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Quiz Session - Attempts With Random Questions

FSBPT NPTE-PT Exam Questions

Page 3 of 61

41.

A physical therapist is performing an evaluation on a 30-year-old female patient with neck and shoulder weakness. During the examination, the therapist decides to test the patient's spinal accessory nerve in isolation.

Which of the following motions and muscles should the therapist assess to BEST test this nerve?

  • Shoulder shrug; Upper trapezius

  • Neck flexion; Sternocleidomastoid

  • Scapular protraction; Serratus anterior

  • Shoulder abduction; Supraspinatus

Correct answer: Shoulder shrug; Upper trapezius

Shoulder shrugging involves the use of the upper trapezius via spinal cord segment C1-C4 and the spinal accessory nerves.

Neck flexion, extension, rotation, and lateral bending involves the spinal cord segment C1-C4 and the C3-4 posterior rami, in addition to the spinal accessory nerves. However, neck motions do not test the spinal accessory nerve as independently as shoulder shrugging does. Shoulder protraction and scapular upward rotation involves the spinal segment C5-C7 and the long thoracic nerves. Shoulder abduction and lateral rotation involves the spinal cord segment C4-C6 and the suprascapular nerves.

42.

Use the following scenario to answer the question.

Given the patient's history of diabetes, which of the following is the MOST appropriate exercise precaution for the physical therapist to take?

  • Hydrate throughout the session

  • Ensure the patient has eaten 1 hour before exercise

  • Do not exercise if the patient's blood glucose reading is <300 mg/dL

  • Exercise in a hot environment

Correct answer: Hydrate throughout the session

Diabetes mellitus is a complex metabolic disorder caused by deficiency or absence of insulin secretion or by defects of the insulin receptors. Type II diabetes mellitus results from insulin resistance and is generally considered a progressive disease that requires ongoing management. Physical therapists treating patients who have diabetes mellitus should follow precautions, including:

  • Do not exercise when blood glucose levels are high (>300 mg/dL)
  • Do not exercise without eating at least 2 hours before exercise
  • Do not exercise without adequate hydration
  • Do not exercise in extreme environmental temperatures

43.

A physical therapist is providing therapeutic exercise to a 40-year-old male patient with a known history of type 1 diabetes. Which of the following exercise precautions is MOST appropriate when working with this patient?

  • Inject short-acting insulin directly into the abdomen, not exercising muscles

  • Do not exercise if blood glucose is more than 70 mg/dL

  • Do not exercise when fasting blood glucose is greater than 500 mg/dL

  • Do not exercise without eating at least half an hour before exercise

Correct answer: Inject short-acting insulin directly into the abdomen, not exercising muscles

If the patient requires an injection of short-acting insulin, it should not be injected in exercising muscles or sites close to exercising muscles, because this will cause the insulin to be absorbed more quickly. Instead, short-acting insulin should be injected into the abdomen if possible.

The other statements are incorrect exercise precautions for patients who have diabetes. Do not exercise if blood glucose is less than 70 mg/dL to avoid hypoglycemic episodes. Do not exercise when fasting blood glucose is greater than 300 mg/dL (not 500 mg/dL), as this is a state of hyperglycemia and can lead to further complications. Do not exercise without eating at least two hours before exercise to ensure that blood glucose is stabilized and to avoid hypoglycemia with exercise.

44.

Use the following scenario to answer this question.

Which of the following is the MOST effective way for the physical therapist to encourage participation from the child and facilitate developmental activities?

  • Use toys, fun activities, balls, and bolsters

  • Use of a timer to schedule activities more efficiently

  • Follow the same routine during each session

  • Utilize static positioning activities

Correct answer: Use toys, fun activities, balls, and bolsters

Cerebral palsy is a group of disorders characterized by tone abnormalities, impaired muscular control, decreased motor learning abilities, and persistence of primitive reflexes. Cerebral palsy may be categorized according to gross motor classification on a scale of I to V. Interventions for children with cerebral palsy should emphasize preventing disability and maximizing gross motor function. To facilitate developmental activities and postural control, therapists should use toys, fun activities, balls, and bolsters to engage the child and encourage postural control.

Timers, routines, and static positioning may be necessary components of care. However, they are less likely to engage the child and facilitate development skills compared to the use of toys and fun activities.

45.

You are exercising with a patient admitted for congestive heart failure who is currently taking high doses of magnesium as prescribed by their physician. During your session, the patient begins to complain of heart palpitations.

Given the patient's history, what are you MOST concerned about in this situation?

  • Cardiac arrest

  • Coronary artery vasospasm

  • Decreased force of contraction

  • Ventricular fibrillation

Correct answer: Cardiac arrest

Hypermagnesemia can cause cardiac arrest. It can also lead to arrhythmias. This is because increased magnesium works as a calcium blocker. Because the patient is taking high amounts of magnesium, they will be more likely to experience hypermagnesemia. 

Hypomagnesemia can cause coronary artery vasospasm. Hyperkalemia can cause a decreased force of contractions. Hypokalemia can cause ventricular fibrillation.

46.

Use the following scenario to answer this question.

Which of the following cranial nerves are MOST likely to be impacted for this patient?

  • CN X, XI, XII

  • CN I, II, III

  • CN IV, V, VI

  • No cranial nerves affected

Correct answer: CN X, XI, XII

Guillain-Barré syndrome is an acute inflammatory demyelinating polyradiculoneuropathy presenting with rapid nonsymmetric loss of myelin in both nerve roots and peripheral nerves. With Guillain-Barré syndrome, many nervous system impairments occur and generally result in severe mobility loss before recovery begins. With this condition, cranial nerves VII, IX, X, XI, and XII are more likely to be impacted, as they are anatomically the most caudal or inferior of the cranial nerves.

Although they may be affected by this condition, cranial nerves I-VI are less likely to be impacted because of their relative anatomical positioning.

47.

Use the following scenario to answer this question.

Based on the patient's cranial nerve testing findings, which of the following is MOST likely affected?

  • Sense of smell

  • Sense of facial sensation

  • Sense of position

  • Sense of hearing

Correct answer: Sense of smell

Cranial nerve testing is performed to assess for function of the cranial nerves, each with a different test and expected result. Cranial nerve I is tested by placing a distinct scent under the patient's nose and asking them what they smell. If the patient is unable to correctly identify the smell, dysfunction of cranial nerve I should be considered.

Sense of facial sensation is primarily associated with cranial nerve V. Senses of position and hearing are associated with cranial nerve VIII.

48.

A physical therapist is providing functional mobility training for a patient who recently experienced a C6 spinal cord injury. Assuming the patient's ASIA level is A or B, which of the following is the MOST appropriate wheelchair recommendation?

  • Manual wheelchair with friction surface hand rims

  • Electric wheelchair with tilt-in-space seating and microswitch controls

  • Manual wheelchair with standard hand rims

  • No wheelchair needed

Correct answer: Manual wheelchair with friction surface hand rims

An appropriate wheelchair prescription for a patient who has experienced a spinal cord injury depends on the severity and the level of injury. For a patient with a C6 spinal cord injury that is ASIA level A or B, a manual wheelchair with friction surface hand rims is most appropriate.

Electric wheelchairs with tilt-in-space seating or reclining seat backs, microswitch or puff-and-sip controls, and a portable respirator may be required for patients with a C1-C4 spinal cord injury. A manual wheelchair with standard hand rims may be more appropriate for a patient with a spinal cord injury at the level of C8-T1 or below. A wheelchair is required for safe mobility for this patient.

49.

You are working with a 65-year-old male patient in the hospital on increasing functional abilities and decide to perform inspiratory muscle training (IMT). Which of the following steps is MOST appropriate for this technique?

  • Choose an aperture opening that requires 30-70% intensity

  • Train for 5 minutes per session

  • Determine minimum inspiratory pressure

  • Instruct the patient to take deep breaths throughout the session

Correct answer: Choose an aperture opening that requires 30-70% intensity

Inspiratory muscle training is used to load muscles of inspiration by breathing through a series of graded aperture openings on a handheld device to increase the strength and endurance of these muscles. For training, it is recommended to choose an aperture that requires 30-70% of maximum inspiratory pressure (MIP).

Patients should perform MIP for at least 10-15 minutes per session. Prior to training, the therapist should determine maximum inspiratory pressure, not minimum inspiratory pressure. Patients should maintain their usual respiratory rate and tidal volume during the session, not focus on deep breathing.

50.

A physical therapist is working with a 46-year-old female patient in an outpatient clinic for left ankle pain. During the session, the patient informs the therapist that they have been experiencing sudden release of urine from their bladder during coughing and laughing. Of the following, what is the MOST likely explanation for the patient's new symptoms?

  • Sphincter weakness

  • Hypersensitive bladder

  • Neurogenic bladder

  • Hyperreflexia

Correct answer: Sphincter weakness

Sphincter weakness is one possible cause of stress urinary incontinence. Other causes associated with stress urinary incontinence include intra-abdominal pressure and weakness of pelvic floor musculature. Based on the patient's symptoms, stress incontinence is the most likely condition.

Hyperreflexia and hypersensitive bladders are both associated with urge urinary incontinence, which is characterized by a sensation of bladder fullness. A neurogenic bladder may cause overflow incontinence, which is characterized by continuous urine leakage.

51.

Use the following scenario to answer this question.

Which of the following levels of traumatic brain injury is MOST accurate for the patient?

  • Moderate

  • Mild

  • Severe

  • Grade IV

Correct answer: Moderate

Traumatic brain injuries (TBIs) occur due to contact forces to the skull and associated rotational acceleration forces. Signs and symptoms of TBI depend on the location and severity of lesions in the cortex resulting from the injury. Traumatic brain injuries are graded as mild, moderate, or severe. A moderate traumatic brain injury is characterized by loss of consciousness between 30 minutes and 24 hours, alteration of consciousness for more than 24 hours, post-traumatic amnesia for between 1 and 7 days, and a Glasgow Coma Scale score of 9-12.

Mild traumatic brain injuries are scored 13-15 on the Glasgow coma scale. Severe traumatic brain injuries are scored below 9 on the Glasgow Coma Scale.

52.

You are evaluating a 75-year-old male patient in a skilled nursing facility for functional mobility and lower extremity strength. During the session, the patient's nurse provides you with recent test results which indicate a sodium serum level of 160 mEq/L.

Of the following, which is the MOST likely cause for this finding?

  • Dehydration

  • Water intoxication

  • Vomiting

  • Hypothyroidism

Correct answer: Dehydration

The normal sodium serum level for urinary regulation is 135 to 146 mEq/L. If an individual’s sodium serum level is greater than 146 mEq/L, hypernatremia occurs. Dehydration, or an insufficient intake of water, is a cause associated with hypernatremia. Signs of hypernatremia include pitting edema, pulmonary edema, tachycardia, and agitation.

Water intoxication and hypothyroidism are both associated with hyponatremia or a deficiency of sodium. Blood transfusions are causes associated with hypomagnesemia or a deficiency of magnesium. Vomiting is a cause associated with hypokalemia or a deficiency of potassium.

53.

A physical therapist is providing education to a patient who recently experienced a spinal cord injury and is learning how to use a wheelchair. Which of the following is the BEST schedule for the patient to perform pressure relief?

  • Every 15-20 minutes

  • Every 30-60 minutes

  • Every 5 minutes

  • Once every hour

Correct answer: Every 15-20 minutes

Pressure relief activities are important to prevent pressure injuries in patients who are regular wheelchair users. Examples of pressure relief activities include wheelchair push-ups, lateral or forward-leaning, or the use of built-in tilting features for motorized wheelchairs. It is recommended to perform pressure relief activities every 15-20 minutes.

Every 30-60 minutes or once every hour may not be frequent enough to prevent pressure injuries. Every 5 minutes may be too frequent and would not promote energy conservation.

54.

You are performing a physical therapy evaluation for a patient who is experiencing wrist and hand pain. During the subjective portion, the patient complains of a tingling sensation over their palm, thumb, and middle three digits.

Which of the following special tests would be MOST appropriate to assess these symptoms?

  • Tinel’s sign

  • Tight retinacular test

  • Two-point discrimination test

  • Modified Allen test

Correct answer: Tinel’s sign

Tinel’s sign is a special wrist and hand test that is conducted by tapping the area in which the median nerve passes through the carpal tunnel. Tinel’s sign is utilized in order to identify carpal tunnel compression of the median nerve. Because this patient presents with symptoms of carpal tunnel, this is the most appropriate test to perform.

The tight retinacular test is used to assess tightness around proximal interphalangeal joints. The two-point discrimination test is performed by applying a caliper, two-point discriminator, or paper clip to the palmar aspect of the fingers to assess the patient's ability to distinguish between two points. The modified Allen test is used to assess vascular compromise of the ulnar or radial artery.

55.

Use the following scenario to answer this question.

Which of the following is MOST likely also to be observed for this patient?

  • Left-sided sensory loss

  • Right-sided sensory loss

  • Bilateral sensory loss

  • Normal sensation

Correct answer: Left-sided sensory loss

Cerebrovascular accident, also called stroke, is a serious neurological injury resulting from compromised blood supply to the brain. Following a stroke, motor and sensory changes are commonly seen on the side contralateral to the lesion. Because this patient has experienced a right-sided stroke, left-sided sensory loss is most likely.

Right-sided sensory loss may occur but would be more expected with a left-sided lesion. Bilateral sensory loss may occur, but more information is required to make this option more likely than left-sided sensory loss. Normal sensation is not expected following a stroke.

56.

Use the following scenario to answer this question.

Which of the following is the MOST likely cause of the patient's presentation?

  • Plantar fasciitis

  • Metatarsalgia

  • Medial tibial stress syndrome

  • Jones fracture

Correct answer: Plantar fasciitis

Plantar fasciitis describes pain in the heel that is characterized by sensitivity and inflammation at the proximal insertion of the plantar fascia. Common risk factors for plantar fasciitis include limited ankle dorsiflexion range of motion, high body mass index in nonathletic individuals, running, and other weight-bearing activities with poor shock absorption. Clinical diagnosis of plantar fasciitis often includes medial heel pain with initial steps, pain with palpation of the proximal plantar fascia, positive windlass test, and the presence of potentially irritating activities. 

Metatarsalgia is most often characterized by pain at the first and second metatarsal heads after long periods of weight bearing. Medial tibial stress syndrome is characterized by pain along the distal posterior medial border of the tibia. A Jones fracture affects the fifth metatarsal and typically does not involve isolated heel pain.

57.

A physical therapist is aware of HIV transmission modes as well as high-risk behaviors for transmission. Which of the following is a mode of transmission for HIV?

  • Breast milk

  • Saliva

  • Urine

  • Sweat

Correct answer: Breast milk

HIV is transmitted through contact with infected body fluids, which include blood, semen, cerebrospinal fluid, breast milk, and vaginal/cervical secretions.

It cannot be transmitted through saliva, respiratory inhalation, skin contact, or human waste including urine, feces, sweat, or vomit.

58.

Physical therapy has been ordered for a 57-year-old female patient admitted to the ICU one week ago for myocarditis. During the physical exam, the therapist notes that the patient has partial-thickness skin loss on their left hip that currently presents as a blister on the skin. How should the therapist document this finding?

  • Stage II pressure injury

  • Stage I pressure injury

  • Stage III pressure injury

  • Stage IV pressure injury

Correct answer: Stage II pressure injury

Pressure injuries are graded based on the stage of their severity. A stage II pressure injury occurs when there is partial-thickness skin loss involving the epidermis and/or dermis skin layers and presents as a blister, abrasion, or shallow crater.

A stage I pressure injury occurs when the skin is fully intact, is nonblanchable, may have a temperature change (cool or warm), and may have a sensation (itching or pain). A stage III pressure injury occurs when there is full-thickness skin loss that involves subcutaneous tissue damage or necrosis, and presents as a deep crater. A stage IV pressure injury occurs when there is full-thickness skin loss that involves tissue necrosis and damage to bone, muscle, or other supporting structures.

59.

Use the following scenario to answer this question.

Which of the following is the HIGHEST level of ambulation the patient may perform?

  • Independent walking with bilateral KAFOs and crutches

  • Short-distance walking with bilateral KAFOs and crutches

  • Electric wheelchair with tilt-in-space seating

  • Manual chair with propulsion aid

Correct answer: Independent walking with bilateral KAFOs and crutches

Spinal cord injuries are partial or complete disruption of the spinal cord, resulting in paralysis, sensory loss, and altered autonomic and reflex activities. Spinal cord injuries may be named according to the level of injury and scored according to the American Spinal Injury Association on a scale of A to E. Patients with high lumbar (T12-L3) spinal cord injuries may ambulate independently with the assistance of bilateral knee-ankle-foot orthoses (KAFOs) and crutches. Since the patient's injury level is L3, this is the highest level of ambulation that may be performed.

Electric wheelchairs with tilt-in-space seating are used for patients with high cervical lesions. Manual chairs with propulsion aids are used for patients with mid-cervical lesions. Short-distance walking with bilateral KAFOs and crutches is used for patients with mid-thoracic lesions.

60.

A physical therapist is performing a neurological evaluation in the hospital for a patient who is recovering from a recent TBI. During the cranial nerve exam, the physical therapist wishes to assess the function of the glossopharyngeal and vagus nerves. 

Which of the following BEST describes how the physical therapist can assess these cranial nerves?

  • Stimulate the back of the patient's throat lightly on each side

  • Have the patient raise their ear to their shoulder

  • Apply sweet, salty, and sour solutions to the patient's posterior tongue

  • Ask the patient to move their tongue side-to-side

Correct answer: Stimulate the back of the patient's throat lightly on each side

There are 12 pairs of cranial nerves, each with a specific set of functions that may be evaluated using a variety of tests. The glossopharyngeal nerve (CN IX) and vagus nerve (CN X) are involved in functions such as phonation, swallowing, pharynx control, and the gag reflex. The gag reflex may be tested by stimulating the back of the patient's throat lightly on each side and observing whether the reflex occurs.

Having the patient raise their ear to their shoulder is a way to assess the accessory nerve (CN XI). Applying sweet, salty, and sour solutions to the patient's posterior tongue is a way to assess the glossopharyngeal nerve (CN IX) but would not be used to assess the vagus nerve. Asking the patient to move their tongue side-to-side is a way to assess the hypoglossal nerve (CN XII).

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