question

All of the following tests would be applicable for initial research on foundational concepts, EXCEPT: A. Cohort studies B. Single case design C. Phase II clinical trail D. Meta-analysis E. Case Reports F. Descriptive studies

answer

Meta-analysis

question

What is the current percentage of physical therapy practice serving the geriatric population? A. 30% B. 15% C. 50% D. 20% E. 40%

answer

40%

question

When age-matched norms are studied, which category of research is being investigated? A. Case study B. Cohort C. Randomized-controlled Trials D. Control studies E. Expert opinion

answer

Randomized-controlled Trials

question

An expert clinical would be considered one who engages in the following practices, EXCEPT: A. Use the paternalistic model of patient care B. Reviews applicable available evidence relevant to the patient case C. Engages in clinical reasoning D. Offers options of care E. Utilizes prior knowledge of similar patient cases F. Does not hold the patient accountable for lack of results

answer

Use the paternalistic model of patient care

question

All of the following include BADLs, EXCEPT: A. Driving B. Toileting C. Bathing D. Feeding E. Walking

answer

Driving

question

Elements of evidence informed practice includes the following, EXCEPT: A. Clinical judgment B. Expert opinion C. Patient preferences D. Best available evidence E. Clinical reasoning

answer

Expert opinion

question

Indicate the order of the Pyramid of Scientific Evidence: A. foundational theories>clinical practice guideline, systematic review and meta-analysis> initial testing of foundational concepts>definitive testing of clinical applicability B. foundational theories> initial testing of foundational concepts>definitive testing of clinical applicability> clinical practice guideline, systematic review and meta-analysis C. foundational theories> initial testing of foundational concepts >clinical practice guideline, systematic review and meta-analysis>definitive testing of clinical applicability D. initial testing of foundational concepts >foundational theories>definitive testing of clinical applicability> clinical practice guideline, systematic

answer

foundational theories> initial testing of foundational concepts>definitive testing of clinical applicability> clinical practice guideline, systematic review and meta-analysis

question

Indicate the singular most impactful health condition on activity limitation in older adults: A. Diabetes B. Osteoporosis/Fractures C. Arthritis D. Mental illness E. Vision/Hearing loss

answer

Arthritis

question

The population older than 65 is expected to makeup what percentage of the population by 2030? A. 1/4 B. 1/5 C. 1/3 D. 1/6 E. 1/2

answer

1/5

question

All of these are Basic Activities of Daily Living, EXCEPT: A. bathing B. driving C. dressing D. transfers E. grooming F. eating

answer

driving

question

Instrumental Activities of Daily Living include all, BUT: A. driving B. cooking C. grooming D. shopping E. housework

answer

grooming

question

Percentage of older adults with one chronic health condition: two or more chronic health conditions, is: A. 60%:30% B. 80%:40% C. 90%:40% D. 70%:50% E. 80%:50%

answer

80%:50%

question

Percent of those older that 85 years, who are physical dependent on others: A. 80% B. 60% C. 70% D. 90% E. 50%

answer

50%

question

Percentage of those older than 80 with sarcopenia: A. 20% B. 50% C. 75% D. 80%

answer

50%

question

All are modifiable risk factors for bone loss EXCEPT: A. Small frame B. Inadequate protein intake C. Calcium intake D. Inactivity E. Smoking F. Race: Asian

answer

Small frame

question

All are age related changes to cardiovascular system EXCEPT: A. Decline in maximal heart rate B. Change in resting heart rate C. Loss of SA node cells D. Slower ventricular filling time E. Thickening of basement membrane in capillaries

answer

Change in resting heart rate

question

The older heart is typically able to exercise safely at which levels of MaxHR zones? A. 40-50% of HRMax B. 50%-60% of HRMax C. 80-90% of HRMax D. 60-70% of HRMax E. 70-80% of HRMax

answer

70-80% of HRMax

question

Hormone replacement therapy research in both genders of rats and humans has been shown to, EXCEPT: A. Increase lean muscle mass B. Increase bone mineral density C. Increase gait speed and jump height D. Increase force output

answer

Increase bone mineral density

question

Age-related changes in the CNS include, EXCEPT: A. decreased reaction time B. fewer axons C. loss of myelin D. decreased fine sensation E. fewer motor neurons F. fewer sensory neurons

answer

fewer motor neurons

question

Which is not a requirement for community mobility: A. Stoop B. Carry >10 pounds C. Turn D. reach E. Walking 1200 feet

answer

Carry >10 pounds

question

Current weekly CDC recommendations for physical activity include all, EXCEPT: A. >150 minutes of moderate activity B. Muscle strengthening at least 2 or more days of the week for major muscle groups C. Stretching and balance on 2 or more days of the week

answer

Stretching and balance on 2 or more days of the week

question

Overload of muscle should initially occur at which level for older adults to achieve a strength gain? A. 80% of 1 RM B. 70% of 1 RM C. 60% of 1 RM D. 50% of 1 RM E. 40% of 1 RM

answer

60% of 1 RM

question

Strength training should progress to which level of intensity for untrained individuals? A. 80% of 1 RM or 12-13 RPE B. 60% of 1 RM or 12-13 RPE C. 80% of 1 RM or 15-16 RPE D. 60% of 1 RM or 15-16 RPE

answer

80% of 1 RM or 15-16 RPE

question

Untrained individuals should initially perform how many sets of strengthening exercises: a. 1 b. 2 c. 3 d. 4

answer

1

question

Current ACSM recommends this frequency of the various types of exercise for older adults: A. Aerobic conditioning 2-4x per week, strengthening 2-3x/week, stretching 4-6x/week B. Aerobic conditioning 2-4x per week, strengthening 2-3x/week, stretching 4-6x/week C. Aerobic conditioning 3-5x per week, strengthening 2-3x/week, stretching 4-6x/week D. Aerobic conditioning 3-5x per week, strengthening 2-3x/week, stretching 5-7x/week

answer

Aerobic conditioning 3-5x per week, strengthening 2-3x/week, stretching 5-7x/week

question

Individuals with CHF in the inpatient setting should perform inspiratory muscle strength and endurance training up to 20-30 minutes daily at: A. 25-35% of maximum inspiratory pressure B. 35-45% of maximum inspiratory pressure C. 45-55% of maximum inspiratory pressure D. 55-65% of maximum inspiratory pressure

answer

25-35% of maximum inspiratory pressure

question

Individuals with CHF in the inpatient setting should initially perform inspiratory muscle strengthening of 3-5 minutes daily at: A. 30-40% of peak oxygen consumption B. 40-50% of peak oxygen consumption C. 50-60% of peak oxygen consumption D. 60-70% of peak oxygen consumption

answer

40-50% of peak oxygen consumption

question

Recommended strength progressions for # of repetitions is: A. 8-10 to 12-15 B. 12-15 to 8-10 C. 6-8 to 10-12 D. 10-12 to 6-8

answer

12-15 to 8-10

question

Frequency of optimal and maintenance strengthening exercise should occur, respectively: A. 1-2, 2-3 B. 2-3, 1-2 C. 1-2, 1-2 D. 3-4, 1-2

answer

2-3, 1-2

question

Borg Progression of exercise for untrained individuals should be: A. 11-13 to 13-15 B. 12-15 to 16-18 C. 12-13 to 15-16 D. 13-14 to 16-17

answer

12-13 to 15-16

question

Rate of falls in community dwelling older adults, >65 consists of: A. 20-40% B. 30-50% C. 40-60% D. 50-70%

answer

30-50%

question

13. The predictors of falls within 6 months of hip fracture are: A. prior history of falls and use of AD B. high pain levels and delayed discharge home C. history of blood clots and prior history of falls D. hypertension and use of AD

answer

prior history of falls and use of AD

question

Each pound of excess body weight lost is attributed to how much decreased stress on the knee joint? A. 2-fold difference B. 3-fold difference C. 4-fold difference D. 5-fold difference

answer

4-fold difference

question

Frailty is defined as, EXCEPT: A. Self-reported exhaustion B. Weak grip C. 20% or slower age matched walking speed D. Decreased lean muscle mass E. Unintended weight loss of >10 pounds F. Low physical activity

answer

Decreased lean muscle mass

question

Exercise should NOT be performed with diabetic patients when blood glucose levels exceed: A. 100-150 mg/dL B. 150-200 mg/dL C. 200-250 mg/dL D. 250-300 mg/dL

answer

250-300 mg/dL

question

Aquatic Exercise is contraindicated EXCEPT: 1. Incontinent 2. Hypertension 3. Open wound 4. Allergy to chlorine

answer

Hypertension

question

Additional benefits of aquatic therapy include EXCEPT: A. Reduced compressive joint forces B. Improved support for upright posture for those with weakness or fearful of falling C. Heart rate reduction D. Carryover to land based function

answer

Carryover to land based function

question

All include relevant information to obtain in the health risk assessment of the older driver EXCEPT: A. Use of special equipment B. Limitations of IADLs C. Number of prior accidents D. Use of multiple medications

answer

Number of prior acccidents

question

Absolute Medical Red flags for driving are, EXCEPT: A. Use of antimetics, muscle relaxers and anti-parkinsonian medications B. Family concern over a driver's abilities C. TBI, TIA or surgery D. Dementia

answer

Dementia

question

Assessment of Driving -related Skills (ADReS) screens the following: A. Motor function, cognition, vision B. Memory, visual acuity, muscle strength C. Visual memory, cognition, strength D. Cervical ROM, balance and peripheral vision

answer

Motor function, cognition, vision

question

Compared to all drivers, older drivers experience: A. Higher fatality per mile driven B. Higher crash rate per mile driven C. Higher injury rate per hour driven D. Lower fatality rate than teen drivers E. Reduce risk of crashes with self-limiting behavior to daytime hours

answer

Higher crash rate per mile driven

question

Motor function tests recommended by ADReS are: A. Rapid-pace walk, AROM, manual muscle testing B. AROM, TUG and Berg Balance Test C. Manual muscle testing, cervical ROM, proprioception D. AROM, manual muscle testing, Tinetti screen E. Visual acuity, Cervical ROM, manual muscle testing

answer

Visual acuity, Cervical ROM, manual muscle testing

question

Patients with dementia should: A. Drive only during the day B. Never drive C. Complete advanced screens D. Have a navigator for directions E. Routinely be assessed for driving abilities

answer

Routinely be assessed for driving abilities

question

Cognitive tests recommended by ADReS are: A. Trail-making test and the Mini-Mental State Exam B. Memory recall and Clock-Drawing Test C. Clock-Drawing Test and Trail-making Test D. Mini-Mental State Exam and reaction time

answer

Clock-Drawing Test and Trail-making Test

question

Sarcopenia, or loss of lean muscle mass begins in earnest in the: A. Second decade B. Third decade C. Fourth decade D. Fifth decade

answer

Fifth decade

question

On average, after the age 20, loss of fat free muscle mass leads to which amount of slowing in resting metabolic rate? A. 1-2% per year B. 1-2% per decade C. 2-3% per year D. 2-3% per decade

answer

2-3% per decade

question

Single most predictive measure for predicting heart disease in overweight and obese individuals is: A. Activity level B. Waist-to-hip ratio C. BMI D. % body fat

answer

Waist-to-hip ratio

question

BMI considered over which value is considered overweight? A. >18.5 kg/m2 B. >25 kg/m2 C. >30 kg/m2 D. >35 kg/m2

answer

>25 kg/m2

question

Gastric bypass surgery leads to weight loss through which mechanism? A. Decreases volume of food that can be consumed at one time B. Blocks neuronal reuptake of chemical mediators to decrease cravings C. Blocks absorption of fat in diet D. Decreases amount of food intake and absorption in the intestines

answer

Decreases amount of food intake and absorption in the intestines

question

The majority of falls in older adults occur: A. In the nursing home at night. B. In the community at night. C. In the hospital at night. D. In the home during the daytime.

answer

In the home during the daytime.

question

Recommended shoewear for individuals at fall risk with Parkinson's disease are: A. Closed toed shoes with leather soles. B. Slippers. C. Shoes with rubber soles. D. Shoes with one inch heel lift.

answer

Closed toed shoes with leather soles.

question

Drugs most associated with increased fall risk include, EXCEPT: A. Benzodiazepines B. Beta-blockers C. Statins D. Diuretics

answer

Statins

question

Ramps should have slopes that do not exceed in a 30 inch rise: A. 1:10 to 1:12 B. 1:12 to 1:14 C. 1:14 to 1:16 D. 1:12 to 1:16

answer

1:12 to 1:16

question

When treating patients with COPD which can interfere most with exercise progression? A. muscle fatigue B. oxygen desaturation C. blunting of blood pressure response D. use of accessory ventilatory muscles

answer

blunting of blood pressure response

question

Which is a good predictor of exercise tolerance in patients with COPD? A. inability to achieve ventilatory threshold B. intolerance of elevated lactate levels C. leg muscle mass or cross sectional area D. lung function measures like FEV1

answer

leg muscle mass or cross sectional area

question

Which is primary factor in limitation to exercise tolerance on those with COPD? A. carbon dioxide build-up B. fatigue of locomotor muscles C. lactic acidosis

answer

fatigue of locomotor muscles

question

Which metabolic factor contributes most to destruction of connective tissue in lungs with COPD? A. lysis of structural proteins B. inflammatory cells C. release of immune mediators such as interleukin-8 and leukotriene B4 D. ongoing neutrophil infiltration

answer

lysis of structural proteins

question

Which most limits passive exhalation during ventilation in patients with COPD? A. airway remodeling B. loss of elastic recoil C. mucosal inflammation D. secretions

answer

loss of elastic recoil

question

Which contributes to lung hyperinflation during exercise? A. recurrent, persistent cough B. accessory muscle contraction C. reduction in inspiratory flow D. decreased time for expiration

answer

decreased time for expiration

question

All of the following are regulatory bodies involving, creating and inforcing restraint regulations EXCEPT: A. CMS B. FDA C. JAHCO D. National Rehabilitation Accreditation Committee

answer

D. National Rehabilitation Accreditation Committee

question

Which is not a primary member of retraint-reduction team? A. administrator B. occupation therapist C. psychologist d. social services

answer

C. psychologist

question

Which of the following is an appropriate use of chemical restraint? A. chemical restraints are never appropriate B. the restraint effect of the medication side effect of the medication used to treat symptoms of a behavioral disorder and is addressed in the care plan C. to prevent an agitated patient from hitting himself or another person when a nurse's aide went home sick D. to temporarily control the wandering of a new admission to a skilled nursing facility until a physician examines the patient

answer

B. the restraint effect of the medication side effect of the medication used to treat symptoms of a behavioral disorder and is addressed in the care plan

question

Which is a secondary negative psychological consequence of physical restraint use? A. falls B. fear C. functional decline D. respiratory depression

answer

B. fear

question

Include physical effects of restraint use EXCEPT: A. orthostatic hypotension B. respiratory depression C. ataxia D. agitation

answer

D. learned helplessness

question

Psychological effects of restraint use EXCEPT: A. falls B. learned helplessness C. fear D. delirium

answer

A. falls

question

Intrinsic fall factors EXCEPT: A. cardiac arrhythmias B. osteoporosis C. reaction to medication D. Muscle weakness

answer

C. reaction to medication

question

Extrinsic fall factors EXCEPT: A. wheelchair breaks not locked B. decreased ROM in LE C. improper footwear D. impediments to movement: siderails or restraints

answer

B. decreased ROM in LE

question

Normal range for blood glucose levels: A. 170-200 mg/dl B. 150-170 mg/dl C. 120-150 mg/dl D. 80-120 mg/dl

answer

D. 80-120 mg/dl

question

A good prosthetic candidate is a patient who can stand pivot transfer, wheelchair push-up and: A. hop a few steps in the parallel bars B. prone lie 2 minutes C. push wheelchair 5 ft D. stand in parallel bars

answer

A. hop a few steps in the parallel bars

question

Optimal method to control edema post amputation is: A. ace wrapping B. compression hose C. post-operative casting D. shrinkers

answer

C. post-operative casting

question

The most important preliminary exercise post amputation patient needs to master to prevent gait deviation is: A. equal stance on bilateral extremities B. acceptance of full weight shift onto prosthetic side C. knee control D. balance without assistance in parallel bars

answer

B. acceptance of full weight shift onto prosthetic side

question

Drug class that stimulates insulin production by pancreas is: A. Thiazolidinediones B. Biguanides C. D-phenylalanine derivatives D. Sulfonylureas

answer

D. Sulfonylureas (end in -ide, Orinase and Tol-Tab)

question

Alpha-glucosidase inhibitors: A. slow digestion of carbohydrates (acarbose, miglitol) B. increase cell sensitivity to insulin C. blocks breakdown of GLP-1 and reduces blood glucose D. increase pancreatic secretion of insulin

answer

A. slow digestion of carbohydrates (acarbose, miglitol)

question

Thiazolidinediones: A. slow digestion of carbohydrates (acarbose, miglitol) B. increase cell sensitivity to insulin C. blocks breakdown of GLP-1 and reduces blood glucose D. increase pancreatic secretion of insulin

answer

B. increase cell sensitivity to insulin

question

Meglitinides and D-phenylalanine derivatives: A. slow digestion of carbohydrates (acarbose, miglitol) B. increase cell sensitivity to insulin C. blocks breakdown of GLP-1 and reduces blood glucose D. increase pancreatic secretion of insulin

answer

D. increase pancreatic secretion of insulin

question

A new diabetes med that quickly reduces glucose in the bloodstream but has side effect of diarrhea: A. Januvia (DPP-4 Inhibitor which prevents hypoglycemia) B. Metformin (decreases liver production of glucose) C. Pioglitazone D. Nateglinide

answer

A. Januvia (DPP-4 Inhibitor which prevents hypoglycemia)

question

Exercise is contraindicated if, EXCEPT: A. Fasting glucose >250 mg/dl with ketosis, caution if >300 mg/dl without ketosis B. white blood cells <3,000mm3 C. Platelets <50,000/mm3 D. Hemoglobin <10mg/dl

answer

D. Hemoglobin <10mg/dl, it is <10g/dl

question

Lower extremity lymphedema causes include, EXCEPT: A. CHF B. high serum albumin C. renal failure D. venous insufficiency

answer

B. high serum albumin, it is actually when low

question

Arterial wounds are characterized by: A. often mistaken for cellulitis B. hemosiderin staining C. LE has pallor on elevation, rubor on dependency (intermittent claudication) D. weepy wound in lower leg

answer

C. LE has pallor on elevation, rubor on dependency (intermittent claudication)

question

Patients who are undergoing chemo or radiation therapy require caution, EXCEPT with: A. manual therapy B. treadmill walking C. stretching exercises D. thermal modalities when labs low

answer

B. treadmill walking

question

Aerobic endurance in older adults can be assessed accurately by: A. maximal exercise testing B. 6 Minute Walk Test C. Long-distance Corridor Walk D. All of the above

answer

D. All of the above

question

Most common residual impairment following TKA with or without any therapy is: A. hamstring weakness B. Knee flexion contracture C. Quads weakness D. Loss of knee flexion ROM

answer

C. Quads weakness

question

Category of diabetic oral medication that can help glucose control and promote weight loss is: A. biguanides B. sulfonylureas C. thiazolidinediones D. meglitidines and D-phelylananine derivatives

answer

A. biguanides

question

68-year old patient has knee OA. History includes progressive medial knee pain, no trauma, extreme tenderness, carefully assess for: A. osteomyelitis B. osteonecrosis C. osteoporosis D. osteosarcoma

answer

B. osteonecrosis

question

Older adults who wish to lose weight can: A. Get better results at higher intensities B. Get better results at lower intensities C. Intensity does not matter D. Only achieve weight loss at higher intensities

answer

A. Get better results at higher intensities

question

Older adults who perform high intensity strengthening may: A. Achieve greater strength gains than at low or moderate intensities B. Achieve similar results exercising 1 versus 2 times per week. C. Both A and B D. None of the above

answer

C. Both A and B

question

Which is a physiological change associated with aging? A. decreased pH B. slowed cognition C. rapid intestinal transit D. increase lean body water content

answer

B. slowed cognition

question

Which results when blood albumin levels drop? A. decreased GI absorption of medications B. increased renal clearance C. induction of CYP450 enzyme system D. higher free-drug concentrations and risk of toxicity

answer

D. higher free-drug concentrations and risk of toxicity

question

Which is true of renal function? A. creatinine is a good measure of renal clearance in older adults B. kidney blood flow decreases C. medication clearance increases due to greater number of nephrons D. medications often require a decreased dose or increase in dosing interval

answer

D. medications often require a decreased dose or increase in dosing interval

question

Which is mostly to cause anterograde amnesia and delirium? A. anticoagulants B. antihypertensives C. benzodiazapines D. SSRI's

answer

C. benzodiazapines

question

Which is a pharmacodynamic drug interaction? A. One drug causes increased blood glucose and another treats diabetes mellitus B. One is a substrate for CYP2D6 while another is it's inhibitor C. One drug is highly protein bound to albumin in the blood and another displaces first drug off the binding site D. 2 drugs compete for excretion in the renal tubule

answer

A. One drug causes increased blood glucose and another treats diabetes mellitus

question

Which may affect patient ability to exercise due to orthostatic hypertension? A. antihistamines B. antihypertensives C. antipsychotics D. all of the above

answer

D. all of the above

question

Which causes variations in a drug's volume of distribution? A. decreased blood flow to GI tract B. decreased lean body mass C.decreased renal mass D. induction of hepatic enzymes

answer

B. decreased lean body mass

question

Which is considered a drug-disease interaction? A. use of acetaminophen in a patient with renal impairment B. use of antidepressants in a patient who has depression C. use of diuretic in patient with benign prostatic hypertrophy D. use of opioids who is constipated

answer

D. use of opioids who is constipated

question

A spiritual assessment is required by: A. Medicare B. JCAHO C. state law D. Hospice

answer

B. JCAHO

question

The foundational ethical principles are: A. autonomy, beneficence, nonmalificence B. autonomy, paternalism, confidentiality C. autonomy, paternalism, confidentiality, veracity D. autonomy, beneficence, nonmalificence, justice

answer

D. autonomy, beneficence, nonmalificence, justice

question

The directive to advocate for patient rights is in: A. code of ethics B. patient bill of rights C. state practice act D. Guide to PT Practice

answer

A. code of ethics

question

Under the perview of the Veterans Affairs: A. National Home for Disabled Veterans B. Veteran's Adminstration C. Veteran's Bureau D. Veteran's Health Administration

answer

D. Veteran's Health Administration

question

The 2 year process for defining scope of practice for licensed professionals is considered: A. boarding B. credentialing C. peer review D. privileging

answer

B. credentialing

question

Developing trends in the Dept. of Veterans Affairs that currently impact physical therapy is: A. health promotion B. joint DVA and DoD initiatives C. polytrauma systems of care D. qualification standard review

answer

A. health promotion

question

A memorandum is best understood as: A. alignment of resources to reduce cost while maintaining quality care B. collaboration between the DVA and DoD to enable seamless transition C. a shift between resource allocation between the DVA and DoD facilities D. a transition of care for returning Operation Iraqi Freedom and Operation Enduring Freedom service members

answer

B. collaboration between the DVA and DoD to enable seamless transition

question

Introducing overhead flexion and abduction exercises immediately after axillary disection could result in: A. adhesive capsulitis B. axillary cording C. seroma formation D. wound dehiscence

answer

C. seroma formation

question

Which is at highest risk of reoccurence of BC? A. ductal carcinoma in situ B. infiltrating ductal carcinoma (Grade II, Stage IIIA) C. infiltrating ductal carcinoma (4-cm tumor, 3 of 15 lymph nodes positive, grade II) D. infiltrating ductal carcinoma and ductal carcinoma in situ

answer

B. infiltrating ductal carcinoma (Grade II, Stage IIIA)

question

Doxorubicin (Adriamycin) is an antitumor antibiotic, in high doses results in: A. stomach ulcers B. peripheral neuropathy C. acute and chronic cardiac toxicity D. skin damage

answer

C. acute and chronic cardiac toxicity

question

Which drug is most likely to cause peripheral neuropathy? A. Taxol B. Adriamycin C. cyclophosphamide D. Herceptin

answer

A. Taxol

question

Long thoracic nerve palsy with resultant scapular weakness noted 3 weeks postop. Which is best intervention for first visit to ensure proper recruitment of scapular muscles? A. overhead wand and chin tuck exercises B. quadruped with scapular protraction/retraction C. rotator cuff strengthening with theraband for IR/ER D. scapular retraction with or without theraband using manual and visual cues

answer

D. scapular retraction with or without theraband using manual and visual cues

question

The Medicare Advantage plans include, EXCEPT: A. HMOs B. medical savings accounts C. regional point of service plans D. regional preferred provider organizations

answer

C. regional point of service plans

question

In order to be eligible for Medicare coverage, a recipient or spouse must have contributed into Medicare for: A. 10 years B. 30 quarters C. 30 years D. 500 consecutive months

answer

A. 10 years

question

Payment rates under Medicare part B are determined by, EXCEPT: A. conversion factor B. geographic practice cost indices C. Medicare economic index D. relative value units

answer

C. Medicare economic index

question

The third level of appeal after an initial determination of a Medicare claim is: A. administrative law judge B. department appeals board c. reconsideration d. fiscal intermediary

answer

A. administrative law judge

question

What could be normal energy cost of breathing of total VO2 in normal and those with severe pulmonary dysfunction at rest? A. 1-4%; 20% B. 1-4%; 40% C. 4-8%; 20% D. 4-8%; 40%

answer

B. 1-4%; 40%

question

The maximum volume of air the lungs contain after a max inspiration? A. Inspiratory Capacity (IC) B. Functional residual capacity (FRC) C. Total lung capacity (TLC) D. Vital capacity (VC)

answer

D. Vital capacity (VC)

question

Amount of air inspired or expired during normal breathing? A. Functional residual capacity (FRC) B. Tidal volume (VT) C. Total lung capacity (TLC) D. Vital capacity (VC)

answer

B. Tidal volume (VT)

question

All occur with normal aging EXCEPT: A. expiratory time is longer due to increased airway resistance B. greater recruitment of accessory muscles of respiration and lowered position and force-production of the diaphragm C. decrease sensitivity of chemoreceptors to hypoxemia and hypercapnia D. Increase in functional residual capacity and residual volume

answer

D. Increase in functional residual capacity and residual volume (actually decrease due to less effective and fewer elastic fibers which impairs elastic recoil during expiration)

question

Mediastinal shift toward the affected side would occur in all BUT: A. lobectomy B. pulmonary fibrosis C. pneumothorax D. atelectasis

answer

C. pneumothorax

question

Causes of both Hypercapnia (increased PaCO2) and Hypoxemia (decreased PaO2) are, EXCEPT: A. diffusion defect B. alveolar hypoventilation C. ventilation-perfusion mismatch D. pulmonary arteriovenous malformations

answer

A. diffusion defect (only with Hypercapnia)

question

Increased resonance to percussion occurs in cases of EXCEPT: A. Acute asthma B. pneumothorax C. consolidation, atelectasis, fibrosis D. bronchitis, emphysema

answer

C. consolidation, atelectasis, fibrosis

question

Absolute indications for terminating aerobic exercise include EXCEPT: A. Increase ST elevation without a diagnostic Q wave B. sustained ventricular tachycardia C. drop in systolic >10mmHg with other evidence of ischemia D. > 2mm depression

answer

D. > 2mm depression (this is a relative indication)

question

Relative aerobic exercise contraindications include, EXCEPT: A. Resting BP>200/110 B. acute systemic infection C. electrolyte abnormalities D. uncontrolled metabolic disease

answer

B. acute systemic infection (this is absolute contraindication)

question

What percentage of adults over 50 with transtibial amputations are community ambulators? A.5%. B.25% C. 50% C.80%

answer

B.25%

question

Drugs with anticholinergic effects may be used in the treatment of PD because... A. Increase in acetylcholine levels in the brain is needed. B. Loss of dopamine creates an imbalance in the neurotransmitters, including an increase in acetylcholine influence, and the drugs DECREASE acetylcholine to help restore the balance. C. Alternatives to use of sinemet may be needed due to diminished response later in the disease process. D. A and C E. B and C

answer

E. B and C. The goal is to decrease the influence of acetylcholine, which is an imbalance created by lack of dopamine, and contributes to sx of rigidity, bradykinesia, resting tremors, and postural instability.

question

Anticholinergic effects ... A. Include CNS sx of confusion, nervousness, dizziness, drowsiness. B. Can be caused by some antihistamines, antidepressants, PD meds, and antipsychotics. C. Include PNS sx of dry mouth, urinary retention, tachycardia, blurred vision, constipation. D. Are due to decreased acetylcholine levels which affects both the CNS and many organs...heart, lungs, GI tract E. All of the above F. A and C only

answer

E. All of the above are true.

question

Factors that contribute to continued assymetrical movement 6 months after TKA typically include all but... A. Pain in the operative knee. B. Persistent muscle weakness. C. Learned motor patterns developed in the presence of pain and weakness BEFORE surgery. D. Persistent uneven WB with functional activities.

answer

A. Pain in the operative knee.

question

Hospitals do not receive a higher reimbursement rate (are paid as if the condition does not exist, treatment is not covered) for some hospital acquired conditions. Which of the following do not apply in the case of a TKA or THA? A. Air embolism B. Fall with additional trauma C. Surgical site infection D. DVT E. Pressure ulcer

answer

C... Surgical site infection only applies for spine, neck, shoulder, and elbow surgeries

question

Which statement is false concerning patients with Dementia with Lewy Bodies (DLB)... A. Can be differentiated from Parkinson's Disease with Dementia (PDD) as motor sx and dementia sx usually start together with DLB, instead of the dementia coming on later as with PDD. B. May be treated with cholinesterase inhibitors, such as rivastigmine. C. Sx usually include hallucinations and delirium. D. Respond well to sinemet.

answer

D. Usually do not respond as well to sinemet

question

Arterial wound characteristics A. Punched out and clearly defined margins B. LE's mainly and can be deep C. Pale-dry, generally painful and decreased hair loss D. Faint or absent pulses and rubor of dependence and cool and pale skin E. All of the above

answer

E. All of the above

question

Good venous ulcer management include A. Control Excudate B. Provide Compression C. Elevation when pt not moving D. Exercise E. All of the above

answer

E. All of the above

question

All of the below include risk factors for chronic venous insufficency except A. Family History B. History of chf, prior DVT, recent edematous episode C. DM and severe trauma to LE D. over-rigorous exercise and # of pregnancies E. weight loss

answer

E. weight loss. Weight gain is a risk factor because of venous pressure from adipose tissue

question

When do we tissue biopsy? A. If history includes Chronic renal failure and dialysis B. Diabetes and Automimmune disease C. History of previous skin cancers and family history of cutaneous cancer D. chronic wound of long duration E. Foreign body and S&S of infection and if wound has changed in appearance, color and drainage F. All of the above

answer

F. All of the above

question

We should suspect Marjolin's ulcer if there is a history of A. Syphilis and Lupus vulgaris B. Immunosuppression from HPV C. Epidermolyis bullosa scar D. Granuloma inqinale E. Small pox vaccination site F. puncture wound, Cat> dog bites and snake bites G. All of the above

answer

G. All of the above

question

Typical venous ulcer bed A. medial malleolus or gator region B. Irreguar and not that painful C. Wet and good granulation D. Staining E. All of the above

answer

E. All of the above

question

All are true regarding Marjolin's ulcer( malignant degeneration chronic wound or scar) except: A. Usually 25-60 years after initial injury B.Patients approx 30 years old C. Usually SCC D. Male to female-3:1 E. Usually pressure ulcer or burn and usually need repeated biopsies

answer

B.Patients approx 30 years old (usually 70)

question

Which is true regarding the ABI A. It is the systolic blood pressure of the leg divided by the systolic blood pressure of the arm B. It is the systolic blood pressure of the arm divided by the systolic blood pressure of the leg. C. It is the brachial artery of the arm and the dorsalis pedis or posterior tibial artery of the leg D. A and C

answer

D. A and C

question

What values of the ABI indicate Ischemic rest pain A. 0.3-0.5 B. 0.9-1.0 C. < 0.3

answer

A. 0.3-0.5- ischemic rest pain and below 0.5 can indicate ischemia with gangrene. 0.5-0.9 =claudication usually present. 0.9-1.0=minimal involvement-asymptomatic

question

During exertion, maximal cardiac output (CO) in healthy, sedentary:healthy elite athlete is: A. 10-15 L/min:20-25 L/min B. 10-15 L/min:25-30 L/min C. 15-20 L/min:30-35 L/min D. 15-20 L/min:35-40 L/min

answer

D. 15-20 L/min:35-40 L/min

question

All are functions of the cardiovascular system EXCEPT: A. maintain acid-base balance B. regulate body temperature C. participate in gas exchange D. deliver hormones, nutrients and water E. removal of metabolites

answer

C. participate in gas exchange (pulmonary system)

question

Positive inotropic (increasing heart contractility) factors include EXCEPT: A. Digitalis and Angiotensin C. Serotonin and Glucagon D. Beta-blockers, Barbiturates and calcium antagonists E. Corticosteroids and catecholamines

answer

D. Beta-blockers, Barbiturates and calcium antagonists

question

These heart sounds in older adults are considered normal EXCEPT: A. S1 B. S2 C. S3 D. S4

answer

C. S3, early rapid filling of ventricles or "ventricular gallop" usually associated with heart failure when heard in adults >40

question

Cardiac causes of dizziness include EXCEPT: A. Cor Pulmonale B. arrhythmias C. Left ventricle dysfunction D. blood pooling in the lower extremities

answer

A. Cor Pulmonale (Right sided heart failure due to pulmonary hypertension)

question

All of these would influence preload (end-diastolic volume at the end of ventricular filling) EXCEPT: A. venous return B. ventricular compliance C. aortic compliance D. total blood volume/hydration

answer

C. aortic compliance (this would influence afterload), decreased aortic compliance, increased afterload (pressure at the end of systole)

question

Which statement is not true about ACE inhibitors? A. Usually end in "pril" B. Prevent vasoconstriction, parasympathetic hormone activation, and aldosterone release. C. A side effect may be orthostatic hypotension. D. When combined with HTC diuretics, reduce fluid overload by increasing urinary output.

answer

B. Prevent vasoconstriction, parasympathetic hormone activation, and aldosterone release. Decrease SYMPATHETIC, not parasympathetic hormone activation

question

Which statement is not true about ACE II receptor antagonists... A. Usually end in "tan" B. Prevent vasoconstriction, sympathetic hormone response, and aldosterone release. C. Orthotic hypotension is usually not a side effect. D. Cozar (losatan) is an example. E. Can be combined with HCT diuretics.

answer

C. Orthotic hypotension IS a common side effect.

question

Which statement is not true about beta blockers? A. Usually end in "lol". B. Exercise intensity for someone on BB should be monitored by the BORG scale and also HR assessment to insure HR does not rise > 30 BPM from resting level. C. May mask hypoglycemia. D. Increase exercise capacity in patients with angina, decrease it with those who do not have angina.

answer

B. Correct except the HR is >20

question

Which statement is not true about calcium channel blockers? A. Side effects include swelling in feet and ankles, and fatigue. B. Usually decrease exercise performance in patients with HTN. C. If meds are adjusted, or changed to another CCB, it is important to monitor that the HR does not increase >20 BPM over resting. D. They promote vasodilation and stabilize the HR.

answer

B. They usually do not affect it or increase it, depending on the medication.

question

Which of these diabetic meds has the lowest risk of hypoglycemia with with exercise? A. Glipizide (glucotrol) B. Repaglinide (prandin) C. Metformin (glucophage) D. Glimepiride ( amaryl)

answer

C. Metformin (glucophage)

question

Your patient's BS checked before your session is 90. What do you do? A. Hold the session. B. Have patient ingest 15 gr carbohydrate prior to starting the session. C. Cancel the session

answer

B...ingest and proceed

question

Which of these drugs may cause extra-pyramidal sx? A. Cholinesterase inhibitors, such as aricept B. Resperidone (risperdal) C. Amitriptyline (elavil) D. Fluoxetine (Prozac)

answer

B...it's an antipsychotic

question

How many calories are required daily for an individual with a low level of activity? (Male, female) A. 1200, 1000 B. 1500, 1200 C. 1600, 1300 D. 2000, 1600

answer

D. 2000, 1600

question

Recommendations to prevent osteoporosis fracture are daily dose of ____ mg calcium and____ 1u vitamin D.

answer

1000-1200; 800

question

Which statement is false? A. Studies show that exercise significantly increases physical performance and decreases fatigue in women with breast CA. B. Patients with colon CA can decrease the risk of return of the CA by 49% if they exercise regularly. C. The correct exercise intensity is 60-80% (aerobic and RT) for cancer patients. D. Exercise programs for patients with CA have minimal side effects if performed at the correct intensity.

answer

C. The correct intensity is 40-60%.

question

Patients with MI or CABG who have not undergone a stress test...which 2 are correct? A. Max training HR is HR rest +20 bpm B. Max training HR. Is HR rest + 30 bpm C. RPE 11-14 D. RPE 15-16

answer

A and C are correct exercise parameters.

question

Listed are some absolute or relative contraindications for RT. Pick out the relative ones. A. Unstable CHD B. Marphan's syndrome C. Acute myocarditis or pericarditis D. Individuals with implanted pacemaker or defibrillator E. HTN >160/>100 mmHg F. 80% 1 RM with retinopathy G. Decompensated HF

answer

D and E are relative

question

Exercising with CHF...pick the incorrect statement. A. Need to be medically stable to begin an exercise program. B. THR 40-75% VO2 max C. Warm up/ cool down 5 minutes D. RPE 11-14

answer

C. Need a lengthened warm up and cool down of 10-15 minutes.

question

The best exercise prescription to improve 24 hour glycemic control would include... A. A 45 minute walk before breakfast. B. Aerobic intensity of 20-40% of HRR C. SHORT 15 minute bouts (X 3) of post meal exercise. D. RT only, timing unimportant.

answer

C. For B, the correct intensity is 40-60%...and timing IS important!

question

What dx takes the largest amt of medicare dollars A. DM B. OA C. heart ailure D. COPD

answer

C: heart failure

question

Which meds increase risk of fx A. corticosteroids B. protein pump inhibitors C. thiazolidinedione (for DM) D. SSRI's E. all of above

answer

E. all of above

question

How many cm decrease in height suggests a new vertebral fx A. 1 B. 2 C. 3 D. 4

answer

B. 2

question

TUG time that correlates with independence A. < 15 sec B. <20 sec C. < 30 sec

answer

B.4 square test has the pt step over canes set up to divide a box into 4 squares with the patient facing forward the whole time clockwise then counterclockwise

question

Diuretics are used to treat HTN to: A. decrease peripheral resistance B. increase cardiac contractile performance C. decrease rate of and force of contractions and decrease sympathetic tone

answer

A. decrease peripheral resistance

question

Beta blockers are used to treat HTN to: A. decrease peripheral resistance B. increase cardiac contractile performance C. decrease rate of and force of contractions and decrease sympathetic tone

answer

C. decrease rate of and force of contractions and decrease sympathetic tone. Can have side effects of: orthostatic hypotension, fatigue, GI disturbance

question

TUG time that correlates with independence A. < 15 sec B. <20 sec C. < 30 sec

answer

B. > 30 sec correlates with DEPENDENCE

question

4 square step test time that correlates with no falls A. <10 sec B. < 15 sec C. < 30 sec

answer

B. 4 square test has the pt step over canes set up to divide a box into 4 squares with the patient facing forward the whole time clockwise then counterclockwise

question

Side effects of opiod analgesics EXCEPT: A. respiratory depression B. anti-cholinergic effects C. urinary incontinence D. mood alteration

answer

C. urinary incontinence

question

True regarding TCA's and SSRI's are EXCEPT: A. SSRI's cause weight loss B. both can cause orthostatic hypotension C. TCA's can cause weight gain D. TCA's can cause tremors

answer

B. both can cause orthostatic hypotension, only TCA's can do this

question

According to the American College of Rheumatology, the drug of choice for chronic pain for OA is: A. naproxen B. aspirin C. acetomenophen D. ibuprofen

answer

C. acetomenophen

question

When is the only indication to use a COX-2 inhibitor for pain: A. patient has GI sensitivity B. history of hypertension or thrombus C. hyperglycemia D. when off of aspirin

answer

A. patient has GI sensitivity

question

What are symptoms to watch out for with pain medications: A. respiratory depression B. orthostatic hypotension C. constipation D. all of the above

answer

D. all of the above

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