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Quiz Session - Attempts With Random Questions

FSBPT NPTE-PT Exam Questions

Page 8 of 61

141.

A physical therapist is performing an evaluation on a patient in an outpatient facility for low back pain following a fall onto their lower back three days prior. During the subjective portion, the patient reports that they are experiencing sensory loss in both of their legs, gradual loss of muscle strength and control, and difficulty controlling their bladder.

Which of the following is the GREATEST concern?

  • Cauda equina injury

  • Central cord syndrome

  • Brown-Séquard syndrome

  • Anterior cord syndrome

Correct answer: Cauda equina injury

Cauda equina injury refers to an injury below the level of L1 that results in injury to the lumbar and sacral roots of peripheral nerves. This injury results in symptoms of sensory loss, paralysis, and autonomous or nonreflex bladder. 

Central cord syndrome, Brown-Séquard syndrome, and anterior cord syndrome are all experienced at the spinal cord or above the level of L1.

142.

A physical therapist is performing an evaluation on a patient who is experiencing right knee pain and instability following a tackle to the front of their knee while playing football. During the physical exam, the therapist plans to assess the patient's posterior cruciate ligament. 

Which of the following tests is MOST appropriate?

  • Posterior drawer test

  • Anterior drawer test

  • Varus stress test

  • Valgus stress test

Correct answer: Posterior drawer test

The posterior drawer test is used to assess the integrity of the posterior cruciate ligament. The test is performed by having the patient lie supine with their hip flexed to 45 degrees and their knee flexed to 90 degrees, passively translating the tibia posteriorly, and assessing the motion of the tibia. A positive result is observed if there is an excessive posterior translation of the tibia compared to the uninvolved limb.

The anterior drawer test is used to assess the anterior cruciate ligament, not the posterior cruciate ligament. The varus and valgus stress tests are used to assess the lateral and medial collateral ligaments, not the posterior cruciate ligament.

143.

A physical therapist is performing an evaluation on a patient with reported sacroiliac joint pain. During the physical exam, the therapist has the patient lie in a side-lying position with their bottom leg in a knee-to-chest position, then passively extends the hip of the top limb to place stress on the sacroiliac joint.

What is the MOST likely purpose of this test?

  • To identify sacroiliac joint dysfunction

  • To assess whether sacroiliac joint dysfunction may be the cause of functional leg length discrepancy

  • To assess the posterior movement of a patient’s ilium in relation to the sacrum

  • To differentiate between sacroiliac joint dysfunction and lumbar spine dysfunction

Correct answer: To identify sacroiliac joint dysfunction

Gaenslen’s test is performed in order to identify sacroiliac joint dysfunction. Gaenslen’s test is deemed positive when there is pain identified in the sacroiliac joint. It is performed by having the patient lie in a side-lying position with the bottom leg in a knee-to-chest position. The therapist passively extends the hip of the top limb, placing stress on the SI joint.

The long sitting test is performed to assess whether sacroiliac joint dysfunction may be the cause of functional leg length discrepancy. Gillet’s test is performed in order to assess the posterior movement of a patient’s ilium in relation to the sacrum. Goldthwait’s test is performed in order to differentiate between sacroiliac joint dysfunction and lumbar spine dysfunction.

144.

A physical therapist is performing an evaluation on a patient in the hospital who has brain cancer. During the physical exam, the therapist tests the patient's vision by having the patient look forward and slowly bringing two fingers from behind the patient's head into their visual field. The patient is unable to see the therapist's fingers until both fingers are in the middle of the visual field of both eyes.

Which of the following BEST explains this finding?

  • Bitemporal hemianopsia

  • Homonymous hemianopsia

  • Anosognosia

  • Unilateral neglect

Correct answer: Bitemporal hemianopsia

Bitemporal hemianopsia describes the loss of the outer half of both the right and left visual fields, resulting in a loss of peripheral vision. This typically occurs with damage to the optic chiasm. 

Homonymous hemianopsia describes the loss of half of the visual field in each eye, contralateral to the side of a cerebral hemisphere lesion. Anosognosia describes severe denial, neglect, or lack of awareness from a patient regarding their own condition. Unilateral neglect describes a condition where an individual is unable to identify the left and right sides of their own body.

145.

You are a physical therapist working in an inpatient hospital and performing your chart review of a patient before their session. You learn from their chart that they have injuries to the lumbar plexus nerve roots.

Which nerve roots does the lumbar plexus arise from?

  • T12 through L4

  • T12 through L2

  • L4 through S3

  • L1 through L3

Correct answer: T12 through L4

The group of nerve roots that the lumbar plexus arises from is T12 through L4. There are 4 spinal nerve plexuses in the body, which are organized as follows:

  • The cervical plexus arises from nerve roots C1 through C4.
  • The brachial plexus arises from nerve roots C5 through T1.
  • The lumbar plexus arises from nerve roots T12 through L4.
  • The sacral plexus arises from nerve roots L4 through S3.

146.

A physical therapist is performing an evaluation on a patient with left ankle pain that started three days ago following an ankle sprain at work. During the physical exam, the therapist suspects pathology of the distal tibiofibular syndesmosis. 

Which assessment is MOST appropriate to test this hypothesis?

  • External rotation stress test

  • Anterior drawer test

  • Talar tilt test

  • Thompson's test

Correct answer: External rotation stress test

The external rotation stress (Kleiger) test is used to identify pathology of the distal tibiofibular syndesmosis. This test is performed by having the patient sit with their knee flexed to 90 degrees and ankle neutral, then applying external rotation force to the foot while holding the tibia in a neutral position. Other tests for assessing the distal tibiofibular syndesmosis include the dorsiflexion-external rotation stress test and squeeze test.

The anterior drawer test assesses the anterior talofibular ligament, not the syndesmosis. The talar tilt test assesses the calcaneofibular and deltoid ligaments. Thompson's test assesses the Achilles tendon for rupture.

147.

A physical therapist is treating a patient who is recovering from a myocardial infarction in the hospital. What is the MOST accurate activity restriction recommendation for the patient?

  • 5 METs or 70% of age-predicted max heart rate for 4-6 weeks

  • 5 METs or 70% of age-predicted max heart rate for 8-12 weeks

  • 7 METs for 4-6 weeks

  • 6 METs for 8-12 weeks

Correct answer: 5 METs or 70% of age-predicted max heart rate for 4-6 weeks

Activity can be increased once acute MI has stopped, as indicated by a peak in cardiac troponin levels. Activity should be limited to 5 METs or 70% of the age-predicted HR max for 4-6 weeks following MI.

Activity restrictions at 5 METs or 70% of the age-predicted max heart rate are for 4-6 weeks, not 8-12 weeks. Activity at 6 or 7 METs would be too high following acute MI.

148.

While preparing for a physical therapy evaluation with a 56-year-old female patient who has been admitted for persistent nausea and constipation, you review the patient's medical chart. The patient's chart includes recent imaging results that indicate a blockage in the upper gastrointestinal tract.

Which of the following structures is the blockage MOST likely to be located in?

  • Stomach

  • Small intestine

  • Colon

  • Large intestine

Correct answer: Stomach

The mouth, esophagus, stomach, and duodenum make up the upper gastrointestinal tract. The upper gastrointestinal tract is responsible for the ingestion and initial digestion of food.

The gastrointestinal (GI) tract is organized as follows:

  1. Upper GI tract: Mouth, esophagus, stomach, and duodenum
  2. Middle GI tract: Small intestine (which consists of the duodenum, jejunum, and ileum)
  3. Lower GI tract: Large intestine (which consists of the cecum, colon, and rectum)
  4. Accessory organs that aid in digestion by producing secretions: salivary glands, liver, and pancreas

149.

A physical therapist is preparing for an evaluation of a 57-year-old female patient in the hospital following a skiing accident with a quadriceps tendon rupture. While reviewing the patient's medical chart, the therapist examines CT scan results of the patient's injury. Since MRI is likely the most effective option for visualization of soft tissue, what is the MOST likely reason that a CT scan was performed?

  • The patient has a pacemaker

  • The patient is claustrophobic

  • MRI may not distinguish between cancer tissue and edema

  • The patient does not wish to be exposed to radiation

Correct answer: The patient has a pacemaker

Various imaging techniques can be used to assess a patient's condition, and each has a different set of advantages and disadvantages. Magnetic resonance imaging (MRI) is a noninvasive test that provides sectional imaging of a patient's anatomy which is especially useful for visualizing soft tissues. However, MRI can cause implanted metal devices, such as a pacemaker, to malfunction, which may prompt the need for another imaging technique to be used in its place.

Claustrophobia may be triggered by both MRI and CT scans. Although it is true that MRI may not distinguish between cancer tissue and edema, this is not a primary concern in this scenario. CT scanning requires exposure to radiation, whereas MRI does not.

150.

Use the following scenario to answer the question.

Which of the following is the MOST likely grade for the patient's ligament sprain?

  • Third degree

  • Second degree

  • First degree

  • Fourth degree

Correct answer: Third degree

Ligament sprains are classified according to their degree using a 1-3 scale as follows:

  • First degree: Little or no instability
  • Second degree: Minimal to moderate instability
  • Third degree: Extreme instability

Because the patient demonstrates extreme instability following a planting injury with valgus force, a third-degree sprain is most likely.

The term "fourth degree" is generally not used to grade ligament sprains.

151.

A physical therapist is performing an evaluation on a patient who has a known history of right-sided stroke. During the physical exam, the therapist observes rigidity in the flexion of the patient's left elbow joint. 

Which of the following spasticity grades BEST describes this finding?

  • 4

  • 3

  • 2

  • 1

Correct answer: 4

The Modified Ashworth Scale is a grading system for spasticity that includes six grades:

  • 0: No increase in muscle tone
  • 1: Slight increase in muscle tone, minimal resistance at end of ROM
  • 1+: Slight increase in muscle tone, minimal resistance through less than half of ROM
  • 2: More marked increase in muscle tone through most of ROM, affected part easily moved
  • 3: Considerable increase in muscle tone, passive movement difficult
  • 4: Affected part rigid in flexion or extension

The patient demonstrates more signs of spasticity than described by a grade of 1, 2, or 3.

152.

You are examining a patient with a neurologic condition in an inpatient hospital. You review the patient chart and learn that they have a documented presence of chorea.

Of the following options, what are you MOST LIKELY to observe in this patient during your treatment session?

  • Quick twitches or "dancing" movements

  • Spasmodic contractions of specific muscles

  • Continuous quivering movements that are rhythmic and oscillating

  • Slow and irregular twisting of the arms

Correct answer: Quick twitches or "dancing" movements

Chorea is an involuntary movement that is best described as quick twitches or "dancing" movements. It is seen with extrapyramidal disorders. You are most likely to observe this type of movement during your treatment session.

Tics are involuntary spasmodic contractions, often of the facial and neck muscles. Tremors are continuous, quivering, involuntary movements. Athetosis is sinuous movement (slow, irregular twisting), often in the upper extremities.

153.

You are referred to the neonatal unit of a hospital to evaluate a 3-day-old infant for reflexes and motor skills. As part of your evaluation, you analyze the infant's respiratory rate. You note hyperpnea and contact the nurse to confirm the newborn's recent respiratory rate readings for comparison.

Which of the following respiratory rates is the MOST likely in this situation?

  • 50 breaths per minute

  • 40 breaths per minute

  • 30 breaths per minute

  • 20 breaths per minute

Correct answer: 50 breaths per minute

The normal respiratory rate for a newborn is 30-40 breaths per minute. If the newborn is demonstrating a breathing rate of >40 breaths per minute, it is referred to as hyperpnea. A respiratory rate of 40 breaths per minute or 30 breaths per minute would be considered normal in this case. A respiratory rate of 20 breaths per minute in this scenario would indicate slower than normal breathing, but not hyperpnea.

The normal respiratory rate for an adult is 12-20 breaths per minute. The normal respiratory rate for a child is 20-30 breaths per minute.

154.

Use the following scenario to answer the question.

According to the Modified Borg Dyspnea Scale, which of the following BEST describes the patient's shortness of breath?

  • Somewhat severe

  • Very slight

  • Severe

  • Very severe

Correct answer: Somewhat severe

Dyspnea refers to shortness of breath, which can be graded as 0-10 using the Modified Borg Dyspnea Scale. A dyspnea rating of 4/10 is described as somewhat severe, which is most consistent with the score provided in the scenario.

A rating of 1/10 is described as very slight. A rating of 5-6/10 is described as severe. A rating of 7-8/10 is described as very severe.

155.

A physical therapist is performing an evaluation on a patient in a skilled nursing facility who has difficulty clearing their foot with a normal gait. During the physical exam, the therapist performs muscle testing of the patient's ankle dorsiflexion and observes that the patient can hold the position against gravity with moderate resistance.

Which of the following muscle testing grades is correct for this patient?

  • 4+/5

  • 3+/5

  • 2+/5

  • 5/5

Correct answer: 4+/5

Muscle testing is a standardized technique that assesses the approximate strength of a patient's muscles during a given motion. Grading for muscle testing is assigned on a scale of 0 to 5. The criteria for each grade are as follows:

  • 5/5: Lift or hold against gravity with maximal resistance
  • 4+/5, 4/5, 4-/5: Lifting or holding against gravity with between moderate and minimal resistance
  • 3+/5, 3/5: Lifting or holding against gravity without resistance
  • 3-/5: Some assistance is required to complete the motion
  • 2+/5, 2/5: Movement with gravity eliminated
  • 2-/5: Some assistance is required to complete the motion with gravity eliminated
  • 1/5: Muscle contraction can be seen or felt; no movement
  • 0/5: No muscle contraction is seen or felt

Because the patient can hold the position against gravity with moderate resistance, their muscle testing grade is either 4/5 or 4+/5. There is no option available for 4/5, so 4+/5 is correct.

156.

Use the following scenario to answer the question.

Which of the following is MOST likely to be observed by the therapist while working with this patient?

  • Increased reactivity to stimulus

  • Decreased reactivity to stimulus

  • Decreased sweating

  • Facial spasm

Correct answer: Increased reactivity to stimulus

Hyperthyroidism is a condition where the secretion of thyroid hormone is increased, leading to weight loss, fatigue, excessive sweating, diarrhea, palpitations, hyperreflexia, tremor, and exophthalmos. Hyperthyroidism is most common in females aged 20-40 and is most commonly caused by Graves disease, an autoimmune condition that affects the thyroid. Hyperthyroidism results in increased sympathetic activity, which can result in increased reactivity to stimulus and may manifest as agitation or anxiety. 

Decreased reactivity to stimulus is not likely with increased sympathetic activity seen in hyperthyroidism. Increased sweating is seen with hyperthyroidism, not decreased sweating. Facial spasm (Chvostek sign) is seen with hypoparathyroidism.

157.

A physical therapist is providing treatment to a patient who has posterior canal canalithiasis BPPV, which may be due to free-floating debris in the posterior semicircular canal. Which of the following treatment maneuvers is MOST appropriate?

  • Epley maneuver

  • Lempert maneuver

  • Appiani maneuver

  • Gufoni maneuver

Correct answer: Epley maneuver

Benign paroxysmal positional vertigo (BPPV) describes brief attacks of vertigo and nystagmus that occur with a change in head position, which is caused by otoconia that are dislodged from the otoliths and trapped in a semicircular canal. Common treatment maneuvers for posterior canal canalithiasis BPPV due to free-floating debris in the posterior semicircular canal include the Epley maneuver and Semont maneuver.

The Lempert maneuver or BBQ roll is used for horizontal canal canalithiasis BPPV. The Appiani maneuver is used for horizontal canal canalithiasis or cupulolithiasis BPPV. The Gufoni maneuver is synonymous with the Appiani maneuver.

158.

A physical therapist is providing treatment to a patient with left hip pain. During the session, the therapist plans to provide ultrasound therapy to the patient's hip with a focus on structures that are approximately 4 cm deep. Which of the following frequencies is MOST appropriate for this goal?

  • 1 MHz

  • 3 MHz

  • 0.5 MHz

  • 3.5 MHz

Correct answer: 1 MHz

Ultrasound therapy is used to modulate pain and increase connective tissue extensibility. The depth of penetration of ultrasound therapy depends on the frequency used. A frequency of 3 MHz creates greater heat production in superficial layers and is most appropriate for tissues 1-2.5 cm deep. A frequency of 1 MHz causes less scatter in superficial tissues and is most appropriate for tissues up to 6 cm deep. Because the therapist is targeting tissues that are approximately 4 cm deep, 1 MHz is the most appropriate option.

A frequency of 3 MHz or more is used for tissues at a maximum depth of 2.5 cm, not 4 cm deep. A frequency of 0.5 MHz may allow for the treatment of tissues deeper than 1 MHz but would not be necessary in this scenario because 1 MHz already delivers energy to the appropriate tissue depth.

159.

A physical therapist is assessing the recent pulmonary function test of a patient and is specifically interested in their tidal volume. What information represents the patient's tidal volume on a pulmonary function test?

  • The volume of gas that an individual inhales (or exhales) during a normal breath

  • The volume of gas that an individual can inhale beyond normal tidal volume inhalation

  • The volume of gas that an individual can exhale beyond normal resting tidal volume exhalation

  • The volume of gas that remains in the lungs after the expiratory reserve volume has been exhaled

Correct answer: The volume of gas that an individual inhales (or exhales) during a normal breath

If you are assessing the volume of gas that an individual inhales (or exhales) during a normal breath, you are assessing their tidal volume.

If you are assessing the volume of gas that an individual can inhale beyond normal tidal volume inhalation, you are assessing their inspiratory reserve volume.

If you are assessing the volume of gas that an individual can exhale beyond normal resting tidal volume exhalation, you are assessing their expiratory reserve volume.

If you are assessing the volume of gas that remains in the lungs after the expiratory reserve volume has been exhaled, you are assessing a person's residual volume.

160.

A physical therapist is providing therapeutic exercise to a patient with a known history of chronic hypoparathyroidism. During the exercise session, what considerations will be MOST appropriate for the patient?

  • Breathing should be focused on during exercise to prevent hyperventilation

  • Exercise is not appropriate for the patient

  • Exercise should be progressed slowly to prevent rhabdomyolysis

  • Resistance exercise should be closely monitored to prevent bone fracture

Correct answer: Breathing should be focused on during exercise to prevent hyperventilation

Hypoparathyroidism refers to decreased secretion of parathyroid hormone, resulting in pronounced neuromuscular and cardiac impairments. Patients with chronic hypoparathyroidism may experience worsening tetany due to hyperventilation during exercise, so breathing should be focused on to limit these complications.

Patients with hypoparathyroidism are appropriate for exercise in the absence of medical complications. Patients with hypothyroidism, not hypoparathyroidism, should have exercise progressed slowly to prevent complications like rhabdomyolysis. Patients with hypercortisolism and resulting osteoporosis should be carefully monitored during weight-bearing activities and resistance exercises to minimize the risk of bone fracture.

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