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Fundamental Orthopedic Management for the Physical Therapist Assistant, 4th Edition Test Bank

Fundamental Orthopedic Management for the Physical Therapist Assistant, 4th Edition Test Bank covers everything from fundamental concepts to advanced problem-solving strategies to help you excel in your exam.

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    Chapter 01: Patient Supervision and Observation During Treatment MULTIPLE CHOICE 1. Who is responsible for carrying out prescribed selected interventions, patient s upervision, data collection, and appropriate supervision of a patient during physical therapy? a. Physical therapist (PT) b. Physical therapist assistant (PTA) c. Nursing assistant d. Medical doctor ANS: B The PTA is responsible for carrying out prescribed selected interventions, patient supervision, data collection skills, and appropriate problem - solving and clinical decision making. REF: P. 3 2. Which of the following is NOT a purpose of the clinical patient supervision process? a. To gather relevant information and data b. To establish and enhance rapport, trust, and confidence c. To prescribe interventions the patient requires d. To assist in the management of the patient ANS: C PTAs do not prescribe interventions for the patient. The PTA observes, documents, and discusses patient observations with the PT. REF: P. 4 3. Select the open - ended question. a. What is your pain level today on a scale of 1 - 10? b. When did the pain begin? c. Tell me about the time that you injured knee. d. When did you take your last pain medication? ANS: C The open - ended question leads the patient to say more than yes or no. Open - ended questions provide much richer details about the incident or experience. REF: P. 6 4. Which of the following statements is true regarding the working environment of PTAs? a. PTAs work in isolation with their patient assignments. b. PTAs work with a team of experts in all areas of a patient’s care. c. PTAs work only with the PT in providing therapy. d. PTAs are the most important people on the rehabilitation team when providing therapy. ANS: B

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    The PTA must be aware of the key members of the rehabilitation team. Occupationa l therapists, PTs, nurses, respiratory therapists, psychologists, and audiologists are only a few of the important members of the rehabilitation team. The PTA does not work in isolation. REF: P. 4 5. Which of the following statements would be used in a discussion with a patient? a. Your blood pressure is 150/90, which indicates hypertension and could lead to a cerebral vascular accident if you don’t take your medications. b. Your blood pressure is higher than normal today, 150/90. Did you take your blood pressure medication this morning? c. The doctor prescribed a beta - blocker for you a month ago. Has that been helping your blood pressure? d. The combination of your calcium - channel blocker and beta - blocker do not seem to be controlling your blood pressure. Let’s call the doctor. ANS: B The PTA should learn to communicate openly, freely, and in a professional manner. The PTA must employ appropriate and professional medical terminology with professional people — but use familiar (lay) terms to describe the same condition to a patient or a family member. Avoiding the use of medical jargon (hypertension, beta - blocker, calcium - channel blocker) with patients is required by PTAs. REF: P. 4 6. How can a PTA demonstrate accountability in their practice? a. Maintain timely documentation about patient interventions. b. Maintain good rapport with patients. c. Continue their education past their initial degree. d. Report all findings to the supervising PT so that modifications can be made in response to changes in patient status. ANS: D PTAs are responsible for reporting all findings to the supervising PT so that modifications can be made in accordance with changes in patient status. REF: P. 6 7. Which type of questioning would you use to find facts or obtain specific responses from a patient about an injury to a limb or joint? a. Open - ended questions b. Closed - ended questions c. A pause d. Neutral phrase ANS: B Figure 1 - 1. Closed - ended questions are used to find out specific details, direct the discussion, or elicit specific responses from the patient. REF: P. 8 8. Which of the following is an example of prompting during a physical therapy session?

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    a. “When you walk up the steps, which foot will you move first?” b. “All right, now pick up your right foot and put it on the next step.” c. Point to the step and touch the patient’s right leg. d. Observe the behavior of the patient to see if they will lift up the correct foot while walking up the steps. ANS: A Prompting a patient to perform a task can be viewed as the presentation of a question. Prompting allows patients to decipher information, solve problems, and provide solutions to activities they must overcome during recovery. Cues are directions. REF: P. 9 9. Who holds the ultimate responsibility for the patient’s physical therapy? a. PTA b. Medical doctor c. Nurse d. PT ANS: D To minimize the confusing array of treatment protocols, the PTA must effectively and efficiently communicate with the supervising PT to clarify differences in patient care, always remembering that the PT has the ultimate responsibility for the interventions provided. REF: P. 10 10. Which of the following actions should you take if you have a disagreement with the PT? a. Refuse to provide the treatment or intervention on the PT’s plan of care. b. Change the treatment for the day and then report to the PT what was done at the end of the day. c. Follow the plan of care no matter what changes are observed in the patient and document later. d. Discuss your findings and rationale with the PT to learn and provide better care. ANS: D A full understanding of the rationale and purpose of PT interventions allows for improved delivery of care and safe and effective care. PTAs cannot change the plan of care by themselves. REF: P. 10 11. What type of behavior is the PTA using in the following example? The PTA quickly agrees to the patient’s request to slow down and stop the treatment for the day instead of discussing the purpose and benefits of the treatment. a. Dominance b. Submission c. Hostility d. Warmth ANS: B

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    Figure 1 - 2. Submission is defined as being passive. People who show submissive behavior are willing to take a back seat and are quick to comply and reluctant to try to exert influence. REF: P. 8 12. What type of behavior is the PTA using in the following example? The PT insists the patient continue treatment for the full time limit even when the tearful patient reports a fear of continuing exercise of a particular joint. a. Dominance b. Submission c. Hostility d. Warmth ANS: C A dominant PTA would try to sway the patient to think or behave in a certain way. In this example, the PTA ignores the patient’s complaints and feelings and continues with the treatment. REF: P. 8 13. In the basic dimensional model, which behaviors would be seen in a warm but submissive person? a. Stubborn, argumentative b. Sincere, open, candid, responsive c. Talks little, doesn’t listen well d. Appeases; compromise leads to lack of focus ANS: D Figure 1 - 3, B. The submissive - warm person demonstrates a lack of organization, appeasing behavior, and compromises. REF: P. 8 14. In the basic dimensional model, which behaviors would be seen in a dominant - hostile person? a. Stubborn and argumentative b. Sincere, open, candid, responsive c. Talks little and doesn’t listen well d. Appeases; compromise leads to lack of focus ANS: A Figure 1 - 3, B. The dominant - hostile person would be stubborn and argumentative, taking fixed positions and sticking to them, talking a lot rather than listening, and being pushy and arrogant. REF: P. 8 15. In the basic dimensional model, which behaviors would be seen in a dominant - warm person? a. Stubborn and argumentative b. Sincere, open, candid, responsive c. Talks little and doesn’t listen well d. Appeases; compromise leads to lack of focus

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    ANS: B Figure 1 - 3, B. The dominant - warm person is sincere, open, and candid; listens; is open - minded and flexible. REF: P. 8 16. In the basic dimensional model, which behaviors would be seen in a submissive - hostile person? a. Talks a lot rather than listens and is belligerent. b. Sincere, open, candid, responsive c. Talks little and doesn’t listen well and avoids issues d. Appeases; compromise leads to lack of focus ANS: C Figure 1 - 3, B. The submissive - hostile person talks little, doesn’t listen well, avoids or ignores issues, is uninvolved, quiet, and backs down easily. REF: P. 8 17. When can a PTA adjust or modify a program of treatment? a. When the PTA observes certain signs and symptoms in the patient. b. After seeking input and direction from the supervising PT. c. The PTA cannot ever change the plan of care. d. None of the above. ANS: B The PTA, with direction and input from the supervising PT, can adjust or modify the program of treatment. REF: P. 9 18. The PTA’s clinical decision - making process should begin with a. taking orderly and specific steps to notify the supervising PT. b. recognizing that a problem exists. c. adjusting the program according to the patient’s needs. d. asking the PT to assess the patient. ANS: B The clinical decision - making process used by the PTA involves recognizing that a problem exists, then taking orderly and specific steps to notify the supervising PT and adjusting the program accordingly. REF: P. 9 19. Which of the following behaviors exemplifies a well - adapted PTA? a. Constantly asks about the rationale for treatment b. Establishes themselves as an eager learner c. Is open to innovative ways of managing various pathologic conditions d. All of the above ANS: D

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    The well - adapted PTA views any apparent roadblocks as learning opportunities. The PTA is advised to take advantage of the broad knowledge and experience of many PTs, constantly inquire about the rationale and scientific basis for a particular program, and establish him - or herself as an eager learning participant who is open to innovative ways of managing various pathologic conditions. REF: P. 10 20. Why do PTAs and PTs use general scales of measurement? a. To standardize assessment and more accurately measure patient progress b. To shorten the amount of time needed to document the patient’s condition c. To demonstrate knowledge of medical terminology d. None of the above ANS: A General scales are used to standardize assessment and more accurately measure patient progress. REF: P. 4

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    Chapter 02: The Role of the Physical Therapist Assistant in Physical Assessment MULTIPLE CHOICE 1. Which health care provider is defined as “a technically educated health care pro vider who assists the physical therapist in the provision of select PT interventions?” a. Physical therapist assistant (PTA) b. Physical therapist (PT) c. Nursing assistant d. Medical doctor ANS: A This is the definition of the PTA as defined by the Guide to Physical Therapy Practice (2nd Ed.). REF: P. 14 2. Which of the following is the responsibility of the PT alone? a. Observation b. Assessment c. Examination d. Evaluation ANS: D Evaluation is the specific process reserved solely for the PT, in which clinical judgments are made from this base of data obtained during the examination. REF: P. 14 3. Which of the following statements is NOT included in the Clinical Performance Instrument (CPI) by the American Physical Therapy Association (APTA) related to the PTA’s role? a. Participates in patient status judgments within the clinical environment based on the plan of care established by the PT. b. Obtains accurate information by performing selected data collection consistent with the plan of care established by the PT. c. Discusses the need for modifications to the plan of care established by the PT. d. Makes clinical judgments based on the assessment and examination of the patient. ANS: D It is the role of the PT to make clinical judgments based on the assessment and examination of the patient. REF: P. 14 4. In the Normative Model of PTA Education (2007), which of the following is NOT an expected performance theme? a. Interventions b. Communication c. Diagnosis d. Resource management

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    ANS: C Diagnosis is not one of the five PT performance expectation themes for PTA education. The five include interventions, communication, education, resource management, and career development. REF: P. 15 5. Which of the following contains the cardinal signs of inflammation? a. Swelling, pallor, cool skin temperature b. Swelling, pain, redness, heat c. Fever, pain, redness, and warmth d. Pain, fever, cool skin temperature ANS: B The commonly accepted and normal cardinal signs and symptoms of inflammation are localized heat, redness, swelling, and pain (with a resultant loss of function in the injured area). REF: P. 15 6. How long does acute inflammation last, assuming the precipitating condition, agent, or event is removed? a. 12 - 24 hours b. 1 - 2 days c. 3 - 5 days d. 4 - 6 days ANS: D Under normal circumstances, signs of acute inflammation persist for 4 - 6 days, assuming the precipitating condition, agent, or event is removed. REF: P. 16 7. When is pain from acute inflammation felt by the patient during range of motion (ROM) exercises? a. Before tissue resistance (before “end” ROM) b. At the same time end ROM is reached c. After ROM exercises are over d. Never felt by the patient during ROM ANS: A Pain before tissue resistance felt before “end” ROM is an indication of acute inflammation. Pain at the same time end ROM is reached is an indication of a subacute inflammatory state. Pain reported as a stretching sensation at the limit of ROM is a sign of inflammation in the chronic state. REF: P. 16 8. Which of the following reports of pain is indicative of chronic inflammation? a. Pain reported before tissue resistance (before “end” ROM) b. Pain reported as a stretching sensation at the limit of ROM c. Pain reported at the same time ROM is reached

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    d. Pain is not seen with chronic inflammation ANS: B Pain before tissue resistance felt before “end” ROM is an indication of acute inflammation. Pain at the same time end ROM is reached is an indication of a subacute inflammatory state. Pain reported as a “stretching sensation” at the limit of ROM is a sign of inflammation in the chronic state. REF: P. 16 9. Your patient has an oral temperature of 101.6°F. Which other signs and symptoms will you look for in your patient assessment? a. General malaise and increased pulse b. Strong appetite and dry skin c. Decreased pulse and respirations d. Paleness in the affected joint ANS: A The clinical signs and symptoms of fever vary based on the underlying cause and stage; they might include general malaise, headache, increased pulse and respirations, general chills, shivering, piloerection, loss of appetite, pale skin, nausea, irritability, and restlessness. REF: P. 16 10. Which is the most effective means of controlling the transmission of infectious agents? a. Isolating infected patients b. Hand washing by the caregiver and patient c. Disinfecting treatment areas routinely d. B and C ANS: D The importance of hand washing by the caregiver and patient cannot be overstated as an effective means of controlling the transmission of infectious agents. In addition, treatment areas should be properly cleaned and disinfected as a routine procedure. REF: P. 16 11. Which of the following actions would be considered discretionary caution by the PTA when performing pool ROM exercises with a patient experiencing a fever of 102.8°F? a. Notify the PT and ask to omit the exercises until the fever resolves. b. Continue with the prescribed walking activities. c. Omit therapy during times the patient has a fever. d. Increase the walking exercises to help break or resolve the fever. ANS: A Discretionary caution is applied with any patient with a fever, because of stresses on the cardiopulmonary and immune systems and the possible further complications related to dehydration. The PTA should be familiar with specific exercise techniques contraindicated in the presence of diseases transmitted via water or air. REF: P. 17

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    12. Which type of redness indicates acute inflammation caused by a bacterial infection? a. Superficial tenderness or hardness of the area b. Red streaks c. Flushed cheeks d. None of the above ANS: B Red streaks might indicate an acute inflammation caused by a bacterial infection (strep, staph, or both). Superficial tenderness or hardness in an area may be a sign of superficial thrombophlebitis. REF: P. 18 13. What technique would you use to assess deep vein thrombosis (DVT)? a. Patient sits in a comfortable position and lifts knee to chest. b. Patient points toes toward the floor and reports any pain in the thigh area. c. Patient points toes upward (dorsiflex) for assessment of pain in the calf. d. Patient holds foot in neutral position and you squeeze the calf. ANS: C A com monly used quick assessment technique to rule out the presence of a DVT is the Homan sign. It is performed by gentle passive stretching of the ankle into full dorsiflexion and assessing for pain in the calf. REF: P. 18 14. What are the risk factors for DVT? a. Prolonged bed rest or prolonged air travel b. Varicose veins, fractures, and age under 60 c. Oral contraceptive use and high cholesterol level d. Obesity and falling ANS: A Box 2 - 1. Risk factors for DVT. Prolonged bed rest and air travel are risk factors. Items listed that are not risk factors are age under 60, high cholesterol level, and falling. REF: P. 18 15. Which term is defined as the excessive pooling of fluid in the spaces between tissues (interstitial spaces)? a. Fracture b. Infection c. Edema d. Hemorrhage ANS: C Edema refers to excessive pooling of fluid in the spaces between tissues (interstitial spaces). The main consideration for the PTA is measurement of the edematous part or extremity. REF: P. 19 16. Which signs and symptoms would be seen with congestive heart failure (CHF)?

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    a. Swelling in one ankle without a change in breathing or muscle strength b. Swelling in both ankles with fatigue and shortness of breath c. No swelling in either ankle, but fatigue and normal respirations d. Weakness without a change in respirations ANS: B Bilateral pitting edema in the distal lower extremities is a common manifestation in CHF. Other signs include a decrease in tolerance to exercise (fatigue, shortness of breath, and muscle weakness). These symptoms need prompt consultation with the supervising PT. REF: P. 19 17. Which of the following is the PTA’s best response to a patient reporting new pain since the last therapy session? a. “Well, some pain is to be expected after our therapy sessions” b. “Really? I didn’t think the last session was that difficult for you” c. “ That pain is normal and should be expected. Take your pain medication before and after our therapy sessions and you should feel better” d. “Tell me about the pain, is it sharp or burning? When do you have the pain?” ANS: D The PTA’s role in assessing pain is to gather data that present a clear picture of any change in pain since the last visit, and to elicit responses of the patient in terms of how interventions to date have affected pain, patterns of pain, and the characteristics of pain. All pain is considered “real” by the PTA and should be investigated and reported to the PT. REF: P. 23 18. Which of the following are the signs and symptoms of a heart attack? a. Pain or pressure u nder the breastbone, neck or jaw with pain in the left arm and shoulder b. Indigestion and pain in the lower abdomen after exercise c. Pain between the shoulder blades and the inside of the left or right arms d. A and C ANS: D Figure 2 - 6. Early warning signs of a heart attack. Indigestion and pain in the lower abdomen are not warning signs of a heart attack. REF: P. 24 19. What should a PTA do when a patient experiences “red flag” pain symptoms during therapy? a. Call the doctor immediately and report the pain b. Continue the therapy session using caution c. Stop any intervention that could be contraindicated and report the findings to the PT d. Ask the patient when he had his last pain medication and contact the nurse to deliver a pain medication ANS: C

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    The PTA must be keenly aware of pain that sends a “red flag” signal. The PTA should not proceed with any interventions or data collection techniques that are potentially contraindicated and should immediately report the findings to the supervising PT. REF: P. 23 20. Which symptoms are exhibited during intermittent claudication? a. Bilateral pain in the calves or thighs described as cramping that goes away with rest b. Unilateral pain in one calf described as cramping that goes away after walking c. Bilateral pain in calves or thighs that goes away with walking d. Unilateral pain in buttocks or thighs that worsens when the patient rests ANS: A It is typically described as aching or cramping that is localized in the region affected by the impaired circulation (calves, thighs, buttocks bilaterally) and is rapidly improved after the aggravating activity is discontinued (such as after resting). REF: P. 23

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    Chapter 03: Differential Diagnosis and Emergent Conditions MULTIPLE CHOICE 1. The process of providing a label that correlates specific signs and symptoms to an identifiable disease or disorder is: a. evaluation. b. diagnosis. c. consideration. d. prognosis. ANS: B Multiple sources have used this definition of diagnosis. REF: P. 38 2. The process of comparing and contrasting patient data points with the goal of appropriate exclusion and inclusion that terminate with the development of intervention strategies is: a. examination. b. prognosis. c. intervention. d. differential diagnosis. ANS: D Examination is the use of tests and measures to screen the patient. Prognosis is the prediction of outcomes. Intervention is the action taken by the physical therapist (PT) or physical therapist assistant (PTA) to resolve the patient’s problem. Differential diagnosis is the process of using patient data to develop intervention strategies. REF: P. 39 3. What is the term for a comprehensive screening of the patient that includes specific tests and measures? a. Examination b. Prognosis c. Intervention d. Differential diagnosis ANS: A Examination is the use of tests and measures to screen the patient. Prognosis is the prediction of outcomes. Intervention is the action taken by the PT or PTA to resolve the patient’s problem. Differential diagnosis is the process of using patient data to develop intervention strategies. REF: P. 39 4. What is the term for a prediction of the outcome of the physical therapy episode of care with the establishment of a plan of care (POC)? a. Examination b. Prognosis

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    c. Intervention d. Differential diagnosis ANS: B Examination is the use of tests and measures to screen the patient. Prognosis is the prediction of outcomes. Intervention is the action taken by the PT or PTA to resolve the patient’ s problem. Differential diagnosis is the process of using patient data to develop intervention strategies. REF: P. 41 5. Which of the following is not a minimum skill for a PTA? a. Collect data on patient’s current condition and compare results to previously collected data b. Communicate to the PT when there are significant changes in patient status c. Develop the POC d. Use clinical problem solving skills to determine if the patient is safe and comfortable with the intervention ANS: C The PT is responsible for the development of the POC. The PTA is expected to have all of the other skills listed (see Table 3 - 1). REF: P. 42 6. The PTA is expected to have which of the following basic assessment skills? a. Assessment of range of motion b. Ability to do manual muscle testing c. Proficiency in anthropometric measurement d. All of the above ANS: D The PTA is expected to be competent in all of the above skills. REF: P. 43 7. Which type of diagnosis emphasizes the influence of a disease or disorder on the patient’ s functional status at the system level and on the interrelationship between the system and the patient as a whole? a. Physical therapy diagnosis b. Medical diagnosis c. Nursing diagnosis d. Functional diagnosis ANS: A A medical diagnosis labels a disease or disorder on a cellular, tissue, or organ level. A physical therapy diagnosis emphasizes the impact of the disorder on the patient’s functional status. REF: P. 41 8. Which of the following is not true about vital signs?

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    a. They provide an objective overview of the patient’s cardiopulmonary function b. They may be influenced by exercise, disease, stress, and age c. Baseline vital signs data should be obtained prior to initiation of a POC d. During an episode of care, vital signs are no longer measured or useful ANS: D Vital signs should be measured periodically during care. Altered vital signs may indicate an adverse response to care and must be evaluated. REF: P. 48 9. What percentage of patients undergoing orthopedic surgery develops an infection? a. 1% b. 2 - 5% c. 10% d. 12 - 15% ANS: B Two to five percent of patients undergoing orthopedic surgery develop an infection. REF: P. 48 10. The signs and symptoms of redness, edema, pain, and increased skin temperature may indicate: a. inflammation or infection. b. infection only. c. inflammation only. d. a prognosis. ANS: A Both inflammation and infection may be indicated by redness, edema, pain, and in creased skin temperature. The health care team needs to evaluate these signs and symptoms to determine if infection is present. REF: P. 48 11. An abnormal response to musculoskeletal trauma that involves the excessive collection of red and white blood cells and fibrin resulting in a partial or complete occlusion of a vessel is: a. inflammation. b. tumor. c. venous thrombosis. d. tachycardia. ANS: C Venous thrombosis is caused when an excessive collection of white and red blood cells and fibrin occlude a blood vessel. If a deep vessel is involved, the thrombosis is referred to as a deep vein thrombosis (DVT). REF: P. 48 12. DVT usually occurs in which location? a. Upper extremities

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