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Quiz Session - Attempts With Random Questions

FSBPT NPTE-PT Exam Questions

Page 9 of 61

161.

You are a physical therapist treating a patient in the hospital for wound care. During the wound assessment, you document a stage II pressure injury over the patient's lateral epicondyle. Since the wound is non-exudative, you would like to monitor it frequently.

Which of the following is the BEST dressing for the patient's wound?

  • Transparent film

  • Hydrocolloid

  • Foam

  • Alginate

Correct answer: Transparent film

Transparent films are adhesive dressings that are clear with semipermeable membranes. Transparent films are used for stage I and II pressure ulcers, skin donor sites, and autolytic debridement. They are permeable to moisture vapor and atmospheric oxygen, but impermeable to bacteria, water, and contaminants. An added benefit of transparent films is the ability to visualize a wound without the removal of the dressing, which is indicated in this scenario.

Hydrocolloids are adhesive wafers that form a gelatinous mass over the wound. Foams are hydrophilic or hydrophobic semipermeable membranes with varying adhesive and absorptive properties. Alginates and hydrofibers are soft, absorbent, nonwoven dressings derived from seaweed and have a fluffy cotton-like appearance.

162.

You are working with a patient who has a recent history of upper and lower-body hemiplegia, impaired sensation, and partial tongue paralysis. Which of the following explanations is the MOST likely given the patient's history?

  • Occlusion of the vertebral anterior branch of the lower basilar artery

  • Occlusion of the vertebral, posterior inferior cerebellar, or basilar artery

  • Occlusion of the paramedian branch of the basilar artery

  • Occlusion of the anterior inferior cerebellar artery

Correct answer: Occlusion of the vertebral anterior branch of the lower basilar artery

Medial medullary syndrome is the occlusion of the vertebral anterior branch of the lower basilar artery. Symptoms of medial medullary syndrome include contralateral hemiplegia, ipsilateral impaired sensation, and contralateral paralysis of half the tongue. This is one possible presentation of vertebrobasilar artery syndrome. Other vertebrobasilar artery syndromes include (but are not limited to) the following:

  • Lateral medullary (Wallenberg's) syndrome is the occlusion of the vertebral, posterior inferior cerebellar, or basilar artery.
  • Medial inferior pontine syndrome is the occlusion of the paramedian branch of the basilar artery.
  • Lateral inferior pontine syndrome is the occlusion of the anterior inferior cerebellar artery.

163.

A physical therapist is performing an evaluation on a patient who is recovering in the hospital following a spinal cord injury due to a gunshot wound. During the physical exam, the therapist determines that the patient has lost their sense of tactile discrimination, pressure, vibration, and proprioception on one side. On the same side, the patient demonstrates spastic paralysis below the level of their injury.

Which of the following BEST describes these findings?

  • Brown-Séquard syndrome

  • Central cord syndrome

  • Anterior cord syndrome

  • Posterior cord syndrome

Correct answer: Brown-Séquard syndrome

There are various clinical syndromes that a patient may present with following a spinal cord injury, depending on the location of the lesion. Brown-Séquard syndrome describes hemisection of the spinal cord that results in ipsilateral loss of tactile discrimination, pressure, vibration, and proprioception; ipsilateral loss of motor function with spastic paralysis below the level of the lesion; and contralateral loss of pain and temperature below the level of the lesion. 

Central cord syndrome describes cavitation of the cervical central cord that results in bilateral loss of pain and temperature, bilateral loss of motor function (primarily in the upper extremities), and preservation of proprioception and discriminatory sensation. Anterior cord syndrome describes the loss of the anterior cord that results in bilateral loss of motor function and spastic paralysis below the level of the lesion; bilateral loss of pain and temperature; and preservation of proprioception, kinesthesia, and vibratory sense. Posterior cord syndrome describes the loss of dorsal columns bilaterally resulting in bilateral loss of proprioception, vibration, pressure, and epicritic sensations with preservation of motor function, pain, and light touch.

164.

A physical therapist is performing an evaluation on a 50-year-old patient who recently had a below-knee amputation. During the subjective portion, the patient reports that they would like to stay active in their community and have concerns about the cosmetic appearance of their prosthesis. During the physical exam, the therapist determines that the patient has moderate lower extremity strength and coordination. 

What is the MOST appropriate foot-ankle assembly for the patient?

  • Energy-storing foot

  • Single-axis foot

  • Multi-axis foot

  • Solid ankle cushion heel

Correct answer: Energy-storing foot

An energy-storing foot is a foot-ankle assembly design that allows for dynamic foot motion and is most appropriate for active or community ambulators. This type of foot-ankle assembly allows for decreased energy consumption due to a smoother gait pattern and energy return during terminal stance and pre-swing. Because the patient has good lower extremity strength and would like to stay active in their community, this is the most appropriate option.

A single-axis foot only permits sagittal plane motion and may not be the best option for this patient. A multi-axis foot is indicated for moderately to highly active individuals but has poor shock absorption and energy return compared to the energy-storing foot. A solid ankle cushion heel is the most commonly prescribed option but is primarily used for young and more sedentary individuals.

165.

Use the following scenario to answer this question. 

Which of the following manual therapy techniques is MOST indicated for this patient?

  • Spray and stretch

  • Sensitization with manual pressure

  • Cervical spine traction

  • Thoracic spine posterior-anterior mobilization

Correct answer: Spray and stretch

Myofascial pain syndrome refers to a clinical entity known as a "trigger point," which is a focal point of irritability found within a muscle. Trigger points can be identified as a taut, palpable band within the affected muscle. Manual therapy techniques used in the treatment of myofascial pain syndrome include soft tissue/massage techniques, joint oscillations/mobilizations, the spray and stretch technique, dry needling, and desensitization with manual pressure. 

Manual pressure is used to desensitize trigger points, not to sensitize them. Cervical spine traction and thoracic spine mobilization may be used, although there is nothing in this scenario to indicate that the patient's symptoms are influenced by joint restrictions in their cervical or thoracic spine.

166.

While working with a patient recently admitted for exacerbation of COPD, you receive the results of their recent pulmonary function test. The results indicate a total lung capacity of six liters. Of the following options, what measurements were MOST likely used to calculate this result?

  • Inspiratory Reserve Volume + Tidal Volume + Expiratory Reserve Volume + Residual Volume

  • Inspiratory Reserve Volume + Tidal Volume

  • Inspiratory Reserve Volume + Tidal Volume + Expiratory Reserve Volume

  • Tidal Volume + Residual Volume

Correct answer: Inspiratory Reserve Volume + Tidal Volume + Expiratory Reserve Volume + Residual Volume

An individual's total lung capacity is the entire amount of air that the thorax contains during the individual's maximum inspiratory effort.

Inspiratory reserve volume + Tidal volume + Expiratory reserve volume + Residual volume is the formula used to calculate one's total lung capacity. There are several types of lung capacity. These can be calculated with the following formulas:

  • Inspiratory Reserve Volume (IRV) + Tidal Volume (TV) = Inspiratory Capacity (IC)
  • Inspiratory Reserve Volume (IRV) + Tidal Volume (TV) + Expiratory Reserve Volume (ERV) = Vital Capacity (VC)
  • Expiratory Reserve Volume (ERV) + Residual Volume (RV) = Functional Residual Capacity (FRC)
  • Inspiratory Reserve Volume (IRV) + Tidal Volume (TV) + Expiratory Reserve Volume (ERV) + Residual Volume (RV) = Total Lung Capacity (TLC)

167.

A physical therapist is examining a patient's reflexes in an outpatient clinic. This patient has no known neurological deficits or diseases.

Which of the following actions would produce a POSITIVE Babinski response?

  • None of these

  • Stroking the lateral sole of the foot and medially across the metatarsal heads

  • Noxious stimulus to the sole of the foot

  • Tapping directly on a tendon

Correct answer: None of these

A positive Babinski response is not seen in healthy patients; this is seen in patients with corticospinal lesions. A therapist tests for this response by stroking the lateral sole of the foot from the calcaneus to the base of the fifth metatarsal, and medially across the metatarsal heads. A healthy, negative response produces plantar flexion of the toes. A positive response produces dorsiflexion of the great toe and fanning of the four lesser toes.

Noxious stimulus to the sole of the foot produces flexor withdrawal in a healthy patient. Tapping directly on a tendon produces a contraction of the agonist muscle with a corresponding quick movement.

168.

A physical therapist is preparing to see a 55-year-old female patient in the hospital for rehabilitation related to stage 1 ovarian cancer. During the chart review, the physical therapist notes recent test results showing urine calcium serum levels of 13.2 mg/dL. Based on this information, which comorbidity does the patient MOST likely have?

  • Hyperparathyroidism

  • Acute pancreatitis

  • Vitamin D deficiency

  • Reduced albumin levels

Correct answer: Hyperparathyroidism

The normal calcium serum level is 8.4 to 10.4 mg/dL. If an individual’s calcium serum level is greater than 10.4 mg/dL, hypercalcemia occurs. Hyperparathyroidism is associated with hypercalcemia. Other causes associated with hypercalcemia include hyperthyroidism, tumors, and vitamin A intoxication. Signs include nausea/vomiting, increased urination, and confusion.

Acute pancreatitis, vitamin D deficiency, and reduced albumin levels are all causes associated with hypocalcemia, or a deficiency in calcium.

169.

A physical therapist is preparing for a treatment session with a patient who has stage IV amyotrophic lateral sclerosis (ALS). Based on this information, which of the following is MOST likely?

  • The patient will use a wheelchair.

  • The patient will use assistive devices for ambulation.

  • The patient will be fully independent with ambulation.

  • The patient will be bedridden.

Correct answer: The patient will use a wheelchair.

ALS is a degenerative disease affecting both upper motor neurons and lower motor neurons with degeneration of anterior horn cells and descending corticobulbar and corticospinal tracts. The progression of ALS can be divided into six stages:

  • Stage I: Early disease, mild focal weakness, asymmetrical distributions; symptoms of hand cramping and fasciculations
  • Stage II: Moderate weakness in groups of muscles with some wasting (atrophy) of muscles; modified independence with assistive devices
  • Stage III: Severe weakness of specific muscles with increasing fatigue; mild to moderate functional limitations; ambulatory
  • Stage IV: Severe weakness and wasting of lower extremities, mild weakness of upper extremities; moderate assistance and assistive devices required; wheelchair use necessary
  • Stage V: Progressive weakness with deterioration of mobility and endurance, increased fatigue, moderate to severe weakness of whole limbs and trunk; spasticity and hyperreflexia; loss of head control; maximal assistance
  • Stage VI: Bedridden, dependent ADLs; progressive respiratory distress

Because the patient is in stage IV of ALS, wheelchair use by the patient would be expected.

170.

You are performing an evaluation on a 57-year-old patient in a subacute facility who reports a loss of stability during everyday activities. During the physical exam, you observe foot drop while analyzing the patient's gait.

Based on this information, which of the following nerves is MOST likely involved?

  • Deep fibular

  • Tibial

  • Lateral plantar

  • Medial plantar

Correct answer: Deep fibular

When a patient has difficulty with ankle dorsiflexion and experiences symptoms in their tibialis anterior muscle, the deep fibular muscle is most likely involved. Foot drop refers to the inability to control the foot during heel strike and may also be influenced by pathology of the L4 nerve root or other nervous system conditions.

If a patient has difficulty with hip extension, knee flexion, leg lateral or medial rotation, or plantar flexion (among other actions), the tibial nerve is likely involved. If a patient has difficulty with toe adduction/abduction, the lateral plantar nerve is likely involved. If a patient has difficulty with second to fifth digit PIP flexion or great toe MTP flexion, the medial plantar nerve is likely involved.

171.

A physical therapist is performing an evaluation on a patient with new-onset right hip pain. In order to assess the strength of the patient's tensor fascia lata muscle, which of the following motions is MOST appropriate for the therapist to test?

  • Hip flexion, abduction, medial rotation

  • Hip flexion, adduction, medial rotation

  • Hip extension, abduction, lateral rotation

  • Hip extension, adduction, medial rotation

Correct answer: Hip flexion, abduction, medial rotation

Various muscles of the lower extremity may be tested by assessing their primary movements. The tensor fascia lata muscle is a muscle of the hip and thigh that is involved in hip flexion, abduction, and medial rotation. Since the therapist plans to assess the tensor fascia lata muscle, this movement combination is the most appropriate choice.

Hip flexion, adduction, and medial rotation are not a combination used to assess a specific lower extremity muscle. Hip extension, abduction, and lateral rotation are not a combination used to assess a specific lower extremity muscle. Hip extension, adduction, and medial rotation are not a combination used to assess a specific lower extremity muscle.

172.

A physical therapist is performing an evaluation on a patient who has new-onset right knee stiffness. During the subjective portion, the patient reports a history of recurrent thigh contusion injuries playing soccer over the years without a history of ligament sprains. During the physical exam, the therapist observes that the patient's right patella tracks inferiorly relative to the left patella, and the patient demonstrates difficulty achieving full extension active range of motion in their right knee compared to their left.

What is the MOST likely explanation for the patient's presentation?

  • Patella baja

  • Patella alta

  • Grade I ACL sprain

  • Grade I PCL sprain

Correct answer: Patella baja

Patella baja refers to the abnormal positioning of the patella in which the patella tracks inferiorly in the femoral intercondylar notch. This condition results in restricted knee extension with abnormal cartilaginous wear, causing DJD, and may be associated with quadriceps tendon rupture. Based on the patient's presentation, this is the most likely option provided.

Patella alta refers to the abnormal positioning of the patella in which the patella tracks superiorly, not inferiorly. Grade I ACL and PCL sprains typically involve a mechanism of injury that stresses the ligament and often results in pain.

173.

A physical therapist is performing an evaluation on a patient who has a known history of amyotrophic lateral sclerosis. During the assessment, the patient demonstrates difficulty with phonation, articulation, and swallowing, and an impaired gag reflex. 

Which of the following MOST likely explains these findings?

  • Bulbar palsy

  • Trigeminal neuralgia

  • Bell's palsy

  • CN VI lesion

Correct answer: Bulbar palsy

Bulbar palsy describes weakness or paralysis of the muscles innervated by the motor nuclei of the lower brainstem, affecting the muscles of the face, tongue, larynx, and pharynx. Bulbar palsy is characterized by changes in phonation, articulation, palatal action, gag reflex, and swallowing due to glossopharyngeal and vagal paralysis. This condition commonly occurs with tumors and vascular or degenerative disease affecting the lower cranial nerve motor nuclei, such as amyotrophic lateral sclerosis.

Trigeminal neuralgia refers to a lesion of the trigeminal nerve (CN V) of unknown etiology that results in brief paroxysms of neurogenic pain reoccurring frequently. Bell's palsy is characterized by unilateral facial paralysis. CN VI (abducens) lesion is more likely to affect eye movement.

174.

You are performing a physical therapy evaluation for a patient who has recently suffered an incomplete cervical spinal cord lesion. To help determine the patient's level of assistance for transfers, you perform key muscle testing using resisted elbow flexion.

Of the following, which is the MOST likely structure being tested?

  • Musculocutaneous nerve

  • Radial nerve

  • Median nerve

  • Ulnar nerve

Correct answer: Musculocutaneous nerve

The musculocutaneous nerve is used during elbow flexion in full supination and neutral. When the forearm is in mid-pronation and supination, the brachioradialis and radial nerve are used.

Elbow extension uses the triceps brachii muscles and the radial nerves. Wrist flexion uses palmaris longus muscles and median nerves. Wrist ulnar flexion uses the flexor carpi ulnaris muscle and the ulnar nerve.

175.

A physical therapist is performing an evaluation in an outpatient clinic on a patient with new-onset knee pain and instability following a planting injury. During the evaluation, the physical therapist decides to assess the patient's medial collateral ligament. 

Which set of knee flexion angles is MOST appropriate for this test?

  • 0 and 30 degrees

  • 10 and 30 degrees

  • 15 and 45 degrees

  • 45 and 90 degrees

Correct answer: 0 and 30 degrees

The varus and valgus stress tests are used to assess the integrity of the lateral and medial collateral ligaments, respectively. Both the varus and valgus stress tests are performed with the patient supine with their knee resting on the edge of the exam table, then applying a force at 0 degrees and 30 degrees of knee flexion.

Although 30 degrees of knee flexion is included in both the varus and valgus stress tests, 10 degrees is not. 15-, 45-, and 90-degree angles of knee flexion are not used in the varus or valgus stress tests.

176.

Physical therapists work with other practitioners in order to coordinate patient care. If a patient is receiving tertiary care, which of the following practitioners is MOST LIKELY to refer a patient to see a physical therapist?

  • Highly-specialized physician

  • Speech therapist

  • Occupational therapist

  • Family practice physician

Correct answer: Highly-specialized physician

A physical therapist would most likely work with a highly-specialized physician when working with a patient who is receiving tertiary care. Tertiary care is care that is highly specialized and technologically-based, such as transplants and other major surgical procedures.

A physical therapist may work with a speech therapist or an occupational therapist if a patient is receiving subacute care, but would not typically be referred patients from these providers. A physical therapist may work with a family practice physician if a patient is receiving primary care.

177.

You are a physical therapist working in an outpatient hospital facility. A patient inquires about the use of a continuous passive motion device and requests that it be used in their next session. Which of the following options is BEST treated by Continuous Passive Motion (CPM)?

  • Post-immobilization fracture

  • Spinal cord injury

  • Prolonged bed rest

  • Orthostatic hypotension

Correct answer: Post-immobilization fracture

Continuous Passive Motion (CPM) is used for post-immobilization fracture. This technique involves the uninterrupted passive motion of the joint through a controlled ROM, using a mechanical device that performs movement for an extended period of time.

A tilt table is indicated for spinal cord injuries, prolonged bed rest, and orthostatic hypotension, as well as immobilization, traumatic brain injury, and spasticity.

178.

A physical therapist is performing an evaluation on a patient in a skilled nursing facility. Prior to admission, the patient experienced a temporary period of neurological symptoms due to a lack of blood supply to their brain. 

Which of the following BEST describes this event?

  • Transient ischemic attack

  • Ischemic stroke

  • Hemorrhagic stroke

  • Vasovagal syncope

Correct answer: Transient ischemic attack

Transient ischemic attack (TIA) refers to a temporary period of symptoms resulting from decreased blood supply to the brain. Although TIA may be confused with a stroke initially, it does not result in permanent brain damage. 

Ischemic stroke occurs due to cerebral thrombosis or cerebral embolism and results in permanent brain damage. Hemorrhagic stroke refers to abnormal bleeding due to the rupture of a blood vessel in the brain. Vasovagal syncope refers to fainting due to acute stress, not necessarily a lack of blood supply to the brain.

179.

You are preparing to see a patient in an outpatient facility with a known history of diabetes for an exercise session. Prior to the session, the patient checks their blood glucose and reports 68 mg/dL. Based on this information, what is the BEST action to take?

  • Provide sugar to the patient and do not exercise

  • Continue with exercise as planned

  • Continue with exercise, but provide 15g of carbohydrates every hour

  • Seek immediate medical treatment

Correct answer: Provide sugar to the patient and do not exercise

Exercise uses glucose. When working with patients who have a risk of becoming hypoglycemic, physical therapists should monitor glucose levels before and after exercise. These patients should not be instructed to exercise if their blood glucose is less than 70 mg/dL. Clinics should have carbohydrate snacks available when patients with diabetes are exercising. Early signs of hypoglycemia include shakiness, sweating, tachycardia, feeling faint, dizziness, fatigue, and walking instability.

In the absence of hypoglycemia, carbohydrates should be provided during exercise (15g per hour). Immediate medical attention is indicated when hyperglycemia is present.

180.

A physical therapist is working on a team where multiple physical therapists and physical therapy assistants who specialize in orthopedics are evaluating, planning, and implementing treatment for a shared group of patients. Based on this information, which of the following BEST describes this team?

  • Intradisciplinary

  • Interdisciplinary

  • Multidisciplinary

  • Unidisciplinary

Correct answer: Intradisciplinary

A team is a group of equally important individuals with common interests who collaborate to develop shared goals and build trusting relationships to achieve their shared goals. Three common examples of team structures that a physical therapist may encounter include multidisciplinary, interdisciplinary, and intradisciplinary. An intradisciplinary team is defined as one or more members of one discipline (physical therapists, physical therapy assistants, and physical therapy consultants) evaluating, planning, and implementing the treatment of a patient. 

An interdisciplinary team involves all disciplines relevant to a specific patient case—not just one discipline—agreeing to collaborate for decision-making. A multidisciplinary team involves a number of professionals from different disciplines conducting assessments and interventions independently. The term unidisciplinary does not describe what an intradisciplinary team is and is therefore not commonly used.

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