TEST BANK for Therapeutic Exercise Foundations and Techniques 8th Edtion by John Kisner, Carolyn; Co

Chapter 1: Therapeutic Exercise: Foundational Concepts

Multiple Choice

1. The ability of the neuromuscular system, using muscle synergistically, to hold a body segment in a stationary position is the definition of: A. balance B. neuromuscular control C. postural control D. stability ANS: D KEY: Book Part: Part I: General Concepts DIF: Intermediate

2. The combination of the sensory and motor systems that enables synergists, agonists, antagonists, stabilizers, or neutralizers to anticipate proprioceptive and kinesthetic information to create coordinated movements is the definition of: A. coordination B. mobility C. muscle performance D. neuromuscular control ANS: D KEY: Book Part: Part I: General Concepts DIF: Intermediate

3. Based on the International Classification of Functioning, Disability and Health (ICF), which of these terms describes the problems an individual may experience with involvement in life situations such as self-care, workplace responsibilities, or social activities?

A. activity limitations B. body function impairments C. environmental factors D. participation restrictions ANS: D KEY: Book Part: Part I: General Concepts DIF: Basic

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4. Based on the International Classification of Functioning, Disability and Health (ICF), which of these terms describes the difficulties an individual may have in executing actions, tasks, and activities?

A. activity limitations B. body function impairments C. environmental factors D. participation restrictions ANS: A KEY: Book Part: Part I: General Concepts DIF: Basic

5. Which of these impairments arise directly from the health condition?

A. indirect impairments B. primary impairments C. secondary impairments D. tertiary impairments ANS: B KEY: Book Part: Part I: General Concepts DIF: Basic

6. Which of these factors is the least important consideration for the PTA when designing a patient-centered therapeutic exercise program?

A. health literacy B. past performance / adherence C. patient motivation / concerns D. PTA / patient rapport ANS: D KEY: Book Part: Part I: General Concepts DIF: Difficult

7. Activities such as walking or ascending stairs (tasks that involve repetitive movements with no distinct beginning or end) are examples of which type of motor tasks?

A. continuous tasks B. discrete tasks

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C. repetitive tasks D. serial tasks ANS: A KEY: Book Part: Part I: General Concepts DIF: Intermediate

8. Based on the Taxonomy of Motor Tasks, which of these activities of daily living (ADL) examples would be the most complex?

A. sipping a drink on a boat B. standing on a moving bus C. walking a large pet on a leash D. walking around children playing ANS: C KEY: Book Part: Part I: General Concepts DIF: Difficult

9. At which stage of motor learning does a patient/client focus on consistency, efficiency, refining movement timing, and exploration of task performance in different environments?

A. associative stage B. autonomous stage C. cognitive stage D. practice stage ANS: A KEY: Book Part: Part I: General Concepts DIF: Intermediate

10. When choosing the type of practice for motor learning, which of these practice types specifically involves the same task or series of tasks performed in the same conditions and in a predictable order?

A. blocked-order practice B. part practice C. physical practice D. random-order practice ANS: A KEY: Book Part: Part I: General Concepts DIF: Intermediate

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11. Using the principles of motor learning, a PTA has a patient practicing sit to/from stand in a circle of chairs. Each chair in the circle is a different height and style. The patient is instructed to move from sit to stand and sit down again three times at a single chair before moving on to the next chair in the circle. This is an example of which type of practice?

A. blocked-order practice B. part practice C. random-order practice D. random/blocked order practice ANS: D KEY: Book Part: Part I: General Concepts DIF: Difficult

12. Which type of feedback provides information about the average performance of several repetitions of a motor skill?

A. delayed feedback B. postresponse feedback C. summary feedback D. terminal feedback ANS: C KEY: Book Part: Part I: General Concepts DIF: Basic

13. Which type of feedback involves proprioceptive, visual, or tactile cues delivered during the performance of a task?

A. augmented feedback B. extrinsic feedback C. intrinsic feedback D. knowledge of results ANS: C KEY: Book Part: Part I: General Concepts DIF: Basic

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14. A PTA is emphasizing a greater number and variety of movements that are of increasing complexity, allowing the patient to practice independently while problem-solving using intrinsic feedback. This patient is in the ___ stage of motor learning.

A. associative stage B. autonomous stage C. cognitive stage D. practice stage ANS: A KEY: Book Part: Part I: General Concepts DIF: Difficult

15. A PTA sets up a series of progressively more difficult tasks that the patient will perform while focusing on speed and agility. The PTA expects to provide very little feedback during the task performance. This patient is in the ___ stage of motor learning.

A. associative stage B. autonomous stage C. cognitive stage D. practice stage ANS: B KEY: Book Part: Part I: General Concepts DIF: Difficult

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Chapter 2: Prevention, Health and Wellness

Multiple Choice

1. Which of these is not a risk factor for both coronary artery disease and osteoporosis?

A. body mass index of 38 B. family history C. history of smoking D. sedentary lifestyle ANS: A KEY: Book Part: Part I: General Concepts DIF: Intermediate

2. After receiving information regarding lifestyle changes necessary to lose weight, an individual believes themselves to be at greater risk of heart disease because of their weight.

Then they consider the perceived benefits of losing weight versus perceived personal barriers such as lack of time to exercise. This would be an example of which behavioral change theory?

A. health belief model B. primary prevention model C. social cognitive theory D. transtheoretical model ANS: A KEY: Book Part: Part I: General Concepts DIF: Intermediate

3. As part of the plan of care, a PTA is discussing a heart healthy exercise program. The patient reveals that she recently joined a local gym and has plans to go with a friend three days per week, starting next week. Based on the transtheoretical model of behavioral change, this patient is in which stage?

A. the action stage B. the contemplation stage C. the maintenance stage D. the preparation stage ANS: D KEY: Book Part: Part I: General Concepts

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DIF: Intermediate

4. Which of these correctly matches the age group with activity recommendations as recommended by the US Department of Health and Human Services published guidelines?

A. children/adolescents: avoid inactivity /engage in regular physical activity B. adults: 60 minutes of moderate/vigorous daily activity C. adults with disabilities: 150 minutes of moderate intensity activity per week D. older adults (65+): 75 minutes of vigorous activity per week ANS: D KEY: Book Part: Part I: General Concepts DIF: Intermediate

5. Which of these accurately reflects the physical activity recommendations for older adults, ages 65+ as recommended by the US Department of Health and Human Services published guidelines?

A. daily vigorous activity of at least 60 minutes B. include muscle strengthening activities at least three days per week C. weekly vigorous activity totaling 100 minutes, in at least 20-minute intervals D. weekly moderate activity totaling 150 minutes, in at least 10-minute intervals ANS: D KEY: Book Part: Part I: General Concepts DIF: Intermediate

6. Which of these is an accurate goal for a fitness program for an individual with developmental delays?

A. aim for 4 sets of 15-minute bouts B. aim to expend 500 calories/day C. include 20 minutes of flexibility exercise D. include 40 minutes of strength training ANS: A KEY: Book Part: Part I: General Concepts DIF: Basic

7. Which of these mindfulness qualities allows for the temporary suspension of preconceived expectations to allow for new learning?

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A. acceptance B. letting go C. not knowing D. present moment ANS: C KEY: Book Part: Part I: General Concepts DIF: Basic

8. Which of these mindfulness qualities is directed at being fully aware on one’s experience just as it is, without trying to force or change that experience?

A. letting go B. non judging C. non striving D. present moment ANS: C KEY: Book Part: Part I: General Concepts DIF: Basic

9. Which of these mindfulness qualities recognizes that life is change and embraces an openness to those changes?

A. acceptance B. fundamental kindness C. letting go D. non striving ANS: C KEY: Book Part: Part I: General Concepts DIF: Basic

10. An active process through which people become aware of, and make choices toward a more successful existence is the definition of…

A. health promotion B. healthy C. quality of life D. wellness ANS: D KEY: Book Part: Part I: General Concepts

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DIF: Basic

11. Which of these is not one of the Six Dimensions of Health, as described by the National Wellness Institute?

A. emotional B. intellectual C. nutritional D. occupational ANS: C KEY: Book Part: Part I: General Concepts DIF: Intermediate

12. A PTA implements a plan of care for an 80-year-old female with a diagnosis of osteoporosis that includes fall prevention activities. This is an example of which type of prevention?

A. primary prevention B. secondary prevention C. tertiary prevention ANS: B KEY: Book Part: Part I: General Concepts DIF: Difficult

13. During a health and wellness screening a client reports a secure sense of self-identity, a positive sense of self-regard, and effective stress management skills. These are all items within which domain of wellness?

A. emotional B. psychological C. social D. spiritual ANS: A KEY: Book Part: Part I: General Concepts DIF: Difficult

14. During a health and wellness screening a client reports that they are living a life that has a positive sense of meaning and purpose, that builds effective relationships with God, neighbors, and self. These are all items within which domain of wellness?

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A. emotional B. intellectual C. social / family / friends D. spiritual / faith life ANS: D KEY: Book Part: Part I: General Concepts DIF: Difficult

15. In developing a basic wellness program for a client that includes aerobic activities, strength training, and flexibility exercises, the PTA considers the balance of positive versus negative reinforcement, high success tasks with frequent rewards, and an overall plan with low failure risk. These considerations are all key elements in which type of motivation?

A. intrinsic motivation B. overall motivation C. performance motivation D. task motivation ANS: C KEY: Book Part: Part I: General Concepts DIF: Difficult

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Chapter 3: Range of Motion Please see corrections for #10 & 12.

Multiple Choice

1. A PTA explains the benefits of passive range of motion to a patient with a diagnosis of cerebral vascular accident (CVA) with left hemiplegia. Which of the following is not correct regarding passive range of motion?

A. passive range of motion aids in nutrition of articular cartilage B. passive range of motion can minimize the potential for contracture development C. passive range of motion will assist with circulation, enhancing venous return D. passive range of motion will prevent muscle atrophy from occurring ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

2. Which of the following is not an immediate goal of active range of motion exercise A. to increase proprioceptive and kinesthetic sensory feedback B. to maintain contractility throughout the available range of motion C. to promote muscle coordination D. to stimulate bone and tissue integrity ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

3. A PTA is instructing a patient on utilizing equipment to assist with range of motion exercises.

Which of the following is not a typical piece of equipment used with active assisted range of motion?

A. CPM machine B. finger ladder C. overhead pulleys D. straight cane ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

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4. Which of these is not true regarding mobility impairments?

A. arthrokinematic factors can influence the available range of motion B. hypermobility and instability issues can be addressed with the same treatments C. mobility impairments can be due to adaptive shortening or contractures D. mobility impairments can involve hypermobility as well as hypomobility ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

5. Which of these is not a benefit of the post-operative use of a CPM machine?

A. promotes functional scar tissue development of the healing incision B. promotes synovial regeneration within the inflamed joint C. prevent the development of adhesions and contractures D. stimulates functional healing of tendons & ligaments ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

6. Which of these is not a goal or indication for the use of passive range of motion (PROM)?

A. PROM can be used as a teaching tool for stretching activities B. PROM can be used when a contraction would disrupt healing C. PROM can be used when active range of motion is too painful D. PROM can prevent strength loss during immobilization ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

7. A PTA is working with a post-operative rotator cuff repair patient that is absolutely restricted from any active range of motion. While doing passive range of motion which of the following would be the most reliable indicator that the patient is actively trying to help do the motion?

A. biofeedback using surface EMG electrodes on target muscles B. palpation of the prime movers while doing passive range of motion C. patient complaints of pain during the motion, especially at end range D. visual observation of muscle twitching in the target muscles

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ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

8. Which of the following is not a suitable situation for the use of active assisted range of motion exercises?

A. with a patient after a stroke, for a muscle group with 2/5 strength while moving against gravity B. with a patient after removal of an orthosis, to increase range of motion in a muscle with a contracture C. with a patient in the return to function phase, when focusing on correct performance of a motion D. with a patient who has a post-operative condition that does not permit a full, strong muscle contraction ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

9. Which of these is best suited for the objective measurement of the available range of motion?

A. a straight leg raise test B. flexibility testing C. muscle length testing D. standardized goniometry ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

10. The distance that a muscle can shorten after it has been elongated to its maximum is best known as: A. flexibility B. functional excursion C. mobility D. range of motion ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

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11. While a patient is standing upright, the left hamstring muscles are fired to bring the knee into full flexion, but the hamstrings are then unable to also bring the hip into full extension at the same time. This is an example of: A. active insufficiency B. passive insufficiency ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

12. Which of these is a goal of active range of motion that is not possible with passive range of motion?

A. enhance synovial movement for cartilage nutrition B. maintain mechanical elasticity of a muscle C. maintain physiologic elasticity and contractility of a muscle D. minimize the formation of muscle contractures ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate 13. Which of these patients is not a candidate for range of motion exercises?

A. cervical fracture with C5 spinal cord injury, prior to spinal stabilization B. immediate post-operative percutaneous transluminal coronary angioplasty C. immediate post-operative total hip arthroplasty using a posterior approach D. mechanically ventilated patient following a period of sedative interruption ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

14. With a patient positioned in supine, the PTA supports the patient’s right arm loosely and comfortably at the wrist and hand. Which motion must be allowed to occur to achieve full shoulder abduction?

A. elbow flexion B. shoulder extension C. shoulder external rotation D. shoulder horizontal adduction ANS: C

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KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

15. To effectively reach the full, normal range of motion of the long head of the triceps brachii muscle, the PTA should position the patient in: A. hook-lying B. prone C. short sitting D. supine ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

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Chapter 4: Stretching for Impaired Mobility Multiple Choice

1. Which of these terms best describes the ability of the body to move through the range of motion?

A. flexibility B. functional mobility C. relative flexibility D. stiffness ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

2. When a PTA develops a stretching program that fits the patient’s lifestyle and that the patient is likely to follow, it is reasonable to expect improvement in all of the following areas except: A. cardiorespiratory performance B. functional performance C. muscle flexibility D. muscle performance ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

3. Which of the following is not an expected outcome associated with poor flexibility?

A. faulty movement patterns in adjacent joints B. localized discomfort in the inflexible tissue C. severe limitations in daily functional activities D. stretch weakness of agonistic muscle groups ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

4. In which of the following cases would stretching not be indicated?

A. a patient after a stroke with shoulder flexion that is limited to 135 degrees

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B. an individual with a severe hip flexor contracture due to prolonged immobilization C. gastrocnemius-soleus stiffness in a swimmer who specializes in 100-meter butterfly D. greater than normal finger flexion tightness in a patient with a C6 spinal cord injury ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

5. Which of these is a correct statement regarding stretching?

A. a carefully selected program of low-load, long duration stretching may correct capsular tightness B. pre-activity stretching will increase all aspects of event performance, particularly in high level athletes C. posture and stabilization do not matter as long as the patient “feels the stretch” with every repetition D. proper stretching is vital to all stages of healing, including the acute inflammatory phase of rehabilitation ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

6. Which of the following correctly matches the muscle stretch receptors / sensors with their normal physiologic function?

A. the Golgi Tendon Organ monitors tension and adjust the force of the agonist muscle during a stretch B. the Golgi Tendon Organ prevents damage during stretching by facilitating surrounding muscles C. the muscle spindle receives and conveys information regarding the rate and strength of fiber contraction D. the muscle spindle responds to gradual changes in velocity and muscle length changes ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

7. Which type of stretch is preferred for a well-trained athlete when being performed as a warmup for explosive activities?

A. ballistic stretching B. dynamic stretching

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C. low load long duration stretching D. PNF stretching E. static stretching ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

8. What type of stretch involves quick, repetitive movements that oscillate in and out of the available range of motion?

A. ballistic stretching B. dynamic stretching C. low load long duration stretching D. PNF stretching E. static stretching ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

9. A patient is instructed to stretch all muscles of the lower leg, using available equipment as necessary, and performing all stretches for 10 repetitions without assistance. Which type of stretching does this describe?

A. overstretching B. PNF stretching C. selective stretching D. self stretching ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

10. Which of these is true regarding proper alignment when stretching the hamstring muscles?

A. the ankle should be positioned in full dorsiflexion B. the hip should be positioned in full extension C. the knee should be positioned in full extension D. the pelvis should be positioned in a full posterior tilt ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques

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DIF: Intermediate

11. A PTA is providing intervention for a patient with a diagnosis of right elbow flexion contracture. As the soft tissues are stretched, the biceps brachii is elongated past the point of tissue resistance and then held in the lengthened position for a sustained amount of time. This is called...

A. ballistic stretching B. cyclic stretching C. dynamic stretching D. static stretching ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

12. A PTA is planning a home stretching program for a patient who has an extremely low pain tolerance. To increase patient compliance, this program will primarily rely on which type of stretching that is known to have a lower possibility of residual soreness?

A. ballistic stretching B. dynamic stretching C. low load long duration stretching D. PNF stretching E. static stretching ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

13. A PTA is providing stretching intervention for a ballet dancer who is trying to increase hip adduction range of motion. The goal is to achieve an aggressive increase in that range by taking advantage of neuromuscular interaction. While the increase is only temporary the dancer can take advantage of that temporary gain, incorporating the newly gained range into their daily dance and practice routine. Which is the stretch of choice for this situation?

A. ballistic stretching B. dynamic stretching C. low load long duration stretching D. PNF stretching E. static stretching ANS: D

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KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

14. Of all the cliché statements that athletes (and therapists) use to motivate, which of these would accurately apply to stretching?

A. “Never compete without pregame stretching” B. “No pain, no gain” C. “Use it or lose it” D. “Winners don’t cry.”

ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

15. Which of these contractures is the result of hypertonicity associated with central nervous system lesions or pain related muscle guarding?

A. arthrogenic contracture B. fibrotic contracture C. myostatic contracture D. pseudomyostatic contracture ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

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Chapter 5: Peripheral Joint Mobilization

Multiple Choice

1. Which of these is least likely to alter joint mechanics and lead to impaired range of motion?

A. conditionals causing pain B. conditions causing swelling C. impaired circulation D. joint capsule adhesions ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

2. Which of these is not considered a joint mobilization technique that addresses capsular restrictions?

A. high velocity thrusts B. manipulation C. oscillations D. self-stretching ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

3. To clearly distinguish between thrust and non-thrust mobilization and/or manipulation techniques, all of these should be documented except: A. the direction of force B. the range of movement C. the rate of movement D. the target muscles ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

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4. A self-stretching technique that specifically uses joint traction or glides to direct the stretch force to specific parts of the capsule is known as: A. auto-mobilization B. high velocity thrust C. mobilization with movement D. thrust manipulation ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate 5. Movements in the joint and surrounding tissues that are involuntary but necessary for normal range of motion is the definition of: A. accessory movements B. auto-mobilization C. joint play movements D. muscle energy motions ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

6. Which of these is not the typical position for testing joint play or applying initial joint mobilizations?

A. closed-pack position B. loose-pack position C. open-pack position D. resting position ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

7. Using active, resisted isometric contractions of deep muscles whose line of pull can cause the desired accessory motion is a technique known as: A. joint play mobilization B. manipulation under anesthesia C. muscle energy techniques D. self-mobilization techniques ANS: C

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KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

8. While moving an ovoid-shaped joint, new surfaces of one bone come in contact with new surfaces of the opposing joint surface. This arthrokinematic movement is known as…

A. glide B. roll C. slide D. spin ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

9. During application of mobilization techniques, the proximal convex surface is held still, while the distal concave surface is moved. The length of the corresponding distal bone will move or swing in which direction as compared to the moving concave joint surface?

A. opposite B. parallel C. perpendicular D. same ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

10. Regardless of whether the joint surface is concave or convex, the accessory movement of joint roll is always in which direction as compared to the swinging bone?

A. opposite B. parallel C. perpendicular D. same ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

11. Which of these is a contraindication or precaution for joint mobilization / manipulation?

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A. excessive pain in the area B. functional immobility C. muscle guarding / spasm D. reversible hypomobility ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

12. Which of these patients might be a candidate for more aggressive mobilization / manipulation techniques?

A. humeroulnar mobilization with radiographic evidence of humeral delayed-union fracture B. one year post glenohumeral arthroplasty to achieve terminal, end range shoulder flexion C. scapulothoracic mobilization with glenohumeral subluxation 3 months post stroke D. tibiofemoral mobilization with acute rheumatoid arthritis flare-up in the knee joint ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

13. When performing non-thrust oscillation techniques, which of these grades involve largeamplitude rhythmic oscillations within the available range, applied at a rate of 2 to 3 per second for 1 to 2 minutes?

A. Grade I B. Grade II C. Grade III D. Grade IV ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

14. While working with a patient with whom range of motion is contraindicated, the therapist applies gentle, intermittent distractions to inhibit pain. The distraction motion is enough to tighten surrounding tissues but stops short of stretching the capsule. This is an example of which grade of non-thrust sustained joint play techniques?

A. Grade I B. Grade II C. Grade III D. Grade IV

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ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

15. In order to achieve distraction of the glenohumeral joint, which of these positions / forces are necessary?

A. patient prone, arm resting at side; therapist applies a downward force at the posterior proximal humerus B. patient seated with arm externally rotated and abducted to approximately 120 degrees; therapist applies a force down and into the trunk C. patient supine, arm resting at side; therapist grasps the forearm just above the wrist and applies long-axis traction D. patient supine, shoulder flexed to 90 degrees, internally rotated and elbow flexed; therapist uses a waist belt looped proximally around the patient’s arm and leans back gently ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

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Chapter 6: Resistance Exercise for Impaired Muscle Performance

Multiple Choice

1. Which of these is not a key element of performance?

A. endurance B. form C. power D. strength ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

2. A 21-year-old college athlete is performing plyometric training to increase upper extremity power. The physical therapist’s plan of care includes throwing 50 passes at a stationary target, then 50 passes at a moving target. This is called: A. the detraining principle B. the overload principle C. the specificity of training D. the transfer of training ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

3. During the maintenance phase of a resistance program, which factors should be decreased following a 2 to 3-week layoff from exercising?

A. load and volume B. repetition maximum and mode C. resistance and zone D. volume and duration ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

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4. Documented strength gains in an unexercised antagonistic muscle or muscle group is an example of which principle?

A. the overload principle B. the reversibility principle C. the SAID principle D. the transfer of training principle ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

5. During strength training the target muscle is worked to the point of fatigue. Which of these is true regarding the recovery time for this muscle?

A. during recovery a build-up of lactic acid will lead to delayed onset muscle soreness B. full recovery of the exercised muscle will generally require 1 to 2 days C. microtrauma in the muscle may require up to 3 weeks to fully recover D. with light activity the muscle will almost completely recover in 3 to 4 minutes ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

6. Near the end of an exercise session a PTA observes a patient exhibiting symptom of acute muscle fatigue. Which of these will not be observed?

A. a significant decline in isokinetic peak torque B. completion of requested motions using substitute motions C. the ability to only do low intensity activities D. tremulous movements of the target muscle ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

7. What is the most appropriate intensity range for resistance training for most healthy adults?

A. 30 to 40% of the repetition maximum B. 40 to 70% of the repetition maximum C. 70 to 80% of the repetition maximum D. 80 to 90% of the repetition maximum

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ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

8. A PTA is working with a patient in the early acute phase of stroke recovery, who is beginning to have low level returns of voluntary motion in previously flaccid muscles. Which of these exercise would be the easiest starting point for this patient?

A. concentric isotonic resistance exercises B. eccentric isotonic resistance exercises C. full range isokinetic resistance exercises D. high repetition multi-angle isometrics exercises ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

9. Which of these is an indication or benefit of isometric exercises?

A. aids in the development of dynamic postural stability B. appropriately challenges acute post-myocardial infarction patients C. eliminates the risk of muscle atrophy in the exercised muscles D. protects the post-surgical structures during the healing process ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

10. Which of these correctly matches age with strength-related characteristics?

A. active elderly patients experience a 30% decline in strength and speed of contraction B. active young adults in their 20’s will begin to experience an 8% strength decline C. adolescent girls will have 3.5 times more muscle mass than boys of the same age D. sedentary elderly patients experience an 80% decline in strength in the eighth decade ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

11. Which type of activity is better to develop high-impact shock absorbing skills?

A. concentric isotonic exercises

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B. eccentric isotonic exercises C. isometric exercises D. isokinetic exercises ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

12. Which type of activity best accommodates for a painful arc of motion?

A. concentric isotonic exercises B. eccentric isotonic exercises C. isometric exercises D. isokinetic exercises ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

13. Which type of activity generates less compressive forces, particularly when performed at higher speeds?

A. concentric isotonic exercises B. eccentric isotonic exercises C. isometric exercises D. isokinetic exercises ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

14. Which of these activities is considered to be a form of dynamic constant external resistance?

A. CybexTM dynamometer B. elastic resistance bands C. hydraulic cam machine D. weight pulley machine ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

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15. A patient has a 10-repetition maximum (RM) of 20 pounds. The exercise program that they are performing begins with 10 repetitions with a 20-pound weight, followed by 10 repetitions with a 15-pound weight, and then finishes with 10 repetitions with a 10-pound weight. Which type of progressive resistive exercise (PRE) program is this patient following A. a daily adjustable progressive resistive exercise (DAPRE) program B. a DeLorme progressive resistive exercise program C. a multi-station, multi-machine circuit training program D. an Oxford progressive resistive exercise program ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

16. Dissatisfied with the traditional progressive resistive exercise (PRE) regimens, a PTA decides to switch a patient to a program that will allow for a more customized level of weight, based on daily ability and performance. Which method would be better suited to achieve this?

A. a daily adjustable progressive resistive exercise (DAPRE) program B. a DeLorme progressive resistive exercise program C. a multi-station, multi-machine circuit training program D. an Oxford progressive resistive exercise program ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

17. Which of these is not true regarding delayed onset muscle soreness (DOMS) following a bout of exercise?

A. it can be felt with stretching or active contraction B. it can cause decreased strength for 7-14 days C. it can result in decreased range of motion and local edema D. it is usually at its worst 24 hours after exercise ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

18. Which of these is the best way to prevent delayed onset muscle soreness (DOMS)?

A. always warm up completely prior to activity or event B. consistently perform regular routine exercises

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C. perform adequate cool down activities after exercises D. wear compression garments over susceptible muscles ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

19. Which of these patients is resistance exercise absolutely contraindicated?

A. 18-year-old Guillain Barre patient, during the subacute rehab phase B. post-myocardial infarction patient, during phase III of cardiac rehab C. post anterior cruciate ligament repair, during the minimal protection phase D. post cerebral vascular accident patient, as part of home exercise program ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

20. Which of these is an advantage of manual resistance exercises over mechanical resistance exercises?

A. allows for precise incremental loading of muscles B. can be used to enhance overall body endurance C. can be used with low-level or acute stage patients D. provides quantitative information for documentation ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

21. In comparison to manual resistance, which of these is a disadvantage associated with mechanical resistance?

A. can only maximally load the target muscle at one point in the range B. poorly loads very strong muscle groups at any point of the range C. requires significant personnel labor and time to effectively deliver D. uses variable and subjective loading that is difficult to document ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

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Chapter 7: Principles of Aerobic Exercise

Multiple Choice

1. Any muscle contraction that substantially increases energy consumption over resting levels is the definition of: A. endurance B. exercise C. physical activity D. physical fitness ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

2. The combination of cardiorespiratory function, endurance, strength, flexibility, and body composition as the body performs physical work is the definition of: A. endurance B. exercise C. physical activity D. physical fitness ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

3. Which of these is not an exercise variable that can be manipulated in an effort to improve aerobic conditioning?

A. frequency B. heart rate maximum C. intensity D. time E. weight ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

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4. Which of these demonstrates the specificity principle as applied to aerobic exercise?

A. developing a cycling program for a weightlifter prior to a competition B. developing a fast-paced circuit training program for the local swim team C. developing a treadmill program for a distance runner prior to a marathon D. developing a weight training program specifically for a geriatric population ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

5. Which of these is true of the adaptation that occurs in response to aerobic exercise?

A. as performance improves, maximum oxygen consumption will increase B. individuals with higher fitness levels can improve at lower levels of demand C. significant cardiovascular change will only occur at increasing levels of demand D. the same frequency, duration and intensity will continue to challenge the aerobic system ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

6. Which of these is a cardiovascular fitness testing method that would be appropriate to a 35year-old moderately active individual?

A. 1 mile walk test B. 6-minute walk test C. 12-minute run test D. variable step test ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

7. Based on currently published evidence, which of these may be the least important factor in aerobic exercise?

A. duration B. frequency C. intensity D. repetitions

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ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

8. Which of these is not a purpose of cardiovascular stress testing?

A. to determine appropriate exercise target levels B. to establish the probability of coronary disease C. to identifying the degree of coronary artery blockage D. to improve patient motivation and program adherence ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

9. When stress testing a 45-year-old male who has no symptoms of coronary heart disease, which of these would be an acceptable reason for stopping a stress test?

A. increased rate and depth of respiration B. patient requests to stop during the test C. rapid diastolic increase to 100 mm Hg D. reports of moderate fatigue while testing ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

10. What percentage of maximum oxygen consumption is an acceptable starting exercise intensity for deconditioned individuals?

A. 20% B. 40% C. 60% D. 80% ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

11. Which of these will yield a higher exercise heart rate?

A. age adjusted target heart rate

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B. blood pressure monitoring C. Karvonen’s formula D. maximum heart rate ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

12. Which of the following is an expected physiologic response to aerobic exercise?

A. decreased cardiac output B. decreased systolic blood pressure C. increased heart rate D. peripheral vasodilation of non-exercising muscles ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

13. A fitness measurement of the body’s efficiency over time and relative to fatigue is the definition of: A. endurance B. exercise C. physical activity D. physical fitness ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

14. Based on METs, which of these would be considered a heart healthy (endurance promoting) activity?

A. bicycling at 8 miles per hour B. competitive knitting C. non-competitive 6-person volleyball D. roller skating ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

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15. A sedentary 45-year-old male with no personal history of heart related problems but a strong family history of heart disease, begins an aerobic exercise program upon advice of his physician but without an ETT. What is your recommended target heart rate for this individual?

A. 85 bpm B. 105 bpm C. 125 bpm D. 155 bpm ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

16. For an individual who has completed an exercise tolerance test, how should their exercise heart rate compare to the symptom-limited heart rate?

A. exercise heart rate and the symptom-limited heart rate are completely unrelated factors B. exercise heart rate and the symptom-limited heart rate will always be the same C. exercise heart rate should exceed symptom-limited heart rate to achieve optimal conditioning D. exercise heart rate should not exceed the symptom-limited heart rate due to safety reasons ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

17. Based on American College of Sports Medicine recommendations for physical activity, what is the aerobic exercise target for children ages 6 – 17 years, exercising moderately to vigorously?

A. 20 minutes daily during recess B. 30 minutes every other day C. 60 minutes every day D. 180 minutes per week ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

18. Based on American College of Sports Medicine recommendations for physical activity, which of these is not an aerobic exercise target for adults ages 18 – 65 years?

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A. 5 minutes of vigorous intensity (greater than 6 MET level) every day B. 10 minutes of moderate intensity (3 to 6 MET level) 3 times per day, 2.5 hours per week C. 20 minutes of vigorous intensity (greater than 6 MET level) daily, 3 days per week D. 30 minutes of moderate intensity (3 to 6 MET level) per day, 5 days per week ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

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Chapter 8: Exercise for Impaired Balance

Multiple Choice

1. The perimeter of the surface contact area between the body and the supporting surface is known as the: A. base of support B. center of gravity C. center of mass D. limits of stability ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

2. For normal adults, in standing with the feet approximately 4 inches apart, the anteroposterior sway limit and the lateral sway limit is approximately how many degrees?

A. anteroposterior sway of 10 degrees; lateral sway of 14 degrees B. anteroposterior sway of 12 degrees; lateral sway of 16 degrees C. anteroposterior sway of 14 degrees; lateral sway of 18 degrees D. anteroposterior sway of 16 degrees; lateral sway of 20 degrees ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

3. Which of these symptoms is most active in providing information regarding body position and motion of the body relative to a firm, flat, and fixed surface?

A. musculoskeletal system B. somatosensory system C. vestibular system D. visual system ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

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4. What type of balance control is used for precise postural adjustments that are needed when a gymnast performs on a balance beam?

A. anticipatory control B. closed loop control C. feed forward control D. open loop control ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

5. Following perturbation, which of these movement systems responds first, is independent of task demands, and produces stereotyped muscle contractions in response to sensory inputs?

A. automatic postural reactions B. motor strategies C. stretch reflexes D. voluntary responses ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

6. This balance strategy is most often used in quiet stance, on a stable surface, and in response to small or slow perturbations: A. ankle strategy B. hip strategy C. stepping strategy D. suspension strategy ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

7. A patient is observed quickly lowering their center of gravity by flexing the hips, knees, and ankles to maintain their balance on a boat moving through moderately turbulent water. This is which type of balance strategy?

A. ankle strategy B. hip strategy C. stepping strategy

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D. suspension strategy ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

8. If an individual experiences a loss of balance during lifting a box of unknown weight that causes the body to topple backwards or necessitates taking a step backward, the person most likely: A. overestimated the weight of the box to be lifted B. failed to bring the box closer to the center of gravity C. started with a base of support that was too narrow D. underestimated the weight of the box to be lifted ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

9. For an elderly patient with poor balance and limited quadricep strength, which of these lifting techniques involves the greatest risk to their balance?

A. forward lifting with knees in a more extended position B. semi-squat forward lift with feet at shoulder width apart C. stoop lift with feet parallel and approximately 4 inches apart D. straddle lift with one leg in stance in front of the other ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

10. The most used balance strategy for patients with diabetic polyneuropathy is the: A. ankle strategy B. hip strategy C. stepping strategy D. suspension strategy ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

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11. Which of these is not a risk factor for falls in the elderly?

A. a history of falls at home B. age greater than 65 years C. diagnosed depression D. use of assistive device ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

12. A PTA assesses a patient’s balance using a standardized outcome measure that observes responses to perturbations (small or large, slow or rapid, anticipated or unanticipated). This type of testing is best suited to assessing this balance category: A. anticipatory B. dynamic C. functional D. reactive ANS: D KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

13. After reviewing the results of a series of feed forward balance assessments, including the functional reach and the multidirectional functional reach test, the plan of care would include which of these activities to address the balance deficits?

A. blindfolded activities B. catching activities C. functional activities D. transitional activities ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

14. While using the Clinical Test of Sensory Integration on Balance (CTSIB), which of these conditions will provide accurate visual and vestibular information and inaccurate somatosensory information?

A. standing on a firm surface with the eyes open B. standing on a firm surface wearing a head dome

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C. standing on a foam surface with the eyes open D. standing on foam surface with the eyes closed ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

15. When designing a balance program for a patient with moderate to severe cognitive deficits, which of these activities provide the best option for patient improvement?

A. dual task activities B. functional activities C. moving surface activities D. obstacle courses activities ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

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Chapter 9: Aquatic Exercise

Multiple Choice

1. Which of the following is not true of hydrostatic pressure?

A. hydrostatic pressure can induce bradycardia B. hydrostatic pressure can reduce or limit effusion C. hydrostatic pressure makes exercises harder to perform when closer to the surface D. hydrostatic pressure relates to Pascal’s law: increased depth equals increased pressure ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

2. Which of the following properties of water cannot be easily manipulated to either challenge and give resistance to a patient or make exercises easier for a patient participating in a poolbased aquatic exercise program?

A. buoyancy B. surface tension C. temperature D. viscosity ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

3. Your patient is 6-foot 9-inches tall and is engaged in water walking to exercise the lower extremities in 4 feet of water. Which of these concepts is accurate as related to hydrostatic pressure?

A. if the patient moves to 3 feet of water, the difficulty of exercise and ambulation will increase B. if the patient moves to 5 feet of water, the pressure on his lower extremities will decrease C. if the patient moves to 6 feet of water, the pressure on the lower extremities will be the same D. the patient may move to a horizontal floating position to increase lower extremity pressure ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

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4. The patient that is scheduled to begin pool therapy today has just informed you that she was recently diagnosed with early-stage renal failure. The PTA should: A. contact the supervising PT for clarification before proceeding with interventions B. continue with aquatic intervention but include more frequent out of water breaks C. increase the aquatic exercise intensity level by using chest level immersion D. proceed cautiously with aquatic interventions as outlined in the plan of care ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

5. A 66-year-old female with a diagnosis of fibromyalgia is attending a WATSU class for general relaxation, stretching, and pain relief. What would be the optimal temperature (in Fahrenheit) of the water for this patient?

A. 75 degrees B. 92 degrees C. 98 degrees D. 104 degrees ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

6. Prior to getting into the pool, a patient who was referred for aquatic exercises tells you that she is afraid of the water because she has lost 3 family members to drowning deaths in the past 10 years. Is her fear of water a precaution or contraindication to aquatic therapy?

A. Contraindication B. Precaution ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

7. What is the maximum immersion time for a patient with a non-compromised cardiopulmonary system who will be pool walking at chest depth?

A. 10 minutes B. 20 minutes C. 30 minutes

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D. up to 2 hours ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

8. A patient with a left transfemoral amputation has difficulty maintaining her position in the pool during aquatic exercise. The PTA places a flotation belt around her with most of the foam on the patient’s right side. This action is manipulating which of these properties of water?

A. buoyance B. center of buoyancy C. drag D. surface tension E. viscosity ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

9. The cumulative effect of both turbulence and fluid viscosity acting on the body is known as: A. drag B. flow C. laminar flow D. turbulent flow ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

10. Following knee surgery, a patient is restricted to toe-touch weight bearing. What is the minimum level of submersion for aquatic walking that will achieve this?

A. at the level of the spinous process of C7 B. at the level of the xiphoid process C. between C7 and the xiphoid process D. between the xiphoid and the umbilicus E. level with the anterior superior iliac spine ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Intermediate

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11. Which of these is not a clinically significant impact of buoyancy?

A. active range of motion is easier due to relative weightlessness created by buoyancy B. fat tissue has a lower specific gravity so obese patients will have increased buoyancy C. buoyancy will decrease when the lungs are fully inflated and increase when deflated D. strengthening can occur when the direction of motion is against the force of buoyancy ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

12. A patient uses a foam ankle cuff to facilitate hip flexor stretching while submerged in the pool at chest level. This use of equipment takes advantage of which of these properties?

A. buoyancy B. drag C. laminar flow D. viscosity ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

13. Which of these correctly pairs a physical property of water with the principle or law upon which it is based?

A. buoyancy is based upon Pascal’s law B. drag is based upon hydromechanics principles C. hydrostatic pressure is based upon Archimedes principle D. surface tension is based upon the law of thermodynamics ANS: B KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Difficult

14. A physically fit individual is performing intense deep water running, training above 80% of maximum heart rate. What is the appropriate pool temperature for this activity?

A. 22 – 26 degrees Celsius B. 26 – 28 degrees Celsius C. 30 – 35 degrees Celsius

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D. above 37 degrees Celsius ANS: A KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

15. What is the maximum temperature threshold for a patient with heat-intolerant multiple sclerosis to prevent fatigue with immersion?

A. 29 degrees Celsius B. 31 degrees Celsius C. 33 degrees Celsius D. 35 degrees Celsius ANS: C KEY: Book Part: Unit 2: Applied Science of Exercise and Techniques DIF: Basic

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Chapter 10: Soft Tissue Injury, Repair, and Management

Multiple Choice

1. The incomplete or partial displacement of the bony part of the joint, often involving secondary trauma to surrounding soft tissue structures, is the definition of: A. dislocation B. sprain C. strain D. subluxation ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

2. Severe stress, stretch, or tear of soft tissues such as ligaments or tendons, is the definition of: A. dislocation B. sprain C. strain D. subluxation ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

3. A patient was diagnosed with degeneration of a tendon due to repetitive microtrauma. The correct term for this problem is: A. tendinitis B. tendinopathy C. tendinosis D. tenosynovitis ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

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4. Following an injury, a patient experiences adaptive shortening of the skin, fascia and muscle which restricts normal mobility or flexibility of the area. This is best known as: A. adhesions B. contracture C. dysfunction D. muscle guarding ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

5. Which grade of ligament injury involves tears to some of the ligament fibers resulting in joint hypermobility, as well as moderate pain that requires activity to be stopped?

A. Grade I B. Grade II C. Grade III D. Grade IV ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

6. During which stage of healing is physical therapy intervention aimed at developing a mobile scar through selective stretching and mobilization of restrictions?

A. acute inflammatory stage B. subacute proliferation stage C. chronic remodeling stage D. chronic maturation stage ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

7. Which of these activities is contraindicated in the acute stage (maximum protection phase) of rehabilitation?

A. grade I joint oscillations B. joint immobilization C. range of motion D. stretching activities

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ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

8. Which of these is not part of the PTA’s role during acute stage (maximum protection phase) rehabilitation management?

A. control the effects of inflammation B. facilitate the tissue healing process C. maintain function of surrounding regions D. safely restore range of motion deficits ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

9. During the maximum protection phase, which of these interventions would a PTA provide to maintain soft tissue mobility and joint integrity of the injured area?

A. cold compression therapy in an elevated position B. grade I joint oscillations in a pain-free position C. intermittent muscle setting with electrical stimulation D. modified aerobic exercises while in an orthosis ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

10. Which of these is a sign that the treatment intervention is appropriate or that the stresses from exercise or activities are being appropriately applied?

A. increased pain compared to the previous session B. increased stiffness/decrease ROM over several sessions C. increased redness and warmth in the healing tissue D. increased soreness up to 12 hours after treatment ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

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11. An important element of treatment for returning an individual to high-demand sport participation is: A. activities in different environments that include surprise events B. activities in simple, single directional movement patterns C. low-intensity activities that do not exacerbate symptoms D. straight-plane, open-chain, non-weight bearing activities ANS: A KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

12. An individual may develop a cumulative trauma or overuse injury from any of these except: A. bony malalignment with weak structural support B. PRE exercise program C. muscle strength and length imbalances D. sustained awkward postures or movements ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

13. Which part of the self-perpetuating pain spasm cycle is caused by circulatory stasis and tissue ischemia?

A. muscle spasm or guarding B. pain or other noxious stimuli C. reflex muscle contraction D. restricted range of motion ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

14. A patient presents 2 weeks after the initial injury, with joint effusion that is decreasing but muscle weakness due to pain. Treatment activities have been moved from multi-angle isometrics to progressive isotonic exercises with increased repetitions. They are spending less time in protective bracing and decreasing the use of assistive devices. This patient is in which stage of healing?

A. acute or maximum protection stage B. subacute or controlled motion stage C. chronic or return to function stage

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D. chronic inflammation or cumulative trauma syndrome ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

15. A patient is receiving ergonomic counselling and wearing a brace to protect the affected joint. While out of the brace, cross-fiber friction massage and soft tissue mobilization is applied to break down adhesions. Exercises are focused on correcting faulty mechanics, postural stabilization and improving timing, coordination, and endurance. This patient is in which stage of healing?

A. acute or maximum protection stage B. subacute or controlled motion stage C. chronic or return to function stage D. chronic inflammation stage ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

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Chapter 11: Joint, Connective Tissue, and Bone Disorders and Their Management

Multiple Choice

1. A patient presents with cartilage degradation, osteophyte formation, joint pain and crepitus (particularly in weight bearing activities), that has become progressively more debilitating over the past 10 years. Which of these best describes this condition?

A. osteoarthritis B. progressive arthrosis C. psoriatic arthritis D. rheumatoid arthritis ANS: A KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

2. For a patient with rheumatoid arthritis, which of these joints is usually targeted in the inflammatory process?

A. carpometacarpal joints B. distal interphalangeal joints C. femoroacetabular joint D. talocrural and subtalar joints ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

3. Following a period of prolonged immobility while in a cast, an individual developed limitations of the joint. This is known as: A. arthralgia B. arthritis C. arthrosis D. ankylosis ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

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4. Extra-articular pathological changes associated with rheumatoid arthritis can include all except: A. muscular weakness B. ossific ankylosis C. rheumatoid nodules D. tenosynovitis ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

5. Which of these joint protection and energy conservation techniques is important for individuals with rheumatoid arthritis?

A. change positions at least every 2 hours throughout the day B. monitor activities and stop when fatigue begins to develop C. omit activities that provoke pain that lasts more than 20 minutes D. plan for less frequent exercise session, usually in the mornings ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

6. Which of these is not associated with a diagnosis of osteoarthritis?

A. capsular laxity with hypermobility and instability B. cartilage splitting and thinning with joint crepitation C. Heberden’s nodes in the proximal interphalangeal joints D. increased density of bone along the joint line ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

7. Which of these is not an element to be included in the interventions for a patient with osteoarthritis?

A. full range of motion exercise with maximum resistance B. joint-play mobilization techniques C. low-impact, full body aerobic exercises D. orthosis to correct faulty movement mechanics

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ANS: A KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate 8. Which of these is associated with myofascial pain syndrome?

A. fatigue and waking unrefreshed B. lack of referred pain patterns C. palpable tight bands of muscle D. site specific tender points ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

9. Which of these is a chronic regional pain condition that is characterized by hyperirritable points within specific muscles?

A. fibromyalgia syndrome B. myofascial pain syndrome C. rheumatoid arthritis D. trigger points syndrome ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

10. Which of these is not a potential cause of the development of trigger points?

A. acute overload of a muscle such as picking up an object of unexpected weight B. chronic, repetitive overload of a muscle due to job related demands C. daily sitting for up to 30 minutes in a properly fitted ergonomic desk chair D. poorly conditioned muscles that are unable to perform at demanded levels ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

11. A patient is diagnosed with secondary osteoporosis. Which of these would not likely contribute to this condition?

A. excessive alcohol consumption B. hyperthyroidism

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C. sedentary lifestyle D. use of glucosteroids ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

12. Which of these is included in the National Osteoporosis Foundation’s exercise recommendations for individuals with osteoporosis?

A. 8-10 major muscle group resistance exercises, 8 to 12 repetitions, 3 days per week B. 10 minutes of vigorous running every day of the week C. 20 minutes of fast walking on level surfaces 5 days per week D. wearing a weighted vest while sleeping ANS: A KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

13. While designing an exercise program for a patient with osteoporosis, the PTA will avoid all except: A. combined trunk flexion rotation B. sitting abdominal machine C. supine partial curl-ups D. trunk extension exercises ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

14. Which type of fracture involves a straight pulling or traction force, usually from overexertion of a muscle or excessive ligament stresses?

C. avulsion B. spiral D. torus A. transverse ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

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15. Which of these would be least effective for eliminating a trigger point?

B. contract-relax active stretch A. contract-relax passive stretch C. intramuscular dry needling therapy D. systematic resting of overloaded muscles ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

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Chapter 12: Surgical Interventions and Postoperative Management

Multiple Choice

1. Which of these is not an indication for surgical management rather than conservative management?

A. abnormal joint alignment that impacts function B. incapacitating pain when the patient is at rest C. prior surgical management of the same joint D. range restricting edema that lasts 3-5 days ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

2. Which of these is not a benefit of pre-operative patient education?

A. the ability to accurately assess post-surgical functional potential B. the ability to accurately assess pre-operative functional status C. the ability to discuss patient goals and functional expectations D. the ability to provide instruction in the home exercise program ANS: A KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

3. What is the most likely reason that a pre-operative physical therapy visit is not scheduled?

A. current evidence does not support the efficacy of this type of visit B. most surgeries are emergency situations and time is not available C. most patients are unable to attend due to functional limitations D. usually third party payers will not authorize the type of visit ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

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4. During a home health visit one week after surgery, a PTA inspects the surgical incision.

Which of these would warrant contacting the supervising physical therapist for re-evaluation due to the potential development of a post-surgical infection?

A. a small amount of serious drainage B. mild warmth around the incision site C. moderate edema throughout the joint D. tissue necrosis around the sutures ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

5. How are post-surgical rehabilitation phases typically described?

A. based on age and pre-operative activity levels B. based on permitted post-operative activity levels C. based on the degree of tissue protection needed D. based on tissue healing transitions or time frames ANS: A KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

6. In which stage of non-conservative rehabilitation management would a PTA focus on gradually restoring functional activities and progressive strengthening?

A. pre-operative patient education phase B. post-operative maximum protection phase C. post-operative moderate protection phase D. post-operative minimum protection phase ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

7. Generally speaking, which stage of non-conservative rehabilitation management begins approximately 4 to 6 weeks after surgery?

A. pre-operative patient education phase B. post-operative maximum protection phase C. post-operative moderate protection phase D. post-operative minimum protection phase

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ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic Intermediate Difficult

8. When progressing a patient through non-conservative rehabilitation management that includes time frames, which of these is the least significant factor to consider?

A. the absence of pain or presence of specific range of motion B. the actual amount of time elapsed since surgery was performed C. the complexity of the surgical procedure that was performed D. the individual patient’s readiness to progress to the next phase ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

9. While performing patellar mobilizations and gentle massage around the total knee arthroplasty scar, a PTA is also providing patient education regarding how to adjust home exercises in response to an increase in pain or swelling. This patient is likely in which stage of non-conservative rehab management?

A. pre-operative patient education phase B. post-operative maximum protection phase C. post-operative moderate protection phase D. post-operative minimum protection phase ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

10. Which of these would not be considered a risk factor for post-surgical pulmonary complications?

A. early aggressive standing activities B. extended confinement to bed rest C. the use of general anesthesia D. the use of pain medications ANS: A KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

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11. Which of these is not an immediate post-surgical complication?

A. deep vein thrombosis or pulmonary embolism B. nerve entrapment from scar tissue formation C. pulmonary dysfunction, including atelectasis D. rupture of soft tissue repair or reconstruction ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

12. Which of these is not a risk factor for the development of deep vein thrombosis and thrombophlebitis?

A. history of pulmonary embolism B. post-operative immobilization C. standing for longer than 6 hours D. use of oral corticosteroids ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

13. When considering an effective protocol of ankle pumping exercises to minimize the risk of a postoperative deep vein thrombosis, which of these accurately reflects the number of minute(s) of active ankle pumping performed with the number of minutes of increased venous blood flow that has been shown to occur after exercise?

A. 1 minute of ankle pumping exercises produces 15 minutes of increased venous blood flow B. 1 minute of ankle pumping exercises produces 30 minutes of increased venous blood flow C. 2 minute of ankle pumping exercises produces 20 minutes of increased venous blood flow D. 5 minute of ankle pumping exercises produces 60 minutes of increased venous blood flow ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

14. Which of these is a surgical procedures that is designed to realign or stabilize a tendon in order to enhance function?

A. tenodesis B. tenolysis C. tenoplasty

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D. tenorrhaphy ANS: A KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

15. In which of these surgical repairs is biofeedback and electrical stimulation an important part of interventions, specifically to enhance patient learning and control of motion?

A. electrothermal capsulorrhaphy B. intraarticular ligament repair C. muscle lengthening procedure D. tendon realignment procedure ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

16. Which of these is a pain-relieving surgical procedure that removes periarticular bone, intentionally creating a space that will be filled in with fibrotic scar tissue?

A. excision arthroplasty B. excision arthroplasty with implant C. interposition arthroplasty D. joint replacement arthroplasty ANS: A KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

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Chapter 13: Peripheral Nerve Disorders and Management

Multiple Choice

1. Which of these does not correctly match the type of neuron with its primary function?

A. alpha motor neurons/innervate smooth muscle fibers B. gamma motor neurons/innervate muscle fibers of the muscle spindle C. sensory neurons/innervate sensory receptors D. sympathetic neurons/innervate blood vessels ANS: A KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate 2. Which of these accurately matches a myotome with its key muscle used for testing myotome integrity?

A. C4, shoulder abduction B. C6, elbow extension and wrist flex C. L4, ankle dorsiflexion D. S1, knee flexion ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

3. A PTA is performing sharp/dull sensory testing at the posterior lateral aspect of the right knee. This test site corresponds to which dermatome?

A. L2 B. L4 C. S2 D. S4 ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

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4. While assisting with an initial evaluation, a PTA records a sensory deficit found on the lateral aspect of the arm, just proximal to the radial styloid process. This deficit should be documented as this dermatome: A. C5 B. C6 C. C7 D. C8 ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

5. Which of these is not a potential compression point of the brachial plexus?

A. costoclavicular space B. interscalene triangle C. retropectoralis minor space D. tunnel of Guyon ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

6. Which of these brachial plexus injuries rarely occurs in isolation?

A. upper plexus injury (C5,6) B. middle plexus injury (C7) C. lower plexus injury (C8, TI) D. total plexus injury ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

7. When gait training with axillary crutches, a PTA is diligent to assure a correct fit and to intentionally caution the patient to not slump or lean on the crutch to prevent injury to this nerve: A. axillary B. median C. radial D. ulnar ANS: C

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KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

8. A patient presents with an equinovarus deformity of the right foot due to unopposed inversion. This is typically due to injury to this nerve: A. calcaneal nerve B. medial plantar nerve C. superficial fibular nerve D. tibial nerve ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

9. Which of these nerve injuries involves disruption of the axon and endoneurium and has a poor prognosis without surgical intervention?

A. first degree / neuropraxia B. second degree / axonotmesis C. third degree / axonotmesis or neuropraxia D. fourth degree / neurotmesis ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

10. When using vibration as a graded modality for desensitization following a nerve injury, which of these reflects the correct order of recovery (first, then later)?

A. rapid vibration then slow vibration B. constant touch then moving touch C. distal sensation then proximal sensation D. hypersensitivity, then constant touch ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

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11. A patient is positioned in scapular depression, shoulder abduction, and internal rotation, with elbow extension, forearm pronation and wrist, thumb, and finger flexion. These are the upper limb tension test positions associated with which of these nerves?

A. axillary B. median C. radial D. ulnar ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic Intermediate Difficult

12. Which of these is a rare type of thoracic outlet syndrome (TOS) that includes an elongated C7 transverse process that produces paresthesia, muscle weakness, intrinsic muscle atrophy and positive EMG findings?

A. arterial vascular thoracic outlet syndrome B. nonspecific neurogenic thoracic outlet syndrome C. neurogenic thoracic outlet syndrome D. venous vascular syndrome ANS: C KEY: Book Part: Unit 3: Principles of Intervention DIF: Intermediate

13. Which of these interventions is not appropriate in the maximum protection phase of postsurgical carpal tunnel syndrome recovery?

A. isometric exercises B. tendon gliding activities C. compression wrapping D. protective orthosis ANS: A KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

14. Which of these interventions is least likely to be included in the management of Complex Regional Pain Syndrome during the acute, warm phase?

A. mirror therapy B. graded motor imagery C. low impact aquatic exercises

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D. splinting for immobilization ANS: D KEY: Book Part: Unit 3: Principles of Intervention DIF: Difficult

15. Which type of complex regional pain syndrome (CRPS) is associated with a crush injury to a nerve that affects the areas innervated by that nerve, as well as areas not associated with that nerve, and also involves edema, skin blood flow abnormalities, and abnormal sudomotor activity?

A. CRPS type I B. CRPS type II C. CRPS (not otherwise specified) ANS: B KEY: Book Part: Unit 3: Principles of Intervention DIF: Basic

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Chapter 14: The Spine: Structure, Function, and Posture

Multiple Choice

1. At the atlanto-occipital joint of the cervical spine, which of these motions are coupled together due to the joint shapes and orientation direction of the articulating surfaces?

A. extension and side bending B. flexion and extension C. rotation and flexion D. rotation and side bending ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

2. In which region of the spine do the facet joints align at 45 degrees from the horizontal plane?

A. cervical B. thoracic C. lumbar D. sacral ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

3. What is the purpose of the joints of Luschka?

A. these joints limit the effects of anterior shear forces B. these joints provide lateral stability to the spine C. these joints reinforce the vertebral disc anterolaterally D. these joints restrict foraminal separation in sidebending ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

4. In which region of the spine do the facets have a biplaner orientation?

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A. cervical B. thoracic C. lumbar D. sacral ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

5. Based on the principles of coupling, when the lumbar spine is moved into lateral flexion, which of these motions will occur?

A. rotation to the opposite side B. rotation to the same side C. extension to the same time D. traction on the same side ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

6. Which of these vertebral curves are considered to be compensatory curves, developing in response to an infant learning head control or assuming an upright posture?

A. cervical, lumbar B. cervical, thoracic C. thoracic, sacral D. lumbar, sacral ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

7. Normal anterior posterior postural sway can be measured at approximately: A. 3 centimeters B. 4 centimeters C. 5 centimeters D. 6 centimeters ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

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8. During a posture examination using a plumb line in which the patient is observed from a lateral view, which of these should be observed if the postural alignment is correct?

A. the gravity line is slightly anterior to the vertebral bodies B. the gravity line is slightly anterior to the ankle joint C. the gravity line is slightly posterior to the atlanto-occipital joint D. the gravity line is slightly posterior to the knee joint ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

9. When instructing in proper lifting mechanics, a PTA is teaching the patient to avoid the Valsalva maneuver and properly activate the transverse abdominis muscle. Which of these would have the greatest impact on this goal when lifting a moderately heavy load?

A. bend the knees while lifting the load B. exhale slowly while lifting the load C. inhale and hold their breath while lifting D. posteriorly tilt the pelvis while lifting ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

10. A patient is observed to have an extremely lordotic posture. Which of these is a likely cause of a lordotic posture?

A. mobility impairments in the iliopsoas and rectus femoris B. mobility impairments in the rectus abdominis and obliques C. tightness in hip extensors and excessive posterior pelvic tilting D. tightness in the unilateral gluteus maximus and medius ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

11. Stretch weakness of the lower rectus abdominis and obliques, stress to the iliofemoral and anterior longitudinal ligaments of the lower lumbar spine, and narrowing of the lower lumbar intervertebral foramen are all problems associated with:

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A. forward head postures B. kyphotic postures C. lordotic postures D. slouched postures ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

12. Which of these is not a potential impairment associated with a significant leg length discrepancy that leads to a lateral curvature of the spine?

A. decreased hip abduction flexibility on the longer leg side B. decreased rib expansion and difficulty breathing C. mobility impairments of the concave side muscles D. stretch weakness of the muscle on the convex side ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

13. Which of these does not correctly match a self-stretching technique, patient position, and the muscle(s) targeted by the stretch?

A. in the seated position, flex, adduct and internally rotate the hip and pull knee toward opposite shoulder to stretch the piriformis B. in the seated position, with axial extension, side bend to same side and rotate toward side of restriction to stretch the scalenes C. in the standing position, move the hip into extension, lateral rotation, and adduction to stretch the tensor fascia latae D. in the quadruped position, move the buttocks back over the feet to stretch the hip and lumbar extensors ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

14. Which of these most effectively matches the muscle(s) targeted by the stretch, with the patient position and self-stretching technique?

A. hip flexors: standing in a modified fencer’s position and perform a deep squat B. latissimus dorsi: from a prone position use the arms to press the body upwards C. levator scapulae: scapular depression with cervical flexion and rotation to opposite side

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D. pectoralis major: supine on a foam roll, reach arms overhead in full flexion ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

15. In order to increase tension in the lumbo-dorsal fascia and provide stability to the lumbar spine, a patient can contract all of these muscles except: A. internal oblique B. latissimus dorsi C. quadratus lumborum D. transverse abdominis ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

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Chapter 15: The Spine: Management Guidelines

Multiple Choice

1. Which of these describes a disk injury in which the nuclear material extends beyond the confines of the posterior longitudinal ligament, or nuclear material that extends above and below the disk space?

A. extrusion B. herniation C. protrusion D. sequestration ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

2. Which of these is a true neurological sign manifested from pressure being applied to the spinal cord or peripheral nerve root?

A. depressed deep tendon reflex responses B. increased myoelectric activity in the hamstrings C. myotome specific muscle weakness D. radiating pain in a dermatomal pattern ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

3. Although rare, when a disk herniation occurs in the thoracic spine, it will most likely occur between which of these levels?

A. thoracic levels 4 and 5 B. thoracic levels 7 and 8 C. thoracic levels 9 and 10 D. thoracic levels 11 and 12 ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

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4. While instructing a patient with a herniation between lumbar levels 3 and 4, the PTA notes during exercises that the patient begins to complain of increased leg pain that travels down their right leg. This is specifically known as: A. centralization B. lateralization C. peripheralization D. radiation ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

5. Which of these actions will tend to peripheralize symptoms?

A. backward bending of the lumbar region B. neck retraction followed by cervical extension C. manual distraction of the cervical vertebrae D. side bending and rotation of the lumbar region ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

6. Which type of disk lesion typically results in back pain but lacks neurological signs?

A. large anterior protrusion B. large posterior protrusion C. posterolateral protrusion D. small posterior protrusion ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

7. Which type of disk lesion typically results in spinal cord signs such as loss of bladder control and saddle anesthesia?

A. large anterior protrusion B. large posterior protrusion C. posterolateral protrusion

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D. small posterior protrusion ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

8. Which of these would be considered a sign or symptom of lateral stenosis rather than central stenosis?

A. bilateral lower extremity symptoms B. unilateral leg pain and back pain C. pain relief that occurs with standing D. radiating pain that occurs during walking ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate 9. Which of these is a chronic autoimmune inflammatory response of the ligaments of the lumbar spine that can lead to fusion of the cartilage bone junction?

A. ankylosing spondylitis B. spondylolisthesis C. spondylosis D. spinal stenosis ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate 10. Which of these is not a key element of spinal stability?

A. active and balanced muscle function B. intact central neural control C. passive bony and ligament integrity D. proper body mechanics when lifting ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

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11. A patient reports that they cannot sit longer than 30 minutes, stand longer than 15 minutes, and walk more than one-quarter mile without an increase in symptoms. These symptoms all relate to which stage of recovery?

A. acute stage with inflammation B. acute stage without inflammation C. subacute stage D. chronic stage ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

12. A PTA is working with the mother of a 2-year-old. While the patient no longer complains of constant lower back pain, she does report occasional pain with some provoking, repetitive movements. Therapy is focused on repititve lifting of a 20 pound load, emphasizing proper posture and mechanics. In which stage of recovery is this patient?

A. acute stage with inflammation B. acute stage without inflammation C. subacute stage D. chronic stage ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

13. A PTA is working with a patient with low back pain who responds well to traction and aquatic therapy. While seated, this patient gets some relief sitting in a chair and leaning slightly forward while resting her arms on the armrests. Her symptoms seem to be worse when standing, particularly if she coughs or sneezes. Which of these best describes this patient?

A. extension bias B. flexion bias C. non-weight bearing bias D. weight bearing bias ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

14. For a patient with a flexion bias - flexion syndrome, which of these passive positioning techniques could be used to relieve their symptoms?

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A. prone positioning without a pillow under the abdomen B. sitting in a low chair with armrests, arms supported C. standing with an ergonomic cushion on the floor D. supine positioning with lower extremity extended ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

15. A PTA is working with a patient with an extension bias - extension syndrome, during the recovery phase after the acute symptoms have stabilized. During this stage of recover, if symptoms of a protrusion are felt, which of these activities would be the least beneficial?

A. full range pelvic rocking with a lumbar roll while seated B. posterior pelvic tilts while in the quadruped position C. prone position press-ups on a mat in the floor D. slow backward bending from the standing position ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

16. Based on current Clinical Practice Guidelines, which of these would be the least effective intervention for a patient with neck pain?

A. a program of strengthening exercises B. a program of stretching exercises C. nerve mobilization techniques D. patient education and counselling ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

17. When providing interventions for a patient with temporomandibular joint (TMJ) dysfunction, which of these techniques would be the first step in teaching facial muscle relaxation?

A. make a clicking sound with the tongue on the roof of the mouth B. perform a superior and inferior petrous sinus release C. perform unilateral distractions with glide D. practice lateral deviation to the opposite side

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ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

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Chapter 16: The Spine: Exercise and Manipulation Interventions

Multiple Choice

1. A patient with chronic low back pain and functional limitations presents for PT intervention.

Which of these fundamental skills should be the starting point of this care?

A. activities of daily living body mechanics training B. functional activities training C. kinesthetic awareness training D. muscle strength and performance training ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

2. Which of these activities is a fundamental or foundational skill for all patients with spinal pain and functional limitations?

A. spinal control stabilization exercises with extremity loading B. dynamic spinal control in functional activities C. gentle spinal movements into painful ranges D. stable spine techniques for movement transitions ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

3. Which of these activities is a Phase II: Basic Training (Controlled Motion/Moderate to Minimum Protection) intervention for a patient?

A. active spinal control stabilization exercises with extremity loading B. grades I and II manipulations to increase range of motion C. habitual use of a neutral spine in all functional activities D. learn their personal bias and positions that provoke symptoms ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

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4. At what point will a patient with spinal pain and functional limitations, who has had a low pain tolerance and slower progression, likely be ready for cardiopulmonary endurance training?

A. Phase I: Maximum to Moderate Protection Phase B. Phase II: Controlled Motion with Moderate to Minimum Protection C. Phase III: Intermediate to Advanced Training/Minimum to No Protection D. none of these since cardiopulmonary training is not indicated ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

5. Which of these is not true of stretching in the acute phase following injury to the low back muscles?

A. fluid stasis may respond to sustained positioning in restricted ranges B. nerve root impingement may be relieved with flexion to widen the intervertebral foramina C. stretches should avoid postures that are difficult to assume due to tissue restrictions D. stretching is generally contraindicated for inflamed muscles ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

6. A PTA is assisting a PT who is doing a spinal manipulation that involves large amplitude oscillations that go up to the restrictive joint barrier. These manipulations have a goal of improving range of motion. Which grade of manipulation is being used?

A. Grade I B. Grade II C. Grade III D. Grade IV ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

7. Which of these is a precaution rather than a contraindication for spinal manipulation techniques?

A. anytime during a phase of acute joint irritation B. radiographically confirmed fracture non-union C. when applied techniques result in radiating pain

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D. with ligament laxity due to rheumatoid arthritis ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

8. A PTA is assisting a PT who is doing a spinal manipulation that involves the patient taking several deep breaths. On the final exhale a single high velocity, low amplitude thrust is applied.

Which grade is being used?

A. Grade I B. Grade II C. Grade III D. Grade IV E. Grade V ANS: E KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

9. When using the principles of motor learning during stabilization training exercises, which of these reflects the correct order of activities from least complex to most complex?

A. complex spinal control; spinal control in unexpected situations; spinal contractions awareness; simple spinal control B. simple spinal control; complex spinal control; spinal contractions awareness; spinal control in unexpected situations C. simple spinal control; complex spinal control; spinal control in unexpected situations; spinal contractions awareness D. spinal contractions awareness; simple spinal control; complex spinal control; spinal control in unexpected situations ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

10. A patient is being taught to use an inflatable Stabilizer TM device to activate the deep segmental lumbar spine muscles in a prone position. Which of these reflects the correct starting inflation pressure and the correct pressure change after the patient performs the drawing-in maneuver?

A. inflate to 20 mm Hg, changing to 30 mm HG after drawing-in B. inflate to 50 mm Hg, changing to 60 mm HG after drawing-in

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C. inflate to 70 mm Hg, changing to 60 mm HG after drawing-in D. inflate to 90 mm Hg, changing to 50 mm HG after drawing-in ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

11. Which of these positions is easiest for teaching a new patient the drawing-in maneuver for transversus abdominis activation so that gravity assists with a relaxed exhalation?

A. hook-lying position B. prone position C. quadruped position D. semi-reclined position ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic 12. When instructing a patient to correctly perform abdominal bracing in a hook-lying position, which of these instructions is not appropriate?

A. do not flex the head or trunk B. do not press down through your feet C. firm up and hold your abdomen in D. hold your breath and flare out the lower ribs ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

13. When instructing a patient in lumbar stabilization activities with progressive limb loading that emphasize abdominal muscle activation, which of these activities would provide the greatest amount of limb loading?

A. hooklying, bilateral weight bearing, then perform the drawing-in maneuver and maintain a pressure monitoring device at 40 mm Hg B. hooklying, then lift one bent leg to 90 degrees of hip flexion C. hooklying, then slide one heel into extension D. hooklying with one leg straight, then straight leg raise to 45 degrees ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic Intermediate Difficult

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14. When instructing a patient in cervical stabilization activities with progressive limb loading that emphasize cervical and thoracic extensors, which of these activities would be appropriate for the maximum to moderate protection phase?

A. prone, lift forehead off the table, adduct the scapulae then move arms in a diagonal pattern B. prone, lift forehead off the table, arms at sides, externally rotate arms and adduct scapulae C. prone, lift forehead off the table, arms in 90 degrees of abduction and external rotation, adduct the scapulae D. prone, lift forehead off the table, arms resting at sides ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic Intermediate Difficult

15. Which of these is the best activity to train the quadratus lumborum in frontal and transverse plane stabilization?

A. ball sitting with diagonal resistance bands B. prone position, modified bicycling C. prone position, resisted hip hiking D. side plank position with elbow prop ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

16. Which of these is the best activity to train the external obliques, generating the strongest contraction?

A. diagonal sit ups to the same side while on an unstable surface B. diagonal sit ups to the same side while on the floor C. diagonal sit ups to the opposite side while lying on a large gym ball D. diagonal sit ups to the opposite side while on the floor ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic Intermediate Difficult

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Chapter 17: The Shoulder and Shoulder Girdle

Multiple Choice

1. A patient with idiopathic frozen shoulder presenting with minimal pain, no synovitis but significant capsular restrictions due to adhesions would be described as being in which of these stages?

A. stage 1 - onset stage B. stage 2 - freezing stage C. stage 3 - frozen stage D. stage 4 - thawing stage ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

2. Which of these techniques would be best suited to improve joint tracking for a patient with glenohumeral joint hypomobility during the controlled motion phase?

A. active shoulder “hiking” exercises B. mobilization with movement techniques C. movement retraining to minimize substitutions D. passive joint mobilization techniques ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

3. Following shoulder manipulation under anesthesia, which of these treatment considerations would be important to follow?

A. emphasize rotation movements below 90 degrees of abduction B. instruct the patient to sleep with the shoulder in neutral C. maintain the arm in adduction and internal rotation D. use caudal glide joint mobilization techniques ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

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4. Which of these shoulder procedures would result in the most restricted range of motion outcomes and is often used as a salvage procedure following failed repair efforts or significant joint damage?

A. arthrodesis B. arthroplasty C. hemiarthroplasty D. reverse arthroplasty ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

5. Which of these arthroplasty procedures is designed to combine moderate stability with mobility for shoulders with rotator cuff deficiencies that cannot be repaired?

A. constrained procedure B. reverse ball and socket procedure C. semi-constrained procedure D. unconstrained procedure ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

6. Following unconstrained total shoulder arthroplasty with sufficient post-surgical shoulder stability, what is the target goal for active shoulder elevation?

A. 90 degrees B. 120 degrees C. 140 degrees D. equal to intraoperative range of motion ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

7. During the maximum protection phase following shoulder arthroplasty, which of these is not a standard precaution that must be observed?

A. avoid all combined extension, adduction, and internal rotation motions B. begin overhead pulley arm elevation with the patient facing the doorway/pulley apparatus

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C. for assisted shoulder rotation in supine, position the humerus slightly anterior to midline D. horizontal adduction beyond neutral in antigravity positions not permitted ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

8. Which of these is not an activity of daily living precautions for post-operative total shoulder arthroplasty during the maximum protection phase?

A. always wear the protective sling while sleeping or in crowded areas B. avoid reaching behind to tuck your phone into your back pocket C. avoid weight-bearing on the arm when transferring or moving in bed D. only do activities that can be done with the arm at shoulder height or below ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

9. A baseball pitcher presents with impingement in a position of elevation, horizontal abduction, and maximum external rotation when the posterior supraspinatus tendon is caught between the humeral head and labrum. This can be classified as: A. internal extrinsic impingement B. intrinsic impingement C. secondary extrinsic impingement with multidirectional instability D. secondary extrinsic impingement with unidirectional instability ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

10. When beginning glenohumeral isometric training after rotator cuff repair, which of these is not part of the safe starting position?

A. elbow flexion B. shoulder adduction C. shoulder elevated to 45 degrees in the scapular plane D. shoulder internal rotation ANS: B

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KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

11. Following anterior dislocation of the shoulder, which of these motions should be avoided to protect the healing structures?

A. abduction to 55 degrees with the shoulder 30 to 45 degrees anterior to the frontal plane B. external rotation with the elbow at the patient’s side C. external rotation with the patient’s shoulder in flexion D. the movement of extension from 0 to 20 degrees ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

12. Which of these is supported by current evidence as the best exercise to cause maximum scapular depression, while isolating the lower trapezius?

A. from a standing position, perform shoulder shrugs with appropriate hand-held weights B. prone, with 90 degrees of shoulder abduction / 90 degrees elbow flexion, perform external rotation C. in a seated position perform a rowing action with appropriate grade of elastic tubing D. with the patient in prone, elevate the arm above the head ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

13. Following shoulder stabilization of a Bankart lesion, when instructing a patient to perform pendulum exercises correctly, where is the patient taught to generate the motion?

A. activation of the scapular stabilizers to indirectly cause the arm to swing B. activation of shoulder musculature to move the arm in one direction or the other C. combining gravity with a rocking motion of the trunk to create passive swing D. using a hand-held weight for distraction, the therapist passively moves the arm ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

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14. Which of these exercises is well-suited for targeting the subscapularis in isolation from the other rotator cuff or shoulder muscles?

A. sidelying external rotation in the plane of the scapula B. narrow grip seated rowing C. resisted forward punches D. wide grip seated rowing ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

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Chapter 18: The Elbow and Forearm Complex Multiple Choice

1. Which of these is the preferred method for surgically repairing a displaced fracture of the radial head since it typically results in improved forearm rotation and flexion secondary to decreased scarring?

A. complete excision of the radial head B. open reduction, internal fixation C. perform a radial head arthroplasty D. use a low-profile fixation process ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

2. Based on arthrokinematics principles, which of these is correct regarding how the radial head moves on the radial notch during the motion of pronation?

A. the radial head will glide laterally B. the radial head will roll anteriorly C. the radial head will roll dorsally D. the radial head spins on the trochlea ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

3. Which of these muscles provide compression and stability to the elbow and is the primary elbow flexor used during rapid movements against high resistance?

A. bicep brachii B. brachialis C. brachioradialis D. triceps brachii ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

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4. Which of these nerves can become entrapped between the heads of the pronator teres or by the bicipital aponeurosis?

A. axillary nerve B. median nerve C. radial nerve D. ulnar nerve ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

5. Which of these is not an appropriate method to increase range of motion following radial head excision in the moderate and minimum protection phases?

A. gentle hold-relax PNF techniques B. low-load, long duration stretching C. static progressive orthotic intervention D. sub-maximal multiangle isometrics ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

6. Which of these techniques is more effective for maximizing extension range of motion in the minimum to non-protection phase following elbow surgery for comminuted radial head fracture?

A. dynamic progressive orthosis B. grade II joint mobilizations C. manual stretching techniques D. static progressive orthosis ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

7. Which of these is a contraindication for total elbow arthroplasty?

A. a patient with debilitating late-stage elbow arthritis B. a patient with neuropathic total elbow joint ankylosis C. a patient with non-union of a distal humeral fracture D. a patient with osteonecrosis and dysfunctional instability

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ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate 8. Which of these is an immediate post-operative complication associated with total elbow arthroplasty?

A. aseptic implant loosening B. periprosthetic fracture C. premature component wear D. ulnar nerve paresthesia ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

9. Post operative total elbow arthroplasty (TEA) bracing in extension can be indicated for all of these except: A. a patient with significant pre-operative flexion contracture B. a patient with symptoms related to ulnar neuropathy C. after unlinked TEA, with lateral complex ligament repair D. following a triceps brachii-reflecting surgical approach ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

10. Which of these is not characteristic of triceps insufficiency following total elbow arthroplasty?

A. elbow pain in the posterior aspect B. difficulty with pulling activities C. terminal elbow extension weakness D. weakness with overhead activities ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

11. What is the purpose of the counterforce brace for the patient with either medial or lateral epicondylitis?

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A. it will dissipate the overload forces generated at the origin of the affected muscles B. it will provide a reminder to do activities carefully to prevent further extensor injury C. it will provide support to the forearm during aggressive activities during sports D. it will provide support to the upper arm when performing routine daily activities ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

12. Which of the following injuries occurs from repetitive overuse and affects the common extensor origin of the extensor carpi radialis longus and brevis, the extensor digitorum, and the extensor digiti minimi?

A. fracture of the distal humerus B. lateral elbow tendinopathy C. medial elbow tendinopathy D. medial valgus stress overload ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

13. What intervention is appropriate for a patient in the acute phase of medial elbow tendinopathy?

A. begin light resistance training with submaximal multiangle isometrics exercises B. focus on ice, NSAIDs, gentle AROM, phonophoresis, and relative active rest C. instruct the client to actively use the shoulders and follow a conditioning program D. protect the elbow with a cast for immobilization and instruct in isometric exercises ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

14. Which of these is an exercise that will strengthen the elbow flexors in combination with shoulder retractors and shoulder extensors?

A. bench press B. military press-ups C. semi-prone push ups D. unilateral rowing ANS: D

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KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

15. Which of these strengthening exercises will specifically target the bicep brachii?

A. sitting elbow curls with a weighted ball gripped in a palm up position B. sitting elbow curls with medium strength elastic tubing, thumb up grip C. standing (arm overhead), posterior elbow curls in a downward direction D. standing elbow curls with hand weight held in a palm down position ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

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Chapter 19: The Wrist & Hand Multiple Choice

1. Which of these joint pathologies or impairments is characteristic of the acute stage of rheumatoid arthritis?

A. carpal tunnel with tenosynovitis B. the ulnar drifting of the fingers C. the ulnar subluxation of carpals D. zigzag deformity of the thumb ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

2. Which of these is not part of the swan-neck deformity associated with rheumatoid arthritis?

A. bowstringing of the lateral bands of the extensor hood mechanism B. proximal interphalangeal hyperextension, distal interphalangeal flexion C. proximal interphalangeal laxity and overstretching of the palmer plate D. the rupture of the central band of the extensor hood mechanism ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

3. A PTA is providing patient education to an individual recently diagnosed with rheumatoid arthritis. This instruction should include all of these joint protection methods except: A. avoid deforming or prolonged positions B. respect pain, discomfort, and fatigue C. strengthen metacarpal phalangeal adduction D. use larger, stronger joints when feasible ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

4. When considering wrist arthroplasty, which of these would be a relative contraindication?

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A. bilateral wrist arthrodesis that is limiting function B. ipsilateral shoulder, elbow, or finger joint stiffness C. the rupture of more than one of the extensor tendons D. wrist deformity with marked limitation of motions ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

5. Which of these does not reflect the normal excursion of wrist motions necessary for most functional activities?

A. requires a combined total of 40% of radial and ulnar deviation B. requires a combined total of 60% of wrist flexion and extension C. requires up to 40% of the motion of straight plane wrist flexion D. requires up to 40% of the motion of straight plane wrist extension ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

6. Following surgical correction of a swan-neck deformity, which of these techniques involving interphalangeal (IP) joint motion would be most likely to damage the surgical repair?

A. limiting the distal IP flexion to 60-75% of available range B. limiting the proximal IP extension to 10 degrees of flexion C. limiting the proximal IP joint to neutral during distal IP motion D. limiting the total amount of proximal IP flexion to 20-30 degrees ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

7. Which of these orthoses is used exclusively during physical therapy exercise sessions?

A. a static dorsal blocking wrist and finger orthosis B. dorsal blocking orthosis with dynamic traction C. dorsal tenodesis orthosis with a wrist hinge D. dynamic extension orthosis with dorsal outriggers ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

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8. Following surgical primary tendon repair a patient is allowed early, active tendon mobilization using a dynamic approach. Which of these would correctly implement this protocol within the custom orthosis?

A. chooses a short arc of motion that minimizes muscle tension and allows the patient to actively perform flexion and extension B. the patient is allowed to actively performs hook flexion activities and straight fist motions of the finger flexors C. with the metacarpal phalangeal joint in flexion, passively move the interphalangeal joints into flexion and asks the patient to hold D. use biofeedback to learn how to hold interphalangeal joint flexion with minimal tension in the flexor digitorum profundus ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

9. Based on the combined approach with progressive tendon loading for early active motion after flexor tendon repair, which of these would put the greatest amount of loading on the repaired tendon and should be performed with less repetitions?

A. active composite finger flexion B. hook and straight fist finger flexion C. isolated finger joint motions D. place-and-hold finger flexion ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

10. Following primary flexor tendon repair (Zones I-III) in which of these positions will the least amount of contraction force be generated in the flexor digitorum superficialis and profundus when performing place-and-hold exercises?

A. wrist extension and metacarpophalangeal joint extension B. wrist extension and metacarpophalangeal joint flexion C. wrist flexion and metacarpophalangeal joint extension D. wrist flexion and metacarpophalangeal joint flexion ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

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11. Which of these is not part of the flexor tendon-gliding exercises?

A. wrist extended, hook fist B. wrist flexed, full fist C. wrist neutral, full fist D. wrist neutral, straight hand ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

12. In which of these flexor tendon-gliding exercises will maximum gliding occur between the flexor digitorum profundus and superficialis tendons and also include gliding of the extensor digitorum tendons?

A. intrinsic plus B. hook fist C. straight hand D. straight fist ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

13. When performing index finger flexor tendon-blocking exercises, which of these exercises should be performed first?

A. isolated distal interphalangeal flexion B. isolated metacarpal phalangeal flexion C. isolated proximal interphalangeal flexion D. with the wrist in neutral, full fist flexion ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

14. A patient is being instructed in strengthening exercises for wrist deviation movements. In standing, holding the arm at the side, which of these would most effectively strengthen the muscles of radial deviation?

A. holding a hand-held weight, move the weight toward the shoulder using the elbow joint

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B. holding a hand-held weight with elbow at 90 degrees, move the weight toward the floor using the wrist C. holding a small bar with an anteriorly positioned weight, move the weight toward the shoulder using the wrist D. holding a small bar with a posteriorly positioned weight, move the weight toward the shoulder using the wrist ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic 15. Which of these would not be effective for strengthening the indicated target muscle?

A. extensor indicis: palm down with index finger over the edge of the table, loop elastic band over end of finger and move up toward ceiling B. flexor digitorum profundus: palm down with fingertips on a cloth with small weights, use fingertips to drag or crawl the weights closer C. lumbricals: with wrist neutral, metacarpophalangeal extension and interphalangeal flexion, push the fingertips outward pushing against the palm of the other hand D. palmar interossei: with the wrist and hand in neutral, loop a small rubber band around two fingers and move them apart in a “v” motion ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

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Chapter 20: The Hip

Multiple Choice

1. A patient presents with tightness in the tensor fasciae latae. Which of these functional impairments or diagnoses is not associated with this condition?

A. iliotibial band friction syndrome B. lateral knee pain and extensor mechanism bowstringing C. trochanteric bursitis of the hip D. varus knee collapse in weight-bearing with hip and knee flexion ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

2. Which of these is a relative contraindication for total hip arthroplasty?

A. active hip joint infection or sepsis B. chronic osteomyelitis of the hip C. inadequate bone stock or bone loss D. insufficient gluteus medius function ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

3. For a 76-year-old patient who has experienced a gradual but persistent decline in hip function who desires a quick return to a moderately active lifestyle, which type of hip fixation would you expect to be used as part of a total hip arthroplasty A. biological ingrowth component B. cemented components C. cementless components D. nonporous with bioactive compounds ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

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4. A patient received a cemented total hip arthroplasty using a traditional, posterolateral approach. What weight-bearing status will be appropriate for gait training 3 weeks post-operative given that his orthopedist favors an aggressive rehab approach?

A. full active weight bearing B. toe-touch weight bearing C. touch-down weight bearing D. weight bearing as tolerated ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

5. A patient underwent a total hip arthroplasty four days ago that required a posterior capsule incision. Which of these is not a likely movement precautions that the surgeon will prescribe?

A. combined hip extension and external rotation B. combined hip internal rotation and adduction C. straight plane hip adduction in all planes D. trunk flexion greater than 90 degrees ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

6. A patient had an anterior surgical approach total hip replacement. Which of the following hip precaution positions is appropriate and unique to an anterior approach versus a posterolateral or lateral approach following surgery?

A. hip adduction B. hip external rotation C. hip flexion greater than 90 degrees D. hip internal rotation ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

7. Following a standard total hip replacement, when can total hip precautions be discontinued?

A. only when the referring doctor elects to discontinue the total hip replacement precautions B. when the patient decides that s/he has enough strength and control to balance appropriately C. when the PT determines the patient has enough quadriceps strength and functional control

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D. when the PTA determines the patient’s strength and flexibility have returned to normal ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

8. Following hemiarthroplasty using a posterolateral approach, which of these activities should be avoided to prevent excessive compressive acetabular forces?

A. maximum effort gluteal sets B. partially assisted heel slides C. partial weight bearing gait D. submax resisted hip abduction ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

9. While working with a patient following an intertrochanteric fracture that was repaired using sliding compression screws, the PTA is alert to possible signs or symptoms of fixation failure.

Which of these would not be an indication of fixation failure?

A. persistent external rotation of the operative limb B. positive Trendelenburg sign on the non-operative side C. progressive painful shortening of the operative limb D. severe, persistent knee pain that increases with movement ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

10. A patient complains of pain over the lateral hip that occasionally radiates down the lateral thigh to the knee. This pain is usually present when standing asymmetrically with the affected hip elevated and adducted or when climbing stairs. Which of these is the most likely diagnosis?

A. iliopectineal bursitis B. ischial bursitis C. psoas bursitis D. trochanteric bursitis ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

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11. A patient presents with femoroacetabular impingement with anterior groin pain, and positive log roll and FABER tests. Which of these interventions is not likely to be included in the plan of care?

A. functional activities that emphasize the gluteus maximus B. targeted gait training to correct knee hyperextension C. passive and active stretching for hamstring flexibility D. strengthening of the hip adductors and internal rotators ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

12. Which of these range limiting stretching techniques will help to increase hip flexion?

A. kneeling fencers stretch B. press-ups in prone C. short sitting stretch D. Thomas Test stretch ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

13. Prior to strengthening the gluteus medius, a PTA should make sure that there is adequate flexibility in the tensor fasciae latae (TFL). When activating the gluteus medius, which of these hip motions would indicate TFL involvement?

A. extension or abduction B. extension or external rotation C. flexion or adduction D. flexion or internal rotation ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

14. Weight bearing exercises can trigger strong contractions of both the gluteus maximus and the gluteus medius. Which of these would primarily isolate and generate a strong gluteus medius contraction?

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A. lateral band walk B. single limb dead lift C. single limb wall slide D. transverse lunge ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

15. When a patient is performing quadruped leg lifts (in quadruped, extending the hip while keeping the knee flexed to 90 degrees) which of these muscles is being isolated for strengthening?

A. gluteus maximus B. quadratus lumborum C. semimembranosus D. semitendinosus ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

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Chapter 21: The Knee

Multiple Choice

1. Which of these motions will increase the Q-angle at the knee, leading to potential patellar malalignment and dysfunction?

A. dynamic knee varus B. external femoral rotation C. internal tibial rotation D. subtalar pronation ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

2. When using joint mobilization techniques to increase knee flexion, which of these is the correct position and glide direction?

A. tibia in lateral rotation; anterior glide applied to posterior aspect of lateral tibial plateau B. tibia in lateral rotation; posterior glide applied to anterior aspect of medial tibial plateau C. tibia in medial rotation; anterior glide applied to posterior aspect of lateral tibial plateau D. tibia in medial rotation; posterior glide applied to anterior aspect of medial tibial plateau ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

3. When applying mobilization with movement to increase knee flexion range of motion and decrease pain, which of these positions is a required component for successful application?

A. knee extension B. hip abduction C. tibial internal rotation D. tibial lateral rotation ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

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4. Which of these activities will generate the highest impact forces on the knee with osteoarthritis?

A. aquatic lunges submerged to waist-level B. bicycling on a stationary bike C. bilateral wall slide mini squats D. deep water running submerged to C7 ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

5. A PTA is working with a 14-year-old cheerleader with patellar malalignment problems that cause recurring pain. Which of these is the least likely cause of this problem?

A. a Q-angle measuring 15 degrees B. tightness in the iliotibial band C. tightness in the rectus femoris D. tightness in the vastus medialis ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

6. A 48-year-old with a diagnosis of medial compartment pain with a bucket-handle medial meniscus tear is scheduled for meniscus transplant surgery. Which of the following procedures might also be done during surgery to improve structural alignment, redistribute weight bearing forces, reduce pain, and potentially delay the need for arthroplasty?

A. anterior cruciate ligament reconstruction B. high tibial osteotomy surgery C. medial collateral ligament repair D. osteochondral allograft transplant ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

7. Which of these procedures is used to repair a single, full-thickness articular cartilage defect measuring 3 cm2 in a younger patient, using healthy cartilage harvested from the patient, cultured in a lab, and then reinjected under a periosteal patch?

A. autologous chondrocyte implantation

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B. microfracturing procedure C. osteochondral allograft transplant D. osteochondral autograft transfer ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

8. Following an osteochondral autograft transfer procedure for a moderately size lesion, which of these is the most important rehabilitation consideration for a successful outcome?

A. avoid any unprotected weight bearing for four weeks to allow adequate healing B. engage in early motion and protected weight bearing for extended periods of time C. permanently avoid all high impact sports activities to prevent graft deterioration D. wear a protective brace that is locked in extension while sleeping for six weeks ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

9. For the post-operative primary total knee arthroplasty patient who received a standard surgical approach, which phase of rehab will include the goals of 0 – 90 degrees of range of motion and ambulation without an assistive device?

A. maximum protection phase B. moderate protection phase C. minimum protection phase D. return to function phase ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

10. Which of these precautions is specifically appropriate for a patient following a posterior cruciate sacrificing (posterior stabilized) total knee arthroplasty procedure?

A. avoid hamstring strengthening in short sitting B. avoid low-level resistance activities for 12 weeks C. avoid side-lying straight leg raises for 8 weeks D. avoid tibiofemoral joint mobilization techniques ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region

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DIF: Difficult

11. For a patient with patellofemoral pain syndrome due to excessive foot pronation and traumatic patellar chondromalacia, closed chain activities in which of these positions is most likely to trigger symptoms?

A. bilateral mini squats in a limited 30 – 50-degree arc of motion B. forward deep lunges with forward knee flexed to 80 degrees C. forward step-ups and step-downs using a 3-inch step height D. terminal knee extension exercises against light resistance ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

12. Which of these would not be safe for a patient after proximal extensor mechanism realignment with lateral retinacular release?

A. avoid maximum voluntary quadricep contractions B. avoid placing a valgus stress to the knee joint C. begin unilateral weight-bearing exercises at two weeks D. perform straight leg raises with orthosis locked in extension ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

13. You are reviewing published information regarding knee ligament injuries and are questioning the validity of the information found. Below are four statements that you discovered. Which one of them is a true or accurate statement?

A. ACL injuries are usually caused by a lateral blow to the knee causing a varus joint force B. forceful hyperextension of the knee is the most common mechanism of injury of the PCL C. males are more prone to injure the ACL than females in similar, non-contact conditions D. the most common ACL injury is forceful combined rotation on the planted stance foot ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

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14. Which of the following exercises would be appropriate in the maximum protection phase of rehabilitation after an anterior cruciate ligament repair with patellar tendon graft reconstruction?

A. isotonic eccentric quadriceps strengthening in a straight plane against gravity B. hamstring and quadriceps co-contraction straight leg raise from 0 – 50 degrees C. low impact plyometric exercise agility drill training on an indoor padded surface D. supported bilateral ballistic movements within a protective brace and parallel bars ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

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Chapter 22: The Ankle & Foot

Multiple Choice

1. An individual with gout in the metatarsal phalangeal joint of the great toe should encounter the least amount of pain in which of these phases of gait?

A. initial contact B. pre-swing C. terminal stance D. toe-off phase ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

2. Which of these arthritis-related forefoot deformities involves a lateral shifting of the great toe proximal phalanx, as well as the lateral shifting of the flexor and extensor muscles, leading to bone hypertrophy and a painful bunion?

A. hallux rigidus B. hallux valgus C. hallux varus D. hammer toe ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

3. Which of these is a contraindication for a total ankle arthroplasty?

A. juvenile rheumatoid arthritis after closure of the growth plates B. osteoarthritis in the presence of moderate physical demands C. rheumatoid arthritis with adequate or sufficient ligament integrity D. talar body avascular necrosis with a 3 degree hindfoot valgus deformity ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

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4. Following total ankle arthroplasty that includes a hindfoot fusion, how long will the patient usually be non-weight bearing?

A. 2 weeks B. 4 weeks C. 6 weeks D. weight bearing as tolerated is allowed immediately after surgery ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

5. Which of these flexibility exercises to increase ankle dorsiflexion is associated with increased muscle soreness due to the high level of eccentric control required?

A. long-sitting with belt looped under forefoot, pull into dorsiflexion B. standing in a lunge position while maintaining back heel flat on floor C. standing on a wedge (with toes up and heels down) and lean forward D. standing with heel over edge of step, slowly lower the heel off the step ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

6. A patient presents with problems during the push-off phase of gait due to metatarsal phalangeal (MTP) hypomobility. Which of these activities will not benefit this problem?

A. sitting, picking up cotton balls or marbles with toes moving them from one bowl to another B. sitting with foot on floor, slide knee into flexion keeping toes on floor while raising heel C. sitting with foot on opposite knee, stabilize the metatarsal and passively extend the MTP joint D. standing with affected foot backward, while in stride, then rock forward lifting the heel ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

7. Which of these will effectively activate and dynamically strengthen the ankle plantar flexors?

A. resisted walking with elastic band at ankle of swing leg, stance leg plantarflexors activate B. resisted walking with elastic band at ankle of swing leg, swing leg crossing over stance C. resisted walking with elastic band at ankle of swing leg, swing leg moving backward D. resisted walking with elastic band at ankle of swing leg, swing leg moving forward

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ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

8. For a patient who receives a primary, open, minimally invasive repair of a ruptured Achilles tendon, which of these is not a progression criterion for advanced land-based plyometric training?

A. when 5 unilateral heel raises at 90% or more of max heel-rise height are done B. absolutely no earlier than at least six months following the surgical procedure C. when normal dorsiflexion range is achieved compared to non-operative side D. when normal gait occurs without an assistive device and is consistently pain-free ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

9. During the maximum protection phase following primary repair of the Achilles tendon, a patient lost their balance and fell during a transfer. The patient reports to the PTA that they have had a significant increase in pain and swelling since that incident. Which of these would be the least concerning element if found in this patient?

A. altered sensitivity around the incision site B. an abnormal Thompson squeeze test result C. decreased ankle resting tension compared to opposite side D. the ability to palpate a defect in the Achilles tendon ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

10. Which of these is an intrinsic factor associated with heel pain?

A. decreased plantarflexion B. female gender C. pes planus foot type D. weak extrinsic muscles ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

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11. Which of these is associated with anterior shin splints?

A. active supination against resistance B. excess pronation when running C. inflamed posterior tibialis muscle D. tight gastrocnemius-soleus complex ANS: B KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

12. Which of these recommendations is not indicated for preventing leg, heel, or foot pain in the return to function phase?

A. allow adequate recovery time after high-intensity exercises B. always choose proper footwear for the ground conditions C. always use a heel lift during all weight-bearing activities D. use gentle repetitive warm-up activities followed by stretching ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

13. A 40-year-old teacher is referred to physical therapy for complaints of pain along the plantar aspect of the heel that is most noticeable when getting out of bed in the morning, upon standing after sitting for longer than 1 hour, and after playing racquetball. During walking, pain is most noticeable at the terminal stance and pre-swing phases of gait. The most likely disorder causing these symptoms is: A. achilles tendonitis B. calcaneal bursitis C. plantar fasciitis D. posterior tibialis tendonitis ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

14. Your patient has plantar fasciitis. Which of the following associated impairments would you not expect to see with this problem?

A. a flexible midfoot pes cavus deformity B. a hypomobile gastrocnemius soleus complex

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C. pain at the calcaneal fascial insertion D. tendinitis of the tibialis anterior muscle ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

15. A 42-year-old female is diagnosed with chronic ankle instability, having sprained her ankle three times in the past while playing tennis. She is in the return to function phase of rehab with normal strength and range of motion and has recently had problems with cutting and running to get to the ball while playing. Physical therapy goals for this patient include increased ankle control on various surfaces. To remedy this problem the exercise program should focus on which of the following?

A. balance training using closed chain disturbed balance activities on a rocker or balance board B. grade I and II joint oscillations to increase motion in the plantarflexors and dorsiflexors C. limited range of motion isometric exercises for both the invertor and evertor muscles D. passive and active-assisted ROM for plantarflexion, dorsiflexion, inversion, and eversion ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

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Chapter 23: Advanced Functional Training

Multiple Choice

1. When does functional training begin?

A. acute phase with a focus on proximal stability B. subacute phase with a focus on balance C. chronic phase with a focus on plyometrics D. return to function phase with a focus on endurance ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate 2. Which of these is not an emphasis in the initial phases of functional training?

A. decreased repetitions to focus on safe performance B. maintaining the correct joint alignment C. maintaining the correct body alignment D. proper movement velocity during exercise ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate 3. Which of these is an accurate progression for balance exercises?

A. moving from complex tasks to multiple tasks B. moving from tandem stance to double leg stance C. moving surroundings to non-moving surroundings D. unresisted to resisted superimposed movements ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

4. The ability to adequately return the body to a state of equilibrium after perturbations are applied is the definition of: A. mobility B. posture

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C. skill D. stability ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

5. A patient is positioning in high kneeling on a foam cushion. With the PTA stabilizing the ankles, the patient is encouraged to lean forward against body weight resistance. This activity will best strengthen or emphasize which of these?

A. lower extremity co-contractions B. the core stabilizing muscle groups C. the full hamstring muscle group D. the quadricep femoris muscles ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

6. Which of these would be the least effective exercise for a patient returning to work conditions that requires heavy lifting?

A. a lunging motion against added resistance B. deep squats with resisted upper extremity motions C. repositioning a weighted crate on a level surface D. unilateral wall slides with weights in each hand ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

7. When performing a forward lunge, which of these adjustments will emphasize hip extensor recruitments of the leg?

A. trunk and arms in a forward position B. trunk erect with both arms abducted C. trunk erect with both arms at sides D. trunk in extension, arms overhead ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Difficult

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8. Which of these is the least significant improvement associated with plyometric training?

A. improved power output B. improved coordination C. increased overall flexibility D. quicker neuromuscular reactions ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate 9. Which of these is the least significant improvement associated with plyometric training?

A. decreasing directional transition times B. developing agility for sudden stopping C. preparing for a rapid and efficient start D. sustaining concentric postural control ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

10. Plyometrics is also known as stretch-shortening drills. Which of these is part of the stretch phase of the drill?

A. the passive or non-contracting rest phase B. the rapid, resisted concentric reversals C. the rapid, resisted eccentric contraction D. the short duration, maintained isometrics ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

11. The focus of plyometric training is to minimize the time required for a muscle to reverse its action, switching from deceleration to acceleration of the load. This timeframe is known as the: A. amortization phase B. reversal phase C. stretch phase D. shortening phase

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ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

12. Which of these is not a type of exercise that employs high-velocity eccentric to concentric loading, reflexive reactions, and functional movement patterns?

A. dynamic functional training B. plyometric training drills C. reactive neuromuscular training D. stretch-shortening drills ANS: A KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

13. Which of these correctly states a criterion that must be met prior to plyometric participation?

A. 70-75% strength level compared to contralateral side B. 80-85% pain free ROM compared to unaffected side C. must have adequate strength, endurance, and flexibility D. sufficient strength and stability of distal musculature ANS: C KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

14. Which of these plyometric activities can be included with children or elderly patients?

A. activities that utilize jumps with weights B. activities with high impact, heavy loading C. drop jumps from a small 6-inch step height D. entry-level activities with light resistance ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Intermediate

15. What is the recommended recovery time for high-level athletes engaged in high-intensity plyometric drills?

A. 12 - 24 hours

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B. 24 - 36 hours C. 36 - 48 hours D. 48 - 72 hours ANS: D KEY: Book Part: Unit 4: Exercise Interventions by Body Region DIF: Basic

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Chapter 24: Exercise for the Older Adult

Multiple Choice

1. A multifactorial fall risk assessment is not indicated for a patient 65 years or older in which of the following situations?

A. has fallen in the past 12 months B. frequently has a fear of falling C. often has difficulty with walking D. uses an assistive device (cane) ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

2. Primary aging is only impacted by: A. disease processes B. disuse of muscles C. environmental factors D. the passage of time ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

3. Aging will decrease all of these physiologic responses except: A. maximum heart rate B. maximum oxygen consumption C. resting heart rate D. stroke volume ANS: C KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

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4. An elderly patient described urinary incontinence when exercising, lifting weights and occasionally when laughing or sneezing. This type of incontinence is known as: A. insensible incontinence B. mixed incontinence C. overactive bladder D. stress incontinence ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

5. Prior to exercise, a PTA notes that a patient’s continuous glucose monitoring device indicates a blood glucose level of 270 mg/dL. The patient reports taking their oral medication exactly as prescribed. Which of these best describes the PTA’s course of action?

A. check for ketosis, exercising only if negative B. proceed with all exercises as initially planned C. provide a snack and proceed with exercise D. seek immediate emergency medical attention ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

6. The most significant cancer-related impact for an exercising patient during physical therapy treatment intervention is: A. bone metastases B. overall fatigue C. neutropenia D. pathologic fracture ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

7. An elderly female with a neck circumference measurement greater than or equal to which of these is at risk for obstructive sleep apnea?

A. 36.8 centimeters B. 40.6 centimeters

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C. 43.2 centimeters D. 45.4 centimeters ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

8. Age related sarcopenia is related to physical inactivity coupled with which of these factors: A. atrophy of slow twitch fibers B. increased hormone levels C. increased protein synthesis D. active motor unit remodeling ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

9. Which of these interventions are appropriate for a patient with tertiary osteoporosis?

A. postural education and nutrition B. progressive gait training activities C. resistance training in weight-bearing D. task specific weight-bearing activities ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

10. The height of an elderly female is being measured. A height loss of greater than which of these measurements increases the likelihood of a vertebral fracture being present?

A. 1.6 centimeters B. 2.4 centimeters C. 3.2 centimeters D. 3.8 centimeters ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

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11. A plan of care was developed for a patient following their fall risk assessment. Interventions include patient education, referral to a community-based fall prevention program, and gait training, strengthening and balance activities. Based on the Center for Disease Control’s STEADI algorithm, this patient would be classified into which of these risk categories?

A. low risk B. moderate risk C. high risk D. extremely high risk ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

12. The recommended 60% threshold of a 1-repitition maximum (1-RM) is designed for when an individual can perform how many exercise repetitions at a modified Borg scale of 3 or 4?

A. 5 repetitions B. 10 repetitions C. 15 repetitions D. 20 repetitions ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

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Chapter 25: Women's Health: Obstetrics and Pelvic Floor

Multiple Choice

1. Which of these is not a normal physiological change that occurs during pregnancy?

A. an increase in anteroposterior chest diameter B. an increase in overall oxygen consumption C. an increase in the total lung capacity D. passive positional elevation of the diaphragm ANS: C KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

2. Which of these is an expected physiologic change that occurs during pregnancy?

A. a decreased lower extremity venous pressure during standing activities B. an increased amount of venous return with an increased cardiac output C. an increase in both the systolic and diastolic blood pressure measurement D. physiologic anemia (increased plasma greater than red blood cell increases) ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

3. In which position will the pregnant uterus place the least amount of pressure on the aorta and will allow for increased cardiac output?

A. left side-lying B. prone positioning C. right quarter turn from prone D. supine positioning ANS: A KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

4. Which of these postural changes is not a normal expectation as pregnancy progresses?

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A. a forward head posture B. decreased thoracic kyphosis C. increased lumbar lordosis D. slight genu recurvatum ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

5. In which stage of labor will the cervix reach full dilation, with strong contractions that are close together?

A. Stage I - cervical dilation phase B. Stage I - transition phase C. Stage II - fetal descent D. Stage II - expulsion ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

6. Which degree of episiotomy involves the underlying superficial muscles but does not extend to the anal sphincter?

A. first degree B. second degree C. third degree D. fourth degree ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

7. During an out-patient exercise program a patient makes frequent trips to the bathroom. Upon questioning by the PTA, the patient describes a frequently occurring and sudden desire to urinate that is almost impossible to ignore. This best describes which type of urinary tract impairment?

A. overactivity of the detrusor B. stress urinary incontinence C. the condition of urinary urgency D. urge urinary incontinence ANS: C

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KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

8. Which of the following is least likely to be a contributing factor in non-pregnancy related pelvic floor dysfunction?

A. a habit of smoking B. chronic constipation C. low impact aerobic exercise D. the presence of obesity ANS: C KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

9. Which of these is not a helpful suppression technique to teach patients with urge incontinence?

A. continue with normal activity and wait 5 minutes B. contract the pelvic floor muscles, holding for 3-5 seconds C. move quickly to the toilet to prevent an accident D. remain calm and focus the mind on something else ANS: C KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

10. While teaching initial pelvis floor muscle activation, the PTA may see all of these substitutions except: A. abdominal muscle activation B. gluteal muscle activation C. use of the hip abductors D. use of the Valsalva maneuver ANS: C KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

11. Testing (including self-testing) for the presence of diastasis recti should be done in all these situations except:

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A. as an element of routine abdominal strength testing B. immediately after delivery (within 24 hours) C. prior to engaging in any abdominal exercises D. throughout pregnancy as part of routine exercises ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

12. Prior to initiating strenuous abdominal strengthening or activities that increase intraabdominal pressure, a diastasis recti separation should be reduced to or less than which of these?

A. 0.25 centimeters B. 1 centimeters C. 2 centimeters D. 3 centimeters ANS: C KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

13. When monitoring an exercise program for a woman in her third trimester, the most appropriate method of determining exercise intensity would be which of these?

A. 220 minus her age, then calculate 40-70% of that number B. exercise at a level that she perceives to be “moderately hard” C. use Karvonen’s formula to determine target heart rate D. none of these - exercise in the third trimester should be avoided ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

14. When monitoring an exercise program for a patient who is pregnant, which of these would be a reason for the PTA to stop all exercises and contact the supervising PT? A. increased rate and amount of fetal movements B. increased heart rate and depth of respiration C. persistent pain in the low back region D. shortness of breath during exercise ANS: C KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise

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DIF: Difficult

15. Which exercise modification is not specifically required for an individual with gestational diabetes?

A. limit exercise duration to 15-30 minutes of time B. limit the maximum aerobic capacity to 50% C. should not induce more than 1 contraction in 15 minutes D. use a Borg rate of perceived exertion between 15-17 ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

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Chapter 26: Management of Lymphatic Disorders

Multiple Choice

1. Which of these is associated with secondary lymphedema?

A. Milroy’s disease B. Praecox C. Tarda D. venous insufficiency ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

2. The accumulation of fluids in the peripheral aspects of the limbs, especially when the distal segment is lower than the heart, is known as: A. dependent edema B. lymphedema C. lymphadenopathy D. phlebolymphedema ANS: A KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

3. A patient presents with long-standing and severe lymphedema of the lower extremities that impairs wound healing. Which of these best describes this condition?

A. brawny edema B. dependent edema C. pitting edema D. weeping edema ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

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4. A PTA observes tissue fibrosis and a positive Stemmer sign in a patient that experiences frequent infections. When palpating, the tissue is brawny and without pitting. This indicates which stage of lymphedema?

A. stage O - latency B. stage I - reversible C. stage II - spontaneously reversible D. stage III – lymphostatic elephantiasis ANS: C KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

5. Which of these will measure limb volume using skin electrodes that record the resistance to the flow of a low-level, alternating current?

A. bioimpedance measurements B. limb girth measurements C. perometer measurements D. volumetric measurements ANS: A KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

6. While teaching precautions and self-management skills for a patient with lymphedema, which of these would be included?

A. always wear compression garments while doing exercises B. carry backpacks or heavy shoulder bags on the involved side C. take a hot bath or use the sauna immediately after exercise D. when sitting for a long period, cross your legs at the ankle ANS: A KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

7. While supervising exercises with a patient with right lower extremity lymphedema, the patient complained of a feeling of heaviness, throbbing, and aching in the limb. The PTA should: A. continue with the current weight but decrease the repetitions B. decrease the weight being used during the exercise activities C. increase the weight being used during the exercise activities D. stop the activity and monitor for redness and increased swelling

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ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

8. In addition to self-manual lymphatic drainage, the other key difference found in Phase II of a Decongestive Lymphatic Therapy program is the use of: A. aggressive strengthening exercises B. deep pressure extremity massage C. high stretch sports bandaging D. multi-layer bandaging at night ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

9. Which of these is a true statement regarding the management of lymphedema?

A. diaphragmatic breathing will cause increase in the uptake of lymph fluid B. interstitial pressure is decreased by manual lymphatic drainage techniques C. localized active muscle contractions will create generalized pressure changes D. putting an extremity in a dependent position will enhance overall fluid return ANS: A KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

10. When choosing the sequence of exercises that encourage lymphatic drainage, all of these are important except: A. avoid static, dependent postures that allow fluid to collect in the limbs B. choose exercises that place affected extremities in an elevated position C. focus on distal activities first that move fluid into central collecting vessels D. use self-massage techniques between exercises to enhance drainage ANS: C KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

11. What is the recommended frequency and duration of lymphatic drainage exercises?

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A. 10-15 minutes, every day B. 20-30 minutes, twice daily C. 30 minutes, 3 times a week D. 1 hour per day, every day ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

12. All of these are important reasons to use abdominal-diaphragmatic breathing in an exercise regimen for lymphedema management except: A. assists with fluid movement during the inspiration phase B. the use of deep breathing will enhance overall relaxation C. intrabdominal pressure changes create a pumping action D. the central lymphatic vessels run superiorly in the chest cavity ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

13. Which of these is not an important principle to incorporate into lymphatic drainage exercises?

A. always wear compression bandages or garments B. increase repetitions gradually to avoid excess fatigue C. perform exercise quickly (less than 1 second/movement) D. use light resistance when adding strengthening exercises ANS: C KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

14. Which of these exercises would be avoided in a patient with upper extremity lymphedema?

A. active shoulder circumduction, while in supine, with the arm flexed to 90 degrees B. shoulder internal/external rotation, in seated position, with arm supported at shoulder level C. shoulder pendulum exercises, in modified standing (lean forward from the waist) D. overhead upper extremity wall press exercises while in a standing or seated position ANS: C KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

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15. Which of these exercises would have the greatest impact on enhancing lower extremity lymphatic drainage?

A. four-way kicks while in standing with light support from a chair or counter B. gluteal setting exercises while maintaining a full posterior pelvic tilt motion C. standing knee bends with light support from a hand on the wall or counter D. wall slides with external rotation in supine with feet propped up against the wall ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

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Chapter 27: Exercises for Special Populations

Multiple Choice

1. For the individua with a chronic spinal cord injury with an ASIA impairment scale grade of B, which of these accurately represents the recommended intensity, frequency and duration of aerobic exercises to build cardiorespiratory fitness levels?

A. 50 – 80% 1-RM, 3 sets of 10 repetitions each, 5 times per week B. mild to moderate intensity for 15 – 30 minutes, 7 days per week C. moderate to vigorous intensity for 10 – 20 minutes, 2 – 3 times per week D. moderate to vigorous intensity for 20 – 44 minutes, 3 – 5 times per week ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

2. Based on the American College of Sports Medicine guidelines for a patient with chronic obstructive pulmonary disease (COPD) engaging in aerobic exercises, at what oxygen saturation level should exercises be stopped?

A. 85% B. 88% C. 92% D. 95% ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

3. The American Association of Cardiovascular and Pulmonary Rehabilitation recommends which of these aerobic programs for a patient with chronic obstructive pulmonary disease (COPD)?

A. 30 – 50% peak work rate; 10 – 20 minutes per session; 2 – 4 weeks B. 40 – 60% peak work rate; 20 – 40 minutes per session; 4 – 8 weeks C. 50 – 70% peak work rate; 40 – 60 minutes per session; 8 – 12 weeks D. 60 – 80% peak work rate; 20 – 60 minutes per session; 4 – 12 weeks ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise

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DIF: Difficult

4. For an individual who is seeking to maintain weight loss or minimize long-term regain of lost weight, how many total minutes per week of aerobic exercise should be recommended?

A. 60 – 120 minutes per week B. 100 – 200 minutes per week C. 200 – 300 minutes per week D. 300 – 400 minutes per week ANS: C KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

5. Which of these exercise precautions is not accurate for an individual with a body mass index (BMI) of 40 who is pursuing exercise to facilitate weight loss goals?

A. always consider the impact of exercise on medications taken B. choose lower impact activities to minimize joint reaction forces C. exercise environments should minimize the risk of hyperthermia D. regardless of age, exercises should be at high intensities ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

6. Which of these is not associated with metabolic syndrome?

A. abdominal obesity B. elevated serum high-density lipoprotein C. elevated serum triglycerides D. insulin resistance ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

7. Which of these exercise guidelines for metabolic syndrome will have the greatest impact on reducing systemic inflammation?

A. a total of 150 – 200 minutes of moderate intensity exercise per week B. aerobic exercise combined with resistance training, regardless of intensity

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C. longer duration, greater frequency aerobic exercise sessions D. resistance training exercises, at least four days per week ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

8. While working with a patient following a rotator cuff repair, the PTA notes several signs or symptoms that might indicate undiagnosed type 2 diabetes. Which of these is not one of those signs or symptoms?

A. excessive fatigue even with low intensity exercises B. more frequent need for hydration breaks C. more frequent need for bathroom breaks D. recent report of significant weight gain ANS: D KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

9. Which of these is not an exercise related benefit of diabetes (type 2) management?

A. decreased hemoglobin A1c levels B. decreased insulin sensitivity C. reduced risk of cardiovascular disease D. regulation of body weight ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Intermediate

10. Patients with type 2 diabetes should be cautioned and alert to the development of hypoglycemia for how many hours after an exercise session?

A. up to 4 hours after exercise B. up to 8 hours after exercise C. up to 12 hours after exercise D. up to 24 hours after exercise ANS: C KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

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11. Prior to beginning an exercise program with a cancer survivor, the National Comprehensive Cancer Network Triage Approach recommends (rather than requires) a pre-exercise medical evaluation by a physician for which of these comorbidities?

A. ataxia B. bone metastasis C. lymphedema D. ostomy ANS: C KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

12. Which of these exercise guidelines is best suited for a 38-year-old patient with a chronic pain disorder?

A. regardless of the activities, a greater amount of recovery time between bouts should be scheduled B. since a chronic pain specific recommendation is not available follow the age appropriate ACSM guidelines C. start with moderate intensity aerobic exercises and encourage the patient to persevere through temporary pain increases D. using a carefully prescribed resistance program that includes target reps and sets is important ANS: A KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

13. Which of these has been shown to have the greatest impact on decreasing both systolic and diastolic blood pressure?

A. aerobic training B. combined aerobic and resistance training C. isometric resistance training D. resistance training ANS: A KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

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14. While supervising exercises for a patient with chronic obstructive pulmonary disease (COPD), the PTA notes an episode of dyspnea on exertion with marked shortness of breath.

Which of the following breathing exercises will be most beneficial to this patient during this episode?

A. diaphragmatic breathing exercises B. glossopharyngeal breathing exercises C. pursed lip breathing exercises D. segmental breathing exercises ANS: C KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Basic

15. What is the recommended exercise regimen for improving cancer-related fatigue in a 55year-old patient with breast cancer?

A. aerobics at 60 – 85% HRmax, RPE of 13, for 60 minutes, three times per week B. aerobics (at 65% HRmax) plus resistance (@ 60% 1-RM), RPE of 12, for 30 minutes, three times per week C. resistance at 60 - 70% 1-RM, RPE of 15, 1 – 3 sets of 8 – 15 reps, two times per week D. resistance at 60 - 75% 1-RM, RPE of 13 - 15, 2 – 3 sets of 8 – 15 reps, three times per week ANS: B KEY: Book Part: Unit 5: Special Areas of Therapeutic Exercise DIF: Difficult

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