NPTE questions and answers, 2022 update, graded A+

NPTE questions and answers, 2022 update, graded A+ 12 weeks post talus fx, cc of catching toe during gait since removal of cast. Eval: limited ankle DF, leg atrophy, ankle weakness. POC should FIRST emphasize: - ...

NPTE questions and answers, 2022 update, graded A+ 12 weeks post talus fx, cc of catching toe during gait since removal of cast. Eval: limited ankle DF, leg atrophy, ankle weakness. POC should FIRST emphasize: - TC jt mobs - Tib ant stretch - gastroc strengthening - fitting for AFO - ✔✔Emphasize jt mobs. Pt has irregular shaped wound at L med Malleolus. Skin around is darkened. Underlying cause? - Lymphedema - Venous Insufficiency - Cellulitis - Osteomyelitis - ✔✔* Venous insufficiency : Presentation- med leg, irregular borders, hyper pigmented periwound - cellulitis painful infection, local bruising, palpable lymph, fever, chills - osteomyelitis: infection of bone; fever, edema, TTP 6 yo w/ RA of C spine, hips, knees, ankles w/ contractures at all jts. C/o of morning stiffness. What gait deviation? - increased cadence - increased PF and range at toe off - decreased hip ext at Terminal stance - decreased Ant pelvic tilt - ✔✔* decreased hip ext d/t contracture of hip flexor Pt w/ TBI 3 weeks ago. Confused/agitated. Eval findings: decreased LE coordination and strength. MOST appropriate intervention? - biofeedback training for LE w/ supervision - walking in // bars with sup - aerobics group exercise class for 30 min - LE exercises while following written handout - ✔✔* walking in // bars with sup adult female indicates a hematocrit value of 42% following minor surgery. Value is indicative of - anemia - inflammation - infection - normal - ✔✔* normal: Hematocrit= amount of RBC in blood - inflammation = increased neutrophils - infection = increased WBCs 14 yo baseball player reports insidious shoulder pain. presents w/ apprehension w/ passive abd and full ER. Which pathology? - Adhesive capsulitis - atraumatic instability - AC separation - Sup labral tear - ✔✔* Atraumatic instability - too young for adhesive capsulitis and has full ER - Labral tears MOI= traumatic/sudden onset Pt had R ruptured MCA aneurysm that was repaired. Which is most likely functional limitation? - Horizontal Nystagmus - Ataxic gait - Apraxia - Rigidity - ✔✔* Apraxia - Horizontal nystagmus, ataxic= Cerebellar involvement - rigidity not due to MCA lesion Abnormal sensation on lat edge of L foot, MMT reveals weakness of L hip abd. Which nerve roots? - L2-L3 - L3-L4 - L5-S1 - S2-S3 - ✔✔* L5- S1 Pt has h/o ulnar n entrapment @ level of hamate. which exercise used to most improve strength deficits? - pinching w/ 1st and 2nd digit - squeeze hand grip - oppose thumb to each other digit 2-5 - squeeze putty between sides of fingers - ✔✔* squeeze putty: isolate interossi/ lumbricals - pinching/opposition = median n Pt reports pain with OH activity, during active abd on affected side, pt shows diminished scap upward rot. Weakness of which following muscles is most likely affected - UT - Post delt - Rhomboids - Teres major - ✔✔* UT: coupled with LT/SA produces upward rot - post delt: ext, abd, ER shoulder - rhomboids: retract, elevate, downward rot scap - teres major: ect, add, IT shoulder Pt w/ L tib fx is restricted to 25% Wbing. Currently walking with single axillary on L side. What is most appropriate action - use RW - use 2 axillary crutches - switch axillary crutch to R side - quad cane to L side - ✔✔* use 2 crutches How to asses ant Tibiofibular Ligament? - talar tilt with ankle in neutral DF - Ant drawer - Compression of shaft of tib/fib - squeezing calf - ✔✔* compression of shaft of tib/fib Paraffin is most beneficial for a pt with which condition? - edematous wrist 1 week following carpal tunnel - swollen elbow resulting from RA - aching fingers resulting in OA - painful hand d/t CRPS - ✔✔* OA in fingers - RA usually is cryo - avoid heat with CRPS/ edema (vasodilation) Resting HR of 32 yo runner is 46 BPM. What can explain this? - individual has hypotension - rate is secondary to increased SV - AV block - endurance training has stimulated Sympathetic nervous system - ✔✔* Increased SV ( CO= HRx SV) - exercise stimulates parasympathetic, induces bradycardia Pt reports fatigue, proximal UE weakness, double vision that increases throughout day. Presents w/ bilat ptosis, difficulty chewing, dysphagia, inability to raise eyebrows. Which condition? - Bell palsy - MG - Trigeminal neuralgia - ALS - ✔✔* MG- increased fatigue = double vision, LMN signs - Bell palsy consistent CN 7 deficits all the time - ALS: UMN/LMN signs 55 yo male w/ LBP. Pt reports difficulty initiating urination. This sx is most often result of? - bladder cancer - stress incontinence - prostate enlargement - renal failure - ✔✔* prostate enlargement Pt admitted to hospital w/ exacerbation of HF preparing for d/c. Which of the following is most important to monitor as Home program? - BP/ fatigue - HR/ cough productivity - cyanosis / diaphoresis - SOB/ dependent edema - ✔✔* SOB / dependent edema - HF sx: fatigue, cough, cyanosis Which of the following is consistent with low risk for metabolic syndrome? - Triglyceride of 135 mg/dl - BP of 135/85 - Fasting blood glucose of 126 mg/dl - Waist of 41 in - ✔✔* triglyceride normal < 150 - waist > 35 in in men/ 40 in in women = greater risk Pt has meralgia paresthetica has been referred to PT. Which is most common feature to assess? - strength of add longus - strength of quad - sensation of sup med aspect of thigh - sensation of lat aspect of thigh - ✔✔* sensation of lat thigh: caused d/t entrapement of lat cut n Pt has DM reports progressive loss of shoulder mobility. (Photograph: showing manual IR in sidelying + manually retracting scap ) - functional horizontal add - Post cap tightness - AC jt tightness - scapular dyskinesia - ✔✔* post cap tightness- DM likely to experience shoulder mobility deficits Exercise session of 25 min practice and 5 min break is? - massed - distributed - blocked - random - ✔✔* massed: practice time> break time - distributed: break time> practice time - blocked: practice of 1 task repeatedly - random: practice of various task Pt w/ COPD becomes SOB when walking 5 ft with RW. Which of following techniques MOST appropriate to increase distance w/o SOB? - Incentive Spirometry - Pacing - Diaphragmatic breathing - Segmental breathing - ✔✔* pacing to learn to work within exercise tolerance. question is asking how to improve tolerance - incentive spirometry = improve inspiratory volume - diaphragm breathing = improve diaphragm mvmt - segmental breathing used with chest hypomobility= improve localized lung expansion Inability to pinch 1st/2nd digit is entrapment of what nerve? - Ant interosseous n - Radial n - post interosseous m - ulnar - ✔✔* ant int N: supplies FPL/ radial half of FDP - Radial/ post int = wrist drop - ulnar: cannot add 5th Pt reports UE numbness that extends from the neck to the 1st/2nd digit. Which of following shoulder positions would exacerbate sx? - ER/abd - IR/abd - ER/add - IR/add - ✔✔* ER/ abd = stress median n Which of following locations of pain is most consistent with bladder infection? - Grion - Sacral area - Lower buttocks - Suprapubic - ✔✔* suprapubic - grion = UTI - sacral = colon cancer L thoracolumbar scoliosis. Pelvic landmark are symmetrical. Which following muscles will most likely be tight - R hip abd - L lat - R QL - L illiocostalis Lumborum - ✔✔* R QL - hip abd normal d/t pelvis level - L lat, illiocostalis = normal or lengthened Pt w/ TBI unable to follow commands. PT arrives for eval and pt is agitated. What actions to take INITIALLY? - observe behavior - postpone assessment - apply soft restraints to calm pt - proceed regardless of agitated state - ✔✔* observe A pt who has hypothyroidism is most likely to exhibit which of following signs/sx - Ptosis - Muscle ache - Dysphagia - Tachycardia - ✔✔* muscle ache - also bradycardia common A pt w/ arthritis of hips/knees is able to partially stand but cannot clear arm rest of WC with stand- pivot transfers. Which is best strategy to facilitate transfer? - increase LE strength - improve AROM of LE - recommend removable arm rests - recommend mechanical lift - ✔✔* removable arm rest Pt has acute RA involving the wrist joints. Which intervention is most appropriate? - resistive exercises to end range - functional fine motor tasks - splints with wrists in neutral position - passive stretching exercises - ✔✔* splints: acute phase = rest and protection - strengthening/ active exercise (fine motor) too painful in acute phase - passive stretching not as important in acute Which activity should be primary emphasis with child who has athetoid CP? - Facilitating co-contraction patterns and encouraging control in voluntary mvmt gradation - increase strength using PREs - facilitating use of primitive reflexes to perform gross motor task - preventing development of contractures and ensuring full voluntary ROM - ✔✔* co-contraction patterns: athetoid CP is involuntary mvmts that are slow, lack control to produce max effort in controlled mvmt - goal would be to gain controlled mvmt - less likely to have contractures Pt who has h/o heart dz being treated for L GH dysfunction. Pt reports L upper quadrant pressure that continues after jt mobs has ceased. Which is most appropriate action? - assess pt C spine nerve root integrity - perform relaxation exercises/ inquire about cardiac sx - stop treatment/ monitor vitals - resume jt mobs at lower intensity and reassess pt status - ✔✔* stop treatment/ assess vitals - signs of MI Which Lab value should PT monitor when treating pt on warafin? - Hemoglobin - RBC - INR -ESR - ✔✔* INR: normal 1, normal on anticoag = 2-3, >3 = increase risk of bleeding - ESR= used to id inflammation process Pts ECG shows junctional rhythm, 60 bpm, regular HR. Which of following waves will most likely be absent? - P - R - S - T - ✔✔* P: stimulation of SA node - junctional Rhythm originates from AV junction producing RST wave IE reveals paresthesia over hypothenar eminence. Most probable cause is? - Carpal tunnel syndrome - C8 nerve root involvement - de Quervain tenosynovitis - pronator teres syndrome - ✔✔* C8 nerve root involvement Rationale for using superficial heat includes all of the following except? - increase core temp - increase tissue temp - promoting relaxation - reducing pain - ✔✔* increase core temp A person with Spina bifida uses KAFO to - support for muscle incoordination - facilitate muscle activity - prevent contractures - substitute for lack of muscle activity - ✔✔* substitute for lack of muscle activity -KAFO used for weak/absent knee to address instability not to prevent contractures or facilitation (Photograph: passive shoulder IR at 90 deg flexion) Testing which pathology? - ant GH instability - cubital tunnel syndrome - shoulder impingement - TOS - ✔✔* shoulder impingement: hawkins kennedy syndrome Pt with advanced emphysema experience difficulty in breathing during exercise because of - hypocapnia - atrophy of secondary breathing muscles - alveolar dilation - damage to the phrenic nerve - ✔✔* alveolar dilation: emphysema= enlargement of air spaces/ changes to alveolar wall - Obstruction dz= slightly elevated CO2, breath with secondary muscles= hypertrophy,. no phrenic n involvement Pt w/ recent MI. Before tx BP was 120/80, HR 90 bpm. Midway through tx BP=130/84, HR was 105 bpm. What is best action for PT? - continue with treatment - increase intensity of tx - stop tx and notify MD - decrease intensity of next treatment - ✔✔*continue with tx After 1 week of PRE program, individual demonstrates strength gains most likely due to what? - increased ratio of fast:slow twitch fibers - improved neuromuscular recruitment - muscle fiber hyperplasia - muscle hypertrophy - ✔✔* improved neuromuscular recruitment Home health PT working with pt with MI 2 weeks ago. Pt reports interrupted sleep, increased swelling of the feet, and SOB. HR is 120 Bpm, RR is 28 breath/min, auscultation reveals crackles in both lung bases. therapist should suspect