Mixed Deck — All PCE Topics Flashcards

When a patient asks a physiotherapist about treatment options that include techniques outside the therapist's competence, the therapist should:

Answer: Provide general information and refer the patient to a competent practitioner

Therapists must acknowledge the limits of their competence, provide accurate information, and facilitate appropriate referral.

A physiotherapist feels they may no longer be competent to treat a highly specialized patient population due to a gap in their continuing education. The most ethical response is to:

Answer: Decline to treat until competence is re-established through education or supervision

Practicing beyond one's current competence level risks patient harm and violates professional standards; addressing the competence gap before treating is required.

A physiotherapist is assessing muscle tone in a patient with a spinal cord injury (SCI) at T6, classified as AIS A. Spasticity below the level of injury is managed primarily to:

Answer: Prevent contractures, maintain hygiene, and improve functional positioning

In complete SCI, spasticity management focuses on preventing secondary complications such as contractures, pressure injuries, and hygiene issues, and optimizing positioning for function.

A patient in cardiac rehabilitation develops chest pain and diaphoresis during exercise. After stopping activity, the physiotherapist should next:

Answer: Activate the emergency response system immediately

Chest pain with diaphoresis during exercise is a cardiac emergency requiring immediate activation of the emergency response system.

Which of the following BEST describes the role of a physiotherapist in a continuous quality improvement (CQI) culture?

Answer: Actively identifying inefficiencies, collecting data, and proposing solutions at the front line

CQI culture empowers front-line clinicians to continuously identify problems, measure performance, and test solutions as part of daily practice.

A physiotherapist develops romantic feelings for a current patient. The most ethical course of action is to:

Answer: Transfer care to another therapist and recognize the therapeutic relationship must end first

Sexual or romantic relationships with current patients are prohibited; care must be transferred before any personal relationship could ethically be considered.

A patient presents with acute ankle inversion sprain. According to best evidence, which intervention should be prioritized in the first 72 hours?

Answer: Protected weight bearing with early functional rehabilitation

Current evidence supports early protected weight bearing and functional rehabilitation over prolonged immobilization for acute lateral ankle sprains.

When setting goals for a pediatric patient using the SMART framework, which element is MOST often missing in novice clinician goal-writing?

Answer: Time-bound

Time-bound elements specifying when the goal will be achieved are most frequently omitted, reducing the goal's clinical utility for tracking progress.

Which test is commonly used to assess balance in patients at risk of falls?

Answer: Berg Balance Scale

The Berg Balance Scale is a widely used clinical tool specifically designed to assess a patient's static and dynamic balance abilities. It comprises 14 functional tasks that evaluate various aspects of balance, making it highly effective for identifying individuals at risk of falls. This comprehensive scale helps physiotherapists quantify balance deficits and tailor appropriate interventions.

During a shoulder assessment, a positive Neer's sign and positive Hawkins-Kennedy test both reproduce anterior shoulder pain. These findings are most consistent with:

Answer: Subacromial impingement syndrome

Both Neer's and Hawkins-Kennedy tests provoke the supraspinatus tendon under the acromion, making subacromial impingement the most likely diagnosis.

Which of the following BEST describes 'unbundling' as a fraudulent billing practice in physical therapy?

Answer: Billing separately for components of a procedure that should be billed as a single comprehensive code

Unbundling involves separating components of a service that should be reported as one inclusive code to artificially increase reimbursement.

When reviewing a physiotherapy program for quality, which type of data source provides the MOST direct evidence of functional improvement?

Answer: Validated functional outcome scores collected at intake and discharge

Validated functional outcome measures collected at standardized time points provide objective, comparable evidence of patient improvement.

What is the importance of maintaining professional boundaries?

Answer: Clear boundaries protect both the professional and the client relationship

Professional boundaries maintain the integrity of the professional-client relationship and protect all parties.

A patient with dementia is unable to provide informed consent. Who holds decision-making authority?

Answer: The legally designated substitute decision-maker or next of kin as defined by law

When a patient lacks decision-making capacity, a legally designated substitute decision-maker, such as a power of attorney, assumes consent authority.

A physiotherapist is treating a patient with rotator cuff tendinopathy. Which phase of rehabilitation should focus on neuromuscular control and proprioception?

Answer: Functional rehabilitation phase

The functional rehabilitation phase emphasizes neuromuscular control, proprioception, and sport- or task-specific activities to prepare the patient for return to full function.

A physical therapist completes an evaluation but is unable to establish a physical therapy diagnosis due to insufficient findings. The MOST appropriate action is to:

Answer: Document findings thoroughly, indicate that further assessment is needed, and seek consultation if appropriate

When insufficient data exists to establish a PT diagnosis, thorough documentation of findings and identification of next steps (including consultation) reflects sound clinical and documentation practice.

A patient is referred following a Colles' fracture. At 6 weeks post-immobilization, which assessment finding would most contraindicate aggressive passive ROM?

Answer: Complex regional pain syndrome signs (allodynia, skin changes)

Signs of CRPS (allodynia, trophic skin changes, vasomotor instability) contraindicate aggressive passive mobilization, which can exacerbate the condition.

Which indicator is an example of a PROCESS measure in physiotherapy quality monitoring?

Answer: Percentage of patients who received a falls risk screen at initial assessment

Process measures evaluate whether specific clinical steps are performed, such as completing a falls risk screen, regardless of the outcome.

What is the primary purpose of a comprehensive patient assessment in PCE practice?

Answer: To establish a baseline for treatment planning

A comprehensive patient assessment establishes a baseline that guides treatment planning and helps track patient progress over time.

A patient refuses a recommended intervention after receiving adequate information about risks and benefits. The physiotherapist MUST:

Answer: Document the refusal and respect the patient's autonomy

Respecting informed refusal is a fundamental ethical and legal obligation; the therapist must document the refusal and continue to support the patient within their expressed wishes.