CHT Clinical Reasoning 3

Question 1

A patient with a zone II flexor tendon repair at 6 weeks post-op shows good passive motion but limited active FDP glide. The MOST likely clinical reasoning is:

Accepted Answer

Tendon adhesions at the repair site

Answer

Limited active FDP glide with preserved passive motion at 6 weeks post zone II repair strongly suggests peritendinous adhesion formation restricting tendon excursion.

Question 2

Which outcome measure is MOST appropriate for capturing a patient's self-reported hand function disability after carpal tunnel release?

Accepted Answer

Disabilities of the Arm, Shoulder and Hand (DASH)

Answer

The DASH is a validated patient-reported outcome measure specifically designed to capture upper extremity functional disability.

Question 3

A patient post-extensor tendon repair (zone VI) presents with an extensor lag at the MP joint. What clinical reasoning step should the CHT take NEXT?

Accepted Answer

Rule out tendon rupture and assess repair integrity

Answer

An extensor lag after zone VI repair requires first ruling out repair rupture before initiating further exercise or splinting.

Question 4

When using clinical prediction rules for therapy, a CHT should PRIMARILY consider:

Accepted Answer

The rule's sensitivity and specificity in the study population

Answer

The diagnostic accuracy of a clinical prediction rule, expressed through sensitivity and specificity, is the primary indicator of its clinical applicability.

Question 5

A 55-year-old patient with rheumatoid arthritis has ulnar drift and swan-neck deformities. Which clinical reasoning principle guides splinting priority?

Accepted Answer

Prioritize function and prevention of further deformity progression

Answer

In RA management, splinting aims to optimize functional use and prevent deformity progression, balancing joint protection with maintaining independence.

(CHT) Certified Hand Therapist Practice Test

(CHT) Certified Hand Therapist Practice Test

CHT Clinical Reasoning 3