PTA Critical Thinking 2 — Questions and Answers
Question 1: A patient reports increased pain after yesterday's treatment session. What is the PTA's BEST first action?
- Discontinue treatment and discharge the patient
- Assess the patient and report findings to the supervising PT (Correct answer)
- Continue with the same plan of care unchanged
- Apply ice and send the patient home early
Correct answer: Assess the patient and report findings to the supervising PT
The PTA must assess changes in patient status and communicate findings to the supervising PT before modifying or continuing care.
Question 2: During gait training, a patient suddenly becomes pale and diaphoretic. The PTA should FIRST:
- Continue activity at a slower pace
- Have the patient sit or lie down and call for assistance immediately (Correct answer)
- Document the observation and notify the PT at the end of the shift
- Apply a cold compress to the patient's forehead
Correct answer: Have the patient sit or lie down and call for assistance immediately
Signs of hemodynamic instability require immediate cessation of activity and prompt action to ensure patient safety.
Question 3: A PTA notices a patient's ROM has plateaued for three consecutive weeks. The MOST appropriate action is to:
- Discontinue PT as the patient has reached maximum benefit
- Increase treatment frequency independently
- Communicate the plateau to the supervising PT for a plan of care review (Correct answer)
- Try a completely different intervention without consultation
Correct answer: Communicate the plateau to the supervising PT for a plan of care review
A clinical plateau is a significant finding that requires the supervising PT to evaluate and potentially revise the plan of care.
Question 4: Which finding would MOST warrant immediate communication to the supervising PT?
- Mild muscle soreness 24 hours after exercise
- A 5-degree improvement in knee flexion ROM
- New onset of chest pain during treatment (Correct answer)
- Patient report of fatigue after a long walk
Correct answer: New onset of chest pain during treatment
New onset chest pain during treatment is a red flag requiring immediate cessation of activity and urgent notification of the supervising PT.
Question 5: A patient states that the prescribed home exercise program feels 'too easy.' The BEST PTA response is to:
- Independently progress all exercises without consulting the PT
- Instruct the patient to perform more repetitions than prescribed
- Inform the supervising PT and request a plan of care review (Correct answer)
- Tell the patient to push harder through any discomfort
Correct answer: Inform the supervising PT and request a plan of care review
Exercise progression is a plan of care modification that requires the supervising PT's authorization; the PTA relays the patient's feedback.
Question 6: A patient's functional outcome measure scores have declined over two consecutive visits. The PTA should:
- Assume the patient is non-compliant with home exercises
- Document findings and immediately inform the supervising PT (Correct answer)
- Wait two more visits before taking action
- Discontinue current treatment and rest the patient
Correct answer: Document findings and immediately inform the supervising PT
A pattern of functional decline is a significant clinical change that must be promptly communicated to the supervising PT.
Question 7: When applying a thermal modality, the PTA discovers the patient has significantly decreased sensation in the treatment area. The MOST appropriate action is to:
- Reduce intensity and continue the treatment
- Avoid the modality and consult the supervising PT before proceeding (Correct answer)
- Increase modality duration to compensate for reduced sensation
- Proceed with standard protocol and document the sensory deficit afterward
Correct answer: Avoid the modality and consult the supervising PT before proceeding
Impaired sensation is a contraindication to many thermal modalities because the patient cannot reliably report tissue damage.
PTA Critical Thinking 2
A patient reports increased pain after yesterday's treatment session.
What is the PTA's BEST first action?