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Quiz Session - Attempts With Random Questions

FSBPT NPTE-PTA Exam Questions

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21.

Which of the following measurements refers to the percentage of blood emptied from the ventricle during systole?

  • Ejection fraction

  • Stroke volume

  • Afterload

  • Cardiac output

Correct answer: Ejection fraction

There are several terms pertaining to hemodynamics that PTs and PTAs should know as they assess and monitor their patients. Ejection fraction is the percentage of blood emptied from the ventricle during systole.

The remaining answer options are incorrect. Stroke volume is the amount of blood ejected with each myocardial contraction, which is approximately 70 mL. Afterload is the force the left ventricle must generate during systole to overcome aortic pressure to open the aortic valve. Cardiac output is the volume of blood discharged from the left to right ventricle per minute, which is approximately 4-6 L per minute in a typical adult.

22.

A PTA decides to incorporate proprioceptive neuromuscular facilitation (PNF) diagonals into treatment in order to improve a patient's shoulder ROM (range of movement). The goal of treatment is for the patient to bring their hand to their mouth in order to self-feed.

Which PNF pattern should the PTA utilize?

  • D1F

  • D1E

  • D2F

  • D2E

Correct answer: D1F

D1F (diagonal 1 flexion) for the upper extremity involves flexion-adduction-external rotation of the shoulder. The therapist cues the patient to "close your hand, turn, and pull your arm up across your face." This motion resembles bringing the hand to one's mouth in order to eat.

D2F (diagonal 2 flexion) for the upper extremity involves flexion-abduction-external rotation of the shoulder. D1E (diagonal 1 extension) for the upper extremity involves extension-abduction-internal rotation of the shoulder. D2E (diagonal 2 extension) for the upper extremity involves extension-adduction-internal rotation of the shoulder.

23.

Which of the following is NOT part of the testing cluster for carpal tunnel syndrome?

  • Scratch collapse test

  • Older than 45 years

  • Shaking hands lessens symptoms

  • Sensation is lost in thumb

Correct answer: Scratch collapse test

The cluster of tests for carpal tunnel syndrome (CTS) includes the following:

  • Older than 45 years
  • Relief of symptoms when shaking hands
  • Loss of sensation in thumb
  • Wrist ratio index of greater than .67
  • CTQ-SSS score is greater than 1.9

If three or more of these are positive, CTS is likely.

The scratch collapse test is another test used to diagnose CTS, but it is not included as part of the testing cluster due to some discrepancies reported related to its sensitivity and specificity for diagnosing the condition.

24.

A PTA is training a patient in proper use of a wheelchair. What is the appropriate way for the patient to move into the wheelie position?

  • Place hands well back on hand rims, then pull wheels forward abruptly and forcefully; lean forward with head and trunk

  • Place hands directly on top of hand rims, then push wheels forward abruptly and forcefully; lean forward with head and trunk

  • Place hands directly on top of hand rims to stabilize them, then use head and trunk to rock backward forcefully; immediately bring head and trunk forward to avoid falling backward 

  • Wheelies are not safe; the PTA should not encourage the patient to do this

Correct answer: Place hands well back on hand rims, then pull wheels forward abruptly and forcefully; lean forward with head and trunk

When learning how to use a wheelchair, patients should practice "popping wheelies" in order to navigate curbs. It is important that the therapist instructs them how to perform this maneuver safely. In order to move into a wheelie position, the patient should place their hands well back on the hand rims, and then pull the wheels forward and abruptly while leaning forward with the head and trunk. 

This requires an understanding of the patient's center of balance and momentum, but this can be done safely and the patient should be taught how to perform this maneuver in order to be as independent as possible in the community.

25.

Which special test of the spine is used to determine the integrity of the transverse ligament and/or atlantoaxial stability?

  • Modified Sharp-Purser test

  • Distraction test

  • Spurling's test

  • Lhermitte's sign

Correct answer: Modified Sharp-Purser test

The modified Sharp-Purser test is used to determine the integrity of the transverse ligament and/or atlantoaxial stability. Positive findings may include myelopathic symptoms with upper cervical flexion, or a decrease in symptoms or posterior translation.

The distraction test identifies compression of neural structures at the intervertebral foramen or facet joint dysfunction. Spurling's test (foraminal compression test) identifies dysfunction of a cervical nerve root. A positive Lhermitte's sign indicates dysfunction of the spinal cord and/or an upper motor neuron lesion.

26.

Which of the following gait patterns is LEAST appropriate for a patient with paraplegia or spina bifida?

  • Delayed three-point gait

  • Swing-to pattern

  • Four-point gait

  • Swing-through gait

Correct answer: Delayed three-point gait

A delayed three-point gait is indicated for patients with unilateral limb involvement who need to move at a slower pace with increased stability. Since paraplegia and spina bifida are present with bilateral limb involvement, this gait pattern is not indicated.

Swing-to gait, swing-through gait, and four-point gait are all potentially appropriate gait patterns for bilateral limb involvement, as seen with these conditions.

27.

When performing gait analysis of a patient with an above-knee amputation, the PTA notices the patient displays lateral bending in the stance phase of gait. Which of the following is the MOST likely cause of this gait deviation?

  • Short prosthesis

  • Long prosthesis

  • Abduction contracture

  • Inadequate suspension

Correct answer: Short prosthesis

A short prosthesis can contribute to lateral bending in the stance phase of gait. This gait deviation can also be caused by a low lateral wall, high medial wall, abductor contracture, or hip pain.

A long prosthesis, locked knee unit, loose friction, inadequate suspension, small or loose socket, abduction contracture, and poor knee control can contribute to noticeable circumduction of the prosthetic limb during the swing phase of gait—not lateral bending during the stance phase.

28.

A physical therapist is reviewing a clinical practice guideline for low back pain. One of the treatment recommendations is level V evidence. Which of the following would fall into this category?

  • A group of seasoned therapists reporting anecdotal success with the treatment is the basis for the recommendation

  • A systematic review of randomized control trials is the basis for the recommendation

  • A series of nonrandomized cohort studies is the basis for the recommendation

  • Poor quality studies are the basis for the recommendation

Correct answer: A group of seasoned therapists reporting anecdotal success with the treatment is the basis for the recommendation

Level V evidence is the worst form of evidence. These recommendations are based solely on expert opinion and anecdotes.

A systematic review of randomized control trials is the basis for the recommendation refers to level I evidence. A series of nonrandomized cohort studies is the basis for the recommendation refers to level III evidence. Poor quality studies are the basis for the recommendation refers to level IV evidence.

29.

A physical therapist is working with a patient who is being seen for knee pain and gait abnormalities. The PT notes that this patient would benefit from a heel lift. Which of the following would serve as a precaution/contraindication for a heel lift?

  • Bilateral foot numbness due to diabetes

  • Hyperlipidemia

  • Genu varum

  • History of a left THA

Correct answer: Bilateral foot numbness due to diabetes

Some people with diabetes will develop polyneuropathy and numbness in their distal extremities. For these patients, it's important not to place any extra structures within their shoes that might cause an increase of pressure in certain areas, leading to pressure sores or other foot damage.

30.

Patients with diabetes commonly experience hypoglycemia when exercising. What is the threshold level of blood glucose at which exercise should be avoided?

  • Below 70 mg/dL

  • Below 50 mg/dL

  • Below 120 mg/dL

  • Below 90 mg/dL

Correct answer: Below 70 mg/dL

Therapists must be aware that exercise uses blood glucose. The glucose levels of patients with diabetes should be monitored before and after exercise in order to avoid causing hypoglycemia. Exercise should not be performed if 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.

31.

To accomplish postural drainage, a therapist positions a patient on their left side with their legs together and a pillow under their knees. The therapist raises the foot of the bed 20 inches.

Which lobes of the lungs are being drained?

  • Anterior basal segments of the right lower lobe

  • Anterior basal segments of the left lower lobe

  • Lateral basal segments of the lower lobe

  • Lingular segments of the left upper lobe

Correct answer: Anterior basal segments of the right lower lobe

To drain the anterior basal segments of the lower lobe, the patient should lie on their side with their head down and a pillow between their knees. The foot of the table should be raised 20 inches. The therapist then claps over the lower ribs.

To drain the anterior basal segments of the left lower lobe, the patient would be in the same position, but lying on the right side instead of the left. To drain the lateral basal segments of the lower lobe, the patient should lie on their abdomen with their head down, and then rotate one quarter turn upward, with their upper leg flexed over a pillow for support. To drain the lingular segments of the left upper lobe, the patient should lie on their right side with their head down, and then rotate one quarter turn backward with their knees flexed and a pillow placed between their shoulder and hip from behind.

32.

A patient has known impairment of sensation over the L4 dermatome. Which of the following areas will have impaired sensation to touch?

  • Patellar region

  • Gastroc-soleus area

  • Groin region

  • Thoracic region

Correct answer: Patellar region

The L4 dermatome is a large area that includes parts of the low back and the anterior thigh, the anterior knee, and portions of the anterior lower leg. The patellar region (anterior surface of the knee) is included in the L4 dermatome.

The gastroc-soleus region is within the S1 and S2 dermatomes. Various parts of the groin area are within the L1, L2, S2, and S3 dermatomes. The thoracic region includes the thoracic dermatomes (T1-T12).

33.

In the study of biomechanics, joints may be classified as levers. Which of the following is MOST commonly found in the human body?

  • Third-class lever

  • Second-class lever

  • First-class lever

  • Fourth-class lever

Correct answer: Third-class lever

Third-class levers are the most commonly found type of lever in the human body. In this type of lever, two forces are applied to one side of an axis, and the effort force lies closer to the axis than the resistance force. Elbow flexion occurs as a result of third-class lever movement.

First-class levers occur when two forces are applied on either side of an axis, as seen in the contraction of the triceps at the elbow. Second-class levers occur when two forces are applied to the same side of one axis, and the resistance lies between the effort force and the axis of rotation. There are very few second-class levers in the human body, but, for example, toe raises are the result of second-class lever movement. 

A rule of thumb for remembering the three types of levers is the acronym ARE. ARE stands for the portion that is in the middle of each type of lever. First class = Axis. Second class = Resistance. Third class = Effort (muscle force).

34.

The PT wants to test the L4 dermatome. Where should he touch the patient to test this dermatome?

  • Anterior-medial lower leg

  • Medial thigh

  • Dorsal surface of foot

  • Abdomen

Correct answer: Anterior-medial lower leg

The L4 dermatome primarily serves the anterior medial lower leg. 

The medial thigh is served by L2 and L3. The dorsal surface of the foot is served by L5. The abdomen is served by the thoracic dermatomes. 

35.

A PT stands behind a patient and slowly brings two fingers forward, asking the patient when she can see them while she looks straight ahead. Which of the following is being tested in this situation?

  • Visual field impairments

  • Anosognosia

  • Somatognosia

  • Apraxia

Correct answer: Visual field impairments

Testing the visual field gives meaningful data about a patient's ability to safely navigate their environment. This test allows the clinician to determine how much of the field has been affected, if any.

Anosognosia is denial of having a condition. Somatognosia is an inability to identify parts of the body. Apraxia is an inability to learn a new task or perform movements requiring learning.

36.

A patient has been diagnosed with a brain abscess. Which of the following is TRUE of this condition?

  • Treatment often involves surgical drainage

  • Treatment involves early gait training

  • The condition is synonymous with meningitis

  • The condition causes severe, widespread inflammation of the brain

Correct answer: Treatment often involves surgical drainage

Brain abscesses are collections of pus in a local area of the brain. Gait training may be initiated later on, but early treatment involves quick identification and surgical drainage, with antibiotic therapy, if indicated.

Meningitis is a distinct condition which involves inflammation of the meninges due to infection. Encephalitis is severe inflammation of the brain (widespread). 

37.

A patient has an intravenous catheter inserted in her arm as she arrives at her PT session. Which of the following is contraindicated?

  • Lifting the arm above the level of the IV

  • Holding a rolling IV pole with the involved arm

  • Performing cardiovascular exercise

  • Performing strength training exercise

Correct answer: Lifting the arm above the level of the IV

There are no specific exercise contraindications when a patient has an IV inserted. However, the patient should be instructed not to lift the involved arm above the IV, as this could cause backflow.

38.

Which type of wound debridement is indicated for a patient with a complicated stage IV pressure ulcer?

  • Surgical

  • Enzymatic

  • Autolytic

  • Mechanical

Correct answer: Surgical

Surgical debridement is indicated for patients with deep or complicated pressure ulcers (stage III or IV). It is performed by a surgeon using sterile instruments and, in some cases, anesthesia.

Enzymatic debridement is a form of selective chemical debridement. Autolytic debridement is a natural intervention that uses dressings to solubilize necrotic tissue. Mechanical debridement is a nonselective method using physical forces to remove contaminated tissue or foreign material.

39.

Use the following scenario to answer this question.

Which of the following modalities is MOST appropriate for this patient?

  • Manual therapy

  • Ice massage

  • TENS

  • Ultrasound

Correct answer: Manual therapy

Because this patient has a pacemaker, both ultrasound and TENS are contraindicated. Ice massage may not be appropriate due to the patient's reported cold intolerance. 

Manual therapy would be appropriate for this patient.

40.

Which lobe of the cerebrum is responsible for processing visual information?

  • Occipital

  • Temporal

  • Parietal

  • Frontal

Correct answer: Occipital

The occipital region of the cerebrum receives and processes visual information. Patients who suffer injury to this region of the brain are likely to have visual deficits and difficulty with extra-ocular muscle movement.

The temporal lobe is responsible for auditory functions, comprehension of spoken words, long-term memory, and visual perception. The parietal lobe functions for the primary sensory cortex, integrating sensation, short-term memory, perception of touch, proprioception, pain, and temperature. The frontal lobe functions for the primary motor cortex for voluntary movement, motor components of speech, cognition, judgment, attention, abstract thinking, and emotional control.

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