PAM Patient Assessment & Clinical Evaluation 2 — Questions and Answers
Question 1: During a PAM assessment, a patient reports pain that worsens with activity and improves with rest. This pattern most likely indicates which type of condition?
- Inflammatory condition
- Mechanical condition (Correct answer)
- Neurogenic condition
- Psychogenic condition
Correct answer: Mechanical condition
Mechanical pain that worsens with activity and improves with rest is a hallmark of mechanical musculoskeletal conditions.
Question 2: When assessing skin integrity prior to applying a thermal modality, which finding is an absolute contraindication?
- Mild erythema from previous session
- Open wound or broken skin (Correct answer)
- Presence of scar tissue
- Hyperpigmentation of the area
Correct answer: Open wound or broken skin
Open wounds or broken skin are absolute contraindications for most thermal modalities due to risk of infection and thermal injury.
Question 3: A clinician uses a two-point discrimination test during patient assessment. This test primarily evaluates which sensory function?
- Pain threshold
- Tactile spatial acuity (Correct answer)
- Proprioception
- Vibration sense
Correct answer: Tactile spatial acuity
Two-point discrimination tests tactile spatial acuity by determining the minimum distance at which a patient can distinguish two separate touch points.
Question 4: Which vital sign change during exercise would most prompt a clinician to reassess appropriateness of a physical agent intervention?
- Heart rate increase of 20 bpm
- Systolic BP drop of 20 mmHg (Correct answer)
- Respiratory rate increase to 18/min
- Temperature increase of 0.5°F
Correct answer: Systolic BP drop of 20 mmHg
A systolic blood pressure drop of 20 mmHg during or after exercise (exercise-induced hypotension) signals a cardiovascular red flag requiring reassessment.
Question 5: In documenting outcomes for PAM treatment, which measurement tool is most appropriate for quantifying functional limitation in activities of daily living?
- Visual Analog Scale (VAS)
- Functional Independence Measure (FIM) (Correct answer)
- McGill Pain Questionnaire
- Numeric Pain Rating Scale (NPRS)
Correct answer: Functional Independence Measure (FIM)
The Functional Independence Measure (FIM) is a standardized tool specifically designed to quantify functional limitation and independence in ADLs.
Question 6: A patient has decreased sensation in the L4 dermatome. Which area should the clinician test when evaluating this dermatomal distribution?
- Lateral foot and small toe
- Medial lower leg and great toe (Correct answer)
- Posterior thigh
- Lateral thigh
Correct answer: Medial lower leg and great toe
The L4 dermatome covers the medial lower leg, medial foot, and great toe region.
Question 7: Which question best elicits information about the 24-hour behavior of a patient's symptoms during a PAM subjective assessment?
- How long have you had this condition?
- Does your pain change throughout the day or with different positions? (Correct answer)
- What medications are you currently taking?
- Have you had previous treatment for this problem?
Correct answer: Does your pain change throughout the day or with different positions?
Asking about symptom variation throughout the day and with positions reveals the 24-hour pain pattern, helping classify the condition and guide modality selection.
PAM Patient Assessment & Clinical Evaluation 2
During a PAM assessment, a patient reports pain that worsens with activity and improves with rest.
This pattern most likely indicates which type of condition?