DPT Geriatric Rehabilitation 5 — Questions and Answers
Question 1: A 91-year-old in the ICU after pneumonia has been on bed rest for 10 days. Which early mobilization protocol outcome is MOST supported by evidence?
- Decreased ICU-acquired weakness and shorter length of stay (Correct answer)
- Increased risk of respiratory failure with early mobility
- No significant functional benefit compared to standard care
- Increased cognitive impairment from premature activity
Correct answer: Decreased ICU-acquired weakness and shorter length of stay
Early progressive mobility in the ICU significantly reduces ICU-acquired weakness, delirium duration, and hospital length of stay per multiple RCTs.
Question 2: Which nutritional deficiency is MOST commonly associated with increased fall risk and myopathy in older adults living in northern latitudes?
- Iron deficiency
- Vitamin D deficiency (Correct answer)
- Calcium deficiency
- Vitamin B12 deficiency
Correct answer: Vitamin D deficiency
Vitamin D deficiency impairs muscle fiber recruitment and neuromuscular function, contributing to proximal muscle weakness and increased fall risk, especially in populations with limited sun exposure.
Question 3: An older adult scores 42/56 on the Berg Balance Scale. How should the PT interpret this result?
- Low fall risk; no intervention needed
- Moderate fall risk; some balance impairment present (Correct answer)
- High fall risk; requires assistive device immediately
- Normal balance for age; discharge from PT
Correct answer: Moderate fall risk; some balance impairment present
A Berg Balance Scale score of 41–48 indicates moderate fall risk, suggesting balance impairment that warrants continued physical therapy intervention and fall prevention strategies.
Question 4: Which cardiac precaution is MOST important during exercise prescription for an older adult who recently completed cardiac rehabilitation after CABG?
- Avoid all aerobic exercise for 6 months post-surgery
- Monitor heart rate and blood pressure; use RPE 11–14 on Borg scale (Correct answer)
- Restrict exercise to passive range of motion only
- Prohibit resistance training indefinitely
Correct answer: Monitor heart rate and blood pressure; use RPE 11–14 on Borg scale
Post-CABG patients can safely perform moderate exercise guided by heart rate monitoring and Borg RPE 11–14 (somewhat hard), which reflects adequate cardiac workload without excessive stress.
Question 5: A geriatric patient demonstrates difficulty with medication management, bill payment, and using the telephone. Which level of function is impaired?
- Basic Activities of Daily Living (BADLs)
- Instrumental Activities of Daily Living (IADLs) (Correct answer)
- Advanced Activities of Daily Living (AADLs)
- Cognitive Activities of Daily Living (CADLs)
Correct answer: Instrumental Activities of Daily Living (IADLs)
Medication management, financial tasks, and telephone use are Instrumental Activities of Daily Living (IADLs), which require higher-order cognitive function than basic self-care tasks.
Question 6: Which intervention has the STRONGEST evidence for reducing fear of falling and improving activity levels in community-dwelling older adults?
- Educating patients to avoid all potentially risky activities
- Multifactorial fall prevention programs combining exercise, education, and home modification (Correct answer)
- Prescribing a standard walker to all patients over age 75
- Recommending complete bed rest following any fall
Correct answer: Multifactorial fall prevention programs combining exercise, education, and home modification
Multifactorial fall prevention programs that combine exercise, patient education, and home hazard modification have the strongest evidence for reducing both fear of falling and fall rates.
Question 7: A 80-year-old patient with severe COPD shows oxygen saturation dropping to 87% during ambulation. What is the MOST appropriate PT response?
- Continue exercise at the same intensity since mild desaturation is expected
- Stop exercise, allow rest, notify the physician, and reassess exercise parameters with supplemental oxygen if prescribed (Correct answer)
- Immediately discharge the patient from physical therapy
- Increase walking speed to build hypoxic tolerance
Correct answer: Stop exercise, allow rest, notify the physician, and reassess exercise parameters with supplemental oxygen if prescribed
Oxygen saturation below 88–90% during exercise requires stopping activity, physician notification, and reassessment; continued exercise at this saturation level risks serious adverse cardiac and neurological events.
DPT Geriatric Rehabilitation 5
A 91-year-old in the ICU after pneumonia has been on bed rest for 10 days.
Which early mobilization protocol outcome is MOST supported by evidence?