PCE Practice and Application 3 — Questions and Answers
Question 1: A patient with COPD is prescribed pursed-lip breathing. What is the primary physiological benefit of this technique?
- Increases respiratory rate to improve oxygenation
- Slows exhalation to prevent airway collapse and reduce air trapping (Correct answer)
- Strengthens the diaphragm through resistance training
- Increases tidal volume by expanding the chest wall
Correct answer: Slows exhalation to prevent airway collapse and reduce air trapping
Pursed-lip breathing creates back pressure that splints open collapsible airways, reducing dynamic hyperinflation and air trapping.
Question 2: A patient with rotator cuff tendinopathy performs the empty can test, which reproduces their pain and shows weakness. Which muscle is most likely involved?
- Infraspinatus
- Subscapularis
- Supraspinatus (Correct answer)
- Teres minor
Correct answer: Supraspinatus
The empty can (Jobe) test isolates the supraspinatus by testing resisted abduction at 90° in the scapular plane with internal rotation.
Question 3: Which grade of joint mobilization according to Maitland is most appropriate for treating acute pain with limited ROM?
- Grade IV
- Grade V
- Grade I or II (Correct answer)
- Grade III
Correct answer: Grade I or II
Grades I and II are small-amplitude oscillations that stimulate mechanoreceptors and inhibit pain without applying significant stretch.
Question 4: During a shoulder examination, a patient is unable to hold their arm at 90° abduction when downward pressure is applied and reports a 'drop.' What does this finding indicate?
- Biceps tendon rupture
- Full-thickness supraspinatus tear (Correct answer)
- Acromioclavicular joint sprain
- Glenohumeral instability
Correct answer: Full-thickness supraspinatus tear
A positive drop arm test indicates a full-thickness rotator cuff (typically supraspinatus) tear, preventing active maintenance of abduction.
Question 5: A therapist notices a patient consistently compensates with lumbar extension during hip flexion exercises. Which impairment best explains this pattern?
- Hip flexor tightness (Correct answer)
- Hamstring weakness
- Hip flexor weakness
- Lumbar extension hypermobility
Correct answer: Hip flexor tightness
Tight hip flexors have a shortened range, causing the pelvis to anteriorly tilt and lumbar spine to extend when hip flexion demand exceeds available range.
Question 6: According to the International Classification of Functioning (ICF) model, difficulty participating in a recreational soccer league due to a knee injury would be classified under which domain?
- Body structure
- Activity
- Participation (Correct answer)
- Environmental factors
Correct answer: Participation
Participation in the ICF model refers to involvement in life situations such as recreational sports, which represents the societal level of functioning.
Question 7: A patient with diabetes mellitus is referred for peripheral neuropathy management. Which assessment tool is most appropriate for detecting loss of protective sensation in the foot?
- Semmes-Weinstein monofilament test (Correct answer)
- Tinel's sign
- Two-point discrimination test
- Vibration threshold testing with a 256 Hz tuning fork
Correct answer: Semmes-Weinstein monofilament test
The 10-gram Semmes-Weinstein monofilament test is the clinical standard for detecting loss of protective sensation and risk of diabetic foot ulcers.
PCE Practice and Application 3
A patient with COPD is prescribed pursed-lip breathing.
What is the primary physiological benefit of this technique?