Review Flashcards

A physical therapist is employed by an orthopedic outpatient clinic. The patient states, "I tore 3 of my 4 Rotator cuff muscles in the past," throughout the patient's history. Which of the following muscles can never be thought to be torn?

Answer: Teres major

The rotator cuff muscles consist of four muscles: Supraspinatus, Infraspinatus, Teres minor, and Subscapularis (SITS muscles). The Teres major muscle is not part of the rotator cuff; it primarily adducts and internally rotates the arm but does not contribute to stabilizing the glenohumeral joint in the same way as the SITS muscles.

A patient is showing signs of right-sided heart failure, the charge nurse on the cardiac unit informs you. In which of the following scenarios would right-sided heart failure not be present?

Answer: SOB (shortness of breath)

Right-sided heart failure primarily causes systemic congestion because the right ventricle cannot pump blood effectively to the lungs. This leads to a backup of blood in the systemic circulation, resulting in symptoms like peripheral edema (rapid weight gain), anorexia, and nausea due to visceral congestion. Shortness of breath (SOB) is a hallmark symptom of left-sided heart failure, where blood backs up into the lungs, causing pulmonary congestion.

A person with a left CVA and right lower extremity hemiparesis is being taught how to utilize a quad cane by a physical therapist. Which of the following gait patterns is appropriate?

Answer: Place the cane in the patient's left upper extremity, encourage cane, then right lower extremity, then left upper extremity gait sequence.

For a patient with hemiparesis, a cane should be held in the hand opposite the affected leg to provide a wider base of support. With right lower extremity hemiparesis, the cane goes in the left hand. The correct gait pattern is to move the cane forward with the affected leg, then follow with the unaffected leg: cane (left hand), then right lower extremity (affected), then left upper extremity (unaffected).

A patient is suffering SOB, calf pain, and warmth across the posterior calf, a physical therapist on an ICU unit notices. Which of the following medical disorders could all of these point to?

Answer: Patient may have a DVT

The combination of shortness of breath (SOB), calf pain, and warmth across the posterior calf are classic signs and symptoms highly suggestive of a Deep Vein Thrombosis (DVT). A DVT in the calf can cause localized pain and warmth, and if a part of the clot dislodges and travels to the lungs (pulmonary embolism), it can cause sudden SOB, which is a medical emergency.

In a pediatric clinic, a physical therapist is answering phone calls. Which of the following reports most urgently calls for the physical therapist's attention right away?

Answer: A 8 year-old boy has been vomiting and appears to have slower movements and has a history of an atrio-ventricular shunt placement.

An 8-year-old boy with a history of an atrio-ventricular (AV) shunt who is vomiting and showing slower movements is exhibiting classic signs of increased intracranial pressure (ICP) due to shunt malfunction. Shunt malfunction is a medical emergency that requires immediate attention to prevent severe neurological damage, making this the most urgent report.

A patient who has recently been diagnosed with COPD and fibromyalgia is being treated by a physical therapist. Which of the ensuing duties need should the physical therapist assign to an assistant?

Answer: Transferring the patient during the third visit

Physical therapist assistants (PTAs) can perform interventions that are part of the established plan of care and do not require complex decision-making. Transferring a patient during their third visit, assuming the patient's condition is stable and the PTA is trained, is an appropriate task. Initial ambulation, setting up exercise programs, and educating on fatigue monitoring typically require the clinical judgment of a physical therapist.

In the step-down unit, a patient is receiving care from a physical therapist. There are indicators of elevated intracranial pressure in the patient. Of the following, which does not indicate elevated intracranial pressure?

Answer: Increased pupil size bilaterally

Elevated intracranial pressure (ICP) typically causes pupillary changes such as unequal pupil size (anisocoria) or fixed and dilated pupils (blown pupil) due to oculomotor nerve compression. Increased pupil size bilaterally without other specific signs of CN III compression is not a primary indicator of elevated ICP. Bradycardia, vomiting, and changes in the level of consciousness (LOC) are all well-recognized signs of increased ICP.