PTI 2 Practical 1 – Flashcards
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Which situation would warrant the coolest water temperature? a. pain management b. general exercise c. treatment of burns d. chronic osteoarthritis
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Answer: b Rationale: The temperature of water for general exercise should be between 79-92 degrees Fahrenheit. Water temperature would need to be significantly higher for the remaining options: pain management 99-104 degrees Fahrenheit; treatment of burns 96-98 degrees Fahrenheit; chronic osteoarthritis 104-110 degrees Fahrenheit
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A therapist plans to administer cryotherapy to a patient for a period of seven minutes. What type of cryotherapeutic agent would be most likely based on the planned duration of the treatment? a. cold bath b. ice massage c. cold pack d. vapocoolant spray
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Answer: b Rationale: Ice massage is typically performed by freezing water in paper cups and applying the ice directly to the treatment area. Since the ice is applied directly, the magnitude of the tissue cooling requires a treatment duration of only five to ten minutes. Ice massage is ideal for small or contoured areas, allows for direct observation of the skin, and is inexpensive to use.
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What ratio of on:off time is most common when using mechanical compression? a. 1:3 b. 3:1 c. 1:6 d. 6:1
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Answer: b Rationale: A 3:1 ratio is generally used for on:off time with inflation between 40 to 100 seconds and deflation between 10 to 35 seconds
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A therapist treats a patient rehabilitating from an ankle sprain using a cold bath. Which value would be most appropriate for the temperature of the cold bath? a. 35 degrees Fahrenheit b. 48 degrees Fahrenheit c. 60 degrees Fahrenheit d. 74 degrees Fahrenheit
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Answer: c Rationale: A cold bath requires water temperature ranging from 55 to 64 degrees Fahrenheit. Cold baths are commonly used for the immersion of distal extremities.
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The temperature of the water in a hot pack machine should be: a. 137 degrees Fahrenheit b. 148 degrees Fahrenheit c. 161 degrees Fahrenheit d. 174 degrees Fahrenheit
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Answer: c Rationale: The water in a hot pack unit should be between 158-167 degrees Fahrenheit
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Which condition would be considered an indication for cryotherapy? a. chronic pain b. circulatory impairment c. cold urticaria d. ischemic tissue
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Answer: a Rationale: Chronic pain is an indication for cryotherapy. Other indications include pain control, myofascial pain syndrome, muscle spasm, bursitis, tendonitis, acute or subacute inflammation, and musculoskeletal trauma. Circulatory impairment, cold urticarial, and ischemic tissue are all considered contraindications for cryotherapy.
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Which property of water increases in proportion to the depth of immersion? a. buoyancy b. hydrostatic pressure c. specific gravity d. total drag force
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Answer: b Rationale: Hydrostatic pressure is the pressure exerted by a fluid at equilibrium due to the force of gravity. Water exerts pressure that is perpendicular to the body and increases in proportion to the depth of immersion.
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A therapist uses compression to treat a patient with edema. How much inflation pressure is necessary when treating the upper extremities? a. 20 mmHg b. 45 mmHg c. 70 mmHg d. 90 mmHg
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Answer: b Rationale: Treatment for the upper extremities requires between 30 and 60 mmHg of inflation pressure
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Which type of hydrotherapy tank would allow the patient to extend their legs, however, would not allow for full body immersion? a. extremity tank b. lowboy tank c. highboy tank d. Hubbard tank
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Answer: b Rationale: A lowboy tank is used for larger parts of the extremities and permits long sitting with water to the midthoracic level. Approximate dimensions for the lowboy tank are a depth of 18 inches, a length of 52-65 inches, and a width of 24 inches.
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Which of the following would be considered a contraindication for mechanical lumbar traction? a. muscle spasm b. joint instability c. nerve impingement d. protruding disc
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Answer: b Rationale: Joint instability is considered a contraindication to mechanical lumbar traction. Muscle spasm, nerve impingement, and protruding disc are indications for traction.
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A therapist applies a hot pack to the lower back of a patient positioned in prone. How long after administering the hot pack should the therapist examine the patient's skin? a. 1 minute b. 5 minute c. 10 minutes d. 20 minutes
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Answer: b Rationale: A therapist should check a patient's skin for redness or signs of a burn shortly after applying the hot pack. Five minutes would be an ideal time to check the patient's skin since there would be ample time for thermal effects; however, there would be insufficient time for a serious reaction given the number of towel layers required.
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A therapist positions a patient in supine prior to initiating mechanical cervical traction. How much neck flexion should be present? a. 5-10 degrees b. 10-15 degrees c. 25-35 degrees d. 45-55 degrees
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Answer: c Rationale: When administering mechanical traction to the cervical spine with the patient in a supine position, the neck should be flexed 25-35 degrees. Traction to the cervical spine can also occur with the patient in a sitting position.
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What form of heat transfer is used by hot packs? a. conduction b. convection c. conversion d. evaporation
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Answer: a Rationale: Hot packs transfer heat through conduction. This type of heat transfer occurs as a result of direct contact between two materials at different temperatures.
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How much force should be used initially when performing mechanical traction to the cervical spine? a. 5 pounds b. 10 pounds c. 25 pounds d. 50 pounds
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Answer: b Rationale: A force between 10 and 15 pounds is often used to initiate mechanical cervical traction. Seven percent of the patient's body weight may be necessary for separation of the vertebrae.
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Which therapeutic modality transfers heat through convection? a. hot pack b. whirlpool c. paraffin d. ice massage
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Answer: b Rationale: Whirlpool transfers heat to the body through convection. Convection refers to the gain or loss of heat as a result of air or water moving in a constant motion across the body.
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Which of the following is an indication for hydrotherapy? a. impaired circulation b. desensitization of a residual limb c. incontinence d. diminished sensation
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Answer: b Rationale: Desensitization of a residual limb can occur using a contrast bath. Impaired circulation, incontinence, and diminished sensation are considered contraindications to hydrotherapy.
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What percentage of body weight is necessary for mechanical separation of the lumbar spine when using spinal traction? a. 10 percent b. 25 percent c. 40 percent d. 50 percent
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Answer: d Rationale: A force of 25-50 pounds is recommended when initiating mechanical lumbar traction, however, 50 percent of body weight is necessary for actual separation of the vertebrae.
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How many towel layers are generally recommended when using a hot pack? a. 2-4 b. 4-6 c. 6-8 d. 8-10
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Answer: c Rationale: A therapist should use 6-8 towel layers around a hot pack before applying a hot pack to a patient. If a therapist uses hot pack covers, each cover counts as two towel layers.
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Which term is responsible for the upward force on the body when immersed in water? a. buoyancy b. hydrostatic pressure c. specific gravity d. total drag force
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Answer: a Rationale: Buoyancy is the upward force caused by fluid pressure that keeps objects afloat. According to Archimedes' principle of buoyancy there is an upward force on the body when immersed in water equal to the amount of water that has been displaced by the body.
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Which type of hydrotherapy tank would hold the largest volume of water? a. extremity tank b. lowboy tank c. highboy tank d. Hubbard tank
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Answer: d Rationale: A Hubbard tank is used for full body immersion and can hold up to 425 gallons. Approximate dimensions for the Hubbard tank are a depth of four feet, a length of eight feet, and a width of six feet.
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How much inflation pressure is necessary when treating the lower extremities with compression? a. 20 mmHg b. 35 mmHg c. 60 mmHg d. 85 mmHg
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Answer: c Rationale: Treatment for the lower extremities requires between 40 and 80 mmHg of inflation pressure. The inflation pressure should not exceed the patient's diastolic blood pressure.
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A therapist would like to increase the lower extremity resistance a patient experiences while exercising in a therapeutic pool. The most appropriate therapist action is: a. increase the depth of water b. decrease the level of body immersion c. increase the speed of movement d. decrease the duration of the exercise
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Answer: c Rationale: Resistance in water increases in proportion to the speed of the motion. The amount of resistance is also influenced by the shape and size of the object (i.e., lower extremity).
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A therapist treats a patient with a cold pack for 30 minutes. Which condition would most warrant the stated treatment period? a. acute pain b. spasticity c. bursitis d. subacute inflammation
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Answer: b Rationale: Cryotherapy used to reduce spasticity may extend to period of 30 minutes. Use of a cold pack for traditional therapeutic benefits (e.g., decrease inflammation, promote analgesia, decrease metabolism) typically requires a duration of 15 minutes.
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A physical therapist elects to use mechanical lumbar traction for a patient rehabilitating from a back injury. The therapeutic goals of the session include decreasing the patient's muscle spasm. The MOST appropriate force based on the stated objective would be: a. 10% of body weight b. 15% of body weight c. 25% of body weight d. 50% of body weight
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Answer: c Rationale: Twenty-five percent of the patient's body weight is generally recommended when the goal of treatment is to decrease muscle spasm or stretch soft tissue in the lumbar spine.
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A patient diagnosed with infrapatellar tendonitis completes a series of functional activities. After completing the activities the physical therapist instructs the patient to use ice massage over the anterior surface of the knee. The MOST appropriate treatment time is: a. 3-5 minutes b. 5-10 minutes c. 10-15 minutes d. 15-20 minutes
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Answer: b Rationale: Ice massage requires a treatment time of 5-10 minutes due to the intensity of the cooling
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A physical therapist elects to begin a trial of mechanical lumbar traction on a 165 pound male diagnosed with suspected nerve root impingement. The MOST appropriate amount of force to initiate the session is: a. 15 lbs. b. 30 lbs. c. 60 lbs. d. 80 lbs.
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Answer: b Rationale: A traction force of 30-45 lbs. is recommended when initiating mechanical lumbar traction. The amount of force is low enough to reduce the risk of protective muscle guarding and spasm, but is sufficient to determine if traction is likely to aggravate the patient's symptoms.
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A physical therapist sets up a patient for mechanical traction to the lumbar spine. The therapist's objective is to provide soft tissue stretch to surrounding muscles. Assuming the therapist uses a force equivalent to 25% of the patient's body weight and the patient has tolerated treatment without difficulty on several other occasions, the MOST appropriate duration of treatment is: a. 5 minutes b. 10 minutes c. 25 minutes d. 40 minutes
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Answer: c Rationale: A duration of 25 minutes would be appropriate when attempting to stretch soft tissue in a patient who has previously tolerated traction without difficulty. A duration of 20-30 minutes is most often recommended for stretching soft tissue or reducing muscle spasm. This amount of time allows for a prolonged stretch without compromising the integrity of other structures.
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A physical therapist positions a patient in prone on a treatment plinth in preparation for a hot pack. When preparing the hot pack for the low back, the therapist should use: a. 2-4 towel layers b. 4-6 towel layers c. 6-8 towel layers d. 8-10 towel layers
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Answer: c Rationale: Six to eight towel layers placed between a hot pack and the treatment surface is generally adequate to allow for the necessary transmission of heat without jeopardizing patient safety.
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A physical therapist treats a patient diagnosed with spinal stenosis. As part of the treatment program the patient lies prone on a treatment plinth with a hot pack draped over the low back. The MOST effective method to monitor the patient while using the hot pack is: a. check on the patient at least every 10 minutes b. supply the patient with a bell to ring if the hot pack becomes too hot c. instruct the patient to remove the hot pack if it becomes too hot d. select an alternate superficial heating modality
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Answer: b Rationale: Supplying the patient with a bell to ring if the hot pack becomes too intense provides a form of instant communication with the therapist. The use of a bell does not negate the need for the physical therapist to formally check on the patient frequently.
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A physical therapist uses intermittent compression to treat a patient with an acute ankle sprain. The patient is positioned in supine with the leg elevated on a 40 degree wedge. The therapist uses an inflation pressure of 50 mm Hg with an on:off time of 40 seconds on and 20 seconds off. The treatment time is scheduled for 20 minutes. After five minutes of treatment the patient reports some discomfort in the ankle. The MOST appropriate modification to the current treatment parameters would be: a. increase the inflation pressure b. increase the off time c. increase the total treatment time d. increase the elevation of the leg
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Answer: b Rationale: Increasing the off time greater than the current 20 second interval would provide the patient with a greater rest period and may therefore decrease the patient's discomfort.
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A patient diagnosed with lumbar spinal root impingement due to narrowing of the intervertebral foramen has been referred to physical therapy for mechanical traction. What is the lowest percentage of body weight that should be considered for the initial traction force when using a split table? a. 15% b. 25% c. 55% d. 85%
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B
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A Contraindication to initiating extremity joint mobilization on a patient with chronic pulmonary disease may include: a. Reflex muscle guarding b. Long-term corticosteroid therapy c. Concurrent inhalation therapy d. Functional chest wall immobility
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B
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Following a total knee replacement (TKR), continuous passive motion (CPM) is initiated. One of the main objectives in using CPM in this case is to facilitate: a. Active knee extension b. Active knee flexion c. Passive knee flexion d. Passive knee extension
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B
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A patient is being treated for secondary lymphedema of the right arm as a result of a radical mastectomy and radiation therapy. The resulting edema (stage 1) can best be managed in physical therapy by: a. Isokinetics, extremity positioning in elevation and massage b. AROM and extremity positioning in a functional arm/hand position c. Isometric exercises, extremity positioning in elevation and compression bandaging d. Intermittent pneumatic compression, extremity elevation and massage
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D
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A patient presents with multiple fractures of both hands and wrists as a result of a mountain bike accident. Now, 5 weeks later, the patient has vertigo, limited wrist and finger motion and dry , scaly skin over the involved areas. The physical agent of Greatest Benefit to select in this case would be: a. Paraffin b. Hot packs c. Functional electrical stimulation d. Contact ultrasound
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A
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A patient sprained the left ankle 4 days ago. The patient complains of pain (4/10), and there is moderate swelling that is getting worse. At this time, which intervention would be Best to use? a. Intermittent compression followed by elevation. b. Contrast baths followed by limb elevation c. Cold whirlpool followed by massage. d. Cold/intermittent compression combination with the limb elevated.
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D
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1. A patient presents with pain radiating down the posterior hip and thigh as a result of a herniated disc in the lumbar spine. The therapist decides to apply mechanical traction. If the patient can tolerate it, the preferred patient position is: a. Supine with one knee flexed b. Prone with pillow under the abdomen c. Supine with both knees flexed d. Prone with no pillow
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B
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12. A patient presents with multiple fractures of both hands and wrists as a result of a mountain bike accident. Now, 5 weeks later, the patient has limited wrist and finger motion and dry, scaly skin over the involved areas. What is the physical agent that would provide the GREATEST benefit? (B-88) a. contact ultrasound b. hot packs c. paraffin d. functional electrical stimulation
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C
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. A physical therapist elects to use mechanical lumbar traction for a patient rehabilitating from a back injury. The therapeutic goals of the session include decreasing the patient's muscle spasm. The MOST appropriate force based on the stated objective would be: a. 10% of body weight b. 15% of body weight c. 25% of body weight d. 50% of body weight
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C
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A physical therapist is scheduled to administer a whirlpool treatment to a patient that is HIV positive. The therapist is concerned about her ability to complete the treatment since she sustained a small paper cut on her fourth digit approximately three hours ago. The MOST appropriate therapist action is: a. Refuse to treat the patient and document the rationale in the medical record b. Treat the patient using appropriate medical asepsis c. Ask the patient to reschedule their appointment d. Select another appropriate treatment procedure
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B
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9. A physical therapist employed by a home health agency visits a patient status post total knee arthropllasty. The patient was discharged from the hospital yesterday and according to the medical record had an unremarkable recovery. the physician orders include the use of a continuous passive motion machine. The MOST appropriate rate of motion would be: a. 2 cycles per minute b. 4 cycles per minute c. 6 cycles per minute d. 8 cycles per minute
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A
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11. A physical therapist prepares to apply a hot pack to the low back of a patient diagnosed with degenerative disk disease. when examining the patient the therapist identifies several blisters on the patient's right side. the patient indicates they were caused by heat from a hot pack applied during the previous treatment session. The patient indicates he was hesitant to tell the therapist that the heat was too intense. The MOST appropriate therapist action is to: a. complete an incident report b. contact the referring physician c. modify the documentation from the previous treatment session d. avoid documenting the event since it occurred during the previous treatment session.
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A
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2. A patient rehabilitating from a lower extremity injury is referred to physical therapy for hydrotherapy treatments. the physical therapist would like the patient to fully extend the involved lower extremity while sitting in the hydrotherapy tank. Which type of whirlpool would NOT allow the patient to extend the involved lower extremity? a. hubbard tank b. highboy tank c. lowboy tank d. walk tank
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B
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3. A physical therapist prepares a whirlpool treatment for a scheduled patient. which treatment area would place the patient at the GREATEST risk for hypothermia? a. wrist and hand b. thigh c. elbow d. foot and ankle
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B
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4. A physical therapist checks the water temperature of the hot pack machine after several patient report the heat being very strong. Which of the following temperatures would be acceptable? a. 64 degrees celsius (147 degrees F) b. 71 degrees C (160 degrees F) c. 83 degrees C (181 degree F) d. 94 degrees C (201 degrees F)
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B
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6. A physical therapist treats a patient rehabilitating from an achilles tendon repair using cryotherapy. Which cryotherapeutic agent would provide the GREATEST magnitude of tissue cooling? a. frozen gel packs b. ice massage c. flouri-methane spray d. cold water bath
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B
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8. A physical therapist positions a patient in prone on a treatment plinth in preparation for a hot pack. When preparing the hot pack for the low back, the therapist should ultilize: a. 2-4 towel layers b. 4-6 towel layers c. 6-8 towel layers d. 8-10 towel layers
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C
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11. A physical therapist treats a patient who sustained a right lateral ankle sprain less than six hours ago. The therapist contemplates the use of cold water immersion as a crytherapeutic agent. what would be the primary limitation of this type of intervention? a. decreased cell metabolism b. excessive vasoconstriction of blood vessels c. the involved extremity cannot be elevated d. decreased nerve conduction velocity
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C
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12. A physical therapist observes a patient's skin shortly after applying moist heat to the low back. The therapist identifies several signs of heat intolerance including uneven blotching and a surface rash. The MOST appropriate action is to: a. continue with the present treatment b. select an alternate superficial heating agent c. limit moist heat exposure to five minutes d. discontinue the moist heat and document the findings
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D
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13. A physician orders compression garments for an ambulatory patient who has significant difficulty with lower extremity edema. How much pressure would typically be necessary to control lower extremity edema? a. 10 mmHg b. 18 mmHg c. 25 mmHg d. 35 mmHg
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D
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18. A physical therapist sets up a patient for mechanical traction to the lumbar spine. The therapist's objective is to provide soft tissue stretch to surrounding muscles. Assuming the therapist uses a force equivalent to 25% of the patient's body weight and the patient has tolerated treatment without difficulty on several other occasions, the MOST appropriate duration of treatment is: a. 5 minutes b. 10 minutes c. 25 minutes d. 40 minutes
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C
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20. A physical therapist preparing a hot pack notices the water in the hot pack unit is cloudy. The MOST probably explanation is: a. power failure b. seepage from a hot pack c. ineffective heating element d. thermostat set too low
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B
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A patient status post knee surgery receives instructions on the use of a continuous passive motion machine. Which of the following would be the MOST essential to ensure patient safety? a. instructions on progression of range of motion b. utilization of proximal and distal stabilization straps c. recommendations for cryotherapy following treatment sessions d. orientation to remote on/off switch
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D
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24. A patient status post motor vehicle accident is referred to physical therapy. the patient has multiple injury sites including the hand, wrist, elbow, and knee. As part of the patient care plan, the physical therapist attempts to increase tissue temperature at each of the invloved sites. The MOST appropriate thermal agent is: a. diathermy b. ultrasound c. hydrotherapy d. hot packs
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C
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2. A physical therapist reviews a patient coverage form that lists the parameters used during a recent ultrasound treatment to the right anterior shoulder: 1.5 W/cm^2, pulsed 20%, 1 MHz, 6 minutes. Assuming the objective of the ultrasound was to increase tissue temperature, which parameter would be the most critical for the therapist to alter? a. time b. duty cycle c. frequency d. intensity
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B
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4. A physical therapist tests a small area of skin for hypersensitivity prior to using a cold immersion bath. The patient begins to demonstrate evidence of cold intolerance within 60 seconds after cold application. The MOST appropriate response is to: a. limit cold exposure to ten minutes or less b. select an alternate cryotherapeutic agent c. continue with the cold immersion bath d. discontinue cold application and document the findings
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D
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5. A physical therapist uses intermittent compression to treat a patient with an acute ankle sprain. The patient is positioned in supine with the leg elevated on a 40 degree wedge. The therapist uses an inflation pressure of 50 mmHg with an on:off time of 40 seconds on and 20 seconds off. The treatment time is scheduled for 20 minutes. After five minutes of treatment the patient reports some discomfort in the ankle. The MOST appropriate modification to the current treatment parameters would be: a. increase the inflation pressure b. increase the off time c. increase the total treatment time d. increase the elevation of the leg
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B
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6. A physical therapist reviews a patient's medical history prior to administering intermittent compression. Which of the following conditions would be considered a contraindication to the use of this mechanical device? a. venous stasis ulcer b. acute pulmonary edema c. intermittent claudication d. lymphedema
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B
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11. A physical therapist treats a patient diagnosed with spinal stenosis. As part of the treatment program the patient lies prone on a treatment plinth with a hot pack draped over the low back. The MOST effective method to monitor the patient while using the hot pack is: a. check on the patient at least every ten minutes b. supply the patient with a bell to ring if the hot pack becomes too hot. c. instruct the patient to remove the hot pack if it becomes too hot d. select an alternate superficial heating modality
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B
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14. A physical therapist works with a patient using a flotation device positioned vertically in the deep end of a pool. Which area of the patient's body would experience the GREATEST amount of hydrostatic pressure? a. shoulders b. torso c. hips d. feet
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D
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15. A physical therapist elects to begin a trial of mechanical lumbar traction on a 165 lb male diagnosed with suspected nerve root impingement. The MOST appropriate amount of force to initiate the session is: a. 15 lbs. b. 30 lbs. c. 60 lbs d. 80 lbs
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B
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16. A patient elevated on a tilt table to 60 degrees suddenly begins to demonstrate signs and symptoms of orthostatic hypotension. The MOST appropriate physical therapist action is to: a. lower the tilt table 10 degrees and monitor the patient's vital signs b. lower the tilt table 20 degrees and monitor the patient's vitals signs c. lower the tilt table 40 degrees and monitor the patient's vital signs d. lower the tilt table completely and monitor the patient's vital signs
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D
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17. A physical therapist obtains a complete medical history prior to administering cryotherapy. Which condition would NOT be considered a contraindication to cryotherapy? a. raynaud's disease b. cryoglobulinemia c. cancer d. cold urticaria
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C
