Fundamental Orthopedic Management for the Physical Therapist Assistant 4th Edition By Robert Manske Test Bank

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Fundamental Orthopedic Management for the Physical Therapist Assistant 4th Edition By Robert Manske Test Bank

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WITH ANSWERS

Fundamental Orthopedic Management for the Physical Therapist Assistant 4th Edition By Robert Manske Test Bank

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 provider 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

 

  1. 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

 

  1. Which of the following statements is NOT included in the Clinical Performance Instrument (CPI) by the American Physical Therapy Association (APTA) related to the PTAs 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

 

  1. 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

 

 

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

 

  1. 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

 

  1. 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

 

  1. 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

 

  1. 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
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

 

  1. Your patient has an oral temperature of 101.6F. 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

 

  1. 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

 

  1. 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 102.8F?
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

 

  1. 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

 

  1. 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 commonly 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

 

  1. 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

 

  1. 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

 

  1. Which signs and symptoms would be seen with congestive heart failure (CHF)?
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

 

  1. Which of the following is the PTAs 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 didnt 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 PTAs 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

 

  1. Which of the following are the signs and symptoms of a heart attack?
a. Pain or pressure under 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

 

  1. 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

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

 

  1. 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

 

 

Chapter 04: Muscle Flexibility and Range of Motion

 

MULTIPLE CHOICE

 

  1. Which of the following is NOT a benefit to having a more flexible body?
a. Injury prevention and quicker recoveries after workouts
b. Faulty postural alignment that leads to injuries
c. Reduced postexercise soreness
d. Facilitation of relaxation

 

 

ANS:  B

Muscle imbalance leads to faulty postural alignment, which affects flexibility.

 

REF:   P. 65

 

  1. Which type of collagen is most abundant in the body, is a thick fiber, and has little elongation when placed under tension?
a. Type I
b. Type II
c. Type III
d. Tropocollagen

 

 

ANS:  A

Type I collagen is made of short fibrils (bundles) found in all different types of connective tissues. The majority of the collagen in the body is type I.

 

REF:   P. 66

 

  1. Which type of collagen would you expect to find in the arteries, liver, and lungs?
a. Type I
b. Type II
c. Type III
d. None of the above

 

 

ANS:  C

Type III collagen serves mainly in a structural support capacity and is found in expansible organs (e.g., arteries, liver, lungs). It also helps out in the early stages of wound repair.

 

REF:   P. 66

 

  1. Which term is defined in force/area (pounds per square inch) and is directly related to the magnitude of force?
a. Stress (load)
b. Strain
c. Deformation
d. Viscoelasticity

 

 

ANS:  A

Stress or load is defined as force/area (i.e., pounds per square inch). It is directly related to the magnitude of force and inversely related to the unit area, but it is independent of the amount of a material. Deformation is a complementary measure related to stress and is also called strain.

 

REF:   P. 66

 

  1. Which of the following terms is defined as a gradual increase in tissue length that occurs when maintaining a constant stress (force)?
a. Stress (load)
b. Creep
c. Deformation
d. Viscoelasticity

 

 

ANS:  B

Creep phenomenon means the gradual increase in tissue length that occurs when maintaining a constant stress or force. The deformation of the tissue will continue until a state of equilibrium is reached when the load is balanced. The longer the duration of the applied force, the greater the deformation or stretching.

 

REF:   P. 68

 

  1. What is increased in ligaments and tendons that experience increasing levels of stress?
a. Collagen
b. Creep
c. Strain
d. None of the above

 

 

ANS:  A

The ability of tissues to recover after stress is extremely important in relation to flexibility. Increasing the levels of stress produces an increase in collagen within ligaments and tendons.

 

REF:   P. 69

 

  1. What effect does heat have on the viscoelastic properties of connective tissue?
a. No effect
b. Greater elongation with stress before tissue failure
c. More microscopic damage under stress
d. Thermal damage to the connective tissues below 45C

 

 

ANS:  B

Viscoelastic and plastic changes occur at higher temperatures with less microscopic damage under stress. A temperature of 45C is needed to reduce tissue damage during strains.

 

REF:   P. 69

 

  1. What happens to flexibility over time in a damaged or unused muscle?
a. The muscle shortens and loses its ability to stretch
b. The muscle is unchanged
c. The muscle remains flexible but weaker
d. The range of motion (ROM) of the joint that the muscle serves remains normal

 

 

ANS:  A

Flexibility refers to the degree of normal ROM available. If a muscle becomes damaged by trauma or disease or becomes shortened because of immobility, its ability to stretch and allow freedom of joint motion is affected. Flexibility will diminish over time if tissues are not stretched or exercised using regular and proper stretching regimens.

 

REF:   P. 69

 

  1. What is the name of the instrument that looks like a protractor with degree measurements and is used to measure ROM for almost all joints in the body?
a. Scale
b. Flexibility test
c. Goniometer
d. ROM meter

 

 

ANS:  C

Measuring joint ROM is accomplished by using standard goniometric instruments. The measuring device most commonly used is a goniometer, which looks like a protractor with degree measurements.

 

REF:   P. 70

 

  1. What are the benefits of a warm-up before strenuous activities?
a. Blood flow to working muscles is increased
b. Temperature in working muscles is increased
c. Cardiovascular response to sudden; dynamic exercise is improved
d. All of the above

 

 

ANS:  D

Warm-up is necessary to help prepare the tissue for activity. Stretching alone is not enough. All of the listed items are benefits of a warm-up before strenuous activities.

 

REF:   P. 73

 

  1. Which term is defined as a common form of stretching that allows one to sustain a controlled stretch by placing a muscle in a fully elongated position and holding that position for a period of time?
a. Static stretching
b. Ballistic stretching
c. Dynamic stretching
d. Proprioceptive neuromuscular facilitation (PNF)

 

 

ANS:  A

Static stretching is the most common form and allows one to sustain a controlled stretch by placing a muscle in a fully elongated position and holding that position for a period of time (Fig. 4-11).

 

REF:   P. 74

 

  1. Which term is defined as using a muscle contraction to stretch a muscle to increase or decrease the joint angle thereby elongating the musculotendinous unit at the end of ROM exercise?
a. Static stretching
b. Ballistic stretching
c. Dynamic stretching
d. PNF

 

 

ANS:  C

Dynamic stretching is defined as using a muscle contraction to stretch it to increase or decrease the joint angle thereby elongating the musculotendinous unit at the end of ROM exercise.

 

REF:   P. 75

 

  1. Which stretching technique is completed by performing the following steps?

The patient is instructed to relax the affected muscle as the therapist passively moves the limb to the limit of motion.

Then the patient actively contracts the restricted muscle against manual resistance for 5-8 seconds.

Then the patient relaxes while the therapist passively moves the limb to the new limits of motion and holds the stretch for 10 seconds.

a. Static stretching
b. Ballistic stretching
c. Dynamic stretching
d. PNF

 

 

ANS:  D

PNF has several techniques. The one described in this question is the contract-relax with agonist contraction technique (Fig. 4-18).

 

REF:   P. 77

 

  1. What is the generally recommended length of time (in seconds) that a static stretch should be held?
a. 0-10
b. 15-30
c. 60-120
d. 120-240

 

 

ANS:  B

Generally, most research recommends stretches be held between 15 and 30 seconds. Current American College of Sports Medicine guidelines recommend 2-5 repetitions for each stretching exercise.

 

REF:   P. 78

 

  1. How many weeks of stretching are needed to demonstrate significant increases in muscular flexibility?
a. 0-2
b. 2-3
c. 4-5
d. 6

 

 

ANS:  D

Approximately 6 weeks of stretching are necessary to demonstrate significant increases in muscular flexibility. A person must stretch at least three times per week to improve flexibility and at least 1 day per week to maintain the flexibility gained during the program.

 

REF:   P. 78

 

  1. Based on the research evidence presented in the text about when to perform stretching exercises, which of the following best describes the state of research?
a. It is best to stretch before exercise
b. It is best to stretch during exercise
c. It is best to stretch after exercise
d. The research supports stretching before, during, and after exercise

 

 

ANS:  D

The evidence presented in the text section When to Stretch supports all three times for stretchingbefore, during, and after exercise.

 

REF:   P. 81

 

  1. How long does it take for an immature adaptable scar to mature and reach its maximum strength?
a. 5 days
b. 40 days
c. 60 days
d. 12 months

 

 

ANS:  D

At 12 months, a new scar is approximately 100% of its maximum strength.

 

REF:   P. 82

 

  1. Which stretching exercises are effective in stretching joint contractures in combination with thermal agents such as moist heat?
a. Static stretching
b. Ballistic stretching
c. Low-load, long-duration stretching
d. PNF

 

 

ANS:  C

Low-load, long-duration (20-60 minutes) stretching of joint contractures in combination with thermal agents to preheat extensible connective tissue has proved effective in the treatment of soft tissue contracture.

 

REF:   P. 83

 

  1. Which of the following terms is defined as a process that alters the structure of connective tissue in response to stress?
a. Stretching
b. Deformation
c. Viscoelasticity
d. Remodeling

 

 

ANS:  D

Remodeling is defined as a process that alters the structure of connective tissue in response to stress.

 

REF:   P. 81

 

  1. Which term is defined as a limitation of function that results from the formation of scar tissue?
a. Adhesion
b. Contracture
c. Strain
d. Sprain

 

 

ANS:  A

An adhesion is a limitation of function that results from the formation of scar tissue. A contracture is a permanent or transient limitation of movement or shortening of muscle or other soft tissue.

 

REF:   P. 81

 

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