrasound over a
20. A therapist elects to utilize joint mobilization to client’s anterior thigh. After one minute of
increase the extensibility of the ulnohumeral joint. treatment, the client reports feeling a slight burning
Which position of ulnohumeral joint would be sensation under the sound head. The therapist’s
inappropriate for joint mobilization? most appropriate action is to ___?
A. 15 degrees extension, 15 degrees pronation A. explain to the client that what she feels is not
B. 70 degrees flexion, 10 degrees supination out of the ordinary when using ultrasound
C. 30 degrees flexion, 25 degrees supination B. temporarily discontinue treatment and
D. full extension and supination examine the amount of coupling
RATIO: 4. Full extension and supination is the close C. discontinue treatment and contact the referring
packed position of the ulnohumeral joint. physician
D. continue with treatment utilizing the current
parameters.
21. A therapist instructs a client to make a fist. The RATIO: 2. A client report of a slight burning sensation
client can make a fist, but is unable to flex the distal under the soundhead can be due to inadequate coupling,
phalanx of the ring finger. This clinical finding can loosening of the crystal or hot spots due to a high beam
best be explained by _________? nonuniformity ratio.
A. a ruptured flexor carpi radialis tendon
B. a ruptured flexor digitorum superficialis 26. A client is positioned on a treatment table in prone
tendon with two pillows under her hips. This position most
C. a ruptured flexor digitorum profundus likely would be used to perform postural drainage
tendon techniques to the _____?
D. a ruptured extensor digitorum communis A. anterior basal segment of the lower lobes
tendon B. lateral basal segment of the lower lobes
RATIO: 3. The flexor digitorum profundus is responsible C. right middle lobe
for flexing the distal interphalangeal joint of the four D. superior segment of the lower lobes
fingers and assisting with flexion of the proximal RATIO: 4. The optimal position for the superior segments
interphalangeal and metacarpophalangeal joints. of the lower lobes is described as having the client lie on
his/her abdomen with two pillows under the hips. The
22. A client with a confirmed posterior cruciate therapist claps over the middle back at the tip of the
ligament tear is able to return to full dynamic scapula on either side of the spine.
activities following rehabilitation. Which of the
following does not serve as a secondary restraint to 27. A client eight weeks post myocardial infarction is
the posterior cruciate ligament? involved in a phase II cardiac rehabilitation program
A. iliotibial band at a local hospital. What event usually signifies the
B. popliteus completion of a phase II program?
C. lateral collateral ligament A. echocardiogram
D. medial collateral ligament B. initiation of a high level aerobic exercise
RATIO: 1. The iliotibial band serves as a secondary program
restraint to the anterior cruciate ligament not the posterior C. low level treadmill test
cruciate ligament. D. maximal treadmill test
RATIO: 4. A phase II cardiac rehabilitation program
23. A nine month old infant with cerebral palsy is begins with the completion of a low level treadmill test and
unable to roll from prone to supine. This ends with a maximal treadmill test.
developmental activity typically occurs by _____?
A. 3 months 28. A client being treated in an outpatient orthopedic
B. 5 months clinic begins to demonstrate signs and symptoms of
C. 7 months stroke, including sudden weakness of the arm and
D. 9 months leg, unexplained dizziness, and loss of vision.
RATIO: 2. Rolling from prone to supine usually occurs Recognizing the symptoms of a stroke the therapist
in the fifth month, while rolling from supine to prone begins to administer first aid. Which of the
occurs in the sixth month. following would not be considered appropriate first
aid management?

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A. monitor the airway, breathing, and circulation the proximal interphalangeal joints and
B. remove mucus from the mouth with a piece of hyperextension at the metacarpophalangeal and
cloth wrapped around a finger distal interphalangeal joints. This deformity
C. position the client in supine and slightly commonly is known as ____?
elevate the legs. A. boutonniere deformity
D. immediately contact medical assistance B. mallet finger
RATIO: 3. Positioning the client in supine with the legs C. swan neck deformity
elevated would be inappropriate first aid management. D. ulnar drift
This position may be warranted in a client with RATIO: 1. The deformity is most frequently encountered
hypovolemic shock. in clients with rheumatoid arthritis or after trauma. It is
caused by damage to the central tendinous slip of the
29. Pharmacological agents eventually must be extensor hood.
eliminated from the body to prevent an excessive
accumulation of a specific drug. Where is the major 34. A therapist discusses the importance of proper
site for drug excretion? nutrition with a client diagnosed with congestive
A. gastrointestinal tract heart failure. Which of the following substances
B. kidneys would be most restricted in this client’s diet?
C. liver A. cholesterol
D. saliva B. potassium
RATIO: 2. The kidneys are the primary site of drug C. sodium
excretion, while the gastrointestinal tract and lungs are D. triglycerides
secondary sites. RATIO: 3. Clients with congestive heart failure may
present with breathlessness, weakness, abdominal
30. A therapist designs an exercise program for a discomfort and edema in the lower extremities resulting
pregnant woman. Which of the following exercises from venous stasis. Since sodium serves to retain water it
would be inappropriate? is often restricted in a client’s diet
A. pelvic floor isometrics
B. squatting 35. A physician reduces a comminuted tibia fracture
C. standing push-ups using an external fixation device. Which stage of
D. bilateral straight leg raising bone healing is associated with the termination of
RATIO: 4. Bilateral straight leg raising is contraindicated external fixation?
for a pregnant woman due to the excessive increase in A. hematoma formation
abdominal pressure and the strain on the low back. B. cellular proliferation
C. callus formation
31. A physical therapist treats a client with generalized D. clinical union
upper and lower extremity weakness following a RATIO: 4. Clinical union provides the necessary bony
prolonged hospitalization. As part of the client’s support to terminate external fixation. Callus formation
treatment program, the therapist designs an aquatic represents the first stage in which bony union occurs,
program emphasizing upper and lower extremity however does not offer adequate support.
range of motion. Which physical property of water
allows the client to move with greater ease? 36. A 62 year-old male diagnosed with ankylosing
A. buoyancy spondylitis is referred to physical therapy. The
B. specific gravity client’s referral is for instruction in a home exercise
C. specific heat program. Which of the following exercises would
D. thermal conductivity you expect to be the most appropriate for this client?
RATIO: 1. Buoyancy makes the body appear to weight A. partial sit ups
less in water than it does in air and as a result clients tend B. posterior pelvic tilts
to move with greater ease when immersed in water. C. spinal extension
D. straight leg raises
32. A therapist examines a grossly obese client referred RATIO: 3. Ankylosing spondylitis is a form of rheumatic
to physical therapy with a hip flexor strain. Which disease characterized by inflammation of the spine
modality would have the greatest ability to elevate resulting in back pain. Since a client with ankylosing
the temperature of fatty tissue to potentially spondylitis often exhibits postural changes such as
dangerous levels? forward head, increased thoracic kyphosis and loss of
A. diathermy lumbar curvature, spinal extension exercises are often a
B. hot packs component of a treatment regimen.
C. paraffin
D. pulsed ultrasound 37. A client diagnosed with piriformis syndrome is
RATIO: 1. Diathermy is considered a deep heating agent referred to physical therapy for one visit for
while the remaining options are superficial heating agents. instruction in a home exercise program. After
examining the client, the therapist feels the client’s
33. A 66 year-old female is referred to physical therapy rehabilitation potential is excellent, but is concerned
with rheumatoid arthritis. During the initial that one visit will not be sufficient to meet the
examination the therapist notes increased flexion at client’s needs. The most appropriate action is to
___?
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 Practice Questions 5
A. schedule the client for treatment sessions, as 41. Clients with abnormal conduction patterns often can
warranted, based on the results of the initial be treated successfully using antiarrhythmic
examination medication. Which of the following side effects of
B. explain to the client that recent health care antiarrythmics would not require immediate medical
reforms have drastically reduced the frequency attention?
of physical therapy visits covered by third A. dizziness
party payers B. insomnia
C. explain to the client that she can continue with C. shortness of breath
physical therapy beyond the initial session, but D. coughing up blood
will be liable for all expenses not covered by RATIO: 2. Dizziness, shortness of breath and coughing
her insurance up blood are all symptoms that place a client’s safety in
D. contact the referring physician and request immediate jeopardy.
approval for additional physical therapy
visits 42. A physical therapist uses a S.O.A.P. formal for all
RATIO: 4. It is an appropriate action to request his daily documentation. Which of the following
additional physical therapy visits from a referring would not be found in the assessment section of a
physician. S.O.A.P. note?
A. short and long term goals
38. A male client with limited shoulder range of motion B. discussion of a client’s progress in therapy
explains that he has difficulty wiping himself after C. client’s equipment needs and equipment
going to the bathroom. How much shoulder range ordered
of motion is required to successfully complete D. client’s rehabilitation potential
toileting activities? RATIO: 3. Equipment needs and equipment ordered are
A. 50 degrees horizontal abduction, 30 degrees typically included in the plan section of a S.O.A.P. note.
abduction, 45 degrees medial rotation
B. 30 degrees horizontal abduction, 45 degrees 43. A rehabilitation manager designs a system to
adduction, 65 degrees medial rotation monitor the productivity of staff therapists. Which
C. 80 degrees horizontal abduction, 40 degrees piece of data would be the least beneficial to
abduction, 90 degrees medial rotation accomplish the manager’s objective?
D. 90 degrees horizontal adduction, 75 degrees A. number of generated timed treatment units
abduction, 60 degrees medial rotation B. results of client satisfaction survey data
RATIO: 3. Full shoulder medial rotation is necessary to C. total hours of direct client treatment time
reach the perineum. D. number of regular payroll hours
RATIO: 2. Productivity is a term used to describe the
39. A therapist completes lower extremity range of efficiency of a given worker or group of workers.
motion activities with a spinal cord injured client. Although measures of quality are often examined
While ranging the client, the therapist notices that concurrently they are not used to determine productivity.
the client’s urine is extremely dark and has a
distinctive foul smelling odor. Which of the 44. A 52 year-old; self referred male is examined in
following is the most appropriate action? physical therapy. The client states that over the last
A. verbally report the observation to the client’s three months he has experienced increasing neck
physician stiffness and pain at night. He also communicates
B. verbally report the observation to the client’s that within the past week he has had several
nurse episodes of dizziness. The client has a family
C. document and verbally report the history of cancer and has smoked two packs of
observation to the client’s nurse cigarettes a day for the last twenty years. The client
D. document and verbally report the observation denies any other significant past medical history and
to the director of rehabilitation lists the date of his medical examination as 10 years
RATIO: 3. Any change in color or odor of urine is ago. The therapist’s most appropriate action is to
significant and should therefore be reported and ___?
documented. A. treat the client conservatively and document
any changes in the client’s status
40. An eight year-old female with a 25 degree scoliotic B. inform the client that he is not a candidate for
curve is fitted for a Milwaukee brace. The brace physical therapy
will likely be worn until ___? C. refer the client to an oncologist
A. the scoliotic curve does not increased within D. refer the client to his primary care
one year period physician
B. the client resumes all recreational and athletic RATIO: 4. The self-referred client offers a medical
activities history that presents several significant issues including
C. the client is pain free for six months episodes of dizziness, neck stiffness with pain at night and
D. spinal growth ceases a family history of cancer. Based on the client’s history
RATIO: 4. An orthotic device such as the Milwaukee and the date of the medical examination he should be
brace is designed to facilitate improved alignment in the referred to a physician.
developing spine and therefore should be used until spinal
growth ceases. 45. Therapists use a wide variety of measurement
methods in their daily documentation. These

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 6 Practice Questions

measurements usually are categorized as subjective areas of the building. What is the minimum space
or objective methods. Which of the following required to turn 180 degrees in a standard
measurement methods would not be considered wheelchair?
objective? A. 32 inches
A. duration of attention B. 48 inches
B. goniometric measurements C. 60 inches
C. rating on a perceived exertion scale D. 72 inches
D. time required to perform a selected activity RATIO: 3. According to the Americans with Disabilities
RATIO: 3. A perceived exertion scale is a subjective scale Act Accessibility Guidelines the distance necessary for a
where clients rate their exercise intensity. 180 degree turn using a wheelchair is 60 inches.

46. Therapists often begin the interview process with a 50. A client is scheduled to undergo a transtibial
new client by using open-ended questions. Which amputation secondary to poor healing of an ulcer on
of the following questions would not be considered his left foot. In addition, the client is two months
open-ended? status post right knee replacement due to
A. What makes your pain better? osteoarthritis. Given the client’s past and current
B. Is your back more painful at night? medical history, the physical therapist can expect
C. How does exercise affect your back? which of the following tasks to be the most difficult
D. Describe your activities in a typical day. for the client following his amputation?
RATIO: 2. Open-ended questions guide the discussion, A. rolling from supine to sidelying
but do not restrict information to categories. Closed-ended B. moving from sitting to supine
questions are more impersonal and provide a limited C. moving from sitting to standing
number of response options. D. ambulating in the parallel bars
RATIO: 3. All of the listed tasks are reasonable
47. A client is referred to physical therapy following expectations for the client, however moving from sitting to
surgery to repair a torn rotator cuff. The physician standing would be the most difficult.
referral does not include postoperative guidelines
and also does not classify the extent or size of the 51. A therapist wears sterile protective clothing while
tear. The therapist’s most appropriate action is to treating a client. Which area of the protective
___? clothing would not be considered sterile even before
A. consult various medical resources that discuss coming in contact with a nonsterile object?
physical therapy management of rotator cuff A. gloves
repairs B. sleeves of the gown
B. consult various protocols of other surgeons in C. front of the gown above waist level
the area D. front of the gown below waist level
C. contact the referring physician and discuss RATIO: 4. Due to the probability associated with
the client’s care incidental contact, the front of the gown below waist level
D. discuss the client’s care with other staff is considered to be non sterile.
members who are more experienced in treating
rotator cuff repairs 52. A physical therapist conducts goniometric
RATIO: 3. Direct personal contact with the referring measurements on a client in supine. When
physician is necessary to plan an effective care plan. measuring elbow flexion the therapist’s stabilizing
force should be directed at the ____?
48. A client with chronic shoulder instability is A. radioulnar joint
scheduled to have an open Bankart procedure. As B. olecranon
part of the surgery, the subscapularis is removed and C. distal humerus
ten reattached to the anterior capsule. In order to D. proximal humerus
protect the subscapularis postoperatively, which of RATIO: 3. Stabilization should occur on the distal
the following shoulder motions initially should be humerus to prevent shoulder flexion.
most limited?
A. flexion 53. A client two days status post transfemoral
B. abduction amputation demonstrates decreased strength and
C. internal rotation generalized deconditioning. Which of the following
D. external rotation positions should be utilized when wrapping the
RATIO: 4. A Bankart lesion is an avulsion of the capsule client’s residual limb?
and glenoid labrum off the anterior rim of the glenoid A. sidelying
resulting from traumatic anterior dislocation of the B. standing
shoulder. Since the subscapularis is placed on stretch with C. supine
external rotation this motion is initially limited after D. prone
surgery. RATIO: 3. A supine position will ensure client safety and
allow the therapist full access to the residual limb.
49. A client paralyzed from the waist down discusses
accessibility issues with an employer in preparation 54. A client who underwent a transtibial amputation one
for her return to work. The client is concerned week ago complains of phantom sensation. Which
about her ability to navigate a wheelchair in certain
Giles and Sanders
 Practice Questions 7
of the following treatment options would be following signs/symptoms is not characteristic of
inappropriate? cerebellar degeneration?
A. tell the client to leave the residual limb A. limb ataxia
exposed to the air at all times B. nystagmus
B. discuss the option of a temporary prosthesis C. dysmetria
with the client’s physician D. hypertonia
C. begin residual limb wrapping RATIO: 4. Clients with cerebellar degeneration often
D. teach the client to tap and massage the residual exhibit hypotonia, not hypertonia.
limb
RATIO: 1. Leaving the residual limb exposed to the air at 60. A therapist attempts to improve neck and upper
all times would result in increased edema and a back extension in an infant with developmental
misshapened residual limb. delay. When passively placed in prone prop, the
infant quickly falls into the prone position. The
55. A therapist transports a client with multiple sclerosis therapist plans to position the child and then use
to the gym for her treatment session. The client is toys and play objects to get the child to look up.
wheelchair dependent and uses a urinary catheter. Which position would be the most appropriate to
When transporting the client, the most appropriate meet the therapist’s treatment objective?
location to secure the collection bag is_____? A. prone prop
A. in the client’s lap B. prone over a gymnastic ball
B. on the lower abdomen C. prone over a wedge
C. on the wheelchair armrest D. quadruped
D. on the wheelchair leg rest RATIO: 3. Prone over a wedge positioning allows for the
RATIO: 4. Positioning of the collection bag on the facilitation of head and back extension through visual
wheelchair leg rest will allow for it to be below the level of tracking or upper extremity movement occurring during
the bladder. therapeutic play.

56. A physical therapist examines a client with multiple 61. An eleven month old child with cerebral palsy
sclerosis. The client has poor to fair strength in her attempts to maintain a quadruped position. Which
legs, good arm strength, and moderate truncal reflex would interfere with this activity if it did not
ataxia. The safest means for the client to ambulate integrate appropriately?
in her home would be ___? this technique? A. Gallant reflex
A. with a single point cane B. symmetrical tonic neck reflex
B. with a walker C. plantar grasp reflex
C. while holding onto furniture or walls D. positive support reflex
D. with axillary crutches RATIO: 2. Head positioning is the stimulus for the
RATIO: 2. The client’s balance and strength require the symmetrical tonic neck reflex. When the head is flexed,
stability provided by the walker. upper extremities flex and lower extremities extend. When
the head extends the upper extremities extend and the
57. A physical therapist attempts to examine the extent lower extremities flex. The reaction of the extremities
of ataxia in a client’s upper extremities. The would not allow for maintaining a hands and knees
preferred method to examine and document ataxia is position.
___?
A. manual muscle test 62. A male therapist is treating a 16 year-old female for
B. sensory test for light touch a low back strain. During the treatment session the
C. functional assessment for rolling in bed client makes several sexually suggestive remarks.
D. finger to nose The therapist ignores the remarks, but the client
RATIO: 4. Ataxia refers to defective muscular reiterates them during the next treatment session.
coordination with active movement. A gross measure of The most appropriate therapist action is to___?
upper extremity ataxia can be assessed through a finger to A. continue to ignore the client’s remarks
nose test. B. explain to the client that her remarks are
offensive
58. A physical therapist treats a client with Parkinson’s C. document the client’s behavior in the medical
disease. In order to improve the client’s motor record
control, the therapist should incorporate which of D. transfer the client to another therapist’s
the following techniques into the treatment session? schedule
A. alternating isometrics RATIO: 2. Inappropriate behavior is unacceptable and
B. rhythmic initiation should not be tolerated. The therapist needs to make the
C. manual resisted exercise client aware that her behavior is inappropriate and
D. lumbar stabilization exercises in quadruped offensive.
RATIO: 2. Rhythmic initiation is a particularly effective
technique to improve motor control in clients with 63. A therapist attempts to schedule a client for an
Parkinson’s disease since they often have difficulty additional therapy session after completing the
initiating movement. initial examination. The physician referral indicates
the client is to be seen two times a week. The
59. A physical therapist examines a client diagnosed therapist suggests several possible times to the
with cerebellar degeneration. Which of the client, but the client insists she can only come in on

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 8 Practice Questions

Wednesday at 4:30. The therapist would like to therapist a sincere fear of dying during surgery. The
accommodate the client, but already has two clients therapist’s most appropriate response would be ___?
scheduled at that time. The most appropriate action A. This surgery is done many times every day.
is to ___? B. I have never had a client of mine die yet.
A. schedule the client on Wednesday at 4:30 C. Surgery can be a very frightening thought.
B. attempt to move one of the client’s schedule on D. You will be back to athletics before you know
Wednesday at 4:30 to a different time it.
C. schedule the client with another therapist on RATIO: 3. The response “surgery can be a very
Wednesday at 4:30 frightening thought” is an empathetic response that
D. inform the referring physician the client only demonstrates respect for the client’s feelings.
will be seen once this week in therapy
RATIO: 3. Scheduling with another therapist will allow 68. Premature ventricular contractions are the most
the client to be seen two times a week as indicated on the commonly observed form of arrhythmias. Which of
referral and will accommodate the client’s schedule. the following does not assist in precipitating PVCs?
A. anxiety
64. A physical therapist develops a series of long and B. tobacco
short term goals for a client. Which of the C. alcohol
following is not a necessary component of a D. sodium
properly written goal? RATIO: 4. Anxiety, tobacco, alcohol and caffeine
A. audience consumption can all serve to precipitate preventricular
B. degree contractions. Sodium has not been shown to have any
C. behavior direct correlation.
D. priority
RATIO: 4. Well written goals contain four distinct 69. A physical therapist using an electrical stimulation
elements: audience, behavior, condition, and degree. device attempts to quantify several characteristics of
a monophasic waveform. When measuring phase
65. A physical therapist consults with an orthotist charge, the standard unit of measure is___?
regarding the need for an ankle-foot orthosis for a A. coulomb
stroke client. The client has difficulty moving from B. ampere
sitting to standing when wearing a prefabricated C. ohm
ankle-foot orthosis. The therapist indicates the D. seconds
client has poor strength at the ankle, intact sensation RATIO: 1. Phase charge is represented by the area under
and does not have any edema or tonal influence. a single phase waveform. The unit of measure is the
The most appropriate type of ankle-foot orthosis for coulomb.
the client would incorporate___?
A. an articulation at the ankle joint 70. A physical therapist instructs a client in ambulation
B. tone reducing features activities using axillary crutches. What two points
C. metal uprights of control should be used when guarding the client?
D. dorsiflexion assist spring A. the client’s thorax and hip
RATIO: 1. An articulation at the ankle joint would allow B. the client’s shoulder and hip
the tibia to advance forward over the fixed foot. This C. the client’s shoulder and thorax
would assist with weight shifting during the sit to stand D. the client’s elbow and hip
transfer. RATIO: 2. Guarding should occur with one hand
positioned on the client’s shoulder and the other on the
66. A physical therapist establishes safe exercise hip. If a gait belt is used the lower hand should grasp the
intensity parameters for a phase I inpatient cardiac gait belt with the forearm in a supinated position.
rehabilitation program. Which parameter would be
the most appropriate for the phase I program? 71. There can be many adverse effects when clients are
A. a maximum heart rate increase of 20 beats fit incorrectly for a wheelchair. Which of the
per minute above resting following could result from a wheelchair with
B. a maximum heart rate increase of 30 beats per excessive seat depth?
minute above resting A. decreased trunk stability
C. a maximum heart rate increase of 40 beats per B. increased weightbearing on the ischial
minute above resting tuberosities
D. a maximum heart rate increase of 50 beats per C. decreased balance
minute above resting D. increased pressure in the popliteal area
RATIO: 1. A maximum heart rate increase of 20 beats RATIO: 4. Increased pressure in the popliteal area can
per minute above resting is considered a safe guideline for lead to skin irritation and circulatory compromise.
a client participating in a phase I program.
72. A therapist assesses the functional strength of a
67. A physical therapist provides preoperative client’s hip extensors while observing a client move
instruction for a client scheduled for anterior from standing to sitting. What type of contraction
cruciate ligament reconstructive surgery. During occurs in the hip extensors during this activity?
the treatment session, the client expresses to the A. concentric

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 Practice Questions 9
B. eccentric RATIO: 4. Although over the counter medications
C. isometric contain low doses of their active ingredients, harmful
D. isotonic effects can occur.
RATIO: 2. The gluteus maximus and the hamstrings
function as primary hip extensors. These muscles function 77. A pregnant client in her third trimester completes a
in an eccentric fashion when moving from standing to series of exercises in supine. In order to prevent
sitting. vena cava compression during the exercise session
the therapist should ____?
73. A rehabilitation manager develops a quality A. place a folded towel under the right side of
assurance program that examines the extent to the client’s pelvis
which physical therapists conform to accepted B. place a folded towel under the left side of the
professional practices. This type of quality client’s pelvis
assurance program is most concerned with ___? C. complete the exercises in sidelying
A. structure D. elevate the client’s feet 12 inches
B. process RATIO: 1. This position will tend to lessen the effects of
C. outcome uterine compression on abdominal vessels and improve
D. product cardiac output by turning the client slightly to the left.
RATIO: 2. Quality assurance programs which focus on
process explore the methods, actions and operations used 78. A therapist completes an upper extremity manual
to bring about a specific result. muscle test on a client diagnosed with rotator cuff
tendinitis. Assuming the client has the ability to
74. A client referred to physical therapy with chronic move the upper extremities against gravity, which of
low back pain has failed to make any progress the following muscles would not be tested with the
toward meeting established goals in over three client in a supine position?
weeks of treatment. The therapist has employed a A. pronator teres
variety of treatment techniques, but has yet to B. pectoralis major
observe any sign of subjective or objective C. lateral rotators of the shoulder
improvement in the client’s condition. The most D. middle trapezius
appropriate action would be to ____? RATIO: 4. Muscle testing of the middle trapezius should
A. transfer the client to another therapist’s occur with the client in the prone position.
schedule
B. re-examine the client and establish new goals 79. A physical therapist is working with a child who has
C. continue to modify the client’s treatment plan cerebral palsy with spastic diplegia. All of the
D. alert the referring physician of the client’s following could be used to improve the child’s
status ability to ambulate except ___?
RATIO: 4. The physician should be informed about the A. stretching and range of motion
client’s lack of progress. The client may be discharged B. strengthening of underlying weak muscles
from physical therapy or referred back to the physician. C. bilateral lower extremity activities such as
“bunny hopping”
75. A client with cardiopulmonary pathology is referred D. trunk and pelvis dissociation activities
to physical therapy. The therapist documents the RATIO: 3. A client with spastic diplegia often utilizes
following clinical signs: pallor, cyanosis, and skin mobility strategies such as “bunny hopping” due to the
coolness. These clinical signs are most consistent lack of dissociation of the lower extremities from each
with ___? other as well as the trunk from the pelvis. These activities
A. cor pulmonale should be discouraged and the focus should instead be on
B. anemia dissociation and reciprocal movement patterns.
C. atelectasis
D. diaphoresis 80. A two year old with T10 spina bifida receives
RATIO: 2. Anemia refers to a reduction in the number of physical therapy for gait training. The preferred
circulating red blood cells. Additional symptoms include method when first teaching the child how to
vertigo, weakness, headache and general malaise. maintain standing is with the use of ____?
A. bilateral HKAFOs and forearm crutches
76. A physician instructs a client to take nonprescription B. a parapodium and the parallel bars
or over the counter medication as part of his C. bilateral KAFOs and the parallel bars
treatment program. Which of the following D. bilateral AFOs and the parallel bars
statements about over the counter medication is not RATIO: 2. For thoracic and high level lumbar lesions the
accurate? parapodium provides the necessary amount of support and
A. The Food and Drug Administration classifies is optimal to assist with standing activities. The parallel
drugs as prescription or nonprescription. bars are the most stable assistive device to initiate standing
B. Over the counter medications are available and to utilize during formal gait training.
without a prescription and can be purchased
directly by consumers. 81. A physical therapist instructs the parents of a
C. Over the counter medications usually contain premature infant on proper positioning. The
low doses of their active ingredient. physical therapist should educate the parents to
D. Potentially harmful effects are not possible avoid ___ when placing their infant in supine?
with over the counter medications. A. lower extremity extension

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B. slight neck flexion insufficiency. Which of the following would not be

C. hands towards midline appropriate to include in the client education
D. scapular protraction program?
RATIO: 1. Premature infants do not have the prolonged A. wear shoes that accommodate to the size and
intrauterine environment which assists in the development shape of your feet
of flexion. There is a high risk for the infant to develop B. observe your skin daily for breakdown
excessive extension and therefore should not be positioned C. wear your compression stockings only at
in full extension in the supine position. night
D. keep your feet elevated as much as possible
82. A 45 year-old female with psoriasis is referred to throughout the day
physical therapy. The client has several lesions on RATIO: 3. Clients with chronic venous insufficiency
the posterior portion of the thigh extending into the must wear compression stockings during periods of activity
popliteal fossa. The most appropriate therapeutic such as ambulation in order to avoid venous stasis and
modality to treat the client’s condition is ____? promote return to the heart.
A. iontophoresis
B. moist heat 87. A 72 year-old female six weeks status post stroke is
C. ultrasound scheduled for discharge from the hospital in one
D. ultraviolet week. At the present time the client is unable to
RATIO: 4. Ultraviolet light combined with topical ambulate and required maximal assistance to
psoralens has proven to be effective in treating psoriasis. complete most transfers. Prior to her hospital
admission the client lived alone in an apartment on
83. A therapist reviews a technical manual for an the first floor. The most appropriate discharge plan
electrical stimulation unit. The manual discusses would be ___?
several inherent electrical terms such as voltage, A. home with no support services
current and resistance. Which of the following B. a nursing home
terms is commonly used to express current? C. home with physical therapy three times per
A. ampere week
B. coulomb D. home with a home health aide during the day.
C. kilohm RATIO: 2. The client’s dependence with ambulation and
D. megohm transfers eliminate home care as a viable option.
RATIO: 1. Ampere is the standard unit of measure for
current. 88. A therapist instructs a client in breathing exercises
to improve ventilation and oxygenation. The
84. A client files suit against a physical therapist therapist’s treatment objective emphasizes the
claiming that she was injured as a result of a specific expansion of a selected area of the chest wall during
treatment technique. In legal proceedings, which of inspiration. The most appropriate breathing
the following would have the most impact on what exercise to achieve the desired outcome is ___?
actually happened at the time of the alleged A. deep breathing
negligent act? B. diaphragmatic breathing
A. the client’s recollections C. segmental breathing
B. the therapist’s recollections D. abdominal breathing
C. the referring physician’s initial examination RATIO: 3. Segmental breathing can be an effective
D. the physical therapist’s daily documentation treatment technique designed to direct activity toward
RATIO: 4. Although a variety of subjective and objective selected areas of the lung.
data are admissible in a court of law, formal
documentation is often paramount. 89. A graded exercise test is performed on a client with
pulmonary disease. During the test the therapist
85. A therapist instructs a client to ascent stairs using identifies that the client’s systolic blood pressure
axillary crutches. Which of the following has decreased by 20 mmHg. The most appropriate
statements most accurately reflects proper guarding action is to ____?
technique? A. continue the graded exercise test
A. the therapist is positioned posterior and B. discontinue the graded exercise test
lateral on the affected side behind the client C. assess the client’s respiration rate
B. the therapist is positioned anterior and lateral D. assess the client’s forced expiratory volume in
on the affected side in front of the client one second
C. the therapist is positioned posterior and lateral RATIO: 2. A decrease in systolic blood pressure of
on the nonaffected side behind the client greater than 10 mmHg or failure of systolic blood pressure
D. the therapist is positioned anterior and lateral to rise with an increase in work load are indications to
on the nonaffected side behind the client discontinue a graded exercise test.
RATIO: 1. This position affords the therapist with the
best opportunity to protect the client in the event of a fall. 90. A 16 year old complete C5 spinal cord injured client
is two weeks status post injury. The client presently
86. A physical therapist prepares a client education tolerates only 30 degrees on the tilt table secondary
program for an individual with chronic venous to orthostatic hypotension. Which transfer would be

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 Practice Questions11
the most appropriate to utilize when moving the assessing the client’s pulse rate, the therapist should
client from bed to the tilt table? measure the client’s pulse for ___?
A. hydraulic lift A. 10 seconds
B. sliding transfer with draw sheet B. 15 seconds
C. two person lift C. 30 seconds
D. dependent standing pivot transfer D. 60 seconds
RATIO: 2. A sliding transfer with drawer sheet is the only RATIO: 4. An irregular pulse should be taken for 60
transfer which will allow the client to maintain a position seconds in order to achieve an accurate measurement.
of less than 30 degrees elevation.
96. A therapist adjusts the height of the parallel bars in
91. It is essential to maintain a sterile field once it has preparation for client ambulation. When at the
been established. Which of the following activities appropriate height, the parallel bars should provide
would not be in violation of a sterile field? ___?
A. sneezing while standing in front of a sterile A. 5-15 degrees of elbow flexion
field B. 15-25 degrees of elbow flexion
B. reaching across a sterile field C. 30-40 degrees of elbow flexion
C. turning your back to the field D. 35-45 degrees of elbow flexion
D. allowing a sterile object to touch another RATIO: 2. The parallel bars should be adjusted to
sterile object provide 15-25 degrees of elbow flexion with a client in
RATIO: 4. Sterile objects which touch each other are still standing and holding the parallel bars six inches anterior
considered sterile. to his/her hips.

92. Residual limb wrapping is often a necessary 97. Standard postural drainage positions for specific
component of a treatment program following lower lung segments utilize a variety of client positions,
extremity amputation. Which of the following is including sitting, sidelying, supine, and prone.
not characteristic of a properly applied bandage? Postural drainage of the ___ typically is
A. smooth and wrinkle free administered with the client in sitting?
B. emphasizes angular turns A. anterior basal segments of the lower lobes
C. provides pressure distally B. posterior segments of the upper lobes
D. encourages proximal joint flexion C. posterior basal segments of the lower lobes
RATIO: 4. Encouraging proximal joint flexion can lead D. right middle lobe
to contractures. RATIO: 2. Postural drainage to the posterior segments of
the upper lobes is performed with the client sitting, leaning
93. A therapist determines that a client rehabilitating over a pillow at a 30 degree angle.
from ankle surgery has consistent difficulty with
functional activities that emphasize the frontal 98. When evaluating a client for a wheelchair, a
plane. Which of the following activities would be therapist determines that the client’s hip width in
the most difficult for the client? sitting and the measurement from the back of the
A. anterior lunge buttocks to the popliteal space are each 16 inches.
B. 6 inch lateral step down Given these measurements, which of the following
C. 6 inch posterior step up wheelchair sizes would best fit this client?
D. 8 inch posterior step down A. seat width 16 inches, seat depth 14 inches
RATIO: 2. The frontal plane divides the body into front B. seat width 18 inches, seat depth 18 inches
and back halves. Movements in the frontal plane occur as C. seat width 16 inches, seat depth 18 inches
side to side movements such as abduction or adduction. D. seat width 18 inches, seat depth 14 inches
Rotary motion in the frontal plane occurs around an RATIO: 4. Seat width = hip width + 2 inches; Seat depth
anterior-posterior axis. = posterior buttock to the popliteal space – 2 inches.

94. A client rehabilitating from a radial head fracture is 99. A client recently admitted to the hospital with an
examined in physical therapy. During the acute illness is referred to physical therapy. During
examination, the therapist notes that the client a scheduled treatment session the client asks what
appears to have an elbow flexion contracture. effect anemia will have on his ability to complete a
Which of the following would not act as an formal exercise program. The most appropriate
appropriate active exercise technique to increase therapist response is?
range of motion? A. you may feel as though your muscles are weak
A. contract-relax B. you may experience frequent nausea
B. hold-relax C. your aerobic capacity may be reduced
C. maintained pressure D. you may have a tendency to become
D. rhythmic stabilization fatigued
RATIO: 3. Maintained pressure is an effective technique RATIO: 4. Anemia is defined as a reduction in the
that can be used to increase range of motion by facilitating number of circulating red blood cells per cubic millimeter.
local muscle relaxation; however it is a passive technique. Symptoms of anemia include pallor of the skin, vertigo and
general malaise.
95. A therapist monitors a client’s pulse after
ambulation activities. The therapist notes that at 100. When performing range of motion exercises with a
times the rhythm of the pulse is irregular. When client who suffered a head injury, a physical

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therapist notes that the client lacks full elbow catheter. Which type of urinary catheter would not
extension and classifies the end feel as hard. The be appropriate for the client?
most likely cause is ___? A. indwelling urinary catheter
A. heterotopic ossification B. external urinary catheter
B. spasticity of the biceps C. Foley catheter
C. anterior capsular tightness D. suprapubic catheter
D. triceps weakness RATIO:2. External catheters are applied over the shaft of
RATIO:1. Heterotopic ossification refers to abnormal a penis and are therefore inappropriate for females.
bone growth in tissue. Signs and symptoms include
decreased range of motion, local swelling and warmth. 105. A client ambulating with an IV in place should be
Heterotopic ossification often occurs in clients following a instructed to grasp the IV pole at what level?
head injury. A. a level where the infusion site is above heart
level
101. A client rehabilitating from injuries sustained in a B. a level where the infusion site at heart level
motor vehicle accident is referred to physical C. a level where the infusion site is below heart
therapy for gait training with an appropriate level
assistive device. The therapist attempts to instruct D. a client with an IV in place should not
the client using axillary crutches, but feels the participate in ambulation activities
assistive device does not offer the client enough RATIO:2. In order to promote optimal fluid flow from an
stability or support. Which of the following IV when ambulating, a client should grasp the pole so the
assistive devices would be the most appropriate for infusion site is at heart level.
the client?
A. walker 106. A therapist monitors a 6 foot 3 inch, 275 pound,
B. cane male’s blood pressure using the brachial artery.
C. Lofstrand crutches Which of the following is most important when
D. parallel bars selecting an appropriate size blood pressure cuff?
RATIO:1. A walker provides more stability than axillary A. client age
crutches and is more functional than the parallel bars. B. percent body fat
C. somatotype
102. A therapist attempts to develop a problem list after D. extremity circumference
examining a client with a transtibial amputation. RATIO:4. The width of a bladder should be
Which of the following would be the most approximately 40% of the circumference of the midpoint
appropriate entry in the client problem list? of the limb. Bladder width for an average size adult is 5-6
A. donning and doffing prosthesis required verbal inches.
cues
B. donning and doffing prosthesis requires verbal 107. Accurate, clear and concise documentation is
cues and minimal assist of 1 becoming increasingly important for all health care
C. dependence with donning and doffing providers. Which of the following suggestions to
prosthesis improve documentation would not be useful?
D. independent donning and doffing prosthesis in A. avoid empty or open lines between entries in
one week the medical record
RATIO:3. The problem list should summarize the B. make sure all entries in the medical record
significant findings of the client as determined by the are typewritten
subjective and objective examination. Since the problem C. use abbreviations that have been standardized
list relates back to the subjective and objective portion of or accepted by a specific facility or the
the note each entry should be described in broad terms. profession
D. co-sign the entries of other medical personnel
103. The director of rehabilitation in an orthopedic when necessary according to state and facility
private practice prepares a list of interview requirements
questions for applicants applying for a vacant RATIO:2. Although typewritten entries in the medical
position. Which of the following would be an record are acceptable, they are not required.
acceptable interview question?
A. Are you in good health? 108. A client informs his therapist that he has to use the
B. How much weight can you lift? bathroom immediately after being transported
C. Have you held a position like this in the outside the hospital to practice car transfers. The
past? therapist’s most appropriate response to meet the
D. Have you ever filed a workers’ compensation client’s physical need is to ___?
claim? A. ask the client if it is an emergency
RATIO:3. Questions asked during interviews should only B. complete the transfer training as quickly as
relate to the functions associated with a given job and possible and allow the client to use the
should not probe into an applicant’s past medical or social bathroom
history. C. transport the client back into the hospital to
use the bathroom
104. A 42 year-old female who is unable to satisfactorily
control the retention and release of urine uses a
Giles and Sanders
 Practice Questions13
D. instruct the client that in the future he should following modalities would bet the most beneficial
use the bathroom before beginning physical to achieve the therapist’s goal?
therapy A. continuous ultrasound
RATIO:3. The only viable solution to meet the client’s B. pulsed ultrasound
physical need is to allow him to use the bathroom. C. ice massage
D. whirlpool
109. A therapist examines a client seven days status post RATIO:3. Ice massage is an accessible and effective
total hip replacement. The client’s medical record cryotherapeutic agent that is often incorporated into a
indicates the surgeon utilized an anterolateral home exercise program to reduce inflammation.
surgical approach. Which of the following motions
would be the most important to restrict during the 114. An athlete is forced to contemplate knee surgery
initial phase of rehabilitation? after spraining the anterior cruciate ligament while
A. knee extension playing soccer. Which situation would provide the
B. knee flexion most direct support for an anterior cruciate ligament
C. hip external rotation reconstruction?
D. hip internal rotation A. grade III ACL and grade I PCL injury
RATIO:3. A client status post total hip replacement using B. grade III ACL sprain with lateral meniscal
an anterolateral surgical approach would be most involvement
restricted in external rotation. Failure to restrict external C. grade II ACL sprain with medial meniscal
rotation may result in hip dislocation or subluxation. involvement
D. functional instability
110. A therapist monitors a client’s pulse rate using the RATIO:4. Many individuals are able to continue to
radial artery. Which of the following general function at high levels despite a variety of ligamentous and
statements regarding pulse rate is not accurate? meniscal injuries; therefore functional instability provides
A. pulse rate is increased with physical exertion the most direct support for an anterior cruciate ligament
B. pulse rate is decreased during relaxation or reconstruction.
sleep
C. pulse rate is decreased with anxiety or stress 115. A therapist asks a client who has been inconsistent
D. pulse rate is higher in children than adults with his attendance in physical therapy, why he is
RATIO:3. Pulse rate is increased with anxiety or stress. having difficulty keeping scheduled appointments.
The client responds that it is difficult to understand
111. A client informs her therapist how frustrated she the scheduling card that lists the appointments. The
feels after being examined by her physician. The therapist’s most appropriate action would be to ___?
client explains that she becomes so nervous; she can A. contact the referring physician to discuss the
not ask any questions during scheduled office visits. client’s poor attendance in therapy
The therapist’s most appropriate response is to B. make sure the client is given a scheduling card
____? at the conclusion of each session
A. offer to go with the client to her next C. write down the client’s appointments on a
scheduled physician visit piece of paper in a manner that the client
B. offer to call the physician and ask any relevant can understand
questions D. discharge the client from physical therapy
C. suggest that the client write down questions RATIO: 3. In order to determine if the client’s
for the physician and bring them with her to poor attendance in therapy is due to difficulty
the next scheduled visit understanding the scheduling card, the information must
D. tell the client it is a very normal response to be be presented in a manner that the client can understand.
nervous in the presence of a physician
RATIO:3. Suggesting the client write down questions for 116. A client status post coronary artery bypass graft is
the physician is a practical and realistic option that will exercising in a phase I cardiac rehabilitation
assist her in future interactions. program. While exercising, the client’s pulse rate is
measured as 125 beats per minute and her
112. A physical therapist observes an electrocardiogram respiration rate is 32 breaths per minute. Based on
of a client on beta blockers. Which of the following the client’s vital signs, the therapist’s most
ECG changes could be facilitated by the beta immediate response should be to ___?
blockers? A. stop the exercise session and continue to
A. bradycardia monitor the client’s vital signs
B. tachycardia B. continue with the exercise session and
C. increased AV conduction time continue to monitor the client’s vital signs
D. ST segment sagging C. notify the referring physician of the client’s
RATIO:1. Beta blockers decrease heart rate and the force vital signs
associated with myocardial contraction. D. document the client’s response to exercise in
the medical record
113. A therapist instructs a client with acute Achilles RATIO:1. Although resting levels of heart rate and blood
tendinitis in a home exercise program. As part of pressure were not provided, a heart rate of 125 beats per
the program, the therapist attempts to reduce the minute and a respiration rate of 32 breaths per minute
inflammation in the involved region. Which of the exceed typical values.

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117. A therapist reviews the medical chart of a client of a feeding device. A feeding device such as a
diagnosed with a fracture of the lower thoracic nasogastric tube can be utilized for a variety of
spine. The chart indicates the client has worn an purposes. Which of the following does not
anterior control thoracolumbar-sacral-orthosis for accurately describe a potential use of the nasogastric
eight weeks. What is the primary purpose of the tube?
anterior control TLSO? A. administer medications directly into the
A. prevent thoracic flexion gastrointestinal tract
B. prevent thoracic extension B. obtain gastric specimens
C. prevent lumbar flexion C. remove fluid or gas from the stomach
D. prevent lumbar extension D. obtain venous blood samples
RATIO:1. TLSOs prevent thoracic flexion and are most RATIO:4. A nasogastric tube is a plastic tube that enters
commonly prescribed in cases of fracture or compression the body through a nostril and terminates in a client’s
of the body of the lower thoracic or upper lumber stomach. As a result the tube is not used for obtaining
vertebrae. TLSOs are sometimes referred to as a “Jewett venous samples.
brace”.
122. All ambulation aids provide varying amounts of
118. Which of the following can be used to examine and stability and support. Many of the aids also have
objectively document motor return in a client with distinct disadvantages, usually resulting from the
hemiplegia? shape and configuration of the device. Which of the
A. Tinetti Balance and Gait Assessment Scale following ambulation aids most likely would cause
B. Somatosensory Organization Test injury to axillary vessels and nerves when used
C. Functional Independent Measure improperly?
D. Fugl-Meyer Assessment of Motor A. walker
Performance B. axillary crutches
RATIO:4. The Fugl-Meyer has been proven to have good C. Lofstrand crutches
validity and reliability for assessing motor function and D. parallel bars
balance in clients with hemiplegia. RATIO:2. Clients using axillary crutches often lean
forward on the crutches to support the body during periods
119. A therapist palpates proximally along the lateral of standing. This activity can lead to damage in the
border of the fifth metatarsal of a client’s foot. axillary region.
Which bone would be palpable as the therapist
continues to palpate proximally along the lateral 123. A therapist conducts a goniometric assessment of
border of the foot? the wrist and hand. When determining the available
A. cuboid range of motion for thumb flexion, the therapist
B. second cuneiform should align the axis of the goniometer over the
C. third cuneiform ___?
D. navicular A. dorsal aspect of the first carpometacarpal joint
RATIO:1. The cuboid is located on the lateral aspect of B. palmar aspect of the first carpometacarpal
the foot immediately posterior to the styloid process of the joint
fifth metatarsal. C. midway between the dorsal aspect of the first
and second carpometacarpal joints
120. A therapist establishes the following short term goal D. midway between the palmar aspect of the first
for client rehabilitating from total knee replacement and second carpometacarpal joints
surgery. Client will ambulate with walker 50% RATIO:2. Carpometacarpal flexion occurs in a frontal
weightbearing and moderate assist of 1 for 20 feet plane around an anterior-posterior axis with the client in
within one week. Three days later, the client the anatomical position.
successfully achieves the established goal. Which
of the following would be the most appropriate 124. A therapist examines a client status post amputation.
revision of the short term goal? Which amputation level would be most susceptible
A. ambulate with walker 25% WB and moderate to a hip flexion contracture?
assist of 1 for 25 feet within one week A. transfemoral
B. ambulate with walker 50% WB and moderate B. knee disarticulation
assist of 2 for 30 feet within one week C. long transtibial
C. ambulate with walker 50% WB and D. short transtibial
minimal assist of 1 for 30 feet within one RATIO:1. Frequent prone positioning is important for
week clients with transfemoral and transtibial amputations;
D. ambulate with the walker 25% WB and however clients with transfemoral amputations are more
minimal assist of 1 for 10 feet within one week susceptible to a hip flexion contracture.

RATIO: 3. The therapist should not alter the client’s 125. A therapist examines a client with post-polio
weightbearing status without prior physician approval. syndrome. Given the client’s diagnosis, which of
the following is the least important component of
121. Clients who are unable to meet their daily the examination?
nutritional needs independently often require the use A. strength
B. sensation
Giles and Sanders
 Practice Questions15
C. endurance B. transporting clients
D. functional mobility C. preparing a treatment area
RATIO:2. Post-polio syndrome is a term used to describe D. implementing an exercise program
symptoms that occur years after the onset of poliomyelitis. RATIO:4. The physical therapy aide is a non licensed
The condition is believed to result as remaining motor worker who is trained under the direction of a physical
units become more dysfunctional. Sensation is typically therapist. Aides are involved in client related and non-
not affected by post-polio syndrome. client related duties, however, would not be responsible for
implementing an exercise program.
126. When observing a client ambulating, a therapist
notes that the client’s gait has the following 131. A therapist prepares to complete an assisted
characteristics: narrow base of support, short step standing pivot transfer with a client that requires
length bilaterally, and decreased trunk rotation. moderate assistance. In order to increase a client’s
This gait pattern is often observed in clients with a independence with the transfer, which of the
diagnosis of ___? following instructions would be the most
A. stroke appropriate?
B. Parkinson’s disease A. I want you to help me perform the transfer.
C. post-polio syndrome B. Try to utilize your own strength to complete
D. multiple sclerosis the transfer.
RATIO:2. Clients with Parkinson’s disease often exhibit C. Only grab onto me if it is absolutely necessary.
difficulty initiating movement, rigidity, absence of D. Use the power in your legs to assist you during
equilibrium responses and diminished associated the transfer.
reactions. RATIO:2. “Try to utilize your own strength to complete
the transfer” is a direct statement which should present the
127. A therapist attempts to assess a client’s fine motor client with a clear understanding of the therapist’s
coordination following wrist surgery. Which of the objective. It also places the client in an active instead of a
following tasks would require the greatest fine passive position.
motor coordination?
A. stacking large blocks 132. A therapist assesses the ligamentous integrity of a
B. assembling small pins, collars and washers client’s knee by completing a series of special tests.
C. turning cards The most accurate way to determine if the client’s
D. picking up large heavy objects ligamentous integrity is compromised is to ___?
RATIO:2. Assembling small bolts, nuts and washers are A. compare the millimeters of ligamentous laxity
activities used in a number of assessment measures which to established norms
examine fine motor coordination such as the Purdue Peg B. instruct the referring physician to order
Board Test. radiographs
C. compare the ligamentous laxity in the
128. A variety of factors can influence blood pressure. involved knee to the uninvolved knee
Which individual would you expect to have the D. compare the ligamentous laxity to other clients
lower systolic blood pressure? in the clinic without knee pathology
A. 10 year old RATIO:3. Since all clients have different degrees of
B. 30 year old ligamentous laxity it is essential to establish a baseline
C. 50 year old with the uninvolved extremity prior to assessing the
D. 70 year old involved extremity.
RATIO:1. Approximate blood pressure by age; 10 years
old 90/60 mmHg, 30 years old 115/75 mmHg, 50 years old 133. A therapist examines a 48 year-old male with
125/82 mmHg, 70 years old 135/88 mmHg. degenerative joint disease. The referring physician
indicates that the client should be seen in physical
129. A therapist designs a cardiovascular training therapy three times per week. During the
program for a 29 year-old male rehabilitating from a examination the client indicates that the car ride to
lower extremity injury. The client has no known therapy takes approximately 50 minutes and that
cardiovascular pathology and has been cleared for child care duties make frequent physical therapy
exercise by his physician. The client’s maximum visits impossible. The therapist’s most appropriate
heart rate during exercise should be calculated as action is to ___?
___? A. reduce the number of weekly visits and
A. 170 beats per minute notify the referring physician
B. 180 beats per minute B. transfer the client to another therapist’s
C. 191 beats per minute schedule
D. 201 beats per minute C. ask the client to discuss the matter with his
RATIO:3. Age predicted maximum heart rate = 220-age. physician
Maximum heart rate = 220-29 = 191. D. treat the client three times per week
RATIO:1. The length of the car ride makes therapy three
130. Physical therapy aides can play an important role in times a week unrealistic. If reducing the number of
the daily operation of a physical therapy department. therapy visits jeopardizes the outcome of care, it may be
Which of the following activities would not be appropriate to find therapy services within a more narrow
appropriate for an aide to perform? geographic radius,
A. cleaning and maintaining exercise equipment

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134. A therapist instructs a client with a lower extremity wheelchair for the majority of her transportation and
amputation to wrap her residual limb. Which of the occasionally uses a swing to gait pattern with
following would be the least acceptable method of Lofstrand crutches. The client reports being
securing the bandages? frustrated by the lack of speed using the swing to
A. clips gait and would like to learn an alternate gait pattern.
B. safety pins What gait pattern would be the most appropriate for
C. tape the client?
D. velcro A. two point alternating
RATIO:1. Clips often provide poor anchors and can cut B. three point
the skin. Safety pins are also of questionable value, C. four point alternating
however are not as dangerous as clips. D. swing through
RATIO:4. A swing through gait pattern relies on the
135. A client uses transcutaneous electrical same principles as a swing to gait pattern, however allows
neuromuscular stimulation for pain modulation. a client to bring the lower extremities beyond the point to
Which set of parameters best describes conventional which the assistive devices were advanced.
TENS?
A. 50-100 pps, short phase duration, low 139. A therapist prepares a client status post stroke with
intensity global aphasia for discharge from a rehabilitation
B. 100-150 pps, short phase duration, high hospital. The client will be returning home with her
intensity husband and daughter. The most appropriate form
C. 150-200 pps, long phase duration, low of education to facilitate a safe discharge is to ___?
intensity A. perform hands on training sessions with the
D. 200-250 pps, short phase duration, low client and family members
intensity B. videotape the client performing transfers and
RATIO:1. Conventional TENS utilizes a pulse rate of 50- ADLs
100 pps, short pulse or phase duration and low intensity to C. provide written instructions on all ADLs and
deliver sensory level stimulation. functional tasks
D. meet with family members to discuss the
136. A therapist observes a client’s skin shortly after client’s present status and abilities
applying moist heat to the lower back. The therapist RATIO:1. Hands on training sessions provide unique
identifies several signs of heat intolerance including opportunities for the therapist to assess the competence of
uneven blotching and a surface rash. The most family members in a structural environment.
appropriate action is to ___?
A. continue with present treatment 140. A therapist is required to transfer a 250 lb.
B. select an alternate superficial heating agent dependent client from a mat table to a wheelchair.
C. limit moist heat exposure to five minutes The therapist is concerned about her ability to
D. discontinue the moist heat and document independently transfer the client, but is unable to
the findings locate another staff member to offer assistance. The
RATIO:4. Treatment should be discontinued when there most appropriate action would be to ___?
is any sign of heat intolerance. It is important to A. instruct the client to take a more active role in
document the incident in order to alert other possible the transfer
providers to the client’s reaction and to make the incident B. attempt to complete the transfer independently
part of the permanent medical record. but stop immediately if body mechanics are
compromised
C. inform the nursing staff to complete the
137. A therapist works with a client rehabilitating from a transfer
traumatic brain injury on a mat program. The D. wait until another staff member is available
program emphasizes various developmental to assist with the transfer
positions to prepare a client for ambulation RATIO:4. Therapists should never place their personal
activities. Which developmental position would be safety in jeopardy.
the most demanding?
A. hooklying 141. A client successfully completes ten anterior lunges.
B. quadruped The therapist would like to modify the activity to
C. kneeling maximally challenge the client in the sagittal plane.
D. modified plantigrade Which of the following modifications would be the
RATIO:4. The modified plantigrade position requires most appropriate?
clients to possess control of equilibrium and proprioceptive A. anterior lunge with concurrent bilateral elbow
reactions. The position offers a small base of support and flexion to 45 degrees with five pound weights
high center of gravity with weightbearing occurring B. anterior lunge with concurrent bilateral
through the lower extremities. shoulder flexion to 90 degrees with five
pound weights
138. A severely disabled client is referred to physical C. anterior lunge with concurrent unilateral
therapy for gait training. The client exhibits good shoulder flexion to 90 degrees with a five
balance and coordination and has normal upper pound weight
extremity strength. The client currently is using a
Giles and Sanders
 Practice Questions17
D. anterior lunge with concurrent bilateral
shoulder abduction to 45 degrees with five
pound weights 146. A client with paraplegia is interested in learning
RATIO:2. The sagittal plane divides the body into left and how to perform a wheelie to assist with community
right halves. Motions in the sagittal plane include flexion mobility. The client is independent with basic
and extension. Bilateral shoulder flexion would create the wheelchair propulsion. When instructing the client
largest forward movement and would therefore provide the to perform a wheelie, the therapist first should teach
greatest challenge for the client. the client to ___?
A. make small adjustments (forward and
142. A therapist teaches a client positioned in supine to backward) after being placed in the wheelie
posteriorly rotate her pelvis. The client has full position
active and passive range of motion in the upper B. move into the wheelie position
extremities, but is unable to achieve full shoulder C. perform turns while holding the wheelie
flexion while maintaining the posterior pelvic tilt. position
Which of the following could best explain these D. statically hold the wheelie position after
findings? being place in it by the therapist
A. capsular tightness RATIO:4. This activity requires the least skill and will
B. latissimus dorsi tightness provide the client with the opportunity to gain a sense of
C. pectoralis minor tightness balance before moving to more difficult activities.
D. quadratus lumborum tightness
RATIO:2. Shortening of the latissimus dorsi often 147. Physical therapists and physical therapist assistants
presents as a limitation of shoulder flexion or abduction perform many of the same functions in the clinic.
due to the muscles origin on the external lip of the iliac Which of the following activities would not be
crest and its insertion on the intertubercular groove of the appropriate for a physical therapist assistant to
humerus. perform?
A. application of superficial modalities
143. A clinical instructor asks a student to complete three B. instruction of a client in gait training
selected joint mobilization techniques on a client C. complete documentation in the medical record
diagnosed with adhesive capsulitis. Which learning D. modification of an established plan of care
domain is emphasized with the desired task? RATIO:4. A physical therapist assistant can modify a
A. cognitive specific intervention procedure when necessitated by a
B. psychomotor change in client status, however cannot alter an
C. affective established plan of care.
D. psychosocial
RATIO:2. The psychomotor domain is directed toward 148. A client sustains a traction injury to the brachial
physical activity. The six categories of objectives in the plexus in a motor vehicle accident and has resultant
psychomotor domain according to Bloom’s taxonomies are C5 and C6 nerve root involvement. Which of the
reflex movements, basic fundamental movements, following muscles would be most affected by the
perceptual abilities, physical abilities, skilled movements injury?
and non discursive communications. A. flexor carpi ulnaris
B. levator scapulae
144. A client sustains a deep laceration on the right thigh C. pectoralis minor
after falling into a modality cart. The laceration D. pectoralis major
causes immediate and excessive bleeding. The RATIO:4. The upper fibers of the pectoralis major are
therapist should first ___? innervated by the lateral pectoral nerve C5 C6 C7.
A. apply direct pressure over the laceration
B. examine the lower extremity 149. A physical therapist observes a burn on the dorsal
C. put on gloves surface of a client’s arm. The therapist notes that
D. contact the chief physical therapist the wound appears to involve the epidermis and
RATIO:3. The first and most appropriate action is to put most of the dermis. The wound area is mottled red
on gloves. Although direct pressure over the laceration is with a number of blisters. The therapist informs the
necessary, a therapist must always protect him/herself first. client that healing should take place in less than
three weeks. This description is most indicative of a
145. As part of the initial examination, a physical ___?
therapist develops long term goals for a client who A. superficial burn
has complete quadriplegia at the C5 level. All of B. superficial partial thickness burn
the following are appropriate long term goals for C. deep partial thickness burn
this client except ___? D. full thickness burn
A. complete lower extremity self range of RATIO:2. A superficial partial thickness burn involves
motion in bed independently both the epidermis and a portion of the dermis. Healing
B. eat independently with adaptive equipment typically occurs in approximately three weeks with little or
C. propel a manual wheelchair 15 feet on level no scarring.
surfaces independently
D. direct a caretaker to perform a car transfer 150. A group of physical therapists develop a research
RATIO:1. Self range of motion of the lower extremity is a project which examines the effect of increased
realistic goal at the C7 spinal injury level, but not at C5. abdominal muscle strength on forced vital capacity

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 18 Practice Questions

and forced expiratory volume. In order to conduct B. educate the adolescent as to the causes of
the study, the therapists are required to have the scoliosis
approval of the Hospital Institutional Review Board. C. devise and exercise program for the adolescent
The primary purpose of the committee is to ___? D. instruct the adolescent in the importance of
A. protect the hospital from unnecessary litigation proper posture
B. ensure that established client care standards RATIO:1. An adolescent with a moderate scoliotic curve
are not compromised should be referred to a physician for further assessment.
C. examine the design of the research project
D. assess the financial ramifications of the 155. A therapist orders a wheelchair for a client recently
research project admitted to a rehabilitation hospital. How many
RATIO:2. Institutional review boards are responsible for inches above the chair seat is the armrest on a
assuring the welfare and safety of clients and establishing standard adult wheelchair?
that ethical, moral and legal standards are not A. 5 inches
compromised by proposed research activity. B. 7 inches
C. 9 inches
151. Members of a community health task force evaluate D. 11 inches
a proposal for a new adolescent screening program. RATIO:3. Nine inches above the chair seat allows the
Several members of the task force raise questions as typical user to sit upright with the shoulders level while
to the validity of the screening instrument. Which bearing weight on the forearms positioned on the armrests.
measure of validity examines the instrument’s
ability to identify diseased persons by comparing 156. A therapist designs a treatment program for a client
true positives? with a traumatic head injury. The client currently is
A. adaptability classified as confused agitated. Which of the
B. selectivity following guidelines would be the least beneficial
C. sensitivity when developing the treatment program?
D. specificity A. The therapist should emphasize previously
RATIO:3. Sensitivity can be calculated by taking the learned skills and avoid teaching only new
number of individuals the instrument identified as skills
diseased, who were diseased, and dividing by the known B. The therapist should maintain a calm and
prevalence of the condition in the group. focused affect.
C. The therapist should concentrate on one
152. A client who had difficulty controlling the release specific activity for each treatment session.
and retention of urine uses a urinary catheter. Upon D. The therapist should schedule the client at the
beginning to examine the client, the therapist notices same time and same place each day.
that the collection bag is almost completely full. RATIO:3. Clients in the confused-agitated stage have a
The most appropriate action is to ___? short attention span and therefore require numerous
A. continue with the examination and periodically activities.
monitor the collection bag
B. disconnect the collection bag during the 157. A therapist orders a wheelchair for a client with C7
examination complete quadriplegia. Which of the following
C. empty the collection bag wheelchairs would be the most appropriate for the
D. contact the client’s nurse and request client?
assistance A. electric wheelchair with chin controls
RATIO:4. Failure to allow for adequate flow of urine into B. manual wheelchair with handrim projections
a collection bag can lead to serious medical complications. C. manual wheelchair with friction surface
handrims
153. A therapist discusses the importance of proper skin D. manual wheelchair with standard handrims
care with a client and his family. Which of the RATIO:3. Friction surface handrims assist a client
following sites is least likely to develop a pressure without a strong grasp.
ulcer in a wheelchair dependent client?
A. scapula 158. A therapist checks the water temperature of the hot
B. ischium pack machine after several clients report the heat
C. heel being very strong. Which of the following
D. elbow temperatures would be acceptable?
RATIO:4. The elbow is not typically in direct contact with A. 71 degrees Celsius
a given component of a wheelchair and is therefore not B. 88 degrees Celsius
likely to be the site of a pressure ulcer. C. 130 degrees Fahrenheit
D. 190 degrees Fahrenheit
154. A group of physical therapists conducts scoliosis RATIO:1. Hot packs should be stored in water that is
screenings on adolescents as part of physical approximately 160 degrees Fahrenheit or 71 degrees
therapy week. The most appropriate action after Celsius.
identifying an adolescent with a moderate scoliotic
curve is to ___? 159. A physical therapy department plans a study to
A. refer the adolescent for further orthopedic examine rehabilitation outcomes in clients who have
assessment
Giles and Sanders
 Practice Questions19
undergone anterior cruciate ligament reconstruction. of the following descriptions most accurately
The study will include a sample of clients from 25 describes proper hand placement when palpating the
orthopedic surgeons in the local region. If the upper lobe?
therapists compile a list of all eligible clients and A. place the palms firmly against the chest wall
select every third client to participate in the study, and hook the fingers over the posterior axillary
what type of sampling was used? fold
A. simple random sampling B. place the palms of the hand firmly over the
B. stratified sampling anterior aspect of the chest from the fourth
C. systematic sampling rib cranially and hook the fingers around
D. cluster sampling the trapezii
RATIO:3. Systematic sampling requires a list of all C. place the thumbs over the spine of the scapulae
individuals in a defined population. Members of the so that the fingers reach around the
population are automatically selected once the first subject anterolateral aspects of the neck
has been chosen. D. extend the thumbs over the posterior midline
of the back and hook the fingers around the
160. A therapist prepares to mobilize the glenohumeral anterior axillary fold
joint by placing the joint in its resting position. RATIO:2. It is often necessary to examine upper, middle
Which of the following explanations best describes and lower lobe expansion during quiet and deep breathing.
why this position is used commonly for joint
mobilization? 164. A therapist presents an in-service entitled
A. joint compressive forces are minimal in the “Preventing Pressure Ulcers” to a group of physical
resting position therapy aides. As part of the in-service, the
B. assessment manipulations are performed easily therapist identifies risk factors associated with the
in the resting position development of pressure ulcers. Which of the
C. there is maximal congruency in the articular following would not be considered a significant risk
surfaces in the resting position factor?
D. oscillations are performed easily in the resting A. nutritional deficiencies
position B. incontinence
RATIO:1. The resting position is a position in which the C. psychological stress and depression
capsule has the greatest laxity. As a result there is D. vocational dysfunction
maximal joint traction and joint play. RATIO:4. Vocational dysfunction is not associated with
pressure sores. Other risk factors include diminished
161. A physical therapist designs a research study in sensation, infection, spasticity and disuse atrophy.
which it is desirable to limit the risk when making a
conclusion or inference from the study. Which of 165. A client suffers a chemical burn on the cubital area
the following levels of significance would be the of the elbow. Which position would be the most
most appropriate for the study? appropriate for splinting of the involved upper
A. .05 extremity?
B. .01 A. elbow flexion and forearm pronation
C. 1.0 B. elbow flexion and forearm supination
D. 10 C. elbow extension and forearm pronation
RATIO:2. Rejecting the null hypothesis at the .01 level D. elbow extension and forearm supination
indicates the researcher is taking a 1% risk of RATIO:4. Splinting in elbow extension and forearm
encountering a Type I error. supination will effectively limit contractures and maximize
functional use of the upper extremity.
162. A client who has completed six months of therapy
receives a referral for eight additional weeks of 166. Electromyography is performed on a client to
physical therapy. The therapist feels the client has objectively determine the extent of pathology after
plateaued and is not a realistic candidate for sustaining a brachial plexus injury. Which of the
continued therapy. The therapist’s most appropriate following responses is most indicative of a normal
action is to ___? muscle at rest?
A. continue the client in physical therapy for eight A. electrical silence
additional weeks B. spontaneous potentials
B. re-examine the client and develop new short C. polyphasic potentials
and long term goals D. occasional motor unit potentials
C. conduct a four week trial to determine if the RATIO:1. The process of electromyography involves
client has made objective progress asking a client to move a particular muscle so that
D. contact the referring physician and discuss voluntary potentials can be recorded. There should not be
the concerns regarding the client’s any recorded electrical activity in a muscle at rest.
rehabilitation potential
RATIO:4. The therapist should not provide additional 167. A client with a C7 nerve root injury is examined in
services when he/she believes the client will no longer physical therapy. Which of the following objective
benefit from therapy. findings would be most indicative of C7
involvement?
163. A therapist uses palpation to assess upper lobe A. paresthesias over the little finger
expansion during quiet and deep breathing. Which B. weak triceps and wrist flexor muscles

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C. paresthesias over the thumb 172. A cardiac client undergoes a low-level symptom
D. weak biceps and supinator muscles limited exercise treadmill test that begins at 1.5
RATIO:2. C7 level: Motor – triceps, wrist flexors, finger METs and progresses to 4 METs. Which of the
extensors; Sensation – middle finger; Reflex – triceps. following activities would require an energy
expenditure of approximately 4 METs?
168. A physical therapist examines a client diagnosed A. sitting quietly at rest
with acromioclavicular joint dysfunction. The B. level walking at 1 mph
therapist instructs the client to abduct his arm in a C. level walking at 3 mph
coronal place to 180 degrees. Which portion of the D. level walking at 5 mph
range of motion would you most expect to elicit RATIO: 3. Walking at 3 mph, bicycling at 6 mph or
pain in the acromioclavicular joint? playing golf while pulling a bag cart are activities which
A. 30-70 degrees required 3-4 METs.
B. 50-90 degrees
C. 90-120 degrees 173. A physical therapist prepares a client for prosthetic
D. 120-180 degrees training. Which of the following amputations would
RATIO: 4. Acromioclavicular dysfunction often results in require the highest energy expenditure when using
a painful arc from 120 – 180 degrees of abduction. A the appropriate prosthesis?
painful arc from 90 – 120 degrees may be indicative of A. bilateral transtibial amputations
subacromial bursitis, calcium deposits or tendinitis of the B. unilateral transtibial amputation
rotator cuff muscles. C. unilateral transfemoral amputation
D. Syme’s amputation
169. A physical therapist employed in a skilled nursing RATIO: 3. A client walking at a comfortable pace with a
facility frequently treats cognitively impaired transfemoral prosthesis requires nearly 50% more oxygen
elderly clients. Which of the following guidelines is than normal.
not recommended when working with this particular
population? 174. A client rehabilitating from a total hip replacement
A. encourage the use of hands on treatment is scheduled for home physical therapy. The
B. explain frequently, consistently, and therapist assigned to the case attempts to schedule
repetitively when necessary the client, but the client indicates that she will be
C. change the client’s environment and staff unavailable for the next week due to a death in the
frequently family. The most appropriate therapist action is to
D. simplify commands and label items for easy ___?
recognition A. insist that the client participate in physical
RATIO: 3. Changing the client’s environment and staff therapy
frequently will yield to greater levels of stress and cognitive B. discharge the client secondary to
dysfunction. noncompliance
C. document the conversation with the client
170. A therapist completes a quantitative gait analysis on and notify the physician
a client rehabilitating from a lower extremity injury. D. ask the physician to convince the client to
As part of the examination the therapist measures begin physical therapy immediately
the number of steps taken by the client in a 30 RATIO: 3. It is important to document any delay in the
second period. This measurement technique can be initiation of physical therapy services and to notify the
used to measure ___? referring physician.
A. acceleration
B. cadence 175. A therapist positions the client in prone with the
C. velocity knee flexed to 70 degrees prior to completing a
D. speed manual muscle test of the hamstrings. To isolate the
RATIO: 2. Cadence is defined as the number of steps biceps femoris the therapist should ___?
taken by a person per unit of time. A. place the thigh in slight lateral rotation and
the leg in slight lateral rotation on the thigh
171. Members of a health promotion task force design a B. place the thigh in slight medial rotation and the
program that annually will screen individuals in leg in slight medial rotation on the thigh
selected retirement communities for osteoporosis. C. position the knee in 100 degrees of flexion
Which screening tool would be the most cost D. position the knee in 120 degrees of flexion
effective and reliable to incorporate as part of the RATIO: 1. The test for the lateral hamstrings is described
program? with the knee in 50-70 degrees of flexion with the thigh in
A. physical activity survey slight lateral rotation and the leg in slight lateral rotation
B. dietary analysis on the thigh. Pressure should be applied against the leg
C. measuring height proximal to the ankle in the direction of knee extension.
D. urinalysis screening
RATIO: 3. Osteoporosis refers to a disease process that 176. A therapist reviews a client’s blood gas analysis.
results in a reduction of bone mass. Screening by The therapist identifies that the PaCO2 is elevated
measuring height can provide an inexpensive method to and the pH is below the normal level. These
screen for this disease. findings are most representative of ___?
A. respiratory acidosis
Giles and Sanders
 Practice Questions21
B. respiratory alkalosis following situations would present the client with
C. metabolic acidosis the largest barrier toward living independently?
D. metabolic alkalosis A. The client resides alone and has no outside
RATIO: 1. Respiratory acidosis is caused by retention of support from family or friends.
carbon dioxide due to pulmonary insufficiency. Signs and B. The client is no longer able to drive and relies
symptoms include dizziness, tingling, and syncope. on a neighbor for all cooking, cleaning and
shopping.
177. A therapist strongly suspects a client is intoxicated C. The client has a two story home.
after arriving for his treatment session. When asked D. The client resides with a woman who has
if he has been drinking, the client indicates he rheumatoid arthritis.
consumed six or seven alcoholic beverages before RATIO: 1. A client with moderate dementia can not live
driving to therapy. The therapist’s most appropriate independently without assistance and frequent supervision.
action is to ___? Without adequate support the client’s safety is jeopardized.
A. continue to treat the client, assuming he can
remain inoffensive to other clients 181. A therapist examines a client diagnosed with
B. modify the client’s present treatment program Guillain-Barre syndrome. All of the following are
to minimize the effects of alcohol signs/symptoms associated with this syndrome
C. contact a member of the client’s family to except ___?
take the client home A. difficulty breathing
D. instruct the client to leave the clinic B. areflexia
RATIO: 3. The client is likely to be intoxicated if he has C. weakness
consumed six or seven beers. Contacting a member of the D. absent sensation
family will prevent the possibility of the client attempting to RATIO: 4. Guillain-Barre is an acute polyneuropathy
drive. causing rapid, progressive loss of motor function.
Although mild sensory loss can be evident, absent
178. A therapist instructs a client to complete a biceps sensation is extremely rare.
strengthening exercise using a ten pound dumbbell
in standing. The exercise requires the client to 182. A physical therapist examines a 42 year-old self-
maximally flex her elbow twelve times without referred female. The client describes the onset of a
moving the trunk. While observing the client variety of medical problems approximately one
performing the exercise, it becomes apparent that month ago. The client’s reported problems include
the client is unable to maintain her trunk in a right lower extremity weakness, decreased balance
stationary position. Which of the following and blurred vision. The physical therapy
modifications would be the most appropriate? examination confirms the client’s complaints, in
A. decrease the number of repetitions to six addition to identifying decreased pinprick sensation
B. decrease the dumbbell weight to five pounds and ankle clonus in the right lower extremity. The
C. instruct the client to perform the exercise while suspected diagnosis of this client is ___?
sitting on a stool A. diabetes
D. no modifications are necessary B. multiple sclerosis
RATIO: 2. Reducing the weight to five pounds will allow C. stroke
the client to maintain the integrity of the originally D. Parkinson’s disease
prescribed exercise, while allowing the client to perform RATIO: 2. Multiple sclerosis is a progressive disease of
the exercise correctly. the central nervous system marked by intermittent damage
to the myelin sheath. Blurred vision and muscle weakness
179. A therapist prepares to apply a sterile dressing to a are common symptoms associated with this condition.
wound after debridement. The therapist begins the
process by drying the wound using a towel. The 183. A 78 year-old male, one month status post open
therapist applied medication to the wound using a reduction and internal fixation of an
gauze pad and then applies a series of dressings intertrochanteric fracture is referred to physical
which are secured using a bandage. Application of therapy. The client has pain with active movement
the ____ would not require the use of sterile and decreased hip range of motion. Which of the
technique? following modalities would be contraindicated for
A. bandage the client?
B. dressings A. moist heat
C. medication B. pulsed ultrasound
D. towel C. cryotherapy
RATIO: 1. A bandage is used to secure underlying D. shortwave diathermy
dressing and therefore does not come in direct contact with RATIO: 4. Internal or external metal objects are
the wound. contraindications for shortwave and microwave diathermy.

180. A therapist interviews a client in an attempt to 184. A physical therapist performs a wheelchair
gather information to assist with discharge planning. evaluation for a client with multiple sclerosis. The
The client is rehabilitating from an intertrochanteric client recently fell while ambulating and sustained a
fracture sustained six weeks ago after a fall. The fracture of the right tibia. Since the client is
client has moderate dementia, but has no other presently unable to bear weight through the
significant past medical history. Which of the involved extremity, the client has difficulty

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 22 Practice Questions

transferring from a chair to a bed. Which of the D. tenderness to palpation in L1-L2 area
following wheelchair prescriptions is most RATIO: 1. The word “will” denotes future tense. This
appropriate for the client? entry is most appropriate in the plan section of a S.O.A.P.
A. light weight wheelchair, removable note.
armrests, removable elevating leg rests
B. light weight wheelchair, removable armrests, 189. A physical therapist is treating a client with
nonremovable leg rests Parkinson’s disease. The client has trouble
C. light weight wheelchair, nonremovable initiating movement and is unable to ambulate
armrests, removable elevating leg rests independently. The client reports that he has fallen
D. standard wheelchair, nonremovable armrests, on three separate occasions within the last two
and leg rests months while attempting to ambulate. Which
RATIO: 1. Removal armrests will assist the client when assistive device would be the most appropriate for
transferring from wheelchair to bed. Elevating legrests this client?
can limit the amount of time the involved leg is in a A. rolling walker
dependent position. B. walker
C. axillary crutches
185. A therapist positions a client in sidelying and D. small base quad cane
performs a talar tilt test. A positive talar tilt test RATIO: 1. A rolling walker will provide the client with
would be most indicative of a ___? the necessary stability to ambulate safely. The wheels will
A. calcaneofibular ligament injury allow for a smoother more coordinated gait pattern.
B. ligamentous instability
C. deltoid ligament injury 190. A client with muscle weakness and compromised
D. excessive tibial torsion balance uses a four-point gait pattern with two
RATIO: 1. The talar tilt test is performed with client in canes. When ascending stairs the most practical
supine with the knee flexed to 90 degrees. The foot should method is to ___?
be maintained in a neutral position while the foot is moved A. use the handrail with the right hand and
from side to side into abduction and adduction. A positive place the two canes in the left hand
test is indicated by excessive adduction. B. use the handrail with the left hand and place
the two canes in the right hand
186. A physical therapist treats a client who is status post C. place one cane in each hand and avoid using
traumatic brain injury. The client is classified as the handrail
level four on the Ranchos Los Amigos Level of D. place the two canes in the left hand and avoid
Cognitive Functioning Scale. Which of the using the handrail
following would be the least appropriate to include RATIO: 1. When ascending stairs clients should follow
in the client’s physical therapy session? the normal flow of traffic. Since the client does not have
A. redirection to tasks unilateral weakness it is most appropriate to ascend the
B. random practice, using a variety of tasks stairs on the right. This necessitates holding the canes
C. repetition of instructions with the left hand and grasping the handrail with the right.
D. ambulation in busy environments
RATIO: 4. Clients that are confused-agitated are often 191. A physical therapist receives a referral for a client
over stimulated by busy environments. who is one week status post head injury. In the
client’s medical record it notes that the client
187. According to the Motor Control/Task Oriented demonstrates decorticate posturing. This type of
Approach, a physical therapy treatment session posturing is characterized by ____?
always should include ___? A. upper extremity extension and lower extremity
A. tone reducing activities flexion
B. positioning B. upper extremity flexion and lower extremity
C. functional activities flexion
D. developmental positions C. upper extremity extension and lower extremity
RATIO: 3. The Motor Control/Task Oriented Approach extension
theorizes that movement is organized around a goal D. upper extremity flexion and lower extremity
behavior. It also believes that strategies for moving are extension
elicited when a client interacts with the environment RATIO: 4. Decorticate posturing is characterized by
during a functional task. abnormal flexor responses in the upper extremity and
extensor responses in the lower extremities. The posture is
188. A therapist completes a daily progress note utilizing usually indicative of a lesion at or above the upper brain
a S.O.A.P. format. Which of the following entries stem.
would not belong in the objective section?
A. will receive continuous ultrasound to the 192. A twelve month-old child with cerebral palsy
right anterior shoulder at 1.5 W/cm2 for 5 demonstrates an abnormal persistence of the
minutes positive support reflex. During therapy this would
B. incision on the left anterior forearm covered most likely interfere with ___?
with steri-strips A. sitting activities
C. left lower extremity range of motion within B. standing activities
normal limits C. prone on elbows activities
Giles and Sanders
 Practice Questions23
D. supine activities 197. A physical therapist uses the upper extremity D1E
RATIO: 2. The positive support reflex promotes extension proprioceptive neuromuscular facilitation pattern
of the lower extremities and trunk with weightbearing and is resisting elbow extension with the goal of
through the balls of the feet. This reflex normally increasing the client’s ability to extend her wrist.
integrates at two months of age. This is an example of ___?
A. reciprocal excitation
193. A physical therapist treats a client with limited B. successive induction
shoulder range of motion. The therapist feels that C. irradiation
the client’s range of motion limitation is due to pain D. quick stretch
and not a specific tissue restriction. Which RATIO: 3. When resistance is applied against a strong
mobilization grade would be most appropriate to component of a pattern it can result in irradiation or
treat this client? overflow of impulses to the weaker muscle groups in that
A. Grade I, II pattern.
B. Grade II, III
C. Grade III, IV 198. A client who has suffered a stroke four weeks ago is
D. Grade IV, V beginning to show the ability to produce movement
RATIO: 1. Grade I or II oscillation or slow intermittent patterns not dictated solely by limb synergies.
grade I or II sustained joint distraction are primarily According to Brunnstrom, this client is in which
utilized for pain. stage of recovery?
A. two
194. A therapist assesses the hip range of motion of a B. three
client with excessive anteversion. Which of the C. four
following clinical findings is common in a client D. six
with anteversion? RATIO: 3. Stage 4 in Brunnstrom’s six stages of recovery
A. increased hip lateral rotation and decreased for hemiplegia consists of a client’s progression to allow
medial rotation for movements performed outside of synergy patterns.
B. increased hip medial rotation and decreased
lateral rotation 199. A therapist works with a client to improve bed
C. increased hip abduction and decreased mobility. Which of the following techniques will
adduction most effectively increase the client’s hip stability?
D. increased hip flexion and decreased extension A. lower trunk rotation in the hooklying position
RATIO: 2. Anteversion refers to the degree of angulation B. bridging
of the neck of the femur. In adults the mean is 18-15 C. assisted hip and knee flexion in supine
degrees. Clients with excessive anteversion often exhibit D. hip abduction and adduction in the hooklying
more than 60 degrees of hip medial rotation and decreased position
lateral rotation. RATIO: 2. Bridging causes the muscles of the low back
and hip extensors to isometrically contact. This action
195. A client diagnosed with lateral epicondylitis is promotes hip stability.
referred to physical therapy. The therapist elects to
use iontophoresis over the lateral epicondyle. 200. A therapist completes a posture screening and a
Which type of current would the therapist use to gross range of motion examination on a client
administer the treatment? referred to therapy with patellar tendinitis. The
A. direct therapist determines that the client has extremely
B. alternating limited lower extremity flexibility, most notably in
C. pulsatile her hip flexors. What common structural deformity
D. interferential often is associated with tight hip flexors?
RATIO: 1. Direct current is necessary to ensure a A. scoliosis
unidirectional flow of ions. B. kyphosis
C. lordosis
196. A client with hemiplegia is ambulating with an D. spondylosis
ankle-foot orthosis. The therapist notes that the RATIO: 3. Clients with tight hip flexors often exhibit an
client’s involved foot frequently drags during the increased lordosis. Shortness of the hip flexors is seen in
initial swing phase of gait. To treat this problem standing as lumbar lordosis with an anterior pelvic tilt or it
most effectively the therapist should emphasize can be assessed using the Thomas test.
___?
A. eccentric strengthening of the hamstrings
B. eccentric strengthening of the gluteus medius
C. concentric strengthening of the plantar flexors
D. concentric strengthening of the
iliopsoas/rectus femoris
RATIO: 4. The hip is required to flex during the initial
swing to allow for proper clearance and advancement of
the limb during gait. Normally, dorsiflexion also occurs.
Without the use of the dorsiflexors the hip flexors need to
be strengthened in order to attain proper clearance.

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