Chapter 3
Interventions
Questions
1. At what stage of HIV is it advisable for an individual to perform moderate or intense exercise?
2. What is correct advice to give to a patient who is HIV infected?
a. Exercise is a safe and beneficial activity for the HIV-infected person.
b. Overtraining should be encouraged.
c. Athletic competition is advisable for individuals with mild to moderate symptoms.
d. Symptomatic patients should continue aggressive exercise.
3. A patient with a diagnosis of chronic fatigue syndrome begins outpatient physical therapy. Which of the following would be an inappropriate intervention on their first day of treatment?
a. Treadmill walking uphill × 20 minutes
b. Upper body ergometer × 5 minute
c. Low-impact aquatic aerobics
4. A patient in the acute stages of fibromyalgia begins physical therapy intervention. Which of the following would be an appropriate exercise prescription for this patient?
a. Long low-load exercises of 30 minutes or more
b. Short, intense exercise sessions
c. 5 to 10 minutes of low-load exercise
5. An individual with hyperthyroidism is beginning outpatient physical therapy. What would you expect to observe clinically in this patient?
6. Which of the following is TRUE regarding rehabilitation of a patient after parathyroidectomy?
a. The patient should lie with the head down and feet elevated.
b. Upper extremity exercise should begin immediately.
c. Early ambulation is essential.
7. Which of the following will occur with adhesive capsulitis associated with diabetes?
a. Loss of external rotation and adduction
b. Equal limitation in external rotation and internal rotation
c. Limitation in hyperextension and internal rotation mostly
8. Which of the following is correct advice for a patient with type 2 diabetes undergoing an exercise program?
a. Exercise is a valuable treatment modality for type 2 diabetes.
b. Hypoglycemia is a common problem for the individual with type 2 diabetes initiating an exercise program.
c. Exercise can be initiated if blood glucose levels are 60 mg/dL or less.
d. It is advisable to begin vigorous exercise 1 hour before attempting to sleep at night.
9. The home health PTA is currently treating a patient with a diagnosis of hepatic encephalopathy. The patient reports that yesterday he had unusual black/tarry stools. What should the PTA do after learning this information?
b. Decrease intensity of treatment
c. Contact the referring physician/supervising physical therapist
10. The PTA is providing intervention for a patient in the hospital diagnosed with acute pancreatitis. The patient asks the PTA what positions may relieve the abdominal pain. Which of the following is incorrect advice to give this patient?
11. A patient with diabetes is receiving physical therapy intervention. Which of the following would NOT be a focus of treatment?
12. Which of the following statements is TRUE about range of motion (ROM) of the diabetic foot?
a. Limitations are of minor concern in the formation of a neuropathic wound.
b. ROM limitations may cause abnormal peak pressures during gait and thereby contribute to ulcer formation.
c. Measuring ROM during a foot examination is important only if there is an ulcer present.
d. Only ankle dorsiflexion limitations affect the risk for ulceration.
13. A 14-year-old baseball player has type 1 diabetes and uses an insulin pump. His teammates want to know more about this condition. You inform them that all the following statements concerning insulin are true EXCEPT which one?
a. It facilitates glucose transport out from the cell and into the blood.
b. It is secreted from beta cells in pancreas.
c. It decreases blood glucose levels.
d. It may be present in decreased levels in those with type 2 diabetes mellitus.
14. To decrease the risk for hypoglycemia in a patient with type 1 insulin-dependent diabetes, which of the following is inappropriate?
a. Eat or drink a snack high in carbohydrates 30 minutes before exercise.
b. Exercise muscles that have not had an insulin injection recently.
c. Eat a carbohydrate snack for each 30 to 45 minutes of exercise.
15. A PTA is discussing appropriate exercise parameters for a patient with type 2 diabetes. Which statement reflects inappropriate advice to the patient?
a. Do not begin exercise if blood glucose is higher than 100 mg/dL.
b. Be sure to stay adequately hydrated.
c. Avoid insulin injections in the active extremities within 1 hour before exercise.
d. Exercise at moderate intensity and use the Borg Scale of Perceived Exertion to help determine response to exercise.
16. What is the most important component of an exercise program to improve a patient’s endurance after a period of deconditioning?
17. A patient is just beginning exercise after a long bout with pneumonia. The PTA begins to walk the patient down the hall of an inpatient facility. The patient’s heart at rest was 86 beats/minute, and 2 minutes into the ambulation the PTA notices the heart rate is now 74 beats/minute. What is the appropriate course of action by the PTA?
b. Stop ambulation immediately and have the patient sit down
c. Increase the intensity of ambulation
18. A patient is beginning an exercise program in outpatient physical therapy after a significant period of deconditioning. Of the choices that follow, which is the most important to include in this patient’s deconditioning program?
19. A patient is beginning an exercise program. Assuming that the patient has not exercised in several years, what would be their target heart rate?
a. 30% to 40% of the estimated maximum heart rate
b. 40% to 50% of the estimated maximum heart rate
c. 55% to 65% of the estimated maximum heart rate
20. What should be the frequency of exercise for a severely deconditioned patient beginning therapy intervention?
21. What is the correct position for bronchial drainage of anterior segments of both upper lobes?
22. What is a major benefit of diaphragmatic breathing?
a. Enhanced expansion and ventilation of the upper lobes
c. Improvement in postural deficits of the thorax
23. What changes does pursed-lip breathing achieve?
24. Which of the following physical therapy interventions is most likely to help a patient with dyspnea?
25. Strength in what muscle groups is needed most for effective coughing?
a. Expiratory muscles of the thorax, and lumbar extensors
b. Inspiratory muscles of the thorax, and abdominal muscles
c. Expiratory muscles of the thorax, and abdominal muscles
26. What is generally the first sign of respiratory distress with inadequate oxygenation during exercise?
27. Which of the following are considered primary accessory muscles of inspiration?
a. Abdominals and back extensors
b. Sternocleidomastoid and scalene muscles
c. Sternocleidomastoid and lumbar extensors
28. What strategy for airway clearance is described by the following: The patient is instructed to take a medium breath then tighten the abdominal muscles firmly while forcibly exhaling with an open glottis. The patient should return to normal gentle breathing for approximately 30 seconds and then forcibly exhale with an open glottis?
29. A patient with cystic fibrosis recently was involved in a motor vehicle collision. The patient has increased intracranial pressure. Because of the advanced stage of cystic fibrosis, the patient requires postural drainage and chest physical therapy for the right middle lobe of the lung. What is the correct positioning for this intervention?
a. Patient in left side-lying position with the foot of the bed elevated 14 inches
c. Patient in left side-lying position on a flat bed
d. Patient in left side-lying position with the foot of the bed raised 20 inches
30. When should PTAs use vibration to loosen secretions in the lungs of a patient with chronic obstructive pulmonary disease?
31. What is the correct position to reduce dyspnea in patients with severe limitations of inspiratory pressure associated with chronic obstructive pulmonary disease?
32. In a patient with heart failure, which of the following would NOT be a reason to terminate the session?
33. Which of the following is incorrect information regarding exercise intervention in a patient after heart transplantation?
a. The patient should perform an adequate warm-up and cool-down.
b. The patient should adhere to sternal precautions.
c. Weight-bearing exercises may reduce the bone loss caused by needed medication.
34. Short bouts of moderate-intensity exercise are safe and effective for improving which of the following in patients with heart failure?
35. Which type of exercise should be avoided by patients with heart failure?
36. At what point on the angina scale should the patient stop exercising?
37. Which of the following activities would have the highest MET range?
38. What are the three most important factors affecting the risk for exercising patients with heart failure?
a. Age, intensity of exercise, and presence of ischemic heart disease
b. Age, fluid retention levels, gender
c. Patient participation level, age, intensity of exercise
d. Presence of ischemic heart disease, age, and fluid retention levels
39. A patient with a functional capacity of less than 3 METs is beginning cardiac rehabilitation. About how long will the patient be able to tolerate exercise before resting?
40. Which of the following interventions is NOT indicated for patients receiving mechanical ventilation?
b. Functional and exercise training
c. Deep-breathing exercises or other techniques to increase ventilation
41. In which of the following scenarios is it acceptable to continue functional exercises with a patient diagnosed with respiratory failure?
42. Which of the following muscles is considered a muscle of accessory expiration?
43. Which of the following interventions should NOT be used with manual lymphatic drainage?
44. Six months after completing a course of complete decongestive physical therapy, a patient with secondary lymphedema after axillary lymph node dissection presents with 20-lb weight loss and a rapid 30% increase in the girth of her affected limb. Which of the following should you do?
a. Increase the hours per day that she wears a compression garment
b. Inform your supervising physical therapist or the patient’s physician
c. Recommend that the patient eat less protein
45. Manual lymphatic drainage should NOT be performed on patients with which condition?
46. Which of the following is NOT a permanent precaution for a person with lymphedema?
a. No blood pressure measurements on the involved extremity
b. No cold packs to the affected extremity
c. No needle sticks or blood draws to the affected extremity
d. Immediate and careful treatment and follow-up of any break in the skin on the affected limb
47. In which of the following cases would it be NOT advisable to use compression therapy?
a. A patient with a venous ulcer
b. A patient with an ankle-brachial index of 1
c. A patient with congestive heart failure
48. Of the choices given, what is the correct frequency of aerobic exercise for an obese person to produce significant weight loss?
49. Which of the following laboratory values represents a contraindication to physical therapy intervention?
50. Which of the following is a postoperative factor that will influence the rate of recovery after chest surgery?
51. What stage of cardiac rehabilitation occurs in the hospital?
52. Generally how long does a phase II cardiac rehabilitation last?
53. At what stage of a seven-step inpatient rehabilitation program for myocardial infarction can a patient ambulate about 500 feet?
54. If a patient is in the prone position, what lobes of the lungs are being drained with postural drainage techniques?
55. During periods of intense physical activity, many physiologic adaptations occur, especially in the circulatory system. Which of the following occurs during increased physical exertion?
56. A patient is referred to physical therapy with a secondary diagnosis of hypertension. The physician has ordered relaxation training. The PTA first chooses to instruct the patient in the technique of diaphragmatic breathing. Which of the below is the correct set of instructions?
a. Slow breathing rate to 8 to 12 breaths/minute, increase movement of the upper chest, and decrease movement in the abdominal region.
b. Slow breathing rate to 12 to 16 breaths/minute, increase movement of the abdominal region, and decrease movement in the upper chest.
c. Slow breathing rate to 8 to 12 breaths/minute, increase movement of the abdominal region, and decrease movement in the upper chest.
d. Slow breathing rate to 12 to 16 breaths/minute, increase movement of the upper chest, and decrease movement in the abdominal region.
57. Which of the following statements is FALSE about cardiovascular response to exercise in trained and/or sedentary patients?
a. If exercise intensities are equal, the sedentary patient’s heart rate will increase faster than the trained patient’s heart rate.
b. Cardiovascular response to increased workload will increase at the same rate for sedentary as it will for trained patients.
c. Trained patients will have a larger stroke volume during exercise.
d. The sedentary patient will reach anaerobic threshold faster than the trained patient, if workloads are equal.
58. Which of the following is incorrect advice to give to a patient with a diagnosis of congestive heart failure that complains of shortness of breath and “smothering” while attempting to sleep?
a. Sleep with the head on two or three pillows.
c. Sleep in a recliner during exacerbations.
d. During exacerbations, come a standing position for short-term relief.
59. A 53-year-old man with chronic obstructive pulmonary disease reports to an outpatient cardiopulmonary rehabilitation facility. Pulmonary testing reveals that forced expiratory volume in 1 second (FEV1) and vital capacity (VC) are within 60% of predicted values. What is the appropriate exercise prescription?
a. Exercise at 75% to 80% of the target heart rate three times per week.
b. Begin exercise with levels of 1.5 METs and increase slowly three times per week.
c. Exercise at 75% to 80% of the target heart rate seven times per week.
d. Begin exercise with levels of 1.5 METs and increase slowly seven times per week.
60. A PTA is ordered by a physician to treat a patient with congestive heart failure in an outpatient cardiac rehabilitation facility. Which of the following signs and symptoms should the PTA NOT expect?
61. Which instruction should be followed for strengthening exercises in persons with hemophilia?
a. Begin as soon as a joint bleed is recognized.
b. Never include isokinetic exercises.
c. Increase exercises using high-repetition, low-load progressive resistance exercises.
62. A patient with cryoglobulinemia presents to outpatient physical therapy with complaints of lumber pain. Which of the following should the PTA avoid during intervention for this diagnosis?
63. The PTA is treating a patient with a history of coronary artery disease. During the treatment, the patient complains of recurring angina that increases when performing activities in standing. Which is the MOST appropriate course of action by the PTA?
a. Stop treatment and contact the supervising physical therapist.
b. Stop treatment until symptoms subside.
c. Assist patient in taking medication for chest pain
64. A patient who sustained a severe heart attack was categorized at a MET level of 2 to 3. The patient has completed the goal of doing homemaking activities, such as washing dishes and ironing. The PTA should progress intervention to include which occupational task?
65. A patient with emphysema complains of shortness of breath and generalized weakness in the upper extremities when performing daily chores. The PTA should encourage which of the following?
a. Pursed lip breathing when working
b. Gravity-assisted exercises before performing chores
c. Use of oxygen with daily activities
66. Persuading a sedentary patient to become more active, the PTA explains the benefits of exercise. Which of the following is an inappropriate list of benefits?
a. Increased efficiency of the myocardium to obtain oxygen, decreased high-density lipoprotein (HDL) cholesterol, and decreased cholesterol
b. Decreased low-density lipoprotein (LDL) cholesterol, decreased triglycerides, and decreased resting blood pressure
c. Increased efficiency of the myocardium to obtain oxygen, decreased cholesterol, and decreased LDL
d. Decreased resting blood pressure, decreased LDL, and increased HDL
67. The PTA is working in an outpatient cardiac rehabilitation facility. A 50-year-old healthy man inquires about the correct exercise parameters for increasing aerobic efficiency. Which of the following is the most correct information to convey to this individual?
a. Exercise at 80% to 90% of maximal volume of oxygen utilization.
b. Exercise with heart rate between 111 and 153 beats/minute.
c. Exercise at about 170 beats/minute.
d. Exercise at level 17 or 18 on the Borg Scale of Perceived Exertion.
68. What lobe of the lungs is the PTA attempting to drain if the patient is in the following position: resting on the left side, rolled ¼ turn back, supported with pillows, with the foot of the bed raised 12 to 16 inches.
a. Right middle lobe, lingular segment
b. Left upper lobe, lingular segment
c. Right upper lobe, posterior segment
69. The PTA works in a cardiac rehabilitation setting. Which of the following types of exercises is most likely to be harmful to a 64-year-old man with a history of myocardial infarction?
70. To determine whether an exercise session should be terminated, the patient is asked to assess level of exertion using the Borg Scale of Perceived Exertion. The patient rates the level of exertion as 9 on the scale of 6 to 19. A rating of 9 corresponds to which of the following?
71. A physician orders stage II cardiac rehabilitation for a patient. The orders are to exercise the patient below 7 METs. Which of the following is a contraindicated activity?
72. A PTA is treating a patient with cystic fibrosis who has just walked 75 feet before experiencing significant breathing difficulties. In an effort to assist the patient in regaining her normal breathing rate, the PTA gives a set of instructions. Which of the following set of instructions is appropriate?
a. Take a slow, deep breath through pursed lips and exhale slowly through your nose only.
b. Take small breaths through your nose only and exhale quickly through pursed lips.
c. Breath in through your nose and exhale slowly through pursed lips.
d. Breath in through pursed lips and breath out slowly through pursed lips.
73. A PTA is treating a 65-year-old man with chronic obstructive pulmonary disease. The patient questions the benefits of the flow incentive spirometer left in the room by the respiratory therapist a few minutes ago. Which of the following is an appropriate response to the patient’s question?
a. It gives visual feedback on lung performance.
b. You should use this for the rest of your life.
c. You need to ask the respiratory therapist this question.
74. Which of the following exercises does NOT increase strength of the muscles of forceful inspiration?
75. All of the following cardiopulmonary function variables will increase in children in response to training EXCEPT which?
76. Which is NOT a maternal response to mild to moderate exercise?
77. What is the most effective approach for treating calcification of tendons within the shoulder?
78. Which of the following amputations will have the most edema postoperatively?
79. Which of the following muscle groups is most important for increasing strength after a transtibial amputation?
80. A client with a diagnosis of stomach cancer is beginning a general strengthening program at outpatient physical therapy. Weight training has been prescribed by the supervising physical therapist. Which of the following is an appropriate program for this patient?
a. Low repetition, high weight with a Borg Scale of Perceived Exertion rating of 14 or above
b. High repetition, low weight with a Borg rating of 14 or below
c. Low repetition, high weight with a Borg rating of 14 or below
d. High repetition, low weight with a Borg rating of 14 or above
81. What is the youngest age that children can begin strength training safely?
82. A 70-year-old patient asks the PTA about beginning an exercise program. The PTA explains some of the benefits of exercise for this individual. Which of the following is NOT a benefit of exercise for an individual in this age group?
83. With aging, what two joints are the most susceptible to proprioception decline?
84. A 15-year-old boy has just initiated a strength training program in a local gym. The client tells the PTA that he feels his strength has increased markedly over the first 3 to 4 weeks of this program. This initial gain is due to what phenomenon?
85. Which of the following is NOT a strength training benefit in the geriatric patient population?
a. Producing substantial increases in strength and power
b. Normalizing blood pressure in those with high normal values
c. Reducing insulin resistance
86. A 45-year-old man informs the PTA that he is beginning an endurance training program. The patient reports he is performing his program 2 days per week, at less than 50% maximal uptake, and for about 5 minutes. What is the correct advice to give this individual?
a. This is an adequate program to increase endurance.
b. The patient should maintain this current level for 2 weeks then increase his exercise intensity.
c. This exercise program is not adequate for increasing an individual’s endurance.
d. The PTA is not qualified to comment on this individual’s exercise program.
87. A patient is referred to physical therapy secondary to a diagnosis of infectious septic knee arthritis. What is the treatment of choice early in this patient’s rehabilitation?
88. A patient has recently undergone surgery for an infection of the bursae in the hand. What is the appropriate course of rehabilitation for this patient?
a. Splinting and gentle passive range of motion
b. Early active range of motion exercise
c. Therapy should be delayed for 2 weeks after surgery
89. Which of the following choices describes a rotationplasty?
a. A custom-made rotating hinge prosthesis is implanted at the knee.
b. The leg is amputated above the knee, and the tibia bone from the lower leg is inverted, making it possible for the ankle end of the tibia to be fused to the bottom of the femur.
c. The tibia is resected, and the ankle joint is fused to the distal tibia at 180 degrees.
d. The surgeon removes the affected bone in the femur, rotates the lower portion of the leg 180 degrees so that the foot faces in the opposite direction, and reattaches it to the upper femoral area.
90. Which of the following activities should be avoided by patients with a diagnosis of osteoporosis?
91. Which of the following is the least effective treatment for Osgood-Schlatter syndrome?
92. How long does morning stiffness associated with osteoarthritis typically last?
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
